tbuckley/cabot-search huggingface dataset:
Anaphylactoid Reaction to Demethylchlortetracycline Hydrochloride
Authors: Waldo Greenspan
Journal: JAMA (1962)

<h3>To the Editor:—</h3> With introduction of many new drugs into medical practice, sensitivity reactions have become commonplace. We report one of the first recorded cases of anaphylactoid reaction to a commonly used antibiotic, demethylchlortetracycline hydrochloride (Declomycin Hydrochloride). Our patient, a 40-year-old man, was first seen on the evening of Jan. 17, 1961, because of upper respiratory infection and bilateral otitis media. Physical findings included a red throat, injected eardrums, and coarse rhonchi throughout the chest. When queried about previous penicillin therapy, the patient replied that he had received penicillin injections numerous times without hives or other untoward reaction developing. Accordingly, he was given 300,000 units of procaine penicillin and a prescription for 10 capsules of demethylchlortetracycline hydrochloride and told to take one that evening and subsequently 4 times a day. He took one capsule at 9 P.M., and at 10 P.M. called to report that in the last few minutes
Clozapine in the management of schizophrenia. Compliance no worse than with other neuroleptic drugs.
Authors: J D Wilson
Journal: BMJ (1993)

benefit from clozapine.So what has got into the therapeutic experts of the Committee on Safety of Medicines?Surely the first principle of therapeutics is that those likely to benefit the most should be those who take the largest risk.As things stand now in Britian, clozapine is often reserved for the worst cases of chronic vegetative schizophrenia, with relatively little chance of success.Why should these unfortunate patients, who are less likely to respond, also shoulder the risk of agranulocytosis, while those most likely to respond are denied the drug and left to endure the severe extrapyramidal side effects of the partially effective classic anti- psychotic drugs?Schizophrenia is a devastating and destructive medical condition whose sufferers are third class citizens and third class patients.Clozapine gives them the best chance of recovery to date.The Clozaril monitoring system is working superbly.Clozapine should be available to all patients.We then predict that a cost-benefit analysis would show dramatic improvements.
316 ACUTE GASTROINTESTINAL BLEEDING PROLONGS QT INTERVAL IN CIRRHOSIS
Authors: A. Zambruni, A. Di Micoli, E. Bracci, K. Fontana, P. Caraceni, M. Domenicali, F. Mirici-Cappa, V. Santi, G. Magini, R. Casadio, M. Frigerio, M. Bernardi, F. Trevisani
Journal: Journal of Hepatology (2008)
Regression of Liver Cell Adenomas Associated with Oral Contraceptives
Authors: HUGH A. EDMONDSON
Journal: Annals of Internal Medicine (1977)

The regression of liver cell adenomas that follow the use of oral contraceptives when steroids are withdrawn was observed in three patients. At diagnosis by needle biopsy in patients without pain or evidence of hemorrhage, prompt cessation of steroid use is suggested as the preferable form of treatment. The same is true for the diagnosis made at surgery if the tumor or tumors are difficult to remove.
THE NON-OVIPAROUS FEMALE HOOKWORM
Authors: WILLIAM LITTERER
Journal: JAMA (1910)

púsoles present.In every examination numerous active tri- chiiinonailes «ere noted until the last week of the disease, during which they gradually decreased ill number und lost their motility, There were still a few present in the sputum on'the day of the patient's discharge (August 5, 1010) from lin' hospital.At no time were liiere more than a few bacteria present in the sputum, Course of tin-Disease.-AIno time during the patient's confinement in the hospital did the temperature rise above normal after the lirst twenty-four hours, but ranged between 07.(i and US.."» I''.The pulse and respiration were normal throughout, 'I he Sputum and pain in the side and over the root of (lie lel'l lung were the only noteworthy symptoms, and on discharge (August 5, 1910) only a Blight soreness over the root ni' the lung remained, the foul and bloody sputum and the pain having quite disappeared.The patient has reported twice sime discharged, at intervals of a week, tor observation, and at the last visit seemed to he in perfect health.
Geometric Assessment of Asymmetric Septal Hypertrophic Cardiomyopathy by CMR
Authors: Anca Florian, Pier Giorgio Masci, Stijn De Buck, Giovanni Donato Aquaro, Piet Claus, Giancarlo Todiere, Johan Van Cleemput, Massimo Lombardi, Jan Bogaert
Journal: JACC. Cardiovascular imaging (2012)
Treatment of Oesophageal Varices in Portal Hypertension by Means of Sclerosing Injections
Authors: R. Macbeth
Journal: BMJ (1955)

In 1949 I briefly described a method of treating oesophageal varices by sclerosing injections based upon nine cases (Macbeth, 1951).The purpose of the present communication is to describe further experience with the method in a total series of 30 cases, and to attempt to justify its use as a valuable means of treatment in patients suffering from portal hypertension. Portal HypertensionThis term, coined by McMichael in 1932, is descriptive of an increase of pressure within the portal venous system.It may be intrinsic by reason of fibrosis of the liver, or extrinsic because of thrombosis of the portal vein or of one-of its main tributaries.The portal system anastomoses with systemic veins at a number of points, but the lower end of the oesophagus and the cardiac end of the stomach provide a site where back-pressure from the portal side is peculiarly apt to produce varicose dilatations.Bellis (1942) compared the portal venous pressure with that in an ankle vein in 16 human subjects who showed no evidence of portal obstruction.He found that the portal pressure ranged from 14 to 22 cm. of saline, while that at the ankle was 5 to 12 cm.Where valves are present in the veins such a pressure differential would not be expected to cause any dilatation of the systemic veins of the oesophagus.Whipple (1949) states that the normal portal pressure is 6 to 14 cm. of saline, but that in hypertension is 40 to 60 cm.Where the pres- sure is so markedly raised on the portal side any valves present in anastomotic veins would soon become incom- petent, the blood flow would be from both ends, and varicosities would develop.Gradually further valves would give way, and ultimately the blood would find its way into the main systemic veins draining the oesophagus. AnatomyA comprehensive description of the veins of the oeso- phagus has been given by Butler (1951).He classified the veins as (a) intrinsic, which include subepithelial, submucous, and perforating; (b) extrinsic (or subserous), which are formed by the union of groups of perforating veins; and (c) venae comitantes of the vagal nerves, which run longi-
Pneumocystis carinii Identified by Gram Stain of Lung Imprints
Authors: ABE M. MACHER
Journal: Annals of Internal Medicine (1983)

The diagnosis of Pneumocystis carinii pneumonia conventionally depends on the time-consuming demonstration of the organisms in pulmonary secretions or lung tissue using toluidine blue 0, methenamine silver, or Gram Weigert stains that require special reagents. In 27 recent episodes of moderate to heavy pneumocystis infections, the cyst form and internal sporozoites of P. carinii could be readily identified on lung imprints using the conventional Gram stain. The Gram stain is unlikely to replace special stains for the diagnosis of pneumocystosis, but it does provide a rapid method to recognize moderate to heavy infections.
Valve Resection for Endocarditis
Authors: L. BARTH RELLER
Journal: Annals of Internal Medicine (1979)

Letters1 February 1979Valve Resection for EndocarditisL. BARTH RELLER, M.D.L. BARTH RELLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-2-277_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The report by Chandraratna and colleagues (1) states that "surgical resection of a vegetation, without valve replacement, has not been previously reported." As a medical intern I helped care for a patient with antibiotic-refractorySerratia marcescensendocarditis who was cured by débridement of vegetations without resection of her tricuspid valve. This case was reported by Alexander, Holloway, and Honsinger (2). Moreover, Parrott and colleagues (3) have reviewed the role of valve débridement without excision in a series of patients who required surgical management for bacterial endocarditis. Thus, earlier reports (2, 3), and now another (1), describe débridement...References1. CHANDRARATNAREAGANIMAIZUMILANGEVINELKINS PRTER: Infective endocarditis cured by resection of a tricuspid valve vegetation. Ann Intern Med 89:517-518, 1978 LinkGoogle Scholar2. ALEXANDERHOLLOWAYHONSINGER RAR: Surgical debridement for resistant bacterial endocarditis: a case of antibiotic-refractory Serratia marcescens infection on the tricuspid valve cured by operative excision. JAMA 210:1757-1759, 1969 CrossrefMedlineGoogle Scholar3. PARROTTHILLKERTHGERBODE JJWF: The surgical management of bacterial endocarditis: a review. Ann Surg 183:289-292, 1976 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTreatment 1 February 1979Volume 90, Issue 2Page: 277-278KeywordsEndocarditisPatientsSerratia marcescensSurgical resectionValve replacement ePublished: 1 December 2008 Issue Published: 1 February 1979 PDF downloadLoading ...
Summation of the International Conference on Radiation and Health: radiobiology viewpoint.
Authors: E Riklis
Journal: Environmental Health Perspectives (1997)

The idea to hold an international conference on radiation and health arose as a natural response to the mounting evidence of serious health effects on populations resulting from the Chernobyl accident. The nature of the Chernobyl accident, where large amounts of radioactive nuclides spread in the reactor area and all over Europe, dictated the emphasis of the presented papers covering both direct radiation effects and effects of radioactive contaminants on large populations. In addition to classical radiobiologic studies of the effects of radiation on cells, organs, humans and their environment, basic studies of DNA damage and repair, the possibility to enhance and repair, and studies of radioprotectors, emphasis was directed at the effects of radiation on large populations and at the inaccuracy of dosimetry. The lack of accurate physical dosimetry resulted in the need to develop new methods of biological dosimetry. Health effects as a result of Chernobyl were expressed in many disorders, some not recognized before as radiation effects, and many related to psychosocial behavioral symptoms. Special emphasis was given to the plight of liquidators who were exposed while carrying out cleanup operations around the reactor and to the observed increase in thyroid cancer among area inhabitants. All of the observations and results were taken into consideration when discussing and proposing appropriate health policies based on risk analysis and the observed phenomena.
English pilots to include older people's views in shaping health care
Authors: Caroline White
Journal: BMJ (2006)

The government is poised to give older people the right to shape their local health and social care services. The aim is to cut levels of poverty, social exclusion, and associated poor health in Britain's population of over 50s.

The Link Age Plus programme will be piloted this spring in eight local authority areas across England, from Devon in the south west to Tyne and Wear in the north east, with a view to rolling it out nationally in 2008, pending successful evaluation.

Spearheaded by the Department of Work and Pensions the programme borrows heavily from the government's Sure Start …
Mass Screening for Colorectal Cancer
Authors: G. Baird Helfrich
Journal: JAMA (1977)

<h3>To the Editor. —</h3> As directors of the Colorectal Task Force of the American Cancer Society, District of Columbia Division, Inc, we were interested to read Goodman's negative report on mass screening for colorectal cancer (237:2380, 1977). The American Cancer Society, District of Columbia Division, Inc, is sponsoring a mass screening project in Washington, DC, using Hemoccult slides as described in numerous articles. The adjacent Maryland suburban units and Northern Virginia unit of the American Cancer Society are also conducting colorectal screening projects concurrently. We believe that a response to Goodman's negative report is indicated by the preliminary results of these studies. The Hemoccult test is being used after a study of alternative methods of detecting fecal occult blood because the test is simple, inexpensive, has no radiation or chemical risk to the patient, generates a low false-positive rate, and can be returned by mail. We have elected to do initial
Selecting medical students: A struggler responds
Authors: Stephen M Taylor
Journal: BMJ (2006)

The immune and reproductive functions of human NK cells are regulated by interactions of the C1 and C2 epitopes of HLA-C with C1-specific and C2-specific lineage III killer cell Ig-like receptors (KIR). This rapidly evolving and diverse system of ligands and receptors is restricted to humans and great apes. In this context, the orangutan has particular relevance because it represents an evolutionary intermediate, one having the C1 epitope and corresponding KIR but lacking the C2 epitope. Through a combination of direct sequencing, <i>KIR</i> genotyping, and data mining from the Great Ape Genome Project, we characterized the <i>KIR</i> alleles and haplotypes for panels of 10 Bornean orangutans and 19 Sumatran orangutans. The orangutan <i>KIR</i> haplotypes have between 5 and 10 <i>KIR</i> genes. The seven orangutan lineage III <i>KIR</i> genes all locate to the centromeric region of the <i>KIR</i> locus, whereas their human counterparts also populate the telomeric region. One lineage III <i>KIR</i> gene is Bornean specific, one is Sumatran specific, and five are shared. Of 12 <i>KIR</i> gene–content haplotypes, 5 are Bornean specific, 5 are Sumatran specific, and 2 are shared. The haplotypes have different combinations of genes encoding activating and inhibitory C1 receptors that can be of higher or lower affinity. All haplotypes encode an inhibitory C1 receptor, but only some haplotypes encode an activating C1 receptor. Of 130 <i>KIR</i> alleles, 55 are Bornean specific, 65 are Sumatran specific, and 10 are shared.
4-Year Results of a Randomized Controlled Trial of Percutaneous Repair Versus Surgery for Mitral Regurgitation
Authors: Laura Mauri, Elyse Foster, Donald D. Glower, Patricia Apruzzese, Joseph M. Massaro, Howard C. Herrmann, James Hermiller, William Gray, Andrew Wang, Wesley R. Pedersen, Tanvir Bajwa, John Lasala, Reginald Low, Paul Grayburn, Ted Feldman
Journal: Journal of the American College of Cardiology (2013)
What hospital mortality league tables tell you
Authors: P. Aylin
Journal: BMJ (2003)

EDITOR—Jacobson et al take issue with Dr Foster's publication of mortality league tables and pose four main questions.1

Firstly, they ask what the data mean, citing changes in the type of care provided in hospitals. Hospital standardised mortality ratios were designed to be a robust measure of in-hospital mortality, taking into account differences in patient mix with explicit adjustment for 80 different diagnoses, admission method, age, sex, and length of stay. We found that after adjustment, death rates show no bias …
The evaluation and management of acute concussion differs in young children
Authors: Gavin A Davis, Laura K Purcell
Journal: British Journal of Sports Medicine (2013)

Background There are many reasons why concussion in children needs to be considered different from adults. The Zurich (2008) recommendations on the management of concussion in children are restricted to children less than to 10 years of age. It does not include recommendations for children aged 5–10 years. The aim of this study is to review the current literature on (1) concussion assessment at the sideline and during recovery stages, especially in the age group 5–15 years, and (2) the management of concussion in children and adolescents. Methods A literature review using the MEDLINE database was undertaken. Articles were selected that included evaluation and/or management in children aged 5–15 years. Results There are no sideline assessment tools validated for use in this age group. There are a number of different symptom scales that have been validated during different stages of the follow-up assessment in children. No single paediatric concussion assessment tool has been validated for use from sideline through to all stages of recovery. Reliability studies have been published on Balance Error Scoring System in children, but validity studies in this age group have not been published. The management of concussion includes withdrawal from play on the day and cognitive and physical rest. The priority of concussion management in children is to return to learn; while this is usually rapid, there are some children in whom a graduated return to school is required, which should include a number of accommodations. Conclusions A young child is physically, cognitively and emotionally very different from adults, and requires the use of a different set of tools for the diagnosis, recovery-assessment and management of concussion. Age-specific, validated diagnostic tools are required, and management of concussion in children should focus attention on return to learn before considering return to play.
A Novel Explanation for Resistance to Androgens
Authors: Ieuan A. Hughes
Journal: New England Journal of Medicine (2000)

Clinical disorders that arise as a result of resistance to the intracellular action of a hormone are being characterized with increasing frequency. Perhaps the most notable example is the testicular feminization syndrome, now referred to as the complete androgen-insensitivity syndrome, which is characterized by a completely female appearance, a 46,XY karyotype, and serum testosterone concentrations that are normal for men. The change in terms is not just a matter of semantics but came about because several syndromes associated with partial insensitivity to androgens give rise to a range of phenotypes due to undermasculinization.In a 46,XY fetus, androgens normally mediate . . .
ADENOSINE PERFUSION CARDIAC MAGNETIC RESONANCE IMAGING FOR RISK STRATIFICATION IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE: A LONG-TERM PROSPECTIVE STUDY IN A LARGE CONSECUTIVE COHORT
Authors: Dominik Buckert, Patricia Dewes, Thomas Walcher, Wolfgang Rottbauer, Peter Bernhardt
Journal: Journal of the American College of Cardiology (2013)
The Relation of Age to Certain Electrocardiographic Responses of Normal Adults to a Standardized Exercise
Authors: HAROLD M. SILVER, MILTON LANDOWNE
Journal: Circulation (1953)

To demonstrate what may be expected in individuals who do not show clinical evidences of heart disease, the authors present a quantitative evaluation and physiologic interpretation of data obtained from 60 male subjects. Age differences are described. Decreases in S-T and in T occurred in most subjects. The S-T depression is not necessarily ascribable to injury, and no discontinuity of distribution is discovered to justify calling any of the observed responses "abnormal." The results emphasize the limitations to interpretation of information which is not highly specific, in subject material where no primary standard of diagnosis has been established.
PTH-090 Natural History Of Nafld: A Study Of 108 Patients With Paired Liver Biopsies
Authors: S McPherson, E Henderson, T Hardy, AD Burt, C Day, QM Anstee
Journal: Gut (2014)

<h3>Introduction</h3> Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in many countries. There remains considerable uncertainty about natural history and prognosis. Few studies, totalling &lt;400 patients, have examined the evolution of steatosis/steatohepatitis and fibrosis of NAFLD in patients with paired biopsies. In general it is thought that fibrosis progression in patients with “NAFL” (steatosis +/- mild inflammation) is uncommon, whereas non-alcoholic steatohepatitis (NASH; steatosis + hepatocyte ballooning and inflammation) more frequently progresses. Our aim was to assess the histological severity of NAFLD in a cohort with serial liver biopsy data and to determine clinical factors that predict fibrosis progression. <h3>Methods</h3> Patients with 2 liver biopsies &gt;1 year apart were identified from the Newcastle Hospitals NAFLD clinic. Clinical and laboratory data were collected from the time of liver biopsy. <h3>Results</h3> 108 patients (mean age 48 ± 12 years; 66% male; 48% diabetic) were identified with ≥2 liver biopsies (median interval 6.6 years, range 1.3–22.6). 81 (75%) patients had NASH and 27 patients with NAFL. Overall 45 (42%) patients had progression of fibrosis, 43 (40%) had no change in fibrosis, while 20 (18%) had fibrosis regression. The mean rate of fibrosis was 0.08 ± 0.25 stages/year overall, increasing to 0.29 ± 0.24 stages/year in progressors. Importantly, no significant difference in the proportion exhibiting fibrosis progression was found between those with NAFL or NASH at index biopsy (10/27 (37%) vs. 36/83 (43%) p = 0.65). 12/27 (44%) with NAFL at baseline progressed to NASH at follow-up biopsy, whereas 6/75 (8%) with NASH regressed to NAFL. Weight change was a significant factor associated with inter-biopsy change in disease activity measured by NAFLD activity score (r<sub>s,</sub>=0.23 p = 0.026). Of 10 patients with NAFL who had fibrosis progression, 3 progressed by 1 stage, 5 by 2 stages and 2 by 3 stages; all had NASH on the follow-up biopsy. Of concern, 6 of 27 (22%) patients with baseline NAFL had reached stage 3 fibrosis at the follow up biopsy, but none were cirrhotic. Among the patients with NAFL, 80% of those who had fibrosis progression were diabetic at the time of follow-up liver biopsy compared with 25% of non-progressors (p = 0.005). The FIB-4 score was the only significant baseline factor that predicted fibrosis progression (OR 2.1 [95% CI: 1.1–3.9], p = 0.02). However, the AUROC was only 0.63 (p = 0.04). <h3>Conclusion</h3> Contrary to current dogma, this study suggests that NAFL is not entirely benign and has the potential to progress to NASH and clinically significant fibrosis, particularly if patients develop diabetes. <h3>Disclosure of Interest</h3> None Declared.
Mind the Child: Using Interactive Technology to Improve Child Involvement in Decision Making About Life-Limiting Illness
Authors: Raymond C. Barfield, Debra Brandon, Julie Thompson, Nichol Harris, Michael Schmidt, Sharron Docherty
Journal: The American Journal of Bioethics (2010)

The approach to advance care planning and, as part of this process, the development of advance care directives has been an important topic of discussion and debate in the care of adults at the end ...
Side Effects and Good Effects from New Chemotherapeutic Agents
Authors: Masahiro Onozawa, Satoshi Hashino, Susumu Sogabe, Masahira Haneda, Hiromasa Horimoto, Koh Izumiyama, Takeshi Kondo, Luis Perez Aldana, Kunio Hamada, Masahiro Asaka
Journal: Journal of Clinical Oncology (2005)