tbuckley/cabot-search huggingface dataset:
Parenteral Hexamethonium in Hypertension
Authors: B. Morrison
Journal: BMJ (1953)

<h3>Purpose</h3> Provide up-to-date insight in incidence of retinopathy of prematurity (ROP), logistics of screening and treatment in the Netherlands and influence of the new national ROP guideline in which more stringent screening criteria were implemented and the early treatment for ROP criteria (ETROP) were emphasised. <h3>Methods</h3> Multicentre prospective nationwide study including all preterm infants, born in the Netherlands in 2017, and considered eligible for ROP screening. Anonymised data from ophthalmologists and paediatricians were merged. Outcome data were compared with the first national ROP inventory (NEDROP-1, 2009). <h3>Results</h3> In 2017, 1492 infants were live born with gestational age (GA) &lt;32 weeks (2009: 1662); 1287 infants were eligible for screening (2009: 2033). Ophthalmologists screened 1085 infants, versus 1688 in 2009, corrected with factor 1.114 for the difference in number of live births, a 28.4% (479/1688) decrease in screened infants was seen. Among surviving infants with GA &lt;32 week, ROP was found in 305/1492 babies, 20.4% (2009: 324/1662, 19.5%) of which 49/1492 stage ≥3, 3.3% (2009: 30/1662, 1.8%). In all infants, report on presence or absence of plus disease was provided, according to the ETROP criteria. Treatment was performed in 39 infants. Of infants with ROP stage ≥3, 3/49 (6.1%) progressed to retinal detachment (2009: 6/30, 20.0%). <h3>Conclusion</h3> The overall ROP incidence expressed as a percentage, remained stable but the number of infants that developed severe ROP nearly doubled. A near one-third reduction in screened infants shows satisfactory implementation of the new screening criteria. A notable decrease in retinal detachment delineates improved treatment outcome.
The Draining Malignant Ulceration
Authors: Donald K. Wood
Journal: JAMA (1980)

ONE OF the major problems in caring for patients with advanced cancer is the presence of a large fungating or ulcerating tumor. The problem becomes severe when these lesions are associated with central necrosis, bleeding, sinus formation, and, finally, a foul-smelling, draining fistula. These problems frequently tax the resourcefulness of the physician and the nursing staff and dishearten the patient and the family. Some physicians feel so desperate that they try to avoid these patients, and a difficult period of adjustment ensues. It is not my objective to discuss the attitudinal behavior of the medical professional when faced with such a patient; rather, it is to provide practical guidelines regarding clinical management of these lesions, either in the patient's home or occasionally, in an extended care facility. A positive attitude on the part of the physician will be readily communicated to the patient. The entire situation, no matter how frustrating
Prevention of Hepatocellular Carcinoma
Authors: Jack R. Wands
Journal: New England Journal of Medicine (2004)

Hepatocellular carcinoma is a significant problem worldwide, and the incidence is increasing in the United States.1 Approximately 90 to 95 percent of these tumors result from the biologic consequences of persistent hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. There are about 450 million chronic carriers of HBV and 200 million carriers of HCV. The general clinical sequence of events is exposure to HBV early in life, and then chronic hepatitis, liver injury and regeneration, development of fibrosis, and cirrhosis. The risk of the development of hepatocellular carcinoma is about 25 to 35 times as high among patients . . .
Toxic Reaction to Prolonged High-Dose Fluorouracil-Reply
Authors: Lorne D. Feldman
Journal: JAMA (1986)

<h3>In Reply.—</h3> Since preparation of our article describing fluorouracil-associated dermatitis of the hands and feet, several additional publications have documented a similar schedule-dependent toxicity.<sup>1,2</sup>Seventeen patients who were being treated with prolonged infusion of fluorouracil developed palmar-plantar erythrodysesthesia syndrome with cutaneous findings similar to those in our patients.<sup>1</sup>These 17 patients, six additional patients with similar cutaneous toxic reactions,<sup>2</sup>and our patients all had a syndrome that was dose and schedule dependent. The occurrence of prodromal tingling and progression to a tender, erythematous, swollen, desquamative eruption of the palms and soles appears to be limited to patients receiving prolonged infusions of fluorouracil at doses exceeding 300 mg per square meter of body surface area per day. The rash improves with discontinuation of chemotherapy and is exacerbated with attempts to reinstitute chemotherapy. A similar syndrome occurs with prolonged infusion, but not with bolus or short-term infusion of doxorubicin.
Corrigendum to “The independent effects of fatigue and UDCA therapy on mortality in primary biliary cirrhosis: Results of a 9 year cohort follow-up” J. Hepatol. 2010 Nov; 53(5):911–917
Authors: David E Jones, Ahmad Al-Rifai, James Frith, Imran Patanwala, Julia L Newton
Journal: Journal of Hepatology (2011)
THE ANTIFUNGAL ACTIVITY OF ANTIBIOTIC XG 1
Authors: Gladys L. Hobby, Peter P. Regna, Nancy Dougherty, William E. Stieg
Journal: Journal of Clinical Investigation (1949)

Lewis, Hopper, and Shultz, in 1946 (1), re- ported the existence of an antimicrobial agent in culture filtrates of an organism closely related to Bacillus subtilis, and demonstrated that this sub- stance possesses a remarkable antifungal activity against Trichophyton gypseumn and certain other pathogenic fungi, as well as against certain of the Gram-positive bacteria.During the following year, Lewis and Hopper undertook to investigate methods of producing this antibiotic on a small scale, and succeeded in recovering a sufficient quantity to permit preliminary study of its bio- logical and chemical properties as well as its therapeutic efficacy in fungous infections in man.These early studies of Lewis and his associates suggested that Antibiotic XG may be a highly effective chemotherapeutic agent in the treatment of fungous infections in man.The present report will discuss certain of the chemical and biological properties of this new an- tifungal agent.2NATURE OF ANTIBIOTIC Antibiotic XG is produced by the growth of an unidentified organism closely related to B. subtilis.The antibiotic may be absorbed from fermentation liquor onto carbon at neutral pH and may be eluted with aqueous acetone.It is soluble in methanol and ethanol.It is insoluble in ether, chloroform, ethyl acetate, and dry acetone.Antibiotic XG is stable in broth when heated at 90°C. for two hours at pH 3.0; it may be auto- claved at 15 pounds pressure, for at least 10 min- utes, at pH 7.0 without significant loss in potency.In wet acetone, it is stable at room temperature
The Night Before (what jacqui said)
Authors: Jennifer Best
Journal: Annals of Internal Medicine (2004)

Ad Libitum6 July 2004The Night Before (what jacqui said)Jennifer Best, MDJennifer Best, MDFrom Seattle, WA 98199.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-1-200407060-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “Sit with me here.Right here, right now,” she said,patting the one small circle on her blanketwithout crusted Lactulose or bits of that morning's scrambled egg.“Sit you down now and stay a while, doc.Let me tell you a story about me—Jacqui—with my one lazy eye,and my new satin nightgown that makes me feel pretty,since it happened that ugly was found inside me, down deep, where I can't see.”“I want ... Author, Article, and Disclosure InformationAffiliations: From Seattle, WA 98199.Current Author Address: Jennifer Best, MD, 2610 Magnolia Lane West, Seattle, WA 98199. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 July 2004Volume 141, Issue 1Page: 69KeywordsHead and neck cancers ePublished: 6 July 2004 Issue Published: 6 July 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract P1-13-03: Is Bone Biopsy of Metastatic Sites Useful in Advanced Breast Cancer Management?
Authors: G Aurilio, A Sciandivasci, V Bagnardi, P Della Vigna, L Monfardini, L Preda, S Rizzo, M Padrenostro, G Renne, E Munzone, D Cullurà, MC Petrella, M Bellomi, F. Nolè
Journal: Cancer Research (2010)

Abstract Background: Biopsies of metastatic sites are not recommended in clinical practice to evaluate changes in biological features in advanced breast cancer (ABC) women. We assessed discordance in expression levels for estrogen receptor (ER), progesterone receptor (PgR) and epidermal growth factor receptor 2 (HER2), between primary tumor and bone metastases and its clinical impact on patient management. Material and Methods: We retrospectively analyzed 109 ABC patients (pts) underwent computed tomography guided bone biopsy at the European Institute of Oncology in Milan, Italy, from 1997 to 2009. Data on ER and PgR status [positive if ≥1% by immunohistochemistry (IHC)] and on HER2 status (positive if IHC3+ and/or FISH amplified), both primary tumor and bone metastases were collected. Fisher and McNemar's test were used for statistical analysis. Results: Median time from primary diagnosis to bone biopsy was 4.2 years (range 0-18.9). Overall discordance rate (ODR) in ER expression was 20.5% (95% CI: 13.4%-29.5%): 3/7 pts (42.9%) shifted from ER negative to positive and 19/100 pts (19%) from ER positive to negative [p=0.0006]. ODR in PgR expression was 43.9% (95% CI: 34.3%-53.8%): 4/21 pts (19%) changed from PgR negative to positive and 43/86 pts (50%) from PgR positive to negative [P&amp;lt;0.0001]. ODR in HER2 status was 6.9% (95% CI: 2.6%-14.6%): 4/78 pts (5.1%) changed from HER2 negative to positive and 2/8 pts (25%) turned from HER2 positive to negative [p=0.41]. Thirteen out of 21 pts (61.9%) with discordant ER status and 23/77 pts (29.8%) with concordant ER status [p=0.01] changed endocrine therapy; there were no differences in chemotherapy [p=0.80]. Four out of 6 pts (66.6%) with discordant HER2 status and 6/72 pts (8.3%) with concordant HER2 status changed immunologic therapy [p=0.002], 3/6 pts (50%) started trastuzumab and 1/6 patient (16.6%) stopped it; there were no differences in chemotherapy [p=0.68]. All pts well tolerated the invasive procedure, requiring only local analgesia. Discussion: Our analysis showed that receptor profile may significantly change between primary breast cancer and bone metastases, with relevant impact on therapy. Bone biopsy might be useful and should be considered in selected cases to optimize therapeutic choices. Large prospective trials are needed to investigate these outcomes. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-13-03.
The crisis in diabetes care in England
Authors: G. Rayman, A. Kilvert
Journal: BMJ (2012)

Failings identified by recent reports must be tackled urgently 

In 2001 the National Service Framework for Diabetes set standards for diabetes care in England, with a delivery strategy designed to achieve a world class diabetes service by 2013.1 However, a series of recent reports from various sources show just how far we are from delivering the standards by the 2013 deadline. A “state of the nation” report from Diabetes UK declares that diabetes care is “in a state of crisis,” and a damning National Audit Office (NAO) report accuses the Department of Health of failing to hold NHS commissioners to account for poor performance and of failure to deliver the recommended standards of care.2 3 Both reports are based on the department’s own commissioned audits.

The National Diabetes Audit reported that in 2010-11 only half of people with diabetes received all of the recommended nine care processes, with fewer than one in five achieving the recommended treatment targets.4 An estimated 24 000 diabetes related deaths each year may have been preventable, and death in young women (aged 15-34 years) with type 1 diabetes has increased ninefold since the 2007-08 audit.5 The National Diabetes Inpatient Audit 2011 found that 15% of hospital inpatients have diabetes.6 Errors in management and prescribing, iatrogenic hypoglycaemia, poor glycaemic control, and hospital acquired foot ulceration commonly compromise their care. The Atlas of Variation 2010-11 shows wide variations in outcomes for complications of diabetes.7 England, unlike the United States and many European countries, has failed to reduce amputation rates, and …
Determining power in clinical trials.
Authors: P. Urbach
Journal: BMJ (1988)

The protoberberine alkaloid berberine carries methylenedioxy moiety and exerts a variety of pharmacological effects, such as anti-inflammation and lipid-lowering effects. Berberine causes potent CYP1B1 inhibition, whereas CYP1A2 shows resistance to the inhibition. To reveal the influence of oxidative metabolism on CYP1 inhibition by berberine, berberine oxidation and the metabolite-mediated inhibition were determined. After NADPH-fortified pre-incubation of berberine with P450, the inhibition of CYP1A1 and CYP1B1 variants (CYP1B1.1, CYP1B1.3, and CYP1B1.4) by berberine was not enhanced, and CYP1A2 remained resistant. Demethyleneberberine was identified as the most abundant metabolite of CYP1A1- and CYP1B1-catalyzed oxidations, and thalifendine was generated at a relatively low rate. CYP1A1-catalyzed berberine oxidation had the highest maximal velocity (<i>V</i><sub>max</sub>) and exhibited positive cooperativity, suggesting the assistance of substrate binding when the first substrate was present. In contrast, the demethylenation by CYP1B1 showed the property of substrate inhibition. CYP1B1-catalyzed berberine oxidation had low <i>K</i><sub>m</sub> values, but it had <i>V</i><sub>max</sub> values less than 8% of those of CYP1A1. The dissociation constants generated from the binding spectrum and fluorescence quenching suggested that the low <i>K</i><sub>m</sub> values of CYP1B1-catalyzed oxidation might include more than the rate constants describing berberine binding. The natural protoberberine/berberine metabolites with methylenedioxy ring-opening (palmatine, jatrorrhizine, and demethyleneberberine) and the demethylation (thalifendine and berberrubine) caused weak CYP1 inhibition. These results demonstrated that berberine was not efficiently oxidized by CYP1B1 and metabolism-dependent irreversible inactivation was minimal. Metabolites of berberine caused a relatively weak inhibition of CYP1.
Clinical, Laboratory, and Scintigraphic Manifestations of Subacute and Chronic Thyroiditis
Authors: CHARLES M. INTENZO, CHAN H. PARK, SUNG M. KIM, DAVID M. CAPUZZI, STANLEY N. COHEN, PAUL GREEN
Journal: Clinical Nuclear Medicine (1993)

The term “thyroiditis” refers to several syndromes of differing etiology. Chronic or Hashimoto's thyroiditis (HT), an autoimmune disorder that is manifested by goiter and hypothyroidism, is by far the most common of these syndromes. Subacute thyroiditis (SAT) encompasses two distinct syndromes: subacute granulomatous thyroiditis (SAGT) and subacute lymphocytic thyroiditis (SLT). SAGT is viral in origin and usually presents with neck tenderness and hyperthyroid symptoms, while SLT, which is likely to be an autoimmune entity, results in goiter and transient hyperthyroidism. SLT is often seen in the postpartum period and is referred to as postpartum thyroiditis (PPT). Less common forms of thyroiditis include Riedel's struma, which is characterized by extensive fibrosis of the thyroid gland, and acute suppurative thyroiditis, which is a bacterial infection. Twenty patients with goiter were evaluated by thyroid scintigraphy. They were ultimately diagnosed as having either HT (14), SAGT (3), SLT (1), or PPT (2). Their scan findings were correlated with both clinical presentations as well as in vitro laboratory analysis.
One Man at a Time — Resolving the PSA Controversy
Authors: Mary F. McNaughton-Collins, Michael J. Barry
Journal: New England Journal of Medicine (2011)

Evidence of a possible small benefit from PSA screening supports a grade C recommendation — not the U.S. Preventive Services Task Force's proposed grade D — for men 55 to 69 years of age, who should participate in screening decisions after discussion with a primary care provider.
Lessons from the flood: will Floyd change livestock farming?
Authors: C W Schmidt
Journal: Environmental Health Perspectives (2000)

When Hurricane Floyd struck eastern North Carolina in September 1999, as many as 50 waste lagoons, many of them several acres in size, were inundated by flood waters. Five lagoons breached, and waterborne animal waste produced nutrient pollution and raised the potential for exposure to pathogens and the risk of disease. As the state recovers, a common question being asked is whether state livestock regulations, particularly regarding facility siting and waste management methods, will be revised to accommodate future flood conditions.
Uptake of 99mTc-Methylene Diphosphonate in Squamous Cell Carcinoma of the Penis
Authors: SHANTILAL LUNIA, BELUR S. CHANDRAMOULY, ROBERT B. CHODOS, JOHN A. DAPOLITO
Journal: Clinical Nuclear Medicine (1979)

LUNIA, SHANTILAL M.D.; CHANDRAMOULY, BELUR S. M.D.; CHODOS, ROBERT B. M.D.; DAPOLITO, JOHN A. M.S., C.H.P. Author Information
Association of High-Density Lipoprotein Cholesterol With Incident Cardiovascular Events in Women, by Low-Density Lipoprotein Cholesterol and Apolipoprotein B100 Levels
Authors: Samia Mora, Julie E. Buring, Paul M Ridker, Yadong Cui
Journal: Annals of Internal Medicine (2011)

Background: Prior studies have found inverse associations between high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A-I levels and cardiovascular disease (CVD). Whether this observation is consistent across low-density lipoprotein cholesterol (LDL-C) levels or total atherogenic particle burden (apolipoprotein B100) is less well-studied, particularly in women. Objective: To determine the association between HDL-C or apolipoprotein A-I level and CVD across a range of LDL-C and apolipoprotein B100 values. Design: Prospective cohort study. Setting: The Women's Health Study, a cohort of U.S. female health professionals. Participants: 26 861 initially healthy women, aged 45 years or older at study entry (1992–1995), who were followed for a mean of approximately 11 years. Measurements: Baseline lipids were measured directly, and apolipoproteins were measured with immunoassays. Outcomes were incident total CVD (n = 929), coronary events (n = 602), and stroke (n = 319). Results: In multivariable analyses, HDL-C and apolipoprotein A-I levels were inversely associated with CVD and coronary events but not stroke. Adjusted coronary hazard ratios for decreasing quintiles of HDL-C were 1.00 (reference), 1.23 (95% CI, 0.85 to 1.78), 1.42 (CI, 0.98 to 2.06), 1.90 (CI, 1.33 to 2.71), and 2.19 (CI, 1.51 to 3.19) (P for linear trend < 0.001); corresponding hazard ratios for apolipoprotein A-I were 1.00 (reference), 0.98 (CI, 0.71 to 1.35), 1.02 (CI, 0.72 to 1.44), 1.37 (CI, 0.98 to 1.90), and 1.58 (CI, 1.14 to 2.20) (P for linear trend = 0.005). Consistent inverse associations were found for HDL-C with coronary events across a range of LDL-C values, including among women with low LDL-C levels. No associations were noted for HDL-C or apolipoprotein A-I among women with low apolipoprotein B100 values (<0.90 g/L). Limitation: Participants were at low risk for CVD, the number of events in the lowest apolipoprotein B100 stratum was small, only a single baseline measurement was obtained, and residual confounding may have occurred. Conclusion: Consistent inverse associations were found for HDL-C with incident coronary events among women with a range of LDL-C values. Among women with low total atherogenic particle burden (apolipoprotein B100 level <0.90 g/L), few events occurred and no associations were seen. Primary Funding Source: Merck & Co. and the National Heart, Lung, and Blood Institute and National Cancer Institute, National Institutes of Health.
Idiopathic Pulmonary Haemosiderosis
Authors: M. Walton, A. A. Williams
Journal: BMJ (1951)

showed numerous " heart-failure," cells, many containing haemosiderin.In the fourth case, that of an adult female, we draw attention to the development of a miliary appearance, localized to one mid-zone, after an attack of acute pulmonaryoedema.Again lung puncture showed numerous pigmented macrophages.Laubry's finding that lung puncture is a valuable diagnostic procedure has therefore been confirmed in our cases.
Obstetrics and Gynecology: The Clinical Core
Authors: Jack Maidman
Journal: JAMA (1984)

With this third edition, Wynn brings into the 1980s a textbook designed to provide the medical student with the clinical core of obstetrics and gynecology. When first published ten years ago, this text provided a radical departure from the classic textbook with its encyclopedic approach to clinical material and the standard course outline, which required extensive supplementation with textbook and lecture materials. It attempted to provide that core of requisite knowledge to fill "the minimal needs of every physician for knowledge and skills in obstetrics and gynecology." The current edition has been extraordinarily updated in all areas. The text, through the use of lines in the margin adjacent to appropriate paragraphs, is codified to separate the data base required for minimal clinical competence from more advanced material required for mastery of examinations and for students interested in a career in the field. Key words and phrases are italicized for rapid
Epileptogenic Side Effects of Psychotropic Drugs
Authors: Lewis Glickman
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Turan M. Itil, MD, and Constantin Soldatos, MD (1980; 244:1460), in their recent discussion of the epileptogenic side effects of psychotropic drugs, have allowed two contradictions to occur between their text and their Fig 1. In their text they state, "The more prominent the sedative properties of a neuroleptic... the more marked is its epileptic potential. Antipsychotic drugs with prominent extrapyramidal side effects [EPS] have fewer epileptogenic properties." However, in their Fig 1 they describe thioridazine, which is the least likely of all neuroleptics to produce EPS,<sup>1-3</sup>and second only to chlorpromazine in its sedative effects<sup>4</sup>to have only "slight" epileptogenic potency (their lowest category) relative to the other psychotropics. They also describe thiothixene, fluphenazine, and haloperidol, all of which are less sedating and more likely to cause EPS than thioridazine, as having "moderate" epileptogenic potency. Haloperidol is both the least sedating and most likely