tbuckley/cabot-search huggingface dataset:
Protein kinase C and calcium channel activation as determinants of renal vasoconstriction by angiotensin II and endothelin.
Authors: T Takenaka, H Forster, M Epstein
Journal: Circulation Research (1993)

The mechanisms mediating renal microvascular constriction induced by angiotensin II (Ang II) and endothelin (ET) have not been fully established. In the present study, we have determined the effects of isradipine, a dihydropyridine calcium antagonist, on Ang II- or ET-induced constriction of afferent arterioles (AAs) and efferent arterioles (EAs) using the isolated perfused hydronephrotic kidney. Ang II (0.3 nmol/L) and ET (0.3 nmol/L) constricted AAs by 36 +/- 2% and 29 +/- 3%, respectively. Isradipine reversed AA constriction induced by both peptides. However, Ang II-induced AA constriction was more sensitive to isradipine than ET-induced constriction (half-maximal inhibitory concentration [IC50], 1.2 +/- 0.2 nmol/L [n = 12] versus 170 +/- 65 nmol/L [n = 19]; P &lt; .01). The sensitivity of Ang II-induced AA constriction to isradipine was identical to that of KCI-induced AA constriction (IC50, 4.2 +/- 0.9 nmol/L; n = 12). Pretreatment with staurosporine (50 nmol/L), a protein kinase C inhibitor, enhanced the sensitivity of ET-induced AA constriction to isradipine (4.3 +/- 1.7 nmol/L, n = 14), rendering it identical to that of KCl-induced AA constriction. Ang II and ET decreased EA diameter by 26 +/- 2% (n = 12) and 12 +/- 2% (n = 8), respectively. In contrast to AA constriction, EA constriction induced by both peptides was relatively refractory to isradipine.(ABSTRACT TRUNCATED AT 250 WORDS)
TICAGRELOR DOES NOT AFFECT PULMONARY FUNCTION TESTS COMPARED TO CLOPIDOGREL IN ACUTE CORONARY SYNDROMES: RESULTS OF THE PLATO PULMONARY SUBSTUDY
Authors: Robert F. Storey, Richard C. Becker, Christopher P. Cannon, Frank Cools, Håkan Emanuelsson, Robert A. Harrington, Steen Husted, Stefan James, Hugo Katus, Khurmi Nardev, Soo Teik Lim, Ph Gabriel Steg, Lars Wallentin
Journal: Journal of the American College of Cardiology (2010)
Delay in Diagnosis among Hospitalized Patients with Active Tuberculosis—Predictors and Outcomes
Authors: Christina Greenaway, Dick Menzies, Anne Fanning, Raj Grewal, Lilian Yuan, J. Mark FitzGerald
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Delayed diagnosis of active pulmonary tuberculosis (TB) among hospitalized patients is common and believed to contribute significantly to nosocomial transmission. This study was conducted to define the occurrence, associated patient risk factors, and outcomes among patients and exposed workers of delayed diagnosis of active pulmonary TB. Among 429 patients newly diagnosed to have active pulmonary TB between June 1992 and June 1995 in 17 acute-care hospitals in four Canadian cities, initiation of appropriate treatment was delayed 1 week or more in 127 (30%). This was associated with atypical clinical and demographic patient characteristics, and after adjustment for these characteristics, with admission to hospitals with low TB admission rate of 0.2–3.3 per 10,000 admissions (odds ratio [OR]: 7.4; 95% confidence interval [CI]: 3.2,17.5) or intermediate TB admissions of 3.4–9.9/10,000 (OR: 2.3; CI: 1.6,3.2) as well as potentially preventable (late) intensive care unit admission (OR: 16.8; CI: 2.0,144) and death (OR: 3.3; CI: 1.7,6.5]). In hospitals with low TB admission rates, initially missed diagnosis, smear-positive patients undergoing bronchoscopy, late intensive care unit admission (OR: 2.3; CI: 0.1,56), and death (OR: 3.8; CI: 1.2,12.1) were more common than in hospitals with high TB admissions ( > 10/ 10,000); a similar trend was seen in hospitals with intermediate TB admissions. Even after adjustment for workers' characteristics and ventilation in patients' rooms tuberculin conversions were disproportionately high in hospitals with low and intermediate TB admission rates and significantly higher in hospitals with overall TB mortality rate above 10% (OR: 2.5; CI: 1.6,3.7). In the hospitals studied, as the rate of TB admissions decreased, the likelihood of poor outcomes and risk of transmission of TB infection per hospitalized patient with TB increased. Institutional risk of TB transmission was poorly correlated with number of patients with TB and better correlated with indicators of patient care such as delayed diagnosis and treatment and overall TB-related patient mortality.
Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes.
Authors: R C Li, N Maffulli, Y C Hsu, K M Chan
Journal: British Journal of Sports Medicine (1996)

To test the hypothesis that increasing the hamstrings and quadriceps (H:Q) isokinetic strength ratio will, in the short term, improve the functional ability of an anterior cruciate ligament (ACL) deficient knee.The isokinetic muscular characteristics at a speed of 60 degrees s-1 and 180 degrees s-1 of 46 recreational athletes with an arthroscopically confirmed ACL tear were determined using the Cybex II+ isokinetic dynamometer. The variables tested included peak torque, endurance ratio, total work output, and explosive power. Functional ability was scored with the Cincinnati rating system, measuring the severity of pain and swelling, the degree of giving way, and the overall ability to walk, run, ascent and descent stairs, jump and twist.Among all muscular characteristics, the H:Q ratio at 180 degrees s-1 at 30 degrees of knee flexion was shown to have the highest correlation to the functional score (r = 0.6249, P < 0.001). All variables involving hamstring strength were shown to be significantly correlated to the functional ability score (P < 0.01), while none of the variables involving quadriceps strength showed significant correlation with the functional ability of the injured knee.The H:Q ratio is strongly correlated to the functional ability of ACL deficient knees in Chinese recreational athletes. It could be used as an additional measure to guide in the decision making process in the management of ACL deficient knees.
Acromegalic pneumonomegaly: lung growth in the adult
Authors: Jerome S. Brody, Aron B. Fisher, Ayhan Gocmen, Arthur B. DuBois
Journal: Journal of Clinical Investigation (1970)

Lung size was evaluated with pulmonary function tests in 10 patients with acromegaly, 1 pituitary giant, and 1 patient who had acromegaly but now has hypopituitarism. In the six acromegalic men all lung volumes were increased. The average values and per cent of predicted were total lung capacity 9.1 liters. 139%; functional residual capacity 5.2 liters, 145%; vital capacity 6.0 liters, 134%; and tissue volume 1.1 liters. There was no evidence of airflow obstruction or air trapping. Anatomic dead space was increased in proportion to the large lung volumes. Lung compliance was increased, averaging 0.43 liters/cm H(2)O, but lung elastic recoil was normal. These studies show that the lung is involved in the general visceromegaly of acromegaly and that lung size increases in acromegalic men as a result of actual lung growth. Despite the large lung volumes, diffusing capacity was normal suggesting that lung growth resulted from an increase in the size rather than from an increase in the number of alveoli. In contrast to the acromegalic men, lung volumes, anatomic dead space and tissue volume were normal in four acromegalic women, suggesting that sex hormones may modify the effect of growth hormone on the lung. Lung size was large in the pituitary giant but lung volumes were normal according to predicted values based on the patient's great height. Lung volumes were normal in the one male who had been acromegalic but who has been hypopituitary for 21 yr. The role of growth hormone in normal postnatal lung growth and in the maintainance of normal lung size remains to be defined.
Development and validation of the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index
Authors: W P Maksymowych, C Mallon, S Morrow, K Shojania, W P Olszynski, R L Wong, J Sampalis, B Conner-Spady
Journal: Annals of the Rheumatic Diseases (2008)

Enthesitis is a recommended core domain for assessment of ankylosing spondylitis (AS), but no measurement has yet been validated according to Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) criteria.The purpose of this study was to seek to validate an enthesitis index for patients with AS according to OMERACT criteria.An enthesitis index was validated in two AS patient cohorts: (1) a longitudinal cohort (n = 223) and (2) 22 patients from three Canadian sites participating in a 24-week randomised placebo-controlled trial of adalimumab in AS. Construct validity was evaluated by correlation analysis with the Bath AS Disease Activity Index (BASDAI), the Bath AS Functional Index (BASFI) and quality of life instruments. Reproducibility was assessed by intraclass correlation coefficient (ICC), and responsiveness was assessed by Guyatt's effect size and standardised response mean.The most frequently affected sites were the greater trochanter and supraspinatus insertion ( approximately 20%). Patients with enthesitis had significantly greater scores for the BASDAI, BASFI, patient global, AS-specific quality of life index (ASQOL) and the Short Form 36 (SF-36) General Health Survey (p<0.001). The enthesitis score contributed significantly to variance in the BASDAI and BASFI. Interobserver ICCs were 0.96 in the longitudinal cohort and 0.89 and 0.77 in the adalimumab clinical trial cohort (for status and change score, respectively). Significant differences in change scores were evident for all patients after 24 weeks of adalimumab treatment, (p = 0.04), this being more significant when a subset of the most commonly affected entheses were analysed (p = 0.01).AS patients with enthesitis constitute a more severe subset of disease, and the Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index is feasible and reliable for measurement of this condition. Discrimination requires further study in larger trials.
Influence of Endogenous Insulin Secretion on Splanchnic Glucose and Amino Acid Metabolism in Man
Authors: Philip Felig, John Wahren
Journal: Journal of Clinical Investigation (1971)

Splanchnic exchange of glucose, 20 individual amino acids, lactate, and pyruvate was studied in normal subjects in the postabsorptive state and after stimulation of endogenous insulin secretion by infusion of glucose at two dose levels. In the basal state, mean splanchnic glucose production was 3.4 mg/kg per min. A net uptake of lactate, pyruvate, and nine amino acids was observed, with alanine accounting for half of the total splanchnic-amino acid extraction. Infusion of glucose at 25 mg/kg per min for 20 min resulted in a fivefold increase in arterial insulin levels and in reversal of splanchnic glucose balance to a net uptake. Splanchnic uptake of alanine, glycine, phenylalanine, lactate, and pyruvate fell by 30-60% due to a reduction in fractional extraction of these substrates, inasmuch as their arterial concentrations did not decline.Administration of glucose at 2 mg/kg per min for 45 min resulted in a 19 mg/100 ml increase in arterial glucose concentration and a doubling of arterial insulin levels. Despite the small increment in insulin, hepatic glucose production fell by 85%. Splanchnic exchange of amino acids, lactate, and pyruvate was unaltered. Estimated total glucose utilization during the infusion was no greater than in the basal state, indicating lack of stimulation of peripheral glucose uptake. IT IS CONCLUDED THAT: (a) inhibition of hepatic glucose production associated with glucose infusion and large increments in insulin levels occurs in the absence of a decrease in the concentration of circulating gluconeogenic substrate, suggesting an hepatic rather than peripheral effect; (b) the liver is the primary target organ whereby glucose homeostasis is achieved with small increments in insulin; (c) the relatively greater sensitivity of the liver's response to insulin as compared with an effect of insulin on the peripheral tissues, may be a consequence of the higher levels of endogenous insulin in portal as compared with peripheral blood.
Clinical Usefulness of Ambulatory Blood Pressure Monitoring
Authors: Paolo Verdecchia, Fabio Angeli, Roberto Gattobigio
Journal: Journal of the American Society of Nephrology (2004)

ABSTRACT. During the past decade, several prospective studies showed that ambulatory BP (ABP) measurements provide a better prediction of major cardiovascular events when compared with clinic BP measurements. This review summarizes the available evidence supporting the use of ABP monitoring to refine prognostic stratification in hypertension. On the basis of available evidence, an operational flowchart is suggested to interpret results of ABP for better treatment of patients with elevated BP.
Scuba diving can induce stress of the temporomandibular joint leading to headache
Authors: C Balestra, P Germonpré, A Marroni, T Snoeck
Journal: British Journal of Sports Medicine (2004)

In ordinary recreational scuba diving, many anatomical parts can be involved in disorders of cranial regions: ears and eyes are involved but also sinuses. Dental problems are generally involved in barotraumas because of bad dental fillings or other matters of interest to the general dental practitioner.1 Very few papers have looked at the articular and periarticular problems of the temporomandibular joint (TMJ).2

Local factors such as joint laxity, anatomical factors, capsular or muscular inflammation, and articular stress of long duration resulting from holding the regulator mouthpiece in scuba diving or the snorkel mouthpiece in skin diving can lead to TMJ disorders including headaches …
Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review
Authors: Victor van der Meer, Arie Knuistingh Neven, Peterhans J van den Broek, Willem J J Assendelft
Journal: BMJ (2005)

<h3>Abstract</h3> <b>Objectives</b> To evaluate the diagnostic accuracy of C reactive protein in detecting radiologically proved pneumonia and to evaluate how well it can discriminate between bacterial and viral infections of the lower respiratory tract. <b>Data sources</b> Medline and Embase (January 1966 to April 2004), with reference checking. <b>Study selection</b> We included articles comparing C reactive protein with a chest radiograph or with microbiological work-up as a reference test. Two authors independently assessed methodological items. <b>Results</b> None of the studies met all validity criteria. Six studies used an infiltrate on chest radiograph as reference test. Sensitivities ranged from 10% to 98%, specificities from 44% to 99%. For adults, the relation of C reactive protein with an infiltrate (in a subgroup analysis of five studies) showed an area under the curve of 0.80 (95% confidence interval 0.75 to 0.85). In 12 studies, the relation of C reactive protein with a bacterial aetiology of infection of the lower respiratory tract was studied. Sensitivities ranged from 8% to 99%, specificities from 27% to 95%. These data were epidemiologically and statistically heterogeneous, so overall outcomes could not be calculated. <b>Conclusion</b> Testing for C reactive protein is neither sufficiently sensitive to rule out nor sufficiently specific to rule in an infiltrate on chest radiograph and bacterial aetiology of lower respiratory tract infection. The methodological quality of the diagnostic studies is generally poor. The evidence not consistently and sufficiently supports a wide introduction of C reactive protein as a rapid test to guide antibiotics prescription.
Vagotomy by chemoneurolysis: an experimental study in the rat.
Authors: T V Taylor, S Holt, P L Andrews, R C Heading
Journal: Gut (1983)

In the pylorus ligated rat vagotomy has been attempted by chemoneurolysis with alcohol. Surgical truncal vagotomy reduced the intragastric acid produced in a five-hour period from 310 +/- 17.6 (SD) mumol to 5.4 +/- 2.4 mumol with a marked reduction in the ulcer score. Injection of 30% alcohol in the region of the vagal trunks at the level of the lower oesophagus produced a marked reduction in gastric acid secretion (7.6 +/- 3.7 mumol). Injection of solutions of alcohol in concentrations over 10% along the lesser curvature reduced gastric acid output to less than 10 mumol with a corresponding reduction in the ulcer score. Four months after the injection of 30% alcohol along the lesser curvature the acid output was 23.0 +/- 5.7 mumol and no gastric ulceration occurred.
Three-dimensional Highfrequency Ultrasonic Parameter Imaging of Anterior Segment Pathology
Authors: Ronald H. Silverman, Mark J. Rondeau, Frederic L. Lizzi, D. Jackson Coleman
Journal: Ophthalmology (1995)

Purpose: High-frequency ultrasound allows high-resolution imaging of anterior segment anatomy and pathology. Acoustic echo data, however, contain information relating to the microanatomic structure of the interrogated tissue which is not evident in B-mode images. The aim of this study is to develop imaging techniques to demonstrate and quantify the distribution of acoustic scattering properties in ocular tissues in three dimensions. Methods: A tumor of the iris and a hyphema were scanned using a 50-MHz ultrasound probe mounted on a computer-controlled two-axis positioning system. Scan data from sequential parallel planes were used to make three-dimensional reconstructions. Digital signal processing and a mathematical model of acoustic backscatter then were used to represent the effective size and acoustic concentration of scattering elements using a false color representation superimposed on B-mode images. Results: Three-dimensional reconstructions improved appreciation of the size and extent of pathology and allowed computation of tissue volumes. Parameter images demonstrated distinctive differences between diffuse and organized blood and allowed quantification of tumor scattering properties. Conclusions: Three-dimensional imaging of the anterior segment with high-frequency ultrasound allows construction of perspective images, which adds to the already significant clinical use of individual high-resolution B-mode images. Acoustic backscatter properties determined by tissue microstructure can be computed from echo data and represented in false color in three-dimensional reconstructions.
Susceptibility of Rats with Renal Hypertension to Pyelonephritis, and Predisposition of Rats with Chronic Pyelonephritis to Hormonal Hypertension
Authors: ALVIN P. SHAPIRO, JEAN L. KOBERNICK
Journal: Circulation Research (1961)

Renal hypertension was produced in rats by unilateral nephrectomy and constriction of the artery to the remaining kidney. Both an increased concentration of bacteria in the kidney 24 hours after inoculation of Escherichia coli , and an increased incidence of lesions of pyelonephritis two weeks after inoculation were noted in these hypertensive rats. Admin istration of desoxycorticosterone (DCA) and saline to rats with chronic experiniental pye lonephritis resulted in development of hyper tension of greater severity thait normal rats. Chronic pyelonephritis alone did not re sult in hypertension, nor did unilateral "fig ure-of-8" ligature in the pyelonephritic rat. Increased susceptibility to pyelonephritis in, hypertension and predisposition to hyperten sion in chronic pyelonephritis thus can ac count for a relationship between hyperten sion and pyelonephritis in the rat. If these results can be applied to the problem in man, they suggest an explanation for the clinical coincidence of the two diseases which seems more consonant with existing facts than a re lationship of direct etiology.
Cough, fever and weight loss in a young male
Authors: R. Summer, J. Zacks, M. Ieong, A. O'Regan
Journal: European Respiratory Journal (2002)

Case historyA 48-yr-old male was admitted with 6 months of nonproductive cough, fever, and weight loss.These symptoms progressed despite a course of antibiotics prescribed for presumed community-acquired pneumonia 2 months prior to admission.A chest radiograph taken at that time is shown in figure 1a.The patient denied any other symptoms, including skin rash, joint pain, and extremity numbness and weakness.Past medical history was significant for infection with Hepatitis-C virus and an accidental shotgun wound.The patient had a 30-pack-yr smoking history, remote use of injected heroin and cocaine and distant ethanol abuse.There was no occupational exposure to asbestos or silica, no recent travel and he had no pets or hobbies.He was not taking any medications.On physical examination the patient was diaphoretic with a temperature of 39.4u C, pulse 107 beat?min -1 , blood pressure 133/75 mmHg, respiration 28 breaths?min -1 and oxygen saturation of 88% on room air.Chest examination revealed bilateral basilar crackles.A 2-cm lymph node that was firm, mobile and not tender was palpated in the right axilla.The rest of the examination was normal.Laboratory studies demonstrated a white blood count of 2.4610 9 L -1 (53% lymphocytes, 25% neutrophils, 15% monocytes, 3% eosinophils and 2% bands), haematocrit of 30% and platelet count 77610 10 L -1 .Serum chemistries, renal and liver function tests were normal.Lactate dehydrogenase was normal.The patient was human immunodeficiency virus (HIV) negative.Chest radiography (fig.1b) was performed on admission, followed by computed tomography (CT) scan of the chest (fig.2).Over the course of the next week repeat blood, urine, and sputum cultures were sterile and a bone marrow aspirate and biopsy was nondiagnostic.A biopsy of the right axillary lymph node was performed (fig.3).
Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study
Authors: Sumit R Majumdar, Finlay A McAlister, Dean T Eurich, Raj S Padwal, Thomas J Marrie
Journal: BMJ (2006)

To determine whether statins reduce mortality or need for admission to intensive care in patients admitted to hospital with community acquired pneumonia; and to assess whether previously reported improvements in sepsis related outcomes were a result of the healthy user effect.Population based prospective cohort study.Six hospitals in Capital Health, Edmonton, Alberta, Canada.Adults admitted to hospital with pneumonia and categorised according to use of statins for at least one week before admission and during hospital stay.Composite of in-hospital mortality or admission to an intensive care unit.Of 3415 patients with pneumonia admitted to hospital, 624 (18%) died or were admitted to an intensive care unit. Statin users were less likely to die or be admitted to an intensive care unit than non-users (50/325 (15%) v 574/3090 (19%), odds ratio 0.80, P=0.15). After more complete adjustment for confounding, however, the odds ratios changed from potential benefit (0.78, adjusted for age and sex) to potential harm (1.10, fully adjusted including propensity scores, 95% confidence interval 0.76 to 1.60).Statins are not associated with reduced mortality or need for admission to an intensive care unit in patients with pneumonia; reports of benefit in the setting of sepsis may be a result of confounding.