tbuckley/cabot-search huggingface dataset:
Evidence-Based Diagnosis: A Handbook of Clinical Prediction Rules
Authors: Helen K. Delichatsios
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes3 September 2002Evidence-Based Diagnosis: A Handbook of Clinical Prediction RulesHelen K. Delichatsios, MD, SMHelen K. Delichatsios, MD, SMMassachusetts General Hospital, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00038 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Ebell MH. 398 pages. New York: Springer-Verlag; 2001. $49.95. ISBN 0387950257. Order at www.springer-ny.com.Field of medicine: Evidence-based medicine.Format: Softcover book and CD-ROM (for Windows 95 or higher).Audience: Clinicians, trainees, and students.Purpose: To provide a collection of clinical prediction rules available in the literature for making rational, evidence-based diagnoses and prognoses.Content: The first chapter is a brief introduction on using clinical prediction rules and a review of statistics terminology. The remainder of the book consists of more than 150 clinical prediction rules organized into 15 chapters covering the classic internal medicine disciplines (for example, gastroenterology, cardiovascular) ... Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, Massachusetts. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 September 2002Volume 137, Issue 5_Part_1Page: 380KeywordsClinical epidemiologyEvidence based medicineHip fracturesIschemiaOphthalmologyPatientsPediatricsPharyngitisSoftware toolsStreptococcal pharyngitis ePublished: 3 September 2002 Issue Published: 3 September 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CHANGES IN BODY COMPOSITION IN ACUTE RENAL FAILURE 1
Authors: L. W. Bluemle, H. P. Potter, J. R. Elkinton
Journal: Journal of Clinical Investigation (1956)

To a large degree the therapy of acute renal failure depends on an understanding of biochemical disturbances that result from the temporary ab- sence of renal excretory and homeostatic functions.Important among these disturbances are changes in the volume and composition of body fluids, par- ticularly with respect to electrolyte constituents.While certain manifestations of these changes are frequently recognized on the clinical level, rela- tively little quantitative data are available from which can be derived a general pattern of body fluid alterations in this disease.One reason for this paucity of information, aside from the limita- tions of investigative techniques, is the inherent difficulty of performing adequate studies on criti- cally ill patients.Sirota and Kroop (1) observed in 4 oliguric patients an expansion of inulin space roughly com- mensurate with estimated positive fluid balance.They postulated that the oliguric phase of acute renal failure is associated with cellular dehydra- tion resulting from a shift of water out of cells, and that hyponatremia may result in part from extracellular dilution and in part from a shift of sodium into cells.The observation by Schwartz, Tomsovic, and Schwartz (2) of greater expansion of inulin space than of D20 space in one anuric child would conform with this concept.Iseri, Batchelor, Boyle, and Myers (3) also suggested that the hyponatremia and hypochloremia of oli- guria may be due in part to cellular uptake of so- dium and shift of water from cells to extracellular fluid.'In one case (K.B.) dialysis was performed on the third day of study, and this day was omitted from the calculations.
Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update
Authors: Mark A. Williams, William L. Haskell, Philip A. Ades, Ezra A. Amsterdam, Vera Bittner, Barry A. Franklin, Meg Gulanick, Susan T. Laing, Kerry J. Stewart
Journal: Circulation (2007)

Prescribed and supervised resistance training (RT) enhances muscular strength and endurance, functional capacity and independence, and quality of life while reducing disability in persons with and without cardiovascular disease. These benefits have made RT an accepted component of programs for health and fitness. The American Heart Association recommendations describing the rationale for participation in and considerations for prescribing RT were published in 2000. This update provides current information regarding the (1) health benefits of RT, (2) impact of RT on the cardiovascular system structure and function, (3) role of RT in modifying cardiovascular disease risk factors, (4) benefits in selected populations, (5) process of medical evaluation for participation in RT, and (6) prescriptive methods. The purpose of this update is to provide clinicians with recommendations to facilitate the use of this valuable modality.
Gee-Thaysen Disease: Idiopathic Steatorrhoea of Adults and Adolescents in Non-tropical Countries
Authors: J. F. O'Sullivan, H. Moore
Journal: BMJ (1941)

This disease, of which two cases alre recorded her-e, has received considerable attention during the past decade.Coeliac disease was first described by Samuel Gee (1888) of London, and the condition as it occurs in adults and adolescents of non-tropical countries was first extensively studied by Thaysen (1929, 1932); hence the reason for the nomenclature, Gee-Thaysen disease, a name first suggested by Moore, O'Farrell, Geraghty, Hayden, and Moriarty (1936) and later supported by Mogensen (1937).These two cases came under the care of Prof. Henry Moore in the Mater Misericordiae Hospital, Dublin, since the puLblication of the ten cases described-by him and his co-workers in the paper mentioned above.Each has been fully investigated on the basis of the criteria then advanced.The recent work of Kantor (1939) has added what may prove another important diagnostic feature-i.e., roentgen- ological changes in the small intestine.These are (a) obliteration of the usual markings of the valvulae conni- ventes-the " moulage " sign; and (b) dilatation of the small intestine and segmentation of the contained barium into "clumps.*In neither of our cases can it be said that Kantor's lindings were discovered.In the previous series of cases from this hospital (Moore and others, 1936) three had duodenal abnormalities, and one of these (Case 4) showed " dLuodenal and jejunal delay with marked diminuition of the typical markings of these bowel segments."Treatmenit in both of our cases proved very gratifying.In this connexion the experiments of Barker and Rhoads (1937) are of interest.These aLuthors concluded that in tropical sprue the parenteral administration of liver extract exerts some specific effect upon the absorptive power of the snmall intestine.Blood-fat determinations in sprite patients before and after liver therapy, with normal
P13.19 * HYPOFRACTIONATED RADIOTHERAPY IN PATIENTS WITH HIGH GRADE GLIOMAS AND POOR PROGNOSTIC FACTORS: A RETROSPECTIVE STUDY
Authors: F. Moretto, C. Mantovani, N. Giaj Levra, M. Levis, C. De Colle, E. Trevisan, M. Magistrello, R. Ruda, R. Soffietti, U. Ricardi
Journal: Neuro-Oncology (2014)

PURPOSE: The standard treatment for patients with high-grade gliomas (HGG) and limited life expectancy is not well defined. Patients with an age over 65 years, poor Karnofsky performance status (KPS) and surgical biopsy/partial resection could not benefit from the combination of radiotherapy (60 Gy in 30 fractions) and chemotherapy with temozolomide (TMZ). In these patients hypofractionated radiotherapy (HypoRT) or TMZ alone have been suggested adequate treatments without significant differences in term of overall survival (OS) and progression free survival (PFS) compared to the standard approach. Furthermore, new clinical trials are investigating the role of a combination of HypoRT and TMZ. The aim of this retrospective study is to evaluate the outcome of HypoRT, with or without TMZ, in a cohort of HGG with poor prognostic factors. MATERIALS AND METHODS: Between January 2006 and December 2013, 69 patients with a diagnosis of HGG and poor prognostic factors (age ≥65 and/or KPS ≤60) were treated at our Institution. All patients were discussed in the Brain Tumor Board and treated with a dose of 42 Gy in 14 fractions with a conformal radiation treatment technique. TMZ was added either in elderly patients with no comorbidities or in poor KPS patients with younger age. Concomitant TMZ was given at a dose of 75 mg/m2 /d while adjuvant TMZ at a dose of 150-200 mg/m2 for 5 days every 28 days until tumor progression or unacceptable toxicity. During follow up a contrast-enhanced MRI was performed 4 weeks after the HypoRT, and thereafter every 3 months. The primary endpoint was overall survival (OS) measured from HypoRT start, according to the Kaplan-Meier method. RESULTS: Median age was 65 years (range, 34-80 years) and median KPS was 60 (range, 50-90). Fifty-four patients (78.3%) received a surgical resection (51 partial and 3 complete resections) and 15 patients (21.7%) underwent a biopsy. Fifty-eight patients had an histological diagnosis of glioblastoma, 7 of grade III glioma and 4 of high grade gliomas (not other specified). Five patients (7%) received concomitant, 5 (7%) concomitant and adjuvant and 13 (19%) adjuvant only TMZ. Median follow-up was 7.7 months (range, 1-34 months). The median survival time (MST) was 7 months; 6-month and 12-month OS rates were 54.4% and 29.5%, respectively. Univariate analysis was used to test the effects of prognostic factors on survival and none of these showed a statistical significance. After multivariate analysis there was a trend toward a better outcome with the addition of adjuvant TMZ (MST 9 vs. 6 months, Log Rank p = 0.06). CONCLUSIONS: Median survival of this cohort of HGG with poor prognostic factors is comparable to the data published in the literature. Adjuvant chemotherapy could improve OS, but prospectives studies with larger sample size and longer follow-up are needed.
Voting set to begin at GMC following retirement of Wendy Savage
Authors: Allison Barrett
Journal: BMJ (2005)

<i>The retirement of <b>Wendy Savage</b> from the General Medical Council opens up the first elected seat since 2003. Whoever wins her seat for the south east of England—voting is from 9 September to 7 October—will have a tough act to follow, says <b>Allison Barrett</b></i>
Inability of normal human intestinal macrophages to form multinucleated giant cells in response to cytokines.
Authors: S Fais, F Pallone
Journal: Gut (1995)

Multinucleated giant cells are an important feature of the granulomatous reaction in Crohn's disease (CD) but their cellular origin is poorly understood. The aim of this study was to discover if intestinal macrophages are capable of generating multinucleated giant cells in vitro in response to cytokine stimulation. Human intestinal macrophages were isolated from the intestinal mucosa of CD and uninflamed surgical specimens. Isolated macrophages were cultured in chamber slides with and without exposure to a panel of cytokines and cell activators. Cell fusion, multinucleated giant cells formation, and the expression of adhesion molecules were assessed at various time intervals. In contrast with the autologous peripheral monocytes cell fusion was very poor in cultures of control intestinal macrophages and virtually no multinucleated giant cells were seen. Control intestinal macrophages seemed to poorly express the adhesion molecules required for cell to cell adhesion and fusion, namely ICAM-1 and LFA-1. None of these functions was affected by the exposure to cytokines, including interferon gamma. In cultures of macrophages isolated from CD tissues multinucleated giant cell formation spontaneously occurred as early as three days and was not enhanced by the addition of cytokines. CD macrophages seemed to highly express both ICAM-1 and LFA-1. These data show that human intestinal macrophages are unable to form multinucleated giant cells in response to stimuli and support the concept that they are downregulated in a number of functions. The data also suggest that macrophages participating in the ganulomatous reaction in CD are recruited from the circulation.
Covert surveillance in Munchausen's syndrome by proxy An infringement of Human rights
Authors: G Tenney, R Wheatley, R A Wheeler, N Ade-Ajayi, E M Kiely, None Anonymous, M P Samuels, D Southall
Journal: BMJ (1994)

EDITOR, - According to Donald Evans, covert video surveillance is not clinical practice but part of a research activity that has not been scrutinised by the local research ethics committee.1 I am a mother who was investigated under covert video surveillance. After my baby repeatedly suffered attacks of apnoea we were referred to a tertiary centre in Staffordshire. We were provided with a home “event” monitor and recorder. Because of suspicions raised by doctors on the basis of the recordings I and my baby were put under secret observation in hospital. During the three weeks of secret observation my baby was kept in a cubicle for the whole time and not allowed out even for an hour; was kept connected to a physiological monitor for the whole of this time and not allowed out of her cot even for meals; and was not allowed to sit in a high chair for feeding - I had to feed her through the bars. I was not allowed to bath her during this time, and, even though she was walking when she went in to hospital, by the time she came out she could not walk. During this period of secret observation I was not offered any respite by the staff and was not offered food. I had to ask a nurse to sit with my daughter so that I could get food. I had no food at all one day because the nurses were too busy to relieve me. Being filmed in this way infringed my human rights and my rights as a mother. 1. 1.↵1. Evans D .Letter. Covert video surveillance in Munchausen's syndrome by proxy.BMJ1994;308: 34. (29 January.) [OpenUrl][1] # Clinical investigation, not research activity {#article-title-3} EDITOR, - In his letter on the ethics of covert video surveillance Donald Evans misses an important point, 1 especially given recent media interest in the matter. For the unwitting subjects (the children) described by Samuels et … [1]: {openurl}?query=rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx
Tissue response to poly(ether)urethane-polydimethylsiloxane-fibrin composite scaffolds for controlled delivery of pro-angiogenic growth factors
Authors: Paola Losi, Enrica Briganti, Angela Magera, Dario Spiller, Chiara Ristori, Barbara Battolla, Michela Balderi, Silvia Kull, Alberto Balbarini, Rossella Di Stefano, Giorgio Soldani
Journal: Biomaterials (2010)
Estrogen-Induced Hypercalcemia
Authors: Peter Boasberg
Journal: JAMA (1973)

<h3>To the Editor.—</h3> I feel that it is appropriate for Drs. Swaroop and Krant to point out the dangers of early estrogen-produced hypercalcemia in patients with metastatic breast cancer (223:913, 1973). It is not well known that the development of hypercalcemia may not, in fact, be deleterious but rather an encouraging prognostic sign, indicating sensitivity of the tumor to sex hormones. Hall et al demonstrated that of 269 patients placed on estrogen therapy, 13 developed hypercalcemia; six of these were able to tolerate treatment for more than two months.<sup>1</sup>Of the remaining patients, three showed regression of the disease, two remained stable, and one showed progression. In patients who developed intolerable hypercalcemia, cessation of therapy followed by reinduction of hormone after the institution of methotrexate can block the hypercalcemic action without interfering with the antitumor effect of the sex hormones and, therefore, allow continued estrogen therapy.<sup>2</sup> Awareness of
Change, we have to
Authors: Gabriele Medley
Journal: Journal of the Royal Society of Medicine (2009)

In my 50th year in the profession, it has become almost an expectation among my young colleagues that I should hark back frequently to the ‘good old days’, but it would be churlish to do so as there has been so much ‘change for the good’. However there is a fundamental change that has happened quite surreptitiously but threatens to bankrupt healthcare systems, at least in Britain and Australia. It is what I have called the ‘millefeuille’ pnenomenon (millefeuille – a rich confection of thin layers of puff pastry and a filling of jam, cream, etc. – Shorter Oxford Dictionary on historical principles. Sixth edition).

The thin ‘vanilla slice’ of my childhood is now quite unmanageable in its transformed existence.

Between the substance of the top (funding) layer and the bottom (healthcare ‘coal face’) layer there is an ever-burgeoning layer, upon which one cannot get a grip, that is absorbing money, like a sponge, leaving the bottom layer dry and poor. The more that is poured into the top, the more is soaked up in a conglomerate that acts with a kind of ‘Brownian motion’ often with the only apparent purpose of sustaining itself.

I believe the only possible solution, so far offered, was by Douglas Adams in The Hitchhikers Guide to the Galaxy, or perhaps the sequel, The Restaurant at the End of the Universe, when the entire ‘management layer’ of this planet was decanted onto another small and distant planet out in space.

Perhaps the current ‘recession’ might start to ration this layer, which is, of course, not the sole prerogative of the healthcare sector. However I fear it will continue to thrive as more and more ‘accountability’ and ‘measuring’ initiatives flood into the system.

Our students, now moving from ‘people-based’ learning to ‘problem-based’ learning, no longer need to know how the body ‘functions and disfunctions’. With the ability to key in the problem and have immediate access to the solution, there is no longer the need to ask ‘why’ and ‘how’, and eventually there is a strong risk that they will just be progressively replaced, or blend into the amorphous ballooning filling of the ‘millefeuille’.
Intercellular interactions and cytokine responsiveness of peritoneal alpha/beta and gamma/delta T cells from Listeria-infected mice: synergistic effects of interleukin 1 and 7 on gamma/delta T cells.
Authors: M J Skeen, H K Ziegler
Journal: The Journal of Experimental Medicine (1993)

Peritoneal gamma/delta T cells from Listeria-immune mice show an enhanced potential to expand when restimulated with antigens or mitogens in vitro (see companion paper [Skeen, M. J., and H. K. Ziegler. 1993. J. Exp. Med. 178:971]). When cocultured with peritoneal alpha/beta T cells, the gamma/delta T cell population expanded preferentially even when the in vitro stimulus was specific for the alpha/beta T cell population. Purified gamma/delta T cells did not respond to alpha/beta T cell-specific stimuli. If isolated T cell subsets were recombined in cell mixing experiments, the resulting proliferative response was greater than additive. Irradiated alpha/beta T cells could enhance the proliferation of responding gamma/delta T cells, but the effect was unidirectional; i.e., irradiated gamma/delta T cells did not stimulate responding gamma/delta T cells. This effect appeared to be cytokine mediated and did not require cell-cell contact. Both recombinant interleukin 2 (rIL-2) and rIL-7 could support the expansion of the gamma/delta T cells, while rIL-7 was only minimally stimulatory for the alpha/beta T cells. The magnitude of the response by gamma/delta T cells to rIL-7 exceeded the response to other in vitro stimuli, including immobilized anti-T cell receptor monoclonal antibody, and was 50-100-fold greater than the alpha/beta T cell response to IL-7. This unique sensitivity of gamma/delta T cells to IL-7 was strongly enhanced by the presence of accessory cells. These cells could be replaced by rIL-1, establishing a synergy for IL-1 and IL-7 as factors that could uniquely stimulate this gamma/delta T cell population. Isolated peritoneal gamma/delta T cells from Listeria-immune mice react to heat-killed Listeria preparations in the presence of macrophages accessory cells in a non-H-2-restricted manner. Considered collectively, these results suggest a potential mechanism by which gamma/delta T cells can predominate in epithelial tissues and at sites of infection.
Interferons and Interferon Inducers
Authors: Daniel L. Weiss
Journal: JAMA (1973)

The fascinating field of the interferons is thoroughly reviewed and brought up to date in this fine volume in the series,<i>Frontiers of Biology</i>. Though a multiauthored presentation, it contains surprisingly little redundancy, a compliment to the editor, N. B. Finter. Following a brief historical review that traces the development of the concept of interferons, a careful and revealing chapter presents the criteria that define a viral inhibitor as an interferon and a documented survey of the biological properties of those substances accepted as interferons. This is a particularly useful chapter, since it cites studies at various levels of observation from gross data on viral growth to intracellular information. Following are two chapters on interferon inducers, one on animal viruses and the second on nonviral substances that induce interferons. Together, these two chapters offer an insight into the problem. They also serve as fine starting points for those who wish
Dendritic cell counts in the peripheral blood of healthy adults
Authors: Joanne Haller Hasskamp, John Louis Zapas, Elias George Elias
Journal: American Journal of Hematology (2005)

Abstract The normal range for adult blood dendritic cells (DC) has not been established. Blood DC counts were assayed directly from blood for 16 female and 11 male healthy adults with an age range of 22–60 years old (median, 46 years). DC were defined as lineage 1‐negative/dim, CD34‐negative/dim, and HLA‐DR‐positive within the total peripheral blood leukocyte (PBL) population. Impedance counter complete blood counts were used with flow cytometry percentages to calculate the absolute DC count and DC percentage of mononuclear cells (MNC). The normal adult ranges for DC calculated as the mean ± 2SD were 0.16–0.68% PBL, 0.55–1.63% MNC, and 13–37 DC/μL of blood. Am. J. Hematol. 78:314–315, 2005. © 2005 Wiley‐Liss, Inc.
Mapping of a Gene Causing Familial Mediterranean Fever to the Short Arm of Chromosome 16
Authors: Elon Pras, Ivona Aksentijevich, Luis Gruberg, James E. Balow, Leandrea Prosen, Michael Dean, Alfred D. Steinberg, Mordechai Pras, Daniel L. Kastner
Journal: New England Journal of Medicine (1992)

Familial Mediterranean fever is an autosomal-recessive disease characterized by acute attacks of fever with sterile peritonitis, pleurisy, or synovitis. The biochemical basis of the disease is unknown, but determining the chromosomal location of the gene for the disorder should be a first step toward defining the biochemical events.
THE SOMATIC ANTIGEN OF A PHAGE-RESISTANT VARIANT OF PHASE II SHIGELLA SONNEI
Authors: Walther F. Goebel, Margeris A. Jesaitis
Journal: The Journal of Experimental Medicine (1952)

1. A phage-resistant variant of Phase II Shigella sonnei has been isolated and the type-specific antigen from it has been obtained. 2. The antigen of the variant microorganism, II/3, 4, 7, differs from that of the parent Phase II bacillus in serological specificity and in chemical make-up. 3. Although the antigen of Phase II Sh. sonnei inhibits all T phages to which the bacillus is susceptible, that of the variant fails to inhibit T(3), T(4), and T(7).
587 BONE-MARROW DERIVED DENDRITIC CELLS CAN EFFECTIVELY BE PULSED BY HBVSVP AND INDUCE SPECIFIC IMMUNE RESPONSES IN BALB/C MICE
Authors: M. Saad-Farag, B. Hoyler, J. Encke, W. Stremmel, K. Weigand
Journal: Journal of Hepatology (2009)