tbuckley/cabot-search huggingface dataset:
Introduction and methods: British Thoracic Society pleural disease guideline 2010
Authors: I. Du Rand, N. Maskell
Journal: Thorax (2010)

Pleural disease remains common, affecting over 3000 people per million population each year. They therefore represent a significant contribution to the workload of respiratory physicians. Pleural disease originates from a wide range of pathologies and a systematic approach to the investigation and management is therefore required. These guidelines attempt to summarise the available evidence to aid the healthcare professional in delivering good quality patient care.

The Standards of Care Committee of the British Thoracic Society (BTS) established a Pleural Disease Guideline Group in December 2007. The objective was to produce an evidence-based update of the last pleural disease guidelines published in 2003. It was recognised that, since the last guideline, a number of good quality primary research papers have been published and the guidelines needed to reflect these new data. In addition, there was a need to develop new sections on local anaesthetic thoracoscopy and thoracic ultrasound to reflect changes in clinical practice.

This guideline is intended for use by all healthcare professionals who may be involved in pleural disease management. This will include doctors, nurses and other healthcare professionals.

The guideline addresses the investigation and medical management of pleural disease in adults. This is divided into the following sections:

1.  Investigation of a unilateral pleural effusion in adults.

2.  Management of spontaneous pneumothorax.

3.  Management of a malignant pleural effusion.

4.  Management of pleural infection in adults.

5.  Local anaesthetic thoracoscopy.

6.  Chest drain insertion and thoracic ultrasound.

The six sections can be downloaded individually from the website. Key points are repeated within sections to give users a full review of the individual documents without the need to cross reference repeatedly. In addition, at the end of this section (Annex 1) there is a list of good areas for audit and future research.

The following areas fall outside the scope of this guideline:

1.  Paediatric pleural …
AMP-activated protein kinase: the guardian of cardiac energy status
Authors: D. Grahame Hardie
Journal: Journal of Clinical Investigation (2004)

Several years ago it was proposed that the AMP-activated protein kinase cascade might protect cells against stresses that deplete cellular ATP. Young et al. have now directly tested this by studying the effects of ischemia and reperfusion in perfused hearts from mice expressing a dominant-negative mutant that suppresses the kinase activity in cardiac muscle. Compared with control hearts, the mutant hearts showed clear evidence for increased necrotic damage and increased apoptosis. These findings may have implications for the treatment of ischemic heart disease.
The Mozart Effect
Authors: J S Jenkins
Journal: Journal of the Royal Society of Medicine (2001)

In 1993 Rauscher et al.1 made the surprising claim that, after listening to Mozart's sonata for two pianos (K448) for 10 minutes, normal subjects showed significantly better spatial reasoning skills than after periods of listening to relaxation instructions designed to lower blood pressure or silence. The mean spatial IQ scores were 8 and 9 points higher after listening to the music than in the other two conditions. The enhancing effect did not extend beyond 10-15 minutes. These results proved controversial. Some investigators were unable to reproduce the findings2,3,4 but others confirmed that listening to Mozart's sonata K448 produced a small increase in spatial-temporal performance, as measured by various tests derived from the Stanford—Binet scale such as paper-cutting and folding procedures5,6,7 or pencil-and-paper maze tasks8. However, Rauscher has stressed that the Mozart effect is limited to spatial temporal reasoning and that there is no enhancement of general intelligence; some of the negative results, she thinks, may have been due to inappropriate test procedures9.

So, does the Mozart effect exist? The generality of the original positive findings has been criticized on the grounds that any Mozart effect is due to `enjoyment arousal' occasioned by this particular music and would not take place in the absence of its appreciation. This interpretation is countered by animal experiments in which separate groups of rats were exposed, in utero followed by a postpartum period of 60 days, to Mozart's piano sonata K448, to minimalist music by the composer Philip Glass, to white noise or to silence and then tested for their ability to negotiate a maze. The Mozart group completed the maze test significantly more quickly and with fewer errors (P <0.01) than the other three groups; thus, enjoyment and musical appreciation is unlikely to have been the basis of the improvement10.
Drug taking and drinking among 11-15 year olds in England have fallen over past 10 years
Authors: A. O'Dowd
Journal: BMJ (2012)

Younger teenagers in England are taking fewer drugs, drinking less alcohol, and smoking less, new figures show.

The decline in such habits was clear from the latest in a long running series of surveys of smoking, drinking, and drug use among secondary school pupils aged 11 to 15 in England.

The report, published on 26 July by the NHS Information Centre for Health and Social Care, contained results from a survey of 6519 pupils from 219 schools carried out between September and December 2011.1

The proportion of secondary school pupils in this age group who had ever taken drugs fell by 12 percentage points in the past 10 years, from 29% in 2001 to 17% …
Small Bowel Disorders
Authors: F Biago
Journal: Gut (2001)

Small Bowel Disorders . Edited by R N Ratnaike (Pp 640; illustrated; £125.00). UK: Arnold, 2000. ISBN 0 340 76008 7.

This is a book that covers not only small intestinal disorders but also the anatomy and physiology of the normal small bowel. Absorption of nutrients is presented in a very detailed way. Although these aspects are very well dealt with, it is somewhat curious that in a book entitled Small Bowel Disorders almost 50% of the text is …
Epidemic<i>Yersinia enterocolitica</i>Infection Due to Contaminated Chocolate Milk
Authors: Robert E. Black, Richard J. Jackson, Theodore Tsai, Michael Medvesky, Mehdi Shayegani, James C. Feeley, Kenneth I. E. MacLeod, Adah M. Wakelee
Journal: New England Journal of Medicine (1978)

In September and October, 1976, an outbreak of illness due to chocolate milk contaminated with Yersinia enterocolitica resulted in hospitalization of 36 children, 16 of whom had appendectomies. Infection with Y. enterocolitica serotype 0:8 was demonstrated in 38 ill persons. Sixty-one per cent of the persons who were infected had a titer greater than 1:160 OH agglutinins to serotype 8 yersinia, whereas 48 per cent of the hospitalized children had a fourfold change in agglutinin titer. An epidemiologic investigation demonstrated that illness was associated with drinking of chocolate milk purchased in school cafeterias, and Y. enterocolitica 0:8 was subsequently isolated from the milk. The investigation suggested that the bacterium was introduced at the dairy during the mixing by hand of chocolate syrup with previously pasteurized milk.
Ketosis-Prone Type 2 Diabetes
Authors: Guillermo E. Umpierrez
Journal: Diabetes Care (2006)

Diabetic ketoacidosis (DKA) is the most serious hyperglycemic emergency in patients with diabetes. DKA is reported to be responsible for >100,000 hospital admissions per year in the U.S. (1) and is present in 25–40% of children and adolescents with newly diagnosed diabetes (2) and in 4–9% of all hospital discharge summaries among adult patients with diabetes (3,4). DKA has long been considered a key clinical feature of type 1 diabetes, an autoimmune disorder characterized by severe and irreversible insulin deficiency. In recent years, however, an increasing number of ketoacidosis cases without precipitating cause have also been reported in children, adolescents, and adult subjects with type 2 diabetes (5–7). These subjects are usually obese and have a strong family history of diabetes and a low prevalence of autoimmune markers. At presentation, they have impairment of both insulin secretion and insulin action, but aggressive diabetes management results in significant improvement in β-cell function and insulin sensitivity sufficient to allow discontinuation of insulin therapy within a few months of treatment (7–9). Upon discontinuation of insulin, the period of near-normoglycemic remission may last for a few months to several years (10–13). This clinical presentation has been reported primarily in Africans and African Americans (6,7,14–16) and also in other minority ethnic groups (12,17,18). This variant of type 2 diabetes has been referred to in the literature as idiopathic type 1 diabetes, atypical diabetes, Flatbush diabetes, diabetes type 1 (1/2) (somewhere between type 1 and type 2 diabetes), and more recently as ketosis-prone type 2 diabetes (9).

In this issue of Diabetes Care , Balasubramayam et al. (19) compared the accuracy of four published classification schemes that have attempted to predict long-term β-cell function and insulin independence …
Extracellular protons acidify osteoclasts, reduce cytosolic calcium, and promote expression of cell-matrix attachment structures.
Authors: A Teti, H C Blair, P Schlesinger, M Grano, A Zambonin-Zallone, A J Kahn, S L Teitelbaum, K A Hruska
Journal: Journal of Clinical Investigation (1989)

Because metabolic acids stimulate bone resorption in vitro and in vivo, we focused on the cellular events produced by acidosis that might be associated with stimulation of bone remodeling. To this end, we exposed isolated chicken osteoclasts to a metabolic (butyric) acid and observed a fall in both intracellular pH and cytosolic calcium [( Ca2+]i). These phenomena were recapitulated when bone resorptive cells, alkalinized by HCO3 loading, were transferred to a bicarbonate-free environment. The acid-induced decline in osteoclast [Ca2+]i was blocked by either NaCN or Na3VO4, in a Na+-independent fashion, despite the failure of each inhibitor to alter stimulated intracellular acidification. Moreover, K+-induced membrane depolarization also reduced cytosolic calcium in a manner additive to the effect of protons. These findings suggest that osteoclasts adherent to bone lack functional voltage-operated Ca2+ channels, and they reduced [Ca2+]i in response to protons via a membrane residing Ca-ATPase. Most importantly, acidosis enhances formation of podosomes, the contact areas of the osteoclast clear zone, indicating increased adhesion to substrate, an early step in bone resorption. Thus, extracellular acidification of osteoclasts leads to decrements in intracellular pH and calcium, and appears to promote cell-matrix attachment.
Development of a method for screening short-lived proteins using green fluorescent protein.
Authors: Xin Jiang, Philip Coffino, Xianqiang Li
Journal: Genome biology (2004)

We have developed a screening technology for the identification of short-lived proteins. A green fluorescent protein (GFP)-fusion cDNA library was generated for monitoring degradation kinetics. Cells expressing a subset of the GFP-cDNA expression library were screened to recover those in which the fluorescence signal diminished rapidly when protein synthesis was inhibited. Thirty clones that met the screening criteria were characterized individually. Twenty-three (73%) proved to have a half-life of 4 hours or less.
Relation of Lymph Node Level Assessment on Prognosis After Surgical Resection in Biliary Tract Cancers
Authors: Martinez-Galán Joaquina, González-Rivas Cynthia, Ruiz-Vozmediano Julia, Castillo-Portellano Lucia, Ochoa Lucia, Conde-Herrero Verónica, García-García Javier, Delgado Pérez Juan Ramón
Journal: Annals of Oncology (2014)
Dorsal calcaneocuboid ligament versus lateral ankle ligament repair: a case-control study
Authors: H Lohrer, T Nauck, S Arentz, T J Vogl
Journal: British Journal of Sports Medicine (2006)

Anatomic reconstruction is the treatment of choice for lateral ankle ligament instability. A similar technique has recently been described for stabilisation of a chronic unstable calcaneocuboid joint as an alternative to the previously proposed tenodesis and arthrodesis procedures.Five consecutive young females experiencing recurrent giving way of six calcaneocuboid joints were treated operatively during a 4 year period using anatomic ligament repair reinforced by a periosteal flap. Results were compared to five patients who underwent anatomic lateral ankle ligament repair in a case-control design. Outcome was measured using the Foot and Ankle Outcome Score, physical examination, and stress radiographic and MRI (calcaneocuboid group) investigation. Functional neuromuscular performance was evaluated by isokinetic torque measurements, posturometry, single-leg drop jumps, and single-leg long jumps.Outcome scores at follow up (5-61 months after surgery) revealed excellent results for both groups. No relevant difference was found between the affected legs and the non-affected legs or between groups with respect to the outcome measures. MRI exhibited ligament-like structures at the repaired dorsal calcaneocuboid joints in five out of six joints.Results of anatomic repair of unstable lateral ankle and isolated calcaneocuboid joint instability equally lead to excellent results.
Pregnancy in women with cystic fibrosis
Authors: F P Edenborough, D E Stableforth, W E Mackenzie
Journal: BMJ (1995)

Outcomes for mother and baby have much improved

The first successful pregnancy in a woman with cystic fibrosis was reported in 1960--at a time when the median survival of children with the disease was less than 10 years.1 The patient died six weeks after delivery, and the authors concluded that “cystic fibrosis is seriously complicated by pregnancy.” Since then reports have documented a gradual change from high fetal loss and maternal death due to cor pulmonale and respiratory failure to a good chance of a successful full term delivery of healthy infants to mothers whose overall health may be little changed.2 3 4 5 Sadly, this outcome is not available to patients whose health is poor or to those few women who have been sterilised or warned not to conceive.

How, then, in the late 1990s should doctors approach the issues …
Effect of lidocaine and quinidine on steady-state characteristics and recovery kinetics of (dV/dt)max in guinea pig ventricular myocardium.
Authors: C M Chen, L S Gettes, B G Katzung
Journal: Circulation Research (1975)

We studied the effects of quinidine and lidocaine on the steady-state relationship between membrane potential and the maximum rate of rise of the action potential, (dV/dt)max, and on the recovery kinetics of (dV/dt)max in guinea pig papillary muscles. The steady-state relationships were determined in fibers stimulated at 0.2/sec and depolarized with KCl. Recovery kinetics were determined at various resting membrane potentials by assessing (dV/dt)max in progressively earlier premature action potentials. Lidocaine caused a dose-dependent decrease in (dV/dt)max, shifted the curve defining the steady-state relationship along the voltage axis in the direction of more negative potentials, and slowed the recovery kinetics of (dV/dt)max. Quinidine caused a dose-dependent decrease in (dV/dt)max but did not alter the shape of the curves defining either the steady-state relationship or the recovery kinetics of (dV/dt)max. Both drugs depressed membrane responsiveness as determined in premature action potentials originating from incompletely repolarized fibers. Our study indicates that the mechanisms whereby quinidine and lidocaine influence (dV/dt)max are different. It is possible that this difference may underlie some of the differences in the clinical effects of these two drugs.
Electrophysiological Effects of Isoproterenol on Purkinje Fibers of the Heart
Authors: DONALD G. KASSEBAUM, ALAN R. VAN DYKE
Journal: Circulation Research (1966)

The effects of isoproterenol on resting and action potentials, automaticity and conduction velocity in isolated Purkinje fibers of sheep hearts were studied with microelectrode recording techniques. In quiescent Purkinje fibers, local application of isoproterenol to the site of microelectrode recording caused depolarization to a potential level from which repetitive discharge occurred. During the acceleration in beat frequency, the threshold and maximum diastolic potentials increased. When isoproterenol was applied to the pacemaker of beating fibers, the steepness of the pacemaker potential increased and the rate accelerated. Threshold and maximum diastolic potentials were affected variably in the beating preparation. Isoproterenol did not change conduction velocity in isolated, stimulated Purkinje fibers. The electrophysiological effects of isoproterenol resemble those described previously for epinephrine. The observations do not permit definition of the mechanism of action.
Pelvic Floor Disorders, Diabetes, and Obesity in Women
Authors: Jean M. Lawrence, Emily S. Lukacz, In-Lu Amy Liu, Charles W. Nager, Karl M. Luber
Journal: Diabetes Care (2007)

OBJECTIVE—We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women. RESEARCH DESIGN AND METHODS—Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/diabetic, obese/nondiabetic, and obese/diabetic. RESULTS—Of 3,962 women, 393 (10%) had diabetes. In unadjusted analyses, women with diabetes and women who were obese had greater odds of having PFDs. Among women with diabetes, being obese was associated with SUI and OAB. After adjusting for confounders, we found that obese/diabetic women were at the highest likelihood of having SUI (odds ratio 3.67 [95% CI 2.48–5.43]) and AI (2.09 [1.48–2.97]). The odds of having OAB among obese women was the same for obese/diabetic women (2.97 [2.08–4.36]) and obese/nondiabetic women (2.93 [2.33–3.68]). Nonobese/diabetic women had higher odds of SUI (1.90 [1.15–3.11]) but did not differ significantly in their OAB (1.45 [0.88–2.38]) and AI (1.33 [0.89–2.00]) prevalence from nonobese/nondiabetic women. CONCLUSIONS—Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs.
Liver resection for colorectal metastases.
Authors: Y Fong, A M Cohen, J G Fortner, W E Enker, A D Turnbull, D G Coit, A M Marrero, M Prasad, L H Blumgart, M F Brennan
Journal: Journal of Clinical Oncology (1997)

PURPOSE More than 50,000 patients in the United States will present each year with liver metastases from colorectal cancers. The current study was performed to determine if liver resection for colorectal metastases is safe and effective and to evaluate predictors of outcome. MATERIALS AND METHODS Data for 456 consecutive resections performed between July 1985 and December 1991 in a tertiary referral center were analyzed. RESULTS The perioperative mortality rate was 2.8%, with a mortality rate of 4.6% for resections that involved a lobectomy or more. The median hospital stay was 12 days and only 9% of patients were admitted to the intensive care unit. The 5-year survival rate is 38%, with a median survival duration of 46 months. By univariate analysis, nodal status of the primary lesion, short disease-free interval before detection of liver metastases, carcinoembryonic antigen (CEA) level greater than 200 ng/mL, multiple liver tumors, extrahepatic disease, large tumors, or positive resection margin was predictive of poorer outcome. Sex, age greater than 70 years, site of primary tumor, or perioperative transfusion was not predictive of outcome. By multivariate analysis, positive margin, size greater than 10 cm, disease-free interval less than 12 months, multiple tumors, and extrahepatic disease were independent predictors of poorer outcome. Short disease-free interval or multiple tumors were nevertheless associated with a 5-year survival rate greater than 24%. CONCLUSION Liver resection for colorectal metastases is safe and effective therapy and currently represents the only potentially curative therapy for metastatic colorectal cancer. The only absolute contraindication to resection is extrahepatic disease. A randomized trial to examine efficacy of surgical resection cannot ethically be performed. Liver resection should be considered standard therapy for all fit patients with colorectal metastases isolated to the liver.
Pre-hospital transportation in Western countries for Ebola patients, comparison of guidelines
Authors: H. Coignard-Biehler, A. Isakov, J. Stephenson
Journal: Intensive Care Medicine (2015)

The emergence of the Ebola virus disease (EVD) outbreak in West Africa threatens regional and global public health security. This epidemic, first announced in March 2014 in Guinea Conakry, has grown dramatically since June 2014 with an extension into Liberia and Sierra Leone. Nigeria, Mali, and Democratic Republic of the Congo were also transiently affected. It was declared to be a public health emergency of international concern by the World Health Organization (WHO) on 8 August 2014. On 21 January 2015, a cumulative total of more than 21,800 cases was reported by the WHO [1], with a case fatality rate (CFR) of between 57 and 59 % among hospitalized patients. A total of 828 healthcare workers (HCWs) have been infected with the Ebola virus since the beginning of the epidemic, with a CFR of 60 %. Some Western countries have also reported imported cases: six patients in the USA, Spain and UK, including one death (CFR of 16.7 %). Direct contact with infected bodily fluids—usually feces, vomit, or blood—is necessary for transmission. Once the Ebola virus is suspected, based on national versions of WHO’s case definition recommendations [2], specific laboratory tests can confirm or disprove diagnoses in a few hours, but for this, the patient has to be transported to a specialized center with specific management conditions [3]. In this article, the authors compared procedures for the transport of Ebola patients in their respective countries (USA, UK, and France) to identify common principles.