tbuckley/cabot-search huggingface dataset:
Needle in Rectal Wall.
Authors: W. C. Brittain
Journal: JAMA (1901)

Cochranton, Pa., Dec. 10, 1901. <h3>To the Editor:</h3> —On the evening of November 20, Mr. T. M. M. came into my office complaining of what he thought was of hemorrhoidal nature, suffering pain and uneasiness in lower part of the rectum. I made an examination and could fine nothing of that character. I treated him for about two days, and being no better, but rather worse, I dilated the anus and could see only a very small ulcerated spot on the wall of the rectum. On further examination with my finger, I found at about one and one-half inches up in the rectum, part of a large sewing needle, with the point down. I could feel the click under my finger nail. I then took a pair of forceps and brought the point through the rectal wall and extracted a large-sized needle. The mischief already done by the needle culminated
The “Environment” for Autism Research: Signs of Improvement?
Authors: Cindy P. Lawler
Journal: Environmental Health Perspectives (2008)

Once thought to be rare, autism spectrum disorders (ASD) have gained increasing public attention as prevalence studies have revealed sharp increases over the past two decades.ASD now represents the second most common category of neurodevelopmental disorders.The prevalence data have been instrumental in mobilizing parents to act on behalf of their affected family members for better services and treatments and for greater research investments aimed at understanding what causes these disorders and how they can be prevented.Increased funding for ASD research has led to visible progress in many areas, although the causes for the sharp increase in prevalence remain unresolved.Changes in awareness, diagnostic practices, and availability of services can account for some of the increase, yet a separate role for increased exposure to one or more environmental agents also has been suggested.The increases in prevalence data also helped fuel speculation regarding a link between the mercury-based vaccine preservative thimerosal and ASD.Many methodologically sound epidemiologic studies have failed to support a causal relationship.Concerns persist for some parents, however, and current time trends remain under scrutiny.The possibility of a small subgroup of children with a unique vulnerability to vaccines or vaccine components has been raised and is more difficult to address.In light of the persistent public attention to ASD prevalence and to vaccines as potential risk factors, it is surprising that an appreciation for the larger fundamental question of how nongenetic/environmental factors may contribute to ASD has grown slowly.This is unfortunate, because a diverse spectrum of environmental factors merit consideration-from pesticides and other agrichemicals to pharmaceuticals, nutrition, and lifestyle.The full explanation for the relative lack of attention to environmental hypotheses is complex.Contributing influences are likely to include the contemporary scientific focus on genetic etiologies of ASD, the possible reluctance of investigators to enter an arena that included the controversial issue of vaccines as risk factors, the lack of strong etiologic clues to pursue, and the need to build new investigative teams and infrastructure that can support sustained research in this nascent area.A recent Institute of Medicine meeting on autism and the environment (Autism and the Environment: Challenges and Opportunities for Research, Washington, DC, 16-17 April 2007) highlighted the continuing challenges and opportunities for research in this area (Altevogt et al. 2008).Despite the relatively tepid scientific interest in the environment and autism over the past 8 years, there have been signs of progress.A U.S. surveillance network established by the Centers for Disease Control and Prevention (CDC) is now in place to aid detection and interpretation of future trends (Rice et al. 2007).
Antagonistic modulatory roles of magnesium and calcium on release of endothelium-derived relaxing factor and smooth muscle tone.
Authors: M E Gold, G M Buga, K S Wood, R E Byrns, G Chaudhuri, L J Ignarro
Journal: Circulation Research (1990)

The objective of this study was to elucidate the mechanisms associated with the reciprocal relation between magnesium and calcium on vascular smooth muscle tone in bovine pulmonary artery and vein. Rapid removal of magnesium from Krebs-bicarbonate medium used to bathe isolated rings of precontracted artery or vein caused transient endothelium- and calcium-dependent relaxation and cyclic GMP accumulation. Both responses were antagonized by oxyhemoglobin, methylene blue, or superoxide anion and were enhanced by superoxide dismutase. The transient relaxation was followed by sustained endothelium-independent contraction. Endothelium-denuded vascular rings contracted in response to extracellular magnesium depletion without alteration in cyclic GMP levels. The data suggest that vascular endothelium-derived nitric oxide is responsible for the calcium-dependent relaxation elicited by extracellular magnesium depletion. Indeed, in bioassay cascade studies, magnesium removal from the medium used to perfuse intact artery or vein enhanced the formation and/or release of an endothelium-derived relaxing factor by calcium-dependent mechanisms. In the absence of both extracellular magnesium and calcium, calcium readdition caused transient endothelium-dependent relaxation and cyclic GMP accumulation, and both responses were abolished by oxyhemoglobin or methylene blue. In the presence of magnesium, however, readdition of calcium to calcium-depleted medium caused only contractile responses. Addition of magnesium to calcium-containing medium consistently caused endothelium- and cyclic GMP-independent relaxation that was not altered by oxyhemoglobin or methylene blue. Thus, magnesium and calcium elicit reciprocal or mutually antagonistic effects at the levels of both endothelium-derived relaxing factor formation and/or release and smooth muscle contraction. This relation may be of physiological importance, and the possibility that a reduction in circulating magnesium levels could lead to calcium-mediated vasospasm may be of pathophysiological concern.
Short- and long-term safety of the 2 × 106 CD34+ cells/kg threshold for hematopoietic reconstitution after high-dose chemotherapy and peripheral blood progenitor cell support
Authors: C. Corsini, F. Bertolini, P. Mancuso, S. Cinieri, F. Peccatori, G. Martinelli
Journal: Annals of Oncology (2002)
THE SUBMUCOUS RESECTION OF DEFLECTED NASAL SEPTI.THE SO-CALLED KILLIAN OPERATION. REPORT OF CASES.
Authors: FRANCIS W. ALTER
Journal: JAMA (1905)

This operation has been credited to various authors, among them being Killian, Hajek, Mensell, Janen, Freer, Krebs, Boenninghaus and others. It is, however, generally spoken of as the Killian operation, and perhaps it will not be amiss for me thus to speak of it in this paper. The operation consists essentially in a submucous resection of the deflected area, whether in the cartilaginous or bony septum, or both, and the<i>modus operandi</i>and technic, while tedious and trying to both patient and operator, yet offer, on the whole, a brilliant and satisfactory result. The various steps will readily be understood by referring to the illustrations here offered. The incision is made from above down, beginning on the side of the occlusion with membraneous septum and tip of the nose turned abruptly away from the occluded nostril. This maneuver brings sharply to view the anterior border of the cartilaginous septum. With
Serum Dioxin Concentrations and Age at Menopause
Authors: Brenda Eskenazi, Marcella Warner, Amy R. Marks, Steven Samuels, Pier ario Gerthoux, Paolo Vercellini, David L. Olive, Larry Needham, Donald G. Patterson, Paolo Mocarelli
Journal: Environmental Health Perspectives (2005)

2,3,7,8-Tetrachlorobenzo-p-dioxin (TCDD), a halogenated compound that binds the aryl hydrocarbon receptor, is a by-product of numerous industrial processes including waste incineration. Studies in rats and monkeys suggest that TCDD may affect ovarian function. We examined the relationship of TCDD and age at menopause in a population of women residing near Seveso, Italy, in 1976, at the time of a chemical plant explosion. We included 616 of the women who participated 20 years later in the Seveso Women's Health Study. All women were premenopausal at the time of the explosion, had TCDD levels measured in serum collected soon after the explosion, and were ≥ 35 years of age at interview. Using proportional hazards modeling, we found a 6% nonsignificant increase in risk of early menopause with a 10-fold increase in serum TCDD. When TCDD levels were categorized, compared with women in the lowest quintile (< 20.4 ppt), women in quintile 2 (20.4–34.2 ppt) had a hazard ratio (HR) of 1.1 (p = 0.77), quintile 3 (34.3–54.1 ppt) had an HR of 1.4 (p = 0.14), quintile 4 (54.2–118 ppt) had an HR of 1.6 (p = 0.10), and quintile 5 (> 118 ppt) had an HR of 1.1 (p = 0.82) for risk of earlier menopause. The trend toward earlier menopause across the first four quintiles is statistically significant (p = 0.04). These results suggest a nonmonotonic dose-related association with increasing risk of earlier menopause up to about 100 ppt TCDD, but not above.
Sex differences in colonic function: a randomised trial.
Authors: J W Lampe, S B Fredstrom, J L Slavin, J D Potter
Journal: Gut (1993)

There are sex differences in large bowel cancer rates and a variety of other gastrointestinal disorders possibly because of differences in gut biology. To determine whether men and women have different gastrointestinal responses when consuming identical intakes of dietary fibre, 16 women and 18 men consumed liquid formula diets and 9quick breads9 with 0 g, and 10 g, and 30 g of fibre as wheat bran and vegetable fibre. The five test diets were consumed in random order, each treatment lasting 23 days. Mean transit time was faster (p = 0.02), and stool weights (g/day) were greater (p = 0.0005) for men than women. Neutral detergent fibre (NDF) excretion was greater in men (p = 0.01), and women tended to digest more NDF (p = 0.06). Men and women seemed to respond differently to wheat bran and vegetable fibre with regard to NDF excretion and digestibility. There were no gender differences in the faecal pH or moisture content. Concentrations and daily excretion of the secondary bile acids, lithocholic and deoxycholic acid, were greater for men than women (p &lt; 0.05). Gender differences in bowel function and bile acid excretion, observed when men and women consumed the same amounts of dietary fibre, may be relevant for understanding colonic disease aetiology and for undertaking future dietary intervention trials.
STUDIES IN EXPERIMENTAL SYPHILIS
Authors: Alan M. Chesney, Jarold E. Kemp
Journal: The Journal of Experimental Medicine (1925)

Rabbits can be successfully infected with syphilis by the inoculation of surface wounds with virulent strains of Treponema pallidum. Old granulating wounds in these animals constitute a particularly favorable terrain for syphilis inoculation, the chancre developing relatively soon and attaining a greater size than the lesion occurring on the basis of a fresh wound. Coal tar dermatitis renders the skin susceptible to infection with Treponema pallidum. The possible reasons for these phenomena are discussed and an hypothesis to account for them is advanced.
Orthopaedic surgeons and thromboprophylaxis
Authors: P. D Triffitt
Journal: BMJ (1991)

300 ml (300 mg) per bottle.This may be a week's supply for a drug dependent adult, but 20-30 ml can be lethal to a small child.Methadone syrup tastes pleasant enough for children to consume 150-200 ml without complaint.Parents often delay bringing to hospital children who have taken methadone.Drug dependent adults who can tolerate large doses of the drug may assume that a child will "sleep it off," and parents may be deterred from taking a child to hospital because they know that their competence to look after the child will be questioned.We are not trying to imply that methadone users should not have the care of their small children, but some steps must be taken to protect these children.We strongly suggest that it should be a legal requirement that all methadone be prescribed in child resistant plastic bottles.Further, metha- done should be bitter to taste.Finally, very serious consideration should be given to limiting the quantity prescribed at any one time to methadone users who are responsible for small children.
Effectiveness of nebulised salbutamol administered in ambulances to patients with severe acute asthma.
Authors: R J Fergusson, C M Stewart, C G Wathen, R Moffat, G K Crompton
Journal: Thorax (1995)

BACKGROUND--Nebulised salbutamol can now be administered by ambulance personnel to patients with severe acute asthma en route to hospital. This treatment, however, is not yet available in all ambulances. The safety and effectiveness of allowing ambulance crews to initiate treatment with nebulised salbutamol has been assessed in patients with acute severe asthma. METHODS--After a basic training course in the assessment of asthma and the use of a nebuliser, ambulance crews initiated treatment with nebulised salbutamol in asthmatic patients under the age of 40 years. Airflow obstruction was measured before and after treatment with a peak flow meter. A subjective assessment of any change in the patient's condition was also made. RESULTS--Nebuliser treatment was associated with a significant increase in peak flow in almost 80% of patients who had recordable values before and after treatment. The mean percentage increase in peak flow was 56.5%. Subjective assessments correlated well with peak flow measurements. No unwanted side effects were recorded. CONCLUSIONS--Nebulised salbutamol is an effective and safe treatment for acute asthma when administered by ambulance personnel after a short training course.
Ethical Dilemmas in Caring for Patients with the Acquired Immunodeficiency Syndrome
Authors: ROBERT STEINBROOK
Journal: Annals of Internal Medicine (1985)

Caring for patients with the acquired immunodeficiency syndrome (AIDS) raises ethical dilemmas about when to provide life-sustaining treatments such as mechanical ventilation and cardiopulmonary resuscitation. In addition, many patients become mentally incompetent and unable to participate in decisions. Homosexual men may want their lover or a friend to make decisions for them, but the patient's partner or friend cannot make these decisions unless he is legally designated. Decision-making guidelines may be hard to implement because caring for patients with AIDS is stressful. We describe three cases that illustrate the difficult ethical dilemmas and stresses of caring for these patients.
The Case of Helga Wanglie
Authors: Marcia Angell
Journal: New England Journal of Medicine (1991)

Helga Wanglie, an 86-year-old Minneapolis woman, died of sepsis on July 4 after being in a persistent vegetative state for over a year. She was the focus of an extremely important controversy over the right to die that culminated in a court decision just three days before her death.1 The controversy pitted her husband and children, who wanted her life maintained on a respirator, against doctors at the Hennepin County Medical Center, who wanted her removed from the respirator because they regarded the treatment as inappropriate. The judge decided in favor of Mr. Wanglie, and Helga Wanglie died still supported . . .
Why we cannot afford <i>not</i> to engage junior doctors in NHS leadership
Authors: Benjamin Brown, Yasmin Ahmed-Little, Emma Stanton
Journal: Journal of the Royal Society of Medicine (2012)

Dubbed the ‘Nicholson Challenge’ by Health Select Committee chair, Stephen Dorrell, the NHS must save £20 billion by 2015, or four per cent per year. Monitor, the independent Foundation Trust (FT) regulator, has more recently indicated that this is more likely to be six per cent per year. However, hospital productivity is falling and primary care trusts are failing to meet savings targets. David Cameron has said: ‘It's not that we can't afford to modernize; it's that we can't afford not to modernize’.1

Despite preoccupation with the reform agenda, the most pressing issue facing the NHS is the need to increase value: maintaining and improving the quality of care whilst saving money. To achieve this, engagement of clinicians is essential. We therefore cannot afford not to involve the junior doctor community. This article examines why junior doctors are essential for the NHS to achieve efficiency savings, why they are currently disengaged from the process and potential initiatives to address this.
Left hemisphere of the brain is underactive in dyslexic people
Authors: S. Abdulla
Journal: BMJ (1998)

The insular, an area in the left hemisphere of the brain that links Broca's area (responsible for the perception of the sound patterns of speech) and Wernicke's area (involved in the production of sound), seems to be underactive in some people with dyslexia, according to Professor Margaret Snowling, vice president of the British Dyslexia Association.

Delivering the Novartis Foundation lecture at the Edinburgh Science Festival last week, Professor Snowling explained how her group had carried out a series of functional scans (using positron emission …
Treatment of Invasive Bladder Cancer by Cisplatin and Radiation in Patients Unsuited for Surgery
Authors: William U. Shipley, George R. Prout, Albert B. Einstein, L. Jean Coombs, Zev Wajsman, Mark S. Soloway, Leonore Englander, Bruce A. Barton, Mark D. Hafermann
Journal: JAMA (1987)

Seventy patients with muscle-invading bladder carcinoma (clinical stages T2 to T4) who were<i>not</i>candidates for cystectomy were treated with combined cisplatin and full-dose external-beam radiation on a multi-institutional prospective protocol from 1980 through 1985. Thirty-six patients are alive, all but three without evidence of cancer. The complete response rate is 77% in the 62 patients completing planned irradiation and 70% for all patients. Among the complete responders, 73% are currently maintained, and this group has a significantly higher four-year survival than those not having a complete response and those with recurrence of disease—57% vs 11%. The observed high complete response rates in patients in all stages and the high survival rates suggest irradiation plus cisplatin therapy offers an important therapeutic gain over radiation therapy alone for invasive cancer of the bladder. These results encourage further evaluation of combining cisplatin-based, multidrug chemotherapy with irradiation in patients with locally very-advanced bladder tumors who are not suited for surgery. (<i>JAMA</i>1987;258:931-935)
Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection
Authors: Andreas Probst, Daniela Aust, Bruno Märkl, Matthias Anthuber, Helmut Messmann
Journal: Endoscopy (2014)

Endoscopic resection is the standard treatment for superficial esophageal cancer. Data on early adenocarcinoma (EAC) are widely restricted to endoscopic mucosal resection (EMR), whereas large studies have been published on endoscopic submucosal dissection (ESD) for early squamous cell carcinoma (ESCC). ESD has potential advantages regarding en bloc and R0 resection rates, which have been demonstrated for ESCC. However, studies have failed to confirm these advantages in EAC. The aim of this study was to investigate the efficacy of ESD in early esophageal cancer.A total of 111 early esophageal cancers (87 EACs and 24 ESCCs) were resected by ESD at a German tertiary referral center. A total of 60 EACs were resected within Barrett's segments ≤ M3. Resection rates, complications, and follow-up data were recorded prospectively.En bloc resection rates were 95.4 % for EAC and 100 % for ESCC (P = 0.575), and R0 resection rates were 83.9 % and 91.7 %, respectively (P = 0.515). The R0 resection rate was higher in Barrett's ≤ M3 vs. > M3 (90 % vs. 70.4 %; P = 0.029). The curative resection rate was 72.4 % for EAC vs. 45.8 % for ESCC (P = 0.026). Endoluminal recurrence was observed in 2.4 % of EACs (8 % in Barrett's > M3, 0 % in Barrett's ≤ M3), and 0 % of ESCCs. Complications included strictures (11.7 %) and bleedings (0.9 %), but no perforation. Disease-specific survival was 97.7 % (EAC) and 95.8 % (ESCC), and overall survival was 96.6 % (EAC) and 66.7 % (ESCC) over a mean follow-up period of 24.3 months and 38.0 months, respectively.ESD was shown to be a safe resection method, achieving high R0 resection rates in both EAC and ESCC. Recurrence rates were low. To improve R0 resection within long Barrett's segments, diagnosis of the lateral extension of the lesion needs to be improved.
Gene-environment interaction in the conversion of a mild-to-severe phenotype in a patient homozygous for a Ser172--&gt;Cys mutation in the lipoprotein lipase gene.
Authors: Y Ma, M S Liu, D Ginzinger, J Frohlich, J D Brunzell, M R Hayden
Journal: Journal of Clinical Investigation (1993)

Normal pregnancy is associated with a two- to threefold increase in plasma triglyceride levels, particularly in the third trimester, due both to the overproduction of VLDLs and to the possible suppression of lipoprotein lipase (LPL) activity. Numerous mutations in the human LPL gene causing complete LPL deficiency have been described, but naturally occurring mutations that result in defective LPL with partial activity have not yet been reported. Here we describe a 30-yr-old woman who was first diagnosed with LPL deficiency during pregnancy after she developed pancreatitis. Her plasma triglyceride levels remained mildly elevated at approximately 300 mg/dl (3.4 mmol/liter) after the first pregnancy but rose significantly after she became pregnant again (1800 to 2000 mg/dl) (20.2 to 22.5 mmol/liter). DNA sequence analysis of the LPL gene showed that the patient is homozygous for a Ser172-->Cys missense mutation in exon 5. In vitro mutagenesis revealed that the Ser172-->Cys mutation caused a mutant LPL protein that had residual activity higher than that seen in all eight other missense mutations in patients with LPL deficiency identified in our laboratory. We propose that some mutations in the LPL gene produce a defective LPL with partial activity, which usually leads to mild hypertriglyceridemia.
Health-related quality of life in chronic hepatitis C: Impact of disease and treatment response
Authors: John E. Ware, Martha S. Bayliss, Michael Mannocchia, Gary L. Davis
Journal: Hepatology (1999)

Hepatitis C infects nearly 4 million Americans. Most have chronic hepatitis C (CHC), which progresses to cirrhosis in about 20% of patients. Interferon treatment leads to transient responses in about 40% of patients and apparent eradication of infection in 7% to 40% of patients. In this report, we document the impact of CHC on health-related quality of life (HQL), and changes in HQL among treatment responders. Three hundred twenty-four CHC patients from 10 countries who had relapsed after responding to interferon-alfa therapy were randomized to monotherapy (IFN alfa-2b + placebo) or combination therapy (IFN alfa-2b + ribavirin), treated for 24 weeks, and followed up for 24 weeks. HQL was assessed using the Hepatitis Quality of Life Questionnaire (HQLQ), containing the generic SF-36 Health Survey, three additional generic scales, and two hepatitis-specific scales. Before treatment, CHC patients were impaired in 5 of 8 SF-36 concepts (physical functioning, role-physical, general health, vitality, and social functioning) in comparison with matched population norms. Sustained virological response (SVR) to treatment yielded improvements on three generic scales (vitality, social functioning, and health distress) and the CHC-specific health distress scale. Overall response to treatment (SVR plus histological improvement) yielded the same pattern of improvements with additional gains in generic general health and CHC-specific limitations. Successful treatment of CHC improved HQL as measured by both CHC-specific and generic measures of functional health and well being.