tbuckley/cabot-search huggingface dataset:
Techniques of managing difficult to wean acute NIV: Comparison between prolongation of time off ventilator and pressure withdrawal
Authors: Yasser Noeman-Ahmed
Journal: European Respiratory Journal (2011)

Introduction:  Recent guidelines suggested gradual reduction of the duration of NIV once clinical improvement is determined. However, a subgroup of patients become dependent on the machine, finding the hours off the machine stressful in the absence of signs of respiratory failure. In this particular group of patients, we compared between slowly prolonging the hours off ventilator as tolerated by the patient and slowly reducing the IPAP levels by 1-2 cm H2O every day.   Methods:  Difficult to wean patients were identified as those unable to tolerate more than one hour off BiPAP on day 3 from the start of NIV. We excluded patients with persistent severe abnormal physiological parameters. All patients were fully alert with no clinical signs of persistent exacerbation. The failure of tolerating more than one hour off ventilator was due to the subjective feeling of tiredness and breathlessness in the absence of desaturation. Five patients (Group 1) were started from Day 4 on the gradual reduction of the IPAP levels at a rate of 1-2 cm H2O per day depending on the Day 3 IPAP level. The other five patients (Group 2) were treated in the conventional way of gradually prolonging time off ventilator as tolerated by the patient. Both groups received same medical management, physiotherapy and psychological support as needed.   Results:  Both groups did not differ significantly in age, sex, physiological parameters or blood gas values. The length of NIV therapy and the length of stay in the hospital were significantly shorter in group 1   Conclusion:  Gradual reduction of IPAP level can be used as an alternative method in a specific group of difficult to wean NIV patients.
Abstract P279: A High Fiber Nutrient Dense Supplement Moves the Metabolome in Obese Parent[[Unable to Display Character: −]]Teen Dyads
Authors: Jung H Suh, Nisha Narayanan, Kirsten Laine-Graves, Joyce C McCann, Swapna V Shenvi, Mark K Shigenaga, Bruce N Ames, Michele Mietus-Snyder
Journal: Circulation (2014)

Objective: To determine whether twice daily intake of a low-calorie (110 kcal), high-fiber, fruit and dark chocolate based nutrient-dense bar with supplemental vitamins/minerals, β-glucan, and docosahexaenoic acid might serve as an effective adjunct to lifestyle counseling for weight management in an inner city population. Methods: 18 overweight, predominantly female adolescent/parent guardian dyads and 2 triads (21 adults, 22 teens, randomized as 12 intervention (INT, with bars), 8 control (C) family units were recruited from a pediatric obesity clinic. The cohort was 48.7% Nonhispanic Black, 34.1% Hispanic, and 17.0% Caucasian. Two adults dropped out. The remaining 41 subjects participated in six identical weekly exercise and nutrition sessions by group. Full assessment of physical (BMI, blood pressure), behavioral (diet, activity), metabolic (cardiovascular and diabetes risk biomarkers), and metabolomic status was conducted at baseline and end-of-study. Results: There was excellent attendance in both INT and C groups with all family units participating in more than 80% of group sessions and 100% of baseline and follow-up assessment visits. Compliance with nutrition bar intake was 86 ± 11% and 87 ± 14% among INT group adults and teens respectively. There was considerable obesity, hypertension, dyslipidemia, inflammation, and insulin resistance in all subjects and baseline diets were universally poor. Self-report activity increased and dietary habits improved in both INT and C groups, adults and teens, most notably decreased saturated fat and total carbohydrates (especially added sugars). Weight was stable, even in the INT group despite the addition of 220 additional kcal in two daily nutrition bars. In paired analyses, systolic blood pressure (SBP) improved significantly in INT teens (-6.7 ± 9.2 mm Hg, p = 0.02), and worsened in C teens (+6.3 ± 7.7 mm Hg, p = 0.04); p = 0.002 for unpaired comparison by teen group. Plasma homocysteine levels and two amino acids, citrulline and sarcosine, implicated in the arginine-urea cycle pathway fell in both INT parents and teens, but not in controls. The drop in citrulline was more significant in INT teens ( p = 0.005) than in adults ( p = 0.047). In a diet-induced obesity mouse model, elevated plasma citrulline has been associated with cardiometabolic complications attributed to decreased systemic arginine bioavailability that may affect capacity to produce nitric oxide. The observed metabolomic changes are consistent with more efficient mitochondrial processing and may relate to the systolic BP improvement observed in teens. Conclusions: A nutritional supplement bar may be a valuable adjunct for weight management, resulting in early favorable metabolomic changes.
Orphan Nuclear Receptor ERRα Controls Macrophage Metabolic Signaling and A20 Expression to Negatively Regulate TLR-Induced Inflammation
Authors: Jae-Min Yuk, Tae Sung Kim, Soo Yeon Kim, Hye-Mi Lee, Jeongsu Han, Catherine Rosa Dufour, Jin Kyung Kim, Hyo Sun Jin, Chul-Su Yang, Ki-Sun Park, Chul-Ho Lee, Jin-Man Kim, Gi Ryang Kweon, Hueng-Sik Choi, Jean-Marc Vanacker, David D. Moore, Vincent Giguère, Eun-Kyeong Jo
Journal: Immunity (2015)
Book: American Surgery, An Illustrated History
Authors: W. Stoney
Journal: BMJ (1999)

Ira M Rutkow Lippincott Williams and Wilkins,£52.93, pp 656 ISBN 0 316 76352 7 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> When you think about it, much of surgical teaching is based on history, particularly teaching done in the operating room. Surgical residents learn early in their training that it is not necessary to repeat mistakes made in the past, and that every useful operation has evolved through a process of trial and error. The concept of standing on the shoulders of giants is not lost on the present generation of surgeons. When asked … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Manufacturing Victims: What The Psychology Industry Is Doing To People
Authors: Raj Persaud
Journal: BMJ (2000)

Tana Dineen 

Constable, £14.99, pp 332 ISBN 0094797900

Rating: ![Graphic][1] ![Graphic][2] 

Distinctions between terms such as psychotherapist, psychoanalyst, psychologist, and psychiatrist frequently ensnare preliminary discussions of mental concepts, and such disorientation extends to popular books like this. The subtitle, “What the psychology industry is doing to people,” is misleading as the real reference should be to psychotherapy or counselling and not the entire academic discipline of psychology, which includes many non-therapy branches such as developmental and comparative psychology.

For a huge amount, if not most, of psychology has absolutely nothing to do with therapy. So the effect of the book's albeit justified criticisms of therapy would be akin to a psychiatrist mounting an attack on the whole of …

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Sudden, Unexpected Death in Epilepsy
Authors: S D Lhatoo, J W A S Sander
Journal: New England Journal of Medicine (2011)

Sudden unexpected death in epilepsy is the most common category of seizure-related death for patients who develop chronic epilepsy, accounting for up to 17% of epilepsy deaths. Sudden unexpected death in epilepsy is defined as a sudden, unexpected, non-accidental death in an individual with epilepsy with or without evidence of a seizure having occurred (excluding documented status epilepticus) and where autopsy does not reveal an anatomical or toxicological cause of death. Incidence rates range between 0.35 and 2.70 per 1000 person-years in the population-based studies and between 1.50 and 9.30 per 1000 person-years in selected cohorts. Seizure frequency appears to be an important factor in sudden unexpected death in epilepsy, although the exact pathogenetic mechanisms involved are unclear.
Abstract 4034: The anti-peritoneal metastasis properties of Yangzheng Xiaoji, the potential role of hyaluronan and CD44
Authors: Wen G. Jiang, Yongning Jia, Lin Ye, Ke Ji, Yong Gao, Cong Wei, Yiling Wu, Nick Topley, Anna Kift-Morgan, Jiafu Ji
Journal: Cancer Research (2014)

Abstract Introduction. Peritoneal metastasis is a frequently occurring complication patients with gastrointestinal, pancreatic, ovarian cancers and is a condition difficult to manage, clinically, due largely to the lack of effective treatment. In the present study, we report an accidental and novel discovery that the extract of Yangzheng Xiaoji (YZXJ), a traditional medical formula used in cancer treatment had an anti-peritoneal metastasis function. Materials and methods. Human primary cultured peritoneal mesothelial cells were used as an in vitro cellular model. Human gastric, colorectal, pancreatic, ovarian and prostate cancer cells were used in the tests. Tumour-mesothelial interaction, invasion and migration were assessed with YZXJ. Athymic nude mice peritoneal metastasis model was used to evaluate the effects in vivo. Results. Soluble YZXJ was firstly extracted in a highly reproducible manner. YZXJ extract (DME25) had a negletable toxicity to cancer cells and mesothelial cells. However, it profoundly inhibited the tumour-mesothelial adhesions in the type of tumour cells tested with pancreatic and colorectal cancer cells amongst the most sensitive ones to YZXJ (p&amp;lt;0.001), a phenomenon seen with a number of cell based assays. The inhibitory effect was also seen with cellular migration. A similar pattern of inhibition was seen on tumour adhesion to hyaluronan (HA) coated surface. It was further revealed that YZXJ and an hyaluronan inhibitor and anti-CD44 antibodies had additive effects with YZXJ on tumour-mesothelial interactions. YZXJ extract had an inhibitory effect on the phosphorylation of SRC kinase in cancer cells and in mesothelial cells as shown by Western blotting and immunofluorescence microscopy. In the peritoneal metastasis in vivo model, it was demonstrated that intraperitoneal administration of YZXJ significantly reduced the formation of metastatic nodules (p=0.035, control vs YZXJ treatment). This was seen with little side effects. We have also shown that hyaluronan inhibitor strengthened the inhibitory effect exerted by YZXJ. Conclusion. Yangzheng Xiaoji has an potent inhibitory effect on tumour-mesothelial interactions of a variety of tumour types and also markedly reduces the peritoneal metastasis in vivo. This effect is likely to be achieved by its effect on the SRC signalling pathway. Yangzheng Xiaoji presents a new way of treating peritoneal metastasis. Citation Format: Wen G. Jiang, Yongning Jia, Lin Ye, Ke Ji, Yong Gao, Cong Wei, Yiling Wu, Nick Topley, Anna Kift-Morgan, Jiafu Ji. The anti-peritoneal metastasis properties of Yangzheng Xiaoji, the potential role of hyaluronan and CD44. [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 4034. doi:10.1158/1538-7445.AM2014-4034
Clinical characteristics and determinants of exacerbation in Japanese patients with COPD: Hokkaido COPD cohort study results
Authors: Masaru Suzuki, Hironi Makita, Satoshi Konno, Kaoruko Shimizu, Natsuko Taniguchi, Yoichi M. Ito, Masaharu Nishimura
Journal: European Respiratory Journal (2012)

Introduction: Exacerbations are one of the major factors that may influence natural history of COPD. However, little is known about clinical characteristics and determinants of exacerbation of COPD in a Japanese population. Aim: To examine characteristics and determinants of exacerbation in Japanese patients with COPD in a 5-year observational cohort study. Methods: A total of 279 patients with COPD participated in the Hokkaido COPD cohort study (AJRCCM 2012) and 268 subjects (GOLD 1, 26%; GOLD 2, 45%; GOLD 3, 24%; GOLD 4, 5%) who had clinical data of multiple visits were analyzed for this analysis. Exacerbation was defined in four ways: symptom criteria, requiring prescription change (prescription criteria), requiring antibiotics treatment (antibiotics criteria), and requiring hospital admission (admission criteria). Exacerbation frequency was observed over a period of 5 years. Results: Exacerbation event frequency was 0.24±0.47/yr (symptom criteria), 0.20±0.43/yr (prescription criteria), 0.13±0.28/yr (antibiotics criteria), and 0.06±0.19/yr (admission criteria). Cox proportional hazard model showed that an increase in SGRQ total score was significantly associated with short exacerbation-free period defined by all criteria and a decrease in body mass index (BMI) was also associated with short exacerbation-free period defined by antibiotics and admission criteria. Subjects who experienced hospital admission >1/yr tended to have rapid annual decline in FEV1 (p=0.07). Conclusion: While exacerbation frequency is low in our cohort subjects, poor health-related quality of life and low BMI are independent risk factors for the development of exacerbation of COPD.
The Heart, Arteries and Veins.
Authors: M.D J.willis Hurst
Journal: Annals of Internal Medicine (1974)

Basic foundations of cardiology General evaluation of the patient, A. History and physical examination The major cardiovascular system Heart failure Electrophysiology and diagnosis and management of disorders of rhythm or conduction Shock, syncope, sudden death and cardio-pulmonary resuscitation Coronary heart disease Systemic arterial hypertension Valvular heart disease Myocardial, pericardial and endocardial disease Congenital heart disease Pulmonary hypertension and pulmonary heart disease The heart and systemic disease or conditions Miscellaneous causes of heart disease The heart and special physiologic conditions Emotions and the cardiovascular system Environmental factors and the cardiovascular system Diseases of the blood vessels - a diagnosis and treatment Diagnostic ultrasound techniques used in the evaluation of the cardiovascular system Diagnostic radionuclide and nuclear techniques used in the evaluation of the cardiovascular system Diagnostic techniques of cardiac catheterization and vascular angiography Cardiovascular pharmacology Techniques of performing interventional therapeutic procedures for the management of patients with vascular and valvular disease The heart, anesthesia and surgery Cardiovascular surgical techniques and temporary procedures to support the circulation Insurance and legal problems.
Original article: Sinonasal pathology in nonallergic asthma and COPD: ‘united airway disease’ beyond the scope of allergy
Authors: G. Hens, B. M. Vanaudenaerde, D. M. A. Bullens, M. Piessens, M. Decramer, L. J. Dupont, J. L. Ceuppens, P. W. Hellings
Journal: Allergy (2008)

In contrast to the epidemiological and clinical association between allergic rhinitis and asthma, upper airway inflammation is less characterized in patients with nonatopic asthma and virtually unexplored in chronic obstructive pulmonary disease (COPD). Here, sinonasal pathology is studied in patients with allergic asthma, nonallergic asthma and COPD.Ninety patients with stable bronchial disease were included in the study, of which 35 were diagnosed with allergic asthma, 24 with nonallergic asthma and 31 with COPD. Concurrently, 61 control subjects without pulmonary disease were included and matched for age and smoking habits respectively with the asthma and the COPD group. Sinonasal symptoms were evaluated on a visual analogue scale and rhinosinusitis-related impairment of quality of life was assessed with the sino-nasal outcome test-22 (SNOT-22) questionnaire. Nasal mucosal abnormalities were quantified with nasal endoscopy and nasal secretions collected for measuring inflammatory mediators.Allergic asthmatics, nonallergic asthmatics and COPD patients reported more nasal symptoms than their respective control subjects, had a higher SNOT-22 score and presented more mucosal abnormalities in the nose. Nasal secretions of both allergic and nonallergic asthmatics contained higher levels of eotaxin, G-CSF, IFN-gamma and MCP-1 than controls. Allergic asthmatics had higher nasal IP-10 levels as well. COPD-patients had higher nasal levels of eotaxin, G-CSF and IFN-gamma than controls.Patients with allergic and nonallergic asthma and COPD show increased nasal symptoms and more nasal inflammation. Hence, our data confirm the 'united airways' concept to be beyond the scope of allergic asthma.
Ethics of Surrogate Consent for Living Organ Donation
Authors: Raquel M Schears
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Clinical Study Of DC-CIK (dendritic cells and cytokine-induced killer cells ) Eliminate Minimal Residual Leukemia
Authors: Zhuanzhen Zheng, Zhang Yuna, Zhang Huimin, Qingchi Liu, Yanping Ma, Weihai Wu, Chuanbao MA, Yuhui Pang, Jianying LI
Journal: Blood (2013)
Abstract 11914: Coronary Sinus Lead Extraction_Laser Required
Authors: Erin A Fender, Charles A Henrikson
Journal: Circulation (2014)

Introduction: Studies of coronary sinus (CS) lead extraction have reported high success rates with manual traction, but largely included leads with dwell times less than 3 years. Our aim was to evaluate CS lead extractions of more chronic leads and establish if dwell time was correlated to complexity of extraction. Methods: This is a single center, retrospective review of 96 consecutive lead extraction procedures. A total of 14 CS leads were identified. Results: Of the 14 CS lead extractions, 13 were successful from an endovascular approach. Indications included 8 cases of endocarditis, 4 pocket infections, 1 dislodged lead and 1 malfunctioning lead. Six extractions were performed with manual traction, dwell time of these leads ranged from 5 months to 28 months, with an average implant time of 10.8 months. Eight extractions required use of a laser sheath (LS) to free the lead from adhesions. In no case was the LS used within the CS. The dwell time of these leads ranged from 45 months to 114 months, with an average lead age of 83.4 months. One LS case also required use of a rotating mechanical sheath. In one LS assisted extraction, the lead fragmented within the CS and could not be recovered endovascularly despite the use of multiple snares. This lead fragment was removed via an open surgical approach. Conclusion: CS leads require the use of advanced extraction tools in the majority of patients. All leads placed in the preceding 28 months were removed with simple manual traction, however all leads that were in place for more than 3 years required use of a LS. In contrast to prior reports, we found that coronary sinus leads posed the same procedural challenges as other cardiac leads and typically require advanced extraction tools.
Hormone Replacement Therapy Falls Out of Favor With Expert Committee
Authors: Brian Vastag
Journal: JAMA (2002)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal