tbuckley/cabot-search huggingface dataset:
Outcome of Patients With Aortic Stenosis, Small Valve Area, and Low-Flow, Low-Gradient Despite Preserved Left Ventricular Ejection Fraction
Authors: Marie-Annick Clavel, Jean G. Dumesnil, Romain Capoulade, Patrick Mathieu, Mario Sénéchal, Philippe Pibarot
Journal: Journal of the American College of Cardiology (2012)
Providing Optimal Preoperative Localization for Recurrent Parathyroid Carcinoma: A Combined Parathyroid Scintigraphy and Computed Tomography Approach
Authors: Paige Clark, Thomas Wooldridge, Kenneth Kleinpeter, Nancy Perrier, James Lovato, Kathryn Morton
Journal: Clinical Nuclear Medicine (2004)

The incidence of parathyroid carcinoma is approximately 0.5% to 5% in patients with primary hyperparathyroidism. Recurrent parathyroid carcinoma is treated with surgical resection of all sites of disease to ameliorate systemic manifestations of hyperparathyroidism, primarily hypercalcemia. This study investigates the role of parathyroid scintigraphy and computed tomography (CT) imaging in recurrent parathyroid carcinoma.A retrospective chart review was performed on 8 patients diagnosed with recurrent parathyroid carcinoma at our tertiary care institution between 1975 and 2001. Surgical reports, histopathology, parathyroid scintigraphy, and CT findings were recorded. Surgical reports and radiologic studies were compared for concordance of recurrence sites.There were 32 imaging studies before reoperation: 15 parathyroid scintigraphy and 17 CTs. Of 15 sites of recurrence potentially seen on scintigraphy, 10 were true-positive (67%). Of 17 sites of recurrence potentially seen on CT, 9 were true-positive (53%). Of the 8 false-negatives on CT, 7 of these recurrences were in the surgical bed (88%). There were 9 instances in which CT and scintigraphy were performed preoperatively for comparison and correlation. CT and scintigraphic findings were incongruent in 7 of 9 of these cases (78%).Successful surgical intervention for recurrent parathyroid carcinoma requires accurate preoperative localization studies and complete excision of metastases. Our data supports combined analysis of parathyroid scintigraphy and CT for patients with recurrent disease before reoperation. Additionally, our review suggests that sensitivity may be optimized with SPECT parathyroid scintigraphy and close correlation with CT.
Endoscopic retrograde cholangiopancreatography catheter and accessory exchange using a short hydrophilic guide wire: a prospective study
Authors: G. Papachristou, T. Baron, F. Gleeson, M. Levy, M. Topazian
Journal: Endoscopy (2006)

Background and study aims: Although hydrophilic guide wires can be used to facilitate stricture cannulation during endoscopic retrograde cholangiopancreatography (ERCP), some endoscopists avoid using them because of concerns about wire loss during exchange. There are no data available on the outcomes of using a short hydrophilic guide wire during ERCP. The aim of this study was to assess the outcomes of therapeutic ERCP procedures in which a short, completely hydrophilic guide wire was used exclusively. Patients and methods: A total of 100 patients undergoing ERCP were studied prospectively. A 0.035-inch, 260-cm long, angled-tip hydrophilic wire (Terumo Glidewire) was used initially. Hydraulic catheter exchange was performed as follows: during catheter withdrawal the assistant advanced all the available wire into the catheter; a 12-ml syringe was then attached to the catheter and water was flushed under pressure to “float the wire” and maintain its position during catheter removal. Variables evaluated included exchange times and wire loss rates. Results: A total of 223 catheter exchanges were performed, 132 (59 %) using the Olympus V-Scope (which held the wire in 62 % of cases): 15 % of exchanges were with catheters/accessories designed for short-wire use (Boston Scientific Rapid Exchange Biliary System or Rx System), and 85 % were with a variety of standard-length accessories. Overall, the mean exchange time was 26 seconds (range 6 - 90 seconds, standard deviation 12 seconds). The mean exchange time was faster with the V-Scope and with non-Rx-System accessories. Wire loss occurred in 5 % of all exchanges. Desired ductal/stricture access was achieved in all the patients. Conclusions: Exchange of short hydrophilic wires is quick and reliable. The Olympus V-Scope is able to hold the wire in some cases. Monorail-type devices and accessories slow catheter exchange down slightly because hydraulic exchange cannot be performed using these systems.
Mechanical Pressure in Inertia of the Uterus
Authors: A. B. Steele
Journal: BMJ (1872)

two years and a half, when he was able to resume his work as a collier.His present condition as regards sensation has not altered in the slightest degree since the fourth month after the accident, and is as fol- lows.The sensibility in the soles of both feet, and in the posterior portion of both legs, is much impaired; and around the anus, perinaeum, inner part of both buttocks, scrotum, and penis, it is entirely destroyed.Although there is a slight sensation under pressure in the testicles, so complete is the absence of sensation in the buttocks, that when, last summer, he sat down on a garden-flue, ignorant of the fact of its being heated, his trousers were burnt through, and the skin com- pletely charred, yet he was unaware of the fact till his wife noticed it, three days afterwards, whilst he was washing.The slough was some- what deep, and the scar is still visible.Whilst at work in the pit, he frequently gets severe scratches and cuts on the soles of his feet, which he hardly feels.Each day, on his return from work, he regularly goes to the closet, and, by dint of powerful efforts, forces the faeces to pass when solid, for, when liquid, they are not retained.At this time, the urine runs involuntarily in a stream, though at other times it drips continuously into an India- rubber urinal which he wears permanently; but in neither case is there any feeling of the passage of faeces or urine.
Occult Factitial Thyrotoxicosis
Authors: Rose E, Sanders Tp, Webbs Wl, Hines Rc
Journal: Annals of Internal Medicine (1969)

Three patients are described with clinical and laboratory findings characteristic of thyrotoxicosis factitia but without proof of self-medication. The diagnosis was supported by the demonstration of accelerated thyroxine turnover comparable to that found in a patient with iatrogenic myxedema receiving large doses of thyroxine. Psychological evaluation of these patients is presented. The term "occult" thyrotoxicosis is suggested for this type of factitial disorder.
Medical, Surgical, and Gynecological Complications of Pregnancy
Authors: Byford F. Heskett
Journal: JAMA (1960)

This convenient sized book is printed in legible type on good paper. Although it is the work of 68 collaborators, it is well-organized and well-written and has a detailed index. Believing in the existence of an exceptional interplay of medicine and surgery in obstetrics, the Mt. Sinai Hospital departed from the usual pattern of organization when it opened its first department of obstetrics in November, 1952. It created 10 specialty clinics within the framework of the department of obstetrics: cardiac, pulmonary, hypertensive, diabetic, hematologic, neurologic, psychosomatic, obstetric-gynecologic, endocrine, and vaginitis and varicose vein. Each of the 10 special clinics meets in the prenatal clinic area at a different time than the ordinary antepartum clinic. Members of the obstetric-gynecologic resident staff attend the special clinics for the dual purpose of their instruction and furnishing patients routine prenatal care. This book is the result of the information gained by the participating group
The Human C3a Receptor Is Expressed on Neutrophils and Monocytes, but Not on B or T Lymphocytes
Authors: Ulrich Martin, Daniel Bock, Lubomir Arseniev, Mark A. Tornetta, Robert S. Ames, Wilfried Bautsch, Jörg Köhl, Arnold Ganser, Andreas Klos
Journal: The Journal of Experimental Medicine (1997)

The pathophysiological relevance of the complement split product C3a as a proinflammatory mediator is still ill defined. The expression pattern of the human C3a receptor (C3aR) can provide important clues for the role of this anaphylatoxin in inflammation. There is strong evidence for C3aR expression on basophils, and eosinophils, but additionally, only on tumor cell lines of leukemic or hepatic origin. It is unclear whether neutrophils also express the C3aR, but need a costimulus provided by eosinophils for certain biological responses, or whether neutrophils lack the C3aR and respond to C3a via a secondary stimulus generated by eosinophils, i.e., by an indirect mode. In the present study, polyclonal antiserum raised against the second extracellular loop of the C3aR was used to characterize C3aR expression on peripheral blood leukocytes. For high degree purification of neutrophils, a negative selection method was established that decreased the contamination with CD9bright+ eosinophils down to &amp;lt;0.2%. Flow cytometric analyses, functional assays, and binding assays on highly purified neutrophils confirmed C3aR expression and coupling. Monocytes were identified as an additional C3aR-positive cell population of the peripheral blood. The expression of the C3aR on eosinophils could be confirmed. In contrast, the receptor could not be detected on unchallenged B or T lymphocytes (or lymphocyte-derived Raji cells).
Primary bile acid diarrhoea without an ileal carrier defect: quantification of active bile acid transport across the ileal brush border membrane.
Authors: A J van Tilburg, F W de Rooij, J W van den Berg, M van Blankenstein
Journal: Gut (1991)

Unexplained bile acid malabsorption associated with diarrhoea that responds to cholestyramine was first described in 1973 but convincing evidence of the proposed mechanism--a defective active ileal bile acid transport--has never been substantiated. Active bile acid transport was quantified in vitro using brush border membrane vesicles prepared from terminal ileal biopsy specimens from 10 patients who fulfilled the criteria of idiopathic bile acid diarrhoea. They were recruited from 181 patients with bile acid malabsorption of various causes. Transport was quantified as in vitro Na+ dependent bile acid transport (INBAT), expressed as pmol taurocholate/mg brush border membrane protein/15 seconds, and in vitro Na+ dependent bile acid local transport capacity (INBALTC), expressed as pmol taurocholate/g ileal biopsy tissue/15 seconds. The lowest INBAT and INBALTC values in the 10 patients with idiopathic bile acid diarrhoea were well above the 10th centile values of a control group of 132 patients. Both INBAT (mean (range) 88 (30-136)) and INBALTC (158 (85-268)) values were significantly higher in the 10 patients than in the control group (INBAT: mean (range) 63 (1-244), INBALTC: mean (range) 98 (1-408)). Quantification of active ileal bile acid transport in these 10 patients with idiopathic bile acid malabsorption suggests that a genetic (carrier) defect is rare in adults.
The microcirculation in venous hypertension
Authors: P.D.C. Smith
Journal: Cardiovascular Research (1996)

To review the factors that result in skin ulceration of patients with chronic venous insufficiency.Index Medicus was searched using an on-line computer system for years 1966-1995 to identify articles relating to venous ulceration and the microcirculation.Articles and sections of articles relating to the mechanisms which cause venous ulceration and the efficacy of the treatment of venous ulceration have been included.It seems unlikely that venous ulceration is attributable to failure of diffusion of oxygen and other small nutritional molecules to the tissues of the skin. It is much more likely that neutrophils attach themselves to the cutaneous microcirculation, become activated and produce endothelial injury. Repeated over many months or years, this leads to the chronic inflammatory process of lipodermatosclerosis. The microvascular changes in the skin are characterised by activated endothelium and perivascular inflammatory cells.There is evidence of leucocyte involvement in the pathogenesis of venous ulceration. The exact mechanisms remain to be resolved. Improved treatment for patients may be devised with a better understanding of the basic causes of this condition.
Demographic and clinical correlates of extent of psoriasis during stable disease and during flares in chronic plaque psoriasis
Authors: J.E. Osborne, P.E. Hutchinson
Journal: British Journal of Dermatology (2008)

Following a previous population-based study, we define a common psoriatic phenotype (A) with a limited area of involvement of stable disease but extensive flares and a less common phenotype (B) with consistently widespread disease.To define these phenotypes quantitatively and to investigate any biological significance through correlations with clinical disease characteristics. Psoriatic plaque thickness was also included in the analyses.Two hundred and ninety-four patients who had had chronic plaque psoriasis for at least 5 years were recruited. Area of involvement during stable disease (A(basal)) and during the most severe flare (A(max)) were derived from current area of involvement and patient history. Mean plaque thickness (T) was calculated from a current Psoriasis Area and Severity Index score.Multivariate regression of each variable on A(basal), A(max) and T showed many highly significant relationships. Usually A(basal) and A(max) were retained in the final models but with some variables only A(basal) was retained, suggesting an intrinsic effect unrelated to A(max). Phenotype A was associated with female gender, age at onset < 40 years, exacerbation by sore throat and stress, decreased concern about psoriasis and good response to ultraviolet B and methotrexate. A(basal) was individually associated with nail and joint involvement and need for second-line therapy. T was related to male gender, nail involvement and decreased exacerbation by stress on univariate analysis but only to nail disease on multivariate analysis.The phenotypes have been shown to have biological significance. A(basal) and A(max) may be useful therapeutic indices of long-term severity in clinical trials and in the investigation of genetic/environmental influences on psoriasis severity.
Contraception and the Risk of Type 2 Diabetes Mellitus in Latina Women With Prior Gestational Diabetes Mellitus
Authors: Siri L. Kjos
Journal: JAMA (1998)

Context.-Effective contraception is essential in women with prior gestational diabetes mellitus (GDM) but should not increase their already substantial risk of developing type 2 diabetes.Objective.-Todetermine whether exposure to low-dose oral contraceptives increases the risk of developing type 2 diabetes mellitus in women with recent GDM.Design.-Retrospective cohort study of 904 Latinas with GDM who gave birth between January 1987 and March 1994, in whom postpartum diabetes was excluded at 4 to 16 weeks post partum.Interventions.-At their initial postpartum visit, 443 women selected a nonhormonal form of contraception, 383 received a low-dose, estrogen-progestin combination oral contraceptive (OC), and 78 breast-feeding women received the progestin-only OC.When breast-feeding ended, patients initially taking progestinonly OCs were switched to combination OCs.Patients were followed up periodically with oral glucose tolerance tests for up to 7 1 ⁄2 years.Main Outcome Measures.-Persontime was used to compute unadjusted average annual incidence rates of developing diabetes mellitus, as defined by the National Diabetes Data Group Criteria.Survival analysis was used to compute the unadjusted cumulative incidence rates and adjusted relative risks of diabetes mellitus.Results.-The unadjusted average annual incidence rates of type 2 diabetes mellitus were 8.7%, 10.4%, and 26.5%, respectively, for patients using nonhormonal forms of contraception, combination OCs, and progestin-only OCs.Cumulative incidence rates were virtually identical for patients with uninterrupted use of combination OCs and nonhormonal forms of contraception, but patients using progestin-only OCs developed diabetes mellitus more rapidly during the first 2 years of use.After adjustment for potential confounding factors, the use of progestin-only OCs almost tripled the risk of type 2 diabetes mellitus compared with equivalent use of low-dose combination OCs (adjusted relative risk, 2.87; 95% confidence interval, 1.57-5.27).The magnitude of this risk increased with duration of uninterrupted use.Conclusion.-Progestin-only OCs were associated with an increased risk of diabetes in breast-feeding Latinas with recent GDM and probably should be prescribed with caution, if at all, in these women.Long-term use of low-dose combination OCs did not increase the risk of type 2 diabetes compared with use of nonhormonal contraception.Thus, combination OCs do not appear to increase the risk of diabetes in non-breast-feeding women with recent GDM.
THE CAUSE, CONDITION, PREVENTION AND CURE OF DRUNKENNESSA Sabbath Evening Address
Authors: W. L. SCHENCK
Journal: JAMA (1892)

For an address upon the cause, condition, prevention and cure of drunkenness we find in the sacred volume many appropriate texts,—"Who hath woe? who hath sorrow? They that tarry long at the wine." "Wine is a mocker, and strong drink is raging, and whoso is deceived thereby is not wise." "Look not upon the wine, for at the last itbiteth like a serpent and stingeth like an adder." Drunkenness reaches back to the earliest records of our race. Sacred history tells us that the ninth generation from Adam was so besotted and debased that all mankind, save only Noah and his family, were destroyed, and that notwithstanding this terrible judgment, soon after the waters of the great flood had subsided, he planted vineyards, made wine, got drunk, and cursed his son with a grievous curse for beholding the nakedness of his debauch. All down the ages, in palace and cottage,
Metastatic pathways and time courses in the orderly progression of cutaneous melanoma
Authors: F. Meier, S. Will, U. Ellwanger, B. Schlagenhauff, B. Schittek, G. Rassner, C. Garbe
Journal: British Journal of Dermatology (2002)

It is known that two-thirds of patients who develop clinical metastases following treatment of a primary cutaneous melanoma initially present with locoregional metastases and one-third initially present with distant metastases. However, few reports in the literature give detailed figures on different metastatic pathways in cutaneous melanoma.The aim of the present study was to perform a detailed analysis of the different metastatic pathways, the time course of the development of metastases and the factors influencing them.In a series of 3001 patients with primary cutaneous melanoma at first presentation, 466 subsequently developed metastasis and were followed-up over the long term at the University of Tuebingen, Germany between 1976 and 1996. Different pathways of metastatic spread were traced. Associated risk factors for the different pathways were assessed. Differences in survival probabilities were calculated by the Kaplan-Meier method and evaluated by the log-rank test.In 50.2% of the patients the first metastasis after treatment of the primary tumour developed in the regional lymph nodes. In the remaining half of the patient sample the first metastasis developed in the lymphatic drainage area in front of the regional lymph nodes, as satellite or in-transit metastases (21.7%) or as direct distant metastases (28.1%). Anatomical location, sex and tumour thickness were significant risk factors for the development of metastasis by different pathways. The most important risk factor appeared to be the location of the primary tumour. The median intervals elapsing before the first metastasis differed significantly between the different metastatic pathways. The direct distant metastases became manifest after a median period of 25 months, thus later than the direct regional lymph node metastases (median latency period, 16 months) and the direct satellite and in-transit metastases (median latency period, 17 months). In patients who developed distant metastases the period of development was independent of the metastatic route. The time at which the distant metastases developed was roughly the same (between 24 and 30 months after the detection of the primary tumour), irrespective of whether satellite or in-transit metastases, lymph node metastases or distant metastases were the first to occur.The time course of the development of distant metastasis was more or less the same irrespective of the metastatic pathway; this suggests that in patients with in-transit or satellite metastasis or regional lymph node metastasis, haematogenic metastatic spread had already taken place. Thus, the diagnostic value of sentinel lymph node biopsy and the therapeutic benefit of elective lymph node dissection may be limited, as satellite and in-transit metastases or direct distant metastases will not be detected and haematogenous spread may already have taken place when the intervention is performed.
Intragraft TGF-β1 mRNA: A correlate of interstitial fibrosis and chronic allograft nephropathy
Authors: Vijay K. Sharma, Roxana M. Bologa, Guo-Ping Xu, Baogui Li, Janet Mouradian, John Wang, David Serur, Venkateshwara Rao, Manikkam Suthanthiran
Journal: Kidney International (1996)
Waiting times and the patient's charter
Authors: A M Ansons, J L Noble, N P Jones, E P O'Donoghue, B Leatherbarrow, A E A Ridgway, K B Mills, A B Tullo, D McLeod, G S Turner
Journal: BMJ (1994)

follow the pilot study with a randomised trial comparing intraluminal treatment with or without external beam radiotherapy (OE04 trial).The aim is to improve the quality and duration of palliation with minimal disruption to patients' lives.The OE03 and OE04 trials have already been agreed to in principle by the MRC's Cancer Therapy Com- mittee, pending the results of the respective pilot studies.We urge clinicians who treat oesophageal cancer to collaborate in large randomised trials.Such trials offer the most reliable method of assessing and comparing treatment policies and so of im- proving the results of treatment.Copies of the protocols and fiurther information can be obtained from the MRC's Cancer Trials Office.We are now particularly eager to recruit more centres into the OE02 trial.
Allergic contact dermatitis caused by transdermal hyoscine.
Authors: C. R. Gordon, A. Shupak, I. Doweck, O. Spitzer
Journal: BMJ (1989)

Number and distribution ofcomputed tomographic head scanners (7une 1987) No of No of Ratio of population No of Population3 health head to head scanner health districts Health region (millions) districts scanners (thousands) with no head scanner
How functional are atypical motor patterns?
Authors: John P. Scholz
Journal: Behavioral and Brain Sciences (1996)

Abstract Latash &amp; Anson are commended for pointing out that investigators of atypical motor performance have too often failed to recognize the adaptive nature of many atypical movement characteristics. However, the authors' assumption that atypical motor patterns can be considered “normal” and, by implication, that it is futile to attempt to teach different patterns to patients that may be more functional, is criticized.