tbuckley/cabot-search huggingface dataset:
The Modular Medical Integrated Curriculum
Authors: Arthur J. Culbert, Ernest H. Blaustein, John I. Sandson
Journal: New England Journal of Medicine (1982)

Modifying the present premedical and basic medical-science curricula is a difficult task. This portion of a physician's training has undergone little revision since the early 1900s, despite pleas for change from medical educators.1 Substantial barriers separate these two phases of education. It has recently been suggested that the education of physicians is in need of change and that there might be advantages to more fully coordinating the college and medical-school experiences in two ways: by integrating the first year of medical school within the present undergraduate curriculum, and by beginning the medical-school curriculum with pathophysiology, physical diagnosis, and history taking, . . .
PTH-131 Endoscopic Gastropexy And Peg Feeding Tube Insertion: A Comparative Study: Abstract PTH-131 Table 1
Authors: SS Salunke, R McKay, D Barber, AW McKinlay, JS Leeds
Journal: Gut (2014)

<h3>Introduction</h3> PEG feeding in patients with head and neck and upper GI cancers is known to derive nutritional and mortality benefits. Standard inside-out PEG insertion is not always technically possible or safe especially when there is narrowing of the oesophagus or pharynx from cancer. There is also concern about tumour seeding with inside-out technique. Similarly, in some patients it is not possible to pass the standard gastroscope through to upper GI tract. Gastropexy is an alternative technique which allows insertion of a gastrostomy tube with outside-in technique and can be performed using ultrathin scopes rather than standard gastroscopes. Gastropexy has been routinely performed in our unit for some time. We aimed to review the experience of Gastropexy insertion in our unit and compare it to age and indication matched controls who underwent PEG insertions. <h3>Methods</h3> A retrospective review of institutionally approved PEG database was conducted. Gastropexy insertions between June 2009 and November 2012 and PEG insertions between March 2006 and January 2012 were reviewed retrospectively. Indication and age matched PEGs were used as controls. Patients with cancers (head and neck, oesophageal and other) undergoing the procedure were selected. Patient characteristics, sedation requirement, technical success, success using ultrathin scopes, safety, complications if any and mortality rates were recorded. <h3>Results</h3> Fifty four patients received 57 gastropexies (30 males, median age 63 (range 39–84) years); 108 patients received 109 PEG’s (55 males, median age 68 (range 20–93) years). Eighty three percent of gastropexy and 97% of PEG’s were done under conscious sedation. The remaining gastropexy insertions were done under GA as a part of another surgical procedure. Technical success was achieved in 98 and 100% for gastropexy and PEG’s respectively. Minor gastric fluid leak in 1 patient in gastropexy group and mouth bleed in 1 patient in PEG group was noted. No procedure related deaths were noted in either of the groups. <h3>Conclusion</h3> In the context of risk from tumour seeding and mucosal trauma to narrowed upper GI tract, endoscopic gastropexy procedure seems non-inferior to PEG’s. It seems safe and can be done with high technical success rate. Perhaps, it may be an alternative to PEG in patients with inherently difficult upper GI tract and major illness like cancers. <h3>Disclosure of Interest</h3> None Declared.
Acute effect of propranolol and isosorbide-5-mononitrate administration on renal blood flow in cirrhotic patients
Authors: A J Stanley, I A D Bouchier, P C Hayes
Journal: Gut (1998)

Propranolol and isosorbide-5-mononitrate (ISMN) are increasingly used in the prophylaxis of variceal haemorrhage in cirrhosis. However, recent studies have suggested that these drugs may compromise renal function, possibly by reducing renal blood flow.To assess the acute effects of propranolol and ISMN on renal blood flow and other haemodynamic parameters in cirrhosis.Twenty six cirrhotic patients were given either 80 mg propranolol, 20 mg ISMN, or a combination of the two drugs. Unilateral renal blood flow (RBF), azygos blood flow (AZBF), hepatic venous pressure gradient (HVPG), mean arterial pressure (MAP), and heart rate (HR) were recorded prior to and one hour after drug administration.Propranolol caused a reduction in HR (p < 0.005), AZBF (p < 0.01), and HVPG (p = 0.05), but no change in MAP or RBF (454.1 (77.3) versus 413.9 (60.3) ml/min). ISMN reduced MAP (p < 0.005) and HVPG (p < 0.01), but had no effect on HR, AZBF, or RBF (302.5 (49.4) versus 301.7 (58.8) ml/min). Combined treatment reduced MAP (p < 0.005), AZBF (p < 0.05), and HVPG (p = 0.002), but HR and RBF (419.2 (62.6) versus 415.1 (61.1) ml/min) remained unchanged.Despite the anticipated changes in other haemodynamic parameters, acute propranolol and/or ISMN administration did not reduce RBF. These drugs do not seem to compromise RBF in cirrhosis.
P684Anthocyanins extracted from grape seed alleviate cardiac remodeling in rats with diabetic cardiomyopathy: possible involvement of PKC-ERK 1/2 signaling pathways
Authors: H Zhu, ZH Liu, J Wang, K Chen, Y He, CH Qiu
Journal: Cardiovascular Research (2014)

Purpose: Increased consumption of anthocyanins is helpful to decrease incidence of cardiovascular morbidity. These cardioprotective activities are closely related to their antioxidant properties. In diabetic cardiomyopathy (DCM), protein kinase C (PKC) is involved in hyperglycemia-induced oxidative stress. Usually, PKC activation provokes modifications in extracellular matrix, induces myocyte hypertrophy and interstitial fibrosis. In this study, we investigated the effects of anthocyanin extracted from grape seed on cardiac remodeling and assessed mechanisms involved. Methods: Diabetes was induced in male SD rats by intraperitoneal injections of streptozotocin (STZ) at a dose of 65 mg/kg. Rats were divided into four groups: normal rat, diabetic rat, normal rat with anthocyanin treatment and diabetic rat with anthocyanin treatment. Anthocyanin (95 purity) was orally administrated at a dose of 100 mg kg-1ôñd-1 for 6 weeks. At termination, evaluation of hemodynamic parameters and oxidative stress status were performed. Left ventricular (LV) tissues were collected for the assessment of myocardial ultrastructure, collagen density, and cardiomyocyte hypertrophy. Finally, expression of PKC and ERK 1/2 in cardiac tissues were determined. Results: After treatment with STZ, rats developed diabetes evidenced by hyperglycemia, while experimental DCM was indicated by LV dysfunctions. Rats with DCM showed lower body weight and higher heart-to-body weight ratio, impaired systolic and diastolic function accompanied with myocyte hypertrophy and interstitial fibrosis, as well as elevated malonaldehyde level. However, anthocyanin treatment significantly restored LV dysfunction, decreased oxidative stress status, and attenuated LV remodeling as evidenced by reduced mean myocyte diameter and interstitial collagen deposition. Meanwhile, brain natriuretic peptide mRNA expression were markedly decreased. More importantly, anthocyanin could dramatically prevent up-regualted expression of phosphorylated PKC alpha and ERK1/2, as well as TGF-β mRNA expression and NF-κB activation Conclusions: Anthocyanin extracted from grape seed has protective potential for targeting cardiac hypertrophy and fibrosis through suppression of PKC-ERK pathway, highlighting a possible cardioprotective therapy for prevention of cardiac remodeling in DCM.
1042-77 Haptoglobin polymorphism is associated with short-term mortality and heart failure in patients with diabetes and acute myocardial infarction
Authors: Mahmoud Suleiman, Doron Aronson, Michael Kapeliovich, Walter Markiewicz, Haim Hammerman, Shimon A Reisner, Rachel Lotan, Michael Shochat, Nina S Levy, Andrew P Levy
Journal: Journal of the American College of Cardiology (2004)
Case 31-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Lewis R. Weintraub, James J. Galdabini
Journal: New England Journal of Medicine (1972)

Presentation of Case First admission. A 69-year-old woman was admitted to the hospital because of retinal hemorrhages.She had been in her usual state of health until six months previously, when there was the onset of weakness, fatigue, gingival bleeding and epistaxis. For several months before admission she had visual blurring; an ophthalmologist examined her and referred her to the hospital.She had had scoliosis since her youth and was known to have Paget's disease of the right femoral neck.The temperature was 36.9°C, the pulse 80, and the respirations 20. The blood pressure was 125/85.On physical examination the . . .
A STUDY OF THE TOXICITY OF THE SALICYLATES BASED ON CLINICAL STATISTICS
Authors: PAUL J. HANZLIK
Journal: JAMA (1913)

This study was undertaken with the hope of clearing up some to the traditions concerning the therapeutic use of salicylates. It is believed by some clinicians that certain of the salicylates are not so toxic as others. There is also a common idea that the toxicity is different—either greater or smaller—in rheumatic fever than in other conditions. Other factors which are but vaguely understood are the relation of age, sex and race to the toxic dose of the salicylates, the influence of the dose on the occurrence of albuminuria and idiosyncrasy. For this study the clinical records of the medical wards of Lakeside Hospital were made available through the courtesy of the medical staff and hospital officials. All of these records have been systematically kept practically since the establishment of the hospital. The fact that they were kept with no definite aim for such an investigation as this helps
Topography of preemptying ventricular segments in patients with Wolff-Parkinson-White syndrome using scintigraphic phase mapping and esophageal pacing.
Authors: W W Chan, V Kalff, M Dick, M A Rabinovitch, J Jenkins, J H Thrall, B Pitt
Journal: Circulation (1983)

We analyzed the sequence of ventricular emptying using the phase image in 10 patients with accessory pathways and in 15 normal subjects. In normal subjects, the earliest emptying occurred in ventricular septal, apical and left basal segments. Eight patients had manifest preexcitation; the earliest emptying occurred ectopically in the right ventricle in one of these patients and in the left ventricle in five. The remaining two patients had normal phase maps. Two patients had concealed left-sided pathways. Their phase maps showed earliest emptying in left basal segments. Six of the 10 patients underwent electrophysiologic mapping. There was complete agreement between phase and electrophysiologic maps. Transesophageal atrial pacing increased preexcitation in one patient, normalized the ECG in another and precipitated narrow QRS tachycardia in four patients. Phase maps then showed enlargement, reduction and loss of the ectopic earliest emptying segments, respectively. We conclude that this technique in conjunction with pacing is successful in lateralizing accessory pathways.
Pennsylvania plans to reward organ donation
Authors: F. Charatan
Journal: BMJ (1999)

Pennsylvania is planning to be the first US state to offer a financial reward for organ donation. The state will pay a stipend of about $300 (£187) towards the funeral expenses of an organ donor under a plan being worked out by an advisory panel.

The panel will issue its recommendations next month, and Republican Governor Tom Ridge is expected to approve the new programme. Payments authorised …
Successful parenteral desensitization to paclitaxel
Authors: David M. Essayan, Anne Kagey-Sobotka, Patrick J. Colarusso, Lawrence M. Lichtenstein, Robert F. Ozols, Earl D. King
Journal: Journal of Allergy and Clinical Immunology (1996)

BACKGROUND: Paclitaxel, a member of a new class of antineoplastic agents called the taxanes, has been associated with anaphylactoid reactions. OBJECTIVE: We report a case of successful parental desensitization to paclitaxel. METHODS: Desensitization was performed with serial 10-fold dilutions (up to 1:100,000) of paclitaxel in sufficient volume to administer successive doses of 1, 2, 4, and 8 ml. Basophil histamine release tests were performed with paclitaxel alone, vehicle alone, and paclitaxel and vehicle combined to determine which agent was responsible for the anaphylactoid reactions. RESULTS: After parental desensitization was performed, the patient was able to tolerate infusion of paclitaxel without complications or need for antihistamines or steroids. Basophil histamine release occurred only with paclitaxel and not with the vehicle. CONCLUSIONS: Successful parenteral desensitization to paclitaxel can be achieved; it is paclitaxel, and not its vehicle, that is most likely responsible for anaphylactoid reactions in patients undergoing treatment. (J ALLERGY CLIN IMMUNOL 1996;97:42-6.)
Association of Frequency and Duration of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk
Authors: Mary Beth Terry, Marilie D. Gammon, Fang Fang Zhang, Heba Tawfik, Susan L. Teitelbaum, Julie A. Britton, Kotha Subbaramaiah, Andrew J. Dannenberg, Alfred I. Neugut
Journal: JAMA (2004)

Use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been associated with a decrease in the risk of several cancers, including breast cancer. NSAIDs inhibit cyclooxygenase activity and thereby reduce prostaglandin synthesis; prostaglandins stimulate aromatase gene expression and thereby stimulate estrogen biosynthesis. Given the importance of estrogen in the pathogenesis of breast cancer, the ability of aspirin and other NSAIDs to protect against breast cancer could vary according to hormone receptor status.To determine the association between the frequency and duration of use of aspirin and other NSAIDs and breast cancer risk and to investigate whether any observed association is more pronounced for women with hormone receptor-positive breast cancers.Population-based case-control study of women with breast cancer, including in-person interviews conducted on Long Island, NY, during 1996-1997 (1442 cases and 1420 controls).Incident invasive and in situ breast cancer by aspirin and NSAID use and hormone receptor status.Ever use of aspirin or other NSAIDs at least once per week for 6 months or longer was reported in 301 cases (20.9%) and 345 controls (24.3%) (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.66-0.97 for ever vs nonusers). The inverse association was most pronounced among frequent users (> or =7 tablets per week) (OR, 0.72; 95% CI, 0.58-0.90). The results for ibuprofen, which was used by fewer women on a regular basis, were generally weaker (OR, 0.78; 95% CI, 0.55-1.10 for <3 times per week vs OR, 0.92; 95% CI, 0.70-1.22 for > or =3 times per week). Use of acetaminophen, an analgesic that does not inhibit prostaglandin synthesis, was not associated with a reduction in the incidence of breast cancer. The reduction in risk with aspirin use was seen among those with hormone receptor-positive tumors (OR, 0.74; 95% CI, 0.60-0.93) but not for women with hormone receptor-negative tumors (OR, 0.97; 95% CI, 0.67-1.40).These data add to the growing evidence that supports the regular use of aspirin and other NSAIDs (which may operate through inhibition of estrogen biosynthesis) as effective chemopreventive agents for breast cancer.
Bacterial Growth in the Duodenum and in the Bile of Patients with Gallstone Disease Treated with Endoscopic Papillotomy (EPT)
Authors: V. Skar, A. G. Skar, T. Midtvedt, M. Osnes
Journal: Endoscopy (1986)

Bacterial growth in the duodenum and in the bile was studied in 30 patients treated by endoscopic papillotomy (EPT) for stones in the common bile duct. Duodenal sampling was done endoscopically with a microbiology specimen brush, and bile was collected from the common bile duct using a catheter designed to avoid contamination from other sources. The same type of fecal flora was found in the duodenum and in the bile. The majority of patients had more than one strain in the duodenum as well as in the bile. Strains belonging to the Enterobacteriaceae and fecal streptococci dominated. Anaerobes were found in the duodenum in 27.7% of the patients, and in the bile in 16.7%. The heavy bacterial infestation of the common bile duct in our patients did not give rise to clinical symptoms.
Technology, funds promise new era in parasitology
Authors: Phil Gunby
Journal: JAMA (1984)

If the projected 8.3 billion people are on earth to welcome the year 2025, there is a reasonable likelihood—if conditions are not altered in the meantime— that more than half of them will be infected with parasitic diseases. However, there now are indications that steps (by the World Health Organization and others) may be taken during the rest of the 1980s and the remaining years of this century to change that gloomy possibility, as well as to give new emphasis and scope to parasitology research. The most dramatic development has come in recent days in the form of an announcement from the John D. and Catherine T. MacArthur Foundation that it will fund "a research consortium dedicated to discovering new means of controlling parasitic illnesses such as malaria, tape-worm, dysentery, and African sleeping sickness." These and other parasitic illnesses are being called "the most costly and debilitating diseases in the
Frequency versus time domain analysis of signal-averaged electrocardiograms. III. Stratification of postinfarction patients for arrhythmic events
Authors: Olusola Odemuyiwa, Marek Malik, Jan Poloniecki, Thomas Farrell, Piotr Kulakowski, Teri Millane, Anne Staunton, John Camm
Journal: Journal of the American College of Cardiology (1992)
Those Deceptive Contraceptives
Authors: Clarence J. Gamble
Journal: JAMA (1963)

To the Editor:  —In his recent article, Those Deceptive Contraceptives ( JAMA  181 :122 [July 14] 1962), Dr. DeCosta included quotations from our report, Oral Contraception by Norethynodrel (Cook, Gamble, and Satterthwaite, Amer J Obstet Gynec  82 :437 [Aug] 1961). These were so brief, his readers may receive an impression different from that presented in the original article.  DeCosta, in discussing the effectiveness of oral contraceptives, says, Cook et al have reported that 11 pregnancies occurred among 550 women they studied. To give an accurate picture of the results, he should have included our succeeding sentences which were, Of these (11 pregnancies), 4 had started before norethynodrel was begun. Three occurred when the women waited more than the prescribed 10 days for the return of menses (one woman waiting 15, one 20, and one 30 days). The other 4 followed failure of the women to take the tablets daily; trustworthy details
Porphyromonas gingivalis infection is associated with carotid atherosclerosis in non-obese Japanese type 2 diabetic patients
Authors: Ataru Taniguchi, Fusanori Nishimura, Yoji Murayama, Shoichiro Nagasaka, Mitsuo Fukushima, Masahiko Sakai, Satoru Yoshii, Akira Kuroe, Haruhiko Suzuki, Yoshihiro Iwamoto, Yoshihiko Soga, Takahide Okumura, Masahito Ogura, Yuichiro Yamada, Yutaka Seino, Yoshikatsu Nakai
Journal: Metabolism (2003)
Ets1 and Ets2 are required for endothelial cell survival during embryonic angiogenesis
Authors: Guo Wei, Ruchika Srinivasan, Carmen Z. Cantemir-Stone, Sudarshana M. Sharma, Ramasamy Santhanam, Michael Weinstein, Natarajan Muthusamy, Albert K. Man, Robert G. Oshima, Gustavo Leone, Michael C. Ostrowski
Journal: Blood (2009)
Takotsubo cardiomyopathy in a patient undergoing hemodialysis
Authors: Fumi Takemoto, Norio Chihara, Naoki Sawa, Junichi Hoshino, Masayuki Yamanouchi, Noriko Hayami, Eiko Hasegawa, Tatsuya Suwabe, Shohei Nakanishi, Michiro Nakamura, Haruo Mitani, Yoshifumi Ubara, Kenmei Takaichi, Minoru Ohno
Journal: Kidney International (2009)
Diagnosis of Gonorrhea
Authors: Ron Neimeister
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Riccardi and Felman stated that confirmation of<i>N gonorrhoeae</i>is necessary only in oral infections. However, several publications (242:1653, 1979)<sup>1-4</sup>show that<i>N meningitidis</i>has been isolated from sites other than the more common nasopharyngeal area. Therefore, limiting confirmation of the<i>Neisseria</i>sp to those isolated in the oral cavity would preclude the possibility of the identification of the meningococci from the atypical sites.
Abstract 5569: The association between statin use and risk of biochemical recurrence in men treated with radical prostatectomy in a cohort of men with inherited forms of prostate cancer
Authors: Miriam Ishak, Kathleen Cooney
Journal: Cancer Research (2011)

Abstract Background: Evidence exists that statin medications are associated with decreased risk of advanced prostate cancer. The risk factors for prostate cancer are increasing age, African-American race and family history of the disease. To date, studies of the association between statin medication and risk of prostate cancer have not considered men with familial or hereditary prostate cancer. Methods: Men enrolled in the University of Michigan Prostate Cancer Genetics Project (PCGP) who had been previously diagnosed with prostate cancer and treated with radical prostatectomy were surveyed as to their past and current statin medication use status, type of statin medication, duration of statin medication use and their incidence of biochemical recurrence. PCGP is a large, family-based study of inherited forms of prostate cancer. The PCGP enrollment criteria included families with two or more living-affected family members in a first-degree or second-degree relationship. The risk of biochemical recurrence (BCR) was modeled using logistic regression models and odds ratios and 95% confidence intervals were calculated. Results: Of 595 unrelated men with past radical prostatectomy surveyed, 91 men experienced BCR. At time of survey, 40% of men were current statin users. Median follow-up time was 67 months for statin users was 75 months for non-statin users. Current statin-use at time of recurrence was associated with a decreased risk of BCR (OR = 0.685; 95% C.I.:0.438 – 1.072; p=0.09); while ever statin-use was not associated with risk of BCR in multivariate models adjusted for age and BMI. Discussion: This represents the only study to date to assess statin medication use and the risk of biochemical recurrence in men with familial and hereditary prostate cancer. Given the importance of family history as a risk factor for prostate cancer, these findings should be confirmed in other studies and may implicate subgroups of men at risk for prostate cancer who may benefit from statin medication use. 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 5569. doi:10.1158/1538-7445.AM2011-5569
Central Bilateral Pulmonary Infiltrates in an Asymptomatic Man
Authors: B. F. Corsello, B. Varkey
Journal: JAMA (1982)

<h3>History</h3> A 34-year-old asymptomatic man was referred to us for evaluation of an abnormal chest roentgenogram obtained during a preemployment evaluation. He had not suffered from any pulmonary disease in the past, and his family history was unremarkable. No history of drug use or abuse was obtained; he had smoked one pack of cigarettes daily for 15 years. He had done some demolition work in Vietnam from 1965 to 1969, odd jobs in southern California from 1969 to 1979, and less than a year of demolition work in Minnesota just before moving to Wisconsin. He stated that he had had no radiological studies of the chest during the past 12 years. Findings from physical examination, urinalysis, screening blood chemistry studies, and pulmonary function studies (spirometry, lung volumes, diffusing capacity, and arterial blood gases) were normal, as was a complete blood cell count. Posteroanterior (PA) and lateral chest roentgenograms are shown