tbuckley/cabot-search huggingface dataset:
Bronchiolitis obliterans with organising pneumonia: outcome.
Authors: U Costabel, J Guzman, H Teschler
Journal: Thorax (1995)

Bronchiolitis obliterans with organising pneumonia (BOOP) is a distinct clinical pathologic syndrome.Most patients experience a good response to therapy, and death from progressive BOOP is uncommon.This report describes the clinical features, etiologic factors, pathologic findings, and outcome of 10 patients with rapidly progressive BOOP that was characterised by severe respiratory failure.The major clinical manifestations were dyspnea, cough, fever, crackles on chest examination, and hypoxemia at rest Underlying conditions or exposures included connective-tissue disease, exposure to birds, and chronic nitrofurantoin therapy.All patients had the characteristic histopathologic findings of BOOR However, at autopsy in six patients, the predominant histologic pattern was that of alveolar septal inflammation and fibrotic honeycombing.Seven patients died and three patients survived but had S59 on August 14,
Instruments for Evaluating Education in Evidence-Based Practice
Authors: Terrence Shaneyfelt, Karyn D. Baum, Douglas Bell, David Feldstein, Thomas K. Houston, Scott Kaatz, Chad Whelan, Michael Green
Journal: JAMA (2006)

Evidence-based practice (EBP) is the integration of the best research evidence with patients' values and clinical circumstances in clinical decision making. Teaching of EBP should be evaluated and guided by evidence of its own effectiveness.To appraise, summarize, and describe currently available EBP teaching evaluation instruments.We searched the MEDLINE, EMBASE, CINAHL, HAPI, and ERIC databases; reference lists of retrieved articles; EBP Internet sites; and 8 education journals from 1980 through April 2006. For inclusion, studies had to report an instrument evaluating EBP, contain sufficient description to permit analysis, and present quantitative results of administering the instrument.Two raters independently abstracted information on the development, format, learner levels, evaluation domains, feasibility, reliability, and validity of the EBP evaluation instruments from each article. We defined 3 levels of instruments based on the type, extent, methods, and results of psychometric testing and suitability for different evaluation purposes.Of 347 articles identified, 115 were included, representing 104 unique instruments. The instruments were most commonly administered to medical students and postgraduate trainees and evaluated EBP skills. Among EBP skills, acquiring evidence and appraising evidence were most commonly evaluated, but newer instruments evaluated asking answerable questions and applying evidence to individual patients. Most behavior instruments measured the performance of EBP steps in practice but newer instruments documented the performance of evidence-based clinical maneuvers or patient-level outcomes. At least 1 type of validity evidence was demonstrated for 53% of instruments, but 3 or more types of validity evidence were established for only 10%. High-quality instruments were identified for evaluating the EBP competence of individual trainees, determining the effectiveness of EBP curricula, and assessing EBP behaviors with objective outcome measures.Instruments with reasonable validity are available for evaluating some domains of EBP and may be targeted to different evaluation needs. Further development and testing is required to evaluate EBP attitudes, behaviors, and more recently articulated EBP skills.
8-Isoprostane is a dose-related biomarker for photo-oxidative ultraviolet (UV) B damage <i>in vivo</i> : a pilot study with personal UV dosimetry
Authors: L.A. Schneider, W. Bloch, K. Kopp, A. Hainzl, P. Rettberg, M. Wlaschek, G. Horneck, K. Scharffetter-Kochanek
Journal: British Journal of Dermatology (2006)

Background Ultraviolet (UV) B irradiation causes visible erythema, which has been linked with DNA damage. However, besides such direct photochemical conformation changes, UVB also induces many indirect photochemical effects in the skin. Lipid peroxidation (LPO) is in this context one of the major pathways by which photo-oxidative stress disturbs cell signalling and promotes photocarcinogenesis and photoageing. So far we lack techniques for visualizing photo-oxidative stress in the skin. Furthermore, LPO has never been linked with individually acquired UVB doses measured by personal dosimetry. Objectives Measuring the skin reaction and photo-oxidative damage by LPO in vivo after UVB exposure in a pilot study surveyed by personal dosimetry in order to allow for a correlation analysis of acquired dose, skin reaction and amount of LPO. Methods UVB exposure was measured with the opto-electronic X2000-1 (Gigahertz Optik, Puchheim, Germany) and the biological DLR Biofilm (German Aerospace Center DLR, Cologne, Germany) portable dosimeter. The skin reaction following UVB exposure was quantified with a Minolta chromameter® (Minolta, Tokyo, Japan) and LPO in vivo was measured by 8-isoprostane generation by means of densitometric analysis of immunohistochemical samples obtained 30 min post-UVB irradiation. Results Regression analysis revealed significant linear relations between UVB exposures recorded by the dosimeters and colorimetry parameters of the skin reaction. Furthermore, an even better linear relation with higher significance was found between the generation of 8-isoprostane in the skin and the dosimeter readouts. Conclusions LPO measured by the generation of 8-isoprostane provides a suitable intrinsic biomarker for photo-oxidative UVB damage in vivo. This study provides a new approach to visualizing photo-oxidative stress in the skin in vivo. Furthermore, future dosimeter readouts can now be set into relation to the expected increase of LPO that can be calculated within the limits of our study.
CR3 (CD11b/CD18) expresses one binding site for Arg-Gly-Asp-containing peptides and a second site for bacterial lipopolysaccharide.
Authors: S D Wright, S M Levin, M T Jong, Z Chad, L G Kabbash
Journal: The Journal of Experimental Medicine (1989)

Polymorphonuclear leukocytes (PMN) from three patients deficient in the CD18 family of receptors (LFA-1, CR3, and p150,95) exhibited an inability to bind erythrocytes coated with C3bi or bacterial LPS. These observations confirm that the CD18 family, and CR3 in particular, can bind the structurally dissimilar molecules C3bi and LPS. Further studies showed that LPS and C3bi bind to CR3 at distinct sites. mAb OKM10 against CR3 blocked binding of C3bi to PMN but did not block the binding of LPS. In contrast, mAb 904, directed against a different epitope on CR3, blocked binding of LPS to PMN but not binding of C3bi, thus suggesting that different regions of CR3 were involved in binding these two ligands. In addition, synthetic peptides based on the sequence in C3bi recognized by CR3 competitively blocked the binding of C3bi to CR3 but did not block the binding of LPS. Rather, occupation of the peptide binding site on CR3 by the synthetic peptides enhanced binding of LPS. These results indicate that CR3 has two distinct binding sites, one that recognizes ligands composed of protein and a second that recognizes LPS.
A Lecture ON THE OCCURRENCE OF HEART-BLOCK IN MAN AND ITS CAUSATION: Delivered at the London Hospital Medical School on November 13th, 1908
Authors: T. Lewis
Journal: BMJ (1908)

the heart should have suddenly stopped in diastole, but it is intera3sting to note the greater calcium content in the left ;-ent:icle than in the right.[The treatment of mitral stenosis was also dealt with, but "s this address was very long Sir James Barr has reserved that portion of it for publication on a future occasion.
Antibiotic treatment for pyelonephritis in children: multicentre randomised controlled non-inferiority trial
Authors: Giovanni Montini, Antonella Toffolo, Pietro Zucchetta, Roberto Dall'Amico, Daniela Gobber, Alessandro Calderan, Francesca Maschio, Luigi Pavanello, Pier Paolo Molinari, Dante Scorrano, Sergio Zanchetta, Walburga Cassar, Paolo Brisotto, Andrea Corsini, Stefano Sartori, Liviana Da Dalt, Luisa Murer, Graziella Zacchello
Journal: BMJ (2007)

<b>Objective</b> To compare the efficacy of oral antibiotic treatment alone with treatment started parenterally and completed orally in children with a first episode of acute pyelonephritis. <b>Design</b> Multicentre, randomised controlled, open labelled, parallel group, non-inferiority trial. <b>Setting</b> 28 paediatric units in north east Italy. <b>Participants</b> 502 children aged 1 month to &lt;7 years with clinical pyelonephritis. <b>Intervention</b> Oral co-amoxiclav (50 mg/kg/day in three doses for 10 days) or parenteral ceftriaxone (50 mg/kg/day in a single parenteral dose) for three days, followed by oral co-amoxiclav (50 mg/kg/day in three divided doses for seven days). <b>Main outcomes measures</b> Primary outcome was the rate of renal scarring. Secondary measures of efficacy were time to defervescence (&lt;37°C), reduction in inflammatory indices, and percentage with sterile urine after 72 hours. An exploratory subgroup analysis was conducted in the children in whom pyelonephritis was confirmed by dimercaptosuccinic acid (DMSA) scintigraphy within 10 days after study entry. <b>Results</b> Intention to treat analysis showed no significant differences between oral (n=244) and parenteral (n=258) treatment, both in the primary outcome (scarring scintigraphy at 12 months 27/197 (13.7%) <i>v</i> 36/203 (17.7%), difference in risk −4%, 95% confidence interval −11.1% to 3.1%) and secondary outcomes (time to defervescence 36.9 hours (SD 19.7) <i>v</i> 34.3 hours (SD 20), mean difference 2.6 (−0.9 to 6.0); white cell count 9.8×10<sup>9</sup>/l (SD 3.5) <i>v</i> 9.5×10<sup>9</sup>/l (SD 3.1), mean difference 0.3 (−0.3 to 0.9); percentage with sterile urine 185/186 <i>v</i> 203/204, risk difference −0.05% (−1.5% to 1.4%)). Similar results were found in the subgroup of 278 children with confirmed acute pyelonephritis on scintigraphy at study entry. <b>Conclusions</b> Treatment with oral antibiotics is as effective as parenteral then oral treatment in the management of the first episode of clinical pyelonephritis in children. <b>Trial registration</b> Clinical Trials NCT00161330.
Identification of Gulf War Syndrome: Methodological Issues and Medical Illnesses
Authors: Ronald E. Gots, Sorell L. Schwartz, Norman Hershkowitz, Vinay Chaudhry, Robert L. Vogel
Journal: JAMA (1997)

<h3>To the Editor.</h3> —The articles by Dr Haley et al<sup>1-3</sup>are fraught with design and interpretive problems. Unique symptom complexes, neurologic syndromes, and toxicologic end points, contrary to established criteria, form the bases of these studies. The clinical data presented<sup>2</sup>provide little evidence from which to conclude that these patients had any neuropathic processes. The authors point out that comprehensive evaluations found that the findings were "nonspecific and not sufficient to diagnose any known syndrome." Importantly, the authors fail to explain what these subtle, neurophysiological findings have to do with the symptoms. In addition, the problems with interpretation of neurologic testing are extensive. For instance, only 5 veterans (2 with "confusion ataxia" and 3 with "arthro-myo-neuropathy") had peripheral neurophysiological tests (nerve conduction studies, electromyography, single fiber electromyography, and quantitative sensory tests). The only abnormality detected was "borderline abnormal motor nerve conduction in the lower extremity in 2" (from syndrome 3) and
Association between various status of hepatitis B virus infection and HLA DRB1∗13/TNF-alpha promoter polymorphism in Korea
Authors: Jaeyoun Cheong, Kwang-hyub Han, Kunhoon Song, Jeonsoo Shin, Hyeyoung Chang, Sanghoon Ahn, Kwansik Lee, Chaeyoon Chon, Youngmyoung Moon
Journal: Journal of Hepatology (2002)
MicroRNA Let-7a Down-regulates MYC and Reverts MYC-Induced Growth in Burkitt Lymphoma Cells
Authors: Valerie B. Sampson, Nancy H. Rong, Jian Han, Qunying Yang, Virginie Aris, Patricia Soteropoulos, Nicholas J. Petrelli, Stephen P. Dunn, Leslie J. Krueger
Journal: Cancer Research (2007)

Abstract Regulation of the MYC oncogene remains unclear. Using 10058-F4, a compound that inhibits MYC-MAX transcription factor, MYC protein and gene expression were down-regulated in Namalwa cells, a Burkitt lymphoma. Compound 10058-F4 decreased MYC mRNA (45%), MYC protein (50%), and cell growth (32%). MYC-MAX transcription factor was disrupted 24 h after treatment, resulting in transcriptional inhibition of target genes. Because microRNAs (miRNA) disrupt mRNA translation, let-7a, let-7b, and mir-98 were selected using bioinformatics for targeting MYC. Inhibition of MYC-MAX transcription factor with 10058-F4 increased levels of members of the let-7 family. In inhibited cells at 24 h, let-7a, let-7b, and mir-98 were induced 4.9-, 1.3-, and 2.4-fold, respectively, whereas mir-17-5p decreased 0.23-fold. These results were duplicated using microRNA multianalyte suspension array technology. Regulation of MYC mRNA by let-7a was confirmed by transfections with pre-let-7a. Overexpression of let-7a (190%) decreased Myc mRNA (70%) and protein (75%). Down-regulation of Myc protein and mRNA using siRNA MYC also elevated let-7a miRNA and decreased Myc gene expression. Inverse coordinate regulation of let-7a and mir-17-5p versus Myc mRNA by 10058-F4, pre-let-7a, or siRNA MYC suggested that both miRNAs are Myc-regulated. This supports previous results in lung and colon cancer where decreased levels of the let-7 family resulted in increased tumorigenicity. Here, pre-let-7a transfections led to down-regulation of expression of MYC and its target genes and antiproliferation in lymphoma cells. These findings with let-7a add to the complexity of MYC regulation and suggest that dysregulation of these miRNAs participates in the genesis and maintenance of the lymphoma phenotype in Burkitt lymphoma cells and other MYC-dysregulated cancers. [Cancer Res 2007;67(20):9762–70]
A First Report of the Department of Defense External Civilian Peer Review of Medical Care
Authors: William Mayer
Journal: JAMA (1988)

In mid-1985, the Department of Defense announced a plan for an external civilian peer review of selected medical and surgical cases in military hospitals. A medical advisory panel consisting of practicing clinical representatives from nine medical specialty societies helped develop written criteria and standards for specific surgical and medical cases. Abstracted data were compared with computer algorithms created from the medical standards and criteria. Those cases failing the review criteria were reviewed by a physician peer review panel. The sampled medical records represented approximately 7% to 8% of the total hospital discharges. Less than 1% of the overall sampled cases were in noncompliance with stated standards. The highest rate of noncompliance was for cases of diabetic ketoacidosis. The most frequent noncompliance event was hysterectomy. Although comparisons are not available, the quality of care among selected cases, as measured by compliance with civilian physician specialty group-endorsed standards, appeared high.
Abstract 5765: Tumor-elicited myeloid progenitors promote metastasis through induction of mesenchymal to epithelial transition
Authors: Dingcheng Gao, Natasha Joshi, Hyejin Choi, Seongho Ryu, Mary Hann, Vivek Mittal
Journal: Cancer Research (2010)

Abstract Malignant primary tumor cells colonize in target organs to form dormant micrometastasis. In some cases, the micrometastases progress to macrometastasis resulting in more than 90% of human cancer related deaths. However, the cellular and molecular regulators of metastatic initiation and progression remains poorly understood. Using a variety of metastatic tumor models we show that recruited bone marrow-derived myeloid progenitor cells comprise a significant fraction of the metastatic lung as compared to the primary tumor that predominantly have infiltrated macrophages. Specific depletion of the myeloid progenitor cells did not affect primary tumor growth but significantly impaired lung metastases. Global gene expression profiling of the CD11b+GR1+ myeloid progenitor cells identified potential pro-metastatic mediators. We have characterized one such mediator that promotes lung metastasis via promoting mesenchymal to epithelial transition (MET) of disseminated tumor cells. Our data suggests that this transition favors enhanced proliferation and survival of disseminated tumor cells so that they can successfully form functional metastases. RNAi-mediated acute suppression of this mediator in the bone marrow markedly inhibited lung metastases. Taken together, these findings illustrate the critical roles of the myeloid progenitors in metastasis and suggest the potential impact of targeting bone marrow cells and MET pathways in metastatic disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5765.
Assessment of Decision Support for Blood Test Ordering in Primary Care
Authors: Marc A.M. van Wijk, Johan van der Lei, Mees Mosseveld, Arthur M. Bohnen, Jan H. van Bemmel
Journal: Annals of Internal Medicine (2001)

Background: Different methods for changing blood test–ordering behavior in primary care have been proven effective. However, randomized trials comparing these methods are lacking. Objective: To compare the effect of two versions of BloodLink, a computer-based clinical decision support system, on blood test ordering among general practitioners. Design: Randomized trial. Setting: 44 practices of general practitioners in the region of Delft, the Netherlands. Participants: 60 general practitioners in 44 practices who used computer-based patient records in their practices. Intervention: After stratification by solo practices and group practices, practices were randomly assigned to use BloodLink-Restricted, which initially displays a reduced list of tests, or BloodLink-Guideline, which is based on the guidelines of the Dutch College of General Practitioners. Measurements: Average number of blood tests ordered per order form per practice. Results: General practitioners who used BloodLink-Guideline requested 20% fewer tests on average than did practitioners who used BloodLink-Restricted (mean [±SD], 5.5 ± 0.9 tests vs. 6.9 ± 1.6 tests, respectively; P = 0.003, Mann–Whitney test). Conclusions: Decision support based on guidelines is more effective in changing blood test–ordering behavior than is decision support based on initially displaying a limited number of tests. Guideline-driven decision support systems can be effective in reducing the number of laboratory tests ordered by primary care practitioners.
Mechanisms underlying the antiarrhythmic and arrhythmogenic actions of quinidine in a Purkinje fiber-ischemic gap preparation of reflected reentry.
Authors: X T Shen, C Antzelevitch
Journal: Circulation (1986)

The effects of therapeutic levels of quinidine were studied in an ischemic gap preparation of reflected reentry. The preparation consisted of a Purkinje fiber mounted in a three-compartment chamber. A narrow central compartment was perfused with a solution prepared to mimic the extracellular milieu at a site of ischemia. Quinidine in concentrations that exert little effect on normal Purkinje tissue, 1 to 2 micrograms/ml, greatly impaired conduction and markedly prolonged refractoriness across the ischemic gap. The drug effected these changes by (1) extending the inexcitable zone within the depressed region, (2) decreasing the amplitude of the input signal entering this zone, and (3) decreasing the excitability of the tissue beyond the depressed zone (evaluated by current clamp techniques). These actions of the drug produced both antiarrhythmic and proarrhythmic effects. When the initial level of conduction impairment was high, quinidine totally suppressed reflected reentry at all frequencies by precipitating complete anterograde conduction block. At intermediate levels of block, the drug generally caused a prominent shift of the frequency dependence of reentrant activity to lower stimulation rates. Finally, when conduction was relatively less impaired, quinidine created the conditions for reflected reentry to occur. Our results suggest that the heart rate dependence of reentrant arrhythmias might be of prognostic value in the administration of antiarrhythmic drugs.
Visual Explanations: Images and Quantities, Evidence and Narrative
Authors: Mark L. Mitchell
Journal: JAMA (1997)

Graphics If you think you might like<i>Visual Explanations</i>—perhaps you have heard that it is the third in a series of beautifully produced books about the graphical display of data—then you should buy it. Not many books have been as widely acclaimed by so many readers working in as many different fields as these have. Edward Tufte and his Graphics Press present here the description of strategies for the display of information about "motion, process, mechanism, cause and effect." The author explains that if the first book in the series,<i>The Visual Display of Quantitative Information</i>, was about pictures of numbers, and the second,<i>Envisioning Information</i>, about pictures of nouns, then this book is about pictures of verbs. Using a series of beautifully reproduced graphical displays, which are variously witty, delightful, and thought-provoking, Tufte continues our education on how data should be displayed. And, as may be the case
Digoxin Tablet Bioavailability: Single-Dose and Steady-State Assessment
Authors: JACEK J. PREIBISZ
Journal: Annals of Internal Medicine (1974)

Variation in the biological availability of digoxin tablets is a significant problem, and the relative accuracy and reliability of various methods of assessing absorption of the glycoside have not been established. In a crossover study, the bioavailability of four lots of digoxin tablets with different dissolution rates was tested in seven normal volunteers after single 0.5-mg doses and 0.5-mg doses were given daily for 9 days. Digoxin preparations that showed marked differences after single doses also showed significant differences by the "steady-state" measurements. Two lots of digoxin from the same manufacturer showed major discrepancies. The single-dose measurements used (peak serum levels, areas under the concentration-time curves, and 24-hour urinary digoxin excretion) did not reliably predict the magnitude of differences found in the steady state when drug products with different rates of absorption were compared. Of the three single-dose measurements, the 24-hour urinary excretion level seemed to be the most reliable screening test.
Exercise Testing in CAD
Authors: ROBERT H. BILBRO
Journal: Circulation (1974)

tion of the coronal cross-section should have been rotated counter-clockwise as pointed out by Dr. Gramiak, although we think his figure shows somewhat exaggerated rotation.However, we do state clearly in our manuscript that the tricuspid valve is anterior to the interventricular septum and that the latter structure is continuous with the anterior aortic margin.In addition, and as also stated in our report, it should be emphasized that the tricuspid valve is positioned inferiorly and medial to the aortic valve.Because figure 3 is a coronal cross-section, the fact that the four cardiac valves are at different superior- inferior levels cannot be appreciated from any diagram.We do not agree that an error exists in the diagrammatic portion of figure 1.We included a portion of a longitudinal section of the sternum in the illustration for clarity since the sternum is a usual anatomic landmark.Moreover, it should be pointed out that the sternum is minimally calcified in infants.While the parasternal position is employed commonly for left ventricular structure imaging the transducer position shown in our illustration does not preclude recording aortic valve or mitral valve images in infants and is preferred for viewing right ventricular structures.