tbuckley/cabot-search huggingface dataset:
Thyroid Remnant Radioiodine Ablation in a Case of Concurrent Thyroid Carcinoma, Graves' Disease, and Thyroid Ophthalmopathy
Authors: Robert Mansberg
Journal: Clinical Nuclear Medicine (2007)

High-dose I-131 thyroid remnant ablation postthyroidectomy for differentiated thyroid carcinoma is beneficial but the risk of visual complications including loss of vision in patients with coexisting Graves' ophthalmopathy is not well documented. We report the case of a 42-year-old man who presented for radioiodine ablation post total thyroidectomy for metastatic papillary carcinoma, who also had Graves' ophthalmopathy and juvenile onset glaucoma. Concurrent presence of all these conditions in the same patient is rarely encountered and this case demonstrates the challenge faced by the clinicians in balancing the benefits and risks of currently recommended management strategies for these conditions. There is a potential risk of visual complications with I-131 therapy in patients with Graves' disease as it can lead to development of or exacerbation of preexisting ophthalmopathy. The acute exacerbation is usually transient and preventable with prophylactic corticosteroids. However, the use of corticosteroids is associated with various complications including exacerbation of glaucoma as demonstrated in this patient.
Skin Lesions Associated With Disseminated Candidiasis
Authors: Gerald P. Bodey
Journal: JAMA (1974)

Characteristic macronodular skin lesions developed in ten patients with disseminated candidiasis. These lesions were present in 13% of patients with this infection. Skin biopsy specimens were obtained from seven of the ten patients and the diagnosis was established in all.<i>Candida</i>organisms were cultured from four of six aspirates from skin lesions. The organism was cultured from the blood of nine patients. Hence, although these skin lesions should assist in establishing the diagnosis of disseminated candidiasis, they are seldom present in patients who do not have readily detectable septicemia. (<i>JAMA</i>229:1466-1468, 1974)
Should NHS mental health services fear the private sector? Yes
Authors: A. M. Pollock
Journal: BMJ (2010)

The coalition government wants to open up the market in the NHS. <b>Allyson Pollock </b> thinks this will result in an impoverished and inequitable service but <b>Elaine Murphy</b> and <b>Philip Sugarman (</b>doi:10.1136/bmj.c5385) believe mental health services have much to gain
Evaluation in Continuing Medical Education
Authors: Stephen Abrahamson
Journal: JAMA (1968)

So many words have been written and so many more have been uttered on this topic that an enormous difficulty is presented to anyone invited to prepare a paper. Evaluation has been defined, described, decried, and defended. The lack of evaluation has been bemoaned, bewailed, and bemused. The need for evaluation has been expressed, exhorted, and extolled. Approaches to evaluation have been proposed, proclaimed, and provided. All in all, one wonders how so much effort can have brought about so little effect. Perhaps that last statement is too harsh; in our interest in the well-turned phrase, we often tend to exaggerate. Indeed, there is every indication that the need for evaluation is now widely accepted. There is no question that evaluative approaches and techniques have become more sophisticated over recent years. There is no question that there is a greater understanding of evaluation as a concept and a process. There
Re: Axel Heidenreich, David Thüer, Sergej Polyakov. Postchemotherapy Retroperitoneal Lymph Node Dissection in Advanced Germ Cell Tumours of the Testis. Eur Urol 2008;53:260–74
Authors: Yvonne Vergouwe, Ewout W. Steyerberg
Journal: European Urology (2008)
Counting calories--caveat emptor
Authors: D. B. Allison
Journal: JAMA (1993)

To determine the accuracy of caloric labeling of "diet" and "health" foods and whether the accuracy differs for certain categories of food suppliers.Survey; "diet" and "health" foods were analyzed via bomb calorimetry and categorized as regionally distributed, nationally advertised, or locally prepared.Foods were sampled from retail merchants throughout the borough of Manhattan, New York, NY.A convenience sample of 40 food items including regionally distributed (n = 12), nationally advertised (n = 20), and locally prepared items (n = 8).Number of kilocalories per item and number of kilocalories per gram.All locally prepared foods had more actual than labeled kilocalories. The mean percentage of actual kilocalories greater than the labeled kilocalories (mean percentage over label) per item was 85.42% (SD = 77.88%; P = .01). Regionally distributed foods had significantly more kilocalories than were reported (P = .001 for kilocalories per item, P = .02 for kilocalories per gram) and mean percentage over label per item was 25.22% (SD = 15.58%) and per gram was 14.97% (SD = 17.95%). Nationally advertised foods did not have significantly more actual than reported kilocalories (P = .37 for per item, P = .78 for per gram). Mean percentage over label per gram was -0.01% (SD = 9.13%) and per item was 2.18% (SD = 13.93%).These findings suggest that food labels may be inadequate sources for caloric monitoring. Health care professionals should consider the accuracy of caloric labeling when advising patients to use food labels to help monitor their caloric intake.
500 Viral resistance occurs very commonly during long-term adefovir therapy in lamivudine-resistant patients with genotype C hepatitis B virus
Authors: Y.-S. Lee, Y.-H. Chung, J.A. Kim, M.H. Choi, S.H. Ryu, S.W. Jung, D.D. Suh, H.J. Min, M.K. Jang, S.H. Kim, K.M. Kim, V.S. Lim, Y.S. Lee, D.J. Suh
Journal: Journal of Hepatology (2006)
Abstract 1302: Delayed elimination of SN-38 and prolonged neutropenia in cancer patients with severe renal failure requiring dialysis who receive irinotecan
Authors: Ken-Ichi Fujita, Yu Sunakawa, Keisuke Miwa, Yuko Akiyama, Minako Sugiyama, Kaori Kawara, Hiroo Ishida, Keishi Yamashita, Keiko Mizuno, Shigehira Saji, Wataru Ichikawa, Wataru Yamamoto, Fumio Nagashima, Toshimichi Miya, Masaru Narabayashi, Yuichi Ando, Takashi Hirose, Yasutsuna Sasaki
Journal: Cancer Research (2011)

Abstract Purpose: We prospectively examined the effects of severe renal failure on the pharmacokinetics and toxicity of irinotecan. Experimental Design: The pharmacokinetics of irinotecan, SN-38 and SN-38 glucuronide (SN-38G), and irinotecan-induced toxicity in 3 cancer patients with severe renal failure (creatinine clearance [Ccr] ≤20 mL/min) who were undergoing dialysis and received 100 mg/m2 irinotecan as monotherapy were compared with those in 5 cancer patients with normal renal function (Ccr ≥60 mL/min). To ensure that the subjects had similar genetic backgrounds of UDP-glucuronosyltransferase (UGT) 1A1, patients with UGT1A1*1/*1, *1/*6, or *1/*28 were enrolled. Results: The estimated terminal elimination rate constant of SN-38 in patients undergoing dialysis was about one tenth that in patients with normal renal function (P=0.025). Consequently, the estimated t1/2 of SN-38 in patients with severe renal failure was roughly 10 times longer than that in patients without renal failure (P=0.025). About 50% of SN-38 was dialyzed with a 2.1-m2 dialysis membrane, whereas 27% was dialyzed with a 1.5-m2 membrane. All patients with severe renal failure experienced neutropenia (grade 2, 3 or 4 at nadir). In two of them experienced grade 2 or 3 neutropenia, the second irinotecan infusion was delayed 10 or 20 days by the prolonged neutropenia. Conclusions: Our results showed that the elimination of SN-38 was significantly delayed in patients with severe renal failure as compared with patients with normal renal function. We demonstrated SN-38 was partly dialyzed. The prolonged neutropenia was seen in patients with severe renal failure. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1302. doi:10.1158/1538-7445.AM2011-1302
A NOTE ON THE "MAN VALUE" OF WORKING CLASS DIETS
Authors: M. Greenwood, C. M. Thompson
Journal: BMJ (1918)

tHE "' man values " of diets consumed by various samples of working-class families were published in a recent report by one of us and Viscount Dunluce.1 The reduction to "-man values " was effected by the application of the co- efficients used in America, and provisionally adopted by the Food Committee of the Royal Society.It was, how- -ever, pointed out. in an appendix to the report (op.cit., pp.40-41) that the only direct measurements of consump- tion available to us, those of Slosse and Waxweiler, sug- goted that the consuming power of children was seriously .underestimated,and consequently the "man value " of "4'4 family diet overestimated, by the orthodox metlhod of calculation.Further evidence has now been accumulated, and the results of Lusk and others make it probable that the;indicationsafforded by Slosse and Waxweiler's measurements are correct.The Inter-Allied Food Commission has Appordingly adopted a new standard (Table 1).The change in: the coefficient for women from 0.80 to 0.83-that is, of.3.75 per cent.-causesall the estimated man values of TABLE I. Attwater's Coefficients.New Coefflicients.
Coxsackievirus A6–Induced Hand-Foot-Mouth Disease
Authors: Campbell L. Stewart, Emily Y. Chu, Camille E. Introcaso, Andras Schaffer, William D. James
Journal: JAMA Dermatology (2013)

<h3>Importance</h3> Hand-foot-mouth disease (HFMD) is an acute, self-limited, highly contagious viral illness that commonly affects children younger than 5 years. It is most typically caused by enterovirus 71 or coxsackievirus A16 and results in asymptomatic infection or mild disease. Immunocompetent adults are rarely affected. Recently, there have been increasing reports of a more severe form of HFMD associated with fevers, joint pains, and widespread painful eruptions. Some of these patients required hospitalization for supportive care. These severe cases were most commonly caused by coxsackievirus A6. <h3>Observations</h3> We describe a 37-year-old white man with widespread, crusted, pruritic papules on the scalp, ears, and face and a purpuric and targetoid painful vesicular eruption on his hands and feet, with associated fevers, neurologic symptoms, and arthritis, who required hospitalization for supportive care. His infection with coxsackievirus A6 was confirmed based on polymerase chain reaction from his oral mucosa and cutaneous vesicle fluid. <h3>Conclusions and Relevance</h3> Dermatologists should be familiar with the severe variant of HFMD caused by coxsackievirus A6, include it in their differential diagnosis of acute febrile blistering diseases, and be aware that certain patients may require hospitalization.
Ventricular Tachycardia Associated With Non-Freon Aerosol Propellants-Reply
Authors: Suman Wason
Journal: JAMA (1987)

A previously well 2-year-old child presented with seizures and ventricular tachycardia shortly after playing with an aerosol can of a well-known proprietary deodorant. She required intensive care and survived without sequelae. The propellants used in this product were isobutane, n-butane, and propane. The propellants have been thought to be safer than the previously used Freons, which were known to be cardiotoxic and neurotoxic. Significant exposure was confirmed by the detection of n-butane and isobutane in the patient's serum. We conclude that unintentional exposure to non-Freon aerosol propellants in a nonconfined space can be hazardous to children. Aerosol cans should be considered to represent toxic hazards and should be kept out of reach of children.
Spontaneous hypoglycemia in diabetic patients with renal insuff- iciency
Authors: M. B. Block
Journal: JAMA (1970)

We have observed three patients with diabetes mellitus, in whom renal insufficiency was associated with decreased requirements for exogenous insulin or hypoglycemic agents given orally. All three patients, while being managed on dietary therapy alone, became hypoglycemic during periods of decreased food intake. Studies on one subject demonstrated low serum insulin, elevated growth hormone, and normal cortisol levels. It seems probable that impaired hepatic glycogenolysis, glyconeogenesis, or both are responsible for this syndrome.
A lack of secretory leukocyte protease inhibitor (SLPI) causes defects in granulocytic differentiation
Authors: Olga Klimenkova, Wienke Ellerbeck, Maksim Klimiankou, Murat Ünalan, Siarhei Kandabarau, Anna Gigina, Kais Hussein, Cornelia Zeidler, Karl Welte, Julia Skokowa
Journal: Blood (2013)
ENURESIS IN CHILDHOOD.
Authors: J. P. Crozer Griffith
Journal: JAMA (1904)

Experience has taught that incontinence of urine, while not uncommon in adults, in women especially, is constantly noted in institutions for the treatment of children. During the past five years at the children's dispensary, University Hospital, we have found 85 cases of enuresis among 1,657 new patients treated, one out of almost every twenty children manifesting this condition, about 5 per cent. These figures tend to corroborate the statement made by Townsend<sup>1</sup>that, when the families of children applying for treatment at the Children's Hospital, Boston, were questioned, 21.5 per cent. of all children were found to have or to have had enuresis. Out of 1,500 children, however, he found but 25 with incontinence of urine, about 1.6 per cent. while Adams<sup>2</sup>reported 55 cases out of 19,261 children, about .25 per cent. It is probable that more of the children whom we saw suffered from enuresis, although the
Inconsistency and Institutional Review Boards
Authors: Jerry Goldman, Martin D. Katz
Journal: JAMA (1982)

To assess the adequacy of peer review for research on human subjects, identical research protocols in oncology and anesthesiology were submitted to 32 institutional review boards (IRBs) at major universities with medical colleges. Each of the protocols posed serious ethical issues, contained flaws in scientific design, and provided an incomplete consent form. Twenty-two IRBs participated in the investigation, which revealed (1) consistency in the nonapproval of the three protocols, (2) substantial inconsistency among IRBs in the reasons offered in support of similar decisions, and (3) substantial inconsistency in the application of ethical, methodological, and informed-consent standards for individual review boards. This evidence suggests that revision of the protocols to satisfy particular objections would result in approval of flawed investigations.The results of an investigation of institutional review board (IRB) decision making are reported. The inconsistencies found in the 22 IRBs evaluated are explored. Summaries are included of their decisions and objections to three test protocols submitted for evaluation. Ethical, methodological, and informed consent objections are detailed. The authors question the adequacy of IRB decision making and suggest that a new approach to the review process may be in order.
EXPERIMENTS ON THE PRODUCTION OF WASSERMANN REAGINS BY MEANS OF TRYPANOSOMES
Authors: K. Landsteiner, J. van der Scheer
Journal: The Journal of Experimental Medicine (1927)

Since it is known that positive Wassermann reactions prevail in trypanosomiasis of rabbits, similar to those in syphilis, trypanosomes were used for an inquiry into the cause of this reaction. Injections with dead trypanosomes into rabbits proved that these microbes are highly active antigens and suffice in themselves to produce strongly positive Wassermann sera, in analogy to the findings reported by F. Klopstock with Spirochaeta pallida. Although a number of questions require further study, yet it seems likely that this antigenic activity of the microbes or their products plays a part in the production of the Wassermann reagins in infections with spirochetes and trypanosomes.
Survey Adds Evidence That Office Visits Indicate 'Just Tip of the Iceberg' of Medical Problems
Authors: Chris Anne Raymond
Journal: JAMA (1988)

PATIENTS OFTEN HEAL themselves, a survey of daily symptoms of illness and their treatment indicates. This could be good news for cost-containment advocates, and it speaks well for the ability of people to apply common sense to bothersome but not life-threatening illness. The survey provides perhaps one of the most detailed pictures yet of how often and in what ways people respond to the misery of runny noses, aching heads, and stiff joints, information that may become increasingly important in a time in which more attention is being paid to the quality of life as well as its duration. And it calls into question some long-standing stereotypes of who seeks medical care most often and why. Known as the Health in Detroit Study, the survey is a random sample of white adults 18 years of age and older. A total of 714 persons were interviewed about past and current health
HIGH SENSITIVITY CARDIAC TROPONIN I AS A DIAGNOSTIC TOOL FOR THE PRESENCE OF CORONARY ARTERY DISEASE IN STABLE DIABETIC PATIENTS
Authors: Alexandre Segre, Whady Hueb, Marilía O. Sprandel, Antonio Casella-Filho, Desiderio Favarato, Celia Strunz, Laura Ventura, Ana Carvalho, Raul C. Maranhão, José Ramires, Roberto Kalil-Filho
Journal: Journal of the American College of Cardiology (2014)
Effect of Supine Posture on Respiratory Mechanics in Chronic Left Ventricular Failure
Authors: JANE C. H. YAP, DAVID M. MOORE, JOHN G. F. CLELAND, NEIL B. PRIDE
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

The mechanisms of orthopnea and the role of changes in respiratory mechanics in left ventricular failure (LVF) are poorly understood. We have measured total respiratory airflow resistance (Rrs) using forced oscillation in the sitting and supine positions in 10 patients with chronic LVF (NYHA II-III) shortly after recovery from acute LVF and in 10 matched control subjects (CON). Seated, the patients with LVF had small lung volumes but no evidence of airway obstruction (mean FEV1/FVC, 81%). Mean Rrs at 6 Hz was only slightly higher in LVF (3.4 cm H2O · L− 1 · s) than in CON (2.6 cm H2O · L− 1 · s). After 5 min supine, breathlessness in LVF increased. Despite much smaller mean falls in mid-tidal lung volume (MTLV) in LVF than in CON, the supine rise in Rrs was 80.5% in LVF and 37.6% in CON; mean increases in specific Rrs (SRrs = Rrs.MTLV) were 75.8% in LVF and 16.6% in CON (p 0.001). Five minutes after resuming the sitting position all values had reverted almost to the original sitting values. In 5 LVF patients, nebulized ipratropium, a muscarinic antagonist, only slightly attenuated the supine rise in SRrs. We conclude that patients with chronic LVF, who had little evidence of airways obstruction when seated, showed a large rise in airflow resistance after lying supine for 5 min. This cannot be attributed to reduction in lung volume when supine and no evidence was found of vagally-induced bronchoconstriction. Further experiments are required to establish the cause of the rapid supine rise in airflow resistance in LVF.
Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1
Authors: S. Vincent Rajkumar, Jean-Luc Harousseau, Brian Durie, Kenneth C. Anderson, Meletios Dimopoulos, Robert Kyle, Joan Blade, Paul Richardson, Robert Orlowski, David Siegel, Sundar Jagannath, Thierry Facon, Hervé Avet-Loiseau, Sagar Lonial, Antonio Palumbo, Jeffrey Zonder, Heinz Ludwig, David Vesole, Orhan Sezer, Nikhil C. Munshi, Jesus San Miguel
Journal: Blood (2011)
Accreditation Council for Graduate Medical Education Initiatives Improve the Education of Cardiology Fellows
Authors: Jeffrey T. Kuvin
Journal: Circulation (2008)

T raining cardiovascular specialists in the present era is highly complex.The list of topics and procedures continues to grow; the required knowledge base for providing cutting-edge clinical care and passing examinations is increasing; and technologies and research are advancing rapidly.Cardiology fellows face a changing template of demands from training programs, governing bodies, professional societies, and potential employers.At the completion of the cardiovascular fellowship training process, it is imperative that graduates are highly capable and complete physicians.Certainly, strict accreditation and adjudication of the fellowship training process are necessary to ensure the highest-quality training of cardiologists and other healthcare providers.
Relations between Pancreatic Enzyme Outputs and Malabsorption in Severe Pancreatic Insufficiency
Authors: Eugene P. DiMagno, Vay L. W. Go, W. H. J. Summerskill
Journal: New England Journal of Medicine (1973)

To investigate the functioning reserve capacity of the exocrine pancreas, we studied the relations of steatorrhea and creatorrhea to lipase and trypsin outputs in 17 patients with chronic pancreatitis and 33 healthy subjects. A standard diet was given, and stools were collected for 48 hours. Total enzyme outputs in response to duodenal perfusion of essential amino acids (78 mM) and intravenously administered cholecystokinin-pancreozymin (0.25 U per kilogram per minute) were compared in patients and in healthy subjects. Steatorrhea was not observed until lipase output was 10 per cent or less of normal; similarly, creatorrhea occurred only when trypsin outputs were less than 10 per cent of normal. These relations demonstrate the large reserve capacity for enzyme secretion by the exocrine pancreas and explain the often late development of steatorrhea and creatorrhea in chronic pancreatitis. (N Engl J Med 288:813–815, 1973)
The T helper cell response in Lyme arthritis: differential recognition of Borrelia burgdorferi outer surface protein A in patients with treatment-resistant or treatment-responsive Lyme arthritis.
Authors: B Lengl-Janssen, A F Strauss, A C Steere, T Kamradt
Journal: The Journal of Experimental Medicine (1994)

The host response to Borrelia burgdorferi is likely to play a role in the pathogenesis of Lyme arthritis. Whereas most patients with Lyme arthritis can be cured with antibiotic therapy, approximately 10% of the patients have persistent arthritis for months or even several years after antibiotic treatment. In this study, we tested the hypothesis that the T cell response to one or more antigens of B. burgdorferi is different in patients with treatment-responsive or treatment-resistant Lyme arthritis. For this purpose, 313 B. burgdorferi-specific T cell lines were derived from the synovial fluid or peripheral blood of four patients with treatment-responsive Lyme arthritis and five patients with treatment-resistant arthritis. 87 T cell lines from treatment-responsive Lyme arthritis and 112 lines from the treatment-resistant group were examined for the recognition of five recombinant. B. burgdorferi proteins: outer surface proteins A (OspA), B, C, p39, and p93. In both groups of patients, the T cell lines frequently recognized OspB, and only occasionally recognized OspC, p39, and p93. In contrast, OspA was preferentially recognized by T cell lines from patients with treatment-resistant arthritis, but only rarely recognized by T cell lines from patients with treatment-responsive arthritis (odds ratio 28.4, 95% confidence interval 9.2-87.8, p &amp;lt; 0.005). These results are compatible with the hypothesis that the T cell response to B. burgdorferi OspA is involved in the pathogenesis of treatment-resistant Lyme arthritis.