tbuckley/cabot-search huggingface dataset:
Massive Pulmonary Embolus and Anabolic Steroid Abuse
Authors: Thomas J. Montine
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Several case reports associating anabolic steroid abuse with arterial thrombosis in young male weight lifters have appeared in the literature.<sup>1-3</sup>Herein we present a case of fatal pulmonary embolus in a 36-year-old power lifter. <h3>Report of a Case.</h3> —The patient had a clinical history of long-standing anabolic steroid abuse and type II diabetes mellitus. Three months before his death, the patient was diagnosed as having right lower lobe pneumonia and was treated as an outpatient. The patient was next seen at the emergency department after collapsing in the street. He was noted to be combative but conscious and complaining of shortness of breath. Within minutes of arrival, the patient suffered cardiopulmonary arrest. Repeated arterial blood gas measurements showed marked hypoxemia and hypercarbia. A clinical diagnosis of fatal pulmonary embolus was made. The postmortem examination disclosed a large saddle pulmonary embolus obstructing both the right and left
Rambling Notes of a Roving Doctor.
Authors: W. S. Caldwell
Journal: JAMA (1900)

Paris, July, 1900. <h3>MEDICAL MATTERS IN VIENNA AND PARIS—TUBERCULOSIS.</h3><h3>To the Editor:</h3> —Nothnagel gave us five lectures on the subject of tuberculosis. He discussed the disease in its different manifestations, and asserted that there were few people living who had not in some part of their economy living tuberculous germs. The old idea that phthisis pulmonalis was always a fatal malady was proved by the many autopsies that showed the existence of healed cicatrices in lung tissues that had been invaded by the specific germ. In his treatment he ignores the use of all drugs almost entirely. The hygienic management and the selection of a desirable climate are the only curative agents upon which he places any confidence. In his choice of a climate, one as free as possible from dust and germs should be selected, very little attention being paid to temperature. Medication is restricted to such agents as
Novel mechanism of fetal hepatocyte injury in congenital alloimmune hepatitis involves the terminal complement cascade
Authors: Xiaomin Pan, Susan Kelly, Hector Melin-Aldana, Padmini Malladi, Peter F. Whitington
Journal: Hepatology (2010)

Evidence suggests that most neonatal hemochromatosis (NH) is the phenotypic expression of gestational alloimmune fetal liver injury. Gestational alloimmune diseases are induced by the placental passage of specific reactive immunoglobulin G and often involve the activation of fetal complement by the classical pathway leading to the formation of membrane attack complex (MAC) as the effector of cell injury. We examined liver specimens from cases of NH, from cases of non-NH liver disease, and from infants without liver disease to determine if they would provide evidence that MAC is involved in hepatocyte injury. Sections were immunostained with anti-human C5b-9 complex, the terminal complement cascade (TCC) neoantigen formed in the assembly of MAC. Fetal liver injury in NH cases is associated with a severe loss of hepatocytes. In all NH cases examined, most remaining hepatocytes showed intense staining for TCC neoantigen, whereas hepatocytes in non-NH liver disease cases showed variable light staining. The percentage of hepatocytes containing TCC neoantigen in NH was much greater than that in non-NH liver disease, and there was no overlap between the groups. Findings in both groups suggest that hepatocytes have mechanisms to protect against MAC, including a biliary pathway for its excretion. Conclusion: The finding that all cases of proven NH contained TCC neoantigen far in excess of cases of other neonatal liver diseases suggests that a single process, namely congenital alloimmune hepatitis, is the principal cause of NH. MAC-mediated alloimmune injury in congenital alloimmune hepatitis is a novel mechanism of liver injury that results from an interplay of maternal adaptive immunity and fetal innate immunity. Hepatology 2010
RUBBER TUBING AS A PERCUSSION HAMMER.A NEW METHOD OF PERCUSSION.
Authors: F. M. POTTENGER
Journal: JAMA (1907)

It may seem presumptuous to offer anything new in a field which has been so thoroughly tried as that of percussion, yet I offer what I believe to be a new method and one that possesses superior advantage over methods in common use. Instead of a percussion hammer or finger with which to percuss the chest, I use a piece of rubber tubing, four or five inches long, and deliver the stroke directly on the surface of the chest. It makes a difference in the sound elicited whether a soft elastic tube or one with rigid walls is used; the former gives more or less of a dead sound, while the latter emits a note. The tubes which I have found most useful are a soft flexible tube with a lumen of 3/16 inch and walls 1/16 inch and a piece of ordinary tubing such as is used on douche
Meningiomas in Lymphangioleiomyomatosis
Authors: Joel Moss
Journal: JAMA (2001)

Context Lymphangioleiomyomatosis (LAM), a cystic lung disease associated with progressive respiratory failure, is found predominantly in women of childbearing age and therefore has been treated with progesterone and other hormonal agents.However, meningiomas have progesterone receptors, and progesterone is believed to be a mitogen for meningioma cells in culture.Since 30% to 40% of patients with tuberous sclerosis complex (TSC) have LAM, we routinely screen patients with LAM for brain lesions found in TSC.Objective To determine the prevalence of meningiomas in women with LAM.Design and Setting Analysis of results from ongoing routine screening protocols initiated in December 1995 at the National Heart, Lung, and Blood Institute.Patients Two hundred fifty women with sporadic LAM who were referred for screening by magnetic resonance imaging (MRI) and/or computed tomography (CT) of the brain. Main Outcome MeasuresPresence of meningiomas on MRI and/or CT scans. ResultsEight women with LAM (3 with and 5 without a diagnosis of TSC) had lesions on MRI scans compatible with meningiomas.Five of the patients had been treated with progesterone.Multiple meningiomas were observed in 2 patients.Conclusions Women with LAM appear to have a high prevalence of meningiomas.We recommend that patients with LAM be screened for meningiomas regardless of diagnosis of TSC.In view of the lack of a documented effect of progesterone on progression of lung disease in LAM and the reported mitogenic response of meningiomas to progesterone, we recommend that the drug not be given to LAM patients with an MRI result consistent with diagnosis of meningioma.
Conventional and pretargeted radioimmunotherapy using bismuth-213 to target and treat non-Hodgkin lymphomas expressing CD20: a preclinical model toward optimal consolidation therapy to eradicate minimal residual disease
Authors: Steven I. Park, Jaideep Shenoi, John M. Pagel, Don K. Hamlin, D. Scott Wilbur, Nural Orgun, Aimee L. Kenoyer, Shani Frayo, Amanda Axtman, Tom Bäck, Yukang Lin, Darrell R. Fisher, Ajay K. Gopal, Damian J. Green, Oliver W. Press
Journal: Blood (2010)
PERSONALITY DISORDERS WITH BRAIN TUMORS
Authors: MARK KANZER
Journal: American Journal of Psychiatry (1941)

1. Symptoms of psychic disorders were found with few exceptions in a series of 205 cases of neoplasm of the brain. 2. The mental disorders with brain tumors are essentially similar to those found with other types of organic psychoses and range in severity from mild neuroses to delirium and dementia. 3. Four groups are distinguished on the basis of the psychiatric findings. 4. The type of clinical picture which develops is influenced by the premorbid personality, by the specific psychic disabilities dependent on regional localization, and by the course and extent of the underlying pathological changes. 5. The adjustments of the personality to the psychic problems resulting from the brain tumor are analyzed. 6. The need for adequate psychopathological studies as a basis for the localization of mental symptoms is discussed.
Cycle helmets and the law
Authors: L Evans
Journal: BMJ (1994)

Any discussions of the law and the use of bicycle helmets will be helped by focusing on three questions. Firstly, how much do cycle helmets affect the risk of injury in a crash? Secondly, how much do laws requiring cyclists to wear helmets affect casualties? And, thirdly, should wearing of bicycle helmets be required by law?

Answers to the first two questions have objective answers that can be sought from specific empirical studies and what is already known about traffic safety.1 Three unrelated sources of evidence consistently show that cycle helmets reduce risk substantially in a crash. The science of biomechanics shows that a helmet reduces the peak acceleration forces that are associated with injury. Many published epidemiological studies, including that by Maimaris and colleagues in this issue of the BMJ and the references it cites,2 find that helmets reduce injury and the risk of death. Such studies fall short of the methodological ideal of comparing harm in matched treatment and control populations - so less direct methods must necessarily be used.

For example, examining the ratio of head injuries to nonhead injuries in cyclists wearing and not wearing helmets indicates that helmets reduce the risk of head injury …
Sequence of events in angina at rest: primary reduction in coronary flow.
Authors: S Chierchia, C Brunelli, I Simonetti, M Lazzari, A Maseri
Journal: Circulation (1980)

To investigate the events that lead to acute myocardial ischemia we monitored continuously the ECG, the left ventricular (four patients) or aortic (two patients) pressure and the great cardiac vein oxygen saturation (CSO2S) by a fiberoptic catheter in six patients with frequent anginal attacks at rest. We recorded 137 transient ischemic episodes (10 with chest pain) characterized by ST-segment elevation in 28 episodes, depression in three episodes and by pseudonormalization of previously inverted or flat T waves in 106 episodes. The onset of electrocardiographic and hemodynamic changes was preceded by a large drop in CSO2S in all 135 episodes with ST-T changes in the anterior leads but not in two episodes with ST elevation on inferior leads. The fall in CSO2S, consistently followed by signs of left ventricular function impairment and never preceded by any detectable increase in the hemodynamic determinants of myocardial oxygen consumption, probably reflects a reduction in regional perfusion. Thus, a reduction in coronary flow may cause transient ischemia in patients with angina at rest. These episodes may be associated with variable, often minor electrocardiographic changes and occasionally with anginal pain.
Community acquired pneumonia
Authors: L. Mandell
Journal: BMJ (2010)

New guidelines focus on management in primary care

Community acquired pneumonia is an important cause of morbidity and mortality, yet it is often misdiagnosed and improperly treated. Guidelines have been produced by several societies, and these have helped to organise the approach to this disease; highlighted areas that need further research; and reduced length of stay, mortality, and costs in patients admitted to hospital.1 2 3 4 5

Recently a summary of the British Thoracic Society (BTS) guidelines for community acquired pneumonia was published that focuses on management in primary care.3 6 The guidelines are a manageable length for general practitioners and have important educational and quality assurance functions.

Some of the BTS recommendations however, differ from those of the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) guidelines. Although the practice of medicine and the prevalence of certain pathogens may differ between the United Kingdom and United States, certain problems are common on both sides of the Atlantic. The diagnosis of pneumonia is one of them.

There are two key factors in the diagnosis of community acquired pneumonia. The first is whether the patient actually has pneumonia and the second is identification of the pathogen responsible.

Several infectious and non-infectious entities can be confused with …
Changes in the phenotype of human small cell lung cancer cell lines after transfection and expression of the c-myc proto-oncogene.
Authors: B E Johnson, J Battey, I Linnoila, K L Becker, R W Makuch, R H Snider, D N Carney, J D Minna
Journal: Journal of Clinical Investigation (1986)

Small cell lung cancer growing in cell culture possesses biologic properties that allow classification into two categories: classic and variant. Compared with classic small cell lung cancer cell lines, variant lines have altered large cell morphology, shorter doubling times, higher cloning efficiencies in soft agarose, and very low levels of L dopa decarboxylase production and bombesin-like immunoreactivity. C-myc is amplified and expressed in some small cell lung cancer cell lines and all c-myc amplified lines studied to date display the variant phenotype. To investigate if c-myc amplification and expression is responsible for the variant phenotype, a normal human c-myc gene was transfected into a cloned classic small cell lung cancer cell line not amplified for or expressing detectable c-myc messenger RNA (mRNA). Clones were isolated with one to six copies of c-myc stably integrated into DNA that expressed c-myc mRNA. In addition, one clone with an integrated neo gene but a deleted c-myc gene was isolated and in this case c-myc was not expressed. C-myc expression in transfected clones was associated with altered large cell morphology, a shorter doubling time, and increased cloning efficiency, but no difference in L dopa decarboxylase levels and bombesin-like immunoreactivity. We conclude increased c-myc expression observed here in transfected clones correlates with some of the phenotypic properties distinguishing c-myc amplified variants from unamplified classic small cell lung cancer lines.
Effects of Soho bomb were little compared with Omagh bomb
Authors: C. R Burges
Journal: BMJ (1999)

EDITOR—Dornan does herself an injustice by stating that “my entire career had been trained for this moment” [at the scene of the Soho bomb].1 Her training would not have covered the immediate care of severely injured people in a street setting while off duty.

Similar statements were common from distressed medical and nursing staff after the Omagh bombing of August 1998 and were often linked with feelings of self …
Abstract A47: Self-renewing cellular compartments in embryonal rhabdomyosarcoma are modulated by hedgehog signaling
Authors: Sampoorna Satheesha, Amandine Bovay, Gabriele Manzella, Peter Bode, Simone Feuchtgruber, Ewa Koscielniak, Reka Belle, Elisa Casanova, Nurhak Dogan, Beat W. Schäfer
Journal: Cancer Research (2014)

Abstract Rhabdomyosarcoma (RMS) is a heterogeneous group of malignancies with features of impaired skeletal muscle differentiation and represents the majority of soft tissue cancers in the pediatric age group. Current treatment regimens show clinical benefit but this has reached a plateau. Since there is significant risk of adverse side effects and secondary tumors later in life, identifying and targeting sub-populations with higher tumorigenic potential and self renewal capacity would not only decrease tumor burden but also lower the probability of relapse. Using in vitro self renewal assays we could identify self-renewing cellular compartments within embryonal RMS (eRMS) cell lines. These compartments showed upregulation of several components of the sonic hedgehog pathway. Here, we now show using both genetic loss- and gain-of-function experiments and clinically relevant small molecule modulators that Hedgehog signalling is important for determining the self-renewal, tumor initiation capability both in vitro as well as in vivo. In addition, the hedgehog pathway can also influence chemoresistance of eRMS cells and altered the differentiation status of the cells by directly modulating the expression of various stem cell associated transcription factors. The pathway was found to be heterogeneously activated within eRMS patient samples in a comprehensive tissue microarray analysis. Importantly, the presence of Hedgehog-active cells identified using effector transcription factors could negatively predict patient survival in a retrospective analysis of this patient cohort. This work elucidates both a novel and central role played by the Hedgehog pathway in eRMS and underscores the importance of studying tumor heterogeneity in pediatric cancer. Citation Format: Sampoorna Satheesha, Amandine Bovay, Gabriele Manzella, Peter Bode, Simone Feuchtgruber, Ewa Koscielniak, Reka Belle, Elisa Casanova, Nurhak Dogan, Beat W. Schäfer. Self-renewing cellular compartments in embryonal rhabdomyosarcoma are modulated by hedgehog signaling. [abstract]. In: Proceedings of the AACR Special Conference on Pediatric Cancer at the Crossroads: Translating Discovery into Improved Outcomes; Nov 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;74(20 Suppl):Abstract nr A47.
Use of lower gastrointestinal endoscopy and fecal occult blood test in the 2007 Swiss Health Interview Survey respondents aged 50 years and older
Authors: A. Spaeth, M. Zwahlen
Journal: Endoscopy (2013)

<b>Background and study aims:</b> Colorectal cancer (CRC) incidence ranks third among all cancers in Switzerland. Screening the general population could decrease CRC incidence and mortality. The aim of this study was to analyze the use of the fecal occult blood test (FOBT) and lower gastrointestinal endoscopy in a representative sample of the Swiss population aged ≥ 50 years. <b>Methods:</b> Data were analyzed from the 2007 Swiss Health Interview Survey and the prevalence estimates and 95 % confidence intervals were calculated based on all instances of lower gastrointestinal endoscopy and FOBT use, as well as on their use for CRC screening. Uni- and multivariate logistic regression analyses were performed to describe the association between screening use and sociodemographic characteristics, indicators of healthcare system use, and lifestyle factors. <b>Results:</b> In 2007, approximately 36 % of the surveyed people who were aged ≥ 50 years had previously undergone FOBT and approximately 30 % had previously undergone lower gastrointestinal endoscopy. CRC screening use was 7.7 % for FOBT (within the past year) and 6.4 % for lower gastrointestinal endoscopy (within the past 5 years). CRC screening by either method was 13 %. The major determinants of participation in CRC screening were found to be sex (male), physician visits during the past year (one or more), type of health insurance (private), and previous screening for other cancer types. <b>Conclusions:</b> The results of the 2007 Swiss Health Interview Survey indicate rather low levels of FOBT and lower gastrointestinal endoscopy use. Furthermore, the results suggest disparities in the use of CRC screening.
Immunohistological comparison of granulated cell proteins in induced immediate urticarial dermographism and delayed pressure urticaria lesions
Authors: M.T. MCEVOY, E.A. PETERSON, A. KOBZA-BLACK, J.S.C. ENGLISH, J.S. DOVER, G.M. MURPHY, B. BHOGAL, M.W. GREAVES, R.K. WINKELMANN, K.M. LEIFERMAN
Journal: British Journal of Dermatology (1995)

Urticarial dermographism and delayed pressure urticaria are two forms of physical urticaria which are well defined clinically and histologically. Previous studies have shown eosinophil granule protein deposition in urticarial reactions, including chronic urticaria, solar urticaria and delayed pressure urticaria. To evaluate and compare the involvement of granulated inflammatory cells in urticarial dermographism and delayed pressure urticaria, we studied sequential biopsies of induced lesions of urticarial dermographism and delayed pressure urticaria by indirect immunofluorescence, to detect eosinophil granule major basic protein (MBP) and neutrophil granule elastase. Biopsies from dermographic lesions at time 0, 5 min, 15 min, 2 h and 24 h, showed few infiltrating eosinophils, with minimal extracellular MBP deposition, and a few infiltrating neutrophils, with minimal neutrophil elastase deposition, throughout the evolution of the lesions. Sequential biopsies of delayed pressure urticaria at time 0, 20 min, 6, 12 and 24 h, showed eosinophil infiltration with extensive MBP deposition beginning at 20 min, and neutrophil infiltration with variable elastase deposition beginning at 20 min. Control tissue specimens from normal volunteers showed neutrophil infiltration and slight degranulation, but no eosinophil infiltration or degranulation. Comparison of urticarial dermographism with delayed pressure urticaria showed marked differences in the patterns of infiltration. Delayed pressure urticaria, with eosinophil and neutrophil degranulation, was strikingly similar to the IgE-mediated late phase reaction. In contrast, eosinophil and neutrophil involvement in urticarial dermographism was minimal. Considering the extent of eosinophil granule protein deposition and the biological activities of the eosinophil granule proteins, the findings in delayed pressure urticaria point to an important pathophysiological role of eosinophils in the disease.
Prolonged small-intestinal transit time in cystic fibrosis.
Authors: A Bali, D E Stableforth, P Asquith
Journal: BMJ (1983)

A lactulose hydrogen breath test was performed on 10 patients with cystic fibrosis and 15 control subjects matched for age and sex. All normal subjects had a fasting breath hydrogen concentration of less than 20 ppm. In contrast, seven of the patients with cystic fibrosis had high concentrations (25-170 ppm), which fell to 20 ppm or below on prolonged fasting (14-23 hours). Two patients showed no rise in breath hydrogen concentrations after lactulose, and in one patient the breath hydrogen concentration rose at 15 minutes, suggesting bacterial colonisation of the small bowel. Seven of the patients had prolonged small-bowel transit times (160-390 minutes) compared with those in the control group (50-150 minutes).
Lung Uptake of Tc-99m HMPAO in Cigarette Smokers Expressed by Lung/Liver Activity Ratio
Authors: WEI-JEN SHIH, STANLEY R. REHM, FRANK GRUNWALD, JOHN J. COUPAL, HANS J. BIERSACK, ROLANDO BERGER, YIH-LOONG LAI, U YUN RYO, MARCUS L. DILLON
Journal: Clinical Nuclear Medicine (1993)

SHIH, WEI-JEN M. D.; REHM, STANLEY R. M. D.; GRUNWALD, FRANK M. D.; COUPAL, JOHN J. PH. D; BIERSACK, HANS J. M. D.; BERGER, ROLANDO M. D.; LAI, YIH-LOONG PH. D.; RYO, U. YUN M. D., PH. D.; DILLON, MARCUS L. M. D.
President's AIDS Commission to Report in December, Again by Middle of Next Year
Authors: Charles Marwick
Journal: JAMA (1987)

THE PRESIDENT'S Commission on Acquired Immunodeficiency Syndrome (AIDS), formally called the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic, is up and running although its initial pace is somewhat faltering. Hardly had it finished its first meeting before it fired its newly appointed executive director and—ordered to produce its final report within 90 days of its creation—it is not expected to report until mid-1988, although an interim report will appear before the end of this year.  The commission held its first full meeting in the National Press Club in Washington, DC, as pickets on the sidewalk outside protested against some of its members and the administration that put it together. While there also was some criticism in the more decorous proceedings indoors, there was a great deal of reasonable advice.  The 13-member commission was created by President Ronald Reagan during the summer and is chaired by Eugene Mayberry, MD,