tbuckley/cabot-search huggingface dataset:
Fungal Peritonitis and Peritoneal Catheters
Authors: ARLEN G. FLEISHER
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 January 1985Fungal Peritonitis and Peritoneal CathetersARLEN G. FLEISHER, M.D., FRED KIMMELSTIEL, M.D., CONRAD G. LATTES, M.D., ROBERT E. MILLER, M.D.ARLEN G. FLEISHER, M.D.Search for more papers by this author, FRED KIMMELSTIEL, M.D.Search for more papers by this author, CONRAD G. LATTES, M.D.Search for more papers by this author, ROBERT E. MILLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-1-138_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Cecchine and Panarello (1) in differing with Kerr and coauthors (2) suggest that a protracted course with an appropriate agent may be useful for the treatment of patients with fungal peritonitis without necessitating removal of a permanent peritoneal catheter.If not promptly treated, peritonitis, manifested by abdominal pain, tenderness, fever, cloudy dialysate, elevated leukocyte count in the dialysate, and positive dialysate cultures, remains a significant and potentially life-threatening complication. In many cases peritonitis can be successfully treated with intraperitoneal or intravenous plus intraperitoneal antibiotic agents.Between 1980 and 1983, of 47 patients with peritonitis secondary to indwelling...References1. CECCHINEPANARELLO EG. Fungal peritonitis in ambulatory peritoneal dialysis [Letter]. Ann Intern Med. 1984;100:321. LinkGoogle Scholar2. KERRPERFECTCRAVEN CJP. Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis. Ann Intern Med. 1983;99:334-7. LinkGoogle Scholar3. FLEISHERKIMMELSTIELLATTES AFC. Surgical complications of peritoneal dialysis catheters. Am J Surg. 1985. (In press). CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: St. Luke's-Roosevelt Hospital Center New York, NY 10025 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1985Volume 102, Issue 1Page: 138-138KeywordsAbdominal painAntibioticsCathetersFeversPatientsPeritonitis Issue Published: 1 January 1985 PDF DownloadLoading ...
The Relationship Between Coronary Angioplasty Procedure Volume and Major Complications
Authors: Stephen E. Kimmel
Journal: JAMA (1995)

To assess the relationship between the volume of percutaneous transluminal coronary angioplasty (PTCA) procedures performed in a cardiac catheterization laboratory and major complications after adjusting for case mix and to evaluate the applicability of current guidelines for minimum laboratory volume.Cohort study using the 1992 and 1993 registries of the Society for Cardiac Angiography and Interventions.Forty-eight cardiac catheterization laboratories from throughout the United States and Canada.All 19 594 consecutive patients without an acute myocardial infarction (MI) undergoing a first coronary balloon angioplasty.Emergency bypass surgery, MI, or in-hospital death.There was a significant decrease in the rates of in-hospital mortality (P = .04), emergency bypass surgery (P < .001), MI (P - .001), and major complications (defined as one or more of these outcomes; P < .001) with increasing cardiac catheterization laboratory volume. After adjustment for case mix using multivariable analysis, these associations persisted, although the association with mortality was no longer statistically significant. There was no significant difference in outcomes in laboratories performing at least 200 vs fewer than 200 procedures per year, the currently recommended minimum laboratory volume (odds ratio [OR] for major complications, 0.81; 95% confidence interval [CI], 0.53 to 1.25). However, a statistically significant decrease in major complications was observed in laboratories performing more than 400 procedures per year (adjusted OR, 0.66; 95% CI, 0.46 to 0.96; P = .03; and OR, 0.54; 95% CI, 0.38 to 0.78; P = .001) when laboratories performing 400 through 599 procedures and at least 600 procedures per year, respectively, are compared with those performing fewer than 200 per year.An inverse association between cardiac catheterization laboratory procedure volume and major complications during PTCA exists independent of differences in patients' risk profiles. Our data suggest that the currently recommended minimum laboratory volume may be too low to distinguish higher-risk from lower-risk laboratories.
Peripheral Neuropathy and Serous Meningitis Due to Horse Serum
Authors: John W. Walsh
Journal: New England Journal of Medicine (1952)

REACTIONS due to horse-serum sensitization, so common prior to the present era of specific antibiotic and chemotherapeutic agents, are now comparatively rare. We are therefore reporting a case of peripheral neuropathy due to tetanus antitoxin in order to re-emphasize the existence of the syndrome and especially to point out the failure of cortisone therapy.Case ReportA 27-year-old construction worker was admitted to the Brooklyn Veterans Administration Hospital on May 22, 1950, because of fever of 6 days' duration, together with urticaria and pains in the neck and arms for 12 hours.The patient stated that on May 10, 1950, . . .
Constructivism: Can directed mutation improve on classical neural selection?
Authors: George N. Reeke
Journal: Behavioral and Brain Sciences (1997)

Quartz &amp; Sejnowski (Q&amp;S) find flaws in standard theories of neural selection, which they propose to repair by introducing Lamarckian mechanisms for anatomical refinement that are analogous to directed mutation in evolution. The reversal of cause and effect that these mechanisms require is no more plausible in an explanation of cognition than it is in an explanation of evolution.
Artificial Cardiac Pacing: Practical Approach
Authors: William H. Wehrmacher
Journal: JAMA (1980)

With more than a third of a million patients now carrying permanently implanted electronic pacemakers and with the lives of many of these patients absolutely dependent on that device, physicians now require at least rudimentary knowledge of their function. Dr Chung has aptly selected 23 American electronic-pacemaker experts to teach physicians in training, family physicians, emergency room physicians, internists, cardiologists, and cardiac surgeons not only how to deal with existing problems but also to recognize the 25,000 to 40,000 new patients each year who require implantation. The new book that these experts have produced together shows a shift from atrioventricular block as the chief indication for implantation of the electronic pacemaker to the socalled sick sinus syndrome. Currently the indications are expanding to include intractable tachydysrhythmias. Dr Doris J. W. Escher writes in the final chapter of the book, "Future Development of Artificial Pacing," about expectation for pacemakers to be
Retrospective Evaluation of the Clinical and Radiographic Risk Factors Associated With Severe Pulmonary Hemorrhage in First-Line Advanced, Unresectable Non–Small-Cell Lung Cancer Treated With Carboplatin and Paclitaxel Plus Bevacizumab
Authors: Alan B. Sandler, Joan H. Schiller, Robert Gray, Isaiah Dimery, Julie Brahmer, Meghna Samant, Lisa I. Wang, David H. Johnson
Journal: Journal of Clinical Oncology (2009)

Purpose Severe (grade ≥ 3) pulmonary hemorrhage (PH) in advanced non–small-cell lung cancer was observed in two prospective, randomized, phase II (N = 99) and phase III (N = 878) trials of bevacizumab plus carboplatin and paclitaxel. Retrospective case-control and cohort analyses were conducted to identify associated radiographic and clinical risk factors for PH. Patients and Methods Six patients with PH from the phase II trial, 15 potential PH patients with hemorrhage at any site from the phase III trial, and their matched controls were evaluated with review of baseline and on-treatment radiographs by an independent radiology facility, blinded to patient/control status. Patients with severe (grade ≥ 3) PH from each trial were matched with up to three controls based on sex, age group, histology (phase II), or sex and age group (phase III). Results Seven PH patients in the phase III trial were identified as severe PH. Six of the patients were early onset (occurred &lt; 150 days of initiating bevacizumab) and one was late onset. Baseline tumor cavitation, not tumor location, was identified as the only potential risk factor for patients with early onset. Combined analysis of severe PH patients from the phase II and phase III trials (n = 13), compared with their pooled matched controls (n = 42), did not identify any additional baseline radiographic or clinical variables associated with PH. Conclusion PH was an uncommon event. Based on these analyses, baseline tumor cavitation may be a potential risk factor for PH. No other baseline clinical variables were predictive for PH although the number of events was small.
The Importance of Genetic Mosaicism in Human Disease
Authors: Andre Bernards, James F. Gusella
Journal: New England Journal of Medicine (1994)

Several genetic diseases can have the clinical features of either a generalized condition or a disorder with an alternating pattern of affected and unaffected body segments. With skin disorders, in which the segmental expression of symptoms is most easily observed, the pattern of affected and healthy skin often follows the so-called lines of Blaschko. Such mosaic patterns have long been assumed to reflect mutations occurring after fertilization. These postzygotic mutations result in genetic mosaicism -- a condition in which people have a mixture of genetically distinct cell populations (Figure 1). The article by Paller and colleagues in this issue of . . .
Prognostic Value of Akt-1 in Human Prostate Cancer: A Computerized Quantitative Assessment with Quantum Dot Technology
Authors: Rile Li, Hong Dai, Thomas M. Wheeler, Mohammad Sayeeduddin, Peter T. Scardino, Anna Frolov, Gustavo E. Ayala
Journal: Clinical Cancer Research (2009)

Akt/protein kinase B signaling pathway has been implicated in tumorigenesis and progression. Previous studies showed the predictive potential of p-Akt-1, but total Akt-1 could provide more reliable information. We used image deconvolution, nanotechnology (quantum dots), and image analysis to improve Akt-1 quantification.This tissue microarray study included 840 radical prostatectomy cases. Slides were incubated with primary antibody against nonphosphorylated Akt-1 (Akt-1) followed by biotinylated secondary antibody and then by Qdot655 streptavidin conjugate. Slides were imaged under fluorescence microscopy and spectral deconvolution (Nuance) and quantified using plug-in image analysis software. Average intensity of Akt-1 signal was measured and subject to statistical analysis. Multivariate analysis (Cox regression) was applied to assess the prognostic value of Akt-1 for biochemical recurrence and prostate cancer-specific death. Akt-1 expression was also examined for correlations with Ki-67 index and apoptotic index in our database.Akt-1 was inversely correlated with apoptotic index (rho = -0.203; P = 0.004) but not with Ki-67 index. The correlation between Akt and p-Akt is significant but weak (P = 0.0496; R(2) = 0.118). On multivariate analysis Akt-1 was independently predictive of biochemical recurrence [hazard ratio, 2.863 (95% confidence interval, 1.127-7.271); P = 0.0270]. Akt-1 level is also predictive of prostate cancer-specific death (P = 0.0376).High levels of Akt-1, assessed by quantum dots, deconvolution imaging, and image analysis, are associated with a higher risk of biochemical recurrence and prostate cancer-specific death.
Chronic inflammation upregulates chemokine receptors and induces neutrophil migration to monocyte chemoattractant protein-1
Authors: Brent Johnston, Alan R. Burns, Makoto Suematsu, Thomas B. Issekutz, Richard C. Woodman, Paul Kubes
Journal: Journal of Clinical Investigation (1999)

Monocyte chemoattractant protein-1 (MCP-1) is a CC chemokine that stimulates monocyte recruitment when injected into tissues of healthy animals. However, the function of this chemokine in models with preexisting inflammation is not known. Therefore, MCP-1 was superfused over the mesentery of naive rats or rats with chronic adjuvant-induced vasculitis. MCP-1 elicited increased leukocyte transendothelial migration in adjuvant-immunized rats compared with naive animals. Surprisingly, histology revealed that neutrophils constituted the majority of leukocytes recruited in adjuvant-immunized animals. In vitro, MCP-1 was also able to induce chemotaxis of neutrophils isolated from adjuvant-immunized rats but not from naive rats. Flow cytometry revealed novel expression of the CC chemokine receptors CCR1 and CCR2 on neutrophils from adjuvant-immunized animals. In naive animals, an antibody against CD18 blocked leukocyte adhesion and emigration in response to MCP-1. In adjuvant-immunized animals, leukocyte adhesion was reduced by antibodies against the alpha4-integrin but not by antibodies against CD18. However, the CD18 antibody did block emigration. To our knowledge, this study is the first to show increased sensitivity to a CC chemokine in a model with preexisting inflammation, and altered leukocyte recruitment profiles in response to MCP-1. It also demonstrates that CD18 is required for chemokine-induced leukocyte transendothelial migration, independent of its known role in mediating firm adhesion. J. Clin. Invest. 103:1269-1276 (1999).
Multiyear Climate Variability and Dengue—El Niño Southern Oscillation, Weather, and Dengue Incidence in Puerto Rico, Mexico, and Thailand: A Longitudinal Data Analysis
Authors: Michael A. Johansson, Derek A. T. Cummings, Gregory E. Glass
Journal: PLoS Medicine (2009)

Background The mosquito-borne dengue viruses are a major public health problem throughout the tropical and subtropical regions of the world. Changes in temperature and precipitation have well-defined roles in the transmission cycle and may thus play a role in changing incidence levels. The El Niño Southern Oscillation (ENSO) is a multiyear climate driver of local temperature and precipitation worldwide. Previous studies have reported varying degrees of association between ENSO and dengue incidence. Methods and Findings We analyzed the relationship between ENSO, local weather, and dengue incidence in Puerto Rico, Mexico, and Thailand using wavelet analysis to identify time- and frequency-specific association. In Puerto Rico, ENSO was transiently associated with temperature and dengue incidence on multiyear scales. However, only local precipitation and not temperature was associated with dengue on multiyear scales. In Thailand, ENSO was associated with both temperature and precipitation. Although precipitation was associated with dengue incidence, the association was nonstationary and likely spurious. In Mexico, no association between any of the variables was observed on the multiyear scale. Conclusions The evidence for a relationship between ENSO, climate, and dengue incidence presented here is weak. While multiyear climate variability may play a role in endemic interannual dengue dynamics, we did not find evidence of a strong, consistent relationship in any of the study areas. The role of ENSO may be obscured by local climate heterogeneity, insufficient data, randomly coincident outbreaks, and other, potentially stronger, intrinsic factors regulating transmission dynamics. Please see later in the article for the Editors' Summary
Companies may face tighter regulation over promoting drugs
Authors: David Spurgeon
Journal: BMJ (2004)

The drug industry may be facing the same kind of sea change in business practices and regulation that other segments of corporate America faced in the wake of Enron and other corporate scandals, says an article in the New England Journal of Medicine (2004;351: 1891-900). David Studdert and colleagues from the Harvard School of Public Health and Harvard Medical School say that the remarkable increase in regulatory, self regulatory, and prose-cutorial activity that currently focuses on conflicts of interest between doctors and drug companies will intensify.
Internal urinary sphincter in maintenance of female continence.
Authors: E Versi, L D Cardozo, J W Studd, M Brincat, T M O'Dowd, D J Cooper
Journal: BMJ (1986)

The integrity of the bladder neck was assessed in 98 continent women. Radiological and physiological evidence showed that half of these women had an incompetent bladder neck, but they were still continent. These data devalue the urodynamic finding of an incompetent bladder neck as an indication for surgery for incontinence and question the physiological importance of the internal sphincter.
The Use of Fresh-Frozen Plasma-Reply
Authors: Harold A. Oberman
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Chapman points out the circular problem related to the inappropriate use of FFP; namely, since physicians continue to request the product, blood banks continue to provide it, regardless of its clinical appropriateness. As indicated in my editorial, hospital transfusion service directors and medical advisory committees of regional blood banks must take a leadership role in reserving FFP for patients having specific clinical indications for it. When indications for FFP are met and yet plasma is appropriate treatment, singledonor plasma, usually in the form of cryoprecipitate-poor plasma, should be issued. Aside from cost, the major reason for avoiding use of FFP relates to its importance as a source of factor VIII for treatment of patients with hemophilia A.
Antiviral Therapy Reduces Risk of Hepatocellular Carcinoma in Patients With Hepatitis C Virus–Related Cirrhosis
Authors: Ashwani K. Singal, Amanpal Singh, Sathya Jaganmohan, Praveen Guturu, Rajasekhara Mummadi, Yong–Fang Kuo, Gagan K. Sood
Journal: Clinical Gastroenterology and Hepatology (2009)
Recent Findings May Inform Breast Density Notification Laws
Authors: Richard Trubo
Journal: JAMA (2015)

Arecent study that questions the effectivenessof supplemental breast cancer screening for women with densebreasts couldbeona collision course with state laws mandating that women be notified if a mammogram shows they have high breast density. Experts say that about 40% to 50%of womenhavedensebreast tissue,whichhas been associated with higher breast cancer risk. Adding ultrasonography to mammography often is suggested because limited data indicate that it can strengthen breast cancer detection rates. Even so, uncertainty has surrounded whether the additional screening improves long-term outcomes and whether it’s cost-effective. But data published late last year show that supplemental ultrasonography produces only small health benefits while it substantially increases costs (Sprague BL et al. Ann Intern Med. doi:10.7326/M14-0692 [published online December 9, 2014]). Breast tissue is considered “dense” if it has excess fibrous or glandular tissue, according to the American College of Radiology. Some estimates have suggested that mammographic density accounts for 16% of all breast cancers (Assi V et al. Nat Rev Clin Oncol. 2012;9[1]:33-40). Consequently, these types of data helped build momentum for laws that require notification of women with dense breasts, largely led by a grassroots movement called “Are You Dense?” Women Need Information Nancy M. Cappello, PhD, has been a key force behind the state-by-state legislation for breast density notification. She has written about her personal experience, which began when her own mammogram was reported as being normal (Cappello NM. J Am Coll Radiol. 2013;10[12]:903908). Only 2 months later, however, she was diagnosed with stage IIIC breast cancer. As she wrote in the article, “My radiologist knew that I had dense breasts. My doctor knew that I had dense breasts. The only person who did not know was me: the woman with the dense breasts.” In fact, according to data published on the “Are You Dense?” website, 95% of women do not know their breast density (http:// www.areyoudense.org/). Fewer than 1 in 10 women learn about their dense breast tissue from their own physicians. In2009,Connecticutwas the first state to implement a breast density notification law requiring women to be notified after a mammogram showed they had high breast density. Since then, 19 other states have joined the movement by enacting laws of their own, with Ohio joining the roll in December 2014. Nearly a dozen additional statesareconsideringsimilar legislation,with only minor differences among the laws of participating states. Federal legislation also is on the drawing board in Congress—the so-called Breast Density and Mammography Reporting Act of 2015. The act would require that a mammography report summary be delivered to patients indicating their breast density according to standardized density measurements used throughout the United States.
Myeloid-Derived Suppressor Cells as an Immune Parameter in Patients with Concurrent Sunitinib and Stereotactic Body Radiotherapy
Authors: Hui-Ming Chen, Ge Ma, Neil Gildener-Leapman, Samuel Eisenstein, Brian A. Coakley, Junko Ozao, John Mandeli, Celia Divino, Myron Schwartz, Max Sung, Robert Ferris, Johnny Kao, Lu-Hai Wang, Ping-Ying Pan, Eric C. Ko, Shu-Hsia Chen
Journal: Clinical Cancer Research (2015)

The clinical effects of sunitinib on human myeloid-derived suppressor cell (MDSC) subsets and correlation of the T-cell-mediated immune responses and clinical outcomes in patients with oligometastases treated by stereotactic body radiotherapy (SBRT) have been evaluated.The numbers of granulocytic and monocytic MDSC subsets, effector T cells, and regulatory T cells in the peripheral blood were evaluated pre- and post-sunitinib treatment and concurrent with SBRT. Correlations between MDSC, Treg, and T-cell responses and clinical outcomes were analyzed.Patients with oligometastases of various cancer types had elevated granulocytic MDSC and certain subsets of monocytic MDSC population. Sunitinib treatment resulted in a significant reduction in monocytic MDSC, phosphorylated STAT3, and arginase levels in monocytic MDSC (CD33(+)CD14(+)CD16(+)), and an increase in T-cell proliferative activity in cancer patients. Interestingly, the effects of sunitinib on reducing the accumulation and immune-suppressive function of MDSC were significantly correlated with Treg reduction, in responders but not in nonresponding patients. SBRT synergized the therapeutic effects of sunitinib, especially as related to decreased numbers of monocytic MDSC, Treg, and B cells, and augmented Tbet expression in primary CD4 and CD8 T cells. These effects were not observed in patients receiving radiation therapy alone. Most interestingly, the responders, defined by sunitinib-mediated reduction in CD33(+)CD11b(+) myeloid cell populations, tend to exhibit improved progression-free survival and cause-specific survival.Sunitinib treatment increased the efficacy of SBRT in patients with oligometastases by reversing MDSC and Treg-mediated immune suppression and may enhance cancer immune therapy to prevent tumor recurrence post-SBRT.
Government waives proposed fees for final year medical students
Authors: J. Westall
Journal: BMJ (1997)

Final year medical students in England will not have to pay tuition fees, after a partial concession by the British government. Medical students will, however, have to pay the planned £1000 ($1600) a year fee for the first four years of their course, in line with most other students, from 1998.

The health secretary, Frank Dobson, also announced that …