tbuckley/cabot-search huggingface dataset:
The Changing Manifestations of Pyogenic Liver Abscess
Authors: Eddy D. Palmer
Journal: JAMA (1975)

THE CONTINUALLY changing biology of human infections leads to confusion for the clinician who has not yet been impressed with the variations it can bring in clinical phenomena. If he is middle-aged or older, he has already learned by observing the change and does not ask whatever happened to lobar pneumonia, or why, all of a sudden, are cytomegalic diseases enjoying a spectacular ascendency? If the clinician is a recent graduate, he is likely to be confounded as he finds that his patients do not demonstrate the manifestations he expected from his textbook studies. Thirty years ago, pyogenic liver abscess behaved as a straightforward, predictable clinical problem. It was blatantly overt, immediately advertising both its nature as an active, acute, septic process and its location within the liver. The clinician could expect to be led directly to the liver by the location of pain and convincing signs of tenderness over
The Surgeon and Ischaemia
Authors: J. Learmonth
Journal: BMJ (1953)

Optimal management of acute myocardial infarction requires rapid administration of thrombolytic therapy. However, only patients who fulfill the following specific criteria are likely to benefit from this treatment: admission within 12 hours of the onset of symptoms, no contraindications, ST elevation or possible new-onset left bundle branch block on the admission electrocardiogram. We employed an aggressive policy to reduce the delay between admission to hospital and the administration of thrombolysis (the 9door-to-needle time9), and investigated whether this approach affected the accuracy of administration of thrombolysis. Patients admitted to the cardiac care unit with acute myocardial infarction, or who were thrombolysed, were identified retrospectively over two equivalent 4-month periods before and after implementation of our policy. Patients were considered eligible for thrombolysis if they fulfilled the criteria mentioned above. The mean (SD) door-to-needle time for all patients who received thrombolysis on admission decreased from 61(70) to 19(20) minutes (p = 0.0004). The proportion of patients eligible for thrombolysis who received treatment increased from 24/38 to 30/30 (p = 0.0002). However, the proportion of patients receiving thrombolysis who did not fulfill our criteria also increased, from 3/27 to 11/41 (p = 0.1). There were no complications of thrombolysis in the first study period, but two cerebrovascular accidents in the second period; both patients fulfiled our criteria for treatment. We conclude that simple educational measures greatly reduced door-to-needle times and led to a higher proportion of eligible patients receiving thrombolysis. However, greater pressure on medical staff to make rapid management decisions increased the proportion of patients being thrombolysed inappropriately.
Alveolar Hypoxia Increases Gene Expression of Extracellular Matrix Proteins and Platelet-derived Growth Factor-B in Lung Parenchyma
Authors: JOHN T. BERG, ELLEN C. BREEN, ZHENXING FU, ODILE MATHIEU-COSTELLO, JOHN B. WEST
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The walls of pulmonary capillaries are extremely thin, and wall stress increases greatly when capillary pressure rises. Alveolar hypoxia causes pulmonary vasoconstriction and hypertension, and if this is uneven, some capillaries may be exposed to high transmural pressure and develop stress failure. There is evidence that increased wall stress causes capillary remodeling. In this study we exposed Madison strain Sprague–Dawley rats to normobaric hypoxia (10% oxygen) for 6 h or 3 d (short-term group), and for 3 d or 10 d (long-term group). Peripheral lung tissue was then collected and messenger RNA (mRNA) levels were determined for extracellular matrix (ECM) proteins and growth factors. Collagen content (hydroxyproline) was also measured. Levels of mRNA for α 2(IV) procollagen increased sixfold after 6 h of hypoxia and sevenfold after 3 d of hypoxia, and then decreased after 10 d exposure. Levels of mRNA for platelet-derived growth factor-B (PDGF-B) doubled after 6 h of hypoxia but returned to control values after 3 d. mRNA levels for α 1(I) and α 1(III) procollagens and fibronectin were increased after 3 d of hypoxia (by seven- to 12-fold, 1.6- to eightfold, and 12-fold, respectively), then decreased toward control values after 10 d. In contrast, neither levels of mRNA for vascular endothelial growth factor (VEGF) nor collagen content changed. These results suggest that alveolar hypoxia causes vascular remodeling in lung parenchyma, and are consistent with capillary wall remodeling in response to increased wall stress.
Acute Sodium Fluoride Poisoning
Authors: Abdul R. Abukurah
Journal: JAMA (1972)

Severe acute sodium fluoride poisoning occurred in a man following the ingestion of 120 gm of sodium fluoride (NaF). Toxic reactions included tetany, multiple episodes of ventricular fibrillation, and esophageal stricture. The management of this case resulted in the patient's survival. To our knowledge, no similar case has been found in the literature.
Air Pollution and Athletic Performance
Authors: Gabe Mirkin
Journal: JAMA (1982)

According to the old fairy tale, the mice had just solved the problem of telling when the cat was coming. They would tie a bell on its neck and would hear the bell when the cat approached. The only problem was that none of the mice could figure out a way to attach the bell. The same thing applies to control of air pollution at the 1984 Olympic Games in Los Angeles. In the first few pages, we learn that air pollution in the Los Angeles area is caused by the action of stagnant air and sunshine on automobile exhaust fumes to form ozone, peroxyacetyl nitrate, photochemical aerosols, and other pollutants. The obvious cure is to ban the automobile. However, with no effective subway system, the problem is how to do it. Instead, the book recommends that, on polluted days, certain events be delayed. The book indicates that vitamins C
Whose research is it anyway?
Authors: Trish Groves
Journal: BMJ (2006)

Taking part in research has had a bad press. No wonder, given catastrophic reactions to new drugs that were being tested in London and Baltimore, the use of dead children's organs without their parents' consent in Liverpool, and drug trials in India done with inadequate consent. These are extreme examples that do not reflect the careful and respectful approach of most researchers. But even the best researchers struggle to strike a proper balance between the overall public good of their work and the need to respect and protect the privacy of research participants. So this week's BMJ carries the first of …
Traumatic Epidural Hematoma
Authors: Gary L Gallia, Michael H Sobotta
Journal: New England Journal of Medicine (2009)

An 18-year-old intoxicated man was assaulted with a glass bottle on the left parietal region of his head and had a 5-minute loss of consciousness. The patient went home, but 2 hours after the injury, he presented to a local emergency department with severe headache, nausea, and vomiting. On physical examination, his score on the Glasgow Coma Scale was 15 (scores range from 3 to 15, with 15 indicating a normal level of consciousness), he had equal and bilaterally reactive pupils, and there was a small contusion on the scalp in the left temporoparietal region. Computed tomography of the head . . .
Malpractice Claims Data as a Quality Improvement Tool
Authors: Richard L. Kravitz
Journal: JAMA (1991)

--To identify potentially preventable sources of medical injury in obstetrics and gynecology, general surgery, anesthesiology, and radiology.--Retrospective review of physician malpractice claim records.--Large New Jersey physician malpractice insurer.--Physicians practicing obstetrics and gynecology, general surgery, anesthesiology, and radiology and covered by the insurance carrier during any portion of 1977 through 1989.--Proportion of claims due to negligence associated with errors in (1) patient management, (2) technical performance, and (3) medical and nursing staff coordination and the clinical and financial consequences of such errors.--Among 1371 claims ascribed to negligence, patient management errors were cited most frequently in all four specialties (48% to 75%) and, compared with performance and coordination problems, were generally associated with a higher frequency of serious injury and higher median payments. Coordination problems accounted for about 9% of claims. In obstetrics and gynecology, newborn delivery claims usually arose from management errors (57% to 68%), whereas gynecologic procedure claims were most often associated with performance errors (55% to 73%). Underperformance of cesarean section was cited more frequently than overperformance (31% vs 3%). General surgery claims were about equally divided between management and performance types regardless of procedure. Failure to perform appropriate diagnostic testing or monitoring was the main problem in 3% to 8% of claims.--Malpractice data can be used to identify problem-prone clinical processes and suggest interventions that may reduce negligence.
Dilated and Failing Cardiomyopathy in Bradykinin B <sub>2</sub> Receptor Knockout Mice
Authors: Costanza Emanueli, Roberta Maestri, Domenico Corradi, Roberta Marchione, Alessandra Minasi, Maria Grazia Tozzi, Maria Bonaria Salis, Stefania Straino, Maurizio C. Capogrossi, Giorgio Olivetti, Paolo Madeddu
Journal: Circulation (1999)

Background —The activation of B 2 receptors by kinins could exert cardioprotective effects in myocardial ischemia and heart failure. Methods and Results —To test whether the absence of bradykinin B 2 receptors may affect cardiac structure and function, we examined the developmental changes in blood pressure (BP), heart rate, and heart morphology of bradykinin B 2 receptor gene knockout (B 2 −/− ), heterozygous (B 2 +/− ), and wild-type (B 2 +/+ ) mice. The BP of B 2 −/− mice, which was still normal at 50 days of age, gradually increased, reaching a plateau at 6 months (136±3 versus 109±1 mm Hg in B 2 +/+ , P &lt;0.01). In B 2 +/− mice, BP elevation was delayed. At 40 days, the heart rate was higher ( P &lt;0.01) in B 2 −/− and B 2 +/− than in B 2 +/+ mice, whereas the left ventricular (LV) weight and chamber volume were similar among groups. Thereafter, the LV growth rate of B 2 −/− and B 2 +/− mice was accelerated, leading at 360 days to a LV weight–to–body weight ratio that was 9% and 17% higher, respectively, than that of B 2 +/+ mice. In B 2 −/− mice, hypertrophy was associated with a marked chamber dilatation (42% larger than that of B 2 +/+ mice), an elevation in LV end-diastolic pressure (25±3 versus 5±1 mm Hg in B 2 +/+ mice, P &lt;0.01), and reparative fibrosis. Conclusions —The disruption of the bradykinin B 2 receptor leads to hypertension, LV remodeling, and functional impairment, implying that kinins are essential for the functional and structural preservation of the heart.
Abstract 1520: Beta-endorphin neuron transplants suppress mammary tumor growth and progression via neuroimmune activation
Authors: Dipak K. Sarkar, Changqing Zhang, Madhavi Dokur, Nadka I. Boyadjieva, Maria Ortigüela, Nicole Rafferty, Sepideh Mojtehedzadeh, Kenneth Reuhl, Murugan Sengottuvelan
Journal: Cancer Research (2011)

Abstract A review of studies that evaluated psychological factors and outcome in cancer patients suggested an association between certain psychological factors and the growth and progression of cancer. It has been suggested that the effect of stress on the immune system may in turn affect the growth of some tumors. We have previously shown that a set of hormone secreting nerve cells in the hypothalamus, called beta-endorphin (BEP) neurons, plays a role in regulating stress response and immune function. Hence, we tested whether activation of BEP neurons reduces stress hormone levels and prevents the N-nitroso-N-methylurea (NMU)-induced mammary tumor burden and malignancy rate. To test this we differentiated rat neural stem cells from the hypothalamus into BEP neurons in culture, which were later transplanted into the paraventricular nuclei (PVN) of the hypothalamus of 90 day old Sprague-Dawley female rats, which were injected with MNU 4 weeks prior to cells transplantation. Control rats were transplanted with cortical cells or not operated. Animals were palpated every week to check for tumor growth for additional 12 weeks. Tumor length and width were measured with a calibrator. Sixteen weeks after MNU injection, animals were sacrificed, tumors were collected, and slices of tumors were put in formalin and processed for histological staining for pathology. Additionally, the impact of cell transplants on plasma levels of stress hormone corticosterone and cytokines interferon gamma (INF-γ), tumor necrosis factor alpha (TNF-α) in plasma and the levels of natural killer (NK) cell and macrophage cytotoxic activities in peripheral blood and spleen were evaluated. When the BEP neurons were transplanted into the PVN of an adult rat, they integrated well with the surrounding cells and produced BEP and it precursor gene proopiomelanocortin. We found that BEP implanted animals have significantly lower tumor incidence, tumor volume, tumor number and malignancy rate. Rats with BEP neuron transplants also showed reduced plasma corticosterone levels, increased NK cell and macrophage activities in the spleens and peripheral blood mononuclear cells, elevated plasma levels of anti-inflammatory cytokine INF-γ and decreased levels of inflammatory cytokine TNF-α. These results identify a protective role of BEP neurons against MNU-induced mammary tumor (animal model for breast cancer) growth and progression via increasing the innate immune function and reducing the inflammatory milieu. (Supported by NIH Grant AA015718). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1520. doi:10.1158/1538-7445.AM2011-1520
Chest Pain in Women with Normal Coronary Angiograms
Authors: Richard O. Cannon, Robert S. Balaban
Journal: New England Journal of Medicine (2000)

In 1991, two articles in the Journal noted that women evaluated for chest pain were less likely than men to undergo coronary angiography.1,2 These studies and others generated concern that the symptom of chest pain was taken less seriously by physicians when it occurred in women than when it occurred in men. As a result, interest in cardiovascular disease in women began to grow at national meetings and symposiums, and cardiac centers for women began to appear across the country. However, as greater attention was directed toward the risk of coronary artery disease in women and as the performance . . .
Modeling of Catecholaminergic Polymorphic Ventricular Tachycardia With Patient-Specific Human-Induced Pluripotent Stem Cells
Authors: Ilanit Itzhaki, Leonid Maizels, Irit Huber, Amira Gepstein, Gil Arbel, Oren Caspi, Liron Miller, Bernard Belhassen, Eyal Nof, Michael Glikson, Lior Gepstein
Journal: Journal of the American College of Cardiology (2012)
Ancient DNA and the Population Genetics of Cave Bears (Ursus spelaeus) Through Space and Time
Authors: Ludovic Orlando, Dominique Bonjean, Herve Bocherens, Aurelie Thenot, Alain Argant, Marcel Otte, Catherine Hänni
Journal: Molecular Biology and Evolution (2002)

The cave bear spread from Western Europe to the Near East during the Riss glaciation (250 KYA) before becoming extinct approximately 12 KYA. During that period, the climatic conditions were highly dynamic, oscillating between glacial and temperate episodes. Such events have constrained the geographic repartition of species, the movements of populations and shaped their genetic diversity. We retrieved and analyzed ancient DNA from 21 samples from five European caves ranging from 40 to 130 KYA. Combined with available data, our data set accounts for a total of 41 sequences of cave bear, coming from 18 European caves. We distinguish four haplogroups at the level of the mitochondrial DNA control region. The large population size of cave bear could account for the maintenance of such polymorphism. Extensive gene flow seems to have connected European populations because two haplogroups cover wide geographic areas. Furthermore, the extensive sampling of the deposits of the Scladina cave located in Belgium allowed us to correlate changes in climatic conditions with the intrapopulational genetic diversity over 90 KY.
Abstract 398: Genome-wide comparison of matched canine osteosarcoma primary tumours and metastases by array comparative genomic hybridization.
Authors: Jonathan H W Liu, Yang Washington Shao, Sam D. Molyneux, Rama Khokha, Geoffrey A. Wood
Journal: Cancer Research (2013)

Abstract Canine osteosarcoma is a common and highly aggressive cancer that shares many characteristics with human osteosarcoma and can serve as a model of this disease. We collected snap frozen normal muscle, primary appendicular skeleton tumour, and matched terminal lung metastases from 8 canine osteosarcoma patients. DNA was isolated from these samples and gene copy number aberrations were assessed using high-resolution oligonucleotide array comparative genomic hybridization (Agilent G3 Canine 180k array). Data analysis was performed using Agilent Genomic Workbench 5.0 analysis software and the Aberration Detection Method 2 and Circular Binary Segmentation algorithms were applied to identify aberrant chromosomal intervals with the log2 ratio threshold set to 0.5. As expected, many cases had copy number aberrations that contain genes commonly altered in canine and human osteosarcoma, including MYC, CDKN2A/CDKN2B, PTEN, p53, and RB. To assess the degree of genomic similarity of the 8 primary tumours to their corresponding metastasis, we used these same samples to generate 8 random pairings of unmatched primaries and metastases, as well as 8 random pairs of primary tumours and 8 random pairs of metastases. A set of 11,000 random 10 base pair segments spanning the entire genome was generated and a correlation analysis was conducted between pairs of samples using the log2 ratios for each segment. Matched samples showed significant correlation with the square of the correlation coefficient (R2) being 0.44 (p&amp;lt;0.05), whereas unmatched primaries and metastases, random pairs of primaries, and random pairs of metastases did not show any significant correlation (R2= 0.08, 0.08, and 0.06 respectively, p&amp;gt;0.05 for each). Thus, as a group, primary tumours are genomically more similar to their corresponding metastasis than to unmatched metastases, and are also more similar than primary tumours or metastases are to each other. However, the range of similarity between matched primaries and metastases was relatively wide, with half the cases showing very high similarity and half showing moderate similarity that was close to the upper range of unmatched samples. These results have implications for therapies that rely on analysis of primary tumours to derive strategies that target metastases. Citation Format: Jonathan H W Liu, Yang Washington Shao, Sam D. Molyneux, Rama Khokha, Geoffrey A. Wood. Genome-wide comparison of matched canine osteosarcoma primary tumours and metastases by array comparative genomic hybridization. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 398. doi:10.1158/1538-7445.AM2013-398
Local Delivery of Poly Lactic-co-glycolic Acid Microspheres Containing Imatinib Mesylate Inhibits Intracranial Xenograft Glioma Growth
Authors: Ofra Benny, Lata G. Menon, Gilert Ariel, Effrat Goren, Seung-Ki Kim, Chaney Stewman, Peter M. Black, Rona S. Carroll, Marcelle Machluf
Journal: Clinical Cancer Research (2009)

Abstract Purpose: In an effort to develop new therapeutic strategies to treat malignant gliomas, we have designed poly (lactic-co-glycolic) acid (PLGA) microparticles that deliver imatinib mesylate, a small molecule tyrosine kinase inhibitor. The local continuous release of imatinib mesylate at the tumor site overcomes many obstacles associated with systemic delivery. Experimental Design: Polymeric microspheres were prepared from various compositions of PLGA and loaded with imatinib mesylate. Imatinib release profiles, biological activity, and effect on PDGFR-B phosphorylation were confirmed in vitro. The therapeutic efficacy of imatinib microspheres was examined in two s.c. and orthotopic human glioblastoma xenograft models. Results: A single local injection of PLGA microspheres loaded with a low concentration of imatinib mesylate led to 88% and 79% reduction in s.c. human (U87-MG) and murine (GL261) glioma tumors, respectively. PLGA-imatinib mesylate administered intracranially led to a 79% reduction in U87MG tumor volume. Immunohistochemical analysis showed a marked decrease in proliferation indices and tumor vessel density in the s.c. model and induction of apoptosis in an intracranial model. Conclusion: This is the first study to show the therapeutic efficacy of the local delivery of imatinib mesylate using a polymeric delivery system.
Kerley's A, B, and C Lines
Authors: Takeharu Koga, Kiminori Fujimoto
Journal: New England Journal of Medicine (2009)

A 59-year-old woman with hypertension and diabetic nephropathy presented with a sudden onset of dyspnea after discontinuing her medications. Physical examination revealed hypertension (blood pressure, 225/122 mm Hg), tachycardia (heart rate, 112 bpm), tachypnea (24 breaths per minute), and hypoxemia (oxygen saturation, 94%, despite treatment with supplemental oxygen). The patient also had elevated jugular venous pressure, bilateral rales, and edema of the legs. The level of brain natriuretic peptide was elevated (780.8 pg per milliliter; normal level, <18.4). A chest radiograph showed an enlarged cardiac silhouette, a dilated azygos vein, and peribronchial cuffing, in addition to Kerley's A, B, and . . .
EPINEPHRIN IN ANESTHESIA
Authors: Carlos Manuel Garcia
Journal: JAMA (1925)

<h3>To the Editor:</h3> —In the article that Dr. Joseph F. Wearn contributes to "Glandular Therapy" (The Journal, Nov. 8, 1924, p. 1508), I note a flagrant contradiction between two assertions: In conditions in which there exist a weak failing heart action and lowered blood pressure but no increase in capillary permeability, epinephrin is an excellent cardiovascular stimulant. An example of such a condition is the collapse that sometimes follows excessive anesthesia. The use of epinephrin either during or immediately after chloroform anesthesia is distinctly contraindicated because of the frequency of ventricular fibrillation and death following the combination of these two drugs. [The matter was referred to Dr. Wearn, who replies:]
Continuing Education — Postgraduate Medical Institute
Authors: Laurence B. Ellis
Journal: New England Journal of Medicine (1964)

THE most baffling problems in the field of medical education are those concerned with the continuing instruction of the practicing physician. As medical diagnosis sharpens with the aid of increasingly complex instruments, as more and more potent drugs become available with great possibilities for good but also for harm, as the whole tempo of increase in medical knowledge quickens, and its extent enormously broadens, the need to help the physician keep abreast of his times becomes more urgent. And yet surprisingly little has been done in a realistic and effective way to deal with this problem. There has been much . . .
Circulating growth differentiation factor‐15 correlates with myocardial fibrosis in patients with non‐ischaemic dilated cardiomyopathy and decreases rapidly after left ventricular assist device support
Authors: Sjoukje I. Lok, Bjorn Winkens, Roel Goldschmeding, Ankie J.P. van Geffen, Fay M.A. Nous, Joyce van Kuik, Petra van der Weide, Corinne Klöpping, J. Hans Kirkels, Jaap R. Lahpor, Pieter A. Doevendans, Nicolaas de Jonge, Roel A. de Weger
Journal: European Journal of Heart Failure (2012)