tbuckley/cabot-search huggingface dataset:
Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial
Authors: P. Little, M. Moore, J. Kelly, I. Williamson, G. Leydon, L. McDermott, M. Mullee, B. Stuart
Journal: BMJ (2013)

<b>Objective</b> To assess strategies for advice on analgesia and steam inhalation for respiratory tract infections. <b>Design</b> Open pragmatic parallel group factorial randomised controlled trial. <b>Setting</b> Primary care in United Kingdom. <b>Participants</b> Patients aged ≥3 with acute respiratory tract infections. <b>Intervention</b> 889 patients were randomised with computer generated random numbers in pre-prepared sealed numbered envelopes to components of advice or comparator advice: advice on analgesia (take paracetamol, ibuprofen, or both), dosing of analgesia (take as required <i>v</i> regularly), and steam inhalation (no inhalation <i>v</i> steam inhalation). <b>Outcomes</b> Primary: mean symptom severity on days 2-4; symptoms rated 0 (no problem) to 7 (as bad as it can be). Secondary: temperature, antibiotic use, reconsultations. <b>Results</b> Neither advice on dosing nor on steam inhalation was significantly associated with changes in outcomes. Compared with paracetamol, symptom severity was little different with ibuprofen (adjusted difference 0.04, 95% confidence interval −0.11 to 0.19) or the combination of ibuprofen and paracetamol (0.11, −0.04 to 0.26). There was no evidence for selective benefit with ibuprofen among most subgroups defined before analysis (presence of otalgia; previous duration of symptoms; temperature &gt;37.5°C; severe symptoms), but there was evidence of reduced symptoms severity benefit in the subgroup with chest infections (ibuprofen −0.40, −0.78 to −0.01; combination −0.47; −0.84 to −0.10), equivalent to almost one in two symptoms rated as a slight rather than a moderately bad problem. Children might also benefit from treatment with ibuprofen (ibuprofen: −0.47, −0.76 to −0.18; combination: −0.04, −0.31 to 0.23). Reconsultations with new/unresolved symptoms or complications were documented in 12% of those advised to take paracetamol, 20% of those advised to take ibuprofen (adjusted risk ratio 1.67, 1.12 to 2.38), and 17% of those advised to take the combination (1.49, 0.98 to 2.18). Mild thermal injury with steam was documented for four patients (2%) who returned full diaries, but no reconsultations with scalding were documented. <b>Conclusion</b> Overall advice to use steam inhalation, or ibuprofen rather than paracetamol, does not help control symptoms in patients with acute respiratory tract infections and must be balanced against the possible progression of symptoms during the next month for a minority of patients. Advice to use ibuprofen might help short term control of symptoms in those with chest infections and in children. <b>Trial registration</b>ISRCTN 38551726.
Case of Rupture of the Heart
Authors: G. May
Journal: BMJ (1869)

Sydenham Society, says: " The jaundice from mental emotion is deve- loped much more rapidly than is even the case in complete closure of the ductus choledochus."He assigns two causes which may produce this effect-" i, by interruptions of the circulation of the blood through the liver, by the influence exerted by the nerves upon the calibre of the por- tal vein; or, 2, by interruptions to the heart's action, the respiratory and the renal circulation."Now undoubtedly, if mental emotion of a depressing character, acting thus on the circulation, can produce jaundice-a fact, I think, suffi- ciently established-it does not appear at all improbable that great losses of blood, producing as they do weakness, irregularity, and obstructed circulation, should lead to the same result.
Expression of Scatter Factor in Human Bladder Carcinoma
Authors: A. Joseph, G. H. Weiss, L. Jin, A. Fuchs, S. Chowdhury, P. O'Shaugnessy, I. D. Goldberg, E. M. Rosen
Journal: JNCI Journal of the National Cancer Institute (1995)

Scatter factor (SF) is a protein secreted by stromal (supporting) cells that induces disruption of intercellular junctions and stimulates motility and invasiveness of carcinoma cells. SF is also a potent inducer of angiogenesis (new blood vessel formation), a process required for tumor growth and dissemination. Invasion and angiogenesis are characteristics of biologically aggressive tumors, suggesting that the accumulation of SF within tumors might promote progression to a more malignant phenotype.This study was designed to determine if SF is overexpressed in carcinoma of the bladder and to evaluate the potential mechanisms that might account for such overproduction.We measured the SF content in urine from 20 patients with carcinoma of the bladder and various control groups. We also measured expression of SF in bladder tumor extracts, histologic sections of tumors, and cell culture models, using a variety of techniques, including enzyme-linked immunosorbent assays, immunohistochemistry, and Western and Northern blot analyses. Statistical comparisons were performed using two-tailed t tests.Urinary SF content was found to be significantly elevated in patients with bladder carcinoma as compared with normal control subjects (P < .001), patients with benign prostatic hypertrophy (P = .0055), and patients with prostate carcinoma, another genitourinary malignancy (P = .002). Extracts of bladder cancers, especially those from high-grade, invasive tumors, contained very high levels of SF. Both SF and its proto-oncogene (c-met)-encoded receptor were detected in bladder carcinoma tissue sections by immunostaining. Three different bladder carcinoma cell lines produced no detectable SF but produced very high titers of a high-molecular-weight (> 30 kd), heat-sensitive protein that stimulates SF production by stromal cell types. High titers of a similar SF-inducing activity were detected in vivo, in bladder carcinoma extracts, and in the urine of patients with bladder carcinoma.Our results suggest that SF is overproduced in bladder carcinomas and accumulates within the tumor and in the urine. Overproduction of SF may result from an abnormal urothelial-stromal interaction in which dysplastic or carcinomatous urothelium secretes factors that stimulate SF expression by bladder wall stromal cells.Quantitation of SF in the urine and tumor deserves further study as a possible marker of urothelial malignancy.
Traumatic Delayed Rupture of the Gallbladder
Authors: D. F. Coulter
Journal: BMJ (1948)

JOURNALthe administration of plasma and the occurrence of jaun- dice (122 days and 63 days, respectively) fall within the accepted limits.There was no history of contact with patients suffering from infective hepatitis.Unfortunately, it proved impossible to trace other patients who had been treated with reconstituted plasma from the batches used in these two cases.Histologically the picture was the usual one of subacute hepatic necrosis.An attempt was made to ascertain the incidence of homologous serum jaundice in babies treated with plasma intravenously.Of 39 babies under 18 months old treated with reconstituted dried pooled plasma 26 survived the initial illness; among these were the two cases described above.Questionaries were sent to the parents of the remaining 24 after an interval of six months or more; 17 replies were received, and no further cases of jaundice
Case 8-2000
Authors: Michael R. Curci, Carolyn C. Compton
Journal: New England Journal of Medicine (2000)

Presentation of CaseAn 8 1/2-year-old girl was admitted to the hospital because of an abdominal mass and pain.The child had had recurrent abdominal pain during the preceding two years. Her mother believed that the symptoms had begun at about the time that an elevated coliform count was discovered in the local water supply. Seventeen months before admission, the girl's blood count and sedimentation rate were normal, and stool examination showed no ova or parasites. Seven weeks before admission, intermittent fevers began, with anorexia, loss of about 4.5 kg in weight, and a reduction in the frequency of bowel . . .
STRABISMUS; ITS TREATMENT.
Authors: A. EDWARD DAVIS
Journal: JAMA (1901)

If some one were good enough, or I might better say wise enough, to formulate a uniform set of tests for the detection and accurate measurement of strabismus, to be used by all observers in order to compare the results or the different methods of treatment, we might arrive at some valuable conclusions as to the best treatment of this affection. Again, a better understanding of the physiological action of the ocular muscles and, indeed, of physiology in general than now, as a rule, obtains would help elucidate the intricacies of the subject. The anatomy of the ocular muscles has been gone into thoroughly, but the physiological action of the ocular muscles and their intimate relation and co-relation in the use and movements of the eyes has been overlooked, or at least not kept in mind, it seems to me. In addition to a résumé of the subject of the
RESTING HEART RATE IS AN IMPORTANT DETERMINANT OF MORTALITY IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION DUE TO CONGENITAL HEART DISEASE
Authors: Mark J. Schuuring, Annelieke van Riel, Jeroen Vis, Marielle Duffels, Rolf Berger, Elke Hoendermis, Arie Van Dijk, Hubert Vliegen, Barbara Mulder, Berto Bouma
Journal: Journal of the American College of Cardiology (2013)
Telling the World
Authors: Terry L. Wahls
Journal: Annals of Internal Medicine (2008)

On Being a Patient1 July 2008Telling the WorldTerry L. Wahls, MD, MBATerry L. Wahls, MD, MBAFrom Veterans Affairs Iowa City Health Care System, Iowa City, IA 52246.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-1-200807010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I had accepted the position of associate chief of staff for ambulatory care and made plans to move once school for the kids had ended. A month later, I was told that I had multiple sclerosis. When I asked about my long-term prognosis, the answers were vague.“It's an unpredictable disease,” they said. “Some do well. Others experience a relentless downhill course. However, you have many favorable signs. You'll probably do relatively well.”I logged on to PubMed to check the literature for myself. What I read was depressing. I confirmed that no cure has been found. Although treatment may ... Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Iowa City Health Care System, Iowa City, IA 52246.Corresponding Author: Terry L. Wahls, MD, MBA, Veterans Affairs Iowa City Health Care System, 1W42, 601 Highway 6 West, Iowa City, IA 52246; e-mail, Terry.[email protected]va.gov. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 2008Volume 149, Issue 1Page: 61-62KeywordsFatigueLower back painMultiple sclerosisRunningShockSwimmingTongueVeteran careWalkingWheelchairs ePublished: 1 July 2008 Issue Published: 1 July 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Imaging Findings in a Child With Loeys-Dietz Syndrome
Authors: Amira Dhouib, Maurice Beghetti, Dominique Didier
Journal: Circulation (2012)

A 3-year-old boy being followed up for bilateral club foot underwent a routine thorax radiography that revealed aortic arch enlargement.Echocardiography showed sinus of Valsalva dilatation.Because of clinical features such as hypertelorism, bifid uvula, and prominent forehead, a genetic investigation was conducted that confirmed Loeys-Dietz syndrome (LDS) by identifying a heterozygous mutation in the gene encoding transforming growth factor-␤ receptor type 2 (TGFBR2).Whole-body magnetic resonance angiography was performed on a 1.5T machine.The magnetic resonance protocol included 3-dimensional contrast-enhanced angiographic sequences of the body and time-of-flight sequences of the brain.Whole-body magnetic resonance imaging demonstrated typical cardiovascular findings: Dilatation of the aorta at the level of sinus of Valsalva; tortuosity of the aortic arch, the 2 internal carotid arteries, the 2 vertebral arteries, and left subclavian artery; and a superior mesenteric artery From the Pediatric Radiology Unit (A.
Repetitive episodes of brief ischaemia (12 min) do not produce a cumulative depletion of high energy phosphate compounds
Authors: J. L SWAIN, R. L SABINA, J. J HINES, J. C GREENFIELD, E. W HOLMES
Journal: Cardiovascular Research (1984)

During myocardial ischaemia the purine (ATP, GTP) and pyrimidine (CTP, UTP) nucleotide content of the myocyte falls. When the ischaemic episode resolves, many hours or even days are required for restoration of nucleotide pools. These observations suggest that repetitive episodes of ischaemia might produce progressive depletion of nucleotide pools. In order to determine the effect of repetitive episodes of brief ischaemia on nucleotide pools, open-chest dogs underwent three 12 min periods of occlusion of the left anterior descending coronary artery, with each occlusion followed by 10 min of reperfusion. During the first occlusion nucleotide pools decreased by 30% (ATP); 36% (GTP), 52% (CTP), and 48% (UTP). The subsequent two occlusions produced no further decrease in nucleotide pools. The myocardial content of adenine nucleotide catabolites (adenosine + inosine + hypoxanthine) tended to be greater during the first occlusion than during the subsequent occlusions, and substrate delivery (ie regional myocardial blood flow) was similar during each of the periods of ischaemia. These results indicate that a decrease in the rate of nucleotide degradation, rather than an increase in nucleotide synthesis, accounts for the maintenance of nucleotide content during subsequent ischaemic episodes after the initial ischaemic period. Thus repetitive episodes of regional ischaemia do not produce a cumulative decrease in the high energy phosphate content of the myocardium.
Unilateral Edema Due to a Thiazolidinedione
Authors: David S.H. Bell
Journal: Diabetes Care (2003)

A 51-year-old African-American man with type 2 diabetes (anti-GAD antibody negative and C-peptide positive) of 7 years duration was controlled (A1c 7.0%) on a combination of 1 g metformin, 2 mg glimeperide, and 4 mg rosiglitazone all twice daily and 40 units Glargine insulin at bedtime. He had been taking rosiglitazone for 26 months and troglitazone for 13 months before changing to rosiglitazone.

The patient suddenly developed painful swelling of the right leg. On examination there was no edema in the left leg and pitting …
Circulating fibrocytes and pulmonary arterial hypertension
Authors: N. Gambaryan, S. Cohen-Kaminsky, D. Montani, B. Girerd, A. Huertas, A. Seferian, M. Humbert, F. Perros
Journal: European Respiratory Journal (2011)

To the Editors:

We read with great interest the recent editorial by Stenmark et al. [1] about the potential role of fibrocytes in pulmonary arterial hypertension (PAH) and the original article by Nikam et al. [2] showing the contribution of bone marrow-derived circulating fibrocytes to hypoxic vascular remodelling and inhibition of their recruitment by treprostinil. Many recent reports indicate a contribution of endothelial and haematopoietic progenitor cells [3], attracted via the CXC chemokine ligand 12/CXC chemokine receptor (CXCR)4 axis in the lung [4], but the role of fibrocytes in PAH is still not clear. A previous study of pulmonary hypertension in rat and calf models has shown that pulmonary adventitial remodelling is due to robust recruitment of nonresident, bone marrow-derived cells that can produce collagen and express smooth muscle cell α-actin, thus representing fibrocytes [5]. A unique feature of fibrocytes, described by Bucala et al. [6], is that they circulate in the bloodstream and are capable of producing extracellular matrix components. They express a variety of mesenchymal markers, including collagen-1, collagen-3, vimentin, haematopoietic markers, such as CD11b and CD45, and the stem cell marker CD34 [6]. Circulating fibrocytes display many functional properties, such as phagocytosis, antigen presentation, cytokine and connective tissue matrix production, and the capacity to proliferate and differentiate. In addition, they respond to a variety of cytokines and growth factors. Fibrocytes also produce angiogenic factors, such as vascular endothelial growth factor and platelet-derived growth factor A, and thus have a potent effect on de novo blood vessel formation, as evidenced by studies in an in vivo Matrigel™ (BD Biosciences, Franklin Lakes, NJ, USA) model of angiogenesis. Fibrocyte expression of matrix metalloproteinase-9, which mediates endothelial cell invasion, further facilitates the angiogenic …
PROSPECTIVE RANDOMIZED COMPARISON OF LONG VERSUS SHORT PULSE DURATION THERAPEUTIC IMPULSES IN IMPROVING EPICARDIAL AND MICROVASCULAR RECANALIZATION DURING A CONTINUOUS MICROBUBBLE INFUSION IN ACUTE MYOCARDIAL INFARCTION
Authors: Feng Xie, Shunji Gao, Juefei Wu, Evan Unger, Jinjin Liu, William T. Shi, Francois Vignon, Jeffry Powers, John Lof, Shelby Kutty, Jia Liu, Thomas Porter
Journal: Journal of the American College of Cardiology (2012)
Today's Esophagologist, Autocastrated
Authors: Eddy D. Palmer
Journal: JAMA (1974)

DIRECT inspection of diseased tissues is the most generally helpful of diagnostic efforts. Years ago, the clinician found that proper management of many gastrointestinal problems requires direct inspection of the appropriate mucosal and serosal surfaces via endoscopy. After many years of serious effort to achieve effective mucosal visualization throughout the whole gastrointestinal tract, from top to bottom, the goal has now almost been reached. Anybody who reads a journal or goes to a meeting knows that these days the mucosal panorama from lips to Treitz' arch is open to view in almost any adult patient, whenever the clinician feels a need for the diagnostic information it can give. The question of whether the patient with gastrointestinal disease fares better these days, now that pangastrointestinal fiberoptic endoscopy has become so popular, cannot be answered as yet. Advances in medical instrumentation have never automatically meant advances in therapeutic effectiveness, but if eventually
Intravenous transplantation of bone marrow mesenchymal stem cells could effectively promote vascularization and skin regeneration in mechanically stretched skin
Authors: S.B. Zhou, C.A. Chiang, K. Liu, Q.F. Li
Journal: British Journal of Dermatology (2014)

Skin expansion is a procedure that stimulates and promotes skin regeneration by applying continuous mechanical stretching. However, the outcome of treatment is limited by the skin's instinctive regeneration capacity.To evaluate the impact of intravenous transplantation of bone marrow mesenchymal stem cells (MSCs) on expanded skin regeneration.MSCs from luciferase-Tg Lewis rats were transplanted into a rat tissue expansion model and tracked in vivo by luminescence imaging. At the end of 21 days of skin expansion, the expanded skin was harvested and skin regeneration was evaluated by inflation volume, skin area and thickness. Counting of capillaries and vascular endothelial cell growth factor (VEGF) expression analysis were conducted to assess the impact of MSCs on expanded skin vascularization.Samples of the skin expansion model from the MSC group were observed to have a significantly higher inflation volume and greater expanded skin area than those from the control group at the end of 21 days' follow-up. In vivo tracing results showed that MSCs were recruited by mechanical stretch and migrated to expanded skin. Migrated MSCs promoted skin vascularization by secreting VEGF and differentiating into CD31+ endothelial cells. Skin sections from the MSC group had a significant advantage in thickness and proliferating cell count, indicating that MSCs effectively enhanced expanded skin regeneration.Intravenous transplantation of MSCs could effectively promote expanded skin regeneration. Transplanted MSCs could be recruited by mechanical stretch and subsequent migration to expanded skin. Engrafted MSCs could contribute to vascularization and cell proliferation.
P1084 PRESENCE OF STEATOSIS AND HBeAg-POSITIVE STATUS ARE INDEPENDENTLY ASSOCIATED WITH PERSISTENTLY ELEVATED SERUM ALT LEVELS IN CHRONIC HBV PATIENTS DURING ANTIVIRAL THERAPY
Authors: I.M. Jacobson, M.K. Washington, A. Thompson, N.H. Afdhal, R. Aguilar Schall, P. Dinh, J. Bornstein, J.F. Flaherty, G.M. Subramanian, J.G. McHutchison, Z. Younossi, P. Marcellin, K. Patel
Journal: Journal of Hepatology (2014)
Pulmonary Artery Aneurysms
Authors: BRIAN BLADES, WILLIAM FORD, PATRICK CLARK
Journal: Circulation (1950)

The successful surgical treatment of an aneurysm of the left main pulmonary artery is reported. It appears that, after ligation of the main pulmonary artery, it is desirable not to remove the lung but preserve it as a space occupying organ which will retain some function. Literature on the subject of pulmonary aneurysms is reviewed.
TRICHINOSIS: DEMONSTRATION OF THE PARASITES IN THE BRAIN
Authors: Edgar R. Pund
Journal: JAMA (1934)

This fatal case of trichinosis is worthy of report for several reasons: At autopsy the parasites were found in the brain; symptoms of encephalitis began three weeks after vaccination against smallpox; eosinophilia was absent; the patient was a child, aged 11 years, and incidentally the child also had sickle-cell anemia. A clinical diagnosis was made of encephalitis of unknown etiology, possibly a delayed postvaccinial complication. Unfortunately, trichinosis was considered neither at the bedside nor in the morgue and the correct diagnosis was made from a study of the microscopic sections of tissues removed at autopsy; only by chance was a small piece of voluntary muscle included in the sections.  REPORT OF CASE  History.—  W. A., a Negro boy, aged 11 years, entered the hospital, Jan. 3, 1933, with an admitting diagnosis of encephalitis of unknown etiology. There was a past history of mumps, whooping cough and chills and fever. Three
Allergy to penicillin: fable or fact?
Authors: S J Surtees, M G Stockton, T W Gietzen
Journal: BMJ (1991)

OBJECTIVE--To assess whether, on the basis of one blood test, penicillin allergy might be excluded sufficiently for general practitioners to give oral penicillin to patients claiming a history of penicillin allergy. DESIGN--Prospective study of patients referred by general practitioners. SETTING--Outpatient allergy clinic in a district general hospital. PATIENTS--175 referred patients who gave a history of immediate type reaction to penicillin, of whom 144 attended as requested and 132 completed the investigations. MAIN OUTCOME MEASURES--History and examination, serum radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin, and oral challenge with penicillin. RESULTS--Of 132 patients, four were confirmed to have penicillin allergy by the radioallergosorbent test and 128 had an oral penicillin challenge without ill effect. CONCLUSIONS--Most patients who gave a history of penicillin allergy are not so allergic, and their actual allergic state should be substantiated whenever feasible. For patients reporting minor or vague reactions negative findings with a radioallergosorbent test to phenoxymethylpenicillin and benzylpenicillin provide sufficient evidence to give oral penicillin safely.
GALECTIN-3 AND MYOCARDIAL FIBROSIS AT CARDIAC MAGNETIC RESONANCE IN NONISCHEMIC DILATED CARDIOMYOPATHY
Authors: Giuseppe Vergaro, Annamaria Del Franco, Concetta Prontera, Aldo Clerico, Andrea Barison, Giovanni Donato Aquaro, Alberico Del Torto, Claudio Passino, Michele Emdin
Journal: Journal of the American College of Cardiology (2014)
Reply to Marcel D. Waldinger and Dave H. Schweitzer's Letter to the Editor re: François Giuliano, Donald L. Patrick, Hartmut Porst, et al. For the 3004 Study Group. Premature Ejaculation: Results from a Five-Country European Observational Study. Eur Urol 2008;53:1048–57
Authors: François Giuliano
Journal: European Urology (2008)