tbuckley/cabot-search huggingface dataset:
Food-Dependent, Exercise-Induced Anaphylaxis
Authors: M. R. El-Dieb
Journal: JAMA (1984)

To the Editor.—  I would like to comment on the CASE REPORT, Food-Dependent, Exercise-Induced Anaphylaxis, by Buchbinder et al 1 published in a recent issue ofThe Journal. The episode of exercise-induced anaphylaxis reported by the patient-subject of this article on Aug 22,1982, after eating grapes and jogging for 2 1/2 miles was assumed by the authors to be related somehow to ingestion of the grapes despite the negative results of skin test to the fruit. At the same time, the patient gave a history of seasonal rhinitis and asthma while the skin testing performed by the authors revealed positive flare and wheal reactions to a variety of pollens. In my opinion it is more likely that this episode is an example of an inhalant-provoked anaphylaxis than a food-induced one. The most likely inhalant in this case is ragweed pollen, which is known to be abundant during that time of
Elevated Circulating Levels of C-C Chemokines in Patients With Congestive Heart Failure
Authors: Pål Aukrust, Thor Ueland, Fredrik Müller, Arne K. Andreassen, Ingvild Nordøy, Halfdan Aas, John Kjekshus, Svein Simonsen, Stig S. Frøland, Lars Gullestad
Journal: Circulation (1998)

Background —Immunologic and inflammatory responses appear to play a pathogenic role in the development of congestive heart failure (CHF). Activation and migration of leukocytes to areas of inflammation are important factors in these immunologic responses. Because the C-C chemokines are potent chemoattractants of monocytes and lymphocytes and can modulate other functions of these cells (eg, generation of reactive oxygen species), we measured circulating levels of three C-C chemokines in CHF. Methods and Results —Levels of macrophage chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), and RANTES ( r egulated on a ctivation n ormally T -cell e xpressed and s ecreted) were measured by enzyme immunoassays in 44 patients with CHF and 21 healthy control subjects. CHF patients had significantly elevated levels of all chemokines with the highest levels in New York Heart Association class IV, and MCP-1 and MIP-1α levels were significantly inversely correlated with left ventricular ejection fraction. Elevated C-C chemokine levels were found independent of the cause of the heart failure, but MCP-1 levels were particularly raised in patients with coronary artery disease. Studies on cells isolated from peripheral blood suggested that platelets, CD3+ lymphocytes, and in particular, monocytes, might contribute to the elevated C-C chemokine levels in CHF. The increased MCP-1 levels in CHF were correlated with increased monocyte activity reflected in an enhancing effect of serum from CHF patients on O 2 − generation in monocytes, which was inhibited by neutralizing antibodies against MCP-1. Conclusions —This first demonstration of increased circulating levels of C-C chemokines in CHF with particularly high levels in patients with severe disease may represent previously unrecognized pathogenic factors in CHF.
Understanding of Prognosis Among Parents of Children Who Died of Cancer
Authors: Joanne Wolfe, Neil Klar, Holcombe E. Grier, Janet Duncan, Susanne Salem-Schatz, Ezekiel J. Emanuel, Jane C. Weeks
Journal: JAMA (2000)

ContextParents' understanding of prognosis or decision making about palliative care for children who die of cancer is largely unknown. However, a more accurate understanding of prognosis could alter treatment goals and expectations and lead to more effective care.ObjectivesTo evaluate parental understanding of prognosis in children who die of cancer and to assess the association of this factor with treatment goals and the palliative care received by children.Design, Setting, and ParticipantsSurvey, conducted between September 1997 and August 1998, of 103 parents of children who received treatment at the Dana-Farber Cancer Institute and Children's Hospital, Boston, Mass, and who died of cancer between 1990 and 1997 (72% of those eligible and those located) and 42 pediatric oncologists.Main Outcome MeasureTiming of parental understanding that the child had no realistic chance for cure compared with the timing of physician understanding of this prognosis, as documented in the medical record.ResultsParents first recognized that the child had no realistic chance for cure a mean (SD) of 106 (150) days before the child's death, while physician recognition occurred earlier at 206 (330) days before death. Among children who died of progressive disease, the group characterized by earlier recognition of this prognosis by both parents and physicians had earlier discussions of hospice care (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.06; P = .01), better parental ratings of the quality of home care (OR, 3.31; 95% CI, 1.15-9.54; P = .03), earlier institution of a do-not-resuscitate order (OR, 1.03; 95% CI, 1.00-1.06; P = .02), less use of cancer-directed therapy during the last month of life (OR, 2.80; 95% CI, 1.05-7.50; P = .04), and higher likelihood that the goal of cancer-directed therapy identified by both physician and parent was to lessen suffering (OR, 5.17; 95% CI, 1.86-14.4; P = .002 for physician and OR, 6.56; 95% CI, 1.54-27.86; P = .01 for parents).ConclusionConsiderable delay exists in parental recognition that children have no realistic chance for cure, but earlier recognition of this prognosis by both physicians and parents is associated with a stronger emphasis on treatment directed at lessening suffering and greater integration of palliative care.
Instrumentation for negative ion detection.
Authors: M McKeown
Journal: Environmental Health Perspectives (1980)

The instrumentation and practical circuitry required for the detection of negative ions exiting the mass analysis section of a mass spectrometer is examined. The potentials needed to bias the electron multiplier when detecting negative ions from a low ion-energy mass spectrometer, e.g., a quadrupole, are contrasted with the biasing requirements of a mass spectrometer having high ion-energies, e.g., a magnetic sector. Methods of decoupling the biasing high voltage on the signal lead of the multiplier in pulse counting measurements are discussed in detail so that normal, ground referenced input, pulse preamplifiers may be used. Easily understood, practical rules for determining the values of circuit components are given together with a simplified theory of transferring pulse signals from multiplier collector to pulse preamplifier. The changes in circuitry needed when attempting to detect ions by current measurement methods from an electron multiplier area detailed. The effects of leakage currents into athe input of the current preamplifier and their avoidance bay using triaxial shielding on vacuum feed-throughs are explained. The article suggests possible methods of decoupling the high voltage referenced input and the ground referenced output of a current measuring preamplifier.
Enhanced stability and gene silencing ability of siRNA-loaded polyion complexes formulated from polyaspartamide derivatives with a repetitive array of amino groups in the side chain
Authors: Tomoya Suma, Kanjiro Miyata, Takehiko Ishii, Satoshi Uchida, Hirokuni Uchida, Keiji Itaka, Nobuhiro Nishiyama, Kazunori Kataoka
Journal: Biomaterials (2011)
Spironolactone in Addition to ACE Inhibition to Reduce Proteinuria in Patients with Chronic Renal Disease
Authors: Anastasia Chrysostomou, Gavin Becker
Journal: New England Journal of Medicine (2001)

To the Editor: Angiotensin-converting–enzyme (ACE) inhibitors have been shown to reduce proteinuria and slow the progression of renal disease.1 Although to date angiotensin II has been the focus of...
Evaluation of the Portable HealthWear Armband
Authors: Diane Mignault, Maxime St.-Onge, Antony D. Karelis, David B. Allison, Remi Rabasa-Lhoret
Journal: Diabetes Care (2005)

Lifestyle modifications involving diet and exercise are effective in reducing the incidence of type 2 diabetes (1–3). In particular, lifestyle changes targeted toward increasing daily energy expenditure are a cornerstone treatment of type 2 diabetes (2). In the Diabetes Prevention Research Group study (4), a goal of 150 min/week of physical activity was recommended, and 74% of the patients in this study group achieved this level by 24 weeks. This type of success in exercise modification is made possible in research protocols by intensive individual counseling (5), which may not be easily reproduced in primary care settings. Because of the critical importance of increasing daily energy expenditure and its central role in preventing and/or treating diabetes, one can surmise that instrumentation providing accurate and simple feedback to type 2 patients may have clinical utility.

Therefore, we provide preliminary data on the accuracy of the HealthWear Armband (Roche Diagnostics, Indianapolis, IN), an instrument designed …
Measuring Central Venous Pressure Through Hyperalimentation Catheters-Reply
Authors: Richard M. Vazquez
Journal: JAMA (1982)

<h3>In Reply.—</h3> Dr Sriram's comments are correct and are sincerely appreciated. The closed method of measuring CVP does not compromise the aseptic quality of an IV hyperalimentation (IVH) infusion system. However, this method can be used only if the infusion system lends itself to this approach. The two circumstances in which the closed method of measuring the CVP may be used are (1) when the electronic infusion-control device being used has a valve on its cassette that may be positioned manually so as to cause the system to be in the continuous free-flow position or (2) when gravity is used to cause infusion of the solution. In the latter situation, an electronic IV controller may or may not be in use. In both situations, the solution must be contained in either container, which would be vented to the atmosphere, or in a flexible container, which need not be vented to
Predictors of Sudden Cardiac Death and Appropriate Shock in the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Trial
Authors: Leslie A. Saxon, Michael R. Bristow, John Boehmer, Steven Krueger, David A. Kass, Teresa De Marco, Peter Carson, Lorenzo DiCarlo, Arthur M. Feldman, Elizabeth Galle, Fred Ecklund
Journal: Circulation (2006)

The factors that determine the risk for sudden death or implantable cardioverter defibrillator therapy in patients receiving cardiac resynchronization therapy (CRT) therapies are largely unknown.We hypothesized that clinical measures of heart failure severity and the presence of comorbid conditions would predict the risk of malignant arrhythmias in the 1520 patients enrolled in the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Trial. Outcomes in the CRT group after implantable cardioverter defibrillator therapy were also evaluated. The CRT-defibrillator device reduced the risk of sudden death by 56% compared with drug therapy (17 of 595 [2.9%] versus 18 of 308 [5.8%], P<0.02). CRT therapy was not associated with sudden death risk reduction (48 of 617 [7.8%]). Other factors associated with reduced sudden death risk were left ventricular ejection fraction >20% (HR, 0.55 [95% CI, 0.35 to 0.87]; P=0.01), QRS duration >160 ms (HR, 0.63 [95% CI, 0.40 to 0.997]; P=0.05), and female gender (HR, 0.56 [95% CI, 0.34 to 0.94]; P=0.003). The risk for sudden death was increased by advanced New York Heart Association class IV heart failure (HR, 2.62 [95% CI, 1.61 to 4.26]; P<0.011) and renal dysfunction (HR, 1.69 [95% CI, 1.06 to 2.69]; P=0.03). An appropriate shock was experienced in 88 (15%) of the 595 CTR-D patients. In the CRT-defibrillator patients, female gender (HR, 0.54 [95 % CI, 0.31 to 0.94]; P=0.03) and use of neurohormonal antagonists were associated with reduced risk. Class IV heart failure status increased risk. Appropriate implantable cardioverter defibrillator therapy was positively associated with risk of death or all-cause hospitalization (HR, 1.57; P<0.002), pump failure death or hospitalization (HR, 2.35; P<0.001), and sudden death (HR, 2.99; P=0.03), but not total mortality (HR, 1.3; P=0.28).In CRT candidates, sudden cardiac death risk is associated with higher New York Heart Association class and renal dysfunction. In CRT-defibrillator recipients, reduction in the risk of an appropriate shock is associated with medical therapy with neurohormonal antagonists, female gender, and New York Heart Association functional class III versus IV clinical status. Shock therapy was associated with worse outcome.
Editorial was confusing
Authors: R. L. Prince, K. Zhu, J. R. Lewis
Journal: BMJ (2010)

The editorialists, two cardiologists and a physicist, are an unusual choice for a non-peer reviewed editorial on the safety and efficacy of treatments for osteoporosis and fracture prevention.1 The question of the expertise of the editorialists in this discipline is relevant as they make highly contentious statements on the efficacy of calcium and vitamin D, which was not the focus of the …
Outcomes After Acute Myocardial Infarction in HIV-Infected Patients
Authors: Luc Lorgis, Jonathan Cottenet, Guillaume Molins, Eric Benzenine, Marianne Zeller, Hervé Aube, Claude Touzery, Joelle Hamblin, Aurélie Gudjoncik, Yves Cottin, Catherine Quantin
Journal: Circulation (2013)

We aimed to assess in-hospital case fatality and 1-year prognosis in HIV-infected patients with acute myocardial infarction.From the PMSI (Program de Medicalisation des Systèmes d'informatique) database, data from 277 303 consecutive acute myocardial infarction patients hospitalized from January 1, 2005, to December 31, 2009, were analyzed. Surviving patients were followed up for 1 year after discharge. HIV-infected patients were compared with uninfected patients. Among the cohort, HIV-infected patients (n=608) accounted for 0.22%. All-cause hospital and 1-year mortality rates were lower in the HIV-infected group than in uninfected patients (3.1% versus 8.1% [P<0.001] and 1.4% versus 5.5% [P<0.001], respectively). From the database, we then analyzed a cohort derived from a matching procedure, with 1 HIV patient matched with 2 patients without HIV, based on age and sex (n=1824). Ischemic cardiomyopathy was more frequent in the HIV group (7.6% versus 4.2%, P=0.003). Hospitalization and 1-year mortality rates were similar in the 2 groups (3.1% versus 2.1% [P=0.168] and 1.4% versus 1.7% [P=0.642], respectively). However, at 12 months, hospitalizations for episodes of heart failure were significantly more frequent in HIV-infected than in uninfected patients (3.3% versus 1.4%, respectively; P=0.020). HIV infection, diabetes mellitus, history of ischemic cardiomyopathy, and undergoing percutaneous coronary intervention were associated in univariate analysis with occurrence of heart failure. By multivariable analysis, HIV infection (odds ratio 2.82, 95% confidence interval 1.32-6.01), diabetes mellitus, and undergoing percutaneous coronary intervention remained independent predictors of heart failure.The present study demonstrates that after acute myocardial infarction, HIV status influences long-term risk, although the short-term risk in HIV patients is comparable to that in uninfected patients.
Confocal endomicroscopy in the evaluation of celiac disease
Authors: R. Leong
Journal: Endoscopy (2010)

We read with interest “Diagnostic value of confocal endomicroscopy in celiac disease” by Günther et al. [1]. Using confocal endomicroscopy (CEM) in celiac disease, they successfully quantified intraepithelial lymphocytes and villous atrophy but not crypt hyperplasia. These results differed from those of our prospective study where crypt hypertrophy was a highly sensitive and specific marker of celiac disease [2]. There were several reasons for this.
Framework for NHS "quality accounts" is launched
Authors: J. Wise
Journal: BMJ (2009)

The Department of Health has published its framework for quality accounts and launched a public consultation on the proposals.

Quality accounts are reports to the public on the quality of an NHS organisation’s services, with a focus on safety, effectiveness, and the experience of patients. They will be published annually alongside financial accounts.

All providers of NHS acute health care in England will need to publish a quality account for the year 2009-10 by June 2010. Primary care and community services, including individual general and dental practices, are exempt for the first year but will have to produce a quality account for 2010-11 by June 2011.

Launching the consultation in a speech to the the health think tank the King’s Fund, the health secretary, Andy Burnham, said, “I want …
Molecular Pathways: Cbl Proteins in Tumorigenesis and Antitumor Immunity—Opportunities for Cancer Treatment
Authors: Mariya S. Liyasova, Ke Ma, Stanley Lipkowitz
Journal: Clinical Cancer Research (2014)

The Cbl proteins are a family of ubiquitin ligases (E3s) that regulate signaling through many tyrosine kinase-dependent pathways. A predominant function is to negatively regulate receptor tyrosine kinase (RTK) signaling by ubiquitination of active RTKs, targeting them for trafficking to the lysosome for degradation. Also, Cbl-mediated ubiquitination can regulate signaling protein function by altered cellular localization of proteins without degradation. In addition to their role as E3s, Cbl proteins play a positive role in signaling by acting as adaptor proteins that can recruit signaling molecules to the active RTKs. Cbl-b, a second family member, negatively regulates the costimulatory pathway of CD8 T cells and also negatively regulates natural killer cell function. The different functions of Cbl proteins and their roles both in the development of cancer and the regulation of immune responses provide multiple therapeutic opportunities. Mutations in Cbl that inactivate the negative E3 function while maintaining the positive adaptor function have been described in approximately 5% of myeloid neoplasms. An improved understanding of how the signaling pathways [e.g., Fms-like tyrosine kinase 3 (Flt3), PI3K, and signal transducer and activator of transcription (Stat)] are dysregulated by these mutations in Cbl has helped to identify potential targets for therapy of myeloid neoplasms. Conversely, the loss of Cbl-b leads to increased adaptive and innate antitumor immunity, suggesting that inhibiting Cbl-b may be a means to increase antitumor immunity across a wide variety of tumors. Thus, targeting the pathways regulated by Cbl proteins may provide attractive opportunities for treating cancer.
Antipsychotics, Other Psychotropics, and the Risk of Death in Patients With Dementia
Authors: Donovan T. Maust, Hyungjin Myra Kim, Lisa S. Seyfried, Claire Chiang, Janet Kavanagh, Lon S. Schneider, Helen C. Kales
Journal: JAMA Psychiatry (2015)

Antipsychotic medications are associated with increased mortality in older adults with dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear.To determine the absolute mortality risk increase and number needed to harm (NNH) (ie, number of patients who receive treatment that would be associated with 1 death) of antipsychotic, valproic acid and its derivatives, and antidepressant use in patients with dementia relative to either no treatment or antidepressant treatment.A retrospective case-control study was conducted in the Veterans Health Administration from October 1, 1998, through September 30, 2009. Participants included 90,786 patients 65 years or older with a diagnosis of dementia. Final analyses were conducted in August 2014.A new prescription for an antipsychotic (haloperidol, olanzapine, quetiapine, and risperidone), valproic acid and its derivatives, or an antidepressant (46,008 medication users).Absolute change in mortality risk and NNH over 180 days of follow-up in medication users compared with nonmedication users matched on several risk factors. Among patients in whom a treatment with medication was initiated, mortality risk associated with each agent was also compared using the antidepressant group as the reference, adjusting for age, sex, years with dementia, presence of delirium, and other clinical and demographic characteristics. Secondary analyses compared dose-adjusted absolute change in mortality risk for olanzapine, quetiapine, and risperidone.Compared with respective matched nonusers, individuals receiving haloperidol had an increased mortality risk of 3.8% (95% CI, 1.0%-6.6%; P < .01) with an NNH of 26 (95% CI, 15-99); followed by risperidone, 3.7% (95% CI, 2.2%-5.3%; P < .01) with an NNH of 27 (95% CI, 19-46); olanzapine, 2.5% (95% CI, 0.3%-4.7%; P = .02) with an NNH of 40 (95% CI, 21-312); and quetiapine, 2.0% (95% CI, 0.7%-3.3%; P < .01) with an NNH of 50 (95% CI, 30-150). Compared with antidepressant users, mortality risk ranged from 12.3% (95% CI, 8.6%-16.0%; P < .01) with an NNH of 8 (95% CI, 6-12) for haloperidol users to 3.2% (95% CI, 1.6%-4.9%; P < .01) with an NNH of 31 (95% CI, 21-62) for quetiapine users. As a group, the atypical antipsychotics (olanzapine, quetiapine, and risperidone) showed a dose-response increase in mortality risk, with 3.5% greater mortality (95% CI, 0.5%-6.5%; P = .02) in the high-dose subgroup relative to the low-dose group. When compared directly with quetiapine, dose-adjusted mortality risk was increased with both risperidone (1.7%; 95% CI, 0.6%-2.8%; P = .003) and olanzapine (1.5%; 95% CI, 0.02%-3.0%; P = .047).The absolute effect of antipsychotics on mortality in elderly patients with dementia may be higher than previously reported and increases with dose.
SOME ADDITIONAL FACTS RELATING TO SKIN GRAFTING.
Authors: Z. J. LUSK
Journal: JAMA (1897)

At the meeting of the New York State Medical Association, held Oct. 15 and 17, 1896, I read a paper the title of which was "The Vitality of Cutaneous Epithelium After Its Separation from the Body." Believing the subject of great surgical importance, and having additional testimony of interest, I decided to briefly submit my experience at this meeting. The question of the "limit of vitality" of skin separated from the body has been the subject of a great deal of experimentation. The longest period of which I can find record is ninety-six hours, or four days.<sup>1</sup> Experiments have been made<sup>2</sup>to ascertain the vitality of skin removed from the cadaver. Skin grafting has been successfully done with epidermis removed from the thigh six hours after death. Skin taken from amputated<sup>3</sup>limbs has been found to make good material. After numerous trials, thirty-six hours was found to
Clinical Significance of Urinary Hydroxyproline.
Authors: T. A. Dull
Journal: Annals of Internal Medicine (1963)

s1 April 1963Clinical Significance of Urinary Hydroxyproline.T. A. Dull, M.D., P. H. Henneman, M.D.T. A. Dull, M.D., P. H. Henneman, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-720_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe Imino Acid hydroxyproline occurs in the body almost exclusively in collagen. Twenty-four-urinary total hydroxyproline was measured in 57 subjects on diets devoid of gelatin. Eight normal adults excreted 8 to 40 mg daily, and 15 adults with various diseases not known to involve connective tissue excreted from 8 to 37 mg of total hydroxyproline daily. Eight normal prepubertal children excreted 30 to 103 mg, while 5 children with growth failure excreted 21 to 42 mg daily. Urinary hydroxyproline in 6 hyperthyroid patients ranged from 79 to 440 mg, and in 15 patients with Paget's disease, values from 67 to... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: T. A. Dull, M.D.; P. H. Henneman, M.D.Affiliations: Jersey City, N. J. (CI) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHydrocortisone and/or desiccated thyroid in physiologic dosage 1 April 1963Volume 58, Issue 4Page: 720-720KeywordsChildrenConnective tissueConnective tissue diseasesDiet ePublished: 1 December 2008 Issue Published: 1 April 1963 PDF downloadLoading ...