tbuckley/cabot-search huggingface dataset:
Etiology, warning signs and therapy of torsade de pointes. A study of 10 patients.
Authors: A Keren, D Tzivoni, D Gavish, J Levi, S Gottlieb, J Benhorin, S Stern
Journal: Circulation (1981)

Torsade de pointes, also called atypical ventricular tachycardia (AVT), was diagnosed in 10 patients, nine on antiarrhythmic therapy and one with acute central nervous system damage. Four patients received quinidine and five disopyramide, either alone or in combination with amiodarone. AVT was dose-dependent in some, but in others, it started shortly after initiation of drug therapy (idiosyncrasy). All patients had QT prolongation longer than 0.60 second immediately before the onset of AVT. This measurement appeared to be a more sensitive predictor of the development of AVT than QTc prolongation or QRS widening. All patients also showed bradycardia before AVT onset. After therapy, the QT immediately decreased, while QTc and QRS remained prolonged for longer periods. Isoproterenol was effective in five of seven patients, but was contraindicated in two others. Ventricular pacing was used in four patients, including the two who did not respond to isoproterenol, and this abolished AVT promptly. Isoproterenol or pacing appear to be the therapy of choice for AVT, while the conventional drugs used to treat the usual form of ventricular tachycardia are not only ineffective, but even contraindicated.
SULFATHIAZOLE FOR ACUTE DIARRHEA AND DYSENTERY OF INFANTS AND CHILDREN
Authors: MERLIN L. COOPER
Journal: JAMA (1941)

Previous studies on mice by one of us (M. L. C.)<sup>1</sup>showed that one dose of 2 mg. of sulfathiazole or sulfapyridine administered by stomach tube three hours after the animals were infected with Shigella paradysenteriae (dysentery bacilli) resulted in survival of all mice inoculated with two minimum fatal doses, survival of the majority of mice inoculated with 100 minimum fatal doses and survival of a few mice inoculated with 1,000 minimum fatal doses. Sulfathiazole was employed because our experience with the sulfonamide drugs indicated that sulfathiazole was tolerated better than sulfapyridine and also because our earlier experiments on mice showed that sulfathiazole and sulfapyridine were equally effective therapeutically. This study was started before sulfaguanidine became available, and the use of sulfathiazole was continued until a sufficient number of observations had been obtained from which conclusions could be drawn. All patients were classified on admission into certain age groups:
John Peter Mettauer of Virginia
Authors: William Bickers
Journal: JAMA (1963)

GREATER TRAGEDY befalls no woman than she whose parturition is followed by a vesicovaginal fistula. Never again will she know the joy of dry clothing. Rejected from her marital bed, ostracized by family and friends, she lives alone in her unriniferous ectoplasm unable to escape her own stench. This greatest of all misfortunes was so prevalent during the 19th century as to inspire a hospital dedicated to its cure, the Woman's Hospital of New York. Its founder was James Marion Sims, that diligent Southerner who brought relief to these afflicted women. He was the father of American gynecology.  There is no more romantic story in all medical history than that of his valiant effort to design an operation for the cure of vesicovaginal fistula. In hisStory of My Life, Sims relates his struggles over a period of 4 years with repeated operations upon two slave women, Lucy and
Anicteric Infectious Hepatitis: A Population Study.
Authors: Frederick W. Sprong, Robert DeForest, James G. Harmeling, Jack T. Jones
Journal: Annals of Internal Medicine (1964)

s1 October 1964Anicteric Infectious Hepatitis: A Population Study.Frederick W. Sprong, Robert DeForest, James G. Harmeling, Jack T. JonesFrederick W. SprongSearch for more papers by this author, Robert DeForestSearch for more papers by this author, James G. HarmelingSearch for more papers by this author, Jack T. JonesSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-4-808_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe incidence of anicteric infectious hepatitis was studied in 737 military personnel from a group who had been inadvertently exposed to infectious hepatitis by the development of this disease in a food handler in their mess. Each week for 10 weeks, the men were questioned for symptomatology consistent with infectious hepatitis and a blood sample obtained for determination of serum glutamic oxaloacetic transaminase (SGOT). Of the entire group, 76% had an elevated SGOT at some time during the course of the study: 96 of these were admitted to the hospital for further study. All but a few of those admitted... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Frederick W. Sprong; Robert DeForest; James G. Harmeling; Jack T. JonesAffiliations: Newport, R. I. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1964Volume 61, Issue 4Page: 808-809KeywordsArmed forcesBloodFoodInfectious diseasesInfectious hepatitisSerum glutamic oxaloacetic transaminase ePublished: 1 December 2008 Issue Published: 1 October 1964 PDF downloadLoading ...
The demand for neonatal intensive care.
Authors: D. J. Field, S. Hodges, E. Mason, P. Burton, J. Yates, S. Wale
Journal: BMJ (1989)

In a one year prospective study within the Trent Regional Health Authority the demand for neonatal intensive care was estimated to be 1.1 cots per 1000 births. Intensive care level 1 (as defined by the British Paediatric Association and British Association for Perinatal Paediatrics) was determined by two separate techniques, which showed close agreement. Intensive care level 2 could not be measured directly, as the definition was too subjective. This aspect of demand was therefore estimated by using data derived from the treatment of babies transferred for intensive care. These findings represent a minimum estimate of need, as the data were obtained from a service constrained by having facilities well below the estimated level (roughly 60% of estimated demand). In the future other factors such as increased survival of extremely preterm infants will be likely to increase demand still further.
Selection bias in cluster trial
Authors: David J Torgerson
Journal: BMJ (2008)

tackling alcohol misuse Needs in adolescentsParker et al's review of alcohol misuse did not deal with the problems and needs of adolescent drinkers, who often present to emergency departments when drunk. 1 Alcohol misuse is common in this age group and its incidence is rising, at great cost to individuals, families, and wider society.It is significantly associated with risk of suicide, violence, and accidents-the most common causes of death for young people. 2 It is also an important marker of serious social problems, which should be explored with all those who present to health services. 3 Despite this, emergency department doctors often don't screen for alcohol misuse in young people and are poor at recognising it without formalised screening tools.AUDIT and its derivatives can be used in adolescents, although lower cut-off scores than for adults are probably wise.Just asking, "How often do you get drunk?"identifies young people at risk of traumatic injury through drinking, 4 and the Paddington alcohol test identifies "binge" drinkers. 5 Testing blood alcohol levels at presentation is no substitute for formally investigating drinking habits and risk behaviour because young people are drunk at lower blood alcohol concentrations than adults and binge drinking is intermittent.Although it has been reported that young people are more prone than adults to hypoglycaemia when drunk, this is rare.Other pathologies must be considered in intoxicated adolescents with hypoglycaemia, including infection or additional toxic and metabolic insults.
Efficacy of 2'-Deoxycoformycin in Hairy-Cell Leukemia: A Study of the National Cancer Institute of Canada Clinical Trials Group1
Authors: J. B. Johnston, E. Eisenhauer, W. E. N. Corbett, J. G. Scott, S. D. Zaentz
Journal: JNCI Journal of the National Cancer Institute (1988)

Thirty-one patients with hairy-cell leukemia were treated with 2'-deoxycoformycin (DCF) in a National Cancer Institute of Canada multicenter trial. The DCF was administered in a cycle (4mg/m2iv weekly × 3), which was repeated every 8 weeks. Following a Complete remission, consolidation was done with two further cycles of DCF. Of 28 patients evaluable for response, 25 obtained a complete remission; 3 had a partial response. To date there has been only one relapse; the median time with no thereapy was 429.5 days (range 99–743days). Toxicity was moderate and included nausea and vomiting, lethargy, and skin rash; with the first cycle of treatment, neutropenia and an increased incidence of fever or infection were also observed. We conclude that low-dose DCF is highly effective in treating hairy-cell leukemia. [J Natl Cancer Inst 1988;80:765–769]
612. Determination of Specific Th1 and Th2 CD4 T Cell Responses in AAV2- and AAV8-Mediated Human Factor IX Gene Therapy in Mice
Authors: Jian Chen, Hui-Chen Hsu, Alex Schlachterman, Katherine A. High, John D. Mountz
Journal: Molecular Therapy (2005)

Recombinant AAV is promising for coagulant factor IX (F.IX) gene transfer due to the long-term expression of hF.IX in the liver and weak immune response using a liver specific promoter. However, in humans and some animals the F.IX expression declines over long time periods and immune responses to vector and transgene can occur. It was shown that C3H (H2k) mice express the highest levels of anti-hF.IX antibodies, which requires the IAka and IAk b and the IL-10 region of Chromosome 1 (Blood 105:1029). We utilized MHC class II peptides in the context of I-Ak and I-Ek to specifically detect Th cells in AAV-hF.IX immunized C3H mice. First, we use a prediction program, SYPFEITHI, to predict MHC II binding peptides from hF.IX, AAV2 and AAV8 capsid proteins (Table 1). C3H mice were iv injected with 2|[times]|1011vg of AAV2- or AAV8-hF.IX, in which hF.IX expression is regulated by a liver-specific ApoE/hAAT promoter. The mice were boosted 30 days later. Blood samples were collected for analysis of ALT and plasma hF.IX. The plasma ALT level was significantly elevated (p<0.05) at day 9 after boost with AAV2- or AAV8-hF.IX. There was no significant decrease in plasma hF.IX levels up to 9 days after boost. To determine the frequency of hF.IX, AAV2 and AAV8 specific CD4 Th cells in liver, mononuclear cells (MNC) were prepared and analyzed by peptide specific ELISPOT assays for production of Th1 cytokine IFN|[gamma]| and Th2 cytokine IL-4, respectively. Liver MNCs were co-cultured with irradiated antigen presenting cells pulsed with the peptides specific for hF.IX, AAV2 or AAV8. The number of IFN|[gamma]| spot forming cells (SFC) was determined 48 hr later (Table 1). For both AAV2-hF.IX and AAV8-hF.IX infected mice, an I-Ak restricted hF.IX epitope AA108-122 induced both IL-4 and IFN|[gamma]| production. In AAV2-hF.IX infected mice, an I-Ek restricted AAV2 epitope AA475-489 induced more IL-4 SFCs than IFN|[gamma]| SFCs (p<0.05). For AAV8-hF.IX infected mice, an I-Ek restricted AAV8 epitope AA126-140 was found to induce more IFN|[gamma]| SFCs than IL-4 SFCs (p<0.05). Similar results were seen in spleen of immunized mice. Other predicted peptides failed to induce IFN|[gamma]| or IL-4 SFCs in immunized mice (data not shown). These results indicated that AAV2- or AAV8-hF.IX gene transfer induced both vector and transgene specific Th cells with the highest response in IFN|[gamma]| production to hF.IX epitope peptide AA108-122. Moreover, these epitope peptides could function differently on Th1 and Th2 cells to drive a Th response towards CD8 T cell response or B cell activation. These findings will facilitate a better understanding in CD8 T cell response or antibody response to AAV-hF.IX gene therapy.
For the Health of a Nation: A Shared Responsibility
Authors: Gilbert S. Omenn
Journal: JAMA (1990)

This report is the product of two years of work by an ad hoc blue-ribbon National Leadership Commission on Health Care, co-chaired by former Republican governor of Iowa Robert D. Ray and former Florida Democratic Congressman Paul G. Rogers. The commission was organized by Henry Simmons, MD, MPH, and supported by numerous corporations, unions, and foundations. The report's indictments of the American health care system are familiar: (1) some 37 million Americans lack private or public health insurance and a similar number have inadequate coverage; (2) despite a decade of competitive forces and various cost-containment schemes, national expenditures for health care reached $550 billion in 1988 and are projected to double by 1995 and triple by 2000, absorbing most of the increase in gross national product; and (3) there is shocking uncertainty about what really works in medical care and what constitutes quality service. The book has two overwhelming problems:
Inhibition of retinol oxidation by ethanol in the rat liver and colon
Authors: Alexandr Parlesak, Ina Menzl, Anette Feuchter, J.C. Bode, C. Bode
Journal: Gut (2000)

<h3>BACKGROUND</h3> Epidemiological evidence has been presented for an increased risk of development of colon cancer after chronic alcohol abuse. Alcohol is degraded by cytosolic alcohol dehydrogenases that also are capable of retinol oxidation. Inhibition of retinol oxidation to retinoic acid has been shown to occur in parallel with profound impairment of intracellular retinoid signal transduction and loss of cell differentiation control. <h3>AIMS</h3> In the present study, the change in cytosolic retinol oxidation and retinoic acid formation by ethanol concentrations that occur in body tissues in humans after social drinking was measured in cells from the liver, and small and large intestine of the rat. <h3>RESULTS</h3> The specific catalytic efficiency V<sub>max</sub>/K<sub>m</sub> (ml/min/g) of cytosolic retinol oxidation in the large intestine (28.9) was found to be distinctly higher than that in the liver (3.4), while the efficiency in the small intestine was negligible (0.20). In the presence of increasing ethanol concentrations (9, 17, and 34 mM), V<sub>max</sub>/K<sub>m</sub> for retinol oxidation decreased in a dose dependent manner to 7.8% of the initial value in the large intestine and to 12% in the liver. The V<sub>max</sub>/K<sub>m</sub>of retinoic acid formation in the liver cytosol decreased to 15%. <h3>CONCLUSIONS</h3> Our data demonstrate impairment of hepatic and intestinal cytosolic retinol oxidation and retinoic acid formation by ethanol at concentrations in body tissues after social drinking in humans. The results suggest that the increased risk of developing colorectal neoplasias after alcohol abuse may, at least in part, be caused by impaired retinoid signal transduction.
Treating Controls in Unblinded Trials
Authors: Lucy Yardley
Journal: Annals of Internal Medicine (2005)

Letters15 February 2005Treating Controls in Unblinded TrialsLucy Yardley, PhDLucy Yardley, PhDFrom University of Southampton, Southampton SO17 1BK, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-4-200502150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Heckerling argues that by offering vestibular rehabilitation to patients in the control group after 3 months, we implied that vestibular rehabilitation is an effective treatment, thereby violating the important principle of equipoise. However, in a pragmatic (1) or phase III trial such as ours, it is assumed that the treatment has already been shown to be beneficial under ideal conditions (normally, this will have been established in efficacy or phase II trials). Consequently, equipoise is maintained instead with regard to the research question: Is the treatment more effective than usual care in typical clinical practice? Moreover, it ...Reference1. Roland M, Torgerson DJ. What are pragmatic trials? BMJ. 1998;316:285. [PMID: 9472515] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Lucy Yardley, PhDAffiliations: From University of Southampton, Southampton SO17 1BK, United Kingdom. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffectiveness of Primary Care–Based Vestibular Rehabilitation for Chronic Dizziness Lucy Yardley , Margaret Donovan-Hall , Helen E. Smith , Bronagh M. Walsh , Mark Mullee , and Adolfo M. Bronstein Treating Controls in Unblinded Trials Paul S. Heckerling Metrics 15 February 2005Volume 142, Issue 4Page: 309-310KeywordsMotivationTreatment guidelines ePublished: 15 February 2005 Issue Published: 15 February 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
OT2-05-04: ACRIN PA 4006: Comparison of Full-Field Digital Mammography with Digital Breast Tomosynthesis Image Acquisition in Relation to Screening Call-Back Rate.
Authors: EF Conant, A Maidment, D Copit, CB Olson, ML Heckel, C Gatsonis
Journal: Cancer Research (2011)

Abstract Background With competing parameters of specificity and sensitivity, breast cancer screening must limit both missed cancers and false-positive call-backs (with potential to biopsy) to reduce cost and unnecessary anxiety to patients. Full-field digital mammography (FFDM) has been shown to provide improved sensitivity over analog mammography in the detection of breast cancers, particularly in women with dense breasts. Unfortunately, call-back rates for both digital and analog screening mammography have similar, elevated rates of approximately 10% (E. Pisano et al, NEJM, 2005). Incorporation of digital breast tomosynthesis (DBT), a novel 3-D reconstruction of multiple low-dose digital mammographic images, may reduce the number of call-back visits needed by providing many of the benefits of diagnostic imaging at screening. This study will assess variations in DBT image acquisition while limiting radiation dose to women with varying breast sizes and densities, to define parameters to be used in a larger national screening tomosynthesis trial. Eligibility: Asymptomatic women 25 years and older with no breast cancer history are eligible for Group A or B (see below). Pregnant women, women unable to tolerate compression of the breast associated with mammography, women with implants, and women with breasts too large for DBT are excluded from participation. Trial design/target accrual: This multicenter trial uses Hologic digital mammography units at two institutions in Philadelphia, Pennsylvania. The timing of the study-related imaging visits are segregated into two cohorts, screening (Group A) and diagnostic (Group B). Group A comprises 500 women who will undergo both FFDM and DBT at screening. Initial independent interpretations of the FFDM and DBT from local readers will determine call back. Enriched Group B comprises 50 women who have been informed of abnormal findings from a FFDM screening within 30 days of enrollment. They will be recruited prior to their diagnostic imaging and consent to DBT of both breasts as part of their diagnostic imaging. Participants from both Groups will be followed or biopsied as recommended by their treating physician. Follow up includes medical record review and images collection at approximately 1-year. Follow-up data may be collected up to 18 months. Specific aims and statistical methods: ACRIN PA 4006 will evaluate the specificity of 2-D FFDM versus a combination of 2-D and 3-D tomosynthesis imaging in breast cancer screening. Specificity will be measured by the participant call-back rate by each modality. Sensitivity and specificity by lesion-type characteristics, especially focused on DBT assessment of calcifications, will be compared. Current accrual: Currently, the trial accrual has reached 259 of 550. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT2-05-04.
A modified international normalized ratio as an effective way of prothrombin time standardization in hepatology†
Authors: Laurent Bellest, Valérie Eschwège, Raoul Poupon, Olivier Chazouillères, Annie Robert
Journal: Hepatology (2007)

International Normalized Ratio (INR), which standardizes prothrombin time (PT) during oral anticoagulation, has been extended to standardize PT in liver diseases and is included in prognostic models such as the Model for End stage Liver Disease (MELD). However, mechanisms of PT prolongation in liver diseases differ from those involved in oral anticoagulation, and the thromboplastin reagents differ in their sensitivities to these 2 mechanisms. Our aim was to determine whether, in the calibration model for thromboplastins proposed by the World Health Organization, the use of plasmas from patients with liver diseases instead of plasmas from patients on oral anticoagulation could lead to a new INR specific for liver diseases (INR "LD"), achieving a real standardization of PT. First, 5 thromboplastins were calibrated against an international reference using 60 plasmas of patients with liver failure and, in a second step, the variation of PT reported as seconds, the ratio of patient PT to normal PT, INR, and INR"LD" was assessed in 34 other patients. MELD scores were calculated with the INR values obtained with the 5 thromboplastins. Only INR"LD" eliminated variability in PT results observed with the different thromboplastins. The discrepancy between MELD scores were up to 4 and 7 points in 52% and 17% of the patients, respectively.INR "LD" may provide a common international scale of PT reporting in hepatology. Its adoption would be an important step because of the significant impact on MELD score induced by interlaboratory variability in INR determination.
What sort of representation is conscious?
Authors: Zoltan Dienes, Josef Perner
Journal: Behavioral and Brain Sciences (2002)

We consider Perruchet &amp; Vinter's (P&amp;V's) central claim that all mental representations are conscious. P&amp;V require some way of fixing their meaning of representation to avoid the claim becoming either obviously false or unfalsifiable. We use the framework of Dienes and Perner (1999) to provide a well-specified possible version of the claim, in which all representations of a minimal degree of explicitness are postulated to be conscious.