tbuckley/cabot-search huggingface dataset:
Topical Tretinoin and Vaginal Bleeding
Authors: Sophie M. Worobec, George W. Creasy, E. George Thorne
Journal: Annals of Internal Medicine (1991)

Letters1 January 1991Topical Tretinoin and Vaginal BleedingSophie M. Worobec, MD, George W. Creasy, MD, E. George Thorne, MDSophie M. Worobec, MDSearch for more papers by this author, George W. Creasy, MDSearch for more papers by this author, E. George Thorne, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-1-97_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: The letter from Meurehg and Xochitl Amelio (1) describing the case of a 64-year-old woman with vaginal bleeding, pelvic and breast vascular congestion, and nausea suggested a causal relation between topical tretinoin and vaginal bleeding. We suggest that alternative diagnoses are more likely to be correct.The patient had been applying tretinoin 0.05% cream (Retin-A, Ortho Pharmaceutical Corporation, Raritan, New Jersey) on photodamaged facial skin for 5 weeks. The results of percutaneous absorption studies done with topical tretinoin 0.05% cream applied to facial skin indicate that only 1% to 7% of the applied dose is absorbed. In...References1. Meurehg C and Xóchitl Amelio P. Vaginal bleeding and tretinoin cream [Letter]. Ann Intern Med. 1990;113:483. LinkGoogle Scholar2. Worobec S, Wong F, Tolman E, Abrams L, Parker G, and Thorne E. Percutaneous absorption of 3H-tretinoin in normal volunteers [Abstract]. Clin Res. 1990;38:786A. Google Scholar3. Napoli J, Pramanik B, Williams J, Dowson M, and Hobbs P. Quantification of retinoic acid by gas-liquid chromatography-mass spectrometry: total versus all-trans-retinoic acid in human plasma. J Lipid Res. 1985;26:387-92. CrossrefMedlineGoogle Scholar4. Jones H. Endometrial carcinoma. In: Jones HW III, Wentz AC, Burnett LS, eds. Novak's Textbook of Gynecology. 11th ed. Baltimore: Williams & Wilkins; 1988:744. Google Scholar5. Burk J, Lehman H, and Wolf F. Inadequacy of the Papanicolaou smear in the detection of endometrial cancer. N Engl J Med. 1974; 291:191-2. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Sophie M. Worobec, MD; George W. Creasy, MD; E. George Thorne, MDAffiliations: The R. W. Johnson Pharmaceutical Research Institute Raritan, NJ 08869-0602 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1991Volume 114, Issue 1Page: 97-97KeywordsHemorrhageNausea ePublished: 1 December 2008 Issue Published: 1 January 1991 PDF downloadLoading ...
EXTRARECTAL MASSES CAUSED BY TUMORS OF THE RECTO-UTERINE OR RECTOVESICAL SPACE
Authors: LOUIS A. BUIE
Journal: JAMA (1941)

An extrarectal mass in the recto-uterine or rectovesical space is encountered frequently in the course of routine digital examination of the rectum. The significance of the mass seldom is recognized, and it is sometimes confused with primary carcinoma of the rectum. Because of the prognostic and diagnostic importance of extrarectal tumors, digital and proctoscopic examination should not be omitted in cases of obscure abdominal disease. In 1895, Strauss,<sup>1</sup>discussing some cases of operative carcinoma of the stomach, stated: "Carcinomatous metastases in the liver were found at operation in this case, also in the retroperitoneal tissue, and in Douglas' pouch. The latter situation we have found repeatedly as a site of metastases in carcinoma of the stomach and which on account of its accessibility to digital exploration merits more frequent attention during examination." This is the first mention that we have found in the literature of malignant growths in the pelvis secondary to primary gastric carcinoma; the importance of these growths was overlooked for fourteen years, until Blumer's 2 description in 1909. Since then "Blumer's shelf" has been mentioned frequently (figs. 1, 2 and 3). According to Blumer's original article, the
Wet nursing increases risk of HIV infection among babies
Authors: Pat Sidley
Journal: BMJ (2005)

South African children using public hospitals are exposed to HIV infection because of a lack of infection control and because some babies are breast fed by women who are not their mothers and who are HIV positive, a new study says.

The study was conducted by the country's Human Sciences Research Council, Medical Research Council, and others for the Nelson Mandela Foundation.

It was commissioned after a previous study by the same …
Platelet-Function Tests: Predictive Value
Authors: Peter H. Levine
Journal: New England Journal of Medicine (1975)

There is now available a bewildering array of platelet-function studies to further bedevil the many clinicians who struggle to understand hemostasis and thrombosis. Platelet aggregation, glass-bead retention, determination of 14C-serotonin release, assay of von Willebrand-factor activity, platelet-factor-3 availability measurements and other technics allow accurate classification of qualitative platelet defects, and have improved our understanding of the pathophysiology of hemostasis. Unfortunately, however, none of these tests correlate well with the clinical importance of platelet disorders. Only the template bleeding time seems to predict the likelihood of excessive bleeding.A pathologic extension of the platelet's role in hemostasis is its role in . . .
Intimal-Medial Thickness of the Carotid Artery in Nondiabetic and NIDDM Patients: Relationship with insulin resistance
Authors: Enzo Bonora, Roberto Tessari, Rocco Micciolo, Marina Zenere, Giovanni Targher, Roberto Padovani, Giancarlo Falezza, Michele Muggeo
Journal: Diabetes Care (1997)

OBJECTIVE The aim of this study was 1) to compare intimal-medial thickness (IMT) of the carotid artery in nondiabetic and NIDDM patients and 2) to evaluate the association of this early marker of atherosclerosis with several cardiovascular risk factors, including plasma insulin and insulin resistance. RESEARCH DESIGN AND METHODS A total of 58 nondiabetic and 56 NIDDM patients, randomly selected among those attending the outpatient Diabetes Clinic or the Clinic for Internal Medicine were examined. BMI, waist-to-hip ratio (WHR), blood pressure, glycohemoglobin (HbA1c), and fasting concentrations of plasma glucose, serum lipids (total and HDL cholesterol, triglycerides), and serum insulin were measured. Insulin resistance was assessed by computing glucose disappearance rate from plasma after intravenous insulin injection (Kitt). IMT of the carotid artery was measured by ultrasonography. RESULTS IMT was significantly higher in diabetic patients, and the difference remained highly significant after adjusting for sex, age, BMI, WHR, presence of hypertension and dyslipidemia, and smoking status (1.39 vs. 1.24 mm, common SD 0.12, P &amp;lt; 0.001). Univariate regression analyses showed that IMT was negatively correlated with Kitt in either nondiabetic (r = −0.348, P &amp;lt; 0.01) or diabetic patients (r = −0.492, P &amp;lt; 0.001). However, multiple regression analyses showed that IMT was independently associated with age and WHR in nondiabetic subjects, whereas in diabetic patients, IMT was independently predicted by Kitt and hypertension. These two variables explained ∼ 62% and ∼35% of the variability of IMT in nondiabetic and diabetic patients, respectively. Plasma insulin was not independently associated with IMT in either groups. CONCLUSIONS These results indicate that 1) diabetes is characterized by a greater thickness of the carotid artery independently of other established risk factor of atherosclerosis, 2) early atherosclerosis is independently associated with insulin resistance in diabetic but not in nondiabetic patients, 3) central adiposity is an independent predictor of IMT in nondiabetic individuals.
Natural course of operated pseudocysts in chronic pancreatitis.
Authors: A Lohr-Happe, M Peiper, P G Lankisch
Journal: Gut (1994)

A longterm review (median follow up 11 years) of the postoperative course of pancreatic pseudocysts was undertaken in 55 patients with chronic pancreatitis. While 96% of the patients were free of pain immediately after the operation this figure fell to 53% subsequently. Alcohol abstinence did not significantly reduce pain. Endocrine pancreatic deterioration (60%) was significantly (p = 0.0059) more frequent than exocrine (38%). Unemployment increased from 2 to 41%; retirement rose from 0 to 33%, mainly as a result of pancreatitis. Twenty one (38%) patients died. Chronic pancreatitis related death rate was 14%. Three patients died of extrapancreatic carcinomas.
Verapamil favorably influences hepatic microvascular exchange and function in rats with cirrhosis of the liver.
Authors: J Reichen, M Le
Journal: Journal of Clinical Investigation (1986)

The effect of the calcium channel blocking agent, verapamil, on microcirculatory patterns and hepatic function was investigated in the perfused liver of cirrhotic rats. Compared with controls, cirrhotic livers had higher vascular resistance, increased intrahepatic shunting, and smaller extravascular albumin space and larger extravascular sucrose space, as determined by a multiple-indicator dilution technique. Hepatic function, estimated by determining propranolol and antipyrine extraction, was markedly reduced in cirrhotic livers. Portal pressure was then reduced 25% either pharmacologically by verapamil or hydrodynamically by lowering inflow. Verapamil decreased vascular resistance by 22%. This was associated with a 38% reduction in intrahepatic shunting and a 62% increase in extravascular albumin space. Hydrodynamically lowering pressure had no or adverse effects. The verapamil-induced improvement in microcirculatory characteristics was associated with a significant improvement in oxygen consumption (+21%) and antipyrine clearance (+20%). We conclude that the microvascular distortions of liver cirrhosis in the rat are partially reversible by vasodilators like verapamil.
Anti-fibrotic activity of NK cells in experimental liver injury through killing of activated HSC
Authors: Alaa Melhem, Nidal Muhanna, Amal Bishara, Carlos E. Alvarez, Yaron Ilan, Taiser Bishara, Amjad Horani, Mithal Nassar, Scott L. Friedman, Rifaat Safadi
Journal: Journal of Hepatology (2006)
Percutaneous endoscopic gastrostomy feeding.
Authors: P. A. Andrews, M. Webb
Journal: BMJ (1992)

ing (including fine bore tube feeding) have been well documented,5 but nasogastric feeding remains an essential part of nutritional support.Percutaneous endoscopic gastrostomy is a major technical advance in obtaining access for nutritional support, and though its safety is well.established, it is still an invasive procedure and not suitable for all.What has not been well established, and which neither Park and colleagues or Forgacs and colleagues addressed, is the indication for nutritional support in patients with disabling neurological conditions.Research and training in nutritional support are needed to define and outline the risks and benefits of nutritional intervention in such patients.Percutaneous endoscopic gastrostomy feeding is an advance for those who require long term tube feeding, and we would not have con- sidered randomising patients who had already had four weeks of nasogastric tube feeding.We do not see percutaneous endoscopic gastrostomy feeding as a panacea for all, nor will its use "prevent the degrading spectacle of elderly, under- nourished patients with their hands bandaged to the side of the bed."2Let clinicians decide whether nutritional support is appropriate and then institute appropriate treatment using well proved techno- logical advances such as percutaneous endoscopic gastrostomy.
1037 HCV INFECTION IMPAIRS GLUCOSE METABOLISM WHICH PROMOTES A MORE AGGRESSIVE COURSE OF LIVER DISEASE AND METABOLIC SYNDROME
Authors: L.E. Adinolfi, R. Zampino, L. Restivo, B. Guerrera, A. Santoro, A. Ciervo, L. Rinaldi, V.R. Scialdone, M. Ferrara, G. Ruggiero
Journal: Journal of Hepatology (2010)
Early Detection of Breast Cancer
Authors: Jonathan E. Rodnick
Journal: JAMA (1985)

<h3>To the Editor.—</h3> The recent report by the Council on Scientific Affairs<sup>1</sup>is a succinct review of a complicated subject. The recommendations on mammography agree with recommendations from the American Cancer Society and the American College of Radiology. However, the costs of these recommendations were not discussed. The report states, "If every woman older than 40 years under-went annual mammography, 7,500 cancer deaths could be prevented each year." In the San Francisco Bay Area, the charges for bilateral xeroradiographic mammography are at least $150. There are at least 40 million American women older than 40 years, and if each were screened yearly, the charge for screening mammography would be $6 billion (or somewhat less if there were some economy of scale)! This translates into a cost of approximately $800,000 per life saved. This only considers mammography costs, and does not include office visits, the costs of biopsies on those who
Trials Reveal No Benefit, Possible Harm of Beta Carotene and Vitamin A for Lung Cancer Prevention
Authors: Charles Marwick
Journal: JAMA (1996)

FOR PEOPLE at high risk of lung cancer—notably current and former smokers and asbestos workers—the notion of being able to undo that risk by taking a vitamin supplement is an appealing one. But hopes of such a preventive magic bullet were recently dashed by the results of two large clinical trials aimed at determining whether taking high-dose supplements of beta carotene and vitamin A could reduce the risk of lung cancer in these high-risk individuals. The trials, the Beta Carotene and Retinol Efficacy Trial (CARET) and the Physicians' Health Study, both showed the supplements conferred no benefit. In CARET, there was even evidence of the opposite effect—a lung cancer rate that was higher in at-risk patients who took high-dose supplements of beta carotene and vitamin A than in at-risk patients who took a placebo. In light of this evidence, the investigators terminated CARET 21 months before it was scheduled to
The future of endoscopic treatment of early Barrett neoplasia: The endoscopist’s view
Authors: G. Falk
Journal: Endoscopy (2008)

The field of Barrett’s esophagus ablation has come a long way since the original pioneering work of Brandt and Berenson in the early 1990s [1] [2]. In fact, ablation is now viewed as a legitimate first-line treatment option for healthy patients with high grade dysplasia and early adenocarcinoma, based on studies performed to date. Furthermore, the notion of complete ablation of Barrett’s esophagus has moved from concept to reality. That being said, many questions about endoscopic ablation of Barrett’s esophagus remain unanswered. This section will try to address the following issues regarding the endoscopic ablation of Barrett’s esophagus:
Primary Lymphoma of the Small Bowel Detected With Red Blood Cell Scintigraphy
Authors: Yasemin Sanli, Isk Adalet, Cuneyt Turkmen, Yersu Kapran, Kezban Berberoglu, Sema Cantez
Journal: Clinical Nuclear Medicine (2005)

Tc-99m-labeled RBC scintigraphy is an easy and noninvasive method in the evaluation of gastrointestinal bleeding. However, the detection of small bowel lesions with bleeding is often found to be difficult. Primary neoplasms of the small bowel are unusual and constitute 1% to 5% of all gastrointestinal tract neoplasms. In this study, we report a case of gastrointestinal bleeding resulting from primary gastrointestinal B-cell lymphoma in the small bowel, which was successfully detected with Tc-99m-labeled RBC scintigraphy.
Anti‐T‐cell strategies in the treatment of allergic disease
Authors: M. Larché
Journal: Allergy (2002)

Specific allergen immunotherapy (SIT) has been shown to be effective in modulating allergic responses in diseases such as rhinitis and asthma. However, the ability of whole allergen to cross link mast cell bound IgE, resulting in release of mediators such as histamine, has limited the application of this therapy to carefully selected patients who have failed conventional pharmacotherapy. The use of peptide sequences corresponding to T cell epitopes of the allergen has been postulated as an alternative to SIT in which high molar doses of T cell epitope can be delivered over a shorter time period and with improved safety. Using peptides from the sequence of the major cat allergen, Fel d 1, we have demonstrated the ability to induce transient T cell activation, resulting in isolated late asthmatic reactions, which are followed by prolonged periods of allergen‐specific hyporesponsiveness, both to peptide re‐challenge and to cutaneous challenge with whole allergen. Thus, peptide therapy may prove safe and efficacious in the treatment of allergic diseases.
Sexual and Physical Abuse in Women with Functional or Organic Gastrointestinal Disorders
Authors: Douglas A. Drossman
Journal: Annals of Internal Medicine (1990)

Study Objectives: To determine the prevalence of a history of sexual and physical abuse in women seen in a referral-based gastroenterology practice, to determine whether patients with functional gastrointestinal disorders report greater frequencies of abuse than do patients with organic gastrointestinal diseases, and to determine whether a history of abuse is associated with more symptom reporting and health care utilization. Design: A consecutive sample of women seen in a universitybased gastroenterology practice over a 2-month period was asked to complete a brief questionnaire. Measurements: The self-administered questionnaire requested information about demographics, symptoms, health care utilization, and history of abuse. Physicians indicated the primary diagnosis for each patient and whether she had ever discussed having been sexually or physically abused. Results: Of 206 patients, 89 (44%) reported a history of sexual or physical abuse in childhood or later in life; all but 1 of the physically abused patients had been sexually abused. Almost one third of the abused patients had never discussed their experiences with anyone; only 17% had informed their doctors. Patients with functional disorders were more likely than those with organic disease diagnoses to report a history of forced intercourse (odds ratio, 2.08; 95% CI, 1.03 to 4.21) and frequent physical abuse (odds ratio, 11.39; CI, 2.22 to 58.48), chronic or recurrent abdominal pain (odds ratio, 2.06; CI, 1.03 to 4.12), and more lifetime surgeries (2.7 compared with 2.0 surgeries; P < 0.03). Abused patients were more likely than nonabused patients to report pelvic pain (odds ratio, 4.05; CI, 1.41 to 11.69), multiple somatic symptoms (7.1 compared with 5.8 symptoms; P < 0.001), and more lifetime surgeries (2.8 compared with 2.0 surgeries; P < 0.01). Conclusions: We found that a history of sexual and physical abuse is a frequent, yet hidden, experience in women seen in referral-based gastroenterology practice and is particularly common in those with functional gastrointestinal disorders. A history of abuse, regardless of diagnosis, is associated with greater risk for symptom reporting and lifetime surgeries.
Labeling of Prescription Drugs
Authors: Arthur M. Master
Journal: JAMA (1963)

<h3>To the Editor:</h3> —I was pleased indeed with the editorial "Labeling of Prescription Drugs" which appeared in the July 27, 1963, issue ofThe Journal(<b>185</b>:316). Ever since I obtained my license to practice medicine, I have insisted that the pharmacist either give the patient the original bottle of medicine put out by the drug house or label his own bottle with the name of the drug. I have never had occasion to regret this; on the contrary, I have always found the patient to be pleased with this arrangement. You have very succinctly reviewed the benefits of labeling prescriptions. I do not see any objection to labeling barbiturates or opiates; I have never had any trouble in prescribing them. With a little explanation, the patient has always understood. For example, I have frequently used small doses of an opiate for a short time in an endeavor to break
Squamous Cell Papilloma of the Esophagus Report on 35 Endoscopic Cases
Authors: R. Sablich, G. Benedetti, S. Bignucolo, D. Serraino
Journal: Endoscopy (1988)

We herein report our experience of 35 cases of esophageal squamous cell papilloma (ESP), diagnosed among 8,095 consecutive upper gastrointestinal endoscopies, and histologically confirmed. The incidence (0.45%) was higher than previously reported. Macroscopically, ESP presented with several distinctive features, thus endoscopy permitted great diagnostic accuracy. Most of the papillomas were located in the middle-third of the esophagus, and no significant association with hiatal hernia and reflux esophagitis was seen. The lesion did not recur after removal either by forceps or by diathermic snare.
Id proteins in the vasculature: from molecular biology to cardiopulmonary medicine
Authors: J. Yang, X. Li, N. W. Morrell
Journal: Cardiovascular Research (2014)

The inhibitors of differentiation (Id) proteins belong to the helix-loop-helix group of transcription factors and regulate cell differentiation and proliferation. Recent studies have reported that Id proteins play important roles in cardiogenesis and formation of the vasculature. We have also demonstrated that heritable pulmonary arterial hypertension (HPAH) patients have dysregulated Id gene expression in pulmonary artery smooth muscle cells. The interaction between bone morphogenetic proteins and other growth factors or cytokines regulates Id gene expression, which impacts on pulmonary vascular cell differentiation and proliferation. Exploration of the roles of Id proteins in vascular remodelling that occurs in PAH and atherosclerosis might provide new insights into the molecular basis of these diseases. In addition, current progress in identification of the interactors of Id proteins will further the understanding of the function of Ids in vascular cells and enable the identification of novel targets for therapy in PAH and other cardiovascular diseases.