tbuckley/cabot-search huggingface dataset:
Pre-Therapy Hyperfunctioning Follicular Thyroid Carcinoma Evaluation With I-131 Whole-Body Scan and With F-18 FDG PET/CT
Authors: Piergiuseppe Orsolon, Marcello Giachetti, Andrea Lupi, Matteo Salgarello, Veronica Malfatti, Pierluigi Zanco
Journal: Clinical Nuclear Medicine (2008)

We describe a patient with persistent hyperthyroidism after total thyroidectomy for toxic multinodular goiter and without therapy with levothyroxine evaluated with I-131 whole-body scan and with F-18 FDG PET/CT scan. Scintigraphy performed 48 hours after radiopharmaceutical administration showed many areas of focal radioiodine uptake. A week later we performed a PET/CT scan to better localize the anatomic site of the iodine-positive lesions. Both scans, performed after methimazole withdrawal, visualized the same lesions, and these results were used as a guide for biopsy. Histologic examination was consistent with metastatic follicular thyroid carcinoma.
Shakespeare on alcohol
Authors: T. Dalrymple
Journal: BMJ (2011)

Shakespeare knew all about drinking; he liked a drink himself. Indeed, we are told that he died after a drinking session in Stratford with Ben Jonson, though whether from alcohol poisoning, an epidemic brought on by the recent flooding in Stratford, or as a matter of coincidence, we do not know.

Perhaps, then, the scenes enacted in the centre of every British town and city on Friday and Saturday nights would not altogether have surprised him because, as Iago says to Cassio in Othello , “They [the English] are most potent in potting. Your Dane, your German, and your swag-bellied Hollander—drink, ho!—are nothing to your English.”

Cassio, in fact, has a low tolerance for alcohol: “I have very poor and unhappy …
Effects of Physiologic Growth Hormone Therapy on Bone Density and Body Composition in Patients with Adult-Onset Growth Hormone Deficiency
Authors: Howard B.A. Baum
Journal: Annals of Internal Medicine (1996)

Background: Patients with adult-onset growth hormone deficiency have reduced bone density and increased fat mass. Growth hormone at high doses may decrease body fat in these patients, but the effects of growth hormone at more physiologic doses on bone density and body composition have not been convincingly shown. Objective: To determine whether long-term growth hormone therapy at a dose adjusted to maintain normal insulin-like growth factor 1 (IGF-1) levels has clinical effects in patients with adult-onset growth hormone deficiency. Design: Randomized, placebo-controlled study. Setting: Tertiary referral center. Patients: 32 men with adult-onset growth hormone deficiency. Intervention: Growth hormone (initial daily dose, 10 µg/kg of body weight) or placebo for 18 months. The growth hormone dose was reduced by 25% if IGF-1 levels were elevated. Measurements: Body composition and bone mineral density of the lumbar spine, femoral neck, and proximal radius were measured by dual energy x-ray absorptiometry at 6-month intervals. Markers of bone turnover were also measured during the first 12 months of the study. Results: Growth hormone therapy increased bone mineral density in the lumbar spine by a mean (±SD) of 5.1% ± 4.1% and bone mineral density in the femoral neck by 2.4% ± 3.5%. In the growth hormone group, significant increases were seen in the following markers of bone turnover: osteocalcin (4.4 ± 3.6 mg/L to 7.2 ± 4.6 mg/L) and urinary pyridinoline (39.0 ± 19.8 nmol/mmol of creatinine to 55.7 ± 25.5 nmol/mmol of creatinine) and deoxypyridinoline (8.4 ± 7.1 nmol/mmol of creatinine to 14.9 ± 9.4 nmol/mmol of creatinine). Percentage of body fat in the growth hormone group decreased (from 31.9% ± 6.5% to 28.3% ± 7.0%), and lean body mass increased (from 59.0 ± 8.5 kg to 61.5 ± 6.9 kg). These changes were significant compared with corresponding changes in the placebo group (P < 0.01 for all comparisons). Conclusions: Growth hormone administered to men with adult-onset growth hormone deficiency at a dose adjusted according to serum IGF-1 levels increases bone density and stimulates bone turnover, decreases body fat and increases lean mass, and is associated with a low incidence of side effects.
Differences in mortality after fracture of hip
Authors: C J Todd, C. Palmer, C Camilleri-Ferrante, C J Freeman, C E Laxton, M J Parker, B V Payne, N Rushton
Journal: BMJ (1995)

EDITOR,--C R Packham1 suggests that case mix may have been responsible for the variation among hospitals in 90 day mortality after admission for fractured hip that we reported.2 The possibility that patients' characteristics may explain differences in outcome is the reason why a multivariate analysis was necessary. Clearly, such an analysis has to be limited to those factors for which information is available, and our prospective audit, like any other study, could not record every conceivable potentially explanatory factor. This …
ROENTGENOGRAPHIC VISUALIZATION OF SUBPERIOSTEAL HEMORRHAGE IN INFANTILE SCURVY
Authors: WALDO E. NELSON
Journal: JAMA (1933)

The criteria for the roentgenographic diagnosis of infantile scurvy have been adequately established and described by Fraenkel,<sup>1</sup>Hess,<sup>2</sup>Wimberger,<sup>3</sup>Pelkan,<sup>4</sup>McLean and McIntosh,<sup>5</sup>Bromer,<sup>6</sup>Kato<sup>7</sup>and others. These authors have demonstrated that such scorbutic changes in the bones as increased density at the end of the diaphysis, increased density around the epiphyseal centers (rimming of the nucleus of ossification in the epiphysis), ground-glass appearance of the shaft of the diaphysis and of the body of the epiphysis, thinning of the cortex of the diaphysis, lateral spurs at the end of the diaphysis, and epiphyseal separation (separation of the metaphysis) can usually be seen on the roentgenogram before the occurrence of subperiosteal hemorrhage. Kato believes that the last mentioned is the one sign that is absolutely unique in infantile scurvy. While not, therefore, an early or even a necessary sign of scurvy, subperiosteal hemorrhage
PTH-038 Findings on Back-To-Back Colonoscopies: An Auditable Standard for Colonoscopy Quality?
Authors: P G Vaughan-Shaw, P Rai, A Goodman, R Valori, M Aung
Journal: Gut (2013)

<h3>Introduction</h3> An important marker of colonoscopy quality is detection of pathology and incidence of missed pathology. Back-to-back colonoscopies cannot ethically be performed for quality assurance alone yet may be required for clinical reasons. This study aims to investigate the incidence of new findings in colonoscopies repeated within a 12 month period. <h3>Methods</h3> All colonoscopies performed over a 3-year period at an Endoscopy training unit were studied. Colonoscopies repeated within a 12-month period were included. Repeats following incomplete colonoscopy were excluded. Data on indication and outcome were collected. <h3>Results</h3> 5747 colonoscopies were performed over the study period. 137 repeat colonoscopies were included with median interval 174 days and indications including requirement for endoscopic mucosal resection (n = 47), inflammatory bowel (n = 13) or polyp surveillance (n = 37), previous imaging or endoscopic abnormalities (n = 15), and persistent or new symptoms (n = 25). 19 (14%) repeat colonoscopies yielded new findings including 1 new cancer, 234 days following a normal colonoscopy. Additional polyps were identified in 13 colonoscopies indicating a missed polyp rate of 9%. A median number of 2 polyps per colonoscopy with median size 5.5mm were found. Crohn’s disease (n = 1), and diverticular disease (n = 3) were also diagnosed at repeat colonoscopy. There was no morbidity associated with repeat colonoscopy in this series. <h3>Conclusion</h3> New pathology was identified in 14% of repeat colonoscopies. Analysis of clinically indicated repeat colonoscopies and rate of detection of new pathology may offer utility in colonoscopy quality assurance. Larger studies are required to define and validate this criterion as an auditable standard for colonoscopy quality. <h3>Disclosure of Interest</h3> None Declared.
The Changing Clinical History of Progressive Renal Failure.
Authors: Catherine J. Condon
Journal: Annals of Internal Medicine (1968)

s1 May 1968The Changing Clinical History of Progressive Renal Failure.Catherine J. Condon, M.D., Richard M. Freeman, M.D.Catherine J. Condon, M.D.Search for more papers by this author, Richard M. Freeman, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1179_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWe contrasted and compared the clinical picture presented by uremic patients in the predialysis era to that of patients with severe renal failure maintained on hemodialysis. The clinical course and autopsy findings of 25 patients with uremia (group I), hospitalized between 1950 and 1955, were reviewed. Group II included 25 patients of comparable age and degree of renal failure on maintenance hemodialysis since 1964. The classical symptoms of uremia in group I (nausea, vomiting, hiccups, bleeding, seizures, coma) were infrequent or of mild intensity in group II. The following clinical problems, absent or unrecognized in group I, were prominent in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Iowa City, Iowa PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1179-1179KeywordsAutopsyComaEpileptic seizuresHemorrhageNauseaRenal failureVomiting Issue Published: 1 May 1968 PDF DownloadLoading ...
Differential Uric Acid Excretion in Essential and Renal Hypertension
Authors: NORMAN M. SIMON, JON E. SMUCKER, VINCENT J. O'CONOR, FRANCESCO DEL GRECO
Journal: Circulation (1969)

In 59 hypertensive patients, differences between the two kidneys in the handling of uric acid were found in renal arterial stenosis and unilateral renal disease but were not found in essential hypertension and bilateral renal parenchymal disease. The differences were greatest in 11 patients with unilateral renal arterial stenosis and were derived from reduced uric acid excretion per unit of glomerular filtration rate by the ischemic kidney. Six patients with unilateral stenosis underwent surgery with subsequent cure of hypertension. Another patient, who did not have impaired ipsilateral uric acid excretion, failed to respond to nephrectomy. Successful revascularization of the ischemic kidney in two patients augmented uric acid excretion with disappearance of the differences between the kidneys. Hyperuricemia was often found in all groups of hypertensive patients. Although the mechanisms underlying the differences in renal handling of uric acid are undefined, separate determinations of the uric acid excretion by the two kidneys may possibly prove useful in the evaluation of patients with hypertension.
Immunohistochemical Detection of Hepatitis C Virus-Infected Hepatocytes in Chronic Liver Disease With Monoclonal Antibodies to Core, Envelope and Ns3 Regions of the Hepatitis C Virus Genome
Authors: Naoki Hiramatsu, Norio Hayashi, Yoshimichi Haruna, Akinori Kasahara, Hideyuki Fusamoto, Chisato Mori, Isao Fuke, Hiroto Okayama, Takenobu Kamada
Journal: Hepatology (1992)

The localization of hepatitis C virus-infected hepatocytes in the human liver remains unclear despite the development of a serological assay for the antibody to hepatitis C virus. We studied their localization immunohistochemically with monoclonal antibodies to core, envelope and NS3 antigens of hepatitis C virus. We examined 48 liver biopsy samples from C100-3 antibody-positive patients with chronic liver disease (chronic persistent hepatitis, 5 cases; chronic active hepatitis, 41 cases; cirrhosis, 2 cases) and 12 liver biopsy samples from C100-3 antibody-negative patients with chronic liver disease (type B chronic hepatitis, 8 cases; alcoholic liver disease, 4 cases). In the C100-3 antibody-positive group, positive immunostaining for core antigen, envelope antigen and NS3 antigen was found in 23% (11 of 48), 24% (11 of 45) and 24% (11 of 46), respectively. Negative results were obtained in the C100-3 antibody-negative group. Hepatocytes with positive staining were scattered in the lobules, and they were found in the same regions irrespective of whether the antibody to core antigen, to envelope antigen or to NS3 antigen was used. Each positive cell was strongly stained in the cytoplasm; these decorations disappeared after absorption of the primary antibody with purified antigen. mean ALT levels in the patients with positive immunostaining for core, envelope or NS3 antigen (174.8 +/- 105.7 U/L) tended to be higher than in those with negative immunostaining (142.0 +/- 93.8 U/L). On histological evaluation of liver specimens with a scoring system of the histological activity index, intralobular inflammation and fibrosis had higher scores for samples with positive rather than negative immunostaining (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
The Mechanism of Limb Segment Reactive Hyperemia in Man
Authors: J. EDWIN WOOD, JULIUS LITTER, ROBERT W. WILKINS
Journal: Circulation Research (1955)

The roles of vasodilator metabolites and/or reduced local intra-arteriolar pressure in producing the reactive hyperemia which follows the sudden release of arterial occlusion were studied. It was found that slight increases of metabolic activity during the period of occlusion increased the reactive hyperemia considerably. Maintenance of intra-arteriolar pressure during arterial occlusion depressed the resultant reactive hyperemia. It was concluded that both factors contribute to the reactive hyperemia. The blood flow "debt" incurred during arterial occlusion was almost invariably "overpaid" during the reactive hyperemia period.
Propranolol and Spurious Hyperbilirubinemia
Authors: R. Belsey, P. Mueggler, J. R. Swanson
Journal: JAMA (1984)

<h3>To the Editor.—</h3> <i>Report of a Case</i>.— Spurious hyperbilirubinemia was found in a 21-year-old man undergoing hemodialysis for chronic renal failure (CRF). Laboratory results were unremarkable except for an elevated bilirubin level on the third day of hospitalization before scheduled renal transplantation (Table). We suspected spurious hyperbilirubinemia because the bilirubin results were normal on the two previous days and the patient's clinical condition was unchanged. Analysis of the patient's serum with two different instruments produced discrepant results (Table). Elevated results were found for both total and direct bilirubin with the DuPont ACA, while the results from a Technicon SMAC were within the normal range. After renal transplant, the results from both analyzers were in agreement and were within the normal range (Table). <i>Comment</i>.—Spurious hyperbilirubinemia has previously been reported inpatients with CRF being treated with propranolol hydrochloride when the tests were processed with a different analyzer.<sup>1,2</sup>Since
Reform of the Health Care System and Professional Liability
Authors: J S Todd
Journal: New England Journal of Medicine (1993)

Without much doubt, sometime in the not-too-distant future, this country is going to undertake some sort of reform of the health care system through federal legislation. Although the nature of that reform remains uncertain, some areas of general agreement are emerging. For the purposes of this discussion, two of these areas are most relevant. First, there will be a reduction in the volume of care provided, and second, if that is to occur, something must be done about the current malpractice “mess” (a term President Bill Clinton used in his address to Congress on September 22). If less care is . . .
Authors' reply to Stockwell and colleagues
Authors: P. E. Ronksley, S. E. Brien, B. J. Turner, K. J. Mukamal, W. A. Ghali
Journal: BMJ (2012)

Stockwell and colleagues adopted an extreme methodological position, proposing to dismiss an entire body of literature on the basis of the presence of predictable limitations in individual studies.1 2 This dogmatic and dichotomous approach to the evaluation of epidemiological studies is counterproductive to scientific epistemology.

Arguably, an alternative means of exploring the impact of specific methodological shortcomings …
Oral Immunosuppressive Therapy for Acquired Hemophilia
Authors: David Green
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Oral Immunosuppressive Therapy for Acquired HemophiliaDavid Green, MD, PhDDavid Green, MD, PhDNorthwestern University Medical School; Chicago, IL 60611Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Shaffer and Phillips [1] made a valuable contribution when they showed that prolonged treatment with oral cyclophosphamide and prednisone may lead to the eradication of factor VIII autoantibodies. However, single-agent therapy may also be effective in this condition and may avoid drug toxicity. We previously reported that an initial short course of prednisone therapy, 1 mg/kg of body weight daily, led to the disappearance of antibody in 10 of 31 patients [2]. Since that report, 10 new cases have been reviewed (Table 1). A decline in antibody titer to less than 1 Bethesda unit and a concomitant ...References1. Shaffer LG, Phillips MD. Successful treatment of acquired hemophilia with oral immunosuppressive therapy. Ann Intern Med. 1997; 127:206-9. Google Scholar2. Green D, Rademaker AW, Briet E. A prospective, randomized trial of prednisone and cyclophosphamide in the treatment of patients with factor VIII autoantibodies. Thromb Haemost. 1993; 70:753-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: Northwestern University Medical School; Chicago, IL 60611 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTreatment Options for Acquired HemophiliaManagement of acquired haemophilia AAdvances in the understanding of acquired haemophilia A: implications for clinical practiceTreatment of acquired hemophilia AAcquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors' OrganisationTransfusion of the Patient with Acquired Coagulation DefectsImmune Tolerance Therapy in Patients with Acquired HemophiliaAutoimmune factor VIII inhibitorsPathogenesis and Management of Acquired Haemophilia 15 February 1998Volume 128, Issue 4Page: 325KeywordsAdverse reactionsAntibody therapyAutoantibodiesBody weightCyclophosphamideHemophiliaHemorrhageImmunosuppressivesSteroid therapy Issue Published: 15 February 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
SOME OF THE VAGARIES OF THE GRIPPE.Read in the Section of Practice of Medicine, Materia Medica and Physiology, at the Forty-first Annual Meeting of the American Medical Association, at Nashville, Tenn., May, 1890.
Authors: C. E. ULRICH
Journal: JAMA (1890)

The influenza, or "grippe," as it is generally called, Protean in its forms and chameleon-like in its aspects, has made a flying trip through our country, and left its multiform impression upon our population. This strange disease enjoys as many titles as a European nobleman: influenza, because it exercises such a decided influence upon all the tissues and functions of the human body;<i>la grippe</i>, because, when it once takes hold, it rarely lets go its grip;<i>rheuma epidemicum</i>, be cause, under its dire influence, the universal nose and throat becomes a perennial fountain;<i>cephalalgia contagiosa</i>, because of the infernally Plu tonian headache it induces; failette, because, when attacked by it, we are driven almost to madness;<i>coquette</i>, because it plays with our feelings as a cat does with a mouse or a young lady with her devoted admirers;<i>petit courier</i>, because it runs from organ to organ, suffering none
The Kaposi's Sarcoma–Associated Herpesvirus G Protein–Coupled Receptor as a Therapeutic Target for the Treatment of Kaposi's Sarcoma
Authors: Silvia Montaner, Akrit Sodhi, Amanda K. Ramsdell, Daniel Martin, Jiadi Hu, Earl T. Sawai, J. Silvio Gutkind
Journal: Cancer Research (2006)

The Kaposi's sarcoma-associated herpesvirus (KSHV) encodes a G protein-coupled receptor (vGPCR) that has been implicated in the initiation of Kaposi's sarcoma, identifying vGPCR as an attractive target for preventing Kaposi's sarcoma. However, as only a fraction of cells in advanced Kaposi's sarcoma lesions express vGPCR, it is unclear whether this unique viral oncogene contributes to Kaposi's sarcoma progression. We therefore set out to determine whether the few cells that express vGPCR in established tumors represent an appropriate therapeutic target for the treatment of patients with preexisting Kaposi's sarcoma. To this end, we generated endothelial cell lines stably expressing vGPCR or key KSHV latently expressed proteins (vCyclin, vFlip, and LANA1). The endothelial cell line expressing vGPCR was rendered sensitive to treatment with the nucleoside analogue ganciclovir by using a bicistronic construct coexpressing the herpes simplex virus 1 thymidine kinase. S.c. injection into nude mice with mixed-cell populations formed tumors that approximate the ratio of vGPCR-expressing and KSHV latent gene-expressing cells. These mice were then treated with ganciclovir to specifically target only the vGPCR-expressing cells. Surprisingly, despite the expression of KSHV latent genes in the vast majority of tumor cells, specifically targeting only the few vGPCR-expressing cells in established tumors resulted in tumor regression. Moreover, we observed an increase in apoptosis of latent gene-expressing cells after the pharmacologic deletion of the vGPCR-expressing cells. These findings indicate that vGPCR may play a key role in Kaposi's sarcoma progression and provide experimental justification for developing molecular-based therapies specifically targeting vGPCR and its effectors for the treatment of Kaposi's sarcoma patients.
Legislating Drug Prescribing Practices
Authors: Renzo Rozzini
Journal: JAMA (1994)

<h3>To the Editor.</h3> —In a recent Editorial, Drs Kane and Garrard,<sup>1</sup>commenting on changes in antipsychotic drug use in nursing homes after the OBRA-87 regulations,<sup>2</sup>claim that, in general, "sticks may work better than carrots" in improvements of health professional prescribing practices. However, they indicate that strict regulations regarding clinical practices may be enforced only if there are clear and specific data supporting such decisions. The comment by Kane and Garrard fits well with the present situation in Italy, which is characterized by a substantial reform of the health system, particularly regarding reimbursement for certain medications by local governments. The drugs have been divided in three categories: class A, free for all patients; class B, free only for those older than 60 years or younger than 10 years; and class C, not reimbursed for anyone. In class A are included some expensive drugs (or previously overprescribed drugs) that