tbuckley/cabot-search huggingface dataset:
Double balloon endoscopy for detection of small-bowel adenomas in familial adenomatous polyposis after pancreaticoduodenectomy according to Whipple
Authors: A. Langers, W. De Vos tot Nederveen Cappel, R. Veenendaal, B. Bonsing, J. Hardwick, H. Vasen
Journal: Endoscopy (2008)

Patients with familial adenomatous polyposis (FAP) have a 5%-10% lifetime risk of developing duodenal cancer. In severe duodenal polyposis, pancreaticoduodenectomy according to Whipple has been considered the only way to cure duodenal polyposis. However, polyps recur even after surgery. We describe a patient with severe adenomatosis of the small bowel in the afferent loop of a Roux-en-Y anastomosis after a Whipple procedure, detected by double balloon endoscopy (DBE). This is the first description of the use of DBE for this indication, and emphasizes the need for surveillance of the small bowel after surgery, especially in the area of the biliary anastomosis.
A memorable patient: An expensive lesson
Authors: W. S Haubrich
Journal: BMJ (2001)

In the year 1947 I was in my final year as a medical student, serving a clinical clerkship at our university hospital. One of my duties was to interview and examine patients newly admitted to the indigent medical ward. As a senior student, I thought I knew nearly all I needed to know. Then came a patient who taught me a lesson.

He was an elderly man with thinning white hair and a ruddy complexion. He did not seem ill and was in no apparent distress. He smiled pleasantly when I introduced myself. I asked what problem had brought him to the hospital. His reply was unexpected. “I'm fine,” he assured me. His speech was somewhat slurred and raspy. I noticed a slight tremor …
Measurement of serum levels of eosinophil cationic protein to monitor patients with seasonal respiratory allergy induced by <i>Parietaria</i> pollen (treated and untreated with specific immunotherapy)
Authors: G. D'Amato, G. Liccardi, M. Russo, M. Saggese, M. D'Amato
Journal: Allergy (1996)

This trial studied the behavior of a marker of eosinophilic inflammation, eosinophil cationic protein (ECP), in the peripheral blood of two groups of subjects with seasonal allergic respiratory symptoms (rhinitis and mild bronchial asthma) induced by pollen allergens of Parietaria, judaica ( P.j .) (one group treated and another untreated with specific immunotherapy [SIT]), to determine what contribution these serial measurements might provide, in comparison with various other tools now available for pollinosis monitoring. In a previously randomized order, we selected 25 patients with monosensitization to P.j . pollen allergens; among them, 12 had started SIT with a P.j . extract in autumn 1993. As a control group, 13 patients were untreated. All patients were studied with various tests at four different times: time I ‐ November 1993; time II ‐ February 1994; time III ‐ end of May 1994; and time IV ‐ September 1994. Blood samples for determination of serum ECP were collected at each time. Methacholine challenge tests were performed at times I and III. A pollen count was also carried out. A statistically significant difference (P&lt;0.05) was observed in mean ECP levels at times I and 111 in SIT treated and untreated patients. The interaction between groups and time was not significant. No statistically significant difference was found between PD 20 FEV 1 values at times I and III in either group. After 1 year of treatment, we did not find any effect of SIT on bronchial hyperresponsiveness or on ECP serum values.
Metabolic Effects of Repeated Weight Loss and Regain in Adolescent Wrestlers
Authors: Suzanne Nelson Steen
Journal: JAMA (1988)

This study examined resting metabolic rate in adolescent wrestlers to test the hypothesis that repeated cycles of weight loss and regain would be associated with reduced energy requirements. Energy restriction lowers resting metabolic rate in normal-weight and obese persons. Repeated cycles of weight loss and regain can increase food efficiency, defined as the degree of weight change per unit of food intake, in animals. Many wrestlers lose weight repeatedly as they "cut weight" for matches. This cycle of weight loss and regain may affect their resting metabolism. Twenty-seven wrestlers were classified as cyclers or noncyclers based on their weight loss history. Resting metabolic rate was measured using indirect calorimetry and body composition was evaluated using six skinfolds. Cyclers and noncyclers did not differ in age, weight, height, surface area, lean body mass, or percent body fat. Cyclers had a significantly lower mean resting metabolic rate than noncyclers (154.6 vs 177.2 kJ/m<sup>2</sup>/h) (4.6 vs 5.5 kJ per kilogram of lean body mass per hour). There was a 14% difference between the cyclers and the noncyclers in resting energy expenditure (6631.8 vs 7702.8 kJ/d). Weight cycling in wrestlers appears to be associated with a lowered resting metabolic rate. (<i>JAMA</i>1988;260:47-50)
Role of medical factors in 1000 fatal aviation accidents: case note study
Authors: S A Cullen, H C Drysdale, R W Mayes
Journal: BMJ (1997)

Objective: To study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus.Design: Population based study of diabetic twins.Setting: Danish population.Subjects: 18 monozygotic and 36 dizygotic twin pairs with one or both partners having insulin dependent diabetes.Main outcome measures: Presence of islet cell antibodies, insulin autoantibodies, and autoantibodies to glutamic acid decarboxylase (GAD65) in serum samples from twin pairs 10 years (range 0-30 years) and 9.5 years (2-30 years) after onset of disease.Results: In those with diabetes the prevalence of islet cell antibodies, insulin autoantibodies, and autoantibodies to glutamic acid decarboxylase in the 26 monozygotic twins was 38%, 85%, and 92%, respectively, and in the dizygotic twins was 57%, 70%, and 57%, respectively.In those without diabetes the proportions were 20%, 50%, and 40% in the 10 monozygotic twins and 26%, 49%, and 40% in the 35 dizygotic twins. Conclusion:There is no difference between the prevalence of islet cell autoantibodies in dizygotic and monozygotic twins without diabetes, suggesting that islet cell autoimmunity is environmentally rather than genetically determined.Furthermore, the prevalence of islet cell antibodies was higher in the non-diabetic twins than in other first degree relatives of patients with insulin dependent diabetes.This implies that the prenatal or early postnatal period during which twins are exposed to the same environment, in contrast with that experienced by first degree relatives, is of aetiological importance.
Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group
Authors: R. Jaeschke
Journal: JAMA (1994)

<h3>CLINICAL SCENARIO</h3> You are a medical consultant asked by a surgical colleague to see a 78-year-old woman, now 10 days after abdominal surgery, who has become increasingly short of breath over the last 24 hours. She has also been experiencing what she describes as chest discomfort, which is sometimes made worse by taking a deep breath (but sometimes not). Abnormal findings on physical examination are restricted to residual tenderness in the abdomen and scattered crackles at both lung bases. Chest roentgenogram reveals a small right pleural effusion, but this is the first roentgenogram since the operation. Arterial blood gases show a Po<sub>2</sub>of 70 mm Hg, with a saturation of 92%. The electrocardiogram shows only nonspecific changes. You suspect that the patient, despite receiving 5000 U of heparin twice a day,
Incidence, Source, Determinants, and Prognostic Impact of Major Bleeding in Outpatients With Stable Coronary Artery Disease
Authors: Martial Hamon, Gilles Lemesle, Olivier Tricot, Thibaud Meurice, Michel Deneve, Xavier Dujardin, Jean Michel Brufau, Jerome Bera, Nicolas Lamblin, Christophe Bauters
Journal: Journal of the American College of Cardiology (2014)
Prevention of Thrombosis in Ambulatory Patients With Cancer
Authors: Punam Rana, Mark N. Levine
Journal: Journal of Clinical Oncology (2009)

Cancer patients with solid tumors or hematologic malignancies receive most of their cancer treatment as outpatients. Thromboembolism, when it occurs, complicates the clinical care of these patients because of the associated morbidity and the need for anticoagulant treatment. It would seem that prevention of venous thromboembolism in these patients would be worthwhile. However, to date there are relatively few trials of anticoagulant prophylaxis in ambulatory patients with cancer and it is not possible to recommend prophylaxis for most patients. Research is needed to better define a population at high enough risk to warrant pharmacologic prophylaxis and to develop new antithrombotic agents for this indication.
Effects of the Gap Junction Modifier Rotigaptide (ZP123) on Atrial Conduction and Vulnerability to Atrial Fibrillation
Authors: Jose M. Guerra, Thomas H. Everett, Ken W. Lee, Emily Wilson, Jeffrey E. Olgin
Journal: Circulation (2006)

Altered conduction is associated with increased atrial fibrillation (AF) vulnerability in canine models of chronic mitral regurgitation (MR) and heart failure (HF). Rotigaptide (ZP123) augments gap junction conductance, improving cell-to-cell coupling. We studied the effects of rotigaptide on atrial conduction and AF vulnerability in the canine MR and HF models.Twenty-one dogs in 3 groups were studied: control (n=7), chronic MR induced by mitral avulsion (n=7), and HF induced by ventricular tachypacing (n=7). Epicardial mapping of both atria was performed with a 512-electrode array at baseline and at increasing rotigaptide doses (10, 50, and 200 nmol/L). Conduction velocity increased in both atria in control animals and MR animals (maximum percentage increase: 24+/-5%, 38+/-6% [P<0.001, <0.001] in the left atrium and 19+/-9%, 18+/-3% [P<0.001, <0.001] in the right atrium). Conduction velocity did not change in the left atrium of the HF group and increased minimally in the right atrium (3+/-3%, 17+/-5% [P=NS, P=0.001]). AF duration was increased at baseline in MR and HF animals (control: 16+/-25 seconds, MR: 786+/-764 seconds, HF: 883+/-684 seconds; P=0.013). At 50 nmol/L of rotigaptide, duration of AF markedly decreased in the MR animals (96% reduction, P<0.001), reducing AF duration to that of control animals (control: 9+/-11 seconds, MR: 14+/-16 seconds, HF: 1622+/-355 seconds; P=0.04).Gap junction modulation with rotigaptide reduces AF vulnerability in a canine MR model of AF to a level similar to control animals but does not affect AF vulnerability in the canine HF model. This may be a novel therapeutic target in some forms of AF.
Pathologists Request Autopsy Revival
Authors: Charles Marwick
Journal: JAMA (1995)

TO LOOK AT the data, the practice of autopsy is a dying procedure. Thirty years ago around 50% of hospital deaths were autopsied. Since then there has been a steady decline, so that today in teaching hospitals only 10% to 20% of deaths are autopsied. In community hospitals, the rate is probably below 5%— and the trend continues downward. "American health care policymakers have relegated the role of autopsy to the back burner of health care reform," said Paul Raslavicus, MD, secretary-treasurer of the College of American Pathologists. The situation worries those who think the autopsy is a valuable tool for the improvement of medical care. "Medicine needs the autopsy. It is the one place where truth can be sought, found, and told without conflicts of interest," said George D. Lundberg, MD, editor-in-chief of the<i>Journal of the American Medical Association</i>. Raslavicus and Lundberg were among the speakers at a
THE DIAGNOSIS OF INTRACRANIAL COMPLICATIONS OF STJPPURATIVE EAR DISEASE.
Authors: JOHN F. BARNHILL
Journal: JAMA (1905)

deformity.He is thoroughly convinced that many of the un- successful cases have not been reported.As soon as a paraffin is obtained that will not cause complications there will be an ideal condition both from a pathologic 'standpoint and from that of cosmetic effect.
Persistent neutropenia in chronic myelogenous leukemia in chronic phase treated with imatinib mesylate
Authors: Yu‐Yan Hwang, Eric Tse, Jason C.C. So, Thomas S.K. Wan, Yok‐Lam Kwong
Journal: American Journal of Hematology (2009)

A physician or a group of physicians considers presentation and evolution of a real clinical case, reacting to clinical information and data (boldface type).This is followed by a discussion/commentary.
The Finger-nails in Chronic Hypoalbuminaemia
Authors: R. C. Muehrcke
Journal: BMJ (1956)

biopsy showed amyloid disease.During three weeks in May, 1954, he received intravenously a total of 750 g. of albumin.This resulted in a diuresis with a 16 lb.(7.26 kg.) weight loss and a transitory rise in the serum albumin.Three months later oedema reappeared and the serum albumin was
Induction of labour.
Authors: J Clinch
Journal: BMJ (1979)

was about two-and-a-half times as large as the corresponding US study from the National Institute of Child Health and Development7 8 and at least as much care was taken to avoid biased assessments as in that study; there were no matched controls in the Canadian study.9It would thus not be surprising if the MRC study proved to be a more sensitive indicator of the possible risks of amniocentesis than either of the other two.The findings, which differ in several respects from those of the US study, certainly deserve more careful consideration than this premature and sweeping dismissal from the United States accorded them.
Physiological and Medical Aspects of the Himalayan Scientific and Mountaineering Expedition
Authors: L. G. C. E. Pugh
Journal: BMJ (1962)

The Himalayan Scientific and Mountaineering Expedi- tion of 1960-61, led by Sir Edmund Hillary, set out from Katmandu on September 14, 1960, and returned in June, 1961, having spent eight months above 15,000 ft.(4,570 m.).It was the first expedition to winter in the Himalayas at high altitude and the first to spend more than six weeks at or above 19,000 ft.(5,790 m.).To do this a much higher standard of protection from the weather was necessary than is usual on climbing expedi- tions, and a prefabricated hut was taken out to the Himalayas in sections.The hut was set up at the head of the Ming Bo glacier at an altitude of 19,000 ft.(5,790 m.) (barometric pressure 380 mm.Hg) and occupied continuously for five and a half months.There was also a staging camp at 18,000 ft.(5,480 m.) and a tented base camp at 15,100 ft.(4,600 m.).In May, 1961, the expedition moved over to Mt. Makalu (27,790 ft.; 8,470 m.) for an attempted ascent of the mountain without oxygen equipment.Oxygen equipment was, however, provided for medical and rescue purposes. Scientific ObjectivesThe scientific programme consisted of physiology, zoology, glaciology, and meteorology.The main emphasis was on physiology, as is evident from the composition of the scientific team.The objectives in this field were to fill in certain gaps in our knowledge of man's adaptation to extreme altitude, and to study some of the effects of oxygen lack on men living at or above the limit of altitude at which complete acclimatization is possible.The composition of the wintering party with whose work this communication is chiefly concerned is given below.Other scientists were with the expedition for shorter periods, mainly in the first three months.
WHO hits out over reports on links with food industry
Authors: A. Gulland
Journal: BMJ (2012)

The World Health Organization has attempted to distance itself from the actions of one of its regional offices, which has been found to have taken money from the food industry.

A report by the news agency Reuters last month found that WHO’s regional office the Pan American Health Organization (PAHO) was taking money from large multinational food companies.1 The investigation found that PAHO had taken $50 000 (£31 000; €39 000) from Coca-Cola, $150 000 from Nestle, and $150 000 from Unilever, which owns the Walls ice cream brand.

In a lengthy rebuttal Margaret Chan, WHO’s director general, said that the Reuters report and follow-up articles were “creating misinformation and confusion …
The Influence of Immunity on Raw Milk— Associated Campylobacter Infection
Authors: Martin J. Blaser, Elizabeth Sazie, L. Paul Williams
Journal: JAMA (1987)

After a retreat to an Oregon farm, 19 of 31 college students developed an acute gastrointestinal illness. Campylobacter jejuni infection was recognized in all the ill students and caused asymptomatic infections in three others. In total, 22 (88%) of 25 students who consumed raw milk for the first time became infected as compared with none of two who had not consumed raw milk. Among ten persons who chronically consumed raw milk, none was ill, a striking difference from the 76% attack rate among the 25 acutely exposed students. The quantity of raw milk consumed was directly related to the occurrence and severity of illness. Acutely infected students showed significant rises in C jejuni-specific immunoglobulins, whereas the low antibody levels seen in unexposed persons did not rise. In contrast, acute-phase serum samples from persons with chronic exposure to raw milk showed elevated antibody levels to C jejuni. These findings indicate that chronic raw milk consumption is associated with elevated levels of C jejuni-specific serum antibodies and with immunity to symptomatic infection.
Converting Tumor-specific Markers Into Reporters of Oncolytic Virus Infection
Authors: Ianko D Iankov, Matthew L Hillestad, Allan B Dietz, Stephen J Russell, Evanthia Galanis
Journal: Molecular Therapy (2009)

Preferential killing of transformed cells, while keeping normal cells and organs unharmed, is the main goal of cancer gene therapy. Genetically engineered trackable markers and imaging reporters enable noninvasive monitoring of transduction efficiency and pharmacokinetics of anticancer virotherapeutics. However, none of these reporters can differentiate between infection in the targeted tumors and that in the normal tissue. Thus, we constructed oncolytic measles virus (MV) armed with a human light immunoglobulin chain reporter gene for the treatment of multiple myeloma (MM). Excessive production of monoclonal immunoglobulin is a key characteristic and marker for diagnostics of MM. Once expressed in infected target cells, vector-encoded lambda protein recombines with myeloma IgG-kappa immunoglobulin creating a unique IgG-kappa/lambda. A modified immunoassay technique allows precise quantification of converted marker molecules. Only antibody producing cells were able to assemble this chimeric immunoglobulin molecule, whereas other cells secreted only free lambda light chain. Human myeloma xenografts inoculated with lambda chain expressing MV secreted converted IgG-kappa/lambda in the plasma of tumor bearing animals and elevated reporter levels correlated with response to the therapy. This is the first report of a gene therapy vector engineered to discriminate between infection in malignant and normal cells by molecular modification of a tumor-specific protein.
Sebum Excretion in Acromegaly
Authors: J. L. Burton, L. J. Libman, W. J. Cunliffe, R. Wilkinson, R. Hall, S. Shuster
Journal: BMJ (1972)

The sebum excretion rate (S.E.R.) was measured in 20 patients with acromegaly. Eleven were untreated at the time of the measurement and nine had previously undergone surgical hypophysectomy or had received pituitary irradiation by yttrium-90 or radiotherapy. In five patients the S.E.R. was measured before and after such treatment. The mean S.E.R. in the untreated acromegalics was much greater than in a normal population and decreased significantly after successful pituitary ablation. No significant decrease in mean S.E.R. occurred in the group of patients with a poor clinical response to ablation. The correlations between S.E.R. and log serum growth hormone, plasma 11-hydroxycorticosteroid levels, and heel-pad thickness were significant, but there was no significant correlation between S.E.R. and serum protein-bound iodine levels. This suggests that the changes in S.E.R. were due to pituitary ablation but could not necessarily be attributed solely to changes in growth hormone, thyroid-stimulating hormone, or adrenocorticotrophic hormone. The association between the clinical state of the acromegaly and the S.E.R. was better than the association between acromegaly and serum growth hormone. We conclude that the S.E.R. is a useful addition to the clinical and endocrinological data used in assessing acromegaly.
The Community-Hospital Library
Authors: Dorothy Dralle
Journal: JAMA (1965)

The hospital library has been described as the "forgotten stepchild of the hospital." The average medical-society library, according to a recent survey, does not fare much better. Still, for physicians who cannot afford extensive and expensive private libraries, these neglected collections are apt to be the crucial link in the chain of medical information. The Joint Committee on Accreditation of Hospitals is not specific in its requirements: The hospital must maintain a medical library according to the needs of the hospital. Facilities should be provided to meet the requirements of the services in the hospital. Basic textbooks and current periodicals should be available and catalogued according to the needs of the hospital. Personnel should be provided to assure efficient service to the medical staff.<sup>1</sup> What constitutes "efficient service to the medical staff" depends on many factors. The physical size of the library must vary with the