tbuckley/cabot-search huggingface dataset:
Open-biopsy-forceps technique for removing biliary metallic stents that have migrated distally and wedged transversely in the duodenum
Authors: M. Matsushita, K. Uchida, K. Okazaki
Journal: Endoscopy (2007)

We read with interest the article by Shin et al. [1] on a prospective study of the endoscopic removal of malfunctioning biliary metallic stents. All attempts at stent removal were made using a therapeutic duodenoscope and a rat-tooth forceps. They removed covered stents easily in 19/22 patients, but were unable to remove any of the eight uncovered stents. Although they successfully removed all the stents that had migrated distally (three covered stents), they did not encounter any stents that had migrated distally and wedged transversely in the duodenum. In such a situation, the distal end of the stent becomes impacted in the duodenal wall opposite the papilla, and endoscopic removal of such stents is extremely difficult [2]. If endoscopic removal of the impacted stent fails, it might have to be removed surgically.
Primary Intraluminal Tumor of the Aorta Producing Malignant Hypertension
Authors: Albert A. Kattus, William P. Longmire, Jack A. Cannon, Roscoe Webb, Clarence Johnston
Journal: New England Journal of Medicine (1960)

PRIMARY intraluminal tumors of the aorta must be exceedingly rare. There is, to our knowledge, only 1 other case in the literature that resembles to any degree the case reported below.1 Our patient is a young woman in whom a tumor of mesenchymal origin occluded the aorta just beyond the arch, producing the physical signs of coarctation of the aorta. Furthermore, extension of the tumor into the renal arteries resulted in the clinical features of malignant hypertension of the Goldblatt-kidney type.Successful surgical removal of the tumor and its extensions has resulted in complete resolution of the hypertensive disease.Case . . .
Germline genetic variations in methotrexate candidate genes are associated with pharmacokinetics, toxicity, and outcome in childhood acute lymphoblastic leukemia
Authors: Susanne Radtke, Oliver Zolk, Bertold Renner, Marios Paulides, Martin Zimmermann, Anja Möricke, Martin Stanulla, Martin Schrappe, Thorsten Langer
Journal: Blood (2013)
Obstetric Analgesia with Pethidine
Authors: W. Spitzer
Journal: BMJ (1944)

In fespect of the 9 slow babies Table 11 shows the dose of pethidine and the time between its administration and the birth of the child.TABLE II Degree of Dilatation Time of Time of Parity of Cervix on Initial Dose Initial Dose Final Dose Final Dose Initial before Birth before Birth Dosage 1 4 fingers 100 mg.i.m. 2 hrs. 10 min. 100mg.i.m. 30 min. 1 3 ,, 100mg.i.m. 55 min._ r 3 ,, 100 mg.i.m. 2 hrs. 25 min. 100mg.i.m. 20 min. 1
A more severe flu pandemic is as inevitable as "death and taxes"
Authors: J. Carlowe
Journal: BMJ (2010)

<h3>Introduction</h3> Subjective tinnitus is very common and has a number of comorbid associations including depression, sleep disturbance and concentration difficulties. Concentration difficulties may be observable in people with tinnitus through poorer behavioural performance in tasks thought to measure specific cognitive domains such as attention and memory (ie, cognitive performance). Several reviews have discussed the association between tinnitus and cognition; however, none to date have investigated the association between tinnitus and cognitive performance through meta-analysis with reference to an established theoretical taxonomy. Furthermore, there has been little overlap between sets of studies that have been included in previous reviews, potentially contributing to the typically mixed findings that are reported. <h3>Methods and analysis</h3> This systematic review aims to comprehensively review the literature using an established theoretical taxonomy and quantitatively synthesise relevant data to determine associations between subjective tinnitus and cognitive performance. Methods are reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. All study designs will be eligible for inclusion with no date restrictions on searches. Studies eligible for inclusion must contain adult participants (≥18 years) with subjective tinnitus and a behavioural measure of cognitive performance. Meta-analysis will be reported via correlation for the association between tinnitus and cognitive performance. <h3>Ethics and dissemination</h3> No ethical issues are foreseen. Findings will be reported in a student thesis, at national and international , ear, nose and throat/audiology conferences and by peer-reviewed publication. <h3>PROSPERO registration number</h3> CRD42018085528.
Nutrient intake and cataract extraction in women: a prospective study.
Authors: S. E. Hankinson, M. J. Stampfer, J. M. Seddon, G. A. Colditz, B. Rosner, F. E. Speizer, W. C. Willett
Journal: BMJ (1992)

OBJECTIVE--To examine prospectively the association between dietary intake of vitamins C and E, carotene, and riboflavin and cataract extraction in women. DESIGN--Prospective cohort study beginning in 1980 with eight years of follow up. SETTING--11 states of the United States. PARTICIPANTS--Female registered nurses who were 45 to 67 years of age. 50,828 women were included in 1980 and others were added as they became 45 years of age. MAIN OUTCOME MEASURE--Incidence of extraction of senile cataracts. RESULTS--493 cataracts were extracted during 470,302 person years of follow up. Intake of carotene and vitamin A was inversely associated with cataract: in multivariate analyses, women in the highest fifth of total vitamin A intake (excluding supplements) had a 39% lower risk of cataract relative to women in the lowest fifth (relative risk 0.61; 95% confidence interval 0.45 to 0.81). Neither riboflavin nor dietary vitamins E or C were associated with cataract in a multivariate analysis. Among specific food items spinach (rather than carrots, the greatest source of beta carotene) was most consistently associated with a lower relative risk. The risk of cataract was 45% lower among women who used vitamin C supplements for 10 or more years(relative risk 0.55 (0.32 to 0.96)), but no association was noted for multivitamin intake. CONCLUSION--Dietary carotenoids, although not necessarily beta carotene, and long term vitamin C supplementation may decrease the risk of cataracts severe enough to require extraction.
Acute Infection with the Human Immunodeficiency Virus (HIV) Associated with Acute Brachial Neuritis and Exanthematous Rash
Authors: LEONARD H. CALABRESE
Journal: Annals of Internal Medicine (1987)

Clinical descriptions of acute or primary infection with the human immunodeficiency virus (HIV) are rare. Among cases previously reported, most describe an acute illness resembling infectious mononucleosis. We describe the case of a 32-year-old homosexual man with an acute illness associated with strong serologic evidence of a primary infection with HIV. This case illustrates two new clinical features: an acute, bilateral brachial neuritis, and a vesicular, pustular exanthematous and enanthematous rash. Studies of HIV-related serologic results show differential sensitivities for enzyme-linked immunosorbent assay, Western blot, immunofluorescence, and viral antigen techniques in the acute phase of HIV infection. There appears to be significant clinical heterogeneity of the acute phase of HIV infection.
Kupffer cell depletion abolishes induction of interleukin-10 and permits sustained overexpression of tumor necrosis factor alpha messenger RNA in the regenerating rat liver
Authors: R M Rai, S Loffreda, C L Karp, S Yang, H Lin, A M Diehl
Journal: Hepatology (1997)

Tumor necrosis factor α (TNF), initiates a cytokine cascade that promotes hepatocyte proliferation after 70% partial hepatectomy (PH) but the mechanisms regulating TNF production after PH are unknown. We previously reported that gadolinium chloride (GdCl), an agent that depletes the liver of phagocytically active Kupffer cells, enhances hepatic expression of TNF messenger RNA (mRNA) and promotes liver regeneration after subsequent PH. This suggests that GdCl interferes with Kupffer cell mechanisms that normally constrain TNF production after PH. To evaluate this, the pre- and post-PH expression of TNF, TNF-inducible cytokines (interleukin [IL]-1, IL-6) and cytokines (transforming growth factor [TGF]β 1 and IL-10) that down-regulate TNF were compared in controls and GdCl-treated rats. In controls, TNF, IL-1, IL-6, and IL-10 increase within 3 hours after PH, whereas TGF-β 1 is induced much later (&gt; 24 hours after PH). GdCl causes sustained overexpression of TNF mRNA and transient overexpression of circulating TNF protein after PH; both TNF-inducible cytokines are also relatively overexpressed. Cytokines that down-regulate TNF are effected differentially by GdCl. Regenerative induction of IL-10 is abolished but TGF-β 1 induction is unaltered. Because IL-10 is known to shorten the half-life of TNF mRNA, these results suggest that Kupffer cell production of IL-10 is an important mechanism that down-regulates TNF production during liver regeneration.
Zidovudine induces molecular, biochemical, and ultrastructural changes in rat skeletal muscle mitochondria.
Authors: W Lewis, B Gonzalez, A Chomyn, T Papoian
Journal: Journal of Clinical Investigation (1992)

Zidovudine (AZT) inhibits HIV-1 replication in AIDS. A limiting side effect is AZT-induced toxic myopathy. Molecular changes in a rat model of AZT-induced toxic myopathy in vivo helped define pathogenetic molecular, biochemical, and ultrastructural toxic events in skeletal muscle and supported clinical and in vitro findings. After 35 d of AZT treatment, selective changes in rat striated muscle were localized ultrastructurally to mitochondria, and included swelling, cristae disruption, and myelin figures. Decreased muscle mitochondrial (mt) DNA, mtRNA, and decreased mitochondrial polypeptide synthesis in vitro were found in parallel. Mitochondrial molecular changes occurred in absence of altered abundance of cytosolic glyceraldehyde-3-phosphate dehydrogenase, or sarcomeric mitochondrial creatine kinase mRNAs. Quadriceps mitochondrial DNA polymerase gamma activity was similar in both AZT-treated and control rats. In vivo findings with rats support the hypothesis that AZT-induced inhibition of mtDNA replication has an effect of depressing the abundance of striated muscle mtDNA, mtRNA, and mitochondrial polypeptide synthesis. This experimental approach may be useful to examine mitochondrial or toxic myopathies.
Effects of New Low-Dosage Form of Norethynodrel-Mestranol
Authors: Charles E. Flowers
Journal: JAMA (1964)

A new low-dosage form of norethynodrel with mestranol (Enovid E), containing 2.5 mg of the progestational agent and 0.1 mg of mestranol, was studied in 3,510 menstrual cycles among 259 women with the minimum of a high school education. The medication was 100% effective as a contraceptive and was medically accepted among 91% of the patients. Simplified dosage schedules and methods of managing side effects were developed. Biopsies revealed that the endometrium of patients receiving the drug continued to respond to hormonal stimulation after two years, without pathological changes. The appearance of the endometrium was consistent and predictable at various stages of the menstrual cycle; it was characterized by secretory regression.
Preeclampsia — A Glimpse into the Future?
Authors: Ravi Thadhani, Caren G. Solomon
Journal: New England Journal of Medicine (2008)

Preeclampsia, a disorder of pregnancy characterized by elevated blood pressure and proteinuria, complicates approximately 5% of pregnancies.1 Although several risk factors for this condition are well recognized, including nulliparity, extremes of maternal age, obesity, and preexisting diabetes or hypertension, the causes of preeclampsia remain uncertain; recent studies have suggested that circulating angiogenic factors, alterations in the renin–angiotensin system, and insulin resistance may be involved in pathogenesis.1 Despite several trials examining various interventions,1 no strategy has proved effective in the prevention or treatment of preeclampsia other than delivery of the fetus. Complications include maternal stroke, renal failure, and placental abruption; offspring . . .
Tissue-Specific Alternative Splicing of Tak1 Is Conserved in Deuterostomes
Authors: J. P. Venables, E. Vignal, S. Baghdiguian, P. Fort, J. Tazi
Journal: Molecular Biology and Evolution (2011)

Alternative splicing allows organisms to rapidly modulate protein functions to physiological changes and therefore represents a highly versatile adaptive process. We investigated the conservation of the evolutionary history of the "Fox" family of RNA-binding splicing factors (RBFOX) as well as the conservation of regulated alternative splicing of the genes they control. We found that the RBFOX proteins are conserved in all metazoans examined. In humans, Fox proteins control muscle-specific alternative splicing of many genes but despite the conservation of splicing factors, conservation of regulation of alternative splicing has never been demonstrated between man and nonvertebrate species. Therefore, we studied 40 known Fox-regulated human exons and found that 22 had a tissue-specific splicing pattern in muscle and heart. Of these, 11 were spliced in the same tissue-specific manner in mouse tissues and 4 were tissue-specifically spliced in muscle and heart of the frog Xenopus laevis. The inclusion of two of these alternative exons was also downregulated during tadpole development. Of the 40 in the starting set, the most conserved alternative splicing event was in the transforming growth factor (TGF) beta-activated kinase Tak1 (MAP3K7) as this was also muscle specific in urochordates and in Ambulacraria, the most ancient deuterostome clade. We found exclusion of the muscle-specific exon of Tak1 was itself under control of TGF beta in cell culture and consistently that TGF beta caused an upregulation of Fox2 (RBFOX2) expression. The alternative exon, which codes for an in-frame 27 amino acids between the kinase and known regulatory domain of TAK1, contains conserved features in all organisms including potential phosphorylation sites and likely has an important conserved function in TGF beta signaling and development. This study establishes that deuterostomes share a remarkable conserved physiological process that involves a splicing factor and expression of tissue-specific isoforms of a target gene that expedites a highly conserved signaling pathway.
Factors affecting choice of hemostatic agent for the hemophilia patient with an inhibitor antibody
Authors: Paul E. Monahan, Louis M. Aledort
Journal: American Journal of Hematology (2004)

Abstract Achieving adequate hemostasis in patients with hemophilia and high‐titer inhibitor antibodies remains a challenge despite the development of plasma‐derived and recombinant therapies to bypass the inhibitory effect. A group of hemophilia treaters met to examine the factors that influence physician choices among the very costly and cumbersome available therapies. Specific knowledge deficits in need of prospective research were identified with respect to the rational treatment of inhibitor patients. Am. J. Hematol. 77:346–350, 2004. © 2004 Wiley‐Liss, Inc.
What catatonia can tell us about “top-down modulation”: A neuropsychiatric hypothesis
Authors: Georg Northoff
Journal: Behavioral and Brain Sciences (2002)

Differential diagnosis of motor symptoms, for example, akinesia, may be difficult in clinical neuropsychiatry. Symptoms may be either of neurologic origin, for example, Parkinson's disease, or of psychiatric origin, for example, catatonia, leading to a so-called “conflict of paradigms.” Despite their different origins, symptoms may appear more or less clinically similar. Possibility of dissociation between origin and clinical appearance may reflect functional brain organisation in general, and cortical-cortical/subcortical relations in particular. It is therefore hypothesized that similarities and differences between Parkinson's disease and catatonia may be accounted for by distinct kinds of modulation between cortico-cortical and cortico-subcortical relations. Catatonia can be characterized by concurrent motor, emotional, and behavioural symptoms. The different symptoms may be accounted for by dysfunction in orbitofrontal-prefrontal/parietal cortical connectivity reflecting “horizontal modulation” of cortico-cortical relation. Furthermore, alteration in “top-down modulation” reflecting “vertical modulation” of caudate and other basal ganglia by GABA-ergic mediated orbitofrontal cortical deficits may account for motor symptoms in catatonia. Parkinson's disease, in contrast, can be characterized by predominant motor symptoms. Motor symptoms may be accounted for by altered “bottom-up modulation” between dopaminergic mediated deficits in striatum and premotor/motor cortex. Clinical similarities between Parkinson's disease and catatonia with respect to akinesia may be related with involvement of the basal ganglia in both disorders. Clinical differences with respect to emotional and behavioural symptoms may be related with involvement of different cortical areas, that is, orbitofrontal/parietal and premotor/motor cortex implying distinct kinds of modulation – “vertical” and “horizontal” modulation, respectively.
Charity calls for improved breast awareness in UK ethnic communities
Authors: Christiane Rehwagen
Journal: BMJ (2005)

Women from minority ethnic groups in the United Kingdom have much less knowledge about breast cancer than white British women, says Breast Cancer Care. The charity is calling on the government and the NHS to improve the situation. It also demands better cooperation between the media, primary care, community organisations, government health departments, breast cancer charities, and the NHS breast screening programme.

The results emerged during a debate held in London last week which discussed the results of a survey commissioned by Breast Cancer Care in March 2005. The survey found that 43% of …
Diffuse Bilateral Pulmonary Edema Associated with Unilobar Miliary Pulmonary Embolization in the Dog
Authors: DONALD SINGER, CHARLES HESSER, RUTH PICK, LOUIS N. KATZ
Journal: Circulation Research (1958)

Unilobar injection of starch solution produced pulmonary infarction at the site of injection and diffuse bilateral pulmonary edema. The predominantly or entirely unilobar distribution of the embolizing material was established by histologic methods and by a technic using whole lung lobe suspension stained with Lugol's solution. Evidence is presented suggesting that the pulmonary edema in the nonembolized lobes is attributable to neural or neurohumoral mechanisms.
Effects of Erythrol Tetranitrate and Amotriphene on Exercise Tolerance Tests in Angina Pectoris
Authors: ARTHUR RUSKIN
Journal: Circulation (1961)

Sublingual erythrol tetranitrate is a potent drug in counteracting coronary insufficiency, as evidenced by reversal of positive electrocardiographic exercise tolerance tests in 72 per cent of 36 cases and reduction of anginal attacks in them by more than 50 per cent. Comparative studies with amotriphene indicate some subjective alleviation of angina, but objective reversals of the electrocardiographic effects of exercise in only 16 per cent of the cases. Side effects of erythrol tetranitrate, particularly headache, are seen in a minority of cases and are often circumvented by starting with a small dose and gradually increasing it as necessary. Alleviation of ectopic beats on exercise occurred equally in a minority of cases on the two drugs.
Subcutaneous Insulin Infusion: Change in Basal Infusion Rate has No Immediate Effect on Insulin Absorption Rate
Authors: P Hildebrandt, K Birch, B M Jensen, C Kühl
Journal: Diabetes Care (1986)

Eight insulin-dependent diabetic patients were simultaneously given subcutaneous infusions (1.12 IU/h each) of 125I-labeled Actrapid insulin in each side of the abdominal wall. After 24 h of infusion, the size of the infused insulin depots was measured by external counting for 5 h. The basal infusion rate was then doubled in one side and halved in the other for the next 4 h. Finally, 1.12 IU/h of insulin was given in both sides of the abdominal wall for an additional 3 h. The changes in the size of the depots were measured, and the absorption rates for each hour were calculated. During the first 5 h of infusion, the depot size was almost constant (approximately 5 IU) with an absorption rate that equaled the infusion rate. Doubling the infusion rate led to a significant increase in depot size, but the absorption rate remained unchanged for the first 3 h, and only thereafter was a significant increase seen. When the infusion rate was reduced to the initial 1.12 IU/h, the absorption rate remained elevated during the next 3 h. Correspondingly, when the infusion rate was decreased, the depot size also decreased, but the absorption rate remained unchanged for the first 3 h. The results show that a change in the basal insulin infusion rate does not lead to any immediate change in the insulin absorption rate. This should be considered when planning an insulin-infusion program that includes alteration(s) in the basal-rate setting.
Arthroscopic surgery added no benefit to optimized physical and medical therapy in knee osteoarthritis
Authors: David T. Felson
Journal: Annals of Internal Medicine (2009)

ACP Journal Club20 January 2009Arthroscopic surgery added no benefit to optimized physical and medical therapy in knee osteoarthritisDavid T. Felson, MD, MPHDavid T. Felson, MD, MPHBoston University School of Medicine, Boston, Massachusetts, USA (D.T.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-2-200901200-02015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationKirkley A, Birmingham TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2008;359:1097-107. https://pubmed.ncbi.nlm.nih.gov/18784099Clinical Impact RatingsGIM/FP/GP: Rheumatology: References1 Moseley JB, O’Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002;347:81-8. [PMID: 12110735] Google Scholar2 Englund M, Guermazi A, Gale D, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359:1108-15. [PMID: 18784100] Google Scholar3 Marx RG. Arthroscopic surgery for osteoarthritis of the knee? N Engl J Med. 2008;359:1169-70. [PMID: 18784107] Google Scholar Author, Article, and Disclosure InformationAffiliations: Boston University School of Medicine, Boston, Massachusetts, USA (D.T.F.)This article was published at Annals.org on 6 January 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 January 2009Volume 150, Issue 2Page: JC1-15KeywordsArthritisArthroscopyKneesOsteoarthritisQuestionnairesSports and exercise medicineSurgeonsSurgery ePublished: 20 January 2009 Issue Published: 20 January 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Current Concepts In Cancer
Authors: William Weiss
Journal: JAMA (1967)

To the Editor:—  Dr. Philip Rubin wrote a comment on the effect of delay in treatment on the prognosis of breast cancer ( JAMA  200 :616, 1967) and reviewed the literature which shows that survival after surgery increases with the delay prior to surgery. This phenomenon is particularly striking if survival is dated from the date of tumor detection instead of from the time of surgery, because those patients who have delayed for years have already survived years before they finally come to surgery. As Dr. Rubin indicated, this phenomenon is probably due to natural selection, because the rapidly growing highly malignant cancers do not permit delay while the slowly growing ones of low malignant potential do. As a result, the group with prolonged delay is weighted with favorable cases while the group with short delay is weighted with unfavorable cases.  This explanation supports the doctrine that biologic predeterminism is the