tbuckley/cabot-search huggingface dataset:
Correction of Excessive Anticoagulation with Low-Dose Oral Vitamin K_1
Authors: Robert T. Weibert
Journal: Annals of Internal Medicine (1997)

Background: Despite earlier acceptance of oral vitamin K1 (phytonadione) for the treatment of excessive anticoagulation, some recent guidelines do not recommend its use. Objective: To reevaluate the efficacy of oral vitamin K1 in correcting excessive anticoagulation. Design: Case series. Setting: Anticoagulation clinics at two university medical centers. Patients: 81 outpatients who had an international normalized ratio (INR) greater than 5.0 but did not have significant bleeding. Interventions: Withholding 1 or 2 doses of warfarin, administering 2.5 mg of oral vitamin K1, measuring the INR after 24 to 48 hours, and adjusting the warfarin dose. Measurements: INRs were obtained from a portable capillary fingerstick monitor or from an automated photooptical coagulometer. Results: In 68 of 71 patients (96%), oral vitamin K1 lowered the INR from between 5.0 and 10.0 to less than 5.0 without inducing resistance to further anticoagulation. Conclusions: Withholding 1 or 2 doses of warfarin and administering 2.5 mg of oral vitamin K1 is a reliable, safe, and inexpensive way to rapidly correct excessive anticoagulation (INR > 5.0) in patients who do not have serious bleeding episodes and have an INR of less than 10.0.
A SKIASCOPIC EYE.
Authors: JAMES THORINGTON
Journal: JAMA (1895)

The rapidly growing popularity of the shadow test as an accurate method of obtaining the exact refraction of an eye under the influence of a mydriatic, prompts the writer to present an inexpensive eye for the use of the student or oculist who may desire to learn skiascopy at his leisure. The eye as here shown, reduced one-third in size, is made of two cylinders of cardboard, one slightly smaller than its fellow, to permit slipping evenly into the other. Both cylinders are well blackened inside. The smaller cylinder is closed at one end, and on its inner surface is placed a colored lithograph of the normal eye ground. The larger cylinder is also closed at one end, except for a central round opening, ten millimeters in diameter, which is occupied by a + 20 diopter lens; and on its outer surface is a colored lithograph of the normal eye with
Altitude Per Se.
Authors: Charles Denison
Journal: JAMA (1893)

<h3>To the Editor of The Journal of the American Medical Association</h3> The relative importance of different climatic attributes in the cure of phthisis is one of the most difficult problems in climatology to solve. The arduousness of the task is not lessened because the inquirer is an invalid himself seeking the total elimination of his tubercular bacilli. The liability of his being unduly influenced by his own experiences and environment is too great. Nevertheless it has to be acknowledged that much of the good work which has been done in climatology has been actuated by the intense interest of personal need. I am reminded that in our own country this field has been covered by such men as Solby, Fisk, Anderson, Keating, Tindale, Loomis and Gleitzman, whom I happen to know were one time invalids. Nor would I wish to dodge the applicability of the criticism to my own writings
Analysis of para-phenylenediamine allergic patients in relation to strength of patch test reaction
Authors: S.G.Y. Ho, D.A. Basketter, D. Jefferies, R.J.G. Rycroft, I.R. White, J.P. Mcfadden
Journal: British Journal of Dermatology (2005)

Despite having a positive patch test reaction to para-phenylenediamine (PPD), some patients continue to dye their hair, while others are forced to give up or abandon this practice. This difference in patient behaviour could be due to the degree of sensitization.To establish whether the ability to continue dyeing hair in PPD allergic patients is related to the strength of patch test reaction. To note differences in other clinical features in relation to the strength of patch test reaction.We analysed retrospectively the patch test records of 400 sequential PPD-positive patients for the strength of patch test reaction (+, ++, +++) and different clinical features. Data were analysed using Cochran-Mantel-Haenszel chi2 tests.There was a strong linear relationship between the strength of patch test reaction and continuation with hair dyeing. Patients were more likely to report a history of hair dye reaction with increasing strength of patch test reaction. There was no difference in strength of patch test reaction in relation to age, site of rash, occupation (hairdressing) or history of atopic eczema. Overall concomitant reactivity with related aromatic amine allergens (benzocaine, N-isopropyl-N-phenyl-para-phenylenediamine, para-aminobenzoic acid) was infrequent.Patients with stronger patch test reactions (++, +++) are more likely to have a clear history of reacting to hair dye and are less likely to still be dyeing their hair.
[481] HBeAg-NEGATIVE CHRONIC HEPATITIS B (CHBe-) IN CHRONIC HBV PATIENTS WITH SERUM HBV-DNA LEVELS BELOW 2,000 lU/mL
Authors: G.V. Papatheodoridis, E.K. Manesis, S. Manolakopoulos, J. Goulis, N. Chrysanthos, A. Bilalis, S. Savvidou, G. Kafiri, I. Delladetsima, D. Tzourmakliotis, A.J. Archimandritis
Journal: Journal of Hepatology (2007)
Compromise or Capitulation? US Food and Drug Administration Jurisdiction Over Tobacco Products
Authors: Stanton A. Glantz, Richard Barnes, Sharon Y. Eubanks
Journal: PLoS Medicine (2009)

the US Congress passed compromise legislation granting the Food and Drug Administration (FDA) jurisdiction over tobacco products, repealing federal pre-emption of state and local regulation of tobacco advertising, and requiring graphical warning labels on tobacco products.N Past legislative compromises with the tobacco industry have led to short-term public health gains at the expense of long-term progress.N The law offers the tobacco industry an opportunity to rehabilitate its image and products because they are now ''FDA regulated.''N Tobacco interests that have violated US racketeering law are inappropriately represented on the Scientific Advisory Committee that influences FDA regulations.N The challenge for the compromise law's advocates will be to accept responsibility for these problems and see that their negative consequences do not materialize.
Clinicopathological factors associated with clinical outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms
Authors: H. Isomoto, H. Nishiyama, N. Yamaguchi, E. Fukuda, H. Ishii, K. Ikeda, K. Ohnita, K. Nakao, S. Kohno, S. Shikuwa
Journal: Endoscopy (2009)

Endoscopic submucosal dissection (ESD) permits removal of colorectal epithelial neoplasms en bloc, but a substantial risk of procedure-related perforation has been reported. We sought to unravel the clinicopathological factors associated with the clinical outcomes of ESD for colorectal epithelial neoplasms in a large series.ESD was done in 278 patients with 292 colorectal tumors that fulfilled the inclusion criteria. The criteria for ESD were: lesion greater than 20 mm in size, lesion with fibrotic scarring, locally residual colorectal lesion, or invasive carcinoma with slight submucosal penetration. Resection was assessed as en bloc or piecemeal, complete (en bloc with tumor-free lateral and basal margins) or incomplete. Complications including perforation and bleeding were assessed, and factors related to each were analyzed using logistic regression. Patients underwent multiple follow-up endoscopic examinations (mean 4.6; median 4; range 2 - 9; total number 1010).En bloc resection was achieved in 90.1 % of lesions (263/292) and resection was deemed to be complete in 233 (79.8 %). Right-side colonic location and the finding of fibrosis were the significant contributors to incomplete resection. Perforation was seen in 24 cases (8.2 %), and was associated with large tumor size and the presence of fibrosis. When the contributive factors for each were combined, the risks of incomplete resection and perforation were substantially increased.The present study provides useful information for predicting risks for incomplete resection and complication in colorectal ESD.
546 VERY LOW ENDOGENOUS LEVELS OF HEPATOCELLULAR MXA PROTEIN SUGGESTS MINIMAL ACTIVATION OF THE TYPE I INTERFERON PATHWAY IN CHRONIC HBV DISEASE
Authors: M. Wallace, A. Messineo, S. Duffy, L. Adams, G. Jeffrey, D. Speers, B. de Boer, M. Platten, W. Cheng, G. MacQuillan
Journal: Journal of Hepatology (2012)
Duodenal diverticulosis and chronic diarrhoea.
Authors: O A Brey, E P Garner, R G Twycross, D Wells
Journal: BMJ (1971)

diagnostic skin tests.All parasites may not necessarily produce as intense or as long-lasting an immediate hypersensitivity as does T. canis (Wiseman and Woodruff, 1970), and any trial of an antigen in subjects with different known infections should preferably include a direct comparison with their response to homologous antigen.This sesponse cannot be predicted reliably from the presence of infection or on the evidence of the eosinophil count or serum IgE level.We are grateful to Dr. S. G. 0. Johansson for the IgE measure-
The 894G T polymorphism in the endothelial nitric oxide synthase gene influences risk for acute myocardial infarction only in subjects with low risk for coronary events
Authors: George K. Andrikopoulos, Dimitri Richter, Dimitri Grammatopoulos, Sevasti Zervou, Michalis Zairis, Elias Karabinos, Antonis Pantazis, Dimitris Manolatos, Nikolaos Exadaktylos, Christodoulos Stefanadis, Stefanos Foussas, John Gialafos, Edward Hillhouse, Pavios Toutouzas
Journal: Journal of the American College of Cardiology (2002)
Prognostic Value of Heart Rate Increase at Onset of Exercise Testing
Authors: Nicholas J. Leeper, Frederick E. Dewey, Euan A. Ashley, Marcus Sandri, Swee Yaw Tan, David Hadley, Jonathan Myers, Victor Froelicher
Journal: Circulation (2007)

The initial response of heart rate to dynamic exercise has been proposed as having prognostic value in limited studies that have used modalities other than the treadmill. Our aim was to evaluate the prognostic value of early heart rate parameters in patients referred for routine clinical treadmill testing.The heart rate rise at the onset of exercise was measured in 1959 patients referred for clinical treadmill testing at the Palo Alto (Calif) Veterans Affairs Medical Center from 1997 to 2004. Multivariable Cox survival analysis was performed for 197 all-cause and 74 cardiovascular deaths that accrued during a mean follow-up of 5.4+/-2.1 years. Decreased heart rate changes at all initial relative exercise workloads were associated with significantly increased all-cause mortality. The heart rate rise at one-third total exercise capacity, however, was the only early heart rate variable that significantly predicted both all-cause and cardiovascular risk after adjustment for confounders. Failing to reach 1 SD in the heart rate rise at one-third total exercise capacity was associated with a 28% increased all-cause mortality rate (hazard ratio, 0.72; 95% CI, 0.61 to 0.85; P<0.001) and a 35% cardiovascular mortality rate (hazard ratio, 0.65; 95% CI, 0.49 to 0.86; P=0.003). Of all heart rate measurements considered (initial and recovery), the heart rate increase at peak exercise was the most powerful predictor of cardiovascular prognosis after adjustment for potential confounders. The Duke treadmill score, however, was superior to all heart rate measurements in the prediction of cardiovascular mortality.In the present study population, a rapid initial heart rate rise was associated with improved survival, but the heart rate increase at peak exercise and other conventional measurements such as exercise capacity and the Duke treadmill score were more powerful predictors of prognosis.
TREATMENT OF SUDDEN SEVERE POSTPARTUM HEMORRHAGE.
Authors: JOSEPH B. DELEE
Journal: JAMA (1899)

Entirely appropriate to the hemorrhage that sometimes occurs after labor is the popular term "flooding." Such furious bleeding as may occur after a labor it is the lot of the general surgeon but very rarely to meet. Postpartum hemorrhage is<i>the</i>obstetric emergency, for here more depends on quick perception, rapid judgment and swift action than in any other condition incident to pregnancy. Even placenta previa and eclampsia, the other two furies of obstetric practice, do not demand such preparedness for complications as does postpartum hemorrhage. Reference is had only to those rare cases where during or after the placental stage, blood gushes from the genitals in a manner which is appalling and places in a few moments the life of the woman in acute jeopardy. Some authors say that these cases are preventable, that they are due to improper care of the third stage, that a man who has
Plasma Concentration of Adenosine during Normoxia and Moderate Hypoxia in Humans
Authors: HIROSHI SAITO, MASAHARU NISHIMURA, HIDEKI SHINANO, HIRONI MAKITA, ICHIZO TSUJINO, EIJI SHIBUYA, FUMIHIKO SATO, KENJI MIYAMOTO, YOSHIKAZU KAWAKAMI
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Adenosine, a purine nucleoside, plays a variety of roles in cardiovascular and ventilatory control, and may be a marker of tissue hypoxia. There is, however, no direct evidence of an increase in plasma or in tissue levels of adenosine during moderate hypoxia in humans. We measured the plasma concentrations of adenosine in an artery and the median cubital vein simultaneously in 12 normal volunteers, and also in the internal jugular vein in seven of them during normoxia and moderate hypoxia (SaO2 = 80%, 20 min) with or without dipyridamole (0.6 mg/kg) pretreatment. Dipyridamole was expected to block reuptake of adenosine by red blood cells and vascular endothelial cells so that the plasma level of adenosine would more likely reflect the tissue level. Blood was sampled with an appropriate stopping solution, and adenosine was measured with a high-pressure liquid chromatographic (HPLC)–fluorometric technique. The plasma concentration of adenosine did not rise either in the artery or in the vein at any phase of hypoxia without the dipyridamole pretreatment. However, when subjects were pretreated with dipyridamole, the plasma concentration of adenosine increased significantly and markedly in a time-dependent manner during hypoxia in the vein, but not in the artery. The adenosine level rose from 20.7 ± 2.5 nM (mean ± SE) during normoxia to 50.7 ± 10.7 nM at 20 min of hypoxia, and returned to the baseline level in the recovery phase. The plasma concentration of adenosine in the jugular vein did not change during hypoxia either with or without dipyridamole pretreatment. These data provide evidence that in humans, the local production of adenosine increases during moderate hypoxia in forearm tissue, although this is not reflected in plasma unless the subject is pretreated with dipyridamole.
Myocardial Infarction in Young Women with Normal Coronary Arteriograms
Authors: D. LUKE GLANCY, MELVIN L. MARCUS, STEPHEN E. EPSTEIN
Journal: Circulation (1971)

Two women, ages 34 and 36 years, suffered an acute transmural anterior myocardial infarction accompanied by typical ECG and serum enzyme changes. At the time of selective cinecoronary arteriography 29 and 57 months later, however, neither had demonstrable narrowing of any coronary artery. Both have persistent ECG changes of an anterior infarct and markedly diminished contractions of a large segment of the anterior wall and apex on left ventriculogram. Neither before nor after infarction has either patient experienced angina pectoris. Both patients are premenopausal, and neither of them has diabetes, hypertension, obesity, valvular heart disease, a lipoprotein abnormality, or a family history of premature coronary arterial disease. Both smoke cigarettes. At the time of infarction one patient was taking an oral contraceptive and the other was 11-days postpartum. The pathogenesis of the myocardial infarcts in these patients is unknown. Embolization or in situ thrombosis of a previously normal anterior descending coronary artery with subsequent clot lysis would explain the infarcts, the normal coronary arteriograms, and the absence of prior or subsequent angina.
Denudation of the esophageal mucosa following ingestion of a foreign body and vinegar
Authors: R. Karagozian, S. Gan
Journal: Endoscopy (2010)

Esophagitis dissecans superficialis (EDS) is a rare condition that involves complete sloughing of the squamous esophageal mucosa to produce a benign esophageal cast; it is most commonly associated with systemic bullous pemphigoid [1] [2]. EDS is distinct from diseases associated with pseudomembranous esophagitis and has also been described in previously healthy people who have experienced trauma to the esophagus [3] [4]. Esophageal injury from various caustic agents is well described in the medical literature, however, there have been only two case reports of household vinegar as a cause [4] [5]. One pattern of injury resulting from ingestion of a corrosive agent that has been described is esophageal mucosal cast formation with complete separation of the squamous mucosa [6]. Here we report a characteristic presentation of EDS following ingestion of a foreign body and vinegar, which to our knowledge has never been described.
Reply to Amitha K Hewavitharana’s Letter to the Editor re: Florian Jentzmik, Carsten Stephan, Kurt Miller, et al. Sarcosine in Urine After Digital Examination Fails as a Marker in Prostate Cancer Detection and Identification of Aggressive Tumours. Eur Urol 2010;58:12–8
Authors: Florian Jentzmik, Carsten Stephan, Klaus Jung
Journal: European Urology (2010)
Climate Change Linked With Increase in Diarrheal Disease
Authors: M. J. Friedrich
Journal: JAMA (2013)

Changes in climate that lead to an increase in temperature and a decrease in precipitation are associated with an increase in diarrheal disease in children in Botswana, a sub-Saharan country with distinct wet and dry seasons (Alexander KA et al. Int J Environ Res Public Health. 2013;10[4]:1202-1230).
NADPH Alkenal/One Oxidoreductase Activity Determines Sensitivity of Cancer Cells to the Chemotherapeutic Alkylating Agent Irofulven
Authors: Ryan A. Dick, Xiang Yu, Thomas W. Kensler
Journal: Clinical Cancer Research (2004)

Abstract Illudins S and M are extremely cytotoxic products of the fungus Omphalotus illudens. They were evaluated as possible anticancer chemotherapeutic agents but displayed unfavorable therapeutic indices. Irofulven (6-hydroxymethylacylfulvene), a less toxic, synthetic derivative of illudin S, has proven very effective in many preclinical and clinical studies. It has been postulated that metabolism via hydrogenation of the 8,9-double bonds of these molecules would unmask the electrophilic, and thus, the toxic nature of their cyclopropyl moieties. Illudins S and M were found to be rapidly metabolized by NADPH-dependent alkenal/one oxidoreductase (AOR) with maximal rates of 115.9 and 44.1 μmol min−1 mg−1, and Kms of 308 and 109 μm, respectively. Irofulven was reduced at a much slower rate: Vmax 275 nmol min−1 mg−1 and Km 145 μm. Human 293 cells transfected with an AOR overexpression vector were 100-fold more sensitive than control cells to irofulven, but displayed little differential sensitivity to illudin M. Addition of glutathione to the α,β-unsaturated ketone moiety of illudin M, but not irofulven, occurred readily at physiological concentrations. Electrophilic intermediates of irofulven and illudin M that were activated by AOR were trapped with glutathione and identified by high performance liquid chromatography with tandem mass spectrometry. Samples of the 60 human tumor cell line panel used by the National Cancer Institute to evaluate potential chemotherapeutic compounds were assayed for AOR activity, which correlated positively with previously determined growth inhibitory measures for irofulven, but not illudin M or S. Collectively, these data indicate that bioactivation of irofulven by AOR plays a predominant role in its chemotherapeutic activity.
Decreased expression of p33ING1 mRNA in lymphoid malignancies
Authors: M. Ohmori, M. Nagai, T. Tasaka, H.P. Koeffler, K. Riabowol, J. Takahara
Journal: American Journal of Hematology (1999)

The ING1 is a newly cloned putative tumor-suppressor gene, which is involved in the p53 signaling pathway. We found decreased expression of ING1 mRNA in 4 of 5 T-cell lines and 5 of 11 B-cell lines including two Burkitt lymphomas and two myelomas. These observations suggest that decreased ING1 expression might play an important role in the development or progression of some lymphoid tumors. Polymerase chain reaction-SSCP and sequencing analyses found neither point mutations nor small deletions in the ING1 gene, suggesting that decreased expression is due to transcriptional or post-transcriptional mechanisms.
Removal of Cerumen
Authors: Edgar K. Marcuse
Journal: JAMA (1984)

<h3>To the Editor.—</h3> The QUESTIONS AND ANSWERS section includes reference to a water-pick external otitis and perforation of the tympanic membrane.<sup>1</sup>I would very much appreciate knowing the basis for this statement. In my hospital, a water-pick instrument and other forms of water irrigation are frequently used. My personal impression is that there has been less damage to the external canal with a water-pick instrument than with the curet. I have seen no data discussing the efficacy and complications of various methods used to remove wax from the external ear. I would very much appreciate having access to the information on which the statements are based.
Effects of dichloroacetate on myocardial substrate extraction, epicardial ST-segment elevation, and ventricular blood flow following coronary occlusion in dogs
Authors: O. D. MJOS, N. E. MILLER, R. A. RIEMERSMA, M. F. OLIVER
Journal: Cardiovascular Research (1976)

Glucose metabolism in the healthy heart is stimulated by dichloroacetate (DCA). The possibility has been examined in dogs that DCA, by increasing glucose utilization, might limit the severity of acute myocardial ischaemic injury. Intravenous administration of DCA reduced the degree of epicardial ST-segment elevation induced by subsequent coronary occlusion, both under basal conditions and during isoprenaline infusion. A similar result was obtained when DCA was given during an established coronary occlusion. This effect could not be explained by changes in mean aortic blood pressure, heart rate, or regional myocardial blood flow as measured by radioactive microspheres. Measurements in arterial and coronary sinus blood demonstrated an increase in the extraction of glucose and a decrease in that of FFA by the heart. Glucose extraction also tended to be increased in the ischaemic zone, as shown by the differences in the concentrations of these substrates between arterial blood and blood obtained from the local vein draining that zone. Lactate release by the ischaemic zone was markedly reduced.
Cryptococcal Hepatitis Presenting As A Surgical Emergency
Authors: John J. Procknow
Journal: JAMA (1965)

The report of a case of cryptococcosis classically presents the total clinical expression of this fungal disease from the acute pulmonary infection, acquired by inhalation of infected pigeon excreta, through spontaneous remission and finally severe dissemination resulting from reactivation of a pulmonary focus. Because of symptoms of an acute abdominal emergency, an exploratory laparotomy was performed. Cryptococcal hepatitis, producing significant hepatic dysfunction, was thus diagnosed. The intravenous administration of amphotericin B in a total dose of 3 gm resulted in apparent cure. The first successful isolations of<i>Cryptococcus neoformans</i>from pigeon excreta collected in the city of Chicago were accomplished.