tbuckley/cabot-search huggingface dataset:
Crohn’s Disease
Authors: J.W. Paulley
Journal: Psychotherapy and Psychosomatics (1971)

39 of 40 patients treated by the author up to 18 years with corticosteroids, antibiotics and psychotherapy replied to a postal questionnaire in 1969. For details, see table I. Previous reports of the relevance of emotional stress and personality to the etiology of Crohn's disease are summarized together with types of provocative stress and personality profile the author has found consistently in this series and previously. The management employed is described. The danger of premature dose reduction of corticosteroids is emphasised. If the normal 33 % relapse rate following surgery is to be avoided or reduced, psychotherapy is essential and also corticosteroids in most cases.
PRESERVATION OF COMPLEMENT
Authors: Meyer D. Moledezky
Journal: JAMA (1918)

A somewhat extensive series of articles have appeared relative to the preservation of complement, and many ingeniously worked out methods have been advocated. It is not the intention now to discuss the merits or demerits of other methods but to offer a method, simple, inexpensive and reliable, which I have used. I have found that complement from freshly bled guineapig blood, centrifuged, is not so powerful as that which stands over night in the refrigerator and is permitted to separate from the slowly contracting clot. This has repeatedly been observed and corroborated in an extensive series of experiments covering a long period of time, by titrating the same complement shortly after obtaining the blood, and likewise the following morning, using the same amboceptor and sheep corpuscles. For the preservation of complement, the worker needs a vacuum bottle into which finely cracked ice is dropped until the bottle is filled almost
Benefits and Harms: The Balance Sheet
Authors: Kurt Haas
Journal: JAMA (1990)

<h3>To the Editor.—</h3> In his otherwise excellent article on the effectiveness of colorectal cancer screening, Dr David Eddy<sup>1</sup>makes a common but serious arithmetic error. Without screening, a high-risk 50-year-old man (like me) has about a 10.3% probability of developing colorectal cancer sometime in the rest of his life and about a 5.3% probability of dying of colorectal cancer. If such a person is screened as Dr Eddy proposes, the probabilities of developing and dying of colorectal cancer are decreased to about 7.3% and 2.9%, respectively. Thus, the effect of this screening strategy is to decrease the actual probability of developing or dying of colorectal cancer by about 3.0% and 2.4%, respectively. Dr Eddy's calculations are erroneous, and the mistake recurs throughout the article. In actuality, a decrease in the likelihood of getting cancer from 10.3% to 7.3% is a 30% improvement. When cancer mortality drops, as a result
Soluble E‐selectin correlates with disease activity in cyclosporin A‐treated patients with atopic dermatitis
Authors: Mk Kägi, H Joller‐jemelka, B Wüthrich
Journal: Allergy (1999)

Background :The expression of adhesion molecules on endothelial cells regulates leukocyte migration. The level of soluble adhesion molecules which are shed into the circulation is known to reflect the degree of inflammation, and this level can therefore be used as an indicator of disease activity. The objective of this study was first to investigate the relationship between sE‐selectin levels and disease activity parameters (scores of extent, severity, itch, and sleep) in atopic dermatitis (AD) patients, and second to determine the effect of therapy with an immunosuppressive drug (cyclosporin A) on sE‐selectin levels. Methods :Fourteen patients with severe AD and 41 healthy controls were studied. sE‐selectin was measured by ELISA both 2 weeks before therapy with cyclosporin A and after 16 weeks of treatment. Results :At baseline, the level of sE‐selectin was significantly higher in patients with AD than in healthy control subjects ( P &lt;0.0001). After treatment of AD with cyclosporin A, there was a significant reduction of the sE‐selectin levels ( P &lt;0.0001). In addition, changes in sE‐selectin levels significantly correlated with changes in disease activity parameters such as severity ( P &lt;0.002) and extent of disease ( P &lt;0.049). Conclusions :Soluble E‐selectin is a new serologic marker in AD which reflects disease activity. Therefore, soluble E‐selectin may be a useful parameter in the monitoring of this disease. Abbreviations : AD: atopic dermatitis; sE‐selectin: soluble E‐selectin; CsA: cyclosporin A; SEM: standard error of mean; ELISA: enzyme‐linked immunosorbent assay; VCAM: vascular adhesion molecule; ICAM: intercellular adhesion molecule; ELAM: endothelial cell‐leukocyte adhesion molecule; LEC‐CAM: leukocyte‐endothelial cell – cellular adhesion molecule.
Internal Medicine Essentials for Clerkship Students
Authors: Krista M. Johnson, Holly J. Humphrey
Journal: Annals of Internal Medicine (2008)

Medical Writings: Book Notes15 April 2008Internal Medicine Essentials for Clerkship StudentsKrista M. Johnson, MD and Holly J. Humphrey, MDKrista M. Johnson, MDFrom University of Chicago Medical Center, Chicago, Illinois.Search for more papers by this author and Holly J. Humphrey, MDFrom University of Chicago Medical Center, Chicago, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-8-200804150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Internal Medicine Essentials for Clerkship StudentsAlguire PC, ed. 293 pages. Philadelphia: American Coll Physicians; 2006. $49.95. ISBN 9781930513822. Order at www.acponline.org.Field of medicine: General medicine and specialties.Format: Softcover book.Audience: Medical students during internal medicine rotations, medicine clerkship directors, faculty who teach medical students.Purpose: To help students care for patients, prepare for clinical rounds, and study for end-of-rotation examination.Content: The preface explains the role of the internist and gives students tips for success during their medicine clerkship. The main text highlights common diagnoses and symptoms encountered by third-year medical students. Most chapters include sections on ... Author, Article, and Disclosure InformationAffiliations: From University of Chicago Medical Center, Chicago, Illinois. Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 April 2008Volume 148, Issue 8Page: 636KeywordsDrug screeningDrug therapyElectrocardiographyEvidence based medicineForecastingPatientsSoftware toolsThorax ePublished: 15 April 2008 Issue Published: 15 April 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Method for Testing Analgesics in Rheumatoid Arthritis using a Sequential Procedure
Authors: J. Hajnal, J. Sharp, A.J. Popert
Journal: Annals of the Rheumatic Diseases (1959)

Low voltage-activated (T-type) Ca<sup>2+</sup> channels are responsible for generating low-threshold spikes (LTS) that facilitate burst firing and transmitter release in neurons. The T-type Ca<sup>2+</sup> channels contain a regulatory α1 subunit, and several isoforms of the α1 subunit (Cav3.1, 3.2, 3.3) have been cloned. The Cav 3.1 α1 subunit is abundantly expressed in the hypothalamus. Previously, we found that 17 β-estradiol (E2) increased the number of arcuate neurons expressing LTS. Therefore, we used an ovariectomized female guinea pig model to measure the distribution and regulation of Cav3.1 mRNA expression by E2. Guinea pig Cav3.1 α1 subunit sequences, which were cloned by PCR, were used in ribonuclease protection (RPA) and <i>in situ</i> hybridization assays to evaluate mRNA expression. Based on a RPA, E2 significantly increased the mRNA expression of Cav3.1 α1 subunit in the mediobasal hypothalamus and the pituitary. <i>In situ</i> hybridization analysis revealed that E2 significantly increased Cav 3.1 mRNA expression in medial preoptic nuclei, bed nuclei stria terminalis, and the arcuate nucleus. Whole-cell patch recordings in arcuate neurons revealed that E2 treatment significantly increased the peak T-type Ca<sup>2+</sup> current density by twofold without affecting the activation/inactivation characteristics and augmented the rebound excitation by threefold to fourfold. These results suggest that estrogen regulates the mRNA expression of T-type calcium channels, which leads to increased functional expression of the channel. Increased expression of T-type channels could be one mechanism by which estrogen augments burst firing and transmitter release in hypothalamic neurons.
Azacitidine Induces Demethylation of the Epstein-Barr Virus Genome in Tumors
Authors: Anthony T.C. Chan, Qian Tao, Keith D. Robertson, Ian W. Flinn, Risa B. Mann, Barbara Klencke, Wing Hong Kwan, Thomas Wai-Tong Leung, Philip J. Johnson, Richard F. Ambinder
Journal: Journal of Clinical Oncology (2004)

To determine whether therapy with a DNA methyltransferase inhibitor is effective in achieving demethylation and gene re-expression in tumor DNA in patients.Biopsy specimens were obtained from patients with Epstein-Barr virus-associated tumors, enrolled on a clinical trial of 5-azacitidine, within 72 hours of the conclusion of the last infusion of the first cycle of therapy, and compared to pretreatment specimens. Methylation-specific polymerase chain reaction, bisulfite genomic sequencing, and immunohistochemistry were used to assess demethylation and gene re-expression.Substantial degrees of demethylation were detected in all latent and lytic Epstein-Barr virus promoters examined. Immunohistochemistry suggested activation of a previously silent viral antigen expression in one instance.Pharmacologic reversal of dense CpG methylation in tumor tissue can be achieved in patients.
Study shows two drugs are best for HIV infection
Authors: L. Dillner
Journal: BMJ (1995)

<h3>Background</h3> Laparoscopic management of colorectal cancer (CRC) has been gaining popularity at a rapid pace across the world. Proponents argue for better short term outcomes including shorter hospital stay, acceptable safety profile and better outcomes of laporoscopic versus open surgery. However, the direct inpatient cost for laparoscopic management of CRC remains unexplored. This assumes even more importance in resource-strapped economies like India. <h3>Methods</h3> A cross-sectional study was carried out with a hospital discharge diagnosis of CRC (ICD-10 C18-C19) from 2015–2018. Patient details on surgery, investigations, days of hospitalization, and drugs from hospital admission to discharge were obtained precisely from the medical records department. Item costs were obtained from the hospital electronic billing section. Economic evaluation included a prevalence-based approach with a societal perspective utilizing the bottom-up technique; cost was expressed as median cost per patient. <h3>Results</h3> 391 (male 288; 73.6%) patients were included. Their median age was 59 (range 49–69) years. The median time for hospitalization was 6 (range 5–11 days). The median inpatient cost was INR 1,86,564, with a wide range of (1,69,514 – 4,51,529); [USD 2743(2492–6640); € 2332(2118–5644)]. Surgical procedure with operation theatre contributed to 30% and was the highest among all the cost components. Consumables incurred (25%), bed charges (16%), anesthesia (8%), investigations (7%), drugs and professional fees of 6% each and miscellaneous charges (2%) contributed to the total cost. <h3>Conclusions</h3> The first pharmacoeconomic study for inpatients with CRC managed laparoscopically incurred modest cost. This study acts as a reference to future pharmacoeconomic studies in CRC. Its usefulness and advantages might lead to increased cost savings but needs justification by cost-benefit analysis in addition to long term outcome post-laparoscopic resection.
Eileen Mary Whapham
Authors: E M Whapham
Journal: BMJ (2002)

Former consultant obstetrician and gynaecologist Southend and Rochford Hospitals (b London 1907; q London 1932; MRCOG, FRCOG, FRCS), d 24 June 2002. 

Eileen M Whapham served in London County Council hospitals throughout the Blitz and later in the emergency medical service in Essex. In 1945 she was appointed consultant gynaecologist to the Mildmay Mission Hospital, moving to the Southend and Rochford Hospitals in 1946. Retiring in 1967, she moved to Hampshire, where she occupied herself with local politics and the care of handicapped children. She was a past chairman of the Southend branch of the BMA and an elder of the United Reformed Church. She did not marry, but leaves an adopted daughter.
Treatment of Angina Pectoris
Authors: ROBERT E. GOLDSTEIN, STEPHEN E. EPSTEIN
Journal: Circulation (1974)

EDITORlingual long-acting nitrates more prolonged than that achieved by nitroglycerin.It is likely that the duration of ac- tion of the sublingual nitrates is not as long as would be ideal, merely more prolonged than that achieved by nitroglycerin: a 1-21/2 hour duration of action seems most likely.Evidence that oral "long-acting nitrates" have a prolonged duration of action is, we agree, lacking.Although the information that nitroglycerin ointment may be superior is potentially exciting,"O its preliminary nature deserves reconfirmation before its acceptance to the exclusion of the sublingual mode of administration.
Aggregating Human Platelets Stimulate the Expression of Thrombin Receptors in Cultured Vascular Smooth Muscle Cells via the Release of Transforming Growth Factor-β <sub>1</sub> and Platelet-Derived Growth Factor <sub>AB</sub>
Authors: Valérie B. Schini-Kerth, Steffen Bassus, Beate Fisslthaler, Carl M. Kirchmaier, Rudi Busse
Journal: Circulation (1997)

Background Thrombin and the thrombin receptor have been implicated in the proliferation of vascular smooth muscle cells (VSMCs) observed after angioplasty and in atherosclerosis. Because thrombin receptor activation is an irreversible proteolytic event, the marked upregulation of the smooth muscle cell thrombin receptor after vascular injury may account for the maintained mitogenic activity of thrombin. The present study was designed to determine whether aggregating platelets stimulate thrombin receptor expression in cultured VSMCs and, if so, to identify the mediators. Methods and Results Thrombin receptor expression was assessed by Northern and Western blot analyses and functionally by measuring the release of 6-keto prostaglandin F 1α . Platelet-derived products (PDPs) released by aggregating human platelets enhanced thrombin receptor mRNA levels in a time- and concentration-dependent manner, an effect that was potentiated by transient acidification of PDPs, which release bioactive transforming growth factor (TGF)-β 1 , and that was slightly inhibited by ketanserin. Among several factors known to be released by aggregating platelets, only TGF-β 1 , platelet-derived growth factor AB (PDGF AB ), and serotonin mimicked the PDP effect. The level of membrane thrombin receptor protein was increased in TGF-β 1 –treated VSMCs. Pretreatment of VSMCs with either acidified PDP, or TGF-β 1 increased the α-thrombin–stimulated release of 6-keto prostaglandin F 1α . This effect was blunted by incubating acidified PDP with either a TGF-β–or a PDGF-neutralizing antibody. Conclusions Aggregating human platelets stimulate the expression of thrombin receptors in VSMCs through the release of TGF-β 1 , PDGF AB , and, to a lesser extent, serotonin. The upregulation of the thrombin receptor by products released by aggregating platelets may sustain the mitogenic activity of thrombin in the vascular wall at sites of injury.
Long-Term Outcome Following Catheter Valvotomy for Pulmonary Atresia With Intact Ventricular Septum
Authors: Henry Chubb, Erkki Pesonen, Sivasankaran Sivasubramanian, Shane M. Tibby, John M. Simpson, Eric Rosenthal, Shakeel A. Qureshi
Journal: Journal of the American College of Cardiology (2012)
Results of the New Nitinol Self-Expandable Stents for Distal Biliary Strictures
Authors: M. Smits, K. Huibregtse, G. Tytgat
Journal: Endoscopy (1995)

The nitinol stent is a self-expandable spiral stent made of nickel-titanium alloy. We performed a pilot study to evaluate the method of stent insertion and stent efficacy.Twenty-eight patients with irresectable malignancy had nitinol stents inserted for obstructive jaundice due to distal biliary strictures. They were followed prospectively for a median of ten weeks (range 1-48) until stent occlusion or death. All patients underwent sphincterotomy prior to stent insertion. Stent deployment was assisted by subsequent balloon dilation of the stent in two patients. Plastic stent insertion was used to temporarily brace the nitinol stent in another three patients.Short-term relief of jaundice was achieved in 20 of the 28 patients (71%). The remaining eight patients had persistent jaundice due to failure of stent insertion (three patients) or early stent dysfunction (five patients). Long-term success was achieved in 12 of 28 patients (43%). Ten of the 12 patients died without complications after a median of 13.5 weeks (range 3-48). One of the 12 patients is still alive with the stent in place for 40 weeks, and one patient underwent elective bypass surgery, and the stent was removed surgically. Eight of the 28 patients had recurrent symptoms due to late stent dysfunction after a median of 19 weeks (range 6-32).Nitinol stents are technically difficult to insert. The problem of stent dysfunction (13 of 28, 46%) is not improved by the use of nitinol stents. Whether improvement of the insertion technique and enhancement of the expanding force of the stent may improve stent efficacy merits further evaluation.
Children's Consent to Research Participation: Social Context and Personal Experience Invalidate Fixed Cutoff Rules
Authors: Richard Ashcroft, Trudy Goodenough, Emma Williamson, Julie Kent
Journal: The American Journal of Bioethics (2003)

David Wendler and Seema Shah (2003) offer an interesting proposal concerning children’s assent to participation in nontherapeutic biomedical research. They argue that children should be considered competent to consent to such participation provided they have attained a level of cognitive and prosocial development such that they are able to understand the nature and point of altruistic decisions and actions. On the basis of psychological evidence they argue that this develops between the ages of 10 and 14. They argue on practical and moral grounds for an agebased cutoff for assent to research participation at 14 years old. Other commentators on Wendler and Shah’s paper draw attention to a number of moral and practical challenges to this proposal. We would like to draw attention to what we regard as weaknesses in the scientiac basis of the paper. It is important to note that Wendler and Shah start with U.S. federal guidelines, move on to identify the underlying moral principles (drawing heavily on the standard “Four Principles” approach), and only then seek to identify a psychological foundation for the means to apply these principles in practice. Their argument turns on a psychological account of the development of the capacity for altruism as the basis for capacity to assent to participation in nontherapeutic biomedical research. Although there is some analytical interest in the proposition that capacity for altruism is a necessary condition for capacity to assent to participation in nontherapeutic research, had they approached the issue of children’s capacity to consent or assent more directly, they might well have obtained a different result. Most work on research ethics commences, as do Wendler and Shah, with a theoretical and legal analysis of the requirements for ethical research. Occasionally, empirical work is conducted to determine the acceptability of guidelines or policy in the aeld of research ethics. Yet we have found almost no research that seeks to analyze in any detail research participants’ reasoning and values concerning the ethical issues in research, or to understand how far the ethical issues identiaed by research participants are consistent with the issues raised by ethicists or ethical
Low-dose intravenous calcitriol treatment of secondary hyperparathyroidism in hemodialysis patients
Authors: Maurizio Gallieni, Diego Brancaccio, Paola Padovese, Davide Rolla, Pierluigi Bedani, Giuseppe Colantonio, Claudio Bronzieri, Bruno Bagni, Gianluigi Tarolo
Journal: Kidney International (1992)
DePuy Orthopaedics replies to Deborah Cohen
Authors: G. Isaac, S. Sinclair
Journal: BMJ (2012)

We highlight some of the factual errors and omissions in Deborah Cohen’s article on the safety of metal-on-metal (MoM) hip implants with regard to such hip implants in general and the DePuy ULTAMET implant in particular—one option used with the Pinnacle acetabular cup system.1

All hip implants, irrespective of the materials used, are known to wear. Indeed, concern that debris from the wear of metal-on-polyethylene hip replacements caused bone damage rekindled interest in developing a new generation of MoM implants. Contrary to Cohen’s suggestion, the potential for reactions to debris from the wear of MoM hip implants has been studied for over two decades. In February 2012 the Medicines and Healthcare Products Regulatory Agency (MHRA) said: “The majority of patients implanted with metal-on-metal hip replacements have well functioning hips and are thought to be at a low risk of developing serious problems.”2

Cohen states that DePuy had been aware since 2008 of raised metal …
Evaluation of Corticosteroid and Exchange-Transfusion Treatment of Acute Yellow-Phosphorus Intoxication
Authors: Geobel A. Marin, Ciro A. Montoya, José L. Sierra, John R. Senior
Journal: New England Journal of Medicine (1971)

To evaluate steroid therapy in patients acutely intoxicated with yellow phosphorus, 49 patients were sequentially assigned to one of three groups. Group A did not receive steroids at any time, Group B received steroids from the time of admission, and steroids were used in Group C only when liver coma developed. Two out of four patients in coma recovered in Group A, none out of five in Group B, and four out of seven in Group C. Thus, steroids did not appear to prevent onset of coma in this type of liver injury and did not increase survival after development of coma. In another group of 44 patients similarly intoxicated, deep hepatic encephalopathy developed in 15. Five of these were given exchange transfusions, with two deaths and three survivals. Of the 10 not given exchange transfusions, seven died, and three survived.
Electrophysiologic Evaluation of Elderly Patients with Sinus Bradycardia
Authors: DIETMAR GANN
Journal: Annals of Internal Medicine (1979)

One hundred three patients with persistent sinus bradycardia were evaluated electrophysiologically and followed prospectively for a mean of 4.6 years. The 5-year survival rate was 74.8%, not significantly different from the 72% rate in the general population with similar age and sex distribution. Forty-one patients had abnormal corrected sinus-node recovery time. Overall accuracy of abnormal corrected sinus-node recovery time in predicting serious sinus node disease in symptomatic and asymptomatic patients was 90% (37 of 41 patients) and 100% in patients with syncope (18 of 18 patients). The sensitivity of the test was 66%. Abnormal corrected sinus-node recovery time in patients with sinus bradycardia appears to be a valuable specific, predictive index of serious sinus node disease and therefore a useful test in selecting patients for pacemaker therapy, especially if symptoms such as dizziness or syncope are present.