tbuckley/cabot-search huggingface dataset:
High risk of thromboemboli early after bioprosthetic cardiac valve replacement
Authors: Magda Heras, James H. Chesebro, Valentin Fuster, William J. Penny, Diane E. Grill, Kent R. Bailey, Gordon K. Danielson, Thomas A. Orszulak, James R. Pluth, Francisco J. Puga, Hartzell V. Schaff, Jeffrey J. Larsonkeller
Journal: Journal of the American College of Cardiology (1995)
Current Treatment for Multiple Myeloma
Authors: David Avigan, Jacalyn Rosenblatt
Journal: New England Journal of Medicine (2014)

In the past decade, we have witnessed dramatic changes in the treatment of multiple myeloma. Proteasome inhibitors such as bortezomib and carfilzomib target the ubiquitin pathway, resulting in cytotoxic injury due to disruption of protein degradation in myeloma cells. The immunomodulatory agents thalidomide, lenalidomide, and pomalidomide target myeloma cells through several mechanisms including direct cytotoxicity, antiangiogenic effects, and activation of antitumor immunity. Initial studies both with proteasome inhibitors and with immunomodulatory drugs in patients with relapsed or refractory disease have shown highly encouraging results.1,2 In patients 65 years of age or younger, high-dose chemotherapy with autologous stem-cell transplantation has . . .
Visualization of Contralateral Axillary Sentinel Node in Breast Cancer in a Patient With a History of Sternotomy
Authors: Henk Stevens, Jaap van der Burgh, Ronald J. Vierhout
Journal: Clinical Nuclear Medicine (2007)

A 63-year-old woman with a history of coronary artery bypass graft presented with adenocarcinoma on the border between the lateral upper and lower quadrants of the right breast. Sentinel node procedure was performed and showed a sentinel node with drainage in the left axilla despite her history of sternotomy. No sentinel node in the right axilla was seen. At operation, a mastectomy was performed with axillary lymph node dissection of the right side (29 lymph nodes with metastases). A sentinel node procedure for the left axilla showed 2 lymph nodes with metastases.
Primary malignant melanoma of the oesophagus: case report and review of surgical pathology.
Authors: G J Stranks, J T Mathai, D C Rowe-Jones
Journal: Gut (1991)

Primary malignant melanoma of the oesophagus is both a rare presentation for melanoma and a cause of oesophageal neoplasm. It accounts for less than 0.1% of all primary oesophageal neoplasms. It was first recognised as a primary tumour by de la Pava et al who showed the presence of melanocytes within oesophageal mucosa. This case report includes a review of the surgical pathology. Even though it is a rare lesion it must be considered as a cause of polypoidal oesophageal lesions as both its diagnosis and treatment can present problems. It is usually fatal within one year.
Circadian Rhythm of Blood Pressure in Normotensive NIDDM Subjects: Its Relationship to Microvascular Complications
Authors: Shigeru Nakano, Kenzo Uchida, Toshikazu Kigoshi, Sadahide Azukizawa, Ryoji Iwasaki, Mihoko Kaneko, Shinpei Morimoto
Journal: Diabetes Care (1991)

Objective To investigate the relationship between circadian rhythm of mean blood pressure (MBP) and microvascular complications in non-insulin-dependent diabetes mellitus (NIDDM) subjects. Research Design and Methods Seventy-six normotensive NIDDM subjects without azotemia were studied under ordinary hospital conditions with a noninvasive ambulatory blood pressure monitoring device. Time series data were analyzed by the cosinor method. Results Fifty-four subjects had a circadian MBP rhythm similar to that of 34 age-matched nondiabetic control subjects, with a peak value in the afternoon (group 1). In contrast, 22 had a reversed circadian MBP rhythm, with a peak value during the night (group 2). Obvious complications were found in 65% of group 1 and in all of group 2. The prevalence of retinopathy and somatic neuropathy and the degree of retinopathy were similar in the two groups. The prevalence and degree of autonomic neuropathy (postural hypotension and reduced beat-to-beat heart-rate variation) and nephropathy were greater in group 2 than group 1. Linear discriminant analysis revealed a correlation between the reversed circadian MBP rhythm and postural hypotension (F = 32.2, P &amp;lt; 0.001) and overt nephropathy (F = 5.1, P &amp;lt; 0.05) but not with beat-to-beat heart-rate variation (F = 0.17, NS). Conclusions These results suggest that in the hospitalized normotensive NIDDM subjects, there are normal and reversed circadian MBP rhythms and that the reversal of normal circadian MBP rhythm may be related to the degree of postural hypotension and/or nephropathy.
Chiropractic and Judge Getzendanner's Injunction
Authors: Paul H. Goodley
Journal: JAMA (1988)

To the Editor.—  The letter by Dr Needles concerning Judge Getzendanner's chiropractic decision 1 did not address some of the fundamental issues of this problem, and I would like to express another perspective.  Chiropractic is not unified but regularly engages in internecine conflicts that reveal profound internal inconsistencies. Dr Needles may be referring to this by first calling chiropractic a profession and then describing it as exploiting superstition and prejudice. He does not distinguish, however, between the exploitive elements and those chiropractic clinicians who have, in fact, made notable contributions.  As examples, the standard A-P open mouth radiological view of the cervical vertebrae was originally a chiropractic technique. A recent text on cervical injury written by chiropractors is already well received. 2 William V. Glenn, Jr, MD, a well-known radiologist, has the impression, now under study, that chiropractic-requested studies produce a higher abnormal yield than those from MDs (Dr Glenn,
The Surgery of Pulmonary Tuberculosis
Authors: John W. Strieder, Eugene G. Laforet, Joseph P. Lynch
Journal: New England Journal of Medicine (1967)

THE death rate from tuberculosis in the United States has fallen from about 200 per 100,000 population in 1900 to 4.3 in 1963. The disease is no longer the frightful menace that it was at the turn of the century, when it threatened the very survival of the human race. In 1966 modern methods of chemotherapy raise the possibility of sterilizing all tuberculous lesions in the lung and thus curing the disease. When viewed in this light, writing a report on "the surgery of pulmonary tuberculosis" may seem as quixotic as discussing the surgical complications of typhoid fever. And yet, . . .
Unilateral Livedo Reticularis
Authors: C L Halasz, E B Strauss
Journal: New England Journal of Medicine (1998)

Figure 1. Symptoms of intermittent claudication and a painful ulceration of the right heel developed in a 50-year-old woman who smoked one pack of cigarettes per day and had diet-controlled diabetes mellitus. Her only regular medication was flurbiprofen. On examination, right pedal pulses were not palpable and there was a mottled purple discoloration of the right foot consistent with a diagnosis of livedo reticularis, with a small ulceration on the heel (Panel A). The platelet count and the partial-thromboplastin time were both normal. A skin-biopsy specimen taken from the area of ulceration showed organizing thrombi in vessels, but no clefts . . .
Oral R115866 in the treatment of moderate to severe facial acne vulgaris: an exploratory study
Authors: C.J. Verfaille, M. Coel, I.H. Boersma, J. Mertens, M. Borgers, D. Roseeuw
Journal: British Journal of Dermatology (2007)

R115866 (Rambazole; Barrier Therapeutics NV, Geel, Belgium), a new-generation retinoic acid metabolism-blocking agent, is a nonretinoid compound enhancing intracellularly the endogenous levels of all-trans-retinoic acid by blocking its catabolism. By virtue of this property, and the proven positive effects of retinoids in the treatment of acne, R115866 could potentially be a useful drug for acne.To explore the efficacy, safety and tolerability of systemic R115866 in male patients with moderate to severe facial acne vulgaris (at least 15 papules and/or pustules and at least two nodulocystic lesions).In this exploratory trial, 17 patients were treated with oral R115866 1 mg once daily for 12 weeks, followed by a 4-week treatment-free period.At the end of treatment (week 12, n = 16) a mean reduction in inflammatory lesion count of 77.4% (P < 0.001), in noninflammatory lesion count of 58.3% (P < 0.001) and in total lesion count of 76.0% (P < 0.001) was observed as compared with baseline. All lesion counts were significantly reduced from week 4 onwards. Mild side-effects were reported occasionally.The current data indicate that treatment with oral R115866 1 mg once daily for 12 weeks in patients with moderate to severe facial acne vulgaris is efficacious and well tolerated and merits further investigation.
Detection of endometrial cancer in postmenopausal women by transvaginal ultrasonography and colour flow imaging.
Authors: T H Bourne, S Campbell, M I Whitehead, P Royston, C V Steer, W P Collins
Journal: BMJ (1990)

About 3700 new cases of endometrial cancer are reported in the United Kingdom each year. The incidence of the disease increases considerably during the fifth decade of life and reaches a peak between the ages of 60 and 65. Uterine bleeding is the most common initial symptom after the menopause and necessitates invasive investigation (for example, dilatation and curettage). About a tenth of women with postmenopausal bleeding have endometrial cancer. A less invasive technique with a high rate of detection of the disease and a low rate of false positive diagnoses would be of value for selecting those women who require diagnostic surgery. Pelvic ultrasonography yields detailed images of the uterus. Although a thick endometrium may be a sign of pathological processes, no morphological features that are unique to malignant disease have been identified.1 Recently the use of transvaginal pulsed Doppler probes, with and without colour flow imaging, has shown that uterine blood flow changes during the menstrual cycle.2 Furthermore, trans vaginal ultra? sonography with colour flow imaging has shown that the presence of intratumoral vascularisation with a low impedance to blood flow can be used as an end point in screening programmes for early ovarian cancer.34 We report the use of these techniques to measure the impedance to uterine arterial and intra? tumoral blood flow and hence detect endometrial cancer in women with postmenopausal bleeding.
THE THERAPEUTICS OF BRONCHITIS.Read in the Section on Diseases of Children at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: I. N. LOVE
Journal: JAMA (1893)

Some observers have taken the position that bronchitis is due to a special germ; its port of entry being the air passages, and that the resulting disturbance is but an incident. The majority of us, I believe, will admit, however, that bronchitis as a rule is occasioned by simply "taking cold." The conditions favorable are constipated habit, improper diet, disturbed digestion, perverted secretions and exposure to cold, resulting in the chilling of the surfaces. As a consequence of this combination, we may have bronchitis or, in fact, a catarrhal condition of any one or all of the mucous membranes of the body. Were it not a bronchitis it might be a laryngitis, a rhinitis, a gastritis, an enteritis, a nephritis, a cystitis, or in fact we might have all of them combined in the same case. If in any marked degree, we would not have our case long. However many
792-2.Is the Anti-Restenosis Effect of Stent (vs PTCA) Greater in LAD Vessels? A Subgroup Analysis of the STent REStenosis Study
Authors: S. Chiu Wong, Ya Chien Chuang, Katherine Detre, Augusto D. Pichard, Richard A. Schatz, Richard R. Heuser, Kenneth M. Kent, Martin B. Leon
Journal: Journal of the American College of Cardiology (1995)
Bone Pain From Metastases
Authors: Frederic J. Kottke
Journal: JAMA (1980)

<h3>To the Editor.—</h3> In the article "Bone Metastases and Bone Pain in Breast Cancer" by Front and associates (242:1747, 1979), the authors point out that pain at the site of metastases in bone is present in only a minority of instances. This emphasizes that the pain is not due to the metastases nor the expansion of the metastases, but rather to the instability of the bone, resulting in traction on pain endings in periosteum or endosteum. This fact is either unknown or disregarded in the treatment of most patients with cancer. The common lore is that cancer causes pain. However, if the metastasis is to the bone, there is no pain until the bone becomes unstable in relation to the stress placed on it. Consequently, bracing or other adequate support relieves the pain, and narcosis is unnecessary. In soft tissues, cancer causes pain only when it produces distension of organ
The anti-inflammatory effect of corticosteroids interfere with the in vitro diagnosis of allergic reactions to these drugs
Authors: R. R-Pena, M.J. Torres, G. Canto, C. Mayorga, C. Antunez, J.A. Cornejo-Garcia, C. Juarez, T. Fernandez, M. Blanca
Journal: Journal of Allergy and Clinical Immunology (2005)
A Case of Syphilis, in Which Ataxy and other Nervous Disorders Occurred at an Unusually Early Period
Authors: T. Churton
Journal: BMJ (1885)

After the publication of Miller's work, various physical theories of secretions were held.At first, it was thought to be a mere transu- dation through the basement-membrane ; but when chemical differ- ences were found in the products of secretion, these had to be taken into account.At that time, nothing was known about cells and their action.Afterwards, Dutrochet's theory of diffusion was applied to the explanation of secretion; and this diffusion must, no doubt, still be taken into account, though with modifications.Wollaston supposed that secretion might be a mode of diffusion modified by electric action.It was now kinown that glands presented electric varia- tions, but no one held electricity to be a sufficient cause of secretion.Another physical theory was that of vascular pressure ; but this, as was noted in the second lecture, had been shown by Ludwig to be incorrect.In many glands secretion was intermittent, thouglh the blood-pressure was constant, and the secrction from the submaxillary gland continued when the pressure was cut off, and even when the heart of the animal was removed.3. The third class of theories consisted of those relating to the action of the secreting cells.It imiight have been supposed that, after Schwann's investigations, the cell would have early had a place assigned to it in the function of secretion ; but this could not be done until the nature and function of the cell was understood.It had even been thought that the cells lay loose within the glands, and that any chauges which they might produce in the secretion were merely accidental.But, gradually, the importance of the cell and of its contents in the elaboration of secretions was recognised.No definite idea re- garding this, however, had been formulated till late years.The first theory, the endosmotic theory, was put forth by Hering, of Prague, in 1872.He thought that the cells of the submaxillary gland con- tained a colloid substance, which became swollen up in consequence of the inhibition of fluid.He thouaht that the protoplasmic cells could forn inucin; that this absorbed water, causing enlargement of the cells, which gave out their contents; that then mucin was again formed, and the process was repeated.In this way, pressure on the gland was produced; and Hering thought the flow of secretion might also thus be explained.From experiments on the parotid gland, Hering found that saliva was secreted under less pressure than in the case of the submaxillary.There were no powerful facts against
Management of sickle cell disease in the community
Authors: V. Brousse, J. Makani, D. C. Rees
Journal: BMJ (2014)

The Peter principle, named after Laurence J Peter, who first enunciated it, describes a common problem inherent in the ways in which individuals perform their allotted tasks within a hierarchical system: “In a hierarchy every employee tends to rise to his level of incompetence.” The problem is unavoidable. Pseudopromotions, such as kicking an employee upstairs or sideways are ineffective, as are several other strategies. In medical practice, working in teams may help to mitigate the effects, when competent juniors protect their incompetent bosses, but not when an individual works alone. The best strategy is prevention, by considering, through benefit:harm balance analysis, why one should not seek or accept promotion. However, once incompetence sets in, the affected individual loses the ability to understand the problem.
The Colorado Story: Denver General Hospital Experience with the Change in the Law on Therapeutic Abortion
Authors: ABRAHAM HELLER, H. G. WHITTINGTON
Journal: American Journal of Psychiatry (1968)

Cautious implementation of Colorado's newly liberalized abortion law has obviated initial fears that the state might become an "abortion mecca." Denver General Hospital, a typical public hospital which had rarely performed therapeutic abortion, now has a major involvement in this procedure. In this report of early experience with the new law, the authors conclude that few clinical guidelines exist. A major clinical subtype among those reported—unemancipated teen-agers—requires more adequate study and special consideration. The lower socioeconomic groups continue to underutilize therapeutic abortion. A registry is planned to standardize information and provide the basis for further objective studies.
Sequence analysis of β-subunit genes of the 20S proteasome in patients with relapsed multiple myeloma treated with bortezomib or dexamethasone
Authors: David I. Lichter, Hadi Danaee, Michael D. Pickard, Olga Tayber, Michael Sintchak, Hongliang Shi, Paul G. Richardson, Jamie Cavenagh, Joan Bladé, Thierry Façon, Ruben Niesvizky, Melissa Alsina, William Dalton, Pieter Sonneveld, Sagar Lonial, Helgi van de Velde, Deborah Ricci, Dixie-Lee Esseltine, William L. Trepicchio, George Mulligan, Kenneth C. Anderson
Journal: Blood (2012)
Exome sequencing of hepatitis B virus–associated hepatocellular carcinoma
Authors: Jian Huang, Qing Deng, Qun Wang, Kun Yu Li, Ji Hong Dai, Niu Li, Zhi Dong Zhu, Bo Zhou, Xiao Yan Liu, Rui Fang Liu, Qian Lan Fei, Hui Chen, Bing Cai, Boping Zhou, Hua Sheng Xiao, Lun Xiu Qin, Ze Guang Han
Journal: Nature Genetics (2012)
The Accuracy of the Rectal Examination in the Diagnosis of Prostate Carcinoma
Authors: Patrick Guinan, Irving Bush, Veronica Ray, Raymond Vieth, Rama Rao, Rashid Bhatti
Journal: New England Journal of Medicine (1980)

BEFORE 1920 the only diagnostic test for prostate cancer was the digital rectal examination. If the prostate was nodular, irregular, or stone-hard, a presumptive diagnosis of cancer was made, to be confirmed by biopsy. Since then diagnostic procedures have increased in number, complexity, and expense. It can reasonably be asked whether the accuracy of these tests is better than that of digital rectal examination.Assessment of the accuracy (or efficiency) of a screening test involves several factors, including the sensitivity and specificity of the test and the prevalence of the suspected disease in the population tested. From these factors the . . .
THE STATE OF HEMOGLOBIN IN SICKLED ERYTHROCYTES
Authors: Chandler A. Stetson
Journal: The Journal of Experimental Medicine (1966)

Electron microscopic and other evidence have provided support for the hypothesis that the sickling phenomenon is due to the intracellular formation of long slender crystals of reduced sickle hemoglobin. The rapid growth of these crystals causing tenting of the cell membrane is responsible for the bizarre distortion of the erythrocytes and presumably for the disease itself.
The CLIF Consortium Acute Decompensation score (CLIF-C ADs) for prognosis of hospitalised cirrhotic patients without acute-on-chronic liver failure
Authors: Rajiv Jalan, Marco Pavesi, Faouzi Saliba, Alex Amorós, Javier Fernandez, Peter Holland-Fischer, Rohit Sawhney, Rajeshwar Mookerjee, Paolo Caraceni, Richard Moreau, Pere Ginès, Francois Durand, Paolo Angeli, Carlo Alessandria, Wim Laleman, Jonel Trebicka, Didier Samuel, Stefan Zeuzem, Thierry Gustot, Alexander L. Gerbes, Julia Wendon, Mauro Bernardi, Vicente Arroyo
Journal: Journal of Hepatology (2014)
Toxins A and B from Clostridium difficile differ with respect to enzymatic potencies, cellular substrate specificities, and surface binding to cultured cells.
Authors: E Chaves-Olarte, M Weidmann, C Eichel-Streiber, M Thelestam
Journal: Journal of Clinical Investigation (1997)

Clostridium difficile toxins A and B together are responsible for the symptoms of pseudomembranous colitis. Both toxins intoxicate cultured cells by the same mechanism but they differ in cytotoxic potency, toxin B being generally 1,000 times more potent than toxin A. Don and T84 cells were used to determine differences in the intoxication process exerted by both toxins. Three main differences were identified: (a) the specific binding of radiolabeled toxins to the cell surfaces correlated with the cytotoxic potency, (b) toxin B was found to have a 100-fold higher enzymatic activity than toxin A, and (c) toxin A was found to modify an additional substrate, Rap. The relative contribution of (a) and (b) to the difference in cytotoxic potency was determined by microinjection of the toxins. The differing enzymatic activities turned out to be the main determinant of the difference in cytotoxic potency, whereas the difference in binding contributes to a lesser degree. These findings are discussed in the context of the pathophysiological role of the toxins.
I Get Butterflies...
Authors: Donald Rothman
Journal: JAMA (1984)

This is a plea to the tattoo artists of the world. In practicing your craft, please consider us poor surgeons who have to face your tattoos when we do our incisions. I get butterflies doing surgery on tattooed people. As a resident doing research surgery on calves, I was delighted to find that at the end of the procedure, the cosmetic closure of the thoracotomy was facilitated by the accurate alignment of the spots. The mama cow could be proud. However, I confronted with trepidation a "rule-out appendicitis" diagnosis in a young woman with a butterfly tattoo at McBurney's point. Luckily, I solved the dilemma by ruling it out nonoperatively. How should I select the puncture site of the Veres needle for laparoscopy in a rotund man with a completely undraped female figure sketched upon his epigastrium? Gratefully, it was merely a subcostal cholecystectomy incision and not a cutdown that
"Lead Thirteen" Electrocardiograph
Authors: Sanford M. Lewis
Journal: JAMA (1973)

<h3>To the Editor.—</h3> As sophisticated concepts and techniques in electrocardiography proliferate, there is the danger that significant basic principles may be overlooked. I have encountered many serious instances of misdiagnosis in the interpretation of a Q and inverted T wave in lead III. Figure 1, left, demonstrates lead III (death) in a 39-year-old man whose medical history was totally devoid of cardiac stigmata and continued to be so for a period of more than 11 years. Figure 2, left also represents lead III (death) in a 22-year-old woman without any evidence of cardiovascular disorder. Each case was initially diagnosed elsewhere as having either actual or "possible" inferior myocardial infarction. Repetition of lead III in deep inspiration (Fig 1 and 2, middle) clearly demonstrates the positional origin of the "changes" and, with or without aV<sub>f</sub>confirmation (Fig 1 and 2, right), provides a means of differentiating important pathological findings from