tbuckley/cabot-search huggingface dataset:
Hypernatremic Dehydration From Hypertonic Enemas in Congenital Megacolon
Authors: Eric W. Fonkalsrud
Journal: JAMA (1967)

FOR MANY DECADES water intoxication from repeated tap water enemas has been recognized as a serious complication occasionally resulting in death in children with congenital megacolon. Although isotonic saline has been recommended as the safest solution for rectal irrigations, additional ions or compounds are frequently added to stimulate peristalsis and produce more complete evacuation. Since chronic constipation in children is frequently managed by repeated enemas, commercial enema preparations have become available.  Scant attention has been directed to the hyperosmotic dehydration which may ensue following repeated use of hypertonic enema solutions in patients with congenital megacolon. These children frequently retain such solutions for many days because of the functional obstruction due to the aganglionic rectal segment. The dilated colon is believed to have a much greater absorptive ability than the normal colon, presumably because of the extremely large mucosal surface.  This report presents an example of acute hypernatremic dehydration which resulted
Money and Health Care
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1980)

"What's going on in medicine is really remarkable," said a vice president of one of the country's biggest brokerage houses — and he wasn't speaking of therapeutics.In charge of monitoring health care for his firm, he was among several of Wall Street's nonmedical medical observers whom I recently visited in quest of a break from the echo-chamber effect that often shapes Washington's impressions of the world."Forget about HCFA and all its cost-containment stuff," he said, referring to the Health Care Financing Administration, which, mainly through Medicare and Medicaid, pays about 25 per cent of the nation's $200-billion-a-year health-care . . .
1172-71 Practical predictors of clinical outcomes in patients initiating beta-blockers for heart failure: Findings of a community-based registry
Authors: Barry Greenberg, Sandra R Lottes, Jeanenne J Nelson, Mary Ann Lukas, Michael B Fowler, Barry M Massie, William T Abraham, Edward M Gilbert, Joseph A Franciosa
Journal: Journal of the American College of Cardiology (2004)
Weak n activity of en(a−) human erythrocyte membranes
Authors: Tatsuo Shinozuka, Yoshihisa Miyata, Kunio Ohyama, Setsuko Takei, Toshio Yamakawa, Katsuyoshi Kurihara, Junichi Yanagida
Journal: American Journal of Hematology (1993)

Abstract The propositus's erythrocytes with phenotype En(a−), which was found for the first time in a Japanese family, reacted more weakly with anti‐N serum than the ordinary phenotype N erythrocytes. The En(a−) erythrocytes lack the major membrane sialoglycoprotein (glycophorin A) as demonstrated by Bio‐Gel 1.5m gel filtration from active sialoglycoproteins, which were isolated from En(a−) erythrocyte membranes by the method of lithium diiodosalicylate (LIS)‐phenol extraction. It is suggested from observation via enzymelinked immunosorbent assay (ELISA) that N activity is derived from the glycophorin B molecule on En(a−) erythrocyte membranes. © 1993 Wiley‐Liss, Inc.
Defining Early Morbidity of Radical Cystectomy for Patients with Bladder Cancer Using a Standardized Reporting Methodology
Authors: Ahmad Shabsigh, Ruslan Korets, Kinjal C. Vora, Christine M. Brooks, Angel M. Cronin, Caroline Savage, Ganesh Raj, Bernard H. Bochner, Guido Dalbagni, Harry W. Herr, S. Machele Donat
Journal: European Urology (2008)
Minor Gynaecological Outpatient Operations
Authors: H. Wagman, D. S. Bamford
Journal: BMJ (1971)

Altogether 143 patients had minor gynaecological operations performed under general anaesthesia in the outpatient department. This method proved to be very acceptable to patient, gynaecologist, and anaesthetist. No complications occurred requiring admission to hospital, and the short recovery time confirmed the safety of early discharge from hospital. This procedure had a beneficial effect on the waiting list, and expensive beds were used more efficiently for major surgical cases. It is recommended that this procedure should be more widely practised, provided that the patients are adequately screened.
Morphologic determinants of airway responsiveness in chronic smokers.
Authors: A Riess, B Wiggs, L Verburgt, J L Wright, J C Hogg, P D Paré
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Nonspecific bronchial hyperresponsiveness (NSBH) occurs in asthmatics and in smokers who have airway obstruction. NSBH may be caused by different mechanisms in these conditions. We hypothesized that NSBH in smokers was a consequence of the structural changes that occur in chronic obstructive pulmonary disease (COPD) and lead to airway obstruction. We measured nonspecific bronchial responsiveness, assessed by PC20, in 77 smokers who had mild to moderate airflow obstruction prior to lung resection for a pulmonary nodule. We related airway responsiveness to baseline airway function (FEV1 % predicted), to functional (PLmax, PL90, and P-V curve shape) and morphometric (alveolar attachments) markers of lung elasticity as well as to thickening in small airways. Airway wall thickness, internal and external to the outer border of smooth muscle was quantified by plotting the square root of airway wall area versus a marker of airway size, airway internal perimeter (Pi). PC20 was significantly related to FEV1% predicted and PLmax. and when these functional parameters were controlled for, PC20 was also inversely related to airway wall thickness. There was also a trend for the most responsive patients to have fewer alveolar attachments per millimeter on the external perimeter of the airway walls. These data suggest that exaggerated nonspecific airway narrowing in COPD is secondary to structural changes caused by the disease.
Injury to the Ca2+ ATPase of the sarcoplasmic reticulum in anesthetized dogs contributes to myocardial reperfusion injury
Authors: Steven C Smart, Kiran B Sagar, Jo El Schultz, David C Warltier, Larry R Jones
Journal: Cardiovascular Research (1997)

Objective: Sarcoplasmic reticulum dysfunction may contribute to calcium (Ca2+) overload during myocardial reperfusion. The aim of this study was to investigate its role in reperfusion injury. Methods: Open chest dogs undergoing 15 min of left anterior descending coronary artery occlusion and 3 h of reperfusion were randomized to intracoronary infusions of 0.9% saline, vehicle, or the Ca2+ channel antagonist, nifedipine (50 μg/min from 2 minutes before to 5 minutes after reperfusion). After each experiment, transmural myocardial biopsies were removed from ischemic/reperfused and nonischemic myocardium in the beating state and analyzed for (i) sarcoplasmic reticulum protein content (Ca2+ ATPase, phospholamban, and calsequestrin) by immunoblotting and (ii) Ca2+ uptake by sarcoplasmic reticulum vesicles with and without 300 micromolar ryanodine or the Ca2+ ATPase activator, antiphospholamban (2D12) antibody. Results: Contractile function did not recover in controls and vehicle-treated dogs after ischemia and reperfusion (mean systolic shortening, −2±2%), but completely recovered in nifedipine-treated dogs (17±2%, p = NS vs. baseline, p<0.01 vs. control). Ventricular fibrillation occurred in 50% of controls and vehicle dogs and 0% of nifedipine-treated dogs (p<0.01). Ca2+ uptake by the sarcoplasmic reticulum vesicles was severely reduced in ischemic/reperfused myocardium of controls and vehicle dogs (p<0.01 vs. nonischemic). Ryanodine and the 2D12 antibody improved, but did not reverse the low Ca2+ uptake. Protein content was similar in ischemic/reperfused and nonischemic myocardium. In contrast, Ca2+ uptake and the responses to ryanodine and 2D12 antibody were normal in ischemic/reperfused myocardium from nifedipine-treated dogs. Conclusion: Dysfunction of the sarcoplasmic reticulum Ca2+ ATPase pump correlates with reperfusion injury. Reactivation of Ca2+ channels at reperfusion contributed to Ca2+ pump dysfunction. Ca2+ pump injury may be a critical event in myocardial reperfusion injury.
More Than Skin Deep: Transdermal Drug-Delivery Systems
Authors: Louis Lasagna, David J. Greenblatt
Journal: New England Journal of Medicine (1986)

Modern pharmaceutics is perhaps four decades old. During this time, the empirical approach to drug delivery has begun to yield to a more theoretical approach, which has brought the principles of physical chemistry to bear on the design of drug-delivery methods. As a result, patients benefit from reservoirs of pilocarpine impregnated in plastic and inserted into the conjunctival sac to treat glaucoma, from intrauterine devices that release progesterone to prevent unwanted pregnancy, and from repository-injection forms of major tranquilizers and hormones.An important focus has been transdermal drug delivery. A scopolamine skin patch can deliver prolonged protection against motion sickness, . . .
DIFFERENTIAL EFFECTS OF SMOKING ON LONG-TERM OUTCOMES IN PATIENTS WITH ATHEROSCLEROTIC VASCULAR DISEASE TREATED WITH ASPIRIN OR CLOPIDOGREL: INSIGHTS FROM THE CLOPIDOGREL VERSUS ASPIRIN IN PATIENTS AT RISK OF ISCHEMIC EVENTS TRIAL
Authors: Jose Luis Ferreiro, Deepak Bhatt, Masafumi Ueno, Deborah Bauer, Dominick Angiolillo
Journal: Journal of the American College of Cardiology (2012)
Dietary Calcium and Hypercalciuria
Authors: M. J. Phillips, J. N. C. Cooke
Journal: BMJ (1967)

rickettsiasis ?. ,adenovirus infection ?). Con- trary to these findings a proliferative endovasculitis with'.secondary thrombosis was observed in.two other cases (see Fig. ).The histopathological lesions in those two cases resemble the morphology of a peripheral arteritis (vaguely resembling thromboangiitis obliterans) in young adult patients with an apparently identical condition.Identical obser- vations of peripheral gangrene were also noticed in the course of an adenovirus infection.2
Who Speaks for the Child?: The Problems of Proxy Consent
Authors: Joan E. Hodgman
Journal: JAMA (1983)

I agreed to review this volume because of the importance of the subject to me. An answer or answers to the question posed in the title are necessary in arriving at therapeutic decisions in the intensive care nursery that I supervise. The book does reflect the problems and inconsistencies in our society between individual rights and proxy consent. It is certainly asking too much to expect succinct consensus in this area. However, despite the timeliness of the subject matter, I found the book disappointing. It was too diffuse and too repetitious to maintain my interest. There were few data presented to support opinions. The chapter by Joseph Goldstein "On State Supervention of Parental Autonomy" was a refreshing defense of the rights of parents to speak for their child but represents a minority opinion, I believe. The opposite position about state supervention, which seems to have many adherents, is not treated
Successful treatment of multiple actinic keratoses in organ transplant patients with topical 5% imiquimod: a report of six cases
Authors: C. Ulrich, J.O. Busch, T. Meyer, I. Nindl, T. Schmook, W. Sterry, E. Stockfleth
Journal: British Journal of Dermatology (2006)

Background Nonmelanoma skin cancer represents a significant cause of morbidity in organ transplant recipients (OTRs). Cutaneous malignancies, mainly invasive squamous cell carcinoma and its precursor actinic keratosis (AK), appear approximately 5–10 years after organ transplantation. Impaired wound healing and high recurrence rates in immunocompromised patients treated with destructive therapies such as cryosurgery or topical 5‐fluorouracil represent frequently known complications. Objectives To evaluate the safety and efficacy of imiqimod 5% in the treatment of AKs in OTRs. Methods Six OTRs (two kidney, two heart, one lung and one liver) with extensive AKs were treated with imiquimod 5% cream two to three times weekly in an open‐label uncontrolled, nonrandomized pilot study. Results In five of six patients treated with imiquimod 5% cream all AK lesions were cleared after 12–16 weeks. One patient showed partial response. Local adverse events at the site of application included erythema, oedema and mild erosion. No wound infection or scarring was observed in any of these patients. All graft‐related laboratory parameters were stable during and after treatment. Immunosuppressive therapy remained unchanged throughout the treatment. Conclusions These results suggest that imiquimod 5% cream may be useful for the local treatment of precancerous AK lesions in OTRs.
Effects of Vaccination on Invasive Pneumococcal Disease in South Africa
Authors: Anne von Gottberg, Linda de Gouveia, Stefano Tempia, Vanessa Quan, Susan Meiring, Claire von Mollendorf, Shabir A. Madhi, Elizabeth R. Zell, Jennifer R. Verani, Katherine L. O’Brien, Cynthia G. Whitney, Keith P. Klugman, Cheryl Cohen
Journal: New England Journal of Medicine (2014)

In South Africa, a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 with a three-dose schedule for infants at 6, 14, and 36 weeks of age; a 13-valent vaccine (PCV13) replaced PCV7 in 2011. In 2012, it was estimated that 81% of 12-month-old children had received three doses of vaccine. We assessed the effect of vaccination on invasive pneumococcal disease.We conducted national, active, laboratory-based surveillance for invasive pneumococcal disease. We calculated the change in the incidence of the disease from a prevaccine (baseline) period (2005 through 2008) to postvaccine years 2011 and 2012, with a focus on high-risk age groups.Surveillance identified 35,192 cases of invasive pneumococcal disease. The rates among children younger than 2 years of age declined from 54.8 to 17.0 cases per 100,000 person-years from the baseline period to 2012, including a decline from 32.1 to 3.4 cases per 100,000 person-years in disease caused by PCV7 serotypes (-89%; 95% confidence interval [CI], -92 to -86). Among children not infected with the human immunodeficiency virus (HIV), the estimated incidence of invasive pneumococcal disease caused by PCV7 serotypes decreased by 85% (95% CI, -89 to -79), whereas disease caused by nonvaccine serotypes increased by 33% (95% CI, 15 to 48). Among adults 25 to 44 years of age, the rate of PCV7-serotype disease declined by 57% (95% CI, -63 to -50), from 3.7 to 1.6 cases per 100,000 person-years.Rates of invasive pneumococcal disease among children in South Africa fell substantially by 2012. Reductions in the rates of disease caused by PCV7 serotypes among both children and adults most likely reflect the direct and indirect effects of vaccination. (Funded by the National Institute for Communicable Diseases of the National Health Laboratory Service and others.).
Antibody response to the streptococcal group A-variant polysaccharide in BASILEA rabbits lacking kappa-polypeptide chains.
Authors: S Weiss, A S Kelus, D G Braun
Journal: The Journal of Experimental Medicine (1977)

Rabbits from a variant strain called BASILEA, in which homozygotes express only lambda-type chains and heterozygotes have normal kappa/lambda ratios, were hyperimmunized with a streptococcal group A variant vaccine. Homozygotes (bas/bas) produced antibodies with lambda-chains, heterozygotes, however, produced predominantly antibodies with kappa-chains. The incidence of restricted high responders in the BASILEA strain was high; it was probably introduced by the original mutant rather than by the loss of kappa-chains (founder effect). The degree of heterogeneity of homozygotes is similar to the heterogeneity of heterozygotes, and to that of rabbits expressing kappa-chains. This suggests that in the rabbit, the repertoire of lambda-chain genes is of similar size to that of kappa-chain genes.
Address in Pathology
Authors: C. Creighton
Journal: BMJ (1883)

SPECIFIC INFECTIONS.MR. PRESIDENT AND GENTLEMEN,-I have unusually good reasons for prefacing my address with an apology.I cannot cla'imn to speak from the fulness of experience, which has given so much value and distinction to the addresses that have been delivered before the Association; and I have a subject assigned to me which'demands experience and a mature judgment in no ordinary degree.Pathology is a growing science, its aspects are constantly changing,.asingle year's work brings us a multitude of new and often puzzling facts; and although the issues are of the most momentous kind, not even the wisest and most judicial minds in the profession can alway see their way to a clear and definite opinion.But, amidst all this uncertainty, there is one central and gaiding prinoiple in the doctrine of disease which we may hold fast to.It is the pbysiological principle, or the idea that diseased states'of the body are but modifications of healthy states, deviations from the beaten track, perturbations of the normal life, shortcomings-of the physiological standard.Thus, even in so formidable a malady as diabetes, we are still within sight of the line of health; there may be a physiological glycosuria; and that fact, as Dr. Bence Jones says, proves to us that the disease is only a little.w y distant from health."H Here as elsewhere," says -that eminent chemist and pathologist, "there is no definite limit where health ends atid disease begins."To find the proper physiological analo- gies for diseased processes is the task of modern pathology; and I do tiot think that there is, in the whole range of science, any better kind of intellectuLal exercise than to expose the working of the trdinary laws of structure and function under the maA of disease.
Middle ear function in patients with juvenile chronic arthritis.
Authors: A Siamopoulou-Mavridou, D Asimakopoulos, A Mavridis, A Skevas, H M Moutsopoulos
Journal: Annals of the Rheumatic Diseases (1990)

The conductive hearing of 18 patients with juvenile chronic arthritis was studied. Tympanometry was therefore undertaken for the assessment of functional state of the tympanic membrane, the ossicular chain with its ligaments and muscles, and the air cushion of the tympanic cavity. Acoustic reflex was present in all patients but an abnormal tympanometric pattern (type As) was found bilaterally or unilaterally in 10 (mostly severe cases) patients. These findings indicate that juvenile chronic arthritis changes middle ear function, probably as a result of inflammation of the synovial ossicular joints, which is followed by stiffness of the tympanic membrane and ossicular chain.
Differential regulation of extracellular matrix synthesis during liver regeneration after partial hepatectomy in rats
Authors: Lenhard K. Rudolph, Christian Trautwein, Stefan Kubicka, Tim Rakemann, Matthias J. Bahr, Nick Sedlaczek, Detlef Schuppan, Michael P. Manns
Journal: Hepatology (1999)

Little is known about the modulation of the extracellular matrix (ECM) during liver regeneration. We studied the temporospatial expression of procollagens and of matrix metalloproteinases (MMPs) and their physiological antagonists, the tissue inhibitors of metalloproteinases (TIMPs) after two-thirds partial hepatectomy (PH) by Northern blot analysis and in situ hybridization. The entry of hepatocytes into the S-phase at 24 hours after PH was accompanied by a peak (sixfold induction) of hepatic TIMP-1 RNA levels that steadily declined thereafter to reach normal levels 144 hours after PH. Moderate MMP-2 and TIMP-2 RNA levels remained constant up to 144 hours after PH, and MMP-1 and -13 RNA were always undetectable. In situ hybridization showed a dramatic upregulation of TIMP-1 RNA transcripts in mesenchymal cells of portal, perisinusoidal and, to a lesser extent, pericentral areas. In contrast, scattered hepatocytes represented only a minor fraction (below 10%) of TIMP-1 RNA positive cells. When hepatocytes stopped DNA synthesis at 72 hours after PH, an upregulation of procollagen alpha1(I) and alpha2(III) transcripts was observed paralleled by threefold increased PIIINP levels in the sera. Our data reveal a tightly regulated program of de novo matrix synthesis after PH. Whereas interstitial procollagens appear to participate in the induction and maintenance of the quiescent hepatocyte phenotype, the early and localized expression of TIMP-1 indicates a role unrelated to its function as a general MMP-antagonist, e.g., as a growth promoting agent for hepatocytes.
Apolipoprotein A-I variants. Naturally occurring substitutions of proline residues affect plasma concentration of apolipoprotein A-I.
Authors: A von Eckardstein, H Funke, A Henke, K Altland, A Benninghoven, G Assmann
Journal: Journal of Clinical Investigation (1989)

Six unrelated families with genetically determined structural variants of apo A-I were found in the course of an electrophoretic screening program for apo A-I variants in dried blood samples of newborns. The following structural variations were identified by the combined use of HPLC, time-of-flight secondary ion mass spectrometry (TOF-SIMS), and automated gas phase sequencing: Pro3----Arg (1x), Pro4----Arg (1x), and Pro165----Arg (4x). All variant carriers were heterozygous for their mutant of apo A-I. Subjects heterozygous for apo A-I(Pro165----Arg) (n = 12) were found to exhibit lower mean values for apo A-I (109 +/- 16 mg/dl) and HDL cholesterol (37 +/- 9 mg/dl) than unaffected family members (n = 9): 176 +/- 41 and 64 +/- 18 mg/dl, respectively (P less than 0.001). In 9 of 12 apo A-I(Pro165----Arg) variant carriers the concentrations of apo A-I were below the fifth percentile of sex-matched controls. By two-dimensional immunoelectrophoresis as well as by densitometry the relative concentration of the variant apo A-I in heterozygous carriers of apo A-I(Pro165----Arg) was determined to account for only 30% of the total plasma apo A-I mass instead of the expected 50%. Thus, the observed apo A-I deficiency may be largely a consequence of the decreased concentration of the variant apo A-I. In the case of the apo A-I(Pro3----Arg) mutant, densitometry of HDL apolipoproteins demonstrated a distinctly increased concentration of the variant proapo A-I relative to normal proapo A-I. This phenomenon was not observed in the apo A-I(Pro4----Arg) mutant or in other mutants. This suggests that the interspecies conserved proline residue in position 3 of mature apo A-I is functionally important for the regular enzymatic conversion of proapo A-I to mature apo A-I.