tbuckley/cabot-search huggingface dataset:
Echocardiography of cardiac valves in pericardial effusion.
Authors: N C Nanda, R Gramiak, C M Gross
Journal: Circulation (1976)

Nine adult patients with large pericardial effusions (PE) demonstrated echocardiographic motion abnormalites of cardiac valves in systole. In four cases (Group 1), the abnormal findings consisted of prominent systolic anterior movements of the mitral valve resembling those seen in idiopathic hypertrophic subaortic stenosis. In Group 2(five cases), typical mitral valve prolapse patterns with large posterior midsystolic displacements well below the C point were observed. Additional abnormalities in Group 2 included tricuspid valve prolapse patterns (four cases), early systolic movement of the aortic valve toward closure (three cases), midsystolic notching of the pulmonary valve (two cases) and abnormal or attenuated motion of the aortic root in all patients. Marked decrease or resolution of PE resulted in complete disappearance of all the observed abnormalities. These findings appeared to be related to large fluid collections behind the left atrium and abnormal movement of the heart in the pericardial space. In the presence of PE, therefore, the echocardiographic observation of abnormal valve motion may not be clinically significant.
Late initiation of parenteral nutrition reduced length of intensive care unit stay
Authors: Daren K. Heyland
Journal: Annals of Internal Medicine (2011)

ACP Journal Club15 November 2011Late initiation of parenteral nutrition reduced length of intensive care unit stayDaren K. Heyland, MD, MScDaren K. Heyland, MD, MScQueen's University, Kingston, Ontario, Canada (D.K.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-10-201111150-02011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationCasaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365:506-17. https://pubmed.ncbi.nlm.nih.gov/21714640Clinical Impact RatingsCritical Care: References1 Finfer S, Chittock DR, Su SY, et al; NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283-97. [PMID: 19318384] Google Scholar2 Clinical Evaluation Research Unit; Kingston General Hospital. Trial of Supplemental Parenteral Nutrition in Under and Over Weight Critically Ill Patients (TOP-UP). In ClinicalTrials.gov [Internet]. Bethesda, MD, US: National Library of Medicine. 2000. www.clinicaltrials.gov/ct2/show/NCT01206166 (accessed 5 Oct 2011). Google Scholar3 University Hospital, Geneva. Impact of SPN on Infection Rate, Duration of Mechanical Ventilation & Rehabilitation in ICU Patients. In ClinicalTrials.gov [Internet]. Bethesda, MD, US: National Library of Medicine. 2000. www.clinicaltrials.gov/ct2/show/NCT00802503 (accessed 5 Oct 2011). Google Scholar Author, Article, and Disclosure InformationAffiliations: Queen's University, Kingston, Ontario, Canada (D.K.H.)This article was published at Annals.org on 1 November 2011. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRole of Disease and Macronutrient Dose in the Randomized Controlled EPaNIC Trial 15 November 2011Volume 155, Issue 10Page: JC5-11KeywordsBody mass indexCritical careGlucoseHypoglycemiaIntensive care unitsNutrition ePublished: 15 November 2011 Issue Published: 15 November 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
1090 MESENCHYMAL STEM CELLS OBTAINED FROM UMBILICAL CORD BLOOD AND ADIPOCYTE TISSUE AND THEIR ABILITY FOR DIFFERENTIATION INTO FUNCTIONAL HEPATOCYTES
Authors: Â.C.M. Luzo, S. Sundararaj, A.S.S. Duarte, M. Andreoli, T.B. Ribeiro, P. Bordeaux-Rego, P. Kharmandayan, F. Costa, S. Saad, I. Boin
Journal: Journal of Hepatology (2011)
Anticholestatic effects of bezafibrate in patients with primary biliary cirrhosis treated with ursodeoxycholic acid
Authors: Akira Honda, Tadashi Ikegami, Makoto Nakamuta, Teruo Miyazaki, Junichi Iwamoto, Takeshi Hirayama, Yoshifumi Saito, Hajime Takikawa, Michio Imawari, Yasushi Matsuzaki
Journal: Hepatology (2012)

Bezafibrate is a widely used hypolipidemic agent and is known as a ligand of the peroxisome proliferator-activated receptors (PPARs). Recently this agent has come to be recognized as a potential anticholestatic medicine for the treatment of primary biliary cirrhosis (PBC) that does not respond sufficiently to ursodeoxycholic acid (UDCA) monotherapy. The aim of this study was to explore the anticholestatic mechanisms of bezafibrate by analyzing serum lipid biomarkers in PBC patients and by cell-based enzymatic and gene expression assays. Nineteen patients with early-stage PBC and an incomplete biochemical response to UDCA (600 mg/day) monotherapy were treated with the same dose of UDCA plus bezafibrate (400 mg/day) for 3 months. In addition to the significant improvement of serum biliary enzymes, immunoglobulin M (IgM), cholesterol, and triglyceride concentrations in patients treated with bezafibrate, reduction of 7α-hydroxy-4-cholesten-3-one (C4), a marker of bile acid synthesis, and increase of 4β-hydroxycholesterol, a marker of CYP3A4/5 activity, were observed. In vitro experiments using human hepatoma cell lines demonstrated that bezafibrate controlled the target genes of PPARα, as well as those of the pregnane X receptor (PXR); down-regulating CYP7A1, CYP27A1, and sinusoidal Na+/taurocholate cotransporting polypeptide (NTCP), and up-regulating CYP3A4, canalicular multidrug resistance protein 3 (MDR3), MDR1, and multidrug resistance-associated protein 2 (MRP2). Conclusion : Bezafibrate is a dual PPARs/PXR agonist with potent anticholestatic efficacy in early-stage PBC patients with an incomplete biochemical response to UDCA monotherapy.
Scientist or showman?
Authors: D. Singh
Journal: BMJ (2003)

To many he is nothing more than a fedora-wearing ringmaster of a circus of cadavers. To others he is an accomplished anatomist who, through his invention of plastination (where body parts are preserved by saturating them with polymer resin), has brought an understanding of the human body to lay people.

As we meet, newspapers report that Munich, the show's next destination, has banned the exhibition, forcing Gunther von Hagens to appeal. He is confident that the show will go ahead, attributing the ban to the conservative and strongly Catholic sensibilities of the region. We meet on the penultimate day of the exhibition in London's east end. Meeting von Hagens is like meeting Hannibal Lecter from the film Silence of the Lambs —both are fiercely intelligent and have a finely tuned appreciation of Renaissance art, opera, and philosophy and a passion for flaying dead bodies.

In pictures he appears bloodless and stern, but in the flesh he is surprisingly normal. He has an honest, open face, smiles a lot, and has a conscientious manner.

He wanted to be a doctor from the age of 6, when he spent six months in hospital with haemophilia A. “When I was 6 years old an artery in my forehead ruptured. My head was heavy and my face was wet with blood. I called the nurse and was rushed to the operating room. I heard the doctors say: …
Colorectal cancer patients show decrease in cellular immunity and enhanced plasma level of transforming growth factor – beta and vascular endothelial growth factor (VEGF)
Authors: Eva Zavadova, Vocka Michal, Konopasek Bohuslav, Terezie Fučíkova, Blanka Rihova, Luboš Petruzelka
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Colorectal cancer is the second leading cause of cancer death in the world. The cause of high mortality is that almost half the cancers are detected at an advanced stage of disease. In addition to surgical and chemotherapy treatment in recent years, applied monoclonal antibody
Abstract 5734: Role of the inflammasome complex in Cr(VI)-induced lung injury and inflammation
Authors: Lauren Hopkins, Thomas Forbes, Brent Schneider, Stephanie L. Constant, David Leitenberg, Arnold M. Schwartz, Steven R. Patierno, Susan Ceryak
Journal: Cancer Research (2012)

Abstract Certain particulate hexavalent chromium [Cr(VI)] compounds are human respiratory carcinogens that release genotoxic soluble chromate, leading to fibrosis, fibrosarcomas, adenocarcinomas and squamous cell carcinomas of the lung. While considerable information exists regarding Cr(VI) genotoxicity in cell culture, the mechanisms by which Cr(VI) causes lung injury and carcinogenesis in vivo are still unknown. We postulate that early inflammatory processes and mediators may contribute to the etiology of Cr(VI) carcinogenesis. We have previously established that intranasal (IN) particulate Cr(VI) administration in Balb/c mice induced a pronounced innate inflammatory response in the lung. Our present aim was to directly test the contribution of inflammasome-mediated inflammatory processes to chromate-mediated lung cancer development. We used WT and inflammasome-deficient (ASC knockout) BALB/c mice for weekly IN delivery of either saline or 10 ug particulate basic zinc chromate, which is an intermediately water soluble chromate typically encountered in mining/chromate production facilities and which is also present as an environmental atmospheric contaminant in urban areas surrounding ferrochrome production facilities. After 9 weeks, immune cells, cytokines, MMPs and pathologic features of lung injury and inflammation were measured in airway lavage fluid and lung tissue. Inflammasome-deficient mice exhibited a markedly reduced number of airway leukocytes in response to Cr(VI) challenge when compared to their WT counterparts, which was particularly evident for macrophages. Moreover, the Cr-induced increase in airway levels of IL6 (8-fold), CXCL/KC (3-fold), as well as pro-MMP9 (100-fold) was significantly attenuated in the inflammasome-deficient mice. In contrast, histological examination of lung tissue in animals challenged with chromate revealed a similar increase in peribronchiolar inflammation in both WT and ASC-/- mice, suggesting that Cr-induced lung inflammation may involve ASC-dependent and independent mechanisms, and that tissue infiltration may be less impacted by ASC-dependent mechanisms. In conclusion, particulate chromate is a potent inducer of inflammatory responses in the lung, mediated in part through the inflammasome complex. We postulate that these early inflammatory processes may contribute to the etiology of Cr(VI) carcinogenesis. The findings may also be relevant to other lung particulates that induce injury and cancer. Supported by NIH grants CA107972 and ES017334 to SC and ES017307 to SRP. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5734. doi:1538-7445.AM2012-5734
Access to circulation by permanent arteriovenous fistula in regular dialysis treatment.
Authors: J S Hanson, M Carmody, B Keogh, W F O'Dwyer
Journal: BMJ (1967)

This isolated and severe yM deficiency can be classified as a dysgammaglobulinaemia.It is distinct from the Giedion-Scheidegger variety (type 1), where yA is also very low and where there is a continual history of all kinds of bacterial infec- tions from birth.Case 4 initially showed a low yA and yM, but this may have been due to delay in immunological matura- tion, for both are now developing normally.Cases I and 2 are also distinct from the Wiskott-Aldrich syndrome (type VA), a sex-linked recessive condition usually fatal to affected males before 10 years of age, where though -yM deficiency appears it is usually associated with a marked increase of yA.Clinically there is a long history of eczema, thrombocytopenia, and recur- rent infections from soon after birth.Cases 1 and 2 have therefore been classified as type VB by Hobbs et al. (1967a).Furthermore, it is realized that isolated deficiency of yM can be found in apparently healthy subjects (type VO) and can be associated with defects of other classes of immunoglobulins in both sexes of given families (Burtin et al., 1964).Thus the finding of yA deficiency in four other relatives of Cases 1 and 2 adds support to a genetic basis for their fatal abnormality. SummarySerum immunoglobulin levels and meningococcal antibodies were measured in nine patients suffering from meningococcal infection.The bactericidal activity of normal serum to meningococci could be attributed largely to yM globulin.Severe yM deficiency, probably inherited, was found in two boys dying from fulminating meningococcal septicaemia.Other evidence supported the view that yM antibodies are an important humoral defence mechanism and that the normal presence of these antibodies in the blood stream restrains systemic meningococcal infection to the C.S.F.
Sickle cell disease and contraception.
Authors: J Guillebaud
Journal: BMJ (1993)

In dogs infusion of noradrenaline alone increases renal vascular resistance; when noradrenaline is combined with dopamine (1-4 ,ug/kglmin) renal blood flow actually increases.2In two clinical series of patients with septic shock noradrenaline infusion led to increased diuresis, increased creatinine clearance, and decreased plasma urea concentration.34Despite optimisation of cardiac index and pulmonary capillary wedge pressure, all patients had had persistently low mean arterial pressure and systemic vascular resistance.These increased during the infusion, in parallel with the onset of diuresis.Renal function in septic shock will reflect a number of factors.If nephrotoxic drugs are not given, all the kidney requires is an adequate renal blood flow, adequate oxygen delivery, and an adequate perfusion pressure.Optimisation of cardiac index and oxygen delivery (by appropriate interventions) should ensure the first two of these.Re-establishing an adequate renal perfusion pressure (by raising mean arterial pressure) may be the critical additional intervention.A degree of efferent arteriolar constriction is (theoretically) of additional benefit to the glomerular filtration rate.Septic shock responds in a heterogeneous manner.Noradrenaline may lead to an overall decline in oxygen delivery,5 but the beneficial effect on renal function of an increased perfusion pressure may outweigh this.When used in a judicious and selective way, with fastidious monitoring, noradrenaline is a potentially useful tool in preventing and treating acute renal failure in patients with septic shock.
Effect of Fluoride-Containing Tubes on Accuracy of Glucometers
Authors: Hung-Yuan Li, Cyue-Huei Hua, Yi-Ru Lin, Mao-Shin Lin, Jung-Nan Wei
Journal: Diabetes Care (2008)

Glucometers are used to quickly obtain glucose concentrations in the hospital and at home. For quality assurance, the American Diabetes Association recommends periodically comparing the results from glucometers with those from referenced laboratories (1). Usually, measurement using glucometers is done one-by-one by technicians, which is costly regarding manpower. In contrast, measurement using blood analyzers in laboratories saves manpower by analyzing after sufficient samples are collected. Tubes containing glycolytic inhibitors such as sodium fluoride are used to keep the glucose level constant (2). If analyses by glucometers could be …
Response: Hereditary fibrinogen A α-chain amyloidosis: phenotypic characterization and the role of liver transplantation
Authors: Arie J. Stangou, Nicholas R. Banner, Bruce M. Hendry, Mohamed Rela, Bernard Portmann, Julia Wendon, Mark Monaghan, Philip MacCarthy, Muriel Buxton-Thomas, Christopher J. Mathias, Juris J. Liepnieks, John O'Grady, Nigel D. Heaton, Merrill D. Benson
Journal: Blood (2010)
P17.80 * ANAPLASTIC GLIOMA: AN UPDATE ON TREATMENT STRATEGIES
Authors: G. Simonetti, P. Gaviani, A. Innocenti, A. Botturi, E. Lamperti, A. Silvani
Journal: Neuro-Oncology (2014)

Anaplastic Gliomas (AG) include 6-10% of all newly diagnoses of primary brain tumors. They've an unfavourable prognosis: median survival ranging between two years for Anaplastic Astrocytoma and four years for Anaplastic Oligodendroglioma. Moreover, there is not an established treatment for AG: standard of care still remains one of the unresolved challenges and medical care are largely determined by histopathology-genetic diagnosis(in particular loss of heterozygosis 1p 19q).We reviewed the scientific literature, in order to define the better sequence and timing of chemo-radiotherapy for AG patients that improves progression-free-survival (PFS) and overall-survival(OS). Four recent randomized clinical trials (RCT) were identified for a total of 1170 patients (anaplastic-astrocytomas, anaplastic-oligoastrocytoma, anaplastic-oligodendroglioma). Three studies compared radiotherapy (RT) treatment vs radio-chemotherapy with procarbazine-lomustine-vincristine (PCV) or temozolomide(TMZ) or dibromodulcitol and bichloroethylnitrosurea (DBD/BCNU) and only one compared RT vs chemotherapy (CT) with PCV or TMZ. Results show no significant differences in terms of PFS/OS between RT/CT alone or combined treatment although a trend toward an improvement of OS was observed after RT + CT treatment (m-OS in RT + adjuvant PCV was 42.3 months vs 30.6 months in RT alone p = 0.0003).Grade 3-4 mielotoxicity has been observed in almost all cases of patients treated with PCV + RT. None of four studies reviewed conducted a head to head comparison between PCV vs TMZ. Only a study randomized patients to PCV/TMZ without however providing data in terms of PSF and OS between the two treatments. It found no significant differences in PFS from initial RT and adjuvant chemotherapy (PCV-TMZ) at progression compared to initial chemotherapy followed by RT at progression. Regarding the timing, no differences were demonstrated between the initial CT group and initial RT alone group. By considering the four RCTs, there seems to be a trend regarding PFS and OS in favour of the combined modality of chemo-radiotherapy. This type of treatment has certainly more risk to develop mielotoxicity and late neurotoxicity linked to RT. Clinical data do not allow to determine the optimal therapeutic approach in AG and this uncertain situation stresses the importance to conducting new randomized trials in the future to achieve reliable data in term of a possible prognostic/predictive role of bio-molecular factors. The optimal treatment of AG should reasonably consider not only the histology as well as the molecular markers of the tumor, but also clinical conditions, age of patients, life expectancy, Karnofsky-Performance-Status and tumor resection to achieve in future the personalization of care.
Medical Aspects of Open-Heart Surgery
Authors: Lee P. Rosky, Theodore Rodman
Journal: New England Journal of Medicine (1966)

Postoperative Complications of Fluid and Acid–Base BalanceOverhydrationPulmonary congestion due to overhydration must be carefully avoided after surgery with cardiopulmonary bypass.46 Fluid given during the first three days after operation should be limited to small amounts of 5 per cent glucose in water unless drainage from the chest or other indications suggest the need for blood. A useful general formula is to administer 500 ml. per square meter of body-surface area on the first, and 750 ml. per square meter on each of the second and third postoperative days.50 Respiratory AlkalosisRespiratory alkalosis, characterized biochemically by a rise in . . .
The Angelchik Antireflux Prosthesis
Authors: James A. Sapala
Journal: JAMA (1987)

To the Editor.—  We read with interest the recent Diagnostic and Therapeutic Technology Assessment (DATTA) report 1 on the Angelchik antireflux prosthesis. As surgeons who implant the prosthesis on a weekly basis, we believe that implantation should not be performed routinely by surgeons unfamiliar with the finer anatomy of the infradiaphragmatic esophagus. However, we do not agree with the panelists' conclusion that concerns about the safety of the device compromise its clinical utility.  In our six-year clinical series, 2 which represents the implantation of 410 Angelchik prostheses, there have been no instances of migration while using the improved device with the single circumferential strap (available after the spring of 1982). In addition, the problem of erosion has been eliminated by doing minimal dissection at the level of the lower esophageal sphincter coupled with an anterior fundal gastropexy.  Further, the major problem following implantation and one that affects many more patients
Fingertip Purpura in a Dental Student
Authors: Lauren Strazzula, Shinjita Das, Vinod E. Nambudiri, Daniela Kroshinsky
Journal: JAMA Dermatology (2014)

Methyl methacrylate (MMA) is a well-known sensitizer commonly found in dental resins, bonding agents, prosthetics, artificial nail adhesive, and industrial glues. Allergic contact dermatitis due to MMA is often seen in individuals with occupational exposure, such as those in the dental profession.
Major Depression During Medical Training
Authors: Mark Zoccolillo
Journal: JAMA (1988)

The article by Clark and Zeldow<sup>1</sup>demonstrates the burden of depression during medical school. The authors used the Beck Depression Inventory (BDI), a self-report depression scale, and found at least 12% of the class with self-reported depression at any assessment during the first three years. As the authors note, the relationship between elevated BDI scores and the psychiatric diagnosis of major depression is an imperfect one. The distinction between a high score on the BDI and a diagnosis of major depression (a syndrome consisting of persistent depressed mood or loss of interest and several symptoms such as sleep or appetite disturbance, fatigue, trouble concentrating, and suicidal thoughts or attempts)<sup>2</sup>is important, as major depression is associated with high morbidity and suicide; the clinical significance of elevated BDI scores, in the absence of a major depression, is unknown. In a study in which first- and second-year medical students were
Concentrations of glycosaminoglycans in synovial fluids and their relation with immunological and inflammatory mediators in rheumatoid arthritis.
Authors: A Bensouyad, A.P Hollander, B Dularay, A.E Bedwell, R.A Cooper, C.W Hutton, P.A Dieppe, C.J Elson
Journal: Annals of the Rheumatic Diseases (1990)

The dimethylmethylene blue assay showed higher concentrations of glycosaminoglycans in many synovial fluids from patients with rheumatoid arthritis (RA) than in autologous sera or sera or synovial fluids from normal subjects. These results were taken to suggest that the glycosaminoglycans in RA synovial fluid were abnormally raised and derived from cartilage. To discover what stimulated such glycosaminoglycan release in RA joints relations were sought between synovial fluid concentrations of glycosaminoglycans and immunological and inflammatory mediators. It was shown that RA synovial fluid glycosaminoglycan concentrations correlated with synovial fluid C3d concentrations but not with synovial fluid rheumatoid factor concentrations, polymorphonuclear leucocyte numbers, myeloperoxidase concentrations, or the ability of the synovial fluids to release free radicals from normal polymorphonuclear leucocytes. A correlation was found between synovial fluid C3d and interleukin 1 concentrations as judged by both lymphocyte activating factor activity and immunoassay, but no significant correlation was detected between interleukin 1 and glycosaminoglycan concentrations. It is suggested that in the rheumatoid joint locally produced cytokines, in addition to interleukin 1, together stimulate glycosaminoglycan release from cartilage and render it vulnerable to attack by other processes.