tbuckley/cabot-search huggingface dataset:
Macrosomia in Pregnancy Complicated by Insulin-Dependent Diabetes Mellitus
Authors: Michael Small, Alan Cameron, C Burnett Lunan, Angus C MacCuish
Journal: Diabetes Care (1987)

We assessed the factors influencing the birth weight of infants born to 83 women with insulin-dependent diabetes mellitus (IDDM) over a 5-yr period. Maternal glycosylated hemoglobin (HbA1) concentrations at delivery correlated with the percentile birth-weight ratios (r = .43, P less than .001) and indicated that approximately 18% of variance in the birth weight could be ascribed to glycemic control in the third trimester. Fetal macrosomia occurred in 22 (27%) pregnancies. When 20 of these pregnancies were compared closely with 20 nonmacrosomic pregnancies in diabetic women, the mothers of macrosomic infants were found to be more obese, have a history of previous macrosomic birth, and have higher concentrations of serum human placental lactogen and urinary estriols in the third trimester. Macrosomic pregnancy was further distinguished by accelerated fetal growth (judged by serial ultrasonography) from the 32nd wk of gestation and by biochemical (but asymptomatic) hypoglycemia in the neonate. In our study, no serious neonatal morbidity could be attributed to macrosomic pregnancy. Good glycemic control was attained in both groups, and no significant differences between the groups in overall glycemic control throughout pregnancy were noted. Thus, despite good glycemic control, macrosomia remains comparatively common in modern pregnancy complicated by IDDM, and factors other than maternal hyperglycemia must contribute to its etiology.
Serious gaps in care of the elderly.
Authors: A. Roberts
Journal: BMJ (1989)

initial removal has been incomplete.The half life of parathyroid hormone is three to four minutes,34 and so it disappears rapidly from serum after successful parathyroidectomy.Results can be available within one hour.Even in mild hyperparathyroidism there is considerable mortality and morbidity.'Surgical re-exploration of Dr Sultan and colleagues' second patient with serum parathyroid hormone measure- ments would be appropriate.
Transvenous Retrieval of Foreign Bodies in the Cardiac Circulation
Authors: Peter C. Block
Journal: JAMA (1973)

A series of six patients had foreign bodies (sheared or broken intravenous lines) lying free in the circulation. "Nonsurgical" transvenous removal was accomplished successfully using a wire snare. Sites of foreign body embolism and subsequent removal included the superior vena cava, the right atrium, the right ventricle, and the pulmonary artery.
Effect of highly selective vagotomy on pancreatic exocrine function and on cholecystokinin and gastrin release.
Authors: N I Ramus, R C Williamson, J M Oliver, D Johnston
Journal: Gut (1982)

The effect of highly selective vagotomy on pancreatic exocrine function and the release of gastrin and cholecystokinin was studied in 10 patients with endoscopically-proven duodenal ulceration. Cholecystokinin and gastrin concentrations in serum both increased significantly after highly selective vagotomy. Amylase concentration in the duodenal aspirate increased significantly after vagotomy, but trypsin concentration remained unchanged. The expected reductions in gastric acid secretion were noted. Thus highly selective vagotomy reduces acid secretion effectively in patients with duodenal ulcer without impairing the exocrine function of the pancreas.
Biliary Leak in a Child After Liver Transplant and Value of Delayed Images
Authors: Nina Mortazavi, Philippe Chauffet-Riffaud, Frédérique Archambaud, Alain Prigent
Journal: Clinical Nuclear Medicine (2008)

A 2-year-old child underwent liver transplant and was referred for postsurgical abdominal pain. Hepatobiliary scintigraphy with Tc-99m iminodiacetic acid (IDA) was performed and with the help of 24-hour delayed images, the diagnosis of biliary leak at the site of anastomosis was made possible. This case report confirms the value of delayed images to facilitate the diagnosis in unequivocal situations and reminds us of the usefulness of this noninvasive method, especially in pediatrics.
Pharmacokinetics of long-term sufentanil infusion for sedation in ICU patients
Authors: Frédéric Ethuin, Said Boudaoud, Isabelle Leblanc, Christian Troje, Olivier Marie, Jean-Claude Levron, Jean-Pierre Le Moing, Patrice Assoune, Benoit Eurin, Laurent Jacob
Journal: Intensive Care Medicine (2003)
Influence of Physician Confidentiality Assurances on Adolescents' Willingness to Disclose Information and Seek Future Health Care
Authors: Carol A. Ford
Journal: JAMA (1997)

Adolescents' concerns about privacy in clinical settings decrease their willingness to seek health care for sensitive problems and may inhibit their communication with physicians.To investigate the influence of physicians' assurances of confidentiality on adolescents' willingness to disclose information and seek future health care.Randomized controlled trial.Three suburban public high schools in California.The 562 participating adolescents represented 92% of students in mandatory classes.After random assignment to 1 of 3 groups, the adolescents listened to a standardized audiotape depiction of an office visit during which they heard a physician who assured unconditional confidentiality, a physician who assured conditional confidentiality, or a physician who did not mention confidentiality.Adolescents' willingness to disclose general information, willingness to disclose information about sensitive topics, intended honesty, and likelihood of return visits to the physician depicted in the scenario were assessed by anonymous written questionnaire.Assurances of confidentiality increased the number of adolescents willing to disclose sensitive information about sexuality, substance use, and mental health from 39% (68/175) to 46.5% (178/383) (beta=.10, P=.02) and increased the number willing to seek future health care from 53% (93/175) to 67% (259/386) (beta=.17, P<.001). When comparing the unconditional with the conditional groups, assurances of unconditional confidentiality increased the number of adolescents willing to return for a future visit by 10 percentage points, from 62% (122/196) to 72% (137/190) (beta=.14, P=.001).Adolescents are more willing to communicate with and seek health care from physicians who assure confidentiality. Further investigation is needed to identify a confidentiality assurance statement that explains the legal and ethical limitations of confidentiality without decreasing adolescents' likelihood of seeking future health care for routine and nonreportable sensitive health concerns.
FDA approves silicone breast implants 14 years after their withdrawal
Authors: Janice Hopkins Tanne
Journal: BMJ (2006)

Silicone gel filled breast implants have been approved by the US Food and Drug Administration for use in women aged 22 years or older for cosmetic purposes and for reconstruction after breast cancer surgery or in women with traumatic or congenital breast defects. 

Silicone implants are said to be softer and feel more natural than implants filled with saline, which has been the only kind available for 14 years in the United States, since silicone implants were taken off the market. 

However, the FDA cautioned, “Breast implants are not lifetime devices and a woman will likely need additional surgeries on her breast at least once over her lifetime; many of the …
Current concepts in metastasis.
Authors: A K Nigam, M Pignatelli, P B Boulos
Journal: Gut (1994)

Metastasis remains an important clinical problem.In gastrointestinal cancers it is the single most important determinant of death.The incidence of metastatic disease from colorectal cancer at presentation is 25%.'Even after curative surgical resection the five year sur- vival rate is no more than 50% with an overall five year survival rate for colorectal cancer of TABLE I Majorfamilies of adhesion molecules Integrins"3 a,P heterodimers 14sx and 81B unitsCadherins14 E-epithelial, N-neural, P-placental, V and T-cadherins Ig Superfamily'5ICAM-1 and 2, V-CAM, Li, N-CAM, CEA, LFA-3 and others Selectins (Lecams) 15 3 identified, E, L and P-selectins 13-15Shows relevant references.
Transmission of Human Herpesvirus 8 by Blood Transfusion
Authors: Wolfgang Hladik, Sheila C. Dollard, Jonathan Mermin, Ashley L. Fowlkes, Robert Downing, Minal M. Amin, Flora Banage, Esau Nzaro, Peter Kataaha, Timothy J. Dondero, Philip E. Pellett, Eve M. Lackritz
Journal: New England Journal of Medicine (2006)

Whether human herpesvirus 8 (HHV-8) is transmissible by blood transfusion remains undetermined. We evaluated the risk of HHV-8 transmission by blood transfusion in Uganda, where HHV-8 is endemic.We enrolled patients in Kampala, Uganda, who had received blood transfusions between December 2000 and October 2001. Pretransfusion and multiple post-transfusion blood specimens from up to nine visits over a 6-month period were tested for HHV-8 antibody. We calculated the excess risk of seroconversion over time among recipients of HHV-8-seropositive blood as compared with recipients of seronegative blood.Of the 1811 transfusion recipients enrolled, 991 were HHV-8-seronegative before transfusion and completed the requisite follow-up, 43% of whom received HHV-8-seropositive blood and 57% of whom received seronegative blood. HHV-8 seroconversion occurred in 41 of the 991 recipients. The risk of seroconversion was significantly higher among recipients of HHV-8-seropositive blood than among recipients of seronegative blood (excess risk, 2.8%; P<0.05), and the increase in risk was seen mainly among patients in whom seroconversion occurred 3 to 10 weeks after transfusion (excess risk, 2.7%; P=0.005), a result consistent with the transmission of the virus by transfusion. Blood units stored for up to 4 days were more often associated with seroconversion than those stored for more than 4 days (excess risk, 4.2%; P<0.05).This study provides strong evidence that HHV-8 is transmitted by blood transfusion. The risk may be diminished as the period of blood storage increases.
The differences between posteroseptal and the other atrioventricular accessory pathways: the coronary sinus morphology and the conduction over accessory pathways
Authors: Sou Takenaka, Hidekazu Hirao, Fumiharu Miura, Yukiko Nakano, Kentaro Ueda, Kenya Sakai, Keiji Matsuda, Yukihiro Fukuda, Hiroki Teragawa, Togo Yamagata, Hideo Matsuura, Kazuaki Chayama
Journal: Journal of the American College of Cardiology (2002)
A Population-Based Case–Control Study of Extreme Summer Temperature and Birth Defects
Authors: Alissa R. Van Zutphen, Shao Lin, Barbara A. Fletcher, Syni-An Hwang
Journal: Environmental Health Perspectives (2012)

Although hyperthermia is a recognized animal teratogen and maternal fever has been associated with birth defects in humans, data on the relationship between high environmental temperatures and birth defects are limited.To determine whether pregnancies are potentially vulnerable to the weather extremes anticipated with climate change, we evaluated the relationship between extreme summer temperature and the occurrence of birth defects.We performed a population-based case-control study by linking the New York State Congenital Malformations Registry to birth certificates for the years 1992-2006. We selected nonmalformed infants from a 10% random sample of live births as controls. We assigned meteorologic data based on maternal residence at birth, summarized universal apparent temperature (UAT; degrees Fahrenheit) across the critical period of embryogenesis, and estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) with multivariable logistic regression, controlling for confounders available on the birth certificate.Among 6,422 cases and 59,328 controls that shared at least 1 week of the critical period in summer, a 5-degree increase in mean daily minimum UAT was significantly associated with congenital cataracts (aOR = 1.51; 95% CI: 1.14, 1.99). Congenital cataracts were significantly associated with all ambient temperature indicators as well: heat wave, number of heat waves, and number of days above the 90th percentile. Inconsistent associations with a subset of temperature indicators were observed for renal agenesis/hypoplasia (positive) and anophthalmia/microphthalmia and gastroschisis (negative).We found positive and consistent associations between multiple heat indicators during the relevant developmental window and congenital cataracts which should be confirmed with other data sources.
A Critical Review of Biomarkers Used for Monitoring Human Exposure to Lead: Advantages, Limitations, and Future Needs
Authors: Fernando Barbosa, José Eduardo Tanus-Santos, Raquel Fernanda Gerlach, Patrick J. Parsons
Journal: Environmental Health Perspectives (2005)

Lead concentration in whole blood (BPb) is the primary biomarker used to monitor exposure to this metallic element. The U.S. Centers for Disease Control and Prevention and the World Health Organization define a BPb of 10 μg/dL (0.48 μmol/L) as the threshold of concern in young children. However, recent studies have reported the possibility of adverse health effects, including intellectual impairment in young children, at BPb levels &lt; 10 μg/dL, suggesting that there is no safe level of exposure. It appears impossible to differentiate between low-level chronic Pb exposure and a high-level short Pb exposure based on a single BPb measurement; therefore, serial BPb measurements offer a better estimation of possible health outcomes. The difficulty in assessing the exact nature of Pb exposure is dependent not so much on problems with current analytical methodologies, but rather on the complex toxicokinetics of Pb within various body compartments (i.e., cycling of Pb between bone, blood, and soft tissues). If we are to differentiate more effectively between Pb stored in the body for years and Pb from recent exposure, information on other biomarkers of exposure may be needed. None of the current biomarkers of internal Pb dose have yet been accepted by the scientific community as a reliable substitute for a BPb measurement. This review focuses on the limitations of biomarkers of Pb exposure and the need to improve the accuracy of their measurement. We present here only the traditional analytical protocols in current use, and we attempt to assess the influence of confounding variables on BPb levels. Finally, we discuss the interpretation of BPb data with respect to both external and endogenous Pb exposure, past or recent exposure, as well as the significance of Pb determinations in human specimens including hair, nails, saliva, bone, blood (plasma, whole blood), urine, feces, and exfoliated teeth.
Patient With a Rash, Abdominal Pain, and Weight Loss
Authors: Brent O’Carrigan, Ju Yong Cheong
Journal: JAMA (2012)

A 49-YEAR-OLD MAN PRESENTS WITH RIGHT ILIAC FOSSA PAIN OF 36 HOURS’ duration. He reports loss of appetite, weight loss, and increasing lethargy over the preceding 10 months with intermittent constipation but no other symptoms. He describes asymmetric altered sensation in his distal lower limbs with left worse than right. The patient smokes, has a history of illicit amphetamine and cannabinoid use, and acquired tattoos in a correctional facility. Past medical history is remarkable for an idiopathic splenic infarction 6 months ago. On physical examination, he is cachectic and he has right iliac fossa tenderness and percussion tenderness. He has a demarcated, erythematous maculopapular rash across his torso and limbs (FIGURE 1). Neurological examination reveals an asymmetric lower limb sensory neuropathy. Laboratory findings include leukocytosis (whitebloodcells, 16 900/μL), elevated inflammatorymarkers (C-reactiveprotein,109g/L; erythrocyte sedimentationrate, 27 mm/h), elevated rheumatoid factor (269 IU/L), low C3 and C4 (0.24 and 0.05 g/L, respectively), and a low titer of atypical perinuclear antineutrophil cytoplasmic antibody(ANCA),not selective foreitherproteinase3ormyeloperoxidase.Doublestranded DNA and extractable nuclear antibodies are negative. Cryoglobulins and serology for human immunodeficiency virus, hepatitis B, and hepatitis C are negative. Renal function is normal with normal urinary sediment. Abdominal computed tomographyrevealsmild thickeningof theascendingcolonandthepreviouslydocumented splenic infarction (FIGURE 2). What Would You Do Next?
A phase III study of the efficacy and safety of a novel iron-based phosphate binder in dialysis patients
Authors: Jürgen Floege, Adrian C. Covic, Markus Ketteler, Anjay Rastogi, Edward M.F. Chong, Sylvain Gaillard, Laura J. Lisk, Stuart M. Sprague
Journal: Kidney International (2014)

Efficacy of PA21 (sucroferric oxyhydroxide), a novel calcium-free polynuclear iron(III)-oxyhydroxide phosphate binder, was compared with that of sevelamer carbonate in an open-label, randomized, active-controlled phase III study. Seven hundred and seven hemo- and peritoneal dialysis patients with hyperphosphatemia received PA21 1.0-3.0 g per day and 348 received sevelamer 4.8-14.4 g per day for an 8-week dose titration, followed by 4 weeks without dose change, and then 12 weeks maintenance. Serum phosphorus reductions at week 12 were -0.71 mmol/l (PA21) and -0.79 mmol/l (sevelamer), demonstrating non-inferiority of, on average, three tablets of PA21 vs. eight of sevelamer. Efficacy was maintained to week 24. Non-adherence was 15.1% (PA21) vs. 21.3% (sevelamer). The percentage of patients that reported at least one treatment-emergent adverse event was 83.2% with PA21 and 76.1% with sevelamer. A higher proportion of patients withdrew owing to treatment-emergent adverse events with PA21 (15.7%) vs. sevelamer (6.6%). Mild, transient diarrhea, discolored feces, and hyperphosphatemia were more frequent with PA21; nausea and constipation were more frequent with sevelamer. After 24 weeks, 99 hemodialysis patients on PA21 were re-randomized into a 3-week superiority analysis of PA21 maintenance dose in 50 patients vs. low dose (250 mg per day (ineffective control)) in 49 patients. The PA21 maintenance dose was superior to the low dose in maintaining serum phosphorus control. Thus, PA21 was effective in lowering serum phosphorus in dialysis patients, with similar efficacy to sevelamer carbonate, a lower pill burden, and better adherence.
Dual-processing explains base-rate neglect, but which dual-process theory and how?
Authors: Jonathan St. B. T. Evans, Shira Elqayam
Journal: Behavioral and Brain Sciences (2007)

Abstract We agree that current evolutionary accounts of base-rate neglect are unparsimonious, but we dispute the authors' account of the effect in terms of parallel associative and rule-based processes. We also question their assumption that cueing of nested set relations facilitates performance due to recruitment of explicit reasoning processes. In our account, such reasoning is always involved, but usually unsuccessful.
Computed virtual chromoendoscopy: a new tool for enhancing tissue surface structures
Authors: J. Pohl, A. May, T. Rabenstein, O. Pech, C. Ell
Journal: Endoscopy (2007)

We conducted a study of a newly developed "computed virtual chromoendoscopy" (CVC) system that enhances the contrast of the mucosal surface without the use of dyes. The CVC imaging technique is based on narrowing the bandwidth of the conventional endoscopic image arithmetically, using spectral estimation technology. Preliminary clinical tests comparing CVC-enhanced visualization of neoplastic and non-neoplastic lesions with images obtained by conventional endoscopy show that CVC enhances the vascular network as well as the pit pattern. CVC might therefore complement high-resolution endoscopy by facilitating the assessment of the nature and extent of gastrointestinal mucosal lesions.
Pharmacodynamics and organ storage of hydroxyethyl starch in acute hemodilution in pigs: Influence of molecular weightand degree of substitution
Authors: Christoph Eisenbach, Alexander H. Schönfeld, Norbert Vogt, Moritz N. Wente, Jens Encke, Wolfgang Stremmel, Eike Martin, Ernst Pfenninger, Markus A. Weigand
Journal: Intensive Care Medicine (2007)
Combination of BMP-2-releasing gelatin/β-TCP sponges with autologous bone marrow for bone regeneration of X-ray-irradiated rabbit ulnar defects
Authors: Masaya Yamamoto, Akishige Hokugo, Yoshitake Takahashi, Takayoshi Nakano, Masahiro Hiraoka, Yasuhiko Tabata
Journal: Biomaterials (2015)
Are Heart-Lung Transplant Recipients Protected From Developing Transplant Coronary Artery Disease?
Authors: Tai Tian Lim, Javier Botas, Heather Ross, David H. Liang, James Theodore, Sharon A. Hunt, Stephen N. Oesterle, Alan C. Yeung
Journal: Circulation (1996)

Background Accelerated coronary artery disease is a major cause of mortality in heart transplant recipients; however, it does not appear to play a major role in the clinical outcome of heart-lung transplant recipients. The purpose of this study was to determine whether the incidence and severity of transplant coronary artery disease as detected by intracoronary ultrasound in heart-lung transplant recipients are less than those encountered in heart transplant recipients. Methods and Results We studied the left anterior descending coronary artery with the use of intracoronary ultrasound imaging in 22 heart-lung transplant recipients at the time of their routine annual coronary angiogram. Twenty-two heart transplant recipients were case matched for number of years after transplant at ultrasound study, recipient age, donor age, and diagnosis of nonischemic cardiomyopathy. Mean intimal area, intimal index, Stanford class, and incidence of at least moderate disease (Stanford class ≥3) were measured and calculated in each group and then compared between the two groups. Mean intimal area (1.6±2.5 versus 3.8±2.8 mm 2 ), mean intimal index (0.07±0.10 versus 0.22±0.14), mean Stanford class (1.7±1.0 versus 2.7±1.2), and incidence of Stanford class ≥3 (14% versus 45%) were significantly lower in the heart-lung transplant recipient group. Conclusions The incidence and severity of transplant coronary artery disease are much less in patients receiving heart-lung transplants than in those receiving heart transplants alone.
Renal Tubular Acidosis and Renal Potassium Wasting Acquired as a Result of Hypercalcemic Nephropathy
Authors: Thomas Ferris, Michael Kashgarian, Howard Levitin, Ira Brandt, Franklin H. Epstein
Journal: New England Journal of Medicine (1961)

THE earliest lesions of certain types of experimental nephrocalcinosis involve the distal portions of the renal tubules and the collecting ducts.1 , 2 Disturbances in renal tubular function might therefore be expected to characterize patients with hypercalcemic renal disease. Many such patients are unable to concentrate their urine normally; impairment of other specific tubular functions, however, has not been widely reported.We have recently had the opportunity to study a boy with hypercalcemic nephropathy in whom renal tubular acidosis and renal potassium wasting apparently developed as a result of repeated episodes of vitamin D intoxication. The purpose of this paper is to . . .
Incentive-Based Formularies
Authors: Cindy Parks Thomas
Journal: New England Journal of Medicine (2003)

While much of the nation has been following the deliberations in Congress over a Medicare drug benefit, a quiet revolution has been taking place in the way benefits are managed for the 200 million Americans who already have insurance for prescription drugs. Just 10 years ago, most insured persons were required to make a standard copayment of $5 or less for a prescription, regardless of the type of medication they purchased. Now, incentive-based formularies are standard, with the amount of copayments depending on the type of drug prescribed; the contracts among the insurer, the manufacturer, and the pharmacy; and the . . .
Disruption of the basal body compromises proteasomal function and perturbs intracellular Wnt response
Authors: Jantje M Gerdes, Yangfan Liu, Norann A Zaghloul, Carmen C Leitch, Shaneka S Lawson, Masaki Kato, Philip A Beachy, Philip L Beales, George N DeMartino, Shannon Fisher, Jose L Badano, Nicholas Katsanis
Journal: Nature Genetics (2007)