tbuckley/cabot-search huggingface dataset:
Diseases of the urinary system. Advances in the treatment of kidney diseases: an introduction.
Authors: J R Curtis
Journal: BMJ (1977)

research into the nature of the biochemical and hormonal abnormalities that occur in chronic renal failure, basic renal physiology, and also the nature of the underlying renal diseases that may result in terminal renal failure-principally the various forms of glomerulonephritis.I want to give a brief introduction to the present state of maintenance haemodialysis and renal transplantation and also to mention a few of the areas of renal pathophysiology where advances have and are being made.Some of these areas will be explored in greater detail in future articles in this series. Maintenance haemodialysis and renal transplantationHaemodialysis was introduced by Kolff in the management of acute renal failure in 1943.Its use was limited to this until 1960
THE PURINES AND PURINE METABOLISM OF SOME TUMORS IN DOMESTIC ANIMALS
Authors: Esmond R. Long
Journal: The Journal of Experimental Medicine (1913)

The purines of tumors are generally the same as those of the normal tissue, chiefly guanine and adenine, little more than traces of xanthine, and relatively small amounts of hypoxanthine being found. No uric acid was found in the tumors of this series. In one tumor, an embryonal adenosarcoma in a pig's kidney, a large amount of hypoxanthine, and no adenine was found, while the yield of xanthine was also unusually high. This result cannot be explained at present on experimental grounds, but evidently a nucleic acid complex containing no adenine was encountered. Possibly hypoxanthine was present in inosinic acid. The purine enzymes are generally the same in tumors as in the normal tissue from which the tumors are derived. This fact sometimes makes it possible to learn by chemical study from what tissue a given kind of tumor is derived, when the microscopic evidence is inconclusive. Although the liver of the sheep contains the enzyme xanthine oxidase, it may be absent from primary tumors in the sheep liver, as it has also been shown to be from secondary tumors in the human liver. As xanthine oxidase is one of the last of the purine enzymes to develop in the embryonal organism, its absence in a malignant tumor containing otherwise the same purine enzymes as the tissue from which it is derived, is evidence of the embryonal character of the tumor tissue.
Changes in Inflammatory Cytokines Are Related to Impaired Glucose Tolerance in Offspring of Type 2 Diabetic Subjects
Authors: Eija Ruotsalainen, Urpu Salmenniemi, Ilkka Vauhkonen, Jussi Pihlajamäki, Kari Punnonen, Sakari Kainulainen, Markku Laakso
Journal: Diabetes Care (2006)

We sought to determine whether levels of inflammatory markers and different cytokines are abnormal in nondiabetic offspring of type 2 diabetic subjects.Cytokine levels were measured in 19 healthy control subjects and 129 offspring of patients with type 2 diabetes (109 with normal glucose tolerance [NGT] and 20 with impaired glucose tolerance [IGT]). Insulin sensitivity was determined with the hyperinsulinemic-euglycemic clamp, insulin secretion with the intravenous glucose tolerance test, and abdominal fat distribution with computed tomography.Levels of C-reactive protein and inflammatory cytokines were elevated in nondiabetic offspring of type 2 diabetic subjects. Interleukin (IL)-1beta was increased in the NGT group and decreased in the IGT group. In contrast, levels of IL-1 receptor antagonist (IL-1Ra) were increased in both groups. IL-1beta and -Ra levels correlated inversely (P < 0.05) with rates of whole-body glucose uptake and IL-1beta positively with visceral fat mass (P < 0.05) in normoglycemic offspring.Nondiabetic offspring of type 2 diabetic subjects have changes in the levels of inflammatory cytokines. The level of IL-1Ra seems to be the most sensitive marker of cytokine response in the pre-diabetic state.
Left ventricular anomalies associated with Ebstein's malformation of the tricuspid valve.
Authors: A A Monibi, W H Neches, C C Lenox, S C Park, R A Mathews, J R Zuberbuhler
Journal: Circulation (1978)

Seventeen patients with Ebstein's malformation of the tricuspid valve have been evaluated. The majority of patients (11/17) presented in the newborn period with cyanosis and cardiomegaly. The remainder (6/17) were referred because of cardiomegaly on chest X-ray and/or a heart murmur heard on routine examination. Three patients have died; one in the newborn period and two suddenly at the age of 11 and 15 years. Thirteen patients have undergone right and left heart cardiac catheterization within the last seven years. Twelve of these 13 patients (92%) had angiocardiographic left ventricular contraction abnormalities. Five patients also had mitral valve prolapse associated with left ventricular dysfunction. Since many patients with Ebstein's anomaly may have significant left ventricular abnormalities, careful and systematic evaluation of the left ventricle is warranted.
Paraplegia after Elective Repair of an Infrarenal Aortic Aneurysm
Authors: Ismail H Mallick, Sathesh Kumar, Ahmed Samy
Journal: Journal of the Royal Society of Medicine (2003)

Paraplegia is a rare but devastating complication of thoracic/thoraco-abdominal aortic aneurysm repair. The incidence after repair of infrarenal aneurysms is lower, at 1.4-2.0% for emergency cases and 0.1-0.2% for elective cases.1,2
Adiponectin and the Incidence of Type 2 Diabetes in Hispanics and African Americans
Authors: Anthony J.G. Hanley, Lynne E. Wagenknecht, Jill M. Norris, Richard Bergman, Andrea Anderson, Y. Ida Chen, Carlos Lorenzo, Steven M. Haffner
Journal: Diabetes Care (2011)

A recent meta-analysis of 13 prospective studies reported that higher levels of adiponectin were significantly associated with lower risk of type 2 diabetes. Most previous studies, however, were limited in their ability to adjust for appropriate confounding variables. Our objective, therefore, was to study this association after adjustment for directly measured adiposity and insulin sensitivity, expressed as the insulin sensitivity index (S(I)).The study included 1,096 Hispanic and African American participants free of diabetes at baseline (2000-2002) who returned for follow-up after 5 years. S(I) was determined from frequently sampled intravenous glucose tolerance tests with minimal model analysis. Visceral adipose tissue (VAT) area was determined by computed tomography. Diabetes and impaired fasting glucose (IFG) were defined using American Diabetes Association criteria. Multivariate generalized estimating equation logistic regression models were used to account for correlations within families.A total of 82 subjects met criteria for incident diabetes. After adjustment for age, sex, ethnicity, and smoking, adiponectin was significantly inversely associated with diabetes (odds ratio [OR] 0.54 per 1 SD difference [95% CI 0.38-0.76]). The association remained significant after additional adjustment in individual models for BMI, homeostasis model assessment of insulin resistance, or VAT (all P < 0.05). However, adiponectin was no longer associated in separate models adjusted for S(I) or IFG (OR 0.81 [0.56-1.16] and 0.75 [0.53-1.06], respectively).Adiponectin was inversely associated with incident diabetes after adjustment for conventional anthropometric and metabolic variables or VAT. Adjustment for detailed measures of S(I) attenuated this relationship, however, suggesting that the link between adiponectin and diabetes may operate at least in part through insulin resistance.
Rifampin preventive therapy for tuberculosis infection: experience with 157 adolescents.
Authors: M E Villarino, R Ridzon, P C Weismuller, M Elcock, R M Maxwell, J Meador, P J Smith, M L Carson, L J Geiter
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

For persons infected with Mycobacterium tuberculosis resistant to isoniazid (INH), rifampin is recommended for the prevention of active disease. However, the adverse effects and acceptability of this preventive therapy are largely uncharacterized. We prospectively followed 157 high-school students exposed to, and probably infected with, M. tuberculosis strains resistant to INH. All 157 students were prescribed preventive therapy with rifampin (10 mg/kg up to 600 mg daily) for 24 wk. While receiving therapy, 41 (26%) reported one or more adverse effects; of these, 18 had therapy interrupted temporarily, two permanently. Four (2.5%) had alanine aminotransferase elevations greater than two times the upper limit of normal (range, 91 to 161 U/L); of these, one had therapy permanently stopped. Six (3.8%) self-discontinued therapy. No student was found to have active disease during the 2 yr of the study (exact 95% upper confidence limit, 2.2). We assumed that without preventive therapy, seven cases of tuberculosis would have occurred during these 2 yr. Therefore, we estimated that rifampin had a minimum protective effect of 56%. In conclusion, preventive therapy with rifampin was well tolerated and well accepted, and it appears effective in preventing active tuberculosis.
Hydrodynamic Delivery of mIL10 Gene Protects Mice From High-fat Diet-induced Obesity and Glucose Intolerance
Authors: Mingming Gao, Chunbo Zhang, Yongjie Ma, Le Bu, Linna Yan, Dexi Liu
Journal: Molecular Therapy (2013)

High-fat diet (HFD) induced obesity is associated with low-grade inflammation, insulin resistance (IR), and glucose intolerance. The objective of this study is to assess the effect of interleukin 10 (IL10), an anti-inflammatory cytokine, on blocking HFD-induced obesity and obesity-associated metabolic disorders by hydrodynamic delivery of IL10-containing plasmid. Animals fed a regular chow or HFD received two injections (one on day 1 and the other on day 31) of plasmids containing green fluorescence protein (GFP) or mouse IL10 (mIL10) gene. Blood concentration of mIL10 reached ~200 ng/ml on day 7 in animals receiving mIL10 plasmid DNA. The transfection efficiency of liver cells was the same in animals fed a regular chow or HFD. No difference was seen in animals on regular chow when injected with plasmids containing either gfp or mIL10 gene. Overexpression of mIL10 prevented weight gain of animals on HFD. Intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance tests (ITT) showed that mIL10 maintained insulin sensitivity and prevented glucose intolerance. The mechanistic study reveals that mIL10 suppressed macrophage infiltration and reduced the development of crown-like structures in adipose tissue (AT). Collectively, these results suggest that maintaining a higher level of IL10 through gene transfer could be an effective strategy in preventing diet-induced obesity.
Proteinuria, impaired kidney function, and adverse outcomes in people with coronary disease: analysis of a previously conducted randomised trial
Authors: Marcello Tonelli, Powell Jose, Gary Curhan, Frank Sacks, Eugene Braunwald, Marc Pfeffer
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objectives</b> To determine whether data on proteinuria are useful for refining estimates of risk based on kidney function alone, and whether the results of kidney function tests can be a useful adjunct to data on proteinuria. <b>Design</b> Analysis of data from a randomised trial. Impaired kidney function was defined as low glomerular filtration rate (&lt; 60 ml/min/1.73 m<sup>2</sup>) and proteinuria ( 1+ protein) on dipstick urinalysis. <b>Setting</b> Study of cholesterol and recurrent events: a randomised trial of pravastatin 40 mg daily versus placebo. <b>Participants</b> 4098 men and women with previous myocardial infarction. <b>Main outcome measures</b> All cause mortality and cardiovascular events. <b>Results</b> 371 participants died in nearly 60 months of follow-up. Compared with participants without proteinuria or impaired kidney function, patients with both characteristics were at high risk (hazard ratio 2.39, 95% confidence interval 1.72 to 3.30), and those with only proteinuria or only impaired kidney function were at intermediate risk (1.69, 1.32 to 2.16; 1.41, 1.12 to 1.79, respectively) of dying from any cause. The results were similar for cardiovascular outcomes, including new cases of heart failure, stroke, and coronary death or non-fatal myocardial infarction. A graded increase in the risk of all cause mortality was seen for severity of renal impairment and degree of proteinuria by dipstick. <b>Conclusions</b> The presence or absence of proteinuria on dipstick urinalysis may be used to refine estimates of risk based on kidney function alone.
Rates and risk factors for prolonged opioid use after major surgery: population based cohort study
Authors: H. Clarke, N. Soneji, D. T. Ko, L. Yun, D. N. Wijeysundera
Journal: BMJ (2014)

To describe rates and risk factors for prolonged postoperative use of opioids in patients who had not previously used opioids and undergoing major elective surgery.Population based retrospective cohort study.Acute care hospitals in Ontario, Canada, between 1 April 2003 and 31 March 2010.39,140 opioid naïve patients aged 66 years or older who had major elective surgery, including cardiac, intrathoracic, intra-abdominal, and pelvic procedures.Prolonged opioid use after discharge, as defined by ongoing outpatient prescriptions for opioids for more than 90 days after surgery.Of the 39,140 patients in the entire cohort, 49.2% (n=19,256) were discharged from hospital with an opioid prescription, and 3.1% (n=1229) continued to receive opioids for more than 90 days after surgery. Following risk adjustment with multivariable logistic regression modelling, patient related factors associated with significantly higher risks of prolonged opioid use included younger age, lower household income, specific comorbidities (diabetes, heart failure, pulmonary disease), and use of specific drugs preoperatively (benzodiazepines, selective serotonin reuptake inhibitors, angiotensin converting enzyme inhibitors). The type of surgical procedure was also highly associated with prolonged opioid use. Compared with open radical prostatectomies, both open and minimally invasive thoracic procedures were associated with significantly higher risks (odds ratio 2.58, 95% confidence interval 2.03 to 3.28 and 1.95 1.36 to 2.78, respectively). Conversely, open and minimally invasive major gynaecological procedures were associated with significantly lower risks (0.73, 0.55 to 0.98 and 0.45, 0.33 to 0.62, respectively).Approximately 3% of previously opioid naïve patients continued to use opioids for more than 90 days after major elective surgery. Specific patient and surgical characteristics were associated with the development of prolonged postoperative use of opioids. Our findings can help better inform understanding about the long term risks of opioid treatment for acute postoperative pain and define patient subgroups that warrant interventions to prevent progression to prolonged postoperative opioid use.
Nursing Home Placement and the Demented Patient
Authors: MARK A. O'ROURKE
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 April 1986Nursing Home Placement and the Demented PatientMARK A. O'ROURKE, M.D.MARK A. O'ROURKE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-4-582_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I applaud the recent article on nursing home placement and the demented patient by Drs. Meier and Cassel (1). It is excellent, timely, and important. The discussion of protective services agencies, however, deserves comment.The article describes a 61-year-old man with newly diagnosed Alzheimer's disease who continued to drive his automobile, despite the recommendation of the geriatrics team and the expressed concern of his employer and a close friend. The conflict between autonomy and benificence and the frustration of the health care team with the upset family are summarized in three questions raised by the health care...References1. MEIER D and CASSEL C. Nursing home placement and the demented patient: a case presentation and ethical analysis. Ann Intern Med. 1986;104:98-105. LinkGoogle Scholar2. KIMSEY I, TARBOX A, and BRAGG D. Abuse of the elderly—the hidden agenda: I. The caretakers and categories of abuse. J Am Geriatrics Soc. 1981;29:465-72. CrossrefMedlineGoogle Scholar3. O'MALLEY T, O'MALLEY H, EVERITT D, and SARSON D. Categories of family-mediated abuse and neglect of elderly persons. J Am Geriatrics Soc. 1984;32:362-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARK A. O'ROURKE, M.D.*GRUBER HE. The origin of the origin of species. Review of Darwin and the Mysterious Mr. X: New Light on the Evolutionists By EISLEY L. The New York Times Book Review 1979 July 22:16. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1986Volume 104, Issue 4Page: 582-582KeywordsAlzheimer diseaseGeriatricsHealth careNursing homes ePublished: 1 December 2008 Issue Published: 1 April 1986 PDF downloadLoading ...
EXAMINATION OF A GENITO-URINARY PATIENT BY THE GENERAL PRACTITIONER.
Authors: FERD. C. VALENTINE
Journal: JAMA (1902)

At the onset it is necessary to avow that the principal object of this paper is to obtain instruction. Through this instruction I hope to make valuable to the general practitioner the methods which study and experience have led me to employ in examining patients whose ailments come within the exclusive genito-urinary specialty. If incidentally to the confessed object it be shown that examination of the majority of genito-urinary patients can well be performed by the general practitioner, the purpose of this effort will be more than attained. <h3>Family History.</h3> —As in all other diseases, the examination of a genito-urinary case, whatever its character, must begin with the history of the patient's family. Heeding a tubercular heredity, for example, will keep us alert to the greater possibility of a patient so stigmatized to fall a victim to genito-urinary tuberculosis. This is especially likely when he has acquired even a mild
Passive smoking: Wider evidence needs to be interpreted
Authors: J. Critchley
Journal: BMJ (2003)

Editor–Enstrom and Kabat's analysis has several omissions.1 First they accept that most epidemiological studies have found positive but not statistically significant relationships between environmental tobacco smoke, coronary heart disease, and lung cancer, but then argue against meta-analysis to establish a causal relation. This is precisely where systematic reviews, and sometimes meta-analysis, show …
CONTAGION AS A FACTOR IN CERTAIN HEART AND JOINT DISEASES
Authors: JOHN J. CARDEN
Journal: JAMA (1934)

<h3>Case 1.—</h3> A woman, aged 35, seen in January 1928, had an acute exacerbation of a chronic bilateral parotitis of five years' duration. Between acute recurrences (four), the parotids had remained at the size of half an orange. In each acute attack their size doubled, the patient had a high temperature and there were signs of septic infection until drainage through the parotid ducts was instituted. During this period of five years, varying transient attacks of rheumatoid arthritis were frequent and a mild atrophic arthritis of both hands and feet had developed. With drainage of the parotids established, this present acute attack subsided. Culture of the parotid secretions revealed a short-lived streptococcus, Staphylococcus albus and aureus and Micrococcus catarrhalis. Autogenous vaccines and an antirheumatic regimen were continued through August 1928 with a steady, though not marked, improvement of both parotid and joint conditions. (The subsequent course of this case will
High-resolution optical mapping of intramural virtual electrodes in porcine left ventricular wall
Authors: O SHARIFOV, R IDEKER, V FAST
Journal: Cardiovascular Research (2004)

Objective: It is believed that shock-induced intramural virtual electrodes (IVE) play a critical role in defibrillation. IVE were recently demonstrated in the porcine left ventricle (LV), but their origin remains unknown. Macroscopic optical mapping showed that strong shocks induce IVE of only one polarity, which contradicts theoretical predictions. It is hypothesized that IVE have a microscopic origin and that microscopic positive and negative IVE are spatially averaged during macroscopic optical mapping. This hypothesis was examined by mapping Vm responses at the transmural LV surface with increased optical resolution.
Murine model for human secondary amyloidosis: genetic variability of the acute-phase serum protein SAA response to endotoxins and casein.
Authors: K P McAdam, J D Sipe
Journal: The Journal of Experimental Medicine (1976)

The serum precursor SAA of the secondary amyloid protein AA has been detected by solid-phase radioimmunoassay as a normal serum alpha-globulin of mol wt 160,000, which dissociates to a more stable 12,500 dalton moiety on treatment with formic acid. In 12 strains of mice, including T-cell-deficient nude mice, treated with the amyloid-inducing agents lipopolysaccharide (LPS) or casein, SAA behaved as an acute-phase reactant. SAA concentration rose to about 750 mug/ml by 24 h and returned to less than 1 mug/ml by 48 h. Since the amyloid-resistant colchicine-treated mice and AJ mice had a normal SAA response to LPS, it appears that their resistance to amyloid induction is due to the nature of their SAA processing rather than decreased SAA production. C3H/HeJ mice, which have defective B-lymphocyte responses to LPS, required extremely high dosages of LPS to cause SAA elevation, although their SAA response to casein was normal. This suggests that SAA is an acute-phase protein produced as a result of B-lymphocyte stimulation. Preliminary evidence suggests that at the height of an acute SAA response, liver homogenates are particularly rich in protein AA cross-reacting material.