tbuckley/cabot-search huggingface dataset:
The Effect of Drug Concentration Expression on Epinephrine Dosing Errors
Authors: Daniel W. Wheeler, Joseph J. Carter, Louise J. Murray, Beverley A. Degnan, Colin P. Dunling, Raymond Salvador, David K. Menon, Arun K. Gupta
Journal: Annals of Internal Medicine (2008)

Background: The expression of drug concentration as a ratio may cause dosing errors. Objective: To examine the effect of ratio expressions on drug administration. Design: Randomized, blinded, controlled study. Setting: Simulation center in an urban hospital. Participants: 28 physicians. Intervention: Participants managed a simulated pediatric acute anaphylaxis scenario by using epinephrine ampules labeled with mass concentration (1 mg in 1 mL) or a ratio (1 mL of a 1:1000 solution). Measurements: The amount of epinephrine given and the time taken to administer it. Results: Compared with providers using ampules with mass concentration labels, those using ratio labels gave more epinephrine (adjusted mean dose, 213 μg above target [95% CI, 76.4 to 350.1 μg]; P = 0.003), and took longer to do so (adjusted mean delay, 91 seconds, [CI, 61.0 to 122.1 seconds]; P ≤ 0.0001). Limitations: Performance in simulated scenarios may not reflect clinical practice. In reality, ampule labels provide both expressions of concentration. Conclusion: The use of ratios to express drug concentration may be a source of drug administration error. Patient safety might be improved by expressing drug concentrations exclusively as mass concentration.
Exercise, voluntary apnoea and reactive oxygen species
Authors: S Mehran Hosseini, Habib Azimi, Mohsen Jamshir
Journal: British Journal of Sports Medicine (2010)

There are some evidences regarding in vitro hypoxic production of reactive oxygen species (ROS) or ‘reductive stress’, which is harmful. However, the formation of ROS is generally thought to be related to reoxygenation that occurs following hypoxic phase. These conditions may be repeated during exercise. In this study, we test the effect of voluntary apnoea as an in vivo physiologic tolerable hypoxic state on serum ROS level. Twelve healthy male volunteer students (age 21 ± 3) were studied during breath holding. Voluntary apnoea was started at the end of normal inspiration and was continued for 40 s. Respiration, pulse rate and arterial haemoglobin saturation were monitored. Blood samples were collected at rest (pre-apnoea) and at the end of breath holding period (before re-breathing). The D-ROM test was used for determination of serum ROS levels. The serum ROS levels did not show any significant changes following apnoea, there was 12.75% reduction in pulse rate (93.3 ± 3.03 bpm, range 87–107 bpm vs 81.43 ± 3.7 bpm, range 71–93 bpm, p&lt;0.003) and 2.05% desaturation of arterial haemoglobin (97.6 ± 0.16%, range 97–98% vs 95.6 ± 0.33%, range 94–97%, p&lt;0.000) during 40 s of breath holding. Single voluntary apnoea had no significant effect on serum ROS level at resting condition. The compensatory homeostatic mechanisms, detection limit of assaying method, time window of sampling and the size of effect may be masked by tiny biochemical changes and can be accounted for this negative result.
Binding and diffusion characteristics of 14C EDTA and 99mTc DTPA in respiratory tract mucus glycoprotein from patients with chronic bronchitis.
Authors: M S Cheema, S Groth, C Marriott
Journal: Thorax (1988)

Measurement of pulmonary clearance of an inhaled aerosol of technetium-99m labelled diethylenetriaminepenta-acetate (DTPA) by external detection methods has been used widely as an index of permeability across alveolar epithelium and bronchial mucosa. To determine the applicability of the tracer to measurement of permeability in the airways the diffusion and binding characteristics of 99mTc DTPA and the chemically related ethylenediaminetetra-acetic acid labelled with carbon-14 (14C EDTA) was studied in purified respiratory tract mucus glycoprotein from patients with chronic bronchitis. The diffusion coefficients for 99mTc DTPA and 14C EDTA through mucus gels were significantly lower than those for tritiated water. Both molecules bound to the mucus gels with high affinity at two independent low capacity sites. Appreciable amounts of 99mTc DTPA or 14C EDTA are therefore unlikely to cross mucus layers of physiological thickness over periods of four or five hours. This suggests that when pulmonary clearance is determined by the 99mTc DTPA method the tracer retained in mucus lined airways will provide background activity. This study supports the assumption that pulmonary clearance measurements are mainly measuring alveolar epithelial permeability and should not be used to study bronchial epithelial permeability.
Interpretation of Serologic Tests for Typhoid Fever
Authors: Steven A. Schroeder
Journal: JAMA (1968)

Although the incidence of typhoid fever in this country has been decreasing,<sup>1</sup>sporadic outbreaks continue to occur.<sup>2,3</sup>Increasing numbers of military personnel and private citizens are being exposed to typhoid during foreign travel to areas where the disease is endemic; consequently, the diagnosis of typhoid fever remains an important problem. The definitive diagnostic procedure is isolation of<i>Salmonella typhosa</i>from blood, stool, or occasionally, urine, but serologic tests are still widely used. This communication will briefly discuss the following aspects of serologic tests for typhoid fever: the antigens used, cross-reactivity with other salmonellae, traditional interpretive criteria of test results, serologic response in the vaccinated patient, the effect of antibiotic treatment on antibody response, and the Vi test for identifying typhoid carriers. Diagnostic tests for typhoid bacillus, such as Widal's reaction, are tube dilution tests which measure agglutinating antibodies against O and H antigens. The Vi antigen is used
Study on autoimmune mechanisms in the neurological process
Authors: A. Munoz, R. Martinez, M. Leon, F. Gallo, M. Velloso, S. Rodriguez, L. Mayordomo, E. Rejon, J. Marenco
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Objectives</h3> Systemic autoimmune disease can have neurologic manifestations. The following study analyses the awareness among neurologists on this topic. <h3>Materials and methods</h3> Descriptive study: The authors have reviewed the clinical history of patients between 15 and 45 years old, with neurologic events between codes 433 and 438 of the ICD-19 (mainly ischemic events, bleeding, motors disorders…). The authors have collected demographic data and analytical. <h3>Results</h3> 143 patients, 95 male (66.43%) and 48 female (33.57%). The majority of admissions were patients between 40 and 45 years old (42.7%). Under 30 years old admitted 20.98% and only five patients (3.5%) under 20 years old. In all patients were requested general analytic study. Hypercoagulability study in 72 patients (50.35%), antinuclear antibody (ANA) in 70 (48.95%), C3 and C4 in 26 (18.18%), anti-neutrophil cytoplasmic antibodies (ANCAs) in 20 (13.99%), lupus anticoagulant in 7 (4.9%) and cryoglobulins in 5 (3.50%). When performing an analysis by age, the authors found the hypercoagulability study was requested in 60% of patients under 30 years old, while only in 37.76% of patients between 31 and 45 years old. The seven patients who requested lupus anticoagulant were over 35 years old. ANA were requested in 56.67% of patients under 30 years old. In none of the five patients under 20 years old requested this study. Between 31 and 45 years old, the neurologists investigated the presence of ANAs in 37.06%. Only four of the patients under 30 years old (13.33%) requested the study of ANCAs. This study was requested in 14.16% of patients between 30 and 45 years old. As for the analytical data, leucopoenia was detected in nine patients (6.29%), neutropoenia in five (3.50%), thrombocytopenia in five (3.50%) elongated APTT in six (4.2%) alterations in urinary sediment in eight patients (5.59%). The authors identified three patients (2.1%) with systemic lupus erythematosus according to American College of Rheumatology criteria (two patients were diagnosed prior to admissions, an one was diagnosed during hospitalisation). <h3>Conclusions</h3> The sensitivity of neurologists regarding the involvement of autoimmune phenomena in neurological processes is lower than expected. Hypercoagulability study and ANA are the most requested, and the percentage of their request is higher in individuals under than 30 years. It seems that there is greater awareness about these diseases in younger patients. It would be of interest to establish measures in collaboration between neurologists-rheumatologists to improve the diagnostic approach to these patients.
The effects of lower body negative pressure on the cardiovascular system of the anaesthetized rabbit
Authors: J. M. YATES, P. H. FENTEM
Journal: Cardiovascular Research (1975)

Journal Article The effects of lower body negative pressure on the cardiovascular system of the anaesthetized rabbit Get access JANET M. YATES, JANET M. YATES From the Department of Physiology, Medical School, University of Nottingham, Nottingham, NG7 2RD Search for other works by this author on: Oxford Academic PubMed Google Scholar P. H. FENTEM P. H. FENTEM From the Department of Physiology, Medical School, University of Nottingham, Nottingham, NG7 2RD Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 9, Issue 2, March 1975, Pages 190–200, https://doi.org/10.1093/cvr/9.2.190 Published: 01 March 1975
Health Care in the Year 2000
Authors: Anthony J. Geraci
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Dr Goldsmith'sSpecial Communicationentitled "The US Health Care System in the Year 2000"<sup>1</sup>encompasses many issues important to the future of the medical profession. Although one can always disagree with what another sees in a crystal ball, articles such as this greatly benefit us by forcing us to think about and examine the consequences of the many changes occurring in medicine today. One important issue that Dr Goldsmith raises is best exemplified by the cartoon showing "Frank's Neurosurgery" (Fig 2). As the author states, we will find more and more "substantially underemployed" specialty physicians as the number of physicians continues to rise. Unfortunately, underemployed specialists sometimes look to primary care as a way to keep patients and income—"Frank's Neurosurgery" becomes "Frank's Neurosurgery and General Practice." Despite a relative lack of attention from medical schools and medical centers, the appropriate treatment of the diseases that make
Cellular Immunity to Nuclear Antigens in Systemic Lupus Erythematosus
Authors: John A. Goldman, Allen Litwin, Louis E. Adams, Robert C. Krueger, Evelyn V. Hess
Journal: Journal of Clinical Investigation (1972)

Cellular immune repsonses were determined by skin testing and mitogen- and antigen-induced blastic transformation of peripheral blood lymphocyte cultures in 24 patients with systemic lupus erythematosus (SLE) and 24 normal subjects. The incidence of positive skin tests with Candida albicans, PPD (tuberculin-purified protein derivative) intermediate strength, Trichophyton and histoplasmin was not significantly different in the two groups nor was lymphocyte stimulation by the mitogen phytohemagglutinin-M (PHA-M), implying that cellular immunity is normal in SLE. However, the SLE patients had a significantly increased incidence of positive skin tests and stimulated lymphocyte cultures to a number of nuclear antigens compared with normal subjects. No correlation could be made between the test results and the activity of the SLE at the time of study except for a significant association between lymphocyte culture stimulation by rabbit thymus native DNA and active SLE nephritis. Patients with a membranous antinuclear factor (ANF) pattern had positive skin tests with rabbit thymus native DNA and usually had active disease.
P06.04 * PEPTIDE RECEPTOR RADIONUCLIDE THERAPY (PRRT) WITH 90Y-DOTATOC TARGETING OF RECURRENT ATYPICAL MENINGIOMA: A CASE REPORT
Authors: S. Iglseder, M. Nowosielski, A. Muigg, G. Stockhammer, C. Freyschlag, J. Lanbach, M. Nevinny-Stickel, S. Buxbaum, C. Uprimny, I. Virgolini
Journal: Neuro-Oncology (2014)

BACKGROUND: At present, limited treatment options are available for patients with meningiomas after surgery and radiotherapy have failed. CLINICAL CASE: A 60 year old female patient presenting with a sensory hemi-syndrome on the right side was diagnosed with an extensive dural based left frontotemporal mass associated with perifocal edema. A gross total resection (GTR) was performed and histological work-up revealed an atypical meningioma WHO grade II. Four years later, MRI showed extensive multifocal tumor progression in the frontal, parietal and occipital lobes without clinical deterioration. Again, the patient underwent GTR of all tumor lesions followed by continuous clinical and imaging follow up visits. Two years later, the patient presented with epileptic seizures and MRI again revealed multifocal tumor progression. Therefore the patient was treated with external beam radiotherapy at a total dose of 59,4 Gy (single fraction 1,8 Gy). Six months after termination of radiotherapy, the performance status of the patient deteriorated and MRI showed enlarging tumor lesions. These tumor lesions revealed strong radiotracer uptake on 68Ga-DOTATOC PET. Based on this high expression of somatostatin receptors, the patient was treatd by peptide receptor radionuclide therapy (PRRT) with 90Y-DOTATOC consisting of 4 cycles (mean dose 4.115 MBq/cycle). This treatment was well tolerated and the patient experienced a significant improvement of the performance status with a reduction of seizure frequency. Three months after termination of peptide receptor radionuclide therapy, disease stabilization could be achieved on MR- and PET-imaging with persisting clinical improvement, which is still ongoing after one year of clinical and imaging follow-up studies. CONCLUSION: A patient with recurrent atypical multifocal meningioma resistant to conventional treatment underwent 4 cycles of peptide receptor radionuclide therapy with 90Y-DOTATOC. After treatment, the patient experienced a significant clinical improvement and a stable tumor disease remained in MRI and PET images. Hence, PRRT proved to be a safe and feasible approach in a palliative treatment setting of recurrent highly somatostatin receptor expressing meningiomas. Nevertheless, prospective clinical trials are warranted to define the value of peptide receptor radionuclide therapy as an additional treatment option for recurrent meningiomas after standard treatment has failed.
Impaired intestinal tolerance in the absence of a functional complement system
Authors: Pirkka T. Pekkarinen, Kirsi Vaali, Hanna Jarva, Eliisa Kekäläinen, Iivo Hetemäki, Sami Junnikkala, Merja Helminen, Outi Vaarala, Seppo Meri, T. Petteri Arstila
Journal: Journal of Allergy and Clinical Immunology (2012)
Donor-derived regulatory B cells are important for suppression of murine sclerodermatous chronic graft-versus-host disease
Authors: Doanh Le Huu, Takashi Matsushita, Guihua Jin, Yasuhito Hamaguchi, Minoru Hasegawa, Kazuhiko Takehara, Thomas F. Tedder, Manabu Fujimoto
Journal: Blood (2013)
Adaptation to supraphysiologic levels of insulin gene expression in transgenic mice: evidence for the importance of posttranscriptional regulation.
Authors: B Schnetzler, G Murakawa, D Abalos, P Halban, R Selden
Journal: Journal of Clinical Investigation (1993)

Insulin production was studied in transgenic mice expressing the human insulin gene under the control of its own promoter. Glucose homeostasis during a 48-h fast was similar in control and transgenic mice, with comparable levels of serum immunoreactive insulin. Northern blot and primer extension analyses indicated that more than twice as much insulin mRNA is present in pancreata from transgenic mice. Primer extension analysis using oligonucleotides specific for mouse insulins I and II or for human insulin, showed that the excess insulin mRNA was due solely to expression of the foreign, human insulin gene. The ratio of mRNA for mouse insulin I and II was unaffected by coexpression of human insulin. There were coordinate changes in the levels of all three mRNA during the 48-h fast, or after a 24-h fast followed by 24-h refeed. Despite the supraphysiologic levels of insulin mRNA in the transgenic mice, their pancreatic content of immunoreactive insulin was not significantly different from controls. The comparison of the relative levels of human and mouse insulin mRNAs with their peptide counterparts (separated by HPLC) indicates that the efficiency of insulin production from mouse insulin mRNA is greater than that from human, stressing the importance of posttranscriptional regulatory events in the overall maintenance of pancreatic insulin content.
Psychiatry in the Emergency 'Room'
Authors: Beverly J. Fauman
Journal: JAMA (1979)

Fifteen years ago an article appeared<sup>1</sup>describing the frequently missed diagnoses and inappropriate referrals of psychiatric patients made by the house staff in a teaching-hospital emergency room. Many health centers had reported a high proportion of patients coming to the emergency room with primary psychiatric problems; nevertheless, most hospitals handled this problem by placing psychiatrists in the emergency room,<sup>2</sup>by training a multidisciplinary team<sup>3</sup>in the emergency room, or by establishing walk-in psychiatric clinics that also accepted referrals from the emergency room.<sup>4</sup>There are several developments in recent years that make it even more important that nonpsychiatrists learn emergency psychiatry, and the article by Barry and colleagues suggests an excellent remedy (p 1394). The first of these changes is that increasing numbers of long-term mental patients are being discharged to the community, where outpatient mental health centers and families are expected to provide the care and
Preparing for partnership
Authors: R. Smith
Journal: BMJ (2003)

Doctors don't like the idea that they don't put patients first—that they aren't “patient centred” in current jargon. Many doctors, particularly older ones, have sacrificed hundreds of nights' sleep, their health, and even their families to the care of patients. How can they not be “patient centred”?

The answer is that being patient centred involves much more than being dedicated and caring. It's a different way of thinking and behaving, where doctors and patients work together as true partners. Neither side finds it easy. This theme issue explores what a true partnership means and looks forward to a time when the BMJ itself—very much the property …
Emergency Aneurysmectomy in the Small Hospital
Authors: Charles M. Abernathy
Journal: JAMA (1981)

To the Editor.—  In the QUESTIONS AND ANSWERS section, Siker and Gross (1981;245:76) were both opposed to granting privileges for emergency aortic aneurysmectomy in a small 62-bed hospital.  We wonder on what data they base their conclusions. In fact, there are some data in the medical literature to support precisely the opposite view. A recent article addressed this problem specifically. 1 The conclusion was that with the appropriate back-up system such as blood banking, monitoring with the Swan-Ganz catheter, and adequate respiratory care, not only could quality vascular surgery be supplied in a small hospital setting, but that particularly in instances such as ruptured aortic aneurysms, it was preferable to the long wait of being transferred to a major medical center.  We presume that Siker and Gross are practitioners in a large metropolitan or suburban area because we, in a rural isolated situation, have found that helicopter evacuation of emergency
P61 Factors influencing improved lung cancer resection rates 2006 2012; A single centre case cohort study: Abstract P61 Table 1.
Authors: S Selvaraj, P Rajesh, B Naidu, M Kalkat, IS Woolhouse
Journal: Thorax (2013)

<h3>Background</h3> Surgical resection rates for lung cancer have increased steadily over the last decade. There are a number of possible explanations for this increase which include: earlier presentation, earlier detection and an increase capacity and/or willingness for thoracic surgeons to operate. The aim of this study is to identify which of these factors are associated with the increase in surgical resection seen at our institution, in particular, whether the increased use of CT scanning across all areas of medicine, e.g. cardiac CT, has impacted on the rate of incidentally detected operable lung cancers. <h3>Methods</h3> We used data submitted to the national lung cancer audit (excluding Mesothelioma) to identify changes in performance status (PS), lung function and stage at presentation from 2006 to 2012. We then performed a retrospective case note analysis of patients who received surgery to identify the proportion of surgical cases in whom the lung cancer had been detected incidentally i.e. on imaging not performed to investigate suspected lung cancer. Statistical comparisons were performed using chi-squared and ANOVA tests. <h3>Results</h3> Mean age was 71 years and did not change across the study period. The remaining results are summarised in the table. Surgical resection rates increased significantly during the study period but there was no change in performance status or lung function at presentation. There was a significant increase in the proportion of patients presenting with early stage disease however the proportion of operable lung cancers detected incidentally did not change during the study period. <h3>Conclusion</h3> The increase in surgical resection rates seen at our institution appears to relate to a stage shift at presentation. Although incidentally detected lung cancers make up a significant proportion of operable lung cancers, this does not account for the stage shift. An alternative explanation is the impact of the national awareness and early diagnosis campaign (formally launched in 2008) prompting patients to present earlier and GPs to refer sooner.
STAT1 inhibits liver fibrosis in mice by inhibiting stellate cell proliferation and stimulating NK cell cytotoxicity
Authors: Won-Il Jeong, Ogyi Park, Svetlana Radaeva, Bin Gao
Journal: Hepatology (2006)

Liver fibrosis, a common scarring response to chronic liver injury, is a precursor to cirrhosis and liver cancer. Here, we identified signal transducer and activator of transcription 1 (STAT1) as an important negative regulator in liver fibrosis. Our findings show that disruption of the STAT1 gene accelerated liver fibrosis and hepatic stellate cell (HSC) proliferation in an in vivo model of carbon tetrachloride (CCl4)-induced liver fibrosis. In vitro treatment with IFN-gamma inhibited proliferation and activation of wild-type HSCs, but not STAT1-/- HSCs. Moreover, compared to wild-type cells, cellular proliferation stimulated by serum or platelet-derived growth factor (PDGF) was enhanced and accelerated in STAT1-/- HSCs, which was partially mediated via elevated PDGF receptor beta expression on such cells. Polyinosinic-polycytidylic acid (poly I:C) or IFN-gamma treatment inhibited liver fibrosis in wild-type mice but not in STAT1-/- mice. Induction of NK cell killing of activated HSCs by poly I:C was attenuated in STAT1-/- mice compared to wild-type mice, which was likely due to reduced NKG2D and TRAIL expression on STAT1-/- NK cells. Finally, activation of TGF-beta/Smad3 signaling pathway was accelerated, whereas induction of Smad7 was diminished in the liver of STAT1-/- mice after CCl4 administration compared to wild-type mice. In conclusion, activation of STAT1 attenuates liver fibrosis through inhibition of HSC proliferation, attenuation of TGF-beta signaling, and stimulation of NK cell killing of activated HSCs. STAT1 could be a new therapeutic target for treating liver fibrosis.