tbuckley/cabot-search huggingface dataset:
P185 Improving The Accuracy Of Microbiological Diagnosis Of Tb Lymphadenitis - Is A Multidisciplinary Approach Necessary?
Authors: A. Saigal, H. Kalsi, R. Sands, A. Jayaratnam
Journal: Thorax (2014)

<h3>Introduction</h3> The gold standard for diagnosing tuberculosis (TB) is from culture of the organism from fluid or tissue. Histological analysis of surgical specimens is well-established, but microbiological analysis is less frequent. Our trust serves a population with a high incidence of TB. Therefore, patients who present with lymphadenopathy should always be considered for a diagnosis of TB and all specimens sent for microbiological and histological diagnosis. <h3>Methods</h3> A retrospective analysis was undertaken of all patients diagnosed with TB lymphadenitis between 2009–2013 using the London TB Register (LTBR), case notes and laboratory data to identify the proportion diagnosed with microbiology data compared with histology data. <h3>Results</h3> 324 patients were diagnosed with TB lymphadenitis from LTBR, of which 73% (235/324) had lymph node (LN) specimens taken for microbiological or histological diagnosis. 233 patients had extrathoracic disease alone, of which 62% (144/233) had LN tissue sent for microbiology with 74% yielding a positive culture. 75 patients had intrathoracic disease, of which 31% (23/75) had LN tissue sent for microbiology with 52% yielding a positive culture. In both groups, a greater percentage of LN tissue was sent for histo-cytological analysis than microbiology (see figure). 75% (12/16) of patients with combined extrathoracic and intrathoracic disease had specimens sent for microbiology. 83% (11/16) gained a positive microbiological diagnosis from lymph node sampling. <h3>Conclusion</h3> Microbiological specimens were more likely to be sent in patients with extrathoracic disease compared to those with intrathoracic disease. This may partly be explained by the fact that all intrathoracic lymph node sampling during this study period was undertaken at other centres, mostly through referrals from the lung cancer MDT. Therefore TB may not have been considered as a possible diagnosis. However, a significant proportion of surgical samples taken locally did not have microbiology specimens sent, which potentially may have impacted on treatment outcomes. This review highlights that more education should be undertaken locally with surgical and radiology departments and the lung MDT, emphasising the need for all lymph node specimens to be sent for both microbiological and histological analysis.
Coal Home Heating and Environmental Tobacco Smoke in Relation to LowerRespiratory Illness in Czech Children, from Birth to 3 Years of Age
Authors: Rebecca J. Baker (posthumous), Irva Hertz-Picciotto, Miroslav Dostál, Jean A. Keller, Jiři Nožička, František Kotìšovec, Jan Dejmek (posthumous), Dana Loomis, Radim J. Šrám
Journal: Environmental Health Perspectives (2006)

ObjectiveThe objective of this study was to evaluate how indoor pollution from tobacco and home heating may adversely affect respiratory health in young children.DesignA birth cohort was followed longitudinally for 3 years to determine incidence of lower respiratory illness (LRI).ParticipantsA total of 452 children born 1994–1996 in two districts in the Czech Republic participated.EvaluationsIndoor combustion exposures were home heating and cooking fuel, mother's smoking during pregnancy, and other adult smokers in the household. Diagnoses of LRI (primarily acute bronchitis) from birth to 3 years of age were abstracted from pediatric records. Questionnaires completed at delivery and at 3-year follow-up provided covariate information. LRI incidence rates were modeled with generalized linear models adjusting for repeated measures and for numerous potential confounders.ResultsLRI diagnoses occurred more frequently in children from homes heated by coal [vs. other energy sources or distant furnaces; rate ratio (RR) = 1.45; 95% confidence interval (CI), 1.07–1.97]. Maternal prenatal smoking and other adult smokers also increased LRI rates (respectively: RR = 1.48; 95% CI, 1.10–2.01; and RR = 1.29; 95% CI, 1.01–1.65). Cooking fuels (primarily electricity, natural gas, or propane) were not associated with LRI incidence. For children never breast-fed, coal home heating and mother's smoking conferred substantially greater risks: RR = 2.77 (95% CI, 1.45–5.27) and RR = 2.52 (95% CI, 1.31–4.85), respectively.ConclusionsMaternal smoking and coal home heating increased risk for LRI in the first 3 years of life, particularly in children not breast-fed.RelevanceFew studies have described effects of coal heating fuel on children's health in a Western country. Breast-feeding may attenuate adverse effects of prenatal and childhood exposures to combustion products.
Spiritual Therapy: How the Physician, Psychiatrist and Minister Collaborate in Healing
Authors: John H. Talbott
Journal: JAMA (1960)

This little book has a remarkable history. A paper by Drs. Richard K. Young and Benjamin S. Patrick, "Outpatient Pastoral Counseling in a Medical Center," was published inThe Journalon Septemberber 6, 1958. Mr. Clarence Hall, senior editor of the<i>Reader's Digest</i>, was so impressed with it that he made two visits to the North Carolina Baptist Hospital, the teaching hospital of the Bowman Gray School of Medicine, to collect material for an article on the work of Chaplain Dick Young and his associates in the department of pastoral care. In order to justify the length of the article, he published it in the Book Section of the<i>Reader's Digest</i>as "condensed form of a forthcoming book" and extracted a promise from Dr. Young that he would write the book thus condensed. "Spiritual Therapy" is the result. The book shows a new approach to the relation between physician and
Abstract 4336: Fluorescence laparoscopy for high-resolution pancreatic tumor imaging in an orthotopic mouse model
Authors: Hop S. Tran Cao, Sharmeela Kaushal, Claudia Y. Lee, Cynthia S. Snyder, Kari J. Thompson, Santiago Horgan, Mark A. Talamini, Robert M. Hoffman, Michael Bouvet
Journal: Cancer Research (2010)

Abstract We report here the development of fluorescence laparoscopy to image green fluorescent protein (GFP)-expressing pancreatic tumors in an orthotopic mouse model. An orthotopic mouse model of human pancreatic cancer was established by injecting GFP-expressing MiaPaca-2 human pancreatic cancer cells into the pancreas of 6-week old female athymic mice. On post-operative day 14, the animals underwent a diagnostic laparoscopy using both white and fluorescent light. The fluorescence laparoscope was constructed by modifying a standard laparoscopic system in the following manner: a 480-nm short pass excitation filter was placed between the light cable and the laparoscope, and a 2-mm thick emission filter that allows leakage of 1% of the background light was placed between the laparoscope and the camera. The camera and recording system were replaced with a MultiCam 310C (UVP, Upland, CA) that allows variable exposure time and gain setting in the controlling software. The exposure time was set to 110 msec and the gain to 97. A 3-mm 0-degree laparoscope was used in the mice. The mouse's abdomen was gently insufflated to 2 mm Hg via a 22-gauge angiocatheter that was secured via a suture. After fluorescence laparoscopy, the animals were sacrificed, and the identified tumors were collected and processed for histology. The experiments were performed in triplicate. Fluorescence laparoscopy allowed facile and rapid identification of the bright fluorescent tumors in the pancreatic body. By employing the specific parameters above mentioned, a clear background was visible along with the fluorescent tumor under the fluorescent light mode. This could proffer an advantage in allowing exact localization of the lesions, eliminating the need to flip back and forth between white and fluorescent lighting, under which the background is usually so darkened that it is difficult to maintain spatial orientation. In summary, the use of fluorescence laparoscopy permits the facile, clear, and rapid identification and localization of tumors that are labeled with fluorescent proteins or other fluorophores. Fluorescence laparoscopy may thus play a useful role in the diagnosis and staging of pancreatic and other aggressive gastrointestinal cancers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4336.
Director of private hospital is cleared of falsely claiming NHS employment
Authors: Owen Dyer
Journal: BMJ (2006)

The founder and medical director of a private day hospital was cleared this week by the General Medical Council of falsely claiming on her curriculum vitae to have been employed by five major NHS hospitals.

Jean Monro, medical director of Breakspear Hospital in Hemel Hempstead, was accused by the GMC's fitness to practise panel of writing a “dishonest” CV with intent to mislead. Dr Monro claimed to have been medical director of the “allergy and environmental medicine department” of the Middlesex Hospital, the London Welbeck Hospital, the Lister Hospital, the St John and St Elizabeth Hospital, and the Nightingale Hospital.

In …
All-in-One inducible lentiviral vector systems based on drug controlled FLP recombinase
Authors: Tobias Maetzig, Johannes Kuehle, Adrian Schwarzer, Soeren Turan, Michael Rothe, Anuhar Chaturvedi, Michael Morgan, Teng Cheong Ha, Michael Heuser, Wolfgang Hammerschmidt, Christopher Baum, Axel Schambach
Journal: Biomaterials (2014)
The role of PAX5 and C/EBP α/β in atypical non-Langerhans cell histiocytic tumor post acute lymphoblastic leukemia
Authors: F Pagni, G Fazio, S Zannella, M Spinelli, C De Angelis, C Cusi, F Crosti, L Corral, C Bugarin, A Biondi, G Cazzaniga, G Isimbaldi, G Cattoretti
Journal: Leukemia (2014)
Kinetic analysis of 25-hydroxyvitamin D3 metabolism in strontium-induced rickets in the chick.
Authors: J L Omdahl, G Jelinek, R P Eaton
Journal: Journal of Clinical Investigation (1977)

Kinetic data analysis was used to derive a six-compartment computer model which describes the in vivo [3H]25-hydroxyvitamin D3 ([3H]25-OHD3) metabolism in control and strontium rachitic chicks. Plasma concentrations of 25-OHD3 (13 pmol/ml) and 25, 25-dihydroxyvitamin D3 (0.9 pmol/ml) were 18 and 125% greater than controls, respectively, whereas the corresponding level for 1alpha,25-dihydroxyvitamin D3 (0.3 pmol/ml) was only 30% of control. Plasma disappearance of 25-HOD3 was fitted using a two-compartment model in which the metabolite extrapolated half-life was nearly twice as large for strontium rachitic chicks (71 compared to 41 h). Intestinal sequestration of 1alpha,25-dihydroxyvitamin D3 was assumed to be irreversible and was fitted by a single exponential term in which metabolite uptake rate and tissue concentration in strontium rickets was suppressed to 20 and 10% of control, respectively. In contrast, uptake of 25-OHD3 by the intestine was observed to occur by a reversible process in which metabolite concentration was 45% greater in the strontium rachitic compared to control group. The developed compartment model accepts time-dependent control or perturbed metabolite data for the plasma and (or) intestinal pools and provides quantitative values for metabolite pool size, flux rate, and turnover time.
Principles of gynaecology
Authors: Irwin H. Kaiser
Journal: JAMA (1963)

T. N. A. Jeffcoate, Professor of Obstetrics and Gynaecology at the University of Liverpool, has produced a personal tour de force, an 800-page textbook of gynecology, now in its second edition. The text is distinguished for the judiciousness and clarity with which clinical gynecology is presented, both in the written word and in a fine set of illustrations. There is no doubt allowed as to the author's opinions, which, except in a few areas, correspond with those accepted in American practice. This is not achieved in so small a compass without some sacrifice. The book has no references nor is authority other than the author's offered with any frequency. As a result, it is an excellent resource for orientation of the student to the clinical aspects of common disorders, but it cannot be used as a starting point for further study, nor as an index to information on rare problems.
Renal Vein Thrombosis
Authors: J. Adan Ganel
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Nephrotic patients with membranous glomerulonephritis have a very high incidence of renal vein thrombosis, as high as 40%.<sup>1</sup>The patient reported by Luft et al (234: 1158,1975) had this type of renal disease, and he also had another important predisposing factor for the development thrombosis—his extreme obesity. Obese patients have a deficient fibrinolytic mechanism<sup>2,3</sup>that correlates with the degree of overweight.<sup>4</sup>Obesity has recently been described in association with large amounts of fibrin in the glomeruli, mesangial IgM, C3, and a form of nephrotic syndrome that is reversible with weight reduction.<sup>5</sup>It is conceivable that fibrin deposition in the glomeruli could limit the phagocytic action of the mesangial cells reducing their efficiency in the removal of immunocomplexes and other mediators of glomerular injury. I share the view that nephrotic patients with massive obesity, as well as those with membranous glomerulonephritis, should be carefully
A REPORT OF TWO CASES OF NEPHRECTOMY, SARCOMA AND PYONEPHROSIS.Read before the Kings County Medical Association. December 8, 1891.
Authors: J. D. SULLIVAN
Journal: JAMA (1892)

The two cases herein reported present many points of special interest, and it is hoped that their consideration will afford some additional knowledge relating to surgical diseases of the kidney. <i>Case 1</i>.—Miss K. D., aged 17 years, nativity New York, called at my office on April 7, 1890, to seek relief from pain in her back and right lumbar region, and a variety of symptoms pertaining to her nervous system. On careful inquiry, I elicited the following history: Father, brothers and sisters are in the enjoyment of good health. Mother died recently from kidney disease accompanied with dropsy. No other hereditary taint. Patient has had irritable bladder since childhood. In February, 1889, she began to have pain in her back and right lumbar region, and frequent headaches. Soon after she began to have fainting spells, which would last from half an hour to two hours, with various nervous phenomena of
Phase 2 trial of copper depletion and penicillamine as antiangiogenesis therapy of glioblastoma
Authors: Steven Brem, Stuart A. Grossman, Kathryn A. Carson, Pamela New, Surasak Phuphanich, Jane B. Alavi, Tom Mikkelsen, Joy D. Fisher
Journal: Neuro-Oncology (2005)

Penicillamine is an oral agent used to treat intracerebral copper overload in Wilson's disease. Copper is a known regulator of angiogenesis; copper reduction inhibits experimental glioma growth and invasiveness. This study examined the feasibility, safety, and efficacy of creating a copper deficiency in human glioblastoma multiforme. Forty eligible patients with newly diagnosed glioblastoma multiforme began radiation therapy (6000 cGy in 30 fractions) in conjunction with a low-copper diet and escalating doses of penicillamine. Serum copper was measured at baseline and monthly. The primary end point of this study was overall survival compared to historical controls within the NABTT CNS Consortium database. The 25 males and 15 females who were enrolled had a median age of 54 years and a median Karnofsky performance status of 90. Surgical resection was performed in 83% of these patients. Normal serum copper levels at baseline (median, 130 μg/dl; range, 50-227 μg/dl) fell to the target range of <50 μg/dl (median, 42 μg/dl; range, 12-118 μg/dl) after two months. Penicillamine-induced hypocupremia was well tolerated for months. Drug-related myelosuppression, elevated liver function tests, and skin rash rapidly reversed with copper repletion. Median survival was 11.3 months, and progression-free survival was 7.1 months. Achievement of hypocupremia did not significantly increase survival. Although serum copper was effectively reduced by diet and penicillamine, this antiangiogenesis strategy did not improve survival in patients with glioblastoma multiforme.
Effectiveness of Emergency Response Planning for Sudden Cardiac Arrest in United States High Schools With Automated External Defibrillators
Authors: Jonathan A. Drezner, Ashwin L. Rao, Justin Heistand, Megan K. Bloomingdale, Kimberly G. Harmon
Journal: Circulation (2009)

US high schools are increasingly adopting automated external defibrillators (AEDs) for use in campus settings. We analyzed the effectiveness of emergency response planning for sudden cardiac arrest (SCA) in a large cohort of US high schools that had onsite AED programs.A cohort of US high schools with at least 1 onsite AED was identified from the National Registry for AED Use in Sports. A school representative completed a comprehensive survey on emergency planning and provided details of any SCA incident occurring within 6 months of survey completion. Surveys were completed between December 2006 and July 2007. In total, 1710 high schools with an onsite AED program were studied. Although 83% (1428 of 1710) of schools have an established emergency response plan for SCA, only 40% practice and review the plan at least annually with potential school responders. A case of SCA was reported by 36 of 1710 schools (2.1%). The 36 SCA victims included 14 high school student athletes (mean age, 16 years; range, 14 to 17 years) and 22 older nonstudents (mean age, 57 years; range, 42 to 71 years) such as employees and spectators. No cases were reported in student nonathletes. Of the 36 SCA cases, 35 (97%) were witnessed, 34 (94%) received bystander cardiopulmonary resuscitation, and 30 (83%) received an AED shock. Twenty-three SCA victims (64%) survived to hospital discharge, including 9 of the 14 student athletes and 14 of the 22 older nonstudents.School-based AED programs provide a high survival rate for both student athletes and older nonstudents who suffer SCA on school grounds. High schools are strongly encouraged to implement onsite AED programs as part of a comprehensive emergency response plan to SCA.
The Albuminuria of Adolescents, often the Beginning of Bright's Disease(?)
Authors: C. Dukes
Journal: BMJ (1881)

wrote a paper, quoting cases, on the frequency of albuminuria in adolescents, aX,d expressetd my belief that it was plysiol,/,ica/-incidentaI to puberty.But in it I stated: " This albun,inuria of puberty is often so persist- cit, and, even when it bus disappeared, recurs again and again so often, that I fear many of the cases pass on to chronic Bright's disease- a!though this I can only surmise, as I lose sight of them; but long cow,inued or often repeated hyperxumia is the cause of all kidney-dis- ea-cs."Since then, I have had numerous cases; and, from this persistence, and from the increasc of the albuumen, I am led to believe that the cd.)ndition is not onlypalzolog*ical, as Dr. George Johnson holds, but tli it I am seeing the very beginning of shat becomes, in many cases, eventually true Bright's dlisease.I have no opportunity of following thznse cases up, anid so this paper is only conjectural; though it may lca i otlhers to inivestigate further than lies in my power.Their Izistary is this.An adolescent has symptoms that make me s .archfor albumen: either morning headaches, disappearing as the day goes on; or miiarked dyspepsia; or increased impulse of heart and arte- ridii tension; or slight wodema observed in the face; or a fecling of dehility, and even syncope: albumen is found, and is followed for years.T:<.e hleaving heart and the increased arterial tension are sometimes so miatked, that I can diagniose the albuminuria from it alone, and I a-ii led to examine for it in consequence.Part of this increased cardiac
Dyspeptic patients with visceral hypersensitivity: sensitisation of pain specific or multimodal pathways?
Authors: J Vandenberghe
Journal: Gut (2005)

Patients with functional dyspepsia who have hypersensitivity to gastric distension have more prevalent pain, suggesting the presence of hyperalgesia. It is unclear whether this reflects activation of pain specific afferent pathways or multimodal afferent pathways that also mediate non-painful sensations. In the former case, hyperalgesia should occur when intensity of non-painful sensations is still low. The aim of the study was to analyse whether the symptom profile during gastric dissentions in functional dyspepsia patients with hyperalgesia reflects sensitisation of pain specific or multimodal pathways.Forty eight consecutive dyspeptic patients (35 female) underwent gastric sensitivity testing with a barostat balloon using a double random staircase protocol. At the end of every distending step, patients scored perception of upper abdominal sensations on a graphic 0-6 rating scale and completed visual analogue scales (VAS 0-100 mm) for pain, nausea, satiety, and fullness. The end point was a rating scale of 5 or more.Hypersensitivity was present in 20 patients (40%); gastric compliance did not differ between normo- and hypersensitive patients. At maximal distension (score 5 or more), hypersensitive patients had significantly lower distending pressures and intra-balloon volumes, but similar VAS scores for pain, nausea, satiety, and fullness compared with normosensitive patients. In both normosensitive and hypersensitive patients, elevation of pain VAS scores with increasing distending pressures paralleled the elevation in VAS scores for nausea, satiety, and fullness.Hypersensitive dyspeptic patients reach the same intensity of painful and non-painful sensations as normosensitive patients but at lower distending pressures. Hyperalgesia occurs in hypersensitive dyspeptic patients at distending pressures that also induce intense non-painful sensations. These findings argue against isolated upregulation of pain specific afferents in functional dyspepsia patients with visceral hypersensitivity.
Risk, Prognosis, and Unintended Consequences in Kidney Allocation
Authors: Benjamin E. Hippen, J. Richard Thistlethwaite, Lainie Friedman Ross
Journal: New England Journal of Medicine (2011)

Proposed changes to the allocation system for deceased-donor kidneys rely on unvalidated models that may unfairly reduce transplantation opportunities for some patients, inappropriately benefit others, and have unintended consequences for donation by living donors.
Laparoscopic Antegrade Biliary Stenting
Authors: M. Rhodes, L. Nathanson, N. O'Rourke, G. Fielding
Journal: Endoscopy (1995)

Laparoscopic common bile duct exploration is successful in 90% of patients, but 10% of patients may have retained stones or impaired biliary drainage at the end of surgery. This study presents the results of laparoscopic biliary stenting in three such patients.Three patients with choledocholithiasis, aged 51, 82, and 100 were treated by laparoscopic antegrade placement of biliary stent.Biliary drainage was established in all three cases. Follow-up at six months revealed all patients to be asymptomatic, with two aged 82 and 101 with the stents still in place.Laparoscopic antegrade biliary stenting deserves consideration when the surgeon encounters impaired biliary drainage after laparoscopic exploration of the common bile duct.