tbuckley/cabot-search huggingface dataset:
Physician Staffing Patterns and Clinical Outcomes in Critically Ill Patients
Authors: Peter J. Pronovost, Derek C. Angus, Todd Dorman, Karen A. Robinson, Tony T. Dremsizov, Tammy L. Young
Journal: JAMA (2002)

ContextIntensive care unit (ICU) physician staffing varies widely, and its association with patient outcomes remains unclear.ObjectiveTo evaluate the association between ICU physician staffing and patient outcomes.Data SourcesWe searched MEDLINE (January 1, 1965, through September 30, 2001) for the following medical subject heading (MeSH) terms: intensive care units, ICU, health resources/utilization, hospitalization, medical staff, hospital organization and administration, personnel staffing and scheduling, length of stay, and LOS. We also used the following text words: staffing, intensivist, critical, care, and specialist. To identify observational studies, we added the MeSH terms case-control study and retrospective study. Although we searched for non–English-language citations, we reviewed only English-language articles. We also searched EMBASE, HealthStar (Health Services, Technology, Administration, and Research), and HSRPROJ (Health Services Research Projects in Progress) via Internet Grateful Med and The Cochrane Library and hand searched abstract proceedings from intensive care national scientific meetings (January 1, 1994, through December 31, 2001).Study SelectionWe selected randomized and observational controlled trials of critically ill adults or children. Studies examined ICU attending physician staffing strategies and the outcomes of hospital and ICU mortality and length of stay (LOS). Studies were selected and critiqued by 2 reviewers. We reviewed 2590 abstracts and identified 26 relevant observational studies (of which 1 included 2 comparisons), resulting in 27 comparisons of alternative staffing strategies. Twenty studies focused on a single ICU.Data SynthesisWe grouped ICU physician staffing into low-intensity (no intensivist or elective intensivist consultation) or high-intensity (mandatory intensivist consultation or closed ICU [all care directed by intensivist]) groups. High-intensity staffing was associated with lower hospital mortality in 16 of 17 studies (94%) and with a pooled estimate of the relative risk for hospital mortality of 0.71 (95% confidence interval [CI], 0.62-0.82). High-intensity staffing was associated with a lower ICU mortality in 14 of 15 studies (93%) and with a pooled estimate of the relative risk for ICU mortality of 0.61 (95% CI, 0.50-0.75). High-intensity staffing reduced hospital LOS in 10 of 13 studies and reduced ICU LOS in 14 of 18 studies without case-mix adjustment. High-intensity staffing was associated with reduced hospital LOS in 2 of 4 studies and ICU LOS in both studies that adjusted for case mix. No study found increased LOS with high-intensity staffing after case-mix adjustment.ConclusionsHigh-intensity vs low-intensity ICU physician staffing is associated with reduced hospital and ICU mortality and hospital and ICU LOS.
The Road to Scientific Therapy
Authors: Lester S. King
Journal: JAMA (1966)

When a medical student begins to learn the numerous diseases that afflict mankind, he wonders why people live as long as they do. A comparable wonder arises when we study the histor of medicine and note the different remedies that physicians have prescribed. Man has survived not only the diseases but also the remedies used against these diseases. Many popular writers, and not a few historians, have devoted great wit to ridiculing the therapy of our medical forefathers. The massive bleedings and purgings, the sweatings and pukings, the weird drugs such as powdered mummy, oil of scorpions, or skin of snakes, all have served as a source of merriment. Numerous authors express only scorn for the fools who inflicted such nauseous remedies upon trusting patients. Yet, although scorn for the past has strong comic appeal, it all represents very bad history. In times past, people were just as intelligent as
Herpes simplex esophagitis presenting as acute necrotizing esophagitis (“black esophagus”) in an immunocompetent patient
Authors: S. Nagri, R. Hwang, S. Anand, J. Kurz
Journal: Endoscopy (2007)

"Black esophagus" is a rare condition which is defined as a dark pigmentation of the esophagus seen during endoscopy, associated with histologic mucosal necrosis. We report a case of proven herpes simplex esophagitis causing black esophagus in an immunocompetent patient. A 54-year-old man with a history of well-controlled schizophrenia and living in an assisted-living facility for the mentally ill was admitted to the hospital because of coffee-ground emesis and melena. The patient was hemodynamically stable on initial evaluation. His hematocrit dropped from 43 % to 33 % in 12 h. Emergency upper endoscopy showed grade D esophagitis with blackish discoloration of the mucosa, mainly affecting the lower third of the esophagus ([Fig. 1]). Esophageal biopsy showed multinucleated giant cells with Cowdry type A intranuclear inclusion bodies in epithelial cells, characteristic of herpes esophagitis ([Fig. 2]). Serologic testing (IgG antibodies) for herpes simplex virus 1 was positive. The patient was treated with intravenous fluid therapy, sucralfate by mouth, and intravenous esomeprazole 40 mg twice a day. Repeat upper endoscopy after 1 week showed healing of the mucosa except for a few tiny superficial ulcers in the esophagus ([Fig. 3]).
New Test for Intervertebral Disk Disease
Authors: RICHARD C. GARDNER
Journal: Annals of Internal Medicine (1971)

Letters, Comments, and Corrections1 September 1971New Test for Intervertebral Disk DiseaseRICHARD C. GARDNER, M.D.RICHARD C. GARDNER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-3-480 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Intervertebral disk disease is one of the commonest disorders of man. Although the chronic trauma of the erect position has been implicated in the cause, the disease is also common in four-legged animals such as the dachshund and bassett hound. The patients often complain more about pain when sitting than when standing erect.The straight leg-raising test and its modifications have been used for many years in diagnosis of lower spinal disease, but they have many shortcomings. They are often positive in individuals with functional back disease such as neurotics and those with compensation syndromes. Because of...Reference1. GARDNER R: The lumbar intervertebral disc. Arch Surg 100:101-104, 1970 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 198 Union Ave. Framingham, Mass. 01701 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe search for the meaning of sciatica: application of the scientific methodDiagnosis of Pain Syndromes of the Spine 1 September 1971Volume 75, Issue 3Page: 480-481 Issue Published: 1 September 1971 PDF DownloadLoading ...
AT1R blockade reduces IFN-γ production in lymphocytes in vivo and in vitro
Authors: Jon A. Weidanz, Lynn M. Jacobson, Rebecca J. Muehrer, Arjang Djamali, Debra A. Hullett, Jenifer Sprague, Maurizio Chiriva-Internati, Vaughan Wittman, Thomas J. Thekkumkara, Bryan N. Becker
Journal: Kidney International (2005)
Abstract 2366: Reduced ecto-5′-nucleotidase CD73 expression and altered purine nucleotide metabolism in colorectal cancer cells robustly causing liver metastases
Authors: Masahiro Matsuyama, Masatoshi Wakui, Makoto Monnai, Tomoko Mizushima, Chiyoko NIshime, Kenji Kawai, Hiroshi Suemizu, Takako Hishiki, Makoto Suematsu, Mitsuru Murata, Tusyoshi Chijiwa, Daisuke Furukawa, Kyoji Ogoshi, HIroyasu Makuuchi, Masato Nakamura
Journal: Cancer Research (2010)

Abstract Liver metastases are frequently inoperative and severely impact the prognoses of patients with cancers. Colorectal cancers as well as pancreatic cancers most commonly metastasize to the liver, although there are some patients with colorectal cancers presenting liver metastases operative contrary to the cases of pancreatic cancers. Through liver metastasis models using NOD/SCID/IL-2Rγcnull (NOG) mice, we have previously established and examined a highly liver-metastatic human pancreatic cancer cell subline, which was derived from the poorly liver-metastatic parental line, identifying a key molecular regulator of liver metastasis. In the present study, we established a highly liver-metastatic human colorectal cancer cell subline SW48LM2 through the serial intrasplenic transfer of cells derived from poor but visible hepatic tumor foci formed by parental SW48 cells transferred to NOG mice. The growth both under monolayer-culture conditions and during formation of the subcutaneous tumors was similar between the two cell lines, although there were morphological differences in the in vitro spheroid formation. Of 41 molecules reportedly associated positively or negatively with tumor progression, four were overexpressed and four were underexpressed in SW48LM2 cells. Most strikingly, this liver-metastatic cell subline exhibited strongly reduced expression of the ecto-5′ -nucleotidase CD73 as well as altered metabolism of purine nucleotides. Contrary to previous studies showing a positive correlation between CD73 expression and metastatic cancer phenotypes, reduced CD73 expression on tumor cells may contribute to the potential of liver metastases. The present study highlights the need for interpretative caution when investigating metastasis-associated molecules for the diagnostic and therapeutic applications, providing insights into the mechanisms of liver metastases. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2366.
TARGET IDENTIFICATION IN GLIOMA INITIATING CELLS
Authors: J. N. Rich
Journal: Neuro-Oncology (2014)

BACKGROUND: Gliomas display cellular hierarchies with tumor initiating cells (TICs) at the apex that are functionally defined by the ability to self renew and propagate tumors similar to the parental tumors from which they are derived. TICs remain controversial, but their clinical relevance has been supported by resistance to cytotoxic therapies (Bao et al. Nature 2006) and promotion of tumor angiogenesis (Bao et al. Cancer Research 2006). TICs reside in specific functional niches in perivascular and hypoxic niches (Li et al. Cancer Cell 2009) that may offer the ability to disrupt tumor maintenance and therapeutic resistance through targeting the niche. Investigating TICs has already yielded novel molecular targets and pathways that are amenable to therapeutic targeting (Kim et al. Genes Development 2012; Eyler et al. Cell 2011; Guryanova et al. Cancer Cell 2011). METHODS: Using patient-derived tumor models, we interrogated the regulation of the TIC phenotype by both cell intrinsic and microenvironmental influences present in tumors. RESULTS: TICs are enriched under low nutrient conditions due to the cooption of the high affinity GLUT3 transporter normally expressed by neurons (Flavahan et al. Nature Neuroscience 2013). We have now extended these findings to demonstrate that cellular metabolism is differentially regulated within the tumor hierarchy at several levels to provide resources for sustained self-renewal and proliferation. We also recently found that TICs have basal genotoxic stress activating PARP permitting radiosensitization (Venere et al. Cell Death Differentiation 2014). To discover novel TIC targets, we are using several technologies, including aptamers (Kim et al. Cancer Research 2013), flow cytometry (Lathia et al. Cell Reports 2014), and in unpublished studies, phage display, showing that TICs manifest nodes of fragility mediating cell survival and invasion (e.g. JAM-A, VAV3, and CD97). Combining TIC models from patients with non-neoplastic progenitors from epilepsy resections, we are interrogating additional molecular regulators of the cellular hierarchy that can be distinguished from normal stem cells to minimize toxicity. CONCLUSIONS: The conventional pyramidal unidirectional differentiation cascade with TICs at the apex has been called into question by studies demonstrating plasticity of the TIC phenotype (Cheng et al. Cell 2013), thus suggesting that targeting only TICs will likely fail to cure patients and require simultaneous targeting of TICs and the bulk tumor. Although the field of TIC biology is relatively young, continued elucidation of the tumor hierarchy holds promise for development of novel patient therapies. SECONDARY CATEGORY: Preclinical Experimental Therapeutics.
The Cytogenesis and Pathogenesis of Pituitary Adenomas*
Authors: Sylvia L. Asa, Shereen Ezzat
Journal: Endocrine Reviews (1998)

I. Introduction: Pituitary Adenomas A. Definition B. Epidemiology C. Classification II. Pituitary Cytodifferentiation A. Early pituitary development B. Pit-1 C. CREB D. Estrogen receptor (ER) E. Thyrotroph embryonic factor (TEF) F. Steroidogenic factor-1 (SF-1) G. Corticotroph upstream transcription-binding element (CUTE) H. Other putative factors I. A model of adenohypophysial cytodifferentiation III. Pathogenetic Mechanisms in Pituitary Adenoma Development and Progression A. Hormonal factors B. Molecular events C. Growth factors and receptors D. An integrated approach to multistep tumorigenesis IV. Concluding Comments
Aldosterone/Renin Ratio Determines Peripheral and Central Blood Pressure Values Over a Broad Range
Authors: Andreas Tomaschitz, Winfried Maerz, Stefan Pilz, Eberhard Ritz, Hubert Scharnagl, Wilfried Renner, Bernhard O. Boehm, Astrid Fahrleitner-Pammer, Gisela Weihrauch, Harald Dobnig
Journal: Journal of the American College of Cardiology (2010)
Estrogen Stimulates Dimethylarginine Dimethylaminohydrolase Activity and the Metabolism of Asymmetric Dimethylarginine
Authors: Desmond P. Holden, Judith E. Cartwright, Stephen S. Nussey, Guy St J. Whitley
Journal: Circulation (2003)

Experimental evidence suggests that estrogens stimulate the production of nitric oxide (NO) by vascular endothelial cells. This effect has been attributed to increased expression and enzymatic activity of both the constitutive and inducible isoforms of NO synthase. In this study, we have investigated whether estrogens regulate the metabolism or release of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase.The concentration of ADMA in the plasma of 15 postmenopausal women was 0.722+/-0.04 micromol/L (mean+/-SEM). Two weeks after subcutaneous implantation with estradiol, there was an increase in plasma estradiol concentration from 0.693+/-0.075 to 0.81+/-87 nmol/L, which was accompanied by a significant fall in plasma ADMA concentration to 0.588+/-0.03 micromol/L (P=0.006). Human and murine endothelial cell lines previously cultured in estrogen-free medium and then exposed to 17beta-estradiol showed a dose-dependent decrease in the release of ADMA. This reached statistical significance at 10-14 mol/L 17beta-estradiol and was accompanied by a corresponding increase in the activity of dimethylarginine dimethylaminohydrolase (DDAH), an enzyme that catalyzes the metabolism of ADMA.We have demonstrated that estrogens can alter the catabolism and release of ADMA in vitro and reduce the circulating concentration in vivo. We therefore propose that increased DDAH activity and the subsequent fall in ADMA could contribute to the positive effect of estrogen on NO synthesis.
The Legal Issues in Alcoholism
Authors: Neil L. Chayet
Journal: New England Journal of Medicine (1965)

IN mid-June, a three-day national conference was sponsored by the Boston University Law-Medicine Institute to examine the legal issues in alcoholism and alcohol usage.Held in the pleasant setting of the New Ocean House at Swampscott, Massachusetts, the conference brought together leaders of the bar, the judiciary, the law schools, the medical profession, the forensic sciences, law enforcement and correction, as well as representatives of alcoholism-treatment programs. The purpose of this column is to discuss several of the dominant themes of the conference and to present some of the recommendations made at a final plenary session.One of the dominant . . .
Loaded Guns in the Home
Authors: Douglas S. Weil
Journal: JAMA (1992)

To identify factors associated with keeping guns loaded. Four hypotheses were tested: that people are more likely to keep their firearms loaded if (1) the primary reason for owning a gun is protection, (2) the gun is a handgun, (3) there are no children in the household, or (4) the gun owner has not received training in the proper use of firearms.A random national telephone survey of gun owners conducted in December 1989. A screening question was used to identify individuals as gun owners. Participants were called at home.605 individuals (approximately two thirds of the population contacted) participated in the survey. All were 18 years and older, most were men (64%), and a few were nonwhite (12%). The majority owned more than one gun (77%).Three of the four hypotheses were substantiated by the data. Handgun owners (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.67 to 2.82), individuals who owned a firearm principally for protection (OR, 1.65; 95% CI, 1.30 to 2.11), and people who lived in households without children (OR, 1.42; 95% CI, 1.13 to to 1.82) were all more likely to keep a gun loaded than other individuals. Instruction in the proper use of firearms did not seem to affect the probability of keeping guns loaded (OR, 0.86; 95% CI, 0.69 to 1.07).The spontaneous nature of many firearm deaths has led to speculation that a substantial proportion of firearm-related morbidity and mortality could be prevented if easy access to loaded weapons were reduced through appropriate storage practices. Our findings show that a significant proportion of gun owners disregard basic safety procedures. However, without information on the specific content of safety instruction, we cannot say that education about safe storage practices is ineffective.
Discrepancies exist between general practitioners' clinical work and a guidelines implementation programme
Authors: T. Lipman
Journal: BMJ (1998)

EDITOR—Doctors need information on how to manage their patients' problems many times each day; one estimate was as high as three or four times per case.1 The problem of how to ensure that doctors base management on sound evidence has been widely debated in recent years. One approach is evidence based medicine, in which patients' problems are formulated into structured, answerable questions for which evidence is sought, found, appraised, and applied.2 Another is the implementation of evidence based guidelines, which expert groups …
1005. Replication and Anti-Tumor Efficacy of Conditionally Replicating Adenoviral Vectors for Glioma Treatment
Authors: Maarten ter Horst, Mark Rodijk, Eric Brouwer, Rob C. Hoeben, Bertie de Leeuw, Peter A.E. Sillvis Smitt
Journal: Molecular Therapy (2005)

In order to improve the efficacy of first generation adenoviral vectors for glioma treatment, we designed conditionally replicating adenoviruses (CRAd's) in which the E1A gene is under the control of the promoter of the glia specific intermediate filament Glial Fibrillary Acidic Protein (GFAP) and similar constructs containing additional glia-specific enhancers (GFAP 'super' promoters).
The complement system in myocardial ischaemia/reperfusion injury
Authors: K. S Kilgore, G. S Friedrichs, J. W Homeister, B. R Lucchesi
Journal: Cardiovascular Research (1994)

Journal Article The complement system in myocardial ischaemia/reperfusion injury Get access Kenneth S Kilgore, Kenneth S Kilgore University of Michigan Medical School, Department of Pharmacology, M6322 Medical Sciences Building I, Ann Arbor, Michigan 48109-0626, USA: K S Kilgore, G S Friedrichs, J W Homeister, B R Lucchesi. Correspondence to Professor Lucchesi. Search for other works by this author on: Oxford Academic PubMed Google Scholar Gregory S Friedrichs, Gregory S Friedrichs University of Michigan Medical School, Department of Pharmacology, M6322 Medical Sciences Building I, Ann Arbor, Michigan 48109-0626, USA: K S Kilgore, G S Friedrichs, J W Homeister, B R Lucchesi. Search for other works by this author on: Oxford Academic PubMed Google Scholar Jonathon W Homeister, Jonathon W Homeister University of Michigan Medical School, Department of Pharmacology, M6322 Medical Sciences Building I, Ann Arbor, Michigan 48109-0626, USA: K S Kilgore, G S Friedrichs, J W Homeister, B R Lucchesi. Search for other works by this author on: Oxford Academic PubMed Google Scholar Benedict R Lucchesi Benedict R Lucchesi University of Michigan Medical School, Department of Pharmacology, M6322 Medical Sciences Building I, Ann Arbor, Michigan 48109-0626, USA: K S Kilgore, G S Friedrichs, J W Homeister, B R Lucchesi. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 4, April 1994, Pages 437–444, https://doi.org/10.1093/cvr/28.4.437 Published: 01 April 1994 Article history Received: 28 September 1993 Accepted: 07 December 1993 Published: 01 April 1994
Multiple Beau's lines due to dysmenorrhoea?
Authors: G. B. COLVER, R. P. R. DAWBER
Journal: British Journal of Dermatology (1984)

Journal Article Multiple Beau's lines due to dysmenorrhoea? Get access G. B. COLVER, G. B. COLVER The Slade Hospital, Oxford, U.K. Dr G.B.Colver, Department of Dermatology, The Slade Hospital, Headington, Oxford OX3 7JH, U.K. Search for other works by this author on: Oxford Academic Google Scholar R. P. R. DAWBER R. P. R. DAWBER The Slade Hospital, Oxford, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue 1, 1 July 1984, Pages 111–113, https://doi.org/10.1111/j.1365-2133.1984.tb04024.x Published: 01 July 1984 Article history Accepted: 26 January 1984 Published: 01 July 1984
Signal transduction via CD40 involves activation of lyn kinase and phosphatidylinositol-3-kinase, and phosphorylation of phospholipase C gamma 2.
Authors: C L Ren, T Morio, S M Fu, R S Geha
Journal: The Journal of Experimental Medicine (1994)

CD40 is a 50-kD glycoprotein that plays an important role in B cell survival, memory, and immunoglobulin isotype switch. Engagement of the CD40 antigen by monoclonal antibodies (mAbs) results in increased protein tyrosine kinase (PTK) activity, which plays an important role in mediating the biologic effects of CD40. We demonstrate, using an in situ phosphorylation technique, that CD40 cross-linking by the anti-CD40 mAb 626.1 resulted within 1 min in increased phosphorylation of the src type kinase, lyn, in Daudi B cell lines and remained sustained for up to 20 min. The activity of lyn kinase, as measured by immune complex kinase assay, was also increased after CD40 engagement, with similar kinetics. In contrast, the phosphorylation and activity of fyn, fgr, and lck kinases demonstrated minimal changes following stimulation of Daudi cells with mAb 626.1 over this same time period. CD40 engagement also resulted in phosphorylation of phospholipase C gamma 2 of phosphatidylinositol (PLC gamma 2) and phosphatidylinositol (PI)-3-kinase. Phosphorylation of PI-3-kinase was shown to be associated with an increase in its enzymatic activity. These results suggest that lyn plays an important role in CD40-mediated PTK activation and identify PLC gamma 2 and PI-3-kinase targets for CD40-mediated phosphorylation, suggesting a role for these two enzymes in CD40 signal transduction.