tbuckley/cabot-search huggingface dataset:
Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma
Authors: Sang Jung Park, Chang Ha Kim, Jin Dong Kim, Soon Ho Um, Sun Young Yim, Min Ho Seo, Dae In Lee, Jun Hyuk Kang, Bora Keum, Yong Sik Kim
Journal: Clinical and Molecular Hepatology (2012)

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained. Keywords: Hepatocellular carcinoma; TACE; Costal metastasis; Paraplegia
The Computer and Clinical Judgment
Authors: G. Octo Barnett
Journal: New England Journal of Medicine (1982)

For a number of years it has been predicted that the use of computer technology would result in radical changes in the storage and retrieval of medical data. Only in the past five years, however, have there been major changes in the management of information in medicine. These changes have for the most part been limited to the support of such administrative functions in hospitals as admissions and discharge tracking and census activities; the communication of structured information (for example, laboratory-test orders and results); and the support of such ancillary service functions as scheduling for radiology, the preparation of pharmacy . . .
Activation of the murine EP3 receptor for PGE2 inhibits cAMP production and promotes platelet aggregation
Authors: Jean-Etienne Fabre, MyTrang Nguyen, Krairek Athirakul, Kenneth Coggins, John D. McNeish, Sandra Austin, Leslie K. Parise, Garret A. FitzGerald, Thomas M. Coffman, Beverly H. Koller
Journal: Journal of Clinical Investigation (2001)

The importance of arachidonic acid metabolites (termed eicosanoids), particularly those derived from the COX-1 and COX-2 pathways (termed prostanoids), in platelet homeostasis has long been recognized. Thromboxane is a potent agonist, whereas prostacyclin is an inhibitor of platelet aggregation. In contrast, the effect of prostaglandin E2 (PGE2) on platelet aggregation varies significantly depending on its concentration. Low concentrations of PGE2 enhance platelet aggregation, whereas high PGE2 levels inhibit aggregation. The mechanism for this dual action of PGE2 is not clear. This study shows that among the four PGE2 receptors (EP1–EP4), activation of EP3 is sufficient to mediate the proaggregatory actions of low PGE2 concentration. In contrast, the prostacyclin receptor (IP) mediates the inhibitory effect of higher PGE2 concentrations. Furthermore, the relative activation of these two receptors, EP3 and IP, regulates the intracellular level of cAMP and in this way conditions the response of the platelet to aggregating agents. Consistent with these findings, loss of the EP3 receptor in a model of venous inflammation protects against formation of intravascular clots. Our results suggest that local production of PGE2 during an inflammatory process can modulate ensuing platelet responses.
Poor attitude among staff is undermining NHS successes, says chief executive
Authors: Nadeeja Koralage
Journal: BMJ (2004)

Staff members who felt “disengaged” from the achievements of the NHS were this week blamed by its leader for its poor public image.

Speaking at a conference on leadership in the NHS, the chief executive of the NHS, Nigel Crisp, said, “Part of the answer may indeed be about the media and about how it chooses to comment on the NHS. But a more worrying idea is that perhaps the public has been listening to NHS staff talking about the NHS.”

He said that despite improvements in service delivery and …
ARRESTED DEVELOPMENT OF THE COLON
Authors: ROBERT L. RHODES
Journal: JAMA (1924)

<h3>J. E. Thompson,1 in 1919, said:</h3> Every operator expects the viscera to occupy normal positions, and, if he fails to find the organ he is searching for, he hunts for it where previous experience has taught him he is most likely to find it. If he has been carefully trained in embryology, he will know beforehand where to look and what to observe; but if not, he will probably begin a ramble over the greater part of the abdominal cavity, which may end disastrously for the patient. The most frequent abnormalities of the abdominal viscera are the intestinal, and result from arrested development of the colon in embryonic life. Recalling that the cecum, when first developed to the point of recognition in the embryo, occupies a position just above and to the left of the umbilicus, and that in the process of development, it rotates approximately 180 degrees and
Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicentre trial
Authors: Jean-Louis Mas, Ludovic Trinquart, Didier Leys, Jean-François Albucher, Hervé Rousseau, Alain Viguier, Jean-Pierre Bossavy, Béatrice Denis, Philippe Piquet, Pierre Garnier, Fausto Viader, Emmanuel Touzé, Pierre Julia, Maurice Giroud, Denis Krause, Hassan Hosseini, Jean-Pierre Becquemin, Grégoire Hinzelin, Emmanuel Houdart, Hilde Hénon, Jean-Philippe Neau, Serge Bracard, Yannick Onnient, Raymond Padovani, Gilles Chatellier
Journal: The Lancet Neurology (2008)
Methylmercury poisoning in Iraqi children: clinical observations over two years.
Authors: L Amin-zaki, M A Majeed, T W Clarkson, M R Greenwood
Journal: BMJ (1978)

The clinical features of 49 children who had eaten bread contaminated with methylmercury in rural Iraq were reviewed. Symptoms and signs relating to the nervous system--varying degrees of ataxia, weakness, and visual and sensory changes--dominated the clinical picture. The severity of poisoning was related to the blood mercury concentration, as was the degree of recovery. Follow-up over two years showed that children who had had mild or moderate poisoning slowly but steadily improved, some of them recovering normal function, though all had a residual generalized hyperreflexia. In some patients ataxia and motor weakness disappeared. Visual changes also improved, though less completely, and of 17 blind children, only five had recovered partial sight by the end of two years. Seven of the 18 children who suffered very severe poisoning were left physically and mentally incapacitated. The degree of clinical progress shown by these children was better than that shown by some other groups of patients, possibly because the poisoning was relatively acute and mercury consumption was stopped immediately after its effects had become obvious.
CD44 antibody-targeted liposomal nanoparticles for molecular imaging and therapy of hepatocellular carcinoma
Authors: Lina Wang, Weijun Su, Ze Liu, Manqian Zhou, Si Chen, Yanan Chen, Dan Lu, Yanhua Liu, Yan Fan, Yizhou Zheng, Zhongchao Han, Deling Kong, Joseph C. Wu, Rong Xiang, Zongjin Li
Journal: Biomaterials (2012)
Diastolic Compliance of Hypertrophied Ventricle Is Not Acutely Altered by Pharmacologic Agents Influencing Active Processes
Authors: David A. Kass
Journal: Annals of Internal Medicine (1993)

Objective: To test, by studying the acute effects of drugs that influence active processes, the hypothesis that in humans with marked ventricular hypertrophy, reduced chamber compliance is primarily caused by passive structural changes. Design: An uncontrolled (before–after) study. Setting: University Medical Center. Patients: Fourteen patients with ventricular hypertrophy (19 4.5-mm diastolic-wall thickness) and normal resting systolic function were studied while they had invasive cardiac catheterization. Intervention: Intravenous -blocker (esmolol) or calcium channel blocker (verapamil) or both. Measurements: Left ventricular function was determined by pressure-volume relations. Volume was measured using conductance catheter, providing a continuous voltage signal proportional to chamber volume. Pressure was measured by micromanometer. Cardiac-specific assessment of change in chamber contractility and diastolic compliance due to each drug was determined. Results: Both drugs lowered contractility by approximately 30% (P < 0.01). Esmolol slowed relaxation and reduced early peak filling rate, whereas verapamil delayed the time to peak filling (all P < 0.05). In contrast to the effects of both drugs on active contraction and early diastole, late-diastolic compliance was unaltered, and end-diastolic pressure-volume relations were almost identical. Conclusion: Neither -receptor nor calcium channel blockade acutely alters left ventricular compliance despite substantial active effects manifest in systole and early diastole. This supports the notion that chamber compliance is principally determined by passive structural elements in the heart rather than by active processes.
The Treatment of Sleep Apnea
Authors: Stuart D. Miller
Journal: JAMA (1986)

<h3>To the Editor.—</h3> The review by Dr Hall<sup>1</sup>in the Feb 21 issue covered the pathophysiology of sleep apnea but neglected the revolution in treating this disorder. For a decade after the 1972 Rimini Symposium, a tracheostomy had been the best treatment available for severe sleep apnea; now, continuous positive airway pressure (CPAP) has replaced tracheostomy as the primary therapy for sleep apnea. Sullivan et al<sup>2</sup>compared the two therapies in 1983. The difficulties of life with a tracheal stoma far outweigh the inconvenience of the CPAP compressor used at night. Dr Hall's references concerning CPAP are dated: CPAP machines and masks are now commercially available and have improved considerably compared with the earlier experimental technology. The current therapeutic procedure with suspected apneics is straightforward. An overnight polysomnogram confirms the diagnosis of sleep apnea in terms of severity and type (obstructive, central, or mixed). After a thorough history
Extinction of autonomous growth potential in embryonic: adult vascular smooth muscle cell heterokaryons.
Authors: R A Majack
Journal: Journal of Clinical Investigation (1995)

Vascular smooth muscle cells (SMC) isolated from embyronic and early fetal (e13-e18) rat aortas exhibit an "embryonic growth phenotype" in culture (Cook, C. L., M. C. M. Weiser, P. E. Schwartz, C. L. Jones, and R. A. Majack. 1994. Circ. Res. 74:189-196). Cells in this growth phenotype exhibit autonomous, serum-independent replication, in contrast to SMC in the "adult" growth phenotype, whose proliferation in culture is dependent on exogenous mitogens. To determine which of these two phenotypes is genetically dominant, heterokaryons were constructed between adult and embryonic (day e17) rat aortic SMC. The fused cells were maintained in serum-free medium for 3 d, then were labeled with bromodeoxyuridine (BrdU) for an additional 24 h. Under these conditions, parental e17 SMC exhibited a high rate of self-driven DNA synthesis (73-85% BrdU-positive cells), while parental adult SMC showed minimal replication (13-21% BrdU-positive cells). Homokaryons of parental cells exhibited parental growth phenotypes and showed the expected mitogenic response when stimulated with serum. Heterokaryons between e17 and adult SMC exhibited a nonautonomous growth phenotype; the "adult" growth phenotype was calculated to be dominant in > 89% of all true heterokaryons. The data suggest that adult SMC express molecules capable of genetically extinguishing or otherwise inhibiting the autonomous replication of embryonic SMC.
Capacity of Persons With Mental Retardation to Consent to Participate in Randomized Clinical Trials
Authors: Celia B. Fisher, Christine D. Cea, Philip W. Davidson, Adam L. Fried
Journal: American Journal of Psychiatry (2006)

Adults with mental retardation have histories of cognitive and adaptive deficits posing unique ethical challenges for research consent assessment. This study examined the capacity of persons with mental retardation to consent to participate in randomized clinical trials.A total of 150 adults (50 each with mild and moderate mental retardation and 50 comparison subjects without mental retardation) responded to a set of consent questions for a hypothetical randomized clinical trial testing a medication for aggressive disorders. Intelligence, adaptive behavior, medical treatment history, and consent history were evaluated. Univariate and multivariate methods were used to compare performance across and within groups.Comparison subjects scored significantly higher on measures of consent capacity than participants with mild mental retardation, who scored higher than those with moderate mental retardation. Most subjects with mental retardation were able to make a participation choice, and many understood research methods and appreciated the protagonist's disorder and the consequences of participation. Almost half of those with mild mental retardation understood human subject protections. Performance was weakest on understanding the purpose of research and reasoning about whether to participate, suggesting vulnerability to the therapeutic misconception. Psychiatric and experiential factors did not predict consent capacity.While adults with mental retardation as a group showed consent deficits, many attained consent capacity scores comparable to those of comparison subjects. Investigators should consider individual differences and a consent format suited to deficits in language, memory, and attention before restricting consent opportunities for persons with mental retardation.
A STUDY ON BACTERIAL PROTEINS WITH SPECIAL CONSIDERATION OF GONOCOCCUS AND MENINGOCOCCUS
Authors: Alden K. Boor, C. Phillip Miller
Journal: The Journal of Experimental Medicine (1934)

Methods of preparation and certain properties of the "nucleoproteins" of the following organisms are described: gonococcus, meningococcus, Micrococcus catarrhalis, R pneumococcus, Streptococcus hemolyticus, Staphylococcus aureus. No essential differences between the nucleoproteins and the intact cells of gonococcus and meningococcus were observed in their ability to engender immune substances (precipitins), to induce bacterial allergy in rabbits, or to elicit cutaneous reactions (of the delayed type) in rabbits rendered hypersensitive to these organisms. Measured by their lethal action in mice, the toxicity of gonococcal and meningococcal nucleoproteins was found to be but slightly less than that of the intact cells. It seems probable, therefore, that the toxic action of these organisms is due, chiefly or entirely, to some constituent of the nucleoprotein fraction. Extraction with acetone and ether in the cold did not reduce appreciably the toxicity of these organisms and their nucleoproteins, nor alter their immunological behavior. Cross-precipitin reactions suggested that gonococcal nucleoprotein contains an antigenic factor in common with the non-encapsulated pneumococcus cell, and meningococcal nucleoprotein one in common with the capsular material of Pneumococcus Type III. Tryptic digestion destroys these antigenic factors, but not those responsible for the cross-reactions within the genus Neisseria.
Heavy Smokers, Smoking Cessation, and Clonidine-Reply
Authors: Alexander H. Glassman
Journal: JAMA (1988)

In Reply.—  We are pleased to hear of Dr Green's use of the transdermal clonidine patch in smoking cessation. We are also aware of an article by Appel1suggesting that the transdermal patch is effective. Cigarette craving during smoking withdrawal is known to show diurnal variation.2Individual pills give a flexibility to dosing over the day that we suspect may give the pill an advantage over the patch. If one clonidine preparation actually had an advantage, this would obviously need to be tested.  Dr Cox asks for clarification of several issues that we agree deserve clarification. Our requirement that smokers cut down a minimum of 50% by quit day to be entered in the study might have distorted our sample. We used this criterion because we believed clonidine reduced withdrawal symptoms and, if a smoker did not cut down his cigarette consumption sufficiently to develop withdrawal symptoms, the
Best practices for safe handling of products containing concentrated potassium
Authors: Michelle Tubman, Sumit R Majumdar, Daniel Lee, Carol Friesen, Terry P Klassen
Journal: BMJ (2005)

<h3>Objective</h3> Post-traumatic headache (PTH) is one of the most frequent and persistent physical symptoms following mild traumatic brain injury (mTBI) and develop in more than 50% of this population. This study aimed to investigate the periaqueductal grey (PAG)-seeded functional connectivity (FC) in patients with mTBI with acute post-traumatic headache (APTH) and further examine whether the FC can be used as a neural biomarker to identify patients developing chronic pain 3 months postinjury. <h3>Methods</h3> 70 patients with mTBI underwent neuropsychological measurements and MRI scans within 7 days postinjury and 56 (80%) of patients were followed up at 3 months. 46 healthy controls completed the same protocol on recruitment to the study. PAG-seeded resting-state FC analysis was measured in 54 patients with mTBI with APTH, in comparison with 46 healthy volunteers. <h3>Results</h3> The mTBI+APTH group presented significantly reduced PAG-seeded FC within the default mode network (DMN), compared with healthy volunteers group. The connectivity strength can also predict patients’ complaints on the impact of headache on their lives. Crucially, the initial FC strength between the PAG-right precuneus as well as the PAG-right inferior parietal lobule became the important predictor to identify patients with mTBI developing persistent PTH 3 months postinjury. <h3>Conclusions</h3> Patients with mTBI+APTH exhibited significant PAG-related FC differences mainly within the DMN. These regions extended beyond traditional pain processing areas and may reflect the diminished top-down attention regulation of pain perception through antinociceptive descending modulation network. The disrupted PAG-DMN FC may be used as an early imaging biomarker to identify patients at risk of developing persistent PTH.
Second drug firm found guilty of “switching” patients to new drugs
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

A second drug company has been forced to abandon a programme of switching patients on GPs' lists to a new drug, after a ruling from the drug industry's regulatory body.

GlaxoSmithKline was found to be in breach of a clause of the code of conduct of the Association of British Pharmaceutical Industry for paying for a third party or practice staff to switch asthma patients who used both salmeterol (Serevent) and beclomethasone (Becotide-100) to Seretide, a dual action inhaler containing salmeterol and fluticasone (Seretide). Beclomethasone is available in generic form, while the other two products are available in the United Kingdom only as branded drugs.

Information drawn up by GlaxoSmithKline to promote the product stated …
Efficacy And Safety Of Fexofenadine In Allergic Rhinitis (AR): A Metanalysis
Authors: E. Compalati, M. Penagos, R. Baena-Cagnani, G. Passalacqua, G.W. Canonica, C.E. Baena-Cagnani
Journal: Journal of Allergy and Clinical Immunology (2009)

RATIONALE: According to recent diffusing grading system of evidence and recommendations, efficacy and safety represent two fundamental features and data from metanalysis of double blind randomized controlled clinical trials (DBPCRTs), the strongest supporting demonstration. Fexofenadine has been adopted in the treatment of AR for many years, although no metanalyses, supporting its use, currently exist. METHODS: According to recommendations of Cochrane group, all DBPCRTs were searched in major databases up to December 2007, in order to assess efficacy and safety of fexofenadine in AR. Outcomes were extracted from original articles and by contacting authors of each trial. RevMan 4.2.8 program was used to perform the meta-analysis. RESULTS: Of 222 identified articles, 19 were potentially relevant trials and 8 satisfied inclusion criteria. Reasons for exclusion: challenge exposition, study limitations, atypical outcome measurement, design for other outcomes, not placebo controlled, single blind. In 2664 patients receiving fexofenadine (2662 placebo), a significant reduction of total symptoms scores (TSS) (SMD −0.33; CI 95% −0.39 to −0.28 p < 0.00001) was found.Positive results were also found for sneezing, rhinorrea, itching, congestion. No significant difference in reported adverse events (AE) between active and placebo (OR 0.99; CI 95% 0.82 to 1.19 p= 0.90). A very low interstudy heterogeneity was detected. CONCLUSIONS: This study has five major values: the first attempt to evaluate efficacy and safety of fexofenadine in AR by means of meta-analysis; consistency between positive results in TSS and individual symptoms; large population studied; not relevant interstudy heterogeneity; confirmed safety. All these values encourage the recommendation of fexofenadine for the treatment of AR.
Variable F-18 fluorodeoxyglucose Avidity of Metastatic Recurrent Adult Granulosa Cell Tumor
Authors: Y T. Huang, J C. Lee, A S. Ravi Kumar
Journal: Clinical Nuclear Medicine (2009)

The appearance of rare ovarian germ cell tumors such as adult granulosa cell tumor (GCT) on F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is reported in this article. We present a patient with recurrent GCT and histologically proven intra-abdominal metastases. Most lesions were above PET resolution (>1 cm). The local recurrence demonstrated moderate FDG uptake but metastases had variable (none to mild) FDG avidity. Ovarian GCTs are of relatively low metastatic potential and frequently present as metastases with solid and cystic components, which are plausible explanations for its variable FDG uptake. Clinicians should be aware of this phenomenon and the potential for false negatives on FDG-PET.
The Incidence and Heredity of Muscular Dystrophy
Authors: Madelaine Ray Brown
Journal: New England Journal of Medicine (1951)

MUSCULAR dystrophy is a condition that has aroused little popular interest, but during the past year a muscular dystrophy research foundation has been granted a charter by the state of Texas, and from the University of Utah have come two papers based on the genealogic records of the Church of Jesus Christ of Latter Day Saints, identifying affected individuals in six generations.1 , 2 In view of these facts it seemed of interest to look at the records of one of the oldest hospitals in the United States.The file by diagnosis in the Record Room of the Massachusetts General Hospital goes . . .
FDG PET/CT Demonstration of Right Atrium Metastasis Overlooked on Contrast-Enhanced CT
Authors: Yang Lu, Gary Ulaner
Journal: Clinical Nuclear Medicine (2011)

A 55-year-old man with high-grade invasive urothelial carcinoma presented for evaluation with FDG PET/CT. An approximately 6 × 3-cm hypermetabolic (maximum standard uptake value, 13) soft-tissue mass involving the right atrial appendage is noted. This mass was overlooked on a dedicated contrast CT performed 2 months before, as the mass might have been misinterpreted as incomplete contrast mixing in the right atrium. This case demonstrates how FDG PET may detect a cardiac metastasis which was overlooked on contrast-enhanced CT.