tbuckley/cabot-search huggingface dataset:
Role of granulocyte colony‐stimulating factor as adjunct therapy for septicemia in children with acute leukemia
Authors: Der‐Cherng Liang, Shu‐Huey Chen, Sue‐Fun Lean
Journal: American Journal of Hematology (1995)

Abstract The granulocyte colony‐stimulating factor (G‐CSF) has been shown to accelerate recovery from severe neutropenia and to decrease the incidence of documented infections after intensive chemotherapy in cancer patients. However, the routine prophylactic use of G‐CSF is expensive. This study was conducted to determine the role of G‐CSF as adjunct therapy for septicemia following neutropenia caused by chemotherapy in children with acute leukemia. Fifty consecutive episodes of septicemia were studied involving 34 episodes of Gram‐negative, 7 episodes of Gram‐positive, 5 episodes of polymicrobial bacterial septicemia, one episode of fungemia, and 3 episodes of disseminated fungal infection. In the first 25 episodes, G‐CSF was not used (group A). For the next 16 episodes, G‐CSF 200 μg per square meter per day subcutaneously was given immediately after the septicemia was documented until the absolute neutrophil count was maintained at more than 1,500 per cubic millimeter (group B). Thereafter, G‐CSF at the same dose as that of group B was prophylactically used in all the children who received high‐dose cytosine arablnc‐side‐containing regimens. Nine episodes of septicemia occurred (group C). The incidences of mortality per episode of septicemia in groups A, B, and C were 12.0% (3/25), 12.5% (2/16) and 0% (0/9), respectively. Statistically, there was no difference between the three groups overall and in pair‐wise comparisons (all P &gt; 0.5). The durations of G‐CSF administration in group B ranged from 6 to 26 days with a median of 12 days and the durations of G‐CSF administration in group C ranged from 10 to 23 days with a median of 19 days. With or without G‐CSF, there may be no significant difference in the mortality of septicemia following neutropenia caused by chemotherapy in children with acute leukemia.
Intravenous recombinant tissue-type plasminogen activator in patients with acute myocardial infarction: a report from the NHLBI thrombolysis in myocardial infarction trial.
Authors: D O Williams, J Borer, E Braunwald, J H Chesebro, L S Cohen, J Dalen, H T Dodge, C K Francis, G Knatterud, P Ludbrook
Journal: Circulation (1986)

The efficacy and safety of a 3 hr, 80 mg intravenous infusion of recombinant tissue-type plasminogen activator (rt-PA) were investigated in 47 patients with acute myocardial infarction. Coronary angiography, performed before the administration of rt-PA and for 90 min thereafter, demonstrated that 37 patients had total coronary occlusion before therapy. After 90 min of rt-PA (50 mg), reperfusion of the infarct-related artery was observed in 25 patients (68%). Continuous infusions of heparin for anticoagulation were administered for 8 to 10 days. Of 36 patients who underwent follow-up coronary cineangiography, 21 had initially presented with total occlusion and had experienced reperfusion at 90 min. Sustained perfusion of the infarct-related artery was observed in 14 (67%) of these 21 initially reperfused patients. Late angiography was performed in nine patients who initially demonstrated subtotal occlusion of the infarct-related artery; sustained perfusion was observed in eight (89%). Significant bleeding was observed in 15 patients (32%). A hematoma at the site of the acute catheterization accounted for most instances of significant bleeding (11/15, 73%). Administration of rt-PA resulted in a significant decline in fibrinogen and plasminogen while amounts of fibrin(ogen) degradation products rose. In no patient, however, did fibrinogen levels decline to less than 140 mg/dl. Thus, rt-PA, administered as a brief 80 mg intravenous infusion, is capable of restoring blood flow in a high proportion of patients with acute myocardial infarction due to total coronary obstruction. Declines in plasma fibrinogen and plasminogen are observed. If combined with heparin anticoagulation and invasive vascular procedures, significant bleeding is a common complication.(ABSTRACT TRUNCATED AT 250 WORDS)
Randomised controlled trial of effect of fruit and vegetable consumption on plasma concentrations of lipids and antioxidants
Authors: S. Zino, M. Skeaff, S. Williams, J. Mann
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To determine the extent to which plasma antioxidant concentrations in people with habitual low intake of fruit and vegetables respond to increased intakes of these foods. To examine whether advice to increase fruit and vegetables will result in reduction of concentrations of total and low density lipoprotein cholesterol. <b>Design:</b> Randomised controlled trial in which intervention and control groups were followed up for eight weeks. The intervention group was asked to consume eight servings of fruit and vegetables a day. <b>Setting:</b> Dunedin, New Zealand. <b>Subjects:</b> Eighty seven subjects with normal lipid concentrations who ate three or fewer servings of fruit and vegetables daily. <b>Main outcome measures:</b> Plasma concentrations of vitamin C, retinol, α and ß carotene, α tocopherol, lipids, and lipoproteins. Dietary intake assessed with diet records over four days. <b>Results:</b> The mean plasma vitamin C, α carotene, and ß carotene concentrations increased in parallel with increased dietary intake of fruit and vegetables in the intervention group. Concentrations of retinol, α tocopherol, lipids, and lipoproteins remained unchanged despite some increase in dietary vitamin E and a small reduction in saturated fat intake. <b>Conclusions:</b> Following a recommendation to increase fruit and vegetable consumption produces change in plasma concentrations of vitamin C, α carotene, and ß carotene likely to reduce incidence of cancer. More specific dietary advice to modify fat intake may be necessary to reduce the risk of cardiovascular disease mediated by lipoprotein and vitamin E. <h3>Key messages</h3> Increasing intake of fruit and vegetables raises plasma concentrations of vitamin C and α and ß carotene These changes in plasma concentrations of antioxidants are probably associated with reduced risk of cancer A simple recommendation to increase fruit and vegetable intake has little effect on plasma concentrations of α tocopherol, lipids, and lipoproteins More specific dietary advice to modify fat intake may be necessary to reduce risk of cardiovascular disease associated with lipoproteins and vitamin E
The Inexcusable Disease
Authors: Geoffrey Edsall
Journal: JAMA (1976)

The SPECIAL COMMUNICATION in this issue, "Serologic Therapy of Tetanus in the United States, 1965-1971" (p 42), is encouraging in that it shows a distinct trend toward the use of human rather than animal antitoxin in the treatment of this gratuitously unnecessary disease, but it demonstrates several other points as well. First, even though serotherapy was of some help, its value in preventing death from tetanus was hardly sufficient to generate any cheers. If one assumes that the "serotherapy" and the "no serotherapy" groups are comparable (a somewhat hazardous assumption, as the authors point out), a reduction in the case fatality rate from 78% without serotherapy to 62% with serotherapy hardly puts serum into the category of a major therapeutic agent. Second, the article points out that the optimal therapeutic dose of tetanus immune globulin (TIG) is yet to be determined, but suggests that 500 units may be as effective
Tuberculosis Bacteriologic Reliability
Authors: Asim K. Dutt
Journal: JAMA (1977)

The reliability of examining mailed specimens of sputum for tubercle bacilli was studied by dividing 132 sputum specimens. One half of each specimen was examined on the same day as collection (fresh); the other half was examined after a delay of from one to eight days (mailed). There were a few discrepancies, but no advantage was shown for use of the fresh portion of the specimens. The rate of contamination was slightly greater in the mailed portions (6.6%).
From Science to Practice
Authors: Andrew D. Oxman
Journal: JAMA (1995)

In this issue ofTHE JOURNAL, Jeng et al<sup>1</sup>report discrepancies between the results of meta-analyses using aggregate data available from the literature (MAL) and meta-analyses using individual patient data (MAP). This may be seen as further grounds for mistrusting meta-analysis in general<sup>2,3</sup>and MAL in particular,<sup>4</sup>but before deciding that all meta-analyses are an exercise in "mega-silliness,"<sup>5</sup>consider the alternatives. See also p 830. The key characteristic of MAPs is the use of individual patient data (IPD). Meta-analyses using aggregate data also can, and frequently do, include unpublished data, so the term<i>IPD meta-analyses</i>is preferable to avoid confusing issues relating to using IPD and issues relating to using unpublished data. IPD meta-analyses require international cooperation between the individuals and groups who have conducted relevant trials and a considerable amount of time, personnel, and financial resources.<sup>6</sup>These global collaborative endeavors have yielded important information
Healed Rib Fractures Presenting as Linear Foci of Increased Tracer Uptake on Bone Scintigraphy
Authors: DAVID C. WONG, VICTOR MANSBERG
Journal: Clinical Nuclear Medicine (1999)

A case of healed rib fractures presenting as linear foci of increased tracer uptake on bone scintigraphy is presented. A 58-year-old woman was referred for bone scintigraphy because of increasing left chest pain. Her history included osteoporosis but no cancer. The Tc-99m MDP bone scan showed abnormal linear foci of intense increased tracer uptake along the left eighth and ninth ribs posteriorly and the right eighth rib posteriorly. Excision biopsy of the posterior left eighth and ninth ribs was macroscopically normal externally, and sectioned bony surfaces and histologic analysis confirmed healed rib fractures.
SYPHILITIC PARALYSIS OF THE OESOPHAGUS
Authors: R. Saundby
Journal: BMJ (1914)

MDCzJORNA 239or personal sources about cosinoplile ascites, butt a feN Nvords may be added aboutt cosinoplhile pleural and cerebro- spinal effuLsions.Eosinop)lile pleural effasions lhavc been reported by Widal annd Revaut9 (4 cases), Barjon anid Cade ' (5 cases), Perkinis and Dudgeon Accorling to EImr1son,3 thee is slig'ht eosinopluilia (2 to 5 per cent.) in tuLberculotus Neldurisy, an-cd Mosny, Dumlont, and Saint-Gironis' state tlhat eosiiopllile leural effusions are commion i Paris.In a traumryiatic lhacmotlhorax time latter observors found 92 per cent.eosinioplhiles, wlhilc time lhaemlic cosinophlile count -was 4 per cenit.; and in 2 cases of pleuiral effusioin due to blullet woundls H. S. Cartce2 reported eosinophilia of 70.2 aind 87.8 per cellt.respectively.Eosinophilc pleural effusions hlave been regarded as uisually transient, b,oenign, anid as iinclicatitng a process oni the way to cure (Widal and Revaut).Perkins anid D udgeon's case, lhowvever, proved fatal.Eosinopliilia m-ay occur in pleuLral effLisions dIuC to stchw idely differelt causes (pst-pneuLmonic, post-typlhoid, haemorrliage, granular kidinev, rheu.natism,tuberculosis) that its presence caniiot be correlated witlh an) special etiological factor.In miiany of tlhe cases the efftisions hlave been sterile oln cltuire.Witl cosinioplile pleiraleifLsions there is usuially, tlhou1ghl n1ot invariably, liaem11iC cosimo- philia, whiiell, lhowever, lnever approaches tlle couint seCen in thle serous effusi )ns.Miosiny, DumIont, anld Saiint- *Girols contend that in tlese cases the eosinophha is a local process.and that under some unknownl illuence the granutilations of tllc polyinorplhoinuclear neutroplile leuno- cytes becomie cosinopliile, the curves of the lnutmber of neut1rophile aIId eositioph-1ile leucocytes in thlesC effuSions.varying( inv,rsely.Tljis hypothesis as to the origin of cosinophile cells is opposced to the usually accepted view, originally puit forwarnd by Ehrlicll anid subse:,uently sup- ported by Opie,6 that the cosinoplhile cells are always dIerived( from11 the bone m1vrrow.Mosny and Harvier report a case of clhronic sypllilitic meninqlitis in N'lviili foiur lumb -tv punctiures were per- formiiel.In tlho first p)uncture fluid cosinopliles were absent, in the second they form-fied 0.3 of tlle cells pr-esent, in tlhe tlhiu-d 5 peir cent., and in tlle fourtlh 9 per cent.All tranisitions fr(;m lymphocytes, to cosiinophlile cells were seen.The eosinyophile cells in the blood welve neOVer mLore thiani 1 per cenlt.This was regarded as an examl)le of local cosinopliilia duec to the tranisformationi of lymphocytes into cosinophile cells as stated by Dominiici.
Rwanda's children struggle to face the future
Authors: C. Court
Journal: BMJ (1996)

Almost all of the Rwandan children interviewed by an international charity believed that they would die during the genocide which swept their country in 1994. The survey, by the United Nations Children's Fund (Unicef), also found that 95% of the children had witnessed violence and death, often involving members of their family.

The one year baseline survey, which looked at trauma after the Rwandan atrocities, was conducted a year later, in May 1995, among 3030 children aged 8 to 19 years in schools and centres …
THE INCIDENCE OF TUBERCULOSIS IN CHILDHOOD
Authors: F. Hamburger
Journal: BMJ (1910)

etc. neither pain nor swelling; tubercle bacilli found in urine.On cystoscopic examination: Dark red swollen mucous mem- brane round orifice of left ureter; urine from right, specific gravity 1020, normal; left, 1005, containing pus.Treatment: Nephrectomy, and injections of tuberculin.Result so far as known to date: Doing well (three months after operation).CASE xxii.-Female,aged 28.Family history of tubercle present; left side.Early symptoms: Frequency of micturition, etc.; neither pain nor swelling; tubercle bacilli found in urine.On cystoscopic examination: Left ureteral orifice surrounded by swollen, woolly-looking mucous membrane; patches of red- news on left sidb of bladder; urine from right, specific gravity 1020, normal; left, specific gravity 1005, containing pus.Treat- ment: Nephrectomy by Dr. John Campbell.Result so far as known to date: Doing well (two months after operation).CASE xxriI.-Female,aged 31.Family history of tubercle absent; both kidneys affected.Early symptoms: Left-sided renal colic, and frequency of micturition ; both kidneys enlarged; no tubercle bacilli found in urine.On cystoscopic examination: A large irregular ulcer at base of bladder; left ureteral orifice buried in this; right orifice just at edge of ulcer ; under CHCI3 with catheters in ureters, no urine; even after injection of indigo-carmine none could be seen flowing into bladder.Result so far as known to date: Instatu quo; had anuria for twenty-four hours after examination.CASE xxiv.-Male,aged 23.Familyhistory of tubercle present; right side; Early symptoms: Right-sided renal colic; right kidlney enlarged; tubercle bacilli was found in urine.On cysto- scopio examination: Right ureteral orifice round, red and dilated; red patches in neighbourhood; right ureter not cathe- terized-left, specific gravity under 1005, containing albumen.Treatment: Medical.Result so far as known to date: Going progressively downhill.
Rapid reduction of plasma atrial natriuretic peptide levels during percutaneous transvenous mitral commissurotomy in patients with mitral stenosis.
Authors: F Ishikura, S Nagata, Y Hirata, K Kimura, S Nakatani, J Tamai, M Yamagishi, F Ohmori, S Beppu, M Takamiya
Journal: Circulation (1989)

To clarify the direct contribution of the left atrial pressure to secretion of human atrial natriuretic peptide (hANP), we have attempted to study the relations between plasma hANP levels, neurohumoral factors, and hemodynamic changes in 13 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). After PTMC, the left atrial pressure fell from 14.7 +/- 1.9 (mean +/- SEM) to 6.5 +/- 0.7 mm Hg in all patients studied (p less than 0.0005), whereas there were no remarkable changes in either the right atrial pressure, mean arterial pressure, or heart rate. Plasma immunoreactive hANP levels obtained from the pulmonary artery decreased from 278 +/- 51 to 137 +/- 31 pg/ml after PTMC (p less than 0.0005). There was a significant correlation between the decrement of hANP levels and that of left atrial pressure (r = 0.72, p less than 0.005). Neither plasma renin activity nor norepinephrine levels changed. In contrast, plasma aldosterone concentrations significantly increased from 11.3 +/- 1.5 to 16.4 +/- 2.7 pg/ml after PTMC (p less than 0.01), although there was no casual relation between plasma concentrations of aldosterone and hANP. The present result with PTMC-induced rapid fall of the left atrial pressure with a concomitant reduction in hANP secretion strongly suggests the importance of the left atrial pressure on hANP secretion in humans.
Increased toxin-induced liver injury and fibrosis in interleukin-6-deficient mice
Authors: Kellen Kovalovich, Robert A. DeAngelis, Wei Li, Emma E. Furth, Gennaro Ciliberto, Rebecca Taub
Journal: Hepatology (2000)

Interleukin-6 null (IL-6−/−) mice have impaired liver regeneration and increased liver necrosis following partial hepatectomy that is corrected with IL-6 treatment. Following acute carbon tetrachloride (CCl 4 ) treatment, we found that IL-6−/− mice developed increased hepatocellular injury and defective regeneration with significant blunting of signal transducer-and-activator of transcription protein 3 (STAT3) and nuclear factor-κB (NF-κB) activation and reduced hepatocyte DNA synthetic and mitotic responses. After CCl 4 treatment, unlike partial hepatectomy, increased hepatocyte apoptosis was noted in IL-6−/− livers. Pretreatment with IL-6 before CCl 4 reduced acute CCl 4 injury and apoptosis and accelerated regeneration in both IL-6+/+ and −/− livers. Repetitive doses of CCl 4 in the presence or absence of phenobarbital resulted in increased injury and fibrosis in IL-6 −/− compared with +/+ livers. After acute and chronic injury, IL-6−/− livers showed the protracted presence of α-smooth muscle actin associated with activated stellate cells, indicating a disturbed response in wound healing that progressed to fibrosis. These data provide evidence for an important role for IL-6 in reducing CCl 4 -induced acute and chronic liver injury and fibrosis.
Long-term results of first salvage treatment in CLL patients treated initially with FCR (fludarabine, cyclophosphamide, rituximab)
Authors: Constantine S. Tam, Susan O’Brien, William Plunkett, William Wierda, Alessandra Ferrajoli, Xuemei Wang, Kim-Anh Do, Jorge Cortes, Issa Khouri, Hagop Kantarjian, Susan Lerner, Michael J. Keating
Journal: Blood (2014)
Binding of benzidine, N-acetylbenzidine, N, N'-diacetylbenzidine and Direct Blue 6 to rat liver DNA.
Authors: C N Martin, F A Beland, J C Kennelly, F F Kadlubar
Journal: Environmental Health Perspectives (1983)

Studies were performed to assess covalent binding of [3H]benzidine, [14C]N-acetylbenzidine, [14C]N, N'-diacetylbenzidine, and the benzidine-derived azo dye Direct Blue 6 to rat hepatic DNA. Following IP injection into male Sprague-Dawley rats, benzidine and N-acetylbenzidine bound to liver DNA to yield the same adduct: N-(deoxyguanosin-8-yl)-N'-acetylbenzidine. The isomeric N-(deoxyguanosin-8-yl)-N-acetylbenzidine and the deacetylated adduct N-(deoxyguanosin-8-yl) benzidine were also synthesized, but neither of these adducts was detected in vivo. Injection of N,N'-diacetylbenzidine resulted in only barely detectable binding which was insufficient for adduct analysis. [3H]Direct Blue 6 was administered to male Wistar rats either by IP injection or by gavage. In both instances, Direct Blue 6 bound covalently to liver DNA; however, binding occurred at a much higher level in the IP injected animals. With IP injected animals, high pressure liquid chromatographic analysis indicated that approximately 70% of the radioactivity was associated with N-(deoxyguanosin-8-yl) benzidine.
May-Hegglin Anomaly
Authors: Frank A. Oski
Journal: JAMA (1963)

To the Editor:—  In their discussion entitled,  Anomaly (JAMA183:737 [March 2] 1963), Dr. Wassmuth and his associates fail to mention the thrombocytopenia that has been reported in this disturbance and they state, It is our judgment that there is no evidence of abnormal bleeding in these cases.  In the three families studied1-3prior to this report, seven of nine affected members were thrombocytopenic. Both in Dr. Hegglin's family, and in ours, the propositi presented with purpura.  Dr. Wassmuth and associates did not state what the platelet counts were in the patients they reported, so it is impossible to determine if thrombocytopenia was or was not associated with the May-Hegglin anomaly in this family.  There is insufficient information at the present time to determine whether this anomaly is or is not completely benign, but the high incidence of thrombocytopenia in the cases reported to date appears to
P505Neuregulin-1 ameliorates right ventricular diastolic dysfunction in pulmonary arterial hypertension
Authors: R Adao, P Mendes-Ferreira, N Hamdani, C Maia-Rocha, MJ Mendes, I Falcao-Pires, GW De Keulenaer, W Linke, AF Leite-Moreira, C Bras-Silva
Journal: Cardiovascular Research (2014)

Neuregulin (NRG)-1 is involved in the preservation of left ventricular performance. Nevertheless, the role of NRG-1 in pulmonary arterial hypertension(PAH) and right ventricular(RV) diastolic stiffness is unknown. We analysed the presence and possible underlying mechanisms of RV diastolic dysfunction in an animal model of PAH and the role of NRG-1 in this context.
Continuing medical education: Quality issues in continuing medical education
Authors: H. A. Holm
Journal: BMJ (1998)

Series editors: Hans Asbjorn Holm and Tessa Richards

This is the fifth in a series of seven articles looking at international trends and forces in doctors' continuing professional development

The need for continuous learning as part of a doctor's professional career is evident. The best ways of introducing and nurturing this learning have been the subject of much controversy, and the quality of medical education at all levels is being questioned and debated in many countries. This article looks at some trends and issues that are being addressed in order to improve the effectiveness of doctors' continuous learning.

Innovations in undergraduate medical education are influencing the whole spectrum of medical education. So too is the growing literature on adult learning1-4 and the doctor as learner. 5 6 The works of Schon especially clarify the importance of the professionals' reflection on their everyday practice as a means of continuous change and learning. 7 8

Clinical problem solving has been identified as the core activity of how doctors learn and keep developing their competence. Creating an environment that provides practitioners with opportunities to explore and understand the personal theories underpinning their own practice is crucial for continuous professional development at all stages.9

Although a division of medical education into stages—undergraduate, postgraduate, and continuing medical education (CME)—seems sound from a regulatory and legal perspective, there are no fundamental differences in the way people learn across the continuum. The student often is told what to learn, but the qualified doctor is responsible for directing his or her own (lifelong) learning.10

#### Self directed learning

“A process in which learners take the initiative … for increasing self and social awareness; critically analysing and reflecting on their work … defining their learning needs … formulating goals … identifying human and material resources for learning … choosing appropriate …
256 THE CAMP EFFECTORS EPAC AND PKA ARE INVOLVED IN THE HEPATIC CYSTOGENESIS OF AN ANIMAL MODEL OF ARPKD
Authors: J.M. Banales, T.V. Masyuk, S.A. Gradilone, A.I. Masyuk, J.F. Medina, N.F. La Russo
Journal: Journal of Hepatology (2009)