tbuckley/cabot-search huggingface dataset:
Two-Step Warfarin Therapy
Authors: Charles W. Francis, Victor J. Marder, C. McCollister Evarts, Samret Yaukoolbodi
Journal: JAMA (1983)

In a randomized, prospective trial of 100 patients, we have studied the safety and efficacy of warfarin sodium in comparison with that of dextran 40 in the prevention of venous thrombosis in patients at high risk for deep vein thrombosis after elective total hip or knee replacement. Warfarin was given in a new two-step regimen designed to avoid bleeding complications while still preventing venous thrombosis. A low dose of warfarin was started ten to 14 days preoperatively, and the prothrombin time was regulated to between 1.5 and 3 seconds longer than control at the time of surgery; immediately after surgery, the dose was increased to prolong the prothrombin time to 1.5 times control. The overall incidence of venous thrombosis as documented by venography was less in the 53 patients treated with warfarin than in the 37 treated with dextran (21% v 51%), as was the incidence of thrombi in the femoral or popliteal veins (2% v 16%). Objective measures of blood loss showed no difference between patients treated with warfarin or dextran, and excessive postoperative bleeding was infrequent and similar in both treatment groups. This study demonstrates that two-step warfarin therapy provides highly effective prophylaxis of postoperative venous thrombosis after elective hip or knee prosthetic surgery without excessive risk of perioperative bleeding. (<i>JAMA</i>1983;249:374-378)
THE ATMOSPHERIC TRACTOR IN OBSTETRICS.Read before the Iowa Union Medical Society at Cedar Rapids, June 14, 1892.
Authors: T. J. SHUELL
Journal: JAMA (1893)

There was a time, not many decades ago, when  regular profession was probably too conservative. There was a time when anything new whether in therapeutics or surgical appliances, was looked upon as savoring of quackery. But I believe that now we have reached  opposite oscillation of  pendulum, and that we are too prone to give credence to  claims of every new drug, and to try every new appliance, surgical, obstetrical or gynecological. Leading drug houses have enriched themselves by reason of our credulity; leading instrument makers have amassed shekels upon  fads termed the recent inventions in surgical appliances.  When put into  crucible of clinical experience some of  drugs put forward in  last quarter of a century have come to stay, whilst  great majority have fallen into deserved desuetude. Some surgical, obstetrical and gynecological instruments arid appliances founded upon strict anatomical knowledge,
Smoking May Induce Inflammation, Platelet Activation and Prothrombotic State in Isolated Coronary Artery Ectasia
Authors: Abdullah Doğan, Fatih Aksoy, Akif Arslan, Atilla İçli, Habil Yücel, Ercan Varol, Hatem Arı, Mehmet Özaydın, Doğan Erdoğan
Journal: Journal of the American College of Cardiology (2013)
Enhanced Nectin-1 Expression and Herpes Oncolytic Sensitivity in Highly Migratory and Invasive Carcinoma
Authors: Zhenkun Yu, Mei-Ki Chan, Pornchai O-charoenrat, David P. Eisenberg, Jatin P. Shah, Bhuvanesh Singh, Yuman Fong, Richard J. Wong
Journal: Clinical Cancer Research (2005)

The current tumor-node-metastasis system is inadequate to accurately classify patients in terms of prognosis. Thus, with the availability of recently developed molecular tools, considerable interest lies in discovering prognostic markers in order to guide treatment decisions. In this study, we sought to determine the prognostic significance of the cell cycle regulator cyclin D1 in oropharyngeal squamous cell carcinoma (OSCC).We studied the protein expression levels of cyclin D1 on a tissue microarray composed of 63 OSCCs with long-term follow-up data available. Protein expression was analyzed with an automated in situ quantitative (AQUA) method which allows preservation of tissue morphology while quantifying protein expression in paraffin-embedded tissue.The mean follow-up time was 35 months. High cyclin D1 nuclear expression was associated with increased 5-year local recurrence rate (48% versus 15%), inferior 5-year disease-free survival (16% versus 58%), and inferior 5-year overall survival (17% versus 53%). In multivariate Cox regression, high nuclear cyclin D1 expression was an independent predictor for local recurrence, disease-free survival, and overall survival at 5 years.Our results indicate that quantitative assessment of nuclear cyclin D1 expression level by automated in situ quantitative analysis is a strong predictor for outcome in OSCC. Thus, cyclin D1 may be a potential target for molecular intervention in patients with oropharyngeal squamous cell cancer.
209 CARDIOMYOPATHY IN PATIENTS WITH CIRRHOSIS. FREQUENCY, CHARACTERISTICS AND RELATIONSHIP WITH CIRCULATORY DYSFUNCTION AND PROGNOSIS
Authors: A. Nazar, M. Sitges, M. Guevara, C. Terra, M. Marinelli, F. Villa, M. Martín-Llahi, M.E. Baccaro, J. Bosch, M. Pavesi, S. Poyatos, V. Arroyo, P. Gines
Journal: Journal of Hepatology (2009)
Clinical Evaluation of Combined Hydrogenated Ergot Alkaloids (Hydergine) in Arterial Hypertension
Authors: RALPH M. TANDOWSKY
Journal: Circulation (1954)

One hundred patients suffering from sustained arterial hypertension were studied over a period of two years during which time the action of parenterally administered hydrogenated ergot alkaloids (Hydergine) constituted the main drug therapy. An immediate transient reduction of both the arterial blood pressure and the pulse rate was demonstrated in over 80 per cent of the entire group within a period of two hours. The average reduction in systolic and diastolic pressure was 36 mm. and 12 mm., respectively, and the pulse rate was reduced 6 beats per minute. Of interest was a group of 22 patients presenting evidence of early central vascular derangement in whom these alkaloids seemed to accomplish their best therapeutic action and possibly aborted what may have been a sustained cerebral accident. Untoward effects were minimal because of rapid dissipation of the drug, and its use in all types of hypertensive disease was deemed safe in the recommended dosage.
Cancer surveillance in longstanding ulcerative colitis: endoscopic appearances help predict cancer risk
Authors: M D Rutter
Journal: Gut (2004)

The risk of colorectal cancer is increased in ulcerative colitis (UC). Patients with UC have diverse colonoscopic appearances. Determining colonoscopic markers for cancer risk could allow patient risk stratification.Following on from an earlier study which demonstrated a correlation between inflammation severity and neoplasia risk, a case control study was performed to look for colonoscopic markers of colorectal neoplasia risk in UC. Each patient with neoplasia detected between 1988 and 2002 was matched with two non-dysplastic colitic controls. Data were collected on post-inflammatory polyps, scarring, strictures, backwash ileitis, a shortened, tubular, or featureless colon, severe inflammation, and normal looking surveillance colonoscopies.Cases (n = 68) and controls (n = 136) were well matched. On univariate analysis, cases were significantly more likely to have post-inflammatory polyps (odds ratio (OR) 2.14 (95% confidence interval 1.24-3.70)), strictures (OR 4.22; 1.08-15.54), shortened colons (OR 10.0; 1.17-85.6), tubular colons (OR 2.03; 1.00-4.08), or segments of severe inflammation (OR 3.38; 1.41-10.13), and less likely to have had a macroscopically normal looking colonoscopy (OR 0.40; 0.21-0.74). After multivariate analysis, a macroscopically normal looking colonoscopy (OR 0.38; 0.19-0.73), post-inflammatory polyps (2.29; 1.28-4.11), and strictures (4.62; 1.03-20.8) remained significant. The five year risk of colorectal cancer following a normal looking colonoscopy was no different from that of matched general population controls.Macroscopic colonoscopic features help predict neoplasia risk in UC. Features of previous/ongoing inflammation signify an increased risk. A macroscopically normal looking colonoscopy returns the cancer risk to that of the general population: it should be possible to reduce surveillance frequency to five years in this cohort.
TRENDS IN INFECTIVE ENDOCARDITIS HOSPITALIZATIONS IN THE UNITED STATES FROM 2000–2008
Authors: Karthik Murugiah, Navdeep Gupta, Abhishek Deshmukh, Sadip Pant, Apurva Badheka, Kaustubh Dabhadkar, Gagan Kumar
Journal: Journal of the American College of Cardiology (2013)
Prevalence and genomic variability of TT virus (TTV) in Italiancryptogenic hepatitis patients and healthy blood donors
Authors: C. Almerighi, M. Artini, E. Cariani, M. Fulco, A. Rossini, L. Pietro-paolo, G. Stivali, G. Montalto, M. Levrero, C. Balsano
Journal: Journal of Hepatology (2000)
Lifelong learning at work
Authors: P W Teunissen, Tim Dornan
Journal: BMJ (2008)

Lifelong learning is a process of continuously scrutinising and building on your practice to be the best doctor you can be Always have three questions in your mind: where am I going?how am I getting on?where to next?Use electronic tools that provide filtered information at the point of care because you cannot hope to stay up to date on everything Keep a learning portfolio so that you can see how you have already developed and how you can develop in the future Keep your learning efforts alive by discussing them with your peers and supervisors
Nursing as Metaphor
Authors: Claire Fagin, Donna Diers
Journal: New England Journal of Medicine (1983)

For some time now we have been curious about the reactions of people we meet socially to being told, "I am a nurse." First reactions to this statement include the comment, "I never met a nurse socially before"; stories about the person's latest hospitalization, surgery, or childbearing experiences; the question "How can you bear handling bedpans (vomit, blood)?" or the remark, "I think I need another drink." We believe the statements reflect the fact that nursing evokes disturbing and discomforting images that many educated, middle-class, upwardly mobile Americans find difficult to handle in a social situation. As nurses, we are . . .
Establishment and characterization of methylmercury-resistant PC12 cell line.
Authors: K Miura, T W Clarkson, K Ikeda, A Naganuma, N Imura
Journal: Environmental Health Perspectives (1994)

Methylmercury (MeHg)-resistant sublines of rat pheochromocytoma (PC12) cells were isolated by repeated exposure to stepwise increased concentrations of MeHg. One of the sublines (PC12/TM) showed an 8- to 10-fold increase in resistance to MeHg compared with parent PC12 cells on the basis of the concentration required for 50% inhibition (IC50) of growth. PC12/TM cells accumulated smaller amounts of MeHg than parent PC12 cells. This reduction in MeHg accumulation in PC12/TM cells resulted from slow uptake and rapid efflux. The intracellular glutathione (GSH) level in PC12/TM cells was four times higher than that of PC12 cells. Pretreatment of PC12/TM cells with buthionine sulfoximine, which decreased the GSH level to that of the parent PC12 cells, increased the sensitivity of PC12/TM cells to MeHg. A close correlation between the MeHg accumulation and MeHg sensitivity was found among seven sublines of PC12 cells and parent PC12 cell line. The GSH level in PC12 sublines was also correlated with their sensitivity to MeHg.
TO WHAT EXTENT SHOULD CLINICAL INSTRUCTION BE AFFORDED STUDENTS OF MEDICINE IN REGULAR COURSE.
Authors: N. S. DAVIS
Journal: JAMA (1892)

The subject of Clinical Instruction, as a part of the regular medical training required for the student during his attendance on his college courses, is one of much importance, and should receive more attention than has been hitherto given it. That the student should receive sufficient true clinical training to make him familiar with the means and methods of the examination of patients, the diagnostic symptoms of diseases, and the application of remedies, before being authorized to commence the practice of medicine and surgery, is generally admitted. Whether such clinical training should take place while the student is actively engaged in prosecuting his medical college studies, or should be assigned to one or two years after he has completed the college curriculum, is a question concerning which much might be said. If the student is required to have a good general education and a fair degree of mental discipline before
Cyclooxygenase-2 is a possible target of treatment approach in conjunction with photodynamic therapy for various disorders in skin and oral cavity
Authors: Y. Akita, K. Kozaki, A. Nakagawa, T. Saito, S. Ito, Y. Tamada, S. Fujiwara, N. Nishikawa, K. Uchida, K. Yoshikawa, T. Noguchi, O. Miyaishi, K. Shimozato, S. Saga, Y. Matsumoto
Journal: British Journal of Dermatology (2004)

Background Anti‐cancer effects of cyclooxygenase (COX)‐2 inhibitors have been reported, but not fully investigated in skin and oral diseases. 5‐aminolaevulinic acid (ALA)‐based photodynamic therapy (PDT) for treating those patients with skin and oral lesions is a highly sophisticated procedure, but the incidence of disease recurrence after treatment is rather significant. Objective To confirm that COX‐2 could be a molecular target in adjunctive therapy to ALA‐based PDT, we investigated (i) COX‐2 expression in various skin and oral diseases, and (ii) the inhibitory effects on cellular growth of COX‐2 selective inhibitor (nimesulide), ALA‐based PDT and their combination on human oral squamous cell carcinoma (SCC) cell lines. Methods A total of 129 biopsy samples from the skin and oral mucosal lesions were tested immunohistochemically for COX‐2 expression. Then the in vitro effects of nimesulide, ALA‐based PDT, and their combination were determined on two SCC cell lines, HSC‐2 and HSC‐4. Three different methods (MTT assay, double‐staining for annexin V and propidium iodide, caspase‐3/CPP32 fluorometric protease assay) were applied for evaluation of their inhibitory effects on these two cell lines. Results Among the skin diseases, a considerable number of COX‐2 high expressers were found in actinic keratosis (15 of 25, 60%), Bowen's disease (13 of 17, 76%) and extramammary Paget's disease (15 of 15, 100%). In contrast, only one of 33 (3%) basal cell carcinoma tumours was a COX‐2 high expresser. Among the oral mucosal biopsies, the proportion of COX‐2 high expressers increased gradually from hyperplasia (one of six, 17%) through mild dysplasia (five of eight, 63%) and moderate dysplasia (20 of 23, 87%) to severe dysplasia (two of two, 100%). Nimesulide had an inhibitory effect in vitro on HSC‐2 (proven to be a COX‐2 high expresser), but not on HSC‐4 (a COX‐2 non‐expresser). While ALA‐based PDT showed an inhibitory effect on both HSC‐2 and HSC‐4, most importantly the combination of nimesulide and ALA‐based PDT demonstrated a significant synergistic effect on the cellular growth inhibition of only HSC‐2, but not of HSC‐4. Conclusions Our study strongly suggests that COX‐2 can be one of the molecular targets in treating various skin and oral diseases. The results from our in vitro experiments also prompt us to develop a new protocol with a combination of COX‐2 selective inhibitor and ALA‐based PDT for more effective treatment of those diseases.
Evaluation of Clinical and Immunogenetic Risk Factors for the Development of Hepatotoxicity during Antituberculosis Treatment
Authors: Surendra K. Sharma, Arumugam Balamurugan, Pradip Kumar Saha, Ravindra M. Pandey, Narinder K. Mehra
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Though several risk factors for the development of hepatotoxicity due to antituberculosis drugs have been suggested, involvement of genetic factors is not fully established. We have studied the major histocompatibility complex (MHC) class II alleles and clinical risk factors for the development of hepatotoxicity in 346 North Indian patients with tuberculosis undergoing antituberculosis treatment. Of these, 56 patients developed drug-induced hepatotoxicity (DIH group), whereas the remaining 290 patients did not (non-DIH group). The DIH group was comparatively older, had lower pretreatment serum albumin, and a higher frequency of moderately/far advanced disease radiographically than the latter. Further, patients with high alcohol intake had threefold higher odds of developing hepatotoxicity. In multivariate logistic regression analysis, older age (odds ratio [OR] 1.2), moderately/far advanced disease (OR 2.0), serum albumin < 3.5 g/dl (OR 2.3), absence of HLA-DQA1*0102 (OR 4.0), and presence of HLA-DQB1*0201 (OR 1.9) were independent risk factors for DIH. Our results suggest that the risk of hepatotoxicity from antituberculosis drugs is influenced by clinical and genetic factors.
High concordance from independent studies by the Children's Cancer Group (CCG) and Pediatric Oncology Group (POG) associating favorable prognosis with combined trisomies 4, 10, and 17 in children with NCI Standard-Risk B-precursor Acute Lymphoblastic Leukemia: a Children's Oncology Group (COG) initiative
Authors: M J Sutcliffe, J J Shuster, H N Sather, B M Camitta, J Pullen, K R Schultz, M J Borowitz, P S Gaynon, A J Carroll, N A Heerema
Journal: Leukemia (2005)
Quantitative Detection of Outlet Strut Separations in Bjo¨rk-Shiley Convexo-concave Mitral Valves
Authors: Kimerly A. Powell, Nancy A. Obuchowski, Klaus D. Mueller, Eric LaPresto, Charles G. Hwang, Jamie Lee Hirsch, Steven E. Nissen, J. Fredrick Cornhill
Journal: Circulation (1996)

As of January 31, 1995, 564 outlet strut fractures (OSFs) of Björk-Shiley convexo-concave (BSCC) heart valves had been reported to the Shiley Heart Valve Research Center, of which approximately two thirds resulted in the death of the patient. Previous studies indicate that one leg of the outlet strut separates (single-leg separation, SLS) from the valve before the second leg breaks, which results in complete OSF. To identify those valves at risk of complete OSF, an in vivo radiographic imaging technique is being developed to evaluate the strut leg integrity. The goal of the present study was to develop an objective postprocessing technique to evaluate outlet strut leg integrity quantitatively in these cineradiographic images.Twenty-two sets (12 intact valves, 10 SLS valves) of cineangiographic images were obtained from individuals whose valve status was subsequently verified ex vivo. Several quantitative measures of SLS were evaluated to identify possible loss of metal or gaps in the SLS legs. Two of these measures, decrease in pixel intensity (DIPI) ratio and gap half-width, are diagnostic metrics of SLS: i.e., the maximum likelihood estimate of the area under the receiver operating characteristic curve was 0.892 (SD, 0.066) for a model based on DIPI ratio and 0.802 (SD, 0.093) for gap half-width.We have developed a postprocessing technique that can be used to objectively evaluate outlet strut integrity in cineradiographic images of BSCC heart valves. At an estimated specificity of 1.0, the estimated sensitivity of the objective review was comparable to that of a subjective expert review panel.
Pregnancy in Cystic Fibrosis of the Pancreas
Authors: Richard J. Grand
Journal: JAMA (1966)

Information is presently available on ten women with cystic fibrosis who have become pregnant: two patients already in the literature, two cases in this report, and six from a national survey. The toll of maternal morbidity and mortality as well as the high risk of fetal prematurity (and death) make the pregnant woman with cystic fibrosis a significant challenge in management. Important considerations must be (1) adequate prenatal evaluation and therapy of pulmonary disease, including cor pulmonale if present; (2) careful management of electrolyte problems which may arise; (3) proper nutrition and pancreatic replacement as indicated; (4) diagnosis of maternal diabetes and, in its presence, appropriate conduct of labor and the care of the newborn; and (5) early studies in the infant to note the presence or absence of cystic fibrosis. All of the 11 living infants in the present study were normal and showed no stigmata of cystic fibrosis.
The general practitioner and changes in obstetric practice.
Authors: G Lloyd
Journal: BMJ (1975)

Compared with the 1960s fewer general practitioners today are obtaining a postgraduate diploma in obstetrics, and the future more stringent criteria for practitioners wishing to undertake this will probably restrict the numbers of family doctors wishing to practise in this field. More deliveries are being performed in institutions--either in consultant or general-practitioner units. Morever, within a decade probably few G.P.s will attend during normal labour or delivery, which can and should be conducted by midwives. In future, therefore, G.P.s should have a new role in obstetrics, being responsible for some antenatal supervision and postnatal care, including postnatal examinations, taking a cervical smear, and advice on birth control.
TUBERCULOSIS FROM THE FAR EAST
Authors: THOMAS J. SCHNEIDER
Journal: Annals of Internal Medicine (1969)

Letters and Comments1 October 1969TUBERCULOSIS FROM THE FAR EASTTHOMAS J. SCHNEIDER, M.D.THOMAS J. SCHNEIDER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-71-4-871 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: The discussion of the paper by Dr. Stead and Bates entitled "Primary Tuberculosis from the Far East" (Ann. Intern. Med. 70: 707, 1969) states that "it [tuberculosis] is certainly not among the primary dangers for persons in such a theater of war where soldiers have little time or inclination to fraternize with the native population."From my personal experiences in Vietnam, I feel that this statement paints an overly optimistic picture. Admittedly, tuberculosis is not one of the "primary" dangers faced by our men in Vietnam, yet it is a very real danger, and one that should... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: THOMAS J. SCHNEIDER, M.D.Affiliations: Department of Gastroenterology Cleveland Clinic Cleveland, Ohio 44106 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTuberculin Skin-Test Conversion in Vietnam 1969 Annual Skin-Test Reports of Navy and Marine CorpsJOSEPH M. SACHS, CHARLES H. MILLER 1 October 1969Volume 71, Issue 4Page: 871-872 ePublished: 1 December 2008 Issue Published: 1 October 1969 PDF downloadLoading ...