tbuckley/cabot-search huggingface dataset:
Conjugation and Maximal Biliary Excretion of Bilirubin in the Rat During Pregnancy and Lactation and During Estroprogestogen Treatment
Authors: Maurizio Muraca, Roger Leyten, Johan Fevery
Journal: Hepatology (1984)

Hepatic bilirubin conjugation and excretion were investigated during pregnancy and lactation in the rat. Bilirubin uridine diphosphate-glucuronyltransferase activity was decreased by 30% in pregnant rats, both when expressed per milligram of protein or as specific activity and per unit of liver weight. Liver size increased during pregnancy, and, as a consequence, total hepatic glucuronyltransferase activity was unchanged. The biliary bilirubin output was normal in pregnant rats, and when loaded with bilirubin, the maximal output in bile for the whole liver was also normal. In lactating rats, specific glucuronyltransferase activity returned to control values, but the activity per unit of liver weight was still lower, due to the decreased hepatic protein concentration. The liver remained enlarged during lactation, and total hepatic glucuronyltransferase activity was increased, together with the maximal output of bilirubin in bile. Two weeks after delivery, hepatic bilirubin conjugation and excretion in nonlactating mothers were comparable to those of virgin females. Parallel modifications of bilirubin glucuronyltransferase assayed in vitro and of maximal biliary output of the pigment in vivo were observed in all animals studied. The output of bilirubin diconjugates in bile was decreased during pregnancy but no changes of the proportion of the monoto diconjugates in bile were observed 2 weeks after delivery both in lactating and in nonlactating rats. The modifications observed during pregnancy could not be reproduced by treatment with β-estradiol and progesterone. This suggests that different hormones or modifications of steroid metabolism are probably involved in the alterations of hepatic bilirubin metabolism in pregnant and lactating rats.
Haiti and the Acquired Immunodeficiency Syndrome
Authors: PETER MOSES
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 October 1983Haiti and the Acquired Immunodeficiency SyndromePETER MOSES, JOHN MOSES, M.D.PETER MOSESSearch for more papers by this author, JOHN MOSES, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-4-565_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: As an outcome of the zealous effort to elucidate factors in the causation of the acquired immunodeficiency syndrome, frustration has given way to speculation about the health and habits of its victims. Haitians are the target of such conjecture by Leonidas and Hyppolite (1). Although a recent, albeit brief, opportunity to observe illness in rural Haiti hardly qualifies us as experts on indigenous Haitian diseases, we learned enough to be certain that the authors' speculations are not applicable to patients living in small villages. Alcoholism is extremely unusual and almost nonexistent among rural people. The use of...Reference1. LEONIDAS J and HYPPOLITE N. Haiti and the acquired immunodeficiency syndrome. Ann Intern Med. 1983;98:1020-1. LinkGoogle Scholar1. . Update on acquired immune deficiency syndrome (AIDS)—United States. MMWR. 1982;31:507-14. MedlineGoogle Scholar2. ANDERSON C and BARRIE H. Fatal Pneumocystis pneumonia in an adult: report of a case. Am J Clin Pathol. 1960;34:365-70. CrossrefMedlineGoogle Scholar3. LYONS H, VINIJCHAIKUL K, and HENNIGAR G. Pneumocystis carinii pneumonia unassociated with other disease: clinical and pathological studies. Arch Intern Med. 1981;108:173-80. Google Scholar4. HENNIGAR G, VINIJCHAIKUL K, ROQUE A, and LYONS H. Pneumocystis carinii pneumonia in an adult: report of a case. Am J Clin Pathol. 1961;35:353-64. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: PETER MOSES; JOHN MOSES, M.D.Affiliations: Massachusetts Institute of Technology Cambridge, MA 02139 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited by“Jack In, Young Pioneer”: Frontier Politics, Ecological Entrapment, and the Architecture of CyberspaceThe emergence of HIV/AIDS in the Americas and beyondHIV Infection in the CaribbeanThe exotic and the mundaneThe social classification of AIDS in American epidemiologyApparent Transmission of Human T-Cell Leukemia Virus Type III to a Heterosexual Woman with the Acquired Immunodeficiency SyndromeJEROME E. GROOPMAN, M.D., M. G. SARNGADHARAN, Ph.D., SYED Z. SALAHUDDIN, M.S., RICHARD BUXBAUM, M.D., MARK S. HUBERMAN, M.D., JOAN KINNIBURGH, R.N., ANN SLISKI, D.Sc., MARY F. McLANE, B.S., MYRON ESSEX, Ph.D., ROBERT C. GALLO, M.D.Acquired Immunodeficiency Syndrome Possibly Arthropod-BorneMARTIN J. BLASER, M.D.Epidemiology, Law, and Social Context 1 October 1983Volume 99, Issue 4Page: 565-565KeywordsAIDSAlcoholismHabits ePublished: 1 December 2008 Issue Published: 1 October 1983 PDF downloadLoading ...
Pharmacogenomics: mapping monogenic mutations to direct therapy
Authors: Palmer Taylor
Journal: Journal of Clinical Investigation (2012)

The molecular mapping of mutations that underlie congenital disorders of monogenic origin can result in both a broader understanding of the molecular basis of the disorder and novel therapeutic insights. Indeed, genotyping patients and then replicating the behavior of the mutant gene products in well-defined biochemical or electrophysiological systems will allow tailoring of therapy to be mutation- and protein sequence-dependent. In this issue of the JCI, Shen and colleagues describe such an approach that identified novel mutations in the α subunit of the nicotinic receptor linked to myasthenia gravis.
Porphyria Treated with Prochlorperazine
Authors: Morris Klatzko
Journal: New England Journal of Medicine (1958)

A CUTE intermittent porphyria is an uncommon illness in which abnormal amounts and kinds of porphyrins are excreted in the urine and feces, resulting from an inborn error of porphyrin metabolism.1 , 2 The diagnosis is usually confirmed by the demonstration of one of the uroporphyrins or the colorless chromogen porphobilinogen in the urine.2 In the following case of porphyria, which is presented because it is believed to be the first treated with prochlorperazine, the drug was employed empirically to relieve vomiting and mental agitation.Case ReportA 47-year-old married woman was admitted to the Maimonides Hospital on November 24, 1957, because . . .
Trusts need to scrutinise GPs' out of hours services more thoroughly, says watchdog
Authors: Z. Kmietowicz
Journal: BMJ (2009)

Doctors working for GPs’ out of hours services need to be vetted more thoroughly to ensure that patients are treated safely and effectively, the NHS watchdog has said, after finding that one provider failed to scrutinise closely enough the quality of its care.

The Care Quality Commission has said that it is not enough for primary care trusts (PCTs) to monitor only the time it takes out of hours service providers to answer calls. They must also look in detail at the quality of clinical decisions, the efficiency of call handling and triage, the number of unfilled shifts, the proportion of shifts covered by non-local doctors, and doctors’ training, to …
Endoscopic ultrasound-guided drainage of pancreatic fluid collections with indeterminate adherence using temporary covered metal stents
Authors: F. Weilert, K. Binmoeller, J. Shah, Y. Bhat, S. Kane
Journal: Endoscopy (2012)

Transenteric drainage of a pancreatic fluid collection (PFC) with poor adherence to the bowel wall risks leakage and perforation. Elimination of tract dilation and the use of a fully covered self-expanding metal stent (FCSEMS) may improve safety. We evaluated endoscopic ultrasound (EUS)-guided drainage of PFCs using a one-step access device followed by placement of a FCSEMS. Eighteen patients (12 males; median age 50) with PFCs (median size 135 mm) meeting the criteria for indeterminate adherence were enrolled. After 7 - 10 days, the FCSEMSs were removed and exchanged for double-pigtail stents. When indicated, tract dilation and endoscopy-guided cyst debridement was performed. FCSEMS placement was technically successful in all patients without complications. Median procedure time was 37.5 minutes. Cystgastrostomy dilation resulted in dehiscence in one patient and was treated with repeat FCSEMS placement. Cyst resolution was achieved in 78 % of patients. FCSEMS placement without tract dilation enables safe initial drainage of PFCs with indeterminate adherence.
Hepcidin levels predict nonresponsiveness to oral iron therapy in patients with iron deficiency anemia
Authors: David B. Bregman, David Morris, Todd A. Koch, Andy He, Lawrence T. Goodnough
Journal: American Journal of Hematology (2012)

Levels of hepcidin, a major regulator of iron homeostasis, may identify patients with iron deficiency anemia ( IDA ) who will not respond to oral iron therapy. In this study, IDA patients underwent a 14‐day trial (run‐in) course of ferrous sulfate therapy. Nonresponders (Hgb increase &lt;1 g/dL with 67% compliance rate) were randomized to IV ferric carboxymaltose ( FCM ; two injections of 750 mg) or further oral iron for 14 days. Screening hepcidin levels were 38.4 versus 11.3 ng/mL, P = 0.0002 in nonresponders versus responders to a trial of oral iron. Hepcidin of &gt; 20 ng/mL, showed sensitivity of 41.3%, specificity of 84.4%, and positive predictive value of 81.6% for predicting nonresponsiveness to oral iron. PPVs for ferritin&gt; 30 ng/mL or transferrin saturation ( TSAT )&gt;15% were 59.2 and 55%, respectively. Negative predictive values for hepcidin, ferritin, and TSAT were 46.3, 22.7, and 19.7, respectively. FCM versus oral iron showed Hgb increases of ≥1 gm/dL in 65.3% versus 20.8% ( P &lt; 0.0001) and Hgb increases of 1.7 ± 1.3 versus 0.6 ± 0.9 g/dL ( P = 0.0025), respectively. We conclude that hepcidin predicts nonresponsiveness to oral iron in patients with IDA and is superior to TSAT or ferritin for this purpose. Nonresponse to oral iron therapy does not rule out IDA , since two‐thirds of patients subsequently responded to intravenous iron. Am. J. Hematol. 88:97–101, 2013. © 2012 Wiley Periodicals, Inc.
INFLUENCE OF HORMONES ON LIVER
Authors: Charles Huggins, Fung-O Yao
Journal: The Journal of Experimental Medicine (1959)

Modification of the endocrine milieu intérieur by administration or withdrawal of hormones considerably influenced the concentration in liver of lactic dehydrogenase, glucose-6-phosphate dehydrogenase, and 6-phosphogluconic dehydrogenase. Hormones effective in this regard are thyroxine, estradiol-17beta, dihydrotestosterone, and 3alpha-hydroxysteroids in the androstane series. These hormonal effects are both organ-selective and, in liver, enzyme-selective. Thyroxine and steroids are not equivalent in their influence on the 3 hepatic dehydrogenases. Thyroxine was preeminent in this regard among hormones investigated in the present experiments. Each of the pyridine nucleotide-linked dehydrogenases in liver had an individually characteristic response to the administration of various hormones which was reflected in its hepatic level. The concentration in liver of lactic dehydrogenase was profoundly raised or lowered, respectively, by the administration of thyroxine or by thyroidectomy, and injection of steroids had small influence on its level. The levels of glucose-6-phosphate dehydrogenase and of 6-phosphogluconic dehydrogenase were considerably influenced by injection of thyroxine, estradiol-17beta, or testosterone. Sex steroids did not increase the levels of these enzymes in hypophysectomized or thyroidectomized rats unless thyroxine was administered concurrently. Under designated conditions, it was found that the concentration of 6-phosphogluconic dehydrogenase was increased by hormonal methods which did not elevate the concentration of glucose-6-phosphate dehydrogenase. But high levels of glucose-6-phosphate dehydrogenase were not achieved without a considerable elevation of 6-phosphogluconic dehydrogenase as well.
Injuries of the Lower Urinary Tract
Authors: Edgar Burns
Journal: JAMA (1963)

Injuries of the urinary tract range from contusions, some of which are of little significance, to rupture with urinary extravasation, which is an important emergency requiring prompt, efficient treatment. Management consists in careful evaluation of the patient's general physical status, institution of stabilizing measures as individually indicated, and performance of specific diagnostic studies to establish whether the urinary tract has been injured, and, if so, the location and possible extent of the injury. Of the five illustrative cases cited, two involved motor vehicles, one was an equestrian mishap, one was discovered after abdominal hysterectomy, and one involved a birth injury. Treatment of the various types of injury is described.
Cocaine-induced Myocardial Infarction in Patients with Normal Coronary Arteries
Authors: Robert L. Minor, Brook D. Scott, Donald D. Brown, Michael D. Winniford
Journal: Annals of Internal Medicine (1991)

Objective: To review the reported cases of myocardial infarction temporally related to recreational and topical anesthetic use of cocaine, with special regard for underlying etiologic factors in patients subsequently found to have normal coronary arteries. Data Sources: Personal records of three cases and a comprehensive literature review using MEDLINE and supplemented by Index Medicus and the bibliographies of case reports. Data Synthesis: A total of 114 cases of cocaine-induced myocardial infarction were identified. The coronary anatomy was defined by angiography or autopsy in 92 patients, 38% of whom had normal coronary arteries. In these 35 patients (average age, 32; range, 21 to 60 years), myocardial infarction typically involved the anterior left ventricular wall (77%). Moderate cigarette smoking with one or fewer associated coronary risk factors was prevalent (68%). Focal coronary vasospasm was shown convincingly in only two cases. Intracoronary thrombus was initially found on 9 of 11 angiograms (82%) done within 12 hours of the myocardial infarction. Experimental evidence suggests that cocaine has direct and indirect sympathomimetic effects on vascular smooth muscle, attenuates endothelium vasodilator capacity, exerts a potent depressant effect on cardiac myocytes, and promotes atherogenesis. Conclusions: Cocaine-induced myocardial infarction in patients with normal coronary arteries probably involves adrenergically mediated increases in myocardial oxygen consumption, vasoconstriction of large epicardial arteries or small coronary resistance vessels, and coronary thrombosis. Accelerated atherosclerosis and impairment of endothelium vasodilator function may occur after chronic cocaine use.
Epidemiology of Hypertrophic Cardiomyopathy–Related Death
Authors: Barry J. Maron, Iacopo Olivotto, Paolo Spirito, Susan A. Casey, Pietro Bellone, Thomas E. Gohman, Kevin J. Graham, David A. Burton, Franco Cecchi
Journal: Circulation (2000)

Background —Death resulting from hypertrophic cardiomyopathy (HCM), particularly when sudden, has been reported to be largely confined to young persons. These data emanated from tertiary HCM centers with highly selected referral patterns skewed toward high-risk patients. Methods and Results —The present analysis was undertaken in an international population of 744 consecutively enrolled and largely unselected patients more representative of the overall HCM spectrum. HCM-related death occurred in 86 patients (12%) over 8±7 years (mean±SD). Three distinctive modes of death were as follows: (1) sudden and unexpected (51%; age, 45±20 years); (2) progressive heart failure (36%; age, 56±19 years); and (3) HCM-related stroke associated with atrial fibrillation (13%; age, 73±14 years). Sudden death was most common in young patients, whereas heart failure– and stroke-related deaths occurred more frequently in midlife and beyond. However, neither sudden nor heart failure–related death showed a statistically significant, disproportionate age distribution ( P =0.06 and 0.5, respectively). Stroke-related deaths did occur disproportionately in older patients ( P =0.002). Of the 45 patients who died suddenly, most (71%) had no or mild symptoms, and 7 (16%) participated in moderate to severe physical activities at the time of death. Conclusions —HCM-related cardiovascular death occurred suddenly, or as a result of heart failure or stroke, largely during different phases of life in a prospectively assembled, regionally based, and predominantly unselected patient cohort. Although most sudden deaths occurred in adolescents and young adults, such catastrophes were not confined to patients of these ages and extended to later phases of life. This revised clinical profile suggests that generally held epidemiological tenants for HCM have been influenced considerably by skewed reporting from highly selected populations. These data are likely to importantly affect risk stratification and treatment strategies importantly for the prevention of sudden death in HCM.
The lymphocyte to monocyte ratio improves the IPI‐risk definition of diffuse large B‐cell lymphoma when rituximab is added to chemotherapy
Authors: Alessandro Rambaldi, Cristina Boschini, Giuseppe Gritti, Federica Delaini, Elena Oldani, Andrea Rossi, Anna Maria Barbui, Daniele Caracciolo, Marco Ladetto, Angela Gueli, Alberto De Crescenzo, Roberto Passera, Liliana Devizzi, Caterina Patti, Alessandro Massimo Gianni, Corrado Tarella
Journal: American Journal of Hematology (2013)

The peripheral blood lymphocyte to monocyte ratio (LMR) at diagnosis can be clinically relevant in patients with diffuse large B-cell lymphoma (DLBCL). We reviewed the outcome of 1,057 DLBCL patients followed from 1984 to 2012 at four centers. LMR was analyzed as a clinical biomarker by receiver-operating characteristic (ROC) analysis and Harrell's C-statistics. Patients were characterized by a median age of 61 years, International Prognostic Index (IPI) score of >2 in 39%, and were treated with a rituximab-containing chemotherapy in 66%. LMR proved strongly predictive for survival in patients treated with rituximab-based programs, but not in those receiving chemotherapy alone. Additionally, an LMR value of ≤2.6 (as determined by ROC analysis) was associated with a worst performance status, a higher lactate dehydrogenase (LDH) level, an advanced clinical stage, and a higher IPI score (P = 0.000). In patients treated with rituximab-supplemented chemotherapy programs, an LMR value of <2.6 was found in most of the primary refractory patients (75%) which proved as the best cutoff to predict both response and survival (P = 0.018). Finally, multivariate analysis and Harrell's C-statistics confirmed the IPI-independent role of LMR on survival (P = 0.0000). In conclusion, LMR is a potent predictor of clinical response and survival in DLBCL treated with rituximab-containing chemotherapy.
673 EVALUATION OF DUAL PRIMING OLIGONUCLEOTIDE (DPO)-BASED MULTIPLEX PCR FOR HBV YMDD MUTANTS IN COMPARISON TO RESTRICTION FRAGMENT MASS POLYMORPHISM (RFMP) AND TRUGENE HBV GENOTYPING
Authors: H.Y. Woo, H.S. Park, B.I. Kim, J.W. Yun, H.J. Kim, Y.K. Cho, W.K. Jeon, Y.J. Kim, J.K. Kim
Journal: Journal of Hepatology (2008)
Hypoxia stimulates prostacyclin synthesis in newborn pulmonary artery endothelium by increasing cyclooxygenase-1 protein.
Authors: A J North, T S Brannon, L B Wells, W B Campbell, P W Shaul
Journal: Circulation Research (1994)

In newborn lambs, pulmonary prostacyclin (PGI2) production increases acutely in response to low oxygen. We tested the hypothesis that decreased oxygenation directly stimulates PGI2 synthesis in arterial segments and cultured endothelial cells from newborn lamb intrapulmonary arteries. In segments studied at PO2 of 680 mm Hg, the synthesis of PGI2 exceeded prostaglandin E2 (PGE2) by 73%. Endothelium removal lowered PGI2 by 77% and PGE2 by 66%. At low oxygen tension (PO2, 40 mm Hg), PGI2 and PGE2 synthesis rose by 96% and 102%, respectively. Similarly, in endothelial cells studied at PO2 of 680 mm Hg, the synthesis of PGI2 exceeded PGE2 by 50%, and at low oxygen tension both PGI2 and PGE2 increased (89% and 64%, respectively). Endothelial cell PGI2 synthesis maximally stimulated by bradykinin, A23187, or arachidonic acid was also increased at low PO2 by 50%, 66%, and 48%, respectively. PGE2 synthesis was similarly altered, increasing by 33%, 37%, and 41%, respectively. In contrast, lowering oxygen had minimal effect on PGI2 and PGE2 synthesis with exogenous PGH2, which is the product of cyclooxygenase. Immunoblot analyses revealed that there was a 2.6-fold greater abundance of cyclooxygenase-1 protein at PO2 of 40 versus 680 mm Hg, and the increase at lower oxygen tension was inhibited by cycloheximide. The cyclooxygenase-2 isoform was not detected. Thus, attenuated oxygenation directly stimulates PGI2 and PGE2 synthesis in intrapulmonary arterial segments and endothelial cells from newborn lambs. This process is due to enhanced cyclooxygenase activity related to increased abundance of the cyclooxygenase-1 protein, and this effect may be due to increased synthesis of the enzyme protein.
“We lost all we had in a second”: coping with grief and loss after a natural disaster
Authors: Samanthika Ekanayake, Martin Prince, Athula Sumathipala, Sisira Siribaddana, Craig Morgan
Journal: World Psychiatry (2013)

Natural disasters cause immense suffering among affected communities. Most occur in developing countries, which have fewer resources to respond to the resulting traumas and difficulties. As a consequence, most survivors have to rely on their own coping resources and draw from what support remains within family, social networks and the wider community to manage and deal with their losses and consequent emotional distress. Taking the 2004 Asian tsunami as an example, this article reports findings from a qualitative study designed to investigate how survivors responded in Sri Lanka, and the range of coping strategies adopted and resources mobilized. In‐depth interviews were conducted with 38 survivors purposively sampled from the Matara district of southern Sri Lanka. Survivors' accounts emphasized the importance of extended supportive networks, religious faith and practices, and cultural traditions in facilitating recovery and sustaining emotional well‐being. Government and external aid responses that promoted these, through contributing to the re‐establishment of social, cultural, and economic life, were particularly valued by participants. Recourse to professional mental health care and Western psychological interventions was limited and survivors preferred to seek help from traditional and religious healers. Our findings tentatively suggest that long‐term mental health following disaster may, in the first instance, be promoted by supporting the re‐establishment of those naturally occurring resources through which communities traditionally respond to suffering.
Unusual Complication of Diagnostic Abdominal Paracentesis
Authors: Seymour Tindel
Journal: JAMA (1965)

IN RECENT YEARS, numerous reports have appeared in the literature on the use of diagnostic paracentesis, particularly in cases of abdominal trauma and acute disease requiring surgery. In these reports, complication rates have been low and the use of this technique has been strongly advocated. Recently, we have encountered a patient in whom an erroneous diagnosis was made due to an abdominal paracentesis. It is our purpose to alert physicians to an error in technique that may lead to a false diagnosis and subsequent unnecessary laparotomy. <h3>Report of a Case</h3> A 20-year-old white man (BMHC 365880) was admitted four hours after being involved in an automobile accident during which he was thrown against the steering wheel of his car. He had lost consciousness for approximately two minutes. Following the accident, the patient developed pain in the right upper abdominal quadrant and right anterior parts of the chest. He vomited once