tbuckley/cabot-search huggingface dataset:
Xenon Ventilation-Perfusion Lung Scans-Reply
Authors: Gerald L. Schall
Journal: JAMA (1979)

In Reply.—  We thank Dr Pomrehn, Dr Martyn, and Ms Mackay for their interest in our work and share their concern over the cost-effectiveness of modern diagnostic medical procedures. We have several comments concerning the points they raise in their correspondence.   We did not equate a normal xenon scan with the absence of inhalation injury, since that obviously would have been begging the question. The final clinical determination of whether inhalation injury was present was based on an evaluation of all the physical signs and symptoms, bronchoscopic examination, and roentgenographic and laboratory data (excluding the scan). It was clearly stated that 31 of 32 patients with normal scans had no conclusive evidence of inhalation injury and that there was one false-negative. Our Table 2 was a comparison of the ancillary data for patients with normal vs abnormal scans, not the presence or absence of inhalation injury.  The correspondents
Botulinum Toxin for the Treatment of Upper Gastrointestinal Diseases: The Future or Already the Past?
Authors: M. H. Madaliński
Journal: Endoscopy (2003)

Pasricha and colleagues, from Johns Hopkins Medical Center, presented the first results for treatment of achalasia using botulinum toxin that could be regarded as promising [1] [2]. Today, however, it might be said that botulinum toxin has not fulfilled all that was expected of it. Nevertheless, it is too early to decide whether botulinum toxin treatment in gastroenterology is in decline, even if only the upper part of the digestive system is taken into account.
Challenges for Communicable Disease Surveillance and Control in Southern Iraq, April-June 2003
Authors: Marta Valenciano
Journal: JAMA (2003)

The recent war in Iraq presents significant challenges for the surveillance and control of communicable diseases. In early April 2003, the World Health Organization (WHO) sent a team of public health experts to Kuwait and a base was established in the southern Iraqi governorate of Basrah on May 3. We present the lessons learned from the communicable disease surveillance and control program implemented in the Basrah governorate in Iraq (population of 1.9 million) in April and May 2003, and we report communicable disease surveillance data through June 2003. Following the war, communicable disease control programs were disrupted, access to safe water was reduced, and public health facilities were looted. Rapid health assessments were carried out in health centers and hospitals to identify priorities for action. A Health Sector Coordination Group was organized with local and international health partners, and an early warning surveillance system for communicable disease was set up. In the first week of May 2003, physicians in hospitals in Basrah suspected cholera cases and WHO formed a cholera control committee. As of June 29, 2003, Iraqi hospital laboratories have confirmed 94 cases of cholera from 7 of the 8 districts of the Basrah governorate. To prevent the transmission of major communicable diseases, restoring basic public health and water/sanitation services is currently a top priority in Iraq. Lack of security continues to be a barrier for effective public health surveillance and response in Iraq.
A Break in the Brake Mechanism in Diabetes
Authors: Aaron Vinik, Archana Nakave, Maria del Pilar Silva Chuecos
Journal: Diabetes Care (2008)

The importance of insulin and glucagon as fine regulators of glycemic excursions is well established (1). Alterations in gastric emptying are generally not considered important contributors to postprandial hyperglycemia until late complications of diabetes such as gastroparesis have occurred (2,3). It is now emerging that the rate of gastric emptying may be a major determinant of postprandial glycemic excursions in healthy subjects, as well as in type 1 and type 2 diabetic patients (4).

Gastroparesis is a relatively rare complication that occurs late in diabetes because of irreversible intestinal nerve damage (4); it must be distinguished from the physiological inhibitory effects of acute hyperglycemia on gastric motility (5,6). The latter has been proposed as a defense mechanism existing to minimize postprandial hyperglycemia by reducing the rate of efflux of glucose into the circulation from the gut (7). This may be of special importance for people with type 1 diabetes who have a reduced ability to delay gastric emptying in response to hyperglycemia (8). Cross-sectional studies suggest that an inverse relationship between the rate of gastric emptying and blood glucose concentration also exists in type 2 diabetic patients (4) and, thus, that similar regulatory mechanisms may exist in both conditions.

### Extrinsic pathway.

Normally, the rate of gastric emptying is tightly regulated as a result of neural and hormonal feedback triggered by the interaction of nutrients within the small intestine known as the ileal break mechanism or “extrinsic pathway” of control. This feedback is caloric-load dependent, relates to the length of small intestine exposed to nutrient, and regulates the overall rate of emptying to about 2–3 kcal/min (9,10). When food reaches the intestine, L- and K-cells in the distal small bowel are stimulated to produce glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), respectively, both of …
Prognostic factors in meningococcal disease. Development of a bedside predictive model and scoring system. Barcelona Meningococcal Disease Surveillance Group
Authors: N. Barquet
Journal: JAMA (1997)

Meningococcal disease is associated with significant morbidity and mortality. Development of a prognostic model based on clinical findings may be useful for identification and management of patients with meningococcal infection.To construct and validate a bedside model and scoring system for prognosis in meningococcal disease.Prospective, population-based study.Twenty-four hospitals in the metropolitan area of Barcelona, Spain.A total of 907 patients with microbiologically proven meningococcal disease. Patients diagnosed with meningococcal disease from 1987 through 1990 were used to develop the prognostic model, and those diagnosed in 1991 and 1992 were used to validate it.Clinical independent prognostic factors for mortality in meningococcal disease. The association between outcome and independent prognostic factors was determined by logistic regression analysis. A scoring system was constructed and tested using receiver operating characteristic curves.Among 624 patients in the derivation set, 287 (46%) were male, the mean age was 12.4 years, and 34 patients (5.4%) died. Among 283 patients in the validation set, 124 (43.8%) were male, the mean age was 12.7 years, and 17 patients (6.0%) died. In multivariate analysis, independent predictors of death were hemorrhagic diathesis (odds ratio [OR], 101; 95% confidence interval [CI], 30-333), focal neurologic signs (OR, 25; 95% CI, 7-83), and age 60 years or older (OR, 10; 95% CI, 3-34), whereas receipt of adequate antibiotic therapy prior to admission was associated with reduced likelihood of death (OR, 0.09; 95% CI, 0.02-0.4). Hemorrhagic diathesis was scored with 2 points, presence of focal neurologic signs with 1 point, age of 60 years or older with 1 point, and preadmission antibiotic therapy was scored as -1. The clinical scores of -1, 0, 1, 2, and 3 or more points were associated with a probability of death of 0%, 2.3%, 27.3%, 73.3%, and 100%, respectively.Hemorrhagic diathesis, focal neurologic signs, and age of 60 years or older were independent predictors of death in meningococcal disease, whereas receipt of adequate antibiotic therapy was associated with a more favorable prognosis. The scoring system presented is simple, is based on findings readily available at the bedside, and may be useful to help guide aggressive therapy.
[314] CHOLANGIOCARCINOMA CELLS ARE SUSCEPTIBLE TO THE MODULATION OF CELL GROWTH BY ENDOGENOUS OPIOID PEPTIDES BUT RESPOND WITH INCREASED PROLIFERATION
Authors: M. Marzioni, S. Saccomanno, G. Fava, C. Candelaresi, C. Rychlicki, G. Alpini, A. Benedetti
Journal: Journal of Hepatology (2007)
CASE 4. Fibrocystic Breast Disease in a 16-Year-Old Female With <i>PTEN</i> Hamartoma Tumor Syndrome
Authors: Annette R. Patterson, A. Marilyn Leitch, Paul Weatherall, Xiao-Ping Zhou, Charis Eng, Gail E. Tomlinson
Journal: Journal of Clinical Oncology (2006)

CASE 3. Benign Pleural Nodules in a Patient With Esophageal Cancer A 29-year-old man was diagnosed with esophageal cancer when he presented with dysphagia.A computed tomography (CT) scan revealed multiple pleural-based soft tissue lesions in the left hemithorax, suspicious for metastases (Fig 1).His history was significant for a previous gunshot injury.A technetium-99 -labeled heat-damaged autologous RBC scan demonstrated multiple foci of uptake corresponding to the CT findings, suggesting splenosis (Fig 2).A repeat CT scan 2 years later showed no interval change in the pleural masses.Thoracic splenosis is the rare autotransplantation of splenic tissue intrathoracically following traumatic splenic injury.Functional imaging with radiolabeled RBCs is a noninvasive method of diagnosis that may be utilized instead of biopsy.The appearance on the CT images, as in this case, can be confused with metastatic tumor nodules.As the presence of pleural metastasis may affect treatment decisions in the setting of localized disease, thoracic splenosis should be considered in the differential diagnosis in patients with cancer, pleural nodules, and a history of splenic injury.
German court rules on euthanasia
Authors: H L Karcher
Journal: BMJ (1994)

Allowing a comatose patient to die by stopping medical treatment can be lawful even without the patient's written consent, if consent to stopping treatment can be sensibly assumed. This is the essence of a decision made by the German Federal High Court in Karlsruhe last month. The ruling has marginally extended the interpretation of existing German laws on the borderline …
Neonatal screening recommended for hearing impairment
Authors: K. Abbasi
Journal: BMJ (1997)

A national neonatal screening programme could identify children with a hearing impairment at a younger age and have a higher rate of detection than the distraction test currently used.

According to a report from the National Coordinating Centre for Health Technology Assessment, about 840 children are born in Britain every year with clinically significant permanent hearing impairment, and by 18 months of age 400 of these children will have been missed by …
ABC of AIDS. Strategies for prevention.
Authors: A M Johnson, M W Adler
Journal: BMJ (1987)

General health educationHealth information aimed at changing behaviour remains the major preventive strategy for reducing the spread ofhuman immunodeficiency virus (HIV) in the United Kingdom.Although research continues, there is at present no immediate prospect ofa cure or vaccine.The pioneers ofhealth education campaigns in the United States and Britain have been voluntary groups, initially directing their efforts towards * General health education homosexual men.Following these educational efforts evidence is accumulating that substantial changes in sexual behaviour, a reduction in * Information counselling and HIV Informatin c the incidence ofnew HIV infections, and a reduction in the incidence of anibd tegonorrhoea have occurred in homosexual men.* Screening of blood and organ donationsAfter the government's health information campaign in Britain most * Heat treatment of blood products people are now aware ofAIDS.Many, however, are seeking more detailed information, particularly from health care staff.Some will be *0 Protection of health care staff inappropriately anxious, while others who are genuinely at high risk will * Surveillance need to obtain accurate information and personal advice.This presents an ideal opportunity for the clinician to practise preventive medicine and respond both sympathetically and with sound practical information.Unless health care staffcan respond effectively there is a danger that the current public information campaign will result only in excessive fear, leading people either to ignore the message or to create a future generation frightened and ashamed oftheir sexuality.
RENAL SAFETY AND THE RISK OF NEPHROGENIC SYSTEMIC FIBROSIS WITH ATRIAL FIBRILLATION RADIOFREQUENCY ABLATION SHORTLY AFTER LATE GADOLINIUM ENHANCEMENT CARDIAC MAGNETIC RESONANCE IMAGING
Authors: Alexis Harrison, Christopher J. McGann, Nazem Akoum, Brent Wilson, Jessiciah Windfelder, LeeAnn Spencer, Nathan S. Burgon, Nassir F. Marrouche
Journal: Journal of the American College of Cardiology (2011)
Effect of 21-Gene Recurrence Score Results on Treatment Recommendations in Patients with Lymph Node-Positive, Estrogen Receptor-Positive Breast Cancer.
Authors: R. Oratz, C. Chao, S. Skrzypczak, B. Kim, B. Kim, M. Broder
Journal: Cancer Research (2009)

Abstract Background: Results of recent Oncotype DX® studies indicate that the Recurrence Score (RS) can identify node-positive, estrogen receptor-positive (N+/ER+) patients who may not benefit from chemotherapy and have a low risk of distant recurrence with hormonal therapy alone. Based on these results, the Oncotype DX® breast cancer assay has been ordered for N+/ER+ patients. There are no data, however, on the impact of the assay on adjuvant treatment planning in N+ patients. We performed a survey to characterize the effect of the Oncotype DX® breast cancer assay on adjuvant treatment recommendations in N+/ER+ breast cancer.Methods: U.S. medical oncologists (N=1,017) who ordered Oncotype DX® for at least 1 patient with N+/ER+ breast cancer were contacted and asked to complete a web-based survey regarding the single most recent N+/ER+ patient for whom the Oncotype DX® assay was ordered. The survey was developed through cognitive interviews with four medical oncologists, and the protocol was institutional review board approved.Results: We analyzed surveys from 160 individual physicians for 160 N+/ER+ patients. Physicians were in community practices (71%) more often than in academic practice settings, they were equally dispersed geographically, and they had a median of 11 years (range, 1–45) of practice experience. The median patient age was 61 years (range, 34–82), and 79% were postmenopausal. T1, T2, or T3 disease was reported in 62%, 35%, and 3% of patients, respectively (unknown in 1 patient). One, two, three, or 4+ nodes were reported in 69%, 18%, 6%, and 3%, respectively (unknown in 8 patients). Fifty-four percent of N+/ER+ patients had an RS &amp;lt;18; 38% had an RS of 18–30; and 8% had an RS ≥31. Before obtaining the RS, chemotherapy was planned in 89 patients (56%), endocrine therapy was planned in 46 patients (29%), there was no recommendation for 22 patients (14%), and other treatments for 3 patients (1%). After obtaining the RS, recommended treatment changed from hormonal therapy plus chemotherapy to hormonal therapy alone in 48 patients (35%) and from hormonal therapy to hormonal therapy plus chemotherapy in 14 patients (10%).Discussion: These findings indicate that for N+/ER+ patients, the RS score is used more often (but not exclusively) in patients with 1–3 positive nodes and T1 or T2 stage disease. Treatment recommendations for these patients with N+ disease were frequently changed by the RS results, with an overall reduction in the recommendation for chemotherapy treatment. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2031.
'Climacteric Gynecology' Fellowships Begin
Authors: Phil Gunby
Journal: JAMA (1992)

CASE WESTERN RESERVE University Hospitals' comprehensive (MacDonald) women's facility and School of Medicine in Cleveland, Ohio, are establishing a "climacteric gynecology" gellowship program. In announcing the program this fall, University Hospitals of Cleveland predicted that more than 20 million women in this country will reach menopausal age by the turn of the century. Fellowship training will focus on managing menopausal changes, including hormone replacement, and "menopause-related Wulf H. Utian, MBBCh, PhD, president, North American Menopause Society, and president-elect, International Menopause Society, is director, Department of Obstetrics and Gynecology, University MacDonald; professor and chair, Department of Reproductive Biology, Case Western Reserve University School of Medicine; and director, Cleveland Menopause Clinic. (Please see preceding articles.) Fellowship funding is through a grant from Wyeth-Ayerst Laboratories, Philadelphia, Pa.
Association Between Variants in or Near PNPLA3, GCKR, and PPP1R3B With Ultrasound-Defined Steatosis Based on Data From the Third National Health and Nutrition Examination Survey
Authors: Ruben Hernaez, Jody McLean, Mariana Lazo, Frederick L. Brancati, Joel N. Hirschhorn, Ingrid B. Borecki, Tamara B. Harris, Thutrang Nguyen, Ihab R. Kamel, Susanne Bonekamp, Mark S. Eberhardt, Jeanne M. Clark, Wen Hong Linda Kao, Elizabeth K. Speliotes
Journal: Clinical Gastroenterology and Hepatology (2013)
Ruptured Stomach After Heimlich Maneuver
Authors: Robert E. Visintine
Journal: JAMA (1975)

APPLYING sharp force to the abdomen just below the diaphragm, as described by Heimlich,<sup>1</sup>has been widely published as a life-saving measure. A considerable number of lives,<sup>2</sup>including that of the patient in this report, have undoubtedly been saved by persons who have read about this technique. The forceful, sudden pressure applied by the quick upward push on the epigastrium can often expel the life-threatening plug of food. To date, no serious complications resulting from this maneuver have been reported. According to Heimlich (personal communication), fractured ribs seem to have been the only significant problem, and they have been rare. The case we are reporting involved a far more serious complication. <h3>Report of a Case</h3> A 74-year-old man was attending a club banquet, when he suddenly appeared to be choking and lost consciousness. An alert companion used the Heimlich maneuver, and a large piece of meat was expelled.
UK universities reluctant to collaborate with NHS for benefit of patients
Authors: Caroline White
Journal: BMJ (2008)

The head of the UK’s first collaborative business venture between the NHS and academia has heavily criticised the reluctance of universities to get involved in health and boost patient care and outcomes.

Professor Stephen Smith, who is chief executive and principal of Imperial College Healthcare NHS Trust, Britain’s first academic health science centre (AHSC), was speaking at the annual conference of the NHS Confederation, held in Manchester last week. Academic health science centres aim to speed up the translation of academic research into better and more effective treatment …
Slipped Capital Femoral Epiphysis in a Sexually Mature Myxedematous Female
Authors: Charles H. Epps, Ernest D. Martin
Journal: JAMA (1963)

THE ROLE OF sex hormones in the closure of epiphyses is generally accepted. However, this condition is also associated with thyroid deficiency states.1 Delayed closure of epiphyses in sexually mature myxedematous women has been previously described. In a review of the literature, no case was found in which displacement of a capital femoral epiphysis occurred. Therefore, it is felt that this case is of interest. <h3>Report of a Case</h3> A 22-yr-old female was admitted to District of Columbia General Hospital on Sept 13, 1960. She complained of pain in the right hip, and had an antalgic limp. The pain had been present for two months, and was described as progressive and aggravated by activity and cloudy weather. X-rays revealed minimal slipping of the left capital femoral epiphysis (Fig 1, A and<i>B</i>). On admission, the patient complained of sluggishness, somnolence, and intolerance to cold weather. She had had the usual
Recognition and Treatment of Anthrax
Authors: David R. Nalin
Journal: JAMA (1999)

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Effect of extracellular ions and modulators of calcium transport on survival of tert-butyl hydroperoxide exposed cardiac myocytes
Authors: G. J Castro, A. Bhatnagar
Journal: Cardiovascular Research (1993)

The aim was to investigate the effects of extracellular ions and agents that modify calcium translocating pathways on oxidative stress induced cell injury.Survival of cardiac myocytes exposed to tert-butyl hydroperoxide (t-BHP, 0.2 to 2 mM) was estimated by their ability to maintain rod shaped morphology and exclude trypan blue, and by the release of lactate dehydrogenase (LDH). Mean life time (mu) of a myocyte was analysed in accordance with the Weibull distribution.In pCa 3.0 Ringer's solution, t-BHP exposed myocytes underwent time and concentration dependent hypercontracture. The fraction of rod shaped cells excluding trypan blue correlated with LDH release. The lifetime of a cell was increased upon reduction of [Ca]o. Myocytes exposed to t-BHP in pCa 7.0 or 8.0 Ringer's solution attained a rigor state and became permeable to trypan blue. t-BHP-induced hypercontracture was delayed on increasing [K]o or [Na]o. Reduction of [Na]o to 67.5 mM, but not to 13.5 mM, accelerated t-BHP induced hypercontracture. Early reduction of [Ca]o to a pCa of 8.0 had no protective effect if 1 mM calcium was reintroduced after half the duration of exposure. Verapamil (10 microM), nifedipine (1 microM), butanedione monoxamine (20 mM), and caffeine (10 mM) accelerated t-BHP-induced loss of rod shaped morphology. Ryanodine (1 microM), Trolox-C (1 microM), and butylated hydroxytoluene (BHT, 500 microM) had no effect on survival of t-BHP exposed myocytes. Survival was prolonged upon preincubation of the myocytes with BAPTA-AM or desferrioxamine or when the cells were exposed to t-BHP in the presence of La (1 mM) or N-propyl gallate (10 microM).Ferrous catalysed free radical reactions initiated by t-BHP lead to hypercontracture or rigor shortening of myocytes, depending upon [Ca]o. It is unlikely that t-BHP-induced hypercontracture is mediated by Ca influx through L- or T-type Ca channels or due to release of Ca from intracellular stores. Activation of Ca influx via Na-Ca exchange and/or increase in the passive membrane permeability to Ca is consistent with the observations reported. Myocyte rigor observed upon attenuation of Ca overload suggests contribution of Ca-independent processes.