tbuckley/cabot-search huggingface dataset:
Stage 0 macular holesObservations by optical coherence tomography
Authors: A CHAN, J DUKER, J SCHUMAN, J FUJIMOTO
Journal: Ophthalmology (2004)

To introduce the concept of a stage 0 macular hole based on optical coherence tomographic observations of the vitreoretinal interface in fellow eyes of patients with unilateral idiopathic macular holes, and to evaluate the subsequent risk of progression to a full-thickness macular hole.Retrospective observational case series.Ninety-four patients with a unilateral stage 2, 3, or 4 full-thickness macular hole.The medical records of patients with a unilateral macular hole diagnosed between 1994 and 2000 at the New England Eye Center were reviewed.Development of a full-thickness macular hole in the fellow eye on biomicroscopic fundoscopy or optical coherence tomography (OCT).In 27 (28.7%) of 94 clinically normal fellow eyes, OCT detected an abnormality of the vitreoretinal interface but normal foveal anatomy. The vitreoretinal abnormalities were further subclassified into severe (4 eyes), moderate (8 eyes), and mild (15 eyes) based on the intensity and morphology of the OCT signal. One of the 4 (25%) severe cases progressed to a full-thickness macular hole, 4 of the 8 (50%) moderate cases became full-thickness macular holes, and no (0%) mild cases progressed to a full-thickness macular hole. Severe and moderate eyes seemed to share characteristic features on OCT that increased their risk of macular hole development (stage 0 macular hole). The macular hole-free survival at 48 months was 94% for stage 0-negative patients, versus 54% for stage 0-positive patients. Univariate analysis revealed that the presence of a stage 0 macular hole was significantly associated with an almost 6-fold increase in the risk of macular hole formation (relative risk: 5.8, 95% confidence interval: 1.16-28.61, P = 0.03).A stage 0 macular hole has a normal biomicroscopic appearance clinically, but has salient features on OCT as a result of oblique vitreous traction. Optical coherence tomographic findings consist of a normal foveal contour and normal retinal thickness and must include the presence of a preretinal, minimally reflective, thin band inserting obliquely on at least one side of the fovea. The presence of a stage 0 macular hole in the fellow eye is a significant risk factor for the development of a second macular hole.
Recurrence of Venous Thromboembolism after Treatment with Unfractionated Heparin
Authors: Jan Dirk Banga
Journal: Annals of Internal Medicine (1996)

Letters1 March 1996Recurrence of Venous Thromboembolism after Treatment with Unfractionated HeparinJan Dirk Banga, MD, H.W. de Valk, MD, and H.K. Nieuwenhuis, MDJan Dirk Banga, MDAcademic Hospital Utrecht 3508 GA Utrecht, the NetherlandsSearch for more papers by this author, H.W. de Valk, MDAcademic Hospital Utrecht 3508 GA Utrecht, the NetherlandsSearch for more papers by this author, and H.K. Nieuwenhuis, MDAcademic Hospital Utrecht 3508 GA Utrecht, the NetherlandsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-5-199603010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Sutton raises an important issue about the optimal dosage of heparin. The predefined therapeutic range of heparin used in our study corresponded to a heparin level of 0.25 to 0.40 U/mL, which is narrower than the generally recommended range of 0.20 to 0.40 U/mL [1]. The dosing practice was standardized and consisted of measurement of the activated partial thromboplastin time 4 hours after any dose adjustment and immediate adjustment of the heparin dosage if the activated partial thromboplastin time was outside the therapeutic range. With this protocol, 15 of the 17 patients in whom thromboembolism recurred while ...References1. Hirsh J. Heparin. N Engl J Med. 1991; 324:1565-74. Google Scholar2. de Valk HW, Banga JD, Wester JW, Brouwer CB, van Hessen MW, Meuwissen OJ, et al. Comparing subcutaneous danaparoid with intravenous unfractionated heparin for the treatment of venous thromboembolism. A randomized, controlled trial. Ann Intern Med. 1995; 123:1-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Academic Hospital Utrecht 3508 GA Utrecht, the Netherlands PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1996Volume 124, Issue 5Page: 532KeywordsHeparinInternational normalized ratioPartial thromboplastin timeThromboembolismVenous thromboembolism Issue Published: 1 March 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Potassium-Induced Lesions of the Small Bowel
Authors: Scott J. Boley
Journal: JAMA (1965)

Enteric-coated potassium chloride is responsible for a striking increase in ulcerative lesions of the small intestine. Pathologically these lesions are venous infarctions of varying severity; patients present with obstruction or signs of perforation, or both, and rarely with bleeding. Roentgenologic studies demonstrate partial intestinal obstruction. Careful investigation of drug ingestion is essential in making the diagnosis. Based on clinical, experimental, and pathological studies, aggressive surgical therapy is recommended. Because irreversible damage may have occurred by the time symptoms appear, medications containing enteric-coated potassium should be limited to patients who require thiazides and whose potassium requirements cannot be met by dietary means.
Constraints on Regulatory Options for Putatively Cognitive Enhancing Drugs
Authors: Wayne Hall, Brad Partridge, Jayne Lucke
Journal: The American Journal of Bioethics (2013)

Click to increase image sizeClick to decrease image size Acknowledgments Since May 2012 Wayne Hall has served as a World Health Organization-nominated member on the International Narcotics Control Board, an independent quasi-judicial body that is appointed by the UN to monitor compliance by member states with the provisions of the 1961, 1971, and 1988 international drug control treaties. Wayne Hall and Jayne Lucke's contribution was funded by Wayne Hall's NHMRC Australia Fellowship and Brad Partridge's work was funded by an NHMRC Post-Doctoral Fellowship.
Intake of Fruits and Vegetables and Risk of Breast Cancer
Authors: Stephanie A. Smith-Warner, Donna Spiegelman, Shiaw-Shyuan Yaun, Hans-Olov Adami, W. Lawrence Beeson, Piet A. van den Brandt, Aaron R. Folsom, Gary E. Fraser, Jo L. Freudenheim, R. Alexandra Goldbohm, Saxon Graham, Anthony B. Miller, John D. Potter, Thomas E. Rohan, Frank E. Speizer, Paolo Toniolo, Walter C. Willett, Alicja Wolk, Anne Zeleniuch-Jacquotte, David J. Hunter
Journal: JAMA (2001)

Some epidemiologic studies suggest that elevated fruit and vegetable consumption is associated with a reduced risk of breast cancer. However, most have been case-control studies in which recall and selection bias may influence the results. Additionally, publication bias may have influenced the literature on associations for specific fruit and vegetable subgroups.
IV. The Founding of the American Medical Association
Authors: Lester S. King
Journal: JAMA (1982)

A medical society is not a philanthropic or altruistic organization. It exists for the sake of its members, to help them gain certain benefits. Societies come into existence when a group of individuals, having aims in common, feel that they can achieve their aims more readily by joint action than by individual effort. If other members of the community also benefit, this will be a plus value that will promote general goodwill and induce more ready acceptance of the society's goals. The American Medical Association, whose origins are well documented, is a prime example of this total process. At its birth in 1846 (under a different name), the reasons for its existence were clearly stated: "<i>Resolved</i>, That it is expedient for the Medical Profession of the United States, to institute a<i>National Medical Association</i>, for the protection of their interests, for the maintenance of their honour and respectability, for the
Clinical Decision Making: Theory vs Practice-Reply
Authors: David M. Eddy
Journal: JAMA (1990)

<h3>In Reply.—</h3> Dr Havener's basic point is correct—that failure to specify the length of time for the outcome could lead to vastly different estimates. However, in this case that cannot explain the results. The question was formulated with the help of the experts, it was discussed to try to ensure that everyone understood it, a specific period was described, and everything was written down on a blackboard for all to see as they developed their answers. After seeing the results, the participants agreed that there was indeed a wide range of perceptions in the room, and they proceeded to discuss how better information could be obtained. My intention with this example was not to expose the participants as fools or to "prove" extreme inaccuracy in the practice of medicine, but to indicate that in the face of poor information, practitioners can develop widely varying perceptions. In fact, this group of
Insulin attenuates vasopressin-induced calcium transients and a voltage-dependent calcium response in rat vascular smooth muscle cells.
Authors: P R Standley, F Zhang, J L Ram, M B Zemel, J R Sowers
Journal: Journal of Clinical Investigation (1991)

Insulin attenuates the contractile responses of vascular smooth muscle (VSM) to various agonists. Insulinopenic and insulin-resistant rats lack this normal attenuation of vascular contractile responses. To study this attenuating mechanism, the effects of insulin on calcium (Ca2+) responses of cultured VSM cells (a7r5) to arginine vasopressin (AVP) and membrane potential were investigated. Insulin (1 and 100 mU/ml) shifted AVP dose-response curves to the right, reducing relative potency of AVP by 16-fold and 220-fold, respectively. Responses to AVP were significantly attenuated within 30 min of insulin application. The AVP-elicited rise in [Ca2+]i was partially dependent upon extracellular Ca2+. AVP-elicited inward current was reduced by 90 min of insulin treatment (100 mU/ml), from a peak current of -103 +/- 27 pA (normal) to -37 +/- 15 pA (insulin treated). Peak voltage-dependent Ca(2+)-dependent inward current was unaffected by insulin; however, the current-voltage curve was shifted 16 +/-3 mV to the right by insulin. Thus, insulin may reduce VSM contractile responses by attenuating agonist-mediated rises in [Ca2+]i mediated, in part, by reductions in Ca2+ influx through both receptor- and voltage-operated channels.
Surgery in Hemophilia
Authors: Armand J. Quick
Journal: JAMA (1973)

ABSTRACT To the Editor.— The article on Aortic Valve Replacement in Hemophilia by Brockman and associates (222:660, 1970) is of special interest to me since I studied this patient in 1963, which enables me to supply additional information. His early medical history was not typical of hemophilia. Severe nosebleeds occurred in childhood, which is rare in uncomplicated hemophilia. At age 9 years, he fell and sustained an injury to his chest that resulted in severe epistaxis and hematemesis. At that time he was told by his physician that he had an infection around the heart. At the age of 28 years, he bled for four weeks after a tooth extraction, despite treatment with a whole blood transfusion, snake venom, thrombin, ascorbic acid, and rutin. The diagnosis of hemophilia was made at the Michael Reese Hospital when he was 39 years old. I confirmed this diagnosis three years later and found that
Tissue engineered regeneration of completely transected spinal cord using human mesenchymal stem cells
Authors: Kkot Nim Kang, Da Yeon Kim, So Mi Yoon, Ju Young Lee, Bit Na Lee, Jin Seon Kwon, Hyo Won Seo, Il Woo Lee, Ha Cheol Shin, Young Man Kim, Hyun Soo Kim, Jae Ho Kim, Byoung Hyun Min, Hai Bang Lee, Moon Suk Kim
Journal: Biomaterials (2012)
The Current Status of the Macrocytic Anemias.
Authors: R. W. Vilter
Journal: Annals of Internal Medicine (1961)

s1 May 1961The Current Status of the Macrocytic Anemias.R. W. Vilter, M.D., F.A.C.P.R. W. Vilter, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-5-1052_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMacrocytic megaloblastic anemias occur because of single or combined deficiencies of folic acid, vitamin B12, or ascorbic acid. Many other situations can result in mild or moderate macrocytosis, such as chronic liver disease, hemolytic anemia, refractory anemia (chronic bone marrow failure), but none of these produce a true megaloblastic bone marrow picture.Chemical, microbiologic, and isotopic studies of patients with macrocytic megaloblastic anemia indicate that several deficiencies usually are responsible. Even the patient with a Shilling test typical of pernicious anemia, which is due to vitamin B12deficiency, often is deficient in folic acid and has a very low ascorbic... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cincinnati, O. (ML) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1961Volume 54, Issue 5Page: 1052-1052KeywordsAnemiaBone marrowBone marrow failureChronic liver diseaseFolic acidHemolytic anemiaMegaloblastic anemiaPernicious anemiaVitamin B12 deficiency Issue Published: 1 May 1961 PDF downloadLoading ...
Bidirectional Effects of Aminophylline on Myocardial Ischemia
Authors: Tetsuo Minamino, Masafumi Kitakaze, Toshikazu Morioka, Koichi Node, Yoshiro Shinozaki BE, Mitsuaki Chujo, Hidezo Mori, Hiroshi Takeda, Michitoshi Inoue, Masatsugu Hori, Takenobu Kamada
Journal: Circulation (1995)

Background Aminophylline blocks adenosine receptors and increases levels of plasma catecholamines. We investigated the effect of aminophylline on myocardial ischemia by varying its severity and attempted to identify the mechanism by which aminophylline modulates myocardial ischemia in the canine model. Methods and Results In 41 open-chest dogs, the left anterior descending coronary artery was cannulated and perfused with blood through a bypass tube from the left carotid artery. When coronary blood flow (CBF) was reduced to 80% of the control, aminophylline increased fractional shortening (FS) from 11.0±0.4% to 18.5±1.7% ( P &lt;.05) and lactate extraction ratio (LER) from 7.5±0.1% to 13.6±1.0% ( P &lt;.01). The endocardial to epicardial flow ratio (Endo/Epi ratio) of regional myocardium was also increased. Release of adenosine was increased compared with the nonischemic condition (7±3 versus 28±5 pmol/mL). Prazosin, an α 1 -adrenoceptor antagonist, blunted the aminophylline-induced improvement in contractile and metabolic function. Administration of 8-phenyltheophylline, a selective antagonist of adenosine receptors, did not increase FS, LER, or the Endo/Epi ratio when CBF was reduced to 80% of control. When CBF was reduced to 60% of control, aminophylline did not change the metabolic and contractile function. In contrast, when CBF was reduced to 33% of control, release of adenosine was increased markedly (243±19 pmol/mL) and aminophylline induced decreases in FS, LER, and Endo/Epi ratio similar to those observed with 8-phenyltheophylline. Conclusions Aminophylline had opposite effects on the ischemic myocardium depending on the severity of ischemia. It improved mild ischemia but worsened severe ischemia. The beneficial effect of aminophylline was attributable to α 1 -adrenoceptor stimulation, which improves endomyocardial flow in the ischemic myocardium. The deleterious effect was attributable to the aminophylline-induced blockade of adenosine receptors.
RADIOTHERAPY FOR INFLAMMATORY CONDITIONS
Authors: ARTHUR U. DESJARDINS
Journal: JAMA (1931)

The value of radiotherapy in the treatment of many acute, subacute and chronic inflammatory processes is not as well known as it deserves to be. This is apparently because the sound experimental basis and the mass of clinical and other evidence on which it rests have not been considered, and because many questionable or wholly unfounded ideas have been advanced as explanations. As in so many other phases of radiotherapy, the first knowledge of the possible value of irradiation in inflammatory conditions resulted from the observation of unexpected benefit following exposure, for diagnostic purposes, of parts of the body which were the seat of inflammatory lesions. <h3>FURUNCLE, CARBUNCLE AND OTHER PYOGENIC INFECTIONS</h3> The influence of irradiation on such lesions, especially when treated during the stage of maximal leukocytic infiltration, which is to say before the stage of frank suppuration, has been demonstrated by Coyle<sup>1</sup>(1906), Dunham<sup>2</sup>(1916), Ross
Comparisons between written and computerised patient histories.
Authors: M J Quaak, R F Westerman, J H van Bemmel
Journal: BMJ (1987)

Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic hypotheses, observer and record variations, and patients9 and doctors9 opinions were analysed for each record, and records were compared with the final diagnosis. About 40% of the data in the patient record were not present in the medical record. Two thirds of the patients said that they could express all or most of their complaints in the patient record. The doctors found that the medical record expressed the main complaints better (52%) than the patient record (15%) but that diagnostic hypotheses were more certain in the patient record (38%) than in the medical one (26%). The number of diagnostic hypotheses in the patient record was about 20% higher than that in the medical record. Intraobserver agreement (51%) was better than interobserver agreement (32%), while the inter-record agreement varied from 25% (between the medical and patient records) to 35% (between the transcribed and patient records). One third of final diagnoses were seen in the medical record, with 29% and 22% for the transcribed and patient records, respectively. Interobserver agreement in the final diagnosis was 35%. The results of the study suggest that computerised history taking is suitable for certain patients in addition to, and not as a substitute for, the oral interview with a doctor.
Magnetic microcapsules as novel biomonitors of cross-linking agents and diet-dependent reactive oxygen species in the human gastrointestinal tract.
Authors: S A Bingham, A B Shah, A Ellul, J H Cummings, I K O'Neill
Journal: Environmental Health Perspectives (1993)

Six healthy, scientifically informed human volunteers were given 14C-labeled polyethyleneimine (PEI) microcapsules by mouth. Fecal 14C recovery was inversely related to mean gut transit time (r = -0.66), and the extent of cross-linking between the membrane and core PEI was inversely related to total fecal output (r = -0.81). Cross-linking of PEI microcapsules may be a biomonitor of endogenous cross-linking agents within the human gastrointestinal tract. Extensive loss of [14C]CH3 label occurred from the microcapsules during human transit and in in vitro fermentations with human fecal flora. A mechanism whereby reactive oxygen species could arise in the iron-rich core of these microcapsules, leading to loss of [14C]CH3 label, is proposed.
Patient fails in attempt to get law on aiding suicide abroad clarified
Authors: C. Dyer
Journal: BMJ (2008)

A woman with multiple sclerosis has failed in a bid to force the director of public prosecutions for England and Wales to issue guidance clarifying whether her husband would face prosecution if he helped her travel to Switzerland for an assisted suicide.

Two senior judges at the High Court in London acknowledged that many people would regard such help as “something that the law should permit” but said that only parliament could change the law.

Debbie Purdy, 45, wanted Ken Macdonald, the director of public prosecutions, to outline the circumstances in which a helper might risk prosecution for aiding or abetting suicide in a country where assisted suicide is lawful. Assisting a suicide …
OP0117 Surveillance of the Outcome of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome
Authors: T. Origuchi, K. Arima, S.-Y. Kawashiri, M. Tamai, H. Nakamura, A. Kawakami, T. Tsukada, T. Miyashita, T. Aramaki, M. Furuyama, Y. Kawabe, N. Iwanaga, Y. Ueki, T. Fukuda, K. Eguchi
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is an acute edematous polyarthritis of the elderly subjects. Although an initial response to corticosteroids is very good, the further outcome of RS3PE syndrome remains to be elucidated. <h3>Objectives</h3> We have tried to investigate the further outcome in patients with RS3PE syndrome. <h3>Methods</h3> This is a retrospective multicenter study held in Nagasaki prefecture, Japan. We have consecutively registered the patients with RS3PE syndrome fulfilling the following criteria: (1) bilateral pitting edema of both hands or feet, or both, (2) sudden onset of polyarthritis, (3) age &gt;50 years, (4) seronegative for rheumatoid factor (RF). The total of 29 cases, between October 2003 and September 2012, were diagnosed as RS3PE syndrome and registered in the present study. Patients gave their informed consent to be subjected to the protocol and the outcome was evaluated by the medical records for 1 year after initial introduction of corticosteroids. <h3>Results</h3> Although an excellent response to initial corticosteroids was noted in all the 29 patients, twenty-five out of 29 patients (86.2%) still received corticosteroids at 1 year and 13 out of 29 patients (44.8%) received prednisolone &gt;5mg/day. Disease-modifying anti-rheumatic drugs including methotrexate were required in three patients (10.3%), furthermore, the elevation of CRP was still noted in 8 patients (27.6%) at 1 year. Accordingly, neoplasm was found in 12 patients (41.2%) and 3 died during 1 year. None of the RS3PE patients without neoplasm died during 1 year. Although there was no statistical difference, corticosteroids tended to be continued in the RS3PE patients with neoplasm (eleven out of 12: 91.7%) as compared with those without neoplasm (fourteen out of 17: 82.4%) during this follow up periods. <h3>Conclusions</h3> The present data suggest that the outcome of RS3PE syndrome may be variable and appears to be worse than expected. Coexistence of neoplasm might influence the outcome of these patients. <h3>References</h3> Arima K, Origuchi T, et al. RS3PE syndrome presenting as vascular endothelial growth factor associated disorder. Ann Rheum Dis. 2005 64(11):1653-5. Origuchi T, et al. High serum matrix metalloproteinase 3 is characteristic of patients with paraneoplastic remitting seronegative symmetrical synovitis with pitting edema syndrome. Modern Rheumatol. 2012 22(4):584-8. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4160
INFECTIOUS JAUNDICE—INFORMATION WANTED
Authors: George Blumer
Journal: JAMA (1922)

<h3>To the Editor:</h3> —For the last seven or eight months, I have been endeavoring through correspondence to obtain information regarding infectious jaundice in the United States. The disease is seldom fatal and usually takes the form of rather sharply localized endemics. For these two reasons, it is not a reportable disease in most states, though it has been made reportable in a few states within the last year or two. I have been able to obtain a good deal of information from state boards of health and from individuals; but I feel confident that the disease is much more widespread than my information would indicate, and I am, therefore, writing toThe Journalin the hope that this request for information will meet the eye of physicians who have observed even small outbreaks of infectious jaundice and that they will write me a brief statement to that effect, giving such