tbuckley/cabot-search huggingface dataset:
Effect of Severe Isolated Unilateral and Bilateral Diaphragm Weakness on Exercise Performance
Authors: Nicholas Hart, Annabel H. Nickol, Derek Cramer, Simon P. Ward, Frédéric Lofaso, Neil B. Pride, John Moxham, Michael I. Polkey
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Patients with isolated diaphragm paralysis depend on recruitment of extradiaphragmatic respiratory muscles to increase ventilation, but little is known about exercise performance or the response of the inspiratory muscles to loaded breathing. By convention, unilateral diaphragm paralysis is regarded as a trivial condition whereas bilateral paralysis is considered to be potentially life-threatening. In fact, no data exist concerning exercise performance under these conditions. We studied incremental treadmill exercise performed by eight patients with bilateral diaphragm paralysis, eight patients with unilateral diaphragm paralysis, and eight age-matched control subjects. Respiratory muscle endurance (RME) was also measured by an inspiratory threshold loading method. Exercise time, compared with control subjects (671 seconds), was moderately reduced in unilateral diaphragm paralysis (512 seconds, p = 0.07) and further reduced in bilateral diaphragm paralysis (456 seconds, p = 0.02). Similarly, peak minute ventilation was lower in patients with unilateral diaphragm paralysis (84 L · min−1, p = 0.01) and in patients with bilateral diaphragm paralysis (69 L · min−1, p = 0.001) compared with control subjects (114 L · min−1). However, patients with unilateral diaphragm paralysis and patients with bilateral diaphragm paralysis had increased ratios of peak oxygen consumption to peak minute ventilation compared with control subjects (p = 0.0007 and p < 0.0001, respectively). Nine patients had normal RME; exercise time was moderately increased in these patients (502 seconds) compared with seven patients with reduced RME (461 seconds). In conclusion, although exercise performance is impaired in bilateral diaphragm paralysis, these patients can sustain a reasonable exercise load, particularly if RME is preserved and compensatory mechanisms have developed. In addition, exercise tolerance is diminished in patients with unilateral diaphragm paralysis.
Social mobility in African patients with duodenal ulcers.
Authors: M G Moshal, L Schlemmer, N K Naidoo
Journal: BMJ (1978)

Management of self-poisoned patients in hospital SIR,-Although we are in broad agreement with the conclusions of Dr R Gardner and his colleagues (18 November, p 1392) we would dispute the methods they adopted to assess success or failure in management.It has been clearly shown that psychiatrists show no uniformity in the management of this group of patients.1 Therefore it is not surprising that physicians proved to be as competent.We would also dispute that success in management can be assessed solely by a junior physician agreeing with the psychiatrist who has trained him over future management.Quite correctly Dr Gardner and his colleagues state that many self-poisoning patients "have taken tablets or medicines prescribed by medical practitioners."However, in a recent study of 236 patients suffering from overdoses in Newcastle upon Tyne we found that 2000 were receiving psychiatric treatment at the time of their overdose while a further 25 0 had at some time been under the care of a psychiatrist.This would not support the conclusion that better training in psychiatric assessment necessarily offers any advantage.We would suggest that from their data one has the right to conclude only that physicians are equally as incompetent as psychiatrists in assessing these patients and that perhaps we should look further to see if another professional discipline can help us.
Two-dimensional echocardiographic findings in atrial septal defect.
Authors: W Lieppe, R Scallion, V S Behar, J A Kisslo
Journal: Circulation (1977)

Two-dimensional echocardiographic findings in a group of 24 patients with atrial septal defects were correlated with findings obtained by cardiac catheterization and M-mode echocardiography. The prevalence of mitral prolapse was 95% by two-dimensional echocardiography and 59% by angiography in patients with secundum and sinus venosus atrial septal defects. The majority of the group with echocardiographic prolapse manifested a distinctive pattern of prolapse, with predominant involvement of the anterior mitral leaflet. Thirty-eight percent of the patients in this series manifested paradoxical septal motion by M-mode and/or two-dimensional echocardiography. In the patients with abnormal septal motion, the net systolic anterior movement of the septum was caused by an exaggerated systolic anterior movement of the main body of the left ventricle. The atrial septal defect could be visualized with confidence by two-dimensional echocardiography only in the two patients with ostium primum atrial septal defects. Cleft anterior mitral leaflets were also clearly demonstrated in these two patients.
Are Spermicides Teratogenic?
Authors: James L. Mills
Journal: JAMA (1982)

Recent evidence suggests that spermicides could be teratogenic. In this study, pregnant women provided data at their first prenatal visit on spermicide and other contraceptive exposures in each of the preceding 12 months. Data on malformations in their offspring were obtained by abstracting medical records. Among women practicing contraception before the last menstrual period but not after, the malformation rate in the offspring of spermicide users was no higher than in users of other methods. The same was true of women who continued to practice contraception after the last menstrual period. When malformations were examined by organ system and by individual defect, spermicide exposure again was not associated with an increased risk. Comparing spermicides by active ingredient with other methods of contraception revealed no increased risk of malformations for any compound. Controlling for age, time in pregnancy at which exposure data were collected, concentration of spermicides used, and other possible confounding factors did not alter the results. This study finds no association between maternal spermicide exposure before or after the last menstrual period and congenital malformations. (<i>JAMA</i>1982;248:2148-2151)
Mechanisms of disrupted language comprehension in schizophrenia
Authors: Ruth Condray, Stuart R. Steinhauer
Journal: Behavioral and Brain Sciences (2003)

Abstract Mechanisms that contribute to perceptual processing dysfunction in schizophrenia were examined by Phillips &amp; Silverstein, and formulated as involving disruptions in both local and higher-level coordination of signals. We agree that dysfunction in the coordination of cognitive functions (disconnection) is also indicated for many of the linguistic processing deficits documented for schizophrenia. We suggest, however, that it may be necessary to add a timing mechanism to the theoretical account.
Leukocyte functional antigen 1 lowers T cell activation thresholds and signaling through cytohesin-1 and Jun-activating binding protein 1
Authors: Omar D Perez, Dennis Mitchell, Gina C Jager, Sharon South, Chris Murriel, Jacqueline McBride, Lee A Herzenberg, Shigemi Kinoshita, Garry P Nolan
Journal: Nature Immunology (2003)
Psychiatric drugs can be used with caution in pregnancy, say experts
Authors: J. H. Tanne
Journal: BMJ (2013)

The increase in risk of birth defects from use of psychotropic drugs during pregnancy is small, said two experts at a press briefing in New York last week.

The possible risk should be balanced against the risks of the mother’s psychiatric illness, said Kimberly Yonkers, a psychiatrist and director of the perinatal psychiatric research program at Yale University School of Medicine in New Haven, Connecticut, and Christina Chambers, director of clinical research at Rady Children’s Hospital and the department of pediatrics at the University of California at San Diego.

Each year more than 500 000 pregnancies in the United States are …
Rhabdomyosarcoma With Widespread Bone Marrow Infiltration
Authors: Nagabushan Seshadri, Penny Wright, Kottekkattu K. Balan
Journal: Clinical Nuclear Medicine (2007)

Alveolar rhabdomyosarcoma (RMS) accounts for 20% to 30% of childhood RMS and is associated with a prognosis worse than embryonal RMS. Disseminated RMS can present with extensive bone marrow involvement. Assessing the extent of the tumor is critical, because therapy and prognosis depend on the degree to which the mass has spread beyond the primary site. The value of F-18 FDG PET in patients with RMS has been reported in some series but none specifically involving bone marrow. Children have a highly cellular hematopoietic bone marrow and differentiation of a highly cellular marrow from neoplastic infiltration may be difficult. Various other conditions associated with diffuse FDG uptake in the bone marrow include marrow hyperplasia resulting from hemolytic/iron-deficiency/blood-loss anemia, after chemotherapy with granulocyte/macrophage colony-stimulating factor and recombinant erythropoietin treatment, leukemia, non-Hodgkin lymphoma, and myelodysplasia. It is therefore important to consider the above differential diagnoses in mind when evaluating cases of unexpected marrow uptake in F-18 FDG PET studies. We report here a case of RMS with diffuse bone marrow involvement detected on F-18 FDG PET wherein FDG PET was useful in determining the true extent (primary and metastases) of RMS before definitive therapy and the valuable adjunct role it has with structural imaging in management.
Organic Electrochemical Transistors for Clinical Applications
Authors: Pierre Leleux, Jonathan Rivnay, Thomas Lonjaret, Jean‐Michel Badier, Christian Bénar, Thierry Hervé, Patrick Chauvel, George G. Malliaras
Journal: Advanced Healthcare Materials (2014)

The ability of organic electrochemical transistors is explored to record human electrophysiological signals of clinical relevance. An organic electrochemical transistor (OECT) that shows a high (&gt;1 mS) transconductance at zero applied gate voltage is used, necessitating only one power supply to bias the drain, while the gate circuit is driven by cutaneous electrical potentials. The OECT is successful in recording cardiac rhythm, eye movement, and brain activity of a human volunteer. These results pave the way for applications of OECTs as an amplifying transducer for human electrophysiology.
Chronic Thromboembolic Pulmonary Hypertension
Authors: Gregory Piazza, Samuel Z. Goldhaber
Journal: New England Journal of Medicine (2011)

Chronic thromboembolic pulmonary hypertension can develop after acute pulmonary embolus but is often overlooked until pulmonary hypertension has led to dyspnea and right ventricular dysfunction. This review provides a guide to early diagnosis and management.
Can mammographic parenchymal patterns foretell breast cancer?
Authors: William A. Check
Journal: JAMA (1980)

Results of two recent studies challenge the value of breast parenchymal patterns as seen on mammography for predicting development of breast cancer in healthy women. But John Wolfe, MD, the radiologist who originally proposed that breast parenchymal patterns are related to risk of subsequent breast cancer, questions whether the investigators involved correctly classified the mammograms. It is important to determine the accuracy of the Wolfe classification scheme in predicting the development of breast cancer in healthy women, since it appears that a sizeable number of physicians already use this system to determine frequency of follow-up mammograms. At least one group in addition to Wolfe's even recommends prophylactic mastectomies on the basis of the patterns (see also pp 287-288). Accordingly, one group of radiologists has begun a long-term, prospective, multi-institutional study to test the predictive value of the system. Wolfe, who is chief of radiology at Hutzel Hospital, Detroit, and clinical
OT1-03-02: SAFIR01: A Molecular Screening Trial for Metastatic Breast Cancer Patients.
Authors: F Andre, C Peletekian, M Jimenez, JM Ferrero, S Delaloge, Roman S Roman, P Dessen, H Bonnefoi
Journal: Cancer Research (2011)

Abstract Background: High number of new drugs are targeting molecular alterations that occur in a few number of patients. Molecular screening that consists in the assessment of single molecular alteration during the screening phase of the therapeutic trial is not suitable. Indeed, this modality of screening is associated with a high rate of screen failure due to the low incidence of the molecular alteration. In order to optimize molecular screening, we have launched a clinical trial that aims at performing array CGH and hot spot mutations in patients with metastatic breast cancer. Patients and Methods. The trial plans to include 400 patients with metastatic breast cancer and included the first patient in may 2011. This trial is being sponsored by French federation of Cancer centers (UNICANCER) and involves 20 centers. Biopsy is being performed on metastatic site. Both frozen and FFPE samples are obtained. DNA extraction is being performed in the investigation center after control for the % of cancer cells. Array CGH and PIK3CA/AKT mutations (SANGE method) are being performed in four genomic platforms. A pilot study that included 106 patients has shown the feasibility of such technologies in the context of daily practice. Data from array CGH are being sent to a bioinformatician who forward the results on both pre-selected targets, DNA instability and some targets of interest selected based on log2(ratio) and function. Recommendations for trials are then being sent to each investigator. There is no limitation for previous lines and it is recommended to perform biopsy in patients who do not present progressive disease. This trial is being funded by French NCI (750 000 euros) Conclusion: SAFIR01 is a trial that aims at using high throughput technologies in order to drive patients with molecular alterations to specific therapeutic trials. Further amendments are being planned including implementation of high throughput sequencing and performance of functional testing. Further trial will compare this high throughput approach to standard methods for target identification. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT1-03-02.
Acid induced duodenal ulcer pain: the influence of symptom status and the effect of an antispasmodic.
Authors: J Y Kang, I Yap, R Guan, H H Tay, M V Math
Journal: Gut (1989)

The aims of this study were to determine whether the development of acid induced duodenal ulcer pain was influenced by the symptomatic status of the patient and whether the administration of an antispasmodic could abolish pain. One hundred millilitres of 0.1 N hydrochloric acid was infused onto the ulcer craters or scars of 143 duodenal ulcer patients on 168 occasions. Symptomatic patients were randomised to receive 40 mg of hyoscine intravenously before acid infusion, or to a control group. Typical ulcer pain developed in seven of 55 (13%) instances for non-symptomatic patients, 24/57 (42%) of control symptomatic patients, and 20/56 (36%) of symptomatic patients given hyoscine. (Asymptomatic group v control symptomatic group, p less than 0.005; control symptomatic group v hyoscine group, NS - 95% confidence limits 12% in favour of the control and 24% in favour of the hyoscine group). The results suggest that acid infusion seldom reproduces ulcer pain in non-symptomatic duodenal ulcer patients and that the pathogenesis of acid induced duodenal ulcer pain probably involves a mechanism other than spasm, as pain was not prevented by an anticholinergic.
Pharmacokinetics of single-dose intravenous amikacin in critically ill patients undergoing slow hemodialysis
Authors: M. Kihara, Y. Ikeda, N. Takagi, H. Fujita, K. Shibata, S. Masumori, K. Shiratori, S. Umemura, H. Shinoiri, M. Ishii
Journal: Intensive Care Medicine (1995)
Laparoscopic Cholecystectomy: Technical Performance, Safety and Patient's Benefity
Authors: H. Troidl, W. Spangenberger, R. Langen, A. Al-Jaziri, E. Eypasch, E. Neugebauer, J. Dietrich
Journal: Endoscopy (1992)

Laparoscopic cholecystectomy seems to be the most promising new technique for the treatment of symptomatic gallstone disease. For different reasons, controlled clinical trials comparing comfort and trauma for the patient of conventional versus laparoscopic cholecystectomy are difficult to perform at our institution. We therefore report on the results of our first 400 laparoscopic cholecystectomies using a strict and detailed protocol on technical performance, safety and benefit for the patient. Data was obtained immediately after the operation and after a short-term follow-up. To analyze the technical performance and the safety of the procedure, we developed a new classification system (I-V) of adverse events, including both the patients' and the surgeons' viewpoints.
Capacity and consent
Authors: I Agell
Journal: Journal of the Royal Society of Medicine (2003)

Dr Jackson and Dr Warner (December 2002 JRSM1) make an assessment of the knowledge of capacity and consent issues across different medical specialties. I am not surprised by the deficits they identify with the results as attendance to many seminars looking at capacity and consent. More worrying is my personal experience as a psychiatric trainee. When on call, both as a senior house officer and as a specialist registrar, I have received requests from non-psychiatric colleagues to implement the Mental Health Act in order to carry out medical or surgical treatment in patients who either refused or clearly were not able to consent to it. Even in teaching sessions for a mixed-specialty group this issue is not clearly discussed. I would like to see education in the use and limitations of the Mental Health Act along with the training regarding issues of capacity and consent.
A5.2 Kawasaki disease and exposure to fine particulate air pollution
Authors: AS Zeft, JC Burns, RS Yeung, BW McCrindle, JW Newburger, SR Dominguez, C Arrington, ST Shulman, J Yoon, H Tewelde, C Mix, CA Pope
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Introduction</h3> Environmental factors play a pathogenic role in the aetiology of Kawasaki Disease (KD). Fine particulate matter (aerodynamic diameter less than or equal to a 2.5-mm cut point, PM<sub>2.5</sub>) is a measurable component of ambient urban pollution. Environmental influences associated with weather, spatial location, and temporal season have been shown to contribute, however the short term environmental triggers which contribute to the clinically recognised onset event of KD remain unclear. Potentially, short-term pollution exposures act as covariates to clinical disease presentation and outcome, including measures of coronary artery involvement. <h3>Methods</h3> A case-crossover study design was used to analyse associations of short-term PM<sub>2.5 </sub>exposures with the event date of KD symptom onset (fever) from cases residing in the metropolitan regions of Boston, Toronto, Cleveland, Chicago, San Diego, Denver, and Salt Lake City. Time trends, seasonality, month, and weekday were controlled for by matching. Selected exposure windows (up to 14 days) of PM<sub>2.5</sub>. were examined. <h3>Results</h3> We have assembled PM<sub>2.5</sub> exposure measurements from urban monitors and have carefully imputed PM<sub>2.5</sub> to provide day-to-day temporal variability and resolution for reliable time series indexes of pollution exposures for each metropolitan area. 3,009 KD events were included where the subject resided within one of the study metro areas and the onset of disease occurred during the years with available PM<sub>2.5</sub> monitoring. The estimated relative risks (and 95% CI’s) of an onset event of KD associated with a 10 µg/m<sup>3</sup> PM<sub>2.5</sub> lagged moving average concentration of lagged exposure period (concurrent day and preceding day (s)) revealed no evidence of a consistent, statistically significant, positive association between elevated exposure to PM<sub>2.5</sub> and elevated risk of KD onset. Extended analysis with stratification by city, sex, and age did not provide evidence of a consistent, statistically significant, positive association between elevated exposure to PM<sub>2.5</sub> and elevated risk of KD onset for any of the strata. <h3>Conclusions</h3> Well-constructed, environmental epidemiology studies examining the triggers of disease onset and exacerbation in paediatric rheumatic diseases are few and far between. While our results failed to establish a risk of the event of KD fever onset with short-term ambient particulate pollution exposure, negative findings from this study add to the growing field of particulate induced environmental epidemiology research of Kawasaki Disease.
Graham David Busfield
Authors: J. Lade
Journal: BMJ (2014)

Born in West Sussex, Graham David Busfield trained at St Mary’s Hospital in Paddington, where he also ran cross country for the medical school. He first worked at the Canadian Red Cross Memorial Hospital in Taplow, where he met, and soon married, Joan, who was a radiographer. After GP training rotation posts in Basingstoke Hospital and Bracknell, Graham became a partner in a large practice in Swallowfield in Berkshire in 1983. Within the practice he held particular responsibilities for psychiatry, learning difficulties, …
Doc, Shouldn’t We Be Getting Some Tests?
Authors: Charles L. Loprinzi, Daniel Hayes, Tom Smith
Journal: Journal of Clinical Oncology (2000)

Article Tools ART OF ONCOLOGY: WHEN THE TUMOR IS NOT THE TARGET Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.11.2345 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10829057 Doc, Shouldn’t We Be Getting Some Tests? Charles L. LoprinzixCharles L. LoprinziSearch for articles by this author , Daniel HayesxDaniel HayesSearch for articles by this author , Tom SmithxTom SmithSearch for articles by this author Show More From the Mayo ClinicRochester, MN; Georgetown University Medical Center, Washington, DC; and Massey Cancer Center, Richmond, VA. https://doi.org/10.1200/JCO.2000.18.11.2345 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Peripheral Arterial Embolism
Authors: Jess R. Young
Journal: JAMA (1963)

In 134 major peripheral emboli involving 160 limbs in 114 patients, the limb survival rate was 85% and the hospital mortality rate was 30%. Embolectomy was performed for all nongangrenous limbs (82) with persistently severe ischemia. Limb survival was 92% when embolectomy was done within the first 12 hours (after embolism), 82% in the 12-to 48-hour period, and 70% in the 2- to 7-day period. Mitral commissurotomy and auricular appendectomy were performed on 24 patients with peripheral embolism; except for four emboli during commissurotomy, no further embolization and only one death have occurred. In the absence of gangrene, prompt embolectomy should be performed on limbs which show persistent signs of severe ischemia resistant to conservative therapy. If intensive medical and surgical attack does not eliminate the source of the embolus, long-term anticoagulation therapy is indicated.