tbuckley/cabot-search huggingface dataset:
Pneumatosis Cystoides Intestinalis
Authors: J. I. Burn, B. S. Jones
Journal: BMJ (1961)

The occurrence and causation of nitrate-induced headache in industrial workers are reviewed, and three cases occurring in a pharmaceutical manufacturing plant are described.The mode of production of this troublesome syndrome and the ease with which it may be prevented are outlined.The relevant literature is reviewed in the context of the account.We are indebted to Dr. L.
Persistent FDG Uptake Around an Inguinal Mesh Prosthesis 25 Years After Implantation
Authors: Ana Koljevic-Markovic, Maria-Victoria Orcurto, Francesco Doenz, Angelika Bischof Delaloye, John O. Prior
Journal: Clinical Nuclear Medicine (2007)

The authors describe the case of a 57-year-old woman who underwent a FDG PET/CT study for staging a left pulmonary apical mass. There was markedly increased metabolic activity in the pulmonary lesion and unexpectedly in the umbilical region. The patient reported a history of hernia repair occurring 25 years before the PET study with implantation of an inguinal mesh prosthesis and was totally free of abdominal pain or inflammatory signs. FDG uptake can be seen in both malignant and inflammatory lesions and knowledge of long-term FDG uptake associated with granulomatous reaction can be useful for clinical interpretation of PET/CT studies.
Effects of Topical Steroids on Tight Junction Proteins and Spongiosis in Esophageal Epithelia of Patients With Eosinophilic Esophagitis
Authors: David A Katzka, Ravikanth Tadi, Thomas C Smyrk, Eesha Katarya, Anamay Sharma, Deborah M Geno, Michael Camilleri, Prasad G Iyer, Jeffrey A Alexander, Navtej S Buttar
Journal: Clinical Gastroenterology and Hepatology (2014)
Cases of Malignant Diseases of the Eye, with Observations
Authors: J. Windsor
Journal: BMJ (1850)

ON a former occasion,* I read to this Society a paper containing a few cases and remarks on malignant affec- tions of the eye, and I beg leave now to relate some additional cases and observations on the sanie subject.In the first place, however, I may observe; that of the three cases mentioned in the former paper, one had then died from the extension of the disease, without submit- ting to the operation of extirpation of the organ affected, although at an earlier period the carcinomatous growth was twice excised from the surface of the eye, but soon afterwards reappeared.The second patient had the eye removed, and, as far as I know, there has been no relapse.In the third case, however, I have been informed, that although there was no re-appearance of disease in the orbit, fungoid or rather melanoid disease, after a pretty considerable period (about twelve or eighteen months) manifested itself in some other parts, and led to a fatal termination.Dr. Martland, of Blackburn, has favoured me with the following report of the progress of the case after the patient's return to that town:- " So far as I can remember, I will endeavour to give a brief account of Mrs. Jackson's case, after she came under my care subsequent to the removal of her eye, but as I have no notes, it is from mere recollection.The operation was performed, I believe, by you in January or February, 1843, and she came under my care at the end of February, 1844, when disease was progressing in the system.She died on the 25th of June in the same year.The soft parts in the orbit never completely healed, but there was only a small surface open, from which a thin matter regularly but slowly issued.She never complained of much pain in the orbit.So far, therefore, as that was concerned, the operation appears to have prolonged her life, and relieved her from much suffering.There were two large melanotic tumours, half the size of an ordinary hen's egg, situated on the chest, one above the mamma on one side, and the other below the opposite mamma; from these she suffered very much.The least touch of her clothes pained her severely.They increased con- siderably in size at first, but remained nearly stationary for the last two months of her life.On the abdomen there were several tumours of a similar kind, I fancy about a dozen, varying from the bulk of a large marble to the smallest size.She was very patient, and seldom complained of these.The cuticle never gave way in any of these tumours, else I fear there would have been serious hemorrhage.They felt as if composed of a
Meta-Analysis of Cell Therapy Trials for Patients With Heart Failure
Authors: Sheila A Fisher, Carolyn Doree, Anthony Mathur, Enca Martin-Rendon
Journal: Circulation Research (2015)

Cell-based therapies are a promising intervention for the treatment of heart failure (HF) secondary to ischemic and nonischemic cardiomyopathy. However, the clinical efficacy of such new treatment requires further evaluation.To assess available clinical evidence on the safety and efficacy of cell-based therapies for HF.Electronic databases (CENTRAL, DARE, NHSEED & HTA, PubMed, MEDLINE, EMBASE, CINAHL, LILACS, KoreaMed, PakMediNet, IndMed, and the Transfusion Evidence Library) were searched for relevant randomized controlled trials to June 2014. Trials of participants with HF and where the administration of any dose of autologous cells by any delivery route was compared with no intervention or placebo were eligible for inclusion. Primary outcomes were defined as mortality and rehospitalization as a result of HF. Secondary outcomes included performance status, quality of life, incidence of arrhythmias, brain natriuretic peptide levels, left ventricular ejection fraction, myocardial perfusion, and adverse events. Thirty-one independent trials (1521 participants) were included. The treatment significantly reduced the risk of mortality and rehospitalization caused by HF. There was a significant improvement in favor of stem cell treatment in performance status and exercise capacity, left ventricular ejection fraction, and quality of life. The treatment was also associated with a reduction of brain natriuretic peptide levels and no increase in the incidence of arrhythmias. However, there was considerable risk of performance, selection, and reporting bias among the included trials.This study shows evidence that autologous cell therapy may be beneficial for patients having HF, but further evidence is required.
Myocardial electrical propagation in patients with idiopathic dilated cardiomyopathy.
Authors: K P Anderson, R Walker, P Urie, P R Ershler, R L Lux, S V Karwandee
Journal: Journal of Clinical Investigation (1993)

Myocardial propagation may contribute to fatal arrhythmias in patients with idiopathic dilated cardiomyopathy (IDC). We examined this property in 15 patients with IDC undergoing cardiac transplantation and in 14 control subjects. An 8 x 8 array with electrodes 2 mm apart was used to determine the electrical activation sequence over a small region of the left ventricular surface. Tissue from the area beneath the electrode array was examined in the patients with IDC. The patients with IDC could be divided into three groups. Group I (n = 7) had activation patterns and estimates of longitudinal (theta L = 0.84 +/- 0.09 m/s) and transverse (theta T = 0.23 +/- 0.05 m/s) conduction velocities that were no different from controls (theta L = 0.80 +/- 0.08 m/s, theta T = 0.23 +/- 0.03 m/s). Group II (n = 4) had fractionated electrograms and disturbed transverse conduction with normal longitudinal activation, features characteristic of nonuniform anisotropic properties. Two of the control patients also had this pattern. Group III (n = 4) had fractionated potentials and severely disturbed transverse and longitudinal propagation. The amount of myocardial fibrosis correlated with the severity of abnormal propagation. We conclude that (a) severe contractile dysfunction is not necessarily accompanied by changes in propagation, and (b) nonuniform anisotropic propagation is present in a large proportion of patients with IDC and could underlie ventricular arrhythmias in this disorder.
Histochemistry of the surface mucous gel layer of the human colon.
Authors: K Matsuo, H Ota, T Akamatsu, A Sugiyama, T Katsuyama
Journal: Gut (1997)

Histochemical analysis of the surface mucous gel layer of the human colon is difficult, as it dissolves in fixatives. This study was undertaken to explore the surface mucous gel layer on the normal mucosa and neoplastic tissues of the large intestine. In addition, the distribution of different mucins secreted from goblet cells was studied with a series of histochemical stains for mucins.Twenty four surgically resected specimens were fixed in Carnoy's solution and embedded in paraffin. In four cases, the surface mucous gel layer was also studied in frozen sections. Serial sections were stained by a battery of histochemical techniques characterising mucins.The surface mucous gel layer consisted of the inner and outer layers. The first covered the luminal surface of the mucosa, consisted of mucins, and showed a vertical striped pattern. The second overlaid the first, showed a lateral striped pattern, and was contaminated with bacteria and other substances. Their thickness in paraffin sections varied considerably among the sites in the large intestine, but was the thickest in the rectum and measured 12.7 (SEM 6.0) microns and 88.8 (SEM 80.1) microns respectively. Mucins forming the inner layer were obviously derived from goblet cells underlying it.
Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: a double-blind, randomized, placebo-controlled trial.
Authors: R S Engelmeier, J B O'Connell, R Walsh, N Rad, P J Scanlon, R M Gunnar
Journal: Circulation (1985)

It has been suspected that the increased sympathetic activity seen in patients with chronic congestive heart failure from dilated cardiomyopathy may be harmful. We therefore tested the long-term effect of metoprolol on eight patients in a double-blind, randomized protocol and 12 patients in an unblinded, crossover protocol who were treated for 12 months (range 10 to 24), and compared them with 16 similar subjects who were treated with placebo for 10 months (range 6 to 12) in a double-blind, randomized protocol. Patients were followed by serial clinical assessment, treadmill testing, radionuclide ventriculography, and echocardiography. Metoprolol-treated patients had an improvement in mean exercise capacity by 3 mets (p less than .0001) while experiencing a significant improvement in functional classification (p less than .001) during both the double-blind and open-label crossover studies and had an improved ejection fraction during the double-blind study (p less than .02). These improvements were not seen in matched control subjects receiving placebo. Seven of 20 patients receiving long-term metoprolol therapy had resolution of nearly all symptoms of heart failure, doubled their exercise capacity, and had progressive improvement in resting radionuclide left ventricular ejection fraction (12.6 +/- 3% to 26.9 +/- 6%) and echocardiographic left ventricular end-diastolic dimension (7.7 +/- 0.5 to 6.5 +/- 0.5 cm). Only one of 21 patients treated was intolerant of metoprolol. We conclude that metoprolol can be given safely to a select group of patients with dilated cardiomyopathy in doses that substantially reduce both resting and exercise heart rates. Long-term beta-blockade improved functional class and exercise capacity in 14 of 20 patients while producing an exceptional clinical response in seven that was accompanied by improved resting parameters of left ventricular function.
Gastrectomy for the treatment of refractory gastric ulceration after radioembolization with<sup>90</sup>Y microspheres
Authors: Sun Young Yim, Jin Dong Kim, Jin Yong Jung, Chang Ha Kim, Yeon Seok Seo, Hyung Joon Yim, Soon Ho Um, Ho Sang Ryu, Yun Hwan Kim, Chong Suk Kim, Eun Shin
Journal: Clinical and Molecular Hepatology (2014)

Transcatheter arterial radioembolization (TARE) with Yttrium-90 (90Y)-labeled microspheres has an emerging role in treatment of patients with unresectable hepatocellular carcinoma. Although complication of TARE can be minimized by aggressive pre-evaluation angiography and preventive coiling of aberrant vessels, radioembolization-induced gastroduodenal ulcer can be irreversible and can be life-threatening. Treatment of radioembolization-induced gastric ulcer is challenging because there is a few reported cases and no consensus for management. We report a case of severe gastric ulceration with bleeding that eventually required surgery due to aberrant deposition of microspheres after TARE. Keywords: Gastrectomy; Gastric ulcer; Hepatocellular carcinoma; Radioembolization; Yttrium-90
Resistance of HBV to adefovir dipivoxil: A case for combination antiviral therapy?
Authors: Costica Aloman, Jack R. Wands
Journal: Hepatology (2003)

Abstract Background &amp; Aims: Adefovir dipivoxil effectively inhibits both hepatitis B virus (HBV) replication and disease activity in patients with chronic hepatitis B. Resistance to treatment was not observed in 2 recent large placebo–controlled 48–week studies with this drug. The aim of this study was to characterize adefovir resistance in a patient who developed clinical and virologic evidence of breakthrough during a 96–week course of treatment. Methods: HBV DNA was PCR amplified and sequenced. Phenotypic studies used patient–derived HBV as well as specific mutations created by site–directed mutagenesis of a HBV/baculovirus recombinant. Results: Following the commencement of treatment with adefovir dipivoxil, the patient initially responded with a 2.4 log10 decrease in serum HBV DNA and normalization of alanine aminotransaminase levels by week 16. During the second year of treatment, however, serum HBV DNA rose progressively, eventually returning to near–pretreatment levels. This increase in viral replication was associated with a marked increase in alanine aminotransferase and mild changes in bilirubin, albumin, and prothrombin time. Comparison of pretreatment and posttreatment HBV DNA by polymerase chain reaction sequencing identified a novel asparagine to threonine mutation at residue rt236 in domain D of the HBV polymerase. In vitro testing of a laboratory strain encoding the rtN236T mutation and testing of patient–derived virus confirmed that the rtN236T substitution caused a marked reduction in susceptibility to adefovir. Conclusions: The development of this novel mutation in the HBV polymerase confers resistance to adefovir dipivoxil. The patient responded to subsequent lamivudine therapy, achieving normalization of alanine aminotransferase and a significant decrease in serum HBV DNA.
Extending Health Maintenance Organization Insurance to the Uninsured
Authors: Harvey Bograd
Journal: JAMA (1997)

<h3>Objective.</h3> —To investigate the utilization of health care services of previously uninsured low-income patients after becoming insured by a health maintenance organization (HMO). <h3>Design.</h3> —Retrospective study of utilization in a previously uninsured study group compared with an age- and sex-matched randomly selected control group of commercial HMO enrollees. <h3>Setting.</h3> —Group model HMO. <h3>Patients.</h3> —A study group of 346 previously uninsured low-income patients and 382 controls. <h3>Measures.</h3> —Outpatient visits for primary and specialty care, outpatient pharmacy, laboratory, and radiology use, and inpatient admissions and hospital days over a 2-year period. Self-reported health status measures were obtained to control for differences in health status. <h3>Principal Findings.</h3> —There were no differences between the study and control groups in hospital admissions, hospital days, and measures of outpatient laboratory, pharmacy, and radiology use. The odds of having an outpatient visit per patient per month was 30% higher for the study group. Approximately half the increase in the odds ratio for outpatient visits was related to the worse self-perceived health status of the study group. While both groups utilized more services in the early phase of their enrollment, the intensity of this start-up effect was similar for both groups. <h3>Conclusions.</h3> —Compared with a commercial group of the same age and sex, the patterns of utilization were similar and the financial costs of care were only moderately more for a previously uninsured group provided with comprehensive HMO insurance. With the growth of managed care, these data should be beneficial in the development of health care programs for the growing number of uninsured Americans.
On Herds, Border Guards, and Ambulatory Infection Control
Authors: Stephen C. Schoenbaum
Journal: JAMA (1985)

Just as all clinicians are aware that on occasion a seemingly simple case can unleash a host of complicated issues, so epidemiologists are aware that a seemingly simple outbreak can raise major theoretical and practical problems. The article in this issue by Remington et al,<sup>1</sup>which describes an outbreak of measles with only four secondary cases, is an example in point. One, and perhaps two, of the four cases would not have occurred had these children been vaccinated against measles at exactly 15 months of age. It is unrealistic to think that all children will be vaccinated precisely on schedule and that may excuse the case that occurred in a 16-month-old, but the case that occurred in an unvaccinated 2 1/2-year-old child has to be considered a failure of preventive medicine. A nationwide immunization program has led to a dramatic reduction in the occurrence of measles in the United
Efficacy and Safety Comparison of Liraglutide, Glimepiride, and Placebo, All in Combination With Metformin, in Type 2 Diabetes
Authors: Michael Nauck, Anders Frid, Kjeld Hermansen, Nalini S. Shah, Tsvetalina Tankova, Ismail H. Mitha, Milan Zdravkovic, Maria Düring, David R. Matthews
Journal: Diabetes Care (2008)

OBJECTIVE—The efficacy and safety of adding liraglutide (a glucagon-like peptide-1 receptor agonist) to metformin were compared with addition of placebo or glimepiride to metformin in subjects previously treated with oral antidiabetes (OAD) therapy. RESEARCH DESIGN AND METHODS—In this 26-week, double-blind, double-dummy, placebo- and active-controlled, parallel-group trial, 1,091 subjects were randomly assigned (2:2:2:1:2) to once-daily liraglutide (either 0.6, 1.2, or 1.8 mg/day injected subcutaneously), to placebo, or to glimepiride (4 mg once daily). All treatments were in combination therapy with metformin (1g twice daily). Enrolled subjects (aged 25–79 years) had type 2 diabetes, A1C of 7–11% (previous OAD monotherapy for ≥3 months) or 7–10% (previous OAD combination therapy for ≥3 months), and BMI ≤40 kg/m2. RESULTS—A1C values were significantly reduced in all liraglutide groups versus the placebo group (P &amp;lt; 0.0001) with mean decreases of 1.0% for 1.8 mg liraglutide, 1.2 mg liraglutide, and glimepiride and 0.7% for 0.6 mg liraglutide and an increase of 0.1% for placebo. Body weight decreased in all liraglutide groups (1.8–2.8 kg) compared with an increase in the glimepiride group (1.0 kg; P &amp;lt; 0.0001). The incidence of minor hypoglycemia with liraglutide (∼3%) was comparable to that with placebo but less than that with glimepiride (17%; P &amp;lt; 0.001). Nausea was reported by 11–19% of the liraglutide-treated subjects versus 3–4% in the placebo and glimepiride groups. The incidence of nausea declined over time. CONCLUSIONS—In subjects with type 2 diabetes, once-daily liraglutide induced similar glycemic control, reduced body weight, and lowered the occurrence of hypoglycemia compared with glimepiride, when both had background therapy of metformin.
Spatial models of imagery for remembered scenes are more likely to advance (neuro)science than symbolic ones
Authors: Neil Burgess
Journal: Behavioral and Brain Sciences (2002)

Hemispatial neglect in imagery implies a spatially organised representation. Reaction times in memory for arrays of locations from shifted viewpoints indicate processes analogous to actual bodily movement through space. Behavioral data indicate a privileged role for this process in memory. A proposed spatial mechanism makes contact with direct recordings of the representations of location and orientation in the mammalian brain.
Design of a Phase III Clinical Trial with Prospective Biomarker Validation: SWOG S0819
Authors: Mary W. Redman, John J. Crowley, Roy S. Herbst, Fred R. Hirsch, David R. Gandara
Journal: Clinical Cancer Research (2012)

Abstract The role of cetuximab in the treatment of advanced non–small cell lung cancer (NSCLC) is currently unclear. The molecular target of cetuximab, epidermal growth factor receptor (EGFR), as measured by FISH, has shown potential as a predictive biomarker for cetuximab efficacy in NSCLC. SWOG S0819 is a phase III trial evaluating both the value of cetuximab in this setting and EGFR FISH as a predictive biomarker. This work describes the decision process for determining the design and interim monitoring plan for S0819. Six possible designs were evaluated in terms of their properties and the hypotheses that can be addressed within the design constraints. A subgroup-focused, multiple-hypothesis design was selected for S0819 that incorporates coprimary endpoints to assess cetuximab in both the overall study population and among EGFR FISH-positive (FISH+) patients, with the sample size determined based on evaluation in the EGFR FISH+ group. The chosen interim monitoring plan specifies interim evaluations of both efficacy and futility in the EGFR FISH+ group alone. The futility-monitoring plan to determine early stopping in the EGFR FISH-nonpositive group is based on evaluation within the positive group, the entire study population, and the nonpositive group. SWOG S0819 uses a design that addresses both the biomarker-driven and general-efficacy objectives of this study. Clin Cancer Res; 18(15); 4004–12. ©2012 AACR.
Missed Diagnoses of Acute Coronary Syndromes in the Emergency Room — Continuing Challenges
Authors: Rajendra H. Mehta, Kim A. Eagle
Journal: New England Journal of Medicine (2000)

Patients with suspected acute coronary syndromes, or acute cardiac ischemia, account for nearly 1.7 million hospital admissions per year in the United States. Between 2 and 8 percent of patients with myocardial infarction are mistakenly released from the emergency department.13 In addition to the implications for patient care of the failure to diagnose acute coronary syndromes, the threat of malpractice suits is also of concern. An estimated 20 percent of the money awarded in malpractice suits against emergency department physicians is related to the misdiagnosis and mistreatment of acute coronary syndromes. Thus, it is not surprising that physicians in . . .