tbuckley/cabot-search huggingface dataset:
Radioisotopic bolus technique as a test to detect circulatory deficit associated with cerebral death. 142 studies on 80 patients demonstrating the bedside use of an innocuous IV procedure as an adjunct in the diagnosis of cerebral death.
Authors: J Korein, P Braunstein, I Kricheff, A Lieberman, N Chase
Journal: Circulation (1975)

A portable radioisotopic technique was developed to demonstrate cerebral circulatory deficit, as part of a collaborative study to define and diagnose cerebral death simply and rapidly, in comatose, apneic patients with electrocerebral silence. The method involves an intravenous injection of 2mCi of 99mTcO4, and recording time/activity curves over the cranial cavity and a femoral artery simultaneously, using twin probe radioisotope detector equipment. Eight comatose, apneic patients had 142 studies in conjunction with clinical electroencephalographic and other laboratory evaluations. The results indicate that the absence of a bolus tracing from the head, as contrasted to the usual bolus seen is indicative of significant circulatory deficit to the cerebrum. This test may be used as an adjunct in confirming the diagnosis of cerebral death. A normal bolus tracing should be simultaneously observed over a femoral artery and this is used as a control. The method is safe and simple and offers significant information about the irreversibility of cerebral blood flow. Although further studies are indicated, the method appears to be most promising as a fundamental bedside laboratory test in the diagnosis of cerebral death in conjunction with other clinical and laboratory criteria.
Substrate availability limits human skeletal muscle oxidative ATP regeneration at the onset of ischemic exercise.
Authors: J A Timmons, T Gustafsson, C J Sundberg, E Jansson, E Hultman, L Kaijser, J Chwalbinska-Moneta, D Constantin-Teodosiu, I A Macdonald, P L Greenhaff
Journal: Journal of Clinical Investigation (1998)

We have demonstrated previously that dichloroacetate can attenuate skeletal muscle fatigue by up to 35% in a canine model of peripheral ischemia (Timmons, J.A., S.M. Poucher, D. Constantin-Teodosiu, V. Worrall, I.A. Macdonald, and P.L. Greenhaff. 1996. J. Clin. Invest. 97:879-883). This was thought to be a consequence of dichloroacetate increasing acetyl group availability early during contraction. In this study we characterized the metabolic effects of dichloroacetate in a human model of peripheral muscle ischemia. On two separate occasions (control-saline or dichloroacetate infusion), nine subjects performed 8 min of single-leg knee extension exercise at an intensity aimed at achieving volitional exhaustion in approximately 8 min. During exercise each subject's lower limbs were exposed to 50 mmHg of positive pressure, which reduces blood flow by approximately 20%. Dichloroacetate increased resting muscle pyruvate dehydrogenase complex activation status by threefold and elevated acetylcarnitine concentration by fivefold. After 3 min of exercise, phosphocreatine degradation and lactate accumulation were both reduced by approximately 50% after dichloroacetate pretreatment, when compared with control conditions. However, after 8 min of exercise no differences existed between treatments. Therefore, it would appear that dichloroacetate can delay the accumulation of metabolites which lead to the development of skeletal muscle fatigue during ischemia but does not alter the metabolic profile when a maximal effort is approached.
Theft of a Microscope
Authors: F. B. Nather
Journal: JAMA (1913)

My Dear Doctor Keiper:\p=m-\The slide from Dr. Verhoeff presents much the same picture that those prepared by us showed, but it is stained differentially to show the structure of the micro-organisms rather than the general histologic picture.In this section there seem to be a great many more of the fungi than in the areas we studied in your specimen.
Surgery of the Adrenal Gland
Authors: R. D. Liechty
Journal: JAMA (1969)

The busy practitioner, who rarely confronts diseases of the adrenal gland, will welcome this monograph. In just 125 actual text pages, the authors summarize current knowledge (from almost 400 listed references) of diseases of the adrenal gland. They season this well with their own experiences. Without any adrenocortical hormones, the average human would die in about a week. Diseases of adrenal hormone overproduction are equally dramatic. The book centers on Cushing's syndrome, aldosteronism, pheochromocytoma, and syndromes of sex-hormone excesses. Crisp, welltailored discussions of these clinical syndromes highlight this book. Although the authors discuss the wide array of diagnostic and therapeutic options, they clearly state their own preferences. For example, in discussing whether hypophyseal irradiation, bilateral total adrenalectomy, or subtotal adrenalectomy is the best treatment for Cushing's disease, they conclude "... the safest and surest form of therapy for the correction of the hypercortisolemia of nontumorous Cushing's disease is total bilateral adrenalectomy."
Faecal blood loss in response to exercise.
Authors: J D Robertson, R J Maughan, R J Davidson
Journal: BMJ (1987)

Recently qualitative tests have indicated that gastrointestinal bleeding during exercise may be an important contributory factor in sports anaemia. In six healthy men who walked 37 km on four consecutive days faecal haemoglobin content remained normal (reference range 0.10-2.53 mg/g faeces) with no significant differences between values. In 28 marathon runners who refrained from taking drugs or food containing blood the median faecal haemoglobin content increased by 0.42 mg/g faeces (95% confidence interval 0.12 to 0.83 mg/g) from 1.06 (0.86 to 1.31) mg/g before the race. In 13 runners who had taken drugs before the race the corresponding increase in the median faecal haemoglobin content was 0.87 (-0.03 to 2.20) mg/g from the value before the race of 0.93 (0.46 to 1.55) mg/g. Prolonged walking had no effect on gastrointestinal blood loss. Intense endurance exercise in the form of marathon running induced a significant but clinically unimportant increase. This may be exaggerated by the ingestion of drugs and assume importance in causing iron deficiency and sports anaemia. The use of drugs, particularly analgesics, by marathon runners should be actively discouraged.
Cardiovascular Health Behavior and Health Factor Changes (1988–2008) and Projections to 2020
Authors: Mark D. Huffman, Simon Capewell, Hongyan Ning, Christina M. Shay, Earl S. Ford, Donald M. Lloyd-Jones
Journal: Circulation (2012)

Background— The American Heart Association's 2020 Strategic Impact Goals target a 20% relative improvement in overall cardiovascular health with the use of 4 health behavior (smoking, diet, physical activity, body mass) and 3 health factor (plasma glucose, cholesterol, blood pressure) metrics. We sought to define current trends and forward projections to 2020 in cardiovascular health. Methods and Results— We included 35 059 cardiovascular disease–free adults (aged ≥20 years) from the National Health and Nutrition Examination Survey 1988–1994 and subsequent 2-year cycles during 1999–2008. We calculated population prevalence of poor, intermediate, and ideal health behaviors and factors and also computed a composite, individual-level Cardiovascular Health Score for all 7 metrics (poor=0 points; intermediate=1 point; ideal=2 points; total range, 0–14 points). Prevalence of current and former smoking, hypercholesterolemia, and hypertension declined, whereas prevalence of obesity and dysglycemia increased through 2008. Physical activity levels and low diet quality scores changed minimally. Projections to 2020 suggest that obesity and impaired fasting glucose/diabetes mellitus could increase to affect 43% and 77% of US men and 42% and 53% of US women, respectively. Overall, population-level cardiovascular health is projected to improve by 6% overall by 2020 if current trends continue. Individual-level Cardiovascular Health Score projections to 2020 (men=7.4 [95% confidence interval, 5.7–9.1]; women=8.8 [95% confidence interval, 7.6–9.9]) fall well below the level needed to achieve a 20% improvement (men=9.4; women=10.1). Conclusions— The American Heart Association 2020 target of improving cardiovascular health by 20% by 2020 will not be reached if current trends continue.
New Approaches to Teaching Basic Interview Skills to Medical Students
Authors: HILLIARD JASON, NORMAN KAGAN, ARNOLD WERNER, ARTHUR S. ELSTEIN, JAMES B. THOMAS
Journal: American Journal of Psychiatry (1971)

The authors describe a teaching program for first-Year medical students that uses videotape and simulated patients. The program helps students acquire the skills necessary for good professional relationships with patients, overcome anxieties in confronting patients, adopt a comfortable professional self-image, and begin involvement in clinical medicine in order to facilitate inter-relationships between preclinical and clinical sciences.
Pediatric AIDS and HIV Infection: Fetus to Adolescent
Authors: Mark W. Kline
Journal: JAMA (1992)

The stated purpose of<i>Pediatric AIDS and HIV Infection</i>is to provide a forum for discussion of all aspects of human immunodeficiency virus infection in children, adolescents, and pregnant women. The editors have adopted a multidisciplinary format for the journal, recognizing the important contributions of specialists in nursing, social work, nutrition, psychology, child development, law, ethics, home care, foster care, hospice care, and religion, as well as various other scientific and medical disciplines. The editorial board is composed predominantly of physicians, with representation by specialists in nursing, public health, law, social work, and medical ethics. The journal accepts submissions in the form of editorials, review articles, short communications and case reports, letters-to-the-editor, and practical papers with a "how-to" format. Manuscripts are reviewed and accepted at the discretion of the editors and members of the editorial board. To date, there is no evidence that the journal has been indexed by major
Activation of mammalian target of rapamycin complex 1 (mTORC1) and Raf/Pyk2 by growth factor-mediated Eph receptor 2 (EphA2) is required for cholangiocarcinoma growth and metastasis
Authors: Xiang-Dan Cui, Mi-Jin Lee, Jong-Hyun Kim, Pei-Pei Hao, Lan Liu, Goung-Ran Yu, Dae-Ghon Kim
Journal: Hepatology (2013)

Eph receptor 2 (EphA2) overexpression is frequently accompanied by the loss of its cognate ligand during tumor progression. However, the molecular mechanism of this ligand-independent promotion of tumor by EphA2 remains unclear in highly malignant and fatal cholangiocarcinoma (CC). We examined the biological role of EphA2 in tumor growth and metastasis in CC tissues and cells according to the degree of differentiation and we explored the downstream signaling pathways of EphA2. Growth factor-mediated EphA2 overexpression itself leads to the activation of the mammalian target of rapamycin complex 1 (mTORC1) and extracellular signal-regulated kinase (ERK) pathways through ligand-independent activation of EphA2 (phosphorylation of S897). An in vitro soft agar assay and in vivo orthotopic or subcutaneous tumor model showed that EphA2 enhanced colony formation and accelerated tumor growth, and which seemed to be mainly associated with Akt (T308)/mTORC1 activation. Aberrant expression and activation of EphA2 was also associated with poorer differentiation and higher metastatic ability. Enhanced metastatic ability was also observed in an orthotopic tumor model or lung metastasis model, correlating with Pyk2(Y402)/c-Src/ERK activation in addition to activation of the canonical Raf/MEK/ERK pathway. The mTORC1 and Raf/Pyk2 pathways also appeared to affect each other. These results suggest that growth factor-mediated EphA2 might be involved in tumor growth and metastasis through activation of the mTORC1 and Raf/Pyk2 pathways. Therapeutic strategies that target EphA2 and its downstream effectors may be useful to control CC. (HEPATOLOGY 2013;57:2248-2260).
Psychosocial problems in epilepsy.
Authors: A. Jacoby, D. Chadwick
Journal: BMJ (1992)

side of the bed, insertion of a percutaneous endoscopic gastrostomy tube will not necessarily prevent this as these tubes may themselves be pulled out by a determined patient-indeed, some authorities believe that psychosis and dementia are relative contraindications to insertion.8Thus percutaneous endoscopic gastrostomy is not the end of the line for nasogastric feeding but an example of one of several useful techniques that may be considered for long term enteral feeding.Nasoenteral tubes will continue to provide the main route of access for most patients requiring enteral nutrition.
Carotid Artery OCT in Cerebral Infarction
Authors: Masanori Kawasaki, Shinichi Yoshimura, Kiyofumi Yamada, Arihiro Hattori, Yoshiyuki Ishihara, Kazuhiko Nishigaki, Genzou Takemura, Toru Iwama, Shinya Minatoguchi
Journal: JACC. Cardiovascular imaging (2013)
Hypocholesterolaemia and cancer?
Authors: G. Rose
Journal: BMJ (1983)

Hypocholesterolaemia and cancer?SIR,-The largest study so far was not mentioned in Dr K G Taylor's leading article (21 May, p 1598).In an international collaborative analysis,' which included a large UK centre, we found that the association with a low serum cholesterol concentration was not specific for colon cancer and that it was almost entirely short term.(table).It seems that the main, and Mean difference in cholesterol concentrations and number of deaths Mean cholesterol difference (mmol/l) Period of follow up (years) All cancers Colon cancer 1 -0-75 (70) -0-65 (4) 2-5 -0-10 (616) -0-23 (41) 6-10 -0-05 (798) +0-08 (60)Conversion: SI to traditional units-Cholesterol: 1 mmol/l 38-7 mg/100 ml.Values in parentheses = number of deaths.
PREDICTIVE POWER OF SPECT APPROPRIATENESS CRITERIA: ASSESSMENT OF APPROPRIATE &amp;amp; INAPPROPRIATE INDICATIONS USING CLINICAL OUTCOMES
Authors: Marlow B. Hernandez, Paola Ballesteros, Randall Schwartz, Melissa Cadette, Craig Asher, Gian Novaro, David Wolinsky, Michael Shen
Journal: Journal of the American College of Cardiology (2012)
Vancomycin resistant staphylococcus reported in Hong Kong
Authors: J. McManus
Journal: BMJ (1999)

Hong Kong's first case of vancomycin resistant Staphylococcus aureus was reported last week.

Hong Kong is the fourth country-after Japan, the United States, and France (27 February, p 557)-to report a case of Staphylococcus aureus resistant to vancomycin. The patient, a middle aged woman with cancer, was admitted in June 1998 to Queen Mary Hospital, Hong Kong, with a fever. She died of bacteraemia after two weeks of treatment had failed to control the infection.

Professor Yuen Kwok-yung, a microbiologist at the University …
Abstract of Clinical Lecture on a Case of Naso-Pharyngeal Polypus
Authors: W. S. Savory
Journal: BMJ (1878)

THE form of tumour called polypus is more common in the region of the nares than in any other part: here it varies in structure and site.While from their shape they all are properly termed polypi, some- and these are the most frequent-have a simple loose fibro-cellular structure, with much fluid in the meshes-the familiar mucous, gela- tinous, or, as it is now termed, myxomatous polypus; some are firmly fibrous-fibromata; while others, consisting of the more immature ele- ments of connective tissue, are sarcomata.I need not add that these several kinds of polypi vary in their nature: some are innocent, others
Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v. Wade
Authors: Wendy Chavkin
Journal: JAMA (1996)

Pickets, murders, firebombings, and a host of harassing activities have come to dominate the public image of abortion in America today. Many have assumed that the current national shortage of abortion providers results from physicians' legitimate fear of this violence. However, Carole Joffe argues in her book<i>Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v. Wade</i>, that the marginal status of abortion provision occurred long before the antiabortion movement took to violence, and that the medical community is responsible. Joffe makes her case through examination of the stories of 45 "doctors of conscience," physicians who performed abortions when they were illegal and have continued to do so since the<i>Roe v Wade</i>decision. Her sample comprises 35 men and 10 women, all of whom had been successfully involved in mainstream medical careers before they began to provide abortions. So much has changed and yet too
The Art of Learning Medicine
Authors: George L. Fite
Journal: JAMA (1974)

The artist wife of a practicing psychiatrist, May Lesser, armed herself with pen and pencil, brush and burin, and followed the medical school class of 1971 of the University of California in Los Angeles throughout its four years. Her experiences in every department of the medical learning process is shown brilliantly within this collection of more than 300 scenes from clinics, dissecting rooms, laboratories, and operating rooms. This remarkable record succeeds in capturing the heart of the educational process in almost effortless manner; the atmospheres, the intensities of the students, the inner earnestness inspire her drawings. Lesser becomes the soul of the student, always serious, always intense, and physicians who review these drawings, etchings, and paintings will recognize, sometimes painfully, the accuracy of her observations. Starting as an accomplished draftsman, mature from the beginning, her work, nevertheless, acquires depth and grasp as she progresses with the class. Late drawings have
EKG Gated First-Transit Radionuclide Angiocardiography
Authors: RICHARD W. MYERS, EDWARD DRASIN
Journal: Clinical Nuclear Medicine (1980)

Radioisotopic assessment of left ventricular ejection fraction and wall motion has previously required either EKG gated blood pool imaging or nongated single-transit angiography. A simplified technique involving EKG gated image acquisition during the first cardiac transit of an isotope bolus was evaluated in 36 patients and compared to results obtained from EKG gated blood pool imaging and contrast ventriculography. The method required rapid intravenous injection of 20 mCi of any Tc-99m agent. EKG gated scintillation camera data collection was started after activity entered the left ventricle and resulted in simultaneous acquisition of end-diastolic and end-systolic images on a dedicated computer system. Thus, images representing summed intervals from eight to ten beats were immediately available for calculation of ejection fraction and subjective evaluation of wall motion. Ejection fraction from the gated first-pass images using the area length method was well correlated (r= .95, P <.001) but tended to be slightly underestimated when compared to contrast values. Abnormal wall motion was identified with a sensitivity of 92%, a specificity of 100%, and an accuracy of 95%. When compared to EKG gated blood pool imaging, inferior wall motion abnormalities, in particular, were more evident on the first-pass study. This method provided simple and accurate assessment of ejection fraction and wall motion and appears to be a useful technique for the noninvasive assessment of left ventricular function.
Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices
Authors: Karl Barange, Jean-Marie Péron, Kamran Imani, Philippe Otal, Jean-Louis Payen, Herve Rousseau, Jean-Pierre Pascal, Francis Joffre, Jean-Pierre Vinel
Journal: Hepatology (1999)

The optimal management of ruptured gastric varices in patients with cirrhosis has not been codified yet. The present study reports the use of transjugular intrahepatic portosystemic shunt (TIPS) in patients with refractory gastric variceal bleeding. Thirty-two consecutive patients were included. All had been unresponsive to vasoactive agents infusion, sclerotherapy, and/or tamponade and were considered poor surgical candidates. They were followed-up until death, transplantation, or at least 1 year (median: 509 days; range 4 to 2,230). Hemostasis was achieved in 18 out of 20 patients actively bleeding at the time of the procedure. In the whole sample of 32 patients, rebleeding rates were 14%, 26%, and 31%, respectively at 1 month, 6 months, and 1 year. De novo encephalopathy was observed in 5 (16%) patients. Seven patients experienced complications and consequently 4 of these patients died. TIPS primary patency rates were 84%, 74%, and 51%, respectively, at 1 month, 6 months, and 1 year. For the same periods of time, survival rates were 75%, 62%, and 59%. These results suggest that TIPS can be used in cirrhotic patients with refractory gastric variceal bleeding and are effective in achieving hemostasis as well as in preventing rebleeding.
Inaccurate Description of Collaborating Hospitals in a Study of the Effect of Folate and Mecobalamin on Hip Fractures After Stroke
Authors: Yoshihiro Sato, Yoshiaki Honda, Jun Iwamoto, Tomohiro Kanoko, Kei Satoh
Journal: JAMA (2006)

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Avascular Necrosis of the Capital Femoral Epiphysis and Poikiloderma Congenitale
Authors: Adolphus W. Dunn
Journal: JAMA (1965)

EPIPHYSEAL OSTEOCHONDROSIS associated with poikiloderma congenitale (Thomson's disease) has not been previously reported, to my knowledge, although a wide variety of other skeletal defects have been observed in association with this syndrome. In the cases reported here, such an association occurred in siblings. <h3>Report of Cases</h3><h3>CASE 1.—</h3> A Puerto Rican boy, age 10 1/2 years, who had Legg-Calvé-Perthes disease on both sides of the body came to the US Naval Hospital in Portsmouth, Va, on Feb 21, 1965, for a follow-up examination. His prenatal development, birth, neonatal development, and early infancy were normal. At the age of one year, his hands, ankles, and feet became red and swollen. Later, the extensor surfaces of the knees and elbows and of the processes of the lumbar spine were similarly affected but not the skin of the face. The erythema and edema gradually disappeared, with resultant linear and punctate areas of cutaneous