tbuckley/cabot-search huggingface dataset:
Hepatic Necrosis After Enflurane Anesthesia
Authors: A. DelPizzo
Journal: JAMA (1974)

<h3>To the Editor.—</h3> It appears that physicians desire to place themselves on another merry-go-round with the introduction of each new halogenated anesthetic. Disconcerting is the description by Dr. L. van der Reis et al. The implication is made that enflurane has caused in this case a specific toxic hepatitis akin to "halothane hepatitis," if such an entity does exist. Current immunological tests do not seem to indicate such a specific reaction. The main problem with the evaluation of the supposed drug toxicity caused by enflurane, or by any drug for that matter, is that although the methods currently in use in the animal laboratory are adequate for most drugs, there will always be the problem of the rare unpredicted responses that may develop in man. Another problem is that conclusions drawn from isolated episodes usually present a fallacious association drawn between the administration of a drug and the subsequent development
Intense Pyrophosphate Heart Uptake with Insignificant Coronary Stenosis
Authors: MYRON C. GERSON, JOSEPH C. MANTIL, JAMES M. ALLEN
Journal: Clinical Nuclear Medicine (1984)

A patient with intense technetium pyrophosphate myocardial activity is presented. The scintigraphic findings are unique in that a pattern consistent with extensive myocardial necrosis was present, but no significant coronary artery stenosis was present by coronary cineangiography.
The spectrum of skin disorders in abdominal stoma patients
Authors: C.C. Lyon, A.J. Smith, C.E.M. Griffiths, M.H. Beck
Journal: British Journal of Dermatology (2000)

Background Skin integrity is essential for the normal usage of a stoma appliance. However, there is little published on the prevalence, nature or management of stoma-related skin disorders. Objectives To document stoma-related skin disorders in a large cohort of patients. Methods We sent a postal questionnaire to all surviving patients who had had abdominal stoma surgery at Hope Hospital, Salford, U.K. in the 10 years from 1 January 1989. Those reporting skin disease were invited to attend a clinic run by a dermatologist and a stoma-care specialist nurse. All lesions were categorized and swabs taken for microbiological examination. Results Of 525 surviving patients, 325 (62%) replied to the questionnaire. Of these, 73% reported a skin problem that had affected normal stoma bag use. Dermatoses included irritant reactions, particularly from leakage of urine or faeces (42%); pre-existing skin diseases, principally psoriasis, seborrhoeic dermatitis and eczema (20%); infections (6%); allergic contact dermatitis (0·7%) and pyoderma gangrenosum (0·6% annual incidence). A further 15% of patients with skin problems had persistent or recurrent dermatitis not explained by allergy, frank infection or faecal irritation. This responded to short-term treatment with topical corticosteroids. Further investigation is under way into its pathogenesis. Conclusions Skin disorders are common in stoma patients, and various patterns can be recognized and effectively treated.
Does genetic polymorphism for platelet glycoprotein illa impact early and long-term outcomes after elective percutaneous coronary interventions?
Authors: Giora Weisz, Roxana Mehran, Eugenia Nikolsky, Eve D. Aymong, Sotir Polena, Izat Hjazi, Issam Moussa, Edward Kreps, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon, George Dangas
Journal: Journal of the American College of Cardiology (2003)
Colonoscopy in the diagnosis of pseudomembranous colitis.
Authors: K Seppala
Journal: BMJ (1978)

ovary 5 59 stage III 45 Carcinoma ovary 6 16 stage IV 61 Carcinoma ovary 7 76 stage IV 92 Carcinoma ovary 8 62 stage IV 59 Carcinoma endometrium 9 65 stage I 34 Carcinoma endometrium 10 64 stage I 39 Carcinoma 11 57 cervix stage I 25
Where are peripheral analgesics acting?
Authors: B Bannwarth, F Demotes-Mainard, T Schaeverbeke, J Dehais
Journal: Annals of the Rheumatic Diseases (1993)

RHEUMATICDISEASES. LeaderWhere are peripheral analgesics acting?Most chronic rheumatic diseases result in pain, deformities, and decreased functional ability.Interestingly, a substantial number of patients, including rheumatoid patients, rank pain relief as the most desirable objective of treatment.'In this respect, the non-narcotic analgesics are usually con- sidered as the best drugs.2"These agents mainly include paracetamol, salicylates, and other non-steroidal anti- inflammatory drugs (NSAIDs), and non-acidic pyrazolone derivatives-for example, dipyrone (metamizole) and phenazone (antipyrine); aminophenazone (aminopyrine) has been withdrawn from the market.5As a group, they share analgesic, antipyretic, and, to a greater or lesser extent, anti- inflammatory properties.2Conversely, these compounds show marked differences in their therapeutic action and side effects.5Their common denominator was thus believed to be their site of action within the damaged tissues,6 and hence they were termed 'peripheral analgesics'.This assumption was mainly based on the following findings.Firstly, the classic cross-circulation experiment performed in the dog by Lim et alP indicated that the analgesic effect of aspirin-like drugs occurred in the pain producing site itself rather than in the central nervous system.Secondly, injections of minute amounts of acetyl- salicylic acid, indomethacin, or paracetamol into the inflamed paws of rats were shown to attenuate the noci- ceptive responses.8Moreover, NSAIDs may alter perceived pain intensity in rodents when applied locally to the injured sites.9 1 In humans too, locally applied aspirin and para- cetamol appeared to be effective for controlling pain in the early postoperative period after third molar surgery.1"Thirdly, pharmacokinetic data are consistent with the peripheral activity of these drugs.5 12 Systemically admin- istered NSAIDs were found to achieve particularly high concentrations in their target tissues in animals5 as well as in humans.13 '4 Finally, the analgesic property of aspirin-like drugs might be ascribed to their ability to inhibit prosta- glandin biosynthesis.6 15Indeed any tissue damage related to trauma, ischaemia, hyperthermia, or inflammation results in the release of various chemical substances, including prostaglandins, which may sensitise the primary afferent nociceptors to pain mediators, such as bradykinin. 16 However, this mechanism ofaction has been questioned. 17 18 Furthermore, experimental and clinical studies support the possibility of an additional central component in the analgesic action of aspirin-like drugs.This paper aims at reviewing these challenging findings.
Gastric Penetration of Gastric Bands
Authors: K. Ocran, M. Ortner, W. Voderholzer
Journal: Endoscopy (2004)

Figure 1 A 48-year-old woman had undergone gastric banding for extreme obesity (body mass index of 47) 3 years earlier. She subsequently complained of diffuse, persistent upper abdominal pain. Upper endoscopy revealed gastritis. No amelioration occurred under treatment with proton pump inhibitor (PPI). Control endoscopy eventually showed intragastric migration of the white gastric band.
Re: Gregory R. Pond, Andrew J. Armstrong, Brian A. Wood, et al. Evaluating the Value of Number of Cycles of Docetaxel and Prednisone in Men with Metastatic Castration-Resistant Prostate Cancer. Eur Urol 2012;61:363–9
Authors: YiJun Shen, DingWei Ye
Journal: European Urology (2011)
Cutaneous amoebiasis: case report.
Authors: L Turner, D M Jones, J Davson
Journal: BMJ (1985)

Une observation: un homme de 21 ans, revenant d'Extreme-Orient, presente un syndrome douloureux de l'hypochondre droit avec tumefaction. Un abces hepatique est soupconne. Une incision permet d'evacuer 250 ml de pus mais la cause de l'abces reste obscure et les cultures ne donnent aucun resultat. Apres nouvelle suppuration et drainage une gangrene de la peau et de la paroi autour de l'incision se developpe. Il ne s'agit pas de gangrene de Meleney (synergique postoperatoire) mais d'une amibiase cutanee, de diagnostic difficile
Screening for testicular cancer Familial predisposition ignored
Authors: R A Huddart, M G Leahy, S M Crawford
Journal: BMJ (1994)

EDITOR, - Joan Austoker clearly evaluates the advantages and disadvantages of population screening for testicular cancer.1 We agree that screening of the general population cannot be justified on present evidence and that greater awareness of this tumour in the general population and among the medical profession should be encouraged. Austoker does not, however, discuss the now substantial evidence concerning familial predisposition to testicular cancer.

Forman et al showed that sons of men with the disease had a relative risk of developing it themselves of 4.0 and that brothers of men with the disease had a relative risk of 9.8.2 Thus siblings of patients with testicular cancer have a …
Shortening of Electromechanical Systole as a Manifestation of Excessive Adrenergic Stimulation in Acute Myocardial Infarction
Authors: RICHARD P. LEWIS, HARISIOS BOUDOULAS, WILBUR F. FORESTER, ARNOLD M. WEISSLER
Journal: Circulation (1972)

The relationship between shortened electromechanical systole (QS 2 I) and 24-hour urinary catecholamine excretion (E+NE) was studied in 51 patients admitted to the coronary care unit with suspected acute myocardial infarction. Among these patients, 24 had a documented acute myocardial infarction while 27 had chest pain without evidence of recent myocardial infarction. Patients receiving cardioactive drugs or with impaired renal function were excluded. Initial elevation of catecholamine excretion was found in 22 of 24 subjects with myocardial infarction and 14 patients without documented myocardial infarction. A close linear correlation (r = -0.82, P &lt; 0.001) was noted between shortening of the QS 2 I and catecholamine excretion among all patients irrespective of the presence of documented infarction. Patients with serious arrhythmias had significantly higher levels of catecholamine excretion. In 13 patients with a short QS 2 I, 2.5 mg of propranolol given intravenously produced a significant lengthening of the QS 2 I while no change in the QS 2 I occurred in normal controls. This test provided useful corroborative evidence that the short QS 2 I was related to excessive adrenergic stimulation. In view of the current availability of effective beta-adrenergic blocking agents, these results may improve the selection of patients for antiarrhythmic therapy with these drugs.
Estrogens and the Liver
Authors: SIDNEY GUTSTEIN
Journal: Annals of Internal Medicine (1968)

Letters and Comments1 June 1968Estrogens and the LiverSIDNEY GUTSTEIN, M.D., LESLIE H. BERNSTEIN, M.D.SIDNEY GUTSTEIN, M.D.Search for more papers by this author, LESLIE H. BERNSTEIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-6-1372_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: In their paper, "Liver Dysfunction with Mestranol but not with Norethynodrel in a Patient with Enovid®-Induced Jaundice" (Ann. Intern. Med. 68: 598, 1968) Urban, Frank, and Kern have clearly shown that the estrogenic component of Enovid® (mestranol) interferes with hepatic excretion of sulfobromophthalein (BSP) and causes cholestasis.However, the progestational component (norethynodrel) produced not only fatigue in their patient, but also a transient rise in BSP retention to 10%. Their conclusion, therefore, that "the patient . . . is insensitive to norethynodrel" is not warranted. Indeed, since Enovid produced hyperbilirubinemia within 5 days during its second course... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: SIDNEY GUTSTEIN, M.D.; LESLIE H. BERNSTEIN, M.D.Affiliations: Department of Medicine Albert Einstein College of Medicine Yeshiva University Bronx, N. Y. 10454 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1968Volume 68, Issue 6Page: 1372-1372KeywordsEstrogensExcretionFatigueLiverLiver diseases ePublished: 1 December 2008 Issue Published: 1 June 1968 PDF downloadLoading ...
Reclassification Calculations for Persons With Incomplete Follow-up
Authors: Nancy R. Cook
Journal: Annals of Internal Medicine (2010)

Letters2 February 2010Reclassification Calculations for Persons With Incomplete Follow-upNancy R. Cook, ScD and Paul M. Ridker, MDNancy R. Cook, ScDFrom Brigham and Women's Hospital, Boston, MA 02215.Search for more papers by this author and Paul M. Ridker, MDFrom Brigham and Women's Hospital, Boston, MA 02215.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-3-201002020-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Drs. Steyerberg and Pencina for bringing up an important point about evaluating reclassification measures in the presence of survival data. When the outcome is time to an event, such as a cardiovascular event, care must be taken to accommodate censoring. The reclassification calibration statistic can easily be calculated by using survival data, as indicated in our article. The Kaplan–Meier estimate of the event rate as of 10 years, for example, can be used to obtain the expected number of events within each cell of the reclassification table. D'Agostino and Nam (1) suggest that with survival data, ...References1. D'Agostino RB, Nam BH. Evaluation of the performance of survival analysis models: discrimination and calibration measures.. In: Balakrishan N, Rao CR, eds. Handbook of Statistics, 23. Philadelphia: Elsevier; 2005:1-25. Google Scholar2. Harrell FE. Regression Modeling Strategies. New York: Springer; 2001. Google Scholar Author, Article, and Disclosure InformationAuthors: Nancy R. Cook, ScD; Paul M. Ridker, MDAffiliations: From Brigham and Women's Hospital, Boston, MA 02215.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAdvances in Measuring the Effect of Individual Predictors of Cardiovascular Risk: The Role of Reclassification Measures Nancy R. Cook and Paul M Ridker Reclassification Calculations for Persons With Incomplete Follow-up Ewout W. Steyerberg and Michael J. Pencina Metrics 2 February 2010Volume 152, Issue 3Page: 196-197KeywordsConflicts of interestStatistical data ePublished: 2 February 2010 Issue Published: 2 February 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
National programme for information technology
Authors: Michael Humber
Journal: BMJ (2004)

Is sorely needed and must succeed—but is off to a shaky start 

With the national programme for information technology, the NHS in England has set itself an enormous task. A programme of this size has never been attempted in the United Kingdom and, in many respects, elsewhere in the world. But what is the national programme, why is it so important to the government and to the viability of the NHS, and is it on course to succeed?

The national programme means an investment of £6.2bn (€9.2bn, $11.1bn) over a 10 year programme of change. It promises to modernise information and communications technology across the NHS and provide the tools to help streamline the healthcare services. It will create a basic health record for all 50 million patients, enabling quick and easy access to the essential information that anyone making health decisions about a patient needs to know. It will connect more than 30 000 general practitioners and 270 acute, community, and mental health trusts in a secure system. It promises to “improve the convenience and quality of care” by having the right information in the right place at the right time. It will sustain …
Effect of stress management on blood pressure in mild primary hypertension.
Authors: D W Johnston, A Gold, J Kentish, D Smith, P Vallance, D Shah, G Leach, B Robinson
Journal: BMJ (1993)

OBJECTIVE--To establish whether stress management had a larger effect than a control treatment on resting blood pressure, ambulatory blood pressure, and left ventricular mass. DESIGN--A 12 week baseline period of habituation to measurement of blood pressure was followed by randomisation to either stress management or mild exercise for six months and follow up six months later. SETTING--General practice, district general hospital, and medical school. PATIENTS--Of the 184 patients aged under 60 with mild primary hypertension who entered the baseline habituation period, 88 were excluded because they failed to meet the entry criteria or they withdrew from the study. The remaining 46 men and 50 women underwent treatment. INTERVENTIONS--10 clinical sessions and daily practice at home of either stress management based on relaxation or non-aerobic stretching exercises. Mildly stressful 15 minute interviews before and after treatment. MAIN OUTCOME MEASURES--Diastolic and systolic blood pressure in the clinic and during 12 hours of ambulatory recording, and left ventricular mass measured by echocardiography. RESULTS--The patients9 blood pressure fell during habituation (systolic pressure from 152 mmHg to 140 mmHg, diastolic pressure from 98 to 93 mm Hg), but neither resting nor ambulatory blood pressure was changed by the treatments. Left ventricular mass was also unchanged. Blood pressure rose during the stressful interview, but this rise was reduced by stress management (systolic pressure rose by 7.4 mmHg before treatment and by 3.7 mmHg after treatment). CONCLUSION--Stress management of a type advocated for treating mild primary hypertension is ineffective in lowering blood pressure in patients who are well habituated to measuring blood pressure.
Breast Cancer
Authors: Daniel Medina
Journal: Clinical Cancer Research (2004)

Abstract It has been firmly established in epidemiological studies that early full-term pregnancy affords lifetime protection against the development of breast cancer. This phenomenon can be mimicked in rat and mouse models of mammary cancer in which the hormones estrogen and progesterone are given for 21 days. Carcinogen-induced proliferation is blocked as a consequence of hormone pretreatment. Among several genes implicated by molecular studies to be differentially expressed is the tumor suppressor gene p53. Both immunohistochemical and Western blot studies indicate that p53 protein expression is increased in hormone-pretreated mice and rats. The p53-regulated gene p21Cip1 is also increased concomitantly with p53. To test directly the causative role of p53 in conferring a protective phenotype, we examined the hormone-induced protective effect in BALB/c p53 null mammary epithelium. In the mammary epithelium, the absence of p53 gene expression abrogated the protective effect of prior pregnancy. The tumor incidence curves were superimposable in p53 null mammary epithelium that were treated with 7,12-dimethylbenzanthracene or pregnancy plus 7,12-dimethylbenzanthracene. These results demonstrate that p53 plays a pivotal role in hormone-induced protection and raises the question of the mechanisms by which the steroid hormones, estrogen and progesterone, functionally activate p53.
Current status of antitachycardia devices.
Authors: M E Rosenthal, M E Josephson
Journal: Circulation (1990)

With the limitations of currently available modalities for treating clinically important tachycardias, the role of implanted antitachycardia devices will continue to expand. The challenge of the future will not only involve continued technological advances but the socioeconomic impact of this efficacious but expensive mode of therapy in an era of increasing financial restraints. Further studies to definitively prove the efficacy of more widespread use of antitachycardia device therapy will be needed.
Resveratrol Prevents the Prohypertrophic Effects of Oxidative Stress on LKB1
Authors: Vernon W. Dolinsky, Anita Y.M. Chan, Isabelle Robillard Frayne, Peter E. Light, Christine Des Rosiers, Jason R.B. Dyck
Journal: Circulation (2009)

Background— Master regulators of protein synthesis such as mammalian target of rapamycin (mTOR) and p70S6 kinase contribute to left ventricular hypertrophy. These prohypertrophic pathways are modulated by a number of kinase cascades, including the hierarchical LKB1/AMP-activated protein kinase (AMPK) energy-sensing pathway. Because oxidative stress inhibits the LKB1/AMPK signaling axis to promote abnormal cell growth in cancer cells, we investigated whether oxidative stress associated with hypertension also results in the inhibition of this kinase circuit to contribute to left ventricular hypertrophy. Methods and Results— In the spontaneously hypertensive rat, a well-established genetic model of hypertension and subsequent cardiac hypertrophy, the development of left ventricular hypertrophy is associated with an increase in the electrophilic lipid peroxidation byproduct 4-hydroxy-2-nonenal (HNE). Using isolated cardiomyocytes, we show that elevated levels of HNE result in the formation of HNE-LKB1 adducts that inhibit LKB1 and subsequent AMPK activity. Consistent with inhibition of the LKB1/AMPK signaling pathway, the mTOR/p70S6 kinase system is activated, which is permissive for cardiac myocyte cell growth. Treatment of cardiomyocytes with resveratrol prevents HNE modification of the LKB1/AMPK signaling axis and blunts the prohypertrophic p70S6 kinase response. Furthermore, administration of resveratrol to spontaneously hypertensive rats results in increased AMPK phosphorylation and activity and reduced left ventricular hypertrophy. Conclusions— Our data identify a molecular mechanism in the cardiomyocyte involving the oxidative stress–derived lipid peroxidation byproduct HNE and the LKB1/AMPK signaling pathway that contributes to the development of left ventricular hypertrophy. We also suggest that resveratrol may be a potential therapy for patients at risk for developing pathological cardiac hypertrophy by preventing this prohypertrophic process.
Paroxysmal Nocturnal Hemoglobinuria
Authors: Joseph E. May, Wendell Rosse, Michael M. Frank
Journal: New England Journal of Medicine (1973)

Erythrocytes from patients with paroxysmal nocturnal hemoglobinuria are abnormally sensitive to the lytic action of complement and undergo lysis in acidified normal human serum. This lysis was examined as a function of calcium and magnesium ion concentration in eight patients and eight normal donors. The addition of as little as 3 x 10–4 molar magnesium (0.6 mEq per liter) to normal human serum initiated lysis of cells from patients with the disorder, via the alternate pathway of complement activation, and markedly potentiated the lysis of these cells in acidified serum by the same pathway. This finding led to a simple modification of the acidified serum lysis test (Ham test), which renders it more accurate in the diagnosis of paroxysmal nocturnal hemoglobinuria and more precise in delineation of the abnormal erythrocyte populations. Also demonstrated is the fact that calcium ion inhibits lysis of the abnormal cells in acidified and nonacidified human serum. Small changes in the concentration of these cations may result in spontaneous activation of the alternate complement pathway, thereby precipitating hemolytic attacks. (N Engl J Med 289:705–709, 1973)
Financing the Struggle against AIDS
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1987)

The federal government, propelled by the first widely publicized indications of serious presidential and congressional concern over the spread of the acquired immunodeficiency syndrome (AIDS), is moving rapidly to increase the resources it allocates to fighting the disease. But it has only begun to address how the war on AIDS will be waged, who will command it, and how government and the private sector will finance it.These difficult questions lie ahead for the federal government as it steps up the drive against AIDS, an infectious disease that has spread throughout most parts of the world but whose current victims . . .