tbuckley/cabot-search huggingface dataset:
Fatal Gastrointestinal Hemorrhage Due to Chronic Relapsing Pancreatitis
Authors: Rudiger Breitenecker
Journal: New England Journal of Medicine (1959)

GASTROINTESTINAL hemorrhage often presents one of the most difficult diagnostic and therapeutic problems in surgery. The point of origin, in most cases, is located in one of relatively few and well recognized lesions; however, bleeding may arise in a number of sites that are not ordinarily considered. Such a site of origin is the pancreas.In the following cases massive and fatal gastrointestinal hemorrhage complicated chronic relapsing pancreatitis.Case ReportsCase 1. G.N., a 43-year-old Negro, was admitted to Cleveland Metropolitan General Hospital on February 17, 1950. He acknowledged chronic alcoholism and gave a history of being ill for 10 . . .
Decompression: Decompression sickness
Authors: D. E. Mackay
Journal: British Journal of Sports Medicine (1986)

Varied topics are featured in this issue, again illustrating the broad spectrum encompassed by sports medicine.The papers on upper limb injuries in rock climbing and the case report of pancreatic trauma during karate, stress the importance of careful history taking and physical examination.When this is overlooked there is likely to be delay in diagnosis and hence, treatment.This point is again emphasised in the correspondence concerning pneumothorax in a soccer player.
Evidence based policymaking
Authors: C. Ham, D. J Hunter, R. Robinson
Journal: BMJ (1995)

That politics is driven more by values than facts is not open to dispute. But at a time when ministers are arguing that medicine should be evidence based,1 is it not reasonable to suggest that this should also apply to health policy? If doctors are expected to base their decisions on the findings of research surely politicians should do the same. Although individual patients may be at less risk from uninformed policymaking than from medicine that ignores available evidence, the dangers for the community as a whole are substantially higher. The impact of policies that are poorly designed and untested may be disastrous—witness the recent failures in mental health services. As such the case for evidence based policymaking is difficult to refute.

This argument applies to politicians of all parties, not simply to those who currently hold office. Certainly, the failure of the government to evaluate the effects of its health care reforms properly at the outset will go down in the history of the NHS as an omission of the highest order, but the record of the Labour party when in government is not entirely creditable either. Rather than dwell on past mistakes, it may be more constructive to consider how future politicians may be better informed by evidence. There is a role here for both the government and independent agencies.

Let us begin with the government. The establishment of the NHS research and development programme has at last focused attention on the importance of evaluation. The programme is also …
A personalized adhesion prevention strategy: E. Arslan, T. Talih, B. Oz, B. Halaclar, K. Caglayan, M. Sipahi, Comparison of lovastatin and hyaluronic acid/carboxymethyl cellulose on experimental created peritoneal adhesion model in rats, Int. J. Surg. 12 (2) (2014) 120–124.
Authors: O.A. Mynbaev, M. Yu Eliseeva, A. Tinelli, A. Malvasi, I.P. Kosmas, M.V. Medvediev, T.I. Babenko, M.I. Mazitova, Zh. R. Kalzhanov, M. Stark
Journal: International Journal of Surgery (2014)
The Role of Cholecystectomy in Reducing Recurrent Gallstone Pancreatitis
Authors: C. Hui, K. Lai, M. Yuen, W. Wong, A. Chan, M. Ng, C. Chan, W. Cheung, S. Lam, C. Lai, B. Wong
Journal: Endoscopy (2004)

Endoscopic sphincterotomy (ES) or cholecystectomy can prevent recurrent acute pancreatitis (RAP) in patients with gallstone-related pancreatitis. However, it is unknown whether cholecystectomy after ES offers additional benefit in preventing RAP in these patients. This is a retrospective study to assess whether cholecystectomy can decrease the incidence of RAP in patients with gallstone-related pancreatitis.Records from 139 patients with gallstone-related pancreatitis were analyzed. Of these, 58 patients had gallbladder stones with concomitant common bile duct (CBD) stones and 81 patients had gallbladder stones without CBD stones. Of the 58 patients who had both gallbladder and CBD stones, 37 (63.8 %) did not undergo cholecystectomy after ES (group 1) and 21 patients (36.2 %) did undergo cholecystectomy after ES (group 2). Of the 81 patients who had gallbladder stones but who did not have CBD stones, 54 (66.7 %) did not undergo cholecystectomy (group 3) and 27 (33.3 %) did undergo cholecystectomy (group 4).At the time of analysis, three patients (8.1 %) in group 1 and three patients (14.3 %) in group 2 developed RAP. There was no significant difference in the estimated probability of occurrence of RAP over time between group 1 and group 2 ( P = 0.41). However, there was a significantly higher probability of patients developing RAP over time in group 3 compared with group 4 (6/54 vs. 0/27 respectively, P = 0.04).In patients with gallbladder stones without CBD stones, cholecystectomy can decrease the incidence of RAP. In patients with both gallbladder and CBD stones, however, the risk of RAP was not further reduced by cholecystectomy after ES and complete removal of CBD stones.
A doctor's lot.
Authors: T Richards
Journal: BMJ (1985)

With regard to treatment chronic venous ulcers may be divided into two categories: those (60%) that respond well to treatment and those (40%) that do not.In those that respond well the ulcer develops above a cushion of dilated veins one ofwhich is usually but not necessarily a perforating vein.Once these veins have been eliminated by compression, injection, or surgery the ulcer heals spontaneously or more rapidly with a partial thickness skin graft.This skin graft should remain supported by adequate elasticated compression from the toes to the knee at all times when the leg is dependent postoperatively and should be continued indefinitely.In ulcers that do not respond well the dependence on dilated veins is not evident and the main pathophysiological factor is severe dysfunction ofthe calf muscle pump.This in turn results from several factors occurring in various combinations.They are: an increased number ofincompetent communicating veins; varicosities of both long and short saphenous veins; a restricted range ofmovement at the ankle and metatarsal joints; and a "chronic compartment syndrome" due to the induration ofepifascial tissues.The treatment ofchoice is the improvement ofthe muscle pump effect by a subfascial operation ligating incompetent perforating veins combined with skin grafting ofthe ulcer.Less often the cause ofnon-healing is mycotic infection, a lowered resistance to infection by the patient, or arterial insufficiency.More rarely ulcers may be oftuberculous or syphilitic origin or a complication of systemic diseases such as ulcerative colitis.It should also be borne in mind that malignancy can occur in long standing ulcers and that a biopsy should therefore be performed whenever there is doubt about the diagnosis.
Telbivudine versus Lamivudine in Patients with Chronic Hepatitis B
Authors: Ching-Lung Lai, Edward Gane, Yun-Fan Liaw, Chao-Wei Hsu, Satawat Thongsawat, Yuming Wang, Yagang Chen, E. Jenny Heathcote, Jens Rasenack, Natalie Bzowej, Nikolai V. Naoumov, Adrian M. Di Bisceglie, Stefan Zeuzem, Young Myoung Moon, Zachary Goodman, George Chao, Barbara Fielman Constance, Nathaniel A. Brown
Journal: New England Journal of Medicine (2007)

Reducing hepatitis B virus (HBV) replication to minimal levels is emerging as a key therapeutic goal for chronic hepatitis B.
The alluring but misleading analogy between mirror neurons and the motor theory of speech
Authors: Lori L. Holt, Andrew J. Lotto
Journal: Behavioral and Brain Sciences (2014)

Abstract Speech is commonly claimed to relate to mirror neurons because of the alluring surface analogy of mirror neurons to the Motor Theory of speech perception, which posits that perception and production draw upon common motor-articulatory representations. We argue that the analogy fails and highlight examples of systems-level developmental approaches that have been more fruitful in revealing perception–production associations.
Convulsions under Thiopentone
Authors: R. I. Bodman
Journal: BMJ (1947)

<h3>Objective.</h3> Impaired microvascular function may contribute to organ complications in patients with systemic sclerosis (SSc). We investigated whether SSc patients with and without pulmonary arterial hypertension (PAH) show a graded impairment of microvascular function compared to healthy controls. <h3>Methods.</h3> Twenty-two patients with SSc and 22 controls were studied. All patients underwent right heart catheterization; 6 had no PAH (SSc-nonPAH) and 16 had PAH (SSc-PAH). Acetylcholine (ACh)-mediated endothelium-dependent vasodilatation and sodium nitroprusside (SNP)-mediated endothelium-independent vasodilatation were assessed by iontophoresis combined with laser Doppler flowmetry. <h3>Results.</h3> Compared to sex- and age-matched controls, ACh-mediated vasodilatation was reduced in SSc-PAH (340.4% vs 79.5%, respectively; p &lt; 0.01), but not in SSc-nonPAH (340.4% vs 397.9%; p = 0.90). No significant differences were present between the groups in SNP-mediated vasodilatation. <h3>Conclusion.</h3> Systemic microvascular endothelium-dependent vasodilatation is markedly reduced in SSc complicated by PAH.
P176 Does BCG protect against atopic diseases only for a limited time period?
Authors: M. F. Linehan, R. M. Niven, D. N. Baxter, T. L. Frank
Journal: Thorax (2011)

<h3></h3> Allergic diseases such as atopic asthma are believed to have their origins in early life1 but the precise mechanisms and timings of the relevant immunoregulation continue to be a focus of research. One area of investigation has been the role of vaccinations in Th cytokine regulation.1 Epidemiological studies investigating the potential of BCG, a potent immunomodulator, to reduce the risk of atopic diseases report conflicting results.2 A Manchester study (MANCAS), using a cohort of children all born in the same hospital in the mid 1990s identified a lower risk of wheeze for children given neonatal BCG.3 Data analysis for a follow-up study 6 years later when the cohort was aged 13–17 yrs has just been completed. Using the same definitions for wheeze and asthma as the first study there was no difference in prevalence of wheeze or asthma between BCG vaccinated and non-vaccinated adolescents (Abstract P176 table 1). Significance tests between the studies were not performed because some participants responded only to one of the two studies. A Medical Research Council study4 in the 1950s investigating the effectiveness of a vaccination programme to prevent tuberculosis identified a progressive decrease in the efficacy of BCG in successive 5 year periods with 80% efficacy 5 years post vaccination reducing to 59% 10–15 yrs after vaccination. If the decrease in efficacy of BCG modifies its ability to protect against atopy it may be that the conflicting results in studies investigating BCG and atopy have occurred because the protection afforded by BCG is limited to within a timeframe after vaccination.
Choosing the Arbiter
Authors: Rashi Fein
Journal: New England Journal of Medicine (1985)

There is a revolution going on in health care organization, payment mechanisms, and financing. Medicine has become the subject of articles in Business Week, The Wall Street Journal, and The New York Times. Hospitals and physician groups are advertising. Consultant groups sponsor conferences, seminars, and meetings on PROs, PPGs, IPAs, and DRGs. A new vocabulary and set of acronyms has entered the language of health care.As in all revolutions, it is a time of confusion. Old and well-established arrangements are being discarded. New and confusing ones are being instituted. It is hard to sort out who will win and . . .
Plastic Surgery: Facial Injuries
Authors: Bradford Cannon, Joseph E. Murray
Journal: New England Journal of Medicine (1954)

THE following quotation is taken from the outline of "Principles of Treatment of Severe Facial Injuries"1 prepared for the American College of Surgeons:In few injuries is the final outcome so directly dependent on early proper care as in the treatment of a severe facial injury. The bony and cartilaginous framework of the face supports the soft tissues and teeth, and provides attachment to the muscles of expression and mastication. The character in the face, the emotional expression, and the function of chewing and eating depend upon a normal anatomical and functional relationship between these structures. Failure to restore the . . .
South African court forces government to rescind strike dismissal notices
Authors: Pat Sidley
Journal: BMJ (2007)

A High Court judge in South Africa granted an urgent interdict to the Treatment Action Campaign, the largest AIDS activist group in the country, compelling the government to rescind dismissal notices it had issued to striking nurses. The nurses would otherwise have been staffing several clinics in Cape Town's poorest areas.

These clinics, some operated and helped by the humanitarian group Medicins Sans Frontieres, provide antiretroviral treatment for local people with HIV as well as treatment for tuberculosis. Any break in the treatment of these two conditions leads to resistance and consequent failure of the …
Loss of the Polycomb Mark from Bivalent Promoters Leads to Activation of Cancer-Promoting Genes in Colorectal Tumors
Authors: Maria A. Hahn, Arthur X. Li, Xiwei Wu, Richard Yang, David A. Drew, Daniel W. Rosenberg, Gerd P. Pfeifer
Journal: Cancer Research (2014)

In colon tumors, the transcription of many genes becomes deregulated by poorly defined epigenetic mechanisms that have been studied mainly in established cell lines. In this study, we used frozen human colon tissues to analyze patterns of histone modification and DNA cytosine methylation in cancer and matched normal mucosa specimens. DNA methylation is strongly targeted to bivalent H3K4me3- and H3K27me3-associated promoters, which lose both histone marks and acquire DNA methylation. However, we found that loss of the Polycomb mark H3K27me3 from bivalent promoters was accompanied often by activation of genes associated with cancer progression, including numerous stem cell regulators, oncogenes, and proliferation-associated genes. Indeed, we found many of these same genes were also activated in patients with ulcerative colitis where chronic inflammation predisposes them to colon cancer. Based on our findings, we propose that a loss of Polycomb repression at bivalent genes combined with an ensuing selection for tumor-driving events plays a major role in cancer progression.
A memorable patient: The man who was too weak to work on Monday
Authors: J W Fletcher
Journal: BMJ (1998)

I don't think I can truthfully say that Mr X was my most memorable case, but memorable for the unusual presentation and happy ending.

In 1951 my wife and I started a new practice in a new town, and within two years it had grown to 4000 patients. Over the evening meal we often swopped tales of anything interesting that had happened during the day. One day my wife said: “I saw Mrs X's baby today, and her husband was at home. Mrs X confided that he was often at home on Mondays as he felt too weak to go to work. She said she wanted him to see his doctor, but he would not go because he thought the doctor would only laugh at him.” My wife added: “He's on your list, but I don't think …
Tufted folliculitis of the scalp: a distinctive clinicohistological variant of folliculitis decalvans
Authors: None Annessi
Journal: British Journal of Dermatology (1998)

Tufted folliculitis is an uncommon folliculitis of the scalp that resolves with patches of scarring alopecia within which multiple hair tufts emerge from dilated follicular orifices. The clinicohistological data from a group of 15 patients with tufted folliculitis were reviewed and compared with those of seven patients with folliculitis decalvans, five with acne keloidalis nuchae, four with dissecting cellulitis of the scalp, three with kerion celsi and 20 with follicular lichen planus. It was found that tufted folliculitis could be differentiated from folliculitis decalvans only by finding several hair tufts scattered within patches of scarring alopecia. Histologically, a single tuft consisted of peculiar clustering of adjacent follicular units opening at the bottom of an epidermal depression. Conversely, the presence of keloidal plaques in acne keloidalis nuchae, coalescing nodules discharging purulent material in dissecting cellulitis of the scalp, erythematous plaques covered by pustules replete with fungal elements in kerion celsi, and the absence of follicular pustules in follicular lichen planus distinguished these diseases from tufted folliculitis. On the basis of these findings, it is suggested that tufted folliculitis should be considered as a distinctive clinicohistological variant of folliculitis decalvans. Tufting of hair is caused by clustering of adjacent follicular units due to a fibrosing process and to retention of telogen hairs within the involved follicular units.
Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus Infection
Authors: Michael W. Fried, Mitchell L. Shiffman, K. Rajender Reddy, Coleman Smith, George Marinos, Fernando L. Gonçales, Dieter Häussinger, Moises Diago, Giampiero Carosi, Daniel Dhumeaux, Antonio Craxi, Amy Lin, Joseph Hoffman, Jian Yu
Journal: New England Journal of Medicine (2002)

Treatment with peginterferon alfa-2a alone produces significantly higher sustained virologic responses than treatment with interferon alfa-2a alone in patients with chronic hepatitis C virus (HCV) infection. We compared the efficacy and safety of peginterferon alfa-2a plus ribavirin, interferon alfa-2b plus ribavirin, and peginterferon alfa-2a alone in the initial treatment of chronic hepatitis C.
Scintigraphic Diagnosis of Rib Lesions in Patients with Lung Carcinoma
Authors: SATORU MATSUMOTO, HITOSHI SHIBUYA, ISAO UMEHARA, SOJI SUZUKI
Journal: Clinical Nuclear Medicine (1987)

One hundred twenty-five patients with carcinoma of the lung received 171 pyrophosphate bone scans. Twentythree (18%) of these 125 patients had abnormal uptake only in the ribs. Of these 23 patients, 14 (61%) were diagnosed as having a benign lesion. Five showed direct invasion from the primary carcinoma and another four were diagnosed as having metastatic rib lesions. Benign rib lesions were also suspected in several patients with multiple metastases.
SHO training. Partial shifts difficult in medicine.
Authors: D Maxwell
Journal: BMJ (1993)

We hope that this extension ofour assessment of the senior house officers in our department proves to be both useful and acceptable to them.The main drawback to this form of assessment is that it is labour intensive, requiring the synchronous participation of both the junior and senior doctors of the department.This programme of assessment is being extended to include other hospitals in our region.Towards the end of this year we hope to report our experiences after assessing the training of further groups of senior house officers working in our department.
PROPOSED CHANGES IN THE CONSTITUTION AND THE BY-LAWS OF THE AMERICAN COLLEGE OF PHYSICIANS
Authors: MAURICE C. PINCOFFS
Journal: Annals of Internal Medicine (1959)

Editorials1 February 1959PROPOSED CHANGES IN THE CONSTITUTION AND THE BY-LAWS OF THE AMERICAN COLLEGE OF PHYSICIANSMAURICE C. PINCOFFS, M.A.C.P.MAURICE C. PINCOFFS, M.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-50-2-520 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe attention of all Masters and Fellows of the College is directed to the proposed revision of the Constitution, which is published in this issue as the first item under the section on College News Notes.The changes in this proposed version of the Constitution and By-Laws were submitted to the Board of Regents by a special Committee under the chairmanship of Dr. Walter L. Palmer. The Regents at their fall meeting voted approval of the changes.The most important changes proposed appear to be the following:INCREASED AUTHORITY FOR THE PRESIDENT:The Executive Committee of the Board of Regents... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MAURICE C. PINCOFFS, M.A.C.P. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1959Volume 50, Issue 2Page: 520-521KeywordsFalls ePublished: 1 December 2008 Issue Published: 1 February 1959 PDF downloadLoading ...
Repeat Coronary Revascularization After Coronary Artery Bypass Surgery in Older Adults
Authors: Emil L. Fosbøl, Yue Zhao, David M. Shahian, Frederick L. Grover, Fred H. Edwards, Eric D. Peterson
Journal: Circulation (2013)

Background— A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era. Methods and Results— We included patients ≥65 years from the Society of Thoracic Surgeons’ National Adult Cardiac Surgery Database who were undergoing first-time isolated CABG from 1991 to 2007 (n=723 134, median age 73 years). After linking to Medicare claims data, long-term outcomes of CABG (up to 18 years after surgery) were examined by use of cumulative incidence curves. Multivariable Cox proportional hazard analysis was used to identify factors associated with 1- and 5-year repeat revascularization trends and variability. We found that the overall 18-year survival rate was 20%. Cumulative incidences of any repeat revascularization (percutaneous coronary intervention or CABG, yet most often percutaneous coronary intervention) were 2%, 7%, 13%, and 16% at 1, 5, 10, and 18 years after surgery, respectively. The rates of repeat CABG procedures were quite low for all time points (0.1%, 0.6%, 1.3%, and 1.7%, respectively). Female sex, disease severity represented by a history of percutaneous coronary intervention, preoperative dialysis, and partial revascularization were strongly associated with a higher revascularization rate, whereas advanced age, left main disease, and smoking were associated with a lower rate. There was approximately a 2-fold variation in repeat revascularization rates across centers at 1 year (interquartile range 1.7–3.6%) and 5 years (interquartile range 6.7–12.0%). Conclusions— Repeat revascularization is performed infrequently among older patients who undergo CABG; however, these rates vary substantially by patient subgroups and among providers.
Ethnic Differences in the Glycemic Response to Exogenous Insulin Treatment in the Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM)
Authors: Lily Agrawal, Nicholas V Emanuele, Carlos Abraira, William G Henderson, Seymour R Levin, Clark T Sawin, Cynthia K Silbert, Frank Q Nuttall, John P Comstock, John A Colwell
Journal: Diabetes Care (1998)

The Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus was conducted in NIDDM patients to determine if a significant difference in HbA1c could be achieved between groups receiving standard and intensive treatment. We observed differences in the response to exogenous insulin between African-Americans and other intensively treated patients. Therefore, we assessed the variations of response and correlated factors that might explain such differences.