tbuckley/cabot-search huggingface dataset:
Coeliac disease and primary biliary cirrhosis: a case for mutual screening
Authors: J METCALF
Journal: Gut (1998)

See article on page120 

The paper by Kingham and Parker (see page 120) provides a strong take home message regarding the importance of establishing associations between diseases which, although relatively rare, have an impact on the health of a relatively young population. The authors have demonstrated an association between the two disorders and suggest that patients with one disease should be tested for the other. Is this advice justified?

Justification for such targeted screening depends on three things: the robustness of the association; the simplicity and reliability of the diagnostic tests; and the evidence that early detection benefits the patient.

The study aims to make a rigorous assessment of the previously described association between coeliac disease and primary biliary cirrhosis,1 and establish relative prevalences of the two diseases. Gastroenterologists in South Wales have kept a register of specifically defined gastrointestinal diseases since 1984, using ICD coding from all in- and outpatient and day case attendances in the department of gastroenterology. The population under study is accurately defined by use of postcode and ONS statistics. These show a relatively stable population of approximately 250 000 individuals (only 0.2% population growth and little migration or immigration). Multiple case finding methods are used to identify all possible cases of each disease and inclusion criteria …
Gas gangrene and intramuscular injection.
Authors: H. Gaylis
Journal: BMJ (1968)

BmnsHR 59 hospital with chest pain due to suspected myo- cardial infarction were analysed for copropor- phyrin concentration by the rapid screening method of Zielhuis,' using the Donath copro- porphyrinometer.Patients who gave a history of regular heavy alcohol consumption, or who were drunk at the time of admission, were excluded.Urinary coproporphyrin excretion in- creases with urine alkalinity,4 but none of the specimens had a pH greater than 7. Thirty-eight of these 50 patients had in fact sustained an acute myocardial infarct according to electrocardiographic criteria5 or changes in the ST segment and T wave suggestive of in- farction accompanied by a significant transient rise in serum aspartate aminotransferase (S.G.O.T.) levels (>50 Reitman and Frankel units).Twenty-four of these 38 (63%) devel- oped an abnoxnally high urinary coproporphyrin concentration (>100 pg./litre) within three days of admission, which returned to normal within 10 days in all cases.The other 12 patients had angina without evidence of infarction and three of these patients (25%) developed increased co- proporphyrinuria.Control urine samples were obtained from 30 patients with illnesses such as peptic ulcer and chronic bronchitis, which are not known to affect corproporphyrin excretion, and all these samples were normal.The results show that this rapid method of measuring coproporphyrinuria was not a reliable means of distinguishing myocardial infarction from angina.The cause of the increased coproporphyrinuria following myocardial infarction or ischaemia is obscure.Increased copropor- phyrinuria occurs In liver dysfunction' and congestive cardiac failure,' but there was no correlation with clinical signs of cardiac failure in the present series, and bromsulpha- lein excretion (5 mg./kg.body weight) was normal in the two patients with the highest levels of coproporphyrinuria.Pyrogenic steroids such as aetiocholanolone are known to increase porphyrin biosynthesis,8 and this in turn might increase coproporphyrin excre- tion.It is possible that adrenal cortico- steroids released during " stress " are meta- bolized to aetiocholanolone or related com- pounds, but in these patients there was no consistent quantitative relationship between either the severity of chest pain or the degree of pyrexia and the levels of urinary coproporphyrin reached.
Witchcraft and Lupus Erythematosus
Authors: Richard A. Kirkpatrick
Journal: JAMA (1981)

THE SYMPTOMS of systemic lupus erythematosus (SLE) are as numerous as its pharmacologic treatments. Hemolytic anemia, vasculitis, synovitis, lymphadenopathy, nephritis, hepatitis, cerebritis, serositis, and rashes may respond to aspirin, corticosteroids, antimalarial and myelosuppressive alkylating agents, and a plethora of synthetic, nonsteroidal, anti-inflammatory concoctions. Apparently, however, there is another treatment. <h3>Report of a Case</h3> In early 1977, a 28-year-old Philippine-American became ill with weakness, hepatomegaly, and intermittent lymphadenopathy. Two referral clinics documented high ESRs, polyclonal gammopathy, and mild anemia. Also found were RBC and WBC casts and a moderate amount of albumin in her urine. Biopsy specimens of the liver and lymph nodes disclosed non-specific inflammatory changes, and the diagnosis of SLE was established only when antinuclear antibody and lupus erythematosus clot test results (formerly negative) became positive. The anti-DNA level was 68 units/dL (normal, &lt;10 units/dL), and the serum creatinine level was 0.7 mg/dL. Shortly after prednisone therapy, 60 mg/day,
Patterns of Evolution in the Unique tRNA Gene Arrays of the Genus Entamoeba
Authors: B. Tawari, I. K. M. Ali, C. Scott, M. A. Quail, M. Berriman, N. Hall, C. G. Clark
Journal: Molecular Biology and Evolution (2007)

Genome sequencing of the protistan parasite Entamoeba histolytica HM-1:IMSS revealed that almost all the tRNA genes are organized into tandem arrays that make up over 10% of the genome. The 25 distinct array units contain up to 5 tRNA genes each and some also encode the 5S RNA. Between adjacent genes in array units are complex short tandem repeats (STRs) resembling microsatellites. To investigate the origins and evolution of this unique gene organization, we have undertaken a genome survey to determine the array unit organization in 4 other species of Entamoeba-Entamoeba dispar, Entamoeba moshkovskii, Entamoeba terrapinae, and Entamoeba invadens-and have explored the STR structure in other isolates of E. histolytica. The genome surveys revealed that E. dispar has the same array unit organization as E. histolytica, including the presence and numerical variation of STRs between adjacent genes. However, the individual repeat sequences are completely different to those in E. histolytica. All other species of Entamoeba studied also have tandem arrays of clustered tRNA genes, but the gene composition of the array units often differs from that in E. histolytica/E. dispar. None of the other species' arrays exhibit the complex STRs between adjacent genes although simple tandem duplications are occasionally seen. The degree of similarity in organization reflects the phylogenetic relationships among the species studied. Within individual isolates of E. histolytica most copies of the array unit are uniform in sequence with only minor variation in the number and organization of the STRs. Between isolates, however, substantial differences in STR number and organization can exist although the individual repeat sequences tend to be conserved. The origin of this unique gene organization in the genus Entamoeba clearly predates the common ancestor of the species investigated to date and their function remains unclear.
Acceleration of sinus rhythm during slow-rate atrial pacing.
Authors: R Haberl, G Steinbeck, B Luderitz
Journal: Circulation (1983)

We evaluated the effects of slow-rate atrial pacing on impulse formation of the sinus node in 13 isolated rabbit right atria using the microelectrode technique. After the spread of activation was mapped to determine true sinoatrial conduction time (SACT) (38 +/- 16 msec [+/- SD]), the atrium was paced for eight beats at constant intervals slightly shorter than spontaneous cycle length in steps of 10 msec. In all preparations, slow-rate atrial pacing failed to capture the pacemaker center, but shortened action potential duration because of electrotonic interaction between atrium and sinus node. The resulting acceleration of impulse formation of dominant fibers ceased instantaneously when atrial pacing was terminated. Estimation of SACT by constant pacing 5 beats/min faster than sinus rhythm seriously underestimated the true values (p less than 0.05), because sinus node acceleration prevented capture of dominant pacemaker fibers in 10 of 13 preparations. At pacing rates 10 beats/min faster than sinus rhythm, capture did not occur in eight of 13 experiments; at pacing rates 20 beats/min faster, the pacemaker center was captured in all preparations. This study describes sinus node acceleration as a consistent and hitherto unknown finding during slow-rate stimulation of the atrium. This phenomenon accounts for the failure of the constant atrial pacing technique to determine SACT accurately in man.
Lowering the price of "good" foods would be better than taxing "bad" foods in reducing obesity
Authors: J. T. Winkler
Journal: BMJ (2013)

It is a positive development that public health specialists now research price policies on obesity.1 This is the sixth UK proposal for taxes on “bad” foods in 18 months. It is the most ambitious, estimating effects on health as well as consumption.

However, none of the other five proposals hasbeen seriously considered by policy makers. This suggestion, for a 20% tax …
Blood Pressures in Pulmonary Fibrosis
Authors: STEPHEN P. GLASSER
Journal: Annals of Internal Medicine (1970)

Letters and Comments1 August 1970Blood Pressures in Pulmonary FibrosisSTEPHEN P. GLASSER, MCSTEPHEN P. GLASSER, MCSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-73-2-341_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. Cohen and co-workers (Ann Intern Med72:537-542, 1970) reported a very fascinating patient with unilateral pulmonary fibrosis. It is unfortunate that flows were not measured at the time of the first catheterization and that a pulmonary wedge pressure was not reported from the second catheterization. Was the right atrial or right ventricular end-diastolic pressure, or both, measured at either catheterization? Without this information one must question whether the values represent a true difference or if some or all of the difference is related to different zero points. This latter is suggested by a change in the...References1. KALTMANHERBERTCONROY AWR: The gradient in pressure across the pulmonary vascular bed during diastole. Circulation 34:377-384, 1966 CrossrefMedlineGoogle Scholar2. HARVEYENSON RY: Pulmonary vascular resistance, in Advances in Internal Medicine, edited by STOLLERMAN GH, Chicago, Year Book Medical Publishers, Inc., 1969, p. 73 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Walter Reed General Hospital Walter Reed Army Medical Center Washington, D.C. 20012 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1970Volume 73, Issue 2Page: 341-341 Issue Published: 1 August 1970 PDF downloadLoading ...
Correction: Should Society Allow Research Ethics Boards to Be Run As For-Profit Enterprises?
Authors: Ezekiel J Emanuel, Trudo Lemmens, Carl Elliott
Journal: PLoS Medicine (2006)

In PLoS Medicine, volume 3, issue 7: DOI: 10.1371/journal.pmed.0030309

The name Carl Elliot was misspelled; the correct spelling is Carl Elliott.
Family Practice
Authors: David N. Sundwall
Journal: JAMA (1977)

THE DEVELOPMENT of family practice as a new specialty is now a matter of history. It has been almost eight years since the American Academy of General Practice officially changed its name to the American Academy of Family Physicians, and the American Board of Medical Specialties recognized family practice as the 20th specialty. The forces that resulted in the elevation of the general medical practitioner to this lofty status are many and complex. In most cases, these changes were not brought about by forces within the hierarchy of the medical profession but were stimulated by the consumer of our health-care system, the politicians, and the practicing family physicians. Regardless of the motivating forces, much energy and money is being spent to educate a new breed of specialist, the family physician. I have been involved in family medicine almost since its inception as a recognized specialty, and much has happened in
Abdominal Pain of Elusive Nature
Authors: Alan Furness White
Journal: JAMA (1971)

Dr. White: This 52-year-old man had a four-month history of abdominal pain in the right upper quadrant, radiating to his back. There had been a 12.2-kg (27-lb) weight loss and, for three years, intermittent diarrhea. Results of physical examination and laboratory tests, including liver function, were normal, as were roentgenograms of the dorsal spine, intravenous pyelograms and cholangiograms, and a gallbladder series. <h3>Discussion</h3> Dr. Jack R. Dreyfuss: The second portion of the duodenum does not appear normal; it is slightly wider than it should be when distended, and the fold pattern is thickened and irregular. The final diagnosis in this case may be carcinoma of the pancreas, but at the moment I can only be sure that there is slight irregularity of the duodenal folds in an otherwise normal gastrointestinal tract. I would like to see a hypotonic duodenogram. Dr. White: There was no duodenogram, but celiac and superior mesenteric
Clinical Note and Remarks on a Disease of the Eyes Peculiar to Colliers
Authors: W. Sykes
Journal: BMJ (1881)

REMARKS.-It will, I think, be generally admitted that the above case, the clinical features of which I have endeavoured to describe, was rotheln.The following points in connection with the case are note- worthy.i. 7zhe Sevcre Characterof the Er-5tioon during the Stage that the Rash was developiin,g,.-During this period, the quick pulse and high temperature, taken along with the constitutional symptoms, made me apprehensive that a much more formidable disease was being ushered in.2. The Chasacter of thie Fever-.-Thetemperature remained steadily at I04°Fahr.during the greater part of the second day; while, in the evening, coincident with the maximum development of the eruption, there was a very sudden defervescence, the thermometer registering 99°Fahr.at I0 P.Mi.With this marked crisis, there was also a lower- ing of the pulse, and a decided improvement in the condition of the patient.The next morning, the temperature was normal, and did not rise again.In looking over the literature of r6theln, one meets with contradic- tory statements as to the character of the fever that accompanies the disease.For example, WVunderlich, in his classical book on Medical Thtermomwonetry, in speaking of rubeola (rotheln), says: "It does not necessarily entail any fever at all, or only a slight transient attack be- fore or during the eruption.The elevations of temperature are gene- rally subfebrile, or, at the worst, moderately febrile.And although, in isolated cases, more considerable elevations of temperature may be met with, they depend, no doubt, either on complications or on the peculiar
A NEW METHOD OF ANASTOMOSING THE OVARIAN TUBE OR VAS DEFERENS
Authors: S. L. CHRISTIAN
Journal: JAMA (1913)

Attempts at repair of the ovarian tube and vas deferens have always been fraught with uncertainty as to whether the lumen of the tube, after simple suturing, would remain patulous or would become obliterated at the site of the suture line. So far as we are able to find out, obliteration of the lumen at the line of sutures is the usual result. It has seemed desirable that some simple method of repairing these structures that would give reasonably certain results be devised. The following plan we have used successfully in three cases, one of which will be cited as an example. When the ovarian tube or vas deferens has been divided from any cause, the cut ends are picked up, a piece of No. 0 twenty-day catgut is inserted ⅜ inch into each end of the tube and the ends are brought together with two apposing catgut sutures, as
Depression in Adults with Diabetes
Authors: Patrick J Lustman, Linda S Griffith, Jeffrey A Gavard, Ray E Clouse
Journal: Diabetes Care (1992)

Depression in diabetes is a prevalent and chronic condition. The etiology is unknown but is probably complex; and biological, genetic, and psychological factors remain as potential contributors. Several neuroendocrine and neurotransmitter abnormalities common to both depression and diabetes have been identified, adding to etiological speculations. Pharmacotherapy of depression may improve both mood and glucose regulation in diabetes, although controlled studies of the efficacy of psychotherapy and pharmacotherapy for depression in diabetes are not yet available. Depression has potential interactions with diabetes on multiple levels and remains an important clinical focus independent of the medical disease.
Acupuncture and Osier
Authors: Scott Hundahl
Journal: JAMA (1978)

<h3>To the Editor.—</h3> While reading Harvey Cushing's<sup>1</sup>Pulitzer Prize-winning biography of Sir William Osler, I came across the following passage. It is an account of Dr Osler's unsuccessful use of acupuncture to treat a patient suffering from lumbago. Although the date of this event is somewhat uncertain, it probably occurred in 1880. ... for the patient was none other than old Peter Redpath, the wealthy Montreal sugar-refiner, who being on the 'M.G.H.' Board had hopes that the newly appointed physician might be able to cure him of an intractable lumbago. He arrived exhausted after mounting the stairs, and in due course they proceeded to treat him by acupuncture, a popular procedure of the day, which consists in thrusting a long needle into the muscles of the small of the back. At each jab the old gentleman is said to have ripped out a string of oaths, and in the end
Fibrinolysin Treatment of Thromboembolism
Authors: Harold L. Israel, George R. Fisher, Otto Mueller, David A. Cooper
Journal: JAMA (1964)

Fibrinolysin (Thrombolysin) has been used in various dosage schedules for thromboembolic disorders, but its clinical value has not been established. In this study, a single large intravenous dose was given at onset of anticoagulant therapy to 170 patients with thrombophlebitis, pulmonary embolism, or acute myocardial infarction. Only in the group treated for pulmonary embolism was the mortality significantly reduced from that observed in patients receiving only anticoagulants. Toxicity attributable to fibrinolysin was minor except for four patients who developed serum hepatitis. It is concluded that an initial infusion of fibrinolysin during anticoagulant therapy is unnecessary for thrombophlebitis and useless for acute myocardial infarction, but advisable for pulmonary embolism if the hazard of serum hepatitis is eliminated.
Internal Mammary Artery Artifact on Bone Scan of Post-CABG Patient
Authors: DAVID L. POSTELNEK, PAUL L. CHANDEYSSON
Journal: Clinical Nuclear Medicine (1993)

A 78-year-old man underwent bone scanning because of skeletal pain 4 weeks after coronary artery bypass graft. Six focal lesions in a line in the left anterior thorax were seen. The cardiothoracic surgeon who performed the CABG identified these as sites of electrocautery where the left internal mammary artery was dissected from the chest wall.
Trolamine Salicylate Cream in Osteoarthritis-Reply
Authors: Gerald H. Stein
Journal: JAMA (1982)

<h3>In Reply.—</h3> We are pleased that our study has promoted interest and controversy. Dr O'Brien is correct in urging further development of safe and effective nonperoral medications for rheumatic disorders. However, some of the points that he has raised need clarification. First, it was never our intent to denigrate the use of topical agents in treating rheumatic disorders. In fact, a recent report has shown efficacy and systemic absorption of trolamine salicylate cream in patients with rheumatoid arthritis treated with one application, in an open-labeled study.<sup>1</sup> For our double-blind controlled study, we realized that the difficulties were formidable in selecting a defined patient group with specific chronic pain disorders of soft tissue that would potentially respond to an agent like trolamine salicylate cream. Hence, we selected patients with osteoarthritis because of the ease of categorizing such a disorder. Although it is true that a significant percentage of our patients
Frequent and prolonged hospitalizations: A risk factor for early mortality in sickle cell disease patients
Authors: Patricia Houston‐Yu, Sohail R. Rana, Betsy Beyer, Oswaldo Castro
Journal: American Journal of Hematology (2003)

Abstract A subset of patients with sickle cell disease (SCD) has frequent and prolonged hospitalizations. Clinical outcomes for this subset of patients are not known. We analyzed mortality data in 71 such patients enrolled in a case management study. Adult patients (mean age 32 years) with SCD and ≥50 hospitalization days/year or ≥6 admissions/year were enrolled. Clinical and psychosocial data were obtained. During a mean 24‐month follow up, 11 of 71 patients died (15.5%). Patients who died had a higher mean number of hospitalization days in the year before study entry (116 vs. 40, P &lt; 0.000008) and were also more depressed than those who survived (mean score 17.8 vs. 11.9, P = 0.031). Frequent and prolonged hospitalizations are a risk factor for early mortality in patients with SCD. Am. J. Hematol. 72:201–203, 2003. © 2003 Wiley‐Liss, Inc.
INFLUENCE OF BIOCHEMICAL ASPIRINRESISTANCE ON PLATELET MORPHOLOGY AND FUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT ST-SEGMENT ELEVATION
Authors: Netiazhenko V. Nonna, Kateryna N. Amosova, Vasyl Z. Netiazhenko, Andrey B. Bezrodniy, Galyna I. Mishanich
Journal: Journal of the American College of Cardiology (2011)
Postoperative Hypofibrinogenemia
Authors: James H. Graham, Charles P. Emerson, Thomas J. Anglem
Journal: New England Journal of Medicine (1957)

IN the process of coagulation in vivo, or in vitro, the clotting of fibrinogen is the only directly observable stage of a chain reaction comprising many stages. This well defined protein has been available in a relatively stable and highly purified form after its separation from pooled plasma. Its principal use to date has been for intravenous administration to correct congenital or acquired fibrinogenopenic states. The majority of these cases fall into the latter group, are associated with a demonstrable fibrinolysin and are most numerous in obstetrics.1 2 3 The general surgical literature is growing in this regard also,4 5 6 most cases being . . .
"ARMCHAIR" TREATMENT OF ACUTE CORONARY THROMBOSIS
Authors: Samuel A. Levine
Journal: JAMA (1952)

Rest for a diseased organ, be it a fractured limb or a tuberculous lung, is a therapeutic principle validated by clinical experience. It is believed that activity, with its complex biochemical and physical demands, diverts from the reparative process the available energy essential for optimal healing. When the heart is diseased, the only feasible application of the principle of rest is the attempted diminution of the cardiac load. Rest in bed has been traditionally regarded as tantamount to optimal rest for the heart. This is the practice in congestive heart failure and finds its most rigid application in acute coronary thrombosis, when the patient is placed flat in bed for three to six weeks.<sup>1</sup> It has been our view that recumbency in bed affords less rest to the heart than the sedentary position in a chair with the feet down.<sup>2</sup>The recumbent position permits maximal venous return from