tbuckley/cabot-search huggingface dataset:
Sexual abuse of children.
Authors: A Bentovim
Journal: BMJ (1986)

<h3></h3> The aim of this study is to compare the combination of intranasal dexmedetomidine and ketamine to intranasal dexmedetomidine and oral midazolam to evaluate induction time and sedation level in children undergoing procedural sedation. this multicentre trial was conducted in a tertiary pediatric teaching hospital and in a secondary hospital on patients in need of procedural sedation who referred from November 2019 to March 2020. All consecutively admitted subjects were randomized to receive one-time dose (4 mcg/kg) of intranasal dexmedetomidine and 3mg/Kg of intranasal ketamine or one-time dose of 4mcg/Kg of intranasal dexmedetomidine and oral midazolam (0.5mg/Kg) with the intended goal to compare induction-time, effectiveness and adverse effects. fifty patients were recruited to receive intranasal dexmedetomidine and ketamine and fifty patients were recruited to receive intranasal dexemdetomidine and oral midazolam. The induction time was significantly lower in the intervention group when compared to the control group (11’ and 33 minutes, respectively). Sedation success rate was similar in both groups without any major adverse observed in both groups according to this preliminary report a combination of intranasal dexmedetomidine and ketamine could be considered as a possible option in for procedural sedation in children, in particular in settings in which shortening induction-time is essential in comparison to an oral midazolam plus in dexmedetomidine association.
ASSESSING PCI OUTCOMES AT 30 DAYS: ARE WE MOVING TOO FAST? A REPORT FROM THE NHLBI DYNAMIC REGISTRY
Authors: Mark J. Ricciardi, Warren K. Laskey, Faith Selzer, Oscar Marroquin, Elizabeth Holper, Lakshmi Venkitachalam, Sheryl Kelsey
Journal: Journal of the American College of Cardiology (2010)
Maintaining Sinus Rhythm — Making Treatment Better Than the Disease
Authors: Michael D. Ezekowitz
Journal: New England Journal of Medicine (2007)

Atrial fibrillation affects patients by increasing their risk of stroke and decreasing their quality of life. Unfortunately, even if restoration of sinus rhythm is possible, most patients remain at risk for stroke and need continued protection with anticoagulation therapy.1,2 Patients with atrial fibrillation usually have shortness of breath, palpitations, and chest pain. An additional and less well appreciated symptom is fatigue, a nonspecific symptom in the elderly population that has a broad differential diagnosis. Since the risk of atrial fibrillation increases with age and since the mean age of Western populations is steadily rising, the well-described projected increase in . . .
Hyperuricosuria Due to High-Dose Pancreatic Extract Therapy in Cystic Fibrosis
Authors: F. Bruder Stapleton, James Kennedy, Sanda Nousia-Arvanitakis, Michael A. Linshaw
Journal: New England Journal of Medicine (1976)

Dysuria, uric acid crystalluria and hyperuricosuria developed in a child with cystic fibrosis and normal serum uric acid. Hyperuricosuria in this patient and two other children was directly related to ingestion of large amounts of pancreatic extract. In these three children, reducing pancreatic extract dosage by 85 percent lowered their purine intake by 307, 225, and 148 mg, respectively; urinary uric acid excretion decreased by 245, 239, and 158 mg. Overmedication resulted from parents' decisions to increase enzyme dosages. In our cystic fibrosis clinic, 15 of 32 patients screened at random were taking higher than the prescribed dose of pancreatic enzymes, and 14 of these 15 children were hyperuricosuric. On the basis of this information, we suggest that the minimal effective dose of pancreatic extract should be determined and adhered to for each child with cystic fibrosis to avoid potential renal injury from hyperuricosuria.
Novel Paracrine Modulation of Notch–DLL4 Signaling by Fibulin-3 Promotes Angiogenesis in High-Grade Gliomas
Authors: Mohan S. Nandhu, Bin Hu, Susan E. Cole, Anat Erdreich-Epstein, Diego J. Rodriguez-Gil, Mariano S. Viapiano
Journal: Cancer Research (2014)

High-grade gliomas are characterized by exuberant vascularization, diffuse invasion, and significant chemoresistance, resulting in a recurrent phenotype that makes them impossible to eradicate in the long term. Targeting protumoral signals in the glioma microenvironment could have significant impact against tumor cells and the supporting niche that facilitates their growth. Fibulin-3 is a protein secreted by glioma cells, but absent in normal brain, that promotes tumor invasion and survival. We show here that fibulin-3 is a paracrine activator of Notch signaling in endothelial cells and promotes glioma angiogenesis. Fibulin-3 overexpression increased tumor VEGF levels, microvascular density, and vessel permeability, whereas fibulin-3 knockdown reduced vessel density in xenograft models of glioma. Fibulin-3 localization in human glioblastomas showed dense fiber-like condensations around tumor blood vessels, which were absent in normal brain, suggesting a remarkable association of this protein with tumor endothelium. At the cellular level, fibulin-3 enhanced endothelial cell motility and association to glioma cells, reduced endothelial cell sprouting, and increased formation of endothelial tubules in a VEGF-independent and Notch-dependent manner. Fibulin-3 increased ADAM10/17 activity in endothelial cells by inhibiting the metalloprotease inhibitor TIMP3; this resulted in increased Notch cleavage and increased expression of DLL4 independently of VEGF signaling. Inhibition of ADAM10/17 or knockdown of DLL4 reduced the proangiogenic effects of fibulin-3 in culture. Taken together, these results reveal a novel, proangiogenic role of fibulin-3 in gliomas, highlighting the relevance of this protein as an important molecular target in the tumor microenvironment.
Practicing Medicine in the Age of Facebook
Authors: Sachin H. Jain
Journal: New England Journal of Medicine (2009)

In my second week of medical internship, I received a "friend request" on Facebook, the popular social-networking Web site. The name of the requester was familiar: Erica Baxter. Three years earlier, as a medical student, I had participated in the delivery of Ms. Baxter's baby. Now, apparently, she wanted to be back in touch.Despite certain reservations, I clicked "confirm," and Ms. Baxter joined my list of Facebook "friends." I was curious to hear about the progress of her baby girl, but I wondered about the appropriateness of this interaction. Was Ms. Baxter simply a grateful patient interested in sharing . . .
A CASE OF SUPPURATING MASTOIDITIS CURED WITHOUT CHISELING.
Authors: ALFRED HINDE
Journal: JAMA (1896)

N. McG., a robust Irish girl aged 17, about ten days in the United States, applied on May 8, 1891, for treatment on account of a severe earache of the right ear that had commenced twenty-four hours before and had become progressively worse since its onset. She gave a history of "catching cold" about three weeks previously, adding to it during the voyage across the Atlantic and on the cars to Chicago. On examination marked tenderness was elicited on pressure over the tragus and downward behind the ramus as far as the angle of the inferior maxilla. The drum membrane was intensely reddened, thickened, and its landmarks buried. The adjacent soft parts of the external auditory canal were swollen and injected, especially those of upper posterior wall. The mucous membrane of the nasal cavities was hypertrophic, and it and that of the naso-pharynx was still inflamed and discharging. The Eustachian
Eighth Fishbein Fellow joins The Journal July 1
Authors: Kathryn Simmons
Journal: JAMA (1985)

Donald E. Riesenberg, MD, joins The Journal on July 1 as the American Medical Association's eighth Morris Fishbein Fellow in Medical Journalism. The yearlong fellowship gives recipients the opportunity to explore the field of medical editing and writing. Two goals that Riesenberg holds for his fellowship are learning how to be an effective medical journalist and determining whether "my talent matches my enthusiasm." He says he also sees the Fellowship as a possible springboard for a full-time career in medical journalism (specifically, he would like to be on the editorial staff of a peer-reviewed journal) and as a foundation for his desire to write for both medical and lay audiences. For this married 43-year-old board-certified internist, such goals constitute a major turn from patient care. Riesenberg's most recent position—as assistant professor of medicine at the Medical College of Virginia and acting associate chief of staff for
The hypolipidemic effect of cilostazol can be mediated by regulation of hepatic low-density lipoprotein receptor-related protein 1 (LRP1) expression
Authors: Hyung Jun Kim, Jae Hoon Moon, Hyun Min Kim, Mi Ra Yun, Byung Hun Jeon, ByungWan Lee, Eun Seok Kang, Hyun Chul Lee, Bong Soo Cha
Journal: Metabolism (2013)
Canadas healthcare system should focus on primary care, report says
Authors: D. Spurgeon
Journal: BMJ (2002)

Sweeping and expensive changes have been proposed to ensure the long term sustainability of Canada's healthcare system. The proposals are contained in a report from the Royal Commission on the Future of Health Care in Canada, which was chaired by lawyer and former politician Roy Romanow.

The report's 47 detailed recommendations, which include implementation timeframes, will cost the federal government $C15bn (£6.2bn; US$9.6bn; €9.6bn) more than the budget currently forecast for health by 2005-6.

In presenting his report Romanow, former premier of the province of Saskatchewan, where Canada's Medicare was born 40 years ago, voiced his strong opposition to private, for profit healthcare programmes. Their failure, he said, was the reason for establishing Canada's public system in the first place, and Canadians were sceptical of them. Over the past 18 months his research included consultations involving tens of thousands of ordinary citizens and health …
Role of the hepatocyte nuclear factor 4α in control of the pregnane X receptor during fetal liver development
Authors: Akihide Kamiya, Yusuke Inoue, Frank J. Gonzalez
Journal: Hepatology (2003)

The fetal liver, the major site of hematopoiesis during embryonic development, acquires additional functions near birth. Among the important liver functions is the response to xenobiotic exposure due to expression of several cytochromes P450 (CYP) and drug efflux transporters. Expression of these genes is regulated by nuclear receptors such as the pregnane X receptor (PXR). In this study, regulation of xenobiotic responses during fetal liver development was analyzed using a fetal hepatocyte primary culture system derived from embryonic day 15 (E15) livers. Hepatocyte nuclear factor (HNF) 4alpha regulates the expression of many genes preferentially in the liver. Expression of several xenobiotic response genes as well as HNF4alpha was increased in fetal hepatocytes stimulated by the hepatic maturation factors oncostatin M (OSM) and Matrigel. To determine the contribution of HNF4alpha to xenobiotic responses in the fetal liver, fetal hepatocytes containing floxed HNF4alpha alleles were cultured and the HNF4alpha gene was inactivated by infection with an adenovirus containing the Cre gene. Expression of CYP3A11 and PXR was suppressed by inactivation of HNF4alpha. An HNF4alpha binding site was characterized in the PXR promoter and found to be required for activation of the PXR promoter in fetal hepatocytes. In conclusion, HNF4alpha is the key transcription factor regulating responses to xenobiotics through activation of the PXR gene during fetal liver development.
FACTORS INFLUENCING THE NATURAL HISTORY OF CORONARY ATHEROMA CALCIFICATION: INSIGHTS FROM SERIAL INTRAVASCULAR ULTRASOUND
Authors: Andrea Lavoie, Julie Thornton, Kathy Wolski, Kiyoko Uno, Ozgur Bayturan, Paul Schoenhagen, Samir Kapadia, E. Murat Tuzcu, Steven E. Nissen, Stephen J. Nicholls
Journal: Journal of the American College of Cardiology (2010)
Current Approaches to Helping Children Cope with a Parent's Terminal Illness
Authors: G. H. Christ, A. E. Christ
Journal: CA A Cancer Journal for Clinicians (2006)

Much has been learned about childhood bereavement in the last few decades as studies have increasingly focused on the direct interviewing of children about their recovery from the tragic loss of a parent. It has been shown that children do indeed mourn, although differently from adults. Important moderating and mediating variables have been identified that impact their recovery from the loss of a parent, which can be the focus of intervention. When death is expected, the terminal phase of an illness has been found to be particularly stressful for children, yet seldom investigated. Similarly, few studies have explored the impact of development on children's experience and expression of grief. We present research findings that clarify phases in children's experience during the terminal illness, hospital visits, the death, and its immediate aftermath, as well as how the parent is mourned and issues in longer term reconstitution. Variations in children's responses in these phases are described as they were experienced by 87 children from 3 different developmental groupings: 3 to 5 years, 6 to 8 years, and 9 to 11 years. Recommendations are suggested for parents and professionals about ways to understand and support children during the terminal illness, at the time of death, and during the phase of reconstitution.
Trib1 is a lipid- and myocardial infarction–associated gene that regulates hepatic lipogenesis and VLDL production in mice
Authors: Ralph Burkhardt, Sue-Anne Toh, William R. Lagor, Andrew Birkeland, Michael Levin, Xiaoyu Li, Megan Robblee, Victor D. Fedorov, Masahiro Yamamoto, Takashi Satoh, Shizuo Akira, Sekar Kathiresan, Jan L. Breslow, Daniel J. Rader
Journal: Journal of Clinical Investigation (2010)

Recent genome-wide association studies have identified a genetic locus at human chromosome 8q24 as having minor alleles associated with lower levels of plasma triglyceride (TG) and LDL cholesterol (LDL-C), higher levels of HDL-C, as well as decreased risk for myocardial infarction. This locus contains only one annotated gene, tribbles homolog 1 (TRIB1), which has not previously been implicated in lipoprotein metabolism. Here we demonstrate a role for Trib1 as a regulator of lipoprotein metabolism in mice. Hepatic-specific overexpression of Trib1 reduced levels of plasma TG and cholesterol by reducing VLDL production; conversely, Trib1-knockout mice showed elevated levels of plasma TG and cholesterol due to increased VLDL production. Hepatic Trib1 expression was inversely associated with the expression of key lipogenic genes and measures of lipogenesis. Thus, we provide functional evidence for what we believe to be a novel gene regulating hepatic lipogenesis and VLDL production in mice that influences plasma lipids and risk for myocardial infarction in humans.
Congenital cardiac disease: a review of 357 cases studied pathologically.
Authors: Paul R. Lurie
Journal: JAMA (1963)

The purpose of this work is limited, but it is most effectively served. A catalogue of the autopsy experience of the Mayo Clinic with congenital heart disease is analyzed, compared with other large pathologic series, and discussed from the point of view of possible functional characteristics affecting length of survival. It provides a ready source of information as to incidence of individual malformations and combinations of malformations, and states age at death, sex, incidence of bacterial endocarditis and brain abscess. The bibliography—50 pages of fine print carefully arranged by subject—is of great value in the light of the burgeoning literature in this field. In this list are well over 20 of Dr. Edwards' own works, usually written in collaboration with one or more clinicians. He is well recognized among pediatric cardiologists as a pathologist who is sincerely interested in clinical problems. The comments upon pathologic physiology which make the book
Control of Tumor Bioenergetics and Survival Stress Signaling by Mitochondrial HSP90s
Authors: Young Chan Chae, M. Cecilia Caino, Sofia Lisanti, Jagadish C. Ghosh, Takehiko Dohi, Nika N. Danial, Jessie Villanueva, Stefano Ferrero, Valentina Vaira, Luigi Santambrogio, Silvano Bosari, Lucia R. Languino, Meenhard Herlyn, Dario C. Altieri
Journal: Cancer Cell (2012)
On Being Ill
Authors: B. Newport
Journal: BMJ (2010)

In this essay Virginia Woolf examines the spiritual change that a minor feverish illness such as flu can bring, enhancing our perception of the world while normal society goes on without us. “Directly the bed is called for we cease to be soldiers in the army of the upright; we become deserters. Mrs Jones catches her train. Mr Smith mends his motor. Men thatch the roof, the dogs bark.” Meanwhile the recumbent can study nature, indifferent but comforting, finding new beauty in “the …
Requirement for three signals in "T-independent" (lipopolysaccharide-induced) as well as in T-dependent B cell responses.
Authors: R H Zubler, A L Glasebrook
Journal: The Journal of Experimental Medicine (1982)

The requirements for different activation signals in the generation of plaque-forming cell (PFC) responses by positively selected B (surface immunoglobulin-positive) cells were analyzed in low-density cultures to minimize the possible effects of contaminating T cells. Using this system, it is demonstrated that not only in T helper cell (TH)-dependent but also in lipopolysaccharide (LPS)-dependent (i.e., so-called T-independent) PFC responses, the resting B cells have to receive at least three different signals: (a) a major histocompatibility complex (MHC)-specific TH signal that can be bypassed by LPS, (b) an antigen signal, and (c) a second TH signal medicated by MHC- and antigen-unspecific helper factor(s) for B cell responses (BHF) that cannot by bypassed by LPS. Specifically, contact of surface immunoglobulin-positive cells with cloned allo-I-A-specific TH or LPS induced a polyclonal PFC response without significant proliferation, whereas contact with BHF alone (obtained as supernatants from different cloned TH, EL-4 thymoma cells, or secondary mixed leukocyte culture cells) had no effect. Only when LPS, antigen, and BHF, or, alternatively, allo-TH (producing themselves BHF) and antigen were present did clonally expanded PFC responses occur. Thus, the data indicate that both an LPS (or specific TH) signal and an antigen signal are required to render the B cells responsive to BHF. BHF seems to act essentially as a nonspecific growth factor, whereas differentiation into antibody-secreting cells appears to be a preprogrammed consequence of B cell activation by an LPS or specific TH signal.
Dysfunctional Baroreflex Regulation of Sympathetic Nerve Activity in Patients With Vasovagal Syncope
Authors: Markus Béchir, Christian Binggeli, Roberto Corti, Rémy Chenevard, Lukas Spieker, Frank Ruschitzka, Thomas F. Lüscher, Georg Noll
Journal: Circulation (2003)

The interplay of resting muscle sympathetic nerve activity (MSA) and the baroreceptor reflex in patients with vasovagal syncope remains elusive. Hence, the aim of the present study was to investigate MSA, baroreceptor sensitivity, heart rate, and blood pressure under resting conditions and during orthostatic stress in patients with a history of vasovagal syncope.MSA was measured using microneurography at rest and during lower body negative pressure (LBNP) to mimic orthostatic stress in patients with a history of vasovagal syncope (n=10) and in age-matched healthy controls (n=8). Heart rate and blood pressure were simultaneously recorded. Cardiac baroreceptor sensitivity was calculated with the spectral technique (alpha coefficient). Resting MSA in the patients with syncope was significantly increased as compared with controls (42.4+/-2.3 versus 26.5+/-3.6 bursts/min, P=0.001), whereas activation of MSA during orthostatic stress in the patient group was significantly blunted (5.1+/-1.6 versus 15.2+/-2.1 bursts/min at LBNP -50 mm Hg, P=0.002). In the patients with syncope, cardiac baroreceptor sensitivity was significantly reduced under supine resting conditions (8.5+/-0.7 versus 13.0+/-1.1 ms/mm Hg, P=0.001), as well as under orthostatic stress (7.3+/-0.7 versus 13.4+/-1.5 ms/mm Hg, P=0.003).This study shows that in patients with vasovagal syncope, resting MSA is increased and baroreflex regulation during orthostatic stress is blunted, thus leading to impaired MSA adaptation. These results provide new insights into mechanisms of vasovagal syncope and suggest that pharmacological modulation of baroreceptor sensitivity may represent a promising treatment of neuromediated syncope.
Contributions of Open Cardiotomy to the Correction of Congenital and Acquired Cardiac Disease
Authors: C. Walton Lillehei
Journal: New England Journal of Medicine (1958)

THE past decade has brought forth an impressive array of advances in the field of cardiac surgery. As recently as 1948 there were only three congenital cardiac lesions then amenable to surgical treatment. These were patent ductus arteriosus, coarctation of the aorta and the systemic-pulmonary-artery anastomotic procedure for tetralogy of Fallot. Less than five years ago there was no patient alive who had been cured of such common malformations as a ventricular septal defect or the lesions of tetralogy of Fallot. Even two years ago such frequently encountered acquired cardiac lesions as mitral regurgitation and aortic insufficiency were beyond the . . .
Philip D'Arcy Hart
Authors: C. Richmond
Journal: BMJ (2006)

Medical researcher who pioneered the controlled clinical trial as a gold standard and who demonstrated the efficacy of streptomycin as a treatment for tuberculosisIn a long career-he lived to 106 and worked until he was 102-Philip D'Arcy Hart showed that pneumoconiosis was an industrial disease for which sufferers should receive compensation.In a landmark controlled clinical trial with Sir Austin Bradford Hill, Hart showed that streptomycin, then newly discovered, cured tuberculosis.In 1965 he was made a CBE for this work.He did other major epidemiology, retired at 65, and spent the next 37 years making fundamental advances on the pathogenesis of tubercle bacilli.