tbuckley/cabot-search huggingface dataset:
Unilateral Proptosis Due to Orbital Metastasis as a Presenting Clinical Manifestation of Carcinoma of the Thyroid
Authors: Gaurav Malhotra, Trupti S. Upadhye, Santosh Menon, Ramesh V. Asopa, Sarbani G. Laskar, Shwetal Pawar, Jinendra K. Bhagat, Prathamesh Joshi
Journal: Clinical Nuclear Medicine (2010)

Differentiated thyroid cancers commonly present with thyroid swelling with or without regional nodal involvement and usually have an indolent clinical course. We report a rare case of unilateral proptosis due to orbital metastasis as a primary manifestation of differentiated thyroid carcinoma. A 55-year-old woman presented with protrusion of the left eye for 6 months and progressively diminishing vision for 7 days duration. She had an anterolateral orbitotomy with radical excision of the tumor that had shown enhancement with osteolytic destruction on contrast-enhanced CT scan. Histopathological examination of the orbital mass revealed a metastatic follicular carcinoma of the thyroid. She then had a total thyroidectomy with lymph node dissection, final histopathology of which revealed widely invasive follicular carcinoma of the thyroid. A diagnostic radioiodine scan after thyroid hormone withdrawal showed residual tumor in the thyroid bed, left orbital, and multiple bony metastases for which she underwent high-dose radioiodine therapy. The case is important due to its unusual clinical presentation that was also the primary manifestation. Even though orbital metastasis of carcinoma of the thyroid is rare, thyroid carcinoma should be considered as a potential primary tumor in such presentations.
<i>Rauwolfia serpentina</i> in the Treatment of Angina Pectoris
Authors: BERNARD I. LEWIS, ROBERT I. LUBIN, L. E. JANUARY, JOHN B. WILD
Journal: Circulation (1956)

Fifteen subjects with coronary artery disease and angina pectoris were given alternate courses of the alseroxylon fraction of Rauwolfia serpentina and placebo. Fourteen improved on the drug as determined by independent clinical evaluations and the "Daily Report Card" data. Seven developed normal electrocardiograms, 2-step tests or ballistocardiograms, that previously had been abnormal. Alseroxylon appeared to induce an unusually prolonged therapeutic effect that was revealed only by an individual "sequential" analysis of each course of drug and placebo. The nature of the underlying mechanism is not clear. Serious hypotensive responses and acute depressive reactions are infrequent at the dosage levels used, but do occur.
The Congressional Office of Technology Assessment
Authors: Roger C. Herdman
Journal: JAMA (1989)

Legislative policy-making in complex modern societies inevitably requires reliable, expert, and unbiased scientific and technological information. To provide such information on current issues and to foresee future problems, the US Congress, in 1972, established a support agency, the congressional Office of Technology Assessment (OTA). Since that time, the OTA has grown to include about 100 professionals in a wide spectrum of scientific disciplines. The OTA may be asked by Congress to study any of the entire range of technological issues that come before the Congress and has served as a model for providing technical input to the policy-making process for a number of foreign governments. This issue ofThe Journalinaugurates occasional reports originating in the Health Program and Biological Applications Program of the OTA on subject matter in health care and biomedical science that various congressional committees have deemed of sufficient interest to require formal study. The OTA is
Doctors defend online system for allocating junior doctor posts
Authors: Zosia Kmietowicz
Journal: BMJ (2006)

Doctors have spoken out to defend the computer system criticised last week for its lack of security and its failure to match one tenth of UK final year medical students with training posts. They claim that the new scheme (see www.newdoctor.org) is fairer and more transparent that the old interview based system and that teething problems are minor and to be expected.

A letter in last Saturday's Times has sparked a fierce media debate over the suitability of the online selection procedure developed by the modernising medical careers scheme to place final year medical students into the first year of the NHS foundation programme (4 March, p 22).

The letter, signed by 84 medical professors and senior clinicians, criticised the scheme as “a process that has been implemented without adequate consultation and without regard to pleas from the medical profession to continue interviews to select candidates for medical training.”

Professor Nicholas Wright, the warden of Barts and The London, Queen Mary's School of Medicine and Dentistry and one of the letter's signatories, is reported to have called for those responsible for the scheme to resign (www.e-health-insider.com).

The online form, which students complete in their final year, contains six fields in which applicants have to list examples of teamwork, leadership, compliance with guidelines, as well as their academic achievements and their reasons for the applying for …
Hypothermia and Sepsis
Authors: NEIL E. DOHERTY
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 August 1985Hypothermia and SepsisNEIL E. DOHERTY, M.D., PETER FUNG, M.D., MICHELE LEFKOWITZ, M.D., A. GRAY ELLRODT, M.D.NEIL E. DOHERTY, M.D., PETER FUNG, M.D., MICHELE LEFKOWITZ, M.D., A. GRAY ELLRODT, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-2-308_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The Annals has shown continued interest in hypothermia (1-3). Most recently, Morris and colleagues (3) have reported that hypothermia does not alter the hemodynamic characteristics of sepsis. Like others (4, 5), they found a significant mortality associated with the concordant presentation of hypothermia and bacteremia. Therefore, we must understand what causes some patients with sepsis to become hypothermic.We retrospectively studied 26 patients with severe infections, bacteremia, and shock. Patients with core or rectal temperatures below 36.1° C were considered to be hypothermic. A 71% mortality rate was seen among 7 hypothermic patients, compared with a 37%...References1. REULER J. Hypothermia: pathophysiology, clinical settings and management. Ann Intern Med. 1978;89:519-27. LinkGoogle Scholar2. DOHERTYADESSHAHSIEGEL NAPR. Hypothermia with acute myocardial infarction. Ann Intern Med. 1984;101:797-8. LinkGoogle Scholar3. MORRISCHAMBERSMORRISSANDE DHMM. Hemodynamic characteristics of patients with hypothermia due to occult infection and other causes. Ann Intern Med. 1985;102:153-7. LinkGoogle Scholar4. HUDSONCONN LR. Accidental hypothermia; associated diagnoses and prognosis in a common problem. JAMA. 1974;227:37-40. CrossrefMedlineGoogle Scholar5. LEWINBRETTMANHOLZMAN SLR. Infection in hypothermic patients. Arch Intern Med. 1981;141:920-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: NEIL E. DOHERTY, M.D.; PETER FUNG, M.D.; MICHELE LEFKOWITZ, M.D.; A. GRAY ELLRODT, M.D.Affiliations: Cedars-Sinai Medical Center University of California Los Angeles, CA 90048 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe significance of altered temperature after traumatic brain injury: an analysis of investigations in experimental and human studies: Part 2 1 August 1985Volume 103, Issue 2Page: 308-308KeywordsBacteremiaDeath ratesHemodynamicsHypothermiaMortalitySepsisShockTemperature ePublished: 1 December 2008 Issue Published: 1 August 1985 PDF downloadLoading ...
Hepatocellular adenomas: Magnetic resonance imaging features as a function of molecular pathological classification
Authors: Hervé Laumonier, Paulette Bioulac-Sage, Christophe Laurent, Jessica Zucman-Rossi, Charles Balabaud, Hervé Trillaud
Journal: Hepatology (2008)

Abstract Hepatocellular adenomas (HCAs) are a group of benign tumors forming three molecular pathological subgroups: (1) hepatocyte nuclear factor 1α (HNF-1α)–inactivated, (2) β-catenin–activated, and (3) inflammatory. Some HCAs present both β-catenin activation and inflammation. We analyzed magnetic resonance imaging (MRI) data for correlations between features on imaging and pathological classification of HCAs. We included 50 cases for which pathology specimens were classified into three groups based on immunohistochemical staining. Two characteristic MRI profiles were identified corresponding to HNF-1α–inactivated and inflammatory HCAs. Fifteen HCAs were HNF-1α–inactivated. The corresponding lesions showed (1) diffuse signal dropout on T1-weighted chemical shift sequence due to steatosis, (2) isosignal or slight hypersignal on T2-weighted (T2W) images, and (3) moderate enhancement in the arterial phase, with no persistent enhancement in the portal venous and delayed phases. For the diagnosis of HNF-1α–inactivated HCA, the positive predictive value of homogeneous signal dropout on chemical shift images was 100%, the negative predictive value was 94.7%, the sensitivity was 86.7%, and the specificity was 100%. Twenty-three HCAs were inflammatory and showed (1) an absence or only focal signal dropout on chemical shift sequence; (2) marked hypersignal on T2W sequences, with a stronger signal in the outer part of the lesions, correlating with sinusoidal dilatation areas; and (3) strong arterial enhancement, with persistent enhancement in the portal venous and delayed phases. Marked hypersignal on T2W sequences associated with delayed persistent enhancement had a positive predictive value of 88.5%, a negative predictive value of 84%, a sensitivity of 85.2%, and a specificity of 87.5% for the diagnosis of inflammatory HCA. Conclusion: HNF-1α–mutated HCAs and inflammatory HCAs were associated with specific MRI patterns related to diffuse fat repartition and sinusoidal dilatation, respectively. (Hepatology 2008.)
Children of war: the real casualties of the Afghan conflict
Authors: Z. A. Bhutta
Journal: BMJ (2002)

Ignorance, isolation, illness, violence, and social upheaval have produced a “lost generation”; failure to provide long term support for Afghanistan risks losing another

To many observers of the Afghan conflict, it seems as if the world suddenly discovered Afghanistan after 11 September 2001. Passing interest following the Soviet invasion in 1979 and the subsequent struggle of the Mujahideen against its occupation was soon replaced by war weariness and disinterest. The rise of the Taliban and their draconian policies made Afghanistan a pariah state. Events have moved quickly in recent months, with the US attack on Afghanistan, the defeat of the Taliban and the installation of an interim multiethnic government. However, few are fully aware of the plight of the main victims of this tragedy, the women and children of Afghanistan. Fewer still understand the genesis and significance of the Taliban movement and its relation to events in neighbouring Pakistan. This article explores the origin of the current Afghan crisis and describes the impact of a quarter of a century of incessant conflict on Afghan children.

#### Summary points

The rise of the Taliban and the genesis of the current Afghan conflict was in no small measure due to global apathy to the plight of Afghanistan

The women and children of Afghanistan, both among refugees and resident populations, have paid a disproportionate price for this conflict

The rates of malnutrition, disease, and death among Afghan children rank among the highest in the world

In addition to the many injuries due to landmines and artillery, over 80% of Afghan children interviewed reveal some psychological scars of war

Women and children must be the prime focus of attention in rebuilding Afghanistan, through sustained efforts at improving health, nutrition, and education

The Soviet invasion of Afghanistan in 1979 and the subsequent brutal military campaign resulted in one …
Uptake and Intracellular Disposition of Iga by Rat Hepatocytes in Monolayer Culture
Authors: Albert L. Jones, Sandra Huling, Gary T. Hradek, Henry S. Gaines, William D. Christiansen, Brian J. Underdown
Journal: Hepatology (1982)

It is well documented that the liver provides an important source of secretory immunoglobulin A (sIgA) in the gut fluid. In the rat, liver parenchymal cells can actively sequester the dimeric form of IgA (dIgA) from plasma and transfer it attached to its receptor, secretory component (SC), via vesicles into the bile. In the present investigation, isolated rat hepatocytes in monolayer culture were studied using quantitative electron microscopic autoradiography to determine if the previous reported specific binding of dIgA by isolated cells would result in internalization of the ligand and, if so, whether its distribution within the cultured hepatocytes would be similar to that found in vivo . The specificity of the process for receptor (SC) availability was evaluated utilizing sIgA and by blocking the receptor with rabbit IgG anti–rat SC antibody. For these studies, purified dIgA and sIgA were iodinated with [ 125 I] and added to fresh culture medium 24 hr following the isolation of the hepatocytes. After 3, 30, and 60 min of incubation with the isotope, the cells were washed, fixed, and processed for light and electron microscopic autoradiography. Binding of dlgA to the cells occurred by 3 min, and the number of autoradiographic grains per unit membrane length remained constant throughout the 60–min time period. With time, there was a progressive increase in the per cent of internalized grains. As in the previous in vivo studies, the majority of these internalized grains were localized to vesicles and smooth surface endoplasmic reticulum. There was no evidence of binding or uptake of sIgA at any time period and pretreatment with anti–SC reduced binding and internalization of dIgA to 16% of the control value. These data provide new evidence that isolated hepatocytes in monolayer culture appear functionally intact with regard to dIgA uptake and demonstrate their usefulness as an in vitro system for future studies of IgA metabolism.
Two studies, same data source, two answers
Authors: F. d. Vries
Journal: BMJ (2010)

Various studies have used the UK General Practice Research Database (GPRD) to evaluate the same side effects of drugs, often with opposite conclusions. Examples include third generation pills and venous thromboembolism; proton pump inhibitors and fracture1; and oral bisphosphonates and gastrointestinal cancers.2 

Only rarely have GPRD data been reanalysed to find out why results vary …
Congenital Heart Disease: A Diagrammatic Atlas
Authors: Otto G. Thilenius
Journal: JAMA (1989)

Those of us who meet regularly in pediatric cardiology conferences are familiar with the difficulties of communicating exact anatomy of simple or complex hearts to fellows, colleagues, and our surgical friends. Nomenclature is easily misunderstood when we use terms like "dextroversion," "dextrocardia," or "upstairs/downstairs hearts." Our catheterization colleagues have long given up the "block diagrams" and have often spent excessive time (with better or poorer skill) in drawing an anatomically meaningful diagram for presentation. The<i>Diagrammatic Atlas</i>of Drs Mullins and Mayer attempts to address this difficulty by providing a series of 167 basic diagrams to accurately present "every possible combination and permutation of congenital heart lesions." These diagrams provide easy identification of right vs left ventricular morphology, mitral-aortic continuity, situs, aortic arches, anomalous veins, etc. For a given heart you photocopy the diagram of your choice (facilitated by the ring binder format of the Atlas), use correction fluid and
Compliance of balloon material does not effect angiographic dissection rate. Results from the CRAC(Compliant Related Acute Complication) study
Authors: J.David Talley, James Blankenship, Steven Werns, Artur Spokojny, Charles Landau, H.V. Anderson, Harvey White, Richard Bach, Robert Siegal, Mitchell Krucoff, Russell Raymond, Stafford Warren, Joe Bissett, Millie Rawert, Wendy Etka, Mitchell Hope, Robert Vogel
Journal: Journal of the American College of Cardiology (1996)
Behavior and Brain Lesions
Authors: Irwin Perlmutter
Journal: JAMA (1971)

To the Editor.—  InThe Journal( 216 :1025, 1971) Mark et al discuss the relationship between abnormal brain function due to trauma and abnormal behavior. The case presented was that of a 27-year-old man who had worked steadily as a handyman for 11 years before he was fired, took to drinking as he had even as a teenager before a head injury, then committed a crime of violence, and finally suicide.  I can only agree with Dr. Geschwind's statement that in such a case the relation between the brain lesion and the behavioral disturbance cannot be made with assurance.  The border lines between neurology, pathologic neurophysiology, and psychiatry are much more vividly expressed in patients with Sturge-Weber disease with hemiparesis, seizures, and abnormal behavior patterns. After hemispherectomy, they have fewer or no seizures, a normal electroencephalogram, and personalities which are not in conflict with the environment. A patient presented in
Computer-Assisted Diagnosis
Authors: Stephen P. Hayden
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 September 1989Computer-Assisted DiagnosisStephen P. Hayden, MDStephen P. Hayden, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-6-544_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:Dr. Bankowitz and colleagues (1) are to be congratulated for their report on a computer-assisted medical diagnostic consultation service. We have also evaluated a computerized diagnostic system, which is being used in the internal medicine service of the Cleveland Clinic Foundation. The system concerned is the Medicomp system, developed by Medicomp of Virginia Inc., Fairfax, Virginia. This system has a knowledge base that contains information on 3000 diseases and their associated symptoms, physical signs, and tests. When evaluated the system was running on an IBM Series 1 computer but a personal-computer version is also available. The Medicomp...Reference1. BankowitzMcNeilChallinorParkerKapoorMiller RMSRWR. A computer-assisted medical diagnostic consultation service. Ann Intern Med. 1989;110:824-32. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Cleveland Clinic Foundation Cleveland, OH 44195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySINGLE DOMAIN ANTIBODIESCOMPUTER-ASSISTED DIAGNOSIS 15 September 1989Volume 111, Issue 6Page: 544-545KeywordsComputersComputing systemsDiagnostic medicineInformation technologyPersonal computersRunningSigns and symptoms Issue Published: 15 September 1989 PDF downloadLoading ...
ABC of palliative care: The carers
Authors: A. Ramirez, J. Addington-Hall, M. Richards
Journal: BMJ (1998)

In general, most of the final year of life is spent at home, although 90% of patients spend some time in hospital and about 55% of all deaths occur there. The burdens and rewards of caring for people in their last year of life are shared between informal carers (relatives and friends or neighbours) and healthcare professionals working in institutions or in the community.



“The death of Theodore Gericault (1791-1824), with his friends Colonel Bro de Comeres and the painter” by Ary Scheffer (1795-1858). Until the start of this century, most people died at home while being cared for by family and friends



About three quarters of people receive care at home from informal carers (residential or non-residential), most of whom are women. About a third of cancer patients receive care from one close relative only, while nearly half are cared for by two or three relatives, typically a spouse and an adult child. A smaller proportion of non-cancer patients than cancer patients have access to such informal care, reflecting their older age at death.

Approximately two thirds of cancer patients and a third of non-cancer patients receive some kind of formal home nursing. District nurses are involved in the care of about half of cancer patients and a quarter of non-cancer patients. Palliative care nurse specialists, such as Macmillan nurses, are involved with about 40% of cancer patients but very few non-cancer patients. General practitioners see most patients at least five times during their last year of life, often at home. Healthcare professionals provide care on acute hospital wards and in outpatient clinics, and hospice inpatient staff care for about 17% of cancer patients during part of their terminal illness.

Without the support of family and friends, it would be impossible for many patients to remain at home. It …
A METHOD FOR STANDARDIZING BACTERIAL VACCINES
Authors: J. GARDNER HOPKINS
Journal: JAMA (1913)

The following method is presented as a convenient means for determining approximately the amount of bacterial substance in suspensions used as vaccines. It consists in measuring the volume of the moist bacteria after centrifugalization in a tube with a graduated capillary tip. Experiments with various forms of tubes show that bacteria pack closely in any tip which is 1.5 mm. or more in diameter. If the capillary portion of the tube is long, the height of the column of bacteria may vary sufficiently to affect the density of the sediment, but if this portion is under 2.5 cm. in length, there is little variation in the packing. In such a tube staphylococci and typhoid bacilli pack to within 20 per cent, of the maximum density obtainable, if centrifugalized for half an hour at 2,800 revolutions per minute, I have obtained from the International Instrument Company of Cambridge, Mass., very satisfactory
Effects of damaging the endocardial surface on the mechanical performance of isolated cardiac muscle.
Authors: D L Brutsaert, A L Meulemans, K R Sipido, S U Sys
Journal: Circulation Research (1988)

The mechanical properties of mammalian ventricular cardiac muscle have been studied in the presence and in the absence of an intact endocardial surface. Isotonic and isometric twitch contractions were obtained from papillary muscles of the right ventricle of cat at 29 degrees and 37 degrees C, at different extracellular calcium concentrations ([Ca2+]o), and at different initial muscle lengths. The endocardial surface was damaged by gentle abrasion of the muscle surface with a plastic blade or by brief immersion for 1 second with 1% Triton X-100. Although there was no evidence of damage to myocardial cells, damaging the endocardial surface resulted in an immediate and irreversible abbreviation of the twitch contractions with, except at the highest ([Ca2+]o, a decrease in peak isometric twitch tension. These changes induced 1) an asymmetrical shift of the tension-[Ca2+]o relation towards increasing [Ca2+]o but with no effect at the highest [Ca2+]o, and 2) a rightward and downward shift of the length-tension relation. Both shifts were significantly more pronounced at 37 degrees C than at 29 degrees C; they were not accompanied by significant changes in Vmax. The asymmetrical shift of the tension-[Ca2+]o relation suggests that the endocardium-mediated chain of events may be mediated by changes in the sensitivity of the contractile proteins to Ca2+. This hypothesis is also supported by the similar pattern of changes (i.e., modulation of the onset of early tension decline) induced by decreasing length at each [Ca2+]o and by the removal of a functional endocardium. Accordingly, the endocardium may help to control the performance of the heart by modulating peak contractile performance and relaxation of the underlying myocardium.