tbuckley/cabot-search huggingface dataset:
When marketing masquerades as education
Authors: D. Spence
Journal: BMJ (2011)

<b>Background: </b>Noninvasive ventilation (NIV) is a common respiratory modality used for patients with acute respiratory failure. It involves use of an oronasal mask, held in place with straps on patient’s face to provide ventilatory support without using artificial airways. NIV use for longer duration and mask strap tension are associated with increased risk of skin breakdown at the nose bridge as well as cheeks, leading to reportable medical device-related injuries. The development of medical device-related skin injuries among hospitalized patients is a growing concern. The primary aim of this quality improvement project was to reduce the incidence of NIV related reportable, pressure ulcers among adult patients with acute respiratory failure. <b>Methods: </b>This was a collaborative, quality improvement (QI) project conducted at an academic medical center from July 2018–June 2020. All adult patients who received continuous NIV for acute respiratory failure were enrolled. The QI plan was devised to include key drivers of change: 1) prophylactic use of a foam dressing (Mepilex Lite) at the initiation of NIV; 2) Q4H skin assessment by bedside nurse and respiratory therapists, and 3) mask rotation for patients receiving NIV &gt; 24 h. Mask rotation refers to sequential use of different masks (eg, oronasal to full face mask) to offload and redistribute the pressure on the underlying skin. The incidence of reportable, stage II and above, hospital acquired pressure injuries related to NIV mask occurred during pre-QI phase (July 2019–June 2019) were compared with the post- QI phase (July–June 2020). <b>Results: </b>During the pre-implementation phase, a total of 8 NIV mask-related, Stage II and above, skin injuries were reported (incidence rate 0.04 per 1,000 patient days). In the post implementation phase, there were total 2 NIV mask-related, Stage II and above, skin injuries identified (incidence rate 0.01 per 1,000 patient days). With the QI plan focused on the prophylactic measures and collaborative efforts between respiratory therapists and nurses, reportable NIV mask related injuries were reduced by 25%. The median Braden Score for pre-QI cohort was 14.5 (IQR 14.5–15) and 13 (13–13) for post-QI cohort representing moderate risk level for developing pressure sores in both the groups. <b>Conclusions: </b>The bundle-based QI plan including prophylactic foam dressing, Q4H skin assessments, and mask rotation was beneficial in reducing the incidence of NIV mask-related, reportable skin injuries in an adult population.
INVESTIGATION OF POLYURIA IN SCHIZOPHRENIA
Authors: Francis H. Sleeper
Journal: American Journal of Psychiatry (1935)

The average urinary output in a series of 92 male schizophrenic patients was 2532 cc., that of 26 presumably healthy control subjects 1328 cc. Restrictions of water intake to about 1900 cc. of water both as such and in food in 10 of the patients with very high urinary output resulted in no particular complaints of thirst on their part although they did complain of the sameness and amount of food. It has been shown that the kidneys of schizophrenic patients are able to concentrate and dilute urine within normal limits in response to the ingestion of one litre of water. The anti-diuretic effect of obstetrical pituitrin is as effective in schizophrenic patients as in normal subjects reported in the literature. Further studies on the cause or causes of polyuria in schizophrenia are indicated.
PTU-013 The Impact of Education on Fluid Prescribing amongst Junior Doctors: Abstract PTU-013 Table 1
Authors: S Biswas, M Stroud, A de Silva
Journal: Gut (2013)

<h3>Introduction</h3> Gastroenterology patients frequently require intravenous fluids but inappropriate prescription is associated with poorer outcomes (1). Educational initiatives can improve fluid prescription (2) and this study examines knowledge of electrolyte requirements and post-operative fluid prescription amongst final year medical students and junior doctors, ten years on from the paper by Lobo <i>et al</i> (3). <h3>Methods</h3> 56 junior doctors and final year medical students in a large UK teaching hospital answered a questionnaire on fluid prescribing practise before attending a formal teaching session on the topic where they also received a pocket handbook on Trust prescribing guidelines. Six months later they were asked to repeat the questionnaire. There were 36 respondents after the teaching session. <h3>Results</h3> Prior to the teaching 25% did not feel confident with fluid prescribing and 34% felt they had unsatisfactory or poor teaching at medical school. 18% stated that fluid balance charts were not checked regularly. Only 10% of respondents were aware of the sodium content of normal saline and 9% would prescribe two or more litres of normal saline per day in a post-operative patient. After the teaching session 94% felt confident with fluid prescribing and 64% knew the sodium content of normal saline. 5% would prescribe two or more litres of normal saline per day in a post-operative patient. <h3>Conclusion</h3> Knowledge of electrolyte requirements and fluid prescribing is still inadequate, but a teaching session with a handout significantly improved knowledge and confidence in prescribing. The six months of experience gained in this time may be a confounding factor, but as the questionnaires indicated lack of fluid chart review with seniors or other relevant teaching sessions, their main source of knowledge was postulated to be from our teaching. More attention should be given to this subject in medical schools and guidance should be given at Trust inductions. <h3>Disclosure of Interest</h3> None Declared <h3>References</h3> Walsh SR <i>et al.</i> Perioperative fluid management: prospective audit. Int J Clin Pract. 2008 Mar; 62(3):492–7. Epub 2007 May 30. De Silva AN <i>et al.</i> Improving peri-operative fluid management in a large teaching hospital: pragmatic studies on the effects of changing practise. Proceedings of the Nutrition Society 2010; 69: 499–507. Lobo DN <i>et al.</i> Problems with solutions: drowning in the brine of an inadequate knowledge base. Clinical Nutrition 2001; 20(2):125–30.
Liver X Receptor Agonists Inhibit Cytokine-Induced Osteopontin Expression in Macrophages Through Interference With Activator Protein-1 Signaling Pathways
Authors: Daisuke Ogawa, Jeffrey F. Stone, Yasunori Takata, Florian Blaschke, Van H. Chu, Dwight A. Towler, Ronald E. Law, Willa A. Hsueh, Dennis Bruemmer
Journal: Circulation Research (2005)

Osteopontin (OPN) is a proinflammatory cytokine and adhesion molecule implicated in the chemoattraction of monocytes and in cell-mediated immunity. We have recently reported that genetic OPN-deficiency attenuates the development of atherosclerosis in apoE-/- mice identifying OPN as potential target for pharmacological intervention in atherosclerosis. Synthetic agonists for the Liver X Receptor (LXR), members of the nuclear hormone receptor superfamily, prevent the development of atherosclerosis by regulating cholesterol homeostasis and suppressing inflammatory gene expression in macrophages. We demonstrate here that LXR ligands inhibit cytokine-induced OPN expression in macrophages. Two synthetic LXR ligands, T0901317 and GW3965, inhibited TNF-alpha, IL-1beta, INF-gamma and lipopolysaccharide induced OPN mRNA and protein expression in RAW 264.7 macrophages. Transient transfection experiments revealed that LXR ligands suppress cytokine-induced OPN promoter activity. Deletion analysis, heterologous promoter assays, and site-directed mutagenesis identified an activator protein-1 (AP-1) consensus site at -76 relative to the initiation site that supports OPN transcription in macrophages and mediates the effects of LXR ligands to inhibit OPN transcription. Electrophoretic mobility shift and chromatin immunoprecipitation assays indicated that LXR agonists inhibit cytokine-induced c-Fos and phospho-c-Jun binding to this AP-1 site. Cytokine-induced c-Fos and phospho-c-Jun protein expression was inhibited by LXR ligands and overexpression of c-Fos and c-Jun reversed the inhibitory effect of LXR ligands on OPN promoter activity in transactivation assays. Finally, treatment of C57BL/6J mice with LXR ligands inhibited OPN expression in peritoneal macrophages indicating that the observed effects of LXR ligands to inhibit OPN expression are applicable in vivo. These observations identify the regulation of macrophage OPN expression as a mechanism whereby LXR ligands may impact macrophage inflammatory responses and atherosclerosis. The full text of this article is available online at http://circres.ahajournals.org.
Trends in Hospitalizations and Outcomes for Acute Cardiovascular Disease and Stroke, 1999–2011
Authors: Harlan M. Krumholz, Sharon-Lise T. Normand, Yun Wang
Journal: Circulation (2014)

Background— During the past decade, efforts focused intensely on improving the quality of care for people with, or at risk for, cardiovascular disease and stroke. We sought to quantify the changes in hospitalization rates and outcomes during this period. Methods and Results— We used national Medicare data to identify all Fee-for-Service patients ≥65 years of age who were hospitalized with unstable angina, myocardial infarction, heart failure, ischemic stroke, and all other conditions from 1999 through 2011 (2010 for 1-year mortality). For each condition, we examined trends in adjusted rates of hospitalization per patient-year and, for each hospitalization, rates of 30-day mortality, 30-day readmission, and 1-year mortality overall and by demographic subgroups and regions. Rates of adjusted hospitalization declined for cardiovascular conditions (38.0% for 2011 compared with 1999 [95% confidence interval (CI), 37.2–38.8] for myocardial infarction, 83.8% [95% CI, 83.3–84.4] for unstable angina, 30.5% [95% CI, 29.3–31.6] for heart failure, and 33.6% [95% CI, 32.9–34.4] for ischemic stroke compared with 10.2% [95% CI, 10.1–10.2] for all other conditions). Adjusted 30-day mortality rates declined 29.4% (95% CI, 28.1–30.6) for myocardial infarction, 13.1% (95% CI, 1.1–23.7) for unstable angina, 16.4% (95% CI, 15.1–17.7) for heart failure, and 4.7% (95% CI, 3.0–6.4) for ischemic stroke. There were also reductions in rates of 1-year mortality and 30-day readmission and consistency in declines among the demographic subgroups. Conclusions— Hospitalizations for acute cardiovascular disease and stroke from 1999 through 2011 declined more rapidly than for other conditions. For these conditions, mortality and readmission outcomes improved.
Topical immunotherapy with contact sensitizers for viral warts
Authors: S. Gibbs
Journal: British Journal of Dermatology (2002)

Journal Article Topical immunotherapy with contact sensitizers for viral warts Get access S. Gibbs S. Gibbs Department of Dermatology, Ipswich Hospital NHS Trust, Ipswich IP4 5PD, U.K. E‐mail: sgibbs@fish.co.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 146, Issue 4, 1 April 2002, Page 705, https://doi.org/10.1046/j.1365-2133.2002.46871.x Published: 01 April 2002
High Incidence of Protein-Truncating <i>TP53</i> Mutations in BRCA1-Related Breast Cancer
Authors: Henne Holstege, Simon A. Joosse, Conny Th. M. van Oostrom, Petra M. Nederlof, Annemieke de Vries, Jos Jonkers
Journal: Cancer Research (2009)

Approximately half of all hereditary breast cancers are compromised in their DNA repair mechanisms due to loss of BRCA1 or BRCA2 function. Previous research has found a strong correlation between BRCA mutation and TP53 mutation. However, TP53 mutation status is often indirectly assessed by immunohistochemical staining of accumulated p53 protein. We sequenced TP53 exons 2 to 9 in 21 BRCA1-related breast cancers and 37 sporadic breast tumors. Strikingly, all BRCA1-related breast tumors contained TP53 mutations, whereas only half of these tumors stained positive for p53 accumulation. Positive p53 staining correlates with the presence of TP53 hotspot mutations in both BRCA1-related and sporadic breast tumors. However, whereas the majority of sporadic breast tumors that stained negative for p53 accumulation had wild-type TP53, the majority of BRCA1-associated breast tumors that stained negative for p53 accumulation had protein-truncating TP53 mutations (nonsense, frameshift, and splice mutations). Therefore, the strong selection for p53 loss in BRCA1-related tumors is achieved by an increase of protein-truncating TP53 mutations rather than hotspot mutations. Hence, immunohistochemical detection of TP53 mutation could lead to misdiagnosis in approximately half of all BRCA1-related tumors. The presence of deleterious TP53 mutations in most, if not all, BRCA1-related breast cancers suggests that p53 loss of function is essential for BRCA1-associated tumorigenesis. BRCA1-related tumors may therefore be treated not only with drugs that target BRCA1 deficiency [e.g., poly(ADP-ribose) polymerase inhibitors] but also with drugs that selectively target p53-deficient cells. This raises interesting possibilities for combination therapies against BRCA1-deficient breast cancers and BRCA1-like tumors with homologous recombination deficiency.
CD24 Expression on T Cells Is Required for Optimal T Cell Proliferation in Lymphopenic Host
Authors: Ou Li, Pan Zheng, Yang Liu
Journal: The Journal of Experimental Medicine (2004)

It is well established that T lymphocytes undergo homeostatic proliferation in lymphopenic environment. The homeostatic proliferation requires recognition of the major histocompatibility complex on the host. Recent studies have demonstrated that costimulation-mediated CD28, 4-1BB, and CD40 is not required for T cell homeostatic proliferation. It has been suggested that homeostatic proliferation is costimulation independent. Here, we report that T cells from mice with a targeted mutation of CD24 have a remarkably reduced rate of proliferation when adoptively transferred into syngeneic lymphopenic hosts. The reduced proliferation cannot be attributed to abnormal survival and homing properties of the CD24-deficient T cells. T cell proliferation in allogeneic hosts is less affected by this mutation. These results demonstrate a novel function of CD24 expressed on T cells. Thus, although distinct costimulatory molecules are involved in antigen-driven proliferation and homeostatic proliferation, both processes can be modulated by costimulatory molecules.
C-Reactive Protein Downregulates TRAIL Expression in Human Peripheral Monocytes via an Egr-1–Dependent Pathway
Authors: Paola Secchiero, Erika Rimondi, Maria Grazia di Iasio, Chiara Agnoletto, Elisabetta Melloni, Ilaria Volpi, Giorgio Zauli
Journal: Clinical Cancer Research (2013)

Abstract Purpose: To investigate the potential link between C-reactive protein (CRP), a known biomarker of acute and chronic inflammation, and TRAIL, a cytokine which plays a key role in the immune-surveillance against tumors. Experimental Design: Primary normal peripheral blood mononuclear cell (PBMC) and CD14+ monocytes were exposed to recombinant CRP (1–10 μmol/L). TRAIL expression was analyzed by ELISA and/or by quantitative real-time PCR (qRT-PCR). In parallel, the potential role of the transcription factor Egr-1 was investigated by analyzing its modulation in response to CRP and by transfection experiments. Results: In vitro CRP exposure induced downregulation of TRAIL expression, both at the mRNA and protein level, in unfractionated PBMC and in purified CD14+ monocytes. TRAIL downregulation was not due to a specific toxicity or to contaminating lipopolysaccharide (LPS), as shown by the lack of induction of monocyte apoptosis and by the inability of the inhibitor of LPS polymyxin B to interfere with CRP activity. Of note, CRP downregulated TRAIL expression/release in CD14+ monocytes also in response to IFN-α, the most potent inducer of TRAIL. At the molecular level, the downmodulation of TRAIL by CRP was accompanied by a significant increase of Egr-1. Consistently, Egr-1 overexpression reduced the baseline levels of TRAIL mRNA, whereas knocking down Egr-1 counteracted the ability of CRP to downregulate TRAIL. Conclusions: Our findings suggest that a chronic elevation of CRP, which occurs during systemic inflammation and often in patients with cancer, might contribute to promote cancer development and/or progression by downregulating TRAIL in immune cells. Clin Cancer Res; 19(8); 1949–59. ©2013 AACR.
Treatment of Inflamed Pancreas with Enkephalin Encoding HSV-1 Recombinant Vector Reduces Inflammatory Damage and Behavioral Sequelae
Authors: Ying Lu, Terry A McNearney, Weidong Lin, Steven P Wilson, David C Yeomans, Karin N Westlund
Journal: Molecular Therapy (2007)

This study assessed the efficacy of pancreatic surface delivered enkephalin (ENK)-encoding herpes simplex virus type 1 (HSV-1) on spontaneous behaviors and spinal cord and pancreatic enkephalin expression in an experimental pancreatitis model. Replication-defective HSV-1 with proenkephalin complementary DNA (cDNA) (HSV-ENK) or control beta-galactosidase cDNA (HSV-beta-gal), or media vehicle (Veh) was applied to the pancreatic surface of rats with dibutyltin dichloride (DBTC)-induced pancreatitis. Spontaneous exploratory behavioral activity was monitored on days 0 and 6 post DBTC and vector treatments. The pancreas, thoracic dorsal root ganglia (DRG, T9-10), and spinal cord (T9-10) were immunostained for met-enkephalin (met-ENK), beta-gal, and HSV-1 proteins. Spinal cord was also immunostained for c-Fos, and pancreas was stained for the inflammatory marker regulated on activation, normal T-cells expressed and secreted (RANTES), mu-opioid receptor, and hemotoxylin/eosin. On day 6, compared to pancreatitis and vector controls, the DBTC/HSV-ENK treated rats had significantly improved spontaneous exploratory activities, increased met-ENK staining in the pancreas and spinal cord, and normalized c-Fos staining in the dorsal horn. Histopathology of pancreas in DBTC/HSV-ENK treated rats showed preservation of acinar cells and cytoarchitecture with minimal inflammatory cell infiltrates, compared to severe inflammation and acinar cell loss seen in DBTC/HSV-beta-gal and DBTC/Veh treated rats. Targeted transgene delivery and met-ENK expression successfully produced decreased inflammation in experimental pancreatitis.
A comparative study on the efficacy of levofloxacin and ceftazidime in acute exacerbation of bronchiectasis
Authors: KW Tsang, WM Chan, PL Ho, K Chan, WK Lam, MS Ip
Journal: European Respiratory Journal (1999)

A prospective randomized study was performed in order to compare the efficacy of oral levofloxacin, a new S- isomer of ofloxacin, with intravenous ceftazidime in the empirical treatment of acute exacerbations of bronchiectasis. Consecutive patients with acute exacerbation of bronchiectasis were recruited at a tertiary referral centre and were randomized to receive 10 days' treatment with either oral levofloxacin (300 mg b..d.) or ceftazidime (1 g i.v.t.d.). Body temperature, cough score, dyspnoea score, sputum purulence and volume and white blood cell and neutrophil count were assessed on day 1 and day 10. Thirty-five patients (mean age 61 yrs, 15 males) completed the study; 17 of these were in the levofloxacin group. There was no significant difference in the distribution of sputum pathogens or clinical parameters between the two groups at entry to and completion of the study. Both groups of patients showed significant improvement in 24-h sputum volume, sputum purulence score, cough score and dyspnoea score (p&lt;0.001) but there was no significant difference between these two groups at entry to or on completion of the study (p&gt;0.05). The results of this study suggest that oral administration of levofloxacin is as effective as parenteral ceftazidime in the empirical treatment of exacerbations in bronchiectasis.
Intimal Hyperplasia of the Infant Parasellar Carotid Artery
Authors: Wolfgang J. Weninger, Gerd B. Müller, Christian Reiter, Stefan Meng, Silvi U. Rabl
Journal: Circulation Research (1999)

Intimal cushions that project into the lumen of arteries are precursors of atherosclerotic plaque formation. The "carotid siphon, " although frequently affected by atherosclerosis, was never analyzed for the occurrence of neonatal intimal hyperplasia. This study provides a topographic and morphometric analysis of intimal cushions in the parasellar internal carotid artery (pICA) of the human infant. A total of 35 specimens were studied in detail, using both standard histological techniques and a new method of computer-aided 3D reconstruction. Intimal hyperplasia occurred at 3 characteristic locations of the pICA: (1) the convex side of the posterior knee (C5 cushion), (2) the bottom of the horizontal segment (C4 cushion), and (3) the concave side of the anterior knee (C3 cushion). The extension of the cushions and the degrees to which they occluded the vessel lumens were measured. The complex shape of the pICA required 3D computer models for exact topographical descriptions and precise measurements. Our results suggest that the occurrence and degree of intimal hyperplasia are related to shape changes of the pICA during postnatal development. We predict that individuals who retain the relatively straight course of the fetal pICA throughout their lives are less prone to develop atherosclerotic lesions at this portion of the carotid artery. A possible contribution of neonatal intimal cushions to the origin of sudden infant death syndrome is discussed.
Increased adjuvant treatment and improved survival in elderly stage III colon cancer patients in The Netherlands
Authors: L.N. van Steenbergen, V.E.P.P. Lemmens, H.J.T. Rutten, A.N.M. Wymenga, J.W.R. Nortier, M.L.G. Janssen-Heijnen
Journal: Annals of Oncology (2012)
Rotavirus Vaccine and the News Media, 1987-2001
Authors: M. Carolina Danovaro-Holliday
Journal: JAMA (2002)

2][3][4][5][6] Environmental measures, such as providing clean food, water, and sanitation, do not reduce rotavirus infection rates. 46][17][18] In March 1999, the Advisory Committee on Immunization Practices (ACIP) recommended the vaccine for all US infants, 5 as had the American Academy of Pediatrics (AAP) in December 1998. 19Adverse events were expected to be mild: in trials, 2% of vaccinees had experienced irritability, fever lower than 39°C, or decreased appetite. 4,5,18,19owever, with widespread use of the rotavirus vaccine, the Vaccine Adverse Event Reporting System (VAERS) of the FDA and the Centers for Disease Control and Prevention (CDC) received reports that some vaccinees had experienced intussusception, a potentially lifethreatening intestinal blockage. 20,21In vaccine trials, intussusception had been noted in 5 per 10000 recipients, an association thought to be coincidental, 5 but the VAERS data suggested the potential of a causal relationship. 21In July 1999, the manufacturer suspended distribution 22 and the CDC recommended postponing use of the rotavirus vaccine. 20Large-scale case-control and population-based studies estimated that 1 to 2 per 10000 vaccinees were at risk for intussusception. 23,24In October 1999, the manufacturer withdrew the vaccine 22 and ACIP withdrew its recommendation.
The association between physician reimbursement in the US and use of hematopoietic colony stimulating factors as adjunct therapy for older patients with acute myeloid leukemia: Results from the 1997 American Society of Clinical Oncology survey
Authors: C.L. Bennett, M.R. Bishop, M.S. Tallman, M.R. Somerfield, J. Feinglass, T.J. Smith
Journal: Annals of Oncology (1999)
Positron emission tomography with fluorine-18-2-fluoro-2-deoxy-D-glucose (F18-FDG) does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type
Authors: M. Hoffmann, K. Kletter, M. Diemling, A. Becherer, F. Pfeffel, V. Petkov, A. Chott, M. Raderer
Journal: Annals of Oncology (1999)