tbuckley/cabot-search huggingface dataset:
Health officials investigate possible cause of dialysis encephalopathy
Authors: Phil Gunby
Journal: JAMA (1979)

Aluminum toxicity is a prime suspect in dialysis encephalopathy, a frequently fatal complication of long-term hemodialysis that first was recognized in 1972. Recently the problem became the subject of a government epidemiologic investigation. Patients in whom this problem develops experience increasingly severe neurological and motor difficulties. There may be seizures that do not respond to anticonvulsant drugs. Motor control degenerates until the patients become immobile. Speech grows hesitant, then is complicated by stuttering, inability to think of the desired word, and problems in structuring sentences, finally resulting in a total inability to talk. This condition also is known as dialysis dementia because patients often deteriorate intellectually, become depressed or paranoid, hallucinate, or have other psychoses. The diagnosis usually is made on the basis of these clinical findings. Because of the variety of problems that may develop, and because exposure to aluminum has not been proved to be the cause, investigators
Morbidity and treatment in patients with atrial fibrillation and chronic kidney disease
Authors: Holger Reinecke, Michael Nabauer, Andrea Gerth, Tobias Limbourg, Andras Treszl, Christiane Engelbertz, Lars Eckardt, Paulus Kirchhof, Karl Wegscheider, Ursula Ravens, Thomas Meinertz, Gerhard Steinbeck, Günter Breithardt
Journal: Kidney International (2014)
TCT-712 Can Amelioration of HDL-C Level by Pitavastatin Improve Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention?
Authors: Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Amro Elnagar, Sung Il Im, Sun Won Kim, Jin Oh Na, Seong Woo Han, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Myung Ho Jeong
Journal: Journal of the American College of Cardiology (2012)
Kinetics of Zinc Status in Children With IDDM
Authors: Toshiro Nakamura, Akimasa Higashi, Soroku Nishiyama, Shigehiro Fujimoto, Ichiro Matsuda
Journal: Diabetes Care (1991)

Objective To ascertain zinc deficiency in patients with insulin-dependent diabetes mellitus (IDDM) and evaluate the relationship between zinc clearance and body height velocity. Research Design and Methods Six boys and 11 girls with IDDM and zincuria and glycosuria were studied. Study quality and specific descriptive information concerning relationship and outcome measurement were assessed. Results The values of total-body zinc clearance in IDDM patients were higher than in the control subjects (24.6 ± 1.8 vs. 15.1 ± 0.6 ml · kg−1.h−1, P &amp;lt; 0.01). There was a negative correlation between body zinc clearance values and height velocity in IDDM patients. Conclusions Patients with IDDM have a secondary zinc deficiency, and normal growth may be stunted.
The Dying Patient's Grief
Authors: C. Knight Aldrich
Journal: JAMA (1963)

Since the full significance of dying, for a patient, includes the anticipated loss of all of his human relationships, a significant element of his response to the awareness of impending death is a type of grief not too different from the anticipatory grief of his potential survivors. This concept of the emotional response to dying helps to clarify some of the individual differences among patients and some of the changes in a patient's reactions as the terminal course progresses. The concept also suggests to the physician that his communication with his dying patient should be couched in terms that will permit the patient either to deny or to accept death, as his current emotional needs require.
Inappropriate Antidiuretic Hormone Syndrome and Carcinoma of Pancreas with Demonstration of Tumor Antidiuretic Activity.
Authors: Leon J. Marks
Journal: Annals of Internal Medicine (1968)

s1 May 1968Inappropriate Antidiuretic Hormone Syndrome and Carcinoma of Pancreas with Demonstration of Tumor Antidiuretic Activity.Leon J. Marks, M.D., F.A.C.P., Donald C. Nabseth, M.D., Lester A. Klein, M.D., Jesse Roth, M.D., Botond Berde, M.D.Leon J. Marks, M.D., F.A.C.P.Search for more papers by this author, Donald C. Nabseth, M.D.Search for more papers by this author, Lester A. Klein, M.D.Search for more papers by this author, Jesse Roth, M.D.Search for more papers by this author, Botond Berde, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1144_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA 59-year-old man with a bronchogenic carcinoma (oat cell) demonstrated inappropriate antidiuresis on the basis of [1] persistent urine hyperosmolality with marked serum hypoosmolality and hyponatremia in the presence of a normal blood volume, [2] correction of hyponatremia with water restriction, and [3] excessive natriuresis with normal renal and adrenal function. Resection of the primary lung tumor did not ameliorate the antidiuretic hormone syndrome. At autopsy, performed 4 months postoperatively, metastatic lung cancer was present in the liver, and a separate pancreatic tumor (adenocarcinoma) was found in the pancreas. Extracts of the pancreatic neoplasm contained very high levels of arginine... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts, Bethesda, Maryland, and Basel, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1144-1145KeywordsAntidiuretic hormoneHyponatremiaLung and intrathoracic tumorsLung resectionLungsPancreasPancreatic cancerRenal cell carcinomaTumor resectionUrine Issue Published: 1 May 1968 PDF DownloadLoading ...
Ketoconazole binds to glucocorticoid receptors and exhibits glucocorticoid antagonist activity in cultured cells.
Authors: D S Loose, E P Stover, D Feldman
Journal: Journal of Clinical Investigation (1983)

We have recently found that ketoconazole inhibits adrenal steroidogenesis; in this paper we investigated whether imidazole antimycotic drugs additionally interact with glucocorticoid receptor sites in target tissues. Our approach was to assess the ability of three drugs: ketoconazole, clotrimazole, and RS 49910, to inhibit [3H]dexamethasone binding to hepatoma tissue culture (HTC) cell cytosol. The results indicated dose-dependent, competitive displacement of [3H]dexamethasone binding that was in the potency sequence: clotrimazole greater than ketoconazole greater than RS 49910. We then examined the functional response of this binding by measuring tyrosine aminotransferase (TAT) activity in HTC cells. The antimycotics did not exhibit TAT agonist activity and inhibition of basal enzyme levels was not detected. However, the drugs were potent antagonists of dexamethasone-induced TAT activity and the effect was temporally reversible. This antagonist activity was in the same sequence and closely correlated with the binding potency of the three drugs. We conclude that ketoconazole and other imidazole antimycotic drugs possess glucocorticoid antagonist activity by virtue of occupancy of glucocorticoid receptor sites in target tissues.
COMPLEMENT FIXATION WITH AN ANTIGENIC CRYSTAL OBTAINED FROM LUETIC LIVER
Authors: CHARLES F. CRAIG
Journal: JAMA (1910)

Since the observation by Wassermann, Neisser, and Bruck 1 of the value of the complement fixation test in lues, the exact nature of the antigenic substance or substances contained in extracts from luetic and normal tissues has received a great deal of attention, and the results appear to show that more than one substance, capable of acting as an antigen, is contained in these extracts. It is the purpose of this contribution to describe briefly a crystal obtained from an alcoholic extract of luetic liver which acts as a very efficient antigen when dissolved in alcohol, and which has not, to my knowledge, been heretofore obtained from such extracts. I regret to state that at the present writing the exact chemical nature of this crystal has not been ascertained, the most that can be said concerning it being that it may belong to the group of crystals which may be obtained from the bile salts.
Tracking of blood lipids and blood pressures in school age children: the Muscatine study.
Authors: W R Clarke, H G Schrott, P E Leaverton, W E Connor, R M Lauer
Journal: Circulation (1978)

In four cross sectional school screens, the Muscatine Study has sampled 8,909 school children; 820 have been studied repeatedly over a six-year period. Tracking of measurements described by the relationship between repeated observations and the relationship between peer rank orderings over the six-year period has been studied. For height and weight, correlations between observations six years apart were approximately 0.74 and about 60% of children initially in the upper quintile were there again six years later. Six-year correlations were 0.65 for skinfold and 0.61 for cholesterol. Four-year correlation for fasting triglyceride was 0.40. Six-year correlations were 0.30 for casual systolic blood pressure and 0.18 for diastolic blood pressure. Peer rank orderings for both blood pressures were highly variable. Height and weight track well, and thus routine measurement of these variables are useful in identifying children with growth perturbing disorders. Cholesterol and, to a lesser degree, triglycerides also track, and a significant proportion of children with initially high values demonstrated consistently high values throughout the study period. Blood pressures do not track as well; consistently high blood pressures are unusual, thus indicating the need for repeated blood pressure measurements to identify children with persistent elevated levels. The future significance of transient blood pressure elevations has yet to be established.
Diesel exhaust and asthma: hypotheses and molecular mechanisms of action.
Authors: Robert J Pandya, Gina Solomon, Amy Kinner, John R Balmes
Journal: Environmental Health Perspectives (2002)

Several components of air pollution have been linked to asthma. In addition to the well-studied critera air pollutants, such as nitrogen dioxide, sulfur dioxide, and ozone, diesel exhaust and diesel exhaust particles (DEPs) also appear to play a role in respiratory and allergic diseases. Diesel exhaust is composed of vapors, gases, and fine particles emitted by diesel-fueled compression-ignition engines. DEPs can act as nonspecific airway irritants at relatively high levels. At lower levels, DEPs promote release of specific cytokines, chemokines, immunoglobulins, and oxidants in the upper and lower airway. Release of these mediators of the allergic and inflammatory response initiates a cascade that can culminate in airway inflammation, mucus secretion, serum leakage into the airways, and bronchial smooth muscle contraction. DEPs also may promote expression of the T(subscript)H(/subscript)2 immunologic response phenotype that has been associated with asthma and allergic disease. DEPs appear to have greater immunologic effects in the presence of environmental allergens than they do alone. This immunologic evidence may help explain the epidemiologic studies indicating that children living along major trucking thoroughfares are at increased risk for asthmatic and allergic symptoms and are more likely to have objective evidence of respiratory dysfunction.
MicroRNA-21 in Pancreatic Cancer: Correlation with Clinical Outcome and Pharmacologic Aspects Underlying Its Role in the Modulation of Gemcitabine Activity
Authors: Elisa Giovannetti, Niccola Funel, Godefridus J. Peters, Marco Del Chiaro, Leyla A. Erozenci, Enrico Vasile, Leticia G. Leon, Luca E. Pollina, Annemieke Groen, Alfredo Falcone, Romano Danesi, Daniela Campani, Henk M. Verheul, Ugo Boggi
Journal: Cancer Research (2010)

MicroRNA-21 (miR-21) was reported to be overexpressed and contributes to invasion and gemcitabine resistance in pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to evaluate whether miR-21 expression was associated with the overall survival (OS) of PDAC patients treated with gemcitabine and to provide mechanistic insights for new therapeutic targets. miR-21 expression was evaluated in cells (including 7 PDAC cell lines, 7 primary cultures, fibroblasts, and a normal pancreatic ductal cell line) and tissues (neoplastic specimens from 81 PDAC patients and normal ductal samples) isolated by laser microdissection. The role of miR-21 on the pharmacologic effects of gemcitabine was studied with a specific miR-21 precursor (pre-miR-21). Patients with high miR-21 expression had a significantly shorter OS both in the metastatic and in the adjuvant setting. Multivariate analysis confirmed the prognostic significance of miR-21. miR-21 expression in primary cultures correlated with expression in their respective tissues and with gemcitabine resistance. Pre-miR-21 transfection significantly decreased antiproliferative effects and apoptosis induction by gemcitabine, whereas matrix metalloproteinase (MMP)-2/MMP-9 and vascular endothelial growth factor expression were upregulated. Addition of inhibitors of phosphoinositide 3-kinase and mammalian target of rapamycin resulted in decrease of phospho-Akt and prevented pre-miR-21-induced resistance to the proapoptotic effects of gemcitabine. miR-21 expression correlated with outcome in PDAC patients treated with gemcitabine. Modulation of apoptosis, Akt phosphorylation, and expression of genes involved in invasive behavior may contribute to the role of miR-21 in gemcitabine chemoresistance and to the rational development of new targeted combinations.
Effects of I.C.I. 50172 in man during erect exercise.
Authors: D. Gibson, E. Sowton
Journal: BMJ (1968)

Preliminary observations on the drug I.C.I. 50172 (4-(2hydroxy-3-isopropylaminopropoxy) acetanilide) have shown it to block isoprenaline-induced tachycardia in the experimental animal (Barrett et al., 1968) and also in normal volunteers (Brick et al., 1968).In this paper we report the haemodynamic effects in man of the intravenous administration of 5 mg. of I.C.I. 50172 during submaximal exercise. Materials and MethodsObservations were made on 10 patients whose ages ranged from 19 to 60.All had been referred for an exercise test, the indication being atypical chest pain in six and a systolic murmur in the others.Two patients had trivial pulmonary stenosis, with a gradient of 10-15 mm.Hg across the valve, and one had very slight aortic incompetence.The others had no demonstrable haemodynamic abnormality.The present investigation was performed immediately after the diagnostic exercise study.Before proceeding, the nature and purpose of the investigation was explained to the patients, and their permission was sought before the drug was administered.Right heart pressures were measured in six patients through a fine nylon catheter, which was introduced percutaneously into an arm vein and advanced to the pulmonary artery.In the three patients with minor valve lesions a No. 8 twin-lumen catheter was introduced and a routine right heart pressure and sample run performed before the start of the study.The catheter was then positioned with its tip impacted in the pulmonary capillary wedge position.Systemic arterial pressures were recorded through Teflon tubing (internal diameter 1.1 mm., external diameter 1.6 mm.) introduced into the brachial artery by the Seldinger technique, and advanced approximately 30 cm. to the subclavian artery.Pressures were measured with Consolidated Electrodynamics strain-gauge transducers (type 4-326-L212) and a Sanborn (964) four-channel direct-writing recorder.The zero level for pressure measurement was taken as the insertion of the fourth rib into the sternum.Mean pressures were derived by electrical integration.The pulse rate was determined from an E.C.G. recorded simultaneously with the pressures.Cardiac output was determined by the dye dilution technique.Indocyanine green (5 mg.) was injected into the right atrium or the pulmonary artery.Arterial blood was withdrawn from the brachial artery catheter by a Kipp and Zonen constant- rate pump through a Gilford densitometer cuvette, feeding a Honeywell wide-chart recorder.The patients were exercised erect throughout the test on an Elema-Schonander bicycle ergometer.For the single patient who developed angina of effort in the initial exercise test, a level of 100 kpm./min.was used, while all the others exercised at 200 or 300 kpm./min.for approximately 15 minutes.Con- trol pressure and cardiac output measurements were made two and four minutes after the start of exercise, and at five minutes 5 mg. of I.C.I. 50172 was given intravenously.Further measurements were made at two-minute intervals over the next 10 minutes.
Langerhans cells in tissue cultures of guinea-pig epidermal cells
Authors: C.N.D. CRUICKSHANK, J.R. COOPER
Journal: British Journal of Dermatology (1975)

Dispersed cell cultures of guinea-pig epidermis have been maintained for up to 36 days. The progress of these cultures has been studied by phase contrast microscopy, the adenosine triphosphatase reaction, and cinephotomicrography. Langerhans cells have been identified and their behaviour studied, particularly in relation to keratinocytes.
Labour would divert 100m from NHS reorganisation into primary care
Authors: Z. Kmietowicz
Journal: BMJ (2014)

A Labour government would ensure that all patients could get an appointment at their GP surgery within 48 hours and see their doctor on the same day if necessary, the party leader, Ed Miliband, has said.

In a speech in Manchester on 12 May, Miliband put the NHS at the heart of the Labour Party’s campaign to win power in next year’s general election. 

He promised to invest an extra £100m (€122m; $169m) a year in primary care by scrapping competition rules in the NHS and cutting bureaucracy created by the coalition government. He said that this money could fund three million more GP appointments every year and take pressure off hospital emergency departments.

Miliband spelt out three ways that Labour planned to improve the NHS: ensuring that physical health, mental health, and social care services work together; making the NHS preventive, …
Acute liver failure secondary to hepatic infiltration: a single centre experience of 18 cases
Authors: D Rowbotham, J Wendon, R Williams
Journal: Gut (1998)

<i>Background</i>—Acute liver failure (ALF) secondary to malignant infiltration of the liver is rare and is diagnosed often only after death. <i>Aims</i>—To determine diagnostic factors and particular clinical patterns of illness. <i>Methods</i>—Review of case notes from all patients with ALF secondary to hepatic infiltration admitted to this unit over an 18 year period (1978–1995). <i>Results</i>—From a total of 4020 admissions, 18 patients were identified with ALF attributable to hepatic infiltration. Mean age was 40.7 years. Aetiology was non-Hodgkin’s lymphoma in nine patients, Hodgkin’s disease in three, infiltrative metastatic carcinoma in four, and haemophagocytosis with no precipitant cause in two cases. Prodromal symptoms were non-specific, but occurred at least two to four weeks before onset of ALF, making the presence of such symptoms of value in differential diagnosis of the cause of ALF. Clinical examination and investigations were unhelpful in distinguishing these cases from more usual causes of ALF. Usually, the clinical course was of rapid deterioration and death from multiorgan failure, and only one patient survived. Diagnosis was made during life in 15 patients. Histology showed evidence of widespread hepatocellular necrosis, with diffuse infiltration by tumour cells rather than focal cellular aggregation. <i>Conclusions</i>—Only with accurate histological diagnosis from liver biopsy and institution of specific therapy early in the management of such patients will the best chance of recovery be achieved. In every case of ALF with prodromal symptoms or abnormal imaging, hepatic histology should be obtained by liver biopsy as soon as possible to diagnose infiltrative hepatic disease.
Sublingual‐swallow immunotherapy (SLIT) with a standardized five‐grass‐pollen extract (drops and sublingual tablets) versus placebo in seasonal rhinitis
Authors: A Pradalier, D Basset, P Couturier, A Claudel, F Wessel, S Galvain, C André
Journal: Allergy (1999)

Background: Recent studies have demonstrated the efficacy of sublingual‐swallow immunotherapy (SLIT) in seasonal and perennial rhinitis. Sublingual administration of solutions is not convenient for all patients. The aim of the study was to evaluate the efficacy and safety of immunotherapy administered sublingually, initially as drops, and then as tablets during maintenance therapy. Methods: A total of 126 patients with grass‐pollen seasonal rhinitis were included in this double‐blind, randomized, placebo‐controlled trial. During the progression of doses phase, the five‐grass extract was given as sublingual drops from 1 to 100 IR/ml. Once the 100 IR dose was reached, the drops were replaced by a single 100‐IR sublingual tablet per day. Results: Throughout the grass‐pollen season, patients in the active treatment group had significantly lower ( P &lt;0.05) total conjunctivitis and ocular redness scores. Rhinitis symptoms were not significantly different between the two groups. Patients given the active treatment were significantly ( P &lt;0.02) less likely to have asthma symptoms. The global medication score showed no significant difference between the two groups. A highly significant difference in favor of the active treatment group was seen in inhaled salbutamol use ( P &lt;0.01). Conclusions: Clinical benefits achieved during the present study included significant improvements in conjunctivitis symptoms and prevention of asthma symptoms. The overall safety profile of the active treatment (drops or tablets) was good.
CATARACT STATISTICS WITH COMMENTS.
Authors: HERMAN KNAPP
Journal: JAMA (1898)

Statistics of cataract operations can be made from different points of view. It is plain that complicated cases do not give as favorable results as uncomplicated ones, and therefore almost all statistics refer only to uncomplicated cataracts. Yet this does not make them comparable with one another, for Dr. A. will count cases among the complicated which Dr. B. will consider uncomplicated. To present a faithful picture of what an operator has accomplished, all his operations should be counted, or if he excludes some he should supplement his statistics by a special report, best with abstracts of the cases. Another point in which reports differ is the standard of success and failure. Shall we make success dependent on the acuteness of sight, or on the perfection of the recovery? Sometimes we have to extract lenses from incurably blind eyes, say a chalky, partially or totally dislocated lens in a young
Earlier diagnosis and survival in lung cancer
Authors: G. Z. Brett
Journal: BMJ (1969)

In a controlled investigation the survival prospects of lung cancer in a population of men aged 40 and over who had been offered six-monthly chest radiographs over a period of three years were compared with lung cancer in a similar population without such x-ray facilities. The five-year survival rate of lung cancer in the study series was 15%, and in cases discovered by six-monthly examination 23%, compared with 6% in the control series. The average expectation of life after diagnosis was 2·5 years for the test cases and 1·2 for the control cases. Survival declined with age. Of resected lung cancer, 32% survived five years in the test series and 23% in the control series. The five-year survival rate for squamous carcinoma and adenocarcinoma in the test series was 28% and 25% respectively, compared with 15% and nil in the control series. On the basis of these results it is concluded that through earlier radiological detection a modest improvement in the prognosis of lung cancer can be achieved.