tbuckley/cabot-search huggingface dataset:
Gynecology: Essentials of Clinical Practice
Authors: Larry McGowan
Journal: JAMA (1965)

The text is written for the medical student obtaining his first training in gynecology in a hospital environment. In addition to those essential chapters on the vulva, vagina, uterus, adnexa, and ovaries, other chapters cover the history and physical examination, laboratory procedures, problems in different age groups, functional menstrual disorders, endocrinologic disorders, disorders of early pregnancy, endometriosis, infertility, disorders of pelvic support, the menopause, marital counseling, basic principles of operative gynecology, postoperative and postradiation management. The chapter on disorders of pelvic support is good, especially where it deals with urinary stress incontinence. The discussions of gynecologic cancer are also extremely effective, not only for students but for residents and family practitioners. Many students will not find the volume as readable as they would like because of the use of smaller-than-usual print in the text. The medical student will need to see a great variety of gynecologic patients to offset the
Fomepizole for ethyleneglycol poisoning
Authors: David S Goldfarb
Journal: The Lancet (1999)

Stephen Borron and colleagues (Sept 4, p 831)1Borron SW Mégarbane B Baud FJ Fomepizole in treatment of uncomplicated ethylene glycol poisoning.Lancet. 1999; 354: 831Summary Full Text Full Text PDF PubMed Scopus (81) Google Scholar report that fomepizole for treatment of ethylene-glycol poisoning will allow avoidance of haemodialysis for poisonings not complicated by renal insufficiency or severe metabolic acidosis. The investigators suggest that fomepizole might prevent the need for small medical centres to transfer patients to centres with capacity to do haemodialysis, or monitor patients in intensive-care units. The issue here is whether or not these smaller centres will have the drug available. With the high cost of the drug (about US$1000 per gram), smaller programmes that see only an occasional case of ethylene-glycol poisoning would be unlikely to keep it in stock. Ethanol, though perhaps more cumbersome to administer, is inexpensive and readily available, at least in its well known oral form. If making the decision to have fomepizole in stock, smaller centres should know that the suggested shelf life of the drug is 3 years, and the manufacturer (Orphan Medical, Minnetonka, MN, USA) will replace it at no charge after that period (S W Borron, personal communication). It therefore seems economical for smaller emergency departments to have the drug in their armamentarium. In settings where there is good access to haemodialysis, we are yet to see whether therapy with fomepizole is better than prompt haemodialysis. Administration of the drug may obviate the time needed for consultation with the dialysis service and preparation of a dialysis machine, and does not require insertion of a catheter into the femoral vein. The comparative costs and efficacy of these two strategies are not yet clear. Borron's report shows that a test of the merits of these treatment options is an important next step.
Myocardial metabolites of ethanol.
Authors: L G Lange, B E Sobel
Journal: Circulation Research (1983)

Because of the importance of alcohol-induced heart muscle disease and the obscurity of its pathogenesis, this study was undertaken to determine whether fatty acid ethyl esters, myocardial metabolites of ethanol recently described in our laboratory to be synthesized in cell-free extracts of rabbit myocardium, accumulate in hearts of human subjects exposed to ethanol in vivo. Lipid extracts were prepared from left ventricular samples obtained at necropsy from six subjects who had been exposed to ethanol acutely or chronically. Fatty acid ethyl esters were present in each extract in concentrations ranging from 9 to 115 microM. In contrast, they were consistently absent from analogous samples obtained from hearts of abstainers (n = 5). In parallel studies in experimental animals, we found that fatty acid ethyl esters are formed not only in the heart but also in the pancreas and liver--targets of injury associated with chronic alcohol abuse. These results demonstrate the presence in human myocardium of a novel metabolite of ethanol that potentially may serve as a marker for exposure to alcohol and that could be relevant to the pathophysiology of excessive alcohol consumption leading to cardiac abnormalities.
Rehabilitation and Treatment by Movement of Contractures in Rheumatoid Arthritis
Authors: G. Edstrom
Journal: Annals of the Rheumatic Diseases (1952)

An in vitro histamine release assay was used to test the hypothesis that passive sensitization of circulating basophils is associated with the activity of immune serum that transfer the ability to elicit cutaneous basophil hypersensitivity (CBH) reactions. Systemic i.v. transfer of several types of immune sera that mediate CBH also led to passive sensitization of circulating basophils for antigen-specific release of histamine in vitro. In addition, we found that immune serum passively sensitizes basophils in vitro. Thus immune sera had three activities that are probably interconnected: sera will 1) passively transfer CBH in vivo, 2) passively sensitize basophils in vivo, and 3) passively sensitize basophils in vitro. These results suggest that passive sensitization of circulating basophils by immune serum contributes to the mechanism by which antibodies transfer the ability to elicit CBH reactions.
Can "big" insulin-like growth factor II in serum of tumor patients account for the development of extrapancreatic tumor hypoglycemia?
Authors: J Zapf, E Futo, M Peter, E R Froesch
Journal: Journal of Clinical Investigation (1992)

The pathogenesis of extrapancreatic tumor hypoglycemia has been related to the secretion of big insulin-like growth factor (IGF) II by the tumor. In 25 of 28 patients with this type of hypoglycemia we found 1.5-8-fold elevated serum levels of immunoreactive big (15-25 kD), but decreased levels of normal IGF II. After removal of the tumor, big IGF II disappeared and normal IGF II increased. Tumors contained elevated levels of IGF II, 65-80% in the big form. The insulin-like bioactivity of big IGF II and its affinity towards IGF-binding proteins (IGFBP)-2 and -3 are similar to those of normal IGF II, but two- to threefold higher on a molar basis. Big IGF II is mainly bound to the 50-kD IGFBP complex. The latter contains approximately 10 times more of this peptide than in normal serum and displays three- to fourfold increased insulin-like bioactivity. The formation of the 150-kD IGFBP complex with 125I-recombinant human IGFBP-3 is impaired in tumor serum. This results in sequestration of IGFBP-3 and predominant association of big IGF II with IGFBP-2 and -3 in the 50-kD complex. Increased bioavailability of big IGF II in this complex due to unrestricted capillary passage and enhanced insulin bioactivity of this big IGF II pool provide a continuous increased insulin-like potential available to insulin and type 1 IGF receptors of insulin-sensitive tissues and thus may lead to sustained hypoglycemia.
Provocative Tests of Growth-Hormone Release
Authors: TU LIN
Journal: Annals of Internal Medicine (1974)

Seven tests of growth-hormone release were evaluated in 31 hospitalized nonobese persons without evidence of endocrine disease. Plasma growth-hormone levels were measured before and after administration of insulin, 0.1 unit/kg body weight intravenously; glucagon, 1 mg intramuscularly; levodopa, 500 mg by mouth; metyrapone, 750 mg by mouth; α 1-24-ACTH (cosyntropin), 0.25 mg intravenously; and 1 to 2 hours after the onset of nocturnal sleep, and after 15 minutes of vigorous stair climbing. Insulin uniformly stimulated growth-hormone release in all 19 persons tested, whereas 21 of 24 (87%) responded to levodopa and 17 of 21 (81%) to glucagon. ACTH stimulated growth-hormone release in only 7 of 12 persons, whereas metyrapone had no effect. A growth-hormone response to sleep was found in only 2 of 11, whereas exercise stimulated growth-hormone release in 4 of 10. Although the highest growth-hormone levels were associated with insulin hypoglycemia, these were not significantly different from levels after administration of levodopa or glucagon (P > 0.05). These data suggest that levodopa is a reasonably effective alternative to insulin hypoglycemia as a test of growth-hormone release. Its advantages are that it is given orally, and there are minor side effects. The efficacy of glucagon approaches that of levodopa.
Plasma fibronectin supports hemostasis and regulates thrombosis
Authors: Yiming Wang, Adili Reheman, Christopher M. Spring, Jalil Kalantari, Alexandra H. Marshall, Alisa S. Wolberg, Peter L. Gross, Jeffrey I. Weitz, Margaret L. Rand, Deane F. Mosher, John Freedman, Heyu Ni
Journal: Journal of Clinical Investigation (2014)

Plasma fibronectin (pFn) has long been suspected to be involved in hemostasis; however, direct evidence has been lacking. Here, we demonstrated that pFn is vital to control bleeding in fibrinogen-deficient mice and in WT mice given anticoagulants. At the site of vessel injury, pFn was rapidly deposited and initiated hemostasis, even before platelet accumulation, which is considered the first wave of hemostasis. This pFn deposition was independent of fibrinogen, von Willebrand factor, β3 integrin, and platelets. Confocal and scanning electron microscopy revealed pFn integration into fibrin, which increased fibrin fiber diameter and enhanced the mechanical strength of clots, as determined by thromboelastography. Interestingly, pFn promoted platelet aggregation when linked with fibrin but inhibited this process when fibrin was absent. Therefore, pFn may gradually switch from supporting hemostasis to inhibiting thrombosis and vessel occlusion following the fibrin gradient that decreases farther from the injured endothelium. Our data indicate that pFn is a supportive factor in hemostasis, which is vital under both genetic and therapeutic conditions of coagulation deficiency. By interacting with fibrin and platelet β3 integrin, pFn plays a self-limiting regulatory role in thrombosis, suggesting pFn transfusion may be a potential therapy for bleeding disorders, particularly in association with anticoagulant therapy.
Development of Ewing's Sarcoma from Primary Bone Marrow–Derived Mesenchymal Progenitor Cells
Authors: Nicolò Riggi, Luisa Cironi, Paolo Provero, Mario-Luca Suvà, Konstantinos Kaloulis, Carlos Garcia-Echeverria, Francesco Hoffmann, Andreas Trumpp, Ivan Stamenkovic
Journal: Cancer Research (2005)

Abstract Ewing's sarcoma is a member of Ewing's family tumors (EFTs) and the second most common solid bone and soft tissue malignancy of children and young adults. It is associated in 85% of cases with the t(11;22)(q24:q12) chromosomal translocation that generates fusion of the 5′ segment of the EWS gene with the 3′ segment of the ETS family gene FLI-1. The EWS-FLI-1 fusion protein behaves as an aberrant transcriptional activator and is believed to contribute to EFT development. However, EWS-FLI-1 induces growth arrest and apoptosis in normal fibroblasts, and primary cells that are permissive for its putative oncogenic properties have not been discovered, hampering basic understanding of EFT biology. Here, we show that EWS-FLI-1 alone can transform primary bone marrow–derived mesenchymal progenitor cells and generate tumors that display hallmarks of Ewing's sarcoma, including a small round cell phenotype, expression of EFT-associated markers, insulin like growth factor-I dependence, and induction or repression of numerous EWS-FLI-1 target genes. These observations provide the first identification of candidate primary cells from which EFTs originate and suggest that EWS-FLI-1 expression may constitute the initiating event in EFT pathogenesis. (Cancer Res 2005; 65(24): 11459-68)
Meta-analyses Evaluating Diagnostic Tests
Authors: Fredric M. Wolf
Journal: Annals of Internal Medicine (1994)

Letters15 November 1994Meta-analyses Evaluating Diagnostic TestsFredric M. WolfFredric M. WolfSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-10-199411150-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:It is difficult to find fault with the analysis by Irwig and colleagues [1]. The authors' criteria and recommendations appear logical, attesting to their thoughtfulness and ability to effectively communicate important and often subtle issues. Their discussion and examples of the distinction between diagnostic accuracy and shifts in classification thresholds are particularly illuminating.The article provoked my curiosity and made me wish that the authors had provided some additional information. I could not help but wonder about the extent to which judgments by two of the three independent raters were needed to reach “consensus” on the application ...References1. Irwig L, Tosteson AN, Gatsonis C, Lau J, Colditz G, Chalmers TC, et al. Guidelines for meta-analyses evaluating diagnostic tests. Ann Intern Med. 1994; 120:667-76. Google Scholar2. Fleiss JL. The measurement of interrater agreement. In: Fleiss JL. Statistical Methods for Rates and Proportions. 2d ed. New York: Wiley; 1981:212-36. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 November 1994Volume 121, Issue 10Page: 817-818KeywordsSpecificity Issue Published: 15 November 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Some Facts About The Cancer Effort
Authors: A. I. Holleb
Journal: CA A Cancer Journal for Clinicians (1975)

Recently it has become the fashion to criticize and condemn the efforts of both governmental and private agen cies in cancer research and control.The prophets of doom, the biologi cal determinists and the therapeutic ni hilists delight in reporting a grim litany of failures and unfulfilled promises.What are the naysayers saying, and what are the facts?Naysayers: Millions of dollars have been spent on the new National Cancer Program with little progress to show for it all.Fact: Significantly increased fund ing for the National Cancer Program did not become available until 1972 and not until 1973 did the Cancer Con trol Program of the NCI begin its first year of operation.The use of 1964 and 1969 survival statistics to evaluate a program which became operational many years later is unscientific, inac curate and unjustifiable.Naysayers: Where is the â€oe¿ break throughâ€• we have been promised?The discovery of a â€oe¿ cure for cancerâ€• was supposedly only a few months away!Fact: Nonsense!Who spoke of such a â€oe¿ breakthroughâ€•?Who said that a cure for all cancer was imminent?The National Cancer Program, mandated by
Abstract 5302: Characterization the role of leukocyte cell-derived chemotaxin 2 (LECT2) in angiogenesis
Authors: Chen Chi-Kuan, Ching-Yao Yang, Huei-Wen Chen, Ming-Lian Kuo
Journal: Cancer Research (2012)

Abstract Leukocyte Cell-Derived Chemotaxin 2 (LECT2) protein is expressed preferentially in the liver in a constitutive manner and secreted into bloodstream. Recently studies indicate that LECT2 potentially associated with the liver injury, repair, and regeneration, but other functions are still unknown. Angiogenesis is a process of new blood vessel formation which has essential roles in development, repair, tumor growth, invasion, and metastasis. In our previous studies, we have recently identified LECT2 as a potential tumor suppressor, correlating with decreased vascular invasion in hepatocellular carcinomas (HCC). In this study, we evaluated the function of recombinant LECT2 (rLECT2) proteins on angiogenesis by using human umbilical vein endothelial cells (HUVEC). We demonstrated a selective and significant inhibition of VEGF165-induced angiogenic activity in HUVEC by rLECT2 protein through inhibiting the proliferation, migration, and tube formation. The rLECT2 protein also suppressed VEGF165-induced angiogenesis in CAM assay and matrigel plug assay. Otherwise, we use different stage of HCC to evaluate the density, amounts, and volumes of blood vessels are associated with LECT2 protein level. Furthermore, we also evaluate the association between LECT2 protein level and the maturity of blood vessels. In conclusion, we for the first time found that LECT2 play an important role in anti-angiogenesis. Moreover, the LECT2 might have broad therapeutic applications in diseases characterized by excessive angiogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5302. doi:1538-7445.AM2012-5302
Hyperacute Rejection of a Pulmonary Allograft
Authors: JOHN K. CHOI, JANE KEARNS, HAROLD I. PALEVSKY, KATHLEEN T. MONTONE, LARRY R. KAISER, CHESTER M. ZMIJEWSKI, JOHN E. TOMASZEWSKI
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

The clinical and pathologic findings seen in hyperacute rejection are well documented in renal and cardiac allografts. We describe the second case of hyperacute rejection in a pulmonary allograft and detail the immediate clinicopathologic findings. The patient underwent a single lung transplant for severe COPD with postoperative course complicated by acute rejection and graft failure. Eleven days later, the patient underwent a second transplant with intra-operative course complicated by rapid pulmonary edema and copious production of frothy, pink fluid from the bronchial orifice of the allograft followed by death within four hours of anastomoses. Intraoperative biopsy and autopsy demonstrated platelet/fibrin thrombi, marked interstitial neutrophilia, alveolar edema, and antibody deposition on the endothelial surface and vasculature walls. Prior to the first transplant, the patient's serum had 0% panel reactive antibody and was crossmatch compatible with the first allograft. The patient's serum prior to the second transplant contained cross-reacting antibodies to the donor's B and T lymphocytes. The immediate clinical findings in this case are similar to the findings in a previously reported case. This report is the first documentation of the immediate pathologic features of hyperacute rejection in a lung allograft which are similar to those seen with other organ allografts.
Hopes that Novartis deal on tuberculosis will spur donations for HIV and malaria
Authors: F. Fleck
Journal: BMJ (2004)

A pledge last month by Swiss pharmaceuticals giant Novartis to donate $7m(£3.9m; €5.5m) worth of drugs to 500 000 patients with tuberculosis in poor countries over the next five years has raised hopes that other drug companies will follow suit to fight HIV/AIDS and malaria.

Under an agreement with the World Health Organization on 19 December, Novartis will provide drugs to help poor countries obtain and distribute drugs to patients with tuberculosis. Two million people die of the disease every year, many of whom have HIV infection or AIDS. There are signs that …
Evaluation of Hospital Readmissions in Surgical Patients
Authors: Greg D. Sacks, Aaron J. Dawes, Marcia M. Russell, Anne Y. Lin, Melinda Maggard-Gibbons, Deborah Winograd, Hallie R. Chung, James Tomlinson, Areti Tillou, Stephen B. Shew, Darryl T. Hiyama, H. Gill Cryer, F. Charles Brunicardi, Jonathan R. Hiatt, Clifford Ko
Journal: JAMA Surgery (2014)

<h3>Importance</h3> The Centers for Medicare &amp; Medicaid Services has developed an all-cause readmission measure that uses administrative data to measure readmission rates and financially penalize hospitals with higher-than-expected readmission rates. <h3>Objectives</h3> To examine the accuracy of administrative codes in determining the cause of readmission as determined by medical record review, to evaluate the readmission measure's ability to accurately identify a readmission as planned, and to document the frequency of readmissions for reasons clinically unrelated to the original hospital stay. <h3>Design, Setting, and Participants</h3> Retrospective review of all consecutive patients discharged from general surgery services at a tertiary care, university-affiliated teaching hospital during 8 consecutive quarters (quarter 4 [October through December] of 2009 through quarter 3 [July through September] of 2011). Clinical readmission diagnosis determined from direct medical record review was compared with the administrative diagnosis recorded in a claims database. The number of planned hospital readmissions defined by the readmission measure was compared with the number identified using clinical data. Readmissions unrelated to the original hospital stay were identified using clinical data. <h3>Main Outcomes and Measures</h3> Discordance rate between administrative and clinical diagnoses for all hospital readmissions, discrepancy between planned readmissions defined by the readmission measure and identified by clinical medical record review, and fraction of hospital readmissions unrelated to the original hospital stay. <h3>Results</h3> Of the 315 hospital readmissions, the readmission diagnosis listed in the administrative claims data differed from the clinical diagnosis in 97 readmissions (30.8%). The readmission measure identified 15 readmissions (4.8%) as planned, whereas clinical data identified 43 readmissions (13.7%) as planned. Unrelated readmissions comprised 70 of the 258 unplanned readmissions (27.1%). <h3>Conclusions and Relevance</h3> Administrative billing data, as used by the readmission measure, do not reliably describe the reason for readmission. The readmission measure accounts for less than half of the planned readmissions and does not account for the nearly one-third of readmissions unrelated to the original hospital stay. Implementation of this readmission measure may result in unwarranted financial penalties for hospitals.
SURGERY OF THE SPINAL CORD.
Authors: JOHN B. MURPHY
Journal: JAMA (1907)

Surgical intervention in spinal cord affections has been at all times a matter of hesitation on the part of surgeons. Results were so varied and indefinite that for a long time no conclusions could be drawn as to the necessity and probable outcome of operative treatment. Statistics were meager and their reliability doubted where favorable results were recorded. In this paper I shall deal mainly with the different types of injuries to the spine and spinal cord, and endeavor to bring out the important points in diagnosis and definite indications for surgical treatment in cases amenable to it. I also hope to be able to show that in certain cases patients should not be operated on, as the cases are absolutely hopeless from our histologic knowledge of spinal cord degeneration and regeneration. Of course, it goes without saying that the basis of all this work is a very thorough and
Caffeine Dependence Syndrome
Authors: Peter Bardsley
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In a recent issue of<i>JAMA</i>, evidence was reported on the existence of caffeine dependence.<sup>1</sup>In an accompanying Editorial, Dr Glass<sup>2</sup>noted that a key finding was the existence of a compulsive pattern of caffeine use associated in many cases with physiological dependence. He also noted that because of the small and unrepresentative sample, the study provided little evidence on the prevalence of the phenomenon. In this letter we report research on another type of evidence for the prevalence of compulsive caffeine use: aggregate data on caffeine consumption. Economics Nobel Laureate Gary Becker has suggested that a great deal of compulsive consumption could be explained by the "rational addiction" hypothesis, ie, (1) current consumption has a long-lasting, though eventually decaying, effect on future tastes and preferences; and (2) consumers are rational and forward-looking and take into account the effect of current consumption on their future