tbuckley/cabot-search huggingface dataset:
Population Strategies to Decrease Sodium Intake
Authors: Mihaly Tapolyai
Journal: Annals of Internal Medicine (2010)

Letters17 August 2010Population Strategies to Decrease Sodium IntakeMihaly Tapolyai, MDMihaly Tapolyai, MDFrom University of Hawaii Postgraduate Medical Program Chubu Hospital, Okinawa 904-2293, Japan.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-4-201008170-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Smith-Spangler and colleagues (1) strategize how to reduce dietary sodium in entire populations and countries for the benefits they assume will result. Unfortunately, their assumptions are incorrect. They state that “sodium consumption raises blood pressure, increasing the risk for heart attack and stroke.” This is true only in a small percentage of the population. Most persons (especially white persons) are not salt-sensitive, as shown in a Cochrane review (2), and salt restriction does not achieve better survival, as shown in NHANES I (First National Health and Nutrition Examination Survey) (3), although it may reduce blood pressure somewhat. ...References1. Smith-Spangler CM, Juusola JL, Enns EA, Owens DK, Garber AM. Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis. Ann Intern Med. 2010;152:481-7, W170-3. [PMID: 20194225] LinkGoogle Scholar2. Jürgens G, Graudal . Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. Cochrane Database Syst Rev. 2004;:CD004022. [PMID: 14974053] MedlineGoogle Scholar3. Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I). Lancet. 1998;351:781-5. [PMID: 9519949] CrossrefMedlineGoogle Scholar4. Calò LA. Revisiting essential hypertension—a “mechanism-based” approach may argue for a better definition of hypertension [Editorial]. Clin Nephrol. 2009;72:83-6. [PMID: 19640364] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Hawaii Postgraduate Medical Program Chubu Hospital, Okinawa 904-2293, Japan.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPopulation Strategies to Decrease Sodium Intake and the Burden of Cardiovascular Disease Crystal M. Smith-Spangler , Jessie L. Juusola , Eva A. Enns , Douglas K. Owens , and Alan M. Garber Population Strategies to Decrease Sodium Intake Puneet Narayan and Anubhav Kumar Population Strategies to Decrease Sodium Intake Crystal M. Smith-Spangler , Douglas K. Owens , and Alan M. Garber Metrics 17 August 2010Volume 153, Issue 4Page: 276KeywordsBlood pressureConflicts of interestHealth surveysHypertensionLife expectancyMyocardial infarctionNutritionSaltsSodiumStroke ePublished: 17 August 2010 Issue Published: 17 August 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Focal Uptake in the Capitate Bone Secondary to Erosive Seronegative Arthropathy Misdiagnosed as Fracture
Authors: Andrew Carter, Siri Kannangara, Pon Ketheswaran, Kevin L. Tay, Clayton J. Frater, Hans Van der Wall
Journal: Clinical Nuclear Medicine (2008)

Bone scintigraphy of the wrist is often performed for the investigation of suspected occult trauma or chronic regional pain syndrome. Focal uptake in carpal bones is invariably diagnosed as fracture but may rarely be secondary to other unexpected conditions. We present a case of focal uptake in the capitate bone secondary to erosion as the first presentation of psoriatic arthropathy. The atypical feature that alerted the alternate possibility was relative photopenia of the capitate in the blood pool image, although there was intense uptake in the capitate in the delayed planar image, which was the basis of the initial diagnosis of a fracture. MRI confirmed the diagnosis of large capitate erosion. Imaging of erosive disease of the carpal bones has only previously been described with rheumatoid arthritis in the scintigraphic literature.
Human placental thyroxine inner ring monodeiodinase in complicated pregnancy
Authors: Katsumi Yoshida, Michiko Suzuki, Toshiro Sakurada, Osamu Shinkawa, Tomomi Takahashi, Nobuaki Furuhashi, Nobuko Kaise, Kazuro Kaise, Hirofumi Kitaoka, Hiroshi Fukazawa, Takashi Nomura, Yoichi Itagaki, Makiko Yamamoto, Shintaro Saito, Kaoru Yoshinaga
Journal: Metabolism (1985)
Improved Skull Tongs
Authors: W. Gayle Crutchfield
Journal: JAMA (1965)

<h3>To the Editor:—</h3> The purpose of this paper is to describe significant improvements in the design of the Crutchfield skull tongs. After examining many skull tongs and drill bits of my basic design produced by various manufacturers, it became apparent why there were complaints about some of the instruments pulling out of the skull. There was a wide variation in the size and shape of the pins and some of the drill bits were too small to be used for the satisfactory application of any instrument. Basically, the modified skull tongs are essentially the same as the original ones made in 1935, the significant difference being in the pins, which now provide a firmer grasp and therefore should eliminate the "pulling out problem" when used under normal circumstances. The modified pins can be installed in most of the stainless steel instruments made since 1935 that have a minimum spread of
Mechanism of intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH)
Authors: Hideki Nakakuma
Journal: American Journal of Hematology (1996)

Paroxysmal nocturnal hemoglobinuria (PNH) hemolysis requires both intravascular complement activation and affected erythrocytes susceptible to complement. This susceptibility is explained by a deficiency in complement regulatory membrane proteins that are attached to the membrane by a glycosylphosphatidylinositol (GPI) anchor. Affected cells lack a series of GPI-anchored membrane proteins with various functions. The lack is caused by a synthetic defect of the anchor due to an impaired transfer of N-acetylglucosamine to phosphatidylinositol which is an early metabolic precursor in the anchor synthesis. Moreover, PIG-A gene responsible for the membrane defect was recently cloned. Further, a possible mechanism of complement activation has been proposed, especially for an infection-induced hemolytic precipitation which is clinically crucial. Thus, the molecular events, leading to intravascular hemolysis characteristic of PNH, has been virtually clarified. Next major concern is the nature of PIG-A: How does PIG-A explain the complex pathophysiology of PNH which exhibits various clinical manifestations? © 1996 Wiley-Liss, Inc.
Electrophysiological Actions of Diphenylhydantoin on Rabbit Atria
Authors: R. A. JENSEN, B. G. KATZUNG
Journal: Circulation Research (1970)

Isolated rabbit left atrial preparations were perfused with Tyrode's solutions containing 1 to 10 µg/ml (4 x 10 -6 -4 x 10 -5 M) diphenylhydantoin (DPH), 2.6-5.6 mM K + , and 154-308 mM Na + . Steady-state transmembrane resting and action potentials were recorded from these preparations with glass microelectrodes at stimulation rates ranging from 0.2 to 3/sec. DPH had little or no effect on the relationship between extracellular [K + ] and membrane resting potential. Action potential overshoot was generally decreased by 5 and 10 µg/ml DPH and increased by 1 µg/ml DPH at stimulation rates of 2 and 3/sec in the presence of increased [K + ]. DPH and increased [K + ] acted synergistically to shorten action potential duration (measured at 50% repolarization). The effect of DPH on phase 0 of the action potential (measured as action potential rise time between 10 and 50% and 50 and 90% depolarization) was markedly dependent upon drug concentration, extracellular [K + ] and stimulation rate. The lowest concentration of DPH (1 µg/ml) usually shortened action potential rise time, particularly when it had been prolonged by increasing extracellular [K + ]. Conversely, the highest concentration of DPH (10 µg/ml) and increased [K + ] acted synergistically to prolong action potential rise time (i.e., decrease depolarization rate). When present, the depressant effect of DPH on membrane depolarization was rapidly antagonized by increasing extracellular [Na + ]. It is proposed that DPH may either enhance or depress (like quinidine) membrane activity in atrial tissue, and that both the direction and magnitude of effect are strongly dependent upon drug concentration, ionic milieu, and heart rate.
Abstract 44: Enhancement endometrial cancer cells malignant transformation by mutual interaction with mesenchymal stem cells through TGF-beta and SDF-1 signaling pathways
Authors: Dah-Ching Ding, Tang-Yuan Chu
Journal: Cancer Research (2012)

Abstract Designated to cyclic shedding, endometrial glandular stroma is rich for mesenchymal stem cells and may play crucial roles in cancer invasion. This study aimed to explore the interaction between endometrial cancer cells and endometrial mesenchymal stem cells (HEMSC). HEMSC were derived from human endometrium and were co-cultured with RL95-2 endometrial cancer cells. Transformation phenotypes including proliferation, migration, anchorage independent growth, colony formation and invasion were characterized. Cancer associated transforming growth factor (TGF)-beta1 and mesenchymal cell associated stromal cell-derived factor (SDF) and their down-stream signaling pathways were investigated. HEMSC had a similar surface marker profile as bone marrow mesenchymal stem cells, i.e. CD44(+), CD90(+) and CD34(-) and CD45(-) and readily be inducible to osteogenic and adipogenic differentiations. Upon coculture with HEMSC, RL95-2 cell secreted TGF-beta 1 which subsequently induced SDF1 secretion from HEMSC. The mutual interaction of these factors is associated with enhancement of cancer cell migration through the CXCR4 receptor and downstream transducer and activator of Stat3, with resulting over-expression of alpha-SMA and cytoskeleton re-organization. The study observed unprecedented interactions between cancer cells and mesenchymal stem cells with resulting enhancement of malignant transformation through mutual activation of cytokines and downstream signals. Mesenchymal stem cells either in adjacent to the lesion or home to the lesion can therefore be important activators of carcinogenesis and good therapeutic targets. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 44. doi:1538-7445.AM2012-44
Portopulmonary hypertension in decompensated cirrhosis with refractory ascites
Authors: F S Benjaminov
Journal: Gut (2003)

<b>Background:</b> The prevalence of portopulmonary hypertension (PPHTN) in patients with cirrhosis and refractory ascites is unknown. Its presence may preclude patients from receiving a transjugular intrahepatic portosystemic shunt or liver transplantation as a definitive treatment for their end stage cirrhosis. <b>Purpose:</b> To determine the prevalence, possible aetiological factors, and predictive factors for the development of PPHTN in these patients. <b>Methods:</b> Sixty two patients (53 males, nine females; mean age 54.5 (1.4) years) with biopsy proven cirrhosis and refractory ascites underwent angiographic measurements of pulmonary and splanchnic haemodynamics. Endothelin 1 levels were measured from the pulmonary artery. Forty nine patients underwent radionuclide angiography for measurements of central blood volume, pulmonary vascular, and cardiac chamber volumes. Forty seven patients also underwent two dimensional echocardiography for measurements of cardiac structural and functional parameters. Cardiac output, and systemic and pulmonary vascular resistance were calculated. <b>Results:</b> Ten patients (16.1%) fulfilled the criteria for PPHTN (mean pulmonary artery pressure ≥25 mm Hg and pulmonary vascular resistance ≥120 dyn×s/cm<sup>5</sup>), with significantly higher mean right atrial (15.4 (1.2) <i>v</i> 7.9 (0.5) mm Hg; p&lt;0.001), and right ventricular pressures (24.7 (1.5) <i>v</i> 14.7 (0.6) mm Hg; p&lt;0.001), and endothelin 1 levels (3.04 (0.40) <i>v</i> 1.98 (0.12) pg/ml; p=0.02). No significant differences in any of the other parameters measured were detected between the two groups. A right atrial pressure of ≥14 mm Hg had a 83% positive predictive value for the presence of PPHTN. <b>Conclusions:</b> Portopulmonary hypertension is common in cirrhosis with refractory ascites, possibly due to excess endothelin 1 in the pulmonary circulation. An elevated right atrial pressure ≥14 mm Hg predicts the presence of PPHTN, which may be helpful in deciding management options in these patients.
Studies on the mechanism of action of unsaturated fats on cholesterol metabolism in the rabbit.
Authors: F A Bieberdorf, J D Wilson
Journal: Journal of Clinical Investigation (1965)

The diet, which was obtained from General Bio- chemicals, Chagrin Falls, Ohio, contained 21% vitamin- free casein, 58% sucrose, 16%o non-nutritive fiber, 4% U.S.P. XIV salt mix, and added vitamins in mg per 100 g of diet: a-tocopherol 10, calcium pantothenate 2, choline chloride 272, inositol 300, menadione 0.1, niacin 27, pyridoxine hydrochloride 0.95, riboflavin 0.95, thiamine hydrochloride 0.95, vitamin A 4.5, vitamin D 3.0, ascorbic acid 0.3, p-aminobenzoic acid 0.2, folic acid 0.
Infections in sport
Authors: R E Meigh
Journal: BMJ (1994)

we took the average cost for a specialty as a starting point.Day cases were included in this cost.Korner data for 1990-1 were used to estimate outpatient activity, but later data were used when available.We agree on the shortcomings of these data, but in North Thames region KMmer data are the main source of information on outpatients.The cost of each outpatient attendance was taken from work by the Department of Health.'Until out- patient care is contracted for separately, it may not be possible to move far from such gross assumptions.We welcome advice to help improve our methods.Consistent biases can produce consistent results.But, as shown above, it is not clear in which direction biases may have operated in our study.A working party with representatives from health authorities in North Thames Regional Health Authority is now developing the methodology further.Also under discussion is whether health authorities should contract separately for fundholding-type hospital care.We agree that estimating and comparing the prices paid by fundholders and health authorities are difficult and that a more detailed analysis is needed.The data illustrated in our paper suggested that prices between fundholders and health authorities were different within specific health agencies but not across the region as a whole.It is therefore difficult to make the case that fundholders were systematically charged more than health authorities.Finally, we believe that our analysis was as robust as was possible with current data and in the time available.While it would be easy to wait for perfect methods and perfect data, decisions about funding for fundholders are being made with little knowledge of the impact on health authorities.We hope that others will see the importance of investigating this issue without delay, especially as fundholding is extended.
Evaluation of the Spatial Aspects of T-Wave Complexity in the Long-QT Syndrome
Authors: Silvia G. Priori, David W. Mortara, Carlo Napolitano, Livia Diehl, Vincenzo Paganini, Francesco Cantù, Giacomo Cantù, Peter J. Schwartz
Journal: Circulation (1997)

The duration of the QT interval is only a gross estimate of repolarization. Besides its limited accuracy and reproducibility, it does not provide information on the morphology of the T wave; thus, morphologic alterations such as notches can be only qualitatively described but not objectively quantified.To measure the complexity of repolarization in the long-QT syndrome (LQTS) patients, we previously applied principal component analysis to body surface mapping and found it useful in distinguishing normal from abnormal repolarization patterns (sensitivity, 87%). In the present study, we applied principal component analysis to 12-lead Holter recordings. The index of complexity of repolarization that we have developed (CR24h) reflects the average 24-hour complexity of repolarization and is mathematically defined as the average ratio between the second and the first eigenvalue. We studied 36 LQTS patients and 40 control subjects. A mean of 22+/-1.3 ECG recordings at 1-hour intervals was used in each patient, and a total of 1655 recordings were analyzed. CR24h was significantly higher in LQTS than in control subjects (34+/-12% versus 13+/-3%; P<.0001). A CR24h exceeding 2 SD above the mean of the control group (>20%) was present in 32 of 36 patients (88%). The negative predictive value of CR24h in LQTS was 88%, and the combination of prolonged QT and abnormal CR24h identified all LQTS patients from normal subjects, including 4 affected symptomatic individuals with a normal QT interval duration, suggesting that CR24h provides information independent of QT duration.Our data suggest that principal component analysis applied to 24-hour, 12-lead Holter recording adequately quantifies the complexity of ventricular repolarization and may become a useful noninvasive diagnostic tool in LQTS.
Transcellular water flow modulates water channel exocytosis and endocytosis in kidney collecting tubule.
Authors: M Kuwahara, L B Shi, F Marumo, A S Verkman
Journal: Journal of Clinical Investigation (1991)

The regulation of osmotic water permeability (Pf) by vasopressin (VP) in kidney collecting tubule involves the exocytic-endocytic trafficking of vesicles containing water channels between an intracellular compartment and apical plasma membrane. To examine effects of transcellular water flow on vesicle movement, Pf was measured with 1-s time resolution in the isolated perfused rabbit cortical collecting tubule in response to addition and removal of VP (250 microU/ml) in the presence of bath greater than lumen (B greater than L), lumen greater than bath (L greater than B), and lumen = bath (L = B) osmolalities. With VP addition, Pf increased from 12 to 240-270 x 10(-4) cm/s (37 degrees C) in 10 min. At 1 min, Pf was approximately 70 x 10(-4) cm/s for B greater than L, L greater than B, and L = B conditions. At later times, Pf increased fastest for L greater than B and slowest for B greater than L osmolalities; at 5 min, Pf was 250 x 10(-4) cm/s (L greater than B) and 158 x 10(-4) cm/s (B greater than L). With VP removal, Pf returned to pre-VP levels at the fastest rate for B greater than L and the slowest rate for L greater than B osmolalities; at 30 min, Pf was 65 x 10(-4) cm/s (B greater than L) and 183 x 10(-4) cm/s (L greater than B). For a series of osmotic gradients of different magnitudes and directions, the rates of Pf increase and decrease were dependent upon the magnitude of transcellular volume flow; control studies showed that paracellular water flux, asymmetric transcellular water pathways, or changes in cell volume could not account for the data. VP-dependent endocytosis was measured by apical uptake of rhodamine-dextran; in paired studies where the same tubule was used for + and - gradients, B greater than L and L greater than B osmolalities gave 168% and 82% of uptake measured with no gradient. In contrast, endocytosis in proximal tubule was not dependent on gradient direction. These data provide evidence that transcellular volume flow modulates the vasopressin-dependent cycling of vesicles containing water channels, suggesting a novel driving mechanism to aid or oppose the targeted, hormonally directed movement of subcellular membranes.
Diet and physical exercise in psoriasis: a randomized controlled trial
Authors: L. Naldi, A. Conti, S. Cazzaniga, A. Patrizi, M. Pazzaglia, A. Lanzoni, L. Veneziano, G. Pellacani
Journal: British Journal of Dermatology (2013)

Increased body mass index and weight gain are risk factors for psoriasis, and the prevalence of obesity in patients with psoriasis is higher than in the general population. Limited data exist regarding the role of diet in psoriasis. To assess the impact of a dietary intervention combined with physical exercise for weight loss on improving psoriasis in overweight or obese patients. This study included 303 overweight or obese patients with moderate‐to‐severe chronic plaque psoriasis who did not achieve clearance after 4 weeks of continuous systemic treatment. They were randomized to receive either a 20‐week quantitative and qualitative dietary plan associated with physical exercise for weight loss or simple informative counselling at baseline about the utility of weight loss for clinical control of psoriatic disease. The main outcome was any reduction of the Psoriasis Area and Severity Index (PASI) from baseline to week 20. Intention‐to‐treat analysis showed a median PASI reduction of 48% (95% confidence interval 33·3–58·3%) in the dietary intervention arm and 25·5% (95% confidence interval 18·2–33·3%) in the information‐only arm (P =0·02). Among secondary outcomes, PASI score reduction of ≥ 50% significantly differed between study arms (49·7% with dietary intervention vs. 34·2% with information only, P =0·006). The weight‐loss target (a ≥ 5% reduction from baseline) was reached by 29·8% of patients in the dietary intervention arm compared with 14·5% in the information‐only arm (P =0·001). A 20‐week dietetic intervention associated with increased physical exercise reduced psoriasis severity in systemically treated overweight or obese patients with active psoriasis.
Multiple organ failure after trauma
Authors: R. Saadia, J. Lipman
Journal: BMJ (1996)

The concept of multiple organ failure dates back to the 1970s,1 but it has recently been redefined as “the progressive (and sometimes sequential) dysfunction of physiologic systems in the presence of a clinical picture of systemic sepsis.”2 Multiple organ failure is often caused by the “systemic inflammatory response syndrome” (SIRS).3 A patient who has been severely injured and has survived initial resuscitation may develop the features of the systemic inflammatory response syndrome and may then deteriorate with features of multiple organ failure, which is often fatal. Despite an enormous amount of experimental and clinical research, a definitive, all encompassing theory accounting for the link between trauma and multiple organ failure has not yet emerged.

Twenty years ago few people doubted the link with infection. The belief was that trauma led to multiple organ failure as a result of unsuspected or uncontrolled infection, and an intra-abdominal abscess4 was most frequently incriminated as the trigger. The adverse clinical course usually started with the acute respiratory distress syndrome and led to the patient's death despite intensive system support. Based on these observations, an aggressive surgical policy …
Stones associated with leg ulcers.
Authors: P. G. Flanagan, R. W. Stout, J. T. Lawson
Journal: BMJ (1989)

Hepatobiliary candidiasis in chronic lymphatic leukaemiaA 64 year old woman with longstanding chronic lymphatic leukaemia presented after six weeks' fever and cough.On examination she had a fever and severe oral candidiasis, signs of pneumonia, mild jaundice, and tender hepatomegaly.A chest x ray film showed bilateral interstitial pneumonia.Ultrasonography and subsequent endoscopic retrograde cholangiopancreatographic examination showed a widespread intraductal biliary cast (white arrows) and multiple small communicating microabscesses (black arrows) (figure).Ultra- sound guided biopsy and microscopy showed fungal mycelia, later identified as Candida albicans.Despite intensive antifungal treat-