tbuckley/cabot-search huggingface dataset:
Lung Cancer Presenting With a Solitary Colon Metastasis Detected on Positron Emission Tomography Scan
Authors: Thomas E. Stinchcombe, Mark A. Socinski, Lisa M. Gangarosa, Amir H. Khandani
Journal: Journal of Clinical Oncology (2006)

The patient is a 60-year-old man with a history of tobacco use (80 pack-years) who presented with a history of a cough of several months’ duration, occasionally productive of bloodtinged sputum. As part of the evaluation of these symptoms, a chest x-ray was performed, which revealed hilar fullness. As a result of this finding a computed tomography (CT) scan was performed, which revealed a left upper lobe mass surrounding the left main stem bronchus to the level of the carina, and the pulmonary artery without evidence of mediastinal lymphadenopathy. The patient was evaluated by the thoracic surgery service and determined to be unresectable. A positron emission tomography (PET) -CT scan was performed, which revealed increased [18]fluorine fluorodeoxyglucose (FDG) uptake in the left hilar mass, and focally increased uptake in the ascending colon (Fig 1), and no increased uptake in the mediastinal lymph nodes. The differential diagnosis for the focal area of increased FDG uptake in the colon was abscess, adenomatous polyps, hamartomatous adenoma, colonic primary, and metastatic lesion. The patient had a colonoscopy performed 2 years before presentation, which did not reveal any evidence of malignancy. A repeat colonoscopy was performed, which revealed a mass in the ascending colon (Fig 2), and biopsy revealed squamous cell carcinoma consistent with a lung primary. The patient’s clinical stage changed from stage III (T4N0M0) to histologic stage IV, and the patient’s treatment plan changed from chemoradiotherapy with curative intent to chemotherapy. In patients with clinical stage III disease, PET scanning will detect extrathoracic metastases in approximately 25% of patients. Patients who are being considered for surgical resection or chemoradiotherapy with extrathoracic areas of increased FDG uptake detected on PET scan should have a pathologic evaluation of the suspected lesions. A pathologic evaluation of solitary lesions is especially important. A recent retrospective review of patients with non–small-cell lung cancer (NSCLC) found that solitary extrapulmonary lesions were observed on PET-CT imaging in 21% of patients, and 46% of the lesions were either another malignancy, benign tumors, or inflammatory conditions. Previously the colon was not considered a frequent site of metastases for NSCLC; however, PET scanning may reveal a higher incidence of colonic metastases than previously suspected. The optimal management of patients with a solitary lesion detected on PET scan is unclear. Data exist that a proportion of patients with solitary brain or adrenal metastasis may experience prolonged survival with resection of both the primary and solitary metastatic lesion. Whether long-term survival is possible with resection of lung primary and solitary visceral metastasis is not known.
The increasing use of peripheral bone densitometry
Authors: T Masud
Journal: BMJ (2000)

Osteoporotic fractures are a major cause of excess mortality, morbidity, and expenditure worldwide. There is a strong inverse relation between bone mineral density and the risk of fracture, with a doubling in fracture incidence for each standard deviation reduction in bone mineral density.1 The World Health Organization has defined osteoporosis as a bone mineral density of more than 2.5 standard deviations (T score <−2.5) below the mean value for young adults.2 This definition was made for epidemiological reasons to compare female populations and not as a threshold for intervention. However, the WHO definition has been used increasingly for the diagnosis of osteoporosis in individuals, based on the measurement of bone mineral density at the hip and spine using dual energy x ray absorptiometry. Recently, newer peripheral densitometry devices have been developed, which have the advantage of low cost and portability. It is likely that these will be used increasingly for the diagnosis of osteoporosis and assessment of fracture risk in the community.

The commoner forms of these devices in Europe and North America include heel and forearm dual energy x ray absorptiometry and quantitative ultrasound at the heel. The various devices have similar overall predictive value for estimating fracture risk regardless of the …
Transplantation of Abdominal Viscera-Reply
Authors: James W. Williams
Journal: JAMA (1989)

In Reply. —  The authors want to thank Drs Lantos and Kohrman for their interest in the article entitled Splanchnic Transplantation by Williams et al in the March 10 issue of JAMA . As we stated in the manuscript, this study was reviewed and approved by the institutional review board. In addition, the patient's family members were thoroughly apprised of the investigational nature of this procedure and the high-risk nature of the procedure, and they were totally aware of both the hopelessness of the patient's condition and the uncertainty of the proposed therapy.  We, of course, agree that innovative, high-risk surgery such as this procedure must be explained to the family or to the patient in the clearest possible terms. A second obligation of the institution performing such research is to gain as much information as is possible from such a procedure. Information was obtained from these experimental procedures that could
Therapy for Acute Cystitis in Adult Women
Authors: Frederick J. Buckwold
Journal: JAMA (1982)

One hundred seventeen unselected women with symptoms of acute cystitis were randomized to groups for immediate therapy with one of the following four single-dose regimens: (1) 1 g of sulfisoxazole; (2) 2 g of sulfisoxazole; (3) a combination of trimethoprim, 160 mg, and sulfamethoxazole, 800 mg; and (4) a combination of trimethoprim, 320 mg, and sulfamethoxazole, 1,600 mg. Forty-one women were excluded, 13 did not return for follow-up, and 28 did not have significant bacteriuria in the pretherapy culture. Escherichia coli was isolated in 81% of infections. Antibacterial activity was significantly greater in urine collected during the 24 hours after therapy in those who received trimethoprim-sulfamethoxazole. However, overall cure varied from 85% to 95%, without any great differences between the regimens. The rate of cure of 69% in the 13 patients with presumptive evidence of renal infection (antibody-coated bacteria present) was significantly lower than the rate of cure of 95% in women without evidence of renal infection. Single-dose therapy with these regimens was safe and effective in adult women with symptoms of acute cystitis, regardless of the localization of the site of infection.
RGS16 is a negative regulator of SDF-1–CXCR4 signaling in megakaryocytes
Authors: Magali Berthebaud, Christel Rivière, Peggy Jarrier, Adlen Foudi, Yanyan Zhang, Daniel Compagno, Anne Galy, William Vainchenker, Fawzia Louache
Journal: Blood (2005)
Risk of human exposure to bovine spongiform encephalopathy
Authors: K. L Tyler
Journal: BMJ (1995)

Recent reports of prion disease developing in four dairy farmers and two teenagers in Britain have raised renewed concerns about the potential health risk of bovine spongiform encephalopathy to humans. Documented transmission of bovine spongiform encephalopathy to non-human primates indicates that such concerns are not without foundation.1 Although prions are not conventional pathogens, many of the basic principles governing microbial pathogenesis seem to apply to the infectious forms of prion diseases. In this context human risk of infection after exposure to bovine spongiform encephalopathy can be considered in terms of the size of the infecting inoculum, the potential routes of entry into the host, and factors of host susceptibility.

Infectivity in human prion diseases is concentrated primarily in neural (brain, spinal cord, eye) and lymphoreticular (liver, spleen, lymph nodes) tissues.2 Human brain material has been estimated to contain 103-105 infectious units per gram of tissue,2 and bioassay in mice has shown brain material from cattle with bovine spongiform encephalopathy to contain 105-106 infectious units per gram.3 In both human prion diseases and bovine spongiform encephalopathy, infectivity is not found in skeletal muscle, adipose tissue, or body fluids (blood, saliva, urine, faeces, semen, milk).2 3 4 5 Fortunately, with …
Catheter Ablation of Chronic Atrial Fibrillation — The Gap between Promise and Practice
Authors: Mark A. Wood, Kenneth A. Ellenbogen
Journal: New England Journal of Medicine (2006)

Atrial fibrillation remains the most common heart-rhythm abnormality seen in general clinical practice, and its incidence is increasing. Atrial fibrillation is an enormous health concern because it increases the risk of death, congestive heart failure, and thromboembolism and decreases the quality of life. It places an increasing burden on the health care system because of the associated costs of hospitalization and outpatient care. The pharmacologic approach to the maintenance of sinus rhythm in patients with atrial fibrillation is compromised by its limited efficacy, side effects, and concern about safety. For these reasons, since the initial description of pulmonary-vein ablation in . . .
Left Ventricular Papillary Muscles
Authors: WILLIAM C. ROBERTS, LAWRENCE S. COHEN
Journal: Circulation (1972)

The left ventricular papillary muscles appear to be the last portions of the heart to be perfused by coronary arterial blood. As a consequence they are sensitive anatomic markers of myocardial ischemia. Foci of necrosis or fibrosis therefore are commonly seen in these structures, particularly the posteromedial papillary muscle, which has a poorer blood supply than does the anterolateral muscle. Coronary arterial luminal narrowing is the most common cause of necrosis or fibrosis of the left ventricular papillary muscles. Other conditions, all associated with inadequate cardiac output, which may produce these lesions include left ventricular outflow tract obstruction, especially that resulting from congenitally malformed aortic valves, acute valvular regurgitation (infective endocarditis), various cardiomyopathies, and primary endocardial fibroelastosis with or without anomalous origin of one or both coronary arteries from the pulmonary trunk. Various infiltrative diseases, including inflammation (Aschoff bodies, sarcoid, abscesses), amyloid, iron, and neoplasms, also may involve the papillary muscles. Their most common congenital malformation is the parachute or single papillary muscle. Fibrosis or necrosis of adjacent left ventricle free wall without involvement of the papillary muscles themselves may simulate clinically "papillary muscle dysfunction." The anterior papillary muscle of the right ventricle is frequently affected by conditions which also affect the left ventricular papillary muscles. Whether or not necrosis or fibrosis of the right ventricular papillary muscle causes tricuspid regurgitation, however, is unknown at present.
Ethical Issues in Measuring Biomarkers in Children’s Environmental Health
Authors: Peter D. Sly, Brenda Eskenazi, Jenny Pronczuk, Radim Šrám, Fernando Diaz-Barriga, Diego Gonzalez Machin, David O. Carpenter, Simona Surdu, Eric M. Meslin
Journal: Environmental Health Perspectives (2009)

Studying the impact of environmental exposures is important in children because they are more vulnerable to adverse effects on growth, development, and health. Assessing exposure in children is difficult, and measuring biomarkers is potentially useful. Research measuring biomarkers in children raises a number of ethical issues, some of which relate to children as research subjects and some of which are specific to biomarker research.As an international group with experience in pediatric research, biomarkers, and the ethics of research in children, we highlight the ethical issues of undertaking biomarker research in children in these environments.Significant issues include undertaking research in vulnerable communities, especially in developing countries; managing community expectations; obtaining appropriate consent to conduct the research; the potential conflicts of obtaining permission from an ethics review board in an economically developed country to perform research in a community that may have different cultural values; returning research results to participants and communities when the researchers are uncertain of how to interpret the results; and the conflicting ethical obligations of maintaining participant confidentiality when information about harm or illegal activities mandate reporting to authorities.None of these challenges are insurmountable and all deserve discussion. Pediatric biomarker research is necessary for advancing child health.
FDA issues advice to women taking hormone replacement therapy
Authors: D. Josefson
Journal: BMJ (2003)

The US Food and Drug Administration, together with the Department of Health and Human Services and the National Institutes of Health, has launched an educational campaign to inform women about the risks and benefits of post-menopausal hormone replacement therapy (HRT).

The US Congress directed the FDA to develop information material after a number of studies found that HRT was associated with an increased risk of developing certain conditions, including …
Proliferative autoimmune glomerulonephritis in rats: A model for autoimmune glomerulonephritis in humans
Authors: W. Kline Bolton, Walter J. May, Benjamin C. Sturgill
Journal: Kidney International (1993)

Some forms of glomerulonephritis (GN) in humans appear consequent to autoimmunity. Experimental autoimmune GN (EAG) has been described in sheep, but attempts to develop EAG in other mammals have resulted only in antibody and proteinuria but no GN. We have developed a model of EAG in an inbred mammalian species to further study pathogenetic mechanisms. We immunized Brown Norway (BN) and Wistar-Kyoto (WKY) rats with glomerular basement membrane (GBM) or collagenase solubilized GBM (csGBM). Circulating and bound anti-GBM antibody developed in all rats. Only interstitial nephritis occurred in BN rats despite amounts of glomerular and serum anti GBM antibodies similar to WKY animals. One hundred percent of WKY rats immunized with csGBM/acid developed reproducible severe GN at two to three weeks with proteinuria and decreased kidney function which progressed to glomerulosclerosis and interstitial fibrosis. Antigen in acid was a requisite for induction of EAG. EAG rats had positive tests for delayed type hypersensitivity, their T cells underwent antigen specific transformation, and T cells and macrophages were present histologically. Passive transfer of EAG serum to naive rats resulted in fixation to recipient GBM but no proteinuria or GN. This new model of EAG in rats appears dependent on genetic factors, may involve cellular immunity in pathogenesis, requires exposure of the nephritogenic antigen, and is highly similar to rapidly progressive GN in humans.
Emergency Coronary-Artery Angioplasty for Cardiogenic Shock Complicating Acute Myocardial Infarction
Authors: Kim Eagle, Harry Feld
Journal: New England Journal of Medicine (1993)

Figure 1. Emergency Coronary-Artery Angioplasty for Cardiogenic Shock Complicating Acute Myocardial Infarction. Coronary-artery angioplasty was performed in a 45-year-old man who presented with two hours of crushing retrosternal chest pain and hypotension (blood pressure, 90/60 mm Hg). Electrocardiography revealed evidence of an acute anterior-wall myocardial infarction. Coronary arteriography (Panel A) showed a left anterior descending artery that was totally occluded in its proximal portion (indicated by the arrow in each panel), with normal right and circumflex coronary arteries. Emergency coronary-artery angioplasty (Panel B) resulted in rapid antegrade flow without residual stenosis at the site of the occlusion (Panel C). The . . .
The Vaginal Cytogram
Authors: Ta-Jung Lin
Journal: JAMA (1963)

Properly performed and interpreted serial vaginal smears constitute the simplest, cheapest, most practical, and most reliable method of estrogen assay in the human. The results of such smears may be used as a guide to adjusting dosages in the treatment of patients with estrogen deficiencies. Estrogens, synthetic or natural, should be used in adequate amounts without fear of carcinogenesis for the prevention of osteoporosis, the control of atherogenesis, and the achievement of a sense of well-being. If the vaginal smear shows evidence of estrogen deficiency, patients undergoing natural or induced menopause should be treated with estrogenic preparations in the presence or absence of symptoms. Vaginal cytograms should be used as widely in our daily practice as the differential count of white blood cells in the initial diagnosis and in the follow-up program.
Communicating about screening
Authors: V. A Entwistle, S. M Carter, L. Trevena, K. Flitcroft, L. Irwig, K. McCaffery, G. Salkeld
Journal: BMJ (2008)

Informed choice is important for screening, but not everyone wants or is able to analyse research data. Vikki Entwistle and colleagues propose a new approach to communication
Monomethyl fumarate augments NK cell lysis of tumor cells through degranulation and the upregulation of NKp46 and CD107a
Authors: Heidi Vego, Kristin L Sand, Rune A Høglund, Lars-Egil Fallang, Glenn Gundersen, Trygve Holmøy, Azzam A Maghazachi
Journal: Cellular and Molecular Immunology (2014)
Activation of terminal components of complement in patients with Guillain-Barré syndrome and other demyelinating neuropathies.
Authors: C L Koski, M E Sanders, P T Swoveland, T J Lawley, M L Shin, M M Frank, K A Joiner
Journal: Journal of Clinical Investigation (1987)

In the present study, the role of antiperipheral nerve myelin antibody (anti-PNM Ab) in demyelination by generating the terminal attack complex (C5b-9) of complement was explored in patients with Guillain-Barré syndrome (GBS) and other demyelinating neuropathies. The presence in serum of SC5b-9, an inactive C5b-9 containing S protein, was assessed quantitatively by enzyme-linked immunosorbent assay using an antibody (Ab) to neoantigens expressed on C9 when complexed with C5b-8 or after tubular polymerization. SC5b-9 was detected in all 19 GBS, four patients with paraprotein-associated neuropathy and five of six patients with chronic recurrent polyneuritis. No SC5b-9 was detected in 10 normal controls. Kinetic studies from six GBS patients showed the highest values of SC5b-9 on the 3rd to 5th d of admission; in contrast, the anti-PNM Ab were highest on the day of admission. Anti-PNM Ab fell rapidly to very low levels by the 15th to 20th d. SC5b-9 declined with similar kinetics to undetectable levels by the 30th d. Levels of Ab and SC5b-9 did not quantitatively correlate with soluble immune complexes in these patients' serum. Membrane-bound C5b-9 was also detected by immunohistochemistry in the peripheral nerves from a GBS patient. These results, which show a relationship between levels of complement-fixing anti-PNM Ab and the tissue-damaging C5b-9 complex, suggest that peripheral nerve myelin may serve as the target for Ab-mediated complement attack.
Recurrent abdominal pain in a patient on haemodialysis
Authors: R Ahmad, B Large, N Raichura
Journal: BMJ (1980)

2) The bacteriological method used for isolation ofKlebsiella was as follows: Standard aliquots of faecal samples were cultured on a differential medium containing 1 °inositol, 1%,/ Lab Lemco, 1%X bacteriological peptone, 1 2%V agar, and bromothymol blue indicator incubated at 37°C for 18 hours.Inositol fermenting colonies were identified using API 20E.(3) There was no difference between the average number of visits from rheumatoid arthritis patients with one positive sample and the number of visits from patients who provided only negative samples.(4) Analysis of positive cultures in males and females was carried out on a patient and not a sample basis: 13 out of 33 men who provided samples on two or more occasions had two positive cultures compared with six out of 58 women who were examined in a similar way.This difference is significant.(5) The comparison among rheumatoid arthritis patients with HLA-B7 CREG antigens was carried on a patient and not a sample basis.(6) The reference to the work of Eastmond and coworkers' was misquoted as this group clearly found an association between isolation of faecal Klebsiella and uveitis (p <001) and peripheral synovitis (p < 0 05) in HLA-B27- positive patients with ankylosing spondylitis.Since we took the presence of uveitis and peripheral synovitis in ankylosing spondylitis as clinical evidence of disease activity we consider the results of this group as providing independent confirmation of our observations.( 7) The association of faecalKlebsiella with disease activity in ankylosing spondylitis has been made not only on clinical but also on biochemical criteria such as elevated erythrocyte sedimentation rate and C-reactive protein levels.2We agree that further studies are clearly indicated, and currently we are carrying out a survey on the prevalence ofKlebsiella in faecal samples obtained from tissue-typed healthy controls not associated with a hospital environment.
Combined use of 99mtechnetium-labelled macroaggregates of albumin and 75selenium-selenomethionine in the diagnosis of lung cancer
Authors: M. Critchley, H. J. Testa, T. B. Stretton
Journal: Thorax (1974)

<b>Critchley, M., Testa, H. J., and Stretton, T. B. (1974).</b><i>Thorax</i>, <b>29</b>, 421-424. <b>Combined use of <sup>99m</sup>technetium-labelled macroaggregates of albumin and <sup>75</sup>selenium-selenomethionine in the diagnosis of lung cancer.</b> A two-stage isotope technique has been used in 30 patients with radiographic evidence of circumscribed pulmonary lesions in an attempt to establish the nature of the underlying pathological process. The test was carried out as a `blind9 procedure without knowledge of the findings of investigations other than the plain chest radiograph. An initial scan was performed with <sup>99m</sup>technetium-labelled macroaggregated albumin. The view showing the lesion most clearly was selected and a second scan was obtained after an intravenous injection of <sup>75</sup>Se-selenomethionine. Scans were interpreted by comparison of the `cold area9 on the technetium scan with the corresponding area on the selenomethionine scan. Accumulation of <sup>75</sup>Se-selenomethionine at the site corresponding to the lesion is described as a positive result and absence of accumulation as negative. The findings suggest that there is selective uptake of <sup>75</sup>Se-selenomethionine by primary bronchogenic carcinoma; in the few patients with secondary carcinomas and non-malignant disease investigated so far, the lesion has failed to concentrate <sup>75</sup>Se-selenomethionine.