tbuckley/cabot-search huggingface dataset:
Dual action of nitric oxide on airway plasma leakage.
Authors: M Bernareggi, J A Mitchell, P J Barnes, M G Belvisi
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

In the rat, plasma leakage in various vascular beds, including the whole lung, occurs after administration of lipopolysaccharide (LPS). LPS-induced microvascular plasma leakage in many organs is associated with an enhanced formation of nitric oxide (NO) after the induction of nitric oxide synthase (iNOS). However, there is limited information concerning the relationship between NO and plasma leakage into the airways. LPS (10 mg/kg, intravenously) caused a significant leakage of Evans blue dye, a marker of microvascular permeability, at 240 min in the trachea which was inhibited by the NOS inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 10 mg/kg, intravenously), or dexamethasone (1 mg/kg, intravenously). This effect was paralleled by an increase in calcium-independent iNOS activity, assessed by measuring the conversion of radiolabeled L-arginine to L-citrulline, in LPS-treated animals. In contrast, L-NAME significantly increased plasma leakage in the trachea of vehicle-treated rats and this effect was inhibited by indomethacin. These results suggest that under "physiological" conditions endogenous NO suppresses plasma leakage but when iNOS is expressed the increased production of NO enhances plasma leakage. These findings may implicate a role for NO in the maintenance of airway function and in the inflammatory process occurring in diseases such as asthma, where iNOS is known to be expressed.
The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension: Update 2009
Authors: Thomas D. Boyer, Ziv J. Haskal
Journal: Hepatology (2009)

The 2009 update of the American Association for the Study of Liver Diseases (AASLD) Practice Guideline "The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Management of Portal Hypertension" is now posted online at www.aasld.org. This is the first update of the original guideline published in 2005.1 DSRS, distal splenorenal shunt; TIPS, transjugular intrahepatic portosystemic shunt. The key changes in the 2009 guidelines are new recommendations on the use of covered versus bare stents in the creation of the TIPS. Use of expanded polytetrafluoroethylene (ePTFE)-covered stents is now preferred. The lower risk of shunt dysfunction and perhaps improved outcomes using covered as opposed to bare stents are the basis for this recommendation.2, 3 Creation of a TIPS increases the risk of hepatic encephalopathy but the prophylactic use of nonabsorbable disaccharides or antibiotics does not appear to reduce this risk and is not recommended.4 The value of TIPS versus a surgical shunt in the prevention of variceal rebleeding in patients who have failed medical therapy has been clarified by the publication of a controlled trial comparing TIPS to distal splenorenal shunt (DSRS).5 Both were effective in preventing rebleeding (rebleeding incidence in 5.5% of DSRS versus 10.5% of TIPS; not significant) with no difference in encephalopathy or survival. The patients in whom TIPS was performed required significantly more interventions to maintain patency because of the use of bare stents. A cost analysis showed TIPS to be slightly more cost effective than DSRS at year 5,6 and these two approaches are now considered to be of equal efficacy in the prevention of variceal rebleeding. The other significant change to the guidelines is how TIPS should be used in the management of patients with Budd-Chiari syndrome. A large (221 patients) retrospective study was published in which patients who failed to improve with use of anticoagulation had a TIPS created (133 patients). One-year and 10-year transplant-free survival was 88% and 69%, respectively, which is better than predicted.7 TIPS patency was best in those who received a covered stent. The recommendation now is for creation of a TIPS in those who fail to improve with anticoagulation.
An Atlas of Salivary Gland Disorders
Authors: HEATHER J. OHRT, REX B. SHAFER
Journal: Clinical Nuclear Medicine (1982)

In the initial evaluation of a possible salivary gland disorder, salivary scintigraphy is a diagnostic and non-invasive examination of function (7). Further definition of anatomical abnormalities may require a panoramic radiograph of teeth and mandible, contrast sialogram, ultrasound, or computerized tomography. However, these latter methods contribute primarily anatomical information, and scintigraphy remains the best assessment of function. Our clinical experience with salivary scintigraphy is summarized in Table 1.
Evidence for a role of proteinpolysaccharides in regulation of mineral phase separation in calcifying cartilage
Authors: Julio C. Pita, Leon A. Cuervo, Juan E. Madruga, Francisco J. Muller, David S. Howell
Journal: Journal of Clinical Investigation (1970)

Our previous studies have indicated the presence of a macromolecular inhibitor of in vitro mineral growth, as well as a mineral nucleational agent in extracellular matrix fluid aspirated by micropuncture methods from epiphyseal hypertrophic cell cartilage. In this report, new miniaturized methods were used to extract proteinpolysaccharide complexes (PPC) from cartilage, to isolate a light fraction (PPL-C), and further, to separate it into R1, R2, and SR2 subfractions. These methods were applied to PPL-C complexes separated from microdissected epiphyseal cartilages and to cetylpyridinium chloride (CPC) precipitates of extracellular matrix fluid aspirated from similar cartilages. Most of all of the inhibitory action on an in vitro system of mineral growth shown by whole cartilage PPL-C and by cartilage fluid PPC obtained from noncalcifying sites was contained in the R2 fraction which represented (1/4)-[unk] of the total hexuronate. The R2 fraction was diminished or absent from calcified cartilage fluids and from whole calcified epiphyseal septa. The ratio R1 + R2: SR2 ranged from 0.37 to 0.71 in the fluids and whole tissue samples of noncalcified cartilages. The R2 fraction was distinguished from SR2 by a 2- to 3-fold higher protein: hexuronate ratio. These data are interpreted to indicate that the inhibitory R2 fraction was degraded or otherwise inactivated at the zone of provisional calcification and that this inhibitor participates in the physiological mechanism that regulates endochondral calcification.
ACUTE URINARY RETENTION AS A COMPLICATION OF PREGNANCY
Authors: Rudolph W. Holmes
Journal: JAMA (1952)

<h3>To the Editor:</h3> —The contribution of Drs. Maxwell Spring and Jesse J. Hymes under the above caption (<i>J. A. M. A</i>.<b>149</b>:1011 [July 12] 1952) is an interesting discussion of a matter pertinent to a bladder dysfunction complicating a retroverted pregnant uterus; however, some of the introductory statements are misleading. In the first place Smellie's contributions on obstetrics were not publicized in 1876; the first editions of his works appeared in 1752—the Sydenham Society merely reproduced them in 1876. The association of urinary retention with incarcerated retroverted pregnant uteri was a relatively common occurrence in the past, especially among women who had no maternity care. Today, inspired by the activities of the American Committee on Maternal Welfare, Inc., with the multiplicity of associated state, county, and local cooperating organizations, the medical profession and the great mass of the laity have acquired a startling "obstetric conscience"; a priori, in these
Preinfection Systemic Inflammatory Markers and Risk of Hospitalization Due to Pneumonia
Authors: Sachin Yende, Elaine I. Tuomanen, Richard Wunderink, Alka Kanaya, Anne B. Newman, Tamara Harris, Nathalie de Rekeneire, Stephen B. Kritchevsky
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Elevated proinflammatory cytokines are associated with severity of pneumonia, but the role of preinfection cytokine levels in the predisposition to pneumonia in humans is less clear.
The Death of Clarence Herbert: Withdrawing Care Is Not Murder
Authors: BERNARD LO
Journal: Annals of Internal Medicine (1984)

Two physicians were charged with murder for discontinuing mechanical ventilation and intravenous fluids for a comatose patient. Although these unprecedented criminal charges were dismissed, the ruling may give physicians little legal reassurance. The case shows the problems in judging prognosis, resolving disagreements with staff, and communicating with families. Indirectly the case suggests how decision making and the care of dying patients may be improved. Physicians will continue to have responsibility for making difficult decisions according to their best medical and ethical judgment, despite legal uncertainty.
A mucosal antibody response following systemic Haemophilus influenzae type B infection in children.
Authors: M E Pichichero, C B Hall, R A Insel
Journal: Journal of Clinical Investigation (1981)

The possibility that mucosal antibody is produced as a host response to Haemophilus influenzae type b (Hib) infection was examined in this study. 17 of 18 prospectively evaluated children ranging in age from 2 mo to 7 yr developed a detectable level of anticapsular antibody in their nasopharyngeal secretions after systemic Hib infection. The mean concentration of nasal anti-capsular antibody of the 18 children was 554 ng/mg IgA (SD = 35-8,863) during the acute phase of illness and declined to 224 ng/mg IgA (SD = 19-2,688) in convalescence. Some children had mucosal antibody detectable at least 10 mo after infection. The mucosal antibody levels were not affected by the length of illness before diagnosis, type of disease, age of the patient, sex, or presence of detectable capsular antigen or viable bacteria in the nasopharynx. The mucosal antibody was predominantly of the IgA class and occurred independent of the serum antibody. Six of the children aged less than 1 yr who did not produce and/or sustain a serum antibody level correlated with protection demonstrated a persistent mucosal antibody response. These findings suggest that the mucosal immune system may have the ability to respond at an earlier age than the serum immune system and lead us to postulate that protective secretory antibodies to prevent systemic Hib disease may be inducible in young infants in spite of the poor serum antibody response occurring at this age.
Bad Outcomes of Questionable Medical Decisions
Authors: Elizabeth Nilson
Journal: Annals of Internal Medicine (2003)

Letters18 March 2003Bad Outcomes of Questionable Medical DecisionsElizabeth Nilson, MDElizabeth Nilson, MDNew York University Downtown Hospital, New York, NY 10038 (Nilson)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-6-200303180-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Drs. Hofer and Hayward make a cogent argument against performing a lengthy root-cause analysis when there is probably no identifiable systems problem that resulted in a bad outcome (1). As they discuss, the bad outcome is probably the result of a series of risky medical procedures and decisions. However, such cases are worthy of analysis for performance improvementsomething that is intimately tied to peer review, quality assurance, and patient safety, as well as mandated by regulatory agencies.The case described by Hofer and Hayward is in itself compelling. An evidence-based medicine discussion about diagnostic tests and their ...References1. Hofer TP, Hayward RA. Are bad outcomes from questionable clinical decisions preventable medical errors? A case of cascade iatrogenesis. Ann Intern Med. 2002;137:327-33. [PMID: 12204016] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: New York University Downtown Hospital, New York, NY 10038 (Nilson) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAre Bad Outcomes from Questionable Clinical Decisions Preventable Medical Errors? A Case of Cascade Iatrogenesis Timothy P. Hofer and Rodney A. Hayward Are Bad Outcomes from Questionable Clinical Decisions Preventable Medical Errors? A Case of Cascade Iatrogenesis Timothy P. Hofer and Rodney A. Hayward Bad Outcomes of Questionable Medical Decisions William B. Weeks and James P. Bagian Bad Outcomes of Questionable Medical Decisions Timothy P. Hofer and Rodney A. Hayward Bad Outcomes of Questionable Medical Decisions Kenneth M. Kessler Metrics 18 March 2003Volume 138, Issue 6Page: 519-520KeywordsDecision makingEvidence based medicineForecastingHealth care quality assessmentMedical educationOutpatientsPeer reviewSafetySports and exercise medicineVentilation perfusion ePublished: 18 March 2003 Issue Published: 18 March 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Obesity treatment is being neglected in favour of prevention, doctor says
Authors: C. White
Journal: BMJ (2010)

The UK government’s focus on prevention to curb the rising tide of obesity has ignored those who are already obese, which is costing the NHS dear, an expert has claimed.

Speaking at the Tackling Obesity 2010 conference in London, Dr David Haslam, chair of the National Obesity Forum, praised government initiatives, such as Change4Life, which aim to stave off obesity by advocating lifestyle changes.

But even that campaign presented an unrealistic “utopian” vision of prevention, he suggested, as the materials featured people who were all fit and slim. “It’s like a kids’ fairy tale without any villains,” he said.

And …
MicroRNA expression patterns in medullary and extramedullary plasmacytoma
Authors: J J Lin, A Mahindra, L Santo, S Amin, A R Sohani, N Raje
Journal: Blood Cancer Journal (2014)

Plasmacytomas are localized tumors of monoclonal plasma cells without evidence of significant bone marrow infiltration or systemic myeloma, comprising ∼2–10% of all plasma cell neoplasms.1 Medullary plasmacytomas classically occur in the bone of the vertebrae or skull, whereas extramedullary plasmacytomas occur in the soft tissues, most frequently in the head and neck region involving the sinuses or rhinopharynx.1 Both medullary and extramedullary plasmacytomas occur in males more often than in females with a median age at diagnosis of 54 years.1 Furthermore, plasmacytomas in general are fairly radiosensitive, such that the current treatment of choice is localized radiation therapy except in cases of neurologic compromise or bone instability that require surgical resection.2 There is no evidence thus far that adjuvant systemic chemotherapy offers additional clinical benefit.2 Despite these similarities, medullary and extramedullary plasmacytomas are considered distinct clinical entities owing to differences in their predisposition to evolve into multiple myeloma (MM). Medullary plasmacytomas are traditionally thought to have a higher risk of progression, also with a lower 5-year survival rate of 33% once they have progressed to MM (as opposed to 5-year survival rate of 100% in extramedullary plasmacytomas that progress to MM).2 Yet, very little is known regarding genetic or molecular factors that distinguish these two groups of plasmacytomas and influence their clinical outcome.
Self poisoning with oral cadmium chloride.
Authors: H M Buckler, W D Smith, W D Rees
Journal: BMJ (1986)

Une observation: suicide d'une jeune etudiante de 17 ans. La mort survient 30 h apres l'hospitalisation, malgre des traitements intensifs. Le poison utilise est du chlorure de cadmium. Troubles metaboliques importants, necroses etendues dans l'appareil digestif
Localization and radiofrequency catheter ablation of left-sided accessory pathways during atrial fibrillation Feasibility and electrogram criteria for identification of appropriate target sites
Authors: Gerhard Hindricks, Hans Kottkamp, Xu Chen, Stephan Willems, Wilhelm Haverkamp, Mohammad Shenasa, Breithardt Günter, Martin Borggrefe
Journal: Journal of the American College of Cardiology (1995)
Clinical and Histologic Features of Azithromycin-Induced Liver Injury
Authors: Melissa A. Martinez, Raj Vuppalanchi, Robert J. Fontana, Andrew Stolz, David E. Kleiner, Paul H. Hayashi, Jiezhun Gu, Jay H. Hoofnagle, Naga Chalasani
Journal: Clinical Gastroenterology and Hepatology (2014)
Temperate Pyomyositis as a Complication of Staphylococcus aureus Septicemia
Authors: James D. Birchall
Journal: Clinical Nuclear Medicine (2005)

A 44-year-old man recently returning from vacation to a temperate country presented with acute renal failure and staphylococcal toxic shock. There was no history of impaired immunofunction or diabetes mellitus. Initial laboratory investigations revealed a urea of 40.1 mmol/L, creatine of 808 mmol/L, creatine phosphokinase 514, and an elevated C-reactive protein of 440. To assess for a potential focal source of infection, a Tc-99m HMPAO-labeled leukocyte study was performed, which demonstrated avid increased uptake in the muscles of the trunk and proximal extremities, particularly within the muscles of the left forearm.
VARIATIONS IN PITX2C EXPRESSION: ALTERING SUSCEPTIBILITY TO ATRIAL FIBRILLATION?
Authors: Peter C. Kahr, Ismail Vokshi, Sven Kaese, Ilaria Piccini, Hans-Heinrich Scheld, Heinrich Rotering, Lisa Fortmueller, Sandra Laakmann, Sander Verheule, Ulrich Schotten, Larissa Fabritz, Nigel A. Brown, Paulus Kirchhof
Journal: Journal of the American College of Cardiology (2011)
The burden of lung disease in Europe: why a European White Book on lung disease?
Authors: R. Loddenkemper, G.J. Gibson, Y. Sibille
Journal: European Respiratory Journal (2003)

On November 25, 2003, the European Lung White Book was presented officially to members of the European Parliament in Brussels, Belgium. This project was initiated 5 yrs ago when the Executive Committee of the European Respiratory Society (ERS) decided to inform the European Community and European Union (EU) decision-makers about the increasing burden of lung disease and the importance of lung health. The European Lung White Book then became part of a global public health awareness campaign supported by the European Lung Foundation: the “Breath of Life” campaign. The main objectives of this White Book, which is the first document to include epidemiological data collected from all European countries on the full spectrum of respiratory disorders are as follows:

1) To raise public awareness of the importance of lung diseases and measures necessary to counter their increase. Major respiratory disorders, pneumonia (third), chronic obstructive pulmonary disease (COPD; fifth), tuberculosis (TB; sixth) and lung cancer (ninth) currently rank among the 10 …
THE CLINICAL USEFULNESS AND UTILIZATION OF TISSUE DOPPLER IMAGING, LONGITUDINAL AND CIRCUMFERENTIAL STRAIN AND STRAIN RATE IN THE DIAGNOSTIC ACCURACY FOR DIFFERENT PHENOTYPES OF HEART FAILURE
Authors: Yau-Huei Lai, Chi-In Lo, Kuo-Tzu Sung, Jen-Yuan Kuo, Yih-Jer Wu, Hung-I Yeh, Chung-Lieh Hung
Journal: Journal of the American College of Cardiology (2013)
Serum free thyroxine in pregnancy.
Authors: A Kurtz, K Dwyer, R Ekins
Journal: BMJ (1979)

<b>Objectives:</b> Many patients with Crohn’s disease (CD) have low bone mineral density (BMD) that may not be solely attributable to glucocorticoid use. We hypothesised that low BMD in patients with CD is associated with elevated circulating levels of the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)<sub>2</sub>D). We further hypothesised that this was secondary to increased synthesis of 1,25(OH)<sub>2</sub>D by inflammatory cells in the intestine. The aim of this study was to examine the relationship between 1,25(OH)<sub>2</sub>D levels and BMD in patients with CD. <b>Methods:</b> An IRB approved retrospective review of medical records from patients with CD (n = 138) or ulcerative colitis (UC, n = 29). Measurements of vitamin D metabolites and immunoreactive parathyroid hormone (iPTH) were carried out. BMD results were available for 88 CD and 20 UC patients. Immunohistochemistry or real time reverse transcription-polymerase chain reaction (RT-PCR) for the enzyme 1α-hydroxylase was performed on colonic biopsies from patients with CD (14) or UC (12) and normal colons (4). <b>Results:</b> Inappropriately high levels of serum 1,25(OH)<sub>2</sub>D (&gt;60 pg/ml) were observed in 42% of patients with CD compared with only 7% in UC, despite no differences in mean iPTH. Serum 1,25(OH)<sub>2</sub>D levels were higher in CD (57 pg/ml) versus UC (41 pg/ml) (p = 0.0001). In patients with CD, there was a negative correlation between 1,25(OH)<sub>2</sub>D levels and lumbar BMD (<i>r</i> = −0.301, p = 0.005) independent of therapeutic glucocorticoid use. 1,25(OH)<sub>2</sub>D levels also correlated with CD activity. Lastly, immunohistochemistry and RT-PCR demonstrated increased expression of intestinal 1α-hydroxylase in patients with CD. <b>Conclusions:</b> These data demonstrate that elevated 1,25(OH)<sub>2</sub>D is more common in CD than previously appreciated and is independently associated with low bone mineral density. The source of the active vitamin D may be the inflamed intestine. Treatment of the underlying inflammation may improve metabolic bone disease in this subgroup of patients.
Ultrasound assessment of the polycystic ovary: international consensus definitions
Authors: A. H. Balen, J. S. E. Laven, S.-L. Tan, D. Dewailly
Journal: Human Reproduction Update (2003)

The polycystic ovary syndrome (PCOS) is a heterogeneous condition, the pathophysiology of which appears to be both multifactorial and polygenic. The definition of the syndrome has been much debated. Key features include menstrual cycle disturbance, hyperandrogenism and obesity. There are many extra‐ovarian aspects to the pathophysiology of PCOS, yet ovarian dysfunction is central. At a recent joint ASRM/ESHRE consensus meeting, a refined definition of the PCOS was agreed, encompassing a description of the morphology of the polycystic ovary (PCO). According to the available literature, the criteria fulfilling sufficient specificity and sensitivity to define the PCO should have at least one of the following: either 12 or more follicles measuring 2–9 mm in diameter, or increased ovarian volume (>10 cm3). If there is a follicle >10 mm in diameter, the scan should be repeated at a time of ovarian quiescence in order to calculate volume and area. The presence of a single PCO is sufficient to provide the diagnosis. The distribution of follicles and a description of the stroma are not required in the diagnosis. Increased stromal echogenicity and/or stromal volume are specific to PCO, but it has been shown that the measurement of ovarian volume (or area) is a good surrogate for quantification of the stroma in clinical practice. A woman having PCO in the absence of an ovulation disorder or hyperandrogenism (‘asymptomatic PCO’) should not be considered as having PCOS, until more is known about this situation. Three‐dimensional and Doppler ultrasound studies may be useful research tools but are not required in the definition of PCO. This review outlines evidence for the current ultrasound definition of the polycystic ovary and technical specifications.