tbuckley/cabot-search huggingface dataset:
Review: Perioperative β-blockers have variable effects on outcomes in cardiac and noncardiac surgery
Authors: Charlotte Andersson
Journal: Annals of Internal Medicine (2015)

ACP Journal Club17 March 2015Review: Perioperative β-blockers have variable effects on outcomes in cardiac and noncardiac surgeryCharlotte Andersson, MD, PhDCharlotte Andersson, MD, PhDGentofte Hospital, University of Copenhagen, Hellerup, Denmark (C.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2015-162-6-002 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationBlessberger H, Kammler J, Domanovits H, et al. Perioperative beta-blockers for preventing surgery-related mortality and morbidity. Cochrane Database Syst Rev. 2014;9:CD004476. https://pubmed.ncbi.nlm.nih.gov/25233038Clinical Impact RatingsHospitalists: Cardiology: References1. Husten L. Erasmus Medical Center releases final report on cardiovascular research scandal. CardioBrief. October 9, 2012. cardiobrief.org/2012/10/09/erasmus-medical-center-releases-final-report-on-cardiovascular-research-scandal/ (accessed 8 Jan 2015). Google Scholar2. Sear JW, Giles JW, Howard-Alpe G, Foëx P. Perioperative beta-blockade, 2008: what does POISE tell us, and was our earlier caution justified? Br J Anaesth. 2008;101:135-8. [PMID: 18614596] Google Scholar3. Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA guideline for coronary artery bypass graft surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2011;58:e123-210. [PMID: 22070836] Google Scholar Author, Article, and Disclosure InformationAffiliations: Gentofte Hospital, University of Copenhagen, Hellerup, Denmark (C.A.)This article was published at Annals.org on 3 March 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 March 2015Volume 162, Issue 6Page: JC2KeywordsArrhythmiaBradycardiaCardiac surgeryClinical trialsHypotensionMorbidityStrokeSurgery ePublished: 17 March 2015 Issue Published: 17 March 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Science, medicine, and the future: Cellular immunotherapy for cancer
Authors: A. C Armstrong, D. Eaton, J. C Ewing
Journal: BMJ (2001)

During the past decade, our rapidly escalating understanding of immune surveillance and an appreciation of the mechanisms by which tumours escape its notice have led to promising new strategies against cancer. This paper reviews the concepts behind current research into cellular immunotherapy for cancer, presents data from clinical trials, and discusses the potential of this treatment as an adjunct to conventional modes of cancer treatment.

All three authors are involved in research into cellular immunotherapy and gene therapy. We searched PubMed and Medline databases using the terms “cancer vaccines,” “dendritic cells,” and “lymphocyte therapy.”

The importance of the interaction between the immune system and cancer cells was recognised in the 1890s when William Coley used streptococcal cultures to treat patients with advanced sarcoma. These attempts to activate general immunity led to clinical responses. More recently, antibodies and T cells that identify tumour antigens have been isolated from patients with cancer. It is clear that the immune system is capable of recognising tumour cells.



Fig 1 
Antitumour immune response. Dendritic cells capture antigens released by cancer cells. After intracellular processing, antigenic peptides are loaded onto major histocompatibility complex (MHC) molecules on the surface of the dendritic cell. Specific T cells encounter these MHC-peptide complexes in conjunction with a costimulatory signal. The activated T cells proliferate and secrete cytokines, resulting in the production of a cascade of immune effector cells (IL-2=interleukin 2; GM-CSF=granulocyte-macrophage colony stimulating factor)



Cellular immunotherapy consists of giving the patient cells that stimulate antitumour activity in the patient (tumour and dendritic cell vaccines) or that have intrinsic antitumour activity (autologous and allogeneic lymphocytes). The aim is to harness potent immunological weapons to destroy cancer cells.

Cytotoxic T lymphocytes are one of the critical effector cells that are able to lyse tumour cells. Receptors on the surface of T cells recognise antigens …
Sporadic disseminated histoplasmosis simulating miliary tuberculosis.
Authors: P Tong, W C Tan, M Pang
Journal: BMJ (1983)

Une observation chez une femme de 45 ans a Singapour. Le tableau clinique simule une tuberculose miliaire: amaigrissement, sueurs nocturnes, affaiblissement rapide, image typique de la radiographie thoracique. Les biopsies de foie et de rate montrent des cellules reticuloendotheliales fortement parasitees par Histoplasma capsulatum
Cloning of the t(1;5)(q23;q33) in a myeloproliferative disorder associated with eosinophilia: involvement of PDGFRB and response to imatinib
Authors: Kathryn Wilkinson, Elvira R. P. Velloso, Luiz Fernando Lopes, Charles Lee, Jon C. Aster, Margaret A. Shipp, Ricardo C. T. Aguiar
Journal: Blood (2003)
Effect of sulphinpyrazone on the development of experimental endocardial vegetations
Authors: C. E JOHNSON, H. A DEWAR
Journal: Cardiovascular Research (1982)

The effect of treating rabbits with sulphinpyrazone on the development of sterile endocardial vegetations has been studied. This drug reduced the overall size of the vegetations compared with placebo treated animals. The relevance of these findings is discussed in respect to the possible uses of the drug in the treatment of bacterial endocarditis.
Incidence and Clinical Characteristics of Group A Rotavirus Infections among Children Admitted to Hospital in Kilifi, Kenya
Authors: D. James Nokes, John Abwao, Allan Pamba, Ina Peenze, John Dewar, J. Kamino Maghenda, Hellen Gatakaa, Evasius Bauni, J. Anthony G Scott, Kathryn Maitland, Thomas N Williams
Journal: PLoS Medicine (2008)

Background Rotavirus, predominantly of group A, is a major cause of severe diarrhoea worldwide, with the greatest burden falling on young children living in less-developed countries. Vaccines directed against this virus have shown promise in recent trials, and are undergoing effectiveness evaluation in sub-Saharan Africa. In this region limited childhood data are available on the incidence and clinical characteristics of severe group A rotavirus disease. Advocacy for vaccine intervention and interpretation of effectiveness following implementation will benefit from accurate base-line estimates of the incidence and severity of rotavirus paediatric admissions in relevant populations. The study objective was to accurately define the incidence and severity of group A rotavirus disease in a resource-poor setting necessary to make informed decisions on the need for vaccine prevention. Methods and Findings Between 2002 and 2004 we conducted prospective surveillance for group A rotavirus infection at Kilifi District Hospital in coastal Kenya. Children < 13 y of age were eligible as “cases” if admitted with diarrhoea, and “controls” if admitted without diarrhoea. We calculated the incidence of hospital admission with group A rotavirus using data from a demographic surveillance study of 220,000 people in Kilifi District. Of 15,347 childhood admissions 3,296 (22%) had diarrhoea, 2,039 were tested for group A rotavirus antigen and, of these, 588 (29%) were positive. 372 (63%) rotavirus-positive cases were infants. Of 620 controls 19 (3.1%, 95% confidence interval [CI] 1.9–4.7) were rotavirus positive. The annual incidence (per 100,000 children) of rotavirus-positive admissions was 1,431 (95% CI 1,275–1,600) in infants and 478 (437–521) in under-5-y-olds, and highest proximal to the hospital. Compared to children with rotavirus-negative diarrhoea, rotavirus-positive cases were less likely to have coexisting illnesses and more likely to have acidosis (46% versus 17%) and severe electrolyte imbalance except hyponatraemia. In-hospital case fatality was 2% among rotavirus-positive and 9% among rotavirus-negative children. Conclusions In Kilifi > 2% of children are admitted to hospital with group A rotavirus diarrhoea in the first 5 y of life. This translates into over 28,000 vaccine-preventable hospitalisations per year across Kenya, and is likely to be a considerable underestimate. Group A rotavirus diarrhoea is associated with acute life-threatening metabolic derangement in otherwise healthy children. Although mortality is low in this clinical research setting this may not be generally true in African hospitals lacking rapid and appropriate management.
Long QT syndrome: novel insights into the mechanisms of cardiac arrhythmias
Authors: Robert S. Kass, Arthur J. Moss
Journal: Journal of Clinical Investigation (2003)

The congenital long QT syndrome is a rare disorder in which mutation carriers are at risk for polymorphic ventricular tachycardia and/or sudden cardiac death. Discovery and analysis of gene mutations associated with variants of this disorder have provided novel insight into mechanisms of cardiac arrhythmia and have raised the possibility of mutation-specific therapeutic intervention.
Assessing improvement of low back pain.
Authors: M E Carson
Journal: BMJ (1980)

Manipulation trialsSIR,-Every doctor and most laymen are well aware of patients who have been treated for backache for months, even years, within the NHS and have finally been adjured to "live with it."A proportion of such patients secured rapid relief from a lay manipulator.It was this well-recognised fact that let me teach spinal manipulation (among other techniques) to my physiotherapy students from 1940 to 1970.The intention was that those who needed this treatment should get it immediately, from skilled personnel, and in full view within the hospital rather than wander off in the end on their own to try their luck with some self-styled layman.This policy worked very well, many patients recovering swiftly-in half of all cases, backache recovered in one session of manipulation.It is very noble of Dr H Sims-Williams and others (24 November, p 1318) to have put up the controlled trial that they describe.The result was negative; but, firstly, the patients were not selected as suited or unsuited to manipulation; secondly, they were treated by Maitland's adaptation of Balfour's' (1819) and Recamier's oscillatory techniques2 (methods with scant resemblance to those taught by me3); and, thirdly, they were all assessed at the end of a month.Physiotherapy (that is, heat and exercises) for backache is useless.Their article states, "The management of non-specific back pain is unsatisfactory and physiotherapy is often prescribed empirically."On what grounds?No patient should be treated until the cause of his symptoms becomes clear, and the measure prescribed should be appropriate to the diagnosis.If manipulation were confined to suitable cases, proper methods were employed, and the assessment were made after a few days a very different picture would emerge.Meanwhile, doctors are discouraged by papers like this one from adopting sensible measures and the jubilant lay manipulators cash in again.
Why Reassurance Fails in Patients with Unexplained Symptoms—An Experimental Investigation of Remembered Probabilities
Authors: Winfried Rief, Andrea Maren Heitmüller, Katja Reisberg, Heinz Rüddel
Journal: PLoS Medicine (2006)

Providing reassurance is one of physicians' most frequently used verbal interventions. However, medical reassurance can fail or even have negative effects. This is frequently the case in patients with medically unexplained symptoms. It is hypothesized that these patients are more likely than patients from other groups to incorrectly recall the likelihoods of medical explanations provided by doctors.Thirty-three patients with medically unexplained symptoms, 22 patients with major depression, and 30 healthy controls listened to an audiotaped medical report, as well as to two control reports. After listening to the reports, participants were asked to rate what the doctor thinks the likelihood is that the complaints are caused by a specific medical condition. Although the doctor rejected most of the medical explanations for the symptoms in his verbal report, the patients with medically unexplained complaints remembered a higher likelihood for medical explanations for their symptoms. No differences were found between patients in the other groups, and for the control conditions. When asked to imagine that the reports were applicable to themselves, patients with multiple medical complaints reported more concerns about their health state than individuals in the other groups.Physicians should be aware that patients with medically unexplained symptoms recall the likelihood of medical causes for their complaints incorrectly. Therefore, physicians should verify correct understanding by using check-back questions and asking for summaries, to improve the effect of reassurance.
P3-11-05: An Efficient Resource To Accelerate Research into the Cause and Prevention of Breast Cancer: The Love/Avon Army of Women.
Authors: SM Love
Journal: Cancer Research (2011)

Abstract Background It is well established that more research into the cause and prevention of breast cancer is needed. While many studies are done in cell lines and laboratory animals, translation of findings to women often falters due to perceived difficulty in recruiting women for research. The Dr. Susan Love Research Foundation received a grant from the Avon Foundation to form the Love/Avon Army of Women (AOW); an on-line recruitment resource launched in 2008, designed to partner one million women with the research community in an effort to accelerate breast cancer research. Methods: Researchers submit a proposal to the AOW Scientific Advisory Committee. If a study is accepted, a mass e-mail describing the study procedures and inclusion/exclusion criteria is sent to the entire AOW database. Women sign up at www.armyofwomen.org to join and receive AOW e-mails about breast cancer research studies. Women self select based on interest and study criteria, and undergo a secondary on-line screening before contact information is passed on to the researcher for the enrollment process. Results: Over 356,000 women have signed up, including survivors and healthy women, ranging from ages 18 to 100, representing all 50 US states and 49 countries. To date, the AOW has recruited for 48 studies, both regional and national, that vary from biomarker and circadian rhythm research to psycho-social and quality of life studies. With over 54,000 AOW members having participated in the research process, this method of recruitment has been found to be effective and efficient. The diversity of the AOW members has proved beneficial for many studies, such as those needing to enroll racial/ethnic minorities, women of varying sexual orientations, or young survivors. Nine studies were closed to enrollment within the first 48 hours after accruing all subjects while others were very quickly over-enrolled by 5–10%. A urine biomarker study in search of healthy women and breast cancer survivors closed within eight hours, after 2,076 women signed up, representing a 58% over-enrollment. This overwhelming response has led many researchers to seek additional funding to increase their statistical significance and accommodate all eligible subjects. Conclusions: The AOW has proved to be a successful resource for scientists to accelerate accrual, expand the number and diversity of their subject population and to obtain exactly the type of specimens they need when they need it. This partnership between women and scientists has revolutionized research and accelerated efforts to eradicate breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-11-05.
EXPERIMENTAL ANEMIA PRODUCED BY PHENYL-HYDRAZINE DERIVATIVES
Authors: Perrin H. Long
Journal: Journal of Clinical Investigation (1926)

Soon after the discovery of acetyl phenyihydrazine (pyrodin) by Liebreich it was observed that this chemical possessed marked anti- pyretic effects, and it therefore came into widespread use in diseases accompanied by fever.Further experience indicated that in addition to reducing the temperature, the drug also produced an anemia that varied in degree according to the dosage.Experiments performed
Pulsatile Flow in Patients With a Novel Nonpulsatile Implantable Ventricular Assist Device
Authors: E. V. Potapov, M. Loebe, B. A. Nasseri, H. Sinawski, A. Koster, H. Kuppe, G. P. Noon, M. E. DeBakey, R. Hetzer
Journal: Circulation (2000)

Ventricular assist devices (VADs) are an accepted therapy for patients with end-stage heart failure. The implantable devices that are available produce a pulsatile flow and are very large. In 6 patients, beginning in November 1998, we started to use the continuous-flow implantable DeBakey VAD device, which weighs 93 g. To detect the flow in peripheral vessels, we measured transcranial Doppler signals in patients after implantation.Transcranial Doppler studies were performed with the MULTI-DOP X4 device with two 2-MHz probes (for the middle cranial arteries) in 4 patients for up to 12 weeks twice weekly after implantation. The blood velocity was measured, and the pulsation index (PI) calculated. The measured pump flow and rotations per minute were registered. The preoperative echocardiographic assessment values were compared with those acquired 6 weeks after implantation. The PI increased continually in all patients after VAD implantation, left ventricular (LV) ejection fraction did not improve, but right ventricular (RV) ejection fraction after implantation improved compared with preoperative values. The LV end-diastolic diameter after implantation decreased between 11% and 46% intraindividually. There was no correlation between PI and blood pressure or, except in 1 patient, between PI and blood flow through the VAD.The DeBakey VAD unloads the LV, which leads to a decrease in LV end-diastolic LV diameter and to the restoration of RV function. The unloaded LV and partially recovered RV provide a nearly physiological pulsatile flow despite the continuous flow of the VAD. Pulsatility is independent of peripheral vascular resistance. The first clinical experience with the DeBakey VAD was positive and has resulted in its continued use.
Effect of Cardiac Contraction on Coronary Blood Flow
Authors: DAVID C. SABISTON, DONALD E. GREGG
Journal: Circulation (1957)

In the experimental animal the basic and controversial problem was studied of the influence of cardiac contraction on coronary blood flow. Normally beating hearts were perfused at a constant pressure, and coronary inflow and outflow were determined. In order to assess the role of systole, prolonged periods of ventricular asystole and fibrillation were induced and observations were made of the changes in coronary flow. With the cessation of cardiac contraction blood flow in the coronary arteries and coronary sinus rose appreciably. The results of these studies support the concept that contraction of the heart muscle, by compression of the myocardial vascular bed, behaves as a throttling mechanism and impedes coronary flow. The method employed permits a separation and quantitation of the effects on coronary flow resulting from cardiac contraction and the vasomotor state of the coronary vessels.
Suction in Abdominal Surgery
Authors: Bernard J. Ficarra
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The editorial "Abdominal Surgery Without Gastrointestinal Suction" states: "The rationale for gastric decompression is prevention and treatment of postoperative abdominal distention." (<b>195</b>:682, 1966) Modern surgery does not subscribe to the teaching of nasogastric intubation for gaseous distention. It is quite unusual for the surgeon of today to employ suction for this purpose. Surgical experiment has proved that only segmental small bowel decompression can be accomplished by either long or short indwelling tubes. Therefore, intubation fails to serve the purpose for which it was intended, and more often than not suction disturbs or depletes the body of valuable electrolytes. Another statement emphasizes that "Suction is valuable if proper indications exist, as in patients with gastrointestinal bleeding or abdominal trauma (to determine the presence of active bleeding)..." Although this is true, another reason for suction should be considered. Since most surgeons employ the hemostatic Connell suture for gastroenterostomy
Clinical efficacy and antiangiogenic activity of thalidomide in myelofibrosis with myeloid metaplasia. A pilot study
Authors: PP Piccaluga, G Visani, SA Pileri, S Ascani, T Grafone, A Isidori, M Malagola, C Finelli, G Martinelli, P Ricci, M Baccarani, S Tura
Journal: Leukemia (2002)
Dietary lactose and the child with abdominal pain.
Authors: J Dearlove, B Dearlove, K Pearl, R Primavesi
Journal: BMJ (1983)

spread metastases and died two months later, having remained normo- calcaemic and swallowed normally until death.Case 2-A 50 year old man developed lymphadenopathy in the left supraclavicular fossa due to squamous carcinoma secondary to a symptomless primary tumour of the left main bronchus.The nodes were treated with palliative radiotherapy, but two months later he developed total dysphagia for solids, anorexia, and nausea.Examination showed some residual lymph- adenopathy but was otherwise unremarkable; a chest x ray film, however, showed a primary carcinoma in the left hilar region and multiple bone metastases.Barium swallow showed free flow of barium with no mechanical hold up but some slight muscular incoordination in the pharynx.A bio- chemical profile showed calcium concentration 3-8 mmol/l (15 ng/100 ml), alkaline phosphatase activity 200 IU/1, urea concentration 17-9 mmol/l (108 mg/100 ml) (normal 2-0-8-1 mmol/l (12-49 mg/100 ml)), and glutamic oxaloacetic transaminase activity 315 IU/l (normal 5-45 IU/1).Treatment with intravenous fluids, high dose steroids, and mithramycin corrected the hypercalcaemia, and his dysphagia had gone completely after five days and he was discharged home.He had no further problems with dysphagia.but died a month later from generalised disease.Postmortem examination confirmed a squamous cell carcinoma of the left main bronchus with wide- spread metastases but with a normal oesophagus that was not obstructed.
Should We Nudge Informed Consent?
Authors: Thom Brooks
Journal: The American Journal of Bioethics (2013)

Critics argue that nudge theory manipulates rather than respects the informed consent of patients.Cohen (2013) convincingly argues that this criticism falls short of the mark.But we might go one step further: nudges are not only defensible, there are also inescapable.Cohen's defence should be more robust and recognize the importance of context and unavoidable framing effects.The question is not whether nudges are acceptable, but rather how they might be better employed to improve informed consent and public policy.This Open Peer Commentary will explain the inevitability of nudging.A respect for informed consent is to respect choices within context.We can improve our efforts to support
Dextrose and Sorbitol as Diluents for Continuous Intravenous Heparin Infusion
Authors: J. M. Chessells, T. A. Braithwaite, D. A. Chamberlain
Journal: BMJ (1972)

A comparison of 5% dextrose and 5% sorbitol as diluents for heparin given by continuous intravenous infusion indicated that neither impaired the potency of the heparin. Previous suggestions that heparin becomes unstable in dextrose solution have not been confirmed.