tbuckley/cabot-search huggingface dataset:
ABC of colorectal diseases. Lower gastrointestinal haemorrhage.
Authors: D. J. Jones
Journal: BMJ (1992)

Ischaemic colitis Inflammatory bowel disease Radiation proctitisBleeding from the lower gastrointestinal tract is a common clinical problem in both general and hospital practice.Patients are alarmed when they pass blood, but most have minor anorectal disorders thait can be investigated and treated on an outpatient or day case basis.A smaller proportion have colorectal neoplasia, inflammatory bowel disease, or profuse life threatening haemorrhage.Lower gastrointestinal haemorrhage affects people of all ages, though the aetiology varies in different age groups. Common clinical patterns of bleedingThe character of blood lost is dependent on the rate of haemorrhage and the site of the source.Patients with brisk haemorrhage and those with distal colorectal lesions tend to pass bright red blood.Ifthe bleeding is slow or the source is in the proximal colon the blood is altered, being darker red in colour, and mixed with faeces.Haemorrhoids -Patients with bleeding haemorrhoids pass bright red streaks of blood, which they initially notice on the faeces, on toilet tissue, or in the toilet bowl.Occasionally bleeding can be vigorous and actually drip from the anal canal.Such bleeding is usually associated with large or prolapsed haemorrhoids and can occur spontaneously.Inflammatory bowel disease Patients with inflammatory bowel disease tend to lose small amounts of blood mixed with mucus and faeces and they usually have increased bowel frequency.Similar symptoms are also seen in patients with irradiation proctocolitis, which usually follows radiotherapy AX X ~~for pelvic malignancy. Bleeding prolapsed haemorrho,dsTumours-Patients with distal colorectal polyps and cancers pass bright red or slightly altered streaks of blood, and this is a common presenting symptom.If the tumour is in the proximal colon the blood lost is darker in colour, and less obvious.Patients with caecal cancer commonly present with iron deficiency anaemia due to occult chronic blood loss with apparently normal unaltered faeces.Diverticular disease and angiodysplasia-Bleeding in patients with colonic diverticular disease and colonic angiodysplasia is often brisk, causing a sudden urge to defecate, followed by the passage of a large dark red stool.This may be repeated but the bleeding usually stops spontaneously.The bleeding may be sufficient to cause life threatening hypovolaemic shock.Severe haemorrhage occasionally develops in patients with solitary rectal ulcers.Ischaemic colitis-Patients with ischaemic colitis are usually elderly and present with left sided abdominal pain associated with blood stained rnlnnncennpvipw nf rninni-ran(-r dhiwinn diarrhoea.
Regional lung function in patients with hepatic cirrhosis
Authors: F. Ruff, J. M. B. Hughes, N. Stanley, D. McCarthy, R. Greene, A. Aronoff, L. Clayton, J. Milic-Emili
Journal: Journal of Clinical Investigation (1971)

The lung volume at which the dependent lung zones begin to trap gas as a result of airway closure (i.e., the "closing volume") was measured with (133)Xe in 10 seated patients with hepatic cirrhosis. In all of them the closing volume was increased above normal, and in eight it was greater than the functional residual capacity, indicating the presence of airway closure and gas trapping during resting tidal volume breathing. Direct measurements made with (133)Xe in five cirrhotic patients (a) confirmed the presence of increased gas trapping in the lower lung zones both at residual volume and at functional residual capacity, and (b) indicated that in liver cirrhosis the ventilation-perfusion ratio of the dependent lung zones may be very low, primarily as a result of decreased ventilation due to airway closure. It is concluded that in hepatic cirrhosis, gas trapping in the dependent lung zones may be an important cause of impaired gas exchange within the lungs. It is suggested that the premature airway closure observed in this disease may be due to mechanical compression of small airways by dilated blood vessels and/or interstitial pulmonary edema.
Attenuation of Obstructive Sleep Apnea and Overnight Rostral Fluid Shift by Physical Activity
Authors: Stefania Redolfi, Michela Bettinzoli, Nicola Venturoli, Marco Ravanelli, Leonardo Pedroni, Luigi Taranto-Montemurro, Isabelle Arnulf, Thomas Similowski, Claudio Tantucci
Journal: American Journal of Respiratory and Critical Care Medicine (2015)
Women consultants lag behind in merit awards
Authors: L Beecham
Journal: BMJ (1994)

The Advisory Committee on Distinction Awards is concerned about the lower percentage of awards given to women consultants compared with their male colleagues. About 20% of women consultants hold awards compared with about 37% of male consultants. In 1993 the women received only 12.7% of the available awards, although they formed 17% of the consultant body.

About one third of all consultants hold awards, of which there were 7103 at the end of 1993, costing pounds sterling 104m.

In the committee's first annual report its chairman, Professor Sir Gordon Robson, says that the imbalance is partly because most female consultants enter five specialties-psychiatry, anaesthetics, paediatrics, radiology, and public health medicine. Last year new consultant entrants to these specialties comprised 64% of women and only 36% of men. The younger age pattern of women consultants is another factor.

In addition, there are wide regional variations. The South Western region with 39 awards available selected only one woman and in Wessex, where 16% of consultants are women, they received only two recommendations for C awards. By contrast, the Thames regions all recommended that 20% or more of their awards should go to women.

Sir Gordon casts doubt on the age limit for merit awards, which was intended to prevent awards being granted close to retirement so as to boost pensions. He says that the number of awards granted to consultants aged between 60 and 65 does not support the contention that they are retirement presents. He believes that the practical effects of the age limits are …
Curing Health Care: New Strategies for Quality Improvement—A Report on the National Demonstration Project on Quality Improvement in Health Care
Authors: Norman L. Cannon
Journal: JAMA (1992)

This book is an exposition of the aims, organization, and design of the National Demonstration Project (NDP), which began when a group of over 100 clinicians, health care executives, and industrial quality control specialists held the September 1987 inaugural meeting on Quality Improvement in Health Care. The NDP brought together 21 experts in quality management from major American companies, universities, and consulting firms and matched them with leadership teams representing 21 American health organizations—hospitals, health maintenance organizations, and group practices. After two days of workshops and training, each team produced a formal statement of the issues to be tackled, a work plan, and an agreement to return to Boston eight months later to report progress. The costs were underwritten by the John A. Hartford Foundation. Two of the 21 teams abandoned participation because of unanticipated organizational changes, and the book is based on examples from 17 of the original teams,
Disappearance of Metastatic Breast Cancer after Oophorectomy
Authors: R. S. Mecklenburg, M. B. Lipsett
Journal: New England Journal of Medicine (1973)

LONG-TERM survival in women with disseminated breast cancer and particularly with visceral metastases is unusual. Among 128 patients with visceral involvement described by Gardner,1 survival ranged from nine to 11 months. Of patients with metastatic disease, those responding to ovarian ablation appear to have longer survivals than nonresponders although extended remissions are not common.2 In the following case of disseminated breast cancer metastases disappeared after oophorectomy, and the patient is alive and well without evidence of disease 25 years after the discovery of the original tumor.Case ReportIn 1948, at the age of 34 years, the patient discovered a . . .
Absorption of bile acids from the large bowel in man
Authors: Paul Samuel, George M. Saypol, Edward Meilman, Erwin H. Mosbach, Mohsen Chafizadeh
Journal: Journal of Clinical Investigation (1968)

The absorption of bile acids from the human large bowel was studied in eight patients. All patients had cholecystitis and cholelithiasis and had to undergo cholecystectomy. Cholic acid-(14)C was injected during surgery into the lumen of the cecum, hepatic flexure of the colon, or transverse colon in six patients, under the visual control of the surgeon. Common duct bile was collected by T tube daily for 5 days, and bile acids were extracted. Significant amounts of radioactivity appeared in T tube bile in each patient. T tube bile acids contained a total of 43.6-84.6% of the administered radioactivity; the average for the six patients was 58.9%. The majority of the tracer was excreted during the first 24 hr. In an additional patient cholic acid-(14)C was given in the form of an enema 5 days postoperatively. In this subject 30.8% of the retained radioactivity was excreted through the T-tube in 48 hr. The labeled cholic acid was recovered as both cholic and deoxycholic acid from T tube bile. Thin-layer chromatographic analysis of the bile acid samples indicated that the fraction of radioactivity recovered as deoxycholate increased with time during the postoperative period. Gas-liquid chromatographic analysis showed that the daily total quantity of excreted bile acids increased significantly from the 1st-5th days of the experiment. The amount of cholate excreted in T tube bile increased markedly with time, that of chenodeoxycholate increased moderately, and that of deoxycholate decreased sharply during the 5 days of the experiment. In three patients, injection of radiopaque material mixed with the tracer showed no evidence of regurgitation into the small bowel by serial X-rays. In an additional patient, tube aspirate from the terminal ileum contained no radioactivity. The results indicate that cholic acid is converted to deoxycholic acid in the human colon, and both of these bile acids are absorbed from the human large bowel in significant amounts. These data establish the previously unproved concept that significant absorption of bile acids takes place from the large bowel of man.
Primary sclerosing cholangitis and ulcerative colitis: Evidence for increased neoplastic potential
Authors: Ulrika Broomé, Robert Löfberg, Béla Veress, Ljusk Siw Eriksson
Journal: Hepatology (1995)

Primary sclerosing cholangitis (PSC) is a biliary destructive disease mostly affecting patients with ulcerative colitis (UC). PSC has been suggested to be an independent risk factor for the development of colorectal malignancy in UC. Patients with PSC also have an increased risk of developing cholangiocarcinoma. This study aimed at assessing the cumulative risk of colorectal neoplasia in PSC and UC, and also to determine risk factors for the development of cholangiocarcinoma. Fifty-eight PSC patients were included. Forty PSC patients having extensive UC were each matched to two control patients of the same age, with extensive colitis and a comparable duration of the colitis, but without PSC. All UC patients had been under colonoscopic surveillance with multiple biopsies. Among the 40 PSC patients with UC, 16 developed colonic dysplasia or carcinoma, versus 10 in the control group (P < .001). The absolute cumulative risk of developing colorectal dysplasia/carcinoma in the PSC/UC groups was 9%, 31%, and 50% after 10, 20, and 25 years of disease duration. In the group with UC only, the corresponding risk was 2%, 5%, and 10%, respectively (P < .001). Ten patients with PSC developed cholangiocarcinoma, all but one having UC. In the control group, no cholangiocarcinoma occurred. Patients with PSC and UC with colorectal neoplasia developed cholangiocarcinoma significantly more often compared with patients with UC and PSC without colonic dysplasia/carcinoma (P < .02). This study demonstrates not only that patients with PSC and UC have a significantly higher risk of developing colorectal neoplasia compared with patients having UC only, but also that patients with PSC and UC having colorectal neoplasia are more prone to develop cholangiocarcinoma.
TRANSPLANTATION OF THE TESTICLE
Authors: VICTOR D. LESPINASSE
Journal: JAMA (1913)

The first experimental work on transplantation of the testicle was done by Berthold<sup>1</sup>in 1849. He used completely castrated roosters and transplanted the testicle into the abdominal cavity. The transplanted testicle grew, maintained its peculiar character as a sexual organ, and the male habits of the chicken continued. Other investigators have confirmed this result in chickens. In frogs, Herlitzka<sup>2</sup>transplanted testicles into the peritoneal cavity, and found that they degenerated and became absorbed. Meyns<sup>3</sup>worked with frogs and implanted parts of the testicle into the dorsal lymph-vessel of the frog and found that these transplants grew and developed new mature spermatozoa. The size of the transplanted organ has a great deal to do with the success or failure of the operation. If the testicle is transplanted<i>in toto</i>, it is almost certain to necrose. If it is cut into thin slices from 1 to 2 mm. in
INTESTINAL PARASITES AMONG FILIPINO FOOD HANDLERS
Authors: HARRY A. WYCKOFF
Journal: JAMA (1925)

Many of the Filipinos that come to the United States find employment in the handling of food supplies. In the public institution here surveyed, some of them are employed as waiters, as bus boys and in the kitchen. A survey of such a group included routine stool examination with direct smears and centrifugalized sediments. The results of these examinations are given in Table 1. In view of the high percentage of infestation, it is rather surprising that none of the men showed any marked symptoms. Out of thirty-four cases examined, twenty-eight were found positive for parasites. Twenty-two of these positive patients harbored either a double or triple infestation. The parasites found were hookworm, in twenty-one cases;<i>Trichuris</i>, sixteen cases;<i>Ascaris</i>, two cases;<i>Fasciolopsis</i>and<i>Hymenolepis</i>in one case each, and protozoa in twelve cases. Compared with the incidence of intestinal protozoa in medical patients in the Stanford service, we find
Cancer and Clotting — Trousseau's Warning
Authors: Roy L. Silverstein, Ralph L. Nachman
Journal: New England Journal of Medicine (1992)

A relation between hypercoagulability and cancer has been recognized for more than 125 years. Trousseau,1 lecturing on phlegmasia alba dolens in 1872, noted that deep-vein thrombosis of the extremities often accompanied visceral cancer and concluded that "spontaneous coagulation is common in cancerous patients" because of a "special crasis of the blood, which irrespective of inflammation, favors intra-venous coagulation." Trousseau's observations have subsequently been verified by the accumulation of clinical and pathological data suggesting systemic activation of the coagulation cascade in patients with cancer. Postmortem studies2 have demonstrated a markedly increased incidence of thromboembolic disease in patients who died of cancer, . . .
Tillie Revisited
Authors: Charles D. Magill
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Single case reports can be of benefit to medical literature, particularly, in this case, to the student of anatomy. However, perhaps more instructive is that attention to anomalies such as this one might direct the emergency room physician's attention to more specific examination of the wrist bones on x-ray films. This could lead to something that ordinarily might be missed, such as a perilunate dislocation, simply by alerting the physician to the fact of the different bones of the wrist. A 26-year-old male medical technologist had pain in the right wrist for six weeks following some unaccustomed weekend hammering. The main symptoms were lack of "normal" strength, and "hurting to shake hands." An x-ray film of the wrist showed a congenital fusion between the lunate and the triquetral bones, but no other bony abnormalities. The diagnosis was tendonitis of the right hand, and the symptoms disappeared with
The SCOFF questionnaire and clinical interview for eating disorders in general practice: comparative study
Authors: Amy J Luck, John F MorganLuck, Fiona Reid, Aileen O'Brien, Joan Brunton, Clare Price, Lin Perry, J Hubert Lacey
Journal: BMJ (2002)

Standards 2 and 3 of the national service framework for mental health outline the need to improve health care for patients with anorexia nervosa and bulimia nervosa.1 Healthcare workers in primary care are at the forefront of screening and managing these disorders. Assessment tools available to primary healthcare professionals can take a long time to administer and may need to be interpretedby specialists2; this may limit improvements in care. A screening tool was developed, but only to facitate epidemiological research.3

The SCOFF questionnaire is a brief and memorable tool designed to detect eating disorders and aid treatment (see figure). It showed excellent validity in a clinical population and reliability in a student population. 4 5 We assessed the SCOFF questionnaire in primary care.

We invited sequential women attenders (aged 18-50) at two general practices in southwest London to participate. We gave participants …
Caput Medusae in medicine and art.
Authors: R. H. Park, M. P. Park
Journal: BMJ (1988)

occurred since in nuclear physics.Further Nobel prizes for doctors working on immunity were those received in 1960 by Sir Macfarlane Burnet (35) and Sir Peter Medawar for their work in acquired immunological tolerance to tissue transplants.The 1913 medicine prize was awarded to Charles Robert Richet, 1850-1935, the French physiologist, for his work on serology and serum treatment.Together with the French bacteriologist Paul Jones Portier, 1875- 1962, he discovered anaphylactic shock and coined the word "anaphylaxis" for certain serum reactions as they appeared to be the opposite of prophylaxis (36).George Bernard Shaw, 1856-1950, who received the literature prize in 1925 (37), published his play The Doctor's Dilemma in 1906 in Berlin.This has an interesting medical connection.The leading character-Sir Colenso Ridgeon-was based on his friend Sir Almroth Wright, 1861-1947, the main protagonist of the theory of opsonins in immunity and also typhoid vaccination of soldiers in the Boer war.
Therapeutic Effect of γ-Secretase Inhibition in KrasG12V-Driven Non-Small Cell Lung Carcinoma by Derepression of DUSP1 and Inhibition of ERK
Authors: Antonio Maraver, Pablo J. Fernandez-Marcos, Daniel Herranz, Marta Cañamero, Maribel Muñoz-Martin, Gonzalo Gómez-López, Francisca Mulero, Diego Megías, Marta Sanchez-Carbayo, Jie Shen, Montserrat Sanchez-Cespedes, Teresa Palomero, Adolfo Ferrando, Manuel Serrano
Journal: Cancer Cell (2012)
The Effectiveness of a New Multibending Scope for Endoscopic Mucosal Resection
Authors: K. Isshi, H. Tajiri, J. Fujisaki, K. Mochizuki, K. Matsuda, Y. Nakamura, N. Saito, N. Narimiya
Journal: Endoscopy (2004)

Each year at our institution we have been performing over 100 endoscopic mucosal resections (EMRs) for gastric tumor. However, there are some tumor locations where it is difficult to carry out this procedure, such as the lesser curvature or posterior wall of the gastric body, the cardia, and the lesser curvature of the antrum. To facilitate EMR of tumors in these locations, a multibending scope (the "M-scope", Olympus GIF-2T240M; Olympus Optical, Tokyo, Japan) has been developed, which has two independently curving segments. The aim of this study was to evaluate the effectiveness of this new multibending scope for EMR of gastric tumors.Using the M-scope, we carried out EMR in 59 patients at the Jikei University Hospital. The lesions were located in the cardia in seven patients, in the gastric body in 30 patients, and in the antrum in 22 patients. The effectiveness of the M-scope was evaluated by experienced endoscopists; a score of 1 was given for very good effectiveness, and a score of 0 was given when there was no notable difference in effectiveness from the conventional scope. Evaluation was done according to the location of the lesions, the method used for EMR, and the tumor diameter. When the score for each item was equivalent to the average overall score for all the procedures or higher, the M-scope was defined as being effective.The overall score for all the procedures was 0.7 +/- 0.4 (average +/- SD) (very good in 43 procedures; no notable difference in 16 procedures). When assessed according to the location of the lesion, the mean effectiveness scores of the M-scope for lesions at the following locations were higher than the average overall score: the lesser curvature of the antrum (0.8 +/- 0.5); the posterior wall of the gastric body (1.0 +/- 0.0); the greater curvature of the gastric body (1.0 +/- 0.0); and the lesser curvature of the gastric body (0.9 +/- 0.4). The results suggested that the M-scope was effective for EMR of gastric tumors at these traditionally difficult locations. With regard to the scores assessed according to the method of EMR, the mean scores were 0.8 +/- 0.4 for the two-channel scope method and 0.9 +/- 0.4 for EMR using an insulated-tip diathermic knife (IT-EMR), again suggesting that the M-scope was effective for EMR by these methods. When evaluated according to tumor size, the score was 0.8 +/- 0.4 when the tumor was 11 mm or greater in diameter, indicating that the M-scope was effective for EMR of large tumors.The results of the study suggest that the M-scope is effective for EMR of tumors in the lesser curvature of the antrum, and in the posterior wall, lesser curvature, or greater curvature of the gastric body. With regard to the method of EMR, the M-scope is effective for both the two-channel scope method and IT-EMR. In relation to tumor size, the M-scope is effective for the resection of large tumors.
Multidrug resistance-associated protein 1 expression is under the control of the phosphoinositide 3 kinase/Akt signal transduction network in human acute myelogenous leukemia blasts
Authors: P L Tazzari, A Cappellini, F Ricci, C Evangelisti, V Papa, T Grafone, G Martinelli, R Conte, L Cocco, J A McCubrey, A M Martelli
Journal: Leukemia (2007)
What makes insulin injections painful?
Authors: E Chantelau, D M Lee, D M Hemmann, U Zipfel, S Echterhoff
Journal: BMJ (1991)

Keeping in mind the limitations of the methods, we believe that long term effects in humans are very likely to occur at levels of maternal alcohol consumption during pregnancy of 300 g or more of absolute alcohol a week.Below this level the evidence is conflicting and open to methodological objections.We continue to support the recommendation from our results of immediate outcome of pregnancy that, allowing for a margin of safety, women should not have more than one standard drink a day (70-85 g absolute alcohol a week), and only as much as this if abstinence is not feasible.
Mucoid Pseudomonas aeruginosa. A sign of cystic fibrosis in young adults with chronic pulmonary disease?
Authors: Herbert Y. Reynolds, Paul A. Di Sant'Agnese, Charles H. Zierdt
Journal: JAMA (1976)

Two adult patients with cystic fibrosis had late onset of symptoms with principal involvement only of the lungs. The absence of other typical features of cystic fibrosis confused the diagnosis. Recovery of mucoid<i>Pseudomonas aeruginosa</i>from sputum cultures helped to establish the diagnosis in these patients, because these mucoid isolates are rarely obtained from subjects who do not have cystic fibrosis. Recent findings, which have identified the mucoid isolates as predominantly a single strain of<i>P aeruginosa</i>and have documented its widespread carriage in the United States by patients with cystic fibrosis, point to an interesting epidemiologic relationship between this bacterium and this disease. (<i>JAMA</i>236:2190-2192, 1976)