tbuckley/cabot-search huggingface dataset:
OC-057 In. Out. “next Please!” Can Person-centred Care Be Delivered In Endoscopy?
Authors: L Ferris, S Henderson
Journal: Gut (2014)

<h3>Introduction</h3> In. Out. “Next please!” Is this the image of endoscopy nursing? It can often be difficult to personalise care or care delivery with such a rapid turnover of patients. As registrants we have a duty to deliver safe, effective, person-centred practice (PCP). Staff at the Belfast City Hospital opted to explore this concept further. <h3>Methods</h3> In order to understand the nature of PCP we used emancipatory practice development tools, as this is the only service improvement methodology which has the delivery of PCP as the explicit outcome. To increase awareness of “self,” staff initially were invited to explore their own inherent values and beliefs, facilitated through a Values Clarification Exercise (VCE) using critical creativity <sup>[1]</sup>. The VCE helped identify key themes which formed the basis of our visioning statement. We used the <i>15 Steps Challenge</i>[2] and Workplace Critical Culture Analysis Tool (WCCAT)[3] to explore the prevailing culture within the department and establish if we were indeed person-centred. <h3>Results</h3> Integral to the PCP framework <sup>[1]</sup> is the therapeutic relationship between service users and care providers. Working on the premise that “first impressions count,” the <i>15 Steps Challenge</i> was performed by key stakeholders and facilitated by junior nursing staff. Observations were made in four key areas of practice. Feedback was collated and presented to the ward manager and a subsequent action plan created, which included improvements to the reception area. In addition, to further explore the workplace culture, eight observations of practice were undertaken using the WCCAT by a representative staff group. These findings were then presented to the wider team who prioritised areas for action. <h3>Conclusion</h3> We believe PCP should not be viewed as a one-time event, but rather a continual process embedded in everyday practice. We are confident that this premise can be extrapolated to any endoscopy unit where staff are empowered to deliver person-centred care. It is our intention to repeat the <i>15 Steps Challenge </i>and WCCAT in late 2014 to demonstrate the continual process of improvement of increasing effectiveness .<sup>1</sup> <h3>References</h3> 1 McCormack, B, Titchen, A. Critical creativity: melding, exploding, blending. <i>Educational Action Research: an International Journal</i>. 2006;14(2):239–266 2 National Health Service Institute for Innovation and Improvement. <i>Putting Patients First – The Productive Series. </i>Coventry: NHS Institute for Innovation and Improvement. 2012 3 McCormack B, Henderson E, Wilson V, Wright J. Making practice visible: the workplace culture critical analysis tool (WCCAT). <i>Practice Development in Health Care</i> 2009;8(1):28–43 4 McCormack B, McCance, T. <i>Person-Centred Nursing Theory and Practice</i>. Sussex, Wiley-Blackwell. 2010 5 Garbett R, McCormack B. A concept analysis of practice development. <i>NT Research.</i> 2002;7(2):87-100 <h3>Disclosure of Interest</h3> None Declared.
9. Appropriateness of Colonoscopy: Lower Abdominal Pain or Constipation 1
Authors: V De Bosset, J J Gonvers, J P Vader, R W Dubois, B Burnand, F Froehlich
Journal: Endoscopy (1999)

This paper deals essentially with abdominal pain and change in bowel habits (mainly constipation) of at least 2 months' duration without known IBD, GI bleeding or symptoms compatible with dyspepsia. In the literature, lower and upper GI endoscopy play a secondary role in the diagnosis of abdominal pain or of change in bowel habits (mainly constipation).
Aquaporin-1 facilitates angiogenic invasion in the pathological neovasculature that accompanies cirrhosis
Authors: Robert C. Huebert, Meher M. Vasdev, Uday Shergill, Amitava Das, Bing Q. Huang, Michael R. Charlton, Nicholas F. LaRusso, Vijay H. Shah
Journal: Hepatology (2010)

Increasing evidence suggests that hepatic fibrosis and pathological angiogenesis are interdependent processes that occur in parallel. Endothelial cell invasion is requisite for angiogenesis, and thus studies of the mechanisms governing liver endothelial cell (LEC) invasion during cirrhosis are of great importance. Emerging research implicates amoeboid-type motility and membrane blebbing as features that may facilitate invasion through matrix-rich microenvironments. Aquaporins (AQPs) are integral membrane water channels, recognized for their importance in epithelial secretion and absorption. However, recent studies also suggest links between water transport and cell motility or invasion. Therefore, the purpose of this study was to test the hypothesis that AQP-1 is involved in amoeboid motility and angiogenic invasion during cirrhosis. AQP-1 expression and localization was examined in normal and cirrhotic liver tissues derived from human and mouse. AQP-1 levels were modulated in LEC using retroviral overexpression or small interfering RNA (siRNA) knockdown and functional effects on invasion, membrane blebbing dynamics, and osmotic water permeability were assayed. Results demonstrate that AQP-1 is up-regulated in the small, angiogenic, neovasculature within the fibrotic septa of cirrhotic liver. AQP-1 overexpression promotes fibroblast growth factor (FGF)-induced dynamic membrane blebbing in LEC, which is sufficient to augment invasion through extracellular matrix. Additionally, AQP-1 localizes to plasma membrane blebs, where it increases osmotic water permeability and locally facilitates the rapid, trans-membrane flux of water. Conclusion: AQP-1 enhances osmotic water permeability and FGF-induced dynamic membrane blebbing in LEC and thereby drives invasion and pathological angiogenesis during cirrhosis. Hepatology 2010
Abstract 5631: The effect of pomegranate extract dose on prostate cancer growth in a carbohydrate restricted mouse xenograft model
Authors: Michael R. Abern, Elizabeth M. Masko, Chenwei Wu, Alexis R. Gaines, Salvatore Pizzo, Stephen J. Freedland
Journal: Cancer Research (2012)

Abstract Introduction: Preclinical studies have shown that dietary carbohydrate restriction slows prostate tumor growth in multiple xenograft models in part due to a reduction insulin-like growth factor (IGF) axis signaling. Pomegranate extract (PE) has been shown to slow prostate tumor growth in-vitro and in vivo similarly through this pathway, as well as decrease markers of angiogenesis and inflammation. In this study, we determined the dose-response of PE on prostate tumor growth in the setting of dietary carbohydrate restriction in a slow-growing mouse xenograft model. For this study, we chose a standardized PE (POMx, Pom Wonderful, Los Angeles, CA), at doses which are easily translatable to human equivalents. Materials and Methods: Male athymic nude mice housed 5 per cage (n = 130) were subcutaneously injected with 1 × 10^5 LAPC-4 cells after a 10 day acclimation period. 14 days post-injection, all mice were all placed on an ad-libitum no-carbohydrate ketogenic diet (NCKD: 83% fat, 0% carbohydrate, 17% protein) (day 0). Each cage was randomly assigned to 1 of 4 doses of PE (placebo = 0 mg, low dose = 2.62 mg, intermediate dose = 5.25mg, or high dose = 7.87mg) suspended in 0.2 mL of PBS delivered via oral gavage 5 days per week. These doses are equivalent to 0, 1, 2, or 3 POMx capsules/day consumed by a 70 kg human. Mice will be sacrificed when tumors reach ≥1,000 mm^3. Results: At randomization, there were no differences in median body weight among groups (p = 0.623). Currently, at day 32, overall survival is decreased in the placebo group (hazard ratio 2.26, 95% confidence interval, 0.83 - 6.10, p = 0.109) relative to the low dose PE group with no survival differences among PE groups. Median tumor volumes for the placebo group are 83.3mm^3, compared to 74.5mm^3, 76.3mm^3, and 70.1mm^3 for the low, intermediate, and high PE doses respectively, which are not statistically different (p = 0.98). Conclusions: Preliminary data show a trend toward improved survival with the combination of an NCKD and PE at the selected doses. Currently, tumor volumes are not significantly different, however completed results will be presented. 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 5631. doi:1538-7445.AM2012-5631
Therapy of Infectious Diseases
Authors: Elias Abrutyn
Journal: Annals of Internal Medicine (2003)

Medical Writings: Book Notes7 October 2003Therapy of Infectious DiseasesElias Abrutyn, MDElias Abrutyn, MDFrom Drexel University College of Medicine, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-7-200310070-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Baddour L and Gorbach SL, eds. 815 pages. Philadelphia: WB Saunders; 2003. $99.00. ISBN 072168145X. Order phone 800-545-2522.Field of medicine: Infectious diseases.Format: Hardcover book.Audience: Clinicians treating patients with infectious diseases, including infectious diseases fellows and faculty as well as laboratory staff who need to understand current infectious diseases therapeutics.Purpose: To provide information on current infectious diseases therapeutics, with attention to antibiotics introduced in recent years. The book also addresses increasing antibiotic resistance; provides busy clinicians with easy access to detailed treatment recommendations, key background information, and recent references; and covers updated recommendations on prevention.Content: This ... Author, Article, and Disclosure InformationAffiliations: From Drexel University College of Medicine, Philadelphia, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 October 2003Volume 139, Issue 7Page: 606KeywordsAntimicrobialsAntiretroviral therapyCentral nervous systemHIVInfectious diseasesLower respiratory tract infectionsRespiratory systemRespiratory system proceduresSkin infectionsZoonoses ePublished: 7 October 2003 Issue Published: 7 October 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Diagnosis of Tricuspid Insufficiency
Authors: GONZALO SEPULVEDA, DANIEL S. LUKAS
Journal: Circulation (1955)

In a series of 146 patients with mitral stenosis studied by cardiac catheterization, 60 were found to have right atrial pressure curves diagnostic of tricuspid insufficiency. The clinical and hemodynamic features of these patients are reviewed. The oft-cited, classic manifestations of tricuspid insufficiency were found with relative infrequency and the diagnosis had been made clinically in less than one fourth of the cases. Modification of criteria for the diagnosis of tricuspid insufficiency is suggested.
Abortion and Coagulation by Prostaglandin
Authors: William R. Bell
Journal: JAMA (1973)

The coagulation and fibrinolytic systems of 20 patients undergoing abortion with intra-amniotically instilled dinoprost tromethamine (prostaglandin F<sub>2</sub>α were studied. In contrast to the technique of intraamniotically instilled hypertonic sodium chloride solution, in the patients receiving dinoprost tromethamine, no appreciable alteration in coagulation or fibrinolytic systems was observed. The alterations in platelet count, fibrinogen concentration, and fibrinogen-fibrin degradation products seen with intra-amniotically given hypertonic sodium chloride solution are possibly due to the destructive action of the high concentration of sodium chloride on the intra-amniotic contents.
Levodopa in the Treatment of Parkinsonism
Authors: George C. Cotzias
Journal: JAMA (1971)

Today's account will indicate first that levodopa (L-dopa) differs from previous drugs in that it may be slowing the progressive deterioration in some patients with parkinsonism. We will then discuss some difficulties encountered by others which have been rare with us. We will consider some questions raised by our own continuous administration of first DL-dopa, and then levodopa. Scientific scrutiny of these questions includes testing of experimental animals so that we can formulate further clinical investigations. We will finally indicate that we do not know the mechanisms of action of levodopa and will propose a hypothesis which may perhaps be testable. <h3>Clinical Considerations</h3> Our clinical experience with levodopa covers to date 48 patients with parkinsonism, as follows: 12 with chronic manganese poisoning including two with muscular dystonia, seven with spontaneous dystonias, one with a dystonia following cyanide poisoning, one hemiplegic, and 20 neurologically normal persons. Most of the latter were
Hyponatremia Responsive to Fludrocortisone Acetate in Elderly Patients After Head Injury
Authors: SAN-E ISHIKAWA
Journal: Annals of Internal Medicine (1987)

Severe hyponatremia developed within 2 weeks of head injuries in three elderly patients. Before the head injuries occurred, normal serum levels of sodium had been found in two of the three patients. Hyponatremia (105 to 117 meq/L) was associated with persistently increased urinary excretion of sodium. The patients appeared dehydrated and had lost weight. The mean plasma level of antidiuretic hormone was 5.0 ±1.6 (SD) pg/mL, which was relatively high despite decreased osmolality. Plasma renin activity was suppressed to 0.25 ±0.13 ng/mL h, and plasma aldosterone levels measured low-normal or normal. Plasma renin activity and plasma aldosterone levels remained unchanged after the patients were given furosemide and placed in an upright position. The hyponatremia promptly resolved after the administration of fludrocortisone acetate, 0.1 to 0.4 mg/d. These observations indicate that severe hyponatremia occurs in elderly persons rapidly after head injuries, that it responds well to mineralocorticoid hormone therapy, and that both central nervous system and renal components may be involved in the mechanisms of action of the disorder.
The Feasibility of Universal Long-Term–Care Benefits
Authors: Rosalie A. Kane, Robert L. Kane
Journal: New England Journal of Medicine (1985)

CANADA'S expansion of its program of universal health insurance to include long-term care offers valuable insights for similar broad-based efforts in the United States. Most Canadian provinces provide universal long-term–care benefits that include health care, personal care, and social services for functionally impaired persons. Such services are offered both in residential settings, such as nursing homes, and in the community. Eligibility is based on functional impairment without regard to the individual's income; co-payments, if levied, are designed to leave even the poorest pensioner with a small disposable income.In the fall of 1981, we undertook a two-year study of long-term . . .
Recurrent Aseptic Meningitis in an Elderly Man
Authors: Pasquale F. Finelli
Journal: JAMA (1976)

NONINFECTIOUS meningeal involvement in systemic lupus erythematosus (SLE) occurs in approximately 8% of cases and is almost always associated with diffuse neurological deficits. The only well-documented case of aseptic meningitis without other neurologic or psychiatric symptoms was that of a patient with known SLE in whom the VDRL test, fluorescent treponemal antibody absorption test, antinuclear antibody test, and lupus erythematosus preparation were positive.<sup>1</sup>Aseptic meningitis as a prodromal manifestation of SLE in a seronegative patient has not been described, to our knowledge. We report such a case. <h3>Report of a Case</h3> A 61-year-old man was admitted to David Grant USAF Medical Center in July 1974 with a two-month history of headaches, generalized myalgia, fever, nausea, anorexia, and a weight loss of 6.8 kg (15 lb). Physical examination results were entirely within normal limits. Laboratory tests showed a hematocrit reading of 35.8%, white blood cell (WBC) counts of 3,200 and
Case Studies in Critical Care Medicine
Authors: Marilyn T. Haupt
Journal: JAMA (1985)

This concise text uses a case-study format to highlight the major problems encountered in adult intensive care units. Each chapter begins with a brief discussion of a topic, which is followed by one or more case studies. The reader is then guided through a stepwise, clinically oriented solution. This format, therefore, serves an educational function that is not provided by standard textbooks or by manuals of therapy. The information presented is selective rather than comprehensive. Each chapter is devoted to a broad area of intensive care, such as mechanical ventilation, cardiac arrhythmias, cardiac failure, acute renal failure, or nutritional support. The introduction of each topic and the accompanying case studies are limited to selected clinical situations. Particular attention is paid to frequent, troublesome, or controversial problems. On occasion, however, the approach would be aided by presenting alternative points of view. Examples in which other approaches could be presented include the
Inhibition of Folate Enzymes by Sulfasalazine
Authors: Jacob Selhub, G. Jeelani Dhar, Irwin H. Rosenberg
Journal: Journal of Clinical Investigation (1978)

Sulfasalazine (salicylazosulfapyridine), an agent widely used for the treatment of ileitis and colitis, is also a competitive inhibitor of intestinal folate transport (1, 2). The mechanism of action of sulfasalazine remains uncertain. To further explore the mechanism of sulfasalazine action, the interaction of the drug with the folate recognition site was tested with three enzymes: dihydrofolate reductase, methylenetetrahydrofolate reductase, and serine transhydroxymethylase, each catalyzing a reaction involving a different folate derivative. Each of these enzymes was inhibited by sulfasalazine in the same concentration range as that previously observed to inhibit intestinal folate transport; the kinetic data are consistent with a competitive mode of inhibition. Specificity of inhibition was demonstrated by the finding that the reduction of the pteridine ring of pteroylheptaglutamic acid by dihydrofolate reductase was subject to inhibition, whereas the hydrolysis of the γ-glutamyl peptide side chain by chicken pancreas conjugase was not affected. These results are interpreted to indicate that sulfasalazine interferes with a folate recognition site which is common to these enzymes and to the intestinal transport system. Sulfasalazine, therefore, has certain properties of an antifolate drug.
Adult liver stem cells: bone marrow, blood, or liver derived?
Authors: H A CROSBY
Journal: Gut (2001)

It has been shown in animal models that hepatocytes and cholangiocytes can derive from bone marrow cells.We have investigated whether such a process occurs in humans.Archival autopsy and biopsy liver specimens were obtained from 2 female recipients of therapeutic bone marrow transplantations with male donors and from 4 male recipients of orthotopic liver transplantations from female donors.Immunohistochemical staining with monoclonal antibody CAM5.2, specific for cytokeratins 8, 18, and 19, gave typical strong staining of hepatocytes, cholangiocytes, and ductular reactions in all tissues, to the exclusion of all nonepithelial cells.Slides were systematically photographed and then restained by fluorescence in situ hybridization (FISH) for X and Y chromosomes.Using morphologic criteria, field-by-field comparison of the fluorescent images with the prior photomicrographs, and persistence of the diaminiobenzidene (DAB) stain through the FISH protease digestion, Y-positive hepatocytes and cholangiocytes could be identified in male control liver tissue and in all study specimens.Cell counts were adjusted based on the number of Y-positive cells in the male control liver to correct for partial sampling of nuclei in the 3-micron thin tissue sections.Adjusted Y-positive hepatocyte and cholangiocyte engraftment ranged from 4% to 43% and from 4% to 38%, respectively, in study specimens, with the peak values being found in a case of fibrosing cholestatic recurrent hepatitis C in one of the liver transplant recipients.We therefore show that in humans, hepatocytes and cholangiocytes can be derived from extrahepatic circulating stem cells, probably of bone marrow origin, and such "transdiVerentiation" can replenish large numbers of hepatic parenchymal cells.
Impaired CD40L signaling is a cause of defective IL-12 and TNF-α production in Sézary syndrome: circumvention by hexameric soluble CD40L
Authors: Lars E. French, Bertrand Huard, Maria Wysocka, Ryan Shane, Emmanuel Contassot, Jean-François Arrighi, Vincent Piguet, Silvio Calderara, Alain H. Rook
Journal: Blood (2004)
Foetal Distress in Domiciliary Midwifery
Authors: M. Goodman
Journal: BMJ (1958)

<h3>Background</h3> Idiopathic achalasia is a rare motor disorder of the oesophagus characterised by neuronal loss at the lower oesophageal sphincter. Achalasia is generally accepted as a multifactorial disorder with various genetic and environmental factors being risk-associated. Since genetic factors predisposing to achalasia have been poorly documented, we assessed whether single nucleotide polymorphisms (SNPs) in genes mediating immune response and neuronal function contribute to achalasia susceptibility. <h3>Methods</h3> 391 SNPs covering 190 immune and 67 neuronal genes were genotyped in an exploratory cohort from Central Europe (589 achalasia patients, 794 healthy volunteers (HVs)). 24 SNPs (p&lt;0.05) were validated in an Italian (160 achalasia patients, 278 HVs) and Spanish cohort (281 achalasia patients, 296 HVs). 16 SNPs in linkage disequilibrium (LD) with rs1799724 (r<sup>2</sup>&gt;0.2) were genotyped in the exploratory cohort. Genotype distributions of patients (1030) and HVs (1368) were compared using Cochran–Armitage trend test. <h3>Results</h3> The rs1799724 SNP located between the <i>lymphotoxin-α</i> (<i>LTA</i>) and <i>tumour necrosis factor-α</i> (<i>TNFα</i>) genes was significantly associated with achalasia and withstood correction for testing multiple SNPs (p=1.17E-4, OR=1.41 (1.18 to 1.67)). SNPs in high LD with rs1799724 were associated with achalasia. Three SNPs located in <i>myosin-5B</i>, <i>adrenergic receptor-β-2</i> and <i>interleukin-13</i> (<i>IL13</i>) showed nominally significant association to achalasia that was strengthened by replication. <h3>Conclusions</h3> Our study provides evidence for rs1799724 at the <i>LTA/TNFα</i> locus as a susceptibility factor for idiopathic achalasia. Additional studies are needed to dissect which genetic variants in the <i>LTA</i>/<i>TNFα</i> locus are disease-causing and confirm other variants as potential susceptibility factors for achalasia.
Interleukin 3 as a trophic factor for central cholinergic neurons in vitro and in vivo
Authors: Masahiro Kamegai, Kenji Niijima, Tatsuhide Kunishita, Masatoyo Nishizawa, Matsuo Ogawa, Masasuke Araki, Akira Ueki, Yoshihiro Konishi, Takeshi Tabira
Journal: Neuron (1990)
DNA Methylation Profiling in Asthmatic and Non Asthmatic Nasal Epithelial Cells During Respiratory Virus Infection
Authors: Peter McErlean, Silvio Favoreto, Fabricio Costa, Junquing Shen, Assel Biyasheva, Maria de Fatima Bonaldo, Denise Scholtens, Hehuang Xie, Marcelo B. Soares, Pedro C. Avila
Journal: Journal of Allergy and Clinical Immunology (2013)