tbuckley/cabot-search huggingface dataset:
Morbid obesity, nonalcoholic fatty liver disease, and weight loss surgery
Authors: Savita Srivastava, Zobair M. Younossi, Hartmut Jaeschke, Kevin Mullen, Darius Moradpour
Journal: Hepatology (2005)

Objective This study examines the impact of biliopancreatic diversion, a malabsorptive variant of gastric bypass, on liver histology. Methods Liver samples were collected from 689 severely obese (BMI 47 ± 9 kg m2) patients undergoing biliopancreatic diversion. Exclusion criteria included: history of hepatitis, exposure to hepatotoxic medications, prior weight loss surgery, and alcohol consumption greater than 100 grams per week. One group of 14 patients had cirrhosis in their initial biopsy. Eleven of those 14 patients underwent multiple biopsies to monitor their liver disease. A second group of 104 patients had re-operations and a second liver biopsy. A hepatopathologist conducted blind evaluations of all biopsy specimens looking for steatosis and fibrosis. Results All patients lost weight and showed improvement in their metabolic syndrome. Of the 104 patients undergoing re-operation with a second liver biopsy, 28 showed a decrease in severe fibrosis, while 42 patients developed mild fibrosis. On average, this group lost 38 ± 18 kg over 41 ± 25 post-surgical months. A sub-group analysis revealed an association between increased fibrosis and post-operative low serum albumin, diarrhea, pre-operative alcohol consumption, and menopausal status. The eleven patients with cirrhosis in their initial biopsy showed a reduction in their fibrosis grade (mean fibrosis grade from 5 to 3) during nine years of follow-up care. Conclusion These findings indicate that significant weight loss after biliopancreatic diversion can improve liver histology in patients with advanced fibrosis.
Stress Testing in the Emergency Department: Not Which Test but Whether Any Test Should Be Done
Authors: Rita F. Redberg
Journal: JAMA Internal Medicine (2015)

Chest pain is oneof themost challenging symptoms for emergencymedicinephysicians toevaluate.Theymust identifypatients with cardiac ischemia without subjecting all patients, the overwhelmingmajority ofwhomdonothave ischemia, to unnecessary testing.Mostpatients evaluated in the emergency department (ED) for chest pain who have normal electrocardiogramfindingsandnegative results of cardiacbiomarker tests do not have cardiac ischemia. Thus, the question shouldnot bewhat further testing toperform, but should any further testing be done in the ED. The study by Foy et al1 in this issue of JAMA Internal Medicine sheds much light on this question. They found that, after more than 6 months of follow-up, only 0.33% of all patients who received treatment for chest pain in the ED were hospitalized with a myocardial infarction. Even more important, this very low risk was the same in patients who underwent cardiac testing (exercise electrocardiography, stress echocardiography, myocardial perfusion scintigraphy, or coronary computed tomographic angiography) compared with those who did not undergo testing. These findings suggest that the current practice of performing a stress test on low-risk patients in the ED is unnecessary and prolongs the length of stay in EDs as well as increases unnecessary medical imaging, with a significant associated radiation risk for tests that include nuclear imaging. It is time to change our guidelines and practice for treatment of chest pain in lowrisk patients. Such patients should be given a close follow-up appointment with a primary care physician who can determine, based on the patient’s condition, whether further evaluation is necessary.
P2-13-09: First Statewide Experience with Telephone Delivery of Cancer Genetic Counseling.
Authors: J Pruski-Clark, A Trivedi, S Kelle, S Rebecca
Journal: Cancer Research (2011)

Abstract Background: National guidelines and multiple professional medical societies recommend genetic counseling as the standard of care for women with a personal and/or family history suggestive of a hereditary cancer syndrome. In addition, the ability to provide risk assessment and genetic counseling is a requirement for accreditation of breast centers by organizations such as the National Accreditation Program for Breast Centers (NAPBC) and the Commission on Cancer. However, there is clear evidence that this standard is not being achieved. Many individuals are undergoing genetic testing for these syndromes without adequate pre- and post-test counseling and, on the other hand, many individuals who are appropriate for genetic testing are not being identified and referred for genetic counseling and therefore not receiving potentially life-saving genetic information and services. A number of factors have been identified as contributors to these poor public health outcomes, including a lack of available genetic counseling services due to a limited number of trained genetics professionals and their limited geographic distribution. Research has demonstrated the effectiveness of cancer genetic counseling delivered by telephone, but to date, almost no real-world experience has been reported. We provided statewide access to board-certified genetic counselors via telephone in Michigan beginning in February 2010 and report our experience with the first 200 patients at risk for hereditary breast and ovarian cancer. Materials and Methods: Baseline data were analyzed for all Michigan patients undergoing telephone genetic counseling through Informed Medical Decisions since service delivery began in February 2010. Variables include demographics, geographic location, personal cancer history, family cancer history, Gail risk and test appropriateness criteria. Results: Analysis has been completed on the first 200 patients referred for consideration of hereditary breast and ovarian cancer. Outcomes include testing, results and, where applicable, reasons testing was not pursued, patient and provider satisfaction, as well as trends over time in patient volumes, providers using the service and uptake by geographic location. Conclusion: Based on statewide experience in Michigan, telephone cancer genetic counseling is a viable method for service delivery in the real world. The Michigan experience can serve as a cost-effective model for improving genetic services in other locations with limited access to genetic experts. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-13-09.
Surgical Health Care Delivery
Authors: Robert E. McCabe
Journal: JAMA (1983)

After two decades of costly new surgical procedures involving open heart surgery and multiple types of replacement therapies, the editor of this volume writes, "surgeons must become actively involved in research on surgical health care services." Rutkow has assembled a group of public health planners to discuss issues of ethics, morality, cost-effectiveness, and cost benefits of surgery in a decade of limited health care dollars. Dr Rutkow has tackled the issue of a higher rate of surgery in the United States. Is such a high rate a consequence of fee for service, in contrast to the prepaid group practice of health maintenance organizations or to nations with nationalized health care programs? Do prepaid group practices and HMOs encourage less than optimal care by denying or delaying elective surgery? Have the surgical second-opinion programs been cost-effective while promoting higher-quality surgical care? What constitutes the "unnecessary surgical procedure"? The authors have addressed
Hepatic FGF21 Expression Is Induced at Birth via PPARα in Response to Milk Intake and Contributes to Thermogenic Activation of Neonatal Brown Fat
Authors: Elayne Hondares, Meritxell Rosell, Frank J. Gonzalez, Marta Giralt, Roser Iglesias, Francesc Villarroya
Journal: Cell Metabolism (2010)
Caseload or workload? Scoring complexity of operative procedures as a means of analysing workload.
Authors: S M Jones, C D Collins
Journal: BMJ (1990)

To present a more realistic assessment of surgical workload than that provided by a case count.Prospective study of all the operative procedures performed in one year, classified according to the British United Provident Association's schedule of procedures and scored by the "intermediate equivalent" value (taking the recommended fee value of an intermediate operation as 1.0) compared with the number of operations performed.General surgical unit of Taunton and Somerset Hospital, comparing four consultant surgeons and their teams.Inpatients and day patients admitted under the care of general surgeons during 1989.Difference between the apparent workload represented by simple case counting (caseload) and the actual workload represented by calculation of the total "intermediate equivalent" value.The workload assessed in terms of intermediate equivalent values was greater than that suggested by case counting for complex operations (12% v 4%), operations at the district hospital (82% v 74%), and operations performed by consultants (53% v 35%) and was lower for minor operations (20% v 42%), operations at the community hospitals (18% v 26%), and operations performed by surgeons in training grades and clinical assistants (47% v 66%).The use of the intermediate equivalent values as an indicator of complexity allows a more realistic assessment of the operative workload than a simple case count of the number of different operations and is recommended for comparing workload in different hospitals and departments.
Abstract 12503: Low-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio is a Useful Risk Marker for Acute Myocardial Infarction and Sudden Death in Normocholesterolemic Male Population
Authors: Fumitaka Tanaka, Shinji Makita, Toshiyuki Onoda, Kazuyoshi Itai, Masaki Ohsawa, Kozo Tanno, Kiyomi Sakata, Kazuko Kawamura, Akira Okayama, Motoyuki Nakamura
Journal: Circulation (2011)
Intra-SA-nodal pacemaker shift: indirect evaluation in the open chest dog
Authors: J.-Y. LE HEUZEY, L. GUIZE, J.-P. MOUTET, C. CABANIS, P. MAURICE, P. PERONNEAU
Journal: Cardiovascular Research (1982)

Thirteen open chest dogs with normal sinus node function were studied by premature stimulations with a constant relative prematurity--50% of the preceding sinus cycle length. These premature beats were induced in the lower part of the crista terminalis of the right atrium and to the roof of the left atrium. Significant linear correlations were found between the return cycle (A2A3) and the spontaneous cycle (A1A1) lengths, with a slope of +0.75 in the right atrium, +1.36 in the left atrium. The evaluation of sinus node function is disturbed by pacemaker shifts, both spontaneous and induced. Sinus node organisation may be assessed by stimulating standardised sites, by measuring intra-atrial conduction time, and by comparing A2A3 with A1A1 at constant relative prematurity during significant variations in A1A1 obtained with changes in vago-sympathetic tone.
Abstract C68: Phenotypic and functional heterogeneity of prostate cancer stem cells
Authors: Xin Liu, Xin Chen, Brian Laffin, Binglan Yin, Tammy Calhoun-Davis, Feng Wang-Johanning, Dean G. Tang
Journal: Cancer Research (2012)

Abstract Recent evidence in many tumor systems suggests that there may exist several or even many tumorigenic subpopulations in each tumor. Utilizing 4 xenograft human prostate cancer (PCa) models, including two AR+/PSA+ (LAPC9 and LAPC4) and two AR-/PSA- (Du145 and PC3) xenografts, and by performing exhaustive limiting-dilution tumor regeneration assays in NOD/SCID mice using purified PCa cells based on functional properties (i.e., side population and Aldefluor assays) or preferential expression of surface markers (ABCG2, CD44, or integrin α2β1), we provide evidence for both the phenotypic and functional heterogeneity of PCa stem cells (i.e., PCa cell subpopulations with enhanced tumor-regeneration activity). Our results show that no single marker or assay seems to be able to capture all tumorigenic subsets in all 4 xenografts. We further show that different tumor-initiating subpopulations appear to co-exist in a common tumorigenic pool. We also demonstrate that some tumorigenic PCa cells overexpress stem cell-associated gene expression profiles. Finally, we provide evidence that primary prostate tumors possess subsets of tumor cells that bear similar phenotypic features to those in xenografts. Our results raise the possibility that different PCa patient tumors may harbor CSCs with distinct phenotypic and functional properties. Note: This abstract was not presented at the conference because the presenter was unable to attend. Citation Format: Xin Liu, Xin Chen, Brian Laffin, Binglan Yin, Tammy Calhoun-Davis, Feng Wang-Johanning, Dean G. Tang. Phenotypic and functional heterogeneity of prostate cancer stem cells [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr C68.
Abstract P2-18-06: Preservation or division of the intercostobrachial nerve in axillary dissection for breast cancer: Meta-analysis of randomised controlled trials
Authors: SK Warrier, S Hwang, C Koh, H Shepherd, C Mak, H Carmalt, M Solomon
Journal: Cancer Research (2013)

Abstract Purpose: Management of the ICBN during axillary dissection is controversial and the division of ICBN is often trivialised.The effect of dividing the ICBN, and its association with sensory disturbance, is unclear. A systemic review and meta-analysis was performed to evaluate the effect of preserving the ICBN during axillary dissection. Methods: A systemic literature review and meta-analysis was performed according to the PRISMA and Cochrane Collaboration guidelines. Two authors (SW and SH) independently searched Medline, Pubmed, Embase, Cochrane Database of Systemic Reviews and the Cochrane Controlled Trials Register from 1950 to December 2012 for studies comparing preservation or division of the ICBN in axillary dissection for breast cancer. The primary outcome of this meta-analysis was sensory disturbance, defined as objectively assessed change in sensation in the distribution of the ICBN after axillary dissection. The nature of sensory disturbance was assessed as a secondary outcome, categorised into two types: “hypersensitivity” and “hyposensitivity”. Results: Three RCTs and four non-RCTs were reviewed. A meta-analysis demonstrated that the incidence of sensory disturbance was significantly lower with preservation of ICBN compared to division of the ICBN with Mantel-Haenzel combined odds ratio 0.31 (0.17-0.57, 95% CI). There was relatively low level of heterogeneity (I2 = 19%, c2 = 2.48, df = 2). The sensory disturbance was more likely to be hyposensitivity when compared to hypersensitivity (p &amp;lt;0.0001). No difference on number of lymph nodes dissected or operating time was noted. Conclusion: This meta-analysis demonstrates that division of the ICBN is associated with higher risk of sensory disturbance, and that the nature of this sensory disturbance is more likely to be hyposensitivity, attributable to reduced nerve function. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-06.
Kaposi's Varicelliform Eruption
Authors: Stanley S. Freedman, John T. Barrett
Journal: New England Journal of Medicine (1949)

IN 1944 Dr. Herbert A. Wenner1 wrote: "The integument of infants and children ill with eczema is frequently infected by bacterial opportunists and less frequently by filtrable viruses." The former is easily recognized; the latter, because of its infrequent occurrence, may easily be overlooked. The case presented below is that of an eight-month-old baby who had had intractable atopic eczema since the age of six days At the age of eight months his eczema became complicated by the disease now known as Kaposi's varicelliform eruption, which is said to be due to a filtrable virus.This skin disease was first . . .
Multimorbidity may be stumbling block
Authors: C. M Martin
Journal: BMJ (2008)

Sadly, Sibbald is probably right.1 Primary care in England is being reduced to disease management, protocol based, and targets funded services that are increasingly privately outsourced. This is an entirely appropriate environment for nurse led management. General practitioners’ roles and responsibilities of the previously very successful model of general practice have been gradually eroded over the recent decades, whereas nurse specialism in …
Sexually Transmitted Diseases
Authors: Jerry D. Smilack
Journal: JAMA (1985)

<h3>Infectious Diseases,</h3> by W. Edmund Farrar and Harold P. Lambert (<i>Pocket Picture Guides to Clinical Medicine</i>), 82+ pp, 164 illus, $11.95, Baltimore, Williams &amp; Wilkins Co, 1984. The publisher of this series of compact books states that the<i>Picture Guides'</i>purpose is "to provide essential visual information about commonly encountered diseases in a convenient, practical and economical format." These two examples from this series fulfill that purpose. Each provides excellent color photographs showing classic clinical appearances of disease. The quality of reproductions is generally superb; concise textual material accompanying each picture highlights diagnostic features. Bingham's work nicely organizes material into four categories: major causes of urethral discharge, vaginal discharge, genital ulceration, and miscellaneous sexually transmitted conditions, eg, warts, scabies, and pediculosis. Farrar and Lambert offer the reader a sampler of more than 160 photographs from their larger, encyclopedic work wth 722 illustrations, entitled<i>Infectious Diseases Illustrated</i>. Naturally, in a pocket-sized
Pulmonary and cardiac expression of preproendothelin-1 mRNA are increased in heart failure after myocardial infarction in rats. Localization of preproendothelin-1 mRNA and endothelin peptide
Authors: Theis Tønnessen, Per Kristian Lunde, Adel Giaid, Ole M Sejersted, Geir Christensen
Journal: Cardiovascular Research (1998)

Objectives: Recent reports indicate that endothelin (ET) plays an important pathophysiological role in congestive heart failure (CHF). However, existing data on local cardiopulmonary ET production are few. No studies have hitherto examined the specific anatomic localization of cardiopulmonary ET synthesis in CHF. Thus, the aims of the present study were to examine whether cardiopulmonary preproET-1 mRNA synthesis is upregulated in CHF and to determine the anatomic localization of preproET-1 mRNA and the mature peptide. Methods: CHF was induced in rats by occluding the left coronary artery. Only animals with a left ventricular end-diastolic pressure above 15 mmHg after one week were included (n=28). Sham-operated animals served as controls (n=24). Hearts and lungs were examined by mRNA slot blot analyses, in situ hybridization (ISH) and immunohistochemistry (IHC). Results: In CHF-rats, slot blot analyses revealed a 3.5±1.1-fold and a 6.4±0.8-fold upregulation of preproET-1 mRNA in the noninfarcted and the infarcted area of the left ventricles, respectively (p<0.05 for both). ISH revealed that the preproET-1 mRNA was localized predominantly over the granulation tissue in the infarcted region. The ET peptide was predominantly localized to inflammatory cells and remaining cardiomyocytes in the infarcted region as determined by IHC. Lungs from CHF-rats showed a 1.5±0.1-fold upregulation of preproET-1 mRNA (p=0.01). The most abundant preproET-1 mRNA and ET-1-like-immunoreactivity (ET-1-ir) was seen over inflammatory cells and over airway epithelial cells. Some ET-1-ir was also located to bronchial and vascular smooth muscle cells. Conclusion: Increased cardiopulmonary ET synthesis strongly suggest a pathophysiological role for ET in CHF.
The HIV-infected Health Care Worker: Another AIDS Policy Conundrum
Authors: H. Denman Scott
Journal: Annals of Internal Medicine (1992)

Editorials15 February 1992The HIV-infected Health Care Worker: Another AIDS Policy ConundrumH. Denman Scott, MDH. Denman Scott, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-4-341 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPolicies to deal with the medical and social consequences of AIDS have evolved amidst tension and controversy. This is not surprising because the public and health professions have become unaccustomed to facing a deadly contagious disease without highly effective preventive and therapeutic tools. In addition, because early cases appeared almost exclusively among homosexual men, the disease accelerated wide discussion of homosexuality and homosexuals' rights. Thus, fear of a disease and strong feelings about homosexuality combined to create an emotionally charged climate.A person who perceives himself or herself to be at risk faces a personal struggle whether to find out...References1. Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Morb Mortal Wkly Rep. 1991, 40 RR-8:1-9. MedlineGoogle Scholar2. TokarsBellMarcus JDR. Percutaneous injuries during surgical procedures (Abstract). VII International Conference on AIDS. v 2. Florence, Italy, 16-21 June 1991:83. Google Scholar3. Amendment 734, Appropriations for Treasury Department and U.S. Postal Service (H.R. 2622) 11 July 1991. Congressional Record: S9778. Google Scholar4. Staver S. Physicians to report physicians? American Medical News. 1991;November 11:1. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: American College of Physicians Philadelphia, PA 19106 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThe College Student, the Dentist, and the North Carolina SenatorGay and Lesbian Physician CouplesPreventing HIV Transmission in Health Care Settings25. The rational use of the HIV antibody test 15 February 1992Volume 116, Issue 4Page: 341-343KeywordsAIDSEmotionsFearHealth care policyHealth care providersHomosexualityHomosexualsPrevention, policy, and public healthPublic policy Issue Published: 15 February 1992 PDF DownloadLoading ...
Better tests of consciousness are needed, but skepticism about unconscious processes is unwarranted
Authors: Ryan Ogilvie, Peter Carruthers
Journal: Behavioral and Brain Sciences (2014)

Abstract What people report is, at times, the best evidence we have for what they experience. Newell &amp; Shanks (N&amp;S) do a service for debates regarding the role of unconscious influences on decision making by offering some sound methodological recommendations. We doubt, however, that those recommendations go far enough. For even if people have knowledge of the factors that influence their decisions, it does not follow that such knowledge is conscious, and plays a causal role, at the time the decision is made. Moreover, N&amp;S fail to demonstrate that unconscious thought plays no role at all in decision making. Indeed, such a claim is quite implausible. In making these points we comment on their discussion of the literature on expertise acquisition and the Iowa Gambling Task.
Re: João Silva, Rui Pinto, Tiago Carvallho, et al. Mechanisms of Prostate Atrophy after Glandular Botulinum Neurotoxin Type A Injection: An Experimental Study in the Rat. Eur Urol 2009;56:134-41
Authors: Tomasz Drewa, Zbigniew Wolski, Janusz Tyloch
Journal: European Urology (2009)