tbuckley/cabot-search huggingface dataset:
Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up?
Authors: Dong Heun Lee
Journal: Annals of Internal Medicine (2009)

Letters6 January 2009Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up?Dong Heun Lee, MDDong Heun Lee, MDFrom Drexel University College of Medicine, Philadelphia, PA 19102.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-1-200901060-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I was delighted to read the article by Schuster and colleagues (1) on the empirical use of fluconazole in critically ill patients in the intensive care unit (ICU). Although there was an 8-year delay between the completion and publication of the study, it is an excellent example of how a “negative” study still provides valuable data on making empirical antifungal treatment decisions in critically ill patients in the ICU. However, one needs to consider this 8-year gap and place it in the context of practicing medicine in 2008. First, I disagree with the authors' statement that “yield ...References1. Schuster MG, Edwards JE, Sobel JD, Darouiche RO, Karchmer AW, Hadley S, et al. Empirical fluconazole versus placebo for intensive care unit patients: a randomized trial. Ann Intern Med. 2008;149:83-90. [PMID: 18626047] LinkGoogle Scholar2. Horvath LL, George BJ, Hospenthal DR. Detection of fifteen species of Candida in an automated blood culture system. J Clin Microbiol. 2007;45:3062-4. [PMID: 17626176] CrossrefMedlineGoogle Scholar3. Trick WE, Fridkin SK, Edwards JR, Hajjeh RA, Gaynes RP. National Nosocomial Infections Surveillance System Hospitals. Secular trend of hospital-acquired candidemia among intensive care unit patients in the United States during 1989-1999. Clin Infect Dis. 2002;35:627-30. [PMID: 12173140] Google Scholar Author, Article, and Disclosure InformationAffiliations: From Drexel University College of Medicine, Philadelphia, PA 19102.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEmpirical Fluconazole versus Placebo for Intensive Care Unit Patients Mindy G. Schuster , John E. Edwards Jr. , Jack D. Sobel , Rabih O. Darouiche , Adolf W. Karchmer , Susan Hadley , Gus Slotman , Helene Panzer , Pinaki Biswas , and John H. Rex Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up? Mindy Schuster , Helene Panzer , and John Edwards Empirical Use of Fluconazole in Critically Ill Patients: Good Study, but What Was the Hold-up? Samuel A. Shelburne Metrics 6 January 2009Volume 150, Issue 1Page: 59KeywordsAntifungalsBloodCandidaConflicts of interestDecision makingDrugsIntensive care units ePublished: 6 January 2009 Issue Published: 6 January 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
'Catch-22s' for Family Physician Educators
Authors: Bruce F. Currie
Journal: JAMA (1981)

FEDERAL and state funds being channeled into the training of family physicians have created a dilemma for many medical school administrators: how to adapt their institutional missions to changing specialty needs without threatening established clinical departments. Conversely, the ambivalence of some university administrators about incorporating a generalist department has created a dilemma for family physician educators in those institutions: how to achieve first-class citizenship without being co-opted by the emphasis on subspecialization. The "catch-22s" for medical schools and new departments of family medicine have some of their origins in the "town-gown" dissension that has often divided private practice physicians from their full-time faculty counterparts in university communities. Because a premium is placed on highly differentiated information in academia, medical school faculties are inclined to question the scholarly value of a discipline like family medicine with its integrative rather than elaborative emphasis.<sup>1</sup>Subspecialist faculty (particularly in internal medicine) also question
Chlamydia trachomatis as possible cause of peritonitis and perihepatitis in young women.
Authors: J W Muller-Schoop, S P Wang, J Munzinger, H U Schlapfer, M Knoblauch, R W Tammann
Journal: BMJ (1978)

Of 11 young women with acute peritonitis proved by laparoscopy, seven of whom also had perihepatitis, nine had serological evidence of recent infection with Chlamydia trachomatis; In five of these nine patients high antibody titres to chlamydiae were found without laboratory evidence of gonococcal infection, while the other four had evidence of simultaneous gonococcal infection. C trachomatis may play an important part in peritoneal inflammation previously attributed only to gonococci.
PHENOL POISONING FROM INK
Authors: Carey P. McCord
Journal: JAMA (1924)

E. M., a girl, aged 18, a shoe worker, was brought to us, July 10, with multiple second degree burns on her face, neck and breasts. The patient stated that her work was the numbering and lettering of pieces of leather used in the manufacture of shoes. In opening a bottle of the marking ink, she splashed a liberal quantity over her body. Water and a common alkali soap were used in an attempt to remove the ink stains. When seen by us, the patient, in addition to extensive burns over the major portion of her face, neck and chest, was depressed, weak and suffering from a headache, and presented an increased heart rate with a feeble pulse. Her condition of collapse was out of proportion to the extent of external injury. An odor of phenol (carbolic acid) was present on the patient's clothing, and it was established that this
Just another nightmare?
Authors: T Sheldon
Journal: BMJ (1994)

A man naked but for a few chicken feathers and riding a moped passes a car's headlights; the village of Oude Tongen wakes to discover a plague of headless chickens; a child's nightmare sequence, full of swirling smoke and bright lights pans chaotically through a cafe where naked adults wear only animal and clowns' masks and the barmaid blows marijuana smoke at the camera; and undercover agents wear absurd dark glasses and drive a bright blue 1960s DAF car. One asks the other in a southern American drawl “Is this Oude Tongen or just another nightmare?”

For the Dutch it could be both. Oude Tongen is …
Mild elevation of urinary biomarkers in prerenal acute kidney injury
Authors: Kent Doi, Daisuke Katagiri, Kousuke Negishi, Sho Hasegawa, Yoshifumi Hamasaki, Toshiro Fujita, Takehiro Matsubara, Takeshi Ishii, Naoki Yahagi, Takeshi Sugaya, Eisei Noiri
Journal: Kidney International (2012)
Remission of pure red cell aplasia in T-cell receptor γδ-large granular lymphocyte leukemia after therapy with low-dose alemtuzumab
Authors: C Schützinger, A Gaiger, R Thalhammer, M Vesely, R Fritsche-Polanz, I Schwarzinger, L Öhler, I Simonitsch-Klupp, F Reinhard, U Jäger
Journal: Leukemia (2005)
Expression of Gi-2α and Gsα in myofibroblasts localized to the infarct scar in heart failure due to myocardial infarction
Authors: D Peterson
Journal: Cardiovascular Research (1999)

Objective: Patients surviving large transmural myocardial infarction (MI) are at risk for congestive heart failure with attendant alteration of ventricular geometry and scar remodeling. Altered Gi-2α and Gsα protein expression may be involved in cardiac remodeling associated with heart failure, however their expression in scar tissue remains unclear. Methods: MI was produced in Sprague–Dawley rats by ligation of the left coronary artery. Gi-2α and Gsα protein concentration, localization and mRNA abundance were noted in surviving left ventricle remote to the infarct, in border and in scar tissues from 8 week post-MI hearts with moderate heart failure. Results: We observed a 4.5- and 5.0-fold increase in immunoreactive Gi-2α protein concentration occurs in the border and scar regions vs. control values, respectively, in 8-week post-MI rat hearts. Similarly, immunoreactive Gsα protein concentration was increased 3.4- and 8.2-fold, respectively, in these tissues vs. controls. Double-fluorescence labeling and phenotyping studies revealed that both Gi-2α and Gsα proteins were localized to myofibroblasts in the infarct scar and to viable myocytes bordering the scar. Northern analysis revealed that the Gi-2α/GAPDH ratio was increased in both viable and scar regions (1.24- and 1.85-fold respectively) from experimental hearts when compared to sham-operated control values when compared to noninfarcted left ventricle, the value of this ratio in scar tissue was elevated ∼1.5 fold. The Gsα/GAPDH ratio was significantly increased (1.28-fold) only in the scar region vs. control. Conclusion: Our results indicate a marked increase in the expression of Gi-2α and Gsα from myofibroblasts of the infarct scar as well as remnant myocytes bordering the scar in 8-week post-MI rat hearts. We suggest that these changes may be associated with ongoing remodeling in the infarct scar in chronic post-MI phase of this experimental model.
Another glossy flyer
Authors: J. O. Drife
Journal: BMJ (1996)

Parasitic Productions, in association with the National Association of Health Authorities and Trusts, invites you to its annual conference on the NHS. It is for opinion leaders, including non-executive board members like you–people who are moulding the NHS for the next millennium.

This month's annual conference is different from last month's annual conference, which was designed to facilitate medium term thinking in small Trusts. This one is designed to facilitate long term thinking in medium sized Trusts. It will also be relevant to large and small Trusts and to medium and short term strategic thinking.

You will hear outstanding speakers whose colour …
The Kiss of Death
Authors: Samuel Vaisrub
Journal: JAMA (1981)

"Ondine's curse," an eponym for apnea caused by loss of automatic control of respiration, owes its origin to the water nymph Ondine, whose mortal husband jilted her to marry a mortal woman. Angered by her husband's infidelity, Ondine cursed him with the loss of respiratory automaticity. As a result, totally dependent on voluntary respiratory movement, he died in his sleep. Before "Ondine's curse" becomes a household term, it is worthwhile to examine the clinical entity that the eponym represents, as well as its applicability to this entity. Ahmad et al<sup>1</sup>have recently reviewed the central alveolar hypoventilation syndrome. They restrict the use of "Ondine's curse" to the primary alveolar hypoventilation that results from a defect in the central chemoreceptor's responsiveness to carbon dioxide. The lungs and rib cage are normal, but the patient has hypercapnea and hypoxemia—both correctable by voluntary ventilation. Well defined as the restricted use of "Ondine's
CELLULAR RECOGNITION IN VITRO BY MOUSE LYMPHOCYTES
Authors: T. Takiguchi, W. H. Adler, R. T. Smith
Journal: The Journal of Experimental Medicine (1971)

The effects of thymectomy and thymus graft restoration upon the in vitro primary responses to alloantigens and PHA have been studied. It has been found that neonatal thymectomy substantially eliminates both PHA reactivity and responsiveness to alloantigens assayed in vitro in host spleen cell populations. Analysis of albumin density gradient-separated subpopulations of the spleen and thymus in such animals was also performed. It was found that the total and proportional representation of the individual density subpopulations was identical in neonatally thymectomized, in normal, and in thymectomized and thymus graft-restored animals. Therefore, thymectomized mice appear to retain a nonfunctioning, small, dense, lymphocyte population. Reconstitution of thymic-dependent in vitro reactivity was nearly complete when syngeneic, but not allogeneic or semisyngeneic thymus was employed. Occasional partial restoration did occur when F(1) thymus was employed, but never when allogeneic thymus was grafted. The grafted thymus contained PHA and alloantigen-reactive cells in a large, less dense B layer subpopulation, whereas the restored animals, as in the case of normals, showed these reactivities to be a property of a small, more dense cell population.
Spinulosis of the face as a manifestation of demodicidosis
Authors: None FariÑA, None Requena, None Sarasa, None MartÍN, None Escalonilla, None Soriano, None Grilli, None DE Castro
Journal: British Journal of Dermatology (1998)

Journal Article Spinulosis of the face as a manifestation of demodicidosis Get access M.C. FariÑA, M.C. FariÑA Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar L. Requena, L. Requena Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar J.L. Sarasa, J.L. Sarasa Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Avda. Reyes Católicos 2, 28040 Madrid, Spain Search for other works by this author on: Oxford Academic Google Scholar L. MartÍN, L. MartÍN Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar P. Escalonilla, P. Escalonilla Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar M.L. Soriano, M.L. Soriano Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar R. Grilli, R. Grilli Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar A. DE Castro A. DE Castro Departments of Dermatology, Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 138, Issue 5, 1 May 1998, Pages 901–903, https://doi.org/10.1046/j.1365-2133.1998.02234.x Published: 01 May 1998
SPLENIC ANEMIAREPORT AND DEMONSTRATION OF A CASE.
Authors: M. J. LICHTY
Journal: JAMA (1904)

Mrs. S., aged 32, who was referred to me last fall through the kindness of Dr. Rosenwasser, gives the following history: The family history, including that of uncles and aunts and grandparents, is negative. She was born and reared in this city; has never lived in a malarial district; has had no venereal disease and was a healthy girl, never having had any serious illness. She was married at 26, and has two healthy children. She has never had any miscarriages. In March, 1900, more than three years ago, she noticed that she was losing weight and strength, and that her feet and ankles were swollen. The abdomen also increased in size, and both the feet and abdomen were tender to touch. The menses became irregular, appearing at intervals of six weeks, or three and sometimes even five months. These symptoms continued more or less uniformly for more than two
The unit area trichogram in the assessment of androgen-dependent alopecia
Authors: H. RUSHTON, K.C. JAMES, C.H. MORTIMER
Journal: British Journal of Dermatology (1983)

The unit area trichogram was defined in the frontal and occipital areas of ten normal men and ten normal women and the results compared with the findings in ten male and fifteen female patients with androgenic alopecia. The epilation technique provided accurate data of normal hair density (higher than previously reported) and the phases of hair growth. The measurement of hair diameter showed that of 7603 hairs, 1241 were less than 40 microns in diameter, of which only 21 were more than 80 mm in length. Variation in the diameter of individual hair fibres was recorded. The number of hairs less than 40 microns diameter per cm2 of scalp was increased in both men and women with androgenic alopecia. It was concluded that the number of hairs greater than 40 microns in diameter per cm2 (meaningful density) reflected most closely the amount of hair usefully contributing to an individual's clinical appearance.
Antisense immunochemogene therapy composed of sirna targeting vegf-a165b mRNA, antivegfmab and txt inhibited vegf mediated desmoplastic response, angiogenesis and lymphangiogenesis inducing maturation of DCS, ADCC, CMC, autophagy and PCD in PDAC
Authors: J. Giannios
Journal: Gut (2011)

<h3>Introduction</h3> In pancreatic ductal adenocarcinoma, the desmoplastic response is predominant. VEGF-A165b causes resistance to bevacizumab. <h3>Methods</h3> We established a clinically relevant model of PDAC in animals by orthotopically inoculating human PDAC cells overexpressing VEGF-A165b and bcl-2. We treat the PDAC models with siRNA VEGF-A165b, termed as SEVINA-VI. We co-administer docetaxel. As control, we used only bevacizumab. <h3>Results</h3> Post-treatment, the RNAi induced by long dsRNA processed into 23 bp dsRNA by DICER has incorporated siRNA into RISC blocking VEGF-A165b mRNA. The formulation SEVINA-VI (under patent) allowed bevacizumab to inhibit VEGF-A blocking VEGFR-1, VEGFR2, angiogenesis and lymphangiogenesis reducing LYVE-1, Prox-1, podoplanin, 5-nucleotidase and LVD. Calcineurin and NFATc1 were blocked, inhibiting Csp1Ex4 and COX-2 and IL-1b. Inhibition of TAMs blocked production of MCP-1, IL-6 and RANTES. DC maturation produced IFN-γ inducing Th1, IL-2, CTL, cellular immunity, phosphorylation of STAT3, p38 and JNK. Also, DCs reduced CD1a/CD208 and with IKDC expressed S-100, CD83, CD86, CD80, Cd40, CCR7, and MHC-II inducing Teff, and Trg. In blood, there was enhancement of IL-1b, IL-6, IP-10, TNF-a and IL-12p70. Bevacizumab induced ADCC and CDC. Docetaxel phosphorylated bcl-2 at ser70 and released beclin1 in cytoplasm interacting with Vps34/Vps15. Autophagy or type II PCD was induced, where LC3II and ATG8 relocated to autophagosomes inhibiting PKCe, PI3K/AKT/mTOR and MAPK. Docetaxel by inhibiting bcl-2 blocks BAG1, TIMP3, AKT1, FAIM, BIM, PUMA, MEK/ERK, Mcl-1, NF-kB, FOXM1, TF and FVIIa circumventing Trousseau9s syndrome, and inhibition of type I PCD activating caspase 3, 8, 9 and PARP cleavage after inhibition of JAK/STAT5. Bevacizumab9s action was antagonised by VEGF-A165b in controls. <h3>Conclusion</h3> AICT formulation composed of antiVEGF-A165b siRNA (SEVINA-VI), anti-VEGF Mab (bevacizumab), and docetaxel would be a novel strategy against PDAC.
Be Not Afraid
Authors: Len M. Nichols
Journal: New England Journal of Medicine (2010)

Voters are angry and distrustful of Washington. Democrats have lost their nerve. Republicans, sensing weakness, are closing in for the kill. We have seen this health care reform horror movie before.Our leaders in Congress and the White House face a fateful fork in the road. They can follow the public's fear and confusion down the path of perpetual inaction. Or they can lead. They can let the confusion fester or they can leverage the support of health care innovators who can explain the benefits of reform to all. This movie can have a happier ending, one that is good . . .
Abuse of Propoxyphene
Authors: Nicholas L. Owen
Journal: JAMA (1971)

<h3>To the Editor.—</h3> With regard to the article by Kiplinger and Nickander on "Pharmacologic Basis for Use of Propoxyphene" (<b>216</b>:288, 1971), while I certainly agree propoxyphene is a useful and effective analgesic, I believe that their remarks regarding toxicity should not stand uncorrected. In the setting of a student health service where most of the patients are young and there is a high percentage of follow-up, we have found that between 5% and 10% of patients are adversely effected by propoxyphene. Their principal complaints are that it induces a "high" consisting of dizziness or floating or drunkenness which many of the students find quite objectionable. Therefore, they refuse to continue to administer the medication or to administer it on a second occasion. We have had to treat two students with tranquillizers for severe, druginduced, agitated states induced by propoxyphene. In addition, multiple communications with the Milwaukee vice squad have
Even “unconscious thought” is influenced by attentional mechanisms
Authors: Narayanan Srinivasan, Sumitava Mukherjee
Journal: Behavioral and Brain Sciences (2014)

Abstract In this commentary, we focus on the role of attentional mechanisms in unconscious thought. We argue that even distracted or unconscious thought is capacity limited and differences in scope of attention influence processing during unconscious thought. Attention also would influence processes at different stages in the proposed lens model. We conclude that there is a clear need to understand the role of attention to better understand conscious or unconscious thought.
Associations of blood group-related antigens to FEV1, wheezing, and asthma.
Authors: F Kauffmann, C Frette, Q T Pham, S Nafissi, J P Bertrand, R Oriol
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Discordant results have been observed regarding the associations of chronic obstructive pulmonary diseases with secretor, Lewis, and ABO histo-blood groups, which are defined by glycosyltransferases. These enzymes build up oligosaccharide structures that play a role in the adhesion of environmental factors to epithelial cells. The objectives of the present study were to assess the role of all three systems, Lewis (Le), salivary ABH secretor (Se), and red cell blood group ABO, on lung function, wheezing, and asthma in a cohort of 228 coal miners studied cross-sectionally, considering the potential modifying effect of environmental factors on these associations. Asthma was significantly related to nonsecretor phenotype. Significantly lower lung function and higher prevalences of wheezing and asthma were observed in Lewis-negative or nonsecretor subjects of blood group O. Very low lung function values were observed in the small group of Lewis-negative nonsecretors who lack both Le and Se controlled fucoses (1% of Caucasians). Lewis-positive, salivary ABH secretors who have these two fucoses represent 70% of Caucasians. Among these subjects, lower lung function was observed in blood group A, and in a lesser extent in blood group B, i.e., with terminal alpha GaINAc or alpha Gal respectively, than in blood group O subjects. ABO, Lewis, and secretor phenotypes did not account for the potential genetic heterogeneity of subjects toward smoking, but alcohol consumption appeared to exert a protective effect on lung function in Lewis-negative subjects (10% of Caucasians). If confirmed in other populations, the magnitude of the effects observed regarding low lung function in Lewis-negative ABH nonsecretors, and the protective effect of Lewis negative on the deleterious effect of alcohol, may be of clinical importance. Further studies of the combined effects of various histo-blood group genetic systems seem worthwhile, particularly for airflow limitation, wheezing, and asthma, possibly with reference to susceptibility to infectious agents.
Rupture of the Heart During Cardiac Massage
Authors: Charles H. Gutenkauf
Journal: JAMA (1961)

THIS CASE is reported because recovery after rupture of the heart during cardiac massage is rare, and only 2 other reported patients have survived after the heart has been seriously damaged by myocardial infarction. Hosler<sup>1</sup>mentions a case of recovery after rupture of a previously infarcted heart during cardiac massage. This occurred through a "paper thin" scar in the right ventricle. His cardiac failure was more pronounced afterward. Haight and Sloan<sup>2</sup>reported a patient with an old myocardial infarct, whose right ventricle ruptured during massage, which almost exactly parallels this one, except their patient survived for 3½ months, twice as long as the patient here reported. <h3>Report of a Case</h3> A 59-year-old man was hospitalized with an anterolateral myocardial infarction on July 19, 1956. Electrocardiograms revealed large Q waves in I, aVL, V5, and V6, and progressive T wave changes. His sedimentation rate (Wintrobe) increased from 20 mm.