tbuckley/cabot-search huggingface dataset:
A 79 year old woman with a swollen right leg
Authors: B. J. Renton
Journal: BMJ (2009)

A 79 year old woman, who had previously been fit and well, was referred by her general practitioner to the emergency medical unit with a three week history of a swollen right leg. She had previously been treated for possible cellulitis, with no improvement. She had no systemic symptoms and no risk factors for deep vein thrombosis. At initial presentation to the emergency medical unit she was documented as having a “unilateral swollen right leg, with no evidence of cellulitis.” The rest of the examination was normal. Baseline blood tests were normal, except for a positive D-dimer test. The impression was of a deep vein thrombosis, so she was treated with low molecular weight heparin and a Doppler ultrasound scan was booked as an outpatient. The results of the Doppler scan were normal and she was reassured and advised to see her general practitioner if the swelling worsened.

She re-presented to the emergency medical unit three months later with persistent swelling of the right leg, which she felt had slowly got worse. On examination, she had a grossly swollen right leg with pitting oedema up to the groin. She also had three large smooth mobile masses in the right inguinal region. Her pre-test probability score for deep vein thrombosis was 3. The results of a repeat Doppler …
Primate-specific microRNA-637 inhibits tumorigenesis in hepatocellular carcinoma by disrupting signal transducer and activator of transcription 3 signaling
Authors: Jin-fang Zhang, Ming-liang He, Wei-ming Fu, Hua Wang, Lian-zhou Chen, Xiao Zhu, Ying Chen, Dan Xie, Paul Lai, Gong Chen, Gang Lu, Marie C.M. Lin, Hsiang-fu Kung
Journal: Hepatology (2010)

MiR-637 (microRNA-637) is a primate-specific miRNA belonging to the small noncoding RNA family, which represses gene regulation at the post-transcriptional expression level. Although it was discovered approximately 5 years ago, its biomedical significance and regulatory mechanism remain obscure. Our preliminary data showed that miR-637 was significantly suppressed in four HCC cell lines and, also, in most of the hepatocellular carcinoma (HCC) specimens, thereby suggesting that miR-637 would be a tumor suppressor in HCC. Simultaneously, the enforced overexpression of miR-637 dramatically inhibited cell growth and induced the apoptosis of HCC cells. The transcription factor, signal transducer and activator of transcription 3 (Stat3), is constitutively activated in multiple tumors, and aberrant Stat3 activation is linked to the promotion of growth and desensitization of apoptosis. Our study showed that Stat3 tyrosine 705 phosphorylation and several Stat3-regulated antiapoptotic genes were down-regulated in miR-637 mimics-transfected and Lv-miR637-infected HCC cells. In addition, miR-637 overexpression negatively regulated Stat3 phosphorylation by suppressing autocrine leukemia inhibitory factor (LIF) expression and exogenous LIF-triggered Stat3 activation and rescued cell growth in these cells. A nude mice model also demonstrated the above-described results, which were obtained from the cell model. Furthermore, we found that LIF was highly expressed in a large proportion of HCC specimens, and its expression was inversely associated with miR-637 expression. Our data indicate that miR-637 acted as a tumor suppressor in HCC, and the suppressive effect was mediated, at least in part, by the disruption of Stat3 activation.
Aging-associated changes in indices of thrombin generation and protein C activation in humans. Normative Aging Study.
Authors: K A Bauer, L M Weiss, D Sparrow, P S Vokonas, R D Rosenberg
Journal: Journal of Clinical Investigation (1987)

In view of the known association of vascular disease with increasing age, we have conducted an analysis of hemostatic system activity with respect to perturbations induced by aging phenomena. We have utilized an immunochemical assay for prothrombin fragment F1 + 2 to quantify Factor Xa activity upon prothrombin in the plasma of 199 healthy males between the ages of 42 and 80. The levels of F1 + 2 in this population generally increased as a function of age (P less than 0.0001). The metabolic behavior of this marker was determined in 10 individuals greater than 65 yr of age with varying levels of F1 + 2, which ranged from 1.28 to 5.85 nM. The elevations in the concentration of this component were not due to diminished clearance of the fragment. Radio-immunoassays for fibrinopeptide A (FPA) and the protein C activation peptide (PCP) were subsequently employed to measure thrombin activity upon fibrinogen and thrombin-thrombomodulin activity upon protein C, respectively, in 82 members of this population ranging in age from 42 to 80. Significant positive correlations were again observed between increasing age and the level of F1 + 2 (P less than 0.0001) as well as FPA (P less than 0.01) and PCP (P less than 0.002). The results of this cross-sectional study indicate that many apparently normal males of increasing age with normal immunologic levels of antithrombin III and protein C exhibit a biochemical defect that denotes the presence of an acquired prethrombotic state.
CONCLUSIONS FROM CLINICAL AND BACTERIOLOGIC EXPERIMENTS WITH HOLOCAIN.
Authors: ROBERT L. RANDOLPH
Journal: JAMA (1898)

I have been using holocain for some months and have recorded here fifty cases where it was recently employed in the eye clinic of the Johns Hopkins Hospital. Seventeen of these cases were foreign bodies in the cornea, and the average time employed to produce anesthesia was a little less than two minutes. In three cases iridectomy was performed and in four cases cataract extraction. Here I made the same number of instillations as I do when employing cocain, that is three in fifteen minutes, and all that can be said is that I noticed no difference in the anesthesia from that produced by cocain, and the same may be said of eight tenotomies. The other cases were where the holocain was used after the application of silver nitrate, after the passing of probes, in operations for tarsal cysts and pterygia. With the exception of the tarsal cysts the anesthesia
EARLY DIAGNOSIS OF CANCER OF THE LUNG
Authors: Louis H. Clerf
Journal: JAMA (1952)

Tremendous strides have been made in the surgical treatment of bronchogenic carcinoma since the first successful pneumonectomy by Graham in 1933. In reviewing the surgical literature, however, the reader is impressed by the fact that successful surgical treatment can be accomplished only if carcinoma is recognized early. Advanced carcinoma still remains the hopeless problem it always has been. Additional progress will be made only when carcinoma is suspected early and appropriate diagnostic procedures are instituted promptly so that the disease may be treated without unnecessary delay.  Bronchogenic carcinoma has steadily increased in incidence until it is now the commonest form of cancer. During 1948, deaths in the United States from bronchogenic carcinoma alone exceeded 16,000. It is important, therefore, that a lively interest be manifested in this disease, that all physicians become cancer of the bronchus-minded, and that all diagnostic aids be utilized whenever necessary. Since some of these aids
A patient who changed my life: Two lives saved
Authors: S. R. Zambrano
Journal: BMJ (2002)

As a native Cuban intensive care doctor, I felt many parts of my life were not mine to control. Having free health and education systems does not make you free. Cuban security forces control many aspects of life, as a colleague and I discovered when we tried to publicise some research about the extent of a local epidemic of dengue fever. We were told to stop or face imprisonment because it showed the country in a bad light. This sort of control contrasts with the treatment of visitors to Cuba from old capitalist enemies such as the United States and Britain. Nowhere is this more apparent …
Is it always really mothers' fault?
Authors: Caterina Spiezio, Alberta Lunardelli
Journal: Behavioral and Brain Sciences (2004)

Falk's paper provides a nice cross-species perspective and an interesting background to formulate a theory of the evolution of human language. However, the author does not provide a complete overview and analysis of the origins of language and takes for granted the “continuity hypothesis.” Also her “infant parking theory” is questionable, as it is not well supported by observations.
ASSESSMENT OF PLAQUE CHARACTERIZATION ON CORONARY CT ANGIOGRAPHY FOR IDENTIFICATION OF HIGH-RISK CORONARY ARTERY LESIONS: A DIRECT COMPARISON TO OPTICAL COHERENCE TOMOGRAPHY
Authors: Ryo Nakazato, Hiromasa Otake, Akihide Konishi, Masamichi Iwasaki, Bon-Kwon Koo, Toshiro Shinke, Ken-ichi Hirata, Jonathan Leipsic, Daniel Berman, James Min
Journal: Journal of the American College of Cardiology (2014)
THE PREOPERATIVE DIFFERENTIAL DIAGNOSIS OF BONE TUMORS
Authors: HENRY W. MEYERDING
Journal: JAMA (1927)

The Clinical, Pathologic Association and Sarcoma Registry have prepared a classification of bone tumors which is easily understood by the general practitioner and conforms with surgical, pathologic and roentgenologic conceptions. For the purpose of this paper I have modified it slightly, and rearranged it so that the tumors progress from the traumatic and infectious through the benign to the most malignant types. It consists of ten groups instead of the original eight. Inflammatory lesions simulating bone tumors (osteoperiostitis): Traumatic (callous, ossifying hematoma). Syphilitic. Infectious (nonsuppurative osteitis of Garre, Brodie's abscess, tuberculosis). Osteitis fibrosa cystica; cysts. Benign osteogenic tumors: Exostosis. Osteoma. Chondroma. Fibroma. Giant-cell tumors. Angioma. Endothelioma (Ewing's tumor). Periosseous fibrosarcoma. Osteogenic sarcoma. Multiple myeloma. Metastatic tumors. With a history, clinical examination, urinalysis, Wassermann test and roentgenogram, an expert may accurately diagnose nine out of ten cases. There exists a small group, however, which defies even the most experienced until
Is sperm motility maturation affected by static magnetic fields?
Authors: L Tablado, F Pérez-Sánchez, C Soler
Journal: Environmental Health Perspectives (1996)

Kinematic parameters were evaluated in mouse epididymal extracts to monitor maturation of sperm movement in animals exposed to static magnetic fields using the Sperm-Class Analyzer computerized image analysis system. For this purpose, animals were exposed to a field of 0.7 T generated by a permanent magnet over 10 or 35 days for either 1 or 24 hr/day. The values of the motion endpoints were similar in animals used as controls and in those exposed to the nonionizing radiation, whatever the period of exposure or daily dosage. Changes in motility were observed in all groups: the percentage of total motile and progressive motile spermatozoa increased during passage through the epididymis, with major changes between the caput and corpus epididymides, and the pattern of swimming changed clearly towards more rapid and straighter trajectories. The processes of initiation of sperm motility and maturation of displacement patterns were not then affected by magnetic treatment. Moreover, it appears that sperm production is unaffected because no changes were observed in testicular or epididymal weights after exposure to static magnetic fields.
CONTINUOUS SUBARACHNOID DRAINAGE FOR MENINGITIS BY MEANS OF A URETERAL CATHETER
Authors: J. Grafton Love
Journal: JAMA (1935)

Repeated spinal drainage has proved advantageous in the treatment of meningitis. It occurred to me that the discomfort of repeated lumbar and cisternal punctures could be avoided by introducing a ureteral catheter, through a specially constructed spinal cannula, into the subarachnoid space and leaving the catheter in place for continuous drainage. For several years, in the neurosurgical service at the Mayo Clinic, a ureteral catheter frequently has been introduced into one of the lateral ventricles, either to secure gradual decompression in cases of internal hydrocephalus or to control the increased intracranial pressure associated with hydrocephalus, of patients who had inoperable neoplasms of the brain, while they were undergoing roentgen therapy. The ureteral catheter is threaded through a flanged ventricular cannula, previously introduced into the ventricle, with its obturator, through a burr hole placed over the posterior horn of one of the lateral ventricles. The ventricles tolerate well the presence of a ureteral
Observations on the Use of Thiouracil in Rheumatoid Arthritis
Authors: K. A. J. Jarvinen
Journal: Annals of the Rheumatic Diseases (1952)

No reports have been published on the possible effects upon rheumatoid arthritis of the thiouracil drugs, which have a potent action on the thyroid and also on the adrenal glands, although several investigators have pointed out certain correlations between disturbances of the thyroid on the one hand, and rheumatoid arthritis on the other, and the study of the adrenal cortex plays a central role in rheumatology.Tripi and others (1949) certainly observed in a careful investigation thiat rats treated with thiouracil developed a more severe experimental arthritis than control animals.However, these animal experiments are not directly applicable to human rheumatoid arthritis, particularly as the animals suffered from a septic arthritis quite different from the human disease.The rats were inoculated with a " pleuropneumonia-like organism "; in connection with the developing joint affections, abscesses were to be found in several organs, and the inoculated micro-organisms could be cultivated both from various organs and from the joints in pure culture.The experimentation with thiouracil medication in cases of rheumatoid arthritis was initiated by a case in which thiouracil seemed to have a favourable action.In 1947, a woman of 65 was admitted to our clinic, after having suffered for 7 years from rheumatoid arthritis and thyrotoxicosis which had appeared at about the same time and had progressed year by year.As the patient would not submit to an operation, which was recommended because of the severe symptoms of thyrotoxicosis, treatment with thiouracil was started in the ward.During this treatment, the symptoms of both thyrotoxicosis and rheumatoid arthritis disappeared simultaneously in the course of a month.The active swelling of the joints regressed, the articular pain disappeared, and the mobility of the joints recovered almost to normal.The erythrocyte sedimentation rate fell from 25 to 11 mm., and the Hb value rose from 79 to 86 per cent.About six months after leaving the hospital the patient stopped the use of thiouracil; within less than a month the articular symptoms began to show signs of aggravation, but they recovered their previous condition when medication was resumed.After about a year, the patient again stopped the use of thiouracil; within 2 months the joint affections began to show an exacerbation, and, at the same time, the symptoms of thyrotoxicosis appeared in a more severe form than before.Medication with thiouracil, which was again given in the hospital, again had a favourable action on both diseases.Since a recovery from the symptoms of rheumatoid arthritis was observed 47 on July 22,
Multi-institutional Validation of the CAPRA-S Score to Predict Disease Recurrence and Mortality After Radical Prostatectomy
Authors: Sanoj Punnen, Stephen J. Freedland, Joseph C. Presti, William J. Aronson, Martha K. Terris, Christopher J. Kane, Christopher L. Amling, Peter R. Carroll, Matthew R. Cooperberg
Journal: European Urology (2013)
1031 DURABILITY OF PEGINTERFERON ALFA-2B TREATMENT BEYOND 5 YEARS IN PATIENTS WITH HEPATITIS B E ANTIGEN (HBEAG) POSITIVE CHRONIC HEPATITIS B
Authors: V.W.-S. Wong, G.L.-H. Wong, K.K.-L. Yan, A.M.-L. Chim, H.-Y. Chan, H.L.-Y. Chan
Journal: Journal of Hepatology (2010)
Doc, my knees give way!
Authors: L. Lee, I. Gill
Journal: BMJ (2010)

A 50 year old obese man presented to the emergency department with pain in both knees. A week before presentation, he had experienced a sudden acute pain in his left knee while walking in his kitchen. He was not able to bear weight on the affected leg, so he attended the accident and emergency department. He was discharged without a definite diagnosis. When he returned home, he struggled to walk. His right knee suddenly gave way painfully as he pivoted himself to turn. He reported not having any pain in the knees before these incidents. 

The patient had no significant medical history. On examination, there was swelling in the suprapatellar region of both knees, with bruising on the left side. He was unable to perform straight leg raise and active extension of either of his knees. Both the knees could be fully extended passively. Active and passive flexion of the knees was limited by pain. Hip examination did not reveal any abnormalities. Knee radiographs were performed.⇓ ⇓



Fig 1  Lateral view radiograph of the patient’s left knee 





Fig 2  Lateral view radiograph of the patient’s right knee 





### 1 What are the radiographic findings?

#### Short answer

The two lateral view radiographs show soft tissue swelling, disruption at the quadriceps tendon, and suprapatellar calcific density.⇓ ⇓ The patellae are low lying.



Fig 3  Lateral view radiograph of the patient’s left knee showing suprapatellar swelling, quadriceps disruption, and suprapatellar calcification …
Pharmacokinetics and Tolerability of a Single Dose of DN-101, a New Formulation of Calcitriol, in Patients with Cancer
Authors: Tomasz M. Beer, Milind Javle, Gilbert N. Lam, W. David Henner, Alvin Wong, Donald L. Trump
Journal: Clinical Cancer Research (2005)

Intermittent administration allows substantial dose escalation of calcitriol but limited bioavailability of the commercially available formulations at high doses is limiting. In this dose escalation study, we sought to evaluate the tolerability and pharmacokinetics of a single oral dose of DN-101, a high-dose calcitriol formulation.DN-101 doses were escalated in sequential groups of three to six patients with advanced solid tumors. Dose-limiting toxicity was defined as grade > or =2 hypercalcemia or grade > or =3 persistent treatment-related toxicities. Single-dose administration of 15, 30, 60, 75, 90, 105, 135, and 165 mug was tested.Thirty-eight patients were enrolled in 2002 and 2003. The median age was 70 years (range, 44-91 years). Dose escalation was stopped at the 165 microg level when the number of capsules required at one time reached 11. No dose-limiting toxicities occurred. Transient and self-limited grade 3 toxicities were hyponatremia (2) and proteinuria (1). A dose-proportional increase in peak concentration (C(max)) and area under the concentration curve (AUC) was seen across the full range of DN-101 doses tested. At the 165 microg dose, C(max) was 6.21 +/- 1.99 ng/mL, AUC(0-24) was 41.3 +/- 9.77 ng h/mL, AUC(0-infinity) was 55.4 +/- 8.44, and half-life (T(1/2)) was 16.2 hours.At doses between 15 and 165 microg, DN-101 exhibits linear pharmacokinetics. At 165 microg, DN-101 achieves systemic exposure that is 5- to 8-fold higher than that achieved with commercial formulations of calcitriol, which makes DN-101 comparable to that required for antitumor activity in vivo in a murine squamous cell carcinoma model.
Lead-Contaminated Health Food: The Tip of an Iceberg
Authors: William H. Crosby
Journal: JAMA (1977)

Yet another case of accidental lead poisoning from health food comes to our attention elsewhere in this issue (p 1539). A California housewife poisoned by herbal health pills imported from Hong Kong recalls the case of the California resident poisoned by a powdered-bone health food imported from England (<i>JAMA</i>237:2627, 1977). In both women, incapacitating hematologic, neurologic, and emotional disabilities developed. Do these two women represent isolated, insignificant cases, or do they represent the tip of an iceberg? The Food and Drug Administration has been quoted (<i>National Observer</i>, June 27, 1977, p 15) that while such cases are regrettable, they are "not representative of a major national problem of lead poisoning." The agency cannot run full cry after every mischief in the nation. Some problems are more important than others, and the FDA does suffer perennially from "money constraints." But they do keep their channels open to physicians, and we
ABC of AIDS. Counselling.
Authors: D Miller
Journal: BMJ (1987)

AIDS counselling has two main aims.The first is to educate sexually active people to avoid and stop the spread ofthe human immunodeficiency virus (HIV).Counselling and health education ofindividuals is the only demonstrably effective means of motivating reliable changes in sexual behaviour.The second aim is to prevent and manage the psychological morbidity Education arsing from fear ofand knowledge of HIV infection.Again, an individual's Safe sex fear of HIV infection is reliably managed only by individual counselling. Public ignoranceWhen counselling is not provided or is insufficient severe, chronic psychological or psychiatric disturbance may result.Suicides have Support occurred, for example, where counselling services have been absent. Individual counselling to preventThese two aims-education and support-are necessary because the psychological morbidity acquiredimmunedeficiency syndrome (AIDS) can soeasilybe prevented by changes in sexual behaviour and because the stigma associated with AIDS can lead to overwhelming fears ofrejection and oppression.The public's ignorance ofthe true nature ofHIV infection, routes oftransmission, and consequences means also that the test for HIV antibodies is widely misunderstood.Counselling therefore has an important part to play well before knowledge ofinfection is reliably determined with the antibody test.
220 PREDICTIVE FACTORS OF TRANSPLANT FREE SURVIVAL IN PATIENTS WITH FULMINANT AND SUBFULMINANT HEPATIC FAILURE: RESULTS FROM A RANDOMIZED CONTROLLED MULTICENTER TRIAL
Authors: F. Saliba, C. Camus, F. Durand, P. Mathurin, B. Delafosse, K. Barange, P.-F. Perrigault, P. Revel, L. Serfaty, M. Belnard, A. Letierce, P. Ichai, D. Samuel
Journal: Journal of Hepatology (2009)
Safety and pharmacokinetics of a novel recombinant fusion protein linking coagulation factor IX with albumin (rIX-FP) in hemophilia B patients
Authors: Elena Santagostino, Claude Negrier, Robert Klamroth, Andreas Tiede, Ingrid Pabinger-Fasching, Christine Voigt, Iris Jacobs, Massimo Morfini
Journal: Blood (2012)
Alveolar Proteinosis
Authors: Douglas W. Jenkins
Journal: JAMA (1975)

LUNG lavage was successful in a patient with severe pulmonary alveolar proteinosis who developed a bronchopleural fistula as a complication of an intercurrent pneumonia.  Report of a Case  A 36-year-old man had intermittent shortness of breath since 1962. Throughout 1969 he had received symptomatic treatment for asthmatic bronchitis. In 1970, progressive increase in cough led to an open lung biopsy, which was diagnostic of pulmonary alveolar proteinosis.  Inhalation of nebulized bronchodilators and mucolytic agents seemed effective initially. However, during a trip to Lake Tahoe (3,000 meters [10,000 feet] above sea level) he had syncope and became increasingly breathless. Subsequently he became refractory to inhalation treatments. On referral to the USAF Medical Center, Scott, Ill (September 1971), physical examination disclosed cyanosis with extreme dyspnea, tachypnea, and diffuse end-inspiratory crackling rales. Cardiac findings included a palpable pulmonic artery, right ventricular lift, accentuated pulmonic closure, and a summation gallop.  A chest x-ray film