tbuckley/cabot-search huggingface dataset:
Intensive therapy in pediatrics.
Authors: G. J. Rees, A. L. Stead, G. H. Bush, R. S. Jones
Journal: BMJ (1966)

An intensive therapy unit was opened at Alder Hey Children's Hospital in Liverpool on 1 September 1964 to deal with acute emergencies arising within the hospital or admitted from without, but excluding purely surgical conditions.It was established at a cost of £10,000, of which approximately half was expended on converting a cubicled ward of 120 by 24 ft.(36.5 by 7.3 m.).The remaining sum was spent on equipment.A pilot scheme had been in operation for several years, during which the techniques of resuscitation and controlled pulmonary ventilation in infants and children were explored.It became obvious that there was a real need for a unit in which these techniques could be applied together with newer methods of investigation, monitoring, and treatment of paediatric emer- gencies.This is a preliminary report on the work of this unit and a consideration of the place of an intensive therapy unit in a children's hospital. The UnitSite.-The unit is situated on the first floor of a three-storey building near the medical wards, the admissions department, and the hospital theatre.Plan of Unit.-The layout adopted is not thought to be ideal, but has worked well in practice (Fig. 1).There are four main divisions: (1) the usual ward offices, consulting-room, and waiting-room near the entrance (rooms 1 to 6); (2) the resuscitation-room and four cubicles where intensive treatment is given (rooms 7 to 11); (3) the laboratory and sister's room (rooms 12 and 13), separating the resuscitation-room and cubicles from ( 4) an open area at the end for convalescent patients (14).Each of the cubicles for acute treatment accom- * Alder Hey Children's Hospital, Liverpool.
Psychophysiological Concomitants of Organizational Change in Health Care Personnel: Effects of a Controlled Intervention Study
Authors: Johan Lökk, Bengt Arnetz
Journal: Psychotherapy and Psychosomatics (1997)

Background: To assess possible psychophysiological changes in personnel being exposed to organizational change and to assess the effects of a structured empowerment programme. Methods: A randomized, prospective, controlled, and non-blinded intervention was carried out in two wards within a geriatric hospital. The I-ward (intervention) was offered a structured intervention programme with a trained, registered psychologist during 20 weekly 1-hour sessions before and after the organizational change. The C-ward (control) was passively attended by the same psychologist during equal time conditions. Blood pressure as well as pulse rate were taken and blood samples were drawn from all participants before (0 weeks), immediately after the intervention (20 weeks) and after another 10 weeks' follow-up (30 weeks). Results: There was a significant time × group interaction with increasing prolactin levels on the C-ward as compared to decreasing levels on the I-ward during the intervention. Conclusions: Our study results suggest a picture of differentiated changes in stress hormone levels. The I-ward exhibited less psychoendocrine stress compared to the C-ward, probably due to the intervention and the possibility for personnel to influence the programme. We suggest that psychosocial empowerment programmes are beneficial when organizational changes are enacted in health care settings.
Prevalence and prognosis of heart failure with preserved ejection fraction and elevated N‐terminal pro brain natriuretic peptide: a 10‐year analysis from the Copenhagen Hospital Heart Failure Study
Authors: Christian Malchau Carlsen, Morten Bay, Vibeke Kirk, Jens Peter Gøtze, Lars Køber, Olav Wendelboe Nielsen
Journal: European Journal of Heart Failure (2012)
Human platelet stimulation by acetyl glyceryl ether phosphorylcholine.
Authors: L M McManus, D J Hanahan, R N Pinckard
Journal: Journal of Clinical Investigation (1981)

Acetyl glyceryl ether phosphorylcholine (AGEPC) induced dose-dependent platelet aggregation and release of [3H]serotonin and platelet factor 4 in citrated human platelet-rich plasma. ADP scavengers or indomethacin prevented irreversible platelet aggregation responses induced by 0.2 microM AGEPC but had no effect upon platelet secretion; prostacyclin inhibited AGEPC-induced aggregation and secretion. EDTA or EGTA inhibited AGEPC-induced aggregation but had no effect on platelet secretion.
Skin whitening cream may contain mercury, and lipstick may contain chromium and nickel, Indian study shows
Authors: C. Travasso
Journal: BMJ (2014)

A study that looked at levels of heavy metals in Indian cosmetics has shown that about 44% of the fairness (skin whitening) creams tested contained mercury and that chromium or nickel were present in over 50% of the lipsticks tested.1

The Pollution Monitoring Laboratory at the Centre for Science and Environment—a New Delhi based non-government organisation—tested over 70 different lipsticks, lip balms, anti-ageing creams, and fairness creams. The manufacturers were reputable brands including Lakme, L’Oreal, Olay, Lancome, and Maybelline.

Of the 32 fairness creams tested, 14 contained mercury. Aroma Magic Fair Lotion (by Blossom Kochhar Beauty Products) contained 1.97 ppm total mercury, Olay Natural White (by Procter & Gamble Home Products) contained 1.79 ppm, and Ponds White Beauty (by Hindustan Unilever) contained 1.36 ppm.

Neither lead nor cadmium was found in any of the lip …
Yield of Serial Evaluation in At-Risk Family Members of Patients With ARVD/C
Authors: Anneline S.J.M. te Riele, Cynthia A. James, Neda Rastegar, Aditya Bhonsale, Brittney Murray, Crystal Tichnell, Daniel P. Judge, David A. Bluemke, Stefan L. Zimmerman, Ihab R. Kamel, Hugh Calkins, Harikrishna Tandri
Journal: Journal of the American College of Cardiology (2014)
Authors' reply to Candido-dos-Reis
Authors: D. Timmerman, J. Kaijser, T. Bourne, B. Van Calster
Journal: BMJ (2014)

We appreciate Candido-dos-Reis's feedback and agree that the variable "oncology centre," 1 which we defined as "tertiary referral centres with a specific gynaecology oncology unit," is unconventional. 2We anticipated that it would raise some questions.The variable was included because it is a predictor of prior risk of malignancy and because it is still predictive after controlling for the other eight patient specific predictor variables.It is the weakest of the nine ADNEX predictor variables, suggesting that patient specific predictors explain most but not all of the differences in outcomes between oncology centres and other hospitals.In practice this variable is easy to use, because clinicians have to decide only once in what type of centre they work.
Is Gatekeeping Better Than Traditional Care?
Authors: E A Halm, N Causino, D Blumenthal
Journal: JAMA (1997)

Nearly all managed care plans rely on a physician "gatekeeper" to control use of specialty, hospital, and other expensive services. Gatekeeping is intended to reduce costs while maintaining or improving quality of care by increasing coordination and prevention and reducing duplicative or inappropriate care. Whether gatekeeping achieves these goals remains largely unproven.To assess physicians' attitudes about the effects of gatekeeping compared with traditional care on administrative work, quality of patient care, appropriateness of resource use, and cost.Cross-sectional survey of primary care physiciansOutpatient facilities in metropolitan Boston, Mass.All physicians who served as both primary care gatekeepers and traditional Blue Cross/Blue Shield providers for the employees of Massachusetts General Hospital, Boston. Of the 330 physicians surveyed, 202 (61%) responded.Physician ratings of the effects of gatekeeping on 21 aspects of care, including administrative work, physician-patient interactions, decision making, appropriateness of resource use, cost, and quality of care.Physicians reported that gatekeeping (compared with traditional care) had a positive effect on control of costs, frequency, and appropriateness of preventive services and knowledge of a patient's overall care (P<.001). They also felt that gatekeeping increased paperwork and telephone calls and negatively affected the overall quality of care, access to specialists, ability to order expensive tests and procedures, freedom in clinical decisions, time spent with patients, physician-patient relationships, and appropriate use of hospitalizations and laboratory tests (P<.001). Overall, 32% of physicians rated gatekeeping as better than traditional care, 40% the same, 21% gatekeeping as worse, and 7% were of mixed opinion. Positive ratings of gatekeeping were associated with fewer years in clinical practice, generalist training, and experience with gatekeeping and health maintenance organization plans.Physicians identified both positive and negative effects of gate-keeping. Overall, 72% of physicians thought gatekeeping was better than or comparable to traditional care arrangements.
Increased leukotriene B4 synthesis in immune injured rat glomeruli.
Authors: M A Rahman, M Nakazawa, S N Emancipator, M J Dunn
Journal: Journal of Clinical Investigation (1988)

We examined glomerular synthesis of the 5-lipoxygenase metabolite, LTB4, in normal and immune-injured rat glomeruli. Glomeruli isolated from normal rats and from rats with nephrotoxic serum nephritis (NSN), passive Heymann nephritis (PHN) and cationic bovine gamma globulin (CBGG)-induced glomerulonephritis were incubated with the calcium ionophore A23187 (3 microM). Lipids in the glomeruli and media were extracted with ethyl acetate, and were purified and fractionated by HPLC. Immunoreactive-LTB4 (i-LTB4) was determined by radioimmunoassay on HPLC fractions with a detection limit of 50 pg of i-LTB4. A large peak of i-LTB4 that comigrated with authentic LTB4 was found exclusively in glomeruli isolated from the CBGG-injected rats. Addition of the lipoxygenase inhibitor BW755C (50 micrograms/ml) to glomerular incubation resulted in greater than 90% inhibition of i-LTB4. Synthesis of i-LTB4 by glomeruli from normal, NSN and PHN rats was undetectable. Glomerular LTB4 synthesis by CBGG-injected rats was confirmed by radiometric HPLC and by gas chromatography mass-spectroscopy (GC-MS) analysis. In order to rule out synthesis of LTB4 by neutrophils entrapped in the glomeruli, a group of rats received 1,000 rad total body x irradiation, with shielding of the kidneys before induction of CBGG glomerulonephritis. Despite greater than 95% reduction in total leukocyte count, glomerular synthesis of LTB4 remained enhanced. Augmented glomerular synthesis of the proinflammatory lipid, LTB4, in the CBGG model of glomerular disease could have an important role in the development of glomerular injury and proteinuria.
Cockroach Allergen Reduction by Extermination Alone in Low-Income, Urban Homes-A Randomized Control Trial
Authors: M.L. Sever, S.J. Arbes, D.C. Zeldin, C. Schal, R.G. Santangelo, J.C. Gore, B. Vaughn, H. Mitchell
Journal: Journal of Allergy and Clinical Immunology (2007)
Carcinoma Diagnosed by Examination of Pericardial Fluid
Authors: Melvyn Leichtling, Harry B. Reibstein, Max H. Stein, Hyman E. Bass
Journal: New England Journal of Medicine (1952)

THE incidence of metastatic tumors of the heart and pericardium has been reported as 6 to 10 per cent of all malignant neoplasms.1 There are few reports of the ante-mortem diagnosis of this condition. Pericardial effusion is often but not regularly present. McCandless and Faloon1 state that there are only 10 cases in the American literature of metastatic disease of the heart and pericardium in which accurate diagnosis was made during the life of the patient. Heninger,2 in 1934, cited only 5 cases of metastatic tumor of the heart and pericardium in which the diagnosis was made before death. The . . .
P704Obesity and insulin resistance are not associated with endothelial dysfunction in rat aortas
Authors: H Strijdom, D Loubser, A Genis, C Westcott, M Mthethwa, S Smit
Journal: Cardiovascular Research (2014)

Background and aims: Obesity and insulin resistance (OIR) are usually associated with endothelial dysfunction. Although endothelial dysfunction has been shown to be an early, reversible precursor of ischaemic heart disease, the underlying mechanisms are not fully elucidated. Methods: In this study, OIR was induced in rats by a 16-week high sucrose, high fat diet (HSFD) regimen. We assessed the vascular effects of OIR on aortic contraction/relaxation by means of ex vivo isometric tension studies, and the expression of critical vascular proteins was investigated by western blot analyses. Results: Biometric data confirmed obesity in terms of total body mass (OIR group: 442±2 g vs Lean group: 354±3g; p<0.05) and visceral fat mass (OIR: 23±1 g vs Lean: 11±1 g; p<0.05). Fasting glucose levels were significantly elevated in OIR animals (OIR: 7.4±0.4 mmol/L vs Lean: 5.8±0.5 mmol/L; p<0.05). There were no differences observed in the cumulative phenylephrine-induced contractile responses of lean and OIR aortic rings without perivascular adipose tissue (PVAT), and this trend was not affected by the presence of PVAT. PVAT exerted significant anti-contractile effects in OIR rings compared to PVAT-free OIR rings, which was abolished by removal of the endothelium (Area Under the Curve in OIR-PVAT+Endothelium: 86.0 vs OIR+PVAT+Endothelium: 64.3 vs OIR+PVAT-Endothelium: 110.4; p<0.05). PVAT-free OIR rings showed significantly greater % maximum acetylcholine (ACh)-induced relaxation (OIR: 94.5±6% vs Lean: 70.4±3.2%; p<0.005). This trend was maintained in rings with PVAT. In PVAT-free aortic tissue, OIR was associated with reduced eNOS levels (Lean: 100% vs OIR: 31.6±2%; p<0.05), and unchanged total PKB/Akt levels. Interestingly, OIR aortic tissue expressed reduced p22-phox (Lean: 100% vs OIR: 53.4±0.8%; p<0.05) and nitrotyrosine (Lean: 100% vs OIR: 41.7±11%; p<0.05) levels respectively. Conclusion: In our hands, diet-induced OIR seemed to be associated with significant pro-relaxation effects in PVAT-free aortic rings, despite significantly reduced eNOS levels. The relaxation was unaffected by the presence of PVAT. Although there were no differences in the lean vs. OIR contractile responses, the presence of PVAT did exert endothelium-dependent anti-contractile responses in OIR aortic rings. In view of the above functional data and associated reduced cellular oxidative stress markers, the findings suggest that in our hands OIR did not induce endothelial dysfunction in the aortas, but rather an adaptive response.
The 5-Year Clinical Outcomes After a Randomized Comparison of Sirolimus-Eluting Versus Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Matteo Tebaldi, Chiara Arcozzi, Gianluca Campo, Gianfranco Percoco, Roberto Ferrari, Marco Valgimigli
Journal: Journal of the American College of Cardiology (2009)
Who needs press releases?
Authors: J. O. Drife
Journal: BMJ (2010)

Every morning I receive an emailed list of stories that are making the news in women’s health. Clicking on links brings up the printed pages, but I rarely bother. Once you’ve read the precis you could write the headline yourself.

I used to be media spokesman for a royal college, hence the daily updates. It was exciting to be on the front line, facing salvos of questions whenever a story broke. Sometimes a platoon of us would be dispatched to …
An intrinsic host defense against HIV-1 integration?
Authors: Paul D. Bieniasz
Journal: Journal of Clinical Investigation (2007)

HSCs are one of only a few cell types that resist HIV-1 infection despite the presence of HIV-1 receptors. An increasing number of genes have been identified that can reduce the sensitivity of cultured cells to retrovirus infection, and in this issue of the JCI, Zhang et al. identify p21Waf1/Cip1/Sdi1 (p21) as a gene product that can influence the sensitivity of HSCs to HIV-1 infection (see the related article beginning on page 473). Strikingly, p21 appears to alter the fate of nuclear HIV-1 DNA, promoting the formation of circular viral DNA forms rather than functional proviruses.
Congenital Cardiac Defects: A Physician's Guide for Evaluation and Management
Authors: RUTH WHITTEMORE, FRANK GLENN, S. GILBERT BLOUNT, EDWARD C. LAMBERT, SIDNEY BLUMENTHAL, HELEN B. TAUSSIG
Journal: Circulation (1957)

This report was designed primarily for the physician who is not a cardiologist but who encounters, in the course of his practice, patients with congenital malformations of the heart. It will help him decide whether and when such patients should have special studies done in a cardiac center or by a cardiologist familiar with these problems. It is divided into three parts: one on infants, one on children and adults, and the last on management. The first two parts are designed to assist the physician in the selection of patients for special studies, the last to aid him in the management of patients under his care. A special section in part III is devoted to care of the pregnant woman with a congenital defect. The decision as to which studies are needed and when they should be performed should be left to the cardiologist or center to which the patient is referred.
THE JUVENILE DIABETIC PATIENT SURVIVING TWENTY YEARS
Authors: H. E. EISELE
Journal: JAMA (1942)

My purpose in this paper is to describe the physical, economic and social status of the juvenile diabetic patient surviving twenty years or more after the onset of the disease and to point out to the physician what he must look for, but not necessarily expect, in the life course of the diabetic child with onset of diabetes before his fifteenth year. The paper presents data on the first series of this kind to be reported. The data should present the most unfavorable picture which one will ever encounter in diabetes of this age group and duration, because the children in the report lived in the preinsulin era at the time of the onset of the disease. <h3>INCIDENCE</h3> As shown in table 1,1,685 juvenile diabetic patients were seen in this clinic between 1898 and March 1, 1942; of these, 1,363 were alive in 1941. Three hundred and twenty-two are dead,
HIV switches to escape
Authors: Hema Bashyam
Journal: The Journal of Experimental Medicine (2008)

![Graphic][1] 

Different HIV strains in one individual that recombine (red/blue overlap) at immune-targeted sites escape T cell attack. On page 

[1789][2], Streeck et al. reveal that a second HIV strain is encouraged by the host's immune pressures to recombine with an earlier strain.
MAX-ing Out MYC: A Novel Small Molecule Inhibitor Against MYC-Dependent Tumors
Authors: I. I. C. Chio, G. Yordanov, D. Tuveson
Journal: JNCI Journal of the National Cancer Institute (2014)

The Myc oncogene features prominently in human cancers, being overexpressed or activated in more than 70% of malignancies (1). It is a basic helix-loop-helix (bHLH) transcription factor that lies at the crossroads of many growth-promoting signal transduction and bioenergetic pathways (2). Genetic studies in animal models have revealed that suppression of Myc activation leads to rapid tumor shrinkage caused by inhibition of cell proliferation, induction of senescence, and apoptosis, as well as remodeling of the tumor microenvironment (3). This phenomenon, coined “oncogene addiction,” has been demonstrated to be a feature of tumors even when MYC is not the initiating oncogenic event, thus rendering MYC a coveted therapeutic target (4).

Insights into the regulation of MYC expression and function have shed light on the development of novel therapies. BET bromodomain-containing proteins were found to be potent regulators of MYC expression through association with active enhancer elements. This has led to the development of the BET bromodomain inhibitor, JQ1, as a powerful therapeutic in murine models of hematological malignancies (5,6). Unfortunately, JQ1 exhibits limited effect in other cancer types, possibly because of lineage-dependent differences in the epigenetic landscape or different mechanisms that regulate MYC expression independent of enhancer
The expression of endosomal rab proteins correlates with endocytic rate in rat liver cells
Authors: L K Juvet, T Berg, T Gjoen
Journal: Hepatology (1997)

Hepatic endocytosis is characterized by a division of labor between the different cell types with respect to endocytosis, which is mediated by receptors expressed on their cell surface. We have investigated the expression of GTPases of the rab family in rat liver parenchymal and endothelial cells. Small GTPases of the rab protein family control distinct steps of intracellular transport both in the secretory and the endocytic pathway. As controls have been employed the normal rat kidney (NRK) cell line and brain tissue, neuronal cells are known to express high levels of components of the endocytic machinery (clathrin, adaptins, dynamin, uncoating adenosine triphosphatase, etc.). Endothelial cells were found to express four to seven times more rab4, rab5, and rab7 than parenchymal cells. A similar relationship was found between the endocytic rates in the two cell types; the rate of internalization from the plasma membrane of mannose receptors in rat liver endothelial cells was 2.3 pools/min, whereas the corresponding value for internalization of the galactose receptor in parenchymal liver cell was 0.27 pools/min (comparable with the rate of transferrin internalization in NRK cells). Both immunofluorescence and subcellular fractionation experiments showed that rab5 and rab7 were associated with compartments along the endocytic pathway. Brain tissue showed a similar high expression of endocytic components (rab4, rab5, and rab7) as liver endothelial cells, whereas lower values were found in NRK cells. We also analyzed the following proteins involved in endocytosis: clathrin, alpha-adaptin, beta-adaptin, and rabaptin-5. These proteins showed the same pattern of expression as the rab proteins. In conclusion, the results obtained with liver cells corroborate the data obtained in transfected cells and support the notion that rab proteins may be involved in controlling the endocytic rate in liver cells.
Improving surveillance for Barrett's oesophagus: AspECT and BOSS trials provide an evidence base
Authors: Janusz Jankowski, Hugh Barr
Journal: BMJ (2006)

EDITOR—We read with interest the quality improvement report for improving surveillance for Barrett's oesophagus by Bampton et al.1 Improving adherence to guidelines that are themselves lacking a sufficient evidence base may not actually improve hard clinical outcomes such as all causes of mortality or even cancer progression.

The major problem with a surveillance only approach is that only an estimated 5-10% of patients with Barrett's oesophagus …
Mouth-to-Mouth Resuscitation
Authors: Burnell R. Brown
Journal: JAMA (1968)

To the Editor:—  Mouth-to-mouth resuscitation is the preferred method of assisting ventilation in the emergency situation and is being taught to many lay groups such as lifeguards and firemen. However, there are complications attendant with the use of the technique, particularly by the less experienced. Complications include partial or total airway obstruction resulting in air being vented via the esophagus into the stomach when the operator exhales forcibly, and active or passive regurgitation of the victim's stomach contents into the upper airway.  Since the report of Sellick, 1 many anesthesiologists have used posterior displacement of the cricoid cartilage to prevent active or passive regurgitation during the induction of anesthesia prior to insertion of an endotracheal tube in the patient with a full stomach. The cricoid cartilage is signet-ring shaped with the large flat plate just anterior to the esophagus. By applying posterior pressure to the skin over the anterior surface