tbuckley/cabot-search huggingface dataset:
Reduced mortality in association with the acute respiratory distress syndrome (ARDS)
Authors: S J C Abel, S J Finney, S J Brett, B F Keogh, C J Morgan, T W Evans
Journal: Thorax (1998)

<h3>BACKGROUND</h3> A study was undertaken to investigate possible reductions in mortality and/or changes in outcome predictive factors in patients with the acute respiratory distress syndrome (ARDS) managed in a single centre. <h3>METHODS</h3> The study was a prospective observational cohort study of two patient populations with ARDS. Group 1 comprised 41 patients enrolled between May 1990 and April 1993, and group 2 consisted of 78 patients enrolled between June 1993 and March 1997. The end points of the study were mortality and various factors predictive of death. <h3>RESULTS</h3> There was a marked reduction in mortality between groups 1 and 2 (66% versus 34%; relative risk 1.77; CI 1.23 to 2.55). There were no significant differences between the groups in terms of age (40.6 (3.3) versus 45.5 (2.2) years), APACHE score (14.5 (0.72) versus 13.6 (0.1)), lung injury score (2.95 (0.07) versus 2.8 (0.1)), incidence of multi-organ failure (29% versus 32%), incidence of sepsis (31% versus 39%), or Pao<sub>2</sub>/Fio<sub>2</sub> (kPa) ratio (11.8 (0.67) versus 12.0 (0.6)). There was a significantly lower proportion of men in group 1 (51% versus 74%). The case mix of the two groups was closely matched: following elective surgery 48% versus 48%, trauma 17% versus 16%, primary lung injury 12% versus 24%. Patients in group 1 were supported using several ventilatory and other modes (volume preset, non-inverse ratio ventilation, n = 15; pressure controlled inverse ratio ventilation (PC-IRV), n = 11; ultra high frequency jet ventilation (UHFJV), n = 13; an intravascular oxygenation device (IVOX) and extracorporeal gas exchange (ECGE), n = 2). Within group 1 no significant difference in mortality was observed between the patients on volume controlled ventilation and the remainder. In group 2 all patients received PC-IRV (n = 78) but, in addition, some received other support techniques (UHFJV n = 4, ECGE n = 2). In group 1 only sepsis on admission (21% (survivors) versus 56% (non-survivors)) predicted death. In group 2 age of survivors and non-survivors (41.2 (2.6) versus 52.6 (3.5)), APACHE score (12.2 (0.6) versus 15.8 (0.9)), and Pao<sub>2</sub>/Fio<sub>2</sub> (12.8 (0.86) versus 10.5 (0.72)) predicted survival, but not the incidence of sepsis or multi-organ failure. <h3>CONCLUSIONS</h3> In recent years a highly significant reduction in mortality associated with ARDS has been observed between two groups of patients well matched for disease severity and case mix. Changes in ICU organisation rather than specific interventions may account for this reduction, although different ventilatory and other management strategies used in the two groups may also be relevant.
The Order of Authorship-Reply
Authors: Don Riesenberg
Journal: JAMA (1991)

In Reply.—  Many thanks to the Drs Fahmy, Mr Miranda, and Dr Hulley, as well as others, for responding to our editorial on the order of authorship. Our perspective is enriched by the views of those who see different facets of the problem.  We encourage use of the acknowledgment section to help with proper assignment of credit for work such as statistical consultation or manuscript preparation, so long as at least two pitfalls are avoided. First, if bibliographies of promotion candidates were to include acknowledgments, this might serve only to shift the battle for inclusion from one part of an article to another. Second, regarding mentors: general encouragement and support are their natural obligations—very few receive written thanks in a medical journal.  Writing by committee is not always a pretty thing. However, with the advent of word processors and computer networks, it is certainly feasible. Yes, Mr Miranda, we both
Brain Metastasis: Opportunities in Basic and Translational Research
Authors: Elizabeth A. Maher, Judy Mietz, Carlos L. Arteaga, Ronald A. DePinho, Suresh Mohla
Journal: Cancer Research (2009)

Brain metastasis is a major public health problem. An alarming increase in the incidence of brain metastasis in patients with otherwise well controlled systemic cancer has drawn attention to this important, yet understudied, dimension of the cancer problem. Today's practicing oncologist encounters
Abstract 2450: Optimization of spontaneous metastasis incidence and quantification in human tumor xenograft models using bioluminescence imaging
Authors: Mary Anne Meade, Meridith Baugher, Jeni Baranski, Jeremy Castorena, Erin Trachet, Deanne R. Lister, Dick Leopold, Patrick McConville
Journal: Cancer Research (2012)

Abstract Introduction: Spontaneous metastasis models are sought after in order to assess the potential of therapies aimed at prevention or treatment of primary tumor metastases. While some human tumor xenograft mouse models show spontaneous metastasis, few show high tissue specific incidence. Commonly the growth of the inherently more advanced primary tumor also limits the ability to characterize far less advanced metastases. Bioluminescence imaging provides a quantitative and convenient means for assessing location, incidence and progression of metastases using metastatic luciferase expressing tumor lines. However, substantially greater light signal from the primary tumor inhibits the ability to find and track much smaller metastasis signals. Several approaches to optimizing metastasis incidence and quantification, and controlling primary tumor growth were used and compared in a MDA-MB-231-luc-D3H2LN xenograft model. Methods: To assess both mouse strain dependence and implant site dependence of primary tumor metastasis, MDA-MB-231-luc-D3H2LN cells (2x106) were implanted in either the mammary fat pad, the sacral region or the quadriceps in several mouse strains, including outbred nu/nu, SHO and nd/bg/xid. To control primary tumor growth in order to facilitate metastasis quantification, both surgical excision and radiation based growth inhibition of of the primary tumors were used. In all cases, whole body bioluminescence imaging was used to quantify metastasis incidence and growth. Shileding of the primary tumor was used in order to characterize smaller metastases. Results and Discussion: While the MDA-MB-231-luc-D3H2LN mammary fat pad implant model has been shown the metastasize spontaneously, tissue specific incidence is generally &amp;lt; 100% and the ability to quantify metastases severely limited by the substantially greater light signal overwhelming much smaller metastasis signals, even when primary tumor shielding is used. In this study, both surgical excision and radiation based primary tumor growth inhibition enhanced the ability to detect metastases in a variety of tissues, including lymph nodes and lungs. The mammary fat pad implant site and the SCID Beige strain provided the highest spontaneous metastasis incidence. Future work will test radiation timing and dose to further optimize metastasis quantification in this and other spontaneous metastasis models. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2450. doi:1538-7445.AM2012-2450
Glutamatergic Signaling Maintains the Epithelial Phenotype of Proximal Tubular Cells
Authors: Milica Bozic, Johan de Rooij, Eva Parisi, Marta Ruiz Ortega, Elvira Fernandez, José M. Valdivielso
Journal: Journal of the American Society of Nephrology (2011)

Epithelial–mesenchymal transition (EMT) contributes to the progression of renal tubulointerstitial fibrosis. The N-methyl-D-aspartate receptor (NMDAR), which is present in proximal tubular epithelium, is a glutamate receptor that acts as a calcium channel. Activation of NMDAR induces actin rearrangement in cells of the central nervous system, but whether it helps maintain the epithelial phenotype of the proximal tubule is unknown. Here, knockdown of NMDAR1 in a proximal tubule cell line (HK-2) induced changes in cell morphology, reduced E-cadherin expression, and increased α-SMA expression. Induction of EMT with TGF-β1 led to downregulation of both E-cadherin and membrane-associated β-catenin, reorganization of F-actin, expression of mesenchymal markers de novo, upregulation of Snail1, and increased cell migration; co-treatment with NMDA attenuated all of these changes. Furthermore, NMDA reduced TGF-β1–induced phosphorylation of Erk1/2 and Akt and the activation of Ras, suggesting that NMDA antagonizes TGF-β1–induced EMT by inhibiting the Ras-MEK pathway. In the unilateral ureteral obstruction model, treatment with NMDA blunted obstruction-induced upregulation of α-SMA, FSP1, and collagen I and downregulation of E-cadherin. Taken together, these results suggest that NMDAR plays a critical role in preserving the normal epithelial phenotype and modulating tubular EMT.
Polycythemia vera. Increased expression of normal committed granulocytic stem cells in vitro after exposure of marrow to tritiated thymidine.
Authors: J W Singer, P J Fialkow, J W Adamson, L Steinmann, C Ernst, S Murphy, K J Kopecky
Journal: Journal of Clinical Investigation (1979)

In previous studies of two patients with polycythemia vera (PV) and heterozygous at the X-linked locus for glucose-6-phosphate dehydrogenase (G-6-PD), only type A isoenzyme was found in non-lymphoid hematopoietic cells. However, some granulocytic and erythrocytic colonies grown in vitro had type B G-6-PD and therefore arose from presumably normal progenitors. In this study we exposed marrow cells from these same two patients to high-specific activity tritiated thymidine (3HTdR) before culture to kill cells actively synthesizing DNA. Individual granulocytic colonies were plucked and tested for G-6-PD after 14 d of culture. The frequency of type B colonies rose after exposure to 3HTdR from 8/101 to 11/36 in patient 1 and from 0/32 to 6/31 in patient 2 (P less than 0.003). No increase in the frequency of normal erythroid bursts after 3HTdR exposure was seen, implying that in PV, early granulopoiesis, and erythropoiesis are regulated differently. The results demonstrated that only type A granulocytic colonies, arising from the abnormal clone, were removed by the 3HTdR. In addition, for patient 2, statistical analysis indicated there was an absolute increase in normal granulocytic colonies detected in culture. Thus, PV clonal colony-forming units in culture (CFU-C) cycle more rapidly than do normal CFU-C and may suppress proliferation of normal CFU-C in vitro.
Quality and the Medical Marketplace — Following Elephants
Authors: Marcia Angell, Jerome P. Kassirer
Journal: New England Journal of Medicine (1996)

Suddenly, “quality” has become the watchword among those who care about the American health care system, and attempts to measure it are giving rise to a whole new industry. Just three short years ago, during the debate about the Clinton plan for reforming the health care system, quality was a secondary issue. The emphasis instead was on providing universal access to health care in a national system designed to contain costs. Now, access seems all but forgotten (even while it shrinks precipitously), and costs are considered not systemwide, but by individual payer groups. Quality and accountability are the focus of . . .
A microarray study to characterize the molecular mechanism of TIMP-3-mediated tumor rejection
Authors: Paula Lam, Kar Sian Lim, Suk Mei Wang, Kam M. Hui
Journal: Molecular Therapy (2005)

Glial cell invasion is a multistep cellular process that involves a complex system of tightly regulated proteases (matrix metalloproteinases; MMPs) and their endogenous inhibitors (tissue inhibitors of metalloproteinases; TIMPs) to mediate the degradation of the basement membrane and extracellular matrix. Tissue inhibitor of metalloproteinases-3 (TIMP-3) is a matrix-bound inhibitor of MMPs. In the present study, we have overexpressed the TIMP3 gene in human glioma cells with a herpes simplex virus type 1 amplicon-based vector. Oligonucleotide DNA arrays were employed to identify genes that were differentially modulated by the overexpression of TIMP-3. Consistent with the function of TIMP-3, genes associated with angiogenesis, growth factors, cytokines, death receptors, and substrates of the various MMPs were found to be up-regulated. Furthermore, caspases are important in the signaling pathway of cellular apoptosis, and the overexpression of TIMP-3 in glioma cells is tightly associated with the activation of caspases, including caspase-1, at both the mRNA level (P=0.0371) and the protein level. Moreover, the activation of an apoptotic pathway via the overexpression of TIMP-3 induced apoptosis of transduced human glioma cells in vitro and the growth inhibition of human glioma tumor xenografts in immunodeficient mice.
Dermoscopic features of stellate spontaneous pseudoscars in five Japanese men
Authors: K. Kobayashi, M. Tanaka, H. Ito, T. Harada, M. Aiba
Journal: British Journal of Dermatology (2008)

Conflicts of interest: none declared. Sir, In 1967 Colomb et al.1 described for the first time skin changes called ‘pseudo‐cicatrices stellaires spontanées’ (stellate spontaneous pseudoscars; SSP) which occurred on the back of the hand and the radial forearm of elderly people. They described multiple, whitish, slightly depressed, irregularly shaped, scar‐like, stellate or frequently linear lesions in patients with senile atrophy and irregularly pigmented skin with senile purpura. We report typical cases of SSP with dermoscopy findings for the first time, and emphasize the importance of the correlation between dermoscopic views and histopathology of these lesions. We encountered five patients (all men; age range 71–82 years, median 76) who had a diagnosis of SSP on the back of the hand or the radial forearm and evaluated dermoscopic features in all cases using a nonpolarized, contact‐type dermoscope with echo gel, Derma 9500 (DMI, Inc., Yokohama, Japan), in combination with PowerShot 620A (Canon, Tokyo, Japan). Results were correlated with histopathological findings. Two qualified dermatologists made the clinicodermoscopic diagnosis of SSP in all cases.
Patient Education Materials about the Treatment of Early-Stage Prostate Cancer: A Critical Review
Authors: Angela Fagerlin, David Rovner, Sue Stableford, Christophir Jentoft, John T. Wei, Margaret Holmes-Rovner
Journal: Annals of Internal Medicine (2004)

Background: To ensure that patients make informed medical decisions, patient education materials must communicate treatment risks and benefits. Objective: To survey publicly available patient education materials and assess their suitability to support informed decision making in early-stage prostate cancer. Design: Cross-sectional review of Internet, print, and multimedia sources. Setting: University data analysis laboratory. Measurements: The content of 44 materials that described all standard treatment options was reviewed. Top-rated documents underwent plain-language review. Total score on 54 content items and accuracy, balance, and plain-language evaluation was measured. Results: 502 of 546 patient education materials did not describe all standard treatments (watchful waiting, surgery, radiation, and hormone therapy). Eighty percent of the 44 materials that addressed standard treatments and underwent content review described anatomy, physiology, stage, and grade of cancer. Half of the materials fully described radical prostatectomy and radiation therapy. One third of the materials included risks and benefits of each treatment; none explicitly compared outcomes of all treatments in a single summary. Information was accurate and balanced but did not include key content for informed consent. Limitations: The search was restricted to publicly available materials and did not include books or materials written in languages other than English. The accuracy, balance, and plain-language reviews were evaluated by 1 reviewer. The criteria reflect the authors' focus on informed decision making. Other aspects of health education may require a different evaluation template. Conclusions: Currently available patient education materials on early-stage prostate cancer treatment do not contain comprehensive information about the risks and benefits of each treatment. To assist patients and physicians in choosing among prostate cancer treatment options, a new generation of materials is needed.
Labour proposes scheme to merge health and social care
Authors: G. Iacobucci
Journal: BMJ (2013)

The UK Labour Party has proposed merging the budgets for health and social care and mental health services in England to dissolve the current boundaries and stop patients “falling into the cracks” in the current system.

In a speech this week at the King’s Fund, the healthcare think tank, the shadow health secretary, Andy Burnham, outlined the party’s vision for the future of health and social care and launched a consultation on how to tackle the key challenges facing the system, including an ageing society, rising numbers of people with comorbidities, and financial pressures.

He said that the …
1086 THE ASSOCIATION OF CRYOGLOBULINEMIA AND SUSTAINED VIROLOGICAL RESPONSE IN PATIENTS WITH CHRONIC HEPATITIS C
Authors: A. Vigani, A. Macedo-de-Oliveira, R. Tozzo, M.H. Pavan, E.S. Gonçales, V. Fais, N.S. Gonçales, F.L. Gonçales
Journal: Journal of Hepatology (2010)
Fasting and post-methionine homocysteine levels in NIDDM. Determinants and correlations with retinopathy, albuminuria, and cardiovascular disease.
Authors: Y M Smulders, M Rakic, E H Slaats, M Treskes, E J Sijbrands, D A Odekerken, C D Stehouwer, J Silberbusch
Journal: Diabetes Care (1999)

OBJECTIVE: The increased cardiovascular risk in subjects with NIDDM is partly explained by an association with established risk factors like hypertension, dyslipidemia, and obesity. Mild hyperhomocysteinemia has emerged as a new risk factor for cardiovascular disease. The purpose of this study was to assess its role in NIDDM. RESEARCH DESIGN AND METHODS: We studied predictors of homocysteine levels and correlations between homocysteine and (micro-)albuminuria, retinopathy, and history of cardiovascular disease in normotensive NIDDM subjects under stable metabolic control. This was done in 85 NIDDM subjects by measuring fasting and post-methionine-loading homocysteine levels together with blood pressure, BMI, serum cholesterol, triglyceride, HDL cholesterol, folate, vitamin B12, pyridoxal-5-phosphate, HbA1c, and (micro-)albuminuria and creatinine clearance in triplicate 24-h urine samples. The relationship between micro- and macrovascular complications and fasting homocysteine only was studied in an additional 65 subjects, giving a total of 150 subjects. RESULTS: In multiple regression analysis, significant (P &amp;lt; 0.05) predictors of fasting homocysteine were low-normal values of creatinine clearance (threshold effect at &amp;lt; 80 ml.min-1 .1.73 m-2), folate (&amp;lt; 20 nmol/l), and vitamin B12 (&amp;lt; 350 pmol/l), and postmenopausal status in women. Determinants of post-methionine homocysteine were pyridoxal-5-phosphate levels &amp;lt; 80 nmol/l, creatinine clearance, and sex (higher levels in women). Hyperhomocysteinemia did not cluster with other cardiovascular risk factors, like hypertension, obesity, or dyslipidemia. Regarding cardiovascular complications, fasting homocysteine, but not post-methionine homocysteine, was higher in subjects with a history of cardiovascular disease. There was a stepwise increase in the prevalence of subjects with cardiovascular disease with increasing fasting homocysteine. The prevalence of cardiovascular disease was 19.4% in the bottom quartile of fasting homocysteine, versus 55.0% in the top quartile (P for trend &amp;lt; 0.01). Neither fasting homocysteine nor post-methionine homocysteine correlated with (micro-)albuminuria or with retinopathy. CONCLUSIONS: The findings suggest that homocysteine levels in NIDDM rise even with modest deterioration of renal function and when vitamin status is in the low to low-normal range. Fasting homocysteine correlates with macrovascular disease, but we found no evidence of a correlation with retinopathy or (micro-)albuminuria. Post-methionine homocysteine levels do not show a correlation with micro- or macrovascular complications.
SHORT TERM ADVERSE EVENTS AND READMISSION RISK FOLLOWING PERCUTANEOUS CORONARY INTERVENTION IN AFRICAN-AMERICANS
Authors: Nevin Baker, Michael Lipinski, Ricardo Escarcega Alarcon, Sa'ar Minha, Marco Magalhaes Pereira, Alfazir Omar, Joshua Loh, Lakshmana Pendyala, Fang Chen, Rebecca Torguson, Lowell Satler, Augusto Pichard, William Suddath, Ron Waksman
Journal: Journal of the American College of Cardiology (2014)
The Undisciplined Speaker
Authors: Werner Tuteur
Journal: JAMA (1965)

<h3>To the Editor:—</h3> At a recent meeting in Chicago, five of six speakers were interrupted by the chairman and asked to terminate their paper because the allotted time had run out. Five times the formal discussant stated, "I regret that the speaker was not permitted to read his paper in its entirety because I am about to discuss exactly that part of his paper which he did not read......." A paper read or heard incompletely is worse than no paper at all. Admittedly, it requires some skill and sense of form to fit a paper into a certain time slot. For the inexperienced it may be said that it takes about two minutes to read a double-spaced typewritten page at moderate speed, with proper enunciation, allowing for appropriate pauses and proper breathing. Ideally, a manuscript should never be "read" verbatim, but the highlights should be communicated in abstract by the
Management of Oral Emergencies
Authors: Edward C. Hinds
Journal: JAMA (1964)

This small volume, discussing oral emergencies, should be of considerable value to those in the general practice of dentistry or medicine. The author's classification of emergencies—admitting, anesthetic, operative, and postoperative—is helpful. Emphasis is placed upon diagnosis and initial treatment. The discussion of oral swelling and hemorrhage is quite good, although no mention is made of the potential danger of general anesthesia in certain severe neck infections. Dr. Laskin's recommendation for preserving teeth where possible after alveolar fractures is well taken. Some aspects may arouse dissent. For instance, antibiotics are recommended much too liberally throughout. The section on temporomandibular joint pain appears to be somewhat inadequate, and the phrase "temporomandibular joint arthritis" might be questioned by specialists in the the field who consider it a neuromuscular imbalance rather than an actual arthritis. The author rightly recommends aspiration before injection of a local anesthetic. He also points out the importance of oxygen
Multiple Sclerosis and Hysteria
Authors: Mark R. Munetz
Journal: JAMA (1981)

<h3>To the Editor.—</h3> In their article, Caplan and Nadelson speculate on the preexistence of hysterical traits that complicated the later course of their patients' MS. I would like to describe a case where the existence of a hysterical personality disorder preceded the onset and obscured the diagnosis of MS. <h3>Report of a Case.—</h3> A 23-year-old woman, two months postpartum, came to our psychiatric emergency room complaining of "blindness and no feeling in my arms and legs. I'm too weak to hold my baby." She had had a normal postpartum physical examination three weeks earlier. Two weeks earlier she was seen in our hospital complaining of depression and decreased concentration. An evaluation at that time failed to confirm a depressive syndrome, and no treatment was instituted. Past history disclosed psychiatric contacts beginning at the age of 14 years, when she was institutionalized for "truancy and acting out." At 18 years she