tbuckley/cabot-search huggingface dataset:
Diagnosis of Adrenal Insufficiency in Severe Sepsis and Septic Shock
Authors: Djillali Annane, Virginie Maxime, Fidaa Ibrahim, Jean Claude Alvarez, Emuri Abe, Philippe Boudou
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Diagnosis of adrenal insufficiency in critically ill patients has relied on random or cosyntropin-stimulated cortisol levels, and has not been corroborated by a more accurate diagnostic standard.We used the overnight metyrapone stimulation test to investigate the diagnostic value of the standard cosyntropin stimulation test, and the prevalence of sepsis-associated adrenal insufficiency.This was an inception cohort study.In two consecutive septic cohorts (n = 61 and n = 40), in 44 patients without sepsis and in 32 healthy volunteers, we measured (1) serum cortisol before and after cosyntropin stimulation, albumin, and corticosteroid-binding globulin levels, and (2) serum corticotropin, cortisol, and 11beta-deoxycortisol levels before and after an overnight metyrapone stimulation. Adrenal insufficiency was defined by postmetyrapone serum 11beta-deoxycortisol levels below 7 microg/dl. More patients with sepsis (31/61 [59% of original cohort with sepsis] and 24/40 [60% of validation cohort with sepsis]) met criteria for adrenal insufficiency than patients without sepsis (3/44; 7%) (p < 0.001 for both comparisons). Baseline cortisol (< 10 microg/dl), Delta cortisol (< 9 microg/dl), and free cortisol (< 2 microg/dl) had a positive likelihood ratio equal to infinity, 8.46 (95% confidence interval, 1.19-60.25), and 9.50 (95% confidence interval, 1.05-9.54), respectively. The best predictor of adrenal insufficiency (as defined by metyrapone testing) was baseline cortisol of 10 microg/dl or less or Delta cortisol of less than 9 microg/dl. The best predictors of normal adrenal response were cosyntropin-stimulated cortisol of 44 microg/dl or greater and Delta cortisol of 16.8 microg/dl or greater.In sepsis, adrenal insufficiency is likely when baseline cortisol levels are less than 10 microg/dl or delta cortisol is less than 9 microg/dl, and unlikely when cosyntropin-stimulated cortisol level is 44 microg/dl or greater or Delta cortisol is 16.8 microg/dl or greater.
Thinking caps on
Authors: T. Delamothe
Journal: BMJ (2009)

When I was a medical student a helpful anaesthetist explained that surgeons wore caps in theatre to stop the bright lights from transilluminating their skulls. Now an anaesthetist has lifted the lid and discovered that surgeons have brains very similar to those of higher primates, with surprisingly complex wiring. Apparently, anaesthetists’ brains differ markedly from surgeons’(doi:10.1136/bmj.b5490). Who would have thought?

While this is brand new research, readers will discover many articles in this issue with a historical theme—intentionally chosen to mark the year that our complete archive (1840-2009) was made available …
Hypercalcemia in Bronchogenic Carcinoma
Authors: RICHARD A. BENDER
Journal: Annals of Internal Medicine (1974)

The relation of hypercalcemia, histologic cell type, and osseous neoplastic involvement was studied in 200 consecutive patients with untreated bronchogenic carcinoma. The overall frequency of hypercalcemia was 12.5%. Twenty-three percent of patients with epidermoid carcinoma, 12.7% with large-cell anaplastic carcinoma, 2.5% with adenocarcinoma, and none with small-cell carcinoma presented with or developed hypercalcemia. Fourteen of 25 patients (56%) with elevated calcium did not have osseous metastases. Osseous involvement was most frequently observed in patients with small-cell carcinoma (66%) and adenocarcinoma (50%). The data indicate that hypercalcemia is predominantly associated with epidermoid and large-cell anaplastic carcinoma and uncommonly associated with adenocarcinoma and small-cell carcinoma, even though the latter two cell types are most frequently associated with osseous metastases.
Three-Dimensional (3-D) Video Systems: Bi-Channel or Single-Channel Optics?
Authors: None van Bergen, None Kunert, None Buess
Journal: Endoscopy (1999)

This paper presents the results of a comparison between two different three-dimensional (3-D) video systems, one with single-channel optics, the other with bi-channel optics. The latter integrates two lens systems, each transferring one half of the stereoscopic image; the former uses only one lens system, similar to a two-dimensional (2-D) endoscope, which transfers the complete stereoscopic picture.In our training centre for minimally invasive surgery, surgeons were involved in basic and advanced laparoscopic courses using both a 2-D system and the two 3-D video systems. They completed analog scale questionnaires in order to record a subjective impression of the relative convenience of operating in 2-D and 3-D vision, and to identify perceived deficiencies in the 3-D system. As an objective test, different experimental tasks were developed, in order to measure performance times and to count pre-defined errors made while using the two 3-D video systems and the 2-D system.Using the bi-channel optical system, the surgeon has a heightened spatial perception, and can work faster and more safely than with a single-channel system. However, single-channel optics allow the use of an angulated endoscope, and the free rotation of the optics relative to the camera, which is necessary for some operative applications.
Abstract 18401: CC Chemokine Receptor 5 Deletion Prevents Macrophage Activation and Collagen Turnover Following Myocardial Infarction
Authors: Rogelio Zamilpa, Rushit Kanakia, Joaquin Cigarroa Iv, Hernan Martinez, Fabio Jimenez, Seema S Ahuja, Merry L Lindsey
Journal: Circulation (2010)

Post-myocardial infarction (MI), chemokine homing of inflammatory cells into injured myocardium regulates ventricular remodeling, in part by stimulating the extracellular matrix (ECM) response. The...
Independent researchers should have right to publish trial results if original researchers don't, campaigners say
Authors: N. Hawkes
Journal: BMJ (2013)

If gaps and errors in research reporting are not put right by the original authors within a year, independent researchers should take on the task, a team of medical scientists has said in the BMJ .1

Increasingly, missing data from trials sponsored by drug companies have become available through court actions and requests made under freedom of information legislation, write Peter Doshi of Johns Hopkins University, Baltimore, and colleagues. 

Absence of such data from the published literature—or misrepresentation of data in trial reports that have been published—distorts the balance of the literature, they say. The biases this creates are difficult to detect but can damage efforts to base treatments on the totality of evidence.

Doshi and colleagues call on those originally …
Abstract LB-113: Non-invasive analysis of drug sensitivity in homo and-heterotypic multicellular tumor spheroids
Authors: Maren Drewitz, Michael Salomon, Christian Thirion, Christian Oberdanner, Jens M. Kelm
Journal: Cancer Research (2012)

Abstract To gain full benefit of more organotypic tumor culture systems, appropriate assays which enable high-throughput analysis over time without destroying the tissues have to be adopted. Especially read outs for co-culture systems which allow the discrimination of a drug effect on the cancer cell and stroma environment will be of advantage to foster drug testing using more complex 3D models. Here we report the development of microtissue models harboring either fluorescent and/or Luciferase for non-invasive drug sensitivity testing of homotypic and heterotypic tumor spheroids. Microtissues were assayed in microtissue assay plate which allows for biochemical assays and quantitative fluorescence of single multicellular tumor spheroids. Both the fluorescent and secreted luciferase reporter can be measured over time without destroying the tissue allowing for additional end point analysis of interest. HCT116, a colon cancer cell line, was transduced with the reporter genes under the control of a constitutive promoter. To assess the dependency of the fluorescence intensity in accordance to microtissue growth, HCT116-GFP microtissues were assayed over time in a multiplate fluorescence reader. The size profile correlated closely to the increase in fluorescence intensity. For further assay validation the IC50 value were determined by intra-tissue lactate dehydrogenase (LDH) and fluorescence decrease after 72h compound incubation. Reference compounds such as Taxol, Staurosprin and Chlorambucil were tested. The IC50 values from both assays resulted in comparable IC50 values. For non-invasive drug sensitivity testing in heterogenic tumor microtissues HCT116 harboring a secreted Luciferase were combined with a red fluorescent mouse fibroblasts (NIH3T3). Assaying Luciferase on the one hand and red fluorescence intensity on the other allowed discriminating effects on cancer cells and the non-proliferative. Discrimination between specific effects of drug treatment on tumor cells and fibrobast matrix cells is also possible using a two color heterotypic cell model composed of GFP-expressing HTC116 and RFP expressing NIH3T3 cells. Cytotoxic agents targeting either the total cell population or only proliferative cells were tested on the model discriminating the biological response on the two cell populations. To enable the implementation of organotypic cell culture systems at an early time point in the drug development process non-invasive assays. Here, we demonstrate for the first time such a dual cell tumor microtissues system with integrated reporter functions which allows to distinguish effects on different cell populations. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-113. doi:1538-7445.AM2012-LB-113
DR MARY WITHAM
Authors: A. Jarrett
Journal: British Journal of Dermatology (1977)

Journal Article DR MARY WITHAM Get access A. Jarrett A. Jarrett Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 96, Issue 1, 1 January 1977, Page 108, https://doi.org/10.1111/j.1365-2133.1977.tb05199.x Published: 01 January 1977
Effect of Vertical Dimension on Efficacy of Oral Appliance Therapy in Obstructive Sleep Apnea
Authors: Andrew J. Pitsis, M. Ali Darendeliler, Helen Gotsopoulos, Peter Petocz, Peter A. Cistulli
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

The aim of this study was to assess the effect of bite opening induced by a mandibular advancement splint (MAS) on efficacy and side effects in the treatment of obstructive sleep apnea. In a randomized crossover fashion, 23 adult patients received either MAS-1 (4 mm of interincisal opening) or MAS-2 (14 mm of interincisal opening) for 2 weeks, followed by the alternate treatment for 2 weeks, with an intervening 1-week washout. Complete response was defined as a resolution of symptoms and a reduction in apnea/hypopnea index (AHI) to less than 5 per hour. Partial response was defined as improved symptoms and a reduction in AHI of 50% or more, with the AHI remaining at a value of 5 or more per hour. Both MAS-1 and MAS-2 produced similar reductions in mean (± SEM) AHI from baseline: 21 ± 2 versus 8 ± 1/hour and 21 ± 2 versus 10 ± 2/hour, respectively (p < 0.001). Either complete response or partial response occurred in 74 and 61% of patients with MAS-1 and MAS-2, respectively. Subjective improvements were reported with both appliances by the majority of patients. Patients preferred MAS-1 (78 versus 22%, p = 0.007). This study suggests that the amount of bite opening induced by MAS does not have a significant impact on treatment efficacy but does have an impact on patient acceptance.
Cyclosporin for polymyositis.
Authors: S van der Meer, J W Imhof, J C Borleffs
Journal: Annals of the Rheumatic Diseases (1986)

Cyclosporin for polymyositis SIR, Cyclosporin has proved its value as an immunosup- pressive drug in transplant patients.In addition, it appears to be effective in patients with autoimmune diseases.Recently, some reports have been published on the successful administration of cyclosporin to patients with severe polymyositis and dermatomyositis, in whom con- ventional treatment with prednisolone, azathioprine, cyc- lophosphamide, or methotrexate had failed.' 2 In these
Histocompatibility antigens and dermatitis herpetiformis with special reference to jejunal abnormalities and acetylator phenotype
Authors: T. REUNALA, O.P. SALO, A. TIILIKAINEN, M.J. MATTILA
Journal: British Journal of Dermatology (1976)

Sixty-one patients with dermatitis herpetiformis (DH) were studied. Of these fifty-three (87%) had the histocompatibility (HL-A) antigen HL-A8 as compared with 17% of a control population; the difference is significant. This incidence of HL-A8 among patients with DH is higher than that reported earlier for such patients and is similar to that reported for patients with adult coeliac disease. The incidence of HL-A1 was also significantly greater in the patient group, and was attributed to the increased frequency of haplotype HL-A1, 8. The frequency of HL-A8 was about equal in patients in whom DH was associated with jejunal abnormalities and in those in whom it was not. When correlated with rate of acetylation, there was no significant difference in the occurrence of various HL-A antigens.
Evaluating Education in Evidence-Based Practice—Reply
Authors: Terrence M. Shaneyfelt, Michael Green
Journal: JAMA (2007)

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 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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
Sexual Function Following Surgery for Ulcerative Colitis
Authors: Michael J. Donovan, Edward T. O'Hara
Journal: New England Journal of Medicine (1960)

THE usual surgical treatment of ulcerative colitis is total removal of the colon and rectum in one or more stages. Since the disease is one that affects young adults, it is important to know whether removal of the rectum seriously interferes with sexual function in the male.1 The basis of this report is a follow-up study of the patients at the Boston Veterans Administration Hospital who had removal of the rectum during the period 1952 to 1956.DataDuring the period 1952 to 1956, 134 patients were admitted to the Boston Veterans Administration Hospital with a diagnosis of ulcerative colitis. . . .
Experts dispute claims of poor cancer survival in UK
Authors: Michael Day
Journal: BMJ (2007)

An influential group of MPs has claimed that widespread financial incompetence is adding to the cost of the United Kingdom's controversial private finance initiative (PFI).The House of Commons Committee of Public Accounts made its new attack on the PFI after it discovered that the government had clawed back £100m (€145m; $200m) less than was predicted from the new private-public profit sharing schemes.The committee's chairman, the Conservative MP Edward Leigh, blamed the loss on the failure of Treasury officials to oversee key refinancing arrangements.In 2002 ministers introduced changes so that public sector bodies could share in some of the financial gains when big PFI loans were rearranged.Typically, these loans were renegotiated on a more favourable basis once PFI projects had been completed and the risks involved were lower.However, left to their own devices, officials in local hospitals had been out of their depth negotiating with their counterparts in the private sector, the committee says.In 2003 the Office of Government Commerce, which then had responsibility for PFI policy, told the public accounts committee that it expected the public sector to receive between £175m and £200m from the voluntary sharing arrangements in early PFI deals.However, up to December 2006 the government had secured the right to gains of only £93m."Proceeds gained by the public sector from PFI debt refinancing under the voluntary code for the sharing of gains are currently well short of expectations" said Mr Leigh.
Communication behaviours in a hospital setting: an observational study
Authors: E. Coiera, V. Tombs
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective:</b> An exploratory study to identify patterns of communication behaviour among hospital based healthcare workers. <b>Design:</b> Non-participatory, qualitative observational study. <b>Setting:</b> British district general hospital. <b>Subjects:</b> Eight doctors and two nurses. <b>Results:</b> Communication behaviours resulted in an interruptive workplace, which seemed to contribute to inefficiency in work practice. Medical staff generated twice as many interruptions via telephone and paging systems as they received. Hypothesised causes for this level of interruption include a bias by staff to interruptive communication methods, a tendency to seek information from colleagues in preference to printed materials, and poor provision of information in support of contacting individuals in specific roles. Staff were observed to infer the intention of messages based on insufficient information, and clinical teams demonstrated complex communication patterns, which could lead to inefficiency. <b>Conclusion:</b> The results suggest a number of improvements to processes or technologies. Staff may need instruction in appropriate use of communication facilities. Further, excessive emphasis on information technology may be misguided since much may be gained by supporting information exchange through communication technology. Voicemail and email with acknowledgment, mobile communication, improved support for role based contact, and message screening may be beneficial in the hospital environment. <h3>Key messages</h3> We observed communication behaviour among 10 hospital based healthcare workers Communication behaviours resulted in an interruptive work place, which seemed to contribute to inefficiency in work practice Medical staff generated twice as many interruptions via telephone and paging systems as they received, and possible causes for this included a bias by staff to interruptive communication methods, a tendency to seek information from colleagues in preference to printed materials, and poor provision of information in support of contacting individuals in specific roles Staff were observed to infer the intention of messages based on insufficient information, and clinical teams showed complex communication patterns, which could lead to inefficiency We conclude that hospital staff may need instruction in appropriate use of communication facilities and that some communication technology—voicemail and email with acknowledgment, cellular telephones for mobile communication, improved support for role based contact, and message screening—may be beneficial
Disappearance of Aortic Intramural Hematoma and Its Significance to the Prognosis
Authors: K. Nishigami, T. Tsuchiya, H. Shono, Y. Horibata, T. Honda
Journal: Circulation (2000)

An aortic intramural hematoma (IMH) is a form of aortic dissection (AD). IMHs regress with time or completely disappear in some patients, whereas they progress to overt AD in other patients. The purpose of the present study was to investigate how IMHs change serially during a follow-up period.We analyzed 44 consecutive medically treated patients with IMHs, in whom transesophageal echocardiography (TEE) was performed serially at both 1 and 6 months after the onset. After TEE, the patients were followed with interviews (mean follow-up 1552+/-539 days). IMHs disappeared at 6 months in 21 patients (48%) (disappearance group), whereas IMHs were still demonstrated at 6 months in 20 patients (45%) (persistent group); in the disappearance group, IMHs disappeared at 1 month in 8 patients (18%). In 3 patients (7%) in whom an IMH was demonstrated at 1 month, overt AD occurred until 6 months. The disappearance group was younger than the persistent group (64+/-11 versus 72+/-8 years, P:<0.01), and the maximum diameter of the aorta was smaller in the disappearance group than in the persistent group (33+/-5 versus 42+/-7 mm, P:<0.01). During the long-term follow-up, overt AD occurred at 7 and 11 months in 2 patients, and progressive aortic dilatation that required surgical treatment occurred at 12 and 24 months in 2 of the persistent group patients, whereas neither overt AD nor progressive aortic dilatation occurred in the disappearance group. In the patients in whom overt AD occurred, the maximal aortic diameter was >45 mm and an IMH was demonstrated at 1 month. On the other hand, those with a maximal aortic diameter of <45 mm or a disappeared IMH did not have overt AD.IMHs disappeared until 1 month in 18% and until 6 months in 48% of patients with IMHs. The disappearance of IMHs was related to the maximum diameter of the aorta and age. Both a disappeared IMH and a maximal aortic diameter of <45 mm suggest a good prognosis.
Arguments for lowering the upper time limit for abortion are flawed, says Lord Steel
Authors: Z. Kmietowicz
Journal: BMJ (2008)

David Steel, whose private member’s bill led to the legalisation of abortion in England, Scotland, and Wales in 1967, this week defended women’s right to request an abortion up to the current time limit of 24 weeks’ gestation.

Speaking ahead of the second reading of the Human Tissue and Embryo Bill in the House of Commons later this month, Lord Steel said that the arguments of many people who are campaigning for a reduced time limit for abortion were flawed. The bill is expected to be open to amendments from backbench MPs to alter the current limit on abortion.

“A lot of the people who are pressing for a reduction in the time limit are doing it …
Spur-Shaped Erythrocytes in Laennec's Cirrhosis
Authors: Robert Silber, Edward Amorosi, Joseph Lhowe, Herbert J. Kayden
Journal: New England Journal of Medicine (1966)

HEMOLYTIC anemia, characterized by the presence of red cells bearing spur-like projections ("spur-cell anemia"), was described by Smith et al.1 in a man with Laennec's cirrhosis. A factor that induced spur formation in normal erythrocytes was reported in the patient's plasma. The subject of the present report is a patient with Laennec's cirrhosis and spur-shaped erythrocytes who manifested hypersplenism and an increased autohemolysis; no plasma factor could be demonstrated despite numerous incubations with normal red cells.Case ReportA 48-year-old housewife entered New York University Hospital on May 21, 1964, with a chief complaint of jaundice of 2 months' duration. . . .