tbuckley/cabot-search huggingface dataset:
Colonic Perforation Due to Colonoscopy: A Retrospective Study of 48 Cases
Authors: P. Orsoni, S. Berdah, C. Verrier, A. Caamano, B. Sastre, R. Boutboul, J. C. Grimaud, R. Picaud
Journal: Endoscopy (1997)

The aim of this retrospective study was to analyze data on the treatment of 48 cases of colonic perforation, with a view to defining the criteria for choosing between medical and surgical treatment.A questionnaire requesting information about complications of colonoscopy and their treatment was sent out to four hospital gastroenterological and surgical units.From January 1979 to December 1993, we reviewed the records of 48 cases of colonic perforation following colonoscopy (24 perforations occurred after diagnostic colonoscopy and 24 after therapeutic colonoscopy). Diagnosis of perforation was delayed in 42% of the patients, with a mean delay of two days (range 0.5-7 days). The treatment was surgical in 35 cases, including eight in which previous medical treatment had been unsuccessful. The perforation was in the sigmoid colon in 74% of the surgical population. Operations were carried out using two procedures, including colostomy, in the case of 20 patients (57%). Colostomy closure was performed in 12 patients (60%) with no mortalities. Surgical mortality occurred in five patients (14%), in four cases due to preexisting medical diseases. Medical treatment was attempted in 21 cases, and was successful in 13, mainly in cases in which perforation had occurred after therapeutic colonoscopy (12 patients).The choice of the right type of treatment for colonoscopic perforation seems to depend on the size of the lesion. Surgical treatment is appropriate when the perforation has occurred during diagnostic colonoscopy, since the lesion in this case is usually a large colonic laceration, whereas nonsurgical treatment seems to be justified after polypectomy, as long as there is rapid clinical improvement.
Durable complete remissions after 2′‐deoxycoformycin treatment in patients with hairy cell leukemia resistant to interferon alpha
Authors: Mark Blick, Jose L. Lepe‐Zuniga, Robert Doig, Jorge R. Quesada
Journal: American Journal of Hematology (1990)

The efficacy of interferon alpha in treatment of hairy cell leukemia is well established. Our experience with low doses of 2'-deoxycoformycin, a competitive inhibitor of adenosine deaminase, showed that it was also effective against hairy cell leukemia in 10 of 11 patients studied whose disease was resistant to interferon alpha. Ten patients entered complete remission after five to 12 doses of 2'-deoxycoformycin (4 mg/m2 every other week), and one patient did not respond. No relapses were observed after median follow-up of 18.5 months; unmaintained complete remissions lasted from more than 10 to more than 30 months. The study demonstrated that 2'-deoxycoformycin induces a high rate of durable, unmaintained complete remissions in patients with hairy cell leukemia resistant to interferon alpha.
The Hawthorne effect
Authors: P. Sedgwick
Journal: BMJ (2011)

Researchers evaluated the effectiveness of a newly developed integrated care programme in facilitating the return to work for patients with chronic low back pain. The newly developed programme was a combined patient and workplace directed intervention delivered in the outpatient setting. A randomised controlled trial study design was used. The control arm received usual care. The study lasted one year.1

Trial participants were recruited from primary and secondary care if they were aged 18-65 years, had been having low back pain for more than 12 weeks, were in paid work for at least eight hours a week, and were absent or partially absent from work. The primary outcome was length of time absent from work until a fully sustained return to work. …
Does Insulin Species Modify Counterregulatory Hormone Response to Hypoglycemia?
Authors: Timothy W Jones, Sonia Caprio, Michael P Diamond, Lynn Hallarman, Susan D Boulware, Robert S Sherwin, William V Tamborlane
Journal: Diabetes Care (1991)

Objective To examine whether pork and human insulin induce different counterregulatory responses to hypoglycemia. Research Design and Methods The responses to a mild hypoglycemic stimulus were determined in 35 healthy young adults with the glucose-clamp technique to ensure standardization of glucose and insulin levels. Either pork (n = 15) or human (n = 20) regular insulin was infused (0.8 mU·kg−1·min−1) to lower plasma glucose from 4.7 ± 0.07 to 3.3 ± 0.04 mM (both groups) over ∼ 40 min. Plasma glucose was maintained at that level (with variable rate glucose infusion) for an additional 60 min. Results Steady-state insulin levels were similar in both groups (316 ± 50 vs. 280 ± 29 pM, pork vs. human). Before insulin administration, basal counterregulatory hormone levels were indistinguishable. Most importantly, after plasma glucose was lowered, hormonal responses were nearly identical. No significant differences in peak values of epinephrine (1769 ± 404 vs. 1775 ± 311 pM, pork vs. human), norepinephrine (1.64 ± 0.23 vs. 1.87 ± 0.20 nM, pork vs. human), glucagon (163 ± 29 vs. 175 ± 20 ng/L, pork vs. human), growth hormone (14 ± 3 vs. 17 ± 3 μ/L, pork vs. human), or cortisol (543 ± 83 vs. 458 ± 28 nM, pork vs. human) occurred. Conclusions Our data suggest that pork and human insulin produce a comparable and robust hormonal response in healthy adults under conditions of controlled hypoglycemia.
Smooth Muscle in the Maintenance of Increased Airway Resistance Elicited by Methacholine in Humans
Authors: David G. Chapman, Chris D. Pascoe, Audrey Lee-Gosselin, Christian Couture, Chun Y. Seow, Peter D. Paré, Cheryl M. Salome, Gregory G. King, Ynuk Bossé
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Rationale: Airway narrowing is maintained for a prolonged period after acute bronchoconstriction in humans in the absence of deep inspirations (DIs).Objectives: To determine whether maintenance of airway smooth muscle (ASM) shortening is responsible for the persistence of airway narrowing in healthy subjects following transient methacholine (MCh)-induced bronchoconstriction.Methods: On two separate visits, five healthy subjects underwent MCh challenges until respiratory system resistance (Rrs) had increased by approximately 1.5 cm H2O/L/s. Subjects took a DI either immediately after or 30 minutes after the last dose. The extent of renarrowing following the bronchodilator effect of DI was used to assess the continued action of MCh (calculated as percent change in Rrs from the pre-DI Rrs). We then used human bronchial rings to determine whether ASM can maintain shortening during a progressive decrease of carbachol concentration.Measurements and Main Results: The increased Rrs induced by MCh was maintained for 30 minutes despite waning of MCh concentration over that period, measured as attenuated renarrowing when the DI was taken 30 minutes after compared with immediately after the last dose (7 min post-DI, −36.2 ± 11.8 vs. 14.4 ± 13.2%; 12 min post-DI, −39.5 ± 9.8 vs. 15.2 ± 17.8%). Ex vivo, ASM shortening was largely maintained during a progressive decrease of carbachol concentration, even down to concentrations that would not be expected to induce shortening.Conclusions: The maintenance of airway narrowing despite MCh clearance in humans is attributed to an intrinsic ability of ASM to maintain shortening during a progressive decrease of contractile stimulation.
The Will To Live among HIV-Infected Patients
Authors: Joel Tsevat, Susan N. Sherman, Judith A. McElwee, Karen L. Mandell, Loretta A. Simbartl, Frank A. Sonnenberg, Floyd J. Fowler Jr.
Journal: Annals of Internal Medicine (1999)

Background: Patients infected with HIV value both longevity and health. Objective: To understand how HIV-infected patients value their health. Design: Interview study. Setting: Regional treatment center for HIV. Patients: 51 patients with HIV infection. Measurements: Life-satisfaction, health rating, time-tradeoff, and standard-gamble scores. Results: Of the 51 patients, 49% (95% CI, 35% to 63%) said that their life was better currently than it was before they contracted HIV infection; only 29% said that life was currently worse. The mean (± SD)time-tradeoff score was 0.95 ± 0.10, indicating that, on average, patients would give up no more than 5% of their remaining life expectancy in their current state of health in exchange for a shorter but healthy life. The average health rating score was 71.0 ± 18.7 on a scale of 0 to 100, and the average standard-gamble score was 0.80 ± 0.27. Factors contributing to life satisfaction and time-tradeoff scores included spirituality and having children. Conclusion: Many patients with HIV have a strong will to live, and many feel that life with HIV is better than it was before they became infected.
Comparison of the Effect of Fluticasone Furoate Nasal Spray (FFNS) Versus Placebo on Ocular Itching and Histamine Levels in the Tears of Subjects with Seasonal Allergic Rhinoconjunctivitis (SARC) due to Tree and/or Grass Pollen
Authors: S.A. Lazzaro, H. Hasman, L.L. Thomas, J.N. Moy
Journal: Journal of Allergy and Clinical Immunology (2010)
Dissent of the testis
Authors: Gareth Williams, Poonam Dharmaraj
Journal: BMJ (2007)

Objective To test whether standard information for patients using Crunchie and Aero chocolate bars to explain bone health and risk of fracture is robust.Design Observational study.Setting Domestic kitchen in rural west Wales.Participants 10 Crunchie bars and 10 Aero bars.Main outcome measure Fracture after falls from varying heights.Results Both Crunchie and Aero bars exhibited the same T and Z scores for bone density.Crunchie bars had a lower chocolate mass index than the Aero bars.Crunchie bars are more liable to fracture.Conclusions Using Crunchie and Aero chocolate bars to explain bone structure to patients may be visually attractive but oversimplifies the situation. IntroductIonIt is important that information provided to patients as part of their treatment should be comprehensive and accurate.Within our area of practice relating to osteoporosis and fragility fracture we have noticed a tendency to compare normal, healthy bone to the finely honeycombed structure of a Crunchie (Cadbury Trebor Bassett; Bournville, Birmingham) chocolate bar and to compare abnormal, osteoporotic bone to the coarser structure of an Aero (Nestle UK; York) bar (fig 1). 1 2 Although this explanation is readily appreciated by patients and clinicians it struck us that the comparison may not be completely valid as no work has been published on the fracture potential of each bar.This might mean that with best intentions we are advising patients to aspire to a bone structure that is actually more liable to fracture.To enable us to provide accurate data to our patients we studied the fracture risk for each chocolate bar. MethodsWe randomly purchased 20 chocolate bars (10 Crunchie and 10 Aero) from a reputable high street confectioner; the number of bars was limited by research funds and our rural environment.Each bar was measured to provide information on height
Insurance Coverage for Breast Reconstruction-Reply
Authors: David G. Dibbell
Journal: JAMA (1980)

<h3>In Reply.—</h3> We did not advocate legislative control of insurance except as a last resort. Legislation might not be necessary if insurance carriers take the responsibility of including breast reconstruction as an indisputable part of all standard policies. Breast reconstruction is not different from the restoration of other body parts treated for cancer and must be included in standard health insurance contracts. Unfortunately, breast reconstruction is the only major reconstructive operation that still requires prior written approval. It is not appropriate to place the burden of change on women who are not included in negotiation of group contracts. It is also wrong to presume that consumers have the medical awareness to define adequate insurance policies. Many women are unaware that their policies deny them breast reconstruction and are not free to change to a different insurance carrier's policy. Women who have or in whom breast cancer may develop should not
EXPERIMENTS ON THE RELATION OF THE INHIBITORY TO THE ACCELERATOR NERVES OF THE HEART
Authors: Reid Hunt
Journal: The Journal of Experimental Medicine (1897)

The experiments described in Part IV of this paper show that in whatever manner the problem of the relation of the vagus to the accelerators is approached, whether the accelerators are stimulated during a stimulation of the vagus, or the vagus during a stimulation of the accelerators, or both are stimulated simultaneously, either for a short or for a longer period, the result is the same, viz., the effect upon the rate of the heart is determined entirely by the relative strength of the stimuli applied to the two nerves. If the stimuli are of approximately the same strength, as judged by the effect of stimulating the nerves separately, the rate of the heart is but slightly affected; if the stimulus applied to the vagus is the stronger, the heart is slowed; if it is weaker, the heart is accelerated. In all cases the result of stimulating the two nerves simultaneously is approximately the algebraic sum of the results of stimulating them separately; sometimes the inhibitory effect slightly predominates, but not more frequently than does the accelerator effect. Moreover, the two nerves may be stimulated simultaneously for a considerable period of time without either completely overcoming the effect of the other. Thus as far as their effect upon the rate of the ventricular beat is concerned, the vagus and accelerator nerves seem to be purely antagonistic; the statement that a minimal stimulation of the one can completely overcome a maximal stimulation of the other is undoubtedly incorrect, and the hypotheses as to the mode of action of these nerves upon the heart, based upon this statement, lose their chief support.
THE INCREASE IN THE CONSUMPTION OF ANIMAL FOOD: A SURVEY OF THE PAST FIFTY YEARS
Authors: C. Watson
Journal: BMJ (1905)

LJOUNAL 67we should endeavour by all the means in our power to obtain a supply of sterile cow's milk, and that until this object can be attained- X. Germs must be killed by some method.The handiest and most generally used being beat.STERILIZATION.Cow's milk, though sterile when drawn, soon becomes infected, and as delivered is full of micro-organisms.One authority states that London milk contains more organisms
Lysergic Acid Diethylamide
Authors: R. A. Sandison
Journal: BMJ (1966)

Cine-angiography of the Mitral Valve SIR,-At some time in our lives all of us have enjoyed the films, and one of the intense pleasures of modern cardiology is sitting at ease in an armchair examining the function of the mitral valve in the manner described in your leading article (4 June, p. 1377).However, it is dangerous to assume that the cardiologist's enthusiasm for the movies justi- fies his abandoning the older, simpler, and safer measures for the newer, more expensive, and most dangerous.Naturally occurring cases of advanced rheumatic mitral disease-that is, those not previously submitted to surgical treatment- show the features of one of three syndromes.In the obstructive syndrome, amenable to treatment by valvotomy without perfusion,
The Metabolism of Lead in Man in Health and Disease.
Authors: John H. Talbott
Journal: JAMA (1963)

More than 35 years ago Aub and associates of Harvard published a monograph on lead poisoning, which was judged the definitive work in this field for a number of years. In the intervening time, Robert Kehoe of the Kettering Laboratory, the University of Cincinnati, has devoted essentially a professional lifetime to the same problem. Since lead is an important heavy metal in current economy and environment, it is imperative that this subject be continually surveyed as a major problem for investigation. The breadth of study must inevitably include normal and nontoxic levels of metabolism of lead in man, plants, and animals, as well as the exposure of man especially to toxic concentrations. And lastly, a comprehensive study must include the treatment of lead intoxication from excessive primary intake or secondarily from absorption by plants and animals. The Harben Lectures review the potential industrial hazards as well as lead inhalation from
Bottle feeding and the sudden infant death syndrome
Authors: R E Gilbert, R E Wigfield, P J Fleming, P J Berry, P T Rudd
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To determine whether the risk of the sudden infant death syndrome is increased in bottle fed babies. <b>Design</b>: Population based case-control study matching for age and time. <b>Subjects</b>: All babies aged 1 week to 1 year dying of sudden infant death syndrome during November 1987 to April 1989 or February 1990 to June 1991 and two live controls. <b>Setting</b>: Avon and north Somerset. <b>Main outcome measures</b>: Breast or bottle feeding, sleeping position, maternal smoking, parental employment, and length of gestation. <b>Results</b>: Compared with being fully breast fed, the crude odds ratio for sudden infant death in fully bottle fed babies was 3.1 and for mixed breast and bottle fed babies 1.5. These odds ratios fell to 1.8 (95% confidence interval 0.7 to 4.8) and 1.2 (0.5 to 2.7) respectively after maternal smoking, parental employment, preterm gestation, and sleeping position had been adjusted for. Sleeping position partly masked the effect of being bottle fed on sudden infant death as breast fed babies were more likely to have slept prone than bottle fed babies. <b>Conclusions</b>: Bottle feeding is not a significant independent risk factor for the sudden infant death syndrome. Patterns of maternal smoking, preterm gestation, and parental employment status account for most of the apparent association with bottle feeding. <h3>Key messages</h3> Key messages Bottle fed babies are more likely to have mothers who smoke, to be born preterm, and to come from poorer families, factors which are in themselves linked with the sudden infant death syndrome Inclusion of maternal smoking, preterm gestation, and parental unemployment in the analysis substantially reduced the association between risk of sudden death and being bottle fed Being fully bottle fed is not a significant independent risk factor for the sudden infant death syndrome
Status of the myocardium and infarct-related coronary artery in 19 necropsy patients with acute recanalization using pharmacologic (streptokinase, r-tissue plasminogen activator), mechanical (percutaneous transluminal coronary angioplasty) or combined types of reperfusion therapy
Authors: Bruce F. Waller, Donald A. Rothbaum, Cass A. Pinkerton, Michael J. Cowley, Thomas J. Linnemeier, Charles Orr, Michael Irons, Robin A. Helmuth, Edward R. Wills, Charles Aust
Journal: Journal of the American College of Cardiology (1987)
Long-term outcome of patients with depressed left ventricular function undergoing percutaneous transluminal coronary angioplasty. The NHLBI PTCA Registry.
Authors: D R Holmes, K M Detre, D O Williams, K M Kent, S B King, W Yeh, A Steenkiste
Journal: Circulation (1993)

Coronary revascularization with bypass has been shown to improve survival in patients with coronary artery disease and left ventricular dysfunction. In these patients, use of nonsurgical revascularization with percutaneous transluminal coronary angioplasty (PTCA) is increasing, although their long-term outcome has not been well delineated. The purpose of this investigation was to characterize the outcome of angioplasty in patients with decreased left ventricular function and contrast it with the results in patients with normal left ventricular function.In the 1985-1986 National Heart, Lung, and Blood Institute's PTCA Registry, of 1,802 patients undergoing PTCA, 244 patients (13.5%) had an ejection fraction of < or = 45% (mean, 39.6 +/- 6.8%). These patients had a higher incidence of prior infarction, a longer and worse history of manifestations of coronary disease, and more extensive coronary artery disease than patients with well-preserved function; 88% and 91%, respectively, had successful dilation of at least one lesion (nonsignificant difference). However, patients with decreased left ventricular function had a decreased frequency of successful dilation of all lesions in which PTCA was attempted (76% versus 84%, p < 0.01). There were no statistically significant differences in in-hospital complications--death occurred in 0.8% and 0.7%, nonfatal myocardial infarction occurred in 4.9% and 4.5%, and emergency surgical revascularization was performed in 4.5% and 3.2%, respectively. Patients were followed for a mean of 4.1 years; during this time, patients with decreased left ventricular function had significantly worse survival and combined event-free survival. Despite this, at 4 years, 87% of the patients with a mean ejection fraction of 39.6% remained alive, and 77% were alive and had not experienced infarction or required bypass.PTCA is effective in selected patients with depressed left ventricular function. Initial outcome and risk-benefit ratio are excellent. Successful dilation of at least one vessel was achieved in 88% of patients with depressed left ventricular function and in 91% of patients with more normal left ventricular function. The former group, however, had a decreased incidence of successful dilation in all lesions in which dilation was attempted (76% versus 84%, p < 0.01). There was no significant difference in in-hospital complications between the two groups. During follow-up, patients with decreased left ventricular function had worse event-free survival, although 77% were alive without infarction or bypass grafting at 4 years.
Comprehensive Pathological Analyses in Lung Squamous Cell Carcinoma: Single Cell Invasion, Nuclear Diameter, and Tumor Budding Are Independent Prognostic Factors for Worse Outcomes
Authors: Kyuichi Kadota, Jun-ichi Nitadori, Kaitlin M. Woo, Camelia S. Sima, David J. Finley, Valerie W. Rusch, Prasad S. Adusumilli, William D. Travis
Journal: Journal of Thoracic Oncology (2014)
PRIMARY CARCINOMA OF THE APPENDIX
Authors: E. W. M. H. Phillips, D. H. Isaac
Journal: BMJ (1930)

A JRNA 1 -27 safely adopted.Meanwhile, it may he fair to suppose that vaPeination can ligiht ulp a dolinianit infe(tion s'uch as low gr-ade septleaemia.4. The compia jorative iimumiiti itv of i nfau,ts to comlntlications a.ftei vaccinaition woultl appell to be (tine to the fTact that thev are liaidly likelv to be hiarLouring suthi ani infection.As forl the still nl)ot Il-](o0llo111 gloss infection of the vaccina- tion site, oling infants are obviously miable to set uip such a condition, since thlte canntlot scratclh thlel' ownll MAWmS.REFFRF.NCEES.
Managed Care: Ethical Issues-Reply
Authors: John Glasson
Journal: JAMA (1995)

<h3>In Reply.</h3> —Dr Rosner and Drs Clancy and Brody<sup>1</sup>observe that the Council on Ethical and Judicial Affairs failed "to come to terms" in its report with "the inherent tension between caring for individual patients and populations of patients and the physician's role in resource allocation."<sup>1</sup>Clancy and Brody further state that the Council "fails to articulate a basic truth" that when physicians use resources for their patients, they are depriving other patients of those resources.<sup>1</sup> The Council's report directly acknowledged and responded to these concerns. First, the Council observed that, "[w]hen deciding whether to order a test or procedure for a patient," physicians in managed care are expected to "consider whether the slot should be saved for another patient or not used at all to conserve the plan's resources." However, as Rosner points out, this expectation can seriously undermine the physician's traditional role as patient advocate.