tbuckley/cabot-search huggingface dataset:
Naloxone in Reversal of Hypotension in Septic Shock
Authors: Neil S. Yeston
Journal: JAMA (1983)

<h3>To the Editor.—</h3> Recent experimental and clinical evidence suggests that the narcotic antagonist naloxone may play a role in reversing the hypotension of septic shock.<sup>1,2</sup> <h3>Report of a Case.—</h3> We recently treated a 66-year-old man who had undergone multiple operations for ruptured diverticulitis. He arrived at the surgical intensive care unit (ICU) in septic shock. Despite adequate resuscitation and monitoring of his condition, the patient exhibited refractory hypotension of 24 hours' duration, requiring dopamine to maintain systolic BP greater than 90 mm Hg. During this 24-hour period, he received a total of 18 mg of morphine sulfate. Three hours after the last subcutaneous injection of morphine sulfate (6 mg), the patient was treated intravenously (IV) with 0.4 mg (1 ampule) of naloxone hydrochloride. He immediately clutched his epigastrium and chest and appeared to be experiencing severe pain. His BP rose to 145/70 mm Hg and remained at this level
O50 THE SPECIFIC INFECTIVITY OF HEPATITIS C VIRUS IS REGULATED BY THE CATALYTIC ACTIVITY OF THE LIPID PEROXIDE SCAVENGER GLUTATHIONE PEROXIDASE 4
Authors: C. Brault, P. Levy, M. Michelet, A. Salle, E.-I. Pecheur, E. Vericel, A.V. Ivanov, H.M. Steffen, M. Odenthal, F. Zoulim, B. Bartosch
Journal: Journal of Hepatology (2014)
Embalming Before Autopsy
Authors: Alvan G. Foraker, Robert V. Joel
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In the past nine years we have performed or supervised more than 1,000 autopsies on bodies which had the<i>arterial</i>stage of embalming accomplished. Comparing these examinations with several thousand autopsies on unembalmed bodies, we believe that the<i>arterial</i>stage of embalming does not materially change postmortem appearances. Of course, if the embalming process is carried through additional stages of cavity preparation—with multiple incisions, trocar punctures, and injections—significant changes do occur, as Dr. Gruhn points out, which interfere with proper gross evaluation. Our arrangement with local funeral directors allows them to do the arterial stage of embalming in routine cases, then return the body for autopsy. We do have the option of doing the examination on the unembalmed body whenever medical indication exists, as, for example, in suspected cases of subacute bacterial endocarditis. Autopsies on unembalmed bodies (in addition to still-born infants and some premature infants) comprise
Intravenous Medications and Green Urine
Authors: Patricia Bowling
Journal: JAMA (1981)

<h3>To the Editor.—</h3> A 48-year-old man was admitted to the emergency room with vomiting, nausea, diarrhea, and abdominal pain. Physical examination, elevated serum and urine amylase values, and a history of alcohol abuse led to the diagnosis of acute pancreatitis. The patient was admitted to the hospital, and at approximately 8 AM on the morning of admission, the patient received intravenous (IV) butorphanol tartrate (Stadol) and IV promethazine hydrochloride (Phenergan). At 8 PM on the day of admission, the patient was first noted to be voiding green urine. At 10:30 PM on the day of admission, the patient was given IV cimetidine, 300 mg. On the second hospital day, the patient was given IV cimetidine, 300 mg at 4 AM, 1 AM, 4 PM, and 10 PM, and at 4 AM on the third hospital day. Thereafter the patient received cimetidine only by the oral route. The patient's urine continued
Abstract 3787: Pharmacokinetics and pharmacodynamics of AV-203, a humanized anti-ERBB3 antibody
Authors: Kristan Meetze, Steven M. Tyler, Christina Fleet, Sylvie Vincent, James Gifford, Jeno Gyuris
Journal: Cancer Research (2012)

Abstract ERBB3 is widely expressed in human carcinomas, and its over expression is associated with poor prognosis in patients with various carcinomas, (i.e., breast, ovarian, prostate, colorectal, pancreatic, gastric, and head and neck cancers). The presence of ERBB3 correlates with local to distal metastasis in lung, gastric, and colorectal cancers as well as bone invasion in prostate cancer. Activation of ERBB3 is also implicated in the development of resistance to current cancer treatments. Due to its lack of kinase activity, the activation of the ERBB3 receptor is dependent on heterodimerization with active receptor tyrosine kinases (RTKs). The recruitment of ERBB3 into active, heterodimer complexes is mediated by its ligand Neuregulin-1 (NRG-1) or by amplified, over expressed RTKs in a ligand independent manner. Therefore, ERBB3 can crosstalk with most major receptors involved in cancer development and maintenance such as epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), and c-MET. AV-203 is a potent, humanized anti-ERBB3 antibody that inhibits both ligand-dependent and independent activation of ERBB3 both in vitro and in vivo. Pharmacokinetics and pharmacodynamics of AV-203 were characterized in mice using the A549 non-small cell lung cancer xenograft model. AV-203 administered IV in mice exhibits acceptable pharmacokinetics supporting preclinical efficacy studies. AV-203 administered IV in A549 NSCLC xenograft tumor bearing mice had lower serum AUC than naïve mice, demonstrating that the presence of human ErbB3 may alter the PK parameters of AV-203. In evaluating pharmacodynamics in vivo, AV-203 was able to down regulate total ERBB3 and ERBB3 signaling in A549 tumors in a time-dependent manner. Inhibition of ERBB3 signaling correlated with significant dose-dependent tumor growth inhibition in the A549 xenograft model. Dose scheduling studies with the constant AV-203 dose of 2.5 mg/kg revealed that the most efficacious schedule is the more frequent dosing at Q3D. In comparing the total dose of 10 mg/kg per 14 day cycle, at varying dose per injection and frequency, AV-203 resulted in significant tumor growth inhibition at all dose schedules. These data conclude that the efficacy of AV-203 is driven by total drug exposure and that AV-203 is not dependent on Cmax for its antitumor activity. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3787. doi:1538-7445.AM2012-3787
CAUSES OF ERROR IN THE DIAGNOSIS OF DISEASES OF THE JOINTS
Authors: WISNER R. TOWNSEND
Journal: JAMA (1913)

Surprise is often expressed by those who specialize in medicine at the number of erroneous diagnoses in the patients who are referred to them for treatment. The expert certainly should be able to make more correct diagnoses in the line of work that he is an expert in than one who is not specializing; but even among so-called experts errors are frequent and the correct diagnosis is sometimes never made, and in other instances many men are seen before the true nature of the disease is arrived at. Much could be written on the necessity for a correct diagnosis as preliminary to correct treatment, and in many instances errors in diagnosis involve serious results for the patient, as faulty treatment may actually render conditions worse; but this phase of the subject does not need to be elaborated. In this connection, however, I quote the following from Richard C. Cabot:<sup>1</sup>
An Address ON TUBERCULIZATION AND DETUBERCULIZATION: Delivered before the International Congress on Tuberculosis at Rome, April, 1912
Authors: R. W. Philip
Journal: BMJ (1912)

THt'H.tuLberculization of the race is a grim chlapter in Iiiiuian hiistory.The universal distribution of tuberculosis tlhrouglhout tlhe civilized world is a fact of immense .significance.Tuberculosis has accomlpaniedI civilization.
EMPYEMA IN CAMP GEORGE H. THOMAS.
Authors: N. SENN
Journal: JAMA (1898)

The short, decisive campaign with Spain just ended was characterized, from a medical standpoint, by the smallness of the number of those killed in the field, the prevalence of disease and the large number of deaths from this source. The brilliant victories on land and sea which forced Spain to sue for peace have cost us so far over three thousand lives—less than three hundred from the effects of bullets and over two thousand nine hundred from disease. The number of deaths from disease will be increased materially, as the different military hospitals at home and abroad still contain a large number of our sick, many of whom will succumb to the diseases contracted during the campaign. Even in case the hostilities are not renewed, it is impossible to predict the total loss of life at the present time, to say nothing of the thousands who will never recover the
Motor Vehicle Accidents and IDDM
Authors: Thomas J Songer, Ronald E LaPorte, Janice S Dorman, Trevor J Orchard, Karen J Cruickshanks, Dorothy J Becker, Allan L Drash
Journal: Diabetes Care (1988)

A case-control study examining the 1-yr motor vehicle accident experiences of 158 insulin-dependent diabetes mellitus (IDDM) cases and 158 nondiabetic siblings was undertaken to evaluate the risk of motor vehicle accidents among drivers with IDDM. In multivariate analyses the overall accident risk of the cases and control subjects did not differ significantly. Female diabetic drivers, however, showed a marked increased risk for motor vehicle accidents. The accident risk among female cases was five times higher than among the female control subjects (P &amp;lt; .05). Age and marital status were also significantly associated with accident probability in the multivariate model. The results suggest that IDDM could have an effect on the accident rate of diabetic drivers, particularly women. However, the traditional risk factors for automobile accidents, i.e., age and marital status, appear to have an equally strong influence on accident occurrence. Further studies are needed to 1) document the role of IDDM in accidents among representative samples of the IDDM population and 2) properly evaluate the licensing restrictions recommended for diabetic drivers.
Regulation of human B cell activation by prostaglandin E2. Suppression of the generation of immunoglobulin-secreting cells.
Authors: D F Jelinek, P A Thompson, P E Lipsky
Journal: Journal of Clinical Investigation (1985)

The role of prostaglandin E2 (PGE2) in the generation of immunoglobulin-secreting cells (ISC) from human peripheral blood B cells was examined. Initial studies demonstrated that monocyte (M phi)-mediated suppression of the generation of ISC in Staphylococcus aureus (SA)-stimulated cultures was mitigated by indomethacin, and thus suggested that the cyclooxygenase pathway products of arachidonic acid played a role in the regulation of B cell activation. The possibility that PGE2, one of the major products of this pathway generated by M phi-affected human B cell responses, was therefore investigated. PGE2 was found to cause concentration-dependent inhibition of the generation of ISC in pokeweed mitogen- or SA-stimulated B cell cultures supported by T cells. Studies were therefore carried out to determine whether PGE2 inhibited the production of necessary T cell factors or directly altered B cell responsiveness. Initially, the effect of PGE2 on the capacity of mitogen-stimulated cells to secrete a factor that supported the differentiation of B cells into ISC was investigated. Excessive numbers of M phi or PGE2 inhibited the production of B cell differentiation factor from mitogen-stimulated T cells. The effect of PGE2 on the capacity of B cells to differentiate into ISC was more complex. PGE2 inhibited the generation of ISC when B cells were stimulated with SA and B cell differentiation factor-containing T cell supernatants. PGE2-mediated inhibition of ISC generation was observed even when addition of PGE2 was delayed until after ISC first were detected in culture. By contrast, PGE2 caused only minimal inhibition of the generation of ISC cultures stimulated by T cell supernatants alone or protein A-free SA and T cell supernatants. These results suggested that SA-responsive B cells were particularly sensitive to inhibition by PGE2. Additional experiments supported the conclusion that B cell sensitivity to inhibition by PGE2 is augmented by the immunoglobulin cross-linking effects of protein A-containing SA. Overall, the results support the conclusion that PGE2 at physiologically relevant concentrations can influence human antibody responses by means of a direct inhibitory action on the responding B cell or an indirect one on the production of necessary T cell factors.
Topical tretinoin: its use in daily practice to reverse photoageing
Authors: M. T. GOLDFARB, C. N. ELLIS, J. J. VOORHEES
Journal: British Journal of Dermatology (1990)

The effect of 0.1% tretinoin cream for the treatment of photoageing was studied in a double-blind, placebo-controlled trial. All patients applied tretinoin cream to one forearm and the vehicle cream to the other, and half of the patients also applied tretinoin cream to the face and the other half used the vehicle cream. Tretinoin treatment produced an improvement in the signs of extrinsic ageing conipared with the vehicle-treated areas. Fine wrinkling was improved most, although coarse wrinkling, brown spots, tactile roughness and overall skin colour also showed clear improvement. The majority of lentigines and sun-induced freckles showed some reduction in coloration with extended treatment. It is important when using tretinoin that the treatment procedure is carefully explained to the patients and that they are warned about a retinoid reaction. It should be stressed that improvement is gradual and that regular application of the cream must continue even after improvement has been achieved. Patients should be assured that there is no evidence of carcinogenicity in humans. Although no teratogenic effects of tretinoin have been reported when applied topically, it is not advisable to use the cream when trying to conceive or when pregnant.
S6. Proffered paper: Anti-tumour immunomodulatory activity of heat shock protein Hsp70 in therapy of malignant brain tumours: preclinical and clinical data
Authors: M Shevtsov, A Kim, W Khachatryan, A Pozdnyakov, I Romanova, I Guzhova, B Margulis
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Immunotherapy provides a specific anti-tumour activity with minimal side effects and thus could be used in treatment of malignant brain tumours. Molecular chaperone Hsp70 is well known for its ability to stimulate innate and adaptive anti-cancer immune response. In in vivo studies
An Imposter Is a Tax Assessor
Authors: Samuel W. Joel
Journal: JAMA (1977)

<h3>To the Editor.—</h3> In the letters titled "The Great Imposter" (236:1846, 1976), should not the spelling be<i>impostor?</i>Would not a better word be<i>simulator</i>, since impostor refers to a person and not a thing?
Complete Stenosis of Common Bile Duct: Operative Cure
Authors: F. Sinclair
Journal: BMJ (1941)

MEDIUTRISNAL 229muscularly, intravenously, or by both routes, and the imme- diate institution of intratracheal insufflation with oxygen.No anaesthetist should approach a young and febrile patient unless he has the means and the ability to adopt these measures at a moment's notice.Boumemouth. S.
HIF-1 : a master regulator of innate host defenses?
Authors: K. A. Zarember
Journal: Journal of Clinical Investigation (2005)

In the days following infection, when the human body develops and refines antibodies and prepares to mount an adaptive immune response, the bulwark of innate host defense against microbial infection is the polymorphonuclear leukocyte (PMN). PMNs seek out, identify, engulf, and sterilize invading microbes using both O2-dependent and O2-independent antimicrobial systems. A decrease in PMN numbers or function caused by immunosuppression or disease increases the risk of infection. In this issue of the JCI, Peyssonnaux et al. identify a novel and essential role for hypoxia-inducible factor–1α in regulating several important PMN functions relevant to host defense, including transcription of cationic antimicrobial polypeptides and induction of NO synthase.
GENETIC FACTORS CONTROLLING ANTI-SHEEP ERYTHROCYTE ANTIBODY RESPONSE AND IMMUNOGLOBULIN SYNTHESIS IN BACKCROSS AND F2 PROGENY OF MICE GENETICALLY SELECTED FOR "HIGH" OR "LOW" ANTIBODY SYNTHESIS
Authors: R. Lieberman, C. Stiffel, R. Asofsky, D. Mouton, G. Biozzi, B. Benacerraf
Journal: The Journal of Experimental Medicine (1972)

Agglutinin responses to sheep erythrocytes and immunoglobulin heavy chain phenotypes determined in F1, F2, and backcross progeny of mice genetically selected for high and low antibody synthesis indicated that an immune response gene for sheep erythrocytes is linked to the immunoglobulin heavy chain allotype. Mice homozygous for the phenotype of the high line had significantly higher titers than mice homozygous for the phenotype of the low line. An association was also observed in some progeny of the backcross of the F1 generation with the low line. However, the control of the immune response was clearly multigenic since heterozygous mice of the same phenotype (2/3, 5) resulting from the two backcrosses (high and low) had very different immune responses. Immunoglobulin levels in the same progeny showed no linkage to the immunoglobulin allotype but a rather simple pattern of inheritance.
PMO-089 Preoperative neutrophil: lymphocyte ratio is not a predictor of outcome following hepatic resection for colorectal metastases
Authors: C E Western, M Wiggans, S Aroori, M Bowles, D Stell
Journal: Gut (2012)

<h3>Introduction</h3> A high pre-operative neutrophil:lymphocyte ratio (NLR) has been shown in several studies to be associated with shorter disease-free and overall survival for a number of malignancies, including colorectal<sup>1</sup> and both primary<sup>2</sup> and secondary<sup>3</sup> liver tumours. This may reflect reduced lymphocyte function, so impaired host response or neutrophil-mediated angiogenesis enhancing tumour spread and has been proposed as a prognostic predictor.<sup>1–3</sup> We aimed to test this association by analysing pre-operative NLR in all patients undergoing liver resection for colorectal metastases (CRM) and attempting correlation with tumour recurrence, overall and disease-free survival. <h3>Methods</h3> Our unit is a tertiary referral centre for both laparoscopic and open hepatic surgery. A prospectively collected database of demographic details, radiological and histological findings and blood test results has been maintained since July 2005 and this data has been retrospectively analysed to demonstrate potential associations with NLR. An NLR &gt;5 was considered raised. <h3>Results</h3> Between 15 July 2005 and 10 January 2012 247 hepatic resections were undertaken for CRM. Median age at surgery was 67 (range 33–91) and 64% were male. Overall median survival was 1818 days and overall median disease-free survival was 542 days. 125/247 (51%) CRM developed recurrent disease within the follow-up period. Follow-up ranged from 10 days to 5.9 years (median 20 months). 30 patients had a NLR &gt;5. When Kaplan–Meier analysis was performed to compare median survival in those with a low vs a high NLR, it was seen that there was no significant difference between the two groups (p=0.81). There was also found to be no association between NLR and tumour recurrence (p=0.49) or time to recurrence (p=0.77). <h3>Conclusion</h3> Contrary to previously published studies, our unit has not demonstrated an association between pre-operative NLR and tumour recurrence or survival in patients undergoing liver resection for CRM and suggests that this is not a useful prognostic indicator in this group of patients. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>Hung HY</b>, Chen JS, Yeh CY, <i>et al.</i> Effect of preoperative neutrophil–lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy. <i>Int J Colorectal Dis</i> 2011;<b>26</b>:1059–65. 2. <b>Gomez D</b>, Farid S, Malik HZ, <i>et al.</i> Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. <i>World J Surg</i> 2008;<b>32</b>:1757–62. 3. <b>Halazun KJ</b>, Aldoori A, Malik HZ, <i>et al.</i> Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. <i>Eur J Surg Oncol</i> 2008;<b>34</b>:55–60.
Reversal of non-Addisonian achlorhydria by a Roux-en-Y loop.
Authors: W M Capper, T J Butler, J O Kilby
Journal: Gut (1967)

EDITORIAL COMMENT A patient with symptomatic achlorhydria has shown some improvement and some increase in acid secretion following excision of the pylorus and distal antrum followed by gastro-jejunal anastomosis using a Roux-en-Y loop.
Missing notes mean case is postponed against doctor arrested during transit in United Arab Emirates
Authors: S. Arie
Journal: BMJ (2012)

The hopes of freedom for Cyril Karabus, a South African paediatric haematologist accused of the manslaughter of a patient he treated in the United Arab Emirates 10 years ago, were dashed again on 20 November when a court postponed a hearing because of missing evidence.

Karabus, who is 77 years old and semi-retired, was detained as he travelled through the UAE in August and learnt that he had been convicted in his absence in 2003 for the death of a 3 year old girl who died from leukaemia while in his care.1 He is accused of failing to administer a crucial blood transfusion to the patient he treated while on …
Management of the Severely Anemic Patient Who Refuses Transfusion: Lessons Learned during the Care of a Jehovah's Witness
Authors: Marianne Culkin Mann, John Votto, Joseph Kambe, Michael J. McNamee
Journal: Annals of Internal Medicine (1992)

▪ Objective: To present the case of a Jehovah's Witness with severe anemia and to review the religious philosophy of such patients, the ethical and medicolegal aspects of their care, and the therapeutic options available to clinicians. ▪ Data Sources: A MEDLINE literature search (1980 to 1992) identified most studies. Other studies were selected from the bibliographies of identified articles. ▪ Study Selection: Selection of articles was limited to the history, philosophy, medicolegal and ethical issues, and clinical management of anemic Jehovah's Witnesses; a recent article on recommendations for red cell transfusion was also reviewed. ▪ Conclusions: A clear understanding of the philosophy of the Jehovah's Witnesses regarding blood transfusion and of the medicolegal and ethical aspects of their care is essential to clinicians who care for such patients. One must also be aware of the many alternative therapeutic options that can maximize oxygen delivery and minimize oxygen consumption. The insights gained from this review are applicable to any severely anemic patient who refuses blood transfusion.