tbuckley/cabot-search huggingface dataset:
An effective technique for delivery of polyglycolic acid sheet after endoscopic submucosal dissection of the esophagus: the clip and pull method
Authors: Satoshi Ono, Yosuke Tsuji, Mitsuhiro Fujishiro, Shinya Kodashima, Nobutake Yamamichi, Kazuhiko Koike
Journal: Endoscopy (2014)

Endoscopic submucosal dissection (ESD) is currently accepted as an established method of treatment for esophageal superficial neoplasms, although it is associated with some complications [1]. Polyglycolic acid (PGA) sheet (Neoveil; Gunze Co., Kyoto, Japan) is an absorbable reinforcement material that has been used for reinforcing the surgical suture to prevent leakage [2]. It has also been reported to be effective in shielding the artificial ulcer after ESD thus preventing perforation or bleeding [3] [4]. However, shielding artificial ulcers is technically difficult especially in the esophagus due to its narrowness. This report describes a novel technique that enables rapid and easy shielding of the esophageal artificial ulcer.
Book Review The World of Deaf Infants: A Longitudinal Study (Perspectives on Deafness.) By Kathryn P. Meadow-Orlans, Patricia Elizabeth Spencer, and Lynne Sanford Koester. 266 pp., illustrated. New York, Oxford University Press, 2004. $46.50. 0-19-514790-1
Authors: Betty R. Vohr
Journal: New England Journal of Medicine (2004)
Longevity in the Eisenmenger Syndrome.
Authors: Dennison Young
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Longevity in the Eisenmenger Syndrome.Dennison Young, M.D., F.A.C.P., Herbert Mark, M.D., F.A.C.P.Dennison Young, M.D., F.A.C.P.Search for more papers by this author, Herbert Mark, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-784_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe presence of the Eisenmenger syndrome renders any underlying shunting defect inoperable. Little attention has been paid, however, to later events in the natural history of these patients. The clinical course, features, and fate of 37 such adults are reviewed. The underlying lesion in 15 was a ventricular septal defect; in 10, an atrial septal defect; in 4, a patent ductus arteriosus; in 2, patent ductus arteriosus and ventricular septal defect; and miscellaneous lesions in 6. Ages ranged from 18 to 57 years. Twenty-two are still living. All suffered functional limitations, but many were able to lead active lives. Most,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 784-784KeywordsAtrial septal defectLesionsPatent ductus arteriosusVentricular septal defects Issue Published: 1 May 1970 PDF downloadLoading ...
Transverse arch hypoplasia predisposes to aneurysm formation at the repair site after patch angioplasty for coarctation of the aorta
Authors: Jan Bogaert, Marc Gewillig, Frank Rademakers, Hilde Bosmans, Johny Verschakelen, Willem Daenen, Albert L. Baert
Journal: Journal of the American College of Cardiology (1995)
DELAYED HYPERSENSITIVITY
Authors: Jonathan W. Uhr, A. M. Pappenheimer, M. Yoneda
Journal: The Journal of Experimental Medicine (1957)

Guinea pigs infected by intradermal injection of living toxigenic diphtheria bacilli and protected by horse antitoxic globulin, given either before or after infection, develop delayed hypersensitivity of the tuberculin type to diphtherial proteins. The highest degree of hypersensitivity is specifically directed against diphtheria toxin (or toxoid) itself, although smaller delayed skin reactions may be evoked in sensitized animals by other diphtherial proteins common to both toxigenic and non-toxigenic strains. Animals sensitized to diphtheria toxin by infection with a toxigenic strain in this way react positively to the Schick test and their serum usually contains no detectable antitoxin 2 to 3 weeks after the initial infection. Animals infected with living non-toxigenic diphtheria bacilli become sensitized to proteins common to both toxigenic and non-toxigenic strains but do not show sensitivity to toxin. The observations suggest that a minute amount of toxoid, or of toxin comparable to that which might be liberated during infection, might induce the hypersensitive state if injected in the form of a complex with excess antitoxin. This prediction is verified by the results reported in the following paper (23).
Inositol 1,4,5-triphosphate-induced granule secretion in platelets. Evidence that the activation of phospholipase C mediated by platelet thromboxane receptors involves a guanine nucleotide binding protein-dependent mechanism distinct from that of thrombin.
Authors: L F Brass, C C Shaller, E J Belmonte
Journal: Journal of Clinical Investigation (1987)

Phosphoinositide hydrolysis in platelets stimulated by thrombin is thought to be regulated by a pertussis toxin-sensitive guanine nucleotide binding protein (G protein) referred to as Gp. The present studies examine the role of Gp in platelet responses to the thromboxane A2 analogue U46619 and in the pathway by which the phosphoinositide hydrolysis product inositol 1,4,5-triphosphate (IP3) causes secretion. In permeabilized platelets, U46619 caused phosphatidic acid formation and secretion, which were abolished by the G protein inhibitor, guanosine 5'-O-(2-thiophosphate) (GDP beta S). Unlike thrombin, however, U46619-induced phosphoinositide hydrolysis was unaffected by pertussis toxin, and U46619 was unable to inhibit the [32P]ADP ribosylation of the 42-kD pertussis toxin substrate in platelets. IP3-induced secretion, which is known to depend upon intracellular Ca release and subsequent arachidonic acid metabolism, was also inhibited by GDP beta S, as was Ca-induced secretion. These observations suggest that platelet thromboxane A2 (TxA2) receptors are coupled to a toxin-resistant form of Gp distinct from the one that is coupled to thrombin receptors, and that TxA2-stimulated phosphoinositide hydrolysis may serve as a feedback mechanism by which stimuli for arachidonic acid release, such as IP3 and Ca, amplify responses to agonists.
Teaching the Future General Practitioner
Authors: Robert G. Priest
Journal: Psychotherapy and Psychosomatics (1979)

Medical students today still graduate with insufficient skills for their role as general practitioner (family doctor, primary care physician). In particular they are lacking in their ability to use psychotherapeutic and counselling techniques for patients with psychological and psychosomatic problems. The author presents the results of a study which suggest that it is unrealistic to teach skills that demand more time than, say, 15 min a session on a total of four occasions. This severe limitation poses difficult questions for those teachers who customarily think in terms of 50 min a week over many months as the basis of the model for psychotherapeutic help. The challenge of these implications is considered, and some practical ways of meeting the requirements are suggested.
How Can We Tell Whether There Are Too Many or Too Few Physicians?
Authors: Steven A. Schroeder
Journal: JAMA (1996)

Public policy debates continue to swirl around the topic of physician supply for at least 4 reasons. First, entry into medicine, in contrast to many occupations, is not left to the dynamics of the market. Numerical limits on the number of medical school positions are determined by a voluntary educational establishment entrusted with the responsibility of training physicians. Even in periods when medicine seemed a relatively unattractive field—as in the mid 1980s—there were substantially more applicants than available first-year positions. Furthermore, and in contrast to schools of law or business, the application pool is diminished by the need to overcome significant academic hurdles (such as organic chemistry) required for admission. See also p 1811. Second, medicine differs from most other careers in the extent to which the public subsidizes the educational process. At the medical school level, this occurs mainly at the 77 public institutions that enjoy some line-item support
This House believes doctors are neglecting their duty to lead health service change: Opposer
Authors: J. Cave
Journal: BMJ (2009)

Doctors have never neglected their duty and have, throughout history, led health service change. It is fanciful to suggest otherwise. Our major teaching hospitals and the specialty of general practice owe their existence to doctors of a different age leading transformational change in service delivery. More recently doctors have shown this ability to lead at the highest levels, championing the calls for bans on smoking, landmines, and torture among other issues.

Successive organisational changes within the NHS in the 1970s and 1980s—particularly the 1983 Griffiths report, which essentially introduced the idea of general management into the NHS—have, however, marginalised doctors from their role in management and have adversely affected their ability …
Studies often overturn accepted medical practice, analysis finds
Authors: M. McCarthy
Journal: BMJ (2013)

Studies published in the New England Journal of Medicine over one decade found that 128 interventions that had become established medical practice were less effective than older practices or practices that did not include intervention, research has found. 

In the study, Vinay Prasad from the National Cancer Institute in Bethesda, Maryland, and colleagues, reviewed 2044 original research articles published in the New England Journal of Medicine from 2001 to 2010, identifying those that tested a medical practice, such as a medication, a diagnostic test, or procedure. Their paper is published online by …
676 FINE SPECIFICITY OF ANTI-NUP62 T-HELPER 1 CELL (TH1) IMMUNE RESPONSE IN PRIMARY BILIARY CIRRHOSIS
Authors: F. Meda, M.S. Longhi, D.P. Bogdanos, P. Invernizzi, Y. Ma, G. Mieli-Vergani, J. Wesierska-Gadek, M. Zuin, M. Podda, D. Vergani
Journal: Journal of Hepatology (2009)
Treatment of Low-Back Pain
Authors: T. W. Meade
Journal: JAMA (1985)

To the Editor.—  The article by Dr Richard A. Deyo1reviews a number of trials of treatment for low-back pain, including our multicenter trial2of physiotherapy in the management of sciatic symptoms. Dr Deyo's assessment of the trials under consideration involved a number of assumptions and arbitrary decisions that, coupled with the omission of any mention of one of its central features, have given a misleading impression of our trial.  First, Dr Deyo implies that assessment of outcome in our trial was not blind. It is, of course, almost impossible to ensure blind assessments in trials of nonpharmacologic treatment methods. In our trial, the assessments of progress used in the analyses were made by the patients and not by the therapists. Dr Deyo's comment that the observers in our trial were not blind is, therefore, irrelevant.  Second, Dr Deyo says that our descriptions of the exercises and of
1210 PRE-EXISTENCE, EMERGENCE AND PERSISTENCE OF HCV GENOTYPE 4 NS5A RESISTANCE VARIANTS FROM THE PHASE 2B COMMAND-1 STUDY: DACLATASVIR PLUS PEGINTERFERON-alfa/ RIBAVIRIN IN TREATMENT-NAIVE PATIENTS
Authors: F. McPhee, N. Zhou, J. Ueland, F. Yu, X. Yang, A. Monikowski, M. Kirk, E.A. Hughes, P.D. Yin, D. Hernandez
Journal: Journal of Hepatology (2013)
Effects of fenofibrate and ezetimibe, both as monotherapy and in coadministration, on cholesterol mass within lipoprotein subfractions and low-density lipoprotein peak particle size in patients with mixed hyperlipidemia
Authors: Diane L. Tribble, Michel Farnier, Geraldine Macdonell, Inna Perevozskaya, Michael J. Davies, Barry Gumbiner, Thomas A. Musliner
Journal: Metabolism (2008)
Factitious sickle cell acute painful episodes: A secondary type of Munchausen syndrome
Authors: Samir K. Ballas
Journal: American Journal of Hematology (1996)

Three adult patients with factitious acute sickle cell painful episodes are presented and the literature is reviewed. The prevalence of this disorder among patients with sickle cell disease in our program was found to be about 0.9%. The patients described to date were all young adults who demonstrated pathological lying (pseudologico fantastico) and most of them had an underlying authentic medical illness to which the feigned signs and symptoms of sickle cell disease were added, thus making the diagnosis more plausible. It is recommended that all patients who present themselves with the signs and symptoms of sickle cell painful episodes be carefully studied in order to confirm the diagnosis. © 1996 Wiley-Liss, Inc.
Peritoneoscopy in Adult Polycystic Kidney Disease: Its Diagnostic Value
Authors: J. Solis-Herruzo, A. Arauzo-Gonzalez
Journal: Endoscopy (1976)

The value of peritoneoscopy in the diagnosis of renal polycystic disease was tested in nine patients with adult polycystic disease and one with congenital hepatic fibrosis. The right kidney was visualized in all ten cases and the left in seven. Renal cysts were recognized by peritoneoscopy in eight of the ten patients. Factors impeding visualization of the kidneys and the cysts were: a) fixation of the splenic flexure of the colon; b) non-superficial renal cysts. Of six cases in which intravenous pyelography was not diagnostic, peritoneoscopy was positive in four. No correlation was found between the degree of hepatic and renal cystic involvement.
Role of Nuclear Medicine Imaging in Recognizing Different Causes of Osteonecrosis of the Jaw
Authors: Jonathan K. Joshi, George M. Kushner, Geetika Bhatt, Aashish D. Bhatt, Ali Cahid Civelek
Journal: Clinical Nuclear Medicine (2012)

The incidence of osteonecrosis of the jaw (ONJ) among patients with cancer and metastatic bone disease being treated with bisphosphonates is as high as 10%, which dictates that an understanding of the risk factors, preventative measures, means of early diagnosis, and treatment is critical. Despite ONJ occurring in the clinical setting of intravenous bisphosphonates, there are other causes associated with higher risk of ONJ, such as multiple dental extractions. Overall, it is important for imaging health care professionals to recognize, describe, and understand ONJ to help minimize biopsies and allow proper treatment to begin as soon as possible.
Universal Markers of Thyroid Malignancies: Galectin-3, HBME-1, and Cytokeratin-19
Authors: Figen Barut, Nilufer Onak Kandemir, Sibel Bektas, Burak Bahadir, Sevinc Keser, Sukru Oguz Ozdamar
Journal: Endocrine Pathology (2010)
Ten-year incidence of HCV infection in northern Italy and frequency of spontaneous viral clearance
Authors: Costanza Mazzeo, Francesco Azzaroli, Silvia Giovanelli, Ada Dormi, Davide Festi, Antonio Colecchia, Anna Miracolo, Pasquale Natale, Giovanni Nigro, Alfredo Alberti, Enrico Roda, Giuseppe Mazzella
Journal: Journal of Hepatology (2002)
Measuring Quality of Hospital Care
Authors: Jeffrey H. Silber
Journal: JAMA (1995)

<h3>To the Editor.</h3> —In discussing estimates of quality of hospital care, Dr Miller and colleagues<sup>1</sup>wrote, "Standardized hospital mortality ratios based on analyses that do not account for variation in admission practice among hospitals are biased.<sup>1(p1493)</sup>... This problem is related to unmeasured severity, but it is more than that.<sup>1(p1495)</sup>... It is important to understand that the bias introduced by differences in admission practices will affect any quality measure that is estimated only on hospitalized samples."<sup>1(p1497)</sup> Miller et al believe comparing care inside hospitals requires collecting data about the health of populations that are sending patients to these hospitals. We believe this difficult task is unnecessary for the specific goal of comparing the care provided inside hospitals. Resources are better spent on collecting complete, standardized, high-quality data that describe the initial health and subsequent outcomes of patients treated inside hospitals. Miller et al are correct on several
Decontamination of instruments and control of cross infection in general practice.
Authors: D R Morgan, T J Lamont, J D Dawson, C Booth
Journal: BMJ (1990)

To assess the effectiveness of decontamination procedures in general practice.Anonymous postal questionnaire survey of 600 general practitioners randomly selected from the national register.General practices throughout the United Kingdom.382 General practitioners, a response rate of 65%.186 General practitioners had autoclaves but 125 used hot water disinfectors or chemical disinfectants to reprocess instruments. 22% (474/2132) Of high risk instruments were inadequately decontaminated. Decontamination was performed by the practice nurse or receptionist in 306 practices. Knowledge of treatment of spillages of blood fluids was uncertain, and only 114 general practitioners used effective methods for dealing with spillages.A comprehensive central code of practice for control of infection is needed for primary health care staff.
New head of US Medicare defends health reforms in brief Senate hearing
Authors: J. H. Tanne
Journal: BMJ (2010)

Donald Berwick, the controversial head of the US Centers for Medicare and Medicaid Services who was expected to be grilled by the Senate Finance Committee when he appeared before them for a hearing on 17 November, was interviewed for just over an hour with much of the time taken up with prepared statements.

Dr Berwick, a paediatrician, is a fan of the National Health Service, has been knighted by the Queen, and is criticised in the US as promoting socialised medicine. He was a Harvard professor and head of the Institute for Health Care Improvement before his appointment to head the centres. The institute campaigned to save the lives of 100 000 patients through more attention to safety ( BMJ 2006; 332:1468; …
Impact of TET2 mutations on response rate to azacitidine in myelodysplastic syndromes and low blast count acute myeloid leukemias
Authors: R Itzykson, O Kosmider, T Cluzeau, V Mansat-De Mas, F Dreyfus, O Beyne-Rauzy, B Quesnel, N Vey, V Gelsi-Boyer, S Raynaud, C Preudhomme, L Adès, P Fenaux, M Fontenay
Journal: Leukemia (2011)
Factors influencing indices of left ventricle contractility in the conscious dog
Authors: D. M. DAVIDSON, J. W. COVELL, C. I. MALLOCH, J. ROSS
Journal: Cardiovascular Research (1974)

Left ventricular function and isovolumic indices of contractility were examined in the awake, chronically instrumented dog to assess their ability to detect changes in inotropic state, and their response to changes in left ventricular end-diastolic pressure (LVEDP). During the initial 8–10 beats following inferior vena cava (IVC) occlusion, the relation between stroke volume and LVEDP exhibited substantial variations in the basal state and, although useful for defining acute responses to isoproterenol (1 μk), it did not detect a response to propranolol (0-· mg/kg). Of the many isovolumic indices examined in the index (dP/dt)/DP at a developed LVP of 40mmHg [(dP/dt)/DP40] offered the least scatter and sensitivity to LVEDP changes and it was sensitive to acutely induced changes in inotropic state. However, this ratio and other isovolumic indices responded poorly to contractility changes originating from LVEDP levels below 4 mmHg. Moreover, its basal level exhibited wide variation in the same animal on different days and in different normal animals.
Packed Red Blood Cells
Authors: Hugh Chaplin
Journal: New England Journal of Medicine (1969)

AS an essential therapeutic agent in modern medical practice, human blood is clearly a valuable and limited natural resource. The total use of blood grows annually, as does the difficulty of procuring it in amounts sufficient to meet expanding needs. There is increasing emphasis on the selective use of partially purified preparations of individual formed elements and of various soluble components of plasma. It behooves the medical profession, therefore, to look critically at current transfusion practice from the point of view both of rational prescription and of economy of all the major blood components. The logical starting point for such . . .
FDG PET Helpful for Diagnosing SAPHO Syndrome
Authors: Susanne Kohlfuerst, Isabel Igerc, Peter Lind
Journal: Clinical Nuclear Medicine (2003)

A 45-year-old man had chronic osteomyelitis in the right tibia since 1996 and developed severe shoulder pain recently. Bone scintigraphy was performed to exclude additional osteomyelitis originating from the primary site. Because of the bone scan results, the presence of osteomyelitis in the sternoclavicular region turned out to be very unlikely. To exclude malignancy, fluorodeoxyglucose positron emission tomography was performed. Further examination showed that the patient had palmoplantar pustulosis. This pattern led to the diagnosis of SAPHO syndrome, which is characterized by synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis. In this case the positron emission tomographic scan, in addition to bone scintigraphy, showed that in SAPHO syndrome certain areas are active (right ankle region) whereas the activity of the disease in other parts of the body has burned out (thoracic lesions).
Repolarization of hepatocytes in culture
Authors: M. A. Talamini, B. Kappus, A. Hubbard
Journal: Hepatology (1997)

We have evaluated the biochemical, morphological, and functional redevelopment of polarity in freshly isolated hepatocytes cultured using a double layer collagen gel sandwich technique. Western blot analysis showed increased cellular levels of the cell adhesion protein uvomorulin as cultured hepatocytes repolarized. Immunofluorescence studies using antibodies against domain-specific membrane proteins showed polarity as early as 48 hours, although the pattern of the polymeric Immunoglobulin-A receptor (pIgA-R) differed from in vivo liver. Electron microscopy showed developing bile canaliculi at 1 day. However, the functional presence of tight junctions was absent at 1 day, but present at 5 days. We further showed functional polarity to be present at 4 days by documenting the ability of cultured hepatocytes to metabolize and excrete fluorescein diacetate into visible bile canaliculi. We conclude that hepatocytes cultured appropriately develop morphological and functional polarity. Hepatocyte culture is therefore a useful tool for the study of mechanisms responsible for the development of polarized function.
Iatrogenic acute hyponatraemia in a college athlete
Authors: R Herfel, C K Stone, S I Koury, J J Blake
Journal: British Journal of Sports Medicine (1998)

Hyponatraemia is one of the most common electrolyte abnormalities, leading to significant morbidity and mortality. In the most basic sense, hyponatraemia can be due to sodium loss or fluid excess. The extracellular fluid status is used to clinically divide hyponatraemia into three categories to help to determine both the cause and treatment required. Hyponatraemic patients can be categorised on the basis of their fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another distinction to make in evaluating hyponatraemia is whether the onset was acute or chronic in nature. The case presented here is iatrogenic acute hypervolaemic hyponatraemia in a college athlete. The patient presented in respiratory distress with an altered mental status after the administration of hypotonic fluids for treatment of muscle cramps. Treatment included intubation, water restriction, and furosemide, to which he responded favourably. Hyponatraemia should be in the differential diagnosis for patients presenting after intravenous fluid administration.