tbuckley/cabot-search huggingface dataset:
Emergent Suicidality in a Clinical Psychotherapy Trial for Adolescent Depression
Authors: Jeffrey A. Bridge, Rémy P. Barbe, Boris Birmaher, David J. Kolko, David A. Brent
Journal: American Journal of Psychiatry (2005)

OBJECTIVE: The authors’ goal was to examine the incidence and predictors of emergent suicidality that occurred during a clinical trial of psychotherapy for adolescent depression. METHOD: The rates and predictors of emergent suicidality in 88 medication-free depressed adolescent outpatients who reported no current suicidality during an intake interview were assessed over 12 to 16 weeks of psychotherapy treatment. RESULTS: The incidence of emergent suicidality was 12.5% (11 of 88 subjects). Self-reported suicidal thoughts at intake were a significant predictor of emergent suicidality, even when suicidality was denied at intake interview. CONCLUSIONS: Emergent suicidality is a common occurrence in psychosocial treatment of adolescent depression, with rates similar to those reported recently in antidepressant trials. To evaluate accurately the role of treatment in emergent suicidality, it is important to assess self-reported suicidality at intake and to balance treatment groups on this key predictor of emergent suicidality.
Efficacy of oseltamivir treatment started within 5 days of symptom onset to reduce influenza illness duration and virus shedding in an urban setting in Bangladesh: a randomised placebo-controlled trial
Authors: Alicia M Fry, Doli Goswami, Kamrun Nahar, Amina Tahia Sharmin, Mustafizur Rahman, Larisa Gubareva, Tasnim Azim, Joseph Bresee, Stephen P Luby, W Abdullah Brooks
Journal: The Lancet Infectious Diseases (2013)
Contrast-enhanced harmonic endoscopic ultrasound
Authors: A. Săftoiu, C. Dietrich, P. Vilmann
Journal: Endoscopy (2012)

Second-generation intravenous blood-pool ultrasound contrast agents are increasingly used in endoscopic ultrasound (EUS) for characterization of microvascularization, differential diagnosis of benign and malignant focal lesions, and improving staging and guidance of therapeutic procedures. Although initially used as Doppler signal enhancers, second-generation microbubble contrast agents are now used with specific contrast harmonic imaging techniques, which benefit from the highly nonlinear behavior of the microbubbles. Contrast-specific modes based on multi-pulse technology are used to perform contrast-enhanced harmonic EUS based on a very low mechanical index (0.08 – 0.12). Quantification techniques based on dynamic contrast-enhanced ultrasound have been recommended for perfusion imaging and monitoring of anti-angiogenic treatment, mainly based on time–intensity curve analysis. Most of the clinical applications include the differential diagnosis of focal pancreatic masses, with adenocarcinoma having a distinct hypovascular (hypo-enhanced) appearance compared with neuroendocrine tumors, which are hypervascular (with strong arterial hyper-enhancement). However, pseudotumoral chronic pancreatitis and autoimmune pancreatitis also have an iso- or hypervascular appearance, making the differential diagnosis difficult. Even more promising is the use of dynamic contrast-enhanced harmonic EUS for the longitudinal monitoring of the effects of chemotherapy and/or anti-angiogenic therapy in advanced digestive cancers, which are difficult to examine by conventional cross-sectional imaging techniques.
Medical Management of Kidney and Electrolyte Disorders
Authors: Mark A. Perazella
Journal: Annals of Internal Medicine (2001)

Medical Writings: Book Notes4 September 2001Medical Management of Kidney and Electrolyte DisordersMark A. Perazella, MDMark A. Perazella, MDSection of Nephrology, Yale University, New Haven, Connecticut (Perazella).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Gennari FJ, ed. 613 pages. New York: Marcel Dekker; 2001. $195.00. ISBN 0824788699. Order phone 800-228-1160.Field of medicine: Clinical nephrology.Format: Hardcover book.Audience: Primary care physicians, generalists, nephrology fellows, housestaff, and medical students.Purpose: To provide a comprehensive yet concise review of important topics in nephrology and to reduce confusion and improve understanding of clinical problems associated with various kidney diseases and hypertensive disorders.Content: The book is organized into three parts, each of which emphasizes a different approach to similar clinical issues in nephrology. The first 4 chapters describe the major symptoms of common clinical renal and ... Author, Article, and Disclosure InformationAffiliations: Section of Nephrology, Yale University, New Haven, Connecticut (Perazella). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 September 2001Volume 135, Issue 5Page: 392KeywordsChronic kidney diseaseKidneysMedical dialysisNephrologyPrimary care physiciansRenal diseasesRenal failureRenal physiologyResearch laboratoriesSoftware tools ePublished: 4 September 2001 Issue Published: 4 September 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Medium-Term Exposure to Traffic-Related Air Pollution and Markers of Inflammation and Endothelial Function
Authors: Stacey E. Alexeeff, Brent A. Coull, Alexandros Gryparis, Helen Suh, David Sparrow, Pantel S. Vokonas, Joel Schwartz
Journal: Environmental Health Perspectives (2011)

Exposure to traffic-related air pollution (TRAP) contributes to increased cardiovascular risk. Land-use regression models can improve exposure assessment for TRAP.We examined the association between medium-term concentrations of black carbon (BC) estimated by land-use regression and levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1), both markers of inflammatory and endothelial response.We studied 642 elderly men participating in the Veterans Administration (VA) Normative Aging Study with repeated measurements of sICAM-1 and sVCAM-1 during 1999-2008. Daily estimates of BC exposure at each geocoded participant address were derived using a validated spatiotemporal model and averaged to form 4-, 8-, and 12-week exposures. We used linear mixed models to estimate associations, controlling for confounders. We examined effect modification by statin use, obesity, and diabetes.We found statistically significant positive associations between BC and sICAM-1 for averages of 4, 8, and 12 weeks. An interquartile-range increase in 8-week BC exposure (0.30 μg/m3) was associated with a 1.58% increase in sICAM-1 (95% confidence interval, 0.18-3.00%). Overall associations between sVCAM-1 and BC exposures were suggestive but not statistically significant. We found a significant interaction with diabetes-where diabetics were more susceptible to the effect of BC-for both sICAM-1 and sVCAM-1. We also observed an interaction with statin use, which was statistically significant for sVCAM-1 and suggestive for sICAM-1. We found no evidence of an interaction with obesity.Our results suggest that medium-term exposure to TRAP may induce an increased inflammatory/endothelial response, especially among diabetics and those not using statins.
Myocardial release of lactate, inosine and hypoxanthine during atrial pacing and exercise-induced angina.
Authors: G Kugler
Journal: Circulation (1979)

The coronary venous efflux of lactate, inosine and hypoxanthine during pacing-induced angina has been compared with myocardial extraction of the catabolites during exercise-induced angina. Inosine and hypoxanthine were analyzed by enzyme assay after separation by column chromatography. Myocardial lactate extraction at rest (15 +/- 9%, mean +/- SD) was converted to production levels (-34 +/- 26%) during pacing-induced angina (p less than 0.0005) and increased (24 +/- 13%) during exercise (p less than 0.05). The arterial values at rest (850 +/- 330 mumol/1) were unchanged during pacing and increased five-fold during exercise (4380 +/- 1860 mumol/1). The mean myocardial inosine extraction at rest (33 +/- 10%) was transformed to release values (-41 +/- 30%) during pacing (p less than 0.0005) as well as during exercise (-20 +/- 27%) (p less than 0.0005). The hypoxanthine extraction at rest (25 +/- 11%) decreased during pacing (-7.8 +/- 29%) (p less than 0.0025) and exercise (10 +/- 25%) (NS). The slight increase of arterial inosine and hypoxanthine values was not significant. Myocardially produced lactate, a sensitive marker of pacing-induced ischemia, was obscured by elevated arterial concentrations during exercise. However, inosine significantly correlated with lactate during pacing, and was useful in detecting ischemic myocardial energy deficiency during exercise-induced angina.
Charting speech with bats without requiring maps
Authors: Jagmeet S. Kanwal
Journal: Behavioral and Brain Sciences (1998)

The effort to understand speech perception on the basis of relationships between acoustic parameters of speech sounds is to be recommended. Neural specializations (combination-sensitivity) for echolocation, communication, and sound localization probably constitute the common mechanisms of vertebrate auditory processing and may be essential for speech production as well as perception. There is, however, no need for meaningful maps.
An Address ON THE MODERN TREATMENT OF SURGICAL TUBERCULOSIS: Delivered before the Windsor Medical Society
Authors: V. W. Low
Journal: BMJ (1908)

This treatment can at present only be employed in a few cases owing to the labour and time involved in the opsonic determination, but it promises to be of real value, and may at any time become of more general application if a simpler measure of its effects than the opsonic index be found.To sum up.The aims of the practitioner should be In the first instance to prevent infection; failing this, to establish the diagnosis as early as possible, and to employ every available means of improving the general health of the child with the object of increasing its protective powers.UJnder such conditions, the outlook In a considerable proportion of the cases is distinctly favourable.
Abstract 434: Radiation-induced matrix metalloprotease-9 promotes mesenchymal transition of Daoy cells and initiates activation of pro-matrix metalloprotease-2.
Authors: Arun Kumar Nalla, Swapna Asuthkar, Venkata Ramesh Dasari, Jasti S. Rao
Journal: Cancer Research (2013)

Abstract Ionizing radiation is an efficient therapeutic modality against cancer and a potent carcinogenic agent with the ability to alter cellular genotype. Earlier, we reported that medulloblastoma cells exposed to ionizing radiation showed enhanced invasive and adhesive characteristics. Invasion is the cumulative effort of cells to degrade the extracellular matrix (ECM) and to modulate cellular phenotype to invade the ECM. Therefore, we examined the modulation gained by irradiated medulloblastoma cells leading to enhanced invasiveness. Radiation-induced invasion increased with the increase in the recovery time after radiation treatment and was identified to be associated with MMP-9/MMP-2 activity. Radiation enhanced the expression of MMP-9 and induced the cleavage of pro-MMP-2 into active form, and the latter was associated with MT-MMP-1 expression. A significant time lag observed between the radiation exposure time and MMP-2 activation was identified as a period required for the irradiated cells to acquire cellular alteration, such as mesenchymal characteristics. Recombinant protein(s) and inhibitor(s) studies demonstrated that radiation-induced MT-MMP-1 expression and MMP-2 activation are in harmony with JNK activation. MMP-9 gene silencing and protein supplementation studies confirmed that MMP-9 activates JNK signaling and potent inducers of mesenchymal markers such as Snai1 and N-Cadherin. Further, gene-specific silencing of either MMP-9 or N-Cadherin showed significant reduction of MMP-2 activation in irradiated Daoy cells. Collectively, our results provide an insight on the role of MMP-9 in radiation-induced invasion and in initiating signaling cascades that modulate Daoy cells to acquire mesenchymal characteristics and activate MMP-2. Citation Format: Arun Kumar Nalla, Swapna Asuthkar, Venkata Ramesh Dasari, Jasti S. Rao. Radiation-induced matrix metalloprotease-9 promotes mesenchymal transition of Daoy cells and initiates activation of pro-matrix metalloprotease-2. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 434. doi:10.1158/1538-7445.AM2013-434
Effects of salmeterol and terbutaline on IgE-mediated dermal reactions and inflammatory events in skin chambers in atopic patients
Authors: R. Grönneberg, M. van Hage‐Hamsten, G. Halldén, J. Hed, J. Raud
Journal: Allergy (1996)

The objective of the present study was to investigate the potential of the long‐acting p‐aonist salmeterol as an inhibitor of various components of IgE‐mediated inflammation in man. For this purpose, we measured gross skin reactivity (diameters of wheal and flare reaction [WFR] and late cutaneous reaction [LCR]) as well as inflammatory cells, mediators, and protein in cutaneous suction blister chambers in eight subjects with allergic rhinitis. Blisters were induced, two on each forearm, by gentle suction and heating, and were unroofed 12 h later, after which plastic chambers were placed over the denuded area. The chambers were challenged for 2 h with antihuman IgE (titer 1:10) in the presence and absence of salmeterol or terbutaline. Normal goat IgG served as negative control. Chamber fluids were removed hourly for the first 4 h, and this was followed by a 4‐h incubation before final collection. Salmeterol (10 ‐6 M) and terbutaline (10 ‐5 M) injected intradermally 30 min before, as well as together with anti‐IgE (titer 1:100), inhibited the WFRs by up to 30%. The effect of salmeterol on the ensuing LCR (75% inhibition at 24 h) tended to be more pronounced than the corresponding inhibition by terbutaline. Both salmeterol and terbutaline very effectively inhibited the anti‐IgE‐induced extravasation of α 2 ‐macroglobulin into skin chambers, with a significantly more sustained effect by salmeterol. Interestingly, only terbutaline reduced the histamine release evoked by anti‐IgE. With the present experimental design, where both drugs were washed out from the chambers after 2 h, neither drug inhibited recruitment of leukocytes (including eosinophils). Taken together, salmeterol had a more sustained inhibitory effect than terbutaline on indices of IgE‐mediated edema formation (late induration and plasma protein extravasation). On the other hand, under the present experimental conditions, salmeterol failed to reduce the histamine release (in contrast to terbutaline), and neither salmeterol nor terbutaline affected the recruitment of leukocytes.
Myocardial glucose utilization and the optimization of F-18-FDG PET imaging in patients with NIDDM, CAD and LV dysfunction
Authors: George Vitale, Terrence D. Ruddy, Rob A. deKemp, LeAnne N. Golanowski, May T. Aung, Barbara A. Aubrey, Rob S.B. Beanlands
Journal: Journal of the American College of Cardiology (1998)
WHO is accused of "crying wolf" over swine flu pandemic
Authors: R. Watson
Journal: BMJ (2010)

Three separate international inquiries will soon be investigating the World Health Organization’s decision to declare the H1N1 virus a pandemic. The most advanced, being conducted by the Council of Europe, began in January.

Also, support is growing inside the European parliament for members to conduct their own investigation, and WHO itself will set up an independent review committee later this month.

Paul Flynn, the British Labour MP who is drafting the report of the Council of Europe’s investigation into the pandemic, believes that the discrepancy between the scale of the warnings and the actual effect of the …
Quantitation of Passive Cutaneous Anaphylaxis (PGA) by Using Radiolabelled Antigen
Authors: Johannes Ring, Jorgen Seifert, Walter Brindel
Journal: Allergy (1978)

The major problem of detecting reaginic antibody by passive cutaneous anaphylaxis IPCA) is the quantitation of the dye reaction. Radiolabelled antigen was used in an attempt to quantitate the PCA reaction (Radio‐PCA). Antisera containing reaginic antibody against human serum albumin (HSA) were produced in rabbits. These antisera were injected into normal rabbit skin in different dilutions. Twenty‐four hours later BSA was injected intravenously either with Evans Blue or as 125‐1‐HSA. Radioactivity found in antibody‐containing skin was significantly higher than in control specimens containing saline or normal rabbit serum, as low as antiserum dilutions of 1:1,000. Compared with the Evans Blue technique Radio‐PCA was able to distinguish quantitatively between different antiserum dilutions at a higher level of statistical significance.
Evidence for Positive Selection on the Floral Scent Gene Isoeugenol-O-methyltransferase
Authors: T. J. Barkman
Journal: Molecular Biology and Evolution (2003)

Isoeugenol-O-methyltransferase (IEMT) is an enzyme involved in the production of the floral volatile compounds methyl eugenol and methyl isoeugenol in Clarkia breweri (Onagraceae). IEMT likely evolved by gene duplication from caffeic acid-O-methyltransferase followed by amino acid divergence, leading to the acquisition of its novel function. To investigate the selective context under which IEMT evolved, maximum likelihood methods that estimate variable d(N)/d(S) ratios among lineages, among sites, and among a combination of both lineages and sites were utilized. Statistically significant support was obtained for a hypothesis of positive selection driving the evolution of IEMT since its origin. Subsequent Bayesian analyses identified several sites in IEMT that have experienced positive selection. Most of these positions are in the active site of IEMT and have been shown by site-directed mutagenesis to have large effects on substrate specificity. Although the selective agent is unknown, the adaptive evolution of this gene may have resulted in increased effectiveness of pollinator attraction or herbivore repellence.
Opportunity knocks: health wins from action on global warming
Authors: I. Roberts
Journal: BMJ (2009)

Will health make it on to the agenda at next month’s United Nations climate change talks in Copenhagen? Concerned that the links between fossil fuel energy use and human health are being overlooked, <b>Ian Roberts</b> talked to England’s chief medical officer to find out what he thinks doctors and health services in high income countries could be doing. He also canvases expert opinion from Bangladesh, where many people are already experiencing the health effects of climate change
Methodologic Problems in Health Manpower Research
Authors: Elkhanan Lahav
Journal: New England Journal of Medicine (1967)

WITH the development and extension of health services and health legislation, the importance of human resources or health manpower has increasingly been recognized. To give an example, McNerney1 stated, in his important study of medical economics in Michigan, that "Too often the problems of manpower are overlooked, and this can be a fatal flaw in planning. The practicability of any change or alternative must ultimately rest on the supply of relevant skills available to do the work."The problem of the spatial distribution of physicians, paramedical personnel, health services and facilities has come to a focus since the recognition of . . .
Plasma levels of granulocyte elastase‐α<sub>1</sub>‐proteinase inhibitor complex in patients with disseminated intravascular coagulation: Pathophysiologic implications
Authors: Kenji Okajima, Ryuji Fujise, Yuichi Motosato, Masato Ushijima, Hiroaki Okabe, Kiyoshi Takatsuki
Journal: American Journal of Hematology (1994)

To investigate the role of neutrophil activation in the pathophysiology and sequelae of disseminated intravascular coagulation (DIC), we measured plasma levels of granulocyte elastase-alpha 1-proteinase inhibitor complex (GEPIC) in 41 patients with DIC and 27 patients with similar underlying conditions but without DIC. Mean GEPIC levels were significantly higher in patients with DIC (421.0 +/- 45.6 ng/ml) than in patients without DIC (246.1 +/- 41.9 ng/ml, P < 0.01). Significant differences were also noted in DIC patients with or without infection (474.7 +/- 61.2 ng/ml vs. 302.4 +/- 48.9 ng/ml, P < 0.04), with or without organ dysfunction (546.6 +/- 72.7 ng/ml vs. 305.6 +/- 42 ng/ml, P < 0.01), and with or without respiratory failure (640.0 +/- 91.2 ng/ml vs. 328.1 +/- 55.1 ng/ml, P < 0.01). No significant difference was found in mean GEPIC levels in DIC patients with or without renal failure, heart failure, hepatic failure, or gastrointestinal bleeding. The frequency of respiratory failure correlated with rising plasma levels of GEPIC. Mortality was higher in patients with GEPIC levels > 500 ng/ml (53.8%) than in patients with GEPIC levels < 500 ng/ml (28.6%). This correlation was particularly strong in patients with DIC, infection, and respiratory failure. Based on these data, we suggest that neutrophil activation, triggered by the coagulation cascade and perhaps augmented by endotoxin or cytokine release with infection, significantly contributes to respiratory failure and mortality in patients with DIC.
Indium-111 platelet scintigraphy for the diagnosis of acute venous thrombosis.
Authors: M D Ezekowitz, C F Pope, H D Sostman, E O Smith, M Glickman, S Rapoport, K W Sniderman, G Friedlaender, R R Pelker, F B Taylor
Journal: Circulation (1986)

Platelets labeled with indium-111 have been used successfully as a marker of active thrombosis in man. To establish the diagnostic accuracy of platelet scintigraphy in comparison to contrast venography in the diagnosis of acute lower limb venous thrombosis, we evaluated 103 consecutive patients divided into two groups. Platelets were labeled by the indium-111 oxine method. Patients from group I (n = 73, 56 had venograms) were asymptomatic and underwent platelet scintigraphy 1.1 +/- 0.6 days (mean +/- 1 SD) after a major orthopedic procedure. Patients from group II (n = 30, all had venograms) were symptomatic and underwent platelet scintigraphy 1.2 +/- 1.7 days after venography. In group II, 15 patients with positive findings on contrast venography were treated with intravenous heparin; five others with positive venograms did not receive heparin until platelet scintigraphy was completed. Both platelet scintigraphy and contrast venography were evaluated by two blinded observers. Only studies with blinded agreement of both platelet scintigraphy and contrast venography were included in the analysis. Sensitivity and specificity of platelet scintigraphy for the whole limb were 93% and 97% in group I and 42% and 67% in group II. The lower sensitivity in group II was most likely attributable to therapy with heparin. These results demonstrate that platelet scintigraphy, a test that permits imaging for up to five days after a single injection, correlates favorably with contrast venography in patients who have not received heparin and may be used as a surveillance test in high-risk patients. The role of platelet scintigraphy in acutely symptomatic patients requires further evaluation.
Bed blocking for beginners
Authors: C. Douglas
Journal: BMJ (1999)

For many years now our students have returned to base from their scattered clinical attachmentswith a case presentation for their final session.

We are not looking for traditional grand rounds material—in which the obscurity of the diagnosis is matched only by the modest diagnostic sagacity of the team involved—but for the really difficult stuff: the kind of case where people had to stop, reflect, worry, or even argue not about biomedical issues, great or small, but about social or ethical aspects of …