tbuckley/cabot-search huggingface dataset:
Points: Predictive value of rectal bleeding in screening for rectal and sigmoid polyps
Authors: M. D Hagen
Journal: BMJ (1985)

Mr P H Chapins and colleagues have provided information useful to practising physicians (25 May, p 1546).Although the authors viewed sigmoidoscopy as unhelpful in differentiating neoplastic (polyps, adenocarcinoma) from non-neoplastic sources (haemorrhoids, diverticula, etc), the data can be viewed as valuable in assessing the validity of rectal bleeding as a historical screening tool.Specifically, the simple characteristic of "no rectal bleeding" appears quite accurate in identifying those individuals without neoplastic disease.The 2 x 2 table is reconstructed from data in the article.The predictive value of a Relation between rectal bleeding and findings on siginoidoscopy Findings on sigmoidoscopy Carcinoma or No polyp or polyp >10cm carcinoma >10cm Rectal bleeding 4 44 No rectal bleeding 8 263positive finding, as described in the paper, is 4/48 or 8%-quite low.In contrast, the predictive value of a negative finding is 263/271 or 97%-that is, a history of no rectal bleeding accurately identified patients without neoplastic processes.While these results must be used cautiously when applied to a population different from that described in their study, it appears that a negative response to inquiry about rectal bleeding may be useful in identifying patients at low risk for rectosigmoid neoplasia.
Lipid peroxidation and antioxidant defense systems in rat liver after chronic ethanol feeding
Authors: Tateo Kawase, Shinzo Kato, Charles S. Lieber
Journal: Hepatology (1989)

The effects of chronic ethanol feeding on hepatic lipid peroxidation, ascorbic acid, glutathione and vitamin E levels were investigated in rats fed low or adequate amounts of dietary vitamin E. Hepatic lipid peroxidation was significantly increased after chronic ethanol feeding in rats receiving a low–vitamin E diet, indicating that dietary vitamin E is an important determinant of hepatic lipid peroxidation induced by chronic ethanol feeding. No significant change was observed in hepatic non–heme iron content, but hepatic content of ascorbic acid and glutathione was increased by ethanol feeding. Both low dietary vitamin E and ethanol feeding significantly reduced hepatic α–tocopherol content, and the lowest hepatic α–tocopherol was found in rats receiving a combination of low vitamin E and ethanol. Plasma α–tocopherol was elevated after ethanol feeding, probably because of the associated hyperlipemia. Both the ratio of plasma α–tocopherol/plasma lipid and the red blood cell α–tocopherol were reduced by ethanol feeding. Furthermore, ethanol feeding caused a marked increase of hepatic α–tocopheryl quinone, a metabolite of α–tocopherol by free radical reactions. Ethanol feeding caused little changes of α–tocopherol and α–tocopheryl quinone content in mitochondria, whereas a striking increase in α–tocopheryl quinone was observed in microsomes. These data suggest that ethanol feeding causes a marked alteration of vitamin E metabolism in the liver and that the combination of ethanol with a low–vitamin E intake results in a decrease of hepatic α–tocopherol content which renders the liver more susceptible to free radical attack.
Performance Status and Smoking Status Are Independent Favorable Prognostic Factors for Survival in Non-small Cell Lung Cancer: A Comprehensive Analysis of 26,957 Patients with NSCLC
Authors: Tomoya Kawaguchi, Minoru Takada, Akihito Kubo, Akihide Matsumura, Shimao Fukai, Atsuhisa Tamura, Ryusei Saito, Yosihito Maruyama, Masaaki Kawahara, Sai-Hong Ignatius Ou
Journal: Journal of Thoracic Oncology (2010)
ESGE–ESGENA guideline: Cleaning and disinfection in gastrointestinal endoscopy
Authors: U. Beilenhoff, C. Neumann, J. Rey, H. Biering, R. Blum, M. Cimbro, B. Kampf, M. Rogers, V. Schmidt
Journal: Endoscopy (2008)

1. Introduction2. Definition of terms3. Endoscopy-related infections4. Principles of infection control5. Chain of infection6. Health and safety of endoscopy personnel7. General requirements7.1. Classification of endoscopic equipment7.2. Aims of the reprocessing procedure7.3. Staff requirements7.4. Reprocessing room7.5. The reprocessing procedure7.6. Manual versus automated reprocessing8. Process chemicals8.1. Detergents8.1.1. Detergents with enzymatic boosters8.1.2. Detergents with alkaline boosters8.1.3. Detergents with enzymatic and alkaline boosters8.1.4. Detergents containing antimicrobial active substances8.2. Disinfectants8.2.1. Glutaraldehyde8.2.2. Orthophthalaldehyde (OPA)8.2.3. Peracetic acid (PAA)8.2.4. Chlorine dioxide8.2.5. Electrolytically generated disinfectants8.3. Rinse aid8.4. Combination of products from different manufacturers8.5. Change of products9. Reprocessing of endoscopes9.1. Manual cleaning9.1.1. Pre-cleaning in the endoscopy room9.1.2. Manual cleaning in the reprocessing room9.2. Reprocessing in washer-disinfectors9.2.1. Definition and process basics for washer-disinfectors9.2.2. Process specifications for washer-disinfectors9.2.3. Specific recommendations for washer-disinfectors9.2.4. Advantages and disadvantages of washer-disinfectors9.3. Reprocessing in automated disinfection devices9.3.1. Definition and process basics for automated disinfection devices9.3.2. Process specifications for automated disinfection devices9.3.3. Specific recommendations for automated disinfection devices9.3.4. Advantages and disadvantages of automated disinfection devices9.4. Manual reprocessing of endoscopes9.4.1. Definition and process basics for manual reprocessing9.4.2. Process specifications for manual reprocessing9.4.3. Advantages and disadvantages of manual reprocessing9.5. Drying, storage and reuse of endoscope10. Quality assurance10.1. Documentation10.2. Maintenance of washer-disinfectors and automated disinfection devices10.3. Process validation and microbiological surveillance10.4. Outbreak management11. Reprocessing of endoscopic accessories11.1. General recommendations11.2. Process specifications11.2.1. Manual cleaning11.2.2. Reprocessing in washer-disinfectors11.2.3. Manual reprocessing11.2.4. Sterilization11.2.5. Storage11.3. Specific recommendations11.3.1. Biliary and pancreatic procedures11.3.2. Injection needles11.3.3. Biopsy forceps11.3.4. Water bottle and its connectors12. AppendicesAppendix 1: Manual cleaning of flexible endoscopesAppendix 2: Reprocessing of flexible endoscopes in washer-disinfectors and automated disinfection devicesAppendix 3: Manual reprocessing of flexible endoscopesAppendix 4: Manual reprocessing of reusable endoscopy accessoriesAppendix 5: Reprocessing of endoscopic accessories in washer-disinfectors and automated disinfection devices13. References
Mast Cell Infiltration Discriminates between Histopathological Phenotypes of Chronic Obstructive Pulmonary Disease
Authors: Andrea Ballarin, Erica Bazzan, Rafael Hernandez Zenteno, Graziella Turato, Simonetta Baraldo, Dora Zanovello, Elena Mutti, James C. Hogg, Marina Saetta, Manuel G. Cosio
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Rationale: COPD is a complex disease with heterogeneous manifestations. Attempts have been made to define different phenotypes that could guide toward better disease understanding. We described before that smokers can develop either panlobular (PLE) or centrilobular emphysema (CLE). The latter has worse small airways remodeling and narrowing, which account for the airflow obstruction similar to asthma.Objectives: Because of the small airways involvement in CLE similar to asthma, we hypothesized a role for mast cells in CLE but not in PLE. Hence, we investigated mast cell infiltration, along with overall inflammation, and their relation with hyperreactivity and emphysema type in COPD.Methods: We studied lung function, emphysema type, mast cells, and overall inflammation in small airways and alveolar walls, along with alveolar wall thickening in 67 subjects undergoing lung resection (59 smokers, 8 nonsmokers).Measurements and Main Results: Twenty-seven smokers had CLE, 24 had PLE, and 8 had no emphysema. Mast cells were significantly increased in CLE compared with PLE and control subjects. Especially relevant was the mast cell increase in airway smooth muscle in CLE, which related significantly to airway hyperreactivity. CD4+T cells, neutrophils, and macrophages, but not eosinophils and CD8+T cells, were significantly higher in CLE than PLE. Alveolar wall thickness was increased in all smokers, but significantly more in CLE.Conclusions: The pathological phenotypes of COPD CLE and PLE show important differences in their overall inflammation with a protagonism of mast cells, which are related to airway reactivity. These findings highlight the distinctness of these COPD phenotypes and the role of mast cells in the pathophysiology of COPD.
Guillain-Barre syndrome after myocardial infarction.
Authors: A J McDonagh, J Dawson
Journal: BMJ (1987)

One patient (case 3) had been taking frusemide and amiloride for six months for cardiac failure.The two other patients were taking no drugs other than stanozolol.The renal failure in cases 1 and 3 occurred during the period of cholestasis and in case 3 necessitated short term peritoneal dialysis.Liver biopsy in cases 1 and 3 showed severe cholestasis and in case 2 showed mixed cholangiolitic and hepatitic changes.Histological examination of the kidney in case 3 showed acute tubular necrosis.The table gives clinical details and biochemical findings.All three patients recovered biochemically over three to six months after withdrawal of the drug.J7aundice associated with stanozolol Case 1 Case 2 Case 3 Age (years) 65 62 65 Sex F F M Indication for treatment Varicose Varicose Varicose ulcer eczema ulcer Duration of treatment before symptoms (months) 4 5 Daily dose of stanozolol (mg) 10 10 10 Other treatment None None Frusemide, amiloride (for 6 months) Biochemical findings* Maximum bilirubin (Vmol/l) (<17 gmol/1)
Mastocytosis associated with a rare germline KIT K509I mutation displays a well-differentiated mast cell phenotype
Authors: Eunice Ching Chan, Yun Bai, Arnold S. Kirshenbaum, Elizabeth R. Fischer, Olga Simakova, Geethani Bandara, Linda M. Scott, Laura B. Wisch, Daly Cantave, Melody C. Carter, John C. Lewis, Pierre Noel, Irina Maric, Alasdair M. Gilfillan, Dean D. Metcalfe, Todd M. Wilson
Journal: Journal of Allergy and Clinical Immunology (2014)
The psychological impact of injury: effects of prior sport and exercise involvement: Table 1
Authors: Lynne H Johnston, Douglas Carroll
Journal: British Journal of Sports Medicine (2000)

Objectives —To test the assumption that the psychological impact of injury varies with involvement in sport and exercise, and that those who are more involved in sport and exercise before injury would experience greater negative affect and retarded recovery. Method —Patients attending for physiotherapy completed a battery of questionnaires including measures of mood and perceived recovery, at the beginning, middle, and end of formal rehabilitation. Complete data were available for 93 patients. Results —Those who were more involved in sport and exercise before injury registered higher levels of confusion and perceived their recovery to be less, possibly reflecting greater information needs and a greater mismatch between current status and that before injury in the athletic sample. Reported negative affect did not vary with sport and exercise involvement. Conclusions —Incapacitation for those not involved in sport and exercise before injury may have much the same affective impact as it does for those with considerable involvement. However, those with considerable involvement did report higher levels of confusion and perceived their recovery to be less towards the end of rehabilitation. This suggests that it may be important to assess affective reactions and perceived recovery during the re-entry phase.
Phlebotomy for Diagnostic Laboratory Tests in Adults
Authors: Bruce R. Smoller, Margot S. Kruskall
Journal: New England Journal of Medicine (1986)

Abstract Although anemia is a frequently observed complication of phlebotomies for laboratory tests in neonates, this problem has received little attention in adult populations. We analyzed the phlebotomy records of 100 hospitalized patients and found that 50 patients who spent all of their hospitalization in general wards had blood samples drawn an average of 1.1 times a day. A mean volume of 12.4 ml a day was drawn, and the total volume drawn during their entire hospitalization was 175.0 ml. In contrast, 50 patients who spent part or all of their hospitalization in an intensive care unit were phlebotomized a mean of 3.4 times a day, for a mean volume of 41.5 ml of blood drawn a day and a total volume of 762.2 ml. Patients in the intensive care unit who had arterial lines had more blood drawn (944.0 ml), more often (4.0 times a day), than patients in the intensive care unit who did not have such lines (300.9 ml; 1.9 times a day). Of 36 patients who received transfusions, 17 (47 percent) had large losses from phlebotomy (>180 ml of red cells) that contributed to their transfusion requirements. We propose the use of sample tubes of the size used in pediatrics, batching of requests for laboratory tests, and review of the cumulative volume of blood removed from individual patients as approaches to reducing blood loss from phlebotomy. (N Engl J Med 1986; 314:1233–5.)
Intra-arterial Delivery of a Recombinant Adenovirus Does Not Increase Gene Transfer to Tumor Cells in a Rat Model of Metastatic Colorectal Carcinoma
Authors: David J. Maron, Hiroomi Tada, A.David Moscioni, John Tazelaar, Douglas L. Fraker, James M. Wilson, Francis R. Spitz
Journal: Molecular Therapy (2001)

Hepatic artery infusion of adenoviral vectors has been shown to increase transduction of certain hepatocellular malignancies in preclinical studies. In addition, clinical trials have begun evaluating the efficacy of gene transfer of cytotoxic genes to metastatic colorectal tumors through hepatic artery infusion. Here we evaluate the extent of gene expression and therapeutic effect following various routes of administration of recombinant adenovirus in a rat model of metastatic colorectal carcinoma. We administered adenovirus (AdCMVlacZ) to rats with established colorectal metastases through infusion into the hepatic artery, intravenous infusion, or direct injection into a tumor. Intravenous administration resulted in transduction of hepatocytes, but not tumor cells. Hepatic arterial administration failed to substantially increase transduction of tumor cells. In addition, ligation of the hepatic artery following infusion of adenovirus or the addition of lipiodol infusion had no effect on the transduction of tumor cells. We administered AdCMVp53 by direct injection into tumors, intravenous administration, or hepatic artery infusion to evaluate the delivery of a therapeutic gene. Direct injection of AdCMVp53 into established hepatic colorectal metastases resulted in a therapeutic response in comparison with both hepatic arterial and intravenous infusion of vector. These preclinical studies fail to support a strategy of infusion through the hepatic artery of recombinant adenovirus targeting tumor cells in the treatment of colorectal cancer liver metastases.
Choosing between randomised and non-randomised studies: a systematic review
Authors: M J Campbell
Journal: BMJ (1998)

Rating:

Randomised controlled trials are often held up as the “gold standard” of medical research, and it is commonly believed that the size of a treatment effect is exaggerated in non-randomised studies. In these days of evidence based medicine, however, where is the empirical evidence that this is so? A widespread criticism of randomised controlled trials is that they are based on highly selected individuals. Are there systematic differences between patients included and excluded in such trials, and do these influence the measured treatment effect?

These are just a few …
[82] RANDOMIZED, COMPARATIVE STUDY OF TERLIPRESSIN AND ALBUMIN VS ALBUMIN ALONE IN PATIENTS WITH CIRRHOSIS AND HEPATORENAL SYNDROME
Authors: M. Martin-Llahi, M.N. Pepin, M. Guevara, A. Torre, A. Monescillo, G. Soriano, F. Diaz Such, F.T. Salmeron, H. Andreu, R. Sola, E. Fabrega, D. De las Heras, J. Rodes, V. Arroyo, P. Gines
Journal: Journal of Hepatology (2007)
EPIDEMIC YELLOW FEVER IN EASTERN NIGERIA, 1986
Authors: K.M. De Cock, A. Nasidi, J. Enriquez, R.B. Craven, B.C. Okafor, T.P. Monath, P.M. Tukei, P. Lichfield, A. Fabiyi, C. Ravaonjanahary, A. Sorungbe
Journal: The Lancet (1988)
Infectious complications of Swan-Ganz pulmonary artery catheters. Pathogenesis, epidemiology, prevention, and management.
Authors: L A Mermel, D G Maki
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

"Infectious complications of Swan-Ganz pulmonary artery catheters. Pathogenesis, epidemiology, prevention, and management.." American journal of respiratory and critical care medicine, 149(4), pp. 1020–1036
Viral Infections of Humans. Epidemiology and Control.
Authors: Alfred S. Evans
Journal: Annals of Internal Medicine (1983)

The third edition of this book has been completely revised and updated, and new chapters have been added on Hantanvirus by Karl Johnson, on retroviruses by William Blattner, and on hepatocellular carcinoma by Joseph Melnick. New authors have replaced previous authors for several chapters. These include Karl Johnson on arenaviruses, Stephen Hadler and Harold Margolin on viral hepatitis, Paul Glezen and Robert Couch on influenza, Alfred S. Evans and Guy de-The on Burkitt lymphoma, and Joseph Melnick, William Rawls, and Ervin Adam on cervical cancer. A summary of the major advances since the last edition in 1982 has been provided by each contributor as given below. Overall, it is clear that the rapid advances in molecular virology, monoclonal antibody, and rapid diagnostic techniques dominate the progress since the last edition and provide a better understanding of pathogenesis, newer tools for epidemiologic investigation, and new methods for vac cine production. Although there is repetition in mention of these advances as written by each contributor, the editor has let these stand to let the reader know how each interprets the impact of these new developments. I. Introduction and Concepts Chapter 1. Epidemiologic Concepts and Methods: The sections on control of infectious diseases has been much expanded to cover progress and problems in both developed and developing countries, the concepts of eradication and elimination, and the means to assess the need and effectiveness of immuniza tion programs.
A pilot study of EUS-guided hot saline injection for induction of pancreatic tissue necrosis
Authors: H. Imazu, K. Sumiyama, K. Ikeda, Y. Uchiyama, H. Aihara, H. Kakutani, M. Kaise, T. Ang, S. Omar, H. Tajiri
Journal: Endoscopy (2009)

Hot saline may be potentially useful for inducing necrosis of pancreatic tissue. However, the local and systemic effects are largely unknown. This pilot study aimed to evaluate the feasibility and safety of EUS-guided injection of hot saline into the pancreas in the porcine model.Boiling hot saline was injected into the tail of normal porcine pancreas under EUS guidance in six pigs via a transgastric approach. Three pigs were killed 4 hours later to study the acute effect of the hot saline injection (acute study). The remaining three pigs were killed after 7 days of clinical observation (survival study).Injection of 5 mL, 2 mL and 1 mL of hot saline produced localized necrosis (7 - 10 mm) of pancreatic tissue in the acute study. However, there was pooling of hot saline on the surface of the pancreas when 5mL was injected. On the basis of the results of the acute study, the volume of hot saline injected in the survival study was 1 mL. One milliliter of hot saline produced localized or sporadic necrosis of pancreatic tissue without any signs of pancreatitis in all three pigs in the survival study; hot saline was observed to pool on the pancreatic surface of one pig. There was no histological evidence of necrosis in the pancreatic tissue adjacent to the pooled hot saline in either the acute or the survival study.EUS-guided hot saline injection of pancreatic tissue in the porcine model was technically successful and led to localized necrosis of pancreatic tissue without any sign of pancreatitis.
Cancer self help groups: an inside view.
Authors: T Brown, P Griffiths
Journal: BMJ (1986)

Although there is great variation in the detail of how different cancer self help groups are set up, the common thread is the desire to improve the lot of people affected by cancer. We see the broad underlying aims as being to provide opportunities for support, participation, learning, and empowerment. There are two categories of groups, whose different aims are as follows. Firstly, there are groups concerned with the individual's emotional and practical wellbeing?whether he or she is the person with cancer or the relative or friend of someone who has or has had cancer. These groups aim at being undogmatic and at extending acceptance to people regardless of the particular ways in which they are dealing with their problems. They also offer people a chance to air questions, doubts, and fears that they are facing, as well as to talk about their feelings and experiences. They aim at helping them to come to terms with what is happening; to respond to what the people are asking for in terms of information about sources of practical help; to build up people's confidence to ask their doctor the questions they have on their minds; or simply to provide an opportunity to talk about topics that people they know in their everyday Ufe may prefer to avoid. The second category comprises those groups that wish to inform people about a range of approaches that either may enhance their quality of fife or are believed to have a capacity for affecting the cancer itself. These groups teach people to help themselves through things such as relaxation, visualisation, and nutrition. There are also groups providing a range of activities incorporating parts of both of these categories.
Systematic review of day hospital care for elderly people
Authors: A. Forster, J. Young, P. Langhorne
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To examine the effectiveness of day hospital attendance in prolonging independent living for elderly people. <b>Design:</b> Systematic review of 12 controlled clinical trials (available by January 1997) comparing day hospital care with comprehensive care (five trials), domiciliary care (four trials), or no comprehensive care (three trials). <b>Subjects:</b> 2867 elderly people. <b>Main outcome measures:</b> Death, institutionalisation, disability, global "poor outcome," and use of resources. <b>Results:</b> Overall, there was no significant difference between day hospitals and alternative services for death, disability, or use of resources. However, compared with subjects receiving no comprehensive care, patients attending day hospitals had a lower odds of death or "poor" outcome (0.72, 95% confidence interval 0.53 to 0.99; P&lt;0.05) and functional deterioration (0.61, 0.38 to 0.97; P&lt;0.05). The day hospital group showed trends towards reductions in hospital bed use and placement in institutional care. Eight trials reported treatment costs, six of which reported that day hospital attendance was more expensive than other care, although only two analyses took into account cost of long term care. <b>Conclusions:</b> Day hospital care seems to be an effective service for elderly people who need rehabilitation but may have no clear advantage over other comprehensive care. Methodological problems limit these conclusions, and further randomised trials are justifiable. <h3>Key messages</h3> The benefits of geriatric day hospital care have been controversial for many years This systematic review of 12 randomised trials comparing a variety of day hospitals with a range of alternative services found no overall advantage for day hospital care Day hospitals had a possible advantage over no comprehensive care in terms of death or poor outcome, disability, and use of resources The costs of day hospital care may be partly offset by a reduced use of hospital beds and institutional care among survivors