tbuckley/cabot-search huggingface dataset:
Balloon Dilation of Ileocolonic Strictures in Crohn’s Disease
Authors: B. P. Saunders, G. J. Brown, M. Lemann, P. Rutgeerts
Journal: Endoscopy (2004)

Crohn’s disease is characterized by chronic, recurrent, transmural inflammation, which as a consequence of partial healing and localized fibrosis may lead to intestinal stricture formation (see Figure [1 a]). Following resectional surgery, recurrence of Crohn’s disease at the anastomosis or in the neo-terminal ileum may lead to stenosis. Treatment options for ileocolonic strictures include:
Blood Letting in High-Ferritin Type 2 Diabetes
Authors: José Manuel Fernández-Real, Georgina Peñarroja, Antoni Castro, Fernando García-Bragado, Abel López-Bermejo, Wifredo Ricart
Journal: Diabetes Care (2002)

In a recent study, iron chelation with deferoxamine led to improvement of endothelial dysfunction in patients with coronary artery disease. We tested the hypothesis that decreasing circulating iron stores might improve vascular dysfunction in patients with type 2 diabetes and increased serum ferritin concentration.A total of 28 type 2 diabetic male patients with serum ferritin levels >200 ng/ml ( approximately 18% of consecutive type 2 diabetic men attending our outpatient clinic) were randomized to iron depletion (three extractions of 500 ml blood at 2-week intervals; group 1A) or to observation (group 1B). C282Y mutation was absent in all patients. Vascular reactivity (high-resolution external ultrasound) was evaluated at baseline and at 4 and 12 months thereafter. The two groups of patients were matched for age, BMI, pharmacological treatment, and chronic diabetic complications.Endothelium-dependent vasodilation remained essentially unchanged in both groups of patients. In contrast, the vasodilation induced by glyceryl trinitrate (GTN) improved significantly after iron depletion (P = 0.006). These changes occurred in parallel to decreases in transferrin saturation index and HbA(1c) levels (-0.6%, P < 0.05) only in group 1A patients. The best predictor of the modifications in endothelium-independent vasodilation was the change in HbA(1c) levels. Changes in endothelium-independent vasodilation also correlated with the change in serum ferritin (r = -0.45, P = 0.04). At 12 months, transferrin saturation index and GTN-induced vasodilation returned to values similar to those at baseline in both groups of subjects.Iron depletion improves vascular dysfunction in type 2 diabetic patients with high ferritin concentrations. The mechanisms by which these changes occur should be further investigated.
Consent to psychiatric treatment: practical implications of the Mental Health (Amendment) Bill.
Authors: M A Beedie, R Bluglass
Journal: BMJ (1982)

The case notes of all patients admitted in 1981 to two Birmingham psychiatric hospitals on compulsory orders for treatment were examined to determine whether, had the new "consent to treatment" proposals in the Mental Health (Amendment) Bill been in operation, a second opinion was necessary. This concluded that there will be difficulties in operating the arrangements to provide a second opinion, and the Government should reconsider the range of these proposals.Proposed legislation in Great Britain regarding consent to treatment by the institutionalized mentally ill is examined. The requirement of obtaining a second opinion for specific kinds of treatment is discussed, and the results of an examination of psychiatric records are reported. The examination showed that so many second opinions would be required that there would be difficulty in implementing the proposed law.
Subdividing Departments of Medicine
Authors: George H. Goldsmith
Journal: Annals of Internal Medicine (1993)

Letters15 December 1993Subdividing Departments of MedicineGeorge H. Goldsmith, MDGeorge H. Goldsmith, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-12-199312150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Regarding the editorial from the Association of Professors of Medicine, it is hardly surprising that a group composed of the current chairpersons of departments of medicine is not thrilled with proposals to downsize their domains. However, it is unreasonable to depict an organizational structure created in a medical environment that no longer exists as a visionary model ideally suited to current challenges.Nothing is sacred or immutable about the organization of medicine or academic medical centers; structural organizations in this complex industry should reflect current internal needs and external forces. That the traditional department of medicine is ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1993Volume 119, Issue 12Page: 1225-1226KeywordsAcademic medicineHealth careResidencyTraditional medicine Issue Published: 15 December 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Case 3-1967
Authors: John W. Grover, Robert E. Scully
Journal: New England Journal of Medicine (1967)

Presentation of Case First admission. A twenty-five-year-old woman, gravida 5, para 5, entered the hospital because of pain in the abdomen.On the day before admission she had the onset of pain in the left lower quadrant of the abdomen, with a moderate vaginal discharge of yellowish-white, malodorous material. There were no cramps or difficulty with urination, and no blood clots were passed.Her last menstrual period had started five and a half weeks previously, and thereafter spotting had continued, requiring 2 to 3 pads per day. She was given a "shot for an overactive pituitary" followed by "contraceptive . . .
A Time To Listen
Authors: Donald A. Barr
Journal: Annals of Internal Medicine (2004)

On Being a Doctor20 January 2004A Time To ListenDonald A. Barr, MD, PhDDonald A. Barr, MD, PhDFrom Stanford, CA 94305-2160.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-2-200401200-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When teaching my students about what goes into a good doctor–patient interaction, I tell them about the studies that show how quickly doctors interrupt their patients. Male physicians especially, I tell them, are notorious for stopping the patient mid-sentence to redirect the discussion. In one study that I came across, female primary care physicians waited an average of 3 minutes before interrupting the patient to redirect the discussion toward issues more relevant to diagnosis. Male physicians waited an average of 47 seconds.How long do I wait, I wondered? I decided to try an experiment. I would let my next ... Author, Article, and Disclosure InformationAffiliations: From Stanford, CA 94305-2160.Corresponding Author: Donald A. Barr, MD, PhD, Stanford University, Building 80 MC 2160, Stanford, CA 94305-2160; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPhysician Well-Being in PracticeSpiritual distress and spiritual care in advanced heart failureGender Differences in Medicine—From Medical School to Medicare 20 January 2004Volume 140, Issue 2Page: 144KeywordsAntibioticsDrugsFeversLung and intrathoracic tumorsLungsNursesPrimary care physiciansThoraxTongue ePublished: 20 January 2004 Issue Published: 20 January 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Phase I Clinical Trial of SYL040012, a Small Interfering RNA Targeting β-Adrenergic Receptor 2, for Lowering Intraocular Pressure
Authors: Javier Moreno-Montañés, Belén Sádaba, Verónica Ruz, Almudena Gómez-Guiu, Javier Zarranz, María Victoria González, Covadonga Pañeda, Ana Isabel Jimenez
Journal: Molecular Therapy (2013)

The objective of this study was to evaluate ocular tolerance, safety, and effect on intraocular pressure (IOP) of a topically administered small interfering RNA; SYL040012, on healthy volunteers. The study was an open-label, controlled, single-center study comprised of two intervals that enrolled 30 healthy subjects having IOP below 21 mmHg. SYL040012 was administered to one eye as a single dose to six subjects during interval 1. During interval 2 two different doses of SYL040012 were administered to one eye on a daily basis to two separate groups of 12 subjects each, over a period of 7 days. The contralateral eye was evaluated but not administered and served as control for the tolerance study. SYL040012 was well tolerated locally. No local or systemic adverse events related to the product developed in response to any of the doses studied. SYL040012 was not detected in plasma at any time point. Administration of SYL040012 over a period of 7 days reduced IOP values in 15 out of 24 healthy subjects regardless of the dose used. IOP decrease was statistically significant in response to one of the doses tested and responsiveness to SYL040012 seemed to be greater in individuals with higher baseline IOP. The objective of this study was to evaluate ocular tolerance, safety, and effect on intraocular pressure (IOP) of a topically administered small interfering RNA; SYL040012, on healthy volunteers. The study was an open-label, controlled, single-center study comprised of two intervals that enrolled 30 healthy subjects having IOP below 21 mmHg. SYL040012 was administered to one eye as a single dose to six subjects during interval 1. During interval 2 two different doses of SYL040012 were administered to one eye on a daily basis to two separate groups of 12 subjects each, over a period of 7 days. The contralateral eye was evaluated but not administered and served as control for the tolerance study. SYL040012 was well tolerated locally. No local or systemic adverse events related to the product developed in response to any of the doses studied. SYL040012 was not detected in plasma at any time point. Administration of SYL040012 over a period of 7 days reduced IOP values in 15 out of 24 healthy subjects regardless of the dose used. IOP decrease was statistically significant in response to one of the doses tested and responsiveness to SYL040012 seemed to be greater in individuals with higher baseline IOP.
Effect of Hypophosphatemia on Myocardial Performance in Man
Authors: Lawrence R. O'Connor, William S. Wheeler, John E. Bethune
Journal: New England Journal of Medicine (1977)

Severe hypophosphatemia is associated in man with low intracellular stores of ATP and a set of specific cellular dysfunctions. To investigate whether hypophosphatemia affects myocardial performance, we measured cardiac output by thermodilution and calculated stroke work in seven patients with severe hypophosphatemia before, during and after repletion with an intravenous potassium phosphate solution. Mean left ventricular stroke work for these patients increased from 49.57 to 71.71 g-m per beat (P less than 0.01) at the same or higher afterload whereas pulmonary-artery wedge pressure fell from a mean value of 10.1 to 6.7 torr (P less than 0.02). Return of serum phosphate to normal, therefore, improved myocardial stroke work independently of the Starling effect. The mechanism of this improvement in contractile force is unknown but may be related to intracellular availability of ATP.
Cadmium in forest ecosystems around lead smelters in Missouri.
Authors: N L Gale, B G Wixson
Journal: Environmental Health Perspectives (1979)

The development of Missouri's new lead belt within the past decase has provided an excellent opportunity to study the dissemination and effects of heavy metals in a deciduous forest ecosystem. Primary lead smelters within the new lead belt have been identified as potential sources of cadmium as well as lead, zinc, and copper. Sintering and blast furnace operations tend to produce significant quantities of small particulates highly enriched in cadmium and other heavy metals. At one smelter, samples of stack particulate emissions indicate that as ms accompanied by 0.44 lb zinc, 4.66 lb lead, and 0.01 lb copper/hr. These point-source emissions, as well as a number of other sources of fugitive (wind blown) and waterborne emissions contribute to a significant deposition of cadmium in the surrounding forest and stream beds. Mobilization of vagrant heavy metals may be significantly increased by contact of baghouse dusts or scrubber slurries with acidic effluents emanating from acid plants designed to produce H2SO4 as a smelter by-product. Two separate drainage forks within the Crooked Creek watershed permit some comparisons of the relative contributions of cadmium by air-borne versus water-borne contaminants. Cadmium and other heavy metals have been found to accumulate in the forest litter and partially decomposed litter along stream beds. Greater solubility, lower levels of complexation with organic ligands in the litter, and greater overall mobility of cadmium compared with lead, zinc, and copper result in appreciable contributions of dissolved cadmium to the watershed runoff. The present paper attempts to define the principle sources and current levels of heavy metal contamination and summarizes the efforts undertaken by the industry to curtail the problem.
Patient Decision Making-Reply
Authors: Paul Rozin
Journal: JAMA (1993)

<h3>In Reply.</h3> —We are grateful to Drs Shapiro and Muskin for pointing out that we did not discuss cognitive impairment or psychiatric disorders. We agree that some harmful decisions originate in emotional disturbances and pathological thought processes. Statistics on suicide rates, for example, poignantly document the consequences of depression. However, readers should not conclude that problems in judgment and decision making are confined to patients with neurological or psychiatric disorders. Our aim in the article was to emphasize that normal human intuitions are prone to predictable errors. Clinicians should be alert to the harmful mistakes that reasonable patients are likely to make in evaluating risks and benefits.
Somatostatin or Octreotide Compared with H<sub>2</sub>Antagonists and Placebo in the Management of Acute Nonvariceal Upper Gastrointestinal Hemorrhage
Authors: Thomas F. Imperiale
Journal: Annals of Internal Medicine (1997)

Purpose: To determine the efficacy of somatostatin or octreotide for the treatment of acute nonvariceal upper gastrointestinal hemorrhage. Data Sources: Database searches of English-language articles published between 1966 and 1996 and the bibliographies of all related articles and textbook chapters. Study Selection: Randomized clinical trials comparing somatostatin or octreotide with H2 blockers or placebo in patients with a clinical or endoscopic diagnosis of acute nonvariceal upper gastrointestinal hemorrhage. Data Extraction: Methods and quality of the studies were evaluated, and quantitative data on outcomes, including continued bleeding, rebleeding during the treatment period, need for surgery, and transfusion requirement, were extracted. Data Synthesis: Among 1829 patients from 14 trials, the relative risk (RR) for continued bleeding or rebleeding was 0.53 (95% CI, 0.43 to 0.63) in favor of somatostatin, with a number needed to treat (NNT) of 5. Among 7 investigator-blinded trials, the relative risk was 0.73 (CI, 0.64 to 0.81) and the NNT was 11. Somatostatin was efficacious for peptic ulcer bleeding (RR, 0.48 [CI, 0.39 to 0.59]; NNT, 4) and showed a trend toward efficacy for non-peptic ulcer bleeding (RR, 0.62 [CI, 0.39 to 1.002]). Although the overall results suggested a decreased need for surgery in the somatostatin group, a subgroup analysis of investigator-blinded trials revealed a more modest effect that was not statistically significant (RR, 0.94 [CI, 0.87 to 1.001]). Conclusion: Somatostatin may reduce the risk for continued bleeding from acutely bleeding peptic ulcer disease. Somatostatin may be useful either as an adjunct treatment before endoscopy or when endoscopy is unsuccessful, contraindicated, or unavailable.
Clinical Epidemiology: The Essentials
Authors: Paul S. Levy
Journal: JAMA (1983)

This book, written by and directed to physicians, presents the basic concepts of epidemiology with conciseness, clarity, and numerous examples from clinical medicine. The authors approach the topic of clinical epidemiology by applying epidemiologic principles and methods to problems encountered in clinical medicine. They believe that knowledge of these principles can help a clinician not only in the evaluation of clinical literature but also in patient care. The book consists of 12 chapters, each covering a broad epidemiologic concept. Among the major topics included are problems in clinical measurements; sensitivity, specificity, and predictive accuracy of diagnostic tests; measurement of disease occurrence and etiology; and assessment of prognosis and of treatment efficacy. The text has interspersed numerous tables and attractive diagrams and figures, and the authors make effective use of tables to summarize their discussions. Major strengths of this book are its clarity, the attractiveness of its presentation, and its avoidance
Neuronal cell death in Alzheimer's disease correlates with apoE uptake and intracellular Abeta stabilization.
Authors: F M LaFerla, J C Troncoso, D K Strickland, C H Kawas, G Jay
Journal: Journal of Clinical Investigation (1997)

The brains of individuals with Alzheimer's disease (AD) are characterized by extracellular deposition of beta-amyloid protein (Abeta), intracellular neurofibrillary tangles, and loss of neurons. To study molecular markers associated with dying cells in the AD brain, in situ DNA labeling techniques were used to visualize cells with DNA fragmentation. We observed that intracellular accumulation of apolipoprotein E (apoE) is correlated with the detection of intracellular Abeta-like immunoreactivity within the same cytoplasmic granules, suggesting that uptake of lipids may have stabilized the hydrophobic Abeta protein within the cell. These apoE-containing neurons also exhibit high expression of a cell surface receptor, gp330, which is known to bind apoE. Cells containing significant nuclear DNA fragmentation express the highest level of cell surface gp330. Extracellular deposition of Abeta is detected only upon neuronal cell death, initially as halos of Abeta immunoreactivity around individual dying neurons, and subsequently as Abeta plaques containing numerous neuronal cell ghosts. Based on our in situ analysis of nuclear DNA fragmentation, we conclude that neuronal cell death likely occurs before the extracellular deposition of Abeta in AD brains.
Attitudes of Cancer Patients
Authors: BARRY LOWITZ
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 December 1980Attitudes of Cancer PatientsBARRY LOWITZ, M.D., PATRICIA GANZ, M.D.BARRY LOWITZ, M.D.Search for more papers by this author, PATRICIA GANZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-6-935_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In their recent paper, Cassileth and colleagues (1) reported on the wishes of cancer patients to be fully informed of their condition and to participate actively in their care (1). In a similar survey, we examined both patient and family attitudes toward information and participation. Patients were asked about the desirability of being under the care of a single medical team throughout their illness. We also examined patients' attitudes toward a mixed ward of actively treated and dying patients. These questions addressed the issue of whether a separate hospice facility and staff were desirable for dying patients....1. CASSILETH B, ZUPKIS R, SUTTON-SMITH K, and MARCH V. Information and participation preferences among cancer patients. Ann Intern Med. 1980;92:832-6. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: BARRY LOWITZ, M.D.; PATRICIA GANZ, M.D.Affiliations: UCLA-San Fernando Valley Program Sepulveda, CA 91343 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1980Volume 93, Issue 6Page: 935-935 ePublished: 1 December 2008 Issue Published: 1 December 1980 PDF downloadLoading ...
Response vs. nonresponse to treatment with erythropoiesis stimulating agents among breast cancer patients with anemia: findings from the European anemia cancer treatment study.
Authors: M Aapro, H Ludwig, C Bokemeyer, P Soubeyran, K MacDonald, T Albrecht, I Abraham
Journal: Cancer Research (2009)

Abstract Abstract #4095 Background. More cancer patients (pts) with anemia are being treated with erythropoiesis stimulating agents (ESA) in Europe than 7 years ago, but treatment response patterns remain poorly documented. The use of ESAs in breast cancer (BCA) is under debate and knowledge about response rates may benefit clinical risk-benefit analysis. We conducted a subgroup analysis of the A.C.T. study to estimate the proportions of responders vs. nonresponders to ESA treatment (Rx) among breast cancer pts with anemia (Hb≤11g/dL) using five commonly used measures of treatment response.&amp;#x2028; Methods. Multicenter, longitudinal retrospective study with at least 3 time points at approximately 1 month intervals, with visit 1 coinciding with start of ESA Rx. 148 centers in 12 European countries contributed 415 BCA pts who were on chemotherapy, anemic, and treated with an ESA (18.9% of total study sample). Patient demographics, clinical status, treatment patterns, and hemoglobin (Hb) and performance outcomes are reported by Aapro et al. (2008 SABCS). Five measures of treatment response were estimated: Hb rise ≥1g/dL, Hb rise ≥1g/dL within 8 weeks, hematopoietic response (Hb rise ≥2g/dL or Hb≥12g/dL achieved), Hb rise ≥2g/dL, and Hb target range of 12.0-12.9g/dL achieved by visit 3.&amp;#x2028; Results. Types of ESA prescribed included epoetin alfa (22.9%), epoetin beta (39.3%), darbepoetin (37.6%), and other (0.2%) at a median standardized dose of 30000 IU/wk. 33.0% of patients received iron supplementation; of these 11.9% received IV iron. Mean Hb increased from 9.9±0.8g/dL to 11.1±1.3g/dL from visits 1 to 3, indicating a positive treatment response across all patients. Table 1 presents the percentages of responders versus nonresponders according to the 5 measures.&amp;#x2028; &amp;#x2028; Conclusions. An increase in Hb of ≥1g/dL over the course of treatment is an attainable goal in approximately three-quarters of BCA pts with anemia. Adding time constraints, increasing the threshold level to ≥2g/dL, and/or setting an evidence-based target range of 12-12.9g/dL is associated with lower response rates. In BCA pts, the therapeutic Hb goal to be achieved may need to be determined under consideration of multiple factors, however the general effectiveness of ESAs in this population is evident. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4095.
Doesn't everyone know that purpose of advertising is to promote products?
Authors: Y Chan
Journal: BMJ (2001)

EDITOR—Hastings and MacFadyen's paper about tobacco advertising tried to establish that the tobacco industry targeted those below the legal age for smoking, but the conclusion seems uncertain.1 They wrote: “The precise definition of ‘young’ remains contentious.” Later they said “Whether the industry is deliberately targeting under 16 years olds remains a matter for dispute.” Words like “contentious” and “dispute” imply uncertainty. The industry insisted that it only targeted young adults—young but adults nevertheless—and there is no concrete evidence from industry documents to disprove this. Documents …