tbuckley/cabot-search huggingface dataset:
Rapid versus standard intravenous rehydration in paediatric gastroenteritis: pragmatic blinded randomised clinical trial
Authors: S. B. Freedman, P. C. Parkin, A. R. Willan, S. Schuh
Journal: BMJ (2011)

<b>Objective</b> To determine if rapid rather than standard intravenous rehydration results in improved hydration and clinical outcomes when administered to children with gastroenteritis. <b>Design</b> Single centre, two arm, parallel randomised pragmatic controlled trial. Blocked randomisation stratified by site. Participants, caregivers, outcome assessors, investigators, and statisticians were blinded to the treatment assignment. <b>Setting</b> Paediatric emergency department in a tertiary care centre in Toronto, Canada. <b>Participants</b> 226 children aged 3 months to 11 years; complete follow-up was obtained on 223 (99%). Eligible children were aged over 90 days, had a diagnosis of dehydration secondary to gastroenteritis, had not responded to oral rehydration, and had been prescribed intravenous rehydration. Children were excluded if they weighed less than 5 kg or more than 33 kg, required fluid restriction, had a suspected surgical condition, or had an insurmountable language barrier. Children were also excluded if they had a history of a chronic systemic disease, abdominal surgery, bilious or bloody vomit, hypotension, or hypoglycaemia or hyperglycaemia. <b>Interventions</b> Rapid (60 mL/kg) or standard (20 mL/kg) rehydration with 0.9% saline over an hour; subsequent fluids administered according to protocol. <b>Main outcome measures</b> Primary outcome: clinical rehydration, assessed with a validated scale, two hours after the start of treatment. Secondary outcomes: prolonged treatment, mean clinical dehydration scores over the four hour study period, time to discharge, repeat visits to emergency department, adequate oral intake, and physician's comfort with discharge. Data from all randomised patients were included in an intention to treat analysis. <b>Results</b> 114 patients were randomised to rapid rehydration and 112 to standard. One child was withdrawn because of severe hyponatraemia at baseline. There was no evidence of a difference between the rapid and standard rehydration groups in the proportions of participants who were rehydrated at two hours (41/114 (36%) <i>v</i> 33/112 (30%); difference 6.5% (95% confidence interval −5.7% to 18.7%; P=0.32). The results did not change after adjustment for weight, baseline dehydration score, and baseline pH (odds ratio 1.8, 0.90 to 3.5; P=0.10). The rates of prolonged treatment were similar (52% rapid <i>v</i> 43% standard; difference 8.9%, 21% to −5%; P=0.19). Although dehydration scores were similar throughout the study period (P=0.96), the median time to discharge was longer in the rapid group (6.3 <i>v</i> 5.0 hours; P=0.03). <b>Conclusions</b> There are no relevant clinical benefits from the administration of rapid rather than standard intravenous rehydration to haemodynamically stable children deemed to require intravenous rehydration. <b>Trail registration</b> Clinical Trials NCT00392145.
Bayesian analysis of data from radionuclide angiocardiograms for diagnosis of coronary artery disease.
Authors: T D Christopher, G Konstantinow, R H Jones
Journal: Circulation (1984)

A continuous Bayesian model was developed by fitting a beta-function to the frequency distributions of resting ejection fraction, exercise ejection fraction, and change in end-systolic volume during exercise measured by radionuclide angiocardiography in a group of 249 men with coronary artery disease (CAD) and in a group of 56 men without disease. This model, then prospectively applied to 250 men with chest pain, did not increase the overall accuracy of the test but did increase the diagnostic content for individual patients. The diagnostic efficacy of the continuous Bayesian model was compared with previously determined optimal discrete criteria of a positive or negative test. Patients with CAD showed a maximum and mean increase in probability of disease of +0.58 and +0.11, respectively, by the continuous Bayesian model and +0.14 and +0.05, respectively, by discrete criteria. Men without significant disease showed a maximum and mean decrease in probability of disease of -0.73 and -0.38, respectively, by Bayesian analysis and -0.36 and -0.27, respectively, by optimal discrete criteria. Moreover, all 29 patients who died during a 35 month interval after study had a probability of CAD of 0.95 or greater by the continuous Bayesian model. These findings indicate that Bayesian analysis of radionuclide angiocardiographic test results with continuous distributions of left ventricular function measurement enhances the diagnostic and prognostic information for individual patients with symptoms suggestive of CAD.
Illogical warnings on Ventolin inhalers.
Authors: G K Crompton
Journal: BMJ (1984)

and neck provided by the full face helmet has been described in Australia and the USA.3 4 5 Initial speculation that the full face helmet might increase accidents by reducing visibility was incorrect.Motorcyclists sustain 20 times the number of deaths and 23 times the number of injuries per kilometre travelled compared with motorists.In Great Britain in 1982 there were 70 000 motorcycle accidents, and 27 000 motorcyclists were killed or seriously injured.6Head and neck injuries remain the commonest cause of death.1 7Control of this modern epidemic is essential.,8The first aim must be prevention of the accident, the second prevention of injury.9Helmet detachment is important, but helmet type is critical.Few can now question the superiority of the full face helmet and its use must be encouraged, if necessary by legislation.
A Quantitative Clinical Index for the Diagnosis of Symptomatic Coronary-Artery Disease
Authors: Peter F. Cohn, Richard Gorlin, Pantel S. Vokonas, Richard A. Williams, Michael V. Herman, Sonja Hemmer
Journal: New England Journal of Medicine (1972)

To evaluate the diagnostic potential of various readily available clinical procedures, 100 selected patients suspected of having coronary-artery disease were studied by both coronary cinearteriography and a selected pattern of standard tests and observations. Sixty-two patients had angiographic evidence of obstructive coronary atherosclerosis; 38 did not. Although individual clinical abnormalities were often unreliable indicators of coronary-artery disease, their diagnostic accuracy increased markedly when they were used in combination with one another to form a clinical index. This index, determined through multiple discriminant analysis, accurately diagnosed 94 of the 100 cases. The index was then applied to a prospective series of 100 similarly selected patients. Ninety-two were correctly diagnosed. In both the original study group and the prospective series, index values less than 100 were rarely associated with coronary atherosclerosis. Conversely, patients with indexes above 100 almost always had obstructive coronary-artery disease.
Adrenergic fibres in the human intestine.
Authors: L Capurso, C A Friedmann, A G Parks
Journal: Gut (1968)

Similar to dopamine (DA), cannabinoids strongly influence prefrontal cortical functions, such as working memory, emotional learning, and sensory perception. Although endogenous cannabinoid receptors (CB<sub>1</sub>Rs) are abundantly expressed in the prefrontal cortex (PFC), very little is known about endocannabinoid (eCB) signaling in this brain region. Recent behavioral and electrophysiological evidence has suggested a functional interplay between the dopamine and cannabinoid receptor systems, although the cellular mechanisms underlying this interaction remain to be elucidated. We examined this issue by combining neuroanatomical and electrophysiological techniques in PFC of rats and mice (both genders). Using immunoelectron microscopy, we show that CB<sub>1</sub>Rs and dopamine type 2 receptors (D<sub>2</sub>Rs) colocalize at terminals of symmetrical, presumably GABAergic, synapses in the PFC. Indeed, activation of either receptor can suppress GABA release onto layer 5 pyramidal cells. Furthermore, coactivation of both receptors via repetitive afferent stimulation triggers eCB-mediated long-term depression of inhibitory transmission (I-LTD). This I-LTD is heterosynaptic in nature, requiring glutamate release to activate group I metabotropic glutamate receptors. D<sub>2</sub>Rs most likely facilitate eCB signaling at the presynaptic site as disrupting postsynaptic D<sub>2</sub>R signaling does not diminish I-LTD. Facilitation of eCB–LTD may be one mechanism by which DA modulates neuronal activity in the PFC and regulates PFC-mediated behavior <i>in vivo</i>.
Policies to tackle social exclusion
Authors: G. Watt
Journal: BMJ (2001)

Papers pp 187-209 Primary care pp 210-7 

In the past 20 years the United Kingdom has become a more unequal society in which many people have prospered while many others have not. 1 2 This issue includes several examples of the adverse health and social effects for groups that have been excluded from general prosperity (and some attempts to ameliorate these effects). But the consequences of social exclusion provide too narrow a focus. Society as whole is also affected and needs to be engaged in supporting solutions to the problem.

Differences in life expectancy between socioeconomic groups have widened, mainly as a result of faster rates of improvement in affluent groups. 1 3 Socially patterned premature mortality is the most stark form of social exclusion, but it occurs late in the process, usually after several decades of living in adversity. 4 5 It is not known to what extent this pattern is being repeated in later generations, whose early life circumstances have been generally more favourable. Nevertheless, the proportion of children born and brought up in households with less than half of average income tripled during the 1980s, catapulting the UK to the highest rates of any country in the European Union. 6 7 This generation is now reaching …
Vasodilator signals from the ischemic myocardium are transduced to the coronary vascular wall by pertussis toxin-sensitive g proteins
Authors: Kouichi Sato, Tatsuya Komaru, Hiroki Shioiri, Satoru Takeda, Katsuaki Takahashi, Hiroshi Kanatsuka, Kunio Shirato
Journal: Journal of the American College of Cardiology (2002)
Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial
Authors: M. Knapp, D. King, R. Romeo, B. Schehl, J. Barber, M. Griffin, P. Rapaport, D. Livingston, C. Mummery, Z. Walker, J. Hoe, E. L. Sampson, C. Cooper, G. Livingston
Journal: BMJ (2013)

<b>Objective</b> To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone. <b>Design</b> Cost effectiveness analysis nested within a pragmatic randomised controlled trial. <b>Setting</b> Three mental health and one neurological outpatient dementia service in London and Essex, UK. <b>Participants</b> Family carers of people with dementia. <b>Intervention</b> Eight session, manual based, coping intervention delivered by supervised psychology graduates to family carers of people with dementia added to usual treatment, compared with usual treatment alone. <b>Primary outcome measures</b> Costs measured from a health and social care perspective were analysed alongside the Hospital Anxiety and Depression Scale total score (HADS-T) of affective symptoms and quality adjusted life years (QALYs) in cost effectiveness analyses over eight months from baseline. <b>Results</b> Of the 260 participants recruited to the study, 173 were randomised to the START intervention, and 87 to usual treatment alone. Mean HADS-T scores were lower in the intervention group than the usual treatment group over the 8 month evaluation period (mean difference −1.79 (95% CI −3.32 to −0.33)), indicating better outcomes associated with the START intervention. There was a small improvement in health related quality of life as measured by QALYs (0.03 (−0.01 to 0.08)). Costs were no different between the intervention and usual treatment groups (£252 (−28 to 565) higher for START group). The cost effectiveness calculations suggested that START had a greater than 99% chance of being cost effective compared with usual treatment alone at a willingness to pay threshold of £30&nbsp;000 per QALY gained, and a high probability of cost effectiveness on the HADS-T measure. <b>Conclusions</b> The manual based coping intervention START, when added to treatment as usual, was cost effective compared with treatment as usual alone by reference to both outcome measures (affective symptoms for family carers, and carer based QALYs). <b>Trial Registration</b> ISCTRN 70017938
Two Cases of Maxillary Cancer with a Similar Clinical Course and Imaging Findings but Markedly Different Levels of FDG Uptake
Authors: Joji Kawabe, Shigeaki Higashiyama, Kenji Torii, Hiroko Kurooka, Takehiro Hayashi, Ai Oe, Jin Kotani, Etsushi Kawamura, Hideki Wanibuchi, Hirokazu Sakamoto, Susumu Shiomi
Journal: Clinical Nuclear Medicine (2005)

We report two cases of poorly differentiated squamous cell carcinoma of the left maxillary sinus. Both patients had a similar clinical course and similar imaging findings. However, FDG uptake by the 2 lesions was very different. The SUVs of the tumor lesions of patient 1 and 2 were 20.67 and 7.56, respectively. Histopathologically, hematoxylin and eosin (H&E) stained sections (×200) were packed with tumor cells, with many more inflammatory cells seen in patient 1. When dealing with cases of carcinoma of the head neck region where tumors are often accompanied by inflammation, we should bear in mind that FDG uptake by tumors is strongly influenced by the activity and timing of inflammation within the tumor lesions.
Hyperbaric Removal of Intestinal Tube Balloon
Authors: JOHN J. ROZANSKI
Journal: Annals of Internal Medicine (1977)

Comments and Correction1 February 1977Hyperbaric Removal of Intestinal Tube BalloonJOHN J. ROZANSKI, M.D., ALAN SAMAREL, M.D., ALLEN KAUFMAN, M.D., ARTHUR VOGELMAN, M.D.JOHN J. ROZANSKI, M.D.Search for more papers by this author, ALAN SAMAREL, M.D.Search for more papers by this author, ALLEN KAUFMAN, M.D.Search for more papers by this author, ARTHUR VOGELMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-2-245_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report by Coffey, Gordon, and Mayes, "Gaseous Distention of an Intestinal Tube Bag Relieved by Transabdominal Puncture," in the October issue (Ann Intern Med 85:480-481, 1976) prompts this report of what might well be the treatment of choice for removal of a distended long-intestinal tube balloon, namely, by oral removal in a hyperbaric chamber.A 19-year-old boy with recurrent partial small bowel obstruction due to regional enteritis of the terminal ileum underwent a prolonged 2-week period of long tube intubation. During this intubation, the balloon of a Kaslow tube became distended with gas despite proper preparation...References1. FRICKENIEWODOWSKI FM: Hazardous gaseous distention of intestinal balloons. JAMA 235:2611-2613, 1976 CrossrefMedlineGoogle Scholar2. FRICKE F: A complication of prolonged intestinal intubation. Am J Dig Dis 21:833-834, 1976 CrossrefMedlineGoogle Scholar3. ROZANSKIKLEINFELD JM: A complication of prolonged intestinal intubation. Am J Dig Dis 21:834, 1976 Google Scholar4. ROZANSKIKLEINFELD JM: A complication of prolonged intestinal intubation: gaseous distention of the terminal balloon. Am J Dig Dis 20:1067-1070, 1975 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Medical Service Mount Sinai Hospital New York, NY 10029 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHyperbaric therapy for the removal of an obstructing intestinal tube balloon 1 February 1977Volume 86, Issue 2Page: 245-246KeywordsEnteritisIleumIntubation Issue Published: 1 February 1977 PDF DownloadLoading ...
Mesothelin
Authors: Raffit Hassan, Tapan Bera, Ira Pastan
Journal: Clinical Cancer Research (2004)

Abstract Mesothelin is a differentiation antigen present on normal mesothelial cells and overexpressed in several human tumors, including mesothelioma and ovarian and pancreatic adenocarcinoma. The mesothelin gene encodes a precursor protein that is processed to yield the 40-kDa protein, mesothelin, attached to the cell membrane by a glycosylphosphatidyl inositol linkage and a 31-kDa shed fragment named megakaryocyte-potentiating factor. The biological function of mesothelin is not known. Mesothelin is a promising candidate for tumor-specific therapy, given its limited expression in normal tissues and high expression in several cancers. SS1(dsFv)PE38 is a recombinant anti-mesothelin immunotoxin that is undergoing clinical evaluation in patients with mesothelin-expressing tumors. There is evidence that mesothelin is an immunogenic protein and could be exploited as a therapeutic cancer vaccine. A soluble mesothelin variant has been identified and could be a useful tumor marker for malignant mesotheliomas.
In-hospital mortality rates from acute myocardial infarction by race in U.S. hospitals: findings from the National Hospital Discharge Survey.
Authors: E Roig, A Castaner, B Simmons, R Patel, E Ford, R Cooper
Journal: Circulation (1987)

Mortality rates in the United States from coronary artery disease are higher among blacks than whites at younger ages, with a crossover to lower rates above the age of 70. The factors that determine this crossover of age-specific death rates have not been elucidated. Selection from the black population of younger individuals who are sicker by virtue of being more coronary prone might leave a relatively healthier group of older persons. Support for this hypothesis would consist in part of evidence that coronary artery disease has an earlier onset in the black population. We examined data from the National Hospital Discharge Survey for the years 1973-1984 to determine if age-related differences in case-fatality rates existed between whites and nonwhites. In-hospital case fatality rates were 10% to 70% higher for each of the 10 year age groups for nonwhites up to age 70, at which time a crossover occurred. The median age at death from myocardial infarction was approximately 5 years younger in nonwhites compared with whites. National estimates of hospitalization rates for myocardial infarction from these data likewise suggest that nonwhites receive less health care for coronary artery disease than whites relative to recorded fatal events. The age-specific trends in case-fatality support the hypothesis that a cohort selection effect in part determines the black/white differentials in coronary artery disease. Relative susceptibility of the black and white population is thus not appropriately estimated by age-adjusted rates, but should be examined on an age-specific basis within the framework of selection effects on a cohort.
Time to Publication Among Completed Clinical Trials
Authors: Joseph S. Ross, Marian Mocanu, Julianna F. Lampropulos, Tony Tse, Harlan M. Krumholz
Journal: JAMA Internal Medicine (2013)

2][3][4] However, among those published, we know little about the length of time required for publication in the peer-reviewed biomedical literature after study completion.Ioannidis previously demonstrated that a sample of randomized phase 2 and 3 trials conducted between 1986 and 1996 required nearly 2.5 years for publication, 5 while our more recent study of National Institutes of Health (NIH)-funded trials found that average time to publication was almost two years. 4We sought to determine time to publication for a recent and representative sample of trials published in 2009. METHODSWe examined clinical trials published during the 2009 calendar year that were indexed via MEDLINE and linked to a ClinicalTrials.govidentifier (NCT Number). 6We excluded articles that were not the first publication reporting on the clinical trial by reviewing article text for citations to and searching MEDLINE for earlier trial publications.We imputed completion dates based on the subject enrollment dates and the longest period of follow-up required for any outcome measure reported in the article.For trials without enrollment dates, we used the completion date provided on ClinicalTrials.
109 Meld underestimated unless enzymatic creatinine used
Authors: N.H. Bzowej, V.R. Huilgol, H. Sebanc, M. Bonacini, J. Rabkin, E. Doo, G. Hisitake, A. Hassoun, A.S. Wakil, R. Osorio, R.G. Gish
Journal: Journal of Hepatology (2004)
Pickled Herring and Tranylcypromine Reaction
Authors: William F. Nuessle
Journal: JAMA (1965)

<h3>To the Editor:—</h3> The Council on Drugs has issued a warning concerning hypertensive reactions from the monoamine oxidase inhibitor tranylcypromine (Parnate) sulfate, especially after ingestion of cheese (<i>JAMA</i><b>186</b>:854 [Nov 30] 1963). The pressor-like substance, tyramine hydrochloride, has been incriminated. There is failure of usual tyramine degradation by monoamine oxidase due to inhibition of this enzyme system by the drug. Large amounts of tyramine have been found in cheese and wine (<i>JAMA</i><b>188</b>:1108-1110 [June 29] 1964) which include products of bacterial action and fermentation. We have recently observed an acute hypertensive episode in a man taking tranylcypromine which followed ingestion of pickled herring. The patient was a 54-year-old businessman who was seen on Nov 14, 1964, with anxiety state and depression. There had been periodic care for chronic anxiety state for which various medications were used with indefinite results. The only recent medicament was methyprylon (Noludar) or glutethimide
Pneumonia in intubated patients: role of respiratory airway care.
Authors: J Rello, R Soñora, P Jubert, A Artigas, M Rué, J Vallés
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

In order to assess potential risk factors for pneumonia within the first 8 d of ventilation, we studied 83 consecutive intubated patients undergoing continuous aspiration of subglottic secretions (CASS). Multivariate analysis showed the protective effect of antibiotic use (relative risk [RR] = 0.10; 95% confidence interval [CI] = 0.01 to 0.71), whereas failure of the CASS technique (RR = 5.29; 95% CI = 1.24 to 22.64) was associated with a greater risk of pneumonia. In addition, there was a trend toward a higher risk of pneumonia (RR = 2.57; 95% CI = 0.78 to 8.03) among patients with persistent intracuff pressures below 20 cm H2O. The remaining factors analyzed were not significant. Failure of CASS did not influence the development of pneumonia among patients undergoing antibiotic treatment (33.0% versus 38.5%, p > 0.20), but was strongly associated with pneumonia (42.1% versus 8.3%, p < 0.01) among intubated patients not receiving antibiotics. When multivariate analysis was repeated in this subpopulation, failure of CASS (RR = 7.52, 95% CI = 1.48 to 38.07) and persistent intracuff pressure below 20 cm H2O (RR = 4.23, 95% CI = 1.12 to 15.92) were factors independently associated with the development of pneumonia. We conclude that leakage of colonized subglottic secretions around the cuff of the endotracheal tube is the most important risk factor for pneumonia within the first 8 d of intubation. This study confirms the importance of maintaining adequate intracuff pressure and effective aspiration of subglottic secretions in preventing pneumonia in intubated patients not receiving antibiotic treatment.
Efficacy of montelukast during allergy season in patients with chronic asthma and seasonal aeroallergen sensitivity
Authors: W.W. Busse, T.B. Casale, M.S. Dykewicz, E.O. Meltzer, S.R. Bird, C.M. Hustad, R.K. Zeldin
Journal: Journal of Allergy and Clinical Immunology (2005)