tbuckley/cabot-search huggingface dataset:
Tracheobronchial Foreign Bodies in Adults
Authors: Andrew H. Limper
Journal: Annals of Internal Medicine (1990)

Study Objective: To define the clinical spectrum of tracheobronchial foreign body aspiration in adults, assess predisposing conditions, evaluate the efficacy of bronchoscopy, and determine outcome and complications. Design: Retrospective analysis of a consecutive clinical series. Setting: A tertiary care, referral-based medical center. Patients: Sixty consecutive adult patients (over 16 years of age) evaluated for tracheobronchial foreign body aspiration. Interventions: All 60 patients had bronchoscopic evaluation; 59 of them had foreign bodies identified and removal was attempted using either rigid or flexible fiberoptic bronchoscopy. Main Results: Of 60 consecutive patients, 25 had underlying impairment of protective airway mechanisms (primary neurologic disorders, trauma with loss of consciousness, or sedative or alcohol use). Fifty-seven were successfully managed with bronchoscopy. Fiberoptic bronchoscopy was successful in 14 of 23 patients, and rigid bronchoscopy was successful in 43 of 44 patients, including 6 of 7 patients in whom previous fiberoptic bronchoscopy had failed. Thoracotomy was required in 3 patients. Complications of bronchoscopy were rare and not serious. Chronic complications of prolonged foreign body impaction included bronchiectasis in 3 patients. Conclusions: Although rare, tracheobronchial foreign body aspiration in adults can occur in various clinical settings. High clinical suspicion is necessary for diagnosis. Removal of foreign bodies can usually be accomplished with bronchoscopy.
Selection of Kidney Recipients-Reply
Authors: Thomas E. Starzl
Journal: JAMA (1987)

In Reply.—  Drs Matas and Tellis merely have extended our argument that waiting time and other factors should be given more weight than antigen matching for kidney allocation. However, we do not believe that matching should be ignored altogether and for that matter neither do Matas and Tellis, as witnessed by their acceptance of six-antigen (full-house) matching.  Their seemingly inequitable scenario is based on nonsense data. When a highly sensitized patient finally achieves a negative cross match, it is almost always found that good antigen matching also has been achieved, particularly at the A and B loci. If not, either the cross match test or the antigen typing is apt to be an error.  Thus, it is not credible that their longest-waiting patient, with a 99% PRA, should have had only one antigen match, whereas it is understandable that their highly sensitized patients who had waited for nine and eight
Bone Scintigraphy in Acute Intraosseous Disc Herniation
Authors: Bronwyn A. Crawford, Hans Van der Wall
Journal: Clinical Nuclear Medicine (2007)

A 57-year-old woman initially presented with the acute onset of low back pain after gardening. Plain film at that time was reported as showing Scheurmann's disease of the lumbar spine. The pain resolved slowly, but recurred acutely after minimal trauma 5 months later. Bone scintigraphy revealed increased uptake in L4 and L5 around the disc space, thought to be suspicious for discitis. Other blood tests revealed a high alkaline phosphatase level with an elevated bone component. The erythrocyte sedimentation rate and leukocyte count were not elevated. Magnetic resonance imaging (MRI) showed an acute disc herniation of the L4/L5 disc into the lower body of L4 with considerable bone marrow edema. Follow-up imaging showed substantial resolution of marrow edema 18 months later. Acute disc herniation has rarely been reported in the scintigraphic literature and should be kept in mind in such circumstances, particularly in older patients.
A Short History of Tractors in Ukrainian
Authors: L. Kearney
Journal: BMJ (2010)

Elder abuse is a complex area of clinical practice and differs hugely from child abuse, as the older person consents to, and partners in, the assessment process. Even as older adults we have the right to behave in ways that may seem injudicious or foolish; and deciding at what point such situations might constitute elder abuse is one of the most complex areas of geriatric medicine. Artists can often handle complexity in a more approachable way than less articulate clinicians, and Marina Lewycka’s debut novel provides thought provoking insights into elder abuse. Written with acerbic wit and humour, this short novel is a hugely entertaining comedy of colourful characters. It also succeeds as an unexpectedly moving account of vulnerability in later life.

It has valuable …
ATF4 is directly recruited by TLR4 signaling and positively regulates TLR4-trigged cytokine production in human monocytes
Authors: Chunyan Zhang, Nan Bai, Antao Chang, Zhuhong Zhang, Jing Yin, Wenzhi Shen, Yaping Tian, Rong Xiang, Chenghu Liu
Journal: Cellular and Molecular Immunology (2012)
Reinforcement gradient, response inhibition, genetic versus experiential effects, and multiple pathways to ADHD
Authors: Joel Nigg
Journal: Behavioral and Brain Sciences (2005)

major contributions emanating from sagvolden et al.'s theory include elucidation of the role in attention-deficit/hyperactivity disorder (adhd) of temporal information processing, social learning, and response extinction learning. key issues include a need for clearer explanation of the relative role of impulsivity versus response suppression/inhibition in the dual process model, and delineation of genotype-environment correlations versus interactions in the social and experiential mechanisms posited.
Inhibitory actions of cyclic adenosine monophosphate and pertussis toxin define two distinct epidermal growth factor-regulated pathways leading to activation of mitogen-activated protein kinase in rat hepatocytes
Authors: P Gines, X Li, S E Brown, T Nakamura, P S Guzelian, L E Heasley, R W Schrier, R A Nemenoff
Journal: Hepatology (1996)

Increased intracellular cyclic adenosine monophosphate (cAMP) levels have been shown in some reports to inhibit and in other studies to stimulate growth factor-mediated activation of the mitogen-activated protein kinase (MAP kinase) pathway, depending on the cell type examined. The relationship between cAMP and MAP kinase in hepatocytes has not been examined. In the current study, stimulation of primary cultures of rat hepatocytes with hepatocyte growth factor (HGF) or epidermal growth factor (EGF) increased Ras, Raf, and MAP kinase activity. Incubation of hepatocytes with cAMP-increasing agents blocked activation of Raf by both HGF and EGF, whereas activation of Ras was unaffected. MAP kinase activation by HGF was completely inhibited, whereas EGF-stimulated MAP kinase activity was only slightly reduced. Incubation of hepatocytes with pertussis toxin slightly blunted MAP kinase activation by EGF but not HGF. Increasing cAMP in hepatocytes preincubated with pertussis toxin completely inhibited the activation of MAP kinase by EGF. In conclusion, HGF activates MAP kinase in hepatocytes exclusively through an Raf-dependent pathway and this activation may be completely blocked by increasing cAMP. In contrast, EGF activates MAP kinase in hepatocytes through both Raf-dependent and Raf-independent pathways: the latter pathway probably involves a pertussis toxin-sensitive G protein.
Assessment of Hepatic Artery Invasion by Bile Duct Cancer Using Intraductal Ultrasonography
Authors: K. Tamada, K. Ido, N. Ueno, M. Ichiyama, T. Tomiyama, T. Nishizono, S. Wada, T. Noda, S. Tano, T. Aizawa, T. Ueno, K. Kimura
Journal: Endoscopy (1995)

Background and Study Aims: This study was performed to clarify the diagnostic accuracy of intraductal ultrasonography (IDUS) in assessing hepatic artery invasion by bile duct cancer.
Factors associated with asthma exacerbations during a long-term clinical trial of controller medications in children
Authors: Ronina A. Covar, Stanley J. Szefler, Robert S. Zeiger, Christine A. Sorkness, Mark Moss, David T. Mauger, Susan J. Boehmer, Robert C. Strunk, Fernando D. Martinez, Lynn M. Taussig
Journal: Journal of Allergy and Clinical Immunology (2008)
Trends in Incidence, Lifetime Risk, Severity, and 30-Day Mortality of Stroke Over the Past 50 Years
Authors: Raphael Carandang, Sudha Seshadri, Alexa Beiser, Margaret Kelly-Hayes, Carlos S. Kase, William B. Kannel, Philip A. Wolf
Journal: JAMA (2006)

Prior estimates of long-term trends in the incidence and severity of stroke have varied; trends in lifetime risk have not been reported.To determine long-term trends in the incidence, lifetime risk, severity, and 30-day mortality of clinical stroke.Prospective evaluation of the community-based Framingham Study original and offspring cohorts. Participants were 9152 men and women free of prevalent stroke and undergoing follow-up for up to 50 years over 3 consecutive periods (1950-1977, 1978-1989, and 1990-2004), with biennial ascertainment of stroke risk factor data and active surveillance for incident clinical stroke and cause-specific mortality.Incidence (age-adjusted, sex-specific), severity, 30-day mortality, and mortality-adjusted 10-year and lifetime risk of stroke in each of the specified periods.There were 1030 incident clinical strokes (450 [44%] in men, 629 atherothrombotic brain infarctions [61%]) in 9152 persons 55 years or older over 174,917 person-years of follow-up. The age-adjusted incidence of first stroke per 1000 person-years in each of the 3 periods was 7.6, 6.2, and 5.3, respectively, in men (P = .02 for trend) and 6.2, 5.8, and 5.1 in women (P = .01 for trend). The lifetime risk at age 65 years decreased from 19.5% to 14.5% in men (P = .11) and from 18.0% to 16.1% in women (P = .61). Age-adjusted stroke severity did not vary across periods; however, 30-day mortality decreased significantly in men (from 23% to 14%; P = .01) but not significantly in women (from 21% to 20%; P = .32).In this cohort of men and women free of prevalent clinical stroke at initial examination, incidence of stroke has decreased over the past 50 years but the lifetime risk has not declined to the same degree, perhaps due to improved life expectancy. The results of this study suggest that improved control of risk factors has lowered stroke incidence but emphasize the need for continued primary prevention efforts.
DEGREES OF CORRELATION BETWEEN VARIOUS PLATELET FUNCTION ASSAYS
Authors: Michael Angelo Gaglia, Rebecca Torguson, Zhenyi Xue, Manuel A. Gonzalez, Itsik Ben-Dor, Gabriel Maluenda, Michael Mahmoudi, Kohei Wakabayashi, Gabriel Sardi, Ana Carnicero, Rafael Romaguera, William O. Suddath, Kenneth M. Kent, Lowell F. Satler, Augusto D. Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2011)
Concomitant Use of Immunomodulators Affects the Durability of Infliximab Therapy in Children With Crohn’s Disease
Authors: Victoria Grossi, Trudy Lerer, Anne Griffiths, Neal LeLeiko, Jose Cabrera, Anthony Otley, James Rick, David Mack, Athos Bousvaros, Joel Rosh, Andrew Grossman, Shehzaad Saeed, Marsha Kay, Brendan Boyle, Maria Oliva-Hemker, David Keljo, Marian Pfefferkorn, William Faubion, Michael D Kappelman, Boris Sudel, James Markowitz, Jeffrey S Hyams
Journal: Clinical Gastroenterology and Hepatology (2015)
Recurrent wheezing in relation to environmental risk factors in infancy
Authors: S. Halken, A. Høst, S. Husby, L. G. Hansen, O. ØTerballe, J. Nyboe
Journal: Allergy (1991)

Clinical course and environmental factors were recorded in a prospective study of 276 unselected infants followed from birth to the age of 18 months. The study was performed with a questionnaire at the age of 6 and 12 months and a physical examination at 18 months. Fifty-nine (21%) of the children had greater than or equal to 2 episodes of wheezing before they were 18 months old. A total of 58 (21%) of the children belonged to the lowest social class V, 182 (66%) were daily exposed to passive tobacco smoking at home and/or in daycare, 164 (59%) were breastfed greater than or equal to 3 months, 192 (70%) were in daycare, 62 (22%) lived in flats and 167 (61%) were in daily contact with furred pets at home and/or in daycare. In social class V a preponderance of children were exposed to passive tobacco smoking, a majority were living in flats and a minority were breastfed greater than or equal to 3 months. Linear logistic regression analysis was used for the purpose of assessing the causal effect of environmental risk factors on the risk of recurrent episodes of wheezing before the age of 18 months. The study demonstrated that male sex and daily exposure to passive tobacco smoking were significant risk factors with estimated odds ratios 1.9 and 2.4, respectively. Maternal tobacco smoking seemed to be associated with the highest risk. There was a tendency--though not significant--indicating that breastfeeding greater than or equal to 3 months had a protective effect.(ABSTRACT TRUNCATED AT 250 WORDS)
The effects of infusion of insulinlike growth factor (IGF) I, IGF-II, and insulin on glucose and protein metabolism in fasted lambs.
Authors: R G Douglas, P D Gluckman, K Ball, B Breier, J H Shaw
Journal: Journal of Clinical Investigation (1991)

In vivo effects of 300-min infusions of recombinant insulinlike growth factor I (IGF-I) and IGF-II on glucose and protein metabolism have been investigated in awake, fasted lambs. Two doses of recombinant human (rh) IGF-I were infused: 6.7 nmol/kg.h, which induced hypoglycemia, and 2.0 nmol/kg.h, which did not. The effects were compared with an insulin infusion (0.17 nmol/kg.h) that had the same hypoglycemic potential as the high dose rhIGF-I infusion. rhIGF-II was infused at a rate of 6.7 nmol/kg.h. Primed constant infusions of isotopically labeled glucose, urea and leucine tracers were used to determine glucose and protein kinetics. rhIGF-I lowered blood glucose by increasing the rate of glucose clearance (P less than 0.01), in contrast to insulin, which both increased clearance and reduced glucose production. Net protein loss was reduced after infusion of low and high dose rhIGF-I and insulin by 11% (P less than 0.05), 15% (P less than 0.01), and 12% (P less than 0.05), respectively. rhIGF-II infusion did not alter the rate of net protein loss. In contrast to insulin, high dose rhIGF-I infusion increased the rate of protein synthesis in skeletal (P less than 0.05) and cardiac muscle (P less than 0.01) and in hepatic tissue (P less than 0.05). We conclude that (a) protein metabolism is more sensitive than glucose metabolism to rhIGF-I infusion, as protein loss was reduced by an rhIGF-I infusion that did not alter glucose kinetics; (b) protein synthesis is increased by rhIGF-I infusion but not by insulin infusion; and (c) rhIGF-II is a less effective anabolic agent than rhIGF-I. We speculate that the effects of rhIGF-I on protein metabolism are not mediated by insulin receptors.
Total Parenteral Nutrition and the Team
Authors: Donald J. Ferguson
Journal: JAMA (1980)

Although total parenteral nutrition (TPN) became indispensable in the management of certain conditions approximately ten years ago and is now increasingly used even when dispensable, some patients are still plagued by technically inept application of the method, as is discussed elsewhere inThe Journal(p 1906). The remedy, says Dr Nehme, is the team approach. His data seem unequivocally in favor of the informed group, compared with the single practitioner who, at least in this study, was sometimes uninformed or inattentive. Others have also described superior performance after forming a group,<sup>1,2</sup>which can accumulate experience more rapidly than an individual, provide a wider background of knowledge, offer formal training, and create the opportunity to conduct controlled trials. At the least, records are kept, and errors are less likely to be ignored when the hospital has a team. This is not to say that a well-trained physician or surgeon, attentive
Depression, Stigma, and Suicidal Ideation in Medical Students
Authors: Thomas L. Schwenk, Lindsay Davis, Leslie A. Wimsatt
Journal: JAMA (2010)

There is a concerning prevalence of depression and suicidal ideation among medical students, a group that may experience poor mental health care due to stigmatization.To characterize the perceptions of depressed and nondepressed medical students regarding stigma associated with depression.Cross-sectional Web-based survey conducted in September-November 2009 among all students enrolled at the University of Michigan Medical School (N = 769).Prevalence of self-reported moderate to severe depression and suicidal ideation and the association of stigma perceptions with clinical and demographic variables.Survey response rate was 65.7% (505 of 769). Prevalence of moderate to severe depression was 14.3% (95% confidence interval [CI], 11.3%-17.3%). Women were more likely than men to have moderate to severe depression (18.0% vs 9.0%; 95% CI for difference, -14.8% to -3.1%; P = .001). Third- and fourth-year students were more likely than first- and second-year students to report suicidal ideation (7.9% vs 1.4%; 95% CI for difference, 2.7%-10.3%; P = .001). Students with moderate to severe depression, compared with no to minimal depression, more frequently agreed that "if I were depressed, fellow medical students would respect my opinions less" (56.0% vs 23.7%; 95% CI for difference, 17.3%-47.3%; P < .001), and that faculty members would view them as being unable to handle their responsibilities (83.1% vs 55.1%; 95% CI for difference, 16.1%-39.8%; P < .001). Men agreed more commonly than women that depressed students could endanger patients (36.3% vs 20.1%; 95% CI for difference, 6.1%-26.3%; P = .002). First- and second-year students more frequently agreed than third- and fourth-year students that seeking help for depression would make them feel less intelligent (34.1% vs 22.9%; 95% CI for difference, 2.3%-20.1%; P < .01).Depressed medical students more frequently endorsed several depression stigma attitudes than nondepressed students. Stigma perceptions also differed by sex and class year.
Herpes Simplex Virus Type 2 — A Persistent Problem
Authors: Ann M. Arvin, Charles G. Prober
Journal: New England Journal of Medicine (1997)

In this issue of the Journal, Fleming and colleagues report that the age-adjusted seroprevalence of herpes simplex virus type 2 (HSV-2) in the United States is now 20.8 percent, an increase of approximately 30 percent over the 13 years between the second and third National Health and Nutrition Examination Surveys (NHANES II and III).1 The obvious inference from the increase in HSV-2 infections is that the spread of sexually transmitted diseases continues unabated, despite the substantial educational efforts made in response to the epidemic of the human immunodeficiency virus (HIV). In NHANES III, HSV-2 seropositivity correlated with a higher lifetime . . .
URINARY EXCRETION OF AMINO ACIDS IN PATIENTS WITH CIRRHOSIS OF THE LIVER AND IN NORMAL ADULTS 12
Authors: George J. Gabuzda, Richard D. Eckhardt, Charles S. Davidson
Journal: Journal of Clinical Investigation (1952)

8 N.P. 0.5 1.6 1+ 1:64 3.0 5.6 3+ 48 W. C. M
Technology, Cost, Cooperation, Ethics Challenges Face Genome Mapping Plan
Authors: Charles Marwick
Journal: JAMA (1989)

WHILE SEQUENCING the entire human genome is now a firmly established national objective, a number of major hurdles face the program before it can move into high gear. These include the following: Developing technology to enable the project to go forward at reasonable cost. Encouraging other nations to contribute to the estimated total $3 billion bill. Considering ethical and legal implications that will flow from the results of the project. These are among the challenges outlined at a congressional hearing on human genome—mapping plans. The hearing was called by Sen Albert Gore (D, Tenn), chair of the Subcommittee on Science, Technology, and Space, which is responsible for keeping an eye on the project. Witnesses included James D. Watson, PhD, and Robert W. Wood, PhD. Watson is director of the National Center for Human Genome Research at the National Institutes of Health, Bethesda, Md. Wood is an associate director of Health
FURTHER EXPERIENCES WITH PHENOBARBITAL (LUMINAL) IN EPILEPSY
Authors: JULIUS GRINKER
Journal: JAMA (1922)

At the session of the American Medical Association in 1920, I had the privilege of making a summary report on personal experiences with phenobarbital (luminal) in the treatment of epilepsy1which was based on the observation of about 100 cases. The majority of them had been under treatment for periods varying from several months to two years, while only a small number had been under uninterrupted treatment since 1914.  This paper is based on a total of 200 cases of epilepsy under my care, exclusive of the patients sent only for consultation and of those who did not return after one or two visits.  My first patients were principally the mild type of ambulatory epileptic, who naturally brought to the office similar material. Following the publication of my paper, however, I was visited by persons with some of the most intractable cases—patients who had received various remedies with little
Exome sequencing reveals a signal transducer and activator of transcription 1 (STAT1) mutation in a child with recalcitrant cutaneous fusariosis
Authors: Xiaowen Wang, Zhimiao Lin, Lujuan Gao, Aiping Wang, Zhe Wan, Wei Chen, Yong Yang, Ruoyu Li
Journal: Journal of Allergy and Clinical Immunology (2012)
EVALUATION OF THERAPEUTIC SUBSTANCES EMPLOYED FOR THE RELIEF OF BRONCHOSPASM. V. ADRENERGIC AGENTS 1
Authors: Elliott Bresnick, John F. Beakey, Leon Levinson, Maurice S. Segal
Journal: Journal of Clinical Investigation (1949)

Many laboratory techniques have been em- ployed in the study of sympathomimetic amines, particularly in an attempt to correlate chemical structure with pharmacological activity (1-7).In Table I are shown the structural formulae of the preparations dealt with in this report.The technique of protection studies in asthmatic human subjects appears to offer an additional method of investigating and evaluating these and other substances in the ultimate test object, man.The technique essentially consists of the measure- ment of the protection afforded by any substance against the dyspnea and bronchospasm induced by repeated administrations of histamine, methacho- line, or allergens, as measured, in part at least, by changes in vital capacity. METHODSThe methods we have employed and their historical development have been extensively presented elsewhere (8, 9).In the experiments reported at this time, the broncho- spastic agents used were histamine diphosphate6 and methacholine chloride employed intravenously or as aerosols.The protecting ability of the therapeutic agent under examination was determined by serial observations of the reduction in vital capacity produced by repeated administration of a constant dose (predetermined as cap- able of producing a consistent reduction in vital capacity
First do no harm: Managing antihistamine impairment in patients with allergic rhinitis
Authors: Thomas B. Casale, Michael S. Blaiss, Erwin Gelfand, Timothy Gilmore, Philip D. Harvey, Ian Hindmarch, F.Estelle R. Simons, Dennis L. Spangler, Stanley J. Szefler, Thomas E. Terndrup, Scott A. Waldman, John Weiler, Dean F. Wong
Journal: Journal of Allergy and Clinical Immunology (2003)