tbuckley/cabot-search huggingface dataset:
Prediction of recurrent choledocholithiasis by quantitative cholescintigraphy in patients after endoscopic sphincterotomy
Authors: K H Lai, N J Peng, G H Lo, J S Cheng, R L Huang, C K Lin, J S Huang, H T Chiang, L P Ger
Journal: Gut (1997)

Background —Endoscopic sphincterotomy (EST) is widely used for the removal of stones from the bile duct, but stones recur in about one fifth of patients. Aims —To investigate hepatic clearance by quantitative cholescintigraphy (QC) in patients after EST and to discern the relationship between biliary emptying and stone recurrence. Methods —One hundred and forty nine patients who had EST and clearance of the bile duct for choledocholithiasis were selected. All patients were confirmed to have complete EST by sphincter of Oddi manometry and underwent QC soon after normalisation of liver function. Regular clinical follow up was performed for each patient. Results —During a mean 36 month follow up, 22 (14.8%) patients developed recurrent stones in the bile duct. Irrespective of the status of the gall bladder, patients with recurrent stones had a slower hepatic clearance of radioisotope during QC compared with patients without stone recurrence, but only the differences in cholecystectomised patients had statistical significance. After carrying out multivariate analysis, one parameter of QC, percentage clearance of maximal count at 45 minutes, was found to be the only significant factor for stone recurrence. All recurrent stones in the common bile duct were successfully removed at endoscopy. Conclusion —Slower hepatic clearance as shown by QC is an important factor responsible for stone recurrence after sphincter ablation.
Erythropoietin Induces Neovascularization and Improves Cardiac Function in Rats With Heart Failure After Myocardial Infarction
Authors: Peter van der Meer, Erik Lipsic, Robert H. Henning, Kristien Boddeus, Jolanda van der Velden, Adriaan A. Voors, Dirk J. van Veldhuisen, Wiek H. van Gilst, Regien G. Schoemaker
Journal: Journal of the American College of Cardiology (2005)
Errors in using clinical thermometers.
Authors: D N Coggon, M P Vessey
Journal: BMJ (1976)

Antinuclear antibodies and the rheumatoid factor in cases of asbestosis probably result from the pulmonary lesions and are not evidence of an autoimmune mechanism in the pathogenesis of the disease.Another probable explanation of the negative finding in our cases is that antophyllite, owing to its different physicochemical structure, causes less destruction of lung tissue than other asbestos materials.
Newborns Do Secrete Tears
Authors: Leonard Apt, Bruce F. Cullen
Journal: JAMA (1964)

FOR YEARS there has been a general belief that newborn infants do not secrete tears. In the latest editions of the standard pediatric texts,<sup>1,2</sup>authors state that lacrimation is absent or minimal during the first few weeks of life. Many ophthalmologists are of the same opinion, based solely on an impression gained from the literature or from clinical teaching. Little definitive experimental work, however, has been done on the subject. The validity of this prevailing clinical impression was questioned for several reasons. First, newborn infants on inspection appear to have a moistened conjunctiva. Secondly, they rarely have the complications of the cornea and conjunctiva which are usually associated with deficient lacrimation. This study, using a simple quantitative test for tear secretion (Schirmer Test I ), was undertaken to determine: (1) whether newborn infants secrete tears, ( 2 ) if there is a pattern in the amount of tear secretion during the first
CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. XXXVII. THE METAL-COMBINING GLOBULIN OF HUMAN PLASMA 1
Authors: Douglas M. Surgenor, Bernard A. Koechlin, Laurence E. Strong
Journal: Journal of Clinical Investigation (1949)

The separation of the proteins of human plasma into a series of fractions and subtractions, uniform with respect to certain physical properties, has gen- erally led also to the separation of proteins with respect to their chemical and biological properties.Among the properties that have long been recog- nized has been the binding of metals by the plasma so that the metals were no longer freely dialyzable (1).When plasma fractionation was undertaken, early in the war, the Committee on Blood Substitutes of the National Research Council were informed that "investigations of the distribution of . . .metals known to be combined with proteins in the blood, such as copper, zinc, and iron, are planned and will be subsequently reported, as will studies upon the hormones and other physiologically important components of human plasma for which methods of bio-assay are available.We feel keenly that these should now be studied in the large amounts of human plasma fractions becom- ing available as by-products of the preparation of human albumin for transfusion in shock" (2).
The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide
Authors: F A Houssiau, C Vasconcelos, D D’Cruz, G D Sebastiani, E de Ramon Garrido, M G Danieli, D Abramovicz, D Blockmans, A Cauli, H Direskeneli, M Galeazzi, A Gül, Y Levy, P Petera, R Popovic, R Petrovic, R A Sinico, R Cattaneo, J Font, G Depresseux, J-P Cosyns, R Cervera
Journal: Annals of the Rheumatic Diseases (2009)

Objective: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomised prospective trial comparing low-dose (LD) and high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis. Patients and methods: Data for survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomised in the ELNT, except in 6 lost to follow-up. Results: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed. Conclusion: The data confirm that a LD IVCY regimen followed by AZA—the “Euro-Lupus regimen”—achieves good clinical results in the very long term.
Consultants' pay goes up, but productivity goes down, MPs told
Authors: Andrew Cole
Journal: BMJ (2006)

UK consultants are being paid more as a result of their new NHS contracts, but productivity has probably diminished, the House of Commons health select committee, examining workforce planning, heard this week.

Professor Alan Craft, chairman of the Academy of Medical Royal Colleges, explained that the contract had helped highlight the huge amount of overtime most consultants were working.

“Most consultants were probably working 60 hours a week. The standard has now gone down to 10 sessions, which is less than 40 hours. Employers have been working towards reducing everybody to the minimum number of contracted hours. So …
Abstract 1772: PDL192, a humanized anti-Tweak receptor monoclonal antibody, mediates antitumor effects in primary human breast carcinoma xenografts
Authors: Ludmilla De Plater, Anne Vincent-Salomon, Patricia Culp, André Nicolas, Eléonore Gravier, Franck Assayag, Ahmed Dahmani, Clément Elbaz, Debra Chao, Daniel Afar, Véronique Diéras, Didier Decaudin
Journal: Cancer Research (2011)

Abstract Background: PDL192 is a humanized IgG1 monoclonal antibody that binds the human TWEAK receptor (TweakR). TweakR, a member of the TNFR (Tumor Necrosis Factor Receptor) superfamily, is overexpressed in several human cancers including breast cancer (BC). In BC, it may also play a role in the invasive and metastatic potential of the disease (Willis et al, Mol Cancer Res 2008). In TweakR-expressing cancer cell lines or mouse xenograft models, PDL192 has a potent antitumor effect (Culp et al., CCR 2010). All these data therefore suggest that anti-TweakR targeting could be a promising new therapeutic approach for human BC patients. Material and methods: TweakR expression was assessed by IHC (immunohistochemistry) on 3 Tissue-Micro-Array (TMA) banks of BC samples (basal-like, ERBB2, and luminal A/B), and 25 primary human BC xenografts (HBCx). The cut-off of positivity was defined as at least 25% cells with membraneous or cytoplasmic staining or by a combined score of percentage of positive staining cells x intensity &amp;gt; 50. The in vivo antitumor effect of PDL192 was then assessed on 7 TweakR-positive models (10 mg/kg thrice a week for 3 weeks by intraperitoneal route) in which one in combination with chemotherapy as maintenance therapy, as previsouly reported (Marangoni et al., BJC 2009). Results: TMA analyses showed that TweakR was expressed in 16/37 basal like BC (43%), 23/37 ERBB2-positive BC (62%), and 38/71 luminal BC (54%). A high TweakR expression was correlated with double estrogen receptor- and Her2-positive tumors. Moreover, 13/25 xenografts have been found to be TweakR-positive (52%). Nine human BC models have been treated with PDL192, with 4 models (44%) showing a tumor growth inhibition (TGI) ranging between 59% and 91%. No correlation has been observed between TweakR expression and in vivo TGI. Moreover, when PDL192 was administered in complete remission after chemotherapy (doxorubicin + cyclophosphamide), we observed a highly significant delay of relapse greater than 2 months. Conclusions: TweakR is expressed in 77/145 human BC samples (53%). In in vivo experiments, PDL192 showed potent TGI in 4/9 models, and significantly delayed tumor relapses after chemotherapy-induced complete remission. All these data therefore support the use of anti-TWEAK receptor monoclonal antibodies in the treatment of TweakR-positive BC patients. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1772. doi:10.1158/1538-7445.AM2011-1772
M27 Should there be a Respiratory-specific Modified Early Warning Score?: Abstract M27 Table 1.
Authors: H Finnamore, M Pritchard, O Abdul Kadhir, J Mayer, J Bannon, H Burhan
Journal: Thorax (2013)

<h3>Introduction</h3> The Modified Early Warning Score (MEWS) was developed and validated as an objective scoring system to aid healthcare staff in identifying patients at risk of “catastrophic deterioration” in the acute hospital setting<sup>(1)</sup>. At the Royal Liverpool and Broadgreen University Hospitals NHS Trust (RLBUHT), the Acute Response Team (ART) is led by advanced nurse practitioners, who respond to calls when patients have a MEWS of 4 or more. It was noted that a large proportion of calls were to respiratory patients, many requiring no intervention. <h3>Methods</h3> Details of every ART call to medical patients throughout 2012 (n = 883) were recorded on clinical proforma and collated on an Excel database. Data were analysed using STATA 12, as part of a service evaluation. Outcomes measured were: numbers of ART calls made to respiratory and remaining medical wards, numbers of Do Not Attempt Resuscitation (DNAR) orders in place, MEWS, investigations performed by the ART, critical care transfer and the 7 and 30 day mortality. <h3>Results</h3> The 53 respiratory beds account for only 14% of the medical bed-base but generated 25% of ART calls. Respiratory patients scored more highly on respiratory rate (RR) and oxygen saturations (SpO<sub>2</sub>) MEWS parameters than other medical patients. ART investigation rates were similar in all patients but only 1% were transferred from respiratory to critical care. There were more DNAR orders and both 7 and 30 day mortality were higher on the respiratory wards (see Table 1). <h3>Discussion</h3> Many respiratory patients score highly on RR and SpO<sub>2</sub> MEWS parameters due to their chronic disease. The increased use of DNAR orders in respiratory patients reflects a greater burden of chronic disease and therefore a poorer prognosis. This may explain the low rates of transfer to critical care and high mortality rates. We suggest a respiratory-specific MEWS may reduce ART calls to stable respiratory patients and, for respiratory patients with DNAR orders, automatic exemption from ART calls should be considered. <h3>References</h3> Subbe, Kruger and Rutherford. <i>QJM</i> (2001) 94 (10): 521–526.
Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure
Authors: Rajiv Jalan, Faouzi Saliba, Marco Pavesi, Alex Amoros, Richard Moreau, Pere Ginès, Eric Levesque, Francois Durand, Paolo Angeli, Paolo Caraceni, Corinna Hopf, Carlo Alessandria, Ezequiel Rodriguez, Pablo Solis-Muñoz, Wim Laleman, Jonel Trebicka, Stefan Zeuzem, Thierry Gustot, Rajeshwar Mookerjee, Laure Elkrief, German Soriano, Joan Cordoba, Filippo Morando, Alexander Gerbes, Banwari Agarwal, Didier Samuel, Mauro Bernardi, Vicente Arroyo
Journal: Journal of Hepatology (2014)
Cases of Attempted Suicide Admitted to a General Hospital
Authors: J. A. Harrington, K. W. Cross
Journal: BMJ (1959)

MYOCARDIAL INFARCTIONBam 463 together with the secondary rise of the aldolase at about five days after its primary peak, and the increasing value of the serum oxidase seem to be characteristic of cardiac infarction.Secondly, in late diagnosis where the patient comes under observation some time after the infarct, the serum transaminases may have returned to normal.Here the diagnosis may be established by finding the secondary peak of the serum aldolase and by the increasing level of the serum oxidase.Thirdly, in prognosis the quicker return of the serum aldolase level to normal may be of aid in assessing the severity of the infarct whilst the transaminases are still elevated.The peak of the aldolase in second infarcts is also more obvious because of this.Summary Serial daily estimations of serum glutamic pyruvic transaminase (S.G.P.T.), serum aldolase, and serum oxidase for at least 10 days have been made in a series of cases of acute myocardial infarction.The results have been compared with similar estimations of serum glutamic oxalacetic transaminase (S.G.O.T.) and with the erythrocyte sedimentation rate (E.S.R.), temperature, and electrocardiogram.Estimations of these enzymes have been made in 50 healthy adults.The upper limit of normal (mean plus twice the standard deviation) in the present series is S.G.O.T. 28 units, S.G.P.T. 21 units, serum aldolase 9.2 units, and serum oxidase 372 units.Elevation of S.G.P.T. occurs in 82% of cases of myocardial infarction with a raised S.G.O.T. Tfhe rise occurs a day later, lasts a day longer, and is of much smaller degree than the rise in S.G.O.T.Serum aldolase rises rapidly in almost all cases of acute myocardial infarction.It reaches a peak in two to three days and falls rapidly.A secondary rise occurs about five days after the initial peak.Serum oxidase rises gradually over the first nine days, may remain steady for a few days, and then falls to normal in most cases by the end of three weeks.There is no direct correlation with S.G.O.T. levels, and serum oxidase may remain normal with markedly elevated S.G.O.T. levels.There is no consistent correlation between the E.S.R., temperature, or electrocardiogram and the secondary rise in serum aldolase or the rise in serum oxidase.Coronary insufficiency without infarction does not alter the level of S.G.O.T. or S.G.P.T.Elevations of S.G.O.T., S.G.P.T., serum aldolase, and serum oxidase may occur in cardiac failure with centrilobular necrosis of the liver.The clinical use of these enzyme estimations is discussed.We thank Dr.
Stafford Hospital receives formal warning from regulator
Authors: C. Dyer
Journal: BMJ (2011)

Stafford Hospital, found to have “appalling” standards of care by a Healthcare Commission investigation in 2009, has received a formal warning from regulators that staff shortages could still be endangering the safety and welfare of patients in the accident and emergency department.

The warning from the Care Quality Commission (CQC) comes just days after the public inquiry into lessons to be learnt from the failings at the hospital finished taking evidence.

The CQC delivered the warning after two unannounced inspections last month “following information that had come to light from the trust itself.” Unless …
Prognosis of acute severe autoimmune hepatitis (AS-AIH): The role of corticosteroids in modifying outcome
Authors: Andrew D. Yeoman, Rachel H. Westbrook, Yoh Zen, William Bernal, Thawab Al-Chalabi, Julia A. Wendon, John G. O’Grady, Michael A. Heneghan
Journal: Journal of Hepatology (2014)
PSA Failure Following Definitive Treatment of Prostate Cancer Having Biopsy Gleason Score 7 With Tertiary Grade 5
Authors: Abhijit A. Patel, Ming-Hui Chen, Andrew A. Renshaw, Anthony V. D’Amico
Journal: JAMA (2007)

In 2005, the International Society of Urologic Pathology consensus conference recommended that men with biopsy Gleason score 3 + 4 or 4 + 3 prostate cancer and tertiary pattern 5 should have their cancer classified as Gleason score 8 or 9, respectively. Yet, the management of men with Gleason score 7 vs 8 or 9 prostate cancer differs.To compare the prognostic significance of Gleason score 7 with tertiary grade 5 vs other Gleason scores with respect to time to prostate-specific antigen (PSA) failure in men with prostate cancer.From 1989 to 2005, 2370 men with clinical tumor category 1c to 3b, node-negative, and nonmetastatic prostate cancer underwent definitive therapy with surgery or radiation therapy with or without hormonal therapy. A pathologist with expertise in genitourinary cancers assigned Gleason scores to the prostate needle biopsy specimens. Cox regression was used to assess whether a significant association existed between the presence of tertiary grade 5 in men with Gleason score 7 disease and time to recurrence compared with men with Gleason score 7 without tertiary grade 5, Gleason score 5 to 6, or 8 to 10 disease, adjusting for known prognostic factors and treatment.Time to PSA failure.Men with Gleason score 7 and tertiary grade 5 disease had a significantly shorter time to PSA failure than men with 7 without tertiary grade 5 (median time, 5.0 vs 6.7 years, respectively; adjusted hazard ratio (HR), 0.56; 95% confidence interval [CI], 0.32-0.97; P = .04) or score of 6 or less (median time, 15.4 years; adjusted HR, 0.24; 95% CI, 0.13-0.43; P < .001). However, a significant difference was not observed when these men were compared with men with Gleason score 8 to 10 disease (median time, 5.1 years; adjusted HR, 0.96; 95% CI, 0.54-1.71; P = .90).In this study population, men with prostate cancer having biopsy Gleason score 7 and tertiary grade 5 had a higher risk of PSA-failure when compared with men with Gleason score 7 without tertiary grade 5 and had a comparable risk with men with Gleason score 8 to 10.
EVEROLIMUS-ELUTING VERSUS SIROLIMUS-ELUTING STENTS IN DIABETIC AND NONDIABETIC PATIENTS
Authors: Duk-Woo Park, chang hoon Lee, Gyung-Min Park, Yong-Giun Kim, Ki Won Hwang, Jung-Min Ahn, Hae Geun Song, Won-Jang Kim, Jong-Young Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2011)
Nicardipine and Urinary Retention
Authors: J. C. Eicher
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Williams and Donaldson<sup>1</sup>reported nifedipine (Procardia)— induced nocturia in men with enlarged prostates. We have seen three patients who had urination disorders when taking nicardipine (Loxen), another dihydropyridine. <h3>Report of Cases.—</h3> A man had been anuric for 18 months and regularly underwent hemodialysis. He began taking nicardipine, 20 mg three times a day, for hypertension. One month after beginning this treatment he was admitted to the hospital with lower abdominal pain. Physical examination revealed bladder distention and benign prostatic hypertrophy. Bladder catheterization allowed evacuation of 2 L of urine. He then underwent prostatectomy, but never urinated again! Two women taking nicardipine, 20 mg three times a day, for hypertension developed urinary retention 36 hours after beginning treatment. One needed bladder catheterization. After withdrawal of drug therapy, urination normalized. Another trial of nicardipine was performed in one patient but the problem did not recur. <h3>Comment.—</h3> Calcium entry
THE SURGICAL CONCEPTION OF PYLORIC OBSTRUCTION.
Authors: H. D. NILES
Journal: JAMA (1903)

Until within the past few years pyloric obstruction was regarded as due either to cancer so situated and so advanced as to render its removal impossible or excessively hazardous, or to a non-malignant pathology usually so obscure and so difficult to diagnose as to make any attempt at surgical interference uncertain and unjustifiable. Hence, surgeons were rarely encouraged to seriously consider operative procedures in stenosis of the pyloric orifice, and the victims of this condition were, with a few exceptions, permitted to die or to drift into chronic invalidism without a single rational effort being made to remove or correct the causative pathology. It has been only within the past decade that the advances made in the surgery of the upper half of the abdomen and of the stomach in particular have inspired us with a new confidence, and given us a much clearer and more practical idea of this
Abstract 3435: GeneChip Analyses Identify Bone Marrow Cells as a Rich Source of Paracrine Factors: Insight From the BOOST Study Program
Authors: Mortimer Korf-Klingebiel, Thomas Sauer, Tibor Kempf, Helmut Drexler, Kai C Wollert
Journal: Circulation (2007)

It has been hypothesized that the improvement of left ventricular function observed after intracoronary bone marrow cell (BMC) transfer in patients with STEMI is related in part to paracrine effects. RNA was prepared from BMC that were obtained from patients with STEMI (n=3) included in the ongoing multicenter BOne marrOw transfer to enhance ST-elevation infarct regeneration (BOOST)-2 trial. Peripheral blood leukocyte (PBL) RNA was obtained from the same 3 patients. GeneChip analyses (Affymetrix HG-U133 Plus 2.0, ca. 47000 probe sets) were performed to characterize the transcriptome in BMC vs. PBL. Using GeneSpring software 7.2, we identified 56 secreted factors that were more strongly expressed (&gt;2-fold) in BMC as compared to PBL. In a second microarray (RNA from n=3 additional patients), 41 of these factors were confirmed. Twelve of these 41 factors were chosen for independent validation by real-time PCR using RNA from 6 additional patients; overexpression in BMC vs. PBL was confirmed for each of these 12 factors. Several factors overexpressed in BMC represented putative cardioprotective cytokines (e.g., BMP-2, CT-1, IGF-1, SDF-1α, VEGF-A). BMC from 7 additional patients were cultured for 24h in serum-free DMEM medium. Conditioned supernatants (SN) were filtered and pooled. BMC-SN (10μL/mL) reduced apoptotic cell death in neonatal rat ventricular cardiomyocytes exposed to simulated ischemia (3h) and reperfusion (1h), as shown by TUNEL (62 ± 7% vs. control, i.e. treatment with unconditioned DMEM medium; n=7; P&lt;0.05) and histone-ELISA (69 ± 12% vs. control; n=5; P&lt;0.05). Moreover, BMC-SN stimulated human umbilical vein endothelial cell (HUVEC) migration (transwell chambers; 293 ± 55% vs. control; n=5; P&lt;0.01) and in-matrigel tube formation (tubular length, 275 ± 35% vs. control; n=5; P&lt;0.05; tube/branch point ratio, 156 ± 10% vs. control; n=5; P&lt;0.05). Finally, BMC-SN promoted enhanced endothelial cell sprouting in the mouse aortic ring assay ex vivo. In conclusion, BMC obtained from patients with STEMI are a rich source of secreted factors. Conditioned BMC supernatants protect cardiomyocytes from I/R-induced apoptosis, and promote pro-angiogenic effects in vitro. Our data tend to support the paracrine hypothesis.