tbuckley/cabot-search huggingface dataset:
Absence of Increased Frequency of Bone and Joint Disease with Hemoglobin AS and AC
Authors: BONNIE B. DORWART
Journal: Annals of Internal Medicine (1977)

Letters1 January 1977Absence of Increased Frequency of Bone and Joint Disease with Hemoglobin AS and ACBONNIE B. DORWART, M.D., F.A.C.P., MARC A. GOLDBERG, M.D., H. RALPH SCHUMACHER, M.D., F.A.C.P., ABASS ALAVI, M.D.BONNIE B. DORWART, M.D., F.A.C.P.Search for more papers by this author, MARC A. GOLDBERG, M.D.Search for more papers by this author, H. RALPH SCHUMACHER, M.D., F.A.C.P.Search for more papers by this author, ABASS ALAVI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-1-66 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptBone and joint disease with hemoglobin SS, hemoglobin SC, and S-thalassemia has been well documented and includes aseptic necrosis, medullary bone infarcts, periostitis, and articular involvement (1). In sickle cell trait (hemoglobin AS) sporadic cases of aseptic necrosis have been reported (2). No studies of the prevalence of joint abnormalities in sickle trait compared with age-matched controls having AA hemoglobin have, however, been published. We report on such a study of 94 patients with hemoglobin AS, 20 with hemoglobin AC, and 114 controls with normal AA hemoglobin.All black patients admitted to the Philadelphia Veterans Administration Hospital for 15 months...References1. SCHUMACHERANDREWSMCLAUGHLIN HRG: Arthropathy in sickle-cell disease. Ann Intern Med 78:203-211, 1973 LinkGoogle Scholar2. NACHAMIEDORFMAN BH: Ischemic necrosis of bone in sickle cell trait. Mt Sinai J Med NY 41:527-536, 1974 MedlineGoogle Scholar3. ALAVISCHUMACHERDORWART AHB: Bone marrow scan evaluation of arthropathy in sickle cell disorders. Arch Intern Med 136:436-440, 1976 CrossrefMedlineGoogle Scholar4. BONDZI-SIMPSON B: Clinical, pathological and radiological features of sickle cell trait. J Trop Med Hyg 65:269-275, 1962 Google Scholar5. MURPHY J: Sickle cell hemoglobin (Hb AS) in black football players. JAMA 225:981-982, 1973 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Veterans Administration Hospital Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHematologic ArthritisMultifocal osteonecrosis secondary to occupational exposure to aluminumHematologic ArthritisRetinopathy in sickle cell trait: Does it exist?Rheumatological complications of sickle cell diseaseOsteoarticular manifestations in sickle-cell disordersThe morbidity of sickle cell trait 1 January 1977Volume 86, Issue 1Page: 66-67KeywordsBoneHemoglobinNecrosis Issue Published: 1 January 1977 PDF DownloadLoading ...
Assessing palliative care is difficult
Authors: C. Salisbury
Journal: BMJ (2000)

EDITOR—Keeley rehearses the problems of recruitment, attrition, data collection, and ethical concerns which make research on palliative care so difficult.1 We recently conducted a comprehensive systematic review of the evidence for the effectiveness of different models of palliative care, commissioned by the NHS Executive.2–4

Our team reviewed more than …
Gallbladder polyps in primary sclerosing cholangitis: Indication for early intervention
Authors: Christoph Schramm, Ansgar W. Lohse
Journal: Hepatology (2012)

We congratulate the investigators for their comprehensive review on cancer surveillance in patients with primary sclerosing cholangitis (PSC).1 Annual ultrasound (US) examinations have been proposed by the American2 as well as European practice guidelines,3 and cholecystectomy is recommended for gallbladder (GB) polyps detected independent of their size. In their current review, Razumilava et al. discuss an alternative strategy consisting of repeat imaging every 3-6 months for the surveillance of polyps of less than 8 mm in size.1 This strategy is based on reports that most GB cancers detected in patients with PSC arise in polyps well above this size.4, 5 We here report on 2 of our patients with GB polyps detected by regular imaging surveillance within the last year. The first patient is a 38-year-old male with a 10-year history of PSC. A 6-mm GB polyp was detected on surveillance US. The patient was advised to have a follow up US within 3-4 months and actually presented 6 months later. The polyp had grown to a size of 4 × 2 cm. Surgery revealed an advanced GB adenocarcinoma with multiple small bilobar liver metastases. The second patient is a 44-year-old male with a 6-year history of PSC. He presented with a 1.6-cm GB polyp 8 months after having received magnetic resonance imaging of his liver without any pathology of the GB. Cholecystectomy revealed a tubular adenoma with focal high-grade dysplasia. These 2 cases underline that GB polyps may grow rapidly in patients with PSC. The first patient might have been cured if immediate cholecystectomy had been performed, as recommended by our current guidelines. The second patient might have developed GB cancer if a longer surveillance interval had been chosen. Yearly surveillance examinations, as recommended by the current guidelines, may not be appropriate in this high-risk population. We now recommend for our patients surveillance intervals of 6 months. More important, we should be cautious not to delay cholecystectomy in a patient with PSC and a GB polyp independent of its size, unless surgical risk far outweighs the benefit of potentially preventing a deadly cancer. Christoph Schramm M.D.*, Ansgar W. Lohse M.D.*, * Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
David Rall: screening for future surprises
Authors: William Check
Journal: JAMA (1979)

Congressional legislation calling for comprehensive toxicity testing of chemicals and the almost simultaneous formation of the National Toxicology Program (NTP) last November signal the heightening interest in the screening of chemicals to prevent public health problems. The NTP will coordinate activities in toxicology by four government agencies—the National Institute of Environmental Health Science (NIEHS), the National Cancer Institute (NCI), the Food and Drug Administration (FDA), and the National Institute of Occupational Safety and Health (NIOSH). At the center is David Rall, MD, PhD, director of NIEHS, who has been chosen to head the NTP while remaining in his NIEHS post. With a background in pharmacology, Rall, now 52, spent some early years at the NCI where he became interested in testing for toxic effects of anticancer drugs. He was associate director of the institute for a time and then, in 1971, was tapped to be director of the NIEHS. As
The implications for health of European Union enlargement
Authors: Martin McKee, Ellen Nolte
Journal: BMJ (2004)

Challenges and opportunities lie ahead 

The European Union has come a long way from its beginnings in 1957 when six countries signed the Treaty of Rome, committing themselves “to lay the foundations of an ever closer union among the peoples of Europe.”1 This aspiration has become reality. The original grouping has widened progressively, to include most of western Europe. It has also deepened, extending beyond coal and steel production to an entity with its own flag, foreign policy, currency, and laws that impinge on almost all areas of daily life. On 1 May 2004 the European Union will undergo the latest stage in its evolution over the years as 10 new countries join it. What impact will this enlargement have on health and health policy?

Although this is only the latest of a series of enlargements, this one is very different from those that have gone before. The most obvious difference is its scale. Earlier enlargements added between one and three countries; this one brings 10, increasing the European Union's surface area by 34% and its population by 28%. A second difference is the …
Peripheral blood features of acute myeloid leukemia with myelodysplasia‐related changes developing in a patient with sickle cell anemia
Authors: Sophie Zemenides, Thomas Erblich, Asad Luqmani, Barbara J. Bain
Journal: American Journal of Hematology (2014)

We classified this case as acute myeloid leukemia (AML) with myelodysplasia-related changes since blast cells were more than 20% of non-erythroid cells in the bone marrow, and there was bilineage dysplasia and a complex cytogenetic abnormality. This diagnosis had been suspected from the blood film features. A small number of cases of myeloid neoplasms have been reported in patients with sickle cell anemia treated with hydroxycarbamide but no causal relationship has been demonstrated. Our patient, who had not received this drug, is a reminder that, as the life expectancy of these patients increases, more cases of AML and related neoplasms are likely to be seen regardless of such therapy.
Lungs Don’t Forget: Comparison of the KRAS and EGFR Mutation Profile and Survival of Collegiate Smokers and Never Smokers with Advanced Lung Cancers
Authors: Anna M. Varghese, Camelia S. Sima, Jamie E. Chaft, Melissa L. Johnson, Gregory J. Riely, Marc Ladanyi, Mark G. Kris
Journal: Journal of Thoracic Oncology (2012)
NF-κB Is a Key Mediator of Cerebral Aneurysm Formation
Authors: Tomohiro Aoki, Hiroharu Kataoka, Munehisa Shimamura, Hironori Nakagami, Kouji Wakayama, Takuya Moriwaki, Ryota Ishibashi, Kazuhiko Nozaki, Ryuichi Morishita, Nobuo Hashimoto
Journal: Circulation (2007)

Background— Subarachnoid hemorrhage caused by the rupture of cerebral aneurysm (CA) remains a life-threatening disease despite recent diagnostic and therapeutic advancements. Recent studies strongly suggest the active participation of macrophage-mediated chronic inflammatory response in the pathogenesis of CA. We examined the role of nuclear factor-κB (NF-κB) in the pathogenesis of CA formation in this study. Methods and Results— In experimentally induced CAs in rats, NF-κB was activated in cerebral arterial walls in the early stage of aneurysm formation with upregulated expression of downstream genes. NF-κB p50 subunit–deficient mice showed a decreased incidence of CA formation with less macrophage infiltration into the arterial wall. NF-κB decoy oligodeoxynucleotide also prevented CA formation when it was administered at the early stage of aneurysm formation in rats. Macrophage infiltration and expression of downstream genes were dramatically inhibited by NF-κB decoy oligodeoxynucleotide. In human CA walls, NF-κB also was activated, especially in the intima. Conclusions— Our data indicate that NF-κB plays a crucial role as a key regulator in the initiation of CA development by inducing some inflammatory genes related to macrophage recruitment and activation. NF-κB may represent a therapeutic target of a novel medical treatment for CA.
Evolution of sea urchin retroviral-like (SURL) elements: evidence from 40 echinoid species
Authors: P. Gonzalez, H. A. Lessios
Journal: Molecular Biology and Evolution (1999)

We conducted a phylogenetic survey of sea urchin retroviral-like (SURL) retrotransposable elements in 33 species of the class Echinoidea (sea urchins, sand dollars, and heart urchins). A 263-bp fragment from the coding region of the reverse transcriptase (RT) gene was amplified, cloned, and sequenced. Phylogenetic relationships of the elements isolated from independent clones, along with those from seven additional echinoid species obtained earlier by Springer et al., were compared with host phylogeny. Vertical transmission and the presence of paralogous sequences that diverged prior to host speciation can explain most of the phylogenetic relationships among SURL elements. Rates of evolution were estimated from cases in which SURL and host phylogenies were concordant. In agreement with conclusions reached previously by Springer et al., average rates of synonymous substitution were comparable with those of single-copy sea urchin DNA. High ratios of synonymous to nonsynonymous substitution suggest that the RT of the elements is under strong purifying selection. However, a high proportion (approximately 15%) of elements with deleterious frameshifts and stop codons and an increase of the ratio of synonymous to nonsynonymous substitutions with divergence time show that in the short term this selection is relaxed. Despite the predominance of vertical transmission, sequence similarity of 83%-94% for SURL elements from hosts that have been separated for 200 Myr suggests four cases of apparent horizontal transfer between the ancestors of the extant echinoid species. In three additional cases, elements with identical RT sequences were found in sea urchin species separated for a minimum of 3 Myr. Thus, horizontal transfer plays a role in the evolution of this retrotransposon family.
THE CONCENTRATION OF CHOLESTEROL IN THE BLOOD SERUM OF NORMAL MAN AND ITS RELATION TO AGE 1
Authors: Ancel Keys, Olaf Mickelsen, Erma V.O. Miller, E. Russell Hayes, Ramona L. Todd
Journal: Journal of Clinical Investigation (1950)

Measurements of blood cholesterol are ordi- narily made for the purpose of comparing the values obtained for the particular individuals, usually prospective or actual patients, with some reference standard.In most cases the reference standard is a value or range of values supposed to represent the "normal" person; sometimes the reference point is a value obtained on some pre- vious occasion from the individual in question.In the latter case, the assumption is implicit that the natural variability of the individual is either negligible or is taken into account in the interpre- tation; in practice this assumption is seldom war- ranted.In the former case, the same assumption enters but an additional assumption is that there is, in fact, a valid reference standard at hand and that this properly defines the normal person or population with which the examinee is to be compared.Scrutiny of the literature, however, suggests that the basic data so far available are inadequate for these reference purposes except where very large deviations are involved.The present paper attempts to provide the bases for more precise evaluation of total blood serum cholesterol de- terminations in persons of various ages.For this purpose we have made about 5000 measurements of serum total cholesterol on 2056 persons known to be physically "normal."These data were ob- tained in two independent research projects cov- ering the years 1947-1949.
Evidence for a local sympathetic venoarteriolar "reflex" in the dog hindleg.
Authors: O Henriksen, O Amtorp, I Faris, K Agerskov
Journal: Circulation Research (1983)

The study was performed in order to determine whether a local sympathetic venoarteriolar "reflex" is present in the dog hindleg. Femoral artery blood flow was measured by an electromagnetic flowmeter probe, and blood flow in the thigh muscle and subcutaneous tissue distally in the paw was measured by the local 133Xe washout technique. Twenty experiments were carried out in seven dogs unilaterally sympathectomized 2-4 weeks previously. Resting vascular tone did not differ in the sympathectomized and nonsympathectomized legs. In the control leg, venous pressure elevation caused a decrease in femoral blood flow of 49% corresponding to an increase in vascular resistance of 58%. In muscle and subcutaneous tissue vascular resistance increased by 81% and 35%, respectively. In the denervated leg, venous stasis caused no change in total vascular resistance. In muscle the vascular resistance increased by only 24%. In subcutaneous tissue, vascular resistance decreased by 12%. The effect of acute lumbar sympathectomy was studied in another group of seven dogs. Operation caused an immediate decrease in vascular resistance of 40%. The increase in vascular resistance during venous stasis in the total leg, as well as in muscle and subcutaneous tissue, was not affected. However, acute lumbar sympathectomy combined with injection of phenoxybenzamine into the femoral artery almost abolished the vasoconstriction induced by venous stasis. In muscle, the increase in vascular resistance was still present, but considerably attenuated. In subcutaneous tissue, the normal response was completely blocked. Finally, local suction induced vasoconstriction in an adjoining area not subjected to changes in vascular transmural pressure, an effect that could be blocked by local neural blockade at the site of suction. The results strongly suggest that a local sympathetic veno-arteriolar (axon) "reflex" is present in muscle and subcutaneous tissue in the dog hindleg.
Pharmacological Modulation of the Human Collateral Vascular Resistance in Acute and Chronic Coronary Occlusion Assessed by Intracoronary Blood Flow Velocity Analysis in an Angioplasty Model
Authors: Jan J. Piek, Rob A. M. van Liebergen, Karel T. Koch, Rob J. de Winter, Ron J. G. Peters, George K. David
Journal: Circulation (1997)

Background The pharmacological responsiveness of the coronary collateral circulation in humans has been studied only by indirect means. Methods and Results Patients with one-vessel disease and recruitable (n=14) or spontaneously visible (n=24) collateral vessels were studied during coronary angioplasty. Collateral flow in the recipient coronary artery was determined with a 0.014-in Doppler guide wire during balloon coronary occlusion and expressed as the diastolic blood flow velocity integral (dVi). Collateral blood flow velocity, mean aortic pressure (Pao), and coronary wedge pressure (Pw) were used to calculate the collateral vascular resistance index: Rcoll=(Pao−Pw)/dVi (mm Hg/cm) and the peripheral vascular resistance index of the recipient coronary artery: R4=Pw/dVi (mm Hg/cm). Adenosine (12 to 18 μg) and nitroglycerin (0.2 mg) were injected as a bolus in the donor coronary artery during subsequent balloon inflations to assess their effect on these hemodynamic variables. The administration of adenosine or nitroglycerin in patients with recruitable collateral vessels did not induce a change in dVi and Pw/Pao ratio. In patients with spontaneously visible collateral vessels, dVi increased from 8.0±4.5 to 10.8±8.0 cm ( P =.01) after adenosine and from 7.4±4.5 to 10.3±6.9 cm ( P =.003) after nitroglycerin. The Pw/Pao ratio remained unchanged after adenosine and nitroglycerin. Rcoll decreased from 10.3±9.5 to 8.6±8.5 mm Hg/cm ( P =.01) after adenosine and from 11.6±10.4 to 8.3±8.9 mm Hg/cm ( P &lt;.001) after nitroglycerin. R4 decreased from 7.7±5.5 to 5.9±5.1 mm Hg/cm ( P &lt;.001) after adenosine and from 8.4±6.6 to 7.1±7.2 mm Hg/cm ( P =.01) after nitroglycerin. Conclusions Coronary collateral blood flow can be increased with adenosine and nitroglycerin in patients with one-vessel disease and spontaneously visible collateral vessels, which is in contrast to patients with recruitable collateral vessels. This effect is the result of a reduction in the collateral vascular resistance and peripheral vascular resistance of the recipient coronary artery.
Hepatitis C Is a Predictor of Poorer Renal Survival in Diabetic Patients
Authors: Errol D. Crook, Sreelatha Penumalee, Bharathi Gavini, Kseniya Filippova
Journal: Diabetes Care (2005)

OBJECTIVE—Hepatitis C virus (HCV) is highly prevalent in the U.S. and worsens renal survival in some kidney diseases. We examined the effects of HCV on renal survival in diabetic patients with renal disease. RESEARCH DESIGN AND METHODS—HCV and diabetes status were noted in patients seen in our nephrology clinic in 2001 and 2002. Charts of diabetic patients were reviewed for demographics, blood pressure, renal function, medicines, the presence of HCV, and other factors at the initial visit and over follow-up. The effect of HCV on renal survival was determined by Cox proportional hazards, using end-stage renal disease (ESRD) as an end point. RESULTS—Of 1,127 patients, prevalence rates for HCV were higher in African Americans than non–African Americans (8.09 vs. 3.93%, respectively, P = 0.06), with African-American men having the highest prevalence rates (12.7%). The charts of 312 diabetic patients were reviewed. Over 80% were African American, as were 23 of 24 patients with HCV. Compared with non-HCV patients, HCV patients were younger, had higher diastolic blood pressure, and had lower BMI. HCV patients had significantly worse cumulative renal survival by Kaplan-Meier. On Cox proportional hazards analysis, HCV was a significant predictor of reaching ESRD independent of initial renal function, proteinuria, blood pressure, sex, race, presence of diabetic nephropathy, age, or duration of diabetes (odds ratio 3.49, 95% CI 1.27–9.57, P = 0.015). CONCLUSIONS—HCV is common in African Americans with diabetes and renal disease and is an independent risk factor for renal survival in this population. Prospective studies are necessary to confirm these observations.
Crohn's Disease
Authors: Duane W. Taebel
Journal: JAMA (1973)

The protean clinical manifestations of Crohn disease require that all physicians have a rather intimate familiarity with it in order that such things as anemia, weight loss, fever, or vaguely described gastrointestinal complaints not be ascribed to other disease processes or, particularly, emotional states. Because of this broad presentation, a book detailing many of the current etiological, clinical, and therapeutic considerations has been most desired. As is indicated in the foreword by Dr. Burrill B. Crohn, the information thus far available has only been fractional and this book may be the most comprehensive thus far at hand. Fortunately, the author, a surgeon from Aberdeen, Scotland, has discussed the subject in an admirable and succinct fashion. He has obviously drawn on his own clinical experience, well documented with many of his own personal publications, and has augmented this experience with a comprehensive review of data from numerous other investigators. The extensive
Ictal and Interictal 99mTc-HMPAO Brain SPECT of a MELAS Case Presented With Epilepsy-like Visual Hallucination
Authors: Cheng-Yu Wei, Heng-Long Hsiao, Shang-Chi Chen, Guang-Uei Hung, Chia-Hung Kao
Journal: Clinical Nuclear Medicine (2012)

A 55-year-old woman was diagnosed with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). She was referred for Tc-HMPAO brain SPECT because of visual hallucinations, which were suspected to be related to epileptic seizures. Ictal SPECT images showed remarkable hyperperfusion in the left occipital cortex, which returned to near-normal status on the interictal SPECT images after treatment with anticonvulsants. It is very rare to see such an ictal SPECT image of epileptic or epilepsy-like disorders, especially in the setting of MELAS syndrome with visual hallucination.
IN VIVO STUDIES OF 5-HYDROXYINDOLE METABOLISM IN PATIENTS WITH HEPATIC CIRRHOSIS AND IN RATS*†
Authors: Robert M. Donaldson, Julian Arabehety, Seymour J. Gray
Journal: Journal of Clinical Investigation (1959)

Widespread interest in 5-hydroxytryptamine (5-HTA) as a biologically active amine and the close association between this substance and malig- nant carcinoidosis have led to detailed studies of the 5-hydroxyindole pathway of tryptophan me- tabolism in man and experimental animals (1-3).Tryptophan is apparently hydroxylated to form the serotonin precursor, 5-hydroxytryptophan(5-HTP) (1, 4).In the presence of a specific, pyridoxine-dependent decarboxylase, 5-HTP is readily decarboxylated in several tissues to form 5-HTA (5).Monoamine oxidase, which is found principally in gut, lung, liver, kidney and brain, catalyzes the oxidative deamination of 5-HTA to form 5-hydroxyindoleacetic acid (5-HIAA) (6, 7).Since both 5-HTP decarboxylase and monoamine oxidase have been demonstrated in liver tissue in vitro, investigation of 5-hydroxyindole metabolism in patients with hepatic cirrhosis was undertaken.The present report summarizes studies of 5-HTA and 5-HIAA excretion in the urine following the intravenous administration of vari- ous 5-hydroxyindole compounds in human sub- jects with and without hepatic cirrhosis and in rats.