tbuckley/cabot-search huggingface dataset:
Benign oesophageal stricture in Barrett's columnar epithelialised oesophagus and its responsiveness to conservative management.
Authors: M Atkinson, C S Robertson
Journal: Gut (1988)

The response to treatment of peptic oesophageal stricture associated with columnar lined (Barretts) oesophagus (CLO) has been compared with that in peptic stricture without CLO. Benign oesophageal stricture was present in 23 (41%) of 56 patients consecutive with CLO. In 18 the stricture lay at the squamocolumnar mucosal junction and was associated with reflux oesophagitis, in five it was situated in the columnar lined segment and in four of these it was known to have been preceded by a chronic ulcer at the site of the stricture. Controls were an age and sex matched group of patients with benign stricture related to reflux oesophagitis unassociated with columnar epithelialisation. CLO associated strictures involving squamous mucosa were situated significantly (p less than 0.01) higher in the oesophagus than non-CLO strictures. The response to endoscopic dilatation and active medical treatment was significantly better, as judged by the need for subsequent dilatation (p less than 0.01) in the CLO than in the non-CLO group. It is concluded that associated columnar epithelialisation of the oesophagus is not in itself an indication for antireflux surgery in the management of benign stricture and these usually respond well to dilatation and medical treatment.
Career Decisions of Internal Medicine Residents
Authors: Colin P. West, Joseph C. Kolars
Journal: Annals of Internal Medicine (2007)

Letters17 July 2007Career Decisions of Internal Medicine ResidentsColin P. West, MD, PhD and Joseph C. Kolars, MDColin P. West, MD, PhDFrom the Mayo Clinic College of Medicine, Rochester, MN 55905.Search for more papers by this author and Joseph C. Kolars, MDFrom the Mayo Clinic College of Medicine, Rochester, MN 55905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-2-200707170-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the comments of Dr. Arora and colleagues. We agree that international medical graduates are an important part of the internal medicine residency workforce. As Dr. Arora and colleagues note, literature on the development of career decisions of international medical graduates is very limited. In our study, we elected to examine factors that have clearly been shown to affect career choice. Therefore, other potentially important variables, such as medical training site, were not evaluated.Our data do allow some insight into how the career plans of international medical graduates may change over the course of training, but ... Author, Article, and Disclosure InformationAffiliations: From the Mayo Clinic College of Medicine, Rochester, MN 55905.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChanges in Career Decisions of Internal Medicine Residents during Training Colin P. West , Carol Popkave , Henry J. Schultz , Steven E. Weinberger , and Joseph C. Kolars Career Decisions of Internal Medicine Residents Vineet Arora , Sameer Badlani , and Mubashir Khan Metrics 17 July 2007Volume 147, Issue 2Page: 145KeywordsConflicts of interestGraduate medical educationResidency ePublished: 17 July 2007 Issue Published: 17 July 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
A Dopamine D2 Receptor-DISC1 Protein Complex may Contribute to Antipsychotic-Like Effects
Authors: Ping Su, Shupeng Li, Sheng Chen, Tatiana V. Lipina, Min Wang, Terence K.Y. Lai, Frankie H.F. Lee, Hailong Zhang, Dongxu Zhai, Stephen S.G. Ferguson, José N. Nobrega, Albert H.C. Wong, John C. Roder, Paul J. Fletcher, Fang Liu
Journal: Neuron (2014)
Phase II Study of Paclitaxel Plus Gemcitabine Salvage Chemotherapy for Germ Cell Tumors After Progression Following High-Dose Chemotherapy With Tandem Transplant
Authors: Lawrence H. Einhorn, Mary J. Brames, Beth Juliar, Stephen D. Williams
Journal: Journal of Clinical Oncology (2007)

Purpose To determine long-term survival and potential cure with salvage chemotherapy with paclitaxel plus gemcitabine after progression after both cisplatin combination chemotherapy and subsequent high-dose chemotherapy with tandem transplantation. Patients and Methods One hundred eighty-four patients received salvage high-dose chemotherapy at Indiana University (Indianapolis, IN) from February 1996 to December 2004. After further evidence of progressive disease, 32 patients were subsequently treated with paclitaxel 100 mg/n 2 over 1 hour plus gemcitabine 1,000 mg/m 2 over 30 minutes, days 1, 8, and 15 every 4 weeks for a maximum of six courses. This is a retrospective review of this patient population. Patients were evaluated for response, duration of response, and survival. Patients were ineligible if they received prior paclitaxel or gemcitabine. Results Ten (31%) of 32 patients achieved objective response, including four partial remissions (2- to 6-month duration) and six complete responses (CRs). Four of these six CRs (12.5% of total patient population) are continuously disease free (NED) with paclitaxel plus gemcitabine alone (no postchemotherapy surgery) at more than 20, 40, 44, and 57 months from start of paclitaxel plus gemcitabine, respectively. One additional CR is currently NED more than 63 months after paclitaxel plus gemcitabine with two subsequent resections of carcinoma. Conclusion Long-term disease-free survival is possible with paclitaxel plus gemcitabine in this patient population that progressed after high-dose chemotherapy, and had not received prior paclitaxel or gemcitabine.
The power of prayer (and adequate fluid resuscitation)
Authors: Diana M Jolliffe
Journal: BMJ (2005)

<h3></h3> Despite the frequency and severity of sepsis in neonatal intensive care units, diagnosing infections remains difficult and time consuming and lacks sensitivity. Evaluating clinical data in conjunction with serial inflammatory mediators may improve detection, ideally before clinical signs and symptoms are present. We designed a pilot study to determine whether a complex computational model evaluating changes in inflammatory mediators combined with clinical data could assist in early detection of neonatal infection. Eligible infants were &lt; 72 hours old and were ≥ 37 weeks EGA (term) or ≤ 32 weeks EGA (preterm). Infants were enrolled for 28 days or until discharge. The plasma from spun hematocrit tubes was evaluated for 165 inflammatory mediators (including IL 1-18, MMPs, CRP, ENA-78, RANTES, TNF, G-CSF, GM-CSF, ICAM-1, TIMP-1, and others) using a chemiluminescent bead assay. Based on clinical and traditional laboratory data, infants were classified daily as having no infection, suspected infection, clinical infection without positive cultures, and culture-proven infection. Changes in inflammatory mediators were correlated with this clinical classification by creating a Bayesian network classifier over the clinical data, using a leave-one-out cross-validation methodology. Fifty-six infants were enrolled, 17 term (39 ± 1.2 wks, 3,242 ± 509 g) and 39 preterm (29 ± 2.2 wks, 1,267 ± 389 g). Nine infants were excluded from analysis (2 due to incomplete sample data and 7 due to incomplete clinical data). Nineteen episodes of positive blood, urine, or wound cultures in conjunction with clinical signs of infection were diagnosed in 9 infants (2 term). Thirteen others had clinical evidence of infection but negative cultures (7 term). Results based on a single application of the initial algorithm using a combination of clinical variables (RR, BP, temperature) and mediators (ENA-78, CRP) identified profiles capable of separating infected from noninfected cases with an overall accuracy of 94%. These preliminary results suggest that, using clinical data and a broad protein array, complex computational analyses may play a role in distinguishing early severe infections in newborns. Supervised machine learning techniques previously developed for microarray analysis are being employed to build and evaluate a classifier to distinguish normal samples from samples related to infection. Further evaluations using temporal computational analysis are ongoing.
Molecular and Cellular Aspects of the Insulin-Like Growth Factor I Receptor
Authors: DEREK LEROITH, HAIM WERNER, DANA BEITNER-JOHNSON, ANDCHARLES T. ROBERTS
Journal: Endocrine Reviews (1995)

THE insulin-like growth factors (IGFs) and their receptors and binding proteins constitute a family of cellular modulators that play essential roles in the regulation of growth and development. The IGF ligands include three structurally related peptides: insulin, IGF-I, and IGF-II. Unlike insulin, IGF-I and IGF-II are expressed ubiquitously, albeit in a highly regulated manner (see reviews in Refs. 1-5). The biological functions of the IGFs are mediated by a family of transmembrane receptors, which includes the insulin, IGF-I, and IGF-II/mannose-6-phosphate (M-6-P) receptors. While the IGF-I receptor is the primary mediator of IGF action, the insulin and IGF-II/M-6-P receptors may also mediate some of these functions (Fig. 1) (6, 7). The biological actions of the IGFs are modulated by a family of at least six IGF-binding proteins (IGFBPs) that are found in the circulation and in extracellular compartments and are produced by most tissues. The IGFBPs are capable of inhibiting or enhancing IGF effects and may even have ligand-independent effects (see reviews in Refs. 8–11). This review will focus on the IGF-I receptor and will discuss various aspects of its molecular structure and the cellular effects elicited by its activation.
More on Cheese
Authors: Lawrence S. Ross
Journal: JAMA (1966)

<h3>To the Editor:—</h3> Your editorial "Cheese—Again!" (<b>197</b>:292, 1966) is responsible for this: For a snack there is nothing to please Like a cracker with fresh cheddar cheese Unless you're depressed When it's not for the best For the pills plus the cheese cause disease.
Chronic Active Hepatitis
Authors: Harold Fallon
Journal: JAMA (1972)

Dr. Rodolfo N. Perez, Jr., Senior Assistant Resident in Medicine, the Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: A 50-year-old black woman was admitted to Jewish Hospital for the first time in October 1968 with a history of jaundice and anorexia. The patient was not aware of exposure to infectious hepatitis, and denied intravenous injections or transfusions, recent surgery, exposure to hepatotoxic agents, or ingestion of any medication. On physical examination, she had scleral icterus and a soft abdomen without palpable organomegaly; Murphy's sign was not elicited. The remainder of her physical examination was within normal limits. The hematocrit reading was 39% and the white blood cell count (WBC), 4,500/cu mm with a normal differential cell count; the urine was positive for bile but was otherwise unremarkable. The total circulating alkaline phosphatase level was 307 international units (IU; normal, &lt; 100 IU); lactic
Phase II Randomized Study of Two Regimens of Sequentially Administered Mitomycin C and Irinotecan in Patients with Unresectable Esophageal and Gastroesophageal Adenocarcinoma
Authors: Maryam B. Lustberg, Tanios Bekaii-Saab, Donn Young, Gregory Otterson, William Burak, Abbas Abbas, Barbara McCracken-Bussa, Mark E. Lustberg, Miguel A. Villalona-Calero
Journal: Journal of Thoracic Oncology (2010)
Declining Incidence of Haemophilus influenzae Type b Disease Since Introduction of Vaccination
Authors: Trudy V. Murphy
Journal: JAMA (1993)

To determine the incidence of invasive Haemophilus influenzae type b disease in children living in Minnesota and Dallas County, Texas, before and since introduction of plain polysaccharide vaccine in 1985, and conjugate vaccine in 1988. Initially, use of these vaccines was limited to infants 18 months of age and older.Identification of culture-proven cases of H influenzae type b disease was through systems of active, laboratory-based surveillance. The mean incidence of disease (cases observed/100,000 child-years) for 1983 and 1984 served as a baseline for comparison with subsequent years through 1991.Children less than 5 years of age in Minnesota and Dallas County, Texas. Overall, there were 2557 confirmed age-eligible cases of invasive H influenzae type b disease from 1983 through 1991.Between the 1983-1984 baseline and 1991, the incidence of H influenzae type b disease decreased 85% in Minnesota and 92% in Dallas. Notably, declines in incidence were observed in children in the age group being vaccinated as well as in infants younger than 18 months of age prior to introduction of vaccination.In two widely separated areas of the United States, a profound decrease in the incidence of H influenzae type b disease has occurred. The data suggest that vaccination may be protecting against disease, as well as decreasing the spread of infection to unvaccinated infants.
Effective tumor targeted gene transfer using PEGylated adenovirus vector via systemic administration
Authors: Jian-Qing Gao, Yusuke Eto, Yasuo Yoshioka, Fumiko Sekiguchi, Shinnosuke Kurachi, Tomohiro Morishige, Xinglei Yao, Hikaru Watanabe, Ratima Asavatanabodee, Fuminori Sakurai, Hiroyuki Mizuguchi, Yuka Okada, Yohei Mukai, Yasuo Tsutsumi, Tadanori Mayumi, Naoki Okada, Shinsaku Nakagawa
Journal: Journal of Controlled Release (2007)
The Intravenous Furosemide Test: A Simple Way to Evaluate Renin Responsiveness
Authors: NORMAN M. KAPLAN
Journal: Annals of Internal Medicine (1976)

To identify patients with low-renin hypertension, we measured plasma renin activity after the administration of 40 mg of furosemide intravenously and 30 minutes of upright posture in 127 normotensive subjects and 363 patients with essential hypertension. Plasma renin activity 30 minutes after intravenous furosemide was found to be closely correlated to the level found after either 2 or 4 h of standing or 3 days of a low-salt diet plus 2 h of upright posture. Renin responsiveness was significantly lower in hypertensive patients, blacks, and women, compared with normotensive subjects, whites, and men respectively. The level of plasma renin activity in most normal white subjects was greater than 1.0 ng/ml · h and in most normal blacks was greater than 0.5 ng/ml · h. It was below those levels in 23% of white hypertensive and 25.2% of black hypertensive patients respectively. The mean level of plasma renin activity fell with increasing age of hypertensive patients. This procedure is recommended as a safe, easy, and reliable test for assessing renin responsiveness and identifying the low-renin state.
Robotic prostatectomy transmitted live to engineers to promote collaboration
Authors: Susan Mayor
Journal: BMJ (2008)

A radical prostatectomy using a robot was transmitted live to a group of surgeons and mechanical engineers last week to stimulate collaboration between the professions and encourage developments in robotic surgery.

The operation was performed at Guy’s Hospital, London, by Prokar Dasgupta, reader and consultant urological surgeon at the hospital and King’s College London, School of Medicine, and transmitted to an audience at the Institution of Mechanical Engineers in London.

“For the last couple of years we have been collaborating with our mechanical engineers at King’s College …
My behavior made me do it: The uncaused cause of teleological behaviorism
Authors: Jordan Hughes, Patricia S. Churchland
Journal: Behavioral and Brain Sciences (1995)

Abstract Toward a neurobiologically grounded approach to explaining self-control we discuss the case of a patient with a bilateral lesion in frontal ventromedial cortex. Patients with such lesions display a marked deficit in social decision making. Compared with an account that examines the causal antecedents of self-control, Rachlin's behaviorist approach seems lacking in explanatory strength.
After two decades, Penn State researchers may be near perfecting replacement hearts and lungs
Authors: M. F. Goldsmith
Journal: JAMA (1993)

KIDS ARE getting artificial hearts at the Milton S. Hershey Medical Center, Hershey, Pa. The baby goats are just the right size for testing electric pediatric ventricular assist pumps—miniature versions of the totally implantable wireless devices for adults that have been under development in calves there for several years. "We're at the point now where we can approach the Food and Drug Administration with a proposal to do a larger series of animals, because we've pretty much worked out the 'bugs' in this little device," says William S. Pierce, MD, professor of surgery and chief of the Division of Cardiothoracic Surgery, Pennsylvania State University College of Medicine, also in Hershey. The pediatric pumps, which have a 15-cm<sup>3</sup>stroke volume and could be used on an infant weighing 2 or 3 kg, are envisioned as supporting children with congenital heart defects prior to or during recovery from surgery. They are
New Insights on the Simultaneous Assessment of Insulin Sensitivity and β-Cell Function With the HOMA2 Method
Authors: Andrea Caumo, Gianluca Perseghin, Amelia Brunani, Livio Luzi
Journal: Diabetes Care (2006)

The homeostasis model assessment (HOMA) is a method for assessing β-cell function and insulin sensitivity that has gained widespread use thanks to its simplicity and validity (1). The method has recently been reviewed by the group of investigators that championed its development (2). They pointed out that β-cell function cannot be interpreted without the knowledge of insulin sensitivity, and, thus, HOMA of insulin sensitivity (HOMA-S%) should always be reported alongside HOMA of β-cell function (HOMA-B%). Unfortunately, and more often than not, the HOMA indexes are not calculated in tandem. In fact, Wallace et al. (2) observed that in 75% of articles adopting the HOMA method, only HOMA-S% was reported. This is disappointing, since evidence has been accumulating that insulin sensitivity and β-cell function are inextricably linked and should be measured simultaneously because their interplay is fundamental to glucose tolerance. In 1979, Turner et al. (3) disclosed the existence of a curvilinear relationship between the indexes of insulin resistance and β-cell deficiency, which was estimated with a mathematical model of the glucose-insulin feedback loop (a precursor of the HOMA method). In 1981, Bergman et al.(4) showed the presence of a similar relationship between the indexes of insulin sensitivity and β-cell function obtained from the intravenous glucose tolerance test with the minimal model. They also introduced the disposition index (DI), the product of insulin sensitivity times β-cell function, showing that this summary measure was associated with the glucose tolerance displayed during the intravenous …
Mitochondrial enteropathy: the primary pathology may not be within the gastrointestinal tract
Authors: P F Chinnery
Journal: Gut (2001)

<h3>BACKGROUND</h3> Mitochondrial DNA (mtDNA) defects are an important cause of disease. Although gastrointestinal symptoms are common in these patients, their pathogenesis remains uncertain. <h3>AIM</h3> To investigate the role of the mtDNA defect in the production of gastrointestinal dysfunction. <h3>PATIENT</h3> A 20 year old woman who presented at 15 years of age with recurrent vomiting and pseudo-obstruction, who did not respond to conservative management and ultimately had subtotal gastrectomy and Roux-en-y reconstruction. She subsequently presented with status epilepticus and was found to have a mitochondrial respiratory chain disorder due to a pathogenic mtDNA point mutation (A3243G). <h3>METHODS</h3> Resected bowel was studied using light and electron microscopy and mtDNA analysed from both mucosal and muscular layers using polymerase chain reaction generated RFLP analysis. <h3>RESULTS</h3> Histological and electron microscopic studies revealed no morphological abnormalities in the resected stomach, and molecular genetic analysis failed to identify the genetic defect in either the mucosal or muscle layers. <h3>CONCLUSION</h3> This study suggests that in some individuals with gastrointestinal symptoms associated with established mitochondrial DNA disease, the primary pathology of the mitochondrial enteropathy lies outside the gastrointestinal tract.
The War on Drugs -- A Peace Proposal
Authors: L Grinspoon, J B Bakalar
Journal: New England Journal of Medicine (1994)

After nearly 10 years of escalation, the government assault on illicit drugs has proved to be a costly failure. We have all been paying the price in misdirected resources, social tension, violent crime, ill health, compromised civil liberties, and international conflict.The war on drugs is, in effect if not in intention, a war on drug users. The federal budget for the control of illicit drugs has increased more than eightfold since 1981, and more than two thirds of the total is devoted to the enforcement of increasingly harsh criminal laws1. These laws needlessly make criminals of at least . . .
Physiological Right Ventricular Adaptation in Elite Athletes of African and Afro-Caribbean Origin
Authors: Abbas Zaidi, Saqib Ghani, Rajan Sharma, David Oxborough, Vasileios F. Panoulas, Nabeel Sheikh, Sabiha Gati, Michael Papadakis, Sanjay Sharma
Journal: Circulation (2013)

Regular, intensive exercise results in physiological biventricular cardiac adaptation. Ethnicity is an established determinant of left ventricular remodeling; black athletes (BAs) exhibit more profound LV hypertrophy than white athletes (WAs). Right ventricular (RV) remodeling has not been characterized in BAs, although the issue is pertinent because BAs commonly exhibit ECG anomalies that resemble arrhythmogenic RV cardiomyopathy.Between 2006 and 2012, 300 consecutive BAs (n=243 males) from 25 sporting disciplines were evaluated by use of ECG and echocardiography. Results were compared with 375 WAs and 153 sedentary control subjects (n=69 blacks). There were no ethnic differences between RV parameters in control subjects. Both BAs and WAs exhibited greater RV dimensions than control subjects. RV dimensions were marginally smaller in BAs than in WAs (proximal outflow tract, 30.9±5.5 versus 32.8±5.3 mm, P<0.001; longitudinal dimension, 86.6±9.5 versus 89.8±9.6 mm, P<0.001), although only 2.3% of variation was attributable to ethnicity. RV enlargement compatible with diagnostic criteria for arrhythmogenic RV cardiomyopathy was frequently observed (proximal outflow tract ≥32 mm; 45.0% of BAs, 58.5% of WAs). Anterior T-wave inversion was present in 14.3% of BAs versus 3.7% of WAs (P<0.001). Marked RV enlargement with concomitant anterior T-wave inversion was observed in 3.0% of BAs versus 0.3% of WAs (P=0.005). Further investigation did not diagnose arrhythmogenic RV cardiomyopathy in any athlete.Physiological RV enlargement is commonly observed in both black and white athletes. The impact of ethnicity is minimal, which obviates the need for race-specific RV reference values. However, in the context of frequent ECG repolarization anomalies in BAs, the potential for erroneous diagnosis of arrhythmogenic RV cardiomyopathy is considerably greater in this ethnic group.
P156NLRP3 mediates cardio-protection during ischemia-reperfusion
Authors: O Sandanger, E Gao, T Ranheim, M Bliksoen, OJ Kaasboll, K Alfsnes, E Lien, P Aukrust, LE Vinge, A Yndestad
Journal: Cardiovascular Research (2014)

Background: NLRP3 is an innate immune receptor that recognizes tissue damage and initiate inflammatory processes: chiefly, upon activation, NLRP3 forms multiprotein complexes with the adaptor protein ASC and caspase-1, termed inflammasomes, which cleaves pro-IL-1β and mediates release of bioactive IL-1β. Thus, NLRP3 activation may lead to further tissue damage. Hence, we hypothesized that NLRP3 mediates tissue damage during acute myocardial infarction and sought to investigate the mechanisms herein.