tbuckley/cabot-search huggingface dataset:
Isolated Loss of Consciousness in Children With Minor Blunt Head Trauma
Authors: Lois K. Lee, David Monroe, Michael C. Bachman, Todd F. Glass, Prashant V. Mahajan, Arthur Cooper, Rachel M. Stanley, Michelle Miskin, Peter S. Dayan, James F. Holmes, Nathan Kuppermann
Journal: JAMA Pediatrics (2014)

A history of loss of consciousness (LOC) is frequently a driving factor for computed tomography use in the emergency department evaluation of children with blunt head trauma. Computed tomography carries a nonnegligible risk for lethal radiation-induced malignancy. The Pediatric Emergency Care Applied Research Network (PECARN) derived 2 age-specific prediction rules with 6 variables for clinically important traumatic brain injury (ciTBI), which included LOC as one of the risk factors.To determine the risk for ciTBIs in children with isolated LOC.This was a planned secondary analysis of a large prospective multicenter cohort study. The study included 42 ,412 children aged 0 to 18 years with blunt head trauma and Glasgow Coma Scale scores of 14 and 15 evaluated in 25 emergency departments from 2004-2006.A history of LOC after minor blunt head trauma.The main outcome measures were ciTBIs (resulting in death, neurosurgery, intubation for >24 hours, or hospitalization for ≥2 nights) and a comparison of the rates of ciTBIs in children with no LOC, any LOC, and isolated LOC (ie, with no other PECARN ciTBI predictors).A total of 42 412 children were enrolled in the parent study, with 40 693 remaining in the current analysis after exclusions. Of these, LOC occurred in 15.4% (6286 children). The prevalence of ciTBI with any history of LOC was 2.5% and for no history of LOC was 0.5% (difference, 2.0%; 95% CI, 1.7-2.5). The ciTBI rate in children with isolated LOC, with no other PECARN predictors, was 0.5% (95% CI, 0.2-0.8; 13 of 2780). When comparing children who have isolated LOC with those who have LOC and other PECARN predictors, the risk ratio for ciTBI in children younger than 2 years was 0.13 (95% CI, 0.005-0.72) and for children 2 years or older was 0.10 (95% CI, 0.06-0.19).Children with minor blunt head trauma presenting to the emergency department with isolated LOC are at very low risk for ciTBI and do not routinely require computed tomographic evaluation.
Serum uric acid level is an independent predictor of restenosis after successful percutaneous transluminal coronary stent implantation
Authors: Kazuaki Kumagai, Masatake Fukunami, Tsuyoshi Shimonagata, Takahisa Yamada, Akio Hirata, Mitsutoshi Asai, Nobuhiko Makino, Hidetaka Kioka, Noritake Hoki
Journal: Journal of the American College of Cardiology (2002)
Therapeutic experience with fludrocortisone in diabetic postural hypotension.
Authors: I W Campbell, D J Ewing, B F Clarke
Journal: BMJ (1976)

Fourteen patients with diabetic postural hypotension were treated with fludrocortisone for a mean 12 months (range 6-30 months). The mean daily dose of fludrocortisone was 0.2 mg (range 0.1 mg-0.4 mg). Standing systolic and diastolic blood pressures increased significantly (P less than 0.001) after treatment with fludrocortisone and the postural hypotension decreased significantly (P less than 0.001). Thirteen patients noted considerable symptomatic improvement. Fludrocortisone should be used cautiously in patients with congestive cardiac failure or the nephrotic syndrome.
ED-05 * GENDER AND REPRODUCTIVE FACTORS IN RELATION TO SURVIVAL IN GLIOBLASTOMA
Authors: K. Egan, L. B. Nabors, J. Olson, R. LaRocca, Z. Thompson, M. Madden, R. Thompson
Journal: Neuro-Oncology (2014)

BACKGROUND: Glioblastoma multiforme (GBM) is the most common and lethal primary tumor of the brain. Known clinical prognostic factors include patient age, surgical extent of tumor resection (EOR), and functional performance (Karnofsky) status (KPS). A few studies have suggested differential survival by gender though to our knowledge no study has examined the prognostic impact of reproductive history and hormonal exposures in women. We evaluated gender-specific mortality in a large cohort of GBM patients that underwent current standard of care and investigated clinical, tumor, and reproductive factors associated with gender-specific differences in survival. METHODS: Analyses were based on 550 patients with GBM (324 men and 226 women) diagnosed 2007-2012 and enrolled in a clinic-based case-control study conducted at medical centers in the Southeast. Information on reproductive and hormonal exposures in women was available from the study interview. RESULTS: Deaths from GBM were documented in 449 patients a median of 17.2 months following diagnosis (16.0 months in men and 18.6 months in women). Men and women were similar in age at diagnosis (median of 59 and 60 years, respectively; P= 0.992), education (41% and 39%, respectively, held a college degree; P= 0.749), KPS (median of 90% in both groups; P = 0.167), and EOR (32% and 29%, respectively, with gross total resection; P= 0.547). A college degree or higher education was independently associated with prolonged survival (multivariate-adjusted p = 0.003). Adjusting for age, education, EOR and KPS, the hazard of death was significantly greater in men (Hazard Ratio (HR): 1.25; 95% Confidence Interval (CI): 1.03, 1.51; p = 0.026). When compared to men, a reduced hazard was observed among parous women (HR: 0.78; p = 0.022) and in those that ever used hormonal replacement therapy (HR: 0.67; p = 0.016) controlling for other covariates. CONCLUSIONS: Reproductive history and exogenous hormones may contribute to a female survival advantage in patients with GBM.
Left Heart Function in Children with Tetralogy of Fallot before and after Palliative or Corrective Surgery
Authors: JAY M. M. JARMAKANI, THOMAS P. GRAHAM, RAMON V. CANENT, PAUL H. JEWETT
Journal: Circulation (1972)

Left heart volume and left ventricular mass (LV mass) were calculated from biplane cineangiocardiograms in 58 tetralogy of Fallot (TF) patients preoperatively, in 31 patients after shunt procedure, and in 24 patients after complete correction. Preoperatively, the LV end-diastolic volume and left atrial maximal volume (LA max ) were normal in cyanotic infants less than 2.0 years old and in acyanotic patients more than 2.0 years old. These variables, however, were less than normal in cyanotic children &gt; 2.0 years old. Left ventricular ejection fraction (LVEF) and LV systolic index (LVSI) were both less than normal in all groups preoperatively. LV mass was normal preoperatively. After successful shunt procedure, there was a significant increase ( P &lt; 0.01) in LVEDV, LVSI, LA max , and LV mass. The LVEF, however, remained less than normal. After successful corrective surgery, the total group showed a significant increase ( P &lt; 0.01) in LVEDV, LVSI, LA max ,and LV mass as compared with preoperative values. Furthermore, the LVEDV was slightly but significantly higher than normal and the LV ejection fraction remained significantly depressed from normal. There was an inverse correlation between LVEDV or LVSI, expressed as a percent of normal, and hemoglobin concentration but not with the net left-to-right shunt or aortic saturation. The decreased LV ejection fraction in cyanotic tetralogy patients in the presence of decreased peak LV pressure (decreased afterload) as well as the decreased LVEF after shunt procedure or complete correction (increased preload) suggests that LV function is depressed in tetralogy patients and remains depressed despite corrective surgery.
Case 41-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Marshall M. Kaplan, Ronald A. DeLellis
Journal: New England Journal of Medicine (1972)

Presentation of CaseA nine-month-old boy was admitted to the hospital because of hepatic enlargement.The child was the product of a full-term second pregnancy of a 28-year-old mother; gestation was complicated only by iron-deficiency anemia. The birth weight was 15 kg. There was mild neonatal jaundice that cleared on the fourth day. A peripheral-blood smear revealed questionable spherocytosis. At the age of two months intermittent icterus developed. The spleen was palpated for the first time, 1 cm below the left costal margin, and the edge of the liver was felt 3 cm below the right costal margin. The hematocrit . . .
Analysis of HLA-DPB1 Polymorphisms in African–Americans with Sarcoidosis
Authors: MARY J. MALIARIK, KANG MEI CHEN, MARCIE L. MAJOR, ROBERTA G. SHEFFER, JOHN POPOVICH, BENJAMIN A. RYBICKI, MICHAEL C. IANNUZZI
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Several studies have found weak associations between certain human leukocyte antigen (HLA) alleles and sarcoidosis, but none have been conclusive. Glutamic acid at position 69 in HLA-DPB1 has been reported to be strongly associated with chronic beryllium disease. The immunopathologic and clinical similarities between chronic beryllium disease (CBD) and sarcoidosis suggest that similar immune-response genes may be involved in susceptibility in both diseases. We analyzed the DNA sequence of HLA-DPB1 exon 2, which contains the hypervariable regions involved in binding antigens, in blood samples from African–American sarcoidosis patients and healthy controls. Results indicate that Val36 (odds ratio [OR] = 2.30) and Asp55 (OR = 2.03) are associated with increased risk for sarcoidosis, but no association with Glu69 was found. These results suggest that although HLA-DPB1 Glu69 is not associated with sarcoidosis, other alleles may make some contribution to susceptibility to sarcoidosis in African–Americans.
Clearance of bacteriuria on discontinuing oral contraception
Authors: E Mayall
Journal: BMJ (1980)

the administration of intravenous sodium bicar- bonate, his urinary output rose to 50 ml/hour.However, by the next day blood urea had risen to 38 mmol/I (229 mg/100 ml) and the urate level was unchanged.Urgent haemodialysis was performed, with biochemical improvement; in particular, postdialysis urate was 0 50 mmol,l (8 40 mg/ 100 ml).Following a single haemodialysis his diuresis continued over the next three days and his recovery was otherwise uneventful, with no residual renal impairment.We agree that acute renal failure due to a nephrotoxic effect of alcohol is unlikely.In our case muscle damage was both apparent clinically and confirmed biochemically.How- ever, the uric acid level was also grossly ele- vated.The mechanism of acute renal failure as a consequence of myoglobinuria is uncertain although it has been suggested that other factors, including shock and acidosis, are important.'It is well recognised that hyperuricaemia occurs following muscle damage.'Additionally, hyperuricaemia may lead to acute renal failure in the absence of muscle damage.3Muscle damage may result from pressure necrosis following immobility during alcoholic stupor.4We suggest that the resulting hyperuricaemia is a major aetiological factor in the development of acute renal failure in this situation.In similar cases, priority should be given to the estimation of uric acid level and if it is grossly elevated then urgent alkalinisation to increase uric acid solubility and dialysis to reduce uric acid load is indicated.In such circumstances haemodialysis is to be greatly preferred to peritoneal dialysis, as urate clearance is significantly greater.3
Contraceptive implants: long acting and provider dependent contraception raises concerns about freedom of choice
Authors: M S Thompson
Journal: BMJ (1996)

David Bromham's editorial on contraceptive implants ignores the wider issues to voice concern that trial by media could limit contraceptive choice by jeopardising research into new methods. However, it is more beneficial to the public for points of conflict to be debated openly. Furthermore, the impetus for research into new contraceptive technology is driven by profit and political motives and is only marginally affected by the media. Implanted contraceptives may increase the choice of contraceptive methods, but they put control of fertility increasingly into the hands of the medical profession. Herein lies their greatest problem: their potential to increase providers' control over clients' choice. There is the danger that certain groups of women may be targeted for their use: in the United States the coercive use of Norplant for mothers receiving welfare benefit has been suggested. Long acting contraceptives are a contraceptive of choice only when they are available without pressure, as part of a wider menu; when instant removal on request is guaranteed; and when there is an open and free flow of information and opinions between users, health professionals, and special interest groups.A previously-published editorial by David Bromham about contraceptive implants argued that spurious concerns over side effects raised by the mass media were unfairly causing women to limit their choice of contraceptive method. In addition, he contended that "trial by media" discourages contraceptive use and jeopardizes research activities. These points fail to acknowledge that information is an important component of choice and that the burden of proof that a method is safe rests with those who produce the method. Debates about methods, therefore, should take place in a public forum. In addition, the impetus for the contraceptive research industry is financial, and "trail by media" has only a small impact on profit. Provider-dependent contraception (such as the Norplant implant) has the potential to increase provider control over the choice of clients. Such control is dangerous, and testing such contraceptives in populations where women are subordinate to men raises ethical questions. An additional danger exists that contraceptive implants may be targeted for use by women with social problems such as those on welfare (as has been proposed in the US). Thus, providers in Britain must not be complacent about claims that Norplant simply increases women's choice of method. More serious questions about contraceptive choice and informed consent will arise with the testing and use of the next generation of long-acting contraceptives. Biodegradable implants are of limited reversibility, and contraceptive vaccines are nonreversible during their period of efficacy. While the range of methods may increase, individual choice may be limited in favor of provider control.
The effect of aortic valve replacement on survival.
Authors: F Schwarz, P Baumann, J Manthey, M Hoffmann, G Schuler, H C Mehmel, W Schmitz, W Kübler
Journal: Circulation (1982)

We retrospectively studied 252 operated and 47 unoperated patients with isolated aortic valve disease. Aortic valve replacement (AVR) was recommended to all patients based on clinical and hemodynamic data. Preoperative hemodynamic and angiographic data were similar in operated and unoperated cohorts. Seventy-one percent of patients received a Björk-Shiley prosthesis. Operative mortality was 7% for the entire surgical series. For patients with predominant aortic stenosis (AS), survival at 3 years was 87% in operated and 21% in unoperated patients (p less than 0.001). For patients with predominant aortic insufficiency (AI), the 5-year survival rate was 86% in operated and 87% in unoperated patients (NS). AVR improved long-term survival in patients with AS who had normal or impaired left ventricular (LV) function. In patients with AI and normal LV function, survival was not improved after AVR, but those with LV dysfunction who were operated on tended to survive longer (NS). Long-term survival of unoperated patients with AI was better than that in unoperated patients with AS. We conclude that AVR improves long-term survival in patients with AS who were normal or abnormal LV function, and that AVR does not change long-term survival in patients with AI, although those with LV dysfunction tended to survive longer.
Dependence of T Cell Antigen Recognition on T Cell Receptor-Peptide MHC Confinement Time
Authors: Milos Aleksic, Omer Dushek, Hao Zhang, Eugene Shenderov, Ji-Li Chen, Vincenzo Cerundolo, Daniel Coombs, P. Anton van der Merwe
Journal: Immunity (2010)

T cell receptor (TCR) binding to diverse peptide-major histocompatibility complex (pMHC) ligands results in various degrees of T cell activation. Here we analyze which binding properties of the TCR-pMHC interaction are responsible for this variation in pMHC activation potency. We have analyzed activation of the 1G4 cytotoxic T lymphocyte clone by cognate pMHC variants and performed thorough correlation analysis of T cell activation with 1G4 TCR-pMHC binding properties measured in solution. We found that both the on rate (k(on)) and off rate (k(off)) contribute to activation potency. Based on our results, we propose a model in which rapid TCR rebinding to the same pMHC after chemical dissociation increases the effective half-life or "confinement time" of a TCR-pMHC interaction. This confinement time model clarifies the role of k(on) in T cell activation and reconciles apparently contradictory reports on the role of TCR-pMHC binding kinetics and affinity in T cell activation.
H5N1 Influenza — Continuing Evolution and Spread
Authors: Robert G. Webster, Elena A. Govorkova
Journal: New England Journal of Medicine (2006)

We don't know whether the next influenza pandemic will be caused by the H5N1 avian influenza virus. But Drs. Robert Webster and Elena Govorkova write that given the number of cases of H5N1 influenza that have occurred in humans to date (251) and the rate of death of more than 50%, it would be prudent to develop robust plans for dealing with such a pandemic.
Human health, animal health, and ecosystems are interconnected
Authors: K. Tagg
Journal: BMJ (2013)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Human health, animal health, and ecosystems are interconnected Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
"Normal" blood glucose and coronary risk
Authors: E. Barrett-Connor
Journal: BMJ (2001)

Papers p 15 

Although diabetes is a strong risk factor for coronary heart disease, the association between glycaemia within the “normal range” and coronary heart disease has been somewhat controversial.1 A 1979 collaborative report from 15 countries found the risk ratio in the highest versus the lowest centile of glycaemia to range from 0.34 to 6.07 in men from Finland, Denmark, France, the United Kingdom, and the United States.2 In other cohort studies, including Whitehall3 and Framingham,4 there appeared to be a threshold effect, with risk observed only at glucose levels approaching or including current diagnostic criteria for diabetes. There are several possible reasons for these contradictory results, including: the failure to exclude people with diabetes from the cohorts, compatible with a threshold effect; the multifactorial aetiology of coronary heart disease, compatible with confounding; or the large intra-individual variation in glucose (especially postchallenge glucose) values, compatible with misclassification bias.

Glycosylated haemoglobin, an integrated estimate of glucose over the preceding 6-12 weeks, …
THALLIUM SCINTIGRAPHY IN PRIMARY CARCINOMA OF THE BREAST
Authors: Alan D. Waxman, Lalitha Ramanna, Michael B. Brachman, Stewart Gleishman, R. James Brenner
Journal: Clinical Nuclear Medicine (1989)

Waxman, Alan D.; Ramanna, Lalitha; Brachman, Michael B.; Gleishman, Stewart; Brenner, R. James Author Information
The "Senseless Crime"
Authors: Charles C. Grossman
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In a recent issue ofThe Journal(vol 186, Oct 19, 1963, adv p 41), there are quotations from a lecture on "Seizure and the 'Senseless Crime.' " This lecture, held at an international meeting in London, contains erroneous statements. Specifically, petit mal is described as one of the "aphasic intervals of suspended consciousness without suspension of motor activity which provide occasions when the sufferer may commit a violent or senseless crime without being aware of it." Any contemporary student of epilepsy will reject this statement as contradictory to all known clinical and pathophysiological characteristics of this disorder. By no stretch of imagination will it be possible for an individual during a petit mal attack to perform the most simple goal-directed motor activity —let alone a violent crime. Epileptic patients bear enough social prejudice and should not be subjected to the additional stigma of being considered potential
Mechanisms Promoting Escape from Mitotic Stress–Induced Tumor Cell Death
Authors: Rebecca Sinnott, Leah Winters, Brittany Larson, Daniela Mytsa, Patrick Taus, Kathryn M. Cappell, Angelique W. Whitehurst
Journal: Cancer Research (2014)

Abstract Non–small cell lung cancer (NSCLC) is notorious for its paltry responses to first-line therapeutic regimens. In contrast to acquired chemoresistance, little is known about the molecular underpinnings of the intrinsic resistance of chemo-naïve NSCLC. Here we report that intrinsic resistance to paclitaxel in NSCLC occurs at a cell-autonomous level because of the uncoupling of mitotic defects from apoptosis. To identify components that permit escape from mitotic stress–induced death, we used a genome-wide RNAi-based strategy, which combines a high-throughput toxicity screen with a live-cell imaging platform to measure mitotic fate. This strategy revealed that prolonging mitotic arrest with a small molecule inhibitor of the APC/cyclosome could sensitize otherwise paclitaxel-resistant NSCLC. We also defined novel roles for CASC1 and TRIM69 in supporting resistance to spindle poisons. CASC1, which is frequently co-amplified with KRAS in lung tumors, is essential for microtubule polymerization and satisfaction of the spindle assembly checkpoint. TRIM69, which associates with spindle poles and promotes centrosomal clustering, is essential for formation of a bipolar spindle. Notably, RNAi-mediated attenuation of CASC1 or TRIM69 was sufficient to inhibit tumor growth in vivo. On the basis of our results, we hypothesize that tumor evolution selects for a permissive mitotic checkpoint, which may promote survival despite chromosome segregation errors. Attacking this adaptation may restore the apoptotic consequences of mitotic damage to permit the therapeutic eradication of drug-resistant cancer cells. Cancer Res; 74(14); 3857–69. ©2014 AACR.
Inherited CARD9 deficiency in otherwise healthy children and adults with Candida species–induced meningoencephalitis, colitis, or both
Authors: Fanny Lanternier, Seyed Alireza Mahdaviani, Elisa Barbati, Hélène Chaussade, Yatrika Koumar, Romain Levy, Blandine Denis, Anne-Sophie Brunel, Sophie Martin, Michèle Loop, Julie Peeters, Ariel de Selys, Jean Vanclaire, Christiane Vermylen, Marie-Cécile Nassogne, Olga Chatzis, Luyan Liu, Mélanie Migaud, Vincent Pedergnana, Guillaume Desoubeaux, Gregory Jouvion, Fabrice Chretien, Ilad Alavi Darazam, Alejandro A. Schäffer, Mihai G. Netea, Jean J. De Bruycker, Louis Bernard, Jacques Reynes, Noureddine Amazrine, Laurent Abel, Dimitri Van der Linden, Tom Harrison, Capucine Picard, Olivier Lortholary, Davood Mansouri, Jean-Laurent Casanova, Anne Puel
Journal: Journal of Allergy and Clinical Immunology (2015)