tbuckley/cabot-search huggingface dataset:
Endoscopic Management of Pancreatic Pseudocyst: A Long-Term Follow-Up
Authors: S. Sharma, N. Bhargawa, A. Govil
Journal: Endoscopy (2002)

No studies with real long-term follow-up after endoscopic drainage of pancreatic pseudocysts are available. The present study was undertaken to investigate the long-term outcome of endoscopic management of pancreatic pseudocyst with a minimum follow-up of 2 years.A total of 38 consecutive patients with pancreatic pseudocyst underwent endoscopic cystogastrostomy (n = 27), endoscopic cystoduodenostomy (n = 6) and transpapillary drainage (n = 5). Patients were monitored at 1 and 3 months after drainage, and finally between 24 and 80 months. Upper gastrointestinal endoscopy was done at 1 and 3 months after drainage while ultrasound was done at 3 months and at the end of follow-up. Endoscopic retrograde cholangiopancreatography (ERCP) was only done before cyst drainage if no cyst bulge was visible in the stomach or duodenum or if obstructive jaundice was present.Biliary pancreatitis was responsible for the pseudocyst in 19 cases while the remaining occurrences were caused by alcohol (n = 12) and trauma (n = 7). All forms of endoscopic drainage were effective in treating pancreatic pseudocyst and there was complete disappearance of the cyst within 3 months of drainage, irrespective of cause. Over a mean follow-up of 44.23 months (24 - 80 months). Three patients had symptomatic recurrences while three had asymptomatic recurrences; all had alcohol-induced pancreatitis. No recurrences were seen in the biliary pancreatitis and trauma group. All symptomatic recurrences were successfully managed with endoscopic cystogastrostomy and stenting. A massive bleed in one patient required surgery while stent block and cyst infection in three patients and perforation in one patient were managed conservatively. ERCP was done before cyst drainage in eight patients because there was no visible bulge into the stomach or duodenum (n = 5), or because obstructive jaundice was present (n = 3). In five patients ERCP revealed cyst duct communication. All these patients were managed by transpapillary drainage and there was only one asymptomatic recurrence in this group.Endoscopic management of pancreatic pseudocyst is quite an effective and safe mode of treatment in experienced hands. ERCP before the procedure is only required when the cyst does not bulge into gut lumen, for a decision about the feasibility of transpancreatic drainage. On long-term follow-up, recurrences were seen only in the alcoholic pancreatitis group. In the biliary pancreatitis group, no recurrences were seen after cholecystectomy and removal of common bile duct (CBD) stones if present. No recurrences were seen in the trauma group.
Genetic rescue of nonclassical ERα signaling normalizes energy balance in obese Erα-null mutant mice
Authors: Cheryl J. Park, Zhen Zhao, Christine Glidewell-Kenney, Milos Lazic, Pierre Chambon, Andrée Krust, Jeffrey Weiss, Deborah J. Clegg, Andrea Dunaif, J. Larry Jameson, Jon E. Levine
Journal: Journal of Clinical Investigation (2011)

In addition to its role in reproduction, estradiol-17β is critical to the regulation of energy balance and body weight. Estrogen receptor α-null (Erα-/-) mutant mice develop an obese state characterized by decreased energy expenditure, decreased locomotion, increased adiposity, altered glucose homeostasis, and hyperleptinemia. Such features are reminiscent of the propensity of postmenopausal women to develop obesity and type 2 diabetes. The mechanisms by which ERα signaling maintains normal energy balance, however, have remained unclear. Here we used knockin mice that express mutant ERα that can only signal through the noncanonical pathway to assess the role of nonclassical ERα signaling in energy homeostasis. In these mice, we found that nonclassical ERα signaling restored metabolic parameters dysregulated in Erα-/- mutant mice to normal or near-normal values. The rescue of body weight and metabolic function by nonclassical ERα signaling was mediated by normalization of energy expenditure, including voluntary locomotor activity. These findings indicate that nonclassical ERα signaling mediates major effects of estradiol-17β on energy balance, raising the possibility that selective ERα agonists may be developed to reduce the risks of obesity and metabolic disturbances in postmenopausal women.
FIVE-MINUTE PSYCHOTHERAPY
Authors: GEORGE A. ZIRKLE
Journal: American Journal of Psychiatry (1961)

Under the conditions of this experiment, the data point to an advantage of 5-minute therapy sessions over 25-minute ones. With other types of patients and with other types of therapy the results would probably have been different. For the reported situation, however, empirical support was provided for the clinical observation that frequent short-term contacts with ward patients have real therapeutic value. Though the experimental trend is pointed, a definitive answer on the relative merits of frequent short term versus infrequent longer term psychotherapy periods must await much fuller evidence.
Educating Farmers, Physicians Who Treat Them, About Rural Life's Potential Health Hazards
Authors: Charles Marwick
Journal: JAMA (1989)

MOVES ARE AFOOT to make farm life more safe through legislation to regulate equipment, pesticides, and fertilizers and provide training in agricultural safety and health. This would be coordinated by a proposed new center within the Public Health Service. It started with conferences in Iowa City and Des Moines that resulted in formation of a National Coalition for Agricultural Safety and Health. This effort moved to Washington, DC, where coalition leaders briefed congressmen and their staffs, including Senator Tom Harkin (D, Iowa) and Representative Tom Tauke (R, Iowa). Tauke, in a joint statement with Representative Mike Synar (D, Okla), promised there would be congressional efforts to address the health care needs of rural Americans. The coalition says that every year 1600 farmers and agricultural workers are killed in accidents and an additional 170 000 are injured or become seriously ill—half of them permanently. In addition, it says, 300 children die
Prognostic efficacy of early clinical categorization of myocardial infarction patients.
Authors: M W Pozen, J K Stechmiller, G C Voigt
Journal: Circulation (1977)

To assess the prognostic validity of "low risk" classification at 24-36 hours as the basis for early transfer to an intermediate coronary care unit, Killip and Hutter/Sidel criteria for risk classicication were applied to 410 patients with acute myocardial infarction (MI) and prospectively compared with respect to mortality and morbidity. Six percent of "low risk" patients by the Killip classification subsequently died and were therefore misclassified. No patients in the group classified as "low risk" by the Hutter/Sidel criteria died; however, more than two and a half times as many potentially "low risk" patients were excluded from this group. With respect to morbidity, 35 of 87 patients (40%) classified as "low risk" by Hutter/Sidel criteria developed 43 major complications during their hospitalization. Nine of these patients developed 11 of the 43 complications (26%) on day six or later, and for five of these patients, this was their first major complication during hospitalization. This significant incidence of morbidity in "low risk" patients, despite their low mortality rates as a group, must be taken into account in developing intermediate coronary care units.
Ex Vivo Transduction and Transplantation of Bone Marrow Cells for Liver Gene Delivery of α1-Antitrypsin
Authors: Hong Li, Yuanqing Lu, Rafal P Witek, Lung-Ji Chang, Martha Campbell-Thompson, Marda Jorgensen, Bryon Petersen, Sihong Song
Journal: Molecular Therapy (2010)

Adult stem cell–based gene therapy holds several unique advantages including avoidance of germline or other undesirable cell transductions. We have previously shown that liver progenitor (oval) cells can be used as a platform for liver gene delivery of human α1-antitrypsin (hAAT). However, this cell source cannot be used in humans for autologous transplantation. In the present study, we tested the feasibility of bone marrow (BM) cell–based liver gene delivery of hAAT. In vitro studies showed that BM cells can be transduced by lentiviral vector (Lenti-CB-hAAT) and recombinant adeno-associated viral vectors (rAAV1-CB-hAAT, and rAAV8-CB-hAAT). Transplantation studies showed that transplanted BM cells homed into liver, differentiated into hepatocytes and expressed hAAT in the liver. Importantly, we showed that transplantation of rAAV8-CB-hAAT vector–transduced BM cells resulted in sustained levels of hAAT in the systemic circulation of recipient mice. These results demonstrated that rAAV vector–mediated BM cell–based liver gene therapy is feasible for the treatment of AAT deficiency and implies a novel therapy for the treatment of liver diseases. Adult stem cell–based gene therapy holds several unique advantages including avoidance of germline or other undesirable cell transductions. We have previously shown that liver progenitor (oval) cells can be used as a platform for liver gene delivery of human α1-antitrypsin (hAAT). However, this cell source cannot be used in humans for autologous transplantation. In the present study, we tested the feasibility of bone marrow (BM) cell–based liver gene delivery of hAAT. In vitro studies showed that BM cells can be transduced by lentiviral vector (Lenti-CB-hAAT) and recombinant adeno-associated viral vectors (rAAV1-CB-hAAT, and rAAV8-CB-hAAT). Transplantation studies showed that transplanted BM cells homed into liver, differentiated into hepatocytes and expressed hAAT in the liver. Importantly, we showed that transplantation of rAAV8-CB-hAAT vector–transduced BM cells resulted in sustained levels of hAAT in the systemic circulation of recipient mice. These results demonstrated that rAAV vector–mediated BM cell–based liver gene therapy is feasible for the treatment of AAT deficiency and implies a novel therapy for the treatment of liver diseases.
Evolution of paediatric-specific vasculitis classification criteria
Authors: S. Ringold, C. A. Wallace
Journal: Annals of the Rheumatic Diseases (2010)

This issue of Annals of the Rheumatic Diseases includes two articles describing the proposed paediatric-specific classification criteria for childhood polyarteritis nodosa (c-PAN), Wegener granulomatosis (c-WG), Takayasu arteritis (c-TA) and Henoch–Schonlein purpura (HSP) which resulted from an ambitious multicentre, international collaborative project that was initiated in Vienna in 2005 and culminated in the 2008 Ankara Consensus Conference ( see articles on pages 790 and 798 ).1 2

The vasculitides are a heterogeneous collection of multisystem disorders that manifest as the inflammation of blood vessels and may occur as a primary process or may be secondary to another disorder, most commonly infection. Despite this commonality, the vasculitides differ significantly in their clinical, radiographic, laboratory and histopathological features. Much of this heterogeneity arises from the different sizes of the blood vessels that are primarily affected, the involvement of arteries, veins, or both, and from the varying patterns of organ involvement, all of which have important implications for the optimal medical treatment and prognosis of the disorders. Perhaps some of the most interesting and significant variations within the vasculitides are those associated with the age of onset. For example, the prevalence of certain vasculitides varies considerably by age of onset. Kawasaki disease (KD), one of the most common paediatric vasculitides, only rarely manifests in adulthood, while other vasculitides, such as giant cell arteritis, are seen only in adulthood. Other vasculitides have different patterns of organ involvement and differing prognoses depending on age of onset, such as in HSP, for which the prevalence of arthritis and the prognosis associated with kidney involvement both vary significantly according to the age of onset.3 4

Development of classification criteria for the vasculitides has been particularly challenging given these variable disease presentations and the evolution of laboratory and radiographic techniques that have changed the way in which the …
Cardiac Alkaline and Acid Phosphatase Activity and Potassium Concentration in Dogs with Acute Myocardial Infarction
Authors: J. P. Manning, R. R. Pensinger, P. A. Fehn
Journal: Cardiovascular Research (1968)

Acid (Acp) and alkaline (Alp) phosphatase activity and potassium (K) concentration were evaluated in infarcted cardiac muscle from dogs between 2 hr and seven days following acute coronary occlusion. Acp increased during the first four days after which the enzyme decreased moderately in both the infarcted and non-infarcted areas. Alp and K were depressed to their lowest concentration at day 3 in the anoxic muscle, while a recovery period was noted from days 4–7.
Risk of Upper Gastrointestinal Bleeding With Low-Dose Acetylsalicylic Acid Alone and in Combination With Clopidogrel and Other Medications
Authors: Luis A. García Rodríguez, Kueiyu Joshua Lin, Sonia Hernández-Díaz, Saga Johansson
Journal: Circulation (2011)

This study evaluated the risk of upper gastrointestinal bleeding (UGIB) associated with use of low-dose acetylsalicylic acid (ASA) alone and in combination with other gastrotoxic medications.The Health Improvement Network UK primary care database was used to identify individuals 40 to 84 years of age with a UGIB diagnosis in 2000 to 2007 (n = 2049). An age-, sex-, and calendar year-matched control group (n = 20,000) was identified from the same source population. The relative risk (RR) of UGIB associated with use of low-dose ASA (75 to 300 mg/d), clopidogrel, and other commonly coadministered medications was estimated by multivariate logistic regression. The risk of UGIB was increased in current users of low-dose ASA (RR, 1.80; 95% confidence interval [CI], 1.59 to 2.03) or clopidogrel (RR, 1.67; 95% CI, 1.24 to 2.24) compared with nonusers. Compared with low-dose ASA monotherapy, the risk of UGIB was significantly increased when low-dose ASA was coadministered with clopidogrel (RR, 2.08; 95% CI, 1.34 to 3.21), oral anticoagulants (RR, 2.00; 95% CI, 1.15 to 3.45), low-/medium-dose nonsteroidal antiinflammatory drugs (RR, 2.63; 95% CI, 1.93 to 3.60), high-dose nonsteroidal antiinflammatory drugs (RR, 2.66; 95% CI, 1.88 to 3.76), or high-dose oral corticosteroids (RR, 4.43; 95% CI, 2.10 to 9.34); this was not apparent with coadministration of statins (RR, 0.99; 95% CI, 0.81 to 1.21) or low-dose oral corticosteroids (RR, 1.01; 95% CI, 0.58 to 1.77).Use of low-dose ASA is associated with an almost 2-fold increase in the risk of UGIB compared with nonuse. This risk is increased further in individuals taking low-dose ASA along with clopidogrel, oral anticoagulants, nonsteroidal antiinflammatory drugs, or high-dose oral corticosteroids.
Tropical Diseases in Veterans of World War II
Authors: James J. Sapero
Journal: New England Journal of Medicine (1946)

SINCE the cessation of hostilities, some ten million soldiers, sailors and marines have returned from overseas and resumed civilian life. Because a significant percentage served in areas notorious for the prevalence of tropical and exotic diseases, a serious concern quite justifiably exists regarding the possible effects on civilian public health and on civilian medical practice in general.Butler and Sapero,1 in 1945, analyzed the possibilities of new tropical diseases being introduced into the United States and stated that, during the two-year period 1943–1944, many thousands of servicemen who had acquired tropical diseases overseas had already returned and that no new . . .
The Full Waiting Room
Authors: H. Paul Johnson
Journal: JAMA (1962)

To the Editor:—  As long as the full waiting room is the criterion by which the public judges the competence of a physician, some waiting rooms will be overcrowded, while others will remain partially empty, no matter how much the number of doctors is increased. As long as there is the tendency to travel from smaller centers to centers of greater population, people will consider it their prerogative to seek service, medical as well as otherwise, in those larger centers, even though the same service is available to them in their own communities. For distance lends enchantment, and familiarity breeds contempt. To prevent this travel would mean some sort of regimentation, so abhorrent to the American tradition.  Peak loads occur in every type of service. To prevent delay in obtaining service (and people equate speed of service with competence) would mean the employment of extra personnel, who would be retained
Repeated electroconvulsive shock produces long-lasting increases in messenger RNA expression of corticotropin-releasing hormone and tyrosine hydroxylase in rat brain. Therapeutic implications.
Authors: L S Brady, A B Lynn, J R Glowa, D Q Le, M Herkenham
Journal: Journal of Clinical Investigation (1994)

Electroconvulsive shock (ECS) is a highly effective therapy for the treatment of major depression, but its mechanisms of action are not known. We report that repeated ECS in rats produces enduring changes in two clinically relevant stress-responsive brain systems: (a) the hypothalamic-pituitary-adrenal axis regulated by corticotropin-releasing hormone (CRH) in the paraventricular nucleus; and (b) the NE system in the locus coeruleus regulated by tyrosine hydroxylase (TH). CRH and TH mRNA levels in these brain regions were assessed by in situ hybridization histochemistry. A single interaural ECS elevated TH but not CRH mRNA measured 24 h later. Repeated daily treatments (3, 7, or 14) elevated both mRNAs, maximally with 7, correlating with the time course of clinical efficacy. The elevations persisted for 3 (CRH) or 8 wk (TH) after the ECS. No other therapeutic treatment is known to produce such long-lasting changes in central nervous system gene expression. The time course of events (delayed onset, long duration) implicate CRH as a principal mediator of the antidepressant effects of ECS. The locus coeruleus-NE system may be important in initiating the central nervous system response.
SUPPRESSION OF IMMUNOGLOBULIN CLASS SYNTHESIS IN MICE
Authors: Alexander R. Lawton, Richard Asofsky, Martha B. Hylton, Max D. Cooper
Journal: The Journal of Experimental Medicine (1972)

Germfree BALB/c mice have been treated from birth with intraperitoneal injections of purified goat antibodies to mouse IgM. The treated mice, and controls which had received an equivalent amount of goat gamma-globulin, were sacrificed at 8 or 13 wk of age. Compared to controls, mice given anti-micro (a) had very few germinal centers in spleen and lymph node, (b) had decreased numbers of mature plasma cells synthesizing IgM and IgG1 in spleen, and virtual absence of IgA-synthesizing plasma cells in the gut, (c) had greatly diminished numbers of B lymphocytes bearing membrane-bound immunoglobulins of the IgM, IgG1, IgG2, and IgA classes in spleen, (d) had reduced synthesis of IgM, IgG2, and IgA by in vitro spleen cultures, and (e) had significant decreases in serum levels of IgM, IgG1, IgG2, and IgA. The treated animals failed to make antibodies to ferritin after hyperimmunization, and lacked natural antibodies to sheep erythrocytes. These results indicate that cells ultimately committed to synthesis of IgG1, IgG2, and IgA immunoglobulins are derived from cells which have expressed IgM determinants at an earlier stage of differentiation. They are consistent with a proposed two-stage model for plasma cell differentiation. The first stage is antigen independent, involves sequential activation of Cmicro, Cgamma, and Calpha genes by progeny of a single stem cell, and results in the formation of B lymphocytes bearing membrane-bound recognition antibodies of each class. The second, antigen-dependent, stage results in formation of mature plasmacytes and memory cells.
Children of mothers with bulimia nervosa.
Authors: A. Stein, C. G. Fairburn
Journal: BMJ (1989)

Effect of bo-wel prcparation with Picolax in patients wit/i inflammatorc bowel disease and other colonic disorders No with No (%) reporting No ("¼o) increased abdominal severe nuisance Mean (SD) increase Diagnosis in group pain after Picolax after Picolax in No of stools/24 h Inflammatory bowel disease 55(21) 7(13) 9(16) 52 (3-6) Irritable bowel syndrome 114 43) 29 25) 29(25) 86 (3*5) Diverticulardisease 35(13) 3 (9) 7(20) 9 3(3 7) Iron deficiency with negative results otf investigations 31 1) 7(23) 0 7-3 (4-5) Other* 32 ('12) 8 (25) 3 (9) 7-2 (3 7)*Includes paticnts with colonic carcinomas, polyps, haemorrhoids, and mesenteric ischaemia.I NHS/t)epartmenlt of Hcalth and Social Sccurily Steering Group on Health Ser\vices Informationi.First report.London:
Classic Papers in Rheumatology
Authors: Robert H. Gifford
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes4 June 2002Classic Papers in RheumatologyRobert H. Gifford, MDRobert H. Gifford, MDYale University School of Medicine, New Haven, Connecticut. (Gifford)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-11-200206040-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Dieppe P, Schumacher HR Jr., Wollheim FA, eds. 452 pages. London: Martin Dunitz; 2002. $65.00. ISBN 1901865487. Order phone 800-634-7064.Field of medicine: Clinical rheumatology.Format: Hardcover book.Audience: Clinical rheumatologists, especially trainees seeking a historical basis for our current knowledge of rheumatic diseases.Purpose: To review, summarize, and critique selected key papers from the 20th century that have helped to clarify our current understanding of the clinical and laboratory features, pathogenesis, therapy, and assessment of rheumatic diseases.Content: Thirty-three distinguished experts selected 193 classic papers from the rheumatologic literature for review. Most authors were limited to fewer than 10 ... Author, Article, and Disclosure InformationAffiliations: Yale University School of Medicine, New Haven, Connecticut. (Gifford) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 June 2002Volume 136, Issue 11Page: 856KeywordsAntinuclear antibodiesArthritisClinical laboratoriesPathogenesisResearch laboratoriesRheumatologySoftware tools ePublished: 4 June 2002 Issue Published: 4 June 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...