tbuckley/cabot-search huggingface dataset:
DETECTION OF OCCLUSION OF THE INTERNAL CAROTID ARTERY BY PHARYNGEAL PALPATION
Authors: Henry S. Dunning
Journal: JAMA (1953)

Recent reports by Johnson and Walker, Fisher, and Walsh and Smith, 1 on occlusion of the internal carotid artery with its disastrous effects on the brain and eye offer explanations for a variety of cerebral and visual symptoms. Since the introduction of carotid arteriography by Moniz in 1927, the frequent occurrence of this lesion has been recognized, and its clinical diagnosis has been made possible. Before the use of arteriography, final diagnosis of occlusion of the internal carotid artery rested with the pathologist. I believe that the lesion can be detected by palpation alone.  The usual site of bifurcation of the common carotid artery into the external and internal carotid arteries is at the level of the hyothyroid interspace. Between this level and the angle of the mandible these two arteries lie close together, with the external carotid slightly anterolateral to the internal. At the level of the angle of
Current smoking of elderly men reduces antioxidants in alveolar macrophages.
Authors: T Kondo, S Tagami, A Yoshioka, M Nishimura, Y Kawakami
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Alveolar macrophages were prepared from 15 healthy elderly male current smokers 60.9 +/- 9.9 yr of age (mean +/- SD). Alveolar macrophages from 11 elderly male nonsmokers 66.7 +/- 8.1 yr of age served as controls. Production of oxygen radical species was higher in alveolar macrophages from current smokers than in those from nonsmokers in the presence and absence of phorbol myristate acetate (29.8 +/- 15.5 versus 13.7 +/- 8.2 mumol/10(6) cells and 3.8 +/- 1.6 versus 2.2 +/- 1.2 mumol/10(6) cells, respectively, p < 0.01). Decreases in antioxidant activity were observed in cells from smokers versus those from nonsmokers for Cu, Zn-superoxide dismutase (114 +/- 41 versus 210 +/- 73 units/mg protein, respectively, p < 0.01), glutathione S-transferase (0.217 +/- 0.091 versus 0.368 +/- 0.017 units/mg protein, p < 0.01), and glutathione peroxidase (0.736 +/- 0.779 versus 1.590 +/- 0.879 units/mg protein, p < 0.05). Immunologic estimation showed a decrease in the levels of Cu, Zn-superoxide dismutase in cells from smokers (104.3 +/- 46.4 versus 184.1 +/- 64.4 ng enzyme/mg protein, respectively, p < 0.01). Northern blot analysis of Cu, Zn-superoxide dismutase mRNA showed no apparent difference between the two groups, suggesting not the inactivation of this enzyme but a reduction of the translational step or increased proteolysis. The oxidant and antioxidant imbalance observed in elderly male current smokers may be a factor in the pathogenesis of respiratory tissue injury caused by smoking.
Regional Differences in Electrophysiological Properties of Epicardium, Midmyocardium, and Endocardium
Authors: Evgeny P. Anyukhovsky, Eugene A. Sosunov, Michael R. Rosen
Journal: Circulation (1996)

Background Microelectrode studies have described a population of cells within the midmyocardium (M cells) displaying a steep rate dependence of action potential duration (APD) and high V̇ max compared with endocardial (Endo) and epicardial (Epi) cells. Methods and Results We studied repolarization in different myocardial layers in vitro and in situ. In addition to confirming the results of earlier studies, we found that after abrupt lengthening of the cycle length (CL), APDs in M cells reached a new steady state faster than in Epi or Endo cells: the time to achieve 90% of the difference in APD (t 90 ) was 13.3±0.7 minutes in Endo cells, 12.8±1.1 minutes in Epi cells, and 2.6±0.4 minutes in M cells ( P &lt;.05 compared with Epi or Endo) when CL changed from 400 to 1000 ms. In situ, we registered activation-recovery intervals (ARIs) in bipolar electrograms obtained from different myocardial layers in conditions of AV block and His-bundle pacing. At all CLs from 300 to 2000 ms, ARIs were equal in all myocardial layers from Epi to Endo cells. Steady-state ARIs coincided with APD of M cells registered in vitro in the physiological range of CL from 300 to 700 ms. When CL was changed from 300 to 1000 ms, the ARI followed the rapid time course typical of M cells (t 90 =2.6±0.5, 2.2±0.4, 2.5±0.4, 2.6±0.5, and 2.3±0.4 minutes for Epi; 3-, 5-, and 7-mm sub-Epi; and Endo cells, respectively). Conclusions In contrast to in vitro results, there is no significant difference in repolarization among myocardial layers in the intact normal canine heart.
Cognitive Development and Dietary Therapy in Phenylketonuric Children
Authors: James Dobson, Richard Koch, Malcolm Williamson, Ronald Spector, William Frankenburg, Margaret O'Flynn, Robert Warner, Frederick Hudson
Journal: New England Journal of Medicine (1968)

Phenylketonuric children (now four years of age or older) were given intelligence and language tests to ascertain their present levels of cognitive functioning. These intellectual abilities were then evaluated in relation to the children's ages at the time diets low in phenylalanine were begun. The influence of distorting nontreatment factors, such as family level of intelligence and sociologic variation, was ascertained by computation of a multiple-regression equation analysis. Examination of the data revealed a consistent inverse relation between present intellectual ability and age of dietary inception. The children treated within one month after birth scored an average of 33 IQ points higher than those for whom treatment was initiated within their fourth and sixth years of life.
Abstract OT3-3-07: Neoadjuvant bevacizumab with weekly nanoparticle albumin bound (nab)-paclitaxel plus carboplatin followed by doxorubicin plus cyclophosphamide (AC) for triple negative breast cancer.
Authors: JN Snider, JW Allen, R Young, L Schwartzberg, Y Javed, M Jahanzeb, JC Sachdev
Journal: Cancer Research (2012)

Abstract Background: Triple negative breast cancer (TNBC) predominantly clusters with “basal like” subtype on genomic profiling. Over-expression of Secreted Protein Acidic and Rich in Cysteine (SPARC) has been observed in basal like breast cancer (Charaffe-Jaufrett et al. Oncogene 2006; 2273–84). Endothelial transcytosis of nab- paclitaxel occurs via albumin- gp60 receptor-caveolin 1 interaction. SPARC entraps the albumin resulting in higher intratumoral accumulation, which may explain the increased efficacy of nab-paclitaxel (Desai et al. Translational Oncology 2009; 59–63). Exploiting this mechanism &amp; the dysfunctional BRCA mediated DNA repair in basal tumors, we hypothesize that nab-paclitaxel + the DNA damaging drug carboplatin would produce high response rates in TNBC. Adding bevacizumab may enhance efficacy by blocking angiogenesis. In TNBC, pathologic complete remission (pCR) to neo-adjuvant therapy correlates with better disease-free survival (DFS). We hypothesize that high pCR rates can be achieved for patients with TNBC with this combination translating to an improved DFS than seen historically. Methods: Patients with palpable &amp; operable TNBC ≥ 2 cm are eligible for this single stage phase II trial. pCR (defined as the absence of invasive tumor cells) in the breast is the primary end point, while pCR in the breast + axillary nodes &amp; pCR + near pCR (residual tumor &amp;lt; 5mm) in the breast are secondary end points. 57 evaluable patients are needed, assuming a pCR rate of 25% vs. 40% for the null &amp; alternate hypotheses respectively. 35 patients have been accrued to date. Patients receive carboplatin AUC 6 day 1 &amp; nab-paclitaxel 100mg/m2 days 1, 8 &amp; 15 of a 28 day cycle for 4 cycles and then dose dense AC for 4 cycles. Bevacizumab is given at 10mg/kg Q 2 weeks with chemotherapy for the first 6 cycles. Surgery &amp; radiation are per institutional standards. Bevacizumab is continued postoperatively to complete 1 year of treatment. A core biopsy for collection of fresh tumor tissue is required prior to the start of study treatment. Blood is collected at baseline, and after 4 &amp; 8 cycles for biomarker analysis. Genomic and expression profiling will be undertaken for correlation with response. This study was approved and funded by the National Comprehensive Cancer Network (NCCN) from general research support from Celgene Corporation. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr OT3-3-07.
Umbilical Cord Clamping
Authors: Richard D. Cutter
Journal: JAMA (1963)

<h3>To the Editor:</h3> —The finding of Moss and his associates (<i>JAMA</i><b>184</b>:48 [April 6] 1963) that "late clamping" of the umbilical cord is perhaps more salubrious for the newborn than "early clamping" illustrates the conflict between nature and artifice. There is an old law of biology that may be germane: ontogeny recapitulates phylogeny. Or, to attempt to apply the law to modern obstetrical practice, perhaps the interval between delivery of an infant and clamping the cord should be the same as it was in primitive evolutionary times. But how can this time interval be determined? I have observed enough home deliveries to realize that the factor determining the crucial interval in primitive accouchments is the availability of a bit of twine to tie the cord. For some reason, no one ever seems to remember to have this essential item on hand, and the cord remains throbbing and untied while
NHS Confederation calls for action to halt loss of clinical trials from UK
Authors: M. Limb
Journal: BMJ (2011)

The European Commission must produce clearer, simpler regulations on clinical trials to prevent the UK health services losing out to other countries in hosting studies and making new treatments available to patients, says the NHS Confederation, the body that represents most NHS organisations in England.

Opportunities for patients in the United Kingdom to take part in clinical trials and for clinicians to gain expertise in new drugs is being hampered because of “bureaucratic” European Union rules, says the confederation.

The UK’s involvement in global clinical trials has “dropped dramatically” since the European Union’s Clinical Trials Directive (2001/20/EC) was introduced in the UK in 2004.

The European Commission is consulting on revisions to the directive, which was brought in to promote good clinical practice and harmonise clinical trial activity across the …
Stalking the Diagnosis
Authors: Bindu Chamarthi, Charles A. Morris, Ursula B. Kaiser, Joel T. Katz, Joseph Loscalzo
Journal: New England Journal of Medicine (2010)

A 58-year-old woman presented to her primary care physician after several days of dizziness, anorexia, dry mouth, increased thirst, and frequent urination. She had also had a fever and reported that food would "get stuck" when she was swallowing. She reported no pain in her abdomen, back, or flank and no cough, shortness of breath, diarrhea, or dysuria.
High prevalence of human rhinovirus C infection in Thai children with acute lower respiratory tract disease
Authors: Piyada Linsuwanon, Sunchai Payungporn, Rujipat Samransamruajkit, Nawarat Posuwan, Jarika Makkoch, Apiradee Theanboonlers, Yong Poovorawan
Journal: Journal of Infection (2009)

To determine the prevalence of human rhinoviruses (HRV) infections in children with lower respiratory disease in Thailand and monitor the association between species of HRV and clinical presentation in hospitalized paediatric patients.Two hundred and eighty-nine nasopharyngeal (NP) suction specimens were collected from hospitalized paediatric patients admitted to King Chulalongkorn Memorial Hospital, Thailand during February 2006-2007. Nucleic acids were extracted from each sample with subsequent amplification of VP4/2 by semi-nested RT-PCR for HRV detection. Other viral respiratory pathogens were also detected by PCR, RT-PCR or real time PCR. Nucleotide sequences of the VP4 region were used for genotyping and phylogenetic tree construction.In total, 87 of 289 specimens were positive for HRV indicating an annual prevalence of 30%. Wheezing or asthma exacerbation was the most common clinical presentation observed in infected patients. Sequence analysis and phylogenetic tree showed that 29 (33%) and 8 (9%) specimens belonged to HRV-A and HRV-B, respectively. Most of the HRV positive samples were HRV-C (58%). Moreover, species C was predominantly found in the paediatric population of Thailand in raining season (p<0.05). The frequency of co-infection of HRV-C with other respiratory viral pathogens was approximately 40%.HRV-C represents the predominant species and is one of the etiologic agents in acute lower respiratory tract infection, causes of wheezing and asthma exacerbation in infants and young children in Thailand.
Prevalence of jumper's knee among non-elite athletes from different sports; a cross-sectional survey
Authors: J Zwerver, SW Bredeweg, I van den Akker-Scheek
Journal: British Journal of Sports Medicine (2011)

Background The jumper's knee (JK) is a difficult-to-treat overuse injury of the patellar and quadriceps tendon with a very negative impact on the careers of many athletes. The prevalence of JK among non-elite athletes from different sports and its aetiology are unknown. Objective To determine the prevalence of JK in non-elite athletes from different sports and to determine potential risk factors for JK. Design Cross-sectional survey. Setting Male and female non-elite athletes. Participants We interviewed 891 male and female non-elite athletes from seven popular sports in the Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey and athletics. Assessment Using a specially developed questionnaire, information was obtained about individual characteristics (age, height and weight), training background, previous and actual knee problems and the VISA-P score. Results The overall prevalence of current JK was 8.5% (78 out of 891 athletes), showing a significant difference between sports with different loading characteristics and playing surfaces. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 out of 502, 10.2%) than female athletes (25 out of 389, 6.4%) (÷2=3.91, p=0.048). Mean duration of symptoms was 18.9 months (SD 21.6; range 2.0–59.8). The mean VISA-P score of the athletes with JK was 71.4 (SD 13.8). Age, height and weight were significantly different between athletes with JK and those without. Conclusion Prevalence of JK is high among non-elite athletes and varies between 14.4% and 2.5% for different sports. JK is almost twice as common among male non-elite athletes compared to female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, playing surface, age, height and weight seem to be risk factors associated with patellar tendinopathy.
Endoscopic Removal of a Large, Obstructing and Bleeding Duodenal Brunner's Gland Adenoma
Authors: Oth. Kehl, H. Bühler, B. Stamm, R.W. Amman
Journal: Endoscopy (1985)

About 10-30 % of benign duodenal tumors are Brunner's gland tumors. These are almost always benign. Usually they present as incidental findings in the form of small polypoid lesions at barium examination or at panendoscopy. We present a case with a large obstructing and bleeding Brunner's gland adenoma located in the duodenal bulb which was removed by endoscopic polypectomy.
Effect of Atrial Fibrillation on Atrial Refractoriness in Humans
Authors: Emile G. Daoud, Frank Bogun, Rajiva Goyal, Mark Harvey, K. Ching Man, S. Adam Strickberger, Fred Morady
Journal: Circulation (1996)

The acute effect of atrial fibrillation (AF) on the atrial effective refractory period (ERP) in humans is unknown.In 20 patients without structural heart disease, the atrial ERP was measured before and after pacing-induced AF at drive cycle lengths of 350 and 500 ms. Immediately after spontaneous AF conversion, the post-AF ERP was measured. The pre-AF ERPs at 350 and 500 ms were 206 +/- 23 and 216 +/- 17 ms, respectively. The time to spontaneous conversion of AF was 7.3 +/- 1.9 minutes. The first post-AF ERPs at drive cycle lengths of 350 and 500 ms were 175 +/- 30 ms (P < .0001 versus pre-AF) and 191 +/- 30 ms (P < .0001 versus pre-AF), respectively. The post-AF ERP returned to the pre-AF ERP value after a mean of 8.4 +/- 0.3 minutes. In 15 patients, during the determination of the post-AF ERP, secondary episodes of AF lasting 1 +/- 1.5 minutes were reinduced 6 +/- 3 times per patient. There was a significant inverse logarithmic relationship between the time to reinduction of AF and the duration of secondary episodes of AF (P < .0001, r = 5).In humans, several minutes of induced AF is sufficient to shorten the ERP for up to approximately 8 minutes. The temporal recovery of the ERP is reflected in progressively shorter episodes of reinduced AF. These data imply that AF transiently shortens the atrial wavelength and suggest a mechanism by which AF may perpetuate itself.
SIRT1/PGC1α-Dependent Increase in Oxidative Phosphorylation Supports Chemotherapy Resistance of Colon Cancer
Authors: Thomas T. Vellinga, Tijana Borovski, Vincent C.J. de Boer, Szabolcs Fatrai, Susanne van Schelven, Kari Trumpi, Andre Verheem, Nikol Snoeren, Benjamin L. Emmink, Jan Koster, Inne H.M. Borel Rinkes, Onno Kranenburg
Journal: Clinical Cancer Research (2015)

Abstract Purpose: Chemotherapy treatment of metastatic colon cancer ultimately fails due to development of drug resistance. Identification of chemotherapy-induced changes in tumor biology may provide insight into drug resistance mechanisms. Experimental Design: We studied gene expression differences between groups of liver metastases that were exposed to preoperative chemotherapy or not. Multiple patient-derived colonosphere cultures were used to assess how chemotherapy alters energy metabolism by measuring mitochondrial biomass, oxygen consumption, and lactate production. Genetically manipulated colonosphere-initiated tumors were used to assess how altered energy metabolism affects chemotherapy efficacy. Results: Gene ontology and pathway enrichment analysis revealed significant upregulation of genes involved in oxidative phosphorylation (OXPHOS) and mitochondrial biogenesis in metastases that were exposed to chemotherapy. This suggested chemotherapy induces a shift in tumor metabolism from glycolysis towards OXPHOS. Indeed, chemotreatment of patient-derived colonosphere cultures resulted in an increase of mitochondrial biomass, increased expression of respiratory chain enzymes, and higher rates of oxygen consumption. This was mediated by the histone deacetylase sirtuin-1 (SIRT1) and its substrate, the transcriptional coactivator PGC1α. Knockdown of SIRT1 or PGC1α prevented chemotherapy-induced OXPHOS and significantly sensitized patient-derived colonospheres as well as tumor xenografts to chemotherapy. Conclusions: Chemotherapy of colorectal tumors induces a SIRT1/PGC1α-dependent increase in OXPHOS that promotes tumor survival during treatment. This phenomenon is also observed in chemotherapy-exposed resected liver metastases, strongly suggesting that chemotherapy induces long-lasting changes in tumor metabolism that potentially interfere with drug efficacy. In conclusion, we propose a novel mechanism of chemotherapy resistance that may be clinically relevant and therapeutically exploitable. Clin Cancer Res; 21(12); 2870–9. ©2015 AACR.
Changing Nodule Activity With Time on Tc-99m Pertechnetate Thyroid Scintigraphy
Authors: Ozhan Ozdogan, Yasar Imren, Isil Topcu, Duygu Gurel, Haluk Vayvada, Hatice Durak
Journal: Clinical Nuclear Medicine (2006)

A patient with a diagnosis of malignant melanoma was found to have a multinodular goiter on routine examination. Thyroid function tests revealed normal free T4 and TSH levels. A multinodular goiter was confirmed by thyroid ultrasonography with the dominant nodule located at the isthmus. Tc-99m pertechnetate thyroid scintigraphy did not reveal nodule activity. Delayed imaging was performed for localization of the dominant nodule with a marker. Surprisingly, the nodule was found to be hyperactive. The nodule was normoactive on I-131 thyroid scintigraphy. Fine needle aspiration biopsy confirmed a colloid nodule with follicular epithelial cells.
Clinical and histopathological spectrum of cutaneous vasculitis in rheumatoid arthritis
Authors: K-R. Chen, A. Toyohara, A. Suzuki, S. Miyakawa
Journal: British Journal of Dermatology (2002)

Summary Background Cutaneous manifestations are the most frequent, and often the initial feature of extra‐articular involvement in patients with rheumatoid vasculitis. Objectives The purpose of the study was to evaluate the clinical and histological spectrum of cutaneous vasculitis and the associated systemic involvement in patients with rheumatoid vasculitis. Methods Among 525 patients with rheumatoid arthritis, 20 tissue specimens with histologically proven cutaneous necrotizing vasculitis from 11 patients were investigated by studying the types and levels of affected vessels and related clinical features. Results Small‐vessel vasculitis identified as dermal necrotizing venulitis was found in 10 patients, clinically characterized by palpable purpura, maculopapular erythema, erythema elevatum diutinum and haemorrhagic blisters. Arteritis histologically resembling cutaneous polyarteritis nodosa, clinically characterized by subcutaneous nodules, livedo reticularis, atrophie blanche and deep ulcers was identified in four patients all with systemic complications. Coexistence of venulitis and arteritis was identified in three patients. Different cutaneous vasculitic manifestations often coexisted and recurred in the same patient. Three patients with systemic complications of mononeuritis multiplex (two of three), interstitial pulmonary fibrosis (two of three) and abdominal microaneurysms (one of three) died within 1 year of onset of the cutaneous vasculitis. Immunofluorescence demonstrated vessel wall deposition of IgM and/or complement in six of the seven patients examined. Conclusions Features of cutaneous rheumatoid vasculitis overlapping both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa together with coexistence of these different type of vasculitis in the same or different lesional skin account for the associated diverse cutaneous vasculitic manifestations. Although dermal venulitis (leucocytoclastic vasculitis) was the most common presentation, the presence of leucocytoclastic vasculitis in rheumatoid patients did not necessarily indicate a favourable prognosis. Associations with mononeuritis multiplex and bowel involvement had a fatal prognosis, while patients with superficial dermal venulitis without other extra‐articular involvement may follow a favourable prognosis.
In critical illness, high-protein enteral nutrition with immune-modulating nutrients did not reduce infections
Authors: Thomas Fekete
Journal: Annals of Internal Medicine (2015)

Source Citation van Zanten AR, Sztark F, Kaisers UX, et al. High-protein enteral nutrition enriched with immune-modulating nutrients vs standard high-protein enteral nutrition and nosocomial infections in the ICU: a randomized clinical trial. JAMA. 2014;312:514-24. 25096691
Expression of IL-9 receptor α chain on human germinal center B cells modulates IgE secretion
Authors: Lama M. Fawaz, Ehssan Sharif-Askari, Oumnia Hajoui, Abdelilah Soussi-Gounni, Qutayba Hamid, Bruce D. Mazer
Journal: Journal of Allergy and Clinical Immunology (2007)