tbuckley/cabot-search huggingface dataset:
Prostitution and risk of HIV: male partners of female prostitutes.
Authors: S Day, H Ward, L Perrotta
Journal: BMJ (1993)

OBJECTIVE--To describe risk behaviours for infection with HIV in male sexual partners of female prostitutes. DESIGN--A cross sectional study. SETTING--Genitourinary medicine clinic, St Mary9s Hospital, London. SUBJECTS--112 self identified male sexual partners of female prostitutes: 101 who reported commercial sexual relationships only, five who reported non-commercial relationships only, and six who reported both commercial and non-commercial relationships. MAIN OUTCOME MEASURES--Reported risk behaviours for infection with HIV. RESULTS--Of the 40 men who had had previous HIV tests or were tested during the study, two (5%) were infected with HIV. Of the men who would answer the questions, 34/94 reported having sex with other men, 2/105 reported using injected drugs, 8/105 had a history of blood transfusion, 14/108 reported a past history of gonorrhoea, 44/102 reported paying for sex abroad, and 8/92 said that they had also been paid for sex. Of the 55 men who reported paying for vaginal intercourse in the past year, 45 (82%) said that they had always used a condom. In contrast, of the 11 non-paying partners of prostitutes, only two (18%) reported ever using a condom with their partners. CONCLUSIONS--Men who have sex with female prostitutes cannot be assumed to be at risk of infection with HIV only by this route: homosexual contact may place them at greater risk. Despite the heterogeneity among male sexual partners of prostitutes, patterns of use of condoms were uniform when they were considered as a reflection of the type of relationship a man had with a female prostitute rather than a consequence of an individual9s level of risk.
Ringer, Hartmann, and Their Solutions
Authors: Benjamin Rigor
Journal: JAMA (1968)

<h3>To the Editor:—</h3> We note with mild amusement that Dr. Hanson would have us substitute one eponym for another. Hartmann did indeed add lactate to Ringer's solution, giving us a better balanced solution with a closer resemblance to the electrolyte content of extracellular fluid and some buffering capacity. Since Dr. Hanson does not wish to invoke the eternal debate concerning the use of eponyms in scientific writing, we feel that Hartmann's solution is the better eponym for the solution we use. Perhaps we are all victims of the language differences that tend to grow up between specialties. Among surgeons, internists, anesthesiologists, and pediatricians the term "Hartmann's" is a familiar one made comfortable to us by long usage. The commercial solution is labeled "Hartmann's Solution" in large letters. Pathologists and those of other specialties who have less reason to use this material may find this terminology strange. If so, any questions
Ouabain binding and inotropy in acute potassium depletion in guinea pigs
Authors: L. BROWN, G. WAGNER, E. HUG, E. ERDMANN
Journal: Cardiovascular Research (1986)

In hypokalaemia the incidence of cardiac toxicity with digitalis is increased, possibly through changes in the affinity or capacity of the digitalis receptor in the heart. Previous studies have reported an increased ouabain binding capacity or Na+-K+ ATPase activity after hypokalaemia in human erythrocytes and rabbit and guinea pig hearts and no change or decreases in rabbit or rat skeletal muscles with no changes in ouabain affinity. The present study determined (a) the effect of potassium on 3H-ouabain binding to normokalaemic guinea pig cardiac cell membranes, (b) the effect of acute hypokalaemia induced by a potassium deficient diet for 14-18 days in guinea pigs on 3H-ouabain binding to erythrocytes and cardiac and skeletal muscle homogenates, and (c) ouabain induced inotropy in isolated contracting guinea pig left atria, right ventricular papillary muscles, and soleus muscle strips from normokalaemic and hypokalaemic guinea pigs. 3H-ouabain binds to cardiac cell membranes in the presence of magnesium and inorganic phosphate with an affinity (KD value) of 1.13 × 10−7 mol·litre−1. Potassium decreased this affinity without changing the binding capacity. Erythrocytes and heart muscle homogenates showed the same affinity as cardiac cell membranes, whereas soleus muscle homogenates had a higher affinity for ouabain (KD 5.1 × 10−8 mol·litre−1). After hypokalaemia, the ouabain affinity did not change in any tissue. The mean(SEM) number of ouabain binding sites on erythrocytes increased from 420(80) (normal) to 1020(100) (hypokalaemia). The binding capacity did not change in heart muscle homogenates (atria, 0.7(0.2) × 1014; ventricles, 1.3(0.1) × 1014 sites per g wet weight), but in soleus muscle potassium depletion decreased the number of ouabain binding sites from 0.15(0.02) to 0.1(0.01) × 1014 sites per g wet weight. The inotropic effect was similar in isolated cardiac tissues from both normokalaemic and hypokalaemic guinea pigs (EC50, 3.5 × 10−7 mol·litre−1; maximal increase, 16 mN in left atria and 6 mN in papillary muscles; toxicity at about 1 × 10−6 mol·litre−1). In contracting soleus muscle strips, ouabain (1 × 10−6mol·litre−1) gave negative inotropy only, to the same extent in both normokalaemic and hypokalaemic guinea pigs. It is concluded that (a) the erythrocyte may not be a suitable model for receptor regulation on other tissues such as the heart or skeletal muscle; (b) an increased cardiac toxicity with digitalis in hypokalaemia, despite unaltered cardiac receptors, can be explained by the increased apparent affinity when the potassium concentration is lowered and the reduction in the skeletal muscle binding thus increasing the amount of digitalis available for binding to the heart.
Serum serotonin levels are not useful in diagnosing fibromyalgia
Authors: G. Jaschko, U. Hepp, M. Berkhoff, M. Schmet, B. A Michel, S. Gay, H. Sprott
Journal: Annals of the Rheumatic Diseases (2007)

potential risk of the R92Q allele are indeed low, the impact of R92Q mutations on the MS and WG burden in the German population is negligibly small.Considering the belief that, as yet unknown, susceptibility loci contribute to TRAPS-like manifestations in R92Q carriers, we wondered if those genes that confer susceptibility to WG and MS convert the low-penetrance status of the R92Q allele into a highpenetrance condition.The clinical histories and archival records of those WG and MS patients that carried R92Q, however, did not provide evidence for preceding inflammatory episodes that are typical of TRAPS.Most strikingly, three WG patients suffered from recurrent serositis, which is highly uncommon in WG.Hence, recurrent serositis might be considered to be a manifestation of the R92Q allele on top of an unfolding WG.With the reasonable assumption that the R92Q allele shows a 1% penetrance rate among the 4% carriers and, in view of the low prevalence of WG (50 per million) in the German population, 10 it is extremely unlikely that both clinical phenotypes developed in a single patient just by coincidence.In the case of MS, such a casual coexistence of both clinical phenotypes is more likely as the prevalence of MS is about 30-fold higher than that of WG.
Case 20-1981
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Mark S.J. Klempner, Ben Z. Pilch
Journal: New England Journal of Medicine (1981)

Presentation of Case First admission. A 29-year-old man was admitted to the hospital because of palatal ulceration.The patient was a native and resident of South America and a medical student. He was well until four months earlier, when a whitish lesion developed on the right side of the soft palate. A physician prescribed penicillin, without benefit. Cultures of the lesion yielded Klebsiella pneumoniae and staphylococci. Tetracycline was substituted, but the lesion enlarged. One month before admission microscopical examination of a biopsy specimen of the lesion showed nonspecific inflammation. A second biopsy specimen was considered suggestive of leishmaniasis by one . . .
Sexuality and health: the hidden costs of screening for Chlamydia trachomatis
Authors: B. Duncan, G. Hart
Journal: BMJ (1999)

In response to a recent expert advisory group report to the chief medical officer, the government has announced the setting up of two pilot schemes to assess the feasibility of a Chlamydia trachomatis screening programme in the United Kingdom.1–3 Chlamydia is the most common, curable, sexually transmitted infection in the Western world. Chlamydia infection is largely asymptomatic, but if it is left untreated it can have particularly severe long term consequences for women. These sequelae include pelvic inflammatory disease, ectopic pregnancy, and infertility.4

The expert advisory group has recommended that the following groups be targeted for screening: everyone with symptoms of chlamydia infection, all those attending genitourinary medicine clinics, and women seeking termination of pregnancy.1 There should also be opportunistic screening of young sexually active women under 25 years and of women over 25 with a new sexual partner or two or more sexual partners in the past year. The report identifies family planning clinics and general practice as key sites for screening. It also emphasises the importance of follow up management of infected individuals, which should be carried out in conjunction with genitourinary medicine clinics.

#### Summary points

The rationale behind targeting women for this screening programme is based on health benefits, cost effectiveness, and accessibility. Firstly, and most importantly, the purpose of the programme is to reduce the morbidity associated with pelvic inflammatory disease. Evidence from countries …
What Are We Teaching About Indigent Patients?
Authors: Steven H. Miles
Journal: JAMA (1992)

AN ADULT woman without health insurance presented to the emergency department of a private, not-for-profit, university hospital. A male acquaintance had assaulted her and had fractured her forearm. After the assault, she impulsively took an overdose of an anticonvulsant, phenytoin. A friend brought her to the emergency department. Because a history of intravenous drug abuse had scarred the patient's peripheral veins, peripheral intravenous access was not possible. An attempt to place a catheter in her subclavian vein led to a pneumothorax and a chest tube. Intravenous access was then obtained through a jugular vein. As the overdose was an emergency, the arm was splinted and she was admitted to the medicine service on which I was the attending physician. Two days later, she was medically stabilized. The overdose was resolved, the chest tube was pulled. A psychiatrist concluded that the overdose was in response to the stress of the assault
Amputation prevention by vascular surgery and podiatry collaboration in high-risk diabetic and nondiabetic patients. The Operation Desert Foot experience.
Authors: C C Van Gils, L A Wheeler, M Mellstrom, E A Brinton, S Mason, C G Wheeler
Journal: Diabetes Care (1999)

OBJECTIVE: To describe a unique multidisciplinary outpatient intervention for patients at high risk for lower-extremity amputation. RESEARCH DESIGN AND METHODS: Patients with foot ulcers and considered to be high risk for lower-extremity amputation were referred to the High Risk Foot Clinic of Operation Desert Foot at the Carl T. Hayden Veterans Affairs' Medical Center in Phoenix, Arizona, where patients received simultaneous vascular surgery and podiatric triage and treatment. Some 124 patients, consisting of 90 diabetic patients and 34 nondiabetic patients, were initially seen between 1 October 1991 and 30 September 1992 and followed for subsequent rate of lower-extremity amputation. RESULTS: In a mean follow-up period of 55 months (range 3-77), only 18 of 124 patients (15%) required amputation at the level of the thigh or leg. Of the 18 amputees, 17 (94%) had type 2 diabetes. The rate of avoiding limb loss was 86.5% after 3 years and 83% after 5 years or more. Furthermore, of the 15 amputees surviving longer than 2 months, only one (7%) had to undergo amputation of the contralateral limb over the following 12-65 months (mean 35 months). Compared with nondiabetic patients, patients with diabetes had a 7.68 odds ratio for amputation (95% CI 5.63-9.74) (P &amp;lt; 0.01). CONCLUSIONS: A specialized clinic for prevention of lower-extremity amputation is described. Initial and contralateral amputation rates appear to be far lower in this population than in previously published reports for similar populations. Relative to patients without diabetes, patients with diabetes were more than seven times as likely to have a lower-extremity amputation. These data suggest that aggressive collaboration of vascular surgery and podiatry can be effective in preventing lower-extremity amputation in the high-risk population.
Methylphenidate abuse produces retinopathy
Authors: Phil Gunby
Journal: JAMA (1979)

Drug abuse seems limitless in its variations and consequences. One currently popular variation is the intravenous injection of a CNS stimulant intended to be taken orally. The consequences may include an unusual form of retinopathy. The drug is methylphenidate (Ritalin) hydrochloride, prescribed for narcolepsy or minimal brain damage. Abusers crush the tablets, prepare an aqueous suspension, and inject it. According to San Francisco investigators Howard Schatz, MD, and Michael Drake, MD, a shower of vascular emboli results from the insoluble talc and cornstarch fillers and binders in the tablet. The particles wedge in capillaries, including those of the lungs, the eye, and other organs. The physicians told an American Academy of Ophthalmology audience in Kansas City, Mo, that they recently have seen 12 patients who presented with "small yellow-white particles in the retina and who admitted that they had injected crushed up methylphenidate intravenously." Schatz and Drake emphasize that they
Abstract 1963: Prognosis-related miRNA expression profiles of neuroblastoma.
Authors: Miki Ohira, Eriko Isogai, Yohko Nakamura, Takehiko Kamijo, Akira Nakagawara
Journal: Cancer Research (2013)

Abstract PURPOSE: Neuroblastoma (NB) is known to exhibit clinical heterogeneity and its accurate risk classification is one of the major challenges to improve the personalized therapy. We have been constructing the genomic/genetic profile-based risk classification system for NB. Recent studies indicated that miRNA expression levels are strongly correlated with patient prognosis of NB. To further improve our tumor stratification system by adding the miRNA classifier, we conducted miRNA expression profiling of favorable (F) and unfavorable (UF) NBs and searched for the prognosis-related miRNAs in our sample set. METHODS: 48 primary samples (19 stage 1 or 2; 16 stage 3 or 4 without MYCN amplification; 13 stage 3 or 4 with MYCN amplification) were analyzed by miRNA microarray (Agilent G4470A). Statistical analysis was conducted by using the information of patient outcome at 3 years after diagnosis. Quantitative RT-PCR (qRT-PCR) was also conducted to validate the results in 101 primary tumors by using Taqman microRNA assays. RESULTS: Among the 470 miRNAs analyzed, 79 miRNAs showed strong correlation to the prognosis (p&amp;lt;0.05): 17 and 62 miRNAs showed higher expressions in UF and F phenotypes, respectively. In the former miRNA group, 5 were located in 1q whose genomic copy number is frequently increased in UF type tumors. On the other hand, the latter includes 5, 6 and 9 miRNAs in 1p, 19q13 and 14q32, respectively, which are frequently decreased in copy numbers in UF type. In addition, miR-542-5p, whose expression has been reported as a prognostic marker by other groups, was also in the latter group in our dataset (p&amp;lt;0.001, 3.3-fold lower in UF). We further conducted qRT-PCR of these picked-up miRNAs with 101 independent NB samples for validation and found that higher expression of miR-181b and miR-149 showed significant correlation with poor and good prognosis of patients (both logrank p&amp;lt;0.001), respectively. In addition, intermediate-risk type of tumors (stage 3 or 4, no MYCN amplification, n=40) were also significantly classified into favorable or unfavorable by these two miRNA classifiers (p=0.021 and p=0.005, respectively). Interestingly, miR-149 has been reported that it has pro-apoptotic function by repressing Akt1 and E2F1 expressions in a neuroblastoma cell line. CONCLUSION: The result suggested that miRNA expression profile exhibited strong correlation with NB prognosis, and integration of miRNA classifier with other markers could improve the prediction system for NB prognosis. Citation Format: Miki Ohira, Eriko Isogai, Yohko Nakamura, Takehiko Kamijo, Akira Nakagawara. Prognosis-related miRNA expression profiles of neuroblastoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1963. doi:10.1158/1538-7445.AM2013-1963
Judge criticises how the GMC judged surgeon's fitness to practise
Authors: C. Dyer
Journal: BMJ (2009)

A cosmetic surgeon has won a High Court ruling that quashes the UK General Medical Council’s finding that his fitness to practise was impaired. The ruling criticises the GMC’s procedures for deciding whether doctors are competent to go on practising.

The judge, Mr Justice Collins, criticised the GMC for delays, for late disclosure of the marking sheets from a clinical assessment, and for basing its decision that Riad Roomi’s fitness to practise was impaired on findings that were outside the scope of the allegations against him.

Mr Roomi, who graduated from the University of Baghdad in 1977, practised in the United Kingdom from 1979 and obtained full registration in …
Adjustment Reactions and the Surgical Intern
Authors: Theodore N. Pappas
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The third edition of the<i>Diagnostic and Statistical Manual of Mental Disorders</i>(DSM III) defines adjustment disorders as maladaptive reactions occurring within three months of an identifiable psychosocial stress. In addition, the disturbance may be expressed as an impairment of social or occupational functioning and should remit when a new level of adaption is achieved. Adjustment reactions occur frequently in patients and families after diagnosis and treatment of many medical and surgical illnesses. The literature is studded with examples of adjustment reactions to stressful conditions such as the post-myocardial infarction life-style,<sup>1</sup>discovery of malignancy,<sup>2</sup>or the sequelae in burn victims.<sup>3</sup>This report suggests that maladaptive reactions can be observed during the early period of surgical internship. There have been frequent reports and editorials discussing the discomforts of internship,<sup>4</sup>and the fact that only 20% of surgical internships supply social and emotional support organizations
Gastro-oesophageal reflux and childhood asthma: the acid test.
Authors: P Macfarlane, V Miller, J Couriel
Journal: Thorax (1986)

Gaso-oesophageal reflux and childhood astusa: the acid test SIR-We would like to comment on the paper by Dr N Wilson and colleagues (August 1985;40:592-7) concerning the relationship between gastro-oesophageal reflux and childhood asthma.The authors have demonstrated that some asthmatic children have increased bronchial responsiveness after swallowing acid solutions, detectable by a change in histamine PC20 (the concentration of histamine producing a 20% fall from baseline peak expiratory flow), but not by changes in peak expiratory flow measurements.The relationship between this phenomenon and oesophageal reflux, as measured by sleeping oesophageal pH monitoring, is less convincing.
Nonspecific binding of IgE to allergens
Authors: E. Jensen‐Jarolim, M. Vogel, V. Zavazal, B. M. Stadler
Journal: Allergy (1997)

Nonspecific IgE binding to allergens was observed in testing myeloma IgEs, namely, IgE-VL and IgE-PS, chimeric IgE (IgE-JW8), and the recombinant IgE Fc epsilon peptide CH1-CH4, in two different immunoassays. This binding was concentration-dependent but detectable only at higher IgE concentration. In RAST inhibition, IgE-allergen interactions could be reduced by using either matching or nonmatching allergens. In order to test whether the nonspecific binding of IgE to allergens was due to carbohydrate interaction, myeloma IgEs and the chimeric IgE were desialized with neuraminidase. Desialized samples were equally well recognized by xenogenic antibodies as native IgEs, but binding of IgE to Fc epsilon receptors on basophils was affected by the treatment, as shown in the histamine-release assay. Desialization of IgE affected also its binding capacity to allergens in RAST: binding of chimeric IgE was reduced, but nonspecific binding of myeloma IgE-VL was enhanced. Hence, nonspecific allergen-IgE binding may be partly due to a lectin-like interaction, but may depend mostly on the tertiary structure of IgE. Thus, nonspecific IgE-allergen interactions might present a problem 1) at high IgE concentration, and 2) depend on the grade of sialization of IgE, which might affect its conformation. This may explain why patients with elevated total IgE levels often have multiple weak positive RASTs with non-cross-reactive allergens.
The Physiology of Cardiopulmonary Resuscitation
Authors: Arthur B. Sanders, Harvey W. Meislin, Gordon A. Ewy
Journal: JAMA (1984)

WHILE great strides have been made in the care of patients who suffer cardiac arrest, there is much room for improvement. The basic technique of cardiopulmonary resuscitation (CPR) has changed little since Kouwenhoven and colleagues<sup>1</sup>introduced it in 1960. The present standard was set by a committee of experts at the National Conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care in 1973<sup>2</sup>and updated in 1979.<sup>3</sup>How successful has this technique been? Recent studies have shown that patients suffering in-hospital cardiac arrest have a 14% to 24% chance of being discharged alive.<sup>4,5</sup>This past year, Bedell and associates<sup>4</sup>reviewed 294 consecutive patients who underwent CPR in a university hospital in Boston. Only 41 patients were discharged alive; many who died, however, had serious underlying medical problems. DeBard<sup>5</sup>reviewed 1,073 cases of patients undergoing CPR in a community hospital in Dayton, Ohio. Fifty-six percent of patients
Infection by airborne Chlamydia trachomatis in a dentist cured with rifampicin after failures with tetracycline and doxycycline.
Authors: M Midulla, D Sollecito, F Feleppa, A M Assensio, S Ilari
Journal: BMJ (1987)

The mode ofthis patient's infection is uncertain.We think that in walking barefoot she may have trodden in contaminated faeces from an infected person or pet.For a local dog or cat to be chronically infected it would have to have been imported from an endemic area, but larvae might persist and develop in warm, moist soil even in an English summer.It is unlikely that larvae would exist in the soil on contaminated vegetables imported from warmer climes.Orogenital transmission of strongyloidiasis has been suggested,3 but this patient denied any sexual contact.
Posts are purely educational
Authors: G. Freeman
Journal: BMJ (1995)

EDITOR,—The evident success of the preregistration rotation in general practice based at St Mary's Hospital over the past decade1 is a tribute to its originator, Harris,2 and to the dedication of subsequent teachers both in practice and in hospital. This training opportunity has always been educationally attractive, and I have often been asked why it is not more widespread. Some of the reasons were discussed when …