tbuckley/cabot-search huggingface dataset:
Clinical Features, Management, and Outcome of Children With Fetal and Postnatal Diagnoses of Isomerism Syndromes
Authors: Joyce S.L. Lim, Brian W. McCrindle, Jeffrey F. Smallhorn, Fraser Golding, Christopher A. Caldarone, Mio Taketazu, Edgar T. Jaeggi
Journal: Circulation (2005)

Background— Isomerism is associated with a complex spectrum of anomalies. There is paucity of data on prenatally detected cases. Methods and Results— Between January 1990 and February 2004, 83 of 166 cases (50%) had a prenatal diagnosis of left isomerism (LAI; 52 of 97) or right isomerism (RAI; 31 of 69) at our institution. The spectrum of anomalies, management, and outcomes was compared for fetal and postnatal diagnoses of LAI and RAI. RAI more often than LAI was associated with AV septal defect (90% versus 56%; P &lt;0.0001), pulmonary outflow obstruction (91% versus 37%; P &lt;0.0001), total anomalous pulmonary venous drainage (73% versus 13%; P &lt;0.0001), and abnormal VA connections (68% versus 33%; P &lt;0.0001), whereas inferior vena cava interruption (3% versus 93%; P &lt;0.0001), complete AV block (0% versus 13%; P =0.004), aortic obstruction (6% versus 33%; P &lt;0.0001), and extracardiac defects (5% versus 25%; P =0.006) were less common. The spectrum of lesions was comparable for fetal and postnatal cases, except for AV block (fetal, 25%; postnatal, 0%; P =0.0002) and AV septal defect (fetal, 67%; postnatal, 42%; P =0.023) in LAI. Fetal demise was due mainly to pregnancy termination (LAI, 42%; RAI, 45%). Survival of actively managed children with LAI was significantly better than for those with RAI ( P &lt;0.0001) but did not differ with regard to fetal versus postnatal diagnosis. Most LAI cases required no intervention or underwent successful biventricular cardiac surgery (65%), unlike RAI cases (13%; P &lt;0.0001). Conclusions— Prenatal diagnosis did not affect overall survival despite facilitated care. The prognosis of RAI was worse compared with LAI because of more complex associated cardiac defects and the inability to perform successful surgical procedures.
AMINO ACID STUDIES AND CLINICAL FINDINGS IN NORMAL ADULTS AND RHEUMATOID ARTHRITIS PATIENTS TREATED WITH ACTH 12
Authors: A. L. Borden, E. C. Brodie, E. B. Wallraff, W. P. Holbrook, D. F. Hill, C. A. L. Stephens, R. B. Johnson, A. R. Kemmerer
Journal: Journal of Clinical Investigation (1952)
Patients and staff as codesigners of healthcare services
Authors: Glenn Robert, Jocelyn Cornwell, Louise Locock, Arnie Purushotham, Gordon Sturmey, Melanie Gager
Journal: BMJ (2015)

<b>Glenn Robert and colleagues</b> describe an approach that aims to ensure that healthcare organisations realise the full potential of patients—the biggest resource they have for improving the quality of care
Tumor and Therapy Associated Abnormal Changes on Bone Scintigraphy Old and New Phenomena
Authors: MARCEL P. M. STOKKEL, RENATO A. VALD??S OLMOS, CORNELIS A. HOEFNAGEL, DICK J. RICHEL
Journal: Clinical Nuclear Medicine (1993)

Bone scintigraphy is very sensitive in detecting metastases in an early stage, when changes in osteoblast function precede morphologic changes. In many oncologic situations, however, osteoarticular abnormal changes seen on the bone scan are not caused by tumor infiltration. They may be due to tumor associated conditions, such as carcinoma polyarthritis and hypertrophic pulmonary osteoarthropathy. They also may be due to therapy-associated conditions, such as the flare effect on metastases due to hormonal treatment, chemotherapy or radiotherapy, and osteonecrosis as a complication of radiotherapy or the use of corticosteroids. The introduction of Colony Stimulating Factors (CSF) to reduce myelotoxicity have allowed higher doses of chemotherapeutic agents to be administered. Currently, there is research being performed on the clinical effects of CSF in phase-ll studies. In addition to the flare response of metastases, increased uptake in the axial skeleton and/or juxta-articular areas on bone scintigraphy in five patients receiving CSF has been observed. This new phenomenon could be explained by a reaction to a very cellular marrow caused by the use of CSF. The clinical relevance of this finding remains to be established. The authors present an overview of these old and new phenomena seen on the bone scan with clinical and roentgenologic correlation.
Aptamer-functionalized PEG–PLGA nanoparticles for enhanced anti-glioma drug delivery
Authors: Jianwei Guo, Xiaoling Gao, Lina Su, Huimin Xia, Guangzhi Gu, Zhiqing Pang, Xinguo Jiang, Lei Yao, Jun Chen, Hongzhuan Chen
Journal: Biomaterials (2011)
Immunologic Aspects of Hepatic and Gastrointestinal Tract Disease
Authors: Peter F. Kohler
Journal: JAMA (1982)

THE IMMUNOLOGIC system appears to play an important role in maintaining the homeostasis of the gastrointestinal (GI) tract. Pathogenic immune reactions have been described in a variety of GI tract and liver diseases. Among the important structural and functional immunologic components of the GI tract are Peyer's patches, intraepithelial lymphocytes, diffusely distributed lamina propria plasmacytes, and all classes of immunoglobulin. In addition, nonimmune mechanisms are important in protecting the gut. These include the barrier to swallowed organisms created by gastric secretions, the cleansing effect on the intestines of peristalsis, and possibly of mucous secretion, the effect of indigenous bacterial flora on potential pathogens, and the filtering effect of the liver. Immunologic mechanisms characteristic of the mucosal immune system may have particular relevance to hypersensitivity reactions in the GI tract. First, mucosal lymphoid follicles (Peyer's patches) may be an important source of IgE cells. Thus, it has recently been shown that
Wean Earlier and Automatically with New Technology (the WEAN Study). A Multicenter, Pilot Randomized Controlled Trial
Authors: Karen E. A. Burns, Maureen O. Meade, Martin R. Lessard, Lori Hand, Qi Zhou, Sean P. Keenan, Francois Lellouche
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Automated weaning has not been compared with a paper-based weaning protocol in North America.We conducted a pilot randomized trial comparing automated weaning with protocolized weaning in critically ill adults to evaluate clinician compliance and acceptance of the weaning and sedation protocols, recruitment, and impact on outcomes.From August 2007 to October 2009, we enrolled critically ill adults requiring more than 24 hours of mechanical ventilation and at least partial reversal of the condition precipitating respiratory failure at nine Canadian intensive care units. We randomized patients who tolerated at least 30 minutes of pressure support and either failed or were not yet ready to undergo a spontaneous breathing trial to automated or protocolized weaning. Both groups used pressure support, included spontaneous breathing trials, used a common positive end-expiratory pressure-FI(O(2)) chart, sedation protocol, and criteria for extubation, reintubation, and noninvasive ventilation.We recruited 92 patients (49 automated, 43 protocolized) over 26 months. Adherence to assigned weaning protocols and extreme sedation scale scores fell within prespecified thresholds. Combined physician-respiratory therapist and nurse acceptance scores of the study weaning and sedation protocols, respectively, were not significantly different. Automated weaning patients had significantly shorter median times to first successful spontaneous breathing trial (1.0 vs. 4.0 d; P < 0.0001), extubation (3.0 vs. 4.0 d; P = 0.02), and successful extubation (4.0 vs. 5.0 d; P = 0.01), and underwent fewer tracheostomies and episodes of protracted ventilation.Compared with a standardized protocol, automated weaning was associated with promising outcomes that warrant further investigation. Minor protocol modifications may increase compliance, facilitate recruitment, and enhance feasibility. Clinical trial registered with www.controlled-trials.com (ISRCTN43760151).
Th17 immune responses contribute to the pathophysiology of aplastic anemia
Authors: Regis Peffault de Latour, Valeria Visconte, Tomoiku Takaku, Colin Wu, Andrew J. Erie, Annahita K. Sarcon, Marie J. Desierto, Phillip Scheinberg, Keyvan Keyvanfar, Olga Nunez, Jichun Chen, Neal S. Young
Journal: Blood (2010)
A-Bomb Radiation Effects Digest
Authors: Glyn G. Caldwell
Journal: JAMA (1994)

During the past 49 years, since the nuclear destruction of Hiroshima and Nagasaki, both Japanese and US scientists have attempted to understand the medical and physical effects of those detonations. A major compilation of that work was published in 1992 as<i>Genbaku Hoshasin no Jintai Eikyou (Effects of A-Bomb Radiation on the Human Body</i>). Because of the great length and scientific complexity of the compendium by 39 authors, making it incomprehensible for laypersons and others not involved in radiation research, this brief, simplified digest outlining major findings was written. The digest contains 12 chapters, a summary, a glossary, and three forewords. Each chapter outlines the major findings, with the first chapter providing the physical and mechanical damage data correlated with location and casualty estimates. Chapters 2 through 12 summarize and outline graphically the major findings related to malignant disease, endocrine and metabolic diseases, ocular lesions, dermatologic effects, chromosome aberrations, mutations,
The Association between For-Profit Hospital Ownership and Increased Medicare Spending
Authors: Elaine M. Silverman, Jonathan S. Skinner, Elliott S. Fisher
Journal: New England Journal of Medicine (1999)

The rate of conversion to for-profit ownership of hospitals has recently increased in the United States, with uncertain implications for health care costs. We compared total per capita Medicare spending in areas served by for-profit and not-for-profit hospitals. We used American Hospital Association data to categorize U.S. hospital service areas as for-profit (meaning that all beds in the area were in for-profit hospitals), not-for-profit (all beds were in not-for-profit hospitals), or mixed in 1989, 1992, and 1995. We then used data from the Continuous Medicare History Sample to calculate the 1989, 1992, and 1995 spending rates in each area, adjusting for other characteristics known to influence spending: age, sex, race, region of the United States, percentage of population living in urban areas, Medicare mortality rate, number of hospitals, number of physicians per capita, percentage of beds in hospitals affiliated with medical schools, percentage of beds in hospitals belonging to hospital chains, and percentage of Medicare beneficiaries enrolled in health maintenance organizations.Adjusted total per capita Medicare spending in the 208 areas where all hospitals remained under for-profit ownership during the study years was greater than in the 2860 areas where all hospitals remained under not-for-profit ownership ($4,006 vs. $3,554 in 1989, $4,243 vs. $3,841 in 1992, and $5,172 vs. $4,440 in 1995; P<0.001 for each comparison). Mixed areas had intermediate spending rates. Spending in for-profit areas was greater than in not-for-profit areas in each category of service examined: hospital services, physicians' services, home health care, and services at other facilities. The greatest increases in per capita spending between 1989 and 1995 were for hospital services (a mean increase of $395 in for-profit areas and $283 in not-for-profit areas, P=0.03 for the comparison between for-profit and not-for-profit areas) and home health care (an increase of $457 in for-profit areas and $324 in not-for-profit areas, P<0.001). Between 1989 and 1995, spending in the 33 areas where all hospitals converted from not-for-profit to for-profit ownership grew more rapidly than in the 2860 areas where all hospitals remained under not-for-profit ownership ($1,295 vs. $866, P=0.03).Both the rates of per capita Medicare spending and the increases in spending rates were greater in areas served by for-profit hospitals than in areas served by not-for-profit hospitals.
Content and synthesis of glycosaminoglycans in the developing lung.
Authors: A L Horwitz, R C Crystal
Journal: Journal of Clinical Investigation (1975)

The function of lung is fundamentally linked to the connective tissue composition of the alveolar interstitium. The composition and synthesis of one class of interstitial connective tissue components, the glycosaminoglycans (GAG), was determined in lung parenchyma of rabbits at different stages of development. Parenchymal GAG content ranged between 0.2 and 0.4% (wt/wt) of dry weight, with highest concentration in adult lung. There were significant changes in types of GAG present at different ages. Fetal lungs contained a relatively high proportion of chondroitin 4-sulfate while the GAG in lung parenchyma of older animals was predominantly dermatan sulfate, heparan sulfate, and heparin. Methods were developed for the study of rates of synthesis of GAG by incorporation of [1-14C]glucosamine into lung explants. The rate of synthesis of total GAG per cell increased with development to a maximum in lung from weanling rabbits and fell to low rates of synthesis in mature rabbits. Fetal rabbit lung parenchyma synthesized mostly hyaluronic acid and heparan sulfate, while in weanling rabbit parenchyma hyaluronic acid and chondroitin 4/6-sulfate synthesis was greatest. In mature animals, the rates of synthesis of all types of GAG were relatively low but there was a relatively greater emphasis on synthesis of dermatan sulfate and heparin. These results may have significance in changes in lung function during development and in effects on other connective tissue components.
Multiphasic Health Testing
Authors: Paul deR Kolisch
Journal: JAMA (1977)

To the Editor.—  David J. Lehman's COMMENTARY (237:2193, 1977) is a nicely balanced discussion of multiphasic health testing. He missed an important point; it is one all too often missed by other than clinical laboratory personnel. The  of mass screening procedures, when compared to that of individual laboratory procedures performed on demand, make the conventional clinical laboratory look very costly. I suggest that the comparison is about as fair as comparing the price of a suit of clothes off the rack to that made-to-measure by one of our top flight tailors. I strongly suspect that close accounting would show that the low cost mass screening prices are far too high when compared to clinical laboratory charges. Unless a clinical laboratory is prepared to perform individual tests on demand on a 24-hour basis, I refuse to have the charges levied by my laboratory judged on the basis of these ostensibly
Hemodynamic Observations after Cardiac Transplantation
Authors: James A. Shaver, Donald F. Leon, Samuel Gray, James J. Leonard, Henry T. Bahnson
Journal: New England Journal of Medicine (1969)

Hemodynamic observations were performed one and six months after cardiac transplantation in a 46-year-old man. Cardiac catheterization revealed normal pressures at rest and a slightly decreased cardiac index. Total cardiac denervation was documented by absence of reflex changes in heart rate during physiologic and pharmacologic stimuli. Intracardiac electrocardiography demonstrated both donor and recipient p waves, the former always controlling the heart rate. Observations during atrioventricular dissociation indicated that the transplanted heart has active atrial transport. The denervated heart responded to the stress of muscular exercise. Cardiac output increased predominantly by increasing stroke volume, although delayed increments in heart rate occurred. After complete beta-adrenergic blockade, the response of the heart rate to exercise was attenuated but not completely blocked. These findings suggest that whereas circulating catecholamines have an important role in cardiac acceleration during exercise, an additional mechanism, intrinsic to the heart itself, may be responsible for the increase in heart rate.
Intravenous Glucose Tolerance as a Tool in Definition and Diagnosis of Diabetes Mellitus
Authors: K. Lundbaek
Journal: BMJ (1962)

GLYCOSURIA AND DIABETESBrMH 1507 with clinitest and if it is positive a glucose-tolerance test should be done.The people whose urine was negative to clinitest would be instructed to bring one- hour postprandial specimens on two subsequent occasions.If either of these were positive a blood- sugar examination would be done, but if they were all negative the patient would be instructed to report back in six months.I suggest that such a scheme is possible and very worth while. SummaryThe results of a comprehensive survey in Halstead, Essex, are reported.Out of 5,843 persons (95.3%/. of the population) included in the survey, 192 cases of glycosuria were discovered-38 known cases of diabetes and 35 newly discovered cases-a total incidence of 1.2%.The newly discovered cases were in subjects over 40 years, and the maximum incidence was in the 60-69 age-group.An attempt was made to classify the other cases of glycosuria into various types.If accurate comparisons are to be made it is essential that comparable methods of blood-sugar analysis and comparable diagnostic criteria are used.The survey confirmed the findings of other surveys that for every known diabetic there is another undiag- nosed case.There may be as many as 300,000 undiagnosed cases in the country, and some suggestions are made for the institution of a large-scale postal diabetes detection drive.
Insulin receptors in cultured human keratinocytes
Authors: P. VERRANDO, J. P. ORTONNE*
Journal: British Journal of Dermatology (1984)

Insulin binding to receptors was studied for the first time in cultured normal epidermal human keratinocytes. Binding was measured at 16°‐C in steady‐state conditions using 125 I‐labelled iodohormone and varying concentrations of unlabelled hormone. Insulin binding was compatible with either (i) a two‐site model‐a high affinity site (about 6000 sites per cell) and a low affinity site (about 88,000 sites per cell) site‐or (ii) one class of binding site with negatively co‐operative interactions, or (iii) both these models may operate. Insulin receptors (IR) have been extensively studied in various biological systems, but not in epidermal cells. However, insulin resistance with defects in IR may be associated with cutaneous abnormalities (acanthosis nigricans). This led us to study insulin binding on normal human keratinocytes in culture.
Endotoxin-induced gene expression differences in the brain and effects of iNOS inhibition and norepinephrine
Authors: Stephanie Wolff, Sabine Klatt, Jens C. Wolff, Jochen Wilhelm, Ludger Fink, Manfred Kaps, Bernhard Rosengarten
Journal: Intensive Care Medicine (2009)

We studied gene expression differences in brain homogenate, hippocampus, somatosensory cortex and cerebellum of rats suffering from sepsis-associated delirium and analyzed the effects of norepinephrine and 1,400 W (specific inhibitor of the inducible nitric-oxide synthase).We applied microarray screenings to rat brain homogenate 1, 3 and 4.5 h after lipopolysaccharide (LPS, 5 mg/kg) or 0.9% NaCl treatment. Therapy groups were analyzed after 4.5 h. Validations and compartment specific investigations were carried out by real-time PCR.Most striking gene expression differences were seen 4.5 h after LPS administration, especially within the hippocampus (chemokines and endothelial cell-specific molecule 1). Norepinephrine resulted in a discrete chemokine up-regulation, while 1,400 W had hardly any effect.Strongest gene regulations were found within the hippocampus. Norepinephrine showed a tendency of having a proinflammatory influence, while 1,400 W had no clear-cut effect onto the gene expression level.
Antenatal screening for Down's syndrome: Authors' reply
Authors: H Cuckle, R Lilford
Journal: BMJ (1993)

poor fit of the distribution of free ( human chorionic gonadotrophin to a Gaussian model in the upper range.More data are required to clarify this, but our present conclusion is that with appropriate allowance for the poor fit, the same parameters2 yield an estimated difference in detection that may be as little as 1-2%.
Remarks ON ACUTE ARTHRITIS OF DOUBTFUL ORIGIN
Authors: H. D. Rolleston
Journal: BMJ (1910)

WE must all have met with cases which, at first assumed to be rheumatic fever, have failed to react to salicylates, and yet, as shown by the sequel, were not pyaemic, gonococcic, or due to any other obvious infection.It is in con- nexion with these-cases of acute arthritis of doubtful origin that I propose to speak.But as a preliminary con- sideration it may be worth while to refer briefly to the value of a reaction to salicylates as evidence of true rheumatism.There is no doubt that one of the main clinical characters of acute rheumatism or rheumatic fever is that it reacts to selicylates; a case which reacts per.
Peptide-functionalized nanoparticles for selective targeting of pancreatic tumor
Authors: Sabrina Valetti, Federica Maione, Simona Mura, Barbara Stella, Didier Desmaële, Magali Noiray, Juliette Vergnaud, Christine Vauthier, Luigi Cattel, Enrico Giraudo, Patrick Couvreur
Journal: Journal of Controlled Release (2014)
Earlier Appearance of Impaired Insulin Secretion Than of Visceral Adiposity in the Pathogenesis of NIDDM: 5-Year Follow-up of Initially Nondiabetic Japanese-American Men
Authors: Kwang-Wen Chen, Edward J Boyko, Richard W Bergstrom, Donna L Leonetti, Laura Newell-Morris, Patricia W Wahl, Wilfred Y Fujimoto
Journal: Diabetes Care (1995)

OBJECTIVE To identify risk factors for development of non-insulin-dependent diabetes mellitus (NIDDM) during a 5-year longitudinal follow-up of second-generation Japanese-American (Nisei) men. RESEARCH DESIGN AND METHODS For 5 years, 137 initially nondiabetic Nisei men were followed with 75-g oral glucose tolerance tests at the initial visit and at 2.5- and 5-year follow-up visits. Body fat distribution was assessed by computed tomography (CT) and body mass index (BMI) calculated at each visit. Fasting insulin and C-peptide, the increment of insulin and C-peptide at 30 min after the oral glucose load, intra-abdominal and total subcutaneous fat by CT, and BMI were compared between those who remained nondiabetic (non-DM) and those who had developed NIDDM at 2.5 years (DM-A) and 5 years (DM-B). RESULTS At baseline, the DM-A group had significantly increased intra-abdominal fat, elevated fasting plasma C-peptide, and lower C-peptide response at 30 min after oral glucose. At the 2.5-year follow-up, this group had markedly increased fasting plasma insulin and decreased 30-min insulin and C-peptide response to oral glucose. The DM-B group also had significantly lower insulin response at 30 min after oral glucose at baseline but no significant difference in intra-abdominal fat or fasting plasma insulin and C-peptide levels. When this group developed NIDDM by 5-year follow-up, however, an increase of intra-abdominal fat was found superimposed on the pre-existing lower insulin response. Fasting plasma insulin and C-peptide remained low. CONCLUSION In DM-A, lower 30-min insulin response to oral glucose (an indicator of β-cell lesion) and increased intra-abdominal fat and fasting C-peptide (indicators of insulin resistance) were the risk factors related to the development of NIDDM. DM-B subjects had a lower 30-min insulin response to oral glucose at baseline and increased intra-abdominal fat at 5-years, when they were found to have NIDDM. Thus, both insulin resistance and impaired β-cell function contribute to the development of NIDDM in Japanese-Americans, and impaired β-cell function may be present earlier than visceral adiposity in some who subsequently develop NIDDM.