tbuckley/cabot-search huggingface dataset:
Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline
Authors: Cristiano Spada, Jaap Stoker, Onofre Alarcon, Federico Barbaro, Davide Bellini, Michael Bretthauer, Margriet De Haan, Jean-Marc Dumonceau, Monika Ferlitsch, Steve Halligan, Emma Helbren, Mikael Hellstrom, Ernst Kuipers, Philippe Lefere, Thomas Mang, Emanuele Neri, Lucio Petruzziello, Andrew Plumb, Daniele Regge, Stuart Taylor, Cesare Hassan, Andrea Laghi
Journal: Endoscopy (2014)

This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). It addresses the clinical indications for the use of computed tomographic colonography (CTC). A targeted literature search was performed to evaluate the evidence supporting the use of CTC. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. <b>Main recommendations</b> <b>1</b> ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. ESGE/ESGAR do not recommend barium enema in this setting (strong recommendation, high quality evidence). <b>2</b> ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. Delay of CTC should be considered following endoscopic resection. In the case of obstructing colorectal cancer, preoperative contrast-enhanced CTC may also allow location or staging of malignant lesions (strong recommendation, moderate quality evidence). <b>3</b> When endoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (strong recommendation, high quality evidence). <b>4</b> ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp ≥ 6 mm in diameter detected at CTC. CTC surveillance may be clinically considered if patients do not undergo polypectomy (strong recommendation, moderate quality evidence). <b>5</b> ESGE/ESGAR do not recommend CTC as a primary test for population screening or in individuals with a positive first-degree family history of colorectal cancer (CRC). However, it may be proposed as a CRC screening test on an individual basis providing the screenee is adequately informed about test characteristics, benefits, and risks (weak recommendation, moderate quality evidence).
Doctors told to seek court orders in good time for expectant mothers who lack capacity
Authors: C. Dyer
Journal: BMJ (2014)

UK doctors caring for expectant mothers who are thought to lack the capacity to make their own decisions on childbirth have been told that they must seek court authorisation in good time if there is a real risk that more than transient force will be needed to effect the delivery or that the process will deprive the mother of her liberty.

Mr Justice Keehan has set out detailed guidance for trusts on deciding whether they need to go to court and the steps they should take.

The guidance comes in an annex to his full judgment in the case of a 24 year old woman with schizoaffective disorder, named only as FG, who was detained under the Mental Health Act and who believed that staff were conspiring to murder …
ENZYMES IN THE TREATMENT OF NASAL POLYPI, ANGIOMA OF THE NOSE. AND CHRONIC OTITIS.
Authors: TALBOT R. CHAMBERS
Journal: JAMA (1899)

Nasal polyps, as has been so succinctly shown by Jonathan Wright<sup>1</sup>of Brooklyn, are so-called because of their pedunculated form, and are usually simply an expression of overnutrition of the part; a coincidence with chronic catarrh, and secondarily arising from the inflammatory condition of subjacent periosteum. A myxomatous polyp, Wright calls "an edematous polyp," because it is a mucous membrane infiltrated and hypertrophied by the encapsulation in fibrous meshes of a more or less fluid mucous secretion. It has varying attenuations, sometimes even being quite firm and resisting. After speaking of the stroma, epithelium, fluid contents, glands and nerves, he says: Blood-vessels are scanty and capillary in size." But these blood-vessels have great importance, and bleed most freely under certain conditions. I will never forget my experience with a patient from whom I had snared, imperfectly perhaps, under eucain, when that deceiving drug was first introduced. The hemorrhage was
Mini-clinics in General Practice
Authors: P. H. Brunyate
Journal: BMJ (1973)

influenzae resistant to trimethoprim is in- creasing rapidly.The suggestion was based on their finding that many strains showed long trailing end-points in sensitivity tests by both the disc and the serial dilution methods.The effects were first observed in the disc method and the authors then assumed that they were due to the use of a medium which contained substances that partially reversed the action of trimethoprim and the sulphon- amides.However, they rejected this explana-
Critics attack chief medical officer's advice to use antivirals for flu
Authors: Zosia Kmietowicz
Journal: BMJ (2014)

Latest government advice telling GPs in England to use antiviral drugs for certain patients with influenza was “disgraceful” for failing to take account of the evidence and for wasting scarce resources, critics have said.

In a notice issued to GPs and others on 27 January, Sally Davies, the chief medical officer for England, and Keith Ridge, the chief pharmaceutical officer, said that surveillance data indicated that there was now a “substantial likelihood” that people presenting with an influenza-like illness were infected with a flu virus.

They said that GPs may now prescribe antivirals “at NHS expense” for the prophylaxis and treatment of flu to people eligible under guidance from the National Institute for Health and Care Excellence (NICE) and …
Lichtenberg Figures Due to a Lightning Strike
Authors: Y Domart, E Garet
Journal: New England Journal of Medicine (2000)

Figure 1. A 54-year-old man was struck by lightning and was initially stuporous. The emergency medical team found him conscious and in sinus rhythm, with normal vital signs and numbness and paresthesia of the left shoulder, flank, and leg. On his arrival at the emergency department, he felt well, and an examination revealed a fern-leaf pattern of erythematous, painless cutaneous marks on his left arm, back, buttocks, and left thigh. The electrocardiogram was normal, and the serum concentrations of creatine kinase and myoglobin were slightly elevated. The patient was sent home after 24 hours. On a follow-up visit two days . . .
Serum antidiuretic hormone is elevated in relation to the increase in average total body transepidermal water loss in severe atopic dermatitis
Authors: T. Aoki
Journal: British Journal of Dermatology (2005)

While elevation of antidiuretic hormone (ADH) (arginine vasopressin) levels in the serum has been reported in severe atopic dermatitis (AD), the cause is as yet unexplained. On the other hand, transepidermal water loss (TEWL) is known to increase in the damaged skin due to AD.As ADH increases as a result of dehydration of the body, this study examined whether the high ADH level in severe AD is a reaction to the increased water loss through the entire body skin surface area.Forty-eight patients of different ages and with various degrees of AD along with six age- and sex-matched control persons were the study subjects. Using a quick responsive evaporimeter, an average total body TEWL (ATEWL) value was obtained for each subject. Laboratory tests including ADH, serum lactate dehydrogenase (LDH) and peripheral blood eosinophil count (EOS) were also performed. Clinical severity grading was made globally. The relevancy of this grading was empirically demonstrated by its statistically significant relation to LDH and EOS which are commonly known as appropriate gauges for AD severity. Results ATEWL was observed to be significantly greater in patients with AD of at least moderate severity than in normal controls, and ADH was significantly greater in patients with severe and very severe AD. Both ATEWL and ADH showed a significant relation to AD severity. Finally, a significant correlation was found between ADH and ATEWL.It is possible that elevated ADH is at least in part a reaction to increased ATEWL.
Abstract 473: Long term clinical and biochemical outcomes following immunotherapy with an novel autologous immunomodulated vaccine in patients with prostate cancer.
Authors: Fernando T. Kreutz, Gustavo Schroeder, Milton Berger
Journal: Cancer Research (2013)

Abstract Background: VAP is an new autologous immunomodulate vaccine, that was previously demonstrate to be safe in an initial phase I trial with local advance prostate cancer patients. The extension of this initial trail into a Phase IIb is now been reported. The primary endpoint of the study reported here is clinical response (PSA and survival) in local advance (T2 and T3) prostate cancer patients, with safety and immunologic responses as secondary endpoints. Methods: Tumor cells from 107 prostatectomy patients were collected (HCPA - Porto Alegre - Brazil). 48 (45%) patients with T3 or T2 with co-morbidity factors were enrolled. 22 patients received the vaccine and 26 were in the control group. Vaccine was given by intradermal injections (4x weekly, 2x monthly and after 3 months). First two doses also ontained BGC as adjuvant. DTH was measured 48 hours after the vaccine doses that did not contained BCG. PBMCs and were collected via apheresis at baseline and D+54 for Tcell proliferation assay in some patients. Clinical flow up was performed and all standard care was given to all patients. Results: The overall follow up was 7.4 years. No grade 3 or 4 toxicity attributable to vaccine was noted. Side effects were largely limited to grade 1 or 2 injection site reactions. DTH was positive (= or higher than 5 mm) in 73% of the vaccinated patients. Cancer related mortality was 9% (2/22) on the vaccinated group and 19% (5/26) on the non-vaccinated group. PSA was undetectable (less than 0.04 ng/ml) in 85% (17/20) of the vaccinated patients and in 48% (10/21) of the non-vaccinated patients after 5 years of follow up.In vitro specific T cell proliferation was demonstrated in vaccinatedpatients. Conclusions: VAP is safe and well tolerated vaccine. There is evidence of clinical activity and immune changes in selected patients. Further studies to confirm these results are warranted. (Financial support from FINEP - Brazilian Innovation Agency) Citation Format: Fernando T. Kreutz, Gustavo Schroeder, Milton Berger. Long term clinical and biochemical outcomes following immunotherapy with an novel autologous immunomodulated vaccine in patients with prostate cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 473. doi:10.1158/1538-7445.AM2013-473
EFFECT OF EXPOSURE TO LOW TEMPERATURES ON DIPHTHERIA TOXIN-ANTITOXIN MIXTURE
Authors: BENJAMIN WHITE
Journal: JAMA (1924)

Early in the last week of January of the present year, an experience due to a peculiar set of unique and fortuitous circumstances occurred which could not have been anticipated by the application of any knowledge then existing. In two towns in Massachusetts, two different lots of diphtheria toxin-antitoxin mixture, after having suffered prolonged exposures to unusually low temperatures, were injected into a total of fifty-four children for the purpose of immunizing them against diphtheria, and produced severe reactions in forty-two of them. Both the local and the systemic reactions were typical of diphtheria intoxication. All the facts strongly suggested the hypothesis that the exposure to temperatures below freezing had caused the antitoxin to dissociate from the toxin, leaving free toxin present in the mixture. In order to determine the validity of this hypothesis, the experiments here reported were carried out. <h3>I. PREPARATION OF THE TOXIN-ANTITOXIN MIXTURE</h3> The mixtures were
K+-induced dilation of a small renal artery: no role for inward rectifier K+ channels
Authors: H Prior
Journal: Cardiovascular Research (1998)

Objective: To investigate the mechanism of K+-induced vasodilation in a small artery from the kidney, with a particular emphasis on the role of inward rectifier K+ channels. Methods: Lumen diameter and isometric tension recordings have been made from rabbit renal arcuate artery using pressurised- and wire-myography respectively. In addition, conventional whole-cell and amphotericin-perforated patch whole-cell recordings have been made from single smooth muscle cells isolated from the vessel. Results: Arcuate arteries dilated when the extracellular K+ concentration was raised to 8–10 mM from either zero or a normal physiological level of about 6 mM. The effect was not endothelium-dependent. Application of 0.01–1 mM Ba2+ to block inward rectifier K+ channels had no significant effect on K+-induced vasodilation in the arcuate artery, but under the same experimental conditions K+-induced dilation of the rat posterior cerebral artery was abolished by Ba2+. In the presence of 60 mM extracellular K+, inward rectifier K+-current was detectable in some single smooth muscle cells isolated from arcuate arteries but on average the current density was low (−1.44 pA pF−1 at −60 mV). K+-induced vasodilation of the arcuate artery was abolished by 10 μM ouabain and the half-effective concentration of K+ which induced vasodilation was 0.9–1.5 mM. Conclusions: The observations suggest that an increase in the extracellular K+ concentration (up to about 10 mM) dilates the rabbit renal arcuate artery and that the primary mechanism underlying the effect may be stimulation of Na+–K+ ATPase in the smooth muscle cell membrane. Inward rectifier K+ channels have a low average density in smooth muscle cells isolated from arcuate arteries and play no significant role in K+-induced vasodilation.
Nottingham Staphylococcus aureus population study: prevalence of MRSA among elderly people in the community
Authors: H. Grundmann
Journal: BMJ (2002)

The spread of methicillin resistant Staphylococcus aureus (MRSA) has caused problems in most hospitals in the United Kingdom in the past decade. 1 The extent to which the community serves as a reservoir for MRSA is unknown despite the growing recognition of MRSA as a community pathogen in various countries. 2 We investigated the prevalence of nasal carriage of MRSA in a sample of people aged 65 and over who live in their own homes and represent the elderly population in the Greater Nottingham Health District, where MRSA is endemic in hospitals.
THE LOCAL USE OF SULFANILAMIDE IN THE TREATMENT OF PERITONEAL INFECTIONS
Authors: R. STERLING MUELLER
Journal: JAMA (1942)

Two years after the report of Domagk<sup>1</sup>in 1935 concerning the chemotherapeutic properties of azosulfamide, certain bacterial infections were commonly treated with sulfanilamide with excellent results. Given by mouth, by rectum or by hypodermoclysis at regular intervals, therapeutic blood and tissue concentrations could be maintained which had a definite bacteriostatic effect on certain organisms. In April 1937 Sinclair and Barker<sup>2</sup>departed radically from the usual plan of administration of sulfanilamide and for the first time made use of high local concentrations of the drug for the treatment of localized infections. They used crushed sulfanilamide tablets in dental surgery, such as for infected operative wounds in the mouth, certain extractions, compound fractures and osteomyelitis of the mandible—with good results in the prophylaxis and treatment of infections. In July 1939 Jensen, Johnsrud and Nelson<sup>3</sup>reported a series of compound fractures treated with local implantation of sulfanilamide. In this series
Pulmonary veins in high-altitude residents: a morphometric study.
Authors: C A Wagenvoort, N Wagenvoort
Journal: Thorax (1982)

The thickness of the media of pulmonary veins and arteries was morphometrically assessed in 12 normal adults resident at altitudes over 3000 m and 12 resident at sea level. The pulmonary veins in the latter group were very thin walled. The average thickness of the pulmonary venous media in the group of highlanders was significantly thicker but this appeared to be due to prominent medial hypertrophy in seven individuals, five others having normal or near-normal pulmonary veins. In six of the 12 highlanders bundles of longitudinal smooth muscle cells occurred in the venous intima. There was close correlation between the thickness of the venous and that of the arterial media, suggesting an individual reactivity with a simultaneous response of all pulmonary vascular smooth muscle to high-altitude hypoxia. Hypertrophy of the media of pulmonary veins is likely to be an expression of venoconstriction and narrowing of the venous lumen may be enhanced by the development of longitudinal smooth muscle cells in the intima. Possibly venoconstriction is one of the factors responsible for high-altitude pulmonary oedema.
EVEROLIMUS-ELUTING STENTS SUPPRESS IN VIVO PLAQUE INFLAMMATORY PROTEASE ACTIVITY AS DETECTED BY INTRAVASCULAR FLUORESCENCE MOLECULAR IMAGING
Authors: Marcella A. Calfon, Georgios Mallas, Amir Rosenthal, Alexander J. Sheehy, Igor Polyakov, R. Nika Razansky, Luis Guerrero, Adam Mauskapf, Frank Kolodgie, Renu Virmani, Ntziachristos Vasilis, Farouc Jaffer
Journal: Journal of the American College of Cardiology (2010)
Cause of Acquired Immune Deficiency Syndrome
Authors: Dennis J. McShane
Journal: JAMA (1984)

To the Editor.—  We feel compelled to reply to the SPECIAL COMMUNICATION in JAMA by Sonnabend et al. Attributing the etiology of AIDS to profound promiscuity rather than a putative viral agent has two major problems. First, such attribution is liable to give a false sense of security to the population at large that they are not at risk for the disease. Since the epidemiology of this syndrome most closely follows that of hepatitis B, clearly there is risk of spread among family members, as was suggested to occur from parent to child in the same JAMA issue. 1,2   Second, as the authors point out, the profound promiscuity theory does indeed fail to explain why hemophiliacs and intravenous drug users are at risk. Clearly, blood transmission of an agent like a virus would explain AIDS in these two groups. The risk to Haitians is as yet unexplained.  Finally, it is
Remarks on DRAINAGE OF BRAIN ABSCESS
Authors: P. Sargent
Journal: BMJ (1928)

THE geineral principles of treatlmienit of abscess of the brain differ in nio essential feature fromii those hich obtain in abscess-es elsewvhere in tthe body, but the peculiar clharacters of the cerebral tissue, tlhe existence of the cer ebro-spinal fluid circulation, and -tlle plhysical condi- tionis of pressure wvithin the craniial cavity creato special difficuilties aild problems.'While the primary object in 'lealiiig w-itlh these cases is the effective dr ainiage of the abscess, yet the possibility of fatal complications following precociouis or imiisdirected surgical measures, togetlher with tlhe danigers of serious damage to brain function, must be giveii due consideration in planning the operation.The great variations of type which occur among cerebral
Chromobronchoscopy in the Diagnosis of Bronchial Tumors
Authors: A.A. Ovchinnikov, V.V. Dianov, G.I. Lukomsky, A. Bilial
Journal: Endoscopy (1980)

Staining of the bronchi with methylene blue was performed during bronchoscopy in 140 patients with various bronchopulmonary diseases. It was found that malignant bronchial tumors selectively stain dark blue; normal mucous membranes remain unstained. On this basis one can judge rather accurately how far the cancerous growth has spread along the bronchus, and so reach the target area by biopsy in those cases where visual signs of abnormality are indistinct or absent.
Abdominal Wall Endometriosis Following Hypertonic Saline Abortion
Authors: Bernard T. Ferrari
Journal: JAMA (1977)

CUTANEOUS endometriosis is usually an easily detectable and treatable disease with a favorable prognosis. Although the lesion may occur in skin and subcutaneous tissue not violated by a surgical incision, there are numerous reports of endometriosis in operative scars. The following case illustrates the occurrence of endometriosis in the lower abdominal wall, following transabdominal hypertonic saline instillation into the uterus of a pregnant woman for elective abortion. <h3>Report of a Case</h3> A 28-year-old woman was referred to the University of California at Los Angeles Hospital surgical service for investigation of a firm mass in the lower midline abdominal wall. The patient first noted the mass seven years previously, three months after she had undergone a transabdominal hypertonic saline injection to induce abortion of a 20-week gestation. The operative record at the time of that abortion reported the use of an 18-gauge needle with stylet, penetrating the abdomen in the lower
Single or multiple dose ursodeoxycholic acid for cholestatic liver disease: biliary enrichment and biochemical response
Authors: Paul C. van de Meeberg, Frank H.J. Wolfhagen, Gerard P. Van Berge-Henegouwen, Jan M.J.I. Salemans, Albert Tangerman, Henk R. van Buuren, Jan van Hattum, Karel J. van Erpecum
Journal: Journal of Hepatology (1996)
Correlation between particle size, in vivo particle persistence, and lung injury.
Authors: G Oberdörster, J Ferin, B E Lehnert
Journal: Environmental Health Perspectives (1994)

Dosimetry parameters such as deposition, clearance, retention, and translocation and dissolution of inhaled particles in and to different lung compartments may be important for the persistence of particles in the lung and may correlate with adverse pulmonary effects. We investigated such correlations using a model involving TiO2 particles of two particle sizes (20 nm diameter, ultrafine; 250 nm diameter, fine) of the same crystalline structure (anatase). A 12-week inhalation experiment in rats resulted in a similar mass deposition of the two particle types in the lower respiratory tract. The ultrafine particles elicited a persistently high inflammatory reaction in the lungs of the animals compared to the larger-sized particles. In the postexposure period (up to 1 year) retention in the alveolar space per se was not different between fine and ultrafine TiO2. However, the following differences between the particle types were noted: a significantly different total pulmonary retention, both quantitatively (significantly prolonged retention of the ultrafine TiO2) and qualitatively (increased translocation to the pulmonary interstitium and persistence there of the ultrafine TiO2); greater epithelial effects (Type II cell proliferation; occlusion of pores of Kohn) and the beginning of interstitial fibrotic foci with ultrafine TiO2; significant sustained impairment of alveolar macrophage function after ultrafine TiO2 exposure as measured by the clearance of test particles. A correlation between particle surface area and effects was observed. A comparison of the adverse reactions with dosimetric parameters of TiO2 in different lung compartments in the postexposure period showed a correlation of the persistence of effects in both the alveolar and interstitial space with the persistence of particles in the respective compartment.