tbuckley/cabot-search huggingface dataset:
Medical Mystery — The Answer
Authors: Bruno François, Olivier Brenet
Journal: New England Journal of Medicine (2004)

To the Editor: The medical mystery in the January 1 issue1 involved a 62-year-old man who had a history of psychosis and who presented with an ileus. An abdominal radiograph revealed a ptotic gastric fundus filled with a very large, radiopaque density (Figure 1A). At laparotomy, the distended stomach was found to contain 5.5 kg of coins, necklaces, and needles (Figure 1B). A partial gastrectomy with Braun's anastomosis was performed because of pressure necrosis. Postoperative complications included septic shock and multiple-organ failure, which resulted in the patient's death on the 12th postoperative day. Close to 90 percent of ingested foreign . . .
Diabetes and Neurodegeneration in Wolfram Syndrome
Authors: Julia Rohayem, Christian Ehlers, Bärbel Wiedemann, Reinhard Holl, Konrad Oexle, Olga Kordonouri, Giuseppina Salzano, Thomas Meissner, Walter Burger, Edith Schober, Angela Huebner, Min Ae Lee-Kirsch
Journal: Diabetes Care (2011)

To describe the diabetes phenotype in Wolfram syndrome compared with type 1 diabetes, to investigate the effect of glycemic control on the neurodegenerative process, and to assess the genotype-phenotype correlation.The clinical data of 50 patients with Wolfram syndrome-related diabetes (WSD) were reviewed and compared with the data of 24,164 patients with type 1 diabetes. Patients with a mean HbA1c during childhood and adolescence of ≤7.5 and >7.5% were compared with respect to the occurrence of additional Wolfram syndrome symptoms. The wolframin (WFS1) gene was screened for mutations in 39 patients. WFS1 genotypes were examined for correlation with age at onset of diabetes.WSD was diagnosed earlier than type 1 diabetes (5.4±3.8 vs. 7.9±4.2 years; P<0.001) with a lower prevalence of ketoacidosis (7 vs. 20%; P=0.049). Mean duration of remission in WSD was 2.3±2.4 vs. 1.6±2.1 in type 1 diabetes (NS). Severe hypoglycemia occurred in 37 vs. 7.9% (P<0.001). Neurologic disease progression was faster in the WSD group with a mean HbA1c>7.5% (P=0.031). Thirteen novel WSF1 mutations were identified. Predicted functional consequence of WFS1 mutations correlated with age at WSD onset (P=0.028).Endoplasmic reticulum stress-mediated decline of β-cells in WSD occurs earlier in life than autoimmune-mediated β-cell destruction in type 1 diabetes. This study establishes a role for WFS1 in determining the age at onset of diabetes in Wolfram syndrome and identifies glucose toxicity as an accelerating feature in the progression of disease.
Log transformation of data
Authors: P. Sedgwick
Journal: BMJ (2012)

Researchers evaluated the effectiveness of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause. A randomised controlled trial study design was used. The intervention was early computed tomography (within 24 hours of admission). The control treatment was standard practice (radiological investigations as indicated). In total, 55 patients were randomised to early computed tomography and 55 to control treatment.1 The main outcome measures included length of hospital stay. The distribution of length of hospital stay was positively skewed. The logarithm function was used to transform the observations, and the Student’s t test was then used to compare the treatment groups. The length of hospital stay for the standard practice group was on average 1.1 days longer than that in the early computed tomography group (geometric mean 6.4 days (range 1 to 60) versus 5.3 days (1 to 31). The ratio of geometric means (standard treatment versus early computed tomography) was 1.21 (95% confidence interval 0.92 to 1.56). The overall conclusions of the study were that early abdominopelvic computed tomography for acute abdominal pain may reduce length of hospital stay and mortality. Furthermore, it could also identify unforeseen conditions and potentially serious complications. Which of the following statements, if any, are true?
A redox-based O2 sensor in rat pulmonary vasculature.
Authors: S L Archer, J Huang, T Henry, D Peterson, E K Weir
Journal: Circulation Research (1993)

The effector mechanism of hypoxic pulmonary vasoconstriction (HPV) involves K+ channel inhibition with subsequent membrane depolarization. It remains uncertain how hypoxia modulates K+ channel activity. The similar effects of hypoxia and mitochondrial electron transport chain (ETC) inhibitors on metabolism and vascular tone suggest a common mechanism of action. ETC inhibitors and hypoxia may alter cell redox status by causing an accumulation of electron donors from the Krebs cycle and by decreasing the production of activated O2 species (AOS) by the ETC. We hypothesized that this shift toward a more reduced redox state elicits vasoconstriction by inhibition of K+ channels. Pulmonary artery pressure and AOS, measured simultaneously using enhanced chemiluminescence, were studied in isolated perfused rat lungs during exposure to hypoxia, proximal ETC inhibitors (rotenone and antimycin A), and a distal ETC inhibitor (cyanide). Patch-clamp measurements of whole-cell K+ currents were made on freshly isolated rat pulmonary vascular smooth muscle cells during exposure to hypoxia and ETC inhibitors. Hypoxia, rotenone, and antimycin A decreased lung chemiluminescence (-62 +/- 12, -46 +/- 7, and -148 +/- 36 counts/0.1 s, respectively) and subsequently increased pulmonary artery pressure (+14 +/- 2, +13 +/- 3, and +21 +/- 3 mm Hg, respectively). These agents reversibly inhibited an outward, ATP-independent, K+ current in pulmonary vascular smooth muscle cells. Antimycin A and rotenone abolished subsequent HPV. In contrast, cyanide increased AOS and did not alter K+ currents or inhibit HPV. The initial effect of rotenone, antimycin A, and hypoxia was a change in redox status (evident as a decrease in production of AOS). This was associated with the reversible inhibition of an ATP-independent K+ channel and vasoconstriction. These findings are consistent with the existence of a redox-based O2 sensor in the pulmonary vasculature.
Peginterferon-α does not improve early peripheral blood HBV-specific T-cell responses in HBeAg-negative chronic hepatitis
Authors: Amalia Penna, Diletta Laccabue, Irene Libri, Tiziana Giuberti, Simona Schivazappa, Arianna Alfieri, Cristina Mori, Diana Canetti, Pietro Lampertico, Mauro Viganò, Massimo Colombo, Elisabetta Loggi, Gabriele Missale, Carlo Ferrari
Journal: Journal of Hepatology (2012)
Systemic Scleroderma with Portal Hypertension
Authors: R. J. Calvert, B. Barling, M. Sopher, M. Feiwel
Journal: BMJ (1958)

CYTOLOGICAL TEST FOR CANCER CURE MEDICALJOURNAL whenever feasible.Failing this, we regard high C.I. read- ings after completion of radical treatment (allowing a three- months period to elapse in the evaluation of pre-menopausal cancer patients after radiotherapy) as suggestive of persis- tence of neoplastic disease, provided, of course, that no oestrogens had been administered.A low C.I. reading during the observation period after completion of treatment is regarded as a favourable prognostic omen only in cases in which pre-treatment C.I.s had been high. Itis not yet established whether our original hypothesis, that malignant tissue is capable of oestrogen production. is correct.In a few of our own cases urinary oestrogen estimations have been undertaken, and we are greatly indebted to Dr. Ian Ferguson Sommerville for kindly carry- ing out these investigations at the Endocrine Laboratories of the Institute of Obstetrics and Gynaecology in the Chelsea Hospital for Women.In the few patients investigated urinary oestrogen excretion was high and compared well with the high C.I. readings.However, these data are as yet incomplete and no conclusions can be drawn from them, although other authors (Young et al., 1957) showed similar good correlation on a larger material.The frequency with which a high C.I. reading is asso- ciated with malignant disease in the female genital tract is significant enough to suggest the use of it as a test for cure.Summary and Conclusions C.I. estimations in patients who had received radical treatment for malignant disease in the genital tract seemed to be of great diagnostic help in the recognition of failure of response or in the detection of early recurrence.Accurate forecasts, relying solely on C.I. readings, had been made in 94.8% of 165 cancer follow- up patients.Nine patients with a poor cytological prog- nosis and no clinical signs of recurrence are still under observation.The cytological prognosis was incorrect in eight patients with persistent or recurrent disease and low C.I. readings.The possible causes of this prognostic error are discussed.The technique of C.I. estimation is easy and can be learned in a short time.We suggest that C.I. estimations should be included in routine cytological cancer follow- up investigations in view of the important implication of this test.
TCT-75 Novel Fully-Quantitative Virtual Histology Analysis of Confluent Necrotic Core Size and Fibrous Cap Thickness in Relation to Conventional Phenotypic Plaque Type Assessment and Cerebral Symptom Occurrence/Timing: The CRACK-VH Study in 252 Consecutive Patients with Atheromatous Carotid Stenosis
Authors: Piotr Musialek, Lukasz Tekieli, Piotr Pieniazek, Adam Mazurek, Wladyslaw Dabrowski, Anna Kablak-Ziembicka, Tadeusz Przewlocki, Anetta Undas, Krzysztof F. Zmudka, Wieslawa Tracz, Piotr Podolec
Journal: Journal of the American College of Cardiology (2013)
Support after perinatal death: a study of support and counselling after perinatal bereavement.
Authors: G C Forrest, E Standish, J D Baum
Journal: BMJ (1982)

After an earlier study into the practical aspects of the management of perinatal death, a counselling service was introduced for parents whose baby had died in the perinatal period. The service was monitored, and the parents who received the service were compared with a group that did not. Fifty families were allocated randomly either to the counselling (supported) group or to the contrast group, who received routine hospital care. Assessment was carried out at six and 14 months after the death, using a semi-structured interview and two self-rating scales (the general health questionnaire and the Leeds scales). Two of 16 mothers in the supported group showed psychiatric disorder at six months, compared with 10 of 19 in the contrast group (p less than 0.01, Fisher9s exact test). There was no significant difference between the two groups at 14 months, when 80% of all the women studied had recovered psychiatric symptoms. Socially isolated women and those who marital relations lacked intimacy had a higher incidence of psychiatric symptoms at six months. Early pregnancy (within six months) was associated with a higher incidence of psychiatric symptoms in the unsupported group. The duration of bereavement reaction after perinatal death was appreciably shortened by support and counselling.
Zeis' Manual of Plastic Surgery
Authors: Richard C. Schultz
Journal: JAMA (1990)

Eduard Zeis is credited with introducing the term "plastic surgery" and with the first comprehensive publication in the field in Dresden, Germany, in 1838. Zeis was a general surgeon with interests in both ophthalmology and pediatrics. His special interest in "plastic surgery" was inspired by Dieffenbach. This original manual, written in German, was favorably reviewed in London, the year after its publication, but was never translated into English until 50 years later by Mr T. J. S. Patterson, a Blair Rogers research fellow in the history of plastic surgery in Oxford, England. Mr Patterson, a plastic surgeon himself, has done an outstanding job of bringing this valuable historic treatise back into the English idiom. He has done this in a scholarly manner by not only expertly conveying the technical and philosophical content of Dr Zeis' original manual, as only an experienced plastic surgeon could do, but also by favoring the
Akt Signaling and Cancer: Surviving but not Moving On
Authors: Alex Toker, Merav Yoeli-Lerner
Journal: Cancer Research (2006)

Abstract The frequent deregulation of the phosphoinositide 3-kinase/Akt survival signaling pathway in cancer has prompted significant interest in blocking this pathway to treat cancer. Recently, however, two studies have shown that the Akt isoform Akt1 limits the invasive migration of breast cancer cells. These studies suggest that Akt1 may have a dual role in tumorigenesis, acting not only pro-oncogenically by suppressing apoptosis but also anti-oncogenically by suppressing invasion and metastasis. We discuss the possible implications of these findings for therapeutic development of Akt inhibitors to treat cancer. (Cancer Res 2006; 66(8): 3963-6)
Biopsy and Cytology in the Diagnosis of Early Gastric Cancer: 10-Year Experience with Direct Vision Techniques at a Japanese Institution
Authors: S. Kobayashi, Y. Yoshii, T. Kasugai
Journal: Endoscopy (1976)

The results of direct vision biopsy and cytology for the diagnosis of early gastric cancer during the periods from 1964 to 1969 and from 1970 to 1974 were compared. From 1964 to 1969 the diagnostic accuracy of gastric biopsy was 94.7% at the initial examination and 97.3% in the final diagnosis, while washing cytology under direct vision gave a diagnostic accuracy of 83.0% at the first washing and 93.3% in the final cytologic diagnosis. Because of such a high yield of gastric biopsy, it was the procedure of the first choice from 1970 to 1974, giving a diagnostic accuracy of 96.7% at the initial examination and 99.4% in the final biopsy diagnosis with only one suspicious case. The cytologic examination by brushing has, therefore, become supplementary to biopsy in cases where a stenosis proximal to a tumor obscures the definitive tissue.
The argumentative theory of reasoning applies to scientists and philosophers, too
Authors: John A. Johnson
Journal: Behavioral and Brain Sciences (2011)

Abstract Logical consistency demands that Mercier and Sperber's (M&amp;S's) argumentative theory of reasoning apply to their own reasoning in the target article. Although they hint that their argument applies to professional reasoners such as scientists and philosophers, they do not develop this idea. In this commentary, I discuss the applicability of argumentative theory to science and philosophy, emphasizing the perils of moral reasoning.
THE DIAGNOSIS OF DISEASES OF THE PROSTATE.
Authors: EDGAR G. BALLENGER
Journal: JAMA (1907)

There is no organ in the human body concerning the diseases of which the average physician has less definite knowledge than he has of those of the prostate gland. Yet there are few conditions susceptible of more accurate diagnosis if the various types of its disorders are familiar to the examiner. In the following paper an effort will be made to present a classification and a brief description of the pathology and diagnostic features of these conditions. Refinement in diagnosing the sub-varieties of prostatitis is not of so much importance in the prognosis and treatment as is the necessity of recognizing the prostate as the source of reinfections and the cause of urinary irritation, sexual weakness or obscure referred pain or symptoms. When approached in a scientific manner and considered with due regard for the anatomy and physiology of the gland and its related organs, these affections lose much of
Hemolysis of Red Cells Due to Sulfone
Authors: KLAUS MAYER
Journal: Annals of Internal Medicine (1970)

Red blood cell survival studies were performed in subjects with dermatitis herpetiformis who received sulfone. It was confirmed that in sufficient dosage sulfones will induce an identical shortening of survival of autogenous and normal donor cells and that this hemolysis was not a random process but was clearly related to cell age. Studies on the pattern of survival of normal red cells transfused into patients receiving long-term sulfones indicate that red cells normally aged are not peculiarly susceptible to lysis in such recipients but that the total red cell population ages more rapidly than normal. A study in which glucose-6-phosphate dehydroganase (G-6-PD)-deficient red cells were transfused into a patient receiving sulfones suggests that the mechanism by which G-6-PD-deficient red cells are affected by sulfones is different from the mechanism by which normal cells are affected.
Access controls on bmj.com
Authors: Frank W Arnold
Journal: BMJ (2005)

Secondary prevention of heart disease with statins Groups were as different as chalk and cheeseEditor-Wei et al say that the results of their observational study of treatment with statins in routine clinical practice in Tayside are consistent with, and similar to, those reported in clinical trials. 1 This conclusion is hardly justified.A cohort of patients, defined by a discharge diagnosis of myocardial infarction between January 1993 and December 2001, was studied to compare the outcomes in those treated with statins and those not receiving these drugs.The data clearly show that the two groups differed substantially in terms of age, sex, comorbidity, and other cardiovascular drug treatment-all of these factors were biased in favour of a poorer outcome in patients not given statins.Furthermore, the two groups belonged to different time periods, most of the untreated patients to the earlier part and most of those given statins to the later part of the study.Given the changes between 1993 and 2001-including, for example, those related to the management of acute myocardial infarction and the criteria for diagnosis-it is only to be expected that the untreated group would have a higher risk of subsequent cardiovascular events.Multivariate analysis was reported as showing that statins reduced all cause mortality by 31% and the composite end point of myocardial infarction plus cardiovascular mortality by 18%.These results should be greeted with scepticism.Firstly, many trials of statins have failed to show any reduction whatsoever in all cause mortality. [2]][4][5] Secondly, as observed in other studies, any reduction in all cause mortality would be expected to be much less than that for composite cardiovascular end points. 2 4 5 The two groups in this study were as different as chalk and cheese.It should come as no surprise, therefore, that the results were anomalous.In such circumstances, no amount of statistical trickery could be expected to furnish anything of value.
Light-chain paraproteins with lupus anticoagulant activity
Authors: Zahida Yasin, Donald Quick, Perumal Thiagarajan, Denise Spoor, Juan Caraveo, Joseph Palascak
Journal: American Journal of Hematology (1999)

A patient with newly diagnosed multiple myeloma manifested by urine kappa light-chain excretion and a small monoclonal spike (0.4 g/dl), presented with lower extremity deep venous thrombosis. A preheparin plasma-activated partial thromboplastin time (aPTT) was prolonged at 68 sec (normal control 26-42 sec). Additional studies confirmed the presence of lupus anticoagulant activity in the serum: the modified Russell Viper Venom Time (MRVVT) was 73 sec (normal control 24–42 sec) and with a 50:50 mix of the patient's plasma and pooled normal plasma, the MRVVT remained prolonged. Kappa light chains (LC) were isolated from the patient's urine and their purity confirmed by electrophoresis and immunofixation using specific immunoglobulin antisera. The patient's LC mixed with pooled normal plasma demonstrated LA activity by in vitro clotting tests (plasma-activated partial thromboplastin time 62 sec, with normal control of 45 sec), MRVVT of 44 sec with normal control of 35 sec. Purified urinary kappa light chains from a control patient with multiple myeloma and normal clotting studies, failed to prolong either the plasma-activated partial thromboplastin time or the MRVVT. We hypothesize that kappa LC in our patient demonstrated LA activity, which was unique to these LCs. Paraproteins with LA activity, to date, have included only intact immunoglobulins (Ig). While intact Ig paraproteins have been reported to possess LA activity, this is the first report to our knowledge of light-chain paraproteins possessing similar activity and resulting in clinically evident thrombosis. Light chain paraproteins could serve as useful models for further study of the mechanisms of activity of acquired LA inhibitors. Am. J. Hematol. 62:99–102, 1999. © 1999 Wiley-Liss, Inc.
Preventing NCDs through nutritional change is not as complex as it may seem
Authors: N. Wilson, G. Thomson
Journal: BMJ (2011)

Preventing non-communicable diseases (NCDs) via nutritional change is not as complex as Yach asserts.1 Firstly, he ignores the use of taxes on unhealthy foods, which are effective and can raise revenue. Such taxes have been successful in several high income countries, with some evidence of benefit (on weight and chronic …
Axis I Comorbidity of Borderline Personality Disorder
Authors: Mary C. Zanarini, Frances R. Frankenburg, Elyse D. Dubo, Amy E. Sickel, Anjana Trikha, Alexandra Levin, Victoria Reynolds
Journal: American Journal of Psychiatry (1998)

Objective:The purpose of this study was to assess the lifetime rates of occurrence of a full range of DSM-III-R axis I disorders in a group of patients with criteria-defined borderline personality disorder and comparison subjects with other personality disorders. Method:The axis I comorbidity of 504 inpatients with personality disorders was assessed by interviewers who were blind to clinical diagnosis and who used a semistructured research interview of demonstrated reliability.Results:Four new findings emerged from this study. First, anxiety disorders were found to be almost as common among borderline patients (N=379) as mood disorders but far more discriminating from axis II comparison subjects (N=125). Second, posttraumatic stress disorder (PTSD) was found to be a common but not universal comorbid disorder among borderline patients, a finding inconsistent with the view that borderline personality disorder is actually a form of chronic PTSD. Third, male and female borderline patients were found to differ in the type of disorder of impulse in which they “specialized.” More specifically, substance use disorders were significantly more common among male borderline patients, while eating disorders were significantly more common among female borderline patients. Fourth, a lifetime pattern of complex comorbidity (i.e., met DSM-III-R criteria for both a disorder of affect and a disorder of impulse at some point before the patients’ index admission) was found to have strong positive predictive power for the borderline diagnosis as well as a high degree of sensitivity and specificity. Conclusions:These results suggest that the lifetime pattern of axis I comorbidity characteristic of borderline patients and distinguishing for the disorder is a particularly good marker for borderline personality disorder. Am J Psychiatry 1998; 155: 1733-1739
Airway epithelial cells activate TH2 cytokine production in mast cells through IL-1 and thymic stromal lymphopoietin
Authors: Deepti R. Nagarkar, Julie A. Poposki, Michael R. Comeau, Assel Biyasheva, Pedro C. Avila, Robert P. Schleimer, Atsushi Kato
Journal: Journal of Allergy and Clinical Immunology (2012)