tbuckley/cabot-search huggingface dataset:
Inadvertent Misconnection of Medical Tubing: Protective Incompatibility
Authors: Leon Katz
Journal: JAMA (1986)

<h3>To the Editor.—</h3> In a recent CASE REPORT, Sperry and Smialek<sup>1</sup>emphasized the importance of thorough investigation of device-related hospital incidents to identify their causes and prevent recurrence. The particular incident they investigated and solved concerned the inadvertent misconnection of an enteral feeding supply line to the inflation port of a tracheostomy cuff. This fatal incident was not unprecedented. Four years earlier, Priem et al<sup>2</sup>reported a remarkably similar incident in which the same devices had been confused and misconnected. Several months ago, the Emergency Care Research Institute<sup>3</sup>published details of another such incident and made a number of important recommendations to prevent recurrence. The publication of three separate fatal misconnections of these widely used devices leads us to suspect a much larger incidence of this misadventure. Furthermore, at least three additional related incidents have been documented.<sup>4,5</sup> Many of the causes for these incidents are now
Nature of Hyperacute (Accelerated Second Set) Rejection in Dog Renal Allographs and Effects of Heparin on Rejection Process
Authors: A. H. Amery, G. D. Pegrum, R. A. Risdon, G. Williams
Journal: BMJ (1973)

Renal allografts were exchanged between unrelated mongrel dogs after previous sensitization with skin and kidney grafts from the same donors. Rapid rejection of the renal allografts was associated with the accumulation of platelets and leucocytes in the peritubular and glomerular capillaries but fibrin deposition was not demonstrated.Heparin infusion delayed but did not prevent the rejection process.
On Not Being Her Doctor
Authors: Mary Bascom Migeon
Journal: Annals of Internal Medicine (2013)

On Being a DoctorJuly 16, 2013On Not Being Her DoctorMary Bascom Migeon, MDMary Bascom Migeon, MDFrom University of Washington, Seattle, Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-2-201307160-00015 Audio Reading - “On Not Being Her Doctor” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "On Not Being Her Doctor," by M.G. Migeon. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail She looked made of bones and paper. Years of smoking had left her lungs mottled and now cancerous. Even a few sentences left her breathing like an angry fledging lost from its nest.She was not like this when we first met, years ago. She was healthy and intelligent and had a smoker's cough that was not strong enough to help her quit smoking. Even then in the beginning, when the future was theoretical, she asked that when the time came, when her time came, would I help her? This request was always accompanied with an intent look.I always ... Author, Article, and Disclosure InformationAffiliations: From University of Washington, Seattle, Washington.Corresponding Author: Mary Bascom Migeon, MD, General Internal Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356429, Seattle, WA 98195. PreviousarticleNextarticle Advertisement Audio Reading - “On Not Being Her Doctor” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "On Not Being Her Doctor," by M.G. Migeon. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics July 16, 2013Volume 159, Issue 2Page: 153-154KeywordsBoneBreathingChocolateConsciousnessDyspneaEmotionsFallsForecastingLungsNursesOpiatesSportsSub-specialty care ePublished: 16 July 2013 Issue Published: July 16, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CHANGES IN THE FACIAL BONES DUE TO ADENOIDS.
Authors: A. T. MITCHELL
Journal: JAMA (1901)

The enormous amount of literature on the subject of lymphatic growths in the nasopharynx that our medical journals have been publishing lately is certainly presumptive evidence that the matter has been well sifted from a clinical point of view. It has, but only in consideration of the effects of the condition on children, under 15 generally. In these cases the assertions of Meyer of Copenhagen, thirty years since, have been thoroughly worked out. The definite connection between habitual mouth-breathing, and mental as well as physical development, has been established. The peculiar characteristic departure from the composite type of human skulls shown by those who throughout life have had functionless noses is also defined, and as this essay hopes to show, logically. The bones whose part is the greatest in this change are those making up the hard palate. From the gently rounded curve of the roof of the mouth, that
Letter: Treatment of giardiasis.
Authors: E Green, D M Lynch, J A McFadzean, I M Pugh
Journal: BMJ (1974)

or, unless the doctor is a 'person about the deceased' (see iv)), to the coroner."It is regrettable that there is no authoritative definition of the vague and archaic phrase "person about the deceased," but it seems likely that it must mean someone, such as next of kin, who is in close daily contact with the patient before death.The doctor may be the ,ppropriate person, or the only such person in certain circumstances.It would be unfortunate if Dr.
Acute lung injury in fulminant hepatic failure following paracetamol poisoning.
Authors: S V Baudouin, P Howdle, J G O'Grady, N R Webster
Journal: Thorax (1995)

There is little information on the incidence of acute lung injury or changes in the pulmonary circulation in acute liver failure. The aim of this study was to record the incidence of acute lung injury in fulminant hepatic failure caused by paracetamol poisoning, to document the associated pulmonary circulatory changes, and to assess the impact of lung injury on patient outcome.The degree of lung injury was retrospectively assessed by a standard scoring system (modified from Murray) in all patients with fulminant hepatic failure caused by paracetamol poisoning, admitted to the intensive care unit over a one year period. The severity of liver failure and illness, other organ system failure, and patient outcome were also analysed.Twenty four patients with paracetamol-induced liver failure were admitted and nine developed lung injury of whom eight (33%) had severe injury (Murray score > 2.5). In two patients hypoxaemia contributed to death. Patients with lung injury had higher median encephalopathy grades (4 v 2 in the non-injured group) and APACHE II scores (29 v 16). Circulatory failure, requiring vasoconstrictor support, occurred in all patients with lung injury but in only 40% of those without. Cerebral oedema, as detected by abnormal rises in intracranial pressure, also occurred in all patients with lung injury but in only 27% of the non-injured patients. The incidence of renal failure requiring renal replacement therapy was similar in both groups (67% and 47%). Pulmonary artery occlusion pressures were normal in the lung injury group. Cardiac output was high (median 11.2 1/min), systemic vascular resistance low (median 503 dynes/s/cm-5), and pulmonary vascular resistance low (median 70 dynes/s/cm-5), but not significantly different from the group without lung injury. Mortality was much higher in the lung injury group than in the non-injured group (89% v 13%).Acute lung injury was common in patients with paracetamol-induced fulminant hepatic failure and was associated with systemic circulatory failure and cerebral oedema. The development of acute lung injury was associated with high mortality.
1264 Changes of agglutinin-reactive alpha-fetoprotein (AFP-L3 fraction) after complete radiofrequency ablation for hepatocellular carcinoma: analysis of 186 patients
Authors: C OGAWA, Y MINAMI, H CHUNG, R NAKAOKA, S MATSUI, T FUKUNAGA, M KITANO, T KAWASAKI, M SHIOMI, M KUDO
Journal: Hepatology (2003)
SC-32 * TARGETING PROLIFERATION AND INVASION IN GLIOBLASTOMA VIA MITOTIC KINESINS
Authors: M. Venere, J. Crish, Q. Wu, C. Horbinski, J. Rich, S. Rosenfeld
Journal: Neuro-Oncology (2014)

The nearly universal tumor recurrence seen in glioblastoma is driven by a myriad of factors including the invasive nature of the disease and a cellular heterogeneity that includes a more treatment resistant population termed glioblastoma stem cells (GSCs). In an effort to identify novel therapeutic targets for GBM with potential efficacy against the GSC sub-population, we queried the mRNA levels of mitotic regulators between GSCs and the neoplastic cells without stem cell characteristic, or non-GSCs. One target, the mitotic kinesin, Eg5, was consistently elevated in GSCs on both the mRNA and protein levels with increased expression correlated with higher-grade glioma and poor prognosis. Highly specific inhibitors of Eg5 are available and several have moved to phase I and II clinical trials in patients with solid malignancies. We found that GSCs exhibited a greater sensitivity to the Eg5 inhibitor ispinesib compared to non-GSCs from the same tumor and that inhibition of Eg5 compromised the key stem cell characteristics of self-renewal and tumor initiation. Using an orthotopic xenograft model, we demonstrated the first in vivo evidence for efficacy of Eg5 inhibition on glioblastoma tumor progression. An unexpected impact on invasion was observed following Eg5 inhibition resulting in the identification of a hitherto unappreciated role for Eg5 outside of cellular proliferation. We therefore propose that Eg5 inhibitors hold promise in preventing treatment resistance and recurrence in GBM and may provide a novel therapeutic target for GSCs.
Devising a course for overseas visitors who don't speak English well.
Authors: B B Seedhom, J E Smeathers, D T Thompson
Journal: BMJ (1985)

Running a residential course requires thorough planning.This is particularly so when the delegates are from a country where the first language is not English.A group from the rheumatism research unit in Leeds recently ran such a course.The subject was biomechanics, particularly of the knee, and the audience was a group of orthopaedic surgeons from Japan who visited this country for 12 days.The need for such a course had been firmly identified, and it was seen as an opportunity to form links between us and the medical profession in Japan while raising funds for the unit.This paper describes the problems we identified, the strategies we adopted, and our successes (and failures) in presenting this particular course. Aims of the coursePersuading a group of professionals to devote considerable time and money to a course requires that a definite need for the course has been established.In our case this was identified in a paper describing the state of biomechanical research in orthopaedics in Japan.The paper was based on a questionnaire sent to medical schools in Japan with orthopaedic depart- ments.One of the conclusions was that "the majority of (Japanese) orthopaedists involved in bioengineering research feel the lack of engineer- ing knowledge and technique and have a desire to gain such knowledge."We decided that a short, intensive bioengineering course on a subject of mutual interest would be attractive to Japanese surgeons.The aims of the course must be clearly identified, and all organisers must be aware of them.It is best to start with organisational aims-namely, why and how you intend to run the course-and work down to the specific educational aims.These should be written down and circulated for discussion.Some members of the team may well disagree with the aims.If this cannot be overcome by discussion they may decide not to contribute.This can be disappointing, but it is far better to find out at this stage than to produce, after days of preparation, material that is inconsistent.The aims of the bioengineering course were split into two groups.The organisational aims were: to form links with the orthopaedic profession in Japan; to raise funds for the research unit; and to provide an attrac- tive package comprising both technical education and recreation.The educational aims were: to ensure that the participants left with a working knowledge of the fundamentals of engineering mechanics and materials science on which orthopaedic biomechanics is based; to provide an insight into the way engineers in general, and bioengineers in particular, approach a problem; to provide a series of lectures on a particular topic of bioengineer- ing to illustrate this; and to make the surgeons aware of the work in progress in the major centres of bioengineering in Great Britain.
THE CARE OF CRIPPLED CHILDREN
Authors: G. R. Girdlestone
Journal: BMJ (1920)

JOUWA 69.r M ~~~~THx BRITTEs 5.The need-in view of acidosis being a probable etiological 'factor in epileptic states-for careful in- vestigation, and the probabilitv tlhat, if suclh is tlhe case, efficient alkaline treatment may cure the condi- tion if recognized at the onset of the fits.Thie giving of bromides wvould seem to be dangerous in suclh a state, as it only tends to dull cellular activities; later on it may be of use in treating nerve cells which have acquired vicious habits.6.The danger to the patient in not adoptina a firm attitude.If such cases are at once sent to hospital before serious m-ental symptoms come on there would soon be marked diminution in tlle admission rate at asyluims.7. The predisposition to microbic diseases afforded by acidosis, above all to tuberculosis.As reaardschildren, there are qtuestious wlicih can best be answered by the general practitioner; for instance: Wlhat is the relationship betwcen " biliousness" in cliildlrenanid subsequent tuberculosis ?Are the sexes equally subject to acidosis?Does it tlhrow any liglit on the greater mortality of nale children?Witlh regard to tuberculosis:Is it a question of' the optimum reaction of the medium necessary for the growtlh of tlie tubercle bacillus ?In otlher words, do certain individuals, as a result of errors of nutrition or-faulty cell metabolism, offer a more favourable pulmonary or lymplhatic culture medium for the growthf of the tuberclc bacillus than do otliers?Finially, is this wlhole question of acidosis, wi-tlhin limits, at the bottom of wlhat we understalnd by lheredity in respect to disease processes ?Is it an effort on the part of tile organisim, to autolyze itself ?All these questions are of extraordinary interest, and 'the wholei subject may bring us vastly nearer a proper comprehension of certaini processes whbiclh up to the present have been shrouded in mystery.
Commentary: A Selective Historical Review of Congener-Specific Human Tissue Measurements as Sensitive and Specific Biomarkers of Exposure to Dioxins and Related Compounds
Authors: Arnold Schecter
Journal: Environmental Health Perspectives (1998)

Estimating internal exposure or dose of dioxins and related chemicals such as dibenzofurans and dioxinlike polychlorinated biphenyls is relatively straightforward in laboratory animals because a known dose is given and the amount absorbed can be measured. In wildlife, direct tissue measurement and measurement of environmental samples have both recently been used to estimate exposure. Until recently, human studies used only indirect indicators such as skin lesions to qualitatively estimate exposure to these chlorinated organic compounds. Environmental measurements have also sometimes been used to estimate human exposure. Dioxins in human tissue were not measured until the 1970s, when 2,3,7,8-tetrachlorodibenzo-p-dioxin was measured in mothers' milk; congener-specific measurement of dioxins and dibenzofurans in tissues (blood, milk, and adipose tissue) of the general population and exposed workers was first performed in the United States in the 1980s. Measurement in a sensitive and specific fashion of the 17 toxic dioxin and dibenzofuran congeners currently found in human tissue from industrial countries began in the 1980s. The use of known chemical standards, capillary columns, high resolution gas chromatography and mass spectrometry (GC-MS) has now become relatively common. GC-MS analysis of blood is currently accepted as the gold standard for estimating human exposure to dioxins. However, analyses are still costly and time consuming, and worldwide there are few qualified laboratories. There is currently a lack of knowledge concerning kinetics at higher and lower exposure levels for most of the toxic dioxin congeners and of levels in target tissues of concern.
Helper or cytolytic functions can be selectively induced in bifunctional T cell clones.
Authors: A Eljaafari, C Vaquero, J L Teillaud, G Bismuth, C Hivroz, I Dorval, A Bernard, G Sterkers
Journal: The Journal of Experimental Medicine (1990)

By using bifunctional T cell populations, we have shown in this report that elicitation of helper versus cytolytic function depends on the stimulatory signal at the membrane. Interestingly enough, the transduction of these signals is likely to be achieved via different metabolic pathways. Thus, helper function is associated with intracellular Ca2+ mobilization and PLC activation, while cytolysis can occur even in the absence of detectable levels of these second messengers. These results indicate that selective activation through the same membrane-transducing molecule may orientate T cell function through qualitatively or quantitatively different second messengers. This would be an important part of immune regulation.
VEGF-Targeted Therapy Stably Modulates the Glycolytic Phenotype of Tumor Cells
Authors: Matteo Curtarello, Elisabetta Zulato, Giorgia Nardo, Silvia Valtorta, Giulia Guzzo, Elisabetta Rossi, Giovanni Esposito, Aichi Msaki, Anna Pastò, Andrea Rasola, Luca Persano, Francesco Ciccarese, Roberta Bertorelle, Sergio Todde, Mario Plebani, Henrike Schroer, Stefan Walenta, Wolfgang Mueller-Klieser, Alberto Amadori, Rosa Maria Moresco, Stefano Indraccolo
Journal: Cancer Research (2014)

Anti-VEGF therapy perturbs tumor metabolism, severely impairing oxygen, glucose, and ATP levels. In this study, we investigated the effects of anti-VEGF therapy in multiple experimental tumor models that differ in their glycolytic phenotypes to gain insights into optimal modulation of the metabolic features of this therapy. Prolonged treatments induced vascular regression and necrosis in tumor xenograft models, with highly glycolytic tumors becoming treatment resistant more rapidly than poorly glycolytic tumors. By PET imaging, prolonged treatments yielded an increase in both hypoxic and proliferative regions of tumors. A selection for highly glycolytic cells was noted and this metabolic shift was stable and associated with increased tumor aggressiveness and resistance to VEGF blockade in serially transplanted mice. Our results support the hypothesis that the highly glycolytic phenotype of tumor cells studied in xenograft models, either primary or secondary, is a cell-autonomous trait conferring resistance to VEGF blockade. The finding that metabolic traits of tumors can be selected by antiangiogenic therapy suggests insights into the evolutionary dynamics of tumor metabolism.
Purification and partial characterization of a megakaryocyte colony-stimulating factor from human plasma.
Authors: R Hoffman, H H Yang, E Bruno, J E Straneva
Journal: Journal of Clinical Investigation (1985)

Human plasma obtained from patients with hypomegakaryocytic thrombocytopenia contains a factor that promotes megakaryocyte colony formation by normal human marrow cells. This megakaryocyte colony-stimulating factor was purified from such a plasma specimen. A four-step purification scheme which included ammonium sulfate precipitation, diethylaminoethyl-Sepharose chromatography, affinity chromatography on wheat germ lectin-Sepharose 6MB, and reverse-phase high performance liquid chromatography resulted in a recovery of 16.6% of the initial biological activity and an increase in specific activity by 3,489-fold. The purified protein produced a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Purified megakaryocyte colony-stimulating factor was capable of promoting megakaryocyte colony formation at a concentration of 7.6 X 10(-8) M. Megakaryocyte colony-stimulating factor was shown to be a glycoprotein and had an apparent 46,000 mol wt. Deglycosylation of megakaryocyte colony-stimulating factor by treatment with trifluoromethane-sulfonate resulted in the loss of its ability to promote megakaryocyte colony formation. Megakaryocyte colony-stimulating factor appears to be an important regulator of in vitro human megakaryocytopoiesis at the level of the colony-forming unit megakaryocyte and may be of importance physiologically.
Book: Disease-Mongers: How Doctors, Drug Companies, and Insurers are Making You Feel Sick
Authors: R. Moynihan
Journal: BMJ (2002)

This title is now only available direct from the USA. See www.wiley.com Rating: ![Graphic][1]</img> Lynn Payer's Disease-Mongers is passionate, provocative, and prescient. The book's thesis is simple, compelling, and for many people utterly counter-intuitive: doctors, drug companies, and device manufacturers are engaged in “broadening the definitions of diseases” in order to increase demand for their products and services. Since the book was first published in 1992, the evidence has mounted that Payer's disturbing view of the medical establishment is all too accurate. Payer quickly establishes her argument that the boundaries of disease are fluid, and that there are too many vested … [1]: /embed/inline-graphic-1.gif
Long-term outcomes of positive fluorescence in situ hybridization tests in primary sclerosing cholangitis
Authors: Sanjay Y. Bangarulingam, Einar Bjornsson, Felicity Enders, Emily G. Barr Fritcher, Gregory Gores, Kevin C. Halling, Keith D. Lindor
Journal: Hepatology (2009)

Patients with primary sclerosing cholangitis (PSC) are at increased risk for developing cholangiocarcinoma (CCA). Fluorescence in situ hybridization (FISH) is a cytological test designed to enhance early CCA diagnosis. The long-term outcome of PSC patients with a positive FISH test (polysomy, trisomy/tetrasomy) are unclear. All PSC patients with at least one FISH test were identified and defined to have CCA if they had a positive tissue biopsy, positive cytology, or evidence of cancer in the explant after liver transplantation. A total of 235 PSC patients had at least one FISH test performed, and 56 patients had CCA on histopathology (n = 35) or cytology (n = 21). Overall, 120 of 235 (51%) of PSC patients tested for FISH were positive, but only one third of these positive patients had CCA. Sensitivity and specificity for FISH polysomy were 46% and 88%, and for trisomy/tetrasomy they were 25% and 67%, respectively. Survival analysis showed that patients with FISH polysomy had an outcome similar to patients with CCA; whereas FISH trisomy/tetrasomy patients had an outcome similar to patients with negative FISH tests. The FISH polysomy patients without cancer compared with those with CCA had lower serum bilirubin, lower carbohydrate antigen 19-9 (CA 19-9), lower Mayo risk score, and lower occurrence of dominant strictures.In PSC patients, the presence of a dominant stricture plus FISH polysomy has a specificity of 88% for CCA. Patients with FISH showing trisomy or tetrasomy have a similar outcome to patients with negative FISH. FISH testing should be used selectively in patients with other signs indicating CCA and not as a screening tool in all PSC patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).