Jewish Hospital

About: Jewish Hospital is a healthcare organization based out in Cincinnati, Ohio, United States. It is known for research contribution in the topics: Antigen & Population. The organization has 3881 authors who have published 3414 publications receiving 123044 citations.

The role of elastases in the development of emphysema

Abstract: Enzymes which degrade elastin can disorganize the network of elastic fibers in the lungs of experimental animals and produce emphysema. Two sources of endogenous elastases in the lung are neutrophils and alveolar macrophages. The neutrophil elastase is an intracellular, granule-associated enzyme which is inhibited by α1-antitrypsin and has the capacity to produce emphysema in experimental animals. The recently identified macrophage elastase appears to be a secretory enzyme, not associated with granules and less effectively inhibited by α1-antitrypsin. The demonstration that macrophages from cigarette smokers release elastase in culture, and that cigarette smoke interferes with the action of inhibitors of elastase, suggests that elastases may be involved in the pathogenesis of emphysema in man. Further research is needed to establish whether degradation of elastin occurs in humans developing emphysema.

Most cystosarcoma phyllodes and fibroadenomas have progesterone receptor but lack estrogen receptor: stromal localization of progesterone receptor.

Abstract: Biochemical study of fibroepithelial tumors of the female breast showed presence of progesterone receptor (PgR) in all five cystosarcoma phyllodes (two malignant, three benign), and in 11 of 13 fibroadenomas tested. Estrogen receptor (ER) was detected in only one of five cystosarcomas and 2 of 13 fibroadenomas. The relative volumes occupied by epithelium and stroma in each tumor were measured from histologic sections. The results were consistent with presence of PgR in the stroma and ER in the epithelium. Different types of cystosarcoma (benign and malignant) and different types of fibroadenomas (intracanalicular, pericanalicular, and mixed) did not differ significantly in content of PgR, and mean levels of PgR in cystosarcoma were comparable with those in fibroadenomas. The presence of PgR in cystosarcomas suggests that progestational therapy, and possibly other forms of hormonal therapy, should be tested in the treatment of advanced, malignant cystosarcoma phyllodes.

Factors associated with epinephrine administration for anaphylaxis in children before arrival to the emergency department

Abstract: Background Epinephrine is the first-line treatment for anaphylaxis but may be underused by patients and medical personnel. Objective To evaluate factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). Methods We performed a retrospective review of electronic medical records for all patients aged 0 to 25 years presenting with anaphylaxis to the ED or UCC at a pediatric academic referral center during 2009 to 2013. Results A total of 408 patients (mean age, 7.25 years; 62% male) were included for analysis. Only 148 patients (36.3%) received epinephrine before arrival at the ED or UCC. Reactions occurring at home (n = 36/114) were less likely to be treated with epinephrine compared with reactions occurring at school (n = 30/49) (odds ratio [OR], 0.29; 95% confidence interval [CI], 0.15–0.59). The odds of receiving epinephrine before arrival at the ED or UCC were significantly lower with a 2-organ system (OR, 0.50; 95% CI, 0.30–0.85) or 3-organ system (OR, 0.41; 95% CI, 0.21–0.81) presentation compared with 1-organ system involvement. Foods (342 [83.8%]) were the most commonly reported provoking trigger. Patients who did not receive epinephrine before arrival at the ED or UCC were significantly less likely to be discharged to home (OR, 0.56; 95% CI, 0.37–0.86; P = .01). Conclusion This study identifies factors associated with prehospital management of anaphylaxis for children, which highlight that epinephrine administration may be occurring with considerable delay. Increased awareness and education of caregivers, patients, and medical professionals are necessary to provide optimal management.

Realist Activity Theory for Digital Library Evaluation: Conceptual Framework and Case Study

Abstract: A critical yet largely unexamined facet of digital library design and use is how library content is assembled and vetted, which in turn has profound implications for ongoing digital library usefulness and usability. This article presents a social realist evaluation framework for an activity theoretic case study of the Flora of North America digital library. Social realist evaluation is a relatively new evaluation paradigm, positing that outcomes follow from mechanisms acting in contingently configured contexts. Because this study focuses on the digital library content vetting process, a significant part of the present analysis concerns the publication subsystem of the Flora of North America digital library – Collaborative Publishing Services – and how problems related to its design and use facilitates our ability to explain the Flora of North America not only as a functioning digital library project, but as a contradiction-driven organizational form in expansive development. Activity theory is a philosophical and cross-disciplinary framework for studying different forms of human practices in a multi-level, stratified manner, developmentally in time and through space. This intensive case study of the Flora of North America digital library illustrates that while social realism, itself content-neutral mechanics of explanation, provides a i>real foundation for activity theoretic analyses of work and technology, activity theory supplies a conceptually and substantively rich vocabulary for explanatory reasoning about technologically mediated social practices, such as digital library assemblage and use.