tbuckley/cabot-search huggingface dataset:
A NEW TIP FOR GASTRODUODENAL TUBES
Authors: Edward Hollander
Journal: JAMA (1923)

The tip here illustrated is constructed to fulfil what I believe are the theoretical mechanical requirements of an ideal tip for gastric and duodenal tubes. In practice, because of its narrow diameter combined with proper weight, it has been found superior to the tips that are in popular use. Its construction is based on the following principles of gastroduodenal intubation and drainage: 1. The diameter of the tip should be as small as possible. This is determined by the caliber of the rubber tubing. No. 8 French tubing is considered most practicable for gastroduodenal work. When such tubing is stretched over the shank of a duodenal tip to secure the latter in place, its outer diameter becomes 6 mm., which should be the diameter of the tip. The advantages of a narrow tip are obvious. It can pass into the duodenum through moderate degrees of pylorospasm more readily than a
Nature of anaemia in rheumatoid arthritis. IX. Folate metabolism in patients with rheumatoid arthritis.
Authors: A Omer, A G Mowat
Journal: Annals of the Rheumatic Diseases (1968)

Moderate anaemia of a hypochromic, normocytic type is a common feature of rheumatoid arthritis (Friereich, Ross, Bayles, Emerson, and Finch, 1957).Macrocytic anaemia has been reported less frequently.Macrocytosis was regarded as co-inci- dental by Short, Bauer, and Reynolds (1957) or due to anticonvulsant drugs (Chanarin, Laidlaw, Lough- ridge, and Mollin, 1960).In a study of the bone marrow in 64 patients with rheumatoid arthritis, Richmond, Gardner, Roy, and Duthie (1956) found
Polymerase Chain Reaction for the Diagnosis of HIV Infection in Adults
Authors: Douglas K. Owens
Journal: Annals of Internal Medicine (1996)

Purpose: To do a meta-analysis of studies that have evaluated the sensitivity and specificity of polymerase chain reaction (PCR) assay for the diagnosis of human immunodeficiency virus (HIV) infection in adults. Evaluating the performance of PCR is difficult because in certain clinical situations, the sensitivity or specificity of PCR may exceed those of the current reference standard tests [enzyme immunoassay followed by confirmatory Western blot analysis]. Therefore, an additional goal was to develop recommendations for 1) the design of future evaluative studies of PCR and 2) the use of PCR in persons with suspected HIV infection. Data Sources: Studies published between 1988 and 1994 that were identified in a search of 17 computer databases, including MEDLINE, and abstracts identified from conference proceedings. Study Selection: Studies were included if DNA amplification by PCR was done on peripheral blood mononuclear cells from adults. Ninety-six studies met the inclusion criteria. Data Extraction: Data were extracted independently by two reviewers. Study design was assessed independently by two investigators blinded to study results. Results: Reported sensitivities for PCR range from 10% to 100%, and specificities range from 40% to 100%. A summary receiver-operating characteristic curve based on all 96 studies has a maximum joint sensitivity and specificity [upper left point on the curve, where sensitivity equals specificity] of 97.0% to 98.1%. If the threshold value that defines a positive PCR result is chosen so that sensitivity is higher than 98.1%, specificity will decrease to less than 98.1%. Conversely, if the threshold value that defines a positive PCR result is chosen so that specificity is greater than 98.1%, sensitivity will decrease to less than 98.1%. If sensitivity and specificity are chosen to be equal, the corresponding false-positive rate is 1.9% to 3.0%. At the maximum joint sensitivity and specificity, the positive predictive value of PCR ranges from 34% to 85% as the prevalence of HIV increases from 1.0% to 10%. We identified seven areas in which study design could be modified to 1) reduce susceptibility to bias in estimates of the sensitivity and specificity of PCR and 2) to increase the generalizability of the study results. These modifications will also help to overcome methodologic problems created by the lack of a reference standard test. Conclusions: The PCR assay is not sufficiently accurate to be used for the diagnosis of HIV infection without confirmation. Use of PCR for the diagnosis of HIV in adults should be limited to situations in which antibody tests are known to be insufficient. Future studies of PCR performance should be sufficiently large and should use adequate reference standard tests and standardized methods for the performance of PCR. Specimens should be evaluated by persons blinded to clinical status and to the results of other diagnostic tests for HIV infection.
Hypoglycemia and impaired hepatic glucose production in mice with a deletion of the C/EBPβ gene
Authors: Sha Liu, Colleen Croniger, Carmen Arizmendi, Mariko Harada-Shiba, Jianming Ren, Valeria Poli, Richard W. Hanson, Jacob E. Friedman
Journal: Journal of Clinical Investigation (1999)

The transcription factor CCAAT/enhancer-binding protein β (C/EBPβ) is enriched in liver and adipose tissue and controls the expression of a wide variety of genes coding for important metabolic pathways, including gluconeogenesis and lipid synthesis. To investigate the role of C/EBPβ on glucose homeostasis, we studied mice with a targeted deletion of the gene for C/EBPβ–/– mice. Adult C/EBPβ–/– mice have hypoglycemia after an 18-hour fast, accompanied by lower hepatic glucose production (40% of that of wild-type mice), with no change in plasma insulin and a lower concentration of plasma free fatty acids (FFA). Glucagon infusion during a pancreatic clamp acutely stimulated hepatic glucose production by 38% in wild-type animals, with no change detected in C/EBPβ–/– mice. Unexpectedly, both the basal and glucagon-stimulated hepatic cyclic adenosine monophosphate (cAMP) levels were lower in C/EBPβ–/– mice, indicating an essential role for C/EBPβ in controlling proximal signal transduction. Fasting hypoglycemia was associated with normal levels of phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase) gene expression, however net liver glycogenolysis was impaired in C/EBPβ–/– mice. FFA release from isolated adipose tissue in response to epinephrine was 68% lower in C/EBPβ–/– mice than in control animals; however, N6,O2′-dibutyryladenosine (Bt2) cAMP stimulated a twofold increase in FFA release in C/EBPβ–/– compared with no further increase in wild-type mice. Because a deletion in the gene for C/EBPβ reduces blood glucose and circulating FFA, it could be an important therapeutic target for the treatment of non–insulin-dependent diabetes and possibly obesity, based on designing antagonists that decrease C/EBPβ activity.
Bacteria, bile and the small bowel
Authors: S. L. Gorbach, S. Tabaqchali
Journal: Gut (1969)

Microbial populations of the small bowel and bile salt metabolism were studied in 15 patients with lesions of the stomach and small intestine. These types of microorganism could be correlated with the site and extent of stasis in the small bowel and the presence of a normally functioning stomach. The presence of obligate anaerobes (bacteroides) and free bile acids could be correlated with areas of stagnation. When these abnormalities were detected throughout the small bowel, steatorrhoea was also noted. However, bacteroides and free bile acids in localized regions of either proximal or distal small bowel were generally associated with normal faecal fat excretion. Vitamin B(12) malabsorption appeared to be related to the total number of bacteria colonizing the small bowel rather than to any specific type of microorganisms. The effect of antibiotics on intestinal function and bacteriology was studied in three patients. In one patient, the broad-spectrum antibiotic tetracycline was effective in eradicating an abnormal bacterial flora. In the other two, lincomycin, which is specifically effective in eradicating the anaerobic flora, restored intestinal function to normal.
Application of the 2010 American Association for the study of liver diseases criteria of remission to a cohort of Italian patients with autoimmune hepatitis
Authors: Luigi Muratori, Paolo Muratori, Giulia Lanzoni, Silvia Ferri, Marco Lenzi
Journal: Hepatology (2010)

To the Editor: We read with great interest the practice guidelines for the diagnosis and management of autoimmune hepatitis recently issued by the American Association for the Study of Liver Diseases (AASLD).1 In particular, we appreciate the new definition of biochemical remission, which now requires not only normal bilirubin and gamma-globulin levels but also normal serum aminotransferases; this is at variance with the 2002 definition,2 which considers aminotransferase levels lower than twice the upper limits of normal to be sufficient. According to the 2002 criteria, nearly 80% of patients with autoimmune hepatitis enter remission within 3 years. The recently coined new definition will result in a tremendous change in the rate of response to immunosuppressive treatment for autoimmune hepatitis. Here we present our own experience, which has already been published in part,3 and compare the different response rates according to the 2002 and 2010 definitions of remission. Among 163 consecutive Italian patients with autoimmune hepatitis diagnosed at a single center, 119 (73%) entered remission according to the 2002 AASLD criteria, whereas only 42 patients (26%) of the same cohort fulfilled the 2010 AASLD criteria. Among 89 patients with a follow-up longer than 60 months, 65 (73%) had aminotransferase levels lower than twice the upper limit of normal (2002 criteria), but only 23 (25.8%) consistently maintained normal aminotransferase levels (2010 criteria) with low steroid doses (2-4 mg of methylprednisolone daily or every other day). Interestingly, from a clinical standpoint, after a mean follow-up longer than 100 months, only 1 of the 23 patients (4%) fulfilling the 2010 criteria of remission experienced histological worsening of the disease (mild to severe liver histology), whereas 36 of the 66 patients (54.5%) whose aminotransferase levels did not normalize had histological (14 with severe histology and 9 with cirrhosis) or clinical evidence (11 with end-stage liver disease, 1 with decompensated cirrhosis, and 1 with hepatocellular carcinoma) of uncontrolled and evolving liver disease. In summary, in our experience, the application of the 2010 criteria flips the previously codified remission rate from 73% to 26%. Complete-response patients have a very good long-term prognosis virtually free of significant clinical events, whereas patients whose serum aminotransferases are unable to be stably normalized are those with the highest probability of developing long-term complications, which not rarely may prove to be lethal. These are the patients most likely to benefit from new pharmacological, cellular, and molecular therapies.4, 5 Luigi Muratori M.D.* , Paolo Muratori M.D.* , Giulia Lanzoni M.D.* , Silvia Ferri M.D.* , Marco Lenzi M.D.* , * Department of Clinical Medicine, Alma Mater Studiorum–University of Bologna, Bologna, Italy, Sant'Orsola-Malpighi Polyclinic, Bologna, Italy.
Interaction between Cyclosporine and Warfarin
Authors: DAVID S. SNYDER
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 February 1988Interaction between Cyclosporine and WarfarinDAVID S. SNYDER, M.D.DAVID S. SNYDER, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-2-311_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Many drugs are known to affect the pharmacokinetics of warfarin and cyclosporine leading to either an increase or decrease in the biologic activity of these two drugs (1, 2). However, there have been no reports of a possible interaction between these two drugs. We report a negative interaction in a patient receiving both cyclosporine and warfarin.A 39-year-old man was diagnosed with pure erythrocyte aplasia in June 1984. He was treated unsuccessfully with standard immunosuppressive methods. In January 1986, he was started on oral cyclosporine and prednisone with a resulting reticulocytosis and rise in hemoglobin level beginning...References1. COHENLOERTSCHERRUBINTILNEYCARPENTERSTROM DRMNCT. Cyclosporine: a new immunosuppressive agent for organ transplantation. Ann Intern Med. 1984;101:667-82. LinkGoogle Scholar2. MANGANI R, ed. Drug Interaction Facts. St. Louis: J. B. Lippincott; 1987: 24-85, 171-7. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: City of Hope National Medical Center Duarte, CA 91010 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited BySkipGNN: predicting molecular interactions with skip-graph networksCoumarin anticoagulantsANTICOAGULANTS, THROMBOLYTIC AGENTS, AND ANTI-PLATELET DRUGSCoumarin anticoagulantsINTERACTIONS OF WARFARINA Subtherapeutic International Normalized Ratio Despite Increasing Doses of Warfarin: Could This Be Malabsorption?Autoimmune Enteropathy in a Pediatric Patient: Partial Response to Tacrolimus TherapyManagement of Drug Interactions With CyclosporineThe additive effect of certain drugs on the Cyclosporine A inhibition of human T-cell proliferationSandimmun®/An Appraisal of Drug InteractionsDrugs affecting blood coagulation and hemostasis 1 February 1988Volume 108, Issue 2Page: 311-311KeywordsBiologicsDrug interactionsDrugsHemoglobinImmunosuppressivesPharmacokinetics Issue Published: 1 February 1988 PDF DownloadLoading ...
Influence of Carotid Baroreceptors and Vasoactive Drugs on Systemic Vascular Volume and Venous Distensibility
Authors: JOHN ROSS, CHARLES J. FRAHM, EUGENE BRAUNWALD
Journal: Circulation Research (1961)

Changes in systemic vascular volume, in venous return, and in the distensibility of the venous system were studied in an experimental canine preparation. The use of an extracorporeal circulation permitted complete exclusion of the heart and lungs and allowed continuous measurement of alterations of intravascular blood volume and of venous return to the oxygenator. Brief occlusion of the venous outflow line permitted the inscription of venous pressure-volume curves. Hypotension in the isolated carotid sinuses, the administration of catecholamines or of acetylcholine resulted in venoconstriction, evidenced by a decrease in vascular volume, an increase in venous return, and flattening of the venous occlusiou curves. Conversely, carotid sinus hypertension or the administration of trimethaphan produced venodilatation, a decline in venous return, and an increase in vascular volume. The significance of these observations in the regulation of cardiac output is discussed.
Thyroid Carcinoma and Radiation
Authors: Leslie DeGroot
Journal: JAMA (1973)

Radiation-associated thyroid carcinomas continue to occur with alarming frequency. Among 50 patients with thyroid carcinoma seen over the past four years, 20 had received prior neck x-ray treatment. These patients developed tumors an average of 20 years after x-ray exposure, and were nearly all under 35 years of age. Clinical findings were similar to those of the nonexposed carcinoma patients, but the tumors were less invasive and never undifferentiated. One patient in the x-ray group succumbed to the illness. Two thirds of our patients who have a history of known x-ray exposure and who showed clinical thyroid abnormalities had cancer. All patients who received significant x-ray exposure during childhood or adolescence should be examined for thyroid abnormalities, which may develop two or more decades after exposure.
Flexion and Extension at the Hip
Authors: Henry Milch
Journal: JAMA (1962)

<h3>To the Editor:—</h3> Under date of Feb. 15, 1958, the report of a Committee on Medical Rating of Physical Impairment was published as a special supplement in The Journal. In describing the measurement of flexion-extension at the hip, it was stated that the total range of motion was 130° of which 30° resulted from "hyperextension" of the hip. This is in error both as regards the actual range of motion as well as the concept of "hyperextension." Its validation by publication inThe Journalmust be contested, to minimize medical errors in reporting the success or failure of surgical interventions on the hip and medicolegal errors in evaluating the consequences of accidental injury to the hip. The mere use of the term "hyperextention" should have directed attention to the possibility of error. Almost 20 years ago, I noted, and my observations were later confirmed, that extension of the thigh with
The influence of endoscopic biliary stents on the accuracy of endoscopic ultrasound for pancreatic head cancer staging
Authors: P. Fusaroli, R. Manta, P. Fedeli, S. Maltoni, A. Grillo, E. Giovannini, L. Bucchi, G. Caletti
Journal: Endoscopy (2007)

Biliary stents have been found to interfere with endoscopic ultrasound (EUS) tumor (T) and nodal (N) staging in patients with periampullary cancer. Our aim was to determine whether this also occurs in patients with pancreatic head cancer.We studied a consecutive series of patients who were undergoing preoperative EUS for diagnosis and staging of suspected pancreatic cancer, some of whom had biliary stents in situ and some of whom did not. The main end point was the uni- and multivariate association of biliary stenting with T and N mis-staging by EUS. The surgical T and N stages were used as gold standards.A total of 65 patients were identified (19 with biliary stents in situ and 46 without). Surgical stage T4 was found more frequently in patients with stents (53% vs. 22%, P = 0.014). The T stage by EUS was correct in 85% of the patients without biliary stents and in 47% of the patients with stents. The frequency of mis-staging by EUS was significant only among patients with a biliary stent. The distribution by EUS N stage did not differ significantly from the surgical N-stage distribution in the two groups of patients. According to the multivariate analysis, patients with stents were 6.55 times more likely to be incorrectly T staged (95% confidence interval [CI] 1.69-25.49) and 3.71 times more likely to be incorrectly N staged (95% CI 1.11-12.45) than patients without stents.The results add support to the recommendation that EUS staging of pancreatic head neoplasms should be performed prior to stent placement.
Clinical, Biological And Molecular Characteristics Of Mast Cell Activation Disorders: A Prospective Study In 62 Patients By The Spanish Network On Mastocytosis (REMA).
Authors: I. Alvarez-Twose, D. González-Olano, L. Sánchez-Muñoz, C. Teodosio, M. Jara-Acevedo, I. Sánchez-Matas, A. Matito, A. García-Montero, A. Orfao, L. Escribano
Journal: Journal of Allergy and Clinical Immunology (2009)
Claims by charity exaggerate dangers of osteoporosis
Authors: R. Moynihan
Journal: BMJ (2003)

The organisers of Australia's “healthy bones week” have come under fire for making exaggerated and misleading claims about the dangers of osteoporosis—the loss of bone density that raises the risk of fracture with age.

“Fact 1” on a poster sent to Australian general practitioners last week read: “More Australian women die from osteoporosis than all female cancers combined.” There was no reference to back up the statement, and a search has been unable to find any evidence to support it. Sydney general practitioner Mark Donohoe, a government adviser on false …
Medical Problems in Lebanon
Authors: Munir H. Shamma'a
Journal: New England Journal of Medicine (1957)

BEFORE 1956 few people in the United States had occasion to show interest in Lebanon and the other Middle Eastern Arab countries. Three things have recently focused American attention on that area: the gradual recognition of Arab potential, both political and economic; the rising tide of Arab nationalism; and the recent nationalization of the Suez Canal, with all its military and socioeconomic repercussions.Lebanon, the primary subject of this article, is one of the smallest but most influential of the Arab states. Its 1,500,000 people enjoy the highest standard of living among the neighboring Arab countries, and its unique geographic . . .
After-school interventions to increase physical activity among youth: Table 1
Authors: R R Pate, J R O’Neill
Journal: British Journal of Sports Medicine (2008)

Most children and adolescents do not meet the recommended 60 minutes or more of moderate to vigorous physical activity per day. One attractive approach to increasing physical activity in young people is providing activity through structured after-school programmes. This paper provides a review of the scientific literature on the effects of after-school programmes on physical activity in children and adolescents. After-school physical activity interventions provided mixed results; some increased children’s physical activity, others did not. Although after-school programmes have the potential to help children and adolescents engage in regular, enjoyable physical activity, the research on these programmes is limited and, in some cases, methodologically weak. Additional, well-controlled studies are needed to identify the components of after-school programmes that promote physical activity and to determine the level of activity that can be attained when children and adolescents participate in these programmes.
Introduction to Neuroradiology
Authors: Bernard S. Wolf
Journal: JAMA (1972)

As the authors of this volume indicate in their preface, "In the past 15 years, it is doubtful if any subspecialty of medicine has grown as rapidly as Neuroradiology; a vast body of information has been accumulated during this time." As a result, recent textbooks of neuroradiology are imposing tomes or multivolumed encyclopedic efforts which require diligent and prolonged study. For those who will not have the continuous responsibility of conducting and interpreting neuroradiological procedures, these texts are not suitable, except as references. It is no longer possible for a neurologist, a neurosurgeon, or a general radiologist to have all this information at his fingertips and to remain current with new developments. There is, therefore, a need for a text which will present a brief and concise overview summarizing and illustrating the most important or salient features of the normal appearances and the abnormal features of selected, relatively common disease
ERRORS IN THE DETERMINATION OF FREE HYDROCHLORIC ACID.
Authors: E. L. WHITNEY
Journal: JAMA (1905)

Since Kuhne demonstrated the necessity for free hydrochloric acid in peptic digestion many methods have been devised for its detection and determination. This multiplicity of tests is a good indication that none of them exactly fills the requirements. The tests chiefly recommended for the detection of free hydrochloric acid may be divided into two classes, those depending on the change in color produced in some indicator, such as congo-red, dimethyl-amido-azo-benzol, benzopurpurin, tropeolin 00 and others of similar character, and those depending on the coloration produced by the acid on certain organic materials, such as the phloroglucinvanillin test of Günzberg and the sugar-resorcin test of Boaz. Against the class of indicators as a whole we may state that, almost without exception, they give a reaction with the organic acids when present in sufficient concentration, as can be easily shown by testing the solutions of the various organic acids with them, the