tbuckley/cabot-search huggingface dataset:
Acute Renal Failure and Ketorolac: Reply
Authors: Harold I. Feldman
Journal: Annals of Internal Medicine (1997)

Letters15 September 1997Acute Renal Failure and Ketorolac: ReplyHarold I. Feldman, MD, MS, Judith L. Kinman, MA, and Brian L. Strom, MD, MPHHarold I. Feldman, MD, MSUniversity of Pennsylvania Medical Center; Philadelphia, PA 19104Search for more papers by this author, Judith L. Kinman, MAUniversity of Pennsylvania Medical Center; Philadelphia, PA 19104Search for more papers by this author, and Brian L. Strom, MD, MPHUniversity of Pennsylvania Medical Center; Philadelphia, PA 19104Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-6-199709150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Buller and Perazella state that studies of acute renal failure associated with NSAIDs should be limited to persons at risk for this condition. We agree with this view, but hospitalized patients ill enough to receive parenteral analgesics are at risk for acute renal failure, which in some cases is blamed on NSAIDs [1]. Furthermore, a substantial minority have conditions (such as volume depletion or hypotension) in which renal function depends on vasodilator prostaglandins; this may place them at higher risk for acute renal failure from such cyclooxygenase inhibitors as ketorolac.Drs. Buller and Perazella questioned whether our ...References1. Corelli RL, Gericke KR. Renal insufficiency associated with intramuscular administration of ketorolac tromethamine. Ann Pharmacother. 1993; 27:1055-7. Google Scholar2. Kleinbaum DG, Kupper LL, Morgenstern H. Epidemiologic Research. Belmont, CA: Lifetime Learning Publications; 1982. Google Scholar3. Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: a prospective study. Am J Med. 1983; 74:243-8. Google Scholar Author, Article, and Disclosure InformationAuthors: Harold I. Feldman, MD, MS; Judith L. Kinman, MA; Brian L. Strom, MD, MPHAffiliations: University of Pennsylvania Medical Center; Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPerioperative Management of Patients with Renal DiseasePerioperative care of the patient with renal failure 15 September 1997Volume 127, Issue 6 Page: 493-494 Keywords Acute renal failure Analgesics Hazard ratio Multivariate analysis NSAIDs Opioids Prostaglandins Renal diseases Toxicity Vasodilators ePublished: 15 August 2000 Issue Published: 15 September 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Cardiac cooling increases Emax without affecting relation between O2 consumption and systolic pressure-volume area in dog left ventricle.
Authors: H Suga, Y Goto, Y Igarashi, Y Yasumura, T Nozawa, S Futaki, N Tanaka
Journal: Circulation Research (1988)

We studied the effects of cardiac cooling by 7 +/- 2 degrees C (SD) from 36 degrees C on both contractility index (Emax) and the relation between O2 consumption per beat (VO2) and systolic pressure-volume area (PVA) of the left ventricle in the excised cross-circulated dog heart preparation. PVA represents the total mechanical energy generated by a contraction. The VO2-PVA relation divides measured VO2 into unloaded VO2 and excess VO2. The slope of the VO2-PVA relation represents inversely the efficiency of the contractile machinery to convert chemical energy from the excess VO2 to total mechanical energy. Cooling is known to decrease myosin ATPase activity (Q10 of 2-3), which in turn is expected to increase the chemomechanical efficiency of cross bridges. Therefore, we expected an increase in the efficiency and hence a decreased slope of the VO2-PVA relation with cooling. The cooling increased Emax by 46 +/- 13% and the time to Emax by 45 +/- 27%. Pacing rate was constant or had to be slightly decreased to avoid arrhythmias with cooling. We found that neither the slope of the VO2-PVA relation nor unloaded VO2 significantly (p greater than 0.05) changed with the cooling. This result contradicts the expected increase in the efficiency with cooling. We conclude that cardiac cooling by 7 degrees C from 36 degrees C does not increase the efficiency of the contractile machinery in excised cross-circulated dog left ventricle.
Resolution of inflammatory acne vulgaris may involve regulation of CD4+ T-cell responses to Propionibacterium acnes
Authors: H.E. Wilcox, M.D. Farrar, W.J. Cunliffe, K.T. Holland, E. Ingham
Journal: British Journal of Dermatology (2006)

Propionibacterium acnes has been strongly implicated in inflammatory acne. However, its role in the disease is unclear. It has been hypothesized that an immune response to P. acnes and/or P. acnes heat shock proteins (HSPs) may play a role in the pathogenesis of inflammatory acne.To compare the cell-mediated immune response to P. acnes and HSPs in acne patients, nonacne controls and individuals with resolved acne.The proliferative response of peripheral blood mononuclear cells (PBMC) from acne patients, resolved acne donors and healthy controls to P. acnes, P. acnes HSP60 and HSP70, and mycobacterial HSPs was assessed by lymphocyte transformation assay (LTA). The proliferative response of purified CD4+ T cells was further analysed by limiting dilution analysis (LDA). Contingency tables (G-test) were used to analyse the proportion of individuals in each group showing a positive proliferative response for LTA or data fitting single-hit kinetics for LDA.Analysis of stimulation of PBMC with P. acnes, P. acnes HSP60 and HSP70 in the LTA showed the proportion of positive responders to be independent of subject group. However, the proportion of acne patients with a positive response to mycobacterial HSPs was significantly higher than those for the other subject groups. Analysis of LDA data showed the proportion of resolved donors with responses to P. acnes fitting the single-hit kinetics model to be significantly lower than those of the other groups. There were no significant differences in responses to other antigens.The significantly lower proportion of resolved donors demonstrating a single-hit kinetics response to P. acnes by LDA may represent negative regulation of the CD4+ T-cell response to P. acnes in these subjects.
Behavior Therapy, Pimozide Treatment and Prolactin Secretion in Anorexia Nervosa
Authors: Abraham Weizman, Sam Tyano, Henricus Wijsenbeek, Menashe Ben David
Journal: Psychotherapy and Psychosomatics (1985)

The involvement of the hypothalamic dopaminergic pathway in the treatment of anorexia nervosa (AN) was evaluated by monitoring the serum prolactin (PRL) levels in 10 adolescent anorectic females. 5 patients were treated by behavior therapy program and 5 were treated with pimozide, an antidopaminergic drug. The study was conducted for a period of 20 weeks. Elevation of PRL levels was used as an indicator of antidopaminergic activity. PRL was increased in the 5 patients receiving the antidopaminergic agent, while no elevation was observed in the patients undergoing behavior therapy. All 10 patients were treated successfully as expressed by their gradual gain in weight. It is concluded that antidopaminergic activity does not seem to be a prerequisite for clinical improvement.
Prenatal immunotoxicant exposure and postnatal autoimmune disease.
Authors: S D Holladay
Journal: Environmental Health Perspectives (1999)

Reports in humans and rodents indicate that immune development may be altered following perinatal exposure to immunotoxic compounds, including chemotherapeutics, corticosteroids, polycyclic hydrocarbons, and polyhalogenated hydrocarbons. Effects from such exposure may be more dramatic or persistent than following exposure during adult life. For example, prenatal exposure to the insecticide chlordane or to the polycyclic aromatic hydrocarbon benzo[(italic)a(/italic)]pyrene produces what appears to be lifelong immunosuppression in mice. Whether prenatal immunotoxicant exposure may predispose the organism to postnatal autoimmune disease remains largely unknown. In this regard, the therapeutic immunosuppressant cyclosporin A (CsA) crosses the placenta poorly. However, lethally irradiated rodents exposed to CsA postsyngeneic bone marrow transplant (i.e., during re-establishment of the immune system) develop T-cell-mediated autoimmune disease, suggesting this drug may produce a fundamental disruption in development of self-tolerance by T cells. The environmental contaminant 2,3,7, 8-tetrachlorodibenzo-(italic)p(/italic)-dioxin (TCDD) crosses the placenta and produces fetal thymic effects (italic)in vivo(/italic) similar to effects of CsA in fetal thymic organ culture, including inhibited thymocyte maturation and reduced expression of thymic major histocompatability complex class II molecules. These observations led to the suggestion that gestational exposure to TCDD may interfere with normal development of self-tolerance. Possibly supporting this hypothesis, when mice predisposed to development of autoimmune disease were treated with TCDD during gestation, postnatal autoimmunity was exacerbated. Similar results have been reported for mice exposed to diethylstilbestrol during development. These reports suggest that prenatal exposure to certain immunotoxicants may play a role in postnatal expression of autoimmunity.
Neutrophilic inflammation in childhood bronchial asthma
Authors: K Yasui
Journal: Thorax (2005)

<h3>Background</h3> Mutations in forkhead box protein P1 (<i>FOXP1</i>) cause intellectual disability (ID) and specific language impairment (SLI), with or without autistic features (MIM: 613670). Despite multiple case reports no specific phenotype emerged so far. <h3>Methods</h3> We correlate clinical and molecular data of 25 novel and 23 previously reported patients with <i>FOXP1</i> defects. We evaluated FOXP1 activity by an in vitro luciferase model and assessed protein stability in vitro by western blotting. <h3>Results</h3> Patients show ID, SLI, neuromotor delay (NMD) and recurrent facial features including a high broad forehead, bent downslanting palpebral fissures, ptosis and/or blepharophimosis and a bulbous nasal tip. Behavioural problems and autistic features are common. Brain, cardiac and urogenital malformations can be associated. More severe ID and NMD, sensorineural hearing loss and feeding difficulties are more common in patients with interstitial 3p deletions (14 patients) versus patients with monogenic <i>FOXP1</i> defects (34 patients). Mutations result in impaired transcriptional repression and/or reduced protein stability. <h3>Conclusions</h3> <i>FOXP1</i>-related ID syndrome is a recognisable entity with a wide clinical spectrum and frequent systemic involvement. Our data will be helpful to evaluate genotype–phenotype correlations when interpreting next-generation sequencing data obtained in patients with ID and/or SLI and will guide clinical management.
OPERATIVE TREATMENT OF THE DISEASES OF THE GALL BLADDER.Read at the Meeting of the Military Tract Medical Association held at Quincy, Ill., Oct. 18 and 19, 1894.
Authors: ALEX. HUGH FERGUSON
Journal: JAMA (1895)

Since the days of Petit (1733) till our own time, very little or no progress was made in the surgery of the gall bladder. To Dr. Bobbs, of Indianapolis, (1867) belongs the credit of being the first to deliberately open the gall bladder for the removal of gall stones; to Marion-Sims (1868) the honor of giving the procedure a scientific name—cholecystotomy; and to Lawson Tait the praise of perfecting its technique as we perform it to-day. It was found that a permanent fistula followed in a certain proportion of the cases operated upon, much to their discomfort, exhaustion, and sometimes even death from the loss of bile. There are certain abnormal conditions which render life loathsome to one's self, and this may be said to be one of them. While it is true that nature had in some cases made an opening into the bowel for the passage of the
Progression from Beryllium Exposure to Chronic Beryllium Disease: An Analytic Model
Authors: Philip Harber, Siddharth Bansal, John Balmes
Journal: Environmental Health Perspectives (2009)

Understanding the progression from beryllium exposure (BeE) to chronic beryllium disease (CBD) is essential for optimizing screening and early intervention to prevent CBD.We developed an analytic markov model of progression to cbd that assigns annual probabilities for progression through three states: from BeE to beryllium sensitization and then to CBD. We used calculations of the number in each state over time to assess which of several alternative progression models are most consistent with the limited available empirical data on prevalence and incidence. We estimated cost-effectiveness of screening considering both incremental (cost/case) and cumulative program costs.No combination of parameters for a simple model in which risk of progression remains constant over time can meet the empirical constraints of relatively frequent early cases and continuing development of new cases with long latencies. Modeling shows that the risk of progression is initially high and then declines over time. Also, it is likely that there are at least two populations that differ significantly in risk. The cost-effectiveness of repetitive screening declines over time, although new cases will still be found with long latencies. However, screening will be particularly cost-effective when applied to persons with long latencies who have not been previously screened.To optimize use of resources, the intensity of screening should decrease over time. Estimation of lifetime cumulative CBD risk should consider the declining risk of progression over time.
T Cells Expressing Constitutively Active Akt Resist Multiple Tumor-associated Inhibitory Mechanisms
Authors: Jiali Sun, Gianpietro Dotti, Leslie E Huye, Aaron E Foster, Barbara Savoldo, Maria M Gramatges, David M Spencer, Cliona M Rooney
Journal: Molecular Therapy (2010)

Adoptive transfer of antigen-specific cytotoxic T lymphocytes has shown promise for the therapy of cancer. However, tumor-specific T cells are susceptible to diverse inhibitory signals from the tumor microenvironment. The Akt/protein kinase B plays a central role in T-cell proliferation, function, and survival and we hypothesized that expression of constitutively active Akt (caAkt) in T cells could provide resistance to many of these tumor-associated inhibitory mechanisms. caAkt expression in activated human T cells increased proliferation and cytokine production, a likely result of their sustained expression of nuclear factor-κB (NF-κB) and provided resistance to apoptosis by upregulating antiapoptotic molecules. caAkt expressing T cells (caAkt-T-cells) were also relatively resistant to suppression by and conversion into regulatory T cells (Tregs). These characteristics provided a survival advantage to T cells cocultured with tumor cells in vitro; CD3/28-stimulated T cells expressing a chimeric antigen receptor (CAR) specific for disialoganglioside (GD2) that redirected their activity to the immunosuppressive, GD2-expressing neuroblastoma cell line, LAN-1, resisted tumor-induced apoptosis when co-expressing transgenic caAkt. In conclusion, caAkt-transduced T cells showed resistance to several evasion strategies employed by tumors and may therefore enhance the antitumor activity of adoptively transferred T lymphocytes. Adoptive transfer of antigen-specific cytotoxic T lymphocytes has shown promise for the therapy of cancer. However, tumor-specific T cells are susceptible to diverse inhibitory signals from the tumor microenvironment. The Akt/protein kinase B plays a central role in T-cell proliferation, function, and survival and we hypothesized that expression of constitutively active Akt (caAkt) in T cells could provide resistance to many of these tumor-associated inhibitory mechanisms. caAkt expression in activated human T cells increased proliferation and cytokine production, a likely result of their sustained expression of nuclear factor-κB (NF-κB) and provided resistance to apoptosis by upregulating antiapoptotic molecules. caAkt expressing T cells (caAkt-T-cells) were also relatively resistant to suppression by and conversion into regulatory T cells (Tregs). These characteristics provided a survival advantage to T cells cocultured with tumor cells in vitro; CD3/28-stimulated T cells expressing a chimeric antigen receptor (CAR) specific for disialoganglioside (GD2) that redirected their activity to the immunosuppressive, GD2-expressing neuroblastoma cell line, LAN-1, resisted tumor-induced apoptosis when co-expressing transgenic caAkt. In conclusion, caAkt-transduced T cells showed resistance to several evasion strategies employed by tumors and may therefore enhance the antitumor activity of adoptively transferred T lymphocytes.
Removing barriers to career development in public health
Authors: K. McPherson
Journal: BMJ (2000)

Human population growth Rich countries need education on resource conservationEditor-"Because rich countries remain the main source of new knowledge and new technologies, responsibility for finding paths to sustainability rests mainly with them." 1 Well said.Unfortunately, the rich countries, or at least the dominant sections in rich countries,have not yet learnt to view the world as a single whole.The world continues to be a space to be dominated.It used to be domination by conquering and colonising, now it is domination through unfair economic and trade agreements.National self interest takes precedence over global good.If corporations in the rich countries do things that exacerbate the divide between rich and poor and make sustainability increasingly difficult to attain, individuals in those countries add their bit by consuming scarce natural resources at an alarming rate.Development experts talk of the great importance of education in the poor countries.I think that educating the rich countries about the need to reduce consumption and conserve resources is equally, if not more, important.Without that it would be futile to expect the rich countries to find paths to sustainability.
Psychosomatic Nursing Assessment of Psychiatric Patients
Authors: A. Raya, J. Manias, M. Priami, S. Andrea, A. Kalokerinou, O. Androulaki, H. Brokalaki, H. Halkiadaki, V. Matziou
Journal: Psychotherapy and Psychosomatics (1991)

This article presents the results of a research study on 547 mental patients testing a form of nursing assessment of mental patients in psychiatric and in general hospitals, as a means to assess their nursing needs and as a basis for planning, implementation and evaluation of their personalized holistic nursing care. The study showed that more depressive than schizophrenic patients went to the general hospital for help. The reverse was observed in the psychiatric hospital. The psychological nursing needs of the patients were significantly correlated with their somatic nursing needs. The psychological as well as the somatic nursing needs of the patients were significantly correlated with sex, age, somatic health state and mental health state in general, and not with their concrete psychiatric diagnosis. It is concluded that the psychiatric nursing assessment should be oriented towards the investigation of the patient's psychosomatic nursing needs rather than be based on his medical diagnosis.
Cryotherapy in Infants With Retinopathy of Prematurity-Reply
Authors: Dale L. Phelps
Journal: JAMA (1990)

<h3>In Reply.—</h3> Dr Hindle emphasizes the importance of each ophthalmologist developing critical judgment in the care of premature infants' eyes, and we agree. Such judgment depends on training, on experience, and, fortunately, increasingly on testing of scientific hypotheses and formal decision-making models. The cryotherapy-ROP trial continues to collect data comparing the visual outcome and long-term side effects of treated eyes with randomly selected untreated eyes with ROP. This factual database will enhance each physician's ability to form his or her own critical judgment. For the interim, based on<i>published data</i>, our analysis used a standard medical decision model to explore the complex treatment choice of none vs one vs two eyes. Such models always contain assumptions; a key part of the analysis seeks to learn which of the yet unknown parameters of the model most critically alter the treatment decision. In our model, we assigned these values based on discussions
Immediate allergic reactions to amoxicillin
Authors: J. M. Vega, M. Blanca, J. J. Garcia, M. J. Carmona, A. Miranda, M. Perez‐Estrada, S. Fernandez, J. M. Acebes, S. Terrados
Journal: Allergy (1994)

A large group of patients with suspected allergic reactions to (β‐lactam antibiotics was evaluated. A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to β‐lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross‐reacting with other penicillin derivatives. Skin tests were performed with benzylpenicilloyl‐poly‐L‐lysine (BPO‐PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX. RAST for BPO‐PLL and AX‐PLL was done. When both skin test and RAST for BPO were negative, single‐blind, placebo‐controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX. A total of 177 patients were diagnosed as allergic to β‐lactam antibiotics. We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG. Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema. All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG. Skin tests with AX were positive in 34 (63%) patients. RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%). None of the sera with negative RAST for AX were positive to BPO. Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative. PG was well tolerated by all 54 patients. We describe the largest group of AX‐allergic patients who have tolerated PG reported so far. Diagnosis of these patients can be achieved only if specific AX‐related reagents are employed. Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods.
Breathing He-O<sub>2</sub> Increases Ventilation but Does Not Decrease the Work of Breathing during Exercise
Authors: T. G. BABB
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

We previously observed an increase in minute ventilation (V˙ e) with resistive unloading (He-O2 breathing) in healthy elderly subjects with normal pulmonary function. To investigate the effects of resistive unloading in elderly subjects with mild chronic airflow limitation (FEV1/ FVC: 61 ± 4%), we studied 10 elderly men and women 70 ± 3 yr of age. These subjects performed graded cycle ergometry to exhaustion, once breathing room air and once breathing a He-O2 gas mixture (79% He, 21% O2). V˙ e, pulmonary mechanics, and Pet CO2 were measured during each 1-min increment in work rate. Data were analyzed by paired t test at rest, at ventilatory threshold (VTh), and during maximal exercise. V˙ e was significantly (p < 0.05) increased at VTh (3.4 ± 4.0 L / min or 12 ± 15% increase) and maximal exercise (15.2 ± 9.7 L / min or 22 ± 13% increase) while breathing He-O2. Concomitant to the increase in V˙ e, Pet CO2 was decreased at all levels (p < 0.01), whereas total work of breathing against the lung was not different. We concluded that V˙ e is increased during He-O2 breathing because of resistive unloading of the airways and the maintenance of the relationship between the work of breathing and exercise work rate.