tbuckley/cabot-search huggingface dataset:
Guerrillas in the mist: how I met a Colombian rebel leader
Authors: J. Mathias
Journal: BMJ (2014)

Jeph Mathias recounts an extraordinary case of tendon repair in the jungle

A hand fell on my shoulder just as I was pulling my hammock’s last knot tight. The rest of my Medecins Sans Frontieres (MSF) team, laughing over dinner preparations, was less than 10 metres away. I turned. He was just a boy, 16 years old perhaps, from the hair shyly fuzzing his upper lip—but camos, an AK47 casually held, and a knife ostentatiously dangling from his belt told me he was a dangerous guerrilla. I was being kidnapped.

“Medico,” he said, “the boss wants to talk.”

“Of course,” I replied nonchalantly, over-riding a panicky scream. “Where is he?” He angled his chin into the congealing dusk: “There. Bring your medicines.”

By making me walk ahead his, now unseen, gun and knife swamped my consciousness. Three hundred metres felt like 300 light years, warping me into a guerrilla camp where AK-47 wielding boys ambled around, camo clad and laughing.

They brought a kid with a severed extensor tendon, macheted by the indigenous man who’d surprised him in his hut. He’d shot the man and continued raping his wife. Consciously ignoring my feelings and switching ethics off, I repaired the tendon, focusing on anatomy and surgical technique and even giving instructions to my armed assistants. I could …
Phytoestrogens are partial estrogen agonists in the adult male mouse.
Authors: S Mäkelä, R Santti, L Salo, J A McLachlan
Journal: Environmental Health Perspectives (1995)

The intake, as well as serum and urinary concentrations, of phytoestrogens is high in countries where incidence of prostate cancer is low, suggesting a chemopreventive role for phytoestrogens. Their significance could be explained by the ability to antagonize the action of more potent endogenous estrogens in initiation or promotion of tumor formation. We have studied estrogenicity and antiestrogenicity of dietary soy and two phytoestrogens, coumestrol and daidzein, in our neoDES mouse model for the study or prostatic neoplasia. Soy was chosen because it is rich in phytoestrogens, is widely used in Oriental diets, and has antiestrogenic and anticarcinogenic properties in the neoDES mouse when given from fertilization onward. In short-term tests with adult animals, no evidence for estrogenicity or antiestrogenicity (capability to antagonize the action of 17 beta-estradiol) of soy was found when development of epithelial metaplasia and expression of c-fos protooncogene in prostate were used as end points of estrogen action. Estrogenic activity of coumestrol and daidzein on c-fos expression was subtle. Coumestrol, either given alone or in combination with 17 beta-estradiol, had no effect on development of epithelial metaplasia. These marginal or missing effects in adult males could be interpreted by assuming that the neonatal period is more critical for estrogenic or antiestrogenic action of soy and phytoestrogens. Once initiated, estrogen-related lesions would develop spontaneously. Alternatively, the chemopreventive action of soy is not due to antiestrogenicity of soy-derived phytoestrogens.
Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding or other safety outcomes in hip arthroplasty
Authors: Pieter W. Kamphuisen
Journal: Annals of Internal Medicine (2008)

ACP Journal Club21 October 2008Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding or other safety outcomes in hip arthroplastyPieter W. Kamphuisen, MDPieter W. Kamphuisen, MDAcademic Medical Center, Amsterdam, The Netherlands (P.W.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-8-200810210-02006 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationEriksson BI, Borris LC, Friedman RJ, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med. 2008;358:2765-75. https://pubmed.ncbi.nlm.nih.gov/18579811Clinical Impact RatingsHematology: Author, Article, and Disclosure InformationAffiliations: Academic Medical Center, Amsterdam, The Netherlands (P.W.K.)This article was published at Annals.org on 7 October 2008. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding in knee arthroplasty Pieter W. Kamphuisen Self-monitoring of blood glucose was not cost-effective in non–insulin-treated type 2 diabetes Sumit R. Majumdar Metrics 21 October 2008Volume 149, Issue 8Page: JC4-6KeywordsAnticoagulantsArthroplastyDrugsHemorrhageHipKneesOrthopedic surgerySafetySurgeryTotal hip arthroplasty ePublished: 21 October 2008 Issue Published: 21 October 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Molecular Characterization of Thyroid Toxicity: Anchoring Gene Expression Profiles to Biochemical and Pathologic End Points
Authors: Christine M. Glatt, Ming Ouyang, William Welsh, John W. Green, John O Connor, Steven R. Frame, Nancy E. Everds, Greg Poindexter, Suzanne Snajdr, Don A. Delker
Journal: Environmental Health Perspectives (2005)

Organic iodides have been shown to induce thyroid hypertrophy and increase alterations in colloid in rats, although the mechanism involved in this toxicity is unclear. To evaluate the effect that free iodide has on thyroid toxicity, we exposed rats for 2 weeks by daily gavage to sodium iodide (NaI). To compare the effects of compounds with alternative mechanisms (increased thyroid hormone metabolism and decreased thyroid hormone synthesis, respectively), we also examined phenobarbital (PB) and propylthiouracil (PTU) as model thyroid toxicants. Follicular cell hypertrophy and pale-staining colloid were present in thyroid glands from PB-treated rats, and more severe hypertrophy/colloid changes along with diffuse hyperplasia were present in thyroid glands from PTU-treated rats. In PB- and PTU-treated rats, thyroid-stimulating hormone (TSH) levels were significantly elevated, and both thyroxine and triiodothyronine hormone levels were significantly decreased. PB induced hepatic uridine diphosphate-glucuronyltransferase (UDPGT) activity almost 2-fold, whereas PTU reduced hepatic 5 -deiodinase I (5 -DI) activity to < 10% of control in support of previous reports regarding the mechanism of action of each chemical. NaI also significantly altered liver weights and UDPGT activity but did not affect thyroid hormone levels or thyroid pathology. Thyroid gene expression analyses using Affymetrix U34A GeneChips, a regularized t-test, and Gene Map Annotator and Pathway Profiler demonstrated significant changes in rhodopsin-like G-protein-coupled receptor transcripts from all chemicals tested. NaI demonstrated dose-dependent changes in multiple oxidative stress-related genes, as also determined by principal component and linear regression analyses. Differential transcript profiles, possibly relevant to rodent follicular cell tumor outcomes, were observed in rats exposed to PB and PTU, including genes involved in Wnt signaling and ribosomal protein expression.
First admissions to psychiatric hospitals in south-east England in 1976 among immigrants from Ireland.
Authors: G Dean, H Downing, E Shelley
Journal: BMJ (1981)

Irish male immigrants had twice and female immigrants 1.7 times the expected number of first admissions to psychiatric hospitals in south-east England in 1976 when the expected number was based on the age- and sex-standardised rates of first admission of the population born in the United Kingdom living in the region. Admissions for alcoholism and alcoholic psychosis were five times higher in men and four times higher in women, and for schizophrenia 2.4 times as high in both sexes, as expected from these rates. When the expected number of first admissions was based on the age- and sex-standardised rates among Irish people living in Ireland the immigrants had fewer admissions than expected. Among migrants from Northern Ireland the number of first admissions was significantly greater than expected. Admissions for alcoholism and alcoholic psychosis in men and women combined were seven times the expected number based on the UK rates. There was no significant difference in the proportion of single people between the Irish immigrants and people born in the UK. Marital state, socioeconomic group, and occupation may partly account for the high number of admissions for alcoholism and schizophrenia among Irish people living in south-east England.
Addiction to Dextromoramide
Authors: J. Johnson, G. Milner
Journal: BMJ (1964)

Feet and FashionSiRs-In connexion with your leading article " Feet and Fashion " (21 November, p. 1282), some figures concerning the epidemiology of fashion may be of interest to your readers.During school medical inspection in 1964 I have recorded the footwear of children in infant, junior, and secondary modern schools in Lancashire.The following Table shows the results.The figures are
Impact of FDG PET/CT on Delineation of the Gross Tumor Volume for Radiation Planning in Non–Small-Cell Lung Cancer
Authors: Daniel E. Spratt, Roberto Diaz, James McElmurray, Ildiko Csiki, Dennis Duggan, Bo Lu, Dominique Delbeke
Journal: Clinical Nuclear Medicine (2010)

Purpose: Computed tomography (CT) remains the gold standard for delineation of tumor volumes for radiotherapy (RT) planning. However, positron emission tomography (PET) overlay on CT has shown to impact the gross target volume (GTV), decrease intraobserver variability, and change the treatment planning in a significant number of patients. The objective of this study was to evaluate the influence and accuracy of FDG PET in GTV definition as a complementary modality to CT for patients with non–small-cell lung carcinoma at Vanderbilt University Medical Center. Methods: Data from 11 consecutive patients with non–small-cell lung carcinoma, which were referred to FDG PET/CT for initial staging and RT planning were analyzed retrospectively. All patients had undergone routine staging using a RT noncontrasted CT. Both the RT CT and PET/CT images were acquired using standard protocols but with the patients positioned in the same RT immobilization devices. Both the CT and PET/CT images were transferred to the RT planning workstation for contouring. GTV, pathologic nodal and metastases volumes were first defined in the conventional manner based on RT CT. The FDG PET and RT CT planning image datasets were coregistered with the help of the transmission CT from PET/CT. FDG PET GTVs were determined by a team of radiation oncologists and nuclear physician with expertise in PET/CT, and displayed simultaneously with the CT contours. The RT CT and PET GTV were measured and the percent difference was calculated for the primary tumor, pathologic lymph nodes, and distant metastases. A difference of 15% was considered significant. Results: The primary tumor GTV was decreased in 36% (n = 4) of patients by differentiating atelectasis and postobstructive pneumonia from tumor, and increased GTV in 27% (n = 3) of patients by detecting additional tumor burden. Increased nodal disease burden was detected in 18% (n = 2) of patients. The use of PET/CT changed treatment from curative to palliative by detecting distant metastasis in 27% (n = 3) of patients. Conclusions: Our results are consistent with the published data of PET/CT altering GTV in a significant number of patients, detecting tumor spread to additional lymph nodes and distant metastases. While these advantages support the use of PET/CT in RT planning, it remains unknown what impact this will have on patient outcomes.
The Pro12Ala polymorphism of the PPARγ2 gene is associated with hepatic glucose uptake during hyperinsulinemia in subjects with type 2 diabetes mellitus
Authors: Miikka-Juhani Honka, Markku Vänttinen, Patricia Iozzo, Kirsi A. Virtanen, Riikka Lautamäki, Kirsti Hällsten, Ronald J.H. Borra, Teemu Takala, Antti P.M. Viljanen, Jukka Kemppainen, Jussi Pihlajamäki, Juhani Knuuti, Pirjo Nuutila, Markku Laakso
Journal: Metabolism (2009)
Neural stem cell migration toward gliomas in vitro
Authors: Oliver Heese, Andreas Disko, Dorothea Zirkel, Manfred Westphal, Katrin Lamszus
Journal: Neuro-Oncology (2005)

Various in vivo studies demonstrated a migration tendency of neural stem cells (NSCs) toward gliomas, making these cells a potential carrier for delivery of therapeutic genes to disseminated glioma cells. We analyzed which factors determine NSC migration and invasion in vitro. Conditioned media prepared from 10 different human glioma cell lines, as well as 13 different tumor-associated growth factors, were analyzed for their chemotactic effects on murine C17.2 NSCs. The growth factor receptor status was analyzed by reverse transcriptase-polymerase chain reaction. Invasion of NSCs into multicellular tumor spheroids generated from 10 glioma cell lines was quantified. NSCs displayed a heterogeneous migration pattern toward glioma spheroids as well as toward glioma-cell-conditioned medium. Chemotactic migration was stimulated up to fivefold by conditioned medium as compared to controls. In coculture assays, NSC invasion varied from single cell invasion into glioma spheroids to complete dissemination of NSCs into glioma spheroids of different cell lines. Among 13 different growth factors, scatter factor/hepatocyte growth factor (SF/HGF) was the most powerful chemoattractant for NSCs, inducing a 2.5-fold migration stimulation. An antibody against SF/HGF inhibited migratory stimulation induced by conditioned media. NSC migration can be stimulated by various growth factors, similar to glioma cell migration. The extent to which NSCs infiltrate three-dimensional glioma cell aggregates appears to depend on additional factors, which are likely to include cell-to-cell contacts and interaction with extracellular matrix proteins.
Measurement of human fetal blood flow.
Authors: J B Sauders, N Wright, K O Lewis
Journal: BMJ (1980)

Real-time B-mode ultrasonography was combined with a pulsed Doppler ultrasound technique for transcutaneous measurement of human fetal blood flow in the aorta and intra-abdominal part of the umbilical vein. The target vessel was located and its diameter measured in the two-dimensional real-time image. The pulsed Doppler transducer was attached to the real-time transducer at a fixed angle. By processing the Doppler shift signals the instrument estimated the mean and maximum blood velocities and the integral under the velocity curves. This permitted calculation of the blood flow. The method was applied to 26 fetuses in normal late pregnancies. Mean blood flow in the descending part of the fetal aorta based on maximum velocity was 191 ml/kg/min. Mean flow in the intra-abdominal part of the umbilical vein was 110 ml/kg/min. This method of measurement is non-invasive and opens new perspectives in studying fetal haemodynamics.
Children are often undertreated for pain
Authors: J. H. Tanne
Journal: BMJ (2003)

“Children in pain rarely seem to get the attention they need. There is a substantive gap between what we know and what we do,” said Dr Richard Howard, from the anaesthesiology department at Great Ormond Street Children's Hospital, London, speaking at the American Medical Association's briefing in New York to launch JAMA 's theme issue on pain.

“Infants used to get much less treatment than adults for the same conditions,” he said, because doctors feared side effects in children. Although improvements had been made in the past 20 years—as doctors learnt more about the immature nervous system—there were few good evidence based studies, he said. …
Body Mass Index and Risk for End-Stage Renal Disease
Authors: Chi-yuan Hsu, Charles E. McCulloch, Carlos Iribarren, Jeanne Darbinian, Alan S. Go
Journal: Annals of Internal Medicine (2006)

Background: Although interest in the relationship between obesity and kidney disease is increasing, few epidemiologic studies have examined whether excess weight is an independent risk factor for end-stage renal disease (ESRD). Objective: To determine the association between increased body mass index (BMI) and risk for ESRD. Design: Historical (nonconcurrent) cohort study. Setting: A large integrated health care delivery system in northern California. Participants: 320 252 adult members of Kaiser Permanente who volunteered for screening health checkups between 1964 and 1985 and who had height and weight measured. Measurements: The authors ascertained ESRD cases by matching data with the U.S. Renal Data System registry through 2000. Results: A total of 1471 cases of ESRD occurred during 8 347 955 person-years of follow-up. Higher BMI was a risk factor for ESRD in multivariable models that adjusted for age, sex, race, education level, smoking status, history of myocardial infarction, serum cholesterol level, urinalysis proteinuria, urinalysis hematuria, and serum creatinine level. Compared with persons who had normal weight (BMI, 18.5 to 24.9 kg/m2), the adjusted relative risk for ESRD was 1.87 (95% CI, 1.64 to 2.14) for those who were overweight (BMI, 25.0 to 29.9 kg/m2), 3.57 (CI, 3.05 to 4.18) for those with class I obesity (BMI, 30.0 to 34.9 kg/m2), 6.12 (CI, 4.97 to 7.54) for those with class II obesity (BMI, 35.0 to 39.9 kg/m2), and 7.07 (CI, 5.37 to 9.31) for those with extreme obesity (BMI ≥ 40 kg/m2). Higher baseline BMI remained an independent predictor for ESRD after additional adjustments for baseline blood pressure level and presence or absence of diabetes mellitus. Limitations: Primary analyses were based on single measurements of exposures. Conclusions: High BMI is a common, strong, and potentially modifiable risk factor for ESRD.
Persistent ductus venosus without portal hypertension in a young alcoholic man
Authors: P. Barjon, J.-L. Lamarque, H. Michel, J. Fourcade, A. Mimran, J.-F. Ginestie
Journal: Gut (1972)

The discovery of a large patent ductus venosus resulted from radiological investigations in a 34-year-old man, a chronic alcoholic of low mental status. Splenoportal and inferior caval venograms were performed because of recent exacerbation of the neurological symptoms and electroencephalographic criteria of portacaval encephalopathy. Portal pressure was 8 mm Hg. A liver scan, a laparoscopy, and a liver biopsy were performed. They showed that the gland was atrophic with a microscopic appearance of alcoholic fibrosis, but without any nodular regeneration. The relationship between the fistula, the mental state, and the atrophic liver is discussed. Such a malformation appears to be very uncommon.
Immunolocalization of adhesion molecules in psoriatic arthritis, psoriatic and normal skin
Authors: D. VEALE, S. ROGERS, O. FITZGERALD
Journal: British Journal of Dermatology (1995)

Adhesion molecule expression in synovial membrane obtained from patients with psoriatic arthritis (PA) has previously been compared with rheumatoid arthritis (RA). Although expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) was similar in both psoriatic and rheumatoid synovium, in contrast, little or no endothelial leucocyte adhesion molecule-1 (ELAM-1) was observed in psoriatic synovium. In the present study, the expression of ICAM-1, ELAM-1 and VCAM-1 was examined in the involved and uninvolved skin from patients with PA (n = 15), patients with psoriasis (Ps) but no arthritis (n = 5) and in normal skin (n = 4). ICAM-1 was intensely expressed on endothelium and keratinocytes of involved skin from patients with Ps with or without arthritis. There was constitutive expression of ICAM-1 on endothelium only in uninvolved and normal skin. In contrast, ELAM-1 expression was restricted to endothelial cells; it was widespread and intense in involved skin, but was minimal in uninvolved and normal skin. VCAM-1 was expressed on endothelium, and also on some dendritic cells in involved psoriatic skin. There was minimal VCAM-1 staining on endothelial cells in uninvolved and normal skin. In conclusion, in involved psoriatic skin from patients with and without arthritis ICAM-1, ELAM-1 and VCAM-1 expression is up-regulated on vascular endothelium, and ICAM-1 is expressed on keratinocytes. However, ELAM-1 and VCAM-1 expression seen in dermal vessels is not found in psoriatic synovial vessels. These differences suggest a mechanism for controlling cellular traffic in Ps and in PA.
Viral diarrhoeas in childhood.
Authors: E. J. Elliott
Journal: BMJ (1992)

fluctuations will relate to the least productive slice of advertis- ing expenditure on the reasonable assumption that advertising is subject to diminishing returns.Accordingly, an outright ban is likely to have far more effect than marginal changes.The report also considered survey evidence that nearly half of all smokers agree that "smoking cannot be really dangerous or the government would ban cigarette advertising."8 The conclusion from the evidence amassed in the Depart- ment of Health's report is clearly that tobacco advertising affects the level of tobacco consumption.The government's white paper The Health of the Nation has set a target to reduce consumption of cigarettes by 40°/ and the prevalence of smoking to 20% by 200O.9To this end the government has committed itself to maintaining the real value of cigarette excise duty.This is by no means sufficient to achieve these targets,'" which are necessarily ambitious, to cut morbidity and mortality from cancer, heart disease, and stroke.Even with a considerable annual increase in real price and health education meeting these targets without an advertising ban is unlikely.The government has already banned tobacco advertising on television and accepts the need to control advertising.If control is good a ban must be better, and anything less would seem second best for health.
Loss of p53 accelerates the complications of myelodysplastic syndrome in a NUP98-HOXD13–driven mouse model
Authors: Haiming Xu, Silvia Menendez, Brigitte Schlegelberger, Narae Bae, Peter D. Aplan, Gudrun Göhring, Tony R. Deblasio, Stephen D. Nimer
Journal: Blood (2012)