tbuckley/cabot-search huggingface dataset:
Wyngaarden to Leave NIH Directorship in July
Authors: Charles Marwick
Journal: JAMA (1989)

COME AUGUST 1, those who have long maintained that James B. Wyngaarden, MD, director of the National Institutes of Health (NIH) for the past 7 years, is indeed "the man who wasn't there" will be correct in the literal sense. Wyngaarden, will have left his job as the 12th NIH director. At the same time there are those who will be sorry to see him go. Wyngaarden already has called a special meeting of his senior staff and directors of the institutes and divisions and told them of his decision to leave. Contrary to reports that he was being forced out by the Bush administration, Wyngaarden insists that his decision to leave was his own. "I never looked for job security here," he said in an interview. "Originally, I intended to stay 5 years. Well, by August I will have been here 7 1/2 years." "Wyngaarden's appointment as director was
A randomized single-blind trial of standard diet versus fiber-free diet with polyethylene glycol electrolyte solution for colonoscopy preparation
Authors: A. Soweid, A. Kobeissy, F. Jamali, M. El-Tarchichi, A. Skoury, H. Abdul-Baki, L. El-Zahabi, A. El-Sayyed, K. Barada, A. Sharara, F. Mourad, A. Arabi
Journal: Endoscopy (2010)

Background and study aims: Colonoscopy preparation usually involves the intake of large volumes of polyethylene glycol electrolyte solution (PEG-ES) in combination with a clear-liquid diet (CLD). Liberalization of the diet might enhance the tolerance to PEG-ES without compromising the quality of the preparation. The primary aims of this study were to evaluate the efficacy and tolerability of PEG-ES given with a CLD compared with a fiber-free diet (FFD) for colonoscopy preparation. The incidence of adverse events among patients in the two diet groups was also assessed as a secondary outcome.
Time-Series Analysis of Mortality Effects of Fine Particulate Matter Components in Detroit and Seattle
Authors: Jiang Zhou, Kazuhiko Ito, Ramona Lall, Morton Lippmann, George Thurston
Journal: Environmental Health Perspectives (2010)

BackgroundRecent toxicological and epidemiological studies have shown associations between particulate matter (PM) and adverse health effects, but which PM components are most influential is less well known.ObjectivesIn this study, we used time-series analyses to determine the associations between daily fine PM [PM ≤ 2.5 μm in aerodynamic diameter (PM2.5)] concentrations and daily mortality in two U.S. cities—Seattle, Washington, and Detroit, Michigan.MethodsWe obtained daily PM2.5 filters for the years of 2002–2004 and analyzed trace elements using X-ray fluorescence and black carbon using light reflectance as a surrogate measure of elemental carbon. We used Poisson regression and distributed lag models to estimate excess deaths for all causes and for cardiovascular and respiratory diseases adjusting for time-varying covariates. We computed the excess risks for interquartile range increases of each pollutant at lags of 0 through 3 days for both warm and cold seasons.ResultsThe cardiovascular and respiratory mortality series exhibited different source and seasonal patterns in each city. The PM2.5 components and gaseous pollutants associated with mortality in Detroit were most associated with warm season secondary aerosols and traffic markers. In Seattle, the component species most closely associated with mortality included those for cold season traffic and other combustion sources, such as residual oil and wood burning.ConclusionsThe effects of PM2.5 on daily mortality vary with source, season, and locale, consistent with the hypothesis that PM composition has an appreciable influence on the health effects attributable to PM.
Case 84-1961
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. Kibbee
Journal: New England Journal of Medicine (1961)

Presentation of Case First admission. A fifty-six-year-old house mover was admitted to the hospital because of dyspnea. Seven months previously he experienced two five-minute episodes of paroxysmal nocturnal dyspnea. Three months later a persistent, nonproductive cough developed; exertion aggravated the cough and caused a sensation of tightness in the chest. The patient gained 25 pounds in weight during the four months before entry. The exertional and nocturnal dyspnea gradually increased, and four weeks before admission progressive orthopnea, peripheral edema and abdominal swelling occurred. The patient had ingested large quantities of alcohol for the previous twenty-five years. He was rejected from . . .
Surfactant protein levels in bronchoalveolar lavage after segmental allergen challenge in patients with asthma
Authors: V. J. Erpenbeck, R. Schmidt, A. Günther, N. Krug, J. M. Hohlfeld
Journal: Allergy (2006)

Background: Allergic asthma is associated with airway inflammation and dysfunction of pulmonary surfactant. Because surfactant proteins (SP) account for immunomodulatory functions as well as biophysical functions, we hypothesized that the allergic response in asthma might be accompanied by a dysregulation of SPs. Methods: We measured levels of SP‐A, SP‐B, SP‐C and SP‐D by enzyme‐linked immunosorbent assay in bronchoalveolar lavage (BAL) fluid of 23 asthma patients and 10 healthy control subjects under well‐controlled conditions before and 24 h after segmental allergen provocation. These data were related to surfactant function, Th 2 cytokine levels in BAL fluid and to the degree of eosinophilic inflammation. Results: In patients with asthma, allergen challenge increased BAL levels of SP‐B, SP‐C and SP‐D while SP‐A was decreased. For SP‐B and SP‐D, a moderate increase was also observed after saline challenge. In contrast, no alterations were observed in healthy control subjects. Levels of SP‐B and SP‐C in asthmatics correlated with the ratio of small to large surfactant aggregates (SA/LA ratio) and correlated negatively with BAL surface activity. Furthermore, increased SP‐C but not SP‐B levels after allergen challenge correlated with eosinophil numbers, interleukin (IL)‐5, and IL‐13 in BAL while increased SP‐D levels only correlated with eosinophil numbers. Conclusions: This study demonstrates significant alterations of all SPs in BAL fluid after allergen challenge of which SP‐C was most closely related to surfactant dysfunction and the degree of the allergic inflammation.
Letter: Hypertension and myocardial infarction.
Authors: D M Lambert
Journal: BMJ (1974)

24 August, p. 520) by our suggestion that beta-adrenergic blocking agents should not be used in patients with moderately severe renal failure (27 April, p. 193).They refer to a previous publication' to show that temporary deterioration in renal function in such patients may occur with the introduction of any hypotensive drug.Their evidence appears to be based on experience with one patient with malignant hypertension who was given 6 different drugs, and is not relevant to the cases described by us.We refer Drs.Kincaid-Smith and Hua to our paper, where they will find that the maximum change in diastolic blood pressure in any of the three cases was 10 mm Hg during the period that renal function deteri- orated.Their comments do not shed any light on the mechanism of the events we described.Drs. Kincaid-Smith and Hua will no doubt agree that renal function should be moni- tored during the course of therapy with hypotensive drugs in patients with renal failure.Our exoerience leads us to suggest that this may be especially important when beta-blocking drugs are prescribed and needs to be emphasized now that these agents are being so forcefully promoted in general prac- tice.-Weare, etc.,
A Product Warning Label to Encourage Prepregnancy Control of Diabetes
Authors: Jeffrey S. Greenspoon
Journal: JAMA (1991)

To the Editor.  —Despite physician awareness of the benefits of preconception glycemic control of diabetes mellitus, many diabetic women of childbearing age are either unaware or unmotivated to optimize control of their diabetes before becoming pregnant. The benefits of preconception glycemic control, including a reduction in the risk of fetal anomalies to that of a normal nondiabetic population 1,2 and a significant decrease in the rate of spontaneous abortion 3,4 have been well established. Implementing a plan to encourage universal prepregnancy diabetes control should be a major priority.  We propose a straightforward and inexpensive tactic to improve compliance with preconception diabetes control programs: put a warning label regarding pregnancy and birth defects on the equipment that diabetic patients routinely use for their daily care. The devices and supplies to be labeled could include insulin syringes, glucose meters, blood glucose monitoring strips, lancets, finger-pricking devices, and urine glucose test strips. The
Advising about pregnancy termination.
Authors: J D Bottomley
Journal: BMJ (1972)

As acute gastritis most commonly results from extrinsic irritants, it seems reasonable to postulate that the levo-dopa may have been the cause of the bleeding in this man's case.The rarity of this complication, and its occurrence in our patient without any pre- vious evidence of gastric disorder, suggests an idiosyncratic response as a possible mechanism.-I am, etc.,
Precocious Sexual Development: A Clinical Study of 100 Children
Authors: Lawson Wilkins
Journal: JAMA (1962)

In 1946, Seckel collected from the literature 612 cases of sexual precocity and classified them according to their causes. Such tabulations do not give an accurate idea of the relative frequency of the different types, because more unusual cases caused by comparatively rare tumors of the ovary or testis are usually reported, whereas the numerous cases of idiopathic or cerebral type do not appear in the literature. In 1955, Jolly reported 69 cases of sexual precocity which he was able to locate throughout England and study personally. Wilkins, in 1957, published 94 cases studied in the previous 20 years in one pediatric endocrine clinic in the United States. In his recent monograph entitled<i>Precocious Sexual Development</i>, Thamdrup has reported all cases which he was able to find in Denmark after studying all hospital records in that country and examining personally children under 8 or 9 years of age in 7
HPA advice on antipyretics does not contradict NICE
Authors: J. McCracken
Journal: BMJ (2009)

This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew <i>Enterococcus faecalis</i>. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Subsequent CT imaging revealed air in the bladder and a colovesical fistula. The patient went on to have Hartmann9s procedure with repair of the bladder defect. This case highlights that: (1) Colovesical fistulae may rarely present with epididymitis. (2) Colovesical fistulae are the most common cause of pneumaturia.
Third-World Interloper-Reply
Authors: Don Riesenberg
Journal: JAMA (1987)

<h3>In Reply.—</h3> I am pleased to echo Dr Fett's praise of the founder of Hôpital Albert Schweitzer. Dr Mellon carried out the potable-water and tetanus-immunization projects to which I refer in my article. It<i>is</i>, of course, important that "Haiti is no richer for my visit." That is just the point: one may go to such a place hoping to relieve suffering and death and leave feeling frustrated and inadequate.
Pretranslational suppression of a glucose transporter protein causes insulin resistance in adipocytes from patients with non-insulin-dependent diabetes mellitus and obesity.
Authors: W T Garvey, L Maianu, T P Huecksteadt, M J Birnbaum, J M Molina, T P Ciaraldi
Journal: Journal of Clinical Investigation (1991)

A major portion of insulin-mediated glucose uptake occurs via the translocation of GLUT 4 glucose transporter proteins from an intracellular depot to the plasma membrane. We have examined gene expression for the GLUT 4 transporter isoform in subcutaneous adipocytes, a classic insulin target cell, to better understand molecular mechanisms causing insulin resistance in non-insulin-dependent diabetes mellitus (NIDDM) and obesity. In subgroups of lean (body mass index [BMI] = 24 +/- 1) and obese (BMI = 32 +/- 2) controls and in obese NIDDM (BMI = 35 +/- 2) patients, the number of GLUT 4 glucose transporters was measured in total postnuclear and subcellular membrane fractions using specific antibodies on Western blots. Relative to lean controls, the cellular content of GLUT 4 was decreased 40% in obesity and 85% in NIDDM in total cellular membranes. In obesity, cellular depletion of GLUT 4 primarily involved low density microsomes (LDM), leaving fewer transporters available for insulin-mediated recruitment to the plasma membrane (PM). In NIDDM, loss of GLUT 4 was profound in all membrane subfractions, PM, LDM, as well as high density microsomes. These observations corresponded with decrements in maximally stimulated glucose transport rates in intact cells. To assess mechanisms responsible for depletion of GLUT 4, we quantitated levels of mRNA specifically hybridizing with human GLUT 4 cDNA on Northern blots. In obesity, GLUT 4 mRNA was decreased 36% compared with lean controls, and the level was well correlated (r = + 0.77) with the cellular content of GLUT 4 protein over a wide spectrum of body weight. GLUT 4 mRNA in adipocytes from NIDDM patients was profoundly reduced by 86% compared with lean controls and by 78% relative to their weight-matched nondiabetic counterparts (whether expressed per RNA, per cell, or for the amount of CHO-B mRNA). Interestingly, GLUT 4 mRNA levels in patients with impaired glucose tolerance (BMI = 34 +/- 4) were decreased to the same level as in overt NIDDM. We conclude that, in obesity, insulin resistance in adipocytes is due to depletion of GLUT 4 glucose transporters, and that the cellular content of GLUT 4 is determined by the level of encoding mRNA over a wide range of body weight. In NIDDM, more profound insulin resistance is caused by a further reduction in GLUT 4 mRNA and protein than is attributable to obesity per se. Suppression of GLUT 4 mRNA is observed in patients with impaired glucose tolerance, and therefore, may occur early in the evolution of diabetes. Thus, pretranslational suppression of GLUT 4 transporter gene expression may be an important mechanism that produces and maintains cellular insulin resistance in NIDDM.
P100Angiotensin II receptor blockers in modulation of transforming growth factor-b cardiac effects in mitral valve prolapse
Authors: E Malev, G Kim, L Vasina, M Omelchenko, E Zemtsovsky
Journal: Cardiovascular Research (2014)

Purpose: The inhibition by angiotensin II receptor blockers (ARB) the transforming growth factor-b (TGF-b) induced extracellular matrix production has been shown recently in cultured valvular interstitial cells obtained from patients with mitral valve prolapse (MVP) undergoing mitral valve repair. Our aim was to evaluate the effect of ARB therapy on TGF-b serum level and possible impact on valve myxomatous degeneration and left ventricular (LV) systolic dysfunction in MVP patients. Methods: A total of 233 asymptomatic patients (mean age: 53.8±12.9) with severe mitral regurgitation (MR) due to mitral valve prolapse were enrolled in our retrospective, non-randomized, single-center study between 2009 and 2011. Concentrations of TGF-b1 and b2 in serum were determined by enzyme-linked immunosorbent assay (Bender MedSystems). Standard echocardiography extended with speckle-tracking echocardiography was performed in all patients (EchoPAC'08, GE). Results: According to the case reports only 43 (18.5%) patients received losartan or telmisartan (study group). Majority of the patients (190, 81.5%) did not receive any ARBs (control group). There were no significant differences between groups in age, other medical treatment (β-blockers, diuretics), heart rate and blood pressure. Mitral regurgitation had the similar effective regurgitant orifice area (0.38±0.12 vs. 0.40±0.14 sm2; p=0.38) and volume (69.5±9.8 vs. 72.3±8.6 ml; p=0.08) by PISA in both groups. TGF-b1 level was significantly higher in subjects without ARB therapy (55.9±70.7 ng/ml) than in ARB group (16.1±32.9 ng/ml; p=0.0003), as well TGF-b2 (7.6±0.5 vs. 2.2±1.5 ng/ml; p<0.0001). Subjects in control group had significantly longer (anterior leaflet: 28.6±3.5 vs. 23.4±3.1 mm, p<0.0001; posterior leaflet: 15.2±2.6 vs. 13.8±2.9 mm, p=0.002) and thicker (AL: 4,2±1,1 vs. 3,5±1,4 mm, p=0.0004; PL: 5,0±1,3 vs. 3,7±0,82 mm, p<0.0001) mitral valve leaflets (echocardiographic signs of myxomatous degeneration) than in ARB group. Despite the lack of difference in LV ejection fraction (62.2±9.6 vs. 60.2±10.3 %; p=0.11), systolic longitudinal strain (-15.5±2.6% vs. -13.6±2.2%; p<0.0001) and SR (-1.16±0.16 s-1 vs. -0.91±0.12 s-1; p<0.0001) values were significantly higher in the ARB group. Conclusions: Patients with MVP and significant MR may benefit in valve myxomatous degeneration and LV systolic function from ARB therapy, probably due to its ability to inhibit TGF- β signalling.
Medical and Health Annual 1985
Authors: Irwin M. Siegel
Journal: JAMA (1985)

The<i>Medical and Health Annual</i>series is prepared by Encyclopaedia Britannica Inc and published yearly as an overview of topics of medical interest and progress. This 1985 edition offers a symposium on genetic disorders and other features, such as "Insights Into Blindness," "Studying the Common Cold," and "Animals: Best Friends and Good Medicine." "The World of Medicine" (a review of recent developments in health and medicine) covers a variety of subjects, including aerospace medicine, the acquired immunodeficiency syndrome (AIDS), alcoholism, allergy and immunity, cancer, contraception, arthritis and connective-tissue disorders, death and dying, health care costs, surgery, trauma, and world medical news. The section "Health Information Update" (instructive and practical reviews about common health concerns) contains articles on premature babies, incontinence, anesthesia, premenstrual syndrome, prostate disorders, hearing aids, stuttering, and other matters of health and disease. All of the articles are written by experts in their various fields, and each is
Back pain, pregnancy, and childbirth
Authors: R. Russell, F. Reynolds
Journal: BMJ (1997)

hould the BMJ reject all studies that do not include informed consent?That's a simple question, and surely the answer should be equally simple-"Yes."Unfortunately, ethical questions rarely allow simple answers, and we want help with answering this one.This issue includes a cluster of material that relates to the question.We publish the materialincluding two studies in which informed consent was not sought-to encourage debate and to arrive at a deeper understanding if not a simple answer.Medical journals must consider the ethical aspects of all the material they publish, and medical editors are presented with ethical issues just as often as doctors-that is, every day.
Pressure recovery in aortic valve stenosis.
Authors: W K Laskey, W G Kussmaul
Journal: Circulation (1994)

Pressure recovery is the variable increase in lateral pressure downstream from a stenotic orifice. The magnitude and clinical significance of pressure recovery in aortic valve stenosis are poorly defined.We obtained high-fidelity pressure and velocity recordings in 11 patients with isolated significant aortic valve stenosis at the time of diagnostic cardiac catheterization. Systematic catheter pullback from the left ventricular cavity revealed a consistent although variable subvalvular gradient. Further pullback across and distal to the region of the stenosed aortic valve revealed a consistent and progressive increase in the ascending aortic pressure. This increase in lateral pressure occurred pari passu with a diminution in amplitude of the velocity pulse. The extent of pressure recovery was directly related to systemic blood flow and transvalvular flow but inversely related to the Gorlin-derived aortic valve area.These findings have potentially important implications for the hemodynamic evaluation of mild to moderately severe aortic valve stenosis. The extent of pressure recovery may be of additional utility in the assessment of aortic valve stenosis under varying physiological states.
The Utility of Furosemide in Complex Bone Scintigraphy
Authors: GLEN PEARCE, BEN GARDON, ANDREW McLAUGHLIN, IAN PROVAN C. MURRAY, HANS VAN DER WALL
Journal: Clinical Nuclear Medicine (2000)

A 61-year-old woman had bone scintigraphy after minor trauma to the left chest wall sustained 2 weeks earlier. The results of radiologic studies of the chest were normal. Bone scintigraphy revealed two fractured ribs in the left hemithorax and a complex pattern of uptake in the pelvis that was of an uncertain location, possibly in the renal tract or in bone. Images obtained after furosemide administration showed substantial clearing, confirming the renal tract as the source. Subsequent information from the patient’s physician confirmed that this pattern was a result of polycystic renal disease.
Exercise capacity for survivors of cardiac transplantation or sustained medical therapy for stable heart failure.
Authors: L W Stevenson, K Sietsema, J H Tillisch, V Lem, J Walden, J A Kobashigawa, J Moriguchi
Journal: Circulation (1990)

Cardiac transplantation is predicted to improve survival for patients with severe symptoms of heart failure and ejection fraction of 20% or less, but the exercise capacity after cardiac transplantation is less than normal. Patients responding to vasodilators and diuretics have progressive improvement in exercise capacity despite low ejection fraction. We hypothesized that among patients currently considered appropriate for transplantation who could nonetheless subsequently be stabilized on medical therapy tailored to hemodynamic goals, survivors after 6 months of sustained medical therapy would demonstrate exercise capacity comparable to that of survivors of transplantation. Of 146 patients referred, 118 (81%) were discharged on tailored therapy without transplantation, and 88 (60%) were stable for at least 1 month. Stability after discharge was more likely in patients with lower right atrial pressures and better renal function on therapy. Of the 88 stable patients, 45 patients were listed for transplant, and 43 were ineligible or unwilling. From these patients, 42 survivors for more than 6 months follow-up after cardiac transplantation or tailoring of medical therapy underwent exercise testing. Baseline functional and hemodynamic status and left ventricular ejection fraction (15 +/- 4%) were not different between the transplant and sustained medical survivor groups at the time of initial evaluation. After 14 +/- 6 months, left ventricular ejection fraction had increased to 62 +/- 7% after transplantation (p less than 0.01) and only 22 +/- 9% after sustained medical therapy (p less than 0.05). However, there were no significant differences in the maximum workload, oxygen uptake, anaerobic threshold, or maximum oxygen pulse between survivors of cardiac transplantation and survivors on sustained medical therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertriglyceridemia may be severe in CML patients treated with interferon‐α
Authors: María Jesús Peñarrubia, Juan Luis Steegmann, Esperanza Lavilla, Felipe Casado, María José Requena, Mónica Picó, Reyes Arranz, José María Fernández‐Rañada
Journal: American Journal of Hematology (1995)

We analyzed serum triglyceride (TG) levels in 22 chronic myeloid leukemia (CML) patients treated with interferon-alpha (IFN-alpha). Hypertriglyceridemia was present in one-half of patients at diagnosis, and IFN-alpha treatment was associated with a further increase in 90% of the total group of patients. This increase was maximal during the first months of therapy. Four patients (18%) reached levels higher than 1,000 mg/dl. This is the first report describing this secondary effect in CML patients treated with IFN-alpha.