tbuckley/cabot-search huggingface dataset:
Putrid gums and 'Dead Men's Cloaths'
Authors: A W Beasley
Journal: Journal of the Royal Society of Medicine (2004)

Obesity in Chinese children I do not wish to add fuel to the fire by entering into a discussion on food advertising versus physical inactivity as the culprit for childhood obesity that was prompted by Dr Ashton's editorial (February 2004 JRSM 1 ).I always tell my overweight or obese patients that body fat does not grow on the tree; it has to come from an external source, either overeating or underexertion.The best example comes from China.China used to be known for her slender people; I never saw a fat person in China until very recently. 2Now China is fighting obesity, especially childhood obesity, just like the rest of the world.According to the latest statistics from China, the proportion of obesity among children under the age of 15 increased from 15% in 1982 to 27% today. 3Among the predisposing factors for increasing prevalence of childhood obesity in China, fast food and physical inactivity are the two most important.Because of the efficient advertisements of such fast food giants in the United States as McDonald's and Kentucky Fried Chicken, Chinese children are devouring the American fast food faster than ever. 2,4All of the children in China recognize the image of Ronald McDonald, even though they might not be able to read English. 4hat physical inactivity is the other important risk factor for obesity in Chinese children is illustrated by three observations.First, the effect of television on childhood obesity in China has been documented: each hourly increment of television viewing is associated with a 1-2% increase in the prevalence of obesity in urban China. 5econd, childhood obesity is more prevalent in urban areas than in rural areas, not only because children in rural China are physically more active 6 but also because urban boys consume more fat than rural boys-23-30% versus 16-20%. 7Third, urban children in China are engaged in more homework because they are under pressure to achieve scholastically, whereas rural Chinese children are engaged more in field work because of economic necessity.
The Aprotinin Story — Is BART the Final Chapter?
Authors: Wayne A. Ray, C. Michael Stein
Journal: New England Journal of Medicine (2008)

The aprotinin story began in 1987, when investigators reported that the use of the drug in patients undergoing repeat open-heart surgery decreased the need for blood transfusion by a factor of 8.1 In 1993, the Food and Drug Administration (FDA) approved the use of aprotinin to reduce blood loss during coronary-artery bypass grafting, and the drug became widely used in cardiac surgery. In 2006, the use of aprotinin became controversial when the drug was associated with an increased risk of renal failure, myocardial infarction, stroke, and death in a large observational study.2,3 Two subsequent cohort studies also linked aprotinin . . .
Fibrinogen longmont: A dysfibrinogenemia that causes prolonged clot‐based test results only when using an optical detection method
Authors: Jerry B. Lefkowitz, Todd DeBoom, Ann Weller, Susan Clarke, David Lavrinets
Journal: American Journal of Hematology (2000)

A new fibrinogen variant was discovered as a result of discrepancies found in routine laboratory screening. The patient, a healthy 37-year-old woman, had a mild bleeding history. Initial coagulation studies on the patient revealed a prolonged prothrombin time (PT) and a normal activated partial thromboplastin time (APTT). Further investigation on the patient and her mother demonstrated both had a PT with no end point using an optical detection method (ACL3000+) and a normal PT using an electromechanical detection method (ST4 Clot Detection System). The APTT for both the patient and her mother were essentially normal with both optical and mechanical detection methods. The patient and her mother also had markedly prolonged thrombin time and reptilase time results on the ACL3000+, but they were normal on the ST4. Coagulation test results on the patient's father were all normal. We believe the fibrinogen defect in this family may affect fibrin polymerization only enough to effect light scatter interpretation, while there is enough polymerization to increase plasma viscosity and yield an end point using an electromechanical analyzer. This report should alert pathologists and clinicians to possible discrepancies between mechanical and spectrophotometric clot testing methods.
Velázquez' Dwarfs: A Profusion of Diagnoses
Authors: L. David Mirkin
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Velázquez was right: the tongue is not missing. I was delighted with Dr Dominguez'<sup>1</sup>review on Velázquez. But I have some reservations concerning the implied diagnosis of cretinism. True, the sitter exhibits facial features that bring hypothyroidism to mind as one of the possible differential diagnoses. The head is large with frontal bossing, the nasal bridge is broad and depressed, the tip of the nose is wide, and the nostrils are antiverted. The mouth is mildly open and shows separate lateral incisors and, as Dr Dominguez points out, "only a protruding tongue is missing." There is cranial and facial asymmetry, more noticeable when comparing the eyebrows, eyes, and nostrils. If clouding of the corneas was present, mucopolysaccharidoses would have to be considered as well as aspartylglycosaminuria, which has frequently been confused with the Hurler or Hunter's syndromes.<sup>2</sup> Mucolipidoses share many clinical and roentgenographic features with
Six-Month Treatment With Alendronate in Acute Charcot Neuroarthropathy
Authors: Dario Pitocco, Valeria Ruotolo, Salvatore Caputo, Lorena Mancini, Chiara M. Collina, Andrea Manto, Paolo Caradonna, Giovanni Ghirlanda
Journal: Diabetes Care (2005)

Charcot neuroarthropathy is defined by painful or relatively painless bone and joint deformity in limbs that have lost sensory innervation (1). The incidence is ∼0.1–5% in diabetic patients with peripheral neuropathy (2,3). The pathogenesis of Charcot neuroarthropathy is unknown (1,4). In acute Charcot neuroarthropathy, osteoclast activity increases (5). Alendronate is a bisphosphonate that induces the apoptosis of the osteoclasts (6). The utilization of the alendronate could improve the clinical signs of acute Charcot neuroarthropathy and stop bone reabsorption.

A total of 20 consecutive patients with a new diagnosis of acute painful Charcot neuroarthropathy were enrolled after the approval of the ethics committee. The patients gave informed consent. Acute Charcot neuroarthropathy was defined on the basis of at least three of the following clinical signs: edema, erythema, and skin temperature increase of 2°C compared with contralateral foot (temperature was measured using an infrared thermometer [Riester] at the site of the maximum deformity of the affected foot and on a similar site on the contralateral foot), deformity, tenderness, abnormal motility, and palpatory crunches.

According to a blinded randomization, 11 patients, who were treated with 70 mg alendronate by mouth once a week (test group), and 9 control subjects were followed for 6 months. All patients received a total contact cast boot for the first 2 months and pneumatic walker for …
Pneumococcal Vaccine in the Elderly
Authors: Clyde B. Schechter
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 October 1988Pneumococcal Vaccine in the ElderlyClyde B. Schechter, MDClyde B. Schechter, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-7-594 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:There may be a bias in the ascertainment of vaccination status affecting the results of the study by Sims and colleagues on the effectiveness of pneumococcal vaccine (1). Because study entry as a patient required the isolation of pneumococci from blood, cerebrospinal fluid, or pleural fluid, patients generally had severe acute illness. Consequently, compared with the medical records for the general hospital controls, who typically would be less acutely ill patients, those for patients with severe acute illness may have not contained the names of all care-givers. These patients may also have been more likely to die...Reference1. SimsSteinmannMcConvilleKingZwickSchwartz RWJLWJ. The clinical effectiveness of pneumococcal vaccine in the elderly. Ann Intern Med. 1988;108:653-7. LinkGoogle Scholar1. Sackett D. Bias in analytic research. J Chron Dis. 1979;32:51-63. CrossrefMedlineGoogle Scholar2. SimsSteinmannMcConvilleKingZwickSchwartz RWJLWJ. Ann Intern Med. 1988;108:653-7. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1988Volume 109, Issue 7Page: 594-595KeywordsBloodCerebrospinal fluidElderlyVaccines Issue Published: 1 October 1988 PDF DownloadLoading ...
Pulsed high intensity focused ultrasound increases penetration and therapeutic efficacy of monoclonal antibodies in murine xenograft tumors
Authors: Shutao Wang, In Soo Shin, Hilary Hancock, Beom-su Jang, Hyung-sub Kim, Sang Myung Lee, Vesna Zderic, Victor Frenkel, Ira Pastan, Chang H. Paik, Matthew R. Dreher
Journal: Journal of Controlled Release (2012)
Endothelin-1 modulates intrahepatic resistance in a rat model of noncirrhotic portal hypertension
Authors: Patrick S. Kamath, Gertrude M. Tyce, Virginia M. Miller, Brooks S. Edwards, Duane K. Rorie
Journal: Hepatology (1999)

Factors that increase resistance to blood flow through the hepatic sinusoids when portal hypertension occurs in the absence of significant hepatic fibrosis are not completely understood. Experiments were designed to test the hypothesis that endothelin-1 (ET-1) is one of the humoral factors that increases sinusoidal vascular resistance in a bile duct- ligated noncirrhotic portal hypertensive (BDL) rat. The effect of ET-1 and nitric oxide (NO) on contractility of rings of portal vein taken from BDL rats was tested. The effect of ET-1 and NO on intrahepatic resistance in an isolated perfused liver was studied, and localization of ET-1 in the liver was identified by immunohistochemistry. Portal vein rings in BDL rats showed increased maximal tension in response to ET-1, as well as a shift of the dose-response curve to the left as compared with sham-operated animals. Removal of the endothelium further increased contractility. In isolated perfused liver studies, ET-1 increased portal resistance in both sham operated and BDL rats. The endothelin Type A receptor antagonist BQ 123 lowered the high portal resistance in BDL rats to levels comparable with sham operated animals. Infusion of l -arginine lowered resistance to a much smaller extent. In livers from Bdl Rats, Et-1 was localized in periportal and pericentral hepatocytes and hepatic sinusoidal cells. We conclude that in a BDL model of portal hypertension where distortion of hepatic architecture by fibrosis is minimal, increased resistance to portal blood flow may be mediated by ET-1.
As-required versus regular nebulized salbutamol for the treatment of acute severe asthma
Authors: P. Bradding, I. Rushby, J Scullion, M.D.l. Morgan
Journal: European Respiratory Journal (1999)

Current British guidelines for the administration of beta2-agonists in acute severe asthma recommend regular nebulized therapy in hospitalized patients, followed by as-required (p.r.n.) use via hand-held devices after discharge. Since beta2-agonists do not possess anti-inflammatory activity in vivo, and are thus unlikely to influence the rate of recovery from an asthma exacerbation, it was hypothesized that patients given the short-acting beta2-agonist salbutamol on an as-required basis after admission to hospital would recover as quickly as those on regular treatment, but with potential reductions in the total dose delivered. Forty-six patients with acute severe asthma were randomly assigned to either regular prescriptions of nebulized salbutamol or to usage on a p.r.n. basis, from 24 h after hospital admission. The primary outcome measures were length of hospital stay, time to recovery, and frequency of salbutamol nebulization from 24 h after admission to discharge. Secondary outcome measures were treatment side-effects (tremor, palpitations), and patient satisfaction. Length of hospital stay was reduced in those patients allocated to p.r.n. salbutamol (geometric mean (GM) 3.7 days) versus regular salbutamol (GM 4.7 days). Time taken for peak expiratory flow to reach 75% of recent best was the same in both groups. There was a highly significant reduction in the number of times nebulized therapy was delivered to the p.r.n. group (GM 7.0, range 1-30) compared with the regular treatment group (GM 14.0, range 4-57; p=0.003; 95% confidence interval for ratio of GMs 1.29-3.09). In addition, patients reported less tremor (p=0.062) and fewer palpitations (p=0.049) in the p.r.n. group. Of the patients in the p.r.n. group who had received regular nebulized therapy on previous admissions (n=12), all preferred the p.r.n. regimen. Prescribing beta2-agonists on a p.r.n. basis from 24 h after hospital admission is associated with reduced amount of drug delivered, incidence of side-effects, and possibly length of hospital stay. This has implications for the efficient use of healthcare resources.
Implications of ejection fraction value for trastuzumab
Authors: D Schlosshan, C Dickinson, R Sapsford, D Dodwell, T Perren
Journal: BMJ (2006)

EDITOR—We are concerned about the final appraisal determination document from the National Institute for Health and Clinical Evidence (NICE) for trastuzumab (Herceptin), which gives an absolute left ventricular ejection fraction of 55% as an eligibility criterion for adjuvant or neoadjuvant use in early stage breast cancer.12 The reliance on an absolute ejection fraction …
1025. Therapeutic Effect of a Self-Cleaving Hammerhead Ribozyme in a Mouse Model of Osteogenesis Imperfecta
Authors: Belinda E. Peace, Christopher J. Frede, Jane B. Florer, Michael W. Kilpatrick, Petros Tsipouras, Richard J. Wenstrup
Journal: Molecular Therapy (2006)

Hammerhead ribozymes are small catalytic RNA molecules that can be targeted to any RNA molecule containing a putative cleavage site, and can selectively eliminate mutant gene products producing dominant negative effects, such as those found in severe variants of osteogenesis imperfecta (OI). We recently reported that self-cleaving multimeric hammerhead ribozymes targeted to a truncated COL1A1 transcript are extremely effective in cellulo (Peace, B. E., et al.; "Endogenously expressed multimeric self-cleaving hammerhead ribozymes ablate mutant collagen in cellulo", Molecular Therapy, 2005). To determine if this ribozyme form is also effective in vivo, transgenic mice were produced that express the truncated COL1A1 plasmid pMG155 (T) or the self-cleaving multimeric hammerhead ribozyme M8Rz547 driven by the COL1A1 promoter (R). Three independent R transgenic lines were selected for further testing The pattern of self-cleavage of the multimeric ribozyme in vivo appeared to be identical to that observed in cellulo. To determine if expression of the ribozyme would have a therapeutic effect in vivo, doubly transgenic mice were produced by breeding male mice heterozygous for pMG155 (T) to females heterozygous for expression of the ribozyme M8Rz547 (R). In doubly transgenic mice (T+R), truncated collagen transcripts in calvaria were reduced by up to 75%. A quantitative assay of activity was then used as a behavioral surrogate for the health status of the mice. While mice expressing pMG155 showed a rapid reduction in movement in a one hour test period, the activity of the doubly transgenic mice was equivalent to the wild-type mice. Biomechanical testing testing and microCT analysis of bone is being performed. These biochemical and behavioral tests demonstrate that self-cleaving multimeric hammerhead ribozymes can produce a therapeutic effect in vivo in a dominant negative mutant disease model.
QUANTIFICATION OF THE MITRAL VALVE APPARATUS BY THREE-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY: AN IN VITRO VALIDATION STUDY COMPARING TWO DIFFERENT ANALYSIS SYSTEMS
Authors: Ken Saito, Hiroyuki Okura, Kikuko Obase, Koichiro Imai, Tomoko Tamada, Akihiro Hayashida, Yoji Neishi, Takahiro Kawamoto, Kiyoshi Yoshida
Journal: Journal of the American College of Cardiology (2011)
Women in Medicine-Reply
Authors: E. Grey Dimond
Journal: JAMA (1983)

In Reply.—  I have read the previous letters and then reread my own article. Each correspondent expresses opinions, just as I expressed mine. I have no quarrel with any of their remarks. The fundamental truth is that American medicine, in all variations—practice, research, academics, administration—is no longer to be an essentially male environment. I remain comfortable with my own reasoned opinions. However, the correspondents and myself are treading in subjective, emotional areas. There is a bit of truth in all our remarks—and a bit of individual bias.  For 13 years, I have been able to see and be a part of this unfolding experience, since my own medical school has averaged more than 40% women medical students during this entire period. I therefore make a certain claim to both experience and an active role in bringing women into medicine. Those are objective facts; I accept all else as subjective and
Breast carcinoma simulation. Mammography in congestive heart failure mimics acute mastitis and advanced carcinoma
Authors: J. L. Stolz
Journal: JAMA (1974)

Diffuse edema and skin thickening of the breast is a well-known clinical and roentgenographic finding in advanced malignant neoplasia and in acute mastitis. Such appearances may be simulated by congestive heart failure. (<i>JAMA</i>229:682-683, 1974)
An enzyme histochemical study of human sinus node, coronary sinus, and mitral valve muscle.
Authors: C Théry, I Krivosic, P Asseman, A E Meijer
Journal: Circulation (1985)

An enzyme histochemical study of the sinoatrial node, the coronary sinus, and the atrial muscle extending into the anterior mitral valve was performed on human hearts. Investigation of the activity and localization of the structurally bound enzymes was performed by conventional histochemical techniques. Determination of the activity of nonstructurally or weakly structurally bound enzymes was performed by histochemical techniques in which leakage of enzymes during the incubation period was reduced by the application of semipermeable membranes. The sinoatrial node is characterized by a high degree of anaerobic enzyme capacity and a relatively low degree of aerobic enzyme capacity. The discriminatory nature of these reactions allows examination of the structure of the sinoatrial node and its approaches. The presence of transitional cells was confirmed; isolated clusters of nodal cells were found in the atrial myocardium around the sinoatrial node, but no evidence of specialized tissue forming the beginning of an internodal pathway was found by this technique. The specific histochemical reactions that characterize the sinoatrial node also occur in the atrial muscle, extending into the anterior mitral valve, the anterior wall of the coronary sinus, and the atrial tissue near the orifice of the coronary sinus. These observations seem to corroborate the hypothesis that arrhythmic ectopic foci can arise in these regions.
Assessment and management of vulval pain
Authors: D. Nunns, R. Murphy
Journal: BMJ (2012)

#### Summary points

The vulva refers to the female external genitalia comprising the mons pubis, clitoris, labia majora, labia minora, and perineum (figure⇓). Vulval pain can be divided into two categories: pain secondary to a specific, identifiable, underlying disorder and idiopathic pain with no recognisable underlying disease. Women use the term pain to include a variety of unpleasant symptoms including burning, soreness, and throbbing, and some women insist that they do not have pain but describe the sensation with one of these words, which can be misleading for clinicians.



Fig 1 Normal vulval anatomy



#### Sources and selection criteria

We searched for papers that had been published up to August 2011 using appropriate index terms (vulval pain, vulvodynia, vestibulodynia, lichen planus, and lichen sclerosus) from the National Library computerised search service (Medline, PubMed). Most studies were observational but a few randomised controlled trials were available.

The exact prevalence of vulval pain in adult women is not known, but a recent population based survey from the United States found that 16% of women had at some time experienced chronic burning, knife-like pain, or pain on contact with the vulva that …
Adapting to Climate Change—Reply
Authors: Jonathan A. Patz, Howard Frumkin, Andrew Haines
Journal: JAMA (2015)

To the Editor Dr Patz and colleagues 1 raised concerns about the adverse health effects of climate change.They reviewed the evidence on the effects to date of the future risks from a changing climate and the opportunities for effective action to reduce risks.Although the authors urged public health preparedness (adaptation) to climate change, there could be limits to the effectiveness of adaptation.The present global burden of disease from climate change is relatively small, and it is often assumed that human beings' capacity to adapt has no limits.Despite health being vulnerable to the vagaries of climate, humans have adjusted their behavioral patterns and technologies to adapt to a diverse range of climates. 2However, projected anthropogenic climate change will pose new challenges that may be beyond existing coping capacities.Some extreme weather events have increased heatrelated illness and deaths.Changes in local temperature and rainfall have altered the distribution of certain disease vectors.Current public health practices, policies, and infrastructure may come under great pressure with the growing risk of maladaptation. 3 Recent assessments have identified an increased risk of experiencing tipping points, and the corresponding effects have been projected to be potentially catastrophic. 4lthough there is little quantification of the adaptation potential of public health associated with projected rates and magnitudes of climate change, susceptible communities are already facing limits in their capacity to adapt to existing climate variability.For example, the health of populations on small islands and in resource-poor countries has been shown to be particularly vulnerable as a result of increasing exposure to severe weather conditions. 5The reason for concern is that as global warming accelerates, increasingly more communities will approach their adaptation limits.The article by Patz et al 1 demonstrates that responding to and communicating the related health risks involves making decisions in a changing climate with continuing uncertainty about the timing and severity of the effects.Health professionals will need to better understand the risks of doing nothing and the benefits to public health of undertaking appropriate and timely action.