tbuckley/cabot-search huggingface dataset:
Relationship between airway inflammation and bronchial responsiveness in children with and without asthma
Authors: Kim van de Kant, Kai-Häkon Carlsen, Petter Mowinckel, Karin Lødrup Carlsen
Journal: European Respiratory Journal (2014)

Bronchial hyperresponsiveness (BHR) is common in asthma, but can also be detected in people without asthma. Information about the association between BHR and airway inflammation in the absence of asthma is scarce. We studied airway inflammation in relation to BHR by exercise induced bronchoconstriction (EIB,n=870) and methacholine bronchial challenge (PD20; inhaled methacholine dose causing 20% FEV1 reduction,n=997) at age 10 in a population based birth cohort.

Fractional exhaled nitric oxide (FeNO), serum eosinophil and neutrophil counts were assessed before challenge tests. Positive EIB was defined as FEV1 fell ≥10% after treadmill test (heart rate 90-95% of maximum). Positive PD20 was defined as ≤8 μmol methacholine. Allergic sensitisation (AS, positive skin test/specific IgE>0.35 kU/l to allergens), allergic rhinitis, asthma, age and sex were studied as potential confounders. Logistic regression was performed for positive BHR and robust regression for BHR severity.

BHR assessed with PD20 was related to FeNO and eosinophils when adjusted for AS, rhinitis and asthma (OR (95%CI): 1.47 (1.08, 2.00) and 1.40 (1.09, 1.79), p 0.05). Neutrophils were not related to BHR tested with PD20 and EIB.

Eosinophilic inflammatory markers, not neutrophilic markers, were associated with BHR to a direct challenge test. Eosinophilic inflammation might be stronger related to BHR induced by methacholine than exercise induced BHR in a heterogeneous paediatric population.
Feasibility and Toxicity of Chemoembolization for Children With Liver Tumors
Authors: Marcio H. Malogolowkin, Philip Stanley, David A. Steele, Jorge A. Ortega
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To determine the feasibility, toxicity, and efficacy of hepatic arterial chemoembolization (HACE) in pediatric patients with refractory primary malignancies of the liver. PATIENTS AND METHODS: Six patients with hepatoblastoma (HB), three with hepatocellular carcinoma (HCC), and two with undifferentiated sarcoma of the liver were treated with HACE every 2 to 4 weeks until their tumors became surgically resectable or they showed signs of disease progression. All but one newly diagnosed patient with HCC had previously received systemic chemotherapy. RESULTS: All patients with HB and HCC responded to HACE, as measured by imaging studies and alpha-fetoprotein levels. Surgical resection (complete or microscopic residual disease) was feasible in five of 11 patients, and three patients remain alive with no evidence of disease. Elevated liver transaminase and bilirubin levels were seen after each one of the 46 courses of HACE. Other toxicities included fever, pain, nausea, vomiting, and transient coagulopathy. CONCLUSION: HACE is feasible, well tolerated, and effective in inducing surgical resectability of primary hepatic tumors in children.
International Union of Pharmacology. XII. Classification of opioid receptors
Authors: BN Dhawan, F Cesselin, R Raghubir, T Reisine, PB Bradley, PS Portoghese, M Hamon
Journal: Pharmacological Reviews (1996)

Facing the rapidly spreading novel coronavirus disease (COVID-19), evidence to inform decision-making at both the clinical and policy-making level is highly needed. Based on the results of a study by Petrilli et al, we have developed a calculator using patient data at admission to predict the risk of critical illness (intensive care unit admission, use of mechanical ventilation, discharge to hospice, or death). 
We report a retrospective validation of the risk calculator on 145 consecutive patients admitted with COVID-19 to a single hospital in Israel. Of the 18 patients with critical illness, 17 were correctly identified by the model(sensitivity: 94.4%, 95% CI, 72.7% to 99.9%; specificity: 81.9%, 95% CI, 74.1% to 88.2%). Of the 127 patients with non-critical illness, 104 were correctly identified. This, despite considerable differences between the original and validation study populations. 
Our results show that data from published knowledge can be used to provide reliable, patient level, automated  risk assessment, potentially reducing the cognitive burden on physicians and helping policy makers better prepare for future needs.
Chemotherapy in the Management of Osteosarcoma and Ewing's Sarcoma
Authors: Scott M. Schuetze
Journal: Journal of the National Comprehensive Cancer Network (2007)

Sarcomas of bone are rare malignancies diagnosed in fewer than 3000 individuals yearly in the United States. Ewing's sarcoma and most osteosarcoma are high-grade neoplasms and account for approximately one half of bone sarcoma cases. Fewer than 20% of patients presenting with localized Ewing's sarcoma or osteosarcoma are cured with surgery alone. Current management typically involves collaboration among orthopedic oncologists, medical oncologists, musculoskeletal radiologists, sarcoma pathologists, and radiation oncologists. Modern multidisciplinary management of Ewing's sarcoma and osteosarcoma has improved the cure rate of patients with localized disease to more than 50%. Primary chemotherapy for high-grade bone sarcomas often involves intensive, multiagent regimens, and few secondary chemotherapy options are available to treat refractory or relapsed disease. Patient participation in clinical trials of novel therapies for Ewing's sarcoma and osteosarcoma should be strongly encouraged.
Bier's Block Revisited: Intercuff Block
Authors: J G Hannington-Kiff
Journal: Journal of the Royal Society of Medicine (1990)

Bier introduced his intravenous technique of local anaesthesia to facilitate palliative surgery on the elbow or knee. He cannulated a suitably large vein in the vicinity of the joint to inject procaine after first isolating the operating site with a proximal and a distal tourniquet. This extra containment of the local anaesthetic solution made it feasible to flush out any unfixed drug with saline before release of the main tourniquet, an advantage which has been lost in the currently fashionable technique of intravenous regional anaesthesia (IVRA) involving a single tourniquet above the elbow or knee and a fine butterfly needle in a vein on the dorsum of the hand or foot. A modern version of Bier's original method is described, conveniently called an intercuff block (ICB), which reintroduces the possibility of effective flushing, offers better operating conditions and engenders new ideas for further study.
Chronic Performance of a Leadless Cardiac Pacemaker
Authors: Reinoud E. Knops, Fleur V.Y. Tjong, Petr Neuzil, Johannes Sperzel, Marc A. Miller, Jan Petru, Jaroslav Simon, Lucie Sediva, Joris R. de Groot, Srinivas R. Dukkipati, Jacob S. Koruth, Arthur A.M. Wilde, Josef Kautzner, Vivek Y. Reddy
Journal: Journal of the American College of Cardiology (2015)
Delay of the Diagnostic Lumbar Puncture and Intrathecal Chemotherapy in Children With Acute Lymphoblastic Leukemia Who Undergo Routine Corticosteroid Testing: Tokyo Children’s Cancer Study Group Study L89-12
Authors: A. Manabe, M. Tsuchida, R. Hanada, K. Ikuta, Y. Toyoda, Y. Okimoto, K. Ishimoto, H. Okawa, A. Ohara, T. Kaneko, K. Koike, T. Sato, K. Sugita, F. Bessho, Y. Hoshi, M. Maeda, A. Kinoshita, T. Saito, Y. Tsunematsu, S. Nakazawa
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To determine the effects of eliminating initial lumbar punctures in 418 consecutively treated children with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: Patients were enrolled onto a trial conducted in central Japan between 1989 and 1992. Treatment consisted of standard four-drug induction therapy followed by a risk-based intensification phase, reinduction therapy, late intensification, and remission maintenance therapy (total of 104 weeks). The initial lumbar puncture, with an intrathecal injection of chemotherapy, was performed after 1 week of prednisolone sensitivity testing (day 8). End points included response to prednisolone, CNS status at the time of the day 8 lumbar puncture, subsequent adverse events in CNS and bone marrow, and event-free survival (EFS). RESULTS: The remission induction rate was 93.1% with a 6-year EFS rate (± SE) of 68.7% ± 2.4%, which is similar to historical results for patients who received their diagnostic lumbar puncture and first instillation of intrathecal chemotherapy on day 0. Overall, 84.5% of the patients had good responses to prednisolone, whereas 15.5% had poor responses. Clinical outcome was strikingly better for the good responders (6-year EFS, 74.1% ± 2.5% compared with 40.1% ± 6.4% for patients with poor responses), suggesting that omission of intrathecal chemotherapy did not alter the predictive value of drug sensitivity testing. Eighteen patients experienced CNS relapse as their first adverse event (cumulative risk, 5.1%; 95% confidence interval, 2.7% to 7.4%), coincident with reports from groups using conventional strategies of CNS clinical management. Bleeding into the CSF at the time of the day 8 lumbar puncture was apparent in 29 cases (8.1%), but leukemic blasts were identified in only two. CONCLUSION: Delay of the initial lumbar puncture and intrathecal injection of chemotherapy seems to be feasible in children with ALL. Further controlled evaluations are needed to establish the validity of this conclusion.
Intramural Ventricular Septal Defect Is a Distinct Clinical Entity Associated With Postoperative Morbidity in Children After Repair of Conotruncal Anomalies
Authors: Jyoti K. Patel, Andrew C. Glatz, Reena M. Ghosh, Shannon M. Jones, Shobha Natarajan, Chitra Ravishankar, Christopher E. Mascio, Thomas L. Spray, Meryl S. Cohen
Journal: Circulation (2015)

Intramural ventricular septal defects (VSDs) are interventricular communications through right ventricular free wall trabeculations that can occur after repair of conotruncal anomalies. We assessed the prevalence of residual intramural VSDs and their effect on postoperative course.Children who underwent biventricular repair of a conotruncal anomaly from January 1, 2006, to June 30, 2013, and had a postoperative transthoracic echocardiogram were included. Images were reviewed for residual intramural or nonintramural VSDs. The primary outcome was a composite of mortality, extracorporeal membrane oxygenation use, and need for subsequent catheter or surgical VSD closure. The secondary outcome was postoperative hospital length of stay. A residual VSD was present in 256 of the 442 subjects (58%), of which 231 (90%) were <2 mm in size. Forty-nine patients (11%) had intramural VSDs, and 207 (47%) had nonintramural VSDs. Patients with intramural VSDs were more likely to reach the primary composite outcome compared with those with nonintramural VSDs or no residual VSD (14 of 49 [29%] versus 15 of 207 [7%] versus 6 of 186 [3%]; P<0.0001). In addition, those with intramural VSDs had longer postoperative hospital length of stay compared with those with nonintramural VSDs or no residual VSD (20 days [interquartile range, 11-42 days] versus 7 days [interquartile range, 5-14 days] versus 6 days [interquartile range, 4-11 days]; P=0.0001). These associations remained significant after adjustment for known risk factors for poor outcomes, including residual VSD size and operative complexity.Among residual VSDs after repair of conotruncal anomalies, intramural VSDs are uniquely associated with postoperative morbidity, mortality, and longer postoperative hospital length of stay. It is important to recognize intramural VSDs in the postoperative period.
Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation
Authors: James D. Douketis, Alex C. Spyropoulos, Scott Kaatz, Richard C. Becker, Joseph A. Caprini, Andrew S. Dunn, David A. Garcia, Alan Jacobson, Amir K. Jaffer, David F. Kong, Sam Schulman, Alexander G.G. Turpie, Vic Hasselblad, Thomas L. Ortel
Journal: New England Journal of Medicine (2015)

It is uncertain whether bridging anticoagulation is necessary for patients with atrial fibrillation who need an interruption in warfarin treatment for an elective operation or other elective invasive procedure. We hypothesized that forgoing bridging anticoagulation would be noninferior to bridging with low-molecular-weight heparin for the prevention of perioperative arterial thromboembolism and would be superior to bridging with respect to major bleeding.We performed a randomized, double-blind, placebo-controlled trial in which, after perioperative interruption of warfarin therapy, patients were randomly assigned to receive bridging anticoagulation therapy with low-molecular-weight heparin (100 IU of dalteparin per kilogram of body weight) or matching placebo administered subcutaneously twice daily, from 3 days before the procedure until 24 hours before the procedure and then for 5 to 10 days after the procedure. Warfarin treatment was stopped 5 days before the procedure and was resumed within 24 hours after the procedure. Follow-up of patients continued for 30 days after the procedure. The primary outcomes were arterial thromboembolism (stroke, systemic embolism, or transient ischemic attack) and major bleeding.In total, 1884 patients were enrolled, with 950 assigned to receive no bridging therapy and 934 assigned to receive bridging therapy. The incidence of arterial thromboembolism was 0.4% in the no-bridging group and 0.3% in the bridging group (risk difference, 0.1 percentage points; 95% confidence interval [CI], -0.6 to 0.8; P=0.01 for noninferiority). The incidence of major bleeding was 1.3% in the no-bridging group and 3.2% in the bridging group (relative risk, 0.41; 95% CI, 0.20 to 0.78; P=0.005 for superiority).In patients with atrial fibrillation who had warfarin treatment interrupted for an elective operation or other elective invasive procedure, forgoing bridging anticoagulation was noninferior to perioperative bridging with low-molecular-weight heparin for the prevention of arterial thromboembolism and decreased the risk of major bleeding. (Funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health; BRIDGE ClinicalTrials.gov number, NCT00786474.).
Afterload reduction governs improvement in RV systolic function and ventriculo-arterial adaptation in patients with pulmonary arterial hypertension (PAH) undergoing rapid dose escalation of treprostinil
Authors: Franz Rischard, Rebecca Vanderpool, Hunter Champion, Marc Simon, Mattius Rischard, Isaac Jenkins, Steven Knoper, Lillian Hansen, Aaron Waxman
Journal: European Respiratory Journal (2014)

The mechanism of vasoactive therapy in PAH on ventriculo-arterial interaction is not well established. Thus, we prospectively investigated the effect of treprostinil (TRE) on pulmonary vascular elastance (Ea), right ventricular (RV) systolic (Ees) and diastolic (s) elastance in PAH patients.  Methods and Results: Single-beat RV pressure-volume analysis was performed in 9 functional class IV PAH patients before and after inpatient dose escalation, and gradual outpatient dose increase of TRE. Data are presented as mean+SEM. TRE dose was 12.8+0.46 ng/kg/min at discharge and 44.2+4.34 ng/kg/min by 3 months (mo.). TRE was associated with a decrease in Ea (2.44+0.26 mmHg/ml baseline, 1.95+0.49 mmHg/ml discharge, and 1.38+0.28 mmHg/ml 3 mo. Ees was decreased slightly at discharge (1.62+0.35 mmHg/ml baseline vs. 1.49+0.3 mmHg/ml) and then reduced further by 3 mo. (0.85+0.18 mmHg/ml). s was high but unaffected by TRE. Although Ees decreased at 3 mo., there was 906+530 mmHg*ml stroke work reserve with exercise and a 139+45 M increase in 6 minute walk distance. Baseline β was related to Ea (R 2 =0.35) but not Ees (R 2 =0.01). RV end-diastolic volumes (RVEDV) however remained elevated (218+24.5 ml) at 3 mo.  Conclusions: Treprostinil primarily exerts its effects by lowering RV afterload (Ea). This effect governs the improvement in RV systolic pump failure and contractile reserve. RV stiffness is related to afterload but unaffected by treprostinil. Thus, small improvements in RVEDV are likely related to a decrease in high baseline preload dependent (heterometric) autoregulation.
Genomic Insights into Respiratory Outcomes after Preterm Birth
Authors: Steven H. Abman, Peter Mourani, Brandie Wagner
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Hardaker and colleagues reported differences in pathophysiological determinants of AHR between younger and older patients with asthma (11).In older patients (aged 50-80 yr), AHR was predicted by gas trapping and ventilation heterogeneity in peripheral, diffusion-dependent airways, whereas in younger patients (aged 18-46 yr), AHR was predicted by ventilation heterogeneity in less peripheral conducting airways and by inflammation, as measured by exhaled nitric oxide.They suggested the gas-trapped and diffusion-dependent areas of the lung in older patients may not respond as well to conventional inhaled mediations.Interestingly, disease duration was not a factor affecting AHR in either group.What can we conclude from the present study of Dunn and colleagues (4)?First, it must be recognized that these data were derived from highly standardized randomized clinical trials, in which patients with prior exacerbations and recent need for oral corticosteroids were excluded, and in which compliance with treatment was high, so the results may not be entirely applicable in the real world.Second, although there were significant increases in exacerbations with increasing age over 30 years, projecting these data to older decades is uncertain.The risks could increase or could plateau at an older age.However, these data do resonate with clinical experience.Further studies are needed, including inflammometry to more precisely determine the cellular and molecular nature of asthma in older subjects, as well as assessment of responses to short-and long-acting b-agonists, especially the new ultra-long-acting molecules, inhaled and oral corticosteroids, and the emerging range of biological therapies.Much remains to be learned.
Soft Tissue Filler Alert
Authors: Rebecca Voelker
Journal: JAMA (2015)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Major trauma
Authors: Otto Chan, Alistair Wilson, Michael Walsh
Journal: BMJ (2005)

Advanced trauma life support is the standard method for the initial management of severely injured patients.The principle is simple-treat the greatest threat to life first.Loss of airway will kill before inability to breathe, and inability to breathe will kill before bleeding and loss of circulation.A definitive diagnosis is not necessary to treat the patient initially.The most important point to remember is that no harm should be done to the patient during treatment.The management of severely injured patients is divided into the primary and secondary survey.This article deals with the imaging during the primary survey.
PROLIFERATIVE AND EXUDATIVE TUBERCULOSIS WITH REFERENCE TO THEIR RELATIONSHIP TO THE VARIOUS FRACTIONS DERIVED FROM THE TUBERCLE BACILLUS
Authors: F. M. Pottenger
Journal: Annals of Internal Medicine (1934)

Article1 August 1934PROLIFERATIVE AND EXUDATIVE TUBERCULOSIS WITH REFERENCE TO THEIR RELATIONSHIP TO THE VARIOUS FRACTIONS DERIVED FROM THE TUBERCLE BACILLUSF. M. POTTENGER, M.D., F.A.C.P.F. M. POTTENGER, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-8-2-123 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOur conception of tuberculosis has been subject to vast changes since Villemin proved the transmissibility of the disease and Koch revealed the cause of infection.The pathology of tuberculosis received a clarifying and purifying touch when the discovery of the bacillus showed the unity of all tuberculous processes; and again, when Koch showed that sensitization of tissue cells plays a part in every infection. When the meaning of these two important facts was comprehended we were ready to define the pathologic changes which take place at the site of infection as the reaction of the tissues to the presence of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Monrovia, California*Read at the Eighteenth Annual Clinical Session of the American College of Physicians, Chicago, April 17, 1934. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byArthritis und Tuberkulose 1 August 1934Volume 8, Issue 2Page: 123-128KeywordsBacillusCellsInfectious diseasesTouchTuberculosis ePublished: 1 December 2008 Issue Published: 1 August 1934 PDF downloadLoading ...
Disorders of Ventilation
Journal: Thorax (1989)

Bronchoalveolar lavage in talc induced lung disease SiR,-Dr A A Redondo and his colleagues (1988;43:1019-21) report a case of inhalational talcosis with abnormal findings in bronchoalveolar lavage fluid.They wonder if lym- phocytosis with predominance of T8' lymphocytosis is a typical finding in talc lung.They also suggest that there is no previous report of lavage findings in talcosis.We had the opportunity to perform bronchoalveolar lavage in eight talc millers exposed to pure talc (Luzenac, French) with pneumoconioses after a long exposure (mean 29-5 years).Lavage findings were characterised by a macrophage alveolitis.No case showed a high lymphocyte count in the lavage fluid (mean 7% (SEM 5%) lymphocytes), but there was a tendency towards polynucleosis (5% (4%)).'In another study we reported that mineralogical analysis of lavage fluid can provide information about the heterogeneity of inhaled talc.2