tbuckley/cabot-search huggingface dataset:
Fumaderm <sup>®</sup> in daily practice for psoriasis: dosing, efficacy and quality of life
Authors: F. Walker, A. Adamczyk, C. Kellerer, K. Belge, J. Brück, T. Berner, K. Merten, N. Núnez Gómez, M. Neureither, M. Röcken, K. Ghoreschi
Journal: British Journal of Dermatology (2014)

Patients with psoriasis suffer from chronic skin disease and impaired quality of life. With a prevalence of 1-3% of the population, psoriasis is one of the most common chronic inflammatory autoimmune diseases. Fumaric acid esters (Fumaderm(®)) are approved for the treatment of psoriasis in Germany, but regular Fumaderm therapy with six tablets per day is often limited due to adverse events.This observational study recorded data on quality of life, treatment efficacy and drug dosing in patients suffering from psoriasis treated with Fumaderm under conditions of daily practice in 78 dermatological centres.In this prospective, multicentre, noninterventional trial we included adult patients with severe plaque psoriasis under outpatient conditions receiving Fumaderm according to the current summary of product characteristics for systemic treatment of psoriasis. At baseline and after 3, 6 and 12 months the dosing regimen under daily conditions, Dermatology Life Quality Index (DLQI) and clinical efficacy with the Psoriasis Area and Severity Index (PASI) were documented.A total of 249 patients were included. The mean DLQI score at study entry was 9·95; the mean PASI was 16·8. The average treatment dose of Fumaderm was 2·8 tablets daily. More than 70% of patients were treated with one to three tablets daily and < 30% were treated with a dose ranging from four to six tablets daily. DLQI and PASI improved in the entire study population by 67·2% and 66·6%, respectively. Specifically, when analysing patients who started Fumaderm within 4 weeks before baseline the mean DLQI score decreased from 11·8 to 2·9 (75% reduction) and the mean PASI score from 19·84 to 7·35 after 12 months (63% improvement).This is the first field study analysing the use of Fumaderm and the improvement of quality of life in patients with psoriasis under daily outpatient conditions. The improvement of DLQI obtained with Fumaderm was comparable with the improvement observed in patients with psoriasis treated with modern biologics. Importantly, in most patients with good clinical response, the treatment dose was one to three tablets daily.
Biliary Bezoar: The Sump Syndrome and Choledochoenterostomy
Authors: J. H. Siegel
Journal: Endoscopy (1982)

The sump syndrome has been reported to occur infrequently following a choledochoenterostomy (duodenostomy or jejunostomy) for stone disease. The enterostomy stoma usually decreases in diameter following surgery allowing for reflux into the distal, inactive segment of the bile duct without adequate egress of the material. This stagnant portion of the bile duct functions as a reservoir for collection of debris and/or lithogenic bile resulting in intermittent obstruction of the stoma producing symptoms of pain and clinical and biochemical evidence of cholestasis and pancreatitis. This symptom complex has been labelled as the sump syndrome and has been effectively diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and treated by duodenoscopic sphincterotomy. Occasionally the enterostomy stoma remains adequate but foreign material or debris aggregates to produce obstruction. The case described in this report matched the latter description and was diagnosed by a new endoscopic application, peroral choledochoscopy. This new technique and the recommendations for evaluation and treatment of the sump syndrome as well as alternate surgical techniques to avoid its occurrence will be discussed.
DNA methylation as a biomarker of progression in barrett's carcinogenesis
Authors: M. A. Alvi, N. B. Shannon, M. O'Donovan, R. Newton, L. Wernisch, R. C. Fitzgerald
Journal: Gut (2011)

<h3>Introduction</h3> Barrett9s oesophagus (BO) increases the risk of developing oesophageal adenocarcinoma (OAC) by around 40-fold. OAC incidence rates have increased sixfold since the 1970s but the bleak prognosis for this disease is improved by early detection. The intermediate dysplastic stage between BO and OAC is the most reliable marker of progression. However the histological presence of dysplasia is subjective due to known sampling bias along with a high inter and intraobserver variability. Aberrant DNA methylation is shown to be characteristic of certain tumours and is known to occur early during transformation. We therefore hypothesise that DNA methylation changes take place early during carcinogenesis in BO patients which could be utilised as progression biomarkers. The study aims were therefore to identify genes showing a variation in methylation through progression and to then validate them on an independent dataset. <h3>Methods</h3> DNA methylation levels were assessed across 27 578 CpG loci covering 14 000 genes in 24 of each BO and OAC test samples using arrays. Both supervised clustering (GSEA software) and unsupervised clustering (R software) were used to identify genes with a statistically significant difference in methylation in BO versus OAC. Genes present in both the lists were selected for validation. Internal validation and external validation on an independent set of 48 BO, 31 BO with dysplasia and 68 OAC samples was carried out using pyrosequencing assays. <h3>Results</h3> Supervised clustering came up with 2822 hypermethylated and 645 hypomethylated genes (p≤0.001) and unsupervised with 1563 hypermethylated and 610 hypomethylated genes (p≤0.01). Genes successfully validated include <i>RGN</i> (senescence marker protein-30), <i>SLC22A18</i> (tumour suppressing subtransferable candidate 5), <i>PIGR</i> (polymeric immunoglobulin receptor), <i>GJA12</i> (gap junction protein, γ2) and <i>TCEAL7</i> (transcription elongation factor A – like 7). After internal validation (spearman9s correlation p &lt;0.001, coefficient=0.9), external validation was carried out and a highly statistically significant gradual increase in methylation was observed for all the above genes in OAC and BO with dysplasia compared to BO: <i>RGN</i> (ANOVA p&lt;0.001, JT p=0.001), <i>SLC22A18</i> (ANOVA p&lt;0.001, JT test p&lt;0.001), <i>PIGR</i> (ANOVA p&lt;0.001, JT p&lt;0.001), <i>GJA12</i> (ANOVA p&lt;0.001, JT p&lt;0.001) and <i>TCEAL7</i> (ANOVA p=0.008, JT p=0.001). <h3>Conclusion</h3> High throughput DNA methylation screening using arrays and robust external validation has allowed us to identify novel genes having biomarker potential previously unknown to play a role in Barrett9s carcinogenesis. Further validation in an EDRN phase III study is underway.
Streptomycin Therapy for Certain Infections of Intestinal Origin
Authors: Edwin J. Pulaski, William H. Amspacher
Journal: New England Journal of Medicine (1947)

SEVERAL reports have already been published concerning the laboratory and clinical investigations on the efficacy of streptomycin in various infections carried out in Army hospitals under the auspices of the Surgeon General during the past eighteen months.1 2 3 4 5 The purpose of the present communication is to enlarge on and bring up to date experience with treated infections of intestinal origin. The Army series is compared with the cumulative experience in these infections as recently reported by the Committee on Therapeutics and Other Agents of the National Research Council.6 BrucellosisThe most recent report of the Committee revealed that, as of September, . . .
Intravenous digital subtraction angiography.
Authors: A P Hemingway
Journal: BMJ (1987)

with the Warwickshire constabulary, probation service, and road safety unit.Finally, we strongly support Coventry's proposals for the introduction of random breath testing in Britain.There is now substantial evi- dence from Australia, New Zealand, Finland, and the United States that this measure is effective in reducing drinking and driving.2
Examania -- North American style.
Authors: R A Millar
Journal: BMJ (1979)

Deciding to return to North America and re-emigrating to Canada in late 1975 presented no problems of licensing, since I had taken the LMCC 17 years earlier and had received FRCP(C) as a late sequel to passing the certification examination in anaesthesia. Then, of course, the LMCC format was of essay type questions, and included orals and clinicals. When I fell into the chairman's position a few months after arriving here, there was a department to restaff, a residency programme to develop, a daily commitment to the operating room, some participation in the intensive care unit, and a little spare time to settle into a new environment. Gradually, with some encouragement from friends there, I moved to a point of decision: to get licensed in the States. I had known for years about the Educational Commission for Foreign Medical Graduates (ECFMG; required of all graduates of medical schools outside the US and Canada), and the Federation Licensing Examination (FLEX; the uniform state licensing exam), which would have to be taken. However, by late 1977, US laws  medical immigration had been tightened, and the first Visa Qualifying Examination (VQE) had been offered to some 4611 foreign physicians who did not have a state licence and were not practising on the day (10 January 1977).
263 EARLY IMMUNE SYSTEM ACTIVATION AT THE SYSTEMIC LEVEL INITIATES IN THE LIVER IN EXPERIMENTAL COMPENSATED CIRRHOSIS
Authors: M. Ubeda, L. Munoz, M. Nieto, M. Lario, D. Diaz, L. Lledo, J. Monserrat, E. Reyes, E. Sanz, A. De-la-Hera, M. Alvarez-Mon, A. Albillos
Journal: Journal of Hepatology (2008)
The Internist's Reading: Outsider and Insider Views
Authors: Henry Schneiderman
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 November 1994The Internist's Reading: Outsider and Insider ViewsHenry Schneiderman, MD and Rosemaria Memoli Schneiderman, BSHenry Schneiderman, MDSearch for more papers by this author and Rosemaria Memoli Schneiderman, BSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-9-199411010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Why should internists read anything except journals? How can one justify, in the little time available, something that doesn't relate to patient care or to furthering one's knowledge of medicine?A physician is not merely what he or she does. The soul of a physician starves if not fed regularly and well. (The related idea of the medicine chest of the soul goes back to Dion Chrysostom in Hellenistic times.) So even when crushed by responsibility, made to feel inadequate by all that is expected, and ferociously put-upon by demands of patients and colleagues, we must fight to keep that ... Author, Article, and Disclosure InformationAffiliations: Corresponding Author: Henry Schneiderman, MD, MC 3940, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3940. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1994Volume 121, Issue 9Page: 727-728KeywordsAntidotesMouthPatientsPregnancySafetySubstance abuseSuicideTechniciansThoraxVision ePublished: 15 August 2000 Issue Published: 1 November 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Transjugular renal biopsy in the treatment of patients with cirrhosis and renal abnormalities
Authors: P Jouet, A Meyrier, F Mal, P Callard, C Guettier, D Stordeur, J Trinchet, M Beaugrand
Journal: Hepatology (1996)

When renal lesions are suspected in patients with cirrhosis, clotting disorders often preclude percutaneous renal biopsy. This study was undertaken to determine whether transjugular renal biopsy is possible, safe, and useful in such patients. From 1987 to 1994, 70 patients with cirrhosis and clotting disorders underwent transjugular renal biopsies, providing renal tissue in 55. Of these 55 patients, 41 were Child-Pugh class B or C, 35 were alcoholic, serum creatinine levels were > or = 130 micromol/L in 46, and proteinuria was > or = 0.5 g/d in 37. Clinically significant complications of transjugular renal biopsy were persistent hematuria in 4 and perirenal hematoma in 4, requiring blood transfusions in 1 and 2 cases, respectively. There were no deaths related to renal biopsy. Renal lesions were identified as glomerular in 41 (74.5%), interstitial in 7, and end-stage in 2 and were absent in 5. Transjugular renal biopsy influenced treatment in 21 patients (38%), including 11 who were proposed for liver transplantation and 4 who had chronic liver rejection. Decisions based on results of transjugular renal biopsy were to perform liver transplantation in 8 and combined renal and liver transplantation in 5, whereas 2 were refused. In 6 other patients, the results of renal biopsy modified the medical regimen. We conclude that transjugular renal biopsy may be a useful procedure in patients with cirrhosis and clotting disorders. This technique does not entail undue risks and may influence treatment decisions, particularly in patients proposed for liver transplantation.
Immunologic Heterogeneity of Autoantibodies in Patients with Pernicious Anemia
Authors: George M. Bernier, John D. Hines
Journal: New England Journal of Medicine (1967)

THE term "autoantibodies" has been applied to immunoglobulins of a person capable of reacting with his own naturally occurring antigens. In patients with pernicious anemia several different kinds of autoantibodies have been demonstrated.1 2 3 4 5 6 7 8 9 10 11 12 13 Two of these are circulating antibodies directed against intrinsic factor alone or a complex of intrinsic factor with vitamin B12. One (the "blocking" antibody) inhibits the attachment of vitamin B12 to intrinsic factor,1 2 3 4 5 6 and the other (the "precipitating" antibody) forms a soluble complex with intrinsic factor and vitamin B12.7 8 9 10 11 It has not been established whether such abnormal antibodies are the result of . . .
Peripheral Circulatory Abnormalities Due to an Arteriovenous Fistula Used for Hemodialysis.
Authors: Joseph Abbott
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Peripheral Circulatory Abnormalities Due to an Arteriovenous Fistula Used for Hemodialysis.Joseph Abbott, M.D., John Bussell, B.S., Robert Lim, M.D.Joseph Abbott, M.D.Search for more papers by this author, John Bussell, B.S.Search for more papers by this author, Robert Lim, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-830_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEstablishment of a subcutaneous arteriovenous fistula between the radial artery and cephalic vein allows for chronic percutaneous hemodialysis. Although vascular insufficiency is a hazard, use of the internal fistula is becoming more popular than the external Scribner shunt because of a low prevalence of infection and occlusion. In seven hemodialysis patients with a side-to-side radial-cephalic arteriovenous fistula, digital and forearm blood flow was measured by pneumatic plethysmography. Forearm blood flow was always increased in the fistula extremity (increase in mean difference, 22 ml/min/100 ml tissue;P< 0.01), but finger blood flow was always decreased in the fistula extremity thumb... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: San Francisco, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 830-830KeywordsArteriesBlood flowFistulasVascular insufficiencyVeins Issue Published: 1 May 1971 PDF downloadLoading ...
STUDIES ON THE CHEMOTHERAPY OF THE HUMAN MALARIAS. VII. THE ANTIMALARIAL ACTIVITY OF PAMAQUINE 123
Authors: Robert W. Berliner, David P. Earle, John V. Taggart, William J. Welch, Charles G. Zubrod, Peter Knowlton, John A. Atchley, James A. Shannon
Journal: Journal of Clinical Investigation (1948)

Pamaquine, synthesized in 1926, was introduced in the treatment of malaria as a schizonticide.It was soon found, however, that the great schizonti- cidal activity which it possessed in cathemerium malaria of canaries did not obtain in the human malarias.It was shown to be relatively ineffec- tive in acute attacks of vivax malaria and to have only minimal activity against the asexual forms of P. falciparum, although it did eradicate the gameto- cytes in this infection.In addition, the general usefulness of pamaquine was limited by the fre- quent occurrence of toxic effects with doses in the therapeutic range.Nonetheless, evidence was advanced favoring both a prophylactic (1, 2, 3) and curative action (4) in vivax malaria.The toxicity of the drug and an incomplete understanding of the biology of vivax malaria led the commission on malaria of the Health Organiza- tion of the League of Nations (5) to state that its prophylactic action was not practical and to dis- count the work of Sinton on its curative action (4).The commission recommended that pama-
Outline of Psychiatry.
Authors: S. H. Kraines
Journal: JAMA (1963)

Unfortunately, in many medical schools, psychiatry has been taught largely from a psychoanalytic approach —and the recent advances in psychiatric therapy, as well as the implications of these advances in terms of etiological mechanisms, have been superficially presented.  Cammer has provided an excellent and thoroughly eclectic review of the forces which operate to produce psychiatric illness. He is erudite in his exposition and draws his material from many sources ranging from Hans Selye to Walter Cannon, from Sigmund Freud to Karen Homey. He discusses man's total functioning, outlining the role of stress in its various forms; growth and development from a psychodynamic point of view; personality structure as a biological concept including the role of conflict; and active will. He evaluates the neurophysiological basis of behavior, conditioned (Pavlovian) behavior, and cerebral integration. There is a clear and lucid discussion of psychoanalysis, its principles and techniques. He emphasizes ecology, demonstrating how
Evidence for expiratory flow limitation of extrathoracic origin in patients with obstructive sleep apnoea
Authors: E Verin
Journal: Thorax (2002)

Background: A study was undertaken to examine the expiratory flow response to a negative pressure (NEP) applied at the airway in patients with no abnormalities of the intrathoracic airway but suffering from the obstructive sleep apnoea syndrome (OSAS). Methods: Nineteen patients with OSAS with normal spirometric values were studied. NEP of –5 cm H2O and –10 cm H2O was applied to the mouth when sitting and when supine. Results: Thirteen patients exhibited expiratory flow limitation when supine (group 1). Of these, three also had flow limitation in the sitting position. The remaining six patients (group 2) had no flow limitation. Patients in groups 1 and 2 were similar with respect to age, sex, and body mass index, but the apnoea/hypopnoea index (AHI) was higher in group 1 than in group 2 (p<0.05). There was a significant correlation between the degree of flow limitation (expressed as a percentage of the expired tidal volume over which the NEP induced flow did not exceed spontaneous flow) and the AHI (p<0.05 for both pressure levels) as well as the desaturation index (DI, number of desaturations per hour of sleep; p<0.05 at –10 cm H2O). Conclusion: This study confirms that the NEP technique can detect expiratory flow limitation of extrathoracic as well as of intrathoracic origin. This technique could be useful for studying the collapsibility of the passive upper airway in awake subjects and might help to predict the severity of OSAS.
EXTENSION OF MALIGNANT TUMORS OF THYROID INTO GREAT VEINS AND RIGHT HEART
Authors: WILLIAM L. HOLT
Journal: JAMA (1934)

Malignant tumors of the thyroid gland may involve neighboring veins and extend as tumor thrombi into the superior vena cava and right side of the heart. Four cases have been reported and are here assembled. This report adds another case studied by me. It is unique in that the tumor thrombosis invaded both venae cavae and the right auricle. <h3>GENERAL CONSIDERATIONS</h3> Malignant tumors of the thyroid gland constitute between 1 and 2 per cent of all goiters and are found about once in every thousand necropsies in the United States. The greatest number of cases occur in the fifth decade. Women are afflicted in from two thirds to three fourths of all cases.<sup>1</sup>Adenomatous goiter precedes malignant conditions of the thyroid in more than 90 per cent, and over 90 per cent is of epithelial origin.<sup>2</sup>Clinical signs of toxic adenoma are present in about half of all
Intramural Virtual Electrodes During Defibrillation Shocks in Left Ventricular Wall Assessed by Optical Mapping of Membrane Potential
Authors: Vladimir G. Fast, Oleg F. Sharifov, Eric R. Cheek, Jonathan C. Newton, Raymond E. Ideker
Journal: Circulation (2002)

Background— It is believed that defibrillation is due to shock-induced changes of transmembrane potential (ΔV m ) in the bulk of ventricular myocardium (so-called virtual electrodes), but experimental proof of this hypothesis is absent. Here, intramural shock-induced ΔV m were measured for the first time in isolated preparations of left ventricle (LV) by an optical mapping technique. Methods and Results— LV preparations were excised from porcine hearts (n=9) and perfused through a coronary artery. Rectangular shocks (duration 10 ms, field strength E ≈2 to 50 V/cm) were applied across the wall during the action potential plateau by 2 large electrodes. Shock-induced ΔV m were measured on the transmural wall surface with a 16×16 photodiode array (resolution 1.2 mm/diode). Whereas weak shocks (E≈2 V/cm) induced negligible ΔV m in the wall middle, stronger shocks produced intramural ΔV m of 2 types. (1) Shocks with E&gt;4 V/cm produced both positive and negative intramural ΔV m that changed their sign on changing shock polarity, possibly reflecting large-scale nonuniformities in the tissue structure; the ΔV m patterns were asymmetrical, with ΔV − m &gt;ΔV + m . (2) Shocks with E&gt;34 V/cm produced predominantly negative ΔV m across the whole transmural surface, independent of the shock polarity. These relatively uniform polarizations could be a result of microscopic discontinuities in tissue structure. Conclusions— Strong defibrillation shocks induce ΔV m in the intramural layers of LV. During action potential plateau, intramural ΔV m are typically asymmetrical (ΔV − m &gt;ΔV + m ) and become globally negative during very strong shocks.
Children intoxicated by alcohol in Nottingham and Glasgow, 1973-84.
Authors: J O Beattie, D Hull, F Cockburn
Journal: BMJ (1986)

The circumstances of ingestion, clinical course, and long term sequelae were examined retrospectively in 143 children (108 boys, 35 girls) admitted with acute alcohol intoxication in Glasgow and Nottingham over the 12 years 1973-84. Fifty three of the children were aged less than 7 years and 90 were aged 7-14. Twelve of the children were hypoglycaemic on arrival at hospital. Trauma related to intoxication occurred in 14 cases, and nine boys became drunk under duress, which in four cases was associated with sexual abuse.