tbuckley/cabot-search huggingface dataset:
The Dietary Fat—Breast Cancer Hypothesis: Is It Really Alive?
Authors: David M. Klurfeld
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The recent article by Schatzkin et al<sup>1</sup>presents the opinion that the relationship of dietary fat and breast cancer is direct and causal and can be quantitated. We wish to point out two major flaws in their presentation of data in that article that significantly weaken the position presented. In attempting to show that data from animal experiments support their view, Schatzkin et al state it is indisputable that animals fed a high-fat, high-energy diet ad libitum have a substantially higher incidence of mammary tumors than animals fed a low-fat, energy-restricted diet. Presenting the comparison this way obfuscates the proper question, which is whether the promoting effect of dietary fat on breast cancer is due to some innate quality of fat or to its higher energy content. Animal experiments clearly show that energy restriction significantly inhibits mammary cancer, even when dietary fat is three to five
BETA 1-ADRENERGIC RECEPTOR POLYMORPHISM ALTERS RESPONSE TO ACUTE BETA-BLOCKADE PRIOR TO GATED CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY
Authors: Vlad Cotarlan, Alessandra Brofferio, Jennifer Sartorius, Glenn Gergard, Xin Chu, Karla Clark, Jamshid Shirani
Journal: Journal of the American College of Cardiology (2011)
Hepatobiliary and Gallium Imaging Findings in Gallbladder Perforation: A Case Report and Review of the Literature
Authors: EDWIN YEO, DAVID C. P. CHEN, MICHAEL E. SIEGEL
Journal: Clinical Nuclear Medicine (1989)

Gallbladder perforation is an unusual condition with a high mortality rate. Early detection with prompt surgical intervention can increase the survival rate. Hepatobiliary imaging using Technetium-99m-labeled iminodiacetic acid has been used for the diagnosis of gallbladder perforation. However, the results vary and are somewhat confusing. The authors report a case of gallbladder perforation with hepatobiliary imaging and an unusual gallium image; review the literature; and propose a classification of three different imaging patterns: 1) visualization of the gallbladder with bile leakage, 2) nonvisualization of the gallbladder with a photopenic fluid collection, and 3) nonvisualization of the gallbladder with bile leakage. These patterns may provide pathophysiologic information for surgeon.
GMC hears charge that doctor ended a patient's life prematurely
Authors: Clare Dyer
Journal: BMJ (2005)

The General Medical Council refused last week to let a former consultant anaesthetist remove her name voluntarily from the medical register and went ahead with a hearing into allegations that she ended an intensive care patient's life prematurely.

Ann David, from Rayleigh, Essex, told a fitness to practise panel that she was “disillusioned by everything that has happened” and had no plans to practise medicine again. But the panel decided there was a public interest in allowing the case against her to proceed.

After her application was rejected her counsel, John Hendy QC, said …
Esophageal Diverticulum Illustrated by Barium Swallow During Left Atrial Catheter Ablation for Atrial Fibrillation
Authors: Sujoya Dey, Eric Good, Fred Morady, Hakan Oral
Journal: Circulation (2006)

L eft atrial radiofrequency catheter ablation guided by a 3-dimensional electroanatomic mapping system (CARTO, Biosense-Webster, Diamond Bar, Calif) was performed in a 67-year-old woman with paroxysmal atrial fibrillation.To avoid delivery of radiofrequency energy near the esophagus, the patient was asked to swallow 5 cm 3 of barium paste (E-Z-EM, Lake Success, NY) before conscious sedation, as described previously. 1 The esophagram delineated a previously undiagnosed esophageal diverticulum (Figure 1).The location of the esophagus relative to the posterior wall of the left atrium was tagged on the electroanatomic map (Figure 2).The diverticulum was 20 mm long and 17 mm wide.This case illustrates the importance of the complete visualization of the esophageal lumen during a left atrial ablation procedure and demonstrates the limitations of using an esophageal probe to monitor the position of the esophagus.If barium paste had not been swallowed, radiofrequency energy may have been delivered unknowingly over the diverticulum, putting the patient at risk of esophageal injury and atrioesophageal fistula.
Moon Tiger and Mr Smith
Authors: T. Dalrymple
Journal: BMJ (2011)

Books evoke memories unpredictably and therefore all the more powerfully. The Moon Tiger of Penelope Lively’s novel of the same name is the brand of mosquito coil that the protagonist uses while she is in Egypt during the war; it brought to my mind the years when I never slept without such a coil by my bed to keep the mosquitoes—culicine rather than anopheline—at bay. (I still caught dengue.) The brand was Double Happiness rather than Moon Tiger, but no one has ever described with more loving accuracy than Mrs Lively the slow smoulder of a mosquito coil as it leaves its delicate spiral of grey ash.

The protagonist, …
Increased Tc-99m MDP in Multiple Lumbar Intervertebral Disk Spaces in Scheuermann Disease Without Concomitant Radiographic Calcification or Diskitis
Authors: ANNA ROZENSHTEIN, JORDAN A. NEGRIN
Journal: Clinical Nuclear Medicine (1994)

A radionuclide bone scan serendipitously revealed deposition of Tc-99m MDP in multiple lumbar intervertebral disk spaces in a 29-year-old man with extensive trauma to the left femur as a result of a motor vehicle accident. In the authors' experience, alcoholic liver disease or altered weight bearing secondary to prior trauma are not associated with intervertebral radiotracer uptake. Although it is possible that radiographically undetectable microcalcifications in the intervertebral disk spaces associated with degenerative changes, common in Scheuermann disease, account for this unusual finding, a literature search found that increased disk uptake had been reported only in two patients with Scheuermann disease who had concomitant active or healing diskitis. No other causes of increased disk uptake of Tc-99m MDP were found.
High Mutation Rate of TPE Repeats: A Microsatellite in the Putative Transposase of the hobo Element in Drosophila melanogaster
Authors: Sémi Souames, Eric Bonnivard, Claude Bazin, Dominique Higuet
Journal: Molecular Biology and Evolution (2003)

The hobo transposable element contains a polymorphic microsatellite sequence located in its coding region, the TPE repeats. Previous surveys of natural populations of Drosophila melanogaster have detected at least seven different hobo transposons. These natural populations are geographically structured with regard to TPE polymorphism, and a scenario has been proposed for the invasion process. Natural populations have recently been completely invaded by hobo elements with three TPE repeats. New elements then appeared by mutation, triggering a new stage of invasion by other elements. Since TPE polymorphism appeared over a short period of time, we focused on estimating the mutation rate of these TPE repeats. We used transgenic lines harboring three TPE and/or five TPE hobo elements that had been evolving for at least 16 generations to search for a new TPE repeat polymorphism. We detected three mutants, with four, seven, and eight TPE repeats, respectively. The estimated mutation rate of the TPE repeats is therefore higher than that of neutral microsatellites in D. melanogaster (4.2 × 10−4 versus 6.5 × 10−6). The role of the transposition mechanism and the particular structure of the TPE repeats of the hobo element in this increase in the mutation rate are discussed.
THE METHODS OF DEALING WITH THE MILK SUPPLY OF NEW YORK CITY.
Authors: THOMAS DARLINGTON
Journal: JAMA (1907)

Among the questions dealt with by sanitary authorities there is no other of greater importance than the one concerning the production and distribution of a supply of pure, clean milk. Many of the features of the vast question of food adulteration are being met by our national government in its regulation of interstate commerce. Of necessity, however, these laws can control the transportation only of the less perishable articles of food, and the responsibility of the milk supply of a community must be left almost entirely to the local authorities. From the time when each family kept its own cow or depended for its supply of milk on a local farmer, to the present situation, when the big cities depend on a supply drawn from thousands of dairies scattered over wide areas, is a far cry. This change has come about so insiduously and cities have grown with such astonishing
Double blind glucocorticoid controlled trial of samarium-153 particulate hydroxyapatite radiation synovectomy for chronic knee synovitis
Authors: E K O'Duffy, G P R Clunie, D Lui, J C W Edwards, P J Ell
Journal: Annals of the Rheumatic Diseases (1999)

<h3>BACKGROUND</h3> Samarium-153 particulate hydroxyapatite (Sm-153 PHYP) is a relatively new radiation synovectomy agent developed for the treatment of chronic synovitis. Although it has been shown that the levels of unwanted extra-articular radiation are lower after intra-articular injection of Sm-153 PHYP than yttrium-90 colloid, its clinical efficacy has not been rigorously studied. <h3>OBJECTIVES</h3> To establish whether Sm-153 PHYP radiation synovectomy results in a clinically useful benefit sustained at one year. <h3>METHODS</h3> In a randomised double blind study, patients received either intra-articular 40 mg triamcinolone hexacetonide alone or 40 mg triamcinolone hexacetonide combined with Sm-153 PHYP in an outpatient clinic. <h3>RESULTS</h3> Sixty patients (28 male, 32 female), median age 51 (18–75) with chronic knee synovitis were studied. Diagnoses included: rheumatoid arthritis (n=29); psoriatic arthritis (n=9); ankylosing spondylitis (n=3); reactive arthritis (n=2); undifferentiated seronegative oligoarthritis (n=13) and miscellaneous inflammatory conditions (n=4). More patients who received Sm-153 PHYP/triamcinolone hexacetonide sustained clinical benefit a year after treatment compared with patients who received corticosteroid alone (12 of 31 (39%) <i>v</i> 6 of 29 (21%), a difference of 18% more patients (95% CI −5% to 41%)) though the difference was not significant (χ<sup>2</sup>=2.31, 0.2&gt;p&gt;0.1, n=60). Despite the variation in injected activity (median 563 MBq, range 218–840 MBq), there was no obvious relation between low levels of injected activity (&lt;555 MBq) and relapse within 12 months of treatment (χ<sup>2</sup> =2.61, 0.2&gt;p&gt;0.1, n=31). <h3>CONCLUSIONS</h3> There was no clear beneficial clinical effect of combined Sm-153 PHYP/triamcinolone hexacetonide injection over triamcinolone hexacetonide alone a year after treatment for chronic knee synovitis.
Second Degree Atrioventricular Block
Authors: Y. Watanabe, L. S. Dreifus
Journal: Cardiovascular Research (1967)

Mechanisms of clinically known varieties of second degree A-V block were studied in isolated rabbit hearts, utilizing ultramicroelectrode techniques. Progressive A-V conduction delay in Wenckebach phenomenon was due mainly to depressed conduction within the A-V node, while Mobitz type 2 block was due to either block in or below His bundle or concealed re-excitation in the A-V junction. Two levels of block were demonstrated both in forward and retrograde A-V transmission.
Reoperation for Mitral Stenosis
Authors: DWIGHT E. HARKEN, HARRISON BLACK, WARREN J. TAYLOR, WENDELL B. THROWER, LAURENCE B. ELLIS
Journal: Circulation (1961)

A series of 80 reoperations for mitral stenosis in 79 patients is reported and analyzed. The most important causes of deterioration after valvuloplasty for mitral stenosis are inadequate initial operation, restenosis, and mitral insufficiency. Generally more than one of these factors pertain. An adequate mitral valvuloplasty requires the complete opening of both the anterior and posteromedial commissures and the mobilization of the chordae tendineae from each other and from the wall of the ventricle. The advantages and limitations of closed reoperation, open reoperation, the right-sided approach, and the use of the transventricular valvulotome are reviewed. More complete correction of stenosis with mobilization of posteromedial, anterior, and subvalvular chordae is emphasized. This is attained by operating from both the ventral and dorsal aspects of the patient through a left posterolateral thoracotomy incision. An Ivalon operating tunnel sutured to the left atrial wall at reoperation makes it possible to carry out the more extensive valvuloplasty at reoperations. A lower operative mortality, better longterm results, and fewer instances of deterioration are anticipated when this concept of improved valvuloplasty is effected initially.
Cervical adenocarcinoma and oral contraceptives.
Authors: C Chilvers, D Mant, M C Pike
Journal: BMJ (1987)

English data comparable to US data on the incidence of cervical cancer are reported.  Annual numbers of registrations of cervical cancer from 1968-82 were obtained from the South Thames Oxford and West Midlands cancer registries.  The cases were divided into adenocarcinoma squamous cell carcinoma and unknown and  cancer.  Incidences were calculated in the 20-34 35-54 and 55 and older age groups and for the periods 1968-72 1973-77 and 1978-82.  Within each age group the incidences were standardized for age by the indirect method using 5 year age groups; the 1968-82 rates for South Thames were taken as standard.  According to the table the incidence of adenocarcinoma of the cervix in women under age 35 increased from 2.4-6.6 million between 1968-72 and 1978-82.  The incidences of squamous and unclassified carcinomas also increased.  Adenocarcinoma as a proportion of all cervical cancers increased from 5.7% to 7.6% in this age group.  In women aged 35-54 the incidences of both squamous carcinoma and adenocarcinoma declined but the proportion of cervical adenocarcinomas increased from 8.9% to 10.5%.  In women over 55 years the incidence of both squamous carcinoma and adenocarcinoma declined slightly; the relative proportion of each histological type changed little.  In England as in the US there has been a marked increase in the incidence of adenocarcinoma in young women which cannot be explained by more accurate classification of previously unspecified cancer.  Squamous cell cancer also has increased in England but to a lesser extent.  The data provide limited support to the suggestion that the 2 histological types may have different etiologies.
Torsion of the Appendix Testis
Authors: Howard B. Simon
Journal: JAMA (1967)

Torsion of the appendix testis is not an uncommon cause of scrotal pain and swelling, and is frequently misdiagnosed as epididymitis or orchitis. The etiology remains obscure. Prompt surgical intervention is warranted almost without exception, to both rule out the more serious possibility of torsion of the spermatic cord, and for prompt relief of the symptoms and local tissue reaction which result in obstructed fertility of the affected testis.
THE LOW COST OF BEING SICK
Authors: Theodore Diller
Journal: JAMA (1933)

<h3>To the Editor:</h3> —So much has been said on the other side of this question that a brief notation of two cases on the low cost of being sick in a hospital I thought might be read with some sense of relief; so I am submitting them for publication. The Foundling Hospital in Dublin, as is well known, has a worldwide fame for the practice and teaching of obstetrics. When I visited this hospital, I was utterly amazed at the simplicity of the building and the equipment of this famous institution. It was very efficient, very clean and very homelike. Only recently I noted inThe Journalthat Dr. Bethel Solomons of this hospital, after an extensive visit to the United States, was asked to give his impression of American hospitals. He replied to the effect that they were far too elaborate and expensive and that with simpler equipment and
Anal function in geriatric patients with faecal incontinence.
Authors: J A Barrett, J C Brocklehurst, E S Kiff, G Ferguson, E B Faragher
Journal: Gut (1989)

The association of faecal incontinence with constipation and confusion in the elderly is well recognised but the anal function of faecally incontinent geriatric patients is poorly understood. Anal studies were therefore performed on 99 geriatric patients (49 with faecal incontinence, 19 continent patients with faecal impaction and 31 geriatric control patients with normal bowel habit) and 57 younger healthy control patients. An age related reduction in anal squeeze pressure but not resting pressure was identified. A reduction in anal resting pressure was detected in the faecally incontinent geriatric patients but squeeze pressure did not differ significantly from that found in the other geriatric patients. Anal sensation was impaired in the faecally incontinent patients. No difference was found between the groups as measured by pudendal nerve terminal motor latency. Gross neuropathy of the distal part of the pudendal nerve does not account for the observed external anal sphincter weakness in geriatric patients or for their faecal incontinence. Internal anal sphincter dysfunction is an important factor in faecal incontinence in the elderly.
Influence of Inpatient Service Specialty on Care Processes and Outcomes for Patients With Non–ST-Segment Elevation Acute Coronary Syndromes
Authors: Matthew T. Roe, Anita Y. Chen, Rajendra H. Mehta, Yun Li, Ralph G. Brindis, Sidney C. Smith, John S. Rumsfeld, W. Brian Gibler, E. Magnus Ohman, Eric D. Peterson
Journal: Circulation (2007)

Background— Since the broad dissemination of practice guidelines, the association of specialty care with the treatment of patients with acute coronary syndromes has not been studied. Methods and Results— We evaluated 55 994 patients with non–ST-segment elevation acute coronary syndromes (ischemic ST-segment changes and/or positive cardiac markers) included in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Quality Improvement Initiative from January 2001 through September 2003 at 301 tertiary US hospitals with full revascularization capabilities. We compared baseline characteristics, the use of American College of Cardiology/American Heart Association guidelines class I recommendations, and in-hospital outcomes by the specialty of the primary in-patient service (cardiology versus noncardiology). A total of 35 374 patients (63.2%) were primarily cared for by a cardiology service, and these patients had lower-risk clinical characteristics, but they more commonly received acute (≤24 hours) medications, invasive cardiac procedures, and discharge medications and lifestyle interventions. Acute care processes were improved when care was provided by a cardiology service regardless of the propensity to receive cardiology care. The adjusted risk of in-hospital mortality was lower with care provided by a cardiology service (adjusted odds ratio 0.80, 95% confidence interval 0.73 to 0.88), and adjustment for differences in the use of acute medications and invasive procedures partially attenuated this mortality difference (adjusted odds ratio 0.92, 95% confidence interval 0.83 to 1.02). Conclusions— Non–ST-segment elevation acute coronary syndrome patients primarily cared for by a cardiology inpatient service more commonly received evidence-based treatments and had a lower risk of mortality, but these patients had lower-risk clinical characteristics. Results from the present analysis highlight the difficulties with accurately determining how specialty care is associated with treatment patterns and clinical outcomes for patients with acute coronary syndromes. Novel methodologies for evaluating the influence of specialty care for these patients need to be developed and applied to future studies.
Diarrhoea associated with medullary carcinoma of the thyroid
Authors: J. J. Bernier, J. C. Rambaud, D. Cattan, A. Prost
Journal: Gut (1969)

Diarrhoea, which is present in roughly one third of cases of medullary carcinoma of the thyroid, was investigated in five cases. Excessive loss of water and electrolytes in the stools was the major factor. Steatorrhoea was mild or absent, and intestinal absorption of glucose and vitamin B(12) was normal; the histological appearance of the small intestinal mucosa was normal or subnormal. Water and sodium diarrhoea seems to be linked to a sometimes considerable increase in the rate of transit through the small intestine and colon, and may be relieved by codeine or codethyline. The frequent increase in the maximum blood sugar level during an oral tolerance test should not be interpreted as evidence of a paradiabetic condition. In fact, the intravenous glucose tolerance test is usually normal and the excessive rise in blood sugar after oral administration seems to be the consequence of the increased rate of transit through the small intestine. The link between the tumour and the disordered motility seems definite in view of certain cases in which removal of the tumour caused the diarrhoea to disappear immediately. Production by the tumour of serotonin or other derivatives of tryptophan or of kallikrein, which activates bradykinin, is rare. With regard to prostaglandins, high concentrations have been observed in the tumours and in the venous blood draining the tumours, but their presence in systemic blood is inconstant. The only hormonal substance, concentration of which seems to be definitely increased in the systemic blood of patients with a medullary carcinoma of the thyroid, is thyrocalcitonin but this hormone does not seem to have any effect on the motor activity of the digestive tract.
Congenital coronary arteriovenous fistula. Report of 13 patients, review of the literature and delineation of management.
Authors: R R Liberthson, K Sagar, J P Berkoben, R M Weintraub, F H Levine
Journal: Circulation (1979)

Thirteen new patients and 174 patients previously reported with coronary arteriovenous fistula (CAVF) were reviewed to delineate the course and management of CAVF and to clarify the role of surgical ligation in the young asymptomatic patient. Patients were grouped according to age: 99 patients (four new and 95 reported) were less than 20 years old and 88 (nine new and 79 reported) were greater than or equal to 20 years old. Of those under 20 years of age, 19% had preoperative symptoms or CAVF-related complications, including congestive heart failure (CHF) in 6%, subacute bacterial endocarditis in 3% and death in one patient. Seventy-six patients younger than 20 years old had CAVF ligation with only one significant complication. In contrast, 63% of the older group and all of our nine older patients had preoperative symptoms or complications, including CHF in 19%, SBE in 4%, myocardial infarction (MI) in 9%, death in 14% and fistula rupture in one patient. Of the 43 ligated older patients, 23% had surgical complications, including MI in three and death in three. Mean pulmonic-to-systemic flow in the entire group was 1.6:1 and did not differ significantly in those with or without symptoms or complications. One of our patients and one previously reported had spontaneous CAVF closure. In summary, early elective ligation of CAVF is indicated in all patients because of the high incidence of late symptoms and complications and the increased morbidity and mortality associated with ligation in older patients.