tbuckley/cabot-search huggingface dataset:
Pathophysiological responses to meals in the Zollinger-Ellison syndrome: I. Paradoxical postprandial inhibition of gastric secretion.
Authors: J R Malagelada
Journal: Gut (1978)

The gastric acid, pepsin, and secretory volume output in response to a mixed meal were measured in six patients with Zollinger-Ellison syndrome caused by a gastrin-producing tumour proved subsequently at surgery. The patients were all normocalcaemic, and none had previous abdominal surgery. In four of the six patients, ingestion of the meal markedly inhibited the gastric secretory output, which decreased to below fasting levels, returning later to basal values. In two other patients, whose fasting acid output was considerably lower, the secretory output increased after the meal, but some inhibiton of gastric secretion was also apparent for variable intervals of time. The serum gastrin concentration in all patients remained essentially unchanged or increased after the meal. Two patients were restudied after successful removal of the duodenal gastrin-producing tumour, and in each the normal gastric secretory and gastrin-releasing responses were completely restored. Our studies suggest that, in patients with the Zollinger-Ellison syndrome caused by a gastrinoma, physiological regulatory mechanisms triggered by food reduce the continuous stimulation of gastric secretion caused by their tumoural hypergastrinaemia.
Intravascular Ultrasound Analysis of Infarct-Related and Non–Infarct-Related Arteries in Patients Who Presented With an Acute Myocardial Infarction
Authors: Jun-ichi Kotani, Gary S. Mintz, Marco T. Castagna, Ellen Pinnow, Chalak O. Berzingi, Anh B. Bui, Augusto D. Pichard, Lowell F. Satler, William O. Suddath, Ron Waksman, John R. Laird, Kenneth M. Kent, Neil J. Weissman
Journal: Circulation (2003)

Previous studies have reported diffuse destabilization of atherosclerotic plaques in acute myocardial infarction (AMI).We used intravascular ultrasound (IVUS) to assess 78 coronary arteries (38 infarct-related arteries [IRAs] with culprit and nonculprit lesions and 40 non-IRAs) from 38 consecutive AMI patients. IVUS analysis included qualitative and quantitative measurements of reference and lesion external elastic membrane (EEM), lumen, and plaque plus media (P&M) area. Positive remodeling was defined as lesion/mean reference EEM >1.0. Culprit lesions were identified by a combination of ECG, wall motion abnormalities (ventriculogram or echocardiogram), scintigraphic perfusion defects, and coronary angiogram. Culprit lesions contained more thrombus (23.7% versus 3.4% in nonculprit IRA plaques and 3.1% in non-IRA plaques; P=0.0011). Culprit lesions were predominantly hypoechoic (63.2% versus 37.9% of nonculprit IRA plaques and 28.1% of non-IRA plaques; P=0.0022). Culprit lesions were longer (17.5+/-10.1, 9.8+/-4.0, and 10.3+/-5.7 mm, respectively; P<0.0001), had larger EEM area (15.0+/-6.0, 11.5+/-5.7, and 12.6+/-5.6 mm2, respectively; P=0.0353) and P&M area (13.0+/-6.0, 7.5+/-3.7, 9.3+/-4.3 mm2, respectively; P<0.0001), smaller lumens (2.0+/-0.9, 4.1+/-3.1, and 3.4+/-2.5 mm2, respectively; P=0.0009), and more positive remodeling (79.4%, 59.0%, and 50.8%, respectively; P=0.0155). The frequency of plaque rupture/dissection was greater in culprit, nonculprit IRA, and non-IRA plaques in AMI patients than in a control group of chronic stable angina patients with multivessel IVUS imaging.Culprit plaques have more markers of instability (thrombus, positive remodeling, and large plaque mass); however, these markers of instability are not typically found elsewhere. This suggests that the vascular event in AMI patients is determined by local pre-event lesion morphologies.
SUICIDES AND HOMICIDES IN THEIR RELATION TO WEATHER CHANGES
Authors: C. A. Mills
Journal: American Journal of Psychiatry (1934)

1. A strong suggestion of storm effect is seen in the distribution of suicides and homicides in North American cities. The rates are not highest where industrialization is most advanced, but rather where barometric pressure and temperature changes are most frequent and severe. 2. Suicides show a definite time relationship to weather changes as high- and low-pressure centers approach and pass by. With tailing pressure and rising temperature, suicides rapidly rise. Most peaks in frequency occur at the time of a low-pressure crisis. With rising pressure and falling temperature few suicides occur. 3. Migration from the South into the more stormy North is accompanied by a marked rise in suicides among negroes. Figures are not available to show whether the same is true of the whites. Increased economic stress in the North may, of course, play a large part in this rise. 4. These findings indicate the likelihood that the wide shifts in temperature and pressure that accompany North American storms may play a considerable part in producing the mental instability of our population and the rising rate of breakdown. Much of this storm effect probably works through increasing the tempo of life and the economic competition. There probably remains, however, a distinct disturbing action of the storm changes as they affect the body directly.
Beta-blockers in patients with refractory ascites: To treat or not to treat. That is the question? But, what is the answer?
Authors: Mónica Guevara, Roberto J. Groszmann, Yasuko Iwakiri, Tamar H. Taddei
Journal: Hepatology (2012)

Abstract Background &amp; Aims: In patients with cirrhosis and refractory ascites the role of beta-blockers in the development of paracentesis-induced circulatory dysfunction (PICD) is unknown. The aim of this study was to investigate the incidence of PICD before and after discontinuation of beta- blockers in patients with cirrhosis and refractory ascites. A self control cross-over study was performed. Methods: Patients with cirrhosis and refractory ascites treated with beta-blockers were selected. Heart rate, arterial pressure, and plasma renin concentrations (PRC) were collected before, immediately after and 1 week after large-volume paracentesis associated with intravenous albumin administration. Beta-blocker therapy was progressively discontinued after complete endoscopic eradication of varices. The clinical and biological evaluation was then repeated. The presence of PICD was defined as an increase in PRC of at least 50% above baseline 1 week after paracentesis. Results: Ten patients were included (nine men, mean age 59.1 ± 10.7 years old). The MELD score was 17.7 ± 4.4 and eight patients were Child–Pugh C. When patients were given betablockers,the heart rate did not change immediately after paracentesis while mean arterial pressure significantly decreased; PICD developed in eight patients. After beta-blockers were discontinued, the heart rate significantly increased immediately after paracentesis and mean arterial pressure significantly decreased; PICD only developed in one patient; the difference in the incidence of PICD was significant when these same patients were treated with beta-blockers. Conclusions: The use of beta-blockers may be associated with a high risk of PICD in patients with cirrhosis and refractory ascites .
Pulmonary function abnormalities in type I Gaucher disease
Authors: E Kerem, D Elstein, A Abrahamov, Y Bar Ziv, I Hadas-Halpern, E Melzer, C Cahan, D Branski, A Zimran
Journal: European Respiratory Journal (1996)

The purpose of this study was to determine the prevalence of pulmonary function and radiographic abnormalities among patients with type I Gaucher's disease, and to analyse the relationship between the pulmonary involvement and genotype and clinical severity score. All patients attending the Gaucher clinic at the Shaare Zedek Medical Center, Jerusalem, Israel, during the years 1992-1993 were prospectively evaluated. Each patient had pulmonary function tests, chest radiography, clinical assessment in terms of degree of organ involvement, and genotype analysis. Of the 95 patients included in the study (mean +/- SD age 29 +/- 15 yrs), 68% had some pulmonary function abnormalities, most commonly a reduced FRC and transfer coefficient for carbon monoxide (Kco), found in 45% and in 42% of the patients respectively. Total lung capacity (TLC) was reduced in 22% of the patients and forced expiratory flows in approximately one third of the patients. Signs of airtrapping (elevated residual volume (RV) or RV/TLC) were seen in 18% of the patients. Males had a higher incidence of reduced expiratory flow than females, (forced expiratory volume in one second (FEV1) was reduced in 36% of males vs 5% of females). Chest radiographic abnormalities were found in 17% of the patients, although only 4% had severe changes. Patients with abnormal pulmonary function had a significantly higher severity score index than those with normal pulmonary function tests. There was no association between abnormal pulmonary function and genotype or age. In conclusion, abnormal pulmonary function is common among type I Gaucher patients. Pulmonary function tests show airways obstruction, with reduced expiratory flows, reduction in lung volumes and alveolar-capillary diffusion abnormality. The rate of progression and the clinical significance need to be determined.
Regulation of PTEN Expression in Intestinal Epithelial Cells by c-Jun NH2-Terminal Kinase Activation and Nuclear Factor-κB Inhibition
Authors: Qingding Wang, Yuning Zhou, Xiaofu Wang, Dai H. Chung, B. Mark Evers
Journal: Cancer Research (2007)

Abstract The tumor suppressor protein phosphatase and tensin homologue deleted on chromosome ten (PTEN) plays an important role in intestinal cell proliferation and differentiation and tumor suppression by antagonizing phosphatidylinositol 3-kinase. Despite its importance, the molecular mechanisms regulating PTEN expression are largely undefined. Here, we show that treatment of the colon cancer cell line HT29 with the differentiating agent sodium butyrate (NaBT) increased PTEN protein and mRNA expression and induced c-Jun NH2-terminal kinase (JNK) activation. Inhibition of JNK by chemical or genetic methods attenuated NaBT-induced PTEN expression. In addition, our findings showed a cross-talk between nuclear factor κB (NF-κB) and JNK with respect to PTEN regulation. Overexpression of the NF-κB superrepressor increased PTEN expression and JNK activity, whereas overexpression of the p65 NF-κB subunit reduced both basal and NaBT-mediated JNK activation and PTEN expression. Moreover, we showed that overexpression of PTEN or treatment with NaBT increased expression of the cyclin-dependent kinase inhibitor p27kip1 in HT29 cells; this induction was attenuated by inhibition of PTEN or JNK expression or overexpression of p65. Finally, we show a role for PTEN in NaBT-mediated cell death and differentiation. Our findings suggest that the JNK/PTEN and NF-κB/PTEN pathways play a critical role in normal intestinal homeostasis and colon carcinogenesis. [Cancer Res 2007;67(16):7773–81]
What fooled us in the knee may trip us up in the hip: lessons from arthroscopy
Authors: Joanne L Kemp, Kay M Crossley, Ewa M Roos, Charles Ratzlaff
Journal: British Journal of Sports Medicine (2014)

“The only good thing about repeating your mistakes is you know when to cringe.” Aleksandr Solzhenitsyn

Those old enough to remember when knee arthroscopy revolutionised treatment of the injured meniscus several decades back might be forgiven if a sense of deja vu is emerging from the hip. Hip labral tears are increasingly seen on imaging and at hip arthroscopy in people with hip and groin pain, which coincides with improved diagnostic techniques and the rapid growth of arthroscopic surgery.1 The number of hip arthroscopies have increased 1800% in the USA over the past 5–10 years,2 with dramatic increases also reported in the UK, Australia and elsewhere worldwide.

The similarities between the meniscus and labrum are striking on several fronts. The knee meniscus and acetabular labrum are comprised of fibrocartilage that has a partially innervated peripheral vascular red zone.3 …
Clinical Significance of High Mobility Group A2 in Human Gastric Cancer and Its Relationship to <i>let-7</i> MicroRNA Family
Authors: Kazuo Motoyama, Hiroshi Inoue, Yoshito Nakamura, Hiroyuki Uetake, Kenichi Sugihara, Masaki Mori
Journal: Clinical Cancer Research (2008)

Abstract Purpose: The high mobility group A2 (HMGA2) nonhistone chromosomal protein can modulate transcription by altering chromatin architecture. HMGA2 is highly expressed during embryogenesis and in various benign and malignant tumors. Recent studies report that HMGA2 is negatively regulated by the let-7 microRNA (miRNA) family. However, no studies have examined the clinical significance of HMGA2 and its relationship to the let-7 miRNA family in gastric cancer. Experimental Design: Using quantitative real-time reverse transcription–PCR, we analyzed HMGA2 expression with respect to various clinicopathologic factors in 110 patients with gastric cancer. We also did an association study comparing HMGA2 expression and let-7 miRNA family expression in gastric cancer. Results: Expression of HMGA2 in cancerous tissues was significantly higher than in noncancerous tissues (P &amp;lt; 0.05). Elevated HMGA2 expression was significantly correlated with serosal invasion (P &amp;lt; 0.05) and poor clinical prognosis (P &amp;lt; 0.05). A multivariate analysis showed that HMGA2 expression status was an independent prognostic factor (P &amp;lt; 0.05). An inverse correlation between HMGA2 and let-7a was found in gastric cancer cell lines (P = 0.08). The expressions of let-7a, let-7b, and let-7c in gastric cancer patients with low HMGA2 expression were significantly higher than those with high HMGA2 expression (P &amp;lt; 0.05). Conclusions: High expression of HMGA2 in gastric cancer correlates with tumor invasiveness and is an independent prognostic factor. Furthermore, our findings suggest that HMGA2 is negatively regulated by the let-7 miRNA family in human gastric cancer.
Non-steroidal anti-inflammatory drugs and risk of cardiovascular disease in patients with rheumatoid arthritis: a nationwide cohort study
Authors: Jesper Lindhardsen, Gunnar Hilmar Gislason, Søren Jacobsen, Ole Ahlehoff, Anne-Marie Schjerning Olsen, None Ole Rintek Madsen, Christian Torp-Pedersen, Peter Riis Hansen
Journal: Annals of the Rheumatic Diseases (2013)

OBJECTIVE: To examine the risk of major cardiovascular disease associated with non-steroidal anti-inflammatory drugs (NSAIDs) in a large 'real-world' contemporary rheumatoid arthritis (RA) cohort. METHODS: A longitudinal cohort study was conducted with use of Danish nationwide individual-level registry data on inpatient and outpatient health care provision, pharmacotherapy and income during 1997-2009. 17 320 RA patients were identified and matched with 69 280 controls (4 : 1) by age and sex. NSAID-associated risk of major cardiovascular disease defined as the combined endpoint of myocardial infarction, stroke or cardiovascular mortality was assessed in multivariable survival models. RESULTS: During follow-up (median 4.9 years) 6283 events occurred. The cardiovascular risk associated with overall NSAID use was significantly lower in RA patients than in controls (HR 1.22 (95% CI 1.09 to 1.37) vs 1.51 (1.36 to 1.66), p<0.01). The pattern of lower NSAID-associated risk in RA patients was generally found with the individual NSAIDs investigated. While use of rofecoxib (HR 1.57 (1.16 to 2.12)) and diclofenac (HR 1.35 (1.11 to 1.64)) was associated with increased cardiovascular risk in RA patients, there was no significant risk increase associated with use of other NSAIDs in these patients. CONCLUSIONS: The cardiovascular risk associated with NSAID use in RA patients was modest and significantly lower than in non-RA individuals. Moreover, only a few of the individual NSAIDs were associated with increased cardiovascular risk. NSAID use should be assessed in the individual patient based on the indication for pain relief and risk factors for adverse effects, and not automatically be avoided due to concerns of severe cardiovascular outcomes alone.
Prevalence, Metabolic Features, and Prognosis of Metabolically Healthy Obese Italian Individuals
Authors: Giliola Calori, Guido Lattuada, Lorenzo Piemonti, Maria Paola Garancini, Francesca Ragogna, Marco Villa, Salvatore Mannino, Paolo Crosignani, Emanuele Bosi, Livio Luzi, Giacomo Ruotolo, Gianluca Perseghin
Journal: Diabetes Care (2010)

OBJECTIVE Some obese individuals have normal insulin sensitivity. It is controversial whether this phenotype is associated with increased all-cause mortality risk. RESEARCH DESIGN AND METHODS Fifteen-year all-cause mortality data were obtained through the Regional Health Registry for 2,011 of 2,074 Caucasian middle-aged individuals of the Cremona Study, a population study on the prevalence of diabetes in Italy. Individuals were divided in four categories according to BMI (nonobese: &amp;lt;30 kg/m2; obese: ≥30 kg/m2) and estimated insulin resistance (insulin sensitive: homeostasis model assessment of insulin resistance &amp;lt;2.5; insulin resistant ≥2.5). RESULTS Obese insulin-sensitive subjects represented 11% (95% CI 8.1–14.5) of the obese population. This phenotype had similar BMI but lower waist circumference, blood pressure, fasting glucose, triglycerides, and fibrinogen and higher HDL cholesterol than obese insulin-resistant subjects. In the 15-year follow-up, 495 deaths (cardiovascular disease [CVD]: n = 221; cancer: n = 180) occurred. All-cause mortality adjusted for age and sex was higher in the obese insulin-resistant subjects (hazard ratio 1.40 [95% CI 1.08–1.81], P = 0.01) but not in the obese insulin-sensitive subjects (0.99 [0.46–2.11], P = 0.97) when compared with nonobese insulin-sensitive subjects. Also, mortality for CVD and cancer was higher in the obese insulin-resistant subjects but not in the obese insulin-sensitive subjects when compared with nonobese insulin-sensitive subjects. CONCLUSIONS In contrast to obese insulin-resistant subjects, metabolically healthy obese individuals are less common than previously thought and do not show increased all-cause, cancer, and CVD mortality risks in a 15-year follow-up study.
Long-Tube Coiling in Enterocolonic Fistula
Authors: Sergio G. S. de Barros
Journal: JAMA (1979)

AN ENTEROCOLONIC fistula is an uncommon complication of diverticular disease<sup>1</sup>and has no distinctive clinical features.<sup>1,2</sup>Barium enema examinations invariably show an abnormality of the pelvic colon but may outline the fistulous tract in only 30% of subjects.<sup>1-4</sup>The diagnosis of the fistulous tract in a patient in whom an enterocolonic fistula secondary to diverticular disease developed was made by the progression of a Miller-Abbott tube through the communication not once but twice. <h3>Report of a Case</h3> A 62-year-old man with a history of acute diverticulitis six years ago was admitted to the Hospital of the University of Pennsylvania for evaluation of intermittent diarrhea of two months' duration. Symptoms included progressive anorexia, weight loss of 9.1 kg, and intermittent bloating. A barium enema examination was performed and showed diverticular disease of the sigmoid colon. On admission he had a mildly distended tympanitic abdomen with normal bowel sounds; his
Delayed Menarche and Amenorrhea in Ballet Dancers
Authors: Rose E. Frisch, Grace Wyshak, Larry Vincent
Journal: New England Journal of Medicine (1980)

YOUNG female ballet dancers attending professional schools or dancing in companies in which thinness is much admired restrict their food intake and are highly active.1 The unusual eating habits and levels of activity of some of these dancers have been related to lack of menstrual cycles.1 Amenorrhea and late menarche among girls and women with average activity levels are associated with undernutrition2 and weight loss in the range of 10 to 15 per cent of the normal weight for height35; such weight loss apparently reduces the fat/lean ratio to less than a critical level.3 We report here on 89 . . .
Cost-Effectiveness Analysis of Routine Surveillance Imaging of Patients With Diffuse Large B-Cell Lymphoma in First Remission
Authors: Scott F. Huntington, Jakub Svoboda, Jalpa A. Doshi
Journal: Journal of Clinical Oncology (2015)

Purpose Surveillance imaging of asymptomatic patients with diffuse large B-cell lymphoma (DLBCL) in first remission remains controversial. A decision-analytic Markov model was developed to evaluate the cost-effectiveness of follow-up strategies following first-line immunochemotherapy. Patients and Methods Three strategies were compared in 55-year-old patient cohorts: routine clinical follow-up without serial imaging, routine follow-up with biannual computed tomography (CT) scans for 2 years, or routine follow-up with biannual [ 18 F]-fluorodeoxyglucose positron emission tomography–computed tomography (PET/CT) for 2 years. The baseline model favored imaging-based strategies by associating asymptomatic imaging-detected relapses with improved clinical outcomes. Lifetime costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for each surveillance strategy. Results Surveillance strategies utilizing 2 years of routine CT or PET/CT scans were associated with minimal survival benefit when compared with clinical follow-up without routine imaging (life-years gained: CT, 0.03 years; PET/CT, 0.04 years). The benefit of imaging-based follow-up remained small after quality-of-life adjustments (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). Costs associated with imaging-based surveillance strategies are considerable; ICERs for imaging strategies compared with clinical follow-up were $164,960/QALY (95% CI, $116,510 to $766,930/QALY) and $168,750/QALY (95% CI, $117,440 to 853,550/QALY) for CT and PET/CT, respectively. Model conclusions were robust and remained stable on one-way and probabilistic sensitivity analyses. Conclusion Our cost-effectiveness analysis suggests surveillance imaging of asymptomatic DLBCL patients in remission offers little clinical benefit at substantial economic costs.
Clinical relevance of circulating CK-19 mRNA-positive cells detected during the adjuvant tamoxifen treatment in patients with early breast cancer
Authors: N. Xenidis, V. Markos, S. Apostolaki, M. Perraki, A. Pallis, G. Sfakiotaki, D. Papadatos-Pastos, L. Kalmanti, M. Kafousi, E. Stathopoulos, S. Kakolyris, D. Mavroudis, V. Georgoulias
Journal: Annals of Oncology (2007)
Ventricular septal defect in a world class runner
Authors: A Boraita, J Esteve-Lanao, M Pérez, M Rabadán, C Foster, A Lucia
Journal: British Journal of Sports Medicine (2005)

We report the case of an elite male, East African endurance runner (18 years old) who ranked in the top 15 in the World Cross Country Championships (sub 21 year old category) despite having a ventricular septal defect (VSD; width: 0.22 cm) that was diagnosed 2 weeks after this event with echocardiographic evaluation. This athlete was a moderate altitude native ( approximately 3000 m). Cardiac dimensions were within normal limits and no significant pathological signs were observed. His Vo(2max) was relatively low given his performance level (67.9 ml kg(-1) min(-1)). Despite his limited training background (only 1 year), his running economy was, however, better than the values reported in our laboratory for Caucasian runners of the same age. Further cardiological follow up might confirm that the VSD causes no pathological effects or any performance detriment in future years.