tbuckley/cabot-search huggingface dataset:
Supervoltage Irradiation
Authors: Franz Buschke
Journal: JAMA (1968)

Based on my personal experience with supervoltage irradiation of carcinoma of the bladder over the last 25 years<sup>19</sup>I find external irradiation indicated as an effective primary method of choice in transitional cell carcinomas. This technique is indicated in grade IV carcinomas regardless of the degree of infiltration and in grade III tumors as long as the carcinoma has not massively invaded the muscle (stages A and B1). It has been found to be ineffective as a curative procedure for grade I carcinoma in doses that are tolerated by the bladder wall. As a matter of fact, in some cases studied, microscopic sections of biopsy specimens taken prior to and following treatment of such carcinomas could have been exchanged.<sup>20, Fig 99, 100</sup>Occasionally, however, the response to irradiation may be sufficiently great to achieve temporary regression. Treatment thus may be of a palliative value for elderly patients with
Widespread Morbilliform Eruption Associated With Telaprevir
Authors: Lauren Strazzula, Daniel S. Pratt, Janet Zardas, Raymond T. Chung, Michael Thiim, Daniela Kroshinsky
Journal: JAMA Dermatology (2014)

Telaprevir, combined with pegylated interferon alfa and ribavirin, is an efficacious approach to treat hepatitis C virus infection. A morbilliform eruption associated with telaprevir is a common adverse effect experienced by patients. Current guidelines mandate telaprevir discontinuation in any patient with a severe, progressive, or unresponsive cutaneous eruption.Eight patients with a grade 3 (severe) widespread morbilliform eruption associated with telaprevir were referred to dermatology for evaluation and treatment. Each patient received a combination of antihistamines, topical corticosteroids, and thick emollient creams, rendering their eruption tolerable for the duration of treatment. No patients had evidence of a systemic or life-threatening drug reaction, developed a systemic drug eruption, or had to prematurely stop triple therapy secondary to a cutaneous eruption.Patients with an uncomplicated grade 3 (severe) widespread morbilliform eruption associated with telaprevir may be able to continue triple therapy with close monitoring and dermatologic consultation. Given our findings, we propose an additional clinical classification of the telaprevir-associated eruption to better reflect the dermatologic classification of drug eruptions.
Rare complication of upper gastrointestinal endoscopy: doubled-back endoscope in the esophagus
Authors: I. Pregun, T. Zágoni, A. Péter, Z. Máthé, I. Hritz, Z. Tulassay
Journal: Endoscopy (2008)

The best-known complications of upper gastrointestinal endoscopy are perforation and hemorrhage. Our case report describes a rare complication that occurred during diagnostic endoscopy.
Congenital Defects of the Abdominal Wall
Authors: Michael D. Klein
Journal: JAMA (1981)

Omphalocele, umbilical cord hernia, and gastroschisis are surgically correctable defects of the abdominal wall. Each of these defects has a distinct embryologic basis that results in a characteristic clinical picture. Twenty-five infants with congenital defects of the abdominal wall were treated at the University of New Mexico Hospital in the past four years. Six infants had omphalocele, one had umbilical cord hernia, and 18 had gastroschisis. Survival among infants who underwent a corrective operation was as follows: omphalocele, 50%; umbilical cord hernia, 100%; and gastroschisis, 82%. Long-term survival for the entire group was 72% (18/25). Gastroschisis, which had a lower incidence of major associated anomalies, had a better prognosis than omphalocele. The mortality of congenital abdominal wall defects was related to presence of severe associated anomalies and to poor clinical condition on admission. Prompt and informed initial care may increase the chance of survival. (<i>JAMA</i>1981;245:1643-1646)
Edmund James Raffle
Authors: K. Raffle, J. Surtees, G. Lowe
Journal: BMJ (2010)

As a medical student, Edmund James Raffle had a tuberculous kidney which necessitated a nephrectomy. After a spell at Alder Hey Children’s Hospital, he spent time in general medicine/cardiology at Dundee, where he met and married Kay, a nursing sister there. It was during five years of general practice in Peterborough and Cheshire that he became interested …
Impaired “outside-in” integrin αIIbβ3 signaling and thrombus stability in TSSC6-deficient mice
Authors: Matt W. Goschnick, Lai-Man Lau, Janet L. Wee, Yong S. Liu, P. Mark Hogarth, Lorraine M. Robb, Michael J. Hickey, Mark D. Wright, Denise E. Jackson
Journal: Blood (2006)
Sustained virological response to interferon plus ribavirin reduces liver-related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus
Authors: Juan Berenguer, Julio Álvarez‐Pellicer, Pilar Miralles Martín, José López‐Aldeguer, Miguel Angel Von‐Wichmann, Carmen Quereda, Josep Mallolas, José Sanz, Cristina Tural, José María Bellón, Juan González‐García
Journal: Hepatology (2009)

Human immunodeficiency virus (HIV) infection modifies the natural history of chronic hepatitis C, thus promoting more rapid progression to cirrhosis and end-stage liver disease. The objective of our study was to determine whether hepatitis C virus (HCV) clearance is associated with improved clinical outcomes in patients positive for HIV and HCV. It was an ambispective cohort study carried out in 11 HIV units in Spain and involved 711 consecutive patients positive for HIV/HCV who started interferon plus ribavirin therapy between 2000 and 2005. We measured sustained virologic response (SVR), i.e., undetectable HCV RNA at 24 weeks after the end of treatment, and clinical outcomes, defined as death (liver-related or non–liver-related), liver decompensation, hepatocellular carcinoma, and liver transplantation. Of 711 patients who were positive for HIV/HCV, 31% had SVR. During a mean follow-up of 20.8 months (interquartile range: 12.2-38.7), the incidence rates per 100 person-years of overall mortality, liver-related mortality, and liver decompensation were 0.46, 0.23, and 0.23 among patients with SVR and 3.12, 1.65, and 4.33 among those without SVR (P = 0.003, 0.028, and <0.001 by the log-rank test), respectively. Cox regression analysis adjusted for fibrosis, HCV genotype, HCV RNA viral load, Centers for Disease Control and Prevention clinical category, and nadir CD4+ cell count showed that the adjusted hazard ratio of liver-related events was 8.92 (95% confidence interval, 1.20; 66.11, P = 0.032) for nonresponders in comparison with responders and 4.96 (95% confidence interval, 2.27; 10.85, P < 0.001) for patients with fibrosis grade of F3-F4 versus those with F0-F2.Because this was not a prospective study, selection and survival biases may influence estimates of effect. Conclusion: Our results suggest that the achievement of an SVR after interferon-ribavirin therapy in patients coinfected with HIV/HCV reduces liver-related complications and mortality. (HEPATOLOGY 2009.)
Presence of clonal T cell populations in chronic B lymphocytic leukemia and smoldering myeloma.
Authors: T Wen, H Mellstedt, M Jondal
Journal: The Journal of Experimental Medicine (1990)

Clonality in the non-neoplastic T cell population was investigated in 21 patients with B cell chronic leukemic (B-CLL) or multiple myeloma (MM) by probing for TCR beta chain gene rearrangements using Southern blot analysis. In three patients with a benign form of B-CLL (stage 0), and in one patient with smoldering MM, evidence was found for predominant T cell clones. As cellular immunity against the malignant cells may be important in leukemia, the results are discussed in view of the potential role of T cell immunity in B-CLL and MM.
Granules of electrolytes for infants.
Authors: T. M. French
Journal: BMJ (1969)

MEDICALJOURNAIto the latter means much.These units could also be used-for teaching purposes.At the general-practitioner hospital at which I attend students accompany me regularly.At the outpatients there they see more everyday cases than they would ever see at their teach- ing hospital, where referred cases tend to be of a highly specialized nature.-Iam, etc., STANLEY AYLETT.London W
Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia
Authors: Shahnaz Shahinfar, Roger L. Simpson, Alexandra D. Carides, Balasamy Thiyagarajan, Yasushi Nakagawa, Jason G. Umans, Joan H. Parks, Fredric L. Coe, None for the Losartan Uric Acid Study Group
Journal: Kidney International (1999)
Extracting the history
Authors: G. Dunea
Journal: BMJ (1995)

The house doctor at a private hospital was extracting a medical history—slowly, painfully, like pulling teeth—from an irritated bored woman who by the sound of it had been through it all before. “Have you had chest pain or anything like that?” “No.” “Have you ever vomited blood or anything like that?” “No.” So he slugged on, one extraction at a time, then writing it all down in a jumble.

He could use some help, I thought from behind the curtain that separated his patient's bed from mine. I felt sorry for the now figuratively toothless old lady; also for the house officer—busy, harassed, paged by everybody while trying to come to grips with all these patients, and now firing away …
Shortage of British graduates
Authors: G. W Forrest
Journal: BMJ (1976)

that in "normal" twin pairs' (anaemic twin IgG 5 40 g/l; normal twin IgG 5 43 g/l).In contrast, in cases of the chronic type of fetofetal transfusion syndrome the donor twin had abnormally low levels of IgG whereas those of the recipient were within the normal range.3There were invariably large intrapair discrepancies and we suggest that this may be due to a disturbance in the maternofetal transfer of the immunoglobulin across the donor portion of the placenta, which is fre- quently oedematous and histologically abnormal in such cases.4
360 ASSOCIATION OF A NON-SYNONYMOUS ABCA1 GENE VARIANT WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)
Authors: S. Canizales-Quinteros, H. Villamil-Ramirez, F. Sanchez-Munoz, T. Flores-Dorantes, T. Villarreal-Molina, A. Dominguez-Lopez, M. Uribe, N. Mendez-Sanchez
Journal: Journal of Hepatology (2010)
High Blood Neutrophil-to-Lymphocyte Ratio Is an Indicator of Poor Prognosis in Malignant Mesothelioma Patients Undergoing Systemic Therapy
Authors: Steven C.H. Kao, Nick Pavlakis, Rozelle Harvie, Janette L. Vardy, Michael J. Boyer, Nico van Zandwijk, Stephen J. Clarke
Journal: Clinical Cancer Research (2010)

Asbestos-induced chronic inflammation is implicated in the pathogenesis of malignant mesothelioma (MM). We have investigated blood neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation, as a prognostic factor in MM patients.Patients with MM who had systemic therapy at participating institutes were studied. Potential prognostic factors such as age, gender, performance status, histologic subtype, and baseline laboratory parameters, including NLR, were analyzed. Overall survival from commencement of therapy was determined by the Kaplan-Meier method. Multivariate analyses using Cox Regression model were performed with significant factors (P ≤ 0.05) to determine their independent effect.A total of 173 MM patients undergoing systemic therapy including 119 patients receiving first-line therapy and 54 patients receiving second- or third-line therapy were included in this retrospective evaluation. Forty-two percent of patients had an elevated NLR at baseline. The following variables were predictive of survival: female gender (P = 0.044), epithelioid histologic subtype (P < 0.001), baseline white blood cell count less than 8.3 × 10⁹/L (P = 0.008), baseline platelet count 400 × 10⁹/L or less (P = 0.05), and NLR of 5 or less (P < 0.001). After multivariate analysis, histologic epithelioid subtype [hazard ratio (HR) = 2.0; 95% confidence interval (CI) = 1.3-2.9; P = 0.001], and NLR less than 5 (HR = 2.7; 95% CI = 1.8-3.9; P < 0.001) remained independent predictors. The 1-year survival rate was 60% versus 26%, whereas the 2-year survival rate was 34% versus 10% for NLR less than 5 and 5 or greater, respectively. In the separate analyses of chemotherapy-naive and previously treated patient groups, NLR was an independent predictor of survival in both groups.Our results indicate that NLR is an independent predictor of survival for patients with MM undergoing systemic therapy.
Experiences with Dicumarol in Acute Myocardial Infarction
Authors: Elliott Bresnick, Louis A. Selverstone, Bernard Rapoport, Kenneth Cheskey, Herbert N. Hultgren, Herbert S. Sise
Journal: New England Journal of Medicine (1950)

NUMEROUS reports1 2 3 4 5 6 during the past few years have emphasized the value of Dicumarol therapy in reducing the mortality rate and the incidence of thromboembolic complications following acute myocardial infarction. These series have in general represented carefully followed cases under the direct supervision of well organized research teams, and results as reported have been favorable. Consequently, the statement has been made that Dicumarol therapy is indicated in every case of myocardial infarction in which proper laboratory facilities are available.However, modes of therapy that work well under research conditions may not be so successful under the conditions of average hospital practice. . . .
Oxyhemoglobin Equilibrium in Ischemic Heart Disease
Authors: Michael A. Nevins
Journal: JAMA (1974)

The equilibrium of oxygen and hemoglobin is under multifactorial control. Shifts of oxyhemoglobin dissociation curves have been observed in patients with heart disease. Whether such changes, measurable in vitro, merely represent compensatory mechanisms or play a contributory role in the pathogenesis of ischemia is still uncertain. With the development of newer techniques, the actual rate of oxygen release from hemoglobin can be measured, and this may prove to be a more valid measurement of physiologic oxygen release. Pharmacologic manipulation of oxyhemoglobin equilibrium can be accomplished with various agents, notably propranolol hydrochloride, acetazolamide, and infusion of inosine, phosphorus, and pyruvate. The clinical significance of these effects has not been established, but ultimately they may prove to be useful in improving tissue oxygenation in ischemic conditions. (<i>JAMA</i>229:804-808, 1974)
Rituximab response in follicular lymphoma: contributions from KIR 2DS1 and HLA-C
Authors: A K Erbe, Wei Wang, B Grzywacz, E A Ranheim, J A Hank, K Kim, L Carmichael, S Seo, E A Mendonca, Y Song, F Hong, R D Gascoyne, E Paietta, S H Horning, B Kahl, P M Sondel
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Immunotherapeutic response in cancer patients, specifically those attributed to antibody-dependent cellular cytotoxicity (ADCC), may be variable dependent upon an individual's genotype. A recent Eastern Cooperative Oncology Group (ECOG) Phase III clinical trial, E4402, sought to
IMPACT OF CILOSTAZOL ON RESTENOSIS AFTER COBALT-CHROMIUM ALLOY STENT IMPLANTATION IN HIGH-RISK PATIENTS
Authors: Hiroshi Ueda, Hiroki Sakamoto, Yuichi Kawase, Shinsaku Shimamoto, Tomoe Murakami, Takashi Tamura
Journal: Journal of the American College of Cardiology (2010)
Proceedings: Mark Twain and Rheumatology.
Authors: G Juttla, V Wright
Journal: Annals of the Rheumatic Diseases (1975)

In 10 patients with classical rheumatoid arthritis indomethacin profiles and articular indices were determined before and after a period of one week's administration of probenecid (1 g daily).There were significant differences between the two indomethacin profile results, and the articular index fell significantly (P < 0 05) from a mean value of 17-6 (±SEM 2-8) before treatment to a mean value of 12-5 units (±SEM 11) after probenecid.Despite attaining very high plasma indomethacin concentrations after probenecid no patient complained of side effects.This effect of probenecid on indomethacin levels was noted in further studies after both oral and rectal administration.When frusemide was administered orally with indo- methacin the indomethacin profile was reduced.These results are preliminary and based on a small number of patients but do raise the question of the advisability of concurrent administration of diuretics and indomethacin.
The outcome of full-intensity and reduced-intensity conditioning matched sibling or unrelated donor transplantation in adults with Philadelphia chromosome–negative acute lymphoblastic leukemia in first and second complete remission
Authors: David I. Marks, Tao Wang, Waleska S. Pérez, Joseph H. Antin, Edward Copelan, Robert Peter Gale, Biju George, Vikas Gupta, Joerg Halter, H. Jean Khoury, Thomas R. Klumpp, Hillard M. Lazarus, Victor A. Lewis, Philip McCarthy, David A. Rizzieri, Mitchell Sabloff, Jeff Szer, Martin S. Tallman, Daniel J. Weisdorf
Journal: Blood (2010)
Another Viewpoint Regarding Periodic Checkups
Authors: Phil Gunby
Journal: JAMA (1987)

ACKNOWLEDGING "that the question of frequency of periodic health examinations and medical testing is controversial," the Dallas-based American Heart Association (AHA) is recommending that medical checkups for all "apparently healthy" adults begin at age 20 years, be repeated at least every five years until age 60 and every 2 1/2 years thereafter until age 75, and be performed annually after the mid-70s. These and other recommendations are in a report titled "Cardiovascular and Risk Factor Evaluation of Healthy American Adults," approved by the association's Steering Committee (the primary science policy—making body), and published in the current issue of the AHA's journal (<i>Circulation</i>1987;75: 1340A-1362A). The position statement was written by a group appointed by the Steering Committee and headed by Scott Grundy, MD, PhD, director, Center for Human Nutrition, University of Texas Health Science Center, Dallas. It concedes that some "maintain that routine screening of the population is expensive and
Review of the epidemiologic literature on EMF and Health.
Authors: I C Ahlbom, E Cardis, A Green, M Linet, D Savitz, A Swerdlow
Journal: Environmental Health Perspectives (2001)

Exposures to extremely low-frequency electric and magnetic fields (EMF) emanating from the generation, transmission, and use of electricity are a ubiquitous part of modern life. Concern about potential adverse health effects was initially brought to prominence by an epidemiologic report two decades ago from Denver on childhood cancer. We reviewed the now voluminous epidemiologic literature on EMF and risks of chronic disease and conclude the following: a) The quality of epidemiologic studies on this topic has improved over time and several of the recent studies on childhood leukemia and on cancer associated with occupational exposure are close to the limit of what can realistically be achieved in terms of size of study and methodological rigor. b) Exposure assessment is a particular difficulty of EMF epidemiology, in several respects: i) The exposure is imperceptible, ubiquitous, has multiple sources, and can vary greatly over time and short distances. ii) The exposure period of relevance is before the date at which measurements can realistically be obtained and of unknown duration and induction period. iii) The appropriate exposure metric is not known and there are no biological data from which to impute it. c) In the absence of experimental evidence and given the methodological uncertainties in the epidemiologic literature, there is no chronic disease for which an etiological relation to EMF can be regarded as established. d) There has been a large body of high quality data for childhood cancer, and also for adult leukemia and brain tumor in relation to occupational exposure. Among all the outcomes evaluated in epidemiologic studies of EMF, childhood leukemia in relation to postnatal exposures above 0.4 microT is the one for which there is most evidence of an association. The relative risk has been estimated at 2.0 (95% confidence limit: 1.27-3.13) in a large pooled analysis. This is unlikely to be due to chance but, may be, in part, due to bias. This is difficult to interpret in the absence of a known mechanism or reproducible experimental support. In the large pooled analysis only 0.8% of all children were exposed above 0.4 microT. Further studies need to be designed to test specific hypotheses such as aspects of selection bias or exposure. On the basis of epidemiologic findings, evidence shows an association of amyotrophic lateral sclerosis with occupational EMF exposure although confounding is a potential explanation. Breast cancer, cardiovascular disease, and suicide and depression remain unresolved.
PTU-022 Preoperative neutrophil: lymphocyte ratio does not predict post-operative complications following hepatic resection: Abstract PTU-022 Table 1
Authors: C E Western, S Aroori, M Bowles, D Stell
Journal: Gut (2012)

<h3>Introduction</h3> Neutrophil:lymphocyte ratio (NLR) is a marker of systemic inflammation and, if high, has been shown in several studies to be correlated with adverse outcome following operative intervention in many conditions.<sup>1–3</sup> We attempted to test this association by analysing pre-operative NLR in all patients undergoing liver resection in our unit and attempting correlation with markers of adverse outcome in the form of post-operative complications and length of inpatient stay. <h3>Methods</h3> Our unit is a regional tertiary referral centre for hepatic surgery undertaken for both benign and malignant disease. A database of patient demographics, radiological and histological findings and blood tests for this cohort has been prospectively maintained since 2005 and the data has been retrospectively analysed for this study. A NLR of &gt;5 was considered elevated. <h3>Results</h3> Between 15 July 2005 and 27 September 2011, 377 hepatic resections were performed. 62% were for colorectal carcinoma metastases, 6% for other metastases, 8% for benign disease, 7% for cholangiocarcinoma, 7% for hepatocellular carcinoma, 4% for gallbladder cancer and 2% for neuroendocrine tumours. Median patient age was 65 and 56% were male. Our median NLR was 2.5. Overall morbidity was 26%. Post-operative complications seen include bile leak 8%, liver failure 1% and post-operative death 2%. There were no intra-operative deaths. Intra-operatively, 19 % of patients required an average of 3.8 units packed cell transfusion, 6% an average of 3.7 units FFP and 2% 1.5 pool platelets. When NLR was correlated against post-operative complications, there was seen to be no association (p&gt;0.5). Median length of inpatient stay was 8 days (range 3 to 70 days). There was also no correlation demonstrable between NLR and length of inpatient stay (p=0.23). <h3>Conclusion</h3> Preoperative NLR does not appear to be a useful predictor of post-operative outcomes in the form of complications and post-operative hospital stay in patients undergoing liver resection. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>Bhutta H</b>, Agha R, Wong J, <i>et al</i>. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. <i>Vasc Endovascular Surg</i> 2011;<b>45</b>:227–31. 2. <b>Gomez D</b>, Farid S, Malik HZ, <i>et al</i>. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. <i>World J Surg</i> 2008;<b>32</b>:1757–62. 3. <b>Jung MR</b>, Park YK, Jeong O, <i>et al</i>. Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. <i>J Surg Oncol</i> 2011;<b>104</b>:504–10.