tbuckley/cabot-search huggingface dataset:
Testing for minimal hepatic encephalopathy in the United States: An AASLD survey
Authors: Jasmohan Singh Bajaj, Ashkan Etemadian, Muhammad Hafeezullah, Kia Saeian
Journal: Hepatology (2007)

We read with interest the recent article by Kale et al. describing the MR imaging of patients with cirrhosis with minimal hepatic encephalopathy (MHE) who were diagnosed using a battery of neuro-psychometric tests.1 MHE is a neurocognitive complication of cirrhosis which is associated with poor quality of life, increased rate of progression to overt hepatic encephalopathy (OHE) and driving skill impairment.2-6 MHE detection is not possible by clinical examination but can only be performed using neuropsychometric/neurophysiological techniques, as in the paper by Kale et al.1, 7-9 We set out to determine the diagnostic approaches of U.S.-based members of AASLD toward MHE systematically to identify potential barriers to routine testing. An anonymous questionnaire querying the practice profile, personal opinions regarding MHE diagnostic strategies, frequency of diagnosis, reasons for testing/not testing for MHE, measures that would increase their testing for MHE and treatment for MHE, was e-mailed to 246 AASLD members. One hundred thirty-seven replies were received, of which 98 (72%) were in academic programs, 33 (24%) in private practice, and 6 (4%) were trainees. The majority of respondents believed that MHE was a problem and agreed that it should be tested for. However, only a minority was able to test for it >50% of the time and 52 (38%) respondents never tested for it (Table 1). The reasons for testing or not testing for MHE are displayed in the table. The majority who tested for MHE tested all cirrhotics (56%), the rest restricted testing to those driving (18%), operating machinery (15%), working full-time (9%), and not actively drinking (8%). Of the respondents, 85% believed that simple and rapid tests for MHE diagnosis which can be administered by clinic personnel would increase the likelihood of testing for MHE; other factors that would increase their likelihood for MHE testing are displayed in the table. In addition, 85% believed that MHE, once diagnosed, should be treated. Lactulose was the preferred agent for 78%, rifaximin 18%, zinc 8%, and the rest believed other treatments would be effective. In conclusion, although the majority of AASLD respondents believe that MHE is a significant problem which should be tested for, only a minority are able to test for it routinely. Barriers to routine MHE testing include added time, resource and personnel requirements and lack of standardized tests in the United States population. Simple and rapid tests for diagnosis of MHE would likely increase the probability of testing for MHE in the future. Jasmohan Singh Bajaj*, Ashkan Etemadian*, Muhammad Hafeezullah*, Kia Saeian*, * Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI.
The Harveian Oration, Delivered at the Royal College of Physicians, London, June 29th, 1867
Authors: J. Alderson
Journal: BMJ (1867)

ALREADY on more than two hundred anniversaries have the Fellows of this College met to do honour to the great name of.Harvey; they have met to claim the brightest decoration of their profession-that reflected lustre transmitted by the memory of him, the great philosopher who revealed the most prolific truth ever disclosed by inquirer into the me- chanism of the human frame.Lovingly have they met to observe the occasion which he instituted for an annual commemoration of such vic- tories over ignorance as have been fairly won; and also to obey his in- junction that they should incite each other towards the achievement of still further conquests.Scarcely less often have the most enlightened and distinguished of each passing generation been invited to assist at the annual commemor- ation, and adorn it by their presence; and I trust that I may be per- mitted on this occasion gratefully to acknowledge the response to this appeal feel that it requires some apology if, for a moment, I postpone the especial topic of the day, in order to revert to certain peculiarities in the circumstances of the present occasion.I wish first to render my sincere thanks to our highly esteemed ex-Prcsident, for having done me the honour to appoint me Harveian Orator for this year.It is not possible to allude to him, without giving expression to the high sense we all entertain of the immense advantage enjoyed by this College and the whole profession in having been presided over by a man of such undis- puted eminence; and I would not omit to add our cordial satisfaction that the sovereign has crowned with honour his laborious and successful career.
Anthrax in Massachusetts: 1943 Through 1962
Authors: Myron H. Matz, Heinrich G. Brugsch
Journal: JAMA (1964)

Fifty-seven cases of cutaneous anthrax of occupational origin were reported in Massachusetts from 1943 through 1962, with little variation in the number of cases from year to year. A physician in private practice was consulted by the patients first as often as the company physician. There probably were unreported cases. Occupational history was important in the diagnosis. Antibiotics were effective in all seven cases described. Immunity from infection was not conferred by years of exposure. Bacteriological studies should be made before starting treatment because antibiotic medication rapidly removes<i>Bacillus anthracis</i>. In addition to the usual preventive measures, vaccination is urged as a valuable means of protecting those exposed.
Impact of childhood cancer on return to normal schooling.
Authors: I J Larcombe, J Walker, A Charlton, S Meller, P Morris Jones, M G Mott
Journal: BMJ (1990)

Most of the research into the psychosocial impact of treatment for cancer in children has concentrated on effects on the family rather than on the children9s return to school. Thus parents and teachers were questioned about the problems experienced by 117 children who returned to school after spending time in hospital. The children comprised 51 with cancer and two groups of control children (34 with chronic diseases such as renal disease and cardiac conditions and 32 with orthopaedic conditions such as thoracic scoliosis, club foot, and injuries resulting from trauma). Children in all three groups experienced problems on returning to school, the greatest number and variety occurring in the children treated for cancer and the fewest in the children with orthopaedic conditions. The variety of physical problems was greatest and the variety of academic problems was least, with psychological and behavioural problems intermediate. Several problems seemed to be related to drug treatment. Several children missed a considerable amount of full time education. Many teachers were unsure of the academic expectations and physical capabilities of children returning to school. To facilitate a smooth return to school for a child with cancer improved liaison is needed between the hospital, school, and home during the child9s absence and teachers need to be better informed.
Mesenchymal-Cel Proliferation in Liver Disease of the Alcoholic
Authors: Carroll M. Leevy, Willem tenHove, Maceo Howard
Journal: JAMA (1964)

AVAILABLE INFORMATION suggests that ethanol-induced hepatic necrosis in the setting of fatty liver initiates a regenerative reaction which ultimately leads to lobular distortion and cirrhosis.<sup>1</sup>Further research is now desirable to elucidate mechanisms responsible for the hepatic cell damage, to discover initiating and controlling factors in regeneration, and to determine the contribution of various cell types to liver repair. The present investigation was undertaken to delineate the degree, localization, and effect of cellular proliferation which accompanies liver injury due to alcoholism. Autoradiographic techniques employing tritiated thymidine (H<sup>3</sup>T) were utilized<sup>2</sup>to evaluate the influence of ethanol intoxication on hepatic deoxyribonucleic acid (DNA) synthesis and regeneration in experimental animals and man. <h3>Materials and Methods</h3> Animal experiments were conducted to determine the effect of acute ethanol intoxication on hepatic DNA synthesis. A single or divided oral dose of 0.6 gm of ethanol per 100 gm weight, each day for 3
3D RECONSTRUCTION OF THE RIGHT VENTRICLE FROM 2D ECHOCARDIOGRAPHIC IMAGES IN PULMONARY ARTERIAL HYPERTENSION: VALIDATION AGAINST CMR
Authors: Nicole Martin Bhave, Lynn Weinert, Megan Yamat, Benjamin Freed, Victor Mor-Avi, Mardi Gomberg-Maitland, Amit Patel, Roberto Lang
Journal: Journal of the American College of Cardiology (2013)
Surgical Treatment of Chronic Pancreatitis
Authors: Henry Doubilet
Journal: JAMA (1961)

A step-by-step procedure is outlined for the surgical treatment of chronic pancreatitis and its complications: If the operative cholangiogram demonstrates an unobstructed pancreatic duct filled by reflux, sphincterotomy is done. If no reflux occurs, an operative pancreatogram is essential after sphincterotomy. If the pancreatogram demonstrates obstruction due to stone or stricture or reveals a pseudocyst in continuity with the pancreatic duct system, the operations here described are carried out. The techniques can bemodified for the correction of chronic pancreatic fistulas.
REMARKS ON ATYPICAL EXOPHTHALMIC GOITRE
Authors: H. L. McKisack
Journal: BMJ (1913)

TiSEDIc BiJaOrsn]ATYPICAL EXOPHTHAL\[IC GOITRE?[FEB.I, r913.pelvic operations is by no means uncommon, but it is an extremely rare event for pulmonary embolism to happen in this form of thrombosis.The oedema of the leg associated with this common form of thrombosis is usually attributed to obstruction of the iliac and femoral veins by internal clot, but there is in addition infection of the lyniplatics, and this causes a hard painful swelling of the thigh in consequence of interference with the lymiiphatic circulation.Surgeons know well that during operations in the armpit the axillary vein is occasicnally cut.This accident is easily repaired by the application of a ligature to the vein above and below the opening.No oedema of the limb follows.When the axillary lymp-hatics are blocked by perilymphangitis due to an extension of mllammlulary cancer, a solid oedema of tlle limb ensues.This is trtie of the lower limb.The femoral vein is somletimes wounded accidentally by the surgeon in the course of an operation, but it is safely controlled by an encircling ligature placed above and below the lhole in the w,all of the vein.No oedema follows, nor is the circutlation in the limb iiimpaired.Reservoirs of Clot.It often liappens that a post-nwortcen exalllination is made on a patient who has died in consequence of a pul- mloniary embolism, and the source of the embolus cannot be found.In considering embolism of the pulmonary artery in relation to hysterectomy it is necessary to point out that the pelvis contains two potential reservoirs of blood clot-the iliac veins and the ovarian veins.Ex- perience, however, teaches that the external iliac veins are the common source of the fatal clot.An embolus large enough to fatally plug the pulmonary artery comes, as a rtule, from large vessels like the iliac veins, the caval veins, or the right auricle.Virchlow pointed out tllat it is not uncommon for an entire tlhrombus to slip out of a vein, and an elongated thlrombus from a venlule may appear to be too tlhin to obstruct a large vessel, but, when such an elongated thrombus reaches its destiny, it is doubled up by the blood stream and serves as an effective plug.An embolus too small to occlude the pulmonary artery mav lodge on the ridge separating the riglht from the left branch, becoming-what is called a riding thrombus; sucll a clot may act as an autochtlhonous
Cardiovascular risk factors in hematopoietic cell transplantation survivors: role in development of subsequent cardiovascular disease
Authors: Saro H. Armenian, Can-Lan Sun, Tabitha Vase, Kirsten K. Ness, Emily Blum, Liton Francisco, Kalyanasundaram Venkataraman, Raynald Samoa, F. Lennie Wong, Stephen J. Forman, Smita Bhatia
Journal: Blood (2012)
250K Single Nucleotide Polymorphism Array Karyotyping Identifies Acquired Uniparental Disomy and Homozygous Mutations, Including Novel Missense Substitutions of <i>c-Cbl</i>, in Myeloid Malignancies
Authors: Andrew J. Dunbar, Lukasz P. Gondek, Christine L. O'Keefe, Hideki Makishima, Manjot S. Rataul, Hadrian Szpurka, Mikkael A. Sekeres, Xiao Fei Wang, Michael A. McDevitt, Jaroslaw P. Maciejewski
Journal: Cancer Research (2008)

Abstract Two types of acquired loss of heterozygosity are possible in cancer: deletions and copy-neutral uniparental disomy (UPD). Conventionally, copy number losses are identified using metaphase cytogenetics, whereas detection of UPD is accomplished by microsatellite and copy number analysis and as such, is not often used clinically. Recently, introduction of single nucleotide polymorphism (SNP) microarrays has allowed for the systematic and sensitive detection of UPD in hematologic malignancies and other cancers. In this study, we have applied 250K SNP array technology to detect previously cryptic chromosomal changes, particularly UPD, in a cohort of 301 patients with myelodysplastic syndromes (MDS), overlap MDS/myeloproliferative disorders (MPD), MPD, and acute myeloid leukemia. We show that UPD is a common chromosomal defect in myeloid malignancies, particularly in chronic myelomonocytic leukemia (CMML; 48%) and MDS/MPD-unclassifiable (38%). Furthermore, we show that mapping minimally overlapping segmental UPD regions can help target the search for both known and unknown pathogenic mutations, including newly identified missense mutations in the proto-oncogene c-Cbl in 7 of 12 patients with UPD11q. Acquired mutations of c-Cbl E3 ubiquitin ligase may explain the pathogenesis of a clonal process in a subset of MDS/MPD, including CMML. [Cancer Res 2008;68(24):10349–57]
Oral use of Swedish moist snuff (snus) and risk for cancer of the mouth, lung, and pancreas in male construction workers: a retrospective cohort study
Authors: Juhua Luo, Weimin Ye, Kazem Zendehdel, Johanna Adami, Hans-Olov Adami, Paolo Boffetta, Olof Nyrén
Journal: The Lancet (2007)
Aortic Regurgitation with Ventricular Septal Defect
Authors: JANE SOMERVILLE, A. BRANDAO, DONALD N. ROSS
Journal: Circulation (1970)

Twenty patients with ventricular septal defect and aortic regurgitation had surgical correction using cardiopulmonary bypass. Direct suture of the ventricular defect through the aorta and repair or replacement of the aortic valve were performed. Homograft replacement of the aortic valve was preferred to repair and was associated with less aortic regurgitation after operation. There were one operative death and one late death due to aortic regurgitation. Follow-up for 1 to 6 years showed that 17 of the 18 survivors have had a satisfactory result.
Incentivising organ donation
Authors: T. A. Callender
Journal: BMJ (2010)

Bird and Harris argue that the time has come to move to presumed consent for organ donation.1 The United Kingdom has one of the lowest organ donor rates in the developed world, roughly 14.5 donors per million population, or 12.9 in 2006 compared with 35.5 in Spain, 26.9 in the United States, and 23.2 in France. …
L-Carnitine improvement of cardiac function is associated with a stimulation in glucose but not fatty acid metabolism in carnitine-deficient hearts
Authors: T. L. Broderick, G. Panagakis, D. DiDomenico, J. Gamble, G. D. Lopaschuk, A. L. Shug, D. J. Paulson
Journal: Cardiovascular Research (1995)

Increasing myocardial carnitine content can improve heart function in patients with carnitine deficiency. We were interested in determining the effects of L-carnitine on cardiac function and substrate metabolism in a rat model of carnitine deficiency.Carnitine deficiency was induced in male Sprague-Dawley rats by supplementing the drinking water with 20 mM sodium pivalate. Control animals received an equimolar concentration of sodium bicarbonate. Following treatment, cardiac function and myocardial substrate utilization were determined in isolated working hearts perfused with glucose and relevant levels of fatty acids. To increase tissue levels of carnitine, hearts were perfused with 5 mM L-carnitine for a period of 60 min.Hearts from sodium pivalate-treated animals demonstrated a 60% reduction in total heart carnitine content, depressions in cardiac function and rates of palmitate oxidation, and elevated rates of glycolysis compared to control hearts. Treatment with L-carnitine increased total carnitine content and reversed the depression in cardiac function seen in carnitine-deficient hearts. However, this was not associated with any improvement in palmitate oxidation. Rates of glycolysis and glucose oxidation, on the other hand, were increased with L-carnitine.Our findings indicate that acute L-carnitine treatment is of benefit to cardiac function in this model of secondary carnitine deficiency by increasing overall glucose utilization rather than normalizing fatty acid metabolism.
[629] THE INFLUENCE OF OBESITY AND DIABETES ON CLINICAL AND THERAPEUTICAL OUTCOME IN HCV RELATED CHRONIC HEPATITIS: AN ITALIAN NATIONWIDE SURVEY STUDY (PROBE GROUP)
Authors: M. Persico, M. Masarone, L. Cimino, B. Fimiani, N. Passariello, C. Coppola, G. Raimondo, E. Resta, P. Del Poggio, A. Orani, M. Sarracino, A. Alberti
Journal: Journal of Hepatology (2007)
"Medical Testament" on Nutrition
Authors: P. A. Galpin
Journal: BMJ (1939)

In this article, the authors compare the performance of two long–term fixed–weight asset allocation models with two dynamic models—one based on historical data and one based in part on analysts9 forecasts. They find that fixed–weight asset allocation outperformed a dynamic approach that used only historical data. They also include a comparison of the performance of the asset allocation recommendations of eight Wall Street brokerage firms and a “Robot Blend.” Four of the eight firms nominally outperformed the Robot Blend after transaction costs, confirming the random chance prediction. The dynamic asset allocation model that used analysts9 forecasts outperformed all other models. This result is robust to the application of reasonable constraints to the dynamic models. The authors suggest that dynamic asset allocation models probably will not outperform fixed–weight asset allocation unless they employ superior analyst judgment. In their data, a static 60/30/10 mix of stocks, bonds, and cash appears to be an attractive long–term choice.
Japan's worst nuclear accident leaves two fighting for life
Authors: J. Lamar
Journal: BMJ (1999)

<h3>BACKGROUND AND PURPOSE:</h3> Former preterm born males are at higher risk for neurodevelopmental disabilities compared with female infants born at the same gestational age. This retrospective study investigated sex-related differences in the maturity of early myelinating brain regions in infants born &lt;28 weeks’ gestational age using diffusion tensor– and relaxometry-based MR imaging. <h3>MATERIALS AND METHODS:</h3> Quantitative MR imaging sequence acquisitions were analyzed in a sample of 35 extremely preterm neonates imaged at term-equivalent ages. Quantitative MR imaging metrics (fractional anisotropy; ADC [10<sup>−3</sup>mm<sup>2</sup>/s]; and T1-/T2-relaxation times [ms]) of the medulla oblongata, pontine tegmentum, midbrain, and the right/left posterior limbs of the internal capsule were determined on diffusion tensor– and multidynamic, multiecho sequence–based imaging data. ANCOVA and a paired <i>t</i> test were used to compare female and male infants and to detect hemispheric developmental asymmetries. <h3>RESULTS:</h3> Seventeen female (mean gestational age at birth: 26 + 0 [SD, 1 + 4] weeks+days) and 18 male (mean gestational age at birth: 26 + 1 [SD, 1 + 3] weeks+days) infants were enrolled in this study. Significant differences were observed in the T2-relaxation time (<i>P</i> = .014) of the pontine tegmentum, T1-relaxation time (<i>P</i> = .011)/T2-relaxation time (<i>P</i> = .024) of the midbrain, and T1-relaxation time (<i>P</i> = .032) of the left posterior limb of the internal capsule. In both sexes, fractional anisotropy (<i>P</i> [♀] &lt; .001/<i>P</i> [♂] &lt; .001) and ADC (<i>P</i> [♀] = .017/<i>P</i> [♂] = .028) differed significantly between the right and left posterior limbs of the internal capsule. <h3>CONCLUSIONS:</h3> The combined use of various quantitative MR imaging metrics detects sex-related and interhemispheric differences of WM maturity. The brainstem and the left posterior limb of the internal capsule of male preterm neonates are more immature compared with those of female infants at term-equivalent ages. Sex differences in WM maturation need further attention for the personalization of neonatal brain imaging.
The Osteopathic Dilemma: Separate or Same?-Reply
Authors: Norman Gevitz
Journal: JAMA (1987)

<h3>In Reply.—</h3> The letters of both Dr Weber and Dr Danier in response to my article undoubtedly reflect the opinions of a number of Doctors of Osteopathy (DOs) who have bypassed osteopathic postgraduate training to pursue American Medical Association—approved programs. They feel ambivalent about their mixed identity and frustrated at the lack of movement toward a merger between DOs and MDs. It should be noted, however, that the non-American Osteopathic Association—approved path to postdoctoral training that these practitioners have taken is one that only a small minority of DOs have chosen to follow since the American Medical Association opened up its residency programs to osteopathic physicians in 1969. Furthermore, it would appear that the great majority of osteopathic practitioners have no desire for a merger of the two professions at present. Most DOs continue to seek both close cooperation with but also independence from allopathic medicine. Dr Weber's assertion that
A double-blind randomized trial of propranolol and verapamil in the treatment of effort angina.
Authors: N N Sadick, A T Tan, P J Fletcher, J Morris, D T Kelly
Journal: Circulation (1982)

In 18 patients with stable effort angina, verapamil, 80 mg four times daily, was compared with propranolol, 80 mg four times daily, in a double-blind, placebo-controlled trial to assess the effects on anginal threshold, exercise capacity and left ventricular function measured by gated equilibrium blood pool scanning. Both propranolol and verapamil improved exercise capacity (placebo 424 +/- 135 W-min; propranolol 513 +/- 168 W-min, p less than 0.01; verapamil 545 +/- 215 W-min, p less than 0.005) and prolonged the time to 1 mm of ST depression (placebo 4.5 +/- 1.3 minutes; propranolol 7.4 +/- 1.4 minutes, p less than 0.005; verapamil 6.6 +/- 1.9 minutes, p less than 0.005). At rest, the mean left ventricular ejection fraction did not change significantly during drug therapy (placebo 57 +/- 13%, propranolol 55 +/- 12%, verapamil 55 +/- 13%). While taking placebo, all 18 patients had a decrease in exercise ejection fraction. In contrast, 12 patients taking propranolol and 14 patients taking verapamil had a 5% or greater increase in ejection fraction during exercise. Verapamil is an effective primary therapy and a satisfactory alternative to propranolol in patients with stable effort angina.
Apoptosis Threshold Set by Noxa and Mcl-1 after T Cell Activation Regulates Competitive Selection of High-Affinity Clones
Authors: Felix M. Wensveen, Klaas P.J.M. van Gisbergen, Ingrid A.M. Derks, Carmen Gerlach, Ton N. Schumacher, René A.W. van Lier, Eric Eldering
Journal: Immunity (2010)