tbuckley/cabot-search huggingface dataset:
Retroperitoneal Ectopic Pregnancy: A Case Report
Authors: Peter C. Sotus
Journal: JAMA (1977)

<h3>To the Editor. —</h3> Of the various types of ectopic pregnancies that have been reported, the retroperitoneal implantation probably represents the rarest. A search of the literature reveals only one other case<sup>1</sup>that appears to be a true retroperitoneal pregnancy. Another report<sup>2</sup>appears, in fact, to be a case of intraligamentous pregnancy. <h3>Report of a Case.—</h3> The patient was a 30-year-old woman with a history of three previous uneventful pregnancies. Her last menstrual period was Oct 18, 1975, and a pregnancy test was positive on Dec 1, 1975. A slightly enlarged uterus had been noted by her obstetrician on Dec 22. Because of some vaginal spotting therapy with dydrogesterone, 10 mg twice a day, was begun. The bleeding increased, and nine days later the uterus was noted to be slightly enlarged with a dilated cervix. It was felt that this represented a poor pregnancy, and a suction curettage
Intracoronary morphology of culprit lesions after reperfusion in acute myocardial infarction: Serial angioscopic observations
Authors: Yasunori Ueda, Masanori Asakura, Atsushi Hirayama, Kazuo Komamura, Masatsugu Hori, Kazuhisa Kodama
Journal: Journal of the American College of Cardiology (1996)
Margaret Siriol Colley
Authors: P. Colley
Journal: BMJ (2012)

Born in 1925 in Lewisham, London, to a Welsh family, Margaret Siriol Colley spent some years at Roedean before later being evacuated to Nova Scotia in Canada during the second world war. It was there at Dalhousie University that she began her medical studies. These were concluded at St Andrew’s in Scotland where she graduated in 1948. She took up her first post at the Royal Naval Hospital in Greenwich before moving to Chatham, where she met fellow doctor Nigel Colley, whom she married in 1950.

The couple established two practices in the Bramcote and Beeston areas of Nottingham. This was at a time when female doctors were few and far between and lead to her being addressed by her patients as “Lady Doctor Margaret.” In the happy years that followed she …
Pancreatic autoantibodies in Crohn's disease: a family study.
Authors: F Seibold, H Mork, S Tanza, A Muller, C Holzhuter, P Weber, M Scheurlen
Journal: Gut (1997)

Pancreatic antibodies occur in about one third of patients with Crohn's disease.To evaluate the relevance of pancreatic antibodies as a genetic marker in patients with Crohn's disease and their first degree family members and spouses. To characterise further pancreatic antibodies by assessment of IgG subclasses.Six hundred and fifty serum samples were tested for pancreatic antibodies by immunofluorescence on sections of human pancreas. Incidence of pancreatic antibodies and their subtypes were studied on 212 serum samples from patients with Crohn's disease. In the familial study, 72 patients with Crohn's disease and 196 first degree family members and 26 patients with ulcerative colitis and 90 first degree family members were included. Ten healthy families served as controls.Pancreatic antibodies were found in 58 (27%) of the patients with Crohn's disease and in none of the controls. Thirty patients had pancreatic antibodies of subtype I characterised by a drop-like fluorescence in the pancreatic acini, 28 patients had subtype II with a fine speckled staining in the acinar cells. Pancreatic antibodies of subtype I were both IgG1 and IgG2 antibodies by contrast with subtype II which were mainly of IgG1 subclass. Only five of 196 first degree relatives of patients with Crohn's disease had pancreatic antibodies. Four of these people had anamnestic data compatible with inflammatory bowel disease. Further investigations showed Crohn's disease in two of these people. In families with more than one member positive for pancreatic antibodies, pancreatic antibodies were of the same subtype in all cases.Pancreatic antibodies are a specific marker for Crohn's disease. Two subgroups of pancreatic antibodies can be distinguished by their pattern and immunoglobulin subclasses. Pancreatic antibodies rarely occur in family members of patients with Crohn's disease. These family members may also have Crohn's disease.
Coincidental finding of May‐Hegglin anomaly in a patient with end‐stage renal failure
Authors: N. Nel, B. W. J van Rensburg, Lizette Du Plessis, C. D. Potgieter, K. Stevens
Journal: American Journal of Hematology (1992)

Abstract We present two cases of May‐Hegglin anomaly incidentally discovered in a patient and his brother during investigation of the patient for end‐stage renal failure and workup for renal transplantation. Routine laboratory tests were performed and included a basically normal clotting profile. Ultrastructural studies of the May‐Hegglin inclusions proved diagnostic, findings were compared with those of two similar granulocyte inclusion bodies, and nomenclature discrepancies that still exist in most references are again emphasized. The finding of the May‐Hegglin anomaly in our patient appears to be incidental to the underlying renal disease. A successful renal transplant has been carried out in this patient. We now report on a patient and his brother in which the MHA was discovered during workup of the patient for end‐stage renal failure and renal transplantation. No association between the underlying renal disease and the MHA could be demonstrated. © 1992 Wiley‐Liss, Inc.
Physicians as Fundraisers: Medical Philanthropy and the Doctor-Patient Relationship
Authors: Julian J. Z. Prokopetz, Lisa Soleymani Lehmann
Journal: PLoS Medicine (2014)

Lisa Lehmann and colleagues discuss how "grateful patient" programs that solicit donations from wealthy individuals who receive care may be problematic for physicians and propose policies that mitigate these risks. Please see later in the article for the Editors' Summary
Effect of Inhibition of Lipolysis on Infarct Size After Experimental Coronary Artery Occlusion
Authors: John K. Kjekshus, Ole D. Mjøs
Journal: Journal of Clinical Investigation (1973)

Recent studies have demonstrated a depressant effect of increased delivery of FFA to the hypoxic heart. Because catecholamines are released in acute myocardial infarction, it is likely that lipolytic activity is increased. The purpose of this study was to determine whether inhibition of hormone-sensitive lipases influence the extent and severity of myocardial ischemic injury produced by coronary occlusion. Myocardial infarction was produced by occlusion of the left anterior descending coronary artery in open-chest dogs. 15 min later a surface map of S-T segments was obtained with the use of 10-14 epicardial leads in the distribution area of the occluded artery. Average S-T segment elevation of all sites was used as an index of myocardial ischemic injury. Before coronary occlusion, the average S-T segment elevation was 0.3±0.2, which increased to 4.1±0.7 mV (SEM, 12 dogs) after occlusion. Inhibition of lipolytic activity by β-pyridyl-carbinol before repeated coronary occlusion reduced the occlusion-induced S-T segment elevation to 2.1±0.6 mV (P < 0.001). When arterial concentrations of FFA were raised by i.v. infusion of a triglyceride emulsion and heparin, average S-T segment elevation after coronary occlusion increased from 1.2±0.7 to 2.2±0.8 mV (P < 0.05) in animals treated with β-pyridyl-carbinol, which suggests an unfavorable effect of circulating FFA in this setting. Isoproterenol given before a repeated occlusion increased the severity and extent of the ischemic injury. The effect of isoproterenol on the occlusion-induced S-T segment elevation was reduced, however, when the lipolytic effect of the drug was inhibited by β-pyridyl-carbinol.
Part time senior registrars, registrars, and senior house officers in general medicine and its specialties: a report to the Royal College of physicians.
Authors: C W Burke, N A Black
Journal: BMJ (1983)

The Department of Health and Social Security introduced schemes for part time training in 1969 and 1976 aimed at improving the use of the growing number of women medical graduates especially; the current scheme is set out in DHSS personnel memorandum PM(79)3. The Oxford region, under the inspiration of Dr E Rosemary Rue, has been the leader in implementing these schemes. The Oxford regional advisers of the Royal College of Physicians have thus had particular concern over the difficulties, and called attention to them at a meeting of college regional advisers in 1976-7 and again in 1979-80. On this last occasion the meeting of regional advisers, supported by the president, responded by commissioning a survey of the problems in general medicine and its subspecialties in England, Wales, and Northern Ireland, which was carried out by us in 1981. A preliminary report was made to the regional advisers in October 1981, but because of its length and subsequent receipt of further data and more research, we now present this final and shortened report to the college for action.
NONSPLINTING TREATMENT OF FRACTURES OF THE ELBOW JOINT
Authors: A. A. NEUWIRTH
Journal: JAMA (1942)

In the treatment of any type of fracture, the first thought that comes to mind is fixation and splinting. Concerning fractures of the elbow joint, however, equal consideration should be given to the concept of nonfixation. That a considerable degree of dysfunction has been the rule rather than the exception with splinting treatment is confirmed by Cohn.<sup>1</sup>He states that "end results in fracture of the elbow are not good." He and others admit that the avoidance of complications such as Volkmann's ischemic contracture, myositis ossificans or ulnar neuritis is easier than treatment of these conditions later. Deviation from traditional treatment was tried in a series of cases because of the unsatisfactory results obtained in a case at Fort Totten in which an officer sustained a minor fracture of the elbow joint as a result of a fall during a basketball game, with resulting ankylosis and calcification. <h3>REPORT OF</h3>
Degree of cross-genotype reactivity of hepatitis C virus-specific CD8+ T cells directed against NS3
Authors: Silvia Giugliano, Filiz Oezkan, Mathias Bedrejowski, Markus Kudla, Markus Reiser, Sergei Viazov, Norbert Scherbaum, Michael Roggendorf, Joerg Timm
Journal: Hepatology (2009)

Abstract The inherent sequence diversity of the hepatitis C virus (HCV) with the existence of multiple genotypes that differ up to 20% at the amino acid level represents one of the major obstacles for immune control. Accordingly, immune control of a heterologous virus challenge, particularly across genotypes, is difficult to achieve; however, the overall role of genotype-specific sequence differences has not yet been defined at the epitope level. The aim of this study was to determine the role of genotype-specific sequence differences for the CD8+ T cell response against HCV. We analyzed a cohort of anti-HCV–positive injection drug users infected with HCV genotype 1 (n = 17) or genotype 3 (n = 22) or undetectable HCV-RNA (n = 14) with overlapping peptides covering consensus sequences of NS3 from both genotypes. Importantly, the majority of HCV-specific CD8 T cells were specific for one genotype only indicating that sequence differences between genotypes are relevant at the epitope level. Interestingly, T cells active against both genotypes were significantly more frequent in HCV-RNA–negative subjects. Of note, we identified five subjects with undetectable viremia and coexistence of two T cell populations—one for each genotype—suggesting immune control of two different genotypes. Conclusion: We systematically analyzed the degree of cross-genotype reactivity of HCV-specific T cells and have shown that CD8 responses targeting different HCV genotypes can be primed in the same individual and that such responses potentially characterize a subgroup among injection drug users being protected from chronic HCV infection. (Hepatology 2009.)
Suffering With Advanced Cancer
Authors: Keith G. Wilson, Harvey Max Chochinov, Christine J. McPherson, Katerine LeMay, Pierre Allard, Srini Chary, Pierre R. Gagnon, Karen Macmillan, Marina De Luca, Fiona O'Shea, David Kuhl, Robin L. Fainsinger
Journal: Journal of Clinical Oncology (2007)

Purpose The alleviation of suffering is a central goal of palliative care, but little research has addressed the construct of suffering as a global experience of the whole person. We inquired into the sense of suffering among patients with advanced cancer to investigate its causes and correlates. Patients and Methods Semistructured interviews were administered to 381 patients. The interviews inquired about physical symptoms, social concerns, psychological problems, and existential issues. We also asked, “In an overall, general sense, do you feel that you are suffering?” Results Almost half (49.3%) of respondents did not consider themselves to be suffering, and 24.9% felt that they suffered only mildly. However, 98 participants (25.7%) were suffering at a moderate-to-extreme level. The latter participants were more likely to experience significant distress on 20 of the 21 items addressing symptoms and concerns; the highest correlations were with general malaise (rho [ρ]= 0.56), weakness (ρ = 0.42), pain (ρ = 0.40), and depression (ρ = .39). In regression analyses, physical symptoms, psychological distress, and existential concerns, but not social issues, contributed to the prediction of suffering. In qualitative narratives, physical problems accounted for approximately half (49.5%) of patient reports of suffering, with psychological, existential, and social concerns accounting for 14.0%, 17.7%, and 18.8%, respectively. Conclusion Many patients with advanced cancer do not consider themselves to be suffering. For those who do, suffering is a multidimensional experience related most strongly to physical symptoms, but with contributions from psychological distress, existential concerns, and social-relational worries.
Margaret McCartney: Don't be bullied into prescribing Tamiflu
Authors: M. McCartney
Journal: BMJ (2015)

I have recurrent thoughts about times when doctors felt adamant about the benefit of interventions—putting babies to sleep on their front, for example, or giving steroids to people with head injury, or bloodletting—that turned out to be lethal.

Now we have guidelines, hundreds of them. Good guidelines would distil evidence cautiously, making clear what we know and where the gaps are. They would say how many people would get what benefit from a treatment, while identifying the cost in terms of harm. But guidelines are not always applicable to our patients,1 and they are meant to guide practice; rarely should they dictate it.

The medical director and the centre director for the Thames Valley area of NHS England have recently written to GPs about the prophylactic use of oseltamivir (Tamiflu) for flu in nursing homes. They wrote, “It is concerning …
Clinical and echocardlographic spectrum of mitral valve and papillary muscle injury as a complication related to percutaneous transvenous mitral commissurotomy with inoue balloon catheter: experience from 6,800 patients
Authors: Jagdish C. Mohan, Partho P. Sengupta, Vineet Jain, Ramesh Arora, Joachim Nesser, Natesa G. Pandian
Journal: Journal of the American College of Cardiology (2002)
CARDIAC-SPECIFIC TRANSGENIC INHIBITION OF NF-KB ACTIVATION PROTECTS AGAINST MYOCARDIAL ISCHEMIA/REPERFUSION INJURY
Authors: Guangming Cheng, Yanjuan Yang, Magdy Girgis, Arash Davani, Carrie M. Quinn, Harold Elias, Jeryl Hauptman, Buddhadeb Dawn
Journal: Journal of the American College of Cardiology (2012)
Hepatocyte swelling stimulates macromolecular synthesis
Authors: Robert Wondergem
Journal: Hepatology (1990)

In hepatocytes from fasted rats, several amino acids are known to stimulate glycogen synthesis via activation of glycogen synthase. The hypothesis that an increase in cell volume resulting from amino acid uptake may be involved in the stimulation of glycogen synthesis is supported by the following observations. 1) The extent of stimulation of glycogen synthesis by both metabolizable and nonmetabolizable amino acids was directly proportional to their ability to increase cell volume, except for proline, which stimulated glycogen synthesis more than could be accounted for by the increase in cell volume. 2) Both cell swelling and stimulation of glycogen synthesis by amino acids were prevented when hepatocytes were incubated in hyperosmotic media containing sucrose or raffinose. 3) Increasing the cell volume by incubating hepatocytes in Na + -depleted media in the absence of amino acids also stimulated glycogen synthesis. 4) Stimulation of glycogen synthesis by Na + depletion was prevented by restoring the normal osmolarity with sucrose, but not with choline chloride which, by itself, stimulated glycogen synthesis and increased cell volume. It is concluded that stimulation of glycogen synthesis by amino acids is due, at least in part, to an increase in hepatocyte volume resulting from amino acid uptake, and that hepatocyte swelling per se stimulates glycogen synthesis.
Markers of Insulin Resistance Are Strong Risk Factors for Retinopathy Incidence in Type 1 Diabetes: The EURODIAB Prospective Complications Study
Authors: N. Chaturvedi, A.-K. Sjoelie, M. Porta, S. J. Aldington, J. H. Fuller, M. Songini, E. M. Kohner
Journal: Diabetes Care (2001)

To determine the incidence of retinopathy and the relative importance of its risk factors in type 1 diabetes.This is a 7.3-year follow-up of 764 of 1,215 (63%) people with type 1 diabetes across Europe, aged 15-60 years at baseline with no retinopathy (the EURODIAB Prospective Complications Study). Retinal photographs were taken at baseline and follow-up and risk factors were assessed to a standard protocol.Retinopathy incidence was 56% (429/764, 95% CI 52-59%). Key risk factors included diabetes duration and glycemic control. We found no evidence of a threshold effect for HbA1c on retinopathy incidence. Univariate associations were observed between incidence and albumin excretion rate, cholesterol, triglyceride, fibrinogen, von Willebrand factor, gamma-glutamyltransferase, waist-to-hip ratio, and insulin dose. No associations were observed for blood pressure, cardiovascular disease, or smoking. Independent risk factors, as assessed by standardized regression effects, were HbA1C (1.93, P = 0.0001), duration (1.32, P = 0.008), waist-to-hip ratio (1.32, P = 0.01), and fasting triglyceride (1.24, P = 0.04).Retinopathy incidence in type 1 diabetes remains high. Key risk factors include diabetes duration and glycemic control, with no evidence of a threshold for the latter. Other independent risk factors, such as waist-to-hip ratio and triglyceride levels, both markers of insulin resistance, were strongly related to incidence.
Differential and tissue-specific regulation of the multiple rat c-erbA messenger RNA species by thyroid hormone.
Authors: R A Hodin, M A Lazar, W W Chin
Journal: Journal of Clinical Investigation (1990)

Thyroid hormone (T3) has been shown to regulate the level of its receptor in a number of tissues and cell lines. Recently, proteins encoded by the protooncogene c-erbA have been identified as T3 receptors. In the rat, four c-erbA gene products have been isolated, three of which, r-erbA alpha-1, r-erbA beta-1, and r-erbA beta-2, encode biologically active T3 receptors; the fourth, r-erbA alpha-2, may play an inhibitory role in T3 action. The present work examines the molecular nature of T3 receptor autoregulation using probes specific for each c-erbA mRNA. Rats were rendered hypothyroid with propylthiouracil and then treated with either saline or T3. Northern blot analyses reveal marked tissue-specific and differential regulation of the multiple c-erbA mRNAs by T3. In the pituitary the levels of r-erbA beta-1 mRNA increase, whereas the levels of the pituitary-specific r-erbA beta-2 mRNA decrease with T3 treatment. In heart, kidney, liver, and brain the levels of r-erbA beta-1 are unaffected by thyroidal status. The levels of both r-erbA alpha mRNAs decrease with T3 treatment in all tissues examined except for the brain, where there is no change. In addition, we find that changes in the mRNAs encoding specific subpopulations of T3 receptors do not always parallel changes in total nuclear T3 binding. Differential regulation of the specific c-erbA mRNA species could have important consequences for T3 action.
Hindsight Is Not 20/20: a Cautionary Tale in Pancreatic Cancer
Authors: D. Robbins, B. Hoffman
Journal: Endoscopy (2004)

It is widely recognized that endoscopic ultrasonography (EUS) in combination with fine-needle aspiration (FNA) has a specificity of almost 100 % in the diagnosis of pancreatic cancer. While EUS is in our view a very sensitive diagnostic tool, the diagnosis of pancreatic cancer can be overlooked even by expert endosonographers. Short of direct procedure-related complications, missed gastrointestinal cancers are the most dreaded and most humbling consequence to face the practicing endoscopist. In a study published in this issue of Endoscopy, Bhutani et al. [1] sought to identify factors leading to a missed or delayed diagnosis of pancreatic cancer on EUS. While this cautionary study identified practical limitations of EUS-FNA in detecting pancreatic cancer, there are several important caveats regarding it which need to be addressed.
APPENDICITIS WITH ORIGINAL REPORT, HISTORIES AND ANALYSIS OF ONE HUNDRED AND FORTY-ONE LAPAROTOMIES FOR THAT DISEASE UNDER PERSONAL OBSERVATION.Read before the Pan-American Medical Congress.
Authors: J. B. MURPHY
Journal: JAMA (1894)

It might seem necessary to offer an apology for presenting a subject that has been so thoroughly discussed at medical associations and so voluminously considered in medical literature in the past four years. But I will offer none for presenting this subject, as many of its important relations to the physician and patient are still moot questions. There is probably no subject in abdominal surgery on which the profession is so divided and on which such opposite views are entertained. Gynecologists are fairly well agreed on what the procedure should be in cases of pyosalpinx, ovarian cysts, and even now on fibroid tumors, but at every medical meeting in which the subject of appendicitis is discussed we find the physicians almost equally divided for and against operative procedure. The question presents itself, Why are they thus divided? The answer is, They are divided because they have different views, or better,
Biochemistry for Medical Sciences
Authors: Howard S. Tager
Journal: JAMA (1980)

To take the author's goals for this book seriously ("to present the biochemical foundation necessary to students of medicine and related fields... [and to produce a text]... useful to biologists and clinicians who wish to keep abreast of ongoing developments and current hypotheses" is to say he has not been extremely successful. His view of biochemistry emphasizes metabolic reactions (with, to the author's credit, chemical structures of reactants and products), but he has little to say about cellular and organellar aspects of biochemical reactions. The organization of the text has been seen before: a brief look at the chemical components of living cells, a lengthy progression through intermediary metabolism, a discussion of nucleic acids and protein biosynthesis, and, finally, a series of chapters on blood, respiration, specialized tissues, and nutrition. The exposition is uninteresting, and although suggested reading lists are provided at the conclusion of each chapter, the lists
Chronic periaortitis presenting as common bile duct obstruction.
Authors: D Remedios, M Coppen, J Bradbeer, A Theodossi
Journal: Gut (1991)

The case of a 67 year old woman is reported who presented with cholestatic jaundice and was found to have, in addition, an inflammatory abdominal aortic aneurysm. Only at necropsy did histopathology show chronic periaortitis as the aetiology of a pancreatic head mass which, during life, mimicked a pancreatic neoplasm obstructing the bile and pancreatic ducts.