tbuckley/cabot-search huggingface dataset:
Serpentine Supravenous Hyperpigmentation
Authors: Chih-Chieh Chan, Sung-Jan Lin
Journal: New England Journal of Medicine (2010)

A 61-year-old man with recently diagnosed, inoperable esophageal squamous-cell carcinoma was treated with induction chemotherapy combining cisplatin and fluorouracil and concurrent radiotherapy. Because of worsening renal function, the use of cisplatin was suspended, and the chemotherapy was shifted to weekly high-dose fluorouracil and leucovorin. After the seventh infusion of fluorouracil–leucovorin, thrombosis developed in the right jugular and subclavian veins. This venous thrombosis prohibited further use of the permanent tunneled central-infusion catheter. The eighth infusion of fluorouracil–leucovorin was administered continuously over a 24-hour period by means of a peripheral catheter in the left forearm. A day later, the patient noticed a . . .
Talk the talk
Authors: Des Spence
Journal: BMJ (2007)

“We had ‘the talk'.” I blushed. My 10 year old daughter had just had her first sex education class. My sex education involved somebody's big brother graphically describing sexual intercourse to hunched groups of ashen faced and goggled eyed 12 year olds in the first few weeks of secondary school. Our formal “sex education” involved a grainy black and white video of a woman giving birth, while we were supervised by a terrified science teacher caught in the headlights of adolescent questioning. I couldn't speak to my parents for three weeks. We …
Post-vagotomy diarrhoea?
Authors: R H Franklin
Journal: BMJ (1970)

MEDICAJBORHL lium into the interstitial tissues and then recirculation via the blood stream.The more pronounced opacification of the pyramids may be due to greater leakage of contrast medium in this region.Chamberlain, Pringle, and Wrong (1966) observed a dense nephrogram in an adult with acute tubular necrosis.Subsequently Chamberlain and Sherwood (1967) showed uniform opacification of the kidneys in rats with tubular necrosis induced by ischaemia or mercuric chloride.We have found uniform opacification of the kidney in young patients with renal failure due to the haemolytic uraemic syndrome, and at necropsy their kidneys have not shown papillary necrosis.A dense uniformly opaque nephrogram has been observed at urography in normal patients who had oliguria and dehydration (Berdon, Schwartz, Becker, and Baker, 1969); this dense nephrogram was thought to be due to precipitation of Tamm-Horsfall protein by contrast medium in the tubules.Precipita- tion of Tamm-Horsfall protein, however, is unlikely to be a factor in the three cases we report, for none was oliguric or dehydrated at the start of the radiological studies.Oliguria did not develop after injection of the contrast medium.Indeed, there was a brisk diuresis resulting in a 5% loss of weight in Case 1 and a 3% loss in Case 3, and this was accompanied by a transient rise in blood urea of about 20 mg./ 100 ml.Both weight and blood urea returned to the preceding levels within 36 hours.The injection of contrast medium did not have any other demonstrable untoward effects.There was no subsequent proteinuria or excretion of casts.The clinical findings alone might suggest that a pre-existing urological lesion was present.There were, however, none of the features of obstructive uropathy, infantile polycystic disease, cystic change of Bowman's capsules, or renal dysplasia at radiology or at the one biopsy.The findings were not those of acute pyelonephritis in infancy (Reilly, 1967).Thus there was no evidence of any renal lesion being antecedent to the acute illness.
Gwyn Elias Roberts
Authors: D. Wilson
Journal: BMJ (2002)

Gwyn Roberts improved the quality of life for people with learning difficulties. While he desired change for the benefit of his patients and their families, he was always realistic about what could be achieved. Despite his dry humour, he was a quiet and contemplative person, in many ways understated and at times troubled by self doubt. However, he will be remembered as a leader and an enabler who made a lasting impression …
Latent Fractures of Vertebral Column after Aircraft Crashes
Authors: H. S. Samuel, J. J. M. D. Cracow
Journal: BMJ (1944)

BRITISH that the condition is not quite so uncommon.It is indeed surprising that locking does not occur more often.Oligohydramnios has been observed in many of the recorded cases, and seems the most likely cause: it was undoubtedly present in the case reported above, in view of the fact that, though there were two children weighing over 5 lb.each, the sze of the abdomen did not suggest to anyone who saw the case that there might be a twin pregnancy.
Plan to force drug companies in France to reveal payments to doctors has been diluted, campaigners say
Authors: P. Benkimoun
Journal: BMJ (2012)

A new draft of the French government’s “sunshine act,” designed to show how much drug companies pay doctors, has watered down the original proposals, critics say. 

They object to the fact that drug companies would not have to declare any payments done for work undertaken, only for unconditional gifts; that they would not have to publicise the payments on their own websites; that they would not have to declare any payments under €60 (£75; $95); and that they would have to ensure that doctors’ names were not indexed, to prevent search engines discovering whether a doctor had received payments from several companies.

The groups objecting to the changes made by the Socialist government span the political spectrum. They also include the independent pharmaceutical journal Prescrire and the medical association Formindep, which has been campaigning for all continuing medical education to be made independent of the drugs industry. At the more conservative end of the spectrum is the Conseil National de l’Ordre des Medecins (CNOM), the regulator of the medical profession. 

In December 2011 the French parliament adopted a bill setting strict rules on drug regulation, in the …
Remarks on the Treatment of Recent Wounds
Authors: R. Maclaren
Journal: BMJ (1882)

to 1035; the highestfwas 1042, the lowest was 1013, and in this latter I to 5 per cent. of sugar was found.The average daily amount of the urine-was 2,500 C. c. to 3,500 c. c. ; in only one case was it 9,ooo c. c.; in 14 cases it was as low as 500 c. c. to 800 c. c., in spite of taking I,6oo grains of the sprudel water ; but wherever the quantity of urine was small the perspiration was great, and where perspiration became copious the sugar decreased, which may explain the beneficial action of pilocarpin and of Turkish baths.Generally the day urine contained most sugar, exercise diminished it, while mental exertion and nervous excitement and pain increased it.The sugar varied from one to three per cent.; in only one case was it as high as eight per cent.When albumen was present, as not unfrequently happened, it seemed to be in inverse.relation to the sugar.After the disappearance of the sugar, a material increase of phosphates, and, in some, of oxalates, was noticed; in four cases, hippuric acid was present.In two cases, sugar was simulated by a form of uric acid when the copper test was used; the fallacy was rectified by the polariscope.When the skin was dry, there were considerable polyuria and much emaciation; if there was a fair
Fast track surgery for anterior cruciate ligament reconstruction in military patients in Scotland
Authors: J Howes, A M Wood, D J Bell, S Wrigley, C Angus
Journal: British Journal of Sports Medicine (2011)

Military patients sustaining an Anterior Cruciate Ligament (ACL) injury are normally listed for “Fast-Track” surgery as the criterion for this is that they are likely to be fully fit for military employment within 12 months. All military patients in Scotland requiring ACL reconstruction should be referred through the Edinburgh Regional Rehabilitation Unit (ERRU) covering a population of 13 772 servicemen. All patients referred to ERRU over a 35 month period requiring ACL reconstruction were retrospectively followed for a minimum of 6 months post referral, with injuries and subsequent employment fitness recorded. 35 patients required “Fast Track” ACL reconstruction giving an incidence of 8.47/10 000/year. 30 patients (86%) had associated ipsilateral knee pathology: 15 (43%) had an associated medial meniscal injury, 16 (46%) lateral meniscal injury, and 16 (46%) had an osteochondral defects (OCD). Only 28/35 (80%) had their fitness outcome recorded. Of these patients 9 (32%) were fully fit, 8 (29%) had limitations, 11 (39%) Unfit. Patients with a combination of ACL, osteochondral defect and meniscal injury had the worst outcomes: Fully fit 2 (20%), limitations 1 (10%) and 7 (70%) unfit. (P=0.01) The mean time for return to full fitness was 13 months (range 8–17) 95% CI 2.17. ACL injury has significant morbidity with regards future military employment. In our study group, only 32% were regarded as fully fit and 39% were unfit. Patients with an associated meniscal and osteochondral defect have a poor prognosis. Further prospective research is required to ascertain which personnel should be referred for “Fast Track” surgery and which patients are unlikely to regain full military fitness so that patients can be fully consented about the full benefits of surgery preoperatively.
CAUSES OF FAILURE IN INJECTION TREATMENT OF VARICOSE VEINS
Authors: H. O. McPHEETERS
Journal: JAMA (1931)

So much has been written on the injection treatment of varicose veins during the past three years that we hesitate to add more to the already extensive literature. New ideas, however, are always welcome and we take the liberty of presenting this paper, hoping that the reader may find something worthy of his attention. The injection treatment of varicose veins has long been accepted as the most rational method of caring for this malady. It is now used by most of the profession. When one considers the disability, the length of hospitalization, the pain, the expense, the scarring, and the mortality risk involved in the operative treatment of the past, one can readily see why the injection treatment is so universally accepted. The one most commonly discussed shortcoming of the injection treatment is the percentage of recurrences.<sup>1</sup>It is granted that varices in veins actually removed by surgical operation
HIV and the Pathogenesis of AIDS
Authors: Mark T. McNally
Journal: Annals of Internal Medicine (1998)

Medical Writings1 December 1998HIV and the Pathogenesis of AIDSMark T. McNally, PhDMark T. McNally, PhDMedical College of Wisconsin, Milwaukee, WisconsinSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-11_Part_1-199812010-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail HIV and the Pathogenesis of AIDS; 2nd edition. Levy JA. 588 pages. Washington, DC: American Society for Microbiology; 1998. $56.95. ISBN 1555811221. Order phone 202-737-1600.Field of medicine: Infectious disease, immunology, and viral oncology.Format: Softcover book.Audience: Medical and graduate students, scientists engaged in HIV and AIDS research, and health care providers.Purpose: To provide a current overview of the rapidly changing field of HIV disease, with particular emphasis on basic and clinical scientific advances made since the first edition was published in 1994.Content: The book distills the vast literature on HIV and AIDS that has accumulated in ... Author, Article, and Disclosure InformationAffiliations: Medical College of Wisconsin, Milwaukee, Wisconsin PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1998Volume 129, Issue 11_Part_1Page: 919KeywordsAIDSHIVHIV vaccinesHealth care providersImmune responseInfectious disease immunologyMicrobiologyPathogenesisScientistsVaccine development ePublished: 15 August 2000 Issue Published: 1 December 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Supply-and-Demand Discrepancy in Academic Pigmented Lesion Clinics
Authors: Erin L. Vickery, Elizabeth M. Seidler, Todd E. Jones, Emir Veledar, Suephy C. Chen
Journal: JAMA Dermatology (2014)

There is an increasing demand for a limited number of pigmented lesion clinic (PLC) visits at dermatology centers.To determine the proportion of visits to PLCs that are more frequent ("additional screening") than the recommended ("standard") follow-up schedule and to determine if certain patient characteristics correlate with the demand for these visits.A retrospective medical chart review of all PLC visits at an academic dermatology center from October 2010 to January 2012. A total of 609 patients associated with 1756 visits were identified. Of these, 25 patients associated with 26 visits were excluded owing to lack of melanoma diagnosis or risk factors, leaving 584 patients and 1730 visits. Diagnoses of these patients included in situ and invasive melanoma, dysplastic nevi, Spitz nevi, atypical nevus syndrome, family history of melanoma only, and other risk factors. The mean (SD) age was 48 (16) years, and 235 (40.2%) of the patients were male.The proportion of additional screening visits compared with standard visits. Standard visits were defined as occurring at the following frequencies: annually for mildly dysplastic nevi, Spitz nevi, or solely family history of melanoma; biannually for the first year, then annually thereafter for moderately dysplastic nevi or atypical nevus syndrome; biannually for up to 3 years, then annually thereafter for severely dysplastic nevi or melanomas in situ; every 3 months for 2 years, biannually for the following 2 years, then annually thereafter for invasive melanoma.A total of 1400 visits (80.9%) were standard, 257 (14.9%) were for additional screening, and 73 (4.2%) were "problem focused." Thirty percent of patients had at least 1 additional screening visit. The distribution of diagnoses among standard vs additional screening visits differed significantly, with "family history only" and "other risk factors" taking up a larger percentage of standard visits (15.1%) than the percentage of additional screening visits (8.9%), and all other diagnoses being better represented among additional screening visits (P = .04). No particular patient characteristic described those who sought additional screening visits.A substantial proportion of additional screening PLC visits exist and are desired by all patients with pigmented lesions. We propose alternative clinic models, such as diagnosis-specific, adjunctive fee-for-additional-service, and teledermatology clinics to meet patient needs while creating resources to expand PLC visits.
Emergency care in general practice
Authors: F. Richardson, P. Donnelly, C. Lester
Journal: BMJ (1995)

Geometric mean lead content in house dust and soil samples in Britain in 1982* and estimated proportions of children aged under 6years with raised blood lead concentrations Estimated % of children with blood lead House dust Soil Location (,ug/g) (,ug/g) >10 I g/dl >25 jig/dI Mean value in national surveyt
Coalition Updates Recommendations on Standards for Primary Stroke Centers
Authors: Mike Mitka
Journal: JAMA (2011)

THE PAST DECADE’S ADVANCES IN the diagnosis and treatment of patients with stroke have led the Brain Attack Coalition to revise and update its recommendations for the establishment of primary stroke centers. The coalition first proposed primary stroke centers in 2000 as a means of improving patient care and outcomes, with the possible added benefit of reducing medical costs associated with the condition. Each year, almost 800 000 people in the United States have a new or recurrent stroke, resulting in annual costs exceeding $73 billion. Formed in 1994, the Brain Attack Coalition is a group of professional, voluntary, and government entities promoting relationships among its member organizations to reduce stroke risk and improve stroke care (http://www .stroke-site.org/). Members of the coalition include the American Academy of Neurology, the American College of Emergency Physicians, the American Stroke Association, the National Institute of Neurological Disorders and Stroke, and many others. Based on the trauma center model, primary stroke centers are intended to be the care facilities that receive most patients with suspected stroke transported by emergency medical services. The coalition’s original proposal recommended that such centers should feature acute stroke teams, dedicated stroke units, written care protocols, and an integrated emergency department and emergency medical services response (Alberts MJ et al. JAMA. 2000; 283[23]:3102-3109). The primary stroke center concept was soon implemented in various care facilities. The primary stroke center health care team stabilizes and provides emergency care for patients with acute
Molecular basis of medium chain acyl-coenzyme A dehydrogenase deficiency. An A to G transition at position 985 that causes a lysine-304 to glutamate substitution in the mature protein is the single prevalent mutation.
Authors: I Yokota, Y Indo, P M Coates, K Tanaka
Journal: Journal of Clinical Investigation (1990)

We sequenced polymerase chain reaction (PCR)-amplified variant medium chain acyl-CoA dehydrogenase (MCAD) cDNAs in cultured fibroblasts from three MCAD-deficient patients. In all three patients, an A to G transition was identified at position 985 of the coding region. Since no appropriate restriction sites for detecting this point mutation were found, we devised a PCR method that amplifies an 87-bp fragment from position 955. In the 5' primer encompassing positions 955 to 984, A-981 was artificially substituted with C. With the presence of C-981 and G-985, an Nco I restriction site is introduced in the mutant copies. When cDNA or genomic DNA from fibroblasts of nine MCAD-deficient patients were tested with this method, the copies from all of them completely cleaved into two shorter fragments by Nco I, indicating their homozygosity for the A----G-985 transition. In contrast, the copies from all eight controls remained intact. Thus, this A----G-985 transition is the single prevalent mutation causing MCAD deficiency, a highly unusual feature for any genetic disorder. The PCR/Nco I digestion method is suitable for the diagnosis of MCAD deficiency.
Effect of Medical Care Review on the Use of Injections
Authors: ROBERT H. BROOK
Journal: Annals of Internal Medicine (1976)

Evaluation of peer review activities in the New Mexico Medicaid program (1971 to 1973) showed that it can affect aspects of quality, that is, the appropriateness of the use of injections as judged by medical criteria. Use of injections, nearly 50% of which were antibiotics, declined by more than 60%, from 41 to 16 per 100 ambulatory visits. Still, at the end of the study, 40% of the injections given were considered medically unnecessary. Analyses showed that [1] groups used injections more appropriately; [2] for solo physicians, being board-certified, being a doctor of medicine, and being a pediatrician were all associated with more proper use of injections; [3] 6% of the physicians gave 40% of the medically unnecessary injections, but even their behavior changed dramatically for the better as a result of the peer review system.
An unusual case of pustulotic arthro-osteitis affecting the leg, and erosive polyarthritis.
Authors: S H Ralston, P D Scott, R D Sturrock
Journal: Annals of the Rheumatic Diseases (1990)

Pustulotic arthro-osteitis is a syndrome, originally described in Japan, in which a sterile inflammatory osteitis of the sternoclavicular region occurs in combination with a non-erosive arthritis, sacroiliitis, and a pustulotic rash on the palms and soles. Although the disease has been reported in white populations, it is rarely seen by rheumatologists in the United Kingdom. The case of a Scottish woman is described in whom the diagnosis of pustulotic arthro-osteitis was overlooked because of an atypical site of the disease--the fibula, an erosive arthritis, and absence of a pustular rash at the time of her presentation with musculoskeletal symptoms. This case shows that the syndrome may easily by missed unless clinical suspicion is high and should be considered in any patient with culture negative osteitis, even outside the sternoclavicular region.
Health minister says data showing that child health in South Africa is not improving are unreliable
Authors: Pat Sidley
Journal: BMJ (2008)

South Africa’s health minister, Dr Manto Tshabalala-Msimang, has become embroiled in a dispute over statistics surrounding the country’s poor performance in crucial areas of maternal and child health.

At the recent conference on mother and child health in Cape Town, Countdown to 2015 Maternal Newborn and Child Survival, she dismissed figures compiled and presented to the conference by the World Health Organization and other UN organisations, which show that South Africa has higher child mortality now than it did in the apartheid years, citing problems with baseline data.

The figures produced by WHO show that between 1990 and …
IL-22 attenuates IL-25 production by lung epithelial cells and inhibits antigen-induced eosinophilic airway inflammation
Authors: Kentaro Takahashi, Koichi Hirose, Saki Kawashima, Yusuke Niwa, Hidefumi Wakashin, Arifumi Iwata, Koji Tokoyoda, Jean-Christophe Renauld, Itsuo Iwamoto, Toshinori Nakayama, Hiroshi Nakajima
Journal: Journal of Allergy and Clinical Immunology (2011)
Sites of Tuberculous Involvement in Patients With AIDS
Authors: HUSSEIN M. ABDEL-DAYEM, SLEIMAN NADDAF, M. AZIZ, B. MINA, TURGUT TUROGLU, M. FATIH, W.S. OMAR, L. DIFABRIZIO, V. LABOMBARDI, J.S. KEMPF
Journal: Clinical Nuclear Medicine (1997)

The purpose of this study was to review autopsy and gallium scan findings in two different acquired immune deficiency syndrome (AIDS) patient populations who had a confirmed diagnosis of tuberculosis (TB) to identify organs involved and accuracy of clinical diagnosis. The first group was comprised of 29 autopsies between January 1982 and December 1994, including only 18 patients who were diagnosed before death. Organs most commonly involved were the lymph nodes (59%), lungs (56%), spleen (53%), liver (45%), and kidneys (37%). Other opportunistic infections were present in 18 (59%) of autopsies, with more than one opportunistic infection present in 11 (37%) of the autopsies. Lungs were involved in 79% of all autopsies. The second population group included 94 patients with AIDS with a proven diagnosis of TB, only 24 of whom had gallium scans in the period between January 1992 and December 1994. Chest x-ray results were negative in 4 patients (17%); gallium scan results were positive in 16 patients (66%). The reasons for false-negative gallium scan results were due to anti-tuberculous treatment for periods varying from 2-21 months in 7 patients or the presence of extra pulmonary tuberculosis. The sites of TB involvement in the chest were: lung parenchyma in 5 patients (19%, 4 in mid and lower lung, and 1 in upper fields). There was lymph node involvement in all 16 patients (24 locations with mediastinal involvement in 23%, supraclavicular 23%, axillary 11%, retroperitoneal 11%, and inguinal region in 4%. We conclude that (1) tuberculosis in patients with AIDS behaves similar to primary tuberculosis; (2) the combination of chest x-ray and gallium imaging is sensitive for the diagnosis of pulmonary tuberculosis in patients with AIDS; (3) the involvement of mediastinal lymph nodes in gallium scans in the presence or absence of chest x-ray abnormalities should raise the possibility of TB involvement in patients with human immunodeficiency virus; (4) anti-TB treatment decreases the sensitivity of gallium scan.