tbuckley/cabot-search huggingface dataset:
PTU-081 Are we Exposing Patients with a Mildly Elevated Faecal Calprotectin to Unnecessary Investigations?
Authors: J P Seenan, F Thomson, K Rankin, K Smith, D R Gaya
Journal: Gut (2013)

<h3>Introduction</h3> Faecal calprotectin (FC) is increasingly used as a non-invasive marker to differentiate irritable bowel syndrome (IBS) from inflammatory bowel disease (IBD). However, it is a non-specific marker of luminal inflammation and false positives are common. We have previously demonstrated a low yield of diagnostic colonoscopy in patients with borderline elevations of FC (50–100 µg/g). Higher FC levels (100–200 µg/g) often prompt more extensive investigation. We sought to determine the diagnostic yield of endoscopic/radiological investigation in patients presenting with new lower GI symptoms and a mildly elevated FC (100–200 µg/g). <h3>Methods</h3> All patients with a faecal calprotectin 100–200 µg/g were identified from our biochemistry laboratory database between September 2009 and September 2011. Patients aged 16 to 50 years attending gastroenterology outpatient clinics with new lower GI symptoms were identified. Patients were excluded if they had a previous FC &gt; 200 µg/g, were taking NSAIDs, had known IBD, positive stool cultures or any 'alarm' symptoms. Details of investigations, diagnosis and clinical outcomes were determined electronically from the NHS Greater Glasgow and Clyde Clinical Portal. <h3>Results</h3> 163 patients (104 female) were identified who met the inclusion criteria. The mean age was 37.5 years with a mean FC of 146.6µg/g. The primary presenting complaint was diarrhoea in 100 (61.3%) and abdominal pain in 63 (38.7%). Secondary symptoms were abdominal pain (28.2%), diarrhoea (18.4%) and constipation (1.8%). A total of 390 endoscopic, radiological and histological investigations were undertaken in 152 patients with an average of 2.6 investigations per patient. 131 colonoscopies were performed with abnormalities detected in only 23 (17.6%). In patients with a macroscopically normal upper GI endoscopy and colonoscopy, the diagnostic yield of any further investigation was only 7%. The negative predictive value (NPV) of a FC 100–200 µg/g was 86.9% for any pathology and 98.1% for significant luminal pathology (IBD, advanced adenoma or colorectal carcinoma). IBD was the final diagnosis in only 3 (1.8%) of patients while 48.5% were diagnosed as having IBS. <h3>Conclusion</h3> In adult patients under 50 years old presenting with new lower GI symptoms, the NPV of a FC between 100 and 200µg/g in excluding significant organic GI disease is high. Patients are often extensively investigated yet the overall diagnostic yield is very low and the majority of these patients have functional disease. We suggest that the manufacturer's FC cut off of 50 µg/g of stool is too low for utilisation in clinical practise and often results in unnecessary, invasive investigations. <h3>Disclosure of Interest</h3> None Declared
Indian MPs criticise HPV vaccination project for ethical violations
Authors: G. Mudur
Journal: BMJ (2013)

A parliamentary panel has criticised the Indian Council of Medical Research and the international non-profit Program for Appropriate Technology in Health (PATH) for their human papillomavirus (HPV) vaccine project in India, which drew controversy three years ago.1

The panel that oversees India’s health ministry has said that the project, which administered the HPV vaccine to about 20 000 girls aged 10 to 14 years in Andhra Pradesh and Gujarat during 2009-10, had breached medical ethics and violated Indian regulations on clinical trials.

Health activists and women’s rights groups had asked the government to look into the project in early 2010 after they had documented irregularities in the project’s informed consent papers and after adverse effects were reported among vaccinated girls in Andhra Pradesh.1

The parliamentary panel, which submitted its report last week, investigated the affair after a committee set up by the health ministry had confirmed that the project had violated ethical guidelines but did not hold anyone or any agency responsible for the lapses.

PATH, which is based in Seattle, …
Abstract 653: Passive smoking facilitate the risk of CIN1 in high risk HPV-positive women: Korean HPV Cohort Study
Authors: Mi Kyung Kim, Binna Lee, Siddhartha Kumar Mishra, Jae Kwan Lee
Journal: Cancer Research (2012)

Abstract Cervical cancer is the second most common malignancy and the second most common cause of cancer-related death worldwide. Recently, the International Agency for Research on Cancer (IARC) of the World Health Organization in France completed reviewing all published studies related to cigarette smoke and cancer. Among several risk factors, tobacco smoking has been less explored despite it being a well-established risk factor for cervical precancer and cancer. The epidemiologic and biological studies suggest the association of passive smoking on the risk of cervical cancer; however, the evidence has been suggestive rather than sufficient to implicate the role of passive smoking in the etiology of cervical cancer among lifetime nonsmoking women. We investigated the associations between passive smoking and risk of cervical intraepithelial neoplasia (CIN), and cervical cancer in high risk HPV-positive women in the Korean HPV cohort study (KHPV). The KHPV recruited 1,306 women, aged 18-65, including HPV-positive women with normal cytology (n=577), CIN1 (n=419), CIN2/3 (n=165), and cervical cancer (n=145) from March 2006 to December 2009. Detailed information on passive smoking and other lifestyle factors were collected by questionnaires. Multinomial logistic analysis was performed to estimate multivariate-adjusted odds ratios. Ex- and current smoker had an increased risk of CIN1 (OR = 1.81; 95% CI: 1.26 ∼ 2.60) as compared to nonsmokers. The risk of CIN1 increased with increasing exposure time of passive smoking regardless of smoking after adjusting for potential confounder (OR = 2.09; 95% CI: 1.33 ∼ 3.28, p for trend = 0.0023). In non-smoker, the subject with passive smoking had an increased of CIN1 (OR = 1.48; 94% CI: 1.04-2.10, p for trend = 0.0276) after adjusting for potential confounder. In smoker, the effects of passive smoking were not statistically significant. Both of exposure time separated by two hours per day (p for trend = 0.0003), and 1 hour and 2 hours per day (p for trend = 0.0006) of passive smoking demonstrated significant associations with development of CIN1. This is the first study to demonstrate that passive smoking is an independent and combined risk factor of CIN1. HPV viral load and alcohol synergize to increase the risk of CIN1 among high-risk HPV-positive women. 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 653. doi:1538-7445.AM2012-653
Foundation for Medical Care Control of Hospital Utilization: CHAP — A PSRO Prototype
Authors: Earl Brian
Journal: New England Journal of Medicine (1973)

Abstract Operating concurrently with a California government program to control hospital utilization in a Medicaid program is the Certified Hospital Admission Program (CHAP), carried out by the Sacramento County Medical Society through its Medical Care Foundation. During the CHAP eight-month study period, May through December, 1970, the observed hospital days of stay declined nearly 17 per cent. The observed number of admissions declined more than 11 per cent, and the average length of stay decreased from 4.7 to 4.4 days —6.4 per cent below the expected number. These reductions exceeded those found in comparable areas where a similar control program was operated by the California state government. Thus, CHAP not only has proved to be as effective as the government-operated program, but has the added dimension of being operated by a medical society, free from direct government intervention. (N Engl J Med 288:878–882, 1973)
Acquired Aortic Stenosis in Systemic Lupus Erythematosus
Authors: Marc R. Pritzker, Joel D. Ernst, Christopher Caudill, Charles S. Wilson, Walt F. Weaver, Jesse E. Edwards
Journal: Annals of Internal Medicine (1980)

Two patients with systemic lupus erythematosus had aortic valvular stenosis resulting from massive thrombotic deposits on the valve. This condition has not been described previously, but a similar process has been reported to have caused mitral stenosis in a patient.
A NEW ANASTOMOTIC CLAMP.
Authors: G. F. ROOSEVELT
Journal: JAMA (1906)

The instrument presented here is designed for use in suture anastomotic work. It was originally intended for use in the operation of gastroenterostomy, but it will probably prove equally as efficient, if not more so, in enteroenterostomy. When two clamps are used the difficulty encountered by the assistant in maintaining the proper relative position of the two portions to be united, sometimes becomes a source of annoyance to the surgeon, occasionally even leading to actual damage to the tissues. In every case it requires the entire use of both hands of the assistant, preventing his being of service in other ways. The clamp which I have designed is expected, in the majority of cases of this class, to replace the two clamps which have hitherto been required, and the slight loss of time, if there should be any, in adjusting the new instrument in position, will be more than regained
Geographical shifts in submissions
Authors: T Opthof
Journal: Cardiovascular Research (1998)

In the January issue of Cardiovascular Research [1]we emphasized the large, recent increase in the number of submissions to the Journal, probably resulting from the increase in impact factor over the last years [1, 2]in combination with the speedy review process [1, 3]. Apart from that there is also a clear trend in the geographical distribution of submissions. In 1997 Cardiovascular Research received most manuscripts from the USA (20%), followed by Japan (14%), the United Kingdom and Germany (both 12%). Fig. 1 shows that these numbers have changed substantially, e.g., for the USA from 33% in 1992 to 20% in 1997. Also, the contribution of the United …
Role of the Anesthesiologist-Reply
Authors: T. Cameron MacCaughelty
Journal: JAMA (1982)

<h3>In Reply.—</h3> After particularly discouraging days, I, too, have wondered why I bothered trying to practice good anesthesiology when those attempts have been denigrated by misguided physicians in other specialties. The answer is, I think, "Do it for the patient." As a physician, the anesthesiologist has a distinct ethical, moral, and legal responsibility to his patients. He has no obligation to be a "handmaiden" to any other physician. To allow oneself to be placed in such a position is to admit defeat and to agree that some other physician should make the decisions that a good anesthesiologist should make. The purpose of my article was to bring to the general medical literature a discussion of problems long known to anesthesiologists, hoping that better cooperation might result. At my own hospital, several internists have begun to list the patient's problems and have stopped using the statement, "history and physical examination dictated,
Phagosomal pH and glass fiber dissolution in cultured nasal epithelial cells and alveolar macrophages: a preliminary study.
Authors: N F Johnson
Journal: Environmental Health Perspectives (1994)

The dissolution rate of glass fibers has been shown to be pH sensitive using in vitro lung fluid simulant models. The current study investigated whether there is a difference in phagosomal pH (ppH) between rat alveolar macrophages (AM) and rat nasal epithelial cells (RNEC) and whether such a difference would influence the dissolution of glass fibers. The ppH was measured in cultured AM and RNEC using flow cytometric, fluorescence-emission rationing techniques with fluorescein-labeled, amorphous silica particles. Glass fiber dissolution was determined in AM and RNEC cultured for 3 weeks with fast dissolving glass fibers (GF-A) or slow dissolving ones (GF-B). The mean diameters of GF-A were 2.7 microns and of GF-B, 2.6 microns, the average length of both fibers was approximately 22 to 25 microns. Dissolution was monitored by measuring the length and diameter of intracellular fibers and estimating the volume, assuming a cylindrical morphology. The ppH of AM was 5.2 to 5.8, and the ppH of RNEC was 7.0 to 7.5. The GF-A dissolved more slowly in RNEC than in AM, and no dissolution was evident in either cell type with GF-B. The volume loss with GF-A after a 3-week culture with AM was 66% compared to 45% for cultured RNEC. These results are different from those obtained using in vitro lung fluid-simulant models where dissolution is faster at higher pH. This difference suggests that dissolution rates of glass fibers in AM should not be applied to the dissolution of fibers in epithelial cells.
Gloucester Infirmary Petition
Authors: A. J. Wood
Journal: BMJ (1844)

5th.-"That as laws bave been enacted against the practice of medicine by unqualified individuals, and enforced from time to time In this country, and in Prance, the Netherlaids, Germany, Italy, and other European nations, it is expedient that an enquiry be made into the operation and results of these laws, so that past legislative experience may be rendered subsement to more effectual legislation."6th.-"That petitions in conformity with these resolutions be presented at the commencement of the next Session to both Houses of Parliament."7th.-" That copies of these resolutions be sent to
DEMENTIA PRECEDING AND FOLLOWING INEBRIETY.
Authors: T. D. CROTHERS
Journal: JAMA (1902)

A study of the early history of inebriates, particularly of the period preceding the use of spirits, indicates the presence of psychosis, and frequently, degrees of dementia which are unrecognized at that time, but later develop into the drink symptoms. In persons with a traceable heredity and history of degenerative parents, neuro-psychopathics are easily recognized, but in others who have no hereditary history and seem well up to the beginning of the drink period, previous psychoses have not been studied or recognized. The theory prevails in most circles of medical literature that the onset of inebriety is a mere chance condition, or an accident which might have been prevented, and is largely under the control of the person. There has been no recognition of an earlier preliminary stage leading up to the alcoholic psychoses. This failure has resulted in confusion and conflict of theory and treatment, with consequent quack remedies
Splenic "Disappearance" During Gated Exercise Nuclear Angiocardiography
Authors: GARY F. GATES, ALAN W. AMES
Journal: Clinical Nuclear Medicine (1986)

Decreasing splenic activity occurred during the maximum exercise phase of gated stress testing in 24 patients who underwent 26 such studies. This event was related to increasing exercise, and correlated with the relative increase in heart rate, pulse-pressure product, and cardiac output, but not ejection fraction. A multiple linear regression analysis showed that the combination of increases in pulse-pressure product and cardiac output had the best correlation with decreasing splenic activity at the conclusion of exercise. Redistribution of cardiac output toward muscle and away from splanchnic viscera is a consequence of exercise, and is graphically demonstrated by decreasing splenic visualization, which in some patients was so marked as to result in disappearance of the organ from the video monitor.
Effects of Quebec Medicare on Physician Consultation for Selected Symptoms
Authors: Alison D. McDonald, J. Corbett McDonald, Vera Salter, Philip E. Enterline
Journal: New England Journal of Medicine (1974)

Abstract In a survey in Montreal before and after the introduction of health insurance (Medicare), questions were asked about 14 common symptoms for which medical advice should probably be sought. The selected symptoms were generally more frequent in lower-income families. Though there was little overall change in the frequency of doctor visits, in 13 of the 14 selected symptoms a higher proportion of persons saw a doctor. Before Medicare those from higher-Income families more often consulted a doctor whereas afterward there was little difference for adults but in children some economic gradient remained. Before Medicare, 41 per cent of women who had had babies in the previous 12 months made their first prenatal visit before the third month as compared with 55 per cent after. Postnatal examination of the mother increased from 66 to 80 per cent, and that of the baby after leaving the hospital from 79 to 85 per cent. The increases were greatest in low-income families. (N Engl J Med 291:649–652, 1974)
Arthroscopic surgery of the knee.
Authors: S C Gallannaugh
Journal: BMJ (1986)

Arthroscopic surgery of the kneeJust as the surgical replacement of joints has changed the practice oforthopaedic surgery in general, so arthroscopy has changed the character ofknee surgery inMparticular.The lead came from surgeons in Japan in the 1960s, but interest in arthroscopy quickly spread to other countries.'-'As surgeons gained experience of diagnostic arthirscopy those with a special interest in knee surgery began to devise ways of developing the arthroscope to enable them to carry out procedures within the joint.In England Dandy has pioneered these methods, which are steadily becoming established in specialist units.
The Early Detection of Pancreatic Cancer: What Will It Take to Diagnose and Treat Curable Pancreatic Neoplasia?
Authors: Anne Marie Lennon, Christopher L. Wolfgang, Marcia Irene Canto, Alison P. Klein, Joseph M. Herman, Michael Goggins, Elliot K. Fishman, Ihab Kamel, Matthew J. Weiss, Luis A. Diaz, Nickolas Papadopoulos, Kenneth W. Kinzler, Bert Vogelstein, Ralph H. Hruban
Journal: Cancer Research (2014)

Abstract Pancreatic cancer is the deadliest of all solid malignancies. Early detection offers the best hope for a cure, but characteristics of this disease, such as the lack of early clinical symptoms, make the early detection difficult. Recent genetic mapping of the molecular evolution of pancreatic cancer suggests that a large window of opportunity exists for the early detection of pancreatic neoplasia, and developments in cancer genetics offer new, potentially highly specific approaches for screening of curable pancreatic neoplasia. We review the challenges of screening for early pancreatic neoplasia, as well as opportunities presented by incorporating molecular genetics into these efforts. Cancer Res; 74(13); 3381–9. ©2014 AACR.
Phase II Trial of Systemic Continuous Fluorouracil and Subcutaneous Recombinant Interferon Alfa-2b for Treatment of Hepatocellular Carcinoma
Authors: Yehuda Z. Patt, Manal M. Hassan, Richard D. Lozano, Thomas D. Brown, J. Nicolas Vauthey, Steven A. Curley, Lee M. Ellis
Journal: Journal of Clinical Oncology (2003)

Because cirrhosis is extremely common in hepatocellular carcinoma (HCC) in the United States, and it precludes the use of several chemotherapy agents, this phase II trial of fluorouracil (FU) and recombinant interferon alfa-2b (rIFNalpha2b) in HCC was launched with the assumption that it could be tolerated by cirrhotics.Forty-three patients with HCC (34), and fibrolamellar HCC (FLHCC; nine) were treated with continuous intravenous (IV) FU (200 mg/m2/d x 21 every 28 days) and subcutaneous (SC) rIFNalpha2b (4 million U/m2) three times weekly. Survival was determined in all 43 patients, and response could be assessed in 28 HCC and 8 FLHCC patients.The median ages of the patients were 63.5 and 19 years among HCC and FLHCC patients, respectively. Liver cirrhosis was present among 71% of HCC patients but among none of the FLHCC patients. Nine of 36 (25%; four of 28 [14%] HCC patients; five of eight [62.5%] FLHCC patients) patients in which a response could be assessed had a complete response (CR; one patient with FLHCC and no patients with HCC) or partial response (PR; eight patients [four HCC and four FLHCC patients]). Four HCC patients underwent resection, and two had a histologic CR; one HCC patient with a PR underwent orthotopic liver transplantation. One FLHCC patient also underwent resection without clear margins. Overall median survival was 19.5 months (95% confidence interval [CI], 11.2 to 27.8 months); median survival was 15.5 months (95% CI, 8.5 to 22.5 months) among HCC patients, and that of FLHCC patients was 23.1 months (95% CI, 10.3 to 35.9 months). Overall grade 3 or 4 toxicity included stomatitis (32.6%), fatigue (4.7%), and hematologic toxicity (9.3%).Continuous IV FU and thrice-weekly SC rIFNalpha2b are an effective treatment, especially for FLHCC, and may have a neoadjuvant role in this disease. This regimen has activity in HCC and can be tolerated even by cirrhotic patients.
WITHDRAWAL OF ZINC THERAPY IN ACRODERMATITIS ENTEROPATHICA
Authors: Benjamin Portnoy, Mohamed Molokhia
Journal: British Journal of Dermatology (1976)

Journal Article WITHDRAWAL OF ZINC THERAPY IN ACRODERMATITIS ENTEROPATHICA Benjamin Portnoy, Benjamin Portnoy The Skin Hospital, Manchester 3 Search for other works by this author on: Oxford Academic Google Scholar Mohamed Molokhia Mohamed Molokhia The Skin Hospital, Manchester 3 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 94, Issue 1, 1 January 1976, Pages 112–113, https://doi.org/10.1111/j.1365-2133.1976.tb04355.x Published: 01 January 1976
Bed sharing and the sudden infant death syndrome
Authors: H. Klonoff-Cohen, S. L Edelstein
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b> : To determine whether infants who died of the sudden infant death syndrome routinely shared their parents9 bed more commonly than control infants. <b>Design</b> : Case-control study. <b>Setting</b> : Southern California. <b>Subjects</b> : 200 white, African-American, Latin American, and Asian infants who died and 200 living controls, matched by birth hospital, date of birth, sex, and race. <b>Main outcome measures</b> : Routine bedding (for example, crib, cradle), day and night time sleeping arrangement 9for example, alone or sharing a bed); for cases only, sleeping arrangement at death. Differences in bed sharing practices among races. <b>Results</b> : Of the infants who died of the syndrome, 45 (22.4%) were sharing a bed. Daytime bed sharing was more common in African-American (P&lt;0.001) and Latin American families (P&lt;0.001) than in white families. The overall adjusted odds ratio for the syndrome and routine bed sharing in the daytime was 1.38 (95% confidence interval 0.59 to 3.22) and for night was 1.21 (0.59 to 2.48). These odds ratios were adjusted for routine sleep position, passive smoking, breast feeding, intercom use, infant birth weight, medical conditions at birth, and maternal age and education. There was no interaction between bed sharing and passive smoking or alcohol use by either parent. <b>Conclusions</b> : Although there was a significant difference between bed sharing among African-American and Latin American parents compared with white parents, there was no significant relation between routine bed sharing and the sudden infant death syndrome.
To Fear Death
Authors: Richard H. Crook
Journal: JAMA (1985)

To the Editor.—  I read with great interest theNov2 COMMENTARY. 1 The concept put forth by the authors was perhaps better stated by Plato ( The Apology ) long before the coming of Christ:  to fear death, my friends, is only to think ourselves wise without really being wise, for it is to think that we know what we do not know. For no one knows whether death may not be the greatest good that can happen to man. But men fear it is as if they knew quite well that it was the greatest of evils. And what is this but that shameful ignorance of thinking that we know what we do not know? 2
Diffusion-Weighted Magnetic Resonance Imaging for Diagnosing Malignant Pulmonary Nodules/Masses: Comparison with Positron Emission Tomography
Authors: Takeshi Mori, Hiroaki Nomori, Koei Ikeda, Koichi Kawanaka, Shinya Shiraishi, Kazuhiro Katahira, Yasuyuki Yamashita
Journal: Journal of Thoracic Oncology (2008)