tbuckley/cabot-search huggingface dataset:
Drug Labeling and Exposure in Neonates
Authors: Matthew M. Laughon, Debbie Avant, Nidhi Tripathi, Christoph P. Hornik, Michael Cohen-Wolkowiez, Reese H. Clark, P. Brian Smith, William Rodriguez
Journal: JAMA Pediatrics (2013)

IMPORTANCE Federal legislation has led to a notable increase in pediatric studies submitted to the Food and Drug Administration (FDA), resulting in new pediatric information in product labeling.However, approximately 50% of drug labels still have insufficient information on safety, efficacy, or dosing in children.Neonatal information in labeling is even scarcer because neonates comprise a vulnerable subpopulation for which end-point development is lagging and studies are more challenging.OBJECTIVE To quantify progress made in neonatal studies and neonatal information in product labeling as a result of recent legislation. DESIGN, SETTING, AND PARTICIPANTSWe identified a cohort of drug studies between 1997 and 2010 that included neonates as a result of pediatric legislation using information available on the FDA website.We determined what studies were published in the medical literature, the legislation responsible for the studies, and the resulting neonatal labeling changes.We then examined the use of these drugs in a cohort of neonates admitted to 290 neonatal intensive care units (NICUs) (the Pediatrix Data Warehouse) in the United States from 2005 to 2010.EXPOSURE Infants exposed to a drug studied in neonates as identified by the FDA website.MAIN OUTCOMES AND MEASURES Number of drug studies with neonates and rate of exposure per 1000 admissions among infants admitted to an NICU. RESULTSIn a review of the FDA databases, we identified 28 drugs studied in neonates and 24 related labeling changes.Forty-one studies encompassed the 28 drugs, and 31 (76%) of these were published.Eleven (46%) of the 24 neonatal labeling changes established safety and effectiveness.In a review of a cohort of 446 335 hospitalized infants, we identified 399 drugs used and 1 525 739 drug exposures in the first 28 postnatal days.Thirteen (46%) of the 28 drugs studied in neonates were not used in NICUs; 8 (29%) were used in fewer than 60 neonates.Of the drugs studied, ranitidine was used most often (15 627 neonates, 35 exposures per 1000 admissions).CONCLUSIONS AND RELEVANCE Few drug labeling changes made under pediatric legislation include neonates.Most drugs studied are either not used or rarely used in US NICUs.Strategies to increase the study of safe and effective drugs for neonates are needed.
Insulin: U40, U80, or U100.
Authors: J Sheldon, D M Hill, B F Brearley, P E Dipple, A Bloom, K J Gurling, T R Pilkington, T M Hayes, P Sonksen, T D Hockaday
Journal: BMJ (1976)

<h3>Background and aims</h3> Health-related quality of life (HRQoL) among systemic lupus erythematosus (SLE) patients is reduced, and fibromyalgia contribute to the decreased HRQoL. The objective of the present study is to evaluate the contributing factors for reduced HRQoL in female SLE patients regarding the presence of fibromyalgia. <h3>Methods</h3> The HRQoL measurement was made using the SF-36 and Euroqol EQ-5D. Sleep quality, fatigue severity, fibromyalgia severity, and SLE disease associated variables were measured. <h3>Results</h3> The scores of HRQoL, including overall scores as well as the physical component summary (PCS) and mental component summary (MCS), were lower in female SLE patients with fibromyalgia (n=41), than in those without fibromyalgia (n=111). SLE patients with fibromyalgia showed higher SLE disease activity, and more severe fatigue score, depressive mood and deteriorated sleep quality, compared with patients without fibromyalgia. In SLE patients with fibromyalgia, education level, SLE organ damage, fatigue severity, sleep quality and fibromyalgia severity were significantly correlated with EQ-5D, whereas age, income, SLE disease activity, steroid dose, and disease duration were not correlated with EQ-5D. On the other hand, education level did not show significant correlation with EQ-5D in SLE patients without fibromyalgia. Multivariate logistic regression analysis revealed that depressive mood is only independent contributing factors for deteriorated HRQoL in female SLE patients with fibromyalgia. Interestingly, in SLE patients without fibromyalgia also showed same result. <h3>Conclusions</h3> The quality of life in SLE patients can be improved by managing depressive mood both in patients with fibromyalgia and in those without fibromyalgia.
OP0021 Genetic Factors for the Severity of ACPA-Negative Rheumatoid Arthritis in Two Cohorts of Early Disease: A Genome-Wide Study
Authors: D. De Rooy, R. Tsonaka, M. Andersson, K. Forslind, A. Zhernakova, C. de Kovel, B. Koeleman, D. van der Heijde, T. Huizinga, R. Toes, J. Houwing-Duistermaat, B. Svensson, A. van der Helm-van Mil
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> ACPA-negative and ACPA-positive Rheumatoid Arthritis (RA) are increasingly regarded as separate clinical entities. Although ACPA-negative patients have a less severe disease course at group level, considerable inter-individual differences in the amount of joint destruction occur. <h3>Objectives</h3> As no studies focusing on genetic risk factors underlying the differences in joint destruction in ACPA-negative patients have been performed thus far, we performed the present study. <h3>Methods</h3> A Genome-Wide Association Study was performed using Illumina Human CytoSNP-12v2 in relation to radiographic joint destruction in 276 ACPA-negative early RA-patients included in the Leiden Early Arthritis Clinic (EAC). According to the Bonferroni correction on the number of tested SNPs, the threshold for genome wide significance was p&lt;2x10<sup>-7</sup>. Subsequently, the significant SNPs were evaluated for association with the progression of radiographic joint destruction in 253 ACPA-negative early RA-patients included in the BARFOT-study. As 11 uncorrelated SNPs were tested, the Bonferroni threshold for significance was 0.0045. In all patients, joint destruction was measured by Sharp-van der Heijde Score with good reproducibility. <h3>Results</h3> 33 SNPs associated significantly to the severity of joint damage (p&lt;2x10<sup>-7</sup>) in phase-1. In phase-2, two SNPs showed a trend towards a significant association with joint damage, rs2833522 (p=0.0049) and rs17763915 (p=0.047). A combined analysis of both the Leiden and BARFOT datasets of rs2833522 showed a highly significant association with joint destruction (p=3.57x10<sup>-9</sup>), the presence of the minor allele associated with more severe damage. <h3>Conclusions</h3> Rs2833522 might be associated with the severity of joint damage in ACPA-negative RA. Larger, longitudinal, studies are needed for confirmation. <h3>Acknowledgements</h3> This work is supported by the Masterswitch project and BtheCure project. The work of Annette van der Helm-van Mil is supported by the Dutch organization for scientific research (ZonMW). The Dutch Arthritis Foundation (Reumafonds) provided financial support for the genotyping. <h3>Disclosure of Interest</h3> None Declared
NONSYPHILITIC PSYCHOSES IN SYPHILITIC PATIENTS
Authors: WILLIAM HOUSE
Journal: JAMA (1924)

Blessed as is the Wassermann test, its results are not unmixed with evil. Through it, every one, no matter how indifferently equipped with medical knowledge, is given a means of diagnosis approaching necromancy, and because of it, detailed history taking, careful study of symptoms and painstaking physical examination seemingly have lost much of their importance. It sometimes appears as if the only necessary diagnostic step is to make a Wassermann test, and, if it is found positive, lo! the cause of the disease is discovered and all that is needed is to administer arsphenamin, with recovery just around the corner. Through the Wassermann test, many previously obscure disorders were solved and syphilis came etiologically more than into its own. Thus, it is not uncommon for a patient suffering, for example, from cardiac disease to give a positive Wassermann reaction, with the result that, regardless of its general characteristics and history,
Anaphylaxis induced by peanuts.
Authors: E S Assem, C M Gelder, S G Spiro, H Baderman, R F Armstrong
Journal: BMJ (1990)

of the bladder, and then by sequential renal function tests.The preoperative reduction in glomerular filtra- tion rate and effective renal plasma flow found in our Prostatectomy 100 - 90i9-CCOJ7 20 ''E ~300 ;i " '1 00 0Z 80 cn50 00 , 0.4 <°0 .3Year patients suggested powerful renal vasoconstriction, possibly due to neurogenic or humoral influences.The stimulus to this might be a raised renal pelvic pressure, although this is, however, appreciably lower than the bladder pressure measured concurrently.'Surgical relief of chronic retention was accompanied by a prompt and sustained rise in glomerular filtration rate and effective renal plasma flow that persisted for several years.Possibly this prolonged recovery of renal function might have been due to amelioration of vasoconstrictive changes, with a gradual process of regeneration of the residual nephron population due to functional adaptation.This latent improvement of renal function was not inhibited by recrudescence of hypotension in one patient, and this suggests that hypertension is not an adverse factor for renal function in these circumstances.Renal damage is probably related to the duration and degree of the preceding high pressure chronic retention, but this might be difficult to prove as the high pressure chronic retention syndrome may be clinically silent, or may present with secondary effects such as hypertension or cardiac failure.Unfortunately, the duration of secondary hypertension, which is probably a late manifestation, gives no indication of how long high pressure chronic retention has been present.Whether the renal damage is reversible depends on the timing of surgical intervention.It is therefore imperative to avoid long delays in referral to hospital and to circumvent lengthy waiting lists to expedite urological assessment and early prostatectomy.5
Routine use of Hemospray for gastrointestinal bleeding: prospective two-center experience in Switzerland
Authors: Michael Sulz, Remus Frei, Christa Meyenberger, Peter Bauerfeind, Gian-Marco Semadeni, Christoph Gubler
Journal: Endoscopy (2014)

Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a hemostatic agent recently introduced for the management of upper gastrointestinal bleeding (GIB). To date, there is little experience with this fairly new hemostatic tool. The aim of this case series was to reflect the use and effectiveness of Hemospray as a treatment option in GIB in everyday clinical practice at two tertiary referral centers. Consecutive patients (n = 16) with active GIB of various origins were treated with Hemospray. The rate of successful initial hemostasis was 93.75 % (15 /16; salvage therapy 92.85 % [13/14]; monotherapy 100 % [2 /2]). The rebleeding rate within 7 days was 12.5 % (2/16). One patient, in whom interventional radiology also failed, had to undergo surgery as salvage therapy. The effectiveness of Hemospray in the management of GIB in various clinical situations is promising. Future multicenter randomized prospective trials for clearly defined bleeding situations are needed for greater generalizability of case series findings.
Anatomic correction of transposition of the great arteries associated with ventricular septal defect: midterm results in 50 patients.
Authors: O Bical, E Hazan, Y Lecompte, L Fermont, J Karam, M M Jarreau, T Tran Viet, D Sidi, F Leca, J Y Neveux
Journal: Circulation (1984)

From May 1977 to August 1982 50 patients who were 1.5 to 44 months old underwent anatomic correction of transposition of the great arteries (TGA) and closure of ventricular septal defect (VSD) at our institution. Thirty-nine patients underwent preliminary pulmonary arterial banding. Hospital mortality was 32%: four patients died as a result of technical problems, seven as a result of associated lesions, three of pulmonary hypertension, and two of left ventricular failure. Three other patients died after the first postoperative month (one of mediastinitis, one at reoperation for a residual VSD, and one of pulmonary hypertension). All 31 survivors are in excellent clinical condition and are in sinus rhythm after a mean follow-up period of 31 +/- 14 months. Twenty-five patients were reinvestigated by echocardiography (M mode and two-dimensional) and/or catheterization. Parameters of left ventricular contractility were within normal limits, but systolic aortic diameter was larger than normal (p less than .01). Seven patients had stenosis of the right ventricular outflow tract and five of these required reoperation. The two persistent problems with the anatomic correction of TGA associated with VSD are a relatively high operative mortality and secondary right outflow tract stenosis. However, use of this procedure results in better left ventricular function and fewer arrhythmias than does use of atrial repair techniques and also results in the use of the anatomically left ventricle as the systemic ventricle.
Masturbation and Clitoridectomy
Authors: John Duffy
Journal: JAMA (1963)

THE NINETEENTH CENTURY, which saw the industrial revolution merge into the technological revolution and witnessed profound developments in the sciences and social sciences, was one of many contradictions. Precisely why, in the midst of this cultural upheaval, the century should have produced its own peculiar attitude towards sex is difficult to say. Whatever the reason, among English-speaking peoples the name of the Victorian Age has become synonymous with prudery. Sexual desires, if properly controlled, were acceptable in the male as necessary for procreation, but it was unthinkable that any decent woman should derive pleasure from sex. A physician writing in a New Orleans medical journal in 1883 declared that he did not believe that one bride in a hundred accepted matrimony from any desire for sexual gratification. He conceded, however, that some of the lower elements might admit to wanting sexual gratification. The modest woman, he concluded, submitted to her
Tubeless Hypotonic Duodenography
Authors: Harvey M. Goldstein
Journal: JAMA (1969)

A tubeless modification of the standard approach to hypotonic duodenography has produced successful examinations in more than 85% of studies. Patient discomfort and inconvenience inherent in tube manipulation is alleviated. Procedure time is significantly reduced and the examination may be performed immediately following a conventional upper-gastrointestinal tract examination if desired. Most important, tubeless hypotonic duodenography is a simple, convenient, and feasible examination accessible to all radiologists for evaluating duodenal and pancreatic disease.
Transcranial Doppler for brain death after decompressive craniectomy: persistence of cerebral blood flow with flat EEG
Authors: E. Vicenzini, S. Pro, F. Randi, P. Pulitano, G. Spadetta, M. Rocco, V. Di Piero, G. L. Lenzi, O. Mecarelli
Journal: Intensive Care Medicine (2010)
Emergency Medicine as an Academic Discipline
Authors: Alton I. Sutnick
Journal: JAMA (1977)

Because of an explosive increase in the use of emergency rooms in hospitals across the country, many hospitals have found it expedient to employ full-time emergency physicians. The demand for emergency physicians has prompted the development of training programs in emergency medicine in academic medical centers. The first such training program was instituted at The Medical College of Pennsylvania in 1970. The 32 current programs in the nation are filling a real need in providing manpower for hospital emergency rooms. With the increasing identification and distribution of emergency physicians, there has been an attempt to develop emergency medicine as a distinct discipline and to establish its legitimacy in the structure of academic medical centers. A variety of problems must be addressed to clarify the role of emergency medicine in the academic setting.
Cardiac Autonomic Dysfunction Is Associated With High-Risk Albumin-to-Creatinine Ratio in Young Adolescents With Type 1 Diabetes in AdDIT (Adolescent Type 1 Diabetes Cardio-Renal Interventional Trial)
Authors: Yoon Hi Cho, Maria E. Craig, Elizabeth A. Davis, Andrew M. Cotterill, Jennifer J. Couper, Fergus J. Cameron, Paul Z. Benitez-Aguirre, R. Neil Dalton, David B. Dunger, Timothy W. Jones, Kim C. Donaghue
Journal: Diabetes Care (2015)

OBJECTIVE This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS Adolescents recruited as part of a multicenter screening study (n = 445, 49% female, aged 10–17 years, mean duration 6.9 years; mean HbA1c 8.4%, 68 mmol/mol) underwent a 10-min continuous electrocardiogram recording for heart rate variability analysis. Time-domain heart rate variability measures included baseline heart rate, SD of the R-R interval (SDNN), and root mean squared difference of successive R-R intervals (RMSSD). Spectral analysis included sympathetic (low-frequency) and parasympathetic (high-frequency) components. Standardized ACR were calculated from six early morning urine collections using an established algorithm, reflecting age, sex, and duration, and stratified into ACR tertiles, where the upper tertile reflects higher nephropathy risk. RESULTS The upper-tertile ACR group had a faster heart rate (76 vs. 73 bpm; P &amp;lt; 0.01) and less heart rate variability (SDNN 68 vs. 76 ms, P = 0.02; RMSSD 63 vs. 71 ms, P = 0.04). HbA1c was 8.5% (69 mmol/mmol) in the upper tertile vs. 8.3% (67 mmol/mol) in the lower tertiles (P = 0.07). In multivariable analysis, upper-tertile ACR was associated with faster heart rate (β = 2.5, 95% CI 0.2–4.8, P = 0.03) and lower RMSSD (β = −9.5, 95% CI −18.2 to −0.8, P = 0.03), independent of age and HbA1c. CONCLUSIONS Adolescents at potentially higher risk for nephropathy show an adverse cardiac autonomic profile, indicating sympathetic overdrive, compared with the lower-risk group. Longitudinal follow-up of this cohort will further characterize the relationship between autonomic and renal dysfunction and the effect of interventions in this population.
Inhibitory Gradient along the Dorsoventral Axis in the Medial Entorhinal Cortex
Authors: Prateep Beed, Anja Gundlfinger, Sophie Schneiderbauer, Jie Song, Claudia Böhm, Andrea Burgalossi, Michael Brecht, Imre Vida, Dietmar Schmitz
Journal: Neuron (2013)
Winter deaths: warm housing is not enough
Authors: W. Keatinge, G. Donaldson
Journal: BMJ (2001)

EDITOR—Olsen's article gives the impression that Britain's high winter mortality and winter crises in health care can be prevented simply by warmer housing, although one reference in it reviews evidence of the importance of outdoor cold exposure. 1 2 Large scale international surveys have shown an independent association of outdoor, as well as …
Endoscopic removal of pharmacobezoar of slow release theophylline.
Authors: J M Cereda, J Scott, E M Quigley
Journal: BMJ (1986)

fracton are compatible with so alled vasomotor nephropathy as the cause of renal failure.2Perhaps the differnces in renal haemodynamic properties between P blockers and the a and P blocker labetalol lead more readily to acute renal failure after an overdose of labetalol.Hypoteion leading to acute oliguric renal failure is accompanied by intense pregknoerular vasoconstriction, which makes filtration highly dependent on an adequately maintained postglomerular resistance.2In thaWpeutic doses labetalol leads to a fall in renal vascular resistance; ,this is in contrast with most i blockers, which cause an increase.34A fall in postglomerular resistance induced by labetalol, perhaps enhanced by the renal vasodilating effects ofdopamine in the dose used in our patient, may have been responsible for the failure of filtration.51 Prichard BNC, Battasby LA,Cuicksh-nkJM.Overdosge with beta-adrenergic blocking agents.Ad,m DYugRzctCAOsaPoiSuixgRev 19843:91-111. Oken DE .iemodynamibasis forhuman acute renal failure (vasomotor nephropathy).
Visualizing CD4 T-cell migration into inflamed skin and its inhibition by CCR4/CCR10 blockades using<i>in vivo</i>imaging model
Authors: X. Wang, M. Fujita, R. Prado, A. Tousson, H-C. Hsu, A. Schottelius, D.R. Kelly, P.A. Yang, Q. Wu, J. Chen, H. Xu, C.A. Elmets, J.D. Mountz, C.K. Edwards III
Journal: British Journal of Dermatology (2009)

Chemokines are critical mediators of T-cell homing into inflamed skin. The complex nature of this multicellular response makes it difficult to analyse mechanisms mediating the early responses in vivo.To visualize directly T-cell homing into inflamed skin and its inhibition by blockades using a unique noninvasive confocal microscopy.A mouse model of allergic contact dermatitis was used. T cells from oxazolone-sensitized and -challenged Balb/c mice were first analysed phenotypically in vitro. CD4 T cells were then labelled with a tracker dye and transferred into Balb/c-SCID mice. The recipient mice were challenged with oxazolone and CD4 T-cell homing into inflamed skin was visualized.T cells with the skin homing receptors CCR4 and CCR10 were increased in the affected skin and draining lymph nodes, and effectively attracted by their specific chemokines CCL17, CCL22 and CCL27 in vitro. Using in vivo imaging, T-cell migration into the inflamed skin was observed at 2 h after application, peaking at 12 h and continuing for 48 h. Simultaneous systemic administration of neutralizing antibodies against CCR4 ligands (CCL17 and CCL22) and CCR10 ligand (CCL27) led to a significant suppression of T-cell migration and skin inflammation.Our data indicate that these tissue-selective adhesion molecules and chemokine/receptor pathways act in concert to attract specialized T-cell populations to mediate cutaneous inflammation. The in vivo imaging technique can be applicable to other models of cutaneous diseases to help with better understanding of the pathogenesis and monitoring the therapeutic effects.
Experimental studies on the antiviral agent famciclovir in Behcet's disease symptoms in ICR mice
Authors: S. Sohn, D. Bang, E-S. Lee, H.J. Kwon, S.I. Lee, S. Lee
Journal: British Journal of Dermatology (2001)

Background Chronic oral aphthae, recurrent genital ulcers and uveitis are the three main manifestations of Behçet's disease (BD). The aetiopathogenesis of BD is still obscure, but herpes simplex virus (HSV) is one of the possible causal factors. Various kinds of drugs, including immunosuppressants and aciclovir have been used in treatment, but effectiveness is variable. Objectives To demonstrate the efficacy of famciclovir, an antiviral compound that acts against HSV, varicella-zoster virus and hepatitis B virus, in a murine model of BD. Methods Using the HSV-induced BD mouse model, famciclovir was administered variously before and after inoculation or from the day of lesion occurrence, with appropriate controls. Ulceration of the mouth and genital skin and eye involvement were monitored. In addition, spleen cytokine expression was measured by polymerase chain reaction. Results Pretreatment and concurrent treatment did not affect the occurrence of BD, but treatment from the appearance of lesions was effective in improving BD and preventing recurrence. After famciclovir, interleukin 2 expression correlated with the recurrence of BD symptoms. Conclusions This model suggests the possible role of immune response to viral infection in the development and activation of BD. The study provides a rationale for clinical trials of famciclovir in the human form of BD.