tbuckley/cabot-search huggingface dataset:
P72 In the Post Ultrasound Era, are Core Medical Trainees Struggling to get Experience in Chest Drain Insertion?
Authors: JL Connor, P Griffiths, M Gautam, A Youzguin
Journal: Thorax (2013)

<h3>Introduction</h3> In the UK, upon completion of Core Medical Training (CMT), procedural independence is expected for pneumothorax drains and is desirable for pleural effusions. In 2009, prompted by a National Patient Safety Agency report, a local guideline was introduced in our hospital aiming to reduce intercostal chest drain (ICD) complications for effusions by formalising training, increasing supervision and utilising bedside ultrasound scan (USS). Consequently, rates of adverse events have significantly been reduced. This raises the question, however, have such measures reduced the procedural exposure for CMT doctors. We aimed to compare the numbers of ICDs inserted by CMT doctors for effusions in 2008 and 2012. The numbers of ICDs inserted by CMTs for pneumothorax compared to effusion in 2012 was also examined. <h3>Methods</h3> All patients who received an ICD for effusion or pneumothorax in 2012 and for effusion in 2008 were retrospectively reviewed. We reviewed grade of doctor performing ICD insertion, supervision, and use of USS (for effusion). <h3>Results</h3> CMTs inserted significantly less ICDs for effusions in 2012 (10/30, 33%) compared to 2008 (20/39, 51%) z = 1.75, p = 0.04. Supervision rates increased from 73% in 2008 to 100% in 2012. Bedside USS was used in 100% of effusion-related ICDs in 2012 compared to 0% in 2008. In 2012 alone, CMTs inserted significantly fewer ICDs for pneumothorax (4/28, 14%) compared to effusions (10/30, 33%) z = -1.69, p = 0.046. A&amp;E doctors inserted the majority of ICDs for pneumothorax (15/28, 53%), whilst a Respiratory Registrar/Consultant inserted the majority of ICDs for effusions (13/30, 43%). <h3>Conclusions</h3> Since 2008, there has been a significant reduction in ICD insertions by CMTs. The majority of ICD insertions for pleural effusions being performed using USS by appropriately trained respiratory physicians may explain this. The significant fall in the number of ICD insertions by CMTs for pneumothorax (where USS guidance is not required) however, suggests that overall ICDs are becoming a specialist procedure rather than a generic competency. Trainees are at risk of not fulfilling their competency requirements and this poses the question should procedural training and curriculum objectives be readdressed in light of the growing need for USS experience.
A lower costly laparoscopic appendectomy: Our experience of more than 2000 cases
Authors: Ching-Shui Hsieh, Yao-Li Chen, Ming-Hsien Lee, Hung-Chi Chang, Shou-Tung Chen, Shou-Jen Kuo
Journal: International Journal of Surgery (2009)

Many authors emphasize the advantages of laparoscopic techniques in their experience, including the excellent cosmetic results, reduced postoperative pain, rapid functional recovery, lower incidence of adhesions, wound infections and believe that laparoscopic appendectomy is a reliable operation for treating acute appendicitis. Laparoscopic appendectomy has become a standard procedure in the treatment of acute appendicitis in our department since it was introduced in 2003. There are 414 patients underwent laparoscopic appendectomy and 37 patients underwent open appendectomy in our department in 2008. More than 2000 laparoscopic appendectomies were performed in our department during 2003-2009. However, open appendectomy is still the standard procedure in many Taiwan and worldwide hospitals. One of the reasons is that the operating costs incurred for laparoscopic appendectomy are higher than that of open appendectomy. We describe, herein, an access technique utilizing existing instrumentation that is reliable and easy.
Comparison of Menopausal Symptoms During the First Year of Adjuvant Therapy With Either Exemestane or Tamoxifen in Early Breast Cancer: Report of a Tamoxifen Exemestane Adjuvant Multicenter Trial Substudy
Authors: Stephen E. Jones, James Cantrell, Svetislava Vukelja, John Pippen, Joyce O'Shaughnessy, Joanne L. Blum, Robert Brooks, Nicole L. Hartung, Angel G. Negron, Donald A. Richards, Ragene Rivera, Frankie Ann Holmes, Sreeni Chittoor, Thomas L. Whittaker, James H. Bordelon, Steven J. Ketchel, Jennifer C. Davis, Des Ilegbodu, Jean Kochis, Lina Asmar
Journal: Journal of Clinical Oncology (2007)

Purpose Hormonal breast cancer treatment increases menopausal symptoms in women. This study investigated differences between the symptoms associated with either adjuvant tamoxifen or exemestane. Patients and Methods Ten common symptoms were assessed by self-report questionnaire administered to 1,614 consecutive patients at baseline and every 3 months during the first year of a double-blind, randomized trial of postmenopausal women with early hormone receptor–positive breast cancer. Symptoms were categorized as none, mild, moderate, or severe. A hot flash score was calculated at each time point. Symptoms were analyzed by repeated-measures analysis of variance. Each time period was tested repeatedly against the baseline; an overall P value was assigned for each reported symptom. Results Compliance was excellent, with 7,286 questionnaires analyzed. Baseline symptom prevalence ranged from 2% (vaginal bleeding) to 60% to 70% (bone/muscle aches and low energy). There were no significant differences in vaginal bleeding, mood alteration, or low energy. Patients receiving tamoxifen had significantly more vaginal discharge (P &lt; .0001). Exemestane patients reported more bone/muscle aches (P &lt; .0001), vaginal dryness (P = .0004), and difficulty sleeping (P = .03). In both groups, the hot flash score peaked at 3 months and decreased thereafter. At 12 months, patients receiving tamoxifen had a significantly higher mean hot flash score (P = .03), with daily hot flashes increasing from baseline by 33% compared with a 7% increase from baseline with exemestane. Conclusion At 12 months, exemestane was associated with fewer hot flashes and less vaginal discharge than tamoxifen, but with more vaginal dryness, bone/muscle aches, and difficulty sleeping. Symptoms were common in both groups.
Intralesional steroids reduce inflammation from extravasated chemotherapeutic agents
Authors: S.W. Whang, S.H. Lee, P.M. Elias, K.R. Feingold, E.H. Choi, S.K. Ahn
Journal: British Journal of Dermatology (2001)

Journal Article Intralesional steroids reduce inflammation from extravasated chemotherapeutic agents Get access S.W. Whang, S.W. Whang Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar S.H. Lee, S.H. Lee Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar P.M. Elias, P.M. Elias Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar K.R. Feingold, K.R. Feingold Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar E.H. Choi, E.H. Choi Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar S.K. Ahn S.K. Ahn Department of Dermatology, Yonsei University College of Medicine, Seoul, South Korea, *University of California, San Francisco, CA, U.S.A.†Yonsei University Wonju College of Medicine, Wonju, South Korea 220‐701 Correspondence: Sung Ku Ahn, MDE‐mail: ahnsk@yumc.yonsei.ac.kr Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 145, Issue 4, 1 October 2001, Pages 680–682, https://doi.org/10.1046/j.1365-2133.2001.04439.x Published: 01 October 2001
Randomized comparison of prophylactic and minimal residual disease-triggered imatinib after allogeneic stem cell transplantation for BCR–ABL1-positive acute lymphoblastic leukemia
Authors: H Pfeifer, B Wassmann, W Bethge, J Dengler, M Bornhäuser, M Stadler, D Beelen, V Vucinic, T Burmeister, M Stelljes, C Faul, P Dreger, A Kiani, K Schäfer-Eckart, R Schwerdtfeger, E Lange, B Kubuschok, H A Horst, M Gramatzki, P Brück, H Serve, D Hoelzer, N Gökbuget, O G Ottmann
Journal: Leukemia (2012)
Tetanus in the South at the Christmas Celebration.
Authors: R. Robinson
Journal: JAMA (1903)

San Antonio, Tex., Sept. 9, 1903. <h3>To the Editor:</h3> —Reading the editorial inThe Journal, August 29, giving the astounding number of the last Fourth of July tetanus cases, it occurred to me to call your attention to the fact that the number of tetanus victims of the blank cartridge will be much greater if you include those which result during the Christmas celebration in the south. On my arrival from the north to this city about four years ago I was pleasantly surprised to find how orderly and quietly the people here celebrate the Fourth of July. Not a single accident case was reported in the press; but my surprise was still greater when Christmas day came: Fire crackers, pistols and cannons were all brought into use in trying to make up for the Fourth of July. The celebration is in part kept up till after the New Year's
Cell pH in the rat proximal convoluted tubule. Regulation by luminal and peritubular pH and sodium concentration.
Authors: R J Alpern, M Chambers
Journal: Journal of Clinical Investigation (1986)

To examine the relative roles of apical and basolateral membrane transport mechanisms in the regulation of cell pH in the proximal convoluted tubule, cell pH was measured in the in vivo microperfused rat tubule using fluorescence. Decreasing luminal pH by 0.7 pH units caused cell pH to decrease by 0.08 pH units, whereas a similar decrease in peritubular pH caused cell pH to decrease by 0.32 pH units. Inhibition of basolateral membrane bicarbonate transport with peritubular 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonate (SITS) enhanced the response to luminal fluid acidification. Removal of luminal sodium caused a small transient acidification which was followed by a late alkalinization. Peritubular SITS increased the magnitude of the transient acidification, and eliminated the late alkalinization. The acidification was partially inhibited by luminal amiloride. The results demonstrate sodium-coupled processes on both the apical (Na/H antiport) and basolateral (Na/HCO3 symport) membranes. Basolateral membrane transporters are more important determinants of cell pH.
Experimental Cancer Research
Authors: F. J. C. Roe
Journal: BMJ (1967)

NUT=SHresults, the author found that the rheumatoid patients in this study did not have any kind of emotional trauma just prior to or at the onset of their disease, though 25% said they had lost someone close to them at the appearance of symptoms.He found that these patients became angry more easily and repressed their anger more than other emotions, but that there was no indication that they symbolically localize their conflicts in specific joints.As a result of his study the author suggests that history-taking of rheumatoid arthritics should include psychological, psychiatric, and psychosocial aspects, and that treatment and management should take notice of these factors.He finds that per- ceptive understanding and sympathetic listen- ing can be quite advantageous, and the patients' chronic!inhibited rage can be dealt with in a number of ways, "one of which is squarely facing the facts of the situation and verbalizing these facts to the patient and letting the patient verbalize his anger to the physician."
GMC asks doctors to take greater care over consent after law changes
Authors: Andrew Cole
Journal: BMJ (2008)

Patients who have confounded doctors with signs and symptoms that elude diagnosis are to be offered the expertise of hundreds of doctors in a unique programme from the US National Institutes of Health."Physicians deal with about 6600 conditions and 6000 of them are quite rare.Even common diseases have many subtypes," the institutes' director Elias A Zerhouni said during a telephone news conference with reporters earlier this week.He said it was not surprising that many can go undiagnosed for years.The programme aims to combine the revolution in tools and information at the molecular level with the expertise of the 1600 doctors at the NIH Clinical Center "to assist patients around the country and their doctors."It will add to the knowledge base by creating a phenotype atlas of disease."We are doing this now because of the advances that have been made over the last five years at the fundamental level.We have many more biologic markers, the significance of which is not always understood." Dr Zerhouni said that for the first time his organisation was going to apply these sophisticated laboratory tests to human diseases on a large scale.Under the current system of research at the NIH Clinical Center, patients with challenging conditions "are triaged to a specific institute or protocol programme, and are assessed by one team," said John I Gallin, director of the centre.Participants in the new programme "will be assessed by a large spectrum of teams."Candidate patients must be referred by a healthcare provider and will have to submit exhaustive medical records that will be reviewed by a multidisciplinary team of 25 senior doctors.Those who are accepted into the programme will travel to the centre for an evaluation, which is likely to take at least a week.Details are available at http://rarediseases.info.nih.gov/
Echocardiography diagnosis of ruptured aneurysm of sinus of Valsalva. Report of two cases.
Authors: M Matsumoto, H Matsuo, S Beppu, Y Yoshioka, Y Kawashima, Y Nimure, H Abe
Journal: Circulation (1976)

Echocardiographic features of two cases of ruptured congenital aneurysm of Valsalva sinus with (case1) and without (case 2) a supracristal ventricular defect were studied before and after surgery by standard echocardiography. M-mode scan and two-dimensional echocardiography. Discontinuity was observed in the echo from the aneurysm wall of the Valsalva sinus in case 1 with ruptured aneurysm, but was not observed in a similar case of unruptured aneurysm. Herniation of the right coronary cusp of the aortic valve into the right ventricular outflow tract was also observed in case 1. After surgical correction the echo from the aneurysm wall and from the herniated right coronary cusp of the aortic valve disappeared. Discontinuity in the echo from the anterior aortic wall and the interventricular septum also disappeared. In case 2, discontinuity in the echo from the anterior aortic wall, and tricuspid flutter with an abnormally low early diastolic peak were observed. These abnormalities disappeared after surgery. The ability of echocardiography to detect ruptured Valsalva aneurysm is discussed.
CONSTIPATION IN INFANTS.
Authors: J. ROSS SNYDER
Journal: JAMA (1904)

Complete digestion embraces a three-fold function—viz., conversion, absorption and evacuation. There is a conversion and an absorption of the nutrient element of food, and following these is an evacuation of the refuse. The successful performance of these several divisions of the digestive function is dependent on each other, on the character of food ingested, and on certain secretions and motions of the organs involved. If the food be of such character, or if it be so contaminated, that it over-stimulates secretions or exaggerates peristalsis, the lower bowel responds to the excitation and a diarrheal condition results. On the other hand, if the secretions are not properly elaborated or if the mechanical movements of the bowel are insufficient to propel the contents of the intestine along its canal, the products of ingestion will be retained beyond that period necessary for all purposes of conversion and of absorption. This constitutes constipation;
Quorum sensing in Staphylococcus infections
Authors: Jeremy M. Yarwood, Patrick M. Schlievert
Journal: Journal of Clinical Investigation (2003)

Quorum sensing via the accessory gene regulator (agr) system has been assigned a central role in the pathogenesis of staphylococci, particularly Staphylococcus aureus. While the control of virulence gene expression in vitro by agr has been relatively straightforward to describe, regulation of both the quorum response itself and virulence genes in vivo is considerably more complex. The quorum response is highly dependent upon the environment in which the organism is grown and is strongly influenced by additional regulators that respond to signals other than cell density. There is increasing evidence that the agr phenotype may influence the behavior and pathogenesis of biofilm-associated S. aureus and S. epidermidis and may contribute to the chronic nature of some biofilm-associated infections.
Altered influenza virus haemagglutinin (HA)-derived peptide is potent therapy for CIA by inducing Th1 to Th2 shift
Authors: Jian Sun, Yuan Jia, Ru Li, Jianping Guo, Xiaolin Sun, Yanying Liu, Yingni Li, Haihong Yao, Xia Liu, Jing Zhao, Zhanguo Li
Journal: Cellular and Molecular Immunology (2011)
Lymphokine activated killer (LAK) cells in patients with gastrointestinal cancer.
Authors: J R Monson, C W Ramsden, G R Giles, T G Brennan, P J Guillou
Journal: Gut (1987)

Lymphokine activated killer (LAK) cells are a recently described cellular immune phenomenon with exciting potential for the treatment of tumours arising from solid organs. A comparison of some aspects of LAK cell precursors and LAK cell function was undertaken in 44 control subjects and 44 preoperative patients suffering from gastrointestinal cancer (20 localised and 24 advanced). Lymphokine activated killer cell precursor (natural killer (NK) cell) activity was significantly diminished in patients with advanced tumours (p less than 0.02) as was fully mature LAK cell activity against an NK resistant target cell (p less than 0.012). T-lymphocyte responses were not significantly different between the three groups. The reduced LAK cell generation was associated with a significantly diminished proliferative response of LAK precursors to stimulation with high dose IL-2 in vitro (p less than 0.012). Impaired LAK cell generation may explain the failure of adoptive cellular immunotherapy with LAK cells in some patients with advanced gastrointestinal cancer and prompts the search for means of augmenting this activity in such patients.
MRI Changes During Water Loading in Patients With Polydipsia and Intermittent Hyponatremia
Authors: Robert A. Leadbetter, Michael S. Shutty, Jr., Ahmed M. Elkashef, Darrell G. Kirch, Thomas Spraggins, Wayne S. Cail, Houwei Wu, Robert M. Bilder, Jeffery A. Lieberman, Richard Jed Wyatt
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: Patients with polydipsia and intermittent hyponatremia have greater ventricle-brain ratios (VBRs) than matched patients without polydipsia and intermittent hyponatremia and normal subjects. Unlike previous studies, this study controlled for the impact of water loading when examining the volume of intracranial structures. METHOD: Under controlled conditions, eight male schizophrenic patients with polydipsia and intermittent hyponatremia were first assigned to either normal fluid intake or oral water loading and then the alternative condition the following day. Magnetic resonance imaging (MRI) volumetric measurements were made with the use of a standardized protocol. RESULTS: During water loading, total VBR and lateral ventricle volume significantly decreased by 13.1% and 12.6%, respectively. A strong association between change in serum sodium concentration and change in VBR was noted across conditions. CONCLUSIONS: These findings indicate that 1) water loading does not account for the diminished brain volume observed in patients with polydipsia and intermittent hyponatremia in previous studies, and 2) hyponatremia can significantly alter brain morphology on MRI.
Quantitative Assessment of Human Endometriotic Tissue Maintenance and Regression in a Noninvasive Mouse Model of Endometriosis
Authors: Marylène Fortin, Manon Lépine, Yannick Merlen, Isabelle Thibeault, Claudine Rancourt, Diane Gosselin, Patrice Hugo, Ann-Muriel Steff
Journal: Molecular Therapy (2004)

Endometriosis is a prevalent disease characterized by the estrogen-dependent ectopic growth of endometrial tissue. Most of the current medical therapies consist in inducing a hypoestrogenic state in patients, but these treatments are associated with severe side effects and high recurrence rates. The development of convenient and reliable endometriosis animal models would be instrumental to accelerate the emergence of new therapeutic alternatives. Recently, we developed an improved experimental model for endometriosis, relying on the infection of human endometrial fragments by an adenovirus carrying the green fluorescent protein. Following injection of fluorescent fragments into nude mice, the implantation and growth of endometriotic-like lesions could be followed noninvasively. In the present work, we demonstrate that this model can be used to quantify the size of fluorescent endometriotic lesions by in vivo imaging. To this end, we repeatedly measured lesion size over a 4-week period in mice supplemented or not with estradiol. The model was adequate to confirm previous results showing that estrogen is dispensable for the implantation phase of endometrial tissue, whereas it is required for lesion maintenance. As a proof of concept for inducing regression of established lesions, ganciclovir was used to treat animals implanted with human fluorescent endometrial fragments expressing thymidine kinase. A significant decrease in lesion size was observed by in vivo imaging in ganciclovir-treated mice. Together, the data indicate that the noninvasive animal model described here provides a tool for drug testing and/or gene target validation in endometriosis.