tbuckley/cabot-search huggingface dataset:
Preventing Aspiration Deaths During Anesthesia
Authors: Daniel C. Weaver
Journal: JAMA (1964)

Aspiration of gastric contents during general anesthesia is often fatal but is preventable. Obstetrical patients and patients requiring emergency surgery most often have a "full stomach." Prevention of aspiration in such patients can be approached positively, by inserting an endotracheal tube before induction of general anesthesia, or negatively, avoiding general anethesia and substituting "conduction" anesthesia. Examination of possible approaches to the "full stomach" leads to a conclusion that risks associated with some anesthetic techniques are unwarranted except in rare instances. Technique of "awake intubation" is described and contraindications to its use are outlined.
Funding cut for deaneries could result in fewer junior doctors, conference told
Authors: Andrew Cole
Journal: BMJ (2006)

Severe cuts in medical deaneries' funding next year could lead to a 10% drop in the number of junior doctors, a conference on careers in academic medicine was warned this week.

Professor Stephen Field, the postgraduate dean at West Midlands Deanery, told delegates at the Royal College of Physicians that deaneries across England were facing a 10% cut in funding in 2006-7.

“The next few years are going to be very difficult,” he said. “Deaneries are under threat and may disappear in name.” His own deanery was set to lose its name in the next four weeks …
Eye gaze and conscious processing in severely brain-injured patients
Authors: Camille Chatelle, Steven Laureys, Steve Majerus, Caroline Schnakers
Journal: Behavioral and Brain Sciences (2010)

Abstract Niedenthal et al. discuss the importance of eye gaze in embodied simulation and, more globally, in the processing of emotional visual stimulation (such as facial expression). In this commentary, we illustrate the relationship between oriented eye movements, consciousness, and emotion by using the case of severely brain-injured patients recovering from coma (i.e., vegetative and minimally conscious patients).
Efficacy of a new nystatin formulation in oral candidiasis
Authors: P-J Lamey, L P Samaranayake
Journal: BMJ (1986)

value was 145 jumol/l; urine sediment showed trace protein and 10-15 epithelial cells and 10-15 leucocytes per high power field.Two days later the urine sediment was normal, but serum creatinine concentra-
Pathways of Proliferation and Antiapoptosis Driven in Breast Cancer Stem Cells by Stem Cell Protein Piwil2
Authors: Jae Ho Lee, Cornelia Jung, Parisa Javadian-Elyaderani, Stefan Schweyer, Dorothea Schütte, Moneef Shoukier, Feridoun Karimi-Busheri, Michael Weinfeld, Aghdass Rasouli-Nia, Jan G. Hengstler, Alejandra Mantilla, Hamid Reza Soleimanpour-Lichaei, Wolfgang Engel, Craig N. Robson, Karim Nayernia
Journal: Cancer Research (2010)

Cancer stem cell studies may improve understanding of tumor pathophysiology and identify more effective strategies for cancer treatment. In a variety of organisms, Piwil2 has been implicated in multiple roles including stem cell self-renewal, RNA silencing, and translational control. In this study, we documented specific expression of the stem cell protein Piwil2 in breast cancer with predominant expression in breast cancer stem cells. In patients who were evaluated, we determined that 90% of invasive carcinomas and 81% of carcinomas in situ exhibited highest expression of Piwil2. In breast cancer cells, Piwil2 silencing suppressed the expression of signal transducer and activator of transcription 3, a pivotal regulator of Bcl-X(L) and cyclin D1, whose downregulation paralleled a reduction in cell proliferation and survival. Our findings define Piwil2 and its effector signaling pathways as key factors in the proliferation and survival of breast cancer stem cells.
Emergence of Ciprofloxacin-Resistant<i>Neisseria meningitidis</i>in North America
Authors: Henry M. Wu, Brian H. Harcourt, Cynthia P. Hatcher, Stanley C. Wei, Ryan T. Novak, Xin Wang, Billie A. Juni, Anita Glennen, David J. Boxrud, Jean Rainbow, Susanna Schmink, Raydel D. Mair, M. Jordan Theodore, Molly A. Sander, Tracy K. Miller, Kirby Kruger, Amanda C. Cohn, Thomas A. Clark, Nancy E. Messonnier, Leonard W. Mayer, Ruth Lynfield
Journal: New England Journal of Medicine (2009)

We report on three cases of meningococcal disease caused by ciprofloxacin-resistant Neisseria meningitidis, one in North Dakota and two in Minnesota. The cases were caused by the same serogroup B strain. To assess local carriage of resistant N. meningitidis, we conducted a pharyngeal-carriage survey and isolated the resistant strain from one asymptomatic carrier. Sequencing of the gene encoding subunit A of DNA gyrase (gyrA) revealed a mutation associated with fluoroquinolone resistance and suggests that the resistance was acquired by means of horizontal gene transfer with the commensal N. lactamica. In susceptibility testing of invasive N. meningitidis isolates from the Active Bacterial Core surveillance system between January 2007 and January 2008, an additional ciprofloxacin-resistant isolate was found, in this case from California. Ciprofloxacin-resistant N. meningitidis has emerged in North America.
Learning medicine in the community
Authors: J. Field, A.-L. Kinmonth
Journal: BMJ (1995)

“Medical Education is a reflection of medical practice; it is not the education that will change the practitioners, but reformed practice that will redesign medical education.”1 George Silver, professor of epidemiology and public health at Yale, wrote in 1983, reflecting on repeated and ineffective attempts over the years to improve medical care through education. We are now undergoing just such a reformation in the delivery of health care. Patients in hospital are likely to be very sick indeed or admitted briefly for minimally invasive surgery or investigation. Much of the natural course of those chronic disorders that put the greatest burden on our society can now be best observed outside hospital. Students based in the community can follow up patients over longer periods than before and, by accompanying these patients when they go into hospital, can see secondary care in an appropriate context.

The General Medical Council recently recommended that medical students should gain more experience in outpatient clinics, general practice, and community health services.2 Pioneering steps have already been taken by King's medical firm in the community,3 the Cambridge community …
A REVIEW OF BRAIN PATHOLOGY IN THE CONVULSIVE DISORDERS
Authors: WILLARD W. DICKERSON
Journal: American Journal of Psychiatry (1943)

We have presented a summary of the gross and microscopic findings in a series of 150 brains from individuals suffering from a convulsive disorder. No etiologic significance is attached to these findings, but the frequency with which the various types of pathologic changes occur has been established.
Training of Physician's Assistants: Use of Clinical Algorithms as a Guidance System for Education and Patient Care.
Authors: Harold C. Sox
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Training of Physician's Assistants: Use of Clinical Algorithms as a Guidance System for Education and Patient Care.Harold C. Sox Jr., M.D., Carol H. Sox, Richard K. Tompkins, M.D.Harold C. Sox Jr., M.D.Search for more papers by this author, Carol H. SoxSearch for more papers by this author, Richard K. Tompkins, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-856_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn algorithm is a step-by-step description of the solution for a problem and, as used in clinical medicine, describes how to evaluate a symptom or sign and arrive at a provisional diagnosis. Clinical algorithms for 13 acute clinical problems have been created for physician's assistants to use under the supervision of a physician. The purpose of the algorithms is to allow physician's assistants with little or no training in the clinical sciences to evaluate and, in some cases, treat patients safely and expeditiously. The algorithms also define precisely the logic of clinical problem solving and thereby facilitate the education of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Hanover, N. H. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 856-856KeywordsAlgorithmsPatientsProblem solving Issue Published: 1 May 1972 PDF DownloadLoading ...
Spinal abscess. Cutaneous erythema perstans as an alerting sign
Authors: C. C. Kao
Journal: JAMA (1971)

Six years after a back operation, a woman's long-term skin lesions and low-back pain were relieved when an abscess in the lumbar region was discovered and treated. Cutaneous erythema perstans was a cardinal manifestation in this case of spinal suppuration. In the presence of such cutaneous lesions the clinician is obligated to search for possible occult infection or malignancy.
Coexistent rheumatoid arthritis and systemic lupus erythematosus: clinical, serological, and phenotypic features.
Authors: C A Brand, M J Rowley, B D Tait, K D Muirden, S F Whittingham
Journal: Annals of the Rheumatic Diseases (1992)

The clinical and serological features and HLA phenotypes are reported for 11 patients with coexistent features of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). All patients had a symmetrical small joint polyarthritis and features of SLE such as rash, photosensitivity, oral ulceration, serositis, cytopenia, and biopsy proved lupus nephritis. Eight had hypocomplementaemia. Autoantibodies were characteristic of the two diseases: all patients had rheumatoid factor and antibodies to double stranded DNA, eight (73%) had antibodies to collagen, and five (46%) had antibodies to Ro (SS-A). There was also an overlap of HLA phenotypes. Six patients were DR4 and seven were DR2 or DR3 positive, and of the five patients who were DR4 negative, four shared class I alleles often associated with DR4. If RA and SLE share a common autoimmune dysfunction, those patients who have the two diseases do so because they have genetic determinants of both.
Familial Incidence of Rheumatoid Arthritis and Acute Rheumatism in 100 Rheumatoid Arthritics
Authors: R. W. Barter
Journal: Annals of the Rheumatic Diseases (1952)

It is comparatively rare in clinical medicine to encounter a condition which can be shown to be inherited as a simple Mendelian gene.As Crew (1947) pointed out, the human subject is by no means satisfactory to study from a genetic point of view; his mate is not chosen for him, he matures slowly, he has few offspring, his chromosomes are numerous, and his mutation rate cannot be speeded up with x rays.The best we can hope to do, in most diseases, is to show whether or not an heredito-familial tendency is involved.The final picture is modified partly by the powers of penetration of a gene or the modifying influence of other genes, but chiefly by the incalculable effect of environment factors.In those conditions where such a tendency can be shown to exist it is important to establish it and, conversely, to disprove it where absent.This will assist us in our understanding of the aetiology, diagnosis, and prognosis.Our knowledge of the aetiology of rheumatoid arthritis remains imperfect.The report by the Scientific Advisory Committee of the Empire Rheumatism Council (1950) is probably the most exhaustive clinical investigation on this subject ever undertaken in Great Britain.The results were reached after careful analysis of the case histories of 532 patients and 532 controls.Investigations into a large number of factors commonly believed to influence the onset of rheumatoid arthritis produced largely negative results.However, in the case of familial factors, the results obtained lend support to the view that these are of aetiological significance. 7per cent. of the fathers of patients as opposed to 3 per cent. of the fathers of controls suffered from arthritis; 15 per cent. of the mothers of patients as opposed to 9 per cent. of the mothers of controls suffered from arthritis; of 2,151 brothers and sisters of patients, 82 (3 8 per cent.) had arthritis, and of 2,143 brothers and sisters of controls, 38 (1I 8 per cent.) had arthritis.These figures are considered to be statistically significant.However, the report adds:The relatively low incidence of a family history of arthritis and the greater likelihood of the patients remembering relatives afflicted with the disease as compared with the controls necessitates withholding any final conclusions on the matter until further investi- gations have been undertaken.39
Eosinophil and neutrophil activity in asthma in a one-year trial with inhaled budesonide. The impact of smoking.
Authors: B Pedersen, R Dahl, R Karlström, C G Peterson, P Venge
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The object of this investigation was to study the long-term effects of antiasthma treatment on blood markers of inflammation and lung function in adult asthmatic subjects. For this purpose 85 allergic and nonallergic asthmatic subjects were randomized into three groups, which were given high-dose (1,600 micrograms/d) inhaled budesonide, low-dose (400 micrograms/d) inhaled budesonide, and oral theophylline (600 mg/d), respectively, and were followed for 11 mo with testing of lung function and blood sampling for the assay in serum of eosinophil cationic protein (ECP), eosinophil protein x/eosinophil derived neurotoxin (EPX/EDN) as eosinophil markers, and myeloperoxidase (MPO) and lactoferrin (LF) as neutrophil markers. Lung functions (FEV1% predicted, and histamine PC20) and the eosinophil markers ECP and EPX/EDN were improved and reduced, respectively, by budesonide in a dose-dependent and temporally parallel fashion. Theophylline did not alter lung functions but reduced ECP and EPX/EDN after prolonged treatment. The treatment efficacy of budesonide was attributed solely to an effect on nonsmoking asthmatic subjects, since neither lung functions nor eosinophil markers changed in smokers even with high-dose budesonide. MPO but not LF was reduced after several months of treatment in all three groups, but only in nonsmokers. We conclude that ECP and EPX/EDN may be used to monitor antiinflammatory treatment in asthmatic patients, and that smoking asthmatic subjects are resistant to inhaled corticosteroids.
ACUTE ACID INTOXICATION IN CHILDREN
Authors: THOMAS C. McCLEAVE
Journal: JAMA (1913)

This paper contains nothing new; but because the subject receives scant discussion in current text-books, and periodical literature contains articles dealing rather with particular aspects of the matter, it may be of some value to make a general survey of our knowledge of that important disorder occurring in children which, for want of a better term for the time being, we may still tentatively designate "acute acid intoxication." Acid intoxication is an extremely common phenomenon in a variety of pathologic conditions, but in children, usually from 2 to 10 years old, we see very frequently a symptom-complex in which acidosis is a marked and constant characteristic. Attacks are commonly recurrent, and may come on suddenly or be preceded for a day or two by a prodromal period in which are observed listlessness, anorexia and coated tongue, and, quite strikingly, a bluish pallid ring around the mouth and beneath the eyes, with
Association of DNA Cross-Linking With Potentiation of the Morpholino Derivative of Doxorubicin by Human Liver Microsomes
Authors: Derick H. M. Lau, Alexander D. Lewis, Branimir I. Sikic
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article Association of DNA Cross-Linking With Potentiation of the Morpholino Derivative of Doxorubicin by Human Liver Microsomes Get access Derick H. M. Lau, Derick H. M. Lau Search for other works by this author on: Oxford Academic PubMed Google Scholar Alexander D. Lewis, Alexander D. Lewis Search for other works by this author on: Oxford Academic PubMed Google Scholar Branimir I. Sikic Branimir I. Sikic Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 13, 5 July 1989, Pages 1034–1038, https://doi.org/10.1093/jnci/81.13.1034 Published: 05 July 1989 Article history Received: 30 January 1989 Revision received: 27 March 1989 Accepted: 31 March 1989 Published: 05 July 1989
Do adults make A-not-B errors in pointing?
Authors: Philippe Vindras, Edouard Gentaz
Journal: Behavioral and Brain Sciences (2001)

We discuss the assumptions put forward by Thelen et al. about motor planning processes. We examine the results of an experiment inspired by the authors' contention that the motor plans of both infants and adults are continuous and graded. We wondered whether adults, in an adapted version of the A-not-B error paradigm, would point between the A and B targets, as in some degraded conditions of pointing (Ghez et al. 1990), or would make A-not-B errors. Unexpectedly, we observed that adults tended to shift the direction of their pointings to B away from A, and did not make any A-not-B errors.
AB0052 Polymyalgia rheumatica is characterized by pro-inflammatory, senescent CD8+ T cells
Authors: K. van der Geest, W. Abdulahad, M. Huitema, B. Kroesen, A. Rutgers, E. Brouwer, A. Boots
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Polymyalgia rheumatica (PMR) is a frequent, inflammatory rheumatic disease affecting elderly people. Previous studies suggest that T cell mediated immune responses contribute to PMR. However, little is known about CD4+ and CD8+ T cell subsets and their function in PMR. Furthermore, it remains to be elucidated if immune ageing contributes to the development of this ageing-related disease. We hypothesized that senescent T cells can functionally contribute to PMR pathogenesis. Therefore, we studied frequencies of circulating T cell subsets in defined stages of differentiation and assessed functional characteristics of senescent (CD28<sup>null</sup>) T cells in PMR patients. <h3>Objectives</h3> The aim of the study is to explore the frequencies and function of distinct T cell subsets in PMR. <h3>Methods</h3> Peripheral blood was obtained from eight newly-diagnosed, untreated PMR patients. Thirty-nine healthy age- matched elderly controls were recruited from the Groningen Longevity Cohort. Flow cytometric analysis of CD45RO, CCR7 and CD28 expression was used to enumerate CD4+ and CD8+ T cell differentiation subsets and senescent (CD28<sup>null</sup>) T cells. Furthermore, naïve and memory regulatory T cells were identified based on CD25 and CD45RA expression. In addition, the prevalence of IFN-gamma, TNF, IL-4 and/or IL-17 producing CD4+ and CD8+ T cells was assessed by intracellular cytokine staining of blood samples from all PMR patients and sixteen elderly controls after 4h <i>in vitro</i> stimulation with PMA/calcium-ionophore in the presence of brefeldin A <h3>Results</h3> Compared to healthy controls, PMR patients had decreased percentages of circulating terminally differentiated (CD45RO-CCR7-) CD4+ T cells. However, no differences were observed in the percentages of Th<sub>1</sub>, Th<sub>2</sub>, or Th<sub>17</sub> cells in PMR patients. In addition, percentages of naïve and memory regulatory T cells were normal in PMR patients. In CD8+ T cells of PMR patients, percentages of naïve (CD45RO-CCR7+) cells were decreased. Interestingly, percentages of CD28<sup>null</sup> cells were increased within the effector memory (CD45RO+CCR7+) and terminally differentiated CD8+ T cell populations of PMR patients. Moreover, a significantly increased potential to produce IFN-gamma and TNF was observed in CD8+T cells of PMR patients. <h3>Conclusions</h3> Our data show premature immune ageing (loss of CD28) of effector memory and terminally differentiated CD8+T cells in PMR patients. This is associated with an enhanced pro-inflammatory potential of CD8+ T cells. In contrast, Th subsets and regulatory T cells are not altered in PMR patients. Together, these findings imply a role for pro-inflammatory, senescent CD8+ T cells in PMR pathogenesis. <h3>Disclosure of Interest</h3> None Declared
Factors Associated with Appendicular Bone Mass in Older Women
Authors: Douglas C. Bauer, Warren S. Browner, Jane A. Cauley, Eric S. Orwoll, Jean C. Scott, Dennis M. Black, Jo L. Tao, Steven R. Cummings
Journal: Annals of Internal Medicine (1993)

Objective: To determine the factors associated with appendicular bone mass in older women. Design: Cross-sectional analysis of baseline data collected for a multicenter, prospective study of osteoporotic fractures. Setting: Four clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela valley, Pennsylvania. Patients: A total of 9704 ambulatory, nonblack women, ages 65 years or older, recruited from population-based listings. Measurements: Demographic and historical information and anthropometric measurements were obtained from a baseline questionnaire, interview, and examination. Single-photon absorptiometry scans were obtained at three sites: the distal radius, midradius, and calcaneus. Multivariate associations with bone mass were first examined in a randomly selected half of the cohort (training group) and were then tested on the other half of the cohort (validation group). Results: In order of decreasing strength of association, estrogen use, non–insulin-dependent diabetes, thiazide use, increased weight, greater muscle strength, later age at menopause, and greater height were independently associated with higher bone mass. Gastric surgery, age, history of maternal fracture, smoking, and caffeine intake were associated with lower bone mass (all P < 0.05). For example, we found that 2 or more years of estrogen use was associated with a 7.2% increase in distal radius bone mass, whereas gastrectomy was associated with an 8.2% decrease in bone mass. The associations between bone mass and dietary calcium intake and rheumatoid arthritis were inconsistent. Alcohol use, physical activity, use of calcium supplements, pregnancy, breast-feeding, parental nationality, and hair color were among the many variables not associated with bone mass. Multivariate models accounted for 20% to 35% of the total variance of bone mass. Conclusions: A large number of factors influence the bone mass of elderly women; however, age, weight, muscle strength, and estrogen use are the most important factors. *For a list of the investigators in the Study of Osteoporotic Fractures Research Group, see the Appendix. For current author affiliations, see end of text.