tbuckley/cabot-search huggingface dataset:
Geophagia-lnduced Hyperkalemia
Authors: Hugh H. Hussey
Journal: JAMA (1975)

Geophagia, melodious word that it may sound to some, is nevertheless a "dirty" word. It means the ingestion of dirt (soil) or clay by persons whose perverted appetites lead them to eat "dirt" instead of nutritious food. In their article on this subject in this issue ofThe Journal(p 738), Gelfand et al delve briefly into the history of geophagia, but their search for the origins of the perversion is by no means complete. They note that geophagia-induced illness that resembled beriberi occurred among black slaves in Louisiana and that geophagia, as a cause of anemia, is still prevalent among blacks living in New York City. For their own part, Gelfand et al report five cases in which geophagia led to life-threatening hyperkalemia in the presence of chronic renal failure. The mechanism appeared to be absorption of large amounts of potassium from ingested clay. One patient, a 45-year-old black
Bill and Bob
Authors: T. Greenhalgh
Journal: BMJ (2002)

We had been asleep for more than an hour when the phone rang. Assuming a wrong number, we ignored it. Fifteen minutes later the bedroom filled with slowly strobing blue light and there was a loud rap-rap at the door. I pulled on a dressing gown and went down to face the policeman.

He read out my full name and I confirmed my identity. He spoke into a walkie-talkie. “Located the next of kin, Sarge, over.” At my kitchen …
Guidelines and Conflicts of Interest
Authors: Zackary D. Berger
Journal: Annals of Internal Medicine (2010)

Letters21 September 2010Guidelines and Conflicts of InterestZackary D. Berger, MD, PhDZackary D. Berger, MD, PhDFrom Johns Hopkins University School of Medicine, Baltimore, MD 21205.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-6-201009210-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Guyatt and colleagues (1) group financial conflicts of interest with intellectual conflicts of interest. I find this puzzling. Financial conflicts of interest are of concern because they do not coincide with and are not accountable to research or clinical aims. But “intellectual conflicts of interest,” according to Guyatt and colleagues, are to be found in persons with substantive knowledge, engagement, or research investment in the question at issue (indeed, according to the authors' view, they themselves would be disqualified from primary authorship of any future expert guideline on intellectual conflicts of interest). But those are precisely the ...References1. Guyatt G, Akl EA, Hirsh J, Kearon C, Crowther M, Gutterman D, et al. The vexing problem of guidelines and conflict of interest: a potential solution. Ann Intern Med. 2010;152:738-41. [PMID: 20479011] LinkGoogle Scholar2. Nagel T. The View From Nowhere. Oxford: Oxford Univ Pr; 1989. Google Scholar3. Goldenberg MJ. On evidence and evidence-based medicine: lessons from the philosophy of science. Soc Sci Med. 2006;62:2621-32. [PMID: 16384628] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Zackary D. Berger, MD, PhDAffiliations: From Johns Hopkins University School of Medicine, Baltimore, MD 21205.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Vexing Problem of Guidelines and Conflict of Interest: A Potential Solution Gordon Guyatt , Elie A. Akl , Jack Hirsh , Clive Kearon , Mark Crowther , David Gutterman , Sandra Zelman Lewis , Ian Nathanson , Roman Jaeschke , and Holger Schünemann Guidelines and Conflicts of Interest Giovanni A. Fava Guidelines and Conflicts of Interest Gordon Guyatt , Holger Schünemann , and Elie Akl Metrics 21 September 2010Volume 153, Issue 6Page: 421KeywordsConflicts of interestEvidence based medicineForecasting ePublished: 21 September 2010 Issue Published: 21 September 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
TCT-318 Contrast Agent and Radiation Exposure in Revascularisation of Chronic Coronary Total Occlusions: Magnetic Navigation versus Conventional Percutaneous Coronary Intervention
Authors: Sabine Scherzer, Berger Rudolf, Lisa Krenn, Clemens Gangl, Christian Roth, Natalija Lajic, Georg Delle Karth, Thomas Neunteufl
Journal: Journal of the American College of Cardiology (2012)
Mean Platelet Volume is Independently Associated with Renal Dysfunction in Stable Coronary Artery Disease
Authors: Hakan Uçar, Mustafa Gür, Nermin Yıldız Koyunsever, Taner Şeker, Caner Türkoğlu, Onur Kaypaklı, Durmuş Yıldıray Şahin, Zafer Elbasan, Murat Çaylı
Journal: Journal of the American College of Cardiology (2013)
Drug eluting stents for patients with diabetes
Authors: K.-H. Mak
Journal: BMJ (2012)

Pathways for presenting proteins from the extracellular fluids on MHC class I molecules have been described in macrophages. However, it is uncertain whether similar mechanisms exist in dendritic cells, because conventional preparations of these cells can be contaminated with macrophages. We addressed this issue by transducing granulocyte-macrophage CSF into bone marrow cultures followed by supertransfection with myc and raf oncogenes. These immortalized clones displayed dendritic morphology, and many expressed the dendritic cell-specific markers DEC-205 and 33D1 as well as high levels of MHC molecules and costimulatory molecules. Using these cloned dendritic cells, we found that exogenous OVA could be presented on both their MHC class I and class II molecules. This presentation was markedly enhanced when the Ag was particulate and internalized by phagocytosis. Presentation of particulate OVA on MHC class I molecules was insensitive to the weak base chloroquine, but was blocked by peptide aldehyde inhibitors of the proteasome, indicating that the class I-presented peptides were generated in the cytosol. Brefeldin A, which inhibits the exocytosis of newly synthesized proteins from the endoplasmic reticulum, also inhibited Ag presentation. These results establish that dendritic cells can present exogenous Ags on MHC class I molecules and appear to use a similar phagosome to cytosol pathway as macrophages. Therefore, dendritic cells are likely to play an important role in generating immune responses to tissue transplants and tumors in vivo. Furthermore, these findings provide an approach for targeting vaccine Ags into these cells to prime immune responses in vivo.
Platelet volume/count relationship aids thrombocytopenia prognosis
Authors: Charles Marwick
Journal: JAMA (1983)

Capitalizing on the relationship between platelet volume and platelet number, a Texas researcher has developed a method of distinguishing those patients with certain forms of thrombocytopenia who will recover from those who will not. In essence, his finding is that if mean platelet volume (MPV) starts to rise, this is a sign of marrow cell recovery and impending (within the next two days) rise in platelet count. The report was given by J. David Bessman, MD, of the University of Texas Medical Branch at Galveston during the recent meeting of the American Society for Clinical Investigation in Washington, DC. The key to Bessman's method lies in a simple chart or nomogram (Figure, next page) developed from data easily obtained from the new generation of automatic blood cell counters. These counters now routinely provide MPVs as well as platelet counts. Previously, in a study of 683 normal subjects, Bessman showed that
Strangulated Cloquet's Hernia
Authors: R. D. H. Parker
Journal: BMJ (1966)

Hg, the pulse remaining about 60 per minute throughout.At this stage he fell asleep.Although his blood-pressure continued to rise slowly, it did not regain the pre-operative figure for 36 hours.Eleven days later (15 days after discontinuing phenelzine) and following the same premedication, his retinal detachment was operated on, this time without any hypo- tensive episodes.Though the patient was also taking perphenazine for an equal time, it is considered that the phenelzine, with its known action in potentiating other drugs, was the agent responsible.-Iam, etc.,
A National Multicenter Phase 2 Study of Prostate-specific Antigen (PSA) Pox Virus Vaccine with Sequential Androgen Ablation Therapy in Patients with PSA Progression: ECOG 9802
Authors: Robert S. DiPaola, Yu-Hui Chen, Glenn J. Bubley, Mark N. Stein, Noah M. Hahn, Michael A. Carducci, Edmund C. Lattime, James L. Gulley, Philip M. Arlen, Lisa H. Butterfield, George Wilding
Journal: European Urology (2014)
More on Contamination: The Use of Asymmetric Molecular Behavior to Identify Authentic Ancient Human DNA
Authors: H. Malmstrom, E. M. Svensson, M. T. P. Gilbert, E. Willerslev, A. Gotherstrom, G. Holmlund
Journal: Molecular Biology and Evolution (2007)

Authentication of ancient human DNA results is an exceedingly difficult challenge due to the presence of modern contaminant DNA sequences. Nevertheless, the field of ancient human genetics generates huge scientific and public interest, and thus researchers are rarely discouraged by problems concerning the authenticity of such data. Although several methods have been developed to the purpose of authenticating ancient DNA (aDNA) results, while they are useful in faunal research, most of the methods have proven complicated to apply to ancient human DNA. Here, we investigate in detail the reliability of one of the proposed criteria, that of appropriate molecular behavior. Using real-time polymerase chain reaction (PCR) and pyrosequencing, we have quantified the relative levels of authentic aDNA and contaminant human DNA sequences recovered from archaeological dog and cattle remains. In doing so, we also produce data that describes the efficiency of bleach incubation of bone powder and its relative detrimental effects on contaminant and authentic ancient DNA. We note that bleach treatment is significantly more detrimental to contaminant than to authentic aDNA in the bleached bone powder. Furthermore, we find that there is a substantial increase in the relative proportions of authentic DNA to contaminant DNA as the PCR target fragment size is decreased. We therefore conclude that the degradation pattern in aDNA provides a quantifiable difference between authentic aDNA and modern contamination. This asymmetrical behavior of authentic and contaminant DNA can be used to identify authentic haplotypes in human aDNA studies.
Right bundle-branch block. Occurrence following nonpenetrating chest trauma without evidence of cardiac contusion
Authors: A. G. Kumpuris
Journal: JAMA (1979)

RIGHT bundle-branch block (RBBB) is an unusual complication of non-penetrating trauma to the chest. Rankin and Patterson<sup>1</sup>in 1952 and Parmley et al<sup>2</sup>in 1958 described transient intraventricular conduction defects that they concluded were due to myocardial contusion. We report a case of transient RBBB that developed following nonpenetrating chest trauma without myocardial injury as evidenced by serial ECGs, technetium Tc 99m pyrophosphate scan, and cardiac enzyme values. <h3>Report of a Case</h3> A 55-year-old man who had been previously healthy was seen in the emergency room of the Houston Veterans Administration Hospital following an automobile accident in which he had sustained blunt trauma to the anterior chest wall. His only complaint was of nonradiating pleuritic chest pain. The patient was in mild distress. The cardiac apical impulse was in the sixth intercostal space of the midclavicular line. His pain increased following firm palpation of the anterior chest wall. Otherwise,
A publicly available database accelerates academic production
Authors: Y.-C. Chen, J.-C. Wu, T.-J. Chen, T. Wetter
Journal: BMJ (2011)

Electronic health databases are popular as research materials in medical studies.1 Our analysis of publications that used the general practice research database (GPRD) as their main data source found that from 1995 to 2009, GPRD had attracted 1251 authors from 22 countries. In total, 749 studies were published in …
TUMOURS OF THE ORBIT: A PLEA FOR OPERATION
Authors: W. Collins
Journal: BMJ (1913)

TIIE orbit is territory upon which the ophthalmologist and the general surgeon meet.Growtths in tllat region may be held to fall -within the splhere of activity of both, and are sometinmes renouncedI by the onie in favour of the other.Their pathology and classification are not tliorougLhly elucidated, and their treatiment is often, I think, not too satisfactory.I am not alluding to simple tumours such as exostoses or dermoid cysts, whiclh arc lnot infrequent in this region, but to vascular and malignant growths, which, though relatively rare, are not so uncomimon as some writers would have us believe; lor, in my experience, is the outlook, if treated by operation, so gloomy as the statistics vouchsafed by some authorities would seem to imply.To illustrate my meaning I will cite the following cases on which I have operated, several of whoml had been previously advised that the risks of the operation itself wore so great or the liability to early recurrence so con* siderable that surgical intervention was discouraged, or even strongly discountenabced.CASE I.
Extracorporeal photopheresis: a useful therapy for patients with steroid-refractory acute graft-versus-host disease but not for the prevention of the chronic form
Authors: P. Rubegni, L. Feci, S. Poggiali, G. Marotta, G. D'Ascenzo, F. Murdaca, M. Fimiani
Journal: British Journal of Dermatology (2013)

Extracorporeal photopheresis (ECP) has been used successfully to treat severe steroid-refractory acute and chronic graft-versus-host disease (aGVHD, cGVHD) since the late 1990s.To evaluate retrospectively the efficacy and safety of ECP in patients with aGVHD. We also assessed whether ECP may play a role in the prevention of cGVHD.Nine consecutive patients with allografts with aGVHD grade II-III, as defined by consensus criteria, and refractory to steroids, were treated with ECP. ECP was started at a median interval of 46·3 days (range 10-70) from aGVHD onset. Patients were treated initially on two consecutive days (one cycle) at 1-week intervals until improvement and then every 2 weeks. Treatment was then tapered off individually. To evaluate statistical relationships with outcome after 30, 60 and 90 days of ECP, all clinical and historical variables of the patients before treatment were analysed.All patients survived and responded within 90 days. The average aGVHD score was 1·72 at aGVHD onset, 2·44 when ECP was started and then gradually declined to 0·44 on day 90. At the same time, the average dose of methylprednisolone declined from 2·22 mg kg(-1) to 0·27 mg kg(-1) (day 90), while the average dose of ciclosporin declined from 2·46 mg kg(-1) to 0·77 mg kg(-1) (day 90). Six of nine patients showed a complete skin response after 90 days of treatment. All patients with liver and gastrointestinal tract involvement had complete responses after 90 days, apart from one patient. All our patients developed cGVHD, seven of nine while still on maintenance regimen (6-13 months after haematopoietic stem cell transplantation, HSCT) and the other two patients after suspension of ECP (6 and 9 months after HSCT).ECP is effective in patients with mild to moderate steroid-refractory aGVHD (grade II-III). On the other hand, ECP did not prevent the development of cGVHD in our patients.
Acute right heart failure complicated by hypovolaemia.
Authors: R J George, D Bihari
Journal: BMJ (1982)

Acute right heart failure complicated by hypovolaemiaThe dangers of inducing diuresis in patients with pulmonary oedema and normal pulmonary wedge pressures have recently been described."We report a complementary case of acute right heart failure due to right ventricular infarction complicated by hypovolaemia.In this, right ventricular output may provide an insufficient preload for the left ventricle, and there is the apparent paradox of an overloaded right ventricle and an inadequately primed "hypovolaemic" left ventricle.Failure to recognise this may lead to inappropriate diuretic or inotropic treatment and potentially irreversible hypovolaemic shock. Case reportA 66-year-old tailor presented with inferior myocardial infarction.He was normotensive and well perfused, with raised jugular venous pressure.Auscultation of the heart was normal and he had no signs of left ventricular failure.Because of the raised jugular venous pressure he underwent diuresis.Over three days he became hypotensive and oliguric.Jugular venous pressure remained raised in the absence of pulmonary congestion, and he developed ankle oedema.Inotropic drugs and diuretics produced no improvement.A Swan-Ganz catheter was inserted (figure).Right atrial pressure was W0 ...... ... ... .. xFe < .' ~~~~~~~~~.{ ...8.< Left ventricular hypovolaemia due to right ventricular infarction.Top: Pressures on insertion of catheter.Bottom: Pressures after 250 mil colloid given immedi9tely.PAP=Pulmonary artery pressure.PCWP =Pulmonary capillary wedge pressure.Insp= Inspiration.Exp = Expiration.raised with a mean systolic pressure of 12 mm Hg from the mid-axilla (normal range 12-20) and a mean pulmonary capillary wedge pressure of
ARTIFICIAL ILLUMINATION, A FACTOR IN OCULAR DISCOMFORT
Authors: NELSON M. BLACK
Journal: JAMA (1913)

INTERPRETATION OF OCULAR DISCOMFORT  From the evidence at hand it seems quite certain that ocular discomfort, the result of exposure of the eyes to light, and especially that observed during close work under improper artificial illumination, must be interpreted largely as muscular fatigue of, and pain in, the extra-ocular and intra-ocular muscles, the result of their constant contraction or spasm in attempting to protect the retina from too much light. The question immediately: Why should this be brought about by artificial light of a certain intensity when there is no complaint made by possessors of healthy eyes from daylight illumination of several times intensity? It seems to us to be based to a large extent on the absence of the adaptatione of the eyes to a comparatively new condition. By adaptation, in this case, is not meant light and dark adaptation of the retina, but adaptation of the eyes by process of evolution to a new environment.  EVOLUTION OF THE EYE  Evolutionary changes in any organ of the body
Ano-rectal Lesions in Patients Taking Suppositories Containing Non-steroidal Anti-inflammatory Drugs (NSAID)
Authors: G. Gizzi, V. Villani, G. Brandi, G. M. Paganelli, G. Di Febo, G. Biasco
Journal: Endoscopy (1990)

We report on 3 cases in which ano-rectal lesions were associated with chronic administration of suppositories containing non-steroidal anti-inflammatory drugs (NSAID). Lesions were characterized by erosions or ulcer in the rectum and by stenosis of the anal verge. Erosions or ulcers were observed in patients taking the drugs for a relatively short time. The lesions remitted after suspension of the treatment. The cases observed indicate that suppositories containing NSAID could induce ano-rectal lesions similar to those observed after the use of suppositories containing ergotamine.
Phase II Trial of Tremelimumab (CP-675,206) in Patients with Advanced Refractory or Relapsed Melanoma
Authors: John M. Kirkwood, Paul Lorigan, Peter Hersey, Axel Hauschild, Caroline Robert, David McDermott, Margaret A. Marshall, Jesus Gomez-Navarro, Jane Q. Liang, Cecile A. Bulanhagui
Journal: Clinical Cancer Research (2010)

This phase II study assessed the antitumor activity of tremelimumab, a fully human, anti-CTL-associated antigen 4 monoclonal antibody, in patients with melanoma.Patients with refractory/relapsed melanoma received 15 mg/kg tremelimumab every 90 days. After 4 doses, patients with tumor response or stable disease were eligible to receive < or =4 additional doses. Primary endpoint was best overall tumor response assessed by an independent endpoint review committee, and secondary endpoints included duration of response, overall survival, progression-free survival, and safety.Of 251 patients enrolled, 246 (241 response-evaluable) received tremelimumab. Objective response rate was 6.6% (16 partial responses); duration of response was 8.9 to 29.8 months. Eight (50%) objective responses occurred in patients with stage IV M(1c) disease, and 11 (69%) were ongoing at last tumor assessment. Eight (3.3%) patients achieved responses in target lesions (Response Evaluation Criteria in Solid Tumors) despite progressive disease within the first cycle. All 8 survived for >20 months; 5 (63%) remained alive. Clinical benefit rate (overall response + stable disease) was 21% (16 partial responses and 35 stable disease), and median overall survival was 10.0 months. Progression-free survival at 6 months was 15%, and survival was 40.3% at 12 months and 22% at 24 months. Common treatment-related adverse events were generally mild to moderate, and grade 3/4 adverse events included diarrhea (n = 28, 11%), fatigue (n = 6, 2%), and colitis (n = 9, 4%). There were 2 (0.8%) treatment-related deaths.Tremelimumab showed an objective response rate of 6.6%, with all responses being durable > or =170 days since enrollment, suggesting a potential role for tremelimumab in melanoma.
What is the long-term outcome of the liver allograft?
Authors: Stefan G. Hübscher
Journal: Journal of Hepatology (2011)

With improved long-term survival following liver transplantation (LT), issues relating to the assessment of the liver allograft in long-term survivors are becoming increasingly relevant. Histological abnormalities are commonly present in late post-transplant biopsies, including protocol biopsies from patients who appear to be well with good graft function. Recurrent disease is the commonest recognised cause of abnormal graft histology, but may be modified by the effects of immunosuppression or interactions with other graft complications, resulting in complex or atypical changes. Other abnormalities seen in late post-transplant biopsies include rejection (which often has different appearances to those seen in the post-transplant period), de novo disease, "idiopathic" post-transplant hepatitis (IPTH) and nodular regenerative hyperplasia. In many cases graft dysfunction has more than one cause and liver biopsy may help to identify the predominant cause of graft damage. Problems exist with the terminology used to describe less well understood patterns of graft injury, but there is emerging evidence to suggest that late rejection, de novo autoimmune hepatitis and IPTH may all be part of an overlapping spectrum of immune-mediated injury occurring in the late post-transplant liver allograft. Careful clinico-pathological correlation is very important and the wording of the biopsy report should take into account therapeutic implications, particularly whether changes in immunosuppression may be indicated. This article will provide an overview of the main histological changes occurring in long-term survivors post-LT, focusing on areas where the assessment of late post-transplant biopsies is most relevant clinically.