tbuckley/cabot-search huggingface dataset:
Follow-up study of refractory obesity treated by fasting.
Authors: A. C. MacCuish, J. F. Munro, L. J. Duncan
Journal: BMJ (1968)

<h3>Objective</h3> To identify whether the partial pressure of oxygen in arterial blood (PaO<sub>2</sub>) level at admission is an independent risk factor as a prognostic biomarker to predict postoperative pneumonia (POP) in the geriatric population who have undergone hip fracture surgical repair at our hospital. <h3>Design</h3> A retrospective cohort study. <h3>Setting</h3> This is a retrospective chart review of POP after hip fracture surgery in China. <h3>Participants</h3> In training cohort, patients aged ≥65 years who had hip fracture surgery between 1 January 2018 and 30 November 2019. In the validation cohort, a series of patients who underwent hip fracture surgery between 1 January 2020 and 28 February 2020. <h3>Interventions</h3> Receiver operating characteristic (ROC) analysis was used to obtain the area under the ROC curve (AUC) and cut-off values of PaO<sub>2</sub> to predict POP. A binomial logistic regression model was used to identify potential risk factors for POP by analysing demographic distribution factors, laboratory results, preoperative comorbidities and surgical factors. Then the regression model was validated using an independent cohort. <h3>Results</h3> In the training cohort, ROC curves were generated to compare the predictive performance of PaO<sub>2</sub> for the occurrence of POP, and the area under the receiver operating characteristic curve (AUC) was 0.653 (95% CI 0.577 to 0.729, p&lt;0.0001), with sensitivity and specificity values of 60.0% and 63.8%, respectively. The cut-off value of the PaO<sub>2</sub> for POP was 72.5 mm Hg. Binary logistic regression analysis revealed that hypoxaemia (PaO<sub>2</sub> &lt;72.5 mm Hg) at hospital admission (OR=3.000, 95% CI 1.629 to 5.528; p&lt;0.0001) was independent risk factors associated with POP after hip fracture surgery. In the validation cohort, PaO<sub>2</sub> had a predictive eﬀect for POP (AUC 0.71, 95% CI 0.541 to 0.891). <h3>Conclusions</h3> The current study revealed that the PaO<sub>2</sub> level at hospital admission is a simple and widely available biomarker predictor of POP after hip fracture surgery in elderly patients.
Abstract P3-13-03: Association between Ethnicity and Survival after Breast Cancer in a Multi-Ethnic Asian Setting: Results from the Singapore-Malaysia Hospital-Based Breast Cancer Registry
Authors: N Bhoo Pathy, HM Verkooijen, NA Taib, N Saxena, P Iau, AM Bulgiba, S-C Lee, C-H Yip, M. Hartman
Journal: Cancer Research (2010)

Abstract Background: Little is known on the impact of ethnicity on survival after breast cancer in the multi-ethnic Asian setting. Material and Methods: Using the multi-institutional Singapore-Malaysia hospital-based breast cancer registry, we investigated the association between ethnicity and risk of mortality after breast cancer in 3,366 patients diagnosed between 1990 and 2007 (Chinese: 77%, Malay: 15%, Indian: 8%). Kaplan-Meier analysis was used to estimate overall cumulative survival (OS). Multivariable hazard ratios (HR) adjusted for tumor and treatment characteristics were computed using Cox regression analysis after splitting follow-up time along the age-axis and calendar-time axis. Results: Malay patients presented at younger age compared to Chinese and Indians (47years vs 52years vs 53years, respectively, P&amp;lt;0.001) with larger tumors (35mm vs 24mm vs 30mm, respectively, P&amp;lt;0.001), and at later stages (TNM stage III or IV) (37% vs 23% vs 25%, respectively, P&amp;lt;0.001). Malay women were least likely to have undergone surgery, and most likely to receive chemotherapy. Five-year OS was 71.9% (95% CI: 69.7%-74.1%) in Chinese, 47.2% (95%CI: 41.9%-52.5%) in Malays and 62.7% (56.0%- 69.4%) in Indians. After adjustment for tumor and treatment characteristics, Malay patients had approximately 60% higher risk of death than the Chinese (HR:1.57; 95%CI:1.40-1.77). Indian ethnicity was not significantly associated with risk of mortality after breast cancer compared to Chinese (HR:1.12; 95%CI: 0.98-1.30). Conclusion: In the Asian setting, Malay ethnicity seems to be associated with significantly poorer survival after breast cancer, independent of tumor and treatment profile. The underlying reasons for this association are unclear but may be explained by variations in susceptibility to treatment, co-morbidity and lifestyle after diagnosis of breast cancer. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-13-03.
Bacteremia in Diabetic Patients with Infected Lower Extremities
Authors: Francisco L Sapico, Alice N Bessman, Hanna N Canawati
Journal: Diabetes Care (1982)

Eleven cases of bacteremia in diabetic patients with infected lower extremities at Rancho Los Amigos Hospital (RLAH) were observed over a 34-mo period. The yearly incidence was 0.6% of admissions to the Ortho-Diabetes service. Aerobic bacteria were recovered in six cases and anaerobic bacteria in five. Bacteroides fragilis was isolated four times, Staphylococcus aureus three times, and nonfragilis Bacteroides sp., Escherichia coli, group B streptococcus, and viridans streptococcus were each seen once. Ten of the 11 patients were febrile at the time of bacteremia. Clinical, laboratory, radiologic, and ultrasonographic parameters were comparable in patients with aerobic and anaerobic bacteremia, and between bacteremi patients and nonbacteremic controls. Fever, however, was significantly more frequent in bacteremic patients. Foul-smelling lesions were seen in two of the five patients with anaerobic bacteremia, and in none of the patients with aerobic bacteremia. Postoperative B. fragilis bacteremia was observed to be transient and resolved without definitive therapy in one patient. Appropriate antibiotic therapy in 10 patients together with surgical intervention in eight cases resulted in resolution of the infection in the remaining patients.
Do patients who move to a new town consult their doctor more often?
Authors: J S Cobb, D P Miles, A E Limentani
Journal: BMJ (1983)

A study was conducted to measure any difference in the consultation rate of patients from two new town housing estates compared with patients from the rest of the practice. Patients from the new estates consulted 15% to 20% more than those in other areas, but newly registered patients showed no difference compared with the indigenous population. It is suggested that patients who chose to move to new town rented accommodation bring with them a more casual attitude to the general medical services.
Inhibition of rat liver fibrogenesis through noradrenergic antagonism
Authors: Liliane Dubuisson, Alexis Desmoulière, Boris Decourt, Laetitia Evadé, Christiane Bedin, Liliane Boussarie, Laurence Barrier, Michel Vidaud, Jean Rosenbaum
Journal: Hepatology (2002)

The effect of adrenergic innervation and/or circulating catecholamines on the function of liver fibrogenic cells is poorly understood. Our aim was to investigate the effects of noradrenergic antagonism on carbon tetrachloride (CCl4)-induced liver fibrosis in rats. Two weeks of CCl4 induced an approximately 5-fold increase in the area of fibrosis as compared with controls. The addition of 6-hydroxydopamine (OHDA), a toxin that destroys noradrenergic fibers, decreased fibrosis by 60%. After 6 weeks of CCl4, the area of fibrosis increased about 30-fold in CCl4-treated animals and was decreased by 36% with OHDA. At 2 weeks, OHDA abrogated the CCl4-induced increase in mRNA level of tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), an inhibitor of extracellular matrix degradation, and it greatly reduced it at 6 weeks. Finally, when rats treated with CCl4 for 2 weeks also received prazosin, an antagonist of alpha1-adrenergic receptors, fibrosis was decreased by 83%. In conclusion, destruction of noradrenergic fibers or antagonism of noradrenergic signaling through alpha1 receptors inhibited the development of liver fibrosis. Because adrenoreceptor antagonists have a very sound safety profile, they appear as attractive drugs to reduce liver fibrogenesis.
A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality
Authors: Matteo Bassetti, Elda Righi, Filippo Ansaldi, Maria Merelli, Trucchi Cecilia, Gennaro De Pascale, Ana Diaz-Martin, Roberto Luzzati, Chiara Rosin, Leonel Lagunes, Enrico Maria Trecarichi, Maurizio Sanguinetti, Brunella Posteraro, Jose Garnacho-Montero, Assunta Sartor, Jordi Rello, Giorgio Della Rocca, Massimo Antonelli, Mario Tumbarello
Journal: Intensive Care Medicine (2014)
Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome
Authors: T Kaiser, J Langhorst, H Wittkowski, K Becker, A W Friedrich, A Rueffer, G J Dobos, J Roth, D Foell
Journal: Gut (2007)

S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation.Faecal S100A12 was determined by ELISA in faecal specimens of 171 consecutive patients and 24 healthy controls. Patients either suffered from infectious gastroenteritis confirmed by stool analysis (65 bacterial, 23 viral) or underwent endoscopic and histological investigation (32 with Crohn's disease, 27 with ulcerative colitis, and 24 with irritable bowel syndrome; IBS). Intestinal S100A12 expression was analysed in biopsies obtained from all patients. Faecal calprotectin was used as an additional non-invasive surrogate marker.Faecal S100A12 was significantly higher in patients with active IBD (2.45 +/- 1.15 mg/kg) compared with healthy controls (0.006 +/- 0.03 mg/kg; p<0.001) or patients with IBS (0.05 +/- 0.11 mg/kg; p<0.001). Faecal S100A12 distinguished active IBD from healthy controls with a sensitivity of 86% and a specificity of 100%. We also found excellent sensitivity of 86% and specificity of 96% for distinguishing IBD from IBS. Faecal S100A12 was also elevated in bacterial enteritis but not in viral gastroenteritis. Faecal S100A12 correlated better with intestinal inflammation than faecal calprotectin or other biomarkers.Faecal S100A12 is a novel non-invasive marker distinguishing IBD from IBS or healthy individuals with a high sensitivity and specificity. Furthermore, S100A12 reflects inflammatory activity of chronic IBD. As a marker for neutrophil activation, faecal S100A12 may significantly improve our arsenal of non-invasive biomarkers of intestinal inflammation.
Biosynthesis and intracellular transport of a bile canalicular plasma membrane protein: Studiesin vivo and in the perfused rat liver
Authors: Michele Maurice, Michael J. Schell, Bernard Lardeux, Ann L. Hubbard
Journal: Hepatology (1994)

B10 is an integral glycoprotein of the plasma membrane that is exclusively localized to the canalicular (apical) domain in normal rat hepatocytes but may be expressed on the basolateral (sinusoidal and lateral) membrane in pathophysiological situations. To understand how B10 may be localized to the basolateral surface, we studied the biosynthesis and transport of this apical protein. In vivo pulse-chase experiments, followed by subcellular fractionation of the liver and immunoprecipitation, showed that B10 is first synthesized as a high-mannose form of 123 kD and then matured to a complex glycosylated form of 130 kD, which peaks in the Golgi apparatus after 15 min of chase and reaches the plasma membrane with a half-time of 30 to 45 min. Analysis of the protein in plasma membrane domain fractions showed that most of the newly synthesized molecule was localized in basolateral fractions after 30 min of chase and subsequently appeared in apical fractions. After 90 min of chase, most of the radiolabeled protein had reached its steady-state apical distribution. The same experiments performed in the perfused rat liver, in which the chase can be improved, gave similar results, except that the apical distribution of the radioactive molecule was attained more quickly. Thus B10, like all apical plasma membrane proteins studied so far in hepatocytes, is first transported to the basolateral surface and then reaches the membrane of the bile canaliculi. Alterations of the transcytotic step from the basolateral to the apical surfaces may result in abnormal basolateral localization. (Hepatology 1994;19:648-655).
Ten Years of Orienting College Students to Careers in Medicine
Authors: Stewart F. Alexander
Journal: JAMA (1992)

MANY college students who contemplate a medical career volunteer for hospital work in order to have hospital experience and something to cite on their medical school applications. In the past, students were often given menial tasks that gave them neither experience nor understanding about what a medical career entails. We were concerned that many young men and women entered medical school without a clear concept of the demands of the profession. Once in medical school, they sometimes realized they were committed to something that they really did not want, with consequent disillusionment or lost time, money, and opportunity. We were also aware that highly qualified students increasingly had been turning away from medicine. We therefore developed a program in 1981 to provide college students from our area with a useful and balanced exposure to medical care and practice so that they could make an informed decision about their future careers.
Antibiotics for Children
Authors: Anita Slomski
Journal: JAMA (2014)

When Jason Newland, MD, MEd, launched a survey of freestanding children’s hospitals 3 years ago, he found that only 16 of 42 hospitals supported a formal antimicrobial stewardshipprogram(ASP).But since thenthenumber likely has increased. “There’sdefinitelymore interest in them now,” saidNewland,medical director of patientsafetyandreliabilityatChildren’sMercy Hospital in Kansas City, Missouri. He expects thatPresidentObama’s recent executive order outlining a national strategy to combatantibiotic-resistantbacteriawill furtherdrivethedevelopmentofpediatricASPs (http://1.usa.gov/ZrXYwP). Another driver may be Newland’s recent research findings, which showed that stopping antibiotics or shortening their duration not only doesn’t harm hospitalized children, it sends them home earlier and keeps them from being readmitted (http: //bit.ly/1rDWENr). The findings may not surprise infectious disease specialists at adult hospitals, whereASPshave longbeenestablishedand studies have demonstrated lower rates of Clostridiumdifficile infection, reducedmortality from sepsis, and more consults to infectious disease teams, leading to fewer treatment failures, according to David Haslam, MD, director of the ASP at Cincinnati Children’s Hospital Medical Center. “Multidrug-resistant organisms have been present in adult hospitals longer than in children’s hospitals, and adults have longer lengths of stay and tend to get more aggressive antibiotic therapy,” prompting earlier attempts by adult hospitals to reduce excessive antibiotic use, Haslam said.
Lawsuits for Malpractice
Authors: Leonard Berlin
Journal: JAMA (1978)

To  Editor.—  Mr Vaccarino's perspective on malpractice may be quite correct in  milieu of Massachusetts General Hospital, but it fails to explain what is happening in  community hospital. Here there is a long-established and close rapport between attending physician and patient, and there are no residents or interns to complicate  physician-patient relationship, yet there is an extremely high incidence of malpractice suits. Therefore, I believe the most significant contributive factor to frivolous claims is not the poor relationship with  provider but rather  litigiousness of  patient coupled with a plaintiff's lawyer who is all too willing to file any kind of malpractice suit, regardless of its merits. However, even assuming that some suits are filed simply because  patient is disgruntled with his physician, is not that  fault of  attorney? Should not a lawyer, who is, after all, an expert in
Relevance of Urine Telomerase in the Diagnosis of Bladder Cancer
Authors: Maria Aurora Sanchini
Journal: JAMA (2005)

The identification of new molecular markers is one of the most challenging goals for the early detection of bladder cancer because available noninvasive methods have neither sufficient sensitivity nor specificity to be acceptable for routine use.To develop a relatively simple, inexpensive, and accurate test that measures telomerase activity in voided urine to apply to large-scale screening programs for bladder cancer detection.Case-control study conducted in 218 men (84 healthy individuals and 134 patients at first diagnosis of histologically confirmed bladder cancer), frequency matched by age and recruited between March 2003 and November 2004 in Italy. Urine telomerase activity was determined using a highly sensitive telomeric repeat amplification protocol (TRAP) assay. Urine samples were processed for cytological diagnosis and TRAP assay. The diagnosis of bladder cancer was based on bioptic and cystoscopic examinations. The performance of the TRAP assay to detect urine telomerase activity was compared with urine cytology as an aid to early cancer detection. Quantification of urine telomerase activity was conducted in a blinded manner.Sensitivity and specificity of TRAP to detect bladder cancer.Using a 50 arbitrary enzymatic unit cutoff value, we validated the results obtained in the pilot study. In the overall series, sensitivity was 90% (95% confidence interval [CI], 83%-94%) and specificity was 88% (95% CI, 79%-93%). Specificity increased to 94% (95% CI, 85%-98%) for individuals aged 75 years or younger. The same predictive capacity of telomerase activity levels was observed for patients with low-grade tumors or with negative cytology results.The present validation study demonstrated the ability of urine telomerase activity levels to accurately detect the presence of bladder tumors in men. This test represents a potentially useful noninvasive diagnostic innovation for bladder cancer detection in high-risk groups such as habitual smokers or in symptomatic patients.
203 EVIDENCE OF CLONAL EVOLUTION OF TUMOR INITIATING CELLS IN HUMAN HEPATOCELLULAR CARCINOMA
Authors: F. Colombo, L. Porretti, F. Baldan, S. Mazzucchelli, S. Guerneri, M. Cadamuro, M. Spreafico, B. Foglieni, D. Prati
Journal: Journal of Hepatology (2011)
Renal Cancer Treatment with Low Levels of Mixed Chimerism Induced by Nonmyeloablative Regimen Using Cyclophosphamide in Mice
Authors: Masahiko Harano, Masatoshi Eto, Toshiro Iwai, Katsunori Tatsugami, Keijiro Kiyoshima, Yoriyuki Kamiryo, Masazumi Tsuneyoshi, Yasunobu Yoshikai, Seiji Naito
Journal: Cancer Research (2005)

Abstract Recently, much attention has been paid to nonmyeloablative allogeneic stem cell transplantation for the treatment of metastatic renal cancer. Mature donor T cells cause graft-versus-host disease (GVHD) although they are also the main mediators of the beneficial graft-versus-tumor activity associated with this treatment. Hence, the segregation of the graft-versus-tumor activity from GVHD is an important challenge in managing the clinical course of treatment. We previously reported a series of studies regarding the allograft tolerance induced by allogeneic spleen cells (with bone marrow cells) and cyclophosphamide in mice. Here, we show a modified cyclophosphamide-induced tolerance system for the treatment of murine renal cell carcinoma, RENCA, by shifting the equal balance between graft-versus-host and host-versus-graft reactions toward graft-versus-host reaction with donor lymphocyte infusion. Our results clearly show the antitumor activity against RENCA with only low levels of mixed chimerism in the periphery and the in vivo and in vitro acquired immunity against RENCA even when mixed chimerism is almost undetectable. Because the withdrawal of mixed chimerism reduces the risk of GVHD, the antitumor activity is thus sequentially segregated from the initial GVHD in our model. We believe that this is the first unique model system of nonmyeloablative allogeneic hemopoietic cell transplantation to ever be reported for the treatment of renal cancer.
The people vote; the doctor calls
Authors: G. Dunea
Journal: BMJ (1998)

It seems that Americans have had enough of Miss Lewinsky. Instead they voted in the last election for middle of the road candidates and sound government, and against right and left wing extremists and puritans. In local elections they likewise chose moderate candidates. In Minnesota, however, they made an unusual choice in electing the Reform Party candidate, who trounced other candidates for governor on a platform of lower taxes and less …
Improvement in Hypertension in Patients With Diabetes Mellitus After Kidney/Pancreas Transplantation
Authors: Michael D. Elliott, Ajoy Kapoor, Michele A. Parker, Dixon B. Kaufman, Robert O. Bonow, Mihai Gheorghiade
Journal: Circulation (2001)

Background Hypertension persists in many patients with diabetes mellitus after kidney transplantation. However, the impact of control of diabetes as well as kidney failure on hypertension by combined kidney and pancreas transplantation has not been studied. Methods and Results Between March 1993 and August 1998, 111 patients with type 1 diabetes mellitus underwent successful pancreas transplantation (108 kidney/pancreas transplantation) and another 28 patients with type 1 diabetes mellitus underwent isolated kidney transplantation. Blood pressure measurements and all antihypertensive medications were determined for both groups before transplantation and at 1, 3, 6, and 12 months and at the most recent outpatient evaluation after transplantation. At baseline, the mean blood pressure was 151/88 and 151/83 mm Hg for the kidney/pancreas and isolated kidney transplant patients, respectively. The mean blood pressure decreased to 134/77 mm Hg 1 month after kidney/pancreas transplantation ( P &lt;0.001) and decreased further to 126/70 mm Hg ( P &lt;0.001) at a mean follow-up of 18 months. This reduction in blood pressure after transplantation occurred despite a decrease in antihypertensive medications and the institution of immunosuppressive agents. At 1 month after kidney/pancreas transplantation, the average number of antihypertensive medications per patient was 0.9±1.0, compared with 2.5±1.1 before surgery ( P &lt;0.001). At 18 months after transplantation, 34% of patients were both normotensive (blood pressure ≤130/85 mm Hg) and receiving no antihypertensive medications. In contrast, there was no significant decrease in systolic blood pressure or antihypertensive medication use in the patients receiving an isolated kidney transplant. Conclusions Successful kidney/pancreas transplantation results in a marked improvement in hypertension treatment that is not observed in patients undergoing isolated kidney transplantation. These data underscore the importance of diabetes in the pathogenesis of hypertension in patients with diabetes and kidney failure.
Manual of Electronystagmography
Authors: Robert W. Cantrell
Journal: JAMA (1977)

<b>Electronystagmography: Technical Aspects and Atlas,</b>by Joseph U. Toglia, 160 pp, with illus, $13.50, Springfield, Ill, Thomas, 1976. Electronystagmography, more correctly electro-oculography, has been related to dizziness the way electrocardiography is related to chest pain. Unfortunately, this comparison is faulty. Electronystagmography is similar to electrocardiography in that electrical impulses generated within the eye can be detected, amplified, and recorded and thereby provide a permanent record of changes in the eye's electrical potential, just as the ECG does with the heart. There the similarity ends. Electronystagmography cannot make a diagnosis, nor is it standardized in recording, interpreting, or reporting. This is partly due to the relatively recent adoption of electronystagmography as a clinical tool, even though the corneoretinal potential has been known and studied for nearly 100 years. This is not to say that electronystagmography is a useless clinical tool. A few years ago, the status of electrocardiography was similar to