tbuckley/cabot-search huggingface dataset:
Studies in Vitamin B Deficiency
Authors: A. G. Clarke, F. Prescott
Journal: BMJ (1943)

Clinical descriptions of the results of a deficiency of mem- bers of the vitamin B complex are common in American published work but scanty in the medical literature of this country.Cheilosis due to riboflavin (vitamin B2, lacto- flavin) deficiency has been described in England by Wilson (1942) and Duckworth (1942); and Deeny (1942) has reported on 16 cases of pellagra in Northern Ireland, where, he says, mild forms of the disease are relatively common and usually pass unrecognized, the patient being diagnosed as suffering from neurasthenia, dyspepsia, or eczema.Studies of pellagra in England between 1934 and 1939 were made by Davies and McGregor (1939), who reviewed 16 cases.Since submitting this paper for publication Hardwick (1943) has described pellagra asso- ciated with chronic psychosis in 10 patients in an English mental hospital.Egafna et al. (1942) and Johnson et al. (1942) have described the effects on human volunteers of experimental diets deficient in the vitamin B complex.These include easy fatigue, loss of ambition and efficiency, poor appetite, insomnia, constipation, muscle pains, and slight anaemia in persons in sedentary occupations.The literature on the clinical manifestations resulting from a deficiency of the B group of vitamins has been reviewed by Bicknell and Prescott (1942). Psychoneurosis and Dietary DeficiencyWe have recently seen 17 cases of vitamin B complex de- ficiency in patients treated primarily for nervous disorders.This represents 2% of the patients seen by us in the out- patient department of the West End Hospital for Nervous Diseases.Originally they were mostly classified as suffering from functional nervous disorder, and with one exception were women.The parallelism' between the manifestations of a de- ficiency of the vitamin B complex and those of psychoneurosis is seen from the following list.All are likely to be met with in the psychoneurotic; those in italics may result from a deficiency of the vitamin B complex.
Treatment of Burns With Intensive Antibiotic Therapy and Exposure
Authors: George E. Collentine
Journal: JAMA (1967)

Five hundred patients were treated with intensive parenteral and local administration of antibiotics and with maximum exposure. Analysis of the mortality among this group of patients was performed by the probit method. Comparison of this mortality with that obtained at burn centers that used other methods of treatment suggests that intensive prophylactic antibiotic therapy may have merit in the treatment of severe burns.
A Neurochemical Mechanism for Exceptional Achievement in Gout
Authors: Norman Sher
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Gout is a disease noted to have a "unique place in social and political history. It stands as the one medical disorder in which a biochemical abnormality seems to be associated with exceptional achievement."<sup>1</sup>The achievement can be in a variety of fields. Among the sufferers from gout are Alexander the Great, Martin Luther, Leonardo da Vinci, Isaac Newton, Goethe, and Benjamin Franklin. Hitherto, the association of gout with wide-ranging achievement has remained unexplained. Gout is a disorder of purine metabolism associated with hyperuricemia. The uric acid elevation may be due to decreased renal excretion or increased purine synthesis, with formation of increased amounts of the precursors of uric acid. Among these precursors are inosine, adenosine, guanosine, and hypoxanthine. Progress in psychopharmacology in the past few decades has brought us the advent of antianxiety pharmaceutical agents. Among the most used of these are the benzodiazepines, particularly
Campbell's Urology
Authors: Frank Hinman
Journal: JAMA (1992)

Each new edition of this classic work lets us increase our knowledge of urology and bring it up to date. With editors from the several important fields within urology and a host of experts, 90 in all, the work is bound to be authoritative and exhaustive. Each volume has over 1000 pages, starting with anatomy, physiology, and (new) genetics. Pathophysiology is adequately covered for what is basically a book for clinically oriented users. Advances in the fields of neurourology, sexual function, and infertility are presented authoritatively. A complete section on urologic surgery in childhood is found, in addition to almost an entire volume on established surgical procedures in adults. In this part, the principles of the operations are described, and, although the number and quality of the illustrations vary from operation to operation, the reader can easily follow the essential steps. New techniques, such as endoscopy, ultrasonography, laser applications, and
Strongyloides stercoralis infection
Authors: D. Greaves, S. Coggle, C. Pollard, S. H. Aliyu, E. M. Moore
Journal: BMJ (2013)

#### Summary points

Strongyloides stercoralis is an intestinal helminth that infects humans through contact with soil containing the larvae. Between 30 and 100 million people are infected worldwide.1 In the United Kingdom, strongyloidiasis is seen predominantly in migrants and returning travellers from endemic areas in the tropics and subtropics. Strongyloidiasis may present with cutaneous or gastrointestinal symptoms but is asymptomatic in over 60% of cases and only indicated by a raised blood eosinophil count.2 Diagnosis is important as the infection may persist for decades.3 Immunosuppressed patients with chronic strongyloidiasis are at high risk of developing strongyloides hyperinfection syndrome, a life threatening complication whereby larval proliferation leads to systemic sepsis and multiorgan failure. If strongyloidiasis is diagnosed early, however, it is easily treatable with oral antihelmintic drugs. In this article we review the epidemiology and common symptoms of strongyloidiasis and strongyloides hyperinfection syndrome, discuss the appropriate investigations, and summarise the evidence on treatment.

#### Sources and selection criteria

We performed a search of PubMed using the search term “ Strongyloides stercoralis ”, and included English language studies only. There is a paucity of randomised controlled trails investigating the treatment of strongyloides infection, and no Cochrane reviews have been published. Likewise there are no national or globally recognised guidelines for the investigation …
THE SIGNIFICANCE AND TREATMENT OF SCIATIC PAIN
Authors: WINCHELL McK. CRAIG
Journal: JAMA (1933)

Sciatica, or more properly sciatic pain, has always been of importance clinically not only because of its prevalence and its resistance to treatment but because it may be a symptom of so many disease entities. The treatment of sciatic pain of uncertain origin has been complicated by the search for a single therapeutic procedure of sufficient potency to produce immediate and complete relief in all cases. Apparently such a procedure has been difficult to find, for of the various types of treatment reported in the literature not one has had universal success. After analyzing the different methods of treatment for sciatica at the Mayo Clinic, it is evident that the different procedures can be combined into two methods, the ambulant and the institutional, with satisfactory results in a fairly high percentage of cases. Cooperation of orthopedists, neurologists and neurosurgeons has made it possible to correlate the results, and we are
Framing a Clinical Trial.
Authors: Harvey J. Dworken
Journal: Annals of Internal Medicine (1966)

s1 May 1966Framing a Clinical Trial.Harvey J. Dworken, M.D., F.A.C.P., Vaun Newill, M.D.Harvey J. Dworken, M.D., F.A.C.P.Search for more papers by this author, Vaun Newill, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-5-1184_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn evaluating responses of patients to drug and therapeutic programs, most investigators recognize that adequate controls, avoidance of bias, and tests of statistical significance are essential to the validity of the study. Despite this, poorly designed studies are still being reported largely because many physicians do not understand the planning techniques. Pharmaceutical houses often use these results in journal advertising, thereby perpetrating possibly faulty conclusions.It is the purpose of this presentation to show how a study was designed to compare the effects of a belladonna-amobarbital combination with a dummy preparation in the short-term therapy of patients with the irritable... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland, Ohio PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1966Volume 64, Issue 5Page: 1184-1184KeywordsClinical trialsDrug regulationDrug therapyDrugs Issue Published: 1 May 1966 PDF DownloadLoading ...
Response to Oligosaccharide-Protein Conjugate Vaccine against<i>Hemophilus influenzae</i>b in Two Patients with IgG<sub>2</sub>Deficiency Unresponsive to Capsular Polysaccharide Vaccine
Authors: Richard A. Insel, Porter W. Anderson
Journal: New England Journal of Medicine (1986)

In healthy persons IgG antibodies to polysaccharides are predominantly of the IgG2 subclass.1 2 3 Selective deficiency of this subclass is associated with inability to produce antibodies to bacterial capsular polysaccharides, which confer protective immunity to encapsulated bacteria. However, the basis of the relation between antibody responses to capsular polysaccharide and the IgG2 subclass has not been defined. Some insight into that mechanism is offered by the present study of two children with selective IgG2 deficiency and a documented lack of antibody response to immunization with the capsular polysaccharide vaccine of Hemophilus influenzae b. Both patients were subsequently immunized . . .
Myocardial relaxation: effects of preload on the time course of isovolumetric relaxation.
Authors: W H Gaasch, J D Carroll, A S Blaustein, O H Bing
Journal: Circulation (1986)

We studied the effect of an isolated increase in preload on isovolumetric relaxation in the intact dog heart and isometric relaxation in isolated cardiac muscle (dog and rat) preparations. In eight anesthetized dogs, 8 to 12 ml of blood was infused into the left ventricle during a single diastole. The exponential time constant (T) of isovolumetric relaxation was measured in single-beat experiments in which the left ventricular systolic pressure increased (112 +/- 2 to 128 +/- 3 mm Hg; p less than .05, n = 62). In a second series of experiments, left ventricular systolic pressure was held constant (109 +/- 2 to 107 +/- 2 mm Hg; p = NS, n = 23) by simultaneous ventricular infusion and aortic unloading. In the first protocol, T increased from 28.0 +/- 0.4 to 30.7 +/- 0.4 msec (p less than .05), whereas in the second protocol (constant systolic pressure) there was no change in T. The time course of isometric relaxation was also studied in six rat left ventricular papillary muscles and four dog right ventricular trabecular muscles. Preload was varied from 30% to 100% of the peak of the isometric length-tension curve in each muscle. Over this wide range of preload, the isometric force decline recordings were superimposable as long as the comparisons were made at equal levels of total load. Thus an isolated increase in preload does not influence the time course of isovolumetric relaxation.
Reed Elsevier and the international arms trade
Authors: Gene Feder, Jon E Rohde, Miguel San Sebastian, Urban Janlert, Masamine Jimba, Enrico Materia, Anna-Karin Hurtig, Stephen Goldin, Tom Stafford, Berit Edvardsson, Bjorn Hilt, Stuart Parkinson, Marion Birch, Anna Jones, Kathy Archibald, John O Pastore
Journal: The Lancet (2005)
Newton's colour circle and Palmer's “normal” colour space
Authors: Gábor A. Zemplén
Journal: Behavioral and Brain Sciences (2004)

Taking the real Newtonian colour circle – and not the one Palmer depicts as Newton's – we don't have to wait 300 years for Palmer to say no to the Lockean aperçu about the inverted spectrum. One of the aims of this historical detour is to show that one's commitment about the “topology” of the colour space greatly affects Palmer's argument.
A memorable patient: The gentleman crook
Authors: J. Horder
Journal: BMJ (1998)

Not long before the great London smog in 1952, I was called one winter evening to a house in Camden Town, to a new patient. The door was opened by an old lady, who said nothing, but pointed to an upstairs room. There was no light in the room, but I could see a bed and a prone figure in it. This was an old man, complaining of chest pain. He was a lodger in the house and said that he ran a mission for children near King's Cross. Examining him in the dark, I heard a pericardial rub (for the only time …
Mental health services for children.
Authors: C. Ni Bhrolchain
Journal: BMJ (1992)

haematology results.Such a comparison may be invalid because of the differing viscosities of blood and semen.Unfortunately, white cell pipettes were commonly used for diluting semen specimens for counting in haemocytometers until the 1960s.Eliasson attributed imprecision in sperm concen- tration determinations to the use of white cell pipettes.4Consequently we must conclude that grounds do exist for suspecting a significant bias to methodological error during the period under consideration.The importance of a possible secular trend in methodological error is apparent when one con- siders that the apparent differences in sperm concentration were found in studies before 1961 and after 1961, as shown in figure 2 in the paper.'Differences were not apparent from 1961 to 1991.Early studies comprised 16% of reports and 1 1% of subjects.The authors are urged to establish that their comparison of historical data is free of method- ological bias; perhaps a more cohesive set (or subset) in which comparable techniques were used could be considered.Can we conclude that there is or is not a genuine decline in sperm counts?Unfortunately, comparison of historical and contemporary methods may not be reliable.The greenhouse effect, global warming, declining sperm counts-all may be true; we just do not know.
Delusions of grandeur and the "manic" preacher
Authors: I. M Ali
Journal: BMJ (2009)

Len already had a 10 year history of bipolar affective disorder when he was admitted with a manic episode. The psychiatrist recorded numerous grandiose delusions: he claimed to hold world records associated with lying on a bed of nails and believed that he held black belts in several martial arts, managed a construction company, was a reverend, and had appeared on television.

After treatment, …
Comparison of intraduodenal and intravenous administration of amino acids on gastric secretion in healthy subjects and patients with duodenal ulcer.
Authors: S J Konturek, N Kwiecien, W Obtulowicz, E Mikos, E Sito, J Oleksy
Journal: Gut (1978)

Case Report: We herein report a case of local recurrence of breast cancer with squamous metaplasia and obvious intratumoral and intertumoral heterogeneity. A 39-year-old female patient was diagnosed with T3N2M0 stage IIIB right breast cancer and underwent right total mastectomy and axillar lymph node dissection. At four years after surgery, she became aware of chest wall pain and diagnostic imaging revealed recurrence in the lung, right thoracic wall and sternum. The recurrent lesions remained stable for 18 months with endocrine therapy. Thereafter, the lesion in the right thoracic wall suddenly became enlarged. Moreover, liver metastasis was confirmed on FDG-PET/CT. She underwent right thoracic wall tumor resection. A biopsy was simultaneously performed to obtain a specimen from the site of liver metastasis. Postoperatively, the right chest wall mass showed obvious intratumoral heterogeneity; squamous differentiation with aggressive features and a papillotubular component similar to the primary tumor. The metastatic liver tumor showed similar pathological features to the primary tumor. Conclusion: Intratumoral and intertumoral heterogeneity within primary tumors and associated metastatic sites may contribute to treatment failure and drug resistance.
Avulsion fracture of the medical epicondyle of the elbow in a young javelin thrower.
Authors: D. W. Haw
Journal: British Journal of Sports Medicine (1981)

A 14 year old boy developed pain in his right elbow after throwing the javelin. He was inexperienced and threw the javelin side arm. His main complaint was pain and limitation of movement. He was referred to the Casualty Department where an X-Ray was taken which showed an avulsion fracture of part of the medial epicondyle (Fig. 1). He was then seen in the routine fracture clinic two days later where the elbow was seen to be stiff and he was told to rest it in a sling. Two weeks later the pain had subsided and the patient was discharged with a full range of movement.
Serial Changes in Highly Sensitive Troponin I Assay and Early Diagnosis of Myocardial Infarction
Authors: Till Keller, Tanja Zeller, Francisco Ojeda, Stergios Tzikas, Lars Lillpopp, Christoph Sinning, Philipp Wild, Sabine Genth-Zotz, Ascan Warnholtz, Evangelos Giannitsis, Martin Möckel, Christoph Bickel, Dirk Peetz, Karl Lackner, Stephan Baldus, Thomas Münzel, Stefan Blankenberg
Journal: JAMA (2011)

<h3>Context</h3>Introduction of highly sensitive troponin assays into clinical practice has substantially improved the evaluation of patients with chest pain.<h3>Objective</h3>To evaluate the diagnostic performance of a highly sensitive troponin I (hsTnI) assay compared with a contemporary troponin I (cTnI) assay and their serial changes in the diagnosis of acute myocardial infarction (AMI).<h3>Design, Setting, and Patients</h3>A total of 1818 patients with suspected acute coronary syndrome were consecutively enrolled at the chest pain units of the University Heart Center Hamburg, the University Medical Center Mainz, and the Federal Armed Forces Hospital Koblenz, all in Germany, from 2007 to 2008. Twelve biomarkers including hsTnI (level of detection, 3.4 pg/mL) and cTnI (level of detection, 10 pg/mL) were measured on admission and after 3 and 6 hours.<h3>Main Outcome Measures</h3>Diagnostic performance for AMI of baseline and serial changes in hsTnI and cTnI results at 3 hours after admission to the emergency department.<h3>Results</h3>Of the 1818 patients, 413 (22.7%) were diagnosed as having AMI. For discrimination of AMI, the area under the receiver operating characteristic (ROC) curve was 0.96 (95% CI, 0.95-0.97) for hsTnI on admission and 0.92 (95% CI, 0.90-0.94) for cTnI on admission. Both were superior to the other evaluated diagnostic biomarkers. The use of hsTnI at admission (with the diagnostic cutoff value at the 99th percentile of 30 pg/mL) had a sensitivity of 82.3% and a negative predictive value (for ruling out AMI) of 94.7%. The use of cTnI (with the diagnostic cutoff value at the 99th percentile of 32 pg/mL) at admission had a sensitivity of 79.4% and a negative predictive value of 94.0%. Using levels obtained at 3 hours after admission, the sensitivity was 98.2% and the negative predictive value was 99.4% for both hsTnI and cTnI assays. Combining the 99th percentile cutoff at admission with the serial change in troponin concentration within 3 hours, the positive predictive value (for ruling in AMI) for hsTnI increased from 75.1% at admission to 95.8% after 3 hours, and for cTnI increased from 80.9% at admission to 96.1% after 3 hours.<h3>Conclusions</h3>Among patients with suspected acute coronary syndrome, hsTnI or cTnI determination 3 hours after admission may facilitate early rule-out of AMI. A serial change in hsTnI or cTnI levels from admission (using the 99th percentile diagnostic cutoff value) to 3 hours after admission may facilitate an early diagnosis of AMI.
Volume regulation in the bovine lens and cataract. The involvement of chloride channels.
Authors: J J Zhang, T J Jacob
Journal: Journal of Clinical Investigation (1996)

The purpose of this study was to investigate volume regulation in the lens and its involvement in lens opacification (cataract) and the role of chloride channels in these processes. Single, isolated lens fiber cells from the lens were whole cell patch clamped. When exposed to hypotonic solution, and outwardly rectifying whole-cell current was activated. The current increased from 1.0 to 32.6 pA/pF, reversed at the chloride reversal potential (Ec1 = O mV), and was blocked by the chloride channel blockers 5, nitro-2-(3-phenylpropylamino) benzoate (NPPB) and tamoxifen. Replacing all but 5mM of the external chloride with gluconate caused the reversal potential to shift +33 mV, consistent with a CL- current with a gluconate/chloride permeability ratio of 0.26. When the whole lens of the eye was exposed to hypotonic solution, there was an initial increase in anterior-posterior diameter (5-8 min), representing lens swelling of 6.5%. This was followed by a decrease in volume to a new steady state value that lasted for up to 2 h. In the longer term (> or = 2h), the lenses began to swell again. The simultaneous exposure to hypotonic solution and tamoxifen or NPPB caused swelling and prevented this volume regulation. Lenses incubated in hypotonic solution and hypotonic solution containing tamoxifen becane ipaque after a 2-h incubation period. We conclude that the lens is able to volume regulate. It possesses volume-activated Cl- channels, the inhibition of which results in inhibition of volume regulation, lens swelling and opacification. Our data suggest the long-term prophylactic use of tamoxifen may make the patient more susceptible to cataract.
Studies on Aldosterone Secretion in Man
Authors: G. W. Thorn, E. J. Ross, J. Crabbe, W. V. Hoff
Journal: BMJ (1957)

Interest in the relation of adrenal cortical function to sodium metabolism was stimulated in 1933 by the studies of Loeb, Atchley, Benedict, and Leland, who described the excessive urinary sodium loss in adrenalectomized dogs, and by similar observations of Harrop, Soffer, Ellsworth, and Trescher (1933), who further suggested that one of the functions of the adrenal cortex was to assist the organism to preserve adequate volume and electrolyte composition within the extracellular compartment.Three years later Harrop, Nicholson, and Strauss (1936) reported that adrenal cortical extracts were capable of inducing sodium retention in dogs, and Thorn, Garbutt, Hitchcock, and Hartman (1936) demon- strated similar effects in normal human subjects as well as in patients with Addison's disease.In 1937 Steiger and Reichstein announced the synthesis of 11-deoxycorticosterone (deoxycortone) acetate.The effectiveness of this substance in correcting the abnor- malities of mineral metabolism in patients with Addison's disease was described by Thorn, Howard, and Emerson in 1939.Although synthetic deoxycortone acetate proved very effective as replacement therapy in such patients, there was no indication that this com- pound was secreted under normal circumstances until the recent findings of Farrell, Rauschkolb, Royce, and Hirschmann (1954), who were able to isolate and identify deoxycortone in the adrenal venous blood of the dog.However, the quantity found in these experiments appeared to be too small to account for any conspicuous biological action.That the " amorphous fraction " of adrenal extracts contained a substance or substances of high sodium- retaining activity was suggested by Kendall in 1937, and indeed Hartman, Spoor, and Lewis (1939) postulated the existence of an adrenal " sodium factor " different from the life-maintaining fractions of the adrenal cortical extracts available at that time for clinical use, and possessing sodium-retaining activity greater than that of deoxycortone.