tbuckley/cabot-search huggingface dataset:
VERONAL POISONING: CASE OF RECOVERY FROM 125 GRAINS
Authors: J. M. H. Munro
Journal: BMJ (1914)

Uz]Dlo" JoUn,AL Chemical reactions with Millon's reagent, a white precipitate soluble in excess.Boiled with KOH, no reaction.Crystals ftused with EOH gave smell of ammonia, anid the resulting solid had a rancid smell; the solid disssolved in water gave a slight browln colour wvith Nessler's reagenit.These clhemical and(I physical reactions afforded adequate evidence that the crystals were veronlal.Portions of the brain and a mixed portioni of viscera wvere examined by the following processes respectively: Treated with about 75 c.cm. of 90 per cent.alcohol acidified with a few dlrops of acetic acid, macerated and allowed to remain for twenty-four hours at 30°C. ; the liquid decanted and the residue treated with feeblyacid alcohol fourtimes; the alcoholic extracts mixed, filtered, and evaporated to a syrupy consistency at about 350 C.;*200 c.cm. of absolute alcohol added and allowed to stand, filtered, and again evaporated to a syrup at 35°C.; taken up witlh water and turbid liquid filtered, concentrated by evaporation at 350 C. to 15 c.cm. ; treated with blood charcoal and filtered; extracted with two volumes of ether four times; ether extract filtered and evaporated to dryness at low tempera- ture.A crystalline residue showing similarphysical characters to the crystals from the urine was obtained in each of these cases.Amount of crystals from viscera, 0.0235 gram.Amount of crystals from brain, 0.0385 gram.On purifying these cirystals a melting point of 1840 C., some- wlhat lower than the melting point of the crystals from the urine, was obtained.Regarding this evidence as sufficient to show the presence of veronal in the body as well as in the urine, and in view of the fact that the visceral 6rgans were not weighed, it seemed best to construct the piobable dose from the urine only.The amount of u'rine received was 225 c.cm.; it was taken from the bladder seventeen hours after the onset of coma; it does not, therefore, represent the total output of urine in twenty-four h6urg, in whiclh time 50 per cent. of the veronal is excreted; it is inot unreasonable to assume that at least twice tllis -amount of urine was excreted, and that .thedeceased person took a dose between the fatal dose of 50 grains and t-he minimum recorded fatal close of .15grains.We are indebted-to Mr, F. E. Need,
Gonorrhea in Female Adolescents: Potential Analogies to Toxic Shock Syndrome
Authors: THOMAS A. BELL
Journal: Annals of Internal Medicine (1982)

Serum progesterone levels are often low during the menstrual cycles of adolescents. Columnar epithelium is exposed on the portio vaginalis of the cervix. These characteristics may enhance the virulence of genital infection with Neisseria gonorrhoeae. Similar mechanisms may contribute to the propensity of adolescents for toxic shock syndrome.
TCT-368 Lower socioeconomic status predicts major adverse cardiac events (MACE) and increased mortality post-percutaneous intervention (PCI): Independent hazard vs. intersection of modifiable risk factors?
Authors: Ali Mithani, Steve Attanasio, Andew Appis, Emily Guhl, Tamar Polonsky, Sandeep Nathan
Journal: Journal of the American College of Cardiology (2012)
Chronic eosinophilic leukemia‐not otherwise specified has a poor prognosis with unresponsiveness to conventional treatment and high risk of acute transformation
Authors: Grzegorz Helbig, Anna Soja, Aleksandra Bartkowska‐Chrobok, Sławomira Kyrcz‐Krzemień
Journal: American Journal of Hematology (2012)

Chronic eosinophilic leukemia-not otherwise specified (CEL-NOS) is a rare disorder with hypereosinophilia and an increased number of blood or marrow blast (<20%) or an evidence of eosinophil clonality.We evaluated the clinical outcome of 10 patients with CEL-NOS. Seven males and three females at a median age of 62 years (range, 23–73) were included. The median leukocyte count at diagnosis was 33.4 3109/l (range, 9.3–175.0) with a median eosinophil count of 15.6 3 109/l (range, 1.5–136.0). Median hemoglobin and platelets were 11.0 g/dl (range, 8.3–13.3) and 158 3 109/l (range, 31.0–891.0), respectively. Clinical manifestations included splenomegaly (n 5 7), hepatomegaly (n 56), cardiac failure (n 5 2), and lung infiltrations (n 5 1). Median survival from diagnosis to death for entire cohort was 22.2 months (range,2.2–186.2). Five of the 10 studied patients developed acute transformation(AT) after median of 20 months from diagnosis (range, 1.6–41.9).None of patients with AT is alive at the time of last follow-up. Median time from AT to death was 2 months (range, 1.0–6.1). Among five patients who did not develop AT, three died in active disease. Two patients are alive in complete remission; first underwent allogeneic stem-cell transplantation preceding by intensive induction chemotherapy;the second remains on imatinib with hydroxyurea. Except the latter patient, imatinib was ineffective in our study population. CEL-NOS is a rare and aggressive disease with high rate of AT and resistance to conventional treatment.
Organochlorine exposure, immune gene variation, and risk of non-Hodgkin lymphoma
Authors: Joanne S. Colt, Nathaniel Rothman, Richard K. Severson, Patricia Hartge, James R. Cerhan, Nilanjan Chatterjee, Wendy Cozen, Lindsay M. Morton, Anneclaire J. De Roos, Scott Davis, Stephen Chanock, Sophia S. Wang
Journal: Blood (2008)
Broadcast of stars colonoscopy puts up screening by 20%
Authors: R. Dobson
Journal: BMJ (2002)

A US television celebrity whose colonoscopy was shown live on television is being credited for a near 20% rise in the number of people having the procedure.

Doctors who tracked the number of colonoscopies in the months after the screening say the increase shows the power of celebrities, and they suggest that more research be carried out on using stars to promote public health messages.

The research, reported at the annual conference of the Society of General Internal Medicine in Atlanta …
Diabetic patients in chronic disease management programmes live longer
Authors: A. Tuffs
Journal: BMJ (2008)

<h3>Introduction</h3> Coffee ground vomiting is defined as the passage of black material which is assumed to be blood. Its presence implies that bleeding has ceased or has been relatively modest.<sup>1</sup> It is therefore considered as low to medium risk upper GI bleeding compared to frank haematamesis and/or malena. Sign guidelines recommend admission and early endoscopy with Rockall score for patients above 60 years who present only with witnessed haematemesis or suspected continued bleeding. <h3>Methods</h3> Aim: evaluate the outcome of coffee ground vomiting in patients above the age of 60 in our hospital. Retrospective analysis of all OGD9s performed in our hospital over the last 3 years (December 2007–December 2011) using the endoscopy register (Endosoft). Patients with the indication of coffee ground vomiting, excluding associated haematamesis and/or malena were identified. Hb urea level and intervention at the time of the procedure were recorded. <h3>Results</h3> Overall, 93 patients were identified. 73 patients were more than 60 years old, 46 females (64%) and 27 males (36%), 24 had ulcer or evidence of bleeding (32%), the causes of bleeding includes: gastric ulcers 6, duodenal ulcers 4, oesophageal ulcers 4, severe gastritis/oesophagitis 5, others 5. Endoscopic Interventions includes: adrenalin injection, banding, heat probe and endoclips. 11 patients (42%) had more than 1 gm drop in Hb while 17 patients (65%) had raised urea. On the other hand, 20 patients were 60 years old or less, three patients had ulcers or evidence of bleeding (15%), four females (20%) and 16 males (80%), the cause of bleeding in all cases were gastric ulcers, two of them treated endoscopically with adrenalin and heat probe. Only one patient had more than one gm drop in Hb and raised urea. <h3>Conclusion</h3> Increase age is an independent risk factor in the assessment of bleeding and is part of the Rockall score. In this small cohort, Patients above 60 years old presenting with coffee ground vomiting were predominantly females with around third had a major cause for upper GI bleeding requiring endoscopic intervention. Raised urea appear to be more significant parameter than drop in Hb. Coffee ground vomiting in this age group should regarded as severe GI bleeding equivalent to haematamesis. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Scottish Intercollegiate Guidelines Network</b>. Management of Acute Upper and Lower Gastrointestinal Bleeding, 2008.
Hypergammaglobulinaemic purpura of Waldenström and Ro/SSA autoantibodies
Authors: S. MIYAGAWA, T. FUKUMOTO, M. KANAUCHI, I. MASUNAGA, T. FUJIMOTO, K. DOHI, T. SHIRAI
Journal: British Journal of Dermatology (1996)

Seven out of nine patients (78%), seen over a 13-year period with hypergammaglobulinaemic purpura of Waldenström were found to have antibodies to Ro/SSA. Over this period we saw 175 patients who had antibodies to Ro/SSA. In six of the seven patients, associated diseases were recognized. Five had Sjögren's syndrome, and one had systemic lupus erythematosus with Sjögren's syndrome and thyroiditis (and died 19 years after initial presentation from cerebral infarction). Screening for antibodies to Ro/SSA is important in the diagnosis of patients with hypergamma-globulinaemic purpura, and is helpful in predicting prognosis.
Sarcoidosis of the Skull
Authors: ROBERTO FRANCO-SAENZ
Journal: Annals of Internal Medicine (1970)

One of the rarest manifestations of sarcoidosis is involvement of the skull; only five cases have been reported (1-5). Bone lesions of any type are rare, and osseous localization is usually more frequent in the chronic stage, especially when there is simultaneous cutaneous involvement (6, 7). A young man with apparent hyperparathyroidism or hypervitaminosis D proved to have sarcoidosis with noncaseating granulomas in a liver and kidney biopsy. Roentgenograms of the skull showed multiple osteolytic lesions, biopsy of which showed scattered noncaseating granulomas consistent with sarcoidosis.
Bullying and Weapon Carrying
Authors: Mitch van Geel, Paul Vedder, Jenny Tanilon
Journal: JAMA Pediatrics (2014)

Studies suggest that adolescents involved in bullying are more likely to carry weapons than their uninvolved peers.To use meta-analyses to determine whether victims, bullies, and bully-victims are more likely to carry weapons than uninvolved peers.PsycINFO, ERIC, MEDLINE, LILACS, EMBASE, and Dissertation Abstracts International were searched for relevant publications (1950 through January 2014). The reference list of a review article and reference lists of retrieved articles were checked for further relevant studies.Studies were included if they provided an effect size comparing the weapon carrying of adolescent victims, bullies, or bully-victims with that of uninvolved peers. Studies that included individuals older than 21 years were excluded, as were studies that focused on incarcerated youth or youth diagnosed as having a psychopathologic condition.Studies were coded independently by 2 of us. The agreement rate was 93%. Effect sizes were coded that compared victims, bullies, or bully-victims with uninvolved peers. Meta-analyses were based on 22 studies for victims (n = 257 179), 15 studies for bullies (n = 236 145), and 8 studies for bully-victims (n = 199 563).This study focused on weapon carrying among adolescents. Hypotheses were formulated before the study.Victims (odds ratio, 1.97; 95% CI, 1.62-2.39), bullies (3.25; 2.72-3.89), and bully-victims (4.95; 3.77-6.50) were more likely to carry weapons than uninvolved peers. Analyses provided no indication of publication bias. Studies conducted in the United States found stronger relations between being a bully-victim and weapon carrying (odds ratio, 7.84; 95% CI, 6.02-10.21) than studies from other countries (3.62; 2.30-5.68; Q1 = 8.401; P = .004).Involvement in bullying as a victim, bully, or bully-victim is related to weapon carrying.
Breast Reconstruction after Surgery for Breast Cancer
Authors: Peter G Cordeiro
Journal: New England Journal of Medicine (2008)

A 45-year-old woman with breast cancer elects to undergo mastectomy and is referred to a plastic surgeon for evaluation for postmastectomy breast reconstruction. For some patients, breast reconstruction restores body image and sexuality and improves the quality of life. Reconstructive surgery does not interfere with detection of breast-cancer recurrence. Special considerations apply to patients who require radiation therapy.
The six disease of WHO.
Authors: M F Waters
Journal: BMJ (1981)

Leprosy is the only bacterial disease included among the six selected for the United Nations Development Programme/ World Bank/World Health Organisation's special programme for research and training in tropical diseases, and it alone has neither intermediate host nor significant animal reservoir or insect vector.It is a complex and chronic inflammatory disease of man, caused by the intracellular Mycobacterium leprae, which displays a wide clinical "spectrum" related to host ability to develop and sustain specific cell-mediated immunity.In high-resistant "tuberculoid" leprosy the localised signs are restricted to skin and nerves.Low-resistant "lepromatous" leprosy is a generalised disease affecting many systems, with widespread lesions of skin, peripheral nerves, upper respiratory tract, eyes, testes, and the reticuloendothelial system.The
Twins, triplets, and cerebral palsy in births in Western Australia in the 1980s.
Authors: B Petterson, K B Nelson, L Watson, F Stanley
Journal: BMJ (1993)

To examine the rate of cerebral palsy in twins and triplets in births from 1980 to 1989 in Western Australia and to identify factors associated with increase in risk.Pluralities for all births in Western Australia were identified through the standardised midwives' notification system, and cases of cerebral palsy were identified from the Western Australian cerebral palsy register.Multiple births, cerebral palsy, excluding postneonatal cause.The prevalence of cerebral palsy in triplets, of 28 per 1000 survivors to 1 year (95% confidence interval 11 to 63) exceeded that in twins (7.3; 5.2 to 10) and singletons (1.6; 1.4 to 1.8). Although twins and triples were more likely than singletons to be low in birth weight, their risks of cerebral palsy if low in birth weight were similar. In contrast, in normal birthweight categories twins had a higher rate of cerebral palsy (4.2; 2.2 to 7.7) than singletons (1.1; 1.0 to 1.3). The prevalence of cerebral palsy was similar in twins of unlike sex pairs, all of whom are dizygotic, and in like sex pairs. A twin pair in which one member died in utero was at higher risk of cerebral palsy: 96 per 1000 twin pairs (36 to 218) compared with 12 (8.2 to 17) for twin pregnancies in which both survived. There was a similar but non-significant trend for death of one triplet to be associated with increased risk of cerebral palsy in the survivors of the set.Triplet pregnancies produced a child with cerebral palsy 47 times more often than singleton pregnancies did and twin pregnancies eight times more often. Eighty six per cent of cerebral palsy in multiple births was in twins. As multiple births are increasing mainly because of personal and medical decisions the increased risk of cerebral palsy in multiple births is of concern.
The future of asthma
Authors: I. P Hall
Journal: BMJ (1997)

<h3>Abstract</h3> Reports in the media describing the discovery of “the asthma gene” or “a new vaccine for asthma” may be inaccurate and often raise patients9 hopes unjustifiably. This article is a personal view of key areas in current asthma research, and it examines how they may impinge on the care of asthmatic patients in the next decade. I have tried to explain the thinking behind some of the approaches under study. I discuss the potential contributions of genetic studies, immunological approaches, and new therapeutic approaches.
Spontaneous Follicular Exclusion of SHP1-deficient B Cells Is Conditional on the Presence of Competitor Wild-type B Cells
Authors: Kerstin N. Schmidt, Christopher W. Hsu, Courtney T. Griffin, Christopher C. Goodnow, Jason G. Cyster
Journal: The Journal of Experimental Medicine (1998)

Engagement of antigen receptors on mature B lymphocytes is known to block cell entry into lymphoid follicles and promote accumulation in T cell zones, yet the molecular basis for this change in cell distribution is not understood. Previous studies have shown that follicular exclusion requires a threshold level of antigen receptor engagement combined with occupancy of follicles by B cells without equivalent receptor engagement. The possibility has been raised that follicular composition affects B cell positioning by altering the amount of available antigen and the degree of receptor occupancy. Here we show that follicular composition affects migration of mature B cells under conditions that are independent of antigen receptor occupancy. B cells deficient in the negative regulatory protein tyrosine phosphatase, SHP1, which have elevated intracellular signaling by the B cell receptor, are shown to accumulate in the T zone in the absence of their specific antigen. Follicular exclusion of SHP1–deficient B cells was found to be conditional on the presence of excess B cells that lack elevated intracellular signaling, and was not due to a failure of SHP-1–deficient cells to mature and express the follicle-homing chemokine receptor Burkitt's lymphoma receptor 1. These findings strongly suggest that signals that are negatively regulated by SHP1 promote B cell localization in T cell zones by reducing competitiveness for follicular entry, and provide further evidence that follicular composition influences the positioning of antigen-engaged B cells.
New rules on controlled drugs would identify a Shipman sooner, says regulator
Authors: M. Gould
Journal: BMJ (2009)

Regulations on controlled drugs that were introduced in the United Kingdom in response to the conviction of the GP Harold Shipman for the murder of 15 patients would make similar crimes harder to commit and would identify a modern day Shipman much sooner, a new report says.

Reviewing the effectiveness of the Controlled Drugs (Supervision of Management and Use) Regulations, introduced in 2007, the Care Quality Commission, the health and social care regulator for England, says that “significant progress” has been made in ensuring the safe storage, use, and disposal of controlled drugs such as diamorphine, …
Acute Hyperglycemia and Autonomic Function
Authors: Raffaele Marfella, Francesco Nappo, Maria Antonietta Marfella, Dario Giugliano
Journal: Diabetes Care (2001)

We read with interest the study by Lefrandt et al. (1) in which they analyzed the association between baroreflex sensitivity (BRS) and blood glucose levels in healthy subjects. They observed a negative relationship between BRS and glucose levels that was independent from other risk factors and that had no glycemic thresholds. Some years ago, we evaluated the effects of acute hyperglycemia (15 mmol/l) on autonomic function in 12 healthy male volunteers (2). Heart rate variations …
Human Labor and Birth
Authors: John W. Huffman
Journal: JAMA (1969)

This is essentially a teaching text for the undergraduate. The subject matter is presented in outline form with specific points listed in an a-b-c fashion so that the student has, in essence, a syllabus of that part of his course in obstetrics which deals with labor and delivery. It was evidently written with the very laudable idea that medical students should know how a fetus gets through the pelvis, what can happen to prevent the normal progress of parturition, and how the obstetrician should manage normal and abnormal labor. The material is presented in the individual chapters in a remarkably clear and readily understood manner. There is nothing notably new or different in the author's teachings, and most obstetricians in the United States will find little fault with their obstetrical practices. The authors seem to emphasize the use of roentgenpelvimetry and apparently take a somewhat dim view of external version.
The Internalization and Degradation of Human Copper Transporter 1 following Cisplatin Exposure
Authors: Alison K. Holzer, Stephen B. Howell
Journal: Cancer Research (2006)

Abstract The human copper transporter 1 (hCTR1), the major transporter responsible for copper influx, mediates one component of the cellular accumulation of cisplatin (DDP). Both copper and DDP cause rapid down-regulation of hCTR1 expression in human ovarian carcinoma cells. In this study, we investigated the mechanism of this effect using digital deconvolution microscopy and Western blot analysis of cells stained with antibodies directed at both ends of the protein. Treatment of 2008 cells with DDP in combination with inhibitors of various endosomal pathways (amiloride, cytochalasin D, nystatin, and methyl-β-cyclodextrin) showed that hCTR1 degradation was blocked by amiloride and cytochalasin D, indicating that hCTR1 was internalized primarily by macropinocytosis. Expression of transdominant-negative forms of dynamin I and Rac showed that loss of hCTR1 was not dependent on pathways regulated by either of these proteins. DDP-induced loss of hCTR1 was blocked by the proteasome inhibitors lactacystin, proteasome inhibitor 1, and MG132. This study confirms that DDP triggers the rapid loss of hCTR1 from ovarian carcinoma cells at clinically relevant concentrations. The results indicate that DDP-induced loss of hCTR1 involves internalization from the plasma membrane by macropinocytosis followed by proteasomal degradation. Because hCTR1 is a major determinant of early DDP uptake, prevention of its degradation offers a potential approach to enhancing tumor sensitivity. (Cancer Res 2006; 66(22): 10944-52)
Hemochromatosis and Congenital Nonspherocytic Hemolytic Anemia in Siblings
Authors: Guillermo Reeves
Journal: JAMA (1963)

The unusual occurrence of both congenital nonspherocytic hemolytic anemia and hemochromatosis in a brother and sister is reported. The strikingly similar clinicopathologic abnormalities, including extraordinarily severe cardiac lesions in these relatively young siblings, is discussed.
The American College of Physicians Award Lecture: Role of Ammonia in the Renal Regulation of Acid-Base Balance.
Authors: Robert F. Pitts
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970The American College of Physicians Award Lecture: Role of Ammonia in the Renal Regulation of Acid-Base Balance.Robert F. Pitts, M.D., F.A.C.P.Robert F. Pitts, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-775_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe kidneys subserve three roles in the regulation of acid-base balance of the body fluids: the reabsorption of bicarbonate from the glomerular filtrate; the titration of fixed urinary buffers from their alkaline to their acid forms; and the secretion of the free base, ammonia. These three processes are all dependent on a single renal mechanism of exchange of H+ ions of tubular cells for Na+ ions of tubular fluid. They accomplish the stabilization of the plasma and extracellular concentration of bicarbonate within limits of 24 to 28 mEq/liter.Of the processes that restore depleted reserves of bicarbonate to normal, secretion... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 775-775KeywordsAmmoniaAttentionBicarbonatesBlood plasmaBody fluidsKidneysTubular cells Issue Published: 1 May 1970 PDF downloadLoading ...