tbuckley/cabot-search huggingface dataset:
Infliximab and adalimumab-induced thrombocytopenia in a woman with colonic Crohn's disease
Authors: A. Salar, X. Bessa, E. Muniz, D. Monfort, C. Besses, M. Andreu
Journal: Gut (2007)

lesions (range 77-91%, polyps (6 mm). 5 However, Chiu et al included only one carcinoma of unknown size, and it therefore remains unclear whether NBI can accurately characterise small polyp carcinomas where endoscopic management is different and formal histopathology is mandatory. 3We report a case where NBI was able to characterise an 8 mm carcinoma in vivo with appropriate modification of the endoscopic approach.A 65-year-old man who had had a low anterior resection for a Duke's B rectal carcinoma 4 years previously presented for his third surveillance colonoscopy.A high definition (HDTV) colonoscope was used which had the capacity to magnify up to 100 times with a prototype narrow band imaging system (XCF-H240FZL/I video colonoscope, XCLV-260HP xenon light source and XCV-260HP video system centre; Olympus, Japan).During withdrawal an 8 mm polyp was seen in the sigmoid colon on white light examination.The polyp was sub-pedunculated on a broad-based stalk with a slightly depressed area on one side of the polyp head (fig 1A).NBI with magnification of the depressed area showed a Kudo type V non-structural pit pattern with type III L pit pattern adjacent (fig 1B).In view of the likelihood of invasive carcinoma, the polyp was carefully snare resected lower on the stalk than usual to try to ensure a clear excision margin and two tattoos were placed immediately distal to the polypectomy site.Histological examination confirmed an adenocarcinoma with a clear resection margin G2, pT1, pV1, Nx, Mx, R0, Haggitt level 2 (invasion of the polyp neck), with high risk features of vascular invasion and tumour budding (fig 1C).A CT scan of the thorax and abdomen revealed no local lymphadenopathy or distant metastasis.In view of multiple co-morbidities, it was decided to view the endoscopic resection as definitive treatment.This case suggests, in combination with the report of Chiu et al, that NBI is able to fulfil the characterisation qualities of methylene blue for small polyps in a more time-efficient way and without the need for potentially carcinogenic dyes. 3Colonoscopists should prepare them- selves for the era of routine ''endohistology'' as NBI becomes widespread.
Inserting Needle for Local Analgesia in Dentistry
Authors: J. Vianden
Journal: BMJ (1948)

SIR.-May I add a few notes to the reply to the inquiry concerning pain in phantom foot ("' Any Questions ?"April 24, p. 817)?French statistics show that 72.50/' of all amputees, at least, complain of pains, most of them being phantom pains (personal statistics).In 1938 I established that such pains are greatly relieved with parenteral thiamine in a very high proportion of cases.When this quite easy method fails to give relief we perform a sympathetic ganglia "novocain ?block or a periarterial injec- tion of novocain.Intra-arterial administration of the drug sometimes relieves the pain immediately and suppresses the phantom limb sensations.At the next stage we proceed with lumbar or cervical sympathectomy, advisable in cases in which the block gives only transitory relief.The surgical treatment of the main sensitivity route (excision of the terminal neuroma, radicotomy, cordotomy) is performed in cases of failure of the above-mentioned more conservative methods.Recently some authors claimed the success of excision of the cortex, but their trials seem to remain merely in an experimental stage.Lately, psychotherapy has been introduced in the treatment of this very refractory condition.-Iam, etc.,
Proactive Tobacco Treatment and Population-Level Cessation
Authors: Steven S. Fu, Michelle van Ryn, Scott E. Sherman, Diana J. Burgess, Siamak Noorbaloochi, Barbara Clothier, Brent C. Taylor, Carolyn M. Schlede, Randy S. Burke, Anne M. Joseph
Journal: JAMA Internal Medicine (2014)

Current tobacco use treatment approaches require smokers to request treatment or depend on the provider to initiate smoking cessation care and are therefore reactive. Most smokers do not receive evidence-based treatments for tobacco use that include both behavioral counseling and pharmacotherapy.To assess the effect of a proactive, population-based tobacco cessation care model on use of evidence-based tobacco cessation treatments and on population-level smoking cessation rates (ie, abstinence among all smokers including those who use and do not use treatment) compared with usual care among a diverse population of current smokers.The Veterans Victory Over Tobacco Study, a pragmatic randomized clinical trial involving a population-based registry of current smokers aged 18 to 80 years. A total of 6400 current smokers, identified using the Department of Veterans Affairs (VA) electronic medical record, were randomized prior to contact to evaluate both the reach and effectiveness of the proactive care intervention.Current smokers were randomized to usual care or proactive care. Proactive care combined (1) proactive outreach and (2) offer of choice of smoking cessation services (telephone or in-person). Proactive outreach included mailed invitations followed by telephone outreach to motivate smokers to seek treatment with choice of services.The primary outcome was 6-month prolonged smoking abstinence at 1 year and was assessed by a follow-up survey among all current smokers regardless of interest in quitting or treatment utilization.A total of 5123 participants were included in the primary analysis. The follow-up survey response rate was 66%. The population-level, 6-month prolonged smoking abstinence rate at 1 year was 13.5% for proactive care compared with 10.9% for usual care (P = .02). Logistic regression mixed model analysis showed a significant effect of the proactive care intervention on 6-month prolonged abstinence (odds ratio [OR], 1.27 [95% CI, 1.03-1.57]). In analyses accounting for nonresponse using likelihood-based not-missing-at-random models, the effect of proactive care on 6-month prolonged abstinence persisted (OR, 1.33 [95% CI, 1.17-1.51]).Proactive, population-based tobacco cessation care using proactive outreach to connect smokers to evidence-based telephone or in-person smoking cessation services is effective for increasing long-term population-level cessation rates.clinicaltrials.gov Identifier: NCT00608426.
Other groups also studying causes, effects of violence
Authors: William A. Check
Journal: JAMA (1985)

As the Centers for Disease Control and others mount campaigns against violence, efforts to study violence scientifically continue in still other groups, including some American Psychiatric Association members. In 1984, the American Psychological Association released a report of a task force on the victims of crime and violence. The chair of that task force, psychologist Morton Bard, PhD, Center for Social Research, City University of New York, suggests that in social violence, a major factor is social and economic deprivation, adding: "There is also evidence that someone who has been the object of violence as a child will have a tendency to commit violence as an adult. "That suggests wide-scale intervention to try to identify and reduce violent acts against children. That will not eliminate subsequent violence... but it will substantially reduce it." A program of research on violence as a psychiatric and public health problem is in place at
Central Registry for Small-Bowel Ulcers
Authors: Arthur C. Allen, Daniel R. Baker, Scott J. Boley, Martin Goldner, Joel F. Panish, R.P. Russell, Wayne H. Schrader, Solomon Schwartz
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In recent years there seems to be a striking increase in the clinical incidence of small-bowel ulceration with attendant stenosis. Lindholmer, Nyman, and Raf in Sweden, and Baker and associates in this country have drawn attention to a possible relationship between this entity and the use of thiazide diuretics in combination with potassium. Because thiazide drugs constitute such and important tool in our therapeutic armamentarium, it is imperative that the available evidence be reviewed and any possible relationships be determined. We are now concerned with a group of more than 80 patients, comprising ( 1) those already reported (see<i>JAMA</i><b>190:</b>586-590 [Nov 16] 1964) and (2) those to be reported by Morganstern, Freilich, and Panish from Los Angeles, Handel from Detroit, and the group from Brooklyn. While available information is imperfect, the patients from these various centers appear to be similar in a number of ways:
A CASE OF TETANUS TREATED BY SUBDURAL AND INTRASPINAL INJECTIONS OF ANTITOXIN. DEATH.
Authors: C. W. WILLE
Journal: JAMA (1904)

<h3>Introduction.</h3> —The interesting phenomena which happened during the progress and treatment of a case of tetanus which occurred recently in my serrice<sup>1</sup>impels me to place the notes of the case on record. I believe the interests of the profession are best served by collating the material from all cases, whether successful or not. <h3>History.</h3> —A male negro, 24 years of age, was admitted to the U. S. Marine Hospital, Baltimore, at 4 p. m., June 16, 1904. He complained of stiffness of the muscles of the lumbar spine, with rigidity of the muscles of the back of the neck. He noticed the beginning stiffness eighteen hours previous to admission to hospital, and ascribed his condition to the free drinking of ice water throughout the day. <h3>Examination.</h3> —On admission he had considerable rigidity of the muscles of the lumbar spine and of the back of the neck.
Role of adenosine triphosphate (ATP) and NaK ATPase in the inhibition of proximal tubule transport with intracellular cystine loading.
Authors: C Coor, R F Salmon, R Quigley, D Marver, M Baum
Journal: Journal of Clinical Investigation (1991)

Cellular cystine loading with cystine dimethyl ester inhibits volume absorption, transepithelial potential difference, glucose transport, and bicarbonate transport in proximal convoluted tubules perfused in vitro. This study examined the roles of ATP and NaK ATPase in this in vitro model of the Fanconi syndrome of cystinosis. Intracellular ATP was measured using the luciferin-luciferase assay. Intracellular ATP was reduced by 60% in proximal convoluted tubules incubated with 0.5 mM cystine dimethyl ester for 15 min at 37 degrees C (P less than 0.001). Incubation of cystine loaded tubules with 1 mM exogenous ATP increased intracellular ATP to levels not significantly different than that of controls. On the other hand, Vmax NaK ATPase activity was unchanged even though the incubation times and the concentration of cystine dimethyl ester were doubled to 30 min and 1 mM, respectively. In proximal convoluted tubules perfused in vitro, 0.5 mM cystine dimethyl ester resulted in an 89% inhibition in volume absorption (0.81 +/- 0.14 to 0.09 +/- 0.09 nl/mm.min), while there was only a 45% inhibition in volume absorption (P less than 0.01) due to cellular cystine loading in the presence of 1 mM lumen and bath ATP (0.94 +/- 0.05 to 0.52 +/- 0.11 nl/mm.min). These data demonstrate that proximal tubule cellular cystine loading decreases cellular ATP concentration, but does not directly inhibit NaK ATPase activity. The inhibition in transport and decrease in intracellular ATP due to cellular cystine loading was ameliorated by exogenous ATP. These data are consistent with cellular ATP depletion playing a major role in the inhibition of proximal tubule transport due to intracellular cystine loading.
Primary Atypical Pneumonia and High Sedimentation Rates
Authors: H.-J. B. Galbraith, K. W. Jones
Journal: BMJ (1958)

OESOPHAGEAL ATRESIAthis case is that the walls of the oesophagus were tissue- paper thin, and at the original operation seemed to consist of mucous membrane only, whereas well-formed and appar- ently normal oesophagus had developed in the three-year interval before excision of the stricture.The mass of scar tissue at the stricture was incredibly hard, forming a block about 2.5 by 2 by 2 cm., and it was not surprising that it did not respond to frequent dilatation. Summary and CondusionsThe experience of one team with 17 cases of atresia of the oesophagus is described.Special points in surgical technique and care of these babies are stressed.Results in relation to the findings are given.It is felt that the knowledge of the simple diagnostic procedures, the possibilities of operative repair, and the location of the nearest unit willing to undertake these cases should be widely disseminated among general prac- titioners and midwives.Experience with these cases is invaluable, from the medical and nursing points of view, in reducing the mortality and morbidity rates.Therefore cases should if possible be sent to an experienced team, and the extra journey with the baby is far outweighed by the advantages of getting the case to such a unit.Great care in performing the anastomosis pays hand- some dividends and speed is of no importance.Special nursing round the clock is essential for these babies in the first few post-operative days.0 We thankl Mr. Kent Harrison for allowing us to include two of his Cambridge cases in this series.We are grateful to Dr. Douglas Gairdner and his paediatric team and the anaesthetists at Addenbrooke's Hospital for their encouragement and help, with-
HIV and multidrug-resistant tuberculosis: overlapping risk factors
Authors: Susan van den Hof, Aigul Tursynbayeva, Tleukhan Abildaev, Malik Adenov, Svetlana Pak, Shakhimurat Ismailov
Journal: European Respiratory Journal (2015)

Recent meta-analyses have indicated that, on average, new HIV-positive tuberculosis (TB) patients are at increased risk of multidrug-resistant (MDR)-TB compared with HIV-negative patients, while this risk is less clear for previously treated TB patients [1, 2]. In a recent issue of the European Respiratory Journal , Dean et al. [3] reported an association between HIV infection and MDR-TB disease based on aggregated data reported annually to the World Health Organization. Overlapping risk factors may explain observed association between HIV and drug resistance in TB patients <http://ow.ly/DdRGT>
Clinical drug response can be predicted using baseline gene expression levels and in vitro drug sensitivity in cell lines
Authors: Paul Geeleher, Nancy J Cox, R Stephanie Huang
Journal: Genome biology (2014)

Abstract We demonstrate a method for the prediction of chemotherapeutic response in patients using only before-treatment baseline tumor gene expression data. First, we fitted models for whole-genome gene expression against drug sensitivity in a large panel of cell lines, using a method that allows every gene to influence the prediction. Following data homogenization and filtering, these models were applied to baseline expression levels from primary tumor biopsies, yielding an in vivo drug sensitivity prediction. We validated this approach in three independent clinical trial datasets, and obtained predictions equally good, or better than, gene signatures derived directly from clinical data.
BMA votes to reduce age of consent for homosexual men
Authors: L Beecham
Journal: BMJ (1994)

The British Medical Association (BMA) has voted overwhelmingly for the age of consent for homosexual men in Britain to be reduced from 21 to 16. An amendment to the Criminal Justice and Public Order Bill calls for a similar reduction and is due to be debated by the House of Commons next week. MPs will be given a free vote. Britain is the only …
Patterns of Nucleotide Substitution in Angiosperm cpDNA trnL (UAA)–trnF (GAA) Regions
Authors: Freek T. Bakker, Alastair Culham, Rosalba Gomez-Martinez*, Jose Carvalho, James Compton, Richard Dawtrey, Mary Gibby
Journal: Molecular Biology and Evolution (2000)

Patterns of substitution in chloroplast encoded trnL-F regions were compared between species of Actaea (Ranunculales), Digitalis (Scrophulariales), Drosera (Caryophyllales), Panicoideae (Poales), the small chromosome species clade of Pelargonium (Geraniales), each representing a different order of flowering plants, and Huperzia (Lycopodiales). In total, the study included 265 taxa, each with >900-bp sequences, totaling 0.24 Mb. Both pairwise and phylogeny-based comparisons were used to assess nucleotide substitution patterns. In all six groups, we found that transition/transversion ratios, as estimated by maximum likelihood on most-parsimonious trees, ranged between 0.8 and 1.0 for ingroups. These values occurred both at low sequence divergences, where substitutional saturation, i.e., multiple substitutions having occurred at the same (homologous) nucleotide position, was not expected, and at higher levels of divergence. This suggests that the angiosperm trnL-F regions evolve in a pattern different from that generally observed for nuclear and animal mtDNA (transition/transversion ratio ≥ 2). Transition/transversion ratios in the intron and the spacer region differed in all alignments compared, yet base compositions between the regions were highly similar in all six groups. A↔T and G↔C transversions were significantly less frequent than the other four substitution types. This correlates with results from studies on fidelity mechanisms in DNA replication that predict A↔T and G↔C transversions to be least likely to occur. It therefore strengthens confidence in the link between mutation bias at the polymerase level and the actual fixation of substitutions as recorded on evolutionary trees and, concomitantly, in the neutrality of nucleotide substitutions as phylogenetic markers.
Laboratory testing for fibrinogen abnormalities
Authors: Madeleine Verhovsek, Karen A. Moffat, Catherine P.M. Hayward
Journal: American Journal of Hematology (2008)

Fibrinogen is essential for the formation of a fibrin clot. Acquired and congenital disorders of fibrinogen may result in decreased concentration or altered function of fibrinogen, often leading to an increased risk of bleeding. Routine coagulation testing and specialized laboratory investigations can guide diagnosis in patients suspected of having a fibrinogen abnormality. This article summarizes the types of laboratory assays that are used to assess fibrinogen disorders, and key abnormalities found in different types of fibrinogen disorders.
The effect of an iron chelating agent on protoporphyrin IX levels and phototoxicity in topical 5-aminolaevulinic acid photodynamic therapy
Authors: K. Choudry, R.C.C. Brooke, W. Farrar, L.E. Rhodes
Journal: British Journal of Dermatology (2003)

Summary Background In 5-aminolaevulinic acid (ALA)-photodynamic therapy (PDT), the prodrug ALA is endogenously converted to the active sensitizer protoporphyrin IX (PpIX), while further conversion of PpIX to haem requires iron. Objectives To explore the potential of the iron chelator desferrioxamine (DFO) to enhance PpIX levels and phototoxicity in ALA-PDT. Methods A series of six doses of 2% ALA solution was iontophoresed into the healthy skin of each ventral forearm of 10 volunteers. One arm was pretreated with 20% DFO in aqueous cream, while the control arm received aqueous cream alone, for 16 h. At 5 h following iontophoresis, skin-surface PpIX fluorescence was measured, following which the forearms were simultaneously irradiated with 100 J cm−2 broadband red light. The phototoxic reaction was assessed at 24 h postirradiation as the minimal phototoxic dose (MPD) and with quantification of erythema. Next, eight patients with two superficial basal cell carcinomas or two plaques of Bowen's disease of similar appearance received 20% ALA topically to one lesion and 20% ALA with 20% DFO to the other, for 3 h. Skin-surface PpIX fluorescence was measured at 5 h, following which lesions were irradiated with 100 J cm−2 broadband red light. Results In healthy skin, PpIX fluorescence increased with increasing ALA dose at DFO-treated and untreated sites (P < 0·0005); PpIX fluorescence peak values were consistently higher in DFO-treated compared with control sites (P < 0·02). Erythema also correlated with ALA dose (P < 0·0005), but a significant difference between active and control sites occurred only at low ALA dose (P < 0·05). The median MPD appeared lower at the DFO-treated sites, at 6 mC vs. 12 mC (P = 0·06). In contrast, in lesional skin there was no consistent difference in PpIX fluorescence levels between those treated with and without DFO. Conclusions While iron chelation augmented ALA-PDT phototoxicity in normal skin, this occurred only at low ALA dose. Addition of DFO does not appear to confer additional benefit in ALA-PDT of nonmelanoma skin cancers.
Longer Examination Time Improves Detection of Gastric Cancer During Diagnostic Upper Gastrointestinal Endoscopy
Authors: Jun Liang Teh, Jin Rong Tan, Linus Jian Fa Lau, Nakul Saxena, Agus Salim, Amy Tay, Asim Shabbir, Sydney Chung, Mikael Hartman, Jimmy Bok-Yan So
Journal: Clinical Gastroenterology and Hepatology (2014)
The Development of Professionalism in the Allied Health Field
Authors: William K. Selden
Journal: JAMA (1968)

A century and a half ago, Dr. Syntax, the character created by the English author, William Combe, declared in rhyme that "The learned professions, all agree,/Are physic, law and divinity." Although this fictional, reverend doctor stated preferences for the three leading professions, he was not sufficiently bold to identify which of these three he considered to be the most important. Nor will I attempt to prove that one profession is more important than another. However, accepting the contention that medicine, law, and theology are the ancient and learned professions, I wish to indicate that medicine presently has opportunities and, in fact, social obligations that involve some features considered to be the prerogatives of the other two professions. These opportunities have been enhanced by the development of professionalism in the allied health field. We all know that medicine is defined in the dictionary as "the science and art of diagnosing, treating,
Impact of Electronic Fetal Monitoring on Obstetric Management
Authors: Orvan W. Hess
Journal: JAMA (1980)

Electronic monitoring equipment improves detection and recording of fetal heart activity and uterine contractions. Fetal heart rate is one indicator of the well-being of the fetus; altered cardiac rate may indicate impairment of the maternal-placenta-fetal circulation or hypoxia with potential fetal damage or stillbirth. Antepartum monitoring of the fetal heart can screen the fetus with low-reserve who may be at risk during labor. Continuous intrapartum monitoring may portend fetal jeopardy early enough for treatment or intervention. Despite substantial decline in perinatal and neonatal mortality and morbidity, direct cause-and-effect relationship to electronic fetal monitoring is questioned. Government agencies have been authorized to assess technology for cost-benefit and social impact.
828-5 Definition of the pulmonary vein ostia during isolation procedures: Comparison between the CARTO approach and intracardiac echo guided isolation
Authors: Yaariv Khaykin, Nassir Marrouche, Walid Saliba, Robert Schweikert, Eduardo Saad, David Burkhardt, Mandeep Bhargava, George Joseph, Antonio Rossillo, Andrea Natale
Journal: Journal of the American College of Cardiology (2004)
A REPORT FROM JAPANESE MULTICENTER REGISTRY DATA FOR CLINICAL RESULTS OF RETROGRADE APPROACH IN PERCUTANEOUS CORONARY INTERVENTIONS FOR CHRONIC TOTAL OCCLUSIONS
Authors: Atsunori Okamura, Masahisa Yamane, Makoto Muto, Tsutomu Fujita, Tetsuo matsubara, Yasumi Igarashi, Shigeru Nakamura, Toshiya Muramatsu, Mitsunori Abe, Etsuo Tsuchikane
Journal: Journal of the American College of Cardiology (2012)