tbuckley/cabot-search huggingface dataset:
PAPILLARY EPITHELIOMA OF THE KIDNEY PELVIS
Authors: CARL EGGERS
Journal: JAMA (1924)

At the New Orleans session of the American Medical Association, in 1920, McCown<sup>1</sup>reported a case of papillomatous epithelioma of the kidney pelvis. He also reviewed forty-seven cases that he had compiled from American and foreign literature, and gave a short abstract of the history and findings in forty-six of these cases. In the ensuing discussion three other cases were reported, and attention was drawn to the important points in the diagnosis and treatment of this condition. Owing to the rarity of this tumor, most authors report only one case each. An exception to this is furnished by Kretschmer with two cases and the Mayo Clinic with five cases. Since 1920, two more cases have been reported, one by McGlannan,<sup>2</sup>and the other by Miller and Herbst.<sup>3</sup>Scholl<sup>4</sup>has presented the condition in a recent article accompanied by illustrations and a complete bibliography. He reports eight
Characterization of double potentials during ventricular tachycardia. Studies during transient entrainment.
Authors: B Olshansky, D Moreira, A L Waldo
Journal: Circulation (1993)

BACKGROUND Double potentials have been recorded during reentrant tachycardias in animal models. Although they have also been recorded during ventricular tachycardia in humans, their meaning is uncertain. METHODS AND RESULTS We used transient entrainment as a method to help further understand the meaning of double potentials recorded during ventricular tachycardia in humans. Three patients with ventricular tachycardia (cycle lengths, 500, 450, and 290 msec) were studied. During transient entrainment of ventricular tachycardia (pacing cycle length, 470-260 msec), both double potential deflections were captured at the pacing cycle length. One deflection was captured with a short activation time, and the other deflection was captured with a long activation time. During ventricular pacing, the deflections were associated by the long rather than the short interdeflection interval. At termination of pacing, each double potential deflection was associated with separate but sequential QRS complexes, and each deflection maintained the same electrogram morphology at relatively "slow" overdrive pacing rates. The short interdeflection interval shortened further with faster pacing rates (to less than the ventricular refractory period), making it unlikely that both deflections of the double potential represent active depolarization of the same tissue. In two patients, at a critically rapid pacing rate, one of the double potential deflections changed morphology abruptly, associated with a shortened stimulus-to-double potential time interval (from 520 to 110 msec and from 530 to 240 msec, respectively), indicating a change in the direction of activation that caused that deflection. Interruption of ventricular tachycardia was associated with disappearance of the double potentials at the same recording site. The double potentials did not immediately bracket an area of slow conduction. CONCLUSIONS These data suggest that double potentials recorded only during ventricular tachycardia represent activation wave fronts on either side of an area of block within a reentrant circuit. Thus, double potentials recorded during ventricular tachycardia in these patients do not appear to represent slow conduction per se but rather appear to represent an area of block at the center of a reentrant circuit around which the reentrant wave front circulates.
LACERATIONS OF THE PELVIC FLOORTHE PRINCIPLES INVOLVED IN THEIR PRIMARY AND SECONDARY REPAIR.
Authors: JAMES HAWLEY BURTENSHAW
Journal: JAMA (1904)

Fortunately for the physical welfare of women, practical unanimity exists among obstetricians regarding the advisability of immediate repair of a laceration of the pelvic floor after labor. Unfortunately, the ultimate results of such an operation are frequently not at all satisfactory, prolapse of the vaginal wall necessitating secondary operative procedures at a later date. The lack of success attending the primary operation is to be attributed to one of three causes, or to a combination of all. First, failure on the part of the operator to appreciate the extent and direction of the subcutaneous tear; second, failure to approximate the edges of the torn muscle and fascia; third, an overstretching of the muscles of the pelvic floor, which can not be overcome or modified except by denudation and suturing of the vaginal wall, an unjustifiable procedure at this stage of the puerperium.
Surveillance of Paralytic Poliomyelitis in the United States
Authors: Cyrus C. Hopkins
Journal: JAMA (1969)

In 1966, 103 cases of paralytic poliomyelitis were reported in the United States. An outbreak of 66 cases caused by type 1 poliovirus occurred in Texas, predominantly in unimmunized, preschool children. In 1967, 40 cases were reported, with 16 in southwestern border states. In both years, sporadic cases of poliomyelitis continued to occur in persons without known contact with either live oral poliovirus vaccine, or with other patients. During the three-year period 1965-1967, eight cases of paralytic poliomyelitis occurred in recent recipients of oral poliovirus vaccine, while 16 additional cases were reported in persons with familial or other close contact with vaccine recipients. In view of the proven benefit of oral poliovirus vaccines, however, these cases present a minor public health problem.
[626] PRE-DOSING TARIBAVIRIN PRIOR TO COMBINATION THERAPY WITH PEGYLATED INTERFERON ALFA-2b VERSUS STANDARD COMBINATION DOSING: 24-WEEK INTERIM RESULTS EXAMINING SAFETY AND VIRAL KINETICS
Authors: M. Palmer, R. Rubin, V. Rustgi, D. Li, B. Murphy
Journal: Journal of Hepatology (2007)
Thalidomide and Related Compounds
Authors: Fredrick F. Yonkman
Journal: JAMA (1962)

<h3>To the Editor:—</h3> In the June 30, 1962, issue ofThe Journal(<b>180</b>:1106), there appears a special communication, "A Study of the German Outbreak of Phocomelia," by Helen B. Taussig, M.D., on which we would like to comment. This relates to the statement beginning on page 1108: "Thalidomide is a synthetic drug which, as the story is told in West Germany, was first conceived and made by Ciba and found by them to have no effect on animals;..." The story heard by Dr. Taussig is not accurate, since Ciba neither conceived nor made thalidomide and was never associated with its clinical investigation. Dr. Taussig has also commented briefly inThe Journalarticle, but more extensively in her testimony before the Celler Committee and in her article in the current issue of<i>Scientific American</i>, that glutethimide (Doriden) is similar in molecular structure to thalidomide. Attention is called to the formulae
Medical history taking in adults should include questions about preterm birth
Authors: C. Crump
Journal: BMJ (2014)

Low gestational age at birth is a long term risk factor for many diseases in adulthood, and such information is invaluable to good clinical care, writes Casey Crump 

Clinicians increasingly encounter adult patients who were born preterm (after fewer than 37 completed weeks of gestation). Advances in neonatal care that were introduced in the 1970s and 1980s, including high frequency ventilation, surfactant therapy, and antenatal corticosteroids, have enabled unprecedented numbers of such infants to survive. The first generation to benefit from those advances are now young adults. And a growing body of evidence for long term health consequences has contributed to a developmental model for early life origins of chronic disease.

Variations in fetal and postnatal nutrition are hypothesised to permanently alter gene expression, resulting in so called programming for the onset of chronic disease in later life.1 This involves a complex interplay of hormonal and immunological mechanisms and is commonly associated with preterm birth. Epidemiological studies have shown that the long term health consequences are wide ranging, including increased risks of diabetes, cardiovascular disease, respiratory disease, and neurological and psychiatric disorders into adulthood.2 3 4 5 These health effects also carry increased long term risks of mortality. 

In a large national cohort study in Sweden, my colleagues and I found that among all people who survived …
Double-Blind Evaluation of Efficacy and Tolerability of Metformin in NIDDM
Authors: Timothy L Dornan, Simon R Heller, Gillian M Peck, Robert B Tattersal
Journal: Diabetes Care (1991)

Objective To test the efficacy and tolerability of metformin. Research Design and Methods An 8-mo double-blind placebo-controlled parallel-group trial was performed at University hospital diabetic clinics on 60 patients with non-insulin-dependent diabetes mellitus (NIDDM) treated by diet alone. Metformin was administered and built up to a maximum dosage of 1 g three times daily. Results Mean HbA1 fell from 11.7 ± 0.4 to 10.3 ± 0.4% (means ± SE) on metformin but rose from 11.8 ± 0.4 to 13.3 ± 0.4% on placebo (P &amp;lt;0.001). Final mean fasting blood glucose was 5.1 mM lower with metformin than placebo (P &amp;lt;0.001). No other biochemical variable differed significantly, and weight did not change. A favorable glycemic response was not restricted to the obese. The mean final dosage of metformin was 1.7 ± 0.1 g and was well tolerated. Conclusions Metformin achieved a 23% lower mean HbA1 than placebo without weight gain or significant unwanted effects.
The Hot Spur Sign of Diastematomyelia
Authors: Bradley P. Thomas, Stephanie E. Spottswood, Curtis A. Wushensky
Journal: Clinical Nuclear Medicine (2007)

A 12-year-old male with back pain was referred for evaluation of scoliosis. A nuclear medicine bone scan was performed, which revealed increased radiopharmaceutical uptake in the L1 spinous process and spinal canal at this level. Follow-up CT and MRI were diagnostic of diastematomyelia.
Abstract 1542: Th1 and Th2 cytokines determine how CD40 activation changes human macrophage function in vitro.
Authors: Nadia Luheshi, Gareth C. Davies, Edd Poon, Matthew McCourt, James W. Legg
Journal: Cancer Research (2013)

Abstract Tumour associated macrophages (TAM) often adopt an M2-like immunosuppressive phenotype, promoting tumour growth and metastasis. However, TAM display phenotypic plasticity, and can be repolarised by agents including CD40 agonists to a Th1-immunostimulatory, tumoricidal M1 phenotype, inhibiting tumour growth. T cell-activating therapies synergise with CD40 agonists to induce more extensive TAM repolarisation and tumour growth inhibition, indicating that T cell-derived cytokines may enhance CD40 agonist effects on TAM. We therefore set out to determine how Th1 and Th2 cytokines shape the functional consequences of CD40 activation on human macrophages in vitro. We report that CD40 ligand (CD40L) activates human monocyte-derived macrophages in a similar, but not identical fashion to bacterial LPS in the absence of Th1 or Th2 cytokines. Under these conditions, CD40L activated macrophages adopt an M2-like phenotype, with low tumoricidal activity and producing high levels of immunosuppressive IL-10. The Th1 cytokine IFNγ enhanced anti-tumour functions of CD40-activated macrophages, promoting a switch from immunosuppressive IL-10 to Th1-immunostimulatory IL-12p70 production, and enhancing direct tumoricidal activity. We found that the Th2 cytokines IL-4 and IL-13 also enhanced IL-12p70 production by CD40L-activated macrophages, but, unlike IFNγ, these cytokines did not inhibit IL-10 production. IL-4 and IL-13 also promoted a smaller enhancement in CD40-induced macrophage tumoricidal activity than IFNγ. Thus the presence of Th1 / 2 T cell-derived cytokines in the tumour microenvironment may shape the outcome of CD40 agonist therapy by modulating CD40 agonist effects on TAM. Citation Format: Nadia Luheshi, Gareth C. Davies, Edd Poon, Matthew McCourt, James W. Legg. Th1 and Th2 cytokines determine how CD40 activation changes human macrophage function in vitro. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1542. doi:10.1158/1538-7445.AM2013-1542
Dual platelet thromboxane A2synthase inhibition/endoperoxide receptor blockade (Ridogrel) and/or aspirin enhance thrombolysis with rt-PA in canine coronary arteries
Authors: Frans Van de Werf, Zaomin Wu, Tony M. Stassen, Fred F. De Clerck, Hilaire De Geest
Journal: Journal of the American College of Cardiology (1991)
Total and free thyroid hormone concentrations in patients receiving maintenance replacement treatment with thyroxine.
Authors: C J Pearce, R L Himsworth
Journal: BMJ (1984)

Total and free serum concentrations of thyroxine and triiodothyronine were measured in 122 subjects with hypothyroidism who were clinically well while receiving conventional replacement treatment with thyroxine. In a third of patients concentrations of total and free thyroxine were raised, often considerably; nevertheless concentrations of total and free triiodothyronine were usually normal. Though significant correlations were obtained between total triiodothyronine concentrations and total thyroxine concentrations (p less than 0.001) and between the triiodothyronine concentrations and free thyroxine concentrations (p less than 0.001) the slope of the line of the regression equation describing these correlations was small, hence large increases in both total and free thyroxine concentrations were accompanied by only modest increases in total and free triiodothyronine concentrations. The presence of total or free thyroxine concentrations above normal in patients taking thyroxine therefore are not necessarily of clinical consequence. In the assessment of adequacy of replacement treatment with thyroxine the most logical combination of in vitro thyroid function test results may be a normal thyrotrophin concentration and normal free triiodothyronine concentration.
Intrinsic neutrophil defects in a child with impaired neutrophil chemotaxis and immunodeficiency
Authors: Hironori Morosawa, Munehiro Yamazaki, Kenichi Sugita, Hiroharu Saitoh, Atsushi Komiyama, Taro Akabane
Journal: American Journal of Hematology (1980)

Abstract A boy with recurrent pyogenic infection was found to have occasional neutropenia, defective neutrophil chemotaxis, hypogammaglobulinemia with increased IgM, and impaired cellular immunity. The T and B lymphocytes were defective in IgG production in vitro. Ultrastructure of the neutrophils was normal. The marrow cells formed normal numbers of granulocytic colonies in culture, but the colonies were apparently small in size. The levels of colony‐stimulating activity were normal. The lymphocytes did not impair granulopoiesis of control marrow cells. These data indicate that the neutropenia and defective neutrophil chemotaxis are due to the intrinsic neutrophil defects and are not secondary to T and/or B lymphocyte dysfunctions in the patient.
Treatment of relapsed adult T-cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation: the Nagasaki Transplant Group experience
Authors: Hidehiro Itonaga, Hideki Tsushima, Jun Taguchi, Takuya Fukushima, Hiroaki Taniguchi, Shinya Sato, Koji Ando, Yasushi Sawayama, Emi Matsuo, Reishi Yamasaki, Yasuyuki Onimaru, Daisuke Imanishi, Yoshitaka Imaizumi, Shinichiro Yoshida, Tomoko Hata, Yukiyoshi Moriuchi, Naokuni Uike, Yasushi Miyazaki
Journal: Blood (2012)
Genitourinary Manifestations of Diverticulitis of the Colon
Authors: Charles D. Hafner
Journal: JAMA (1962)

THE CLOSE proximity of the distal gastrointestinal and genitourinary tracts necessitates a more thorough evaluation of the patient who presents genitourinary symptoms, either alone, or associated with gastrointestinal symptoms. The literature on the general subject of diverticulitis of the colon is voluminous. However, the many studies produced in the past have either covered broader aspects of the disease, or have stressed other specific features. Consequently, the paucity of statistical data covering genitourinary manifestations of diverticulitis is apparent. This study was undertaken in order to give a detailed analysis of this important relationship.  Anatomy It is no wonder that inflammatory disease of the colon produces symptoms referable to the genitourinary system. These symptoms are produced through 3 main mechanisms, namely, bladder irritation, pain, and fistulous formation.  Bladder irritation and its many symptoms, such as frequency, urgency, and dysuria, are related, for the most part, to direct contact of the urinary bladder
P223 Medical Thoracoscopy - patient experience of Advanced Nurse Practitioner- provided conscious sedation
Authors: D O'Neill, K Pink, AA Ionescu
Journal: Thorax (2013)

<h3></h3> Medical thoracoscopy (MT) is a safe procedure provided by respiratory physicians across the UK. The conscious sedation is administered by staff with a variable level of training. <h3>Aim</h3> To assess a simple patient comfort score at MT when conscious sedation (CS) was provided by an advanced nurse practitioner (ANP) compared to others (senior nurse, endoscopy nurse or junior doctor). <h3>Methods</h3> A patient comfort score is recorded routinely as part of our thoracoscopy service immediately after the procedure once the patient is awake in recovery. The ANP is an ALS provider with senior experience in critical care. Intraoperative administration of midazolam for sedation and alfentanyl for pain control pre-biopsies was undertaken by a dosing schedule determined by the level of sedation assessed by the ANP who also monitored the patient during the procedure. When CS was given by others midazolam was administered in an initial bolus followed by boluses as indicated by the thoracoscopist in keeping with information by the monitoring nurse on the level of sedation or discomfort. Patient comfort score was evaluated using a 5 point scale within 30 minutes of return to the recovery area. The CS was administered either by the ANP or others in keeping with their availability on the day; no randomisation was performed. The analysis used SPSS programme. <h3>Results</h3> 50 consecutive patients undergoing thoracoscopy were included. 27 had CS by ANP (group 1) and 23 by others (group 2). Overall the procedure was well tolerated. Patient comfort score was better in group 1 (mean, SD 0.59 +/- 0.8) vs. group 2 (1.63 +/- 1.3), p &lt; 0.05. This was achieved with a larger dose of midazolam in group 1 (2.87 +/- 1.12 mg) vs. group 2 (2.30 +/- 0.70 mg), p &lt; 0.05 and smaller dose of alfentanyl (0.245 +/- 0.14 mg) in group 1 vs. group 2 (0.527 +/- 0.25 mg), p &lt; 0.01. <h3>Conclusions</h3> conscious sedation for medical thoracoscopy when provided by a critical care experienced ANP resulted in an improved patient experience of the procedure and this was achieved through and adequate use of midazolam and lesser doses of alfentanyl; this was cost-saving since the ANP also monitored the patient. Retaining of trained staff is essential for this specialised service.
Individualizing Glycemic Targets in Type 2 Diabetes Mellitus: Implications of Recent Clinical Trials
Authors: Faramarz Ismail-Beigi, Etie Moghissi, Margaret Tiktin, Irl B. Hirsch, Silvio E. Inzucchi, Saul Genuth
Journal: Annals of Internal Medicine (2011)

One of the first steps in the management of patients with type 2 diabetes mellitus is setting glycemic goals. Professional organizations advise setting specific hemoglobin A1c (HbA1c) targets for patients, and individualization of these goals has more recently been emphasized. However, the operational meaning of glycemic goals, and specific methods for individualizing them, have not been well-described. Choosing a specific HbA1c target range for a given patient requires taking several factors into consideration, including an assessment of the patient's risk for hyperglycemia-related complications versus the risks of therapy, all in the context of the overall clinical setting. Comorbid conditions, psychological status, capacity for self-care, economic considerations, and family and social support systems also play a key role in the intensity of therapy. The individualization of HbA1c targets has gained more traction after recent clinical trials in older patients with established type 2 diabetes mellitus failed to show a benefit from intensive glucose-lowering therapy on cardiovascular disease (CVD) outcomes. The limited available evidence suggests that near-normal glycemic targets should be the standard for younger patients with relatively recent onset of type 2 diabetes mellitus and little or no micro- or macrovascular complications, with the aim of preventing complications over the many years of life. However, somewhat higher targets should be considered for older patients with long-standing type 2 diabetes mellitus and evidence of CVD (or multiple CVD risk factors). This review explores these issues further and proposes a framework for considering an appropriate and safe HbA1c target range for each patient.
Effects of <i>VHL</i> Deficiency on Endolymphatic Duct and Sac
Authors: Sven Gläsker, Russell R. Lonser, Maxine G.B. Tran, Barbara Ikejiri, John A. Butman, Weifen Zeng, Patrick H. Maxwell, Zhengping Zhuang, Edward H. Oldfield, Alexander O. Vortmeyer
Journal: Cancer Research (2005)

Abstract The von Hippel-Lindau (VHL) disease is caused by VHL germ line mutation. Inactivation of the wild-type copy of the VHL gene leads to up-regulation of hypoxic response and tumor formation within central nervous system (CNS), kidneys, pancreas, adrenal glands, epididymis, broad ligament, and the endolymphatic sac/petrous bone. Endolymphatic sac tumors (ELST) have been proposed to be derived from endolymphatic sac epithelium, but other possible structures of origin have been implicated. To clarify the anatomic and cellular origin of ELSTs, we did a morphologic and molecular pathologic analysis of 16 tumors. In addition, we investigated effects of VHL deficiency on “tumor-free” endolymphatic duct and sac of VHL patients. Several tumors included in this study were &amp;lt;1 cm in size, and their origin could be placed in the intraosseous portion of the endolymphatic duct/sac. Furthermore, by analysis of clinically uninvolved “tumor-free” endolymphatic duct and sac tissues of VHL patients, we discovered a variety of VHL-deficient microscopic abnormalities with morphologic similarities to ELSTs. We conclude that most, if not all, ELSTs arise within the intraosseous portion of the endolymphatic duct/sac, the vestibular aqueduct. In analogy to renal parenchyma and selected topographical sites within the CNS, endolymphatic duct/sac epithelia are preferentially and multifocally targeted in VHL disease. The primary effect of VHL deficiency on human endolymphatic duct/sac epithelium seems to be the generation of multifocal sites of VHL-deficient cell proliferations from which tumorigenesis may or may not occur. Therefore, inactivation of the VHL wild-type allele seems necessary but not sufficient for the formation of tumor.