tbuckley/cabot-search huggingface dataset:
Ipriflavone in the Treatment of Postmenopausal Osteoporosis&lt;SUBTITLE&gt;A Randomized Controlled Trial&lt;/SUBTITLE&gt;
Authors: Peter Alexandersen
Journal: JAMA (2001)

ContextData on the efficacy and safety of ipriflavone for prevention of postmenopausal bone loss are conflicting.ObjectivesTo investigate the effect of oral ipriflavone on prevention of postmenopausal bone loss and to assess the safety profile of long-term treatment with ipriflavone in postmenopausal osteoporotic women.Design and SettingProspective, randomized, double-blind, placebo-controlled, 4-year study conducted in 4 centers in Belgium, Denmark, and Italy from August 1994 to July 1998.ParticipantsFour hundred seventy-four postmenopausal white women, aged 45 to 75 years, with bone mineral densities (BMDs) of less than 0.86 g/cm2.InterventionsPatients were randomly assigned to receive ipriflavone, 200 mg 3 times per day (n = 234), or placebo (n = 240); all received 500 mg/d of calcium.Main Outcome MeasuresEfficacy measures included spine, hip, and forearm BMD and biochemical markers of bone resorption (urinary hydroxyproline corrected for creatinine and urinary CrossLaps [Osteometer Biotech, Herlev, Denmark] corrected for creatinine), assessed every 6 months. Laboratory safety measures and adverse events were recorded every 3 months.ResultsBased on intent-to-treat analysis, after 36 months of treatment, the annual percentage change from baseline in BMD of the lumbar spine for ipriflavone vs placebo (0.1% [95% confidence interval {CI}, −7.9% to 8.1%] vs 0.8% [95% CI, −9.1% to 10.7%]; P = .14), or in any of the other sites measured, did not differ significantly between groups. The response in biochemical markers was also similar between groups (eg, for hydroxyproline corrected for creatinine, 20.13 mg/g [95% CI, 18.85-21.41 mg/g] vs 20.67 mg/g [95% CI, 19.41-21.92 mg/g]; P = .96); urinary CrossLaps corrected for creatinine, 268 mg/mol (95% CI, 249-288 mg/mol) vs 268 mg/mol (95% CI, 254-282 mg/mol); P = .81. The number of women with new vertebral fracture was identical or nearly so in the 2 groups at all time points. Lymphocyte concentrations decreased significantly (500/µL (0.5 × 109/L]) in women treated with ipriflavone. Thirty-one women (13.2%) in the ipriflavone group developed subclinical lymphocytopenia, of whom 29 developed it during ipriflavone treatment. Of these, 15 (52%) of 29 had recovered spontaneously by 1 year and 22 (81%) of 29 by 2 years.ConclusionsOur data indicate that ipriflavone does not prevent bone loss or affect biochemical markers of bone metabolism. Additionally, ipriflavone induces lymphocytopenia in a significant number of women.
Promotion of Hepatocellular Carcinoma by the Intestinal Microbiota and TLR4
Authors: Dianne H. Dapito, Ali Mencin, Geum-Youn Gwak, Jean-Philippe Pradere, Myoung-Kuk Jang, Ingmar Mederacke, Jorge M. Caviglia, Hossein Khiabanian, Adebowale Adeyemi, Ramon Bataller, Jay H. Lefkowitch, Maureen Bower, Richard Friedman, R. Balfour Sartor, Raul Rabadan, Robert F. Schwabe
Journal: Cancer Cell (2012)

Increased translocation of intestinal bacteria is a hallmark of chronic liver disease and contributes to hepatic inflammation and fibrosis. Here we tested the hypothesis that the intestinal microbiota and Toll-like receptors (TLRs) promote hepatocellular carcinoma (HCC), a long-term consequence of chronic liver injury, inflammation, and fibrosis. Hepatocarcinogenesis in chronically injured livers depended on the intestinal microbiota and TLR4 activation in non-bone-marrow-derived resident liver cells. TLR4 and the intestinal microbiota were not required for HCC initiation but for HCC promotion, mediating increased proliferation, expression of the hepatomitogen epiregulin, and prevention of apoptosis. Gut sterilization restricted to late stages of hepatocarcinogenesis reduced HCC, suggesting that the intestinal microbiota and TLR4 represent therapeutic targets for HCC prevention in advanced liver disease.
1020-5 A Flow Convergence Method to Quantitate Regurgitant Flow with a Flail Mitral Valve Leaflet: Finite Element Modeling and Experimental Studies
Authors: Curt G. DeGroff, Antonio M. Baptista, Takahiro Shiota, John Cable, Larissa Foster, David J. Sahn
Journal: Journal of the American College of Cardiology (1995)
Early Postnatal Exposure to Ultrafine Particulate Matter Air Pollution: Persistent Ventriculomegaly, Neurochemical Disruption, and Glial Activation Preferentially in Male Mice
Authors: Joshua L. Allen, Xiufang Liu, Sean Pelkowski, Brian Palmer, Katherine Conrad, Günter Oberdörster, Douglas Weston, Margot Mayer-Pröschel, Deborah A. Cory-Slechta
Journal: Environmental Health Perspectives (2014)

Background: Air pollution has been associated with adverse neurological and behavioral health effects in children and adults. Recent studies link air pollutant exposure to adverse neurodevelopmental outcomes, including increased risk for autism, cognitive decline, ischemic stroke, schizophrenia, and depression.Objectives: We sought to investigate the mechanism(s) by which exposure to ultrafine concentrated ambient particles (CAPs) adversely influences central nervous system (CNS) development.Methods: We exposed C57BL6/J mice to ultrafine (< 100 nm) CAPs using the Harvard University Concentrated Ambient Particle System or to filtered air on postnatal days (PNDs) 4–7 and 10–13, and the animals were euthanized either 24 hr or 40 days after cessation of exposure. Another group of males was exposed at PND270, and lateral ventricle area, glial activation, CNS cytokines, and monoamine and amino acid neurotransmitters were quantified.Results: We observed ventriculomegaly (i.e., lateral ventricle dilation) preferentially in male mice exposed to CAPs, and it persisted through young adulthood. In addition, CAPs-exposed males generally showed decreases in developmentally important CNS cytokines, whereas in CAPs-exposed females, we observed a neuroinflammatory response as indicated by increases in CNS cytokines. We also saw changes in CNS neurotransmitters and glial activation across multiple brain regions in a sex-dependent manner and increased hippocampal glutamate in CAPs-exposed males.Conclusions: We observed brain region– and sex-dependent alterations in cytokines and neurotransmitters in both male and female CAPs-exposed mice. Lateral ventricle dilation (i.e., ventriculomegaly) was observed only in CAPs-exposed male mice. Ventriculomegaly is a neuropathology that has been associated with poor neurodevelopmental outcome, autism, and schizophrenia. Our findings suggest alteration of developmentally important neurochemicals and lateral ventricle dilation may be mechanistically related to observations linking ambient air pollutant exposure and adverse neurological/neurodevelopmental outcomes in humans.Citation: Allen JL, Liu X, Pelkowski S, Palmer B, Conrad K, Oberdörster G, Weston D, Mayer-Pröschel M, Cory-Slechta DA. 2014. Early postnatal exposure to ultrafine particulate matter air pollution: persistent ventriculomegaly, neurochemical disruption, and glial activation preferentially in male mice. Environ Health Perspect 122:939–945; http://dx.doi.org/10.1289/ehp.1307984
Anesthesia Sends Shivers Up One's Spine, But Hypothermia Per Se May Not Be Culprit
Authors: Chris Anne Raymond
Journal: JAMA (1988)

WHO SHIVERS, but not from cold? Who is cold, but doesn't shiver? These riddles have puzzled anesthesiologists for years. Now, a team of investigators may have turned some of the accepted answers on their heads. When Daniel I. Sessler, MD, was a resident in anesthesiology at the University of California, Los Angeles (UCLA), School of Medicine in the early 1980s, he proposed an explanation for why a substantial proportion of the estimated 25 million patients who undergo surgery each year are stricken with severe tremors during postoperative recovery. The shivering phenomenon, first described in 1950, sometimes dangerously boosts a patient's heart rate and blood pressure, pulls apart incisions, or damages surgical repairs. Common wisdom has it that the tremors arise because core body temperature drops during the patient's partially clothed sojourn through the cool confines of the surgical suite, inhaling cold gases and receiving cold intravenous fluids. Sessler had a
Ectopic Functioning Thyroid Tissue in the Thyroglossal Duct Detected by Radionuclide Imaging
Authors: P Nageswara Rao, Nandini Pandit, Rajesh Kumar, Indira V. Upadhya, M S. Vidya Sagar
Journal: Clinical Nuclear Medicine (2005)

A 49-year-old man with a clinical diagnosis of Graves' disease was referred for a thyroid scan and radioactive ablation of the gland. Tc-99m pertechnetate scan revealed a diffuse toxic goiter and radiotracer concentration in the thyroglossal duct. He was given 10 mCi of I-131 orally as treatment of thyrotoxicosis. Repeat scanning of the anterior neck 2 days later revealed concentration of radioiodine in the diffusely enlarged gland and the thyroglossal duct as found on the Tc-99m pertechnetate scan, thus confirming the presence of functioning thyroid tissue in the thyroglossal duct.
OBSERVATIONS ON THE PATHOLOGICAL CHANGES FOLLOWING EXPERIMENTAL HYPERTENSION PRODUCED BY CONSTRICTION OF THE RENAL ARTERY
Authors: Charles G. Child
Journal: The Journal of Experimental Medicine (1938)

The clinical histories and pathological findings of six animals dying within a few days following bilateral constriction of the renal arteries have been presented. No explanation for the rise in blood pressure was found. The clinical histories and pathological findings of twelve animals with a sustained hypertension have been considered together with the detailed account of one of these in which a marked degree of arterial disease was found. It has been suggested from the study of this group that, though no cause for the initiation of the hypertension was found, the induced arterial disease might account for its maintenance.
A New Locus for Congenital Cataract, Microcornea, Microphthalmia, and Atypical Iris Coloboma Maps to Chromosome 2
Authors: Hana Abouzeid, Françoise M. Meire, Ihab Osman, Nihal ElShakankiri, Sylvain Bolay, Francis L. Munier, Daniel F. Schorderet
Journal: Ophthalmology (2008)
The bland bombshell
Authors: Des Spence
Journal: BMJ (2008)

I try not to be judgmental, but I do struggle with society’s fastest growing group—the terminally dull. This presents a problem in medicine, as patients actively avoid the tedious doctor.

People didn’t used to be so bland and timid. A generation ago people enjoyed salt on their chips, deep fried everything, and filled their tea with sugar. There was more social diversity and a great number of different musical and fashion factions (rockers, mods, hippies, new romantics, goths, reggae Rastas, and …
ACR–ASTRO Practice Guideline for the Performance of Therapy With Unsealed Radiopharmaceutical Sources
Authors: Robert E. Henkin, John D. Del Rowe, Perry W. Grigsby, Alan C. Hartford, Hossein Jadvar, Roger M. Macklis, J. Anthony Parker, Jeffrey Y. C. Wong, Seth A. Rosenthal
Journal: Clinical Nuclear Medicine (2011)

This guideline is intended to guide appropriately trained and licensed physicians performing therapy with unsealed radiopharmaceutical sources. Adherence to this guideline should help to maximize the efficacious use of these procedures, maintain safe conditions, and ensure compliance with applicable regulations. The topics dealt with in this guideline include indications for the use of iodine-131, both for the treatment of hyperthyroidism and thyroid carcinoma. In addition, indications for other less common procedures include those for the use of phosphorous-32 in its liquid and colloidal forms, strontium-89, samarium-153, and the use of Y-90 antibodies.
AMA's `Medicine Today' TV Program
Authors: Lawrence Grouse
Journal: JAMA (1985)

The American Medical Association's (AMA) national television series for physicians, "Medicine Today," premiered on Jan 6, 1985. This broadcast was part of the launch of Lifetime Medical Television's "Doctors' Sunday," a mini-network providing a full day of programs for physicians each week on the Lifetime cable television network. "Medicine Today" is a half-hour program of medical news and commentary that can be seen each week as a part of "Physicians' Journal Update," a review of the medical literature. "Medicine Today" represents an important step by physicians in using the immediacy and power of television to advance the practice of medicine in this country. It provides rapid and personal communication between physicians; it establishes a collegial forum, devoted to issues and information that affect physicians; and it improves the dissemination of information about advances in medical research to the profession. The content of "Medicine Today" is derived from the journals, the
Delays in Out-patients
Authors: G. W. Garland
Journal: BMJ (1965)

Extensively drug-resistant tuberculosis (XDR-TB) is present in all regions and poses serious challenges for public health and clinical management. Laboratory diagnosis is difficult and little evidence exists to guide clinicians in treating people with XDR-TB effectively. To summarise the available data on diagnosis and treatment, the current authors performed a systematic review on 13 recent studies of the epidemiology and clinical management of XDR-TB. Studies that met inclusion criteria were reviewed, in order to assess methodology, treatment regimens and treatment outcomes. Meta-analysis of currently available data is not possible because of inconsistent definitions and methodologies. Data show that XDR-TB can be successfully treated in up to 65% of patients, particularly those who are not co-infected with HIV. However, treatment duration is longer and outcomes are in general poorer than for non-XDR TB patients. To strengthen the evidence for extensively drug-resistant tuberculosis diagnosis, treatment and prevention, future studies should: 1) be prospective in design; 2) adopt standardised, internationally accepted definitions; 3) use quality-assured laboratory testing for all first- and second-line drugs; and 4) collect data on an agreed-upon set of standard variables, allowing for comparisons across studies. Early diagnosis and aggressive management of extensively drug-resistant tuberculosis provide the best chance of positive outcome, but prevention is still paramount.
Chirurgie des Gehirns und Rückenmarks im Kindes- und Jugendalter
Authors: Oscar Sugar
Journal: JAMA (1968)

The first 360 pages of this multiauthored compendium deals with neurological examination, anatomy and physiology, neurological examination, and the accessory diagnostic techniques, including electroencephalography, echoencephalography, radiography, angiography, brain scanning, etc. Each is covered in a short monograph. Sections on preoperative and postoperative care and anesthesia for neurosurgery precede the special, more-specific neurosurgical portion which begins with tumors, first as general pathologic types and then in specific areas. Separate chapters on hydrocephalus, unilateral exophthalmos, vascular disease, infections, injuries, malformations, convulsive disorders, stereotactic approaches, complete the material on the brain. Similar but much shortened treatment is given to anatomy, physiology, operative techniques, and pathology of the spinal co d (amounting to 58 pages of general material, and 64 pages of special interest in malformations, infections, neoplasms, and injuries). In comparison with the German pediatric neurosurgical text of Gerlach et al (reviewed in JAMA<b>201</b>: 784 [Sept 4] 1967), this one has more
THE TREATMENT OF ENTERIC FEVER BY COLD BATHS.Read in the Section of Practice of Medicine, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: W. GILMAN THOMPSON
Journal: JAMA (1893)

The treatment of enteric fever by cold baths according to the Brand system,<i>i. e.</i>, by sudden immersion in cold water accompanied by vigorous rubbing, has been slowly but steadily gaining adherents in this country. My own experience with it includes ninety-five cases treated during the past three years at the New York Hospital, where Dr. Peabody first employed the system, and at the Presbyterian Hospital, where I introduced it last year. While the number of cases thus far treated at these two institutions is not yet large enough to furnish absolutely convincing statistics, the figures already obtained are certainly significant. Thus 340 cases treated by other methods at the Presbyterian Hospital, New York, from 1892 to 1892 gave a mortality of 17.8 per cent., and 501 cases treated by other methods at the New York Hospital from 1877 to 1889 gave a mortality of 19.4 per cent. Ten years
HIV/AIDS responsible for 25% of deaths in South Africa, report says
Authors: Pat Sidley
Journal: BMJ (2001)

The South African Medical Research Council has said that AIDS is South Africa's leading cause of death, with the disease causing 40% of deaths last year in people aged between 15 and 49 years.

The council carried out a study of mortality caused by HIV/AIDS over the whole population and concluded that the disease caused a quarter of all deaths.

The findings of the study, conducted by a team of specialists from South Africa and other countries, were initially kept under wraps, but several leaks provoked the government's statistical office—Statistics SA—into trying to discredit the …
Increase in Haemoglobin A2 Appearing After Homograft of Foetal Haemopoietic Tissue
Authors: J. M. Bridges, D. W. Neill, H. Lehmann
Journal: BMJ (1961)

DBRiTisH 1349 virus diseases, including many that are arthropod-borne, in which high concentrations of virus are attained in the blood-stream.It seems possible that some epidemics of jaundice not due to yellow fever-for example, that described by Hahn and Bugher (1953)-may have occurred as a result of haemolysis in enzyme-deficient subjects.The observations that some patients had dark urine, and that males were more severely affected than females, are consistent with this interpretation.A further search for haemolysis associated with virus infections should be made.This discussion has been concerned with some of the selective agents likely to be operating under natural conditions.They have left in African and other populations a genetic legacy that is also a medical hazard, since G6PD-deficient subjects are liable to haemolysis when exposed to a wide range of drugs in therapeutic concentrations.These include the antimalarial 8-amino- quinolines and sulphonamides (Beutler, 1959), and also nitrofurazone, which is used in trypanosomiasis (Robertson, 1960).Indeed, it appears likely that many of the alleged cases of blackwater fever reported in immune Africans are due to severe haemolytic episodes in G6PD-deficient subjects ; several such cases in Nigeria have been found by Gilles (private communication) to have enzyme deficiency.Summary P. falciparum malaria parasite rates and densities were found to be significantly lower in young African children with erythrocyte glucose-6-phosphate dehydrogenase deficiency than in children with normal enzymes.Reasons are given in the discussion why this might be so.This fact helps to explain why the enzyme-deficiency trait remains common in malarious areas even though it predisposes carriers to haemolysis under certain conditions.The enzyme tests were carried out in laboratory space provided through the courtesy of the late Dr. D. B. Wilson
Early Appearance of an Edematous Tissue Reaction During Left Atrial Linear Ablation Using Intracardiac Echo Imaging
Authors: Rukshen Weerasooriya, Pierre Jaïs, Prashanthan Sanders, Christophe Scavée, Li-Fern Hsu, Mélèze Hocini, Jacques Clementy, Michel Haïssaguerre
Journal: Circulation (2003)
Clinical Bone Marrow Transplantation
Authors: Mortimer M. Bortin
Journal: JAMA (1984)

This book on bone marrow transplantation in humans, as a practical rather than experimental treatment strategy, is timely and first-rate. The editors contend that while bone marrow transplantation is still an expensive and high-risk form of treatment, success comparable with that achieved at major bone marrow transplant centers only requires an excellent supportive care system plus a dedicated and knowledgeable staff of physicians and nurses. The recent rapid expansion in the number of centers undertaking bone marrow transplantation and the improving success rate in the field support their contention. The editors, who are based at the City of Hope National Medical Center in Duarte, Calif, selected 15 internationally recognized authorities to prepare the 14 chapters covering some fundamentals of bone marrow transplantation, but focusing primarily on current results. Separate chapters address the main disease categories for which bone marrow transplantation is being applied: leukemia, lymphoma, and other malignant diseases; aplastic
The Roles of Scintigraphy in Splenic Trauma
Authors: ANITA G. MOALLEM, PAUL T. KHOURY
Journal: Clinical Nuclear Medicine (1982)

A case is presented of an accessory spleen that was identified on nuclear scan at the time of diagnosis of splenic rupture. This information, proven by subsequent angiography, alerted the surgeons to the ease with which functional splenic tissue could be preserved in this patient. A sulfur colloid scan obtained post surgery confirmed the success of this more conservative operation. In addition, free peritoneal blood was also demonstrated preoperatively as the patient was rotated for a left anterior oblique view.
Complications of Arterial Puncture
Authors: J. C. Nicholls
Journal: BMJ (1964)

BRiTisH 877 1,400 units the patient was having strong con- tractions lasting 50-60 seconds every 90 seconds.The remnants of the, tablets were removed.Pethilorfan (pethidine hydrochloride and levallorphan tartrate), 150 mg., was given intra- muscularly.The contractions continued at the same frequency, the second stage being com- plete 50 minutes later.The foetal heart rate was regular.The baby cried lustily on arrival.The secundines were delivered complete in 10 minutes.Steady vaginal bleeding continued in spite of a well-contracted uterus and further ergometrine.The patient felt faint and
ERCP training---time for change
Authors: M D HELLIER
Journal: Gut (2000)

It has become increasingly clear that no longer is it appropriate or practical to train all specialist gastroenterology registrars in endoscopic retrograde cholangiopancreatography (ERCP). This realisation has caused much disquiet and uncertainty among trainees, concern among trainers, and debate in the journals.1 At present the implication of the Joint Committee for Higher Medical Training (JCHMT) curriculum for higher specialist training in gastroenterology is that all trainees are expected to become proficient in all areas of endoscopy. In recent months this issue has been extensively discussed by the appropriate bodies—Training Committee of the British Society of Gastroenterology (BSG), Joint Advisory Group on Endoscopy Training (JAG), and in particular the Specialist Advisory Committee in Gastroenterology to the Joint Committee for Higher Medical Training (SAC to JCHMT). It is the JCHMT alone that has the statutory powers to enforce decisions on training.

The SAC Gastroenterology, with the approval of the other bodies, has decided that from now, ERCP will no longer be an essential requirement for a certificate of completion of specialist training.

Most gastroenterologists would accept the need for full training in oesophago-gastro-duodenoscopy and in colonoscopy. These are areas of endoscopy where demand can be expected to continue to rise, especially with the increasing need for cancer screening. In contrast, despite the recent sharp rise in demand for ERCP coming on the back of laparoscopic cholecystectomy, it is likely that numbers will plateau or even fall as magnetic resonance cholangiopancreography and laparoscopic exploration of the common bile duct become more widespread. Even with the existing numbers of cases it is not possible for all trainees to meet the requirements of JAG and become proficient in ERCP, nor would trainers be able to maintain their expertise.

These concerns were very clearly expressed in a recent paper by Wicks et al , with …