tbuckley/cabot-search huggingface dataset:
APACHE: A Nonproprietary Measure of Severity of Illness
Authors: William A. Knaus, Douglas P. Wagner
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 February 1989APACHE: A Nonproprietary Measure of Severity of IllnessWilliam A. Knaus, MD, Douglas P. Wagner, PhDWilliam A. Knaus, MDSearch for more papers by this author, Douglas P. Wagner, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-4-327_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their recent editorial, Couch and Nash (1) encourage physicians to pay some much-needed attention to the measurement of severity of illness. We agree with many of their conclusions but wish to correct the statement that all of the currently available severity measures are proprietary.The method for defining APACHE II (Acute Physiology and Chronic Health Evaluation II) scores has been reported (2, 3) in the clinical literature. The APACHE measure is also the only system for classification of the severity of disease that many independent investigators have used to study the efficacy of different treatment approaches...References1. CouchNash JD. Severity of illness measurement: opportunities for clinicians. Ann Intern Med. 1988;109:771-3. LinkGoogle Scholar2. KnausDraperWagnerZimmerman WEDJ. APACHE II—a severity of disease classification system. Crit Care Med. 1985;13:818-29. CrossrefMedlineGoogle Scholar3. KnausDraperWagnerZimmerman WEDJ. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986;104:410-8. LinkGoogle Scholar4. DellingerWertzMeakins EMJ Surgical infection stratification system for intra-abdominal infection. Arch Surgery. 1985;120:21-9. CrossrefMedlineGoogle Scholar5. DuboisRogersMoxleyDraperBrook RWJDR. Hospital inpatient mortality: is it a predictor of quality? N Engl J Med. 1987;317:1674-80. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHospital Variations in Severe Sepsis MortalityApplication of a Facial Injury Severity Scale in Craniomaxillofacial TraumaNocturnal Care Interactions with Patients in Critical Care UnitsThe Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice PlansComparison of APACHE II, trauma score, and injury severity score as predictors of outcome in critically injured trauma patients 15 February 1989Volume 110, Issue 4Page: 327-328 Issue Published: 15 February 1989 PDF DownloadLoading ...
Psoriatic arthritis clinical registries and genomics
Authors: D D Gladman, C Ritchlin, P S Helliwell
Journal: Annals of the Rheumatic Diseases (2005)

To understand better a complex disease such as psoriatic arthritis (PsA), collection of a large amount of information on clinical, laboratory, and radiological features is required over an extended period of time. Longitudinal data can be effectively collected and stored in clinical registries and databases. This article reviews current databases in PsA and proposes a structure for an international PsA registry. Careful collection and analysis of patient data through collaborative efforts will likely advance our knowledge of pathogenesis and provide new and much needed insights about the course and prognosis of the disease.
Transplantation of allogeneic T cells alters iron homeostasis in NOD/SCID mice
Authors: Steven Bair, Emily Spaulding, Jaakko Parkkinen, Howard M. Shulman, Vladimir Lesnikov, Mary Beauchamp, François Canonne-Hergaux, Kris V. Kowdley, H. Joachim Deeg
Journal: Blood (2008)
Human Malignant Melanoma
Authors: Lawrence M. Solomon
Journal: JAMA (1979)

This book is an excellent statement of our current knowledge of melanoma, not only of the skin but the uveal tract as well. Melanoma is, next to lung cancer, the most proliferating carcinoma to afflict humans, so that this text comes at a propitious moment. It has excellent scope and clarity. The authors and contributors are not equivocal in their opinions. As a result, we are treated to an optimistic and didactic approach to the subject ("Using our present knowledge of primary melanoma and presently available forms of therapy, we should reduce the mortality rate of melanoma to less than 10 percent.") The book starts with an overview of the melanin pigmentary system in man and goes on to discuss the usual lesional clinical progression, pathology, and epidemiology. In this first section, of particular interest is the classification of the different melanomas, including the acral lentiginous variety, the hereditary variant
Hepatic organic anion transporting polypeptide transporter and thyroid hormone receptor interplay determines cholesterol and glucose homeostasis
Authors: Henriette E. Meyer zu Schwabedissen, Joseph A. Ware, David Finkelstein, Amarjit S. Chaudhry, Sara Mansell, Matilde Leon-Ponte, Stephen C. Strom, Hani Zaher, Ute I. Schwarz, David J. Freeman, Erin G. Schuetz, Rommel G. Tirona, Richard B. Kim
Journal: Hepatology (2011)

The role of organic anion transporting polypeptides (OATPs), particularly the members of OATP1B subfamily, in hepatocellular handling of endogenous and exogenous compounds is an important and emerging area of research. Using a mouse model lacking Slco1b2, the murine ortholog of the OATP1B subfamily, we have demonstrated previously that genetic ablation causes reduced hepatic clearance capacity for substrates. In this study, we focused on the physiological function of the hepatic OATP1B transporters. First, we studied the influence of the Oatp1b2 deletion on bile acid (BA) metabolism, showing that lack of the transporter results in a significantly reduced expression of Cyp7a1, the key enzyme of BA synthesis, resulting in elevated cholesterol levels after high dietary fat challenge. Furthermore, Slco1b2-/- mice exhibited delayed clearance after oral glucose challenge resulting from reduced hepatic glucose uptake. In addition to increased hepatic glycogen content, Slco1b2-/- mice exhibited reduced glucose output after pyruvate challenge. This is in accordance with reduced hepatic expression of phosphoenolpyruvate carboxykinase (PEPCK) in knockout mice. We show that this phenotype is due to the loss of liver-specific Oatp1b2-mediated hepatocellular thyroid hormone entry, which then leads to reduced transcriptional activation of target genes of hepatic thyroid hormone receptor (TR), including Cyp7a1 and Pepck but also Dio1 and Glut2. Importantly, we assessed human relevance using a cohort of archived human livers in which OATP1B1 expression was noted to be highly associated with TR target genes, especially for glucose facilitating transporter 2 (GLUT2). Furthermore, GLUT2 expression was significantly decreased in livers harboring a common genetic polymorphism in SLCO1B1.Our findings reveal that OATP1B-mediated hepatic thyroid hormone entry is a key determinant of cholesterol and glucose homeostasis.
Topological Constraints Governing the Use of the Chicken HS4 Chromatin Insulator in Oncoretrovirus Vectors
Authors: Evangelia Yannaki, Julie Tubb, Mari Aker, George Stamatoyannopoulos, David W. Emery
Journal: Molecular Therapy (2002)

The expression of integrated oncoretrovirus vectors is subject to the inhibitory effects of surrounding chromatin. A previous report from our laboratory indicated that such position effects can be overcome by flanking a reporter vector with the cHS4 chromatin insulator. To characterize this activity more thoroughly, we switched the promoter–gene combinations in the reporter vector and analyzed expression of these vectors flanked with the cHS4 fragment in both orientations following bone marrow transduction and transplantation in mice. The results indicate that the cHS4 fragment can function in both orientations and can insulate both the virus long-terminal-repeat (LTR) promoter and an internal phosphoglycerate kinase (Pgk) promoter. However, insulation of the LTR promoter diminished when the orientation of the cHS4 fragment placed the CTCF-binding core element immediately proximal to the U3 region, suggesting a minimal distance requirement. Moreover, placement of the cHS4 fragment in the U3 region of the 3′ LTR dramatically decreased the level of expression from an internal Pgk promoter, presumably by blocking interaction with the 3′ LTR enhancer. Finally, sorting studies suggest that the severity of position effects or autonomous promoter silencing increases as transduced progenitors differentiate into mature progeny. These findings have direct implications for the use of chromatin insulators such as cHS4 in oncoretrovirus vectors. The expression of integrated oncoretrovirus vectors is subject to the inhibitory effects of surrounding chromatin. A previous report from our laboratory indicated that such position effects can be overcome by flanking a reporter vector with the cHS4 chromatin insulator. To characterize this activity more thoroughly, we switched the promoter–gene combinations in the reporter vector and analyzed expression of these vectors flanked with the cHS4 fragment in both orientations following bone marrow transduction and transplantation in mice. The results indicate that the cHS4 fragment can function in both orientations and can insulate both the virus long-terminal-repeat (LTR) promoter and an internal phosphoglycerate kinase (Pgk) promoter. However, insulation of the LTR promoter diminished when the orientation of the cHS4 fragment placed the CTCF-binding core element immediately proximal to the U3 region, suggesting a minimal distance requirement. Moreover, placement of the cHS4 fragment in the U3 region of the 3′ LTR dramatically decreased the level of expression from an internal Pgk promoter, presumably by blocking interaction with the 3′ LTR enhancer. Finally, sorting studies suggest that the severity of position effects or autonomous promoter silencing increases as transduced progenitors differentiate into mature progeny. These findings have direct implications for the use of chromatin insulators such as cHS4 in oncoretrovirus vectors.
Discordance Between F-18 Fluorodeoxyglucose Uptake and Contrast Enhancement in a Brain Abscess
Authors: MICHAEL A. MEYER, KIRK A. FREY, MARKUS SCHWAIGER
Journal: Clinical Nuclear Medicine (1993)

A 29-year-old human immunodeficiency virus-negative intravenous drug abuser with a right hemispheric staphylococcal brain abscess underwent PET imaging of 18F-fluorodeoxyglucose (FDG) brain uptake. Diffuse right cortical hypometabolism was noted, as well as crossed cerebellar diaschisis. Unlike previous PET findings on FDG uptake in a brain abscess, however, the most intense uptake of FDG was found within the abscess and not in the contrast-enhancing walls.
Atopic dermatitis - all you can do from the outside
Authors: C. Gelmetti, A. Wollenberg
Journal: British Journal of Dermatology (2014)

Atopic dermatitis (AD) affects both the epidermal barrier and the immune system and, as such, therapy needs to address both. Skin cleansing supported by emollients and moisturizers is the primary topical therapy when treating patients with AD. However, it should be remembered that the direct use of emollients on inflamed skin is poorly tolerated and that the flares need to be treated effectively, usually by topical corticosteroids (TCS) and/or topical calcineurin inhibitors (TCI). This contribution outlines a number of strategies for effectively managing AD, from reactive therapy using TCS and TCI to proactive therapy. Proactive therapy is an alternative, evidence-based, immunologically founded treatment approach, based on the fact that normal-looking, nonlesional skin of patients with AD is not normal. The advantage of the proactive approach is that the patients are in control of their disease and are actively involved in its management. The avoidance of external irritants is recommended wherever possible.
Delayed Treatment of Dysbarism
Authors: Kenneth W. Kizer
Journal: JAMA (1982)

Fifty cases of decompression sickness are reviewed in which recompression treatment was delayed for 12 hours or longer after the onset of dysbaric symptoms. Twenty-four patients (48%) had pain only. The other 26 patients (52%) had more serious decompression sickness; two patients may have had air embolisms. Ninety percent of the patients recovered either completely (66%) or substantially (24%) with recompression and associated treatment, although standard recompression protocols had to be lengthened in many of the cases.
Abstract 187: Clinically relevant efficacious doses of resveratrol induce changes in the AMPK/mTOR pathway, accompanied with senescence in preclinical models of colorectal cancer .
Authors: Abeer O. Kholghi
Journal: Cancer Research (2013)

Abstract Resveratrol, a polyphenol present in red wine and peanuts exerts an array of beneficial effects, including anticancer activity and calorie restriction (CR) mimicry. Recent work from our laboratory has shown that low doses of resveratrol, comparable to amounts contained in a glass of red wine significantly reduced adenoma development in ApcMin mice when given with a high fat diet (Scott et al, unpublished). The protective effect was more pronounced than that caused by higher amounts, equivalent to doses used in clinical trials. The CR activity of resveratrol is mediated via the energy regulator AMP-activated kinase (AMPK). This study aims to investigate whether AMPK signalling contributes to the chemopreventive effect of resveratrol. Intestinal mucosa from female ApcMin mice maintained on a high fat diet containing resveratrol (0.00007 or 0.014% in their diet) for 10 weeks was analysed by Western blotting to assess AMPK signalling, and the induction of autophagy and senescence. For more detailed mechanistic interrogation APC10.1 cells originally derived from adenomas of ApcMin mice were incubated with resveratrol (0.001-10μM) for 6 days and protein expression examined. The extent of AMPK activation in vivo correlated with the degree of adenoma inhibition; AMPK expression and phosphorylation was evident in mucosa of resveratrol treated mice, but not in control animals, with highest levels in those that ingested the low dose. This chronic resveratrol treatment was also associated with increased expression of p21, a biomarker of senescence, particularly at the low dose. In APC10.1 cells resveratrol caused significant increases in AMPK phosphorylation at 0.01, 0.1 and 1μM, but not at 10μM, consistent with a bell-shaped dose-response. Activity was accompanied by significantly reduced phosphorylation of the mammalian target of rapamycin (mTOR), which is regulated by AMPK signalling, plus its downstream targets p70S6K and 4E-BP1. Furthermore, these concentrations also increased autophagy and senescence, as measured by LC3-II and p21 expression, respectively, and greater numbers of senescence-associated β-galactosidase positive cells. The results suggest that activation of AMPK signalling and the induction of senescence may contribute to the cancer chemopreventive effects of resveratrol at dietary relevant intakes. Citation Format: Abeer O. Kholghi. Clinically relevant efficacious doses of resveratrol induce changes in the AMPK/mTOR pathway, accompanied with senescence in preclinical models of colorectal cancer . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 187. doi:10.1158/1538-7445.AM2013-187
Faecal elastase 1: not helpful in diagnosing chronic pancreatitis associated with mild to moderate exocrine pancreatic insufficiency
Authors: P G Lankisch, I Schmidt, H Konig, D Lehnick, R Knollmann, M Lohr, S Liebe
Journal: Gut (1998)

The suggestion that estimation of faecal elastase 1 is a valuable new tubeless pancreatic function test was evaluated by comparing it with faecal chymotrypsin estimation in patients categorised according to grades of exocrine pancreatic insufficiency (EPI) based on the gold standard tests, the secretin-pancreozymin test (SPT) and faecal fat analysis.In 64 patients in whom EPI was suspected, the following tests were performed: SPT, faecal fat analysis, faecal chymotrypsin estimation, faecal elastase 1 estimation. EPI was graded according to the results of the SPT and faecal fat analysis as absent, mild, moderate, or severe. The upper limit of normal for faecal elastase 1 was taken as 200 micrograms/g, and for faecal chymotrypsin 3 U/g stool. Levels between 3 and 6 U/g stool for faecal chymotrypsin are usually considered to be suspicious for EPI. In this study, both 3 and 6 U/g stool were evaluated as the upper limit of normal.Exocrine pancreatic function was normal in 34 patients, of whom 94, 91, and 79% had normal faecal elastase 1 and faecal chymotrypsin levels (< 3 U/g and < 6 U/g) respectively. Thirty patients had EPI, of whom 53, 37, and 57% had abnormal faecal enzyme levels (differences not significant). When EPI was graded as mild, moderate, or severe, 63% of patients had mild to moderate EPI, and 37% had severe EPI. In the latter group, between 73 and 91% of patients had abnormal faecal enzymes. In the group with mild to moderate EPI, abnormal test results were obtained for both faecal enzymes in less than 50% of the patients (differences not significant). Some 40% of the patients had pancreatic calcifications. There were no significant differences for either faecal enzyme between the two groups with and without pancreatic calcifications. In 62% of the patients who underwent an endoscopic retrograde cholangiopancreatography (ERCP), abnormal duct changes were found. Again, there were no significant differences for either faecal enzyme between the two groups with abnormal and normal ERCP.Estimation of faecal elastase 1 is not distinctly superior to the traditional faecal chymotrypsin estimation. The former is particularly helpful only in detecting severe EPI, but not the mild to moderate form, which poses the more frequent and difficult clinical problem and does not correlate significantly with the severe morphological changes seen in chronic pancreatitis.
Superior Vena Cava Syndrome-Reply
Authors: Jacob J. Lokich
Journal: JAMA (1975)

<h3>In Reply.—</h3> Dr. Davidson's comments are appropriate in that judicious venography can be performed safely in<i>most</i>patients. However, the major issue is whether venography contributes substantially to the diagnosis and potential treatment. Our position is that the diagnosis of SVCS is a clinical one, and that treatment is not determined in most circumstances by the venogram. Furthermore, the potential complication, which is primarily hemorrhage from the venapuncture site, though of a low order of incidence, does not justify<i>routine</i>venography. Dr. Johnston's comments with regard to a controlled trial of radiation therapy do not seem appropriate. Clearly, radiation therapy is an effective palliative measure in the majority of patients with SVCS, whether or not one demonstrates relief of venous obstruction objectively. Additional measures, such as fluid restriction and diuretic therapy, could and should be employed. However, these measures are clearly not focusing on the specific pathophysiology of the syndrome.
Parenting and child mental health: a cross-cultural perspective
Authors: Marc H. Bornstein
Journal: World Psychiatry (2013)

In its most general instrumental sense, parenting consists of care of the young in preparing them to manage the tasks of life. Parents provide childhood experiences and populate the environments that guide children's development and so contribute to child mental health. Parenting is expressed in cognitions and practices. However, parents do not parent, and children do not grow up, in isolation, but in multiple contexts, and one notable context of parenting and child mental health is culture. Every culture is characterized, and distinguished from other cultures, by deep-rooted and widely acknowledged ideas about how one needs to feel, think, and act as an adequately functioning member of the culture. Insofar as parents subscribe to particular conventions of a culture, they likely follow prevailing "cultural scripts" in childrearing. Broadening our definition, it is therefore the continuing task of parents also to enculturate children by preparing them for the physical, psychosocial, and educational situations that are characteristic of their specific culture. Cross-cultural comparisons show that virtually all aspects of parenting children are informed by culture: culture influences when and how parents care for children, what parents expect of children, and which behaviors parents appreciate, emphasize and reward or discourage and punish. Thus, cultural norms become manifest in the mental health of children through parenting. Furthermore, variations in what is normative in different cultures challenge our assumptions about what is universal and inform our understanding of how parent-child relationships unfold in ways both culturally universal and specific. This essay concerns the contributions of culture to parenting and child mental health. No study of a single society can address this broad issue. It is possible, however, to learn lessons about parenting and child mental health from the study of different societies.
The yin and yang of viruses and interferons
Authors: Ben X. Wang, Eleanor N. Fish
Journal: Trends in Immunology (2012)

Interferons (IFNs)-α/β are critical effectors of the innate immune response to virus infections. Through activation of the IFN-α/β receptor (IFNAR), they induce expression of IFN-stimulated genes (ISGs) that encode antiviral proteins capable of suppressing viral replication and promoting viral clearance. Many highly pathogenic viruses have evolved mechanisms to evade an IFN response and the balance between the robustness of the host immune response and viral antagonistic mechanisms determines whether or not the virus is cleared. Here, we discuss IFNs as broad-spectrum antivirals for treatment of acute virus infections. In particular, they are useful for treatment of re-emerging virus infections, where direct-acting antivirals (DAAs) have limited utility due to DAA-resistant mutations, and for newly emerging virus strains in which the time to vaccine availability precludes vaccination at the onset of an outbreak.
Positive Gastrointestinal Bleeding Study from Tumor Extension into Intestine
Authors: JOAN M. MACK, RONALD J. ROSENBERG, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1987)

A man with adenocarcinoma of the intestine (and liver involvement) had the lesion resected and bowel continuity reestablished. Two months later gastrointestinal bleeding occurred, caused by tumor in the liver growing into the colon. Thus, direct tumor extension into the bowel can produce gastrointestinal bleeding.
STUDIES OF THE INCORPORATION OF Fe59 INTO NORMAL AND ABNORMAL HEMOGLOBINS*
Authors: Helen M. Ranney, Paul Kono
Journal: Journal of Clinical Investigation (1959)

This study was undertaken to ascertain whether different normal and abnormal hemoglobin com- ponents exhibit different rates of Fe59 incorpora- tion in human subjects and in experimental ani- mals.The hemoglobin of normal man contains minor components, hemoglobins A2 and A3, in ad- dition to the principal component, hemoglobin A1.Patients with hereditary hemoglobin abnormali- ties have relatively large amounts of abnormal hemoglobins; electrophoretic analysis of the hemo- globin of many experimental animals reveals a small amount of an electrophoretically rapid com-