tbuckley/cabot-search huggingface dataset:
PTU-025 Radiological investigations within the Bowel Cancer Screening Programme: an overview across BCSP: Abstract PTU-025
Authors: A Ignjatovic, D Burling, C Nickerson, B P Saunders, J Patnick
Journal: Gut (2010)

<h3>Introduction</h3> Patients with a positive faecal occult blood test as a part of the Bowel Cancer Screening Programme (BCSP) are offered colonoscopy or if unsuitable for colonoscopy, an alternative radiological colonic examination (barium enema, BE; CT colonography, CTC; abdominal CT). However, there are no guidelines recommending which patients should be offered an alternative radiological test and no published data about current practice. The aim of this study was to review the demographics and outcomes of patients who underwent radiological screening investigation. <h3>Methods</h3> Patient data are prospectively collected for each BCSP episode and collated at the central office. We retrospectively reviewed data recorded for patients who underwent radiological investigation as part of BCSP from the start of the programme to November 2008. Patient demographics and outcomes were evaluated. Categorical variables were compared using Fisher9s exact test. <h3>Results</h3> There were 440 patients (mean age 66 years, SD 3.9) who underwent 446 radiological investigations (Barium enema, BE: n=120, CT colonography, CTC: n=264, abdominal CT: n=54, AXR: n=8). There is wide geographical variation in choice of radiological investigation across England (Abstract 025). Patients9 mean ASA status was 2.5 (SD 0.8) and 43/440 (10%) were diabetic, 86/440 (20%) were taking warfarin and 47/440 (11%) clopidogrel. The indications for radiological investigation were documented for 370/440 (84%) patients—unsuitable for colonoscopy, n=213 (58%), incomplete colonoscopy, n=60 (16%), patient preference, n=54 (15%) and consultant preference, n=38 (10%). Eight cancers were diagnosed by a primary radiological investigation and there were 176 (39%) normal investigations (50/120, 42% vs 126/264, 48%, p=0.32 for BE and CTC, respectively). In 16 cases (4%; 3/120 vs 13/264, p=0.41 for barium enema and CTC, respectively) another test was required due to incomplete test (9 due to poor bowel preparation) and in 123 of cases (30%; BE 24/120, 20% vs CTC 99/264, 38%, p&lt;0.001) a test was completed but an another investigation was required (therapy, n=52 and biopsies, n=59). <h3>Conclusion</h3> There is a difference across the BCSP in the choice of radiological investigation offered to patients. Overall, 40% of patients having radiological investigation avoid further invasive endoscopic investigation with bowel preparation. More patients who have CTC require further investigation compared to BE, likely reflecting the greater sensitivity of the former.
Factors Influencing the Course and Prognosis of Systemic Lupus Erythematosus
Authors: Robert P. McCombs, James F. Patterson
Journal: New England Journal of Medicine (1959)

UNTIL about 1950 systemic lupus erythematosus was generally considered to be a progressive and fatal disease. This concept began to change, gradually at first and then more rapidly, when Jessar, Lamont-Havers and Ragan1 reported on 44 of their own cases and 279 from the medical literature between 1948 and 1952. In this series spontaneous remissions were noted in nearly a third of the cases. Others2 3 4 confirmed these findings and suggested that survival for five years from the time of diagnosis was not unusual. Also, about 1950 the Hargraves or L.E.-cell test came to be generally recognized as a very helpful . . .
195TiP: Pembrolizumab (MK-3475) versus platinum-based chemotherapy for PD-L1+ NSCLC in a phase 3, randomized, open-label study: KEYNOTE-042
Authors: T. Mok, Y.-L. Wu, S. Sadowski, J. Zhang, R. Rangwala, D. Kush, G. de Lima Lopes
Journal: Journal of Thoracic Oncology (2016)
Phenotypic Expression of Non-Hodgkin's Lymphomas in China
Authors: L Z Xu, L Y Tu, Y F Liu, S M Hsu, B S Qiu, Z X Li
Journal: JNCI Journal of the National Cancer Institute (1984)

Monoclonal antibodies were used to label malignant lymphomas obtained from 57 patients. On the basis of morphologic criteria, 18 lymphomas were the B-cell type, 10 were the T-cell type, and 6 were histiocytic; for 23 the type could not be determined. After monoclonal antibody labeling, 18 lymphomas of B-cell lineage were confirmed, 16 of the T-cell type were demonstrated, 6 were true histiocytic, and 17 were the null cell (non-T, non-B) type. Of the 16 lymphomas of T-cell lineage, 6 were lymphoblastic and 10 were the peripheral type. The percentages of cell types in the non-Hodgkin's lymphomas were as follows: B-cell, 31.5%; T-cell, 28%; null cell, 29%; and histiocytic, 10%. Of the 16 lymphomas of T-cell origin, 15 belonged to helper T-cell subsets (Leu1+, Leu4+, and Leu3a+), and the la marker was positive in all 16. Of the 18 B-cell lymphomas, 14 were kappa-positive and 4 were lambda-positive. Eleven were both B1- and kappa-positive, and 1 was kappa-positive but B1-negative. In the 4 cases that were lambda-positive, 2 were both lambda- and B1-positive. The results indicate that Leu4, Leu2a, Leu3a, and B1 are the most important markers to differentiate T-cell and B-cell lymphomas for pathologic classification. The findings also show a higher percentage of T-cell neoplasm in China as compared to that in Western countries.
Use of Progesterone in the Treatment of Post-Partum Psychosis
Authors: Willis H. Bower, Mark D. Altschule
Journal: New England Journal of Medicine (1956)

STUDIES previously made at this hospital suggest that the adrenal cortex is hyperactive in early but not in chronic schizophrenic, manic-depressive and involutional psychoses.1 Nevertheless, although adrenocortical dysfunction in general often causes mental changes (the psychologic disorders accompanying Addison's and Cushing's diseases are well known), in the "functional" psychoses the adrenal factor is peripheral and is not of primary etiologic significance.1 On the other hand, the administration of large amounts of testosterone, a steroid hormone that depresses pituitary-adrenocortical function, often results in improvement in patients with "functional" psychoses of recent onset — as was shown in a study made here . . .
Short versus long hospitalization: a prospective controlled study. V. One-year follow-up results for nonschizophrenie patients
Authors: I D Glick, W A Hargreaves, J Drues, J A Showstack
Journal: American Journal of Psychiatry (1976)

The authors studied the effect of long-term versus short-term hospitalization on a group of 74 patients with the diagnoses of affective disorder, neurosis and personality disorder, and hysterical personality one year after their admission to the hospital. Although they had found in an earlier study that short-term patients seemed to integrate more rapidly in the hospital, the results reported in this study showed no statistically reliable differences between the long-term and short-term groups. In contrast to the author's results for schizophrenic patients, their findings for nonschizophrenic patients do not support extended hospitalization.
Spinal-Fluid pH and Neurologic Symptoms in Systemic Acidosis
Authors: Jerome B. Posner, Fred Plum
Journal: New England Journal of Medicine (1967)

RECENTLY, we have encountered a series of patients with severe metabolic acidosis and serum pH values less than 7.0. Although such severe acidosis is widely regarded as leading rapidly to delirium and unconsciousness, only some of these patients were in coma; the others were awake and alert. In the awake and alert patients, the pH of the cerebrospinal fluid was normal or near to it, but in those in coma, it lay in the far acid range. These observations combined with some previously made on patients with respiratory acidosis1 have led to the postulate that acidosis in the cerebrospinal fluid . . .
Treatment of Respiratory Acidosis with N-Allylnormorphine (Nalline)
Authors: M. J. Dulfano, F. X. Mack, M. S. Segal
Journal: New England Journal of Medicine (1953)

IN 1943 Unna1 first reported the results of animal studies on the antagonistic properties of N-allyl-normorphine (Nalline) to morphine. In recent years, the therapeutic application of these properties has been under investigation in human subjects.2 3 4 Nalline is chemically related to morphine by the substitution of an allyl bromide group in the morphine radical.1 , 5 It counteracts the toxic effects of morphine in animals, especially the depression of respiration, and in some animals it apparently serves as a mild analgesic drug.1 In human beings it not only has no demonstrable analgesic activity in itself but also abolishes the analgesic effects of morphine . . .
Rupture of an Iliac-Artery Aneurysm into the Sigmoid Colon
Authors: Harvey L. Atin
Journal: New England Journal of Medicine (1958)

ALTHOUGH rupture of an abdominal aneurysm into the gastrointestinal tract was described as far back as the middle of the nineteenth century, it was not until 1943, when Rottino1 presented his excellent paper, that its clinical importance was realized. Since then, the role of this rare syndrome in modern medicine has been re-emphasized many times.2 3 4 5 6 7 8 9 Kane et al.,6 in a review of 28,400 consecutive autopsies, found aneurysmal rupture into the gastrointestinal tract responsible for 6.1 per cent of all fatal gastrointestinal hemorrhages. Because the majority of aneurysms in their series were aortic and were thoracic and syphilitic in character, this . . .
Treatment of Recurrent Pancreatitis by Transduodenal Sphincterotomy and Exploration of the Pancreatic Duct
Authors: Marshall K. Bartlett, George L. Nardi
Journal: New England Journal of Medicine (1960)

THE management of the patient with recurrent pancreatitis is controversial. It will probably continue to be so until there is a better understanding of the underlying causative mechanisms. Of the various theories of the cause of pancreatitis the two that have received most attention in recent years are those of obstruction to outflow of the pancreatic secretions from the duct system, and reflux from the common duct into the pancreatic duct through a "common channel" formed by the entrance of the duct of Wirsung into the common bile duct proximal to the papilla of Vater.Retrograde injection of an irritating . . .
Emerging and Reemerging Rickettsial Diseases
Authors: David H. Walker, J. Stephen Dumler
Journal: New England Journal of Medicine (1994)

The article by Kass et al.1 in this issue of the Journal is an appropriate reminder that rickettsialpox, like rickettsial diseases in general, is still with us. The rickettsialpox diagnosed in 13 patients at one hospital in New York City undoubtedly represents only a fraction of the actual cases of this endemic disease. Rickettsia akari is maintained in a zoonotic cycle involving house mice and mites, passing rickettsiae transovarially from one generation of mites to the next. Such firmly established, highly evolved ecologic niches are unlikely to disappear, nor are humans likely to avoid encountering the bacteria that flourish in . . .
Occult Pseudoxanthoma Elasticum in Patients with Premature Cardiovascular Disease
Authors: Mark Lebwohl, Jonathan Halperin, Robert G. Phelps
Journal: New England Journal of Medicine (1993)

Pseudoxanthoma elasticum is an inherited disorder of connective tissue that is associated with numerous systemic manifestations, including premature coronary artery disease. Without a serologic marker, the diagnosis relies on clinical features and the histologic demonstration of abnormal, calcified elastic fibers1,2. The typical patient presents with yellow macules or papules that can become confluent to form plaques and, in severe cases, redundant folds of skin. Cutaneous lesions have been likened to “plucked chicken skin.” In patients whose skin is mildly affected, the condition may be difficult to recognize. Ocular complications occasionally occur without the characteristic skin lesions. The histologic . . .
The psychedelic model of schizophrenia: the case of N,N- dimethyltryptamine
Authors: J C Gillin, J Kaplan, R Stillman, R J Wyatt
Journal: American Journal of Psychiatry (1976)

The authors review the research on N,N-dimethyltryptamine (DMT) as a possible "schizotoxin." DMT produces psychedelic effects when administered to normal subjects, the means are present to synthesize it in man, it has occasionally been found in man, and tolerance to its behavioral effects is incomplete. However, DMT concentrations have not been proven to differ significantly in schizophrenics and normal controls. Also, in vivo synthesis of DMT has not been convincingly demonstrated, and the psychological changes it produces do not closely mimic the symptoms of schizophrenia. The authors conclude that more data are necessary before the validity of this theory can be determined.
<i>Notes from the Field</i>: Health Care–Associated Outbreak of Epidemic Keratoconjunctivitis — West Virginia, 2015
Authors: Joel Massey, Roberto Henry, Linda Minnich, Daryl M. Lamson, Kirsten St.George
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

On September 4, 2015, the West Virginia Bureau for Public Health (WVBPH) was notified by an urban ophthalmology practice of 13 patients with epidemic keratoconjunctivitis (EKC) diagnosed during the preceding 3 weeks. EKC is an eye infection characterized by severe inflammation of the conjunctiva and cornea, and can result in vision loss. Pathogens commonly detected in EKC outbreaks are human adenovirus (HAdV) serotypes 8, 19, and 37, which are spread person-to-person or by fomites; no vaccines or effective antiviral treatments are available. HAdVs that cause EKC are resistant to desiccation and certain common surface disinfectants. Incubation periods of approximately 14 days, prolonged viral shedding, and persistence of live virus on some surfaces for up to 30 days hamper outbreak prevention and control efforts. EKC often occurs simultaneously in health care settings and the community. EKC is not a reportable disease and outbreak reporting is often delayed; the incidence in West Virginia is unknown.
P230 Investigating the role of chest physiotherapy in the collection of sputum samples from individuals with cystic fibrosis (CF)
Authors: R Dacie, R Howlin, M Carroll, G Connett
Journal: Thorax (2015)

<h3>Introduction</h3> Chronic respiratory infection is responsible for the majority of the morbidity and mortality of CF patients. In order to guide treatment regimes and improve understanding of the pathophysiology of CF, airway secretions are sampled and analysed. Sputum is usually the selected method of sampling. Often, large quantities of sputum are required to facilitate comprehensive laboratory testing. Hence, when designing studies, it is important to consider the quantity of sputum likely to be produced by patients and to ensure that the composition of the sputum samples is not altered by the procedure by which they are obtained. This study aimed to investigate the effect of chest physiotherapy on the quantity and composition of sputum samples collected from individuals with CF. It was hypothesised that physiotherapy would increase the quantity of sputum produced, reduce the salivary content and alter the microbiological content. <h3>Methods</h3> Clinically stable adults with CF were recruited at outpatient clinics and randomised into group A (physiotherapy group, n = 21) or group B (no physiotherapy group, n = 25). Laboratory processing of the samples involved determining sample weights and counting human cells (alive respiratory cells, dead respiratory cells and squamous cells). The dissolved sputum was also transferred onto plates of cetrimide agar for culturing <i>Pseudomonas aeruginosa</i>. Colony-forming units (CFUs) were counted on the plates after 24 h. <h3>Results</h3> Samples from the physiotherapy group had significantly greater weights than the no physiotherapy group (p &lt; 0.001). When considering the total number of cells per gram of sputum, there was no statistical difference between the two groups (p = 0.396). However, the numbers of squamous cells per gram, and dead respiratory cells per gram were both significantly greater in the no physiotherapy group (p = 0.039 and p = 0.001 respectively). There were no significant differences between numbers of alive respiratory cells per gram (p = 0.487) or CFUs (p = 0.459). <h3>Conclusion</h3> Whilst physiotherapy was found to increase the quantity of sputum collected, there were significant differences in sputum composition, suggesting that the two groups represent samples from different niches. Hence, when planning a study involving sputum analysis, the procedure by which the sample is obtained has to be considered when interpreting the results.
The Causes of Neonatal Hypoglycemia
Authors: Charles A. Stanley, Lester Baker
Journal: New England Journal of Medicine (1999)

The risk of hypoglycemia in neonates is high. If their first feeding is delayed for as little as three to six hours after birth, 10 percent of normal neonates cannot maintain plasma glucose concentrations above 30 mg per deciliter (1.7 mmol per liter).1 The risk is even higher among premature infants and those who are small or large for gestational age. After 12 hours of life, the risk of hypoglycemia in normal neonates falls, but it remains substantial throughout the newborn period, especially in infants with birth asphyxia or low birth weight.Although neonatal hypoglycemia can cause seizures and permanent . . .
Recurrence of Autoimmune Diabetes Mellitus in Recipients of Cadaveric Pancreatic Grafts
Authors: Gunnar Tydén, Finn P. Reinholt, Göran Sundkvist, Jan Bolinder
Journal: New England Journal of Medicine (1996)

Insulin-dependent diabetes mellitus is an autoimmune disease in which the beta cells of the islets of Langerhans are selectively destroyed.1 In a patient with this disease, a transplanted pancreas should be as susceptible to the autoimmune process as the native pancreas. Indeed, insulin-dependent diabetes mellitus can recur in an immunocompetent or minimally immunosuppressed recipient of a pancreatic transplant from an identical twin or HLA-identical sibling.2 Usually, however, the degree of immunosuppression required to prevent rejection is sufficient to prevent autoimmune damage to the pancreatic graft.3 We report on two patients who underwent pancreatic transplantation with poor HLA matching and in . . .
Intraglomerular C3 synthesis in human kidney detected by in situ hybridization.
Authors: M Miyazaki, K Abe, T Koji, A Furusu, Y Ozono, T Harada, P K Nakane, M Yagame, M Endoh, Y Nomoto, H Sakai
Journal: Journal of the American Society of Nephrology (1996)

Complements 3 and 4 are known to be synthesized in diseased renal tissue and the mRNA of these complements has been demonstrated, using polymerase chain reaction, in renal biopsies from nephritic patients. However, the types of cells producing the complements in intact renal tissue have not been defined. To identify the renal cellular components involved in complement synthesis, we analyzed the expression of C3 mRNA in renal tissues from patients with immune-complex glomerulonephritis by a high-resolution in situ hybridization using digoxigenin-labeled oligonucleotide. Renal tissues from 15 patients with immunoglobulin (Ig) A nephropathy (IgAN), five with lupus nephritis (LN), and five with minimal change nephrotic syndrome (MCNS) were examined. Uninvolved portions of surgically removed kidney with tumors served as normal controls. C3 mRNA was detected in mesangial cells, glomerular epithelial cells, and Bowman's capsule in IgAN and LN. In the interstitium, some tubules and some infiltrating mononuclear cells were positively stained for C3 mRNA. C3 mRNA was not detected in MCNS and control tissues. Our results confirm that the glomerular resident cells can synthesize C3 in immune-mediated glomerulonephritis and suggest that locally synthesized complement may be involved in tissue injury in glomerulonephritis.
RTRB-16COCHLEAR RADIATION DOSE IS ASSOCIATED WITH DECREASED HEARING PRESERVATION FOR VESTIBULAR SCHWANNOMA PATIENTS TREATED WITH RADIOSURGERY
Authors: Panayiotis Pelargos, Lawrance Chung, Brittany Voth, Winward Choy, Marko Spasic, Kimberly Thill, Alessandra Gorgulho, Stephen Tenn, Nader Pouratian, Tania Kaprealian, Michael Selch, Antonio De Salles, Quinton Gopen, Isaac Yang
Journal: Neuro-Oncology (2015)

BACKGROUND: Radiation therapy has emerged as an effective alternative treatment modality for vestibular schwannomas (VS) to achieve tumor control and hearing preservation. The purpose of this study is to evaluate the radiation delivered to the cochlea during stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) and to determine its effect on hearing preservation. METHODS: Patients receiving SRS or SRT treatment for VS at UCLA from 2009 to 2013 were analyzed for clinical and hearing outcomes. The dosimetric data to the cochlea volume was associated with the hearing outcome of patients. Patients treated with SRS received a marginal dose of 12 Gy, and patients treated with SRT received a marginal dose of 50.4 Gy delivered through 28 fractions. Statistical analysis was completed using 2-tailed, Mann-Whitney U test with a significance level of 0.05. RESULTS 40 patients underwent either SRS or SRT for vestibular schwannoma with a mean follow-up of 23.2 months. The mean total radiation dose delivered to the cochlea volume ranged from 4.0 to 11.9 Gy (median: 8.7 Gy) for SRS treatment and 30.2 to 51.4 Gy (median: 44.8 Gy) for SRT treatment. Hearing was preserved in 60% of SRS patients and in 63% of SRT patients. The cochlea received statistically significantly more radiation in patients with decreased hearing in SRS (p = 0.031), but not in SRT (p = 0.097). CONCLUSIONS: Our data suggests that increased cochlear radiation dose is significantly associated with decreased rates of hearing preservation following SRS treatment but not with SRT treatment. Irradiation of cochlear structures may be a critically important aspect of radiosurgery treatment that warrants careful evaluation in the radiation treatment of vestibular schwannomas. Future prospective studies with randomization may further validate this data.
Optic Neuropathy of Graves's Disease
Authors: Colum A. Gorman, Lawrence W. DeSanto, Colon S. MacCarty, Fenwick C. Riley
Journal: New England Journal of Medicine (1974)

Patients with ophthalmopathy of Graves's disease accompanied by impaired visual acuity and visual-field defects were treated by transantral (10 patients) or transfrontal (nine patients) orbital decompression (one patient was treated by both approaches). The two procedures seemed equally effective in improving visual acuity and visual-field defects, and both induced a mean recession of proptosis of 4 mm. Diplopia developed after operation in three patients with transantral but not in any with transfrontal decompression. The transantral procedure is accomplished without an externally visible incision; the transfrontal operation requires head shaving and bilateral frontal craniotomies. Hospitalization time was shorter in the transantral (five to six days) than in the transfrontal group (10 to 12 days). The transfrontal procedure is indicated when orbital exploration is advisable. The transantral procedure is contraindicated if the sinuses are infected. Seven patients apparently were never thyrotoxic — an unexpectedly large proportion of the total group. (N Engl J Med 290:70–75, 1974)