tbuckley/cabot-search huggingface dataset:
PMO-198 Post-operative endoscopy in bariatric surgery patients
Authors: A Desai, G Bahra, A Thillainayagam, A Ahmed
Journal: Gut (2012)

Introduction Bariatric surgical patients may require endoscopy in the post-operative phase. The current study analyses the indications and findings of upper GI endoscopy (OGD) in post-operative bariatric surgery patients. Methods A retrospective analysis of all bariatric surgery patients referred for oesophagogastroduodenoscopies (OGDs) at Charing Cross Hospital from 1 January 2009 to 30 October 2011. The Endoscopy units' electronic database of OGDs performed was analysed to determine how many bariatric surgery patients had OGDs post-operatively. Further sub-analysis was done for each operation type. Results During this time period 1093 bariatric surgeries were performed. These included 542 laparoscopic gastric bypasses, 220 laparoscopic gastric bands, 223 laparoscopic sleeve gastrectomies and 108 revisional bariatric procedures. 147 OGDs were performed on a total of 116 Bariatric surgical patients, with 23 patients having had more than one OGD. Of these 147, 103 were done post-operatively; 58 (56.3%) post-roux-en-y gastric bypass, 34 (33%) post-gastric band insertion, 6 (5.8%) post-gastric sleeve gastrectomy and 5 (4.9%) post- bariatric revisional surgery. Indications for OGDs were abdominal pain (44.7%), vomiting (15.5%), haematemesis/malaena (9.7%), failure of weight loss (7.8%), follow-up for previous scopes/imaging (6.8%), reflux symptoms (3.9%), dysphagia (3.9%), interventional purposes (3 naso-jejunal tube insertions and 1 stricture dilatation) (3.9%), suspected abnormal positioning/band erosion (2.9%) and microcytic anaemia (0.9%). Of the 34 gastric band OGDs done 13 were normal and 21 showed abnormalities including 7 gastric band erosions, 6 with mucosal inflammation, 2 with insufficient band compression, 2 with abnormal band position and 2 hiatal hernias. Of the 58 post-bypass endoscopies done 33 were normal, 15 showed anastomotic/pouch ulceration/inflammation/erosion, 4 showed signs of recent haemorrhage and 3 oesophageal irritation. Out of 6 post-sleeve OGDs 2 were normal, 1 was done for an interventional stricture dilatation, 1 showed a gastric stricture, 1 oesophageal candidiasis and 1 a hiatal hernia. Four OGDs out of 5 done post-revisional surgery were normal. Of all OGDs referred for post-operative abdominal pain, 50% yielded abnormal findings. Conclusion Endoscopy units need to be familiar with and prepared for bariatric surgery patients as post-operatively a substantial number will need endoscopic postoperative assessments. In our study 9.4% of all postoperative bariatric surgery patients underwent endoscopy, the commonest referral reason was abdominal pain and the commonest finding was normal. Competing interests None declared.
Interaction of helper T cells and Lyb5+ B cells responding to phosphorylcholine is MHC-restricted.
Authors: D E Mosier, A J Feeney
Journal: The Journal of Experimental Medicine (1984)

The requirements for T cell/B cell interaction for the induction of primary in vitro antibody responses to phosphorylcholine (PC)-keyhole limpet hemocyanin (KLH) were examined. Long-term helper T cell lines derived from KLH-primed (CBA/N X BALB/c) F1 female mice (H-2k/d) were able to support a T15-idiotype dominant, IgM anti-PC response of BALB/c (H-2d) B cells and macrophages, but could not activate PC-specific responses by BALB.B (H-2b) B cells, even in the presence of irradiated H-2k/d antigen-presenting cells. Polyclonal IgM secretion in the same cultures did not appear to depend upon a major histocompatibility complex (MHC)-restricted T-B interaction. Since IgM anti-PC responses seem to be entirely derived from the Lyb5+ B cell subpopulation, we conclude that at least some Lyb5+ B cells can only be activated by MHC-restricted T-B interactions. We also found that xid B cells from (CBA/N X BALB/c) F1 male mice could be polyclonally activated by helper T cell lines by an apparently MHC-unrestricted interaction. Our data thus suggests that residence in the Lyb5- or Lyb5+ B cell subset does not determine the T:B interaction requirements for antibody synthesis.
The Operative Treatment of Simple Enlargements and Tumours of the Thyroid Gland
Authors: C. Frankau
Journal: BMJ (1919)

Unfortunately the fact that the great war has found the men of literatuLre and of science amongst the most active and polemnical writers on eitlher side, goes to show that the liighest grade of miental cultivation lhas little influence on thle elemental characters of man's nature.Tljus wlhile the Central Powers have gone so far as to strive to prevent thteir medical literature reaclling their enemDies' lhands, the conditions of war have furtlhered a most intimate asso- (iation between the medical services of the armies allied ill the same cause.Not only has a brotherly alliance existed, unbroken tlhroughoout by any national jealousy, but tlle same lines of thought and the same tide of action and reaction in practice lhas been observable in all.The lreports of the Inter-Allied Conference on the Treatment of WN'ounds furnish an excellent illustration of these facts.Amongst thle surgeons of the allied nations an increased spirit of fraternity and intimate co-operation has certainly flourished.Just as the armies of the different states have placed their resources of every kind at the disposal of each other, so the workers in medical science have pooled their lkuowledge and growing experience, and readily received and adopted variations or advances from whatever source they might emanate.T'llose who were privileged to take part 'in tlle recent campaign will at once recoguize tlhat although omissions have no doubt been made in sketclhing this outline of the (luties of the consulting surgeon, yet it embodies in the imiain wlhat has been the practice in the British army, and a system whichl has been appreciated and even imitated in the armies of our allies.Still, as far as I ama aware, the system remains founded upon usage during tle var; it lhas resulted from a process of development in successive steps, and it is no doubt capable of further regularization alnd organization.Conclusion.
Low Risk for Hepatitis C in Hemophiliacs Given a High-Purity, Pasteurized Factor VIII Concentrate
Authors: P. M. Mannucci
Journal: Annals of Internal Medicine (1990)

Study Objective: To assess whether the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV) are transmitted to hemophiliacs by a high-purity factor VIII concentrate in which the method of virus inactivation is pasteurization. Design: Hepatitis B virus markers, the antibody to HCV (anti-HCV), the antibody to HIV (anti-HIV), and aminotransferases were measured on serum samples collected before the first concentrate infusion and at regular time intervals thereafter. Setting: Seventeen hemophilia centers in Italy, the Federal Republic of Germany, Belgium, Austria, and the Democratic Republic of Germany. Patients: Twenty-nine patients with hemophilia A who had not received a previous transfusion with blood products and who had normal alanine and aspartate aminotransferases (ALT and AST) were included in the final analysis. Measurements and Main Results: No patient became positive for anti-HCV or anti-HIV or developed sustained increases in aminotransferase levels. Similarly, none of the 15 unvaccinated patients developed markers of HBV infection. Conclusion: This prospective study conducted in previously untransfused hemophiliacs highly susceptible to developing post-transfusion hepatitis shows that a large-pool clotting factor concentrate treated with pasteurization carries a low risk for transmitting HCV, the major causative agent of post-transfusion hepatitis.
Management of Insomnia in Hospitalized Patients
Authors: RICHARD M. BERLIN
Journal: Annals of Internal Medicine (1984)

In hospitalized patients, the commonest causes of acute insomnia are the effects of illness, environmental sleep disruption, medication, anxiety, and depression. Treatment should correct underlying medical disorders; reduce environmental sleep disruptions; and lower anxiety with psychological interventions, sedative or hypnotic medication, and relaxation training. Special clinical problems include chronic pain, delirium, and insomnia in the elderly.
TCT-653 An Intracoronary Near-infrared Spectroscopy Signature of Culprit Lesions in Non-ST-Segment Elevation Myocardial Infarction
Authors: Ryan D. Madder, Mustafa Husaini, Jan Harnek, Matthias Gotberg, Margaret Chi, Zaahir Turfe, David Klungle, Stacie M. Vanoosterhout, David Erlinge
Journal: Journal of the American College of Cardiology (2013)
Long-Term Failure of Endoscopic Suturing in the Treatment of Gastroesophageal Reflux: A Prospective Follow-Up Study
Authors: H. Abou-Rebyeh, N. Hoepffner, T. Rösch, E. Osmanoglou, J. Haneke, R. Hintze, B. Wiedenmann, H. Mönnikes
Journal: Endoscopy (2005)

Background and Study Aims: Several endoscopic antireflux therapies have been marketed, but long-term data on their objective and clinical efficacy are sparse. This report presents prospective 1-year follow-up results, including technical, clinical, and functional success rates, for the first of these treatments to be developed, endoscopic gastroplication (EGP).Patients and Methods: A total of 43 EGP procedures were carried out in 38 patients with gastroesophageal reflux disease (GERD). Two or three EndoCinch gastroplications were constructed at the level of the gastric cardia in each patient; five patients were treated twice within 6 - 12 months. Each endoscopic suture joined two gastric folds to each other as a double fold, known as a ”gastroplication”, in order to narrow the esophagogastric junction. Postprocedure data after 2 months and after 1 year were compared with preoperative data, focusing on symptoms, medication requirements, endoscopic findings, and pH-metry results.Results: In contrast to the findings at 2 months (which showed that 72 % of the sutures were present and that there was a reduction in the percentage of time when the esophageal pH was < 4 from 15.4 % to 8.7 %), the results 1 year after EGP were considered to indicate failure of the treatment in all 38 patients because none of them still had all of the initially placed gastroplications in situ (90 % of gastroplications were lost). The percentage of patients who did not require proton pump inhibitor medication decreased from 52 % at 2 months to only 20 % at 1 year and even more patients had evidence of reflux esophagitis at 1 year (56 %) than had initially demonstrated signs of this (41 %).Conclusions: EGP has some short-term beneficial effects on clinical symptoms and pH-metry. However, mainly due to the loss of the endoscopically placed sutures, these effects were not maintained at the 1-year follow-up. EGP cannot therefore be recommended for routine clinical use. Better endoscopic methods need to be developed, and they should be adequately tested before being marketed.
SPASMODIC ASTHMA CAUSED BY AORTIC ANEURISM.
Authors: GEORGE TULLY VAUGHAN
Journal: JAMA (1896)

It seems to me that a form of dyspnea, which closely resembles spasmodic asthma and from which it seems at times impossible to differentiate it, as a symptom in aortic aneurism, is important enough to deserve especial notice. In the three cases I am about to report it was a prominent and distressing symptom while other symptoms of aneurism were rather obscure. Asthma from aneurism is no doubt caused by pressure on the pneumogastric nerve and is not always continuous as might be supposed, for in one of my cases the patient had only three attacks in all and these occurred at irregular intervals during the last two months of his life. In the other cases this symptom was continuous but with marked remissions. In obstinate and persistent cases of asthma in elderly persons, aneurism should always be born in mind as a possible cause, for in the absence of
Australia proposes two tier system for paying for GP consultations
Authors: C. Zinn
Journal: BMJ (2003)

The Australian government's controversial plans to reform Medicare, the national public health system, have been rejected by the four major doctors' groups, which claim that the proposals will not resolve the crisis in general practice.

The latest changes to the system are designed to tackle the developing shortage of GPs and the growing problem of poor people in some areas having to pay for visiting a doctor. In some places, GPs charge patients a “gap” fee for consultations, demanding the shortfall between what the government reimburses them for the consultation and the scheduled fee.

The most radical changes in the system's 19 year history will see it effectively split into two tiers, …
Computers in the Practice of Medicine, vol 1: Introduction to Computing Concepts; vol 2: Issues in Medical Computing
Authors: Blaine T. Garfolo
Journal: JAMA (1980)

The increasingly widespread application of computers in the medical environment is a challenge to the physician, as well as to the computer scientist. Physicians knowledgeable in the basics of computer applications in medicine are in a position to influence the direction of computer growth in the medical field. More often than not, the only learning resources available to them have been inappropriate for the background they have received in their medical training. As a result, many physicians have failed to pursue their interest in this field. This two-volume set presents an introduction to the field of computers in medicine from the point of view of the physician, rather than the computer scientist. Volume 1 is a general introduction to computers, with examples from the practice of medicine. It leads the reader into the material without overwhelming him with "computer jargon" and excessive detail, thereby allowing him to become comfortable with
Cancer registration hub opens in Mumbai to expand data collection in Asia
Authors: M. Kay
Journal: BMJ (2012)

The International Agency for Research on Cancer has opened its first regional hub for cancer registration at a new facility in the Tata Memorial Hospital in Mumbai to support cancer registries in 30 countries in south central, southeastern, and southern Asia.

The Mumbai hub is one of several being launched across three continents to serve as local resource centres capable of providing developmental support for population based cancer registration in defined …
Inquest begins into deaths after concerns about diamorphine prescribing
Authors: C. Dyer
Journal: BMJ (2009)

An enzyme linked fluorescence immunoassay (ELFA) has been evaluated for the detection of antibodies against Chlamydia trachomatis. Reticulate bodies and elementary bodies from C trachomatis L2/434 strain were used as antigens. An enzyme linked immunosorbent assay (ELISA) has also been evaluated using the same antigens. Results obtained by ELISA and ELFA for human sera with these two antigens were compared with each other and with the results obtained by a micro-immunofluorescence (micro-IF) test. Serum IgG antibodies against C trachomatis L2 reticulate bodies and elementary bodies were found in 32 (20.0%) and 11 (6.9%), respectively, of 160 serum samples from pregnant women by the micro-IF test (titre greater than or equal to 1/32). All of these 32 pregnant women had IgG antibodies to C trachomatis reticulate bodies (titre greater than or equal to 1/100), whereas 20 (12.5%) had IgG antibodies to elementary bodies in the ELISA. On the other hand, 25 (15.6%) and 19 (11.9%) of them had IgG antibodies to C trachomatis L2 reticulate bodies and elementary bodies, respectively, by the ELFA (titre greater than or equal to 1/500).
South East Asia faces severe shortage of safe blood
Authors: R. Sharma
Journal: BMJ (2000)

South East Asia is experiencing a severe shortage of safe blood. The region collects only 7 million units a year but needs a total of 15 million units. This problem is worsened by inappropriate use of blood without separation into its components, with 80-85% of blood being used as whole blood. In addition, the Supreme Court in India has banned the use of blood from professional blood sellers because they were considered to be a high-risk group of HIV. Unscreened blood is also allowed to flourish in both Bangladesh and Pakistan because these countries do not have any national blood policy. Moreover, even with blood screening in India, hepatitis B and C are present because the virus is not tested in this country. In the screened blood in India, the seroprevalence of hepatitis B is 0.06-8.5% and that of hepatitis C is 1.2-3%. While in Islamabad, Pakistan, testing results showed that 8.1% of blood was infected with hepatitis C. Lastly, 5-10% of HIV infections in Southeast Asia are transfusion-induced.
Cytosolic proteins from human neutrophils bind to eNOS mRNA: Regulation by tumor necrosis factor and during myocardial infarction
Authors: L. Sánchez de Miguel, T. De Frutos, J. Romero, A. Nuñez, J. Gómez, L. Rico, M. García‐Durán, S. Casado, J. Farré, A. López‐Farré
Journal: European Journal of Heart Failure (2000)
Trial Halted as Sickle Cell Treatment Proves Itself
Authors: Charles Marwick
Journal: JAMA (1995)

THE FIRST EFFECTIVE treatment for reducing the frequency of the painful crises caused by sickle cell anemia has just been tested and pronounced helpful. This is the finding from a double-blind placebo-controlled study of the use of hydroxyurea in sickle cell disease. The study was begun by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health (NIH), Bethesda, Md, in January 1992 and planned to run until May of this year. However, the results were so compelling that the study was stopped in January, said Claude Lenfant, MD, the institute's director. Daily administration of hydroxyurea reduced by approximately 50% the frequency of painful episodes and hospital admissions for the condition as well as the acute chest syndrome that is "a life-threatening complication of sickle cell anemia characterized by chest pain, fever, and an abnormal chest X-ray," said Samuel Charache, MD, Johns Hopkins University School of
Nonabandonment: A Central Obligation for Physicians
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (1995)

Nonabandonment is one of a physician's central ethical obligations; it reflects a longitudinal commitment both to care about patients and to jointly seek solutions to problems with patients throughout their illnesses.The depth of this commitment may vary depending on the physician's and the patient's values and personalities, their shared experiences, and the patient's clinical circumstances. Traditional principled ethical analyses must balance the personal histories, values, motivations, and intentions of the participants with more general considerations. Such analyses often focus on a particular act, isolated in time, and yet the consequences of one decision immediately lead to a new set of choices. Nonabandonment places the physician's open-ended, long-term, caring commitment to joint problem solving at the core of medical ethics and clinical medicine. There is a world of difference between facing an uncertain future alone and facing it with a committed, caring, knowledgeable partner who will not shy away from difficult decisions when the path is unclear.
Effect of cardiopulmonary bypass on circulating concentrations of leucocyte elastase and free radical activity
Authors: C R K HIND, J F GRIFFIN, S PACK, Y E LATCHMAN, H F DRAKE, H M JONES, J BROSTOFF, T L DORMANDY, T TREASURE
Journal: Cardiovascular Research (1988)

Circulating concentrations of leucocyte elastase and free radical activity were measured in 11 adults undergoing cardiopulmonary bypass. In all patients the bypass procedure was associated with pronounced changes in plasma elastase concentrations, and peak enzyme concentrations correlated closely with the duration of bypass (r = 0.91, p less than 0.001). Serial measurement of octadeca-9, 11-dienoic acid, a non-peroxide marker of free radical activity, showed significant changes only in the plasma free fatty acid fraction, suggesting a direct relation to the action of heparin rather than to the bypass procedure as such. These studies support the hypothesis that neutrophil activation plays a central role in the organ dysfunction that may complicate cardiopulmonary bypass and suggest that elastase release rather than free radical generation may be the appropriate marker of the event.
I-123 Whole Body Scanning: Case Report and Discussion
Authors: Herbert A. Klein, Kenneth J. DiSibio, Diane Sims, Helen C. Singleton, Lois J. Worthy
Journal: Clinical Nuclear Medicine (2005)

In managing differentiated thyroid carcinoma, concern over the stunning that may occur with traditional whole body imaging using I-131 has fostered an interest in using I-123 for this purpose. A case is presented as a focus for discussion of the issues, with special reference to accuracy and the effect thereon of technical factors.A 43-year-old man with papillary carcinoma of the thyroid was scanned after thyroidectomy using 10 mCi I-123. Images at 24 and 48 hours demonstrated foci including multiple regional metastases. They were less well demonstrated in images 7 days after therapeutic I-131, and negative imaging 1 year later implied therapeutic success.I-131 has the advantages of a longer half-life, facilitating delayed imaging and lower price. I-123 has the advantages of favorable gamma-ray energy and less useless radiation to thyroid tissue and the whole body. Despite its short half-life, with a sufficient amount, images at 48 hours are practical. In the case presented, there are several possible reasons why superior lesion detection occurred in diagnostic I-123 images. In any case, the outcome demonstrates that I-131 posttherapy images are not an absolute "gold standard" for accuracy. Investigations comparing I-123 with I-131 imaging have been subject to biases, including insufficient dose of I-123, lack of delayed I-123 imaging, suboptimal collimation for I-131, and the relatively high dose of I-131 in posttherapy scanning.The evidence, although not definitive, strongly suggests that I-123 is at least as accurate for diagnostic whole body imaging as I-131.
High nut consumption may reduce risk of diabetes
Authors: D. Josefson
Journal: BMJ (2002)

Women who increase their consumption of nuts and peanut butter may gain some protection against the development of type 2 diabetes, a new study has suggested ( JAMA 2002;288: 2554-60)

The researchers, led by Drs Rui Jiang, Frank Hu, Meir Stampfer, and JoAnn Manson from the Departments of Medicine and Public Health at Harvard University School of Medicine in Boston and Cambridge, Massachusetts, conducted a prospective cohort study to …
Association Between Chronic Caregiving Stress and Impaired Endothelial Function in the Elderly
Authors: Brent T. Mausbach, Susan K. Roepke, Michael G. Ziegler, Milos Milic, Roland von Känel, Joel E. Dimsdale, Paul J. Mills, Thomas L. Patterson, Matthew A. Allison, Sonia Ancoli-Israel, Igor Grant
Journal: Journal of the American College of Cardiology (2010)
Malignant Melanoma in Husband and Wife
Authors: Birdsall N. Carle
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Robertson (217:1553, 1971) reported the contemporaneous occurrence of melanomas in a husband and wife; a second similar report was made by Robinson and Manheimer (220:277, 1972); and Baumar reported melanomas occurring about the same time in a brother and his adopted stepbrother (218:1300, 1971). The present report is of a young couple who both died of melanoma with cerebral metastases within a two-year period, leaving behind four small children. The wife, a 31-year-old, obese, fair-complexioned female, had a mole on her right calf during her entire life. In February 1968, this mole became inflamed and appeared to be infected. On June 23, 1968, she went to her family physician, who performed an excision biopsy. The pathologic diagnosis was malignant melanoma with lymphatic invasion and extension to the surgical margin. Results of a complete blood cell (CBC) count, urinalysis, 12-channel survey, chest x-ray examination, and VDRL test were all