tbuckley/cabot-search huggingface dataset:
Corticosteroids in Aspiration Pneumonia
Authors: Emerson C. Graham
Journal: JAMA (1963)

ASPIRATION of gastric contents often presents a difficult therapeutic problem, and may become a life-threatening emergency.<sup>1</sup>It is seen with greater frequency as a complication following obstetrical anaesthesia.<sup>2</sup>Recent experimental studies by Bannister, and his associates, demonstrated that corticosteroids may be a valuable therapeutic adjuvant in this entity.<sup>3</sup> <h3>Report of a Case</h3> A 19-year-old primiparous patient was admitted to the obstetrical service in early labor. At the end of 12 hours, little progress in labor was noted, and amniotomy was performed. Eighteen hours after admission, pelvimetry was done which revealed cephalopelvic disproportion. Cesarean section was elected and performed with the patient under cyclopropane and oxygen anesthesia. The patient experienced several emetic episodes and aspirated while under anesthesia. In the immediate postoperative period, the patient's pulse was noted to be rapid and respirations were slightly increased. A few rales were heard in both lung fields. The patient was
Effects on inflammation parameters of a double‐blind, placebo controlled one‐year course of SLIT in children monosensitized to mites
Authors: F. Marcucci, L. Sensi, F. Frati, R. Bernardini, E. Novembre, A. Barbato, S. Pecora
Journal: Allergy (2003)

Background: Clinical documentation about effects on local markers of inflammation of sublingual immunotherapy (SLIT) in children is still poor. Methods: Twenty‐four children (age range 4–16 years, average 8.5 years) monosensitized to house dust mites (HDMs) were randomized to receive active or placebo SLIT for this allergen according to a double‐blind, placebo‐controlled design. Before treatment and 10–12 months later the following parameters were checked: ECP and tryptase in sputum and nasal secretion, serum and nasal mite‐specific IgE (sIgE), allergen‐specific nasal challenge test (sNCT), nasal symptoms and tryptase after sNCT. Results: Nasal tryptase and nasal IgE in basal conditions were unchanged in treated children but significantly increased in untreated children ( P = 0.0156 and P = 0.0313, respectively). The threshold for sNCT was unchanged in both groups of children, but the symptom score after sNCT was unchanged in the placebo group and significantly decreased in the active group ( P = 0.0084). The nasal tryptase after sNCT was unchanged in the active group and significantly increased in the placebo group ( P = 0.0218). Intergroup comparison showed a significant difference in oral tryptase and nasal tryptase after sNCT in favour of the active group. Conclusions: These interim results after only 1 year of treatment show that SLIT in children monosensitized to HDMs is able to avoid the spontaneous increase in both nasal sIgE antibodies and in local allergic inflammation in basal conditions. These outcomes are confirmed and supported by the decrease of symptoms in the active group combined with the increase of nasal tryptase only in the control group in both cases after sNCT.
Diagnosis of the Partial Androgen Insensitivity Syndrome During Infancy
Authors: P. A. Lee, T. R. Brown, H. A. LaTorre
Journal: JAMA (1986)

WHEN a child is born with ambiguous genitalia, the sex of rearing becomes of preeminent importance. Androgen insensitivity must be recognized in those genetic males with borderline phallic development if appropriate assignment as females is to be made. The androgen insensitivity syndrome (AIS) may occur in the complete form (CAIS), in which no masculinization of the external genitalia occurs during fetal development and rearing clearly should be female, and the partial form (PAIS), in which varying degrees of virilization of the external genitalia occur. The latterform presents at birth with ambiguous genitalia and must be differentiated from other forms of male pseudohermaphroditism. If CAIS is diagnosed during infancy, the clinical presentation may include the presence of palpable inguinal gonads, inguinal herniae, or both.<sup>1</sup>Partial androgen insensitivity syndrome may be diagnosed in infants with ambiguous genitalia and a 46,XY genotype. The defect in CAIS may be caused by absent
Management of the patient with coronary artery disease. A surgeon's perspective.
Authors: V L Willman
Journal: Circulation (1982)

The patient who has symptomatic coronary artery disease suffers from a chronic, incurable illness. The physician must help such a patient adapt to the disease. Coronary artery bypass surgery is, in many instances, a valuable therapeutic adjunct that provides both physiologic and psychologic benefit. It frees many patients from angina pectoris and, in some instances, prolongs life. It often gives the patient the confidence of knowing that maximum effort is being expended to combat the disease. Selectively used, coronary artery bypass is an effective component in the total management of patients with coronary artery disease.
The determination of peripheral flow mediated vasodilation is a sensitive and specific predictor for the presence of coronary artery disease
Authors: S. Schroeder, M. Enderle, R. Osson, A. Baumbach, C. Hordeg, M. Ptehl, K.K. Haase, H.U. Haering, K.R. Karsch
Journal: Journal of the American College of Cardiology (1998)
Clinical Efficacy of Fidarestat, a Novel Aldose Reductase Inhibitor, for Diabetic Peripheral Neuropathy
Authors: Nigishi Hotta, Takayoshi Toyota, Kempei Matsuoka, Yukio Shigeta, Ryuichi Kikkawa, Toshio Kaneko, Akira Takahashi, Kimiya Sugimura, Yasuo Koike, Jun Ishii, Nobuo Sakamoto
Journal: Diabetes Care (2001)

OBJECTIVE—The purpose of this study was to evaluate the efficacy of fidarestat, a novel aldose reductase (AR) inhibitor, in a double-blind placebo controlled study in patients with type 1 and type 2 diabetes and associated peripheral neuropathy. RESEARCH DESIGN AND METHODS—A total of 279 patients with diabetic neuropathy were treated with placebo or fidarestat at a daily dose of 1 mg for 52 weeks. The efficacy evaluation was based on change in electrophysiological measurements of median and tibial motor nerve conduction velocity, F-wave minimum latency, F-wave conduction velocity (FCV), and median sensory nerve conduction velocity (forearm and distal), as well as an assessment of subjective symptoms. RESULTS—Over the course of the study, five of the eight electrophysiological measures assessed showed significant improvement from baseline in the fidarestat-treated group, whereas no measure showed significant deterioration. In contrast, in the placebo group, no electrophysiological measure was improved, and one measure significantly deteriorated (i.e., median nerve FCV). At the study conclusion, the fidarestat-treated group was significantly improved compared with the placebo group in two electrophysiological measures (i.e., median nerve FCV and minimal latency). Subjective symptoms (including numbness, spontaneous pain, sensation of rigidity, paresthesia in the sole upon walking, heaviness in the foot, and hypesthesia) benefited from fidarestat treatment, and all were significantly improved in the treated versus placebo group at the study conclusion. At the dose used, fidarestat was well tolerated, with an adverse event profile that did not significantly differ from that seen in the placebo group. CONCLUSIONS—The effects of fidarestat-treatment on nerve conduction and the subjective symptoms of diabetic neuropathy provide evidence that this treatment alters the progression of diabetic neuropathy.
“Healing, Papa would tell me, is not a science, but the intuitive art of wooing nature.”—W.H. Auden
Authors: Daniel Bosch
Journal: Annals of Internal Medicine (2011)

Ad Libitum17 May 2011“Healing, Papa would tell me, is not a science, but the intuitive art of wooing nature.”—W.H. AudenDaniel BoschDaniel BoschFrom Cambridge, MA 02139.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-10-201105170-00004 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail He got run over by a carAt twelve, and during his recoveryHe saved his scabs. It wasn't hard—He'd got run over by a car,So he filled albums, pried raw barkFrom faint pink limbs. The mysteryOf his being run over by a carAt twelve? Enduring his recovery.Daniel BoschCambridge, MA 02139 Author, Article, and Disclosure InformationAffiliations: From Cambridge, MA 02139.Current Author Address: Daniel Bosch, 154 Auburn Street 2W, Cambridge, MA 02139. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 May 2011Volume 154, Issue 10Page: 655 ePublished: 17 May 2011 Issue Published: 17 May 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Sundowning on a sunny day in Cornwall
Authors: Simon Noble
Journal: BMJ (2004)

of the materials used was ensured.We put particular emphasis on ascertaining the patient's sensation of Deqi when acupuncture was applied, and on describing secondary effects and the success of the technique in improving the patient's quality of life (PQLC).Similar results were found in a small, short term and long term study, carried out by using the waiting list as the control group, 11 and in another study that compared acupuncture plus baseline treatment with baseline treatment alone. 12In these studies, the absence of a placebo was a serious limitation to the validity of the conclusions; a third study incorporated a placebo, but in a hospital environment considered to be of low quality, 4 whereas treatment was of greater intensity and duration of treatment was shorter. 13Another study compared acupuncture with sham acupuncture and found no statistically significant differences. 14 Future research should extend the observation period after treatment in order to evaluate the duration of the improvement obtained and to establish treatment protocols.We thank M J Cano, J G de Hoyos, E Bassas, and C Andrés for their work in the conduct of the study, and J G de Hoyos for his useful comments on the initial protocol.
BCR-Mediated Decrease of CXCR4 and CD62L in CLL – Letter
Authors: Maite P. Quiroga, Jan A. Burger
Journal: Cancer Research (2010)

Recently, Vlad and colleagues ([1][1]) published that cross-linking of the B-cell receptor (BCR) regulates chronic lymphocytic leukemia (CLL) cell retention within lymphatic tissues by downregulation of CXCR4 chemokine receptors, l-selectins (CD62L), reduced CLL chemotaxis toward the ligand for
Diverticulum of the Pericardium
Authors: HERBERT C. MAIER
Journal: Circulation (1957)

A diverticulum of the pericardium can often be confused with other lesions of the heart and great vessels as well as mediastinal cysts and other masses. Pericardial effusion, sometimes associated with heart lesions causing cardiac enlargement, is a frequent factor in producing diverticular formation. The mode of development of a pericardial diverticulum is better appreciated when certain features of the anatomic structure of the parietal pericardium are understood. Two cases of pericardial diverticulum that illustrate the etiologic, clinical, and roentgen features of the lesion are presented.
Hepatitis B virus quasispecies susceptibility to entecavir confirms the relationship between genotypic resistance and patient virologic response
Authors: Carl J. Baldick, Betsy J. Eggers, Jie Fang, Steven M. Levine, Kevin A. Pokornowski, Ronald E. Rose, Cheng-Fang Yu, Daniel J. Tenney, Richard J. Colonno
Journal: Journal of Hepatology (2008)
P08.16 * NECK PAIN DUE TO UNDETECTED METASTATIC LUNG ADENOCARCINOMA
Authors: C. L. Zaruma, E. Arregui, L. Gonzalez, J. C. Villa, M. Claramonte, J. M. B. Moreno
Journal: Neuro-Oncology (2014)

PURPOSE: Computed tomography (CT) and magnetic resonance imaging (MRI) have contributed greatly to the ability to identify metastases in head and neck cancer. However the deficiencies in the assessment of lymphadenopathy still exist. The aim of this case report is to emphasize the importance of adequate knowledge of the patient's medical history, physical examination and a detailed analysis of imaging studies. METHODS: A 62-year-old man in whom the first manifestation of a metastatic lung adenocarcinoma was advanced severe and incapacitating neck pain of approximately 4 months of progression attributed to a degenerative disc disease of the cervical spine based in the cervical MRI results. During physical exploration showed no neurological deficit, just a pain in the back of the neck and limitation of the cervical spine motion. After detailed analysis of cervical MRI images, in which we observe the presence of a small nodule in the posterior cervical region surgery was recommended to get a sample, and then perform the corresponding histopathological study. RESULTS: After radical excision, the histopathological study has referred metastases in soft tissue of lung adenocarcinoma, infiltrating fibroadipose tissue and skeletal muscle. Immunohistochemically was positive for cytokeratin 7 (CK7+), thyroid transcription factor-1 (TTF-1+) and negative for cytokeratin 20 (CK20-). CONCLUSIONS: Don et al. (1995), in 36 neck dissections from patients with squamous cell cancer found a large number of malignant nodes having diameters of less than 10 mm. Since the current radiological criteria for assessing the status of the cervical lymph nodes are based largely on size, the findings indicate the major limitations in the detection capabilities of metastatic disease. For this reason it is important the history, the physical examination and a detailed analysis of imaging studies. Because, of this depends that patients receive an adequate treatment for their condition and needs.
Multiple unilateral schwannomas: segmental neurofibromatosis type 2 or schwannomatosis?
Authors: M. Leverkus, L. Kluwe, E-M. Roll, G. Becker, E-B. Brocker, V.F. Mautner, H. Hamm
Journal: British Journal of Dermatology (2003)

Journal Article Multiple unilateral schwannomas: segmental neurofibromatosis type 2 or schwannomatosis? Get access M. Leverkus, M. Leverkus Departments of Dermatology and Dr Martin Leverkus. E‐mail: leverkus_m@klinik.uni‐wuerzburg.de Search for other works by this author on: Oxford Academic Google Scholar L. Kluwe, L. Kluwe Department of Neurosurgery, University Hospital Eppendorf, Germany Search for other works by this author on: Oxford Academic Google Scholar E‐M. Röll, E‐M. Röll Neurology, University of Würzburg, Josef‐Schneider‐Str. 2, 97080 Würzburg, Germany Search for other works by this author on: Oxford Academic Google Scholar G. Becker, G. Becker Neurology, University of Würzburg, Josef‐Schneider‐Str. 2, 97080 Würzburg, Germany Search for other works by this author on: Oxford Academic Google Scholar E‐B. Bröcker, E‐B. Bröcker Departments of Dermatology and Search for other works by this author on: Oxford Academic Google Scholar V.F. Mautner, V.F. Mautner Department of Neurology, Klinikum Nord Ochsenzoll, Hamburg, Germany Search for other works by this author on: Oxford Academic Google Scholar H. Hamm H. Hamm Departments of Dermatology and Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 148, Issue 4, 1 April 2003, Pages 804–809, https://doi.org/10.1046/j.1365-2133.2003.05249.x Published: 01 April 2003 Article history Accepted: 17 October 2002 Published: 01 April 2003
Accuracy of subjective measurements made with or without previous scores: an important source of error in serial measurement of subjective states.
Authors: J Scott, E C Huskisson
Journal: Annals of the Rheumatic Diseases (1979)

Pain severity was assessed on visual analogue scale in 4 groups of patients receiving long-term therapy. A comparison was made between pain measurements made with and without access to initial scores. The differences between these measurements increased with the duration of treatment. Patients tended to overestimate their pain severity when previous scores were not available. It is suggested that initial scores should be made available when serial measurements of pain are made in long-term experiments.
Serum polybrominated diphenyl ethers (PBDE) in pooled human serum are higher in children (2-5 years of age) than in infants and adults
Authors: Leisa-Maree L. Toms, Andreas Sjodin, Fiona Harden, Peter Hobson, Richard Jones, Emily Edenfield, Jochen F. Mueller
Journal: Environmental Health Perspectives (2009)

Background: Polybrominated diphenyl ethers (PBDEs) are used as flame retardants in many products and have been detected in human samples worldwide. Limited data show that concentrations are elevated in young children.
Objectives: We investigated the association between PBDEs and age with an emphasis on young children from Australia in 2006–2007.
Methods: We collected human blood serum samples (n = 2,420), which we stratified by age and sex and pooled for analysis of PBDEs.
Results: The sum of BDE-47, -99, -100, and -153 concentrations (Σ4PBDE) increased from 0–0.5 years (mean ± SD, 14 ± 3.4 ng/g lipid) to peak at 2.6–3 years (51 ± 36 ng/g lipid; p   60 years (p = 0.894). The mean Σ4PBDE concentration in cord blood (24 ± 14 ng/g lipid) did not differ significantly from that in adult serum at ages 15–30 (p = 0.198) or 31–45 years (p = 0.140). We found no temporal trend when we compared the present results with Australian PBDE data from 2002–2005. PBDE concentrations were higher in males than in females; however, this difference reached statistical significance only for BDE-153 (p = 0.05).
Conclusions: The observed peak concentration at 2.6–3 years of age is later than the period when breast-feeding is typically ceased. This suggests that in addition to the exposure via human milk, young children have higher exposure to these chemicals and/or a lower capacity to eliminate them.
Key words: Australia, children, cord blood, human blood serum, PBDEs, polybrominated diphenyl ethers. Environ Health Perspect 117:1461–1465 (2009). doi:10.1289/ehp.0900596
Developmental neurotoxicity elicited by prenatal or postnatal chlorpyrifos exposure: effects on neurospecific proteins indicate changing vulnerabilities.
Authors: Stephanie J Garcia, Frederic J Seidler, Theodore A Slotkin
Journal: Environmental Health Perspectives (2002)

The developmental neurotoxicity of the organophosphate pesticide chlorpyrifos (CPF) is thought to involve both neurons and glia, thus producing a prolonged window of vulnerability. To characterize the cell types and brain regions involved in these effects, we administered CPF to developing rats and examined neuroprotein markers for oligodendrocytes (myelin basic protein, MBP), for neuronal cell bodies (neurofilament 68 kDa, NF68), and for developing axons (neurofilament 200 kDa, NF200). Prenatal CPF administration on gestational days (GDs) 17-20 elicited an immediate (GD21) enhancement of MBP and NF68; by postnatal day (PN) 30, however, there were deficits in all three biomarkers, with the effect restricted to females. Exposure in the early postnatal period, PN1-4, did not evoke significant short-term or long-term changes in the neuroproteins. However, with treatment on PN11-14, we found reductions in MBP in the immediate posttreatment period (PN15, PN20) throughout the brain, and deficiencies across all three proteins emerged by PN30. With this regimen, males were targeted preferentially. The sex-selective effects seen here for the GD17-20 and PN11-14 regimens match those reported earlier for subsequent behavioral performance. These results indicate a shift in the populations of neural cells targeted by CPF, dependent upon the period of exposure. Similarly, developmental differences in the sex selectivity of the biochemical mechanisms underlying neurotoxicant actions are likely to contribute to discrete behavioral outcomes.
Treatment Modalities of Obesity
Authors: Vojtĕch Hainer, Hermann Toplak, Asimina Mitrakou
Journal: Diabetes Care (2008)

The prevalence of obesity is increasing in both developed and developing countries, with rates reaching ∼10–35% among adults in the Euro-American region. Obesity is associated with increased risks of cardiovascular diseases, type 2 diabetes, arthritis, and some type of cancers. Obesity significantly affects the quality of life and reduces the average life expectancy. The effective treatment of obesity should address both the medical and the social burden of this disease. Obesity needs to be treated within the health care system as any other complex disease, with empathy and without prejudice. Both health care providers and patients should know that the obesity treatment is a lifelong task. They should also set realistic goals before starting the treatment, whereas keeping in mind that even a modest weight loss of 5–15% significantly reduces obesity-related health risks. Essential treatment of obesity includes low-calorie low-fat diets, increased physical activity, and strategies contributing to the modification of lifestyle. Anti-obesity drugs facilitate weight loss and contribute to further amelioration of obesity-related health risks. A short-term weight loss, up to 6 months, is usually achieved easily. However, the long-term weight management is often associated with a lack of compliance, failures, and a high dropout rate. Regular physical activity, cognitive behavioral modification of lifestyle, and administration of anti-obesity drugs improve weight loss maintenance. Bariatric surgery is an effective strategy to treat severely obese patients. Bariatric surgery leads to a substantial improvement of comorbidities as well as to a reduction in overall mortality by 25–50% during the long-term follow-up. Obesity treatment should be individually tailored and the following factors should be taken into account: sex, the degree of obesity, individual health risks, psychobehavioral and metabolic characteristics, and the outcome of previous weight loss attempts. In the future, an evaluation of hormonal and genetic determinants of weight loss could also contribute to a better choice of individual therapy for a particular obese patient. A multilevel obesity management network of mutually collaborating facilities should be established to provide individually tailored treatment. Centers of excellence in obesity management represented by multidisciplinary teams should provide comprehensive programs for the treatment of obesity derived from evidence-based medicine.