tbuckley/cabot-search huggingface dataset:
Predictors of presence, multiplicity, size and dysplasia of colorectal adenomas. A necropsy study in New Zealand.
Authors: J R Jass, P J Young, E M Robinson
Journal: Gut (1992)

Three hundred and thirty six forensic necropsy specimens of large bowel were examined in order to identify subject related variables that independently predicted the following adenoma characteristics: presence, size (largest), multiplicity and high grade dysplasia. The variables were age, gender, body mass index, race (European origin versus Maori/Polynesian) and presence of hyperplastic (metaplastic) polyp(s). Subjects included 303 New Zealanders of European origin (M = 185, F = 118) yielding 149 adenomas and 251 hyperplastic polyps and 33 Maori/Polynesians (M = 25, F = 8) yielding five adenomas and one hyperplastic polyp. Independent predictors of adenoma presence as determined by regression analysis were age (p = 0.0001), presence of hyperplastic polyps (p = 0.0001) and male gender (p = 0.05). Models were poor at explaining variation in size, multiplicity, and dysplasia. Larger adenomas occurred more frequently in subjects with multiple adenomas (p = 0.03) and multiple adenomas were probably associated with hyperplastic polyps (p = 0.09) and male gender (p = 0.09) in Europeans. High grade dysplasia was more frequent in women (p = 0.05) and possibly in subjects with hyperplastic polyps (p = 0.2). Body mass index and ethnicity did not predict any adenoma characteristics, but hyperplastic polyp prevalence was influenced by European origin (p = 0.04) and to a lesser extent by body mass index (p = 0.08) as well as presence of adenoma (p = 0.0002) and age ( = 0.005). The association of hyperplastic polyp with presence, multiplicity but not size of adenoma and with a high risk group for colorectal cancer (New Zealanders of European origin) suggests that the hyperplastic polyp serves as a marker for a factor which influences neoplastic evolution at the stages of initiation/transformation but not promotion. Fifty nine per cent of individuals with adenoma(s) did not have hyperplastic polyp(s) emphasising that the last would serve only as a marker of populations and not individuals at high risk of bowel cancer. Low intracolonic butyrate may be the factor linking the expression of the two types of polyp.
Case 14-1967
Authors: Daniel B. Drachmen, Edward P. Richardson
Journal: New England Journal of Medicine (1967)

Presentation of Case First admission. A twenty-one-year-old college student was admitted to the hospital because of weakness in the legs and confusion.He had been well until thirteen months previously, when he fell while skiing, landing in a sitting position. He continued to ski but six hours later entered another hospital because of back pain and slight pain in the neck. A large hematoma was observed in the left buttock. X-ray films of the lower spine were normal. He was discharged after two days, and the symptoms subsided. Two months thereafter he became aware of weakness and a "rubbery . . .
(26) Neurogenic ulcer of the sole. Lumbar cord lesion? syringomyelia
Authors: R.R.M. Harman
Journal: British Journal of Dermatology (1977)

Journal Article (26) Neurogenic ulcer of the sole. Lumbar cord lesion? syringomyelia Get access R.R.M. Harman R.R.M. Harman Bristol Royal Infirmary Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 97, Issue s15, 1 December 1977, Pages 60–61, https://doi.org/10.1111/j.1365-2133.1977.tb14334.x Published: 01 December 1977
Emphasizing Chest Pain as a Symptom of Heart Attack-Reply
Authors: John Paraskos
Journal: JAMA (1993)

<h3>In Reply.</h3> —The AHA agrees completely with Dr Bahr's point that chest pain and chest discomfort are extremely important prodromal symptoms in a heart attack and the public needs to be aware of this. It is precisely for this reason we stated very clearly in the Guidelines, "The public, especially those at high risk and their families and friends, must be educated to recognize the usual signs of a heart attack and the need for prompt attention. They must be taught how to gain rapid access to the EMS system.... The community must take responsibility to ensure that calling this number initiates a rapid response.... Each person should have a well-formulated plan of action for use in an emergency, based on local community resources and the EMS system. When symptoms occur that suggest an MI, a mobile life support system should be summoned to reduce elapsed time from onset of
Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls
Authors: A. Steventon, S. Tunkel, I. Blunt, M. Bardsley
Journal: BMJ (2013)

<b>Objectives</b> To test the effect of a telephone health coaching service (Birmingham OwnHealth) on hospital use and associated costs. <b>Design</b> Analysis of person level administrative data. Difference-in-difference analysis was done relative to matched controls. <b>Setting</b> Community based intervention operating in a large English city with industry. <b>Participants</b> 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease; and a history of inpatient or outpatient hospital use. These individuals were matched on a 1:1 basis to control patients from similar areas of England with respect to demographics, diagnoses of health conditions, previous hospital use, and a predictive risk score. <b>Intervention</b> Telephone health coaching involved a personalised care plan and a series of outbound calls usually scheduled monthly. Median length of time enrolled on the service was 25.5 months. Control participants received usual healthcare in their areas, which did not include telephone health coaching. <b>Main outcome measures</b> Number of emergency hospital admissions per head over 12 months after enrolment. Secondary metrics calculated over 12 months were: hospital bed days, elective hospital admissions, outpatient attendances, and secondary care costs. <b>Results</b> In relation to diagnoses of health conditions and other baseline variables, matched controls and intervention patients were similar before the date of enrolment. After this point, emergency admissions increased more quickly among intervention participants than matched controls (difference 0.05 admissions per head, 95% confidence interval 0.00 to 0.09, P=0.046). Outpatient attendances also increased more quickly in the intervention group (difference 0.37 attendances per head, 0.16 to 0.58, P&lt;0.001), as did secondary care costs (difference £175 per head, £22 to £328, P=0.025). Checks showed that we were unlikely to have missed reductions in emergency admissions because of unobserved differences between intervention and matched control groups. <b>Conclusions</b> The Birmingham OwnHealth telephone health coaching intervention did not lead to the expected reductions in hospital admissions or secondary care costs over 12 months, and could have led to increases.
The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Trial: Effects of Intensive Atorvastatin Treatment on Early Recurrent Events After an Acute Coronary Syndrome
Authors: Gregory G. Schwartz, Anders G. Olsson, Michael D. Ezekowitz, Peter Ganz, Michael F. Oliver, David Waters, Andreas Zeiher, Bernard Chaitman, Sally Leslie, Theresa Stern
Journal: Circulation (2000)
PWE-123 Predictors Of Hepatic Encephalopathy and Mortality Following Tips Insertion for Refractory Ascites
Authors: O M Dissanayake, A Young, M Morgan, J MacNaughtan, D Patch
Journal: Gut (2013)

<h3>Introduction</h3> Transjugular intrahepatic portosystemic shunt (TIPS) insertion has been used for over twenty years to treat the complications of portal hypertension. TIPS insertion provides better control of refractory ascites than large volume paracentesis but with a higher risk of developing hepatic encephalopathy (HE). In addition, a survival benefit has only been found in carefully selected patients. The aims of this study were to review the use of TIPS for the treatment of refractory ascites, in a single centre, over a twenty-year period with the aim of identifying factors predictive of the development of HE and survival. <h3>Methods</h3> All patients who underwent TIPS for refractory ascites in the Royal Free Hospital, London, between 1992 and 2012 were reviewed. All non-transplanted patients still alive in 2012 were recalled for assessment of their neuropsychiatric status using clinical, neuropsychometric and neurophysiological criteria. The factors associated with the development of post–TIPS HE were determined by multivariate analysis using the Cox proportional regression model. Differences in survival were determined by Kaplan-Meier analysis. <h3>Results</h3> Of the 169 patients identified, 96 (56.8%) had died, 22 (13.1%) had been transplanted while the remaining 51 were alive. The median survival time was 18.8 months. The factors predictive of death were a higher serum AST (p &lt; 0.04), ALP (p &lt; 0.02), and sodium (p &lt; 0.02) and an increased INR (p &lt; 0.01). Survival rates were higher in patients of non-British white ethnic origin (p &lt; 0.00). Of the 27 patients available for review, 21 (78%) had some degree of HE although less than 30% were on anti-encephalopathy treatment. The factors predictive of HE were older age (p &lt; 0.01), with the risk increasing by 6.5% for every year of age, and white British ethnicity (p &lt; 0.01). <h3>Conclusion</h3> Older patients and those of white British origin are particularly at risk for developing HE and should be monitored carefully following the TIPS procedure. The finding that patients with hypernatraemia have significantly reduced survival rates is novel; it most likely reflects overdiuresis and should be corrected pre-procedure. Thus, careful assessment and selection of candidates for TIPS insertion for refractory ascites as well as closer and longer-term monitoring may help prevent the development of HE and lead to improved outcomes. <h3>Disclosure of Interest</h3> None Declared.
Ames Agrees With Mom's Advice: Eat Your Fruits and Vegetables
Authors: Rebecca Voelker
Journal: JAMA (1995)

IT HAPPENS about 10 000 times a day to every cell in the human body.  Oxidants—the by-products of human metabolism—deliver damaging blows to the cells' DNA. Repair enzymes cut out much of the damage, but eventually time takes its toll. Oxidative attacks on the cells' DNA outpace the ability of enzymes to remove lesions. The cumulative damage is believed to be a major factor in the development of certain cancers and other aging-related illnesses, such as cardiovascular disease.  But in recent years, scientists have pointed to the disease prevention potential of antioxidant properties found in certain nutrients, most notably vitamins C and E and beta carotene. As a result, fruits and vegetables that contain these compounds have taken a prominent place in contemporary recommendations to promote good health and prevent disease.  This is what mothers have known all along, says Bruce Ames, PhD, professor of biochemistry and molecular biology and
Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest
Authors: Theresa M Olasveengen, Kjetil Sunde, Cathrine Brunborg, Jon Thowsen, Petter A Steen, Lars Wik
Journal: JAMA (2009)

<h3>Context</h3>Intravenous access and drug administration are included in advanced cardiac life support (ACLS) guidelines despite a lack of evidence for improved outcomes. Epinephrine was an independent predictor of poor outcome in a large epidemiological study, possibly due to toxicity of the drug or cardiopulmonary resuscitation (CPR) interruptions secondary to establishing an intravenous line and drug administration.<h3>Objective</h3>To determine whether removing intravenous drug administration from an ACLS protocol would improve survival to hospital discharge after out-of-hospital cardiac arrest.<h3>Design, Setting, and Patients</h3>Prospective, randomized controlled trial of consecutive adult patients with out-of-hospital nontraumatic cardiac arrest treated within the emergency medical service system in Oslo, Norway, between May 1, 2003, and April 28, 2008.<h3>Interventions</h3>Advanced cardiac life support with intravenous drug administration or ACLS without access to intravenous drug administration.<h3>Main Outcome Measures</h3>The primary outcome was survival to hospital discharge. The secondary outcomes were 1-year survival, survival with favorable neurological outcome, hospital admission with return of spontaneous circulation, and quality of CPR (chest compression rate, pauses, and ventilation rate).<h3>Results</h3>Of 1183 patients for whom resuscitation was attempted, 851 were included; 418 patients were in the ACLS with intravenous drug administration group and 433 were in the ACLS with no access to intravenous drug administration group. The rate of survival to hospital discharge was 10.5% for the intravenous drug administration group and 9.2% for the no intravenous drug administration group (P = .61), 32% vs 21%, respectively, (P&lt;.001) for hospital admission with return of spontaneous circulation, 9.8% vs 8.1% (P = .45) for survival with favorable neurological outcome, and 10% vs 8% (P = .53) for survival at 1 year. The quality of CPR was comparable and within guideline recommendations for both groups. After adjustment for ventricular fibrillation, response interval, witnessed arrest, or arrest in a public location, there was no significant difference in survival to hospital discharge for the intravenous group vs the no intravenous group (adjusted odds ratio, 1.15; 95% confidence interval, 0.69-1.91).<h3>Conclusion</h3>Compared with patients who received ACLS without intravenous drug administration following out-of-hospital cardiac arrest, patients with intravenous access and drug administration had higher rates of short-term survival with no statistically significant improvement in survival to hospital discharge, quality of CPR, or long-term survival.<h3>Trial Registration</h3>clinicaltrials.gov Identifier: NCT00121524
SOME OBSERVATIONS ON RESECTION OF THE RIBS IN EMPYEMA.
Authors: ANDREW STEWART LOBINGIER
Journal: JAMA (1902)

The management of effusion into the thorax will depend much upon the character and extent of the inflammatory process which produced it. Netter has shown that in children empyema is of tubercular origin in 25 per cent. of all cases. The other 75 per cent, is due principally to the pneumococcus, with the staphylococcus, streptococcus, the Eberth and colon bacillus as occasional sources of infection. In adults Netter and Eichhorst have found 65 to 69 per cent. to be tuberculous. It is generally recognized that empyema resulting from tubercular pleurisy has a much less favorable prognosis than when of pneumococcus origin. The latter variety of cases is attended by a less stable proliferation and the lung is left more patent and resilient than is the case in tuberculosis. A very small percentage of cases are permanently cured by aspiration. Da Costa believes the cures to be limited chiefly to post-pneumonia
A Community Heart Program
Authors: Egon E. Kattwinkel, Vlado A. Getting, Ernest M. Morris, William J. Zukel
Journal: New England Journal of Medicine (1951)

ONE year has passed since the last report on the Newton Heart Demonstration Program was presented to the Massachusetts Medical Society;1 two years since the first official report appeared in the New England Journal of Medicine 2; and three years since the program was initiated What have we learned in those three years about the community approach to the ever-growing problem of heart disease?We have learned that medical knowledge of the prevention of rheumatic fever and subacute bacterial endocarditis can be applied in a practical way in a community. We have learned that several hospital services can be carried . . .
Abstract 281: Novel nucleic acid constructs and formulations for treatment of bladder cancer and malignant ascites
Authors: Yan Liu, Yan Chen, Kathy Fosnaugh, Shaguna Seth, Yoshiyuki Matsui, Pierrot Harvie, Rachel Johns, Akihide Takagi, Shobana Vaidyanathan, Greg Severson, Tod Brown, Tianying Zhu, Pat Charmley, Alan So, Michael Houston, Mike Templin
Journal: Cancer Research (2012)

Abstract Nucleic acid-based therapeutics offer significant promise in treatment of difficult diseases by providing high sequence specificity against target genes including “non-druggable targets”. Different nucleic acid constructs, single-stranded antisense oligonucleotides, microRNA mimetics, miRNA-specific antagomirs (AntimiR), and double-stranded short-interfering RNAs (siRNAs), provide diverse therapeutic platforms to access targets in treatment of cancer and other diseases. Single-stranded oligonucleotides require additional modifications for increased serum stability, nuclease resistance, and to minimize immune response. Conformationally restricted nucleotide (CRN)-substituted AntimiRs targeting miR-21 and miR-122 demonstrated significant improvement in hybridization affinity with a concomitant increase in potency. A CRN-substituted AntimiR targeting microRNA-122 dosed at up to 50 mg/kg/day over three consecutive days led to a dose-dependent effect on de-repression of downstream liver-specific target genes, Aldolase A (AldoA), Glycogen Synthase I (GYS1) and Solute Carrier Family 7 member 1 (SLC7A1). This CRN-modified AntimiR produced up to a 5-fold increase in AldoA mRNA while demonstrating a good tolerability profile with no body weight changes and normal serum chemistry. Development of therapeutic siRNA constructs can be hampered by off-target effects and cytokine induction. Substitution of unlocked nucleobase analogs (UNAs) at specific positions in the passenger and guide strands of siRNA confers high specificity with minimal to no off-target activity. UsiRNAs were successfully delivered to bladder or abdominal tumors when encapsulated in DiLA2- or SMARTICLES®-derived liposomes. DiLA2−encapsulated polo-like kinase 1 (PLK1) UsiRNA demonstrated 95% mRNA reduction and up to 70-fold tumor growth inhibition in a bladder cancer orthotopic mouse model and 40-70% mRNA inhibition and ∼80% reduction in tumor-specific bioluminescence in a malignant ascites mouse model following intravesical or intraperitoneal dosing, respectively. In an orthotopic liver tumor animal model, liposomal encapsulated miRNA mimetics provided ∼80% reduction in tumors compared to buffer control. Combinations of formulations and construct capitalize on the advantages of nucleic acid-based therapeutics for precise targeting and flexible delivery to challenging drug targets in cancer and other indications. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 281. doi:1538-7445.AM2012-281
Salmonella Infections in Patients with the Acquired Immunodeficiency Syndrome
Authors: JONATHAN L. JACOBS
Journal: Annals of Internal Medicine (1985)

Defects in T-cell function have been seen in patients with the acquired immunodeficiency syndrome. Although the cellular immune system plays a key role in host defense against Salmonella, there have been no detailed reports of salmonellosis in patients with this syndrome. We report our experience with salmonella infections in six patients. Salmonellosis in these patients was unusually severe, characterized by widespread infection, bacteremia, and relapse, despite standard antibiotic treatment. Because of the difficulty in eradicating salmonella infection in patients with the acquired immunodeficiency syndrome, long-term suppressive treatment with antibiotics seems warranted.
Mass in Tuberculous Peritonitis
Authors: J. F. JOHN
Journal: Annals of Internal Medicine (1973)

Letters, Comments, and Corrections1 February 1973Mass in Tuberculous PeritonitisJ. F. JOHN JR., M.D.J. F. JOHN JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-2-303_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The prospective study of Borhanmanesh and others (Ann Intern Med 76:567-572, 1972) of 32 cases of tuberculous peritonitis indicated the frequent presence of an abdominal mass in this disease. We recently observed the following case:A 26-year-old, nulliparous black female presented with fever and chest pain of 4 weeks' duration. For several weeks she also had noted a gradually enlarging, slightly painful, lower abdominal mass. On examination she was a thin woman with a temperature of 38.3 °C [101 °F]. Bi-basilar rales and diminished breath sounds were present. There was a tender infraumbilical mass of about 4...References1. JOHNSTON F and SANFORD J: Tuberculous peritonitis. Ann Intern Med 54:1125-1133, 1961 LinkGoogle Scholar2. GONNELLA J and HUDSON E: Clinical patterns of tuberculous peritonitis. Arch Intern Med 117:164-169, 1966 CrossrefMedlineGoogle Scholar3. SOCHOCKY S: Tuberculous peritonitis. A review of 100 cases. Am Rev Resp Dis 95:398-401, 1967 MedlineGoogle Scholar4. BURACK W and HOLLISTER R: Tuberculous peritonitis. A study of forty-seven cases encountered by a general medical unit in twenty five years. Am J Med 28:510-523, 1960 CrossrefMedlineGoogle Scholar5. HUGHES J, CARR D, and GRACI J: Tuberculous Peritonitis: a review of 34 cases with emphasis on the diagnostic aspects. Dis Chest 38:42-50, 1960 CrossrefMedlineGoogle Scholar6. SINGH M, BHARGAVA A, and JAIN K: Tuberculous peritonitis. An evaluation of pathogenic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med 281:1091-1094, 1969 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. F. JOHNJR., M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1973Volume 78, Issue 2Page: 303-304KeywordsFeversIschemiaPeritonitisProspective studiesTemperature ePublished: 1 December 2008 Issue Published: 1 February 1973 PDF downloadLoading ...
484 INTRACELLULAR REDOX CHANGES AND C-JUN N-TERMINAL KINASE ACTIVATION AS CRUCIAL EVENTS IN CYTOKINE-INDUCED CHEMOTAXIS OF HUMAN ACTIVATED HEPATIC STELLATE CELLS
Authors: E. Novo, L. Valfre' di Bonzo, C. Bertolani, D. Povero, C. Busletta, S. Cannito, E. Zamara, A. Compagnone, S. Colombatto, F. Marra, M. Pinzani, M. Parola
Journal: Journal of Hepatology (2008)