tbuckley/cabot-search huggingface dataset:
Micro-organisms isolated from skin under wedding rings worn by hospital staff.
Authors: P N Hoffman, E M Cooke, M R McCarville, A M Emmerson
Journal: BMJ (1985)

A. Glomerules showing focal necrosis (arrows) and exrtracapiliary reaction.B: Arteriole with necrosis (arrow) around needle shaped crystalline deft.MAasson's trichrome X 300 (original magnification). CommentOur patient had evidence of atheroembolic disease in the retina, brain, and kidney.The necrotising glomerulonephritis was probably directly related to renal cholesterol embolisation because fibrinoid necrosis around a cholesterol crystal was observed in the renal biopsy specimen.Necrotising angiitis of distal vessels associated with choles- terol microemboli has been described in other organs,3 4 and cholesterol embolisation may result in a multisystemic disease simulating poly- arteritis nodosa.3Our case indicates that necrotising angiitis resulting from cholesterol embolisation may also occur in the kidney and lead to severe glomerulonephritis with formation of crescents similar to those observed in the microscopic form of polyarteritis nodosa.Cholesterol embolisation may occur spontaneously but is usually a complication of angiographic procedures or aortic surgery.'In our case aortic catheterisation for carotid angiography may have had a role in the development of renal embolisation; the time between the angiography and the onset of renal failure was consistent with this hypo- thesis.'The nephropathy of our patient was rapidly progressive and irreversible, as usually occurs after renal cholesterol embolisation.5Cholesterol embolisation may result in protean clinical manifesta- tions and is recognised as a possible cause of renal failure in patients with aortic atheromatosis.'We suggest that necrotising glomerulonephritis should be included in the clinical manifestationsof cholesterol eni.bolisation.
THE EFFECT OF CHANGES IN VENTILATION AND PULMONARY BLOOD FLOW ON THE DIFFUSING CAPACITY OF THE LUNG*†
Authors: G. M. Turino, M. Brandfonbrener, A. P. Fishman
Journal: Journal of Clinical Investigation (1959)

Symbols: BSA = body surface area, square meters; f = respiratory frequency, breaths per minute; VT = tidal volume, ml.BTPS; Vo2 = oxygen consumption, ml. per minute STPD; RE = respiratory exchange ratio, expired air; Paco2 = tension of carbon dioxide in arterial blood, mm.Hg; Vco = uptake of carbon monoxide, ml. per minute STPD; PACo = mean alveolar carbon monoxide tension, mm.Hg; Paco = tension of carbon monoxide in arterial blood, mm.Hg; VD/VT X 100 = ratio of personal dead space (total dead space minus the instrument dead space) to tidal volume, per cent; COF X 100 = ratio of the uptake of carbon monoxide to the volume of carbon monoxide inspired, per cent; and DLco = diffusing capacity of the lung for carbon monoxide, ml. per minute per mm.Hg.
Hazards of Metal Processing
Authors: Peter Gann, Jerry Roseman
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The appearance of two reports inThe Journalon hydrogen sulfide (H<sub>2</sub>S) poisoning (1981; 246:1588) and mercury poisoning from home gold ore processing (1981; 246:1929) prompts us to report an unusual fatal case of poisoning that combines aspects of both reports. As the authors of the second report point out, the recent increase in the price of gold has stimulated many individuals to attempt to recover pure metal as a home "industry." The starting materials often include metals contained in waste industrial products. Silver, although not nearly as profitable to cover, is also processed, and makes up in part for its lower price by being much more readily available, particularly in outdated photographic film. <h3>Report of a Case.—</h3> A case was brought to our attention involving a 20-year-old man who engaged in full-time gold and silver processing in a friend's home. Two weeks before his
The Pathophysiology and Treatment of Sepsis
Authors: Richard S. Hotchkiss, Irene E. Karl
Journal: New England Journal of Medicine (2003)

Sepsis is the leading cause of death in critically ill patients in the United States. Yet the individual host response to septicemia is variable, depending on the patient's immune response, age, nutritional status, and coexisting conditions, as well as on the virulence of the organism and the size of the inoculum. This review examines evolving concepts of sepsis and discusses new and potential therapies. Recent clinical advances include therapy with activated protein C, stringent control of blood glucose, and early goal-directed therapy to treat cellular oxygen deficit. Future therapies may be focused on modulating the immune response in the light of the characteristics of the specific pathogen, the genetic profile of the patient, and the duration of the disease.
Inducing Resectability of Chemotherapy Refractory Colorectal Liver Metastasis by Radioembolization With Yttrium-90 Microspheres
Authors: Marc Van den Eynde, Patrick Flamen, Issam El Nakadi, Gabriel Liberale, Philippe Delatte, Denis Larsimont, Alain Hendlisz
Journal: Clinical Nuclear Medicine (2008)

Liver metastases represent the principal cause of death for patients with advanced colorectal cancer. Resection remains the only potentially curative treatment. Selective internal radiation therapy by means of the administration of yttrium-90 labeled resin microspheres (SIR-Spheres; Sirtex Medical Limited, Sydney, Australia) into the arterial supply of the liver is a local treatment option for patients with unresectable malignant liver tumors. We report the case of a patient with an unresectable liver colorectal metastasis refractory to chemotherapy downstaged to allow resectability after selective internal radiation therapy.
Mannose-binding lectin polymorphisms and pulmonary outcome in premature neonates: a pilot study
Authors: Ettore Capoluongo, Giovanni Vento, Sandro Rocchetti, Emiliano Giardina, Paola Concolino, Cecilia Sinibaldi, Concetta Santonocito, Valentina Vendettuoli, Milena Tana, Chiara Tirone, Cecilia Zuppi, Costantino Romagnoli, Giuseppe Novelli, Bruno Giardina, Franco Ameglio
Journal: Intensive Care Medicine (2007)
Electronic Health Records
Authors: Alan W. Feld
Journal: Annals of Internal Medicine (2014)

Letters4 November 2014Electronic Health RecordsAlan W. Feld, MDAlan W. Feld, MDFrom Nevada Heart Institute, Las Vegas, Nevada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5021-5 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Sinsky and colleagues’ (1) essay with great interest. My experience in observing physicians using the EHR has not been favorable or impressive. The physician often sits with his or her back to the patient, concentrates on pushing buttons, and does not connect with the patient. I think that the “busy work” of inputting information into the computer may so distract physicians that important questions may be omitted.I believe that the big push for EHRs has come from government. In my opinion, physicians functioned better without EHRs and patients communicated better with physicians who faced ...Reference1. Sinsky CA, Beasley JW, Simmons GE, Baron RJ. Electronic health records: design, implementation, and policy for higher-value primary care. Ann Intern Med. 2014;160:727-8. [PMID: 24842418] doi:10.7326/M13-2589 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Nevada Heart Institute, Las Vegas, Nevada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0330. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoElectronic Health Records: Design, Implementation, and Policy for Higher-Value Primary Care Christine A. Sinsky , John W. Beasley , Greg E. Simmons , and Richard J. Baron Electronic Health Records: Design, Implementation, and Policy for Higher-Value Primary Care Christine A. Sinsky , John W. Beasley , Greg E. Simmons , and Richard J. Baron Electronic Health Records Michael E. Miller Electronic Health Records John W. Beasley and Christine A. Sinsky Correction: Antiretroviral Regimens for Treatment-Naive, HIV-1–Infected VolunteersElectronic Health Records John W. Beasley and Christine A. Sinsky Electronic Health Records Michael E. Miller Metrics 4 November 2014Volume 161, Issue 9Page: 679-680KeywordsComputersDisclosureElectronic medical records ePublished: 4 November 2014 Issue Published: 4 November 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Subclinical Brain Embolization in Left-Sided Infective Endocarditis
Authors: Howard A. Cooper, Elissa C. Thompson, Robert Laureno, Anthon Fuisz, Alexander S. Mark, Mark Lin, Steven A. Goldstein
Journal: Circulation (2009)

Background— Acute brain embolization (ABE) in left-sided infective endocarditis has significant implications for clinical decision making. The true incidence of ABE, including subclinical brain embolization, is unknown. Methods and Results— We prospectively studied 56 patients with definite left-sided infective endocarditis. Patients were examined by a study neurologist, and those without contraindication had magnetic resonance imaging of the brain. Patients without clinical evidence of acute stroke but with magnetic resonance imaging evidence of ABE were considered to have subclinical brain embolization. Clinical stroke was present in 14 of 56 patients (25%). Among 40 patients undergoing magnetic resonance imaging, the incidence rates of subclinical brain embolization and any ABE were 48% and 80%, respectively. ABE was present in 18 of 19 patients (95%) with Staphylococcus aureus infection. At 3 months, mortality was similar among patients with clinical stroke and subclinical brain embolization (62% versus 53%; P =NS) and was higher among patients with any ABE than among those without ABE (56% versus 12%; P =0.046). Valvular surgery was performed in 25 patients (45%), including 16 with ABE, at a median of 4 days. No patient suffered a postoperative neurological complication. Surgery was independently associated with a lower risk of mortality at 3 months (odds ratio, 0.1; 95% confidence interval, 0.03 to 0.6; P =0.008). Conclusions— Magnetic resonance imaging detected subclinical brain embolization in a substantial number of patients with left-sided infective endocarditis, suggesting that the incidence of ABE may be significantly higher than reports based on clinical and computed tomography findings have indicated. Brain magnetic resonance imaging may play a role in the complex decision about surgical intervention in infective endocarditis.
Pulmonary Histoplasmosis of 27 Years' Duration With Ultimate Lung Resection
Authors: Sidney Clayman
Journal: JAMA (1971)

<h3>To the Editor.—</h3> This case began in 1944 when the 23-year-old patient developed pains on the right side of the chest while serving aboard a naval vessel. Treatment consisted of chest wrappings and analgesia. Later, flecks of blood were demonstrated in the sputum and in 1945, this led him to the St. Albans Naval Hospital where he remained for eight months. The discharge diagnosis was "right pleural effusion." <h3>Development.—</h3> In February 1948, at the Buffalo General Hospital, bronchograms showed marked constriction in the right upper bronchus. Apparently, the right middle and lower lobes were completely atelectatic. A bronchial biopsy showed no tumor. In April 1948, at another hospital, bronchoscopy revealed stenosis of the right main stem bronchus. Many bronchograms, x-ray films, and "some" bronchoscopies were done at this hospital. Bacteriologic studies of the sputum and bronchial aspirations showed no tubercule bacilli or other organisms, and included guinea pig inoculations and
Some Further Notes on Congressional Oversight of the NIH
Authors: Arnold S. Relman, Orrin G. Hatch, Henry A. Waxman, John K. Iglehart
Journal: New England Journal of Medicine (1985)

Editor's note: In his Health Policy Report of November 29, 1984,* our Special Correspondent, John K. Iglehart, discussed the politically sensitive subject of congressional oversight of the National Institutes of Health (NIH). His report focused on a bill (S. 540, The Health Research Extension Act) that had been passed by both houses of Congress at the end of the 98th session but vetoed by President Reagan just before the Presidential election. The bill would have extended for two years the statutory authority under which the NIH operates, and it contained a number of provisions (including the establishment of two new . . .
TV: Panorama: "The Secrets of Seroxat"
Authors: P J Cowen
Journal: BMJ (2002)

Rating: ![Graphic][1]</img> BBC 1, 13 October at 10 15 pm The postmodern media critic Jean Baudrillard once asserted that the Gulf war did not happen, and was only a televised simulation of a war. By the end of Panorama 's "The Secrets of Seroxat" my own grip on reality, never particularly strong, was faltering. This mental fragility disappointed me because I know quite a lot about selective serotonin reuptake inhibitors (SSRIs), having prescribed them, done research on them, and taken them. It may have been the nature of Panorama 's "secrets" that undermined me. For example, the Shorter Oxford Textbook of Psychiatry notes both the key issues raised in the programme, namely that SSRIs, particularly paroxetine (Seroxat), can cause unpleasant withdrawal symptoms and that early in SSRI treatment restlessness and agitation might increase the risk of suicidal behaviour. Despite this it seems likely that … [1]: /embed/inline-graphic-1.gif
Distinct evolution and predictive value of hepatitis B virus precore and basal core promoter mutations in interferon-induced hepatitis B e antigen seroconversion
Authors: Hung-Chih Yang, Chi-Ling Chen, Yueh-Chi Shen, Cheng-Yuan Peng, Chun-Jen Liu, Tai-Chung Tseng, Tung-Hung Su, Wan-Long Chuang, Ming-Lung Yu, Chia-Yen Dai, Chen-Hua Liu, Pei-Jer Chen, Ding-Shinn Chen, Jia-Horng Kao
Journal: Hepatology (2012)

Precore (PC) (G1896A) and basal core promoter (BCP) (A1762T/G1764A) mutations of the hepatitis B virus (HBV) genome often emerge in chronic hepatitis B (CHB) patients. Their roles in hepatitis B e antigen (HBeAg) seroconversion induced by interferon (IFN) therapy remain controversial, partly because quantitative analysis for these mutants is lacking. This study aimed to develop a new assay to accurately quantify the PC and BCP mutant percentages and correlate their dynamic changes with IFN-induced HBeAg seroconversion in HBeAg-positive CHB patients. The PC and BCP mutant percentages were analyzed by polymerase chain reaction (PCR)-pyrosequencing. Our results showed that this quantitative assay for PC and BCP mutants achieved high accuracy (R2 &gt; 0.99) within a range between 10% and 90% mutants. We examined dynamic changes of the PC and BCP mutant percentages following IFN treatment in 203 HBeAg-positive CHB patients. By multiple logistic regression analysis, we found that the chance of HBeAg seroconversion increased by 2.2% (odds ratio [OR] = 1.022, 95% confidence interval [CI]: 1.009–1.034, P = 0.001) and 2.3% (OR = 1.023, 95% CI: 1.010–1.037, P = 0.001) per 1% increase of the pretreatment PC and BCP mutant percentages, respectively, after adjustment for other predictors. However, only the pretreatment PC mutation percentage was significantly associated with HBeAg seroconversion with HBV DNA &lt; 2,000 IU/mL (OR = 1.030, 95% CI: 1.014–1.047, P &lt; 0.001). Furthermore, the mutant percentage of PC, but not BCP, in patients achieving HBeAg seroclearance with HBV DNA &lt; 20,000 IU/mL increased significantly during IFN treatment ( P = 0.039). Interestingly, patients with HBeAg seroconversion who had a high PC mutant percentage at the end of IFN treatment tended to exhibit high viremia after seroconversion. Conclusion: Quantitative analysis of PC and BCP mutants can predict IFN-induced HBeAg seroconversion and demonstrate their distinct evolution patterns during HBeAg seroconversion. (Hepatology 2013)
Waldenström macroglobulinemia: 2011 update on diagnosis, risk stratification, and management
Authors: Morie A. Gertz
Journal: American Journal of Hematology (2011)

Abstract Disease overview: Waldenström macroglobulinemia (WM) is a lymphoplasmacytic lymphoma with immunoglobulin M (IgM) monoclonal protein. Clinical features include anemia, thrombocytopenia, hepatosplenomegaly, and lymphadenopathy. Diagnosis: Presence of IgM monoclonal protein associated with ≥10% clonal lymphoplasmacytic cells in bone marrow confirms the diagnosis. Risk stratification: Age, hemoglobin level, platelet count, β 2 ‐microglobulin, and monoclonal IgM concentrations are characteristics required for prognosis. Risk adapted therapy: Not all patients who fulfill WM criteria require therapy; these patients can be observed until symptoms develop. Rituximab‐based therapy is used in virtually all US patients with WM and can be combined with alkylating agent or purine nucleoside analogue, or both. The preferred Mayo Clinic nonstudy therapeutic induction is rituximab, cyclophosphamide, and dexamethasone. Future stem cell transplantation should be considered in induction therapy selection. Management of refractory disease: Bortezomib, thalidomide, lenalidomide, and bendamustine have all been shown to have activity in WM. Given WM's natural history, reduction of complications will be a priority for future treatment trials. Am. J. Hematol. 86:411–416, 2011. © 2011 Wiley‐Liss, Inc.
Observations vs Statistics-Reply
Authors: Naomi Vaisrub
Journal: JAMA (1985)

<h3>In Reply.—</h3> Regrettably, Dr Feldman has missed the major point of my editorial, namely, that "final recommendations concerning the suitability of manuscripts for publication are made in consideration of the overall quality of the studies submitted, the careful documentation of results and interpretation of findings, and the perceived validity and importance of research conclusions."<sup>1</sup>Within the peer review process, the statistical reviewer may be called on to ascertain whether reported results are based on cogent observations and logical reasoning, as well as on appropriate data analysis. Therefore, the concept of statistically sound experiments that are flawed by unsound logic is incongruous and erroneous. It is the very preservation of basic principles of sound reasoning that constitutes the primary concern of the statistical reviewer—more so than the degree of statistical sophistication exhibited in any manuscript. Although some of the studies cited by Dr Feldman may not have benefited from statistical
Anaemia in obstetrics: an evaluation of treatment by iron-dextran infusion.
Authors: J. Bonnar
Journal: BMJ (1965)

Anaemia remains one of the commonest problems facing the obstetrician.In clinical practice the problem is most acute in two groups of patients.The first group consists of patients with anaemia in the last few weeks of pregnancy; the second group is made up of patients with anaemia following obstetric haemorrhage, particularly that associated with abortion and delivery.Elective blood transfusion is commonly employed as a quick solution to this problem.This report concerns the use of an infusion of iron-dextran (Imferon) as a method for the rapid correction of the anaemia of patients within these two groups.The study was carried out at Robroyston Maternity Hospital, Glasgow, from August 1963 to November 1964.
QUININ AND UREA HYDROCHLORID IN THE TREATMENT OF SCIATICA
Authors: H. A. Cables
Journal: JAMA (1913)

During 1913 I have treated eight cases of sciatica. In one case the anterior crural as well as the sciatic nerve was involved. These cases were all treated by hypodermic injections of a 4 per cent, solution of quinin and urea hydrochlorid in a normal salt solution into the subcutaneous tissue over the course of the nerves. No attempt was made to inject the nerve. The skin was washed thoroughly with 65 per cent, alcohol. There were fifty injections in all with no untoward result other than the little soreness that always follows any hypodermic injection. Seven patients received six injections each, and one received eight.  Eight months have elapsed since the first case was treated and in none has there been a return of the attack. All the patients experienced decided relief within a short time after the first treatment and none had a severe attack after the third.
Natural history and early diagnosis of LAD-1/variant syndrome
Authors: Taco W. Kuijpers, Robin van Bruggen, Nanne Kamerbeek, Anton T. J. Tool, Gonul Hicsonmez, Aytemiz Gurgey, Axel Karow, Arthur J. Verhoeven, Karl Seeger, Özden Sanal, Charlotte Niemeyer, Dirk Roos
Journal: Blood (2006)
<i>Malassezia sympodialis</i> differently affects the expression of LL‐37 in dendritic cells from atopic eczema patients and healthy individuals
Authors: B. Agerberth, E. Buentke, P. Bergman, H. Eshaghi, S. Gabrielsson, G. H. Gudmundsson, A. Scheynius
Journal: Allergy (2005)

Atopic eczema (AE) is a multifactorial disease, which has increased in prevalence. The skin-colonizing yeast Malasezzia sympodialis can induce IgE- and T-cell reactivity in patients with AE. LL-37 is an endogenous peptide antibiotic belonging to the cathelicidin family. The aim of this study was to examine whether exposure to M. sympodialis would affect the expression of LL-37 in dendritic cells.The presence of LL-37 was analyzed in monocyte-derived dendritic cells (MDDCs) generated from healthy individuals and patients with AE by Western blotting and the corresponding cDNA by real-time quantitative RT-PCR. Antibacterial activity was measured with an inhibition zone assay in fractions after reverse phase chromatography.For the first time we here present data, showing that LL-37 is produced by MDDCs. Notably, the secretion of LL-37 was substantially enhanced in M. sympodialis-exposed MDDCs generated from patients with a high degree of eczema, as measured by SCORAD, compared to healthy controls and patients with a low SCORAD. The relative expression of LL-37 transcript in MDDCs generated from patients was up-regulated after 1 h of exposure to M. sympodialis and declined gradually at the time points analyzed, whereas the transcription was unaffected in the MDDCs of healthy controls.Our results suggest that M. sympodialis can trigger the innate immune response differently in patients with AE and healthy individuals. The enhanced LL-37 secretion from the MDDCs in the patients with AE may reflect the severity of their inflammatory response to M. sympodialis.
Central nervous system--a confession of ignorance
Authors: A. G. M. Weddell
Journal: BMJ (1969)

REDICAL JOSRNALBecause of the high ferrous content of the inland sands pure white glass was difficult to obtain, but cobalt-tinted glass was favoured for the storage of light-sensitive concoctions while opaline vessels were much in demand because they were inexpensive.It is interesting to note that madder pink, a favourite colour for the decoration of the white-glazed Holic faience, was introduced by settlers from Strasbourg.The translation is admirable.W. H. MCMENEAIEY.
Reduced plasma fetuin-A levels in patients with obstructive sleep apnoea: Table 1–
Authors: Antonia Barceló, Javier Piérola, Cristina Esquinas, Mónica de la Peña, Meritxell Arqué, Manuel Sánchez-de la Torre, Alberto Alonso-Fernandez, Ferran Barbé
Journal: European Respiratory Journal (2012)

Reduced plasma fetuin-A levels in patients with obstructive sleep apnoeaTo the Editors:Obstructive sleep apnoea syndrome (OSAS) has been increasingly linked to cardiovascular disease.fetuin-A is an inhibitor of vascular calcification and an anti-inflammatory cytokine.We tested the hypothesis that plasma levels of fetuin-A are decreased in patients with OSAS.We studied 119 patients with OSAS and 35 controls.Participants were recruited and studied at the sleep unit at Hospital Universitari Son Espases, Palma de Mallorca, Spain.Serum levels of fetuin-A, glucose, triglycerides, cholesterol, highdensity lipoprotein (HDL) cholesterol, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) were determined.