tbuckley/cabot-search huggingface dataset:
Clinical Recognition of Leprosy: Some Factors Leading to Delays in Diagnosis
Authors: S. Powell, C. McDougall
Journal: BMJ (1974)

The case histories of eight patients in the United Kingdom admitted to hospital for the diagnosis of leprosy are examined in detail. Review of their early symptoms and signs showed that there had been delays in diagnosis, ranging from a few months to many years. Possible reasons for delay are discussed, and attention is called to the importance of nasal symptoms in the early diagnosis of lepromatous leprosy.
Diphtheria-tetanus-acellular pertussis (DTaP) vaccine
Authors: B. J. Howe
Journal: JAMA (1996)

<h3>In Reply.</h3> —We are glad to know that the work of Dr Durand and colleagues confirms our results of hepatitis B seroepidemiology after a mass immunization program on populationbased samples of children 3 to 4 years of age. A hepatitis B vaccination program without administration of HBIG may yield good results in an area of lower maternal hepatitis B virus e antigen (HBeAg) seropositivity rate in HBsAg-carrier mothers. In a previous study, the efficacy of hepatitis B immunization increased from 75% with vaccination alone to 94% with addition of HBIG in infants born to HBeAg-seropositive, HBsAg carrier mothers.<sup>1</sup>The strategy of maternal screening and administration of HBIG may differ with consideration of HBeAg seropositivity rate and financial issues in different areas. However, a universal hepatitis B immunization program is recommended for all newborns in both high-rate and low-rate endemic areas to prevent HBV infection and its related diseases.
Reconstructive Procedures in Surgery
Authors: John R. Hilsabeck
Journal: JAMA (1983)

In this work, British experts review and update their respective fields and preferred methods in managing specific problems of reconstruction of body conduits that carry fluids in the thorax, abdomen, and extremities. A special section deals with internal fixation of fractures, breast reconstructions, and abdominal hernia repairs. The first of five sections deals with the general physiological, anatomic, and pathological reconstructive principles shared in common by these conduits for blood, urine, gastric juices, intestinal contents, bile or lymph, the metabolic basis of repair generally, and the suitability of specific biomaterials for repair, including their tolerance by the body. In the next three sections, knowledge of specific conduit conditions and corrective procedures is updated for gastroenterology, urology, and cardiovascular surgery, and the experts defend their methods. The final section deals with the aforementioned special topics. Excellent line drawings throughout make for easier understanding of the varied reconstruction problems and procedures. Designed
A pain in the neck type of headache
Authors: R. R. Shabiyulla
Journal: BMJ (2013)

A 29 year old right hand dominant chef presented to the emergency department with a four day history of feeling “not normal.” He was sent home from work because of a gradual onset of dull pain on the left side of his neck radiating up into his head, which was getting progressively worse, as well as “seeing two of everything.” The pain was not influenced by changes in posture. In addition, his right side felt numb and he was dropping things at work. He felt unsteady on his feet, which prompted him to seek medical advice. He thought all his symptoms had come on suddenly and were gradually getting worse. He denied any recent alcohol consumption, illicit drug use, seizure activity, head injury, or loss of consciousness. He had no medical history of note, apart from hypothyroidism, for which he was taking thyroxine.

On examination, he was alert and orientated. His blood pressure was 141/94 mm Hg and other vital signs were normal. He had moderate weakness on the right side (Medical Research Council grade 4), mainly in the upper limb, with pronator drift, and reduced sensation to pinprick, light touch, and proprioception on the same side. There was evidence of a resting and intention tremor, with dysdiadochokinesia of the upper limbs, which was more evident on the right side than the left. Furthermore, he had a broad based gait consistent with cerebellar ataxia when attempting to walk. He had an upgoing plantar response on the right and a downgoing one on the left. His pupils were equal and reactive to light, but he had diplopia on both extremes of gaze, although there was no clinical evidence of ocular palsy. Papilloedema was not detected on examination of his fundi.

Given his history and the constellation of findings on examination, a …
Refresher Courses for Service M.O.s
Authors: E. L. Graff
Journal: BMJ (1943)

<h3>Abstract</h3> Coalescent-based species tree inference has become widely used in the analysis of genome-scale multilocus and SNP datasets when the goal is inference of a species-level phylogeny. However, numerous evolutionary processes are known to violate the assumptions of a coalescence-only model and complicate inference of the species tree. One such process is hybrid speciation, in which a species shares its ancestry with two distinct species. Although many methods have been proposed to detect hybrid speciation, only a few have considered both hybridization and coalescence in a unified framework, and these are generally limited to the setting in which putative hybrid species must be identified in advance. Here we propose a method that can examine genome-scale data for a large number of taxa and detect those taxa that may have arisen via hybridization, as well as their potential “parental” taxa. The method is based on a model that considers both coalescence and hybridization together, and uses phylogenetic invariants to construct a test that scales well in terms of computational time for both the number of taxa and the amount of sequence data. We test the method using simulated data for up 20 taxa and 100,000bp, and find that the method accurately identifies both recent and ancient hybrid species in less than 30 seconds. We apply the method to two empirical datasets, one composed of <i>Sistrurus</i> rattlesnakes for which hybrid speciation is not supported by previous work, and one consisting of several species of <i>Heliconius</i> butterflies for which some evidence of hybrid speciation has been previously found.
LOW-DOSE ACETYLSALICYLIC ACID-ASSOCIATED PEPTIC ULCERS AND DYSPEPTIC SYMPTOMS ARE REDUCED BY ESOMEPRAZOLE 20 MG AND 40 MG ONCE DAILY
Authors: James Scheiman, Johan Herlitz, Philip Devereaux, Emma Naucler, Lars-Erik Svedberg
Journal: Journal of the American College of Cardiology (2010)
Prospective Randomized Trial of Moderately Strenuous Aerobic Exercise After an Implantable Cardioverter Defibrillator
Authors: Cynthia M. Dougherty, Robb W. Glenny, Robert L. Burr, Gayle L. Flo, Peter J. Kudenchuk
Journal: Circulation (2015)

Despite its salutary effects on health, aerobic exercise is often avoided after receipt of an implantable cardioverter defibrillator (ICD) because of fears that exercise may provoke acute arrhythmias. We prospectively evaluated the effects of a home aerobic exercise training and maintenance program (EX) on aerobic performance, ICD shocks, and hospitalizations exclusively in ICD recipients.
TREATMENT OF RINGWORM OF THE SCALP WITH THALLIUM ACETATE
Authors: D. R. Lewis, W. A. Lloyd
Journal: BMJ (1933)

rCTiAHEP BMITIsHwt 99 of its elimination and rate of absorption is only partial, TREATMENT OF RINGWORM OF THE SCALP and although we have certain facts to guide us in its WITH THALLIUM ACETATE' administration, our ignorance of its pharmacological action BY still awaits daylight.
P23 500 consecutive referrals to a DGH sleep service: how useful is the Epworth?
Authors: L. H. White, S. Backway, A. Kerry, A. Stanton, M. Juniper
Journal: Thorax (2011)

<h3>Introduction and Objectives</h3> Our sleep service offers assessment and treatment of sleep-disordered breathing (SDB). Our commissioners suggested that patients with an Epworth Sleepiness Score (ESS) = 9 did not require assessment. We assessed the characteristics of patients referred and usefulness of baseline ESS. All patients referred for assessment of SDB were entered onto a database prospectively from October 2009 to June 2011. Baseline data recorded was: referral source, demographics, ESS, sleep study type, oxygen desaturation index &gt;4% (ODI), study interpretation, treatment decision. <h3>Results</h3> 500 patients were referred, most commonly by GP (n=349), endocrinology (n=50), respiratory (n=34) and ENT (n=29). 365 patients were male, mean age (±SD) 51.3±13.5 years. 476 patients (95.2%) underwent respiratory polygraphy (377 inpatient, 99 at home) and 24 (4.8%) overnight oximetry. Initial mean ESS (±SD) was 13.3±6.0 and was positive (=10) in 354 patients (70.8%). SDB was demonstrated in 309 patients (61.8%) and periodic limb movements in 8. Positivity rates varied with referral source (GP–64.8%, diabetes–55.2%, respiratory–67.6%, ENT – 55.2%) and sleep study type (inpatient polygraphy-60.2%, home polygraphy-76.8%, oximetry-58.3%). Diagnosis was obstructive sleep apnoea (OSA) (n=246, 15 with coexistent hypoventilation), upper airways resistance (n=56), obesity hypoventilation (n=4), central sleep apnoea (n=2) and COPD-related nocturnal hypoxia (n=1). Median ODI for all studies was 9 (range 0–150). OSA was mild in 72 patients (29.3%), moderate in 65 (26.4%) and severe in 106 (43.1%). ODI was &lt;5 in 3 patients (1.2%) but the study deemed positive. Following clinical assessment, 269 patients (53.8%) commenced CPAP, of whom 36 (13.4%) had an initial ESS=9. In these patients, severity of SDB did not relate to baseline ESS (mean ODI 32.0 (ESS=9) vs 30.5 ESS=10)). Of the 106/500 patients with ESS=9, 54.3% had a positive study and 33.3% were commenced on CPAP, as compared to 65.5% and 58.8% respectively of patients with ESS=10. <h3>Conclusion</h3> We identified a reasonable percentage of patients referred with suspected SDB. A significant number of such patients had a normal ESS, which may underestimate symptoms warranting CPAP. A negative ESS should not preclude sleep referral and should be used with caution when designing referral criteria.
The Riddle of Suggestion
Authors: N. WILLIAM WINKELMAN, STEVEN D. SAUL
Journal: American Journal of Psychiatry (1972)

Suggestion has played a crucial role in psychiatric healing for thousands of years. The nature of suggestion as a psychological phenomenon is not understood. Unless the riddle is solved, a synthesis between the various schools of psychology is unlikely. The crucial variables must be related in a manner that is meaningful to both psychoanalysts and social-oriented investigators.
Advanced glycation end‐products, anti‐hypertensive treatment and diastolic function in patients with hypertension and diastolic dysfunction
Authors: Jasper W.L. Hartog, Ruud M. van de Wal, Casper G. Schalkwijk, Toshio Miyata, Wybren Jaarsma, H.W. Thijs Plokker, Leen M. van Wijk, Andries J. Smit, Dirk J. van Veldhuisen, Adriaan A. Voors
Journal: European Journal of Heart Failure (2010)
Genotype–Phenotype Correlations for the Paranasal Sinuses in Cystic Fibrosis
Authors: MARK B. JORISSEN, KRIS DE BOECK, HARRY CUPPENS
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Genotype-phenotype correlations in cystic fibrosis (CF) have been found for lung and pancreatic function, but not for paranasal sinus disease. Because such correlations may have pathophysiological and clinical implications, the correlation of mutations, in particular DeltaF508, with paranasal sinus disease was investigated in 113 CF patients with known genotype. The clinical importance of paranasal sinus disease was evaluated using three parameters: polyps, overall clinical severity of upper airway problems, and surgery. Polyps were evaluated by nasal endoscopy and graded on a five-point scale. Four severity groups were distinguished based on history, clinical records, and examination: no upper airway problems; more problems than in control subjects; severe, recurrent or chronic problems; and paranasal sinus surgery cases. DeltaF508 homozygosity correlated with clinical severity (p < 0.02) and with the presence of polyps on endoscopy (p < 0.05). The relative risk for paranasal sinus surgery in DeltaF508 homozygous CF patients was 2.33. In conclusion, there are genotype-phenotype correlations for paranasal sinus disease in CF. DeltaF508 homozygosity is a risk factor for paranasal sinus disease in CF.
Arc/Arg3.1 Is Essential for the Consolidation of Synaptic Plasticity and Memories
Authors: Niels Plath, Ora Ohana, Björn Dammermann, Mick L. Errington, Dietmar Schmitz, Christina Gross, Xiaosong Mao, Arne Engelsberg, Claudia Mahlke, Hans Welzl, Ursula Kobalz, Anastasia Stawrakakis, Esperanza Fernandez, Robert Waltereit, Anika Bick-Sander, Eric Therstappen, Sam F. Cooke, Veronique Blanquet, Wolfgang Wurst, Benedikt Salmen, Michael R. Bösl, Hans-Peter Lipp, Seth G.N. Grant, Tim V.P. Bliss, David P. Wolfer, Dietmar Kuhl
Journal: Neuron (2006)
Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis. Alterations with penicillin and methylprednisolone.
Authors: W M Scheld, R G Dacey, H R Winn, J E Welsh, J A Jane, M A Sande
Journal: Journal of Clinical Investigation (1980)

Acute bacterial meningitis may be associated with increased intracranial pressure, neurological sequelae such as communicating hydrocephalus, and a slow response to antibiotic therapy. Alterations in cerebrospinal hydrodynamics are at least partially responsible for these complications. Constant, low-flow short-duration manometric infusion studies through a hollow-bore pressure monitoring device in direct continuity with the supracortical subarachnoid space were performed in rabbits with experimental meningitis. Maximal resistance to cerebrospinal fluid (CSF) outflow from the subarachnoid to vascular space was markedly increaed in acute pneumococcal meningitis when compared to control, uninfected animals (6.77 +/- 3.52 vs. 0.26 +/- 0.04 mm Hg/microliter per min, P less than 0.001). Similar elevations (8.93 +/- 4.15 mm Hg/microliter per min were found in experimental Escherichia coli meningitis. Despite eradication of viable bacteria from the CSF by penicillin therapy during the acute stage of pneumococcal meningitis, resistance remained elevated (6.07 +/- 4.68 mm Hg/microliter per min) and had not returned to normal up to 15 d later. Administration of methylprednisolone during the early stages of acute pneumococcal meningitis reduced mean peak outflow resistance towards control values (0.59 mm Hg/microliter per min) and no "rebound" effect was apparent 24 h later. These hydrodynamic alterations in experimental meningitis prevent normal CSF absorption and decrease the ability of the bran to compensate for changes in intracranial volume and pressure.
Taxane associated with trastuzumab-induced early ventricular impairment: Correlation with biologic markers of chronic inflammation and oxidative stress.
Authors: Clelia Madeddu, Mariele Dessi', Christian Cadeddu, Alessandra Piras, Giorgia Antoni, Martino Deidda, Giovanni Mantovani, Giuseppe Mercuro
Journal: Journal of Clinical Oncology (2014)

e11566 Background: Currently, there are little data on the short and long term cardiac effects of TZM associated with Taxane in the treatment of HER-2 positive breast cancer cancers. Speckle Tracking (ST) imaging based deformation indexes have shown to be very sensitive identifying left ventricular dysfunction. Methods: A phase IV prospective non-randomized study was carried out to assess cardiotoxicity induced by TZM and taxane-based regimens in adjuvant setting of HER-2 positive breast cancer patients. Exclusion criteria: LVEF <55%; ECOG PS >2, history of cardiac disease. The following assessments were carried out at baseline, after each TZM treatment and every 3 months during 1 year follow-up: ECOG PS, conventional echocardiography and ST parameters (global circumferential, radial and longitudinal S and SR), chronic inflammation (IL-6 and TNF-alpha) and oxidative stress (reactive oxygen species and glutathione peroxidase) markers. The correlation between changes detected by echocardiography and chronic inflammation/oxidative stress parameters was studied. Results: At January 2014, 30 patients (mean age ±SD: 53±10 y) have been enrolled and evaluated. A significant progressive reduction of the peak of longitudinal SR was observed throughout all treatment starting at 4th dose of TZM (0.81±0.16 s-1 vs 0.58±0.16 s-1,p<0.001) as signs of systolic dysfunction. Furthermore, a significant reduction of the circumferential SR (0.51±0.14 s-1 vs 0.6±0.15 s-1; p<0.01) and of the rotation (1.45±0.57 vs 2.49±1.08; p<0.001) appeared at the first dose of TZM. At the 3rd dose of TZM, increased significantly (16.7±15.6 pg/ml vs 25±11.7; p=0.03), whilst the other laboratory parameters did not change significantly in comparison to baseline values. Conclusions: The concomitant administration of Taxanes and TZM proved to induce a subclinical early impairment of left ventricular function. These effects seem to be related to an increase of TNF alpha. Follow up data will show if this myocardial impairment will persist over time.
Impact of Metabolic Control and Serum Lipids on the Concentration of Advanced Glycation End Products in the Serum of Children and Adolescents With Type 1 Diabetes, as Determined by Fluorescence Spectroscopy and <i>N</i>ε-(Carboxymethyl)Lysine ELISA
Authors: Angela Galler, Grit Müller, Reinhard Schinzel, Juergen Kratzsch, Wieland Kiess, Gerald Münch
Journal: Diabetes Care (2003)

OBJECTIVE—Advanced glycation end products (AGEs) are a complex and heterogenous group of proteins that are formed by nonenzymatic glycation in a series of reactions. It is hypothesized that they may play a role in the pathogenesis of diabetes-related complications; at present, however, their exact biological role is scarcely understood. Clinical studies so far have shown that serum levels of AGEs are correlated with clinical stages of diabetes complications such as retinopathy and nephropathy. This study was performed in children and adolescents with type 1 diabetes to examine the putative role of serum AGEs in respect to metabolic control and diabetes complications in relation to a number of clinical and laboratory parameters. RESEARCH DESIGN AND METHODS—We studied 99 children and adolescents up to the age of 20 years with type 1 diabetes and 60 control subjects. Serum levels of AGEs were measured with two different methods [fluorescence spectroscopy and Nε-(carboxymethyl)lysine (CML) enzyme-linked immunosorbent assay] and correlated with clinical data, such as age, diabetes duration, BMI, and long-term metabolic control determined by HbA1c, and laboratory parameters, such as serum lipids. RESULTS—Serum levels of fluorescent AGEs, but not of CML-AGEs, in children and adolescents with type 1 diabetes were significantly higher compared with control subjects. There was an age-dependent increase of fluorescent AGEs in children and adolescents with diabetes that was not seen in healthy children and adolescents. Levels of fluorescent AGEs in patients with diabetes between 13 and 16 years of age correlated positively with HbA1c levels. No significant association between levels of AGEs and diabetes duration was found. Children and adolescents with diabetes and high serum triglycerides had significantly higher serum levels of fluorescent AGEs. Children and adolescents with diabetes between the age of 13 and 16 years with high levels of LDL had significantly higher levels of fluorescent AGEs. CONCLUSIONS—In this study we demonstrated a clear age-dependent increase of fluorescent AGEs but not of CML-AGEs in children and adolescents with diabetes type 1. Moreover we showed a strong association between serum AGEs and serum triglycerides and cholesterol. The observed effect may be caused by a loss of optimal regulation of lipid metabolism. It could suggest a link between triglycerides and formation of AGEs. This new and interesting finding and its impact on metabolic control and the development of diabetes complications should be examined in the future.
Brachioradial pruritus: Mayo Clinic experience over the past decade
Authors: S.A. Mirzoyev, M.D.P. Davis
Journal: British Journal of Dermatology (2013)

Brachioradial pruritus (BRP) is a fascinating condition that is seen increasingly often, but any additional data from retrospective observational studies can still enhance our understanding.To review our experience at the Mayo Clinic with patients presenting with BRP.We retrospectively reviewed the clinical records of patients diagnosed with BRP between 1999 and 2011.In total, 111 patients (80 female, 72%) had been diagnosed with BRP. Their mean age was 59 years, range 12-84 years. Symptoms were bilateral in 84 (75.7%). Fifty-four patients (48.6%) reported prolonged exposure to the sun, and 16 had a history of neck concerns. Forty-five (40.5%) had undergone imaging studies of the neck; of these, eight had foraminal stenosis, six had protrusion of the intervertebral disk and six had stenosis of the spinal canal; 10 had more than one cervical abnormality. Thirty-one patients had been referred to neurology; eight of these had BRP attributed to a radiculopathy or peripheral neuropathy. Several topical and oral medications were prescribed. Seventy-five patients had a follow-up; of these, nine (12%) had complete resolution, 13 (17%) had improvement, four (5%) showed no change and 49 (65%) had no mention of BRP.Brachioradial pruritus presented most commonly in female patients and was observed over a wide age range. Although a third of patients with imaging studies had cervical abnormalities, the significance of these findings is unclear, as no structural causes of BRP were found in most cases. Some treatments were more successful than others.
High mean platelet volume after myocardial infarction
Authors: A. Trowbridge, D. Slater, Y. Kishk, J. Martin
Journal: BMJ (1985)

retrospective study and a graph of symphysisfundus height was not used.Dr Neilson and colleagues admit that mothers who may have been referred before 34 weeks with suspected intrauterine growth retardation were not included in their study and report that of six babies with intrauterine growth retardation who died three died before 34 weeks.Gentz et al have pointed out that in a Swedish study nearly half the stillbirths occurred before admission and 80O, of these fetuses died before the onset of labour.Yet use of the symphysis-fundus graph in their hands can detect intrauterine growth retardation as early as 28 weeks (16 000 deliveries).No serious student of intrauterine growth retardation can afford to neglect reading Westin's account of his work.Symphysis-fundus graphs are simple to use and indicate in a much more specific way in each patient when to refer for an ultrasound check.This is much better than an expensive, time consuming routine test which may be done too late.