tbuckley/cabot-search huggingface dataset:
Intensive Care Society's APACHE II study in Britain and Ireland--I: Variations in case mix of adult admissions to general intensive care units and impact on outcome.
Authors: K M Rowan, J H Kerr, E Major, K McPherson, A Short, M P Vessey
Journal: BMJ (1993)

OBJECTIVES--To describe the extent of variation in the case mix of adult admissions to general intensive care units in Britain and Ireland and investigate the impact of such variation on outcome. DESIGN--Prospective, cohort study of consecutive admissions to intensive care units. SETTING--26 general intensive care units in Britain and Ireland. SUBJECTS--9099 admissions to the intensive care units studied. MAIN OUTCOME MEASURE--Death or survival at discharge before and after adjustment of case mix (age, history of chronic conditions, surgical status, diagnosis, and severity of illness) according to the APACHE II method. RESULTS--Important differences in case mix were found, with large variations between the units. Hospital mortality was significantly associated with most of the case mix factors investigated. CONCLUSIONS--Comparing crude death rates in hospital between intensive care units may be misleading indicators of performance. The collection of data on case mix needs to be standardised and differences in case mix adjusted for when comparing outcome between different intensive care units.
Current Pediatric Therapy
Authors: Herbert C. Miller
Journal: JAMA (1964)

<b>Pediatric Therapy.</b>Edited by Harry C. Shirkey. 1,144 pp, 343 illus. $16.50. C. V. Mosby Co., 3207 Washington Blvd, St. Louis 3, 1964 Both these texts speak with the voice of authority. Gellis and Kagan gathered 246, and Shirkey, 76 expert collaborators. In both instances the various authorities compose a veritable "Who's Who" in child health. Both volumes aimed towards comprehensive coverage of medical, psychological and surgical problems of children, but in other respects the two volumes have rather distinct differences. Gellis and Kagan purposefully directed their team of specialists not to include discussion of diagnosis, etiology, or pathogenesis in relation to therapy, but to focus simply on acceptable management and therapeutic regimens. Shirkey, on the other hand, did not make this rigid separation and purposefully included sufficient discussion of etiology and pathogenesis to make treatment understandable. His is more of a pediatric text with emphasis on treatment. Shirkey put
ErbB2/Her2-specific NK cells for adoptive immunotherapy of glioblastoma
Authors: Congcong Zhang, Michael Burger, Lukas Jennewein, Sabrina Genßler, Manuel Grez, Torsten Tonn, Michel Mittelbronn, Joachim Steinbach, Winfried Wels
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Significant progress has been made over the last decade towards realizing the potential of natural killer (NK) cells for cancer immunotherapy. NK cells can respond rapidly to transformed and stressed cells, and have the intrinsic potential to extravasate and reach their targets in
Confidence and Uncertainty Long After Initial Treatment for Early Prostate Cancer: Survivors' Views of Cancer Control and the Treatment Decisions They Made
Authors: Jack A. Clark, James A. Talcott
Journal: Journal of Clinical Oncology (2006)

The many years most men diagnosed with early prostate cancer live after diagnosis allow evolving assessments of their cancer control and their treatment choices, but little is known of these outcomes or the factors that influence them.We surveyed an established, prospective cohort that had initiated treatment for early prostate cancer 4 to 8 years previously. We assessed perceived cancer control, quality of treatment decisions, and other domains of quality of life, along with treatment-related urinary, bowel, and sexual dysfunction.Most men reported high confidence in cancer control and their treatment decisions, but many reported misgivings about one or both. The diagnostic, treatment, and quality-of-life factors associated with these two outcomes were distinct. Perceived cancer control was lower among those with adverse medical factors: higher pretreatment Gleason scores, subsequent rises in prostate-specific antigen (PSA), and secondary androgen ablation therapy. Confidence in treatment decisions was unrelated to these factors and was higher in men who opted for radical prostatectomy or brachytherapy, reported close attention to current PSA, had high masculine self-esteem and little distress from sexual dysfunction, and were married.Although perceptions of cancer control and the quality of their treatment decisions are linked, men can distinguish between these two outcomes. They incorporate objective indicators of high risk and adverse outcomes when assessing their cancer control; confidence in treatment decisions represents a more complex psychosocial adjustment to the persistent uncertainty that originates with their diagnosis.
Systemic immunoregulatory and proteogenomic effects of tacrolimus to sirolimus conversion in liver transplant recipients
Authors: Josh Levitsky, James M. Mathew, Michael Abecassis, Anat Tambur, Joseph Leventhal, Dhivya Chandrasekaran, Nancy Herrera, Patrice Al-Saden, Lorenzo Gallon, Anmaar Abdul-Nabi, Guang-Yu Yang, Sunil M. Kurian, Daniel R. Salomon, Joshua Miller
Journal: Hepatology (2012)

Abstract Immunosuppression (IS) withdrawal from calcineurin inhibitors is only possible in ˜20% of liver transplant recipients. However, mammalian target of rapamycin inhibitors (e.g., sirolimus; SRL) appear to be more immunoregulatory and might promote a tolerant state for withdrawal. Our aim was to determine whether systemic (i.e., blood, marrow, and allograft) signatures of immunoregulation are promoted by conversion from tacrolimus (TAC) to SRL. We therefore performed the following serial assays before and after SRL conversion in liver transplant recipients to test for enhanced markers of immunoregulation: (1) flow-cytometry immunophenotyping of peripheral blood mononuclear cells (PBMCs) and bone marrow aspirates for regulatory T cells (Tregs) (e.g., CD4 + CD25 +++ FOXP3 + ) and regulatory dendritic cells (DCregs) (immunoglobulin-like transcript 3 + /4 + ); (2) liver biopsy immunohistochemical staining (e.g., FOXP3:CD3 and CD4:CD8 ratios) and immunophenotyping of biopsy-derived Tregs after growth in culture; (3) effects of pre- versus postconversion sera on Treg generation in mixed lymphocyte reactions; (4) peripheral blood nonspecific CD4 responses; and (5) peripheral blood gene transcripts and proteomic profiles. We successfully converted 20 nonimmune, nonviremic recipients (age, 57.2 ± 8.0; 3.5 ± 2.1 years post–liver transplantation) from TAC to SRL for renal dysfunction. Our results demonstrated significant increases in Tregs in PBMCs and marrow and DCregs in PBMCs ( P &lt; 0.01) after conversion. In biopsy staining, FOXP3:CD3 and CD4:CD8 ratios were significantly higher after conversion and a number of biopsy cultures developed new or higher FOXP3 + cell growth. Nonspecific CD4 responses did not change. Both pre- and postconversion sera inhibited mixed lymphocyte reactions, although only TAC sera suppressed Treg generation. Finally, 289 novel genes and 22 proteins, several important in immunoregulatory pathways, were expressed after conversion. Conclusions : TAC to SRL conversion increases systemic Tregs, DCregs, and immunoregulatory proteogenomic signatures in liver transplant recipients and may therefore facilitate IS minimization or withdrawal. (Hepatology 2013)
Mitral Valve Abnormalities Identified by Cardiovascular Magnetic Resonance Represent a Primary Phenotypic Expression of Hypertrophic Cardiomyopathy
Authors: Martin S. Maron, Iacopo Olivotto, Caitlin Harrigan, Evan Appelbaum, C. Michael Gibson, John R. Lesser, Tammy S. Haas, James E. Udelson, Warren J. Manning, Barry J. Maron
Journal: Circulation (2011)

Background— Whether morphological abnormalities of the mitral valve represent part of the hypertrophic cardiomyopathy (HCM) disease process is unresolved. Therefore, we applied cardiovascular magnetic resonance to characterize mitral valve morphology in a large HCM cohort. Methods and Results— Cine cardiac magnetic resonance images were obtained in 172 HCM patients (age, 42±18 years; 62% men) and 172 control subjects. In addition, 15 HCM gene-positive/phenotype-negative relatives were studied. Anterior mitral leaflet (AML) and posterior mitral leaflet lengths were greater in HCM patients than in control subjects (26±5 versus 19±5 mm, P &lt;0.001; and 14±4 versus 10±3 mm, P &lt;0.001, respectively), including 59 patients (34%) in whom AML length alone, posterior mitral leaflet length alone, or both were particularly substantial (&gt;2 SDs above controls). Leaflet length was increased compared with controls in virtually all HCM age groups, including young patients 15 to 20 years of age (AML, 26±5 versus 21±4 mm; P =0.0002) and those ≥60 years of age (AML, 26±4 versus 19±2 mm; P &lt;0.001). No relation was evident between mitral leaflet length and LV thickness or mass index ( P =0.09 and P =0.16, respectively). A ratio of AML length to LV outflow tract diameter of &gt;2.0 was associated with subaortic obstruction ( P =0.001). In addition, AML length in 15 genotype-positive relatives without LV hypertrophy exceeded that of matched control subjects (21±3 versus 18±3 mm; P &lt;0.01). Conclusions— In HCM, mitral valve leaflets are elongated independently of other disease variables, likely constituting a primary phenotypic expression of this heterogeneous disease, and are an important morphological abnormality responsible for LV outflow obstruction in combination with small outflow tract dimension. These findings suggest a novel role for cardiac magnetic resonance in the assessment of HCM.
Optimizing the therapeutic approach in tinea capitis of childhood with itraconazole
Authors: M. Möhrenschlager, C. Schnopp, H. Fesq, K. Strom, A. Beham, M. Mempel, S. Thomsen, K. Brockow, D.B. Wessner, A. Heidelberger, S. Ruhdorfer, L. Weigl, H.P. Seidl, J. Ring, D. Abeck
Journal: British Journal of Dermatology (2000)

Background Tinea capitis is the most common dermatophytosis of childhood with increasing incidence. Whereas griseofulvin is considered by many as the mainstay of treatment, newer oral antifungal agents, including fluconazole, itraconazole and terbinafine have demonstrated higher efficacy, resulting in shorter treatment durations. Objectives We aimed to determine the optimum regimen for the treatment of childhood tinea capitis with itraconazole. Methods A mycological culture outcome‐dependent combination of a 28‐day continuous and facultative additional 14‐day courses with itraconazole was used in 42 children (20 girls; 22 boys) aged 12–140 months (mean 66) with tinea capitis due to Microsporum canis (n = 26) and Trichophyton violaceum (n = 16). The drug was given orally according to the patients’ body weight (50 mg daily for < 20 kg; 100 mg daily for ≥ 20 kg) over 4 weeks. Direct microscopy and fungal culture as a parameter for efficacy were repeated 2 weeks after termination of treatment. Assessment of efficacy was based on the evaluation of results from light microscopy and culture at 8 weeks after initiation of treatment, and in the case of a further positive mycological culture at 14 and 20 weeks, respectively. A positive fungal culture at these times resulted in an additional course for 2 weeks with the initially chosen itraconazole dosage. Results In 34 of 42 patients a single 4‐week course of itraconazole resulted in a complete mycological cure of lesions as demonstrated by light microscopy and mycological culture. Four of 42 patients had to be treated by a second itraconazole course for 2 weeks, and four children received a third course of itraconazole for 2 weeks until all lesions showed negative direct microscopy and mycological culture. No abnormal haematological or biochemical results occurred. Apart from transient, completely reversible indigestion in two children, no side‐effects were observed. Conclusions A culture‐based 28‐day continuous therapeutic regimen plus facultative cultural outcome‐dependent additional 14‐day courses of a body weight‐adapted dosage of itraconazole in tinea capitis due to M. canis and T. violaceum is discussed; this offers the advantage of an effective therapy with complete negative direct microscopy as well as negative cultural results, within a shorter active treatment period (cf. previous studies with continuous administration of itraconazole).
Association between mitogenicity and immunogenicity of 4-hydroxy-3,5-dinitrophenacetyl-lipopolysaccharide, a T-independent antigen.
Authors: E Smith, L Hammarström, A Coutinho
Journal: The Journal of Experimental Medicine (1976)

Polymyxin B, which is a basic polypeptide produced by various strains of Bacillus Polymyxa, has previously been shown to prevent the lethal effect of LPS and to neutralize the Schwartzmann reaction. In this study we have investigated the interactions between polymyxin B and lipopolysaccharide (LPS) and hapten LPS conjugates. Polymyxin B was found to suppress mitogenicity of LPS and also to inhibit immunogenicity of the hapten conjugate 4-hydroxy-3,5-dinitrophenacetyl (NNP)-LPS. Inhibition was not due to interference with the expression of NNP determinants nor to cross-reactivity between PB and the hapten. Since mitogenicity and immunogenicity decreased in parallel, we conclude that B-cell activation in specific thymus independent responses does not take place in the absence of a nonspecific (non-Ig-mediated) signal.
32 SERUM PROTEIN PROFILING OF ALCOHOLIC HEPATITIS USING MASS SPECTROMETRY (SELDI-TOF MS PROTEINCHIP): IDENTIFICATION OF A BIOMARKER OF RESPONSE TO CORTICOSTEROIDS
Authors: S. Dharancy, G. Briand, A. Louvet, C. Dutoit, A. Hollebecque, C. El Makhloufi, L. Dubuquoy, P. Mathurin
Journal: Journal of Hepatology (2008)
Enhanced expression of the antimicrobial peptide LL-37 in lesional skin of adults with atopic eczema
Authors: N. Ballardini, C. Johansson, G. Lilja, M. Lindh, Y. Linde, A. Scheynius, B. Agerberth
Journal: British Journal of Dermatology (2009)

Atopic eczema (AE) is a common multifactorial chronic skin disease associated with a defective skin barrier and increased susceptibility to skin infections. The human cathelicidin LL-37 plays a role in the host defence of skin. Studies have demonstrated deficient expression of LL-37 in skin of AE patients.The aim of this study was to investigate the expression of LL-37 in lesional skin compared with nonlesional skin in patients with different severity of AE, patients with other eczema and healthy subjects.Twenty patients with AE, four patients with other eczema and 10 healthy subjects were included. Severity of AE was graded using SCORing of atopic dermatitis (SCORAD). Skin biopsies were taken from lesional and nonlesional skin from all patients and from skin of healthy controls. The levels of LL-37 mRNA were analysed by quantitative reverse transcriptase-polymerase chain reaction. Evaluation of dermal and epidermal protein expression of LL-37 and the degree of inflammation was performed by immunohistochemical stainings.Patients with AE and patients with other eczema had significantly (P < 0.05) higher levels of LL-37 in lesional skin than in nonlesional skin. The expression of LL-37 was not statistically associated to severity of AE valued by SCORAD. Nonlesional skin from patients did not differ from skin of healthy subjects in terms of LL-37 expression. In the presence of epidermal injury or vesicles the LL-37 peptide was always detected.Patients with AE exhibit enhanced expression of LL-37 in lesional skin compared with nonlesional, suggesting a role of LL-37 in AE that might be associated with the process of re-epithelialization.
Pulmonary Rheumatoid Nodule With Cavitation and Chronic Lipid Effusion
Authors: Bruce F. Stengel
Journal: JAMA (1966)

Unusual findings were noted in a case of nodular rheumatoid pulmonary disease with roentgenographic evidence of cavitation. Biopsy specimen of the cavitated nodule was identical microscopically to the patient's typical subcutaneous rheumatoid nodule. Of further interest was the associated pleural effusion with low glucose concentration, high total lipid content, and extremely high lactic acid dehydrogenase level. To the best of the author's knowledge, chronic lipid effusion and elevated lactic acid dehydrogenase have not been previously reported in association with rheumatoid disease of the lung. The diagnostician must consider rheumatoid disease in the differential diagnosis of cavitary pulmonary lesions in the patient with associated rheumatoid disease. Adequate biopsy and microscopic confirmation of the process are still required for definite diagnosis.
Analysis of Colonoscopic Findings in the Differential Diagnosis Between Intestinal Tuberculosis and Crohn’s Disease
Authors: Y. Lee, S.-K. Yang, J.-S. Byeon, S.-J. Myung, H.-S. Chang, S.-S. Hong, K.-J. Kim, G. Lee, H.-Y. Jung, W.-S. Hong, J.-H. Kim, Y. Min, S. Chang, C. Yu
Journal: Endoscopy (2006)

Background and Study Aims: Intestinal tuberculosis and Crohn's disease are chronic inflammatory bowel disorders that are difficult to differentiate from one another. This study aimed to evaluate the diagnostic value of various colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease. Patients and Methods: Colonoscopic findings on initial work-up were prospectively recorded in patients with an initial diagnosis of either intestinal tuberculosis or Crohn's disease. These findings were analyzed after a final diagnosis of intestinal tuberculosis (n = 44) or Crohn's disease (n = 44) had been made after follow-up. Results: Four parameters (anorectal lesions, longitudinal ulcers, aphthous ulcers, and cobblestone appearance) were significantly more common in patients with Crohn's disease than in patients with intestinal tuberculosis. Four other parameters (involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps) were observed more frequently in patients with intestinal tuberculosis than in patients with Crohn's disease. We hypothesized that a diagnosis of Crohn's disease could be made when the number of parameters characteristic of Crohn's disease was higher than the number of parameters characteristic of intestinal tuberculosis, and vice versa. Making these assumptions, we calculated that the diagnosis of either intestinal tuberculosis or Crohn's disease would have been made made correctly in 77 of our 88 patients (87.5 %), incorrectly in seven patients (8.0 %), and would not have been made in four patients (4.5 %). Conclusions: A systematic analysis of colonoscopic findings is very useful in the differential diagnosis between intestinal tuberculosis and Crohn's disease.
Safety and Efficacy of Allogeneic Cell Therapy in Infarcted Rats Transplanted With Mismatched Cardiosphere-Derived Cells
Authors: Konstantinos Malliaras, Tao-Sheng Li, Daniel Luthringer, John Terrovitis, Ke Cheng, Tarun Chakravarty, Giselle Galang, Yiqiang Zhang, Florian Schoenhoff, Jennifer Van Eyk, Linda Marbán, Eduardo Marbán
Journal: Circulation (2011)

Cardiosphere-derived cells (CDCs) are an attractive cell type for tissue regeneration, and autologous CDCs are being tested clinically. However, autologous therapy necessitates patient-specific tissue harvesting and cell processing, with delays to therapy and possible variations in cell potency. The use of allogeneic CDCs, if safe and effective, would obviate such limitations. We compared syngeneic and allogeneic CDC transplantation in rats from immunologically-mismatched inbred strains.In vitro, CDCs expressed major histocompatibility complex class I but not class II antigens or B7 costimulatory molecules. In mixed-lymphocyte cocultures, allogeneic CDCs elicited negligible lymphocyte proliferation and inflammatory cytokine secretion. In vivo, syngeneic and allogeneic CDCs survived at similar levels in the infarcted rat heart 1 week after delivery, but few syngeneic (and even fewer allogeneic) CDCs remained at 3 weeks. Allogeneic CDCs induced a transient, mild, local immune reaction in the heart, without histologically evident rejection or systemic immunogenicity. Improvements in cardiac structure and function, sustained for 6 months, were comparable with syngeneic and allogeneic CDCs. Allogeneic CDCs stimulated endogenous regenerative mechanisms (cardiomyocyte cycling, recruitment of c-kit(+) cells, angiogenesis) and increased myocardial vascular endothelial growth factor, insulin-like growth factor-1, and hepatocyte growth factor equally with syngeneic CDCs.Allogeneic CDC transplantation without immunosuppression is safe, promotes cardiac regeneration, and improves heart function in a rat myocardial infarction model, mainly through stimulation of endogenous repair mechanisms. The indirect mechanism of action rationalizes the persistence of benefit despite the evanescence of transplanted cell survival. This work motivates the testing of allogeneic human CDCs as a potential off-the-shelf product for cellular cardiomyoplasty.
Safety of transesophageal echocardiography. A multicenter survey of 10,419 examinations.
Authors: W G Daniel, R Erbel, W Kasper, C A Visser, R Engberding, G R Sutherland, E Grube, P Hanrath, B Maisch, K Dennig
Journal: Circulation (1991)

During the past few years, transesophageal echocardiography (TEE) has been increasingly used in clinical cardiology; data concerning the practicability and safety of the technique, however, are rare.This report analyzes the experience of 15 European centers performing TEE studies for at least 1 year. At the time of this survey, 10,419 TEE examinations had been attempted or performed in these institutions. These TEE examinations were carried out by 54 physicians, 53.7% of whom had been trained in endoscopic techniques. Within the same time period, 160,431 precordial echocardiographic examinations were performed in the 15 institutions; the ratio between TEE and transthoracic studies averaged 9.03 +/- 6.4% (range of the 15 centers, 1.4-23.6%). Of the 10,419 patients, 9,240 (88.7%) were conscious inpatients or outpatients at the time of the TEE examination; the vast majority of the conscious patients did not receive intravenous sedation before TEE. In 201 cases (1.9%), insertion of the TEE probe was unsuccessfully attempted because of a lack of patient cooperation and/or operator experience (98.5%) or because of anatomical reasons (1.5%). In 90 of 10,218 TEE studies (0.88%) with successful probe insertion, the examination had to be interrupted because of the patient's intolerance of the echoscope (65 cases); because of pulmonary (eight cases), cardiac (eight cases), or bleeding complications (two cases); or for other reasons (seven cases). One of the bleeding complications resulted from a malignant lung tumor with esophageal infiltration and was fatal (mortality rate, 0.0098%).This multicenter survey documents that TEE studies are associated with an acceptable low risk when used by experienced operators under proper safety conditions.
Plasma interleukin-6 is independently associated with mortality in both hemodialysis and pre-dialysis patients with chronic kidney disease
Authors: Daniela V. Barreto, Fellype C. Barreto, Sophie Liabeuf, Mohammed Temmar, Horst-Dieter Lemke, Christophe Tribouilloy, Gabriel Choukroun, Raymond Vanholder, Ziad A. Massy
Journal: Kidney International (2009)