tbuckley/cabot-search huggingface dataset:
Isolated palsy of the hypoglossal nerve after central venous catheterization.
Authors: H B Whittet, M J Boscoe
Journal: BMJ (1984)

The clinical and morphological features are presented of eight infants who developed a chronic respiratory illness in the first year of life characterised by tachypnoea and inspiratory crackles on auscultation. The median age at the onset of symptoms was 1 month (range 1 day to 7 months). Five of the infants required supplemental oxygen. Chest radiographs showed only non-specific perihilar alveolar shadowing and generalised hyperinflation. Investigations into the cause of the illness in these infants, including studies for infection, cardiac disease, and gastro-oesophageal reflux, were negative, and an open lung biopsy sample was subsequently taken from each infant. Histological examination showed mild lymphocytic bronchiolar infiltration only in six of the eight infants. The other two biopsy samples were normal. Seven of the infants were given a trial of steroids by mouth (mean duration of treatment four months) without any apparent benefit. These infants have now been followed up for a median duration of 21 months (range 1–9 years). All have shown continuous improvement, with either the end of oxygen treatment (three patients) or the use of low flow oxygen only at night (two patients). All have normal development and all but one have normal growth. Chest examination has become normal in four subjects. In the remainder the inspiratory crackles have persisted, although they have decreased markedly in all patients. It is proposed that these infants have a previously unreported respiratory entity and that the clinical and lung biopsy sample findings reported here predict a favourable medium term prognosis.
Randomized Crossover Trial of Two Treatments for Sleep Apnea/Hypopnea Syndrome
Authors: Heather M. Engleman, James P. McDonald, David Graham, Glenn E. Lello, Ruth N. Kingshott, Emma L. Coleman, Thomas W. Mackay, Neil J. Douglas
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Mandibular repositioning splints (MRSs) and continuous positive airway pressure (CPAP) are used to treat the sleep apnea/hypopnea syndrome (SAHS). There are some data suggesting that patients with milder symptoms prefer MRS, but there are few comparative data on outcomes. Therefore, we performed a randomized crossover trial of 8 weeks of CPAP and 8 weeks of MRS treatment in consecutive new outpatients diagnosed with SAHS (apnea/hypopnea index [AHI] >or= 5/hour, and >or= 2 symptoms including sleepiness). Assessments at the end of both limbs comprised home sleep study, subjective ratings of treatment value, sleepiness, symptoms, and well-being, and objective tests of sleepiness and cognition. Forty-eight of 51 recruited patients completed the trial (12 women; age [mean +/- SD], 46 +/- 9 years; Epworth 14 +/- 4; median AHI, 22/hour; interquartile ratio [IQR], 11-43/hour). Significant (p <or= 0.01) differences between MRS and CPAP were observed for 7 of 21 variables (effect sizes, 0.3-0.6 SDs), all favoring CPAP, including AHI (15 +/- 16 and 8 +/- 6/hour, respectively), effectiveness rating, symptoms, Epworth (12 +/- 5 and 8 +/- 5, respectively), functional outcomes of sleepiness questionnaire, short-form 36 health survey mental component, and health transition scores. Objective sleepiness, cognitive performance, and preference for treatments were not different. In patients experiencing a mild form of the syndrome (AHI < 15, n = 18), symptoms, treatment efficacy and satisfaction, and subjective sleepiness were also better with CPAP than with MRS (effect sizes, 0.7-1.1 SDs). These results do not support these MRS devices as first-line treatment for sleepy patients with SAHS.
Antibodies to a trypsin sensitive pancreatic antigen in chronic inflammatory bowel disease: specific markers for a subgroup of patients with Crohn's disease.
Authors: F Seibold, P Weber, H Jenss, K H Wiedmann
Journal: Gut (1991)

The presence of antibodies against pancreatic juice (PAB) in patients with Crohn9s disease has recently been reported. In our study sera from 273 patients with inflammatory bowel disease (222 with Crohn9s disease, 51 with ulcerative colitis) have been examined for PAB and also for antibodies against gut tissues by means of indirect immunofluorescence. PAB were found in 68 of the 222 patients with Crohn9s disease (31%), with titres ranging from 1/10 to 1/1280, and in only two patients with ulcerative colitis (4%), with titres of 1/20. None were found in 198 patients with various chronic inflammatory diseases and healthy control subjects. No differences were found between the PAB positive and negative patients when the following parameters were compared: disease activity (Crohn9s disease activity index), involvement of bowel segments, incidence of extraintestinal disease, or treatment with anti-inflammatory drugs. Only seven of the patients with Crohn9s disease had a history of pancreatic disease and of these, four had detectable pancreatic antibodies. Longitudinal observations of 40 patients with Crohn9s disease showed a stable pattern for PAB, independent of disease activity and treatment. Partial characterisation of the PAB antigen, isolated from pancreatic juice, showed a trypsin sensitive macromolecular protein of more than 10(6) daltons not identical with a panel of defined exocrine pancreatic proteins. By contrast, antibodies against goblet cells (GAB) were found in 13 of 51 patients with ulcerative colitis (29%) and in none of the patients with Crohn9s disease or control subjects. PAB were found as a highly specific serological marker for Crohn9s disease and GAB for ulcerative colitis, but the relevance of PAB and GAB in the pathogenesis in Crohn9s disease remains unclear.
Miconazole Treatment for Severe Dermatophytoses
Authors: Stephen J. Mandy
Journal: JAMA (1974)

The effect of miconazole nitrate applied topically to problem dermatophyte infections (primarily tinea cruris) was studied in double-blind clinical trials. A 2% cream preparation was compared against its vehicle in 62 men. The miconazole treatment was both clinically and mycologically effective in more than 90% of the active treatment group (vs less than 20% in the placebo control group) with prompt relief of symptoms. More important, there was but a single recurrence of disease in the miconazole group during the month after therapy was stopped. (<i>JAMA</i>230:72-75, 1974)
Quality assurance for synovial fluid examination for crystals: an improved method
Authors: N. W McGill, V. G McGill
Journal: Annals of the Rheumatic Diseases (1997)

<h3>OBJECTIVE</h3> To determine the best method of preparing synovial fluid specimens for use in quality assurance (QA) surveys designed to assess accuracy of crystal identification. <h3>METHODS</h3> A previously published method (A) was compared with a new method (B) in the setting of a QA survey. Ten Australian, one New Zealand, and one Hong Kong hospital laboratories took part in the survey. Each laboratory examined six different synovial fluid specimens prepared using method A (first round) and a separate six specimens using method B (second round). In method A, a drop of synovial fluid on a glass slide was surrounded by a rim of Ultramount, sealed with a coverslip, and distributed. The participating laboratory did not need to perform any processing of the specimen before examination. In method B, a capillary tip was filled with synovial fluid, heat sealed, and distributed. The fluid was expelled onto a glass slide in preparation for examination after arrival in the participating laboratory. <h3>RESULTS</h3> Using method A 36 of 71 (51%) of the specimens were rated as satisfactory, compared with 53 of 61 (87%) of the specimens using method B (Fisher’s exact test, p&lt;0.001). <h3>CONCLUSIONS</h3> An improved method of preparation of synovial fluid specimens for QA surveys is described. Using the new method it is feasible to perform a synovial fluid QA survey covering a large area (Australasia).
Responses to the Tooke inquiry show support for his proposals
Authors: Zosia Kmietowicz
Journal: BMJ (2008)

The proposals in the final report from the inquiry into postgraduate medical training led by John Tooke (see News doi: 10.1136/bmj.39455.498600.4E) drew widespread support across the medical professions.

“Under MMC, trainees are required to make specialty choices far too early in their career without having gained enough experience or the opportunity to experience ‘taster placements’ in other related specialties they may subsequently prefer. The college strongly favours training which allows a greater freedom of movement between specialties.”

“The virtually unanimous positive response by the medical profession to the report is unparalleled, and so we very much hope that the report is accepted by the government and implemented without delay.”

“It is vital that the …
Hematopoietic Stem Cell Expansion Precedes the Generation of Committed Myeloid Leukemia-Initiating Cells in C/EBPα Mutant AML
Authors: Oxana Bereshchenko, Elena Mancini, Susan Moore, Daniel Bilbao, Robert Månsson, Sidinh Luc, Amit Grover, Sten Eirik W. Jacobsen, David Bryder, Claus Nerlov
Journal: Cancer Cell (2009)
A CLINICAL STUDY OF BILIARY TRACT DISEASE
Authors: ALFRED BLALOCK
Journal: JAMA (1924)

This paper is based on a statistical study<sup>1</sup>of all cases with a diagnosis of disease of the biliary tract that have been in the surgical service of the Johns Hopkins Hospital between 1889 and 1924. This consideration will not include the cases with malignancy of the biliary tract, and those with a clinical diagnosis of disease which was not confirmed by an operation. The cases are divided into three groups: (1) stones in the gallbladder or cystic duct, or both (460 cases); (2) stones in the common duct, regardless of the location of other stones (139 cases), and (3) acute or chronic cholecystitis without the presence of stones (136 cases). The main interest centers in the ultimate condition of the patients following operation; but the more important points as regards (1) etiology, (2) symptomatology, (3) physical findings, (4) laboratory tests, (5) operation and reoperation, (6) bacteriology and pathology,
Improved Survival in Thrombotic Thrombocytopenic Purpura–Hemolytic Uremic Syndrome
Authors: William R. Bell, Hayden G. Braine, Paul M. Ness, Thomas S. Kickler
Journal: New England Journal of Medicine (1991)

Thrombotic thrombocytopenic purpura—hemolytic uremic syndrome (TTP-HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, central nervous system abnormalities, and renal dysfunction. In early reports the mortality approached 100 percent. A treatment protocol was introduced in 1979 for patients admitted to Johns Hopkins Hospital with the diagnosis of TTP-HUS. Treatment regimens included 200 mg of prednisone a day, for patients with minimal symptoms and no central nervous system symptoms, and prednisone plus plasma exchange, for patients with rapid clinical deterioration who did not improve after 48 hours of prednisone alone and for patients presenting with central nervous system symptoms and rapidly declining hematocrit values and platelet counts.
Treatment of hypertension in older adults.
Authors: J. A. Lewis
Journal: BMJ (1992)

control.The indicators of prostaglandin metabolism are related to the HbAI concentrations- namely, to the different stages of diabetic control.It is reasonable to suppose that the uncontrolled diabetic state and the shift in the balance of two antagonistic prostaglandins towards pathogenic direction might have a role in diabetic microangiopathy.Our observations support the authors' opinion.
Choosing Medical Care in Old Age: What Kind, How Much, When to Stop
Authors: Sheldon M. Retchin
Journal: JAMA (1995)

The science of geriatric medicine has largely been cultivated as a means of dispelling myths. Whether repudiating the effectiveness of multiple medications or avoiding the conventional approach for aggressive therapeutic interventions, geriatricians preach the merits of "less is more." <i>Choosing Medical Care in Old Age</i>, by Muriel Gillick, debates conventional medical care for the oldest old and offers profound advice on the intersect of frailty and medical decision making. Dr Gillick's premise is that prevailing medical care often runs counter to geriatric intentions for preserving dignity and function. This premise is elaborated by a series of case histories, almost like folk tales, all representing Gillick's patients and their families. The result is a series of novelettes, richly described anecdotes about her elderly patients in the throes of difficult decisions over medical care or social support. Though the book is predominantly aimed at a nonprofessional audience, health care scholars will also
Vascular Remodeling in Transplant Vasculopathy
Authors: Richard N. Mitchell, Peter Libby
Journal: Circulation Research (2007)

As therapeutic strategies to prevent acute rejection progressively improve, transplant vasculopathy (TV) constitutes the single most important limitation for long-term functioning of solid organ allografts. In TV, allograft arteries characteristically develop severe, diffuse intimal hyperplastic lesions that eventually compromise luminal flow and cause ischemic graft failure. Traditional immunosuppressive strategies that check acute allograft rejection do not prevent TV; indeed 50% of transplant recipients will have significant disease within five years of organ transplantation, and 90% will have significant TV a decade after their surgery. TV can involve the entire length of the transplanted arterial bed, including penetrating intraorgan arterioles. Indeed, the luminal narrowing of such penetrating vessels may be the most functionally significant because arterioles represent the major contributors to tissue vascular resistance. Because of the diffuseness of TV involvement in the allograft vascular bed, the only currently definitive therapy requires re-transplantation. Nevertheless, as we better understand the pathogenesis and critical mediators of these lesions, pharmacological advances can be anticipated. Other articles in this thematic review series focus on the specifics of the inciting injury, the cytokines and chemokines that drive TV development, and the nature of the recruited cells in TV lesions, as well as the pathogenic similarities between TV and other vascular lesions such as atherosclerosis. This review focuses on the mechanisms of vascular wall remodeling in TV, including the intimal accumulation of smooth muscle-like cells and associated extracellular matrix, medial smooth muscle cell degeneration, and adventitial fibrosis. A brief overview highlights the aneurysmal changes that can accrue when vessel wall inflammation has a cytokine profile distinct from the typical proinflammatory interferon-gamma-dominated milieu.
Abstract 5086: BEX protein attenuates the mitotic checkpoint and induces preneoplastic aneuploidy
Authors: Jin-Kwan Lee, Geun-Hyoung Ha, Janet Lee, Chang-Woo Lee
Journal: Cancer Research (2014)

Abstract The mitotic checkpoint plays a critical role in preventing chromosome missegregation and the adaptation of aneuploid cells. BubR1 kinase is a member of the mitotic checkpoint machinery. To understand the function of BubR1-mediated mitotic checkpoint, we have screened a novel BubR1-interating protein, BEX, by performing yeast two-hybrid systems. Here, we show that overexpression of BEX protein with sustained spindle poison results in a production of aneuploid cells and less apoptotic cell death. Inhibition of BubR1 expression increases aneuploid cell populations, whereas knockdown of both BEX and BubR1 avoid polyploidy by undergoing apoptosis in BubR1-depleted aneuploid cells. In addition, forced BEX expression significantly induces the colony forming potential and accelerates the proliferation rate. Interestingly, BEX is localized on X chromosome, and seems to be selectively expressed at cancer cells and tissues. These results indicate that BEX expression leads to mitotic dysfunction, and contributes to unstable chromosome aneuploid cells to be preneoplastically adapted. Citation Format: Jin-Kwan Lee, Geun-Hyoung Ha, Janet Lee, Chang-Woo Lee. BEX protein attenuates the mitotic checkpoint and induces preneoplastic aneuploidy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5086. doi:10.1158/1538-7445.AM2014-5086
Relationship of Intraoperative Cerebral Oxygen Saturation to Neurodevelopmental Outcome and Brain Magnetic Resonance Imaging at 1 Year of Age in Infants Undergoing Biventricular Repair
Authors: Barry D. Kussman, David Wypij, Peter C. Laussen, Janet S. Soul, David C. Bellinger, James A. DiNardo, Richard Robertson, Frank A. Pigula, Richard A. Jonas, Jane W. Newburger
Journal: Circulation (2010)

Background— Near-infrared spectroscopy monitoring of cerebral oxygen saturation (rS o 2 ) has become routine in many centers, but no studies have reported the relationship of intraoperative near-infrared spectroscopy to long-term neurodevelopmental outcomes after cardiac surgery. Methods and Results— Of 104 infants undergoing biventricular repair without aortic arch reconstruction, 89 (86%) returned for neurodevelopmental testing at 1 year of age. The primary near-infrared spectroscopy variable was the integrated rS o 2 (area under the curve) for rS o 2 ≤45%; secondary variables were the average and minimum rS o 2 by perfusion phase and at specific time points. Psychomotor and mental development indexes of the Bayley scales, head circumference, neurological examination, and abnormalities on brain magnetic resonance imaging did not differ between subjects according to a threshold level for rS o 2 of 45%. Lower Psychomotor Development Index scores were modestly associated with lower average ( r =0.23, P =0.03) and minimum ( r =0.22, P =0.04) rS o 2 during the 60-minute period after cardiopulmonary bypass but not with other perfusion phases. Hemosiderin foci on brain magnetic resonance imaging were associated with lower average rS o 2 from postinduction to 60 minutes post cardiopulmonary bypass (71±10% versus 78±6%, P =0.01) and with lower average rSO 2 during the rewarming phase (72±12% versus 83±9%, P =.003) and during the 60-minute period following cardiopulmonary bypass (65±11% versus 75±10%, P =0.009). In regression analyses that adjusted for age ≤30 days, Psychomotor Development Index score ( P =0.02) and brain hemosiderin ( P =0.04) remained significantly associated with rS o 2 during the 60-minute period following cardiopulmonary bypass. Conclusions— Perioperative periods of diminished cerebral oxygen delivery, as indicated by rS o 2 , are associated with 1-year Psychomotor Development Index and brain magnetic resonance imaging abnormalities among infants undergoing reparative heart surgery. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT00006183.
Investigations editor's reply to Holt and to Barnett and O'Hare
Authors: D. Cohen
Journal: BMJ (2013)

A 13 year old boy is described with hypereosinophilia associated with Kimura9s disease, who showed repeated life threatening syncopal attacks during daily activities or at rest. Coronary arteriography demonstrated small aneurysms with irregular vessel walls of both coronary arteries, and the absence of organic stenotic lesions. Infusion of a minimal dose of ergonovine into the right coronary artery induced severe spasm of the vessel. Ventricular fibrillation recurred even after administration of nifedipine and isosorbide was started, but was completely inhibited by prednisolone.
THE PEDIATRIC OUTLOOK.CHAIRMAN'S ADDRESS IN THE SECTION ON DISEASES OF CHILDREN, AT THE FIFTY-SEVENTH ANNUAL SESSION OF THE AMERICAN MEDICAL ASSOCIATION, BOSTON, 1906.
Authors: W. C. HOLLOPETER
Journal: JAMA (1906)

In view of the full and interesting program of scientific business, your chairman's address will be brief. An attempt to outline recent progress in pediatrics would be, in a measure, but a repetition of the excellent digests offered to us by our many periodicals and year-books. A few remarks on the outlook for broadening the pediatric horizon, however, seem most timely. The progress of our specialty in the last two decades has been stupendous. With the increasing number of physicians who are devoting their attention to the study of diseases of children, the multiplicity of special works and relative periodical literature and the extra facilities for special study, I can hardly realize that in my student days pediatrics was hopelessly entangled and practically lost in the chair of obstetrics. Then a special chair or clinic on diseases of children was practically unknown. Following in the wake of other specialties, pediatrics
The lungs in renal failure.
Authors: H Y Lee, T B Stretton, A M Barnes
Journal: Thorax (1975)

Pulmonary function was studied in 55 patients with renal failure and no clinical or radiographic evidence of lung disease. A defect of gas transfer was found to be the rule due to a reduction in the diffusing capacity across the alveolar capillary membrane; this abnormality appeared to be related to the severity of the renal impairment. There was also a restrictive ventilatory defect which was more marked in male than in female patients. The significance of these findings is discussed, and attention is drawn to their relevance for patients receiving immuno-suppressive therapy or renal transplantation, in whom pulmonary complications are relatively common.
Pathological Q Waves in Myocardial Infarction in Patients Treated by Primary PCI
Authors: Ronak Delewi, Georges IJff, Tim P. van de Hoef, Alexander Hirsch, Lourens F. Robbers, Robin Nijveldt, Anja M. van der Laan, Pieter A. van der Vleuten, Cees Lucas, Jan G.P. Tijssen, Albert C. van Rossum, Felix Zijlstra, Jan J. Piek
Journal: JACC. Cardiovascular imaging (2013)
Cholesterol Reduction Rapidly Improves Endothelial Function After Acute Coronary Syndromes
Authors: Jocelyn Dupuis, Jean-Claude Tardif, Peter Cernacek, Pierre Théroux
Journal: Circulation (1999)

Background —Cholesterol lowering reduces coronary events. One mechanism could be improvement of endothelial function. In line with this hypothesis, this study investigates whether cholesterol reduction can result in rapid improvement of endothelial function after acute coronary syndromes. Methods and Results —Patients with acute myocardial infarction or unstable angina and total cholesterol levels at admission ≥5.2 mmol/L or LDL ≥3.4 mmol/L were randomized to placebo (n=30) or pravastatin 40 mg daily (n=30) for 6 weeks. Brachial ultrasound was used to measure endothelium-dependent flow-mediated dilatation (FMD) and response to endothelium-independent nitroglycerin. Changes in the levels of markers of platelet activation, coagulation factors, and plasma endothelin levels were also assessed. Total and LDL cholesterol levels were similar at admission and before randomization in both groups. With pravastatin, but not with placebo, they decreased by 23% ( P &lt;0.05) and 33% ( P &lt;0.01), respectively. FMD was unchanged with placebo, 5.43±0.74% (mean±SEM) to 5.84±0.81%, but increased with pravastatin, 4.93±0.81% to 7.0±0.79% ( P =0.02), representing a 42% relative increase. Responses to nitroglycerin were similar during the time course of the study in the 2 groups. Markers of platelet activity, coagulation factors, and endothelin levels were not affected by pravastatin. Conclusions —Cholesterol reduction with pravastatin initiated early after acute coronary syndromes rapidly improves endothelial function after 6 weeks of therapy.