tbuckley/cabot-search huggingface dataset:
P2-16-16: Nipple Sparing Mastectomy and Immediate Breast Reconstruction: Critical Appraisal of Five Year, Single Centre Outcomes.
Authors: D Westbroek, I Karat, H Min-Hui, I Gukas, R Daoud, IJ Laidlaw
Journal: Cancer Research (2011)

Abstract Background Approximately 5,000 patients undergo breast reconstruction annually in the United Kingdom ( 2:1 ratio of immediate versus delayed respectively). Whilst skin sparing mastectomy is an accepted modality for local control in appropriately selected patients, nipple preservation remains controversial. In over 1,800 peer reviewed nipple sparing mastectomy (NSM) cases, the local event rate attributable to NAC preservation following NSM (therapeutic and prophylactic) is 0.16% with no evidence of deleterious impact on disease free survival. This study aims to evaluate in a selected cohort of patients, the oncological safety and aesthetic outcome of nipple- sparing mastectomy and immediate breast reconstruction (IBR). We highlight the surgical technique used and propose in/exclusion criteria. Material and Methods: Patients were identified retrospectively from our Institution's electronic patient records and WinPath™ database by searching clinical codes corresponding to NSM &amp; IBR, performed by the senior authors (IJL and RD) between January 2004 and December 2008. Pre-operative selection criteria included: 100% pre-operative lesion characterisation; 5mm margin acceptance; submission of separate nipple core specimens for paraffin block histological assessment and re-excision of all involved/close margins. Follow-up data was verified from patients’ case notes, histo- pathological review and standardised photographic views. Endpoints include: local recurrence rate, disease free survival, peri-operative NAC subcutaneous tissue loss and validated aesthetic outcome measures. Results*: 84 patients underwent NSM &amp; IBR for invasive disease. The mean age was 52.1 years and a median follow-up of 38 months. IBR utilised autologous tissue (latissimus dorsi or transverse rectus abdominus musculocutaneous flaps) with/without implant prosthesis. There was one case of local recurrence (1.2%) in a patient who declined re-excision of close/involved margins and no recorded breast cancer related deaths. Peri-operative complication rates were within the national mastectomy breast reconstruction audit outcome guidelines. Conclusion: In this cohort of patients, nipple sparing mastectomy and immediate breast reconstruction achieves comparable oncological outcomes with excellent aesthesis relative to traditional ablative procedures for local control. Nipple preservation although not evaluated independently does enhance cosmetic outcomes. *(Preliminary analysis) Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-16.
Complications of Local Corticosteroid Injections
Authors: Norman L. Gottlieb
Journal: JAMA (1980)

Unusual complications associated with local microcrystalline corticosteroid injections were observed in four patients with diverse rheumatic disorders. Adverse reactions included (1) bilateral digital flexor tendon rupture following carpal tunnel injection for idiopathic median nerve compression syndrome; (2) bowstring deformity of a finger after local corticosteroid treatment of psoriatic digital flexor tendonitis; (3) carpal tunnel infection following dorsal arthrocentesis of a wrist in a patient with rheumatoid arthritis; and (4) pronounced flushing of the face, neck, and chest after intrasynovial corticosteroid injection in a patient with psoriasis and arthritis. This article considers some physiologic actions of corticosteroids possibly responsible for development of these untoward effects.
Metabolism of apolipoprotein B-100 in large very low density lipoproteins of blood plasma. Kinetic studies in normal and Watanabe heritable hyperlipidemic rabbits.
Authors: N Yamada, D M Shames, K Takahashi, R J Havel
Journal: Journal of Clinical Investigation (1988)

The metabolism of radioiodinated apo B-100 in large VLDL from normal and Watanabe heritable hyperlipidemic (WHHL) rabbits, with diameters exceeding 450 A, was studied in corresponding recipient rabbits. In both cases approximately 87% of the particles contained apolipoprotein (apo) E (B,E particles). In normal rabbits, apo B in these B,E particles was removed from blood plasma much more rapidly than apo B in B,E particles in smaller VLDL and few of the large B,E particles were converted to lipoproteins of higher density. In WHHL rabbits, approximately 60% of the apo B in B,E particles in large VLDL was removed at a comparably rapid rate, but an appreciable fraction of the remainder, which was removed slowly, was converted to particles of higher density, as are the B,E particles in smaller VLDL. From kinetic analysis of these and other data, an hypothesis was formulated from which it is estimated that apo B in large VLDL accounts for 18 and 41% of apo B transport in normal and WHHL rabbits, respectively, despite the fact that these lipoproteins contain less than 5% of the apo B in total VLDL. Failure to account for the contribution of large VLDL to VLDL turnover may lead to serious underestimation of total apo B transport in the blood.
Lactic Acidosis and Phenformin Hydrochloride
Authors: George M. Bernier
Journal: JAMA (1963)

Two cases of diabetic patients on phenformin (phenethylbiguanide) hydrochloride therapy in metabolic acidosis due to lactic acidosis are described. Each had hypotension due to myocardial and mesenteric infarction respectively. Significant ketosis was not present. Altered lactate metabolism has been described in diabetic patients treated with phenformin hydrochloride. It is possible that the hyperlactatemia of vascular collapse may have been magnified by a biguanide block in oxidative metabolism. However, it is equally possible that the association was entirely fortuitous, particularly since lactic acidosis is being described with increasing frequency in patients not receiving phenformin hydrochloride.
Renal Tubular Transport of Electrolytes.
Authors: C. W. Gottschalk
Journal: Annals of Internal Medicine (1962)

s1 April 1962Renal Tubular Transport of Electrolytes.C. W. Gottschalk, M.D., F.A.C.P.C. W. Gottschalk, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-697_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCertain aspects of renal tubular transport of water, sodium, chloride, and bicarbonate are considered with emphasis on data obtained by micropuncture concerning localization and mechanism of transport. All water movement is believed to be passive and secondary to solute transport. Sodium transport is considered to be active, since sodium can be reabsorbed against an electrical and chemical concentration gradient even in the proximal tubule. The transtubular potential difference (luminal fluid negative to interstitial fluid) is believed to result primarily from the active transport of sodium out of the tubule. The fall in pH of proximal fluid is of such magnitude... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chapel Hill, N. C. (BS) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 697-697KeywordsAttentionBicarbonatesFallsInterstitial fluidSaltsSodiumSodium chloride ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
Trends in Acute Coronary Heart Disease Mortality, Morbidity, and Medical Care From 1985 Through 1997
Authors: Paul G. McGovern, David R. Jacobs, Eyal Shahar, Donna K. Arnett, Aaron R. Folsom, Henry Blackburn, Russell V. Luepker
Journal: Circulation (2001)

Background —Coronary heart disease (CHD) mortality continued to decline from 1985 to 1997. Methods and Results —We tabulated CHD deaths (ICD-9 codes 410 through 414) in the Minneapolis/St Paul, Minnesota, area. For 1985, 1990, and 1995, trained nurses abstracted the hospital records of patients 30 to 74 years old with a discharge diagnosis of acute CHD (ICD-9 codes 410 or 411). Acute myocardial infarction (AMI) events were validated and followed for 3-year all-cause mortality. Between 1985 and 1997, age-adjusted CHD mortality rates in Minneapolis/St Paul fell 47% and 51% in men and women, respectively; the comparable declines in US whites were 34% and 29%. In-hospital mortality declined faster than out-of-hospital mortality. The rate of AMI (ICD-9 code 410) hospital discharges declined almost 20% between 1985 and 1995, whereas the discharge rate for unstable angina (ICD-9 code 411) increased substantially. The incidence of hospitalized definite AMI declined ≈10%, whereas recurrence rates fell 20% to 30%. Three-year case fatality rates after hospitalized AMI decreased consistently by 31% and 41% in men and women, respectively. In-hospital administration of thrombolytic therapy, emergency angioplasty, ACE inhibitors, β-blockers, heparin, and aspirin increased greatly. Conclusions —Declining out-of-hospital death rates, declining incidence and recurrence of AMI in the population, and marked improvements in the survival of AMI patients all contributed to the 1985 to 1997 decline of CHD mortality in the Minneapolis/St Paul metropolitan area. The effects of early and late medical care seem to have had the greatest contribution to rates during this time period.
Trends in Blood Pressure and Hypertension Detection, Treatment, and Control 1980 to 2009
Authors: Russell V. Luepker, Lyn M. Steffen, David R. Jacobs, Xia Zhou, Henry Blackburn
Journal: Circulation (2012)

Hypertension is common and treatable, but detection and control remain a major health challenge. This study sought to determine population trends in blood pressure and in the control of hypertension in the Minneapolis/St. Paul area (2010 population, 2.85 million) from 1980 to 2009.Surveys of risk factors were performed every 5 years among randomly selected adults aged 25 to 74 years. Data on hypertension knowledge and use of medications were collected by interview. Blood pressure was measured by standardized methods, with hypertension defined as blood pressure ≥140 mm Hg systolic and/or 90 mm Hg diastolic or controlled at <140 and/or 90 mm Hg with medications. Six surveys included 11 192 men and 12 795 women. Mean systolic blood pressure fell from 124.9 mm Hg in 1980 to 1982 to 121.1 mm Hg in 2007 to 2009 for men (P<0.0001) and from 120.1 to 114.7 mm Hg for women (P<0.0001). Similar trends for diastolic blood pressure were observed. The percentage of adults with uncontrolled blood pressure (≥140 and/or 90 mm Hg) with or without medication use fell from 20.3% to 5.8% (P<0.001) for men and from 13.1% to 2.7% (P<0.0001) for women. Antihypertensive medication use rose to >50% among all adults aged 55 to 74 years. Sixty-six percent of men and 72% of women with hypertension had their hypertension treated or controlled by 2007 to 2009. A majority of the decline in mean population blood pressure was the result of control with aggressive use of antihypertensive drugs. Stroke mortality in this population fell in parallel.The rate of hypertension detection and control in this community is among the highest observed in a US population and already exceeds Healthy People 2020 goals.
Bronchobiliary Fistula and Lithoptysis after Endoscopic Retrograde Cholangiopancreatography and Liver Biopsy in a Patient with Paroxysmal Nocturnal Hemoglobinuria
Authors: Jonathan M. Harnoss, Rex Yung, Robert A. Brodsky, Ralph H. Hruban, John K. Boitnott, David J. Murphy, Stephen C. Yang, Michael A. Choti
Journal: American Journal of Respiratory and Critical Care Medicine (2013)
General-practitioner Hospital Beds: A Review
Authors: S. Israel, P. Draper
Journal: BMJ (1971)

This paper reviews literature related to general-practitioner hospital beds. In England and Wales 21% of all maternity beds are controlled by general practitioners rather than consultants, and the proportion has increased considerably since 1955. Nearly one in five of these 21% are sited in the wards of a consultant hospital. General-practitioner beds, other than maternity, represent 3% of all hospital beds (excluding psychiatric beds) and this proportion has remained constant over the past 15 years. Only about 1% of these general-practitioner beds are located in a consultant hospital. In the discussion three questions are raised: Will general-practitioner inpatient care have a useful function in the future? What might that function be? Where should the care be located? The broader issue of the future role of the general practitioner needs to be considered before these questions can be satisfactorily answered. Unless a “hospital orientated” role of the general practitioner prevails there seems little place for practitioner inpatient care in urban areas. In the more rural areas, however, whatever the role of the practitioner becomes, certain groups of patients might advantageously receive inpatient care from their practitioners. Firmer answers to the questions raised cannot be given until a co-ordinated programme of research and development concerning different patterns of care is started.
"Morphinism Among Physicians."
Authors: T. D. Orothers
Journal: JAMA (1899)

Hartford, Conn., Nov. 11, 1899. <h3>To the Editor:</h3> A paper read recently before the New York State Medical Association on "Morphinism Among Physicians" (seeJournal, November 4, pp. 1165 and 1173), has created unusual interest, and brought me a very large correspondence relating to it. A number of critics have asserted, with hysterical dogmatism, that the statement that from 6 to 10 per cent. of all physicians used drugs and opium was gross exaggeration and untrue. An equal number of persons are confident that this is a minimum estimate, especially in certain sections of the country. In other localities it may seem unsupported by observation. In an eastern city of over five hundred physicians, over 20 per cent. used spirits and opium to excess, and yet a prominent physician in a newspaper interview asserted that not 2 per cent, were spirit or drug takers. While the study of 3244 physicians
862 THE IMPACT OF IL28B rs12979860 SNP ON THE ASSOCIATION BETWEEN TREATMENT DURATION AND SUSTAINED VIROLOGIC RESPONSE IN HIV/HCV COINFECTED PATIENTS
Authors: M. Mandorfer, T. Reiberger, B.A. Payer, K. Neukam, A. Rivero, M. Puoti, D. Ernst, C. Boesecke, A. Baumgarten, J. Jaroszewicz, A. Grzeszczuk, R. Zangerle, D. Meyer-Olson, J.K. Rockstroh, P. Ferenci, A. Rieger, J.A. Pineda, M. Peck-Radosavljevic
Journal: Journal of Hepatology (2013)
Adolescent-onset ichthyosiform-like erythroderma with lichenoid tissue reaction: a new entity?
Authors: B. Mevorah, M. Landau, A. Gat, P. De Viragh, S. Brenner
Journal: British Journal of Dermatology (2001)

A patient with severe ichthyosiform erythroderma and lichenoid histological changes is presented. We discuss the clinical and histological differential diagnosis, including lupus erythematosus, lichenoid drug eruption, lichen planus, graft-versus-host disease, lymphoma, keratosis lichenoides chronica, Netherton's syndrome and ichthyosiform erythroderma. None of these is consistent with the features in our case, which may represent either a hitherto unreported form of ichthyosiform erythroderma or possibly a new entity.
193 Carbon monoxide-mediated activation of large conductance calcium-activated potassium channels contributes to mesenteric vasodilatation in cirrhotic rats with ascites
Authors: M. Bolognesi, D. Sacerdoti, A. Piva, M. Di Pascoli, S. Quarta, R. Motterlini, P. Angeli, C. Merkel, A. Gatta
Journal: Journal of Hepatology (2006)
The Trial of the Assassin Guiteau: Psychiatry and Law in the Gilded Age
Authors: Paul Chodoff
Journal: JAMA (1990)

On July 2, 1881, as President James A. Garfield entered the almost deserted Baltimore & Potomac railway station in Washington, DC, embarking on a vacation, he was set upon by one Charles Julius Guiteau, who fired two bullets into the President's back. Guiteau's professed motive was a divinely inspired mission to save the country from great political turmoil and possible civil war. Mortally wounded, Garfield lingered until September 17. The trial of the assassin followed, and its ramifications in mid-19th-century society are the subject of Charles E. Rosenberg's vivid, informative, and interesting book.  The trial began on November 14, 1881. It fascinated the American public—both the spectators who crowded the courtroom and those throughout the country who read about it in newspaper accounts, pamphlets, and Guiteau's own broadsides. The only defense and the only issue was the relationship of Guiteau's mental state to the crime he had committed, and in
Accurate prediction of death by serial determination of galactose elimination capacity in primary biliary cirrhosis: A comparison with the mayo model
Authors: Jürg Reichen, Thomas Widmer, Jacques Cotting
Journal: Hepatology (1991)

We retrospectively analyzed the predictive accuracy of serial determinations of galactose elimination capacity in 61 patients with primary biliary cirrhosis. Death was predicted from the time that the regression line describing the decline in galactose elimination capacity vs. time intersected a value of 4 mg.min-1.kg-1. Thirty-one patients exhibited decreasing galactose elimination capacity; in 11 patients it remained stable and in 19 patients only one value was available. Among those patients with decreasing galactose elimination capacity, 10 died and three underwent liver transplantation; prediction of death was accurate to 7 +/- 19 mo. This criterion incorrectly predicted death in two patients with portal-vein thrombosis; otherwise, it did better than or as well as the Mayo clinic score. The latter was also tested on our patients and was found to adequately describe risk in yet another independent population of patients with primary biliary cirrhosis. Cox regression analysis selected only bilirubin and galactose elimination capacity, however, as independent predictors of death. We submit that serial determination of galactose elimination capacity in patients with primary biliary cirrhosis may be a useful adjunct to optimize the timing of liver transplantation and to evaluate new pharmacological treatment modalities of this disease.
Abstract 5448: Common targets of epigenetic dysfunction in distinct target tissues of arsenic and cadmium induced malignant transformation
Authors: Paul L. Severson, Erik J. Tokar, Lukas Vrba, Michael P. Waalkes, Bernard W. Futscher
Journal: Cancer Research (2012)

Abstract Arsenic and cadmium are known human carcinogens and rank as number one and seven respectively on the Agency for Toxic Substances and Disease Registry (ATSDR) substance priority list. Accumulating evidence suggests that long-term exposure to arsenic or cadmium induces epigenetic dysfunction and this effect may be an important aspect of their carcinogenic activity. To this end we analyzed the epigenetic dysfunction associated with arsenic or cadmium induced malignant transformation of immortalized urothelial and prostate epithelial cells. Using methyl-DNA immunoprecipitations coupled to human promoter microarrays as well as Sequenom MassArray, we found that arsenic and cadmium mediated malignant transformation of immortalized urothelial and prostate epithelial cells produced thousands of DNA methylation changes. Many of the DNA hypermethylation events appear to be localized to individual genes whereas others cluster into groups that are within large genomic regions on the order of 100kb. Significant aggregates of DNA hypermethylation events occur within the protocadherin and HOX gene clusters. Intersecting the arsenic induced hypermethylation events from the two distinct models results in an overlap of 113kb of DNA which represents roughly 100 genes. This overlap is significantly more than expected by chance, suggesting these genes are targeted for aberrant DNA methylation in both models of arsenic induced malignant transformation. A similar result is seen in the cell lines transformed by cadmium, and the cadmium induced DNA hypermethylation events are highly concordant with the hypermethylation profiles induced by arsenic. Most of the DNA hypermethylated regions found in the arsenic or cadmium transformed cells are also targets of aberrant DNA hypermethylation in human bladder tumors. Comparing the hypermethylated regions from our models to publicly available H3K27me3 ChIP-seq data from embryonic stem cells revealed that the targets of DNA hypermethylation fall disproportionately within H3K27me3 domains of human stem cells. H3K27me3 chromatin immunoprecipitations coupled to real-time PCR confirmed that the promoters of candidate genes NPR3 and LTK are marked with H3K27me3 in normal and immortalized cells before becoming DNA hypermethylated in the arsenic transformed cells. This H3K27me3 data supports the previously discovered association between H3K27me3 marked regions of normal cells and DNA hypermethylation in malignant cells. All together, these observations suggest commonality in the mechanisms of epigenetic change induced by carcinogenic metals. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5448. doi:1538-7445.AM2012-5448
Khalil Zarroug Aburugba
Authors: Omar Zarroug Abdelkafi
Journal: BMJ (2004)

Consultant orthopaedic surgeon Misurata Teaching Hospital, Misurata, Libya (b Misurata, Libya, 1951; q Garyounis Medical School, Benghazi, Libya, 1977; FRCSI), died from complications of chronic renal failure on 28 September 2003.​2003.




Figure 1




Khalil worked as a senior house officer in general surgery in Benghazi, Libya, before coming to London in 1980 for postgraduate training in surgery. After obtaining his primary FRCS, he moved to Ireland in 1983, where he completed his FRCS and spent a few years working in general surgery and orthopaedics. In 1990 he returned to his home town, Misurata, where he was appointed as a consultant orthopaedic surgeon and head of the orthopaedic department. He leaves a wife and eight children.
Diminished Blood Flow and Oxygen Deprivation as Principal Factors in Progression of Shock.
Authors: Arthur C. Guyton
Journal: Annals of Internal Medicine (1964)

s1 October 1964Diminished Blood Flow and Oxygen Deprivation as Principal Factors in Progression of Shock.Arthur C. Guyton, M.D.Arthur C. Guyton, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-4-798_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMany different research workers in the field of shock have recently come to the conclusion that one of the major factors that causes progression of shock is the deprivation of oxygen to the tissues resulting from diminished blood flow. This concept is supported by two primary types of evidence as follows: First, transport of oxygen to the tissues is even normally nearly "flow-limited." That is, a slight diminishment in cardiac output immediately begins to decrease the amount of oxygen used by the body. Thus, a 25% diminishment in cardiac output causes about 10% decrease in oxygen utilization; 50% decrease in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Arthur C. Guyton, M.D.Affiliations: Jackson, Miss. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1964Volume 61, Issue 4Page: 798-798KeywordsBlood flowCardiac outputOxygenShock ePublished: 1 December 2008 Issue Published: 1 October 1964 PDF downloadLoading ...