tbuckley/cabot-search huggingface dataset:
Hospital-acquired pneumonia (HAP) in patients admitted in Imam Khomeini Hospital between January and August 2012
Authors: Siavash Abedi, Ebrahim Salehi Far, Ali Sharifpour, Masood Aliali
Journal: European Respiratory Journal (2013)

Back ground   HAP is the most commonly – acquired infection in icu patients and related to a high mortality rate.  The detection of the most common causative microorganism, are imperative for guiding an initial empiric therapy in pneumonia   Methods   All Patients were Studied Prospectively for the occurrence of Pneumonia.  Those were the inclusion criteria in terms of APACHE II, CPIS, outcome, therapy were investigated.  Antimicrobial Susceptibility test were determined by disk diffusion method and dilution medium (the MIC) according to CLSI guideline on the ETA and BAL sampling.   Results   Incidence of nosocomial pneumonia was 11.5%, including 91. 4% VAP and 8,6% Non – Vap: VAP also includes 80% early – onset and 20% Late – onset. The. The most common microorganisms isolated was Acinetobacter SPP 22% and Staphylococcus aureus (14.6%), respectively. 30% of Acinetobacter SPP were resistant to all antimicrobial agents. Although most routin antibiotics had no effect on Acinetobacter SPP resistance (100%), but Ceftazidime was the most effective (Resistance 22.2%)   Discussion   Acinetobacter spp. Were the most Frequently isolated microorganism(22%), followed by Stapylococus aureus(14.6%) .Although resistance rates to Acinetobacter SPP. other Strains was very high, but ceftazidime was the most active agent against Acinetobacter SPP. The best options for empirical antibiotic therapy is as follow: Among the cephalosporins, ceftazidime: Among the aminoglycosides, tobramycin and Among Fluoroquinolones, ofloxacin are thebetter option. in this study the death rate beween two groups is not significant. ETA technique was Known as a method for the routine assessment of resistance.
SELECTIVE CORTICAL UNDERCUTTING
Authors: WILLIAM BEECHER SCOVILLE, EDWARD K. WILK, ANTHONY J. PEPE
Journal: American Journal of Psychiatry (1951)

1. Complete lobotomy causes too much blunting of the personality to warrant its further use except in severely deteriorated psychotic patients. 2. Selective cortical undercutting is presented as a new method of fractional lobotomy and offers certain technical advantages over other methods, in precision, preservation of adjacent blood supply, facility, and accessibility. 3. A sufficient number of undercuttings have now been done to permit specific recommendations for its therapeutic use. 4. The results of undercutting indicate that there is little specificity of the frontal lobes in their effect on psychoses but definite specificity in their effect on personality. The psychoses are favorably affected by quantitative isolation of any area of the frontal lobes. The personality is unaffected and shows little if any blunting following isolating of the orbital surface and a definite blunting upon isolation of the superior surface, similar but to a less degree to that found in a standard lobotomy. 5. There is more apparent personality deficit in nonpsychotic than in psychotic patients following any type of lobotomy. Hence only fractional lobotomies should be used in patients suffering from mood disorders, neuroses, or pain. 6. Undercutting of the orbital surface appears the ideal operation for psychoneuroses and milder mood disturbances because of the almost complete absence of personality change. 7. Undercutting of the superior surface or the orbital surface is recommended for the schizophrenic and severe affective psychoses, the results being roughly equal to those obtained in standard lobotomy with significantly less personality deficit. 8. Pain, if accompanied by addiction, psychalgia, or excessive anxiety, responds well to undercutting of the superior surface. 9. Undercutting of the medial, cingulate gyrus surface is technically more difficult and dangerous with inferior early, and possibly equal late, results making final evaluation difficult. 10. Certain cases showing an inadequate response to selective undercutting can be converted to a more complete lobotomy as a second-stage procedure.
Association between lower respiratory tract symptoms and falls in peak expiratory flow in children
Authors: J B Clough, P D Sly
Journal: European Respiratory Journal (1995)

Peak expiratory flow (PEF) measurements are increasingly recommended in childhood asthma management. However, few data are available on the temporal relationship between the onset of upper and lower respiratory tract symptoms and significant falls in PEF. We wanted to determine whether falls in PEF constitute a sensitive marker for clinical episodes of respiratory morbidity. We therefore analysed data on daily PEF and respiratory symptom recording from a 12 month longitudinal study in 192 children aged 7 and 8 yrs with current respiratory symptoms. Outcome measures were number of and relationship between: 1) episodes of fall in PEF (defined as a fall in PEF for more than 2 days to < 1.5 SD below individual mean morning PEF); and 2) upper and lower respiratory tract symptom events (defined as a respiratory symptoms score of > 3 units within three consecutive days). One hundred and eight six of the 192 children completed the study. For the group as a whole, the mean number of PEF episodes per subject was 3.5, and the mean number of symptom events 8.9, with 29% of symptom events being temporally associated with a PEF episode, and 40% of PEF episodes not being accompanied by a symptom event. Forty nine percent of PEF episodes were preceded by at least two consecutive days of either upper or lower respiratory symptoms. We conclude that falls in PEF alone were not a sensitive marker for episodes of respiratory morbidity. On almost half of the occasions where PEF did fall, morbidity could have been detected at least 2 days earlier using symptom reporting.(ABSTRACT TRUNCATED AT 250 WORDS)
Comparison of ResMed AutoSet (version 3.03) with polysomnography in the diagnosis of the sleep apnoea/hypopnoea syndrome
Authors: M Gugger
Journal: European Respiratory Journal (1997)

In patients with the sleep apnoea/hypopnoea syndrome (SAHS), accurate and timely diagnostic evaluation and initiation of effective treatment is important. Therefore, an increasing number of limited sleep studies are now performed nowadays diagnosing the SAHS in typical patients. It was the aim of the present study to evaluate the diagnostic accuracy of one such system, the updated ResMed Sullivan AutoSet, against polysomnography. Sixty seven patients underwent full overnight polysomnography and simultaneous data acquisition with the AutoSet. Up to now, the AutoSet was designed for apnoea detection only. The new AutoSet, with software version 3.03, detects apnoeas if ventilation drops to <25%, and apnoeas+hypopnoeas if ventilation drops to <50%, compared with the recent average (100 s), using two independent detectors. A two page report with graphically displayed information on oximetry, snoring and breathing parameters, and an apnoea+hypopnoea index (AHI) and an apnoea index (AI) are provided at the end of each study night. There was a correlation between the AHI assessed by the AutoSet (AHI-AutoSet) and by polysomnography (AHI-PSG; r=0.95). The mean difference between the AHI-AutoSet minus the AHI-PSG was 4.2 (SD 7.2) respiratory events x h(-1) (p<0.001). The AutoSet identified patients with an AHI-PSG >20 events x h(-1) (a level of respiratory disturbance that would warrant consideration for treatment in most centres for sleep disorders), with a sensitivity of 97% and a specificity of 77%. The AutoSet was superior to oximetry alone. As event counting was similar between the two methods, the AHI-AutoSet may provide a reasonable indicator of the respiratory disturbance at night, especially when taking the patients graphic study report into consideration. In conjunction with full clinical information on the patients under investigation, the AutoSet might become a useful device in diagnosing the sleep apnoea/hypopnoea syndrome.
Products of neutrophils and eosinophils increase the responsiveness of human isolated bronchial tissue
Authors: AR Hallahan, CL Armour, JL Black
Journal: European Respiratory Journal (1990)

This study examines the possibility that products of neutrophils and eosinophils could increase the responsiveness of human isolated bronchial tissue. Neutrophils and eosinophils were isolated from the peripheral blood of healthy volunteers. The cells were incubated with 1 microM calcium ionophore A23187 for 10-15 min then centrifuged, the supernatant collected and stored at -70 degrees C. Human bronchial rings (2-3 mm diameter, 3-4 mm long) were prepared from specimens resected at thoracotomy. The tissues were suspended in organ baths under a 1 g load and changes in tension measured isometrically. Stable contractions to bolus doses of histamine (0.1-10 microM) or to electrical field stimulation (40-100 V, 4-16 Hz, 1 ms for 20 s) were established. Supernatant from 106 neutrophils or 105 eosinophils was then added and tissue responsiveness reassessed. Neutrophil supernatant increased tissue responsiveness to histamine and electrical field stimulation by 54 +/- 17% (n = 5, p less than 0.05) and 18 +/- 7% (n = 6, p less than 0.05), respectively. Eosinophil supernatant increased the histamine response by 60 +/- 23% (n = 8, p less than 0.05) while tissue responsiveness to electrical field stimulation was unchanged (n = 3). Thus, as neutrophils and eosinophils can change the responsiveness of human bronchus in vitro it is possible that they do this in vivo and may not simply be temporally related to the development of bronchial hyperresponsiveness.
The basal ganglia within a cognitive system in birds and mammals
Authors: Christopher I. Petkov, Erich D. Jarvis
Journal: Behavioral and Brain Sciences (2014)

Abstract The primate basal ganglia are fundamental to Ackermann et al.'s proposal. However, primates and rodents are models for human cognitive functions involving basal ganglia circuits, and links between striatal function and vocal communication come from songbirds. We suggest that the proposal is better integrated in cognitive and/or motor theories on spoken language origins and with more analogous nonhuman animal models.
Lymphoepithelioid cell lymphoma (Lennert’s lymphoma) presenting as atypical granuloma annulare
Authors: M. Bhushan, N.M. Craven, G.R. Armstrong, R.J.G. Chalmers
Journal: British Journal of Dermatology (2000)

Journal Article Lymphoepithelioid cell lymphoma (Lennert's lymphoma) presenting as atypical granuloma annulare Get access M. Bhushan, M. Bhushan Departments of Dermatology and M.Bhushan. E‐mail: mbhushan@fs1.ho.man.ac.uk Search for other works by this author on: Oxford Academic Google Scholar N.M. Craven, N.M. Craven Departments of Dermatology and Search for other works by this author on: Oxford Academic Google Scholar G.R. Armstrong, G.R. Armstrong Pathology, Hope Hospital, Stott Lane, Manchester M6 8HD, U.K. Search for other works by this author on: Oxford Academic Google Scholar R.J.G. Chalmers R.J.G. Chalmers Departments of Dermatology and Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 4, 1 April 2000, Pages 776–780, https://doi.org/10.1046/j.1365-2133.2000.03425.x Published: 01 April 2000
Annulate Lamellae in Four Cases of Diffuse Lymphocytic Lymphoma
Authors: Shaw Watanabe, Costan W. Berard, Timothy Triche
Journal: JNCI Journal of the National Cancer Institute (1977)

Annulate lamellae were observed in 4 cases of diffuse lymphocytic lymphoma. Two lymphomas were well differentiated and 2 were of intermediate differentiation. These lymphomas had additional abnormalities of membranes: specifically, excessive blebbing of nuclear membranes and lattice-like formations of tubular endoplasmic reticulum.
Sympathetic Reinnervation Is Required for Mammalian Cardiac Regeneration
Authors: Ian A. White, Julie Gordon, Wayne Balkan, Joshua M. Hare
Journal: Circulation Research (2015)

Although mammalian cardiac regeneration can occur in the neonatal period, the factors involved in this process remain to be established. Because tissue and limb regeneration require concurrent reinnervation by the peripheral nervous system, we hypothesized that cardiac regeneration also requires reinnervation.To test the hypothesis that reinnervation is required for innate neonatal cardiac regeneration.We crossed a Wnt1-Cre transgenic mouse with a double-tandem Tomato reporter strain to identify neural crest-derived cell lineages including the peripheral autonomic nerves in the heart. This approach facilitated the precise visualization of subepicardial autonomic nerves in the ventricles using whole mount epifluorescence microscopy. After resection of the left ventricular apex in 2-day-old neonatal mice, sympathetic nerve structures, which envelop the heart under normal conditions, exhibited robust regrowth into the regenerating myocardium. Chemical sympathectomy inhibited sympathetic regrowth and subsequent cardiac regeneration after apical resection significantly (scar size as cross-sectional percentage of viable left ventricular myocardium, n=9; 0.87%±1.4% versus n=6; 14.05±4.4%; P<0.01).These findings demonstrate that the profound regenerative capacity of the neonatal mammalian heart requires sympathetic innervation. As such, these data offer significant insights into an underlying basis for inadequate adult regeneration after myocardial infarction, a situation where nerve growth is hindered by age-related influences and scar tissue.
Expression of water and ion channels proteins in acute respiratory distress syndrome from different etiologies
Authors: Ruy Pires-Neto, Ellen Nascimento, Joao Souza, Alfredo Rodrigues, Fabiola Bernardi, Thais Mauad, Luiz Silva, Marisa Dolhnikoff
Journal: European Respiratory Journal (2014)

Introduction: Aquaporins (AQP) and ion channels are membrane proteins that facilitate the rapid movement of water and solute across biological membranes. Diffuse alveolar damage compromises the function of these channels and impairs pulmonary edema resolution. Currently, there is no evidence that these channels are similarly impaired in Acute respiratory distress syndrome (ARDS) of different etiologies. Aim: In this study we quantified the expression of AQP1, Na-K-ATPase and Epithelium Sodium Channel (ENaC) in alveolar septa of patients that died of ARDS from different etiologies. Methods: Using immunohistochemistry and image analysis we analyzed autopsy lung tissue of patients that died with ARDS (n=45) secondary to: Leptospirosis (n=15), Influenza-A H1N1 (n=16) and sepsis (n=14). Two groups of patients were used as controls (n=28): Cardiogenic alveolar edema (n=13) and normal lungs of patients that died of non-pulmonary causes (n=15). Data are shown as positive area/ alveolar epithelial length (µm 2 /µm). Results: Compared to control groups, ARDS patients showed a lower expression of AQP1 (0.69±0.3 vs 0.53±0.3 µm 2 /µm; p=0.017) and ENaC (0.91±0.43 vs 0.57±0.33 µm 2 /µm; p=0.001) and a higher expression of Na-K-ATPase (0.74±0.41 vs 1.26±0.86 µm 2 /µm; p=0.018). In a subgroup analysis of ARDS patients, there was no difference in proteins expression among ARDS of different etiologies. Conclusion: Water and ions channels are impaired in ARDS patients independently of ARDS etiology.
Expression and preferential inhibition of inducible nitric oxide synthase in aortas of endotoxemic rats.
Authors: A L Weigert, E M Higa, M Niederberger, I F McMurtry, M Raynolds, R W Schrier
Journal: Journal of the American Society of Nephrology (1995)

Septic shock is associated with high mortality. There is in vitro evidence that the induction of nitric oxide synthase (iNOS) in vascular smooth muscle cells may be an important mediator of the systemic vasodilation and hypotension associated with sepsis. In this study, an in vivo murine model of sepsis was used to further examine this important question. Lipopolysaccharide (LPS), the major wall component of gram-negative bacteria, was administered to rats. By the use of a selective cDNA probe for iNOS, mRNA for iNOS was demonstrated in the aortas of these rats. The functional significance of this iNOS was then examined with aminoguanidine, a preferential inhibitor of iNOS. Aminoguanidine reversed the blunted phenylephrine-evoked contraction of endothelium-denuded aortic rings from LPS-treated rats or rings exposed to LPS in vitro. Aminoguanidine did not impair the relaxation of aortic rings with endothelium to acetylcholine, a known stimulator of endothelial NOS. The reversal of LPS-induced vascular hyporesponsiveness by aminoguanidine therefore strongly supports the functional importance of iNOS mRNA expression in the aorta of endotoxemic rats. Future clinical trials in treating septic shock should therefore consider the preferential inhibition of iNOS while maintaining the integrity of endothelial NOS.
Thyroid Dysfunction in Chronic Renal Failure
Authors: Victoria Sy Lim, Victor S. Fang, Adrian I. Katz, Samuel Refetoff
Journal: Journal of Clinical Investigation (1977)

Thyroid function was evaluated in 46 patients with end-stage kidney disease and 42 normal subjects. Patients were studied before and after the institution of maintenance hemodialysis (HD) and after renal transplantation (RT). Serum total triiodothyronine concentrations (TT3, ng/100 ml, mean±SD) were 63±17 and 83±22 in the non-HD and HD groups, respectively. Values from normal subjects were 128±25 and from RT patients 134±20. The TT3 was in the hypothyroid range (<78 ng/100 ml; 2 SD below normal mean) in 80% of non-HD and 43% of HD patients. Mean serum total thyroxine concentration (TT4), although within the normal range, was lower than the control value. T4-binding globulin capacity was also slightly lower but the difference was not statistically significant. Among patients whose TT4 was 1 SD below the normal mean, the free T4 index was equally depressed, suggesting that factors other than decreased binding capacity might be responsible for the low TT4. In addition, there was a 37% incidence of goiter. Mean serum thyroid-stimulating hormone (TSH) was not elevated and the TSH response to thyrotropin-releasing hormone (TRH) was distinctly blunted, suggesting the possibility of pituitary dysfunction as well. In vivo 125I-l-T4 and 131I-l-T3 kinetics during 0.2 mg/day of l-T4 replacement showed marked reduction in T3 turnover rate in the uremic patients, both before and during HD; the values (μg T3/day, mean±SD) for the different groups were as follows: normal, 33.8±6.1; non-HD, 13.5±2.6; HD, 12.9±3.1; and RT, 30.3±7.1. The low T3 turnover rate was due to impaired extrathyroidal conversion of T4 to T3. The mean percent±SD of metabolized T4 converted to T3 was 37.2±5.8 in normal subjects, 15.7±3.1 in non-HD, 12.8±1.7 in HD, and 34.0±14.7 in RT patients. In contrast, thyroidal T3 secretion rate was not different between the control and the three patient groups. Thus, it appears that uremia affects thyroid function at several levels: (a) subnormal pituitary TSH response to TRH; (b) possible intrathyroidal abnormalities as suggested by slightly decreased TT4 and high incidence of goiter; and (c) abnormal peripheral generation of T3 from T4. Restoration of renal function with RT resulted in normalization of all parameters of thyroid function with the exception of blunted or absent TSH response to TRH. The latter may be a direct consequence of glucocorticoid administration.
Persistent Tachypnea of Infancy. Usual and Aberrant
Authors: Daniela Rauch, Martin Wetzke, Simone Reu, Waltraud Wesselak, Andrea Schams, Meike Hengst, Birgit Kammer, Julia Ley-Zaporozhan, Matthias Kappler, Marijke Proesmans, Joanna Lange, Amparo Escribano, Eitan Kerem, Frank Ahrens, Frank Brasch, Nicolaus Schwerk, Matthias Griese
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Persistent tachypnea of infancy (PTI) is a specific clinical entity of undefined etiology comprising the two diseases neuroendocrine cell hyperplasia of infancy (NEHI) and pulmonary interstitial glycogenosis. The outcome of typical NEHI is favorable. The outcome may be different for patients without a typical NEHI presentation, and thus a lung biopsy to differentiate the diseases is indicated.To determine whether infants with the characteristic clinical presentation and computed tomographic (CT) imaging of NEHI (referred to as "usual PTI") have long-term outcome and biopsy findings similar to those of infants with an aberrant presentation and/or with additional localized minor CT findings (referred to as "aberrant PTI").In a retrospective cohort study, 89 infants with PTI were diagnosed on the basis of clinical symptoms and, if available, CT scans and lung biopsies. Long-term outcome in childhood was measured on the basis of current status.Infants with usual PTI had the same respiratory and overall outcomes during follow-up of up to 12 years (mean, 3.8 yr) as infants who had some additional localized minor findings (aberrant PTI) visualized on CT images. Both usual and aberrant PTI had a relatively favorable prognosis, with 50% of the subjects fully recovered by age 2.6 years. None of the infants died during the study period. This was independent of the presence or absence of histological examination.PTI can be diagnosed on the basis of typical history taking, clinical findings, and a high-quality CT scan. Further diagnostic measures, including lung biopsies, may be limited to rare, complicated cases, reducing the need for an invasive and potentially harmful procedure.
In Finland anticoagulant treatment is monitored by general practitioners
Authors: K Eskola, I Virjo, M Isokoski, P. Aittobiemi, H Kurunmaki, A Latva-Nevala, M Paloneva, A-M Wallin, M Viitaniemi, S Ylinen, S Ohman
Journal: BMJ (1996)

A random sample of 151 patients (83 female) was given a questionnaire, and the current international normalised ratio was noted in addition.The mean (SD) age was 63-7 (10-7) years (range 24-93).Most of the patients (126) had a cardiac diagnosis (valve replacement, valvular disease, etc), while the rest had deep venous thrombosis and pulmonary embolism.Strength of warfatin tablets-Warfarin tablets are available in three strengths (1, 3, and 5 mg).Only seven patients used the 5 mg tablet.Since only five patients were taking 9 mg or more daily, we suggest that all patients could be simply and perhaps more safely treated with the 1 and 3 mg tablets only.We suggest that the 5 mg tablet be abandoned.Playing safe and computerisation-With increasing numbers of patients being treated, computeri- sation of the dose is being considered.The official target for the international normalised ratio was 2-0-3-0.Our results showed a peak in the lower half of the target zone, presumably because the doctors were playing safe: the ratio was 1-0-1-4 in 11 patients, 1-5-1-9 in 37, 2-0-2-4 in 45, 2-5-2.9 in 38, 3 0-3 4 in 16, 3 5-3 9 in three, and 4-0-4-4 in one.The low incidence of side effects (only one patient required admission to hospital) reflects this caution.A transfer to computerised control, aiming for the middle of the official target zone, would shift the distribution to the right, possibly increasing the rate of complications.Communication with patients-Patients were aware of their dose of warfarin (n-148), knew the reason for taking it (143), and were meticulous in their compliance (149 took it at same time each day, and 138 knew not to take a double dose to compensate for forgetting a dose).Ninety five, however, did not know the desirable international normalised ratio, and only three knew that the abbreviation INR stood for international normalised ratio.With patients being encouraged to have more involvement in their treatment, it is important for them to have a better of under- standing of the goals of treatment and the terms used to monitor it.