tbuckley/cabot-search huggingface dataset:
EFFECTS OF HORMONES ON THE ADRENAL NECROSIS PRODUCED BY BESNOITIA JELLISONI IN GOLDEN HAMSTERS
Authors: J. K. Frenkel
Journal: The Journal of Experimental Medicine (1956)

Adrenal necrosis has been described in golden hamsters where it occurs during the course of infection with Besnoilia jellisoni. This necrosis results directly from the active intracellular proliferation by this obligate intracellular protozoan organism. After infection, adrenal necrosis is rarely observed in hypophysectomized hamsters. In unoperated animals adrenal necrosis is suppressed to varying degrees by cortisone (E), hydrocortisone (F), corticosterone (B), 11-dehydrocorticosterone (A), and possibly by 11-desoxycorticosterone (DOCA). Besnoitia organisms proliferate in otherwise "immune" hamsters around the subcutaneous deposits of the acetates of cortisone (E), hydrocortisone (F), and 11-dehydrocorticosterone (A); a marked depression of general immunity follows the administration of pharmacologic doses of the former two hormones. Organisms do not proliferate around the sites of corticosterone acetate (B) and 11desoxycorticosterone acetate (DOCA) injection, nor next to deposits of testosterone propionate, 11-desoxy-17-hydroxycorticosterone acetate (Reichstein's compound S) and epinephrine in oil. It is postulated that certain glucocorticoids can so modify immunity mechanisms locally, that general immunity becomes ineffective; this occurs in the adrenal glands owing to endogenous corticoid production, at the sites of exogenous corticoid injection, and proximal to that in the lungs. A comparison is made with the pathogenesis of tuberculosis and histoplasmosis of the adrenal gland which results in Addison's disease in man, and it is concluded that a similar pathogenetic mechanism is operative. The use of glucocorticoids for replacement therapy is discussed in reference to their relative resistance-depressing activities in pharmacologic doses. These undesirable side effects would appear to be less pronounced, if not absent, if corticosterone (B) rather than cortisone (E) and hydrocortisone (F) therapy were used. Porcine adrenocorticotrophic hormone (ACTH) appearsto depress the incidence of adrenal necrosis in unoperated hamsters, and supports proliferation of organisms in the adrenal cortex with subsequent necrosis in only a small proportion of hypophysectomized hamsters. The possibility is discussed that ACTH from a different species (hog) might lead to a change in the secretory activity of the hamster adrenal gland.
Attitudes of Japanese Physicians Toward Terminal Dehydration: A Nationwide Survey
Authors: Tatsuya Morita, Yasuo Shima, Isamu Adachi
Journal: Journal of Clinical Oncology (2002)

PURPOSE: To clarify physician attitudes toward terminal dehydration and identify the physician-related factors contributing to their attitudes. METHODS: A cross-sectional survey of Japanese physicians with a self-reported questionnaire was used. RESULTS: A total of 584 responses were analyzed (response rate, 53%). In the vignette of a gastric cancer patient with an estimated survival of 1 month and almost impossible oral intake due to intestinal obstruction, 50% chose intravenous hydration of 1,000 mL/d, while 24% selected more than 1,500 mL/d. For a lung cancer patient with cachexia, 58% chose 1,000 mL/d, while 26% selected no hydration or 500 mL. Multivariate analyses revealed that the physicians with more positive attitudes toward intravenous hydration were significantly less involved in end-of-life care, more likely to regard the physiologic requirement of fluid and nutrition as important in initiating intravenous hydration, more likely to believe that intravenous hydration is effective for symptom palliation, and more likely to believe that intravenous hydration is the minimum standard of care. CONCLUSION: Physicians have considerably divergent attitudes toward intravenous hydration for terminally ill cancer patients. To resolve the discrepancy, the priority in hydration research should be to clarify the appropriate physiologic requirements of fluid and nutrition in dying patients, the effects of intravenous hydration on patient symptoms, and the reasons why physicians consider intravenous hydration to be the minimum standard of care.
S76 Non-invasive positive pressure ventilation to reduce childhood mortality from acute respiratory failure in rural ghana
Authors: RE Balfour-Lynn, G Marsh, D Gorayi, E Elahi, JM LaRovere
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> Acute respiratory failure (ARF) is a major cause of mortality in the developing world, exacerbated by resource limitation. Non-invasive positive pressure ventilation (NIPPV) is a potential simple way to reduce mortality, and whilst established in adults, evidence in children is lacking. <h3>Methods</h3> The study was conducted in Tumu District Hospital in Northern Ghana, which serves a catchment of 56,000 and has an under-5 Mortality of 142 per 1000 live births. Two Nippy Junior paediatric pressure controlled portable ventilators, chosen for ease of use and robustness, were used along with finger monitors to measure oxygen saturation and heart rate. Training of nurses, the nurse anaesthetist and the doctor was achieved with interactive lectures, hands-on workshops and competency assessment over 3 days in November 2011 and April 2012. Laminated guides attached to each machine outlined criteria to commence, escalate and wean NIPPV. Criteria for commencing NIPPV were based on respiratory rate, oxygen saturation, intercostal recession and expiratory grunting. <h3>Results</h3> In the initial 4 months of NIPPV use, 657 children under 5 were admitted with 11 deaths, of whom 84 received NIPPV with 3 deaths. In the subsequent 9 months, NIPPV was used in 46 children and 11 adults, with no deaths. Of 140 patients ventilated in 2012, 106 (76%) were under five and 60 (43%) under the age of two. There were 2 deaths from malaria/sepsis with an overall mortality of 1.4% (1.9% &lt;5 years). Primary diagnoses by age as best available are displayed in figure 1. No complications were reported apart from discomfort in some patients. Patients were ventilated for shorter periods than usual in the developed world. Ventilation times were notably shorter in malaria patients. Those with respiratory tract infections and pneumonia tend to be ventilated longer and were often more comfortable with ventilation for longer periods at a time. <h3>Conclusions</h3> This feasibility study shows NIPPV for ARF in children in a rural setting can be delivered safely with minimal training and appears to impact significantly on mortality in those under 5.
Christopher Dyer Saudek, MD: Diabetes Expert and Implantable Insulin Pump Pioneer
Authors: Sherita Hill Golden, Rita Rastogi Kalyani, Tom Donner
Journal: Diabetes Care (2013)

Christopher Dyer Saudek, MD



Christopher Dyer Saudek, MD, was a pioneer in the development of implantable insulin pumps, which brought freedom and flexibility to the field of diabetes. Saudek was born to Robert and Elizabeth Saudek in 1942. (Robert Saudek was the creator of the 1950s critically acclaimed television series Omnibus .) The young Saudek grew up in Bronxville, New York, and, along with his siblings, would often accompany his father on Sunday mornings to New York City. Standing just off camera, the youngsters would watch dress rehearsals of performances for Omnibus , which in turn kindled Christopher’s lifelong interest in theater and music. (It is a surprising twist that he chose medicine as his career, but it is no surprise that he was highly successful in his choice.) Throughout his public school years, Saudek excelled in academics, sports, orchestra, and student government. After graduating from Bronxville High School in 1959, he earned his bachelor’s degree from Harvard College in 1963 and his medical degree from Cornell University Medical School in 1966. He subsequently trained in internal medicine at Chicago’s Presbyterian-St. Luke’s Hospital and in endocrinology and metabolism at Harvard Medical School and Boston City Hospital. Dr. Saudek was a fellow at the National Institutes of Health and was a Robert Wood Johnson Foundation Health Policy Fellow (1979–1980). He taught at Cornell Medical School for 8 years before arriving at Johns Hopkins University in 1980. He was part of a group of researchers that described the early use of hemoglobin A1c as a measure of glycemia in The New England Journal of Medicine in 1976 (1).

The academic experiences from his early years as a young faculty member provided the physiological, health policy, and teaching expertise that would be the foundation for a stellar career as a diabetes …
Renal cortical blood flow distribution in obstructive nephropathy in rats.
Authors: N J Siegel, R A Feldman, B Lytton, J P Hayslett, M Kashgarian
Journal: Circulation Research (1977)

To examine the role of intrarenal hemodynamics in in obstructive nephropathy, we determined cortical blood flow distribution (CBFD) in rats with bilateral ureteral occlusion (BUO) and unilateral ureteral occlusion (UUO) during and after release of obstruction. Prior to release of obstruction of 24 hours' duration, we found that outer cortical perfusion decreased by 20+/-5% in both BUO and UUO rats. Furthermore, one hour after release of BUO, there was rapid normalization of CBFD associated with a modest return of glomerular filtration rate (GFR), an almost complete return of renal blood flow (RBF), and a marked postobstructive diuresis. In contrast, after release of UUO, we observed that outer cortical perfusion remained decreased by 21+/-31%, both GFR and RBF remained markedly depressed, and no diuresis occurred. These data demonstrate (1) marked ischemia of the outer cortex in both BUO and UUO during obstruction, (2) a rapid return of CBFD to a normal pattern after release of BUO, but (3) persistent outer cortical ischemia following release of UUO.
Mapping of left ventricular wall thickness distribution in hypertrophic cardiomyopathy by 3D echocardiography: Comparison with 2D echo and normal controls
Authors: Andreas Franke, Harald P. Kühl, Christian Flaskamp, Jürgen Frielingsdorf, Winfried Krebs, Heinrich G. Klues, Frank A. Flachskampf, Peter Hanrath
Journal: Journal of the American College of Cardiology (1996)
Identification of the Retinoic Acid-Inducible Gprc5a As a New Lung Tumor Suppressor Gene
Authors: Q. Tao, J. Fujimoto, T. Men, X. Ye, J. Deng, L. Lacroix, J. L. Clifford, L. Mao, C. S. Van Pelt, J. J. Lee, D. Lotan, R. Lotan
Journal: JNCI Journal of the National Cancer Institute (2007)

Lung cancers develop via multiple genetic and epigenetic changes, including inactivation of tumor suppressor genes. We previously cloned human G protein–coupled receptor family C type 5A (GPRC5A), whose expression is suppressed in some human lung carcinoma cells, and its mouse homolog Gprc5a. We generated Gprc5a knockout mice by homologous recombination and studied their phenotype by macroscopic observation and microscopic histologic analysis of embryos and lungs of 1- to 2-year-old mice. GPRC5A mRNA expression was analyzed by reverse transcription–polymerase chain reaction in surgical specimens of 18 human lung tumors and adjacent normal tissues and by analyzing previously published data from 186 lung tumor tissues of a variety of histologic types and 17 normal lung samples. Human embryonic kidney, human non–small-cell lung cancer, and mouse lung adenocarcinoma cells were transfected with a GPRC5A expression vector or a control vector, and colony formation in semisolid medium was assayed. Statistical tests were two-sided. Homozygous knockout mice developed many more lung tumors at 1–2 years of age (incidence: 76% adenomas and 17% adenocarcinomas) than heterozygous (11% adenomas) or wild-type (10% adenomas) mice. Human GPRC5A mRNA levels were lower in most (11 of 18 [61%]) human lung tumors than in adjacent normal tissues. The mean GPRC5A mRNA level in adenocarcinoma (n = 139), squamous cell carcinoma (n = 21), small-cell lung cancer (n = 6), and carcinoid (n = 20) tissues was 46.2% ( P = .014), 7.5% ( P <.001), 5.3% ( P <.001), and 1.8% ( P <.001), respectively, that in normal lung tissues (n = 17) GPRC5A transfection suppressed colony formation in semisolid medium of immortalized human embryonic kidney, human non–small-cell lung cancer, and mouse lung adenocarcinoma cells by 91%, 91%, and 68%, respectively, compared with vector controls (all P <.001). Gprc5a functions as a tumor suppressor in mouse lung, and human GPRC5A may share this property. The Gprc5a-deficient mouse is a novel model to study lung carcinogenesis and chemoprevention.
Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster
Authors: Jeanne Mager Stellman, Rebecca P. Smith, Craig L. Katz, Vansh Sharma, Dennis S. Charney, Robin Herbert, Jacqueline Moline, Benjamin J. Luft, Steven Markowitz, Iris Udasin, Denise Harrison, Sherry Baron, Philip J. Landrigan, Stephen M. Levin, Steven Southwick
Journal: Environmental Health Perspectives (2008)

The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures.Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers' children.Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire.Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers.Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed.
The endothelial cell receptor GRP78 is required for mucormycosis pathogenesis in diabetic mice
Authors: Mingfu Liu, Brad Spellberg, Quynh T. Phan, Yue Fu, Yong Fu, Amy S. Lee, John E. Edwards, Scott G. Filler, Ashraf S. Ibrahim
Journal: Journal of Clinical Investigation (2010)

Mucormycosis is a fungal infection of the sinuses, brain, or lungs that causes a mortality rate of at least 50% despite first-line therapy. Because angioinvasion is a hallmark of mucormycosis infections, we sought to define the endothelial cell receptor(s) for fungi of the order Mucorales (the fungi that cause mucormycosis). Furthermore, since patients with elevated available serum iron, including those with diabetic ketoacidosis (DKA), are uniquely susceptible to mucormycosis, we sought to define the role of iron and glucose in regulating the expression of such a receptor. Here, we have identified glucose-regulated protein 78 (GRP78) as what we believe to be a novel host receptor that mediates invasion and damage of human endothelial cells by Rhizopus oryzae, the most common etiologic species of Mucorales, but not Candida albicans or Aspergillus fumigatus. Elevated concentrations of glucose and iron, consistent with those seen during DKA, enhanced GRP78 expression and the resulting R. oryzae invasion and damage of endothelial cells in a receptor-dependent manner. Mice with DKA, which have enhanced susceptibility to mucormycosis, exhibited increased expression of GRP78 in sinus, lungs, and brain compared with normal mice. Finally, GRP78-specific immune serum protected mice with DKA from mucormycosis. These results suggest a unique susceptibility of patients with DKA to mucormycosis and provide a foundation for the development of new therapeutic interventions for these deadly infections.
Too many unknowns stymie response to MERS
Authors: John Maurice
Journal: The Lancet (2015)

Too many unknowns stymie response to MERSThe spread of the Middle East respiratory syndrome to Asia has put the public health community on trial for a lack of adequate preparedness in preventing such infections.John Maurice reports.Camels, bats, cats, dogs, pigs-the list is long of the animals that coronaviruses choose to infect.This virus comes in at least 25 strains.It mutates easily and can jump easily from animal to animal.Six strains, however, have been identifi ed that can jump from animals to human beings and cause severe respiratory disease, multiorgan failure, and, in about a third of cases, death.People with pre-existing diseases or elderly people are particularly at risk of severe illness.There is no therapeutic drug to treat, nor a vaccine to prevent, the infection.The fi rst known serious coronavirus epidemic-severe acute respiratory syndrome (SARS)-broke out in 2002 and caused 8275 cases and 775 deaths in 14 countries.The latest epidemic, Middle East respiratory syndrome (MERS), so named for its first appearance in the Arabian Peninsula, in 2012, has, as of June 26, caused 1350 cases in 26 countries and at least 480 deaths.Most cases and deaths have occurred in Saudi Arabia.At the end of May, to the surprise of the international health community, 162 cases and 19 deaths occurred, not in the Middle East, but in South Korea.Current epidemiological evidence points to dromedary (Arabian one-humped) camels as the main reservoir of the coronavirus causing the Middle-East cases.(The source of
Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases Involving Bone: A Multicenter Study
Authors: Matthew P. Goetz, Matthew R. Callstrom, J. William Charboneau, Michael A. Farrell, Timothy P. Maus, Timothy J. Welch, Gilbert Y. Wong, Jeff A. Sloan, Paul J. Novotny, Ivy A. Petersen, Robert A. Beres, Daniele Regge, Rodolfo Capanna, Mark B. Saker, Dietrich H.W. Grönemeyer, Athour Gevargez, Kamran Ahrar, Michael A. Choti, Thierry J. de Baere, Joseph Rubin
Journal: Journal of Clinical Oncology (2004)

Purpose Few options are available for pain relief in patients with bone metastases who fail standard treatments. We sought to determine the benefit of radiofrequency ablation (RFA) in providing pain relief for patients with refractory pain secondary to metastases involving bone. Patients and Methods Thirty-one US and 12 European patients with painful osteolytic metastases involving bone were treated with image-guided RFA using a multitip needle. Treated patients had ≥ 4/10 pain and had either failed or were poor candidates for standard treatments such as radiation or opioid analgesics. Using the Brief Pain Inventory–Short Form, worst pain intensity was the primary end point, with a 2-unit drop considered clinically significant. Results Forty-three patients were treated (median follow-up, 16 weeks). Before RFA, the mean score for worst pain was 7.9 (range, 4/10 to 10/10). Four, 12, and 24 weeks following treatment, worst pain decreased to 4.5 (P &lt; .0001), 3.0 (P &lt; .0001), and 1.4 (P = .0005), respectively. Ninety-five percent (41 of 43 patients) experienced a decrease in pain that was considered clinically significant. Opioid usage significantly decreased at weeks 8 and 12. Adverse events were seen in 3 patients and included (1) a second-degree skin burn at the grounding pad site, (2) transient bowel and bladder incontinence following treatment of a metastasis involving the sacrum, and (3) a fracture of the acetabulum following RFA of an acetabular lesion. Conclusion RFA of painful osteolytic metastases provides significant pain relief for cancer patients who have failed standard treatments.
Prophylaxis of Hemodialysis Graft Thrombosis with Fish Oil
Authors: Paul G. Schmitz, Linda K. McCloud, Sanford T. Reikes, Cindy L. Leonard, Mary E. Gellens
Journal: Journal of the American Society of Nephrology (2002)

Diets enriched with fish oil may favorably affect the vascular perturbations underlying synthetic graft thrombosis. Therefore, these studies were designed to test the hypothesis that diets enriched with fish oil would decrease the incidence of thrombosis in newly constructed polytetrafluorethylene grafts. A double-blind, randomized trial was conducted. Twenty-four patients were randomized to receive 4000 mg of fish oil or 4000 mg of control oil. Both preparations were enriched with antioxidants and deodorized with peppermint. Patients began therapy within 2 wk after graft placement and were monitored for 12 mo or until thrombosis developed. With a permuted-block randomization schedule, 12 patients received fish oil and 12 patients received control oil. The primary patency rates at 365 d were 14.9% for the control group and 75.6% for the fish oil-treated group. Survival analysis revealed a significant difference between fish oil-treated and untreated patients (P < 0.03, Mantel-Cox test), with a power of 90%. Moreover, analysis of covariables, including age of > or =50 yr, gender, race, body weight, diabetes mellitus, bleeding times, and lipid profiles, indicated that this effect occurred principally as a result of fish oil administration. Importantly, fish oil treatment also decreased venous outflow resistance and systemic BP, compared with control values. Fish oils possess unique biologic properties that favorably affect the incidence of polytetrafluorethylene graft thrombosis, and they thus represent a potential treatment strategy for the prevention of access thrombosis.
Effects of Adrenergic Receptor Activation and Blockade on the Systolic Preejection Period, Heart Rate, and Arterial Pressure in Man
Authors: Willard S. Harris, Clyde D. Schoenfeld, Arnold M. Weissler
Journal: Journal of Clinical Investigation (1967)

We have investigated the possibility that alterations in the duration of the systolic preejection period can be used to estimate adrenergic influences on the human left ventricle. The preejection period was determined from high speed, simultaneous recordings of the phonocardiogram, carotid pulse tracing, and electrocardiogram. The preejection period was shortened by isoproterenol, epinephrine, and moderate doses of norepinephrine—all of which activate beta adrenergic receptors—and by cedilanid-D. It was unaltered by changes in heart rate induced by atropine and right atrial electrical pacing. Beta adrenergic receptor blockade by propranolol abolished the shortening effects of the three catecholamines but did not inhibit that due to cedilanid-D. Vasoconstriction, both alpha adrenergic (epinephrine and norepinephrine after propranolol) and nonadrenergic (angiotensin), prolonged the preejection period. Most of the shortening of the preejection period by beta adrenergic receptor activating agents and cedilanid-D and all of the prolongation accompanying pharmacologic vasoconstriction occurred after the onset of the first heart sound, thereby excluding changes in electrical-mechanical delay as a major factor in the observed preejection period responses. Shortening of the preejection period by beta adrenergic activity induced with isoproterenol was dose-related. Increasing doses of propranolol produced parallel shifts to the right in the isoproterenol dose-response curve.