tbuckley/cabot-search huggingface dataset:
Endoscopic Ultrasonography versus Computed Tomography in the Differential Diagnosis of Perianorectal Complications in Crohn's Disease
Authors: A. U. Schratter-Sehn, H. Lochs, H. Vogelsang, H. Schurawitzki, C. Herold, M. Schratter
Journal: Endoscopy (1993)

In this prospective study the performance of transrectal or transvaginal endoscopic ultrasonography (EUS) was compared with that of computed tomography (CT) in the diagnosis of perirectal fistulae, abscesses and diffuse inflammatory changes in the lower pelvis in 25 patients with Crohn's disease. Results were verified by surgery in eight patients and by correlation with findings on endoscopy, barium radiography and fistulography, and the clinical course in all other patients. EUS was superior to CT in diagnosing fistulae (14 vs 4 correct diagnoses) and inflammatory infiltration of the lower pelvic muscles (11 vs 2 correct diagnoses). The methods were equivalent in diagnosing perianorectal abscesses. CT was superior in the detection of inflammatory changes in the pararectal fasciae and fatty tissue which could not be detected by EUS. It is concluded that EUS should be used as the primary method for diagnosing perianorectal changes in patients with Crohn's disease especially in the case of fistulae and abscesses, having the added advantage of lack of radiation for the patient.
THE PULSE AFTER HANGING.
Authors: John P. Blankenship
Journal: JAMA (1883)

Maryville, Tenn., Nov. 28, 1883. Prof. N. S. Davis, M.D., Editor: On the 23d inst., Andy Taylor was executed or hanged at Loudon, Loudon County, Tenn. Being one of the physicians appointed to be present at the execution, I took the following notes: Pulse after the rope was adjusted, 121; first minute after the drop, pulse 54; second minute, 52; third minute, 39; fourth minute, 20; fifth minute, 0; sixth minute, 70; seventh minute, 73; eighth minute, 0; ninth 34. After this no pulse was perceptible; neck not dislocated; died from strangulation. The heart beat the nineteenth minute one time, and two or three times only from the ninth to the nineteenth, when life was extinct. No priapism produced. Drop fell at 3:15 P. M.; the body was cut down in thirty minutes. I send you the above items, thinking that they would be of some interest to the profession
Clinical Evaluation of Gastric Freezing for Duodenal Ulcer
Authors: Claude R. Hitchcock, James E. Bitter, R. Duncan Sutherland
Journal: JAMA (1964)

In a study testing the value of gastric freezing to control duodenal ulcer, about 70% of patients were palliated for short periods by a single freeze. Symptoms have recurred, however, in a progressively large percentage of patients evaluated at six weeks to nine months postfreeze. Of those who accepted a second freeze, nearly one half had return of symptoms in 6 to 12 weeks after refreeze. Acid peptic secretion was decreased for a few weeks only. No correlation was found between return of symptoms and level of acid peptic secretion. Occasional patients, without symptoms, harbored newly formed craters after freezing, thus demonstrating a danger inherent in "pain" control without persistent reduction in acid peptic secretion. Psychological reinforcement inherent in the treatment makes objective evaluation difficult.
A Case Illustrating the Relief of Chronic Gastric Disease by Gastro-Enterostomy
Authors: A. E. Barker
Journal: BMJ (1901)

Hty.-W.O., male,raged 26, had had symptoms of gastric ulcer, with well-marked dilatation of the stomiach, for two yearl-s; althouglh thle sym- ptoms'were not acute, the loss of fieshl and strength Was well 'marked, and the patient was rendered too feeble to Work.Operation.-Ifound the pylorusa.dlherentto tlhe under surface of tlhe iver, and after detaching it I dilated the pylorus by invaginating the stomach wall until I could easily get two fiiigers tlhrouglh it.RRecovery was rapid, and the patient gained fieslh, but I lhear that the dilatation lhas not.subsided materially, thlouglh lie lhas nio vomitinig or paini.If hlis symptoms recur I shall advise a gastro-entcrostomy.
Contrast-harmonic endoscopic ultrasound for the diagnosis of pancreatic adenocarcinoma: a prospective multicenter trial
Authors: Rodica Gincul, Maxime Palazzo, Bertrand Pujol, Florence Tubach, Laurent Palazzo, Christine Lefort, Fabien Fumex, Alexandra Lombard, Daniel Ribeiro, Monique Fabre, Valerie Hervieu, Michel Labadie, Thierry Ponchon, Bertrand Napoléon
Journal: Endoscopy (2014)

<b>Background and study aims:</b> Histology is the gold standard for the diagnosis of pancreatic adenocarcinoma. However, the negative predictive value of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis remains low. The aims of this prospective multicenter study were: (1) to compare the performance of contrast-harmonic EUS (CH-EUS) with that of EUS-FNA for the diagnosis of pancreatic adenocarcinoma; (2) to assess the intra- and interobserver concordances of CH-EUS. <b>Patients and methods:</b> A total of 100 consecutive patients with a solid pancreatic mass of unknown origin were prospectively included at three centers (July 2009 – April 2010). All patients were examined by CH-EUS followed by EUS-FNA. Absence of vascular enhancement at CH-EUS was regarded as a sign for pancreatic adenocarcinoma. The final diagnosis (gold standard) was based on pathological examination (EUS-FNA, surgery) or 12-month follow-up. <b>Results:</b> The final diagnoses were: 69 adenocarcinoma, 10 neuroendocrine tumors, 13 chronic pancreatitis, and 8 other lesions. In diagnosing adenocarcinoma, CH-EUS and EUS-FNA had respective accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 95 %, 96 %, 94 %, 97 %, and 91 %, and of 95 %, 93 %, 100 %, 100 %, and 86 % without significant difference. Five false-negative cases with EUS-FNA were correctly classified by CH-EUS. Interobserver agreement (seven endosonographers) was good (kappa 0.66). Intraobserver agreement was good to excellent (kappa 0.76 for junior, 0.90 for senior). <b>Conclusions:</b> The performance of CH-EUS for the diagnosis of pancreatic adenocarcinoma was excellent. The good intra- and interobserver concordances suggest an excellent reproducibility. CH-EUS could help to guide the choice between surgery and follow-up when EUS-FNA is inconclusive.
Puromycin-insensitive leucyl-specific aminopeptidase (PILSAP) binds and catalyzes PDK1, allowing VEGF-stimulated activation of S6K for endothelial cell proliferation and angiogenesis
Authors: Tohru Yamazaki, Tetsuya Akada, Osamu Niizeki, Takahiro Suzuki, Hiroki Miyashita, Yasufumi Sato
Journal: Blood (2004)
WHAT THE AMERICAN MEDICAL ASSOCIATION STANDS FOR.
Authors: GEORGE H. SIMMONS
Journal: JAMA (1907)

[After thanking the association for the honor conferred on him in asking him to deliver the annual address, and bearing witness to the large share taken in the past by Kentucky in support of the American Medical Association and its objects, the speaker proceeded to show that those objects were almost entirely altruistic. He took a bird's eye view of the origin of the Association from a national convention originally summoned to suggest measures for the elevation of the standards of medical education, and showed how that object had alternately come prominently forward and fallen into the background until, in 1874, a period set in in which the business affairs of the Association became almost completely subordinated to the scientific work. The speaker continued:] During all these years, and with all the discouragements, there were some who persisted in the attempt to accomplish something. On the other hand, there were
Reducing Side Effects in Ketamine Anesthesia
Authors: Elemer K. Zsigmond
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The report on the work of Dr. Albin and associates in the MEDICAL NEWS section (226:414, 1973) indicated that the duration of ketamine hydrochloride anesthesia in dogs can be shortened, and recovery of good gait can be accelerated by tetrahydroaminacrine (THA) which is an acetylcholinesterase inhibitor. Since tetrahydroaminacrine antagonized automic, central, and motor activity induced by ketamine equally well, it is likely that ketamine exerts its effect by the same mechanism, possibly by a central cholinergic mechanism at all three sites.<sup>1</sup> As we reported earlier, ketamine first activates and, in larger doses, inhibits human plasmacholinesterase activity.<sup>2</sup>Therefore, we postulated that a central cholinergic mechanism, which in turn may cause release of norepinephrine in some brain areas, may be responsible for all the side effects associated with intravenous ketamine administration.<sup>3</sup>In relation to the hallucinations induced by ketamine, it is of interest that some hallucinogenic
Management of cutaneous malignant melanoma by dermatologists of the American Academy of Dermatology. II. Definitive surgery for malignant melanoma
Authors: Thomas G Salopek, Johnny M Slade, Ashfaq A Marghoob, Darrell S Rigel, Alfred W Kopf, Robert S Bart, Robert J Friedman
Journal: Journal of the American Academy of Dermatology (1995)
Benign Brenner Tumor of the Ovary Detected on Tc???99m Methylene Diphosphonate Bone Scan
Authors: JORDAN B. RENNER, WILLIAM H. McCARTNEY
Journal: Clinical Nuclear Medicine (1984)

Many disease states, including neoplasia, have been detected by bone scanning. Among the neoplastic processes detected by bone imaging agents are ovarian tumors, both benign and malignant. This report is concerned with the visualization of a benign Brenner tumor during routine Tc–99m MDP bone scanning.
OPERATING UNDER X-RAYS.
Authors: J. F. BALDWIN
Journal: JAMA (1901)

The removal of foreign bodies which have been accurately located by the fluoroscope or skiagraph has come to constitute every-day operations in surgical work. I have not, however, as yet seen any report of a case in which the surgical work itself was done under the light furnished by the x-ray and with the aid of the fluoroscope. Having had one such experience I deem it worthy of presentation to the profession. George E. R., aged 9 years, was shot July 4, 1899. The bullet was a Flobert and entered just above the right patella. The injury seemed to be slight and the wound healed by first intention. Some three weeks later, the joint beginning to give him trouble, an examination was made by his physician, Dr. S. M. Sherman, of this city, who thought he detected the bullet under the skin at one side of the patella. He cut
Psychological Emergencies in War Time
Authors: F. Dillon
Journal: BMJ (1939)

<h3>Objectives</h3> To estimate the changes in costs associated with acute coronary syndrome (ACS) admissions in New Zealand (NZ) public hospitals over a 12-year period. <h3>Design</h3> A cost-burden study of ACS in NZ was conducted from the NZ healthcare system perspective. <h3>Setting</h3> Hospital admission costs were estimated using relevant diagnosis-related groups and their costs for publicly funded casemix hospitalisations, and applied to 190 364 patients with ACS admitted to NZ public hospitals between 2007 and 2018 identified from routine national hospital datasets. Trends in the costs of index ACS hospitalisation, hospital admissions costs, coronary revascularisation and all-cause mortality up to 1 year were evaluated. All costs were presented as 2019 NZ dollars. <h3>Primary outcome measures</h3> Healthcare costs attributed to ACS admissions in NZ over time. <h3>Results</h3> Between 2007 and 2018, there was a 42% decrease in costs attributed to ACS (NZ$7.7 million (M) to NZ$4.4 M per 100 000 per year), representing a decrease of NZ$298 827 per 100 000 population per year. Mean admission costs associated with each admission declined from NZ$18 411 in 2007 to NZ$16 898 over this period (p&lt;0.001) after adjustment for key clinical and procedural characteristics. These reductions were against a background of increased use of coronary revascularisation (23.1% (2007) to 38.1% (2018)), declining ACS admissions (366–252 per 100 000 population) and an improvement in 1-year survival post-ACS. Nevertheless, the total ACS cost burden remained considerable at NZ$237 M in 2018. <h3>Conclusions</h3> The economic cost of hospitalisations for ACS in NZ decreased considerably over time. Further studies are warranted to explore the association between reductions in ACS cost burden and changes in the management of ACS.
Role of Stereotypes in Selecting Patients for Psychotherapy
Authors: Andreas B. Blaser
Journal: Psychotherapy and Psychosomatics (1980)

This investigation addressed the question of what implicit notions on the suitability for psychotherapy are operative in the therapist and how they affect his perception of the real patient in the first interview. Study 1 compared 13 psychotherapist's ratings of ideal, implicit notions of suitability for a variety of psychotherapies to their ratings of 20 videotaped patients. A significant correlation was found for analytical indication stereotypes only. Clinical person perception in this task seems to be focused on desirable patient variables, leading to paradoxes. In study 2, a Swiss sample of 67 therapists was able to differentiate only two indication stereotypes, an analytical one versus a nonanalytical one. Results suggest that goal variables of psychoanalytical therapies must be present in the ideally suited patient at the onset of therapy.
Bayer to spend $20m to correct misleading advertising for oral contraceptive Yaz
Authors: J. H. Tanne
Journal: BMJ (2009)

Bayer Healthcare Pharmaceuticals has agreed to spend $20m (£14m; €15.6m) to correct misleading direct to consumer advertising of its birth control pill Yaz (drospirenone and ethinylestradiol), the most popular birth control pill in the United States, with sales of about $616m last year. 

The corrective advertisements began running last month and will continue through June, the US Food and Drug Administration (FDA) said.

Bayer reached an agreement with the FDA and 27 state attorneys general, led by Bill McCollum, the Florida attorney general. The agreement follows a warning letter sent to Bayer in October by Thomas Abrams, the director of the FDA’s division of drug marketing, advertising, and communications. It adds new requirements to a 2007 agreement about problems related to Bayer’s non-disclosure of safety risks associated …
Higher-order structure in pericentric heterochromatin involves a distinct pattern of histone modification and an RNA component
Authors: Christèle Maison, Delphine Bailly, Antoine H.F.M. Peters, Jean-Pierre Quivy, Danièle Roche, Angela Taddei, Monika Lachner, Thomas Jenuwein, Geneviève Almouzni
Journal: Nature Genetics (2002)
beyond the evidence
Authors: Gillian Hawthorne, Maggie Blott
Journal: BMJ (2004)

Firstly, the imperative to "do no harm" is not straightforward in this case.As Trisha Greenhalgh points out, there are risks involved whatever choice is made, and the weight that should be given to these risks is a personal assessment. 2 So the imperative not to harm is not clearly in contradiction with patient self determination. 3 Tommy knows best what would be most harmful to her: the possible adverse outcomes of pregnancy or not having this child.This also reminds us that evidence based medicine is a source of factual knowledge.No less, but no more.It will not, by itself, solve ethical difficulties.Knowing what should be done certainly includes knowing the facts-the team was correct to go to the literature with such care-but the difficulties do not end there. 4 This difficulty with medical decision making is not, of course, Tommy's problem.Her decision, whether to endanger her body in order to give birth, is one that women were already facing long before people started writing about it.Only recently did inventions of the human mind make this risk more distant and less generally accepted.
Director of top research organization for mental health criticizes DSM for lack of validity
Authors: M. McCarthy
Journal: BMJ (2013)

Just weeks before the release of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), the director of the country’s leading research organization on mental health has criticized its inadequacies.

Thomas Insel, director of the United States National Institute of Mental Health, wrote in a blog posted on the institute’s website that the manual had been useful because it provided labels and definitions that created a common language for describing psychopathology.1

“The strength of each of the editions of DSM has been ‘reliability’—each edition has ensured that clinicians used the same terms the same ways,” Insel wrote. “The weakness is its lack of validity.” …
Liver regeneration is impaired in lipodystrophic fatty liver dystrophy mice
Authors: Vered Gazit, Alexander Weymann, Eric Hartman, Brian N. Finck, Paul W. Hruz, Anatoly Tzekov, David A. Rudnick
Journal: Hepatology (2010)

We previously reported that mice subjected to partial hepatectomy exhibit rapid development of hypoglycemia followed by transient accumulation of fat in the early regenerating liver. We also showed that disrupting these metabolic alterations results in impaired liver regeneration. The studies reported here were undertaken to further characterize and investigate the functional importance of changes in systemic adipose metabolism during normal liver regeneration. The results showed that a systemic catabolic response is induced in each of two distinct, commonly used experimental models of liver regeneration (partial hepatectomy and carbon tetrachloride treatment), and that this response occurs in proportion to the degree of induced hepatic insufficiency. Together, these observations suggest that catabolism of systemic adipose stores may be essential for normal liver regeneration. To test this possibility, we investigated the hepatic regenerative response in fatty liver dystrophy (fld) mice, which exhibit partial lipodystrophy and have diminished peripheral adipose stores. The results showed that the development of hypoglycemia and hepatic accumulation of fat was attenuated and liver regeneration was impaired following partial hepatectomy in these animals. The fld mice also exhibited increased hepatic p21 expression and diminished plasma levels of the adipose-derived hormones adiponectin and leptin, which have each been implicated as regulators of liver regeneration. Conclusion: These data suggest that the hypoglycemia that develops after partial hepatectomy induces systemic lipolysis followed by accumulation of fat derived from peripheral stores in the early regenerating liver, and that these events may be essential for initiation of normal liver regeneration. (HEPATOLOGY 2010)
Pregnancy Dx? Rx May Now Include Condoms
Authors: Marsha F. Goldsmith
Journal: JAMA (1989)

AMONG THE CHANGES pregnancy brings into a couple's life, perhaps one of the most welcome for many has been no more need to use contraceptives during sexual intercourse for awhile. Now comes word from the National Family Planning and Reproductive Health Association (NFPRHA), Washington, DC, that for some women, use of one type of contraceptive—condoms— should be<i>continued</i>the whole 9 months. The objective is no longer contraception, obviously, but the device's other role——prophylaxis. In this age of increasing incidence of acquired immunodeficiency syndrome (AIDS) and rampant sexually transmitted diseases (STDs), the association recently issued two policy statements concerning condom efficacy and use. The target audience is family planning programs and agencies, and the recommendations are spelled out clearly. The first statement, "On the Effectiveness of Condoms," reiterates that the devices are effective, though not perfect, for preventing both pregnancy and infection. It recommends that "all human service providers assume
Monitoring serum HBV-DNA during lamivudine therapy by quantitative pcr assay may predict development of YMDD mutants
Authors: P. Lampertico, M. Iavarone, G. Lunghi, A. Orlandi, F. De Fillppi, M.G. Rumi, G. Colucci, E. Del Ninno, M. Colombo
Journal: Journal of Hepatology (2000)
Pineal gland calcification and defective sense of direction.
Authors: C R Bayliss, N L Bishop, R C Fowler
Journal: BMJ (1985)

Calcification of the pineal gland is shown to be closely related to defective sense of direction. In a tricentre prospective study of 750 patients lateral skull radiographs showed that 394 had calcified pineal glands. Sense of direction was assessed by subjective questioning and objective testing and the results noted on a scale of 0-10 (where 10 equals perfect sense of direction). The average score for the 394 patients with pineal gland calcification was 3.7 (range 0-8), whereas the 356 patients without pineal gland calcification had an average score of 7.6 (range 2-10). This difference was highly significant (p less than 0.01). A smaller parallel study in pigeons showed that pineal calcification also leads to a reduction in homing abilities. The findings suggested that the pineal gland plays an important part in directional sense and that damage to the gland, as indicated by calcification, causes defective sense of direction - perhaps by altering the intrinsic intracranial electromagnetic environment and thus affecting the magnetite response mechanism.
Differential expression of p73 isoforms in relation to drug resistance in childhood T-lineage acute lymphoblastic leukaemia
Authors: M Meier, M L den Boer, J P P Meijerink, M J C Broekhuis, M M C J Passier, E R van Wering, G E Janka-Schaub, R Pieters
Journal: Leukemia (2006)
Stage at Diagnosis and Treatment Patterns Among Older Women With Breast Cancer
Authors: Gerald F. Riley
Journal: JAMA (1999)

Few studies have compared patterns of care in health maintenance organization (HMO) and fee-for-service (FFS) settings.To examine breast cancer stage at diagnosis and, for those at an early stage, treatment patterns for elderly women in HMO and FFS settings.Cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) program linked to Medicare enrollment records.Women aged 65 years or older residing in 11 geographic areas who were newly diagnosed as having breast cancer between 1988 and 1993.Standardized percentage of cases diagnosed at late stages for HMO vs FFS; standardized percentage of early-stage cases undergoing initial treatment with breast-conserving surgery (BCS); and, among BCS cases, standardized percentage receiving adjuvant radiation therapy. Standardization was achieved through logistic regression, controlling for patient demographics, cancer history, county of residence, year of diagnosis, and educational attainment at the census tract level. Analyses of treatment patterns were controlled for stage at diagnosis and tumor size.The HMO enrollees were less likely to have breast cancer diagnosed at late stages than FFS patients (HMO, 7.6%; FFS, 10.8%; difference, -3.2% [95% confidence interval (CI), -4.2% to -2.2 %]). Among early-stage cases, the percentages undergoing BCS were similar in HMO and FFS settings overall (HMO, 38.4%; FFS, 36.8%; difference, 1.6% [95% CI, 0.0%-3.2%]); percentages varied markedly at the individual plan level. Among women undergoing BCS, HMO enrollees were significantly more likely to receive radiation therapy but, again, results varied by plan (HMO, 69.0%; FFS, 63.7%; difference, 5.3% [95% CI, 2.9%-7.7%]). In general, use of BCS and radiation therapy was substantially higher than that found in an earlier study examining cases diagnosed between 1985 and 1989.Treatment of early-stage breast cancer in HMOs often differs from local FFS patterns, but not in a consistent way. During the period of our study, elderly HMO enrollees did not appear to have systematic access problems with adjuvant radiation therapy following BCS compared with women in an FFS setting.
Tumor-associated macrophages predict inferior outcomes in classic Hodgkin lymphoma: a correlative study from the E2496 Intergroup trial
Authors: King L. Tan, David W. Scott, Fangxin Hong, Brad S. Kahl, Richard I. Fisher, Nancy L. Bartlett, Ranjana H. Advani, Rena Buckstein, Lisa M. Rimsza, Joseph M. Connors, Christian Steidl, Leo I. Gordon, Sandra J. Horning, Randy D. Gascoyne
Journal: Blood (2012)