tbuckley/cabot-search huggingface dataset:
Pediatric palliative care in the community
Authors: Erica C. Kaye, Jared Rubenstein, Deena Levine, Justin N. Baker, Devon Dabbs, Sarah E. Friebert
Journal: CA A Cancer Journal for Clinicians (2015)

Answer questions and earn CME/CNE Early integration of pediatric palliative care (PPC) for children with life‐threatening conditions and their families enhances the provision of holistic care, addressing psychological, social, spiritual, and physical concerns, without precluding treatment with the goal of cure. PPC involvement ideally extends throughout the illness trajectory to improve continuity of care for patients and families. Although current PPC models focus primarily on the hospital setting, community‐based PPC (CBPPC) programs are increasingly integral to the coordination, continuity, and provision of quality care. In this review, the authors examine the purpose, design, and infrastructure of CBPPC in the United States, highlighting eligibility criteria, optimal referral models to enhance early involvement, and fundamental tenets of CBPPC. This article also appraises the role of CBPPC in promoting family‐centered care. This model strives to enhance shared decision making, facilitate seamless handoffs of care, maintain desired locations of care, and ease the end of life for children who die at home. The effect of legislation on the advent and evolution of CBPPC also is discussed, as is an assessment of the current status of state‐specific CBPPC programs and barriers to implementation of CBPPC. Finally, strategies and resources for designing, implementing, and maintaining quality standards in CBPPC programs are reviewed. CA Cancer J Clin 2015;65:315–333. © 2015 American Cancer Society.
Fluoridation of water supplies
Authors: D. Coggon, C. Cooper
Journal: BMJ (1999)

The British government has recently announced a new expert review of fluoride and health with a view to strengthening the legislation that underpins fluoridation of water supplies if the findings are supportive.1 The epidemiological evidence that fluoride protects against dental caries is overwhelming, but in England and Wales less than 10% of the population receives fluoridated water,2 and proposals to extend the coverage provoke strong opposition from a vociferous minority who view the intervention as hazardous and unjustified. The debate raises both scientific and ethical questions.

The scientific challenge is to quantify reliably the benefits and risks from fluoridation as compared with alternative strategies for preventing caries. Early surveys found that among children rates of decayed, missing, or filled teeth were some 50% lower in places with water fluoride concentrations of about 1 ppm than in those where they were 0.1 ppm or less.3 These differences …
Refusal of ECT by a patient with recurrent depression, psychosis, and catatonia [clinical conference]
Authors: John Boronow, Anne Stoline, Steven S. Sharfstein
Journal: American Journal of Psychiatry (1997)

The patient, Z, was a 36-year-old white man with an 8-year history of psychiatric symptoms, including psychotic, depressive, and obsessive-compulsive features. He was transferred to a private psychiatric hospital for treatment of catatonia that did not respond to a brief hospitalization on the psychiatric unit of a general hospital. The informants for the history were the patient, his father, and one brother. Few previous medical records were available.
Abstract 11559: The Relative Atrial Index - A Transthoracic Echocardiographic Indicator of Intracardiac Shunt Status Pre and Post Amplatzer Atrial Septal Defect Closure
Authors: Tegan E. Draheim, Natalie F. Kelly, Sudhir Wahi, Stephen V. Cox, Darren L. Walters, Darryl J. Burstow, Gregory M. Scalia
Journal: Circulation (2011)

INTRODUCTION: The Relative Atrial Index (RAI) has been shown to be a reliable indicator of intracardiac shunting. The suggested normal cut-off is RAI  0.92 highly predictive of a...
Website of the week: Earthquake disaster in Turkey
Authors: A. Berger
Journal: BMJ (1999)

From the first unconfirmed reports of 250 people believed dead in Turkey on 17 August to official figures of 14 000-18 000 dead just a week later, the Turkish earthquake disaster has hit media and humanitarian aid websites alike. Both the International Red Cross (www.ifrc.org/news/specials/turkey) and Medecins Sans Frontieres (www.msf.org/projects/turkey) offer wide coverage with daily …
Socioeconomic correlates of hospitalization, medical visits and utilization of diagnostic tests in asthmatic children in Poland
Authors: Jan E. Zejda, Grzegorz M. Brozek, Irena Smolka
Journal: European Respiratory Journal (2011)

A recent (2010) population-based questionnaire survey of 4535 children aged 5-15 years in Katowice District, Poland yielded 186 cases (3.9%) of physician-diagnosed asthma. In the last 12 months 5.9% of asthmatic children underwent respiratory hospitalization and 44.0% were seen by physician, 30.6% had spirometry, and 24.7% skin prick tests, and all of those outcomes strongly depended on asthma attacks in the last 12 months. The goal of the study was to find out if other than health-related factors could also explain the examined outcomes. In univariate analyses hospitalization was related to age (p=0.007), medical visits to age (p=0.009), spirometry to rural residence (p=0.007), skin prick tests to age (p=0.001) and number of siblings (p=0.01). The identified correlates were tested by a multivariate regression - the table shows logistic Odds Ratios (and 95% CIs) if p=<0.1:

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Clinical status of asthmatic children and their young age are important determinants of utilization of medical care and diagnostic procedures. The effect of rural residence and family size may reflect a better maternal care over a sick child and/or better compliance with medical advice – in both settings (rural and urban) diagnostic tests require time consuming arrangements with specialized centers, usually located at a distance from family physicians' surgeries.
Vinblastine in Neoplastic Disease Midwest Cooperative Chemotherapy Group
Authors: Thomas L. Wright, John Hurley, Donald R. Korst, Raymond W. Monto, Robert J. Rohn, John J. Will, John Louis
Journal: Cancer Research (1963)

Summary  In a cooperative study by members of the Midwest Cancer Chemotherapy Group, 265 patients with neoplastic disease were treated with vinblastine to determine its spectrum of activity as an antineoplastic drug.  The best and most frequent responses were obtained in patients with Hodgkin9s disease, often after they were refractory to currently available modes of therapy.  Patients with other types of neoplastic disease occasionally obtained worth-while objective responses with this agent, but these occurred infrequently.  VLB is a relatively safe oncolytic agent when used with proper precautions. The dose is variable, and it is suggested that the optimum therapeutic dose is that quantity which will produce mild leukopenia without severely depressing the bone marrow or inducing other side effects. Recovery from leukopenia is usually prompt except with the severest toxicity.
Effect of treatment on exercise endurance tolerance and ventilatory efficiency in patients with pulmonary arterial hypertension (PAH)
Authors: Dario Martolini, Paolo Onorati, Gabriele Valli, Alessandro Maria Ferrazza, Paolo Marinelli, Mattia Internullo, Liborio Sardo, Cristina Gambardella, Beatrice Pezzuto, Carmine Dario Vizza, Paolo Palange
Journal: European Respiratory Journal (2011)

Incremental CardioPulmonaryExercise Test (CPET) or 6-Minute Walking Test, (69MWT) are utilized for the evaluation of Pulmonary Arterial Hypertension (PAH) patients (pts), although the parameters obtained (e.g. peak oxygen uptake -V9O2Peak - and walking distance, respectively) have a different predictive value, depending on outcomes of interest (e.g. prognosis, response to therapy). We evaluated the effect of treatment on principal indexes obtained during CPET, constant work rate test on cycle ergometer (CWR) (e.g. endurance time, TLim), and 69MWT.   Methods:  Nine naive PAH pts (age 41±15 SD years; meanPAP 51±13 SD mmHg) underwent, before (PRE) and after (POST) treatment, CPET, CWR (80% max work load at PRE-CPET) and 69MWT. V9O2, CO2 output (V9CO2), ventilation (V9E), heart rate (HR) and other derived parameters (V9E/V9CO2) were measured breath-by-breath (Quark b2, COSMED, Rome, Italy); PRE- and POST- values at peak and at isotime were compared (paired t-test).   Results:  During CWR, POST-TLim resulted significantly longer than PRE-TLim (POST-TLim 11924”± 6907” vs PRE-TLim 5938”±3903”, p   Conclusions:  The better POST-treatment exercise tolerance in PAH pts seems to be linked to a ventilatory efficiency improvement, and the parameters obtained at CWR and 69MWT, compared to CPET, appear to be more sensible to the effect of medical treatment.
Calcium Channel Blocking Agents and Risk of Cancer in Patients With Coronary Heart Disease 11This study was supported by Boehringer-Mannheim Ltd., Mannheim, Germany.
Authors: Shimon Braun, Valentina Boyko, Solomon Behar, Henrietta Reicher-Reiss, Shlomo Laniado, Elieser Kaplinsky, Uri Goldbourt
Journal: Journal of the American College of Cardiology (1998)
QUANTITATIVE PETTENKOFER VALUES IN BLOOD WITH SPECIAL REFERENCE TO HEPATIC DISEASE
Authors: Leonard G. Rowntree, Carl H. Greene, Martha Aldrich
Journal: Journal of Clinical Investigation (1927)

So long as there was not a satisfactory method of determining quan- titatively the level of the bile acids in the blood it was practically impossible to ascertain the part these substances play in disease.Since the bile acids have unusual properties and are physiologically important in the organism, it is highly desirable that something should be known of their quantitative distribution in the blood, tissues, and body fluids, and also of the changes accompanying their altered con- centration.With this in mind one of us (Aldrich) undertook the development of a method for the quantitative determination of bile acids in the blood.The Pettenkofer reaction, although subject to several objections, appeared to offer the best basis for the method.The quantitative adaptation of this reaction, is, in our opinion, of value and is yielding data of considerable significance.That bile acids may occur in the blood after biliary obstruction or intravenous injection was shown by the experiments of Kuihne and Huppert.Various observers have reported qualitative colorimetric tests for bile acids in the blood.Moleschott, Lehmann, Blankenhorn, Gilbert: Chabrol and Benard, Petren and others obtained positive Pettenkofer tests under appropriate conditions.Recently Tashiro, and Herzfeld and Haemmerli have reported partially successful at- tempts to adapt this test to quantitative determinations.Perlzweig and Barron report a new colorimetric test for bile acids, using acetic anhydride and sulphuric acid; Szilard precipitates the bile acids with
106. Functional Human alpha 1 Antitrypsin Secreted from Muscle Transduced by Adeno-Associated Virus (rAAV1) Vector
Authors: Yuanqing Lu, Martha Compbell-Yhompason, Chengwen Li, Terence R. Flotte, Sihong Song
Journal: Molecular Therapy (2004)

Alpha 1 antitrypsin (AAT) is a serine proteinase inhibitor (serpin). The well-known function of this protein is to inactivate neutrophil elastase and to prevent degradation of elastin fibers and other connective tissue components of the alveolar wall AAT deficiency can cause emphysema. The majority of serum AAT is produced in the liver. We have previously shown that therapeutic serum levels (500–800ug/ml) of AAT were achieved by gene delivery to skeletal muscle with recombinant adeno-associated virus serotype 2 (rAAV2) vectors. However, whether murine muscle expressed human AAT is functional remains unclear. In present study, we performed intramuscular injections of five serotypes (1, 2, 3, 4, and 5) of rAAV vectors (1×1011 particles) and showed that rAAV1 mediated the highest hAAT secretion among other serotypes. Immunolocalization confirmed expression of hAAT transgene in skeletal muscle. Importantly, western blot analysis showed that this murine muscle secreted hAAT formed a complex with human neutrophil elastase in dose dependent manner. These results provide strong support for the clinical studies of muscle directed AAT gene therapy.
Long-Term Anti-Ischemic Effects of Angiotensin-Converting Enzyme Inhibition in Patients After Myocardial Infarction fn1fn1This study was presented in part at the 46th Annual Scientific Session of the American College of Cardiology, Anaheim, California, March 1997 and was supported by a grant from Bristol Meyers Squibb, Woerden, The Netherlands.
Authors: Ad F.M. van den Heuvel, Wiek H. van Gilst, Dirk J. van Veldhuisen, Rob J.M. de Vries, Peter H.J.M. Dunselman, J.Herre Kingma
Journal: Journal of the American College of Cardiology (1997)
Influence of acute and chronic graft-versus-host disease on relapse and survival after bone marrow transplantation from HLA-identical siblings as treatment of acute and chronic leukemia [published erratum appears in Blood 1989 Aug 15;74(3):1180]
Authors: KM Sullivan, PL Weiden, R Storb, RP Witherspoon, A Fefer, L Fisher, CD Buckner, C Anasetti, FR Appelbaum, C Badger
Journal: Blood (1989)
Significance of Preradiographic Magnetic Resonance Imaging Lesions in Persons at Increased Risk of Knee Osteoarthritis
Authors: Leena Sharma, Joan S. Chmiel, Orit Almagor, Dorothy Dunlop, Ali Guermazi, Joan M. Bathon, Charles B. Eaton, Marc C. Hochberg, Rebecca D. Jackson, C. Kent Kwoh, W. Jerry Mysiw, Michel D. Crema, Frank W. Roemer, Michael C. Nevitt
Journal: Arthritis & Rheumatology (2014)

Objective Little is known about early knee osteoarthritis (OA). The significance of lesions on magnetic resonance imaging (MRI) in older persons without radiographic OA is unclear. Our objectives were to determine the extent of tissue pathology by MRI and evaluate its significance by testing the following hypotheses: cartilage damage, bone marrow lesions, and meniscal damage are associated with prevalent frequent knee symptoms and incident persistent symptoms; bone marrow lesions and meniscal damage are associated with incident tibiofemoral (TF) cartilage damage; and bone marrow lesions are associated with incident patellofemoral (PF) cartilage damage. Methods In a cohort study of 849 Osteoarthritis Initiative (OAI) participants who had a bilateral Kellgren/Lawrence (K/L) score of 0, we assessed cartilage damage, bone marrow lesions, and meniscal damage using the MRI OA Knee Score, as well as prevalent frequent knee symptoms, incident persistent symptoms, and incident cartilage damage. Multiple logistic regression (one knee per person) was used to evaluate associations between MRI lesions and each of these outcomes. Results Of the participants evaluated, 76% had cartilage damage, 61% had bone marrow lesions, 21% had meniscal tears, and 14% had meniscal extrusion. Cartilage damage (any; TF and PF), bone marrow lesions (any; TF and PF), meniscal extrusion, and body mass index (BMI) were associated with prevalent frequent symptoms. Cartilage damage (isolated PF; TF and PF), bone marrow lesions (any; isolated PF; TF and PF), meniscal tears, and BMI were associated with incident persistent symptoms. Hand OA, but no individual lesion type, was associated with incident TF cartilage damage, and bone marrow lesions (any; any PF) with incident PF damage. Having more lesion types was associated with a greater risk of outcomes. Conclusion MRI‐detected lesions are not incidental and may represent early disease in persons at increased risk of knee OA.
A Small Interventional Device to Occlude Persistently Patent Ductus Arteriosus in Neonates: Evaluation in Piglets11Drs. Neuss and Redel own patents on aspects of the device described in this article and may receive royalties if and when it is marketed.
Authors: RALPH G. GRABITZ, MALTE B. NEUSS, DIERK A. REDEL, JAMES Y. COE, STEFAN HANDT, GÖTZ von BERNUTH
Journal: Journal of the American College of Cardiology (1996)
Uracil in the mammalian genome: roles of the SMUG and UNG DNA glycosylases
Authors: Deborah Barnes, Qian An, Peter Robins, Tomas Lindahl
Journal: Cancer Research (2005)

SY35-1   A major threat to the genetic integrity of living cells comes from endogenous DNA damage, due to the unavoidable exposure of DNA to reactive molecules such as active oxygen and water during normal cellular metabolism. One of the most abundant miscoding DNA lesions is uracil, which can arise in DNA by hydrolytic deamination of cytosine, generating a premutagenic U:G mispair and C to T transition mutations. Uracil may also occur in a U:A base pair through occasional use of dUTP instead of TTP during DNA replication. The repair of uracil in DNA is achieved by means of the base-excision repair pathway, and initiated via excision of uracil by a DNA glycosylase. Multiple uracil-DNA glycosylase enzymes are widely distributed in bacteria, archaea and eukaryotes, signifying the importance of eliminating uracil from the genome. We have previously reported the generation of gene-targeted mice deficient in the ubiquitous Ung uracil-DNA glycosylase. A primary role for Ung during DNA replication was revealed, where slow removal of uracil from misincorporated dUMP resulted in a ∼100-fold increased steady-state level of uracil in the genome of Ung-/- mice. This is consistent with the proliferation-dependent expression of UNG in the mammalian cell nucleus, its direct interaction with PCNA in the replisome, and a major role of Ung in counteracting U:A base pairs. In collaboration with the laboratory of Michael Neuberger (MRC Laboratory of Molecular Biology, Cambridge, UK), Ung was also shown to have a role in resolving U:G lesions, specifically generated by the AID enzyme (activation induced cytidine deaminase) in immunoglobulin variable genes during somatic hypermutation and class switch recombination. In support of this function for Ung in the immune system, we have reported that aging Ung-/- null mice have a greatly increased incidence of B-cell lymphomas. The molecular mechanism of lymphomagenesis remains unclear, although it is in some cases correlated with deregulation of the AID enzyme in Ung-/- tumours; it has yet to be established whether patients with hyper-IgM syndrome due to mutations in the human UNG gene are at an elevated risk of B-cell malignancies. A complementary uracil-excising activity was identified in Ung-deficient mice that acts on premutagenic U:G lesions resulting from genome-wide hydrolytic deamination of cytosine. This second major uracil-DNA glycosylase, which has evolved in insects and vertebrates, is due to the SMUG enzyme, and accounts for the only modest mutator phenotype in Ung-deficient mammalian cells, in contrast to the greatly increased frequency of spontaneous C to T mutations in Ung null mutants of bacteria and yeast. We have now generated stable siRNA-mediated Smug knockdown cell lines and transgenic mice, on both an Ung-proficient and -deficient background, to address: (i) the role of SMUG as an anti-mutator, and (ii) the delineation/overlap of function between the UNG and SMUG uracil-DNA glycosylases, in maintenance of the mammalian genome.
Abstract 6074: Vitamin K Epoxide Reductase Genotype Alters Warfarin Dose Requirements in Pediatric Patients
Authors: Cheryl M Takao, Masato Takahashi, Vera Pravica, Cheryl Barton, Gilbert Burckhart
Journal: Circulation (2008)

Warfarin is an oral anticoagulant used for prevention of thromboembolism in children. Its dosing is difficult due to the narrow therapeutic index &amp; individual variability in effective dosage. Genetic polymorphism in 2 enzymes involved in warfarin metabolism, vitamin K epoxide reductase (VKORC) &amp; cytochrome P450 isoenzyme 2C9 (CYP2C9), have been associated with lower dose requirements in adults. Testing for these polymorphisms is now recommended and being performed to guide dosing in adult patients(pts). Currently there is no information available on these polymorphisms &amp; warfarin dosing in children. To examine the relationship between warfarin dosing &amp; polymorphisms of CYP2C9 &amp; VKORC1 in pediatric patients. Pts 0 –18 years old on warfarin for minimum 2 weeks were included. Data included ethnicity, age, weight, body surface area, gender, indication, dose, INR, target INR, medical illness or medications &amp; adverse effects. Blood sample tested for CYP2C9 &amp; VKORC1 genotypes &amp; correlated with above variables. Dose at time of stable INR was compared to genetic alleles. Multivariate linear regression analysis was performed to identify factors associated with warfarin dosing. 29 pts were studied(62% males). There were 18 Hispanics, 7 Caucasian, 2 African Americans &amp; 2 Mixed ethnicities. Indication for warfarin included Congenital heart disease(CHD) 45% &amp; non CHD 55%. Mean age 5yrs 2mo(6mo-18yrs) &amp; wt 22kg(6.9 – 84). For VKORC1, there were 13 AA(44%), 9 GA(31%), &amp; 7 GG (24%) alleles. For CYP29, 4/23 were *2(17%) &amp; 0 *3 alleles. There was no relationship between ethnicity &amp; VKORC1 alleles. Pts with VKORC1 AA + AG allele required a significantly lower dose/kg(0.10mg/kg) compared to GG allele(0.19mg/kg)(p &lt;0.001) even after adjusting for target INR. In this study, pts with VKORC1 AA + AG alleles require a 47% lower dose/kg compared to pts with GG alleles. This preliminary data suggest that VKORC1 status is an important factor in dosing requirements in pediatric pts. A study using a larger pediatric population is necessary to construct a dosing nomogram based on presence of genetic polymorphism.
Reducing Firearm-Related Harms
Authors: Christine Laine, Darren B. Taichman
Journal: Annals of Internal Medicine (2015)

Letters18 August 2015Reducing Firearm-Related HarmsChristine Laine, MD, MPH and Darren B. Taichman, MD, PhDChristine Laine, MD, MPHSearch for more papers by this author and Darren B. Taichman, MD, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5125-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Jessee cites several sources that support his views about restrictions on firearms research and the effectiveness of strategies to reduce firearm violence. Figures 2 and 3 of the Crime Prevention Research Center report to which he refers do not show that published articles about firearms decreased after the 1996 and 2011 restrictions on the use of government funding for firearms research (1). However, Figure 1 of that report shows an increase from approximately 3 firearms articles per 10 000 medical journal articles in 1985 to 15 per 10 000 articles in 1996 when the Centers for Disease Control and ...Reference1. Lott JR Jr, Whitley JE. Myth: firearms research fell after the NRA restrictions on federal funding. Crime Prevention Research Center. 26 February 2014. Accessed at http://johnrlott.tripod.com/Did_Federal_Fund_Cuts_Really_Stop_Gun_Control_Research_Final.pdf on 16 July 2015. Google Scholar Author, Article, and Disclosure InformationAuthors: Christine Laine, MD, MPH; Darren B. Taichman, MD, PhDDisclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0428. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReducing Firearm-Related Harms: Time for Us to Study and Speak Out Darren B. Taichman and Christine Laine , on behalf of the Annals editors* Reducing Firearm-Related Harms Charles Jessee Metrics Cited byFirearm Legislation and Advocacy 18 August 2015Volume 163, Issue 4Page: 325-326KeywordsAssaultConflicts of interestCrimeDisclosureFearFirearm injuriesPrevention, policy, and public healthResearch fundingResearch reporting guidelinesSafety ePublished: 18 August 2015 Issue Published: 18 August 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...