tbuckley/cabot-search huggingface dataset:
Analysis of Missed Cases of Abusive Head Trauma
Authors: Carole Jenny
Journal: JAMA (1999)

Context Abusive head trauma (AHT) is a dangerous form of child abuse that can be difficult to diagnose in young children.Objectives To determine how frequently AHT was previously missed by physicians in a group of abused children with head injuries and to determine factors associated with the unrecognized diagnosis.Design Retrospective chart review of cases of head trauma presenting between January 1, 1990, and December 31, 1995.Setting Academic children's hospital.Patients One hundred seventy-three children younger than 3 years with head injuries caused by abuse.Main Outcome Measures Characteristics of head-injured children in whom diagnosis of AHT was unrecognized and the consequences of the missed diagnoses.Results Fifty-four (31.2%) of 173 abused children with head injuries had been seen by physicians after AHT and the diagnosis was not recognized.The mean time to correct diagnosis among these children was 7 days (range, 0-189 days).Abusive head trauma was more likely to be unrecognized in very young white children from intact families and in children without respiratory compromise or seizures.In 7 of the children with unrecognized AHT, misinterpretation of radiological studies contributed to the delay in diagnosis.Fifteen children (27.8%) were reinjured after the missed diagnosis.Twenty-two (40.7%) experienced medical complications related to the missed diagnosis.Four of 5 deaths in the group with unrecognized AHT might have been prevented by earlier recognition of abuse. ConclusionAlthough diagnosing head trauma can be difficult in the absence of a history, it is important to consider inflicted head trauma in infants and young children presenting with nonspecific clinical signs.
The nonhospital costs of care of patients with CF in The Netherlands: results of a questionnaire
Authors: MF Wildhagen, JB Verheij, JG Verzijl, J Gerritsen, W Bakker, HB Hilderink, LP ten Kate, T Tijmstra, L Kooij, JD Habbema
Journal: European Respiratory Journal (1996)

Cystic fibrosis (CF) causes a relatively high medical consumption. A large part of the treatment takes place at home. Because data regarding nonhospital care are lacking, we wished to determine the costs of care of patients with CF outside the hospital. A questionnaire was sent to 73 patients with CF from two Dutch hospitals (response rate 64%, 14 children and 33 adults). Average consumption and average costs per patient per year were calculated for children and adults for six categories: nonhospital medical care; domestic help; diet; travelling because of CF; medication; and devices and special facilities at home, work or school. The average nonhospital costs of care amounted to Pounds 4,641 per child per year (range Pounds 712-13,269) and Pounds 10,242 per adult (range Pounds 1,653-26,571). Nonhospital medical care for children and adults accounted for, respectively, 8 and 5% of these costs, domestic help for 15 and 9%, diet for 10 and 7%, travelling because of CF for 4 and 8%, medication for 63 and 67%, and devices and special facilities at home, work or school for 1 and 4%. Nonhospital costs of care of cystic fibrosis are very high and amount to 50% of the total (medical and nonmedical) lifetime costs of cystic fibrosis.
Long-term Erythromycin Therapy Is Associated with Decreased Chronic Obstructive Pulmonary Disease Exacerbations
Authors: Terence A. R. Seemungal, Tom M. A. Wilkinson, John R. Hurst, Wayomi R. Perera, Ray J. Sapsford, Jadwiga A. Wedzicha
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: Frequent chronic obstructive pulmonary disease (COPD) exacerbations are a major cause of hospital admission and mortality and are associated with increased airway inflammation. Macrolides have airway antiinflammatory actions and may reduce the incidence of COPD exacerbations.Objectives: To determine whether regular therapy with macrolides reduces exacerbation frequency.Methods: We performed a randomized, double-blind, placebo-controlled study of erythromycin administered at 250 mg twice daily to patients with COPD over 12 months, with primary outcome variable being the number of moderate and/or severe exacerbations (treated with systemic steroids, treated with antibiotics, or hospitalized).Measurements and Main Results: We randomized 109 outpatients: 69 (63%) males, 52 (48%) current smokers, mean (SD) age 67.2 (8.6) years, FEV1 1.32 (0.53) L, FEV1% predicted 50 (18)%. Thirty-eight (35%) of the patients had three or more exacerbations in the year before recruitment, with no differences between treatment groups. There were a total of 206 moderate to severe exacerbations: 125 occurred in the placebo arm. Ten in the placebo group and nine in the macrolide group withdrew. Generalized linear modeling showed that the rate ratio for exacerbations for the macrolide-treated patients compared with placebo-treated patients was 0.648 (95% confidence interval: 0.489, 0.859; P = 0.003) and that these patients had shorter duration exacerbations compared with placebo. There were no differences between the macrolide and placebo arms in terms of stable FEV1, sputum IL-6, IL-8, myeloperoxidase, bacterial flora, serum C-reactive protein, or serum IL-6 or in changes in these parameters from baseline to first exacerbation over the 1-year study period.Conclusions: Macrolide therapy was associated with a significant reduction in exacerbations compared with placebo and may be useful in decreasing the excessive disease burden in this important patient population.Clinical trial registered with www.clinicaltrials.gov (NCT 00147667)
Metastatic Pancreatic Small-Cell Carcinoma Presenting As Acute Pancreatitis
Authors: Christina Fitzmaurice, Daniel D. Cornett, Bret J. Spier, Patrick Pfau
Journal: Journal of Clinical Oncology (2010)

A 77-year-old woman presented with nausea and acute onset of severe epigastric pain with radiation to her back.Physical examination revealed epigastric tenderness without rebound or guarding.Laboratory analysis showed lipase at 1,970 U/L (reference range, 23 to 300 U/L) and amylase at 220 U/L (reference range, 30 to 110 U/L) with normal liver chemistries, including bilirubin at 0.3 mg/dL (reference range, 0.2 to 1.3 mg/dL), alkaline phosphatase at 100 U/L (reference range, 38 to 136 U/L), ALT at 22 U/L (reference range, 9 to 72 U/L), and AST at 35 U/L (reference range, 14 to 59 U/L).She was diagnosed with acute pancreatitis, and gastroenterology consultation was obtained for further evaluation and management.A right upper quadrant ultrasound demonstrated a 2.3 cm ϫ 1.9 cm area of hypoechogenicity in the pancreatic head suggestive of a primary pancreatic neoplasm.An abdominal computed tomography (CT) scan confirmed an ill-defined 2.2-cm low-attenuation mass in the pancreatic head.Also seen were bilateral adrenal masses measuring up to 5 cm in size.Her cancer antigen 19-9 (CA 19-9) was 26 U/L (reference range, Ͻ 37 U/L).The liver appeared normal without evidence of metastatic disease.An endoscopic ultrasound with fine-needle aspiration of the pancreatic head (Fig 1) and adrenal (Fig 2) masses revealed small-cell carcinoma (Fig 3).Immunohistochemistry was performed, and thyroid transcription factor 1, synaptophysin, and chromogranin were positive, confirming the diagnosis.The patient did not have any respiratory complaints but was a long-time smoker with a 55-pack-year history.A chest CT demonstrated enlarged axillary, mediastinal, and hilar lymph nodes as well as a solitary 8-mm sclerotic lesion in the midthoracic spine but was notably negative for pulmonary nodules or masses.Further staging work-up included a brain CT scan that showed several small enhancing masses consistent with diffuse brain
Small Molecule Inhibition of ERK Dimerization Prevents Tumorigenesis by RAS-ERK Pathway Oncogenes
Authors: Ana Herrero, Adán Pinto, Paula Colón-Bolea, Berta Casar, Mary Jones, Lorena Agudo-Ibáñez, Rebeca Vidal, Stephan P. Tenbaum, Paolo Nuciforo, Elsa M. Valdizán, Zoltan Horvath, Laszlo Orfi, Antonio Pineda-Lucena, Emilie Bony, Gyorgy Keri, Germán Rivas, Angel Pazos, Rafael Gozalbes, Héctor G. Palmer, Adam Hurlstone, Piero Crespo
Journal: Cancer Cell (2015)
Immune tolerance in liver disease
Authors: Ian N. Crispe
Journal: Hepatology (2014)

Liver tolerance is manifest as a bias toward immune unresponsiveness, both in the context of a major histocompatibility complex–mismatched liver transplant and in the context of liver infection. Two broad classes of mechanisms account for liver tolerance. The presentation of antigens by different liver cell types results in incomplete activation of CD8+ T cells, usually leading to initial proliferation followed by either clonal exhaustion or premature death of the T cell. Many liver infections result in relatively poor CD4+ T-cell activation, which may be because liver antigen-presenting cells express a variety of inhibitory cytokines and coinhibitor ligands. Poor CD4+ T-cell activation by liver antigens likely contributes to abortive activation, exhaustion, and early death of CD8+ T cells. In addition, a network of active immunosuppressive pathways in the liver is mediated mostly by myeloid cells. Kupffer cells, myeloid-derived suppressor cells, and liver dendritic cells both promote activation of regulatory T cells and suppress CD8+ and CD4+ effector T cells. This suppressive network responds to diverse inputs, including signals from hepatocytes, sinusoidal endothelial cells, and hepatic stellate cells. Conclusion: Though liver tolerance may be exploited by pathogens, it serves a valuable purpose. Hepatitis A and B infections occasionally elicit a powerful immune response sufficient to cause fatal massive liver necrosis. More commonly, the mechanisms of liver tolerance limit the magnitude of intrahepatic immune responses, allowing the liver to recover. The cost of this adaptive mechanism may be incomplete pathogen eradication, leading to chronic infection. (Hepatology 2014;60:2108–2116)
A vesicular variant of bullous pemphigoid with autoantibodies against unidentified 205- and 150-kDa proteins at the basement membrane zone
Authors: S. SATOH, M. SEISHIMA, T. IZUMI, A. ITO, H. KAMIYA, Y. KITAJIMA
Journal: British Journal of Dermatology (1997)

Journal Article A vesicular variant of bullous pemphigoid with autoantibodies against unidentified 205‐ and 150‐kDa proteins at the basement membrane zone Get access S. SATOH, S. SATOH Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Search for other works by this author on: Oxford Academic Google Scholar M. SEISHIMA, M. SEISHIMA Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Mariko Seishima, E‐mail: seimarik@gumail.cc.gifu‐u.ac.jp Search for other works by this author on: Oxford Academic Google Scholar T. IZUMI, T. IZUMI Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Search for other works by this author on: Oxford Academic Google Scholar A. ITO, A. ITO Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Search for other works by this author on: Oxford Academic Google Scholar H. KAMIYA, H. KAMIYA Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Search for other works by this author on: Oxford Academic Google Scholar Y. KITAJIMA Y. KITAJIMA Department of Dermatology, Gifu University School of Medicine, Tsukasarnachi 40, Gifu 500, Japan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 137, Issue 5, 1 November 1997, Pages 768–773, https://doi.org/10.1046/j.1365-2133.1997.19502046.x Published: 01 November 1997 Article history Accepted: 12 June 1997 Published: 01 November 1997
Participation of atrial specialized conduction pathways in atrial flutter.
Authors: G Pastelin, R Mendez, G K Moe
Journal: Circulation Research (1978)

The circus movement theory of flutter has been supported by numerous theoretical, experimental, and clinical studies, but there has been little consideration of the possible participation of the specialized conduction pathways of the atria.In the present work we have studied experimental atrial flutter in relation to the behavior of these pathways, in response to elevated potassium and to surgical interruption.Application of trains of ttimuli at frequencies appropriate to Induce a self-sustained flutter revealed that (1) flutter can be more easily induced by stimuli applied to the left atrial insertion of Bachmann's bundle than to the body of the right atrium, (2) flutter can be initiated by appropriate trains of stimuli without the creation of an artificial obstacle, and (3) flutter exhibits the same characteristic behavior, with or without artificial obstacles.Doses of potassium that elevate the plasma concentration to 9.5 mM/liter cause total inactivation of atrial myocardium without suppressing flutter waves as recorded from the vicinity of the intemodal pathways.Section of the middle internodal pathway reduces the frequency of experimental flutter, section of both the middle and posterior pathways prevents the establishment of flutter.The results suggest that the specialized intemodal pathways play an important role in the genesis and maintenance of circus movement flutter.
THE ETIOLOGY OF PELLAGRA
Authors: W. R. Aykroyd
Journal: BMJ (1930)

PROFFSSOR WILSON's note on the etiology of pellagra,' puiblislhed in the British .M1Iedical Journial early this ear, tends to give a wrong impression of some recent researches in, conniexion with that disease.Wilson's theory of pellagra is that it follows diets in which the biological value of the proteins consuimed daily falls below the value of 40 to 45 grams of meat proteini, a theory developed as the result of a series of observations made in Egypt duriing the wanr.2At that timie Goldberger and Ihis colleagues of the U.S. Public Health Service had begun the long and eventually satisfactory investigation in the course of which they shJowed the non-communicability of pellagra, its clear association with faulty diet, and the methods, simple from a scientific point of view, required for its prevention; and their woork was already lendinig fresh poinit to old theories of the dietary origin of the disease.
p53 Regulates Cellular Resistance to Complement Lysis through Enhanced Expression of CD59
Authors: Rossen M. Donev, Duncan S. Cole, Baalasubramanian Sivasankar, Timothy R. Hughes, B. Paul Morgan
Journal: Cancer Research (2006)

It has been recently hypothesized that the CD59 gene has two putative p53-responsive elements that may be involved in defense of host cells from damage by the complement system in inflammation. Here we have examined the roles of these putative p53-binding sequences within the CD59 gene in regulation of CD59 expression. We have shown that both of these potential responsive elements bind p53 in vitro. Knocking down expression of p53 using small interfering RNA led to a 6-fold decrease in CD59 protein expression in HeLa cells. We have previously observed a decrease of CD59 in camptothecin-induced apoptotic IMR32 cells, whereas expression was increased in the surviving fraction compared with untreated cells. Here, we have shown that these changes are associated with altered expression levels and acetylation status of p53. We have also shown that acetylation status of p53 regulates CD59 expression on cells exposed to inflammatory cytokines to model inflammation. Our data suggest that p53 and in vivo positive/negative regulators of p53 could be used to modulate susceptibility of tumor cells to complement lysis in chemotherapy.
An Ethics Consultation Service in a Teaching Hospital
Authors: John La Puma
Journal: JAMA (1988)

A newly established formal ethics consultation service in a university teaching hospital was prospectively evaluated. A physician-ethicist interviewed and examined patients, interviewed family and others as needed, and entered a formal consultation note in the medical record. The requesting physician and the consultant independently completed structured questionnaires. Fifty-one consultation requests were received from 45 physicians from seven departments between July 1, 1986, and June 30, 1987. Seventeen (33%) of 51 patients were in the intensive care unit, and 19 patients (37%) were fully oriented at the time of consultation. Overall, 61% of the patients survived to leave the hospital. The requesting physician sought assistance with withholding or withdrawing life-sustaining treatment in 49% of cases, with resuscitation issues in 37%, and with legal issues in 31%. Assistance with more than one issue was sought in 39 cases (76%). In 36 cases (71%), the requesting physician stated that the consultation was "very important" in patient management, in clarifying ethical issues, or in learning about medical ethics. We conclude that ethics consultation performed by physician-ethicists provides useful, clinically acceptable assistance in a teaching hospital.The Center for Clinical Medical Ethics at the University of Chicago Hospitals and Clinics established a formal ethics consultation service in July 1986. Fifty-one subsequent requests for consultations by attending physicians were studied by La Puma, et al., to determine the actual clinical role of the new service. The authors sought to describe (1) the characteristics of the patients whose physicians requested consultation, (2) the reasons physicians sought consultation, from the point of view of the physician and the ethics consultant, and (3) if and how physicians found ethics consultation helpful. Three cases illustrating the role of the ethics consultants in patient care are presented. The authors conclude that by functioning as an objective clinical voice in nonurgent but very difficult cases, an ethics consultation service can help physicians "identify, analyze, and resolve ethical issues in patient care."
Use of the University of California Los Angeles Integrated Staging System to Predict Survival in Renal Cell Carcinoma: An International Multicenter Study
Authors: Jean-Jacques Patard, Hyung L. Kim, John S. Lam, Frederick J. Dorey, Allan J. Pantuck, Amnon Zisman, Vincenzo Ficarra, Ken-Ryu Han, Luca Cindolo, Alexandre De La Taille, Jacques Tostain, Walter Artibani, Colin P. Dinney, Christopher G. Wood, David A. Swanson, Claude C. Abbou, Bernard Lobel, Peter F.A. Mulders, Dominique K. Chopin, Robert A. Figlin, Arie S. Belldegrun
Journal: Journal of Clinical Oncology (2004)

To evaluate ability of the University of California Los Angeles Integrated Staging System (UISS) to stratify patients with localized and metastatic renal cell carcinoma (RCC) into risk groups in an international multicenter study.4,202 patients from eight international academic centers were classified according to the UISS, which combines TNM stage, Fuhrman grade, and Eastern Cooperative Oncology Group performance status. Distribution of the UISS categories was assessed in the overall population and in each center.The UISS stratified both localized and metastatic RCC into three different risk groups (P <.001). For localized RCC, the 5-year survival rates were 92%, 67%, and 44% for low-, intermediate-, and high-risk groups, respectively. A trend toward a higher risk of death was observed in all centers for increasing UISS risk category. For metastatic RCC, the 3-year survival rates were 37%, 23%, and 12% for low-, intermediate-, and high-risk groups, respectively; in 6 of 8 centers, a trend toward a higher risk of death was observed for increasing UISS risk category. A greater variability in survival rates among centers was observed for high-risk patients.This study defines the general applicability of the UISS for predicting survival in patients with RCC. The UISS is an accurate predictor of survival for patients with localized RCC applicable to external databases. Although the UISS may be useful for patients with metastatic RCC, it may be less accurate in this subset of patients due to the heterogeneity of patients and treatments.
Metabolic Remodeling in the Hypertrophic Heart
Authors: John C. Chatham, Martin E. Young
Journal: Circulation Research (2012)

][4][5] What is less clear, however, is whether such chronic metabolic shifts should be considered a cause or consequence in the pathogenesis of contractile dysfunction.In the case of diabetes mellitus, the heart exhibits an increased dependence on fatty acids for oxidative energy production, and this increase in lipid metabolism has been proposed to significantly contribute to the etiology of impaired cardiac function. 6Similarly, increased rates of fatty acid oxidation immediately after an ischemic event have been implicated in exacerbation of reperfusion injury. 7However, in both of these pathophysiological settings, compelling data to support a direct causal relationship between contractile abnormalities and metabolic dysregulation remain elusive.
New insights into paracrine mechanisms of human cardiac progenitor cells
Authors: Hagen Maxeiner, Nina Krehbiehl, Andrea Müller, Nadine Woitasky, Hakan Akintürk, Matthias Müller, Markus A. Weigand, Yaser Abdallah, Sascha Kasseckert, Rolf Schreckenberg, Klaus‐Dieter Schlüter, Sibylle Wenzel
Journal: European Journal of Heart Failure (2010)
NT-proBNP accurately reflects the impact of severe COPD exacerbation on the right ventricle (RV)
Authors: Lamia Ouanes-Besbes, Zineb Hamouda, Islem Ouanes, Fahmi Dachraoui, Fekri Abroug
Journal: European Respiratory Journal (2013)

Introduction 

The type and extent of RV function alterations during COPD exacerbation are poorly described. Whether these alterations could be reflected by changes in NT-proBNP levels, is also unknown.

This study aimed to describe the changes in RV morphology and function during COPD exacerbation, and delineate their relationship with circulating levels of NT-pro BNP.

Patients and Methods 

Sixty-nine consecutive patients (mean age 66 ± 10, 53 men) presenting with COPD exacerbation requiring ventilatory support, underwent echocardiographic assessment of RV function (RV diameter, RV/LV ratio, TAD, Teig, PAPs) on admission and at discharge in survivors (n = 57). NT-pro BNP levels were measured simultaneously.

Results 

Exacerbation was ascribed to infectious origin in 54 patients. Non invasive ventilation was used in 58 patients. 57 patients survived the index episode and had an echocardiographic examination at discharge. Variation of RV echocardiographic variables between admission and discharge are depicted in figure 1.

![Figure][1] 



NT-proBNP levels significantly decreased from 2111±400 to 595±111 pg/ml. Significant correlations were found between NT-proBNP on one side, and the ratio RV/LV (R2 = 0.22 ; p = 0.02), PAPs (R2 = 0.37 ;p = 0.001), and RV diameter (R= 0.24; p=0.01).

Conclusion : COPD exacerbation has a significant impact on both, the morphology and function of the right ventricle. NT-proBNP accurately reflects these changes.

 [1]: pending:yes
Association of white blood cell subfraction concentration with fitness and fatness
Authors: N M Johannsen, E L Priest, V D Dixit, C P Earnest, S N Blair, T S Church
Journal: British Journal of Sports Medicine (2008)

Objective To examine the association between fitness, BMI, and neutrophil, lymphocyte, monocyte, basophil, and eosinophil concentrations in apparently healthy, non-smoking men. Design Cross-sectional study of 452 men from the Aerobics Center Longitudinal Study examining the resting concentration of white blood cell subfractions across fitness (maximal METs during a treadmill exercise test) and fatness (BMI) categories after adjusting for age. Results Fitness was inversely associated with all WBC subfraction concentrations. After further adjustment for BMI, only total WBC, neutrophil, and basophil concentrations remained significantly associated with fitness. BMI was directly associated with total WBC, neutrophil, lymphocyte, monocyte, and basophil concentrations and, when fitness was added to the model, only monocytes lost significance. Conclusion Fitness (inversely) and fatness (directly) are associated with WBC subfraction populations.