tbuckley/cabot-search huggingface dataset:
Risk Factors and Outcome of Nosocomial Infections: Results of a Matched Case-control Study of ICU Patients
Authors: EMMANUELLE GIROU, FRANÇOIS STEPHAN, ANA NOVARA, MICHEL SAFAR, JEAN-YVES FAGON
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Intensive-care-unit (ICU) patients are at risk for both acquiring nosocomial infection and dying, and require a high level of therapy whether infection occurs or not. The objective of the present study was to precisely define the interrelationships between underlying disease, severity of illness, therapeutic activity, and nosocomial infections in ICU patients, and their respective influences on these patients' outcome. In a 10-bed medical ICU, we conducted a case-control study with matching for initial severity of illness, with daily monitoring of severity of illness and therapeutic activity scores, and with analysis of the contribution of nosocomial infections to patients' outcomes. Forty-one cases of patients who developed nosocomial infections during a 1-yr period were paired with 41 controls without nosocomial infection according to three criteria: age (+/- 5 yr), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (+/- 5 points), and duration of exposure to risk. Successful matching was achieved for 118 of 123 (96%) variables. Neurologic failure on the third day after ICU admission was the sole independent risk factor for nosocomial infection (adjusted odds ratio [OR]: 1.34; 95% confidence interval [CI]: 1.09 to 1.64; p = 0.007). Unlike control patients, case patients showed no clinical improvement and required a high level of therapeutic activity between ICU admission and the day of infection. Mortality attributable to nosocomial infection was 44%. Excess length of stay and duration of antibiotic treatment attributable to nosocomial infection were 14 d and 10 d, respectively. Attributable therapeutic activity as measured with the Therapeutic Intervention Scoring System (TISS) and Omega score was 368 and 233 points, respectively. Such consequences were observed in patients who developed multiple infections. These findings suggest that a persistent high level of therapeutic activity and persistent impaired consciousness are risk factors for nosocomial infections in ICU patients. These infections are responsible for excess mortality, prolongation of stay, and excess therapeutic activity resulting in important cost overruns for health-care systems.
Thiazolidinediones inhibit hepatocarcinogenesis in hepatitis B virus-transgenic mice by peroxisome proliferator-activated receptor γ-independent regulation of nucleophosmin
Authors: Andrea Galli, Elisabetta Ceni, Tommaso Mello, Simone Polvani, Mirko Tarocchi, Francesca Buccoliero, Francesca Lisi, Laura Cioni, Barbara Ottanelli, Valeria Foresta, Guido Mastrobuoni, Gloriano Moneti, Giuseppe Pieraccini, Calogero Surrenti, Stefano Milani
Journal: Hepatology (2010)

Antidiabetic thiazolidinediones (TZD) have in vitro antiproliferative effect in epithelial cancers, including hepatocellular carcinoma (HCC). The effective anticancer properties and the underlying molecular mechanisms of these drugs in vivo remain unclear. In addition, the primary biological target of TZD, the ligand-dependent transcription factor peroxisome proliferator-activated receptor γ (PPARγ), is up-regulated in HCC and seems to provide tumor-promoting responses. The aim of our study was to evaluate whether chronic administration of TZD may affect hepatic carcinogenesis in vivo in relation to PPARγ expression and activity. The effect of TZD oral administration for 26 weeks was tested on tumor formation in PPARγ-expressing and PPARγ-deficient mouse models of hepatic carcinogenesis. Proteomic analysis was performed in freshly isolated hepatocytes by differential in gel electrophoresis and mass spectrometry analysis. Identified TZD targets were confirmed in cultured PPARγ-deficient hepatocytes. TZD administration in hepatitis B virus (HBV)–transgenic mice (TgN[Alb1HBV]44Bri) reduced tumor incidence in the liver, inhibiting hepatocyte proliferation and increasing apoptosis. PPARγ deletion in hepatocytes of HBV-transgenic mice (Tg[HBV]CreKOγ) did not modify hepatic carcinogenesis but increased the TZD antitumorigenic effect. Proteomic analysis identified nucleophosmin (NPM) as a TZD target in PPARγ-deficient hepatocytes. TZD inhibited NPM expression at protein and messenger RNA levels and decreased NPM promoter activity. TZD inhibition of NPM was associated with the induction of p53 phosphorylation and p21 expression. Conclusion: These findings suggest that chronic administration of TZD has anticancer activity in the liver via inhibition of NPM expression and indicate that these drugs might be useful for HCC chemoprevention and treatment. HEPATOLOGY 2010
INCIDENCE OF VASCULAR COMPLICATIONS IN TRANSFEMORAL TRANSCATHETER AORTIC VALVE REPLACEMENT ACCORDING TO FEMORAL ARTERY ACCESS TECHNIQUE
Authors: Pei-Hsiu Huang, James McCabe, Tsuyoshi Kaneko, Frederick Welt, Michael Davidson, Marvin Eng, Keith Allen, Ke Xu, David Brown, Michael Mack, John Webb, Craig Smith, Martin Leon, Andrew Eisenhauer
Journal: Journal of the American College of Cardiology (2014)
Thermographic Localization of Incompetent Perforating Veins in the Leg
Authors: K. D. Patil, J. R. Williams, K. L. Williams
Journal: BMJ (1970)

Incompetent perforating veins in the leg were localized separately by clinical and thermographic methods. Clinically, the methods used were a multiple tourniquet test and palpation for fascial defects. Thermographically, the diagnosis of an incompetent perforator was made by finding rapid and localized heat flow to the skin in a cooled limb with occlusion of circulation in the superficial veins distally and proximally. Exploration of all the sites marked clinically or thermographically showed that the clinical method detected 60%, missed 40%, and gave false-positive results in 40%, while thermography detected 94·5%, missed 5·5%, and contributed 13% false-positive results. All these findings show a highly significant difference (P&lt;0.0005) in favour of the thermographic technique as against the clinical method.
Managing spinal cord compression in small cell lung cancer.
Authors: P. Watson
Journal: BMJ (1991)

Royal Brompton Grand RoundsManaging spinal cord compression in small cell lung cancer Radiotherapy needed for those at risk Small cell lung cancers account for a fifth of all lung cancers, and in most cases cytotoxic chemotherapy is the treatment of choice.The disease is almost always disseminated at presentation and therefore most organ systems can be affected.Central nervous system complications of lung cancer can cause devastating morbidity.Symptoms from cerebral metastases usually respond disappointingly to radiotherapy and those patients with such metastases often spend most of their remaining life in hospital.'Spinal cord compression is potentially even more serious as the patient can become paraplegic within hours.We present two cases of spinal cord compression in small cell lung cancer and consider how to predict and minimise this serious complication. Case histories CASE 1A 67 year old woman who had smoked 20 cigarettes a day for 47 years presented in May 1989 with weight loss and a mass in her chest radiograph in the upper lobe with mediastinal lymphadenopathy.Bronchoscopy and biopsy confirmed small cell lung cancer.Radio- isotope bone scanning showed increased uptake of technetium-99 at TIO and T12 (fig 1).Her bio- chemical test results and abdominal ultrasonogram were normal.She was treated with chemotherapy but after her second course developed Gram negative septicaemia and treatment was discontinued.A chest radiograph showed a complete remission, and she was then followed up as an outpatient.In October 1989 she developed right sided loin pain with abdominal tenderness.Abdominal ultrasono- graphy, barium enema examination, and biochemical investigations all gave normal results.She had no back pain but a chest radiograph in December 1989 showed a recurrence at the primary site.A second radioisotope bone scan showed increased 99Tc uptake at T3, T8, and T9 as well as at the lesion previously noted.
N-acetylcysteine Preserves Oxygen Consumption and Gastric Mucosal pH during Hyperoxic Ventilation
Authors: Konrad Reinhart, Claudia D. Spies, Andreas Meier-Hellmann, Donald L. Bredle, Lutz Hannemann, Martin Specht, Walter Schaffartzik
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Hyperoxic ventilation, used to prevent hypoxemia during potential periods of hypoventilation, has been reported to paradoxically decrease whole body oxygen consumption (VO2). Reduction in nutritive blood flow due to oxygen radical production is one possible mechanism. We investigated whether pretreatment with the sulfhydryl group donor and O2 radical scavenger N-acetylcysteine (NAC) would preserve whole body VO2 and prevent deterioration of oxygenation in gastric mucosal tissue during hyperoxia. Thirty-eight patients, requiring hemodynamic monitoring (radial and pulmonary artery catheters) due to sepsis syndrome, were included in this randomized experiment. All patients exhibited stable clinical conditions (hemodynamics, body temperature, hemoglobin, FIO2 < 0.5). A gastric tonometer was placed to measure the gastric intramucosal pH (pHi), which indirectly assesses nutritive blood flow to the mucosa. Cardiac output was determined by thermodilution and VO2 by cardiovascular Fick. After baseline measurements, patients randomly received either 150 mg.kg-1 NAC (n = 19) or placebo (n = 19) in 250 ml 5% dextrose intravenously over a period of 15 min. Measurements were repeated 30 min after starting NAC or placebo infusion, 30 min after starting hyperoxia (FIO2 = 1.0), and 60 min after resetting the original FIO2. There were no significant differences between groups in any of the measurements before treatment and after the return to baseline FIO2 at the end of the study. NAC, but not placebo infusion, caused a slight but significant increase in cardiac output and decrease in systemic vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)
Statistical Review Process
Authors: J. J. Shuster
Journal: JAMA (1976)

<h3>Recommended Procedures for Biomedical Research Articles</h3> Most biomedical research requires some form of statistical analysis of the experimental data. Although physicians who read the results of such research should not concern themselves with the details of the statistical methods, these physicians should be given some protection against incorrect data analyses and misinterpretation of results. In STA 635, "Biostatistics," given to graduate statistics majors at the University of Florida, the instructor ("somewhat randomly") selected from ten medical journals 11 articles to be reviewed by the students to afford them practical experience in reading the journals. Major errors were found in all but one of these articles. Where errors occurred, the conclusions drawn by the authors are suspect. To strengthen review processes, we recommend the following (added) procedures for editing medical journals: Any article containing even the most elementary statistical procedures should be reviewed by a competent biostatistician (the simplest techniques,
Policies on Medical Decisions Concerning the End of Life in Dutch Health Care Institutions
Authors: Ilinka Haverkate
Journal: JAMA (1996)

<h3>Objective.</h3> —To describe the prevalence and some features of policies on medical decisions concerning the end of life (MDELs) in Dutch hospitals, nursing homes, and institutions for the mentally disabled. <h3>Design.</h3> —A cross-sectional descriptive postal survey of 558 Dutch health care institutions. <h3>Setting.</h3> —All Dutch hospitals, nursing homes, and general institutions for the mentally disabled. <h3>Participants.</h3> —Directors of patient care of the institutions. <h3>Main Outcome Measures.</h3> —Respondents' reports on the existence of policies and guidelines on the following MDELs: euthanasia/assisted suicide (EAS), life-terminating acts without explicit request of the patient, refusal of treatment by patient, withholding or withdrawing treatment, symptom and pain control, and do-not-resuscitate (DNR) decisions. <h3>Results.</h3> —Of 558 health care institution managers, 86% responded. Most of the hospitals (69.2%) and nursing homes (73.9%) but only 16.3% of the institutions for the disabled had a written EAS policy. Nursing homes with a ban on EAS often had religious affiliations. In 37% of nursing homes, 15% of hospitals, and 15% of institutions for the disabled, the management had written policies on terminating life without request. Sixty percent of the hospitals, 35% of the nursing homes, and 17% of the institutions for the disabled had guidelines for one or more of four other distinct MDELs. Forty-five percent, 20%, and 8% of hospitals, nursing homes, and institutions of mentally disabled, respectively, had guidelines on DNR decisions. The management of 89% of the hospitals and 94% of the nursing homes communicated their policies on EAS to physicians and nurses in their institutions without being asked. Far fewer of these hospitals (3.9%) and nursing homes (30.5%) made their policies on EAS known to patients without being asked. <h3>Conclusions.</h3> —This study indicates that an important step toward policy development on EAS has been made by Dutch hospitals and nursing homes. Particularly with respect to policies on such decisions as withholding or withdrawing treatment, symptom and pain control, and DNR orders, an unexplored field is open to management for policy development in the Netherlands. (<i>JAMA</i>. 1996;275:435-439)
DEATH FOLLOWING COAGULATION OF THE CERVIX
Authors: Robert I. Hiller
Journal: JAMA (1935)

From a survey of the literature, one would gain the impression that coagulation and cauterization of the cervix were entirely harmless procedures. Yet I am aware of two deaths following cauterization of the cervix, reports of which have not as yet appeared in the literature. In one of these cases a retroperitoneal phlegmon and in the other a generalized peritonitis were found at autopsy. In 1928 Curtis<sup>1</sup>casually mentioned three cases of pelvic cellulitis from the use of cautery treatment of the endocervix. All of his patients recovered. He felt that this complication was perhaps more common in those women who have a retrodisplacement of the uterus. The two cases reported here emphasize the fact that coagulation of the cervix is not entirely without danger, especially if there has been a previous history of septic abortion. <h3>REPORT OF CASES</h3><h3>Case 1.</h3><h3>—History.</h3> —M. R., a white woman
IQPNNI: Moving Fast Through Tree Space and Stopping in Time
Authors: L. S. Vinh
Journal: Molecular Biology and Evolution (2004)

An efficient tree reconstruction method (IQPNNI) is introduced to reconstruct a phylogenetic tree based on DNA or amino acid sequence data. Our approach combines various fast algorithms to generate a list of potential candidate trees. The key ingredient is the definition of so-called important quartets (IQs), which allow the computation of an intermediate tree in O(n(2)) time for n sequences. The resulting tree is then further optimized by applying the nearest neighbor interchange (NNI) operation. Subsequently a random fraction of the sequences is deleted from the best tree found so far. The deleted sequences are then re-inserted in the smaller tree using the important quartet puzzling (IQP) algorithm. These steps are repeated several times and the best tree, with respect to the likelihood criterion, is considered as the inferred phylogenetic tree. Moreover, we suggest a rule which indicates when to stop the search. Simulations show that IQPNNI gives a slightly better accuracy than other programs tested. Moreover, we applied the approach to 218 small subunit rRNA sequences and 500 rbcL sequences. We found trees with higher likelihood compared to the results by others. A program to reconstruct DNA or amino acid based phylogenetic trees is available online (http://www.bi.uni-duesseldorf.de/software/iqpnni).
Early spontaneous intermittent myocardial reperfusion during acute myocardial infarction is associated with augmented thrombogenic activity and less myocardial damage
Authors: Agha W. Haider, Felicita Andreotti, David R. Hackett, Dimitris Tousoulis, Cornelis Kluft, Attilio Maseri, Graham J. Davies
Journal: Journal of the American College of Cardiology (1995)
The Igα/Igβ Heterodimer on μ-Negative ProB Cells Is Competent for Transducing Signals to Induce Early B Cell Differentiation
Authors: Kisaburo Nagata, Tetsuya Nakamura, Fujiko Kitamura, Satomi Kuramochi, Shinsuke Taki, Kerry S Campbell, Hajime Karasuyama
Journal: Immunity (1997)
DICK TEST IN CHILDREN
Authors: Clarence A. Earle
Journal: JAMA (1934)

My records show that of a large number of children who have been Dick tested and retested from two to ten or twelve times during the past ten and one-half years a relatively large number have shown such irregularities in reaction that my faith in the specificity of this test has been shaken. The claims of specificity are further challenged by the frequent reports of Dick negative children getting scarlet fever. Convinced as I had been of the reliability of the Schick test, I was slow to believe that such discrepancies could occur with the Dick test. I have never seen a case of true diphtheria in a Schick negative child, but I have records of eight Dick negative children who later contracted scarlet fever. In justice to the accuracy of this test I must state that five of the eight had also given one or more positive Dick tests.
Hemoglobin A1 Properties of Diabetic and Uremic Patients
Authors: Munetada Oimomi, Yukio Yoshimura, Shinzo Kubota, Tomiyasu Kawasaki, Kiyoshi Takagi, Shigeaki Baba
Journal: Diabetes Care (1981)

Patients with diabetes mellitus as well as those with renal failure had high hemoglobin A1 (HbA1) levels. However, the portion of HbA1a+b fractions was larger in patients with renal failure than in diabetic patients. Thus, if renal disorder is advanced, caution should be exercised in evaluating HbA1 data. Furthermore, not only is the collective determination of Hb minor components such as HbA1 required, but also investigation of changes in HbA1a+b in patients with renal failure or diabetic nephropathy.
The National Health Service: A Political History
Authors: J. Bunker
Journal: BMJ (1998)

Charles Webster

Oxford University Press, £9.99, pp 233

ISBN 0 19 289296 7

Doctors in the United States still express a strong distaste for what they perceive as socialised medicine in Great Britain. But, of course, few of them are familiar with the NHS and how it functions. They are not familiar, for example, with how much greater freedom of practice the British doctor has had, at least up to the recent past. It could be argued, as J R Hampton did in his famous 1983 editorial, that clinical freedom was at an end. But Hampton was arguing that it was the freedom to ignore what we now call evidence based medicine that was at an end. It is another kind of freedom, the freedom of what Eliot Freidson has called “the flexible discretionary judgement that is necessary to adapt to individual [patients’] needs” that is being eroded as the NHS adopts the worst of managerial style, American managed care.



Not all conditions of the mouth are due to disease. Tribal tattooing of the upper gums is illustrated in the second edition of Oral Diseases , edited by C Sculley, S R Flint, and S R Porter (Martin Dunitz, £75, ISBN 1 85317 …
Mutant p53–associated myosin-X upregulation promotes breast cancer invasion and metastasis
Authors: Antti Arjonen, Riina Kaukonen, Elina Mattila, Pegah Rouhi, Gunilla Högnäs, Harri Sihto, Bryan W. Miller, Jennifer P. Morton, Elmar Bucher, Pekka Taimen, Reetta Virtakoivu, Yihai Cao, Owen J. Sansom, Heikki Joensuu, Johanna Ivaska
Journal: Journal of Clinical Investigation (2014)

Mutations of the tumor suppressor TP53 are present in many forms of human cancer and are associated with increased tumor cell invasion and metastasis. Several mechanisms have been identified for promoting dissemination of cancer cells with TP53 mutations, including increased targeting of integrins to the plasma membrane. Here, we demonstrate a role for the filopodia-inducing motor protein Myosin-X (Myo10) in mutant p53-driven cancer invasion. Analysis of gene expression profiles from 2 breast cancer data sets revealed that MYO10 was highly expressed in aggressive cancer subtypes. Myo10 was required for breast cancer cell invasion and dissemination in multiple cancer cell lines and murine models of cancer metastasis. Evaluation of a Myo10 mutant without the integrin-binding domain revealed that the ability of Myo10 to transport β₁ integrins to the filopodia tip is required for invasion. Introduction of mutant p53 promoted Myo10 expression in cancer cells and pancreatic ductal adenocarcinoma in mice, whereas suppression of endogenous mutant p53 attenuated Myo10 levels and cell invasion. In clinical breast carcinomas, Myo10 was predominantly expressed at the invasive edges and correlated with the presence of TP53 mutations and poor prognosis. These data indicate that Myo10 upregulation in mutant p53-driven cancers is necessary for invasion and that plasma-membrane protrusions, such as filopodia, may serve as specialized metastatic engines.
VEGF and RANKL Regulation of NFATc1 in Heart Valve Development
Authors: Michelle D. Combs, Katherine E. Yutzey
Journal: Circulation Research (2009)

Rationale: NFATc1 (nuclear factor of activated T-cells cytoplasmic 1) activity in endocardial cushion (ECC) endothelial cells is required for normal ECC growth and extracellular matrix (ECM) remodeling during heart valve development. Objective: The mechanisms of NFATc1 activation and downstream effects on cell proliferation and ECM-remodeling enzyme gene expression were examined in NFATc1 mutant mice and chick ECC explants. Methods and Results: NFATc1 −/− mice display reduced proliferation of ECC endothelial and mesenchymal cells at embryonic day 10.5, whereas myocardial cells are unaffected. Vascular endothelial growth factor A (VEGF) activates NFATc1 and promotes ECC cell proliferation via the regulatory phosphatase, calcineurin, and mitogen-activated protein kinase–extracellular signal-regulated kinase 1–extracellular signal-regulated kinase 1/2 (MEK1-ERK1/2)–dependent signaling. As ECCs mature, RANKL (receptor activator of nuclear factor κB ligand) and the ECM-remodeling enzyme cathepsin K (CtsK) are expressed by ECC endothelial cells. RANKL inhibits VEGF-induced cell proliferation while causing increased expression of CtsK via calcineurin/NFATc1 and c-Jun N-terminal kinase (JNK)1/2-dependent signaling. Conclusion: These data support a novel mechanism for the transition from ECC growth to remodeling in which NFATc1 promotes a sequential pattern of gene expression via cooperation with ligand-specific cofactors such as MEK1-ERK1/2 or JNK1/2.
EFFECT OF ORGANOMERCURIALS ON THE RENAL CONCENTRATING OPERATION IN HYDROPENIC MAN: COMMENTS ON SITE OF ACTION*
Authors: Jerome G. Porush, Marvin H. Goldstein, Gilbert M. Eisner, Marvin F. Levitt
Journal: Journal of Clinical Investigation (1961)

The term "nonspecific solute diuretic" is used for those agents which act to increase the quantity