tbuckley/cabot-search huggingface dataset:
Helping to find the most accurate diagnosis
Authors: J. E. Dimsdale, M. Sharpe, F. Creed
Journal: BMJ (2013)

Twenty years ago Frances chaired the DSM ( Diagnostic and Statistical Manual of Mental Disorders ) taskforce, which emphasised “medically unexplained symptoms” as the key feature of somatoform disorders.1 Where did that get us?

Patients feel that their problems are viewed as inauthentic, and doctors can’t agree about what is or is not medically unexplained. All of this reinforces …
Polymorphism in Abalone Fertilization Proteins Is Consistent with the Neutral Evolution of the Egg's Receptor for Lysin (VERL) and Positive Darwinian Selection of Sperm Lysin
Authors: Willie J. Swanson, Charles F. Aquadro, Victor D. Vacquier
Journal: Molecular Biology and Evolution (2001)

The evolution of species-specific fertilization in free-spawning marine invertebrates is important for reproductive isolation and may contribute to speciation. The biochemistry and evolution of proteins mediating species-specific fertilization have been extensively studied in the abalone (genus Haliotis). The nonenzymatic sperm protein lysin creates a hole in the egg vitelline envelope by species-specifically binding to its egg receptor, VERL. The divergence of lysin is promoted by positive Darwinian selection. In contrast, the evolution of VERL does not depart from neutrality. Here, we cloned a novel nonrepetitive region of VERL and performed an intraspecific polymorphism survey for red (Haliotis rufescens) and pink (Haliotis corrugata) abalones to explore the evolutionary forces affecting VERL. Six statistical tests showed that the evolution of VERL did not depart from neutrality. Interestingly, there was a subdivision in the VERL sequences in the pink abalone and a lack of heterozygous individuals between groups, suggesting that the evolution of assortative mating may be in progress. These results are consistent with a model which posits that egg VERL is neutrally evolving, perhaps due to its repetitive structure, while sperm lysin is subjected to positive Darwinian selection to maintain efficient interaction of the two proteins during sperm competition.
Metoprolol-Induced Polymyalgia-Like Syndrome
Authors: Steven Snyder
Journal: Annals of Internal Medicine (1991)

Letters1 January 1991Metoprolol-Induced Polymyalgia-Like SyndromeSteven Snyder, MDSteven Snyder, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-1-96_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Common side effects of metoprolol and other beta adrenergic-receptor blocking agents (beta blockers) include bradycardia, exacerbation of congestive heart failure, bronchospasm, and attenuation of physiologic responses to hypoglycemia (1). Vasculitis and other rheumatic syndromes, aside from exacerbation of Raynaud phenomenon, are uncommon but potential side effects (1-4). I describe the case history of a patient with a severe polymyalgia rheumatica-like syndrome associated with metoprolol use.In 1987, a 60-year-old white man presented with a 1-month history of bilateral upper leg myalgias, anorexia, and fatigue. He had a history of hypertension for which he had taken metoprolol, 100...References1. PetrieGallowayJeffersWebster JDTJ. Adverse reaction to beta blocking drugs: a review. Postgrad Med J. 1976;52(Suppl 4): 63-9. MedlineGoogle Scholar2. WolfOphirEomanKrakowski RJMA. Atenolol-induced cutaneous vasculitis. Cutis. 1989;43(3):231-3. MedlineGoogle Scholar3. HarrisonSiscaWood TTW. Propanolol-induced lupus syndrome. Postgrad Med J. 1976;59:241-4. CrossrefGoogle Scholar4. GouetMarechaudAucouturier DRP. Atenolol-induced systemic lupus erythematosus syndrome. J Rheumatol. 1986;13:446-7. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Permanente Medical Group South San Francisco, CA 94080 University of California, San Francisco San Francisco, CA 94121 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEvaluation of antihypertensive drugs in combination with enzyme replacement therapy in mice with Pompe diseaseMetoprololDrugs Used to Treat Hypertension, Heart Failure, and Angina PectorisPolymyalgia rheumatica: diagnosis and treatmentPseudopolyarthrite rhizomélique : diagnostic et traitementMetoprololSpondyloarthropathy presenting as a polymyalgia rheumatica-like syndromeβ-adrenoceptor antagonists and antianginal drugsDrug-induced myopathies 1 January 1991Volume 114, Issue 1Page: 96-97KeywordsBradycardiaFatigueHeart failureHypertensionHypoglycemiaMyalgiaVasculitis Issue Published: 1 January 1991 PDF DownloadLoading ...
New helpline will advise those who blow whistle on research fraud
Authors: Bryan Christie
Journal: BMJ (2007)

A confidential helpline has been established in the United Kingdom to offer advice and guidance to whistleblowers who think they may have uncovered cases of misconduct in medical research.

It will also be a source of expert advice to universities, the NHS, and private companies in helping them respond effectively to allegations of research misconduct.

The helpline, which was set up by the UK Panel for Research Integrity in Health and Biomedical Sciences and will be staffed by the Research Integrity Office, was …
Cushing's Syndrome—Still a Conundrum
Authors: Samuel Vaisrub
Journal: JAMA (1978)

Hypersecretory endocrinopathies are generally treated by surgical removal or radiation of the incriminated gland even when direct pharmacologic antagonists to its oversecreted hormone are available. Such drugs are often unsuited for prolonged use because of toxic effects or loss of effectiveness. Apart from offering a prompt cure, surgical or radiological ablation of a gland eliminates the risk of malignant change or spatial expansion. On the other hand, ablation frequently generates undesirable complications, such as uncontrolled overactivity of a modulating organ and a need for major, lifelong replacement therapy. Perplexities mount when the primary cause of the endocrinopathy is called into question. Is the hyperactive organ the true culprit, or is it merely a puppet manipulated by an organ in a higher order of the endocrine hierarchy? These sources of hesitancy and confusion are epitomized in the therapeutic and conceptual approaches to Cushing's syndrome. Adrenalectomy, which is still the most widely
Segmentalized consciousness in schizophrenia
Authors: Andrew Crider
Journal: Behavioral and Brain Sciences (1995)

Abstract Segmentalized consciousness in schizophrenia reflects a loss of the normal Gestalt organization and contextualization of perception. Grays model explains such segmentalization in terms of septohippocampal dysfunction, which is consistent with known neuropsychological impairment in schizophrenia. However, other considerations suggest that everyday perception and its failure in schizophrenia also involve prefrontal executive mechanisms, which are only minimally elaborated by Gray.
Adenosine diphosphate-ribosylation of G-actin by botulinum C2 toxin increases endothelial permeability in vitro.
Authors: N Suttorp, M Polley, J Seybold, H Schnittler, W Seeger, F Grimminger, K Aktories
Journal: Journal of Clinical Investigation (1991)

The endothelial cytoskeleton is believed to play an important role in the regulation of endothelial permeability. We used botulinum C2 toxin to perturb cellular actin and determined its effect on the permeability of endothelial cell monolayers derived from porcine pulmonary arteries. The substrate for botulinum C2 toxin is nonmuscle monomeric actin which becomes ADP-ribosylated. This modified actin cannot participate in actin polymerization and, in addition, acts as a capping protein. Exposure of endothelial cell monolayers to botulinum C2 toxin resulted in a dose- (3-100 ng/ml) and time-dependent (30-120 min) increase in the hydraulic conductivity and decrease in the selectivity of the cell monolayers. The effects of C2 toxin were accompanied by a time- and dose-dependent increase in ADP-ribosylatin of G-actin. G-Actin content increased and F-actin content decreased time- and dose-dependently in C2 toxin-treated endothelial cells. Phalloidin which stabilizes filamentous actin prevented the effects of botulinum C2 toxin on endothelial permeability. Botulinum C2 toxin induced interendothelial gaps. The effects occurred in the absence of overt cell damage and were not reversible within 2 h. The data suggest that the endothelial microfilament system is important for the regulation of endothelial permeability.
Emin Kaya Alpar
Authors: Vijay Vardhan Killampalli
Journal: BMJ (2006)

​FormerFormer consultant trauma and orthopaedic surgeon Birmingham (b Istanbul, Turkey, 1943; q Ankara 1966; MD, MCh, FRCS Ed), died from an intracerebral bleed on 3 November 2005.



Figure 1



Emin Kaya Alpar trained in orthopaedics in the United Kingdom before returning to work in Turkey. In 1980 he came back to the UK to become a senior lecturer and a consultant trauma and orthopaedic surgeon in Birmingham. He resigned from the NHS in 2002 and practised in Harley Street, London, until 2005. He pioneered a course in surgery of trauma that became world renowned, and his research activities covered a broad range of subjects and included a novel study on neuropeptides. One of his main interests was in the clinical presentation and diagnosis of atypical carpal tunnel syndrome associated with whiplash injuries. He leaves two sons.
Can malt whisky be discriminated from blended whisky? The proof. A modification of Sir Ronald Fisher's hypothetical tea tasting experiment.
Authors: S J Chadwick, H A Dudley
Journal: BMJ (1983)

A modified version of Fisher's tea tasting experiment was performed to test the confident assertions of some members of an academic surgical unit that they could easily distinguish malt from blend whisky. Eight male volunteers from the unit, divided into regular and inexperienced whisky drinkers, were blindfolded and given a glass of each of six whiskies. The whiskies included three malts and three blends, and each subject tasted each whisky six times. They were asked whether the whisky was malt or blended, whether they could identify the distillery, and whether they liked it (ranked on a nine-point scale). The four regular whisky drinkers identified the whiskies as malts 57 times, as blends 84 times, and did not know three times; the inexperienced drinkers identified them as malts 64 times, as blends 79 times, and did not know on one occasion. The regular drinkers correctly identified the malts 36 times and the blends 48 times, and the inexperienced drinkers correctly identified malts 30 times and blends 40 times. Statistical analysis of the data suggested that within the unit malt whisky could not be distinguished from blended whisky and that experience did not alter powers of discrimination. A surgeon with no discriminatory prowess at all could be expected to achieve complete discrimination of malt from blend whisky once in 2 occasions. These results suggest that, although "uisgebeatha" has unique properties, the inexpert drinker should choose his whisky to suit his taste and pocket and not his self image.
Micropuncture determination of pH, PCO2, and total CO2 concentration in accessible structures of the rat renal cortex.
Authors: T D DuBose, L R Pucacco, M S Lucci, N W Carter
Journal: Journal of Clinical Investigation (1979)

Previous studies evaluating the mechanism of renal HCO-3 reabsorption have assumed equilibrium between systemic arterial blood and tubular fluid PCO2. We have recently reported that the PCO2 in proximal and distal tubular fluid as well as the stellate vessel significantly exceeded arterial PCO2 by 25.9 +/- 0.92 mm Hg. The purpose of this study was to determine directly, for the first time, pH, PCO1, and total CO2 concentration in the accessible structures of the rat renal cortex with both microelectrodes and microcalorimetry. In addition, the concentrations of chloride and total CO2 were compared in the stellate vessel. The data demonstrate that: (a) values for total [CO2] in both the proximal tubule and stellate vessel calculated from in situ determination of pH and PCO2 closely agree with the measured values for total [CO2]: (b) values for chloride concentration in the stellate vessel are significantly less than the corresponding values in systemic plasma (delta[Cl-] = 5.6 meq/liter); and (c) the rise in [HCO-3] from systemic to stellate vessel plasma closely approximates the observed reciprocal fall in [Cl-] in this structure.
Gallstone, Causing Bleeding and Pyloric Stenosis Syndrome, Diagnosed by Urgent Gastroscopy
Authors: I. Györi, J. Ferenc, P. Tóth, F. Agai
Journal: Endoscopy (1983)

By means of urgent gastroscopy the authors, right before surgery, recognized a pyloric stenosis syndrome and a gallstone that had caused massive melena in a female patient of 73. Cholecystectomy and a Billroth II gastric resection were performed. Following surgery, a transitory duodenal fistula developed. After a month of clinical treatment the patient was sent home cured. This case draws attention to the importance of removing a gallbladder filled with stones as soon as possible in order to prevent complications, as well as to the necessity for gastroscopy in cases of unexplained abdominal complaints.
Harry Hubert Grayson Eastcott
Authors: E. Kalodiki
Journal: BMJ (2010)

Although he was baptised Harry Hubert Grayson Eastcott, to his friends he was known as Felix. He was born in Montreal, Canada, where his father was an engineer on the Canadian Pacific railroad. They returned in 1922 and settled in Plymouth, Devon. In 1929-30 they moved to London where Felix was educated at Latymer School.

In 1939, he met his future wife, a theatre nurse, while working at Hammersmith Hospital. They were married in 1941. In 1943, he joined the Royal Naval Volunteer Reserve …
Detection of K-ras Mutation in Colonic Effluent Samples From Patients Without Evidence of Colorectal Carcinoma
Authors: M. Tohi, F.-C. Luo, Z. Ronai
Journal: JNCI Journal of the National Cancer Institute (1994)

K-ras gene mutation appears in more than 50% of patients with colon tumors. Both its frequency and early appearance may qualify this mutation as a potential biomarker. To enable early detection of mutant K-ras alleles, we had previously developed a sensitive polymerase chain reaction (PCR)-based assay, i.e., enriched PCR, which enables detection of one mutant K-ras allele present within 10,000 normal alleles. Using the enriched PCR, we were able to detect mutant K-ras alleles in "normal-appearing" colonic mucosa in patients with colorectal cancer.A study was initiated to determine whether mutant K-ras alleles could be identified in colonic effluent samples of patients who may be at risk to develop colorectal cancer.Over 9 years, colonic effluent samples were collected prior to routine colonoscopy from 39 patients who were apparently free of colorectal cancer. These samples were collected from patients with a family history of colorectal cancer (n = 7), adenomatous polyps (n = 7), previously resected colorectal cancer (n = 5), inflammatory bowel disorders (n = 13), normal colonoscopic examination (n = 6), and familial adenomatous polyposis (n = 1). All of the samples were double coded and analyzed for K-ras gene mutation.Of the 39 patients, seven were found to harbor mutant K-ras codon 12 alleles. Mutations were found in patients with a family history of colorectal cancer (three of seven), adenomatous polyps (one of seven), previously resected colorectal carcinoma (two of five), and familial adenomatous polyposis (one of one). In one case, effluent was found to harbor a mutant K-ras allele 4 years before the patient was diagnosed with colorectal cancer.(a) Effluent samples contain enough DNA to be detected with enriched PCR. Such samples may well be representative of the entire colon in general as opposed to a localized area such as that usually analyzed during colonoscopy. (b) K-ras gene mutation can be identified in routinely obtained colonic washings of patients who are at risk of developing colorectal cancer. Such mutations were absent in patients with inflammatory bowel disorders and in those who had undergone normal colonoscopic examinations. Detection of K-ras mutation in colonic washings may assist in identifying patients who may be at high risk for developing adenocarcinoma of the colon.The ability to examine colonic effluents provides a powerful and convenient source of sampling and may be adapted for future large-scale screening.
POSSIBLE CAUSES OF COMA AND CONVULSIONS.
Authors: J. T. Jelks
Journal: JAMA (1884)

Hot Springs, Ark., Jan. 18, 1884. <h3>Editor of Journal:</h3> — In a recent issue ofThe Journal, my friend, Dr. John Thad. Johnson, of Atlanta, Ga., suggested the advisability of employing stenographers to report the proceedings and debates of the various Sections of the American Medical Association. The suggestion is a good one. These Sections usually adopt resolutions requesting the members participating in the discussions to furnish the Secretaries with copies of their remarks, but said resolutions usually amount to nothing. For instance, as acting Secretary of the Section of "Obstetrics and Diseases of Women," I only got two or three of the speeches made before that body, and there were a nnmber of valuable ones delivered. The present Chairman of the Section made some very interesting remarks on several papers, and yet they are lost save to the memories of those who had the privilege of hearing him. I
Prevalence and Correlates of Traumatic Brain Injuries Among Adolescents
Authors: Gabriela Ilie, Angela Boak, Edward M. Adlaf, Mark Asbridge, Michael D. Cusimano
Journal: JAMA (2013)

Traumatic brain injury (TBI) among adolescents has been identified as an important health priority. However, studies of TBI among adolescents in large representative samples are lacking.This information is important to the planning and evaluation of injury prevention efforts, particularly because even minor TBI may have important adverse consequences. We describe the prevalence of TBI, the mechanisms of injury, and adverse correlates in a large representative sample of adolescents living in Ontario, Canada. Language: en
THE USE OF YELLOW FEVER VIRUS MODIFIED BY IN VITRO CULTIVATION FOR HUMAN IMMUNIZATION
Authors: Max Theiler, Hugh H. Smith
Journal: The Journal of Experimental Medicine (1937)

The response of rhesus monkeys to a subcutaneous inoculation with varying amounts of virus modified by prolonged cultivation in vitro has been studied. The tissue components of the medium consisted of chick embryo tissue containing minimal amounts of nervous tissue. The immunity produced in monkeys, as measured by the antibody titer developed, has no relation to the amount of virus inoculated. Monkeys inoculated subcutaneously with the tissue culture virus are rendered immune to a subsequent injection of a highly virulent yellow fever virus. This resistance is already present 7 days after vaccination. The subcutaneous inoculation of the culture virus into immune persons leads to a substantial increase of the serum antibody titer. The results of vaccinating eight normal persons with culture virus are presented. The reactions were minimal. The highest temperature recorded following vaccination was 37.4 degrees C. The sera taken from the eight vaccinated persons 2 to 4 weeks after inoculation with the tissue culture virus showed the presence of yellow fever antibodies.
13C protein breath tests
Authors: Y Ghoos, B Beaufrere
Journal: Gut (1998)

Tracer techniques are attractive for the in vivo study of different aspects of nutrient assimilation and metabolism. Stable isotopes are the preferred tracers in studies involving human subjects, mainly because of safety reasons. Their widespread use in recent years has been stimulated by improvements both in the increased availability and diversity of stable isotope labelled compounds and in analytical (that is, mass spectrometric) methods for their quantitative analysis.1 

Labelled amino acids have been used to study protein metabolism in vivo in a large number of studies mainly directed towards the measurement of protein synthesis and breakdown rates. Generally speaking, constant infusions of labelled amino acids such as L-[1-13C]-leucine are used.2 3 To study protein assimilation or protein metabolism during feeding, however, a representative oral tracer—that is, labelled protein, is needed.

Only a few techniques have hitherto been described for the production of stable isotope labelled proteins. Limitations and drawbacks inherent to those techniques have prevented their widespread application (small yield, low enrichment level of protein, inadequate labelling pattern), but now two proteins common in the normal diet are available in labelled forms—that is, milk and egg proteins labelled with L-[1-13C]-leucine.

These proteins have been recently produced by “Laboratoire de Nutrition Humaine” (Clermont-Ferrand, France) and by “Laboratorium Digestie-Absorptie” (Leuven, Belgium) (abstract 1).4 5In both cases the labelling technique is well described so that it can be reproduced by other scientists. Each technique has advantages for different reasons: production of egg proteins has a high tracer recovery, and infusion of lactating cows produces two types of proteins (whey protein and casein) with different physicochemical properties. Labelled proteins can be used to evaluate protein assimilation in various diseases in adults and children (pancreatic disease, abstract 2),6 to monitor the beneficial or detrimental effect of …
Use of Laboratory Tests in a Teaching Hospital: Long-Term Trends
Authors: PAUL F. GRINER
Journal: Annals of Internal Medicine (1979)

We have assessed long-term trends in the use of laboratory tests among patients hospitalized on the medical service of a large teaching hospital. A significant decline in numbers of chemistry tests and no growth in numbers of microbiology or hematology tests or roentgenograms were noted between 1970 and 1977. Per-patient increases in laboratory costs and charges were considerably less than increases in total hospitalization costs and charges. These findings contrast to an average increase of 13.8% per year in numbers of laboratory tests for hospital laboratories in this country between 1970 and 1975. Factors responsible for the observed stability in numbers of laboratory tests per patient per hospitalization included, but were not limited to, increased reliance on test batteries as opposed to individual tests; changing patterns of care leading to decreased use of nonautomated tests; and the impact of administrative and educational strategies directed toward optimum use of the laboratory.
705 Screening of severe liver fibrosis in the general population and by GP
Authors: E. Oberti, E. Cailliez, I. Fouchard-Hubert, B. Robin, Y. Gallois, F. Rabouin, C. Ternisien, E. Dubois, B. Lebot, G. Soulard, S. Fanello, P. Cales
Journal: Journal of Hepatology (2006)