tbuckley/cabot-search huggingface dataset:
Correction: Dr. Datta's Name
Authors: SYAMAL KUMAR DATTA
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 September 1972Correction: Dr. Datta's NameSYAMAL KUMAR DATTA, M.D.SYAMAL KUMAR DATTA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-77-3-486_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: My name was printed incorrectly in the letter published in the June 1972 issue (Ann Intern Med76:1045-1046). The first name should be spelled Syamal. I shall appreciate your making the correction.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cook County Hospital Chicago, Ill. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1972Volume 77, Issue 3Page: 486-486 Issue Published: 1 September 1972 PDF DownloadLoading ...
Syncope and Functional Infranodal Block
Authors: Archana Patel
Journal: Annals of Internal Medicine (1990)

Letters15 December 1990Syncope and Functional Infranodal BlockArchana Patel, MD, Daniel Goldman, MDArchana Patel, MDSearch for more papers by this author, Daniel Goldman, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-12-994 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:We read with interest the article by Manolis and colleagues (1) and offer the following comments. Their Figure 6 shows an early atrial premature beat that blocks below the bundle of His, and in the legend the authors state, "The probability of intermittent heart block causing syncope in this patient was sufficiently high to merit a permanent pacemaker" (1). We would like to point out that block of early atrial premature beats below the His bundle can be a physiologic type of block with no pathologic significance, because in some patients the effective refractory period of the...References1. ManolisLinzerSalemEstes AMDN. Syncope: current diagnostic evaluation and management. Ann Intern Med. 1990;112:850-63. LinkGoogle Scholar2. JosephsonSeides MS. Clinical Cardiac Electrophysiology: Techniques and Interpretations. Philadelphia: Lea & Febiger; 1979:45-8. Google Scholar3. WitWeissBerkowitzRosenSteinerDamato AWWKCA. Patterns of atrioventricular conduction in the human heart. Circ Res. 1970;27:345-59. CrossrefMedlineGoogle Scholar4. AkhtarDamatoCaractaBatsfordJosephsonLau MAAWMS. Electrophysiologic effects of atropine on atrioventricular conduction studied by His bundle electrogram. Am J Cardiol. 1974;33:333-43. CrossrefMedlineGoogle Scholar5. DamatoVargheseCaractaAkhtarLau APAMS. Functional 2:1 AV block within the His-Purkinje system: simulation of type II second degree A-V Block. Circulation. 1973;47:534-42. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Jersey City Medical Center Jersey City, NJ 07304 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1990Volume 113, Issue 12Page: 994-995KeywordsAtrial premature beatHeartPacemakersSyncope Issue Published: 15 December 1990 PDF DownloadLoading ...
Biochemical diagnosis of ventricular dysfunction in elderly patients in general practice: observational study
Authors: H Smith
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To investigate the usefulness of measuring plasma concentrations of B type natriuretic peptide in the diagnosis of left ventricular systolic dysfunction in an unselected group of elderly people. <b>Design:</b> Observational study. <b>Setting:</b> General practice with four centres in Poole, Dorset. <b>Participants:</b> 155 elderly patients aged 70 to 84 years. <b>Main outcome measures:</b> Diagnostic characteristics of plasma B type natriuretic peptide measured by radioimmunoassay as a test for left ventricular systolic dysfunction assessed by echocardiography. <b>Results:</b> The median plasma concentration of B type natriuretic peptide was 39.3 pmol/l in patients with left ventricular systolic dysfunction and 15.8 pmol/l in those with normal function. The proportional area under the receiver operator curve was 0.85. At a cut-off point of 18.7 pmol/l the test sensitivity was 92% and the predictive value 18%. <b>Conclusions:</b> Plasma concentration of B type natriuretic peptide could be used effectively as an initial test in a community screening programme and, possibly, using a low cut-off point, as a means of ruling out left ventricular systolic dysfunction. It is, however, not a good test to "rule in" the diagnosis, and access to echocardiography remains essential for general practitioners to diagnose heart failure early.
ABC of psychological medicine: Fatigue
Authors: Michael Sharpe, David Wilks
Journal: BMJ (2002)

Fatigue can refer to a subjective symptom of malaise and aversion to activity or to objectively impaired performance. It has both physical and mental aspects. The symptom of fatigue is a poorly defined feeling, and careful inquiry is needed to clarify complaints of “fatigue,” “tiredness,” or “exhaustion” and to distinguish lack of energy from loss of motivation or sleepiness, which may be pointers to specific diagnoses (see below). 

Prevalence—Like blood pressure, subjective fatigue is normally distributed in the population. The prevalence of clinically significant fatigue depends on the threshold chosen for severity (usually defined in terms of associated disability) and persistence. Surveys report that 5-20% of the general population suffer from such persistent and troublesome fatigue. Fatigue is twice as common in women as in men but is not strongly associated with age or occupation. It is one of the commonest presenting symptoms in primary care, being the main complaint of 5-10% of patients and an important subsidiary symptom in a further 5-10%.

Fatigue as a symptom—Patients generally regard fatigue as important (because it is disabling), whereas doctors do not (because it is diagnostically non-specific). This discrepancy is a potent source of potential difficulty in the doctor-patient relationship. Fatigue may present in association with established medical and psychiatric conditions or be idiopathic. Irrespective of cause, it has a major impact on day to day functioning and quality of life. Without treatment, the prognosis of patients with idiopathic fatigue is surprisingly poor; half those seen in general practice with fatigue are still fatigued six months later.
Influence of coronary collateral blood flow on the development of exertional ischemia and Q wave infarction in patients with severe single-vessel disease.
Authors: S B Freedman, R F Dunn, L Bernstein, J Morris, D T Kelly
Journal: Circulation (1985)

The functional significance of coronary collateral flow from a nonobstructed supply artery was studied in 121 patients with severe (greater than or equal to 80%) single-vessel disease, 64 with and 57 without Q wave infarction. All patients underwent exercise thallium imaging and coronary angiography. On angiography, collateral flow was present in 85% of 74 occluded arteries compared with only 17% of 47 arteries with subtotal obstruction (p less than .001). Collateral flow was not seen in arteries with lesions of less than 90% obstruction. Collateral flow was present in 100% of 29 occluded arteries in patients without Q wave infarction compared with only 76% of 45 occluded arteries with Q wave infarction (p less than .005). Clinical variables did not correlate with collateral flow. Collateral flow did not prevent ischemia on exercise thallium imaging in patients without Q wave infarction: 30 of 33 (91%) with collateral flow had reversible thallium defects compared with 24 of 24 (100%) without collateral flow (p = NS). In patients with Q wave infarction, partially reversible exercise thallium defects (peri-infarctional ischemia) were more common with flow to the area from either subtotal obstruction (73%) or collateral flow (45%) than with no flow from total occlusion (27%; p = .05). In patients with severe single-vessel disease the presence of collateral flow is principally determined by coronary occlusion. Collateral flow may protect from Q wave infarction but does not prevent exercise ischemia on thallium imaging.
THE KRAG-JORGENSEN BULLET-WOUND
Authors: VALERY HAVARD
Journal: JAMA (1898)

At my request, Dr Mariano Ojuna, surgeon in chief of the military hospital at Santiago de Cuba, kindly sent me, on Aug. 19, 1898, some notes which I offer as a small but interesting contribution to a very important subject. Dr. Ojuna regretted his inability to prepare a more elaborate report, being at the time exceedingly busy in superintending the transfer of the sick and wounded to the Spanish transports. But first a few preliminary remarks. He states that 541 wounded—43 officers and 498 men came into the military hospital for treatment. Of the killed he makes no mention. As this hospital was the only available one, we may infer that all the wounded really<i>hors de combat</i>were admitted to it. On the other hand, according to the official Spanish report, the casualties were as follow: Killed, officers 17, men 107; wounded, officers 59, men 556; missing, officers 7,
Evaluation of a System for Automatic Detection of Diabetic Retinopathy From Color Fundus Photographs in a Large Population of Patients With Diabetes
Authors: John A. Olson, Peter F. Sharp, Alan Fleming, Sam Philip
Journal: Diabetes Care (2008)

We read with interest the recent article by Abramoff et al.(1) but were disappointed in their conclusion that automated grading software could not be recommended for clinical practice.

Our group's published work (2) shows that automated grading of diabetic retinopathy, based on image-quality assessment and microaneurysm detection, can safely reduce the burden of grading in diabetic retinopathy screening programs. Comparing manual and automated grading against a reference standard grading of 14,406 images (from 6,722 patients), we found that our automated system attained a higher sensitivity for detection of patients requiring “full disease” grading than the …
Introduction to the Compendium on Calcific Aortic Valve Disease
Authors: Donald D. Heistad, Catherine Shanahan, Linda L. Demer
Journal: Circulation Research (2013)

O nce symptoms arise, stenotic aortic valve disease leads rapidly to death unless surgical or interventional replacement is performed.Already the most prevalent form of valvular heart disease in the Western world, fibrocalcific aortic valve disease affects 25% of those aged >65 years, 1 and its incidence is growing inevitably as our population ages.Valve replacement is second only to coronary bypass surgery among operations in the heart.Food and Drug Administration approval of percutaneous transcatheter aortic valve replacement this past year has sparked growing interest in the underlying pathophysiology of the disease.According to many of our textbooks, aortic valve stenosis results from an inevitable, degenerative disorder of aging, due solely to mechanical wear and tear.However, with advances in experimental models and based on pioneering work 2-4 by Mohler, Otto, and Rajamannan, recent research findings are now converging on a major shift in paradigm, with inflammation and atherogenic phenomena as the emerging mechanisms.The goal of this Compendium-the first of its category in Circulation Research-is to update investigators and clinicians on the dramatic changes in our understanding of aortic valve disease through a series of reports covering the spectrum of research, from basic science in valvular interstitial cells, and molecular mechanisms in animal models, to epidemiology of populations and clinical trials in patients.Carabello 5 opens the series with a historical perspective on the new disease of aortic valve stenosis.With rheumatic fever no longer a major cause of aortic stenosis in developed countries, patients now present at older ages, resulting in changes in natural history, clinical signs, and comorbidities.He addresses mechanisms, such as hemodynamic stress and inflammation, which account for the new clinical manifestations.He also comments on the team-based, interventional option, now available for advanced stages of disease, in which a mechanical valve is inserted via a catheter within and, like a stent, expanded over the diseased valve.In their contribution on hemodynamic and cellular response feedback, Gould, Srigunapalan, Simmons, and Anseth 6 report on the mechanically hostile environment facing valves, including shear, bending, tensile, and compressive forces, and how the effects of these stresses depend on the intrinsic mechanical properties of the extracellular matrix.They describe how the growth of calcific nodules on the aortic faces of the cusps in fibrocalcific aortic stenosis depends on the degree to which stress is transferred to the Compendium
Indian Medical Association rejects call to prescribe generic drugs
Authors: M. Kay
Journal: BMJ (2013)

The Indian Medical Association has said that it needs guarantees on the quality of generic forms of drugs before it could fully back a call from the Medical Council of India for doctors to prescribe generics whenever possible.

Clarifying the association’s stand, its honorary secretary general, Narendra Saini, said, “We do not oppose [the Medical Council of India]’s directive but want the government to put mechanisms in place that guarantee the quality of the generic drugs available in the market.”

In January the council wrote to the heads of medical colleges …
Human pulmonary alveolar proteinosis associated with a defect in GM-CSF/IL-3/IL-5 receptor common beta chain expression.
Authors: U Dirksen, R Nishinakamura, P Groneck, U Hattenhorst, L Nogee, R Murray, S Burdach
Journal: Journal of Clinical Investigation (1997)

Pulmonary alveolar proteinosis (PAP) is a heterogeneous disorder of genetic or acquired etiologies. In some cases congenital PAP is associated with hereditary surfactant protein (SP)-B deficiency. To date, the molecular defect in the majority of patients with PAP has not been identified. In mice, PAP has been generated by targeted deletion of the genes for either the GM-CSF/IL-3/IL-5 receptor common beta chain (beta c) or GM-CSF. Here, we describe an expression defect of beta c in three of seven pediatric patients with PAP and in one patient with severe lung disease suspected to be PAP. The patients failed to express normal levels of beta c as shown by flow cytometry. Strikingly reduced or absent function of beta c was demonstrated by ligand binding studies and progenitor clonogenic assays. Analysis of beta c DNA revealed a point mutation from proline to threonine at codon 602 in one patient. Our findings provide evidence that a defect in the expression of a hematopoietic cytokine receptor is associated with human PAP.
Computer aided prescribing: Computer aided prescribing is not panacea but can help
Authors: Keith Farrar, Ann Slee, Don Hughes, Peter Marsh, Carol Makin
Journal: BMJ (2004)

EDITOR—In his review of computer aided prescribing Ferner reminds us that computers are not a panacea for the elimination of error.1 However, our experience shows that electronic prescribing improves the legibility and completeness of prescriptions2 and can be tailored to reduce particular prescribing risks.3

The perceived safety of …
Detection of mosquito saliva‐specific IgE antibodies by capture ELISA
Authors: H. Brummer‐Korvenkontio, K. Palosuo, T. Palosuo, M. Brummer‐Korvenkontio, P. Leinikki, T. Reunala
Journal: Allergy (1997)

We developed an IgE-capture ELISA and measured mosquito saliva-specific IgE antibodies in 27 children sensitive to mosquito bites. Children with large 15-min bite wheals had significantly higher (P < 0.0005) mosquito saliva-specific IgE levels than children with small wheals. In the latter group, the saliva-specific IgE level was significantly higher (P = 0.031) than the levels of six infants never exposed to mosquitoes. A positive correlation (r = 0.65; P = 0.0002) was found between the size of the 15-min wheal and the mosquito saliva-specific IgE antibody levels. These results further support the role of mosquito saliva-specific IgE antibodies in the pathogenesis of mosquito-bite whealing. Compared to immunoblotting, IgE-capture ELISA provides a quantitative method to measure mosquito saliva-specific IgE antibodies.
The effect of methotrexate and hydroxyurea on neutrophil chemotaxis
Authors: J. J. CREAM, D. S. POLE
Journal: British Journal of Dermatology (1980)

Methotrexate depresses motility of neutrophils in chamber membranes, but does not interfere with random motility in tubes. Hydroxyurea has no such effect. The therapeutic response to methotrexate in psoriasis may be due in part to a reduction in migration of neutrophils into the epidermis.
Mechanism of impaired glucose-potentiated insulin secretion in diabetic 90% pancreatectomy rats. Study using glucagonlike peptide-1 (7-37).
Authors: Y A Hosokawa, H Hosokawa, C Chen, J L Leahy
Journal: Journal of Clinical Investigation (1996)

Chronic hyperglycemia causes a near-total disappearance of glucose-induced insulin secretion. To determine if glucose potentiation of nonglucose secretagogues is impaired, insulin responses to 10(-9) M glucagonlike peptide-1 (GLP-1) (7-37) were measured at 2.8, 8.3, and 16.7 mM glucose with the in vitro perfused pancreas in rats 4-6 wk after 90% pancreatectomy (Px) and sham-operated controls. In the controls, insulin output to GLP-1 was > 100-fold greater at 16.7 mM glucose versus 2.8 mM glucose. In contrast, the increase was less than threefold in Px, reaching an insulin response at 16.7 mM glucose that was 10 +/- 2% of the controls, well below the predicted 35-40% fractional beta-cell mass in these rats. Px and control rats then underwent a 40-h fast followed by pancreas perfusion using a protocol of 20 min at 16.7 mM glucose followed by 15 min at 16.7 mM glucose/10(-9) M GLP-1. In control rats, fasting suppressed insulin release to high glucose (by 90%) and to GLP-1 (by 60%) without changing the pancreatic insulin content. In contrast, in Px the insulin response to GLP-1 tripled in association with a threefold increase of the insulin content, both now being twice normal when stratified for the fractional beta-cell mass. The mechanism of the increased pancreas insulin content was investigated by assessing islet glucose metabolism and proinsulin biosynthesis. In controls with fasting, both fell 30-50%. In Px, the degree of suppression with fasting was similar, but the attained levels both exceeded those of the controls because of higher baseline (nonfasted) values. In summary, chronic hyperglycemia is associated with a fasting-induced paradoxical increase in glucose-potentiated insulin secretion. In Px rats, the mechanism is an increase in the beta-cell insulin stores, which suggests a causative role for a lowered beta-cell insulin content in the impaired glucose-potentiation of insulin secretion.
PGE2 induces angiogenesis via MT1-MMP–mediated activation of the TGFβ/Alk5 signaling pathway
Authors: Arántzazu Alfranca, Juan Manuel López-Oliva, Laura Genís, Dolores López-Maderuelo, Isabel Mirones, Dolores Salvado, Antonio J. Quesada, Alicia G. Arroyo, Juan Miguel Redondo
Journal: Blood (2008)
Sustained intraspinal delivery of neurotrophic factor encapsulated in biodegradable nanoparticles following contusive spinal cord injury
Authors: Yu-Chao Wang, Yi-Ting Wu, Hsin-Ying Huang, Hsin-I. Lin, Leu-Wei Lo, Shun-Fen Tzeng, Chung-Shi Yang
Journal: Biomaterials (2008)
Exposure to Phthalates and Phenols during Pregnancy and Offspring Size at Birth
Authors: Claire Philippat, Marion Mortamais, Cécile Chevrier, Claire Petit, Antonia M. Calafat, Xiaoyun Ye, Manori J. Silva, Christian Brambilla, Isabelle Pin, Marie-Aline Charles, Sylvaine Cordier, Rémy Slama
Journal: Environmental Health Perspectives (2011)

Data concerning the effects of prenatal exposures to phthalates and phenols on fetal growth are limited in humans. Previous findings suggest possible effects of some phenols on male birth weight.Our aim was to assess the relationships between prenatal exposures to phthalates and phenols and fetal growth among male newborns.We conducted a case-control study on male malformations of the genitalia nested in two French mother-child cohorts with recruitment between 2002 and 2006. We measured, in maternal urinary samples collected between 6 and 30 gestational weeks, the concentrations (micrograms per liter) of 9 phenol (n = 191 pregnant women) and 11 phthalate metabolites (n = 287). Weight, length, and head circumference at birth were collected from maternity records. Statistical analyses were corrected for the oversampling of malformation cases.Adjusted birth weight decreased by 77 g [95% confidence interval (CI): -129, -25] and by 49 g (95% CI: -86, -13) in association with a 1-unit increase in ln-transformed 2,4-dichlorophenol (DCP) and 2,5-DCP urinary concentrations, respectively. Benzophenone-3 (BP3) ln-transformed concentrations were positively associated with weight (26 g; 95% CI: -2, 54) and head circumference at birth (0.1 cm; 95% CI: 0.0, 0.2). Head circumference increased by 0.3 cm (95% CI: 0.0, 0.7) in association with a 1-unit increase in ln-transformed BPA concentration. For phthalate metabolites there was no evidence of monotonic associations with birth weight.Consistent with findings of a previous study, we observed evidence of an inverse association of 2,5-DCP and a positive association of BP3 with male birth weight.
Co-administration With the Pharmacological Chaperone AT1001 Increases Recombinant Human α-Galactosidase A Tissue Uptake and Improves Substrate Reduction in Fabry Mice
Authors: Elfrida R Benjamin, Richie Khanna, Adriane Schilling, John J Flanagan, Lee J Pellegrino, Nastry Brignol, Yi Lun, Darlene Guillen, Brian E Ranes, Michelle Frascella, Rebecca Soska, Jessie Feng, Leo Dungan, Brandy Young, David J Lockhart, Kenneth J Valenzano
Journal: Molecular Therapy (2012)

Fabry disease is an X-linked lysosomal storage disorder (LSD) caused by mutations in the gene (GLA) that encodes the lysosomal hydrolase α-galactosidase A (α-Gal A), and is characterized by pathological accumulation of the substrate, globotriaosylceramide (GL-3). Regular infusion of recombinant human α-Gal A (rhα-Gal A), termed enzyme replacement therapy (ERT), is the primary treatment for Fabry disease. However, rhα-Gal A has low physical stability, a short circulating half-life, and variable uptake into different disease-relevant tissues. We hypothesized that coadministration of the orally available, small molecule pharmacological chaperone AT1001 (GR181413A, 1-deoxygalactonojirimycin, migalastat hydrochloride) may improve the pharmacological properties of rhα-Gal A via binding and stabilization. AT1001 prevented rhα-Gal A denaturation and activity loss in vitro at neutral pH and 37 °C. Coincubation of Fabry fibroblasts with rhα-Gal A and AT1001 resulted in up to fourfold higher cellular α-Gal A and ~30% greater GL-3 reduction compared to rhα-Gal A alone. Furthermore, coadministration of AT1001 to rats increased the circulating half-life of rhα-Gal A by >2.5-fold, and in GLA knockout mice resulted in up to fivefold higher α-Gal A levels and fourfold greater GL-3 reduction than rhα-Gal A alone. Collectively, these data highlight the potentially beneficial effects of AT1001 on rhα-Gal A, thus warranting clinical investigation.