tbuckley/cabot-search huggingface dataset:
Known Unknowns and Unknown Unknowns at the Point of Care
Authors: Gurpreet Dhaliwal
Journal: JAMA Internal Medicine (2013)

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Fragile-X: neuropsychological test performance, CGG triplet repeat lengths, and hippocampal volumes.
Authors: P Jäkälä, T Hänninen, M Ryynänen, M Laakso, K Partanen, A Mannermaa, H Soininen
Journal: Journal of Clinical Investigation (1997)

We compared cognitive performance and hippocampal volumes using magnetic resonance imaging (MRI) in adult fragile-X [fra(X)] males and females with either premutation (pM) or full mutation (fM) (n = 10 in all groups). Cognitive performance of fM males in the Wechsler Adult Intelligence Scale-Revised was worse than that of pM males, and the deficits in fM females were qualitatively similar, but less severe. In a visual memory test, both fM groups were impaired. In a list learning test, fM males were impaired in the learning phase and in delayed recognition. In a logical memory test, fM males and females were not significantly different from pM subjects. Hippocampal volumes normalized for intracranial or brain area did not significantly differ between fM and pM groups. However, positive correlations between left normalized hippocampal volumes and performance in many delayed memory tests observed in pM subjects were absent in fM subjects. Furthermore, in > 50% of the fM subjects, nonspecific changes, such as enlargement of ventricles and perivascular spaces, focal hyperintensities in temporal pole white matter, and/or subjectively assessed atypical appearance of hippocampal morphology, were observed in MRI. The data suggest minor abnormalities in temporal lobe structures in adult fra(X) subjects with fM.
Peanut allergy may be transferred by lung transplantation, case shows
Authors: R. Dobson
Journal: BMJ (2008)

A case of peanut allergy possibly being transferred between a donor and recipient of a lung transplant has been reported.

The 12 year old donor had died from anaphylactic shock after eating peanut related food. Seven months after the transplantation the 42 year old recipient, who had no prior history of allergy, had an anaphylactic reaction after eating food containing peanuts, which she survived ( Journal of Heart and Lung Transplantation doi:10.1016/j.healun.2008.07.015).

“This case emphasises the importance of considering donor allergy transfer when caring for all solid organ transplant recipients in order to avoid a life threatening event,” write the authors of the case report, from Detroit, Michigan. “It is …
The Metabolism of Lactate and Pyruvate in Children with Congenital Heart Disease
Authors: RICHARD J. HAVEL, ELTON WATKINS, Katharine S. Gullixson
Journal: Circulation (1950)

Venous blood lactic acid and pyruvic acid concentrations and lactate-pyruvate ratio were studied in 42 normal adults, 16 normal children and 18 children with congenital heart disease. There was elevation of resting values in children as compared with adults, but no significant change of values of resting children with congenital heart disease as compared with normal children. Following a standard exercise test, children with patent ductus arteriosus showed a time curve comparable to normal children, but children with cyanotic heart disease showed a persisting elevation of all values. The lactate-pyruvate ratio varied inversely with calculated mean capillary blood pO 2 .
Environmental Florence Nightingales: nursing's new front line.
Authors: J Wakefield
Journal: Environmental Health Perspectives (2001)

Nurses comprise the largest health professional group in terms of number, and they can be found in almost every health care setting, including homes, schools, work sites, and hospitals. To a large extent, nurses have always been aware of environmental factors when doing their job, but the definition of environmental health nursing is being expanded. Today, in addition to considering the possibility of environmental influences when taking patient health histories, evaluating symptoms, and conducting community assessments, nurses may change environmental conditions of affected individuals or populations through direct care, teaching, advocacy, and public policy initiatives. Nurses are helping patients evaluate the relative risks of various types of environmental exposures, such as lead. And they are also playing a key role in establishing a national tracking system of environmental health as well as in conducting patient research.
Commonly used, easily confused: let's eliminate hyper and hypo
Authors: A. Frankel, P. Vecchio
Journal: BMJ (2010)

Medicine is steeped in tradition, more so than most other professions. Perhaps with the exception of legal studies no field is so heavily dominated by terms derived from classical ancient languages (especially Latin and Greek). In contrast, particularly in recent times, there has been much focus on the need for better communication in medicine, whether among professionals or with our patients.1 2 3 Indeed poor communication (in a variety of guises) is an oft cited cause of iatrogenic error, itself a cause of morbidity, mortality, and litigation in hospitals the world over. Avoidable medication errors form a large part of this group.

A useful method of improving communication is to avoid specialty specific jargon across multidisciplinary teams.4 However, some words in common use among a wide range of health professionals can also be a source of confusion and error. A case at our hospital illustrated this.

During a busy morning a patient in the intensive care unit was noted by a doctor to have high blood pressure requiring immediate …
Predicting Aminoglycoside Nephrotoxicity-Reply
Authors: Lois Shikuma
Journal: JAMA (1986)

<h3>In Reply.—</h3> Removing the earliest clinical trial from the data used to derive the published nomogram because the "year of study" was significantly different from other clinical trials in the same institution raises several questions as to whether the proposed model can be applied consistently within the authors' institution and other institutions such as ours. What was different? The protocols are remarkably similar, especially in terms of aminoglycoside therapy. Moore et al, using a cutoff point of 0.75, generate data in an additional 143 medical and surgical patients. In these data, they indicate a sensitivity (true-positive test result) of 73%. What they do not point out is that the data presented have a false-negative rate of 27%. Thus, we continue to question the usefulness of this model on a prospective basis for decision analysis. We would also like to question whether the initial creatinine clearance is an a priori discriminator
No special BMA representation for women or overseas doctors
Authors: L. Beecham
Journal: BMJ (1983)

Women and overseas doctors do not want separate representa- tion, reserved seats, or special electoral mechanisms on existing BMA committees.This message-based on a "straw poll"came out of two informal gatherings at BMA House last month.But did the audience, invited from regions in all parts of the United Kingdom and from standing committees, reflect their colleagues' views or were they the ones who had already made it on to BMA divisions, local medical committees, and other local and central committees ?The latter seemed to be the case at the meeting on women doctors, for they voted decisively against special treatment, though when asked they said that they believed that their views were shared by their colleagues.The vote at the afternoon meeting of overseas doctors, however, was much closer, some of the overseas doctors reporting that after several years they had not been able to progress through the existing structure.(A leading article appears at p 3.)The meetings had been called, according to the chairman of council, Mr A H Grabham, because of "the concern in some quarters that these two groups had problems in achieving representation."So Mr Grabham and the chairman of the representative body, Dr John Marks, who chaired both sessions, came to listen to representatives from these groups discuss their problems.Thoiugh other organisations representing women and
Re: "Use of A-bomb survivor studies as a basis for nuclear worker compensation".
Authors: Richard Wakeford
Journal: Environmental Health Perspectives (2003)

Correspondence 1.18 (90% CI, < 0-3.73), and the corresponding ratio for all malignant neoplasms excluding leukemia and lung cancer is 0.89 (90% CI, < 0-3.65).The ratio of lung cancer risk coefficients in the LSS and in groups of underground miners is close to the value suggested by the latest International Commission on Radiological Protection (ICRP 1994) model of lung dosimetry (Birchall and James 1994; Little 2002b).The general consistency of risks in the LSS and in medically and occupationally exposed groups implies that there are no serious biases in the LSS dosimetry.
Catapres (ST-155)-induced changes in coronary vascular resistance
Authors: W. G. Nayler, I. McInnes, J. Stone, V. Carson, T. E. Lowe
Journal: Cardiovascular Research (1970)

The effect of the anti-hypertensive drug, Catapres, on coronary vascular resistance and myocardial oxygen consumption was studied. Catapres lowered coronary vascular resistance by a direct and an indirect action. The indirect coronary vasodilator effect may result from a central action of the drug and is not associated with an increase in myocardial oxygen consumption.
The detection of viral genomes by polymerase chain reaction in the myocardium of pediatric patients with advanced HIV disease
Authors: Neil E Bowles, Debra L Kearney, Jiyuan Ni, Antonio R Perez-Atayde, Mark W Kline, J.Timothy Bricker, Nancy A Ayres, Steven E Lipshultz, William T Shearer, Jeffrey A Towbin
Journal: Journal of the American College of Cardiology (1999)
Adrenergic mechanisms in control of plasma lipid concentrations.
Authors: A Lehtonen
Journal: BMJ (1982)

on nasal application of "asthmolysine" (containing adrenalin and posthypophyseal hor- mone) was measured on patients suffering from asthma.We found that both hormones were resorbed from the nasal mucosa and that about 530% of the effect of the same subcu- taneous dose could be achieved by this route.However, the effect was unstable and variable, and, therefore, we did not propose intranasal insulin treatment for the treatment of diabetes.In contrast to this, in certain cases of asthma the intranasal application of antiasthmatic preparations could enlarge our therapeutic possibilities.
ADP plays an important role in mediating platelet aggregation and cyclic flow variations in vivo in stenosed and endothelium-injured canine coronary arteries.
Authors: S K Yao, J C Ober, J McNatt, C R Benedict, M Rosolowsky, H V Anderson, K Cui, J P Maffrand, W B Campbell, L M Buja
Journal: Circulation Research (1992)

The goal of this study was to test the hypotheses that endogenous ADP plays an important role in vivo in mediating platelet aggregation and cyclic coronary artery blood flow variations (CFVs) in stenosed and endothelium-injured coronary arteries in an experimental canine model. Anesthetized animals were studied and coronary blood flow velocities monitored by a pulsed Doppler flow probe positioned around the left anterior descending coronary artery. CFVs were established by an external constrictor positioned at sites with injured endothelium. Apyrase, an ADP-removing enzyme, was infused into the left anterior descending coronary artery (0.3-1.8 units/min) 30 minutes or 2 hours after the establishment of CFVs. Complete abolition of CFVs was achieved in 81% (13/16) of dogs with 30-minute CFVs and in 83% (five of six) of dogs with 2-hour CFVs. In other dogs, a potent inhibitor of ADP-induced platelet aggregation, clopidogrel, was administered as a 10 mg/kg i.v. bolus and a 2.5 mg/kg/hr infusion 30 minutes and 3 hours after the establishment of CFVs. This treatment resulted in complete abolition of CFVs in 14 dogs (100%) with either 30-minute or 3-hour CFVs. Epinephrine was infused into some dogs after CFVs had ceased as a result of either apyrase or clopidogrel administration and into some dogs in whom SQ29548, a thromboxane A2 receptor antagonist, had been given when apyrase failed to abolish CFVs. Epinephrine restored CFVs in all dogs treated with apyrase alone, 67% (four of six) of dogs treated with the combination of apyrase and SQ29548, and 29% (two of seven) of dogs treated with clopidogrel. The plasma epinephrine levels required for CFV restoration were 20 times higher than baseline values in dogs receiving apyrase alone, 100 times higher when a combination of apyrase and SQ29548 had been given, and more than 5,000 times higher in dogs receiving clopidogrel. In vitro studies showed that apyrase only inhibited ADP-induced platelet aggregation, whereas clopidogrel not only inhibited ADP-induced platelet aggregation, but also reduced platelet aggregation induced by the thromboxane mimetic U46619 and serotonin. These data suggest that 1) ADP is an important mediator of platelet aggregation and CFVs in vivo and 2) combined inhibition of thromboxane A2 and ADP's effects provides marked protection against CFVs in experimentally stenosed and endothelium-injured canine coronary arteries. These data and our previous observations are consistent with the possibility that specific antagonists of thromboxane A2, serotonin, and ADP, alone and together, may provide substantial protection against platelet aggregation leading to CFVs at sites of endothelial injury and coronary artery stenosis.
Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau
Authors: K Molbak, A Gottschau, P Aaby, N Hojlyng, L Ingholt, A P J Da Silva
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b> : To analyse the impact of breast feeding on diarrhoeal disease and survival in children above 1 year of age in Guinea-Bissau, west Africa. <b>Design</b> : A community study of an open cohort followed up weekly by interviews over 15 months. Data on feeding practices, anthropometry, and survival were recorded for three years. <b>Setting</b> : 301 randomly selected houses in a semiurban area in the capital, Bissau. <b>Subjects</b> : 849 children aged less than 3 years. <b>Main outcome measures</b> : Incidence and duration of diarrhoea, weight for age, and death of a child. <b>Results</b> : The incidence of diarrhoea was higher in weaned children than in partially breast fed children, both in 1 year olds (relative risk 1.41; 95% confidence interval 1.23 to 1.62) and in 2 year olds (1.67; 1.29 to 2.15). The mean duration of an episode of diarrhoea was 5.3 days in breast fed children compared with 6.3 days in weaned children (P= 0.001). Independent of the age of weaning, a similar increase was found in an analysis comparing, for each child, the rate and duration of diarrhoea one month before and one month after weaning. Children with low weight for age were breast fed longer than the better nourished children (P=0.02). Children aged 12-35 months who were not breast fed had a 3.5 times higher mortality (1.4 to 8.3) than breast fed children. <b>Conclusions</b> : The beneficial effects of breast feeding are not restricted to infancy. Though children who are partially breast fed after infancy may have a lower state of nutrition than the weaned ones, the benefit in terms of lower morbidity may be more important for child survival in places with a high morbidity from diarrhoea and with high mortality.
The Role of Maintenance Therapy in Disseminated Testicular Cancer
Authors: Lawrence H. Einhorn, Stephen D. Williams, Michael Troner, Robert Birch, Frank A. Greco
Journal: New England Journal of Medicine (1981)

We concluded a prospective study of the value of maintenance therapy in disseminated testicular cancer after chemotherapy-induced complete remission or chemotherapy cytoreduction followed by surgical resection of residual teratoma. A group of 171 patients were randomized to treatment consisting of cisplatin, vinblastine, and bleomycin, or these drugs plus doxorubicin. There was no apparent difference between these two induction regimens. Complete remission was achieved in 113 patients (66 per cent), and 19 (11 per cent) were free of disease by surgical resection of residual tumor. Of the 171 who started, 113 were eligible to receive either maintenance doses of vinblastine (58 patients) or no further therapy (55 patients) after remission-induction therapy. There was a 9 per cent relapse rate during maintenance with vinblastine and a 7 per cent relapse rate with no maintenance therapy; the overall relapse rate was 8 per cent (nine of 113). Our data indicate that maintenance therapy is unnecessary in disseminated testicular cancer.
EC to promote open access publishing
Authors: Rory Watson
Journal: BMJ (2007)

The European Commission is considering a series of initiatives to promote open access publishing as part of moves to disseminate scientific information as widely as possible.

The online consultation exercise that it ran last year showed that open access aroused conflicting views, with widespread support from the scientific community but strong opposition from the publishing industry.

The commission has come down on the side of the scientific community. It maintains that publicly funded research data should, in principle, be accessible to all, and it considers that wide access to research results is important to the commission's objective …
Angiogenesis Inhibitors: Current Strategies and Future Prospects
Authors: K. M. Cook, W. D. Figg
Journal: CA A Cancer Journal for Clinicians (2010)

Angiogenesis has become an attractive target for drug therapy because of its key role in tumor growth. An extensive array of compounds is currently in preclinical development, with many now entering the clinic and/or achieving approval from the US Food and Drug Administration. Several regulatory and signaling molecules governing angiogenesis are of interest, including growth factors (eg, vascular endothelial growth factor, platelet-derived growth factor, fibroblast growth factor, and epidermal growth factor), receptor tyrosine kinases, and transcription factors such as hypoxia inducible factor, as well as molecules involved in mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K) signaling. Pharmacologic agents have been identified that target these pathways, yet for some agents (notably thalidomide), an understanding of the specific mechanisms of antitumor action has proved elusive. The following review describes key molecular mechanisms and novel therapies that are on the horizon for antiangiogenic tumor therapy.
Absence or pharmacological blocking of placental P-glycoprotein profoundly increases fetal drug exposure
Authors: Johan W. Smit, Maarten T. Huisman, Olaf van Tellingen, Hugh R. Wiltshire, Alfred H. Schinkel
Journal: Journal of Clinical Investigation (1999)

It was recently shown that naturally occurring Mdr1a mutant fetuses of the CF-1 outbred mouse stock have no placental Mdr1a P-glycoprotein (P-gp) and that this absence is associated with increased sensitivity to avermectin, a teratogenic pesticide. To further define the role of placental drug-transporting P-gp in toxicological protection of the fetus, we used mice with a targeted disruption of the Mdr1a and Mdr1b genes. Mdr1a(+/-)/1b(+/-) females were mated with Mdr1a(+/-)/1b(+/-) males to obtain fetuses of 3 genotypes (Mdr1a(+/+)/1b(+/+), Mdr1a(+/-)/1b(+/-), and Mdr 1a(-/-)/1b(-/-)) in a single mother. Intravenous administration of the P-gp substrate drugs [(3)H]digoxin, [(14)C]saquinavir, or paclitaxel to pregnant dams revealed that 2.4-, 7-, or 16-fold more drug, respectively, entered the Mdr1a(-/-)/1b(-/-) fetuses than entered wild-type fetuses. Furthermore, placental P-gp activity could be completely inhibited by oral administration of the P-gp blockers PSC833 or GG918 to heterozygous mothers. Our findings imply that the placental drug-transporting P-gp is of great importance in limiting the fetal penetration of various potentially harmful or therapeutic compounds and demonstrate that this P-gp function can be abolished by pharmacological means. The latter principle could be applied clinically to improve pharmacotherapy of the unborn child.
Epinephrine Autoinjectors For The First-aid Treatment Of Anaphylaxis: Epinephrine Dose Ejected After 11-13 Years In Controlled Storage Conditions
Authors: K.J. Simons, O.M. Rachid, M.M. Rawas-Qalaji, E.R. Simons
Journal: Journal of Allergy and Clinical Immunology (2011)
Aberrant expression of CD123 (interleukin-3 receptor-α) on neoplastic mast cells
Authors: A Pardanani, T Lasho, D Chen, T K Kimlinger, C Finke, D Zblewski, M M Patnaik, K K Reichard, E Rowinsky, C A Hanson, C Brooks, A Tefferi
Journal: Leukemia (2015)
Ventilation and Circulation with Closed-Chest Cardiac Massage in Man
Authors: Peter Safar
Journal: JAMA (1961)

The author's experience has confirmed the circulatory efficacy of closed-chest cardiac massage. However, it cannot be relied upon for pulmonary ventilation. In curarized adults, with the head unsupported, rhythmic sternal pressure produced no respiratory tidal exchange, because of pharyngeal obstruction by the tongue. With the trachea intubated, sternal pressure produced an average tidal volume of 156 ml. in curarized subjects and no tidal exchange in patients with cardiac arrest. Sternal pressure failed to reoxygenate 5 of 6 hypoxic curarized subjects. Therefore, rhythmic sternal pressure must be accompanied by intermittent positive-pressure ventilation; coordinating ventilation and pressure is desirable.
Variant "Goodpasture's Syndrome"?
Authors: Jose S. Martinez, Peter F. Kohler
Journal: Annals of Internal Medicine (1971)

The immunopathogenic mechanisms in three men with rapidly progressive glomerulonephritis and hemorrhagic pneumonitis were studied. Nephritis and fatal pulmonary hemorrhage occurred simultaneously in two patients. Typical Goodpasture's syndrome was defined in one by the presence of noncomplement-fixing IgG antiglomerular basement membrane (GBM) antibodies in his circulation, kidney, and lung. Immunofluorescent studies were negative in the second patient, although an immune complex pathogenesis was suggested by the presence of mixed cryoglobulinemia, decreased serum complement, and arteritis. The third patient also had anti-GBM-mediated nephritis, but his ultimately fatal pulmonary disease did not develop until after nephrectomy. Recurrence of the same anti-GBM nephritis was documented in his renal transplant at necropsy. It is suggested that "Goodpasture's syndrome" be restricted to patients with anti-GBM antibody-mediated nephritis and concomitant hemorrhagic pneumonitis.
Influence of cardiac‐resynchronization therapy on heart rate and blood pressure variability: 1‐year follow‐up
Authors: Gianfranco Piccirillo, Damiano Magrí, Silvia di Carlo, Tiziana De Laurentis, Alessia Torrini, Sabrina Matera, Marzia Magnanti, Leda Bernardi, Franco Barillà, Raffaele Quaglione, Evaristo Ettorre, Vincenzo Marigliano
Journal: European Journal of Heart Failure (2006)