tbuckley/cabot-search huggingface dataset:
Bedtime cimetidine maintenance treatment: optimum dose and effect on subsequent natural history of duodenal ulcer.
Authors: W J Fitzpatrick, W S Blackwood, T C Northfield
Journal: Gut (1982)

Sixty patients, whose duodenal ulcers had healed endoscopically after six weeks of treatment with cimetidine 1 g/day in divided doses, were treated with maintenance cimetidine 800 mg at bedtime for six months. Eighteen relapsed endoscopically (30%). Of the 42 still in remission, 36 then completed a six month double-blind comparison of bedtime cimetidine 400 mg and placebo. Twelve of the 19 (63%) cimetidine-treated patients and 10 of 17 (59%) placebo-treated patients relapsed within six weeks (NS). This high relapse rate on cimetidine contrasts with our earlier trial, in which the six week relapse rate was only two out of 21 (10%) on bedtime cimetidine 800 mg and 16 out of 24 (66%) on placebo (P less than 0.0005). Apart from the difference in the dose of cimetidine, both our trials used the same experimental protocol during the double-blind part of the trial. In the earlier trial, however, there was no period of pretreatment with maintenance cimetidine as in the present trial. The pattern of placebo relapse was similar in both trials. We conclude that bedtime cimetidine maintenance treatment does not alter the long-term natural history of duodenal ulcer once it has been withdrawn; and that either tolerance to cimetidine develops during long-term maintenance treatment, or that bedtime cimetidine maintenance treatment in the conventional dose of 400 mg is not as effective as 800 mg in prevention of endoscopic relapse, although it does reduce symptoms.
Chronic beryllium disease and cancer risk estimates with uncertainty for beryllium released to the air from the Rocky Flats Plant.
Authors: P D McGavran, A S Rood, J E Till
Journal: Environmental Health Perspectives (1999)

Beryllium was released into the air from routine operations and three accidental fires at the Rocky Flats Plant (RFP) in Colorado from 1958 to 1989. We evaluated environmental monitoring data and developed estimates of airborne concentrations and their uncertainties and calculated lifetime cancer risks and risks of chronic beryllium disease to hypothetical receptors. This article discusses exposure-response relationships for lung cancer and chronic beryllium disease. We assigned a distribution to cancer slope factor values based on the relative risk estimates from an occupational epidemiologic study used by the U.S. Environmental Protection Agency (EPA) to determine the slope factors. We used the regional atmospheric transport code for Hanford emission tracking atmospheric transport model for exposure calculations because it is particularly well suited for long-term annual-average dispersion estimates and it incorporates spatially varying meteorologic and environmental parameters. We accounted for model prediction uncertainty by using several multiplicative stochastic correction factors that accounted for uncertainty in the dispersion estimate, the meteorology, deposition, and plume depletion. We used Monte Carlo techniques to propagate model prediction uncertainty through to the final risk calculations. We developed nine exposure scenarios of hypothetical but typical residents of the RFP area to consider the lifestyle, time spent outdoors, location, age, and sex of people who may have been exposed. We determined geometric mean incremental lifetime cancer incidence risk estimates for beryllium inhalation for each scenario. The risk estimates were < 10(-6). Predicted air concentrations were well below the current reference concentration derived by the EPA for beryllium sensitization.
Sclerotherapy in Acute Variceal Bleeding: Technique and Results
Authors: J. Terblanche, P.C. Bornman, D. Kahn, R.E. Kirsh
Journal: Endoscopy (1986)

The current Cape Town management policy for patients with suspected acute variceal bleeding includes vasopressin infusion 0.4 units/minute, and emergency diagnostic endoscopy. Sengstaken balloon tube tamponade is reserved for patients with active variceal bleeding at the time of emergency endoscopy. Only these patients have early emergency sclerotherapy. The results of the Cape Town five-year prospective evaluation of sclerotherapy with the rigid Negus oesophagoscope using general anaesthesia are presented. We conclude that the combined use of balloon tube tamponade and sclerotherapy has markedly simplified the management of patients with variceal bleeding at our institution. The preliminary results of the 2-year analysis of our ongoing prospective randomised controlled clinical trial comparing the above technique with a new combined paravariceal and intravariceal sclerotherapy technique using a fibreoptic endoscope without anaesthesia are presented. We conclude that both techniques successfully control acute variceal bleeding in the majority of poor-risk patients, but that the rigid scope has some advantages, particularly in those few patients who rebleed at the time of injection. We currently recommend a standard portacaval shunt or a devascularisation and transection procedure for the rare failures of sclerotherapy. Controversial areas of sclerotherapy are reviewed, and a new treatment policy for acute variceal bleeding is proposed on the basis of our experience and a review of the literature.
Assessment of uterine receptivity prior to embryo transfer: a review of currently available imaging modalities
Authors: L. Turnbull
Journal: Human Reproduction Update (1995)

This article aims to review in detail the current literature concerning the efficacy of, and problems associated with, the use of ultra-sonography and magnetic resonance imaging in predicting uterine receptivity and hence the outcome of assisted conception. Although the quality of the embryo and transportation to the uterine cavity are obvious requirements for in-vitro fertilization/embryo transfer treatment, attention has recently centred on the receptivity of the endometrium to the growing blastula. High resolution ultrasonography is currently the imaging modality of choice, but measurement of endometrial thickness is only associated with successful treatment outcome if ovarian stimulation includes clomiphene citrate. However, the ultrasonographic texture of the endometrium may have a greater prognostic value for implantation. The current literature is relatively unanimous that a 'triple' layered appearance of the uterus is associated with a 23-42% pregnancy rate and that endometrium is unreceptive when iso- or hyperechoic compared with myometrium. In an attempt to improve prediction rates, new techniques including magnetic resonance (MR) imaging are being used to determine uterine receptivity. Early results from MR imaging suggest that in patients treated with standard regimen of GnRHa, followed by human gonadotrophin (HMG), neither the endometrial thickness nor the volume is related to outcome. However, the relative signal intensity of the uterine layers provides good discrimination prior to embryo transfer, between pregnant and non-pregnant groups.
Aging and the Environment: A Research Framework
Authors: Andrew M. Geller, Harold Zenick
Journal: Environmental Health Perspectives (2005)

The rapid growth in the number of older Americans has many implications for public health, including the need to better understand the risks posed to older adults by environmental exposures. Biologic capacity declines with normal aging; this may be exacerbated in individuals with pre-existing health conditions. This decline can result in compromised pharmacokinetic and pharmacodynamic responses to environmental exposures encountered in daily activities. In recognition of this issue, the U.S. Environmental Protection Agency (EPA) is developing a research agenda on the environment and older adults. The U.S. EPA proposes to apply an environmental public health paradigm to better understand the relationships between external pollution sources --> human exposures --> internal dose --> early biologic effect --> adverse health effects for older adults. The initial challenge will be using information about aging-related changes in exposure, pharmacokinetic, and pharmacodynamic factors to identify susceptible subgroups within the diverse population of older adults. These changes may interact with specific diseases of aging or medications used to treat these conditions. Constructs such as "frailty" may help to capture some of the diversity in the older adult population. Data are needed regarding a) behavior/activity patterns and exposure to the pollutants in the microenvironments of older adults; b) changes in absorption, distribution, metabolism, and excretion with aging; c) alterations in reserve capacity that alter the body's ability to compensate for the effects of environmental exposures; and d) strategies for effective communication of risk and risk reduction methods to older individuals and communities. This article summarizes the U.S. EPA's development of a framework to address and prioritize the exposure, health effects, and risk communications concerns for the U.S. EPA's evolving research program on older adults as a susceptible subpopulation.
S30 Salivary pepsin as a biomarker of airway reflux in idiopathic pulmonary fibrosis - An observational study
Authors: JM Dudziak, MG Crooks, AD Woodcock, PW Dettmar, AH Morice, SP Hart
Journal: Thorax (2013)

<h3>Introduction and Objectives</h3> Current understanding of IPF proposes repetitive pulmonary epithelial injury with aberrant healing as a principal mechanism. Gastro-oesophageal reflux (GOR) and micro-aspiration of gastric contents may cause lung injury with subsequent fibrosis, and GOR is known to be prevalent in IPF patients. We assessed the feasibility of salivary pepsin measurement in IPF patients and investigated the temporal variability and relationship between salivary pepsin and symptoms. <h3>Methods</h3> IPF patients collected saliva samples at multiple time points over the course of one day. Early morning, lunch- and dinner-time samples were analysed and compared with results from a historical control group of 100 healthy volunteers. Samples were analysed for the presence of pepsin using Peptest™ (RD Biomed Ltd). Patients were defined as pepsin positive if they had pepsin detectable in at least 1 saliva sample. The St George’s Respiratory Questionnaire (SQRQ), Hull Airways Reflux Questionnaire (HARQ), and the REFLUX questionnaire were used to assess the relationship between pepsin positivity and symptoms. <h3>Results</h3> All 21 IPF patients successfully provided saliva samples, of which 17 patients (81%) were pepsin positive compared to 36 of 100 healthy volunteers (36%), p = 0.0004. The proportion of subjects with 1, 2 and 3 positive samples during a 24 hour period were 52%, 14% and 14% respectively in IPF patients and 20%, 12% and 4% in control subjects. There was no significant difference in reflux-related quality of life or respiratory quality of life between pepsin positive and pepsin negative patients measured using the REFLUX questionnaire (mean 93.6 ± 2.6 SEM vs 97.8 ± 2.3, p = 0.47) and SGRQ (49.5 ± 3.5 vs 34 ± 11.9, p = 0.1). The HARQ score was significantly higher in pepsin positive patients (23.8 ± 3.3 vs 7.5 ± 3.3, p = 0.03). <h3>Conclusion</h3> Salivary pepsin measurement is simple, convenient and acceptable to patients. Our results confirm an increased prevalence of positive salivary pepsin in IPF patients compared to healthy volunteers but demonstrate a marked temporal variability. Therefore, more than one sample or repeated sample collection is required for optimal sensitivity.
A Jewish Physician's Harvest
Authors: ASHER J. FINKEL
Journal: JAMA (1980)

This volume is a gathering of essays and lectures published during a span of 44 years (1932 to 1976) in a variety of medical and other journals. Various chapters deal with geriatrics, psychiatry, and with the historical role of Jews in medicine in light of Jewish traditions. These often charming essays are the work of a devoted physician whose love of Jewish learning and lore are everywhere manifest, although the writing is somewhat marred by an infelicity of style. The book will be of special interest to those who would like to gain some insight into the favored role of medicine in Jewish life and tradition.
Clinical Pathology of Pancreatic Disorders
Authors: EMYR W BENBOW
Journal: Gut (1997)

Clinical Pathology of Pancreatic Disorders . Edited by J A Lott. (Pp 218; $99.50.) Totowa, New Jersey: The Humana Press, 1997. ISBN 0-896-03475-5.

Pathologists think themselves very good at classifying things, but they’re not even good at classifying themselves. In the United Kingdom, “pathologist” sometimes means histopathologists only, and sometimes bacteriologists, chemical pathologists and haematologists, too. As a histopathologist, I think that what I do is very clinical, but in many parts of the world, I’d be labelled an “anatomic pathologist”, a “morbid anatomist”, or even both, to distinguish me from “clinical” pathologists. I rather like to label the latter …
Steady-State Cardiac Output Determination During Combined Right and Left Heart Catheterization
Authors: PHILIP SAMET, WILLIAM H. BERNSTEIN, ROBERT S. LITWAK, H. TURKEN, LEONARD SILVERMAN
Journal: Circulation (1958)

Interpretation of the meaning of a mean diastolic atrioventricular gradient or a mean systolic ventricular-great vessel gradient requires simultaneous determination of the level of the gradient, the heart rate, and the cardiac output. The feasibility of steady-state Fick principle cardiac output determination during combined right and left heart catheterization is investigated.
Effect of Trastuzumab and Chemotherapy on Circulating Tumor Cells in Patients with Poor Prognosis Metastatic Breast Cancer.
Authors: U. De Giorgi, U. De Giorgi, M. Mego, N. Ueno, B. Handy, S. Jackson, J. Reuben, V. Valero, M. Cristofanilli
Journal: Cancer Research (2009)

Abstract Background. Trastuzumab has significant activity in HER2 neu amplified metastatic breast cancer (MBC). We hypothesized that it may selectively act against circulating tumor cells (CTC) in HER2-positiveMBC. We assessed the effect of trastuzumab-based regimens on CTC in HER2-positive MBC with poor prognosis (≥ 5 CTC).Patients and Methods. We retrospectively evaluated patients with poor prognosis MBC (baseline ≥ 5 CTC) treated with a first-line regimen consisting of trastuzumab+antimitotic agents in 11 HER2-positive patients not previously pretreated with trastuzumab, chemotherapy with antimitotic agents in 24 HER2-normal patients, and other chemotherapeutic drugs (mainly capecitabine) in other 16 HER2-normal patients. CTC were detected and enumerated using the CellSearch system (Veridex LLC, Warren NJ, USA). We evaluated the effect on CTC counts and on progression-free survival (PFS) and overall survival (OS).Results. At a median follow-up of 16 months (range, 4 to 48), 24 patients (47%) died. All 11 HER2-positive patients treated with trastuzumab+antimitotic agents had &amp;lt;5 CTC during the treatment. Only 16 (67%) with HER2-normal MBC had &amp;lt;5 CTC with antimitotic agents (p = 0.037), and 28 (70%) with other chemotherapeutic regimens (p = 0.048). No statistically significant difference was observed between patients treated with antimitotic agents and those treated with other chemotherapeutic agents (p = 0.73). There was no difference between patients receiving polychemotherapy and monochemotherapy (p = 0.73). The median PFS was 12 months in HER2-positive patients treated with trastuzumab+antimitotic agents compared with 7 months for those with HER2-normal (p = 0.09). The median OS was not reached (&amp;gt;20 months) and 19 months (p = 0.034), respectively. The median PFS was 8 months in HER2-normal patients with ≥5 CTC and 4 months in those with &amp;lt;5 CTC (p = 0.01). The median OS was not reached (&amp;gt;17 months) and 9 months (p = 0.01), respectively.Conclusions. Trastuzumab is highly effective in patients with HER2-positive MBC with poor prognosis (≥ 5 CTC). Antimitotic agents and other chemotherapy agents did not show a similar effect in HER2-normal MBC. CTC might be useful in the monitoring of poor prognosis MBC patients undergoing therapy with trastuzumab. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3014.
Pesticide use and adult-onset asthma among male farmers in the Agricultural Health Study
Authors: J. A. Hoppin, D. M. Umbach, S. J. London, P. K. Henneberger, G. J. Kullman, J. Coble, M. C. R. Alavanja, L. E. Beane Freeman, D. P. Sandler
Journal: European Respiratory Journal (2009)

Although specific pesticides have been associated with wheeze in farmers, little is known about pesticides and asthma. Data from 19,704 male farmers in the Agricultural Health Study were used to evaluate lifetime use of 48 pesticides and prevalent adult-onset asthma, defined as doctor-diagnosed asthma after the age of 20 yrs. Asthma cases were categorised as allergic (n = 127) and nonallergic (n = 314) based on their history of eczema or hay fever. Polytomous logistic regression, controlling for age, state, smoking and body mass, was used to assess pesticide associations. High pesticide exposure events were associated with a doubling of both allergic and nonallergic asthma. For ever-use, 12 individual pesticides were associated with allergic asthma and four with nonallergic asthma. For allergic asthma, coumaphos (OR 2.34; 95% CI 1.49–3.70), heptachlor (OR 2.01; 95% CI 1.30–3.11), parathion (OR 2.05; 95% CI 1.21–3.46), 80/20 mix (carbon tetrachloride/carbon disulfide) (OR 2.15; 95% CI 1.23–3.76) and ethylene dibromide (OR 2.07; 95% CI 1.02–4.20) all showed ORs of &gt;2.0 and significant exposure–response trends. For nonallergic asthma, DDT (dichlorodiphenyltrichloroethane) showed the strongest association (OR 1.41; 95% CI 1.09–1.84), but with little evidence of increasing asthma with increasing use. Current animal handling and farm activities did not confound these results. There was little evidence that allergy alone was driving these associations. In conclusion, pesticides may be an overlooked contributor to asthma risk among farmers.
Abstract 1391: SOX2-p63 interaction and genomic co-localization in squamous cell carcinomas
Authors: Hideo Watanabe, Qiuping Ma, Shouyong Peng, Guillaume Adelmant, Danielle Swain, Wenyu Song, Cameron Fox, Joshua M. Francis, Chandra Sekhar Pedamallu, David S. Deluca, Angela N. Brooks, Jianwen Que, Anil K. Rustgi, Kwok-kin Wong, Keith L. Ligon, X. Shirley Liu, Jarrod A. Marto, Matthew Meyerson, Adam J. Bass
Journal: Cancer Research (2014)

Abstract SOX2 is a transcription factor essential for pluripotent stem cells and the development and maintenance of squamous epithelium. We previously reported SOX2 to be an oncogene subject to highly recurrent genomic amplification in squamous cell carcinomas (SCCs). Here, we aim to further characterize SOX2's function in SCC. We demonstrate that SOX2 binds to distinct genomic loci in SCCs than in embryonic stem (ES) cells through comparative ChIP-seq analysis. Through mass-spectrometric analysis following tandem-affinity immunopurification in SCCs we identify SOX2 interacts with another master squamous transcription factor, p63, instead of its partner in ES cells, OCT4. We find that genomic occupancy of SOX2 in SCC overlaps with that of p63 at a large number of loci and this SOX2-p63 coordinate binding is absent in ES cells. We further demonstrate that SOX2 and p63 jointly regulate gene expression, including the oncogene ETV4, which we find essential for SOX2-amplified SCC cell survival. Together, these findings demonstrate that SOX2's actions in SCC differ substantially from its role in pluripotency. The identification of novel SOX2-p63 interaction enables deeper characterization of SOX2's function in SCC and normal squamous epithelial physiology. Citation Format: Hideo Watanabe, Qiuping Ma, Shouyong Peng, Guillaume Adelmant, Danielle Swain, Wenyu Song, Cameron Fox, Joshua M. Francis, Chandra Sekhar Pedamallu, David S. Deluca, Angela N. Brooks, Jianwen Que, Anil K. Rustgi, Kwok-kin Wong, Keith L. Ligon, X. Shirley Liu, Jarrod A. Marto, Matthew Meyerson, Adam J. Bass. SOX2-p63 interaction and genomic co-localization in squamous cell carcinomas. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1391. doi:10.1158/1538-7445.AM2014-1391
GP consortiums must learn from US experience, says expert
Authors: N. Hawkes
Journal: BMJ (2011)

GP led commissioning in England could lead to financial crisis for many consortiums if US experience is ignored, an American expert advises.

Lawrence Casalino says in a report for the healthcare policy think tank the Nuffield Trust that, of 1500 doctor led networks and groups set up in the United States, only a 10th proved successful at managing the financial risks of commissioning.

Many failed, and some went bankrupt, for a mixture of reasons. These included too little focus on the management and infrastructure needed to handle the financial risk; a lack of clinical leadership; resentment among patients that family doctors were acting as gatekeepers to care; an inability to stand up to the tough negotiating stance adopted by hospitals and specialists; and shrinking budgets imposed by insurers.

The US networks, called independent practitioner associations (IPAs), are the closest international parallel to the …
CASE OF FOREIGN BODY IN THE RECTUM
Authors: Frank M. Conlin
Journal: JAMA (1913)

On the morning of Aug. 11, 1913, I was called by the proprietor of a hotel to see one of his employees, a dishwasher, who, he said, had been sick since the day before. The patient, a Dane, aged 68, stated that he had fallen on a cup about two weeks before and cut himself. He complained of severe pain in the left iliac and hypogastric region. He gave no history of vomiting, but stated that his bowels had moved the day before and that he had urinated that morning. His temperature was 99 and his pulse 80. There was blood on the bed. Examination showed a mass in the left iliac region. I took him to the hospital, and on further examination found blood coming from the rectum, and a deep laceration through the mucous membrane and the sphincter muscle in its posterior aspect. Examination under anesthesia disclosed a
Oscillatory Flow Impedance in Electrical Analog of Arterial System:
Authors: GERARD N. JAGER, NICO WESTERHOF, ABRAHAM NOORDERGRAAF
Journal: Circulation Research (1965)

In the analog computer for the human systemic circulatory system, the electrical equivalents of a segment of artery as designed up till now are not satisfactory, because they lack representation of the sleeve effect, which results from the interaction between viscous and inertial forces during pulsatile blood flow. First, a network which accounts for this effect was derived, starting out from entirely different equations. It was surprising to find that this does not alter the circuit completely, but only requires adding to the former circuit a corrective network which, however, may have considerable influence. Second, the effect of the anomalous viscosity of blood was taken into account. Its influence on oscillatory flow has been investigated by Taylor, who derived an expression for the relation between pressure-gradient and flow under the assumption that there exists a small boundary layer of lower viscosity at the wall, and found a similar formula for the case in which the blood is assumed to slip at the wall. The modifications of the electrical circuit, necessary to represent these conditions, are given in this paper and turn out to be remarkably simple.