tbuckley/cabot-search huggingface dataset:
Virtual Autopsy in the Intensive Care Unit
Authors: Dominic Wichmann, Stefan Kluge
Journal: Annals of Internal Medicine (2012)

Letters5 June 2012Virtual Autopsy in the Intensive Care UnitDominic Wichmann, MD, DTM and Stefan Kluge, MDDominic Wichmann, MD, DTMFrom University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.Search for more papers by this author and Stefan Kluge, MDFrom University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-11-201206050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments from Dr. Kirsch and agree that, especially for cervical central lines, ultrasonography is an easy-to-perform, noninvasive method to control the correct positioning of the device. This case once more underscores the value of virtual and classic autopsy forms for quality control (1), because control mechanisms were not sufficient to prevent the displacement of the device. This is why we disagree with Dr. Kirsch in classifying the event as minor. In a patient with septic shock, measuring central venous pressure and providing adequate volume and vasopressor therapy are considered crucial (2). Because this cannot be ...References1. De Vlieger GY, Mahieu EM, Meersseman W. Clinical review: what is the role for autopsy in the ICU? Crit Care. 2010;14:221. [PMID: 20565845] CrossrefMedlineGoogle Scholar2. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-77. [PMID: 11794169] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Dominic Wichmann, MD, DTM; Stefan Kluge, MDAffiliations: From University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1201. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVirtual Autopsy as an Alternative to Traditional Medical Autopsy in the Intensive Care Unit Dominic Wichmann , Frieder Obbelode , Hermann Vogel , Wilhelm Wolfgang Hoepker , Axel Nierhaus , Stephan Braune , Guido Sauter , Klaus Pueschel , and Stefan Kluge Virtual Autopsy in the Intensive Care Unit Carl M. Kirsch Metrics 5 June 2012Volume 156, Issue 11Page: 839KeywordsAutopsyConflicts of interestIntensive care unitsQuality improvementShockUltrasound imagingVasopressor therapy ePublished: 5 June 2012 Issue Published: 5 June 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Herceptin and the Heart — A Molecular Modifier of Cardiac Failure
Authors: Kenneth R. Chien
Journal: New England Journal of Medicine (2006)

Translation, translation, translation. Around the halls of academic medicine, translation is the mantra of the moment. In the literary world, translation is the process of interpreting an extant body of written work and converting it into a new language. In the scientific world, translation is the application of fundamental discoveries in basic science to clinical medicine, with the goal of developing new treatments for debilitating diseases.In this arena, the development of a humanized monoclonal antibody against the HER2 protein (trastuzumab, or Herceptin) as adjuvant therapy for early HER2-positive breast cancer ranks as one of the most satisfying and powerful . . .
Management of Shock in Acute Myocardial Infarction
Authors: ABRAHAM GOOTNICK, FREDERICK H. KNOX
Journal: Circulation (1953)

Shock complicating acute myocardial infarction contributes materially to the over-all mortality. The wisdom of combating the shock has been a matter of dispute, many clinicians holding that the fall in blood pressure has the salutary effect of reducing the work of an acutely injured heart. This report deals with a four-year experience in active intervention for shock. The data suggest that timely intervention for shock is frequently life-saving, and may be instrumental in halving themortality of the sickest patients.
Novel activating JAK2 mutation in a patient with Down syndrome and B-cell precursor acute lymphoblastic leukemia
Authors: Sebastien Malinge, Raouf Ben-Abdelali, Catherine Settegrana, Isabelle Radford-Weiss, Marianne Debre, Kheira Beldjord, Elizabeth A. Macintyre, Jean-Luc Villeval, William Vainchenker, Roland Berger, Olivier A. Bernard, Eric Delabesse, Virginie Penard-Lacronique
Journal: Blood (2006)
ABC of sexually transmitted diseases. Psychosexual problems.
Authors: D Goldmeier
Journal: BMJ (1984)

Since the 1960s the increase in erotic entertainment has conveyed a clear message: the more sex the better.This has resulted in myths about sexual norms, which if believed may lead to behaviour result- ing in the acquisition of sexually transmitted diseases or in sexual dysfunction, or both.The psychosexual problems seen in departments of genitourinary medicine are either secondary to sexually acquired infection or primarily psychological. General reactionsWhen genital lesions are seen, felt, or suspected most patients lose interest in sexual intercourse, or at least restrain themselves for fear of infecting their partners.Those disinhibited by drugs or alcohol or of a psychopathic nature may, however, continue to have inter- course, and particular care must be taken to explain the dangers to others of such behaviour.Marital discord-The innocently infected partner ofa patient who has had intercourse outside a stable relationship may realise the implications of a sexually transmitted disease but may not want the diagnosis spelt out.The doctor therefore should not force the diagnosis on the patient but give him or her room to manoeuvre by saying, for instance, "Is there anything more you would like to know?".Often the answer is "No."Anger, anxiety, guilt, and depression-Under the stress of having a sexually transmitted disease the extravert may become angry and the introvert anxious or depressed.Anger may be directed at the clinic staff as well as the person who transmitted the infection.Recognition of this anger may allow the doctor to intervene and discuss the facts and feelings surrounding a patient's illness.This may prevent later violence towards the patient's sexual partner.Unfortunately, in the case of the psychopath such intervention may not alter the patient's strong feelings or the outcome.The neurotic introvert is more likely to become anxious or depressed under stress, particularly when he or she has had intercourse outside a stable relationship.When severe these symptoms must be taken seriously.Clinical anxiety may be dealt with by letting the patient voice his feelings, and later by reassurance.In some patients the anxiety is so severe that a short course ofbenzodiazepines (such as diazepam 2 mg three times a day) may need to be given.Guilt and depression often go together, though most cases of depression seen in clinics are not severe; if necessary antidepressants such as mianserin 30-60 mg at night may be given; the dose should be built up slowly to prevent undue sleepiness in a working person.When the depression is deeper, psychiatric help should be enlisted, but the patient may refuse unless the psychiatrists are on the spot at the clinic.A clinically trivial condition such as recurring non-gonococcal urethritis, as well as the more serious problems of genital herpes, pelvic inflammatory disease, acute epididymitis, and hepatitis B, may all cause anger, anxiety, guilt, and depression.Allowing such patients to air their feelings is vital.
Superficial Esophageal Carcinoma Arising from the Diverticulum of the Esophagus
Authors: H. Kimura, K. Konishi, Y. Tsukioka, K. Muraoka, K. Yabushita, K. Maeda, Y. Kuroda, M. Tsuji, A. Miwa
Journal: Endoscopy (1997)
Scientists identify enzymes implicated in Alzheimer's
Authors: F. Charatan
Journal: BMJ (1999)

A team of scientists working at Amgen, a leading biotechnology company at Thousand Oaks, California, has succeeded in identifying two proteases believed to be responsible for the formation of amyloid plaques in the brains of patients with Alzheimer's disease.

Their report is published in the current issue of Science (1999;286:735-41) Amyloid has been clearly implicated in the pathogenesis of Alzheimer' sdisease (BMJ 1998;317:102). The Amgen team found that the deposition …
Antibodies to foodstuffs in schizophrenia.
Authors: I Mascord, D Freed, B Durrant
Journal: BMJ (1978)

similar cases treated by various progestins alone.2Inhibition of breast cancer growth by progestins is seen in both premenopausal and postmenopausal women but is favoured by the presence of circulating oestrogen.In the series treated with contraceptive steroids the response rate was only 60% in elderly patients with an atrophic vaginal smear, but it was 40 % in younger patients with evidence of oestrogen- isation in the smear.The observation is par- ticularly interesting because Huggins: re- ported that a combination of low-dosage oestradiol and high-dosage progesterone is capable of extinguishing the growth of the hormone-sensitive chemically induced mam- mary cancer in non-castrated female rats.He emphasised that the relative dose of oestrogen and progestin may be critical for success.
Researchers get 1.6m to look at scientific basis of chronic fatigue syndrome
Authors: Z. Kmietowicz
Journal: BMJ (2011)

Five research teams have been handed more than £1.6m (€1.9m; $2.5m) by the UK Medical Research Council to investigate the biological processes that underpin chronic fatigue syndrome. 

Stephen Holgate, chairman of the council’s population and systems medicine board and who helped allocate the funding, said that the scientific basis of the syndrome, also known as myalgic encephalomyelitis, has been insufficiently explored …
Abstract 1385: Fusion protein containing RGD-endostatin and human Fc of IgG4improves anti-angiogenic and anti-tumor activity
Authors: Yawu Jing, Kailang Wu, Huarui Lu, Indira V. Subramanian, Sundaram Ramakrishnan
Journal: Cancer Research (2010)

Abstract Inhibiting angiogenesis is a promising strategy for cancer therapy. Endostatin, a C-terminal fragment of collagen XV[[Unsupported Character - &amp;#1064;]], is an endogenous inhibitor of angiogenesis. We have earlier shown that addition of integrin-targeting sequences to a mutant endostain (P125A-endo) improved localization to tumor vasculature. In the present study, we investigated whether genetically fusing endostatin to Fc region of human IgG can prolong circulatory half-life and improve anti-tumor activity. Two types of constructs were made: a) RGD-endostatin-Fc and b) Endostatin-RGD-Fc. The location of the RGD moiety was either placed at the NH2-terminus or between the carboxyl terminus of endostatin and Fc. Both constructs were expressed in HEK-293 cells and purified using affinity chromatography. Our results show the biological activity of endostatin was significantly enhanced by linking to the Fc region of IgG when compared to P125A-endostatin expressed in yeast. Both RGD-Endo-Fc and Endo-RGD-Fc were able to bind endothelial cells very efficiently and inhibited endothelial cells proliferation, migration in vitro and angiogenesis in vivo. We then investigated the ability of the fusion protein to inhibit ovarian cancer growth in a xenograft model. Once a week administration of the fusion protein into mice bearing established ovarian tumors inhibited tumor growth and increased their survival. Anti-tumor activity of the fusion protein was comparable to Bevacizumab-mediated suppression of tumor growth. Furthermore, when mice were treated with a combination of the fusion protein and Bevacizumab, more than additive inhibition of tumor growth was observed. These data suggest that fusion with Fc-fragment can improve the anti-angiogenic and anti-tumor activity of endostatin. Moreover, our results support a strategy to combine two anti-angiogenic reagents such as anti-VEGF antibody and endostatin-Fc fusion protein to additively inhibit ovarian cancer growth. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1385.
Long term acid suppressing treatment Survey shows variation in practice
Authors: M McCullagh, C Brown, D Bell, K Powell, W Hammerton
Journal: BMJ (1994)

nine of these were said to have been deliberate.Four of these assaults involved bottles.These results suggest that tempered glasses may be preferable to annealed glasses.Even so, several safety problems were also reported in relation to tempered glasses.There is probably no such thing as a safe glass.Public bars are a commonplace forum for intoxication, aggression, and related injuries and assaults.Indeed, the design and operation of such premises may influence levels of aggression and intoxication.4Evidence on the merits of tempered glasses is not definitive.More research is required to produce a clear picture of the role of glasses, bottles, and other artefacts in bar injuries.It is particularly important to ascertain whether the introduction of tempered glasses into bars leads to a fall in injuries or simply to the adoption of other forms of weapon.
Cohort study of association of risk of breast cancer with cyst type in women with gross cystic disease of the breast
Authors: P. Bruzzi, L. Dogliotti, C. Naldoni, L. Bucchi, M. Costantini, A. Cicognani, M. Torta, G. F. Buzzi, A. Angeli
Journal: BMJ (1997)

Objective: To assess correlation between type of breast cyst and risk of breast cancer in women with gross cystic disease of the breast. Design: Cohort study of women with breast cysts aspirated between 1983 and 1993 who were followed up until December 1994 for occurrence of breast cancer. Setting: Major cancer prevention centre. Subjects: 802 women with aspirated breast cysts. Main outcome measures: Type of breast cyst based on cationic content of cyst fluid: type I (potassium:sodium ratio >1.5), type II (potassium:sodium ratio <1.5), or mixed (both types). Subsequent occurrence and type of breast cancer. Results: After median follow up of six years (range 2-12 years) 15 cases of invasive breast cancer and two ductal carcinomas in situ were diagnosed in the cohort: 12 invasive cancers (and two carcinomas in situ) among the 417 women with type I cysts, two cancers among the 325 women with type II cysts, and one among the 60 women with mixed cysts. The incidence of breast cancer in women with type I cysts was significantly higher than that in women with type II cysts (relative risk 4.62 (95% confidence interval 1.26 to 29.7)). These results were confirmed after adjustment for several risk factors for breast cancer (relative risk 4.24 (1.12 to 27.5)). Conclusions: The increased risk of breast cancer of women with breast cysts seems to be concentrated among women with type I breast cysts. #### Key messages
Monitoring of psychotropic drug prescribing in general practice.
Authors: P J Dennis
Journal: BMJ (1979)

Over 1000 repeat prescriptions of psychotropic drugs, which were given without the doctor seeing the patient, were analysed from a population of over 100 000 patients during a two-week period. The analysis showed that the longer repeat prescribing had taken place the older the patient was likely to be and the less closely were they monitored by their general practitioner.
Cancer and Psychosocial Traits, Continued-Reply
Authors: Paul T. Costa
Journal: JAMA (1990)

<h3>In Reply. —</h3> In her response to our recent article, Dr Andrianopoulos suggests that depression may be a risk factor for a subgroup of cancers that are sensitive to immunodeficiency. We did not present analyses by site or type of cancer because we did not have sufficient numbers of cases to conduct conclusive analyses. Of the 637 cases of any diagnosis of cancer, only 71 (11%) were of the types specified by Dr Andrianopoulos. Most of these (47) were carcinomas of the lip and skin. New proportional hazards analyses, with and without adjustment for standard risk factors, showed no significant association between depressive symptoms on the General Well-being Schedule and these types of cancer (relative risk, 1.1), nor was there a significant association when the Center for Epidemiological Studies Depression scale was examined. Even with the small number of cases in these analyses, it appears fair to conclude that if
THE RÔLE OF OPHTHALMOLOGY IN PREVENTIVE MEDICINE
Authors: HIRAM WOODS
Journal: JAMA (1910)

The rôle of ophthalmology in preventive medicine includes, it seems to me, at least three phases which may be profitably studied by the general profession: 1. Prevention of blindness from infectious diseases and accidents. 2. Prevention of eye deterioration by violation of ocular hygiene. 3. Prevention of remote lesions through recognition of early ocular symptoms of systemic disease. It is my purpose to speak briefly of each of these, bearing in mind the fact that this section has to do rather with the practical results of scientific study than with the details of the study itself. <h3>OPHTHALMIA NEONATORUM</h3> Among infectious eye troubles, the most destructive, by long odds, is ophthalmia neonatorum. The number of its victims is little short of a professional disgrace. Its cause is definitely known. While due exceptionally to infection other than gonococcic, and while differential diagnosis is important, the fact remains that clinical experience shows the
Bone Lead Levels and Delinquent Behavior-Reply
Authors: Herbert L. Needleman
Journal: JAMA (1996)

In Reply.  —Dr Sachs and Dr Sayres are skeptical; they have treated lead-poisoned children but have not observed antisocial behavior. Both relied on personal behavioral observation in a clinic setting; we used structured behavioral inventories from 3 separate informants, all of whom had the benefit of prolonged, close-up observation. Sachs notes that 69 subjects she treated with extreme elevations in blood lead levels (>4.83 μmol/L [>100 μg/dL]) seemed to be doing well on follow-up. She actually treated 105 children with lead levels in this dangerous range, but she ignores 36 subjects who were not located. Subjects not located after treatment generally have worse outcomes than those who are located. It is reasonable to ask how many of her missing lead-poisoned subjects are in special schools, are homeless, are in prison, or are dead.  Dr Ernhart criticizes our report because the CBCL delinquency clusters did not reach statistical significance when classified
Inflammasome and toll-like receptor 9: Partners in crime in toxic liver injury
Authors: Leif E. Sander, J. Magarian Blander, Kris Kowdley, Geoffrey McCaughan, Christian Trautwein
Journal: Hepatology (2009)

Hepatocyte death results in a sterile inflammatory response that amplifies the initial insult and increases overall tissue injury. One important example of this type of injury is acetaminopheninduced liver injury, in which the initial toxic injury is followed by innate immune activation. Using mice deficient in Tlr9 and the inflammasome components Nalp3 (NACHT, LRR, and pyrin domain- containing protein 3), ASC (apoptosis-associated speck-like protein containing a CARD), and caspase-1, we have identified a nonredundant role for Tlr9 and the Nalp3 inflammasome in acetaminophen- induced liver injury. We have shown that acetaminophen treatment results in hepatocyte death and that free DNA released from apoptotic hepatocytes activates Tlr9. This triggers a signaling cascade that increases transcription of the genes encoding pro-IL-1beta and pro-IL-18 in sinusoidal endothelial cells. By activating caspase-1, the enzyme responsible for generating mature IL-1beta and IL-18 from pro-IL-1beta and pro-IL-18, respectively, the Nalp3 inflammasome plays a crucial role in the second step of proinflammatory cytokine activation following acetaminophen-induced liver injury. Tlr9 antagonists and aspirin reduced mortality from acetaminophen hepatotoxicity. The protective effect of aspirin on acetaminophen-induced liver injury was due to downregulation of proinflammatory cytokines, rather than inhibition of platelet degranulation or COX-1 inhibition. In summary, we have identified a 2-signal requirement (Tlr9 and the Nalp3 inflammasome) for acetaminophen-induced hepatotoxicity and some potential therapeutic approaches.
353 NATURAL KILLER CELL FUNCTION IS ENHANCED AFTER HCC RADIOFREQUENCY THERMAL ABLATION: RATIONAL FOR THE DEVELOPMENT OF ADJUVANT IMMUNOTHERAPY
Authors: A. Zerbini, M. Pilli, G. Pelosi, E. Negri, A. Molinari, D. Tola, D. Laccabue, C. Cavallo, F. Fagnoni, C. Ferrari, G. Missale
Journal: Journal of Hepatology (2008)
Aprotinin and transfusion requirements in orthotopic liver transplantation: a multicentre randomised double-blind study
Authors: Robert J Port, I Quintus Molenaar, Bruno Begliomini, Theo HN Groenland, Anna Januszkiewicz, Leena Lindgren, Gualtiero Palareti, Jo Hermans, Onno T Terpstra
Journal: The Lancet (2000)
A FATAL CASE OF COCCIDIOIDALA
Authors: Philip King Brown
Journal: JAMA (1913)

<h3>History.</h3> —The patient was a Yaqui Indian, aged 30, speaking no English (history obtained through interpreter). He worked at McKittrick, Valley, California, with construction gang. He knew nothing of his family history. He said that he had never been sick before and denied venereal diseases. <h3>Presen—Trouble.</h3> —July 25, 1911: Patient said that he had been sick for ten days. He felt warm and had pains all over him, in shoulders, hips and all joints. He had coughed for several months and had had some pains in the lungs. A couple of weeks after admittance, patient said that he had no pains anywhere, no chills and no sore throat, but that he had perspired freely day and night. <h3>Physical Examination.</h3> —There was no evidence of a lesion anywhere. The heart-tones were clear and strong; there was no couth; there were no signs in the lungs of
Long-term outcome after endoscopic resection in patients with hypopharyngeal carcinoma invading the subepithelium: a case series
Authors: Y. Shimizu, T. Yoshida, M. Kato, S. Ono, M. Nakagawa, A. Homma, N. Oridate, M. Asaka
Journal: Endoscopy (2009)

Patients with early stage hypopharyngeal carcinoma can be treated with endoscopic resection. However, strict indication for endoscopic resection in cases of hypopharyngeal carcinoma is unclear. In this paper, we evaluated the long-term outcome after endoscopic resection in patients with hypopharyngeal carcinoma invading the subepithelium. Among 16 patients with hypopharyngeal carcinoma who underwent endoscopic resection, eight patients who were histologically confirmed to have tumors with shallow invasion of the subepithelium were studied. Depth of tumor invasion in the subepithelium in those patients ranged from 300 to 720 µm (mean ± SD, 490 ± 140 µm). During a median follow-up period of 40 months, none of the eight patients had local recurrence or metastasis. Kaplan-Meier estimates of relapse-free survival rates at 5 years in the eight patients were 100 %. The results of this study suggest that hypopharyngeal carcinoma with slight invasion to the subepithelium can be successfully treated by endoscopic resection.
OBSTRUCTIVE VENTILATORY DISORDER IN HEART FAILURE: NOT ALWAYS COPD!
Authors: Susanne Brenner, Gülmisal Güder, Kilian Frö;hlich, Gö;tz Gelbrich, Roland Jahns, Berthold Jany, Georg Ertl, Christiane E. Angermann, Stefan Stö;rk
Journal: Journal of the American College of Cardiology (2010)