tbuckley/cabot-search huggingface dataset:
Abstract 18729: Comparative Analysis of the Use of Extracorporeal Membrane Oxygenation During Cardiopulmonary Resuscitation Within a Pediatric Cardiac Intensive Care Unit
Authors: Stephanie J Conrad, Matthew K Bacon, Brittney C Hatch, John David Hughes, Michelle K Terrell, Patrick Maynord, Andrew H Smith
Journal: Circulation (2014)

Background: Mechanical support to aid in restoration of circulation during cardiopulmonary resuscitation (CPR) is increasingly common in the pediatric cardiac intensive care unit (CICU). We sought to both identify and quantify factors predicting the implementation of extracorporeal membrane oxygenation to support CPR (eCPR). Methods and Results: Events associated with CPR from July 2010 through December 2013 within our pediatric CICU were retrospectively reviewed. Of 135 arrests among 88 patients, 84% were among postsurgical patients and 98% (n=133) resulted in a return of circulation, either spontaneous (n=100, 74%) or with the assistance of mechanical support (n=33, 24%). Median age at arrest was 106 days (interquartile range [IQR] 26-207 days) and weight was 3.9 kg (IQR 3.0-6.0 kg). Median length of stay (LOS) at the time of arrest was 5 days (IQR 1-49 days). Common primary causes included low cardiac output (38%), respiratory failure (33%), and arrhythmia (15%). Univariate predictors of an eCPR arrest included smaller size (3.3 v. 4.3 kg, p=0.004), younger age (25 v. 130 days, p&lt;0.001), shorter length of stay at time of arrest (1 v. 8.5 days, p=0.001), single ventricle physiology (30% v. 14% among biventricular physiology arrests, p=0.04), and arrests not related to respiratory failure (34% v. 5% eCPR among respiratory failure arrests, p&lt;0.001). Unit factors not associated with an increased frequency of arrests resulting in eCPR included unit capacity, night shift, and the experience levels of both the bedside nurse and attending. Among patients with at least one arrest, median ICU LOS was 18 days (IQR 9-72 days) and overall survival to ICU discharge was 72%. Survival to ICU discharge was not significantly different with respect to use of eCPR as compared to conventional CPR (60% v. 77% respectively, p=0.11). Conclusions: We report predictors of the need for mechanical support during cardiopulmonary resuscitation within a pediatric CICU, and demonstrate comparable post-resuscitation survival to ICU discharge among those rescued with eCPR. Further longitudinal investigation is necessary to identify potential eCPR-associated differences in morbidity and neurocognitive outcomes following a CICU arrest.
Lesson of the week: Death from tetanus after a pretibial laceration
Authors: O. C S Cassell
Journal: BMJ (2002)

It is important to follow the guidelines for treating wounds prone to tetanus 

Clinicians should be familiar with Department of Health guidelines for immunoprophylaxis when wounds through which tetanus can be acquired occur.1 I report on a patient in whom tetanus immunoprophylaxis did not follow the guidelines.

A 76 year old woman fell in her garden and sustained a pretibial laceration. Her wound was cleaned and approximated with Steri-strips (3M; Loughborough) at an emergency department. Her status for tetanus immunisation at the time was recorded as “?no previous tetanus injection,” and a course of antitetanus treatment was started. However, no immunoglobulin was given.

She returned one week later with a necrotic and malodorous wound. She was unwell and complained of diffuse pains. She was admitted for debridement and split skin grafting.

Her condition worsened. Twenty four hours later she developed the signs and symptoms of tetanus, with increasing jaw stiffness, opisthotonos, and generalised limb spasticity. Cultures from the wound produced a …
Pay Attention: Ritalin Acts Much Like Cocaine
Authors: B Vastag
Journal: JAMA (2001)

WASHINGTON—Advanced imaging research has answered a 40-year-old question about methylphenidate (Ritalin), which is taken daily by 4 million to 6 million children in the United States: how does it work? The answer may unsettle many parents, because the drug acts much like cocaine, albeit cocaine dripped through molasses ( J Neurosci. 2001;21:RC121). Taken orally in pill form, methylphenidate rarely produces a high and has not been reported to be addictive. However, injected as a liquid it sends a jolt that “addicts like very much,” said Nora Volkow, MD, psychiatrist and imaging expert at Brookhaven National Laboratory, Upton, NY. “They say it’s like cocaine.” Acknowledged as leaders in the field of brain imaging of drug effects, Volkow and colleagues have spent several years tracing the effects on the brain of drugs of addiction, using positron emission tomography (PET) and other advanced techniques. Among their long list of findings, they’ve identified the brain’s dopamine system as a major player in compulsive behavior, including drug taking and overeating.
Role of the ataxia-telangiectasia gene (ATM) in breast cancer
Authors: M. Lavin
Journal: BMJ (1998)

Genetic predisposition accounts for 5-10% of breast cancer, and two genes—BRCA1 and BRCA2—have attracted most attention as high risk factors.1However, these two genes probably account for only a small proportion of the genetic risk while other more common but less penetrant genes may explain the remainder of genetically predisposed breast cancers.2 One such candidate is the gene, ATM, mutated in the human genetic disorder ataxia-telangiectasia (A-T).3 A-T heterozygotes (estimated to be 1% of the population) do not show any of the major symptoms of the disease, though there is good evidence that they have an underlying cellular radiosensitivity, but to a lesser extent than observed in A-T homozygotes.4These observations, together with earlier epidemiological studies, reveal a raised incidence of mortality from cancer among blood relations of patients with ataxia-telangiectasia, with the greatest relative risk for breast cancer (5.1) in female relatives of patients.5

An association between the incidence of breast cancer and A-T heterozygosity was also revealed in two separate but smaller studies. 6 7 Based on an independent assessment …
OBSERVATIONS ON THE USE OF THIOURACIL
Authors: W S REVENO
Journal: Annals of Internal Medicine (1946)

Article1 November 1946OBSERVATIONS ON THE USE OF THIOURACILWILLIAM S. REVENO, M.D., F.A.C.P.WILLIAM S. REVENO, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-25-5-822 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn the two and one half years that have elapsed since Astwood's1 discovery and use of the potent agent, thiouracil, numerous investigators have fully confirmed his original observations and have added much useful data regarding the behavior of this chemical substance. This invested effort is now beginning to show returns in increased interest in and better understanding of the general nature of its action on the thyroid, and in a growing recognition of the value of thiouracil for combating the thyrotoxic state and reducing it to a safe tractable level.A number of facts regarding thiouracil appear to be generally...Bibliography1. ASTWOOD EB: Treatment of hyperthyroidism with thiourea and thiouracil, Jr. Am. Med. Assoc., 1943, cxxii, 78. CrossrefGoogle Scholar2. KINGROSELLINI BTLJ: Treatment of acute thyroiditis with thiouracil, Jr. Am. Med. Assoc., 1945, cxxix, 267. CrossrefGoogle Scholar3. MACKENZIEMACKENZIE CGJB: Sulfonamides, thioureas and thyroid, Endocrinology, 1943, xxxii, 185. CrossrefGoogle Scholar4. REVENO WS: Effect of thiouracil on human tissues, Jr. Clin. Endocrinol., 1945, v, 403. CrossrefGoogle Scholar5. REVENO WS: Thiouracil effect in diabetes mellitus complicated by hyperthyroidism, Am. Jr. Med. Sci., 1946, ccxi, 174. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Detroit, Michigan*Received for publication February 19, 1946.From the Department of Medicine, Harper Hospital and Wayne University College of Medicine.The thiouracil was supplied through the courtesy of Dr. Stanton M. Hardy, Lederle Laboratories, Inc. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byObservations on the Use of Antithyroid DrugsW. S. REVENO, M.D., F.A.C.P., H. ROSENBAUM, M.D., F.A.C.P.Treatment of Hyperthyroidism with Methylthiouracil. 1 November 1946Volume 25, Issue 5Page: 822-831KeywordsBehaviorHospital medicineThyroid ePublished: 1 December 2008 Issue Published: 1 November 1946 PDF downloadLoading ...
Precision Medicine in Active Surveillance for Prostate Cancer: Development of the Canary–Early Detection Research Network Active Surveillance Biopsy Risk Calculator
Authors: Donna P. Ankerst, Jing Xia, Ian M. Thompson, Josef Hoefler, Lisa F. Newcomb, James D. Brooks, Peter R. Carroll, William J. Ellis, Martin E. Gleave, Raymond S. Lance, Peter S. Nelson, Andrew A. Wagner, John T. Wei, Ruth Etzioni, Daniel W. Lin
Journal: European Urology (2015)
Specificity of IgE antibodies to sequential epitopes of hen's egg ovomucoid as a marker for persistence of egg allergy
Authors: K.‐M. Järvinen, K. Beyer, L. Vila, L. Bardina, M. Mishoe, H. A. Sampson
Journal: Allergy (2007)

Background: Approximately two‐thirds of egg‐allergic infants become tolerant within the first 5 years of life. Objective: We sought (1) to compare the recognition of sequential (linear) and conformational binding sites of ovomucoid, ovalbumin and ovotransferrin, by IgE antibodies of children with persistent and transient egg allergy, (2) to identify immunodominant IgE‐and IgG‐binding epitopes of ovomucoid, and (3) to compare epitope‐specificity of IgE antibodies between patients with differing natural histories of egg allergy. Methods: Using immunodot‐blots or ImmunoCAPs, IgE‐antibodies against conformational (native) and sequential (reduced and alkylated) egg proteins were determined at the time of clinical reactivity in patients who retained their allergy and in those who developed clinical tolerance. IgE‐ and IgG‐binding epitopes were mapped for ovomucoid using overlapping decapeptides on SPOTs membranes. Recognition of the major IgE‐binding epitopes were compared between patients with differing natural histories of egg allergy. Results: The patients with long‐lasting egg allergy had a higher concentrations of IgE antibodies against sequential and native ovomucoid and ovalbumin than the children who subsequently gained tolerance ( P &lt; 0.01). Four major IgE‐binding epitopes were identified in ovomucoid at amino acid 1–10, 9–20, 47–56, and 113–124. IgE antibodies of all seven patients with persistent egg allergy recognized these epitopes whereas none of the 11 children who outgrew their egg allergy did so. Conclusions: Patients with persistent egg allergy develop IgE antibodies against more sequential and conformational epitopes of ovomucoid and ovalbumin. The presence of serum IgE antibodies to specific sequential epitopes of ovomucoid may be used as a screening instrument for persistent egg allergy.
Amputation of the peritoneal dialysis catheter in the abdominal cavity
Authors: Nakatsuka Mineo, Yoshida Ryochi, Tone Mari, Hakozaki Yuuji, Uchiyama Kiyotaka, Kamijo Yuka, Furutera Rie, Ishibashi Yoshitaka
Journal: Kidney International (2015)

An 83-year-old female patient with a 3-year history of peritoneal dialysis (PD) for diabetic nephropathy presented to our clinic with abrupt dialysate drainage failure. The Tenckhoff catheter inserted 3 years ago was a two-cuffed, straight-type flexible silicone tube. Before presentation, she had no abnormal sensation in the abdomen, had not performed any vigorous exercises, or received external force to the abdomen that could have caused catheter damage. No crack or fracture was observed in the PD catheter outside the exit site. Computed tomography revealed a completely amputated PD catheter. The break point of the catheter was 5 mm from the inner side of the peritoneal cuff. The distal part of the broken catheter was lying freely in the peritoneal cavity (Figure 1). Open surgery was performed to repair the PD access and remove the broken catheter. An incision was made near the peritoneal cuff. Rectal sheaths were opened for inspection of the abdominal cavity (Figure 2). The broken catheter was found lying in the pelvis within finger’s reach, and was removed manually. For preserving the percutaneous cuff and exit site, a new catheter was connected and placed in the rectouterine excavation. After the repair, the patient experienced no major access-related complications.Figure 2The amputated peritoneal dialysis catheter is seen projecting into the abdominal cavity (arrow). The cross-sectional surface of the amputated catheter was relatively sharp.View Large Image Figure ViewerDownload (PPT) With the advent of silicone rubber catheters that are specially designed for PD treatment, the incidence of catheter-related complications has reduced, and the patency of catheters has increased compared with that in the early years of PD treatment. Catheter amputation in the intraperitoneal cavity is rare. In this case, no clinical symptoms or findings indicative of catheter amputation were observed, and the mechanism of the damage is not known.
932. SV40 Pseudovirions Are Efficient and Safe Myocardial Gene Therapy Vectors
Authors: Ronen Beeri, Thea Pugatsch, Suzane Abedat, Mahmud Abdel Latif, Ariella Oppenheim
Journal: Molecular Therapy (2004)

Background: Simian virus-40 (SV40) is an efficient vector for gene therapy; however, it has not yet been used in the context of myocardial gene delivery. In contrast to adenovirus, which has generally been the vector of choice for many heart trials, SV40 does not elicit an immune response allowing repeated administrations, if necessary, to prolong the effect of the delivered gene. Furthermore, SV40 vectors are capable of infecting dividing or non-dividing cells. Our unique vector, prepared in vitro from recombinant SV40 capsid proteins and plasmid DNA, has no viral sequences, providing unique critical safety advantages. Therapeutic DNA of considerable size can be readily packaged into these vectors.
Drug reduces death from sepsis
Authors: Xavier Bosch
Journal: BMJ (2001)

Several drugs given as adjuvant therapy to reduce mortality in patients with sepsis have proved unsuccessful so far. Now a large clinical trial has found that administration of recombinant human activated protein C—or drotrecogin alfa activated—leads to a significant reduction in mortality among patients with severe sepsis.

“Our results indicate that in this population, one additional life would be saved for every 16 patients treated with drotrecogin alfa activated” wrote Gordon Bernard, Vanderbilt University School of Medicine, Nashville, and colleagues ( New England Journal of Medicine 2001;344:699-709).

Despite …
Ga-67-positive and F-18 FDG-negative imaging in well-differentiated hepatocellular carcinoma.
Authors: FRANCISCO JOSE HOSSRI NOGUEIRA BRAGA, PATRICK FLAMEN, LUC MORTELMANS, SIGRID STROOBANTS, FILIP HOMANS, ALEX MAES
Journal: Clinical Nuclear Medicine (2001)

JOSÉ HOSSRI NOGUEIRA BRAGA, FRANCISCO M.D., Ph.D.; FLAMEN, PATRICK M.D.; MORTELMANS, LUC M.D., Ph.D.; STROOBANTS, SIGRID M.D.; HOMANS, FILIP M.D.; MAES, ALEX M.D., Ph.D. Author Information
Abstract P179: Abdominal Skin-fold Thickness Improves Anthropometric Prediction of Insulin Resistance in Prepubescent Colombian Children
Authors: Noel T Mueller, Mark A Pereira, Adriana Buitrago, Diana C Rodriguez, Alvaro E Duran, Alvaro J Ruiz, Christian F Rueda-Clausen, Cristina Villa-Roel
Journal: Circulation (2012)

Introduction: Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), have been considered poor measures of cardiometabolic risk in children, in whom increases in these measures may reflect increases in lean mass more so than fat mass. Hypothesis: We examined the hypothesis that abdominal skinfolds (ASF) have better predictive value than BMI and other anthropometric measures for identifying insulin resistance (IR) in prepubescent Colombian children. Methods: We used data from a population-based cross-sectional study of 1,262 children, aged 6-10 y, in Bucaramanga, Colombia. Logistic regression stepwise variable selection (P&lt;0.05 for entry and retention) was performed to identify anthropometric predictors of IR, as determined by homeostatic model assessment (HOMA). Receiver operating characteristic (ROC) curves were used to compare area under the curve (AUC). Results: There were 57 boys and 70 girls classified as IR (HOMA &gt;90th percentile). Among anthropometric measures compared - including WC, WHtR, and four skinfolds - only age- and sex-specific ASF and BMI z-scores were retained as independent anthropometric predictors of IR. Prediction of IR was marginally better using ASF z-scores than BMI z-scores (P for contrast= 0.13). However, the final Model, which included both ASF and BMI, significantly increased the AUC from 0.80 (95% CI: 0.75-0.84) to 0.82 (95% CI: 0.78-0.86) - an improvement of 0.02 (95% CI: 0.004-0.04; P for contrast= 0.01)(see table ). In the final Model, after adjusting for BMI z, a 1-SD increment in ASF z was associated with 2.38 (95% CI: 1.74-3.26) greater odds of IR; whereas a 1-SD increment in BMI z, after adjustment for ASF z, was associated with 1.46 (95% CI: 1.11-1.91) greater odds of IR. Conclusions: ASF was independent from and marginally better than BMI in predicting IR in Colombian children. Furthermore, integration of ASF with BMI improved IR risk stratification compared to BMI alone, opening new perspectives in the prediction of cardiometabolic risk in children. ROC Curve Contrast Estimation and Testing Results for Anthropometric Measures of Insulin Resistance ROC Curve Contrasts Difference in AUC 95% CI P for Contrast WCz - BMIz 0.006 (-0.016, 0.028) 0.622 WHtRz - BMIz −0.045 (-0.074, -0.016) 0.002 ASFz - BMIz 0.018 (-0.005, 0.040) 0.126 Model (ASFz + BMIz) - BMIz 0.021 (0.004, 0.038) 0.014 BMI z-score (BMIz) was used as reference in all contrast estimates and tests against waist circumference z-score (WCz), waist-to-height z-score (WHtRz), abdominal skinfolds z-score (ASFz), and the best stepwise-selection Model (includes ASFz + BMIz)
Abstract 2090: Initial ECG Acquisition within 10 Minutes of Arrival to the Emergency Department in Persons Presenting with Ischemic Symptoms: Frequency, Time, and Gender Differences
Authors: Jessica K Zegre, Claire E Sommargren, Barbara J Drew
Journal: Circulation (2006)

The American Heart Association recommends all patients presenting to the emergency department (ED) with complaints of chest pain/anginal equivalent symptoms receive an initial ECG within 10 minutes...
A mistake that changed my practice: The wrong notes
Authors: C. Essex
Journal: BMJ (1999)

Our first visit to the antenatal clinic was an example of the poor quality service that you hear people complain about frequently in their dealings with the NHS: a 45 minute wait to be seen; being told by the antenatal receptionist to go to the ultrasound reception desk and vice versa. My wife went to the lavatory after the scan and was then asked for a sample of urine; we saw three members of staff who did not wear badges, did …
The spondyloarthritis research consortium of Canada (SPARCC) magnetic resonance imaging (MRI) index: A new scoring system for the evaluation of sacroiliac joint inflammation in spondyloarthritis
Authors: W P Maksymowych, S S Dhillon, R D Inman, D Salonen, M Stone, B Spady, R Krishnananthan, M Williams, R G W Lambert
Journal: Annals of the Rheumatic Diseases (2004)
Abstract 19182: Epicardial Adipose Tissue Volume Selectively Predicts Myocardial Redox State in Patients With Ischemic Heart Disease
Authors: Alexios S Antonopoulos, Nikant Sabharwal, Cheerag Shirodaria, Andrew Kelion, Raman Uberoi, Suzan Anthony, Rana Sayeed, Stefan Neubauer, Keith M Channon, Charalambos Antoniades
Journal: Circulation (2014)

Introduction: Myocardial redox state is a strong determinant of heart biology. Epicardial adipose tissue (EpAT) is in close contact with the human heart and it is likely that by secreting a wide range of adipokines it may affect the biology of the underlying myocardium. Hypothesis: We hypothesised that EpAT volume may predict myocardial redox state and consequently myocardial function in ischaemic heart disease (IHD). Methods: We recruited 38 patients undergoing coronary artery bypass grafting surgery. Patients underwent transthoracic echocardiography to assess cardiac function and cardiac computerised tomography to determine the volume of EpAT, pericardial (PerAT) and subcutaneous (ScAT) AT, by using a strictly pre-defined protocol. Samples of right atrium appendage were collected during surgery and myocardial NADPH oxidase activity was assessed by lucigenin-enhanced chemiluminescence (using its substrate -NAPDH 100uM +/- its specific inhibitor VAS2870 40uM). Results: Increased EpAT volume index (EpAT volume/body surface area), but not PerAT or ScAT, was strongly associated with increased myocardial NADPH oxidase activity (Figure). EpAT volume index was not related with left ventricle (LV) mass index or LV systolic/diastolic function (p=NS for all). EpAT volume index was also unrelated to risk factors or body mass index (p=NS for all). Conclusions: These findings introduce the concept of a local cross-talk between EpAT and the underlying myocardium in humans. EpAT volume can be used as a surrogate of myocardial redox state, and this may have direct implications in risk stratification of patients undergoing coronary bypass surgery.
Management of Wilderness and Environmental Emergencies
Authors: Paul S. Auerbach, Edward C. Geehr
Journal: Annals of Internal Medicine (1989)

one appearing in 1984-a year of rapidly breaking developments in the microcomputer field.For example, it discusses the influential role of the IBM/PC, and it appropriately does not mention the Osborne computer.No book, to my knowledge, will satisfy all the needs of a physician who may wish to enlarge a suddenly awakened interest in medical office com- puting.This one, however, does contain a wealth of factual material and many useful references to the relevant literature, all of which is apt to prove handy.
Allergen microarray detection of specific IgE in southern Chinese pollen allergy patients
Authors: Wenting Luo, Baoqing Sun, Nili Wei, Peiyan Zheng, Huimin Huang, Heng Zhong
Journal: European Respiratory Journal (2014)

Background : Dust mites have been considered to be the most important allergens in China, while pollen allergens are often neglected, especially in southern China. We tried to use allergen microarray to investigate the distribution of pollen allergens in southern China.  Methods: The study was conducted using patient sera from Guangzhou. In total 60 sera with one or more sIgE-positive were selected for testing against 112 individual allergens. Timothy and Bermuda grass extract specific IgE were also detected by ImmunoCAP.  Results: In 60 selected patients, 33.3% patients showed IgE-reactivity towards pollen allergen. 18.3% were IgE positive to nCyn d 1 (bermuda grass), 16.7% to rPhl p 4 (timothy grass). 11.7% to rPla a 2 (plane tree), 10.0% to nCup a 1 (cypress), 5.0% to nCry j 1 (Japanese cedar) and 3.3% positive to nArt v 1 (mugwort) and nSal k 1 (saltwort). There were 8.3% with nMUXF3 sIgE positive, the CCD marker. The distribution in these patients were shown in  .  Conclusions: This study clearly confirms that grass group 1 are major allergens of grass pollen allergens. With the urbanization and living environment changing, specific IgE-sensitization towards pollen allergens is increasing in southern China.These pollen allergy patients are major multi-sensitized. There may be cross-reactivitis between the pollen allergens, causing by nMUXF3. Extracts and components showed simultaneously positive detected by ImmunoCAP and ISAC.