tbuckley/cabot-search huggingface dataset:
Prevalence and Factors of Intensive Care Unit Conflicts
Authors: Élie Azoulay, Jean-François Timsit, Charles L. Sprung, Marcio Soares, Kateřina Rusinová, Ariane Lafabrie, Ricardo Abizanda, Mia Svantesson, Francesca Rubulotta, Bara Ricou, Dominique Benoit, Daren Heyland, Gavin Joynt, Adrien Français, Paulo Azeivedo-Maia, Radoslaw Owczuk, Julie Benbenishty, Michael de Vita, Andreas Valentin, Akos Ksomos, Simon Cohen, Lidija Kompan, Kwok Ho, Fekri Abroug, Anne Kaarlola, Herwig Gerlach, Theodoros Kyprianou, Andrej Michalsen, Sylvie Chevret, Benoît Schlemmer
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs.To record the prevalence, characteristics, and risk factors for conflicts in ICUs.One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries).Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings.Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.
A genetic mechanism for Tibetan high-altitude adaptation
Authors: Felipe R Lorenzo, Chad Huff, Mikko Myllymäki, Benjamin Olenchock, Sabina Swierczek, Tsewang Tashi, Victor Gordeuk, Tana Wuren, Ge Ri-Li, Donald A McClain, Tahsin M Khan, Parvaiz A Koul, Prasenjit Guchhait, Mohamed E Salama, Jinchuan Xing, Gregg L Semenza, Ella Liberzon, Andrew Wilson, Tatum S Simonson, Lynn B Jorde, William G Kaelin, Peppi Koivunen, Josef T Prchal
Journal: Nature Genetics (2014)
Management of swallowed razor blades--retrieve or wait and see?
Authors: J R Butterworth
Journal: Gut (2004)

Fatigue is probably the most intriguing symptom affecting patients with chronic cholestatic disorders, in particular those with primary biliary cirrhosis.It is postulated that fatigue in patients with primary biliary cirrhosis may be associated with morphological abnormalities of the central nervous system secondary to accumulation of manganese.However, we are still far from understanding this complex issue.. . . . . .
Imaging DNA Damage <i>In Vivo</i> Using γH2AX-Targeted Immunoconjugates
Authors: Bart Cornelissen, Veerle Kersemans, Sonali Darbar, James Thompson, Ketan Shah, Kate Sleeth, Mark A. Hill, Katherine A. Vallis
Journal: Cancer Research (2011)

DNA damage responses (DDR) occur during oncogenesis and therapeutic responses to DNA damaging cytotoxic drugs. Thus, a real-time method to image DNA damage in vivo would be useful to diagnose cancer and monitor its treatment. Toward this end, we have developed fluorophore- and radioisotope-labeled immunoconjugates to target a DDR signaling protein, phosphorylated histone H2A variant H2AX (γH2AX), which forms foci at sites of DNA double-strand breaks. Anti-γH2AX antibodies were modified by the addition of diethylenetriaminepentaacetic acid (DTPA) to allow (111)In labeling or the fluorophore Cy3. The cell-penetrating peptide Tat (GRKKRRQRRRPPQGYG) was also added to the immunoconjugate to aid nuclear translocation. In irradiated breast cancer cells, confocal microscopy confirmed the expected colocalization of anti-γH2AX-Tat with γH2AX foci. In comparison with nonspecific antibody conjugates, (111)In-anti-γH2AX-Tat was retained longer in cells. Anti-γH2AX-Tat probes were also used to track in vivo DNA damage, using a mouse xenograft model of human breast cancer. After local X-ray irradiation or bleomycin treatment, the anti-γH2AX-Tat probes produced fluorescent and single photon emission computed tomography signals in the tumors that were proportionate to the delivered radiation dose and the amount of γH2AX present. Taken together, our findings establish the use of radioimmunoconjugates that target γH2AX as a noninvasive imaging method to monitor DNA damage, with many potential applications in preclinical and clinical settings.
Safety of sputum induction
Authors: M.M.M. Pizzichini, R. Leigh, R. Djukanović, P.J. Sterk
Journal: European Respiratory Journal (2002)

One of the most important recent advances in the investigation of airway inflammation has been the introduction of sputum induction by inhalation of an aerosol of hypertonic saline, by Pin et al. 1 in 1992, to directly obtain airway secretions in asthma. This method has a number of advantages over invasive methods. Safety and practicality are the most obvious. The method of obtaining induced sputum is relatively noninvasive and can be carried out at random 2 and repeatedly in subjects with varying disease severity 3–13. Therefore, it is not surprising that the examination of induced sputum has become the most clinically applicable method for the assessment of airway inflammation.

The induction procedure is simple and safe. The risks in patients with stable asthma or chronic obstructive pulmonary disease (COPD) with mild­to­moderate airflow limitation are acceptable 1, 3–5, 8, 12–14. It can also be safe in patients with more severe airflow limitation 6, 10, 11 provided that the induction is performed with caution using a modified procedure 6. The safety of sputum induction has been specifically addressed in several recent publications 3–5, 12, 14. To date, there have been no reports of death or need for hospital admission in patients undergoing sputum induction for the assessment of airway inflammation; the airway constriction caused by sputum induction with hypertonic saline is quickly reversed by treatment with an inhaled short­acting β2‐agonist.

It is well known, however, that inhalation of hypertonic or even isotonic saline can cause airway constriction in asthmatic subjects and in COPD, particularly in those with associated airway hyperresponsiveness (AHR). In 1958, Bickerman et al. 15, using aerosols of saline generated by jet nebuliser with concentrations ranging 3.0–15%, observed …
Prevalence of dementia in Latin America, India, and China: a population-based cross-sectional survey
Authors: Juan J Llibre Rodriguez, Cleusa P Ferri, Daisy Acosta, Mariella Guerra, Yueqin Huang, KS Jacob, ES Krishnamoorthy, Aquiles Salas, Ana Luisa Sosa, Isaac Acosta, Michael E Dewey, Ciro Gaona, AT Jotheeswaran, Shuran Li, Diana Rodriguez, Guillermina Rodriguez, P Senthil Kumar, Adolfo Valhuerdi, Martin Prince
Journal: The Lancet (2008)
Cetuximab/C225-Induced Intracellular Trafficking of Epidermal Growth Factor Receptor
Authors: Hong-Jun Liao, Graham Carpenter
Journal: Cancer Research (2009)

The monoclonal antibody C225 interacts with the ectodomain of the epidermal growth factor (EGF) receptor (EGFR) to block ligand binding and initiates receptor endocytosis and intracellular trafficking. The data herein show that C225-dependent EGFR trafficking relocalizes the receptor to the endoplasmic reticulum (ER) and nucleus. This mechanism, which also involves interaction of the C225-internalized receptor with the Sec61 translocon within the ER, is, in most respects, analogous to the pathway previously described for EGF-induced trafficking to the ER and nucleus. However, although inhibition of receptor tyrosine kinase activity blocks EGF-induced nuclear localization of the receptor, the same kinase inhibitors stimulate C225-dependent nuclear localization of EGFR in the nucleus. In contrast, the kinase inhibitor Lapatinib fails to stimulate nuclear accumulation of the receptor in C225-treated cells and does not provoke receptor dimerization as do inhibitors that recognize the open conformation of the receptor kinase. This suggests that inhibitor-dependent receptor dimerization may facilitate C225-induced receptor trafficking.
OP04 * QUANTITATIVE MEASUREMENT OF BLOOD FLOW IN PAEDIATRIC BRAIN TUMOURS - A COMPARATIVE STUDY OF DYNAMIC SUSCEPTIBILITY CONTRAST AND MULTI-TIMEPOINT ARTERIAL SPIN LABEL IMAGING
Authors: L. J. Abernethy, R. Vidyasagar, B. L. Pizer, C. L. Mallucci, S. Avula, L. M. Parkes
Journal: Neuro-Oncology (2014)

INTRODUCTION: Arterial spin labeling (ASL) is a MR technique that allows for noninvasive quantification of cerebral blood flow (CBF). This technique, predominately used in research, has seen significant technical developments in the last few years that have led to more clinical applications. Currently, the main MR method used to provide perfusion measures in brain tumours is dynamic susceptibility contrast (DSC). DSC traces the signal changes caused by the transit of a bolus of gadolinium contrast agent. ASL has the advantage of not requiring bolus injection of contrast. We have performed a comparative study of DSC and multi-timepoint ASL in paediatric brain tumours (PBT). METHOD: Data from a total of 19 PBT patients (mean age: 9 ± 5 years; 10 females, 9 males) were included in the analyses for this study. Data used were from first presentation scans performed before any surgical intervention. Comparisons of the quantitative measures of CBF and blood arrival time between the two techniques were carried out to test the feasibility of ASL to provide useful quantification measures of CBF in PBT. RESULTS: DSC measurements of tumour blood flow showed a significant decrease in flow in comparison with normal brain, but this is not seen with ASL. There was a strong correlation between ASL and DSC measures of blood flow in normal brain (r = 0.65, p = 0.009), but not in tumour blood flow (r = 0.33, p = 0.2). CONCLUSION: This study demonstrates the feasibility and potential utility of ASL as a non-invasive technique for measuring blood flow in PBT. However, there is a discrepancy between ASL and DSC measures, that may be due to leakage of gadolinium contrast, reflecting the abnormal characteristics of tumour blood vessels in PBT.
Amphotericin B nephrotoxicity
Authors: B P Sawaya, J P Briggs, J Schnermann
Journal: Journal of the American Society of Nephrology (1995)

Amphotericin B (AmB) has been in clinical use for more than 30 yr but has remained the most effective drug for treatment of serious fungal infections. Its use has increased in recent years, as the result of increases in aggressive intensive care support and increased numbers of immunocompromised patients. Nephrotoxic manifestations are common, and this is the major factor limiting the clinical use of the drug. A number of recent studies have contributed to a better understanding of the mechanism by which AmB exerts its nephrotoxic effect. AmB alters cell membrane permeability and probably as a consequence alters tubular and vascular smooth muscle cell function, leading to various tubular transport defects and vasoconstriction. Decreased RBF appears to play a major role in AmB-induced reduction GFR, and recurrent ischemia may be the basis of permanent structural nephrotoxic effects. Salt loading is the only measure proven by controlled prospective study to ameliorate AmB nephrotoxicity in humans. Liposomal AmB and the formulation of an emulsion of AmB in lipid may provide a protective effect based on altering the affinity of AmB for mammalian cell membranes, while preserving high efficacy against fungal cells. However, further studies are needed to evaluate the efficacy and safety of these new AmB formulations.
Amino acid substitution in hepatitis C virus core region and genetic variation near the interleukin 28B gene predict viral response to telaprevir with peginterferon and ribavirin
Authors: Norio Akuta, Fumitaka Suzuki, Miharu Hirakawa, Yusuke Kawamura, Hiromi Yatsuji, Hitomi Sezaki, Yoshiyuki Suzuki, Tetsuya Hosaka, Masahiro Kobayashi, Mariko Kobayashi, Satoshi Saitoh, Yasuji Arase, Kenji Ikeda, Kazuaki Chayama, Yusuke Nakamura, Hiromitsu Kumada
Journal: Hepatology (2010)

Genetic variation near the IL28B gene and substitution of amino acid (aa) 70 and 91 in the core region of hepatitis C virus (HCV) genotype 1b can predict the response to pegylated interferon (PEG-IFN)/ribavirin combination therapy, but its impact on triple therapy of telaprevir/PEG-IFN/ribavirin is not clear. The aims of this study were to investigate the predictive factors of sustained virological response to a 12-week or 24-week regimen of triple therapy in 72 of 81 Japanese adults infected with HCV genotype 1. Overall, sustained virological response and end-of-treatment response were achieved by 61% and 89%, respectively. Especially, the sustained virological response was achieved by 45% and 67% in the 12- and 24-week regimens, respectively. Multivariate analysis identified rs8099917 near the IL28B gene (genotype TT) and substitution at aa 70 (Arg70) as significant determinants of sustained virological response. Prediction of response to therapy based on a combination of these factors had high sensitivity, specificity, and positive and negative predictive values. The efficacy of triple therapy was high in the patients with genotype TT, who accomplished sustained virological response (84%), irrespective of substitution of core aa 70. In the patients having genotype non-TT, those of Arg70 gained high sustained virological response (50%), and sustained virological response (12%) was the worst in patients who possessed both genotype non-TT and Gln70(His70). Conclusion: This study identified genetic variation near the IL28B gene and aa substitution of the core region as predictors of sustained virological response to a triple therapy of telaprevir/PEG-IFN/ribavirin in Japanese patients infected with HCV genotype 1b. (HEPATOLOGY 2010)
Comparison of the Efficacy of Gefitinib in Patients with Nsclc According to the Type of Egfr Mutation
Authors: Masashi Kasajima, Satoshi Igawa, Mikiko Ishihara, Michiko Kimura, Seiichiro Kusuhara, Sinya Harada, Yasuhiro Hiyoshi, Ken Katono, Jiichiro Sasaki, Noriyuki Masuda
Journal: Annals of Oncology (2014)
PTU-138 Population-based Study Of Ethnicity And The Diagnosis Gap In Liver Disease
Authors: W Alazawi, R Mathur, K Abeysekera, S Hull, K Boomla, J Robson, GR Foster
Journal: Gut (2014)

<h3>Introduction</h3> Awareness of liver disease as a major cause of morbidity and mortality has led to an increase in liver function tests (LFTs) performed in primary care with abnormal results a common finding. However, we hypothesise that a large gap exists between numbers of patients with abnormal LFTs and those with recorded liver diagnoses. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury. Metabolic syndrome, common in people from the Indian subcontinent, is an important risk factor for NAFLD. We hypothesise that NAFLD is more common among adults of South Asian ethnicities. <h3>Methods</h3> In a cross-sectional study of 690,683 adults, registered in co-terminus general practices in a region with high ethnic diversity, we extracted demographic information and clinical care data including LFTs in the previous two years, liver disease diagnoses and co-morbidites from the EMIS Web computerised medical records. The breakdown of age, gender, deprivation, BMI, smoking status, alcohol consumption, co-morbidities and cholesterol was described for the whole population and for the six main ethnic groups of Bangladeshi, Indian, Pakistani, White, African and Caribbean. STATA 12 was used to conduct multivariate logistic regression analyses. <h3>Results</h3> LFTs were performed on 218,032 patients, of whom 31,627 had elevated serum transaminases. Testing varied by age, ethnicity and the presence of co-morbidities. The prevalence of abnormal LFTs was highest among Bangladeshis and independent risk factors for abnormal LFTs included male gender, alcohol consumption and elements of the metabolic syndrome. The most commonly recorded liver diagnosis was NAFLD, followed by chronic viral infection and alcoholic liver disease. 88.4% (n = 27,985) of patients with abnormal LFTs did not have a coded liver diagnosis. The prevalence of recorded NAFLD was highest among patients of Bangladeshi ethnicity. In a multivariate analysis, independent risk factors for NAFLD included Bangladeshi ethnicity, diabetes, raised BMI, hypertension and hypercholesterolaemia. <h3>Conclusion</h3> Abnormal LFTs are common in the population, but are under-investigated and often remain undiagnosed. Bangladeshi ethnicity is an important independent risk factor for NAFLD. Among the group of patients with abnormal LFTs and no recorded liver diagnosis, many will have a liver disease that is amenable to further management, which may prevent complications. There is a need for evidence-based guidelines for the investigation, referral and management of patients with abnormal liver tests in the community in order to ensure early identification of treatable disease. <h3>Disclosure of Interest</h3> None Declared.
On Haemorrhagia, and its Treatment by Storing and by Intrafusion: With Cases
Authors: J. F. Le Page
Journal: BMJ (1884)

COMPARATIVELY few of the operations which the surgeon is called upon to perform imperatively demand of him immediate operative treatment.In most cases, ample time is afforded for preparation, and, it need be, for deliberation too.To thig rule, a most marked exception is the treatment of h1morrhagia, the exigencies of which often call for ingtant action.And not only on the surgeon is this demand made -for the physician, at the shrine of duty, is required here to forget the too carefully defined line 'which divides medrcine from surgery, and to act expeditiously.With the treatment of heemor- rhaga therefore, be it idiopathic, be it symptomatic, or be it traum- atic, every practitioner should be perfectly familiar.With the special treatment for the arrest of particular heemorrhages, based, as it is, on principles with which we all, of course, are acquainted, I have in this paper nothing to do.My reference is to the general effects of haemorrhagia-effects which often threaten to extinguish life; and to the means at our disposal in prophylaxis and in treatment.So widely differing are the conditions induced by sudden hiemor- rhagia, as contrasted with those produced by protracted heemorrhage, that the management of the one differs very materiallv from that of the other.In the first, we are met by a syncope which threatens to be fatal; in the second, by the sequelsi of aneemia.Now, the syncope in the first class of cases appears to be instituted by nature for the very purpose of mitigating the evil.Were it not for the loss of vaso- motor tension, which is a sequela of the suspension of the functions of the brain, vascular tension would quickly complete the work of depleion to a stage beyond all hope.But the very first effect of acute hemorrhage on the functions essential to vitality is cerebral ansemia, and then follows vascular flacciditv, with dynamic incom- petency of the heart.To intelligently meet this state of things, our attention must be directed to the brain; for it is there alone that we must look for a reassertion of vital conditions.Undoubtedly, by transfusion, a recuperation of nature's forces may be effected.Without by any means wishing' to disparage that opera.
Reversible Refractory Anemia in Pregnancy
Authors: Franklin A. Kyser
Journal: JAMA (1960)

Primary refractory anemia is rare in pregnancy, and the diagnosis is difficult. Only 17 previous cases have been reported, and only six patients survived. In the present case the patient, a 26-year-old primigravida, was found in the course of an office examination to be anemic, and subsequent examinations showed that the anemia had become more severe despite ordinary antianemic treatment. After transfusions of whole blood and of platelets and a trial of induced labor, a healthy 3,300 Gm. baby was delivered by cesarean section. The postoperative course of the mother was uneventful, and her hemogram returned gradually to normal. The authors believe that therapeutic abortion is not indicated in this condition if facilities for dealing with the anemia and with possible complications are adequate.
Intracoronary adenosine and papaverine do not increase myocardial systolic thickening
Authors: R S. Kiesz, J D. Gehman, J. A Gascho
Journal: Cardiovascular Research (1991)

The aim was to determine if myocardial systolic thickening increases when coronary flow is augmented by infusing intracoronary vasodilators (adenosine and papaverine).Systolic thickening fraction was measured with pulsed Doppler crystals and sonomicrometer crystals before and during the intracoronary infusion of adenosine and papaverine.Sixteen anaesthetized mongrel dogs were studied.Intracoronary adenosine did not alter systemic haemodynamics, but did induce a three- to fourfold increase in myocardial blood flow. Intracoronary papaverine caused a slight decrease in systemic arterial pressure and rise in heart rate. Neither intracoronary adenosine nor intracoronary papaverine increased systolic thickening: control thickening fraction (TF%) = 20 (SEM 1)%, adenosine TF% = 18(1)%; control TF% = 22(2)%, papaverine TF% = 20(2)%.These experiments do not support the hypothesis that an increase in myocardial blood flow induced by intracoronary vasodilators causes an increase in myocardial systolic function.
Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion
Authors: S.Z. Goldhaber, P.C. Come, R.T. Lee, E. Braunwald, J.A. Parker, W.D. Haire, M.L. Feldstein, M. Miller, R. Toltzis, J.L. Smith, A.M. Taveira de Silva, A. Mogtader, T.J. McDonough
Journal: The Lancet (1993)
Accumulation of Immune Complexes in Glomerular Disease Is Independent of Locally Synthesized C3
Authors: Neil S. Sheerin, Katsushige Abe, Paul Risley, Steven H. Sacks
Journal: Journal of the American Society of Nephrology (2006)

Although complement activation can make immune complex glomerulonephritis worse, the third complement component also can solubilize immune complexes and thus reduce the severity of disease. How C3 that is produced within the kidney contributes to this balance is unknown. This study therefore investigated the relative roles of systemic and local C3 production in a model of glomerular immune complex disease. Injection of sheep anti–glomerular basement membrane antibody into preimmunized mice resulted in accumulation of immune complexes and progressive loss of function over 14 d that was much more marked in C3-deficient (C3−/−) mice. In C3-sufficient mice that received a transplant of a C3−/− mouse kidney and in C3−/− mice with C3-sufficient mouse kidney transplants, the severity and the pattern of injury went with the complement status of the recipient. That is, mice with deficient circulating C3 developed severe glomerular immune complex disease, whereas those with a high level of circulating C3 had well-preserved glomerular structure and function. It is concluded that circulating C3 is a critical factor in reducing the glomerular accumulation of immune complexes. Local synthesis of C3 did not have a major influence on this aspect of glomerular disease.