tbuckley/cabot-search huggingface dataset:
Fetal Transfusion in Severe Rh Isoimmunization
Authors: John M. Bowman
Journal: JAMA (1969)

A total of 218 fetal transfusions were carried out on 100 fetuses in a 55-month period. The survival rate improved from 28% (11 of 39) in the first 22 months to 62% (38 of 61) in the last 33 months. Failure to reduce the incidence of hydrops fetalis is due to failure to refer sensitized women for investigation sufficiently early in gestation. Administration of digoxin to the hydropic fetus and digoxin and diuretics to the mother may have accounted for the survival of six hydropic fetuses in the last 33-month period. Fetal transfusions are undertaken if serial amniotic fluid optical density rise measurements show an increase into the top four fifths of zone 2 of Liley. Fetal salvage, in Winnipeg, is satisfactory when fetal transfusions are begun early. Two thirds of all fetuses initially transfused before 26 weeks gestation now survive.
Food‐induced anaphylaxis
Authors: B. Wüthrich, B. K. Ballmer‐Weber
Journal: Allergy (2001)

To date, there are no population‐based epidemiologic studies providing information about the prevalence of food‐induced anaphylaxis. However, statistics from the United Kingdom demonstrated an increase of anaphylaxis from 5.6 cases per 100000 hospital discharges in 1991–92 to 10.2 cases in 1994–95. The increase for the subcategory of food‐induced anaphylaxis was above the overall increase in anaphylaxis. In the UK register of fatal anaphylactic reactions, all food‐induced fatalities have been accompanied by respiratory problems with respiratory arrest. Atopic individuals with bronchial asthma and prior allergic reactions to the same food are at a particularly high risk. Not only peanuts, seafood and milk can induce severe, potentially lethal, anaphylaxis, but indeed a wide spectrum of foods, according to the different patterns of food sensitivity in different countries. Foods with “hidden” allergens and meals at restaurants are particularly dangerous for patients with food allergies. Similarly, schools, public places and restaurants are the major places of risk. However, the main factor contributing to a fatal outcome is the fact that the victims did not carry their emergency kit with adrenaline (epinephrine) with them. Therefore, we suggest that the pharmaceutical industry should reintroduce an adrenaline inhaler that is more effective, especially in asthmatic reactions.
Abstract 1430: Identification of distinct metabolic subtypes within pancreatic ductal adenocarcinoma through broad metabolite profiling
Authors: Anneleen Daemen, David Peterson, Nisebita Sahu, Ron McCord, Kaska Kowanetz, Anna Hitz, Xiangnan Du, Bonnie Liu, Min Gao, John Moffat, Rebecca Hong, Deepak Sampath, Mark Merchant, Thomas O'Brien, Bob Yauch, Jeff Settleman, Jing Qing, Georgia Hatzivassiliou, Marie A. Evangelista
Journal: Cancer Research (2014)

Abstract Targeting cancer metabolism is currently being evaluated as a potential therapeutic target. Identification of tumor subtypes with specific metabolic requirements will enable the success of such therapies. Using cell line models of pancreatic ductal adenocarcinoma (PDAC), we conducted broad metabolite profiling and identified 3 metabolic subtypes through non-negative matrix factorization (NMF) consensus clustering. Among the most distinguishing features between the subtypes were levels of metabolites important for lipid synthesis, amino acid, and energy-related pathways, suggestive of distinct metabolic dependencies. Using RNAseq we show that these subtypes are defined at the transcriptional level and are associated with known subtypes of PDAC. In metabolic flux experiments, we also show that glucose and glutamine are differentially utilized by each subtype, and as a consequence, exhibit distinct sensitivity to inhibition of various metabolic pathways. Finally, through screening of a large panel of tumor cell lines with various metabolic inhibitors, we cross-validate our finding in PDAC and provide strong evidence that these same subtypes exist and can be identified in other tumor indications. Our findings highlight the utility of broad metabolite profiling to predict sensitivity to metabolic inhibitors in cancer cells. Citation Format: Anneleen Daemen, David Peterson, Nisebita Sahu, Ron McCord, Kaska Kowanetz, Anna Hitz, Xiangnan Du, Bonnie Liu, Min Gao, John Moffat, Rebecca Hong, Deepak Sampath, Mark Merchant, Thomas O'Brien, Bob Yauch, Jeff Settleman, Jing Qing, Georgia Hatzivassiliou, Marie A. Evangelista. Identification of distinct metabolic subtypes within pancreatic ductal adenocarcinoma through broad metabolite profiling. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1430. doi:10.1158/1538-7445.AM2014-1430
Law's Influence on Medicine and Medical Ethics
Authors: Alan A. Stone
Journal: New England Journal of Medicine (1985)

Ginzberg recently described in the Journal the monetarization of medical care.1 Law follows money, and along with monetarization have come new laws and legal regulations — constraints that cast a lengthening shadow over the clinical practice of medicine. PSRO (professional standards review organization), PRO (professional review organization), DRG (diagnosisrelated group), and CON (certificate of need) are acronyms that have entered the physician's consciousness — along with malpractice liability, antitrust actions, and federal and state regulation. The health-insurance industry, increasingly the target of legal regulation by administrative agencies, legislatures, and courts, is itself a powerful regulatory influence and has acted in . . .
Cardiac Atrophy After Bed-Rest Deconditioning
Authors: Benjamin D. Levine, Julie H. Zuckerman, James A. Pawelczyk
Journal: Circulation (1997)

Background The cardiovascular adaptation to bed rest leads to orthostatic intolerance, characterized by an excessive fall in stroke volume (SV) in the upright position. We hypothesized that this large fall in SV is due to a change in cardiac mechanics. Methods and Results We measured pulmonary capillary wedge pressure (PCWP), SV, left ventricular end-diastolic volume (LVEDV), and left ventricular mass (by echocardiography) at rest, during lower-body negative pressure, and after saline infusion before and after 2 weeks of bed rest with −6° head-down tilt (n=12 subjects aged 24±5 years). Pressure (P)-volume (V) curves were modeled exponentially by P= ae k V + b and logarithmically by P=− S ln[(V m −V)/(V m −V 0 ], where V 0 indicates volume at P=0, and the constants k and S were used as indices of normalized chamber stiffness. Dynamic stiffness (dP/dV) was calculated at baseline LVEDV. The slope of the line relating SV to PCWP during lower-body negative pressure characterized the steepness of the Starling curve. We also measured plasma volume (with Evans blue dye) and maximal orthostatic tolerance. Bed rest led to a reduction in plasma volume (17%), baseline PCWP (18%), SV (12%), LVEDV (16%), V 0 (33%), and orthostatic tolerance (24%) (all P &lt;.05). The slope of the SV/PCWP curve increased from 4.6±0.4 to 8.8±0.9 mL/mm Hg ( P &lt;.01) owing to a parallel leftward shift in the P-V curve. Normalized chamber stiffness was unchanged, but dP/dV was reduced by 50% at baseline LVEDV, and cardiac mass tended to be reduced by 5% ( P &lt;.10). Conclusions Two weeks of head-down–tilt bed rest leads to a smaller, less distensible left ventricle but a shift to a more compliant portion of the P-V curve. This results in a steeper Starling relationship, which contributes to orthostatic intolerance by causing an excessive reduction in SV during orthostasis.
Persistent Intrathecal Antibody Synthesis 15 Years After Recovering From Anti– N-methyl-D-aspartate Receptor Encephalitis
Authors: Hans-Christian Hansen, Christine Klingbeil, Josep Dalmau, Wenhan Li, Benedikt Weißbrich, Klaus-Peter Wandinger
Journal: JAMA Neurology (2013)

<h3>Background</h3>Anti– N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune disorder characterized by high intrathecal antibody synthesis. Little is known about the long-term follow-up of the cerebrospinal fluid antibody status.<h3>Objective</h3>To describe persistent intrathecal antibody synthesis in a clinically healthy person 15 years after recovering from anti-NMDAR encephalitis.<h3>Design</h3>Case report.<h3>Setting</h3>Academic medical center.<h3>Patient</h3>A 40-year-old woman who had been diagnosed as having encephalitis of unknown origin in 1995.<h3>Main Outcome Measures</h3>Clinical evaluation and NMDAR antibody testing.<h3>Results</h3>On reexamination in 2011, the patient had fully recovered. Investigation of archived as well as follow-up serum and cerebrospinal fluid samples revealed intrathecal synthesis of NMDAR antibodies.<h3>Conclusions</h3>This is the longest follow-up on a patient with anti-NMDAR encephalitis. Our findings emphasize that intrathecal antibody synthesis does not necessarily reflect disease activity and that the significance of NMDAR antibody titers needs to be interpreted for each patient according to the clinical context.
Argentaffinomata of Ileum Revealed by Secondary in Epididymis
Authors: J. R. O'Brien
Journal: BMJ (1951)

BRITISH 1315 whom, following sensitization to and subsequent administration of sulphonamides, there occurred (i) sensitization dermatitis, (ii) toxic erythema, (iii) dyspnoea resembling asthma, (iv) migraine, and (v) polyarteritis'nodosa.Our case presented a somewhat similar train of events providing presumptive evidence of an allergic basis, but questioning failed to elicit any history of exposure to sulphonamides or any personal or family history of allergy.The chemical compounds, other than sulphonamides, sensitivity to which has been held responsible for polyarteritis nodosa are: desoxycorticosterone acetate (Selye et al., 1944), thiourea (Gibson and Quinlan, 1945), organic arsenicals (Miller and Nelson, 1945), and iodine (Rich, 1945).In our case there was no history of exposure to any of these drugs.The marked eosinophilia which was present in our case could not be regarded as more than suggestive evidence of allergy, as it has been shown to be an inconstant concomitant of at least one form of proved hypersensitivity to drugs (e.g., Cruickshank and Squire, 1949), while it may occur occasionally in conditions demonstrably without allergic basis (Bickel, 1950).Accordingly, we have regarded the condition described above as a diffuse arteritis, resembling other more clearly defined varieties of granulomatous arteritis, but have considered the likelihood of its having been allergic in origin as unproved.Summary A case is described which showed the progressive develop- ment of diarrhoea and vomiting, acute erythroderma going on to exfoliative dermatitis, Raynaud's symptom-complex leading to gangrerie of the fingers, transient visual disturb- ances, enlargement of spleen and lymph nodes, pyrexia and leucocytosis with eosinophilia, thrombosis of temporal and radial arterles, and remarkable and unexpected recovery.Biopsies from various sites showed evidence of wide- spread inflammatory arteritis with eosinophilic infiltration of the tissues and viscera.The relationship of this case to various other conditions showing similar histological changes and of supposedly allergic origin is discussed.Our grateful thanks are due to Dr. Ernest Bulmer
Clinical Practice Guidelines
Authors: William W. Parmley
Journal: JAMA (1994)

This issue ofThe Journal<sup>1</sup>contains the first of a series of four articles to be published in<i>JAMA</i>that summarize selected aspects of a much larger document, "Heart Failure: Evaluation and Care of Patients With Left Ventricular Systolic Dysfunction," which was published as a clinical practice guideline by the US Department of Health and Human Services.<sup>2</sup> See also p 1361. With the support of staff from RAND, a panel of 16 individuals knowledgeable in various aspects of heart failure authored the larger document, while selected members have authored the four subsections accepted for publication in<i>JAMA</i>. The potential value of these and other guidelines is that the authors have carefully evaluated the world's literature, with particular emphasis on well-controlled trials, as the basis for decision making. In the original document, a laudable attempt was made to classify the scientific validity of each study and conclusion using seven
Patients With Syncope Admitted to Medical Intensive Care Units
Authors: Marc D. Silverstein
Journal: JAMA (1982)

The records of 108 patients admitted to a medical intensive care unit (ICU) for syncope during a two-year period were reviewed. Explicit criteria were used to classify patients by presumed etiologic diagnosis. Thirty-six percent of the cases of syncope were due to cardiovascular disease, 17% were due to noncardiovascular disease, and 47% were unexplained at hospital discharge. Seventy-two percent of presumed etiologic diagnoses were based on information available at the time of patient admission. The remainder were based on ICU monitoring and additional diagnostic tests. Patients were prospectively studied after hospital discharge. The one-year mortality was 19% in the cardiovascular group, 6% in the noncardiovascular group, and 6% among patients whose syncope remained unexplained. Age-standardized comparisons between the unexplained syncope group, the US population, and other ICU patients suggest that patients with syncope unexplained at hospital discharge do not have an increased risk of death during the subsequent year. (<i>JAMA</i>1982;248:1185-1189)
Long-term prognostic importance of patency of the infarct-related coronary artery after thrombolytic therapy for acute myocardial infarction.
Authors: H D White, D B Cross, J M Elliott, R M Norris, T W Yee
Journal: Circulation (1994)

BACKGROUND After thrombolytic therapy, long-term patency of the infarct-related artery may reduce arrhythmias, limit ventricular dilatation, and provide collaterals to another infarct zone if further infarction occurs. However, independent long-term prognostic value of infarct artery patency has not been shown. METHODS AND RESULTS We followed 312 patients with first myocardial infarction treated &lt; 4 hours after pain onset with thrombolysis (streptokinase [n = 188] or recombinant tissue-type plasminogen activator [n = 124]). At 28 +/- 11 days, cardiac catheterization was performed. Flow of the infarct-related artery was assessed by the TIMI scoring system, and a scoring system relating coronary stenoses and flow to the amount of myocardium supplied was also used. Follow-up was for 39 +/- 13 months. Cardiac death occurred in 5.8% of patients, and there were two noncardiac deaths. Revascularization was performed in 11.5% of patients. On univariate and multivariate analysis, ventricular function (ejection fraction, P = .006 and .02, or end-systolic volume index, P = .01 and .06) was the most important prognostic factor. Patency of the infarct-related artery measured as TIMI 3 flow was marginally significant on univariate analysis (P = .08) but not on multivariate analysis (P = .2). Patency was an independent prognostic factor in univariate and multivariate analysis when measured as an occlusion score (amount of myocardium supplied by an occluded artery, P = .01 and &lt; .05). When the ejection fraction was &gt; or = 50%, only occluded arteries supplying &gt; 25% of the left ventricle affected prognosis adversely. If the ejection fraction was &lt; 50%, occluded arteries supplying &lt; 25% of myocardium also adversely affected prognosis. Treadmill exercise duration 4 weeks after infarction was the only other prognostic factor identified. CONCLUSIONS Ventricular function and infarct-related artery patency are independent prognostic factors after thrombolytic therapy for acute myocardial infarction.
Potential Misclassification in Some Studies Claiming an Association Between Chlorophenol Exposure and Various Malignancies
Authors: Stanley Pierce, James Ruger
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article Potential Misclassification in Some Studies Claiming an Association Between Chlorophenol Exposure and Various Malignancies Get access Stanley Pierce, Stanley Pierce Search for other works by this author on: Oxford Academic PubMed Google Scholar James Ruger James Ruger Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 22, 21 November 1990, Pages 1785–1786, https://doi.org/10.1093/jnci/82.22.1785 Published: 21 November 1990
Effects of Inhaled KP-496, a Novel Dual Antagonist for Cysteinyl Leukotrienes Receptor and Thromboxane A2 Receptor, on Allergic Asthmatic Responses in Guinea Pigs
Authors: M SUDA, T OKUDA, M ISHIMURA, S KUROKAWA, S TOKUOKA, T NAKAMURA, Y TAKAHASHI, H TANAKA, H NAGAI
Journal: Journal of Allergy and Clinical Immunology (2008)
Fluorouracil as an Adjuvant to Colorectal Cancer Surgery
Authors: Min C. Li
Journal: JAMA (1976)

Drs Hansen and Stein raised the question as to the validity of using historical controls to assess a new therapeutic modality. The authors are very well aware of the merit and pitfalls of concurrent randomized studies. In many situations, the circumstances do not permit a concurrent randomized control, or, if the historical control is very much compatible with the studied groups, historical control may be the only valid background. For example, in the successful treatment of gestational choriocarcinoma with the chemotherapy, the initial treatment of Wilms tumor with chemotherapy and radiotherapy during the postoperative period, and even radiotherapy for stage I and stage II Hodgkin disease, there were no concurrent randomized controls. In addition, the effect of digitalis on congestive heart failure, the effect of adrenal steroids on adrenal crisis, and the effect of insulin on diabetic coma are all examples. To go a step further, when a
Corticosteroid Use after Hospital Discharge among High-risk Adults with Asthma
Authors: Jerry A. Krishnan, Kristin A. Riekert, Jonathan V. McCoy, Dana Y. Stewart, Spencer Schmidt, Arjun Chanmugam, Peter Hill, Cynthia S. Rand
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Despite the efficacy of corticosteroid therapy, patients hospitalized for asthma exacerbations are at high risk for re-exacerbation and death after discharge. The objective of this prospective cohort study was to evaluate adherence to inhaled corticosteroids (ICS) and oral corticosteroids (OCS) after discharge in adults hospitalized for asthma exacerbations. ICS and OCS were equipped with electronic medication monitors and were provided at discharge. Adherence (use/prescribed use x 100%) was measured by self-report and canister weight (ICS), pill count (OCS), and electronic medication monitors (both ICS and OCS) 2 weeks after discharge. Poor adherence was defined as adherence of less than 50%. The Asthma Control Questionnaire was used to assess symptom control. Sixty patients were enrolled (age 42.2 years, 98.3% African American, 65.0% female, 46.7% with history of near-fatal asthma). Electronically measured adherence to both corticosteroids dropped to approximately 50% within 7 days of discharge. Poor adherence to both corticosteroids predicted significantly worse symptom control (p = 0.04). Self-report, canister weight, and pill count all had low sensitivity (29.2%, 65.0%, and 7.7%, respectively) for detecting poor adherence. We conclude that adherence to ICS and OCS deteriorates within days of hospital discharge but may not be recognized in a substantial proportion of patients.
Sign of the cross
Authors: E. Ingall
Journal: BMJ (2009)

There we stood in room 17 of the neurosurgical ward—ENT specialist registrar poised with tracheal dilator, ENT senior house officer with head light, and staff nurse armed with suction—surrounding a teenage patient with cerebral palsy on the bed for routine change of his long term tracheostomy tube. Suddenly the patient’s eyes began to roll, and his limbs began to jerk. Nurses were called for, and the ENT team started looking edgy in that “please someone else lead …
Government sets out vision for clinical governance
Authors: L. Beecham
Journal: BMJ (1999)

The NHS Executive has set out its vision for the implementation of clinical governance in England for the next five years and highlighted the key tasks for the first year.

The introduction of clinical governance—“a framework through which local organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”—was one of the main recommendations …
Synchronous surgical training and academic profile development in current atmosphere: Impractical or plausible?
Authors: Chandrasekaran Kaliaperumal, George Kaar, Michael O'Sullivan, Charles Marks
Journal: International Journal of Surgery (2013)

A total of 28 publications and over 52 (oral and poster) presentations in both national and international meetings happened in that duration. The publications included research, review and case reports in international peer reviewed journals. 8 audits were carried on and one comment was published in an international news paper. All the trainees had one or more publications or presentations during the course of this study.
Blood Pressure and Serum Creatinine
Authors: M. E. Salive, R. J. Havlik
Journal: JAMA (1993)

To the Editor.  —We were intrigued by the report of Perneger et al 1 that blood pressure level was associated with subsequent creatinine levels in middle-aged adults and wanted to replicate the analysis using data on older adults. We examined data from 3958 older residents of three communities in the Established Populations for the Epidemiologic Studies of the Elderly, 2,3 whose blood pressure was measured (average  of two readings) in 1982 and 1983 and in 1988 and 1989 and serum creatinine was analyzed in 1988 and 1989. We performed a statistical analysis similar to that reported by Perneger et al and found somewhat similar results.  Serum creatinine level was associated more strongly with past than with current blood pressure levels (Table). Limiting the analysis to participants who were not receiving antihypertensive therapy at the time of their blood pressure measurement in 1982 and 1983 had little effect on the results.
Abstract 4815: Colorectal Cancer Mortality in Hong Kong, Japan, Korea, and Singapore.
Authors: Aesun Shin, Kyu Won Jung, Young-Joo Won
Journal: Cancer Research (2013)

Abstract Although colorectal cancer mortality has started to decrease in many Western countries, its high incidence and mortality in most Asian countries are challenging health problems. We analyzed the colorectal cancer mortality in four Asian countries using the World Health Organization mortality database and the Korea National Statistics Office database. The annual age-standardized rates and truncated rated for the three age groups (30-49/50-69/70+ years) for Hong Kong (1969-2009), Japan (1955-2009), Korea (1985-2006), and Singapore (1966-2009) were estimated. A joinpoint regression model was used to detect significant trends in mortality rates. Colorectal cancer mortality in men started to decrease in 1992 in Japan followed by Singapore and Hong Kong in 1995. The mortality rates in women stared to decrease in 1980 in Singapore, followed by Hong Kong and Japan in 1996. In all countries and both genders, except for women in Singapore, the decrease in mortality began in the younger age groups. In conclusion, the colorectal cancer mortality in the four studied Asian countries has started to decrease, and the decrease occurred first in the younger age groups. Citation Format: Aesun Shin, Kyu Won Jung, Young-Joo Won. Colorectal Cancer Mortality in Hong Kong, Japan, Korea, and Singapore. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4815. doi:10.1158/1538-7445.AM2013-4815