tbuckley/cabot-search huggingface dataset:
Memory of intraoperative events
Authors: J G Jones
Journal: BMJ (1994)

Considerable public interest and anxiety exist about patients waking up during general anaesthesia with explicit memories of painful and terrifying intraoperative events. Using conventional clinical signs, anaesthetists find it almost impossible to recognise conscious awareness in patients with complete neuromuscular blockade.1 In elective surgery such awareness is often due to the anaesthetists not realising that the delivery of anaesthetic has failed. Occasionally there are fictitious claims of conscious awareness, and rarely there are cases with no obvious explanation.

Fortunately, the incidence of conscious awareness with pain during surgery is only 0.01% during elective general anaesthesia.2 The incidence has fallen considerably since the 1960s, when Hutchinson found that 0.6% of patients anaesthetised with unsupplemented nitrous oxide were awake and in pain.3 The incidence is much higher during operations for major trauma, where anaesthetic concentrations are reduced to preserve cardiovascular function.4

The psychological consequences of conscious awareness with explicit memory of pain are not known. Moerman et al described the sequelae in 26 patients.1 Eleven had a persistent fear of anaesthesia; seven had sleep disturbances, nightmares, anxiety, or mental distress; and eight had no ill effects. The proportion of …
Increased Risk of Pneumonia and Bronchiolitis after Bacterial Colonization of the Airways as Neonates
Authors: Nadja H. Vissing, Bo L. K. Chawes, Hans Bisgaard
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Rationale: The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation. We hypothesized that alterations in the airway microbiome in early life may be associated with susceptibility to pneumonia and bronchiolitis in young children.Objectives: To investigate the relation between neonatal airway colonization and pneumonia and bronchiolitis during the first 3 years of life.Methods: Participants comprised children of the Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) cohort, a prospective birth cohort study of 411 children born to mothers with asthma. Aspirates from the hypopharynx at age 4 weeks were cultured for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. Clinical information on pneumonia and bronchiolitis within the first 3 years of life was prospectively collected by the research physicians at the center. Analyses were adjusted for covariates associated with pneumonia and bronchiolitis and bacterial airway colonization.Measurements and Main Results: Hypopharyngeal aspirates and full clinical follow-up until 3 years of age were available for 265 children. Of these, 56 (21%) neonates were colonized with S. pneumoniae, H. influenzae, and/or M. catarrhalis at 4 weeks of age. Colonization with at least one of these microorganisms (but not S. aureus) was significantly associated with increased incidence of pneumonia and bronchiolitis (adjusted incidence rate ratio, 1.79 [1.29–2.48]; P < 0.005) independently of concurrent or later asthma.Conclusions: Neonatal airway colonization with S. pneumoniae, H. influenzae, or M. catarrhalis is associated with increased risk of pneumonia and bronchiolitis in early life independently of asthma. This suggests a role of pathogenic bacterial colonization of the airways in neonates for subsequent susceptibly to pneumonia and bronchiolitis.
US broadcast regulator says "sponsorship" of news should be disclosed
Authors: B. Roehr
Journal: BMJ (2012)

The US regulator of broadcasting has called for greater disclosure of the use of unacknowledged corporate placement of “news” stories on television broadcasts, a practice widely used by hospitals to promote their products and services.

The US Federal Communications Commission says that the practice, called “pay for play,” involves a business or other interest providing some or all of the video and reporting in a story, which the station uses as part of its newscast. The company may simply make the material available for free, pay for its placement, or purchase advertising as part of a package deal.

The commission says …
Thrombotic-Hemorrhagic Diathesis of Polycythemia Vera Treated With Aspirin
Authors: Joel M. Levin
Journal: JAMA (1974)

MUCH has been written in the recent literature concerning both platelet function and the use of antiplatelet drugs to control thrombotic complications of various disease entities. Polycythemia vera is complicated by a hemorrhagic-thrombotic diathesis in 33% to 50% of patients.<sup>1</sup>We present a case of polycythemia vera in which the problem of disseminated intravascular coagulopathy (DIC) syndrome was successfully treated with aspirin. <h3>Report of a Case</h3> A 70-year-old woman was admitted to St. Joseph's Hospital Sept 18, 1972, with severe dyspnea and evidence of pulmonary edema. A previous admission to the same hospital in 1967 for severe headache, mild hypertension, and plethoric appearance led to the diagnosis of polycythemia vera. The pertinent laboratory data at that time were as follows: hemoglobin level, 21.0 gm/100 ml; hematocrit reading, 63%; white blood cell (WBC) count, 11,400/cu mm; and platelet count 488,000/cu mm. Roentgenograms of the chest and skull and intravenous pyelography were
Perinatal and infant postmortem examination
Authors: M. Chiswick
Journal: BMJ (1995)

Background: O-GlcNAcylation is a single sugar attachment of serine and/or threonine residues on intracellular proteins. Recent reports reveal that it can modify several secretory proteins; however, the underlying mechanisms are largely unexplored. Materials and Methods: To investigate whether extracellular vesicles (EVs) carry secretory O-GlcNAc-modified proteins that were isolated from colorectal cancer (CRC) cells, two-dimensional gel electrophoresis followed with O-GlcNAc immunoblotting and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were applied. Results: It was revealed that the O-GlcNAc modification of many EV proteins was increased in metastatic cells. Among these, transitional endoplasmic reticulum ATPase (TER ATPase) and RuVB-like1 were successfully confirmed for the O-GlcNAc modification in which the levels were significantly higher in EVs of metastatic CRC cell line. Conclusion: These data, demonstrate that proteins carried by EVs are O-GlcNAc-modified. Importantly, elevated aberrant O-GlcNAcylation of EV proteins might serve as a potential biomarker of metastatic CRC.
Abstract 5500: Sensitivity of metastatic breast cancer (4T1) cells to apoptotic effect by Lactobacillus kefiri P-IF via a mechanism that involves hole piercing in cancer cells
Authors: Mamdooh H. Ghoneum
Journal: Cancer Research (2014)

Abstract Objective: Metastasis, the spread of cancer from its origin, is primarily responsible for the majority of deaths from human solid-organ cancer. Lactobacillus kefiri P-IF, a freeze-dried form of heat-killed L. kefiri, is a specific strain of lactic acid bacteria that has a unique DNA sequence and PET scans showing a 99.6% homology with regular kefiris. In the current study, we evaluate the apoptotic effect of L. kefiri P-IF on metastatic breast cancer (MBC) cells. Materials and Methods: 4T1, murine MBC, were cultured with different concentrations of L.kefiri P-IF (0, 1.25, 2.5 and 5 mg/ml) and the apoptotic response was assessed by propidium iodide assay and trypan blue exclusion test. Changes in mitochondrial membrane potential (MMP) were monitored by flow cytometry. Changes in percentages of cancer cells bearing holes were examined by Giemsa-stained cytospin preparation under a light microscope. Results: L.kefiri P-IF induced apoptosis in 4T1 cells. Incubation with L. Kefiri P-IF at 5 mg/ml induced apoptosis in 91% of 4T1 cells compared to 7% apoptosis for control untreated cells. A significant apoptotic effect by L.kefiri P-IF was detected as early as 90 min post exposure with cancer cells, showing 25 fold increase in apoptotic non-adherent cells as compared to control untreated cells. The apoptotic effect was further increased 30 to 75 fold at 24 and 48 hours, respectively. The induction of apoptosis by L.kefiri P-IF was associated with significant decrease in the polarization of MMP and an increase in the percentages of adherent cells bearing multiple holes, suggesting that the mechanism by which L.kefiri P-IF induces its apoptotic effect involves piercing holes in cancer cells. Thes holes are shown to vary in circumference and depth. Control untreated adherent cells showed 40% cells with no holes and 43% cells bearing more than 5 holes. In contrast, L.kefiri P-IF treated adherent cells showed only 7% cells with no holes, while cells bearing more than 5 holes reached 87 %, this represents a 2 fold increase in cells with multiple holes over control cells. Conclusion: These results suggest that L.kefiri P-IF exerts an apoptotic effect on MBC cells by a mechanism that involves the hole piercing in cancer cells, and may represent a new class of adjuvants for the treatment of metastatic breast cancer. L.kefiri P-IF was provided by Paitos Co., Ltd. Yokohama, Kanagawa, Japan. Citation Format: Mamdooh H. Ghoneum. Sensitivity of metastatic breast cancer (4T1) cells to apoptotic effect by Lactobacillus kefiri P-IF via a mechanism that involves hole piercing in cancer cells. [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 5500. doi:10.1158/1538-7445.AM2014-5500
Detection of Metastatic Liver Disease
Authors: Margaret A. Tempero, Richard J. Petersen, Rowen K. Zetterman, Henry M. Lemon, Jud Gurney
Journal: JAMA (1982)

The records of 94 patients with a known diagnosis of extrahepatic cancer having liver scan, biochemical liver tests (alkaline phosphatase, SGOT, lactic dehydrogenase, and bilirubin levels, and subsequent liver biopsy within a six-week period were reviewed. The sensitivity, specificity, and accuracy of the scan and biochemical tests in the detection of metastatic liver disease were calculated. The most sensitive single examination was the group of biochemical liver tests. Liver scans performed in the presence of normal biochemical test results were insensitive when compared with the liver scan alone or the liver scan in the presence of abnormal biochemical test results. The specificity and accuracy of all tests and test combinations were statistically equivalent. Screening for hepatic metastases in patients with cancer is best accomplished with the more sensitive and less expensive group of biochemical liver tests, reserving the liver scan for those patients with abnormal biochemical test results. (<i>JAMA</i>1982;248:1329-1332)
Sex Differences in Perioperative and Long-term Cardiac Event–Free Survival in Vascular Surgery Patients
Authors: Robert C. Hendel, Ming Hui Chen, Gilbert J. L’Italien, John B. Newell, Sumita D. Paul, Kim A. Eagle, Jeffrey A. Leppo
Journal: Circulation (1995)

Background Little information is available regarding the occurrence of perioperative and late cardiac events in women with vascular disease. The current study was performed to examine whether sex-specific differences exist in these outcomes in a large population of vascular surgery patients and to determine the value of clinical and dipyridamole thallium variables in predicting myocardial infarction and cardiac death. Methods and Results Preoperative dipyridamole thallium imaging was performed in 567 vascular surgery patients, including 380 men and 187 women. The incidence of nonfatal myocardial infarction and cardiac death was noted during the perioperative period and during a follow-up period of 50±5 months. Fixed and reversible thallium perfusion abnormalities were more common in men than in women ( P &lt;.001 and P =.004, respectively). Perioperative cardiac event rates were similar in men and women, 8.4% and 7.5%, respectively ( P =.07). A transient thallium defect was associated with an increased risk of cardiac events by 3.9-fold in men (CI, 1.5 to 10.2) and 5.5-fold in women (CI, 1.4 to 22). Various clinical factors also were predictive of events but demonstrated substantial sex differences. For example, dipyridamole-induced ST-segment depression was strongly associated with perioperative events in men but not in women. There were 22 nonfatal myocardial infarctions and 29 cardiac deaths in men during the follow-up period, with comparable event rates noted for women. Cardiac event–free survival rates also were similar for men and women ( P =.40). Multivariate analysis demonstrated that a history of heart failure was an important prognostic variable for both sexes, as was a fixed thallium defect. Significant sex differences in the predictive value of other clinical factors for late cardiac events was apparent. Conclusions The present study demonstrates that (1) thallium perfusion defects are more common in men; (2) transient thallium defects are associated with perioperative myocardial infarction and cardiac death in both sexes; (3) long-term survival rates after vascular surgery are similar between men and women; (4) a fixed perfusion defect is predictive of late cardiac events in women, with a trend noted in men; and (5) sex-specific differences were noted with regard to the prognostic value of various clinical risk factors. Therefore, dipyridamole thallium plays a significant role in the assessment of perioperative and long-term prognosis for both male and female vascular surgery patients. On the basis of these observations, modifications in risk stratification based on sex may be appropriate for men and women with vascular disease.
Mental handicap and the family
Authors: B. A. Smith, M. Bush, J. Brown
Journal: BMJ (1967)

methohexitone methods' no immediate or late complications occurred, and in 2,000 of these the treatment lasted for one to two and even more hours.The technique is described in a film.8A Scottish dental school has recently proposed a diploma course in dental anaesthesia.While one must deplore the creation of too many " splinter " diplomas, the suggestion in this case is worth serious consideration, particularly if the course provides adequate training in the newer intravenous techniques.-I am, ete.,
GPs' leader to meet review body on out of hours GPs' committee will be elected by wider franchise Health secretary agrees to revise deputising circular New group will look at public health manpower Consultation document launched on data protection
Authors: L. Beecham
Journal: BMJ (1996)

# GPs' leader to meet review body on out of hours {#article-title-2}

There was anger at last week's meeting of the General Medical Services Committee at what it saw as slow progress in solving the outstanding issues on out of hours services in general practice. At the February meeting the committee called for a supplementary report from the Review Body on Doctors' and Dentists' Remuneration on a separate pricing for out of hours by 16 May. If this was not forthcoming the committee resolved to ballot the profession on the out of hours settlement and to recommend to the BMA council that the review body should resign (24 February, p 465).

But when the chairman, Dr Ian Bogle, announced that he had not yet met the review body chairman—a meeting will take place shortly—some speakers called for immediate action. They said that they had sold the September 1995 deal to their constituents on the basis that the out of hours component of their contract would be separately priced. A general practitioner in north London, Dr Laurence Buckman, did not think that the review body was independent. The GMSC had fallen into a trap and was a target for criticism by his constituents.

Dr John Canning, who practises in Middlesbrough, urged Dr Bogle to emphasise to the review body how unhappy general practitioners were. “They are in despair, doctors are not going into vocational training schemes, and those who do do not want to be general practitioners.”

But other speakers pointed to the progress on the deputising circular and health promotion (see below). Dr Peter Skolar, a …
A Common Genetic Mechanism in Malignant Bone Marrow Diseases
Authors: Ross L. Levine, Martin Carroll
Journal: New England Journal of Medicine (2009)

The myelodysplastic syndromes, myeloproliferative disorders, and acute myeloid leukemia (AML) are seemingly unrelated diseases except for their origin in hematopoietic precursor cells in bone marrow. A principal feature of the myeloproliferative disorders, which include polycythemia vera, essential thrombocythemia, and primary myelofibrosis, is overproduction of blood cells. By contrast, a prominent feature of the myelodysplastic syndromes is a reduction in the number of one or more cells in the hematopoietic lineage. In AML, primitive myeloid cells in the bone marrow do not differentiate into mature granulocytes. These three groups of bone marrow disorders are distinct, yet they have overlapping features. Moreover, . . .
Adequacy and reporting of allocation concealment: review of recent trials published in four general medical journals
Authors: Catherine Hewitt, Seokyung Hahn, David J Torgerson, Judith Watson, J Martin Bland
Journal: BMJ (2005)

In randomised controlled trials, allocation concealment (separating the process of randomisation from the recruitment of participants) is important for rigorously designed trials.1–4 In 1996 many major medical journals adopted the CONSORT statement (whereby researchers have to include a short checklist of essential items and a flow diagram when reporting trials),5 and this move encouraged the reporting of allocation concealment. We reviewed the prevalence of adequate allocation concealment and its association with the statistical significance of trial results.

We searched by hand four general medical journals (the BMJ, JAMA , the Lancet , and the New England Journal of Medicine ) to identify randomised controlled trials published from January 2002 to December 2002. We included articles if the authors reported that participants were randomised and if the trial was published as a full report with the results of the main analyses. We categorised articles according to whether allocation concealment was adequate (the person who executed the allocation sequence was different from the person who recruited …
A prospective study of antineutrophil cytoplasmic antibody (c-ANCA) and clinical criteria in diagnosing Wegener's granulomatosis
Authors: J.K Rao, J.K Rao, J.R Feussner, M Weinberger, J.K Rao, N.B Allen, J.R Feussner, M Weinberger
Journal: The Lancet (1995)
Abstract 3833: Ceramide/tamoxifen nanoliposomal combination - A promising strategy for treatment of chemoresistant breast cancer
Authors: Samy A.F. Morad, Jonathan C. Levin, Mark Kester, Sriram S. Shanmugavelandy, Myles C. Cabot
Journal: Cancer Research (2012)

Abstract Drug resistance in breast and other cancers results from multiple gene interactions. Ceramide, a key intermediate in the sphingolipid pathway, can act as a powerful tumor suppressor. The employ of ceramide-based agents as opposed to the administration of ceramide generators such as daunorubicin, could be a smart strategy for cancer therapy. Polychemotherapy remains the best option for treatment of breast cancer at the aggressive, metastatic stage. The aim of our study was to investigate the cytotoxic and antiproliferative effects of ceramide (short-chain C6-ceramide) administered in combination with tamoxifen, used here as an inhibitor of ceramide glycosylation. We previously demonstrated the cytotoxicity of this combination in MDA-MB-231 cells; however, little regarding mechanism was established. The present study employs nanoliposomal formulations of both agents, a strategy to enhance efficacy. Four triple-negative chemoresistant breast cancer cell lines, MDA-MB-231, MDA-MB-468, BT-20 and Hs578T were used. Cytotoxicity assays revealed that C6-ceramide/tamoxifen synergistically reduced viability, compared to single agents in all four cell lines. For example, in MDA-MB-468 cells, nanoliposomal C6-ceramide (2.5 µM), tamoxifen (5 µM), and the combination reduced cell viability to 70, 85, and 10% of control, respectively (96 hr). A hallmark of cancer, implicated in tumor growth as well as metastasis, is resistance to induction of apoptosis. Assessment of cellular apoptosis showed that C6-ceramide/tamoxifen treatment promoted DNA fragmentation in a dose-dependant manner, attaining a value that was 36% over control at 24 hr. Introduction of the pan-caspase inhibitor, z-VAD-fmk, completely reversed DNA fragmentation, showing that apoptosis was mediated by caspase activation. The aggressive and metastatic behavior of any tumor is dependent on the ability of the cells to proliferate. Interestingly, the lower concentrations of our drug combination (2.5 µM) induced cell cycle arrest at G1, the first growth phase. In summary, this approach has potential to circumvent limitations of ceramide-based therapies, such as rapid ceramide clearance due to metabolism, the inability to attain therapeutic levels when ceramide-generating agents are employed, and inherent insolubility that is encountered. These findings demonstrate the in vitro efficacy of combination C6-ceramide/tamoxifen nanoliposomal formulations for suppressing growth of breast cancer cells, and suggest that tamoxifen may be an effective adjuvant for enhancing ceramide-driven cell death cascades. Supported by NIGMS 77391 and ABC's, Los Angeles. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3833. doi:1538-7445.AM2012-3833
A Defect in Interleukin 12–Induced Activation and Interferon γ Secretion of Peripheral Natural Killer T Cells in Nonobese Diabetic Mice Suggests New Pathogenic Mechanisms for Insulin-Dependent Diabetes Mellitus
Authors: Marika Falcone, Brian Yeung, Lee Tucker, Enrique Rodriguez, Nora Sarvetnick
Journal: The Journal of Experimental Medicine (1999)

The function of natural killer T (NKT) cells in the immune system has yet to be determined. There is some evidence that their defect is associated with autoimmunity, but it is still unclear how they play a role in regulating the pathogenesis of T cell–mediated autoimmune diseases. It was originally proposed that NKT cells could control autoimmunity by shifting the cytokine profile of autoimmune T cells toward a protective T helper 2 cell (Th2) type. However, it is now clear that the major function of NKT cells in the immune system is not related to their interleukin (IL)-4 secretion. In fact, NKT cells mainly secrete interferon (IFN)-γ and, activated in the presence of IL-12, acquire a strong inflammatory phenotype and cytotoxic function.