tbuckley/cabot-search huggingface dataset:
Acute effects of inhaled salbutamol on the metabolic rate of normal subjects.
Authors: P Amoroso, S R Wilson, J Moxham, J Ponte
Journal: Thorax (1993)

BACKGROUND--This study was designed to investigate the contribution of inhaled salbutamol to the increase in resting metabolic rate found in patients with chronic airflow limitation who were receiving bronchodilator therapy. METHODS--The resting metabolic rate of 10 normal subjects (age 20-47 years, weight 42-105 kg, seven men) was studied after inhalations of salbutamol or placebo. An open canopy method of indirect calorimetry was used to measure resting oxygen consumption (VO2) and resting carbon dioxide production (VCO2). Subjects inhaled two, four, eight, or 12 puffs (100 micrograms/puff) of salbutamol or placebo in a double blind manner. Recordings of VO2 and VCO2 were made after inhalation of the four doses of salbutamol or placebo, integrated over one hour, and compared. RESULTS--VO2 and VCO2 increased in a dose dependent manner after inhaled salbutamol with a maximum effect at five minutes after inhalation. After four puffs, VO2 was 203 and 188 ml/kg/h for salbutamol and placebo respectively. After eight puffs, VO2 was 207 and 185 and VCO2 was 167 and 155 ml/kg/h. After 12 puffs, VO2 was 220 and 190 with a VCO2 of 181 and 168 ml/kg/h. Twelve puffs of salbutamol increased the mean (SE) respiratory quotient from 0.85 (0.01) to 0.93 (0.04) at five minutes indicating an increase in ventilation in excess of metabolic demand. Mean heart rate increased in parallel with VO2. CONCLUSION--Inhaled salbutamol significantly increases resting metabolic rate in a dose dependent manner.
Brucellosis--An Island Epidemiological Study
Authors: M. Brodigan, A. McDiarmid, P. G. Mann, J. F. Skone
Journal: BMJ (1961)

It seems clear from the history of Case 2 that attacks occur in which operation is not required, and that prompts one to wonder how many patients who are admitted with acute obstruction after partial gastrectomy and who settle on conservative treatment are actually obstructed by a bolus.One should look out for this syndrome in order to advise such patients to be careful about mastication of food.It must be emphasized that in most cases the bolus can be milked on into the caecum.The story of Case 4 illustrates the added risk involved in doing an enterotomy at operation, and the wound infection in Case 6 was probably due to the enterotomy.Davies and Lewis (1959) stress this aspect of treatment.An endeavour is now made at St. James' Hospital to impress upon every patient who has a partial gastrectomy the importance of chewing food well, though this was not always the case.This should be a universal piece of advice, to be given to every patient who has a partial gastrectomy.Summary Nine cases of food bolus occurring after partial gastrectomy are described.A brief discussion of the condition and its treatment is added.It is noted how common the condition is becoming, and prevention of its cause is stressed.
Access to clinical trial data
Authors: A.-W. Chan
Journal: BMJ (2011)

Results and protocols go hand in hand

The high frequency and negative impact of selective reporting of data from clinical trials are well documented.1 The widespread occurrence of data suppression means that healthcare practitioners and policy makers largely make decisions on the basis of an incomplete and biased subset of trial results. Selective reporting can often be identified by reviewing trial protocols and publications; it can be mitigated by defining standard core outcome sets for trials, and by ensuring access to all unpublished and published data⇓.2 3



However, two linked articles highlight major difficulties in obtaining access to protocols and unpublished data for both industry and non-industry trials and provide new insight into trialists’ reasons for suppressing data.4 5 These types of challenges have been described before,6 7 and they reinforce the core principle that full knowledge of both the methods and results for all trials, independent of publication status, is essential for a complete and unbiased evaluation of an intervention.

Sources of information that should be consulted when appraising an intervention include trial protocols, registry records, regulatory agency documents, trial datasets, and journal publications. Smyth and colleagues (doi:10.1136/bmj.c7153) also show …
Loss of Mll5 results in pleiotropic hematopoietic defects, reduced neutrophil immune function, and extreme sensitivity to DNA demethylation
Authors: Michael Heuser, Damian B. Yap, Malina Leung, Teresa Ruiz de Algara, Alaeddin Tafech, Steven McKinney, John Dixon, Rosemary Thresher, Bill Colledge, Mark Carlton, R. Keith Humphries, Samuel A. Aparicio
Journal: Blood (2008)
Cancer Institute Takes a Look at Ascorbic Acid
Authors: Charles Marwick
Journal: JAMA (1990)

THE NATIONAL CANCER Institute is taking a look at the biologic functions of ascorbic acid, beginning with a 3-day symposium that Nobelist Linus Pauling, PhD, Palo Alto, Calif, says revealed  astonishing amount of information bearing on ascorbic acid and its relation to cancer; I didn't realize there was so much.  The institute's Gladys Block, PhD, says a number of the symposium reports on ascorbic acid's effects on animals and in cell cultures are worth pursuing. She notes a suggested role for ascorbate as an adjuvant to conventional cancer therapy and to reduce toxicity.  One move in this direction is to ask the investigators to return to Bethesda, Md, site of the institute and symposium, for additional discussion of their work.  The symposium had its genesis in a meeting 18 months ago between Pauling and the National Cancer Institute's director, Samuel Broder, MD. Among results of that meeting, Pauling says,
Fluoxetine-warfarin interaction.
Authors: S Woolfrey, N S Gammack, M S Dewar, P J Brown
Journal: BMJ (1993)

Queen Alexander Hospital, Ports- mouth) write: We report a case of reversible opiate toxicity to Tylex not previously described.An 86 year old woman with chronic lung disease collapsed and was brought to the casualty department.She was unresponsive, cyanosed with minimal respiratory effort, and hypotensive.She displayed small pupils with no other abnormal neurological signs and had bilateral basal respiratory crackles.Her electrocardiogram and chest radiograph showed nothing abnormal, and blood gas measure- ment confirmed she was acidotic ([H+i 56-6 nmol/l), hypercapnic (Pco2 10 6 kPa), and hypoxic
Serum 2-Hydroxyglutarate Production in <i>IDH1</i>- and <i>IDH2</i>-Mutated De Novo Acute Myeloid Leukemia: A Study by the Acute Leukemia French Association Group
Authors: Maxime Janin, Elena Mylonas, Véronique Saada, Jean-Baptiste Micol, Aline Renneville, Cyril Quivoron, Serge Koscielny, Laurianne Scourzic, Sébastien Forget, Cécile Pautas, Denis Caillot, Claude Preudhomme, Hervé Dombret, Céline Berthon, Robert Barouki, Daniel Rabier, Nathalie Auger, Frank Griscelli, Elisabeth Chachaty, Edwige Leclercq, Marie-Hélène Courtier, Annelise Bennaceur-Griscelli, Eric Solary, Olivier Adrien Bernard, Virginie Penard-Lacronique, Chris Ottolenghi, Stéphane de Botton
Journal: Journal of Clinical Oncology (2013)

Purpose Mutated isocitrate dehydrogenases (IDHs) 1 and 2 produce high levels of 2-hydroxyglutarate (2-HG). We investigated whether, in acute myeloid leukemia (AML), serum 2-HG would predict the presence of IDH1/2 mutations at diagnosis and provide a marker of minimal residual disease (MRD). Patients and Methods Serum samples from 82 patients at diagnosis of de novo AML (IDH1/2 mutated, n = 53) and 68 patients without AML were analyzed for total 2-HG and its ratio of D to L stereoisomers by mass spectrometry. We measured 2-HG levels and molecular markers of MRD (WT1 and NPM1) in serial samples of 36 patients with IDH1/2 mutations after induction therapy. Results In patients with AML with IDH1/2 mutations, 2-HG serum levels were significantly higher than in patients with IDH1/2 wild type (P &lt; .001). Area under the receiver operating characteristic curve was 99%. The optimum diagnostic cutoff between IDH1/2 mutated and normal was 2 μmol/L (sensitivity, 100%; specificity, 79%). Quantification of the D/L stereoisomers increased specificity (100%; 95% CI, 83% to 100%) compared with total 2-HG (P = .031). In patients with IDH2 R172 mutations, 2-HG levels were higher relative to those with other IDH1/2 mutations (P &lt; .05). During follow-up, serum 2-HG levels showed strong positive correlation with WT1 and NPM1 (P &lt; .001). After induction therapy, total 2-HG serum levels &lt; 2 μmol/L were associated with better overall (P = .008) and disease-free survival (P = .005). Conclusion Serum 2-HG is a predictor of the presence of IDH1/2 mutations and outcome in these patients. Discrimination between D/L stereoisomers improved specificity.
Evaluating Tuberculosis Case Detection via Real-Time Monitoring of Tuberculosis Diagnostic Services
Authors: JLucian Davis, Achilles Katamba, Josh Vasquez, Erin Crawford, Asadu Sserwanga, Stella Kakeeto, Fred Kizito, Grant Dorsey, Saskia den Boon, Eric Vittinghoff, Laurence Huang, Francis Adatu, Moses R Kamya, Philip C Hopewell, Adithya Cattamanchi
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Tuberculosis case-detection rates are below internationally established targets in high-burden countries. Real-time monitoring and evaluation of adherence to widely endorsed standards of tuberculosis care might facilitate improved case finding.
US babies born in withdrawal from opioids quadruples in nine years, study finds
Authors: M. McCarthy
Journal: BMJ (2015)

The rate of newborns admitted to US neonatal intensive care units (NICUs) with neonatal abstinence syndrome nearly quadrupled in the nine years from 2004 to 2013, from seven cases in 1000 admissions to 27 in 1000, a study has found.1

As a result of the increased admissions and longer NICU stays, care for infants with the syndrome accounted for 4% of all NICU hospital stays nationwide in 2013—a sevenfold increase from 2004, the researchers wrote.

Neonatal abstinence syndrome is a drug withdrawal syndrome most commonly caused …
Importance of Early Treatment of the Nephrotic Syndrome
Authors: Walter Heymann
Journal: JAMA (1961)

During a five-year period, 63 children with the nephrotic syndrome were treated with 40 mg. of prednisone or 32 mg. of triamcinolone according to a long-term regimen. These were divided into 34 children who had been treated within the first three months after onset and 29 in whom therapy was started any time thereafter. A favorable prognosis was noted in 29 children or 86% for the former and 15 or 52% for the latter; a difference of statistical significance (p &lt; 0.025). When treatment was evaluated by number of hospital admissions or by length of needed steroid administration to maintain a protein-free urine, statistically valid figures were again obtained to suggest that early steroid treatment enhances the chance for a favorable outcome.
An Operation for Femoral Hernia
Authors: E. Coldrey
Journal: BMJ (1952)

<h3>Objectives</h3> To address the limited long-term outcome data for catheter ablation (CA) of persistent atrial fibrillation (PeAF), we analysed consecutive ablations performed at our centre from 1 January 2008 to 31 December 2010 and followed patients prospectively until January 2014. <h3>Methods</h3> Both arrhythmia recurrence and symptom relief were assessed. Follow-up data were collected from hospital records, supplemented by data from general practitioners and referring hospitals. At the end of the follow-up period, all patients were contacted by phone to determine their up-to-date clinical condition. <h3>Results</h3> 188 consecutive patients with PeAF (157 male, mean age 57.3±9.7 years, 20% with long-standing PeAF) underwent a mean of 1.75 procedures (range 1–4). Telephone follow-up was achieved for 77% of surviving patients. Over a mean follow-up of 46±16 months (range 4–72), 139 (75%) patients experienced arrhythmia recurrence after a single procedure and 90 (48%) after their final procedure. Median time to first recurrence was 210 days (range 91–1850). 71% of recurrences were within the first year following ablation and 91% within 2 years. At final follow-up, 82% of patients reported symptomatic improvement. 7 (2.3%) major complications occurred, and there was no procedure-related death or stroke. <h3>Conclusions</h3> CA for PeAF is safe with a low rate of complications. Over a follow-up period of up to 6 years, a large majority of patients experience significant symptomatic improvement but recurrence after the initial procedure is the norm rather than the exception. 2 years9 follow-up is sufficient to observe 90% of AF recurrences, but recurrence can occur even after 5 years9 remission.
Endobronchial Ultrasonography in the Assessment of Centrally Located Early-Stage Lung Cancer before Photodynamic Therapy
Authors: YUKA MIYAZU, TERUOMI MIYAZAWA, NORIAKI KURIMOTO, YASUO IWAMOTO, KOJI KANOH, NOBUOKI KOHNO
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

To evaluate the utility of endobronchial ultrasonography (EBUS) in selecting appropriate candidates with centrally located early-stage lung cancer for photodynamic therapy (PDT) with curative intent, we performed EBUS before PDT in 18 biopsy-proven squamous cell carcinomas (including three carcinoma in situ) that had been considered to be appropriate candidates for PDT by conventional bronchoscopy and high-resolution computed tomography (HR-CT). Nine lesions were diagnosed as intracartilaginous by EBUS and subsequently PDT was performed. Long-term complete remission has been achieved in these patients with a median follow-up term after PDT of 32 months. The remaining nine lesions were diagnosed as extracartilaginous by EBUS and were considered candidates for other therapies such as surgical resection, chemotherapy, and radiotherapy, although two were invisible by HR-CT, three were superficial, and five were < or = 1 cm in diameter on observation by bronchoscopy. The depth of tumor invasion estimated by EBUS was proven to be accurate by histopathologic findings in six specimens after surgical resection. We conclude that EBUS is a useful technique that might be considered in addition to conventional bronchoscopy and HR-CT to improve the efficacy of PDT in patients with centrally located early-stage lung cancer.
Diffuse Pulmonary Disease in a 2 1/2-Year-Old Child
Authors: Michael E. Berlow
Journal: JAMA (1982)

<h3>History</h3> A 2 1/2 -year-old boy was first seen because of a nonproductive cough of two months' duration. A clinical diagnosis of bronchitis was made and the patient was discharged. Increasing dyspnea and fatigue during the subsequent three months precipitated further evaluation. The physical examination findings and laboratory data were unremarkable except for non-specific changes on auscultation of the chest. A chest roentgenogram was obtained (Figure) that demonstrates mild hyperaeration with predominately interstitial diffuse parenchymal infiltrates. "Cystic" areas are noted at the bases. The family relocated at this time. The child was examined at a distant medical center and treated for<i>Mycoplasma</i>infection without improvement. A radioisotope scan of the liver and spleen, a bone marrow biopsy specimen, and a radiological skeletal survey were normal. No additional physical signs were present. A lung biopsy was then performed. <h3>Diagnosis</h3> Primary pulmonary histiocytosis, often referred to as histiocytosis X. Microscopic examination of
Letter by Reynolds et al Regarding Article, “Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial”
Authors: Stephanie Reynolds, David Parra, Robert S. Rosenstein
Journal: Circulation (2012)
Ultrasonography and Limited Computed Tomography in the Diagnosis and Management of Appendicitis in Children
Authors: Barbara M. Garcia Peña
Journal: JAMA (1999)

ContextLimited computed tomography with rectal contrast (CTRC) has been shown to be 98% accurate in the diagnosis of appendicitis in the adult population, but data are lacking regarding the accuracy and effectiveness of this technique in diagnosing pediatric appendicitis.ObjectiveTo determine the diagnostic value of a protocol involving ultrasonography and CTRC in the diagnosis and management of appendicitis in children and adolescents.Design, Setting, and ParticipantsProspective cohort study of 139 children and adolescents aged 3 to 21 years (2 patients were older than 18 years) who had equivocal clinical findings for acute appendicitis and who presented to the emergency department of a large, urban, pediatric teaching hospital between July and December 1998.InterventionsChildren were first evaluated with pelvic ultrasonography. If the result was definitive for appendicitis, laparotomy was performed; if ultrasonography was negative or inconclusive, CTRC was obtained. Patients who did not undergo laparotomy had telephone follow-up at 2 weeks and medical records of all patients were reviewed 4 to 6 months after study completion.Main Outcome MeasuresSpecificity, sensitivity, positive predictive value, negative predictive value, and accuracy of tests based on final diagnoses; surgeons' estimated likelihood of appendicitis on a scale of 1 to 10 for each case and their case management plans before imaging, after ultrasonography, and after CTRC.ResultsA total of 108 patients underwent both ultrasonography and CTRC examinations. The protocol had a sensitivity of 94%, specificity of 94%, positive predictive value of 90%, negative predictive value of 97%, and accuracy of 94%. A normal appendix was identified by ultrasonography in 2 (2.4%) of 83 patients without appendicitis and by CTRC in 62 (84%) of 74 patients. A negative ultrasonography result did not change the surgeons' clinical confidence level in excluding appendicitis (P=.06), while a negative CTRC result did have a significant effect (P&lt;.001). Positive results obtained for either ultrasonography or CTRC significantly affected surgeons' estimated likelihood of appendicitis (P=.001 and P&lt;.001, respectively). Ultrasonography resulted in a beneficial change in patient management in 26 (18.7%) of 139 children while CTRC correctly changed management in 79 (73.1%) of 108.ConclusionsThese data show that CTRC following a negative or indeterminate ultrasonography result is highly accurate in the diagnosis of appendicitis in children.
Physiological evidence of exaggerated startle response in a subgroup of Vietnam veterans with combat-related PTSD
Authors: R W Butler, D L Braff, J L Rausch, M A Jenkins, J Sprock, M A Geyer
Journal: American Journal of Psychiatry (1990)

One of the diagnostic criteria for posttraumatic stress disorder (PTSD) is an exaggerated startle response; however, this phenomenon has not been verified empirically. The authors compared 20 Vietnam combat veterans with PTSD and 18 combat veterans without PTSD on the eyeblink reflex electromyographic response of the startle reaction. Subjects in both groups who failed to show an eyeblink response to the startle stimuli were eliminated from further analyses. Among the remaining subjects, the 13 with PTSD had a significantly greater startle response amplitude than the 12 control subjects at intermediate intensities of acoustic stimuli. The relationship between startle responsivity and both negative and positive symptoms was also investigated.
Use of Ultrasound to Measure Left Ventricular Stroke Volume
Authors: HARVEY FEIGENBAUM, ADIB ZAKY, WILLIAM K. NASSER, Charles L. Haine
Journal: Circulation (1967)

Several empirical observations made during ultrasound examinations for pericardial effusion have led to the possibility that this diagnostic technique might be used to measure left ventricular stroke volume in man. The hypothesis that left ventricular stroke volume was proportional to the amplitude of an echo originating from a portion of the left ventricle near the mitral ring (MREa) times the distance between the echoes from the anterior and posterior ventricular walls (LVD) has been validated. Ultrasound examinations were performed simultaneously with cardiac output determinations using the direct Fick method on 16 patients proven to have competent mitral and aortic valves. Correlation between the two methods of measuring left ventricular stroke volume was excellent (r = 0.973; P &lt; 0.001). When ultrasound measurements were used in the regression equation to predict stroke volume, the calculated values were within 11 ml or 15% of those determined by the Fick method. The fact that an ultrasound examination is simple, can be done as a bedside determination in a matter of minutes, and is totally harmless to the patient make it a promising diagnostic procedure. The measurement of left ventricular stroke volume represents another addition to the growing list of medical uses for this intriguing technique.
Hypofibrinogenaemia as a cause of bleeding in chronic myeloid leukaemia.
Authors: J A Whittaker, M Khurshid
Journal: BMJ (1975)

PIG. 2-Histological section ofbrain showing perivenous demyelinization with cellular infiltration. (Loyez myclin preparation.O x 350).vaccination against smallpox (Brain and Walton, 1969).This type of lesion when due to viral infections and prophylactic vaccination appears to have an allergic basis (Miller et al., 1956; Greenfield and Norman, 1963).There is evidence that the inflammatory reaction with oedema and perivascular cuffing results from a combination of Coombs's type 2, 3, and 4 reac- tions (Webb, 1969).Peripheral neuropathy, probably of an allergic origin, has been documented after preventive inocula- tion against typhoid fever (Greenfield and Norman, 1963).Thus the acute encephalomyelitis in this patient, like the occurrence of a Guillain-Barre syndrome as a complication of typhoid fever (Chanmugam and Waniganetti, 1969), probably resulted from an allergic process in the nervous system due to infection with S. typhi.Studies on viral encephalitis have indicated that severe viraemia and the late appearance of antibodies, resulting in an excess of antigen over antibody, may be of importance in the pathogenesis of the disease (Webb, 1969).Interestingly our patient had a septicaemia late in the course of his clinical illness with a poor antibody response.Though metabolic disturbances, toxaemia, hyperpyrexia, vitamin deficiency, and non-specific cerebral changes such as oedema and vascular lesions have been postulated as the patho- genesis of the neurological complications in typhoid fever ( Wilson and Bruce, 1954; Aita, 1972) there appears to be little doubt that in some cases acute disseminated encephalo- myelitis could be the cause.The present case also illustrates that bacterial infections, like viral infections, can produce neuroLogical manifestations due to the occurrence of an acute disseminated encephalomyelitis.
Using the Lives of Children Who Are Thriving as a Baseline for Minimal Risk Is not Useful for IRB Determinations
Authors: Judith Navratil, Melissa Miklos
Journal: The American Journal of Bioethics (2014)

"Using the Lives of Children Who Are Thriving as a Baseline for Minimal Risk Is not Useful for IRB Determinations." The American Journal of Bioethics, 14(9), pp. 21–22
The Emergency Intravenous Route
Authors: Arnold M. Sobol
Journal: JAMA (1966)

To the Editor:—  As a further contribution to the correspondence in your Letters section concerning emergency establishment of an intravenous route, I would like to point out that it is usually very easy to insert a plastic catheter (of the Intracath or Angiocath type) into the grossly dilated external jugular vein in patients requiring cardiac resuscitation. With a little practice the subclavian vein can also be used as an emergency route.
A Randomized Comparison of Paclitaxel-Eluting Stents Versus Bare-Metal Stents for Treatment of Unprotected Left Main Coronary Artery Stenosis
Authors: Andrejs Erglis, Inga Narbute, Indulis Kumsars, Sanda Jegere, Iveta Mintale, Ilja Zakke, Uldis Strazdins, Andris Saltups
Journal: Journal of the American College of Cardiology (2007)