tbuckley/cabot-search huggingface dataset:
Non-neoplastic Narrowing of the Esophagogastric Junction.
Authors: Joseph A. Rinaldo
Journal: Annals of Internal Medicine (1964)

s1 February 1964Non-neoplastic Narrowing of the Esophagogastric Junction.Joseph A. Rinaldo Jr., M.D. (Associate), Max D. Clark, M.D., Thomas Gahagan, M.D.Joseph A. Rinaldo Jr., M.D. (Associate)Search for more papers by this author, Max D. Clark, M.D.Search for more papers by this author, Thomas Gahagan, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-324_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study consists of clinical, physiologic, and histologic information obtained from eight patients with non-neoplastic narrowing of the esophagogastric junction. Seven of the patients were studied by simultaneous cineradiographic and manometric technique during this past year, the remaining patient was studied prior to that time, and only manometric measurements were made in conjunction with spot films. This group of patients has been unusually helpful in defining the anatomic relationships because of the ease of demonstrating the narrowed gastroesophageal junction. A definite intrinsic sphincter was demonstrated above this "B" ring, separate from the diaphragm.Although six men and two women ranging... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Joseph A. RinaldoJr., M.D. (Associate); Max D. Clark, M.D.; Thomas Gahagan, M.D.Affiliations: Detroit, Michigan PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe narrow lower esophageal ring: Pathogenesis and physiology 1 February 1964Volume 60, Issue 2_Part_1Page: 324-325KeywordsGastroenterology and hepatology ePublished: 1 December 2008 Issue Published: 1 February 1964 PDF downloadLoading ...
GPs asked not to demand payments from drug company representatives
Authors: Lynn Eaton
Journal: BMJ (2004)

The Code of Practice Authority, which enforces the pharmaceutical industry's rules for promoting drugs in the United Kingdom, has asked GPs to stop requesting payments from drug company representatives because such payments infringe the authority's code.

In its May review the authority says it has had reports of general practices asking drug company representatives for payments such as contributions to the cost of coffee or lunch when they attend a GP's surgery to talk about the company's drug products.

Heather Simmonds, director of …
Sex-Based Differences in Early Mortality of Patients Undergoing Primary Angioplasty for First Acute Myocardial Infarction
Authors: Babak A. Vakili, Robert C. Kaplan, David L. Brown
Journal: Circulation (2001)

Morbidity and mortality after an acute myocardial infarction (AMI) has been reported to be higher in women than men. However, in some prior reports, women were not treated as aggressively as men, suggesting a treatment bias. We sought to determine whether sex influenced short-term outcomes in a cohort of AMI patients, all of whom underwent primary angioplasty.We conducted a retrospective cohort study of all patients undergoing primary angioplasty for a first AMI in New York State in 1995. A total of 1044 patients, 317 women and 727 men, were identified. Mean age was 59+/-12 years in men and 65+/-12 years in women (P<0.05). Women had a higher prevalence of hypertension (59% versus 44%, P<0.05), diabetes (19% versus 14%, P<0.05), and peripheral vascular or carotid disease (9.5% versus 5.5%, P<0.05) than men. Men were more likely to be treated earlier (within 6 hours) from the time of symptom onset than women (74% versus 63%, P<0.05). Women had a higher incidence of shock or hemodynamic instability than men (25% versus 17%, P<0.05). The unadjusted in-hospital mortality rate was 7.9% in women and 2.3% in men (P<0.05). After multivariate logistic regression analysis, women maintained a 2.3-fold higher risk of in-hospital death compared with their male counterparts (95% confidence interval [CI], 1.2 to 4.6, P=0.016).After correcting for age and baseline risk differences, women undergoing primary angioplasty for AMI have a significantly higher in-hospital mortality rate than men.
Emergent Dilated Cardiomyopathy Caused by Targeted Repair of Dystrophic Skeletal Muscle
Authors: DeWayne Townsend, Soichiro Yasuda, Sheng Li, Jeffrey S Chamberlain, Joseph M Metzger
Journal: Molecular Therapy (2008)

Duchenne muscular dystrophy (DMD) is a fatal disease characterized by deterioration of striated muscle, affecting skeletal and cardiac muscles. Recently, several therapeutic approaches have shown promise for repairing dystrophic skeletal muscles. However, these methods often leave the dystrophic heart untreated. Here we show that, in comparison to fully dystrophin-deficient animals, targeted transgenic repair of skeletal muscle, but not cardiac muscle, in otherwise dystrophin-deficient (mdx) mice paradoxically elicited a fivefold increase in cardiac injury and dilated cardiomyopathy in these animals in vivo. Skeletal muscle repair was shown to increase the voluntary activity of the mdx mice as quantified by voluntary running on the exercise wheel. Because the dystrophin-deficient heart is highly sensitive to increased stress, we hypothesize that increased activity (enabled by the repaired skeletal muscle) provided the stimulus for heightened cardiac injury and heart remodeling. In support of this hypothesis, the primary cellular compliance defect in dystrophin-deficient cardiac myocytes was found to be unchanged by skeletal muscle repair in the mdx mice. These findings provide new information on the evolution of cardiac disease in dystrophin-deficient animals and underscore the importance of implementing global striated muscle therapies for muscular dystrophy.
Sexual Dysfunction as a Marker of Cardiovascular Disease in Males With 50 or More Years of Type 1 Diabetes
Authors: Sara J. Turek, Stephanie M. Hastings, Jennifer K. Sun, George L. King, Hillary A. Keenan
Journal: Diabetes Care (2013)

Vascular dysfunction is a major contributor to diabetes complications. It is also the primary physiologic cause of erectile dysfunction and considered an independent predictor of cardiovascular disease (CVD) in males over age 40 years. A cohort of individuals with 50 or more years of type 1 diabetes, Joslin Medalists, have low rates of small but not large vessel complications. This study aims to identify the prevalence and longitudinal association of sexual dysfunction (SD) with CVD in Joslin Medalists.Description and association of self-assessment of SD in males of the Medalist cohort by self-reported sexual problems with CVD. SD is validated through the use of the abbreviated International Index of Erectile Dysfunction (IIEF).Of 301 males in the Medalist Study, 69.8% reported a history of SD. Unadjusted risk factors included elevated glycated hemoglobin (HbA1c) (P=0.02), elevated BMI (P=0.03), higher total cholesterol (P=0.02), lower HDL (P<0.01), and increased levels of interleukin-6 (P=0.03). SD was independently associated with CVD (age-, HbA1c-, and BMI-adjusted OR 1.9 [95% CI 1.0-3.5]). In adjusted analyses, retinal, neural, and renal complications were not associated (P>0.05) with SD. Current report of SD (IIEF score≤17) in a subset of Medalists was significantly correlated with self-reported longitudinal SD.SD in those with extreme-duration type 1 diabetes is independently associated with CVD, representing a large-vessel pattern. The findings suggest that SD may predict CVD in those with type 1 diabetes of long duration. These individuals have also been found to be relatively free of microvascular complications.
The Kidney in Heart Failure
Authors: Paul J. Cannon
Journal: New England Journal of Medicine (1977)

The kidneys participate to a major extent in the pathogenesis of congestive heart failure. When the heart fails as a pump, a complex alteration of homeostatic mechanisms results. Among the adjustments that occur are changes in the hemodynamic and hormonal mechanisms that regulate the volume and tonicity of the extracellular fluid so that the ability of the kidneys to excrete salt and water is reduced.1 Retention of sodium chloride and water expands the volume of the extracellular fluid, which, in turn, may produce circulatory congestion and edema. This article is a review of some of the physiologic alterations that participate . . .
Renal Abnormalities in Potential Transplant Donors.
Authors: P. K. Spanos
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Renal Abnormalities in Potential Transplant Donors.P. K. Spanos, M.D., R. L. Simmons, M.D., C. M. Kjellstrand, M.D., T. J. Buselmeier, M.D., V. M. Uranga, M.D., J. S. Najarian, M.D.P. K. Spanos, M.D.Search for more papers by this author, R. L. Simmons, M.D.Search for more papers by this author, C. M. Kjellstrand, M.D.Search for more papers by this author, T. J. Buselmeier, M.D.Search for more papers by this author, V. M. Uranga, M.D.Search for more papers by this author, J. S. Najarian, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-875_5 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptScreening techniques to detect renal failure and prevent its progression traditionally have been unsuccessful. One method of screening with high yield may be to study the relatives of patients with renal failure. Two-hundred and nine persons volunteered to be kidney donors for their sibling, parent, or child; donors were found to be totally healthy. Forty-one rejected donors had significant abnormalities of the urinary tract. None had previously had any illness, and no donors with histories of familial renal disease were included.Notincluded were unilateral multiple renal arteries (50), bilateral multiple renal arteries (21), double collecting systems (4), or double... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Minneapolis, Minn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 875-876KeywordsChild healthKidneysRenal arteriesRenal diseasesRenal failure Issue Published: 1 May 1972 PDF DownloadLoading ...
Review of Values in Medical Practice
Authors: RUDOLPH J. NAPODANO
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 March 1987Review of Values in Medical PracticeRUDOLPH J. NAPODANO, M.D.RUDOLPH J. NAPODANO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-3-482_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The review by Dr. Arnold (1) of Values in Medical Practice misjudges and misinterprets my book and is very misleading to interested readers. The reviewer compares and contrasts my book to a manual in clinical ethics. This is not the book's intent nor its principal message. In addition, the reviewer fails to recognize that many of the 206 references represent a rich literature from the humanities and social sciences on teaching human values.Values in Medical Practicechallenges the contemporary manner in which physicians are educated and prepared to care for the sick. Using the Socratic approach,...Reference1. ARNOLD R. Values in medical practice: a statement of philosophy and a model for teaching a healing science [Book review]. Ann Intern Med. 1986; 105:988. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Rochester School of Medicine and Dentistry Rochester, NY 14642 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1987Volume 106, Issue 3Page: 482-482 ePublished: 1 December 2008 Issue Published: 1 March 1987 PDF downloadLoading ...
Discordant Response to Chemotherapy Between Lymphadenopathy and Bone Lesions on Gallium-67 Scanning in Hodgkin??s Disease
Authors: Sadri Bazarjani, Gina Di Primio
Journal: Clinical Nuclear Medicine (2005)

A 33-year-old woman with a diagnosis of Hodgkin's disease had a prechemotherapy whole-body Ga-67 scan to document gallium avidity of lesions and to assess response to therapy. A posttherapy scan showed a discordant response with complete resolution of lymphadenopathy and persistence of bone lesions. Radiographic evaluation of the left humerus, radius, and ulna demonstrated typical fibrous dysplasia as a cause for persistence of Ga-67 activity and shoulder activity probably representing arthropathy. She was in remission 3 years later although she fell and fractured the humerus through the bony lesion, and biopsy at the time of internal fixation confirmed fibrous dysplasia.
The epidemiology of antimicrobial resistance in hospital acquired infections: problems and possible solutions
Authors: M. J Struelens
Journal: BMJ (1998)

*

Hospitals, and particularly intensive care units, are an important breeding ground for the development and spread of antibiotic resistant bacteria. This is the consequence of exposing to heavy antibiotic use a high density patient population in frequent contact with healthcare staff and the attendant risk of cross infection. 1 2 Antibiotic resistance increases the morbidity and mortality associated with infections and contributes substantially to rising costs of care resulting from prolonged hospital stays and the need for more expensive drugs.1–3 In this review I will outline the current problems caused by major drug resistant nosocomial pathogens, examine factors that promote antibiotic resistance in hospitals, and discuss strategies for control.

#### Summary points

Among pathogens causing hospital infections, Gram positive cocci have become predominant over the past two decades. This trend is related to these pathogens' capacity for accumulating antibiotic resistance determinants.2 A notable example is that of methicillin resistant strains …
Dementia patients should have more say in their end of life care, NICE says
Authors: I. Torjesen
Journal: BMJ (2012)

People with dementia should have more say in decisions related to their long term care and what happens to them at the end of their life, the National Institute for Health and Clinical Excellence has recommended.

NICE has issued draft standards on “supporting people to live well with dementia”1 that set out the aspirational but achievable care that the care system should consider when planning and delivering services to ensure that the quality of services improve.

The standards on supporting people to live …
Optimal Provision of Daytime NPH Insulin in Patients Using the Insulin Analog Lispro
Authors: Abu Baker Ahmed, Philip D Home
Journal: Diabetes Care (1998)

OBJECTIVE Insulin lispro improves early postprandial blood glucose control but can result in late interprandial hyperglycemia. As an approach to resolving this problem, we performed a randomized, crossover study with four treatment arms, comparing the daytime metabolic profile after either premeal lispro alone or premeal lispro with optimal daytime NPH insulin and with standard human regular insulin. RESEARCH DESIGN AND METHODS Twelve C-peptide negative type 1 diabetic patients were studied on four separate study days, at least 7 days apart. On each study day, patients received one of the four study insulin treatments, in random order, with identical meals and snacks. The four treatments were 1) premeal human regular insulin before lunch and supper at unchanged dose; 2) premeal lispro (unchanged dose) at lunchtime and dinner; 3) prelunch reduced-dose lispro (70%) before lunch and supper with supplemental lunchtime NPH and with a 6-h interval until dinner; and 4) pre-lunch reduced-dose lispro (70%) before lunch and supper with supplemental lunchtime NPH and with a 8-h interval until dinner. All patients were using their usual premeal plus basal insulin regimen during the period of the study, with human regular insulin before meals and NPH insulin at bedtime. RESULTS Postprandial blood glucose concentrations (1230–1500) were lower after reduced or usual lispro dose compared with human regular insulin (5.5 ± 0.2 and 5.6 ± 0.2 vs. 8.2 ± 0.5 mmol/l, P &amp;lt; 0.001), with no difference between the lispro doses. However, preprandial (1800) blood glucose levels deteriorated to higher levels after usual-dose lispro alone compared with either human regular insulin (P &amp;lt; 0.05) or reduced-dose lispro plus NPH (P &amp;lt; 0.05) (8.9 ± 0.3 vs. 7.1 ± 0.8 and 6.4 ± 0.4 mmol/l), with no difference between human regular insulin and reduced-dose lispro plus NPH. During the 2 h between the usual and delayed mealtime, blood glucose concentrations remained controlled on lispro plus NPH (2000: 6.5 ± 0.4 mmol/l). CONCLUSIONS Reduced-dose lunchtime lispro plus NPH maintained the improvement in postprandial blood glucose control with no deterioration in interprandial blood glucose control, even up to a late meal.
A STUDY OF THE EFFECT OF SENSITIZATION ON THE DEVELOPMENT OF THE LESIONS OF EXPERIMENTAL PNEUMONIA IN THE RABBIT
Authors: Mary Butler Kirkbride
Journal: The Journal of Experimental Medicine (1915)

While preliminary treatment with culture filtrates or dead cells of the extremely virulent strain A gave rise to varying degrees of immunity, the exudative lung lesions developing after tracheal injection with live organisms of the same virulent strain were not strikingly increased in any group or series of these rabbits. Despite carefully graduated dosage in the preliminary treatment, none of the animals developed symptoms of a definitely anaphylactic nature. In similar experiments following sensitization with the attenuated avirulent culture AA, tracheal injection of virulent or avirulent organisms of the same strain failed to incite any definite increase in the exudative lung reaction. In none of the rabbits were symptoms resembling anaphylaxis noted. The immunity which was induced by the larger sensitizing doses of culture filtrates of the strain in the virulent state was lacking when similar doses of the culture filtrates of organisms in the non-virulent state were used. Extensive lesions developed in both sensitized and unsensitized rabbits when the strain used in the tracheal injection was one apparently combining moderate virulence with exceptional toxicity, indicating that the exudative lung reaction was one of adjustment rather than of acquired hypersusceptibility. When, in the experiments, small amounts of sera from normal rabbits, or from animals immunized to culture filtrates, were added to the culture before tracheal injection, an increased fibrinous lung reaction was frequently found. The present study would seem to give some ground for the view that while in pneumonia a hypersensitive condition probably takes some part in the inception of the infection, the subsequent development of the diffuse exudative reaction in the lung is not directly due to an acquired hypersusceptibility, but to intrinsic qualities possessed by the pneumococcus itself. This study was carried on in the Department of Bacteriology of the College of Physicians and Surgeons of Columbia University, New York, and later, through the courtesy of Dr. Charles Norris, in the Bellevue Hospital Laboratories. It was completed in the Laboratories of the New York State Department of Health at Albany. I am greatly indebted to Dr. Augustus Wadsworth for his advice and criticism.
Myocardial necrosis, fibrosis, and DNA synthesis in experimental cardiac hypertrophy induced by sudden pressure overload.
Authors: S P Bishop, L R Melsen
Journal: Circulation Research (1976)

The development of myocardial fibrosis as a result of cardiac hypertrophy was studied in 11 cats in which the pulmonary artery was banded, six rabbits in which the ascending aorta was banded, and eight cats with various congenital cardiac anomalies. Histological examination of the myocardium revealed multifocal areas of degeneration and necrosis with healing by fibrosis in the right ventricle of cats in which the pulmonary artery was banded and in the left ventricle of rabbits in which the aorta was banded. In five of eight cats with congenital anomalies, myocardial necrosis and fibrosis were not present in spite of heart weight to body weight ratios 2-4 times greater than in the experimental models. In the other three cats, fibrosis was subendocardial or diffuse rather than multifocal as in the banded animals. This suggests that the increased connective tissue found in animals with cardiac hypertrophy induced by banding the aorta or pulmonary artery is an artifact of the preparation. Autoradiographic studies of the myocardium of pulmonary artery-banded cats indicated that all newly synthesized DNA in this model is restricted to interstitial cell and endothelial cell proliferation.
Theory and Therapy In Dynamic Psychiatry
Authors: H. Keith Fischer
Journal: JAMA (1974)

Revised and expanded from an earlier edition, fortified with recent developments and forty-eight case histories, the book is intended as a brief, inclusive, and integrative introduction to psychology and psychiatry for professional students and those interested in dynamic behavior and treatment.  Concepts of personality, disorder, disease, and therapy cover nine pages. Experimental approaches use 19 pages. Interview techniques and diagnostic objectives require 18 pages. Psychiatric  need 64 pages. Under the title of Past, Present, and Future, 39 pages are devoted to UR-defenses, Freud and psychoanalysis, and Erikson's concepts. Modern modes of therapy use 25 pages. A glossary of terms, references, bibliography, and indexes complete the volume.  Given to explaining word derivations, summaries of major philosophies (each in one line), and liberal running comment on the entire scene, the book is Masserman! Discussing formal therapies and their theoretical formulations as scarcely worth the effort, and only partially and temporarily effective,
Civil Commitment of the Mentally III
Authors: George M. Solan
Journal: JAMA (1980)

To the Editor.—  The article New Developments in Civil Commitment of the Mentally Ill by Williams (242:2307, 1979) comes as a breath of fresh air to an area of medicine once nearly suffocating from legalistic intrusion. The recapture of humanistic attitudes toward the patient and his illness, family, and physician in decriminalizing civil commitments are yearned-for developments that are long overdue. Active advocacy for the medical model, stemming from Chief Justice Burger's opinion in theAddington vs Texascase, is indeed welcome news.  When a psychiatrist is placed as an adversary to his patient, both suffer from the antitherapeutic (and antipsychiatric) position. We have been able to soften this dilemma for the patient somewhat by discussions before and after the event describing where we stand in the hearings. (Repetitive hearings may actually develop unexpected assets by forcing clarity and verbal facility in the therapist's systems of expressing diagnosis, prognosis, and
Recurrence rates of excised keloids treated with postoperative triamcinolone acetonide injections or interferon alfa-2b injections
Authors: Brian Berman, Francisco Flores
Journal: Journal of the American Academy of Dermatology (1997)

Keloids that are surgically removed commonly recur within the excision sites.Our purpose was to determine whether postsurgical adjunctive therapy reduces such recurrences.We determined the rate of recurrence after excision alone (n = 43) and postoperative injection with triamcinolone acetonide (TAC; n = 65) or interferon alfa-2b (IFN-alpha 2b; n = 16).Of lesions excised without postoperative injections, 51.1% (22 of 43) recurred; 58.4% of TAC-treated lesions (38 of 65) recurred and 18.7% of IFN-alpha 2b-treated lesions (3 of 16) recurred (p = 0.025).Postoperative TAC injections do not reduce the number of keloid recurrences. However, injection of keloid excision sites with IFN-alpha 2b offers a therapeutic advantage over keloid excision.