tbuckley/cabot-search huggingface dataset:
Scleroderma of the Small Intestine: Clinical Aspects Emphasizing Obstructive Symptoms and Malabsorption.
Authors: Harold H. Scudamore
Journal: Annals of Internal Medicine (1968)

s1 May 1968Scleroderma of the Small Intestine: Clinical Aspects Emphasizing Obstructive Symptoms and Malabsorption.Harold H. Scudamore, M.D., F.A.C.P.Harold H. Scudamore, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1149_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTen patients having scleroderma of the small intestine were observed to assess the main clinical findings, pathogenesis, and management of this uncommon but serious disorder. The patients were evaluated by clinical studies, laboratory analysis, and measurements in a metabolic study, unit. Most of the patients had diffuse involvement including esophagus, colon, lungs, and heart as well as the small intestine. The extent of skin involvement varied from mild to severe and widespread. The symptoms ranged from vague dyspepsia, bloating, and abdominal distress to those suggesting intestinal obstruction and often leading to abdominal exploration. The bowel habits varied from constipation to... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Harold H. Scudamore, M.D., F.A.C.P.Affiliations: Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChronic idiopathic intestinal pseudo-obstruction 1 May 1968Volume 68, Issue 5Page: 1149-1150KeywordsConstipationEsophagusHabitsHeartLungsMetabolic analysisPathogenesisResearch laboratoriesSclerodermaSmall intestine ePublished: 1 December 2008 Issue Published: 1 May 1968 PDF downloadLoading ...
Do selective serotonin reuptake inhibitors cause suicide?: Let's keep it in perspective
Authors: Isaac Sakinofsky, David L Streiner
Journal: BMJ (2005)

Do selective serotonin reuptake inhibitors cause suicide? Risk of suicide should be assessed for whole class of antidepressantsEditor-Gunnell et al's report on suicide risk with selective serotonin reuptake inhibitors (SSRIs) raises several issues. 1 Firstly, clinicians have observed that the first weeks of treatment of severe depression with an antidepressant are accompanied by a higher risk of suicide because of a drug induced motor disinhibition that is not yet accompanied by mood improvement. 2 Secondly, the authors' finding of a trend towards a protective effect of SSRIs against suicidal thoughts (odds ratio 0.77) compared with a trend towards an increased risk of self harm (odds ratio 1.57) is paradoxical.More surprising is the heterogeneity of results among SSRIs.Why would sertraline show a protective effect for suicidal thoughts and simultaneously increase the risk of self harm?The risk difference between citalopram and its active S-enantiomere, escitalopram, is also strange.No strong biological rationale can explain such heterogeneity among drugs with the same mechanism of action.Thirdly, the authors mention that the Medicine and Healthcare products Regulatory Agency found little evidence for a risk difference between SSRIs and the other antidepressants.The two accompanying papers show that the suicidal risk seems similar for serotoninergic and tricyclic antidepressants. 3 4The risk of suicide must be assessed for the whole class of antidepressants.The next stage would be to measure the risk of suicide according to the time since starting an antidepressant.Initially, the risks are higher than the benefits.To confirm old clinical observations by evidence based methods would be interesting and useful.
Meningeal Mycosis Fungoides: Clinical and Cellular Characteristics
Authors: THOMAS W. HAUCH
Journal: Annals of Internal Medicine (1975)

A patient with mycosis fungoides developed meningeal disease while his skin disease was in remission with systemic chemotherapy. His central nervous system involvement with mycosis fungoides was controlled with intrathecal methotrexate for 7 months. The proliferating cells recovered from the spinal fluid showed similarities to the Sézary cell by light and electron microscopy. Surface receptor studies suggested that these cells were lymphoid cells of thymic derivation. Although mycosis fungoides has been shown to spread to the central nervous system in autopsied cases, reports of clinical neurologic disease are rare, and in only one earlier report have malignant cells been found in the spinal fluid. Thus, as in other lymphoproliferative disorders, prompt consideration of meningeal involvement in a patient exhibiting neurologic symptoms while in peripheral remission may allow earlier treatment of this complication.
P5-01-16: The Detection of Circulating CK19 mRNA-Positive Cells in the Blood and the Mitotic Index of the Primary Tumor Have Independent Prognostic Value in Early Breast Cancer.
Authors: K Tryfonidis, M Perraki, S Apostolaki, M Kafousi, S Agelaki, V Georgoulias, EN Stathopoulos, D Mavroudis
Journal: Cancer Research (2011)

Abstract Background: Previous studies have shown that the molecular detection of CK-19 mRNA in peripheral blood and the mitotic index of primary tumor have prognostic value in early breast cancer. The aim of the present study was to assess the association between these variables. Patients and Methods: The primary tumors of 223 operable breast cancer patients (92 premenopausal and 131 postmenopausal) were evaluated for the mitotic activity index (MAI) classified either as &amp;lt;5/10, 6–10/10 and &amp;gt;10/10 or &amp;lt;10/10 and &amp;gt;10/10 mitoses/hpf using a standardized protocol as previously reported (Baak JP et al, Breast Cancer Res Treat 2009, 115:241–254). Peripheral blood was also collected before the start and after the end of adjuvant chemotherapy for detection of CK-19 mRNA-positive cells by RT-PCR as previously described (Stathopoulou et al, Clin Cancer Res 2003, 9:5145–5151). Results: After a median follow-up of 118 months, 75 (33.6%) patients have experienced disease relapse and 56 (25.1%) have died of breast cancer. MAI was strongly associated with disease-free survival (DFS) and overall survival (OS) (p&amp;lt;0.001 for both DFS and OS). Detection of CK19 mRNA-positive cells in the peripheral blood before but not after adjuvant chemotherapy was marginally associated with worse DFS (p=0.055) and OS (p=0.059). There was no correlation between MAI and CK19 mRNA detection before chemotherapy. Cox regression analysis revealed that both MAI and CK19 mRNA-positive cell detection before adjuvant chemotherapy were independent variables associated with decreased DFS (p&amp;lt;0.001 and p=0.038, respectively) and OS (p&amp;lt;0.001 and p=0.029, respectively). The interaction test showed no significant association between MAI and detection of CK19 mRNA-positive cells. Conclusion: MAI of the primary tumor and detection CK-19 mRNA-positive cells in the blood before the start of adjuvant chemotherapy in women with early breast cancer are two independent prognostic factors associated with clinical outcome. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-01-16.
PREDICTION OF INCIPIENT LEFT VENTRICULAR DYSFUNCTION IN PATIENTS WITH CHRONIC PRIMARY MITRAL REGURGITATION: A VELOCITY VECTOR IMAGING STUDY
Authors: Sherif E. Moustafa, Mayank Kansal, Mohsen Alharthi, Yan Deng, Krishnaswamy Chandrasekaran, Farouk Mookadam
Journal: Journal of the American College of Cardiology (2011)
Cortisone Habituation — A Clinical Note
Authors: Austin McCawley
Journal: New England Journal of Medicine (1965)

THE sense of well-being produced by ACTH, cortisone and related steroids raises the question whether emotionally insecure persons may become dependent on these drugs for psychologic reasons. Hollender† reports on a patient who, because of a tense depression, was tempted to depend on cortisone. There is little other mention of psychic dependency on these drugs in the literature, and I could find no reports of addiction. That extreme psychic dependency on such agents may develop in emotionally insecure persons is demonstrated by the following 3 cases:Case 1. The patient had been treated for 6 years with steroids for asthma. . . .
18F-FDG PET/CT Demonstration of Diffuse Lymphohistiocytic Granulomatous Vasculitis
Authors: Meena Kumar, Andrei Iagaru
Journal: Clinical Nuclear Medicine (2013)

Surveillance FDG PET/CT was performed in a 75-year-old woman with history of melanoma and colon cancer. She had rash and erythematous papules on the forearms, elbows, knees, and thighs and then developed right-leg weakness, difficulty with fine motor movement, and ptosis. Chest CT identified a right-lung spiculated nodule. Skin and pulmonary nodule biopsies showed lymphohistiocytic infiltrate with granulomatous features, without lymphoid cells, metastatic carcinoma or melanoma cells, or microorganisms. Epstein-Barr immunostain result was negative, making lymphomatoid granuloma unlikely. The inflammatory process involved the peripheral vasculature on FDG PET, and given the related neuropathy, findings were compatible with granulomatous vasculitis.
Congenital leukemia and mongolism.
Authors: M Barber
Journal: BMJ (1971)

patient were less helpful and did not accurately reflect the marked fluctuations which occurred in the urinary F.D.P.We agree with Dr. Clarkson and his co- workers that in certain groups of patients the urinary F.D.P. are derived from the renal glomeruli and do not represent filtration from the systemic circulation.In this con- text it is of interest that we have observed two patients with disseminated intravascular coagulation but with normal renal function.Both had serum F.D.P. greater than 1,000 ,Jg/ml, but in neither patient were we able to detect F.D.P. in the urine.We note that the Edinburgh workers were unable to de- tect urinary F.D.P. in patients with un- complicated polycystic disease.We also were unable to detect breakdown products in this type of patient, but in one patient with polycystic disease and progressive impair- ment of renal function urinary F.D.P. were greater than 20 ,ig/ml, and it may be that in this group also urinary fibrin/fibrinogen breakdown products may be of value in assessing the progression of the renal lesion.Though an estimation of the 24-hour ex- cretion of F.D.P. provides a more accurate assessment of renal involvement such collections are difficult to carry out on an outpatient basis, and it is of some value there- fore to note that our results were obtained on random urine samples collected during an afternoon outpatient clinic.We would like, therefore, to reiterate the views expressed by Dr. Clarkson and his colleagues that estimation of urinary F.D.P. may afford a simple but sensitive means of assessing the activity of the disease process in patients with certain types of renal dis- order.-Weare, etc.,
Surgery outcomes are to be made public—but a five year wait is likely
Authors: Caroline White
Journal: BMJ (2007)

The Royal College of Surgeons of England plans to make information on the performance of individual hospital units in all types of surgery publicly available in the next five years. 

However, press reports have said that proposals to make data on surgical outcomes public would be included in the NHS operating framework for 2008-9 ( Guardian , 28 Aug, p 1).

The move is seen as the best way to provide reliable information on which to base NHS commissioning decisions and the recertification of surgeons, as well as to help patients decide where they …
Pneumoperitoneum. A complication of mechanical ventilation
Authors: J. T. Stringfield
Journal: JAMA (1976)

Pneumoperitoneum occurred in three adults receiving mechanical ventilatory support. Since the presence of a perforated viscus could not be confirmed by combinations of clinical, surgical, or autopsy findings in any of these patients, it appears that the free abdominal air in these patients was a complication of the ventilatory therapy. It is possible that such a complication may be more common than is currently recognized and thus should be added to the differential diagnosis of pneumoperitoneum.
Phase II Study of Docetaxel in Combination with Everolimus for Second- or Third-Line Therapy of Advanced Non–Small-Cell Lung Cancer
Authors: Suresh S. Ramalingam, Taofeek K. Owonikoko, Madhusmita Behera, Janakiraman Subramanian, Nabil F. Saba, Scott A. Kono, Anthony A. Gal, Gabriel Sica, R. Donald Harvey, Zhengjia Chen, Carmen M. Klass, Dong M. Shin, Haian Fu, Shi-yong R. Sun, Ramaswamy Govindan, Fadlo R. Khuri
Journal: Journal of Thoracic Oncology (2013)
Fibroblast growth factors are expressed in coronary lesions of patients with unstable angina pectoris and those who have post angioplasty restenosis
Authors: Moshe Y. Flugelman, Rosaly Correa, Zu-Xi Yu, Ged Keren, Martin B. Leon, Lowell F. Satler, Kenneth M. Kent, Ward Casscells, Stephen E. Epstein
Journal: Journal of the American College of Cardiology (1991)
Do overweight people remove their shoes before being weighed by a doctor? Consecutive study of patients in general practice
Authors: T. Harlow
Journal: BMJ (1997)

Casual observation and discussion with colleagues led me to the hypothesis that patients who are overweight tend to remove their shoes before being weighed by their doctor. I thought that this action was probably an attempt to reduce the reading on the scales. I tested this hypothesis by measuring the body mass index of patients who needed to be weighed as part of their management and noting whether they removed their shoes unprompted. To my knowledge, no such study has previously been performed. …
Hemoglobin S/OARAB: Thirteen new cases and review of the literature
Authors: Sherri A. Zimmerman, Erin E. O'Branski, Wendell F. Rosse, Russell E. Ware
Journal: American Journal of Hematology (1999)

Hemoglobin S/OArab (Hb S/OArab) is a rare compound heterozygous hemoglobinopathy characterized by the presence of two variant β-globin chains: β6Glu → Val (Hb S) and β121Glu → Lys (Hb OArab). The diagnosis of Hb S/OArab requires electrophoresis on both cellulose acetate and citrate agar, since Hb OArab co-migrates with Hb C at alkaline pH and close to Hb S at acidic pH. To date only case reports and small series of patients with Hb S/OArab have been described. To better characterize the clinical and laboratory aspects of this unusual disorder, we reviewed the Duke University Medical Center experience. We identified 13 African-American children and adults with Hb S/OArab ranging in age from 2.7 to 62.5 years. All patients had hemolytic anemia with a median Hb of 8.7 gm/dL (range 6.1–9.9 gm/dL), and a median reticulocyte count of 5.8% (range 1.2–10.3%). The peripheral blood smear typically showed sickled erythrocytes, target cells, polychromasia, and nucleated red blood cells. All 13 patients have had significant clinical sickling events including acute chest syndrome (11), recurrent vasoocclusive painful events (10), dactylitis (7), gallstones (5), nephropathy (4), aplastic crises (2), avascular necrosis (2), leg ulcers (2), cerebrovascular accident (CVA) (1), osteomyelitis (1), and retinopathy (1). Four patients have died, including two from pneumococcal sepsis/meningitis at ages 5 and 10 years, one of acute chest syndrome at age 14 years, and one of multiorgan failure at age 35 years. We conclude that Hb S/OArab disease is a severe sickling hemoglobinopathy with laboratory and clinical manifestations similar to those of homozygous sickle cell anemia. Am. J. Hematol. 60:279–284, 1999. © 1999 Wiley-Liss, Inc.
38 Sclerotherapy vs variceal ligation as emergency endoscopic treatment, associated with somatostine, for the management of acute variceal bleeding
Authors: M. Piqueras, C. Aracil, C. Gomez, D. Monfort, E. Fort, B. Gonzalez, J.M. Lopez-Balaguer, A. Gallego, G. Soriano, S. Sainz, X. Torras, C. Villanueva, J. Balanzo
Journal: Journal of Hepatology (2004)
Subsets of Patients with Aplastic Anemia Identified by Flow Microfluorometry
Authors: Beverly Torok-Storb, Kristine Doney, George Sale, E. Donnall Thomas, Rainer Storb
Journal: New England Journal of Medicine (1985)

We used flow microfluorometry to analyze peripheral-blood mononuclear cells from 50 patients with aplastic anemia, to determine whether patients who would recover after immunosuppressive therapy could be distinguished before treatment from those who would not recover. Cells were labeled with murine monoclonal antibodies that are relatively specific for B cells, T cells, T-cell subsets, and monocytes. The data suggested that the number of lymphocytes and the ratios of various subclasses of T cells were not useful in identifying patients who were likely to recover. The complete absence of monocytes was found to identify patients who would not recover, but the presence of monocytes was also sometimes associated with lack of recovery. An unexpected finding was the significant (P less than 0.0001) association between clinical recovery and the presence of a population of small cells (4 to 8 micron) that were phenotypically associated with the erythroid lineage. If this association is confirmed, flow microfluorometry may be useful in selecting the optimal treatment for individual patients with aplastic anemia.
Treatment of Chronic Rhinosinusitis With Nasal Polyposis With Oral Steroids Followed by Topical Steroids
Authors: Sriram Vaidyanathan, Martyn Barnes, Peter Williamson, Pippa Hopkinson, Peter T. Donnan, Brian Lipworth
Journal: Annals of Internal Medicine (2011)

Background: Chronic rhinosinusitis (CRS) with nasal polyposis is common. The long-term efficacy and safety of approaches to medical management are not well-known. Objective: To evaluate the efficacy and safety of a 2-week regimen of oral steroid therapy followed by 26 weeks of sequential topical steroid maintenance therapy. Design: Parallel randomized trial with computer-generated block randomization and central allocation. Patients and investigators were blinded to group assignment. (ClinicalTrials.gov registration number: NCT00788749) Setting: A specialty rhinology clinic in Tayside, Scotland. Patients: 60 adults with CRS and moderate-sized or larger nasal polyps who were referred by their primary physicians for specialty care. Interventions: Patients were randomly assigned in a 1:1 ratio to receive oral prednisolone, 25 mg/d, or placebo for 2 weeks, followed in both groups by fluticasone propionate nasal drops, 400 µg twice daily, for 8 weeks and then fluticasone propionate nasal spray, 200 µg twice daily, for 18 weeks. Measurements: Polyp grading (primary outcome), hyposmia score, quality of life, symptoms, nasal patency, adrenal function, and bone turnover. Results: The mean decrease in polyp grade from baseline to 2 weeks was 2.1 units (SD, 1.1) in the prednisolone group and 0.1 unit (SD, 1.0) in the placebo group (mean difference between groups, −1.8 units [95% CI, −2.4 to −1.2 units]; P < 0.001). The difference between groups was −1.08 units (CI, −1.74 to −0.42 unit; P = 0.001) at 10 weeks and −0.8 unit (CI, −1.8 to 0.2 unit; P = 0.11) at 28 weeks. The mean decrease in hyposmia score from baseline to 2 weeks was 31.12 mm (SD, 30.1) in the prednisolone group and 1.41 mm (SD, 30.6) in the placebo group (mean difference between groups, −28.33 mm [CI, −42.71 to −13.96 mm]; P = 0.002). The difference between groups was −16.06 mm (CI, −30.99 to −1.13 mm; P = 0.03) at 10 weeks and −12.13 mm (CI, −30.55 to 6.29 mm; P = 0.19) at 28 weeks. Prednisolone therapy resulted in transient suppression of adrenal function and increase in bone turnover after 2 weeks, with a return to baseline at 10 and 28 weeks. Limitations: Patients were referred from primary care to a single-center rhinology clinic, which limits the generalizability of results. Serial measurements of surrogates of nasal inflammation (such as nitric oxide or cytokine levels) were not performed. Conclusion: Initial oral steroid therapy followed by topical steroid therapy seems to be more effective over 6 months than topical steroid therapy alone in decreasing polyp size and improving olfaction in patients referred for specialty care of CRS with at least moderate nasal polyposis. Primary Funding Source: Chief Scientist Office, Scotland; National Health Service Tayside Small Grants Scheme; and an Anonymous Trust grant from University of Dundee.
ALLERGY AND THE ACID-BASE BALANCE
Authors: HARRY BECKMAN
Journal: JAMA (1930)

In presenting at this time the hypothesis that there is an intimate connection between the state of allergy and the acid-base balance in the body, I do not wish in the least to disparage the sensitization theory and the work of desensitization that has been built upon it. These things are of immense value; indeed, they constitute the greatest advance that has been made in the understanding and treatment of the allergic ailments. For instance, it is nowadays known that a normal non-allergic individual can be passively sensitized locally by the intracutaneous injection of serum taken from an allergic individual, and that if the recipient then takes an article of food that affects the donor the locally sensitized area responds by reaction; this is undoubted proof of the existence of such a thing as sensitization. Furthermore, it is known that carefully performed skin tests will sometimes make it possible to
Mercury-binding proteins from the marine mussel, Mytilus edulis.
Authors: G Roesijadi
Journal: Environmental Health Perspectives (1986)

The marine mussel, Mytilus edulis, possesses low molecular weight, metal-binding proteins which can be induced by and, in turn, bind mercury when individuals are exposed to low, but elevated concentrations of mercury as HgCl2. Induction of the proteins by exposure of mussels to copper, cadmium, or mercury is associated with enhanced tolerance to mercury toxicity. Mercury-binding proteins isolated from gills of mussels occur as two molecular weight variants of about 20-25 and 10-12 kdaltons, respectively, on Sephadex G-75. These have been designated as HgBP20 and HgBP10 following the nomenclature used for cadmium-binding proteins. HgBP20 represents the primary mercury-binding species. These exist as dimers which can be dissociated into subunits by treatment with 1% 2-mercaptoethanol. Further purification of HgBP20 by DEAE-cellulose ion-exchange chromatography resulted in the resolution of three major mercury-binding protein peaks; analysis of two of these showed that both had similar amino acid compositions with 26% half-cystine, 16% glycine, and very low levels of the aromatic amino acids phenylalanine and tyrosine (0.3-0.5%), histidine (0.4%), methionine (about 0.5%), and leucine (about 1%). These are similar to the compositions of proteins reported as mussel thioneins by others. Separation of HgBP20 by anion-exchange high-performance liquid chromatography resulted in the resolution of six peaks, indicating a more complex situation than was evident from DEAE-cellulose separations. Although not completely purified, these also contain cysteine- and glycine-rich proteins.
Absence of host plasminogen activator inhibitor 1 prevents cancer invasion and vascularization
Authors: K. Bajou, A. Noël, R.D. Gerard, V. Masson, N. Brunner, C. Holst-Hansen, M. Skobe, N.E. Fusenig, P. Carmeliet, D. Collen, J.M. Foidart
Journal: Nature Medicine (1998)
Subperiosteal Hemorrhage in Neurofibromatosis: Appearance in Bone Scintigraphy
Authors: HUSSEIN M. ABDEL-DAYEM, THEODORE PAPADEMETRIOU
Journal: Clinical Nuclear Medicine (1981)

* Department of Radiology; State University of New York at Buffaio, Erie County Medical Center, Buffalo, New York † Department of Orthopedics; State University of New York at Buffaio, Erie County Medical Center, Buffalo, New York