tbuckley/cabot-search huggingface dataset:
Renal Scintigraphy in the Diagnosis of Aortic Dissection Affecting the Renal Arteries
Authors: MIGUEL GORENBERG, SIMONA BEN-HAIM, DAVID GROSHAR, ABRAHAM EYAL, DOV FRONT
Journal: Clinical Nuclear Medicine (1995)

Aortic dissection type “A” in a patient with chronic renal failure is presented. The patient had acute deterioration of renal function, which was thought to be due to renal artery involvement by progression of the dissecting aneurysm. Abdominal CT without contrast enhancement was normal, but renal scintigraphy with Tc-99m DTPA showed aortic dissection with involvement of the renal arteries. Early pharmacologic treatment is indicated in all patients with aortic dissection except for those with vital organ involvement who should be operated. Involvement of the renal arteries, shown on renal scintigraphy, was useful in the case presented to indicate the need for immediate surgery due to the dissection affecting the renal arteries.
Society and Medication: Conflicting Signals for Prescribers and Patients
Authors: Louis Lasagna
Journal: JAMA (1983)

Ordinarily, the proceedings of a conference that took place more than two years ago turn out to be prose so mortal as to deserve a decent burial rather than public exhibition of the corpse. Such a judgment cannot be leveled at this interesting book because its contents are not only of compelling interest and importance but of the sort that are not quickly outdated. I confess, however, to a sense of disquiet in communicating an appropriate appreciation of the book's merits, because the smörgasbord that Morgan and Kagan have put together is a remarkably rich and varied one. The book contains data on such topics as the size and nature of the prescription drug market, the prescribing habits of physicians, drug use review schemes, the role of the Food and Drug Administration in encouraging proper drug use, the potential of postmarketing substitution laws, the prescribing and regulation of psychoactive drugs,
Endotracheal intubation: friend or foe?
Authors: S Mehta
Journal: BMJ (1986)

Scott, I have found that listening to each upper lung area is a reliable guide of tube placement in the trachea or, for that matter, right mainstem bronchus.This allows gentle easing back of the tube above the carina even without radiographic help.It is inappropriate to give to endotracheal intu- bation a mystique which might lead to its not being used on the very patients who need it most.
606. Identification of a 45-aa Domain of the F12-Vif Mutant Possessing Anti-HIV Activity
Authors: Simona Porcellini, Rossella Lupo, Giuliana Vallanti, Maurizio Federico, Fulvio Mavilio, Chiara Bovolenta
Journal: Molecular Therapy (2006)

Our previous results have demonstrated that T-cell lines and primary T lymphocytes transduced with a Tat-dependent HIV-based lentiviral vectors expressing the mutant isoform of the vif gene, F12-vif, are protected from HIV-1 infection. F12-Vif is a 192-aa natural variant polypeptide owing 14 unique amino acid substitutions. The substitutions are randomly scattered along the entire sequence with the exception of a 5-aa cluster located at positions 127, 128, and 130–132. None of the 14 aa substitutions is present in the SOCS box that recruits the E3 ubiquitin ligase responsible of APOBEC3G (AP3G) degradation during HIV infection. In line with this notion, we have shown that the antiviral function of F12-Vif is not due to a dominant negative feature of the mutant in regards to the Vif-mediated degradation of AP3G rather to some other unknown means. Therefore, in the effort to elucidate the F12-Vif mechanism of action, we started to identify the protein domain of F12-Vif responsible of HIV-1 inhibition. To this end, we have constructed three chimeric genes (Chim1, Chim2 and Chim3) composed by wild-type and F12-vif regions. T cell lines and cord blood derived CD4+T lymphocytes were transduced with the lentiviral vectors expressing the chimeric genes and then challenged with both X4 and R5 HIV-1 strains. We show that 45 amino acids in the C-terminal domain of the F12-Vif mutant are sufficient to exert anti-viral effect in transduced cells. In contrast to F12-Vif, Chim3 does not allow the rescue of the replication of a vif-deficient HIV-1 in the context of either X4 or R5 tropism in non permissive cells. This specific feature renders Chim3 a truly dominant negative protein more suitable than F12-Vif for an anti-HIV gene therapy approach.
Quality at general practice consultations: cross sectional survey
Authors: J. G R Howie, D. J Heaney, M. Maxwell, J. J Walker, G. K Freeman, H. Rai
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objectives:</b> To measure quality of care at general practice consultations in diverse geographical areas, and to determine the principal correlates associated with enablement as an outcome measure. <b>Design:</b> Cross sectional multipractice questionnaire based study. <b>Setting:</b> Random sample of practices in four participating regions: Lothian, Coventry, Oxfordshire, and west London. <b>Participants:</b> 25 994 adults attending 53 practices over two weeks in March and April 1998. <b>Main outcome measures:</b> Patient enablement, duration of consultation, how well patients know their doctor, and the size of the practice list. <b>Results:</b> A hierarchy of needs or reasons for consultation was created. Similar overall enablement scores were achieved for most casemix presentations (mean 3.1, 95% confidence interval 3.1 to 3.1). Mean duration of consultation for all patients was 8.0 minutes (8.0 to 8.1); however, duration of consultation increased for patients with psychological problems or where psychological and social problems coexisted (mean 9.1, 9.0 to 9.2). The 2195 patients who spoke languages other than English at home were analysed separately as they had generally higher enablement scores (mean 4.5, 4.3 to 4.7) than those patients who spoke English only despite having shorter consultations (mean 7.1 (6.9 to 7.3) minutes. At individual consultations, enablement score was most closely correlated with duration of consultation and knowing the doctor well. Individual doctors had a wide range of mean enablement scores (1.1-5.3) and mean durations of consultation (3.8-14.4 minutes). Doctors9 ability to enable was linked to the duration of their consultation and the percentage of their patients who knew them well and was inversely related to the size of their practice. At practice level, mean enablement scores ranged from 2.3 to 4.4 and duration of consultation ranged from 4.9 to 12.2 minutes. Correlations between ranks at practice level were not significant. <b>Conclusions:</b> It may be time to reward doctors who have longer consultations, provide greater continuity of care, and both enable more patients and enable patients more. <h3>Key messages</h3> 38% of practices approached on a random basis in four areas of the United Kingdom collected data for 2 weeks showing the feasibility of surveying the content and outcome of routine consultations in general practice At consultation level, enablement correlates best with the duration of consultations and how well the patient knows the doctor These correlates apply at doctor level as well—more enabling doctors work in smaller practices than less enabling doctors Case mix does not seem to be a determinant of enablement scores, but patients with more complex problems require longer consultations to achieve equal enablement Patterns of duration of consultation and enablement in patients who speak languages other than English are different and require further study
Cardiac Surgery in La Jolla: An Error Perpetuated
Authors: David B. Carmichael
Journal: JAMA (1990)

<h3>To the Editor.—</h3> In 1988 Caper,<sup>1</sup>using the technique of small-area analysis, indicted the cardiovascular surgical program of Scripps Memorial Hospital, La Jolla, Calif. His research failed to uncover the fact that the program encompassed not only the community of La Jolla, a suburb of San Diego, but also a wide referral base and nearly 400 000 beneficiaries of Kaiser Permanente Medical Care Program. This error was elucidated in a series of letters and a correction in the<i>New England Journal of Medicine</i>.<sup>2-5</sup> In an essay entitled "Economics" contained in Contempo '90 in<i>JAMA</i>, Dr C. J. Schramm<sup>6</sup>repeats the error. His literature search did not include the justified corrections made in the<i>New England Journal of Medicine</i>. This problem points up at least two things: (1) an error that was "corrected" in subsequent publications may reappear elsewhere as legitimate, and (2) editorial and opinion pieces need
Decreased Resistance to Hemorrhage in Neurohypophysectomized Dogs
Authors: JULIAN FRIEDEN, ALLEN D. KELLER, CLEVELAND P. HlCKMAN, JOHN H. WATERS
Journal: Circulation Research (1954)

The diabetes insipidus dog is more susceptible to hemorrhage than the normal dog as determined by a standardized hemorrhage procedure. When aqueous pitressin is administered in subpressor dosages, this susceptibility to hemorrhage is reversed to or toward normal. Aqueous pitressin does not increase the intact dog's resistance to hemorrhage. The foregoing observations are interpreted as demonstrating that the neurohypophysial pressor principle serves a physiologic role in maintaining blood pressure during hemorrhage.
Increased Intestinal Permeability in Patients with Crohn's Disease and Their Relatives
Authors: Daniel Hollander, Constance M. Vadheim, Edward Brettholz, Gloria M. Petersen, Thomas Delahunty, Jerome I. Rotter
Journal: Annals of Internal Medicine (1986)

The cause of Crohn's disease is unknown, although alterations in intestinal permeability may play a primary role. Because we were interested in permeability changes that occur before the onset of intestinal inflammation, we took advantage of the known genetic predisposition to this disease and studied not only patients with Crohn's disease, but their clinically unaffected relatives as well. Intestinal permeability was assessed using the marker polyethylene glycol-400 ingested with a standard meal. We found that 17 normal volunteers absorbed 215 ± 29.6 mg (mean ± SE), whereas 11 patients with Crohn's disease absorbed 514 ±94.7 mg and their 32 healthy relatives absorbed 566 ±62.4 mg. The twofold increase in permeability of patients and their relatives (p <0.005 compared with controls) indicates that the intestinal defect in the ability to exclude larger sized molecules is not secondary to clinically recognized intestinal inflammation, but is a primary defect that may be an etiologic factor in this disease.
Efficacy of tumour necrosis factor blockers in reducing uveitis flares in patients with spondylarthropathy: a retrospective study
Authors: S Guignard, L Gossec, C Salliot, A Ruyssen-Witrand, M Luc, M Duclos, M Dougados
Journal: Annals of the Rheumatic Diseases (2006)

To evaluate the efficacy of anti-tumour necrosis factor (TNF) treatments (given for rheumatological manifestations) in reducing uveitis flares in patients with spondylarthropathy in daily practice.A retrospective observational study of all patients with spondylarthropathy with at least one uveitis flare treated with anti-TNF in one centre (December 1997-December 2004). The number of uveitis flares per 100 patient-years was compared before and during anti-TNF treatment; each patient was his or her own control. The relative risk (RR) and the number needed to treat (NNT) were calculated.46 patients with spondylarthropathy treated with anti-TNF drugs had at least one uveitis flare (33 treated with anti-TNF antibodies, infliximab or adalimumab, and 13 with soluble TNF receptor, etanercept). The mean age at first symptoms was 26 years, 71% were men. Patients were followed for 15.2 years (mean) before anti-TNF versus 1.2 years during anti-TNF treatment. The number of uveitis flares per 100 patient-years before and during anti-TNF were, respectively: for all anti-TNF treatments,-51.8 v 21.4 (p = 0.03), RR = 2.4, NNT = 3 (95% confidence interval (CI) 2 to 5); for soluble TNF receptor-54.6 v 58.5 (p = 0.92), RR = 0.9; and for anti-TNF antibodies-50.6 v 6.8 (p = 0.001), RR = 7.4, NNT = 2 (95% CI 2 to 5).Anti-TNF treatments were efficacious in decreasing the number of uveitis flares in patients with spondylarthropathy. Anti-TNF antibodies decreased the rate of uveitis flares, whereas soluble TNF receptor did not seem to decrease this rate. These results could have consequences for the choice of anti-TNF treatment in certain patients.
Abdominal Films and Corticosteroid Treatment
Authors: STEVEN BROZINSKY
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 November 1982Abdominal Films and Corticosteroid TreatmentSTEVEN BROZINSKY, M.D.STEVEN BROZINSKY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-5-786_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their analysis of plain abdominal radiographs in the diagnosis of abdominal pain Eisenberg and associates (1) state that "patients with inflammatory bowel disease or toxic megacolon almost always have moderate or severe abdominal tenderness, often with bloody diarrhea, by the time radiographic abnormalities can be detected." The authors fail to consider inflammatory bowel disease patients who may already be on high doses of corticosteroids when they present with abdominal pain. I have seen progressive, toxic dilitation of the colon on serial plain films with absolutely no change in the clinical findings of these patients. That daily...References1. EISENBERGHEINEKENHEDGCOCKFEDERLEGOLDBERG RPMMH. Evaluation of plain abdominal radiographs in the diagnosis of abdominal pain. Ann Intern Med. 1982;97:257-61. LinkGoogle Scholar2. KATZKAKATZMORRIS ISE. Management of toxic megacolon: the significance of early recognition in medical management. J Clin Gasteroenterol. 1979;1:307-11. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University Hospital San Diego, CA 92103 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1982Volume 97, Issue 5Page: 786-786KeywordsAbdominal painColonDiarrheaInflammatory bowel diseaseMegacolon Issue Published: 1 November 1982 PDF DownloadLoading ...
Neurogenic muscarinic vasodilation in the cat. An example of endothelial cell-independent cholinergic relaxation.
Authors: J E Brayden, J A Bevan
Journal: Circulation Research (1985)

Nerve-mediated and acetylcholine-induced dilator behavior of feline posterior auricular arteries was studied in vitro. We evaluated the muscarinic nature and endothelial cell-dependence of the vasodilations and attempted to determine if there are inhibitory muscarinic receptors located directly on the smooth muscle cells in this artery. Transmural nerve stimulation of arteries which were pretreated with guanethidine (5 X 10(-6)M) and constricted with prostaglandin F2 alpha (3 X 10(-6)M) caused a frequency-dependent, tetrodotoxin-sensitive relaxation of up to 50% of induced tone. Atropine (10(-7)M) blocked more than 95% of this response at all frequencies. Removal of the endothelium by rubbing the intimal surface did not affect the magnitude of the response, but prolonged it slightly. Neurogenic relaxations in rubbed preparations were atropine-sensitive, although less so than control at higher stimulation frequencies. Relaxation of this artery to the calcium ionophore A23187 was completely endothelial cell-dependent. However, exogenous acetylcholine caused dose-dependent relaxations both in control and rubbed preparations. We conclude that the posterior auricular artery is an example of a blood vessel which has muscarinic receptors located directly on its smooth muscle cells which, when activated by acetylcholine released from perivascular nerves, mediate a smooth muscle cell relaxation. This finding contrasts with models of the vascular smooth muscle cell which indicates an excitatory role for muscarinic receptors.
Protein turnover in cardiac cell growth and survival
Authors: N HEDHLI, M PELAT, C DEPRE
Journal: Cardiovascular Research (2005)

Protein turnover represents the balance between protein synthesis and degradation. It can be controlled quantitatively, for instance by an activation of protein synthesis during cardiac hypertrophy or by activating protein degradation during ventricular unloading. It can also be regulated qualitatively by changing the steady state concentration of specific proteins and enzymes. The recent literature points to an emerging role for the mammalian target of rapamycin (mTOR) and for the ubiquitin-proteasome system (UPS) in this process, and both pathways interact in the regulation of cell growth and survival. We highlight the critical role played by such interaction in different cellular functions, including insulin signaling, stress response to hypoxia, adaptation to variations in workload, regulation of protein phosphatase activity, apoptosis and post-ischemic recovery. A deregulation of these pathways participates in the mechanisms of cardiac ischemia, hypertrophy and failure, and controlling their activity represents an opportunity for novel therapeutic avenues.
"Fish Vertebrae," Homocystinuria, and Sickle Cell Anemia
Authors: Maxwell P. Westerman
Journal: JAMA (1974)

HUMAN vertebrae occasionally resemble fish vertebrae in that a concave depression is present on the upper and lower surfaces of the vertebral bodies. This change, readily shown on roentgenographic examination, may be observed in individuals with osteoporosis as well as in patients with hemoglobin disorders, particularly those associated with sickle hemoglobin. Although the vertebral changes observed in osteoporosis and sickle cell disorders appear similar, careful examination has shown that they are distinctly different in cause as well as in morphology, and that the "fish vertebrae" of sickle cell disorders are unique. 1 We have recently seen a patient with homocystinuria in whom the vertebrae resembled the "fish vertebrae" of patients with sickle cell disorders. This suggests a similarity in the vascular pathology of both disorders. <h3>Report of a Case</h3> A 22-year-old white man had homocystinuria resulting from cystathionine synthetase deficiency. He was mentally retarded, had previously had bilateral iridectomy
Enhanced Antitumor Activity of Murine-Human Hybrid T-Cell Receptor (TCR) in Human Lymphocytes Is Associated with Improved Pairing and TCR/CD3 Stability
Authors: Cyrille J. Cohen, Yangbing Zhao, Zhili Zheng, Steven A. Rosenberg, Richard A. Morgan
Journal: Cancer Research (2006)

Abstract Little is known about the biology of murine T-cell receptors (TCR) expressed in human cells. We recently observed that a murine anti-human p53 TCR is highly functional when expressed in human lymphocytes. Herein, we compare human and mouse TCR function and expression to delineate the molecular basis for the apparent superior biological activity of murine receptors in human T lymphocytes. To this end, we created hybrid TCRs where we swapped the original constant regions with either human or mouse ones, respectively. We showed that murine or “murinized” receptors were overexpressed on the surface of human lymphocytes compared with their human/humanized counterparts and were able to mediate higher levels of cytokine secretion when cocultured with peptide-pulsed antigen-presenting cells. Preferential pairing of murine constant regions and improved CD3 stability seemed to be responsible for these observations. These enhanced biological properties translated into significantly greater antitumor response mediated by TCR with mouse constant regions. Furthermore, we were able to circumvent the natural low avidity of class I MHC TCR in CD4+ cells by introducing the murinized TCR into CD4+ lymphocytes, giving them the ability to recognize melanoma tumors. These findings have implications for human TCR gene transfer therapy and may provide new insights into the biology of the TCR/CD3 complex. (Cancer Res 2006; 66(17): 8878-86)
Two-Year Cognitive, Emotional, and Quality-of-Life Outcomes in Acute Respiratory Distress Syndrome
Authors: Ramona O. Hopkins, Lindell K. Weaver, Dave Collingridge, R. Bruce Parkinson, Karen J. Chan, James F. Orme
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Acute respiratory distress syndrome (ARDS) has a high mortality and is associated with significant morbidity. Prior outcome studies have focused predominant on short-term outcomes (6-12 months). We assessed longitudinal neurocognitive, emotional, and quality of life in ARDS survivors at hospital discharge, and 1 and 2 years after hospital discharge using neuropsychologic tests and emotional and quality-of-life questionnaires. Neurocognitive sequelae occurred in 73% (54 of 74) of ARDS survivors at hospital discharge, 46% (30 of 66) at 1 year, and 47% (29 of 62) at 2 years. ARDS survivors report moderate to severe depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. The ARDS survivors had decreased quality of life, with the physical domains improving at 1 year, with no additional change at 2 years. Role emotional, pain, and general health did not change from hospital discharge to 2 years. Mental health improved during the first year and declined at 2 years. ARDS results in significant neurocognitive and emotional morbidity and decreased quality of life that persists at least 2 years after hospital discharge. ARDS can cause significant long-term, brain-related morbidity manifest by neurocognitive impairments and decreased quality of life.
Trends in the Leading Causes of Death in the United States, 1970-2002
Authors: Ahmedin Jemal
Journal: JAMA (2005)

The decrease in overall death rates in the United States may mask changes in death rates from specific conditions.To examine temporal trends in the age-standardized death rates and in the number of deaths from the 6 leading causes of death in the United States.Analyses of vital statistics data on mortality in the United States from 1970 to 2002.The age-standardized death rate and number of deaths (coded as underlying cause) from each of the 6 leading causes of death: heart disease, stroke, cancer, chronic obstructive pulmonary disease, accidents (ie, related to transportation [motor vehicle, other land vehicles, and water, air, and space] and not related to transportation [falls, fire, and accidental posioning]), and diabetes mellitus.The age-standardized death rate (per 100,000 per year) from all causes combined decreased from 1242 in 1970 to 845 in 2002. The largest percentage decreases were in death rates from stroke (63%), heart disease (52%), and accidents (41%). The largest absolute decreases in death rates were from heart disease (262 deaths per 100,000), stroke (96 deaths per 100,000), and accidents (26 deaths per 100,000).The death rate from all types of cancer combined increased between 1970 and 1990 and then decreased through 2002, yielding a net decline of 2.7%. In contrast, death rates doubled from chronic obstructive pulmonary disease over the entire time interval and increased by 45% for diabetes since 1987. Despite decreases in age-standardized death rates from 4 of the 6 leading causes of death, the absolute number of deaths from these conditions continues to increase, although these deaths occur at older ages.The absolute number of deaths and age at death continue to increase in the United States. These temporal trends have major implications for health care and health care costs in an aging population.
UK blood donation needs reorganisation
Authors: F. Booth
Journal: BMJ (1998)

EDITOR—Fifty years after the start of the National Blood (Transfusion) Service collection of blood from volunteers in the United Kingdom still takes place predominantly in church halls and community centres, uses an archaic assessment of haemoglobin concentration (the copper sulphate test), and sees fleets of pantechnicons trundling many miles across the countryside. The collection service mainly operates from Monday to Friday, and each team's period of productive blood collection is perhaps …