tbuckley/cabot-search huggingface dataset:
GASTRO-ENTEROSTOMY, PERFORATION OF THE STOMACH, PERFORATION OF THE INTESTINE, INTESTINAL OBSTRUCTION, AND SOME OF THE LESSONS THEY TEACH.
Authors: R. HARVEY REED
Journal: JAMA (1895)

It is only a few years since stenosis of the pylorus, intestinal obstruction and gastric and intestinal perforation were considered fatal diseases. For the surgeon to have even suggested operative interference under the circumstances would have only been to have incurred censure on the part of the medical profession as well as the laity. During the last decade the advancement of surgical knowledge and the improvement of its technique has enabled the surgeon to invade the abdominal cavity, and handle it with comparatively the same accuracy and confidence that the mechanic controls or repairs a machine. When invited by your secretary to read a paper on this occasion, I was at a lose to know what subject I should select that would be of interest, saying nothing of benefit to the members of this active and progressive Association and its guests on this occasion. At first thought it occurred to
Disenrollment From Medicare Managed Care Among Beneficiaries With and Without a Cancer Diagnosis
Authors: E. B. Elkin, N. Ishill, G. F. Riley, P. B. Bach, M. Gonen, C. B. Begg, D. Schrag
Journal: JNCI Journal of the National Cancer Institute (2008)

BackgroundMedicare managed care may offer enrollees lower out-of-pocket costs and provide benefits that are not available in the traditional fee-for-service Medicare program. However, managed care plans may also restrict provider choice in an effort to control costs. We compared rates of voluntary disenrollment from Medicare managed care to traditional fee-for-service Medicare among Medicare managed care enrollees with and without a cancer diagnosis.
Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988-2008: ecological study
Authors: P. Keown, S. Weich, K. S. Bhui, J. Scott
Journal: BMJ (2011)

To examine the rise in the rate of involuntary admissions for mental illness in England that has occurred as community alternatives to hospital admission have been introduced.Ecological analysis.England, 1988-2008.Publicly available data on provision of beds for people with mental illness in the National Health Service from Hospital Activity Statistics and involuntary admission rates from the NHS Information Centre.Association between annual changes in provision of mental illness beds in the NHS and involuntary admission rates, using cross correlation. Partial correlation coefficients were calculated and regression analysis carried out for the time lag (interval) over which the largest association between these variables was identified.The rate of involuntary admissions per annum in the NHS increased by more than 60%, whereas the provision of mental illness beds decreased by more than 60% over the same period; these changes seemed to be synchronous. The strongest association between these variables was observed when a time lag of one year was introduced, with bed reductions preceding increases in involuntary admissions (cross correlation -0.60, 95% confidence interval -1.06 to -0.15). This association increased in magnitude when analyses were restricted to civil (non-forensic) involuntary admissions and non-secure mental illness beds.The annual reduction in provision of mental illness beds was associated with the rate of involuntary admissions over the short to medium term, with the closure of two mental illness beds leading to one additional involuntary admission in the subsequent year. This study provides a method for predicting rates of involuntary admissions and what may happen in the future if bed closures continue.
Impaired Myofibrillar Energetics and Oxidative Injury During Human Atrial Fibrillation
Authors: Michael J. Mihm, Fushun Yu, Cynthia A. Carnes, Peter J. Reiser, Patrick M. McCarthy, David R. Van Wagoner, John Anthony Bauer
Journal: Circulation (2001)

Atrial fibrillation (AF) is associated with severe contractile dysfunction and structural and electrophysiological remodeling. Mechanisms responsible for impaired contractility are undefined, and current therapies do not address this dysfunction. We have found that myofibrillar creatine kinase (MM-CK), an important controller of myocyte contractility, is highly sensitive to oxidative injury, and we hypothesized that increased oxidative stress and energetic impairment during AF could contribute to contractile dysfunction. Methods and Results-- Right atrial appendages were obtained from AF patients undergoing the Maze procedure and from control patients who were in normal sinus rhythm and undergoing cardiac surgery. MM-CK activity was reduced in AF patients compared with controls (25.4+/-3.4 versus 18.2+/-3.8 micromol/mg of myofibrillar protein per minute; control versus AF; P<0.05). No reduction in total CK activity or myosin ATPase activity was detected. This selective reduction in MM-CK activity was associated with increased relative expression of the beta-myosin isoform (25+/-6 versus 63+/-5%beta, CTRL versus AF; P<0.05). Western blotting of AF myofibrillar isolates demonstrated no changes in protein composition but showed increased prevalence of protein oxidation as detected by Western blotting for 3-nitrotyrosine (peroxynitrite biomarker) and protein carbonyls (hydroxyl radical biomarker; P<0.05). Patterns of these oxidative markers were distinct, which suggests discrete chemical events and differential protein vulnerabilities in vivo. MM-CK inhibition was statistically correlated to extent of nitration (P<0.01) but not to carbonyl presence.The present results provide novel evidence of oxidative damage in human AF that altered myofibrillar energetics may contribute to atrial contractile dysfunction and that protein nitration may be an important participant in this condition.
Obesity: The Role of Gastric Surgery-Reply
Authors: John F. Wilber
Journal: JAMA (1991)

In Reply.  —Because this article was derived from a 20-minute NIH Grand Rounds that was limited in scope, all aspects of obesity management could not be considered. I recognize, nevertheless, that gastric surgery is an important option in management of severely obese individuals.  The more common morbidity of liver disease, renal stones, and polyarthritis, which represent a major group of difficulties for patients undergoing jejunoileal bypass, is infrequent in individuals with gastric bypass. However, long-term results of this procedure have been somewhat disappointing, and patients have tended to regain the weight they have lost. 1   Second, although gastric surgery has clearly superseded jejunoileal bypass and will produce significant weight loss, patients after 3 years remain substantially overweight and may experience symptomatic biliary disease. Because of these problems, the American Academy of Clinical Nutrition has recommended that gastric procedures should be done only in patients (1) who are 100% in excess
Reasons for requesting laser removal of unwanted tattoos
Authors: None VARMA, None LANIGAN
Journal: British Journal of Dermatology (1999)

Laser removal of tattoos is not generally or readily available on the National Health Service and removal in privately run clinics is expensive. For those seeking removal of their tattoo this can create significant financial hardship. We investigated the psychological, social and financial impact of tattoos on the lives of those patients requesting laser removal. Sixty-eight patients with a mean age of 36 years participated. Twenty-seven (40%) had one tattoo, whereas eight (12%) possessed 10 or more; 54% had an amateur tattoo. Only 18% had received an explanation of the procedure or side-effects. The mean age at application of the first tattoo was 16 years; 48 (71%) were tattooed below the legal age limit of 18 years. Most tattoos were applied for the sake of fashion. The median duration of regret was 14 years before seeking removal. The main reasons for removal were enhancement of self-esteem and social, domestic and family reasons. In those patients attending for removal, most tattoos are applied impulsively and inexpensively in youth. They are often regretted for decades and create significant psychological, social and financial burdens.
THE CONSERVATIVE TREATMENT OF TUBERCULAR JOINT DISEASE,OR, MORE EXPLICITLY, THE PURELY CONSERVATIVE TREATMENT OF TUBERCULOSIS OF THE JOINT STRUCTURES. Read in the Section on Surgery and Anatomy at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: HARRY M. SHERMAN
Journal: JAMA (1894)

For the purpose of the present paper it does not especially concern us which or how many of the different tissues which together constitute a joint are affected, and I shall not attempt to discuss methods of treatment based on anatomic differentiation of the location of the lesion. It may, however, be stated that in the great majority of cases the initial lesion, so far as the joint is concerned, is in the bone; but in the purely conservative treatment the management of these cases differs hardly any from that of those which are primarily synovial. Underlying the treatment of all forms of chronic tuberculosis, of whatever tissue or wherever situated, is the gospel of rest and food. This is founded upon the fact, learned in the first place by experience, and confirmed later by the results of biologic investigations, that there is in living tissues an inherent antagonism to
Tories may offer patients chance to keep their records on Google
Authors: M. Cross
Journal: BMJ (2009)

The United Kingdom’s opposition Conservative party is considering offering NHS patients the option to maintain their own medical records on commercial internet services rather than in NHS computers.

The idea, say Tory policy makers, is to “yield control of personal information to individual citizens,” both as an end in itself and as a way of saving money on centrally procured electronic health records systems, which, they say, are unpopular and subject to delays.

However, the plan will raise concerns …
The Role of Allogeneic-Cell Transplantation in Leukemia
Authors: John H. Kersey
Journal: New England Journal of Medicine (2010)

In the early 1970s, patients with high-risk hematologic cancers had a small chance of long-term survival. This chance began to increase with allogeneic blood or bone marrow transplantation, which combines high-dose chemotherapy, total-body irradiation, and graft-versus-leukemia effects.1,2 In subsequent years, many patients with high-risk leukemia and lymphoma have had long-term remissions. However, toxicity from myeloablative conditioning, infections, and graft-versus-host disease (GVHD) resulted in a significant risk of death that prevented older patients or those with coexisting conditions from undergoing transplantation.1,2 In recent years, studies have been designed to improve the outcomes of transplantation. Researchers at the Fred Hutchinson . . .
Surgery for cataract
Authors: Christopher M Wood
Journal: BMJ (2007)

Despite increasing provision of school sex education, teenage sexual health in the United Kingdom is in overall decline, with increasing rates of terminations and sexually transmitted infections in under 18s outweighing recent modest reductions in conception rates in this age group. 1 2 w1 Counterintuitively, rather than improving sexual health, sex behaviour interventions can make it worse.w2 Most studies on sex education programmes in schools examine intermediate outcomes only, such as pupil satisfaction or reported condom use.This often facilitates premature false claims of success, whereas more robust outcome measures such as rates of terminations, unplanned conceptions, and sexually transmitted infections show no benefit.In this week's BMJ Henderson and colleagues report the effect of a theoretically based teacher delivered sex education programme (SHARE) on registered conceptions and terminations. 3 The trial found no significant difference between the intervention and control groups in National Health Service registered conceptions (per 1000 pupils: 300 SHARE v 274 control; difference 26, 95% confidence interval 33 to 86) or terminations (127 SHARE v 112 control; difference 15, 13 to 42) between ages 16 and 20.The results should stimulate urgently needed change from previous ineffective approaches to school sex education for which, as the authors admit, "evidence of effectiveness is mixed."Evidence shows that increased knowledge is a necessary but insufficient cause of change in sexual behaviour.w3 It is also clear that strategies such as promoting availability and correct use of condoms and increasing use of the emergency pill do not necessarily lead to a reduction in sexually transmitted disease rates, 1 pregnancies, w4 or terminations. 4 So what needs to happen next?Henderson and colleagues stress the need for more comprehensive approaches that incorporate the influence of parents on sexual experience in teenagers, and to improve the future life opportunities for vulnerable young people.The false assumption that "young teens will have sex anyway" is an insult to many young people who have the capacity to rise to a far more effective challenge than just "use a condom every time."Delaying first intercourse is recognised as an important outcome measure of sex education programmes, and teenagers are more likely to save sex (a more positive and helpful term than "abstinence") when their parents communicate the importance of doing so. 5 Of course, to be involved in this way, parents have to be with their RESEARCH p133
Investigation of stroke.
Authors: D A Shaw
Journal: BMJ (1972)

has an appreciable incidence and in which early diagnosis and surgical intervention may be life-saving.50 At thmoment one cannot differentiate between small localized intracerebral haematoma and ischaemic disease on clinical grounds but many physicians are now prepared cautiously to treat patients with a diastolic blood pressure of 110 mm or more who first present with symptoms of cerebral ischaemia. The benefits of such treatment seem to be estab lished.12 5152
Association of Cryoprecipitate and Tranexamic Acid With Improved Survival Following Wartime Injury
Authors: Jonathan J. Morrison, James D. Ross, Joseph J. Dubose, Jan O. Jansen, Mark J. Midwinter, Todd E. Rasmussen
Journal: JAMA Surgery (2012)

To quantify the impact of fibrinogen-containing cryoprecipitate in addition to the antifibrinolytic tranexamic acid on survival in combat injured.Retrospective observational study comparing the mortality of 4 groups: tranexamic acid only, cryoprecipitate only, tranexamic acid and cryoprecipitate, and neither tranexamic acid nor cryoprecipitate. To balance comparisons, propensity scores were developed and added as covariates to logistic regression models predicting mortality.A Role 3 Combat Surgical Hospital in southern Afghanistan.A total of 1332 patients were identified from prospectively collected U.K. and U.S. trauma registries who required 1 U or more of packed red blood cells and composed the following groups: tranexamic acid (n = 148), cryoprecipitate (n = 168), tranexamic acid/cryoprecipitate (n = 258), and no tranexamic acid/cryoprecipitate (n = 758).In-hospital mortality.Injury severity scores were highest in the cryoprecipitate (mean [SD], 28.3 [15.7]) and tranexamic acid/cryoprecipitate (mean [SD], 26 [14.9]) groups compared with the tranexamic acid (mean [SD], 23.0 [19.2]) and no tranexamic acid/cryoprecipitate (mean [SD], 21.2 [18.5]) (P < .001) groups. Despite greater Injury Severity Scores and packed red blood cell requirements, mortality was lowest in the tranexamic acid/cryoprecipitate (11.6%) and tranexamic acid (18.2%) groups compared with the cryoprecipitate (21.4%) and no tranexamic acid/cryoprecipitate (23.6%) groups. Tranexamic acid and cryoprecipitate were independently associated with a similarly reduced mortality (odds ratio, 0.61; 95% CI, 0.42-0.89; P = .01 and odds ratio, 0.61; 95% CI, 0.40-0.94; P = .02, respectively). The combined tranexamic acid and cryoprecipitate effect vs. neither in a synergy model had an odds ratio of 0.34 (95% CI, 0.20-0.58; P < .001), reflecting nonsignificant interaction (P = .21).Cryoprecipitate may independently add to the survival benefit of tranexamic acid in the seriously injured requiring transfusion. Additional study is necessary to define the role of fibrinogen in resuscitation from hemorrhagic shock.
Successful Resuscitation From Cardiac Arrest Using High-Dose Epinephrine Therapy
Authors: Eric M. Koscove
Journal: JAMA (1988)

A patient with cardiac arrest failed to respond to prolonged standard therapy for multiple dysrhythmias. High-dose intravenous epinephrine hydrochloride was administered 22 and 26 minutes after arrest. Coarsening of ventricular fibrillation and defibrillation with subsequent return of spontaneous circulation occurred. The patient was neurologically intact when eventually discharged. In another patient, prolonged asystole failed to respond to standard advanced cardiac life-support therapy. High-dose epinephrine was given 38 minutes after arrest, and return of spontaneous circulation subsequently occurred. Intensive treatment efforts were discontinued after admission to the hospital, and the patient died. The temporal sequence in these patients suggests that high-dose epinephrine therapy caused the return of spontaneous circulation. Recent studies suggest that presently recommended epinephrine doses may be too low, and investigation of graded epinephrine doses for the treatment of cardiac arrest is indicated. (<i>JAMA</i>1988;259:3031-3034)
BRONCHIAL ASTHMA CAUSED BY LIVER AND LIVER EXTRACT DIET IN A PATIENT SUFFERING FROM PRIMARY ANEMIA
Authors: Edward Matzger
Journal: JAMA (1931)

W. A. M., a white man, aged 36, referred by Dr. H. W. Davis, Sept. 11, 1929, complained chiefly of severe bronchial asthma. His family history was negative for all allergic diseases. As a child, he had measles, mumps, whooping cough and recurring attacks of bronchitis, croupy in character. A tonsillectomy was performed in 1913, followed by severe hemorrhage twenty-four hours later. He was treated with horse serum without reaction. In 1914 the patient began having recurring attacks of bronchial asthma of from two to three days' duration, at intervals of from four to six weeks. Attacks became progressively worse, more frequent and of longer duration. In the fall of 1920 the patient moved to the country and the asthma was greatly improved. Attacks recurred only once a month. In 1928 he returned to the city; the asthma remained unchanged. He went to Dr. Henry Abrahm with the chief complaint
Immunoregulation of dendritic and T cells by alpha-fetoprotein in patients with hepatocellular carcinoma
Authors: Marcus Ritter, Mona Y. Ali, Christian F. Grimm, Robert Weth, Leonhard Mohr, Wulf O. Bocher, Katja Endrulat, Heiner Wedemeyer, Hubert E. Blum, Michael Geissler
Journal: Journal of Hepatology (2004)
Nurr1 regulates Top IIβ and functions in axon genesis of mesencephalic dopaminergic neurons
Authors: Xin Heng, Gang Jin, Xin Zhang, Dehuang Yang, Mingzhe Zhu, Shijun Fu, Xuping Li, Weidong Le
Journal: Molecular Neurodegeneration (2012)

Abstract Background NURR1 (also named as NR4A2) is a member of the steroid/thyroid hormone receptor family, which can bind to DNA and modulate expression of target genes. Previous studies have shown that NURR1 is essential for the nigral dopaminergic neuron phenotype and function maintenance, and the defects of the gene are possibly associated with Parkinson's disease (PD). Results In this study, we used new born Nurr1 knock-out mice combined with Affymetrix genechip technology and real time polymerase chain reaction (PCR) to identify Nurr1 regulated genes, which led to the discovery of several transcripts differentially expressed in the nigro-striatal pathway of Nurr1 knock-out mice. We found that an axon genesis gene called Topoisomerase IIβ ( Top IIβ ) was down-regulated in Nurr1 knock-out mice and we identified two functional NURR1 binding sites in the proximal Top IIβ promoter. While in Top IIβ null mice, we saw a significant loss of dopaminergic neurons in the substantial nigra and lack of neurites along the nigro-striatal pathway. Using specific TOP II antagonist ICRF-193 or Top IIβ siRNA in the primary cultures of ventral mesencephalic (VM) neurons, we documented that suppression of TOP IIβ expression resulted in VM neurites shortening and growth cones collapsing. Furthermore, microinjection of ICRF-193 into the mouse medial forebrain bundle (MFB) led to the loss of nigro-striatal projection. Conclusion Taken together, our findings suggest that Top IIβ might be a down-stream target of Nurr1 , which might influence the processes of axon genesis in dopaminergic neurons via the regulation of TOP IIβ expression. The Nurr1-Top IIβ interaction may shed light on the pathologic role of Nurr1 defect in the nigro-striatal pathway deficiency associated with PD.
Ephrin-B2 and EphB1 Mediate Retinal Axon Divergence at the Optic Chiasm
Authors: Scott E. Williams, Fanny Mann, Lynda Erskine, Takeshi Sakurai, Shiniu Wei, Derrick J. Rossi, Nicholas W. Gale, Christine E. Holt, Carol A. Mason, Mark Henkemeyer
Journal: Neuron (2003)
Psychotomimetic Effects of Drugs — A Common Pathway to Schizophrenia?
Authors: David J. Gerber, Susumu Tonegawa
Journal: New England Journal of Medicine (2004)

Researchers have long been interested in identifying a final, common pathway for psychosis. The existence of such a pathway is implied by the fact that various drug intoxications, schizophrenia and bipolar disorders, psychotic depression, severe sensory deprivation, and Alzheimer's disease can all cause similar psychotic phenomena. Fueling the interest in finding a common pathway is the possibility that the side effects of antidopaminergic neuroleptic agents — principally movement disorders, such as tardive dyskinesia — might be averted by precise targeting of molecules downstream of the dopamine receptor. Svenningsson and colleagues1 recently described a candidate pathway in a mouse model.Focusing . . .
Tribute to an ideal exemplar of scientist and person
Authors: Dominic W. Massaro
Journal: Behavioral and Brain Sciences (2001)

Roger Shepard's creativity and scientific contributions have left an indelible mark on Psychology and Cognitive Science. In this tribute, I acknowledge and show how his approach to universal laws helped Oden and me shape and develop our universal law of pattern recognition, as formulated in the Fuzzy Logical Model of Perception (FLMP). [Shepard; Tenenbaum &amp; Griffiths]
USE OF LARGE DIAMETER STENTS WITH MAXIMAL EXPANSION LIMITS RE-INTERVENTION IN TREATMENT OF NATIVE COARCTATION OF THE AORTA
Authors: Brendan McCluskey Smith, Francisco Guzman-Pruneda, Carlos Mery, Henri Justino, Athar Qureshi, Dhaval Parekh
Journal: Journal of the American College of Cardiology (2015)