tbuckley/cabot-search huggingface dataset:
P222 A Comparison in Service Provision Models For Ventilatory Assessment in Motor Neurone Disease Patients
Authors: H Yung, IE Smith, MG Davies
Journal: Thorax (2012)

<h3></h3> Specialist neurological MDT clinics improve outcomes in patients with motor neurone disease (MND)<sup>1</sup>. Non-invasive ventilation (NIV) was utilised in only 3% of this study group, but has since been shown to improve survival in selected patients<sup>2</sup>. With increasing referrals for NIV, our initial experience indicated a need for respiratory MDT input and a patient preference for day-case assessment. We established a clinic comprising regular specialist respiratory, nursing, physiotherapy and speech therapy assessment, ideally prior to the need for NIV. We undertake regular blood gases, overnight community sleep studies and lung function tests, in line with NICE recommendations. This study looks at our experience in transitioning to a dedicated MND day-case model, and how it has affected quality of care. <h3>Methods</h3> We looked at two cohorts of MND patients seen over a 3-month period before (2009) and after (2012) the day-case clinic was established. There were 66 patients in the first cohort and 82 patients in the second. We compared the quality of service delivered by looking at the proportion of patients who had received the appropriate respiratory assessments. For lung function studies, we excluded those in whom mouthpiece testing was not possible (due to significant bulbar problems). For blood gases and sleep studies, all were included. <h3>Results</h3> The current cohort comprised 9 new referrals and 73 follow-ups (55 male, average age 63 yrs). Of these, 53 (65%) did not currently require NIV, 27 (33%) were already established on NIV and 2 (2%) received tracheostomy ventilation. As expected, there was a major shift towards day-case attendance (from 33% in 2009 to 82% in 2012). There was a clear increase in objective screening tests. Table 1 shows the proportion of eligible patients receiving these tests. <h3>Discussion</h3> These results show that a dedicated day-case MDT clinic improves the ventilatory assessment of MND patients. Whilst the uptake of NIV and, ultimately, survival, can only be determined in due course, we have previously shown a significant increase in NIV uptake in our MND patients (70% in 2011). We feel that the greater availability of objective testing, demonstrated here, and the structured approach of the service has contributed to this. Traynor BJ et al. J Neurol Neurosurg Psychiatry 2003. Bourke SC et al. Lancet Neurology 2006.
Higher nurse to patient ratios on stroke units could cut one death in 25, research shows
Authors: A. Cole
Journal: BMJ (2014)

The number of nurses on stroke units at weekends significantly affects patient mortality as higher nurse to patient ratios may prevent one death in every 25 admissions, new research has shown.

But the study—by Benjamin Bray of King’s College, London and colleagues—did not find a similar correlation among doctors, and it concluded that no significant difference in patient mortality risk existed between units that provided weekend rounds by specialist stroke doctors and those that did not.

The study, published in PLoS Medicine ,1 is of particular interest given that a number of studies have shown higher mortality rates among patients admitted at weekends—the so called “weekend effect,” which has led NHS England to identify seven day working as a policy priority for the NHS.

For …
NICE is told to halt work on 19 public health topics
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The UK government has asked the National Institute for Health and Clinical Excellence (NICE) to stop working on guidance on six public health topics and “to put on hold” work on a further 13.

NICE has been told to abandon its guidance on preventing road injuries in children and young people; spatial planning for health (changing the physical environment to improve health); policies for smoke free homes and cars; support for people buying nicotine replacement products; and what commissioners and local authorities can do to combat trade in illicit tobacco products.

Changes to the NICE workload follow the publication of the public health white paper, Healthy Lives, Healthy People …
Do the acute platelet responses of patients with immune thrombocytopenic purpura (ITP) to IV anti‐D and to IV gammaglobulin predict response to subsequent splenectomy?
Authors: James B. Bussel, Craig P. Kaufmann, Russell E. Ware, B.M.R. Woloski
Journal: American Journal of Hematology (2001)

Abstract The acute platelet response to Intravenous Gammaglobulin (IVIG) has been reported to predict response to subsequent splenectomy of patients with ITP. The current study was undertaken to determine if the platelet response to IV anti‐D (Winrho‐SDF) predicts response to subsequent splenectomy. The 61 HIV‐uninfected children and adults in this study had taken part in the pre‐licensing studies of IV anti‐D and were all those who not only had evaluable platelet responses to IV anti‐D but also had undergone splenectomy and had information available describing its 1‐year outcome. Results of treatment with IVIG were available in 38 of these 61 patients. Neither response to the initial infusion of IV anti‐D, nor response to the initial or last IVIG, predicted the response in either children or adults to subsequent splenectomy. However, response to the last anti‐D infusion in adults was strongly correlated ( P = 0.003) to response to subsequent splenectomy as was hemolysis ≥2.0 gm/dl after IV anti‐D ( P = 0.03). There was no overall relationship between response to IV anti‐D or IVIG, and response to subsequent splenectomy. However, a good platelet response in adults to the last IV anti‐D and a hemoglobin decrease ≥2.0 gm/dl both appeared to predict response to subsequent splenectomy. Am. J. Hematol. 67:27–33, 2001. © 2001 Wiley‐Liss, Inc.
Symptoms and Distress in Children With Advanced Cancer: Prospective Patient-Reported Outcomes From the PediQUEST Study
Authors: Joanne Wolfe, Liliana Orellana, Christina Ullrich, E. Francis Cook, Tammy I. Kang, Abby Rosenberg, Russ Geyer, Chris Feudtner, Veronica Dussel
Journal: Journal of Clinical Oncology (2015)

Thousands of children are living with advanced cancer; yet patient-reported outcomes (PROs) have rarely been used to describe their experiences. We aimed to describe symptom distress in 104 children age 2 years or older with advanced cancer enrolled onto the Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) Study (multisite clinical trial evaluating an electronic PRO system).Symptom data were collected using age- and respondent-adapted versions of the PediQUEST Memorial Symptom Assessment Scale (PQ-MSAS) at most once per week. Clinical and treatment data were obtained from medical records. Individual symptom scores were dichotomized into high/low distress. Determinants of PQ-MSAS scores were explored using linear mixed-effects models.During 9 months of follow-up, PQ-MSAS was administered 920 times: 459 times in teens (99% self-report), 249 times in children ages 7 to 12 years (96% child/parent report), and 212 times in those ages 2 to 6 years (parent reports). Common symptoms included pain (48%), fatigue (46%), drowsiness (39%), and irritability (37%); most scores indicated high distress. Among the 73 PQ-MSAS surveys administered in the last 12 weeks of life, pain was highly prevalent (62%; 58% with high distress). Being female, having a brain tumor, experiencing recent disease progression, and receiving moderate- or high-intensity cancer-directed therapy in the prior 10 days were associated with worse PQ-MSAS scores. In the final 12 weeks of life, receiving mild cancer-directed therapy was associated with improved psychological PQ-MSAS scores.Children with advanced cancer experience high symptom distress. Strategies to promote intensive symptom management are indicated, especially with disease progression or administration of intensive treatments.
Letter: Penicillin in leptospirosis.
Authors: H Nicholls
Journal: BMJ (1973)

<h3>ABSTRACT</h3> Peritoneal dialysis (PD) is limited by glucose-mediated peritoneal membrane (PM) fibrosis, angiogenesis and ultrafiltration failure. Influencing PM integrity by pharmacologically targeting sodium-dependent glucose transporter (SGLT)-mediated glucose uptake has not been studied. In this study wildtype C57Bl/6N mice were treated with high-glucose dialysate via an intraperitoneal catheter, with or without addition of selective SGLT2 inhibitor dapagliflozin. PM structural changes, ultrafiltration capacity and PET status for glucose, urea and creatinine were analyzed. Expression of SGLT and GLUT was analyzed by real-time PCR, immunofluorescence and immunohistochemistry. Peritoneal effluents were analyzed for cellular and cytokine composition. We found that peritoneal SGLT2 was expressed in mesothelial cells and in skeletal muscle. Dapagliflozin significantly reduced effluent TGF-β concentrations, peritoneal thickening and fibrosis as well as microvessel density, resulting in improved ultrafiltration, despite the fact that it did not affect development of high glucose transporter status. <i>In vitro</i>, dapagliflozin reduced monocyte chemoattractant protein-1 release under high glucose conditions in human and murine peritoneal mesothelial cells. Pro-inflammatory cytokine release in macrophages was reduced only when cultured in high glucose conditions with an additional inflammatory stimulus. In summary, dapagliflozin improved structural and functional peritoneal health in the context of high glucose PD.
Metabolism of hexachlorobenzene in humans: association between serum levels and urinary metabolites in a highly exposed population.
Authors: J To-Figueras, M Sala, R Otero, C Barrot, M Santiago-Silva, M Rodamilans, C Herrero, J Grimalt, J Sunyer
Journal: Environmental Health Perspectives (1997)

Serum and urine from 100 subjects of a general population highly exposed to airborne hexachlorobenzene (HCB) were analyzed to obtain new insights into the metabolism of this ubiquitous compound. HCB was detected in all serum samples with concentrations ranging between 1.1 and 953 ng/ml. The major known metabolites of HCB were investigated in urine collected over 24 hr. Pentachlorophenol (PCP) was detected in all urines with values ranging between 0.58 and 13.9 micrograms excreted in 24 hr [mean +/- standard deviation (SD), 2.52 +/- 2.05; geometric mean, 2.05]. A sulfur derivative that, after hydrolysis, yielded pentachlorobenzenethiol (PCBT) could also be identified and quantified in all the urines with values ranging between 0.18 and 84.0 micrograms of PCBT excreted in 24 hr (mean +/- SD, 3.47 +/- 10.8; geometric mean, 1.39). The sulfur derivative assessed as PCBT appeared to be the main metabolite, with urinary concentrations surpassing those of PCP in the subjects with higher HCB accumulation (HCB in serum > 32 ng/ml). PCBT concentration in urine collected over 24 hr showed a very strong association with HCB concentration in serum; the association was stronger in males than in females. An increase of 1 ng/ml of HCB in serum led to an increase of 2.12 micrograms of PCBT excreted in urine collected over 24 hr in males (95% CI, 1.82-2.44) and to an increase of 0.67 microgram of PCBT in females (CI, 0.33-1.09). A weaker association was found between PCP in urine and HCB in serum, which was only statistically significant in males (an increase of 1 ng/ml of HCB in serum led to an increase of 0.63 microgram of PCP excreted in urine collected over 24 hr; (CI, 0.34-0.95). These results show that the formation of the cysteine conjugate is a quantitatively more important metabolic pathway in humans than the formation of PCP. Moreover, the association found suggests that PCBT is a good urinary marker of HCB internal dose and glutathione-mediated metabolism.
Stevens-Johnson syndrome/toxic epidermal necrolysis mouse model generated by using PBMCs and the skin of patients
Authors: Nao Saito, Naoya Yoshioka, Riichiro Abe, Hongjiang Qiao, Yasuyuki Fujita, Daichi Hoshina, Asuka Suto, Satoru Kase, Nobuyoshi Kitaichi, Michitaka Ozaki, Hiroshi Shimizu
Journal: Journal of Allergy and Clinical Immunology (2012)
Association of Intrauterine and Early-Life Exposures with Diagnosis of Uterine Leiomyomata by 35 Years of Age in the Sister Study
Authors: Aimee A. D’Aloisio, Donna D. Baird, Lisa A. DeRoo, Dale P. Sandler
Journal: Environmental Health Perspectives (2009)

Early-life exposures to hormonally active compounds and other factors may affect later response to estrogen or progesterone and hence may influence development of uterine leiomyomata (fibroids).We evaluated associations of in utero and early-life exposures, including soy formula, with self-report of physician-diagnosed fibroids by 35 years of age.Our study included 19,972 non-Hispanic white women who were 35-59 years of age when they enrolled in the Sister Study in 20032007. We estimated risk ratios (RRs) and 95% confidence intervals (CIs) using log-binomial regression models for fibroid associations with adjustment for participant's age and education, maternal age at participant's birth, birth order, and childhood family income.Greater risk of early fibroid diagnosis was associated with soy formula during infancy (RR = 1.25; 95% CI, 0.971.61), maternal prepregnancy diabetes (RR = 2.05; 95% CI, 1.163.63), low childhood socioeconomic status (RR = 1.28; 95% CI, 1.011.63), and gestational age at birth (RR = 1.64; 95% CI, 1.272.13, for being born at least 1 month early). In utero diethylstilbestrol (DES) exposure was also associated with early fibroid diagnosis (RR = 1.42; 95% CI, 1.131.80), but this association was driven by women reporting probable rather than definite exposure.There are plausible biological pathways by which these early-life factors could promote fibroid pathogenesis. This is the first epidemiologic study to evaluate such exposures, with the exception of in utero DES, in relation to fibroid risk, and replication of findings in other populations is needed.
Calcium Dynamics and the Mechanisms of Atrioventricular Junctional Rhythm
Authors: Daehyeok Kim, Tetsuji Shinohara, Boyoung Joung, Mitsunori Maruyama, Eue-Keun Choi, Young Keun On, Seongwook Han, Michael C. Fishbein, Shien-Fong Lin, Peng-Sheng Chen
Journal: Journal of the American College of Cardiology (2010)
Allergen-specific CD8+ T cells and atopic disease
Authors: Suranjith L. Seneviratne, Louise Jones, Abigail S. King, Antony Black, Sheila Powell, Andrew J. McMichael, Graham S. Ogg
Journal: Journal of Clinical Investigation (2002)

Considerable evidence suggests that IL-10 may have a role in the manifestation of atopic disease. We sought to test the hypothesis that at the single cell level, allergen-specific T cells have diminished IL-10 production capacity in severely affected atopics compared with asymptomatic atopics. We defined three A*0201-restricted Der p 1 CD8+ T cell epitopes. Using human leukocyte antigen-A*0201–peptide (HLA-A*0201–peptide) tetrameric complexes and enzyme-linked immunospot assays to analyze peripheral blood mononuclear cells from A*0201-positive severely symptomatic atopics, asymptomatic atopics, and nonatopic controls, we observed a significant association between the frequency of the Der p 1–specific CD8+ T cells and disease activity. The specific T cells expressed an antigen-experienced cell surface phenotype, and 45.7% were positive for cutaneous lymphocyte-associated antigen. The specific T cells were able to produce IFN-γ efficiently, but their IL-10 production was significantly reduced in severely affected atopics. In contrast, viral-specific CD8+ T cells were able to produce equivalent amounts of IL-10 in the severely affected atopics compared with asymptomatic atopics and nonatopics. Through defining the first human atopic allergen HLA class I epitopes, we have provided a possible cellular mechanism to link the previous association of low IL-10 levels and severe atopic disease. These data are consistent with a role for CD8+ T cells in atopic disease pathogenesis and may provide a basis for future T cell immunotherapy strategies.
Of books and symbols
Authors: L. S. King
Journal: JAMA (1973)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Hepatitis E in a Traveler to Bangladesh
Authors: J. Kirk Roberts, Robert T. Whitlock
Journal: Annals of Internal Medicine (1992)

Letters1 July 1992Hepatitis E in a Traveler to BangladeshJ. Kirk Roberts, MD, Robert T. Whitlock, MDJ. Kirk Roberts, MDSearch for more papers by this author, Robert T. Whitlock, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-1-93_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Water-borne epidemics of enterically transmitted non-A, non-B hepatitis, now known as hepatitis E, have been reported in India, Nepal, Pakistan, Burma, the former Soviet Union, and areas of Africa (1), as well as in Mexico (2). To our knowledge, reports of hepatitis E in the United States have been limited to four cases, all in travelers who had visited areas of risk (3, 4).We recently treated a 35-year-old Bangladeshi man living in New York City, who was found to have hepatitis E after returning from a visit to Bangladesh in June 1991. On 2 August 1991,...References1. Bradley D. Enterically-transmitted non-A, non-B hepatitis. Br Med Bull. 1990;46:442-6. CrossrefMedlineGoogle Scholar2. VelazquezStetlerAvilaOrnelasAlvarezHadler OHCGCS. Epidemic transmission of enterically transmitted non-A, non-B hepatitis in Mexico, 1986-1987. JAMA. 1990;263:3281-5. CrossrefMedlineGoogle Scholar3. De CockBradleySandfordGovindarajanMaynardRedeker KDNSJA. Epidemic non-A, non-B hepatitis in patients from Pakistan. Ann Intern Med. 1987;106:227-30. LinkGoogle Scholar4. BaderKrawczynskiPolishFavorov TKLM. Hepatitis E in a U.S. traveler to Mexico. N Engl J Med. 1991;325:1659. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHepatitis E as a cause of adult hospitalization in Bangladesh: Results from an acute jaundice surveillance study in six tertiary hospitals, 2014-2017Hepatitis E should be considered a neglected tropical diseaseThe Global Impact of Hepatitis E: New Horizons for an Emerging VirusHepatitis A and E in Potable Water: A Threat to HealthHepatitis E virus infection in developed countriesHepatitis EHepatitis Viruses (HAV-HEV)Risk of Hepatitis E Infection to TravelersHepatitis E probably contracted via a Chinese herbal medicine, demonstrated by nucleotide sequencingSerological evidence for hepatitis E virus infection in IsraelPrior hepatitis A virus infection enhances acute hepatitis E virus infection 1 July 1992Volume 117, Issue 1Page: 93-93KeywordsHepatitis AHepatitis ERisk management ePublished: 1 December 2008 Issue Published: 1 July 1992 PDF downloadLoading ...
Defective adenosine triphosphate synthesis. An explanation for skeletal muscle dysfunction in phosphate-deficient mice.
Authors: B D Hettleman, R L Sabina, M K Drezner, E W Holmes, J L Swain
Journal: Journal of Clinical Investigation (1983)

The basis for skeletal muscle dysfunction in phosphate-deficient patients and animals is not known, but it is hypothesized that intracellular phosphate deficiency leads to a defect in ATP synthesis. To test this hypothesis, changes in muscle function and nucleotide metabolism were studied in an animal model of hypophosphatemia. Mice were made hypophosphatemic through restriction of dietary phosphate intake. Gastrocnemius function was assessed in situ by recording isometric tension developed after stimulation of the nerve innervating this muscle. Changes in purine nucleotide, nucleoside, and base content of the muscle were quantitated at several time points during stimulation and recovery. Serum concentration and skeletal muscle content of phosphorous are reduced by 55 and 45%, respectively, in the dietary restricted animals. The gastrocnemius muscle of the phosphate-deficient mice fatigues more rapidly compared with control mice. ATP and creatine phosphate content fall to a comparable extent during fatigue in the muscle from both groups of animals; AMP, inosine, and hypoxanthine (indices of ATP catabolism) appear in higher concentration in the muscle of phosphate-deficient animals. Since total ATP use in contracting muscle is closely linked to total developed tension, we conclude that the comparable drop in ATP content in association with a more rapid loss of tension is best explained by a slower rate of ATP synthesis in the muscle of phosphate-deficient animals. During the period of recovery after muscle stimulation, ATP use for contraction is minimal, since the muscle is at rest. In the recovery period, ATP content returns to resting levels more slowly in the phosphate-deficient than in the control animals. In association with the slower rate of ATP repletion, the precursors inosine monophosphate and AMP remain elevated for a longer period of time in the muscle of phosphate-deficient animals. The slower rate of ATP repletion correlates with delayed return of normal muscle contractility in the phosphate-deficient mice. These studies suggest that the slower rate of repletion of the ATP pool may be the consequence of a slower rate of ATP synthesis and this is in part responsible for the delayed recovery of normal muscle contractility.