tbuckley/cabot-search huggingface dataset:
A degradable esophageal stent in the treatment of a corrosive esophageal stenosis in a child
Authors: Y. Vandenplas, B. Hauser, T. Devreker, D. Urbain, H. Reynaert
Journal: Endoscopy (2009)

A 10-year-old boy accidentally ingested drain cleaner (15 % NaOH solution; pH 12.5) from a bottle. He vomited and developed dysphagia and retrosternal pain. Endoscopy showed major circumferential ulcerations (grade IIb) [1]. Follow-up endoscopy after 4 weeks showed a stenosis at the mid esophagus, allowing passage of a neonatal endoscope (diameter 4.9 mm). A self-expandable, biodegradable SX-Ella esophageal stent (diameter 25 mm, length 80 mm; Ella-CS, s. r. o., Hradec Králové, Czech Republic) was inserted 6 weeks after the ingestion with the patient under anesthesia ([Fig. 1]). Retrosternal pain, dysphagia, and nausea occurred for a few days. About 10 days later, the boy became asymptomatic. During all this time, oral omeprazole (20 mg/day) was given. Further follow-up endoscopy after 3 weeks showed that the distal end of the stent had extended into the stomach ([Fig. 2]). About 12 weeks after insertion, the stent was 50 % degraded. At that time, the esophageal mucosa had healed. Although the patient remained symptom-free for 4 months, he developed a severe distal esophageal stenosis over 4 cm about 10 months after the initial ingestion and 6 months after the stent placement.
Comparison of Pioglitazone vs Glimepiride on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes
Authors: Steven E. Nissen, Stephen J. Nicholls, Kathy Wolski, Richard Nesto, Stuart Kupfer, Alfonso Perez, Horacio Jure, Robert De Larochellière, Cezar S. Staniloae, Kreton Mavromatis, Jacqueline Saw, Bo Hu, A. Michael Lincoff, E. Murat Tuzcu, for the PERISCOPE Investigators
Journal: JAMA (2008)

No antidiabetic regimen has demonstrated the ability to reduce progression of coronary atherosclerosis. Commonly used oral glucose-lowering agents include sulfonylureas, which are insulin secretagogues, and thiazolidinediones, which are insulin sensitizers.To compare the effects of an insulin sensitizer, pioglitazone, with an insulin secretagogue, glimepiride, on the progression of coronary atherosclerosis in patients with type 2 diabetes.Double-blind, randomized, multicenter trial at 97 academic and community hospitals in North and South America (enrollment August 2003-March 2006) in 543 patients with coronary disease and type 2 diabetes.A total of 543 patients underwent coronary intravascular ultrasonography and were randomized to receive glimepiride, 1 to 4 mg, or pioglitazone, 15 to 45 mg, for 18 months with titration to maximum dosage, if tolerated. Atherosclerosis progression was measured by repeat intravascular ultrasonography examination in 360 patients at study completion.Change in percent atheroma volume (PAV) from baseline to study completion.Least squares mean PAV increased 0.73% (95% CI, 0.33% to 1.12%) with glimepiride and decreased 0.16% (95% CI, -0.57% to 0.25%) with pioglitazone(P = .002). An alternative analysis imputing values for noncompleters based on baseline characteristics showed an increase in PAV of 0.64% (95% CI, 0.23% to 1.05%) for glimepiride and a decrease of 0.06% (-0.47% to 0.35%) for pioglitazone (between-group P = .02). Mean (SD) baseline HbA(1c) levels were 7.4% (1.0%) in both groups and declined during treatment an average 0.55% (95% CI, -0.68% to -0.42%) with pioglitazone and 0.36% (95% CI, -0.48% to -0.24%) with glimepiride (between-group P = .03). In the pioglitazone group, compared with glimepiride, high-density lipoprotein levels increased 5.7 mg/dL (95% CI, 4.4 to 7.0 mg/dL; 16.0%) vs 0.9 mg/dL (95% CI, -0.3 to 2.1 mg/dL; 4.1%), and median triglyceride levels decreased 16.3 mg/dL (95% CI, -27.7 to -11.0 mg/dL; 15.3%) vs an increase of 3.3 mg/dL (95% CI, -10.7 to 11.7 mg/dL; 0.6%) (P < .001 for both comparisons). Median fasting insulin levels decreased with pioglitazone and increased with glimepiride (P < .001). Hypoglycemia was more common in the glimepiride group and edema, fractures, and decreased hemoglobin levels occurred more frequently in the pioglitazone group.In patients with type 2 diabetes and coronary artery disease, treatment with pioglitazone resulted in a significantly lower rate of progression of coronary atherosclerosis compared with glimepiride.clinicaltrials.gov Identifier: NCT00225277.
A POINT OF VIEW AS TO THE NATURE OF SCHIZOPHRENIA
Authors: NATHAN S. KLINE
Journal: American Journal of Psychiatry (1957)

1. Traditional approaches to the problem of schizophrenia have made various theoretical and operational assumptions, six of which are reviewed and criticized. 2. An approach is proposed which offers certain advantages such as empirical verifiability. 3. Speculation as to the nature of schizophrenia is given within this general framework.
An injectable thiol-acrylate poly(ethylene glycol) hydrogel for sustained release of methylprednisolone sodium succinate
Authors: Christopher D. Pritchard, Timothy M. O’Shea, Daniel J. Siegwart, Eliezer Calo, Daniel G. Anderson, Francis M. Reynolds, John A. Thomas, Jonathan R. Slotkin, Eric J. Woodard, Robert Langer
Journal: Biomaterials (2010)
Lack of effect of prior training on subsequent ischaemic and infarcting myocardium and collateral development in dogs with normal hearts
Authors: M. V COHEN, R. M STEINGART
Journal: Cardiovascular Research (1987)

To determine whether exercise training in animals with normal coronary arteries has a salutary effect on ischaemic myocardium, 24 dogs were randomly assigned to be either trained or confined to cages for three months. All dogs then underwent left thoracotomy for placement of indwelling right and left atrial and aortic catheters and a loose snare ligature around the proximal left circumflex coronary artery. Three days after operation control scintigrams were recorded after injection of thallous chloride-201 in animals running on a treadmill to achieve exercise heart rates of 220 beats.min-1. Four days later the snares were pulled to occlude the left circumflex artery and infarct size determined by measuring venous activity of creatine phosphokinase. Three days after infarction the first post-ligation scintigram was performed after thallium-201 injection in exercising animals. Exercise scans were repeated at 10 days and 2, 4, and 6 weeks after coronary ligation. During the final exercise study collateral blood flow was measured with radioactive microspheres. There was no difference in mean creatine phosphokinase appearance time, peak creatine phosphokinase activity, or measured infarct size between the trained and sedentary dogs. The ratio of thallium-201 activity in left circumflex artery or ischaemic area to left anterior descending artery or normally perfused myocardium fell from 100% before occlusion to 86.6% in the sedentary animals and 80.6% in the trained dogs three days after coronary ligation. Although these falls were significant (p less than 0.025 and p less than 0.005 respectively), there was no difference between groups. Over the next five and a half weeks the scintigraphic defect shrank as the thallium-201 ratio gradually increased, but changes were again similar in both groups. At six weeks there was little difference in exercise collateral flow to left circumflex artery myocardium and flow to normal myocardial tissue in cage confined and trained dogs. Therefore, no beneficial effect of exercise training in dogs with normal hearts could be seen on ischaemic or infarcting myocardium or coronary collateral development after coronary ligation.
Intraoperative Death Associated with Acrylic Bone Cement
Authors: Edith R. Kepes
Journal: JAMA (1972)

Two cases of sudden death occurred during the insertion of hip prostheses with the use of methyl methacrylate polymer as bone cement. In one case in which an autopsy was performed, widespread marrow emboli were found. Hypotension was also an additional factor in cardiopulmonary collapse.
MICROANGIOPATHIC HÆMOLYTIC ANÆMIA AND THE PATHOGENESIS OF MALIGNANT HYPERTENSION
Authors: A.L. Linton, H.E. Hutchison, H. Gavras, D.H. Lawson, R.I. Gleadle, A.F. Lever, R.F. Macadam, G.P. Mcnicol, J.I.S. Robertson
Journal: The Lancet (1969)
The High Price of Product Endorsement
Authors: Jerome P. Kassirer, Marcia Angell
Journal: New England Journal of Medicine (1997)

The National Hardware Show was the site chosen for a joint news conference between a spokesperson for the American Medical Association (AMA) and the chief executive officer of the Sunbeam Corporation of Delray Beach, Florida. In their first-ever such arrangement with a commercial enterprise, the AMA had agreed to an exclusive endorsement of nine Sunbeam products, including scales, air cleaners, massagers, thermometers, vaporizers, and humidifiers. In exchange for the use of the AMA name and logo on these Sunbeam products and in advertisements, the medical organization would receive an undisclosed royalty for each item sold, and health information would be . . .
Managed Care Ethics
Authors: Victor Gurewich
Journal: Annals of Internal Medicine (1998)

Letters15 October 1998Managed Care EthicsVictor Gurewich, MDVictor Gurewich, MDHarvard Medical School; Cambridge, MA 02138Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their lengthy article, Hall and Berenson [1] attempt to provide “a realistic set of ethical principles” for physicians. It is a vain attempt. A system that seeks to influence treatment decisions by holding a physician's livelihood hostage is fundamentally unethical, no matter how strong “a dose of realism” or rationalization is applied.The authors state that bedside rationing is preferable to “centralized, role-based rationing,” but this is precisely not the case. At the bedside, the physician's time-honored and essential role is to be nothing else than the patient's advocate. Anything that compromises this must be repudiated. ...References1. Hall MA, Berenson RA. Ethical practice in managed care: a dose of realism. Ann Intern Med. 1998; 128:395-402. Google Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School; Cambridge, MA 02138 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1998Volume 129, Issue 8Page: 672-673KeywordsMotivationPatient advocacy Issue Published: 15 October 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 2573: Carnosol and carnosic acid, from rosemary, promote endoplasmic reticulum stress and androgen receptor degradation in prostate cancer cells
Authors: Sakina M. Petiwala, Gongbo Li, Jeremy J. Johnson
Journal: Cancer Research (2012)

Abstract Background: Prostate cancer is one of the most prevalent forms of cancer among men, especially in the United States. Previously, we have shown that carnosol, a dietary diterpene from rosemary (Rosmarinus officinalis), has a unique function in that it is a dual disruptor of androgen and estrogen receptor alpha. Herein, we examined how carnosol and another dietary diterpene from rosemary, carnosic acid, promote endoplasmic reticulum (ER) stress and modulate the activity and expression of androgen receptor (AR). Materials and Methods: Experiments were performed using the prostate cancer cell lines 22Rv1 and LNCaP cells. Cell proliferation and cell viability were studied using BrdU and MTT assay respectively. Western blotting, ELISA and siRNA were used to evaluate the relationship between ER stress and androgen receptor degradation. Results: Both, carnosic acid and carnosol, inhibited growth and decreased the cell viability of 22Rv1 and LNCaP cells in a dose-dependent manner. The anti-proliferative effect was associated with apoptosis as evidenced by a significant increase in levels of cleaved caspase-3 protein. Interestingly, these diterpenes modulated proteins associated with ER stress including BiP, IRE1 and CHOP. Furthermore, we saw a dose-dependent decrease in expression of AR in 22Rv1 and LNCaP cells when treated with either carnosol or carnosic acid. The proteasome has been shown to be regulated by multiple proteins including proteins associated with ER stress. The AR expression increased in presence of proteasome inhibitor, MG-132, suggesting that decrease in AR expression was due to proteasomal degradation. Carnosic acid and carnosol, also showed a decrease in expression of prostate-specific antigen (PSA) levels in a dose-dependent manner. Conclusion: Both, carnosic acid and carnosol, induce ER stress-mediated apoptotic cell death in prostate cancer cell lines, 22Rv1and LNCaP cells, leading to disruption of AR expression. Our data suggests that these natural diterpenes possess strong anticancer activity and should be evaluated further as potential chemopreventive and/or chemotherapeutic agents for controlling prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2573. doi:1538-7445.AM2012-2573
Comparative study of carcinoembryonic antigen and epithelial membrane antigen expression in normal colon, adenomas and adenocarcinomas of the colon and rectum.
Authors: B R Davidson, V R Sams, J Styles, C Dean, P B Boulos
Journal: Gut (1989)

The heterogeneous nature of tumour antigen expression may require selection of monoclonal antibodies on an individual patient or tumour basis to allow adequate tumour localisation.Carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) expression has not previously been compared in colorectal cancer patients.Sections of cancer (n=52), adjacent normal colon (n=45), synchronous adenomas (n= 11) and nodal metastases (n=49) were examined by indirect immunoperoxidase staining in 51 consecutive patients with colorectal cancer using monoclonal antibodies to CEA and EMA.The percentage of cells with positive staining in the primary tumours was graded 1:<25%, 2: 25-49%, 3: 50-75%, 4>75%.All primary colorectal cancers expressed CEA and 43 of 52 expressed EMA (83%).Grading showed CEA greater than EMA in 39, equal in 11 and less in two.Well differentiated cancers were more frequently graded three or four for CEA staining (23 of 27) than moderately differentiated cancers (11 of 22) (p<0.01).Equivalent figures for EMA were four of 27 and three of 22 (not significant) (NS) although the majority (86%) were graded 1 and 2. Grade 1 CEA expression was found in six of 15 proximal and only two of 37 distal lesions (p<0-01, X2 test) while for EMA equivalent figures were three of 15 and six of 37 (NS).Nodal deposits all expressed CEA and 45 of 49 expressed EMA (92%); 29 of 45 normal colon sections showed CEA expression (64%) as did all adenomas.EMA was not expressed by normal colon or adenomas.These results suggest that EMA expression is more specific but less sensitive than CEA for colonic cancer and is independent of tumour differentiation and site.Thus selecting monoclonal antibodies to CEA or EMA based on tumour biopsies may allow improved tumour localisation for imaging or therapy in patients with colorectal cancer.Carcinoembryonic antigen (CEA) and epithelial localisation"7 and have potential for drug, radio- membrane antigen (EMA) are both expressed by isotope or toxin conjugated therapy.`'colorectal cancers.'2Monoclonal antibodies to theseThe heterogenous nature of tumour antigen tumour associated antigens may have a role in expression, however, may necessitate the use of diagnostic immunohistochemistry,34 in localisation more than one antibody whether used for diagnosis of tumours and their metastases by radioimmuno-or therapy."In a previous study we have shown CEA and EMA expression in colorectal cancers and shown
Reform of undergraduate medical teaching in the United Kingdom: “Problem based learning” <i>v</i> “traditional” is a false debate
Authors: Joshua D R Payne
Journal: BMJ (2004)

Governance of academic medicine should be with public trusteesEditor-Many of the problems arising in academic medicine are due to the divergence of academic goals and the values of society.Academic institutions are not currently governed in a way that fosters a strong and healthy alliance with government and the population at large, and there is a failure to support satisfactorily the public interest against vested and other competing interests. 1e suggest that a good first step is to turn over the governance of academic medicine to public trustees with protected authority.Public trustees must ensure that the three familiar goals of research, teaching, and patient care are supplemented by the unsung fourth goal of community service.Moreover, trustees have the right to insist that most of the research and teaching programmes in academic medicine be placed in the context of the health needs of the entire population.It is also time to reform the governance of medical schools.We suggest that it fosters tunnel vision for the dean when the executive committee of the medical school is composed primarily of department chairpeople whose main responsibility is the welfare of individual departments, not the mission of the school as a whole.We advocate instead an executive committee comprising senior faculty and public representatives, while excluding department heads.If academic medicine exists to promote the public interest, is it not time to grant patients and the public at large a controlling interest in setting priorities and overseeing operations?
LINEAR GROWTH FAILURE IS ASSOCIATED WITH WORSE NEURODEVELOPMENTAL OUTCOME IN INFANTS WITH SINGLE VENTRICLE PHYSIOLOGY
Authors: Chitra Ravishankar, Victor Zak, David Bellinger, Amanda Cook, J. William Gaynor, Nancy Ghanayem, Catherine Krawczeski, Daniel J. Licht, Lynn Mahony, Jane Newburger, Victoria Pemberton, Teresa Atz, Svetlana Khaikin, Renee Sananes, Ismee A. Williams, Richard V. Williams, Daphne Hsu
Journal: Journal of the American College of Cardiology (2011)
Interstitial collagenase (matrix metalloproteinase-1) expresses serpinase activity.
Authors: P E Desrochers, J J Jeffrey, S J Weiss
Journal: Journal of Clinical Investigation (1991)

Human endothelial cells treated with either interleukin-1 beta, tumor necrosis factor-alpha, or phorbol myristate acetate secreted a metalloproteinase that hydrolyzed and inactivated the two major serine proteinase inhibitors (Serpins) found in plasma, alpha 1-proteinase inhibitor and alpha 1-antichymotrypsin. Surprisingly, the responsible metalloproteinase was identified as human interstitial collagenase (matrix metalloproteinase-1), an enzyme whose only known physiologic substrate has heretofore been believed to be the extracellular matrix molecule, collagen. The metalloproteinase inactivated the Serpins by cleaving peptide bonds at sites unrelated to those hydrolyzed in collagenous macromolecules. NH2-terminal sequence analysis localized the cleavage sites in the Serpins to regions near their respective reactive site centers at three distinct peptide bonds on the amino-terminal side of bulky, hydrophobic residues. Together, these data indicate that matrix metalloproteinase-1 displays an expanded substrate repertoire that supports the existence of a new interface between connective tissue turnover and Serpin function.
Multiparameter flow cytometry as a tool to evaluate antipsoriatic therapy
Authors: C.P. GLADE, P.E.J. VAN ERP, J.B.M. BOEZEMAN, P.C.M. VAN DE KERKHOF
Journal: British Journal of Dermatology (1997)

Objective comparison of different antipsoriatic therapies requires quantitative assessment of disease severity. However, clinical assessment with the widely used Psoriasis Area and Severity Index (PASI) introduces inaccuracy. An alternative is the quantitative analysis of different epidermal cell parameters using multiparameter flow cytometry. Our aim in the present study was to compare the clinical and flow cytometric approach to monitor disease activity and to evaluate antipsoriatic efficacy. Clinical scores for erythema, induration and scaling were assessed and biopsies for flow cytometric analysis were obtained from the psoriatic plaques of 89 patients before and after treatment with different therapeutic regimens consisting of vitamin D3 analogues and corticosteroids. In total, 219 epidermal cell suspensions were analysed using triple-labelling, with the simultaneous staining of markers for epidermal proliferation (DNA dye TO-PRO-3), differentiation (antikeratin 10), and inflammation (antivimentin). Correlation analysis was performed on 166 paired values obtained from 83 patients. A highly significant correlation was observed between erythema and the percentage of vimentin-positive cells, between scaling and the percentage of keratin 10 positive keratinocytes, and between induration and the number of basal keratinocytes in the S- and G2M phase, when all 166 biopsies were assessed. The correlation remained in the same range if the analysis was restricted to the 83 pretreatment biopsies. In contrast to the clinical scores, the flow cytometric analysis permitted a clear separation between the antiproliferative and anti-inflammatory or keratinization-enhancing effects of antipsoriatic treatment. The vitamin D3 analogues proved to exert a mainly antiproliferative effect. The combination of calcipotriol and a topical corticosteroid improved all cell biological markers substantially, and clobetasol monotherapy had a powerful effect on these markers. In conclusion, multiparameter flow cytometry has been shown to be a sensitive tool to evaluate the growth inhibiting, anti-inflammatory and keratinization-enhancing effects of antipsoriatic therapies.
Agranulocytosis From Cephalosporins
Authors: Sherman Jay Silber
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Rare reports have associated neutropenia with prolonged administration of cephalothin.<sup>1</sup>We have recently had a patient with agranulocytosis caused by relatively low doses of cephalosporin antibiotics. <h3>Report of a Case.—</h3> A 44-year-old man had difficulty voiding and symptoms of myxedema. Results of the physical examination revealed typical signs of hypothyroidism. There were no palpable lymph nodes or other abnormalities. His hematocrit reading was 45% and white blood cell (WBC) count was 7,700/cu mm with a normal differential. Urinalysis showed no protein, sugar, bacteria, or cells. Radioactive iodine uptake and serum thyroxine content were well below normal. Serum cholesterol level was 359 mg/100 ml; blood urea nitrogen level, 15 mg/100 ml; and the creatinine level was 1.3 mg/100 ml. Chest roentgenogram was normal, and the electrocardiogram showed T-wave flattening. He was treated with desiccated thyroid starting at 0.16 mg/day. A week after admission he developed a dental