tbuckley/cabot-search huggingface dataset:
Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin.
Authors: W Y Lau, S T Fan, S H Wong, K P Wong, G P Poon, K W Chu, W C Yip, K K Wong
Journal: Gut (1987)

In the past six years, 37 patients with gastrointestinal bleeding of obscure origin had their bleeding sites localised preoperatively or intraoperatively. Preoperative investigations followed a regime consisting of endoscopy, barium meal and follow through, small bowel enema, 99mTc pertechnetate scan, 99mTc-labelled red blood cell scan and selective coeliac and mesenteric angiography. Bleeding lesions were localised preoperatively in 36 patients. In one patient, diagnostic laparotomy had to be carried out immediately before any investigation because the bleeding was severe. At operation, angiosarcoma of ileum was found. Unless preoperative investigations showed the lesions to be in anatomically fixed organs like the duodenum or colon, the lesions had still to be found at operation. Palpation and transillumination detected the lesion intraoperatively in 21 patients while only some lesions were found in three patients with multiple lesions. Sigmoidoscopy through enterotomies was required in one patient. Intraoperative enteroscopy was done for small lesions not found grossly at operation in nine patients, to detect additional lesions in three patients or to rule out suspicious lesion shown on preoperative tests in one patient. In another patient with diffuse lymphoma of small bowel with bleeding from only a small segment of jejunum, injection of methylene blue intraoperatively through a previously placed angiographic catheter stained the bleeding segment of jejunum blue. This segment was identified easily and resected. These preoperative and intraoperative localisation procedures were simple and effective and we recommend them to be used more freely.
Reporting of euthanasia in medical practice in Flanders, Belgium: cross sectional analysis of reported and unreported cases
Authors: T. Smets, J. Bilsen, J. Cohen, M. L. Rurup, F. Mortier, L. Deliens
Journal: BMJ (2010)

<b>Objectives</b> To estimate the rate of reporting of euthanasia cases to the Federal Control and Evaluation Committee and to compare the characteristics of reported and unreported cases of euthanasia. <b>Design </b>Cross sectional analysis. <b>Setting </b>Flanders, Belgium. <b>Participants</b> A stratified at random sample was drawn of people who died between 1 June 2007 and 30 November 2007. The certifying physician of each death was sent a questionnaire on end of life decision making in the death concerned. <b>Main outcome measures</b> The rate of euthanasia cases reported to the Federal Control and Evaluation Committee; physicians' reasons for not reporting cases of euthanasia; the relation between reporting and non-reporting and the characteristics of the physician and patient; the time by which life was shortened according to the physician; the labelling of the end of life decision by the physician involved; and differences in characteristics of due care between reported and unreported euthanasia cases. <b>Results</b> The survey response rate was 58.4% (3623/6202 eligible cases). The estimated total number of cases of euthanasia in Flanders in 2007 was 1040 (95% CI 970 to 1109), thus the incidence of euthanasia was estimated as 1.9% of all deaths (95% CI 1.6% to 2.3%). Approximately half (549/1040 (52.8%, 95% CI 43.9% to 60.5%)) of all estimated cases of euthanasia were reported to the Federal Control and Evaluation Committee. Physicians who perceived their case as euthanasia reported it in 93.1% (67/72) of cases. Cases of euthanasia were reported less often when the time by which life was shortened was less than one week compared with when the perceived life shortening was greater (37.3% <i>v</i> 74.1%; P&lt;0.001). Unreported cases were generally dealt with less carefully than reported cases: a written request for euthanasia was more often absent (87.7% <i>v</i> 17.6% verbal request only; P&lt;0.001), other physicians and caregivers specialised in palliative care were consulted less often (54.6% <i>v</i> 97.5%; 33.0% <i>v</i> 63.9%; P&lt;0.001 for both), the life ending act was more often performed with opioids or sedatives (92.1% <i>v</i> 4.4%; P&lt;0.001), and the drugs were more often administered by a nurse (41.3% <i>v</i> 0.0%; P&lt;0.001). <b>Conclusions</b> One out of two euthanasia cases is reported to the Federal Control and Evaluation Committee. Most non-reporting physicians do not perceive their act as euthanasia. Countries debating legalisation of euthanasia should simultaneously consider developing a policy facilitating the due care and reporting obligations of physicians.
Scaffold attachment factor B1 (SAFB1) heterozygosity does not influence Wnt-1 or DMBA-induced tumorigenesis
Authors: Benny Kaipparettu, Klaudia M Dobrzycka, Ora Britton, Adrian V Lee, Alan J Herron, Yi Li, Michael T Lewis, Daniel Medina, Steffi Oesterreich
Journal: Molecular Cancer (2009)

Scaffold Attachment Factor B1 (SAFB1) is a multifunctional protein which has been implicated in breast cancer previously. We recently generated SAFB1 knockout mice (SAFB1-/-), but pleiotropic phenotypes including high lethality, dwarfism associated with low IGF-I levels, and infertility and subfertility in male and female mice, respectively, do not allow for straightforward tumorigenesis studies in these mice. Therefore, we asked whether SAFB1 heterozygosity would influence tumor development and progression in MMTV-Wnt-1 oncomice or DMBA induced tumorigenicity, in a manner consistent with haploinsufficiency of the remaining allele. We crossed female SAFB1+/- (C57B6/129) mice with male MMTV-Wnt-1 (C57B6/SJL) mice to obtain SAFB1+/+/Wnt-1, SAFB1+/-/Wnt-1, and SAFB1+/- mice. For the chemical induced tumorigenesis study we treated 8 weeks old SAFB1+/- and SAFB+/+ BALB/c mice with 1 mg DMBA once per week for 6 weeks. Animals were monitored for tumor incidence and tumor growth. Tumors were characterized by performing H&E, and by staining for markers of proliferation and apoptosis. We did not detect significant differences in tumor incidence and growth between SAFB1+/+/Wnt-1 and SAFB1+/-/Wnt-1 mice, and between DMBA-treated SAFB1+/+ and SAFB1+/-mice. Histological evaluation of tumors showed that SAFB1 heterozygosity did not lead to changes in proliferation or apoptosis. There were, however, significant differences in the distribution of tumor histologies with an increase in papillary and cribriform tumors, and a decrease in squamous tumors in the SAFB1+/-/Wnt-1 compared to the SAFB1+/+/Wnt-1 tumors. Of note, DMBA treatment resulted in shortened survival of SAFB1+/- mice compared to their wildtype littermates, however this trend did not reach statistical significance. Our data show that SAFB1 heterozygosity does not influence Wnt-1 or DMBA-induced mammary tumorigenesis.
Abstract 154: [6]-Shogaol inhibits cell growth and induces apoptosis in non-small-cell lung cancer (NSCLC) cells by regulating multiple targets
Authors: Mee-Hyun Lee, Myoung Ok Kim, Naomi Oi, Ki Beom Bae, Zunnan Huang, Soouk Kang, Hua Xie, Tae-Gyu Lim, Ann M. Bode, Zigang Dong
Journal: Cancer Research (2012)

Abstract Non-small-cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. Despite substantial progress in developing chemotherapeutics for the treatment of NSCLC, primary and secondary resistance limits the success of these therapies. NSCLC cells exhibit different EGFR mutations and EGFR has extensive cross-talk with other cell signaling pathways. Therefore, suppression of the inappropriate expression of multiple targets is considered to be a rational therapeutic and preventive strategy for the management of NSCLC. Our initial molecular-target oriented virtual screening revealed that the ingredients of ginger, including [6]-gingerol, [6]-shogaol and [6]-paradol appeared to be potential candidates for the prevention and therapy of NSCLC cells. Among the three compounds, [6]-shogaol showed the greatest inhibitory effect on growth and soft agar colony formation of NSCLC cells. [6]-Shogaol induced cell cycle arrest (G1 or G2/M) and apoptosis. Furthermore, [6]-shogaol interacted with PI3-K and AKT and inhibited AKT kinase activity. Finally, [6]-shogaol increased the expression of p27, which is one of the target proteins in the AKT signaling pathway. The present results clearly indicate that [6]-shogaol exerted a strong anti-cancer effect and can be regarded as useful tool for the treatment of NSCLC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 154. doi:1538-7445.AM2012-154
Violence in Health Care: A Practical Guide to Coping with Violence and Caring for Victims
Authors: P E Mullen
Journal: BMJ (1994)

Ed Jonathan Shepherd Oxford University Press, £16.95, pp 195 ISBN 0-19-262157-2

The editor describes Violence in Health Care as a “a handbook which summarises information relevant to those who treat victims and to those at risk of violence.” First in the list of those at whom the work is targeted are general practitioners.

I can only assume that the editor forbade contributors to reference their claims and statements and instead enjoined them to provide a brief list of further reading. This prohibition has been followed by all except David Farrington, and it is probably no chance that his is by the far the most satisfactory and informative of the contributions. The lack of references in fields of inquiry many of which are both in rapid flux and prone to exuberant, not to say exaggerated, claims is unfortunate. For example, Farrington makes what seems an outrageous suggestion - that …
The demonstration and function of antibodies in the gastrointestinal tract.
Authors: D J Shearman, D M Parkin, D B McClelland
Journal: Gut (1972)

Progress reportThe demonstration and function of antibodies in the gastrointestinal tractThe presence of antibody activity in intestinal secretions has been known for 50 years since Davies1 demonstrated specific antibodies in the faeces of patients suffering from dysentery.It is now well documented that the gut of germ-free animals2 and the human neonate3 contains very few plasma cells, and after bacterial contamination the normal complement of plasma cells appears rapidly.These studies have been reviewed recently2.This germ-free condition is associated with absence of immunoglobulin A in the intestinal secretions and the immunoglobulin appears as a response to colonization.The importance of IgA in secretions has been emphasized in reviews by Tomasi and Bienenstock4, by Tomasi and DeCoteau5, and by Heremans6.Work on salivary IgA has been extensively reviewed by Brandtzaeg, Fjel- langer, and Gjeruldsen7.It is the purpose of this review to present recent information on gastro- intestinal antibody production, particularly in the stomach and small intestine, with emphasis on the probable functions of the antibody.There are many technical difficulties in the detection and measurement of antibodies in gastrointestinal secretions.If the gastroenterologist is to maintain a critical understanding of the many relevant papers in this immunological field, then he must appreciate some of the technical problems which are reviewed here.Furthermore, antibody responses within the bowel are important in the study of oral vaccination and some of the relevant experimental work is discussed.The immunological changes in inflammatory bowel disease have been reviewed by Kraft and Kirsner8, and the bowel abnormalities in IgA deficiency are discussed by Bull and Tomasi9.These are not dealt with in the present review. Origin of Intestinal ImmunoglobulinImmunoglobulin may reach the lumen of the gut either by transudation from serum, or as a result of local production and release.There is evidence from studies in animals'0.1'and man'2 that exudation into the gut is a most important route in the catabolism of serum globulins.Currently, however, interest is focused mainly on the local production of immunoglobulin in the tissues of the gut itself.Tissue culture studies show that radioactively labelled amino acids are incorporated into IgG, A, and M by tissues taken from various levels of the gastrointestinal tract'314.Immunofluorescent studies, using fluorescein-labelled antisera specific for the various immuno- globulin classes, have shown the presence of immunoglobulin-containing cells in all gut tissues examined.5-20.The immunoglobulin-containing cells are
Thrombotic Thrombocytopenic Purpura
Authors: Wolfgang E. Fuchs
Journal: JAMA (1976)

THROMBOTIC thrombocytopenic purpura (TTP) is an acute, usually fatal syndrome of unknown etiology, characterized by fever, thrombocytopenia, microangiopathic hemolytic anemia, and central nervous system and renal abnormalities. It is more common in women than men, and in 20 reported cases, the onset was during pregnancy.<sup>1</sup>Familial occurrences in siblings<sup>2</sup>and concomitant occurrence in a husband and wife<sup>3</sup>have been reported. The hemolytic-uremic syndrome, which may be clinically identical to TTP, has also been reported to occur in families.<sup>4-6</sup> We report here the occurrence of the classical syndrome of fatal TTP in two sisters (Table). In each sister, the disease began suddenly, near the end of her first pregnancy: one in September 1972, the other in September 1974. eralized weakness in the 36th week of her first pregnancy. Four days later, she experienced transient numbness and paresthesias on the left side <h3>Report of Cases</h3><h3>Case 1.—</h3>
Statins and the Risk of Lung, Breast, and Colorectal Cancer in the Elderly
Authors: Soko Setoguchi, Robert J. Glynn, Jerry Avorn, Helen Mogun, Sebastian Schneeweiss
Journal: Circulation (2006)

Background— Although most randomized trials and meta-analyses suggest a slight or no increase in the risk of cancer in statin users, results from observational studies have been conflicting, and some have even suggested a large protective effect of statins on certain cancers. Long-term statin users tend to be healthier, less frail, and more adherent to therapy than nonusers, however. This could explain such apparent “protective” effects. Methods and Results— We conducted the present cohort study by linking data from a large state drug benefit program with cancer registry data and Medicare healthcare utilization data. We identified all initiators of statins; initiators of glaucoma medications, another preventive drug, served as a comparison group. Outcomes included all registry-identified cases of colorectal, lung, and breast cancer. Multivariable Cox proportional models were used to adjust for confounding. Patient characteristics were similar in both groups, but statin initiators (n=24 439) were slightly younger and used some services more frequently than glaucoma drug initiators (n=7284). The mean follow-up was 2.9 years, with the longest follow-up being 8.4 years. Incidence rates of colorectal, lung, and breast cancers in both groups were very similar to rates in the general population. Adjusted hazard ratios were 0.96 (95% CI, 0.70 to 1.31) for colorectal cancer, 1.11 (95% CI, 0.77 to 1.60) for lung cancer, and 0.99 (95% CI, 0.74 to 1.33) for breast cancer. Conclusions— These data from a large population of typical older patients who began using statins indicate that it is unlikely that statins confer a clinically important decrease or increase in the risk of colorectal, lung, or breast cancer over the durations studied.
Is the risk of narcolepsy also increased with non-adjuvanted flu vaccines?
Authors: L. Waldenlind, B. Grundmark, F. Azarbayjani, A. Borjesson, H. Olaisson
Journal: BMJ (2013)

In line with previous studies, Miller and colleagues find an increased risk of narcolepsy after vaccination with AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine (Pandemrix; odds ratio 16.2, 95% CI 3.1 to 84.5) and call for similar studies on other flu vaccines.1

Several flu vaccines are available in Europe, both adjuvanted and non-adjuvanted. All suspected adverse vaccine reactions must be reported to pan-European database EudraVigilance (www.adrreports.eu), which will soon be fully publicly accessible. The first suspected case of narcolepsy associated with a non-adjuvanted flu …
THE TREATMENT OF HEMORRHOIDS BY THE INJECTION METHOD.
Authors: LEWIS H. ADLER
Journal: JAMA (1897)

I am sure that my experience is by no means unique, in that the majority of patients with hemorrhoidal troubles come to me greatly prejudiced against any operative procedure involving the employment of general anesthesia, and especially the use of the knife. These objections have been raised not only by the laity, but also by physicians who have been similarly affected. Such an argument should not and would not prove a factor in altering the character of advice to be given to a patient were I satisfied that only one plan of treatment could effect a cure; but where a choice of several methods exists for effecting the same or similar results it is not only our duty but a necessity for us to respect the patient's wishes. In a number of instances, sufficient to convince me of the efficacy of the method and to enable me to place my
Ammonia and 1,4-benzodiazepines in patients with fulminant hepatic failure
Authors: M.L. Zeneroli, I. Venturini, L. Corsi, R. Avallone, F. Farina, G. Ardizzone, M. Centanaro, A. Arrigo, P. Schreier, M. Kleinschnitz, M. Baraldi
Journal: Journal of Hepatology (1998)
The Patient Needs
Authors: Hugh H. Hussey
Journal: JAMA (1974)

Late summer 1973 found the famous columnist Sydney J. Harris enduring a protracted stay in a highly regarded teaching hospital. There he underwent a major surgical operation, and, as might have been expected, he later wrote about his experiences in a series of three articles published in<i>Chicago Daily News</i>on Nov 5, 6, and 7, 1973. He stated that he knew his odds of eluding death and of recovery were high, thanks to medical advances, that his own care was rather better than average, "yet even this—with the best will in the world on the part of the top people— was only haphazardly translated down to the lower levels, where the quality of care depended on who happened to be on duty at what hour." Most poignant of all, Mr. Harris observed that during his convalescence, when his psychological needs for attention were strongest, his treatment was most impersonal
Subcutaneous Glucose Concentration in Humans: Real estimation and continuous monitoring
Authors: Fabio Sternberg, Carsten Meyerhoff, Franz J Mennel, Friederike Bischof, Ernst F Pfeiffer
Journal: Diabetes Care (1995)

OBJECTIVE To determine the real subcutaneous glucose concentration in healthy volunteers to help in the development of new calibration methods for subcutaneous glucosensors. RESEARCH DESIGN AND METHODS We developed a new method to estimate the real subcutaneous glucose concentration based on the recirculation of phosphate-buffered saline (PBS) in a microdialysis probe inserted into the subcutaneous tissue. Tissue glucose diffuses into the probe until complete equilibration between the glucose concentration outside and inside the microdialysis probe is achieved. Later, the glucose content of the recirculated PBS is assessed in vitro. We applied the method in 10 healthy volunteers under fasting state and during a hyperglycemic clamp. In addition, we monitored the subcutaneous glucose with an enzymatic-amperometric glucosensor combined with a microdialysis probe. RESULTS The subcutaneous glucose concentration measured by the recirculation method was 72 ± 6 and 78 ± 6% of the blood glucose measured in the fasting state and during the hyperglycemic clamps, respectively. On the other hand, the glucosensor's signal correlated significantly with the blood glucose. CONCLUSION The recirculation method estimated the real subcutaneous glucose concentration, opening the way to develop new calibration procedures for subcutaneous glucosensors. However, a suitable calibration procedure is still lacking.
Fertility authority consults on screening prospective parents to ensure children's welfare
Authors: Caroline White
Journal: BMJ (2005)

The Human Fertilisation and Embryology Authority's, the UK regulatory body for assisted conception and human embryo research, has started a consultation on clarifying its guidance on the welfare of children born to patients having infertility treatment.

Fertility clinics are legally obliged to consider the welfare of any future children resulting from assisted conception before giving prospective parents the go-ahead for treatment. This assessment takes account of medical, physical, psychological, and social factors and routinely involves family doctors.

The Human Fertilisation and Embryology Authority's guidance on interpreting this aspect of the legislation has not been fully revised since the authority …
Effect of Lung Volume Reduction Surgery on Gas Exchange and Pulmonary Hemodynamics at Rest and during Exercise
Authors: MONIQUE OSWALD-MAMMOSSER, ROMAIN KESSLER, GILBERT MASSARD, JEAN-MARIE WIHLM, EMMANUEL WEITZENBLUM, JEAN LONSDORFER
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Lung volume reduction surgery (LVRS) has become an extended surgery for emphysema in order to improve the dyspnea of severely affected patients. Because resection of lung areas may reduce the vascular bed, which is an important factor of pulmonary hypertension in emphysematous patients, especially during exercise, the aim of our study was to assess the outcome of pulmonary hemodynamics and gas exchange at rest and during exercise after LVRS. Nine patients had right heart catheterization before and 3 to 12 mo (mean, 4.5 mo) after LVRS. FEV1 increased from 705 to 1,005 ml (p < 0.05) after LVRS. PaO2 , PaCO2 and mean pulmonary artery pressure (Ppa) did not change after LVRS, either at rest or during exercise. However, a significant overall decrease of the respiratory swings of the pulmonary artery diastolic pressure ( Δ Pd) at rest (median value, from 12 to 8 mm Hg, p < 0.01) and during exercise (from 20 to 15 mm Hg, p < 0.05) was observed. There was a significant correlation between the change in resting Ppa (Ppa before minus Ppa after LVRS) and the change in resting Δ Pd (r = 0.73, p < 0.03), and also between the change in exercising Ppa and the change in resting Δ Pd (r = 0.80, p < 0.02). Significant correlations were also found between the change in exercising Ppa and the change in exercising PaO2 (r = − 0.70, p < 0.05), and between the change in exercising Ppa and the change in exercising PaCO2 (r = 0.76, p < 0.03). We conclude that pulmonary hemodynamics in most cases are not impaired by LVRS either at rest or during exercise. The possible mechanisms influencing hemodynamics after a lung volume reduction procedure are discussed.
The ED and the PC
Authors: Robert Sikorski
Journal: JAMA (1997)

If people think nature is their friend, then they sure don't need an enemy. Kurt Vonnegut, Jr A chemistry graduate student is brought to the emergency department (ED) after an unintentional exposure to an unknown amount of the organic solvent aniline. The treating physician who sees the student is not familiar with all of the potential adverse health effects of the compound. While a colleague begins initial stabilization of the patient, the physician uses a computer in the ED to rapidly access an Internet site that provides detailed toxicology information from the US Environmental Protection Agency. In addition to general background information, the physician learns that a methemoglobin level can be used to indicate the degree of systemic poisoning. The paramedics who brought the student to the ED, concerned about their own possible exposure, also spend time on the Net reviewing the literature on aniline. Emergency physicians are increasingly