tbuckley/cabot-search huggingface dataset:
A Prospective Multicenter Study of Adrenal Function in Critically Ill Children
Authors: Kusum Menon, Roxanne E. Ward, Margaret L. Lawson, Isabelle Gaboury, James S. Hutchison, Paul C. Hébert
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Rationale: Adrenal insufficiency is a clinical condition associated with fluid- and catecholamine-resistant hypotension.Objectives: The objectives of this study were to determine the prevalence of adrenal insufficiency, risk factors and potential mechanisms for its development, and its association with clinically important outcomes in critically ill children.Methods: A prospective, cohort study was conducted from 2005 to 2008 in seven tertiary-care, pediatric intensive care units in Canada on patients up to 17 years of age with existing vascular access. Adrenocorticotropic hormone stimulation tests (1 μg) were performed and adrenocorticotropic hormone levels measured in all participants.Measurements and Main Results: A total of 381 patients had adrenal testing on admission. The prevalence of adrenal insufficiency was 30.2% (95% confidence interval, 25.9-35.1). Patients with adrenal insufficiency had higher baseline cortisol levels (28.6 μg/dl vs. 16.7 μg/dl, P < 0.001) and were significantly older (11.5 yr vs. 2.3 yr, P < 0.001) than those without adrenal insufficiency. Adrenal insufficiency was associated with an increased need for catecholamines (P < 0.001) and more fluid boluses (P = 0.026). The sensitivity and specificity of the low-dose adrenocorticotropic hormone stimulation test were 100% and 84%, respectively.Conclusions: Adrenal insufficiency occurs in many disease conditions in critically ill children and is associated with an increased use of catecholamines and fluid boluses. It is likely multifactorial in etiology and is associated with high baseline cortisol levels. Further research is necessary to determine which of these critically ill children are truly cortisol deficient before any treatment recommendations can be made.
Ventricular Support Systems for End Stage Heart Failure Patients: Which patient, When?
Authors: Yaprak Engin, Çağatay Engin, Tahir Yağdı, Serkan Ertugay, Sanem Nalbantgil, Mehdi Zoghi, Özlem Balcıoğlu, Pelin Öztürk, Mustafa Özbaran
Journal: Journal of the American College of Cardiology (2013)
OBSERVATIONS ON THE EXTRINSIC NERVOUS CONTROL OF THE AURICLES AND VENTRICLES IN COMPLETE AURICULO-VENTRICULAR BLOCK IN MAN
Authors: Arthur C. De Graff, Soma Weiss
Journal: Journal of Clinical Investigation (1926)

MAN' We are using the term "vagus" synonymously with "parasympathetic nerves."We realize that both the sympathetic nerve trunk to the heart and the vagus contain both sympathetic and parasympathetic types of nerve.Atropin paralyzes the parasympathetic endings both in the vagus and in the sympathetic trunk. 1 56 M.
Review of Clinical Risk Management
Authors: J. Leaning
Journal: BMJ (1996)

Ed Charles Vincent BMJ Publishing Group, 1995, £34.95, pp 570 ISBN 0-7279-0947-9

This ambitious book attempts to examine the rapidly evolving field of clinical risk management from many points of view, drawing on industrial experience of accidents and crisis management, on legal, psychological, and cognitive theory, and on the body of knowledge acquired in general and hospital based practice. It focuses on developments in Britain and views clinical risk management as the effort of institutions and leaders to promote a culture of safe practice in an enterprise fraught with the potential for adverse events.

The first section of the book, dealing with the principles of risk management, contains several excellent chapters that provide good theoretical underpinning. The chapter on human factors, by James Reason, provides a concise discussion of the difference between “active” and “latent” failures, in which people make errors in settings where organisational decisions have undermined the institutional defences of regulation, …
EFFECT OF AURICULAR FIBRILLATION ON FUNCTIONAL ABILITY OF THE HEART
Authors: THEODORE B. BARRINGER
Journal: JAMA (1924)

A heart beating irregularly does not expel as much blood per minute as a heart beating with regular rhythm, other factors, such as rate, size of heart, and condition of the muscle fibers, being equal. This is a quite generally accepted teaching of physical physiology. The establishment of a normal rhythm in auricular fibrillation by means of quinidin sulphate ought, therefore, to improve the heart's efficiency, and a number of reports have already appeared in which just this end was achieved.  The use of graduated exercise to build up the reserve power of the heart in patients with auricular fibrillation has been an interesting experiment, and the results, a few of which are here reported, may throw some light on the problem of handling these patients and afford clinical confirmation of the physiologic dictum stated above. One case, in particular, offered very convincing evidence that the reserve power of the
Immunotherapy of Cancer
Authors: John R. Durant
Journal: New England Journal of Medicine (1987)

This issue of the Journal includes reports by two different groups of investigators concerning their experience with adoptive immunotherapy for cancer.1 , 2 A total of 48 responses (8 complete, 28 partial, and 12 minor) are reported among 146 patients (of the 156 who were entered) treated with a variety of doses and schedules of interleukin-2 and lymphokine-activated killer (LAK) cells. Among 46 evaluable patients (of 49 entered) who received the highest tolerable doses of interleukin-2 alone, seven responses (one complete, five partial, and one minor) are reported.Since the first 25 patients treated with interleukin-2 and LAK cells were described in . . .
Acute Suppurative Parotitis
Authors: Edwin J. Pulaski, William M. Keeling
Journal: New England Journal of Medicine (1955)

ACUTE suppurative parotitis is no longer commonly encountered in surgical practice. Gustafson1 found 5 cases in a three-year period (1947–1950) at the University Hospitals, University of Michigan. The opportunity to observe and treat 2 cases within a year in two widely separated hospitals has prompted this report.Case ReportsCase 1. On March 26, 1954, a 38-year-old man in Walter Reed Army Hospital underwent pancreaticoduodenal resection for carcinoma of the ampulla of Vater. Oxytetracycline was given for prophylaxis against postoperative infection. On the 5th postoperative day moderate serous drainage from a lateral stab drain wound was noted, increasing as the . . .
Moving up the registrar ladder.
Authors: P Rhodes
Journal: BMJ (1982)

individual clinician holds the whole budget?such as his own time. It is probably less easy to see for other categories of resource; who knows what the cost of requesting an extra diagnostic test is ? It certainly does not mean that another patient goes without a test, but it may add to overall delays or cause more resources to be devoted to the service department concerned and taken away from other clinical services. In short, once we acknowledge that more than one patient is affected by a clinical action it is not unethical to consider costs.
Obesity in COPD: the effect of water-based exercise
Authors: Renae J. McNamara, Zoe J. McKeough, David K. McKenzie, Jennifer A. Alison
Journal: European Respiratory Journal (2013)

To the Editor: 

Rutten et al. [1] recently summarised the literature regarding obesity as a comorbidity in chronic obstructive pulmonary disease (COPD). Obesity in COPD has been associated with increased symptoms of dyspnoea [2], poorer health-related quality of life [2], increased levels of fatigue [3] and exercise performance limitations, including a decreased tolerance to weight-bearing exercise such as walking [4].

We have previously reported the results of a randomised controlled trial examining the effect of water-based exercise in 53 individuals with COPD with physical comorbidities, including obesity [5]. In order to contribute to the discussion on the impact of obesity in COPD we present additional data from the subgroup of 24 obese (defined as body mass index ≥32 kg·m−2) individuals with COPD in our trial. These 24 participants were randomised to either 8 weeks water-based exercise (n=8), land-based exercise (n=8) or control (no exercise) (n=8). Participant characteristics and body composition results are presented in table 1. Within-group comparisons using a paired t-test demonstrated that participants in the water-based exercise group lost the greatest amount of weight over the eight-week period (p=0.02) (table 1). Between-group comparisons using independent group t-tests found a significant difference in change in weight between the water-based exercise group and the control …
Colchicine and Disk Disease
Authors: Michael R. Rask
Journal: JAMA (1986)

To the Editor.—  Dr Garfin,1in the QUESTIONS AND ANSWERS section inJAMA, is misinformed about the use of colchicine in painful disk (and other) spinal disorders. There have been two reports of US Food and Drug Administration-approved double-blind studies on the use of colchicine in  disk disease (the term resistant means refractory to ordinary therapeutic measures [eg, rest, usual medications, previous surgery, chemonucleolysis, and bed rest]). These studies have confirmed beyond the shadow of a doubt that colchicine is a most highly effective therapeutic agent in patients who suffer  disk disease.2,3  Dr Garfin's inference that my original study on the use of colchicine in painful disk disorders4included patients who might have recovered otherwise is also an incorrect assumption on his part. All of these original 50 patients had proved  disk disease. In fact, in my most recent study of more than 3,000
De novo germline and postzygotic mutations in AKT3, PIK3R2 and PIK3CA cause a spectrum of related megalencephaly syndromes
Authors: Jean-Baptiste Rivière, Ghayda M Mirzaa, Brian J O'Roak, Margaret Beddaoui, Diana Alcantara, Robert L Conway, Judith St-Onge, Jeremy A Schwartzentruber, Karen W Gripp, Sarah M Nikkel, Thea Worthylake, Christopher T Sullivan, Thomas R Ward, Hailly E Butler, Nancy A Kramer, Beate Albrecht, Christine M Armour, Linlea Armstrong, Oana Caluseriu, Cheryl Cytrynbaum, Beth A Drolet, A Micheil Innes, Julie L Lauzon, Angela E Lin, Grazia M S Mancini, Wendy S Meschino, James D Reggin, Anand K Saggar, Tally Lerman-Sagie, Gökhan Uyanik, Rosanna Weksberg, Birgit Zirn, Chandree L Beaulieu, Jacek Majewski, Dennis E Bulman, Mark O'Driscoll, Jay Shendure, John M Graham, Kym M Boycott, William B Dobyns
Journal: Nature Genetics (2012)
Age and prognosis in breast cancer.
Authors: W H Redding, J M Thomas, T J Powles, H T Ford, J C Gazet
Journal: BMJ (1979)

since ischaemia or procaine block of peripheral nerves usually abolishes it.34Toxic reactions to penicillamine, especially haematological, renal, and gastrointestinal disturbances, occur in patients with rheumatoid arthritis.Neurological complications are relatively uncommon.Polymyositis and myasthenia gravis have been reported, but both were excluded in our patient.The decremental EMG response found only at higher stimulation rates, in the absence of single fibre EMG abnormalities, is unlike that found in myasthenia gravis or Eaton- Lambert syndrome.5To recognise neuromyotonia requires careful clinical and EMG examination since it is easily mistaken for myasthenia gravis.
CHEMISTRY OF ALUMINUM HYDROXIDE SUSPENSIONS
Authors: HENRY R. KREIDER
Journal: JAMA (1941)

The problem of the chemistry of aluminum hydroxide preparations was originally referred by the Council on Pharmacy and Chemistry to Dr. Victor C. Myers and his associates at Western Reserve University, Cleveland. In 1938 Dr. Myers compared the chemical properties of commercial products then available with a preparation made by a method devised by Dr. I. H. Einsel. This method depended on the possible intermediary formation of aluminum carbonate resulting from the double decomposition of equivalent quantities of aluminum chloride and sodium carbonate in aqueous solution. The aluminum carbonate hydrolyzes to form aluminum hydroxide and carbonic acid. Most of the carbonic acid is decomposed to form free carbon dioxide and water. The resulting mixture was adjusted to be slightly alkaline to phenol red. This material was then centrifuged, the supernatant liquid discarded and the residue made up to the original volume with water. This was again centrifuged, and the final
Inhibition of histone methylation arrests ongoing graft-versus-host disease in mice by selectively inducing apoptosis of alloreactive effector T cells
Authors: Shan He, Jina Wang, Koji Kato, Fang Xie, Sooryanarayana Varambally, Shin Mineishi, Rork Kuick, Kazuhiro Mochizuki, Yongnian Liu, Evelyn Nieves, Ram-Shankar Mani, Arul M. Chinnaiyan, Victor E. Marquez, Yi Zhang
Journal: Blood (2011)
Vaccination against the Forkhead Family Transcription Factor Foxp3 Enhances Tumor Immunity
Authors: Smita Nair, David Boczkowski, Martin Fassnacht, David Pisetsky, Eli Gilboa
Journal: Cancer Research (2007)

Abstract Depletion of CD4+CD25+ regulatory T cells (Treg) by treatment with αCD25 antibody synergizes with vaccination protocols to engender protective immunity in mice. The effectiveness of targeting CD25 to eliminate Treg is limited by the fact that CD25, the low-affinity interleukin-2 receptor, is up-regulated on conventional T cells. At present, foxp3 is the only product known to be exclusively expressed in Treg of mice. However, foxp3 is not expressed on the cell surface and hence cannot be targeted with antibodies. In this study, we tested the hypothesis that vaccination of mice against foxp3, a self-antigen expressed also in the thymus, is capable of stimulating foxp3-specific CTL that will cause the depletion of Treg and enhanced antitumor immunity. Vaccination of mice with foxp3 mRNA-transfected dendritic cells elicited a robust foxp3-specific CTL response and potentiated vaccine-induced protective immunity comparably with that of αCD25 antibody administration. In contrast to αCD25 antibody treatment, repeated foxp3 vaccination did not interfere with vaccine-induced protective immunity. Importantly, foxp3 vaccination led to the preferential depletion of foxp3-expressing Treg in the tumor but not in the periphery, whereas αCD25 antibody treatment led to depletion of Treg in both the tumor and the periphery. Targeting foxp3 by vaccination offers a specific and simpler protocol for the prolonged control of Treg that may be associated with reduced risk of autoimmunity, introducing an approach whereby specific depletion of cells is not limited to targeting products expressed on the cell surface. [Cancer Res 2006;67(1):371–80]
Drainage of the Abdomen
Authors: H. L. Duthie
Journal: New England Journal of Medicine (1972)

IN all walks of life drains are used to lead away unwanted material. Drainage of the abdomen is no exception. The material may have collected before operation, as in an intra-abdominal abscess. In these circumstances a drain is used therapeutically to ensure that the pus is all evacuated and to prevent closure of the drainage hole while the cavity is still large enough to produce more pus, which might reaccumulate. There is fairly general agreement on the use of drains in this therapeutic sense.When the drain is used prophylactically no such agreement exists. After certain procedures fluid may gather . . .
Fitz-Hugh and Curtis Syndrome in a Man
Authors: Gordon L. Fung
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The Fitz-Hugh and Curtis syndrome (gonococcal perihepatitis) in a man is rare,<sup>1</sup>but we have seen a probable case. <h3>Report of a Case.—</h3> A 26-year-old homosexual man was admitted to the hospital because of a three-week history of right upper quadrant abdominal pain. The pain had gradually increased in intensity, was not pleuritic, and was associated with anorexia and one episode of clear vomitus. The patient denied having other symptoms, intravenous drug abuse, alcohol abuse, recent travel, or urethral discharge. Physical examination showed a well-nourished man in moderate distress from abdominal pain. Abdominal examination showed substantial right upper quadrant tenderness with slight rebound tenderness. Bowel sounds were present. The liver edge was felt 4 cm below the right costal margin, with a total span of 12 cm by percussion. There was no splenomegaly. Findings from the remainder of the examination were within normal limits. Admission temperature
A Model of Eosinophilic Esophagitis (EE) and Villus Atrophy (VA) after Challenge in Mice Sensitized to Peanuts: Improvement by Epicutaneous Immunotherapy (EPIT)
Authors: L. Mondoulet, V. Dioszeghy, M. Ligouis, V. Dhelft, Thibaut T. Larcher, Yan Cherel, C. Dupont, P.H. Benhamou
Journal: Journal of Allergy and Clinical Immunology (2010)
Glucocorticoid activation of chromogranin A gene expression. Identification and characterization of a novel glucocorticoid response element.
Authors: D J Rozansky, H Wu, K Tang, R J Parmer, D T O'Connor
Journal: Journal of Clinical Investigation (1994)

Glucocorticoids regulate catecholamine biosynthesis and storage at several sites. Chromogranin A, an abundant protein complexed with catecholamines in secretory vesicles of chromaffin cells and sympathetic axons, is also augmented by glucocorticoids. This study reports isolation of the rat chromogranin A promoter to elucidate transcriptional regulation of chromogranin A biosynthesis by glucocorticoids in neuroendocrine cells. Endogenous chromogranin A gene expression was activated up to 3.5-fold in chromaffin cells by glucocorticoid, in time-dependent fashion. Inhibition of new protein synthesis by cycloheximide did not alter the rise in chromogranin A mRNA, suggesting that glucocorticoids directly activate the chromogranin A promoter; nuclear runoff assays confirmed a 3.3-fold increased rate of initiation of new chromogranin A transcripts after glucocorticoid. Transfected rat chromogranin A promoter/luciferase reporter constructs were activated 2.6-3.1-fold by glucocorticoid, and selective agonist/antagonist studies determined that dexamethasone effects were mediated by glucocorticoid receptors. Both rat and mouse chromogranin A promoter/luciferase reporter constructs were activated by glucocorticoid. A series of promoter deletions narrowed the region of glucocorticoid action to a 93-bp section of the promoter, from position -526 to -619 bp upstream of the cap site. A 15-bp sequence ([-583 bp] 5'-ACATGAGTGTGTCCT-3' [-597 bp]) within this region showed partial homology to a glucocorticoid response element (GRE; half-site in italics) consensus sequence, and several lines of experimental evidence confirmed its function as a GRE: (a) site-directed mutation of this GRE prevented glucocorticoid activation of a chromogranin A promoter/reporter; (b) transfer of this GRE to a heterologous (thymidine kinase) promoter/reporter conferred activation by glucocorticoid, in copy number-dependent and orientation-independent fashion; and (c) electrophoretic gel mobility shifts demonstrated binding of this GRE by ligand-activated glucocorticoid receptor, though at 2.75-fold lower affinity than the glucocorticoid receptor interaction with a consensus GRE. The rat chromogranin A GRE showed functional and structural similarities to GREs in other genes proportionally regulated by glucocorticoids. We conclude that a discrete domain of the chromogranin A promoter is both necessary and sufficient to confer glucocorticoid regulation onto the gene, and that the activity of this region also explains the degree of activation of the endogenous gene by glucocorticoid.
Regional Cerebral Blood Flow Measurement Using Tc-99m HMPAO SPECT in a Patient With Adrenoleukodystrophy
Authors: HIROSHI MATSUDA, HIDEJI UESUGI, KAZUHIKO KAMATA, NOBUHIKO SUNOHARA, AKIRA YAGISHITA
Journal: Clinical Nuclear Medicine (1995)

Regional cerebral blood flow (rCBF) measurement using Tc-99m HMPAO angiography and SPECT was performed in a patient with adrenoleukodystrophy. The whole brain CBF showed great reduction to 31 ml/100 g/min as compared with an age-matched normal value of 45.9 ml/100 g/min. rCBF showed extremely decreased values of approximately 28 and 10 ml/100 g/min in bilateral frontal cortex and white matter respectively. The SPECT scan provided useful information on gray matter involvement to MRI findings of widespread white matter lesions. This quantitative nuclear medicine technique may contribute to pathophysiologic evaluation of adrenoleukodystrophy complementary with MRI.
Sport concussion assessment tool-2 (SCAT2) scores in the acute phase following concussion in high school athletes
Authors: Richelle M Mayfield, Lindsey Shepherd, Tamara C Valovich McLeod, R Curtis Bay
Journal: British Journal of Sports Medicine (2013)

Objective To investigate changes in SCAT2 scores in high school athletes in the first 10 days post-concussion. Design Within subjects, repeated measures. Setting High school athletic facilities. Patients 119 high school athletes who sustained a sport-related concussion diagnosed by their athletic trainer (102 males, 15 females, and 2 missing, age=15.8±1.2, grade=10.0±1.0 level). Interventions The SCAT2 was administered during a preseason baseline, day of injury (DOI), and days 3 (D3) and 10 (D10) post-concussion. The SCAT2 total score is calculated by summing each component score, and has a maximum of 100 points. Main Outcome Measures Day of testing served as the independent variable and the dependent variable was SCAT2 total score. Analyses were conducted using a generalised estimating equations approach to accommodate repeated measures of the same participants. An inverse Gaussian distribution and identity link were specified, along with robust variance estimators. Follow-up pairwise tests employed a Bonferroni correction. Results The omnibus test was significant (p&lt;0.001). Scores at DOI (73.5, 95% CI 70.8 to 76.1) were significantly lower than BL (86.0, 95% CI 84.8 to 87.3). D3 scores (79.8, 95% CI 77.2 to 82.3) remained significantly lower than BL, but were significantly higher than DOI. Scores at D10 (88.8, 95% CI 87.3 to 90.3) were significantly higher than DOI, D3, and BL. Conclusions SCAT2 scores decreased significantly during the first 3 days post-concussion, demonstrating impairments in a composite score that includes symptoms, mental status, and balance. Deficits in the SCAT2 recovered to levels above baseline by D10, indicating a resolution of concussion related impairments. Acknowledgements This study was funded by a grant from the National Operating Committee for Standards on Athletic Equipment (NOCSAE). Competing interests None.
Book Review History and Health Policy in the United States: Putting the Past Back in (Critical Issues in Health and Medicine.) Edited by Rosemary A. Stevens, Charles E. Rosenberg, and Lawton R. Burns. 364 pp. New Brunswick, NJ, Rutgers University Press, 2006. $68 (cloth); $24.95 (paper). 978-0-8135-3837-2 (cloth); 978-0-8135-3838-9 (paper).
Authors: Constance Wei-Fang Liu, Duncan B. Neuhauser
Journal: New England Journal of Medicine (2007)
782 HEPATIC MIRNA SIGNATURE PREDICTING SUSTAINED VIROLOGICAL RESPONSE IN CHRONIC HEPATITIS C
Authors: E. Estrabaud, I. Bièche, M. Lapalus, S. De Muynck, O. Lada, M. Martinot-Peignoux, A. Duces, D. Valla, P. Bedossa, P. Marcellin, M. Vidaud, T. Asselah
Journal: Journal of Hepatology (2011)
The Q-T Interval in the Electrocardiogram of Children with Tuberculosis
Authors: THEODORE T. FOX, HERBERT BERGER, ELLIOTT KAPLAN, JOHN C. MARSHAL
Journal: Circulation (1950)

It is stated that prolongation of the Q-T interval is a reliable criterion of active carditis. A control investigation of a group of tuberculous children was undertaken with particular reference to this point. It was observed that prolongation of the Q-T interval is a rather frequent finding in childhood tuberculosis, but is not an expression of the cardiac status of the patient. The value of the Q-T interval as an indicator of active carditis is therefore questioned.