tbuckley/cabot-search huggingface dataset:
ANSWER: Talocalcaneal tarsal coalition
Authors: Bippan Sangha, Julia Grebenyuk, Teri Fisher, Bruce B Forster
Journal: British Journal of Sports Medicine (2011)

### Anteroposterior radiograph of right ankle

No abnormality is appreciable on this anteroposterior radiograph.

### Lateral radiograph of right ankle

This image demonstrates a complete C-sign with osseous bridging. There is narrowing of the posterior subtalar facet, a short talar neck and a small dorsal subtalar beak.

### Sagittal fast spin echo T1, sagittal fat saturated T2 and coronal fast short tau inversion recovery magnetic resonance images

The magnetic resonance images demonstrate bone marrow oedema across the middle subtalar joint, cortical irregularity and small subchondral cysts, in keeping with fibrous coalition.

Tarsal coalition is an abnormal union between two or more tarsal bones. The coalition can be osseous, fibrous or cartilaginous. Tarsal coalition is relatively common on autopsy, with an incidence of up to 1% of the population; although the majority of these are thought to be asymptomatic.1 Most cases of tarsal coalition occur between the calcaneonavicular and talocalcaneal joints.2 However, coalitions between almost any two adjacent tarsal bones have been reported.3 Altered joint biomechanics in the presence of union are thought to account for the symptoms.

The histopathology of tarsal coalition changes over time with gradual ossification of the fibrous bar.2 Progressive ossification limits hindfoot motion, interfering with joint mechanics, and leading to secondary inflammation that predisposes to joint degeneration. The increasing synostosis commonly leads to symptom onset in early to mid-adolescence.

Tarsal coalition can present with varying complaints. These include ankle pain, rigid pes planus, limp, peroneal tendon contracture, tarsal tunnel syndrome and …
Cationic Shifts and Blood Pressure Regulation
Authors: SYDNEY M. FRIEDMAN, CONSTANCE L. FRIEDMAN, MIYOSHI NAKASHIMA
Journal: Circulation Research (1957)

The effects of Pitressin and norepinephrine on movements of sodium, potassium, and water into and out of the intracellular compartment were measured in bilaterally nephrectomized rats using inulin as a measure of extracellular fluid volume. Observations were made from 0.5 to 7 min. following injection of the test substances. Pitressin causes a movement of sodium and water into cells and the extrusion of potassium during the pressor plase of its action. These effects were observed at 0.75 and 1.5 min. after the injection of 30 or 60 mU. The reverse movements were observed during the subsequent return of the blood pressure towards normal. A secondary shift of sodium into cells was observed at 5 min. Norepinephrine caused similar shifts in sodium, water, and potassium in relation to its blood pressure effects. These were more rapid in onset than those induced by Pitressin. Our operational theory is that the regulation of the blood pressure depends, inter alia, on the "sodium transfer systems" broadly defined, which govern the rate of entrance and extrusion of sodium, water and potassium in smooth muscle cells.
Measuring the improvement in pulsed dye laser treated port wine stains
Authors: S.W. Lanigan
Journal: British Journal of Dermatology (2000)

Considerable improvement has been made over the past 20 years in the laser treatment of Port Wine Stains (PWS). The pulsed dye laser (PDL) has been developed, with a wavelength (585 nm) and pulse duration (450 µs), to produce selective photothermolysis of cutaneous blood vessels in PWS. The PDL is now considered the treatment of choice for PWS both in children and adults.1 How do we measure the effectiveness of laser treatment of PWS? There are two end points we could consider: eradication of the birthmark and patient satisfaction. Measuring eradication of the birthmark is not that simple since, despite early optimistic reports, complete eradication of a PWS occurs in only a small minority.2,3 The vast majority of patients treated with the PDL will experience lightening of their birthmark to a greater or lesser degree. Assessment of improvement by clinicians and in most published papers is subjective, comparing the affected site after treatment with a pretreatment photographic record. The paper by Currie and Monk4 attempts to assess the reliability of this assessment method. They compared intra‐assessor concordance for three different subjective scoring systems. The simplest scoring system of ‘poor, fair, good and excellent’ resulted in the highest intra‐assessor concordance.
Training care givers of stroke patients: economic evaluation
Authors: Anita Patel, Martin Knapp, Andrew Evans, Inigo Perez, Lalit Kalra
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Background</b> Training care givers reduces their burden and improves psychosocial outcomes in care givers and patients at one year. However, the cost effectiveness of this approach has not been investigated. <b>Objective</b> To evaluate the cost effectiveness of caregiver training by examining health and social care costs, informal care costs, and quality adjusted life years in care givers. <b>Design</b> A single, blind, randomised controlled trial. <b>Setting</b> Stroke rehabilitation unit. <b>Subjects</b> 300 stroke patients and their care givers. <b>Interventions</b> Caregiver training in basic nursing and facilitation of personal care techniques compared with no caregiver training. <b>Main outcome measures</b> Health and social care costs, informal care costs, and quality adjusted life years in care givers over one year after stroke. <b>Results</b> Total health and social care costs over one year for patients whose care givers received training were significantly lower (mean difference -£4043 ($7249; €, 95% confidence interval -£6544 to -£1595). Inclusion of informal care costs, which were similar between the two groups, did not alter this conclusion. The cost difference was largely due to differences in length of hospital stay. The EQ-5D did not detect changes in quality adjusted life years in care givers. <b>Conclusion</b> Compared with no training, caregiver training during rehabilitation of patients reduced costs of care while improving overall quality of life in care givers at one year.
Management of the Pregnant Patient with Hodgkin's Disease
Authors: CHARLOTTE JACOBS
Journal: Annals of Internal Medicine (1981)

Fifteen pregnant women with Hodgkin's disease were followed. Five patients had irradiation, 1000 to 3000 rad to the neck, mediastinum, or both, during the second or third trimester with normal outcome of pregnancy. One patient had a spontaneous abortion in the first trimester after radiotherapy of 4400 rad to the breast, an estimated fetal dose of 9 rad. One patient who received chlorambucil throughout pregnancy delivered a normal infant. Six patients had therapeutic abortions; one had early induction of labor. In one patient previously treated for supradiaphragmatic Hodgkin's disease, detection of a subdiaphragmatic relapse was delayed because of pregnancy. We recommend abortion for patients who develop Hodgkin's disease early in pregnancy or who have received chemotherapy or irradiation during the first trimester. During the latter half of pregnancy, asymptomatic disease may be closely followed but early delivery is recommended. Supradiaphragmatic, symptomatic disease can be treated with modified irradiation. For subdiaphragmatic, symptomatic, or extranodal disease, single-agent chemotherapy may be preferable. Treatment requires individualization to insure that the patient will be cured and the fetus protected.
Metabolic effects of antihypertensive treatment should not be overstated
Authors: P. H Winocour
Journal: BMJ (1997)

<h3>Objectives</h3> Evidence showed that the prevalence of sexual violence during the whole human trafficking period was high. However, the distribution of sexual violence along the stages of the trafficking cycle is unclear. This study aimed to determine the prevalence of sexual violence at each stage of trafficking and factors associated with it among Ethiopian trafficked females. <h3>Design</h3> A retrospective cohort study was conducted to study trafficking returnees regarding their previous experiences at each stage of trafficking. <h3>Settings</h3> Data were collected at immigration offices in three border towns of Ethiopia located bordering Sudan, Kenya and Djibouti. <h3>Participants</h3> Six hundred and seventy-one women who were trafficked from Ethiopia were recruited into the study consecutively. They were recruited when they came back home via the three border towns either by deportation or voluntary return. <h3>Outcome measure</h3> The outcome variable was sexual violence. <h3>Results</h3> The prevalence of sexual violence was estimated at 10% (95% CI 7.9 to 12.5) during predeparture, 35.0% (95% CI 31.5 to 38.7) travelling period, 58.1% (95% CI 54.2 to 61.8) at destination and 19.5% (95% CI 15.2 to 24.6) detention stages. The odds of sexual violence among returnees aged 14–17 years was about twofold when compared with that of women aged 26–49 years (adjusted OR (AOR)=1.97; 95% CI 1.11 to 3.52). Similarly, being smuggled initially (AOR=1.54; 95% CI 1.09 to 1.93), restricted freedom (AOR=1.45; 95% CI 1.13 to 1.86) and time spent at each stage of trafficking (AOR=1.028; 95% CI 1.024 to 1.033) were positively associated with sexual violence. <h3>Conclusions</h3> The prevalence of sexual violence at each stage of trafficking after departure was high. This could imply that victims might be affected by subsequent negative sexual health outcomes. Young age, initially being smuggled and time spent at each stage of the trafficking process were positively associated with the events of sexual violence. Efforts must be made on modifiable factors such as ‘smuggling’ to minimise subsequent sexual violence during trafficking.
Nephropathia epidemica. The Scandinavian form of hemorrhagic fever with renal syndrome
Authors: M. Saari
Journal: JAMA (1977)

We report epidemiologic, clinical, laboratory, and biopsy findings in 14 cases of nephropathia epidemica. The patients were between 19 and 49 years of age. The onset of the disease was characterized by high fever, nausea, headache, backache, abdominal pain, proteinuria, oliguria, hematuria, and uremia. The symptoms subsided rapidly during the polyuria phase, which followed the oliguria stage. Because of renal failure, hemodialysis was required in eight cases. Edema of eyelids, conjunctival injection and hemorrhages, transitory myopia, and acute glaucoma were the most common eye abnormalities. Renal biopsy specimens showed glomerular changes, with mild swelling of the epithelial cells of Bowman's capsule, thickening of the basement membrane of glomerular capillaries, glomerular adhesions, inflammatory cell infiltration, leukocytoclasis and hemorrhages in the interstitium, and eosinophilic hyaline degeneration and vacuolization of the epithelial cells of the proximal tubuli.
DIPHTHERIA IMMUNIZATION IN PROVIDENCE
Authors: CLARENCE L. SCAMMAN
Journal: JAMA (1927)

In the fall of 1921, Dr. Charles V. Chapin, superintendent of health of Providence, R. I., decided to try on a practical basis the feasibility of active immunization against diphtheria. This immunization has now been continued four years with complete records of children immunized, and histories of all cases of diphtheria which have occurred in Providence. As an indication of the results that may be expected under regular health department practice in large cities, it now seems desirable to submit this preliminary report. During the winter and spring of 1921-1922, four immunization clinics were opened in Providence. A special endeavor was made to reach the preschool child, but without noticeable success. The next year the clinics were discontinued but the work was taken up in the schools, and, by the end of the school year 1923-1924, approximately 8,000 children had received protective treatments or had been found naturally immune; that
Routine preoperative restaging CTs after neoadjuvant chemoradiation for locally advanced rectal cancer are low yield: A retrospective case study
Authors: Jennifer S. Davids, Karim Alavi, J. Andres Cervera-Servin, Christine S. Choi, Paul R. Sturrock, W. Brian Sweeney, Justin A. Maykel
Journal: International Journal of Surgery (2014)
Mediator Complex Dependent Regulation of Cardiac Development and Disease
Authors: Chad E. Grueter
Journal: Genomics Proteomics & Bioinformatics (2013)

Abstract Cardiovascular disease (CVD) is a leading cause of morbidity and mortality. The risk factors for CVD include environmental and genetic components. Human mutations in genes involved in most aspects of cardiovascular function have been identified, many of which are involved in transcriptional regulation. The Mediator complex serves as a pivotal transcriptional regulator that functions to integrate diverse cellular signals by multiple mechanisms including recruiting RNA polymerase II, chromatin modifying proteins and non-coding RNAs to promoters in a context dependent manner. This review discusses components of the Mediator complex and the contribution of the Mediator complex to normal and pathological cardiac development and function. Enhanced understanding of the role of this core transcriptional regulatory complex in the heart will help us gain further insights into CVD.
Thyromimetic effects of 3,5-dimethyl, 3′-isopropyl thyronine (DIMIT) and 3,5-diethyl, 3′-isopropyl thyronine (DIET) in various tissues of the rat
Authors: Inder J. Chopra, Tien-Shang Huang, Robert E. Hurd, David H. Solomon
Journal: Metabolism (1984)
Mouse type I IFN-producing cells are immature APCs with plasmacytoid morphology
Authors: Carine Asselin-Paturel, Andre Boonstra, Marc Dalod, Isabelle Durand, Nadia Yessaad, Colette Dezutter-Dambuyant, Alain Vicari, Anne O'Garra, Christine Biron, Francine Brière, Giorgio Trinchieri
Journal: Nature Immunology (2001)
Sunbeds and young people: an easy target for legislation?
Authors: B. Diffey
Journal: British Journal of Dermatology (2013)

The advent of the social desirability of a tanned skin is generally attributed to Coco Chanel who, on returning from holiday on the French Riviera, proclaimed ‘The 1929 girl must be tanned’. For the next 50 years a uniform, tanned skin could only be achieved by sunbathing but in the 1970s, the sunbed industry was born following the development of high‐intensity ultraviolet (UV) A fluorescent lamps, the same lamps that allowed psoralen plus UVA (PUVA) therapy to be established. In the period subsequent to the late 1970s, there have been several reports on the demographics of sunbed use. A study in the BJD1 confirms a common feature of sunbed users, which has been present in all demographic studies ever since the first study of sunbed users in the U.K. appeared in this journal in 1986,2 that is, that young females are the predominant group who engage in cosmetic tanning. However, a worrying feature of the German study1 was the finding that age at initiation of sunbed use decreased significantly across birth cohorts from 25 to 19 years (25th percentile; cohorts 1966–75 to 1986–93).
"DEPILATORY AND ANTISEBACEOUS ACTIONS OF BORIC ACID"
Authors: Albert P. Mathews
Journal: JAMA (1923)

To the Editor:  —In a recent communication by Dr. P. J. Hanzlik (The Journal, September 29, p. 1134), he quotes a statement made incidentally in my textbook of Physiological Chemistry in the course of a discussion on surface tension. The statement is to the effect that sufficient ingestion of boric acid so prevents the secretion of oil in the skin that a rod touched to the skin and then to water no longer lowers the surface tension of water, and I put in the further statement that this loss of oil was accompanied by a falling out of the hair which might be total. Dr. Hanzlik criticizes this statement. He says: This reference to the depilatory and antisebaceous actions of boric acid is not, however, supported by evidence in the book, and one searches in vain for evidence in the existing scientific and clinical literatures [italics mine], and in current
Outcomes in ankylosing spondylitis: what makes the assessment of treatment effects in ankylosing spondylitis different?
Authors: M M Ward
Journal: Annals of the Rheumatic Diseases (2006)

There are four major challenges in the assessment of outcomes in patients with ankylosing spondylitis (AS) that are particularly relevant to the evaluation of new therapies. Firstly, measures of symptoms and impairment in AS are not specific for inflammatory processes, they also capture mechanical symptoms and fixed limitations. The non-specific nature of these measures may cause them to be less responsive and therefore less useful in determining treatment efficacy. Secondly, acute phase reactants have limited value as measures of AS activity and other surrogate markers have not yet been established. Thirdly, the assessment of the disease modifying potential of new therapies is hampered by the slow rate of spinal fusion. Fourthly, work disability has not be studied as an endpoint in clinical trials in AS, despite the fact that work disability is an important outcome in patients with AS. Research into ways to overcome these challenges in outcome measurement will help identify useful therapies and define the range of outcomes that they influence.
Models of accelerated sarcopenia: Critical pieces for solving the puzzle of age-related muscle atrophy
Authors: Thomas W. Buford, Stephen D. Anton, Andrew R. Judge, Emanuele Marzetti, Stephanie E. Wohlgemuth, Christy S. Carter, Christiaan Leeuwenburgh, Marco Pahor, Todd M. Manini
Journal: Ageing Research Reviews (2010)
The Flexner Report at the Century Mark
Authors: Mike Mitka
Journal: JAMA (2010)

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Cost-Effectiveness of a Primary Care Treatment Program for Depression in Low-Income Women in Santiago, Chile
Authors: Ricardo Araya, Terry Flynn, Graciela Rojas, Rosemarie Fritsch, Greg Simon
Journal: American Journal of Psychiatry (2006)

Objective: The authors compared the incremental cost-effectiveness of a stepped-care, multicomponent program with usual care for the treatment of depressed women in primary care in Santiago, Chile. Method: A cost-effectiveness study was conducted of a previous randomized controlled trial involving 240 eligible women with DSM-IV major depression who were selected from a consecutive sample of adult women attending primary care clinics. The patients were randomly allocated to usual care or a multicomponent stepped-care program led by a nonmedical health care worker. Depression-free days and health care costs derived from local sources were assessed after 3 and 6 months. A health service perspective was used in the economic analysis. Results: Complete data were determined for 80% of the randomly assigned patients. After we adjusted for initial severity, women receiving the stepped-care program had a mean of 50 additional depression-free days over 6 months relative to patients allocated to usual care. The stepped-care program was marginally more expensive than usual care (an extra 216 Chilean pesos per depression-free day). There was a 90% probability that the incremental cost of obtaining an extra depression-free day with the intervention would not exceed 300 pesos ($1.04 U.S.). Conclusions: The stepped-care program was significantly more effective and marginally more expensive than usual care for the treatment of depressed women in primary care. Small investments to improve depression appear to yield larger gains in poorer environments. Simple and inexpensive treatment programs tested in developing countries might provide good study models for developed countries.
The Pituitary Adenoma
Authors: Rafael Luboshitzky
Journal: JAMA (1981)

When I first received this book, I expected another endocrinologically oriented work dealing with pituitary tumors. In the preface, however, the authors' stated aim is a "comprehensive review of current aspects [of] the pathogenesis, diagnosis and treatment of pituitary adenomas... to present a balanced viewpoint on these different areas." The book is exceptionally well edited and written. Subjects are well referenced and include material published as recently as 1978. The book is divided into four major sections. Part 1 is an updated review of the pathophysiology of pituitary tumors. The chapters on hypothalamic-pituitary regulation and the etiology of pituitary adenomas provide solid background and understanding of the different aspects of diagnostic tests, medical management, and etiology of pituitary tumors. Moreover, they provide an understanding of hypothalamic-pituitary disorders in general. The chapter on the pathology of pituitary adenomas is well written and appropriately illustrated and gives traditional concepts as well as
The Prevention of Deaths From Reactions to Insect Venoms
Authors: Claude A. Frazier
Journal: JAMA (1989)

<h3>To the Editor.—</h3> I read the article "Epidemiology of Insect Venom Sensitivity."<sup>1</sup> As a lone crusader, I have worked diligently for legislation in each of our 50 states to deal with training and licensing of laypersons such as teachers and law enforcement officers (anyone dealing with the public) to be able to carry and administer epinephrine in emergency situations, when a physician is not immediately available. The time span in cases of anaphylactic reaction is often the difference between life and death, and death could occur within as little as 5 minutes. I have lobbied for the proper laws to be passed so that when emergencies arise, from either a reaction to an insect sting or additives in food, beverages, or drugs, we might be able to circumvent an unnecessary death by having trained laypersons administer treatment immediately, without having to wait for a licensed physician to arrive. I
TOXIC EFFECT OF SULFANILAMIDE ON THE HEMOPOIETIC ORGANS IN A CASE OF POLYCYTHEMIA VERA
Authors: Louis Greenwald
Journal: JAMA (1942)

An extensive literature has accumulated<sup>1</sup>reporting the toxic effects of sulfanilamide on the blood forming organs. These reactions consist of acute hemolytic anemia with leukocytosis, occasionally a leukemoid blood picture,<sup>2</sup>severe leukopenia with granulocytopenia and thrombopenia with hemorrhagic phenomena. Such deviations may occur singly or in combination. The outcome occasionally has been fatal.<sup>3</sup>The cases reported up to the present time usually have presented initially a normal hemoglobin and red cell count or slightly diminished values. A careful search of the literature fails to disclose any referenceto a case of polycythemia vera in which there was a toxic reaction of the blood in the course of the administration of sulfanilamide. The following is the report of a case of polycythemia vera and prostatic infection in which anemia, severe leukopenia and neutropenia developed as the result of the administration of sulfanilamide. A white man aged 61, born