tbuckley/cabot-search huggingface dataset:
Women With Gestational Diabetes Mellitus Randomized to a Higher–Complex Carbohydrate/Low-Fat Diet Manifest Lower Adipose Tissue Insulin Resistance, Inflammation, Glucose, and Free Fatty Acids: A Pilot Study
Authors: Teri L. Hernandez, Rachael E. Van Pelt, Molly A. Anderson, Melanie S. Reece, Regina M. Reynolds, Becky A. de la Houssaye, Margaret Heerwagen, William T. Donahoo, Linda J. Daniels, Catherine Chartier-Logan, Rachel C. Janssen, Jacob E. Friedman, Linda A. Barbour
Journal: Diabetes Care (2015)

OBJECTIVE Diet therapy in gestational diabetes mellitus (GDM) has focused on carbohydrate restriction but is poorly substantiated. In this pilot randomized clinical trial, we challenged the conventional low-carbohydrate/higher-fat (LC/CONV) diet, hypothesizing that a higher–complex carbohydrate/lower-fat (CHOICE) diet would improve maternal insulin resistance (IR), adipose tissue (AT) lipolysis, and infant adiposity. RESEARCH DESIGN AND METHODS At 31 weeks, 12 diet-controlled overweight/obese women with GDM were randomized to an isocaloric LC/CONV (40% carbohydrate/45% fat/15% protein; n = 6) or CHOICE (60%/25%/15%; n = 6) diet. All meals were provided. AT was biopsied at 37 weeks. RESULTS After ∼7 weeks, fasting glucose (P = 0.03) and free fatty acids (P = 0.06) decreased on CHOICE, whereas fasting glucose increased on LC/CONV (P = 0.03). Insulin suppression of AT lipolysis was improved on CHOICE versus LC/CONV (56 vs. 31%, P = 0.005), consistent with improved IR. AT expression of multiple proinflammatory genes was lower on CHOICE (P &amp;lt; 0.01). Infant adiposity trended lower with CHOICE (10.1 ± 1.4 vs. 12.6 ± 2%, respectively). CONCLUSIONS A CHOICE diet may improve maternal IR and infant adiposity, challenging recommendations for a LC/CONV diet.
妊娠糖尿病的治疗 问题不是是否需要治疗，而是如何治疗及哪些人需要治疗？
Authors: Sara, Meltzer, 潘洁敏, 包玉倩
Journal: BMJ (2010)

妊娠糖尿病是妊娠期最常见的合并症。随着糖尿病患病率的不断升高，育龄妇女合并糖尿病成为一个越来越严峻的问题。在相对应的系统性回顾和荟萃分析（见本期第302页，doi：10．1136／bmj．c1395）中，Horvath等评估了妊娠糖尿病的筛查、诊断和治疗方法的有效性。这一回顾性结论是治疗组的部分特定“复合”终点事件（围产期死亡、新生儿肩难产、骨折、神经麻痹等）以及产伤（胎儿及母体）显著降低。
Abstract 14374: Chronic Treatment with Rapamycin Attenuates Diabetes-Associated Adverse Effects and Protects Against Myocardial Ischemia/Reperfusion Injury in Type II Diabetic Mice
Authors: Anindita Das, David Durrant, Fadi N Salloum, Saisudha Koka, Rakesh C Kukreja
Journal: Circulation (2011)

Background: Diabetes mellitus is a major risk factor for cardiovascular disease. The elevated mammalian target of rapamycin (mTOR) signaling contributes to the pathogenesis of diabetes. mTOR inhibi...
Patient Education and Chronic Obstructive Pulmonary Disease
Journal: Thorax (1995)

Letters to the editor look at first glance as though ICI 118 551 has no effect on exercise-induced hyperkalaemia compared with placebo.However, the base- line potassium concentration was significantly lower in the ICI 118 551 group than in the placebo group, and this may explain the ap- parent lack of effect on exercise response.Furthermore, in that study atenolol had no effect on the exercise-induced potassium re- sponse, suggesting that ,13 receptors are not involved.Indeed, in our own study sal- butamol had no effect on the exercise heart rate response, showing that PI3 blockade did not occur.It has also been shown that a low dose of nadolol (5 mg), which has a minimal P, blockade, exhibits marked P2 blockade as assessed by exercise-induced hyperkalaemia.3Thus, the fact that in our study both sal- butamol and propranolol significantly aug- mented the exercise-induced potassium response is in keeping with a P2 receptor mediator mechanism linked to the Na/K-ATPase pump.This hypothesis is further sup- ported by the enhancement of exercise-induced hyperkalaemia by digitalis which directly inhibits the Na/K-ATPase pump.4We therefore remain of the firm opinion that, in the presence of high adrenergic tone, salbutamol exhibits 12 antagonist activity as demonstrated by augmentation of exerciseinduced hyperkalaemia.This would be in keeping with the known pharmacological properties ofsalbutamol as a partial P2 agonist along with in vitro data showing salbutamol to antagonise the relaxant effect of isoprenaline in the presence of carbachol- induced bronchoconstriction.5 Whilst we agree that salbutamol is of great value in treating acute bronchospasm, it may be that a P2 agonist with greater intrinsic activity may be preferable in certain situations where airway tone is increased.
Commentary: when do we say “no”?
Authors: Thomas R Aust
Journal: BMJ (2004)

Tommy's doctors made the right decision to support her in trying for a natural pregnancy by optimising her diabetic treatment and advising her of the risks of becoming pregnant.1 This is because many patients will carry on and conceive with or without their doctors' blessing. After all, we would prefer it if drug misusers didn't inject heroin, but if they must we would rather they use clean needles.

Tommy's request for assisted conception was a different matter because all complications of assisted conception are, by definition, iatrogenic. Her doctors had to consider whether they would be prepared to help her produce a potentially damaged child or even kill herself in the process. As reproductive physicians we are never absolved from this moral responsibility, even when patients have given their consent and fully understand the risks.

One respondent felt that Tommy's (fetotoxic) angiotensin converting enzyme inhibitor should not have been stopped while she was trying for a natural conception but continued until she became pregnant.2 I feel that if her remaining fallopian tube had been checked for patency and found to be blocked, her angiotensin converting enzyme inhibitor could have been continued to optimise her blood pressure control until she started treatment for in vitro fertilisation.

One rapid respondent suggested that only two rather than three embryos should be transferred to reduce the chance of multiple pregnancy and thus the risks of prematurity, pre-eclampsia, and miscarriage (among others).2 One could even have considered replacing a single embryo (and freezing any remaining embryos) to reduce this risk even further. In Sweden, where mandatory single embryo transfer has been introduced, excellent pregnancy rates have been reported but with a much reduced twinning rate.3

The ovarian response at the time of egg collection often gives an indication of the risk of developing ovarian hyperstimulation syndrome. The decision to freeze or replace embryos (and risk worsening ovarian hyperstimulation syndrome if a pregnancy occurs) around this time is difficult as the success rates after replacement of frozen embryos tend to be poorer.4 Unfortunately, recent legislation changes in Italy have removed this option for safety5 and would drastically alter Tommy's management if she were treated today.

Many of the rapid responses point out that there is a paucity of evidence of the risks of ovarian stimulation and pregnancy for people like Tommy. Even if all the risks were quantifiable, they may be ignored by couples whose lives become dominated by their desperation for a child. In reproductive medicine we see couples who risk their relationships, jobs, homes, and health for an attempt at in vitro fertilisation. At what level of risk do we say no?
Increased IL6 plasma levels in indolent systemic mastocytosis patients are associated with high risk of disease progression
Authors: A Mayado, C Teodosio, A C Garcia-Montero, A Matito, A Rodriguez-Caballero, J M Morgado, C Muñiz, M Jara-Acevedo, I Álvarez-Twose, L Sanchez-Muñoz, S Matarraz, C Caldas, J I Muñoz-González, L Escribano, A Orfao
Journal: Leukemia (2015)
Abstract 10215: Characteristics of a Population at High Risk of Heart Failure, and Relationship of NT-proB Natriuretic Peptide with Underlying Risk Factors and Medication: Screen-HF Study
Authors: Michele McGrady, Christopher M Reid, Louise Shiel, Rory Wolfe, Umberto Boffa, Duncan J Campbell, Jennifer M Coller, David L Prior, Henry Krum
Journal: Circulation (2011)

PURPOSE: NT-proB natriuretic peptide (NT-proBNP) is a sensitive marker of ventricular dysfunction. Understanding the relationships between risk factors and NT-proBNP is the first step in developing...
Deficient Expression of Bruton's Tyrosine Kinase in Monocytes From X-Linked Agammaglobulinemia as Evaluated by a Flow Cytometric Analysis and Its Clinical Application to Carrier Detection
Authors: Takeshi Futatani, Toshio Miyawaki, Satoshi Tsukada, Shoji Hashimoto, Toshio Kunikata, Shigeyuki Arai, Masashi Kurimoto, Yo Niida, Hiroshi Matsuoka, Yukio Sakiyama, Tsutomu Iwata, Shigeru Tsuchiya, Osamu Tatsuzawa, Kazuyuki Yoshizaki, Tadamitsu Kishimoto
Journal: Blood (1998)
Management of cardiac arrest by ambulance technicians and paramedics
Authors: A. K Marsden, S. M Cobbe
Journal: BMJ (1995)

Paramedics have other uses beside attending cardiac arrests

EDITOR,--The paper by U M Guly and colleagues, of Edinburgh, shows the wisdom of the former managers of the Scottish Ambulance Service who in 1989, before the widespread introduction of paramedic training in Scotland, resolved to equip all frontline ambulances with defibrillators and train staff in their use.1 Since the start of the “Heartstart Scotland” programme about 1000 patients have recovered completely after a cardiac arrest outside hospital. …
Abstract 2521: Safety of Modern Chronic Total Occlusion Percutaneous Coronary Interventional Approach in Europe. A Real World Registry
Authors: Sanjay Sastry, Thierry Lefevre, Aleem Khand, Philippe Garot, Mohamed Chettibi, Marta Bande, Nabil Bendaoud, Oscar Tavolaro, Thierry Unterseeh, Alice Ohanessian, Thomas Hovasse, Yves Louvard
Journal: Circulation (2008)
Effects Of Ruxolitinib Therapy On Megakaryocyte Morphology and Inflammatory Bone Marrow Reaction In Patients With Myelofibrosis
Authors: Hans Michael Kvasnicka, Juergen Thiele, Carlos E. Bueso-Ramos, Shilpa Kamalanabhaiah, Jorge E. Cortes, Hagop M. Kantarjian, Srdan Verstovsek
Journal: Blood (2013)
The Histopatliology of Bacterial Infection in Irradiated Mice
Authors: Charles C. Congdon, Fletcher P. Williams, Robert T. Haberman, Egon Lorenz
Journal: JNCI Journal of the National Cancer Institute (1955)

Journal Article The Histopatliology of Bacterial Infection in Irradiated Mice Get access Charles C. Congdon, Charles C. Congdon National Cancer Institute and National Institute of Arthritis and Metabolic Diseases,4Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar Fletcher P. Williams, Jr., Fletcher P. Williams, Jr. National Cancer Institute and National Institute of Arthritis and Metabolic Diseases,4Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert T. Haberman, Robert T. Haberman National Cancer Institute and National Institute of Arthritis and Metabolic Diseases,4Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar Egon Lorenz Egon Lorenz National Cancer Institute and National Institute of Arthritis and Metabolic Diseases,4Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 15, Issue 4, February 1955, Pages 855–875, https://doi.org/10.1093/jnci/15.4.855 Published: 01 February 1955 Article history Received: 23 July 1954 Published: 01 February 1955
Intravenous Administration of Rituximab in the Treatment of Primary Cutaneous B-Cell Lymphomas (PCBCLs): A Retrospective Study
Authors: Giovangiacinto Paterno, Annagiulia Zizzari, Daniela Nasso, Lorenzo Tonialini, Cecilia Angeloni, Sara Vaccarini, Massimiliano Postorino, Livio Pupo, Luca Franceschini, Ida Provenzano, Manuela Rizzo, Laura Giannì, Lucia Anemona, Alessandro Mauriello, Giuseppe Alfonso Lombardo, Enrico Scala, Maria Cantonetti
Journal: Blood (2014)
Abstract 2922: <i>KCNQ1</i> Gain-of-function Mutation Associated With Familial Atrial Fibrillation
Authors: Dawood Darbar, Robert Abraham, Gayle Kucera, Tanya Stubblefield, Tao Yang, Dan M Roden
Journal: Circulation (2007)

Background : Family history is a risk factor for atrial fibrillation (AF). We report here a 3-generation Caucasian family with familial AF and a highly dysfunctional mutation in KCNQ1 . Methods and Results: In the proband, there was a 9-bp duplication resulting in insertion of the amino acids IAP (IAP54 –56) in the N-terminus of the protein. The kindred included 4 other family members with AF or palpitations. Each affected family member presented with early onset paroxysmal lone AF and no QT prolongation. This variant has previously been reported in presumed healthy African-American individuals (minor allele frequency 1.3%), but has not been studied in vitro . In transfected CHO cells, coexpression of IAP54 –56 with KCNE1 generated currents that were much larger and activated much earlier that wild-type I Ks ( Figure ); e.g. at +20 mV, peak current was 75±8 [IAP54 –56] vs 25±5 [wt] pA/pF after 5-sec pulses (n=7 each, P&lt;0.001). Computational simulations of human atrial action potential (AP) that incorporated Markov models of wt or IAP54 –56-I Ks were performed. At a cycle length of 400ms, accelerated activation of IAP54 –56-I Ks resulted in open state accumulation and increased maximum I Ks amplitude ~40-fold (351 vs 9 pA/pF), resulting in ~6-fold AP duration shortening (44 vs 259 ms). Conclusions: We have identified a KCNQ1 indel in a moderate sized Caucasian kindred with familial AF and normal QT intervals. This variant results in an I Ks gain-of-function and the resulting shortening of atrial action potentials may predispose to AF. This variant has been reported in 1.3% of African-Americans, suggesting it may be a common risk allele in some populations.
Abstract 13186: Lipoprotein-Associated Phospholipase A(2) is Expressed in Human Adipose Tissue and Correlates with HbA1C in Obese Subjects
Authors: Elise L Donovan, Tracy L Nelson, Stefan M Pettine, John E Hokanson, Karyn L Hamilton, Benjamin F Miller
Journal: Circulation (2011)

Background:  Elevated circulating lipoprotein-associated phospholipase A(2) (Lp-PLA2) is an independent risk factor for coronary artery disease (CAD), and Lp-PLA2 activity is elevated in plasma of type 2 diabetics. Few studies have considered the presence of Lp-PLA2 in non-vascular tissues despite its elevated presence in diabetics, and while it is known that Lp-PLA2 has multiple glycosylation sites the role of glycosylation in humans is unknown. The purpose of this study was to determine if LpPLA2 is expressed in adipose tissue. We hypothesized that Lp-PLA2 would be present in human adipose tissue and would be related to glucose homeostasis.   Methods:  Visceral adipose tissue from 15 morbidly obese (mean BMI= 50 kg/m2, mean age= 45 yrs) and 13 lean (mean BMI =25 kg/m2, mean age= 44 yrs) subjects was collected during bariatric surgery or a comparable non-bariatric surgery, respectively. Lp-PLA2 protein in visceral adipose lysates was examined by western blotting. Hemoglobin A1C (HbA1C) was measured in available pre-surgical samples from the same cohort (lean= 8, obese= 11).   Results:  HbA1C was significantly (p= 0.009) higher in obese subjects (6.409 ± 0.36) than lean (5.150 ± 0.10). In adipose lysates a 45 kD band representing unmodified Lp-PLA2, in addition to bands at approximately 56 kD were detected. Analyses were performed hypothesizing that the 56 kD band represents the glycosylated (GL) enzyme. When lean and obese data were combined, there was no correlation between the ratio of GL Lp-PLA2 to unmodified and HbA1C (r= 0.020, p= 0.934), but there was a correlation between the ratio of GL to unmodified Lp-PLA2 and age (r= 0.332, p =0.131). When data from obese subjects were analyzed separately from lean, the ratio of GL Lp-PLA2 to unmodified was correlated with HbA1C (r=0.360, p= 0.277) and age (r= 0.692, p= 0.006). Controlling for age did not change these correlations, but controlling for BMI strengthened the correlation with HbA1C (r= 0.504, p=0.138).   Conclusions:  These results show for the first time that Lp-PLA2 is expressed in human visceral adipose tissue. Moreover, in morbidly obese subjects there is a relationship between modified Lp-PLA2 and HbA1C. The roles of different sources of Lp-PLA2, and the function of GL Lp-PLA2 in humans are yet to be determined.
Abstract 103: The Fate of Patients Treated in Emergency for True-Ruptured Abdominal Aortic Aneurysms After 30 Says and 6 Months: Is There a Benefit from Endovascular Repair?
Authors: P De Rango, M Lenti, Enrico Cieri, Fabio Verzini, Gioele Simonte, P Bonanno, A Casalino, Piergiorgio Cao
Journal: Circulation (2011)
18F-FDG PET/CT in Hepatosplenic Gamma-Delta T-Cell Lymphoma
Authors: Elske Quak, Véronique Salaun, Cécile Le Naoures, Christophe Fruchart
Journal: Clinical Nuclear Medicine (2015)

Hepatosplenic T-cell lymphoma (HSTCL) is a rare and often difficult-to-diagnose subtype of lymphoma that can occur in the chronically immunosuppressed patient. We present the typical FDG PET/CT findings of HSTCL in a renal transplant recipient. The whole-body metabolic and morphologic information provided by FDG PET/CT can be of great additional value in establishing this diagnosis, thus allowing for a timely start of treatment.
Abstract 1600: Vascular Adiponectin-Resistance in Hyperlipidemic Rats and Its Involved Mechanisms
Authors: Rong Li, Yajing Wang, Wayne Bond Lau, Ling Tao, Yuexing Yuan, Xiaoliang Wang, Wei Yi, Xufeng Wei, Theodore Christopher, Bernard Lopez, Xin Ma
Journal: Circulation (2009)

Adiponectin (APN) is an adipocyte-derived vascular protective molecule. Recent clinical studies suggest that, like insulin resistance, patients with metabolic syndrome may also develop APN resistan...
Abstract 4187: Identification of Late Gadolinium Enhancement by Contrast-Enhanced Magnetic Resonance Imaging as a Major Risk Factor for Sudden Death in Hypertrophic Cardiomyopathy
Authors: Ronen Rubinshtein, James F Glockner, Steve R Ommen, Philip A Araoz, Michael J Ackerman, A J Tajik, Bernard J Gersh
Journal: Circulation (2008)

Background: Myocardial late gadolinium enhancement (LGE) on Contrast-Enhanced Magnetic Resonance Imaging (CE-MRI) of patients (pts) with hypertrophic cardiomyopathy (HCM) may indicate intra-myocardial fibrosis. We explored whether the presence and extent of LGE on CE-MRI among pts with HCM predicted ventricular arrhythmogenicity, and decreased survival. Methods: 424 HCM pts [age = 55 ± 16 years (range 2 – 90), 41% females], without prior history of septal ablation/myectomy, underwent CE-MRI (GE 1.5T) during a 6-year period. We compared the presence and amount of LGE with degree of ventricular ectopy on Holter ECG (available in 220 pts) recorded during the same time period of the CE-MRI. All cause death and appropriate, VF-terminating ICD therapies were then recorded during a mean follow-up of 34 ± 14 months (range 7 – 85). Results: 239 pts (56%) had LGE ranging from 0.4 – 65% of the myocardium. LGE -positive pts were more likely to have non-sustained ventricular tachycardia on Holter ECG [34/126 (27%) vs 8/94 (8.5%), p &lt; 0.001], and had more total ventricular extrasystoles/24 hours (700 ± 2080 vs 103 ± 460, p &lt; 0.001). During follow-up, 7 pts died and 4 received appropriate ICD discharges (9.7% of 41 pts with ICD). All 11 pts were LGE-positive. Event free survival was excellent (100%) in pts without LGE, and lower (95.4%) in pts with LGE (log rank, p &lt; 0.002). Multivariate analysis (adjusting for age, gender, morphologic and functional data, and comorbidities) identified LGE involving ≥ 5% of LV mass (p=0.03, present in 7/11 pts with events), septal thickness≥30mm (p=0.03), and atrial fibrillation (p=0.02) as independent predictors of death or appropriate ICD discharges. Conclusions : In pts with HCM, LGE by CE-MRI was strongly associated with surrogates of arrhythmia and was independently associated with subsequent death and/or ICD discharge. If replicated, LGE may be considered a major risk for sudden death in HCM.
Abstract 244: A Prospective Randomized Study of the Efficacy of Rectilinear and Truncated Exponential Biphasic Waveforms in the Elective Cardioversion of Atrial Fibrillation
Authors: Charles D Deakin, Stephanie Connelly, Brian Yuen
Journal: Circulation (2011)

INTRODUCTION: Several different biphasic waveforms are now available for clinical use. Few studies have compared differences in the efficacy of these waveforms. We compared biphasic rectilinear (BR) and biphasic truncated exponential (BTE) waveforms in their efficacy to cardiovert patients undergoing elective cardioversion for atrial fibrillation. METHODS: In a prospective randomised study, sequential adult patients undergoing elective cardioversion for atrial fibrillation were recruited. Patients were randomised to receive synchronised defibrillation using either a BR or BTE waveform, both using a 50J, 100J, 150J, 200J, 200J selected energy escalating protocol. Successful cardioversion was defined as a return to sinus rhythm immediately after a given shock. Failure to cardiovert after a second 200J shock was classed as failed defibrillation. The power of this study was 80% with 5% significance level to detect a difference of 20% or greater between groups. Survival analysis was used to assess the total energy delivered (and number of shocks) to achieve successful cardioversion between groups. RESULTS: A total of 202 patients were recruited over a four-year period, of which data was complete for 199 (100 BR waveform; 99 BTE waveform). There was no major difference in demographic data (Median age; BR 65.5 yrs, BTE 68.0 yrs: Median weight; BR 90.2 kg, BTE 88.9 kg; Median duration of AF; BR 7.0 months, BTE 6.0 months: Amiodarone; BT 23.8%, BTE 18.2%). Cardioversion rates and associated energy delivered are shown below. Median number of shocks to achieve cardioversion was 2 for the BR waveform and 3 for the BTE waveform (Log rank test, P=0.059). CONCLUSIONS: BR and BTE waveforms show similar efficacy in the elective cardioversion of atrial fibrillation.
Small Airways in Idiopathic Pulmonary Fibrosis
Authors: Jack D. Fulmer, William C. Roberts, Edwyna R. von Gal, Ronald G. Crystal
Journal: Journal of Clinical Investigation (1977)

18 patients with idiopathic pulmonary fibrosis were studied to determine if they had morphologic evidence of small airways disease and if physiologic testing could predict morphologic findings. In the presence of normal airway function by standard physiologic studies (forced expiratory volume in 1 s/forced vital capacity and airway resistance by plethysmography), dynamic compliance, maximum expiratory flow-volume curves, and maximum flowstatic recoil curves were measured to detect physiologic alterations consistent with small airways abnormalities. These physiologic data were then compared with estimates of small airways diameter made in lung biopsy specimens.
Ampullary Carcinoid Tumor Presenting as Acute Pancreatitis in a Patient with von Recklinghausen’s Disease: Case Report and Review of the Literature
Authors: W Mayoral, J Salcedo, F Al-Kawas
Journal: Endoscopy (2003)

A patient with von Recklinghausen syndrome presented with multiple attacks of pancreatitis. Evaluation using computed tomography, endoscopic retrograde cholangiopancreatography, and endosonography revealed an ampullary carcinoid.