tbuckley/cabot-search huggingface dataset:
Inadvertent Sodium Heparin Administration to a Newborn Infant
Authors: Helen I. Glueck
Journal: JAMA (1965)

THE USE of sodium heparin in adults is a wellknown aspect of modern therapy. The recent availability of highly concentrated aqueous heparin preparations has made subcutaneous administration both effective and reliable. This route of administration often has replaced the more cumbersome intravenous method. Heparin has restricted use in infancy, in contrast to the adult patient. It has been used as an anticoagulant in laboratory blood specimens, in the syringe rinse during exchange transfusions,<sup>1</sup>and occasionally in transfusion blood itself.<sup>1</sup>Because of the infrequent use of heparin in the nursery and because of the increasing use of the highly concentrated solutions elsewhere in the hospital, an awareness of these potent solutions is in order. An infant with a coagulation disorder resulting from inadvertently administered concentrated heparin is described. <h3>Report of a Case</h3> The mother was a 19-year-old, married, white primiparous woman. Her blood group was 0, Rh positive. Following
Statistical Modeling Suggests that Antiandrogens in Effluents from Wastewater Treatment Works Contribute to Widespread Sexual Disruption in Fish Living in English Rivers
Authors: Susan Jobling, Robert. W. Burn, Karen Thorpe, Richard Williams, Charles Tyler
Journal: Environmental Health Perspectives (2009)

The widespread occurrence of feminized male fish downstream of some wastewater treatment works has led to substantial interest from ecologists and public health professionals. This concern stems from the view that the effects observed have a parallel in humans, and that both phenomena are caused by exposure to mixtures of contaminants that interfere with reproductive development. The evidence for a "wildlife-human connection" is, however, weak: Testicular dysgenesis syndrome, seen in human males, is most easily reproduced in rodent models by exposure to mixtures of antiandrogenic chemicals. In contrast, the accepted explanation for feminization of wild male fish is that it results mainly from exposure to steroidal estrogens originating primarily from human excretion.We sought to further explore the hypothesis that endocrine disruption in fish is multicausal, resulting from exposure to mixtures of chemicals with both estrogenic and antiandrogenic properties.We used hierarchical generalized linear and generalized additive statistical modeling to explore the associations between modeled concentrations and activities of estrogenic and antiandrogenic chemicals in 30 U.K. rivers and feminized responses seen in wild fish living in these rivers.In addition to the estrogenic substances, antiandrogenic activity was prevalent in almost all treated sewage effluents tested. Further, the results of the modeling demonstrated that feminizing effects in wild fish could be best modeled as a function of their predicted exposure to both antiandrogens and estrogens or to antiandrogens alone.The results provide a strong argument for a multicausal etiology of widespread feminization of wild fish in U.K. rivers involving contributions from both steroidal estrogens and xenoestrogens and from other (as yet unknown) contaminants with antiandrogenic properties. These results may add further credence to the hypothesis that endocrine-disrupting effects seen in wild fish and in humans are caused by similar combinations of endocrine-disrupting chemical cocktails.
Viral kinetics during antiviral therapy in patients with chronic hepatitis C and persistently normal ALT levels
Authors: Bernd Kronenberger, Eva Herrmann, Florence Micol, Michael von Wagner, Stefan Zeuzem
Journal: Hepatology (2004)

The aim of the present study was to compare viral kinetics between patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels and those with elevated ALT levels. Kinetic parameters were derived from nonlinear, least square fitting of serum hepatitis C virus RNA quantifications collected from patients with chronic hepatitis C and persistently normal (n = 20) and elevated (n = 19) ALT levels before and during treatment with 180 μg pegylated interferon α–2a once weekly plus daily ribavirin. Patients with chronic hepatitis C and persistently normal ALT levels showed a trend to lower pretreatment infected cell loss (δ) ( P = .13) but no differences in efficacy of blocking virus production (ε) and infected cell loss during treatment ( mδ ) compared with patients with elevated ALT levels. Differences were significant for ε ( P = .02) and δ ( P = .04) when applying updated “healthy” levels for ALT (0.75 times and 0.63 times upper limit of normal for male and female patients, respectively). A significant reduction of the kinetic parameters ε, δ, and m δ was observed in patients with elevated γ–glutamyltranspeptidase (GGT) levels compared with patients with normal GGT levels ( P = .02, P = .005, and P = .02, respectively). In conclusion , viral kinetics are similar in patients with chronic hepatitis C and persistently normal ALT levels and those with elevated ALT levels. However, in patients with elevated GGT levels, a major association with reduced efficacy of blocking virus production and lower infected cell loss was observed. These data show that virological response in patients with chronic hepatitis C is less associated with baseline ALT than with GGT levels. (Hepatology 2004;40:1442-1449.)
Emphysematous-Bullous Form of Bronchial Cancer
Authors: M. R. Castex, E. S. Mazzei
Journal: BMJ (1951)

IDIOPATHIC PULMONARY HAEMOSIDEROSISBwrJomL 391lesion.His blood pressure was 95/75.Other systems were normal.Blood investigations during this period of observa- tion were: July 1l, 1949: Hb 85%, white cells 6,500 (poly- morphs 67%, lymphocytes 28%, monocytes 4%); September 28: Hb 989%, white cells 6,700 (polymorphs 52%, lympho- cytes 47%, monocytes 1 %); July 28, 1950: Hb 102%, white cells 11,600 (polymorphs 68%, lymphocytes 29%, mono- cytes 3%).Sternal puncture showed a hyperplastic normo- blastic marrow.Radiographs of the chest showed fanshaped, bilateral, symmetrical shadowing occupying midzones from hilum to periphery, enlarged pulmonary conus, and enlargement of the right side of the heart.The shadow- ing appeared to be made up of multiple fine densities.On July 16, 1950, signs of congestive cardiac failure were more pronounced.The.patient was very apathetic, there were sacral oedema and oedema of the ankles.He died on August 17.Post-mortem examination was performed by Dr. P. Coleman (assistant pathologist, Middlesbrough Central Clini- cal Laboratory), who gave the following report."The body was that of a young man aged 19.There were no external marks or injuries.The heart weighed 2+ lb.(1.1 kg.) and was dilated, although there
Prospective Randomized Study to Assess the Efficacy of Site and Rate of Atrial Pacing on Long-Term Progression of Atrial Fibrillation in Sick Sinus Syndrome
Authors: Chu-Pak Lau, Ngarmukos Tachapong, Chun-Chieh Wang, Jing-feng Wang, Haruhiko Abe, Chi-Woon Kong, Reginald Liew, Dong-Gu Shin, Luigi Padeletti, You-Ho Kim, Razali Omar, Kreingkrai Jirarojanakorn, Yoon-Nyun Kim, Mien-Cheng Chen, Charn Sriratanasathavorn, Muhammad Munawar, Ruth Kam, Jan-Yow Chen, Yong-Keun Cho, Yi-Gang Li, Shu-Lin Wu, Christophe Bailleul, Hung-Fat Tse
Journal: Circulation (2013)

Atrial-based pacing is associated with lower risk of atrial fibrillation (AF) in sick sinus syndrome compared with ventricular pacing; nevertheless, the impact of site and rate of atrial pacing on progression of AF remains unclear. We evaluated whether long-term atrial pacing at the right atrial (RA) appendage versus the low RA septum with (ON) or without (OFF) a continuous atrial overdrive pacing algorithm can prevent the development of persistent AF.We randomized 385 patients with paroxysmal AF and sick sinus syndrome in whom a pacemaker was indicated to pacing at RA appendage ON (n=98), RA appendage OFF (n=99), RA septum ON (n=92), or RA septum OFF (n=96). The primary outcome was the occurrence of persistent AF (AF documented at least 7 days apart or need for cardioversion). Demographic data were homogeneous across both pacing site (RA appendage/RA septum) and atrial overdrive pacing (ON/OFF). After a mean follow-up of 3.1 years, persistent AF occurred in 99 patients (25.8%; annual rate of persistent AF, 8.3%). Alternative site pacing at the RA septum versus conventional RA appendage (hazard ratio=1.18; 95% confidence interval, 0.79-1.75; P=0.65) or continuous atrial overdrive pacing ON versus OFF (hazard ratio=1.17; 95% confidence interval, 0.79-1.74; P=0.69) did not prevent the development of persistent AF.In patients with paroxysmal AF and sick sinus syndrome requiring pacemaker implantation, an alternative atrial pacing site at the RA septum or continuous atrial overdrive pacing did not prevent the development of persistent AF.URL: http://www.clinicaltrials.gov. UNIQUE IDENTIFIER: NCT00419640.
Social bonds, motivational conflict, and altruism: Implications for neurobiology
Authors: Stephanie L. Brown, R. Michael Brown
Journal: Behavioral and Brain Sciences (2005)

depue &amp; morrone-strupinsky (d&amp;m-s) do not address how a reward system accommodates the motivational dilemmas associated with (a) the decision to approach versus avoid conspecifics, and (b) self versus other tradeoffs inherent in behaving altruistically toward bonded relationship partners. we provide an alternative evolutionary view that addresses motivational conflict, and discuss implications for the neurobiological study of affiliative bonds.
Antismoking campaigns should "target 4 year olds"
Authors: J. Jones
Journal: BMJ (1999)

Children as young as 4 years old should be educated about the dangers of cigarettes if government targets to reverse the rise in smoking among children are to be met.

Many traditional methods of dissuading young people from taking up the habit have little or no effect, possibly because they do not start early enough, according to a study from the NHS Centre for Reviews and Dissemination, University of York ( Effective Health Care 1999;5(5)). 

Existing programmes mostly target 11-17 year olds, by which time many young …
Corynebacterium hemolyticum Peritonsillar Abscess Mimicking Diphtheria
Authors: Anthony L. Kovatch
Journal: JAMA (1983)

IT IS uncertain whether the organism<i>Corynebacterium hemolyticum</i>is merely one of the bacterial species that colonize the human oropharynx or is an important pathogen in upper respiratory tract infections. While the organism has long been associated with pharyngitis in young adults,<sup>1</sup>sometimes accompanied by a maculopapular<sup>2</sup>or scarlatiniform rash,<sup>3</sup>it has never been thought to possess the invasive or toxigenic potential of<i>Corynebacterium diphtheriae</i>. Recently, however, Green and LaPeter<sup>4</sup>reported a case of membranous pharyngitis caused by<i>C hemolyticum</i>in a 16-year-old girl that so strongly mimicked classic diphtheria that antitoxin was given. This report describes a case in which this organism was cultured from the exudate that was aspirated from a typical peritonsillar abscess. <h3>Report of a Case</h3> A 16-year-old girl was in her usual state of good general health until two weeks before admission to the hospital, when a sore throat with low-grade
Abstract 3697: Phase II study of therapy selected by molecular profiling in patients with previously treated metastatic pancreatic cancer - SU2C-001
Authors: Michael T. Barrett, Elizabeth Lenkiewicz, Lisa Evers, Tara Holley, Meraj Aziz, Jeffrey Kiefer, Anirban Maitra, Manuel Hidalgo, Rajesh Kumar, William Hlavacek, Edward Stites, Richard G. Posner, Ramesh Ramanathan, Dan D. Von Hoff
Journal: Cancer Research (2012)

Abstract We have completed a second line Phase II study of therapy to be selected by molecular profiling in 35 patients with previously treated metastatic pancreatic cancer. On this study all patients have a biopsy of a metastatic lesion (usually liver). Therapeutic targets are identified by profiling the metastatic biopsies with the combined use of immunohistochemistry (IHC), comparative genomic hybridization (CGH) on sorted tumor populations, and correlating gene expression microarray data to that of a panel of xenografts for which drug sensitivity has been previously determined. The IHC assays are performed in a CLIA certified laboratory and include the following therapeutic targets: MRP1, TOPO1, MGMT, PGP, Her2/Neu, PTEN, c-kit, RRM1, EGFR, BCRP, PDGFR, TOP2A, TS, ERCC1, SPARC, ER, PR, and AR. In addition each sample is screened by PCR for the presence of the most common K-RAS mutations. Gene expression microarray analysis is performed at John Hopkins University using Affymetrix U133 Plus 2.0 gene arrays. For CGH analysis flow sorted nuclei of diploid and aneuploid tumor cell populations are processed and hybridized to 400,000 feature CGH arrays. We have identified distinct high level focal amplicons targeting AKT2, LYN, RET, CDK6, K-RAS, MYCBP, BCL11A, RASA1 and WNT6, and gene specific homozygous deletions including CDKN2A, PTEN, MAP2K4, RASA1 and PARK2 in the sorted aneuploid tumor nuclei. In an effort to elucidate new targets and potential contexts of vulnerability based on the results of this trial, we have extracted combined gene level data for each patient and present these mapped to 32 pancreatic specific pathways and processes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3697. doi:1538-7445.AM2012-3697
Transgenic 4-1BBL-engineered vaccine stimulates potent Gag-specific therapeutic and long-term immunity via increased priming of CD44+CD62Lhigh IL-7R+ CTLs with up- and downregulation of anti- and pro-apoptosis genes
Authors: Rong Wang, Andrew Freywald, Yue Chen, Jianqing Xu, Xin Tan, Jim Xiang
Journal: Cellular and Molecular Immunology (2014)
Teaching the Neophyte
Authors: John T. Flynn
Journal: JAMA (1964)

To the Editor:—  Professor Willis Brown's address as Chairman of the Section on Obstetrics and Gynecology, Who Teaches the Neophyte? (JAMA187:287 [Jan 25] 1964) is a refreshing, unbiased restatement of old truths. Several thoughts can be added to his very clear presentation.  The professor of grantsmanship will be with us a long time, in spite of many criticisms against him. None of us shoots Santa Claus, even if we criticize his baggy clothes, obesity, lack of haircut and a shave, or his refusal to use the front door.  One very important teacher of neophytes was not mentioned in Dr. Brown's article, ie, other neophytes, on residency staffs, who have graduated a year or two ahead of their juniors. The paradox of delayed clinical teaching is worsened by the fact that some of our most eager teachers are still waiting for the ink to dry on their diplomas.  The
MONILIFORM HAIRS (MONILETHRIX)
Authors: WALLACE BEATTY, J. ALFRED SCOTT
Journal: British Journal of Dermatology (1892)

MONILIFORM HAIRS (NONILETHRIX).Nodosa," considering that this term is much more applicable to the condition than to that to which it is usually applied, as " the hairs are really nodose as well as brittle.""Crockert uses the name monilethrix," which has the advantage of being short, and which expresses very well the clinical appearances.Behrend suggests the cumbrous pathological definition, " Aplasia Pilorum Intermittens seu Moniliformis," on the ground that the aplasia, as pointed out by Virchow, is the essential part of the disease, and not the n0dosities.fBefore describing my case, I shall review the cases of the disease which have been published up to the present.-Walter Smith's first case.$-MaryM., a dressmaker, aged 19, of fair complexion, with dark hair.She had " ringworm " at the age of three ; with that exception she had never suffered from any disease of the skin.There was no history of syphilis.Up to the age of fifteen she possessed " good long hair " down to her shoulders ; about that time she began to shed the hair.The catamenia set in between fifteen and sixteen years of age after the hair had begun to fall.The head became scurfy.At times the skin was itchy, and became tender.Shortly after the hair commenced to fall she had scarlatina.The thinning of the hair was worse afterwards than before the fever.Over the whole scalp the hair was uniformly thinned, although nowhere was there complete baldness.The longest hairs measured about five inches; they could be readily extracted without pain, and their free extremities appeared sharply broken off.Many of the hair-follicles projected so as to form pale or pink elevations, most numerous about the nape of the neck.The hair was very dry, of an uniform dark colour, and felt crisp to the touch.On close inspection, it was observed that many of the hairs were bent abruptly at a right angle, and that the length of the hairs was very unequal.The hairs, especially the shorter hairs, exhibited an appearance consisting of a regular beading, or succession of swellings, along the shaft, commencing immediately above the root.The nodes were fusiform, dark throughout, or pale in the lower segment and black in the upper ; whenever the hair was broken, as offen happened, the fracture always occurred at an internode.On an average one node went to each millimetre of length of hair.Each node would seem to represent about two days' growth.Scattered over the head were also many short, club-shaped stumps, representing single nodes implanted in the skin, and the root-ends likewise were pointed.On some of the longer hairs small bits were split off longitudinally about their middle.The eyebrows were thin, but no beaded hairs could be detected either among them or among the eyelashes.The axillary hairs were scanty, but appeared normal.The microscopical examination of the hairs was made by the late B. WiUs Richardson, and revealed the following condition :- Scarcely a trace of scale imbrication was seen on the nodes, but it was tolerably
Ventilation Inhomogeneities in Relation to Standard Lung Function in Patients with Cystic Fibrosis
Authors: Richard Kraemer, Andrea Blum, Andreas Schibler, Roland A. Ammann, Sabina Gallati
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Based on serial lung function measurements performed in 142 children (68 males; 74 females) with cystic fibrosis (CF), prospectively evaluated over an age range of 6 to 20 years, we attempted to determine whether the lung clearance index (LCI) as a measure of ventilation inhomogeneities could be a discriminating factor of disease progression. Annual follow-up lung function measurements featuring FRC determined by whole-body plethysmography and multibreath nitrogen washouts, effective specific airway resistance, flow-volume curves, LCI, and gas exchange characteristics were analyzed by linear mixed-model analysis and Kaplan-Meier statistics. The earliest occurring and strongest factor of progression was the LCI, followed by maximal expiratory flow (MEF(50)) and FRC determined by plethysmography (p < 0.0001). Associations between onset of chronic Pseudomonas aeruginosa infection and CF transmembrane conductance regulator (CFTR) genotype with FEV(1) (p = 0.027) and FVC (p = 0.007) were identified. The study shows that the LCI predicts earlier in life and represented much better functional progression than FEV(1). Moreover, there is no single functional predictor of progression in CF, but aside from risk factors, such as onset of chronic P. aeruginosa infection and genotype, pulmonary hyperinflation, airway obstruction, and ventilation inhomogeneities are important pathophysiologic processes that should be evaluated concomitantly as determinants of lung progression in CF.
Hereditary hemochromatosis: A prevalent disorder of iron metabolism with an elusive etiology
Authors: Marcel E. Conrad, Jay N. Umbreit, Elizabeth G. Moore, Richard T. Parmley
Journal: American Journal of Hematology (1994)

Abstract Hereditary hemochromatosis is a prevalent inherited disorder with an estimated frequency of homozygosity of 0.2 to 0.45% in Caucasians. The disease is characterized by progressive iron overload until a massive accumulation of body iron occurs. Undetected, the disorder eventually can produce either cirrhosis, diabetes mellitus, cardiac disease, arthritis, or hepatocellular carcinoma or a combination of these manifestations. Early diagnosis and treatment prevents organ damage and normalizes life expectancy. Screening studies to detect hemochromatosis are most effectively accomplished by measurement of the serum iron and total iron binding capacity. Treatment is most effectively performed by frequent phlebotomy until body stores are empty and then 3 to 4 times yearly for life. The basic defect of hemochromatosis appears to increase iron absorption, decrease iron excretion, and produce preferential deposit of iron in hepatic parenchymal cells rather than Kupffer cells. The genetic abnormality of hemochromatosis is located on chromosome 6 in close association with the gene for HLA antigens. Recent speculation postulates that tumor necrosis factor may be involved in the etiology of this disease because of its location on chromosome 6 and its effect upon iron transport. © 1994 Wiley‐Liss, Inc.
Huffman and colleagues' response to Abramson and colleagues' article on statins in low risk people
Authors: M. Huffman, F. Taylor, S. Ebrahim
Journal: BMJ (2014)

The BMJ Analysis article on statins in low risk people stated, "the evidence does not show that the benefits of statins in low risk patients outweigh the harms and that the advice for treatment of this group should not be changed." 1 It criticises our Cochrane systematic review on statins for the primary prevention of cardiovascular disease for not coming to the same conclusion. 2Readers of the BMJ may be interested in our views on their arguments.This article predated by three weeks the publication of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol treatment guidelines (12 November 2013), but statements were made about "proposed standards" without full knowledge of these guidelines.Notably, none of the authors were acknowledged reviewers of the ACC/AHA guidelines. 3ramson and colleagues state: "Under the proposed 2013 standards, however, no level of risk would preclude statin therapy, raising the question whether all people over the age of 50 should be treated."Neither the Cochrane review nor the ACC/AHA cholesterol guidelines proposed treatment for everyone over the age of 50 years.The ACC/AHA guidelines recommend that initiation of moderate intensity statin treatment be considered for patients with a predicted 10 year "hard" risk of arteriosclerotic cardiovascular disease of 5.0% to less than 7.5%.The Cochrane review questioned the feasibility and desirability of having to treat most people over the age of 50 years with a statin.The authors comment that the inclusion of four additional trials "did not substantially alter the previously documented effect of statin therapy."The updating of the evidence base resulted in an expected narrowing of confidence intervals, and the addition of the JUPITER trial added important evidence on diabetes risk.
Who pays for community care? The same old question.
Authors: P Lelliott, A Sims, J Wing
Journal: BMJ (1993)

Trends in mental health service funding over the past 40 years show that the programme of hospital closures has not resulted in a significant release of resources to fund community based services. Far from being excessive, the current provision of residential services (both NHS and non-NHS) for mentally ill people is now below levels recommended as sufficient by the government, the Royal College of Psychiatrists, and the National Schizophrenia Fellowship. What clinical research evidence there is suggests that more rather than fewer residential places are required. This situation is likely to be compounded by the recent transfer of responsibility for funding private and voluntary residential care from the Department of Social Security to local authority social services departments.