tbuckley/cabot-search huggingface dataset:
Pneumonitis and Hydrochlorothiazide
Authors: ARTHUR KAUFMAN
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 August 1973Pneumonitis and HydrochlorothiazideARTHUR KAUFMAN, M.D., EDUARDO MONTILLA, M.D., MAXWELL HELFGOTT, M.D., RICHARD FIORELLI, M.D., HILTRUD MUELLER, M.D.ARTHUR KAUFMAN, M.D.Search for more papers by this author, EDUARDO MONTILLA, M.D.Search for more papers by this author, MAXWELL HELFGOTT, M.D.Search for more papers by this author, RICHARD FIORELLI, M.D.Search for more papers by this author, HILTRUD MUELLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-2-282_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with great interest the report of hydrochlorothiazide-induced allergic pneumonitis by Beaudry and Laplante (Ann Intern Med 78:251-253, 1973). Their patient's history and clinical course bears a striking resemblance to that of a patient we recently treated, who developed acute respiratory distress with pulmonary edema soon after an orally administered dose of propranalol.A 52-year-old white woman was admitted to the intensive care unit of St. Vincent's Hospital in acute respiratory distress. She had had hypertension, treated with hydrochlorothiazide (Hydrodiuril®), for 10 years. Twelve months before admission her private physician had added propranalol (Inderal®), 10 mg...References1. Rosenow E: The spectrum of drug-induced pulmonary disease. Ann Intern Med 77:977-991, 1972 LinkGoogle Scholar2. BrettnerHeitzmanWoodin AEW: Pulmonary complications of drug therapy. Radiology 96:31-38, 1970 CrossrefMedlineGoogle Scholar3. McNeillIngram RC: Effect of propranalol on ventilatory function. Am J Cardiol 18:473-475, 1966 CrossrefMedlineGoogle Scholar4. Stephen S: Unwanted effects of propranalol. Ibid., pp. 463-472 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ARTHUR KAUFMAN, M.D.; EDUARDO MONTILLA, M.D.; MAXWELL HELFGOTT, M.D.; RICHARD FIORELLI, M.D.; HILTRUD MUELLER, M.D.Affiliations: Department of Medicine St. Vincent's Hospital and Medical Center New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChronic Diffuse Lung DiseasesThiazide diureticsChronic Diffuse Lung DiseasesDiureticsIsoniazid-induced interstitial pneumoniaPharmacological and pathological responses of the human pulmonary circulation to drugs 1 August 1973Volume 79, Issue 2Page: 282-283KeywordsEdemaHypertensionIntensive care unitsPneumonitisVentilators ePublished: 1 December 2008 Issue Published: 1 August 1973 PDF downloadLoading ...
Advances in Early Diagnosis of Perinatal HIV Infection
Authors: Edward Connor
Journal: JAMA (1991)

Early intervention using antiretroviral therapy and prophylaxis for infections has become the standard of care for adults and children infected with human immunodeficiency virus (HIV). Advances in the field of HIV treatment have resulted in improvement in quality and/or duration of life for patients of all ages. Zidovudine therapy is now approved and routinely indicated for treatment of symptomatic HIV-infected children and for those with evidence of immunodeficiency.<sup>1</sup>Prophylaxis for<i>Pneumocystis carinii</i>pneumonia is routinely recommended for children with significant CD4 lymphocyte depletion, and intravenous γ-globulin has been shown to reduce the rate of serious bacterial infections in some HIV-infected chiidren.<sup>2,3</sup>However, for therapeutic interventions to be applied optimally, it is essential for the diagnosis of HIV infection to be made as early in the course as possible,<i>before</i>immunodeficiency and symptomatic illness are manifest. For children with perinatally acquired HIV infection, this is particularly problematic.<sup>4,5</sup>
Involvement of nerves and calcium channels in the intestinal response to Clostridium difficile toxin A: an experimental study in rats in vivo
Authors: J Sorensson
Journal: Gut (2001)

<h3>BACKGROUND</h3> The involvement of nerves and calcium channels in the intestinal response to <i>Clostridium difficile</i> toxin A (luminal concentration 1 or 15 μg/ml) was studied in the small intestine of rats in vivo. <h3>METHODS</h3> Inflammation was quantified by estimating myeloperoxidase (MPO) activity in the intestinal lumen, extravascular accumulation of Evan9s blue (EB) in the intestine, and number of red blood cells (RBCs) in veins in histological sections. Intestinal damage was estimated using a histological grading system. In some experiments net fluid transport was recorded using a gravimetric technique. <h3>RESULTS</h3> In acutely denervated intestines, toxin A caused marked destruction of the villi, increased luminal release of MPO activity, and augmentation of intestinal content of EB and venous RBCs. Denervating the intestine 3–4 weeks prior to the actual experiment prevented the development of villus damage and significantly decreased the number of RBCs in intestinal veins in experiments with a low toxin concentration, whereas no effect was demonstrated on luminal MPO activity. Using a high toxin concentration, chronic denervation decreased only the number of RBCs. Pretreatment with hexamethonium (low toxin concentration; acute denervation) attenuated the effect of toxin A on morphology, luminal MPO activity, and number of RBCs. Pretreatment with nifedipine (low toxin concentration; acute denervation) significantly decreased intestinal MPO activity and number of RBCs. Tissue accumulation of EB was not influenced by experimental manipulation. Net fluid transport was measured in experiments exposing the intestinal mucosa to a high toxin concentration. Fluid secretion caused by the toxin was significantly attenuated by intravenous hexamethonium whereas no effect was observed after administration of nifedipine or granisetron. <h3>CONCLUSIONS</h3> At a low toxin concentration, intramural reflexes are involved in the inflammatory response whereas axon reflexes contribute to tissue damage. At a high toxin concentration no nervous involvement in the toxin A response was demonstrated except for fluid secretion evoked by the toxin.
The gatekeeper and the wizard revisited.
Authors: N. Mathers, T. Usherwood
Journal: BMJ (1992)

by chronically disturbed mentally ill patients. The south west has not experienced the latter problem and has therefore virtually always been able to admit prisoners in urgent need of psychiatric treatment. This would appear to be an extremely important use of the regional secure unit, and therefore the ability to run at just below full capacity, thus allowing for emergency admissions from prison, may be desirable. Nevertheless, there are less favourable interpre? tations of the data. The increasing use of section 48 may indicate larger numbers of severely mentally ill prisoners on remand. Could this in turn reflect a failure of community psychiatric services and a lack of longer term facilities for the severely mentally ill? Table I shows that both in the south west and nationally the increased use of section 48 has been associated with more than a 30% reduction in the number of psychiatric beds. Interestingly, nearly all of the section 48 patients in the present series were already known to the psychiatric services. It could be argued that those regions with few section 48 admissions are providing a superior service for this group of patients compared with regions that make greater use of the section 48 provision. Clearly more detailed studies are required to clarify this. It is unlikely that any straightforward conclusions can be drawn from these data. The relation between the use of section 48 and other factors such as the availability of general psychiatric facilities, secure beds, and the recognition of the need to treat mentally ill offenders outside the prison system is a complex equation. Nevertheless, the use of section 48 should be included as one of the parameters by which the psychiatric services are monitored and should be subject to regular audit. For more serious offenders suffering from mental illness who cannot be diverted from the criminal justice system at an early stage the use of section 48 should be encouraged.
Muscle biopsy abnormalities in systemic lupus erythematosus: correlation with clinical and laboratory parameters.
Authors: K L Lim, R Abdul-Wahab, J Lowe, R J Powell
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVES--To investigate the incidence and significance of Type II fibre atrophy, vessel wall thickening, lymphocytic vasculitis and myositis in needle quadriceps muscle biopsies from patients with systemic lupus erythematosus (SLE) and their correlations with clinical and laboratory parameters. METHODS--Needle quadriceps muscle biopsies from 55 patients with SLE and 26 controls were prospectively examined. Clinical and laboratory parameters recorded at the time of muscle biopsy included arthralgia, arthritis, myalgia, proximal weakness, vasculitic rashes, Schirmer test, ENA antibodies, ESR, serum creatine kinase (CK) and plasma C3 degradation products. RESULTS--Abnormal muscle biopsies were significantly more frequent in patients with SLE compared with controls (P &lt; 0.005). None of the controls had lymphocytic vasculitis and/or myositis. The difference in incidence between patients with SLE and controls for lymphocytic vasculitis was significant at P &lt; 0.005. Due to the small number of SLE patients with myositis, the difference in incidence for this abnormal finding reached only P = 0.09. In the SLE patient group, lymphocytic vasculitis was associated with significantly higher ESR values (P = 0.007) and higher incidence of arthritis (P = 0.01); and appears to characterise a subset of patients with positive Schirmer tests, anti-Ro and/or anti-La antibodies. Raised serum CK was found to correspond with underlying myositis in patients with SLE and these patients also had an increased incidence of symptoms of proximal weakness and/or anti-RNP antibodies. In contrast, both Type II fibre atrophy and vessel wall thickening failed to correlate with any of the clinical and laboratory parameters studied and appear to be non-specific findings. CONCLUSIONS--Abnormal muscle biopsies are common in patients with SLE and the presence of lymphocytic vasculitis and/or myositis signify pathology in these patients. Histopathological abnormalities in needle quadriceps muscle biopsies are further valuable parameters in the assessment of patients with SLE.
Mycobacteremia and the New Blood Culture Systems
Authors: PHILLIP F. PIERCE
Journal: Annals of Internal Medicine (1983)

Clinical and microbiologic aspects of mycobacteremia occurring in 11 patients are presented. Ten of the 11 patients were immunosuppressed. Disseminated disease was shown in 7 patients, transient bacteremia in 2, and endocarditis in 1. Blood cultures were positive in 11 blood culture systems. Newer blood culture systems appear to provide more rapid detection of mycobacteremia.
Sugar's web of influence 2: Biasing the science
Authors: J. Gornall
Journal: BMJ (2015)

The relationship between receptor number and agonist-induced intracellular responses has been well studied in receptors coupled to adenylate cyclase; however, for receptors coupled to phospholipase C (PLC), very little is known about the effect of receptor number on receptor-mediated processes. To explore this issue, we investigated the effect of the number of receptors for gastrin-releasing peptide (GRP) on ligand affinity and on the ability to activate intracellular messengers [PLC, tyrosine phosphorylation of p125 focal adhesion kinase (p125<sup>FAK</sup>)] and cause receptor modulation (internalization, desensitization, down-regulation) and ligand degradation. Three BALB 3T3 cell lines were made that stably expressed the gastrin-releasing peptide receptor (GRP-R) with receptor numbers varying by 280-fold (GRP-R-Low, GRP-R-Med, and GRP-R-Hi). Each cell line had the same affinity for agonist. The efficacy for bombesin to increase [<sup>3</sup>H]inositol phosphates but not tyrosine phosphorylation of p125<sup>FAK</sup> correlated well with receptor number. In contrast, the EC<sub>50</sub> value for [<sup>3</sup>H]inositol phosphate generation for bombesin was the same in each cell line. Receptor number did not alter internalization. In the absence of protease inhibitors, there was an inverse correlation between receptor number and receptor down-regulation and desensitization. However, with protease inhibitors present, GRP-R-Med and GRP-R-Hi down-regulated significantly less than the GRP-R-Low. Similarly, GRP-R-Low desensitized significantly more than GRP-R-Med or GRP-R-Hi. GRP-R-Hi caused significantly greater ligand degradation than GRP-R-Low, and protease inhibitors completely inhibited degradation by GRP-R-Low and inhibited degradation by 70% for GRP-R-Hi. In conclusion, we show that for the PLC-coupled GRP-R, receptor number had little or no effect on binding affinity, potency for activating PLC, tyrosine phosphorylation of p125<sup>FAK</sup>, or extent of receptor internalization. In contrast, receptor number had an effect on ligand degradation, down-regulation, desensitization, and efficacy of PLC activation without altering the efficacy of tyrosine phosphorylation of p125<sup>FAK</sup>. These results demonstrate that the effect of receptor number differs for the different functions mediated by the GRP receptor and differs from that reported for adenylate cyclase-coupled receptors such as receptors mediating the action of adrenergic agents, secretin, and opioids.
Cardiac, skeletal and ophthalmologic abnormalities in relatives of patients with the Marfan syndrome.
Authors: M N Payvandi, R E Kerber, C D Phelps, G F Judisch, G El-Khoury, H G Schrott
Journal: Circulation (1977)

Nine patients with the Marfan syndrome and 40 of their first degree relatives were evaluated for the presence of cardiac, skeletal and ophthalmologic abnormalities. Aortic root dilatation and mitral valve prolapse were sought by echocardiography, and the metacarpal index was calculated from hand X-rays. Abnormalities of all the tests performed were present in all nine index cases, except for one normal eye exam. Mitral prolapse was present in thirteen relatives (33%) and aortic root dilatation in seven (18%). At least one cardiac abnormality was present in nineteen (47%) relatives. Aortic root dilatation was more common in male relatives; the incidence of mitral prolapse was approximately equal in the two sexes. Abnormal metacarpal index (greater than 8.0) occurred in fifteen of twenty-six relatives examined (58%). Ophthalmologic abnormalities were found in only four relatives. Two relatives had abnormalities of all three organ systems evaluated, five others had abnormalities of two systems, and fourteen had abnormalities of one system. We conclude that cardiac and skeletal abnormalities are demonstrable in a high percentage of first degree relatives of patients with the Marfan syndrome.
Clinical Value of the Sentinel-Node Biopsy in Primary Cutaneous Melanoma
Authors: Charles M. Balch, Jeffrey E. Gershenwald
Journal: New England Journal of Medicine (2014)

In this issue of the Journal, Morton and colleagues1 report the final analysis of the Multicenter Selective Lymphadenectomy Trial (MSLT-I), a landmark prospective, randomized clinical trial that caps a 35-year effort to resolve the controversy surrounding the survival benefit of surgical excision of regional lymph nodes as a component of the initial treatment of patients with primary melanoma. Spanning two decades, the MSLT-I also shows the importance of the sentinel-node biopsy for staging and prognostic assessment of melanomas with a thickness of 1.20 mm or more. In the cohort of node-positive patients with intermediate-thickness primary melanomas (defined in this study . . .
Identification of metastasis-related microRNAs in hepatocellular carcinoma
Authors: Anuradha Budhu, Hu-Liang Jia, Marshonna Forgues, Chang-Gong Liu, David Goldstein, Amy Lam, Krista A. Zanetti, Qing-Hai Ye, Lun-Xiu Qin, Carlo M. Croce, Zhao-You Tang, Xin Wei Wang
Journal: Hepatology (2008)

MicroRNAs (miRNAs) have been used as cancer-related biomarkers. Hepatocellular carcinoma (HCC) is an aggressive cancer with a dismal outcome largely due to metastasis and postsurgical recurrence. We investigated whether the expression of certain miRNAs are associated with HCC metastasis. We examined the miRNA expression profiles of 482 cancerous and noncancerous specimens from radical resection of 241 patients with HCC. Using a supervised algorithm and a clinically well-defined cohort of 131 cases, we built a unique 20-miRNA metastasis signature that could significantly predict ( P &lt; 0.001) primary HCC tissues with venous metastases from metastasis-free solitary tumors with 10-fold cross-validation. However, significant miRNAs could not be identified from the corresponding noncancerous hepatic tissues. A survival risk prediction analysis revealed that a majority of the metastasis-related miRNAs were associated with survival. Furthermore, the 20-miRNA tumor signature was validated in 110 additional cases as a significant independent predictor of survival ( P = 0.009) and was significantly associated with both survival and relapse in 89 cases of early stage HCC ( P = 0.022 and 0.002, respectively). These 20 miRNAs may provide a simple profiling method to assist in identifying patients with HCC who are likely to develop metastases/recurrence. In addition, functional analysis of these miRNAs may enhance our biological understanding of HCC metastasis.
BMA president criticises government for "grotesque" use of word fairness
Authors: H. Mooney
Journal: BMJ (2010)

The president of the British Medical Association has hit out at the coalition government’s spending cuts last week, claiming that its continued insistence that its proposals would create a fairer society were a “grotesque parody of the word fairness.”

Speaking to the World Medical Association’s general assembly in Vancouver on 14 October, Michael Marmot criticised the government’s proposed benefit cuts, which he said would hit poor people the hardest.

“They raise value added tax, which is regressive, and they say we are doing this in the interests of fairness. They cut benefits to the poor, and they say they are …
Tissue-specific Aberrations of Gene Expression in HPRT-deficient Mice: Functional Complexity in a Monogenic Disease?
Authors: Shaochun Song, Theodore Friedmann
Journal: Molecular Therapy (2007)

We have used the hypoxanthine-guanine phosphoribosyltransferase (HPRT) enzyme-deficient mouse model of human Lesch-Nyhan disease (LND) to examine the tissue-specificity of altered global gene expression in a genetically "simple" monogenic human disease. We have identified a number of genes and gene families whose expression is aberrant in the mouse knockout model of the LND, and we have identified different patterns of aberrant gene expression in two principal target tissues associated with the disease phenotype, i.e., the central nervous system and the liver. The major neurological phenotype reflects dysfunction of the dopamine neurotransmitter system in the basal ganglia, and we have now identified aberrant expression of a small number of genes in HPRT-deficient striata. The abnormal metabolic phenotype of hyperuricemia in HPRT-deficient mice is also reflected in an aberrant gene expression in the liver. We interpret these findings to suggest that the genetic consequences of a primary HPRT knockout in the mouse produces transcriptional aberrations in a number of other genes that may play a role in the disease phenotype. Knowledge of these secondary genetic defects may help in the identification of targets for drug- and gene-based therapy.
Improvement in exercise capacity and exercise blood pressure response after transcoronary alcohol ablation therapy of septal hypertrophy in hypertrophic cardiomyopathy
Authors: J.-J. Kim, C.W. Lee, S.-W. Park, M.-K. Hong, H.-Y. Lim, J.-K. Song, Y.-S. Jin, S.-J. Park
Journal: Journal of the American College of Cardiology (1998)
Retention of heroin and morphine–6β–glucuronide analgesia in a new line of mice lacking exon 1 of MOR–1
Authors: Alwin G.P. Schuller, Michael A. King, Jiwen Zhang, Elizabeth Bolan, Ying–Xian Pan, Daniel J. Morgan, Albert Chang, Maureen E. Czick, Ellen M. Unterwald, Gavril W. Pasternak, John E. Pintar
Journal: Nature Neuroscience (1999)
Charles Bonnet Syndrome in a Centenarian
Authors: Carlos A. Reyes-Ortiz
Journal: JAMA (1996)

To the Editor.  —Charles Bonnet syndrome (CBS) includes visual pseudohallucinations (hallucinations with preserved insight), visual deprivation, and preserved cognitive status.1We present a patient who improved without medications.  Report of a Case.  —A 103-year-old widow presented with a 1-year history of visual hallucinations, which she recognized as unreal. They appeared during the day and disappeared when she closed her eyes. The visions were related to past experiences, such as when she was a child or a teacher, and were often pleasant. She was previously treated with phenothiazines, but without effect. She had glaucoma of the right eye and a cataract in the left eye. She had decreased visual acuity (OD 20/200, OS 20/100). Results of her neurological examination, cognitive status, Geriatric Depression Scale, and computed tomographic scan were normal. Increasing communication and occupational therapy decreased the frequency of the visions.  Comment.  —The diagnosis of CBS is by exclusion of
Oncogene-Targeting T Cells Reject Large Tumors while Oncogene Inactivation Selects Escape Variants in Mouse Models of Cancer
Authors: Kathleen Anders, Christian Buschow, Andreas Herrmann, Ana Milojkovic, Christoph Loddenkemper, Thomas Kammertoens, Peter Daniel, Hua Yu, Jehad Charo, Thomas Blankenstein
Journal: Cancer Cell (2011)
Observations on the Reliability and Safety of Bladder Catheterization for Bacteriologic Study of the Urine
Authors: Lucien B. Guze, Paul B. Beeson
Journal: New England Journal of Medicine (1956)

THE usual method of culturing urine is to obtain a specimen from the bladder by catheterization and inoculate it in liquid mediums. If growth results, urinary-tract infection may be assumed to be present. The reliability of this procedure seems questionable for two reasons. In the first place, although care is taken to cleanse the area around the urethral meatus before insertion of a sterile catheter, there is no practical, harmless way of destroying bacteria that may lie within the urethral channel. These could be transferred into the bladder during passage of the catheter and could then be the origin of . . .
Prodromal angina favorably alters relationship between time to reperfusion and outcomes in patients with a first anterior acute myocardial infarction
Authors: Masaharu Ishihara, Ichiro Inoue, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Kenji Nishioka, Takashi Umemura, Shuji Nakamura, Masashi Yoshida
Journal: Journal of the American College of Cardiology (2003)
Trichobezoar in a Four-Year-Old Girl
Authors: John L Lanoue, Marc S Arkovitz
Journal: New England Journal of Medicine (2003)

A four-year-old girl was brought to her pediatrician by her parents because of intermittent bilious emesis, which had started two weeks earlier. There were no other changes in her bowel or bladder habits, and she had not lost weight. Her parents reported that she occasionally pulled at and ate her hair, but they did not believe that this behavior was compulsive or obsessive (trichotillomania). Physical examination revealed a firm mass in the upper abdomen, but the rest of the examination was unremarkable. An upper gastrointestinal series revealed a large trichobezoar in the child's stomach and proximal small bowel (Panel A). . . .