tbuckley/cabot-search huggingface dataset:
<i>Clostridium welchii</i>Infection Due to Plaster of Paris after a Shelf Procedure of the Hip
Authors: Harold A. Kozinn
Journal: New England Journal of Medicine (1962)

CLOSTRIDIUM infection after elective surgery is an unusual and unwelcome complication. Murray and Denton1 reported a fatal case that followed arthrodesis of a knee for tuberculosis. The etiologic agent, Clostridium tetani, was isolated from the plaster of Paris. The following case was due to Cl. welchii, similarly isolated from the plaster of Paris.Case ReportP.H., a 12-year-old boy, was admitted to St. Charles Hospital on May 10, 1961. He had been treated for bilateral congenital dislocation of the hips since 5 months of age. Numerous castings and manipulations had been performed. On March 11, 1960, an abduction-rotational subtrochanteric osteotomy . . .
Prenatal Diagnosis — Advances Bring New Challenges
Authors: Michael T. Mennuti
Journal: New England Journal of Medicine (1989)

During the past two decades, the diagnosis of genetic diseases in the fetus has become an integral part of obstetrical care. Most commonly, cells obtained by amniocentesis after a 16-week gestation are being used for testing. The safety, efficacy, and accuracy of midtrimester amniocentesis have been studied collaboratively in the United States and in other countries. In the U.S. study, the rates of total fetal losses in the amniocentesis group (3.5 percent) and in nonrandomized controls (3.2 percent) were not significantly different.1 These results led to the estimate that the risk of fetal loss due to amniocentesis does not exceed . . .
NSAIDs and Upper Gastrointestinal Bleeding
Authors: C. Rollhauser
Journal: Endoscopy (2003)

I appreciate the opportunity to respond to the letter from Dr. Küçükardalı and colleagues, which was prompted by the comments made in our review article regarding NSAID-related upper gastrointestinal bleeding (UGIB) in elderly patients [1]. Discussion concerning the outcome of gastrointestinal bleeding in this population is important in the light of recent data showing that admission rates for gastric and duodenal ulcer hemorrhage are increasing among older patients [2]. Several studies have documented that the risk of serious NSAID-associated gastrointestinal events increases with age. The reported magnitude of the risk associated with age ≥ 60 years has generally been in the range of 2.5 - 5.5 times that in patients younger than 60 [3] [4] [5], reaching as high as 12.7 for patients older than 75 years [6]. A recent observational study also found increased adjusted rate ratios for hospitalization due to upper gastrointestinal bleeding in elderly patients treated with nonselective NSAIDs and rofecoxib [7].
Deficient colour vision and interpretation of histopathology slides: cross sectional study
Authors: C J M Poole, D J Hill, J L Christie, J Birch
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> 20 To determine whether histopathologists with deficient colour vision make more errors in slide interpretation than those with normal colour vision. <b>Design:</b> Examination of projected transparencies of histopathological slides under standardised conditions by subjects whose colour discriminating ability was accurately assessed. <b>Setting:</b> Departments of histopathology in 45 hospitals in the United Kingdom. <b>Subjects:</b> 270 male histopathologists and medical laboratory scientific officers. <b>Main outcome measures:</b> Number of slides correctly identified by subjects whose colour vision was measured on the Ishihara, City University, and Farnsworth-Munsell 100 hue tests. <b>Results:</b> Mean (SD) scores (out of 10) for doctors with colour deficient vision were 9.4 (0.7) v 9.9 (0.4) for controls (P&lt;0.01) and 7.5 (1.6) v 9.4 (0.7) for scientific officers (P&lt;0.001). When subjects with colour deficient vision were categorised into severe, moderate, or mild, there was a significant trend towards those with severe deficiency making more mistakes (P&lt;0.001). <b>Conclusions:</b> Histopathologists and medical laboratory scientific officers should have their colour vision tested; if they are found to have a severe protan or deutan deficiency, they should be advised to adopt a safe system of working. <h3>Key messages</h3> Coloured images are being used increasingly as an aid to diagnosis, but 8% of men and 0.5% of women have colour deficient vision Histopathologists and medical laboratory scientific officers who stain histopathological specimens should have their colour vision tested; if they are found to have a severe protan (red) or deutan (green) deficiency, they should be advised to adopt a safe system of working Students at medical school should have their colour vision tested as this may help with their choice of specialty and alert them to potential difficulties with their work
Developmentally regulated and strain-specific expression of murine VH gene families.
Authors: G D Yancopoulos, B A Malynn, F W Alt
Journal: The Journal of Experimental Medicine (1988)

We have devised a simple assay that provides an instantaneous representation of VH family usage in primary and peripheral lymphoid tissues. This assay lacks complex manipulations out of the animal and thus minimizes the risk of in vitro artifacts. We have used this assay to demonstrate a dramatic preference for utilization of the most JH-proximal VH segments in the newborn liver of BALB/c and C57BL/6 mice. Furthermore, we find that VH segments from across the entire VH locus are utilized early in development, but at frequencies directly related to their JH proximity. A major shift away from the position-dependent VH repertoire of the neonate is seen in unprimed or polyclonally-activated adult spleen cells, in which relative utilization of the various VH families is related to family size. We also report consistent strain-specific differences in the expression of certain VH families. Our data indicate that a position-dependent VH repertoire is generated in differentiating pre-B lymphocytes (probably reflecting constraints imposed by the immunoglobulin gene assembly process), and that mechanisms that operate subsequent to rearrangement then randomize this position-dependent repertoire in a strain-specific manner.
Points: Anaesthetists and anesthesiologists
Authors: S. Mather
Journal: BMJ (1984)

but no obstructing lesion or other abnormality were found.He had an uneventful recovery.Acute pseudo-obstruction of the large bowel is a recognised, potentially fatal, clinical syndrome.'The mechanism is unknown, but the condition may be associated with serious pathology inside or outside the abdomen.'-3Our experience suggests that pulmonary thromboembolism may lead to this condition.1 Addison NV.Pseudo-obstruction of the large bowel.
A farmer with fever and right upper quadrant pain
Authors: V. Chhaya, S. Gupta
Journal: BMJ (2012)

A 22 year old Asian man presented with right upper quadrant pain and associated nausea, fever, and dark urine. He had worked as a farmer in Pakistan before moving to the United Kingdom in 2004. He was icteric with a 3 cm hepatomegaly. His blood tests showed a white blood cell count of 10.9×109/L (reference range 4.0-11.0), eosinophil count of 2.1×109/L (0.04-0.4), and a C reactive protein of 26 mg/L (0-5). His bilirubin was 105 µmol/L (<21 µmol/L), with alkaline phosphatase 220 U/L (30-130) and aspartate aminotransferase 101 U/L (0-32). He had no relevant medical history.

Despite treatment with broad spectrum antibiotics, he developed biliary sepsis with tachycardia and hypotension. He underwent various tests including imaging of his abdomen (fig 1⇓).



Fig 1 Transverse magnetic resonance imaging scan taken through the upper abdomen





### 1 What does the magnetic resonance imaging scan show and what is the probable diagnosis?

#### Short answer

The scan shows large complex cystic lesions with multiple septations suggestive of daughter cysts. The most likely diagnosis is hydatid disease secondary to Echinococcus granulosus (fig 2⇓).



Fig 2 Transverse magnetic resonance imaging scan showing two large cystic lesions (black arrowheads) in the liver with daughter cysts that are characteristic of hydatid cysts. The black arrow indicates the stomach and the white arrow indicates the liver



#### Long answer

Hydatid cysts are secondary to a parasitic infection caused by the cestode E granulosus .1 Molecular studies have identified 10 distinct genetic types (G1-G10), with the sheep strain (G1) being commonly associated with human infections.2 3 The …
Inflicted burns and scalds in children.
Authors: J H Keen, J Lendrum, B Wolman
Journal: BMJ (1975)

Ten children who had been burnt and six who had been scalded by parents or those caring for them were seen over three years. In no case did the thermal injury affect more than 5% of the body surface and there were no deaths. In seven the perineum or buttocks were in the burnt area. In 12 children there was evidence of other inflicted injury including six recent fractures. Staff caring for burnt children should be aware of this type of inflicted injury. X-ray skeletal surveys should be carried out in doubtful cases and a case conference initiated with the appropriate social work services to consider supervising the family after the child's discharge or taking legal care proceedings.
Roles of the C-terminal tyrosine residues of LAT in GPVI-induced platelet activation: insights into the mechanism of PLCγ2 activation
Authors: Ashraf Ragab, Sonia Séverin, Marie-Pierre Gratacap, Enrique Aguado, Marie Malissen, Martine Jandrot-Perrus, Bernard Malissen, Jeannie Ragab-Thomas, Bernard Payrastre
Journal: Blood (2007)
Influence of birth weight on differences in infant mortality by social class and legitimacy.
Authors: D A Leon
Journal: BMJ (1991)

OBJECTIVE--To investigate the influence of birth weight on the pronounced social class differences in infant mortality in Britain. DESIGN--Analysis of routine data on births and infant deaths. SETTING--England and Wales. SUBJECTS--All live births and infant deaths, 1983-5. MAIN OUTCOME MEASURE--Mortality in infants by social class, birth weight, and legitimacy according to birth and death certificates. RESULTS--Neonatal and postneonatal mortality (deaths/1000 births) increased with social class. Neonatal and postneonatal mortality was 4.2/1000 and 2.3/1000 respectively for social class I and 6.8/1000 and 5.6/1000 respectively for social class V. Mortality was lower among births registered within marriage (postneonatal 3.5/1000; neonatal 5.2/1000) than among those jointly registered outside marriage (5.1/1000; 6.4/1000); mortality was highest in those solely registered outside marriage (7.2/1000; 7.0/1000). For neonatal mortality the effect of social class varied with birth weight. Social class had little effect on neonatal mortality in low birthweight babies and increasing effect in heavier babies. For postneonatal mortality the effect of social class was similar for all birth weights and was almost as steep as for all birth weights combined. CONCLUSION--Birth weight mediates little of the effect of social class on postneonatal mortality.
Severe Interstitial Lung Disease Associated with Amrubicin Treatment
Authors: Kiyotaka Yoh, Hirotsugu Kenmotsu, Yoko Yamaguchi, Kaoru Kubota, Hironobu Ohmatsu, Koichi Goto, Seiji Niho, Yuichiro Ohe, Nagahiro Saijo, Yutaka Nishiwaki
Journal: Journal of Thoracic Oncology (2010)
Extensively drug-resistant tuberculosis: back to the future
Authors: G.B. Migliori, G. Sotgiu, C. Lange, R. Centis
Journal: European Respiratory Journal (2010)

Tuberculosis (TB) has been found in mammoth bones and in Egyptian mummies. It has affected mankind since its appearance, despite many efforts to control and eliminate it.

Epidemiology indicates that, in the absence of any intervention ( e.g. under the natural history model), one infectious case is likely to infect ∼10 persons·yr−1 for 2 yrs, thus generating 20 infected individuals 1. Given that the lifetime breakdown is estimated to be 10%, and that ∼50% of cases are likely to become sputum smear-positive, one infectious source is likely to generate another infectious (sputum smear-positive) case 1. This is in the absence of intervention (fig. 1a). The interventions recommended by the directly observed treatment, short course (DOTS) strategy and the Stop TB Strategy 2 ( e.g. rapid diagnosis of 70% of existing sputum smear-positive cases and effective treatment of 85% of cases) are very powerful in modifying this cycle (fig. 1b). The period of infectiousness is reduced by ≤6 months and the number of infected individuals is reduced to only five. Given the same breakdown rate and the same risk of developing a sputum smear-positive form of TB, one infectious case produces only a quarter the number of infectious cases of TB. In other words, it takes four infectious cases to produce one new one.



Figure 1– 
Tuberculosis transmission model in a) the absence of control interventions and b) the application of early diagnosis and effective treatment.



If the TB programme is able to reduce transmission so dramatically, one can expect a levelling off of the epidemic curve in a given setting after 5–7 yrs following implementation of the Stop TB Strategy. This has been demonstrated in countries such as Cuba and Peru. Recently it has been …
Anderson's Pathology
Authors: Mark L. Mitchell
Journal: JAMA (1996)

First published in 1948,<i>Anderson's Pathology</i>was for many years the principal encyclopedic text of general pathology in North America. It was widely used as a sophomore pathology text for medical students until the appearance of the briefer and zippier<i>Robbins Pathologic Basis of Disease</i>(first edition, 1974) and more recently the even more succinct and colorfully illustrated<i>Pathology</i>, edited by Emanuel Rubin and John L. Farber (first edition, 1988). The last incarnation of<i>Anderson's Pathology</i>was the 1990 edition edited by John Kissane; this latest edition is a completely new book with two new editors, Ivan Damjanov, chairman of pathology at the University of Kansas School of Medicine, and James Linder, vice chairman at the University of Nebraska Medical Center. The book has exploded from 42 to 80 chapters and from 58 to 170 contributing authors of whom 136 are from the United States. It has nine sections, including
INDIUM-111 LABELLED POLYCLONAL IMMUNOGLOBULIN G (MACROSCINT) CAN BE USED TO MONITOR THE SUCCESS OF ANTI-PNEUMOCYSTIS THERAPY IN PATIENTS (PTS) WITH AIDS
Authors: J. R. Buscombe, I. Khalkhali, G. Mason, P. J. Ell, R. F. Miller
Journal: Clinical Nuclear Medicine (1995)

Buscombe, J. R.; Khalkhali, I.; Mason, G.; Ell, P. J.; Miller, R. F. Author Information
Reviews and Notes: Immunology and Rheumatology: Arthritis and Allied Conditions: A Textbook of Rheumatology
Authors: Richard W. Martin
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 January 1994Reviews and Notes: Immunology and Rheumatology: Arthritis and Allied Conditions: A Textbook of RheumatologyRichard W. Martin, MDRichard W. Martin, MDMichigan State University, Grand Rapids, MI 49503Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-1-199401010-00039 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Arthritis and Allied Conditions: A Textbook of RheumatologyTwelfth edition. Volumes 1 and 2. Daniel J. McCarty and William J. Koopman; eds. 2151 pages. Philadelphia: Lea & Febiger; 1993. $198.50.American health care and internal medicine are undergoing a great transition with the evolving predominance of ambulatory services and managed care. In some ways this challenge is an opportunity for the internist to broaden the scope of his or her practice. Because occupational, sports-related, degenerative, and inflammatory musculoskeletal diseases are frequently seen in the clinic, rheumatology (broadly defined) is a major portion of adult ambulatory medicine. Thus, a text such ... Author, Article, and Disclosure InformationAffiliations: Michigan State University, Grand Rapids, MI 49503 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1994Volume 120, Issue 1Page: 95-96KeywordsArthritisDrugsImmunologyOrthoticsRashesRheumatoid arthritisRheumatologySportsStrokeSystematic reviews ePublished: 15 August 2000 Issue Published: 1 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
On Supporting the Perinaeum
Authors: E. W. Murphy
Journal: BMJ (1861)

<h3>Abstract</h3> Local selection can promote phenotypic divergence despite gene flow across habitat mosaics, but adaptation itself may generate substantial barriers to genetic exchange. In plants, life-history, phenology, and mating system divergence have been particularly proposed to promote genetic differentiation in sympatry. In this study, we investigate phenotypic and genetic variation in <i>Mimulus guttatus</i> (yellow monkeyflowers) across a geothermal soil mosaic in Yellowstone National Park (YNP). Plants from thermal annual and nonthermal perennial habitats were heritably differentiated for life history and mating system traits, consistent with local adaptation to the ephemeral thermal-soil growing season. However, genome-wide genetic variation primarily clustered plants by geographic region, with little variation sorting by habitat. The one exception was an extreme thermal population also isolated by a 200m geographical gap. Individual inbreeding coefficients (FIS) were higher (and predicted by trait variation) in annual plants and annual pairs showed greater isolation by distance at local (&lt;1km) scales. Finally, YNP adaptation does not re-use a widespread inversion polymorphism diagnostic of annual vs. perennial <i>M. guttatus</i> range-wide, suggesting a novel genetic mechanism. Overall, this work suggests that life history and mating system adaptation strong enough to shape individual mating patterns does not necessarily generate incipient speciation without geographical barriers.
The tired patient
Authors: B. Renton
Journal: BMJ (2009)

A 66 year old female presented with a three week history of lethargy and malaise, reduced oral intake, and nausea but no vomiting. Medical history included hypertension, hypercholesterolaemia, and cervical spondylosis, and she was a lifelong smoker. Medications included simvastatin, aspirin, bendroflumethiazide, amlodipine, co-codamol, atenolol, and furosemide. Pulse oximetry showed reduced oxygen saturation (90% on air), but the patient was not tachypnoeic. She had a mild reduction in skin turgor; otherwise, the rest of her examination was unremarkable.

The patient’s electrocardiogram is shown in the figure⇓. In view of the reduced oxygen saturations, an arterial blood gas was performed. This test showed a pH of 7.631 (normal range 7.35-7.45), a pCO2 of 6.49 kPa (4-6 kPa), a pO2 of 7.79 kPa (10-13 kPa), a HCO3 of 59.9 mmol/l (22-26 mmol/l), and a base excess of +35.2 (−2 to +2). …
Intracellular Chloride Accumulation and Subcellular Elemental Distribution During Atrial Fibrillation
Authors: Joseph G. Akar, Thomas H. Everett, Ruoya Ho, Joseph Craft, David E. Haines, Andrew P. Somlyo, Avril V. Somlyo
Journal: Circulation (2003)

Background— Ion channel remodeling occurs during atrial fibrillation (AF); however, the extent of alteration in the subcellular distribution of elements (Na, K, Cl, Ca, Mg, P) is unknown. Electron probe microanalysis was used to determine the total (free+bound) in vivo subcellular concentration of these elements during AF. Methods and Results— The left atrial appendage (LAA) was snap-frozen in situ after pacing (640 bpm) for 3 minutes (n=5 dogs), 30 minutes (n=3), or 48 hours (n=5). Dogs in sinus rhythm (n=3) served as controls. Whole-cell, cytosolic, and mitochondrial elemental concentrations were measured in cryosections. LAA effective refractory period (ERP) was measured before and after pacing. LAA ERP decreased significantly after 48 hours (116±3 to 88±10 ms, P =0.02). Whole-cell Cl increased by 9.0 mmol/L and 17 mmol/L after 3 and 30 minutes of pacing, respectively ( P &lt;0.0001), without a concomitant increase in Na. However, at 48 hours, whole-cell Na was reduced by 51% ( P &lt;0.01). Cytosolic Ca increased by 1.1 mmol/kg dry wt after 3 minutes ( P &lt;0.005), but mitochondrial Ca remained low and unchanged. Cell size measured in transverse cryosections increased after 3 minutes of pacing (75±5 to 109±11 μm 2 , P =0.007) but returned to baseline by 30 minutes (66±5 μm 2 ). Conclusions— Intracellular Cl accumulation induced by rapid pacing is a novel finding and may play a role in AF pathogenesis by causing resting membrane depolarization and ERP reduction. There was no evidence of cellular or mitochondrial Ca overload despite the development of electrical remodeling and transient increase in cytoplasmic Ca.
Prevalence of drug and alcohol use in urban Afghanistan: epidemiological data from the Afghanistan National Urban Drug Use Study (ANUDUS)
Authors: Linda B Cottler, Shaun Ajinkya, Bruce A Goldberger, Mohammad Asrar Ghani, David M Martin, Hui Hu, Mark S Gold
Journal: The Lancet Global Health (2014)

Previous attempts to assess the prevalence of drug use in Afghanistan have focused on subgroups that are not generalisable. In the Afghanistan National Urban Drug Use Study, we assessed risk factors and drug use in Afghanistan through self-report questionnaires that we validated with laboratory test confirmation using analysis of hair, urine, and saliva.The study took place between July 13, 2010, to April 25, 2012, in 11 Afghan provinces. 2187 randomly selected households completed a survey, representing 19 025 household members. We completed surveys with the female head of the household about past and current drug use among members of their household. We also obtained hair, urine, and saliva samples from 5236 people in these households and tested them for metabolites of 13 drugs.Of 2170 households with biological samples tested, 247 (11·4%) tested positive for any drug. Overall, opioids were the most prevalent drug in the biological samples (5·6%), although prescription drugs (prescription pain pills, sedatives, and tranquilliser) were the most commonly reported in the past 30 days in the questionnaires (7·6%). Of individuals testing positive for at least one substance, opioids accounted for more than 50% of substance use in women and children, but only a third of substances in men, who predominantly tested positive for cannabinoids. After controlling for age with direct standardisation, individual prevalence of substance use (from laboratory tests) was 7·2% (95% CI 6·1-8·3) in men and 3·1% (2·5-3·7) in women-with a national prevalence of 5·1% (4·4-5·8) and a prevalence of 5·0% (4·1-5·8) in Kabul. Concordance between laboratory test results and self-reports was high.These data suggest the female head of household to be a knowledgeable informant for household substance use. They also might provide insight into new avenues for targeted behavioural interventions and prevention messages.