tbuckley/cabot-search huggingface dataset:
THE ARMY SURGEON IN THE PHILIPPINES.
Authors: WILLIAM J. LYSTER
Journal: JAMA (1901)

In a number of islands, stretched out through a thousand miles of the greatest of oceans, is the United States Army of occupation in the Philippines, holding positions in the interior of islands as large as the State of Ohio, many of whose inhabitants had never before seen the faces of white men. With the troops combating diseases of new type, among barbarous communities ignorant of all sanitary precautions, is the army surgeon, attempting to carry with him the principles and appliances of modern science necessary to the preservation of life, in a climate that is strange to him and which impels a study of its peculiarities at the same time that it increases his work. The medicines, instruments and foods necessary for the victims of wounds and disease in these remote places must be carried, with difficulties of which even the quartermaster's department is scarcely competent to judge. Troops
Victims of Violence in Schools: ASK
Authors: Bill C. DeMoss
Journal: JAMA (1995)

<h3>To the Editor.</h3> —We must all make sure that our schools are providing a safe environment in which to get an education. Within the last year I have treated many children who are victims of school violence. These children suffered stab wounds to the back, marks on the neck, black eyes, split lips, loosened teeth, bloody noses, facial pain, razor lacerations, and bruises of the gums and face, not to mention the psychological trauma of assault. Children should not have to risk their lives when they attend school in pursuit of an education. I have found that if I routinely inquire about violence during periodic screening assessments, using nonthreatening questions, I can detect problems and take preventive action (ie, document and report violent behavior) before a disaster occurs. During my early preventive screening diagnosis and treatment visits, I ask a series of questions to open the door to the subject
The Regulation of Hemostasis: The Protein C System
Authors: Lawrence H. Clouse
Journal: New England Journal of Medicine (1986)

We speak very frequently of the normal clotting time. In a glass tube?... Glass tubes have held the center of the stage for quite a long time but the process of clotting is now observed in plastic vessels and a considerably longer period of time is required than when glass is used.... If the same blood were kept outside the body in a test tube made from a vein or artery it would take a very long time to clot.— Charles H. Best, 19481 EXTENSIVE investigation into the mechanisms of blood clotting has yielded substantial insights into the process . . .
Appropriateness of Autologous Blood Transfusion-Reply
Authors: Harold A. Oberman
Journal: JAMA (1988)

<h3>In Reply.—</h3> In noting the rarity of complications of blood transfusion, Dr Avoy somewhat overstates the case. In the best of all worlds, human error would not occur; unfortunately, this is hardly the present situation. Only those cases of misidentification of blood recipients that resulted in fatal outcomes were included in the 1980 report by Myhre. Undoubtedly, far more accidental transfusions of inappropriate blood that resulted in adverse reactions short of death occurred during this interval. Similarly, while fluid overload usually results from poor transfusion practice, it is a continuing problem, as is bacterial contamination of units of blood. The latter was responsible for the recent reduc
The acidosis of chronic renal failure activates muscle proteolysis in rats by augmenting transcription of genes encoding proteins of the ATP-dependent ubiquitin-proteasome pathway.
Authors: J L Bailey, X Wang, B K England, S R Price, X Ding, W E Mitch
Journal: Journal of Clinical Investigation (1996)

Chronic renal failure (CRF) is associated with negative nitrogen balance and loss of lean body mass. To identify specific proteolytic pathways activated by CRF, protein degradation was measured in incubated epitrochlearis muscles from CRF and sham-operated, pair-fed rats. CRF stimulated muscle proteolysis, and inhibition of lysosomal and calcium-activated proteases did not eliminate this increase. When ATP production was blocked, proteolysis in CRF muscles fell to the same level as that in control muscles. Increased proteolysis was also prevented by feeding CRF rats sodium bicarbonate, suggesting that activation depends on acidification. Evidence that the ATP-dependent ubiquitin-proteasome pathway is stimulated by the acidemia of CRF includes the following findings: (a) An inhibitor of the proteasome eliminated the increase in muscle proteolysis; and (b) there was an increase in mRNAs encoding ubiquitin (324%) and proteasome subunits C3 (137%) and C9 (251%) in muscle. This response involved gene activation since transcription of mRNAs for ubiquitin and the C3 subunit were selectively increased in muscle of CRF rats. We conclude that CRF stimulates muscle proteolysis by activating the ATP-ubiquitin-proteasome-dependent pathway. The mechanism depends on acidification and increased expression of genes encoding components of the system. These responses could contribute to the loss of muscle mass associated with CRF.
Oncology ASAP
Authors: Robert Sikorski
Journal: JAMA (1997)

A physician receives the following unsolicited e-mail message:  Dear Sir or Madam: I am in search of someone who can help me. My wife is 35 years old and has stage III ovarian, cervix, and bowel cancer. I know that somewhere, somehow we will find technology or procedures that can help. I understand Russia uses something called hydrazine sulfate, France is using Taxotere, and Cuba has used shark cartilage, but I feel other countries also might have something with a good success rate. I am looking for the top cancer institutes or doctors' names and e-mail addresses or telephone numbers in your country. If you please can help, it would be appreciated more than you know. If you don't have any answers, could you pass this message along to someone who might be able to help?  The physician refers the sender to the National Cancer
Cardiovascular Effects of the Somatostatin Analog Octreotide in Acromegaly
Authors: Philippe Chanson
Journal: Annals of Internal Medicine (1990)

Objective: To determine the cardiovascular effects of the somatostatin analog octreotide in patients with acromegaly. Design: Prospective nonrandomized study. Setting: Referral-based endocrinology clinic. Patients: Seven patients with active acromegaly, three of whom had refractory congestive heart failure. The other four patients were free of symptoms associated with heart failure. Interventions: All patients were treated with octreotide, 100 to 500 μg subcutaneously three times daily. The three patients with heart failure continued to receive cardiovascular therapy (angio-tensin converting enzyme inhibitors, digitalis, diuretics). Measurements and Main Results: During octreotide therapy, patients showed a rapid decrease in growth hormone and insulin-like growth factor 1 (IGF-1): Mean levels (± SD) fell from 28.1 ± 32.7 μg/L to 5.2 ± 8.3 μg/L and 740 ± 126 μg/L to 372 ± 64 ±g/L, respectively (P < 0.025). Plasma volume returned to normal and heart rate decreased significantly. In the four patients without heart failure, right-heart catheterization done before and after 3 months of octreotide therapy showed an 18.3% ± 11% reduction in stroke volume and a return to normal of the cardiac index. The three patients with congestive heart failure, evaluated before and after 40 days and up to 2 years of therapy, showed a dramatic clinical improvement that was associated with an increase in stroke volume (by 24% to 51%). In these patients, the cardiac index remained in the normal range, filling pressures were markedly decreased, and pulmonary wedge pressure returned to normal. This improvement was sustained for up to 3 years in the two patients with heart failure who were receiving long-term treatment. Conclusion: The rapid and sustained cardiac improvement seen in our patients shows that octreotide therapy for patients with acromegaly may be highly beneficial, even in those patients with advanced cardiac failure.
Postmarketing surveillance studies.
Authors: S. Ebrahim, E. Dickinson, R. Dickinson, J. Horobin
Journal: BMJ (1992)

During the trial two subjects failed to don the equipment correctly and one suffered extreme rebreathing, which limited his exercise tolerance in the test atmosphere to less than two minutes.Two volunteers refused to undergo the session in the test atmosphere wearing the hood as they perceived it as too stressful.We have also studied two other commercially available smoke hoods with filters in two volunteers exercising in air at only 75 W.One resulted in a ventilation of 109 /min in one subject, while the other subject was unable to exercise beyond two minutes when his oxygen saturation fell to 87% and his ventilation reached 919 I/min.The other device resulted in ventilations of 103-1 l/min and 107 71/min in the same volunteers.Our subjects represent the healthiest of those who travel by air, whose range of states of health and disease is wide.Tolerance to wearing a smoke hood is probably reduced in less healthy people, elderly people, and children.The hazards of rebreathing while wearing a smokehood and attempting to escape from fire need to be investi- gated further before widespread use of smoke hoods can be recommended.Our study further emphasises the widely held view that people who wear respiratory protection should be specifically trained in its use.Without training, such equipment carries a risk that might limit escape from fire even if the atmosphere is minimally toxic.We believe that existing smoke hoods carry an intrinsic risk to the wearer that in some instances outweighs their potential benefits.
Treatment of Alcoholism With Organic Brain Damage
Authors: Arthur C. Walsh
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Some of your readers who have to treat chronic alcoholics with organic brain damage may be interested in the experience I have had with a new form thereof. As a consultant, I see at least two patients weekly with such brain damage—patients often in their 40s and 50s. By the time I see them, they have been given the standard treatment, and disposition has become a problem. They are not well enough oriented to care for themselves at home, and consideration has to be given to longterm hospitalization in a nursing home or state hospital. Previous experience has indicated that dicumarol therapy has been beneficial to many patients with organic brain syndrome and vascular insufficiency of the brain. Since these alcoholic patients exhibited similar symptoms, I suggested a trial of dicumarol therapy for them. The results were unexpectedly good: eight were discharged home and response to treatment
Off-Pump Coronary-Artery Bypass Surgery
Authors: Eric A. Rose
Journal: New England Journal of Medicine (2003)

Inspired in 1931 by a bedside vigil for a dying patient with massive pulmonary embolism, John Gibbon had by the early 1950s developed the heart–lung machine, or pump oxygenator. Although it affected the management of pulmonary embolism only trivially, the pump made possible the era of modern heart surgery for congenital, valvular, and coronary artery disease. An estimated 800,000 patients per year worldwide undergo coronary-artery bypass grafting in order to achieve the extensively documented improvement in survival and quality of life that it can provide to appropriate candidates.That benefit is offset by a perioperative mortality rate of 1 to . . .
Frequency of homozygous deletion at p16/CDKN2 in primary human tumours
Authors: Paul Cairns, Thomas J. Polascik, Yolanda Eby, Kaori Tokino, Joseph Califano, Adrian Merlo, Li Mao, John Herath, Robert Jenkins, William Westra, Joni L. Rutter, Alan Buckler, Edward Gabrielson, Mel Tockman, Kathleen R. Cho, Lora Hedrick, G. Steven Bova, William Isaacs, Wayne Koch, Donna Schwab, David Sidransky
Journal: Nature Genetics (1995)
Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case-control study
Authors: J. Cha, K. Lim, S. Lee, Y. Joo, S. Hong, T. Kim, H. Kim, D. Park, S. Kim, D. Yang, J. Shin
Journal: Endoscopy (2013)

<b>Background and study aims:</b> Post-polypectomy coagulation syndrome (PPCS) is a well known complication of colonoscopic polypectomy. However, no previous studies have reported on the clinical outcomes or risk factors of PPCS. The aim of the current study was to analyze the clinical outcomes and risk factors of PPCS developing after a colonoscopic polypectomy. <b>Patients and methods:</b> Data for all patients who underwent colonoscopic polypectomies and required hospitalization in nine university hospitals were analyzed retrospectively. The incidence, clinicopathological characteristics, and clinical outcomes of PPCS cases were examined. Additionally, patients who developed PPCS were compared with controls who were matched by age and sex, in order to assess for possible risk factors. <b>Results:</b> The rate of PPCS that required hospitalization after colonoscopic polypectomy was 0.7/1000. All patients with PPCS were treated medically without the need for surgical interventions. The median durations of therapeutic fasting, hospitalization, and antibiotic use were 3 days, 5.5 days, and 7 days, respectively. The rates of major PPCS and mortality were 2.9 % and 0 %, respectively. On multivariate analysis, hypertension (OR = 3.023, 95 %CI 1.034 – 8.832), large lesion size (OR = 2.855, 95 %CI 1.027 – 7.937), and non-polypoid configuration (OR = 3.332, 95 %CI 1.029 – 10.791) were found to be independent risk factors related to the development of PPCS. <b>Conclusions: </b>In this study, the rates of major PPCS and mortality were only 2.9 % and 0 %, respectively. Hypertension, large lesion size, and non-polypoid configuration of the lesion were independently associated with PPCS. Therefore, patients may be reassured by the excellent prognosis of PPCS, while endoscopists should be especially careful when performing colonoscopic polypectomies in patients with hypertension or large and non-polypoid lesions.
Serial Impedance Plethysmography in Pregnant Patients with Clinically Suspected Deep-Vein Thrombosis
Authors: Russell D. Hull
Journal: Annals of Internal Medicine (1990)

Study Objective: To determine the safety of withholding anticoagulant therapy in pregnant patients with clinically suspected deep-vein thrombosis who have negative results by serial impedance plethysmography. Design: Prospective study evaluating prognosis by long-term follow-up to 3 months postpartum in all patients. Setting: University-affiliated community hospital and referral center. Patients: One hundred fifty-two consecutive pregnant patients referred with clinically suspected deep-vein thrombosis. All patients completed the study. Interventions: Anticoagulant therapy was withheld in 139 patients negative by serial impedance plethysmography, and the patients were followed long term. Measurements and Main Results: None of 139 patients (0%; 95% CI, 0% to 2.6%) had symptomatic pulmonary embolism or recurrent venous thrombosis. Conclusions: The findings establish the safety of withholding anticoagulant therapy in pregnant patients who have negative results after serial impedance plethysmography. Sufficient patients were entered to provide narrow confidence intervals on the outcomes observed in patients with negative findings by impedance plethysmography. These findings are similar to those seen after venography in symptomatic patients. These data extend the role of non-invasive testing in patients with clinically suspected deep-vein thrombosis to the pregnant symptomatic patient.
Criteria for Judging Methadone Maintenance Programs-Reply
Authors: Mark V. Nadel
Journal: JAMA (1991)

In Reply.—  We are pleased that Drs Newman and Des Jarlais agree with us on the need to develop result-oriented performance standards for these programs, and we share their concerns regarding the difficulty in identifying criteria and developing regulatory policies. Our use of the 20% criterion to distinguish between programs that were effective in achieving the benefits of methadone treatment and those that were not was based on consultation with various methadone maintenance treatment experts. We did not advocate in our report that this criterion be regarded as the only or the best one. In fact, we recommended that the Secretary of Health and Human Services direct the National Institute on Drug Abuse and the Food and Drug Administration, the two federal agencies responsible for overseeing and regulating methadone treatment, to develop the most appropriate result-oriented performance standards.  The authors' calculated correlations between dosage and outcome run the risk of
New coalition to defend public health services launched in Catalonia
Authors: M. Jara
Journal: BMJ (2009)

<h3>Abstract</h3> <h3>Background</h3> This study aimed to investigate the protective effect of metformin on the trabecular meshwork (TM) and explore its molecular mechanisms <i>in vivo</i> and <i>in vitro</i>. <h3>Methods</h3> Ocular hypertension (OHT) mouse models were induced with dexamethasone (DEX) and further treated with metformin to determine its IOP lowering effect. Cultured human TM cells (HTMC) were pre-stimulated with tert-butyl hydroperoxide (tBHP) to induce oxidative damage and then supplemented with metformin for another 24 h. The expression of fibrotic markers and integrin/ROCK signals, including α-SMA, TGF-β, fibronectin, F-actin, integrin beta 1, Rho-associated kinase (ROCK)1/2, AMP-activated protein kinase (AMPK), myosin light chain 1 (MLC 1), and F-actin were determined by western blotting (WB) and immunofluorescence (IF). Reactive oxygen species (ROS) content was analysed using flow cytometry (FCM). <h3>Results</h3> Administration of metformin reduced the elevated IOP and alleviated the fibrotic activity of aqueous humour outflow in OHT models. Additionally, metformin rearranged the disordered cytoskeleton in the TM both <i>in vivo</i> and <i>in vitro</i>. Furthermore, metformin significantly inhibited ROS production and activated integrin/ROCK signalling induced by tBHP in HTMC. <h3>Conclusion</h3> Metformin reduced the elevated IOP in steroid-induced OHT mouse models and exerted its protective effects against oxidative injury by regulating cytoskeleton remodelling through the integrin/ROCK pathway. This study provides new insights into metformin use and preclinical evidence for the potential treatment of primary open-angle glaucoma.
Abstract 4738: Clinicopathological roles of adiponectin receptor and leptin receptor in endometrial carcinoma
Authors: Hiromitsu Yabushita, Keita Iwasaki, Taiki Ueno, Akihiko Wakatsuki
Journal: Cancer Research (2014)

Abstract Objectives: To clarify the roles of adiponectin receptor (AdipoR) and leptin receptor (ObR) in endometrial carcinoma, expressions of AdipoR-1 and -2 and ObR in endometrial cancer were examined immunohistochemically and relationships to clinicopathological implications were also analyzed. Methods: Under the written informed consent, paraffin-embedded tissues were obtained from 77 patients with endometrial carcinoma and were stained immunohistochemically using antibodies against AdipoR-1, AdipoR-2 and ObR. Results: AdipoR-1, AdipoR-2 and ObR were localized predominantly in the cell membrane and cytoplasm of tumor cells and normal endometrial cells. In 77 cases of endometrial cancer, positive expression was observed in 46 cases (59.7%) for AdipoR-1, 47 cases (61.0%) for AdipoR-2 and 33 cases (42.9%) for ObR. Expression of AdipoR-1 was observed more in stage I cases, G1 tumours, tumors with shallow myometrial invasion, tumors negative for lymphovascular space involvement, cases negative for adnexal invasion, and cases with no lymph node metastasis. However, expressions of AdipoR-2 and ObR showed no relationship to any clinicopathological factors. Kaplan-Meier analyses revealed that progression-free and overall survivals were longer in cases with positive AdipoR-1 expression compared with negative AdipoR-1 expression. Conclusion: Poor expression of AdipoR-1 thus appears to be associated with tumour grade, myometrial invasion, adnexal invasion, lymph-vascular space involvement and lymph-node metastasis, as well as poor prognosis in endometrial cancer. Citation Format: Hiromitsu Yabushita, Keita Iwasaki, Taiki Ueno, Akihiko Wakatsuki. Clinicopathological roles of adiponectin receptor and leptin receptor in endometrial carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4738. doi:10.1158/1538-7445.AM2014-4738
Decisions about Resuscitation: Inequities among Patients with Different Diseases but Similar Prognoses
Authors: Robert M. Wachter
Journal: Annals of Internal Medicine (1989)

Study Objective: To assess whether decisions about "do-not-resuscitate" (DNR) orders are made equitably in patients with different diseases but similar prognoses. Design: Retrospective cohort study. Setting: Three teaching hospitals: a university referral center, a county hospital serving a largely indigent population, and a Veterans Administration hospital. Patients: Consecutive patients with any of the four following discharge diagnoses: the acquired immunodeficiency syndrome (AIDS) (100 patients); unresectable non-small-cell lung cancer (51 patients); cirrhosis with esophageal varices (51 patients); and severe congestive heart failure with coronary artery disease (115 patients). Measurements and Main Results: Do-not-resuscitate orders were written for 52% of patients with AIDS and 47% of patients with cancer but for only 16% of patients with cirrhosis and 5% of patients with congestive heart failure (P < 0.0001). Although DNR orders were associated with functional and mental status, reason for admission, and severity of illness, the strong association between DNR orders and disease category persisted after adjustment for these potential confounders by multiple logistic regression. A survey of housestaff showed that DNR orders were discussed more frequently with patients who had AIDS or lung cancer than with patients who had cirrhosis or heart failure, despite an accurate understanding of the generally similar prognoses among the four groups. Conclusions: Despite relatively similar prognoses, patients with AIDS or lung cancer are much more likely to receive DNR orders than patients with cirrhosis or severe congestive heart failure. This discrepancy cannot be explained by differences in severity of illness among patients or by misunderstandings of prognosis by clinicians. From our data, we cannot determine if patients with cirrhosis or heart failure receive too few DNR orders or if patients with AIDS or lung cancer receive too many. Our findings should encourage physicians to determine the preferences of patients about life-sustaining treatments more equitably.
A man who called hospitals to account
Authors: Wendy Moore
Journal: BMJ (2007)

Sir Derek Wanless is not the first banker to call health services to account with his hard hitting criticism of productivity and efficiency. Predating the former NatWest chief executive by more than a century, the unsung pioneer of modern hospital management Sir Henry Burdett (1847-1920) started out as a humble clerk behind a desk at Midland Bank in Birmingham.

The son of a vicar who harboured ambitions to become a doctor, the young Burdett had to abandon his altruistic aims at 17 when his father's death put paid to …