tbuckley/cabot-search huggingface dataset:
The Necessary Length of Hospital Stay for Chronic Pulmonary Disease
Authors: Alvin I. Mushlin
Journal: JAMA (1991)

--To determine the necessary length of stay for patients admitted to the hospital with an exacerbation of chronic pulmonary disease and to compare this with the length of stay assigned by the diagnosis related group system.--A cohort of patients were followed up prospectively after hospital admission to determine when complications, critical incidents, and the need for monitoring occurred. The medically derived necessary lengths of stay were statistically compared with the lengths of stay assigned by the diagnosis related group. Clinical factors were used to predict long vs short necessary lengths of stay.--Two acute care hospitals: one was the principal and the other a major community teaching hospital.--A consecutive sample of 83 patients who were 45 years of age or older and who required admission for treatment of chronic pulmonary disease.--The occurrence and time of complications, critical interventions, and monitoring.--After 6 days in the hospital, 90% of patients were free of complications or the need for monitoring. However, 16 days elapsed before 90% of patients had been discharged from the hospital. The length of stay that was considered necessary for care averaged 6.9 days; the actual mean length of stay was 8.7 days. The correlation between each patient's ideal length of stay and the length of stay assigned by the diagnosis related group was low and was not statistically significant. Three clinical variables at the time of admission (high PCO2 levels, symptoms that were present for more than 1 day, and antibiotic treatment) were associated with the need for longer hospital stays.--The medically required length of stay for patients with an exacerbation of chronic pulmonary disease was between 6 and 7 days, on average. This length of stay, which was based on clinical events, differs from the length of stay that was calculated as a statistical norm by the diagnosis related group system. Clinical characteristics may help to identify patients who require a longer length of stay.
Short course chemotherapy for tuberculous lymphadenitis in children.
Authors: M S Jawahar, S Sivasubramanian, V K Vijayan, C V Ramakrishnan, C N Paramasivan, V Selvakumar, S Paul, S P Tripathy, R Prabhakar
Journal: BMJ (1990)

OBJECTIVE--To assess the efficacy of a short course chemotherapy regimen for treating tuberculosis of the lymph nodes in children. DESIGN--Open, collaborative, outpatient clinical trial. SETTING--Outpatient department of the Tuberculosis Research Centre, paediatric surgery departments of the Institute of Child Health and Hospital for Children and the Government Stanley Hospital, Madras, South India. PATIENTS--Children aged 1-12 years with extensive, multiple site, superficial tuberculous lymphadenitis confirmed by biopsy (histopathology or culture). INTERVENTIONS--Patients were treated with a fully supervised intermittent chemotherapy regimen consisting of streptomycin, rifampicin, isoniazid, and pyrazinamide three times a week for two months followed by streptomycin and isoniazid twice a week for four months on an outpatient basis. Surgery was limited to biopsy of nodes for diagnosis and assessment. MAIN OUTCOME MEASURES--Response to chemotherapy was assessed by regression of lymph nodes and healing of sinuses and abscesses during treatment and follow up. Compliance with treatment and frequency of adverse reactions were also estimated. RESULTS--197 Patients were admitted to the study and 168 into the analysis. The regimen was well tolerated and compliance was good with 101 (60%) patients receiving the prescribed chemotherapy within 15 days of the stipulated period of six months. Those whose chemotherapy extended beyond that period received the same total number of doses. Clinical response was favourable in most patients at the end of treatment. Sinuses and abscesses healed rapidly. Residual lymphadenopathy (exceeding 10 mm diameter) was present in 50 (30%) patients at the end of treatment; these nodes were biopsied. Fresh nodes, increase in size of nodes, and sinuses and abscesses occurred both during treatment and follow up. After 36 months of follow up after treatment only 5 (3%) patients required retreatment for tuberculosis. CONCLUSION--Tuberculous lymphadenitis in children can be successfully treated with a short course chemotherapy regimen of six months.
Low-energy impedance-compensating biphasic waveforms defibrillate pre-hospital ventricular fibrillation at high rates
Authors: J.E. Poole, R.D. White, K.-G. Kanz, S.M. Dillon, B.E. Gliner, D.B. Jorgenson, C.B. Morgan, W.D. Weaver, G.H. Bardy
Journal: Journal of the American College of Cardiology (1998)
Chemoprophylaxis for Pneumocystis Carinii Pneumonia in AIDS-Reply
Authors: Margaret A. Fischl
Journal: JAMA (1988)

<h3>In Reply.—</h3> We agree with Mr Liu that it would have been preferable to include a placebo. However, all patients were carefully evaluated prior to study entry and at follow-up, and all eligible patients were randomly assigned to treatment vs no treatment. We therefore doubt that the results of the study would have been significantly different. Consecutive patients with "newly" diagnosed Kaposi's sarcoma seen at the medical center during the course of the study were evaluated, and only patients with newly diagnosed Kaposi's sarcoma who had no prior opportunistic infection or active opportunistic infection were eligible for the study. All eligible patients agreed to participate in the study. Every effort was therefore made to limit any potential sampling or observation bias. All patients were evaluated rigorously for the presence of opportunistic infection. All patients with any respiratory symptoms, regardless of treatment group, were evaluated as outlined in the "Methods" section
Turkish government is considering raising limits of reimbursement for private hospitals
Authors: M. Hotopf
Journal: BMJ (2009)

Private hospitals in Turkey may soon be allowed to increase the rates that they charge the health department for treating publicly insured patients because they are facing severe financial problems. 

All Turks can use state national health insurance to pay for part of the cost of treatment in the private sector with a Ministry of Health tariff paying set amounts for defined procedures. But in July 2008 the Ministry of Health introduced regulations that limited the private sector to charging individuals no more than an extra 30% above this level. The Ministry of Health is now considering raising that ceiling to 70%. 

The private hospital sector in Turkey is labouring under $3bn (£2.1bn; €2.1bn) of debt …
Methacholine Challenge-Reply
Authors: James R. Myers
Journal: JAMA (1982)

<h3>In Reply.—</h3> As Dr Polk points out, methacholine challenge has been used as a research tool for many years. However, its use in the clinical laboratory has lagged. We would agree with Dr Polk that methacholine challenge is not indicated in the obstructed patient who responds to an inhaled bronchodilator such as isoproterenol or epinephrine. In the patient with normal baseline pulmonary function, bronchodilator administration does not distinguish between asthmatics and normal subjects.<sup>1</sup>In this group of patients with unexplained respiratory symptoms, we recommend a methacholine challenge. In more than 600 studies in our laboratory we have had no bronchoconstriction requiring anything more than simple inhalation of isoproterenol. We have found the methacholine challenge to be a safe, simple, and invaluable aid in the diagnosis of obscure asthma.
Multiple Organ Failure Syndrome in the 1990s
Authors: Alan L. Beal
Journal: JAMA (1994)

OBJECTIVE--This review of the systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) provides an overview of a common but complex problem found in critically ill patients. It emphasizes definitions, common clinical patterns, metabolic responses, and pathophysiological changes. A brief discussion of treatment concepts is also included. DATA SOURCES--Data for this review were gathered from peer-reviewed journals, review articles by experts in SIRS/MODS, and selections from reference volumes written on SIRS/MODS. STUDY SELECTION--Reference selections were chosen on the basis of quality of research. Peer-reviewed journals were given primary consideration. Those review articles cited were felt to be essential to any discussion of SIRS/MODS. DATA EXTRACTION--Where possible, randomized, controlled, prospective studies were reviewed and conclusions used in this overview of SIRS/MODS. CONCLUSION--Our ability to care for critically ill patients has led to a new problem, SIRS and eventually MODS, which may become progressive organ failure and death. Unfortunately, these conditions are extremely frequent and carry high mortality rates. Increased oxygen consumption demands highlight the physiological response. The typical metabolic responses are characterized by hyperglycemia and accelerated protein catabolism. Unrecognized perfusion deficits, an uncontrolled septic focus, a persistent source of inflammation, or injured tissue is commonly present with SIRS/MODS and should be corrected. Restoration of oxygen transport and metabolic support are also important components of treatment. The cause of SIRS/MODS is complex and not fully understood, but multiple mediators and stimulated macrophages likely are important components and areas where treatment may well be focused.
Effect of oxprenolol on heart rate.
Authors: A Hedges, P Turner
Journal: BMJ (1973)

Effect of Oxprenolol on Heart Rate SIR,-Dr.U. Thadani and others (20 January, p. 138) found that the resting heart rate was higher after intravenous than after oral administration of oxprenolol.We recently gave oxprenolol intravenously (0.1 and 0-2 mg/kg body weight) and orally (40 and 80 mg) to six normal volunteers under double-blind conditions in an investi- gation to determine whether it influenced central nervous activity at these doses.No significant changes were found in critical flicker frequency, hand-eye co-ordination, or serial subtraction, nor did the resting heart rate after intravenous oxprenolol differ from that after a placebo.After oral oxprenolol, however, there was a significant, doserelated reduction in resting heart rate (P < 0-05), most marked at four hours.A possible explanation of these observations could be the formation of a metabolite after oral administration which has a potent /-receptor blocking action without the intrinsic activity possessed by the parent compound.-Weare, etc.,
Localization of a gene for expression of mouse mammary tumor virus antigens in the GR/Mtv-2- mouse strain.
Authors: R Nusse, J de Moes, J Hilkens, R van Nie
Journal: The Journal of Experimental Medicine (1980)

The GR/Mtv-2- mouse strain is congenic to the GR strain but lacks the Mtv-2 gene for high amounts of mouse mammary tumor virus (MMTV) virion particles in the milk and early mammary tumors. With a sensitive competition radioimmunoassay for individual viral proteins of MMTV, substantial amounts of the gag proteins p27 and p10 could still be detected in extracts of the mammary glands of GR/Mtv-2- mice, but essentially no viral envelope antigens. The genetic transmission of the MMTV gag expression in the GR/Mtv-2- strain was investigated. In a cross with the virus-negative BALB/c strain, the MMTV p27 expression behaved as a dominant feature. Double backcross analysis proved that the p27 expression was governed by a single gene located on chromosome 11, cloe to the Es-3 locus. The gene was thereby not allelic to any of the previously described MMTV induction genes, Mtv-1 and Mtv-2, and is therefore called Mtv-3. It is concluded that the total MMTV expression in the GR strain is under control of two separate loci, Mtv-2 on chromosome 18, inducing high levels of complete virus particles and also early mammary tumors; and Mtv-3 on chromosome 11, coding for partial MMTV expression.
Resolution of ST-segment elevation 90 minutes after thrombolysis for acute myocardial infarction predicts outcome: a GUSTO-III substudy
Authors: R.D. Anderson, H.D. White, E.M. Ohman, G.S. Wagner, M.W. Krucoff, P.W. Armstrong, H.P. Iparraguirre, W.W. Weaver, W.B. Gibler, R.M. Califf
Journal: Journal of the American College of Cardiology (1998)
Specific Subtypes of Cutaneous Mechanoreceptors Require Neurotrophin-3 Following Peripheral Target Innervation
Authors: Matti S Airaksinen, Martin Koltzenburg, Gary R Lewin, Yasuo Masu, Christian Helbig, Eckhard Wolf, Gottfried Brem, Klaus V Toyka, Hans Thoenen, Michael Meyer
Journal: Neuron (1996)
Use of Oral Contraceptives by Women With Epilepsy
Authors: Kenneth W. Elkington
Journal: JAMA (1986)

<h3>To the Editor.—</h3> After reading the excellent article by Mattson et al<sup>1</sup>on oral contraception use in epileptic women, I would like to raise the following points. The authors discuss valproic acid (Depakene) from the standpoint of decreased incidence of breakthrough bleeding, but fail to mention studies linking its use in pregnancy to a 2% risk of neural tube defects. This level of risk has prompted the Centers for Disease Control to establish a regist registry for women receiving valproate during pregnancy.<sup>2</sup>It would seem reasonable that this particular anticonvulsant be avoided and used only as a last resort. While the authors acknowledge the tenuous link between breakthrough bleeding and oral contraceptive efficacy, the relatively high rate of breakthrough bleeding in the patient population discussed makes it a real concern for both clinician and patient. The recommendation to switch from a 30or 40-μg preparation to "50 μg of
The placebo effect Wrong patients receive treatment
Authors: M Dixon, J Chalmers, J R Price, D B Double
Journal: BMJ (1994)

<h3>Abstract</h3> Recent advances in gene therapy have brought novel treatment options to multiple fields of medicine, including cancer. However, safety concerns and limited payload capacity in commonly-utilized viral vectors prevent researchers from unlocking the full potential of gene therapy. Virus-free DNA transposons, including <i>piggyBac</i>, have been shown to obviate these shortcomings. We have previously demonstrated the superior transposition efficiency of a modified <i>piggyBac</i> system in HEK293 cells. Here, we further advanced and broadened the therapeutic application of this modified <i>piggyBac</i> system. We demonstrated that the internal domain sequence (IDS) within the 3’ terminal repeat domain of hyperactive <i>piggyBac</i> (<i>hyPB</i>) donor vector contain dominant enhancer elements. We showed that a plasmid-free donor vector having IDS-free terminal inverted repeats in conjunction with a helper plasmid expressing <i>Quantum pBase</i>™ v2 form the most optimal <i>piggyBac</i> system, <i>Quantum pBac</i>™ (<i>qPB</i>), in T cells. We further demonstrated that T cells transfected with <i>qPB</i> expressing CD20/CD19 CAR outperformed cells transfected with the same donor vector but with plasmid expressing <i>hyPB</i> transposase in CAR-T cell production. Importantly, we showed that <i>qPB</i> produced mainly CD8<sup>+</sup> CAR-T cells that are also highly represented by T<sub>SCM</sub>. These CAR-T cells effectively eliminated CD20/CD19-expressing tumor cells <i>in vitro</i> and in Raji-bearing immunodeficient mice. Our findings confirm that <i>qPB</i> is a promising virus-free vector system that is safer, and highly efficient in mediating transgene integration with the payload capacity to incorporate multiple genes. <h3>Significance Statement</h3> An effective, high capacity and safe gene integration vector system is critical to the success of gene therapy. We have previously modified a virus-free <i>piggyBac</i> transposon vector system and demonstrated its potential application in gene therapy. Here we further demonstrate that shortening of the <i>piggyBac</i> donor vector terminal repeat domain and backbone, coupled with <i>Quantum pBase</i>™ (<i>qPBase</i>) <i>v2</i>, result in the most optimal <i>Quantum pBac</i>™ (<i>qPB</i>) <i>piggyBac</i> system in human T cells. <i>qPBase v2</i> outperformed hyperactive <i>piggyBac</i> transposase in chimeric antigen receptor T (CAR-T) production. <i>qPB</i> produced CAR-T cells that are mainly CD8<sup>+</sup>, highly represented by T<sub>SCM</sub>, and effectively eliminated tumors <i>in vivo</i>. Our findings solidify <i>qPB</i> as a promising virus-free vector system for therapeutic application.
AN OPERATIVE METHOD FOR THE REDUCTION OF HYPERTROPHY OF THE INFERIOR TURBINATEOTHER THAN BY CAUTERIZATION OR EXSECTION.
Authors: D. A. KUYK
Journal: JAMA (1907)

If the methods of treatment now in vogue for the reduction of hypertrophy or hyperplasia of the inferior turbinate were wholly free from objectionable features it were then, indeed, superfluous to write aught concerning it. As it is there are so many, and so serious, objections to each method now commonly employed that it may not be misconstrued if an effort be made to advance some suggestion for its relief other than those generally accepted. Any treatment which primarily gives temporary relief, but whose secondary effects are hurtful, worse, indeed, than the original disease which it is sought to relieve, must be relegated to the rear as soon as another method is brought forward whose primary effect is fully that desired, permanent in nature and followed by no secondary effect whatever except that which is beneficial. If it can be proven that such result is attainable without any extraordinary instrumentation,
Cross-Sectional Associations Bet ween Abdominal and Thoracic Adipose Tissue Compartments and Adiponectin and Resistin in the Framingham Heart Study
Authors: Shilpa H. Jain, Joseph M. Massaro, Udo Hoffmann, Guido A. Rosito, Ramachandran S. Vasan, Annaswamy Raji, Christopher J. O'Donnell, James B. Meigs, Caroline S. Fox
Journal: Diabetes Care (2009)

To test the association of regional fat depots with circulating adiponectin and resistin concentrations and to assess the potential mediating effect of adipokines on associations between abdominal fat depots and cardiometabolic risk factors.Participants from the Framingham Heart Study offspring cohort (n = 916, 55% women; mean age 59 years) free of cardiovascular disease underwent computed tomography measurement of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), pericardial fat, and intrathoracic fat volumes and assays of circulating adiponectin and resistin.VAT, SAT, pericardial fat, and intrathoracic fat were negatively correlated with adiponectin (r = -0.19 to -0.34, P < 0.001 [women]; r = -0.15 to -0.26, P < 0.01 [men] except SAT) and positively correlated with resistin (r = 0.16-0.21, P < 0.001 [women]; r = 0.11-0.14, P < 0.05 [men] except VAT). VAT increased the multivariable model R(2) for adiponectin from 2-4% to 10-13% and for resistin from 3-4% to 3-6%. Adjustment for adipokines did not fully attenuate associations between VAT, SAT, and cardiometabolic risk factors.Adiponectin and resistin are correlated with fat depots cross-sectionally, but none of the adipokines can serve as surrogates for the fat depots. Relations between VAT, SAT, and cardiometabolic risk factors were not fully explained by adiponectin or resistin concentrations.
The mucosal immune system in the oral cavity—an orchestra of T cell diversity
Authors: Rui-Qing Wu, Dun-Fang Zhang, Eric Tu, Qian-Ming Chen, WanJun Chen
Journal: International Journal of Oral Science (2014)

The mucosal immune system defends against a vast array of pathogens, yet it exhibits limited responses to commensal microorganisms under healthy conditions. The oral-pharyngeal cavity, the gateway for both the gastrointestinal and respiratory tracts, is composed of complex anatomical structures and is constantly challenged by antigens from air and food. The mucosal immune system of the oral-pharyngeal cavity must prevent pathogen entry while maintaining immune homeostasis, which is achieved via a range of mechanisms that are similar or different to those utilized by the gastrointestinal immune system. In this review, we summarize the features of the mucosal immune system, focusing on T cell subsets and their functions. We also discuss our current understanding of the oral-pharyngeal mucosal immune system. The diverse immune responses provided by T cells in the lining of the oral cavity have been reviewed by US and Chinese researchers. The oral-pharyngeal cavity is the gateway to the gastrointestinal (GI) and respiratory tracts, and is exposed to microbes, food particles and other substances. The oral mucosal layers contain many different types of T cells that protect against infection but detailed knowledge of their function is limited. WanJun Chen, Qian-Ming Chen and co-workers at the National Institutes of Health in Maryland, and Sichuan University in Chengdu, base their review on the more established knowledge of the GI mucosal system. They find that the oral cavity lining has many similar functions to the lining of the GI but produces some unique signalling proteins. The authors highlight the need for more research into this important immune barrier.
1α,25(OH)2 vitamin D3 increases intracellular calcium in human keratinocytes
Authors: B. BITTINER, S. S. BLEEHEN, SHEILA MACNEIL
Journal: British Journal of Dermatology (1991)

Vitamin D3 metabolites have been found to improve psoriasis but their mechanism of action is not clear. Keratinocyte proliferation and differentiation are known to be dependent on calcium concentrations in vitro. The aim of this study was to examine whether 1 alpha,25(OH)2 vitamin D3 had any direct effect on intracellular free calcium concentrations in cultured keratinocytes. A response to 1 alpha,25(OH)2 vitamin D3 was seen in 88% of monolayers of normal human keratinocytes attached to glass coverslips. An increase in intracellular free calcium was seen in 80% of the reactive cultures, with over half the responses occurring within 30 s of exposure to 1 alpha,25(OH)2 vitamin D3 and the remainder occurring within minutes. Responses could be seen at physiological concentrations of 1 alpha,25(OH)2 vitamin D3 and were not blocked by the protein synthesis inhibitor cycloheximide. The response to 1 alpha,25(OH)2 vitamin D3 took the form of rapid transient increases in intracellular free calcium in 29 out of 59 coverslips. The basal intracellular free calcium was calculated to be 245 +/- 47 nM rising to a maximum of 834 +/- 267 nM (mean +/- SEM; n = 20) following exposure to 1 alpha,25(OH)2 vitamin D3. We conclude that 1 alpha,25(OH)2 vitamin D3 acts directly on keratinocytes to increase intracellular free calcium and that this may be relevant to its mechanism of action in psoriasis.
Gerontology unit focuses on mobility, not restraint
Authors: Phil Gunby
Journal: JAMA (1983)

To most people, five interlocked rings symbolize the Olympic games. To Ronald D. T. Cape, MD, they represent a "geriatric quintet" of problems that commonly are found in elderly patients: mental confusion, injurious falls, homeostatic impairment, incontinence, and iatrogenic disorders. In an attempt to deal with these problems, Cape has established a unique gerontology unit at Parkwood Hospital, London, Ontario, where he is chief of geriatric medicine. The hospital is affiliated with the University of Western Ontario. With Cape's arrival from Britain in 1975, the university became the first Canadian medical school to appoint a full-time coordinator of geriatric medicine. Approximately 10% of Canadians are older than 65 years, as are more than 11% of Americans. The latter figure is expected to reach 12% in 1985.) Among iatrogenic problems that the new Parkwood unit will seek to avoid, Cape says, are overuse of restraints and lack of encouragement for patients
The Mitochondrial Targeting Chaperone 14-3-3ε Regulates a RIG-I Translocon that Mediates Membrane Association and Innate Antiviral Immunity
Authors: Helene Minyi Liu, Yueh-Ming Loo, Stacy M. Horner, Gregory A. Zornetzer, Michael G. Katze, Michael Gale
Journal: Cell Host & Microbe (2012)