tbuckley/cabot-search huggingface dataset:
PTH-129 A Retrospective Audit Of Peg Indications And Complications At A District General Hospital Following The Introduction Of A Multi-disciplinary Nutrition Team
Authors: M. Abdulla, N. Mitha, K. Basavaraju
Journal: Gut (2014)

<h3>Introduction</h3> Percutaneous endoscopic gastrostomy (PEG) is the preferred method for inserting feeding gastrostomy tubes. The national confidential enquiry into PEG outcomes showed that patient selection was paramount for improving associated mortality and morbidity rates<sup> [1]</sup>. We carried out a retrospective audit into the indications and complications associated with PEG insertion at West Suffolk Hospital, a district general hospital, during 2008–2009 and 2013. During this period a multidisciplinary nutrition team approach and PEG referral proforma were introduced. <h3>Methods</h3> Retrospective audit data were collected during two periods, January 2008 to December 2009 and January to September 2013. The indication for PEG, documentation of antibiotic prophylaxis, the presence of a MDT review and complications post PEG insertion were audited. <h3>Results</h3> 55 PEG placements occurred during the first audit cycle. 56% were inserted for dysphagia caused by cerebrovascular accident. Antibiotic prophylaxis were documented in 80% of cases. Seven patients did not have an MDT discussion during the admission. There were no immediate complications. Three patients died within 30 days of PEG insertion (two died of pneumonia and one from large bowel obstruction). There were 36 PEG insertions during the second audit cycle. 39% were inserted for dysphagia caused by CVA. Antibiotic prophylaxis were documented in 83% of cases. All patients had an MDT discussion. Two immediate complications were reported. There were no reported deaths 30 days post procedure. <h3>Conclusion</h3> Following the introduction of a systematic MDT approach to PEG, there has been a reduction in 30 day mortality post-PEG insertion. When carefully monitored the use of PEG for long term enteral feeding can be used safely and successfully in a district general hospital. <h3>Reference</h3> Simon D, Johnston Tony CK, Tham Marisa Mason, Death after PEG: results of the National Confidential Enquiry into Patient Outcome and Death. <i>Gastrointestinal Endoscopy</i> August 2008; 68(2):Pages 223–227, ISSN 0016–5107 <h3>Disclosure of Interest</h3> None Declared.
The Canterbury Tales and cardiology.
Authors: J W Hurst
Journal: Circulation (1982)

An Appreciation"' and fail to recognize Herrick's great intellect, common sense, kindness, gentleness and place in history.Herrick demonstrated his perceptiveness in 1912 when he wrote, Obstruction of a coronary artery or of any of its large branches has long been regarded as a serious accident.Several events contributed toward the preva- lence of the view that this condition was almost always suddenly fatal ... But there are reasons for believing that even large branches of the coronary arteries may be occluded -at times acutely occluded -without resulting death, at least without death in the immediate future.Even the main trunk may at times be obstructed and the patient live.It is the ob- ject of this paper to present a few facts along this line, and particularly to describe some of the clinical manifestations of sudden yet not immediately fatal cases of coronary obstruction.2Herrick revealed his broad interest in medicine in 1910 when he reported the "Peculiar Elongated and Sickle-Shaped Red Blood Corpuscles in a Case of Severe Anemia."3He, therefore, earned for himself the distinction of recognizing and describing two clinically important disorders: obstruction of coro- nary arteries without sudden death and sickle cell dis- ease.He showed us his love of history and men with ideas when he gave us "Allan Burns: 1781-1813; Anatomist, Surgeon and Cardiologist."4Young Allan Burns described the pathophysiology of myocardial ischemia and postulated that coronary artery spasm could occur.Herrick wrote that Burns' "native talent, combined with the ability and willingness to work, chiefly accounts for his success . .While Herrick's medical writing is of great inter- est, I have always been intrigued by his delightful es- say "Why I Read Chaucer at Seventy,"5 which he read as an after-dinner address of the Association of American Physicians in Atlantic City in 1931.
Book Review Anesthesia: Biologic foundations Edited by Tony L. Yaksh, Carl Lynch III, Warren M. Zapol, Mervyn Maze, Julien F. Biebuyck, and Lawrence J. Saidman. 1504 pp., illustrated. Philadelphia, Lippincott–Raven, 1998. $229. 0-397-58742-2
Authors: Brian P. Kavanagh
Journal: New England Journal of Medicine (1998)
Mark Jones's reply to Myles and Leonardi-Bee's response to his critique of their paper reported in The BMJ
Authors: M. Jones
Journal: BMJ (2014)

Thank you for the explanation of how you conducted your time dependent analysis.1 2 It is now clear why you obtained such a biased estimate of treatment effect. By ignoring the time before treatment with a neuraminidase inhibitor you have increased the immortal time bias, not eliminated it. In fact, you did not include treatment as a time dependent exposure—you just began the follow-up at different points in time for each treatment group. You failed to take into account that patients in both treatment groups needed to survive long enough to reach hospital. Once they reached …
Technegas Versus Krypton-81m Gas as an Inhalation Agent
Authors: TOYOHARU ISAWA, TAKEO TESHIMA, YOSHIKI ANAZAWA, MAKOTO MIKI, PRITAM S. SONI
Journal: Clinical Nuclear Medicine (1994)

Exactly how the pulmonary distribution of inhaled radioactive gas and Technegas, or ultra-small aerosol particulates, differs from each other, is still uncertain. The authors compared the distribution of inhaled Kr-81m gas and Technegas in the lungs at total lung capacity in 13 control subjects with no clinical conditions and 13 patients with various chest diseases. In normal lungs, there was no difference in the distribution ratios in the right and left lungs between inhaled Kr-81m gas and Technegas. However, there was a significant difference in the lungs of patients with pulmonary disease. Technegas tended to deposit more in the lung bases than did Kr-81m gas. Despite these statistical differences, they were visually, or qualitatively, similar. From a practical and clinical standpoint, Technegas seems to be useful as an inhalation agent, unless quantitative analyses are required.
Just say “no” to viral hepatitis?
Authors: Raymond T. Chung
Journal: Hepatology (1994)

Interferons (IFNs) induce antiviral activity in many cell types. The ability of IFN- γ to inhibit replication of ectromelia, vaccinia, and herpes simplex-1 viruses in mouse macrophages correlated with the cells’ production of nitric oxide (NO). Viral replication was restored in IFN- γ -treated macrophages exposed to inhibitors of NO synthase. Conversely, epithelial cells with no detectable NO synthesis restricted viral replication when transfected with a complementary DNA encoding inducible NO synthase or treated with organic compounds that generate NO. In mice, an inhibitor of NO synthase converted resolving ectromelia virus infection into fulminant mousepox. Thus, induction of NO synthase can be necessary and sufficient for a substantial antiviral effect of IFN- γ .
Oestrogen replacement therapy after hysterectomy.
Authors: N. Weaver
Journal: BMJ (1992)

usual cut off of S 23/30.Nearly one eighth of those scoring . 23/30 were suffering from functional illnesses.The lack of national guidance on this matter is probably due to an understanding that the methodology of cognitive screening in the com- munity is neither sufficiently sophisticated nor proved to be effective, as well as of the difficulties of diagnosing early dementia.)The abbreviated mental test score proposed by the Alzheimer's Disease Society works well in hospital settings.Two problems detract from its use in community screening.One is that all short tests (about 10 questions) suffer from a more pronounced "ceiling effect" than longer scores (such as the mini-mental state examination), whereby many patients with mild cognitive impairment may score no errors.'The second problem is that the abbreviated mental test asks the patient to recognise two people-a question of limited utility in the homes of the many older people living alone.The recognition of organic brain disease in elderly patients by general practitioners virtually quadrupled from 1 5Q in 1964 to 5800 in 1988.'This occurred in the absence of community screening.It is worth waiting for more research on the topic before recommending any particular mental test score for community screening for cognitive impairment.
Rhinomucormycosis
Authors: Morris Berk
Journal: JAMA (1961)

VARIOUS fungi are capable of causing primary infection (coccidioidomycosis, histoplasmosis, blastomycosis, and so forth), whereas others usually complicate an underlying disease (aspergillosis, cryptococcosis, and monilia). A relative newcomer to the latter group of fungus infections is mucormycosis, a disease unique in its acute course and highly fatal outcome. Out of 114 cases reported in the world literature,<sup>1</sup>the majority being discovered post mortem, scarcely over a handful have recovered. Diabetes and leukemia are the 2 main disease states for which mucormycosis has a predilection. However, it has become evident that corticosteroids, antibiotics, and antileukemic agents play a vital role in the invasiveness of the fungus.<sup>2</sup>Most commonly the disease presents as an infection of the nose, paranasal sinuses, and orbit, with eventual extension into cranial structures. Clinical findings are now considered sufficiently distinctive so that a diagnosis can be made before bacteriologic or tissue confirmation. Such was the
46 IMMUNOLOGICAL PROFILES OF NON-RESPONDER AND RELAPSER PATIENTS WITH CHRONIC HCV INFECTION TREATED WITH STANDARD OF CARE THERAPY
Authors: B. Oliviero, D. Mele, E. Degasperi, S. Varchetta, A. Aghemo, M.G. Rumi, C. Tinelli, M. Colombo, M.U. Mondelli
Journal: Journal of Hepatology (2012)
Dietary calcium, physical activity, and risk of hip fracture: a prospective study.
Authors: C. A. Wickham, K. Walsh, C. Cooper, D. J. Barker, B. M. Margetts, J. Morris, S. A. Bruce
Journal: BMJ (1989)

OBJECTIVE--To determine whether low dietary calcium intake and physical inactivity are risk factors for hip fracture among subjects aged 65 and over. DESIGN--Fifteen year follow up study of a large cohort of randomly selected elderly people living in the community, who had taken part in the 1973-4 survey of the Department of Health and Social Security, and for whom dietary and other data were recorded at initial interview and medical assessment. SETTING--Eight areas in Britain (England (five), Wales (one), and Scotland (two]. SUBJECTS--1688 Subjects living in the community, of whom 1419 subjects (720 men and 699 women) agreed to participate. 1356 Subjects completed a seven day dietary record and 983 (542 men and 441 women) agreed to be assessed by a geriatrician. RESULTS--Incidence of hip fracture increased with age and was higher in women than men. Comparison with matched controls showed no evidence that the risk of hip fracture was related to calcium intake: the odds ratio for the lowest third of dietary calcium compared with the highest was 0.7 (95% confidence interval 0.1 to 3.9) after adjustment for smoking and body mass index. The adjusted odds ratio for the lowest third of outdoor activity compared with the highest was 4.3 (0.7 to 26.8), and that for grip strength was 3.9 (0.7 to 23.0). CONCLUSIONS--Reduced intake of dietary calcium does not seem to be a risk factor for hip fracture. Further evidence is provided that physical activity in the elderly protects against hip fracture.
Nonsteroidal anti-inflammatory drug metabolism potentiates interferon alfa signaling by increasing STAT1 phosphorylation
Authors: Stefania Giambartolomei, Marco Artini, Cristiana Almerighi, Sabrina Maria Moavero, Massimo Levrero, Clara Balsano
Journal: Hepatology (1999)

A sustained response to standard interferon therapy for chronic hepatitis C has been demonstrated in no more than 25% of patients. To improve interferon alfa (IFN-α) antiviral effect, a number of combination therapies with IFNs plus other drugs have been proposed for both relapser and nonresponder hepatitis C virus (HCV)-infected patients. Although the causes of IFN resistance in subsets of HCV-infected patients are unknown, both viral and host factors have been involved, including defects in IFN signal transduction and IFN-α/β receptor down-regulation. Here, we report that nonsteroidal anti-inflammatory drugs (NSAIDs), which have been proposed for IFN-α combination therapy in nonresponders, potentiate IFN-α signaling. We found that, in the hepatoma cell lines, CCL13/Chang and HepG2, indomethacin, a selective cyclo-oxygenase 1 and 2 (COX-1 and COX-2) inhibitor, increases IFN-α stimulation of interferon-stimulated response element (ISRE)-dependent transcription in a dose-dependent manner. Interestingly, maximal potentiation was observed with suboptimal IFN-α concentrations. Indomethacin exerts its effects by synergizing with IFN-α in inducing STAT1 activation by phosphorylation, without affecting concurrent Jak1 phosphorylation. Our data indicate that blockade of arachidonic acid (AA) metabolism by indomethacin activates a signaling pathway that converges on STAT1 activation to potentiate IFN-α-dependent gene activation.
Rheumatic symptoms after cardiac surgery: a prospective study.
Authors: K. Walton, P. J. Holt
Journal: BMJ (1988)

The incidence of different types of shoulder pain after open heart surgery was studied prospectively. Of 101 patients studied, 45 developed rheumatic symptoms during the first six weeks after the operation. Thirty eight patients reported pain in the region of the shoulder girdle with no loss of shoulder function (postpericardiotomy rheumatism). Three of these patients also had features compatible with the postpericardiotomy syndrome (fever, malaise, or pleuritic chest pain), and seven developed the syndrome without pain in the shoulder girdle. Of these 10 patients, one had generalised myalgia. Postpericardiotomy rheumatism alone was not associated with increased inflammation (measured by the erythrocyte sedimentation rate and concentration of C reactive protein); immunological tests including measurement of antibodies to cardiac muscle yielded inconclusive results. Replies to a postal questionnaire showed that symptoms of postpericardiotomy rheumatism were present for over three months in 18 patients and for six months or longer in 14. In view of the large number of patients now having open heart surgery postpericardiotomy rheumatism should be considered when patients report pain around the shoulders so that it is not misdiagnosed as angina.
COMPREHENSIVE ANALYSIS OF LSFs
Authors: D. J. Wood, J. R. Sonnad, M. F. D'souza, A. M. Daus, G. N. Chacko, J. R. Prince
Journal: Clinical Nuclear Medicine (1996)

Wood, D.; Sonnad, J. R.; D'souza, M. F.; Daus, A. M.; Chacko, G. N.; Prince, J. R. Author Information
Child spacing and two child policy in practice in rural Vietnam: cross sectional survey
Authors: H T Hoa, N V Toan, A Johansson, V T Hoa, B Hojer, L A Persson
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To explore the reproductive pattern of women in rural Vietnam in relation to the existing family planning policies and laws. <b>Design</b>: Cross sectional survey with questionnaires on reproductive history. <b>Setting</b>: Tien Hai, a district in Red River Delta area, where the population density is one of the highest in Vietnam. <b>Subjects</b>: 1132 women who had at least one child under 5 years of age in April 1992. <b>Main outcome measures</b>: Birth spacing and probability of having a third child. <b>Results</b>: The mean age at first birth was 22.2 years. The average spacing between the first and the second child was 2.6 years. Mothers with a lower educational level, farmers, and women belonging to the Catholic religion had shorter spacing between the first and second child and also a higher probability of having a third child. In addition, women who had no sons or who had lost a previous child were more likely to have a third child. <b>Conclusion</b>: Most families do not adhere to the official family planning policy, which was introduced in 1988, stipulating that each couple should have a maximum of two children with 3–5 years9 spacing in between. More consideration should be given to family planning needs and perceptions of the population, supporting the woman to be in control of her fertility. This may imply improved contraceptive services and better consideration of sex issues and cultural differences as well as improved social support for elderly people. <h3>Key messages</h3> The adherence to the family planning policy was lower among mothers with less education, among farmers, and in Catholic households The perceived necessity of having at least one son was a major factor for not adhering to the two child policy Death of an earlier child increased the tendency to have a third child More consideration should be given to the women9s own family planning needs and percep- tions
Nonchemical Elimination of Inspiratory Motor Output via Mechanical Ventilation in Sleep
Authors: MAKATO SATOH, PETER R. EASTWOOD, CURTIS A. SMITH, JEROME A. DEMPSEY
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

In six dogs studied in nonrapid eye movement (NREM) sleep, we found that the frequency, volume, and timing of application of mechanical ventilator breaths had marked and sustained inhibitory effects on diaphragm electromyogram (EMGdi). Single ventilator breaths of tidal volume (Vt) 75–200% of control caused apnea (up to three times eupneic expiratory time [Te]) when applied during the initial 25–65% of expiratory time. When continuous controlled mechanical ventilation (CMV) was applied with ventilator frequency increased as little as 1 cycle/min > eupnea and PaCO2 and Vt maintained at near eupneic control levels, EMGdi was silenced and triangularis sterni EMG (EMGts) became tonic within 2 to 5 ventilator cycles. On cessation of normocapnic CMV, apnea ensued with Te ranging from 1.2 to five times eupneic Te. The spontaneous Vt and EMGdi determined immediately after these prolonged apneas were also markedly reduced in amplitude. The larger the Vt applied during the isocapnic CMV (120–200% of eupnea) and the longer the duration of the CMV (3–90 s), the longer the duration of the postventilator apnea. Significant postventilator apneas and postapneic hypoventilation also occurred even when end-tidal CO2 pressure (PET CO2 ) was raised 3–5 mm Hg > eupnea (and 7–10 mm Hg > normal apneic threshold) throughout CMV trials at raised frequency and Vt. Our findings demonstrate that the increased frequency of CMV was critical to the elimination of inspiratory motor output and the onset of tonic expiratory muscle activity; furthermore, once EMGdi was silenced, the tidal volume and duration of the passive mechanical ventilation determined the magnitude of the short-term inhibition of inspiratory motor output after cessation of CMV.
Interleukin (IL)-1 and IL-4 synergistically stimulate NF-IL6 activity and IL-6 production in human mesangial cells
Authors: Yuichi Nakazato, Tomoko Hayashida, Yoshihiko Kanno, Hiroyuki Sasamura, Hirokazu Okada, Hiromichi Suzuki, Takao Saruta
Journal: Kidney International (1998)
Minnesota Mining and Manufacturing Company's hazardous waste program.
Authors: H J Van Noordwyk, M A Santoro
Journal: Environmental Health Perspectives (1978)

This paper discusses the present hazardous waste program of 3M Company (Minnesota Mining and Manufacturing Company). 3M's definition of hazardous waste and the company's position on hazardous waste disposal are first considered. The company position is that wherever and whenever the disposal of a waste material threatens the environment or public safety, then that waste should be considered a hazardous waste and treated accordingly in terms of its handling and ultimate disposal. The generation of hazardous wastes and the differentiation of "hazardous" and "nonhazardous" wastes are described next. Handling of hazardous wastes from their generation to their disposal is then covered. This includes a definition of internal 3M terminology and a description of the hazard rating system used by the company. Finally, 3M disposal practices are presented. It is 3M's position that thermal destruction of hazardous wastes, where appropriate, is the best method for their disposal. With this in mind, 3M has constructed incineration facilities throughout the country. The rotary kiln incinerator at the 3M Chemolite plant in Cottage Grove, Minnesota is briefly described. Disposal of certain hazardous wastes in controlled secure land disposal sites is then briefly discussed.
Abstract P1-08-39: Tumor-infiltrating CD8+ lymphocytes as an independent predictive factor for pathologic complete response to primary systemic therapy in breast cancer
Authors: AN Seo, HJ Lee, EJ Kim, HJ Kim, HE Lee, YJ Kim, JH Kim, SY Park
Journal: Cancer Research (2013)

Abstract Background: Tumor infiltrating lymphocytes (TILs), stem cell phenotype and epithelial-mesenchymal transition (EMT) are known to be associated with response to primary systemic therapy (PST) in breast cancer. However, these markers are strongly correlated with triple negative breast cancer, which shows high pathologic complete response (pCR) to PST. This study was conducted to evaluate clinical implication of these markers as predictive factor for pCR after PST in breast cancer and to find independent predictive factors, irrespective of breast cancer subtype. Methods: The pre-chemotherapeutic biopsy specimens of 153 breast cancer patients who underwent surgical resection after anthracycline-or anthracycline/taxane-based PST were enrolled. TILs (CD4, CD8, and FOXP3), breast cancer stem cell phenotype (CD44+/CD24-, and ALDH1), expression of EMT markers [vimentin, smooth muscle actin (SMA), osteonectin, E-cadherin, and N-cadherin] were evaluated by immunohistochemistry and were correlated with pCR after PST. Results: High infiltration of TILs (CD4+, CD8+, and FOXP3+), expression of stem cell markers (CD44+/CD24-, ALDH1+) and expression of EMT markers (expression of vimentin, SMA and osteonectin; loss of E-cadherin) were significantly associated with high histologic grade and triple negative breast cancer. Of them, high TILs (CD4+, CD8+, and FOXP3+) and expression of ALDH1, vimentin and osteonectin were associated with pCR. In multivariate analysis, CD8+ TILs and a conventional predictive marker, Ki67 were found to be independent predictors for pCR. In subgroup analyses, high CD8+ TILs was remained as a predictive factor for pCR, irrespective of PST regimen and tumor subtype. Conclusion: CD8+ TILs could therefore be used as a reliable predictor of response to PST in breast cancer. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-39.
Direct evidence for myogenic autoregulation of the renal microcirculation in the hamster.
Authors: J P Gilmore, K G Cornish, S D Rogers, W L Joyner
Journal: Circulation Research (1980)

We transplanted neonatal hamster renal tissue into a hamster check pouch chamber and subjected the renal tissue to increases and decreases in extravascular pressure. A decrease in extra-vascular pressure decreased, and an increase in extravascular pressure increased, the diameter of preglomerular arterioles. Thus, the change in preglomerular arteriolar diameter was directly related to alterations in extravascular pressure. Neither saralasin nor indomethacin affected these changes, whereas papaverin prevented them. The efferen arterioles responded passively to changes in extravascular pressure; i.e., the changes in their diameter were inversely related to changes in extravascular myogenic autoregulation of preglomerular vessels.