tbuckley/cabot-search huggingface dataset:
Tuberculosis of the Spine on Tc-99m MDP Bone Scan
Authors: Gopinath Gnanasegaran, Tara Barwick, Heather Milburn, Sanjay Vijayanathan, Ignac Fogelman
Journal: Clinical Nuclear Medicine (2009)

Dedicated multislice single-photon emission computed tomography-computed tomography (SPECT-CT) is useful for accurate anatomic localization and lesion characterization of abnormal findings on planar scintigraphy. We present a case of a 33-year-old woman with a history of low back pain. Lumbar spine radiographs demonstrated irregularity of the superior end plate of L2 with an associated compression fracture. A Tc-99m MDP bone scan was performed given her young age and the absence of a history of trauma. The whole body planar imaging revealed nonspecific findings of diffuse linear increased tracer uptake involving L2. The SPECT-CT findings were in keeping with spinal tuberculosis. This was confirmed with culture of CT-guided aspiration of a left psoas collection, which revealed heavy growth of Mycobacterium tuberculosis. This case highlights the benefits of multislice SPECT-CT imaging in the anatomic localization of increased metabolic activity and provision of additional diagnostic information. This enabled rapid diagnosis and management.
Reduction of reperfusion injury in the canine preparation by intracoronary adenosine: importance of the endothelium and the no-reflow phenomenon.
Authors: B Olafsson, M B Forman, D W Puett, A Pou, C U Cates, G C Friesinger, R Virmani
Journal: Circulation (1987)

We hypothesized that the endogenous coronary vasodilator adenosine may reduce infarct size by progressively increasing reflow in a preparation of coronary occlusion-reperfusion. After 90 min of proximal left anterior descending artery occlusion, 20 dogs were randomized to blood reperfusion with (n = 10) or without (n = 10) adenosine into the proximal left anterior descending vessel at 3.75 mg/min for 60 min after reperfusion. Regional myocardial blood flow was determined serially with microspheres and regional ventricular function was assessed by a computerized radial shortening method. At 24 hr, the area at risk was defined in vivo with monastral blue dye and area of necrosis was determined after incubation of left ventricular slices in triphenyltetrazolium chloride. Hemodynamic variables were similar in the two groups during the experimental protocol. Infarct size was significantly reduced in treated animals, both when expressed as a percentage of the area at risk (9.9 +/- 2.8% vs 40.9 +/- 6.6%, p less than .001) and as a percentage of the left ventricle (4.6 +/- 1.3% vs 18.0 +/- 3.4%, p = .002). This was associated with significant improvement in radial shortening in the ischemic zone 24 hr after reperfusion (10.1 +/- 2.5 vs -2.8 +/- 2.2%, p less than .01). Regional myocardial blood flow was significantly increased in endocardial and epicardial regions from the lateral ischemic zone 1 hr after reperfusion in adenosine-treated animals. Light microscopy demonstrated decreased neutrophil infiltration in the ischemic zone and electron microscopy showed relative preservation of endothelial structure in the subendocardium with reduced neutrophil and red cell stagnation of capillaries in the treated group. These findings suggest that intracoronary administration of adenosine after reperfusion significantly reduces infarct size and improves regional ventricular function in the ischemic zone in the canine preparation.
Novel biodegradable lipid nano complex for siRNA delivery significantly improving the chemosensitivity of human colon cancer stem cells to paclitaxel
Authors: Changxing Liu, Gang Zhao, Jian Liu, Nianchun Ma, Padmanabh Chivukula, Loren Perelman, Keisaku Okada, Zongyou Chen, David Gough, Lei Yu
Journal: Journal of Controlled Release (2009)
Human rights abuses are fuelling HIV epidemic, charities say
Authors: P. Moszynski
Journal: BMJ (2008)

Nitric oxide (NO) is now recognized as a transmitter of neurons that express the neuronal isoform of the enzyme nitric oxide synthase. NO, however, violates some of the key tenets of chemical transmission, which is classically regarded as occurring at points of close apposition between neurons. It is the ability of NO to diffuse isotropically in aqueous and lipid environments that has suggested a radically different form of signaling in which the transmitter acts four-dimensionally in space and time, affecting volumes of the brain containing many neurons and synapses. Although “volume signaling” clearly challenges simple connectionist models of neural processing, crucial to its understanding are the spatial and temporal dynamics of the spread of NO within the brain. Existing models of NO diffusion, however, have serious shortcomings because they represent solutions for “point-sources,” which have no physical dimensions. Methods for overcoming these difficulties are presented here, and results are described that show how NO spreads from realistic neural architectures with both simple symmetrical and irregular shapes. By highlighting the important influence of the geometry of NO sources, our results provide insights into the four-dimensional spread of a diffusing messenger. We show for example that reservoirs of NO that accumulate in volumes of the nervous system where NO is not synthesized contribute significantly to the temporal and spatial dynamics of NO spread.
South American pemphigus foliaceus: electron microscopy and immunoelectron localization of bound immunoglobulin in the skin and oral mucosa
Authors: MIRIAN N. SOTTO, SUMIE HOSHINO SHIMIZU, JULIA MARIA COSTA, T. DE BRITO
Journal: British Journal of Dermatology (1980)

Five skin and two oral biopsies from patients with South American pemphigus foliaceus (SAPF) were studied by electron and immunoelectron microscopy for the ultrastructural localization of bound immunoglobulin in epidermal and oral lesions. Electron microscopy showed the tonofilament-desmosome complex to be preserved in the various layers of the epidermis. Immunoglobulin was bound over the plasma membrane and permeated the desmosomal junctions both in the skin and oral mucosa, thus suggesting that pemphigus antibodies are attached to the glycocalyx. It appears that the initial injury in SAPF acantholysis involves the glycocalyx and that it might be caused by interaction with intercellular antibodies present in the patient's serum.
Ankle Brachial Pressure Index
Authors: J G Jones
Journal: Journal of the Royal Society of Medicine (2007)

It is clear the authors are ignorant of the role, training and history of my profession; otherwise they would have known better than to use the surgical role as their example.To appreciate the folly of this example, one must understand that for many years the theatre nursing hierarchy sought to deny ODPs the opportunity to practice in the surgical role-claiming this 'a purely nursing function'.My profession was then predominantly associated with providing care as part of the anaesthetic team, where patients are initially conscious, often fearful and requiring both psychological and physiological support.As far back as the 1970s our syllabus incorporated patient care (e.g.'Respect the dignity and rights of the patient; Principles of ethics and etiquette; Psychological reaction of patients to surgery and the theatre environment').These were introduced early and developed throughout the course.Today's qualification has developed these themes into the modern era, with emphasis on the assessment, planning and evaluation of care.Caring is not genetically implanted into nurses, but taught to all professions with caring responsibilities.The notion that ODPs are 'expropriating nurses' knowledge and skills' is laughable.We had the first nationally organized course in operating department practice in 1951.In 1989 Bevan 2 noted 'only 13.8% of nurses working in theatre had received post-registration training in operating department and/or anaesthetic nursing.'Throughout the 1990s the NVQ in Operating Department Practice, the ODP's primary qualification, was taken by many perioperative nurses as their preferred postgraduate qualification.
Chemotherapy in Psychiatry
Authors: Frank J. Ayd
Journal: JAMA (1977)

The author of this lucid and compact monograph is an academician, a clinician, a researcher, and a gifted teacher and writer who for years has been conducting successful seminars in psychopharmacology at Massachusetts General Hospital. He has used his many talents and critical judgment to produce this pragmatic, authoritative guide to the safe, effective, and economical prescription of antipsychotic, antimanic, antidepressant, and antianxiety drugs. Each group of these medicines is briefly but amply covered in separate chapters. In addition, there is an excellent exposition on psychopharmacotherapy for children and the elderly.  This is a book for clinicians by a colleague who believes  psychiatric chemotherapy requires more than recognition of a syndrome and selection of an appropriate agent and dose and that personal sensitivity and effective application of more traditional psychological and social aspects of psychiatric care are still required. In this distillate of his encyclopedic knowledge of psychopharmacotherapy, he
Breath condenser coatings affect measurement of biomarkers in exhaled breath condensate
Authors: P. P. Rosias, C. M. Robroeks, H. J. Niemarkt, A. D. Kester, J. H. Vernooy, J. Suykerbuyk, J. Teunissen, J. Heynens, H. J. Hendriks, Q. Jöbsis, E. Dompeling
Journal: European Respiratory Journal (2006)

Exhaled breath condensate collection is not yet standardised and biomarker measurements are often close to lower detection limits. In the current study, it was hypothesised that adhesive properties of different condenser coatings interfere with measurements of eicosanoids and proteins in breath condensate. In vitro, condensate was derived from a collection model using two test solutions (8-isoprostane and albumin) and five condenser coatings (silicone, glass, aluminium, polypropylene and Teflon). In vivo , condensate was collected using these five coatings and the EcoScreen® condenser to measure 8-isoprostane, and three coatings (silicone, glass, EcoScreen®) to measure albumin. In vitro , silicone and glass coatings had significantly higher albumin recovery compared with the other coatings. A similar trend was observed for 8-isoprostane recovery. In vivo, median (interquartile range) 8-isoprostane concentrations were significantly higher using silicone (9.2 (18.8) pg·mL -1 ) or glass (3.0 (4.5) pg·mL -1 ) coating, compared with aluminium (0.5 (2.4) pg·mL -1 ), polypropylene (0.5 (0.5) pg·mL -1 ), Teflon (0.5 (0.0) pg·mL -1 ), and EcoScreen® (0.5 (2.0) pg·mL -1 ). Albumin in vivo was mainly detectable using glass coating. In conclusion, a condenser with silicone or glass coating is more efficient for measurement of 8-isoprostane or albumin in exhaled breath condensate, than EcoScreen®, aluminium, polypropylene or Teflon. Guidelines for exhaled breath condensate standardisation should include the most valid condenser coating to measure a specific biomarker.
Aspergillus Infections in Cancer Patients
Authors: Joseph Aisner
Journal: JAMA (1976)

INFECTION is the major cause of mortality in patients with acute leukemia and lymphoma.<sup>1-3</sup>Among infections in patients with altered host defenses, an increasing incidence of such fungal complications is well established.<sup>4-6</sup>Fungal infections caused by<i>Aspergillus</i>spp are second in frequency only to candidiasis in these patient populations.<sup>3-5,7</sup>When present,<i>Aspergillus</i>infections are the major contributory factor to their demise,<sup>6,8</sup>and are of serious consequence in patients receiving immunosuppressive therapy for other circumstances, such as collagen vascular diseases,<sup>9</sup>renal transplants,<sup>10</sup>and cardiac transplants.<sup>11</sup> The Baltimore Cancer Research Center admits for intensive therapy patients with acute and chronic leukemia, lymphoma, multiple myeloma, brain tumors, metastatic sarcomas, and metastatic carcinomas. In the past six years there has been essentially no change in either the basic patient population or in treatment philosophy. The necropsy rate has remained consistently high. Shortly after relocation of the Center to
F-18 FDG PET/CT Evaluation of Osseous and Soft Tissue Sarcomas
Authors: Andrei Iagaru, Andrew Quon, I Ross McDougall, Sanjiv S. Gambhir
Journal: Clinical Nuclear Medicine (2006)

Osseous and soft tissue sarcomas (OSTS) represent a histologic heterogeneous group of malignant tumors. Most of the current clinical data on the role of F-18 FDG PET in sarcomas come from patients studied with dedicated PET and less frequently with hardware fusion PET/CT. Therefore, we were prompted to review our experience with F-18 FDG PET/CT in OSTS.This is a retrospective study (January 2003-December 2005) of 44 patients with histologic diagnoses of OSTS who had F-18 FDG PET/CT at our institution. The group included 22 men and 22 women with an age range of 2 of 84 years (average, 37 +/- 20.2 years). The administered doses of F-18 FDG range 4.1 to 19.5 mCi (average, 14.3 +/- 3 mCi). Reinterpretation of the imaging studies for accuracy and data analysis from medical records was performed.The sensitivity and specificity of combined F-18 FDG PET/CT were 100% (95% confidence interval [CI] = 75.7-100) and 93.3% (95% CI = 78.7-98.1) for the primary OSTS, and 80% (95% CI = 58.4-91.9) and 86.4% (95% CI = 66.7-95.2) for metastases. When interpreted separately, CT outperformed PET for pulmonary metastases detection: CT was 76.5% sensitive and 88% specific, whereas PET was only 57.1% sensitive but 96.4% specific. For detection of other metastases, CT was 82.3% sensitive and 76% specific, with PET demonstrating 78.6% sensitivity and 92.8% specificity.Relatively similar results (except better specificity for PET and PET/CT) were noted when examining the rate of metastases detection, excluding pulmonary lesions. However, CT had a better detection rate for pulmonary metastases when compared with PET alone. A negative PET scan in the presence of suspicious CT findings in the chest cannot reliably exclude pulmonary metastases from OSTS.
Effects of Acetazolamide on Ventilatory, Cerebrovascular, and Pulmonary Vascular Responses to Hypoxia
Authors: Luc J. Teppema, George M. Balanos, Craig D. Steinback, Allison D. Brown, Glen E. Foster, Henry J. Duff, Richard Leigh, Marc J. Poulin
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Acute mountain sickness (AMS) may affect individuals who (rapidly) ascend to altitudes higher than 2,000-3,000 m. A more serious consequence of rapid ascent may be high-altitude pulmonary edema, a hydrostatic edema associated with increased pulmonary capillary pressures. Acetazolamide is effective against AMS, possibly by increasing ventilation and cerebral blood flow (CBF). In animals, it inhibits hypoxic pulmonary vasoconstriction.We examined the influence of acetazolamide on the response to hypoxia of ventilation, CBF, and pulmonary vascular resistance (PVR).In this double-blind, placebo-controlled, randomized study, nine subjects ingested 250 mg acetazolamide every 8 h for 3 d. On the fourth test day, we measured the responses of ventilation, PVR, and CBF to acute isocapnic hypoxia (20 min) and sustained poikilocapnic hypoxia (4 h). Ventilation was measured with pneumotachography. Hypoxia was achieved with dynamic end-tidal forcing. The maximum pressure difference across the tricuspid valve (DeltaPmax, a good index of PVR) was measured with Doppler echocardiography. CBF was measured by transcranial Doppler ultrasound.In normoxia, acetazolamide increased ventilation and reduced DeltaPmax, but did not influence CBF. The ventilatory and CBF responses to acute isocapnic hypoxia were unaltered, but the rise in DeltaPmax was reduced by 57%. The increase in DeltaPmax by sustained poikilocapnic hypoxia observed after placebo was reduced by 34% after acetazolamide, the ventilatory response was increased, but the CBF response remained unaltered.Acetazolamide has complex effects on ventilation, PVR, and CBF that converge to optimize brain oxygenation and may be a valuable means to prevent/treat high-altitude pulmonary edema.
ASSOCIATION BETWEEN CORONARY ARTERY CALCIUM SCORE AND ARTERIAL ELASTICITY: AN ANALYSIS OF HEALTHY LOW RISK MULTIETHNIC US ADULTS
Authors: Sidakpal S. Panaich, Naga VA Kommuri, Sandip K. Zalawadiya, Vikas Veeranna, Ashutosh Niraj, Maithili Shenoy, Ramanjit Kaur, Sony Jacob, Luis Afonso
Journal: Journal of the American College of Cardiology (2011)
High Risk of Unexpected Late Fetal Death in Monochorionic Twins Despite Intensive Ultrasound Surveillance: A Cohort Study
Authors: Olivia Barigye, Lucia Pasquini, Paula Galea, Helen Chambers, Lucy Chappell, Nicholas M Fisk
Journal: PLoS Medicine (2005)

Background The rationale for fetal surveillance in monochorionic twin pregnancies is timely intervention to prevent the increased fetal/perinatal morbidity and mortality attributed to twin–twin transfusion syndrome and intrauterine growth restriction. We investigated the residual risk of fetal death after viability in otherwise uncomplicated monochorionic diamniotic twin pregnancies. Methods and Findings We searched an electronic database of 480 completed monochorionic pregnancies that underwent fortnightly ultrasound surveillance in our tertiary referral fetal medicine service between 1992 and 2004. After excluding pregnancies with twin–twin transfusion syndrome, growth restriction, structural abnormalities, or twin reversed arterial perfusion sequence, and monoamniotic and high-order multiple pregnancies, we identified 151 uncomplicated monochorionic diamniotic twin pregnancies with normal growth, normal liquor volume, and normal Doppler studies on fortnightly ultrasound scans. Ten unexpected intrauterine deaths occurred in seven (4.6%) of 151 previously uncomplicated monochorionic diamniotic pregnancies, within 2 wk of a normal scan, at a median gestational age of 34+1 wk (weeks+days; range 28+0 to 36+3). Two of the five cases that underwent autopsy had features suggestive of acute late onset twin–twin transfusion syndrome, but no antenatal indicators of transfusional imbalance or growth restriction, either empirically or in a 1:3 gestation-matched case–control comparison. The prospective risk of unexpected antepartum stillbirth after 32 wk was 1/23 monochorionic diamniotic pregnancies (95% confidence interval 1/11 to 1/63). Conclusion Despite intensive fetal surveillance, structurally normal monochorionic diamniotic twin pregnancies without TTTS or IUGR are complicated by a high rate of unexpected intrauterine death. This prospective risk of fetal death in otherwise uncomplicated monochorionic diamniotic pregnancies after 32 wk of gestation might be obviated by a policy of elective preterm delivery, which now warrants evaluation.
An Epidemiologic Study of Contraception and Preeclampsia
Authors: Hillary S. Klonoff-Cohen, David A. Savitz, Robert C. Cefalo, Margaret F. McCann
Journal: JAMA (1989)

The primary hypothesis of this study was that contraceptive methods that prevent exposure to sperm and seminal fluid (condoms, diaphragms, spermicides, withdrawal) are associated with an increased risk of developing preeclampsia during the subsequent pregnancy. A case-control study was conducted comparing the contraceptive and reproductive histories of 110 primiparous women with preeclampsia with 115 pregnant women without preeclampsia, aged 15 to 35 years, who gave birth at North Carolina Memorial Hospital, Chapel Hill, between 1984 and 1987. Controls were frequency matched to cases by age, race, and distance from the hospital. Unconditional logistic regression analysis indicated a 2.37-fold (95% confidence interval, 1.01 to 5.58) increased risk of preeclampsia for users of contraceptives that prevent exposure to sperm. A dose-response gradient was observed, with increasing risk of preeclampsia for those with fewer episodes of sperm exposure. These results were supportive of the hypothesis that birth control methods that prevent sperm exposure may play a role in the etiology of preeclampsia.
Gene regulation and genetic susceptibility to neoplastic transformation: AP-1 and p80 expression in JB6 cells.
Authors: L R Bernstein, E T Ben-Ari, S L Simek, N H Colburn
Journal: Environmental Health Perspectives (1991)

The mouse epidermal JB6 cell system consists of clonal genetic variants that are sensitive (P+) or resistant (P-) to the promotion of neoplastic transformation by phorbol esters and other tumor-promoting agents. P+ cells display AP-1-dependent phorbol-ester-inducible transactivation of gene expression, whereas P- cells have a defect in transactivation. Transfection of promotion sensitivity gene pro-1 into P- cells reconstituted both P+ phenotype and AP-1-dependent phorbol-ester-inducible transactivation. P- and P+ cells exhibited induction of c-jun and c-fos messenger RNA levels by phorbol ester, but P- cells had significantly lower basal and induced levels of jun mRNA than P+ cells. Basal and induced levels of c-jun protein were significantly lower in P- cells as well. Differences in levels the 80-kDa pI 4.5 protein p80 were also observed in JB6 cells as a function of preneoplastic progression; high levels of p80 protein and mRNA were observed in P- cells, intermediate levels in P+ cells, and negligible levels were observed in transformed derivatives of JB6 cells. Phorbol ester treatment induced phosphorylation but not synthesis of p80. These data are consistent with the hypotheses that AP-1 is required in the signal transduction pathway for promotion of neoplastic transformation by tumor promoter, that pro genes may control AP-1 activity, that threshold levels of Jun mRNA and protein may play a role in transactivation and promotion sensitivity, and that the p80 protein in JB6 cells may behave in vivo as a suppressor of cellular transformation.
Villous adenoma of the common hepatic duct: the role of ultrasound in management.
Authors: P E Jennings, J Rode, A Coral, J Dowsett, W R Lees
Journal: Gut (1990)

<b>Background:</b> There is a broad literature exploring the investigation, treatment, management and outcomes of patients suffering from pulmonary embolism (PE). Chronic thromboembolic pulmonary hypertension (CTEPH) has been studied but less is known about outcomes for the large majority of individuals surviving PE who do not have persistent thrombus or CTEPH. <b>Methods:</b> Radiology, hospital and primary care records were reviewed in patients with central pulmonary emboli presenting to a large hospital in South Wales between 2013-16. <b>Results:</b> 2501 CTPA were reviewed. 380 (15.2%) showed PE and of these 127 (33.4%) involved the main pulmonary arteries or the pulmonary trunk. 4 patients received systemic and 1 catheter directed thrombolysis. 16 (12.6%) patients died of PE during the admission. Excluding patients dying within 3 months, 49 patients (48.5%) were more SOB than before the PE (73.7 % if there was evidence of right heart strain during admission). Of these 5 patients (10.2%) had evidence of persisting PE and/or pulmonary hypertension. In patients with no evidence of persisting clot or pulmonary hypertension where full lung function was performed there was an isolated reduction in gas transfer measurement (mean TLCO 57%). <b>Conclusion:</b> Many patients remain breathless following large volume pulmonary embolism particularly in those with evidence of right ventricular strain at presentation. The pathophysiology is unclear but lung function testing is consistent with persisting damage to the pulmonary vascular bed. These findings may allow clinicians to better advise patients of expected outcomes following major pulmonary embolus and may avoid unnecessary further investigation.