tbuckley/cabot-search huggingface dataset:
Home versus intensive care pressure support devices. Experimental and clinical comparison.
Authors: F Lofaso, L Brochard, T Hang, H Lorino, A Harf, D Isabey
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

A bench study using an artificial lung model and a clinical study in patients were performed to evaluate six commercially available home pressure support devices. Six devices were tested in the in vitro study, including five designed for home use and one designed for use in intensive care units. Minimal positive end-expiratory pressure (PEEP) varied across home devices, from 0.5 cm H2O to 4.3 cm H2O. Work imposed during exhalation varied up to six-fold across devices. A substantial rebreathing volume has present for the three home devices with a common inspiratory and expiratory line. This rebreathing volume decreased with increasing PEEP level, as expected, but remained substantial at the widely used PEEP level of 5 cm H2O. Use of a non-rebreathing valve increased both the work imposed by the circuit during the exhalation phase and the time required to attain the relaxation equilibrium. Except for two home devices and a bilevel positive airway pressure (BiPAP) device equipped with a non-rebreathing valve, differences in inspiratory trigger sensitivities were small between home and intensive care devices. During pressure support, the total work performed by the machines did not differ by more than 15% between devices, whereas differences of more than 300% were observed in flow acceleration. Only one home device gave a flow acceleration similar to or better than that obtained with the intensive care device. In a randomized, crossover clinical study, we compared a home device to a device specially designed for intensive care use in seven intubated patients during weaning from mechanical ventilation. The main differences between the two devices were trigger sensitivity and initial flow acceleration. For the same level of pressure support, there were no significant differences in arterial PCO2, tidal volume, respiratory rate, or minute ventilation between these two devices. However, the esophageal pressure-time product was 30% higher with the home device (165 +/- 93 versus 119 +/- 80 cm H2O/min, p < 0.05). In conclusion, differences exist between devices in terms of occurrence of rebreathing, speed of attainment of stable pressure support level, and expiratory resistance. These differences characterizing the delivery of pressure support may have clinical impact on the inspiratory effort of patients.
Polypharmacy and comorbidity in heart failure
Authors: F. A Masoudi
Journal: BMJ (2003)

Such action is effective only if it is taken in time, and it needs to be taken by the general public as well as staff working in homes caring for elderly people.The time to check that windows can be opened, and that a fan is available, is when hot weather is forecast, not when it occurs; delay until temperature reaches a peak may mean that nobody can free a jammed window, or find a fan, for many hours.Elderly people unable to do this themselves, or to get help from relatives or neighbours, need to be given a number to call for help.Brief messages, giving simple advice on these lines in news broadcasts and daily press when hot weather is forecast, could be the most effective way to reduce illness and death in heat waves.
FOREIGN BODY IN THE STOMACH WALL SIMULATING A NEOPLASM
Authors: Arkell M. Vaughn
Journal: JAMA (1953)

When a patient has vague gastrointestinal symptoms that persist unchanged, the surgeon should consider the possibility that the patient has ingested a foreign body, perhaps without knowing it. The literature on the subject reveals many interesting case reports but a high percentage of error in diagnosis. In the case reported here, the diagnosis was delayed until a subtotal gastric resection was performed. SYMPTOMS AND DIAGNOSIS An ingested foreign body may cause no symptoms in passage through the alimentary canal. If the foreign body is small or blunt, it may pass freely through the gastrointestinal tract, despite the valves. Symptoms appear only when chronic granuloma secondary to irritation of the gastric mucosa develops or when perforation is impending. When the foreign body is blocked at the pyloric area, symptoms usually simulate those emanating from duodenal or gallbladder lesions. The patient may complain of distention, eructation, dyspepsia, or vague pain. Although the
Bile duct cancer
Authors: R. A. Norton, E. A. Foster
Journal: CA A Cancer Journal for Clinicians (1990)

Bile duct cancer, although not among the common tumors, still accounts for more than 4,000 deaths a year in the United States. Clinicians caring for these patients are faced with difficulties in diagnosis, even with the best of modern imaging techniques, and if the tumor is not resectable (as is true for about 75 percent of all patients), the mean survival time is only a few months. Endoscopic diagnostic and therapeutic techniques have improved markedly. As with other malignant tumors, biliary cancer is best managed by a multidisciplinary team approach.
THE VOLUME OF DISTRIBUTION OF MANNITOL AS A MEASURE OF THE VOLUME OF EXTRACELLULAR FLUID, WITH A STUDY OF THE MANNITOL METHOD 1
Authors: J. Russell Elkinton
Journal: Journal of Clinical Investigation (1947)

METHODSThe method of determination of mannitol used was that introduced by Smith, Finkelstein, and Smith (1), with modifications as indicated below.The method involves the oxidation of glucose-free filtrate with the reduction of a known excess of KIO, and quantitation of the re- maining KIO4 by iodometric titration with NaSO,.Reagents.Acid cadmium sulfate: 34.68 grams 3CdSQ4.8H20and 169.10 ml. 1 N H2SO& made up to 1000 ml.H20.Sodium hydroxide 1.1 N. Baker's starch-free yeast: approximately 20 per cent suspension.Mannitol 2 standard solution: 100 mgm.per 100 ml.Acid potassium periodate: 0.60 gram KI04 and 20 ml.conc.H2S04 made up to 1000 ml.H2O.8 Concentrated KI: approximately 50 per cent solution.Amylose: 1 per cent solution.Sodium thiosulfate: 0.005 N NaS20, made from 0.1 N stock solution.
Increased VEGFR-2 Gene Copy Is Associated with Chemoresistance and Shorter Survival in Patients with Non–Small-Cell Lung Carcinoma Who Receive Adjuvant Chemotherapy
Authors: Fei Yang, Ximing Tang, Erick Riquelme, Carmen Behrens, Monique B. Nilsson, Uma Giri, Marileila Varella-Garcia, Lauren A. Byers, Heather Y. Lin, Jing Wang, Maria G. Raso, Luc Girard, Kevin Coombes, J. Jack Lee, Roy S. Herbst, John D. Minna, John V. Heymach, Ignacio I. Wistuba
Journal: Cancer Research (2011)

VEGF receptor-2 (VEGFR-2 or kinase insert domain receptor; KDR) is a known endothelial target also expressed in NSCLC tumor cells. We investigated the association between alterations in the KDR gene and clinical outcome in patients with resected non-small-cell lung carcinoma (NSCLC; n = 248). KDR copy number gains (CNG), measured by quantitative PCR and fluorescence in situ hybridization, were detected in 32% of tumors and associated with significantly higher KDR protein and higher microvessel density than tumors without CNGs. KDR CNGs were also associated with significantly increased risk of death (HR = 5.16; P = 0.003) in patients receiving adjuvant platinum-based chemotherapy, but no differences were observed in patients not receiving adjuvant therapy. To investigate potential mechanisms for these associations, we assessed NSCLC cell lines and found that KDR CNGs were significantly associated with in vitro resistance to platinum chemotherapy as well as increased levels of nuclear hypoxia inducible factor-1α (HIF-1α) in both NSCLC tumor specimens and cell lines. Furthermore, KDR knockdown experiments using small interfering RNA reduced platinum resistance, cell migration, and HIF-1α levels in cells bearing KDR CNGs, providing evidence for direct involvement of KDR. No KDR mutations were detected in exons 7, 11, and 21 by PCR-based sequencing; however, two variant single nucleotide polymorphism genotypes were associated with favorable overall survival in adenocarcinoma patients. Our findings suggest that tumor cell KDR CNGs may promote a more malignant phenotype including increased chemoresistance, angiogenesis, and HIF-1α levels, and that KDR CNGs may be a useful biomarker for identifying patients at high risk for recurrence after adjuvant therapy, a group that may benefit from VEGFR-2 blockade.
From the Green City
Authors: Antoinette Rose
Journal: Annals of Internal Medicine (1997)

On Being a Patient15 November 1997From the Green CityAntoinette Rose, MDAntoinette Rose, MDCamino Medical Group; Los Altos, CA 94022Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-10-199711150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Willie wasn't really a hospital volunteer, but he liked to think he was. Not that it was so hard to become a hospital volunteer, but actually being one would have ruined it for him somehow. Besides, the application to become a volunteer-two pages of little boxes and lines-required a grip on reality that just didn't interest Willie. A few real things interested him. First, he liked the blue coats that the volunteers got to wear. Being resourceful, he managed a decent facsimile from an old work shirt that he found in a garbage bin at 24th and Kansas and just ... Author, Article, and Disclosure InformationAuthors: Antoinette Rose, MDAffiliations: Camino Medical Group; Los Altos, CA 94022Corresponding Author: Antoinette Rose, MD, 4906 El Camino Real, Los Altos, CA 94022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 November 1997Volume 127, Issue 10Page: 921KeywordsAlcoholicsDeoxyadenosine monophosphateHand strengthScabiesScars ePublished: 15 August 2000 Issue Published: 15 November 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bendamustine in chronic lymphocytic leukemia: Outcome according to different clinical and biological prognostic factors in the everyday clinical practice
Authors: Francesco Zaja, Michael Mian, Stefano Volpetti, Carlo Visco, Cinzia Sissa, Ilaria Nichele, Monica Castelli, Achille Ambrosetti, Simona Puglisi, Renato Fanin, Sergio Cortelazzo, Giovanni Pizzolo, Livio Trentin, Francesco Rodeghiero, Rossella Paolini, Paolo Vivaldi, Rosaria Sancetta, Miriam Isola, Gianpietro Semenzato
Journal: American Journal of Hematology (2013)

Bendamustine proved to be effective for the treatment of chronic lymphocytic leukemia (CLL). However, the relationship between its activity with clinico‐biological prognosticators has been addressed only in few studies. We retrospectively evaluated the efficacy of bendamustine, in a real‐life contest, on 142 patients, median age 70 years, median number of previous regimens 2 (0–8, 13% previously untreated). Bendamustine was administered for a median number of 4 cycles, in 84% of cases with rituximab. Overall (ORR) and complete response (CRR) rates were 68 and 16.5%, respectively. Multivariate analysis demonstrated a relationship between ORR and number of prior treatments (OR 0.25, 95% CI 0.08–0.71; P = 0.009), del(17p) (OR 0.10, 95% CI 0.03–0.32; P &lt; 0.001) and concomitant rituximab (OR 4.37, 95% CI 1.12–17.04; P = 0.033). The estimated 1‐ and 2‐years overall survival (OS) and progression free survival (PFS) rates were 76, 61, 51, and 26%, respectively. Previous sensitivity to fludarabine (HR 0.36, 95% CI 0.16–0.82), response to bendamustine (HR 0.21, 95% CI 0.10–0.45), and del(17p) (HR 2.18, 95% CI 1.002–4.74) had a prognostic significance in multivariate analysis for PFS, while the number of previous therapies (HR 3.48, 95% CI 1.29–9.38; P = 0.014), concomitant use of rituximab (HR 0.32, 95% CI 0.11–0.93) and response to bendamustine (HR 0.22, 95% CI 0.07–0.66) were significant for OS. Side effects included grade 3–4 neutropenia, infections, thrombocytopenia and anemia which occurred in 40, 14, 14, and 10% of patients, respectively. These results confirm the activity and safety of bendamustine and rituximab combination even in patients with unfavorable clinical and biological features excluding del(17p). Am. J. Heamtol. 88:955–960, 2013. © 2013 Wiley Periodicals, Inc.
Chronic Hyperglycemia Impairs Endothelial Function and Insulin Sensitivity Via Different Mechanisms in Insulin-Dependent Diabetes Mellitus
Authors: Sari Ma¨kimattila, Antti Virkama¨ki, Per-Henrik Groop, John Cockcroft, Tapio Utriainen, Johan Fagerudd, Hannele Yki-Ja¨rvinen
Journal: Circulation (1996)

Background We explored whether chronic hyperglycemia is associated with defects in endothelium-dependent vasodilatation in vivo and whether defects in the hemodynamic effects of insulin explain insulin resistance. Methods and Results Vasodilator responses to brachial artery infusions of acetylcholine, sodium nitroprusside, and N G -monomethyl- l -arginine and, on another occasion, in vivo insulin sensitivity (euglycemic insulin clamp combined with the forearm catheterization technique) were determined in 18 patients with insulin-dependent diabetes mellitus (IDDM) and 9 normal subjects. At identical glucose and insulin levels, insulin stimulation of whole-body and forearm glucose uptake was 57% reduced in the IDDM patients compared with normal subjects ( P &lt;.001). The defect in forearm glucose uptake was attributable to a defect in glucose extraction (glucose AV difference, 1.1±0.2 versus 1.9±0.2 mmol/L, P &lt;.001, IDDM versus normal subjects), not blood flow. Within the group of IDDM patients, hemoglobin A 1c was inversely correlated with forearm blood flow during administration of acetylcholine ( r =−.50, P &lt;.02) but not sodium nitroprusside ( r =.07). The ratio of endothelium-dependent to endothelium-independent blood flow was ≈40% lower in patients with poor glycemic control than in normal subjects or patients with good or moderate glycemic control. Conclusions We conclude that chronic hyperglycemia is associated with impaired endothelium-dependent vasodilatation in vivo and with a glucose extraction defect during insulin stimulation. These data imply that chronic hyperglycemia impairs vascular function and insulin action via distinct mechanisms. The defect in endothelium-dependent vasodilatation could contribute to the increased cardiovascular risk in diabetes.
NEW ANTIHYPERTENSION DRUGS
Authors: Henry A. Schroeder
Journal: JAMA (1952)

<h3>To the Editor:—</h3> Recent announcements in the press of a method to control hypertension by the use of hexamethonium chloride and hydrazinophthalazine have inspired considerable confusion and conflicting comments in both lay and medical circles. Some tabloid newspapers gave a distorted, overenthusiastic view, other papers were reasonably factual, but several reprinted follow-up stories inspired by another investigator branding the method as "dangerous." In addition, literature mailed to physicians by the manufacturer of a preparation of hexamethonium chloride contained erroneous statements attributed to me. Since the truth lies between these conflicting statements, I am attempting to clarify the confusion. A method for the partial temporary control of arterial hypertension has been developed, a preliminary report of which was published in the<i>A. M. A. Archives of Internal Medicine</i>(<b>89</b>:523 [April] 1952). This method has been extended to include approximately 120 patients suffering from arterial hypertension of all degrees of severity,
RIP-ed and ready to dance: new mechanisms for polycystin-1 signaling
Authors: Lisa M. Guay-Woodford
Journal: Journal of Clinical Investigation (2004)

Polycystin-1, the protein encoded by the principal gene involved in autosomal dominant polycystic kidney disease, has been implicated in extracellular sensing as well as in cell-cell and cell-matrix interactions. However, the precise mechanisms involved in polycystin-1 signaling are not well defined. A report in this issue of the JCI demonstrates that the C-terminal tail of polycystin-1 is cleaved from the membrane through regulated intramembrane proteolysis (RIP) and that this domain translocates to the nucleus, where it activates the AP-1 transcription pathway. This translocation appears to be modulated by polycystin-2, with which polycystin-1 is thought to interact. These findings provide what we believe to be the first evidence that polycystin-1 can signal directly to the nucleus and that polycystin-1–polycystin-2 interactions do not require colocalization of these proteins in the same membrane compartment.
The Management of Infertility
Authors: Larry McGowan
Journal: JAMA (1969)

The infertile couple has been the subject of many texts, but rarely of one like this, which stresses the familiar diagnostic tests and therapeutic maneuvers and their proper usage. This book places a welcome emphasis upon the art of caring for the infertile couple, with the chapters on definition and causes of infertility, and on the postcoital test, tubal insufflation, endometrial biopsy, basal body temperature, evaluation of the male factor, and management of infertility. The chapter on the cervical (insemination) factor and the one on therapeutic donor insemination concisely present the practical aspects of the problems and procedures in this area today. As opportunities develop for a physician to receive training in endocrinology, surgery, psychiatry, marriage counseling, and male infertility, the fertility specialist will develop suitable attitudes and skills. And this, as the author so accurately maintains, will provide the best care for the infertile couple. Physicians now caring for
92 Final week-72 results of the aids pegasys ribavirin international co-infection trial (APRICOT): A randomized, partially blinded, multinational comparative trial of peginterferon ALFA-2A (40KD) (PEGASYS®) plus ribavirin (RBV) (COPEGUS®) vs interferon ALFA-2A(IFN)
Authors: F.J. Torriani, J. Rockstroh, M. Rodriguez-Torres, E. Lissen, J. Gonzalez, A. Lazzarin, G. Carosi, J. Sasadeusz, C. Katlama, D. Dieterich
Journal: Journal of Hepatology (2004)
Breast Reconstruction Following Mastectomy
Authors: J. Bostwick
Journal: CA A Cancer Journal for Clinicians (1989)

Breast reconstruction after mastectomy can avoid a permanent deformity. As a member of the breast management team, the reconstructive surgeon can give advice on timing and techniques. Breast reconstruction can either be started at the time of the mastectomy or delayed for months or years. Newer techniques of tissue expansion permit breast reconstruction without additional scars or significant hospitalization. Autogenous tissue breast reconstruction techniques are available that provide natural, long-lasting breast reconstruction without the need for a silicone breast implant.
Nitric Oxide Produced by Endothelial Cells Increases Production of Eicosanoids Through Activation of Prostaglandin H Synthase
Authors: Sandra T. Davidge, Philip N. Baker, Margaret K. McLaughlin, James M. Roberts
Journal: Circulation Research (1995)

Abstract The endothelium serves many functional roles, including the modulation of vascular smooth muscle tone through the release of vasoactive agents such as nitric oxide (NO) and the eicosanoids. We proposed that NO produced by endothelial cells would increase the production of eicosanoids through enhanced expression and/or activation of prostaglandin H synthase. NO and eicosanoid synthesis were stimulated in a bovine coronary microvessel endothelial cell line with the calcium ionophore A23187 (1 μmol/L). Our data demonstrated the following: (1) A23187 stimulated NO synthesis along with prostacyclin and thromboxane production. (2) Inhibition of NO synthesis with N G -nitro- l -arginine methyl ester (0.1 mmol/L) significantly diminished both prostacyclin and thromboxane production. (3) Cells incubated with hemoglobin (2 μg/mL), which inactivates NO, decreased A23187-stimulated prostacyclin production, whereas cells incubated with superoxide dismutase (20 U/mL), which protects NO from superoxide anions, enhanced prostacyclin production. (4) Exogenous NO stimulated prostacyclin production. (5) The interaction of NO with prostacyclin persisted in the presence of excess exogenous arachidonic acid (100 μmol/L). (6) Cyclooxygenase activity in cell lysates increased in the first hour of NO stimulation. (7) NO stimulation of prostacyclin occurred within 1 hour and continued for 8 hours. (8) Neither constitutive nor inducible prostaglandin H synthase enzyme expression was altered by NO. (9) Cycloheximide (10 μmol/L) had no effect on A23187 stimulation of prostacyclin production. (10) Exogenous cGMP (10 μmol/L) or a phosphodiesterase inhibitor (1 mmol/L) did not affect prostacyclin production. These data indicate that stimulating synthesis of endogenous NO in cultured endothelial cells increased eicosanoid production through activation of prostaglandin H synthase.
In or Out of Nursing Homes, Elder Care's Costly
Authors: Phil Gunby
Journal: JAMA (1993)

RECENT WARNINGS that the principal (hospital insurance) trust fund for Medicare could run out of money in 5 to 7 years come on the heels of a report suggesting that some kind of government assistance with long-term care will be even more critical in the future.  The report, Health Data on Older Americans: United States, 1992 (Rockville, Md: Department of Health and Human Services; January 1993), notes that Medicare's supplementary medical insurance expenditures, more than 70% of which go for physician services and the rest for outpatient hospital care, rose from $11 billion in 1980 to nearly $32 billion in 1987. The five Medicare trustees, three of whom are cabinet officers, now say that figure rose to nearly $51 billion last year and the growth shows little sign of abating.  However, this supplemental medical insurance fund is actuarially sound, trustees say. Still, they are concerned about its rapid growth rate.
MINERAL SPRINGS OF CALIFORNIA.
Authors: WINSLOW ANDERSON
Journal: JAMA (1894)

From the earliest dawn of history, mineral waters have been highly extolled for their medicinal properties. The ancient Egyptians and Arabians used mineral waters in the treatment of many diseases. The hot sulphurous springs of Tiberias (now called Tabareah) have been in extensive use for the past 3,000 years, as they are at the present day, by patients from all parts of Syria. The thermal baths of Calirrhoe near the Dead Sea, made famous by Herod are still in use. The ancient Greek and Roman physicians prescribed mineral waters extensively, as may be seen from the writings of Hippocrates, Aristotle and Herodotus. Homer speaks of using mineral waters for bathing, for the preparation of sacrifice, for the reception of oracles and for holy marriages. Josephus and Pliny refer to the marvelous curative powers of mineral waters. The thermal springs of Thermopylæ, immortalized by the heroic Spartans, have been in use
947-110 Measurement of Adenylyl Cyclase Activity in the AV Nodal Region of the Canine Heart: Evidence for Inhibition by Adenosine and Acetylcholine
Authors: Atsushi Sugiyama, Scott McKnite, Phi Wiegn, Wayne Adkisson, Jennifer Pennington, Keith G. Lurie
Journal: Journal of the American College of Cardiology (1995)