tbuckley/cabot-search huggingface dataset:
Choriocarcinoma of the Thymus
Authors: Paul Jernstrom
Journal: JAMA (1962)

Choriocarcinoma is a notorious, highly malignant tumor of placental or teratoid testicular origin. An obscure entity referred to as "primary extragenital chorionepithelioma of the mediastinum" is described herewith as choriocarcinoma of the thymus. The fact that this neoplasm occurs almost exclusively in young men is substantiated by similar sequences iterated in 43 reports in the literature. A typical case is presented of a 26-year-old man whose fatal 2-month course was epitomized by hemoptysis, dyspnea, pain, gynecomastia, testicular atrophy, and positive tests for chorionic gonadotropin. Effective treatment for choriocarcinoma was wanting until a few years ago. This radioresistant tumor has responded to a folic acid antagonist, and to combinations of an antimetabolite, an alkylating agent, and the antitumor antibiotic actinomycin D. These approaches to the therapy of choriocarcinoma, however, appear to be less satisfactory in men than in women.
Clinical Features of Hypertrophic Cardiomyopathy Caused by a Lys183 Deletion Mutation in the Cardiac Troponin I Gene
Authors: Hiromasa Kokado, Masami Shimizu, Hiroyuki Yoshio, Hidekazu Ino, Kazuyasu Okeie, Yorito Emoto, Toru Matsuyama, Masato Yamaguchi, Toshihiko Yasuda, Noboru Fujino, Hideki Ito, Hiroshi Mabuchi
Journal: Circulation (2000)

Mutations that cause hypertrophic cardiomyopathy (HCM) have been identified in 9 genes that code proteins in the sarcomere. Previous reports have demonstrated that cardiac troponin I (cTnI) gene mutations may account for familial HCM; however, the clinical characteristics and prognosis of patients with HCM caused by cTnI gene mutations are not known.We analyzed cTnI gene mutations in 130 unrelated probands with HCM and their families to clarify the genotype-phenotype correlations. We identified 25 individuals in 7 families with a Lys183 deletion (Lys183 del) mutation in exon 7 of the cTnI gene. The disease penetrance in subjects aged >20 years was 88% by echocardiography and 96% by ECG. Sudden death occurred in 7 individuals of 4 families at any age. Overall, 7 (43.8%) of 16 individuals aged >40 years had left ventricular systolic dysfunction, and 3 (18.8%) displayed dilated cardiomyopathy-like features. Of affected individuals, 4 of 5 individuals aged >40 years followed by echocardiography showed septal thinning and decreased fractional shortening during >5 years of follow-up.The Lys183 del mutation in the cTnI gene in patients with HCM is associated with variable clinical features and outcomes. HCM caused by the Lys183 del mutation has a significant disease penetrance. This mutation is associated with sudden death at any age and dilated cardiomyopathy-like features in those aged >40 years. However, it remains unclear whether screening of families with HCM for this mutation will be useful in patient management and counseling.
Annual Rates of Arterial Thromboembolic Events in Medicare Neovascular Age-Related Macular Degeneration Patients
Authors: Sherri L. Alexander, Walter T. Linde-Zwirble, Winifred Werther, Eric E. Depperschmidt, Laura J. Wilson, Ram Palanki, Namrata Saroj, Sara L. Butterworth, Tsontcho Ianchulev
Journal: Ophthalmology (2007)
Inhibition of Gastric Acid Secretion in Man by Peptide Analogues of Cholecystokinin
Authors: A. Marvin Brooks, Andrea Agosti, Giulio Bertaccini, Morton I. Grossman
Journal: New England Journal of Medicine (1970)

In human subjects gastric acid secretion was stimulated by intravenous infusion of 1 μg of pentagastrin per kilogram hour. One hour after the start of pentagastrin, when acid secretion had reached a plateau, either caerulein (eight tests), a decapeptide extracted from frog skins, or carboxy-terminal heptapeptide amide of cholecystokinin (five tests), each in a dose of 0.1 μg per kilogram hour, was added to the pentagastrin infusion for one hour. Both peptides produced about 70 per cent inhibition of acid output. Since both peptides have the same carboxy-terminal tetrapeptide amide sequence as pentagastrin, presumably they inhibited by competing with pentagastrin for a common receptor. In separate tests this dose of caerulein alone produced slight stimulation of acid secretion in two of five subjects. Screening of related peptides might yield a specific competitive inhibitor of gastrin with even less stimulatory action than was noted with those tested.
New Guidelines Examine Drug Firm, CME Relations
Authors: Teri Randall
Journal: JAMA (1991)

NEW ETHICAL guidelines that address the relationship between pharmaceutical companies and continuing medical education (CME) programs are expected to be approved this month by the Accreditation Council for Continuing Medical Education (ACCME). The new guidelines build on and strengthen previous guidelines adopted in 1984, and address several ethical concerns that were previously ambiguous. Throughout the 1980s, funding of CME programs and other symposia emerged as the fastest growing area in pharmaceutical marketing. A congressional survey reveals that industry funding of symposia increased 14-fold between 1975 and 1988 (adjusted for inflation). During the same period, expenditures for gifts and reminder items increased only two to three times (adjusted for inflation). While acknowledging that funding from industry serves an important and beneficial function, the public and the medical community have voiced increasing concern that the influence of industry in these programs could compromise the integrity of physicians' continuing education. Extravagant promotional schemes,
A CASE OF NODOSE BROMIDE ERUPTION IN A BREAST-FED INFANT
Authors: E. H. MOLESWORTH
Journal: British Journal of Dermatology (1917)

Tiih: subject of this note Avas brought for consultation on May 16th, 1916, Avith the following history :The baby was 10 months oH at the time of the visit, and had up to that time been entirely breast-fed and had taken no drugs.Three and a half Aveeks before the consultation the eruption had beguu in the i'orm of small, bright red lumps on the forearms, hands, and face.Similar lesions had appeared soon after on the trunk, but these were more sparsely distributed.The earlier lesions became crusted and granulomatous in appearance in eit^ht to ten days from their beginning, and these characteristics were daily becoming more pronounced.The mother described the formation of actual pustules at the summits of the nodes, but at the time of consultation only crusting Avas evident.When flrst seen there Avere multiple nodes of various sizes, the distribution of Avhich is best demonstrated by the photographs.The lesions rose abruptly fi-om the surface of the skin, and except at their summit Avere not of a very marked redness, though the mother said that at their first appearance they Avere of a vivid red.To palpation they were firm and elastic, and Avhen pressed exuded small droplets of pus from multiple small openings.They did not appear to be to any extent painful or tender to the touch, though the child Avas fretful and restless.The pulse and temperature Avere both normal and the general health Avas good.l^he bromide apparently Avas contained in the mother's milk, as the child had taken no poAvders of medicine of any kind, whereas the mother had for three or four months been taking nearly every night a sleeping draught consisting of 30 grains of potassium bromide.It was reported that the lesions gradually died away about six weeks after the mother had given up takiug the drug.-E.H. M.This case appears to me to have two or three points of interest.In the first place, cases of bromide eruption due to ingestion in the
Treatment of Asthma-Reply
Authors: Gordon W. Josephson
Journal: JAMA (1980)

In Reply.—  Dr Salberg is correct in noting that no rigid criteria were used in determining suitability for discharge or admission, although none of our discharged patients were sent home with PEFs of less than 200 L/min. While some studies have used PEF data and response to initial treatment as the basis for prompt decision making regarding admission (235:1337, 1976), and others have attempted to grade asthma based on physical examination, 1 we relied on the individual judgment of our investigator-physician with regard to patient discharge or admission.  Patients showing satisfactory improvement, both subjectively (improved sense of well-being and less shortness of breath) and objectively (increased respiratory excursion, decreased inspiratory-expiratory ratio, increased peak expiratory flow, and decreased wheezing), were discharged. In general, emergency room treatment was limited to 12 hours, so that patients not well enough to go home at that time were routinely admitted. Patients showing marked refractoriness to
Detection of Thyroid Carcinoma in Wall of a Cystic Lesion by FDG PET
Authors: Narendra Nair, Archi Agrawal, U N. Nayak
Journal: Clinical Nuclear Medicine (2005)

Three cases are described, in which positron emission tomography (PET) led to the diagnosis of carcinoma in solitary thyroid nodules (STN), which were considered benign by clinical assessment, ultrasonography, and fine needle aspiration cytology (FNAC).These 3 cases were from a group of 51 patients with solitary thyroid nodules that were nonfunctioning or "cold" on pertechnetate scans that were later studied with FDG PET scanning.Of the entire group, 28 patients showed the nodule to be nonfunctioning on FDG scans. Of these, 3 showed one or more small foci of intense FDG uptake in the periphery. On histopathology, these sites were found to harbor carcinoma, papillary carcinoma in 2 patients and a follicular variant of papillary carcinoma in one.These cases demonstrate the usefulness of FDG PET in detection of cancer that may lurk in the wall of a cystic thyroid nodule, often misinterpreted as benign by conventional methods.
NLRX1 Protein Attenuates Inflammatory Responses to Infection by Interfering with the RIG-I-MAVS and TRAF6-NF-κB Signaling Pathways
Authors: Irving C. Allen, Chris B. Moore, Monika Schneider, Yu Lei, Beckley K. Davis, Margaret A. Scull, Denis Gris, Kelly E. Roney, Albert G. Zimmermann, John B. Bowzard, Priya Ranjan, Kathryn M. Monroe, Raymond J. Pickles, Suryaprakash Sambhara, Jenny P.Y. Ting
Journal: Immunity (2011)
The waking-to-dreaming continuum and the effects of emotion
Authors: Ernest Hartmann
Journal: Behavioral and Brain Sciences (2000)

The three-dimensional “AIM model” proposed by Hobson et al. is imaginative. However, many kinds of data suggest that the “dimensions” are not orthogonal, but closely correlated. An alternative view is presented in which mental functioning is considered as a continuum, or a group of closely linked continua, running from focused waking activity at one end, to dreaming at the other. The effect of emotional state is increasingly evident towards the dreaming end of the continuum. [Hobson et al.; Nielsen; Solms]
Are Internists Functioning as Family Physicians?
Authors: WILLIAM W. ENGSTROM
Journal: Annals of Internal Medicine (1967)

Editorials1 March 1967Are Internists Functioning as Family Physicians?WILLIAM W. ENGSTROM, M.D.WILLIAM W. ENGSTROM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-3-613 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe report by the Millis Commission on the Graduate Education of Physicians (1) suggests that "sweeping change is necessary" to train the "primary" physician and that he be taught "a new body of knowledge." The primary content of his graduate education would consist of medicine, psychiatry, pediatrics, medical gynecology, and preventive medicine. At the same time, the American College of Physicians "thinks a man certified by the American Board of Internal Medicine is the ideally trained man for adult family practice as currently defined" (2, 3). While it is not the intention of this communication to critically analyze the Millis...References1. Report of the Citizens Committee on Graduate Medical Education: The Graduate Education of Physicians. American Medical Association, Chicago, 1966. Google Scholar2. ROSENOW EC: Executive Director's page. Bull. Amer. Coll. Physicians 6: 217, 1965. Google Scholar3. : Resolution on family practice. Bull. Amer. Coll. Physicians 7: 178, 1966. Google Scholar4. Report of the Ad Hoc Committee on Education for Family Practice of the Council on Medical Education: Meeting the Challenge of Family Practice. American Medical Association, Chicago, 1966. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WILLIAM W. ENGSTROM, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byResolving the Conflicts between General and Subspecialty Medicine: The Internist as Consulting Physician-ScientistA National Study of Internal Medicine and Its Specialties: II. Primary Care in Internal MedicineROBERT C. MENDENHALL, M.S., ALVIN R. TARLOV, M.D., ROGER A. GIRARD, Ph.D., JANET K. MICHEL, M.S., STEPHEN E. RADECKI, M.A.Internal Medicine and Family PracticeRestructuring Medical Education for Management of the Chronically Ill Aged*What One Internist Does in His Practice Implications for the Internist's Disputed Role and EducationJOHN F. BURNUM, M.D., F.A.C.P.Medical Schools, Internships, Residencies and BoardsResidency Training in Internal Medicine, For What; Subspecialty Boards, What For?WILLIAM W. ENGSTROM, M.D., F.A.C.P.Curriculum Changes: Pass or Fail for Town and GownLOCKHART B. MCGUIRE, M.D.Psychiatric Training for Physicians in Internal MedicineMORTON D. BOGDONOFF, M.D., F.A.C.P. 1 March 1967Volume 66, Issue 3Page: 613-616KeywordsGraduate medical educationPediatricsPreventive medicine ePublished: 1 December 2008 Issue Published: 1 March 1967 PDF downloadLoading ...
Measures to cut Germany's drugs bill start to take effect
Authors: N. Stafford
Journal: BMJ (2011)

Germany’s public health insurers spent only 1% more on prescription drugs in 2010 than in the previous year, stemming a four year trend of sharp rises, a new annual study of German drug costs shows. But they are still paying much more than the United Kingdom is for top selling branded and generic drugs.

Ulrich Schwabe, coeditor of the annual Prescription Drug Report and professor emeritus of pharmacology at the University of Heidelberg, told the BMJ that recent measures to slow the rises in prices of patent protected drugs are beginning to take effect. “I would assume that total [drug] spending in 2011 will go down,” he said.

In 2010 Germany’s public health insurers spent €32bn (£20bn; $44bn) on …
“Multiple Drafts” of subjective experience viewed within a microgenetic framework for cognition and consciousness
Authors: Joseph Glicksohn
Journal: Behavioral and Brain Sciences (1995)

Abstract The notion of “multiple drafts” is one that has attracted the attention of researchers working within the “microgenetic” framework to perception and cognition, deriving from the work of Heinz Werner (1948). Dennett and Kinsboume's (1992) position can be further explored with reference to this earlier literature. The present commentary attempts to ground the D&amp;K model within this larger theoretical debate.
R.M.B.F. Christmas Appeal
Authors: A. Lawson
Journal: BMJ (1946)

<h3>Background</h3> Sexual behavioural studies among men who have sex with men (MSM) are predominantly focused on penile-anal intercourse. Other non-anal sexual activities are under-studied. This study aimed to examine the age pattern of a range of sexual activities among MSM with the most recent male sex partner. <h3>Methods</h3> We conducted a survey among MSM attending the Melbourne Sexual Health Centre in 2017. This survey asked about nine different sexual activities with their most recent regular and casual partner. A Chi-square trend test was used to examine the age patterns of each sexual activity. <h3>Results</h3> A total of 1596 men answered the survey and their median age was 30 (IQR 25–37) years. With casual partners, kissing was the most common activity (92.4%), followed by performing penile-oral sex (86.0%) and receiving penile-oral sex (83.9%). The least common activity was insertive rimming (38.1%). Young men were more likely to engage in kissing (p<sub>trend</sub>&lt;0.001), receptive rimming (p<sub>trend</sub>=0.004) and receptive penile-anal sex (p<sub>trend</sub>&lt;0.001) but they were less likely to have insertive penile-anal sex compared with older MSM. With regular partners, the most common activity was kissing (97.4%), followed by touching penises (90.0%) and performing penile-oral sex (88.3%). Age was not associated with most types of sexual activity with regular partners except mutual masturbation and receptive penile-anal sex. Younger men were more likely to masturbate mutually (p<sub>trend</sub>=0.028) and engage in receptive penile-anal sex (p<sub>trend</sub>=0.011). <h3>Conclusions</h3> The pattern of sexual activities shows age-related differences with casual partners but less so with regular partners in MSM.
Cost-effectiveness of stroke prophylaxis for nonvalvular atrial fibrillation
Authors: Brian D. Kan, David A. Katz
Journal: JAMA (1996)

<h3>In Reply.</h3> —We agree with Dr Edmunds and colleagues that ongoing immunization will ultimately lower the risk of HBV infection in a population. Modeling the dynamics of infection risk into evaluations of immunization strategies would provide better assessment of long-term prevention effectiveness. However, few such analyses exist, making cost comparisons with other infectious diseases difficult. We have dynamically modeled the expected reduction in HBV infection associated with various immunization strategies in populations with varying endemicity of infection (P. J. C., unpublished data, 1995). In populations in which infections occur predominantly during early childhood (eg, Gambians and Alaskan Natives), infant immunization combined with catch-up immunization of young children would dramatically reduce infection risk in a decade. In such a setting, the force of infection resides in a limited young age group and is rapidly eliminated by immunization. However, in low-endemicity populations, most infections are transmitted among young adults over a wide
VIRUS OF WESTERN EQUINE ENCEPHALITIS IN THE SPINAL FLUID
Authors: Bruce Chown
Journal: JAMA (1942)

Recovery of the virus from the cerebrospinal fluid of patients with encephalitis has rarely been reported. There are only 2 reports of this in the medical literature.<sup>1</sup> During the epidemic of western equine encephalitis in Manitoba in July and August 1941, positive results were obtained with the spinal fluid from a 6 weeks old baby admitted to the hospital on August 19 with fever and convulsions which had become apparent the previous day. Lumbar puncture was done on admission. The fluid was slightly cloudy and contained 998 cells per cubic millimeter, 80 per cent of which were polymorphonuclears. There was a decided increase in globulin content. Organisms were not found on smear or culture. On August 20, guinea pigs 1 and 2, each weighing approximately 300 Gm., were each injected intracerebrally with 0.2 cc. of spinal fluid from this patient. Guinea pig 2 remained well. On August 26 the
Polypyrrole-coated electrodes for the delivery of charge and neurotrophins to cochlear neurons
Authors: Rachael T. Richardson, Andrew K. Wise, Brianna C. Thompson, Brianna O. Flynn, Patrick J. Atkinson, Nicole J. Fretwell, James B. Fallon, Gordon G. Wallace, Rob K. Shepherd, Graeme M. Clark
Journal: Biomaterials (2009)
Suppression of Thromboxane A<sub>2</sub>but Not of Systemic Prostacyclin by Controlled-Release Aspirin
Authors: Robert J. Clarke, Gail Mayo, Patricia Price, Garret A. FitzGerald
Journal: New England Journal of Medicine (1991)

The antithrombotic efficacy of aspirin is attributed to its inhibition of the enzyme prostaglandin G/H synthase, which is necessary for the formation of thromboxane A2 in platelets. Thromboxane A2 is a potent vasoconstrictor and platelet agonist. However, the formation of prostacyclin by vascular endothelium also requires prostaglandin G/H synthase, and prostacyclin exerts opposite effects on platelet function and vascular tone. We wanted to see whether controlled-release aspirin would affect the formation of thromboxane A2 but not prostacyclin by reducing the aspirin concentration that reaches the posthepatic circulation.
Unusual Hepatic Uptake Pattern of Technetium-99m Sulfur Colloid and Technetium-99m HDP in Amyloidosis
Authors: LAWRENCE M. VINCENT, WILLIAM H. McCARTNEY, TIMOTHY C. FLYNN
Journal: Clinical Nuclear Medicine (1986)

A patient with idiopathic systemic amyloidosis presented with an unusual pattern of liver hypertrophy, manifesting a focal region of relatively increased sulfur colloid activity and relatively diminished bone agent uptake. Functional hyposplenism with splenic uptake of bone agent also was documented.
Elastic DNA Elements -- Boon or Blight?
Authors: James F. Gusella
Journal: New England Journal of Medicine (1993)

The human genome is often viewed as a stable collection of genes, embedded both in the DNA necessary to regulate their expression and in the chromosomal packaging. According to this relatively static picture, genetic diseases may be caused by rare mutation events that damage a gene, deleting a portion or altering its coding sequence. However, the human genome is also populated by DNA sequences that are not at all static, but vary with considerable frequency. This issue of the Journal presents an example of one such sequence, particular variants of which are associated with an increased risk of cancer1. . . .
The interaction of human peripheral blood eosinophils with bacterial lipopolysaccharide is CD14 dependent
Authors: Sabine G. Plötz, Arnd Lentschat, Heidrun Behrendt, Werner Plötz, Lutz Hamann, Johannes Ring, Ernst Th. Rietschel, Hans-Dieter Flad, Artur J. Ulmer
Journal: Blood (2001)
Reversal of atrial electrical remodeling following cardioversion of long-standing atrial fibrillation in man
Authors: W Yu
Journal: Cardiovascular Research (1999)

Background: In animal studies, atrial fibrillation has been shown to shorten the atrial refractory period and impair its rate adaptation. However, little is known about the effects of chronic atrial fibrillation on atrial electrophysiology and its recovery course in humans. Methods and results: Nineteen patients, mean age 64±14 years, with chronic atrial fibrillation of more than six months duration were included in this study. All of them were successfully converted to sinus rhythm with an external defibrillator. Atrial effective refractory periods at right atrial appendage and distal coronary sinus were determined with five pacing cycle lengths (300, 400, 500, 600 and 700 ms) at 30 min after cardioversion and once a day for four days. The atrial conduction properties, including P wave duration of surface ECG, and right and left atrial conduction times, were also measured at the same time interval. Twenty age-matched patients without a history of atrial tachyarrhythmia were evaluated as controls. In comparison with controls, chronic atrial fibrillation significantly shortened the atrial effective refractory period, impaired its rate adaptation response, especially at distal coronary sinus, and depressed the conduction properties of atria. The atrial conduction properties did not change during the four-day follow-up period; however, the atrial effective refractory period was gradually prolonged and its rate adaptation response improved after restoration of sinus rhythm. Conclusions: In humans, chronic atrial fibrillation significantly shortened the atrial effective refractory period, and impaired its rate adaptation response. Restoration and maintenance of sinus rhythm could reverse these electrophysiological changes.