tbuckley/cabot-search huggingface dataset:
Electrophysiologic effects of papillary muscle traction in the intact heart.
Authors: C C Gornick, H G Tobler, M C Pritzker, I C Tuna, A Almquist, D G Benditt
Journal: Circulation (1986)

In this study we used transmural multipolar electrodes, sonomicrometers implanted within the left ventricular wall, and cardiac electrical stimulation techniques to examine the effect of transient mechanical posterior papillary muscle traction on local myocardial electrophysiologic characteristics. Nine open-chest dogs were atrially paced (cycle length 400 msec) followed by insertion of timed premature extrastimuli at left ventricular epicardial pacing sites either in the vicinity of (traction zone) or remote from (nontraction zone) the site of papillary muscle traction. Electrophysiologic recordings were made before and during periods of intermittent papillary muscle traction of predetermined timing, application rate (25 cm/sec), and duration (170 msec). Papillary muscle traction was applied in late diastole just before the last beat of each atrial drive train. In seven of nine dogs application of transient papillary muscle traction resulted in significantly earlier local ventricular activation (mean activation advancement 30 +/- 13 msec), altered QRS morphology of the last conducted atrial drive-train beat, and relative prolongation of ventricular functional refractory period in the traction zone. Conversely, in nontraction zones in these seven dogs, early activation did not occur and refractoriness remained unchanged as tested by a locally placed extrastimulus. In two of nine dogs traction failed to induce early activation and changes in refractoriness did not occur. Alterations in regional myocardial blood flow (assessed by radioactive microsphere technique) did not appear responsible for the observed changes, since there was no demonstrable traction-induced difference in regional blood flow between the traction and nontraction zones.(ABSTRACT TRUNCATED AT 250 WORDS)
Emergency percutaneous transluminal coronary angioplasty in acute myocardial infarction: A 3 year experience
Authors: Donald A. Rothbaum, Thomas J. Linnemeier, Ronald J. Landin, Edward F. Steinmetz, J. Stanley Hillis, Clifford C. Hallam, R. Joe Noble, Martin R. See
Journal: Journal of the American College of Cardiology (1987)
BMA annual representative meeting: Wishes of patients who have lost mental capacity must be respected
Authors: Linda Beecham
Journal: BMJ (2004)

Patients who have lost their mental capacity but have previously indicated that they wish to receive artificial hydration and nutrition should have their wishes respected. This proposal from the Worcestershire division was endorsed at the annual meeting by 59 votes to 56.

Dr Anthony Cole, a consultant paediatrician at the Worcester Royal Infirmary, said that guidelines from the BMA about the withdrawal of hydration and …
Book Review Renegotiating Health Care: Resolving conflict to build collaboration By Leonard J. Marcus, with Barry C. Dorn, Phyllis B. Kritek, Velvet G. Miller, and Janice B. Wyatt. 453 pp. San Francisco, Jossey-Bass, 1995. $36.95. 0-7879-0151-2
Authors: Gordon D. Schiff
Journal: New England Journal of Medicine (1996)
Carotid Artery Stenting in Acute Stroke
Authors: Panagiotis Papanagiotou, Christian Roth, Silke Walter, Stefanie Behnke, Iris Q. Grunwald, Julio Viera, Maria Politi, Heiko Körner, Panagiotis Kostopoulos, Anton Haass, Klaus Fassbender, Wolfgang Reith
Journal: Journal of the American College of Cardiology (2011)
P270 Motor neurone disease (MND); a survey of deaths in the era of non-invasive ventilation
Authors: S. K. Banerjee, M. G. Davies, I. E. Smith
Journal: Thorax (2011)

<h3>Background</h3> The care of patients with MND has changed radically with greater uptake of non-invasive ventilation (NIV) and tube feeding (TF). Community colleagues in our region have expressed anxiety about how such supported patients might die and in particular whether the process of dying might be prolonged. We sought to investigate these concerns. <h3>Methods</h3> A structured questionnaire was distributed to involved clinicians, community practitioners and MNDA care co-ordinators. They completed questionnaires for patients dying under their care, where necessary/appropriate with the input of family members. The data are compared with an historical, retrospective series (n=50) reported by the Wisdom Hospice (WH).1 <h3>Results</h3> From October 2010 to June 2011, 51 deaths were recorded (mean age 67 years, 29 men). Thirty deaths were in an acute hospital, 15 at home, six in a hospice or community hospital. 16 patients had advance care plans (ACP) of whom 10 died in their “preferred place”. Assisted ventilation had been prescribed to 30 and tube feeding to 37 patients. NIV and TF were discontinued before death in 13 and five patients respectively. For 22 patients the process of dying was sudden or &lt;24 h in duration. NIV was not associated with a prolonged process of dying. The commonest certified cause of death was an unqualified “MND”, with pneumonia reported in seven cases. No patient had a post mortem examination. The WH cohort had a similar proportion of men and the mean age at death was 66 years. None of the patients had assisted ventilation and only seven had tube feeding. The process of dying was 24 h or less for 24 patients. The commonest recorded cause of death was respiratory failure (22 individuals). <h3>Conclusion</h3> These preliminary results show that there is no trend to prolonged deaths in patients with MND using NIV and TF. Several patients have elected to discontinue NIV. ACP9s in our region remain patchy and require further attention. The quality of death certification is poor with little detail on the mechanism of death.
Carcinoma of the Cervix
Authors: Milton Terris
Journal: JAMA (1960)

122 patients with histologically confirmed squamous cell carcinoma of the cervix admitted to the gynecological wards of Charity Hospital in New Orleans from July 1, 1959, through March 31, 1960, were studied; suitable controls were selected from the same wards. All interviews were conducted by the same interviewer nurse who was unaware of the diagnoses. Hospital charts were later examined. Educational level of patients, occupation of husband and father, residence, original diagnosis, and religion were similar to those of controls. Less than 1/3 had more than grammar school education. Most husbands and fathers were farmers of unskilled laborers. In only 1/5 of the patients had the original cancer diagnosis been made by private physicians or at noncharity hospitals. About 45% were Catholics, 45% Baptists, and the remaining 10% other Protestant denominations. 49% of the patients and 43% of the controls reported 6 or more pregnancies. Douching practices were similar to controls; few had ever used other contraceptive measures. 13 patients and 6 controls had positive serological tests for syphilis. Only 6, 1 patient and 5 controls, had never been married. Of cancer patients, 47% had been married more than once vs. 16% of controls. 34% of the patients with cancer were married before the age of 17 vs. 14% of controls. 54% of patients with cancer and 26% of controls reported extramarital partners. 53% of patients had 1st coitus before age 17 vs. 26% of the controls. There was a considerably higher frequency of coitus in patients than in controls. It is concluded that no relation between number of pregnancies and cancer was shown. Douching with coal tar derivatives was not a factor. The association of carcinoma and syphilis was not certain as many had never had a serological test. The effect of circumcision of partners was not determined as it was often unknown. A significant association was shown with early marriage, extramarital relations, coitus at an early age, and frequent coitus at all ages.
Hormone replacement therapy prevents bone loss in patients with inflammatory bowel disease.
Authors: D Clements, J E Compston, W D Evans, J Rhodes
Journal: Gut (1993)

Patients with inflammatory bowel disease have an increased prevalence of osteoporosis, and suffer high rates of spinal bone loss. Hormone replacement therapy (HRT) is effective in the treatment and prevention of osteoporosis but has not been studied in patients with inflammatory bowel disease. A two year prospective study of HRT in inflammatory bowel disease was performed in 47 postmenopausal women aged 44 to 67 years with ulcerative colitis (25) or Crohn9s disease (22). Patients had radial and spinal bone density measured annually by single photon absorptiometry and quantitative computed tomography respectively. The mean (95% confidence intervals) annual change in radial bone density was +1.42%/yr (+0.58 to +2.26; P &lt; 0.005) and for spinal bone +2.60%/yr (+1.06 to +4.15; p &lt; 0.005). There was no significant correlation between rates of change of bone density at the two sites, or between the rates of change and the initial bone density either in the radius or spine. Twelve patients were given prednisolone during the study, and their rates of change for spinal bone density were lower, but values were not statistically significantly different from those who did not receive corticosteroids. Changes in bone density for patients with ulcerative colitis and Crohn9s disease were not significantly different. The change in bone density did not correlate with the patients9 age or number of years after the menopause. It is concluded that HRT is effective in prevention of bone loss in postmenopausal women with inflammatory bowel disease.
Treatment of Gall Stones by Large Doses of Olive Oil
Authors: W. H. Stephenson
Journal: BMJ (1895)

grammes when dry; it is so soft that it can be indented by the fingernail; one side of the stone is black with dark- brown patches, the other side is yellowish-grey.There is a shallow depression in the duodenum half an inch from the pylorus in which the stone was found; at the bottom of the depression is a circular aperture one-eighth of an inch in diameter, leading into a passage of similar diameter, and nearly 2 inches in length; from the end of the passage a dis- tended hepatic duct leads into the left lobe of the liver for as distance of 7 inches.The gall bladder measures threequarters of an inch in length, one-third of an inch in breadth.No trace of cystic duct can be found.The bile papilla opens into the duodenum 3 inches from the pylorus; the common duct appears normal; the liver is of normal weight; it is covered by adhesions on both the upper and under surface of the right lobe."The facts of the whole case appear clear.In January, 1889, the stone left the gall bladder, and was lodged at the junction of the common and cystic ducts.In January, 1892, adhesion to the duodenum and ulceration occurred, setting up a, general peritonitis with accumulation of fluid.This gradually subsided, and by degrees the peri- toneal sac was obliterated by adhesions.Interstitial changes progressed in the liver, enormous congestion of the spleen occurred, which was relieved by several small haemorrhages, and on November 30th by an enormous haematemesis (up- wards of two quarts).As all this blood had been stored up in the spleen, outside the circulation as it were, no great im- mediate collapse occurred; but the patient's death ensued in a few days, in consequence, no doubt, of further blood being withdrawn from the " general circulation " by the obstruction in the liver.The case appears interesting in several particulars: 1.The unexampled duration of the jaundice.2. The very great enlargement of the spleen during the later stages, and eomparatively moderate size (21 ounces) after death, a fact explained by the very copious hvematemesis (2 quarts) which occurred a few daya before death, and ex- plaining the comparatively slight general upset resulting from such an enormous sudden loss of blood.3. The entire absence of xanthelasma in 1894 when its presence was noted in 1892.4. That the presence of a gall stone causing irritation and jaundice for a period of six years had not given rise to any appearance suggestive of malignancy.
Abstract 4734: Activation of yap1 is significantly associated with poor prognosis and cetuximab resistance in colorectal cancer patients
Authors: Keun-Wook Lee, Sung Sook Lee, Sang-Bae Kim, Yun-Yong Park, Bo Hwa Sohn, Hyun-Sung Lee, Ju-Seog Lee
Journal: Cancer Research (2014)

Abstract Purpose: To investigate the clinical significance of activation of YAP1, a newly identified oncogene in colorectal cancer (CRC). Patients and Methods: A gene expression signature reflecting YAP1 activation was identified in CRC cells, and CRC patients were stratified into two groups according to this signature: activated YAP1 CRC (AYCC) or inactivated YAP1 CRC (IYCC). Stratified patients in six test cohorts were evaluated to determine the effect of the signature on CRC prognosis and response to treatment with cetuximab. Results: The activated YAP1 signature was associated with poor prognosis for CRC in four independent patient cohorts with stage I-III disease (total n = 1,028). In a multivariate analysis, the impact of the YAP1 signature on the disease-free survival rate was independent of other clinical variables [hazard ratio (HR), 1.63; 95% confidence interval (CI), 1.25-2.13; P &amp;lt; .001]. In patients with stage IV CRC, AYCC patients had a poorer disease control rate and progression-free survival duration after cetuximab-based monotherapy than did IYCC patients (HR, 1.82; 95% CI, 1.05-3.16; P = .03). In multivariate analysis, the effect of YAP1 activation on PFS was independent of KRAS mutation status and cetuximab-based therapy was effective only in IYCC patients without KRAS mutations. Conclusion: Activation of YAP1 is highly associated with poor prognosis for CRC and may be useful in identifying patients with CRC resistant to treatment with cetuximab. Citation Format: Keun-Wook Lee, Sung Sook Lee, Sang-Bae Kim, Yun-Yong Park, Bo Hwa Sohn, Hyun-Sung Lee, Ju-Seog Lee. Activation of yap1 is significantly associated with poor prognosis and cetuximab resistance in colorectal cancer patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4734. doi:10.1158/1538-7445.AM2014-4734
Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment
Authors: Fumiaki Imamura, Renata Micha, Shahab Khatibzadeh, Saman Fahimi, Peilin Shi, John Powles, Dariush Mozaffarian
Journal: The Lancet Global Health (2015)

BackgroundHealthy dietary patterns are a global priority to reduce non-communicable diseases. Yet neither worldwide patterns of diets nor their trends with time are well established. We aimed to characterise global changes (or trends) in dietary patterns nationally and regionally and to assess heterogeneity by age, sex, national income, and type of dietary pattern.MethodsIn this systematic assessment, we evaluated global consumption of key dietary items (foods and nutrients) by region, nation, age, and sex in 1990 and 2010. Consumption data were evaluated from 325 surveys (71·7% nationally representative) covering 88·7% of the global adult population. Two types of dietary pattern were assessed: one reflecting greater consumption of ten healthy dietary items and the other based on lesser consumption of seven unhealthy dietary items. The mean intakes of each dietary factor were divided into quintiles, and each quintile was assigned an ordinal score, with higher scores being equivalent to healthier diets (range 0–100). The dietary patterns were assessed by hierarchical linear regression including country, age, sex, national income, and time as exploratory variables.FindingsFrom 1990 to 2010, diets based on healthy items improved globally (by 2·2 points, 95% uncertainty interval (UI) 0·9 to 3·5), whereas diets based on unhealthy items worsened (−2·5, −3·3 to −1·7). In 2010, the global mean scores were 44·0 (SD 10·5) for the healthy pattern and 52·1 (18·6) for the unhealthy pattern, with weak intercorrelation (r=–0·08) between countries. On average, better diets were seen in older adults compared with younger adults, and in women compared with men (p<0·0001 each). Compared with low-income nations, high-income nations had better diets based on healthy items (+2·5 points, 95% UI 0·3 to 4·1), but substantially poorer diets based on unhealthy items (−33·0, −37·8 to −28·3). Diets and their trends were very heterogeneous across the world regions. For example, both types of dietary patterns improved in high-income countries, but worsened in some low-income countries in Africa and Asia. Middle-income countries showed the largest improvement in dietary patterns based on healthy items, but the largest deterioration in dietary patterns based on unhealthy items.InterpretationConsumption of healthy items improved, while consumption of unhealthy items worsened across the world, with heterogeneity across regions and countries. These global data provide the best estimates to date of nutrition transitions across the world and inform policies and priorities for reducing the health and economic burdens of poor diet quality.FundingThe Bill & Melinda Gates Foundation and Medical Research Council.
IMMUNOLOGIC REACTIONS WITH TOBACCO MOSAIC VIRUS
Authors: Helen A. Purdy
Journal: The Journal of Experimental Medicine (1929)

1. Antisera were produced, separately, in rabbits to normal sap from healthy Turkish tobacco plants and to irus-sap from tobacco plants, affected with mosaic disease. 2. The immunologic reactions of the antisera were studied by means of: (a) Alexin-fixation tests. (b) Precipitation experiments, including: Precipitin-absorption tests with the same tobacco virus multiplied in tobacco, tomato, pepper, and petunia plants. (c) Experiments with the inactivation properties of both antisera and normal serum on virus-sap. 3. From the results obtained from the above experiments, the following conclusions were drawn: (a) Normal-tobacco-sap and virus-tobacco-sap possess antigenic substances in common. (b) Normal sap and virus-sap of tomato, pepper, and petunia plants contain antigenic substances in common with normal sap of tobacco. (c) Virus-saps of tomato, pepper, and petunia plants, have antigenic substances in common with virus-sap of tobacco, that are either not present in the normal tobacco sap or present only in small amounts. (d) The two antisera possess alexin-fixing antibodies and precipitins in common. (e) All of the precipitins to normal tobacco sap may be removed from either antiserum by absorption with virus-sap of tobacco. (f) Specific precipitins for virus-sap of tobacco, tomato, pepper, and petunia are present in the antiserum to tobacco virus-sap and cannot be removed by complete absorption with normal sap of tobacco. (g) Antiserum to virus-sap of tobacco, when used in an appropriate amount, has the power of completely inactivating virus-sap. A corresponding quantity of antiserum to normal tobacco sap, or normal rabbit or guinea-pig serum, does not exhibit the same preventive action on virus-sap. (h) There is some evidence that a specific antibody to virus-sap, lytic in nature, is present in the homologous antiserum.
Gene therapy saves immune deficient babies in France
Authors: R. Dobson
Journal: BMJ (2000)

Gene therapy has been successfully used by French researchers to treat severe combined immunodeficiency (SCID). Two babies, aged 8 and 11 months, who received the treatment are no longer in isolation and live at home without any treatment, enjoying normal growth and development for their ages.

The normal functioning of the infants' immune system has lasted 11 months without any side effects so far, and a third patient is making similar progress four months after …
The Presence of a Positive Pressure Gradient from Pancreatic Duct to Choledochal Cyst Demonstrated by Duodenoscopic Microtransducer Manometry: Clue to Pancreaticobiliary Reflux
Authors: M. Tanaka, S. Ikeda, K. Kawakami, F. Nakayama
Journal: Endoscopy (1982)

A case of choledochal cyst is presented. The diagnosis was established by endoscopic retrograde cholangiopancreatography, which also demonstrated that the common bile duct joined the pancreatic duct at an abnormally long distance from the papilla. Duodenoscopic manometry using a microtransducer catheter showed that the pressure in the pancreatic duct was higher than that in the choledochal cyst by 1.1 mmHg. The cyst-to-duodenum pressure gradient of 3.5 mmHg was not different from the common duct-to-duodenum gradient in patients with other common biliary tract diseases, making the presence of a stenosis as an etiology of this entity unlikely. The bile aspirated from the gallbladder had an extremely high amylase content, suggesting influx of the pancreatic juice into the biliary system. The pancreaticobiliary reflux caused by the positive pressure gradient from the pancreatic duct to the choledochal cyst may be related to the development of the disease.
Chronic Progressive Radiation Myelopathy
Authors: Thomas J. Reagan
Journal: JAMA (1968)

Ten patients with chronic progressive radiation myelopathy were studied at the Mayo Clinic. Most of them had primary carcinomas of head or neck and all had received radiation therapy. The interval between termination of radiation and onset of neurologic symptoms varied from 5 1/2 to 30 months. The lower extremities were usually affected first. Sensory symptoms predominated. The spinal cord disease was cervical in eight and dorsal in two, corresponding to the segment of the cord irradiated. In four patients, the striking neurologic finding was a Brown-Séquard syndrome, whereas in six the picture was that of an incomplete transverse myelopathy. Myelograms were normal in all but one patient. Seven patients had died; average survival time was ten months. The differential diagnosis mainly concerned intramedullary tumor metastasis and "remote" carcinomatous myelopathy.
Diagnosis and management of colorectal cancer: summary of NICE guidance
Authors: G. J. Poston, D. Tait, S. O'Connell, A. Bennett, S. Berendse
Journal: BMJ (2011)

Colorectal cancer is the third leading cause of death from cancer in the United Kingdom, with a lifetime risk of about 2% in England and Wales, and its incidence is rising.1 The outcome for people with colorectal cancer is improving, but the overall five year survival rates are still lower than 60%.1 There is a need for greater accuracy in diagnosis and staging, more appropriate use of neoadjuvant and adjuvant therapies when treating potentially curable disease, and more effective use of resources when managing patients with advanced disease. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of people with colorectal cancer in secondary care.2 Recommendations for referral from primary care for patients with suspected colorectal cancer are in the NICE clinical guideline 27.3 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Investigations for diagnosis and staging #### Confirming a diagnosis of colorectal cancer The recommendations in this section refer to people whose condition is being managed in secondary care. For recommendations for urgent referral from primary care for patients with suspected colorectal cancer, see the NICE clinical guideline 27.3