tbuckley/cabot-search huggingface dataset:
Methods of Air Disinfection
Authors: J. Plesch
Journal: BMJ (1941)

<h3>Objective</h3> To determine the effect of β-amyloid (Aβ) level on progression risk to mild cognitive impairment (MCI) or dementia and longitudinal cognitive change in cognitively normal (CN) older individuals. <h3>Methods</h3> All CN from the Australian Imaging Biomarkers and Lifestyle study with Aβ PET and ≥3 years follow-up were included (n = 534; age 72 ± 6 years; 27% Aβ positive; follow-up 5.3 ± 1.7 years). Aβ level was divided using the standardized 0–100 Centiloid scale: &lt;15 CL negative, 15–25 CL uncertain, 26–50 CL moderate, 51–100 CL high, &gt;100 CL very high, noting &gt;25 CL approximates a positive scan. Cox proportional hazards analysis and linear mixed effect models were used to assess risk of progression and cognitive decline. <h3>Results</h3> Aβ levels in 63% were negative, 10% uncertain, 10% moderate, 14% high, and 3% very high. Fifty-seven (11%) progressed to MCI or dementia. Compared to negative Aβ, the hazard ratio for progression for moderate Aβ was 3.2 (95% confidence interval [CI] 1.3–7.6; <i>p</i> &lt; 0.05), for high was 7.0 (95% CI 3.7–13.3; <i>p</i> &lt; 0.001), and for very high was 11.4 (95% CI 5.1–25.8; <i>p</i> &lt; 0.001). Decline in cognitive composite score was minimal in the moderate group (−0.02 SD/year, <i>p</i> = 0.05), while the high and very high declined substantially (high −0.08 SD/year, <i>p</i> &lt; 0.001; very high −0.35 SD/year, <i>p</i> &lt; 0.001). <h3>Conclusion</h3> The risk of MCI or dementia over 5 years in older CN is related to Aβ level on PET, 5% if negative vs 25% if positive but ranging from 12% if 26–50 CL to 28% if 51–100 CL and 50% if &gt;100 CL. This information may be useful for dementia risk counseling and aid design of preclinical AD trials.
Tacrolimus ointment is safe and effective in the treatment of atopic dermatitis: Results in 8000 patients
Authors: John Y.M. Koo, Alan B. Fleischer, William Abramovits, David M. Pariser, Calvin O. McCall, Thomas D. Horn, Alice B. Gottlieb, Eileen Jaracz, M. Joyce Rico
Journal: Journal of the American Academy of Dermatology (2005)
Smallpox vaccination for students.
Authors: G D Smith
Journal: BMJ (1977)

Dr Slater is wrong when he states that "Wright3 estimated that a 1°C rise in tempera- ture will increase the estimated blood alcohol concentration by 6.5o/o."Careful scrutiny of Wright's paper shows that he made no such claim.However, in the same proceedings Dubowski4 stated that "it may be well to point out that each 1°C increase in actual alveolar breath exit temperature between 34°C and 37°C would tend to increase a blood alcohol concentration calculated on the basis of an assumed 1:2100 ratio by about 6 50 over the actual level.
TRANSCUTANEOUS AORTIC VALVE IMPLANTATION INCREASES LEFT VENTRICULAR ROTATION ASSESSED BY SPECKLE TRACKING ECHOCARDIOGRAPHY
Authors: Stella Brili, Ilias Stamatopoulos, Maria Misailidou, Ioanna Dima, Kostas Toutouzas, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2014)
The Alteration of Physicians' Orders by Nonphysicians
Authors: Donna M. Meyer
Journal: JAMA (1988)

<h3>To the Editor.—</h3> The article "Alteration of Physicians' Orders by Nonphysicians"<sup>1</sup>addresses a well-documented problem<sup>2,3</sup>that wastes limited health care resources and threatens patient care:<sup>4,5</sup>inappropriate use of clinical laboratory services. As described by Finn et al,<sup>1</sup>the intervention of clinical laboratory scientists (medical technologists) is effective in improving the percentage of appropriate test orders, and we agree. However, we disagree with the authors' conclusions that interventions by technically knowledgeable laboratory scientists constitute "errors in the transmission of information" and "[have] the potential to delay diagnosis, and increase unnecessary testing." On the contrary, the test-ordering process and the clinician-laboratory interface can be improved by these kinds of actions as well as by other strategies, such as clinical laboratory scientists' use of laboratory-triggered algorithms, which have the potential to reduce the time and cost of rendering diagnosis.<sup>6,7</sup> Generally, such interventions now occur on an informed but
Study of Two-Year Rotating Internship
Authors: John Romano
Journal: JAMA (1964)

THISbout our experiences with a two-year internship program in the University of Rochester Medical Center during the years 1949 through 1961. It is a record of 124 interns, 15 women and 109 men. Hopefully, the record of our experiences may be found useful now or in the future for comparative purposes with other programs, particularly as experiments in the design and operation of internships, much neglected aspects in medical education, may be anticipated. Cumulative experience of the author in a number of university medical centers heightened by the experience during World War II led to the notion of a new type of rotating internship of two years' duration which would attempt to correct some of the deficiencies of the traditional one-year internship. In Rochester (1946-1948) this idea was discussed with the dean, the hospital medical director, and the chairmen of the clinical departments. It led, in July, 1949, to the
Recording diastolic blood pressure in pregnancy: Authors' reply
Authors: I. Perry, D G Beevers, D M Luesley
Journal: BMJ (1991)

<h3>Abstract</h3> Plants release volatiles in response to caterpillar feeding that attract natural enemies of the herbivores, a tri-trophic interaction which has been considered an indirect plant defence against herbivores. The caterpillar-induced plant volatiles have been reported to repel or attract conspecific adult herbivores. Apple seedlings infested with <i>Pandemis pyrusana</i> larvae uniquely release five compounds (benzyl alcohol, benzyl nitrile, phenylacetaldehyde, indole, and (<i>E</i>)-nerolidol). These compounds and other known caterpillar-induced plant volatiles were tested to investigate the response of both herbivores and natural enemies. In field tests, binary blends of benzyl nitrile and acetic acid or 2-phenylethanol and acetic acid attracted a large number of conspecific male and female adult moths. On the other hand, a ternary blend of benzyl nitrile, 2-phenylethanol and acetic acid attracted the largest numbers of the general predator, the common green lacewing, <i>Chrysoperla carnea.</i> This study provides the first record of caterpillar-induced plant volatile attraction to conspecific adult herbivores as well as predators under natural conditions.
The GMC: expediency before principle
Authors: Richard Smith
Journal: BMJ (2004)

Further difficult reforms are essential 

T he General Medical Council (GMC) has been submitted to a highly detailed forensic examination and found severely wanting. It has broken its contract with the public—to protect patients in exchange for the privilege of self regulation—and if it wants to survive it must now launch into a further round of reforms, even while those of the last few years are still being implemented.

The forensic examination has been conducted by Dame Janet Smith as part of her inquiry into the issues arising from the case of Harold Shipman, a general practitioner who murdered over 200 of his patients. Her fifth and final report, which is over 1000 pages long and makes 109 recommendations, examines the performance of bodies responsible for monitoring primary care and makes recommendations on how better to protect patients in the future.1 I want to concentrate here on what Dame Janet said about the GMC.

Dame Janet's examination of the GMC has been complicated by her prey being on the move. But if the leaders of the council ever hoped that they could reassure her that she need not worry because reforms were under way they must have been seriously disappointed. She finds deficiencies not only in the “old” fitness to practise procedures but also in …
Intravenous insulin infusion in diabetic emergencies.
Authors: R D Leslie, J D Mackay
Journal: BMJ (1978)

Continuous intravenous insulin and dextrose infusions were used in managing various diabetic emergencies. Standard and constant rates of insulin and dextrose infusion resulted in satisfactory control of blood glucose concentrations during labour, after major surgery, and in patients recovering from ketoacidosis (average insulin infusion rates 1, 2, and 3 U/h respectively). Higher infusion rates were used to correct or prevent ketoacidosis in pregnant diabetic women who had received steroids and sympathomimetic agents. The infusion method is simple, reliable, and flexible, and may help to simplify management of diverse types of diabetic emergencies.
Low‐dose arabinosyl cytosine in acute leukemia after a myelodysplastic syndrome and in elderly leukemia
Authors: Emilio P. Alessandrino, Ester Orlandi, Ercole Brusamolino, Mario Lazzarino, Carlo Bernasconi
Journal: American Journal of Hematology (1985)

Abstract Low‐dose arabinosyl cytosine (ARA‐C) was tested in 15 patients with acute leukemia after a myelodysplastic syndrome (MDS) and in six elderly patients with acute nonlymphoid leukemia (ANLL). The drug was given subcutaneously at 10 mg/m 2 , every 12 hr for 2 weeks, every 28 days. The overall response rate was 19% (one complete remission, three partial responses), and the median duration of response was 4 months. No particular features at diagnosis were predictive of response. Pancytopenia and marrow hypoplasia occurred after 44 (78%) of 56 courses of therapy and were more severe in nonresponders. Four patients died during the aplasia following ARA‐C therapy. Subcutaneous low‐dose ARA‐C was of limited benefit and bore a noticeable hematologic toxicity.
Unusual Pattern of lndium-111 Leukocyte Distribution in a Patient with Widespread Infection
Authors: MARIA A. FAWCETT, H DANIEL FAWCETT
Journal: Clinical Nuclear Medicine (1989)

A 44-year-old diabetic female with extensive superficial, intrathoracic, and intra-abdominal abscesses had an unusual pattern in the pelvic region caused by tracking of abscesses through both sciatic foramina into the buttocks.
Tuberculin Skin Testing
Authors: William Macmillan Rodney
Journal: JAMA (1978)

To the Editor. —  I should like to comment on the negativity of the tuberculin skin test performed on the patients described in the article entitled Transtracheal Aspiration in Diagnosis of Sputum-Spear—Negative Tuberculosis (238:1037-1040, 1977). I do not see mention made of control skin tests placed simultaneously with the tuberculin skin test. This would be of interest, as anergy is a frequent phenomenon in the chronically ill and debilitated patient. One recent study has indicated a 29% negative cellmediated immunity phenomenon in a hospitalized population. 1 The question of PPD false-negative vs anergy might be illuminated by (1) assessment of malnutrition criteria such as triceps skin fold or total protein and albumin levels and (2) placement of streptokinase-streptodornase skin test controls.  This information is frequently available from the charts of hospitalized patients and may be of interest to the readers of this study.
P17.66 * GLIOMATOSIS CEREBRI WITH MALIGNANT TRANSFORMATION TO A LONG-SURVIVAL GLIOBLASTOMA MULTIFORME AFTER TEN YEARS OF EVOLUTION
Authors: J. Perez, J. Fernandez, T. Ribas, P. Barrio, A. Mostaza
Journal: Neuro-Oncology (2014)

OBJECTIVES: We report an unusual case of gliomatosis cerebri which transformed into a high-grade glioma, both of them with a long-survival period. We emphasize in the lack of large studies about the biological and clinical behavior of these tumors, impeding the improvement of therapeutic options and our knowledge. METHODS: A 34-year-old male came to consulting room suffering an intense pain located around the right mastoid apophysis, with no neurological deficit associated. In the Magnetic Resonance Image (‘MRI’) it is shown a left frontal cortico-subcortical mass with no enhancing-image and not well-defined edges. This image was not initially related to the clinical process of the patient. The surgery was performed successfully and the pain was solved. Once the mass was diagnosed as a gliomatosis cerebri, the patient received adjuvant treatments and, after 10 years of uneventful consultations he referred headache and showed a nominal dysphasia. The ‘MRI’ and ‘SPECT’ confirmed the malignant transformation of the left frontal lesion into a high-grade glioma, without cerebroespinal fluid dissemination and/or multifocal progression. This mass was removed in 2011 guided with 5-ALA, and the post-operative period had not any complications. The patient received new cycles of chemotherapy and radiotherapy and, after 3 years of progression-free survival and 14 years of overall survival since the first diagnosis, the patient keeps a high-quality of life, with a Karnofsky Performance Status of 100. RESULTS: The first sample showed slight architectural changes in the white matter with higher cellular density and atypical cells which followed the myelinated bands. There was no endovascular proliferation and/or necrosis. It was positive for p53. The second sample showed all the criteria for glioblastoma multiforme, with predominance of gemistocytic cells. It was also positive for p53 and its MIB-1 index was over 20%. Currently, we are concluding the tests for IDH-1 and IDH-2 mutations. To our knowledge, this is the case with a longer survival period between both diagnosis. CONCLUSIONS: The gliomatosis cerebri is not a well-known entity and its biological mechanisms are unknown yet. Its survival is very changeable, from weeks to several years. Once the malignant transformation happens, the survival of these patients is meaningfully reduced. In our case, maybe because of the immunohistochemycal characteristics and/or not being a diffuse lesion, the patient is having a very long-surveillance period for both lesions, showing us that there are many concepts that we have to learn about the biological behavior of the tumors.
Guidance has high priority in interventional procedures: Objective evidence needs to be provided
Authors: Anton E Joseph
Journal: BMJ (2004)

EDITOR—The views expressed by Dent et al about new interventional procedures and about interventional clinicians are disturbing, particularly in view of the positions held by the authors.1 Response from clinicians has been very poor. Is it apathy or acceptance?

Problems with interventional procedures were covered comprehensively, but the solutions proposed were for clinicians more training to evaluate procedures, for manufacturers to do more …
Abstract LB-44: Persistent androgen ablation promotes enhanced neuroendocrine features in Pten-deficient prostate cancer
Authors: David J. Mulholland
Journal: Cancer Research (2014)

Abstract Background: The development of potent androgens has increased survival of CRPC patients. Clinical data also suggests that the number of neuroendocrine (NE) CaPs frequently found in soft tissue metastasis has steadily increased over recent years and may be correlated with the use of potent androgen receptor (AR) inhibitors such as Enzalutamide or Aberaterone Acetate. These data suggest that NE cells may escape hormonal castration and that active inhibition of the AR may promote aggressive disease. Approach. To investigate this hypothesis, we have taken both genetic and pharmacological approaches to oppose AR signaling in Pten deficient CaP. Surgical castration of Pten-null mutant mice (Pb-Cre+;PtenL/L) led to both an increased EMT signature but also enhanced content of NE cells that were Synaptophysin+ and Pten-low/null. Chronic Enzalutamide treatment (4 wks., 10 mg/kg/d) promoted an increased percentage Synaptophysin+ cells, an observation that was potentiated when coinciding with surgical castration. Interestingly, the highest potentiation of NE cells was in the proximal anterior region of Pten-null mice. Consistent with our previous results, epithelial deletion of AR signaling in Pten-null epithelium (Pb-Cre+;PtenL/L;ArL/Y) did not prevent CaP progression under surgical castrate conditions. Moreover, compared to Pten-null mutants, Pten-null;Ar-null mutants showed an enhanced stem cell signature (p63+ cells, LSChigh subpopulation) but also marked increase content of NE cells upon both surgical castration and chronic Enzalutamide treatment (4-8 wks., 10 mg/kg/d). To consider whether total systemic ablation of the AR signaling axis could impact progression, resected Pten-null explants (“chuncks”) were isolated from Pb-Cre+;PtenL/L mutants and transplanted to the kidney capsule of Tfm;Rag1-null mice, immune incompetent hosts that are genetically null for Ar. Consistent with our hypothesis, Tfm;Rag1-null mutants showed more NE cells in explants than those transplanted to control AR intact control (Rag1-null) mice. Conclusion: Chronic blockade of the AR signaling axis results in a poorly differentiated phenotype characterized by increased stemness and enhanced NE phenotype. Citation Format: David J. Mulholland. Persistent androgen ablation promotes enhanced neuroendocrine features in Pten-deficient prostate cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-44. doi:10.1158/1538-7445.AM2014-LB-44
Letter: Lesser curve necrosis after proximal vagotomy.
Authors: S J Hefferman
Journal: BMJ (1976)

Polyuria in paroxysms of tachycardia SIR,-Your expert's explanation of the polyuria in paroxysms of tachycardia (8 November, p 339) is incomplete and may be incorrect.Wood' was attracted by the hypothesis that polyuria is the result of a transient diabetes insipidus.Thus the diuresis may be related to left atrial distention, non-osmotic stimulation of the baroreceptors, and subsequent anti- diuretic hormone inhibition.2 3 This does not exclude other possible mechanisms, but it bears no direct relationship to cardiac output and renal perfusion if the attack is not a pro- longed one.The polyuria is immediate but bladder emptying may be delayed.
Recognition and Management of Smoke Inhalation
Authors: James R. Webster, Margaret M. McCabe, Mary Karp
Journal: JAMA (1967)

In spite of its significance, smoke inhalation has received little attention in the medical literature. Three representative case histories demonstrate the variable course of this entity and the need for individualized care of the victims. Of particular importance is recognition of the 6- to 48-hour latent period which may ensue before complications of acute bronchial obstruction, pneumonia, pulmonary edema, and eventual cardiopulmonary failure develop. Management may require tracheostomy, prolonged intermittent positive-pressure breathing with appropriate concentrations of oxygen and high humidity, and, when indicated, administration of systemic antibiotics and steroids. Frequent arterial blood gas measurements are essential for proper evaluation in these cases, both to delineate the status of the patients and to guide and determine the effectiveness of therapy. If victims of smoke inhalation can be managed through the acute phases of their illness, they often make a complete recovery.
Insulin resistance is associated with a higher risk of hepatocellular carcinoma in cirrhotic HIV/HCV-co-infected patients: Results from ANRS CO13 HEPAVIH
Authors: Dominique Salmon, Firouzé Bani-Sadr, Marc-Arthur Loko, Hind Stitou, Anne Gervais, Jacques Durant, Eric Rosenthal, Yann Quertainmont, Karl Barange, Daniel Vittecoq, Michka Shoai-Tehrani, Muriel Alvarez, Maria Winnock, Jean Claude Trinchet, François Dabis, Philippe Sogni
Journal: Journal of Hepatology (2011)
Sharpening Occam's razor: Is there need for a hand-signing stage prior to vocal communication?
Authors: Conrado Bosman, Vladimir López, Francisco Aboitiz
Journal: Behavioral and Brain Sciences (2005)

We commend Arbib for his original proposal that a mirror neuron system may have participated in language origins. However, in our view he proposes a complex evolutionary scenario that could be more parsimonious. We see no necessity to propose a hand-based signing stage as ancestral to vocal communication. The prefrontal system involved in human speech may have its precursors in the monkey's inferior frontal cortical domain, which is responsive to vocalizations and is related to laryngeal control.
Cultured neonatal rat cardiac myocytes and fibroblasts do not synthesize renin or angiotensinogen evidence for stretch-induced cardiomyocyte hypertrophy independent of angiotensin II
Authors: C van Kesteren
Journal: Cardiovascular Research (1999)

Objective: The hypertrophic response of cardiomyocytes exposed to mechanical stretch is assumed to depend on the release of angiotensin (Ang) II from these cells. Here we studied the synthesis of renin–angiotensin system (RAS) components by cardiac cells under basal conditions and after stretch. Methods: Myocytes and fibroblasts were isolated by enzymatic dissociation from hearts of 1–3-day-old Wistar rat strain pups, grown for 1 day in serum-supplemented medium and then cultured in a chemically defined, serum-free medium. Medium and cell lysate were collected 5 days later or after exposure of the cells to cyclic stretch for 24 h. Prorenin, renin and angiotensinogen were measured by enzyme-kinetic assay; Ang I and Ang II were measured by radioimmunoassay after SepPak extraction and HPLC separation. Results: Prorenin, but none of the other RAS components, could be detected in the medium of both cell types. However, its levels were low and the Ang I-generating activity corresponding with these low prorenin levels could not be inhibited by the specific rat renin inhibitor CH-732, suggesting that it was most likely due to bovine and/or horse prorenin sequestered from the serum-containing medium to which the cells had been exposed prior to the serum-free period. When incubated with Ang I, both myocytes and fibroblasts generated Ang II in a captopril-inhibitable manner. Myocyte and fibroblast cell lysates did not contain prorenin, renin, angiotensinogen, Ang I or Ang II in detectable quantities. Stretch increased myocyte protein synthesis by 20%, but was not accompanied by Ang II release into the medium. Conclusion: Cardiac myocytes and fibroblasts do not synthesize renin, prorenin or angiotensinogen in concentrations that are detectable or, if not detectable, high enough to result in Ang II concentrations of physiological relevance. These cells do synthesize ACE, thereby allowing the synthesis of Ang II at cardiac tissue sites when renin and angiotensinogen are provided via the circulation. Ang II is not a prerequisite to observe a hypertrophic response of cardiomyocytes following stretch.