tbuckley/cabot-search huggingface dataset:
Privacy Beliefs and the Violent Family
Authors: David M. Baughan
Journal: JAMA (1993)

To the Editor.  —I applaud the publication of the article by Dr Jecker entitled Privacy Beliefs and the Violent Family. 1 In 15 years of clinical and academic medicine, I have been frequently frustrated with the inadequacy of ethical discussions as they apply to privacy concepts and significant, expensive health problems, such as family violence and substance abuse, that I commonly detect in primary care. I am also aware that I am not detecting these problems as often as possible owing to the habits and inhibitions of my socialization and medical training. I find the application of the concept of justice to the ethical analysis of the physician's role to be entirely appropriate.  In support of the call in Dr Jecker's last sentence for questioning the assumptions underpinning ethical analysis, I would like to suggest additional concepts that may be pertinent to family violence and other health problems in which
Relation Between Soluble Adhesion Molecules and Insulin Sensitivity in Type 2 Diabetic Individuals
Authors: Giovanni Targher, Riccardo C. Bonadonna, Maria Alberiche, Marina B. Zenere, Michele Muggeo, Enzo Bonora
Journal: Diabetes Care (2001)

OBJECTIVE—The purpose of this study was to explore the relation between insulin resistance and plasma levels of soluble adhesion molecules and to examine the effects of acute hyperinsulinemia on these molecules in type 2 diabetic individuals. RESEARCH DESIGN AND METHODS—Intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E- and P-selectin plasma concentrations were measured in 36 nonobese type 2 diabetic patients without cardiovascular disease and in 7 healthy subjects. Insulin sensitivity was assessed by a 4-h euglycemic (∼5 mmol/l)-hyperinsulinemic (∼300 pmol/l) clamp performed in combination with [3H]3-d-glucose infusion. RESULTS—Diabetic subjects were insulin resistant but did not show plasma concentrations of adhesion molecules that were significantly higher than control subjects. In diabetic subjects, plasma ICAM-1 and E-selectin were negatively correlated with total glucose disposal during the insulin clamp (r = −0.432, P &amp;lt; 0.01; and r = −0.375, P &amp;lt; 0.05, respectively), whereas plasma VCAM-1 and P-selectin were not. Plasma ICAM-1 as well as E- and P-selectin were positively correlated with BMI, total body fat (TBF), and waist girth (P &amp;lt; 0.05–0.001). In multiple regression analyses, the relation of plasma ICAM-1 and E-selectin with insulin sensitivity was lost after adjustment for potential confounders, including HbA1c, blood pressure, and/or LDL cholesterol. In these analyses, BMI was the only independent predictor of plasma ICAM-1 (R2 = 0.244, P &amp;lt; 0.002), whereas TBF was the only independent predictor of plasma E-selectin (R2 = 0.202, P = 0.01). The 4-h insulin infusion during the glucose clamp did not significantly change plasma levels of adhesion molecules. CONCLUSIONS—Overall adiposity, rather than insulin resistance, may be a determinant of plasma levels of ICAM-1 and E-selectin in type 2 diabetic individuals. In these patients, acute hyperinsulinemia does not exert any significant effect on plasma adhesion molecules. These findings support the possibility that adipose tissue releases one or more factors that may adversely affect endothelial function on one hand and insulin sensitivity on the other.
Commission calls for medical training to become more generalist
Authors: J. Wise
Journal: BMJ (2011)

<b>Background:</b> Some obese patients with OSA also develop OHS at some point, which is thought to be a gradual process. The aim of this study is to characterize a spectrum of OSA patients to further elucidate the transition from pure OSA to OHS. <b>Methods:</b> We present data from a prospective observational study. Patients with (suspected) SRBD and BMI &gt;30 kg/m² got arterial blood gas analyses (ABG) before, during and after initial polysomnography (PSG). Following measurements comprised bodyplethysmography, cardiopulmonary exercise testing (CPET), lung compliance and hypercapnic ventilatory response (HCVR). <b>Results:</b> Until now, 18 patients were examined (4 f, 55.4±13.5 y, BMI 40±6 kg/m², ESS Score 7±5). Mean PaCO2 before/during/after PSG was normal (39±3/42±5/39±6mmHg). Mean AHI was 50±31/h, oxygen desaturation index 45±34/h with minimal saturation of 70±19%. Lung function was normal except for reduced expiratory reserve volume (45±23%). Mean lung compliance was normal with large interindividual variation (Cstat 3.8±5.4, Cdyn 2.4±3.3). Mean HCVR was 2.0±1.4 L/min/mmHg. CPET (n=17) showed reduced maximal performance (75±37%pred.), good O2 uptake (VO2max 112±20%pred, VO2 at AT 1527±425 ml/min), no pulmonary limitations (AaDo2 35±8, BR 17±23, VT/IC 0.7±0.2). Heart rate reserve was not reached (HRR 36±12). 2/17 patients were hypercapnic (PaCO2 47 &amp; 54 mmHg) and thus showed signs of OHS onset. <b>Conclusion:</b> These preliminary data do not yet allow for comprehensive characterization of different stages in the development from OSA to OHS. However, a small fraction of patients showed indication of being in a transitory state. An increasing number of study subjects will allow doing a more detailed analysis in the future.
Suppression of natural killing in vitro by monocytes and polymorphonuclear leukocytes: requirement for reactive metabolites of oxygen.
Authors: W E Seaman, T D Gindhart, M A Blackman, B Dalal, N Talal, Z Werb
Journal: Journal of Clinical Investigation (1982)

Natural killer cells spontaneously lyse certain tumor cells and may defend against malignancy. We have previously shown that natural killing (NK) by human peripheral blood mononuclear cells (PBMC) is suppressed in vitro by phorbol diester tumor promoters, including 12-O-tetradecanoylphorbol-13-acetate (TPA). We here demonstrate that suppression of NK is mediated by monocytes or polymorphonuclear leukocytes (PMN) and that suppression is dependent on the generation of reactive forms of molecular oxygen (RO), particularly hydrogen peroxide (H2O2). NK was suppressed not only by TPA but also by opsonized zymosan (yeast cell walls), which, like TPA, was not toxic to PBMC. Both TPA and zymosan stimulated the production of superoxide anion (O2-) and H2O2 by PBMC. Production of RO correlated with suppression of NK. When PBMC were depleted of monocytes, the production of RO and the suppression of NK were both markedly reduced. Suppression could be restored by monocytes or PMN, both of which produced RO in response to TPA or zymosan. Suppression of NK was dependent on RO. Monocytes or PMN from a patient with chronic granulomatous disease, whose cells cannot generate RO, did not mediate suppression of NK. Suppression was also reduced in glucose-free medium, which did not support the generation of RO. Suppression of NK by TPA was inhibited by catalase. Bovine superoxide dismutase had a limited effect on suppression, even in high concentration, and tyrosine-copper (II) complex, which also enhances dismutation of O2- to H2O2, had almost no effect on suppression. When H2O2 was directly generated enzymatically from glucose oxidase and glucose, NK was suppressed and suppression was reversed by catalase. NK was also suppressed by the enzymatic generation of O2- from xanthine oxidase and xanthine, but suppression under these conditions was again inhibited by catalase and not by superoxide dismutase, indicating that suppression was due to the secondary formation of H2O2 from O2-. These results indicate that H2O2 is important in suppression of NK. Myeloperoxidase did not appear to play a role in suppression because inhibition of this enzyme by sodium azide, cyanide, or aminotriazole did not prevent suppression of NK. Suppression of NK was reversible; after exposure to zymosan, NK could be partially restored by the addition of catalase and superoxide dismutase or by the removal of zymosan. These studies demonstrate cellular regulation of NK by monocytes or polymorphonuclear leukocytes and indicate a role for RO in immunoregulation.
Large granular lymphocytes from B‐chronic lymphocytic leukemia patients inhibit normal B cell proliferation
Authors: Robert T. Perri, Neil E. Kay
Journal: American Journal of Hematology (1989)

Large granular lymphocytes (LGL) may exert regulatory influences on B cell immunoglobulin synthesis. We, therefore, investigated the influence of LGL from controls and B cell chronic lymphocytic leukemia patients (B-CLL) on control B cell proliferation to costimulation with the F(ab')2 fragment of goat antihuman mu and B cell growth factor (BCGF). Purified LGL (greater than 90% by morphology) from control and B-CLL peripheral blood were added in various concentrations to purified control B cells and incubated with anti-mu and BCGF for 3 days. [3H]-thymidine uptake of B cells was then measured. There was no proliferation of control or CLL LGL alone to the costimulatory signals of the F(ab')2 fragments of goat antihuman mu chain and BCGF. Addition of control LGL to equal numbers of control B cells did not blunt control B cell responsiveness to BCGF (with control LGL 8,649 +/- 298 cpm vs. control B cells alone 8,336 +/- 556 cpm, mean +/- SEM). When control LGL were increased to 10:1 LGL:B cell ratio, the maximal inhibition by control LGL of control B cell proliferative response to BCGF was 23%. In contrast, addition of CLL LGL at a 1:1 LGL:B cell ratio resulted in marked impairment of the control B cell proliferative response to BCGF (with CLL LGL 3,586 +/- 954 cpm vs. control B cells alone 8,649 +/- 298 cpm). Inhibition by CLL LGL occurred in a cell-concentration-dependent manner. No difference in CLL LGL's inhibitory effect on either resting or activated control B cell responsiveness to BCGF was noted. Inhibition of de novo protein synthesis (by cycloheximide inhibition) of CLL LGL did impair CLL LGL's inhibitory capacity for BCGF-induced B cell proliferation. A possible explanation for these findings includes the possibility that a subgroup of LGL with B cell suppressive activity may have expanded as a host response to the B cell leukemia or as part of the disordered cell regulation in B-CLL.
MST3 Kinase Phosphorylates TAO1/2 to Enable Myosin Va Function in Promoting Spine Synapse Development
Authors: Sila K. Ultanir, Smita Yadav, Nicholas T. Hertz, Juan A. Oses-Prieto, Suzanne Claxton, Alma L. Burlingame, Kevan M. Shokat, Lily Y. Jan, Yuh-Nung Jan
Journal: Neuron (2014)
Diffuse Bronchopulmonary Aspergillosis
Authors: A. O. Bech
Journal: Thorax (1961)

Diffuse bronchopulmonary aspergillosis is a comparatively rare condition.The number of reported cases in the more recent literature are few, where confirmation has been obtained from the study of necropsy material or of material obtained by pulmonary resection.In this paper two cases of diffuse broncho- pulmonary aspergillosis are reported in detail.The post-mortem findings and histology are described; the relevant literature is also reviewed. MYCOLOGYAspergillosis is caused by certain species of aspergillus, which belongs to the group of filamentous fungi.The morphological appearance of the different species pathogenic to man and their cultural characteristics have been fully described by Thom and Raper (1945), by Ross (1951), by Hinson, Moon, and Plummer (1952), and by Conant, Smith, Baker, Callaway, and Martin (1954).In the majority of cases aspergillosis is caused by A. fumigatus, but occasionally by A. niger, and only rarely have strains such as A. vesicular, A.
TCT-583 The Extent of Lipid-Rich Plaque Assessed by Near-Infrared Spectroscopy May Predict DES Failure: A COLOR Registry Analysis
Authors: Tomotaka Dohi, Giora Weisz, Eric R. Powers, Daniel H. Steinberg, James Goldstein, Priti R. Shah, James E. Muller, Gary S. Mintz, Gregg Stone, Akiko Maehara
Journal: Journal of the American College of Cardiology (2013)
ORTHOPEDIC PROBLEMS IN LEPROSY
Authors: PAUL A. McILHENNY
Journal: JAMA (1926)

In the spring of 1924, Dr. O. E. Denney, the officer in charge of U. S. Marine Hospital No. 66, the National Leprosarium, at Carville, Louisana, conceived the idea that many of the patients could be greatly benefited by orthopedic treatment, and perhaps relieved of their characteristic deformities; if so, one of their most serious problems, after being discharged from the colony, would be solved. I was asked to visit the hospital and to make a survey of the patients from an orthopedic standpoint, so as to advise what could be done to help restore these unfortunates to usefulness. After making an extensive tour of the institution during which about half of the 250 patients were examined, my conclusions were that the majority of the deformities could be prevented, and many could be greatly benefited by the establishment of an orthopedic service, provided a well equipped physiotherapy department was installed.
PHARMACISTS AND PHYSICIANS AND THE FOOD AND DRUGS ACT.REPORT OF THE SECRETARY TO THE SECTION ON PHARMACOLOGY AND THERAPEUTICS, AMERICAN MEDICAL ASSOCIATION, ATLANTIC CITY, JUNE, 1907.
Authors: C. S. N. HALLBERG
Journal: JAMA (1907)

The past year has been an eventful one for medicine and pharmacy. The federal Food and Drugs Act, which went into effect Jan. 1, 1907, marked a new era, since for the first time in the history of the United States definite standards were adopted for drugs, chemicals and medicines through the legal recognition of the U. S. Pharmacopeia and its auxiliary, the National Formulary. Although the standards of the U. S. Pharmacopeia have been recognized by different departments of the Federal Government for a long time and have been generally accepted by the state pharmacy acts and by the courts, not until this year may it be said to have secured general recognition throughout the Union. There are two provisions in the act to which it is desired to direct attention, since state legislation modeled on their identical lines has been attempted and already secured by several states:
Diagnosis and Surgical Correction of Congenital Coronary Artery-Coronary Sinus Fistula
Authors: J. ALEX HALLER, JOSEPH A. LITTLE
Journal: Circulation (1963)

Congenital coronary arteriovenous fistula is easily confused with patent ductus arteriosus. An illustrative case is presented which emphasizes the special tests that are necessary to establish the diagnosis. Finally, the successful surgical correction of this abnormality is described.
Rheumatoid arthritis and ankle surgery.
Authors: J Kirkup
Journal: Annals of the Rheumatic Diseases (1990)

Twenty years' experience in a foot clinic com- bining the interests of a rheumatologist with those of an orthopaedic surgeon indicates that the foot disabled by rheumatoid arthritis com- monly presents with (a) multiple joint damage at different stages of evolution and also of asymmetrical distribution between the two feet; (b) a commonly progressive and yet often erratic pathology; and (c) management problems posed by proximal joint disease, especially at the knee and in the hip.Thus rheumatoid disease can affect many and occasionally all of some 25 closely interrelated joints in the foot, including the ankle joint, which is rarely attacked in isolation and is usually influenced by the other joints.For example, damaged subtaloid and midtarsal joints may cause a valgus or, less frequently, a varus attitude of the foot, leading to a valgus or varus strain, or, indeed, a subluxation at the ankle joint.Thus intertarsal correction takes precedence over ankle surgery.Similarly, severe destruction of the metatarsophalangeal joints combined with skin breakdown and infection in the sole demands their prior solu- tion.Knee valgus induces a valgus strain on the foot, and if the knee is painful and unstable it may need surgical attention before the foot, which can often be stabilised with orthoses.A fixed flexion attitude of the hip and particularly of the knee induces a dorsiflexed attitude of the foot under load, and thus arthrodesis of the ankle in the classical position of moderate equinus may prove a disservice to the patient.
Latent Radiation Injury of Lungs or Heart Activated by Steroid Withdrawal
Authors: Ronald A. Castellino, Eli Glatstein, M. M. Turbow, Saul Rosenberg, Henry S. Kaplan
Journal: Annals of Internal Medicine (1974)

Seven patients with Hodgkin's disease had radiation pneumonitis or radiation-induced heart disease that developed during MOPP (nitrogen mustard, vincristine sulfate (Oncovin®), procarbazine, and prednisone) chemotherapy that had been preceded by "mantle" radiation therapy. In all patients the symptoms developed shortly after completion of either cycle 1 or cycle 4 of MOPP, the only cycles in which high doses of prednisone are given. Intervals between radiation and the development of overt radiation injury ranged from a few months to 6 years, without any prior radiographic or clinical suggestion of injury. We believe the rapid withdrawal of high-dose corticosteroids may activate subclinical radiation injury in the lungs or heart. The importance of recognizing this syndrome, which responds to high doses of corticosteroids tapered during many months, is emphasized.
Smoking and Autoimmune Thyroid Disease
Authors: Luisa Fernandez-Soto
Journal: Annals of Internal Medicine (1997)

Letters15 June 1997Smoking and Autoimmune Thyroid DiseaseLuisa Fernandez-Soto, MD, Amalia Gonzalez-Jimenez, MD, and Fernando Escobar-Jimenez, MDLuisa Fernandez-Soto, MDUniversity Hospital, Granada, SpainSearch for more papers by this author, Amalia Gonzalez-Jimenez, MDUniversity Hospital, Granada, SpainSearch for more papers by this author, and Fernando Escobar-Jimenez, MDUniversity Hospital, Granada, SpainSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-12-199706150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Evidence increasingly suggests that smoking has an effect on autoimmune thyroid disease. In particular, smoking has been shown to worsen Graves disease and Graves ophthalmopathy [1]. The exact role of smoking on the autoimmune mechanism is unclear, but smoking is known to have an antithyroid effect [2, 3]. We investigated antithyroid peroxidase antibodies (TPO-Ab) and antithyroglobulin antibodies (Tg-Ab) in a large cohort of healthy pregnant women before 16 weeks of gestation (n = 349). Levels of TPO-Ab were significantly increased (P < 0.001) in the 32 women who smoked more than 10 cigarettes per day before gestation ...References1. Winja B, Mandahl A, Karlsson FA. Graves' disease, endocrine ophthalmopathy and smoking. Acta Endocrinol. 1993; 128:156-60. Google Scholar2. Fukuyama H, Nasu M, Murakami S, Sugawara M. Examination of antithyroid effects of smoking products in cultured thyroid follicles: only thiocyanate is a potent antithyroid agent. Acta Endocrinol. 1992; 127:520-5. Google Scholar3. Bartalena L, Bogazzi F, Tand M, Maneti L, Dell'unto C, Martino E. Cigarette smoking and the thyroid. Eur J Endocrinol. 1995; 133:507-11. Google Scholar4. Glinoer D, Riahi M, Grun JP, Kinthaert J. Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab. 1994; 79:197-204. Google Scholar Author, Article, and Disclosure InformationAuthors: Luisa Fernandez-Soto, MD; Amalia Gonzalez-Jimenez, MD; Fernando Escobar-Jimenez, MDAffiliations: University Hospital, Granada, Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThyroid Autoimmunity in Schoolchildren in an Area with Long-Standing Iodine Sufficiency: Correlation with Gender, Pubertal Stage, and Maternal Thyroid AutoimmunityActualización clínica de la enfermedad tiroidea autoinmuneThyroid Function During Pregnancy and The Postpartum Period: Iodine Metabolism and Disease States 15 June 1997Volume 126, Issue 12Page: 1005KeywordsAntibodiesPeroxidasesPregnancyThyroid diseasesThyroid-stimulating hormoneThyroxine ePublished: 15 August 2000 Issue Published: 15 June 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
THE SIGNIFICANCE OF LYMPHATIC INVOLVEMENT IN INFECTIONS
Authors: WILLIAM J. MAYO
Journal: JAMA (1923)

A clinician of great experience once made the statement that if he had his choice between an infection disseminated through the blood stream and one spread by the way of the lymphatics, he would choose the former, giving as a reason that when a noxious agent enters the blood, the whole force of the organism acts on it quickly, with the reasonable chance that it will be carried to some portion of the body with sufficient resistance to develop immunity; whereas, if it enters the lymphatics and is not overcome in the lymph nodes, the toxic agent may be permitted to enter the blood stream more or less continually, and will perhaps eventually lead to an incurable infection. This opinion was so greatly at variance with that of the medical profession at large that I speculated on the number and importance of the facts to sustain it. In the light
African American Women Who Receive Primary Anthracycline- and Taxane-Based Chemotherapy for Triple-Negative Breast Cancer Suffer Worse Outcomes Compared With White Women
Authors: Ani Balmanoukian, Zhe Zhang, Stacie Jeter, Shannon Slater, Deborah K. Armstrong, Leisha A. Emens, John H. Fetting, Antonio C. Wolff, Nancy E. Davidson, Lisa Jacobs, Julie Lange, Theodore N. Tsangaris, Richard Zellars, Edward Gabrielson, Vered Stearns
Journal: Journal of Clinical Oncology (2009)

Comparisons were made excluding unknowns.Percentages may not add up to 100 due to rounding.Abbreviations: PST, primary systemic therapy; A, doxorubicin; C, cyclophosphamide; T, docetaxel; P, paclitaxel; pCR, pathological complete response.*Total number of tumors ϭ 40.Two women had synchronous tumors (one white woman with a stage I and II tumors, and one other woman with stage II and III tumors).†P values were obtained using Fisher's exact test, exact 2 test, or Wilcoxon rank sum test, as appropriate.‡One woman had progressive disease and metastases while on primary systemic therapy.
Mapping of Pelvic Lymph Node Metastases in Prostate Cancer
Authors: Steven Joniau, Laura Van den Bergh, Evelyne Lerut, Christophe M. Deroose, Karin Haustermans, Raymond Oyen, Tom Budiharto, Filip Ameye, Kris Bogaerts, Hein Van Poppel
Journal: European Urology (2012)