tbuckley/cabot-search huggingface dataset:
An unusual gum lesion with a positive pregnancy test
Authors: C. Alifrangis, R. Evans, J. Williams, M. J. Seckl
Journal: BMJ (2011)

A previously well 46 year old woman presented to her dentist with toothache. She was otherwise asymptomatic. On examination, the dentist noticed a bleeding lesion in the left upper gum (fig 1⇓). In the middle of the examination, she felt warm, flushed, and faint; she briefly became unconscious but rapidly recovered with no evidence of convulsions or other problems. An ambulance was nevertheless called. In the emergency department her pulse, blood pressure, respiratory rate, and temperature were normal but the odd gum lesion was again noted. To her surprise, a routine pregnancy test before chest radiography was positive. She had experienced irregular light periods for the previous few months. The date of her last menstrual period was unknown, and she had been using no regular contraception. Because she had two children aged 5 and 7 years, it was assumed that she might be pregnant again. Radiography was deferred and she underwent an ultrasound of her pelvis, which showed a large vascular uterus with no viable pregnancy. Her serum human chorionic gonadotrophin concentration was 343 255 IU/L (reference value <5 IU/L). After exclusion of a viable pregnancy, chest radiography was performed and showed multiple lung lesions. An urgent computed tomography scan of the whole body showed a large vascular uterine mass together with lesions within the kidney, liver, lungs (fig 2⇓), and both cerebral hemispheres.



Fig 1 Vascular lesion indicated by blue arrow





Fig 2 Initial computed tomogram of the thorax showing multiple rounded opacities within both lung fields (arrows)





### 1 The computed tomogram of the thorax shows two “cannonball” lesions; what is the differential diagnosis for this appearance?

#### Short answer

Cannonball lesions are commonly caused by cancer, although non-malignant disease can mimic this presentation. Malignant cannonball …
Pain: Pasion, Compassion, Sensibility
Authors: Vittal Katikireddi
Journal: BMJ (2004)

A Wellcome Trust exhibition at the Science Museum, London SW7, from 13 February until 20 June 2004. Admission free www.wellcome.ac.uk/pain www.sciencemuseum.org.uk/ 

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Pain. Pleasure. Religion. Catharsis. This exhibition considers all these things, but, above all, pain. “This exhibition is about the cultural place of pain and how science and other ways of thinking have shaped our beliefs, our understanding, and our attempts to control it,” explains the curator, Spanish philosopher Javier Moscoso.

Moscoso has teamed up with the Science Museum and the Wellcome Trust to look at pain from its widest perspective. He explores not only the history of pain (including its evolution from antiquity to modernity), but also its effect on individuals and society.

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German anaesthetic equipment dating from the first world war

“The …

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Case 5-1983
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, John T. Harrington, Robert T. McCluskey
Journal: New England Journal of Medicine (1983)

Presentation of CaseA 72-year-old man was admitted to the hospital because of purpura and impaired renal function.There was a long history of hypertension, managed in recent years with hydrochlorothiazide. Myocardial infarction occurred 15 years before admission and was followed by infrequent angina pectoris, which responded to nitroglycerin. He also took irregular doses of propranolol because of palpitation. Six years before entry he was first seen at this hospital because of a chronic ulcer of the right leg. The urine was normal. The hematocrit was 41 per cent; the white-cell count was 9500, with normal differential count. The urea . . .
Rickets, the Continuing Challenge
Authors: Francis H. Glorieux
Journal: New England Journal of Medicine (1991)

Appropriate environmental measures and the wide use of vitamin D have led to the nearly complete disappearance of common rickets in most developed countries (with the exception of those few that have yet to begin fortifying milk). In other parts of the world, however, rickets remains a public health problem. In addition, there are acquired and heritable forms of rickets that develop despite adequate availability of vitamin D. Precise diagnosis and management of these forms have improved considerably over the past two decades.Strictly speaking, rickets is caused by any interference with the process of endochondral bone formation — that . . .
Study should have reported more data about associated diseases
Authors: A. Sgadari, G. Gambassi, C. Pedone, G. Onder
Journal: BMJ (2001)

EDITOR—In reporting their case-control study with 245 incident hip fractures, Pierfitte et al conclude that use of benzodiazepines does not confer any added risk.1 Unusually, plasma benzodiazepine concentrations were measured.

Fracture is considered to be the result of either an increased tendency to fall or an increased tendency to fracture, or both, so it would have been appropriate to gather information on history of fall. Use of benzodiazepines may lead to hip fracture by increasing the risk of falling and by affecting …
Effect of magnesium on blood pressure
Authors: H.-G. Gullner
Journal: BMJ (1983)

The <i>Caenorhabditis elegans</i> gene <i>eat-4</i>affects multiple glutamatergic neurotransmission pathways. We find that<i>eat-4</i> encodes a protein similar in sequence to a mammalian brain-specific sodium-dependent inorganic phosphate cotransporter I (BNPI). Like BNPI in the rat CNS,<i>eat-4</i> is expressed predominantly in a specific subset of neurons, including several proposed to be glutamatergic. Loss-of-function mutations in <i>eat-4</i> cause defective glutamatergic chemical transmission but appear to have little effect on other functions of neurons. Our data suggest that phosphate ions imported into glutamatergic neurons through transporters such as EAT-4 and BNPI are required specifically for glutamatergic neurotransmission.
Important role of tissue angiotensin-converting enzyme activity in the pathogenesis of coronary vascular and myocardial structural changes induced by long-term blockade of nitric oxide synthesis in rats.
Authors: M Takemoto, K Egashira, M Usui, K Numaguchi, H Tomita, H Tsutsui, H Shimokawa, K Sueishi, A Takeshita
Journal: Journal of Clinical Investigation (1997)

The long-term administration of N(omega)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthesis, produces coronary vascular remodeling and myocardial hypertrophy in animals. This study used a rat model to investigate the role of angiotensin I converting enzyme (ACE) in the pathogenesis of such changes. We studied the following groups, all of which received drug treatment in their drinking water: untreated controls, and those administered L-NAME, L-NAME, and an ACE inhibitor (ACEI), and L-NAME and hydralazine. Cardiovascular structural changes and tissue ACE activities were evaluated after the first, fourth, and eighth week of treatment. In rats treated with L-NAME alone, vascular remodeling was evident at the fourth and eighth week, and myocardial hypertrophy was present at the eighth week of treatment. The vascular and myocardial remodeling were characterized by increased tissue ACE activities and immunodetectable ACE in those tissues. These changes were markedly reduced by ACEI, but not by hydralazine treatment. Increased local ACE expression may thus be important in the pathogenesis of cardiovascular remodeling in this model.
Alcohol Withdrawal Syndrome in Mice.
Authors: Gerhard Freund
Journal: Annals of Internal Medicine (1969)

s1 May 1969Alcohol Withdrawal Syndrome in Mice.Gerhard Freund, M.D., F.A.C.P.Gerhard Freund, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1101_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptProgress in alcoholism research has been slow because of the lack of a suitable animal model of the alcohol withdrawal syndrome. This is the first description of an alcohol withdrawal syndrome induced in animals drinking alcohol. A liquid diet containing 40% calories as ethanol was the only source of calories and fluids for 20 adult female ICR mice for 3 months. The mice lost weight, from 27 to 30 g at the beginning of the experiment to 20 to 30 g at the time of withdrawal. During the 10 days before ethanol withdrawal all mice that developed a withdrawal reaction... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Gainesville, Florida PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1101-1101KeywordsAlcoholismAlcoholsAnimal modelsDietEthanol Issue Published: 1 May 1969 PDF DownloadLoading ...
Psychological Factors and Vulnerability to Psychiatric Morbidity after Myocardial Infarction
Authors: Lluisa Garcia, Manuel Valdés, Inmaculada Jòdar, Nadine Riesco, Tomás de Flores
Journal: Psychotherapy and Psychosomatics (1994)

A sample of 97 males suffering from myocardial infarction was studied in order to determine the influence of psychological variables and emotional states on psychopathology displayed by patients in the course of their cardiological recovery. Discriminant analysis revealed that depression in the coronary unit and nonuse of problem-solving strategies were the most sensitive variables to correctly classify psychiatric and nonpsychiatric cases (76.6% of the total sample). Multiple regression analysis of the psychological variables and emotional states showed that severity of psychopathology was directly related to early depressive reaction and use of avoidant strategies. The prevalence of psychiatric disorders was 55.5%, with depression (RDC) being the most frequent diagnosis (59.4%), followed by 'irritable dysphoria' (27%) and anxiety disorders (RDC; 21.6%).
MYOCARDIAL STRAIN REVEALS BIVENTRICULAR IMPAIRMENT IN ASYMPTOMATIC ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY MUTATION CARRIERS
Authors: Kristina H. Haugaa, Sebastian I. Sarvari, Ole-Gunnar Anfinsen, Trond P. Leren, Otto A. Smiseth, Jan P. Amlie, Thor Edvardsen
Journal: Journal of the American College of Cardiology (2010)
Combined short-stay/day surgery/investigation unit in a district general hospital.
Authors: R S Ramaiah, D T Jones, A K Pal
Journal: BMJ (1982)

Over the past few years there has been a growing interest in seeking alternatives to traditionally accepted patterns of in patient care. The reasons for this development are probably complex but are partly attributable to the economics of providing health care. Examples of facilities evolved as a result of this trend are units for day surgery, programmed investigation, five-day wards, and short-stay wards. There are many references to the operation of short-stay observation wards attached to accident and emergency depart? ments,1-4 five-day wards,5 programmed investigation,6 7 and day surgery units.8 9 These references mostly described units developed as discrete entities performing one function only. We describe a unit that from its inception was intended to fulfil three functions?namely, a short-stay observation ward for a major accident and emergency department and an in? vestigation and day surgery unit for both medical and surgical specialties. It is our contention, on the basis of the results for six months, that (a) such a unit can function efficiently and (b) it contributes to making the maximum use of expensive capital resources.
PWE-053 Variation In Adenoma Detection Rate In Bowelscope Screening
Authors: R Bevan, C Nickerson, R Blanks, J Patnick, R Loke, B Saunders, J Stebbing, R Tighe, A Veitch, J Painter, CJ Rees
Journal: Gut (2014)

<h3>Introduction</h3> The English Bowel Cancer Screening Programme has been expanded to include a one-off flexible sigmoidoscopy offered to all 55 year olds, called BowelScope Screening. Screening commenced in May 2013, with 6 pilots sites performing flexible sigmoidoscopies in the first 8 months of screening. <h3>Methods</h3> The NHS Bowel Cancer Screening System database was interrogated and ADRs reviewed for each screening centre and screening endoscopist. A funnel plot was constructed using the log odds method. <h3>Results</h3> 49 endoscopists have performed 4444 sigmoidoscopies at 6 screening centres. Endoscopists had performed 2–330 procedures (median 66, mean 91), 29 endoscopists had performed ≥50 procedures, of these, 17 had performed ≥100 procedures. Overall BowelScope ADR is 8.6%. ADR by centre is shown in Table 1. Centre 2 has a higher ADR than the other centres. When considering all procedures, this difference reaches statistical significance when compared to centres 3, 5, and 6 (p &lt; 0.05), and approaches significance when compared to centre 1 (p = 0.0687) and centre 4 (p = 0.0548). When considering procedures done by endoscopists who have performed ≥50 or ≥100 sigmoidoscopies, there remains a significant difference (p &lt; 0.05) between centre 2 compared to centres 5 and 6, but not to the other centres. Creating a funnel plot of individual endoscopist ADRs, demonstrates one endoscopist below the 99.8% control limit (Figure 1). <h3>Conclusion</h3> Adenoma detection rates within BowelScope screening show variation between centres. There is also variation between endoscopists in terms of individual ADRs, although all but 1 endoscopist are above the 99.8% lower control level on funnel plot. These variations require further exploration at both centre and individual level; feedback and education methods will be used to improve ADRs. Consideration should be given to establishing an ADR standard. <h3>Disclosure of Interest</h3> None Declared.
Local Anesthesia, Its Scientific Basis and Practical Use.
Authors: Heinrich Braun, Percy Shields
Journal: JAMA (1924)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
P233 Death and the Respiratory Physician: Challenges to Providing Optimal End-Of-Life Care by Generalists
Authors: LJ Smith, S Vergnaud, H Wright, C Bates
Journal: Thorax (2012)

<h3>Background</h3> Surveys show most patients want to die at home. However 53% of all UK deaths occur in hospital. Patients with chronic respiratory disease are more likely to die in hospital (66% of COPD deaths) yet hospital end of life care is often poor. Clinicians are advised to use the ‘surprise question’ to identify patients that need advance care planning (ACP). Do not attempt resuscitation (DNAR) orders (evidence of ACP) are often not completed. Barriers previously identified include: lack of training, time, appropriate opportunity and experience; personal discomfort; and perceived lack of patients’/carers’ understanding. <h3>Objective</h3> We investigated experiences, beliefs and attitudes of doctors in a district general hospital towards end of life care, focusing on issues relevant to Respiratory patients. <h3>Methods</h3> Clinicians of varying grades were invited to complete a multiple-choice questionnaire during ‘Dying Matters Awareness Week 2012’. <h3>Results</h3> Amongst the 73 doctors (49% male) there was a high degree of confidence (eg 76% agreed or strongly agreed that they were comfortable talking to patients/relatives about death and dying).However this did not correlate with familiarity with the ‘surprise question’ (23% said they were familiar but only 3% gave a correct response), or knowledge of the most distressing end of life symptom (only 18% identified shortness of breath correctly), or knowledge of the patient group with the highest unmet palliative care needs (only 23% identified patients with Respiratory diseases). 40% believed “palliative care is a specialist skill that should be delivered by specialists”. <h3>Discussion</h3> There is a pressing need for greater expertise in general palliative care amongst hospital doctors. Patients with COPD and other progressive respiratory conditions have extensive palliative care needs. Accurate prognostication is challenging; the surprise question is useful in prompting ACP. DNAR decisions and ACP should not be left to the last days of life. We identified a mismatch between knowledge and confidence levels in our sample. Lack of awareness of their need for education may represent a barrier to doctors accessing training. Respiratory physicians are well placed to lead improvements in ACP and general palliative care in hospital.
STAT3 controls the neutrophil migratory response to CXCR2 ligands by direct activation of G-CSF–induced CXCR2 expression and via modulation of CXCR2 signal transduction
Authors: Hoainam Nguyen-Jackson, Athanasia D. Panopoulos, Huiyuan Zhang, Haiyan S. Li, Stephanie S. Watowich
Journal: Blood (2010)
Abstract 5253: A model of tumor dormancy in Luminal A breast cancer
Authors: Pasquale Sansone, Lauren Shapiro, Qing Chang, Marjan Berishaj, Jaqueline Bromberg
Journal: Cancer Research (2011)

Abstract Introduction: The clinical course and biologic features of metastasis vary extensively depending on the type of cancer. Latency is one of the most important variables in metastasis. Late-onset recurrences are frequently found in Luminal A (ER+/PR+/Her2-) breast cancer patients. In both ER+ tumors and ER+ breast cancer cell lines, tumor cells preferentially disseminate to the bone marrow where they are capable of remaining dormant. The identification of mechanisms that support the survival of disseminated cancer cells (DTCs) has clear implications for understanding the biology of latent metastatic disease. Method: ER+ breast cancer cell lines expressing a GFP luciferase vector (for in vivo bioluminescent monitoring of tumor growth and dissemination) were orthotopically injected in the mammary fat pad (MFP) of mice. DTCs were isolated and characterized from the bone marrow and lungs after several months. Results: The isolated DTCs from the bone and lung do not proliferate, are resistant to both chemo and hormonal therapy (HT) and are endowed with a highly invasive/disseminating capacity (loss of E-Cadherin and gain of EMT features). Moreover, these DTCs exhibit decreased expression of ER compared to the cancer cells within the primary tumor. Since ER activity is required for ER+ breast cancer cell growth in vitro and in vivo, our data suggest that loss of ER activity can be a mechanism of tumor dormancy in Luminal A breast cancer. Conclusion: An understanding of the consequences of ER activity in terms of tumor dormancy and dissemination potential of ER+ breast cancer cells has implications for improving the treatment of latent metastatic disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5253. doi:10.1158/1538-7445.AM2011-5253
Doctor-Patient Relation in Severe Illness
Authors: Kenneth L. Artiss, Arthur S. Levine
Journal: New England Journal of Medicine (1973)

Abstract In an attempt to deal with the anxiety aroused in young physicians who must care for terminal patients, and with the often inappropriate defenses employed in response to this anxiety, we organized a practical teaching seminar that used the principles of preventive and social psychiatry. Six to 10 oncology fellows met weekly with a psychiatrist and a senior attending physician for approximately five months. The major initial defenses of the fellows were identified as anger and denial. The most severe problems discussed were the formation of dependency relations between doctors and patients, the patient's denial of illness, the phenomenon of social death, and the physician's identification with his patient. The last problem often appears to be a productive one, since it encourages the physician to confront the basic issues of his own life. When this confrontation had been examined, most oncology fellows became increasingly effective with their patients. (N Engl J Med 288:1210–1214, 1973)
Endoscopic retrograde brush cytology in patients with primary and secondary malignancies of the pancreas.
Authors: M Osnes, A Serck-Hanssen, O Kristensen, T Swensen, S Aune, J Myren
Journal: Gut (1979)

Endoscopic retrograde brush cytology (ERBC) was performed in 29 patients with primary pancreatic malignancies verified later by histology. Results were positive in 21 patients, suspicious in five, and negative in three. ERBC performed in seven patients with uncertain findings at endoscopic retrograde cholangiopancreatography (ERCP) was positive for malignancy in six and suspicious in one. Endoscopic aspiration cytology (EAC) performed in 10 patients with primary tumours was positive for malignancy in three, suspicious in two, and negative in five cases. ERBC and/or EAC performed in five cases with secondary tumours were positive for malignancy in one and negative in four. It is concluded that ERBC gives a high rate of positive or suspicious (90%) diagnosis of malignancy in patients with primary pancreatic lesions. In secondary tumours cytology seems to be negative in most cases. The study further shows that many of the malignant tumours found by ERP are secondary lesions. Cytology is often able to detect malignancy when ERP has proved inconclusive.