tbuckley/cabot-search huggingface dataset:
Toxic shock syndrome after orchidectomy.
Authors: T Aganaba, R P Evans, P O'Neill
Journal: BMJ (1983)

Irrespective of the cause of the observed differences in serum creatinine concentrations between the study patients and controls, the serum creatinine concentration should clearly be interpreted with caution in patients with rheumatic diseases.Perhaps lower normal or reference values should be used in such patients and in other patients with atrophic muscles.1 Brochner-Mortensen J.A simple method for the determination of glomerular filtration rate.
Large Cardiac Registries: The Path to Higher Quality and Lower Cost in Our Healthcare System
Authors: Thomas J. Ryan
Journal: Circulation (2010)

Fuchs that the 3 major reasons to undertake systematic reform of the US healthcare system are (1) to provide coverage for the uninsured, (2) to correct significant lapses in quality, and (3) to control the high and rapidly increasing cost of care. 1 The "how to" for achieving each of these objectives is clear.It merely requires defining who is to be covered under universal coverage, insisting that we have "effective care," and deciding the best way to achieve payment reform.On the other hand, the devil is in the details, as became abundantly clear during this past year of congressional debate before the passing of the Patient Protection and Affordability Act.Of the 3 issues cited, coverage is the most clearly addressed in this legislation, although, as it now stands, some millions of uninsured will still remain.The other 2 issues, quality and cost of care, appear the most threatening.Michael Chernow of the Harvard Department of Health Care Policy, in discussing the increasingly larger annual deficits ($1.3 trillion dollars in 2010) and their resultant debt burden ($8.8 trillion at the end of 2010), representing 60% of the gross domestic product, underscores how unsustainable these figures are and cautions that the result will be a financial Armageddon. 2 Accordingly, it is imperative that we members of the cardiovascular community provide workable solutions to improve quality and reduce the cost of care because, if we fail, it will bankrupt us.
Continuous positive airway pressure and mechanical ventilation by facemask in newborn infants.
Authors: L P Allen, A M Blake, G M Durbin, D Ingram, E O Reynolds, P D Wimberley
Journal: BMJ (1975)

During a nine-month period 24 newborn infants were treated with continuous positive airway pressure (CPAP) or mechanical ventilation delivered through a facemask. The mask was held in place in a way that minimised trauma and distortion of the head. The median birth weight of the infants was 1096 g and their median gestational age 29 weeks. The usual reason for treatment was hyaline membrane disease or recurrent apnoea due to inadequate control of breathing. Twenty-one of the infants survived. The technique was simple to apply and complications were minimal. We suggest that it may have advantages over other methods of applying CPAP or mechanical ventilation to infants mildly affected by respiratory illnesses and that it should be useful in avoiding endotracheal intubation or reducing the length of time that infants with more serious illnesses are intubated.
GLP-1 based agents and acute pancreatitis
Authors: E. A. M. Gale
Journal: BMJ (2013)

Drug safety falls victim to the three monkey paradigm 

Investment companies knew that the Food and Drug Administration safety database carried a signal for acute pancreatitis with the antidiabetic drug exenatide (a glucagon-like peptide 1 (GLP-1) agonist) in 2006, a year before the agency alerted doctors1—a curious reflection on the way we mix business with medicine. The signal had reached astronomical dimensions (more than 10 times that in control drugs) by 2011 and has accelerated since.2 Furthermore, all GLP-1 based agents that have been on the market for more than two years have also generated a signal for acute pancreatitis, suggesting a class effect.

The regulators asked companies to provide more data, and companies have responded with studies showing that acute pancreatitis is more common in diabetes than previously thought and that clear evidence of an increased risk of pancreatitis with GLP-1 based treatments is lacking.3 Warnings on the label notwithstanding, the industry has been able to maintain that the problem does not exist—and has a huge incentive to do so.

This is no …
Investigation of the Relationship Between Volume and Mortality for Surgical Procedures Performed in New York State Hospitals
Authors: Edward L. Hannan
Journal: JAMA (1989)

Recent studies have demonstrated that the number of times a hospital or surgeon performs certain procedures annually has an inverse relationship with in-hospital mortality rates for patients undergoing the procedures. This study uses an improved measure of physician volume to test the combined relationship of hospital and physician volume with in-hospital mortality rates and to explore the existence of threshold volumes that optimally discriminate high- and low-volume providers. Five procedure groups have significant volume-mortality relationships. For total cholecystectomies, hospital volume is the more significant volume measure, but physician volume is marginally related to mortality rate. For coronary artery bypass surgeries, resection of abdominal aortic aneurysms, partial gastrectomies, and colectomies, physician volume is more significant than hospital volume, but hospital volume is marginally significant. Annual hospital volume thresholds for these data appear to exist at approximately 5 procedures for partial gastrectomies, 40 procedures for colectomies, and 170 procedures for total cholecystectomies. (<i>JAMA</i>. 1989;262:503-510)
Dynamics of right heart flow in patients after Fontan procedure.
Authors: M Nakazawa, T Nakanishi, H Okuda, G Satomi, S Nakae, Y Imai, A Takao
Journal: Circulation (1984)

In seven patients who underwent Fontan procedures but in whom no valves were inserted, dynamics of right heart flow were evaluated with the use of a catheter-tipped velocity transducer, pulsed Doppler echocardiography, and angiocardiography. Right atrial (RA) contraction caused a forward flow to the pulmonary artery (PA) and a backward flow to the inferior vena cava (IVC). Backward flow to the superior vena cava (SVC) was minimal. As the right atrium relaxed, a rapid forward flow occurred at the IVC and SVC that filled the atrium and a small amount of pulmonary regurgitant flow was observed. Subsequently, a forward flow was observed at the IVC, SVC, and PA during RA diastole. Angiographically determined RA stroke volume (SV) was less than 40% of the left ventricular (LV) SV in three patients in whom the postoperative increase in atrial "a" wave pressure (delta p) was greater than 8 mm Hg, while it was similar to or greater than LVSV in four patients in whom delta p was 6 mm Hg or less. In all patients LV end-diastolic volume was 107 +/- 27(SD)% of normal but LV ejection fraction was 0.53 +/- 0.07, resulting in the reduced cardiac output (2.8 +/- 0.7 l/min/m2). There was no correlation between the RASV or RA ejection fraction and cardiac output. These data show that the RA contraction causes a forward flow to the PA and that pulmonary regurgitation is not significant after Fontan procedure even when valves are not inserted. Also, the postoperative increase in the RA afterload may depress RA function.(ABSTRACT TRUNCATED AT 250 WORDS)
Pathogenesis, Natural History, Treatment, and Prevention of Hepatitis C
Authors: T. Jake Liang, Barbara Rehermann, Leonard B. Seeff, Jay H. Hoofnagle
Journal: Annals of Internal Medicine (2000)

Approximately 4 million persons in the United States and probably more than 100 million persons worldwide are infected with hepatitis C virus. The virus has the unique ability to cause persistent infection in susceptible hosts after parenteral or percutaneous transmission, and its underlying mechanisms are not well understood. The immunologic correlates of protection and viral clearance and the pathogenesis of liver injury are yet to be defined, but recent studies suggest the importance of cell-mediated immune responses. Although 70% to 80% of infected persons become chronic carriers, most have relatively mild disease with slow progression. However, chronic and progressive hepatitis C carries significant morbidity and mortality and is a major cause of cirrhosis, end-stage liver disease, and liver cancer. Development of an effective hepatitis C virus vaccine is not imminent, but recent advances in technology and basic knowledge of molecular virology and immunology have engendered novel approaches to the fundamental problems encountered in vaccine development. Current therapy for hepatitis C, although effective in some patients, is problematic and still evolving. Advances in modern biology and immunology promise new therapies for this important disease.
Specificity of T cells invading the skin during acute graft-vs.-host disease after semiallogeneic bone marrow transplantation.
Authors: J Gaschet, B Mahé, N Milpied, M C Devilder, B Dréno, J D Bignon, F Davodeau, M M Hallet, M Bonneville, H Vié
Journal: Journal of Clinical Investigation (1993)

The mechanisms responsible for skin lesions during acute graft-vs.-host disease (aGVHD) after allogeneic bone marrow transplantation (BMT) are poorly understood. The exact role of various effector cell populations and "major" (particularly HLA-DP) or "minor" antigens as target molecules is not known. To investigate the nature of cells responsible for tissue injury, we cultured T cells from skin biopsy first with interleukin 2 (IL-2) alone and then in polyclonal activation conditions to avoid in vitro antigenic sensitization before specificity testing. We applied this method to two biopsies performed during aGVHD after semiallogeneic BMT and obtained cytotoxic T cells against four graft mismatches: CD8+ T cells against HLA-A2.2 and HLA-B27 and CD4+ T cells against HLA-DP101 and HLA-DP401. This demonstrates that T cells with documented specificity can be obtained from an aGVHD lesion without antigenic selection. Moreover, these data directly implicate DP as a potential target antigen for aGVHD.
A Functional Synonymous Coding Variant in the<i>IL1RN</i>Gene Is Associated with Survival in Septic Shock
Authors: Nuala J. Meyer, Jane F. Ferguson, Rui Feng, Fan Wang, Parth N. Patel, Mingyao Li, Chenyi Xue, Liming Qu, Yichuan Liu, John H. Boyd, James A. Russell, Jason D. Christie, Keith R. Walley, Muredach P. Reilly
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Rationale: Death from infection is a highly heritable trait, yet there are few genetic variants with known mechanism influencing survival during septic shock.Objectives: We hypothesized that a synonymous coding variant in the IL-1 receptor antagonist gene (IL1RN), rs315952, previously associated with reduced risk for acute respiratory distress syndrome, would be functional and associate with improved survival in septic shock.Methods: We used a human endotoxin (LPS) model of evoked inflammatory stress to measure plasma IL-1 receptor antagonist (IL1RA) following low-dose Food and Drug Administration–grade LPS injection (1 ng/kg) in 294 human volunteers. RNA sequencing of adipose tissue pre- and post-LPS was used to test for allelic imbalance at rs315952. In the Vasopressin and Septic Shock Trial cohort, we performed a genetic association study for survival, mortality, and organ failure–free days.Measurements and Main Results: Adipose tissue displayed significant allelic imbalance favoring the rs315952C allele in subjects of European ancestry. Consistent with this, carriers of rs315952C had slightly higher plasma IL1RA at baseline (0.039) and higher evoked IL1RA post-LPS (0.011). In the Vasopressin and Septic Shock Trial cohort, rs315952C associated with improved survival (P = 0.028), decreased adjusted 90-day mortality (P = 0.044), and faster resolution of shock (P = 0.029).Conclusions: In European ancestry subjects, the IL1RN variant rs315952C is preferentially transcribed and associated with increased evoked plasma IL1RA and with improved survival from septic shock. It may be that genetically determined IL1RA levels influence survival from septic shock.
Patient-Physician Shared Decision Making
Authors: David R. Veroff, John D. Birkmeyer, David E. Wennberg
Journal: JAMA (2014)

We believe that the Viewpoint by Drs Katz and Hawley1 on shared decision making inaccurately states its premise and misrepresents the evidence about its effects. Katz and Hawley’s position is that the evidence for the effect of shared decision making on medical costs and use is inadequate. In their review of a randomized trial of shared decision making by 2 of us,2,3 they suggested that the large observed decreases in medical and surgical admissions and the associated reduction in costs in the intervention group were a result of clinician-directed decisions rather than patient involvement.
Silk Fibroin in Tissue Engineering
Authors: Naresh Kasoju, Utpal Bora
Journal: Advanced Healthcare Materials (2012)

Abstract Tissue engineering (TE) is a multidisciplinary field that aims at the in vitro engineering of tissues and organs by integrating science and technology of cells, materials and biochemical factors. Mimicking the natural extracellular matrix is one of the critical and challenging technological barriers, for which scaffold engineering has become a prime focus of research within the field of TE. Amongst the variety of materials tested, silk fibroin (SF) is increasingly being recognized as a promising material for scaffold fabrication. Ease of processing, excellent biocompatibility, remarkable mechanical properties and tailorable degradability of SF has been explored for fabrication of various articles such as films, porous matrices, hydrogels, nonwoven mats, etc., and has been investigated for use in various TE applications, including bone, tendon, ligament, cartilage, skin, liver, trachea, nerve, cornea, eardrum, dental, bladder, etc. The current review extensively covers the progress made in the SF‐based in vitro engineering and regeneration of various human tissues and identifies opportunities for further development of this field.
955-57 Intravenous Dextrose Albumin Sonicated with Evaporated Perfluoropentane Reduces Left Ventricular Cavity Attenuation and Improves the Echocardiographic Detection of Posterior Myocardial Perfusion Abnormalities
Authors: Thomas Porter, Feng Xie, Alan Kricsfeld
Journal: Journal of the American College of Cardiology (1995)
The Morton Lecture on Cancer and Cancerous Diseases: Delivered before the Royal College of Surgeons of England
Authors: S. G. Shattock
Journal: BMJ (1894)

JIF cancer was a microparasitic disease, it sliouldl be capable of experimental transm ission.'Mr.Bal lance and tlle lecturebr liad carried out a series of experimeiits in whlichltley liad inserte d portions of freslily removed careiiioiiia of tlle breast inito tlle abdominal cavity, tlle subeutaneous tissue, the muscles, and the anterior cliamber of the eye, of various animals.T}le esult was in all cases negative; the portions so inserted un- derwent coagulation, necrosis, and were eitlier absorbed or became encapsuled.At tlle present time there wras no autlientic case on record in w}liich lhuman carcinoma liad been transferred to any of the lower animals.Suceess, liowever, liad followed in certain cases wlien the traiisplantations liad been made from one animal to anotlher of tlle same species, And in this the re- sults followed the laws of graft'ing .ratlierthan those of ordinary infec-tion; they showed that a portion of a growi'ng carcinoma, if so transferred, would grow 'in a second indi- vridual as it wvould havre done in tlle first; but they did not really show that carcinoma was infective.A graft from one species of anilmal never forined an integral and permanent part of another of a diferent species; he referred to Hunter's
AIDS, Autopsies, and Abandonment
Authors: Richard M. Ratzan
Journal: JAMA (1988)

The obligation of the medical profession to ensure that autopsy is available for AIDS patients is analyzed from the historical perspective of the risk and sacrifice inherent in medicine and the ethical obligations and responsibilities of physicians. Inappropriately avoiding autopsies in AIDS patients causes potential harm to the decedent, the loss of all benefits derived from autopsies, and harm to the professional status of physicians. The practice of medicine now requires doctors to take personal risks for their patients, as it did up until the advent of penicillin, and presents challenges of conscience and dedication for all who strive to heal.
Decreased protein C inhibitor after percutaneous transluminal coronary angioplasty in patients with acute myocardial infarction
Authors: Motoaki Tanigawa, Hideo Wada, Kouzou Minamikawa, Yoshihiro Wakita, Shozaburo Nagaya, Tateyuki Mori, Shigehisa Tamaki, Hideo Nishikawa, Yutaka Kakuta, Takeshi Nakano, Tatsuya Hayashi, Koji Suzuki, Hiroshi Shiku
Journal: American Journal of Hematology (1995)

Plasma thrombin-antithrombin III complex (TAT), FDP-D-dimer, activated protein C (APC)-protein C inhibitor (PCI) complex, and tissue type plasminogen activator (t-PA), PA inhibitor-1 (PAI-I) were significantly increased in patients with acute myocardial infarction (AMI) at onset. These patients exhibited a hypercoagulable state and protein C activation at onset. The plasma PCI level at onset of AMI was within the normal range, but was significantly decreased after percutaneous transluminal coronary angioplasty (PTCA). After PTCA, plasma t-PA, FDP-D-dimer, and plasmin-alpha 2-plasmin inhibitor were increased but APC-PCI complex and TAT were not. The decrease in PCI after PTCA may have been caused by the activation of fibrinolysis. PCI may play an important role in the inhibition of fibrinolysis in stimulated or damaged endothelial cells. These findings suggest that the protein C pathway plays an important role in the onset of AMI and after PTCA.
Propensity of ectopic liver to hepatocarcinogenesis: Case reports and a review of the literature
Authors: Masahiro Arakawa, Yoshio Kimura, Kenji Sakata, Yasuhiko Kubo, Takashi Fukushima, Kunio Okuda
Journal: Hepatology (1999)

Two patients with ectopic liver are described. In one patient, a small ectopic liver attached to the gastric serosa developed hepatocellular carcinoma (HCC). The preoperative diagnosis was an α-fetoprotein (AFP)-producing carcinoma and a malignant ulcer of the stomach. Total gastrectomy and esophago-jejunostomy were performed. The tumor that measured 4 × 2 × 2 cm contained an AFP-producing HCC and normal liver tissue. In another patient who had alcoholic cirrhosis, ectopic liver on the serosa of the gallbladder was found to have the same histological changes as the mother liver. A survey of the literature disclosed more than 20 cases in which HCC developed outside the liver; the liver did not have HCC. By contrast, there was only one report on HCC occurring in the liver in the presence of a noncancerous, relatively large accessory liver lobe. Because ectopic liver does not have a complete vascular and ductal system as a normal liver, it is perhaps functionally handicapped and more prone to hepatocarcinogenesis.
Explorations in Psychohistory: The Wellfleet Papers
Authors: Marjorie C. Meehan
Journal: JAMA (1975)

In the past few years the term<i>psychohistory</i>has been applied to a number of works that try to combine the disciplines of psychology and history. Of course, biographers and historians have always been interested in psychological factors, but perhaps it is only since Freud that psychiatrists have tried to interpret history. Freud's own contributions, especially<i>Totem and Taboo</i>and<i>Moses and Monotheism</i>, are essentially works of imagination and psychoanalytic theory, but they stimulated other writers to serious exploration of the relation of history and psychopathology. Beginning in 1966, several of the prominent workers in this field have met each summer in Wellfleet to exchange ideas. This book includes 13 essays that were presented there. They cover a wide range of subject matter and it is not always clear why the essays are described as psychohistory. In two papers, Robert Lifton attempts to define and explain the meaning of psychohistory
Abstract 5251: Endosialin: A novel cell surface therapeutic target for early-stage and late-stage neuroblastoma
Authors: Cecile Rouleau, Robert Smale, Leslie Kurtzberg, William Weber, Craig Jones, Stephanie Roth, Christy Bormann, Sarah Dunham, Roy Krumbholz, Maritza Curiel, Gina Wallar, Yao-Shi Fu, Bruce Horten, Diego Gianolio, Steven Schmid, Glenn Miller, Beverly A. Teicher
Journal: Cancer Research (2010)

Abstract Hypothesis: Endosialin emerged recently as a potential marker and therapeutic target for adult and pediatric sarcoma. Given evidence of a possible common progenitor cell for mesenchymal and neural cell lineages, we wondered whether expression of endosialin may be shared by sarcomas and neuroblastomas, which are cancers of mesenchymal origin and neural crest origin, respectively. Methods: Endosialin protein expression was studied in live human neuroblastoma cell lines by flow cytometry using a fully human monoclonal antibody against human endosialin. Endosialin-positive human neuroblastoma cells were subsequently implanted at different anatomic sites in nu/nu mice and allowed to grow. Tumors were collected, formalin fixed and subjected to immunohistochemistry using a fully human monoclonal antibody against human endosialin. Using the same IHC assay, endosialin protein expression was also studied in formalin-fixed paraffin-embedded human clinical specimens of neuroblastoma. Results: We tested 10 human neuroblastoma cell lines for endosialin protein expression by flow cytometry and found that 9/10 expressed endosialin. Several of the positive cell lines were derived from bone marrow metastases, suggesting that endosialin expression is maintained in advanced disease. We modeled endosialin-positive neuroblastoma in vivo by implanting SK-N-AS cells in mice subcutaneously and in the subrenal capsule, kidney being a site where neuroblastoma sometimes originates. Immunohistochemical analysis revealed that SK-N-AS cells, which are positive for endosialin in vitro and derived from the bone marrow metastasis of an adrenal primary tumor, formed endosialin-positive subcutaneous tumors and endosialin-positive renal tumors, demonstrating that endosialin expression is supported by different microenvironments in various anatomic locations. Immunohistochemistry of human clinical specimens of neuroblastoma showed expression of endosialin. All specimens of neuroblastoma were bone marrow metastases, demonstrating that endosialin is expressed in advanced disseminated neuroblastoma. Conclusions: Our work demonstrates that endosialin expression is shared by sarcomas and neuroblastomas. The expression of endosialin in neuroblastoma potentially opens up a new therapeutic horizon for neuroblastoma patients, including those suffering from advanced disease. 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 5251.