tbuckley/cabot-search huggingface dataset:
Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study
Authors: J M M Evans, A D McMahon, M M McGilchrist, G White, F E Murray, D G McDevitt, T M MacDonald
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To evaluate the relation between topically applied non-steroidal anti-inflammatory drugs and upper gastrointestinal bleeding and perforation. <b>Design</b>: A case-control study with 1103 patients admitted to hospital for upper gastrointestinal bleeding or perforation between January 1990 and December 1992 (cases). Two different control groups were used, with six community controls and with two hospital controls for each case. Previous exposure to topical and oral non-steroidal anti-inflammatory drugs and ulcer healing drugs was assessed. Study population--The population of 319465 people who were resident in Tayside and were registered with a Tayside general practitioner between January 1989 and October 1994. A record linkage database containing all data on hospital events and dispensed drugs between 1989 and 1992 was used for this population. <b>Main outcome measures</b>: Unadjusted and adjusted odds ratios of exposure in those admitted to hospital compared with controls. <b>Results</b>: Significant unadjusted associations were detected between all three classes of drug and upper gastrointestinal complications. The significant association detected for topical non-steroidal anti-inflammatory drugs was no longer evident in analyses which adjusted for the confounding effect of concomitant exposure to oral anti-inflammatories and ulcer healing drugs (odds ratio=1.45; 95% confidence interval 0.84 to 2.50 with community controls; 1.06; 0.60 to 1.88 with hospital controls). <b>Conclusion</b>: In this study topical non-steroidal anti-inflammatory drugs were not significantly associated with upper gastrointestinal bleeding and perforation after adjustment for the confounding effects of concomitant use of oral anti-inflammatories and ulcer healing drugs.
Cardiac Hypertrophy Is Not a Required Compensatory Response to Short-Term Pressure Overload
Authors: Joseph A. Hill, Mohsen Karimi, William Kutschke, Robin L. Davisson, Kathy Zimmerman, Zhengyi Wang, Richard E. Kerber, Robert M. Weiss
Journal: Circulation (2000)

Cardiac hypertrophy is considered a necessary compensatory response to sustained elevations of left ventricular (LV) wall stress.To test this, we inhibited calcineurin with cyclosporine (CsA) in the setting of surgically induced pressure overload in mice and examined in vivo parameters of ventricular volume and function using echocardiography. Normalized heart mass increased 45% by 5 weeks after thoracic aortic banding (TAB; heart weight/body weight, 8.3+/-0.9 mg/g [mean+/-SEM] versus 5. 7+/-0.1 mg/g unbanded, P<0.05). Similar increases were documented in the cell-surface area of isolated LV myocytes. In mice subjected to TAB+CsA treatment, we observed complete inhibition of hypertrophy (heart weight/body weight, 5.2+/-0.3 mg/g at 5 weeks) and myocyte surface area (endocardial and epicardial fractions). The mice tolerated abolition of hypertrophy with no signs of cardiovascular compromise, and 5-week mortality was not different from that of banded mice injected with vehicle (TAB+Veh). Despite abolition of hypertrophy by CsA (LV mass by echo, 83+/-5 mg versus 83+/-2 mg unbanded), chamber size (end-diastolic volume, 33+/-6 microL versus 37+/-1 microL unbanded), and systolic ejection performance (ejection fraction, 97+/-2% versus 97+/-1% unbanded) were normal. LV mass differed significantly in TAB+Veh animals (103+/-5 mg, P<0.05), but chamber volume (end-diastolic volume, 44+/-6 microL), ejection fraction (92+/-2%), and transstenotic pressure gradients (70+/-14 mm Hg in TAB+Veh versus 77+/-11 mm Hg in TAB+CsA) were not different.In this experimental setting, calcineurin blockade with CsA prevented LV hypertrophy due to pressure overload. TAB mice treated with CsA maintain normal LV size and systolic function.
An Inflatable Penile Prosthesis for Treatment of Diabetic Impotence
Authors: F. BRANTLEY SCOTT
Journal: Annals of Internal Medicine (1980)

Surgical results have improved considerably since the first implantation of the inflatable penile prosthesis in 1973. The incidence of infection appears to be less than 2% and the overall success rate greater than 95%. With strict attention to details of preoperative preparation and to asepsis, the incidence of infection is probably no greater in the diabetic patient. Although there will always be mechanical problems with this more sophisticated device, the ease with which these problems can be corrected and the advantages of having natural erections, as well as flaccidity, makes the inflatable prosthesis the most desirable treatment for organic impotence.
Vascular prostacyclin is increased in patients ingesting omega-3 polyunsaturated fatty acids before coronary artery bypass graft surgery.
Authors: R DeCaterina, D Giannessi, A Mazzone, W Bernini, G Lazzerini, S Maffei, M Cerri, L Salvatore, B Weksler
Journal: Circulation (1990)

Interest in the antithrombotic potential of diets enriched with fish oil-derived polyunsaturated fatty acids (omega-3 PUFAs) prompted us to examine how these fatty acids, when taken preoperatively, affect hemostasis, plasma lipid levels, and production of prostacyclin (PGI2) by vascular tissues in atherosclerotic patients undergoing coronary artery bypass graft surgery. Fifteen patients with angiographically proven coronary artery disease received 3 g/day eicosapentaenoic acid and 1.3 g/day docosahexaenoic acid as capsules of purified fish oil for 28 days before surgery. Platelet aggregation induced by low concentrations of ADP, collagen, and epinephrine decreased (p less than 0.05) and serum thromboxane B2 decreased 36% (p less than 0.01) from baseline values. Bleeding times increased 40% (p less than 0.01) from baseline. Serum triglycerides decreased 50% (p less than 0.05) without a change in total serum cholesterol. Spontaneous production of PGI2 measured as 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha), its stable hydrolytic product, by saphenous vein and aortic and atrial tissues obtained at surgery was greater in tissues from patients receiving omega-3 PUFA supplements than in tissues from matched controls (13.8 +/- 2.2 versus 8.6, 21.0 +/- 3.1 versus 11.5 +/- 2.1, and 166 +/- 13 versus 102 +/- 15 ng/g, respectively, all p less than 0.05). Arachidonate-stimulated production of PGI2, as indicated by increased levels of 6-keto-PGF1 alpha, was increased. Despite changes in platelet function, bleeding time, and vascular PGI2, the perioperative blood loss was not increased in subjects receiving fish oil supplements. Thus, omega-3 PUFAs at moderate dosages may exert antithrombotic effects by increasing prostacyclin production by vessel walls as well as by direct inhibition of platelet activity.
Direct Reversal of Glucocorticoid Resistance by AKT Inhibition in Acute Lymphoblastic Leukemia
Authors: Erich Piovan, Jiyang Yu, Valeria Tosello, Daniel Herranz, Alberto Ambesi-Impiombato, Ana Carolina Da Silva, Marta Sanchez-Martin, Arianne Perez-Garcia, Isaura Rigo, Mireia Castillo, Stefano Indraccolo, Justin R. Cross, Elisa de Stanchina, Elisabeth Paietta, Janis Racevskis, Jacob M. Rowe, Martin S. Tallman, Giuseppe Basso, Jules P. Meijerink, Carlos Cordon-Cardo, Andrea Califano, Adolfo A. Ferrando
Journal: Cancer Cell (2013)
Alliance Boots accused of avoiding over 1bn in UK tax
Authors: I. Torjesen
Journal: BMJ (2013)

Alliance Boots, the parent company of Britain’s biggest high street pharmacy chain, Boots, has avoided paying at least £1.12bn (€1.3bn; $1.8bn) in UK tax since it became a privately held company six years ago, by offsetting debt repayments against its UK profits, it has emerged.

The £1.12bn figure is given in a report published on Tuesday 15 October by the trade union Unite, the antipoverty charity War on Want, and the Change to Win federation of US trade unions.1

Alliance Boots has issued a statement claiming that the report contains several inaccuracies and emphasising that it “conducts its business and organises its tax affairs strictly in compliance with all applicable law (including legislation in the UK) and observes the highest standard of good ethics.” The statement adds that the company found it “extraordinary and disappointing” that the report’s authors had not contacted …
Multiple-Balloon-Kymograph Recording of the Effect of Banthine, Belladonna and Placebos on Upper-Intestinal Motility
Authors: William P. Chapman, Arthur B. French, Phyllis S. Hoffman, Chester M. Jones
Journal: New England Journal of Medicine (1952)

RECENT studies have demonstrated that Banthine, β-diethylaminoethyl xanthine-9-carboxylate methobromide, has a definite action on gastrointestinal function. This new drug acts chiefly as a blocking agent on the parasympathetic nervous system and, to a lesser degree, on the sympathetic nervous system.1 In dosages in the toxic range it exerts a curare-like action on skeletal muscle. In man, Banthine has been found to retard gastric emptying, decrease contractions of the small and large intestine and diminish the volume of gastric secretion.2 3 4 When administered therapeutically, present observations indicate that Banthine is effective in the treatment of patients with peptic ulcer and in certain . . .
Type I Interferons potently suppress gene expression following gene delivery using liposome–DNA complexes
Authors: Karen Sellins, Lee Fradkin, Denny Liggitt, Steven Dow
Journal: Molecular Therapy (2005)

Gene delivery by intravenous injection of cationic liposome-DNA complexes (LDC) can generate efficient transgene expression in the lungs and other organs, but the duration of expression is typically short. Previous studies have suggested a major role for interferon-gamma (IFN-gamma) and TNF in this process. However, plasmid DNA is also capable of eliciting production of type I IFNs. Therefore, we assessed the ability of LDC to elicit production of type I IFNs in vivo and assessed the effects of type I IFNs on suppression of transgene expression following in vivo gene delivery with LDC. Injection of LDC was found to induce production of high levels of both IFN-alpha and IFN-beta in vivo. Moreover, the levels of transgene expression following in vivo gene delivery were markedly increased in mice lacking functional type I IFN receptor genes, compared to wild-type mice or mice lacking IFN-gamma or TNF receptors. Addition of recombinant IFN-alpha and IFN-beta inhibited transgene expression by in vitro-transfected endothelial cells, and incubation of macrophages with LDC in vitro triggered production of both IFN-alpha and IFN-beta. Therefore, type I IFNs appear to play a key role in suppressing transgene expression in vivo following systemic nonviral gene delivery using LDC.
Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study
Authors: Arnaud Jaccard, Nathalie Gachard, Benoit Marin, Sylvie Rogez, Marie Audrain, Felipe Suarez, Hervé Tilly, Franck Morschhauser, Catherine Thieblemont, Loic Ysebaert, Alain Devidas, Barbara Petit, Laurence de Leval, Philippe Gaulard, Jean Feuillard, Dominique Bordessoule, Olivier Hermine
Journal: Blood (2010)
Irrational testing for antiphospholipid antibodies
Authors: C. Nelson-Piercy, B. J. Hunt, M. Khamashta, L. C. Chappell
Journal: BMJ (2013)

We read Binder and Ellis’s article with interest,1 but the incongruity of recommending irrational testing in a “Rational Testing” article did not escape us.

The authors advise testing women with a history of two miscarriages for antiphospholipid antibodies, despite clinical classification criteria for antiphospholipid syndrome stipulating three or more …
Agranulocytosis Induced by Certain Phenothiazine Derivatives
Authors: Anthony V. Pisciotta
Journal: JAMA (1969)

Phenothiazine derivatives implicated as a frequent cause of agranulocytosis include chlorpromazine, mepazine, promazine, and thioridazine. Perphenazine, prochlorperazine, and triflupromazine are also suspect, but not incriminated. Apparently promethazine and methdilazine do not cause agranulocytosis. Clinical and hematologic characteristics of phenothiazine-induced agranulocytosis suggest that the mechanisms underlying the development of this condition are related to a possible suppressive effect of phenothiazines on cell division. This suggests that even before exposure to chlorpromazine, sensitive patients have a less efficient mechanism for cell division or deoxyribonucleic acid synthesis than the nonsensitive ("normal") patients. Because of its in vitro affinity for soluble protein, it is possible that chlorpromazine exerts its effect by combining with biologically active proteins to inactivate their physiologic properties. Unexpected hematologic reactions may develop in rare cases from the administration of certain drugs in dosages that ordinarily are not harmful to most people. These reactions may result from the interaction of a
Testing for human immunodeficiency virus infection in patients with tuberculosis.
Authors: P F Barnes, C Silva, M Otaya
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

To investigate the utility of testing all tuberculosis patients for HIV infection in Los Angeles, we prospectively evaluated 183 hospitalized patients with acid-fast smear-positive tuberculosis who gave no history of HIV infection. HIV serologic testing was performed, and the presence of risk factors for HIV infection was assessed by interview and review of the medical record. Thirty-three patients (18%) were infected with HIV. Based on data obtained by interview, 124 (68%) of 183 patients had at least one risk factor for HIV infection. The most common risk factors were related to heterosexual transmission of HIV (prostitute contact, multiple sex partners, and a history of sexually transmitted disease). These risk factors were frequently not documented in the medical record. Among the 33 patients who were infected with HIV, 30 were identified by interviewing as having significant risk factors. We concluded that most tuberculosis patients in Los Angeles have risk factors for HIV infection and that systematic questioning does not identify risk factors in all HIV-infected tuberculosis patients. These data support current recommendations to screen all tuberculosis patients for HIV infection.
Early days of anaesthesia and the BMJ
Authors: P. Board
Journal: BMJ (2010)

The BMJ ’s first mention of anaesthesia appears in January 1847, some three or four months after William Morton successfully anaesthetised a patient for excision of a neck tumour at Massachusetts General Hospital. George Edwards described the case of an above knee amputation under ether anaesthesia performed on a young woman of highly nervous temperament who “dreaded the pain of the operation exceedingly.”1 Consequently, it was deemed “a favourable opportunity to test the efficacy of this new discovery.”

A chemist assisted in the preparation of the ether and its administration, and the young …
Excretion of Hexachlorobenzene and Metabolites in Feces in a Highly Exposed Human Population
Authors: Jordi To-Figueras, Carme Barrot, Maria Sala, Raquel Otero, Mary Silva, Maria Delores Ozalla, Carme Herrero, Jacint Corbella, Joan Grimalt, Jordi Sunyer
Journal: Environmental Health Perspectives (2000)

A set of 53 individuals from a population highly exposed to airborne hexachlorobenzene (HCB) were selected to study the elimination kinetics of this chemical in humans. The volunteers provided blood, 24-hr urine, and feces samples for analysis of HCB and metabolites. The serum HCB concentrations ranged from 2.4 to 1,485 ng/mL (mean +/- SD, 124 +/- 278), confirming that this human population has the highest HCB blood levels ever reported. All analyzed feces samples contained unchanged HCB (range, 11-3,025 ng/g dry weight; mean +/- SD, 395 +/- 629). The HCB concentration in feces strongly correlated with HCB in serum (r = 0.85; p < 0.001), suggesting an equilibrium in feces/serum that is compatible with a main pulmonary entrance of the chemical and low intestinal excretion of nonabsorbed foodborne HCB. The equilibrium is also compatible with a nonbiliary passive transfer of the chemical to the intestinal lumen. Two HCB main metabolites, pentachlorophenol (PCP) and pentachlorobenzenethiol (PCBT), were detected in 51% and 54% of feces samples, respectively. All urine samples contained PCP and PCBT, confirming the conclusions of a previous study [Environ Health Perspect 105:78-83 (1997)]. The comparison between feces and urine showed that whereas daily urinary elimination of metabolites may account for 3% of total HCB in blood, intestinal excretion of unchanged HCB may account for about 6%, thus showing the importance of metabolism in the overall elimination of HCB. The elimination of HCB and metabolites by both routes, however, appears to be very small (< 0.05%/day) as compared to the estimated HCB adipose depots. Features of HCB kinetics that we present in this study, i.e., nonsaturated intestinal elimination of HCB and excretion in feces and urine of inert glutathione derivatives, may explain, in part, the absence of porphyria cutanea in this human population heavily exposed to HCB.
ETIOLOGY AND TREATMENT OF MIGRAINE.
Authors: J. M. AIKIN
Journal: JAMA (1902)

Of all the common and much-dreaded nervous diseases we recognize, none are less perfectly understood than migraine; nor is there any other nervous disorder which is so disastrous to the physician's ability for effectual treatment. Under the title I wish to be understood as excluding neuralgia, neuritis, headaches due, proximately, to improper alimentation, nervous exhaustion or brain fatigue. I would exclude the head pains as not migraine that are cured by merely correcting ocular or nasal abnormalities. The causes for headache seen through the speculum of the gynecologist and proctologist are not a few; and the many radical cures effected by their rational treatment are glowing tributes to medical progress; but these headaches are not true migraine. The uric acid diathesis is a step in the right direction, but even Haig, its foremost advocate, has not reported his own case of migraine as cured by using alkalithia. It is easy
Endoscopic Techniques to Diagnose and Manage Biliary Tumors
Authors: William R. Brugge
Journal: Journal of Clinical Oncology (2005)

Malignancies of the bile duct are often suspected in patients with abnormal serum hepatic enzyme levels and obstruction of the biliary system. Although cross-sectional imaging can provide evidence for biliary obstruction and a malignancy arising from the bile duct, a definitive diagnosis is often obtained through the use of endoscopic procedures. Endoscopic retrograde cholangiopancreatography (ERCP), the most commonly performed procedure for cholangiocarcinoma, can provide a tissue diagnosis through brush cytology of the bile duct. Relief from biliary obstruction can be provided with temporary plastic stenting or permanent metal stenting. Photodynamic therapy guided by ERCP may provide improved palliation from biliary obstruction in the future. Endoscopic ultrasonography complements the role of ERCP and may provide a tissue diagnosis through fine-needle aspiration and staging through ultrasound imaging. High-resolution ultrasound images can provide detailed information regarding the relationship between a mass and the bile duct wall. Despite these advances in endoscopic techniques and imaging of the bile duct, a tissue diagnosis often remains elusive in many patients. In the future, molecular markers will be employed to improve the sensitivity for the detection of malignancy in bile duct samples obtained through brushing, aspiration, and biopsy.
Review of<i>Neuroinfections</i>
Authors: Israel Steiner
Journal: JAMA Neurology (2014)

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Preoperative Renal Risk Stratification
Authors: Glenn M. Chertow, J. Michael Lazarus, Cindy L. Christiansen, E. Francis Cook, Karl E. Hammermeister, Frederick Grover, Jennifer Daley
Journal: Circulation (1997)

After cardiac surgery, acute renal failure (ARF) requiring dialysis develops in 1% to 5% of patients and is strongly associated with perioperative morbidity and mortality. Prior studies have attempted to identify predictors of ARF but have had insufficient power to perform multivariable analyses or to develop risk stratification algorithms.We conducted a prospective cohort study of 43 642 patients who underwent coronary artery bypass or valvular heart surgery in 43 Department of Veterans Affairs medical centers between April 1987 and March 1994. Logistic regression analysis was used to identify independent predictors of ARF requiring dialysis. A risk stratification algorithm derived from recursive partitioning was constructed and was validated on an independent sample of 3795 patients operated on between April and December 1994. The overall risk of ARF requiring dialysis was 1.1%. Thirty-day mortality in patients with ARF was 63.7%, compared with 4.3% in patients without ARF. Ten clinical variables related to baseline cardiovascular disease and renal function were independently associated with the risk of ARF. A risk stratification algorithm partitioned patients into low-risk (0.4%), medium-risk (0.9% to 2.8%), and high-risk (> or = 5.0%) groups on the basis of several of these factors and their interactions.The risk of ARF after cardiac surgery can be accurately quantified on the basis of readily available preoperative data. These findings may be used by physicians and surgeons to provide patients with improved risk estimates and to target high-risk subgroups for interventions aimed at reducing the risk and ameliorating the consequences of this serious complication.
Healing the Wounds: A Physician Looks at His Work
Authors: Christine K. Cassel
Journal: JAMA (1986)

The immediacy of the writing in<i>Healing the Wounds</i>is such that one would think these vignettes, these stories, were written by a journalist. But the precision of the small details of both the ridiculous and the sublime in medical practice make it clear that this is a physician's voice. It is the real world of a physician who cares about people, who touches his own rage and sorrow, who understands the limitations of human knowledge and human suffering, and who sees the dramas of medical care being enacted within a system that brutalizes the caregivers and makes impossible demands on the patients' economic resources. He does this with an intensity worthy of the combination of Trapper John, St Elsewhere, and Mary Worth. When I first read Hilfiker's article "Playing God," which appeared in the<i>New England Journal of Medicine</i><sup>1</sup>three years ago, I found myself impatient, even indignant,