482 research outputs found

    Pergolide As Primary Therapy for Macroprolactinomas

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    The objective of this study is to determine whether pergolide therapy is an effective modality for the de novo treatment of patients with macroprolactinomas. Twenty-two consecutive patients with macroprolactinomas were included in the study and followed prospectively. These included 16 men and 6 women in whom pregnancy was not of concern. Pergolide was administered once or twice a day depending on the patient's preference. Ten patients received 0.1 mg daily as a maintenance regimen and in the others the daily dose ranged from 0.05 to 0.5 mg. Eight patients reported minor but tolerable side effects. One patient had to be switched to cabergoline because of intolerable nausea. After a mean of 12 months (range, 3–36), mean PRL levels declined from 3,135 ng/ml (range, 126–31,513) to 50 ng/ml (3–573), representing a mean PRL suppression of 88% (range, 0–99). PRL levels became normal in 15 patients and decreased to 25–40 ng/ml in 3 others. The mean tumor volume shrinkage was 25% or greater in 19 patients (86%), 50% or greater in 17 patients (77%), and 75% or greater in 10 patients (45%). Visual abnormalities were reversible after pergolide therapy in all but 1 of 12 patients with initially abnormal formal visual testing. Two out of 4 premenopausal women did not normalize PRL levels and had persistent oligomenorrhea. Testosterone was low in 14 men at presentation and normalized in 3 with pergolide therapy. We conclude that pergolide is a safe, inexpensive, and generally well-tolerated dopamine agonist for the treatment of macroprolactinomas in men and women in whom pregnancy is not of concern. In these specific populations, pergolide may become the first-line therapy for treatment of macroprolactinomas.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47496/1/11102_2004_Article_382165.pd

    Rapid Re-expansion of a Macroprolactinoma After Early Discontinuation of Bromocriptine

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    Prolactin (PRL)-secreting pituitary adenomas are the most common functioning pituitary tumors. Medical treatment with dopamine agonists is the therapy of choice for macroprolactinomas (≥10 mm). Withdrawal of bromocriptine after weeks or months of uninterrupted therapy has been associated with rapid tumor re-expansion as evidenced by x-ray and CT scanning of the pituitary region. We report a patient with a giant macroprolactinoma who had a dramatic response to bromocriptine (tumor volume shrinkage of 53% within a month) but rapid re-expansion to its original dimensions one week after discontinuation of bromocriptine. To our knowledge, this is the first time that the rapid shrinkage/re-expansion of a macroprolactinoma has been documented with serial MRI scans.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47493/1/11102_2004_Article_324060.pd

    Indenture, John Egbert and co. with Susan U. Niemcewicz, August 27, 1804

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    The following document is an indenture between John Egbert and his wife Hannah, Sarah J. Crane, Evos Egbert and his wife, William Egbert and his wife, Daniel Egbert and his wife, Samuel Egbert, and Susan U. Niemcewicz. The document is a contract that acknowledged the parties of the first part, for an inconsideration of the sum of two hundred twenty-five dollars was well and truly paid by the party of the second part (Susan U. Niemcewicz). The parties of the first part granted, bargained, sold, aliened, enfeoffed, conveyed and confirmed and gave, granted, bargained, sold, aliened, enfeoffed, conveyed and confirmed to the part of the second part (Susan U. Niemcewicz) and her heirs and assigns forever all of the lots, tracts, or parcels of land and premises that were described, situated, lying, and being in the township of Union in the county of Essex and state of New Jersey. The land was described as follows: “Butted and Bounded as follows – Beginning the first lot at the Highway that leads from the Morris Turnpike to the old Cooper Woodruff Farm adjoining lands late of James Townley Decd. Recuring from said highway North West thirty six rods; thence South West sixty rods to highway; thence South Eastly thirty six rods; Thence North East fifty six rods to the place of beginning containing thirteen acres more or less & is bounded Northerly and Westerly by lands of John Stiles and Oliver Stiles, Easterly by the second lot herein described and Southerly by the said highway – which lot John Littell purchased of Eliakim Littell by deed dated September 9th 1798 – Also a certain other lot adjoining the above lot which the said John Littell in his lifetime purchased of Stephen Potter consisting of three acres bounded Northerly by Silas Nandslive[?] East by land of James Townley’s Estate Southerly by said highway and Westerly by the first described lot which two lots lie together and form the harvested farm of the said John Egbert and wife containing together sixteen acres more or less and was devised by the said John Littell to his daughter Hannah Egbert and the above children.” People mentioned: Moses Chandler, Samuel Egbert, William Egbert, Mary Egbert, Evos Egbert, Susanna Egbert, Damel Egbert, John Egbert, Hannah Egbert, John Townley, Anthony Rutgers, Asa Whitehead, Abner Parsnell, and Susan Niemcewicz.https://digitalcommons.kean.edu/lhc_1820s/1147/thumbnail.jp

    Towards an Improved High Resolution Global Long-Term Solar Resource Database

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    This paper presents an overview of an ongoing project to develop and deliver a solar mapping processing system to the National Renewable Energy Laboratory (NREL) using the data sets that are planned for production at the National Climatic Data Center (NCDC). NCDC will be producing a long-term radiance and cloud property data set covering the globe every three hours at an approximate resolution of 10 x 10 km. NASA, the originators of the Surface meteorology and Solar Energy web portal are collaborating with SUNY-Albany to develop the production system and solar algorithms. The initial result will be a global long-term solar resource data set spanning over 25 years. The ultimate goal of the project is to also deliver this data set and production system to NREL for continual production. The project will also assess the impact of providing these new data to several NREL solar decision support tools

    Ernst Freund as Precursor of the Rational Study of Corporate Law

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    Gindis, David, Ernst Freund as Precursor of the Rational Study of Corporate Law (October 27, 2017). Journal of Institutional Economics, Forthcoming. Available at SSRN: https://ssrn.com/abstract=2905547, doi: https://dx.doi.org/10.2139/ssrn.2905547The rise of large business corporations in the late 19th century compelled many American observers to admit that the nature of the corporation had yet to be understood. Published in this context, Ernst Freund's little-known The Legal Nature of Corporations (1897) was an original attempt to come to terms with a new legal and economic reality. But it can also be described, to paraphrase Oliver Wendell Holmes, as the earliest example of the rational study of corporate law. The paper shows that Freund had the intuitions of an institutional economist, and engaged in what today would be called comparative institutional analysis. Remarkably, his argument that the corporate form secures property against insider defection and against outsiders anticipated recent work on entity shielding and capital lock-in, and can be read as an early contribution to what today would be called the theory of the firm.Peer reviewe

    Etiology of Severe Non-malaria Febrile Illness in Northern Tanzania: A Prospective Cohort Study.

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    The syndrome of fever is a commonly presenting complaint among persons seeking healthcare in low-resource areas, yet the public health community has not approached fever in a comprehensive manner. In many areas, malaria is over-diagnosed, and patients without malaria have poor outcomes. We prospectively studied a cohort of 870 pediatric and adult febrile admissions to two hospitals in northern Tanzania over the period of one year using conventional standard diagnostic tests to establish fever etiology. Malaria was the clinical diagnosis for 528 (60.7%), but was the actual cause of fever in only 14 (1.6%). By contrast, bacterial, mycobacterial, and fungal bloodstream infections accounted for 85 (9.8%), 14 (1.6%), and 25 (2.9%) febrile admissions, respectively. Acute bacterial zoonoses were identified among 118 (26.2%) of febrile admissions; 16 (13.6%) had brucellosis, 40 (33.9%) leptospirosis, 24 (20.3%) had Q fever, 36 (30.5%) had spotted fever group rickettsioses, and 2 (1.8%) had typhus group rickettsioses. In addition, 55 (7.9%) participants had a confirmed acute arbovirus infection, all due to chikungunya. No patient had a bacterial zoonosis or an arbovirus infection included in the admission differential diagnosis. Malaria was uncommon and over-diagnosed, whereas invasive infections were underappreciated. Bacterial zoonoses and arbovirus infections were highly prevalent yet overlooked. An integrated approach to the syndrome of fever in resource-limited areas is needed to improve patient outcomes and to rationally target disease control efforts

    Wave-particle energy exchange directly observed in a kinetic Alfvén-branch wave

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    Alfvén waves are fundamental plasma wave modes that permeate the universe. At small kinetic scales, they provide a critical mechanism for the transfer of energy between electromagnetic fields and charged particles. These waves are important not only in planetary magnetospheres, heliospheres and astrophysical systems but also in laboratory plasma experiments and fusion reactors. Through measurement of charged particles and electromagnetic fields with NASA’s Magnetospheric Multiscale (MMS) mission, we utilize Earth’s magnetosphere as a plasma physics laboratory. Here we confirm the conservative energy exchange between the electromagnetic field fluctuations and the charged particles that comprise an undamped kinetic Alfvén wave. Electrons confined between adjacent wave peaks may have contributed to saturation of damping effects via nonlinear particle trapping. The investigation of these detailed wave dynamics has been unexplored territory in experimental plasma physics and is only recently enabled by high-resolution MMS observations
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