tbuckley/cabot-search huggingface dataset:
Spontaneous Movements in Brain-Dead Patients-Reply
Authors: Gregory S. Liptak
Journal: JAMA (1986)

<h3>In Reply.—</h3> Patients who are brain dead often have unusual spontaneous movements when they are disconnected from their ventilators. Numerous authors<sup>1-3</sup>have described these disconcerting phenomena. Patients who fulfill all the criteria for death, including deep unresponsive coma, fixed unreactive pupils, absent oculovestibular response, absent corneal reflexes, apnea with Pco2 level greater than 50 mm Hg, and electrocortical silence for 30 minutes or longer, may experience any of the following: goose bumps, shivering, extensor movements of the arms, rapid flexion of the elbows, elevation of the arms above the bed, crossing of the hands, reaching of the hands toward the neck, forced exhalation, and thoracic respiratory-like movements. In addition, flexing the neck (for example, when a parent holds his dying child) may elicit a Moro-like myoclonic response. These complex sequential movements are felt to be release phenomena from the spinal cord including the upper cervical cord and do<i>not</i>
Abstract A18: Uncovering molecular subgroups and a novel cancer driver, ACVR1, in diffuse intrinsic pontine gliomas
Authors: Pawel Buczkowicz, Christine Hoeman, Patricia Rakopoulos, Sanja Pajovic, Andrew Morrison, Eric Bouffet, Ute Bartels, Oren Becher, Cynthia Hawkins
Journal: Cancer Research (2014)

Abstract Diffuse intrinsic pontine glioma (DIPG) is a devastating paediatric brain tumor with no effective therapy and near 100% fatality. The failure of most therapies can be attributed to the delicate location of these tumors and choosing therapies based on assumptions that DIPGs are molecularly similar to adult disease. Recent studies have unravelled the unique genetic make-up of this brain cancer with nearly 80% harbouring a K27M-H3.3 or K27M-H3.1 mutation. However, DIPGs are still thought of as one disease with limited understanding of the genetic drivers of these tumors. Here we apply methylation profiling, whole genome sequencing, expression profiling, and copy number analysis to discover that DIPGs are three molecularly distinct subgroups (H3-K27M, Silent, and MYCN) and uncover a mutations in a novel driver, ACVR1 in 20% of DIPGs. Mutations in ACVR1 were constitutively activating, leading to SMAD phosphorylation and increased expression of downstream activin signalling targets ID1 and ID2. The MYCN subgroup is not associated with histone mutations and is instead characterized by hypermethylation and chromothripsis of chromosome 2p with high-level amplifications of MYCN, ID2, and KIDINS220. The Silent subgroup affects younger children, has genomes with minimal genomic instability and fewer mutations, over-expresses WNT pathway genes, as well as genes with known cancer association such as MDM2, MSMP and ADAM33. The H3-K27M subgroup is highly K27M-H3 mutated and associated with additional hits including activating mutations in ACVR1, frequent RB1 and TP53 deletions, PVT-1/MYC or PDGFRA gains/amplifications, genomic instability and alternative lengthening of telomeres. Our results show that this seemingly homogeneous entity in fact comprises three distinct subgroups with different demographic and molecular features. This complexity needs to be considered when designing new therapeutic approaches in order to improve outcome for these children. Citation Format: Pawel Buczkowicz, Christine Hoeman, Patricia Rakopoulos, Sanja Pajovic, Andrew Morrison, Eric Bouffet, Ute Bartels, Oren Becher, Cynthia Hawkins. Uncovering molecular subgroups and a novel cancer driver, ACVR1, in diffuse intrinsic pontine gliomas. [abstract]. In: Proceedings of the AACR Special Conference on Pediatric Cancer at the Crossroads: Translating Discovery into Improved Outcomes; Nov 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;74(20 Suppl):Abstract nr A18.
Iron-binding Proteins in Milk and Resistance to Escherichia coli Infection in Infants
Authors: J. J. Bullen, H. J. Rogers, L. Leigh
Journal: BMJ (1972)

Human milk contains large quantities of iron-binding protein, of which the greater proportion is lactoferrin, though small amounts of transferrin are also present. Three samples of human milk with unsaturated iron-binding capacities of between 56 and 89% had a powerful bacteriostatic effect on <i>Escherichia coli</i> O111/B4. The bacteriostatic properties of milk were abolished if the iron-binding proteins were saturated with iron. Purified human lactoferrin, in combination with specific <i>E. coli</i> antibody, strongly inhibited the growth of <i>E. coli</i>, and this effect was also abolished by saturating the lactoferrin with iron. Guinea-pig milk also contains lactoferrin and transferrin. Newly born guinea-pigs fed on an artificial diet and dosed with <i>E. coli</i> O111 had higher counts of <i>E. coli</i> O111 in the intestine than suckled animals. The apparent suppressive effect of guinea-pig milk on <i>E. coli</i> in the intestine could be reversed by feeding the iron compound haematin. It seems that iron-binding proteins in milk may play an important part in resistance to infantile enteritis caused by <i>E. coli</i>.
Scientists develop more sensitive grading system for prostate cancer
Authors: D. Spurgeon
Journal: BMJ (2002)

Researchers in the United States have developed a simple test that can be used to identify which patients with prostate cancer need the most aggressive treatment, even among those whose tumours seem to be at the same stage of development.

The test has been developed by a team of researchers from the University of Minnesota led by Akhouri Sinha, professor of genetics and cell biology. The research is published in the journal Cancer , and the authors include Dr Donald Gleason, who developed the present system of rating the development of prostate tumours, known as the Gleason rating system (2002;94:3135-41).

The Gleason system uses a scale of 1-10 to rate the degree to which prostate cancers have progressed, based on the …
Decreased platelet deposition and smooth muscle cell proliferation after intramural heparin delivery with hydrogel-coated balloons.
Authors: M A Azrin, J F Mitchel, D B Fram, C A Pedersen, R W Cartun, J J Barry, L M Bow, D D Waters, R G McKay
Journal: Circulation (1994)

BACKGROUND In vitro and in vivo studies have demonstrated both anticoagulant and antiproliferative effects of heparin. The purpose of this study was to assess the effect of local intramural delivery of heparin, using heparin-coated hydrogel balloons, on platelet deposition and early smooth muscle cell proliferation after in vivo balloon angioplasty. METHODS AND RESULTS The effects of local heparin delivery were assessed during balloon angioplasty of porcine peripheral arteries. All balloon dilatations were performed with oversized hydrogel balloons coated with a known quantity of heparin. Balloon dilatations in contralateral vessels with uncoated hydrogel balloons served as study controls. The pharmacokinetics of heparin delivery were assessed using 3H-heparin to quantitate heparin wash-off from the balloon surface, heparin delivery to the arterial wall, and intramural persistence of drug. Platelet deposition at 1 hour after balloon injury was quantified using 111In-labeled platelets. Smooth muscle cell proliferation was assessed 6 to 7 days after angioplasty with immunohistochemical staining for proliferating cell nuclear antigen. 3H-heparin wash-off from the hydrogel balloon surface occurred rapidly, with approximately 95% of the heparin coating disappearing within 10 seconds in the intact circulation. Approximately 2% of heparin on the balloon surface was delivered intramurally at the time of angioplasty. Intramural heparin dissipated rapidly, although small amounts of intramural heparin could still be detected for at least 48 hours. In comparison to control vessels, there was less 111In-platelet deposition (P = .002) and less medial smooth muscle cell proliferation (P = .03) in heparin-treated vessels. CONCLUSIONS Local intraluminal delivery of heparin at the time of balloon angioplasty with heparin-coated hydrogel balloons results in intramural deposition of drug that persists for at least 48 hours. This in vivo technique significantly decreases platelet deposition and early smooth muscle cell proliferation after angioplasty injury.
Targeting B cell leukemia with highly specific allogeneic T cells with a public recognition motif
Authors: I W Abrahamsen, E Stronen, S Wälchli, J N Johansen, S Kjellevoll, S Kumari, M Komada, G Gaudernack, G Tjonnfjord, M Toebes, T N Schumacher, F Lund-Johansen, J Olweus
Journal: Leukemia (2010)
Immunofluorescent localization of enteroglucagon cells in the gastrointestinal tract of the dog
Authors: J. M. Polak, S. Bloom, I. Coulling, A. G. E. Pearse
Journal: Gut (1971)

Localization of the endocrine polypeptide cells responsible for `glucagon-like immunoreactivity9 in the gastrointestinal tract of the dog has been achieved with an immunofluorescent technique using antibodies raised against porcine pancreatic glucagon. The cells, for which we prefer the term `enteroglucagon9, could only be demonstrated by this technique in tissues fixed in carbodiimide. The enteroglucagon cells possess cytological, cytochemical, and ultrastructural characteristics in common with those of the pancreatic α<sub>2</sub> cell and they are equivalent in the stomach to the A cell and in the intestine to the L cell of the Wiesbaden terminology. Their distribution, predominantly in fundus and jejunum, correlates precisely with the distribution of glucagon-like immunoreactivity by radioimmunoassay and bioassay. The storage form of enteroglucagon differs in many respects from that of pancreatic glucagon although there are some close resemblances between the two forms of specific hormone-containing granule. Elucidation of the role of enteroglucagon should be assisted by the ability to demonstrate enteroglucagon cells.
T Lymphocyte Activation in Stable Angina Pectoris and After Percutaneous Transluminal Coronary Angioplasty
Authors: A. Blum, S. Sclarovsky, B. Shohat
Journal: Circulation (1995)

Background Inflammatory reactions have an important part in atherosclerosis. Smooth muscle cells, endothelial cells, monocytes, and T lymphocytes are actively involved. The purpose of this study was to assess whether T lymphocytes are activated in patients with stable angina pectoris who are candidates for a percutaneous transluminal coronary angioplasty (PTCA) and the influence of PTCA on this process. Methods and Results Twenty-four patients participated in the study. All were 40- to 60-year-old men, and all but one underwent successful PTCA. Blood samples were taken 1 day before PTCA and 1 week, 1 month, and 2 months after. Two groups of patients were detected: group A, 11 patients who had high levels of soluble interleukin-2 receptor (sIL-2R) before PTCA that decreased toward normal during the follow-up period in most of them; and group B, 13 patients who did not have elevated sIL-2R levels before PTCA and in whom sIL-2R levels did not change after the procedure. Group C consisted of 15 healthy men whose sIL-2R levels were in the normal range (control subjects). Conclusions (1) T lymphocytes are activated in stable angina patients. (2) The level of sIL-2R can be a reliable laboratory marker for follow-up of patients after PTCA, especially those with high sIL-2R levels before the procedure.
Peer Review Organizations
Authors: Peter E. Dans, Jonathan P. Weiner, Sharon E. Otter
Journal: New England Journal of Medicine (1985)

Abstract The Health Care Financing Administration has contracted with 54 peer review organizations (PROs) to monitor hospital use and quality of care for Medicare patients. PROs promised reductions in readmissions, in "unnecessary" admissions or invasive procedures, and in "avoidable" mortality and morbidity. A review of contract summaries for 49 PROs revealed wide variations in reduction targets. In attempting to meet their goals, PROs will encounter numerous potential pitfalls, including inaccurate and incomplete discharge data, inadequate descriptors for the variety of patients and physicians' management plans, honest differences in judgments about patient care, and limited research on the criteria used to set their reduction targets as well as the means to accomplish them. Despite having more explicit quality-of-care objectives, PROs, like PSROs (professional standards review organizations) before them, are more likely to be seen as agents of cost containment than of quality assurance. Both their credibility and their effectiveness might be enhanced if an expert panel of clinicians and health services researchers were established to help them set and achieve reasonable objectives for quality of care. (N Engl J Med 1985; 313:1131–7.)
Quality and Duration of Survival in Glioblastoma Multiforme
Authors: Fred H. Hochberg
Journal: JAMA (1979)

A retrospective evaluation of the quality and length of survival of 74 patients nonrandomly receiving lomustine, 100 to 110 mg/sq m, following craniotomy and irradiation for glioblastoma multiforme was performed. After surgery all patients were capable of at least partial self-care. Patients receiving postoperative irradiation and lomustine had a median survival of 11.5 months. While receiving chemotherapy, 40% of these patients were capable of at least partial employment; 75% were able to care for themselves. These levels of function were stable for 70% of the average postoperative course (8.0 months), following which a decline ensued.
Induction of myocardial nitric oxide synthase by cardiac allograft rejection.
Authors: X Yang, N Chowdhury, B Cai, J Brett, C Marboe, R R Sciacca, R E Michler, P J Cannon
Journal: Journal of Clinical Investigation (1994)

Cardiac transplantation, effective therapy for end-stage heart failure, is frequently complicated by allograft rejection, the mechanisms of which remain incompletely understood. Nitric oxide (NO), a vasodilator which is cytotoxic and negatively inotropic, can be produced in large amounts by an inducible NO synthase (iNOS) in response to cytokines. To investigate whether iNOS is induced during cardiac allograft rejection, hearts from Lewis or Wistar-Furth rats were transplanted into Lewis recipients. At day 5, allogeneic grafts manifested reduced contractility and histologic evidence of rejection (inflammatory infiltrate, edema, necrosis of myocytes). The mRNA for iNOS and iNOS protein were detected in ventricular homogenates and in isolated cardiac myocytes from rejecting allogeneic grafts but not in tissue and myocytes from syngeneic control grafts. Immunocytochemistry showed increased iNOS staining in infiltrating macrophages and in microvascular endothelial cells and cardiac muscle fibers and also in isolated purified cardiac myocytes from the rejecting allografts. Using a myocardial cytosolic iNOS preparation, nitrite formation from L-arginine and [3H] citrulline formation from [3H]L-arginine were increased significantly in the rejecting allogeneic grafts (P < 0.01). Myocardial cyclic GMP was also increased significantly (P < 0.05). The data indicate myocardial iNOS mRNA, protein and enzyme activity are induced in infiltrating macrophages and cardiac myocytes of the rejecting allogeneic grafts. Synthesis of NO by iNOS may contribute to myocyte necrosis and ventricular failure during cardiac allograft rejection.
OPERATION FOR INTUSSUSCEPTION COMPLICATED BY MEASLES AND BRONCHOPNEUMONIA
Authors: S. T. Irwin
Journal: BMJ (1913)

N TiR 725 equipped hospitals, where such a complicatiion as perfora- tion is likely to be recognized at the earliest possible moment, and immediate arrangements made for operation is eminently favourable to surgical success.2. It is very desirable to operate as rapidly as possible, and to avoid all unnecessary handling and exposure of intestine.These patients are totally unable to bear much manipulation.3. The quickest way to find the perforation is to go straighbt for the ileo-caecal valve and trace the ileum upwards.It will rarely be necessary to lhandle more than 2 to 3 ft. of bowel.4. All sutures should be of catgut, as silk or linen is almost certain to become infected and give rise to a troublesonme sinus.The catgut I use is prepared by boiling in absolute alcohol for thirty minutes, and stored in tincture of iodine one p)art, proof spirit ten parts.5. These patients bear the Fowler position and continuous rectal saline quite well.6. Coliuria being a very likely complication, it appears wise to put these patients at once on alkaline treatment.Whether as a result of this procedure or not, my last two cases showed no sign of this troublesome ailment.Success in the cases lhere recorded was chiefly due to the promptness with which Dr. Gardner Robb recognized the complication and made arrangements for operation; and in a very large measure also to the care and attention bestowed on tho patients by the resident officers, Drs.Kevin, Glass, and Millar.
Swiss child has successful bone marrow transplant from “saviour sibling”
Authors: Bojan Pancevski
Journal: BMJ (2006)

A successful bone marrow transplant from a baby created to save the life of its sibling has sparked a heated debate on medical ethics in Switzerland.

The 1 year old, named only as Elodie H, for legal reasons, was born from an embryo selected from a group by pre-implantation genetic diagnosis (PGD) and tissue typing as a fitting donor for her 6 year old brother Noah, who has chronic granulomatous disease that compromises his immune system.

The disease is a rare inherited disorder of phagocytic cells that usually affects males, and leads to recurrent life threatening bacterial and fungal infections. People with chronic granulomatous disease have an average life expectancy of 30 years unless they have some form of stem …
Case Volume and Mortality in Pediatric Cardiac Surgery Patients in California, 1998–2003
Authors: Lianna G. Bazzani, James P. Marcin
Journal: Circulation (2007)

Previous reports have found an inverse relationship between pediatric cardiac surgery case volume and in-hospital mortality. This association has been noted recently to be decreasing for coronary artery bypass grafting, possibly because of improved training programs, quality improvement activities, or other innovations to improve outcomes. It is unknown whether the volume-mortality association among pediatric cardiac surgery patients is decreasing similarly.We used data from the state of California's patient discharge data set from the years 1998-2003 to replicate 4 previous research studies of pediatric cardiac surgery volume and mortality. The total number of pediatric surgeries varied from 12,801 to 13,971 depending on the selection criteria applied. Using this larger and more contemporary data set, we found a weaker and less consistent volume-mortality relationship than had been reported previously. We also developed a new model, which incorporated elements of the old models, and found a statistically significant relationship with higher volume and lower mortality (odds ratio=0.86 per 100-patient increase in annual volume; 95% CI, 0.81 to 0.92). Post hoc analyses show that this relationship was related to the performance of the single largest-volume hospital.With the use of data from California, the volume-mortality relationship among pediatric cardiac surgery patients has changed since previous research, such that the old models no longer describe a clear or consistent association. With the use of a continuous definition of volume and an updated model, an association is observed but is dependent on highly leveraged covariate patterns found in the largest-volume hospital.
Health Insurance Portability and Accountability Act Privacy Rule and Research Consent Documents
Authors: David Wendler, David Shalowitz
Journal: Annals of Internal Medicine (2006)

Letters21 November 2006Health Insurance Portability and Accountability Act Privacy Rule and Research Consent DocumentsDavid Wendler, PhD and David Shalowitz, PhDDavid Wendler, PhDFrom the National Institutes of Health, Bethesda, Maryland.Search for more papers by this author and David Shalowitz, PhDFrom the National Institutes of Health, Bethesda, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-10-200611210-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We agree with Dr. Gorelick that the right to withdrawal from research participation is a vital safeguard, and investigators should respect research participants' decision to withdrawal, no matter how it is expressed. We did not mean to suggest otherwise. Rather, we recommended that, when applicable, research participants should be informed that the HIPAA Privacy Rule allows investigators to continue to use an individual's protected health information until the individual withdraws his or her authorization for such use in writing. Author, Article, and Disclosure InformationAffiliations: From the National Institutes of Health, Bethesda, Maryland.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInformed Consent for Research and Authorization under the Health Insurance Portability and Accountability Act Privacy Rule: An Integrated Approach David Shalowitz and David Wendler Health Insurance Portability and Accountability Act Privacy Rule and Research Consent Documents David A. Gorelick Correction: Health Insurance Portability and Accountability Act Privacy Rule and Research Consent Documents Metrics Cited ByBisphosphonates: are they standard of care for the treatment of breast cancer?Correction: Health Insurance Portability and Accountability Act Privacy Rule and Research Consent Documents 21 November 2006Volume 145, Issue 10Page: 790-791KeywordsConflicts of interestHealth information technology ePublished: 21 November 2006 Issue Published: 21 November 2006 CopyrightCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Rapid Suppression of Spontaneous Ventricular Arrhythmias during Oral Amiodarone Loading
Authors: Soo G. Kim, Michael M. Mannino, Robert Chou, Scott Roth, James A. Roth, Basavaraj Desai, Kevin J. Ferrick, John D. Fisher
Journal: Annals of Internal Medicine (1992)

To determine the time course of effects of amiodarone during an oral loading period.A prospective, nonrandomized study.Arrhythmia referral center at a university hospital.Fifty patients with refractory sustained ventricular tachycardia (n = 44) or ventricular fibrillation (n = 6) and frequent (greater than or equal to 30/h) ventricular premature complexes.Oral amiodarone, 1200 mg/d for 14 days and 400 mg/d thereafter.Ambulatory electrocardiographic monitorings, 12-lead electrocardiograms, and amiodarone blood levels on days 3, 5, 7, 9, 11, 13, and 28.Dramatic reductions of ventricular arrhythmias were noted during the first 72 hours of the therapy. Average ventricular premature complexes/h, couplets/h, and nonsustained ventricular tachycardias/24 h were 524 +/- 1224/h, 16 +/- 61/h, and 167 +/- 611/24 h, respectively, at baseline, and reduced to 140 +/- 243/h, 11 +/- 50/h, and 33 +/- 117/24 h, respectively, on day 3 (P less than 0.05 for all). Subsequent reductions of ventricular arrhythmias from day 3 to day 13 were more gradual but were still significant (P less than 0.05). A significant reduction of ventricular arrhythmias (greater than or equal to 70% reduction of ventricular premature complexes and greater than or equal to 90% reduction of nonsustained ventricular tachycardias) was noted in 50% of patients on day 3, in 65% on day 7, and in 83% on day 13. Prolongation of the QT interval exhibited a similar time course. There were no further differences in reduction of ventricular premature complexes or QT intervals between day 13 and day 28.Oral amiodarone given in loading doses produces rapid and dramatic reductions in spontaneous ventricular arrhythmias within 72 hours. Subsequent reductions of spontaneous arrhythmia were gradual and less dramatic.