tbuckley/cabot-search huggingface dataset:
Paradoxical Hypertension from Clonidine
Authors: Elizabeth Young, Barbara A. Levey, Alvin P. Shapiro
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 August 1984Paradoxical Hypertension from ClonidineELIZABETH YOUNG, M.D., BARBARA A. LEVEY, M.D., ALVIN P. SHAPIRO, M.D.ELIZABETH YOUNG, M.D.Search for more papers by this author, BARBARA A. LEVEY, M.D.Search for more papers by this author, ALVIN P. SHAPIRO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-2-282_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Clonidine is an alpha-receptor agonist that has both central and peripheral stimulating effects. Its central agonism produces vasodilation that predominates over peripheral vasoconstriction and results in lower blood pressures in hypertensive patients. However, in patients with idiopathic orthostatic hypotension and impaired central sympathetic outflow, the peripheral vasconstrictor effects of Clonidine have recently been noted to predominate, and the drug thus can be used to treat this condition (1).Hypertensive diabetic patients often have orthostatic hypotension from autonomic nervous system neuropathy, making their hypertension particularly difficult to treat. We recently saw such a patient who was given Clonidine...Reference1. ROBERTSONGOLDBERGHOLLISTERWADEROBERTSON DMADR. Clonidine raises blood pressure in severe idiopathic orthostatic hypotension. Am J Med. 1983;74:193-200. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByClonidine-Induced Hypertension in a Patient with a Spinal LesionDrug Interactions with Agents Used to Treat Endocrine DisordersHigh Blood Pressure: Side Effects of Drugs, Poisons, and FoodHypertension caused by clonidine in patients with diabetic autonomic neuropathyHypertensive Crisis 1 August 1984Volume 101, Issue 2Page: 282-283KeywordsAutonomic nervous systemBlood pressureDrugsHypertensionHypotensionNeuropathySympathetic nervous systemVasoconstrictionVasodilation Issue Published: 1 August 1984 PDF DownloadLoading ...
Spontaneous remission of multilobated non‐Hodgkin lymphoma
Authors: Andrew P. Grigg, George R. Gray, John D. Shepherd
Journal: American Journal of Hematology (1992)

Abstract A 67‐year‐old previously well man was admitted with hypercalcemia after a 7‐day history of fever, night sweats, and back pain. The blood showed 5% multilobated lymphoid cells. A multilobated non‐Hodgkin lymphoma associated with marked reticulin fibrosis was diagnosed on a bone marrow biopsy. During the next 7 days, in the absence of specific therapy, his symptoms disappeared. Three weeks after admission his biochemical abnormalities had resolved and after 9 weeks his bone marrow examination was normal. He remains in clinical and laboratory remission 16 months after presentation. © 1992 Wiley‐Liss, Inc.
Medullary Cystic Disease vs Nephrophthisis
Authors: Kenneth D. Gardner
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I wish to offer Drs Giangiacomo, Monteleone, and Witzleben an alternate explanation for their findings (232:629, 1975). In actuality, they documented nephrophthisis (adequately, in my opinion) in a single generation of 12 surviving siblings, whose parents were considered free of evidence of renal dysfunction. The renal deaths of earlier generations, not proven to be caused by medullary cystic disease, could reflect the fact that renal disease is the fourth leading cause of death, after heart disease, cancer, and stroke. I wish to suggest to the authors that recessive inheritance transmitted the renal lesion in their family and that the possibility that I am right, not wrong, in recognizing hereditary variance of medullary cystic disease remains unchallenged by their presentation. I wonder if this article would have been considered worthy of publication had these authors stood by their facts, rather than by speculation contained in the report. My
Acute Epiglottitis in Adults-Reply
Authors: Timothy D. Frantz
Journal: JAMA (1995)

In Reply.  —We appreciate Dr Deeb's comments regarding indications for airway intervention in adults with epiglottitis. In our study, we found that stridor and an erect posture were significantly associated with airway intervention when retrospectively reviewed; however, we believe that airway intervention in an adult with epiglottitis demands clinical judgment on an individual basis. We did not state that airway intervention should be reserved for patients with stridor, erect posture, or drooling. All the signs and symptoms of airway compromise must be considered when making this decision. If there is any question of respiratory compromise, the safest course of action is to secure the airway.  Airway intervention is not required in all patients with epiglottitis and tachycardia. In our study, 48% of patients initially presented with tachycardia. If all of these patients had been managed with endotracheal intubation or tracheotomy, most of these procedures would have been performed unnecessarily.
TRANSCATHETER “THROMBIN-BLOOD PATCH” INJECTION: A NOVEL AND EFFECTIVE APPROACH TO TREAT CATHETER INDUCED ARTERIAL PERFORATION
Authors: Gabriel Maluenda, Lavinia Mitulescu, Michael A. Gaglia, Kohei Wakabayashi, Manuel A. Gonzalez, Itsik Ben-Dor, Ana Laynez-Carnicero, Gabriel Sardi, Rafael Romaguera, Rebecca Torguson, William O. Suddath, Lowell F. Satler, Augusto D. Pichard, Ron Waksman, Nelson L. Bernardo
Journal: Journal of the American College of Cardiology (2011)
Estimation of urine specific gravity and osmolality using a simple reagent strip.
Authors: A J Frew, J McEwan, G Bell, M Heath, M S Knapp
Journal: BMJ (1982)

giving potassium supplements to elderly patients where their need is not urgent.Since the absorption of fluid from the infusion site is slow, we do not recommend this method for giving potassium when large amounts are needed urgently.There seems to be no danger of hyperkalemia with the method used here.Although hypodermoclysis is suitable for use in nursing homes, we feel that subcutaneous potassium infusions should be given only in hospitals until more experience is gained.We would like to thank Cilla Gerber, Ilana Elroy, and the other members of the nursing staff for their help and co-operation.
Why doctors must grapple with health economics
Authors: P. Draper
Journal: BMJ (1987)

suggest that they are at high risk of developing leptospirosis, the remarkably low incidence of the disease in such communes argues to the contrary.The clustering of so many cases in the commune, the finding of only a moderate rise in the tempera- ture at the centre of a meatball cooked on a hot plate,2 and the very peculiar interaction of the index case with the commune strongly suggested that food was the common source.
Human exposures to mutagens--an analysis using the genetic activity profile database.
Authors: R R Tice, H F Stack, M D Waters
Journal: Environmental Health Perspectives (1996)

The Genetic Activity Profile (GAP) database was used to identify and compare agents showing genotoxic activity in humans. The database revealed several substances for which both human and rodent cytogenetic data existed. Based on the ratio of the lowest effective doses (LEDs) in rodents versus human studies, humans appear to be at least 10 times more sensitive than rodents to the majority of the genotoxic substances examined. Several caveats are discussed which may be responsible, in part, for the apparent differences in sensitivity. Some of these differences could be due to variations in the test protocols or they may, in fact, reflect real differences between human and rodent cells. However, in contrast to the in vivo comparison, the LEDs for human data from in vitro studies were not uniformly lower than for comparable studies in rodents. The in vitro comparison suggests that the apparent differences in human versus rodent cell sensitivity seen in vivo must be viewed with a degree of caution. Nevertheless, the overall GAPs for these agents, and particularly the human in vivo data, underscore the concern for adequate protection of humans exposed to these environmental mutagens.
Mitral Valve Disease Complicated by Left-to-Right Shunt at Atrial Level
Authors: ROBERT J. MARSHALL, HERBERT E. WARDEN
Journal: Circulation (1964)

The clinical features and the changes in hemodynamics are described before and after operation in two patients with mitral valve disease associated with left-to-right shunt at atrial level. The first patient had severe rheumatic mitral stenosis, which masked the associated moderate shunt. Since the interatrial communication was small, there was a moderate gradient in pressure between the two atria. Thus, the finding of an elevated left atrial or pulmonary artery wedge pressure in a patient with mitral stenosis and an increase in the saturation of blood at atrial level does not eliminate the possibility of a small interatrial communication. The second patient had severe mitral regurgitation due to a structurally abnormal valve with ruptured chordae tendineae, and had also functional pulmonary and tricuspid valve regurgitation. These lesions also masked the associated large left-to-right shunt. Electrocardiographic and angiocardiographic criteria were used to exclude the possibilities of persistent atrioventricular canal defect and of left ventricle-right atrium shunt. After operation, cardiac catheterization demonstrated a return of the hemodynamic changes toward normal in both patients. There was also a striking clinical improvement. In both, the interatrial communication was situated in the fossa ovalis. It appeared to be a foramen ovale that had become patent due to stretching of the walls of the left atrium, rather than a true atrial septal defect. Although left-to-right shunting may occur through a patent foramen ovale in infants with mitral or aortic valve atresia, we are unaware of previous hemodynamic or surgical evidence of a similar phenomenon developing as a consequence of severe mitral valve disease in adults.
Epidermal Growth Factor Receptor, C-kit, and Her2/neu Immunostaining in Advanced or Recurrent Thymic Epithelial Neoplasms Staged According to the 2004 World Health Organization in Patients Treated with Octreotide and Prednisone: An Eastern Cooperative Oncology Group Study
Authors: Seena C. Aisner, Suzanne Dahlberg, Meera R. Hameed, David S. Ettinger, Joan H. Schiller, David H. Johnson, Joseph Aisner, Patrick J. Loehrer
Journal: Journal of Thoracic Oncology (2010)

Advanced or recurrent nonresectable thymic epithelial tumors show only a modest response to standard chemotherapy. A recent study using octreotide and prednisone in thymic tumors, Eastern Cooperative Oncology Group study E1C97, was conducted to verify the activity of octreotide for thymic tumors. The aim of this study was to determine whether epidermal growth factor receptor (EGFR) immunoreactivity correlated with outcomes and to identify new biologic markers for potential targeted therapy. Three markers, EGFR, C-kit, and Her2/neu, were selected for evaluation in patients with advanced thymic epithelial tumors treated on E1C97.Of the 42 patients entered onto E1C97, 34 patients (World Health Organization [WHO] categories: type A = 1, type AB = 1, type B1 = 10, type B2 = 11 type B3 = 8, and type C = 3) had sufficient tissue available for immunohistologic study. Each tumor was assessed to have 0, 1+, 2+, or 3+ immunoreactivity in the cytoplasm or membranes of the neoplastic cells for Her2/neu and EGFR and for the presence or absence of C-kit immunoreactivity.EGFR immunoreactivity of 2+ or 3+ was associated with more aggressive thymic tumors (WHO types B2 and B3). However, strong EGFR immunoreactivity was not consistently seen with thymic carcinoma. The presence of EGFR within cells was associated with a significantly improved progression-free survival (PFS) and a trend for overall survival (OS). Twelve patients demonstrated C-kit immunoreactivity; the lack of C-kit immunoreactivity was significantly associated with superior PFS but not OS. Her2/neu immunoreactivity was uniformly negative for all tumors evaluated. There was no association between response and biomarker status.High EGFR immunoreactivity is seen in more aggressive thymic neoplasms as classified according to the 2004 WHO, but regardless of classification, the presence of EGFR in tumor cells (1+, 2+, and 3+) is associated with improved performance free survival (PFS) and a trend for better OS. In contrast, the absence of C-kit immunoreactivity was associated with improved PFS. These data suggest that EGFR and C-kit may be prognostic, and further studies of these markers in subcategories of thymic malignancies is warranted.
Systemic Inflammation Induced by Lipopolysaccharide Increases Neointimal Formation After Balloon and Stent Injury in Rabbits
Authors: Haim D. Danenberg, Frederick G. P. Welt, Matthew Walker, Philip Seifert, Greg S. Toegel, Elazer R. Edelman
Journal: Circulation (2002)

Emerging data indicate that the inflammatory response after mechanical arterial injury correlates with the severity of neointimal hyperplasia in animal models and postangioplasty restenosis in humans. The present study was designed to examine whether a nonspecific stimulation of the innate immune system, induced in close temporal proximity to the vascular injury, would modulate the results of the procedure. Methods and Results- Rabbits subjected to iliac artery balloon injury (balloon denudation with or without stent deployment) were injected twice with a bacterial lipopolysaccharide (LPS) (500 ng/rabbit) before and after surgery. The dose was chosen to be sufficient to induce systemic inflammation but not septic shock. A systemic marker of inflammation (serum interleukin-1beta levels measured by ELISA) and monocytic stimulation (CD14 levels on monocytes measured by flow cytometry) were increased after LPS administration. Arterial macrophage infiltration at 7 days after injury was 1.7+/-1.2% of total cells in controls and 4.2+/-1.8% in LPS-treated rabbits (n=4, P<0.05). Morphometric analysis of the injured arteries 4 weeks after injury revealed significantly increased luminal stenosis (38+/-4.2% versus 23+/-2.6, mean+/- SEM; n=8, P<0.05) and neointima-to-media ratio (1.26+/-0.21 versus 0.66+/- 0.09, P<0.05) in LPS-treated animals compared with controls. This effect was abolished by anti-CD14 Ab administration. Serum interleukin-1beta levels and monocyte CD14 expression were significantly increased in correlation with the severity of intimal hyperplasia. LPS treatment increased neointimal area after stenting from 0.57+/-0.07 to 0.77+/- 0.1 mm(2) and stenosis from 9+/-1% to 13+/-1.7% (n=5, P< 0.05).Nonspecific systemic stimulation of the innate immune system concurrently with arterial vascular injury facilitates neointimal formation, and conditions associated with increased inflammation may increase restenosis.
Snake Venom Poisoning
Authors: John C. Key
Journal: JAMA (1984)

It has been said that everyone knows how to build a fire, run a hotel, and coach a football team; "treat snakebite" could probably be added to that list. Everyone thinks he has the right answer. Those favoring surgical treatment view antivenin use as heretical at best, while proponents of antivenin use seem to believe that surgeons are remnants of an era that recommended bloodletting and other procedures now considered bizarre. As a recent convert to antivenin therapy for snakebite, I anxiously read Russell's new book on the treatment of snake venom poisoning. He has attempted to write a general reference and treatment guide for physicians treating snakebite, and I believe that he has done a good job in fulfilling this goal. Those merely seeking the "true path" for treatment of snakebite will find a large portion of the book's 500+ pages to be devoted to basic zoology and toxicology.
Whose Death Is It, Anyway
Authors: Brian J. Bohlmann
Journal: Annals of Internal Medicine (1997)

Letters1 April 1997Whose Death Is It, AnywayBrian J. Bohlmann, MDBrian J. Bohlmann, MDUniversity of Wisconsin Medical School, Madison, WI 53717Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-7-199704010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The essay by Hansot [1] highlights the importance of recognizing the need to limit intensive medical interventions when they would only prolong the dying process and inflict unintentional cruelty. Dr. Hansot implies that she would have been more satisfied if the decision to withdraw life support had occurred earlier than her mother's fifth day of hospitalization.As a senior resident, I hospitalized an elderly woman who had had a massive myocardial infarction. Her condition deteriorated steadily, with a decrease in arterial blood pH and bicarbonate and an increase in lactate levels. Our teaching service and the consulting ...REFERENCE1. Hansot E. A letter from a patient's daughter. Ann Intern Med. 1996; 125:149-51. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Wisconsin Medical School, Madison, WI 53717 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1997Volume 126, Issue 7Page: 586KeywordsElderlyHeart failureHospitalizationsIntensive care unitsLactatesMyocardial infarctionNursing homesPatientsResidencyShock Issue Published: 1 April 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Effect of ascorbic acid in patients with Charcot–Marie–Tooth disease type 1A: a multicentre, randomised, double-blind, placebo-controlled trial
Authors: Joëlle Micallef, Shahram Attarian, Odile Dubourg, Pierre-Marie Gonnaud, Jean-Yves Hogrel, Tanya Stojkovic, Rafaelle Bernard, Elisabeth Jouve, Severine Pitel, Francois Vacherot, Jean-Francois Remec, Laurent Jomir, Eric Azabou, Mahmoud Al-Moussawi, Marie-Noelle Lefebvre, Laurence Attolini, Sadek Yaici, Daniel Tanesse, Michel Fontes, Jean Pouget, Olivier Blin
Journal: The Lancet Neurology (2009)
Book: Health Care in Central Asia
Authors: J. Salvage
Journal: BMJ (2002)

Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>. Before September 11 2001 and its sequelae, the five former Soviet republics of central Asia were little known to the rest of the world. Their proximity to Afghanistan has raised their profile, with foreign troops using them as bases and refugees streaming across their borders. The fledgling nations of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan have been through hard times since unexpectedly gaining independence in 1990-1. Every aspect of life was affected, often for the worse, to the point of a bloody civil war in Tajikistan. I first saw the region in 1992 with World Health Organization teams visiting Kazakhstan and Kyrgyzstan in their new … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Inducible inactivation of hepatic LRP gene by cre-mediated recombination confirms role of LRP in clearance of chylomicron remnants.
Authors: A Rohlmann, M Gotthardt, R E Hammer, J Herz
Journal: Journal of Clinical Investigation (1998)

The multifunctional low density lipoprotein (LDL) receptor-related protein (LRP) has been postulated to participate in a number of diverse physiological and pathological processes ranging from the homeostasis of plasma lipoproteins, atherosclerosis, and fibrinolysis to neuronal regeneration and survival. It has not been possible to demonstrate in vivo the physiological significance of LRP for each of these complex processes by a conventional gene knockout approach because LRP is essential for embryonic development. Here we have used the Cre/loxP recombination system to achieve inducible, tissue-specific and quantitative disruption of the LRP gene in adult mice. Inactivation of LRP in the livers of LDL receptor-deficient mice resulted in the accumulation of cholesterol-rich remnant lipoproteins in the circulation. In normal animals, this caused a compensatory upregulation of the LDL receptor in the liver. Conditional gene targeting has thus allowed us to isolate a specific physiological function of LRP for in vivo analysis and has provided unequivocal evidence for another LDL receptor-independent cholesterol clearance pathway in liver.
Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine
Authors: Maurizio Cecconi, Daniel De Backer, Massimo Antonelli, Richard Beale, Jan Bakker, Christoph Hofer, Roman Jaeschke, Alexandre Mebazaa, Michael R. Pinsky, Jean Louis Teboul, Jean Louis Vincent, Andrew Rhodes
Journal: Intensive Care Medicine (2014)

Circulatory shock is a life-threatening syndrome resulting in multiorgan failure and a high mortality rate. The aim of this consensus is to provide support to the bedside clinician regarding the diagnosis, management and monitoring of shock. The European Society of Intensive Care Medicine invited 12 experts to form a Task Force to update a previous consensus (Antonelli et al.: Intensive Care Med 33:575–590, 2007). The same five questions addressed in the earlier consensus were used as the outline for the literature search and review, with the aim of the Task Force to produce statements based on the available literature and evidence. These questions were: (1) What are the epidemiologic and pathophysiologic features of shock in the intensive care unit? (2) Should we monitor preload and fluid responsiveness in shock? (3) How and when should we monitor stroke volume or cardiac output in shock? (4) What markers of the regional and microcirculation can be monitored, and how can cellular function be assessed in shock? (5) What is the evidence for using hemodynamic monitoring to direct therapy in shock? Four types of statements were used: definition, recommendation, best practice and statement of fact. Forty-four statements were made. The main new statements include: (1) statements on individualizing blood pressure targets; (2) statements on the assessment and prediction of fluid responsiveness; (3) statements on the use of echocardiography and hemodynamic monitoring. This consensus provides 44 statements that can be used at the bedside to diagnose, treat and monitor patients with shock.
TCTAP A-157 Retrograde Coronary Vein Infusion Achieves Targeted Cell Engraftment into Infarcted Myocardium for Cardiac Repair
Authors: Xiao Wang, Shao-Ping Nie, Lei Zhen, Huang-Tai Miao, Hong-Mei Ren, Shu-Tian Shi, Xing-Xin Wu
Journal: Journal of the American College of Cardiology (2014)