tbuckley/cabot-search huggingface dataset:
Predictors of Hematoma Volume in Deep and Lobar Supratentorial Intracerebral Hemorrhage
Authors: Guido J. Falcone, Alessandro Biffi, H. Bart Brouwers, Christopher D. Anderson, Thomas W. K. Battey, Alison M. Ayres, Anastasia Vashkevich, Kristin Schwab, Natalia S. Rost, Joshua N. Goldstein, Anand Viswanathan, Steven M. Greenberg, Jonathan Rosand
Journal: JAMA Neurology (2013)

<h3>Importance</h3> Hematoma volume is the strongest predictor of outcome in intracerebral hemorrhage (ICH). Despite known differences in the underlying biology between deep and lobar ICHs, limited data are available on location specificity of factors reported to affect hematoma volume. <h3>Objective</h3> To evaluate whether determinants of ICH volume differ by topography, we sought to estimate location-specific effects for potential predictors of this radiological outcome. <h3>Design</h3> Prospective cohort study. <h3>Setting</h3> Academic medical center. <h3>Participants</h3> A total of 744 supratentorial primary ICH patients (388 deep and 356 lobar) aged older than 18 years admitted between January 1, 2000, and December 31, 2010. <h3>Main Outcomes and Measures</h3> Intracerebral hemorrhage volume measured from the computed tomography scan obtained on presentation to the emergency department. Linear regression analysis, stratified by ICH location, was implemented to identify determinants of log-transformed ICH volume. <h3>Results</h3> Median ICH volume was larger in lobar hemorrhages (39 mL; interquartile range, 16-75 mL) than in deep hemorrhages (13 mL; interquartile range, 5-40 mL;<i>P</i> &lt; .001). In multivariable linear regression, independent predictors of deep ICH volume were intensity of anticoagulation (β = 0.32; standard error [SE] = 0.08;<i>P</i> &lt; .001; test for trend across 4 categories of the international normalized ratio), history of coronary artery disease (β = 0.33; SE = 0.17;<i>P</i> = .05), male sex (β = 0.28; SE = 0.14;<i>P</i> = .05), and age (β = −0.02; SE = 0.01;<i>P</i> = .001). Independent predictors of lobar ICH volume were intensity of anticoagulation (β = 0.14; SE = 0.06;<i>P</i> = .02) and antiplatelet treatment (β = 0.27; SE = 0.13;<i>P</i> = .03). <h3>Conclusions and Relevance</h3> Predictors of hematoma volume only partially overlap between deep and lobar ICHs. These findings suggest that the mechanisms that determine the extent of bleeding differ for deep and lobar ICHs. Further studies are needed to characterize the specific biological pathways that underlie the observed associations.
Atherosclerotic renovascular disease in United States patients aged 67 years or older: Risk factors, revascularization, and prognosis
Authors: Philip A. Kalra, Haifeng Guo, Annamaria T. Kausz, David T. Gilbertson, Jiannong Liu, Shu-Cheng Chen, Areef Ishani, Allan J. Collins, Robert N. Foley
Journal: Kidney International (2005)
T lymphocytes in kidney allograft recipients.
Authors: T Tursz, C Fournier, H Kreis, J Crosnier, J F Bach
Journal: BMJ (1976)

The spontaneous sheep erythrocyte (E) rosette test was used on 340 occasions to measure T cell levels in 28 renal allograft recipients. The E rosette counts were reduced by high-dose steroids but usually returned towards normal under maintenance treatment with azathioprine and low-dose prednisone. Unexpectedly, rejection crises were more often associated with a decrease in E rosettes before steroid treatment (12 cases) than with an increase in E rosettes (5 cases). Our results show the need for caution in using the E rosette test and more generally B and T cell markers for monitoring anti-graft immunity in renal allograft recipients.
Plasmacytoma of Lymph Nodes
Authors: Leon Suissa
Journal: JAMA (1966)

MULTIPLE MYELOMA is a neoplastic disease of unknown origin, usually associated with the proliferation of abnormal plasma cells. It is characterized by multiple involvement of the skeletal system. Tissue other than the skeletal system may also be involved in multiple myeloma. Extraosseous involvement of lymph nodes, spleen, kidneys, tonsils, and other tissue has been described. Extraosseous myelomatous involvement may take the form of extramedullary plasma cells histologically indistinguishable from myeloma cells of the bone marrow. These occur most often in the upper respiratory tract or oral cavity. In a review of 127 published cases of extramedullary plasmacytoma, Hellwig1found that 63 originated in the air passages. Recently Dolin and Dewar2reviewed 161 reported cases. Excluding lesions of conjunctiva, 78% occurred in the upper air passages and oral cavity.  Occasionally myeloma may be found in only a single focus such as a rib, mandible, spine, or lymph node. These
Hepatitis B Prophylaxis in Dental Professionals-Reply
Authors: Frederic E. Shaw
Journal: JAMA (1986)

In Reply.—  Drs Oyer and Redondo have misinterpreted our statement about the vaccination of dental professionals early in their careers. We were simply reinforcing existing recommendations that dental professionals (and other high-risk health care workers) receive HB prophylaxis during their training years, when it will do the most good.1Since we do not know exactly when the dentist became infected, it is impossible to state precisely if or when vaccination could have prevented his infection and the subsequent outbreak. Although he was probably infected by January 1984, it is possible that he acquired his infection months or even years earlier.  Vaccination of susceptible persons prevents both infection and subsequent progression to the carrier state. Consequently, if the vaccine could have been given to the dentist in time to prevent his infection, then he would not have become a carrier. We certainly never claimed that the carrier state could be
Spontaneous abortions in hospital sterilising staff
Authors: S. G Austin
Journal: BMJ (1983)

With regard to oral treatment, advice in the British National Formulary lacks consistency.In the main text we read, "In patients with moderate heart failure a loading dose is not required and a satisfactory concentration can be achieved over a period of about a week of 125-250 j&g twice daily which can then be reduced."Whereas, in the summary we read: "Dose by mouth 250 /eg twice daily until digitalised then 125-500 4g daily."This ambiguity could lead to the prescription of 500 ,ug daily for a week, which would result in a potentially toxic total dose of 3-5 mg.We appreciate that general cautionary advice on the use of digoxin is included but think this entry in the British National Formulary needs revision.Simplified instruc- tions on loading doses as discussed by Jelliffe4 could then be supplemented by fuller guidance on estimation of maintenance dose.5
Improving early management of bloodstream infection: a quality improvement project
Authors: Jane Minton, James Clayton, Jonathan Sandoe, Hugh Mc Gann, Mark Wilcox
Journal: BMJ (2008)

Problem Bloodstream infection is a common but serious illness with high mortality and morbidity, which is seen in many clinical specialties. Errors such as delay in diagnosis and lack of effective treatment often occur. Design Initial observational study followed by prospective study before and after intervention in a high risk clinical area. Setting 1400 bed teaching hospital in the United Kingdom where the initial management of all inpatients with bloodstream infections was surveyed over six weeks. This showed 55 major errors in 46 (30%) of 157 episodes of bloodstream infection. Most (44) were in general areas of the hospital without a specific protocol for managing sepsis. 29 of the 55 errors were caused by delay in giving effective antibiotics to critically ill patients. In 19 cases, effective antibiotics were still not given despite advice from infection services based on blood culture results. A diagnosis of bloodstream infection had not been considered in 7 patients already in hospital despite clear signs of sepsis for more than 48 hours. Strategy for improvement Development of guidelines for recognition and initial management of patients with severe sepsis and bloodstream infection, implementation of an education programme on clinical standards for managing sepsis, and introduction of a bacteraemia service that included feedback. Key measure of improvement Reduction in incidence of major errors in early management of bloodstream infection. Effects of change In the second part of the study, major errors were found in 11 of 37 episodes (30%) immediately before the intervention in the main high risk area (medical wards), whereas such errors were found in 6 of 79 episodes (8%) after the intervention. Lessons learnt The early management of patients with bloodstream infection was often suboptimal. The underlying factors included failure to recognise patients with serious infection; delays in giving antibiotics as a result of poor communication between medical, nursing, and pharmacy teams; and lack of understanding of empirical antimicrobial selection. Introduction of improvement measures was associated with considerable improvement in the early management of severe sepsis caused by bloodstream infection.
Cellular Mechanisms of Benzodiazepine Action
Authors: Robert E. Study
Journal: JAMA (1982)

BENZODIAZEPINES are in common clinical use because they possess a fortunate combination of important therapeutic properties. They are effective in the treatment of two common clinical conditions—anxiety and insomnia—and they are useful in the treatment of seizure disorders and certain kinds of spasticity as well. In addition to these therapeutic actions, these drugs lack significant side effects outside of the CNS and have low toxicity, factors that have contributed to their widespread clinical use. Since the introduction of chlordiazepoxide hydrochloride (Librium) in 1960, research into the cellular mechanisms of benzodiazepine action has increased in parallel with the use of these agents. In this review, some recent advances in elucidating the mechanisms of action of benzodiazepines in the CNS are described. The principal lines of basic research on benzodiazepines fall into two general categories: biochemical and electrophysiological. Although they will be discussed separately, they represent complementary strategies for achieving a comprehensive
One in three people in the US want to see “radical change” in health care
Authors: Bob Roehr
Journal: BMJ (2008)

The proportion of US citizens who want “radical change” in their healthcare system reached 36% Republican pollster Bill McInturff told a briefing in Washington DC last week. He has tracked the question since 1992 and has seen the response go as low as 22%. “Every time we have gotten into the mid 30s or higher we have had a huge debate about healthcare.” 

“Among the people who say they want radical change are small business owners [43%] and people who work at companies of less than 10 employees [48%]. That is important because much of the opposition to reform during the Clinton administration came from small business.”

Mr McInturff told the meeting, which was sponsored by the journal Health Affairs , that there had been an underlying shift in attitude towards the role of government over the past 13 years.

In 1995, almost two thirds of US …
Adenosine, methacholine, and exercise challenges in children with asthma or paediatric chronic obstructive pulmonary disease.
Authors: A Avital, C Springer, E Bar-Yishay, S Godfrey
Journal: Thorax (1995)

BACKGROUND--Bronchial hyperreactivity to methacholine is present in children with asthma and other types of paediatric chronic obstructive pulmonary disease (COPD), while hyperreactivity to exercise is more specific for asthma. Adenosine 59-monophosphate (AMP) is a potent bronchoconstrictor and, like exercise, may provoke asthma by activating mast cells. This study investigated the suitability of AMP as a specific challenge for asthma in children. METHODS--Bronchial provocation challenges with methacholine and AMP were performed in a double blind fashion using tidal breathing in 51 children with asthma, 21 with paediatric COPD of various types, and in 19 control children. Each subject also underwent a standardised exercise challenge after inhalation challenges were completed. Sensitivity and specificity curves were constructed and the intersection point of sensitivity and specificity for each type of challenge was determined. RESULTS--When the asthmatic patients were compared with the children with COPD, the intersection points for AMP, exercise and methacholine were 90%, 85%, and 50%, respectively. When compared with the controls the same intersection points were 98%, 84%, and 92%, and when children with paediatric COPD were compared with controls they were 55%, 50%, and 82%. CONCLUSIONS--Methacholine distinguishes both asthma and paediatric COPD from controls with a sensitivity of 82-92%, but does not distinguish between asthma and paediatric COPD; exercise and AMP distinguish asthma from controls with a sensitivity and specificity of 84-98% but they also distinguish asthma from paediatric COPD with a sensitivity and specificity of 85-90%. AMP inhalation is a practical aid for diagnosing asthma and distinguishing it from COPD in children of all ages.
Folate Therapy and In-Stent Restenosis after Coronary Stenting
Authors: Helmut Lange, Harry Suryapranata, Giuseppe De Luca, Caspar Börner, Joep Dille, Klaus Kallmayer, M. Noor Pasalary, Eberhard Scherer, Jan-Henk E. Dambrink
Journal: New England Journal of Medicine (2004)

Vitamin therapy to lower homocysteine levels has recently been recommended for the prevention of restenosis after coronary angioplasty. We tested the effect of a combination of folic acid, vitamin B6, and vitamin B12 (referred to as folate therapy) on the risk of angiographic restenosis after coronary-stent placement in a double-blind, multicenter trial.A total of 636 patients who had undergone successful coronary stenting were randomly assigned to receive 1 mg of folic acid, 5 mg of vitamin B6, and 1 mg of vitamin B12 intravenously, followed by daily oral doses of 1.2 mg of folic acid, 48 mg of vitamin B6, and 60 microg of vitamin B12 for six months, or to receive placebo. The angiographic end points (minimal luminal diameter, late loss, and restenosis rate) were assessed at six months by means of quantitative coronary angiography.At follow-up, the mean (+/-SD) minimal luminal diameter was significantly smaller in the folate group than in the placebo group (1.59+/-0.62 mm vs. 1.74+/-0.64 mm, P=0.008), and the extent of late luminal loss was greater (0.90+/-0.55 mm vs. 0.76+/-0.58 mm, P=0.004). The restenosis rate was higher in the folate group than in the placebo group (34.5 percent vs. 26.5 percent, P=0.05), and a higher percentage of patients in the folate group required repeated target-vessel revascularization (15.8 percent vs. 10.6 percent, P=0.05). Folate therapy had adverse effects on the risk of restenosis in all subgroups except for women, patients with diabetes, and patients with markedly elevated homocysteine levels (15 micromol per liter or more) at baseline.Contrary to previous findings, the administration of folate, vitamin B6, and vitamin B12 after coronary stenting may increase the risk of in-stent restenosis and the need for target-vessel revascularization.
Implant‐assisted complete prostheses
Authors: Elham Emami, Pierre‐Luc Michaud, Imad Sallaleh, Jocelyne S. Feine
Journal: Periodontology 2000 (2014)

The current review was undertaken to obtain a better understanding of the knowledge base of implant-assisted complete dental prostheses (fixed and removable) in the treatment of the completely edentulous maxilla or mandible. Indications, advantages and disadvantages, complications and maintenance issues, as well as the cost-effectiveness of both treatments, are discussed to help clinicians in their therapeutic decision-making. In summary, when indicated and depending on the patients' needs, both removable and fixed implant-assisted prostheses are highly safe, reliable and satisfactory treatment modalities for the rehabilitation of edentulous jaws. Careful and precise treatment planning is highly recommended to assist the clinician in preventing potential prosthetic failures. The review also reveals that there is still a need for data, generated using robust research methods, on some patient-based and clinical outcomes.
Beneficial effect of adenosine during reperfusion following prolonged cardioplegic arrest
Authors: S. Ledingham, O. Katayama, D. Lachno, N. Patel, M. Yacoub
Journal: Cardiovascular Research (1990)

Study objective – The aim of the study was to investigate the effect of reperfusion with adenosine after prolonged cardioplegic arrest in the isolated working rat heart. Design – After 3 h of hypothermic (20°C) ischaemic arrest with multidose (every 30 min) infusions of St Thomas's Hospital cardioplegic soluton No 1, rat hearts were reperfused with either ordinary perfusion fluid (Krebs-Henseleit bicarbonate buffer) or with additional adenosine (1 mg·litre−1) for 15 min prior to assessing recovery of function. Experimental material – Hearts (n=10 in each group) were obtained from male rats weighing 250-300 g. Measurements and main results – Mean coronary flow during the period of reperfusion was increased from 11.8(SEM 0.8) ml·min−1 with ordinary perfusate to 17(0.7) ml·min−1 with adenosine reperfusate (p<0.001). Mean recoveries of functional indices (as percent of preischaemic control values) in hearts receiving ordinary reperfusates v adenosine reperfusates were: peak aortic pressure 76.2(2.8)% υ 86.9(2.2)%, dP/dt 35.6(6.0)% υ 66.2(4.3)%, aortic flow 26.1(7.4)% υ 60.9(4.2)%, coronary flow 50.1(3.4% υ 75.6(3.6)%, and cardiac output 31.4(6.4)% υ 64.5(3.2)%. Recovery of all indices was significantly superior with adenosine than without (peak aortic pressure p<0.01, other indices p<0.001). A parallel series of experiments showed that the nucleotide content of both groups was similar at the end of the 15 min reperfusion period. Conclusions – Improvement in functional recovery occurs with low dose adenosine during reperfusion. This is likely to be due to an increase in coronary flow to the microvasculature rather than to an increase in intramyocardial ATP.
18F Sodium Fluoride PET/CT Detects Osseous Metastases From Breast Cancer Missed on FDG PET/CT With Marrow Rebound
Authors: Ryan Avery, Phillip H. Kuo
Journal: Clinical Nuclear Medicine (2013)

Intense FDG uptake by bone marrow following recent chemotherapy limits evaluation for osseous metastases. The impact of marrow rebound on accuracy of (18)F-fluoride PET/CT is unclear. A 73-year-old woman with breast cancer presented for restaging FDG PET/CT, which showed intense activity throughout almost the entire axial skeleton and no osseous metastases. An (18)F-fluoride PET/CT performed 7 days later identified multiple osseous metastases in the spine, ribs, and pelvis. This case demonstrates that (18)F-fluoride PET/CT should be considered for the evaluation of osseous metastases in patients with rebound marrow uptake on FDG PET/CT.
SCARLET FEVER PREPARATIONS
Authors: George F. Dick
Journal: JAMA (1925)

<h3>To the Editor:</h3> —Since we described a skin test for susceptibility to scarlet fever and preventive immunization of susceptible persons with the sterile toxin, and the corresponding antitoxin for therapeutic and prophylactic treatment, various commercial biologic concerns have been producing the toxin. Some have also been distributing serums under the label of "Scarlet Fever Streptococcus Antitoxin." On inquiry and testing, we found that much of the toxin was made from broth to which considerable amounts of horse blood had been added, thus introducing, quite unnecessarily, the possibility of sensitizing to horse serum during the course of preventive immunization with the toxin. Some preparations of the toxin were not standardized with sufficient accuracy to give dependable results; and most of the toxin was put out in doses too small to produce satisfactory immunization in many susceptible persons. Much of the serum sold as scarlet fever streptococcus antitoxin was put out in
Myocarditis and Myocardosis
Authors: M. A. BLANKENHORN, EDWARD A. GALL
Journal: Circulation (1956)

Search of 3,141 autopsies found 108 examples of myocardial disease of which 77 were inflammatory (nonrheumatic) and 31 noninflammatory but degenerative and not due to sclerosis or hypertension. These are designated myocardosis. Myocarditis was associated with infections in a manner often described; myocardosis was associated with a variety of noninfectious disorders. A discussion of the use of this term is elaborated. Clinical records also were studied to find what part such lesions played in causing death and how such myocardial lesions could be diagnosed with more certainty.
SUCCESSFUL TREATMENT OF ACTINOMYCOSIS WITH "STILBAMIDINE"
Authors: Joseph M. Miller
Journal: JAMA (1952)

Crystalline penicillin G has been proposed as the remedy of choice with sulfadiazine as alternate in the treatment of actinomycosis.<sup>1</sup>The two agents have also been used in combination. Streptomycin,<sup>2</sup>bacitracin,<sup>3</sup>and aureomycin<sup>4</sup>have also been reported to be efficacious. The observation that "stilbamidine" (4,4′-stilbenedicarboxyamidine) was a useful therapeutic agent for infections caused by Blastomyces dermatitidis<sup>5</sup>prompted its use in a patient with actinomycosis resistant to prolonged administration of penicillin and sulfadiazine. <h3>REPORT OF A CASE</h3> A 51-year-old white man was admitted to the Veterans Administration Hospital on Jan. 4, 1951, with a mass in the left submental region that had appeared after extraction of a tooth in November, 1950. The tumor had become progressively larger. Pain in the right side of the chest and a cough had been treated by the patient's physician with aureomycin for two days. The patient lost 9 lb. (4.1
Safety of Portable Oxygen Equipment
Authors: J. E. Cotes
Journal: BMJ (1965)

EDIBAsL have facilities on their premises for the storage of vaccines under correct conditions.It would seem, therefore, that, even if effective and innocuous vaccines are produced by the manufacturers, there is a considerable chance that by the time they are administered to patients they will have lost much of their effectiveness, and may, in addition, possess a considerable toxicity.-Iam, etc. Leeds 16.
Pulmonary Adenocarcinomas with Mutant Epidermal Growth Factor Receptors
Authors: Markus J. Riemenschneider, Daphne W. Bell, Daniel A. Haber, David N. Louis
Journal: New England Journal of Medicine (2005)

To the Editor: Activating mutations of the DNA sequence encoding the catalytic kinase domain of the epidermal growth factor receptor (EGFR) have been shown to underlie responsiveness to gefitinib i...