tbuckley/cabot-search huggingface dataset:
Improved Myocardial Function during Exercise after Successful Percutaneous Transluminal Coronary Angioplasty
Authors: Kenneth M. Kent, Robert O. Bonow, Douglas R. Rosing, Carolyn J. Ewels, Lewis C. Lipson, Charles L. McIntosh, Stephen Bacharach, Michael Green, Stephen E. Epstein
Journal: New England Journal of Medicine (1982)

Fifty-nine consecutive patients with coronary-artery disease undergoing percutaneous transluminal coronary angioplasty were evaluated with radionuclide ventriculography at rest and during exercise before angioplasty (when possible) and afterward, when it was successful. Thirty-eight patients (64 per cent) had an angiographically successful procedure. Three (5 per cent) had coronary occlusion as a complication. Arterial stenosis was reduced from 74±2 per cent to 31 ±3 per cent (mean ±S.E.M.). The mean ejection fraction was 55±2 per cent at rest and 51±3 per cent during exercise before the procedure. After successful angioplasty, the ejection fraction was unchanged at rest but increased to 62±2 per cent (P<0.001) during exercise. Regional dysfunction was present during exercise in 94 per cent of the patients before the procedure and in only 8 per cent after successful angioplasty. Of the 38 patients in whom the procedure was successful, 19 had sustained improvement for over six months, and eight for three to six months. Eleven patients had recurrence of symptoms; the second angioplasty was initially successful in nine. In 24 patients remaining asymptomatic for six months (19 after the first procedure and five after the second), the left ventricular ejection fraction during exercise remained stable or improved. (N Engl J Med. 1982; 306:441–6.)
Fatal pancreatitis after endoscopic balloon dilation for extraction of common bile duct stones in an 80-year-old woman
Authors: J. García-Cano
Journal: Endoscopy (2007)

Some studies have reported that endoscopic balloon dilation (EBD) for extracting common bile duct stones is associated with higher complication rates in comparison with endoscopic sphincterotomy (EST) [1], although EBD has been found to be a safe method in other reports [2] [3]. However, it appears that EBD should be used with extreme caution in patients aged 50 years or younger [4], since in relatively young and healthy patients, the technique has been associated with increased rates of pancreatitis, leading even to death [5]. In this group of patients, the complication rate with EBD appears to be higher than with endoscopic biliary sphincterotomy. The morbidity associated with EBD is presumed to be due to edema or spasm caused by the trauma of dilation, which can lead to transient obstruction of the pancreatic duct and trigger the inflammation cascade of pancreatitis. This effect may be more pronounced in young patients, while older ones may have a less severe inflammatory response [6].
Diet-induced obese mice develop peripheral, but not central, resistance to leptin.
Authors: M Van Heek, D S Compton, C F France, R P Tedesco, A B Fawzi, M P Graziano, E J Sybertz, C D Strader, H R Davis
Journal: Journal of Clinical Investigation (1997)

Leptin administration reduces obesity in leptin-deficient ob/ob mice; its effects in obese humans, who have high circulating leptin levels, remain to be determined. This longitudinal study was designed to determine whether diet-induced obesity in mice produces resistance to peripheral and/or central leptin treatment. Obesity was induced in two strains of mice by exposure to a 45% fat diet. Serum leptin increased in proportion to body weight (P < 0.00001). Whereas C57BL/6 mice initially responded to peripherally administered leptin with a marked decrease in food intake, leptin resistance developed after 16 d on high fat diet; mice on 10% fat diet retained leptin sensitivity. In AKR mice, peripheral leptin significantly decreased food intake in both 10 and 45% fat-fed mice after 16 d of dietary treatment. However, after 56 d, both groups became resistant to peripherally administered leptin. Central administration of leptin to peripherally leptin-resistant AKR mice on 45% fat diet resulted in a robust response to leptin, with a dose-dependent decrease in food intake (P < 0.00001) and body weight (P < 0.0001) after a single intracerebroventricular infusion. These data demonstrate that, in a diet-induced obesity model, mice exhibit resistance to peripherally administered leptin, while retaining sensitivity to centrally administered leptin.
Antidepressant prescribing and suicide: Analysis is misleading
Authors: J. Moncrieff
Journal: BMJ (2003)

EDITOR—Hall et al's data on suicide rates and antidepressant prescribing contradict their own conclusions.1 The conventional and intuitive way of analysing trends in rates of antidepressant use by age group would be to look at ratios of rates of use in 1998-2001 and 1990-1.



Data on bmj.com show that rates increased 7.5 times for men aged 25-34 and 2.1 times for men …
Dapsone-induced agranulocytosis: spontaneous reporting data
Authors: E.M. Cockburn, S.M. Wood, P.C. Waller, S.S. Bleehen
Journal: British Journal of Dermatology (1993)

Journal Article Dapsone‐induced agranulocytosis: spontaneous reporting data Get access E.M. Cockburn, E.M. Cockburn Medicines Control Agency, 1 Nine Elms Lane, Vauxhall, London SW8 5NQ U.K. Search for other works by this author on: Oxford Academic Google Scholar S.M. Wood, S.M. Wood Medicines Control Agency, 1 Nine Elms Lane, Vauxhall, London SW8 5NQ U.K. Search for other works by this author on: Oxford Academic Google Scholar P.C. Waller, P.C. Waller Medicines Control Agency, 1 Nine Elms Lane, Vauxhall, London SW8 5NQ U.K. Search for other works by this author on: Oxford Academic Google Scholar S.S. Bleehen S.S. Bleehen Committee on Safety of Medicines, 1 Nine Elms Lane, Vauxhall, London SW8 5NQ U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 128, Issue 6, 1 June 1993, Pages 702–703, https://doi.org/10.1111/j.1365-2133.1993.tb00272.x Published: 01 June 1993
Absorption of hemoglobin iron: the role of a heme-splitting substance in the intestinal mucosa
Authors: Lewis R. Weintraub, Morton B. Weinstein, Hans-Jurg Huser, Sheila Rafal
Journal: Journal of Clinical Investigation (1968)

The dog behaves like man in his ability to utilize dietary hemoglobin iron and, therefore, is an excellent model in which to study the mechanisms of absorption. Heme is taken up intact into the epithelial cell of the small intestine but the iron appears in the plasma in a nonheme form. A substance is present in mucosal homogenates which is capable of releasing iron from a hemoglobin substrate in vitro. This has a molecular weight greater than 64,000, and appears to behave as an enzyme. There is no difference in the in vitro, effective concentration of the hemesplitting substance in the mucosa of iron-loaded and iron-deficient dogs to explain in vivo changes in iron absorption. However, the rate at which the heme-splitting substance works in vivo appears to be increased by the removal of the nonheme-iron-end product from the epithelial cell to the plasma. Reduction of the heme-iron content within the epithelial cell may then enhance uptake from the lumen. These studies suggest that the labile nonheme-iron content of the intestinal epithelial cell determines its ability to accept heme as well as ionized iron from the lumen.
Elevated Cholesterol and Bile Acid Synthesis in a Young Patient with Homozygous Familial Hypercholesterolemia
Authors: Kathleen B. Schwarz, Joseph Witztum, Gustav Schonfeld, Scott M. Grundy, William E. Connor
Journal: Journal of Clinical Investigation (1979)

Cholesterol balance studies were carried out twice in a young male patient with homozygous familial hypercholesterolemia. At 13 mo, cholesterol balance in this patient averaged 31.3 mg/kg per d, and bile acid excretion was 12.0 mg/kg per d; at 3 yr, results were similar, 27.3 and 15.5 mg/kg per d for cholesterol balance and bile acids, respectively. A normal boy of 3 yr was also studied for comparison with the second study in our patient. Cholesterol balance and bile acid outputs in the normal child were 11.5 and 3.3 mg/kg per d, respectively. Thus, in comparison with the normal child, the patient with homozygous familial hypercholesterolemia had a marked increase in synthesis of cholesterol and bile acids. Although synthesis of bile acids was high in this patient, the fraction of newly synthesized cholesterol converted into bile acids (40-56%) was in the normal range; this suggests that the enhanced output of bile acids was secondary to an increased synthesis of cholesterol and not to malabsorption of bile acids, which likely would have produced a higher fractional conversion. Although our patient has been studied at a younger age than any reported in the literature, two similar children 5 and 6 yr of age were also observed to have elevated cholesterol synthesis. This finding contrasts with those in older children with the homozygous as well as heterozygous forms of this disease who appear to have normal synthesis of cholesterol and bile acids. Therefore, increased synthesis of cholesterol seems to be characteristic of early homozygous familial hypercholesterolemia, and may be a manifestation of a loss of feedback inhibition of cholesterol synthesis secondary to an absence of specific cell-surface receptors for low density lipoproteins. However, as children with this disease grow older, other mechanisms may come into play to restore cholesterol synthesis to normal levels.
Medicine for Mountaineering
Authors: Charles G. Roland
Journal: JAMA (1968)

The victim of a mountaineering accident is usually hours, and often days, from definitive medical care. Therefore, the authors of this book attempt to provide enough medical knowledge for a layman to diagnose and treat injuries and medical emergencies so that a victim can survive the strain of evacuation. I think the authors have succeeded beyond all reasonable expectations. They have generally avoided the twin dangers of "too simple" and "too complicated." Discussing hemorrhage, they quite rightly advise against the use of pressure points and tourniquet. The recommendations for management of flail chest and of frostbite are models of excellent counsel which, if followed carefully, should permit more long-term survivals from flail chest and fewer, less extensive, amputations after frostbite. Some sections deserve reconsideration and rewriting for a second edition. Particularly disturbing is the implication that a sleeping bag is as useful as a warm stove in treating a patient
Physical Activity and Risk of Gastrointestinal Hemorrhage in the Elderly
Authors: Stephen D. Phinney
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Dr Pahor and colleagues<sup>1</sup>report the intriguing association between habitual physical activity and reduced gastrointestinal hemorrhage (GIH) and discuss the potential for a direct causal relationship. An alternate possibility is an underlying causal factor common to both. A potential common factor is a reduced proportion of arachidonic acid in membranes of the gastrointestinal mucosa and muscles. Membrane arachidonate is the substrate for mucosa-protective prostaglandins, and reduced muscle membrane arachidonate is associated with insulin resistance (ie, reduced enpheral glucose disposal).<sup>2</sup>Insulin resistance results in reduced muscle glycogen deposition, and the level of muscle glycogen correlates with improved endurance performance.<sup>3</sup>Thus, it is possible that the elderly, for whom walking may represent a high level of endurance performance, choose to exercise because membrane composition enables them to do so, and the same membrane composition protects against ulceration. We have reported considerable variability in phospholipid arachidonate among
Detection of Merkel cell polyomavirus in cutaneous squamous cell carcinoma before occurrence of Merkel cell carcinoma
Authors: Kana Kaibuchi-Noda, Kenji Yokota, Takaaki Matsumoto, Masaki Sawada, Akihiro Sakakibara, Michihiro Kono, Yasushi Tomita, Daisuke Watanabe, Hitomi Fukumoto, Harutaka Katano, Masashi Akiyama
Journal: Journal of the American Academy of Dermatology (2011)
Book Review Tuskegee's Truths: Rethinking the Tuskegee Syphilis Study Edited by Susan M. Reverby. 630 pp., illustrated. Chapel Hill, University of North Carolina Press, 2000. $27.50 (paper); $69.95 (cloth). 0-8078-4852-2 (paper); 0-8078-2539-5 (cloth).
Authors: Nancy Jecker
Journal: New England Journal of Medicine (2000)
The Complex Relationship between BRCA1 and ERα in Hereditary Breast Cancer
Authors: Julia J. Gorski, Richard D. Kennedy, Alison M. Hosey, D. Paul Harkin
Journal: Clinical Cancer Research (2009)

Breast cancer 1 (BRCA1) was initially identified as one of the genes conferring genetic predisposition to both breast and ovarian cancer. One of the interesting aspects of BRCA1-linked cancers is the observed specificity for estrogen-responsive tissues such as breast and ovary. Recent advances in our understanding of BRCA1-linked breast cancers have revealed a complex relationship between BRCA1 and estrogen receptor alpha (ERalpha) signaling. Estrogen stimulation increases expression of BRCA1 at the mRNA and protein level and conversely BRCA1 functions to both induce ERalpha mRNA expression and act as a negative regulator of ERalpha signaling. Here, we review the relationship between BRCA1 and ERalpha and discuss the use of antiestrogen therapies such as tamoxifen and aromatase inhibitors in the treatment of BRCA1 mutation carriers.
Investigation Results in Disciplinary Action Against Researchers, Retraction of Articles
Authors: Jody W. Zylke
Journal: JAMA (1989)

QUESTIONABLE ETHICAL practices seem to infect many sectors of society, with the current antidote being to get rid of the offender. Congress sweeps out its own speaker of the house. Wall Street executives are prosecuted. And the scientific community investigates its researchers. In the latter category, inquiry into a controversial case has just been completed by the National Institute of Mental Health (NIMH), Rockville, Md, resulting in disciplinary action against two researchers and the retraction of a number of papers, two in American Medical Association journals. The saga began in the summer of 1986, when Stanford (Calif) University received a formal complaint about possible fiscal and professional misconduct on the part of the director of its Mental Health Clinical Research Center (MHCRC), Philip Berger, MD. Berger was also the principal investigator for the NIMH grant that funded the center. A university investigation found not only that money had been improperly
CGA Gene (Coding for the α Subunit of Glycoprotein Hormones) Overexpression in ERα-Positive Prostate Tumors
Authors: Ivan Bièche, Alain Latil, Béatrice Parfait, Dominique Vidaud, Ingrid Laurendeau, Rosette Lidereau, Olivier Cussenot, Michel Vidaud
Journal: European Urology (2002)
Tracheobronchomegaly: an unusual presentation of a rare condition.
Authors: D L Smith, N Withers, B Holloway, J V Collins
Journal: Thorax (1994)

Tracheobronchomegaly is a rare cause of recurrent chest infections often with persistent, unproductive cough. A case is described which presented as a severe life threatening pneumonia in which the bronchoscopic, radiographic, and computed tomographic findings are given.
Arterial Wall Potassium in Renal Hypertensive Rats
Authors: S. CHARLES FREED, SHIRLEY ST. GEORGE, RAY H. ROSENMAN
Journal: Circulation Research (1959)

An elevation of potassium content of the aorta is found in renal hypertensive rats. Reduction of hypertension by potassium deprivation is followed by a proportional decrease in the aorta potassium content. Restoration of hypertension in such rats by cortisone administration is associated with a return of the aorta potassium content to the previous elevated levels. It is suggested that the potassium content of the arteries influences arterial tone and, by altering peripheral vascular resistance, may be a significant factor in blood pressure regulation.
The Exposure of Health Care Workers to Ribavirin Aerosol
Authors: John S. Bradley
Journal: JAMA (1989)

To the Editor. —  We differ with an opinion expressed inThe Journalon April 7 regarding health care worker exposure to ribavirin, an antiviral agent with in vitro activity against respiratory syncytial virus (RSV).1Data regarding the efficacy of this agent in the treatment of RSV infections in children have been published.2,3Guidelines for the use of this drug have been published by the American Academy of Pediatrics.4Faculty from the Department of Pediatrics, University of California, San Diego, and Children's Hospital, San Diego, were faced with the same concerns regarding health care worker safety as those expressed by Guglielmo et al.1The Pharmacy and Therapeutics Committee of Children's Hospital appointed a similar task force from the University of California and Children's Hospital composed of representatives from the Divisions of Infectious Diseases, Pulmonary Medicine, General Pediatrics, and Pharmacy to discuss these issues as well as
ABC of psychological medicine: Musculoskeletal pain
Authors: Chris J Main, Amanda C de C Williams
Journal: BMJ (2002)

Musculoskeletal symptoms of various types (neck pain, limb pain, low back pain, joint pain, chronic widespread pain) are a major reason for consultation in primary care. This article uses the example of low back pain because it is particularly common and there is a substantial evidence base for its management. The principles of management outlined are also applicable to non-specific musculoskeletal symptoms in general.

The increasing prevalence of musculoskeletal pain, including back pain, has been described as an epidemic. Pain complaints are usually self limiting, but if they become chronic the consequences are serious. These include the distress of patients and their families and consequences for employers in terms of sickness absence and for society as a whole in terms of welfare benefits and lost productivity. Many causes for musculoskeletal pain have been identified. Psychological and social factors have been shown to play a major role in exacerbating the biological substrate of pain by influencing pain perception and the development of chronic disability. This new understanding has led to a “biopsychosocial” model of back pain. 

Research has also shown that there are many different reasons for patients to consult their doctor with pain—seeking cure or symptomatic relief, diagnostic clarification, reassurance, “legitimisation” of symptoms, or medical certification for work absence or to express distress, frustration, or anger. Doctors need to clarify which of these reasons apply to an individual and to respond appropriately.
Abstract P2-19-05: Oncoplastic breast conserving surgery with perforator flap in breast cancer patients
Authors: HY Park, JG Kang, HH Choi, SO Hwang, WW Kim, JH Jung, YH Lee, JD Yang, SJ Lee
Journal: Cancer Research (2013)

Abstract Purpose : Oncoplastic breast surgery has been used widely as a treatment protocol for breast cancer. Thoracodorsal artery perforator (TDAP) flap and intercostal artery perforator (ICAP) flap can provide adequate cover without sacrificing any muscle and allow closing of the donor sites in inconspicuous sites. Therefore, among the oncoplastic volume replacement techniques indicated using local flap that can adequately cover the volume of breast, TDAP and ICAP are especially suggested. This study describes the use of TDAP and ICAP flap techniques after breast conserving surgery. Methods : From March 2010 to August 2012, 38 patients with breast cancer received breast reconstruction. All patients who were selected had small- to moderate-sized defects on breasts, middle aged, and were not sensitive to scars. The TDAP flap is the first choice for performing the surgery, but if the perforator of the TDAP flap is not found, a dissection toward the anterior area to find an adequate perforator is made and the serratus anterior artery perforator is normally used. Otherwise after the dissection is performed more anterior, ICAP can be used. If the perforator penetrates the LD muscle, the TDAP flap can be used. The perforator that penetrates from the serratus anterior muscle is also used in the anterior area. Otherwise, ICAP can be used in partial breast reconstruction. The TDAP flap can be applied to any defect site regardless of the size of the defect area. Results : The mean age was 44.9 years and the average follow-up interval was 6 months. The average specimen weight was 98g. Complications developed in 4 cases including 3 cases of venous congestion, though self-limited, and 1 case of wound disruption on the inframammary fold suture area. Majority of the patients were satisfied with the cosmetic result. Conclusion : Thoracodorsal artery perforator flap (TDAP) and intercostal artery perforator flap (ICAP) techniques can be reliable and useful in correcting breast deformity after breast conservation surgery, especially in patients with small- to moderate-sized defects on breasts. Key Words : intercostal artery perforator flap, thoracodorsal artery perforator flap Oncoplastic surgery, ICAP, TDAP. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-19-05.
Efficacy of transbronchial biopsy in pulmonary vaculitides
Authors: A Schnabel, K Holl-Ulrich, K Dalhoff, M Reuter, WL Gross
Journal: European Respiratory Journal (1997)

This study was performed to determine the value of transbronchial biopsy (TBB) in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides and mild-to-moderate pulmonary involvement. Included in the study were 19 patients with Wegener's granulomatosis (WG) and six patients with Churg-Strauss syndrome (CSS) with evidence of active pulmonary disease but without gross parenchymal lesions accessible by radiologically guided biopsy. All of the patients had undergone staging examinations which included TBB taken from peripheral lung tissue and from any focal tracheobronchial lesions. Any suspicious lesion in the upper respiratory tract was biopsied by an otolaryngologist and the number of positive biopsies was compared with that of TBB. In the WG patients, only two out of 17 biopsies of alveolar tissue yielded histopathological findings supporting the diagnosis of WG. In five WG patients, ulcerative or exophytic airway lesions were found whose histopathologies were invariably positive. Otolaryngological examination revealed abnormal findings in 19 WG patients and biopsies from these sites yielded positive results in 13 instances. In CSS, TBB produced a diagnostically helpful histopathology in four of six cases and biopsies from the upper respiratory tract were positive in five out of six cases. We conclude that transbronchial biopsies of alveolar tissue are seldom positive in Wegener's granulomatosis patients with mild-to-moderate pulmonary disease unless they are taken from grossly abnormal lung areas. Conversely, ulcerative, exophytic or stenotic tracheobronchial lesions had a high rate of positive findings. These results further suggest that the upper rather than the lower respiratory tract should be the biopsy site of first choice in Wegener's granulomatosis. In Churg-Strauss syndrome, the upper and lower respiratory tract seem to yield a roughly equal number of positive biopsies.
The Robert Wood Johnson Clinical Scholars Program
Authors: Alvan R. Feinstein, John C. Beck
Journal: New England Journal of Medicine (1975)

For almost a century, clinicians who wished to engage in creative scholarship were encouraged to work in a traditional scientific laboratory, investigating the biologic mechanisms of health and disease. With the increasing application of basic scientific advances in the past few decades, clinical investigators pursuing this form of biomedical research have achieved a spectacular, well known series of successes.At the same time, however, other major clinical issues have not received corresponding scholarly attention in either the quantity of concerned qualified investigators or the quality of research methods. The type of creative vigor that has been established and demanded for . . .