tbuckley/cabot-search huggingface dataset:
Cystic Fibrosis in Adults
Authors: CHARLES ANDREWS
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 January 1978Cystic Fibrosis in AdultsCHARLES ANDREWS, M.D., MARTIN MANGO, M.D., ROCCO C. VENUTO, M.D., F.A.C.P.CHARLES ANDREWS, M.D.Search for more papers by this author, MARTIN MANGO, M.D.Search for more papers by this author, ROCCO C. VENUTO, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-1-128_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Stern and co-workers (1) have reviewed the adolescent and adult presentation of cystic fibrosis in the August issue (Ann Intern Med 87:188-191, 1977). An adult male was recently discovered to have cystic fibrosis after a unique clinical presentation not mentioned in the review article.A 42-year-old white man came to the emergency room complaining of several days of profuse sweating, muscle cramps, extreme thirst, and abdominal pain. These symptoms occurred during a period of sustained high ambient temperatures. He was consuming from three to five litres of water, beer, and fruit juices daily. He denied vomiting, diarrhea,...References1. STERNBOATDOERSHUKTUCKERMILLERMATTHEWS RTCARL: Cystic fibrosis diagnosed after age 13. Twenty-five teenage and adult patients including three asymptomatic men. Ann Intern Med 87:188-191, 1977 LinkGoogle Scholar2. SHWACHMANKOWALSKIKHAW HMK: Cystic fibrosis: a new outlook. 70 patients above 25 years of age. Medicine (Baltimore) 56:129-149, 1977 CrossrefMedlineGoogle Scholar3. WOODBOATDOERSHUK RTC: Cystic fibrosis. Am Rev Respir Dis 113:833-878, 1976 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Buffalo General Hospital Buffalo, NY 14203 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1978Volume 88, Issue 1Page: 128-129KeywordsAbdominal painAdolescentsBeerCystic fibrosisDiarrheaEmergency departmentMusclesTemperatureVomiting Issue Published: 1 January 1978 PDF DownloadLoading ...
Thrombotic thrombocytopenic purpura: Recovery after splenectomy associated with persistence of abnormally large von willebrand factor multimers
Authors: Jacob M. Rowe, Charles W. Francis, Elizabeth M. Cyran, Victor J. Marder
Journal: American Journal of Hematology (1985)

Abstract A patient with thrombotic thrombocytopenic purpura (TTP) responded transiently to four courses of plasma exchange therapy, then subsequently had a sustained completed remission following splenectomy. The von Willebrand factor multimeric pattern during remission following each plasma exchange and during the entire postsplenectomy period showed abnormally large forms that were not present on presentation and with each clinical relapse. These findings support prior observations regarding the presence of abnormal von Willebrand factor multimers in relapsing TTP and suggest that the multimers contribute to platelet aggregation and the thrombotic lesions. The association of sustained remission and persistence of the abnormally large plasma multimers after splenectomy suggests that this response was not coincidental. This supports the concept that a subgroup of patients with TTP may exist in which the pathophysiology of disease is significantly modulated by the spleen and in which splenectomy may induce long‐lasting remission.
Etiology of Right Bundle-Branch Block in Patients Undergoing Total Correction of Tetralogy of Fallot
Authors: HENRY GELBAND, ALBERT L. WALDO, GERARD A. KAISER, FREDERICK O. BOWMAN, JAMES R. MALM, BRIAN F. HOFFMAN
Journal: Circulation (1971)

The electrocardiographic (ECG) pattern of right bundle-branch block (RBBB) occurs routinely in patients after open-heart surgery for tetralogy of Fallot (TF). To determine the etiology of the RBBB pattern, 14 patients with TF, seven with ventricular septal defects (VSD), and one with pulmonary stenosis (PS) were studied during and after cardiac surgery. Bipolar electrograms from 10 selected right ventricular epicardial sites were recorded simultaneously with an ECG. Records were obtained before and immediately after vertical right ventriculotomy, after infundibular resection, and after repair of a ventricular septal defect (VSD). The vertical ventriculotomy alone was always associated with significant prolongation of the time of epicardial activation only to the recording sites lateral to the incision with prolongation of the QRS complex by an average of 39 msec, and with the appearance of an RBBB ECG pattern. Infundibular resection and VSD repair were not associated with any changes in the electrophysiologic parameters measured. A retrospective analysis of 251 patients with TF, VSD, and PS revealed a 100% incidence of RBBB pattern in the electrocardiograms of only those who had undergone ventriculotomy. It can be concluded that the RBBB pattern seen postoperatively in patients with TF is due to changes in right ventricular activation secondary to the vertical ventriculotomy.
The Effect of Smoking on Lactation and Infantile Colic
Authors: Ingrid Matheson
Journal: JAMA (1989)

<h3>To the Editor.—</h3> The deleterious effect of smoking on pregnancy and infant morbidity is now well recognized. Less is known about the effect of maternal smoking on lactation and the breast-fed infant. Because smoking is reported to shorten the period of breast-feeding,<sup>1</sup>our aim was to investigate whether this was related to sociodemographic factors. <h3>Study.—</h3> Data were collected about maternal smoking, breast-feeding, infant disorders, and demographic characteristics in a random sample of 16% of the women giving birth in Oslo, Norway, in 1985 (N = 885). They answered a mailed questionnaire (78% response rate) four months post partum. The infant birth weights in this study did not differ from those of official birth statistics. Validity testing was done by subsequent interviews with 96 of the respondents. Statistical analysis used the χ<sup>2</sup>test. Three hundred forty-eight of the mothers (39.6%) were daily smokers (≥1 cigarette per day) and 18 (2%)
Pneumonitis Caused by Metronidazole
Authors: Aril Frydén
Journal: JAMA (1988)

<h3>To the Editor.—</h3> As many as 50% of patients are admitted to the hospital because of adverse drug reactions; up to 18% of hospitalized patients suffer from side effects of drugs, which sometimes may be fatal.<sup>1</sup>Over 20 years, metronidazole has earned a reputation of being remarkably safe, although in recent years doses and duration of treatment have gradually increased, for example, when treating Crohn's disease.<sup>2</sup> Adverse reactions have mostly been mild and reversible, such as nausea, vomiting, fever, urticaria, and metallic taste, but sometimes can be more severe, such as polyneuropathy, mental confusion, convulsions, and leukopenia. Recently, cases of serum sickness and meningitis have been described. We report a case of pneumonitis caused by metronidazole.<sup>2</sup> <h3>Report of a Case.—</h3> A 42-year-old woman was admitted to the hospital for the first time on Aug 3,1985. She had a known pollen allergy, but no known hypersensitivity to drugs.
Polymyositis with cardiac manifestations and unexpected immunology
Authors: I Morrison
Journal: Annals of the Rheumatic Diseases (2002)

Polymyositis is an inflammatory myopathy of skeletal muscle. Cardiac involvement in the disease was first described in 18991 but has only been studied in detail over the past 20 years. About 10–15% of all patients with polymyositis have a cardiac abnormality as their initial presenting feature, while up to 70% of all those with polymyositis will have some cardiac involvement diagnosed non-invasively during the course of their illness.2 These can manifest either as cardiac failure; electrocardiographic changes, including non-specific ST changes, and varying forms of AV block; myocarditis; valve disease and myocardial ischaemia in the presence of normal coronary vasculature.3

Myasthenia gravis is thought to be an autoimmune disease characterised by the presence of antibodies to the acetylcholine receptor of the motor end plate. Idiopathic forms are rarely associated with polymyositis,4 but a much stronger correlation exists in the presence of a thymoma, particularly in those with myocardial involvement, when anti-titin antibodies are usually present.5 However, thymoma is often less than 1 mm in size and therefore not visible on computed tomographic (CT) scanning.

We describe a 56 year old woman with polymyositis, …
699. Bactofection into Airway Epithelial Cells In Vitro and In Vivo Using a Genetically Modified Escherichia coli
Authors: Mia D.B. Larsen, Uta Griesenbach, Sylvie Goussard, Dieter Gruenert, Duncan M. Geddes, Catherine Grillot-Courvalin, Eric W.F.W. Altom
Journal: Molecular Therapy (2006)

Bactofection has emerged as an approach for gene therapy. Here, we assessed bactofection into airway epithelial cells in vitro and in vivo using E. coli genetically engineered to enter non-phagocytosing cells (invasive strain).
Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA Registry.
Authors: M J Cowley, S M Mullin, S F Kelsey, K M Kent, A R Gruentzig, K M Detre, E R Passamani
Journal: Circulation (1985)

To assess whether gender influenced the outcome of percutaneous transluminal coronary angioplasty (PTCA), we analyzed data from the NHLBI PTCA Registry. Early results were compared in 705 women and 2374 men. Women were older (p less than .01) and had more unstable angina (p less than .01), and class 3 or 4 angina (p less than .01). Men had more multivessel disease (p less than .01), prior bypass surgery (p less than .01), and abnormal left ventricular function (p less than .05). Women had a lower angiographic success rate (60.3 vs 66.2%; p less than .01) and had a lower clinical success rate (56.6% vs 62.2%; p less than .01). More women had complications (27.2% vs 19.4%; p less than .01), but overall frequency of major complications (death, myocardial infarction, emergency surgery) was not different (9.8% vs 9.3%). Women had a higher incidence of coronary dissection (p less than .05) and higher in-hospital mortality (1.8% vs 0.7%; p less than .01). PTCA-related mortality was nearly six times higher in women (1.7% vs 0.3%; p less than .001) and mortality with emergency surgery was more than five time higher (17.4% vs 3.2%; p less than .001). Multivariate analysis indicated that female gender was an independent predictor for lower success (p less than .05) and early mortality (p less than .05) and was the only baseline predictor for PTCA-related mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
The stage question in cognitive-developmental theory
Authors: Charles J. Brainerd
Journal: Behavioral and Brain Sciences (1978)

Abstract The term “stage” appears to be used in three general senses in theories of behavioral development: ( a ) as a metaphor: ( b ) as a description of behaviors that undergo age change; ( c ) as an explanation of age-related changes in behavior. Although most existing stage models are purely descriptive, a few of them purport to have explanatory power. One such model, Piaget's stages of cognitive development, is considered in this paper. To be viewed as potentially explanatory, a stage model must describe some behaviors that undergo age change, posit antecedent variables believed to cause the changes, and provide procedures whereby the behavioral changes and the antecedent variables can be independently measured. Piaget's stages seem to satisfy some but not all of these requirements. Piaget's stages describe many agerelated changes in behavior, and some antecedent variables have been proposed. However, procedures do not exist for measuring the two factors independently. In lieu of such procedures, Piaget has outlined a “program” of five empirical criteria whereby the reality of his stages can ostensibly be verified. Some objections to these criteria are considered. The five criteria in Piaget's program are invariant sequence, cognitive structure, integration, consolidation, and equilibration. Three of the criteria (invariant sequence, integration, and consolidation) lead to the same sorts of empirical predictions (culturally universal sequences in the acquisition of certain behaviors). Such predictions are subject to the objection that Piagetian invariant sequences are often measurement sequences. A measurement sequence is said to occur when some late-appearing behavior consists of some earlier-appearing behavior plus additional things. The cognitive structure criterion is subject to at least three criticisms: First, it yields, at most, descriptions of behavior; second, these are often nothing more than descriptions of task structure; third, they cannot be regarded as unique to the given stages for which they are posited. The fifth criterion, equilibration, generates some predictions that might be considered as prima facie evidence for the existence of stages. However, these predictions conflict with the current data base on Piaget's stages. It is concluded that there is no compelling support for Piaget's hypothesis that his cognitive stages do more than describe age-related changes in behavior. Since explanatory statements involving stages appear with some regularity in Piagetian and neo-Piagetian writings, there are grounds for supposing this conclusion to be nontrivial.
Dermal and bronchial hyperreactivity in urticarial dermographisrn and urticaria factitia
Authors: B. M. Henz, S. Jeep, F. S. Ziegert, J. Niernann, G. Kunkel
Journal: Allergy (1996)

For investigation of a possible relationship between cutaneous and bronchial hyperreactivity, 74 subjects were grouped according to the presence (n = 33) or absence (n = 41) of urticarial dermographism after application of a standardized shearing pressure with a dermographometer (12.7 x 10(5) Pa). the two groups did not differ in age, sex, smoking habits, presence of urticaria and atopy, or serum IgE levels. Erythema of the dermographic test sites was always significantly greater (P < 0.001) in the group with urticarial dermographism at 2, 4, and 8 min, and cutaneous reactivity with titrated prick tests was significantly increased in this group with low concentrations of histamine, 0.01% and substance P (0.25 mM) (P < 0.05). After bronchial provocation with acetylcholine, 51 of the 74 subjects, 25 with and 26 without urticarial dermographism, exhibited bronchial hyperreactivity. However, significantly more subjects with urticarial dermographism had an increase in airway resistance and a decrease in specific airway conductance (P < 0.05). In the subgroup (n = 9) of subjects with symptomatic urticarial dermographism (urticaria factitia), these differences were even more significant (P < 0.001). These subjects also had larger skin test reactions and significantly higher IgE levels (P < 0.01). Thus, the present data show an association, which may be based on common mechanisms of allergic inflammation, between cutaneous and bronchial hyperreactivity.
Lost in More Than Just Translation
Authors: Barbara M. Young
Journal: Annals of Internal Medicine (2011)

On Being a Doctor5 April 2011Lost in More Than Just TranslationBarbara M. Young, MD, CMBarbara M. Young, MD, CMFrom McGill University, Montreal, Quebec H3A 2T5, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-7-201104050-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Having recently attended an excellent lecture on the evaluation of dementia, I was eager to test out my refreshed and updated skills on my next patient. “Failing to thrive. Patient difficult to evaluate,” the consult said. “Please rule out dementia.” Internet access is always very slow in Kuujjuaq, but, using the computer in the head nurse's office, I finally succeeded in downloading the cognitive assessment tool that had been suggested by the lecturer. I then retreated back to the little room designated for visiting specialists and sat down to read the patient's chart.I'd flown up to the subarctic community ... Author, Article, and Disclosure InformationAffiliations: From McGill University, Montreal, Quebec H3A 2T5, Canada.Corresponding Author: Barbara M. Young, MD, CM, Montreal General Hospital, Division of General Internal Medicine, Room B2-118, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 5 April 2011Volume 154, Issue 7Page: 502KeywordsChartsComputersDementiaGamesHospital medicineInternetMemoryNursesQuestionnairesTwins ePublished: 5 April 2011 Issue Published: 5 April 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Pulmonary eosinophilia due to Trichomonas tenax.
Authors: A. El Kamel, N. Rouetbi, M. Chakroun, M. Battikh
Journal: Thorax (1996)

A 39 year old woman was admitted with fever and an exacerbation of asthma. The chest radiograph showed extensive bilateral lung infiltrates, but transtracheal needle aspiration did not reveal any infectious organisms. The bronchoalveolar fluid lavage contained a large number of Trichomonas tenax and an increased percentage of eosinophils. Corticosteroids provided a dramatic response. Because of the relatively high frequency of colonisation of the human mouth by T tenax (about 20%), this organism should be considered in all cases of pulmonary eosinophilia.
ESWL in Hemophiliac Patients
Authors: Maciej Czaplicki, Tomasz Jakubczyk, Janusz Judycki, Andrzej Borkowski, Wojciech Ja&sacute;kowiak, Jan M. Ziemski, Romuald Scharf, Andrzej Misiak, Pawel Szalecki
Journal: European Urology (2000)
Greenwich asthma study
Authors: G. Feder
Journal: BMJ (2000)

Editor—Premaratne et al amassed an impressive amount of data in the Greenwich asthma study,1 but their outcome measures were unlikely to be able to detect an effect of their intervention. We think that they may have had an unreal expectation of the impact of the intervention in primary care, perhaps reflecting the absence of primary care researchers in the study team.

Designing large scale studies to test guidelines and educational interventions is not easy, particularly in inner city general practice.2 When testing whether nurses improve the care of patients with asthma in general practice, appropriate primary outcomes are measures of asthma control and health service use in the patients who consulted with the nurses rather than in the wider population of asthmatic patients. To judge the efficacy of the study nurses on their lack of effect on patients they did not see seems harsh, although asking asthmatic patients to attend review sessions is arguably part of their role. Though the mean square root of quality of life of the total asthmatic population is clearly an important (secondary) outcome, its importance may be obscure to many readers. Even the chosen secondary outcomes (steroid prescribing, attendance at accident and emergency departments, hospital admission) did not use as a denominator the patients who consulted during the study; neither is it clear that the study was sufficiently powered to detect differences for these variables. Focusing on the questionnaires or clinical records of these patients or a predetermined high risk group would have elucidated better the efficacy of the intervention.

Most studies showing the efficacy of education and guided self management have been carried out in hospital or outpatient populations—that is, among those with more severe disease. An intervention judged on its efficacy among all asthmatic patients registered in general practice, even those not receiving drug treatment, might be expected not to show a benefit. Intervention by a practice nurse is not necessarily appropriate for all asthmatic patients.

Few data are presented about the delivery of a complex health service intervention. For instance, interactive educational methods may be more effective than simple information transfer when implementing asthma guidelines.3 A qualitative analysis unpicking the black box of this educational programme would have been instructive.4 Without this it may be too early to suggest, as the authors do, that doctors might be more effective than nurses in educating patients with asthma.

Should the results of the study influence government policy? To conclude that primary care nurses trained by hospital specialist nurses are ineffective would be premature until other studies with more focused outcome assessment and cost effectiveness data have been reported.
Determinants of long-term prognosis in patients with small vessel disease who underwent coronary angioplasty; implication of abnormal glucose tolerance
Authors: Y. Ohtsuka, S. Miyazaki, A. Itoh, S. Daikoku, I. Morii, T. Matsumoto, Y. Goto, H. Nonogi
Journal: Journal of the American College of Cardiology (1998)
Common polymorphic deletion of glutathione S‐transferase theta predisposes to acquired aplastic anemia: Independent cohort and meta‐analysis of 609 patients
Authors: Daria V. Babushok, Yimei Li, Jacquelyn J. Roth, Nieves Perdigones, Joshua D. Cockroft, Jaclyn A. Biegel, Philip J. Mason, Monica Bessler
Journal: American Journal of Hematology (2013)

Acquired aplastic anemia (AA) is a rare life-threatening bone marrow failure syndrome, caused by autoimmune destruction of hematopoietic stem and progenitor cells. Epidemiologic studies suggest that environmental exposures and metabolic gene polymorphisms contribute to disease pathogenesis. Several case-control studies linked homozygous deletion of the glutathione S-transferase theta (GSTT1) gene to AA; however, the role of GSTT1 deletion remains controversial as other studies failed to confirm the association. We asked whether a more precise relationship between the GSTT1 null polymorphism and aplastic anemia could be defined using a meta-analysis of 609 aplastic anemia patients, including an independent cohort of 67 patients from our institution. We searched PubMed, Embase, and the Cochrane Database for studies evaluating the association between GSTT1 null genotype and development of AA. Seven studies, involving a total of 609 patients and 3,914 controls, fulfilled the eligibility criteria. Meta-analysis revealed a significant association of GSTT1 null genotype and AA, with an OR = 1.74 (95% CI 1.31-2.31, P < 0.0001). The effect was not driven by any one individual result, nor was there evidence of significant publication bias. The association between AA and GSTT1 deletion suggests a role of glutathione-conjugation in AA, possibly through protecting the hematopoietic compartment from endogenous metabolites or environmental exposures. We propose a model whereby protein adducts generated by reactive metabolites serve as neo-epitopes to trigger autoimmunity in aplastic anemia.