tbuckley/cabot-search huggingface dataset:
Antenatal maternal serum screening for Down's syndrome: results of a demonstration project.
Authors: N. J. Wald, A. Kennard, J. W. Densem, H. S. Cuckle, T. Chard, L. Butler
Journal: BMJ (1992)

OBJECTIVES--To assess the implementation of antenatal screening for Down9s syndrome in practice, using individual risk estimates based on maternal age and the three serum markers: alpha fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin. DESIGN--Demonstration project of Down9s syndrome screening; women with a risk estimate at term of 1 in 250 or greater were classified as "screen positive" and offered diagnostic amniocentesis. SETTING--Hospital and community antenatal clinics in four health districts in London. SUBJECTS--12,603 women of all ages with singleton pregnancies seen between February 1989 and the end of May 1991, with follow up of the outcome of pregnancy completed to the end of 1991. MAIN OUTCOME MEASURES--Uptake of screening, detection rate for Down9s syndrome, false positive rate, odds of being affected given a positive result, and uptake of amniocentesis in women with positive screening results, together with the costs of the screening programme. RESULTS--The uptake of screening was 74%. The detection rate was 48% (12/25), and the false positive rate was 4.1%, consistent with results expected from previous work based on observational studies. There was a loss of detection due to the selective use of ultrasound scans among women with positive screening results. One affected pregnancy occurred among 205 reclassified as negative; this illustrated the danger of false negatives occurring in this group and lends weight to the view that if an ultrasound estimate of gestational age is used it should be carried out routinely on all women rather than selectively among those with positive results. The estimated cost of avoiding the birth of a baby with Down9s syndrome was about 38,000 pounds, substantially less than the lifetime costs of care. CONCLUSION--Antenatal maternal serum screening for Down9s syndrome is effective in practice and can be readily integrated into routine antenatal care. It is cost effective and performs better than selection for amniocentesis on the basis of maternal age alone.
Giant Müllerian Duct Cyst
Authors: Richard C. Rhame
Journal: JAMA (1961)

CYSTIC abnormalities of the retrovesical space have aroused interest since the original case reports of Englisch in 1875<sup>1</sup>who demonstrated 5 such cysts, lined by epithelium and connected by fibrous tissue with the veru montanum, in 70 autopsies. Moore demonstrated 7 retrovesical cysts in 678 autopsies. In the majority of these cases, however, the cysts were quite small and represented anatomical curiosities rather than clinical entities. Coppridge in 1939 reported a case of a large midline mass, palpable rectally above the prostate, which proved to be a müllerian duct cyst.<sup>2</sup>A review of the literature at that time disclosed only 6 references to symmetrical midline cystic tumors which simulated over-distended bladders and which at operation or autopsy revealed massive cysts originating deep in the pelvis, between the bladder and rectum. The literature now contains approximately 50 similar cases.<sup>3</sup> The müllerian duct cyst reported here is of
Use of Steroids in Penicillin-Sensitive Patients with Bacterial Endocarditis
Authors: A. Jarrell Raper, V. Eric Kemp
Journal: New England Journal of Medicine (1965)

THE natural history of bacterial endocarditis is characterized by a uniformly fatal outcome unless appropriate therapy is given. Penicillin is the drug of choice in patients with sensitive organisms.1 2 3 4 Penicillin is unsurpassed in bactericidal qualities and ability to penetrate fibrin, two characteristics that are vital in the therapy of bacterial endocarditis.5 No other drug or combination of drugs can equal its record of success, which approaches 95 per cent of cases with sensitive organisms.A history of penicillin allergy or its appearance during treatment of the patient with bacterial endocarditis presents a difficult problem, for many cases of mortality and . . .
Ultrastructural changes in the duodenal mucosa induced by ingested histamine in patients with chronic urticaria
Authors: G. Kanny, G. Grignon, M. Dauca, J. C. Guedene, D. A. Moneret‐Vautrin
Journal: Allergy (1996)

Histamine in food may be responsible for some cases of food intolerance. We previously demonstrated disturbances in the metabolism of ingested histamine in patients with chronic urticaria (CU) and proposed that this could be related to increased intestinal permeability to histamine. The present study was undertaken to look for ultrastructural changes in the intestinal tract that might explain this abnormality. We examined duodenal biopsies from seven patients with CU before and after intraduodenal administration of histamine (120 mg). Five subjects had clinical symptoms (diarrhea, urticaria, headache, accelerated heart rate. and drop in blood pressure) within 1 h of duodenal histamine challenge (DHC). Ultrastructural changes. including edema of the interstitial tissue, enlargement of the basal intercellular spaces, slight congestion of the endothelial cells, and pericapillary edema, were observed in six subjects 45 min after DHC. In all the biopsies, the epithelium was normal, and the tight junctions were not modified by DHC. This morphologic study demonstrates that histamine can induce edema in the basal intercellular spaces of the duodenal mucosa and in the submucosa without evident change in the integrity of intercellular junctions. The most plausible route for histamine to have taken would appear to be an intracellular one.
Chronic Treatment of Ménétrier’s Disease With Erbitux: Clinical Efficacy and Insight Into Pathophysiology
Authors: Stephen H. Settle, Kay Washington, Christopher Lind, Scott Itzkowitz, W. Haley Fiske, J. Steven Burdick, W. Gray Jerome, Margaret Ray, Wilfred Weinstein, Robert J. Coffey
Journal: Clinical Gastroenterology and Hepatology (2005)
Two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) compared with single-stage treatment with intraoperative ERCP for patients with symptomatic cholelithiasis with possible choledocholithiasis
Authors: L. Rábago, C. Vicente, F. Soler, M. Delgado, I. Moral, I. Guerra, J. Castro, E. Quintanilla, J. Romeo, R. Llorente, J. Vázquez Echarri, J. Martínez-Veiga, F. Gea
Journal: Endoscopy (2006)

Background and study aims: An ideal treatment for choledocholithiasis in the laparoscopic era has not been established. The objective of this study was to elucidate whether a treatment strategy of performing intraoperative endoscopic retrograde cholangiopancreatography (ERCP) during laparascopic cholecystectomy (when choledocholithiasis is confirmed by intraoperative cholangiography) is better for patients with suspected common bile duct stones than the current strategy (preoperative ERCP followed by laparoscopic cholecystectomy). Patients and methods: This was a prospective randomized study to evaluate which of these two approaches was most benefit- and cost-effective for patients with intermediate risk of choledocholithiasis. Patients underwent either preoperative ERCP followed by a laparoscopic cholecystectomy a few weeks later (the "preoperative ERCP" group) or intraoperative ERCP (the "intraoperative ERCP" group). Intraoperative ERCP was performed using the rendezvous technique. Results: There were 64 patients in the preoperative ERCP group and 59 patients in the intraoperative ERCP group. The demographic and clinical characteristics of the two groups were similar, except that the bilirubin and gamma-glutamyl transferase (GGT) levels and the number of patients treated on an inpatient basis were higher in the preoperative ERCP group. Success rates were similar (96.6 % in the preoperative ERCP group vs. 90.2 % in the intraoperative ERCP group in the per-protocol study). Total morbidity, post-ERCP morbidity, and post-ERCP acute pancreatitis rates were higher in the preoperative ERCP group, but there were no differences between the two groups in the frequency of residual common bile duct stones, the conversion rate to open cholecystectomy, or surgical morbidity. The length of hospital stay and costs were lower in the intraoperative ERCP group despite the longer surgical times in this group. Univariate analysis did not find any relationship between morbidity and total bilirubin or GGT. Logistic regression analysis confirmed that morbidity was related only to the treatment group and the time spent in the operating room: the relative risk (RR) was 4.37 for morbidity and 1.015 for the time spent in the operating room); the RR for papillotomy was 5.49. Conclusions: Both treatment approaches were equally effective but the intraoperative ERCP group had less morbidity, a shorter hospital stay, and reduced costs. The lower morbidity in the intraoperative ERCP group resulted from the lower rate of papillotomy and lower rates of post-ERCP pancreatitis and cholecystitis. Total morbidity was principally related to the type of treatment approach used.
Why Not the House Cat?
Authors: J. M. Laurison
Journal: JAMA (1898)

Lansdowne, Pa., March 2, 1898. <h3>To the Editor:</h3> —I have been interested in the letters regarding the castration of squirrels, in the March 5 issue of your excellentJournal, and it occurs to me to suggest that some learned member of the profession set himself to the bringing out of some scheme whereby the squirrels might be led to teach their progeny-limiting process to the common house cat! In the interest of peace and quietness and sweet refreshing sleep, such an happy "artificial cut-off" as Saxe says, is needed. Fame and fortune await him who will bring to pass this step toward Heaven. Sincerely,
Prevention of nosocomial infections in acute respiratory failure patients
Authors: E. Girou
Journal: European Respiratory Journal (2003)

Patients with acute respiratory failure are predisposed to acquire nosocomial infection primarily because they may need ventilatory support, usually invasive mechanical ventilation. The presence of an endotracheal tube impairs natural defences of the respiratory tract and favours airways colonisation and lung infection. Cross transmission of microorganisms may also occur <i>via</i> contaminated hands of healthcare workers that manipulate invasive devices. Thus, avoiding the endotracheal tube and increasing hand hygiene compliance are major measures to prevent ventilator­associated pneumonia. The use of noninvasive ventilation has been shown to reduce the incidence of nosocomial infections and should be used whenever possible. Using hand rubbing with waterless alcohol­based products evidenced higher efficacy to reduce hand contamination as compared to conventional hand washing with soap. Due to its rapid activity and ease of access, hand rubbing constitutes a promising avenue for improving hand hygiene compliance and thus reducing cross infection.
The Placenta: Biological and Clinical Aspects
Authors: H. Robert Misenhimer
Journal: JAMA (1975)

The eighth Harold C. Mack Symposium was dedicated to updating the current state of knowledge on the placenta. Twenty-nine contributors from around the world have presented the results of their work in 16 chapters. Two of these are devoted to placental structure as studied by transmission and scanning electron microscopy. The authors present many observations but make little effort to correlate their findings with accrued information. Seven chapters consider placental transport and exchange mechanisms, and five deal with metabolic and endocrine functions of the placenta. Included in these detailed presentations are discussions of carbon dioxide transfer, glucose metabolism in the fetus and uterus, protein transport, steroid synthesis, and similar pertinent topics. Newer techniques and experimental approaches have permitted these investigators to work on aspects of placental function that, in the past, have been suggested but not proved. In addition, the authors introduce many new concepts. As was true of the
Dual Peroxisome Proliferator–Activated Receptor α/δ Agonist GFT505 Improves Hepatic and Peripheral Insulin Sensitivity in Abdominally Obese Subjects
Authors: Bertrand Cariou, Rémy Hanf, Stéphanie Lambert-Porcheron, Yassine Zaïr, Valérie Sauvinet, Benoit Noël, Laurent Flet, Hubert Vidal, Bart Staels, Martine Laville
Journal: Diabetes Care (2013)

The development of new insulin sensitizers is an unmet need for the treatment of type 2 diabetes. We investigated the effect of GFT505, a dual peroxisome proliferator-activated receptor (PPAR)-α/δ agonist, on peripheral and hepatic insulin sensitivity.Twenty-two abdominally obese insulin-resistant males (homeostasis model assessment of insulin resistance>3) were randomly assigned in a randomized crossover study to subsequent 8-week treatment periods with GFT505 (80 mg/day) or placebo, followed by a two-step hyperinsulinemic-euglycemic insulin clamp with a glucose tracer to calculate endogenous glucose production (EGP). The primary end point was the improvement in glucose infusion rate (GIR). Gene expression analysis was performed on skeletal muscle biopsy specimens.GFT505 improved peripheral insulin sensitivity, with a 21% (P=0.048) increase of the GIR at the second insulin infusion period. GFT505 also enhanced hepatic insulin sensitivity, with a 44% (P=0.006) increase of insulin suppression of EGP at the first insulin infusion period. Insulin-suppressed plasma free fatty acid concentrations were significantly reduced on GFT505 treatment (0.21±0.07 vs. 0.27±0.11 mmol/L; P=0.006). Neither PPARα nor PPARδ target genes were induced in skeletal muscle, suggesting a liver-targeted action of GFT505. GFT505 significantly reduced fasting plasma triglycerides (-21%; P=0.003) and LDL cholesterol (-13%; P=0.0006), as well as liver enzyme concentrations (γ-glutamyltranspeptidase: -30.4%, P=0.003; alanine aminotransferase: -20.5%, P=0.004). There was no safety concern or any indication of PPARγ activation with GFT505.The dual PPARα/δ agonist GFT505 is a liver-targeted insulin-sensitizer that is a promising drug candidate for the treatment of type 2 diabetes and nonalcoholic fatty liver disease.
Assimilation of lactitol, an 'unabsorbed' disaccharide in the normal human colon.
Authors: G K Grimble, D H Patil, D B Silk
Journal: Gut (1988)

The fate of orally ingested lactitol, a non-absorbed sugar, was measured in six healthy human subjects by following the three routes of disposal of universally 14C-labelled sugar. Lactitol was given as a 20 g daily dose to six healthy volunteers for 14 days and on the seventh day, 10 muCi of L-[U-14C]-lactitol was given with the unlabelled sugar and excretion of the 14C in breath, urine and faeces was followed. The peak of 14CO2 excretion occurred at six hours and total 14CO2 accounted for 62.9 (5.0)% of isotope given, whilst 6.5 (3.6)% and 2.0 (0.3)% of the label were recovered from faeces and urine respectively. These data suggest that lactitol is extensively metabolised in the human colon and that a significant proportion of the bacterial metabolites are available for colonic absorption. Calculation revealed that 54.5% of the theoretical energy content of this compound was utilised by the subjects. It is suggested that this sugar, and other soluble 9non-absorbed9 sugars (lactulose, sorbitol, mannitol), may undergo a similar pattern of colonic metabolism and can be considered as reduced calorie compounds.
Hemorrhage From Superficial Gastric Carcinoma
Authors: George F. Longstreth
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Overt bleeding is rarely the presenting manifestation of gastric malignant neoplasm. Most reported series of cases of carcinoma that does not extend beneath the submucosa do not mention clinically evident hemorrhage as a feature. Early gastric carcinoma is uncommonly diagnosed in the United States but has a favorable prognosis. The following is a report of superficial gastric carcinoma with bleeding. <h3>Report of a Case.—</h3> A previously healthy 58-year-old woman was hospitalized with melena. Findings from physical examination were normal. Endoscopic examination showed a focal, indeterminate, gastric mucosal abnormality with an adherent blood clot and active bleeding. Her hemoglobin level decreased to 9.0 g/dL, but the bleeding stopped. A few days later, the endoscopic examination was repeated. An area of mucosa in the anterior corpus, approximately 2 cm in diameter, appeared slightly mammillated and had delicate submucosal hemorrhages surrounding a small stellate erosion. The remainder of the stomach
Fertility and Conception Control.
Authors: G. Pincus
Journal: Annals of Internal Medicine (1962)

s1 April 1962Fertility and Conception Control.G. Pincus, M.D.G. Pincus, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-682_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwo major causes of infertility, anovulation and ovum blighting, may be imitated experimentally in animals by ovulation inhibition and anti-progestational compounds. Extensive investigations of natural and synthetic steroids in animals disclose: (a) highly potent ovulation inhibitors which are also active progestins; (b) certain substances exhibiting potency greater in oral administration than by parenteral administration; (c) anti-progestins of two types, estrogenic and competitive inhibitors; and (d) significant ovum blighting by anti-progestins.Clinical trials with two highly active steroidal ovulation inhibitors, norethynodrel and ethynodiol diacetate confirm studies made on animals which indicate the superior potency of the latter, particularly when orally administered.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Shrewsbury, Mass. (ML) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 682-682KeywordsClinical trialsCompetitive inhibitorsEstrogensInfertilityOral administrationOvulationSteroids Issue Published: 1 April 1962 PDF DownloadLoading ...
Abstract 5238: Lung adenocarcinoma harboring EGFR L858R mutation has increased invasive ability through up-regulation of CXCR4
Authors: Tzu-Hua Chang, Hsiao-Yin Yang, Meng-Feng Tsai, Kang-Yi Su, Pan-Chyr Yang, Jin-Yuan Shih
Journal: Cancer Research (2011)

Abstract Our previous study disclosed EGFR L858R mutation rate of lung adenocarcinoma with malignant pleural effusions of is higher than that of surgically resected lung adenocarcinoma (Wu et al, Eur Respir J 2008). The molecular mechanism is not clear. The chemokine receptor CXCR4 has recently been shown to mediate the movement of malignant cancer cells to specific organs. Stable clones of wild type and mutant L858R EGFR from lung cancer cell line H1299 were obtained from Dr. Chen (Chen YR et al Oncogene 2006). The Invasive ability of L858R EGFR H1299 cells was higher than that of wild type EGFR H1299 cell. L858R EGFR H1299 cell had higher CXCR4 expression, which was required for L858R EGFR-mediated invasion in vitro. Up-regulation of CXCR4 in L858R EGFR H1299 cell promoted invasion via increased activity of ERK. These results provide a plausible mechanism for L855R EGFR-mediated lung tumor metastasis and establish a functional link between mutant EGFR and CXCR4 signaling pathways. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5238. doi:10.1158/1538-7445.AM2011-5238
New Blood, Old Blood, or No Blood?
Authors: John W. Adamson
Journal: New England Journal of Medicine (2008)

The use of blood transfusions in medicine is so well established that the procedure is an afterthought to many physicians. Scientific advances have rendered blood and blood products extremely safe through the introduction of donor-deferral strategies, infectious-disease testing, pathogen-inactivation methods, and recombinant DNA technologies for particular therapeutic proteins. These advances have dramatically reduced the likelihood of transfusion-transmitted disease so that the risk of transfusion-associated human immunodeficiency virus 1 or hepatitis C infection, for example, is now on the order of 1 in 2 million donated units.1 Concern persists about the transmission of other infectious agents, for which testing is not . . .
Cytoplasmic mutated nucleophosmin (NPM1) in blast crisis of chronic myeloid leukaemia
Authors: P P Piccaluga, E Sabattini, F Bacci, C Agostinelli, S Righi, F Salmi, N Testoni, S Paolini, F Castagnetti, G Martinelli, B Falini, S A Pileri
Journal: Leukemia (2009)
Junior hospital doctors' hours of work campaign
Authors: T. Fenton
Journal: BMJ (1985)

admission was severity of symptoms or admission for social reasons.I found it surprising that there was no mention of pleural pain, since this is a relatively common reason for admission to hospital and in my experience prevents effective coughing in some patients.I am yet to be convinced of the value of physiotherapy in the treatment of primary pneumonia, but this paper has not caused me to question my present therapeutic practice of asking the physiotherapist to help expectoration in patients with pneumonia, especially those with pleural pain.
Frequency of Chromosomal Variation
Authors: J. L. Wilkins
Journal: BMJ (1967)

A brief introduction to each chapter considers older drugs that have been used for the same general purposes and relates them to newer agents.The volume illustrates the value of the official names of drugs, without the use of which it would be largely unintelligible.Unlike many American medical publica- lions, the price is extremely moderate con- sidering the great quantity of useful, prac- tical information it conveys.This is a good book, and can be unreservedly recommended to the practising physician.
Osteoporotic bone microstructure by collagenase etching.
Authors: I G Mackie, M Green, H Clarke, D H Isaac
Journal: Annals of the Rheumatic Diseases (1989)

Collagenase etching has been used to show the microstructure of bone from patients suffering from primary osteoporosis. Both polished and unpolished surfaces of trabecular bone from femoral heads were treated with collagenase solution before study in the scanning electron microscope. The polished surfaces show the mineral component of this bone as small rounded units approximately 10-20 nm across, which aggregate to form a continuous phase of contiguous spheroidal particles approximately 100 nm across. Lamellations are clearly seen to be due to the removal of collagen fibres up to approximately 200 nm across, fibres in adjacent lamellae being arranged approximately perpendicular to each other. The unpolished surfaces also show small rounded units, which aggregate into rods of mineral approximately 100 nm across. Although these rods form a connected system, they are loosely packed, compatible with their being interspersed with the collagen fibres in vivo. This model for the detailed microstructure of bone is consistent with specimens from a number of other sources and shows no features unique to osteoporosis.
Osteoblastic Bone Flare on F18-FDG PET in Non-small Cell Lung Cancer (NSCLC) Patients Receiving Bevacizumab in Addition to Standard Chemotherapy
Authors: Yelena Krupitskaya, Hedieh K. Eslamy, Dorothy D. Nguyen, Atul Kumar, Heather A. Wakelee
Journal: Journal of Thoracic Oncology (2009)