tbuckley/cabot-search huggingface dataset:
Dopamine (3-Hydroxytyramine) metabolism in parkinsonism
Authors: McC. Goodall, Harold Alton
Journal: Journal of Clinical Investigation (1969)

Three patients with idiopathic parkinsonism and six normal subjects were infused over a 4 hr period with 104.6 muc of dopamine-2-(14)C (3,4-dihydroxyphenylethylamine, 3-hydroxytyramine),(1) the immediate precursor in the synthesis of the sympathetic neurohormone, noradrenaline (norepinephrine). Urine was collected during the infusion period, 0-2 hr, 2-4 hr, 4-8 hr, 8-24 hr, and thereafter for 4 additional days. Using a technique herein described, the various metabolic and biosynthetic products of dopamine, including noradrenaline and its metabolic products, were separated, identified, and their radioactivity measured. The metabolic pattern of dopamine in the normal subject was compared to that of the three parkinsonism patients. The results indicate that in idiopathic parkinsonism there is a decrease in the recovery of free radioactive noradrenaline in the urine following an infusion of dopamine-2-(14)C and a slight shift toward dopamine metabolism. The latter is reflected by an increase in the following metabolites of dopamine: 3,4-dihydroxyphenylacetic acid and the conjugates of 3-methoxy-4-hydroxyphenylacetic acid, 3,4-dihydroxyphenylacetic acid, 3-methoxy-4-hydroxyphenylethanol and dopamine.
Hypertension in Adults Across the Age Spectrum
Authors: Donald M. Lloyd-Jones, Jane C. Evans, Daniel Levy
Journal: JAMA (2005)

Data are sparse regarding current rates of hypertension treatment and control, and risks associated with hypertension, among persons older than 80 years.To determine the prevalence of blood pressure stages, hypertension treatment and control, and cardiovascular risk among older patients with hypertension.A community-based cohort study in which data were collected during all Framingham Heart Study examinations attended in the 1990s. Participants were pooled according to age: younger than 60 years, 60 to 79 years, or 80 years or older. There were 5296 participants who contributed 14 458 person-examinations of observation, including 7135 hypertensive person-examinations (4919 treated).Prevalence of hypertension, its treatment, and its control were compared across age groups. Risks for incident cardiovascular disease during follow-up of up to 6 years were estimated as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression.Prevalence of hypertension and drug treatment increased with advancing age, whereas control rates were markedly lower in older women (systolic <140 and diastolic <90 mm Hg). For ages younger than 60 years, 60 to 79, and 80 years and older, respectively, control rates were 38%, 36%, and 38% in men (P = .30) and 38%, 28%, and 23% in women (P<.001). Relative risks for cardiovascular disease associated with increasing blood pressure stage did not decline with advancing age, and absolute risks increased markedly. Among participants 80 years of age or older, major cardiovascular events occurred in 9.5% of the normal blood pressure (referent) group, 19.8% of the prehypertension group (HR, 1.9; 95% CI, 0.9-3.9), 20.3% of the stage 1 hypertension group (HR, 1.8; 95% CI, 0.8-3.7), and 24.7% of the stage 2 or treated hypertension group (HR, 2.4; 95% CI, 1.2-4.6).Relative to current national guidelines, rates of blood pressure control in the community are low, especially among older women with hypertension. Short-term risks for cardiovascular disease are substantial, indicating the need for greater efforts at safe, effective risk reduction among the oldest patients with hypertension.
Liver Damage due to Methotrexate in Patients with Psoriasis
Authors: M. G. C. Dahi, M. M. Gregory, P. J. Scheuer
Journal: BMJ (1971)

Liver function and histological changes in liver biopsies were studied in 37 patients who had been treated for psoriasis with methotrexate. Cirrhosis was found in seven (19%) and hepatic fibrosis of varying severity in 10 (27%). Minor abnormalities in another 17 (46%) consisted of fatty change, round cell infiltration, and extensive vacuolation of liver cell nuclei. In only three (8%) was hepatic histology entirely normal. The severity of liver damage was related to the duration of methotrexate treatment. Minor abnormalities of liver function tests and liver histology were also found in eight control psoriatic patients. Standard liver function tests were of little value in predicting the degree of liver damage. It appears that methotrexate, in the doses normally used to control psoriasis, may cause cirrhosis if treatment is prolonged and that liver biopsy is necessary for evaluation of liver damage in these patients.
Comparative Clinical Evaluation of Chlordiazepoxide and Promazine in Treatment of Alcohol-withdrawal Syndrome
Authors: G. Sereny, H. Kalant
Journal: BMJ (1965)

MEDICALJOURNALfalciparum in the peripheral blood of these patients is note- worthy in view of the frequency with which this parasite is encountered in blood-film surveys in Uganda.Clinically these patients do not show any specific diagnostic features apart from marked splenomegaly and a lesser degree of hepatomegaly with evidence of secondary hypersplenism and a short red-cell life.Holzbach et al. (1964) have shown that increased red-cell sequestration in the spleen correlates with an increase in splenic size regardless of the underlying cause of the splenomegaly.The association of haemolytic anaemia in preg- nancy with splenomegaly, hepatic sinusoidal changes, and a raised malarial antibody titre has also been noted at Mulago (Gebbie et al., 1965, in preparation).Finally, it must be men- tioned that the specificity of the malaria antibody test used here is still not precisely delineated.Also the scanty P. malariae parasitaemia could be a result rather than the cause of this marked splenomegaly. SummaryPatients with large spleens are common in the wards at Mulago Hospital, 64 being investigated in a period of eight months.Like previous workers, we could find no cause for many of the enlarged spleens.An unusual liver-biopsy appear- ance with sinusoidal infiltrates of lymphocytes and plasma cells was noted in many of the patients in the " idiopathic " group.Most of these patients were anaemic, and Leather's finding of an increased intrasplenic pressure mi such cases was confirmed.In a group of patients with sinusoidal infiltrates P. malariae trophozoites were found in the peripheral blood of 45 % of patients after a prolonged search and malarial antibody titres were elevated when compared with control groups.There is therefore a suggestion that P. malariae is implicated in a number of such cases in Uganda, and also that the liver biopsy may be helpful in the diagnosis of this syndrome.The relation- ship between splenomegaly, these hepatic findings, and infection with quartan malaria requires further study.ADDENDUM.-Since this paper was written eight rhesus monkeys with chronic malarial infections of one to ten years' duration have had liver biopsy specimens examined.These represented simian infections of quartan and vivax types.Only one showed histological changes resembling those described in this paper.This monkey had had the infection for the longest time-namely, 10 years-with Plasmodium inui.Studies on monkeys with long-standing infections are being continued.We are grateful to the physicians, surgeons, and obstetricians at Mulago Hospital for access to patients and general co-operation; also to Mr. R. Tunnicliffe for the photomicrographs.
Major Potential Confounder Not Addressed
Authors: Jennifer Vines
Journal: PLoS Medicine (2006)

Jennifer Vines This is the fi rst of 12 Correspondence pieces in this issue that are in response to an important PLoS Medicine Research Article: Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, et al. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2(11): e298. Readers wishing to add their own views may do so using our E-letters facility, where the debate continues.
Ventricular Tachycardia following Exercise in a Case of Angina Pectoris
Authors: R. Bruce
Journal: BMJ (1955)

ADDENDUM.-Since this paper was written a case of this syndrome associated with hypertrophic pyloric stenosis has been recognized in a 2-months-old infant (Keay and Lewis, 1954).These authors, however, described bthe oedema of the extremities in their patient as non-pitting in character.
Who Should Test the Testers?-Reply
Authors: H. Friedman
Journal: JAMA (1987)

In Reply.—  Dr Baron incorrectly makes an analogy between the clinical evaluation of a patient and the chemical measurement of a drug concentration in a biologic sample. Assessment of a human being—an overwhelmingly complex organism—requires application of scientific principles together with intuition, instinct, and experience. The variables are so numerous that no two physicians would go about it in exactly the same way, and in many cases two informed and reasonable physicians would come to different conclusions. Quantitation of drug concentrations in plasma is a different matter. There is no ambiguity, uncertainty, or room for evaluation or interpretation. There is one and only one correct value of a given drug concentration in a given sample. A chemical analysis either provides or does not provide the correct value (within specified limits). Proficiency testing of analytic laboratories, using both blind and nonblind testing procedures, is a widely accepted and important component of
Low‐density lipoproteins induce the polar secretion of PAI‐1 by endothelial cells in culture
Authors: Ion S. Jovin, Antje Willuweit, Uwe Taborski, Andreas Lehnhardt, Karin Schreiner, Wolf‐Peter Klövekorn, Gert Müller‐Berghaus
Journal: American Journal of Hematology (2003)

Patients with hypercholesterolemia and with coronary atherosclerosis have increased plasma levels of plasminogen activator inhibitor (PAI)-1. PAI-1 and low-density lipoproteins (LDL) are also present in the walls of atherosclerotic vessels, where they participate in the development and remodeling of the atherosclerotic plaques. We investigated the influence of LDL on the apical (luminal) and basolateral (subendothelial) secretion of PAI-1 by human umbilical vein endothelial cells in a two-compartment cell-culture model. Confluent cells were incubated with LDL either in the apical compartment or in the basal compartment. Cells incubated with culture medium served as controls. A significantly higher concentration of PAI-1 was found in both the apical (P = 0.025) and the basal compartment (P = 0.025) if cells were incubated with LDL on the basolateral side. In contrast, incubation of the cells with LDL apically resulted in an increased PAI-1 concentration only in the apical compartment (P = 0.028) and not in the basal compartment. Our findings indicate that the LDL particles that reach the subendothelial space can induce an increased release of PAI-1 by endothelial cells into the vessel lumen and also contribute to the release of PAI-1 into the subendothelial space and thus to the process of atherosclerotic plaque remodeling.
Albumin fusion of thioredoxin — The production and evaluation of its biological activity for potential therapeutic applications
Authors: Shotaro Ikuta, Victor Tuan Giam Chuang, Yu Ishima, Keisuke Nakajou, Masato Furukawa, Hiroshi Watanabe, Toru Maruyama, Masaki Otagiri
Journal: Journal of Controlled Release (2010)
Towards quality management of medical information on the internet: evaluation, labelling, and filtering of information
Authors: G. Eysenbach, T. L Diepgen, J A M. Gray, M. Bonati, P. Impicciatore, C. Pandolfini, S. Arunachalam
Journal: BMJ (1998)

# Towards quality management of medical information on the internet: evaluation, labelling, and filtering of information {#article-title-2} The principal dilemma of the internet is that, while its anarchic nature is desirable for fostering open debate without censorship, this raises questions about the quality of information available, which could inhibit its usefulness. While the internet allows "medical minority interest groups to access information of critical interest to them so that morbidity in these rare conditions can be lessened,"1 it also gives quacks such as the "cancer healer" Ryke Geerd Hamer a platform (http://www.geocities.com/HotSprings/3374/index.htm).2–4 Quality is defined as "the totality of characteristics of an entity that bear on its ability to satisfy stated and implied needs."5 For quality to be evaluated, these needs have to be defined and translated into a set of quantitatively or qualitatively stated requirements for the characteristics of an entity that reflect the stated and implied needs. So how can we define consumers' "needs" in the case of medical information on the internet? The quality of medical information is particularly important because misinformation could be a matter of life or death.6 Thus, studies investigating the "quality of medical information" on the various internet venues—websites,7 mailing lists and newsgroups, 8 9 and in email communication between patients and doctors10—are mostly driven by the concern of possible endangerment for patients by low quality medical information. Thus, quality control measures should aim for the Hippocratic injunction "first, do no harm." Most papers published so far about the problem of quality of medical internet information focus on assessing reliability, but, as box 1 shows, this should be only one aspect of quality measures aiming for "first, do no harm." Another should be to provide context. Although these two problems are different in nature and different measures may be proposed to solve them, we discuss a common measure that could … Correspondence to: Dr Bonati
Effects of ultrapure and non-sterile dialysate on the inflammatory response during in vitro hemodialysis
Authors: Christian Tielemans, Cécile Husson, Thierry Schurmans, Karine Gastaldello, Philippe Madhoun, Jean-Pierre Delville, Arnaud Marchant, Michel Goldman, Jean-Louis Vanherweghem
Journal: Kidney International (1996)
A patient with type 2 diabetes and a burning sensation in his feet
Authors: I. Eleftheriadou, N. Tentolouris, E. B. Jude
Journal: BMJ (2014)

A 64 year old man with type 2 diabetes diagnosed nine years earlier attended the outpatient diabetes clinic because of suboptimal diabetes control. His glycated haemoglobin over the past five years had been 64-77 mmol/mol (8-9.2%; optimal value <53 mmol/mol (7%)). He was being treated for diabetes with gliclazide and metformin. He also received simvastatin and enalapril for dyslipidaemia and hypertension, respectively, and 75 mg acetylsalicylic acid daily for the prevention of primary cardiovascular disease.

He had painful symptoms in his legs, which he described as a burning sensation, with tingling in the feet. He had been experiencing the burning pain for the past six months, especially during the night, and he had to walk about or put his feet in water to find relief. He thought that the symptoms may be related to poor circulation in his legs and he was worried that he might need an amputation.

On examination he could not feel the 128 Hz tuning fork up to his knees bilaterally or the 10 g Semmes-Weinstein monofilaments on two out of three sites on the plantar surface of his feet. Pedal pulses, however, were palpable in both feet.



### 1. What is the diagnosis?

#### Short answer

The patient has painful diabetic peripheral neuropathy.1 Painful symptoms develop as a result of damage to, or dysfunction of, the system that normally signals pain.2 3 Doctors should examine patients with diabetes for symptoms of this condition because most patients are not aware that their symptoms are associated with diabetes.

#### Long answer

Diabetic peripheral neuropathy is defined as the presence of symptoms and signs of peripheral nerve dysfunction in patients with diabetes after exclusion of other causes.1 It has a prevalence of 30-50% in patients with diabetes, and …
Peripheral Arterial Embolism
Authors: H. Agar
Journal: BMJ (1943)

CHILDHOOD INFECTION: RELATION TO ADULT PHTHISIS MEDBRITJURNAL 10 in their home environment; (3) they are sent to a sanatorium; (4) they are, in only a few instances, treated by artificial pneumothorax. Treatment of Symptomless Adolescent Pulmonary TuberculosisFor those who can afford the time and treatment it is prob- able that with rest at home, followed by gradually increasing activity and then by years of sheltered life, healing may take place.It is, however, only a favoured few who can afford this; for the majority a more rapid return to work is neces- sary.Moreover, it is unusual to find any person who, while apparently in good health, will submit to this treatment and at the same time retain a healthy outlook on his "illness," also the capacity to return to a normal life at the end of it.For the majority, therefore, some other course is advised.Sanatorium treatment is the usual one adopted for these patients.Owing to the healthy condition of the patient on admission to the sanatorium and the constant urge to get home and back to work, it is usually impossible to keep him or her at the institution long enough to hope to effect a cure.There may be a temporary improvement in a few cases, but in the majority there is no material change in the x-ray picture,
Bypass Surgery with Psychological and Spiritual Support (the BY.PASS Study): Results of a Pragmatic Trial Based on Patients’ Preference
Authors: Jenny Rosendahl, Katharina Tigges-Limmer, Jan Gummert, Ralf Dziewas, Johannes Maximilian Albes, Bernhard Strauss
Journal: Psychotherapy and Psychosomatics (2012)

Some general hospitals within the German health system provide supportive interventions, psychological as well as spiritual, to their patients. It remains to be proven if these interventions are effective when used in routine clinical practice.To evaluate the effectiveness of psychological and spiritual interventions on improving recovery following bypass surgery.The BY.PASS study is a pragmatic, patient preference trial (ISRCTN 07297983). Adult patients scheduled for elective coronary bypass surgery were enrolled. Patients were assigned to study conditions according to their personal preference: preference for psychological interventions, for spiritual interventions or for no intervention. Patients who were open for any kind of intervention were randomly assigned either to psychological or spiritual interventions. During a control period, patients were asked about their preference, but did not receive any interventions. Primary outcomes of the study were in-hospital morbidity and early mortality. Psychological measures served as secondary outcomes.A total of 847 patients were enrolled. Patients of the control (n = 260) and the intervention group (n = 269) who explicitly wanted to have interventions were compared. No significant treatment effects either for morbidity (d = 0.08, 95% CI -0.09 to 0.25), or for mortality (OR = 1.81; 95% CI 0.50-6.57) could be found. A reduction of negative mood resulted from both interventions.Although the effects observed were small, the study can serve as a basis to discuss methodological as well as theoretical aspects of a pragmatic trial, based upon patients' preferences.
Upper airways obstruction in 153 consecutive patients presenting with thyroid enlargement
Authors: N J L Gittoes, M R Miller, J Daykin, M C Sheppard, J A Franklyn
Journal: BMJ (1996)

Thyroid enlargement affects up to 10% of the British population. Surgery is indicated for severe tracheal compression, and assessment of a respiratory flow volume loop is regarded as the best method for evaluating upper airways obstruction. Upper airways obstruction is considered rare in patients with goitre and indicated by symptoms such as breathlessness and choking. To investigate the prevalence of this problem we performed a prospective study of euthyroid patients presenting with nodular or diffuse thyroid enlargement, including those with and without symptoms suggesting tracheal compression.

We studied 153 consecutive patients (134 female, 19 male) referred to our thyroid clinic because of thyroid enlargement. Clinical evaluation included completion of standardised questionnaires concerning breathlessness1 and goitre symptoms. Plain radiography of the thoracic inlet was performed and flow volume loops were recorded.2

Flow volume loops showed upper airways obstruction in 51 of 153 patients (33%). Forced vital capacity, forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) were expressed …
1773 and All That
Authors: D. Geraint James
Journal: New England Journal of Medicine (1973)

The Medical Society of London was founded in 1773 by John Coakley Lettsom (1744–1815), who described himself in his M.D. thesis as "Americanus" and considered himself as such all his life.1 He was born on November 22, 1744, of a Quaker family on Tortola, in the West Indies, as one of seven pairs of male twins. He came to England as a boy of six, first to Yorkshire for his schooling and surgical apprenticeship, and then to London for his training as an apothecary. In 1773, at the age of 29 years, he was elected a fellow of the Royal . . .
Stem Cells and the Kidney
Authors: Gianpaolo Zerbini, Lorenzo Piemonti, Anna Maestroni, Giacomo Dell’Antonio, Giuseppe Bianchi
Journal: Journal of the American Society of Nephrology (2006)

In the past few years, a number of studies have shown that stem cells can be found in virtually every organ of the adult organism. The kidney is not an exception, and resident stem cells have been identified both in the papilla and along the tubules. Of interest, kidney-bound stem cells have been identified also in the bone marrow. When injected, both resident and bone marrow–derived stem cells are able to reach the injured renal tissue and, once there, to differentiate into renal cells. The evidence that, in humans, some of the acute and most of the chronic renal damages lead to ESRD suggests that in normal conditions, the reservoir of stem cells (considering both resident and bone marrow–derived stem cells) is insufficient to allow a major renal regeneration. Probably the number of stem cells that are ready to intervene in an adult kidney are sufficient to compensate for the normal cell turnover but largely inadequate to counteract a major injury. This is confirmed further by the finding that, even by transplanting a syngenic bone marrow in rats with ablation of 5/6 of the renal function, it is not possible to increase the life expectancy of the animals. Altogether, this evidence suggests that, to clarify the potentiality of a stem cell therapy for renal diseases, experiments that aim to clarify the ideal concentration of stem cells to be injected and to identify the best way of administration are needed.
Abstract 8868: High-Dose Sotalol is Safe and Effective in Neonates and Infants with Refractory Supraventricular Tachyarrhythmias
Authors: Jarrod D Knudson, Bryan C Cannon, Jamie A Decker, Jeffrey J Kim, Brady S Moffett
Journal: Circulation (2010)

Introduction: Sotalol is used for supraventricular tachycardia (SVT) in neonates and infants. However, few studies have evaluated safety and efficacy of therapy in this age group; especially high-d...
TCT-894 Impact Of Transcatheter Aortic Valve Implantation On Mitral Regurgitation. Insights From A Multicenter Study
Authors: Konstantinos Toutouzas, Antonios Karanasos, Konstantinos Spargias, Konstantinos Stathogiannis, George Latsios, Andreas Synetos, Michalis Chrisoheris, Antonios Chalapas, Aias Antoniades, Gregory Pavlides, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2012)