tbuckley/cabot-search huggingface dataset:
Multidisciplinary Teams in Consultation-Liaison Psychiatry: The Yale Model
Authors: Hoyle Leigh
Journal: Psychotherapy and Psychosomatics (1987)

The consultation-liaison service at Yale features integrated teams of psychiatrists, social workers, and clinical nurse specialists working together in both consultation and outpatient settings. The model is based on the tenets that (1) comprehensive evaluation of patients is essential for effective treatment; (2) role definition is necessary for specific disciplines, including the definition of overlapping and separate areas of expertise and practice. The multidisciplinary teams are coordinated by a psychiatric resident, who is supervised by an attending psychiatrist. The role of the resident is that of a diagnostician and coordinating physician. The social worker functions as an expert in family evaluation and treatment, and the nurse specialist functions as supportive therapist and liaison with the nursing staff. The structure of the division of consultation-liaison and ambulatory services at Yale is described and the advantages and disadvantages of the multidisciplinary team concept are discussed in comparison with other models of consultation-liaison psychiatry.
Reduced FEZ1/LZTS1 Expression and Outcome Prediction in Lung Cancer
Authors: Daisuke Nonaka, Alessandra Fabbri, Luca Roz, Luigi Mariani, Andrea Vecchione, G. William Moore, Luca Tavecchio, Carlo M. Croce, Gabriella Sozzi
Journal: Cancer Research (2005)

Abstract Chromosomal deletions are often observed in lung cancers suggesting that inactivation of tumor suppressor genes plays an important role in the development of this neoplasm. The region around chromosome 8p22 is a frequent and early target of these deletions and has therefore been investigated for the presence of candidate genes. The FEZ1/LZTS1 gene, located at 8p22, is inactivated in many cancers with 8p deletions, including prostate, esophageal, gastric, bladder, and breast cancer and the Fez1 protein has been shown to suppress growth of cancer cells and to regulate mitosis. To elucidate the role of FEZ1 in lung cancer, we have analyzed its expression by immunohistochemistry in 103 primary lung cancer specimens including 98 non–small cell lung cancers (57 adenocarcinomas, 32 squamous cell carcinomas, 7 large cell carcinomas, and 2 others) and five small cell carcinomas. Absence of Fez1 protein expression was observed in 27 cases (26%) and additional 43 cases (42%) showed strong reduction in immunoreactivity. There was a positive association between loss of FEZ1 expression and tumor grading (P = 0.0345) and a tendency toward a reduction in the mortality rate in subjects with strong FEZ1 expression. Overall, these data indicate an important role for FEZ1 in lung cancer and suggest the possibility that it may serve as a novel prognostic indicator.
The microcirculation of the human heart: end-capillary loops with discrete perfusion fields.
Authors: S M Factor, E M Okun, T Minase, E S Kirk
Journal: Circulation (1982)

We studied 10 autopsied human hearts by perfusing colored Microfil into separate coronary arteries to define organization of capillaries at the borders between two perfusion fields. Sections of "cleared" myocardium were examined with epiillumination at the grossly identified borders of Microfil perfusion. In two- and three-color-injected hearts, the capillaries were arrayed in a pattern of arcades and loops without connections between separately perfused capillary beds. In hearts perfused through only one coronary artery, the capillaries were organized into tufted loops at the border. These findings contrast with the microcirculatory pattern in canine skeletal muscle and brain, in which heterologous capillaries are focally interconnected. We conclude that the human microcirculation is composed of end-capillary loops that supply discrete perfusion fields. This pattern of unconnected heterologous capillary beds suggest that there is no obvious anatomic arrangement of the microcirculation that could account for a significant ischemic lateral border zone in human myocardial infarctions.
Clinical Evaluation of Chlorothiazide
Authors: WALTER M. KIRKENDALL
Journal: Circulation (1959)

In the 2 years chlorothiazide has been available, it has been demonstrated to have many of the characteristics of the ideal diuretic agent. It has become an important drug in the treatment of patients with edema and hypertension. Experience has indicated that the side effects and toxic reactions are not severe nor do they prohibit long-term use of the drug. In the vast majority of patients, clinical effectiveness has persisted for the duration of the study, up to 2 years in some and more than a year in many. Chlorothiazide is a new type of powerful diuretic agent. Surely other similar compounds will be introduced. For these reasons, it is especially important that we understand its mechanism of action and shortcomings. Interest in the pharmacology of chlorothiazide already has brought us new information about certain fundamental problems of kidney function and systemic arterial hypertension.
Infusion of mature megakaryocytes into mice yields functional platelets
Authors: Rudy Fuentes, Yuhuan Wang, Jessica Hirsch, Cheng Wang, Lubica Rauova, G. Scott Worthen, M. Anna Kowalska, Mortimer Poncz
Journal: Journal of Clinical Investigation (2010)

Thrombopoiesis, the process by which circulating platelets arise from megakaryocytes, remains incompletely understood. Prior studies suggest that megakaryocytes shed platelets in the pulmonary vasculature. To better understand thrombopoiesis and to develop a potential platelet transfusion strategy that is not dependent upon donors, of which there remains a shortage, we examined whether megakaryocytes infused into mice shed platelets. Infused megakaryocytes led to clinically relevant increases in platelet numbers. The released platelets were normal in size, displayed appropriate surface markers, and had a near-normal circulating half-life. The functionality of the donor-derived platelets was also demonstrated in vivo. The infused megakaryocytes mostly localized to the pulmonary vasculature, where they appeared to shed platelets. These data suggest that it may be unnecessary to generate platelets from ex vivo grown megakaryocytes to achieve clinically relevant increases in platelet numbers.
PROGNOSTIC VALUE OF ISCHEMIC BURDEN OF DOBUTAMINE STRESS CARDIAC MAGNETIC RESONANCE IMAGING
Authors: Sebastian Kelle, Sorin Giusca, Eike Nagel, Sebastian Buss, Valentina Puntmann, Ernst Wellnhofer, Eckart Fleck, Hugo Katus, Grigorios Korosoglou
Journal: Journal of the American College of Cardiology (2014)
A HEMOSTATIC CLAMP FOR THE RAPID EXCISION OF GOITER
Authors: C. E. Tennant
Journal: JAMA (1924)

The greatest problem in the surgical handling of goiter is the operative risk; therefore, the more simple the technic and the shorter the time on the operating table, the less trying will be the patient's experience with shock and hemorrhage. Operations for goiter are now quite common, being performed frequently by surgeons in the smaller centers. Some of these surgeons are successful in picking up the blood supply to the thyroid with hemostats, and tying each separately after the removal of the gland. This, of course, requires considerable time, and some of the vessels may escape notice, these vessels later causing considerable embarrassment. However, this accident is not altogether limited to those who have had little experience with the work, for those who do a great number of cases are not without their mishaps. A method that will provide positive hemostasis while the gland is being enucleated from the capsule,
Erratum to: “Interleukin-28B genetic variants in identification of hepatitis C virus genotype 1 patients responding to 24 weeks peginterferon/ribavirin” [J Hepatol 2012;56:34–40]
Authors: Chung-Feng Huang, Jee-Fu Huang, Jeng-Fu Yang, Ming-Yen Hsieh, Zu-Yau Lin, Shinn-Cherng Chen, Liang-Yen Wang, Suh-Hang Hank Juo, Ku-Chung Chen, Wan-Long Chuang, Hsing-Tao Kuo, Chia-Yen Dai, Ming-Lung Yu
Journal: Journal of Hepatology (2012)
Atresia of right pulmonary veins and anomalous left pulmonary venous drainage into portal circulation
Authors: M. Samanek, S. Tuma, D. Benesova, V. Povysilova, F. Prazsky, E. Capova
Journal: Thorax (1974)

<b>Šamánek, M., Tůma, S., Benešová, D., Povýšilová, V., Pražský, F., and Čápová, E. (1974).</b><i>Thorax</i>, <b>29</b>, 446-450. <b>Atresia of right pulmonary veins and anomalous left pulmonary venous drainage into portal circulation.</b> An anomaly of pulmonary venous drainage in a male newborn infant is described whereby the left pulmonary veins entered the portal vein and the right pulmonary veins were atretic. A correct diagnosis was made by detecting high-oxygen saturation in the hepatic veins, right-to-left shunt at atrial level, and increased pulmonary artery wedge pressure in comparison with the left atrial pressure, and was confirmed by angiography.
The Electrocardiogram and Coronary Insufficiency
Authors: Travis Winsor
Journal: JAMA (1968)

The exercise tolerance test is the most important of all widely employed office techniques for the detection and evaluation of coronary arteriosclerosis. A reliable sign of coronary insufficiency is the S-T segment abnormality occurring in the postexercise electrocardiogram indicating ischemia. The S-T segment shift refers to a horizontal flattening or sagging depression of the S-T segment induced by exercise. The depressions occur most often in lead V<sub>4</sub>or similar apical leads. They are produced usually by an amount of exercise equivalent to the double Master "two-step" exercise test, persist for more than one minute after the cessation of exercise, and are seen more easily with the patient in the supine position. The test is only reliable when the patient has not received digitalis for three weeks or quinidine for 24 hours prior to the test, or when hypokalemia, hypocalcemia, or hyperventilation are not present. The test can be interpreted
Updating Protections for Human Subjects Involved in Research
Authors: Jonathan Moreno
Journal: JAMA (1998)

For decades, all federally funded research involving human subjects has been subject to regulations that require the informed consent of the subject and oversight by the local institution. These regulations last underwent major revision in 1981 and have remained unchanged despite significant changes in the nature of clinical science, the financial sources of research support, and the institutional environment in which clinical research is conducted. In the intervening years, doubt has evolved as to whether the regulations currently in place adequately protect the welfare and rights of research subjects in today's clinical research environment and whether the costs, in terms of time, bureaucracy, and delay, are justified by the level of protection afforded. The Human Research Ethics Group, administered by the Center for Bioethics at the University of Pennsylvania Health System, extensively reviewed the status of existing human subjects protections with the aim of making recommendations to improve and reform the regulations. Here, we present recommendations constituting a consensus of the group members for reform in 3 key areas: protecting subject populations with special needs and vulnerabilities, oversight by institutional review boards, and regulatory policy.
Novel use of cryotherapy to control bleeding in advanced esophageal cancer
Authors: M. Shah, F. Schnoll-Sussman
Journal: Endoscopy (2010)

We report the first case of endoscopic cryotherapy to control bleeding in unresectable esophageal cancer. A 62-year-old Caucasian man with locally advanced esophageal adenocarcinoma was admitted with melena and symptomatic anemia. Medical history included chronic kidney disease, significant cerebrovascular disease, testicular cancer, and brain chordoma. Upper endoscopy revealed diffuse hemorrhage from the known infiltrative, circumferential mass extending 30 – 40 cm from the incisors ([Fig. 1]). Hemostasis was attempted with both epinephrine injection and argon plasma coagulation but with limited success. The patient soon became dependent on transfusion; a total of 30 blood transfusions were required over a 2-week period.
Smoking and doctors' mortality.
Authors: L T Kozlowski, R C Frecker, K A Wagner
Journal: BMJ (1980)

was particularly marked in one patient, who had been following an intensive endurance training programme for several years.On pindolol he was unable to complete his training programme and complained of an insatiable apetite, presumably owing to low blood glucose levels.On metoprolol these changes were not apparent.Similar differences in terms of working capacity have also been shown by Fellenius et al2 between the non-selective betablocker propranolol and metoprolol.Fatigue is a commonly encountered problem in patients treated with beta-blockers.On the basis of these findings it would appear that in these circumstances the predominantly cardioselective beta-blocker metoprolol may be preferable since it would appear to have less effect on energy metabolism during physical stress.
Second malignancies in total therapy 2 and 3 for newly diagnosed multiple myeloma: influence of thalidomide and lenalidomide during maintenance
Authors: Saad Z. Usmani, Rachel Sexton, Antje Hoering, Christoph J. Heuck, Bijay Nair, Sarah Waheed, Yazan Al Sayed, Nabeel Chauhan, Nisar Ahmad, Shebli Atrash, Nathan Petty, Frits van Rhee, John Crowley, Bart Barlogie
Journal: Blood (2012)
THE APPROXIMATE VITAMIN REQUIREMENTS OF HUMAN BEINGS
Authors: ROGER J. WILLIAMS
Journal: JAMA (1942)

Most of the research on vitamins and nutrition is directed ultimately to the solution of problems of human nutrition. In a war situation such as ours it is particularly desirable that we be able to apply whatever we may know or learn to practical ends. A fully adequate idea of the requirements of human beings for the various vitamins could presumably be obtained only as a result of a series of extended controlled studies using human subjects. Even if it were feasible to plan and carry out experiments of this type just as animal experiments are planned and carried out, individual differences, assuming that small numbers of subjects were used, would doubtless make the results very irregular. Recently we have developed assay methods for a number of the B vitamins,<sup>1</sup>and because of an increased accumulation of information from various sources it becomes possible to state more definitely the
Use of fetal eggs for infertility treatment is banned
Authors: L Dillner
Journal: BMJ (1994)

Eggs from aborted fetuses and cadavers should not be used to treat infertile women in Britain, although they can be used for research, said the Human Fertilisation and Embryology Authority (HFEA) last month. The authority, which licenses fertility clinics, made its ruling after six months of public consultation on the use of donated ovarian tissue. The authority received nearly 10 000 responses to its consultation document - 83% were against using fetal eggs for infertility treatment. More than half the responses were in favour of using fetal eggs for research.

The HFEA said that only ovarian tissue from live, consenting donors would be acceptable for treatment. “While we have no objection in principle to the use of cadaveric ovarian tissue from adult women, we will not currently approve its use,” said the authority. Sir Colin Campbell, chairman of the HFEA, said that they would be willing to review the issue in the future. “We do not think we need to act on this with urgency,” he said. “It is not just an issue of …
Endoscopic Removal of a Large Ulcerated Brunner's Gland Adenoma
Authors: H.T. Khawaja, M. Deakin, D.G. Colin-Jones
Journal: Endoscopy (1986)

A case of a large and ulcerated Brunner's gland adenoma presenting as chronic blood loss and resected endoscopically with complete resolution of symptoms. The pathological features of the tumour and the therapeutic approaches are discussed with particular reference to endoscopic surgery.
Thyroid Antibody Screening in Children and Adolescents With Type 1 Diabetes
Authors: Olga Kordonouri, Reinhard Hartmann, Reinhard W. Holl
Journal: Diabetes Care (2003)

We thank Dr. Hoffman for his critical comments (1). According to his calculations, based on our cross-sectional study data, he found a specificity of 80% and only a low sensitivity of 35% for the thyroid antibody–screening test. Thus, he does not support our recommendation for yearly examinations of …
Genomic approaches to the development of prostate cancer diagnostics
Authors: Shujath Ali, Yongming Sun, Carrie Drumright, Luis Carretero, Christina Tran, Anton Nguyen, Dan Medynski, Yan Liu, Vu Viet Hoang, Brandon Liang, Herve Recipon, Robert Cafferkey, Roberto Macina
Journal: Nature Genetics (2001)
Overlap syndromes: The International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue
Authors: Kirsten Muri Boberg, Roger W. Chapman, Gideon M. Hirschfield, Ansgar W. Lohse, Michael P. Manns, Erik Schrumpf
Journal: Journal of Hepatology (2010)

Some patients present with overlapping features between disorders within the spectrum of autoimmune liver diseases (i.e. autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC)) and are commonly classified as having an "overlap syndrome". Standardized definitions of "overlap syndromes" are lacking. The aim of this report by the International Autoimmune Hepatitis Group (IAIHG) is to evaluate if there are important reasons to classify conditions with overlapping features between autoimmune liver diseases as separate diagnostic entities. Definition of diagnostic criteria for overlap conditions can only be arbitrary. The IAIHG scoring system for diagnosis of AIH has been widely used to diagnose "overlap syndromes", but was not intended for such use and has not proven to be an efficient tool for this purpose. Some patients with overlapping features between a cholestatic and hepatitic disorder appear to benefit from treatment with a combination of ursodeoxycholic acid and immunosuppressants, but this strategy is not evidence-based, and it seems unjustified to define new diagnostic groups in this regard. The IAIHG suggests that patients with autoimmune liver disease should be categorized according to the predominating feature(s) as AIH, PBC, and PSC/small duct PSC, respectively, and that those with overlapping features are not considered as being distinct diagnostic entities. The IAIHG scoring system should not be used to establish subgroups of patients. Patients with PBC and PSC with features of AIH should be considered for immunosuppressive treatment. Due to the low prevalence of such "overlap syndromes", prospective interventional therapeutic trials cannot be expected in the foreseeable future.
Influence of insulin antibodies on pharmacokinetics and bioavailability of recombinant human and highly purified beef insulins in insulin dependent diabetics.
Authors: R S Gray, P Cowan, U di Mario, R A Elton, B F Clarke, L J Duncan
Journal: BMJ (1985)

Sixteen insulin dependent diabetics of long standing, with undetectable fasting plasma C peptide concentrations, and eight non-diabetic controls were each infused intravenously with biosynthetic human and highly purified beef insulin (1 mU/kg/min) while euglycaemia was maintained by a Biostator. No difference was observed between the two insulins in respect of insulin pharmacokinetics or biological action. The diabetics showed appreciable insulin resistance, manifested by a 40% reduction in the rate of insulin mediated glucose disposal, which was unrelated to the presence of insulin antibodies. Insulin binding antibodies, however, increased insulin's clearance rate and distribution space and prolonged its pharmacological and biological half lives. The rate at which insulin action was lost, after an intravenous infusion, was more rapid in diabetics without insulin antibody binding than in controls. In respect of their influence on insulin pharmacokinetics, moderate concentrations of insulin antibodies may be of positive advantage to all diabetics without endogenous insulin secretion and are not responsible for the insulin resistance of type 1 diabetes.
Practical responses to confidentiality dilemmas in elite sport medicine
Authors: Dominic Malcolm, Andrea Scott
Journal: British Journal of Sports Medicine (2013)

To examine the ethical challenges of upholding patient confidentiality in sports medicine and the practical responses of clinicians to these challenges.Questionnaire survey and follow-up semi-structured interviews with the members of the British Olympic Association's Medical Committee and Physiotherapy Forum.Clinicians identified three contextual factors that influenced issues related to patient confidentiality in sports medicine: the use of confidentiality waivers; the facilities available for treatment; and the cultural norms of elite sport. They further identified interpersonal strategies used to lessen or eradicate conflicts, including emphasising the benefits and avoidance of disbenefits for athletes and the potential negative consequences for others.Aspects of clinicians' practice environment should be designed to enable compliance with the highest levels of ethical conduct. Professional associations should establish guidelines for clinicians' interpersonal conduct in dealing with confidentiality issues and consider their provision of ethics-based continuous professional development. They should also petition for the establishment of athletes' codes of conduct which identify a context-relevant understanding of 'serious harm' and how that might impact on information disclosure.
A Quarter-Century of Antiviral Therapy
Authors: Thomas C. Merigan
Journal: New England Journal of Medicine (1995)

In patients with acute viral infection, therapy with systemic antiviral agents can save lives, as in the case of Lassa fever, or prevent the progression of disease, as in influenza or herpes simplex infection.1 The challenge is greater when these agents are used over the long term to suppress or eradicate chronic viral infections with such pathogens as hepatitis B or C virus, cytomegalovirus, or human immunodeficiency virus (HIV).1 This issue of the Journal contains two articles that show how a new nucleoside agent, lamivudine, can be helpful in two of these chronic infections.2,3 This drug is a purified . . .
p21-activated kinase regulates mast cell degranulation via effects on calcium mobilization and cytoskeletal dynamics
Authors: Jayme D. Allen, Zahara M. Jaffer, Su-Jung Park, Sarah Burgin, Clemens Hofmann, Mary Ann Sells, Shi Chen, Ethel Derr-Yellin, Elizabeth G. Michels, Andrew McDaniel, Waylan K. Bessler, David A. Ingram, Simon J. Atkinson, Jeffrey B. Travers, Jonathan Chernoff, D. Wade Clapp
Journal: Blood (2009)
Retrocaval Ureter Demonstrated by Tc-99m MDP Bone Scintigraphy
Authors: HYO-SUNG KWAK, MYUNG-HEE SOHN
Journal: Clinical Nuclear Medicine (1999)

Retrocaval ureter occurs in approximately 1 in 1,000 persons. It is a venous anomaly in which a persistent right subcardinal vein traps the ureter behind the inferior vena cava. Tc-99m MDP bone imaging performed for bone pain in a 54-year-old man showed an S-shaped deformity with dilatation above the midureter on the right side. MR urography suggested a retrocaval ureter (type 1, long loop) on the right side, which was confirmed at surgery. FIGURE 1Fig. 1: Tc-99m MDP bone scintigraphy (posterior renal area) showed an S-shaped deformity with dilatation above the midureter and beak-like narrowing of the ureter without hydronephrosis (arrow). This findings suggested a retrocaval ureter.FIGURE 2Fig. 2: MR urography showed an S-shaped deformity in the midureter and beak-like narrowing of the ureter at the lateral border of the psoas muscle and passing behind the inferior vena cava (IVC; arrow). The more common radiographic pattern of retrocaval ureter has an S-shaped deformity of the midureter as it courses around the IVC (1). A retrocaval ureter can be recognized on CT and ultrasound by following the opacified ureter around the IVC (2,3). The MR urography in this case showed radiographic findings of a retrocaval ureter (type 1, long type).