tbuckley/cabot-search huggingface dataset:
Recognising and diagnosing autism in children and young people: summary of NICE guidance
Authors: G. Baird, H. R. Douglas, a. director, M. S. Murphy
Journal: BMJ (2011)

Autism affects children, young people, and adults and describes qualitative difference and impairments in reciprocal social interaction and communication behaviours combined with a restricted range of interests and rigid or repetitive behaviours. Autism is diagnosed when features meet the criteria defined in the ICD-10 (international classification of diseases, 10th revision)1 and the DSM-IV-TR (diagnostic and statistical manual of mental disorders, fourth edition, revised)2 for “pervasive developmental disorder” and have a considerable impact on function. Core autism behaviours are typically present in early childhood, but are not always apparent until the circumstances of the child or young person change—for example, when the child goes to nursery or primary school or moves to secondary school. Autism is also associated with several coexisting conditions including neurodevelopmental, medical, and mental health problems. Autism was once thought to be an uncommon developmental disorder, but recent studies have reported increased prevalence and the condition is now thought to occur in at least 1% of children.3 4 5 This has increased demand for diagnostic services for children and young people of all ages in the health service. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on how to recognise and diagnose autism in children and young people up to the age of 19 years.6 This summary focuses on recommendations for the non-specialist on how to recognise the condition and when to refer to a specialist autism team. NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Recognition of autism
Imbalance between levels of nitrogen oxides and peroxynitrite inhibitory activity in chronic obstructive pulmonary disease
Authors: H Kanazawa
Journal: Thorax (2003)

The prevalent theory concerning the pathogenesis of chronic obstructive pulmonary disease (COPD) is of an imbalance between oxidants and antioxidants in the lung. It has recently been reported that the production of peroxynitrite, an extremely potent oxidant, is increased in the airways of patients with COPD. A study was undertaken of the imbalance between the levels of nitrogen oxides and antioxidant activity against peroxynitrite in the airways of patients with COPD.Sputum induction was performed in 30 patients with COPD and 15 normal control subjects. Levels of nitrogen oxides, percentage of neutrophils, and interleukin 8 (IL-8) levels were measured in sputum samples, and peroxynitrite inhibitory activity was assayed by monitoring rhodamine formation.Nitrite and nitrate levels in induced sputum were significantly higher in patients with COPD than in normal controls (949 (133) microM v 621 (89) microM, p<0.001). In contrast, peroxynitrite inhibitory activity in induced sputum was significantly lower in patients with COPD than in normal controls (47.4 (12.7)% v 92.9 (3.9)%, p<0.001). There was a negative correlation between nitrite and nitrate levels and peroxynitrite inhibitory activity in induced sputum (r=-0.775, p<0.001). Peroxynitrite inhibitory activity was also significantly correlated with forced expiratory volume in 1 second (FEV(1)) % predicted (r=0.539, p=0.004), FEV(1)/FVC (r=0.512, p=0.006), and carbon monoxide transfer factor (TLCO) (r=0.486, p=0.009). Moreover, there was a significant negative correlation between peroxynitrite inhibitory activity and the degree of neutrophilic inflammation (percentage of neutrophils: r=-0.754, p<0.001; IL-8 levels: r=-0.497, p=0.007).Reduced peroxynitrite inhibitory activity and increased levels of nitrogen oxides are found in induced sputum from patients with COPD. An imbalance in nitrogen oxides and antioxidant defence may contribute to the pathogenesis of COPD.
Prediction of Critical Illness During Out-of-Hospital Emergency Care
Authors: Christopher W. Seymour, Jeremy M. Kahn, Colin R. Cooke, Timothy R. Watkins, Susan R. Heckbert, Thomas D. Rea
Journal: JAMA (2010)

Early identification of nontrauma patients in need of critical care services in the emergency setting may improve triage decisions and facilitate regionalization of critical care.To determine the out-of-hospital clinical predictors of critical illness and to characterize the performance of a simple score for out-of-hospital prediction of development of critical illness during hospitalization.Population-based cohort study of an emergency medical services (EMS) system in greater King County, Washington (excluding metropolitan Seattle), that transports to 16 receiving facilities.Nontrauma, non-cardiac arrest adult patients transported to a hospital by King County EMS from 2002 through 2006. Eligible records with complete data (N = 144,913) were linked to hospital discharge data and randomly split into development (n = 87,266 [60%]) and validation (n = 57,647 [40%]) cohorts.Development of critical illness, defined as severe sepsis, delivery of mechanical ventilation, or death during hospitalization.Critical illness occurred during hospitalization in 5% of the development (n = 4835) and validation (n = 3121) cohorts. Multivariable predictors of critical illness included older age, lower systolic blood pressure, abnormal respiratory rate, lower Glasgow Coma Scale score, lower pulse oximetry, and nursing home residence during out-of-hospital care (P < .01 for all). When applying a summary critical illness prediction score to the validation cohort (range, 0-8), the area under the receiver operating characteristic curve was 0.77 (95% confidence interval [CI], 0.76-0.78), with satisfactory calibration slope (1.0). Using a score threshold of 4 or higher, sensitivity was 0.22 (95% CI, 0.20-0.23), specificity was 0.98 (95% CI, 0.98-0.98), positive likelihood ratio was 9.8 (95% CI, 8.9-10.6), and negative likelihood ratio was 0.80 (95% CI, 0.79- 0.82). A threshold of 1 or greater for critical illness improved sensitivity (0.98; 95% CI, 0.97-0.98) but reduced specificity (0.17; 95% CI, 0.17-0.17).In a population-based cohort, the score on a prediction rule using out-of-hospital factors was significantly associated with the development of critical illness during hospitalization. This score requires external validation in an independent population.
Recognition of virus-infected cells by natural killer cell clones is controlled by polymorphic target cell elements.
Authors: M S Malnati, P Lusso, E Ciccone, A Moretta, L Moretta, E O Long
Journal: The Journal of Experimental Medicine (1993)

Natural killer (NK) cells provide a first line of defense against viral infections. The mechanisms by which NK cells recognize and eliminate infected cells are still largely unknown. To test whether target cell elements contribute to NK cell recognition of virus-infected cells, human NK cells were cloned from two unrelated donors and assayed for their ability to kill normal autologous or allogeneic cells before and after infection by human herpesvirus 6 (HHV-6), a T-lymphotropic herpesvirus. Of 132 NK clones isolated from donor 1, all displayed strong cytolytic activity against the NK-sensitive cell line K562, none killed uninfected autologous T cells, and 65 (49%) killed autologous T cells infected with HHV-6. A panel of representative NK clones from donors 1 and 2 was tested on targets obtained from four donors. A wide heterogeneity was observed in the specificity of lysis of infected target cells among the NK clones. Some clones killed none, some killed only one, and others killed more than one of the different HHV-6-infected target cells. Killing of infected targets was not due to complete absence of class I molecules because class I surface levels were only partially affected by HHV-6 infection. Thus, target cell recognition is not controlled by the effector NK cell alone, but also by polymorphic elements on the target cell that restrict NK cell recognition. Furthermore, NK clones from different donors display a variable range of specificities in their recognition of infected target cells.
The Influence of Gender, Race, and Marital Status on Survival in Lung Cancer Patients: Analysis of Radiation Therapy Oncology Group Trials
Authors: Farzan Siddiqui, Kyounghwa Bae, Corey J. Langer, James C. Coyne, Victoria Gamerman, Ritsuko Komaki, Hak Choy, Walter J. Curran, Deborah Watkins-Bruner, Benjamin Movsas
Journal: Journal of Thoracic Oncology (2010)
RENAL FUNCTION AS AFFECTED BY EXPERIMENTAL UNILATERAL KIDNEY LESIONS
Authors: T. F. Nicholson, R. W. I. Urquhart, D. L. Selby M.D.
Journal: The Journal of Experimental Medicine (1938)

1. A method is described for the production of a nephrosis in one kidney of an experimental animal. The normal kidney in the same animal is available for a control. 2. The nephrosis produced by the injection of 7.5 per cent sodium tartrate is limited to the proximal convoluted tubule. There is no histological evidence of glomerular damage. 3. This damage results in a disturbance of water and chloride excretion as well as a decrease in the clearances of urea, xylose, inulin, creatinine and phenol red, and is observed under conditions of no diuresis, sugar diuresis and salt diuresis. 4. Excreted ferrocyanide is found in the cells of the proximal tubule of the damaged kidney. It is not present in these cells in the normal kidney. This is taken to be evidence of back diffusion of ferrocyanide through the damaged cells. 5. The decrease in clearance of creatinine and inulin, which in the dog represent glomerular filtrate, may therefore be explained by back diffusion and is not necessarily due to glomerular change. 6. The phenol red clearance from the damaged kidney is diminished in relation to inulin. This is further evidence of depressed tubular activity.
Catheterization of the Left Ventricle in Man
Authors: MORRIS F. STEINBERG, ARTHUR SELIGMANN, IRVING G. KROOP, ARTHUR GRISHMAN
Journal: Circulation (1951)

Simultaneous catheterization of the left and right ventricles was performed in a case of right bundle branch block. It was thought that in right bundle branch block the polarity of the initial deflection of the potentials obtained in the left ventricular cavity could be studied without interference of those contributed by the right ventricular cavity. A description of the technic employed is given. The results confirm those obtained in dogs. There is initial negativity of the potentials obtained within the left ventricular cavity.
BMPs as Mediators of Roof Plate Repulsion of Commissural Neurons
Authors: Adela Augsburger, Anita Schuchardt, Sally Hoskins, Jane Dodd, Samantha Butler
Journal: Neuron (1999)

During spinal cord development, commissural (C) neurons, located near the dorsal midline, send axons ventrally and across the floor plate (FP). The trajectory of these axons toward the FP is guided in part by netrins. The mechanisms that guide the early phase of C axon extension, however, have not been resolved. We show that the roof plate (RP) expresses a diffusible activity that repels C axons and orients their growth within the dorsal spinal cord. Bone morphogenetic proteins (BMPs) appear to act as RP-derived chemorepellents that guide the early trajectory of the axons of C neurons in the developing spinal cord: BMP7 mimics the RP repellent activity for C axons in vitro, can act directly to collapse C growth cones, and appears to serve an essential function in RP repulsion of C axons.
Ultrastructural features and distribution of dendritic cells (DC) in portal infiltrates of patients with HCV-related chronic active hepatitis (CAH)
Authors: R.M.S. DeFranco, M.B. Gallè, R.G. Romanelli, P. Montalto, P. Gentilini, P. Romagnoli, M. Pinzani
Journal: Journal of Hepatology (2000)
Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy.
Authors: C A Bush, J M Stang, C F Wooley, J W Kilman
Journal: Circulation (1977)

Significant pericardial disease can exist without overt manifestations. Occult constrictive pericardial disease (OCPD) is identified by normal baseline hemodynamics and normal left ventricular systolic function with a characteristic response to rapid volume infusion. Following the intravenous administration of 1000 ml of normal saline over six to eight minutes, striking elevations of filling pressures are seen; however, diagnosis depends specifically upon a) the development of typical pressure pulse morphology of constriction, b) loss or reversal or respiratory variation of right atrial pressure, and c) precise diastolic equilibration of intracardiac pressures. Nineteen patients with OCPD have been identified in a five year period. Unexplained fatigue, dyspnea and chest pain was the uniform pattern of presentation. Eleven have undergone pericardiectomy resulting in a dramatic symptomatic improvement in all. Each demonstrated gross and/or microscopic evidence of pericardial disease. Recatheterization with volume infusion in five patients following pericardiectomy has revealed return to normal or near normal hemodynamics. This study describes the method for diagnosis of OCPD and recommends pericardiectomy for the management of disabling symptoms.
Gas exchange mechanism of orthodeoxia in hepatopulmonary syndrome
Authors: Federico P. Gómez, Graciela Martínez-Pallí, Joan A. Barberà, Josep Roca, Miquel Navasa, Robert Rodríguez-Roisin
Journal: Hepatology (2004)

The mechanism of orthodeoxia (OD), or decreased partial pressure of arterial oxygen (PaO 2 ) from supine to upright, a characteristic feature of hepatopulmonary syndrome (HPS), has never been comprehensively elucidated. We therefore investigated the intrapulmonary (shunt and ventilation-perfusion [V̇ A /𝑄̇] mismatching) and extrapulmonary factors governing PaO 2 in 20 patients with mild to severe HPS (14 males, 6 females; 50 ± 3 years old SE) at upright and supine, in random order. We set out a cutoff value for OD, namely a PaO 2 decrease ≥5% or ≥4 mm Hg (area under the receiver operating characteristic curve, 0.96 each). Compared to supine, 5 patients showed OD (PaO 2 change, −11% ± 2%, −7 ± 1 mm Hg, P &lt; .05) with further V̇ A /𝑄̇ worsening (shunt + low V̇ A /𝑄̇ mode increased from 19% ± 7% to 21% ± 7% of cardiac output [𝑄̇ T ], P &lt; .05), as opposed to 15 patients who did not (+2% ± 2%, +1± 1 mm Hg) with V̇ A /𝑄̇ improvement (from 20% ± 4% to 16% ± 4% of 𝑄̇ T , P &lt; .01). Cardiac output was significantly lower in OD patients in both positions. Changes in extrapulmonary factors at upright, such as increased minute ventilation and decreased 𝑄̇ T , were of similar magnitude in both subsets of patients. In conclusion , our data suggest that gas exchange response to OD in HPS points to a more altered pulmonary vascular tone inducing heterogeneous blood flow redistribution to lung zones with prominent intrapulmonary vascular dilatations. (Hepatology 2004;40:660-666.)
Points from letters: Sign of the times?
Authors: B W Perriss
Journal: BMJ (1976)

Government's spokesmen, including the Prime Minister, admit that the counter-inflation policy of 1975-6 was unjust to certain members of the community, including consultants on the incremental scale.They argue, however, that the steps were necessary in the national interest.The professions' negotiators did not 'acquiesce' in the imposition of this counterinflation policy, but vigorously opposed it- and succeeded in securing the modification for 1976-7 which has allowed the incremental scales to be reactivated.The withholding of contractual increments (and distinction awards) which has in effect meant for some consultants a 12-month wait for what they were entitled to was secured by the Remuneration, Charges, and Grants Act 1975-which rapidly went through Parliament without opposition and specifically allows employing authorities to breach contracts in this respect."-ED, BMJ. Keeping tabs on trainers
Intramural Pressure in the Left Ventricle of the Dog
Authors: G. Brandi, M. McGregor
Journal: Cardiovascular Research (1969)

Journal Article Intramural Pressure in the Left Ventricle of the Dog Get access Giorgio Brandi, Giorgio Brandi † From the McGill University Clinic of the Royal Victoria Hospital, Montreal, Canada † Present address: Instituto di Fisiologia dell Universita, Modena, Italy. Search for other works by this author on: Oxford Academic PubMed Google Scholar Maurice McGregor Maurice McGregor From the McGill University Clinic of the Royal Victoria Hospital, Montreal, Canada Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 3, Issue 4, October 1969, Pages 472–475, https://doi.org/10.1093/cvr/3.4.472 Published: 01 October 1969 Article history Received: 02 May 1969 Published: 01 October 1969
Part-time Training Programs
Authors: Leon G. Smith
Journal: JAMA (1978)

<h3>To the Editor.—</h3> St Michael's Medical Center was one of the first medical training schools to offer an individualized program to part-time interns and residents. Part-time residencies have been offered to practicing physicians, married women, researchers, and physicians with large debts. Because of the growing cost of medical education and the depletion of funds to pay house officers by third-party payers, we have had a great interest in the part-time program lately. This program has been particularly appealing to those with large financial responsibilities who are seeking highly specialized fellowships or miniresidencies in special skills. It has also attracted physicians who wish to transfer from one specialty to another. In all, seven house officers have participated in St Michael's program: five men and two women physicians. The programs were arranged to meet their individual needs. One American-trained woman, for example, did her internship over a three-year period during a time
Implantation of an Elastic Ring at Equator of the Left Ventricle Influences Cardiac Mechanics in Experimental Acute Ventricular Dysfunction
Authors: Paolo Ferrazzi, Michele Senni, Maria R. Iascone, Maurizio Merlo, Michele Triggiani, Roberto Lorusso, Paul Herijgers, Jan J. Schreuder, Samuele Pentiricci, Attilio Iacovoni, Eugenio Quaini
Journal: Journal of the American College of Cardiology (2007)
REVIEW OF THE OPERATIVE TECHNIQUE ADOPTED IN DETERMINING THE LOCATION OF INTESTINAL OBSTRUCTION, WITH THE SUGGESTION OF A SIMPLE AND SAFE METHOD.
Authors: ROBERT J. REED
Journal: JAMA (1898)

ing it seem preferable to other forms of operation usual in ordinary cases.Twice during the formation of the posterior flap, the patient complained of a smarting sensation following the use of the knife.The first time an injection of ster- ilized water removed the ground for complaint.The second time a little severer twinge from incision of that part of the flap lying next to the bone, showed that anes- thesia of that portion was not yet complete.A free application was then made with sterilized, borated
Catabolism of Very Low Density Lipoprotein B Apoprotein in Man
Authors: Michael F. Reardon, Noel H. Fidge, Paul J. Nestel
Journal: Journal of Clinical Investigation (1978)

The turnover and the catabolic fate of the B apoprotein of very low density lipoprotein (VLDL-B) was studied in 15 normal and hyperlipidemic subjects using reinjected autologous VLDL labeled with radioiodine. The specific radioactivity-time curve of the B apoprotein in total VLDL (S(f)20-400) was multiexponential but conformed to a two-pool model during the first 48 h of catabolism. The flux was highest in several hypertriglyceridemic subjects. The mass of pool A exceeded the intravascular content of VLDL-B by 30% on average, indicating extravascular metabolism of VLDL. The two-pool model might reflect the input of several populations of particles or heterogeneity of catabolic processes or pools. The flux of B apoprotein was also measured in several subclasses of VLDL, in smaller intermediate density lipoproteins, and in low density lipoproteins (LDL). In three subjects the flux was similar in S(f) 60-400 and in S(f) 12-60 lipoproteins, suggesting that VLDL was catabolized at least to a particle in the density range S(f) 12-60. Subsequent catabolism appeared to proceed by two pathways: in normotriglyceridemic subjects, B apoprotein flux in the S(f) 20-400 and in S(f) 12-20 lipoproteins was similar, whereas in hypertriglyceridemic subjects flux through S(f) 12-20 accounted for only part of the VLDL-B flux. The flux of low density lipoprotein B apoprotein (LDL-B), which is believed to be derived from VLDL catabolism, was calculated from the area between the specific activity time curves of VLDL-B and LDL-B. In subjects with normal plasma triglyceride concentration, LDL-B flux was from 91% to 113% of that of VLDL-B; but in three hypertriglyceridemic subjects showing high rates of VLDL-B transport, LDL-B flux was only one-third that of VLDL-B. This suggests that when VLDL-B flux is high, VLDL is substantially catabolized by a route other than through LDL and possibly leaves the circulation as a particle in the S(f) 20-60 density range.
Pulmonary model to predict the effects of series ventricular interaction.
Authors: R F Appleyard, S A Glantz
Journal: Circulation Research (1990)

To fully describe the mechanisms of diastolic interaction between the right ventricle and left ventricle, it is necessary to understand how a change in right ventricular output (Qrvo) is transmitted across the pulmonary circulation. This series ventricular interaction is manifest as the temporal response in left ventricular filling (Qlvf) to a change in Qrvo. To quantify series interaction we used a three-element, two-parameter model of the pulmonary circulation. The parameters represented the pulmonary arterial and venous resistance and pulmonary vascular compliance. Using beat-to-beat values of mean pressure and flow measured at the input and output of the pulmonary circulation during the transient response to caval or pulmonary artery occlusion, we estimated the parameters for this model in eight open-chest dogs under control conditions, after autonomic blockade, and after fully opening the pericardium. From 110 separate data episodes, the average values of the pulmonary arterial and venous resistance and pulmonary vascular compliance were 0.14 +/- 0.08 mm Hg.sec/ml and 4.81 +/- 3.17 ml/mm Hg (+/- SD). These estimates were insensitive to the simultaneous effects of autonomic reflexes and direct ventricular interaction, so they uniquely measure the bulk transport properties of the pulmonary circulation. The time constant, which measures the response of Qlvf to a change in Qrvo, averaged 0.26 +/- 0.15 second, which implies that effects of series interaction on Qlvf are manifest within one beat. The model was also able to predict the dynamic response of Qlvf to changes in Qrvo and thus can be used to measure and predict the effects of series interaction in the intact cardiopulmonary system.