tbuckley/cabot-search huggingface dataset:
Pathogenesis of Bartter's Syndrome
Authors: A. David Goodman, Anthony H. Vagnucci, Phyllis M. Hartroft
Journal: New England Journal of Medicine (1969)

In a patient with Bartter's syndrome (increased plasma renin, juxtaglomerular-cell hyperplasia, hyperaldosteronism and hypokalemia, but no hypertension), aldosterone excretion and secretion were increased only moderately despite marked elevation of plasma renin, presumably because of suppression of aldosterone production by hypokalemia. When the serum potassium was raised by administration of potassium chloride and spironolactone, while normal sodium balance was maintained, aldosterone excretion rose markedly. Infusion of albumin decreased plasma renin and aldosterone secretion, and restored normal sensitivity to the pressor effect of exogenous angiotensin. Suppression of aldosterone production to normal limits by administration of albumin, amino-glutethimide or dexamethasone failed to correct the hypokalemia, indicating that some factor other than hyperaldosteronism may contribute to urinary potassium wastage in this syndrome. This study and others raise the possibility that in some patients with Bartter's syndrome the primary defect is impairment of proximal sodium reabsorption.
Dramatic Improvement or Death Spiral — Two Members of Congress Assess the Medicare Bill
Authors: Edward M. Kennedy, Bill Thomas
Journal: New England Journal of Medicine (2004)

The Journal asked Representative Bill Thomas (R-Calif.), chairman of the House Ways and Means Committee, and Senator Edward M. Kennedy (D-Mass.), ranking member of the Senate Health, Education, Labor, and Pensions Committee, to respond to the following question: “If you were to rewrite the recently passed Medicare bill, how would you change it?” Their responses follow. . .
AB1083 Effects of L-Arginin for Prevention of Atherosclerosis in Patients with Systemic Disease
Authors: O. Mytrokhina, O. Kuryata, L. Tatyana
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Patients with systemic diseases are a group at high risk for the development of atherosclerosis and related complications. The most pressing issue remains the prevention of atherosclerosis in patients with systemic diseases. The role of L-arginin for prevention of atherosclerosis in patients with systemic diseases remains debatable. <h3>Objectives</h3> We aimed to evaluate the effects of L-arginin for prevention of atherosclerosis in patients with systemic diseases. <h3>Methods</h3> 30 patients (mean age – 48,73±1,25 years) with systemic diseases were enrolled. 17 (56,7%) patients received the standard treatment and L-arginin 4,2% 100 ml by infusion (1 group), while 13 (43,3%) (2 group) – received only the standard treatment for 2 weeks. Flow-mediated dilation (FMD) was assessed during reactive hyperemia and intima-media thicknes (IMT) by ultrasound. <h3>Results</h3> FMD were decreased in 73,3% pts (mean level - 8,45±0,53%). Among them 10% pts with paradoxal vasoconstriction reaction. Increased IMT were in 30% pts (mean level - 0,91±0,02 mm). Among them 20% pts had plaque form. After 2 weeks of treatment with L-arginin 1 group had increased FMD by 22,2% (p&lt;0,05), than 2 group (decrease by 8,7% (p&lt;0,05)). 1 group had decreased IMT (p&lt;0,05), than 2 group IMT were increase by (p&lt;0,001)). <h3>Conclusions</h3> L-arginin is effective and safe for the pts with systemic diseases. Its administration may provide benefits for the reduction of hospitalizations and mortality in its population. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5855
Detection of Deep-Vein Thrombosis by Real-Time B-Mode Ultrasonography
Authors: Anthonie W.A. Lensing, Paolo Prandoni, Dees Brandjes, Peter M. Huisman, Mario Vigo, Giovanni Tomasella, Jelmer Krekt, Jan Wouter ten Cate, Menno V. Huisman, Harry R. Büller
Journal: New England Journal of Medicine (1989)

In 220 consecutive outpatients with clinically suspected deep-vein thrombosis of the leg, we compared contrast venography with real-time B-mode ultrasonography, using the single criterion of vein compressibility with the ultrasound transducer probe. The common femoral and popliteal veins were evaluated for full compressibility (no thrombosis) and noncompressibility (thrombosis). Both veins were fully compressible in 142 of the 143 patients with normal venograms (specificity, 99 percent; 95 percent confidence interval, 97 to 100). All 66 patients with proximal-vein thrombosis had noncompressible femoral veins, popliteal veins, or both (sensitivity, 100 percent; 95 percent confidence interval, 95 to 100). For all patients (including 11 with calf-vein thrombi), sensitivity and specificity were 91 (95 percent confidence interval, 82 to 96) and 99 percent, respectively. The sensitivity for isolated calf-vein thrombosis was only 36 percent. The compression ultrasound test was repeated in a subset of 45 consecutive patients by a second examiner, unaware of the results of the first test, whose results agreed in all patients with those of the first examiner (kappa = 1). We conclude that ultrasonography with the single criterion of vein compressibility is a highly accurate, simple, objective, and reproducible noninvasive method for detecting proximal-vein thrombosis in outpatients with clinically suspected deep-venous thrombosis.
Abstract 1351: Lack of matrix metalloproteinase-10 exacerbates inflammation-associated colon tumor development
Authors: Felicitas L. Koller, E. Ashley Dozier, Barbara M. Fingleton
Journal: Cancer Research (2010)

Abstract Ulcerative colitis is the most common inflammatory bowel disease, and is associated with increased risk of colon cancer. Understanding the mechanisms by which carcinogenesis occurs in the setting of colitis could lead to both prevention strategies and improved therapies. Matrix metalloproteinase-10 (MMP10), a member of the matrix metalloproteinase family of proteolytic enzymes, is expressed at healing edges of colonic ulcers. Although MMPs are usually considered as destructive players in inflammatory disease, we considered the possibility that MMP10 had a beneficial role in ulcerative colitis. We used dextran sulfate sodium (DSS) treatment in MMP10-null and corresponding control wild-type mice to investigate the consequences of MMP10 deletion on colitis development and recovery. Groups of mice were exposed to DSS for 7-day periods and sacrificed at different timepoints following the cessation of the DSS. Strikingly, MMP10-null mice were more severely affected by the treatment as determined by gross observations such as weight loss and colon length. Histological analysis at the various timepoints indicated that wild-type mice showed almost complete recovery from DSS within 14 days after DSS treatment. In contrast, MMP10-null mice still showed clear signs of damage with persistent inflammatory foci and non-healing ulcers. In situ hybridization indicated MMP10 expression predominantly in inflammatory cells, although some fibroblasts were also positive. Colonic epithelium was negative for MMP10. Bone marrow transplant experiments indicated that wild-type bone marrow partially rescued the MMP10-null phenotype. Measurement of cytokines by ELISA in colonic lavage fluid from MMP10-null and wild-type mice showed that IL-1α was significantly increased in the absence of MMP10. Levels of other cytokines such as TNFα, IL6, IL17 and G-CSF were not different. Multiple exposures to DSS results in conversion of an acute colitis to a chronic inflammatory disease. With only 2 DSS exposures, MMP10-null mice manifested a chronic condition which failed to resolve even after 3 months. Similarly-treated wild-type mice, however, appeared normal at this timepoint. Examination of the colonic tissue from the DSS double exposure showed a significant increase in the number of dysplastic foci present in the MMP10-null mice. Thus, expression of MMP10 appears necessary for resolution of colitis, and in its absence, the development of chronic colitis results in tumor development. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1351.
Long-Term Prognosis of Mitral-Valve Prolapse
Authors: Peter Mills, John Rose, Jane Hollingsworth, Ingrid Amara, Ernest Craige
Journal: New England Journal of Medicine (1977)

We examined the natural history of mitral-valve prolapse in 53 patients who had had a midsystolic click or late systolic murmur (or both) documented phonocardiographically a mean of 13.7 years earlier. Thirty-eight patients were alive without serious complications, and seven had died of unrelated causes. In two patients prolapse was implicated in the cause of death. Other complications were ventricular fibrillation in one patient and bacterial endocarditis in three. Progressive mitral regurgitation developed in five patients, requiring valve replacement in two. These complications occurred in a total of eight patients (15 per cent), and were significantly (P = 0.15) associated with a late systolic murmur rather than an isolated midsystolic click. Thus it appears that the diagnosis of mitral-valve prolapse should not be regarded as ominous; however, patients in whom this diagnosis is associated with a late systolic murmur should be followed carefully.
Abstract 1715: Leptin regulates the IL-1 system in breast cancer
Authors: Weiqiang Zhou, Ruben R. Gonzalez-Perez
Journal: Cancer Research (2010)

Abstract Leptin and IL-1 are inflammatory cytokines promoting breast cancer angiogenesis that are often linked to worse prognosis. We hypothesize the leptin angiogenic effects in mammary tumor (MT) may be linked to, or regulated, in part by IL-1 signaling, therefore, leptin and IL-1 may have synergistic functions in MT progression. To test this hypothesis leptin-dose (0-6.2 nM) and time-course (0-48h) effects on levels of IL-1 system components (IL-1α, IL-1β, IL-1Ra and IL-1R tI) were investigated in mouse MT-4T1 cells. To determine the contribution of specific leptin-activated signaling pathways on IL-1 regulation several kinase inhibitors AG490 (JAK2/STAT3), PD98059 (MEK/MAPK/ERK1/2), Wortmannin (PI-3K/AKT1), Rapamycin (mToR), Go6976 (PKC-Ca dependent), SB203580 (p38 MAP kinase) and SP600125 (JNK) were used and IL-1 system component levels were determined by ELISA and Western blot. To determine if leptin could regulate its own receptor (long isoform, OB-Rb and all isoforms) flow cytometry was used. Our results show that basal levels of IL-1α were 14 fold higher than IL-1β. Remarkably, leptin up-regulates all IL-1 system components and all OB-R isoforms showing the highest effects at 1.2nM/24h. JAK2/STAT3 and MAPK/ERK 1/2 were essential for leptin upregulation of IL-1 system. In contrast, PI-3K/AKT1, PKC and p38 kinases were mainly linked to leptin regulation of IL-1 receptor-related proteins (IL-1R tI and IL-1Ra). JNK and mTOR were related to leptin-mediated induction of IL-1R tI but were not involved on IL-1α or IL-1Ra regulation. Interestingly, leptin-mediated activation of mTOR appears to be a negative regulator of IL-1α but acts as an inductor of IL-1Ra. In conclusion, leptin is an important regulator of IL-1 system in MT. In turn, IL-1 signaling can promote VEGF expression and tumor macrophage recruitment that could indirectly enhance leptin-mediated angiogenic effects and MT growth. This work was supported in part by NIH/NCI 1SC1CA138658-02; NIH/UAB Breast SPORE Career Development Award; BC 504370 Susan G. Komen Foundation for the Cure and the Georgia Cancer Coalition Distinguished Cancer Scholar Award (to RRGP). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1715.
P170 Heart Rate Recovery At One Minute Following Incremental Shuttle Walk Test Predicts Outcome In Pulmonary Hypertension
Authors: C. Billings, J. Hurdman, M. Austin, I. Armstrong, C. Elliot, R. Condliffe, D. Kiely
Journal: Thorax (2014)

<h3>Background</h3> Heart-rate recovery during the first minute of rest (HRR1) after a six minute walk test (6MWT) has been shown to be a strong predictor of clinical worsening in patients with pulmonary arterial hypertension.<sup>1</sup> No data as yet has been published regarding the utility of HRR1 as a predictor of mortality. <h3>Aim</h3> To assess the prognostic value of HRR1 after an Incremental Shuttle Walk Test (ISWT) in patients with pulmonary hypertension (PH). <h3>Methods</h3> Data was retrieved for consecutive cases of PH diagnosed in our unit from 2001–2010. ISWT was performed routinely as part of baseline assessment according to a modified protocol of Singh <i>et al</i>.<sup>2</sup> Only treatment-naive patients with ISWT and HRR data from -90 to +30 days from date of diagnosis were included. HRR1 was defined as the difference between maximum heart rate during the ISWT and heart rate after 1 min of rest following the termination of ISWT. <h3>Results</h3> Data was available for 491 patients (including patients from each of the 5 main PH diagnostic groups). HRR1 correlated significantly with ISWT distance, highest heart-rate, maximal change in heart-rate,% predicted carbon monoxide diffusion (DLco%pred), pulmonary vascular resistance, cardiac output and mixed venous oxygen saturation (p all ≤0.01). Using a cut-off point of 18bpm the Kaplan Meier graph for survival for patients with HRR1 &gt;18 bpm (n = 179) was significantly better than HRR1 ≤18 bpm (n = 312), p = 0.007 (Figure 1) for all patients and for diagnostic Groups 1 and 2 separately (p = 0.045, p = 0.006). Using univariate Cox proportional hazard analysis for all patients HRR1 (continuous data) had a Hazard Ratio for mortality (HR) of 0.990 with a confidence interval (CI) of 0.962–0.997, p = 0.008. Compared to patients with HRR1 &gt;18, those with HRR1≤18 had a HR of 1.559 (CI 1.127–2.156) p = 0.007. Grouping patients by median distance walked and HRR1–18 demonstrated that the HRR1 proved a useful predictor only in patients who walked less than 180 m. <h3>Conclusion</h3> HRR1 following ISWT predicts outcome in patients with pulmonary hypertension with more severe disease. <h3>References</h3> 1Minai OA <i>et al</i>. <i>Am J Respir Crit Care Med</i>. 2012;185:400-408 Singh <i>et al</i>. <i>Thorax</i> 1992;47:1019–1024
Conference on AIDS criticises inaction
Authors: S. Willott
Journal: BMJ (1995)

Experts on AIDS warned last week that the epicentre of the epidemic is moving from sub-Saharan Africa to Asia. Speaking at the third international conference on AIDS in Asia and the Pacific, in Thailand, last week, Meechai Veravaidhaya of Thailand's Population and Community Development Association, criticised his government for not doing more to prevent the spread of HIV. Thailand has an estimated …
Localization of Gastrointestinal Bleeding Using Tc-99m HSA-DTPA SPECT and Maximum-Intensity Projection Imaging
Authors: SANGKIL HA-KAWA, TSUNETAKA YOSHIDA, YOSHIZUMI AOKI, MITSUHARU SOUGAWA, SATOSHI SAWADA
Journal: Clinical Nuclear Medicine (2002)

HA-KAWA, SANGKIL M.D.; YOSHIDA, TSUNETAKA M.D.; AOKI, YOSHIZUMI M.D.; SOUGAWA, MITSUHARU M.D.; SAWADA, SATOSHI M.D. Author Information
AB0847-HPR Cognitive mechanisms of change in multidisciplinary treatment of patients with chronic wide spread pain: a prospective cohort study
Authors: A. De Rooij, M. R. de Boer, M. van der Leeden, L. D. Roorda, M. P. Steultjens, J. Dekker
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Cognitive mechanisms of change in the multidisciplinary treatment of patients with chronic widespread pain (CWP) are only partially understood. <h3>Objectives</h3> To evaluate the contribution of improvement in negative emotional cognitions, active cognitive coping, and control and chronicity beliefs to the outcome of the multidisciplinary treatment in patients with chronic widespread pain (CWP). <h3>Methods</h3> Data were used from baseline, 6 months and 18 months follow-up of a prospective cohort study of 120 CWP patients who completed a multidisciplinary pain management treatment. Longitudinal relationships were analyzed between changes in cognitions and outcome, using generalized estimated equations. Outcome domains included: pain, interference of pain in daily life, depression and global perceived effect. <h3>Results</h3> Improvements in negative emotional cognitions were associated with improvements in all outcome domains, in particular with improvement in interference of pain in daily life and depression. Improvements in active cognitive coping were associated with improvements in interference of pain in daily life. Finally, improvements in control and chronicity beliefs were associated with improvements in pain and depression. <h3>Conclusions</h3> Improvement in negative emotional cognitions seems to be a key mechanism of change of multidisciplinary treatment in CWP. Improvement of active cognitive coping and improvement of control and chronic timeline beliefs may constitute mechanisms of change as well, although the evidence is less strong. <h3>Disclosure of Interest</h3> None Declared
The Effect of the Ingestion of Ethanol on Obstruction of the Left Ventricular Outflow Tract in Hypertrophic Cardiomyopathy
Authors: Rami Paz, Ruth Jortner, Paul A. Tunick, Samuel Sclarovsky, Betty Eilat, John L. Perez, Itzhak Kronzon
Journal: New England Journal of Medicine (1996)

Ethanol causes vasodilatation, which might have an adverse effect, due to increased obstruction of the left ventricular outflow tract, in patients with hypertrophic obstructive cardiomyopathy. We assessed the hemodynamic effects of the ingestion of ethanol, in an amount commonly consumed socially, in patients with hypertrophic cardiomyopathy.
AB0884 Cardiac involvement in ankylosing spondylitis in a tunisien population
Authors: S. Boussaid, I. Gharsallah, L. Metoui, F. Ajili, N. Ben Abdelhafidh, B. Louzir, L. Bassem, S. Othmeni
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Cardiac involvement in ankylosing spondylitis is uncommon. We have tried through this study to analyze the cardiovascular events among 50 patients with ankylosing spondylitis. <h3>Methods</h3> A retrospective study including 50 patients with ankylosing spondylitis. all patients underwent a complete physical examination with a heart and lung auscultation and an electro-cardiogram (ECG). Transthoracic ultrasound was performed whenever there was an abnormal physical examination and/or ECG. <h3>Results</h3> the study included 47 men and 3 women, the sex ratio is 15.6. The average age of onset was 26±7 years. The mode of onset is axial in 95% of cases (low back pain and/or buttock). The extra-articular manifestations are present in 54% of cases. Cardiac involvement is present in 9 cases (18% of cases). The reason for consultation is dyspnea in 2 patients. In other cases, cardiac involvement was discovered incidentally. Aortic regurgitation was noted in 4 patients. Mitral insufficiency was found in 3 cases. Two patients have predominantly septal hypertrophic cardiomyopathy and one patient presented an array of pulmonary insufficiency. The average time of onset of cardiac involvement was 8±5 years. All patients were put under special medical treatment of their heart, with good clinical outcome. <h3>Conclusions</h3> Cardiac involvement in ankylosing spondylitis is seen more frequently in men, especially in the old cases. A close relationship between time to onset of aortic insufficiency and duration of disease progression was found. It would be responsible for one third of deaths of patients. It was significantly more frequent in HLA B27 positive patients (especially complete atrioventricular block and aortic insufficiency). Cardiac involvement should be sought routinely in patients with APS because it presents a poor prognosis that can be life-threatening. <h3>Disclosure of Interest</h3> None Declared
A novel endoscopic submucosal dissection technique with robust and adjustable tissue traction
Authors: Masashi Hirota, Motohiko Kato, Makoto Yamasaki, Naoki Kawai, Yasuhiro Miyazaki, Takuya Yamada, Tsuyoshi Takahashi, Tetsuo Takehara, Masaki Mori, Yuichiro Doki, Kiyokazu Nakajima
Journal: Endoscopy (2014)

<b>Background and study aims:</b> A novel esophageal endoscopic submucosal dissection (ESD) technique was devised using a newly developed overtube to achieve adequate tissue traction. The aim of this study was to evaluate the feasibility and safety of this new full-traction ESD (tESD) technique. <b>Methods:</b> The key feature of tESD is tissue traction by grasping forceps, which is passed through the built-in side channel of the overtube. The strength and direction of traction is controlled by rotating the overtube and by adjusting its depth. The en bloc resection rate, procedure time, adverse events, and dissected area per minute were evaluated in a porcine model (n = 10) and compared with those of conventional ESD (n = 10). <b>Results:</b> tESD provided robust and adjustable tissue traction during the procedure. En bloc resection was accomplished in all lesions with no complications. Median procedure time was similar to that of the conventional technique (25 vs. 27 minutes; <i>P</i> = 0.4723) but the submucosal injection catheter was used less often (1.5 vs. 6; <i>P</i> < 0.01). <b>Conclusions:</b> tESD might contribute to more efficient esophageal ESD by providing adequate tissue traction. This inexpensive technique may become an attractive option in esophageal ESD.