tbuckley/cabot-search huggingface dataset:
A CONTRIBUTION TO THE PATHOLOGY OF PRIMARY SPLENOMEGALY (GAUCHER TYPE), WITH THE REPORT OF AN AUTOPSY ON A MALE CHILD FOUR AND ONE HALF YEARS OF AGE
Authors: F. S. Mandlebaum
Journal: The Journal of Experimental Medicine (1912)

As a result of this study it may be stated that primary splenomegaly of the Gaucher type is a distinct disease, related in all probability to the blood diseases. It begins usually at an early age, frequently affects several members of a family, and runs a chronic course. The clinical manifestations are: pronounced hypertrophy of the spleen, subsequent enlargement of the liver, absence of palpable lymph nodes, absence of jaundice and ascites, absence of characteristic blood changes, discoloration or pigmentation of the skin, and a tendency to epistaxis or other hemorrhages. The lesions are found in the spleen, lymph nodes, bone marrow, and liver. These organs show the presence of iron-containing pigment, and large multinuclear cells with a characteristic cytoplasm. In the early cases peculiar large phagocytic cells arising from atypical large lymphocytes are found in the follicles (keimcentra) of the hemapoietic system. After leaving the follicles these cells possess phagocytic qualities for a certain period. As a result of the phagocytosisthe cells enlarge, the nature of the cytoplasm changes, and the cells acquire a characteristic vacuolated and wrinkled appearance. The cells are carried from the spleen through the portal system to the liver, where they are destroyed. The irritation produced by this destructive process gives rise to an increase in the intralobular connective tissue. The disease is eminently a chronic one, without any of the manifestations of malignancy, and always terminating as the result of some intercurrent affection. The etiology is unknown, although a family predisposition to some toxic agent which causes an irritability of the follicles in the hemapoietic system probably exists. The possibility of some protozoan infection as an etiological factor must not be overlooked.
Progress in ARDS research: a protection racket?
Authors: J DAKIN
Journal: Thorax (2001)

The acute respiratory distress syndrome in adults (ARDS) may complicate a wide variety of serious medical and surgical conditions, not all of which involve the lung directly.1 The pathogenesis remains unclear, but involves neutrophil recruitment to the alveoli and inflammatory pathway activation leading to increased permeability of the alveolar-capillary membrane and disordered vascular control, manifest clinically as pulmonary oedema formation and refractory hypoxaemia. Compliance is reduced and work of breathing is increased to the extent that most patients require endotracheal intubation and mechanical ventilatory support.2 Despite the recent publication of within-centre studies showing a fall in mortality,3 4 some 40–60% of patients with ARDS fail to survive with most of the deaths being attributable to multiple organ system failure.

It has been appreciated for some years that mechanical ventilation can itself exacerbate pre-existing alveolar injury. This may develop directly as a result of barotrauma and so called “volutrauma”, or indirectly through the adverse effects of increasing the inspired oxygen concentration to obviate hypoxaemia. Thus, studies in experimental animals have suggested that injury rises markedly above an end inspiratory (or plateau) pressure of 35 cm H2O.5 Secondly, computed tomographic scanning in patients with ARDS subjected to varying levels of positive end expiratory pressure (PEEP) has shown that dependent consolidated areas of lung tend to remain poorly compliant and underventilated, and the application of conventional tidal volumes of the order of 10 ml/kg can overdistend the spared functioning regions.6Consequently, the last decade has seen the emergence of ventilation …
Ductal Carcinoma in Situ of the Breast
Authors: Rafael Fonseca, Lynn C. Hartmann, Ivy A. Petersen, John H. Donohue, Thomas B. Crotty, John J. Gisvold
Journal: Annals of Internal Medicine (1997)

Purpose: The increasing incidence and biological heterogeneity of ductal carcinoma in situ (DCIS) of the breast have made the management of this entity challenging and controversial. This paper reviews data on the natural history of the disease and results obtained with various management approaches. Data Sources: Computerized MEDLINE search of articles related to DCIS published since 1966. Study Selection: Randomized trials were given higher value; however, because these were relatively scarce, retrospective studies and data published in abstract form were also included. Data Extraction: The authors reviewed all sources critically. No formal statistical calculations were made. Data Synthesis: The incidence of DCIS is increasing, and a greater proportion of diagnoses are being made in asymptomatic patients. No data from randomized trials compare mastectomy and breast-conserving therapy for the treatment of DCIS. A large randomized trial comparing lumpectomy with lumpectomy plus radiotherapy showed lumpectomy plus radiotherapy to be effective for management of this disease. The presence of comedo necrosis and surgical margin status are frequently used as predictors of subsequent recurrence, although this practice is controversial. The risk for in-breast recurrence at 5 years after lumpectomy and radiotherapy is approximately 8%. With more refined molecular analysis, the relation of DCIS to invasive breast cancer will be better defined. Conclusions: Treatment strategies for DCIS have evolved, and lumpectomy followed by radiotherapy is an appropriate alternative for most patients. The use of lumpectomy alone in selected patients remains controversial.
Accuracy of weighed dietary records in studies of diet and health.
Authors: M B Livingstone, A M Prentice, J J Strain, W A Coward, A E Black, M E Barker, P G McKenna, R G Whitehead
Journal: BMJ (1990)

OBJECTIVE--To provide an independent evaluation of seven day weighed dietary records, which are currently accepted as the most accurate technique for assessing habitual dietary intake in studies investigating the links between diet and health. DESIGN--Subjects who had previously participated in the Northern Ireland diet and health study were reselected by stratified random sampling to represent the range of energy intakes in the study as assessed by the seven day weighed dietary record. SETTING--Northern Ireland. SUBJECTS--31 Free living adults (16 men and 15 women). MAIN OUTCOME MEASURES--Energy intake as measured by the seven day weighed dietary record and total energy expenditure estimated concurrently by the doubly labelled water technique. RESULTS--Average recorded energy intakes were significantly lower than measured expenditure in the group overall (9.66 MJ/day v 12.15 MJ/day, 95% confidence interval 1.45 to 3.53 MJ/day). Among those in the upper third of energy intakes the mean (SE) ratio of intake to expenditure was close to 1.0, indicating accurate records (men 1.01 (0.11), women 0.96 (0.08]. In the middle and lower thirds the ratios for men were only 0.74 (0.05) and 0.70 (0.07) respectively and for women 0.89 (0.07) and 0.61 (0.07). CONCLUSIONS--These results show a serious bias in reporting habitual energy intake. If substantiated they may have wide implications for the interpretation of many nutritional studies.
Inhibition of Red Cell Aggregation Prevents Spontaneous Echocardiographic Contrast Formation in Human Blood
Authors: Diane Fatkin, Thanasis Loupas, Joyce Low, Michael Feneley
Journal: Circulation (1997)

Background Spontaneous echocardiographic contrast (SEC) is a pattern of blood echogenicity that has been attributed to ultrasonic backscatter from blood cell aggregates that form under low shear conditions. Patients with left atrial SEC have an increased thromboembolic risk. This study examined the role of red cell and platelet aggregates in the pathogenesis of SEC in human blood and the effects on SEC of antithrombotic therapy and red cell disaggregatory agents. Methods and Results Blood echogenicity was examined with the use of quantitative videodensitometry over a controlled range of flow velocities in an in vitro model characterized by nonlaminar flow conditions. One hundred ninety study samples were prepared from single fresh blood donations (40 to 120 mL) from 24 healthy volunteers and 11 patients. Whole blood echogenicity was unaltered by depletion of platelets, stimulation of platelet aggregation with adenosine diphosphate, or inhibition of platelet aggregation with aspirin. Low flow–related echogenicity increased with increasing hematocrit ( P &lt;.001) but was abolished when red cells were lysed selectively with saponin ( P &lt;.001). In the presence of red cells, low flow–related echogenicity increased with increasing fibrinogen concentration ( P &lt;.001) and with plasma paraproteins. Low flow–related echogenicity in whole blood was unaltered by heparin and warfarin but was reduced in a dose-dependent manner by dextran 40 (40 mg/mL, 70% reduction, P &lt;.001) and poloxamer 188 (8 mg/mL, 47% reduction, P &lt;.001), which inhibited red cell aggregation. Conclusions These results support protein-mediated red cell aggregation as the mechanism of SEC in human blood. Inhibition of red cell aggregation, indexed by resolution of SEC, may provide an alternative to anticoagulant and antiplatelet therapy to reduce cardiac thromboembolic risk.
Whose Death Is It, Anyway?
Authors: Timothy Gilligan
Journal: Annals of Internal Medicine (1996)

As medicine has increasingly gained the power to prolong life in the face of devastating illness, patients have increasingly become concerned about maintaining some control over how and when death arrives.Competent patients have the legal right to refuse treatment, but critically ill patients are frequently unable to participate in decision making. Advance directives were designed to help patients establish the level of care they would receive if they were to be rendered incompetent; yet, as the case discussed in this essay shows, even a valid advance directive does not guarantee that unwanted medical interventions will not be forced on us. The problem of physicians ignoring their patients' wishes goes beyond issues of communication and reflects an ongoing ambivalence about power and control in the physician–patient relationship. Unfortunately, many physicians find it easier to define success in terms of life and death than to try to determine what sort of existence is meaningful to an individual patient.
Reciprocal regulation of antral gastrin and somatostatin gene expression by omeprazole-induced achlorhydria.
Authors: S J Brand, D Stone
Journal: Journal of Clinical Investigation (1988)

Gastric acid exerts a feedback inhibition on the secretion of gastrin from antral G cells. This study examines whether gastrin gene expression is also regulated by changes in gastric pH. Achlorhydria was induced in rats by the gastric H+/K+ ATPase inhibitor, omeprazole (100 mumol/kg). This resulted in fourfold increases in both serum gastrin (within 2 h) and gastrin mRNA levels (after 24 h). Antral somatostatin D cells probably act as chemoreceptors for gastric acid to mediate a paracrine inhibition on gastrin secretion from adjacent G cells. Omeprazole-induced achlorhydria reduced D-cell activity as shown by a threefold decrease in antral somatostatin mRNA levels that began after 24 h. Exogenous administration of the somatostatin analogue SMS 201-995 (10 micrograms/kg) prevented both the hypergastrinemia and the increase in gastrin mRNA levels caused by omeprazole-induced achlorhydria. Exogenous somatostatin, however, did not influence the decrease in antral somatostatin mRNA levels seen with achlorhydria. These data, therefore, support the hypothesis that antral D cells act as chemoreceptors for changes in gastric pH, and modulates somatostatin secretion and synthesis to mediate a paracrine inhibition on gastrin gene expression in adjacent G cells.
The Handbook of Medical Ethics
Authors: David I. Olch
Journal: JAMA (1986)

<i>The Handbook of Medical Ethics</i>is a compendium of fundamental concepts that have been developed as guidelines to the everyday practice of medicine in the United Kingdom. The majority of the materials discussed do not necessarily address ethical concepts as we have come to view them in the United States. The statement is made that these basically are guidelines for practice and are not codified in law as in many European countries. However, many of the issues covered in detail directly relate to legal guidelines, such as the relationship of etiquette to the law. This approach is interesting, because, in England, national standards do apply, especially in the initiation of practice in the National Health Service. In this section, the handbook actually addresses the problems concerning the location of the physician's office, directories, canvasing for patients, professional courtesy, and the "undisclosed sharing of fees." In addition, sections are included that
P57MicroRNA-150 activates expression of MAP2K4 during hypoxia/reoxygenation in cardiomyocytes
Authors: CH Yeh, TP Chen, YC Wang, HJ Chien, HY Liang, SW Fang, YC Fang
Journal: Cardiovascular Research (2014)

Purpose: MicroRNAs (miRNAs), which are regulators of gene repression and steimulation, participate in diverse biological functions in association with ribonucleoprotein factors and cellular conditions.
In atrial fibrillation, dabigatran had similar efficacy to warfarin but caused less bleeding in higher GFR
Authors: Sajiram Sarvananthan, Prakash P. Punjabi
Journal: Annals of Internal Medicine (2014)

Source Citation Hijazi Z, Hohnloser SH, Oldgren J, et al. Efficacy and safety of dabigatran compared with warfarin in relation to baseline renal function in patients with atrial fibrillation: A RE-LY (Randomized Evaluation of Long-term Anticoagulation Therapy) trial analysis. Circulation. 2014;129:961-70. 24323795
Bone marrow cells differentiate into wound myofibroblasts and accelerate the healing of wounds with exposed bones when combined with an occlusive dressing
Authors: Y. Yamaguchi, T. Kubo, T. Murakami, M. Takahashi, Y. Hakamata, E. Kobayashi, S. Yoshida, K. Hosokawa, K. Yoshikawa, S. Itami
Journal: British Journal of Dermatology (2005)

Background The usefulness of bone marrow cells in accelerating wound healing has not been evaluated despite increasing evidence that bone marrow contains mesenchymal stem cells that have multipotentiality to differentiate into various types of cells after they enter the microenvironment of a specific tissue (niche). Objectives To determine the effects of bone marrow cells and occlusive dressings in promoting wound healing in rats. Methods We investigated by grafting, biopsy and immunohistochemistry whether various types of cells derived from green fluorescent protein (GFP)-transgenic rats would differentiate into wound component cells when administered topically on the wounds of rats. We also investigated whether topical application of bone marrow cells with an occlusive dressing would accelerate the healing of wounds with exposed bones, as measured by planimetry. Results GFP-labelled bone marrow cells contained multipotent stem cells that sufficiently differentiated into wound myofibroblasts presenting with α-smooth muscle actin in granulation tissue. Other types of cells, including myocytes, adipocytes, peripheral blood cells from buffy coat and dermal fibroblasts, did not express myofibroblast characteristics morphologically or immunohistochemically. Application of bone marrow cells and an occlusive dressing accelerated the repair of wounds with exposed bones, compared with an occlusive dressing only or with the topical administration of bone marrow cells plus a semidry to dry dressing. Conclusions Our study indicates that bone marrow cells accelerate the healing of wounds at least in part through their differentiation into wound myofibroblasts. Thus, treatment of wounds with bone marrow cells and a supportive occlusive dressing is effective in promoting the formation of healthy granulation tissue and also for the preparation of an ideal wound bed.
RELATION OF PLASMA NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL) LEVELS WITH MYOCARDIAL FUNCTION AND PROGNOSIS IN PATIENTS WITH CHRONIC SYSTOLIC HEART FAILURE
Authors: Kevin L. Shrestha, Richard W. Troughton, Allen G. Borowski, Allen L. Klein, Wai Hong Wilson Tang
Journal: Journal of the American College of Cardiology (2010)
EPICARDIAL ADIPOSE TISSUE AS A PREDICTOR OF ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WITH CORONARY ARTERY DISEASE. A COHORT STUDY.
Authors: Felipe N. Albuquerque, Gustavo Blume, William Miranda, Andrew Calvin, Yoel Korenfeld, Rui Qin, Virend K. Somers, Francisco Lopez-Jimenez
Journal: Journal of the American College of Cardiology (2011)
Hepatic mitochondrial function assessment through 13C- methionine, 13C-octanoate and 13C-ketoisocaproate breath tests
Authors: M. Candelli, A. Armuzzi, M.A. Zocco, E.C. Nista, A. De Lorenzo, A. Grieco, L. Miele, S. Di Caro, G. Gasbarrini, A. Gasbarrini
Journal: Journal of Hepatology (2001)
Percutaneous closure of the left atrial appendage was noninferior to warfarin in atrial fibrillation
Authors: Magdalena Sobieraj-Teague
Journal: Annals of Internal Medicine (2009)

Source Citation Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374:534-42. 19683639
Points: Therapeutic diets
Authors: S. Beaven
Journal: BMJ (1985)

Dr M C Petch should perhaps have called his review "Lack of lessons from ambulatory electro- cardiography" (7 September, p 617).This is especially true in the case of ventricular ectopic activity.It is worth repeating what Sir Thomas Lewis had to say: "When extrasystoles are found, the heart among other organs should be scrutinised closely.If no further signs are detected, the extrasystole can be neglected; if other signs are found, the prognosis will be based on these; the extrasystole has served its purpose and can again suffer neglect."'Even with respect to so called "warning arrhythmias," my colleagues and I have shown these months to years before they "progressed" to ventricular fibrillation or bradyarrhythmic death on repeat Holter monitoring.2I would like to differ from Dr Petch on only one specific point: that bradycardia proceeding to asystole suggests a non-cardiac cause.In most cases documented so far the underlying disease was still cardiac,3 although not necessarily coronary.4
GW25-e4431 Pulmonary arterial and bronchial obstruction due to external compression in a patient with chronic mycrobacterium avium infection. Successful therapy with bronchial and pulmonary artery stent implantation
Authors: Matthias Peuster, Fuad Baroody, Maria Dowell, Micah Bhatti, Gerhard Ziemer
Journal: Journal of the American College of Cardiology (2014)
Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213
Authors: RJ Wells, DC Arthur, A Srivastava, NA Heerema, M Le Beau, TA Alonzo, AB Buxton, WG Woods, WB Howells, DR Benjamin, DL Betcher, JD Buckley, SA Feig, T Kim, LF Odom, FB Ruymann, WA Smithson, R Tannous, JK Whitt, L Wolff, T Tjoa, BC Lampkin
Journal: Leukemia (2002)
Brivanib in Patients With Advanced Hepatocellular Carcinoma Who Were Intolerant to Sorafenib or for Whom Sorafenib Failed: Results From the Randomized Phase III BRISK-PS Study
Authors: Josep M. Llovet, Thomas Decaens, Jean-Luc Raoul, Eveline Boucher, Masatoshi Kudo, Charissa Chang, Yoon-Koo Kang, Eric Assenat, Ho-Yeong Lim, Valerie Boige, Philippe Mathurin, Laetitia Fartoux, Deng-Yn Lin, Jordi Bruix, Ronnie T. Poon, Morris Sherman, Jean-Frédéric Blanc, Richard S. Finn, Won-Young Tak, Yee Chao, Rana Ezzeddine, David Liu, Ian Walters, Joong-Won Park
Journal: Journal of Clinical Oncology (2013)

Brivanib is a selective dual inhibitor of vascular endothelial growth factor and fibroblast growth factor receptors implicated in tumorigenesis and angiogenesis in hepatocellular carcinoma (HCC). An unmet medical need persists for patients with HCC whose tumors do not respond to sorafenib or who cannot tolerate it. This multicenter, double-blind, randomized, placebo-controlled trial assessed brivanib in patients with HCC who had been treated with sorafenib.In all, 395 patients with advanced HCC who progressed on/after or were intolerant to sorafenib were randomly assigned (2:1) to receive brivanib 800 mg orally once per day plus best supportive care (BSC) or placebo plus BSC. The primary end point was overall survival (OS). Secondary end points included time to progression (TTP), objective response rate (ORR), and disease control rate based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) and safety.Median OS was 9.4 months for brivanib and 8.2 months for placebo (hazard ratio [HR], 0.89; 95.8% CI, 0.69 to 1.15; P = .3307). Adjusting treatment effect for baseline prognostic factors yielded an OS HR of 0.81 (95% CI, 0.63 to 1.04; P = .1044). Exploratory analyses showed a median time to progression of 4.2 months for brivanib and 2.7 months for placebo (HR, 0.56; 95% CI, 0.42 to 0.76; P < .001), and an mRECIST ORR of 10% for brivanib and 2% for placebo (odds ratio, 5.72). Study discontinuation due to treatment-related adverse events (AEs) occurred in 61 brivanib patients (23%) and nine placebo patients (7%). The most frequent treatment-related grade 3 to 4 AEs for brivanib included hypertension (17%), fatigue (13%), hyponatremia (11%), and decreased appetite (10%).In patients with HCC who had been treated with sorafenib, brivanib did not significantly improve OS. The observed benefit in the secondary outcomes of TTP and ORR warrants further investigation.
Treatment of Denuded Skull Table
Authors: P. Clarkson, J. Schorstein
Journal: BMJ (1945)

our knowledge.The flexible part of the Hermon Taylor gastroscope is 2 mm.wider (i.e., 14 mm.wide) and is appreciably stiffer than the corresponding part of the original Wolf-Schindler instrument.It is possible that extra care is necessary for its passage into the oesophagus.The Hermon Taylor model gives a much better view of the stomach than can be obtained with the Wolf-Schindler instrument, and we consider it is the gastro- scope of choice provided it is passed with care.SummaryTwo cases of fatal hypopharyngeal perforation of the oesophagus with the flexible gastroscope are reported.This accident appears to be the most serious risk of gastroscopy with the flexible gastroscope, and is not so infrequent as the rarity of reported cases suggests.It is important that inexperienced gastroscopists should appreciate that caution is necessary in the passage of the flexible gastroscope.
Poliomyelitis in Isolated Populations
Authors: Francis L. Black
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I was interested in the recent article by Lewis and Brannon (230:1295, 1974) on two cases of presumed poliomyelitis in the Trio Indians of Surinam. We have observed another instance of paralytic disease in an approximately 30-year-old member of the Brazilian branch of the same tribe.<sup>1</sup>This man had antibody to type 2 poliomyelitis only, indicating that if the disease were poliomyelitis it must have been type 2. The six reported cases together represent an incidence of paralytic disease of about 1/100. This is comparable to the 1/125 rate calculated by Paul et al<sup>2</sup>in a 1930 epidemic of type 2 in Eskimos of northern Alaska. Higher rates have been reported in type 1 outbreaks<sup>2,3</sup>in isolated groups, but urban epidemics have not been as virulent, presumably because of previously acquired immunity. What has seemed to us more remarkable than the fact that poliomyelitis