tbuckley/cabot-search huggingface dataset:
Empyema thoracis: a problem with late referral?
Authors: C W Cham, S M Haq, J Rahamim
Journal: Thorax (1993)

BACKGROUND--Patients are often referred to thoracic units for management of empyema after the acute phase has been treated with antibiotics but without adequate drainage. This study evaluates the effects of delay in surgical treatment of empyema thoracis on morbidity and mortality. METHODS--Thirty nine consecutive patients were studied from January 1991 to June 1992. Two groups (group 1, 16 patients; group 2, 23 patients) were compared depending on the time spent under the care of other specialists before referral to the thoracic unit (group 1, seven days or less; group 2, eight days or more). The reasons for delay in referral were analysed. RESULTS--Four patients were treated conservatively with chest drainage alone (all in group 1). Thirty five patients required rib resection and drainage of their empyema (group 1, 12 patients; group 2, 23 patients). Nineteen (all in group 2) of the 35 patients who had rib resections went on to have decortication. The commonest cause of empyema was post-pneumonic (37 out of 39 patients). Staphylococcus aureus was the commonest organism isolated. Misdiagnosis (five patients), inappropriate antibiotics (six patients), and inappropriate placement of chest drainage tubes (three patients) all contributed to persistence and eventual progression of empyema. The overall mortality was 10% and mortality increased with age. The median stay in hospital was 9.5 days (range 7-12 days, n = 4) for patients treated with closed tube drainage only; 18 days (range 10-33 days, n = 16) for patients who had undergone rib resections and open drainage; and 28 days (range 22-49 days, n = 19) for patients who underwent decortication. The likelihood of having a staged procedure (antibiotics, closed tube drainage, open drainage with rib resection, and finally decortication) increased when closed tube drainage was persevered with for more than seven days. The total hospital stay was positively related with the time before referral for surgical treatment. Anaemia, low albumin concentrations, and worsening liver function were found in group 2 compared with group 1. CONCLUSIONS--Early adequate operative drainage in patients with empyema results in low morbidity, shorter stays in hospital, and good long term outcome. These patients should be treated aggressively and early referral for definitive surgical management is recommended.
Determinants of serum zinc in a random population sample of four Belgian towns with different degrees of environmental exposure to cadmium
Authors: Lutgarde Thijs, Jan Staessen, Antoon Amery, Pierre Bruaux, Jean-Pierre Buchet, FranÇoise Claeys, Pierre De Plaen, Geneviève Ducoffre, Robert Lauwerys, Paul Lijnen, Laurence Nick, Annie Saint Remy, Harry Roels, Désiré Rondia, Francis Sartor
Journal: Environmental Health Perspectives (1992)

This report investigated the distribution of serum zinc and the factors determining serum zinc concentration in a large random population sample. The 1977 participants (959 men and 1018 women), 20–80 years old, constituted a stratified random sample of the population of four Belgian districts, representing two areas with low and two with high environmental exposure to cadmium. For each exposure level, a rural and an urban area were selected. The serum concentration of zinc, frequently used as an index for zinc status in human subjects, was higher in men (13.1 μmole/L, range 6.5–23.0 μmole/L) than in women (12.6 μmole/L, range 6.3–23.2 μmole/L). In men, 20% of the variance of serum zinc was explained by age (linear and squared term, R = 0.29), diurnal variation (r = 0.29), and total cholesterol (r = 0.16). After adjustment for these covariates, a negative relationship was observed between serum zinc and both blood (r = −0.10) and urinary cadmium (r = −0.14). In women, 11% of the variance could be explained by age (linear and squared term, R = 0.15), diurnal variation in serum zinc (r = 0.27), creatinine clearance (r = −0.11), log γ-glutamyltranspeptidase (r = 0.08), cholesterol (r = 0.07), contraceptive pill intake (r = −0.07), and log serum ferritin (r = 0.06). Before and after adjustment for significant covariates, serum zinc was, on average, lowest in the two districts where the body burden of cadmium, as assessed by urinary cadmium excretion, was highest. These results were not altered when subjects exposed to heavy metals at work were excluded from analysis.
TWO POSSIBLE CAUSES OF EMACIATION NOT GENERALLY RECOGNIZED.
Authors: RICHARD C. CABOT
Journal: JAMA (1906)

Some physicians and many laymen are in the habit of thinking and speaking as if the bulk of the human body could be increased or diminished as simply as we load and unload a vessel: Pour in the cargo and the displacement increases; hoist it out and she rides light on the water. But to feed a patient up or to starve him down is not nearly so simple. Our state of nutrition depends on the number, the contents and the activities of our body cells; but these cells are not buckets to be filled or emptied at our pleasure. They multiply or atrophy, take up food or reject it, burn fuel or refuse to do so according to their own laws. Without food they can no more do their work than a miner can dig coal or a composer produce sonatas. But no one supposes that you can get
Involvement of junctional adhesion molecules in lymphatic vascular remodelling in rheumatoid arthritis
Authors: A. F. Milia, M. Manetti, S. Pfanner, F. Nacci, G. Fiori, S. Guiducci, E. Romano, C. Ceccarelli, L. Ibba-Manneschi, M. Matucci-Cerinic
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Background and objective</h3> Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, in which neovascularisation of the synovium is regarded as a crucial step in its development and progression. Lymphatic neovascularisation has been observed in RA joints. Junctional adhesion molecule A (JAM-A) and JAM-C regulate leucocyte-endothelial cell (EC) interactions. JAMs also interact at inter-EC junctions regulating vascular permeability and are implicated in pathophysiological processes involving leukocyte transmigration, tight junction assembly and angiogenesis. The aim of this study was to investigate the role of JAM-A and JAM-C in mediating the lymphoangiogenic process in RA synovium. <h3>Materials and methods</h3> Synovial biopsies from RA and osteoarthritic (OA) patients, used as control, has been collected during arthroplasty or synovectomy. Synovial sections were stained with primary antibodies (Abs) antihuman JAM-A or JAM-C followed by fluorochrome-conjugated secondary Abs. The lymphatic EC specific marker podoplanin (D2-40) was used to differentiate blood (D2-40−) and lymphatic (D2-40+) vessels. <h3>Results</h3> Immunohistochemical analysis showed, in RA synovium, the presence of abundant D2-40+ structures, identifiable as lymphatic vessels. Many D2-40+ cells were also found in the intimal lyning layer, specially in the hyperplasic areas. Lymphatic vessels were distributed in the sublining, specially around blood vessels. Clusters of D2-40+ cells were also found in the inflammatory infiltrate, in structures resembling new lymphatic vessels. In all sections from RA, JAM-A and JAM-C were observed on almost all vasculature including the lymphatic (D2-40+) and blood vessels (D2-40−). Initial lymphatic vessels reacted with anti-JAM-A and anti-JAM-C. In the synovial lining, JAM-A and JAM-C were expressed on D2-40+ macrophage-like synoviocites. D2-40+ cells in the inflammatory infiltrate showed positivity for both JAM-A and JAM-C. The immunostaining for both JAMs was weaker in OA than in RA synovium. <h3>Conclusion</h3> This results confirm the presence of an increased number of lymphatic vessels in RA synovial tissue. Moreover, the authors observed D2-40+ structures, mostly around pre-existing blood vessels, indicating the development of a new lymphatic network in the synovial sublining. The presence of D2-40+ cells in the inflammatory infiltrate and in the macrophage-like synoviocites, lead us to hypothesise that in RA, macrophages are activated and may function as lymphatic precursors. In RA synovium, both JAM-A and JAM-C are expressed in all D2-40+ cells, indicating their participation in the inflammatory process and intercellular junction assembly. Their expression in new lymphatic vessels and in D2-40+ cells stimulated to form new vessels, confirm their involvement in the lymphoangiogenic process occurring in RA.
Atypical Antipsychotic Drugs and the Risk for Acute Kidney Injury and Other Adverse Outcomes in Older Adults
Authors: Y. Joseph Hwang, Stephanie N. Dixon, Jeffrey P. Reiss, Ron Wald, Chirag R. Parikh, Sonja Gandhi, Salimah Z. Shariff, Neesh Pannu, Danielle M. Nash, Faisal Rehman, Amit X. Garg
Journal: Annals of Internal Medicine (2014)

Several adverse outcomes attributed to atypical antipsychotic drugs, specifically quetiapine, risperidone, and olanzapine, are known to cause acute kidney injury (AKI). Such outcomes include hypotension, acute urinary retention, and the neuroleptic malignant syndrome or rhabdomyolysis.To investigate the risk for AKI and other adverse outcomes associated with use of atypical antipsychotic drugs versus nonuse.Population-based cohort study.Ontario, Canada, from 2003 to 2012.Adults aged 65 years or older who received a new outpatient prescription for an oral atypical antipsychotic drug (n=97,777) matched 1:1 with those who did not receive such a prescription.The primary outcome was hospitalization with AKI (assessed by using a hospital diagnosis code and, in a subpopulation, serum creatinine levels) within 90 days of prescription for atypical antipsychotic drugs.Atypical antipsychotic drug use versus nonuse was associated with a higher risk for hospitalization with AKI (relative risk [RR], 1.73 [95% CI, 1.55 to 1.92]). This association was consistent when AKI was assessed in a subpopulation for which information on serum creatinine levels was available (5.46% vs. 3.34%; RR, 1.70 [CI, 1.22 to 2.38]; absolute risk increase, 2.12% [CI, 0.80% to 3.43%]). Drug use was also associated with hypotension (RR, 1.91 [CI, 1.60 to 2.28]), acute urinary retention (RR, 1.98 [CI, 1.63 to 2.40]), and all-cause mortality (RR, 2.39 [CI, 2.28 to 2.50]).Only older adults were included in the study.Atypical antipsychotic drug use is associated with an increased risk for AKI and other adverse outcomes that may explain the observed association with AKI. The findings support current safety concerns about the use of these drugs in older adults.Academic Medical Organization of Southwestern Ontario.
Perimenopausal women's views on taking hormone replacement therapy to prevent osteoporosis.
Authors: J Draper, M Roland
Journal: BMJ (1990)

To find out perimenopausal women's views on taking hormone replacement therapy to prevent osteoporosis.Semistructured postal questionnaire survey; the questionnaire was enclosed with a letter to explain the purpose of the study and to give patients some information about hormone replacement therapy and osteoporosis.Mixed social class, urban general practice with 12,000 registered patients.All women aged 50, 51, or 52 were selected from the age-sex register; 102 women were identified and 84 (87%) replied to the questionnaire.Response rates to questions on interest in taking hormone replacement therapy, the importance of preventing osteoporosis, and worries about side effects of the treatment.More than three quarters of the respondents (65) were interested in taking hormone replacement therapy to prevent osteoporosis, but 48 of them would have liked further information. Sixty four women thought that it was very important to prevent osteoporosis. More than half of the respondents (51) were worried about side effects of the treatment, but only 15 women thought that continued menstruation would be a major disadvantage.There is considerable interest among perimenopausal women in taking hormone replacement therapy to prevent osteoporosis. The resource implications for primary care in meeting this interest are substantial.
Prospects for reducing fumonisin contamination of maize through genetic modification.
Authors: J Duvick
Journal: Environmental Health Perspectives (2001)

Fumonisins (FB) are mycotoxins found in (italic)Fusarium verticillioides-infected maize grain worldwide. Attention has focused on FBs because of their widespread occurrence, acute toxicity to certain livestock, and their potential carcinogenicity. FBs are present at low levels in most field-grown maize but may spike to high levels depending on both the environment and genetics of the host plant. Among the strategies for reducing risk of FB contamination in maize supplied to the market, development and deployment of Fusarium ear mold-resistant maize germplasm is a high priority. Breeding for increased ear mold tolerance and reduced mycotoxin levels is being practiced today in both commercial and public programs, but the amount of resistance achievable may be limited due to complicated genetics and/or linkage to undesirable agronomic traits. Molecular markers can be employed to speed up the incorporation of chromosomal regions that have a quantitative effect on resistance (quantitative trait loci). Transgenic approaches to ear mold/mycotoxin resistance are now feasible as well. These potentially include genetically enhanced resistance to insect feeding, increased fungal resistance, and detoxification/prevention of mycotoxins in the grain. An example of the first of these approaches is already on the market, namely transgenic maize expressing Bacillus thuringiensis (Bt) toxin, targeted to the European corn borer. Some Bt maize hybrids have the potential to reduce FB levels in field-harvested grain, presumably through reduced feeding of Bt-susceptible insects in ear tissues. However, improved ear mold resistance per se is still an important goal, as the plant will still be vulnerable to noninsect routes of entry to (italic)Fusarium. A second approach, transgene-mediated control of the ability of Fusarium to infect and colonize the ear, could potentially be achieved through overexpression of specific antifungal proteins and metabolites, or enhancement of the plant's own defense systems in kernel tissues. This has not yet been accomplished in maize, although promising results have been obtained recently in other monocots versus other fungal and bacterial pathogens. Achieving reproducible and stable enhanced ear mold resistance under field conditions will be immensely challenging for biotechnologists. A third approach, transgene strategies aimed at preventing mycotoxin biosynthesis, or detoxifying mycotoxins in planta, could provide further protection for the grower in environments where FBs present a risk to the crop even when the maize is relatively resistant to Fusarium mold. In one example of such a strategy, enzymes that degrade FBs have been identified in a filamentous saprophytic fungus isolated from maize, and corresponding genes have been cloned and are currently being tested in transgenic maize.
Impact of impaired fasting glucose and impaired glucose tolerance on arterial stiffness in an older Chinese population: the Guangzhou Biobank Cohort Study–CVD
Authors: Lin Xu, Chao Qiang Jiang, Tai Hing Lam, Kar Keung Cheng, Xiao Jun Yue, Jie Ming Lin, Wei Sen Zhang, G. Neil Thomas
Journal: Metabolism (2009)
Assisted Ventilation of the Neonate
Authors: Henrique Rigatto
Journal: JAMA (1982)

<b>The Lung and Its Disorders in the Newborn Infant</b>, by Mary Ellen Avery, Barry D. Fletcher, and Roberta G. Williams (<i>Major Probl Clin Pediatr</i>, vol 1, Alexander J. Schaffer and Milton Markowitz, eds), ed 4; 367 pp, 244 illus, $36, Philadelphia, WB Saunders Co, 1981. The authors of Assisted<i>Ventilation of the Neonate</i>and their colleagues have taken up the difficult task of writing a book on ventilatory assistance to neonates with respiratory tract failure. The result is not entirely satisfactory. To its credit, the book covers almost every possible aspect of respiratory care. An initial chapter on physiological principles is followed by others dealing with various aspects of ventilatory care in infants. The authors discuss the use of positive and negative pressure ventilation at length. Cardiovascular management is discussed in relation to its pulmonary implications, and the final chapters cover intraoperative management and the surgical management of the airway.
Improvement in Biomarkers of Bone Formation During Infliximab Therapy in Pediatric Crohn's Disease: Results of the REACH Study
Authors: Meena Thayu, Mary B. Leonard, Jeffrey S. Hyams, Wallace V. Crandall, Subra Kugathasan, Anthony R. Otley, Allan Olson, Jewel Johanns, Colleen W. Marano, Robert B. Heuschkel, Gigi Veereman–Wauters, Anne M. Griffiths, Robert N. Baldassano
Journal: Clinical Gastroenterology and Hepatology (2008)
Dietary omega-3 fatty acid deficiency and visual loss in infant rhesus monkeys.
Authors: M Neuringer, W E Connor, C Van Petten, L Barstad
Journal: Journal of Clinical Investigation (1984)

Linolenic acid (18:3 omega 3) is a dietary precursor of docosahexaenoic acid (22:6 omega 3), the major fatty acid in the photoreceptor membranes of the retina. We hypothesized that rhesus monkeys deprived of dietary omega-3 fatty acids during prenatal and postnatal development would show plasma depletion of these fatty acids and visual impairment. Semipurified diets low in omega-3 fatty acids were fed to one group of adult female rhesus monkeys throughout pregnancy and to their infants from birth. A control group of mothers and infants received similar diets but supplying ample linolenic acid. In the plasma phospholipids of deficient infants, linolenic acid was generally undetectable and 22:6 omega 3 levels became progressively depleted, falling from 42% of control values at birth to 21% at 4 wk, 9% at 8 wk, and 6% at 12 wk of age. In the other plasma lipid classes, 22:6 omega 3 was undetectable by 12 wk. The visual acuity of the deprived infants, as measured by the preferential looking method, was reduced by one-fourth at 4 wk (P less than 0.05) and by one-half at 8 and 12 wk (P less than 0.0005) compared with control infants. These results suggest that omega-3 fatty acids may be an essential nutrient, and that 22:6 omega 3 may have a specific function in the photoreceptor membranes of the retina.
WHO sets up expert committee to advise on coronavirus
Authors: A. Gulland
Journal: BMJ (2013)

The World Health Organization has convened a group of international experts to advise it on the Middle East respiratory syndrome coronavirus.

The committee, convened under the WHO’s international health regulations, is made up of experts including immunologists, virologists, and epidemiologists and held its first telephone conference on Tuesday 9 July, when it reviewed current information about the disease. This is the first time that an international committee of experts, independent of WHO, has met since the H1N1 pandemic in 2009.

Keiji Fukuda, WHO’s assistant director general for health, security, and environment, told a press conference on 4 July that it was unlikely that the committee, convened to investigate the causes of the disease and how it is likely to evolve, would make recommendations on 9 July, but he …
China revises law on infectious diseases
Authors: Ma Guihua
Journal: The Lancet Infectious Diseases (2004)

China has revised its 15-year-old Law on the Prevention and Control of Infectious Diseases that was adopted by China's top legislature, the National People's Congress. Severe acute respiratory syndrome, lung anthrax, and highly pathogenic strains of avian influenza are to be treated as class A diseases. The new law also upgrades tuberculosis, neonatal tetanus, and schistosomiasis from class C to class B.
MONITORING CHANGES IN GLUCOSE METABOLISM IN LIVER MELANOMA METASTASES SEQUENTIALLY TREATED WITH GM-CSF AND CYCLOPHOSPHAMIDE WITH FDG PARAMETRIC IMAGING AND PET
Authors: C Messa, C Hoh, Y Choi, J Gasson, S Rege, E Nietsche, M Phelps, J Glaspy, M Lee, R A Hawkins
Journal: Clinical Nuclear Medicine (1992)

Messa, C.; Hoh, C.; Choi, Y.; Gasson, J.; Rege, S.; Nietsche, E.; Phelps, M.; Glaspy, J.; Lee, M.; Hawkins, R. A. Author Information
Ectopic and Abnormal Hormone Receptors in Adrenal Cushing’s Syndrome*
Authors: André Lacroix, Nina N′Diaye, Johanne Tremblay, Pavel Hamet
Journal: Endocrine Reviews (2001)

The mechanism by which cortisol is produced in adrenal Cushing's syndrome, when ACTH is suppressed, was previously unknown and was referred to as being "autonomous." More recently, several investigators have shown that some cortisol and other steroid-producing adrenal tumors or hyperplasias are under the control of ectopic (or aberrant, illicit, inappropriate) membrane hormone receptors. These include ectopic receptors for gastric inhibitory polypeptide (GIP), beta-adrenergic agonists, or LH/hCG; a similar outcome can result from altered activity of eutopic receptors, such as those for vasopressin (V1-AVPR), serotonin (5-HT4), or possibly leptin. The presence of aberrant receptors places adrenal cells under stimulation by a trophic factor not negatively regulated by glucocorticoids, leading to increased steroidogenesis and possibly to the proliferative phenotype. The molecular mechanisms responsible for the abnormal expression and function of membrane hormone receptors are still largely unknown. Identification of the presence of these illicit receptors can eventually lead to new pharmacological therapies as alternatives to adrenalectomy, now demonstrated by the long-term control of ectopic P-AR- and LH/hCGR-dependent Cushing's syndrome by propanolol and leuprolide acetate. Further studies will potentially identify a larger diversity of hormone receptors capable of coupling to G proteins, adenylyl cyclase, and steroidogenesis in functional adrenal tumors and probably in other endocrine and nonendocrine tumors.
The Deubiquitinating Enzyme USP5 Modulates Neuropathic and Inflammatory Pain by Enhancing Cav3.2 Channel Activity
Authors: Agustin García-Caballero, Vinicius M. Gadotti, Patrick Stemkowski, Norbert Weiss, Ivana A. Souza, Victoria Hodgkinson, Chris Bladen, Lina Chen, Jawed Hamid, Anne Pizzoccaro, Mickael Deage, Amaury François, Emmanuel Bourinet, Gerald W. Zamponi
Journal: Neuron (2014)
The Four Horsemen of the Apocalypse
Authors: Robert G. Petersdorf
Journal: JAMA (1982)

Governance of academic medical centers is in a process of change. This essay reviews some of the historical factors that have affected the present status of academic medical center governance and describes the functions of the four individuals who are most involved in the operation of academic medical centers: vice-presidents for health affairs, deans of schools of medicine, department chairmen, and hospital directors. The relationships between these four individuals are analyzed, and points of conflict are identified. Some suggestions about how these individuals can work together more effectively are made. (<i>JAMA</i>1982;247:1153-1161)