tbuckley/cabot-search huggingface dataset:
Lupus-like Reaction to Phenelzine
Authors: Conrad Swartz
Journal: JAMA (1978)

AN ADVERSE reaction was encountered in a patient with depression who was receiving phenelzine sulfate, a reaction which, to my knowledge, has not been previously reported. Phenelzine is an antidepressant of the monoamine-oxidase-inhibiting (MAO) class. It is customarily reserved for treating major depressions in which tricyclic antidepressants and electroconvulsive therapy are ineffective or contraindicated, and for anxiety states. Within the class of MAO-inhibitors, there are hydrazines (such as phenelzine) and nonhydrazines (such as tranylcypromine sulfate, but there are no data of statistical significance on differential effectiveness between these two subclasses. Best known among adverse effects is supersensitivity to exogenous sympathomimetic substances, with resulting severe hypertension and occasional secondary cerebral hemorrhage, arrhythmia, pulmonary edema, headache, or acute glaucoma. Anticholinergic side effects of dry mouth, gastrointestinal hypoperistalsis, hesitancy of micturition, and impotence are also seen.<sup>1</sup>Maximum dosage is commonly delimited by intolerable orthostatic hypotension. Some lesser-known effects include hyperpyrexia and seizures in
Cyclophosphamide induced nail pigmentation
Authors: PRABODH C. SHAH, K.R.P. RAO, ASHOK R. PATEL
Journal: British Journal of Dermatology (1978)

Cyclophosphamide therapy may occasionally cause black pigmentation of the nails. We report five cases with this side effect and review the data on eleven cases in the literature. These changes start in the proximal nail beds and progress distally; on withdrawal of cyclophosphamide, clearing of the nail pigmentation proceeds in a similar fashion. The development of the nail pigmentation does not bear any relation to the primary condition for which cyclophosphamide was prescribed. The dose of the drug before the onset of pigmentation ranged from 1.2 to 12.3 g; the duration of treatment ranged from 10 days to 26 weeks. The mechanism of the nail pigmentation is unknown.
Patient-orientated gastroenterology.
Authors: R H Salter, T P Cole, W G Scott-Harden, T G Girdwood, M A Reid
Journal: BMJ (1975)

Analysis of the first year's working of a combined gastroenterology clinic in a district hospital has shown that the major benefit was improved patient management. Hospital attendances were reduced, the diagnostic process accelerated, and unnecessary radiological investigations and surgical operations avoided. There were no obvious major disadvantages.
Immunolocalization of β <sub>2</sub> -Glycoprotein I (Apolipoprotein H) to Human Atherosclerotic Plaques
Authors: Jacob George, Dror Harats, Boris Gilburd, Arnon Afek, Yair Levy, Jacob Schneiderman, Iris Barshack, Juri Kopolovic, Yehuda Shoenfeld
Journal: Circulation (1999)

Background —β 2 -Glycoprotein I (β2GPI) is a major antigenic target of antiphospholipid antibodies, which possesses natural anticoagulant properties. The aim of the present study was to determine its presence and localization within human atherosclerotic plaques and to study its association with endothelial cells and monocyte macrophages in vitro. Methods and Results —Human atherosclerotic lesions were obtained after carotid endarterectomies and studied immunohistochemically with anti-β2GPI as well as antibodies to CD4/CD8, macrophages, and adhesion molecules. In vitro, human umbilical vein endothelial cells (HUVECs) and U937 (myelomonocytic cell line) cells were investigated for their ability to associate with radiolabeled β2GPI. We found β2GPI to be abundantly expressed within the subendothelial regions and intimal-medial borders of human atherosclerotic plaques and to colocalize with CD4-positive lymphocytes. This observation was confirmed by Western blot applied on homogenates of atherosclerotic lesions with anti-β2GPI antibodies. Both HUVECs and U937 cells bound labeled β2GPI, and the process was inhibited by oxidized LDL and not by native LDL. Conclusions —The abundant presence of human β2GPI within the lesions, its association with endothelial cells and macrophages, and its colocalization with CD4-positive lymphocytes suggests that it may serve as a target for an immune-mediated reaction that can influence lesion progression.
Reply to T. Maughan et al
Authors: Howard S. Hochster
Journal: Journal of Clinical Oncology (2010)

COIN (COntinuous chemotherapy versus INtermitent chemotherapy) trial investigators Maughan et al 1 question the conclusions of the editorial 2 on the OPTIMOX2 (Optimized Leucovorin-Fluorouracil-Oxaliplatin) trial that chemotherapy-free intervals should not be a routine standard of care.This follows as a result of the COIN trial, recently presented in abstract form at the European Society for Medical Oncology meeting in September. 3s these data have not been published, and there is still much to be known about this study, it is difficult to incorporate their results into a consideration of chemotherapy scheduling for advanced colorectal cancer.As noted in the letter, 1 1,630 patients were randomly assigned to fluorouracil, leucovorin, and oxaliplatin (FOLFOX) or capecitabine and oxaliplatin (CapeOX) continuously versus intermittent therapy consisting of 12 weeks of treatment followed by observation until the first signs of progression.The results presented and quoted in the letter show a hazard ratio of 1.08 favoring the continuous treatment, which does not fit their (admittedly strict) definition of noninferiority.Even in the COIN trial, 12-week induction therapy was inferior to continuous treatment.However, we should also note that the median overall survival for both arms was quite short at 15 months and did not reach the survivals reported in recent colorectal trials conducted in the United States and Europe.A general practice in the United Kingdom is to stop all chemotherapy at the time neurotoxicity is reached with FOLFOX or CapeOX regimens.COIN may therefore come down to a comparison of 12 weeks of FOLFOX versus a somewhat longer treatment of 20 to 24 weeks.Data on median number of doses given in both arms were not presented, but the investigators reveal that only a disconcerting 38% (309 of 815 patients) in arm C actually received additional therapy or an actual intermittent approach.Furthermore, for those in arm B, even with KRAS wild-type tumors, the addition of cetuximab did not improve PFS or OS, as compared with a number of other positive first-line trials adding anti-epidermal growth factor receptor antibodies to combination chemotherapy.Failure to optimize use of oxaliplatin, as done in the CONcePT (Combined Oxaliplatin Neurotoxicity Prevention Trial) study, would tend to dilute the added effect of any biologic.In short, COIN may be statistically valid, but clinically the results may be of limited applicability to US and European treatment paradigms.The COIN investigators 1 have, in fact, echoed my editorial 2 comments that better biomarkers or predictive tests are needed to prospectively identify those patients that we see in the clinic who have highly responsive tumors and a long, more indolent course.Such patients, as a matter of course, are treated intermittently, but until appropriate biomarkers are available, clinical observation still governs our management, and we should not routinely adopt chemotherapyfree intervals for all patients.
ANGLE-SPECIFIC CHANGES IN ECCENTRIC HAMSTRING TORQUE AND HAMSTRING TO QUAD RATIO FOLLOWING SIMULATED SOCCER
Authors: D Cohen, B Zhao, B Okwera, M Martyn, A Delextrat
Journal: British Journal of Sports Medicine (2014)

Background Soccer-specific fatigue decreases eccentric peak torque and the functional peak hamstring to quadriceps torque ratio ( f H ecc :Q con ), changes thought to increase the risk of hamstring strain (HS). Inadequate eccentric muscle strength specifically at long length may also be a risk factor for HS. The effect of simulated soccer on the hamstring eccentric torque-angle profile, or the hamstring:quad torque ratio at specific joint angles has not been reported. Objective To determine the effect of a simulated soccer on angle-specific eccentric hamstring torque and angle-specific.H ecc :Q con (AS.H ecc :Q con ) across the range of motion. Design Acute intervention. Setting Semi-professional soccer. Participants 9 male players. Risk factor assessment Isokinetic concentric and eccentric knee flexion and concentric knee extension was evaluated in the dominant limb at 120°·s −1 pre and post the Loughborough Intermittent Shuttle Test (LIST). Main outcome measurements Changes in eccentric hamstrings torque, concentric quadriceps torque and hamstring:quadriceps torque ratios at 9 joint angles (AS.H ecc :Q con ), angle of peak torque (APT), and f H ecc :Q con . Results The LIST resulted in significant decreases in eccentric hamstring torque at 60˚, 50˚ and 10˚ and a significant (21.8%) decrease in AS.H ecc :Q con at 10˚ (P&lt;.05). Eccentric hamstring APT increased significantly (P&lt;.05) from 7.1˚to 18.8˚. Conclusions Simulated soccer produces angle-specific changes in hamstring eccentric torque and in AS.H ecc :Q con and a shift in the eccentric hamstring APT. Our findings suggest that a prevention programs should both increase fatigue resistance in the hamstrings and include exercises that specifically develop long-length eccentric hamstring strength. Further research is also needed to determine if the evaluation of angle-specific.H ecc :Q con improves the predictive power of injury risk screening over assessment of the peak torque f H ecc :Q con alone.
Isaac Ovenseri (“Ovens”) Iredia
Authors: Ian Clark
Journal: BMJ (2005)

Consultant obstetrician and gynaecologist Western Isles Hospital (b Benin City, Nigeria, 1948; q Queen's University, Belfast, 1977; FRCOG), died from malignant lymphoma on 2 November 2004.

Ovens trained in obstetrics and gynaecology in Belfast until 1983, when he returned to Nigeria to take up a post as lecturer and consultant at the school of medicine, Bendel State University. One year later the school was closed by the Nigerian military government. Undaunted, Ovens opened his own clinic and hospital in Benin City, which continued to operate until the late 1990s, although, as the political situation in Nigeria became less congenial, Ovens left to work abroad. After a brief spell in Northern Ireland he became a consultant in Saudi Arabia in 1990. He again tried to continue his work in Nigeria, but left finally to posts in the north of Scotland. He leaves a wife, Patricia, and five children.
Russia cracks down on tobacco advertising and smoking in public places
Authors: T. Parfitt
Journal: BMJ (2010)

The Russian government has launched a package of new measures aimed at breaking the back of the country’s smoking habit.

Almost 40% of Russians smoke—one of the highest rates in the world—and cigarettes kill up to half a million people a year. A powerful tobacco lobby has so far managed to water down antitobacco legislation and restrictions on smoking in public.

But a new proposal adopted by Prime Minister Vladimir Putin’s government says that all advertising and promotion of cigarettes will be illegal from 2012 and that a complete ban on smoking in enclosed public spaces and in all “medical, sports, and …
Defining the quality characteristics of endoscopy for acute variceal hemorrhage in cirrhosis
Authors: Jayant A. Talwalkar
Journal: Hepatology (2010)

Abstract Objectives: The optimal timing of endoscopy with acute variceal bleeding (AVB) is unknown. The aim of this study was to evaluate the association between the timing of endoscopy and outcomes of stable AVB patients. Methods: Patients admitted at two tertiary-care centers with hemodynamically stable AVB from 1997 to 2006 were evaluated retrospectively. The primary outcome was mortality. Other recorded outcomes included stigmata at endoscopy, hemostasis, blood transfusions, rebleeding, renal function, hospitalization length, infection, transjugular intrahepatic portosystemic shunt use, and balloon tamponade use. Logistic regression analysis was used to assess the association of time to endoscopy with mortality. Outcome comparisons were also performed for three different urgency times (&lt; or = vs. &gt; 4 h, &lt; or = vs. &gt; 8 h, and &lt; or = vs. &gt; 12 h). Results: There were 210 patients with stable AVB, accounting for 52% of the total number of AVB patients. The mean (+/− s.d.) age was 55 (+/− 12) years. The mean presenting systolic blood pressure and heart rate were 121 (+/− 16) mm Hg and 98 (+/− 20) bpm, respectively. Esophageal varices accounted for 91% (n = 191) of variceal bleeding. The mean time to endoscopy was 12 (+/− 12) h. The overall hemostasis rate after endoscopy was 97% (n = 203). The mortality rate was 9.5% (n = 20). There was no significant association of time to endoscopy with mortality (odds ratio, OR, 1.0; 95% confidence interval, CI, 0.92-1.08; P = 0.91). Significant independent predictors for mortality were lower albumin (OR, 0.82; 95% CI, 0.73-0.93; P = 0.001), infection during admission (OR, 8.9; 95% CI, 2.5-31.6; P &lt; 0.001), and higher model end-stage liver disease (MELD) (OR, 1.17; 95% CI, 1.06-1.29; P = 0.002). There was no difference in outcomes with different urgency times. Conclusions: For patients who present with hemodynamically stable variceal bleeding, hemostasis after endoscopy is high, and the time to endoscopy does not appear to be associated with mortality.
Bollywood delivers 14.3 billion tobacco images to Indian audiences each year
Authors: S. Bhaumik
Journal: BMJ (2013)

Top grossing Bollywood films deliver about 14.3 billion separate tobacco images to Indian audiences (in terms of numbers of images multiplied by numbers of viewers)—many more than the estimated 920 million images delivered by Hollywood films screened to UK audiences, a study has found.

The study, published in Heart Asia , said that the association between young people’s use of tobacco products and the depiction of tobacco use in films in India has already been established.1

For the new study, researchers from Imperial College London, in collaboration with an Indian non-governmental organisation called Health Related Information Dissemination Amongst Youth, analysed …
Advances in virtual reality are wide ranging
Authors: F. Rubino
Journal: BMJ (2002)

EDITOR—McCloy and Stone have reviewed virtual reality in surgery.1 Providing an updated and clear picture of a field that changes and advances continuously is hard, and we would like to point out some other things that virtual reality offers to surgery. Applications are likely to determine advances not only in surgical training but also in operative planning, operative strategy, and techniques, as well as in telesurgery.



Fig 1. 
Automated 3D liver reconstruction



Systems that allow the assessment of psychomotor skills hold great interest for surgical training. We believe, though, that training …
An analysis of the cost effectiveness of the implantable defibrillator.
Authors: M Kuppermann, B R Luce, B McGovern, P J Podrid, J T Bigger, J N Ruskin
Journal: Circulation (1990)

The automatic implantable defibrillator has been shown to decrease the mortality of patients who have survived cardiac arrest due to ventricular tachycardia or fibrillation and are at high risk for recurrence. We performed a cost-effectiveness analysis of this seemingly expensive new technology with data obtained from the 1984 Medicare data base, the medical literature, Medicare carriers, individual pharmacies and hospitals, and expert opinion. Analyzing combinations of principal and secondary discharge diagnoses across 18 diagnosis-related groups, we estimated the cost of hospitalization for a comparison group of patients. Hospitalization costs for the defibrillator group were obtained from reported empirical data. Rehospitalization rates and other health-care use estimates were solicited from an expert panel of physicians, and mortality rates for both groups were obtained from the literature. Using a decision-analytic model, we estimated that the net cost effectiveness of the defibrillator, when used in the high-risk patient, is approximately $17,100 per life-year saved, with sensitivity analyses suggesting that the true value lies between $15,000 and $25,000. This estimate is well within the range that is currently accepted by the US medical care system for other life-saving interventions. We also estimated the cost effectiveness of the defibrillator in a 1991 scenario to be $7,400 per life-year saved, when the device would have greater longevity, would be programmable, and would not require a thoracotomy. Sensitivity analyses suggest that the true value lies between a value that is cost saving (less expensive than pharmacologic therapy) and $19,600 per life-year saved.
THE DIAGNOSIS OF SCARLET FEVER AND SCARLATINOID AFFECTIONS.
Authors: JAY F. SCHAMBERG
Journal: JAMA (1904)

Of all the acute eruptive fevers, scarlatina, in obscure cases, offers the greatest difficulties in diagnosis. In well-pronounced and typical cases the nature of the disease is quite clear. When all the symptoms are well developed an unmistakable syndrome is presented. Who could fail to diagnose a disease characterized by sudden vomiting, high fever, prostration, diffuse punctiform rash, circumoral pallor, red and swollen throat, enlarged glands and strawberry tongue, followed by desquamation, otitis media and albuminuria? But the picture is frequently incomplete. Those who have had experience with scarlet fever have observed that in very mild cases all the symptoms are commonly poorly marked. When the eruption is intense the throat is usually severely attacked, the tongue is characteristic and the fever is high. When, on the other hand, the general symptoms are very mild, the rash is, as a rule, faint and poorly developed. It is under the latter
Dabigatran and Mechanical Heart Valves — Not as Easy as We Hoped
Authors: Elaine M. Hylek
Journal: New England Journal of Medicine (2013)

Warfarin is the mainstay of anticoagulation for patients with mechanical heart valves. However, warfarin has well-known limitations, including interactions with food and drugs and the requirement for lifelong monitoring of the international normalized ratio (INR).1 Variability of the INR is the strongest independent predictor of reduced survival after mechanical valve replacement.2 Thus, there is a pressing need for alternatives to warfarin, and the advent of the target-specific oral anticoagulants has been highly anticipated.Eikelboom et al.3 now report in the Journal the results of a study whose primary aim was to validate a new dosing regimen for dabigatran, as compared . . .
EFFECT OF REPEATED SUPERINFECTION UPON THE POTENCY OF IMMUNE SERUM OF MONKEYS HARBORING CHRONIC INFECTIONS OF PLASMODIUM KNOWLESI
Authors: Lowell T. Coggeshall, Henry W. Kumm
Journal: The Journal of Experimental Medicine (1938)

Protection tests have been utilized to determine the effect of superinfection upon the potency of immune serum of monkeys with chronic Plasmodium knowlesi infections. The results of these tests showed that: 1. In 2 groups of monkeys with comparable P. knowlesi infections the immune serum of 8 monkeys which had been superinfected on 7 separate occasions over a period of 2 months was much more potent than the immune serum of a group of 7 monkeys which were allowed to continue their chronic course of infection without superinfection. 2. After a series of 9 more intense superinfections the serum from the same 2 groups of monkeys contained no demonstrable protective antibodies. 3. The serum from 8 of the 10 monkeys in the original 2 groups showed a relatively high concentration of protective antibodies following a month's rest and a single superinfection. 4. The results of the experiments indicate that it is possible to increase the potency of immune serum by superinfection, but it is also possible to obtain a decrease in the protective property of the serum by too severe superinfections.
Tuberculosis in Indochinese Refugees
Authors: KENNETH E. POWELL
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 August 1980Tuberculosis in Indochinese RefugeesKENNETH E. POWELL, M.D., RICHARD A. GOODMAN, M.D., LAURENCE S. FARER, M.D.KENNETH E. POWELL, M.D.Search for more papers by this author, RICHARD A. GOODMAN, M.D.Search for more papers by this author, LAURENCE S. FARER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-93-2-375_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The Bay Area Medical Volunteers' recently published letter (1) suggested that the prevalence of health problems among Indochinese refugees calls for a program for systematic screening at U.S. ports of entry. We wish to clarify the issues related to tuberculosis.In accordance with U.S. Public Health Service and Immigration Statutory Requirements, chest roentgenograms are obtained on all Indochinese refugees 15 years or older to screen for active or suspected active (class A) and other than active (class B) pulmonary tuberculosis (2) before departure. Refugees with infectious tuberculosis are not allowed to travel to the United States. Before...References1. ADUANMCCUTCHEONEITZSANGER RMMP. Refugees from Indochina. Ann Intern Med. 1980;92:266. Letter. LinkGoogle Scholar2. . Health status of Indochinese refugees. Morbid Mortal Weekly Rep. 1980;28:385-90, 395-8. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KENNETH E. POWELL, M.D.; RICHARD A. GOODMAN, M.D.; LAURENCE S. FARER, M.D.Affiliations: Center for Disease Control Atlanta, GA 30333 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1980Volume 93, Issue 2Page: 375-376KeywordsMedical servicesThoraxTuberculosis ePublished: 1 December 2008 Issue Published: 1 August 1980 PDF downloadLoading ...
The WAVE2/Abi1 complex differentially regulates megakaryocyte development and spreading: implications for platelet biogenesis and spreading machinery
Authors: Koji Eto, Hidekazu Nishikii, Takunori Ogaeri, Shiro Suetsugu, Akihide Kamiya, Toshihiro Kobayashi, Daisuke Yamazaki, Atsushi Oda, Tadaomi Takenawa, Hiromitsu Nakauchi
Journal: Blood (2007)