tbuckley/cabot-search huggingface dataset:
A surprising cause of masses in the chest
Authors: Chad Cherington, Steven R. Schuster, Madappa Kundranda, Riccardo Valdez, Ruben A. Mesa, Donald W. Northfelt
Journal: American Journal of Hematology (2012)

An 82-year-old male presented to the emergency department with an acute onset of chest pain and mild shortness of breath at rest. The pain in his left lower chest was pleuritic with intensity 9- on a 10-point scale. He had driven 2 h in his car that day, but had no other prolonged immobility. About 15 years previously, he was found to have increased hemoglobin (18.1 g/dL) and diagnosed with secondary erythrocytosis due to active smoking, chronic obstructive pulmonary disease (COPD), and residence in Payson, Arizona (altitude 4,999 ft). Polycythemia vera was entertained, but not pursued due to multiple secondary risks. He had been treated with daily aspirin and monthly phlebotomies to maintain a hematocrit below 45%. He also had a history of superficial thrombophlebitis, nephrolithiasis, hypertension and superficial transitional cell carcinoma of the bladder resected and in remission. There was also a deep venous thrombosis (DVT) and pulmonary embolism (PE) 13 years previously, believed to be provoked by prolonged immobility after a radical prostatectomy for prostate cancer now in remission. His medications were aspirin and lisinopril; he had no known drug allergies. He quit smoking 2 years prior after a 70 pack-year history. There was no other family history of thrombosis or bleeding disorder, autoimmune disorders, pulmonary disease or malignancy.
The Heavenly Ladder
Authors: Howard Spiro
Journal: Annals of Internal Medicine (2002)

Medical Writings: Book Notes19 November 2002The Heavenly LadderHoward Spiro, MDHoward Spiro, MDYale University New Haven Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-10-200211190-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Coulehan J. 64 pages. Canberra, Australia: Ginninderra Pr; 2001. $11.00. ISBN 1740270991. Order at www.ginninderrapress.com.au.Field of medicine: Poetry.Format: Softcover book.Audience: Practicing physicians, medical students, and others in the medical field who want to share the humanity of their patients and discover why most clinicians find so much gratification in their work.Purpose: To present poetry inspired by clinical experience and reflective encounters with patients and writers.Content: This slim book contains almost 50 poems divided into four sections. The title and cover art are derived from a Byzantine icon of the heavenly ladder leading to Paradise with ... Author, Article, and Disclosure InformationAffiliations: Yale University New Haven Connecticut. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 19 November 2002Volume 137, Issue 10Page: 858KeywordsEmotionsEpilepsySoftware tools ePublished: 19 November 2002 Issue Published: 19 November 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Genotype-phenotype relationship in Brugada syndrome: electrocardiographic features differentiate SCN5A-related patients from non–SCN5A-related patients
Authors: Jeroen P.P Smits, Lars Eckardt, Vincent Probst, Connie R Bezzina, Jean Jacques Schott, Carol Ann Remme, Wilhelm Haverkamp, Günter Breithardt, Denis Escande, Eric Schulze-Bahr, Hervé LeMarec, Arthur A.M Wilde
Journal: Journal of the American College of Cardiology (2002)
PMO-143 The use of dry blood spot testing (DBS) for viral hepatitis in mosques-a pilot study of 3 surrey centres
Authors: S Readhead, A Ahmed, H Jenkins, M Nicholls, P Berry, G Foster, A Ala
Journal: Gut (2012)

<h3>Introduction</h3> Chronic Viral Hepatitis (CVH) affects ˜0.5% of native UK population. However, endemicity varies world wide &amp; previous studies show that ethnic minorities are likely to preserve the higher rates of their region of origin. The estimated prevalence of chronic HBV &amp; HCV in Pakistan is &gt;5% &amp; the current UK Pakistani population is &gt;1.2 million. The study aimed to (1) characterise HBV &amp; HCV prevalence in a local Pakistani community within Surrey using DBS testing (2) test the hypothesis that 2nd generation immigrants (ie, those born in UK) retain this higher prevalence (3) promote awareness of viral hepatitis within this population. <h3>Methods</h3> We approached community leaders of three Woking (Surrey, UK) mosques &amp; prospectively arranged testing sessions over 10 months (2011–2012), which were advertised during religious gatherings. Following approval by the Local Ethical Board &amp; formal consent, finger prick DBS were tested for HBsAg, HBcore antibody, antiHCV Ab, HCV (Genotype &amp; RNA quantification). Volunteers filled out a questionnaire outlining risk factors for CVH. Subjects who were HBsAg and/or AntiHCV Ab were invited back to the Mosques for focused counselling &amp; offered outpatient confirmatory testing including specialist Hepatology assessment &amp; treatment as necessary. <h3>Results</h3> A total of 219 subjects were tested (164M, 55F), age 18–81 yrs, mean age 45 yrs, median 44 yrs &amp; modal age range 30–39 yrs. The mean total duration of stay in the UK prior to testing was 24 yrs; 195 cases (89%) were of Pakistani origin of which there were 176 1st &amp; 19 2nd gen immigrants. Of those tested, 4(2F &amp; 2M) were HBSAg+ve and four (all M) were antiHCV+ve with 3HCV RNA+ve (2Genotype 3a and 1, 3k). Definite risk factors for CVH transmission were not identified. Mean duration of stay in the UK for +ve cases was 13 yrs, all were 1st generation Pakistani (fibroscan score &lt;8 kPa, normal LFTS, two with prior family history and three were first degree relatives). <h3>Conclusion</h3> DBS testing confirms that our local Pakistani community has retained CVH prevalence rates atleast seven times greater than that of the native UK population. Primary &amp; secondary physicians need better awareness to engage &amp; identify individuals in susceptible ethnic populations. This study has not picked up any cases of viral hepatitis in 2nd generation immigrants &amp; further work is required to conclusively analyse this subset of the community. Our results suggest inequalities in health related to viral hepatitis in the Pakistani population &amp; provide evidence for a wider UK study in this vulnerable group. Places of worship may act as focal testing points to improve screening uptake, management &amp; potential treatment of viral hepatitis in at risk populations. <h3>Competing interests</h3> None declared.
The Illness of Vincent van Gogh
Authors: Dietrich Blumer
Journal: American Journal of Psychiatry (2002)

Vincent van Gogh (1853-1890) had an eccentric personality and unstable moods, suffered from recurrent psychotic episodes during the last 2 years of his extraordinary life, and committed suicide at the age of 37. Despite limited evidence, well over 150 physicians have ventured a perplexing variety of diagnoses of his illness. Henri Gastaut, in a study of the artist's life and medical history published in 1956, identified van Gogh's major illness during the last 2 years of his life as temporal lobe epilepsy precipitated by the use of absinthe in the presence of an early limbic lesion. In essence, Gastaut confirmed the diagnosis originally made by the French physicians who had treated van Gogh. However, van Gogh had earlier suffered two distinct episodes of reactive depression, and there are clearly bipolar aspects to his history. Both episodes of depression were followed by sustained periods of increasingly high energy and enthusiasm, first as an evangelist and then as an artist. The highlights of van Gogh's life and letters are reviewed and discussed in an effort toward better understanding of the complexity of his illness.
Noninvasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two-dimensional echocardiography.
Authors: T Skjaerpe, L Hegrenaes, L Hatle
Journal: Circulation (1985)

In 30 patients with aortic stenosis, 14 of whom also had significant aortic regurgitation, the velocities in the stenotic jet (V') and below the valve (V) were recorded by Doppler ultrasound. With two-dimensional echocardiography, two subvalvular areas (A) were calculated from leading-to-leading edge ("large") and trailing-to-leading edge ("inner") diameter measurements. The aortic valve area was calculated by the equation of continuity (A' = A X peak V/peak V') and by calculating stroke volume below the valve [A X integral of V (t) and dividing by the integral of V' (t) (= A"). Based on cardiac output estimations from single-plane angiographic images, Gorlin's formula was used to calculate invasive valve areas. In patients with no or mild aortic regurgitation a second invasive estimate was based on cardiac output measured by the Fick method. The best correlation was found when A' (with "large" diameter) was compared with invasive results based on cardiac output measured by the Fick method (r = .89, SEE +/- 0.12, n = 16); the worst was found when A" (with "large" diameter) was compared with invasive results based on cardiac output measurements by single-plane angiography (r = .80, SEE +/- 0.20, n = 30). The results indicate that valve area in patients with aortic stenosis can be reliably estimated noninvasively, even in those with significant aortic regurgitation.
NCOA5 Haploinsufficiency Results in Glucose Intolerance and Subsequent Hepatocellular Carcinoma
Authors: Shenglan Gao, Aimin Li, Feiye Liu, Fengsheng Chen, Mark Williams, Chengliang Zhang, Zakiya Kelley, Chin-Lee Wu, Rongcheng Luo, Hua Xiao
Journal: Cancer Cell (2013)
Quantitative Phosphoproteomics Reveals a Cluster of Tyrosine Kinases That Mediates Src Invasive Activity in Advanced Colon Carcinoma Cells
Authors: Cédric Leroy, Camille Fialin, Audrey Sirvent, Valérie Simon, Serge Urbach, Joël Poncet, Bruno Robert, Patrick Jouin, Serge Roche
Journal: Cancer Research (2009)

Abstract The nonreceptor tyrosine kinase Src is frequently overexpressed and/or activated in human colorectal carcinoma (CRC), and its increased activity has been associated with a poor clinical outcome. Src has been implicated in growth and invasion of these cancer cells by still not well-known mechanisms. Here, we addressed Src oncogenic signaling using quantitative phosphoproteomics. Src overexpression increased growth and invasiveness of metastatic SW620 CRC cells. Stable isotope labeling with amino acids in cell culture in combination with liquid chromatography tandem mass spectrometry allowed the identification of 136 proteins which exhibited a significant increase in and/or association with tyrosine phosphorylation upon Src expression. These mainly include signaling, cytoskeleton, and vesicular-associated proteins. Interestingly, Src also phosphorylated a cluster of tyrosine kinases, i.e., the receptors Met and EphA2, the cytoplasmic tyrosine kinase Fak, and pseudo-tyrosine kinase SgK223, which were required for its invasive activity. Similar results were obtained with metastatic Colo205 CRC cells that exhibit high endogenous Src activity. We concluded that Src uses a tyrosine kinases network to promote its invasive activity in CRC and this implicates a reverse signaling via tyrosine kinase receptors. Targeting these tyrosine kinases may be of significant therapeutic value in this cancer. [Cancer Res 2009;69(6):2279–86]
Cellular electrophysiological changes in "round heart disease" of turkeys: a potential basis for dysrhythmias in myopathic ventricles
Authors: S. EINZIG, B. L. S DETLOFF, B. K BORGWARDT, N. A STALEY, G. R NOREN, D. G BENDITT
Journal: Cardiovascular Research (1981)

Arrhythmias are commonly recorded in "round heart disease", a presumed viral, congestive cardiomyopathy of turkeys. To assess whether cellular electrophysiological changes may be associated with arrhythmia susceptibility, we compared transmembrane action potential characteristics in left and right ventricular endocardial muscle fibres from 19 inbred myopathic turkeys with findings in 13 normal control turkeys (age 1 to 74 days). In left ventricular tissue, as a group, action potential duration at 50% repolarisation (APD50) was reduced in myopathic hearts (201 ± 6(SEM) vs 228 ± 9 ms in controls, P <0.01), while the maximum rate of phase 0 (dV/dtmax) action potential amplitude, diastolic resting membrane potential and action potential duration at 90% repolarisation (APD90) did not differ from control turkeys. By contrast, in myopathic right ventricular tissue, as a group, both APD50 (186 ± 5 vs 206 ± 4 ms in controls) and APD90 (208 ± 4 vs 228 ± 3 ms in controls) were shorter (P <0.01). The plateau potential in both right and left ventricular tissue was significantly higher in inbred turkeys. Since a spectrum of cardiac dilatation and hypertrophy is present in myopathic turkeys, we examined the effect of hypertrophy on action potential characteristics. In "round heart disease" turkeys, left ventricular hypertrophy was characterised by reduced dV/dtmax (98 ± vs 274 ± 26 V s−1, P <0.01) and right ventricular hypertrophy by further shortening of both APD50 (174 ± 7 vs 202 ± 6 ms, P <0.01) and APD90 (193 ± vs 224 ± 5 ms, P <0.01), but no change in dV/dtmax (105 ± 13 vs 120 ± 9 V s−1, P = NS). These results indicate that certain electrophysiological differences (eg reduced action potential duration), may, in part, contribute to dysrhythmia susceptibility in this presumed viral cardiomyopathy model.
Gene deletions correlate with the development of alloantibodies in von Willebrand disease.
Authors: B B Shelton-Inloes, F F Chehab, P M Mannucci, A B Federici, J E Sadler
Journal: Journal of Clinical Investigation (1987)

Among all patients with von Willebrand disease (vWD), alloantibodies to von Willebrand factor (vWF) have been described only in severe vWD (type III). The relationship between the development of alloantibodies and the nature of the genetic lesion in vWD is not known. In hemophilia B, large deletions within the factor IX gene appear to correlate with the occurrence of alloantibodies, whereas in hemophilia A no such correlation is apparent. We have studied 19 patients with severe recessive vWD (type III) and 19 with autosomal dominant vWD (type I) by Southern blotting with probes encompassing the full 9 kilobases (kb) of the vWF cDNA. Two apparently unrelated patients were shown to have large deletions within the vWF gene. Both patients had severe vWD (type III) and were the only patients among those studied that had inhibitory alloantibodies to vWF. The extent of deletion was similar in both patients, corresponding to at least the 3'-7.4 kb of the vWF cDNA. The deletion in each patient was estimated to exceed 110 kb. In addition, the localization of the vWF gene to chromosome 12 was confirmed, and a homologous sequence on chromosome 22 was identified.
Influence of cyclic loading on the fracture toughness and load bearing capacities of all-ceramic crowns
Authors: Rao-Rao Wang, Cheng-Lin Lu, Gang Wang, Dong-Sheng Zhang
Journal: International Journal of Oral Science (2013)

The purpose of this study was to investigate how cyclic loading influenced the fracture toughness of hot-press lithium disilicate and zirconia core materials and whether there was an increase in the propensity for crown failure. Two types of all-ceramic crowns including the IPS e.max Press system (n=24) and the Lava zirconia system (n=24), were selected. Sectioned specimens were subjected to cyclic loading with the maximum magnitude of 200 N (R=0.1) until two million cycles. The material properties including Young's modulus (E) and hardness (H) and the fracture toughness (KIC) of the core materials were evaluated using indentation methods (n=12 each). The load-bearing capacities of the specimens were examined by means of monotonic load to fracture (n=12 each). It was found that the material properties, including E, H and KIC, of the two types of dental ceramics, were reduced. Statistical analysis indicated that there were no significant influences of fatigue loading on material properties E and H for both types of dental ceramics or KIC for zirconia, while for the IPS e.max Press core, KIC, which was parallel to the direction of the lithium disilicate crystals, was significantly reduced (P=0.001). A conclusion was drawn that zirconia possesses high mechanical reliability and sustainable capacity to resist fatigue loading, while fatigue loading remarkably degraded the anisotropic mechanical behaviour of hot-press lithium disilicate ceramics. Zirconia-based ceramic crowns are strong, mechanically reliable and resist loading fatigue over time, according to research from China. Crowns made entirely from ceramics are frequently used as tooth replacements, but repeated stresses can cause cracks to propagate and sometimes lead to total failure of the crown. Dong-Sheng Zhang at Shanghai University and co-workers compared the impact of cyclic loading on two leading types of ceramic crown: one is made from hot-press lithium disilicate and the other from zirconia core materials. The researchers subjected the crowns to two million loading cycles of different magnitudes and measured the changes in the crowns' elasticity, hardness and fracture toughness over time. They found that cyclic loading had no significant influence on zirconia crowns, but the lithium-based crowns had a markedly lower load-bearing capacity.
The Toll-like receptor 2 R753Q mutation modifies cytokine production and Toll-like receptor expression in atopic dermatitis
Authors: Salima Mrabet-Dahbi, Alexander H. Dalpke, Margarete Niebuhr, Markus Frey, Christian Draing, Stephanie Brand, Klaus Heeg, Thomas Werfel, Harald Renz
Journal: Journal of Allergy and Clinical Immunology (2008)
Thirteen-year retrospective study of Bowen's disease in Northern Ireland
Authors: D. J. EEDY, ANNA T. GAVIN
Journal: British Journal of Dermatology (1987)

In a retrospective study we measured the incidence of internal malignancy in patients diagnosed as having Bowen's disease, in Northern Ireland, between 1970 and 1983. Data on 157 patients were obtained from hospital notes, death certificates, the Northern Ireland Cancer Registry and the patients' general practitioners. There was a preponderance of females with Bowen's disease with a female to male ratio of 2.8:1. The incidence of internal malignancy was significantly greater in patients with Bowen's disease than that expected for the general population, suggesting that these patients should be screened for occult malignancy. Patients with multiple areas of Bowen's disease did not appear to be more at risk of internal malignancy than those with a single lesion.
Treatment of Gastrointestinal Motility Disorders in Pregnancy
Authors: Alan M. Nichols
Journal: Annals of Internal Medicine (1993)

Letters1 October 1993Treatment of Gastrointestinal Motility Disorders in PregnancyAlan M. Nichols, MDAlan M. Nichols, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-7_Part_1-199310010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Baron and colleagues [1] state that sucralfate (Carafate) appears to be safe (in pregnancy) because none of the drug is absorbed. Although the therapeutic action of the drug is believed to be topical, 0.5% to 2.2% of ingested sucralfate is excreted in the urine. Given that a standard dose of sucralfate is 1 g, even these small percentages result in a significant amount of circulating drug. At the highest ranges, the amount of sucralfate in circulation could exceed the total therapeutic dose of other agents such as famotidine (20 mg). Sucralfate may well be safe in pregnancy, ...References1. Baron TH, Ramirez B, Richter JE. Gastrointestinal motility disorders during pregnancy. Ann Intern Med. 1993; 118:366-75. Google Scholar2. Giesing D, Lanman R, Runser D. Absorption of sucralfate in man (Abstract). Gastroenterology. 1982; 82:1066. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByUse of high-resolution colonic manometry to establish etiology and direct treatment in patients with constipation: Case series with correlation to histologyIsobaric tags for relative and absolute quantification-based proteomic analysis that reveals the roles of progesterone receptor, inflammation, and fibrosis for slow-transit constipation 1 October 1993Volume 119, Issue 7_Part_1Page: 635KeywordsDrugsFamotidineGastrointestinal motility disordersPregnancyUrine Issue Published: 1 October 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
The Machinery of the Brain.
Authors: Shirley A. McMahon
Journal: JAMA (1963)

Electronics and electrical circuitry may have significant application to the natural sciences, particularly the study of nervous mechanisms. To attract the physical scientists' interest and to provide an empirical biological background, Wooldridge has produced this review of brain function, designed for the lay reader, and published in paperback format. In well-organized fashion the book progresses from the neuron and its electrical properties to the complexities of conscious mental processes. Even though the straightforward biological descriptions of these first five chapters are clearly written, and the comparison of nerve structure and function to electronic devices is often apt and enlightening, this first portion is occasionally tiresome. In the ensuing chapters, the book becomes alive. The same lucid style of writing combines with absorbing content. Current knowledge of the brain's higher functions— emotion and consciousness, personality and speech, memory and learning—is expounded. The well-chosen reports of experimental progress illuminate and add color
Website of the week: Searching for the good doctor
Authors: R. E Ashcroft
Journal: BMJ (2002)

Looking on the internet for guidance on what makes a good doctor yields some unexpected results. Readers who can remember the 1970s will be pleased to find a site dedicated to legendary pub rock band Dr Feelgood (www.thegooddoctorfeelgood.com/). Perhaps the band's prescription of “Milk and Alcohol” would be of value for some purposes, but pending the long overdue report from NICE into its clinical effectiveness this cannot be admitted definitively into the pharmacopoeia.

The feelgood approach to defining what makes a doctor good presses “patient centredness” too far. There is more to clinical virtue than doing what most satisfies patients' desires and doing so efficiently. Yet …
Doxorubicin cardiotoxicity. Serial endomyocardial biopsies and systolic time intervals
Authors: M. A. Friedman
Journal: JAMA (1978)

Doxorubicin, whose dose-limiting toxicity is cardiomyopathy, was given to four cancer patients. Endomyocardial biopsy specimens and test results of cardiac function were obtained before, during, and after treatment. The biopsy specimens were examined by light and electron microscopy and were graded blindly. Evidence of specific doxorubicin injury was found in 3/4 patients with as little as 180 mg/sq m of the drug and became progressively more severe with higher doses. All test results of cardiac function, including systolic time intervals, remained normal. These data suggest that a specific, progressive subclinical injury to the heart occurs with doxorubicin therapy, which cannot be reliably detected by routine tests. This potential risk must be taken into account with the use of doxorubicin, especially when combined with synergistic agents. (<i>JAMA</i>240:1603-1606, 1978)