tbuckley/cabot-search huggingface dataset:
Allergy to Dermatologic Agents
Authors: Ernst Epstein
Journal: JAMA (1966)

Between 1962 and 1965, 78 cases of allergy to topically administered medicaments were documented in the author's private practice. In 60 of the 78 patients the allergy had been responsible for causing or aggravating a dermatitis. Antimicrobials, antihistamines, and anesthetics were the most prominent allergens with neomycin being the single most frequent sensitizer. Topically administered medicaments that commonly sensitize should be avoided unless their use provides clear-cut therapeutic benefits.
Defining the disease liability of variants in the cystic fibrosis transmembrane conductance regulator gene
Authors: Patrick R Sosnay, Karen R Siklosi, Fredrick Van Goor, Kyle Kaniecki, Haihui Yu, Neeraj Sharma, Anabela S Ramalho, Margarida D Amaral, Ruslan Dorfman, Julian Zielenski, David L Masica, Rachel Karchin, Linda Millen, Philip J Thomas, George P Patrinos, Mary Corey, Michelle H Lewis, Johanna M Rommens, Carlo Castellani, Christopher M Penland, Garry R Cutting
Journal: Nature Genetics (2013)
Genetic and Environmental Risk Assessment and Colorectal Cancer Screening in an Average-Risk Population
Authors: David S. Weinberg, Ronald E. Myers, Eileen Keenan, Karen Ruth, Randa Sifri, Barry Ziring, Eric Ross, Sharon L. Manne
Journal: Annals of Internal Medicine (2014)

New methods are needed to improve health behaviors, such as adherence to colorectal cancer (CRC) screening. Personalized genetic information to guide medical decisions is increasingly available. Whether such information motivates behavioral change is unknown.To determine whether individualized genetic and environmental risk assessment (GERA) of CRC susceptibility improves adherence to screening in average-risk persons.2-group, randomized, controlled trial. (ClinicalTrials.gov: NCT0087360).4 medical school-affiliated primary care practices.783 participants at average risk for CRC who were not adherent to screening at study entry.Participants were randomly assigned to usual care or GERA, which evaluated methylenetetrahydrofolate reductase polymorphisms and serum folate levels. On the basis of prespecified combinations of polymorphisms and serum folate levels, GERA recipients were told that they were at elevated or average risk for CRC.The primary outcome was CRC screening within 6 months of study entry.Overall screening rates for CRC did not statistically significant differ between the usual care (35.7%) and GERA (33.1%) groups. After adjustment for baseline participant factors, the odds ratio for screening completion for GERA versus usual care was 0.88 (95% CI, 0.64 to 1.22). Within the GERA group, screening rates did not significantly differ between average-risk (38.1%) and elevated-risk (26.9%) participants. Odds ratios for elevated- versus average-risk participants remained nonsignificant after adjustment for covariates (odds ratio, 0.75 [CI, 0.39 to 1.42]).Only 1 personalized genetic and environmental interaction and 1 health behavior (CRC screening) were assessed.In average-risk persons, CRC screening uptake was not positively associated with feedback from a single personalized GERA. Additional studies will be required to evaluate whether other approaches to providing GERA affect screening utilization differently. These findings raise concern about the effectiveness of moderately predictive assessment of genetic risk to promote favorable health care behavior.National Institutes of Health.
Bone Scan in Patient With Horseshoe-Kidney Mimicking Skeletal Lumbar Metastasis
Authors: NUNZIO BONANNO, SERGIO BALDARI, ANTONIO CERRITO, GIOVANNI ZIMBARO
Journal: Clinical Nuclear Medicine (1995)

A 66-year-old man with prostatism had Tc-99m MDP bone scintigraphy that showed, on anterior imaging, increased uptake in the lumbar spine, suggestive of a skeletal metastasis of L3. Additional SPECT imaging demonstrated that focal radionuclide accumulation was located anterior to the spine and was interpreted as the bridge of functioning renal tissue in a horseshoe-kidney. This diagnosis was confirmed by ultrasonography and pyelography.
Contempo 1997: End-of-Life Care
Authors: James Burke
Journal: JAMA (1997)

To the Editor.  —In the end-of-life care article 1 in the 1997 Contempo issue of JAMA , Drs Sulmasy and Lynn note that the current funding for health professionals' education does not require attention to end-of-life care. Yet opportunities to make a significant improvement in this area abound. Many hospices are closely associated with acute care institutions, and the present day cost-conscious health care system would seem to encourage hospice use for both patient care and physician education, as noted by Christakis and Escarce 2 and others. 3,4   We surveyed (unpublished data, 1996) 782 chief executive officers of hospices that were listed as a division of a hospital according to records provided by the National Hospice Organization. Based on data from 280 responders, hospices were deemed to improve the public's perception of the affiliated hospital (91%) and to foster better pain management (86%). Yet the value of the hospice for both
State of the art lecture: Endoscopic ultrasonography: Training and competence
Authors: T. Rösch
Journal: Endoscopy (2006)

Endoscopic ultrasonography (EUS) has become an important diagnostic and - recently - also therapeutic tool in gastrointestinal endoscopy, mostly complementary to other primary investigations. Its application in oncology as well as in a variety of benign conditions, the mixture of endoscopy and ultrasound as an imaging technique as well as the complexity of instrument handling to generate adequate visualization have all raised the necessity to define competence and hence design respective training programmes.
Use of CD63 expression as a marker of <i>in vitro</i> basophil activation and leukotriene determination in metamizol allergic patients
Authors: P. M. Gamboa, M. L. Sanz, M. R. Caballero, I. Antépara, I. Urrutia, I. Jáuregui, G. González, I. Diéguez, A. L. De Weck
Journal: Allergy (2003)

We assessed the reliability of basophil activation test (FAST) and sulphidoleukotriene production (CAST) in the in vitro diagnosis of allergy to metamizol, evaluating its sensitivity and specificity.Twenty-six patients allergic to metamizol and 30 control individuals were studied. Skin tests with metamizol, FAST, and CAST were performed.FAST sensitivity was 42.3% and specificity 100%. The PPV of FAST is 100% and the NPV 99.4%. The likelihood ratio for a positive value cannot be calculated because the specificity is 100% and the likelihood ratio for a negative value is 0.58. CAST sensitivity was 52%, and specificity 90%. The PPV of the test is 5% and the NPV 99.5%. The likelihood ratio for a positive result was 5.2 and that for a negative result 0.53. FAST detects a larger number of cases when patients are studied within the first 6 months after the clinical reaction (chi = 4.2, P = 0.04) than later. Together with skin tests, FAST allowed detection of 69.2% patients allergic to metamizol, the same as CAST 76%. The joint use of the three techniques allowed identification of 76.9% of cases.FAST and CAST are useful for the diagnosis of allergy to pyrazolones. Its usefulness clearly increases when recent reactions are studied.
The Probiotic VSL#3 Has Anti-inflammatory Effects and Could Reduce Endoscopic Recurrence After Surgery for Crohn's Disease
Authors: Richard N. Fedorak, Brian G. Feagan, Naomi Hotte, Des Leddin, Levinus A. Dieleman, Denis M. Petrunia, Robert Enns, Alain Bitton, Naoki Chiba, Pierre Paré, Alaa Rostom, John Marshall, William Depew, Charles N. Bernstein, Remo Panaccione, Guy Aumais, A. Hillary Steinhart, Alan Cockeram, Robert J. Bailey, Paolo Gionchetti, Cindy Wong, Karen Madsen
Journal: Clinical Gastroenterology and Hepatology (2014)
Plasminogen activators in human colorectal neoplasia.
Authors: J S Gelister, M Mahmoud, M R Lewin, P J Gaffney, P B Boulos
Journal: BMJ (1986)

A crucial step in the transition from adenomatous polyp to invasive colorectal cancer is the degradation of the epithelial basement membrane. Plasminogen activators may play a part in regulating the extracellular protease environment necessary for this to occur. Both functional and antigenic activity of the two principal activators of plasminogen, tissue plasminogen activator and urokinase, were measured in 30 colorectal cancers, matched samples of mucosa, and eight adenomatous polyps. Both polyps (p less than 0.01) and carcinomas (p less than 0.001) had raised urokinase activities compared with normal mucosa, the activity being highest in the carcinomas. Activity of tissue plasminogen activator, however, was diminished in both polyps (p less than 0.01) and carcinomas (p less than 0.001) compared with normal mucosa, the values being lowest in carcinomas. Plasmin generation by urokinase--in contrast with tissue plasminogen activator--is fibrin independent and thus less subject to physiological control.
Opinions Vary, But Some Recommend Hitting Certain Cancers 'Harder and Earlier'
Authors: Andrew Skolnick
Journal: JAMA (1991)

NEW TECHNOLOGIES are making it possible to treat many cancer patients with far more toxic levels of chemotherapy than generally have been used until now. A panel of scientists addressed this sometimes controversial issue in Phoenix, Ariz, at the 33rd American Cancer Society Science Writers' Seminar. With the help of such new techniques, these panelists agreed, cancers now should be hit earlier and a lot harder. Despite the higher chances of longer survival or cure, physicians have been reluctant to use more toxic doses of chemotherapy because of its many adverse effects, especially the life-threatening bleeding and infections that result from destruction of the patient's bone marrow. But now, say the researchers, there are ways to quickly restore or replace the patient's immune system with cell growth factors and with autologous and allogeneic bone marrow transplants. <h3>Antiemetics Available</h3> In addition, there are new agents that can minimize the nausea and
Group Psychotherapy: Its Effects on Mothers Who Rate Social Performance of Retardates
Authors: BESS SIEGEL, KATHLEEN SHERIDAN, EDWARD P. SHERIDAN
Journal: American Journal of Psychiatry (1971)

The authors studied the effect of group psychotherapy on the mothers of retarded individuals. They found that the mothers who underwent psychotherapy rated the retardates significantly higher in security and appearance than they did before therapy, while the mothers in the control group saw no changes in their retarded children.
Did Experimental Biology Die? Lessons from 30 Years of p53 Research
Authors: Shalom Madar, Ido Goldstein, Varda Rotter
Journal: Cancer Research (2009)

The recent decade has greatly challenged biological research because there has been exponential growth in the amount of information that has been accumulated and published. Now, more than ever before, piles of biological data are waiting to be sieved through robust scientific reasoning and
Epidermal hydration levels in patients with rosacea improve after minocycline therapy
Authors: S. Ní Raghallaigh, F.C. Powell
Journal: British Journal of Dermatology (2013)

Background Patients with rosacea frequently report increased skin sensitivity, with features suggestive of an abnormal stratum corneum (SC) permeability barrier. Sebum, pH and hydration levels influence epidermal homeostasis. The correlation of changes in these parameters with clinically effective treatment has not been previously analysed. Objectives To analyse sebum, pH and epidermal hydration levels of patients with papulopustular rosacea (PPR) before and after treatment with systemic minocycline. Methods We analysed sebum casual levels, pH and hydration along with erythema levels (as a marker of disease activity and response to treatment) on seven designated facial sites of 35 patients with active PPR and compared the results with values on the same sites of 34 control subjects with normal facial skin. To determine the effect of minocycline on these parameters, we re-examined the patients with PPR at the same sites after a 6-week course of treatment. Results Patients with untreated PPR had significantly increased erythema indices, normal sebum casual levels, a more alkaline centrofacial region and reduced epidermal hydration levels compared with controls. Treatment with minocycline resulted in reduced erythema and increased hydration levels, with the most marked changes evident in the cheeks (13·3% reduction in erythema indices, P < 0·001; 12·4% increase in hydration levels, P = 0·012). There was no change in skin pH or sebum casual levels following treatment. Conclusion Patients with PPR have increased erythema indices, normal sebum casual levels, a more alkaline centrofacial region and reduced epidermal hydration levels compared with control subjects. Treatment with systemic minocycline reduces erythema and increases hydration, in the absence of any change in skin pH or sebum casual levels.
Coping with loss: The dying adult
Authors: C M Parkes
Journal: BMJ (1998)

This is the seventh in a series of 10 articles dealing with the different types of loss that doctors will meet in their practice

This paper focuses on two common problems that arise when people come close to death, fear and grief. Fear is the psychological reaction to danger; grief the reaction to the numerous losses that are likely to occur in the course of an illness that is approaching a fatal outcome. Both can be expected to arise in patients, their families, and—though we are reluctant to admit it—in their doctors and other carers. Both fear and grief need to be taken into account if we are to mitigate the psychological pains of dying.

#### Summary points

We should never assume that we know what people with terminal illness fear

Most patients will benefit if we can help them to feel secure enough to share their fears

Fear can aggravate pain, and pain fear

Patients with life threatening illnesses experience a series of losses as the illness progresses

Grief is natural and needs to be acknowledged and expressed

Though it may seem obvious that people who are dying are likely to be afraid, we should not assume that we know what they fear. The box shows the fears, in approximate order of frequency, expressed to me by patients in a hospice. It is clear that fears of death itself come quite far down on the list. Difficult to quantify but of particular importance is reflected fear, the fear that people see in the eyes of those around them or hear in the questions that are not asked.1 Many problems in communication arise out of fear, and we may need to take time to create trust and a safe place in which people can begin to talk about the things that make …
No eradication of polio without inactivated vaccine, says expert
Authors: G. Mudur
Journal: BMJ (2003)

India will have to abandon its traditional animosity to the inactivated injectible poliomyelitis vaccine to achieve complete eradication of polio, a leading public health expert has said.

Although the oral polio vaccine used in India and other developing countries will eliminate the wild poliovirus, the oral vaccine could itself be a source of future outbreaks of polio, said Dr Thekekarra Jacob John, former head of clinical virology at the Christian Medical College, Vellore, in southern India.

“The oral vaccine will continue to [release] vaccine derived poliovirus into the environment,” Dr John said at …
Serum Lipids and Enzymes
Authors: G. L. Calvy, L. D. Cady, M. A. Mufson, J. Nierman, M. M. Gertler
Journal: JAMA (1963)

The relationship between exercise and a high-calorie, high-saturated-fat diet was studied over a 22-week period in 101 Marine trainees with an average age of 20.5 yr. Their diet consisted of 4,500 calories (fat 2,025 calories or 225 gin, carbohydrates 2,025 calories or 506 gm, and proteins 450 calories or 112 gm). The program consisted of 16 hr of rigorous daily activity. There were no statistically significant changes in serum uric acid, lipid phosphorus, total cholesterol, lactic dehydrogenase, and malic dehydrogenase. Weight and blood pressure did not change. Serum content of triglycerides rose significantly, and isocitric dehydrogenase dropped significantly. It is suggested that a high-calorie and high-saturated-fat diet (milk, butter, and eggs) may not be atherosclerogenic if sufficient calories are utilized to offset this intake.
Effects of Continuous Enhanced Vagal Tone on Dual Atrioventricular Node and Accessory Pathways
Authors: Chuen-Wang Chiou, Shih-Ann Chen, Ming-Ho Kung, Mau-Song Chang, Eric N. Prystowsky
Journal: Circulation (2003)

The aim of this study was to test the electrophysiological effects of continuous enhanced vagal tone on dual atrioventricular (AV) nodal and accessory pathways.This study included 10 patients with typical, slow-fast AV nodal reentrant tachycardia (AVNRT) and 10 patients with AV reciprocating tachycardia. Electrophysiological data were measured before and during continuous vagal enhancement by using phenylephrine infusion (0.6 to 1.5 microg/kg per min). For patients with AVNRT, during phenylephrine infusion, 1:1 conduction times over the anterograde fast and slow and retrograde fast pathways were prolonged (453+/-64 to 662+/-120 ms, P<0.001; 379+/-53 to 443+/-95 ms, P<0.05; 405+/-112 to 442+/-118 ms, P<0.05). The effective refractory period and functional refractory period of the anterograde fast pathway were prolonged with phenylephrine (394+/-73 to 544+/-128 ms, P<0.001; 454+/-60 to 596+/-118 ms, P<0.001). In contrast, the effective refractory period and functional refractory period of the anterograde slow and retrograde fast were not significantly changed. No significant change was observed in the conduction or refractoriness of the accessory pathways in patients with AV reciprocating tachycardia nor in atrial or ventricular refractoriness.Enhanced vagal tone produces disparate effects on the refractoriness of the slow and fast AV nodal conduction pathways, with the anterograde fast pathway being the most sensitive. These changes are conducive to induction of AVNRT with a premature atrial complex and may explain in part the relatively common occurrence of AVNRT during sleep or other periods of presumed increased parasympathetic tone.
Eosinophilic esophagitis: Epithelial mesenchymal transition contributes to esophageal remodeling and reverses with treatment
Authors: Amir F. Kagalwalla, Noorain Akhtar, Samantha A. Woodruff, Bryan A. Rea, Joanne C. Masterson, Vincent Mukkada, Kalyan R. Parashette, Jian Du, Sophie Fillon, Cheryl A. Protheroe, James J. Lee, Katie Amsden, Hector Melin-Aldana, Kelley E. Capocelli, Glenn T. Furuta, Steven J. Ackerman
Journal: Journal of Allergy and Clinical Immunology (2012)
Limited Exercise Testing Soon After Myocardial Infarction
Authors: KERRY M. SCHWARTZ
Journal: Annals of Internal Medicine (1981)

Forty-eight patients within 3 weeks of myocardial infarction underwent both limited treadmill graded exercise testing and coronary and left ventricular angiography. Nineteen (90%) of 21 patients with positive exercise tests (≥ 1 mm ST depression, angina, or both) had multivessel coronary artery disease. In the 27 patients with negative exercise test results, 15 (55%) had multivessel disease, 11 (41%) had single-vessel disease, and one (4%) had no coronary stenosis. Exercise-induced ST segment elevation occurred in 24 patients and predicted a significantly lower ejection fraction and higher angiographic abnormally contracting segment size. Patients experiencing angina during or after exercise had a significantly shorter 2-year survival (54% ± 21%) than patients without exercise-induced angina (97% ± 3%) (p < 0.03). Thus limited exercise testing postinfarction is useful in evaluating the presence of multivessel coronary artery disease and left ventricular dysfunction and predicting long-term survival.
Identification of coronary artery stenoses and poststenotic blood flow patterns using a miniature high-frequency epicardial transducer.
Authors: A Kenny, L M Shapiro
Journal: Circulation (1994)

Intraoperative epicardial coronary Doppler ultrasound has the potential to provide anatomic and functional information. This technique has been hindered by the large size of standard transducers, but a miniature transducer is available that may fulfill the potential of coronary ultrasound.Twenty consecutive patients who were undergoing coronary artery bypass grafting were studied and compared with 9 control patients with normal coronary arteries who were undergoing routine mitral valve surgery. A miniature 6.5-MHz transducer was used to image coronary arteries and measure coronary blood flow velocities. Seventeen proximal left anterior descending and 3 right coronary artery stenoses were studied. As defined by coronary angiography (1 to 34 days before surgery), there were 13 severe stenoses (> 70%), 4 moderate stenoses (40% to 70%), 2 minor stenoses (< 40%), and 1 subtotal occlusion. Stenoses were readily identified by ultrasound. Color flow mapping demonstrated laminar flow in normal arteries and nonlaminar flow across moderate and severe stenoses. In the control patients with unobstructed arteries, peak and mean diastolic velocities were 35 +/- 2.1 and 26 +/- 1.9 cm/s with peak and mean systolic velocities of 16 +/- 1.4 and 11 +/- 0.8 cm/s, respectively. Prestenotic flow velocities were not significantly different from normal control values, but a wide range of poststenotic flow disturbances were detected. Analysis of the 20 study patients did not reveal significant differences in poststenotic compared with prestenotic flow. A subgroup analysis of 12 patients with severe left anterior descending coronary artery stenoses was performed, and reversed poststenotic systolic flow was seen in 9. Prestenotic peak and mean systolic velocities were 16.5 +/- 1.7 and 11.9 +/- 1.1 cm/s, respectively, and were significantly altered downstream of the stenoses at -22.7 +/- 17.2 and -15.9 +/- 10.9 cm/s (P < .05 and P < .01, respectively). Reversed systolic flow was seen only distal to severe left anterior descending coronary artery stenoses and did not correlate with retrograde collateral filling as determined by preoperative coronary angiography. Moderate stenoses appeared to increase both systolic and diastolic components of poststenotic flow.Epicardial Doppler ultrasound with a miniature transducer identifies coronary stenoses and associated blood flow disturbances. Compared with moderate lesions, severe stenoses demonstrated different poststenotic flow patterns. Intraoperative use of this technique may determine the hemodynamic significance of coronary stenoses.
DOES DIABETES PREDISPOSE TO PYOGENIC SKIN INFECTIONS?
Authors: Frederick C. Hill
Journal: JAMA (1942)

<h3>To the Editor:—</h3> In the article by J. R. Williams "Does Diabetes Mellitus Predispose the Patient to the Pyogenic Skin Infections?" (The Journal, April 18, p. 1357) the author concludes that pyogenic skin infections occur no more frequently in diabetic than in nondiabetic persons, but the statistics presented by him do not bear out his point. In one of the hospitals studied by him 330 diabetic patients were admitted during the years 1938, 1939 and 1940. Eight of these had boils or carbuncles, which gives a percentage of 2.4. During this same period there were 26,879 nondiabetic admissions, among which there were 166 boils or carbuncles. This gives an incidence of 0.6 per cent. In other words, according to the author's own figures boils or carbuncles were four times as common among diabetic as among nondiabetic patients. In the other hospital studied, one is unable to make this calculation because