tbuckley/cabot-search huggingface dataset:
A Hospitalization from Hell: A Patient's Perspective on Quality
Authors: Paul D. Cleary
Journal: Annals of Internal Medicine (2003)

Patients usually cannot assess the technical quality of their care; however, examining a hospitalization through the patients' eyes can reveal important information about the quality of care. Patients are the best source of information about a hospital system's communication, education, and pain-management processes, and they are the only source of information about whether they were treated with dignity and respect. Their experiences often reveal how well a hospital system is operating and can stimulate important insights into the kinds of changes that are needed to close the chasm between the care provided and the care that should be provided. This article examines the case of a patient admitted for ankle arthrodesis due to severe hemophilia-related arthritis. The surgery was successful, but the hospital stay was marked by inefficiency and inconveniences, as well as events that reveal fundamental problems with the hospital's organization and teamwork. These problems could seriously compromise the quality of clinical care. Unfortunately, most of these events occur regularly in U.S. hospitals. Relatively easy and inexpensive ways to avoid many of these problems are discussed, such as reducing variability in non-urgent procedures and routinely asking patients about their experiences and suggestions for improvement.
Salmonellosis in Disseminated Malignant Diseases
Authors: Tin Han, Joseph E. Sokal, Erwin Neter
Journal: New England Journal of Medicine (1967)

ALTHOUGH many bacterial infections, such as typhoid fever, diphtheria and pertussis, have been effectively controlled by public-health measures or immunization, the incidence of salmonellosis of man, other than typhoid fever, has been on the increase. This infection usually occurs in otherwise healthy subjects, notably in the form of food poisoning and gastroenteritis; it is seen less commonly as focal infection of various organs and salmonella fever; and finally, salmonellas are present in carriers, with or without antecedent overt illness. In addition, salmonellosis may complicate diseases such as malaria, relapsing fever, sickle-cell anemia, bartonellosis or Carrión's disease and liver disease.1 2 3 Several . . .
Autonomic and Non-Autonomic Circulatory Components in Essential Hypertension in Man
Authors: P. I. KORNER, J. SHAW, J. B. UTHER, M. J. WEST, R. J. MCRITCHIE, J. G. RICHARDS
Journal: Circulation (1973)

The circulatory effects of blocking cardiac and peripheral autonomic effectors were studied in 32 subjects with established essential hypertension, and in 15 normotensives. The mean resting arterial pressure, heart rate and total peripheral resistance index (TPRI) were significantly higher in the hypertensives, but cardiac index was the same in both groups. In subjects with blocked cardiac effectors (atropine + beta-blocking drugs, i.v.) the sympathetic constrictor effects on TPRI were estimated from the changes after giving i.v. guanethidine + phentolamine. The autonomic component of TPRI was higher in hypertensives than in normotensives. The residual resistance after `total' autonomic block (non-autonomic TPRI) was higher in hypertensives, accounting for 60 to 80% of the initial difference in resting TPRI between the two groups. With an increase in non-autonomic TPRI, the increased autonomic TPRI effect in hypertension is not necessarily due to increased sympathetic nerve activity. Vagal and cardiac sympathetic effects on heart rate were compared in the two groups. Each estimate was based on the average of the responses to the appropriate blocking drug (1) in subjects not previously given a blocking drug, and (2) in subjects with the other cardiac effector pathway already blocked. The higher heart rate in established hypertension was predominantly due to change in vagal rather than cardiac sympathetic effects.
Anal human papillomavirus infection in heterosexuals with genital warts: prevalence and relation with sexual behaviour.
Authors: C Sonnex, J H Scholefield, G Kocjan, G Kelly, C Whatrup, A Mindel, J M Northover
Journal: BMJ (1991)

The clinical and subclinical manifestations of anal human papillomavirus infection have been well reported in homosexual men.' Although anal warts have been reported to accompany genital warts in heterosexual men and women,23 the prevalence of subclinical anal human papillomavirus infection in heterosexual people has not been addressed previously. The mode of transmission of human papillomavirus to the anus is poorly understood and, although in some cases it may result from anal coitus,4 this fails to explain anal infection in heterosexual men. The aims of this study were to assess the prevalence of anal human papillomavirus infection in heterosexual men and women with genital warts and to examine whether anal infection is related to specific sexual behaviours.
Prodrug Strategy to Achieve Lyophilizable, High Drug Loading Micelle Formulations Through Diester Derivatives of β‐Lapachone
Authors: Xinpeng Ma, Xiumei Huang, Gang Huang, Longshan Li, Yiguang Wang, Xiuquan Luo, David A. Boothman, Jinming Gao
Journal: Advanced Healthcare Materials (2014)

β-Lap prodrug micelle strategy improves the formulation properties of β-lap therapeutics. The resulting micelles yield apparent high β-lap solubility (>7 mg mL−1), physical stability, and ability to reconstitute after lyophilization. In the presence of esterase, β-lap prodrugs are efficiently converted into parent drug (i.e., β-lap), resulting in NQO1-dependent lethality of NSCLC cells. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Creatinine Clearance and Age
Authors: REED E. PYERITZ
Journal: Annals of Internal Medicine (1976)

Comments1 October 1976Creatinine Clearance and AgeREED E. PYERITZ, M.D., PH.D.REED E. PYERITZ, M.D., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-4-534 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Rowe and colleagues are fortunate to have the Baltimore Longitudinal Study of Aging (BLSA) available to provide the data from which to construct the age-adjusted standards for creatinine clearance (Ann Intern Med 84:567-569, 1976). This is a unique population of middle-class, well-educated male volunteers who receive regular medical care and who are, in addition, concerned enough about the study of aging phenomena to adhere faithfully to various protocols. However, before the published nomogram finds routine use by other health professionals, several caveats deserve emphasis.Because the function of a body system such as the urinary tract depends...REFERENCE1. KLAHRALLEYNE SG: Effects of chronic protein-calorie malnutrition on the kidney. Kidney Int 3:129-141, 1973 CrossrefMedlineGoogle Scholar1. RowANDRESTOBIN JRJ: Age-adjusted standards for creatinine clearance. Ann Intern Med 84:567-569, 1976 LinkGoogle Scholar2. SIERSBAEK-NIELSENMØLHOLM HANSENKAMPMANN KJJ: Rapid evaluation of creatinine clearance. Lancet 1:1133-1134, 1971 CrossrefMedlineGoogle Scholar3. JELLIFFE R: Creatinine clearance: bedside estimate. Ann Intern Med 79:604-605, 1973 LinkGoogle Scholar4. COCKCROFTGAULT DM: Prediction of creatinine clearance from serum creatinine. Nephron 16:31-41, 1976 CrossrefMedlineGoogle Scholar5. DOBBSMAWERRODGERS SGE: Can digoxin dose requirements be predicted. Br J Clin Pharmacol 3:231-237, 1976 CrossrefMedlineGoogle Scholar6. CHRISTIANSENKØLENDORFSIERSBAEK-NIELSEN NKK: Serum digoxin values following a dosage regimen based on body weight, sex, age and renal function. Acta Med Scand 194:257-259, 1973 CrossrefMedlineGoogle Scholar7. LUMHOLTZKAMPMANNSIERSBAEK-NIELSEN BJK: Dose regimen of kanamycin and gentamicin. Acta Med Scand 196:521-524, 1974 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 ByEvaluation of changes in renal function in PARAMOUNT: a phase III study of maintenance pemetrexed plus best supportive care versus placebo plus best supportive care after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancerECarbohydrates 1 October 1976Volume 85, Issue 4Page: 534-536KeywordsAgingCreatinineLongitudinal studies Issue Published: 1 October 1976 PDF DownloadLoading ...
Hirsutism and virilisation.
Authors: J Ginsburg, M C White
Journal: BMJ (1980)

Hirsutism by definition describes the quality of body hair, implying coarseness, but common usage has extended the mean ing to denote an excess of hair?locally or generalised. Body hair is of two types: fine, non-pigmented vellus hair?for example, facial down?and coarser pigmented terminal hair as in the scalp and axillas. The visual impression of hairiness is produced by the coarser type. Hirsutism reflects the response of hair follicles to androgenic stimulation, and is therefore a symp tom and a clinical sign but not a specific disease entity. Both genetic and hormonal factors affect hair growth, and in different parts of the world cultural factors determine what is socially acceptable in respect of quality, quantity, and distribution of body hair. Thus hirsutism that is quite acceptable in one com munity may cause severe embarrassment or even psychological disturbance to a woman in another. Yet around 30% of women between the ages of 15 and 44 normally have hair on the upper lip, 9% on the chin, and 6% on the sides of the face.1 In virilisation progressive hirsutism is complicated by deepen ing of the voice, clitoromegaly, temporal hair recession, breast atrophy, and an increase in muscle bulk. The appearance of any of these additional signs is an indication for full investigation.
Abstract 2038: Establishment and analysis of an in vitro model for hemangioblastomas of the central nervous system
Authors: Ana Martins Metelo, Elizabeth Lockerman, Fred Barker, Jeffrey Engelman, Othon Iliopoulos
Journal: Cancer Research (2014)

Abstract Von-Hippel Lindau (VHL) disease is a familial genetic syndrome characterized by a germline mutation in the VHL gene. VHL patients develop different tumors, including renal cell carcinomas, pheochromocytomas and hemangioblastomas (HB). HBs are complex tumors located in the central nervous system and are currently the main cause of morbidity and mortality among VHL patients. 60-80% percent of VHL patients will develop multiple, synchronous or metachronous HBs in the Central Nervous System. These tumors can also occur sporadically. HBs are refractory to radiation or current targeted therapies. Surgery is the only treatment modality, but due to their location (brain, cerebellum, spine and retina) surgery may be debilitated or not even feasible at all. Both alleles of the VHL gene were reported as inactivated (mutations and LOH studies) in both VHL-related and sporadic HB, but the cellular component(s) harboring this bi-allelic inactivation are unknown. HBs have a complex histology and unclear cell lineage. They are known to consist of a network of stromal cells, endothelial cells and pericytes. Hematopoetic cells may also be present in some HB tumors. In addition to this cellular complexity, the origin of the tumor cell -“stromal cell” - remains unknown. To gain insight into the biology and therapeutic targets of HB, we established an in vitro model of the disease. Using modifications of a previously described technique (Am J Pathol. 2012;180(2):599-607) we generated cell lines from hemangioblastomas of VHL patients. This approach allows the propagation of diverse cell clones, reflecting the complexity of the tumor microenvironment. The different clones and polyclonal populations were characterized using qRTPCR and immunofluorescence. The molecular and phenotypic analysis of the cell lines will be presented. This resource is fundamental for the study of HB biology and it will allow us to dissect the cellular origin of these tumors. In addition, it may facilitate the development of HB xenografts. Citation Format: Ana Martins Metelo, Elizabeth Lockerman, Fred Barker, Jeffrey Engelman, Othon Iliopoulos. Establishment and analysis of an in vitro model for hemangioblastomas of the central nervous system. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2038. doi:10.1158/1538-7445.AM2014-2038
STUDIES ON THE GENERALIZED SHWARTZMAN REACTION
Authors: Lewis Thomas, Floyd W. Denny, Joan Floyd
Journal: The Journal of Experimental Medicine (1953)

Cutaneous and systemic infections of rabbits by Group A streptococci bring about a state of preparation for, respectively, the local and generalized Shwartzman reactions, produced by intravenous injection of meningococcal or S. marcescens toxin. With maximal systemic streptococcal infections, the lesions of the generalized Shwartzman reaction do not differ from those caused by two successive intravenous injections of Gram-negative bacterial toxins. The characteristic lesions of the reaction are bilateral cortical necrosis of the kidneys, hemorrhagic necrosis in the lungs, liver, and spleen, and myofiber necrosis in the myocardium. Under optimal conditions involving the dosages of streptococci and toxin, and the time interval between the injections, a new lesion consisting of necrosis and the accumulation of fibrinoid material in the walls of the coronary arteries occurred in approximately 50 per cent of animals within 48 hours after the injection of meningococcal toxin. Fibrinoid necrosis was not observed in the arteries of tissues other than the heart. It did not occur in control rabbits injected with streptococci alone or toxin alone, nor in animals with the generalized Shwartzman reaction produced by two intravenous injections of toxin. Streptococcal bacteriemia was present at the time of death in one-third of the animals with fibrinoid necrosis. In one animal, a group of bodies resembling cocci in chains was seen within the wall of a coronary artery with fibrinoid necrosis. A series of photomicrographs to illustrate the pathological changes in the hearts and kidneys of streptococcus-infected rabbits subjected to the Shwartzman reaction is presented.
Abstract 1306: Synergistic function of a novel cell cycle regulator, Ecdysoneless with oncogenic Ras in the regulation of cell cycle and transformation
Authors: Aditya Bele, Sameer Mirza, Riyaz Mir, Shakur Mohibi, Hamid Band, Vimla Band
Journal: Cancer Research (2014)

Abstract We have previously identified the mammalian ortholog of Drosophila ecdysoneless (Ecd) protein as a novel and essential regulator of Rb-E2F-dependent cell cycle progression. Consistent with role of Ecd in cell cycle, our recent studies show Ecd is overexpressed in breast cancer cell lines as well as in ductal carcinoma in situ and infiltrating ductal carcinomas of the breast. To explore the mechanism of Ecd overexpression and its correlation with oncogenesis, we overexpressed either Ecd alone, HRas-61L alone or both genes together in hTERT-immortalized human mammary epithelial cells (hMECs). These transfectants were then examined for their oncogenic properties. We observed while vector infected cells do not exhibit anchorage independence, all three transfectants showed increase in anchorage independent proliferation, particularly Ecd+Ras showed a significant increase in anchorage independence in comparison with either Ecd or Ras. Similarly, other oncogenic traits such as proliferation on matrigel, invasion and migration were dramatically increased when both genes were expressed in comparison with individual genes. Further analysis showed Ecd+Ras-expressing hMECs were unable to synchronize completely after growth factor deprivation and showed rapid progression into cell cycle, demonstrating synergy in altered cell cycle pathways in these cells. Most significantly, Ecd+Ras expressing hMECs were able to form tumors when implanted into mammary fat pads of NOD-SCID mice, whereas no tumors were observed with Ecd or Ras alone. These results demonstrate complete transformation of hMECs by overexpression of Ecd together with mutant Ras. Considering the known oncogenic role of Ras in human cancer and the known role of Ecd in cell cycle, these data are highly significant and present a novel synergistic pathway for mammary cell transformation. Current studies are directed towards defining the mechanism of synergy between Ecd and Ras in cellular transformation. Citation Format: Aditya Bele, Sameer Mirza, Riyaz Mir, Shakur Mohibi, Hamid Band, Vimla Band. Synergistic function of a novel cell cycle regulator, Ecdysoneless with oncogenic Ras in the regulation of cell cycle and transformation. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1306. doi:10.1158/1538-7445.AM2014-1306
Painkillers before knee surgery improve outcomes
Authors: J. H. Tanne
Journal: BMJ (2003)

Patients who had pre-emptive treatment of pain with a cyclooxygenase-2 (COX 2) inhibitor before knee replacement surgery had less pain and vomiting after the surgery, needed fewer opioids, slept better, had better knee flexion, and needed less physical therapy. The randomised controlled trial was reported by …
Review: Combining 2 classes of blood pressure–lowering drugs has an approximately additive effect on systolic blood pressure
Authors: Alena Shantsila
Journal: Annals of Internal Medicine (2009)

Source Citation Wald DS, Law M, Morris JK, Bestwick JP, Wald NJ. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11, 000 participants from 42 trials. Am J Med. 2009;122:290-300. 19272490
A memorable patient (and doctor): Nothing said
Authors: D C Owen
Journal: BMJ (2001)

I was undertaking my first surgical block of training in medical school. A group of us were shadowing a surgical senior house officer during his intake. The patient was a young woman who presented in a busy admissions department with abdominal pain.

The case was memorable because of the patient's resounding screaming and crying, which drowned out all the background noise. The medical students looked on anxiously, but the senior house officer was calm and unmoved. He examined the patient, ordered a urine test, and proceeded to the next case. I was confused. Surely the woman had something terribly wrong with her, but no words were spoken to either the patient or the students. I never did find out what was wrong with that woman.

What the case taught me, in retrospect, was that psychiatry is relevant to all medical disciplines. It may have been that the patient had emotional lability as part of an underlying mental illness, but such aspects of a case were rarely discussed during my medical training. Occasionally, or perhaps frequently, clinicians remarked glibly that a patient had “supratentorial overlay.” A dismissive approach would then usually be adopted.

I hope that medical training has moved beyond this, otherwise students will remain in the dark, puzzled by the apparent cold and uncaring manner of some of those they are following and may wish to emulate in their chosen profession.
OBSTETRIC SIGNIFICANCE OF BARBITURATES AND VITAMIN K
Authors: J. E. FITZGERALD
Journal: JAMA (1942)

It is well known that various types of hemorrhage in the newborn account for a considerable percentage of stillbirths and neonatal deaths. Bundesen and others<sup>1</sup>reported that there were 237 deaths from intracranial hemorrhage among 2,260 neonatal deaths in 1936 and 1937. In an endeavor to decrease the percentage of stillbirths and to decrease mortality and maldevelopment in the newborn, we have studied the effect of vitamin K administered in various ways to women in labor or administered directly to the newborn. In a previous article<sup>2</sup>we reviewed the history of vitamin K and appended an extensive bibliography. The cases cited in that article are included in this report. The methods of determining the prothrombin were the same for the whole series, namely a modification of the Smith bedside technic for determinations on maternal and cord blood and the micro method of Kato and Poncher for determinations on
WHO welcomes G8's commitment on AIDS, but campaign group says it is not enough
Authors: Paul Ress
Journal: BMJ (2005)

The G8's “aim of providing near-universal access to AIDS treatment for all people living with HIV/AIDS by 2010, combined with prevention and care, has the potential to turn the tide on this epidemic,” said Lee Jong-wook, director general of the World Health Organization. “The G8 has made an unprecedented commitment to health which has the potential to forever change the lives of millions of people in Africa,” he added.

But the UK …
Diamine oxidase (histaminase). A circulating marker for rat intestinal mucosal maturation and integrity.
Authors: G D Luk, T M Bayless, S B Baylin
Journal: Journal of Clinical Investigation (1980)

Diamine oxidase (histaminase) is an enzyme found in high concentrations in the intestinal mucosa of humans and other mammalian species. We investigated whether plasma and mucosal levels of diamine oxidase activity reflect both the maturational status of the mucosa during its development in the newborn rate and the degree of mucosal damage during its injury in the adult rat. Litter mates were reared under identical conditions and killed at different ages from day 0 to day 40 after birth. Diamine oxidase in the small intestine was low at birth, increased gradually with age, reached a peak at 22 d, and then remained at normal adult levels, similar to the developmental patterns of maltase and sucrase. Plasma diamine oxidase rose in parallel with intestinal levels (n = 500, r = 0.84, P less than 0.001), reached a peak at 24 d, and then remained at normal adult levels. Diamine oxidase activity in 15 nonintestinal tissues was less than 5% of ileal mucosal activity, and no nonintestinal activities showed increase with age. Adult rat intestinal loops were perfused with hyperosmolar sodium sulfate solutions to produce selective damage to villus mucosa. With increasing mucosal damage, there was a progressive decrease in the enzyme activities studied; first, lactase levels fell, then maltase and sucrase, and finally mucosal and plasma diamine oxidase activity levels fell. The decrease in plasma diamine oxidase reflected the degree of mucosal damage (n = 29, P less than 0.04). Diamine oxidase activity is thus unique among intestinal mucosal enzymes studied to date in that circulating levels can serve as a marker of mucosal maturation and integrity.