tbuckley/cabot-search huggingface dataset:
US drug shortages are set to reach record high in 2011, report says
Authors: J. H. Tanne
Journal: BMJ (2011)

Drug shortages in the US have increased since 2006 and are likely to set a record in 2011, says a report issued on 15 December by the US Government Accountability Office, the investigative arm of Congress. The report recommends that Congress require manufacturers to alert the Food and Drug Administration of possible shortages and that the FDA increase its ability to respond to drug shortages.

President Barack Obama issued an Executive Order in October calling the shortages “a perilous and growing threat to public health” ( BMJ 2011;343:d7158, doi:10.1136/bmj.d7158). He directed the FDA to prevent and reduce shortages by requiring manufacturers to give the FDA advance notice of shortages. He also told the FDA to expedite its review of new drug suppliers, manufacturing sites, and manufacturing changes. He directed the FDA to alert the Department of Justice about attempts to stockpile drugs or sell them at exorbitant prices.

Bills have been …
A case of clear cell acanthoma presenting as nipple eczema
Authors: D-H. Kim, C-W. Kim, S-J. Kang, T-Y. Kim
Journal: British Journal of Dermatology (1999)

S ir, Clear cell acanthoma is a relatively uncommon benign epidermal tumour, which usually presents as solitary, rarely multiple tumours, often localized on the lower legs of middle aged or elderly individuals. 1 Clear cell acanthoma presents as a flat or dome‐shaped, sharply demarcated papule or nodule, sometimes with a keratotic scale in bright red or pink colour, which make the tumour appear as a vascular lesion. 2 We report a case of clear cell acanthoma presenting as nipple eczema in a patient with atopic dermatitis. A 23‐year‐old Korean woman presented with a 3‐month history of a pruritic, irregular bordered, brownish plaque on the left nipple ( Fig. 1a). Previously, she had been treated intermittently for atopic dermatitis in private dermatologic clinics. Her family history was non‐contributory. As the lesion showed the clinical appearance of nipple eczema, she was treated with a systemic and topical steroid for 2 weeks without any clinical improvement. A skin biopsy was done, and histopathological findings showed parakeratosis, sharply demarcated acanthosis composed of clear cells, regular elongation of rete ridges in the epidermis (Fig. 1b). The clear cells had bright cytoplasm and normal nuclei. Clear cells stained positively to the periodic acid‐Schiff (PAS) reaction, which was diastase‐labile, indicating the presence of glycogen. Electron microscopy showed many intracytoplasmic glycogen granules.
Disulfiram (Antabuse) Psychosis
Authors: SIM C. LIDDON, RICHARD SATRAN
Journal: American Journal of Psychiatry (1967)

A case of disulfiram psychosis is presented; the patient also had grand mal convulsions even though he had no prior history of epilepsy. The literature on disulfiram psychoses is reviewed, and it is pointed out that there is little conformity among different authors in their use of this term. For the sake of clarity, the 52 cases previously reported as psychoses secondary to disulfiram ingestion are classified into three groups. In both Group I and Group II, delirium is present. However, in the latter group the psychosis is complicated by other symptoms, such as depression, paranoid ideations, or manic behavior. Group III consists of those psychoses without delirium. The evidence that disulfiram does have a deleterious effect on the central nervous system of some individuals is discussed. Also presented is the evidence that psychogenic factors contribute to the genesis of these psychoses, particularly in the cases of Group II and Group III.
Complicated Migraine and Haemoglobin AS in Nigerians
Authors: B. O. Osuntokun, O. Osuntokun
Journal: BMJ (1972)

Among 123 Nigerians with migraine seen at one clinic 49 (40%) had complicated migraine, with ophthalmoplegia in 20 and amaurosis or field defects in 13. Haemoglobin AS was found in 60% of patients with complicated migraine, compared with 20% of those with simple migraine.
(3) The pathology and pathogenesis of stucco keratoses
Authors: L. Shall, R. Marks
Journal: British Journal of Dermatology (1987)

Stucco keratoses are benign acquired acral keratotic papular lesions usually occurring on the distal parts of the lower limbs of elderly men. They are poorly characterized in the literature and their pathogenesis is uncertain. We have studied eight patients with multiple stucco keratoses who presented in the previous 18 months, in an attempt to understand the nature of these lesions. All eight subjects were male, aged from 50 to 72 years. Their lesions had a characteristic stuck-on appearance and were most numerous over the fronts of the lower legs, but were also evident over other areas of the limbs. All patients had a history of prolonged solar exposure. Three of the subjects had concurrent facial solar keratoses (one also had a squamous cell carcinoma) and one had a lentigo maligna affecting the face. However, the stucco keratoses themselves showed no dysplastic change. Histologically, they showed a characteristic ‘church spire’ type retention hyperkeratosis without marked acanthosis. The lack of an obvious marked increase in epidermal cell population size is reflected in the normal in vitro tritiated thymidine autoradiographic labelling indices (7·81 ± 1·67%, normal range 5–9%). Ultrastructurally, there were no viral particles evident (confirmed by immunocytochemical studies) and a normal pattern of differentiation was evident. Two of the patients with myriads of lesions were treated for 2 months with etretinate and showed a dramatic improvement which, however, lasted for 6 months only. In summary, it appears that (i) these lesions are more common than previously believed; (ii) they are in some way the result of solar exposure, although not themselves dysplastic; (iii) they show normal epidermal differentiation, although they have a localized retention hyperkeratosis; and (iv) they respond to etretinate treatment.
Relation Between Troponin T and the Risk of Subsequent Cardiac Events in Unstable Coronary Artery Disease
Authors: Bertil Lindahl, Per Venge, Lars Wallentin
Journal: Circulation (1996)

Early risk assessment is important in patients with unstable coronary artery disease, ie, unstable angina or non-Q-wave myocardial infarction. Some previous small studies have indicated that patients with unstable angina and elevation of troponin T (tn-T) have worse short-term and long-term prognoses. In this study, the prognostic value of tn-T was evaluated and compared with other early available risk indicators.Nine hundred seventy-six patients participating in a randomized study of low-molecular-weight heparin in unstable coronary artery disease were followed for 5 months after the index episode. The risk of cardiac events increased with increasing maximal levels of tn-T obtained in the initial 24 hours. The lowest quintile (<0.06 microgram/L) constituted a low-risk group, the second quintile (0.06 to 0.18 microgram/L) an intermediate-risk group, and the three highest quintiles (> or =0.18 microgram/L) a high-risk group, with 4.3%, 10.5%, and 16.1% risk of either myocardial infarction or cardiac death, respectively. Troponin T level was identified together with age, hypertension, number of antianginal drugs, and ECG changes at rest as independent prognostic variables for myocardial infarction or cardiac death in a multivariate analysis. The prognostic value of tn-T was independent of the classification of index event into unstable angina or myocardial infarction.Troponin T determination is an inexpensive and widely applicable method for early risk assessment in patients with unstable coronary artery disease. The maximum tn-T value obtained during the first 24 hours provides independent and important prognostic information.
Peritonitis and Bowel Perforation in Peritoneal Dialysis
Authors: J. RUBIN
Journal: Annals of Internal Medicine (1974)

Letters1 September 1974Peritonitis and Bowel Perforation in Peritoneal DialysisJ. RUBIN, M.D., D. G. OREOPOULOS, M.D., T. T. LIU, M.D., R. MATHEWS, M.D., G. A. DEVEBER, M.D.J. RUBIN, M.D.Search for more papers by this author, D. G. OREOPOULOS, M.D.Search for more papers by this author, T. T. LIU, M.D.Search for more papers by this author, R. MATHEWS, M.D.Search for more papers by this author, G. A. DEVEBER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-3-402 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We have recently reviewed the incidence and management of peritonitis and bowel perforation that occurred during the last 3 years in our chronic peritoneal dialysis programme. During this period approximately 6000 dialyses were done in 87 patients who were on chronic peritoneal dialysis for periods up to 38 months (average, 9 months). Dialysis was done for 24 hours twice weekly. Access to the peritoneal cavity was by repeated abdominal punctures (in the initial stage of our programme only), by the use of the Deane prosthesis (1), or the permanent Tenckhoff catheter.Peritonitis, defined by fever, abdominal tenderness,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Toronto Western Hospital, Toronto, Ontario, Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIs Computerized Tomography Useful in Identifying Abdominal Catastrophes in Patients Presenting with Peritonitis?Abdominal Catastrophe Revisited: The Risk and Outcome of Enteric Peritoneal ContaminationAbdominal Catastrophe: Visceral Injury as a Cause of Peritonitis in Patients Treated by Peritoneal DialysisExtracorporeal Methods in the Intensive Care UnitWhat Is the Actual Incidence of Peritonitis in Maintenance Peritoneal Dialysis? A Prospective StudyComplications of peritoneal dialysis other than peritonitis 1 September 1974Volume 81, Issue 3Page: 402-403KeywordsCathetersFeversMedical dialysisPeritoneal dialysisPeritonitis Issue Published: 1 September 1974 PDF downloadLoading ...
Hyperparathyroid and Hypoparathyroid Disorders
Authors: Stephen J. Marx
Journal: New England Journal of Medicine (2000)

The four parathyroid glands, through the secretion of parathyroid hormone, regulate serum calcium concentrations and bone metabolism.1 In turn, serum calcium concentrations regulate parathyroid hormone secretion; high concentrations inhibit secretion by the parathyroid glands of parathyroid hormone and low concentrations stimulate it.2 Low or falling serum calcium concentrations act within seconds to stimulate parathyroid hormone secretion, initiated by means of a calcium-sensing receptor on the surface of the parathyroid cells.2 This receptor is a heptahelical molecule, like the receptors for light, odorants, catecholamines, and many peptide hormones.3 Parathyroid hormone secretion is 50 percent of the maximal level at a serum . . .
Pneumatic retinopexy in the treatment of recurrent retinal detachment: Authors’ reply
Authors: Tarun Sharma, Sengamedu Srinivasa Badrinath, Bickol N Mukesh, Lingam Gopal, Mahesh P Shanmugam, Pramod Bhende, Muna Bhende, Nitin S Shetty, Rajat Agrawal
Journal: Ophthalmology (1998)
Aspiration around high-volume, low-pressure endotracheal cuff.
Authors: P Sanderson
Journal: BMJ (1981)

histolytica.3We feel it is important that there should be an awareness of the possibility that amoebiasis may exist in homosexual patients presenting with diarrhoea, since this may be misdiagnosed as inflammatory bowel disease and corticosteroids would be inappropriate in such cases and might result in fulminant amoebic infection.7
Nutrition Principles and Diabetes: A role for “lente carbohydrate”?
Authors: David J A Jenkins, Alexandra L Jenkins
Journal: Diabetes Care (1995)

The current nutrition recommendations of the American Diabetes Association (ADA) represent a thoughtful synthesis of much current data. They depart from tradition by not advocating specific figures for total fat and carbohydrate intake. Rather, since many issues are still topics of scientific debate, they endorse the principle of individualization and set guidelines accordingly. One topic that may be worthy of further debate is the principle of “spreading the nutrient load,” or lengthening the absorption time. This principle covers the effects of altered meal frequency, viscous dietary fibers, low-glycemic index foods, and inhibitors of carbohydrate absorption. In its simplest form it is illustrated by studies of altered meal frequency (“nibbling versus gorging”). Reducing the size and increasing the frequency of meals has been shown acutely to result in lower mean blood glucose and insulin levels over the day in type II diabetes and to result in reduced 24-h urinary C-peptide losses. In the longer term in nondiabetic subjects, total and low-density lipoprotein cholesterol levels are reduced, together with fasting apolipoprotein B and serum uric acid levels, as additional risk factors for coronary heart disease. These and other physiological effects make slowing carbohydrate absorption (“lente carbohydrate”) a potentially useful therapeutic modality. However, of the possible ways of slowing absorption, only alteration in meal frequency was of general interest in the current ADA nutrition recommendations. Nevertheless, the effects of slowing carbohydrate absorption by various means may have beneficial metabolic effects in diabetes and may support the use of ethnic foods in diets compatible with further modifications identified more favorably in the current nutrition recommendations (e.g., increased use of monounsaturated fat).
A Compressible Scaffold for Minimally Invasive Delivery of Large Intact Neuronal Networks
Authors: Amélie Béduer, Thomas Braschler, Oliver Peric, Georg E. Fantner, Sébastien Mosser, Patrick C. Fraering, Sidi Benchérif, David J. Mooney, Philippe Renaud
Journal: Advanced Healthcare Materials (2014)

Millimeter to centimeter‐sized injectable neural scaffolds based on macroporous cryogels are presented. The polymer‐scaffolds are made from alginate and carboxymethyl‐cellulose by a novel simple one‐pot cryosynthesis. They allow surgical sterility by means of autoclaving, and present native laminin as an attachment motive for neural adhesion and neurite development. They are designed to protect an extended, living neuronal network during compression to a small fraction of the original volume in order to enable minimally invasive delivery. The scaffolds behave as a mechanical meta‐material: they are soft at the macroscopic scale, enabling injection through narrow‐bore tubing and potentially good cellular scaffold integration in soft target tissues such as the brain. At the same time, the scaffold material has a high local Young modulus, allowing protection of the neuronal network during injection. Based on macroscopic and nanomechanical characterization, the generic geometrical and mechanical design rules are presented, enabling macroporous cellular scaffold injectability.
HLA class I deficiencies due to mutations in subunit 1 of the peptide transporter TAP1
Authors: Henri de la Salle, Jacques Zimmer, Dominique Fricker, Catherine Angenieux, Jean-Pierre Cazenave, Mitsuo Okubo, Hiroo Maeda, Alessandro Plebani, Marie-Marthe Tongio, Anne Dormoy, Daniel Hanau
Journal: Journal of Clinical Investigation (1999)

The transporter associated with antigen processing (TAP), which is composed of two subunits (TAP1 and TAP2) that have different biochemical and functional properties, plays a key role in peptide loading and the cell surface expression of HLA class I molecules. Three cases of HLA class I deficiency have previously been shown to result from the absence of a functional TAP2 subunit. In the present study, we analyzed two cases displaying not only the typical lung syndrome of HLA class I deficiency but also skin lesions, and found these patients to be TAP1-deficient. This defect leads to unstable HLA class I molecules and their retention in the endoplasmic reticulum. However, the absence of TAP1 is compatible with life and does not seem to result in higher susceptibility to viral infections than TAP2 deficiency. This work also reveals that vasculitis is often observed in HLA class I–deficient patients.
Could fewer islet cells be transplanted in type 1 diabetes?
Authors: N. Waugh
Journal: BMJ (2000)

EDITOR—At a meeting in Bristol Dr James Shapiro presented the most recent data on islet cell transplantation in type 1 diabetes mellitus,1 which White et al referred to in their editorial.2 Islet cell transplantation has now been successfully carried out in 12 patients, with the longest follow up being 17 months. We need more evidence from longer follow up and larger numbers, as called for in the editorial, but results look promising. …
TCT-399 The Impact Of STENTYS® (STENTYS SA, Paris, France) Self-Apposing Coronary Artery Stent Placement On The Lipid Core Plaque Burden, As Assessed With Near-Infrared Spectroscopy; How Does The Lipid Rich Plaque Modify After Stent Deployment And After Balloon Post-Dilatation?
Authors: Huangling Lu, Maik J. Grundeken, Maribel I. Madera Cambero, Jan G. Tijssen, Robbert J. de Winter, Karel T. Koch, Joanna J. Wykrzykowska
Journal: Journal of the American College of Cardiology (2014)
Characteristics of histamine-releasing activity in the sera of patients with chronic idiopathic urticaria
Authors: Burton Zweiman, Mary Valenzano, Paul C. Atkins, Tonny Tanus, John A. Getsy
Journal: Journal of Allergy and Clinical Immunology (1996)

The serum histamine-releasing activity (HRA) found in a sizable percentage of patients with chronic idiopathic urticaria (CIU) has been partially characterized. However, the variable effect of individual HRA+ sera in basophils of different donors and the relationship of HRA to the clinical course require further investigation.The study was performed to characterize the HRA found in sera of some members of a sizable group of carefully evaluated patients with CIU.Sera of 70 patients with CIU, evaluated with a standard protocol, were screened for increased HRA. HRA+ sera were fractionated, heated, and tested on unaltered and altered basophils obtained from a panel of normal donors. HRA levels were compared with concomitant clinical manifestations.HRA+ sera were found in 30% of our patients with CIU, HRA was predominantly in the IgG fraction, sensitive to 56 degrees C heating for 4 hours, and generally reacted more with IgE-stripped basophils. Considerable variation in the degree of response to HRA+ sera in the basophils of different normal subjects did not correlate with the degree of response of these cells to heterologous anti-IgE antiserum. Serum HRA levels were generally much lower when symptoms decreased in these patients with CIU.Serum HRA from patients with CIU appears to bind most commonly to the IgE receptor and may be a marker of clinical disease activity. HRA appears in an IgG-containing fraction of the serum and may contain IgE in some cases.
PROGNOSTIC ROLE OF HEMOCONCENTRATION IN PATIENTS HOSPITALIZED FOR HEART FAILURE WITH REDUCED EJECTION FRACTION: AN ANALYSIS OF THE EVEREST TRIAL
Authors: Stephen John Greene, Muthiah Vaduganathan, Andrew Ambrosy, Robert Mentz, Haris Subacius, Aldo Maggioni, Savina Nodari, Marvin Konstam, Javed Butler, Mihai Gheorghiade
Journal: Journal of the American College of Cardiology (2013)
Orocaecal transit time in health and in thyroid disease.
Authors: M V Tobin, R A Fisken, R T Diggory, A I Morris, I T Gilmore
Journal: Gut (1989)

Altered bowel habit commonly occurs in thyroid disease. We measured orocaecal transit in healthy volunteers and in hyperthyroid and hypothyroid patients before and after treatment, using the lactulose hydrogen breath test incorporating a standard liquid meal to obtain a more physiological assessment. Mean transit time in 12 control subjects was 85 (8) minutes (mean (SE)) (mean coefficient of variation between replicate studies, 8.6% (3%)). In eighteen hyperthyroid patients transit was more rapid at 49 (4) minutes (p less than 0.01). Ten hypothyroid patients had a transit time similar to controls at 91 (9) minutes. Transit time returned to normal in thyrotoxic patients after treatment but in eight hypothyroid patients retested, it remained unchanged. Our findings suggest that (a) the inclusion of a liquid meal provides a reproducible method of measuring orocaecal transit using the lactulose hydrogen breath test, (b) rapid small bowel transit in thyrotoxicosis may be one factor in the diarrhoea which is a feature of the disease and (c) if altered gut transit is the cause of sluggish bowel habit in hypothyroidism, delay in the colon, and not small bowel, is likely to be responsible.
Body Fat, Leptin, and Hypothalamic Amenorrhea
Authors: Rexford S. Ahima
Journal: New England Journal of Medicine (2004)

Hypothalamic amenorrhea can be defined as the cessation of menstruation due to a dysfunction of hypothalamic signals to the pituitary gland, resulting in a failure of ovulation. Typically, young women who are affected by the condition have no obvious structural abnormalities of the hypothalamus or the rest of the brain, pituitary gland, or ovaries. The common type of hypothalamic amenorrhea (also called functional amenorrhea) is a diagnosis of exclusion. Hyperprolactinemia, primary deficiency of gonadotropin-releasing hormone, and other hormonal abnormalities must be ruled out. Affected women are reportedly more likely to be underweight, athletic, engaged in “intellectual” professions, or exposed to . . .
Clusters of Master Control Genes Regulate the Development of Higher Organisms
Authors: Edward B. Lewis
Journal: JAMA (1992)

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Lucy O'Brien
Authors: John Kelly
Journal: BMJ (2006)

Former obstetrician and gynaecologist Monze District Hospital, Zambia (b 1923; q University College Dublin 1952; DTMH FRCOG, FRCPI), d 10 April 2006.

Lucy was professed a missionary sister of the Holy Rosary in 1945 and went to Nigeria in 1953. In 1964 she helped open the first two storey hospital there. In 1967 she changed her plans to prepare for the MRCOG in Bristol to help those in need in the Biafran war. She went to Sierra Leone in 1971 and Zambia in 1976, where she died. She was obstetrician and gynaecologist at Monze Mission Hospital until 1999 and largely responsible for Monze being nominated the Fistula Centre for Zambia; a new such centre is planned in her memory. She retired to Lusaka, where she cared for orphans and built clinics. In 2004 she was honoured by President Mwanawasa of Zambia with the Order of Distinguished Service, First Division.