tbuckley/cabot-search huggingface dataset:
Is the acidity of ascitic fluid a reliable index in making the presumptive diagnosis of spontaneous bacterial peritonitis?
Authors: Giovambattista Pinzello, Roberto Virdone, Francesca Lojacono, Maddalena Ciambra, Gabriella Dardanoni, Germana Fiorentino, Loredana Riccobono, Luigi Pagliaro
Journal: Hepatology (1986)

Ascitic fluid pH and arterial-ascitic fluid pH gradient were compared to ascitic fluid polymorphonuclear cell count in 84 patients with cirrhotic ascites and in 12 with malignant ascites to assess their role as diagnostic tests for spontaneous bacterial peritonitis and to clarify the relationship between ascitic fluid pH and lactate. Ascitic fluid pH was significantly lower (pH 7.30) in spontaneous bacterial peritonitis (n = 18) and probable spontaneous bacterial peritonitis (n = 12) than in sterile ascites (pH 7.41; n = 54). Since blood pH levels were not different in the presence of infection, arterial-ascitic fluid pH gradient was significantly higher in spontaneous bacterial peritonitis and probable spontaneous bacterial peritonitis than in sterile ascites (0.12 vs. 0.02). The close correlations between arterial-ascitic pH gradient and lactate (r = 0.77, p less than 0.0001), lactate and bicarbonate gradient (r = 0.64, p = 0.003) and arterial-ascitic pH gradient and pCO2 gradient (r = -0.90, p less than 0.0001) suggest that the low ascitic fluid pH may be due to an increase in lactate and CO2. Patients with Escherichia coli-induced spontaneous bacterial peritonitis had significantly lower ascitic fluid pH and higher lactate than those with spontaneous bacterial peritonitis by other organisms. Values of ascitic fluid pH, lactate and arterial-ascitic fluid pH gradient in malignant ascites were similar to those of spontaneous bacterial peritonitis and probable spontaneous bacterial peritonitis. Cutoff points, selected by receiver operating characteristic curves analysis, of 450 per mm3 for polymorphonuclear cells and of 0.07 for arterial-ascitic fluid pH gradient, allow high positive and negative predictive values for spontaneous bacterial peritonitis.(ABSTRACT TRUNCATED AT 250 WORDS)
Nitrates, Package Inserts, and the Food and Drug Administration
Authors: Jonathan Abrams
Journal: JAMA (1981)

A DILEMMA exists regarding the usefulness of long-acting nitrate preparations in patients with angina pectoris or congestive heart failure and the present Food and Drug Administration approved package inserts (regulatory monographs), outlining nitrate dosage regimens and clinical indications. This group of drugs, whether given orally or topically, has been documented to be bioavailable and clinically effective for four to six hours or longer.<sup>1</sup>Yet the FDA continues to classify all oral long-acting nitrate preparations as being only "possibly effective." In addition, maximal dosages currently recommended by the pharmaceutical manufacturers are considerably smaller than the amounts found to be safe, necessary, and efficacious in a variety of recent investigations.<sup>2,3</sup>Finally, promotional literature, including the package insert, may not recommend nitrates for use in vasodilator therapy of congestive heart failure. No pharmaceutical company has yet submitted a New Drug Application to the FDA for use of any long-acting nitrate in
Postprandial response of salivary ghrelin and leptin to carbohydrate uptake
Authors: M Groschl
Journal: Gut (2006)

Circulating ghrelin rapidly responds to food intake, being decreased by carbohydrates and fat1 and increased by proteins1 or amino acids.2 Leptin also affects energy expenditure. While ghrelin stimulates food intake,3 leptin induces satiety.4 It has therefore been postulated as an antagonist of ghrelin.4

The salivary glands are additional sources of both peptides.5,6 Determination of salivary values has been suggested as a non-invasive alternative to serum.7 We investigated the postprandial response of salivary ghrelin and leptin to determine whether this non-invasive application is useful in clinical practice.

Serum and saliva were obtained from healthy males (n = 11; 18–40 years; body mass index (BMI) 19–27 kg/m2), before and two hours after intake of 1 g/kg glucose (fig 1). Patients (n = 18, 9.9 (4.4) years, BMI 13–26.5 kg/m …
Gefitinib radiosensitizes non-small cell lung cancer cells through inhibition of ataxia telangiectasia mutated
Authors: Soo-Yeon Park, Young Mee Kim, Hongryull Pyo
Journal: Molecular Cancer (2010)

Abstract Purpose Inhibitors of epidermal growth factor receptor (EGFR) have shown dramatic results in a subset of patients with non-small cell lung cancer (NSCLC), and have also been shown to enhance the effect of ionizing radiation (IR). We investigated how gefitinib, an orally given EGFR inhibitor for NSCLC patients, can radiosensitize NSCLC cells. Experimental Design and Results In clonogenic survival assays performed in three NSCLC cell lines, gefitinib radiosensitized NCI-H460 and VMRC-LCD but not A549 cells. Gefitinib pretreatment induced multinucleated cells after IR exposure in NCI-H460 and VMRC-LCD, but not in A549 cells. Gefitinib also inhibited activation of ataxia telangiectasia mutated (ATM) after IR-exposure in NCI-H460 and VMRC-LCD, but not in A549 cells. An ATM specific inhibitor increased IR-induced multinucleated cells in both NCI-H460 and A549 cells. Gefitinib pretreatment inhibited the gradual decrease of γH2AX foci relative to time after IR exposure in NCI-H460 but not in A549 cells. Suppression of COX-2 in A549 cells induced multinucleated cells and caused radiosensitization after gefitinib+IR treatment. In contrast, COX-2 overexpression in NCI-H460 cells attenuated the induction of multinucleation and radiosensitization after the same treatment. Conclusions Our results suggest that gefitinib radiosensitizes NSCLC cells by inhibiting ATM activity and therefore inducing mitotic cell death, and that COX-2 overexpression in NSCLC cells inhibits this action of gefitinib.
Abstract B09: Sphingosine kinase 1 (SPHK1) is a novel mediator of tumor-stroma interaction in ovarian cancer
Authors: Jessica A. Beach, Paul-Joseph Aspuria, Dong-Joo Cheon, Maricel C. Gozo, Beth Y. Karlan, Sandra Orsulic
Journal: Cancer Research (2015)

Abstract Sphingosine kinase-1 (SPHK1) is an enzyme that catalyzes the formation of the prosurvival second messenger sphingosine-1-phosphate (S1P) from the proapoptotic lipid sphingosine. The balance between sphingosine and S1P forms a sphingolipid rheostat that is primed for cell death when the balance shifts towards sphingosine/ceramide or to cell survival when S1P levels are increased. Elevated levels of S1P have been observed in several cancers, including ovarian cancer where it is elevated in both the ascites and serum of patients. Correspondingly, high expression of SPHK1 has also been described in multiple cancer types and has been linked to disease progression. Here we report that SPHK1 is overexpressed in a subset of epithelial ovarian cancers (EOC) and correlates with poor progression-free survival. Overexpression and knockdown of SPHK1 in multiple human EOC cell lines modulates in vitro cell proliferation, anchorage-independent growth, and chemosensitivity. In mouse xenograft studies, intraperitoneal administration of a SPHK1-specific inhibitor (SKI-5c) decreases tumor size, indicating that SPHK1 may be a potential therapeutic target in EOC. S1P is a secreted factor that has been shown to influence the tumor microenvironment of other cancers; however its role in EOC has not been fully established. Using a co-culture model, we show that overexpression of SPHK1 in EOC cells stimulates the transition of normal ovarian stromal fibroblasts to myofibroblasts, and enhances stromal SPHK1 expression. In a reciprocal manner, overexpression of SPHK1 in stromal fibroblast results in increased expression of MMP2 and MMP9 in EOC cells, which may contribute to a more invasive phenotype. Interestingly, stromal SPHK1 expression also enhanced expression of SPHK1 and the S1P receptor (S1PR1) in the EOC cells. Biostatistical analysis suggests a significant correlation between SPHK1 expression in EOC cells and the expression of several extracellular matrix genes (FN1, POSTN, VCAN), which have been shown to have role in the EOC tumor microenvironment. Overall, these results suggest that SPHK1 is a critical regulator of ovarian tumor cell proliferation and survival, and a mediator of tumor-stroma interaction. Citation Format: Jessica A. Beach, Paul-Joseph Aspuria, Dong-Joo Cheon, Maricel C. Gozo, Beth Y. Karlan, Sandra Orsulic. Sphingosine kinase 1 (SPHK1) is a novel mediator of tumor-stroma interaction in ovarian cancer. [abstract]. In: Abstracts: AACR Special Conference on Cellular Heterogeneity in the Tumor Microenvironment; 2014 Feb 26-Mar 1; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(1 Suppl):Abstract nr B09. doi:10.1158/1538-7445.CHTME14-B09
Current Urologic Therapy
Authors: Harry Bergman
Journal: JAMA (1981)

Dr Kaufman has edited an interesting book. He and his contributors attempt to cover practically every urologic problem in a concise desk-reference. The book offers a new urologic approach with practically no illustrations or bibliography. The emphasis is on therapy with short descriptions of etiology and diagnostic measures. One hundred fifty-three authors describe 239 urologically related conditions. The book is divided according to various conditions afflicting various organs, and practically all are well presented. At times, an individual author, to be thorough and concise, will compress so much in a short space as to become ambiguous— requiring rereading of the material. A definitive criticism is that descriptions of surgical procedures would be enhanced by a few simple, pertinent illustrations. It is difficult to visualize some of the described operations without these. I found the excellent chapter on metabolic disorders somewhat difficult for a surgical urologist to digest. It is actually
Detecting cheating in written medical examinations
Authors: Suneel Bhat
Journal: BMJ (2005)

Health inequalities under New Labour Relative rather than absolute gaps are important over time and placeEditor-We agree with Shaw et al that the method of measuring inequality in health outcomes used in setting the government targets is problematic (A Low, UKPHA (UK Public Health Association), 13th annual public health forum, Gateshead, April 2005). 1 However, the government's targets are based on reducing relative gaps in life expectancy and infant mortality. 2 The slope index of inequality (SII) used by Shaw et al measures absolute gaps.
Extreme Denial in Breast Cancer Patients and Capacity for Object Relations
Authors: Margaret S. Wool
Journal: Psychotherapy and Psychosomatics (1986)

This study tested an assumption of the theoretical hierarchy of defenses: denial reflects primitive ego development. The study hypothesized a positive relationship between extreme denial and immature object relationship functioning. Twenty breast cancer patients who demonstrated extreme denial and delayed help-seeking were compared on a measure of object relations with a group of 30 similar patients who did not manifest denial or delay. The central hypothesis was not supported, although trends suggested possible validity. Further study may improve our understanding of the mechanisms which influence symptom recognition, help-seeking, and emotional adjustment to cancer.
Hospital-Based Active Shooter Incidents
Authors: Eli Y. Adashi, Hans Gao, I. Glenn Cohen
Journal: JAMA (2015)

On January 20, 2015, Michael J. Davidson, MD, a cardiothoracic surgeon, was fatally shot on the premises of the Brigham and Women’s Hospital in Boston, Massachusetts. In the year leading up to this tragic day, a total of 14 active shooter incidents occurred in hospitals throughout the United States, leaving 15 fatalities in their wake. This reality and its potential amplification by copycats has reignited the debate over the adequacy of current and future hospital security arrangements. In this Viewpoint, we discuss the evolving frequency of hospital-based active shooter incidents, the relevant legal framework, and the role of hospitals and physicians in countering this threat. As defined by the US Department of Homeland Security, an active shooter incident is one wherein “an individual is actively engaged in killing or attempting to kill people in a confined and populated area.” By several accounts, the overall prevalence of this otherwise rare occurrence is increasing. A study by the Federal Bureau of Investigation (FBI) reveals the overall number of active shooter incidents to have increased from 6.4 per year (2000-2006) to 16.4 per year (2007-2013). Similar rates have been reported for the hospital setting wherein the average number of active shooter incidents has increased from 9 per year (2000-2005) to 16.7 per year (2006-2011), claiming 161 lives in the process. It would thus appear that the frequency of hospital-based active shooter incidents has evolved to constitute at least a monthly occurrence. Rare as these events might be when considered in light of the enormity of the health care universe, they threaten the all-important sanctity of this benevolent and altruistic enterprise. The US Department of Health and Human Services (DHHS) has long recognized active shooter incidents as an extant threat to health care facilities. On December 1, 2014, the office of the assistant secretary for preparedness and response of the DHHS issued a planning guide encouraging health care facilities to incorporate active shooter incident planning into their emergency operation plans. Joint signatories to the guide included the Department of Homeland Security, the FBI, the US Department of Justice, and the Federal Emergency Management Agency. Focused on prevention, protection, mitigation, response, and recovery, the DHHS guide makes special mention of the practical application of the 3-part run, hide, fight protocol.... Language: en
Human colonic smooth muscle: spontaneous contractile activity and response to stretch.
Authors: R C Gill, K R Cote, K L Bowes, Y J Kingma
Journal: Gut (1986)

The length dependence of the spontaneous contractile activity of human colonic muscle was assessed in vitro. Muscle obtained from the right colon was more distensible than that of the left colon. This was true for all muscle layers. Maximum spontaneous active stress was exerted by both circular and longitudinal muscle layers of the right colon at greater degrees of stretch (p less than 0.001) than those of the left colon. The contractile frequency of longitudinally oriented strips increased with length. The contractile frequency of intertaenial longitudinally oriented strips from the right colon was lower (p less than 0.001) than that of strips from the left colon. The contractile frequency of circularly-oriented strips from the right colon (6.25 +/- 0.38 min) was higher (p less than 0.001) than that of strips from the left colon (3.35 +/- 0.35 min). The human colon appears to consist of two distinct areas based on the mechanical behaviour of the smooth muscle during spontaneous contraction.
Obstructive lung function in sarcoidosis may be missed, especially in older white patients: Figure 1–
Authors: M. Thillai, L. Potiphar, C. Eberhardt, M. Pareek, R. Dhawan, O.M. Kon, M. Wickremasinghe, A. Wells, D. Mitchell, A. Lalvani
Journal: European Respiratory Journal (2012)

Obstructive lung function in sarcoidosis may be missed, especially in older white patients
Sir Gordon Gordon-Taylor and me
Authors: David Crosby
Journal: BMJ (2004)

Residual thrombosis was related to the incidence of post-thrombotic syndrome (hazard ratio 4.0, 1.1 to 15.0).Of other potential risk factors, only thrombosis affecting the axillary and subclavian veins was related, albeit not significantly, to the development of post-thrombotic syndrome (hazard ratio 2.9, 0.8 to 10.7).
A QUANTITATIVE STUDY OF THE VASOCONSTRICTION INDUCED BY SMOKING
Authors: R. STARR LAMPSON
Journal: JAMA (1935)

Since Buerger<sup>1</sup>described the disease that bears his name there has been controversy concerning the significance of smoking as a factor<sup>2</sup>in the cause and progress of the symptoms in thrombo-angiitis obliterans. Until recently, slight experimental attention had been given to the effect of smoking on the peripheral vascular system. The studies dealing with these reactions indicate that vasoconstriction is induced by the use of tobacco. A fall in peripheral skin temperature after smoking has been reported by Maddock and Coller,<sup>3</sup>by Barker<sup>4</sup>and by Wright and Moffat.<sup>5</sup>These reports, as well as the volumetric studies of Simici and Marcu<sup>6</sup>and of Bruce, Miller and Hooker<sup>7</sup>have shown quite convincingly that there is a decrease in the peripheral circulation during smoking. The experiments here reported were undertaken in an attempt to make a quantitative estimate of the reduction in
Plasma Retinol-Binding Protein-4 Concentrations Are Elevated in Human Subjects With Impaired Glucose Tolerance and Type 2 Diabetes
Authors: Shai Gavi, Saima Qurashi, Mark M. Melendez, Dennis C. Mynarcik, Margaret A. McNurlan, Marie C. Gelato
Journal: Diabetes Care (2007)

In their recent study, Cho et al. (1) demonstrated higher levels of retinol-binding protein-4 (RBP4) in in-dividuals with impaired glucose tolerance and type 2 diabetes. Additionally, higher waist circumferences increased with plasma RBP4 quartiles. This was also demonstrated by Graham et al. (2). Cho et al. suggested that visceral fat may be more important than total body fat in determining circulating RBP4 levels. In our study (3), we investigated whether visceral …
How far does prophylaxis against infection in total joint replacement offset its cost?
Authors: U. Persson, F. Montgomery, A. Carlsson, B. Lindgren, L. Ahnfelt
Journal: BMJ (1988)

Selection of a cost effective method of prophylaxis against infection for patients undergoing total joint replacement was shown to depend on the number of arthroplasties performed each year at individual hospitals. When 100 arthroplasties were performed each year the prophylactic use of systemic antibiotics minimised the total costs of the department—that is, the combined costs of prophylaxis and reoperation for deep sepsis. Some departments also used local antibiotic prophylaxis in the form of polymethylmethacrylate cement impregnated with gentamicin or a combination of systemic and local prophylaxis at almost as low a total cost and with comparable effect. Selection of a method of prophylaxis should not be determined solely on the basis of reducing costs. When a value was assigned to the effects of loss of health an economic optimum was established that allowed selection of a more costly method of prophylaxis together with further reductions in the incidence of infection and the need for reoperation.
Collaboration in Clinical Ethics Consultation: A Method for Achieving “Balanced Accountability”
Authors: Rosalind McDougall, Clare Delany, Merle Spriggs, Lynn Gillam
Journal: The American Journal of Bioethics (2014)

Weise and Daly (2014) refer to current debates about the role and function of clinical ethicists, including clinical ethicists’ qualifications, required competencies, and evaluation of their impact...
1264 CRITICAL ROLE OF TRIGLYCERIDES AND LONG CHAIN FATTY ACYL COA ACCUMULATION IN LIVER INSULIN RESISTANCE IN THE BABOON. A NEW NON-HUMAN PRIMATE MODEL OF NAFLD
Authors: S. Kamath, A.O. Chavez, F. Casiraghi, G. Cline, A. Davalli, G. Halff, G. Abrahamian, R. Bastarrachea, A. Comuzzie, A. Gastaldelli, M. Federici, V. Marzano, A. Urbani, R. DeFronzo, F. Folli
Journal: Journal of Hepatology (2011)
Right Ventricular Volume Determinations in Children
Authors: THOMAS P. GRAHAM, JAY M. JARMAKANI, GERALD F. ATWOOD, RAMON V. CANENT
Journal: Circulation (1973)

Right ventricular (RV) volumes were calculated from biplane cineangiocardiograms in 46 patients undergoing diagnostic cardiac catheterization. Validation of methodology was performed by comparison of known and calculated volumes of postmortem RV casts as well as by comparison of cineangiocardiographic RV and left ventricular (LV) stroke volumes of patients without shunts or valvular insufficiency. Seven infants, &lt;1 year of age, with normal right hearts as compared with older children showed smaller RV end-diastolic volumes (39 ± 8 vs 70 ± 13 ml/m 2 , P &lt; 0.001) as well as decreased RV systolic indices (SI) (3.71 ± 0.68 vs 4.66 ± 1.10 liters/min/m 2 , P &lt; 0.05). There were no differences between normal infants and older children for RV ejection fraction (EF), RVEDV/LVEDV = 1.01, RVSI/LVSI = 0.99, and RVEF/LVEF = 1.04 vs 0.99. In 13 patients with isolated pulmonary stenosis, RVEDV, RVEF, RVSI, RVEDV/LVEDV, and RVSI/LVSI were not different from normal, but RVEF/LVEF averaged 1.13 vs 0.99 in normal infants, P &lt; 0.05. In contrast, 11 patients studied with atrial septal defect or total anomalous pulmonary venous connection had significant increases in RVEDV (128 ml/m 2 ), RVSI (9.34 liters/min/m 2 ), RVEDV/LVEDV (2.36), RVSI/LVSI (2.81), and RVEF/LVEF (1.17), but normal values for RVEF. There was a significant linear relationship between Q p /Q s from oxygen data and RVSI/LVSI. In three patients studied an average of 1 year following atrial septal defect (ASD) repair, RVEDV remained elevated. In volume overload, alterations in RV volume characteristics are apparent and can be useful in shunt estimation; adaptation to an RV pressure overload, however, is not associated with detectable volume alterations.
<i>Helicobacter pylori</i>Infection
Authors: Sebastian Suerbaum, Pierre Michetti
Journal: New England Journal of Medicine (2002)

H. pylori is one of the most common bacterial infections in human beings, and its discovery 20 years ago altered the diagnosis and treatment of gastroduodenal disease. This review considers current knowledge about the epidemiology and transmission of H. pylori, as well as the role of this infectious agent in the pathogenesis of upper gastrointestinal tract disease. Diagnostic approaches, indications for therapy, and measures of therapeutic efficacy are reviewed.