tbuckley/cabot-search huggingface dataset:
Elevation of Serum Creatine Kinase in Divers with Arterial Gas Embolization
Authors: Robert M. Smith, Tom S. Neuman
Journal: New England Journal of Medicine (1994)

Arterial gas embolism due to pulmonary barotrauma and the resultant cerebral gas embolism are catastrophic complications of diving. Previous studies have only rarely noted evidence of gas embolism to noncranial sites.Among 142 persons with diving-related injuries evaluated between January 1982 and July 1991, we identified 29 who had arterial gas embolism and who underwent biochemical studies indicative of muscle injury. Of the 29 patients, 4 were excluded because cardiopulmonary resuscitation had been performed and 3 were excluded because the duration of their dives met or exceeded standard limits set for dives not requiring staged decompression. The outcome at the time of hospital discharge in the remaining 22 patients was correlated with clinical factors and the results of biochemical studies. We also studied 22 subjects after uncomplicated dives and 11 patients who had sustained blunt trauma.All the patients with diving-associated gas embolism had elevated serum creatine kinase activity (normal, < or = 175 U per liter); the values were markedly elevated (> 900 U per liter) in 14. The MB isoenzyme of creatine kinase was detected in the serum of 13 of 20 patients in whom it was measured and was > or = 4 percent of total creatine kinase activity in 6 patients. In three patients electrocardiography showed myocardial injury. Changes in serum creatine kinase activity of similar magnitude were not present in the subjects who had uncomplicated dives or in the patients with blunt trauma. Thirteen patients recovered fully, four had minor residual neurologic deficits, three were severely impaired, and two died. Logistic-regression analysis revealed a significant correlation between peak serum creatine kinase values and clinical outcome.Biochemical evidence of muscle injury is frequently found after diving-associated arterial gas embolism. The correlation between serum creatine kinase activity and outcome suggests that serum creatine kinase is a marker of the size and severity of arterial gas embolism.
Bronchoalveolar Lavage for Rapid Diagnosis of the Fat Embolism Syndrome in Trauma Patients
Authors: Jean Chastre
Journal: Annals of Internal Medicine (1990)

Objective: To evaluate the usefulness of bronchoalveolar lavage in establishing the diagnosis of the fat embolism syndrome in trauma patients with long-bone fractures. Design: Case series. Setting: Referral hospital. Patients: Eighteen trauma patients with long-bone fractures, including 5 with definite fat embolism syndrome, 5 in whom the diagnosis had been clinically suspected but was impossible to confirm or exclude before bronchoscopy, and 8 with no clinical evidence of the syndrome. Control groups included 9 patients without previous trauma who developed the adult respiratory distress syndrome for various reasons and 15 normal volunteers. Measurements and Main Results: Each patient had fiber-optic bronchoscopy with bronchoalveolar lavage, and the percentage of lavage cells containing intracellular fat droplets stained with oil red 0 were determined. In the five patients with definite fat embolism syndrome, light microscopic study of bronchoalveolar cells stained with oil red 0 showed many large intracellular fat droplets (mean percentage of cells containing fat droplets, 63%; range, 31% to 82%), whereas less than 2% of cells recovered by lavage from trauma patients with no clinical evidence of the syndrome, from patients with the adult respiratory distress syndrome, or from normal volunteers contained such inclusions. Use of the same technique in the five patients with possible fat embolism syndrome permitted the immediate identification of three patients in whom this diagnosis was later confirmed by subsequent autopsy or clinical follow-up. Conclusions: The identification of fat droplets within cells recovered by bronchoalveolar lavage in trauma patients may be a rapid and specific method for establishing the diagnosis of the fat embolism syndrome.
Papular acrodermatitis of childhood and other papulo-vesicular acro-located syndromes
Authors: FERDINANDO GIANOTTI
Journal: British Journal of Dermatology (1979)

Papular acrodermatitis of childhood (PAC), first recognized in Milan and described by Gianotti in 1955, is an infectious disease of childhood, of low infectivity, fairly widespread, and characterized by: 1 Non-relapsing erythemato-papular dermatitis localized to the face and limbs, lasting about 3 weeks. 2 Paracortical hyperplasia of lymph-nodes. 3 Acute hepatitis, usually anicteric, which lasts at least 2 months and may progress to chronic liver disease. 4 Hepatitis B surface antigenaemia, subtype ayw, which may persist for a long time. PAC must be differentiated from other frequent papular or papulo-vesicular acro-located eruptions of unknown origin, which should be classified as 'Papulo-vesicular acro-located syndrome' until their aetiology is clarified.
Evaluation of Consistency in Dosing Directions and Measuring Devices for Pediatric Nonprescription Liquid Medications
Authors: H. Shonna Yin, Michael S. Wolf, Benard P. Dreyer, Lee M. Sanders, Ruth M. Parker
Journal: JAMA (2010)

<h3>Context</h3>In response to reports of unintentional drug overdoses among children given over-the-counter (OTC) liquid medications, in November 2009 the US Food and Drug Administration (FDA) released new voluntary industry guidelines that recommend greater consistency and clarity in OTC medication dosing directions and their accompanying measuring devices.<h3>Objective</h3>To determine the prevalence of inconsistent dosing directions and measuring devices among popular pediatric OTC medications at the time the FDA's guidance was released.<h3>Design and Setting</h3>Descriptive study of 200 top-selling pediatric oral liquid OTC medications during the 52 weeks ending October 30, 2009. Sample represents 99% of the US market of analgesic, cough/cold, allergy, and gastrointestinal OTC oral liquid products with dosing information for children younger than 12 years.<h3>Main Outcome Measures</h3>Inclusion of measuring device, within-product inconsistency between dosing directions on the bottle's label and dose markings on enclosed measuring device, across-product use of nonstandard units and abbreviations, and presence of abbreviation definitions.<h3>Results</h3>Measuring devices were packaged with 148 of 200 products (74.0%). Within this subset of 148 products, inconsistencies between the medication's dosing directions and markings on the device were found in 146 cases (98.6%). These included missing markings (n = 36, 24.3%) and superfluous markings (n = 120, 81.1%). Across all products, 11 (5.5%) used atypical units of measurement (eg, drams, cc) for doses listed. Milliliter, teaspoon, and tablespoon units were used for doses in 143 (71.5%), 155 (77.5%), and 37 (18.5%) products, respectively. A nonstandard abbreviation for milliliter (not mL) was used by 97 products. Of the products that included an abbreviation, 163 did not define at least 1 abbreviation.<h3>Conclusion</h3>At the time the FDA released its new guidance, top-selling pediatric OTC liquid medications contained highly variable and inconsistent dosing directions and measuring devices.
Alterations of Ventilation to Perfusion Ratios Distribution Associated with Successive Clinical Stages of Pulmonary Emphysema*
Authors: Claude Lenfant, William R. Pace
Journal: Journal of Clinical Investigation (1965)

Studies reported by Briscoe and co-workers (1) and Finley (2) have demonstrated the blood gas abnormalities of patients with pulmonary emphysema to be mainly the result of impaired distribution of the ventilation to perfusion (VA/Q) ratios throughout the lung.Finley provided no information about the differences in clinical severity of his subjects, however, and Briscoe and co-workers apparently studied patients representing only one stage of the dis- ease according to the classification of Baldwin, Cournand, and Richards (3).Thus, neither study established the actual nature of changes in VA/Q distribution that develop as the disease progresses.Unanswered is the question of whether there occurs an increase of range,' of dispersion, or of both.Yet it is important to know what modifications develop as the disease worsens, because knowledge of these progressive changes may lead to a better understanding of the basic physiological impairments occurring with age (4, 5).This paper is a report of experiments that were made in an attempt to assess the nature of the differences in VA/Q distribution present in three groups of subjects selected ac-
Fistula between the Left Internal Thoracic Artery and the Coronary Sinus
Authors: Vincent P.P.G. Renard, Johan Vandenbogaerde
Journal: New England Journal of Medicine (2000)

To the Editor: Coronary cameral fistulas are communications between the coronary arterial circulation and the chambers or great vessels of the heart. The majority of these fistulas are congenital in origin. However, acquired coronary cameral fistulas are increasingly recognized as a complication of exogenous trauma (e.g., chest injury) or endogenous trauma (e.g., permanent ventricular pacing leads, cardiac surgery,1,2 or myocardial infarction). Acquired fistulas may also complicate the course of severe atherosclerosis.3 The symptoms are highly variable: the majority of patients have no symptoms, but others have chest pain and dyspnea. We describe a 78-year-old man who had progressive angina, . . .
Risk Perception for Developing Diabetes
Authors: Elizabeth A. Walker, C.K. Mertz, Maria R. Kalten, James Flynn
Journal: Diabetes Care (2003)

OBJECTIVE—To assess personal risk perceptions for developing diabetes among practicing physicians. RESEARCH DESIGN AND METHODS—Little is known about comparative risk perceptions concerning diabetes among medical experts. We administered the new Risk Perception Survey for Developing Diabetes to 535 nondiabetic physicians. The participants were 86% male, had a mean age of 49 years, and were 66% white and 24% Asian. Almost 37% were considered at higher risk for developing diabetes based on self-reported risk factors. Over 91% of respondents were either internal medicine or family medicine physicians. RESULTS—Of the four subscales, Comparative Disease Risk and Environmental Risk indicated moderate risk perceptions, whereas Personal Control scores indicated a robust sense of control over developing diabetes. Optimistic Bias scores showed a tendency toward participants’ being optimistic that they were less likely to develop diabetes. Based on self-reported risk factor categories, a comparison of scores between physicians at higher risk (n = 196) and those at lower risk (n = 313) for developing diabetes showed greater comparative disease risk perception among the higher risk physicians (P &amp;lt; 0.01), as well as greater perception of diabetes risk (P &amp;lt; 0.001). Nearly 50% of higher risk physicians, however, reported an optimistic bias that they were less likely to develop diabetes than other people of their same age and sex. Women (n = 75) reported greater perception of environmental risks than men (P &amp;lt; 0.001). Asian respondents (n = 126) reported greater perception of environmental risk (P &amp;lt; 0.001) and greater worry about developing diabetes (P &amp;lt; 0.0001) than white respondents (n = 355). Regression analyses showed that scores for nondiabetes comparative disease risks (0.39) and level of optimistic bias (0.31) were predictive of diabetes risk perception (P &amp;lt; 0.0001). CONCLUSIONS—The data gathered on physicians’ perception of their personal risk for developing diabetes and other comparative risk judgments provided an expert comparison for future analyses of at-risk or lay individuals’ perceptions of diabetes risk. Effective communication of diabetes risk among physicians, patients, and the general public relies on knowledge of and sensitivity to group differences in these perceptions.
President Obama apologises to Guatemala over 1940s syphilis study
Authors: J. H. Tanne
Journal: BMJ (2010)

President Barack Obama has expressed his deep regret to Alvaro Colon, president of Guatemala, about a 1940s study in which 696 Guatemalans were deliberately infected with syphilis. The president extended his apologies to President Colon and to all those who had been affected.

The US secretary of state, Hillary Clinton, and the secretary of health and human services, Kathleen Sebelius, issued a joint public statement saying that the study was “clearly unethical.” Participants had been infected with syphilis to see whether penicillin could be used immediately after sex to prevent infection.

In their statement Ms Clinton and Ms Sebelius said, “Although these events occurred more than 64 years ago, we are outraged that such reprehensible research could have occurred under the guise of public health. We deeply …
Once Stung, Twice Shy
Authors: Lawrence M. Lichtenstein, Anne Kagey-Sobotka, David B. K. Golden, Martin D. Valentine
Journal: JAMA (1980)

IT IS not clear what—or who—has provoked the ire of Howard S. Rubenstein, MD, but his communication, "Allergists Who Alarm the Public" (243:793-794, 1980), serves to provoke emotion rather than thought and fails to bring to the reader a balanced view of current knowledge regarding the diagnosis and treatment of insect sting allergy. Having worked on this problem for a number of years and having authored a recent report<sup>1</sup>that demonstrated the efficacy of venom immunotherapy, we feel compelled to respond to his remarks. Dr Rubenstein's major point seems to be that since so few people die of insect stings, physicians who recommend venom immunotherapy are unmitigated fearmongers. We agree that the reported mortality from insect stings is low but point out that the morbidity associated with systemic reactions to stings is much greater. Although adequate epidemiologic studies have not been reported, we have seen, from the Baltimore area alone,
Effect of Postmenopausal Hormone Therapy on Lipoprotein(a) Concentration
Authors: Mark A. Espeland, Santica M. Marcovina, Valery Miller, Peter D. Wood, Carol Wasilauskas, Roger Sherwin, Helmut Schrott, Trudy L. Bush
Journal: Circulation (1998)

Background —Postmenopausal hormone therapy has been reported to decrease levels of lipoprotein (Lp)(a) in cross-sectional studies and small or short-term longitudinal studies. We report findings from a large, prospective, placebo-controlled clinical trial that allows a broad characterization of these effects for four regimens of hormone therapy. Methods and Results —The Postmenopausal Estrogen/Progestin Interventions study was a 3-year, placebo-controlled, randomized clinical trial to assess the effect of hormone regimens on cardiovascular disease risk factors in postmenopausal women 45 to 65 years of age. The active regimens were conjugated equine estrogens therapy at 0.625 mg daily, alone or in combination with each of three regimens of progestational agents: medroxyprogesterone acetate (MPA) at 2.5 mg daily (ie, continuous MPA), MPA at 10 mg days 1 to 12 (ie, cyclical MPA), and micronized progesterone at 200 mg days 1 to 12. Plasma levels of Lp(a) were measured at baseline (n=366), 12 months (n=354), and 36 months (n=342). Assignment to hormone therapy resulted in a 17% to 23% average drop in Lp(a) concentrations relative to placebo ( P &lt;.0001), which was maintained across 3 years of follow-up. No significant differences were observed among the four active arms. Changes in Lp(a) associated with hormone therapy were positively correlated with changes in LDL cholesterol, total cholesterol, apolipoprotein B, and fibrinogen levels and were similar across subgroups defined by age, weight, ethnicity, and prior hormone use. Conclusions —Postmenopausal estrogen therapy, with or without concomitant progestin regimens, produces consistent and sustained reductions in plasma Lp(a) concentrations.
Thermographic imaging during nasal peanut challenge may be useful in the diagnosis of peanut allergy
Authors: A. Clark, J. Mangat, Y. King, S. Islam, K. Anagnostou, L. Foley, J. Deighton, P. Ewan
Journal: Allergy (2012)

Abstract Background Double‐blinded challenges are widely used for diagnosing food allergy but are time‐consuming and cause severe reactions. Outcome relies on subjective interpretation of symptoms, which leads to variations in outcome between observers. Facial thermography combined with nasal peanut challenge was evaluated as a novel objective indicator of clinical allergy. Methods Sixteen children with positive blinded peanut challenge underwent nasal challenge with 10 μg peanut protein or placebo. Mean skin temperatures were recorded from the mouth and nose using infrared thermography over 18 min. Results The area under curve of nasal skin temperature was significantly elevated after peanut vs placebo (18.2 vs 4.8°Cmin). The maximum increase in temperature was also significantly greater after peanut: mean difference +0.9°C. Conclusion This feasibility study shows thermography can detect inflammation caused by nasal challenges whilst employing one thousand‐fold less peanut than an oral challenge. This novel technique could be developed to provide a rapid, safe and objective clinical allergy test.
NHS to fund treatment for 10000 patients with MS
Authors: R. Little
Journal: BMJ (2002)

Patients with multiple sclerosis will now be able to have “disease modifying” drugs under a new government scheme of “risk sharing” for England and Wales, the Department of Health announced this week. Patients who are assessed as likely to benefit from the drugs will be given them until they are deemed to be no longer effective.

Simultaneously, the National Institute for Clinical Excellence (NICE) released its “guidance on drugs for multiple sclerosis” which recommended against the use of interferon beta or glatiramer acetate by the NHS on the basis of “clinical and cost effectiveness.”

NICE recommended in October that the Department of Health, the National Assembly for Wales, and drug manufacturers should explore cost effective ways of making the drugs available to patients with multiple sclerosis (10 November, p 1087). In response the NHS and five pharmaceutical manufacturers have …
Health activists attack Indian compensation formula for deaths attributed to clinical trials
Authors: G. Mudur
Journal: BMJ (2013)

A formula proposed by the Indian government to calculate the amount of compensation that pharmaceutical companies would need to pay for deaths of subjects who volunteer for clinical trials has drawn criticism from health activists and industry analysts.

A committee of experts set up by the Central Drugs Standard Control Organisation, India’s drug regulatory agency, has proposed a formula that takes into account the age of subjects and a risk value linked to their health status to determine the amount of compensation payable when a death is attributed to a clinical trial.1 A healthy volunteer is assumed to be taking the highest risk and a terminally ill patient the least risk.

The formula leads to compensation amounts ranging from Rs 400 000 (£4064; €4783; $6509) for the death of a 65 year old terminally ill subject with expected survival …
Congenital hypothyroidism due to mutations in the sodium/iodide symporter. Identification of a nonsense mutation producing a downstream cryptic 3' splice site.
Authors: J Pohlenz, I M Rosenthal, R E Weiss, S M Jhiang, C Burant, S Refetoff
Journal: Journal of Clinical Investigation (1998)

A 12-yr-old hypothyroid girl was diagnosed at birth as athyreotic because her thyroid gland could not be visualized by isotope scanning. Goiter development due to incomplete thyrotropin suppression, a thyroidal radioiodide uptake of < 1%, and a low saliva to plasma ratio of 2.5 suggested iodide (I-) transport defect. mRNA isolated from her thyroid gland and injected into Xenopus oocytes failed to increase I- transport. Sequencing of the entire Na+/I- symporter (NIS) cDNA revealed a C to G transversion of nucleotide (nt) 1146 in exon 6, resulting in a Gln 267 (CAG) to Glu (GAG) substitution. This missense mutation produces an NIS with undetectable I- transport activity when expressed in COS-7 cells. Although only this missense mutation was identified in thyroid and lymphocyte cDNA, genotyping revealed that the proposita and her unaffected brother and father were heterozygous for this mutation. However, amplification of cDNA with a primer specific for the wild-type nt 1146 yielded a sequence lacking 67 nt. Genomic DNA showed a C to G transversion of nt 1940, producing a stop codon as well as a new downstream cryptic 3' splice acceptor site in exon 13, responsible for the 67 nt deletion, frameshift, and premature stop predicting an NIS lacking 129 carboxy-terminal amino acids. This mutation was inherited from the mother and present in the unaffected sister. Thus, although the proposita is a compound heterozygote, because of the very low expression (< 2.5%) of one mutant allele, she is functionally hemizygous for an NIS without detectable bioactivity.
The key to cultural innovation lies in the group dynamic rather than in the individual mind
Authors: Sonia Ragir, Patricia J. Brooks
Journal: Behavioral and Brain Sciences (2012)

Abstract Vaesen infers unique properties of mind from the appearance of specific cultural innovation – a correlation without causal direction. Shifts in habitat, population density, and group dynamics are the only independently verifiable incentives for changes in cultural practices. The transition from Acheulean to Late Stone Age technologies requires that we consider how population and social dynamics affect cultural innovation and mental function.
770. Novel Physical Methods for Nonviral DNA Transfer to Rabbit Retina
Authors: Thomas W. Chalberg, Alexander Vankov, Philip Huie, Fanni E. Molnar, Michele P. Calos, Daniel V. Palanker
Journal: Molecular Therapy (2005)

Purpose: We recently demonstrated nonviral gene transfer to rat retinal pigment epithelium (RPE) by using electroporation and long-term transgene expression mediated by the phiC31 site-specific integrase 1. In these experiments, however, procedures used caused collateral damage and could not be directly translated to clinical applications. We now demonstrate safe and effective DNA delivery to the mammalian retina in a large animal model.
HDAC3 is essential for DNA replication in hematopoietic progenitor cells
Authors: Alyssa R. Summers, Melissa A. Fischer, Kristy R. Stengel, Yue Zhao, Jonathan F. Kaiser, Christina E. Wells, Aubrey Hunt, Srividya Bhaskara, Jessica W. Luzwick, Shilpa Sampathi, Xi Chen, Mary Ann Thompson, David Cortez, Scott W. Hiebert
Journal: Journal of Clinical Investigation (2013)

Histone deacetylase 3 (HDAC3) contributes to the regulation of gene expression, chromatin structure, and genomic stability. Because HDAC3 associates with oncoproteins that drive leukemia and lymphoma, we engineered a conditional deletion allele in mice to explore the physiological roles of Hdac3 in hematopoiesis. We used the Vav-Cre transgenic allele to trigger recombination, which yielded a dramatic loss of lymphoid cells, hypocellular bone marrow, and mild anemia. Phenotypic and functional analysis suggested that Hdac3 was required for the formation of the earliest lymphoid progenitor cells in the marrow, but that the marrow contained 3-5 times more multipotent progenitor cells. Hdac3(-/-) stem cells were severely compromised in competitive bone marrow transplantation. In vitro, Hdac3(-/-) stem and progenitor cells failed to proliferate, and most cells remained undifferentiated. Moreover, one-third of the Hdac3(-/-) stem and progenitor cells were in S phase 2 hours after BrdU labeling in vivo, suggesting that these cells were impaired in transit through the S phase. DNA fiber-labeling experiments indicated that Hdac3 was required for efficient DNA replication in hematopoietic stem and progenitor cells. Thus, Hdac3 is required for the passage of hematopoietic stem/progenitor cells through the S phase, for stem cell functions, and for lymphopoiesis.