tbuckley/cabot-search huggingface dataset:
A59: Dexamethazone Therapy for Septic Arthritis in Children: a Follow Up Study
Authors: Itay Fogel, Jacob Amir, Elhanan Bar-On, Liora Harel
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

In our previous prospective study we have demonstrated that the administration of Dexamethasone as an adjuvant therapy lead to a significant clinical and laboratory improvement in children with septic arthritis. This therapy has become accepted in some of the pediatric wards at Schneider's medical center. The aim of this study was to evaluate the effect of adding Dexamethasone to antibiotic therapy on the clinical course of septic arthritis in children not under controlled study.



Methods:

A retrospective study included all children hospitalized with the diagnosis of septic arthritis at Schneider Children's Medical Center from 2008–2013 .Part of the patients were treated with antibiotics alone, whereas others were treated with Dexametasone in addition to antibiotics, according to the policy of the admitting ward.



Results:

116 medical records were included in our study. Of which, 26 (22.4%) patients were treated with Dexamethasone and antibiotics and 90(77.6%) were treated with antibiotics only. There was no significant difference between the groups in age, duration of symptoms prior to hospitalization, body temperature or levels of acute phase reactants. Bacteria were isolated from 23 patients (20%) without any difference between the two groups. Patients treated with Dexamethasone had a significantly shorter duration of fever (mean 1st day without fever 2.3 vs. 3.9) (p = 0.002), shorter duration of parenteral antibiotic treatment (mean of 7.1 vs. 11.4 days) (p < 0.001) and accelerated clinical improvement (mean 1stday without pain or any limitation in physical examination 6.3 vs. 10 days)(p<0.001).



Likewise, C-reactive protein (CRP) levels declined faster below 1mg/dL in the Dexamethasone group (mean of 5.3 vs. 8.4 days) (p = 0.002) and the hospital stay was significantly shorter (mean of 8 vs. 10.7 days) (p = 0.004). No side effects of treatment were recorded in either group, but in the Dexamethasone group a short rebound of symptoms occurred in 3/26 (11.5%) patients after completing the course of steroids.



Conclusion:

A short course of Dexamethasone given early, in addition to antibiotics, leads to a significant clinical and laboratory improvement, shortens duration of treatment and accelerates recovery in children with septic arthritis.
Case 29-1981
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, David S. Rosenthal, Nancy L. Harris
Journal: New England Journal of Medicine (1981)

Presentation of CaseA 68-year-old woman was admitted to the hospital because of lymphadenopathy.Her health was good until 17 years earlier, when her mouth became dry and the right parotid gland became swollen and tender. A parotid abscess was drained. A Schirmer test demonstrated decreased tear formation. A left sialographic examination showed generalized sialectasis. Nine years before admission swelling of the left parotid gland developed, and radiation treatment was given, with improvement. Two years later right parotid swelling recurred, and slight enlargement of the left parotid gland was also observed. Serum immunoelectrophoresis revealed a marked, diffuse increase in IgG . . .
Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases
Authors: J. Emery, R. Walton, M. Murphy, J. Austoker, P. Yudkin, C. Chapman, A. Coulson, D. Glasspool, J. Fox
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objectives:</b> To evaluate the potential effect of computer support on general practitioners9 management of familial breast and ovarian cancer, and to compare the effectiveness of two different types of computer program. <b>Design:</b> Crossover experiment with balanced block design. <b>Participants:</b> Of a random sample of 100 general practitioners from Buckinghamshire who were invited, 41 agreed to participate. From these, 36 were selected for a fully balanced study. <b>Interventions:</b> Doctors managed 18 simulated cases: 6 with computerised decision support system Risk Assessment in Genetics (RAGs), 6 with Cyrillic (an established pedigree drawing program designed for clinical geneticists), and 6 with pen and paper. <b>Main outcome measures:</b> Number of appropriate management decisions made (maximum 6), mean time taken to reach a decision, number of pedigrees accurately drawn (maximum 6). Secondary measures were method of support preferred for particular aspects of managing family histories of cancer; importance of specific information on cancer genetics that might be provided by an "ideal computer program." <b>Results:</b> RAGs resulted in significantly more appropriate management decisions (median 6) than either Cyrillic (median 3) or pen and paper (median 3); median difference between RAGs and Cyrillic 2.5 (95% confidence interval 2.0 to 3.0; P&lt;0.0001). RAGs also resulted in significantly more accurate pedigrees (median 5) than both Cyrillic (median 3.5) and pen and paper (median 2); median difference between RAGs and Cyrillic 1.5 (1.0 to 2.0; P&lt;0.0001). The time taken to use RAGs (median 178 seconds) was 51 seconds longer per case (95% confidence interval 36 to 65; P&lt;0.0001) than pen and paper (median 124 seconds) but was less than Cyrillic (median 203 seconds; difference 23. (5 to 43; P=0.02)). 33 doctors (92% (78% to 98%)) preferred using RAGs overall. The most important elements of an "ideal computer program" for genetic advice in primary care were referral advice, the capacity to create pedigrees, and provision of evidence and explanations to support advice. <b>Conclusions:</b> RAGs could enable general practitioners to be more effective gatekeepers to genetics services, empowering them to reassure the majority of patients with a family history of breast and ovarian cancer who are not at increased genetic risk.
Meningitis Complicating Sacral Decubitus Ulcer
Authors: Arthur Kaufman
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Cerebrospinal menigitis as an extension from epidural and retroperitoneal abscesses became the fatal complication of a bed-ridden patient with a sacral decubitus ulcer. <h3>Report of a Case.—</h3> A 54-year-old woman with severe rheumatoid arthritis, a temperature of 103 F, and a sacral decubitus ulcer for a month before admission had received little care at home and lay on her back continuously. She consumed alcohol to ease her arthritic pain and add color to her waning existence. After a week of pain in the back and malaise, this febrile, debilitated, arthritic woman appeared older than her stated age. Ankyloses of legs and neck were severe. A decubitus ulcer, 8×6 cm in size, over the sacrum extended completely through the subcutaneous tissue down to the bone. The wound was debrided extensively and cleaned daily. The white blood cell count (WBC) was 19,250/cu mm, with 87% neutrophils. Sacral x-ray film
Long-Term Beneficial Effect of Late Reperfusion for Acute Anterior Myocardial Infarction With Percutaneous Transluminal Coronary Angioplasty
Authors: Hajime Horie, Masayuki Takahashi, Kazuo Minai, Masafumi Izumi, Atsushi Takaoka, Masato Nozawa, Hiroshi Yokohama, Tamotsu Fujita, Taizo Sakamoto, Osamu Kito, Hiroshi Okamura, Masahiko Kinoshita
Journal: Circulation (1998)

Background —Although the short-term and long-term beneficial effects of early coronary revascularization by primary PTCA or thrombolytic therapy have been established for acute myocardial infarction, thrombolytic therapy &gt;24 hours after the onset of acute myocardial infarction has not been shown to improve clinical outcome. The purpose of this study was to assess the effect of late revascularization by primary PTCA over a 5-year period. Methods and Results —Eighty-three patients with initial Q-wave anterior myocardial infarction &gt;24 hours after onset were randomized into a PTCA group (n=44) and a no-PTCA group (n=39). Long-term follow-up was conducted with regard to end points, which included cardiac death, nonfatal recurrence of myocardial infarction, and development of congestive heart failure. Left ventricular ejection fraction and regional wall motion at 6 months after myocardial infarction were similar in the 2 groups. Left ventricular end-diastolic and end-systolic volume indexes were significantly smaller in the PTCA group than in the no-PTCA group ( P &lt;0.0001). With cardiac events as end points, a 5-year Kaplan-Meier event-free survival analysis revealed that the no-PTCA group had a worse prognosis than the PTCA group ( P &lt;0.0001). Patency of the infarct-related artery, left ventricular ejection fraction, end-diastolic volume index, and end-systolic volume index were significantly associated with cardiac events by a Cox proportional hazards analysis (hazard ratios 0.120, 0.845, 1.065, and 1.164, respectively). Conclusions —In initial Q-wave anterior myocardial infarction, we conclude that even with late reperfusion, PTCA had beneficial effects on cardiac events over the 5-year period after myocardial infarction, with the prevention of left ventricular dilation after myocardial infarction being a possible mechanism.
Colon Cancer, Dysplasia, and Surveillance in Patients with Ulcerative Colitis
Authors: Robert H. Collins, Mark Feldman, John S. Fordtran
Journal: New England Journal of Medicine (1987)

Most gastroenterologists and current textbooks1 2 3 recommend that patients who have had widespread ulcerative colitis for 7 to 10 years should be entered into a surveillance program designed to detect colonic dysplasia (precancer). This involves frequent colonoscopies with multiple mucosal biopsies. The recommended frequency of colonoscopy is any time from every year to every three years. Although there is no clear rationale for choosing one interval over another, the Medical Knowledge Self-Assessment Profile, a publication of the American College of Physicians, states that patients with long-term extensive ulcerative colitis should have a colonoscopy every year.4 The argument for surveillance in such . . .
Methacholine bronchial challenge using a dosimeter with controlled tidal breathing.
Authors: M M Nieminen, A Lahdensuo, L Kellomaeki, J Karvonen, A Muittari
Journal: Thorax (1988)

A new inhalation synchronised dosimeter triggered by low inspiratory flow rates has been assessed. The methacholine challenge test using dosimeter nebulisation with controlled tidal breathing was compared with continuous nebulisation using De Vilbiss No 40 nebulisers with deep inhalations in 11 asthmatic subjects. Within subject PD20 FEV1 values were lower with the dosimeter method than with the continuous nebulisation method (geometric means 158 and 588 micrograms). The repeatability of the dosimeter method with controlled tidal breathing was studied in 11 asthmatic subjects, and the 95% range for a single measurement was +/- 0.72 doubling doses of methacholine. The dosimeter method has greater efficacy because aerosol is delivered during the first part of an inhalation, minimising loss of aerosol outside the respiratory tract. The dosimeter technique combined with controlled tidal breathing appears to be a useful method for carrying out standardised non-specific bronchoprovocation tests.
The Glycolytic Shift in Fumarate-Hydratase-Deficient Kidney Cancer Lowers AMPK Levels, Increases Anabolic Propensities and Lowers Cellular Iron Levels
Authors: Wing-Hang Tong, Carole Sourbier, Gennady Kovtunovych, Suh Young Jeong, Manish Vira, Manik Ghosh, Vladimir Valera Romero, Rachid Sougrat, Sophie Vaulont, Benoit Viollet, Yeong-Sang Kim, Sunmin Lee, Jane Trepel, Ramaprasad Srinivasan, Gennady Bratslavsky, Youfeng Yang, W. Marston Linehan, Tracey A. Rouault
Journal: Cancer Cell (2011)
EXTENSIVE COLLOID CHANGES IN THE CHOROID, WITH REPORT OF CASES.
Authors: JOHN T. CARPENTER
Journal: JAMA (1895)

In some of the text-books on ophthalmology mention is made of a senile change in the fundus oculi, characterized by the appearance of small yellowish and yellowish white spots which have been regarded as hyalin or colloid degeneration in the lamina vitrea choroidea. In Noyes we find a full description under the head of degenerative changes of the choroid, in which he assumes the identity of drusen and this colloid degeneration of the lamina vitrea. He calls attention to the clinical fact that vision is not impaired in these cases. Two excellent colored plates representing two varieties of the affection are shown, to both of which I wish to call attention. In one, the large, globular, mulberry-like masses are seen both upon the nerve-head and in the outlying fundus. This plate is taken from Lawson's case, reported in the Transactions of the Ophthalmological Society of the United Kingdom, vol. III.
Vasoactive mediators and the progression from oedematous to necrotising experimental acute pancreatitis.
Authors: H Weidenbach, M M Lerch, T M Gress, D Pfaff, S Turi, G Adler
Journal: Gut (1995)

Little is known about the pathophysiological factors that determine the clinical severity of acute pancreatitis. Because impairment of pancreatic circulation and oxygenation is associated with greater disease severity and morphological damage in experimental pancreatitis it has been suggested that various vasoactive mediators might participate in the progression from the oedematous to the necrotising variety of the disease. This study used an animal model of acute pancreatitis induced by intravenous caeruleint (10 micrograms/kg/h for up to six hours), which does not entail either haemorrhage or significant necrosis of the pancreas. This study considered whether the administration or the inhibition of either nitric oxide, bradykinin, or adrenergic mediators can convert this mild variety into haemorrhagic and necrotising pancreatitis. Neither nitric oxide nor catecholamines were involved in the progression from oedematous to haemorrhagic pancreatitis. Their substitution, activation, and inhibition all failed to change the severity of the disease process. Bradykinin alone seemed to be critically involved in the pathogenesis of pancreatic haemorrhage and necrosis. However, the inhibition of bradykinin and not its activation or substitution increased the severity of the disease.
Recent Progress in Understanding the Hormonal Regulation of Phosphodiesterases
Authors: MARCO CONTI, GEORGES NEMOZ, CLAUDIO SETTE, ELENA VICINI
Journal: Endocrine Reviews (1995)

LAYER after layer of novel regulatory circuits have been added to the map charting the signal transduction pathways that transport information throughout the cell. New components of these pathways are found at a breathtaking pace, and new functions for old components are continuously uncovered. It is now recognized that the complexity of these pathways resembles the intricacy and integration of the pathways of intermediate metabolism. This is especially true for the cyclic nucleotide-dependent signal transduction and its components, including cyclic nucleotide phosphodiesterases (PDEs).These are the enzymes that with cyclases control the intracellular concentration of cyclic nucleotides. With the development of new molecular tools, a wealth of new information has accumulated on the structure and function of these enzymes. Four years ago we reviewed the current knowledge on the mechanisms of hormonal regulation of PDEs (1). Here, we update this survey, reporting the most recent developments of this field. Since our previous review, many primary structures of the human and mammalian PDEs have been elucidated. This has brought about a better understanding of the structure/function relationship of these proteins. Furthermore, PDE gene structure is being actively investigated, adding a further dimension to the regulation of these enzymes and opening new avenues of investigation. Novel mechanisms of regulation have been uncovered, linking these enzymes to new hormone-dependent functions. As we will discuss in detail, the overall picture derived from these findings reinforces the concept that PDEs may serve three major functions in the cell target for hormones and neurotransmitters: 1) They are effectors in signal transduction, 2) they play a role in integrating different signal transduction pathways, and 3) they may also serve as a dampening device to decrease or terminate hormonal stimulation.
Screening Men for Prostate and Colorectal Cancer in the United States
Authors: Brenda E. Sirovich, Lisa M. Schwartz, Steven Woloshin
Journal: JAMA (2003)

Context The debate about the efficacy of prostate-specific antigen (PSA) screening for prostate cancer has received substantial attention in the medical literature and the media, but the extent to which men are actually screened is unknown. If practice were evidence-based, PSA screening would be less common among men than colorectal cancer screening, a preventive service of broad acceptance and proven efficacy. Objective To compare the prevalences of PSA and colorectal cancer screening among US men. Design, Setting, and Population The 2001 Behavioral Risk Factor Surveillance System, an annual population-based telephone survey of US adults conducted by the Centers for Disease Control and Prevention, was used to gather data on a representative sample of men aged 40 years or older from all 50 states and the District of Columbia (n = 49 315). Main Outcome Measures Proportions of men ever screened and up to date on screening for prostate cancer (with PSA testing) and colorectal cancer (with fecal occult blood testing, flexible sigmoidoscopy, or colonoscopy). Results Overall, men are more likely to report having ever been screened for prostate cancer than for colorectal cancer; 75% of those aged 50 years or older have had a PSA test vs 63% for any colorectal cancer test (risk ratio [RR], 1.20; 95% confidence interval [CI], 1.18-1.21). Up-to-date PSA screening is also more common than colorectal cancer screening for men of all ages. Among men aged 50 to 69 years (those for whom there is the greatest consensus in favor of screening), 54% reported an up-to-date PSA screen, while 45% reported up-to-date testing for colorectal cancer (RR, 1.19; 95% CI, 1.16-1.21). In state-level analyses of this age group, men were significantly more likely to be up to date on prostate cancer screening compared with colorectal cancer screening in 27 states, while up-to-date colorectal cancer screening was more common in only 1 state. Conclusion Among men in the United States, prostate cancer screening is more common than colorectal cancer screening. Physicians should ensure that men who choose to be screened for cancer are aware of the known mortality benefit of colorectal cancer screening and the uncertain benefits of screening for prostate cancer.
Marriage and psychiatric illness.
Authors: J Dominian
Journal: BMJ (1979)

Psychiatric disturbance is well known to occur in both spouses more often than could be expected by chance,1 and appreciable marital discord and psychiatric disturbance are also associated. An Australian study showed that the highest rate of minor psychiatric morbidity was among men and women who were separated or divorced.2 In an outpatient psychiatric clinic in the USA divorce was associated particularly with alcoholism but also with homosexuality.3 Several studies have also shown that marital stress is asso ciated with the whole range of major psychiatric diagnoses.4 Psychiatric patients who are divorced are also more likely to be readmitted within a month of discharge.5 Thus a whole variety of psychiatric disorders are linked with marital pathology; some of the commonest are described below.
SYPHILITIC ULCERATION OF THE RECTUM.
Authors: JAMES P. TUTTLE
Journal: JAMA (1896)

While syphilis is acknowledged to be the most frequent cause of stricture of the rectum, and the profession at large are well posted as to this fact, I have been surprised in post-graduate teaching to find how little the modus operandi of its production is understood, and how little the prodromic and precursive conditions are appreciated. I do not propose in the present paper to discuss stricture of the rectum in a general way, as this would lead me into too wide a field. In order, therefore, to make plain the bearing of my remarks it may be well to state at the outset that I have little faith in any syphilitic stricture of the rectum, that has not been preceded by ulceration of that organ. Gummata may produce narrowing of the canal as in the cases reported by Zapula (Arch. f. derm. und syph., Prague) and Molliere, but certainly
Stem cell therapies for liver failure and cirrhosis
Authors: Zheng Zhang, Fu-Sheng Wang
Journal: Journal of Hepatology (2013)

Liver failure and cirrhosis occur as a result of a variety of chronic hepatic injuries. They display sequential and overlapping severe pathogenic processes that include severe inflammation, hepatocyte necrosis, and fibrosis/cirrhosis, and carry a high mortality rate [1]. There is a prevailing contradiction between the urgent need for liver transplants and a severe shortage of donor livers, which highlights the need to develop new therapeutic strategies for these conditions. Recent studies have shown that stem cell-based therapies may reduce liver inflammation, and subsequently improve scarring and replenish hepatocytes, which could be a promising strategy for patients with liver failure and cirrhosis [2].
Essential Role of Pre–B-Cell Colony Enhancing Factor in Ventilator-induced Lung Injury
Authors: Sang-Bum Hong, Yong Huang, Liliana Moreno-Vinasco, Saad Sammani, Jaideep Moitra, Joseph W. Barnard, Shwu-Fan Ma, Tamara Mirzapoiazova, Carrie Evenoski, Ryan R. Reeves, Eddie T. Chiang, Gabriel D. Lang, Aliya N. Husain, Steven M. Dudek, Jeffrey R. Jacobson, Shui Q. Ye, Yves A. Lussier, Joe G. N. Garcia
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

We previously demonstrated pre-B-cell colony enhancing factor (PBEF) as a biomarker in sepsis and sepsis-induced acute lung injury (ALI) with genetic variants conferring ALI susceptibility.To explore mechanistic participation of PBEF in ALI and ventilator-induced lung injury (VILI).Two models of VILI were utilized to explore the role of PBEF using either recombinant PBEF or PBEF(+/-) mice.Initial in vitro studies demonstrated recombinant human PBEF (rhPBEF) as a direct rat neutrophil chemotactic factor with in vivo studies demonstrating marked increases in bronchoalveolar lavage (BAL) leukocytes (PMNs) after intratracheal injection in C57BL/6J mice. These changes were accompanied by increased BAL levels of PMN chemoattractants (KC and MIP-2) and modest increases in lung vascular and alveolar permeability. We next explored the potential synergism between rhPBEF challenge (intratracheal) and a model of limited VILI (4 h, 30 ml/kg tidal volume) and observed dramatic increases in BAL PMNs, BAL protein, and cytokine levels (IL-6, TNF-alpha, KC) compared with either challenge alone. Gene expression profiling identified induction of ALI- and VILI-associated gene modules (nuclear factor-kappaB, leukocyte extravasation, apoptosis, Toll receptor pathways). Heterozygous PBEF(+/-) mice were significantly protected (reduced BAL protein, BAL IL-6 levels, peak inspiratory pressures) when exposed to a model of severe VILI (4 h, 40 ml/kg tidal volume) and exhibited significantly reduced expression of VILI-associated gene expression modules. Finally, strategies to reduce PBEF availability (neutralizing antibody) resulted in significant protection from VILI.These studies implicate PBEF as a key inflammatory mediator intimately involved in both the development and severity of ventilator-induced ALI.