tbuckley/cabot-search huggingface dataset:
PWE-039 Informing Patients and the Multi Disciplinary Team of a Diagnosis of Gastro-Intestinal Malignancy
Authors: J E Rimmer, J Hookway, S P Dunlop
Journal: Gut (2013)

<h3>Introduction</h3> The management of gastro-intestinal (GI) malignancy is largely determined by multi-disciplinary team (MDT) discussion, where members have not met the patient. The quality of information given to the patient immediately following endoscopy, and subsequently to the MDT, is variable. <h3>Methods</h3> A 3 month retrospective audit of all outpatient endoscopic diagnoses of upper and lower GI malignancies at Derriford Hospital, Plymouth. The endoscopy report (Endosoft), endoscopy care pathway and medical notes were reviewed. Information provided regarding the description of pathology; post endoscopic patient discussion; GI Cancer Nurse Specialist (CNS) involvement and request for staging imaging was interrogated. Inpatients were excluded. <h3>Results</h3> There were 65 patients with GI malignancy (oesophago-gastric cancer [OGC] n = 24; colorectal cancer [CRC] n = 41). For patients with confirmed OGC the report recorded suspected malignancy in 19/24 (79%). Post endoscopy patient discussion was recorded on the report in 7/19 (37%); patient informed &amp; recorded only in the nurse’s care pathway in 5/19 (26%); no evidence of discussion with patient in 7/19 (37%). GI CNS involvement was documented on the report in 5/19 (26%); the report documented requesting of staging imaging by the endoscopist in 10/19 (53%). For patients with confirmed CRC the report recorded suspected malignancy in 33/41 (80%). Post endoscopy discussion was recorded on the report in 10/33 (30%); patient informed &amp; recorded only in the nurse’s care pathway in 13/33 (39%); no evidence of discussion with patient in 10/33 (30%). GI CNS involvement was documented in 15/33 (45%). The report documented requesting of staging imaging by the endoscopist in 22/33 (67%). <h3>Conclusion</h3> The MDT relies upon patients being informed of their suspected diagnosis, and accurate endoscopic documentation in order to make informed decisions and to allow direct referral to Surgical and Oncological specialities. However, a significant proportion of patients with upper and lower GI cancer leave the endoscopy department without a diagnosis of suspected cancer being made, and even when it is suspected, are frequently not informed by the endoscopist. <h3>Disclosure of Interest</h3> None Declared.
Abstract B02: Telomere-driven chromosome instability impacts on microRNA expression through epigenetic mechanisms
Authors: Karina Jouravleva, Luis Castro-Vega, Arturo Londono-Vallejo
Journal: Cancer Research (2013)

Abstract Telomere shortening is a major source of chromosome instability (CIN) at early stages during carcinogenesis. However, the mechanisms through which telomere-driven CIN (T-CIN) contributes to the acquisition of tumor phenotypes remain uncharacterized. We have used human epithelial kidney cells (HEK cells), a well-established in vitro model of progressive telomere instability, to study the impact of T-CIN in the expression of miRs and the biological consequences that might be relevant for the acquisition of tumor phenotypes. We discovered that human epithelial kidney cells undergoing T-CIN display massive microRNA (miR) expression changes that are not related to local losses or gains. This widespread miR deregulation encompasses a miR-200-dependent epithelial-to-mesenchymal transition (EMT) that confers to immortalized pretumoral cells phenotypic traits of metastatic potential. Since deregulation of miRs in HEK CIN+ cells was widespread, orchestrated, and not related with copy number changes we hypothesized that this phenomenon utilizes epigenetic cues. Indeed, investigation of the mechanisms controlling miR-200 expression revealed that both DNA methylation and histone modifications changed significantly in cells undergoing T-CIN. Unbiased approaches are now being used to describe the epigenome changes genome-wide that are associated with CIN during cell transformation. Citation Format: Karina Jouravleva, Luis Castro-Vega, Arturo Londono-Vallejo. Telomere-driven chromosome instability impacts on microRNA expression through epigenetic mechanisms. [abstract]. In: Proceedings of the AACR Special Conference on Chromatin and Epigenetics in Cancer; Jun 19-22, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2013;73(13 Suppl):Abstract nr B02.
Torsade de Pointes and Nifedipine
Authors: DENNIS M. KRIKLER
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 October 1982Torsade de Pointes and NifedipineDENNIS M. KRIKLER, M.D., EDWARD ROWLAND, M.D.DENNIS M. KRIKLER, M.D.Search for more papers by this author, EDWARD ROWLAND, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-4-618_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the letter purporting to show that nifedipine caused torsade de pointes (1). Although prenylamine (not phenylamine) is a calcium channel blocker, it also prolongs the QT interval considerably (2, 3). Lidoflazine does not fall into this class of agents. In our clinical and electrophysiologic experience with nifedipine (4-6) we have never seen this tendency, and can think of no way a single small dose would produce torsade de pointes. In a patient who is hypokalemic, taking digoxin and an antidepressant, and has a severe coronary heart disease, the potential for various ventricular arrhythmias...References1. GRAYSONKENNEDY HJ. Torsades de pointes and nifedipine [Letter]. Ann Intern Med. 1982;97:144. LinkGoogle Scholar2. KRIKLERCURRY DP. Torsade de pointes, an atypical ventricular tachycardia. Br Heart J. 1976;38:117-20. CrossrefMedlineGoogle Scholar3. OAKLEYJENNINGSPURITZKRIKLERCHAMBERLAIN DKRDD. The effect of prenylamine on the QT interval of the resting electrocardiogram in patients with angina pectoris. Postgrad Med J. 1980;56:753-6. CrossrefMedlineGoogle Scholar4. ROWLANDEVANSKRIKLER ETD. Effects of nifedipine on atrioventricular conduction as compared with verapamil: intracardiac electrophysiologic study. Br Heart J 1979;42:124-7. CrossrefMedlineGoogle Scholar5. LYNCHDARGIEKRIKLERKRIKLER PHSD. Objective assessment of antianginal treatment: a double-blind comparison of propranolol, nifedipine, and their combination. Br Med J. 1980;281:184-7. CrossrefMedlineGoogle Scholar6. DARGIEROWLANDKRIKLER HED. Role of calcium antagonists in cardiovascular therapy. Br Heart J. 1981;46:8-16. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Royal Postgraduate Medical School Hammersmith Hospital London W12 OHS England PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNifedipineDrugs Used to Treat Hypertension, Heart Failure, and Angina PectorisNifedipineVentricular Tachyarrhythmias in the Long QT SyndromesAnti-anginal and betaadrenoceptor blocking drugsNifedipine and Torsades de PointesHOWARD A. GRAYSON, JOSEPH D. KENNEDY 1 October 1982Volume 97, Issue 4Page: 618-619KeywordsArrhythmiaCalcium channel blockerCoronary heart diseaseFalls Issue Published: 1 October 1982 PDF downloadLoading ...
Facticious Ventricular Tachycardia
Authors: PETER R. BERGETHON
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 October 1987Facticious Ventricular TachycardiaPETER R. BERGETHON, M.D.PETER R. BERGETHON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-4-593 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Facticious etiologies of disease syndromes or signs are considered frequently in the differential diagnosis of patients with paradoxical histories and findings. As medicine has developed an ever-increasing "high-tech" sophistication, so have patients who present with facticious disease.A 33-year-old man presented to our hospital wth epigastric pain, hematemesis, melanotic stools, and dizziness for 2 days. He reported recent discharge from an Arkansas hospital after undergoing treatment for a bleeding ulcer that required transfusion. On physical examination he was orthostatic to both blood pressure and pulse. Except for epigastric discomfort on deep palpation his examination was normal. Rectal...References1. ATKINSON R and EARIL J. Munchausen syndrome with renal stones. JAMA. 1974;230:89. CrossrefMedlineGoogle Scholar2. PETERSDORF R and BENNETT I. Facticious fever. Ann Intern Med. 1957;46:1039-62. LinkGoogle Scholar3. REICH P and GOTTFRIED L. Facticious disorders in a teaching hospital. Ann Intern Med. 1983;99:240-7. LinkGoogle Scholar4. ADUAN R, FAUCI A, DALE D, HERZBERG J, and WOLFF S. Facticious fever and self induced infection: a report of 32 cases and review of the literature. Ann Intern Med. 1979;90:230-42. LinkGoogle Scholar5. TIZES R. The professional cardioversion patient: A new medical and psychiatric entity. Chest. 1977;71:434. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: PETER R. BERGETHON, M.D.Affiliations: Boston University School of Medicine Boston, MA 02118 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWide-complex tachycardia in a patient with syncopeWide-complex tachycardia as the presenting complaint in a case of malingeringCardiopathia Fantastica: The Cardiac Variant of Munchausen SyndromeFactitious disorders presenting as acute emergencies 1 October 1987Volume 107, Issue 4Page: 593-594KeywordsBlood pressureEtiologyHeart rateHemorrhageUlcersVentricular tachycardia ePublished: 1 December 2008 Issue Published: 1 October 1987 PDF downloadLoading ...
"HEROISM AND SCIENTIFIC PROGRESS"
Authors: Mazyck P. Ravenel
Journal: JAMA (1926)

<h3>To the Editor:</h3> —The editorial on "Heroism and Scientific Progress" inThe Journal, February 6, rightly calls attention to the sacrifices made in the progress of medicine. Without any intention of detracting from the credit of the three men mentioned as martyrs to science, I cannot see why these have been selected above others who deserve equal credit, having paid the price of their devotion with their lives. In this country the name of James Francis Coneffe should always be mentioned in connection with that of Ricketts, since he died of the same disease as Ricketts, contracted during his experiments on it. Thomas L. McClintick of the Public Health Service, and A. H. McCray of the Montana State Board of Health, lost their lives while working on Rocky Mountain spotted fever, and deserve equal honor with those who you have mentioned. Among foreigners, the brilliant Walter Myers lost his life
Fecal excretion of Bifidobacterium infantis 35624 and changes in fecal microbiota after eight weeks of oral supplementation with encapsulated probiotic
Authors: Duane Charbonneau, Roger D. Gibb, Eamonn M.M. Quigley
Journal: Gut Microbes (2013)

Certain randomized, placebo-controlled trials of oral supplementation with B. infantis 35624 have demonstrated the amelioration of symptoms of irritable bowel syndrome. Potential GI colonization by B. infantis 35624 or effects of supplementation on resident GI microbiota may pertain to these clinical observations. In this study, fecal excretion of B. infantis 35624 before, during and after 8 weeks of daily treatment was compared in subjects with IBS who received either the encapsulated oral supplement (n = 39) or placebo (n = 37) and in healthy subjects who received the supplement (n = 41). Secondarily, changes in assessed fecal microbiota and IBS symptoms were determined. Supplementation significantly increased fecal B. infantis 35624 excretion vs. placebo in IBS subjects; excretion in healthy subjects receiving supplement was quantitatively similar. Fecal levels of the probiotic declined and approached baseline once dosing ceased, documenting that colonization is transient. Although supplementation increased numbers of B infantis 35624 within the GI tract, limited changes in 10 other fecal taxa were observed either in healthy subjects or those with IBS. No impact on IBS symptoms was observed. Detection of bacterial DNA in fecal samples suggests that the probiotic is able to survive transit through the GI tract, although strain selective culture techniques were not performed to confirm viability of B. infantis 35624 in the feces. Continuous probiotic administration was necessary to maintain steady-state transit. Given the complex spectrum of GI microbiota, however, monitoring perturbations in selected taxa may not be not a useful indicator of probiotic function.
Asymmetric Cell Divisions Sustain Long-Term Hematopoiesis from Single-sorted Human Fetal Liver Cells
Authors: Tim H. Brummendorf, Wieslawa Dragowska, J.Mark J.M. Zijlmans, Gayle Thornbury, Peter M. Lansdorp
Journal: The Journal of Experimental Medicine (1998)

Hematopoietic stem cells (HSCs) in adult marrow are believed to be derived from fetal liver precursors. To study cell kinetics involved in long-term hematopoiesis, we studied single-sorted candidate HSCs from fetal liver that were cultured in the presence of a mixture of stimulatory cytokines. After 8-10 d, the number of cells in primary cultures varied from <100 to >10,000 cells. Single cells in slow growing colonies were recloned upon reaching a 100-200 cell stage. Strikingly, the number of cells in subclones varied widely again. These results are indicative of asymmetric divisions in primitive hematopoietic cells in which proliferative potential and cell cycle properties are unevenly distributed among daughter cells. The continuous generation of functional heterogeneity among the clonal progeny of HSCs is in support of intrinsic control of stem cell fate and provides a model for the long-term maintenance of hematopoiesis in vitro and in vivo.
Cerebral Blood Flow on ECD SPECT in a Patient With Adult Onset Alexander Disease
Authors: Kimiteru Ito, Sousuke Takeuchi, Kanehiro Hasuo, Miyako Morooka, Kazuo Kubota, Hiroshi Matsuda
Journal: Clinical Nuclear Medicine (2009)

A 61-year-old woman with progressive gait disturbance underwent Tc-99m ECD SPECT. Regional cerebral blood flow (rCBF) was analyzed by an easy Z-score imaging system (eZIS). The SPECT and eZIS showed decreased rCBF in the bilateral occipital cortex. The T1WI of magnetic resonance imaging (MRI) showed severe atrophy of the medulla oblongata. However, the abnormality of white matter in the whole brain was not evident in the T2WI. The medulla finding was specific for adult-onset Alexander disease (AOAD). AOAD had been diagnosed based on a mutation in the glial fibrillary acid protein (GFAP) gene. The finding of a decreased rCBF on SPECT and eZIS might precede the leukoencephalopathy in AOAD.
Progress in Medical Genetics
Authors: Ruth T. Gross
Journal: JAMA (1964)

This represents the third volume of an excellent series covering a wide variety of timely subjects in medical genetics. Actually, the nature of the material is such that since the publication of this volume new developments have already occurred in some areas. It is to the credit of the editors and contributing authors that each topic is presented with a background sufficiently broad to provide an excellent foundation for understanding future developments in the field. The nature of the gene, the genetic code, and the mechanism of protein synthesis are presented in chapter 1 by Strauss in the extremely comprehensible and yet sophisticated style which characterized his earlier text on this subject. In chapter 2 Motulsky emphasizes to clinicians and geneticists the importance of pharmacogenetics. Lehmann and Lidell describe an excellent experimental model for the study of pharmacogenetics in their treatment of human serum pseudocholinesterase. Amos presents transplantation genetics and
Preoperative Prediction of Postoperative Delirium-Reply
Authors: Edward R. Marcantonio
Journal: JAMA (1994)

In Reply.  —We disagree strongly with the substantive issues raised by Drs Carson, O'Hara, Kushins, and Rozner and even more strongly with their philosophical undertone. Our article and their letters should stand or fall based on scientific quality and the ensuing objective debate, rather than on the basis of anyone's board-certification status, previous publication record, or institutional affiliation. Our perioperative research project is a joint effort of our departments of medicine, surgery, anesthesiology, and orthopedics. Although our current article did not include one of our anesthesiologic coinvestigators as an author, one anesthesiologist is the principal investigator of a study of the determinants of postoperative pain control and two others are coauthors of a report on the influence of perioperative medications on the incidence of postoperative delirium.1We deeply resent any disparaging implications regarding our outstanding department of anesthesiology or the collegiality of our research effort, and we trust that
Using Tc-99m Pertechnetate Scintigraphy to Predict the Outcome of Sialoendoscopy in Obstructive Submaxillaritis
Authors: Jie-Hua Xu, Yu-Xiong Su, Mu-Hua Cheng, Yong Zhang, Ping Wang, Ju Jiao, Chun-Xing Wu, Gui-Qing Liao, Hong Shan
Journal: Clinical Nuclear Medicine (2010)

The purpose of this study was to investigate whether the findings of Tc-99m pertechnetate salivary gland scintigraphy (SGS) can predict the outcome of sialoendoscopic intervention in patients with obstructive submaxillaritis.Eleven patients with obstructive submaxillaritis were prospectively recruited. All patients underwent sialoendoscopy. Tc-99m pertechnetate SGS was performed both before and after sialoendoscopy.Sialoendoscopy was effective in the glands with tracer uptake (n = 9) demonstrated on SGS before the procedure, evidenced by not only relief of the symptoms but also improvement in excretion in post therapy salivary gland scintigraphy. In contrast, sialoendoscopy was ineffective in the glands without tracer uptake (n = 2) in pretherapy scans.In patients with submaxillaritis, whether a sialoendoscopy should be performed depends on the results of salivary gland scintigraphy.
Idarubicin, cytarabine, and topotecan in patients with refractory or relapsed acute myelogenous leukemia and high‐risk myelodysplastic syndrome
Authors: Seung Tae Lee, Joon Ho Jang, Hyung Chan Suh, Jee Sook Hahn, Yun Woong Ko, Yoo Hong Min
Journal: American Journal of Hematology (2001)

Abstract In an effort to develop more effective therapy for patients with refractory or relapsed acute myelogenous leukemia (AML) and high‐risk myelodysplastic syndrome (MDS), we investigated the efficacy of a combination chemotherapy consisting of idarubicin, cytarabine, and topotecan. Twenty‐seven patients were treated: four with primary refractory AML, nine with AML in first relapse, four with AML in second relapse, and 10 with MDS‐RAEB/RAEBT. Patients received as salvage therapy a single course of idarubicin 12 mg/m 2 IV bolus on days 1–3, cytarabine 1 g/m 2 over two hours q 12 hr on days 1–5, and topotecan 1.25 mg/m 2 over 24 hr on days 1–5. Median age was 42 years (range 17–65 years). All patients were evaluable for response: 14 (51.9%) achieved complete remission, 10 with AML (59%) and four with MDS (40%), respectively. Thirteen AML patients (excluding four relapsed after autologous stem cell transplantation) were grouped into four categories to stratify the probability of achieving complete remission (CR): group 1, first CR duration &gt; or = 2 years and receiving first salvage treatment (S1); group 2, first CR duration 1–2 years and receiving S1; group 3, first CR duration 0–1 years and receiving S1; and group 4, first CR duration 0–1 years and receiving S2, S3, or S4 after failing S1. The response rate of each group was as follows: group 1, one of two (50%); group 2, one of one (100%); group 3, four of four (100%); group 4, two of six (33.3%). The median remission duration and survival of patients with AML were six and 12 months, respectively. Median duration of survival in 10 MDS patients was 15 months, and all four MDS patients achieving a CR maintained continuous CR with a median follow‐up of 11 months. Severe myelosuppression was observed in all patients, resulting in fever or documented infections in 89% of patients. Median time to recovery of neutrophils ≥0.5 × 10 9 /l was 22 days (11–34) and for platelets &gt; 20 × 10 9 /l 35 days (11–58). Reversible grade 3–4 toxicities included diarrhea (two patients) and mucositis (seven patients). We conclude that combination chemotherapy with intermediate dose cytarabine, idarubicin, and topotecan has significant antileukemic activity and acceptable toxicity in salvage AML and high‐risk MDS. Am. J. Hematol. 68:237–245, 2001. © 2001 Wiley‐Liss, Inc.
Dextrostix-Eyetone in the insulin hypoglycaemia test.
Authors: M A Preece, R G Newall
Journal: BMJ (1977)

The Ames Dextrostix-Eyetone system was evaluated for monitoring the blood glucose concentration during insulin-induced hypoglycaemia. The results agreed well with laboratory values for plasma glucose, obtained by an orthotoluidine method, and the method was practicable as a bedside technique. In two cases quick results obtained with the Eyetone enabled the insulin tolerance test to be interrupted to prevent severe hypoglycaemia before the clinical indications were obvious. The extra time and effort required were minimal, and its value seems to far outweigh the disadvantage of the extra work entailed. Nevertheless, care in using the system was important, and the operator must familiarise himself with the system before the most reliable results can be obtained.
Maurice Ravel's illness: a tragedy of lost creativity
Authors: R A Henson
Journal: BMJ (1988)

Maurice Ravel had been subject to psychiatric disorder for many years when signs of organic brain disease appeared at the age of 52. Aphasia, apraxia, agraphia, and alexia became established some five years later. Musical creativity was lost. Alajouanine diagnosed cerebral atrophy with bilateral ventricular enlargement. Though Ravel9s condition deteriorated progressively, generalised dementia was not apparent. He died in December 1937, after a craniotomy performed by Clovis Vincent, possibly from a subdural haematoma. Vincent9s operative findings are described here. The likely cause of Ravel9s illness was a restricted form of cerebral degeneration.