tbuckley/cabot-search huggingface dataset:
Simplified surgical treatment of chondrodermatitis nodularis by cartilage trimming and sutureless skin closure
Authors: W. Hussain, R.J.G. Chalmers
Journal: British Journal of Dermatology (2008)

Background Chondrodermatitis nodularis (CN) is a common painful ear condition, most commonly seen at the apex of the helix. Many different treatment methods for it have been advocated but excision of cartilage alone has been shown to be therapeutically and cosmetically effective. Objectives To describe and present our experience of a simplified and minimally invasive method of cartilage trimming for CN with sutureless skin closure. Methods A retrospective review of all cases of CN seen in our department treated by this technique. Results Of 34 patients treated over 12 years, 19 were men (mean age 61 years; range 47–83) and 15 were women (mean age 65 years; range 48–92). Right (n = 18) and left (n = 17) ears were almost equally represented. One patient required treatment for both ears. The antihelix was involved in seven cases; the remainder involved the helix. All patients were reviewed at 4 months. An excellent response with no discomfort or clinical recurrence of CN was observed in 32 (94%). Conclusions Our simplified technique of cartilage trimming and sutureless skin closure is a rapidly performed, minimally invasive and highly effective method of treating CN.
Congenital bronchial atresia with regional emphysema associated with pectus excavatum.
Authors: R J van Klaveren, W J Morshuis, L K Lacquet, A L Cox, J Festen, F M Heystraten
Journal: Thorax (1992)

Two cases of congenital bronchial atresia with pectus excavatum are reported. Costosternal retraction during the efforts to overcome the airway obstruction due to encroachment on normal lung tissue by the hyperinflated segments may play a part in causing pectus excavatum.
The Use of a New Apparatus for the Prolonged Administration of Artificial Respiration
Authors: Philip Drinker
Journal: JAMA (1986)

A number of patients have come under our observation who have shown intercostal paralysis and considerable weakness of the diaphragm early in the paralytic stage of anterior poliomyelitis; yet the accessory muscles and the diaphragm have been able to support sufficient respiratory movement to keep the patient alive until, in the course of a few days, the paralyzed intercostal muscles began to improve and the patient went on to almost complete recovery. Although this is not the usual termination of these cases, it occurs often enough to stimulate the desire to give all patients with respiratory paralysis this opportunity to recover normal breathing by maintaining artificial respiration over a period of hours, or even days. <h3>LIMITATIONS OF PRESENT METHODS OF PROLONGING LIFE</h3> The means of prolonging life in these patients are limited to the available methods of applying artificial respiration. Of these, the manual methods are not adapted to prolonged
Prazosin—new Hypertensive Agent
Authors: Alexander Schirger
Journal: JAMA (1977)

Prazosin hydrochloride, a new antihypertensive agent, is said to be of mild-to-moderate potency when used as a sole agent in mild-to-moderate hypertension and when used in conjunction with other agents in severe hypertension. In our study of 14 patients comparing hydrochlorothiazide with prazosin, the antihypertensive effect of prazosin was less than that of hydrochlorothiazide. The greatest application of prazosin may be in conjunction with thiazide diuretics and β-adrenergic blocking agents as the second or third drug. (<i>JAMA</i>237:989-991, 1977)
Full impact in Taiwan of typhoon is yet to emerge
Authors: J. Parry, K. Her
Journal: BMJ (2009)

The full effects of typhoon Morakot, which hit Taiwan on Saturday 7 August, are only now beginning to emerge. The death toll as at 17 August was 124, but this did not include the hundreds of villagers feared buried under a mudslide that hit the village of Hsiaolin in Kaohsiung county in the south of the country.

The Taiwanese government has been widely criticised domestically for reacting too slowly to the disaster. It has also been accused of declining help from overseas, leaving thousands of people stranded in remote mountainous villages without …
Neural Substrates for the Perception of Acutely Induced Dyspnea
Authors: CLAUDINE PEIFFER, JEAN-BAPTISTE POLINE, LIONEL THIVARD, MICHEL AUBIER, YVES SAMSON
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Little is currently known about the brain regions involved in central processing of dyspnea. We performed a functional imaging study with positron emission tomography (PET) to assess brain activation associated with an important component of dyspnea, respiratory discomfort during loaded breathing. We induced respiratory discomfort in eight healthy volunteers by adding external resistive loads during inspiration and expiration. Brain activation was characterized by a significant increase in regional cerebral blood flow (rCBF) (Z score of peak activation > 3.09). As compared with the unloaded control condition, high loaded breathing was associated with neural activation in three distinct brain regions, the right anterior insula, the cerebellar vermis, and the medial pons (respective Z scores = 4.75, 4.44, 4.41). For these brain regions, we further identified a positive correlation between rCBF and the perceived intensity of respiratory discomfort (respective Z scores = 4.45, 4.75, 4.74) as well as between rCBF and the mean amplitude of mouth pressure swings ( Δ Pm), the index of the main generating mechanism of the sensation (respective Z scores = 4.67, 4.36, 4.31), suggesting a common activation by these two parameters. Furthermore, we identified an area in the right posterior cingulate cortex where neural activation was specifically associated with perceived intensity of respiratory discomfort that is not related to Δ Pm (Z score = 4.25). Our results suggest that respiratory discomfort related to loaded breathing may be subserved by two distinct neural networks, the first being involved in the concomitant processing of the genesis and perception of respiratory discomfort and the second in the modulation of perceived intensity of the sensation by various factors other than its main generating mechanism, which may include emotional processing.
<scp>l</scp> -Arginine Induces Nitric Oxide–Dependent Vasodilation in Patients With Critical Limb Ischemia
Authors: Stefanie M. Bode-Böger, Rainer H. Böger, Heiko Alfke, Doris Heinzel, Dimitrios Tsikas, Andreas Creutzig, Klaus Alexander, Jürgen C. Frölich
Journal: Circulation (1996)

Background l -Arginine is the precursor of endogenous nitric oxide (NO), which is a potent vasodilator acting via the intracellular second-messenger cGMP. In healthy humans, l -arginine induces peripheral vasodilation and inhibits platelet aggregation due to an increased NO production. Prostaglandin E 1 (PGE 1 ) induces peripheral vasodilation via stimulating prostacyclin receptors. Methods and Results We investigated the effects of one intravenous infusion of l -arginine (30 g, 60 minutes) or PGE 1 (40 μg, 60 minutes) versus those of placebo (150 mL 0.9% saline, 60 minutes) on blood pressure, peripheral hemodynamics, and urinary NO 3 − and cGMP excretion rates in patients with critical limb ischemia (peripheral arterial occlusive disease stages Fontaine III or IV). Blood flow in the femoral artery was significantly increased by l -arginine (+42.3±7.9%, P &lt;.05) and by PGE 1 (+31.0±10.2%, P &lt;.05) but not by placebo (+4.3±13.0%, P =NS). Urinary NO 3 − excretion increased by 131.8±39.5% after l -arginine ( P &lt;.05) but only by 32.3±17.2% after PGE 1 ( P =NS). Urinary cGMP excretion increased by 198.7±84.9% after l -arginine ( P &lt;.05) and by 94.2±58.8% after PGE 1 ( P =NS). Both urinary index metabolites were unchanged by placebo. Conclusions We conclude that intravenous l -arginine induces NO-dependent peripheral vasodilation in patients with critical limb ischemia. These effects are paralleled by increased urinary NO 3 − and cGMP excretion, indicating an enhanced systemic NO production. Increased urinary NO 3 − excretion may be a sum effect of NO synthase substrate provision ( l -arginine) and increased shear stress (PGE 1 and l -arginine).
A Radical View of the Advertising Business.
Authors: J. Clark Stewart
Journal: JAMA (1897)

Minneapolis, Minn., March 27, 1897. <h3>To the Editor:</h3> —The short letter of Dr. W. S. Fullerton in theJournalof March 13, it seems to me, touches on a subject of the greatest importance, but one in regard to which, unfortunately, medical practitioners are too indifferent. I refer to the too common habit among manufacturing chemists of first introducing their goods to the regular profession in an ethical way, and after a time spent in such introduction and in obtaining testimonials from certain members of the profession, advertising the remedy in the secular press in the most unblushing manner for the benefit of the general public. Scott's emulsion and vin Mariani are two of the most notorious examples of this breach of faith with the profession, but it seems that during the past year the evil is growing, and that even heretofore reputable manufacturers are boldly advertising their goods to
Poor Long-Term Survival after Acute Myocardial Infarction among Patients on Long-Term Dialysis
Authors: Charles A. Herzog, Jennie Z. Ma, Allan J. Collins
Journal: New England Journal of Medicine (1998)

Cardiovascular disease is common in patients on long-term dialysis, and it accounts for 44 percent of overall mortality in this group. We undertook a study to assess long-term survival after acute myocardial infarction among patients in the United States who were receiving long-term dialysis.
Candida Endophthalmitis Complicating Candidemia
Authors: BURT R. MEYERS
Journal: Annals of Internal Medicine (1973)

Seven patients with endophthalmitis secondary to Candida species had complicated medical or surgical problems. Six patients had been given multiple antibiotics, and two received corticosteroids. Candidemia was demonstrable in five patients; in three, extraocular sites of candida infection were noted. Redness and irritation of the eye, which suggested simple conjunctivitis to the internist, appeared 3 to 35 days after detection of candidemia. Ophthalmological examination showed marked iritis in six patients; chorioretinal involvement in two; vitreous abscesses in four; and an iris abscess in one patient. Pathological examination of the eyes in four patients showed yeast or pseudohyphal forms in all specimens. Three patients were treated with antifungal agents; two responded favorably to amphotericin B, and one did not respond to 5-fluorocytosine. After fungemia is detected, an eye examination should be carried out and, when ocular lesions are noted, vigorous antifungal therapy instituted.
P576 MANAGEMENT OF HYPOVASCULAR HYPOINTENSE NODULES ON HEPATOBILIARY PHASE OF Gd-EOB-DTPA ENHANCED MRI
Authors: A. Sakamoto, R. Kita, H. Oku, R. Sada, M. Fukuhara, S. Marui, E. Iguchi, Y. Ohara, H. Takeda, S. Saito, N. Nishijima, A. Nasu, H. Nishikawa, H. Komekado, T. Kimura, Y. Osaki
Journal: Journal of Hepatology (2014)
Phenytoin in rheumatoid arthritis.
Authors: K A Grindulis, F E Nichol, R Oldham
Journal: Annals of the Rheumatic Diseases (1988)

Phenytoin in rheumatoid arthritis SIR, We were interested to read the comparative study of phenytoin and gold in rheumatoid arthritis (RA) by Richards et al,' prompted by the work of Macfarlane et al, who had shown improvements in clinical and laboratory tests and suggested that phenytoin may, therefore, have properties of a second line drug.2Richards et al found phenytoin to have significant beneficial effects on haemo- globin and the erythrocyte sedimentation rate but on only one of four clinical measurements.We have also studied phenytoin in RA,3 but without knowledge of other work in progress.Our interest was
Does IL‐22 protect against liver fibrosis in hepatitis C virus infection?
Authors: Liyuan Wu, Jingmin Zhao
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. Author names in bold designate shared co‐first authorship. To the Editor: We read with interest the article by Sertorio et al.,1 which has been published in a recent issue of Hepatology. The authors stated that interleukin (IL)‐22 protects against and IL‐22BP aggravates liver fibrosis and cirrhosis in humans with chronic hepatitis C by single‐nucleotide polymorphism genotyping assay. This study had improved our understanding of the pathogenesis of liver fibrosis. However, there are some comments we would like to raise. The authors found that IL‐22 concentrations in cultures of peripheral blood mononuclear cells (PBMCs) were inversely correlated with liver fibrosis severity in PBMC donors infected with Schistosoma japonicum. It had been pointed out that the liver was an important source of serum IL‐22 under conditions of hepatic inflammation/injury,2 thus IL‐22 level from in vitro experiment may not necessarily reflect the amount of this cytokine locally in the liver, and this inverse association might be spurious. In fact, a recent study showed that liver‐infiltrating IL‐22 cells were positively associated with liver fibrosis staging scores in hepatitis B virus (HBV)‐infected patients.3 We also found increased IL‐22 liver levels in HCV‐infected patients with advanced liver fibrosis (Fig. 1). Moreover, contrary to the authors' view, a recent study showed that HCV was a hepatotropic, noncytopathic RNA virus, and the ineffective immune response to HCV in chronically infected patients established continuous cycles of low‐level liver cell destruction that led to fibrosis, cirrhosis, and hepatocellular carcinoma.4 Zhao et al. demonstrated that IL‐22 played a pathological role in exacerbating chronic liver inflammation and fibrosis by recruiting hepatic T helper 17 cells in HBV‐infected patients.Figure 1: IL‐22‐producing cells were accumulated in livers of HCV‐infected patients. (A) Healthy control (×400). (B) G1S1. (C) G2S3‐4.To summarize, correlations in medicine are not, by definition, synonymous with pathogenesis. Functional experiments in the liver compartment are needed to confirm the roles of IL‐22/IL‐22BP in hepatic disease concluded from the genetic analysis of the study.
A MEMORABLE PATIENT
Authors: R. Ramasamy
Journal: BMJ (1995)

I first met this 20 year old man in 1992 in his isolated village in Tamil Nadu in India. He lived with his elderly, widowed father, who was deaf, in a crumbling stone and mud house and earned a hopelessly low income on the coffee estates. He had sought help for his symptoms from open pulmonary tuberculosis only when they were bad enough to stop him working. He already had some irreversible lung damage. …
231 A comprehensive study of hepatitis C virus prevalence and risk factors in the incarcerated setting: inmates, parolees and prison workers in California state corrections
Authors: R FOX, S CURRIE, J EVANS, L TOBLER, M BUSCH, T WRIGHT, K PAGESHAFER
Journal: Hepatology (2003)

Substance use disorders are common conditions among repeat criminal offenders. Without addressing these underlying substance use behaviors, parolees are significantly more likely to recidivate within 1 year of release. New Jersey is one of the first states to actively pursue substance abuse treatment options for inmates who are in the final stages of their sentences. Given the fiscal realities of taxpayer-supported programs, such initiatives must clearly demonstrate economic benefits for sustainability and growth. This article conducted one of the few comprehensive economic evaluations of prerelease substance abuse treatment to determine whether Community Education Centers' programs in New Jersey generated desirable outcomes, significant economic benefits, and positive net benefits. Relative to a matched comparison group of offenders who did not receive treatment, the intervention group returned an average economic benefit of $4,307 to $6,209 over the 1-year postrelease period. These economic benefits are underscored by the fact that the treatment program is housed in a separate facility, with a lower average per diem from that of the general inmate population. These results provide quantitative economic evidence that prerelease substance abuse treatment programs have the potential to reduce recidivism and save taxpayer dollars without adding to existing prison resources.
BMJ Publishing Group to launch an international campaign to promote academic medicine
Authors: J. Clark
Journal: BMJ (2003)

Please join us 

Academic medicine is in crisis across the world.1–4 Medicine's capacity to research, think, and teach is collapsing just at the time when science, social trends, and globalisation are offering great opportunities—and threats. The BMJ Publishing Group wants to help revitalise—and reinvent—academic medicine. How can academic medicine best prepare for the 21st century? We don't have an answer, but we propose a great debate.

We are not even entirely clear on the diagnosis. Why is academic medicine failing? The increasing pressure to provide …
Eliminating Waste in US Health Care
Authors: Donald M Berwick, Andrew D Hackbarth
Journal: JAMA (2012)

The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste—overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse—the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies.
Genealogy certainly matters for multifactorial genetic disease
Authors: A. Kong, J. Gulcher, K. Stefansson
Journal: BMJ (1999)

EDITOR—We have some difficulties understanding Edwards's letter about the genetic mapping in Iceland.1 His first paragraph suggested that it was not about ethical or political issues, but the last paragraph was. His collaborations with some of our local critics who have been doing research on the genetics of schizophrenia may explain this.

What is clear, however, is that Edwards takes the rather narrow view that genealogical information is useful only for diseases that can be …
Estrogen-induced gallstone formation in males. Relation to changes in serum and biliary lipids during hormonal treatment of prostatic carcinoma.
Authors: P Henriksson, K Einarsson, A Eriksson, U Kelter, B Angelin
Journal: Journal of Clinical Investigation (1989)

To assess if and by which mechanisms pharmacological estrogen treatment induces gallstone disease, we examined patients with recently diagnosed prostatic cancer randomly allocated to estrogen therapy (n = 37) or orchidectomy (n = 35). According to gallbladder ultrasonography, after 1 yr new gallstones had developed in 5 of 28 estrogen-treated patients, compared with 0 of 26 orchidectomized patients (P = 0.03). Estrogen therapy for 3 mo increased the relative concentration of cholesterol and cholesterol saturation of bile by approximately 30% (n = 10). Serum LDL cholesterol was reduced by approximately 40%, and its relative change related inversely to that of bile cholesterol (Rs = -0.77). There were no changes in biliary or serum lipids after orchidectomy (n = 9). Secretion rates of biliary lipids were measured with a duodenal perfusion technique. Patients on chronic estrogen therapy (n = 5) had approximately 40% higher biliary excretion rates of cholesterol than age-matched controls (n = 7). Phospholipid secretion was also higher, but no difference in bile acid secretion was found. We conclude that an increased hepatic secretion of cholesterol results in increased cholesterol saturation of bile and an enhanced rate of gallstone formation during estrogen treatment. The changes in bile cholesterol seem to be related to the induced changes in serum lipoprotein metabolism.
The AKT inhibitor perifosine in biochemically recurrent, hormone-sensitive prostate cancer (HSPC): A phase II California Cancer Consortium trial
Authors: K. G. Chee, P. N. Lara, J. Longmate, P. Twardowski, D. I. Quinn, G. Chatta, D. R. Gandara
Journal: Journal of Clinical Oncology (2005)

4642 Background: Perifosine is an oral alkylphospholipid that inhibits cancer cell growth via decreased AKT phosphorylation. To evaluate its efficacy and tolerability in early stage prostate cancer, we conducted a phase II trial of perifosine in patients (pts) with HSPC. Methods: Eligible pts had: histologically confirmed prostate cancer, prior prostatectomy and/or radiation, and a rising PSA without radiographic metastasis. Prior androgen deprivation therapy of < 9 mo completed 1 yr prior to registration was allowed. Primary endpoint was PSA response (PSA decrease ≥ 50% from baseline). Secondary endpoints were PSA doubling time and progression-free survival (PFS). A 2-stage optimal design was used. Treatment: loading dose of 900mg PO on day 1 in divided doses at least 6 hrs apart, then 100mg PO daily starting 24 hrs later. Cycle length = 28 days. Results: Of 25 pts enrolled, 22 pts are evaluable for response. Pt characteristics: median age = 67 yrs; Karnofsky 80/90/100 = 2/17/13; median number of cycles = 5. Median follow-up = 8 months. 18 pts (82%) had stable disease and 3 (14%) had PSA progression. No pt had a PSA decline ≥ 50%, thus accrual was halted per protocol design. However, 5 pts (23%) had PSA decline of < 50%. Median PFS was 9.5 months. There was no change in the PSA doubling time (7 mo) prior to and during treatment. Grade (gr) 3–4 toxicities included gr 3 hyponatremia, gr 3 arthritis, gr 3 hyperuricemia, and gr 3 vision change. Conclusions: Oral perifosine in HSPC pts is feasible, well-tolerated, and can reduce PSA (by < 50%) in some pts. Based on its inhibitory effects on P13K/AKT, there remains a strong preclinical rationale for testing perifosine as a means of enhancing apoptosis in combination with androgen ablation and chemotherapy. (N01-CM 17101, ACSCRTG 1970 CCE) No significant financial relationships to disclose.
Corticosteroid-resistant bronchial asthma is associated with increased c-fos expression in monocytes and T lymphocytes.
Authors: S J Lane, I M Adcock, D Richards, C Hawrylowicz, P J Barnes, T H Lee
Journal: Journal of Clinical Investigation (1998)

Unstimulated peripheral blood mononuclear cells (PBMCs) from corticosteroid-resistant (CR) but not corticosteroid-sensitive (CS) asthmatics demonstrate increased activating peptide-1 (AP-1)- and decreased glucocorticoid receptor (GR)-DNA binding. We test whether these abnormalities are associated with excessive generation of c-fos, the inducible component of AP-1. The c-fos transcription rate, mRNA and protein levels, and GR-DNA binding were quantitated in PBMCs, T cells, and monocytes from CS, CR, and nonasthmatic subjects. There was a 1.7-, 4.2-, and 2.3-fold greater increase in the baseline c-fos transcription rate, mRNA expression, and protein levels, respectively, in PBMCs derived from CR compared with CS patients. At optimal stimulation with PMA, there was a 5.7-, 3.4-, and 2-fold greater increase in the c-fos transcription rate, mRNA accumulation, and protein levels, respectively, in CR compared with CS PBMCs. These abnormalities were detected in both the T cell and monocyte subpopulations. PMA stimulation converted PBMCs from a CS to a CR phenotype and was associated with direct interaction between c-Fos and the GR. Pretreatment of PBMCs from CR patients with c-fos antisense oligonucleotides enhanced GR-DNA binding activity in CR PBMCs stimulated with dexamethasone. We suggest that increased c-fos synthesis provides a major mechanism for the increased AP-1- and decreased GR- DNA binding seen in CR asthma.