tbuckley/cabot-search huggingface dataset:
PWE-199 Quality of flexible sigmoidoscopy for colorectal cancer screening: are we there yet?
Authors: S K Butt, H Defoe, K Besherdas
Journal: Gut (2012)

<h3>Introduction</h3> Colorectal cancer (CRC) screening with flexible sigmoidoscopy (FS) has been associated with reduced incidence and mortality from CRC. The NHS in UK is introducing FS screening for all men and women at 55 years of age following a multicentre randomised controlled trial which found that FS was a safe and practical test which, when offered only once conferred a substantial and lasting benefit. Quality in performance of FS will be important for success within the screening programme. One aspect of quality of FS performance is the depth of insertion. The definition of an adequately inserted screening FS is subjective and not currently defined. However, in clinical practice, one should examine as much of the distal colon as possible, recognising that it can be difficult to precisely define the furthest extent. It is expected that the rectum and sigmoid colon should be inspected completely and the descending and more proximal colon can often also be visualised. By taking the analogue of colonoscopy one could expect the "decending colon intubation rate" to be at least 90%. In addition, the preparation should be such that the endoscopist is confident that lesions other than small polyps (5 mm or smaller) are not obscured. If adequate insertion is not achieved or the sigmoid colon is not adequately prepared, the procedure may have to be repeated increasing the burden on an already overstretched endoscopy service. <h3>Methods</h3> To assess the completion rate (depth of insertion in FS) defined as examination up to at least the decending colon and reasons for incompletion. A single centre, retrospective study in a district general hospital endoscopy unit in London of consecutive FS over a 2-month period in 2011. The FS reports were scrutinised for depth of insertion and if splenic/decending colon was not reached the reason for this. <h3>Results</h3> Within the study period, the splenic flexure was reached in 40% (58 of a 148), and the decending colon in 66% (94 of 148). The reasons stated for not reaching the decending colon/splenic flexure include: inadequate bowel prep (26/148), pathology encountered (16/148), patient discomfort (4/148), planned limited procedure (7/148). In 87/148 no reason for not reaching the splenic flexure/decending was documented. <h3>Conclusion</h3> In this study, in the majority of patients undergoing FS the splenic flexure in not reached. Only 66% of patients have the rectum and sigmoid colon assessed during planned FS. The reasons for failure of examination to decending colon is not documented in the majority, and this may be because clear guidelines on "decending colon intubation rates" are not available. In order to implement FS as screening for CRC we recommend development of clear quality standard including one of depth of intubation (or "decending colon intubation rate") as is currently available for colonoscopy. <h3>Competing interests</h3> None declared.
Endoscopic submucosal dissection with a ligation device for the treatment of rectal carcinoid tumor
Authors: T. Shida, M. Aminaka, Y. Shirai, K. Okimoto, S. Tsuruta, E. Kita, S. Tsuchiya, K. Kato, M. Takahashi
Journal: Endoscopy (2012)

Rectal carcinoid tumor is a relatively rare tumor, which is occasionally found during screening colonoscopy. Tumors less than 1 cm in diameter and limited in depth to the submucosal layer can be managed by endoscopic treatment, several types of which have been reported for rectal carcinoid tumor [1] [2]. Because carcinoid tumor extends to the submucosal layer, simple endoscopic mucosal resection (EMR) will often leave tumor involvement in the deeper tissue levels [3]. Recently the technique of endoscopic submucosal dissection (ESD) has been shown to be useful in the treatment of rectal carcinoid tumor [3] [4]. However, ESD requires high levels of technical skill and procedure times are long. In addition, the rate of complications, such as perforation, is higher with ESD than with EMR. To overcome this situation, we developed a new technique, known as endoscopic submucosal dissection with band ligation (ESD-L), for the treatment of rectal carcinoid tumor. This new technique is a combination of circumferential mucosal cutting and rubber band ligation ([Fig. 1]).
Youth Suicide: The Physician's Role in Suicide Prevention
Authors: Susan J. Blumenthal
Journal: JAMA (1990)

One of the most difficult clinical problems facing the physician is the prediction and prevention of youth suicide. Since one goal of medicine is to avert untimely mortality, the death of a young person by suicide may be particularly devastating to the clinician, raising issues about whether and how the tragedy might have been prevented. Although the percentage of youth who visit health care professionals prior to their suicide has not been well documented, it is generally believed that most young people have exhibited warning signs to family, friends, teachers, and physicians, suggesting that the clinician may have important opportunities to detect suicidal behavior and intervene appropriately to prevent these tragedies. 1   Suicide is the third leading cause of death among young people 15 to 24 years of age in the United States. 1 Completed suicide is rare in children but increases with each of the teenage years, reaching a
Are short normal children at a disadvantage? The Wessex growth study
Authors: A B. Downie, J. Mulligan, R. J Stratford, P. R Betts, L. D Voss
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To examine whether short stature through childhood represents a disadvantage at around 12 years. <b>Design:</b> Longitudinal non-intervention study of the physical and psychological development of children recruited from the community in 1986-7 after entry into primary school at age 5-6 years; this is the second psychometric assessment made in 1994-5 after entry into secondary school at age 11-13 years. <b>Setting:</b> Southampton and Winchester health districts. <b>Subjects:</b> 106 short normal children (&lt;3rd centile for height when recruited) and 119 controls of average stature (10th-90th centile). <b>Main outcome measures:</b> Psychometric measures of cognitive development, self concept development, behaviour, and locus of control. <b>Results:</b> The short children did not differ significantly from the control children on measures of self esteem (19.4<i>v</i> 20.2), self perception (104.2 <i>v</i> 102.4), parents9 perception (46.9 <i>v</i> 47.0), or behaviour (6.8 <i>v</i> 5.3). The short children achieved significantly lower scores on measures of intelligence quotient (IQ) (102.6 <i>v</i> 108.6; P&lt;0.005), reading attainment (44.3 <i>v</i> 47.9; P&lt;0.002), and basic number skills (40.2 <i>v</i> 43.5; P&lt;0.003) and displayed less internalisation of control (16.6 <i>v</i> 14.3; P&lt;0.001) and less satisfaction with their height (P&lt;0.0001). More short than control children, however, came from working class homes (P&lt;0.05). Social class was a better predictor than height of all measures except that of body satisfaction. Attainment scores were predicted by class and IQ together rather than by height. Height accounted for some of the variance in IQ and locus of control scores. <b>Conclusions:</b> These results provide only limited support for the hypothesis that short children are disadvantaged, at least up until 11-13 years old. Social class seems to have more influence than height on children9s psychological development. <h3>Key messages</h3> Most studies into the psychology of short stature in childhood have been of children referred to clinics, who do not necessarily come from a range of social classes In this study, in which referral bias was avoided, short children displayed normal psychosocial adjustment up to age 11-13 years Social class was shown to be a better predictor than stature of psychometric performance.
CORRECTION OF INTERVIEW BY DR. BETHEL SOLOMONS
Authors: Bethel Solomons
Journal: JAMA (1933)

<h3>To the Editor:</h3> —I have lately returned from a tour in Canada and the United States of America, where I had the honor of addressing the American Association of Obstetricians, Gynecologists and Abdominal Surgeons, and other learned societies. I was tremendously impressed with your hospitals and with the amount of scientific and practical work which is being carried out. I have brought back with me many ideas which I hope to get started here. Unfortunately, in an interview, a member of the lay press got an entirely wrong idea of what I intended to convey. I did not bother to contradict this, until it was published in the British medical press and now in your valuable journal. What I meant to convey was that I admired your beautiful buildings. I stated that I also admired the great amount of research carried on in the institutions, but that it was possible
A year in the life of a surgical day unit.
Authors: T H Berrill
Journal: BMJ (1972)

nearest kidney transplant unit as many potential donors as are available.In doing this doctors will need to enlarge their vision from concern for the patients under their own care to include other patients who may otherwise die.From this survey it seems that a sustained campaign is required to improve the communication between doctors and nurses caring for potential donors and those working in kidney transplant units.These measures may be taken on a regional basis, as described for six large Liverpool hospitals by Sells and Heal.' National approval and support for such local schemes by the Department of Health and Social Security would be valuable and appears to be indicated.
Class II transactivator (CIITA) is sufficient for the inducible expression of major histocompatibility complex class II genes.
Authors: C H Chang, J D Fontes, M Peterlin, R A Flavell
Journal: The Journal of Experimental Medicine (1994)

The class II transactivator (CIITA) has been shown to be required for major histocompatibility complex (MHC) class II gene expression in B cells and its deficiency is responsible for a hereditary MHC class II deficiency. Here we show that CIITA is also involved in the inducible expression of class II genes upon interferon gamma (IFN-gamma) treatment. The expression of CIITA is also inducible with IFN-gamma before the induction of MHC class II mRNA. In addition, CIITA mRNA expression does not require new protein synthesis, although new protein synthesis is necessary for the transcription of class II. This suggests that synthesis of new CIITA protein may be essential to induce class II gene expression. We also showed that the JAK1 protein tyrosine kinase activity is required to induce the expression of CIITA upon IFN-gamma stimulation. This finding indicates that CIITA is part of the signaling cascade from the IFN-gamma receptor to the activation of class II genes. In addition, the expression of CIITA is sufficient to activate class II genes in the absence of IFN-gamma stimulation suggesting that CIITA is the major regulatory factor for the inducible expression of class II genes. Together, these data suggest that CIITA is the IFN-inducible cycloheximide sensitive factor previously shown to be required for the induction of MHC class II gene expression.
Hypercholesterolemia and atherosclerosis in primary biliary cirrhosis: What is the risk?
Authors: Jeffrey S. Crippin, Kieth D. Lindor, Roberta Jorgensen, Bruce A. Kottke, Jay M. Harrison, Paul A. Murtaugh, E. Rolland Dickson
Journal: Hepatology (1992)

Hypercholesterolemia is commonly associated with primary biliary cirrhosis. In the general population, elevated serum cholesterol is associated with an increased risk of atherosclerosis. The relative risk has been poorly defined in primary biliary cirrhosis patients with hyperlipidemia. In addition, the hyperlipidemic state seen with primary biliary cirrhosis has not been well studied. We prospectively observed 312 patients with primary biliary cirrhosis for a median of 7.4 yr. During this period, 128 patients died. The incidence of atherosclerotic death in patients with primary biliary cirrhosis was not statistically different when compared with an age-matched and sex-matched U.S. control population. A similar group of 50 consecutive PBC patients had detailed serum lipid profiles. Findings included progressive increases in total cholesterol and low-density lipoprotein cholesterol with an increasing histological stage or severity of disease. High-density lipoprotein cholesterol was elevated in all stages, with the highest levels in histological stage 2 and 3 disease. Triglycerides were normal or slightly elevated in all stages. Apoprotein A-I was elevated in all but histological stage 4 disease. Our study suggests the hyperlipidemia associated with primary biliary cirrhosis does not place these patients at risk for atherosclerotic death. In light of the limitations imposed by our relatively small sample size, however, additional patients should be studied. Furthermore, an examination of the pathophysiological mechanisms leading to hypercholesterolemia should be the topic of further study. (HEPATOLOGY 1992;15:858–862).
Of Looking Back and Looking Forward
Authors: Daniel G. Haller
Journal: Journal of Clinical Oncology (2003)

Anniversaries offer an opportune time for reflecting on what has come before and thinking about what lies ahead. This year marks the 40th anniversary of the American Society of Clinical Oncology (ASCO), and this issue heralds the beginning of the 21st year of publication of the Journal of Clinical Oncology (JCO). In looking back, we are all encouraged by the many outstanding accomplishments of the Society and its journal that have paved the way for the future. From its inception, the strength of the JCO has been the strength of the ASCO membership—a global body of committed physicians dedicated to cancer research and patient treatment. The journal has published many seminal papers in our field; the most highly cited include clinical guidelines and reviews. These papers—together with the contributions of Editors Emeriti Joseph R. Bertino and George P. Canellos, numerous Associate Editors, and hundreds of volunteer Editorial Board members— have established JCO as one of the most highly regarded benefits of ASCO membership and as one of the highly respected medical journals in the world. JCO’s content is noteworthy, and support for the journal’s quality continues as the highest priority for ASCO. In turn, JCO revenues are a major contributor of funds to other ASCO programs. For many years, ASCO worked with a commercial publisher to support the JCO editors and the JCO program, which thrived as a scholarly publication.
GENDER-BASED CLINICAL OUTCOMES IN REAL-WORLD PATIENTS RECEIVING XIENCE V® EVEROLIMUS-ELUTING STENTS: ONE-YEAR RESULTS FROM THE XIENCE V USA STUDY
Authors: David R. Rutledge, Mitchell Krucoff, Vivian Mao, Weiying Zhao, Qing Zheng, Lalitha Jonnavithula, Sudhir Krishnankutty, James Hermiller, Abbott Vascular
Journal: Journal of the American College of Cardiology (2011)
Management of patients in persistent vegetative state. Economic arguments threaten all disabled people.
Authors: A Davis
Journal: BMJ (1993)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Management of patients in persistent vegetative state. Economic arguments threaten all disabled people. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome
Authors: Matthieu Schmidt, Elie Zogheib, Hadrien Rozé, Xavier Repesse, Guillaume Lebreton, Charles-Edouard Luyt, Jean-Louis Trouillet, Nicolas Bréchot, Ania Nieszkowska, Hervé Dupont, Alexandre Ouattara, Pascal Leprince, Jean Chastre, Alain Combes
Journal: Intensive Care Medicine (2013)
Prognostic value of the lymph node ratio in node positive colon cancer
Authors: M De Ridder, V Vinh-Hung, Y Van Nieuwenhove, A Hoorens, A Sermeus, G Storme
Journal: Gut (2006)

Concordance of OCT and brush cytology with the final diagnosis in patients with nonneoplastic strictures was 100% for both techniques; in the presence of a neoplastic MPD stricture, values were 100% and 66.7%, respectively.In conclusion this pilot study showed that OCT is feasible during ERCP, could distinguish a non-neoplastic from a neoplastic MPD wall with a diagnostic accuracy superior to brush cytology, but appeared to be unable to discriminate between a normal structure and chronic pancreatitis ductal changes.
Seroepidemiological survey of hepatitis E in Hong Kong by recombinant-based enzyme immunoassays
Authors: A.S.F. Lok, R.T. Chan, C.-L. Lai, H.T. Chung, W.-K. Kwan, T.S.T. Lai, R. Moeckli, P.O. Yarbough, G.R. Reyes
Journal: The Lancet (1992)
CASE OF ACUTE PANCREATITIS WITH FAT NECROSIS—OPERATION—RECOVERY.
Authors: WILLIAM J. MAYO
Journal: JAMA (1902)

J. C., male, aged 59, American, was admitted to St. Mary's Hospital on June 11, 1901, with the following history: For two years he had suffered from attacks of indigestion and at times had refrained from eating for twenty-four hours or more to obtain relief. While able to attend to his professional duties during this time, he lost 25 pounds in weight. On June 4, was suddenly seized with agonizing pain in the epigastrium, accompanied by marked symptoms of collapse, requiring anodynes and vigorous stimulation. Vomiting and retching were frequent. The abdomen became greatly distended and symptoms of acute obstruction of the bowels developed. June 5 and 6 the condition remained about the same, temperature ranging from 100 to 102, pulse from 96 to 120. Hiccough became most distressing. The bowels acted slightly as a result of purgation and enemata but without relief to the abdominal distention. Beginning on June
Acute Meningitis Caused by<i>Neisseria sicca</i>
Authors: Charlotte Bansmer, Jacob Brem
Journal: New England Journal of Medicine (1948)

THE gram-negative diplococci such as Neisseria catarrhalis and N. sicca, commonly found in the pharynx, rarely cause meningitis. However, upon occasions they have been proved to be the sole cause of the disease.1 2 3 4 5 6 7 8 9 10 The following case of meningitis due to N. sicca was proved by culture and serologic examination.§R. L., a 6 1/2-year-old boy, entered the hospital on January 20, 1947, with a history of sore throat, frontal headache, fever and vomiting of 24 hours' duration. The temperature had risen to 104°F., the headache had increased in severity and he had developed a stiff neck a few hours before . . .
Thallium-201 Myocardial Perfusion Imaging in Myocarditis
Authors: NAGARA TAMAKI, YOSHIHARU YONEKURA, KAZUNORI KADOTA, HIROFUMI KAMBARA, KANJI TORIZUKA
Journal: Clinical Nuclear Medicine (1985)

TI-201 myocardial perfusion imaging was performed in six patients with clinically documented myocarditis. Each case manifested electrocardiographic abnormalities with elevation of serum cardiac enzymes and no significant stenosis of the coronary arteries observed on angiogram. Resting TI-201 images were visually assessed by three observers. Focal perfusion defects were observed in three cases (50%), among which two showed multiple perfusion defects. Emission computed tomography using TI-201 clearly delineated multifocal lesions in the first case. On the other hand, no significant perfusion defects were noted in the remaining three cases. Thus, myocarditis should be considered as one of the disease entities that may produce perfusion defects on TI-201 myocardial imaging.
Risk Factors for Incident Peripheral Arterial Disease in Type 2 Diabetes: Results From the Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) Trial
Authors: Andrew D. Althouse, J. Dawn Abbott, Alan D. Forker, Marnie Bertolet, Emma Barinas-Mitchell, Rebecca C. Thurston, Suresh Mulukutla, Victor Aboyans, Maria Mori Brooks
Journal: Diabetes Care (2014)

OBJECTIVE The aim of this article was to define risk factors for incidence of peripheral arterial disease (PAD) in a large cohort of patients with type 2 diabetes mellitus (T2DM), overall and within the context of differing glycemic control strategies. RESEARCH DESIGN AND METHODS The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) randomized controlled trial assigned participants to insulin-sensitizing (IS) therapy versus insulin-providing (IP) therapy. A total of 1,479 participants with normal ankle-brachial index (ABI) at study entry were eligible for analysis. PAD outcomes included new ABI ≤0.9 with decrease at least 0.1 from baseline, lower extremity revascularization, or lower extremity amputation. Baseline risk factors within the overall cohort and time-varying risk factors within each assigned glycemic control arm were assessed using Cox proportional hazards models. RESULTS During an average 4.6 years of follow-up, 303 participants (20.5%) experienced an incident case of PAD. Age, sex, race, and baseline smoking status were all significantly associated with incident PAD in the BARI 2D cohort. Additional baseline risk factors included pulse pressure, HbA1c, and albumin-to-creatinine ratio (P &amp;lt; 0.05 for each). In stratified analyses of time-varying covariates, changes in BMI, LDL, HDL, systolic blood pressure, and pulse pressure were most predictive among IS patients, while change in HbA1c was most predictive among IP patients. CONCLUSIONS Among patients with T2DM, traditional cardiovascular risk factors were the main predictors of incident PAD cases. Stratified analyses showed different risk factors were predictive for patients treated with IS medications versus those treated with IP medications.