tbuckley/cabot-search huggingface dataset:
REMARKS on the SURGICAL TREATMENT of PYLORIC OBSTRUCTION, with an ACCOUNT of TWENTY CASES, and of a NEW WAY of PERFORMING GASTRO-ENTEROSTOMY
Authors: F. T. Paul
Journal: BMJ (1898)

STENOSIS of the pyloric orifice of the stomach is brought about in several different ways.It is due to- i. Congenital insufficiency.2. Obstruction from the external pressure of tumours, bands, etc. 3. Reflex spasm.4. Fibrous contraction.5. Cancerous and other growths.In dealing with these conditions I propose to restrict my remarks to personal experience.CONGEBNITAL INSUFFICIENCY I have no positive knowledge of in the adult, unless it was the primary cause of stenosis in Case iv.OBSTRUCTION FROM WITHOUT in such a degree and under such circumstances as to suggest surgical interference is very rare, owing to the mobility of the stomach.I have known omental bands connected with a hernial orifice and acting through the transverse colon to so drag on the stomach as to give rise to symptoms of obstruc- tion.In such a case the treatment is obvious and simple.Scirrhous cancer of the gall bladder also drags on the pylorus, but in the opposite direction.It is somewhat rare.I have seen two cases in which obstruction was caused in this way.REFLEX SPASM occurs both in association with ulceration and Independently of it.In t896 1 operated upon a case in which symptoms of pyloric obstruction apparently depended upon muscular spasm only.CASE I.The patient was a man, aged 21.He was admitted into the Royal Infirmary under the care of Dr. Caton in November, I895, for pain in the epigastric region and a lump The lump proved to be a largely dilated stomach, In which splashing sounds could be easily produced.He was treated by careful dieting and washing out the stomach, but not having materially improved in January, I896, was transferred to me.The patient was anaemic and decidedly of neurotic type On Jan 6th the abdomen was opened for exploratory purposes The stomach was found dilated, the pylorus thick but not tibrous, and upon invaginating the anterior wall upon the forefinger into the pyloric orifice abnormal re- sistance was met with.This was gradually overcome by continued steady pressure, and ultimately the opening was over-dilated without splitting by passing three flogers through it.No cut was made in the organ.The patient healed well, but was subsequently attacked with acute mania, and had to be sent to the County Asylum, where he re- mained five months before he got his discharge.He had no recurrence of the gastric symptoms.FIBROUS STRICTURE * Read at the iAverpool Medical Institution.have used divulsion in two cases in addition to the one just described.LORETA'S OPERATION.CASE II -P.K., aged 36.Fibrous stricture of pylorus.Two years ago vomited blood in small quantities on four occasions.Eleven months ago first began to suffer from the collecting of " burning wind " in his stomach, with nausea but no vomiting.He gradually gave up various articles of diet, living mostly on bread and milk.He 108t 3 st. in weight.Was admitted underDr.Caton in November, i8go, and was for some time
Racial Inequalities in the Use of Procedures for Patients With Ischemic Heart Disease in Massachusetts
Authors: Mark B. Wenneker
Journal: JAMA (1989)

To examine interracial differences in the utilization of coronary angiography, coronary artery bypass grafting, and coronary angioplasty for white and black patients, we examined all admissions for circulatory diseases or chest pain to Massachusetts hospitals in 1985. After controlling for age, sex, payer, income, primary diagnoses, and the number of secondary diagnoses, whites underwent significantly more angiography and coronary artery bypass grafting procedures. Whites also underwent more angioplasty procedures, but the difference was not statistically significant. Although utilization differences may reflect patient preference or different levels of disease severity and socioeconomic status not adequately accounted for, this study suggests that substantial racial inequalities exist in the use of procedures for patients hospitalized with coronary heart disease. (<i>JAMA</i>1989;261:253-257)
Activated Charcoal in Phenobarbital Overdose-Reply
Authors: Susan M. Pond
Journal: JAMA (1985)

<h3>In Reply.—</h3> Goldberg and colleagues have pointed out a number of reasons why our group of phenobarbital-overdosed patients treated with repeated doses of charcoal may have been more ill than the control group. They suggest this because of some differences in the numbers of patients in the single-dose and repeated-dose groups that had high phenytoin or alcohol concentrations, aspiration pneumonia, low mean arterial pressure, and high Fio<sub>2</sub>requirement. We looked at the data from each subject to see if patients with these factors had longer coma times than the others in the group. This was not the case. Patient 9, aged 32 years, at the time of hospital admission, had a mean arterial pressure of 26 mm Hg and aspiration pneumonia, required an Fio<sub>2</sub>of 0.4, a blood alcohol concentration of 87 mg/dL<i>and</i>a serum phenytoin concentration of 25 μg/mL However, it was only 44 hours after
118 METABOLIC FATTY-LIVER DISEASE INCREASES THE RISK OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH ALCOHOLIC CIRRHOSIS LISTED FOR LIVER TRANSPLANTATION
Authors: R. Pais, P. Lebray, G. Rousseau, M. Rudler, D. Thabut, F. Charlotte, L. Bonyhay, O. Lucidarme, L. Hannoun, T. Poynard, J.-C. Vaillant, V. Ratziu
Journal: Journal of Hepatology (2013)
Harmonizing Reporting of Financial Conflicts
Authors: Bridget M. Kuehn
Journal: JAMA (2013)

fused tomagneticnanoparticles toallow theprobetobetrackedbyamagneticresonanceimagingscan.Whenincubatedwith slices fromthehumanfrontal cortex, the probe binds to the ADDLs with high affinityandspecificity insynapsesofnerve cells in the hippocampus, a brain region that plays an important role in memory. Because the blood-brain barrier is impervious to large molecules such as antibodies for use in vivo, the researchers developed an intranasal delivery system that circumvents this impediment. In experiments in mouse models of AD, the antibody prevented memory failure in the treated mice, suggesting that this strategy might work as a therapeutic as well as a diagnostic tool. Not only is it important to detect AD early, it is also important to distinguish it fromdementiathatoccursinotherneurodegenerativedisorders, includingParkinson disease (PD) and dementia with Lewybodies (DLB), saidPaulaDesplats, PhD, at the University of California, San Diego.Hergroupisfocusingonepigenetic mechanisms—the changes that modify thechromatinstructure toallowgenes to be expressed without altering the DNA sequence. “We are learning that epigenetic changes are crucial to the neurodegenerative process very early in the disease process,” she said. Usingbrainautopsysamples fromthe frontal cortexofpatientswithconfirmed diagnosesofthe3differentdiseasesaswell as fromhealthycontrolsmatched forage andsex,theresearchersexaminedchanges in theactivityof84genes thatencodeenzymes thatmodify thestructureofDNA, such as histone deacetylases. They observeddysregulationofepigenetic factors inall3groups,with13genesbeingaltered in AD, 17 in PD, and 20 in DLB, with a particular “signature” for each disorder. The next challenge will be to devise a way to observe these signatures through a blood test to improve diagnoses of neurodegenerative conditions early on, said Desplats. This work may also point to new therapeutic targets, she added.
Malonyl coenzyme A and adiposity in the dahl salt-sensitive rat: Effects of pioglitazone
Authors: T.G. Kurowski, A.K. Saha, B.A. Cunningham, R.I. Holbert, J.R. Colca, B.E. Corkey, N.B. Ruderman
Journal: Metabolism (1996)

These studies were designed to assess the effects of pioglitazone, a new oral antidiabetic agent that acts by improving insulin sensitivity, on blood pressure, plasma and tissue lipids, and insulin resistance in the Dahl salt-sensitive (Dahl-S) rat. Reaven et al had reported that male Dahl-S rats are moderately hyperinsulinemic and insulin-resistant. This was of particular interest since these rats are not obese but are hypertriglyceridemic, and on a high-salt diet they become hypertensive. In the current study, male Sprague-Dawley control and Dahl-S rats were compared when fed standard chow or high-fat, high-sucrose (HFHS) diets with or without pioglitazone (20 mg/kg body weight/d) for 3 weeks. On the standard chow diet, Dahl-S rats were hypertriglyceridemic and had high tissue levels of malonyl coenzyme A ([CoA] Dahl-S 5.0 v control 3.3 nmol/g in muscle, and Dahl-S 15.6 v control 10.7 nmol/g in liver); however, they were not hyperinsulinemic. Pioglitazone therapy decreased both malonyl CoA and plasma triglycerides toward control values, but had no effect on plasma insulin levels. On the HFHS diet, both groups became glucose-intolerant and hyperinsulinemic; however, the hyperinsulinemia was greater and more sustained in Dahl-S rats. In addition, the HFHS diet appeared to increase the mass of retroperitoneal fat in the Dahl-S but not in the control group. Treatment with pioglitazone decreased retroperitoneal fat, but as reported previously, it increased the mass of the epididymal fat pad. The results suggest that the hypertriglyceridemia of the Dahl-S rat is associated with an increase in the concentration of malonyl CoA in both liver and muscle. They also show that pioglitazone reverses both of these abnormalities independently of its effect on plasma insulin. Whether these high levels of malonyl CoA predispose the Dahl-S rat to hyperinsulinemia and possibly obesity when placed on a HFHS diet remains to be determined.
Novel therapeutic strategies for cardioprotection
Authors: Joost P.G. Sluijter, Gianluigi Condorelli, Sean M. Davidson, Felix B. Engel, Peter Ferdinandy, Derek J. Hausenloy, Sandrine Lecour, Rosalinda Madonna, Michel Ovize, Marisol Ruiz-Meana, Rainer Schulz, Linda W. Van Laake
Journal: Pharmacology & Therapeutics (2014)
Surgical management of the Budd-Chiari syndrome: No place for a procrustean bed
Authors: Alan N. Langnas, Michael F. Sorrell, Jeremiah P. Donovan, Byers W. Shaw
Journal: Hepatology (1992)

ABSTRACT Over 12 years, 22 patients with the Budd–Chiari syndrome were treated surgically. Eighteen underwent a mesenterico–caval shunt (MCS); two, a side–to–side portacaval shunt; one, a mesentericoatrial shunt (MAS); and one, a liver transplantation (OLT). One patient died after operation from the precipitating condition, and two MCS grafts that thrombosed were restored. All 21 surviving patients remain well, free from ascites, and all shunts are patent after a mean follow–up of 5.6 ± 1 years, five patients with more than 10 years' follow–up. This long–term survival achieved by portasystemic shunts suggests that they have a major role in the treatment of the Budd–Chiari syndrome. The authors prefer the mesenterico–caval shunt using a jugular graft. This ensures a total portasystemic shunt, avoids subhepatic surgery, and reduces the long–term risk of prosthetic graft thrombosis. The MAS was reserved for cases with complete caval thrombosis. Patients with significant degrees of caval compression were satisfactorily decompressed by MCS. In patients not promptly treated, the disease progresses to cirrhosis and such patients must be evaluated for transplantation similarly to those with other hepatopathies.
Tumor necrosis factor-alpha expressed constitutively in erythroid cells or induced by erythropoietin has negative and stimulatory roles in normal erythropoiesis and erythroleukemia
Authors: Sarah M. Jacobs-Helber, Kwan-ho Roh, Daniel Bailey, Emmanuel N. Dessypris, John J. Ryan, Jingchun Chen, Amittha Wickrema, Dwayne L. Barber, Paul Dent, Stephen T. Sawyer
Journal: Blood (2002)
Impact of Partner Bereavement on Quality of Cardiovascular Disease Management
Authors: Sunil M. Shah, Iain M. Carey, Tess Harris, Stephen DeWilde, Christina R. Victor, Derek G. Cook
Journal: Circulation (2013)

Bereavement is a period of increased risk of cardiovascular death. There is limited understanding of the potential contribution of quality of cardiovascular disease management to this increased risk.In a UK primary-care database, 12 722 older individuals with preexisting cardiovascular disease (coronary heart disease, hypertension, diabetes mellitus, stroke) and a partner bereavement were matched with a non-bereaved control group (n=33 911). We examined key routine annual process measures of care in the year before and after bereavement and cardiovascular medication prescribing (lipid-lowering, antiplatelet, renin-angiotensin system drugs). Odds ratios for change after bereavement compared with the change in non-bereaved matched controls are presented. In the bereaved, uptake of all annual measures was lower in the year before bereavement, with improvement in the year after, whereas in the controls, uptake was relatively stable. The odds ratio for change was 1.30 (95% confidence interval, 1.15-1.46) for cholesterol measurement and 1.40 (95% confidence interval, 1.22-1.61) for blood pressure measurement. For all medication, there was a transient fall in prescribing in the peri-bereavement period lasting until about 3 months after bereavement. The odds ratio for at least 80% prescription coverage in the 30 days after bereavement was 0.80 (95% confidence interval, 0.73-0.88) for lipid-lowering medication and 0.82 (95% confidence interval, 0.74-0.91) for antiplatelet medication compared with the change in non-bereaved individuals.Lower uptake of key cardiovascular care measures in the year before bereavement and reduced medication coverage after bereavement may contribute to increased cardiovascular risk. Clinicians need to ensure that quality of cardiovascular care is maintained in the pre- and post-bereavement periods.
Systemically Injected Exosomes Targeted to EGFR Deliver Antitumor MicroRNA to Breast Cancer Cells
Authors: Shin-ichiro Ohno, Masakatsu Takanashi, Katsuko Sudo, Shinobu Ueda, Akio Ishikawa, Nagahisa Matsuyama, Koji Fujita, Takayuki Mizutani, Tadaaki Ohgi, Takahiro Ochiya, Noriko Gotoh, Masahiko Kuroda
Journal: Molecular Therapy (2012)

Despite the therapeutic potential of nucleic acid drugs, their clinical application has been limited in part by a lack of appropriate delivery systems. Exosomes or microvesicles are small endosomally derived vesicles that are secreted by a variety of cell types and tissues. Here, we show that exosomes can efficiently deliver microRNA (miRNA) to epidermal growth factor receptor (EGFR)-expressing breast cancer cells. Targeting was achieved by engineering the donor cells to express the transmembrane domain of platelet-derived growth factor receptor fused to the GE11 peptide. Intravenously injected exosomes delivered let-7a miRNA to EGFR-expressing xenograft breast cancer tissue in RAG2(-/-) mice. Our results suggest that exosomes can be used therapeutically to target EGFR-expressing cancerous tissues with nucleic acid drugs.
Medical Residency: Years of Change
Authors: Harriet S. Meyer
Journal: JAMA (1983)

"Medical Residency: Years of Change" is a half-hour videotape program that begins to treat the question of the value of the grueling hours worked by residents. Dr Jim Talcott, a second-year internal medicine resident, and Dr Cynthia Musto, a first-year obstetricsgynecology resident four months out of medical school, are the principals. We see them treating patients, consulting with colleagues, tracking down laboratory data. Dr Talcott takes an admitting history from a patient on a stretcher in a hallway, apologizing to her for the many interruptions she will encounter. Dr Musto obtains a consent for a cesarean section with the form propped up on a patient's issue of<i>Hot Rod</i>. The residents always seem to be at the eye of a tornado; the camera tracks them principally, with the patient and a crowd of (presumably) other residents, students, and hospital personnel at the periphery. Three other physicians are interviewed separately. Paul
Which whistleblower is more vulnerable: the Indian doctor or nurse?
Authors: A. Braillon, S. Bewley
Journal: BMJ (2015)

In his article on protection for doctors who speak out in India, Chatterjee missed the bigger picture, which is mostly about imbalances of power.1 Surprisingly, protection for nurses is not even mentioned. Nurses are the core of the healthcare team, they are closer to patients than doctors, and they have more …
Revival of Medical Maintenance in the Treatment of Heroin Dependence
Authors: Donald R. Wesson
Journal: JAMA (1988)

In this issue ofThe JOURNAL, a group from Beth Israel Medical Center, including Vincent Dole, MD, and the late Marie Nyswander, MD, the discoverers of methadone maintenance, report their clinical experience in "medical maintenance" of former heroin addicts receiving methadone in which primary care physicians with experience in drug abuse treatment provided continuing methadone maintenance of socially rehabilitated, non—drug abusing patients in a medical office practice. The frequency of follow-up visits was determined by the treating physician on the basis of medical need and could be as infrequent as every 28 days. This is a major departure from the practice of methadone maintenance clinics, which usually require visits at least once weekly for monitoring and methadone dispensing. In addition, methadone tablets, rather than the liquid form of methadone mixed with juice that is usually dispensed by methadone maintenance clinics, were prescribed. The authors conclude that some socially rehabilitated methadone
Immunophenotypic, cytogenetic and functional characterization of circulating endothelial cells in myelodysplastic syndromes
Authors: M G Della Porta, L Malcovati, G M Rigolin, V Rosti, E Bonetti, E Travaglino, E Boveri, A Gallì, S Boggi, M Ciccone, T Pramparo, G Mazzini, R Invernizzi, M Lazzarino, M Cazzola
Journal: Leukemia (2007)
Gas Endarterectomy of Right Coronary Artery
Authors: JACK H. KLIE, LEWIS JOHNSON, HAROLD SMULYAN, JAMES L. POTTS, ANIS I. OBEID, C. THOMAS FRUEHAN, ROBERT H. EICH, FREDERICK B. PARKER, WATTS R. WEBB
Journal: Circulation (1974)

Results of gas endarterectomy of the right coronary artery were evaluated in 29 consecutive patients. There were one surgical and two early postsurgical deaths. All three had postmortem examination, and in two there was occlusion of the gas endarterectomy. Five patients did not have repeat catheterization. Twenty-one patients were completely re-evaluated and had repeat cardiac catheterization one to sixteen months after surgery (mean eight months). Ten patients (Group A) had gas endarterectomy without a saphenous vein graft to the right coronary artery. Only one patient had significant vessel patency. Eleven patients (Group B) had the combined procedure of a saphenous vein graft anastomosed to the segment of artery that had the endarterectomy. There was excellent graft patency in seven patients (64%) and good distal flow into the segment that had endarterectomy in six of the seven patients. In conclusion, gas endarterectomy is not of value unless it can be combined with a saphenous vein graft to provide good flow to the distal vessel that had endarterectomy. Results with the combined procedure suggest that even with a severely diseased artery, gas endarterectomy can often provide continuing distal runoff for the graft.
Accuracy of Diagnostic Biopsy for the Histological Subtype of Malignant Pleural Mesothelioma
Authors: Steven Chuan-Hao Kao, Tristan D. Yan, Kenneth Lee, Juliet Burn, Douglas W. Henderson, Sonja Klebe, Catherine Kennedy, Janette Vardy, Stephen Clarke, Nico van Zandwijk, Brian C. McCaughan
Journal: Journal of Thoracic Oncology (2011)
Angiogenic effects of prostaglandin E2 are mediated by up-regulation of CXCR4 on human microvascular endothelial cells
Authors: Rosalba Salcedo, Xia Zhang, Howard A. Young, Nelson Michael, Ken Wasserman, Wei-Hong Ma, Manuela Martins-Green, William J. Murphy, Joost J. Oppenheim
Journal: Blood (2003)
Prognostic factors associated with healing of venous leg ulcers: a multicentre, prospective, cohort study
Authors: G. Chaby, P. Senet, O. Ganry, A. Caudron, D. Thuillier, C. Debure, S. Meaume, F. Truchetet, P. Combemale, F. Skowron, P. Joly, C. Lok
Journal: British Journal of Dermatology (2013)

Some prognostic markers of venous leg ulcer (VLU) healing have been evaluated, mostly in retrospective studies.To identify which clinical characteristics, among those known as possible prognostic factors of VLU healing, and which VLU-associated sociodemographic and psychological factors, are associated with complete healing at week 24 (W24).A prospective, multicentre, cohort study was conducted in 22 French dermatology departments between September 2003 and December 2007. The end point was comparison between healed and nonhealed VLUs at W24, for patient clinical and biological characteristics; psychological, cognitive and social assessments; affected leg inclusion characteristics; venous insufficiency treatment and percentage of initial wound area reduction during follow-up.In total, 104 VLUs in 104 patients were included; 94 were analysed. The mean VLU area and duration were 36.8 ± 55.5 cm2 and 24.8 ± 45.7 months, respectively. At W24, 41/94 VLUs were healed. Univariate analysis significantly associated complete healing with superficial venous surgery (P = 0.001), adherence to compression therapy at W4 (P = 0.03) and W24 (P = 0.01), ankle-joint ankylosis (P = 0.01) and mean percentage of VLU area reduction at W4 (P = 0.04). Multivariate analysis retained superficial venous surgery during follow-up [odds ratio (OR) 8.4, 95% confidence interval (CI) 1.9-48.2] and percentage reduction of the VLU area at W4 (OR 1.6, 95% CI 1.0-2.14) as being independently associated with healing.These results indicate that complete healing of long-standing, large VLUs is independently associated with ablation of the incompetent superficial vein and percentage of wound area reduction after the first 4 weeks of treatment.
Acute rejection in human heart transplantation: Identification and characterization of two important markers (MIP-1β and VE-cadherin)
Authors: Ana L.S. Roussoulieres, Olivier Raisky, Lara Chalabreysse, George Dureau, Catherine Cerutti, Pascale Boissonnat, Laurent Sebbag, Jean-Paul Gare, Jean-François Obadia, Jean Ninet, Olivier Bastien, Françoise Thivolet-Bejui, John L. McGregor
Journal: Journal of the American College of Cardiology (2003)
Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility
Authors: Frank Zerbib, Sabine Roman, Stanislas Bruley Des Varannes, Guillaume Gourcerol, Benoît Coffin, Alain Ropert, Patricia Lepicard, François Mion
Journal: Clinical Gastroenterology and Hepatology (2012)