tbuckley/cabot-search huggingface dataset:
Cystic fibrosis--a gastroenterological cornucopia.
Authors: P L Zentler-Munro
Journal: Gut (1987)

Progress reportCystic fibrosis -a gastroenterological cornucopia Cystic fibrosis, once the province of the paediatrician, has now entered the realm of the adult physician.The most common lethal Mendelian disease of Caucasians, it affects about 1 in 2000 births in Europe and North America.With recent advances in treatment about 60% of affected children can now expect to survive into adulthood, and many at least into their 30s.At least 1000 new patients are now expected to enter adulthood over the next five years.Adults usually come under the care of a chest physician, as the pulmonary manifestations of the disease usually determine survival.Until recently, therefore, both clinical research and management have tended to concentrate on the lungs.Gastrointestinal manifestations, however, occur in most adults and are increasingly recognised to impair the quality of life and to contribute to mortality.Furthermore, the disease may not be manifest until adulthood when it may present in a variety of guises to the gastroenterologist or even to the general surgeon.Cystic fibrosis (CF) therefore now concerns the gastroenterologist dealing with adults.There have been three recent reviews of the gastrointestinal manifesta- tions of CF," of which the first is the most comprehensive.I have therefore selected for discussion those aspects where recent research in CF or in other fields of gastroenterology has improved treatment, or where advances in CF illuminate gastrointestinal physiology in general.
Decreased Thyroid Uptake of Tc-99m Pertechnetate in Patients with Advanced-Stage Sjögren Syndrome
Authors: SHIN-ICHI TAURA, YUJI MURATA, WINN AUNG, RYUJI ISHIDA, LIN ZHANG, MOINUL HOSSAIN, YUZO TAKAHASHI, NORIHIKO OKADA, HITOSHI SHIBUYA
Journal: Clinical Nuclear Medicine (2002)

Purpose The authors assessed the uptake of Tc-99m pertechnetate in the thyroid using salivary gland scintigraphy in patients with Sjögren syndrome and in healthy controls. Materials and Methods Salivary gland scintigraphy and a labial biopsy were performed in 73 patients with Sjögren syndrome. Based on the labial biopsy findings, 32 patients with a histopathologic grade of 1 or 2 were regarded as having early-stage Sjögren syndrome and 41 patients with a grade of 3 or 4 were regarded as having an advanced stage. After the administration of 370 MBq (10 mCi) Tc-99m pertechnetate, dynamic salivary gland scintigraphy was performed for 50 minutes. Lemon juice was used to stimulate the salivary glands, and the thyroid gland was included in the imaging area. Scintigraphy was also performed in an age- and sex-matched control group of 25 healthy persons. The thyroid uptake ratio was calculated for the scintigraphic images and compared among the three groups: healthy controls, patients with early-stage Sjögren syndrome, and those with advanced-stage Sjögren syndrome. Results When compared with the control group, the thyroid uptake ratio of the early-stage Sjögren syndrome group was not significantly different, whereas that of the advanced-stage group was significantly lower. Conclusions Thyroid uptake of Tc-99m pertechnetate was less in patients with advanced-stage Sjögren syndrome than in patients with early-stage Sjögren syndrome or in healthy controls. Measuring the thyroid uptake of Tc-99m pertechnetate using salivary gland scintigraphy is an easy and useful method for assessing thyroid disorders in Sjögren syndrome and thus should be performed routinely.
Managing and Reducing Uncertainty in an Emerging Influenza Pandemic
Authors: Marc Lipsitch, Steven Riley, Simon Cauchemez, Azra C. Ghani, Neil M. Ferguson
Journal: New England Journal of Medicine (2009)

The early phases of an epidemic present decision makers with predictable challenges. Marc Lipsitch and colleagues write that the combination of urgency, uncertainty, and the costs of interventions makes the effort to control infectious diseases especially difficult.
Deteriorated contractility and disturbance of the myocardial energy metabolism in A.CA/SNJ mice following immunisation with the ADP/ATP carrier
Authors: Bernhard Witzenbichler, Karsten Schulze, Michael Schmöckel, Gertraud Krähn, Heinz-Peter Schultheiss, Bodo E. Strauer
Journal: Journal of the American College of Cardiology (1991)
The Physician's Role in Health Promotion — A Survey of Primary-Care Practitioners
Authors: Henry Wechsler, Sol Levine, Roberta K. Idelson, Mary Rohman, James O. Taylor
Journal: New England Journal of Medicine (1983)

Although evidence that people can do much to promote their own health is growing, the role of the primary-care physician in helping patients change their health behavior is still problematic. At least one study has examined what physicians do to promote their own health.1 Little is known, however, about the extent to which physicians promote the health of their patients, their success in helping patients change their behavior, or the types of training and support services physicians believe they need. This study examined the health-promotion beliefs, attitudes, and practices of a representative sample of primary-care physicians in Massachusetts.MethodsThe . . .
Endonasal Sinus Surgery with Endoscopical Control: From Radical Operation to Rehabilitation of the Mucosa
Authors: M. Wigand, W. Steiner, M. Jaumann
Journal: Endoscopy (1978)

The radical operations of the paranasal sinuses with total removal of the diseased mucosa very often produced postoperative disability due to scar formation and nerve irritation. A new concept of endonasal sinus surgery is based on the reestablishment of paranasal draining, reventilation, and preservation of the lining mucosa. This became possible by a strictly endonasal approach using angle-optic endoscopes for the optical control of manipulations. The principles of endonasal antrostomy, ethmoidectomy, and infundibulotomy are outlined, and their preliminary results are given. The importance of long-range postoperative local treatment is emphasized.
Cutaneous Lesions After Intestinal Bypass
Authors: ERNST J. DRENICK
Journal: Annals of Internal Medicine (1980)

Twenty-three of 81 intestinal bypass patients with episodes of bypass enteropathy had papulopustular or nodular skin lesions. Histologic examination of the dermal lesions showed various forms of vasculitis in nine of 14 subjects. In six of 11 patients examined by immunofluorescent microscopy, both the lesions and uninvolved sun-exposed skin areas had immunoglobulin and complement deposits in linear or granular patterns in the dermoepidermal line, giving the appearance of a positive lupus band test. Skin lesions resolved with spontaneous improvement of bypass enteropathy or in response to metronidazole therapy. After the bypass was dismantled, the eruptions disappeared permanently, and previously positive lupus band tests became negative. The skin lesions were frequently observed in association with arthritis, suggesting an immune-complex mechanism, probably originating in "blind loop" bacterial overgrowth.
The role of complement in experimental bullous pemphigoid.
Authors: Z Liu, G J Giudice, S J Swartz, J A Fairley, G O Till, J L Troy, L A Diaz
Journal: Journal of Clinical Investigation (1995)

Bullous pemphigoid (BP) is a blistering skin disease associated with an IgG autoimmune response directed against the ectodomain of the hemidesmosomal protein, BP180. An animal model of BP has recently been developed by our laboratory based on the passive transfer of rabbit antimurine BP180 antibodies into neonatal BALB/c mice. The experimental animals develop a blistering disease that reproduces all of the key immunopathological features of BP. In the present study we have investigated the role of complement in the pathogenesis of subepidermal blistering in the mouse model of BP. We demonstrate the following. (a) Rabbit anti-murine-BP180 IgG was effective in inducing cutaneous blisters in a C5-sufficient mouse strain, but failed to induce disease in the syngeneic C5-deficient strain; (b) neonatal BALB/c mice, pretreated with cobra venom factor to deplete complement, became resistant to the pathogenic effects of the anti-BP180 IgG; (c) F(ab')2 fragments generated from the anti-BP180 IgG exhibited no pathogenic activity in the mouse model; and (d) histologic evaluation of the skin of mice described in points b and c above showed minimal or no neutrophilic cell infiltration in the upper dermis. Thus, anti-BP180 antibodies trigger subepidermal blistering in this BP model via complement activation. This experimental model of BP should greatly facilitate future studies on the pathophysiology of autoantibody-mediated diseases of the dermal-epidermal junction.
Liberal Arts and the Premedical Curriculum
Authors: John T. Bruer
Journal: JAMA (1981)

Twenty-five leading physicians, medical educators, and humanists convened and affirmed the contributions of a liberal arts education to the study and practice of medicine. Participants agreed that overemphasizing technical expertise does have deleterious effects on premedical and medical education, which might be alleviated by encouraging a more broadly based undergraduate and medical curriculum. Admissions statistics show that approximately 50% of all applicants of medical school are admitted to some school and that there is no apparent bias against nonscience majors in the admissions process. Increased student awareness of these statistics should relieve anxieties and intense competitive pressures. A publication based on the conference recommendations will be made available to deans, advisors, and career counselors. (<i>JAMA</i>1981;245:364-366)
Decision analysis in medicine.
Authors: J. G. Thornton, R. J. Lilford, N. Johnson
Journal: BMJ (1992)

<b>Study objectives:</b> This study assessed the feasibility, reliability, and validity of the 28 item short child health questionnaire parent form (CHQ-PF28) containing the same 13 scales, but only a subset of the items in the widely used 50 item CHQ-PF50. <b>Design:</b> Questionnaires were sent to a random regional sample of 2040 parents of schoolchildren (4–13 years); in a random subgroup test-retest reliability was assessed (n = 234). Additionally, the study assessed CHQ-PF28 score distributions and internal consistencies in a nationwide general population sample of (parents of) children aged 4–11 (n = 2474) from Statistics Netherlands. <b>Main results:</b> Response was 70%. In the school and general population samples seven scales showed ceiling effects. Both CHQ summary measures and one multi-item scale showed adequate internal consistency in both samples (Cronbach’s α&gt;0.70). One summary measure and one scale showed excellent test-retest reliability (intraclass correlation coefficient &gt;0.70); seven scales showed moderate test-retest reliability (intraclass correlation coefficient 0.50–0.70). The CHQ could discriminate between a subgroup with no parent reported chronic conditions (n = 954) and subgroups with asthma (n = 134), frequent headaches (n = 42), and with problems with hearing (n = 38) (Cohen’s effect sizes 0.12–0.92; p&lt;0.05 for 39 of 42 comparisons). <b>Conclusions:</b> This study showed that the CHQ-PF28 resulted in score distributions, and discriminative validity that are comparable to its longer counterpart, but that the internal consistency of most individual scales was low. In community health applications, the CHQ-PF28 may be an acceptable alternative for the longer CHQ-PF50 if the summary measures suffice and reliable estimates of each separate CHQ scale are not required.
F-18 FDG Uptake in Bilateral Pulmonary Artery Leiomyosarcomata, One Mimicking a Pulmonary Embolus
Authors: Steven Allen, Johnathan Todd, Susan Copley, Adil Al-Nahhas
Journal: Clinical Nuclear Medicine (2005)

A 53-year-old woman was admitted for investigation of a 3-month history of increasing shortness of breath, cough, and hemoptysis. She had previously undergone a hysterectomy for uterine leiomyomata. A computed tomography scan was performed to exclude a pulmonary embolus and demonstrated an atypical intraluminal filling defect involving the right pulmonary artery and an exophytic mass arising from the left pulmonary artery. FDG PET was performed for further evaluation. Both intraluminal and exophytic mass lesions showed intense tracer uptake and on biopsy were proven to be pulmonary artery leiomyosarcomata.
Report to Obstetricians
Authors: R. Gerald Rice
Journal: New England Journal of Medicine (1955)

I SPENT two years as a general practitioner in a small village 35 miles from a hospital in the Province of Quebec. A large part of the practice consisted of obstetrics. Four and a half years' Army service immediately before I set up practice had done nothing to improve my skill as an obstetrician. My first maternity patient came to see me early in her pregnancy and made regular visits. In my efforts to give her adequate prenatal care I did religiously all that I had been taught to do — in fact more. I must have measured her pelvis . . .
Abstract 1016: Brain-derived neurotrophic factor increases vascular endothelial growth factor expression and subsequently enhances angiogenesis in human chondrosarcoma cells
Authors: Chih-Yang Lin, Chih-Hsin Tang
Journal: Cancer Research (2014)

Abstract Chondrosarcomas are a type of primary malignant bone cancer, with a potent capacity for local invasion and distant metastasis. Brain-derived neurotrophic factor (BDNF) is commonly upregulated during neurogenesis. The aim of the present study was to examine the mechanism involved in BDNF-mediated vascular endothelial growth factor (VEGF) expression and angiogenesis in human chondrosarcoma cells. Here, we knocked down BDNF expression in chondrosarcoma cells and assessed their capacity to control VEGF expression and angiogenesis in vitro and in vivo. We found knockdown of BDNF decreased VEGF expression and abolished chondrosarcoma conditional medium-mediated angiogenesis in vitro as well as angiogenesis effects in vivo in the chick chorioallantoic membrane and Matrigel plug nude mouse models. In addition, in the xenograft tumor angiogenesis model, the knockdown of BDNF significantly reduced tumor growth and tumor-associated angiogenesis. BDNF increased VEGF expression and angiogenesis through the TrkB receptor, PLCγ, PKCα, and the HIF-1α signaling pathway. Finally, we analyzed samples from chondrosarcoma patients by immunohistochemical staining. The expression of BDNF and VEGF protein in 56 chondrosarcoma patients was significantly higher than in normal cartilage. In addition, the high level of BDNF expression correlated strongly with VEGF expression and tumor stage. Taken together, our results indicate that BDNF increases VEGF expression and enhances angiogenesis through a signal transduction pathway that involves the TrkB receptor, PLCγ, PKCα, and the HIF-1α. Therefore, BDNF may represent a novel target for anti-angiogenic therapy for human chondrosarcoma. Citation Format: Chih-Yang Lin, Chih-Hsin Tang. Brain-derived neurotrophic factor increases vascular endothelial growth factor expression and subsequently enhances angiogenesis in human chondrosarcoma cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1016. doi:10.1158/1538-7445.AM2014-1016
Interventricular septal shift due to massive pulmonary embolism shown by CT pulmonary angiography: an old sign revisited
Authors: T B Oliver, J H Reid, J T Murchison
Journal: Thorax (1998)

The computed tomographic (CT) pulmonary angiogram appearances of acute right ventricular dysfunction due to massive pulmonary embolus in a patient are described. Abnormal findings comprised right ventricular dilatation, interventricular septal shift, and compression of the left ventricle. These changes resolved following thrombolysis. Use of CT pulmonary angiography to diagnose pulmonary emboli is increasing. Secondary cardiac effects are established diagnostic features shown by echocardiography. These have not been previously described but are important to recognise as they may carry important prognostic and therapeutic implications.
Preventing the Return of Smallpox
Authors: Joel G. Breman, Isao Arita, Frank Fenner
Journal: New England Journal of Medicine (2003)

Each state party to this Convention undertakes never in any circumstances to develop, produce, stockpile or otherwise acquire or retain: (1) Microbial or other biological agents, or toxins whatever their origin or method of production, of types and in quantities that have no justification for prophylactic, protective or other peaceful purposes; (2) Weapons, equipment or means of delivery designed to use such agents or toxins for hostile purposes or in armed conflict. — Biological and Toxin Weapons Convention, 1972, Article 11 It is imperative and urgent that we prevent the intentional or unintentional release of variola (smallpox) virus into an . . .
Mentally ill offenders in prison.
Authors: R W Reeves
Journal: BMJ (1985)

Yet again, judges including the Lord Chief Justice have complained of the scandal that mentally ill offenders have to be sent to prison for lack of hospital places.After an appeal to the Court of Appeal a severely mentally dis- ordered woman has been transferred from prison to hospital.1 Wendy Christine Porter, aged 23, has an Intelligence Quotient of 65 and has spent four months in prison since being sentenced in October last year by Judge Verney at Aylesbury Crown Court to life imprisonment for arson and causing criminal damage.2She had previously come before the courts in 1981 accused of arson of a printing works causing £100000 worth of damage.On that occasion the Department of Health had refused her a place in a special hospital, and no other appropriate facilities had been available in the county or region.Milton Keynes Health Authority had paid about £50 000 for her to receive treatment at St Andrews Psychiatric Hospital, Northampton (where there are no secure facilities) under the terms of a three year probation order.In June 1984 St Andrews Hospital discharged her, and within two weeks she had caused £700 worth of damage to a car by scratching graffiti on it.While in a remand hostel she set a wastepaper bin alight and was severely disruptive.St Andrews Hospital was unwilling to readmit her, believing that she would not respond to treatment, and in any case no funds were available to pay for her care there.Neither Buckinghamshire Social Services nor Oxford Regional Health Authority could provide facilities for her treatment.
Thyroid disease in women is linked to non-stick chemicals, study finds
Authors: G. Watts
Journal: BMJ (2010)

Sarcomatoid carcinoma is a rare clinical entity, especially when presenting in the nasopharynx. We describe the first documented case of nasopharyngeal sarcomatoid carcinoma with intracranial extension in a 59-year-old Caucasian man presenting with severe bifrontal headache and diplopia, secondary to left abducens nerve palsy. We highlight some of the major diagnostic challenges and describe its unusual histological appearance. We outline the importance of a multidisciplinary approach to his management, which includes input from the medicine, neurosurgery, Ear, Nose and Throat (ENT), pathology, radiology, oncology and respiratory teams. In the context of limited evidence, we then describe the rationale to proceed with induction chemotherapy followed by concurrent chemoradiotherapy. Although there was a partial response to treatment, it was not sufficient enough to allow subsequent surgical clearance. The plan going forward is to palliate with chemotherapy as and when the disease progresses.
Derivation and Validation of a Preoperative Prediction Rule for Delirium After Cardiac Surgery
Authors: James L. Rudolph, Richard N. Jones, Sue E. Levkoff, Christopher Rockett, Sharon K. Inouye, Frank W. Sellke, Shukri F. Khuri, Lewis A. Lipsitz, Basel Ramlawi, Sidney Levitsky, Edward R. Marcantonio
Journal: Circulation (2009)

Delirium is a common outcome after cardiac surgery. Delirium prediction rules identify patients at risk for delirium who may benefit from targeted prevention strategies, early identification, and treatment of underlying causes. The purpose of the present prospective study was to develop a prediction rule for delirium in a cardiac surgery cohort and to validate it in an independent cohort.Prospectively, cardiac surgery patients > or =60 years of age were enrolled in a derivation sample (n=122) and then a validation sample (n=109). Beginning on the second postoperative day, patients underwent a standardized daily delirium assessment, and delirium was diagnosed according to the confusion assessment method. Delirium occurred in 63 (52%) of the derivation cohort patients. Multivariable analysis identified 4 variables independently associated with delirium: prior stroke or transient ischemic attack, Mini Mental State Examination score, abnormal serum albumin, and the Geriatric Depression Scale. Points were assigned to each variable: Mini Mental State Examination < or =23 received 2 points, and Mini Mental State Examination score of 24 to 27 received 1 point; Geriatric Depression Scale >4, prior stroke/transient ischemic attack, and abnormal albumin received 1 point each. In the derivation sample, the cumulative incidence of delirium for point levels of 0, 1, 2, and > or =3 was 19%, 47%, 63%, and 86%, respectively (C statistic, 0.74). The corresponding incidence of delirium in the validation sample was 18%, 43%, 60%, and 87%, respectively (C statistic, 0.75).Delirium occurs frequently after cardiac surgery. Using 4 preoperative characteristics, clinicians can determine cardiac surgery patients' risk for delirium. Patients at higher delirium risk could be candidates for close postoperative monitoring and interventions to prevent delirium.
Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction
Authors: Patrick W. Serruys, Maarten L. Simoons, Haryanto Suryapranata, Frank Vermeer, William Wijns, Marcel van den Brand, Frits Bär, Chris Zwaan, X. Hanno Krauss, William J. Remme, Jan Res, Freek W.A. Verheugt, Ronald van Domburg, Jacobus Lubsen, Paul G. Hugenholtz
Journal: Journal of the American College of Cardiology (1986)
Long-term stability of the defibrillation threshold with a pectoral unipolar defibrillation system
Authors: Werner Jung, Christian Wolpert, Burkhard Hügl, Thomas Korte, Christian Schneider, Bahman Esmailzadeh, Dietrich Pfeiffer, Jürgen Tebbenjohanns, Susanne Spehl, Berndt Lüderitz
Journal: Journal of the American College of Cardiology (1996)
Time Course of Tension in Papillary Muscles of Heart
Authors: George E. Burch
Journal: JAMA (1965)

Any comprehensive theory of myocardial function must take into consideration the stresses developed within the myocardium during the cardiac cycle. The moment-to-moment variations in myocardial tension during the cardiac cycle have been discussed in previous papers from this as well as other laboratories. 1-4 However, relatively little attention has been given to the mechanical stresses and strains placed upon the papillary muscles during the cardiac cycle. Nevertheless, the mechanical properties of the papillary muscles are intimately related to a number of clinical problems. For example, mechanical failure of a papillary muscle may result in valvular insufficiency and congestive heart failure, or a damaged papillary muscle may rupture under certain loads.  It was reported previously that, because of the mechanical nature of the heart as a pump, it was possible to apply physical principles towards an estimation of the load which must be supported by the ventricles of the heart during