tbuckley/cabot-search huggingface dataset:
Hepatitis C virus cure as motivation for alcohol withdrawal?
Authors: Régine Truchi, Eve Gelsi, Faredj Cherikh, Albert Tran, Patrice Couzigou
Journal: Hepatology (2012)

Innes et al.1 must be congratulated for providing important data on liver-related morbidity and mortality in patients treated for hepatitis C virus (HCV) infection. The authors underlined the importance of comorbidity, particularly in alcohol consumption. Recently, Backus et al.2 showed a strong decrease in hepatic mortality and, more surprisingly, in nonhepatic and global mortality in cases of sustained virological response (SVR). We hypothesized that patient empowerment prompted by an SVR could lead these patients to consider comorbidities such as alcohol intake, and in this way could decrease hepatic and/or global morbidity or mortality.3 We conducted a pilot study aimed at evaluating the impact of SVR on detoxification in 40 alcoholic heavy drinkers (26 men, 14 women; mean age, 46 years; mean daily quantity, 87 g alcohol) infected with HCV. All patients presented an abuse or dependence according to DSM-IV classification and a CAGE questionnaire score ≥2 at baseline. Thirty-three patients (20 genotypes 1/4, 13 genotypes 2/3) were treatment-naïve. Pegylated interferon-α and ribavirin were initiated simultaneously with a treatment course for alcohol detoxification according to the recommendations (48 weeks for genotypes 1/4, 24 weeks for genotypes 2/3, 72 weeks for nonresponders). The patients were regularly followed up by a team composed of a nurse, a psychiatrist, a psychologist, and a hepatologist. Six patients discontinued treatment (two for severe anemia, one for hepatocarcinoma, and three for psychiatric side effects [depression, massive alcohol consumption]). For treatment-naïve patients, the SVR observed on intention-to-treat and per-protocol analysis was 40% and 50%, respectively, for genotypes 1/4 and 69% and 82%, respectively, for genotypes 2/3. At the end of the study, 55% of the 40 patients were weaned off alcohol; among these, 71% of the treatment-naïve patients with SVR were also weaned off alcohol, whereas only 37% of nonresponders were weaned off alcohol (P = 0.056). At the end of the study, the Hamilton's score significantly improved in patients with an SVR (P = 0.07). Treatment of HCV concomitant with a program of alcohol weaning was possible in heavy drinkers when subjected to effective psychiatric evaluation. Therefore, our results and the Innes et al. data fit well with the proposed hypothesis3: that patients achieving an SVR are more prone to change their way of life and to control some pathological factors, such as excessive alcohol consumption. Régine Truchi*, Eve Gelsi*, Faredj Cherikh*, Albert Tran*, Patrice Couzigou*, * Service Hépato-Gastroenterology, Hôpital du Haut Leveque, Pessac, France.
Informed Consent—The Rejoinder
Authors: Don Harper Mills
Journal: JAMA (1975)

I AM NOT surprised at Professor Meisel's characterization of some of my suggestions for handling the issues involved in informed consent. His position is precisely what we need to guard against, in my opinion. Physicians have already overreacted to the informed consent doctrine; they do not need to be told "to err, if at all, on the side of overdisclosure." The intent of my article was to strike a<i>reasonable balance</i>for the benefit of physicians and their patients. With specific reference to the penicillin issue, the duty to obtain an adequate history and to make disclosures for purposes of informed consent are clearly separable and I would hope that most judges are capable of treating them in this manner. During the year, I have worked on dozens of penicillin-reaction cases without noting any difficulty in this regard. While I cannot guarantee that courts will not bring the duty to
Intussusception after Rotavirus Vaccination — Spontaneous Reports
Authors: Sylvie Escolano, C. Paddy Farrington, Catherine Hill, Pascale Tubert-Bitter
Journal: New England Journal of Medicine (2011)

To the Editor: Patel et al. report an increased risk of intussusception after rotavirus vaccination.1 We conducted a case-series analysis2 of 151 spontaneous reports of intussusception worldwide after administration of the rotavirus vaccine RV1 (Rotarix, GlaxoSmithKline Biologicals). On the basis of a report citing the incidence of intussusception after administration of the rotavirus vaccine RotaShield (Wyeth Laboratories),3 we tested for an increased risk of intussusception 3 to 7 days after administration of the first dose. Incidence ratios were calculated for the periods 0 through 2 days (with 0 indicating the day of vaccination), 3 through 7 days, and 8 through . . .
COMBINED SUSPENSION AND EXTENSION APPARATUS FOR COMPOUND FRACTURES ABOUT THE HIP
Authors: G. M. Hodges
Journal: BMJ (1917)

THE following case of gunllshot wvollund of the lhead v)resented some features of intre'st: Pte.G. wvas admitted in tlle early mtiorning of Noveniber 5th stiffering from buLllet wound of the lhead.He w as unconsclious and collapsed; the pulse was imperceptible, temiperature tsuibnormal, and-res'pirations shallow..He was verx cold and evidently suffering from shock.The scalp wonud( was about 3 inches long, of the gtutter type, anld lay natero-px,steriorly in the left parietal region.It was *el dviti-and *ja.-ed .%vith b)lood clot and brain tisste esca i1)g horn1 ito Ili i grigut armIand right leg were paraly-sed.Firolst Opera'(ioit}?.Ile' was put to l)ed.inifuLsed subettaneously wvitfi normal saline,and the wound wiias dressed.In the evening his coI- ,6 71 < 90 '1 /2 /.3If 1t3_.ii /A /7 / /9 20 2/ 12.1 23 32 tS 26 27 2' /0 2 3 9 iij!IIi El
Activating Autoantibodies to the Beta-1 Adrenergic and M2 Muscarinic Receptors Facilitate Atrial Fibrillation in Patients With Graves' Hyperthyroidism
Authors: Stavros Stavrakis, Xichun Yu, Eugene Patterson, Shijun Huang, Sean R. Hamlett, Laura Chalmers, Reji Pappy, Madeleine W. Cunningham, Syed A. Morshed, Terry F. Davies, Ralph Lazzara, David C. Kem
Journal: Journal of the American College of Cardiology (2009)
Is intervention necessary after a first episode of acute idiopathic pancreatitis?
Authors: A B Ballinger, E Barnes, E M Alstead, P D Fairclough
Journal: Gut (1996)

Acute idiopathic pancreatitis is a term used when no underlying cause has been identified on routine investigation. However, more specialised investigations may identify aetiological factors, biliary sludge and sphincter of Oddi dysfunction for example, in 38-72% of patients with recurrent episodes. Treatment of these abnormalities may prevent further episodes of pancreatitis. The aim of this study was to follow up and determine the outcome in patients with a first episode of idiopathic pancreatitis, and thus determine the need for further investigation and treatment in this group of patients. Thirty one patients with a single episode of idiopathic pancreatitis were studied who had no specialised investigations or specific treatment. During a median follow up of 36 months only one patient has had recurrent pancreatitis. Two patients experienced a single episode of unexplained abdominal pain; serum amylase, liver biochemistry, and abdominal ultrasound were all normal and the pain resolved within 48 hours. In conclusion, in the medium term, the prognosis is good after a first episode of idiopathic pancreatitis and specialised investigation is unnecessary.
929-67 Reversibility of Ischemic Myocardial Injury can be Predicted by Gadolinium-DTPA Enhanced Magnetic Resonance Imaging After Reperfusion
Authors: Jun Kitamura, Yo Murakami, Toshio Shimada, Kouichi Ochiai, Hironori Tsukihashi, Kazuya Sano, Yutaka Ishibashi, Shigefumi Morioka
Journal: Journal of the American College of Cardiology (1995)
Therapy and prevention of thrombotic thrombocytopenic purpura during pregnancy: A clinical study of 16 pregnancies
Authors: Yossef Ezra, Michal Rose, Amiram Eldor
Journal: American Journal of Hematology (1996)

Thrombotic thrombocytopenic purpura (TTP) is a severe multisystem disorder of unknown pathogenesis, with preference to women. The mortality rate of patients with TTP was 90% until the introduction of plasma therapy that increased the survival rate to 70–80%, with minimal or no sequelae. Of the survivors, 30–60% suffer from relapses, often in association with precipitating factors such as infections, surgery, and pregnancy. Women who are either pregnant or in the postpartum period make up 10–25% of TTP patients, and once the disease occurs during a pregnancy, it tends to recur in subsequent ones. We treated five women who suffered at least one TTP episode during pregnancy. They had a total of 16 pregnancies, eight of which were complicated by TTP. They suffered seven additional TTP episodes that were not associated with pregnancy. We assessed the severity of each TTP episode with a scoring system used in our previous studies. Presented is the course of their disease and their pregnancies, and guidelines for the management and prevention of TTP during pregnancy are provided. © 1996 Wiley-Liss, Inc.
Modification of the Two-way Gastrostomy Tube for Vagotomy and Pyloroplasty
Authors: M. Lee
Journal: BMJ (1966)

BRDITALsH 611 treated disks.A collar or traction do not achieve this.The range of extension can be increased by means of a relaxed extension lying on a block under the upper dorsal region.The active extension must be carried out lying supine, and arching up to lie on back of head and buttocks.Carried out in this way ,the spine is not weight-bearing.It must be done as a stretch, not as physical jerks.This treatment has been carried out for a good many years in the hospitals I visit, 'with gratifying results.-Iam, etc.,
Relapsing Polychondritis and Pulseless Disease
Authors: W. M. Seymour, M. H. Lessof, R. A. C. Hughes
Journal: BMJ (1974)

24 November, p. 488) concerning immunological investigations in relapsing polychondritis.We should, how- ever, like to correct one misquotation con- cerning the findings reported by Hughes et al.,' who, by means of a standard indirect immunofluorescent technique using fetal car- tilage as a substrate, detected positive diffuse fluorescence throughout the cartilage matrix with sera from only two of 12 (not from all 12) patients with rheumatoid arthritis.We have examined sera from a further 104 patients with probable, definite, or classical rheumatoid arthritis as defined by the Am- erican Rheumatism Association2 and detected cartilage matrix fluorescence in 10 (9.6%).Positive results have been found in only one of 102 normal blood donors and in two of 149 patients with a variety of diseases.Of eight patients with relapsing polychondritis tested, three had positive matrix fluorescence and one other showed a weakly positive re- action.3-Weare, etc.,
The Physiology of Vision
Authors: H. Hartridge
Journal: BMJ (1947)

MEDBIIJURNAL69it was shown that treatment of certain proteins, such as casein, with iodine under mildly alkaline conditions produced iodo- proteins which exhibited thyroid activity by the oral route and from which thyroxine could be isolated after hydrolysis.Since iodocasein could be made quite readily from available materials it was evident that here was a cheap and plentiful supply of artificial thyroid hormone lending itself to easy administration to cows under practical conditions.Large-scale experiments.
Computer assisted shared care in hypertension.
Authors: J C Petrie, O J Robb, J Webster, A K Scott, T A Jeffers, M D Park
Journal: BMJ (1985)

A computer assisted shared care scheme for the long term management and follow up of hypertensive patients has been developed in the Grampian Region. The scheme aims at facilitating the exchange of clinically important information between doctors and at achieving target levels of blood pressure with treatment in patients at highest risk of cardiovascular events. The shared care scheme has been well received by the local practitioners. Two hundred and fifty seven patients (18%) of 1426 patients under current long term follow up are assigned to follow up in the hospital aspect of the scheme. At the most recent visit 32% of patients in the hospital aspect and 10% of 1169 patients in the general practice aspect had blood pressure recordings above the target levels of 160/95 mm Hg. The stratification of patients formerly attending hospital clinics into grades of risk has rationalised our follow up procedures to allow the specialist resources to be freed and concentrated on those patients at highest risk and with the most complex problems. This computer assisted patient records system could be applied to other groups of high risk patients in whom long term follow up and surveillance are necessary--for example, patients with diabetes mellitus--and has implications for optimising and monitoring the delivery and outcome of care without overwhelming limited hospital resources.
Phospholipid composition of psoriatic epidermis
Authors: Dionysios Tsambaos
Journal: British Journal of Dermatology (1979)

Journal Article Phospholipid composition of psoriatic epidermis Get access Dionysios Tsambaos Dionysios Tsambaos Department of Dermatology, University of Göttingen, v.Siebold Str.3, 34 Göttingen, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 100, Issue 5, 1 May 1979, Page 613, https://doi.org/10.1111/j.1365-2133.1979.tb05590.x Published: 01 May 1979
Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: descriptive study
Authors: C. L. Vale, L. H. M. Rydzewska, M. M. Rovers, J. R. Emberson, F. Gueyffier, L. A. Stewart
Journal: BMJ (2015)

<b>Objective</b> To establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines. <b>Design</b> Descriptive study. <b>Setting</b> Database maintained by the Cochrane IPD Meta-analysis Methods Group, supplemented by records of published IPD meta-analyses held in a separate database. <b>Population</b> A test sample of systematic reviews of randomised controlled trials that included a meta-analysis of IPD, and a separate sample of clinical guidelines, matched to the IPD meta-analyses according to medical condition, interventions, populations, and dates of publication. <b>Data extraction</b> Descriptive information on each guideline was extracted along with evidence showing use or critical appraisal, or both, of the IPD meta-analysis within the guideline; recommendations based directly on its findings and the use of other systematic reviews in the guideline. <b>Results</b> Based on 33 IPD meta-analyses and 177 eligible, matched clinical guidelines there was evidence that IPD meta-analyses were being under-utilised. Only 66 guidelines (37%) cited a matched IPD meta-analysis. Around a third of these (n=22, 34%) had critically appraised the IPD meta-analysis. Recommendations based directly on the matched IPD meta-analyses were identified for only 18 of the 66 guidelines (27%). For the guidelines that did not cite a matched IPD meta-analysis (n=111, 63%), search dates had preceded the publication of the IPD meta-analysis in 23 cases (21%); however, for the remainder, there was no obvious reasons why the IPD meta-analysis had not been cited. <b>Conclusions</b> Our results indicate that systematic reviews and meta-analyses based on IPD are being under-utilised. Guideline developers should routinely seek good quality and up to date IPD meta-analyses to inform guidelines. Increased use of IPD meta-analyses could lead to improved guidelines ensuring that routine patient care is based on the most reliable evidence available.
Long-term Follow-up of Transsphenoidal Selective Adenomectomy for Prolactinoma
Authors: Elise F. Rodman, Mark E. Molitch, Kalmon D. Post, Bruce J. Biller, Seymour Reichlin
Journal: JAMA (1984)

Although transsphenoidal selective resection of prolactinoma has high cure rates and low morbidity, the frequency of late recurrence of adenoma is controversial. Long-term follow-up data were available on 29 of our patients having initial return to normal prolactin levels after microadenoma resection; in 24, prolactin levels remained normal at 50 +/- 3 months' (range, 11 to 81 months) follow-up. Five patients manifested hyperprolactinemia again after intervals of six to 16 months. In five patients with normal prolactin levels immediately after macroadenoma resection, who were available for long-term follow-up, prolactin levels remained normal in four at 41 +/- 3 months; one patient had a relapse 78 months after surgery. Testing of prolactin secretory dynamics six weeks postoperatively was not predictive of who would suffer relapse. It is not known whether these relapses are due to regrowth of tumor remnants or represent new tumor formation.
Induction of the skeletal alpha-actin gene in alpha 1-adrenoceptor-mediated hypertrophy of rat cardiac myocytes.
Authors: N H Bishopric, P C Simpson, C P Ordahl
Journal: Journal of Clinical Investigation (1987)

Myocardial hypertrophy in vivo is associated with reexpression of contractile protein isogenes characteristic of fetal and neonatal development. The molecular signals for hypertrophy and isogene switching are unknown. We studied alpha (sarcomeric)-actin messenger RNA (mRNA) expression in cultured cardiac myocytes from the neonatal rat. In the cultured cells, as in the adult heart in vivo, expression of cardiac alpha-actin (cACT) predominated over that of skeletal alpha-actin (sACT) mRNA, the fetal/neonatal isoform. alpha 1-Adrenergic receptor stimulation induced hypertrophy of these cells, increasing total RNA and cytoskeletal actin mRNA by 1.8-fold over control, and total alpha-actin mRNA by 4.3 fold. This disproportionate increase in total alpha-actin mRNA was produced by a preferential induction of sACT mRNA, which increased by 10.6-fold over control versus only 2.6-fold for cACT mRNA. The alpha 1-adrenoceptor is the first identified molecular mediator of early developmental isogene reexpression in cardiac myocyte hypertrophy.
B3-06: Interim safety results from TRUST, a global open-label study of erlotinib in patients with advanced non-small-cell lung cancer (NSCLC)
Authors: Andrea Ardizzoni, Evangelia Razis, Mikhail Lichinitser, Ugur Yilmaz, Alexandru C. Grigorescu, José Luis Morero, Jana Skrickova, Guadalupe Cervantes, Maya Gottfried, Jan Van Meerbeeck
Journal: Journal of Thoracic Oncology (2007)
Acute Duodenitis and Duodenal Ulceration After Burns
Authors: Albert J. Czaja
Journal: JAMA (1975)

The clinical and pathological characteristics of Curling ulcer were defined by early and serial endoscopic examination of the duodenum in 37 burned patients. Duodenal disease was present in 27 patients and occurred only in patients with burns involving more than 38 percent of the total body surface. Erosive "duodenitis" could occur within 12 hours after injury and was usually associated with acute gastric disease. Isolated duodenitis occurred only in patients with pancreatitis. Contrast roentgenograms did not reliably show the superficial mucosal disease. Duodenal ulcerations were present in 12 patients and developed on a background of diffuse superficial mucosal injury. Other complications in the patient's postburn course influenced disease progression. Hemorrhage occurred in six patients with duodenal disease, usually originating from a posterior duodenal ulcer. Uncomplicated ulcers invariably healed within five weeks after diagnosis.
Coronary vasodilator reserve, pain perception, and sex in patients with syndrome X.
Authors: S D Rosen, N G Uren, J C Kaski, D Tousoulis, G J Davies, P G Camici
Journal: Circulation (1994)

BACKGROUND It remains unclear whether myocardial ischemia due to coronary microvascular dysfunction is the cause of chest pain in syndrome X (chest pain, ischemic-like stress ECG despite angiographically normal coronary arteries). To assess the function of the coronary microcirculation and its relation to pain perception, we measured myocardial blood flow (MBF) and coronary vasodilator reserve (CVR) in 29 patients with syndrome X and 20 matched normal control subjects. METHODS AND RESULTS MBF at rest and after intravenous dipyridamole (0.56 mg.kg-1 over 4 minutes) was measured using positron emission tomography with H2(15)O. CVR was calculated as MBFdipyridamole/MBFrest. ECG changes and chest pain after dipyridamole in syndrome X were compared with those in 35 patients with coronary artery disease (CAD). Resting and postdipyridamole MBFs were homogeneous throughout the left ventricle in syndrome X patients and control subjects. MBF was 1.05 (0.25), mean (SD) versus 1.00 (0.22) mL.min-1.g-1 (P = NS) at rest and 2.73 (0.81) versus 3.00 (1.00) mL.min-1.g-1 (P = NS) after dipyridamole in patients and control subjects, respectively. CVRs were 2.66 (0.76) and 3.06 (1.08) (P = NS) and after correction of resting MBF for rate-pressure product were 2.35 (0.83) and 2.34 (0.90) (P = NS) in patients and control subjects, respectively. Female syndrome X patients had higher resting MBF than males, at 1.18 (0.20) versus 0.88 (0.19) mL.min-1.g-1 (P &lt; .001). Chest pain after dipyridamole occurred in syndrome X as frequently as in CAD (21/29 versus 22/35, P = NS). CONCLUSIONS When patients with syndrome X are compared with control subjects, no differences are found in MBF either at rest or after dipyridamole, despite syndrome X patients experiencing chest pain after dipyridamole to the same extent as patients with CAD. These findings, together with the absence of any relation among MBF, chest pain, and ECG changes under stress, cast further doubt on ischemia as the basis of the chest pain, at least in the majority of syndrome X patients.
Venous Thromboembolism After Trauma
Authors: Kyle J. Van Arendonk, Eric B. Schneider, Adil H. Haider, Paul M. Colombani, F. Dylan Stewart, Elliott R. Haut
Journal: JAMA Surgery (2013)

IMPORTANCENo national standardized guidelines exist to date for venous thromboembolism (VTE) prophylaxis after pediatric trauma.While the risk of VTE after trauma is generally lower for children than for adults, the precise age at which the risk of VTE increases is not clear.OBJECTIVE To identify the age at which the risk of VTE after trauma increases from the low rate seen in children toward the higher rate seen in adults.DESIGN, SETTING, AND PARTICIPANTS Multivariable logistic regression models were used to estimate the association between age and the odds of VTE when adjusting for other VTE risk factors.Participants included 402 329 patients 21 years or younger who were admitted following traumatic injury between January 1, 2008, and December 31, 2010, at US trauma centers participating in the National Trauma Data Bank. MAIN OUTCOMES AND MEASURES Diagnosis of VTE as a complication during hospital admission.RESULTS Venous thromboembolism was diagnosed in 1655 patients (0.4%).Those having VTE were more severely injured compared with those not having VTE and more frequently required critical care, blood transfusion, central line placement, mechanical ventilation, and surgery.The risk of VTE was low among younger patients, occurring in 0.1% of patients 12 years or younger, but increased to 0.3% in patients aged 13 to 15 years and to 0.8% in patients 16 years or older.These findings remained when adjusting for other factors, with patients aged 13 to 15 years (adjusted odds ratio, 1.96, 95% CI 1.53-2.52;P < .001)and patients aged 16 to 21 years (adjusted odds ratio, 3.77; 95% CI, 3.00-4.75;P < .001)having a significantly higher odds of being diagnosed as having VTE compared with patients aged 0 to 12 years.These findings were consistent across the level of injury severity and the type of trauma center. CONCLUSIONS AND RELEVANCEThe risk of VTE varies considerably across patient age and increases most dramatically at age 16 years, after a smaller increase at age 13 years.These findings can be used to guide future research into the development of standardized guidelines for VTE prophylaxis after pediatric trauma.