tbuckley/cabot-search huggingface dataset:
Imaging of pulmonary venous pathway obstruction in patients after the modified fontan procedure
Authors: Mark A. Fogel, Alvin J. Chin
Journal: Journal of the American College of Cardiology (1992)

To evaluate the efficacy of chest roentgenograms and echocardiograms in identifying pulmonary venous pathway obstruction in patients after the modified Fontan procedure, the records of 297 patients who underwent 307 Fontan procedures between 1984 and 1990 were reviewed. Twelve cases of pulmonary venous pathway obstruction documented by autopsy (3 cases) or cardiac catheterization (9 cases with an A wave gradient greater than or equal to 4 mm Hg) were found in 10 patients (mean age 43 +/- 28 months). The mechanisms of obstruction included narrow pulmonary vein ostia in six cases, narrow left atrial outlet in four and atrial baffle obstruction in three. Two causes of obstruction were present in one case. No patient had pulmonary venous congestion on chest roentgenograms. Pathway diameters indexed to 3 square root of body surface area with two-dimensional echocardiography were found to be 6.8 +/- 1.2 mm/3 square root of m2 in the subcostal frontal view, 7.9 +/- 0.6 mm/3 square root of m2 in the subcostal sagittal view and 6.5 +/- 1.7 mm/3 square root of m2 in the apical "four-chamber" view. These values differed significantly from those in 11 age-matched patients undergoing the Fontan procedure without pulmonary venous pathway obstruction documented by catheterization (p = 0.001). With pulsed Doppler ultrasound, there was a relatively narrow range of velocities distal to the obstruction (1.3 to 2.5 m/s). In five of the seven cases with pulsed Doppler measurements, flow was continuous and the Doppler spectral recordings were not phasic. Thus, in patients who have undergone the Fontan procedure and have pulmonary venous pathway obstruction 1) chest roentgenography cannot be used as a screening tool; 2) distal velocities as low as 1.3 m/s occur, usually with nonphasic, continuous forward flow; and 3) pathway diameters indexed to 3 square root of body surface area may be used as an output-independent parameter to cross-check Doppler data.
De novo diffuse large B‐cell lymphoma with coexpression of CD5 and CD23
Authors: Sumeet Gujral, Meenal Jain, Kiran Thorat, Dipen Maru, Chandrika N. Nair
Journal: American Journal of Hematology (2007)

Copper Deficiency and DietTo the Editor: Harless et al. [1] reported two women with copper deficiency of unclear etiology whose deficiency quickly resolved after supplementation with copper gluconate.They suggested that consumption of 100 oz daily of soft drinks containing sucrose or fructose may have contributed to the problem because these simple sugars have been shown to disrupt copper utilization in animal experiments.A diet low in copper also may have been contributory.The Western diet often is low in copper [2], according to pooled data of more than 900 diets analyzed chemically and summarized in several articles.Recently, 62 and 36% of diets of 80 randomly selected adults in Baltimore, MD [3], were below the recommended dietary allowance (0.9 mg/day) and the estimated average requirement for adults (0.7 mg/day).The estimated average requirement is the median of a distribution of requirements; it applies only to apparently healthy people.Although soft drinks may have increased the copper requirements of the women, it seems unlikely that with body mass indices of 17 and 21 they had eaten sufficient copper from food when drinking 1400 kcal of Mountain Dew, or equivalent, daily.Recovery in a month from 2 mg copper gluconate daily (14.0%copper) yielding only 40% of the estimated average requirement is remarkable.
India plans to move towards free universal healthcare coverage
Authors: G. Mudur
Journal: BMJ (2011)

A panel of Indian doctors and economists asked by the government to come up with strategies to implement universal healthcare has proposed free health services to be financed mainly through tax revenues.

In its draft report the panel, called the High Level Expert Group, has proposed an increase in public spending on healthcare from the current 1.4% of India’s gross domestic product ($1.54 trillion (£1 trillion; €1.1 trillion) in 2010) to more than 3% by 2016.

The Indian government set up the panel last year amid longstanding concerns that India’s public spending on health has been persistently low and, as a consequence, that 70% of the country’s spending on healthcare comes out of the pockets of patients and their families.

A study published four years ago indicated that up to six million households in India faced catastrophic health costs that could financially cripple them ( BMJ 2007;334:447, doi:10.1136/bmj.39139.656678.DB).

The panel says that …
EFFECTS OF DIPEPTIDYL PEPTIDASE-4 INHIBITION ON ENDOTHELIAL NITRIC OXIDE RELEASE, BLOOD PRESSURE AND SICAM-1 LEVELS IN HYPERTENSIVE RATS
Authors: R. Preston Mason, Robert Jacob, J. Jose Corbalan, Ruslan Kubant, Aleksander Ciszewski, Tadeusz Malinski
Journal: Journal of the American College of Cardiology (2012)
EXPERIMENTAL STUDY OF CLINICAL VITAMIN B DEFICIENCY 1
Authors: Katharine O'Shea Elsom
Journal: Journal of Clinical Investigation (1935)

Clinical disturbances incident to mild deficiency of vitamin B 2 in the diet, as opposed to frank deficiencies such as beriberi and pellagra, are com- monly believed to be very rare in man and are thought to occur only when the diet is grossly ab- normal or when there is serious interference with absorption from the gastro-intestinal tract.Cer- tain observations made in this Gastro-Intestinal Section, however, have suggested that clinical evi- dences of such partial deficiency may develop on given for the first five months a diet moderately deficient in vitamin B though adequate in every other known requirement and the effects of this diet were studied.When clinical signs suggestive of deficiency were manifest, various vitamin B fractions were added to the diet, in series, and the effects of their administration studied.The sec- ond patient (Case 2), who entered the hospital with fully developed clinical evidence of defi-
Abstract 5239: MiR-148a promotes apoptosis in urothelial cell carcinoma of the bladder cells in part by targeting DNMT1
Authors: Alan Lombard, Ben Mooso, Steve Libertini, Rebecca Lim, Nicole Costanzo, Paramita Ghosh, Maria Mudryj
Journal: Cancer Research (2014)

Abstract Introduction: MiRNAs are now recognized as major players in cancer. MiR-148a has been shown to be a tumor suppressor in the context of several cancers including prostate, gastric, and lung but a study investigating its role in bladder cancer has never been performed. Here we characterized the expression and role of miR-148a in bladder cancer. Methods: Real time PCR was used to assess the levels of miR-148a across several bladder cancer cell lines. MiR-148a mimics were employed in T24 and UM-UC-3 cells to assess proliferation by CCK-8 proliferation assay, colony formation assay, and flow cytometry. Mimics were also used to assess apoptosis by immunoblot and annexin-V staining coupled to flow cytometry. Immunoblot was used to probe for targets of miR-148a and siRNA was used to knock-down DNMT1 to phenocopy miR-148a treatment results. CCK-8 proliferation assays and crystal violet staining were used to assess the additive effects of miR-148a with either cisplatin or doxorubicin on T24 and UM-UC-3 cells and CCK-8 proliferation assays were also used to assess the role DNMT1 plays in cisplatin sensitivity. Results: All bladder cancer cell lines had significantly reduced expression of miR-148a than that of a control immortalized urothelial cell line. MiR-148a mimic treatment of T24 and UM-UC-3 cells led to large decreases in viability. Flow cytometry demonstrated an increase in S-phase and no major G1 or G2/M arrests in miR-148a mimic treated cells versus control oligo treated cells suggesting that the effects observed on viability were due to increased apoptosis. Immunoblots for cleaved caspase-3 and cleaved PARP along with annexin-V staining coupled to flow cytometry showed as expected a strong induction of apoptosis in miR-148a mimic treated cells. Immunoblots demonstrated that miR-148a targets DNMT1 and DNMT1 knock-down was able to partially phenocopy results from miR-148a mimic treatment suggesting DNMT1 is downstream of miR-148a. Finally, we found that miR-148a can be used with either cisplatin or doxorubicin for an additive effect in inducing apoptosis and that DNMT1 targeting is involved in sensitivity to cisplatin. Conclusions: Our work demonstrates for the first time that miR-148a plays a tumor suppressive role in bladder cancer and suggests it could be used as a novel therapeutic agent either alone or in conjunction with chemotherapeutics. Citation Format: Alan Lombard, Ben Mooso, Steve Libertini, Rebecca Lim, Nicole Costanzo, Paramita Ghosh, Maria Mudryj. MiR-148a promotes apoptosis in urothelial cell carcinoma of the bladder cells in part by targeting DNMT1. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5239. doi:10.1158/1538-7445.AM2014-5239
Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice
Authors: F. Bonifazi, M. Jutel, B. M. Biló, J. Birnbaum, U. Muller
Journal: Allergy (2005)

Based on the knowledge of the living conditions and habitat of social Aculeatae a series of recommendations have been formulated which can potentially greatly minimize the risk of field re-sting. After a systemic sting reaction, patients should be referred to an allergy specialist for evaluation of their allergy, and if necessary venom immunotherapy (VIT). An emergency medical kit should be supplied, its use clearly demonstrated and repeatedly practised until perfected. This should be done under the supervision of a doctor or a trained nurse. Epinephrine by intramuscular injection is regarded as the treatment of choice for acute anaphylaxis. H1-antihistamines alone or in combination with corticosteroids may be effective in mild to moderate reactions confined to the skin and may support the value of treatment with epinephrine in full-blown anaphylaxis. Up to 75% of the patients with a history of systemic anaphylactic sting reaction develop systemic symptoms once again when re-stung. Venom immunotherapy is a highly effective treatment for individuals with a history of systemic reaction and who have specific IgE to venom allergens. The efficacy of VIT in yellow jacket venom allergic patients has been demonstrated also by assessing health-related quality of life. If both skin tests and serum venom specific IgE turn negative, VIT may be stopped after 3 years. After VIT lasting 3-5 years, most patients with mild to moderate anaphylactic symptoms remain protected following discontinuation of VIT even with positive skin tests. Longer term or lifelong treatment should be considered in high-risk patients. Because of the small but relevant risk of re-sting reactions, in these patients, emergency kits, including epinephrine auto-injectors, should be discussed with every patient when stopping VIT.
3-D Vision Improves Performance in a Pelvic Trainer
Authors: H. T. Tevaearai, X. M. Mueller, L. K. von Segesser
Journal: Endoscopy (2000)

Background and Study Aims: Experienced endoscopic surgeons have adapted to the absence of depth perception while using two-dimensional (2-D) visualization. However, three-dimensional (3-D) vision may prove useful at least at the beginning of the learning curve in celioscopic training.
Papillae alterations around single-implant restorations in the anterior maxillae: thick versus thin mucosa
Authors: Mi-Si Si, Long-Fei Zhuang, Xin Huang, Ying-Xin Gu, Chung-Hao Chou, Hong-Chang Lai
Journal: International Journal of Oral Science (2012)

To evaluate the papilla alterations around single-implant restorations in the anterior maxillae after crown attachment and to study the influence of soft tissue thickness on the papilla fill alteration. According to the inclusion criteria, 32 patients subjected to implant-supported single-tooth restorations in anterior maxillae were included. The patients were assigned to two groups according to the mucosal thickness: (i) group 1, 1.5 mm≤mucosal thickness≤3 mm; and (ii) group 2, 3 mm<mucosal thickness≤4.5 mm. Assessments of interproximal papillae at the time of crown placement (baseline) and at 6-month postloading (follow-up) were made by two prosthodontists using papilla fill index (PFI). The mean mucosal thickness was (2.49±0.31) mm (group 1) and (3.81±0.31) mm (group 2) for the two groups respectively. A significant difference in PFI between the groups was detected at the baseline (P<0.001). PFI improvements over time occurred after 6-month follow-up irrespective of the groups. When compared to group 1, the likelihood to obtain papilla fill was significantly higher for group 2 with an odds ratio of 6.05 (P<0.001). The interproximal papilla level around single-implant restorations could improve significantly over time after 6-month restoration according to PFI assessment. The thicker mucosa before implant placement implied a more favorable esthetic outcome in papilla alteration. After insertion of a crown, individuals with naturally thick gum tissue may have a higher chance of it regenerating properly, research from China shows. In a pilot study of 40 individuals, Hong-Chang Lai at the Shanghai Jiao Tong University School of Medicine and colleagues at this university and the University of Hong Kong, tracked the natural response of gum tissue (mucosa) for six months following a single front tooth crown insertion with no post-crown intervention. The researchers focused on the development of the papillae—the triangular sections of gum between teeth—around the crown. Their results showed that the participants with a naturally thicker mucosa tended to develop a neater, more aesthetically acceptable papilla around the crown, avoiding the so-called ‘black triangle’ effect of missing or discolored papilla.
Subacute Erosive (Peptic) Esophagitis Associated with Achlorhydria
Authors: Eddy D. Palmer
Journal: New England Journal of Medicine (1960)

THE opinion that common erosive esophagitis is caused by surface contact with acid-pepsin material refluxed from the stomach continues to be expressed, and the terms "reflux," "regurgitant" and "peptic" are in common use to describe this form of esophageal disease. Histopathologic observations previously described1 make it difficult to believe that surface contact with gastric secretions could account for esophagitis; rather, the microscopical evidence suggests that the inflammatory process begins in the mucosa's tunica propria and the submucosa and that the epithelial surface becomes involved only by upward extension of the inflammation from below. These findings appear to have been confirmed . . .
PWE-062 Terminal Ileal Intubation Over A Five Year Period; Was It Useful?
Authors: S Ghuman, H Khan
Journal: Gut (2014)

<h3>Introduction</h3> The value of routine ileoscopy during colonoscopy is unclear, but intubation of the terminal ileum (TI) is considered to be the main method of confirming completeness of colonoscopy. TI intubation rates are variable and intubation is often omitted due to time constraints and the perception of little added diagnostic value. Our aim was to assess the diagnostic yield of TI intubation during colonoscopies at our institution. <h3>Methods</h3> A retrospective study was undertaken at our institution. Colonoscopy data over a 5 year period (1<sup>st</sup> October 2007 to 30<sup>th</sup> September 2012), were retrieved from the Endoscopy Reporting System database (Unisoft, Enfield, UK). Patients with ileo-caecal resection were excluded. Demographic data, TI pathology (endoscopic and histopathologic) and indications for colonoscopy were analysed. <h3>Results</h3> 8016 colonoscopies were performed with a caecal intubation rate of 90.3%. The endoscopists were of different grades including gastroenterologists, colorectal surgeons and a nurse endoscopist. 206 with ileo-caecal resection were excluded. Mean age was 61 with a female preponderance at 52.6%. The TI w as intubated in 1845 (23.5%). Endoscopic TI pathology was identified in 42 patients (2.3%). Histology was available for 31, of which 23 (1.3%) had confirmed histological abnormalities. Diagnoses on ileoscopy included one adenocarcinoma, one carcinoid tumour, one metastatic malignant melanoma and 20 with terminal ileitis, of which, 6 had histological Crohn’s disease. The most common indications in those with TI pathology were diarrhoea (15), abdominal pain (8) and rectal bleeding (8). <h3>Conclusion</h3> Although the overall diagnostic yield was low, TI intubation identified significant pathologies requring further action, including three malignancies. Ileoscopy at colonoscopy is a simple manoeuvre, which, apart from quality assurance can identify important pathology. The most common indication in those with confirmed TI pathology was diarrhoea, therefore ileoscopy may have added diagnostic value in this context. <h3>Disclosure of Interest</h3> None Declared.
Reproducibility of Exercise‐Induced Asthma in Children
Authors: J. M. Henriksen
Journal: Allergy (1986)

The reproducibility of exercise‐induced asthma (ELA) was studied in children with perennial asthma, using treadmill exercise challenge tests repealed at mean intervals of 1 week (Group I, n = 20), I month (Group II, n = 20) and 1 year (group III, n = 18). The protocol was standardized with respect to 1) intensity and duration of exercise, 2) time of last medication prior to exercise, 3) air humidity, 4) use of corticosteroids, 5) asthma attacks, and 6) pollen season. The mean percentage fall in peak expiratory flow (PEF) following exercise remained significantly unchanged in the three groups. The reproducibility of EIA was improved compared with previous studies. Although the random variation of EIA tended to be greater in Group III, the individual severity of ELA was remarkably stable whatever the interval between tests. Improvements in baseline airway function between tests were not followed by a simultaneous decrease in EIA. In conclusion, the severity of EIA is reproducible in children with perennial asthma, when the exercise Protocol is standardized for factors known to influence bronchial reactivity.
Shigella Effector IpaB-Induced Cholesterol Relocation Disrupts the Golgi Complex and Recycling Network to Inhibit Host Cell Secretion
Authors: Joëlle Mounier, Gaëlle Boncompain, Lidija Senerovic, Thibault Lagache, Fabrice Chrétien, Franck Perez, Michael Kolbe, Jean-Christophe Olivo-Marin, Philippe J. Sansonetti, Nathalie Sauvonnet
Journal: Cell Host & Microbe (2012)
Stomach cancer incidence has halved over past 30 years in Britain
Authors: O. Mashta
Journal: BMJ (2009)

The annual number of new cases each year of stomach cancer in Great Britain has fallen by nearly half over the past 30 years, new figures released by Cancer Research UK show.

The incidence fell from about 14 000 in 1975 to 7485 in 2006 but remains higher among men, with almost two (1.8) men with the disease to every woman.

The number of new cases in men nearly halved since 1980, when a peak of nearly 8300 was reached, to around 4800 cases in 2006. The number of cases in women fell by more …
Response to Letter Regarding Article, “Increased Adipose Tissue Oxygen Tension in Obese Compared With Lean Men Is Accompanied by Insulin Resistance, Impaired Adipose Tissue Capillarization, and Inflammation”
Authors: Gijs H. Goossens, Yvonne Essers, Ellen Konings, Johan W.E. Jocken, Ellen E. Blaak, Alessandro Bizzarri, Merima Čajlaković, Volker Ribitsch, Karine Clément, Nicolas Venteclef, Jack P. Cleutjens
Journal: Circulation (2012)

We thank Drs Lecoultre and Tam
A Case of Subclavian Aneurysm: Circulation Controlled in the Sac by Digital Pressure on the First Part of the Vessel; Macewen's Operation; Amputation at the Shoulder-Joint
Authors: C. A. Morton
Journal: BMJ (1894)

OIXIof age.In Ilasse's' series only 4 out of 995 began between 60 and 70." About 70 the dispositioni to epilepsy," says Dr. Maclagan, in his book on the J)i8eases oJ Advanced Life, " again increases in frequency ;" and among various quotations of Imuchi in- terest, hie says: "' WVitlhin the slhort space of thiree years 1 lhad under my care no fewer than 10 cases, all occurring in meii above 65 years of age, in a population of 500, and in an insti- tution from whlichl epileptics are excluded whlen the disease is known prior to admission."Almost certainly senile epi- lepsy is not hereditary, or the attacks would have come on earlier in life, before the 290th year.There lhave been cases wherein epileptic seizures have come oni in infancy or clhild- lhood, have ceased, and recommenced at an advanced age, but these must be very few and far between.In Dr. Work Dodd's1 series of 100 cases of epilepsy there were only 2 commencing in advanced life-that is, one at 57 and the second at 62; in neither was there any history of family predisposition.The nature of the seizures is pre- cisely similar to those of earlier life; the two forms, the major and minor, occur, though the latter is probably the more frequent.The semi-comatose state after a fit of con- vulsions is frequently long, and sometimes deepens into the coma of death.Epilepsy, generally speaking, is not a fatal disease, except as just mentioned, when it comes on late on life, thouglh even these persons do not die in the fits but in the after-state-the post-epileptic coma.
Super Scan Leading to Definitive Diagnosis in a Patient With Recurrent Syncope
Authors: Jabour Khoury, Jacqueline Jerushalmi, Hector Isaac Cohen, Norman Loberant, Adnan Zaina
Journal: Clinical Nuclear Medicine (2003)

A "super scan" pattern detected on bone scintigraphy usually indicates either metabolic bone disease or diffuse metastases. We report a rare case of a 45-year-old man with recurrent episodes of syncope of 10 years' duration in whom bone scintigraphy showed a super scan with an axial skeleton distribution of uptake. Bone marrow biopsy established the diagnosis of systemic mastocytosis. The few reports in the literature of super scans associated with systemic mastocytosis showed diffuse axial and appendicular increased uptake. The present case shows a super scan involving the axial skeleton, which led to the diagnosis of systemic mastocytosis.
Gangrene Aggravation After Use of Dopamine
Authors: Naresh K. Julka
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Alexander et al<sup>1</sup>reported development of pedal gangrene following use of dopamine hydrochloride. We encountered a patient who showed development and progressive worsening of gangrene in all extremities after use of dopamine. <h3>Report of a Case.—</h3> A 58-year-old woman, weighing 49 kg and known to be mildly diabetic for the past 15 years, was admitted with chest pain that lasted for six hours, accompanied by diaphoresis and cold, clammy extremities. The patient gave a history of peripheral cyanosis involving all four extremities for two weeks prior to admission. She had had rheumatic fever in childhood. Four years ago, she had a myocardial infarction with recurrent ventricular arrhythmias. The patient had been on treatment with digitoxin, furosemide (Lasix), quinidine, and isosorbide dinitrate (Isordil). On admission, the dorsalis pedis and posterior tibial pulses were found to be absent bilaterally, though both ulnar and radial pulses were intact. One