tbuckley/cabot-search huggingface dataset:
Papillary Muscle Rupture in Fatal Acute Myocardial Infarction
Authors: JEANNE Y. WEI
Journal: Annals of Internal Medicine (1979)

Although cardiogenic shock in acute myocardial infarction is usually associated with a critical loss of myocardium, this may not be the case in papillary muscle rupture. During the past 21 years, 13 patients came to autopsy (11 died in cardiogenic shock) with a papillary muscle rupture complicating myocardial infarction. Rupture occurred from 2 to 7 (mean, 4) days after the infarct, and survival after rupture was usually brief (median, 3 days). The infarct involved between 1% and 50% (mean, 19%) of the left ventricle, and in 10 it was less than 25%. In all instances myocardium around the mitral annulus was not infarcted. Because papillary muscle rupture occurred mostly with first infarcts (eight), involved relatively small areas of necrosis, and spared the myocardium surrounding the annulus, early mitral valve replacement should make this cause of fatal acute myocardial infarction one of the most treatable forms of cardiogenic shock.
Paronychia and Pyogenic Granuloma of the Great Toes in Patients Treated with Indinavir
Authors: Fabrice Bouscarat, Cécile Bouchard, Damien Bouhour
Journal: New England Journal of Medicine (1998)

To the Editor: Forty-two patients infected with human immunodeficiency virus type 1 (HIV-1) (38 men and 4 women) presented with paronychia of the great toes during the period from September 1996 to September 1997. The median age of the patients was 36 years (range, 22 to 64); 36 were homosexuals, 3 were intravenous-drug users, and 3 were heterosexuals with no known risk factors. Thirty-six patients had AIDS. The mean CD4 lymphocyte count was 255 per cubic millimeter (range, 16 to 892). Plasma HIV RNA was undetectable in 13 patients and ranged from 600 to 10 6 copies per milliliter in the . . .
ABC of Rheumatology: RHEUMATOID ARTHRITIS--II: TREATMENT
Authors: M Akil, R S Amos
Journal: BMJ (1995)

Goals of treatment in rheumatoid arthritis * Relief of symptoms * Preservation of function * Prevention of structural damage and deformity * Maintenance of patient's normal lifestyle Physical therapy Role of physiotherapy for rheumatoid arthritis * Education of patients * Reduction of pain and swelling * Mobilisation of joints to minimise deformity * Strengthening of muscles and prevention of disuse atrophy * Increase range of movements and function Role of podiatry for rheumatoid arthritis * Local redistribution of loading to
Aspirin: The Story of a Wonder Drug
Authors: Boleslav L Lichterman
Journal: BMJ (2004)

I t might seem strange to have a popular book of more than 300 pages dedicated to just one drug. But aspirin is a special case. One of the most brilliant medical historians and journalists of our time, the late Roy Porter, wrote a book called The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present ( BMJ 1998;316: 713). Replace “humanity” for “aspirin” in the title, and it would ideally fit the book under review. Diarmuid Jeffreys, a journalist and television producer, has written an inspiring story based on archival sources, interviews, and an amazing knowledge of the relevant literature. His book clearly demonstrates that the border between academic medical history and journalistic investigation is blurred.

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Diarmuid Jeffreys

Bloomsbury, £16.99, pp 352 ISBN 0 7475 7077 9 http://www.bloomsbury.com/

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Jeffreys describes aspirin as, among other things, “the most remarkable drug the world has ever seen,” “one of the astonishing inventions in history,” and “one of the most endurably successful commercial products of all time.” Such claims are well substantiated. Aspirin is not only the subject of about 26 000 scientific papers, but …

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Networks of Innovation: Vaccine Development at Merck, Sharp and Dohme, and Mulford, 1895-1995
Authors: G. W Roberts
Journal: BMJ (1996)

Louis Galambos, Jane Eliot Sewell Cambridge University Press, £35, pp 273 ISBN 0 521 56308 9

Fear of plagues makes for bestselling material. Books such as The Hot Zone and The Coming Plague have made bugs into Hollywood blockbusters. Networks of Investigation chronicles a century of struggle between industry and bacteria by telling the story of Merck, Sharp and Dohme's efforts to acquire, develop, and sustain the skills and abilities needed to manufacture and market new serum antitoxins and vaccines.

I had hoped for an entertaining and insightful read. Insights there are, but this is a book for aficionados of the topic: the style …
Sublingual immunotherapy alters expression of IL-4 and its soluble and membrane-bound receptors
Authors: C. E. Nestor, E. Dadfar, J. Ernerudh, M. Gustafsson, J. Björkander, M. Benson, H. Zhang
Journal: Allergy (2014)

Seasonal allergic rhinitis (SAR) is a disease of increasing prevalence, which results from an inappropriate T helper cell, type 2 (Th2) response to pollen. Specific immunotherapy (SIT) involves repeated treatment with small doses of pollen and can result in complete and lasting reversal of SAR. Here, we assayed the key Th2 cytokine, IL-4, and its soluble and membrane-bound receptor in patients with SAR before and after SIT. Using allergen-challenge assays, we found that SIT treatment decreased IL-4 cytokine levels, as previously reported. We also observed a significant decrease in the IL-4 membrane-bound receptor (mIL4R) at the level of both mRNA and protein. SIT treatment resulted in a significant increase in the inhibitory soluble IL-4 receptor (sIL4R). Reciprocal changes in mIL4R and sIL4R were also observed in patient serum. Altered mIL4R and sIL4R is a novel explanation for the positive effects of immunotherapy with potential basic and clinical research implications.
Analysis of genotypes and amino acid residues 2209 to 2248 of the NS5A region of hepatitis C virus in relation to the response to interferon-? therapy
Authors: M Kurosaki, N Enomoto, T Murakami, I Sakuma, Y Asahina, C Yamamoto, T Ikeda, S Tozuka, N Izumi, F Marumo, C Sato
Journal: Hepatology (1997)

In chronic hepatitis C virus (HCV) infection, genotypes other than genotype 1b of HCV (HCV-1b) and low serum HCV-RNA levels are known to be associated with favorable outcome of interferon alfa (IFN-alpha) therapy. In addition, we recently reported a close correlation between the number of mutations in amino acid sequences 2209 to 2248 of the nonstructual protein 5A gene (NS5A2209-2248) of HCV-1b and the response to IFN-alpha. In the present study, we analyzed these viral factors in relation to the efficacy to IFN-beta, another type I IFN. The pretreatment sera of 40 patients treated with IFN-beta intravenously at 6 MU daily for 42 days were studied. HCV genotypes, serum HCV-RNA levels, and the amino acid sequence of NS5A2209-2248 in HCV-1b were determined. A sustained complete response to IFN therapy occurred in none of the ten patients with the wild-type HCV-1b who had an NS5A2209-2248 sequence identical to the prototype HCV-1b and in none of the six patients with the intermediate-type HCV-1b that had 1 mutation. In contrast, complete responses occurred in the following: 4 of 6 patients with the mutant-type HCV-1b that had five to ten mutations; 6 of 13 patients with genotype 2a of HCV (HCV-2a); and 2 of 5 patients with genotype 2b of HCV (HCV-2b). Among patients with the mutant-type HCV-1b or genotype 2 of HCV (HCV-2) the rate of complete response was significantly higher (12 of 24 vs. 0 of 16 patients, P < .001) and HCV-RNA levels were significantly lower (4.5 [4.0-6.5] vs. 6 [4.5-6.5] log copies/mL, median [range]; P < .001) compared with patients with the wild- or the intermediate-type HCV-1b. Patients with the mutant-type HCV-1b or HCV-2 whose HCV-RNA levels were lower than 6 log copies/mL had a complete response rate of 75% (12 of 16 patients) in contrast to 0% (0 of 24 patients) of the others (P < .001). These results indicate that the mutant-type HCV-1b or HCV-2 are sensitive to IFN-beta as well as IFN-alpha. In conclusion, the determination of HCV genotypes, NS5A2209-2248 of HCV-1b and serum HCV-RNA levels may facilitate the selection of patients with a high likelihood of response to IFN-beta.
URETHRAL DISEASE AND MARRIAGE.
Authors: FREDERICK W. ROBBINS
Journal: JAMA (1899)

One who has followed the literature of pelvic surgery for the last few years has no doubt come to believe that the great majority of cases of salpingitis and allied diseases are of gonorrheal origin. One need not have practiced medicine for a long time before having under his care patients who give a history of perfect health before marriage, but that event has ushered in discomfort, distress even, to the extent of practically rendering one unable to cope with the duties of life. Life has lost its charm; there is no home; sexual life is repulsive or impossible; children do not come to brighten the family life; love itself is fast ebbing away, and both husband and wife are beginning to wish that the marriage contract had never been entered into. The wife in her innocence does not think to question her husband's virtue, and the husband is very
Heterogeneity in surface antigen and glycoprotein expression of cell lines derived from different melanoma metastases of the same patient. Implications for the study of tumor antigens.
Authors: A P Albino, K O Lloyd, A N Houghton, H F Oettgen, L J Old
Journal: The Journal of Experimental Medicine (1981)

Three established lines of melanoma cells were derived from anatomically distinct metastases occurring in a single patient (DX). The lines, DX-1, DX-2, and DX-3, showed marked phenotypic diversity, as indicated by characteristic differences in growth rate, morphology, pigmentation, and the expression of surface antigens and glycoproteins. DX-1 and DX-3 expressed HLA-DR products, whereas DX-2 lacked HLA-DR expression. DX-1, DX-2, and DX-3 could also be distinguished on the basis of the profile of radiolabeled glycoproteins. Additional quantitative differences in the surface antigenic phenotype of the three cell lines were revealed by serological tests with a battery of monoclonal and conventional antibodies defining melanoma differentiation antigens. In tests for autologous humoral immunity to melanoma cells, sera from patient DX were found to have IgG antibody that reacted with surface antigens of DX-2 cells; no autologous reactivity was seen with DX-1 or DX-3 target cells or with three more recently established melanoma cell lines from patient DX. Absorption analysis indicated that the antigen detected by DX sera on DX-2 cells is a class 1 melanoma antigen, having been detected only on DX-2 cells and in much lower but demonstrable amounts on DX-1 and DX-3 cells. No other cell type, including DX normal fibroblasts, DX B cells, or 45 allogeneic melanoma cell lines expressed the class 1 antigen of DX melanoma. The fact that only one of the melanoma cell lines derived from patient DX was suitable target for the detection of autologous class 1 reactivity has implications for the study of human tumor antigens and may explain why antibody to class 1 antigens has been found so infrequently in past studies of melanoma patients.
Management of the Pregnant Diabetic
Authors: J. H. Peel
Journal: BMJ (1955)

Towards the end of the 1931-7 period the sulphonamides were just coming in, with a dosage not fully understood, with some dangers overemphasized and others not realized.When one remembers the horrible problems of septicaemia, arthritis, and osteomyelitis, a total of 25 deaths was not larger than one would expect.In 1947 penicillin was becom- ing cheaper and more fully available, and in the intervening years its successors have kept appearing with gratifying regu- larity.In addition, all through this second seven-year period we have had the steady support of readily available blood transfusion-available in quantity to sustain the patient until the specific remedy was found and had time to take effect.Not only did this disease group almost vanish, to a mortality of one death in a thousand patients, but in the second seven-year period there were double the number of admissions ; and an acute infection which in the first period took days, weeks, or even months-for example, in the case of bone diseases to clear up now suddenly disappears after a few days' treatment with one of the " wonder drugs."This has been accompanied, too, by the almost total dis- appearance of gross subsequent deformities.Osteomyelitis suddenly changed; from a septicaemia with simple or multiple local manifestations, it became a disease with a sterile blood stream.The bony lesions still showed necrosis-perhaps a sterile necrosis-till the suitable com- bination of decompression of the bone by minute drill-holes and the use of an antibiotic was established.Perhaps another seven-year period 20 years from now may not show as good results if a population of antibioticresistant patients has by then been produced.Or will there still be bigger and better spectra of antibiotics ? Congenital Pyloric StenosisIn surgery the best results are obtained from the relief of mechanical obstructions, and this condition is a perfect example.With suitable pre-operative preparation of the patient, with adequate hydration, with a basal narcotic-for example, rectal thiopentone-with the operation performed under a local analgesic, with a transverse incision, and with the abdominal wound closed by a suitably non-absorbent suture-for example, nylon-a simple surgical technique can be evolved.Staining and shock are avoided.The patient should be awake at the end of the operation.There is no fear that the abdominal wound will burst apart, and yet the child is given full freedom.The operation should have a mortality of nil, but the missed diagnosis, the neglected case, and the wasted child with intercurrent disease still appear to make the operation a hazardous procedure, no matter how well carried out.SummaryThe death rates from some of the more frequent surgical conditions are compared in two seven-year periods, 1931-7 and 1947-53.Some of the factors responsible for this improvement are discussed.
A Prospective Study of Breast Cancer Incidence and Stage Distribution in Women with a BRCA1 or BRCA2 Mutation under Surveillance with and without Magnetic Resonance Imaging.
Authors: E. Warner, K. Hill, P. Causer, D. Plewes, R. Jong, M. Yaffe, J. Wong, F. Wright, P. Sun, S. Narod
Journal: Cancer Research (2009)

Abstract Introduction: The sensitivity of MRI for the detection of pre-clinical breast cancer exceeds that of mammography and of other screening tests. If MRI screening leads to reduced mortality in women with a BRCA1 or BRCA2 mutation, then it is expected that the incidence of advanced stage breast cancers should be reduced in a cohort of women undergoing regular MRI screening, compared to conventional screening.Methods: We followed 1275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years for incident breast cancers. 445 women were enrolled in an MRI screening trial in Toronto and 830 controls, from elsewhere in Canada and the United States, underwent conventional screening. The cumulative incidences of DCIS, of early-stage and of late-stage breast cancer were estimated at six years in the two cohorts.Results: There were 41 cases of breast cancer diagnosed in the MRI-screened cohort and 76 cases of breast cancer diagnosed in the control cohort. The cumulative incidence of DCIS or stage I breast cancer at six years was 12.7% in the MRI-screened cohort and was 9.5% in the control group (p = 0.02; log rank test). The cumulative incidence of stage II – IV breast cancers at six years was 2.0% in the MRI-screened cohort and was 7.1% in the control group (p = 0.02; log rank test). The adjusted hazard ratio for the development of stage II – IV breast cancer associated with membership in the MRI-screened cohort was 0.30 (95% CI: 0.12 to 0.72; p = 0.008).Conclusion: Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced stage breast cancer in BRCA1 and BRCA2 carriers.Funding for this study is generously provided by the Canadian Breast Cancer Research Alliance. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 26.
Geriatricians v psychogeriatricians
Authors: P. Catlin
Journal: BMJ (1977)

the legs and abdomen.No further outbreaks occurred after the exclusion of fish from the diet.Of questionable significance is the finding of moderate skin-test reactions to fish, shellfish, cheese, milk, grasses, house dust, and dust-mite despite the absence of a history of any atopic reactions in the past at all.
Thousands of Ugandans with AIDS don't get free drugs
Authors: Henry Wasswa
Journal: BMJ (2006)

The Ugandan government was jubilant when, before the end of last June, the number of people with AIDS receiving antiretroviral treatment reached 60 000, which had been its target for the whole of 2005. But the authorities are worried that since June, the number of people being treated for AIDS has risen by only about 15 000.

Uganda has secured free antiretroviral drugs for its citizens under a programme funded by the Global Fund to fight AIDS, tuberculosis, and malaria; the World Health Organization; and the US government. The target was to treat 60 000 people in 2005.

Although the target was reached six months ahead of time, many fewer people have come forward for treatment since. The authorities …
Prenatal initiation of endotoxin airway exposure prevents subsequent allergen-induced sensitization and airway inflammation in mice
Authors: K GERHOLD, A AVAGYAN, C SEIB, R FREI, J STEINLE, B AHRENS, A DITTRICH, K BLUMCHEN, R LAUENER, E HAMELMANN
Journal: Journal of Allergy and Clinical Immunology (2006)
Soluble intercellular adhesion molecule-1 and soluble E-selectin levels in patients with atopic dermatitis
Authors: S. HIRAI, T. KAGESHITA, T. KIMURA, M. TSUJISAKI, K. OKAJIMA, K. IMAI, T. ONO
Journal: British Journal of Dermatology (1996)

Journal Article Soluble intercellular adhesion molecule‐1 and soluble E‐selectin levels in patients with atopic dermatitis Get access S. HIRAI, S. HIRAI Department of Dermatology, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar T. KAGESHITA, T. KAGESHITA Department of Dermatology, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar T. KIMURA, T. KIMURA Department of Dermatology, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar M. TSUJISAKI, M. TSUJISAKI First Department of Internal Medicine. Sapporo Medical School, Sapporo, Japan Search for other works by this author on: Oxford Academic Google Scholar K. OKAJIMA, K. OKAJIMA Department of Laboraatory Medicine, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar K. IMAI, K. IMAI Department of Dermatology, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar T. ONO T. ONO Department of Dermatology, Kumamoto University School of Medicine, Honjo 1‐1‐1 Kumamoto, 860 Japan Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 134, Issue 4, 1 April 1996, Pages 657–661, https://doi.org/10.1111/j.1365-2133.1996.tb06965.x Published: 01 April 1996 Article history Accepted: 12 June 1995 Published: 01 April 1996
18F-FDG PET/CT Findings in a Patient With Isolated Intracranial Rosai-Dorfman Disease
Authors: Emmanuel Deshayes, Jean-Philippe Le Berre, Emmanuel Jouanneau, Alexandre Vasiljevic, Gérald Raverot, Pascal Seve
Journal: Clinical Nuclear Medicine (2012)

Rosai-Dorman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare histiocytic disorder first described in 1969. RDD involving the central nervous system is considered to be rare, with fewer than 120 cases reported in the literature. We present a 51-year-old woman with a history of panhypopituitarism, episodic memory disturbance, and a hypothalamic tumor. Stereotaxic hypothalamic lesion biopsy showed histiocytic proliferation positive for S100 protein and CD68, but negative for CD1a, typical for RDD. ¹⁸F-FDG PET/CT 4 months later demonstrated increased hypothalamic metabolic activity.
Stones, lithotripters, trails, and arguments
Authors: M. J Hensley
Journal: BMJ (1986)

<h3>Background</h3> The National Authority for Health (HAS) updated in 2018 its recommendations on the anticoagulation for vascular prevention after ischaemic stroke. <h3>Purpose</h3> The objective was to assess and compare oral anticoagulant (OAC) prescriptions to the guidelines in patients hospitalised for ischaemic stroke in a stroke unit. <h3>Material and methods</h3> This was an observational retrospective study of OACs prescriptions including Vitamin K antagonist (VKA) and direct-acting oral anticoagulant (DOAC) in patients admitted for ischaemic stroke in a comprehensive stroke centre. Data on prescribed OAC from January to August 2018 was collected from the electronic inpatient records. The prescriptions’ evaluation was based on indication, dosage and drug interactions for DOAC, and indication and bridging anticoagulation for VKA. The thrombotic risk was quantified using the CHA2DS2-VASC score. <h3>Results</h3> The mean age of the 86 included patients was 72.8±14.5 years old (49% female). About 69% had an OAC initiation during hospitalisation and 31% was previously treated. At hospitalisation discharge DOAC were three times more prescribed than VKA (77% versus 23%). DOAC prescriptions of 92% conformed to the guidelines (dosage and no drug interaction). VKA prescriptions could not be evaluated because of ambulatory follow-up. The main OAC therapeutic indication was a confirmed atrial fibrillation (AF) in 62% patients (mean CHA2DS2-VASC=4.93±1.36). In 21%, AF was suspected, based on an association of factors such as: atrial hyperexcitability (59%), dilated left atrium (47%) and ischaemic stroke background in patients undergoing antiplatelet therapy (23%) (mean theoretical CHA2DS2-VASC=4.82±1.67). The remaining indications for OAC were: patent foramen ovale (PFO) before closure (7%, only DOAC), mechanical heart valve (5%, only VKA) and antiphospholipid syndrome (APS) (2%, only VKA). <h3>Conclusion</h3> Even though HAS gave no recommendation concerning OAC prescription in patients with an AF suspicion, neurologists prescribe it to prevent relapse stroke risk due to paroxysmal AF. A Holter monitoring is prescribed after discharge to decide upon the continuation of OAC at the neurologist’s follow-up visit. This practice should be investigated further to prove its efficiency. Concerning mechanical heart valves, neurologists follow the HAS recommendations. For PFO, neurologists use DOAC regardless of the HAS recommendations. No recommendation has been given for APS. <h3>References and/or acknowledgements</h3> https://www.has-sante.fr/portail/jcms/c_1252051/fr/prevention-vasculaire-apres-un-infarctus-cerebral-ou-un-accident-ischemique-transitoire No conflict of interest.