tbuckley/cabot-search huggingface dataset:
Clearance of hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort chronically infected with hepatitis B virus
Authors: Josephine Simonetti, Lisa Bulkow, Brian J. McMahon, Chriss Homan, Mary Snowball, Susan Negus, James Williams, Stephen E. Livingston
Journal: Hepatology (2009)

Some individuals who are chronically infected with hepatitis B virus (HBV) eventually lose hepatitis B surface antigen (HBsAg). Hepatocellular carcinoma (HCC) has been demonstrated to occur in a few patients after loss of HBsAg. Neither factors associated with loss of HBsAg nor the incidence of HCC thereafter have been clearly elucidated. We performed a prospective population-based cohort study in 1,271 Alaska Native persons with chronic HBV infection followed for an average of 19.6 years to determine factors associated with loss of HBsAg and risk of developing HCC thereafter. HBsAg loss occurred in 158 persons for a rate of HBsAg clearance of 0.7%/year. Older age, but not sex, was associated with clearance of HBsAg, and loss of HBsAg was not associated with any particular HBV genotypes (A, B, C, D, and F) found in this population. Participants were followed for an average of 108.9 months after HBsAg loss. Six patients, two with cirrhosis and four without, developed HCC a mean of 7.3 years after HBsAg clearance (range, 2.0-15.5 years). The incidence of HCC after clearance of HBsAg was 36.8 per 100,000 per year (95% CI 13.5-80.0) which was significantly lower than the rate in those who remained HBsAg-positive (195.7 cases per 100,000 person-years of follow-up [95% CI 141.1-264.5; P < 0.001]). After loss of HBsAg, HBV DNA was detected in the sera of 28 (18%) of those who cleared a median of 3.6 years after clearance. HCC can occur in persons with chronic hepatitis B who have lost HBsAg, even in the absence of cirrhosis. These persons should still be followed with periodic liver ultrasound to detect HCC early.
Atypical Radionuclide Scan Appearance in Cellulitis due to Group A Streptococcus
Authors: MARGARET C. FISHER, MARGARET A. GAINEY, MARIE A. CAPITANIO
Journal: Clinical Nuclear Medicine (1988)

The scintigraphic manifestations of cellulitis consist of a diffuse increase in activity in the affected soft tissues without a focal increase in activity in the bone. The radionuclide images in two children with Group A streptococcal cellulitis were atypical, as no increased activity was noted in the soft tissues. The false-negative radionuclide images in these children is attributed to the marked amount of edema present at the sites of infection.
Peer review weighed in the balance.
Authors: S Lock
Journal: BMJ (1982)

venting latency.32Whether the prevention of latency would be either practicable or desirable in human populations is another matter.It may be that latent virus helps to maintain the levels of virus-neutralising antibody-possibly as a result of reactiva- tion of virus both with and without symptoms.An interesting era in antiviral treatment is developing.Acyclovir seems set to become one ofthe first effective antiviral agents that can be given systemically in safety.It is almost certainly the forerunner of more.
Funding for HIV/AIDS needs to double to ensure universal access to drugs
Authors: C. Dyer
Journal: BMJ (2009)

A global investment of $25bn (£17bn; €19bn) will be needed in 2010—nearly double the $13.7bn provided in 2008—to meet targets for universal access to HIV/AIDS prevention, treatment, care, and support, according to the joint United Nations Programme on AIDS (UNAIDS).

Michel Sidibe, the new executive director of UNAIDS, acknowledged that it would not be easy to close the funding gap but insisted that it was “achievable and absolutely necessary if we are to accelerate the pace of the response to the AIDS epidemic.”

Speaking from the township of Khayelitsha on the outskirts of Cape …
THE DESIRABILITY OF EARLY DIAGNOSIS OF MENTAL DEFECT IN CHILDREN, AND MENTAL TESTS AS AN AID
Authors: A. C. ROGERS
Journal: JAMA (1913)

The physician may come in various ways in contact with mental deficiency of varying degrees, and his ability to diagnose a given case will often be taxed severely unless he keeps clearly in mind the essential nature of the condition and brings to his aid all available diagnostic means. Every physician of experience recognizes the undirected and shifting gaze, the lack of prehensile grasp and the general failure of response to external stimuli through the special senses that indicate idiocy in the infant. He may also recognize the group of symptoms that indicate some form of primary dementia. He is, however, aware that the great majority of children that show mental abnormality are neither idiotic nor affected with any psychosis and that their condition is not even included in the well-recognized types, usually associated with mental deficiency, such as cretinism, mongolianism, hydrocephalus, microcephalus, etc. He has little assistance from the
Dorland's Illustrated Medical Dictionary
Authors: John H. Dirckx
Journal: JAMA (1995)

Who needs medical dictionaries? Students of medicine and allied professions and crafts need them to find brief, clear definitions of terms encountered in their reading. Medical writers and editors need them to verify spellings, plurals, abbreviations, and kindred linguistic minutiae. Journalists, lawyers, and insurance clerks need them for their own multifarious if not nefarious purposes. Medical transcriptionists need them to find words that dictating physicians have mispronounced or misused, and hence some physicians evidently need them too. For all of the above, the latest<i>Dorland's Illustrated Medical Dictionary</i>has the answers. The definitions in this latest edition perpetuate<i>Dorland's</i>traditionally high standards of succinctness, lucidity, and precision. It is a pleasure to read the work of lexicographers who not only understand what they are writing about but also handle relative clauses and participles with authority, and even know the difference between<i>compose</i>and<i>comprise</i>. A comparison of this edition with
Respiratory Sinus Arrhythmia
Authors: Junichiro Hayano, Fumihiko Yasuma, Akiyoshi Okada, Seiji Mukai, Takao Fujinami
Journal: Circulation (1996)

Background The primary mechanisms of respiratory sinus arrhythmia (RSA) are understood to be the modulation of cardiac vagal efferent activity by the central respiratory drive and the lung inflation reflex, and the degree of RSA increases with cardiac vagal activity. However, it is unclear whether RSA serves an active physiological role or merely reflects a passive cardiovascular response to respiratory input. We hypothesized that RSA benefits pulmonary gas exchange by matching perfusion to ventilation within each respiratory cycle. Methods and Results In seven anesthetized dogs, a model simulating RSA was made. After elimination of endogenous autonomic activities, respiration-linked heartbeat fluctuations were generated by electrical stimulation of the right cervical vagus during negative pressure ventilation produced by phrenic nerve stimulation (diaphragm pacing). The vagal stimulation was performed in three conditions: phasic stimulation during expiration (artificial RSA) and during inspiration (inverse RSA) and constant stimulation (control) causing the same number of heartbeats per minute as the phasic stimulations. Although tidal volume, cardiac output, and arterial blood pressure were unchanged, artificial RSA decreased the ratio of physiological dead space to tidal volume (V d /V t ) and the fraction of intrapulmonary shunt (Q sp /Q t ) by 10% and 51%, respectively, and increased O 2 consumption by 4% compared with control. Conversely, reverse RSA increased V d /V t and Q sp /Q t by 14% and 64%, respectively, and decreased O 2 consumption by 14%. Conclusions These results support our hypothesis that RSA benefits the pulmonary gas exchange and may improve the energy efficiency of pulmonary circulation by “saving heartbeats.”
The Glove Compartment Is an Oven, Not a Medicine Cabinet
Authors: Richard Seymour
Journal: JAMA (1987)

To the Editor.—  The practice of keeping medications in automobile glove compartments should be reconsidered, because the solar heating effect causes excessively high temperatures, even in mild sunny weather. Temperatures in glove compartments from April to October in the northern hemisphere have been found to exceed outdoor temperatures by as much as 28°C (50°F), with the result that stored medications may be subjected to temperatures exceeding 66°C (150°F). These high temperatures can hasten degradation of the product.  A pilot study in the San Joaquin Valley of California showed glove compartment temperatures above 66°C (150°F) on some afternoons, 54°C (130°F) as early as March, and 43°C (110°F) as late as mid-November. Temperatures of floor areas shielded from direct sunlight averaged 11°C(20°F) less.  Prescription labels rarely bear any recommendation concerning storage temperatures. Medication kept in automobiles in warm or hot weather should be placed in insulated containers on the floor and shielded
Classification of Acute Leukemia
Authors: HARVEY R. GRALNICK
Journal: Annals of Internal Medicine (1977)

The classification of acute leukemia has almost invariably been based on the morphologic diagnosis into two broad categories: acute lymphocytic and acute myeloid leukemia. Despite the wide range of morphologic variation in both groups, strict criteria to define the subgroups have only recently been proposed. The conventional markers for B and T cells are now being applied to leukemic cells as are cytochemistry and electron microscopy, terminal deoxynucleotidyl transferase, serum lysozyme, and surface markers, E-rosettes, membrane immunoglobulin, antinull acute lymphocytic leukemia antiserum, and Fc and C3 receptors. The myelodysplastic syndromes may mimic acute leukemia and it is important that they be identified and treated appropriately. The high incidence with which chronic myelomonocytic leukemia terminates in acute leukemia suggests that it is a preleukemic condition, whereas refractory anemia with excess blasts and acquired idiopathic sideroblastic anemia may have long, drawn-out courses. Only a small population of patients with the latter conditions develop acute leukemia.
Reverse remodeling following insertion of left ventricular assist devices (LVAD): A review of the morphological and molecular changes
Authors: J WOHLSCHLAEGER, K SCHMITZ, C SCHMID, K SCHMID, P KEUL, A TAKEDA, S WEIS, B LEVKAU, H BABA
Journal: Cardiovascular Research (2005)

Left ventricular assist devices (LVAD) are used to "bridge" patients with end-stage heart failure until transplantation of a donor heart can be performed ("bridge to transplantation"). However, in a subset of patients, support by LVAD sporadically results in improved cardiac function, with heart transplantation no longer necessary even after removal of the LVAD ("bridge to recovery"). Also, LVAD appears to be an optional treatment alternative to heart transplantation in patients with contraindications for organ replacement ("destination therapy").
THE SUSCEPTIBILITY OF MICE AND RATS TO INFECTION WITH BACILLUS ABORTUS
Authors: William A. Hagan
Journal: The Journal of Experimental Medicine (1922)

1. White mice are highly susceptible to infection by inoculation with Bacillus abortus. The susceptibility appears to be as great as that of the guinea pig, and this animal probably can be substituted satisfactorily for guinea pigs in diagnostic work. 2. Both mice and rats are very refractory to feeding infection with Bacillus aborlus. The failure to infect mice in this way was complete, but the feeding of large amounts of culture gave infection in rats. Subcutaneous inoculation resulted in infection of all the animals. The difficulty of infecting rats and mice with Bacillus abortus by feeding makes it very doubtful whether these animals can have any rôle in the propagation and spread of infectious abortion in cattle.
Measuring hsCRP—An Important Part of a Comprehensive Risk Profile or a Clinically Redundant Practice?
Authors: James P. McCormack, G. Michael Allan
Journal: PLoS Medicine (2010)

With the publication of the JUPITER trial [1] there is now considerable interest in measuring high-sensitivity C-reactive protein (hsCRP). While treatment with rosuvastatin decreased the chance of clinically important events in the JUPITER trial, does this necessarily justify treatment based on hsCRP measurements? Here, we discuss issues surrounding hsCRP measurements in patients.
THE MECHANISM OF POTASSIUM REABSORPTION IN THE PROXIMAL TUBULE OF THE RAT*
Authors: H. Allan Bloomer, Floyd C. Rector, Donald W. Seldin
Journal: Journal of Clinical Investigation (1963)

According to present concepts, renal excretion of potassium is mediated by a three-component system: complete filtration of plasma potassium at the glomerulus, virtually complete reabsorption in the proximal tubule, and active secretion in the distal portions of the nephron.Of these mechanisms, proximal reabsorption has been the most difficult to examine experimentally.Conventional clearance techniques have provided only indirect evidence for the existence and magnitude of this process.Berliner (1) cites the following experiments as support for essentially complete reab- sorption of filtered potassium in the proximal tu- bule: 1) in the dog infused with saline and given an organic mercurial diuretic, potassium excretion remains constant and independent of large varia- tions in filtered potassium (2), and 2) in the dog with a split bladder subjected to unilateral renal artery constriction, if sodium excretion is main- tained by infusions of sodium salts or by diuretics, potassium excretion on the experimental side does not change despite a 30 to 35 per cent reduction in filtered potassium (3).Since these observations suggest that potassium excretion is independent of filtered load, the conclusion is drawn that either potassium reabsorption is adjusted exactly to fil- tered load, or, more likely, that filtered potassium is completely reabsorbed proximal to the secretory site and does not contribute to excreted potassium.The stop-flow technique has been of definite value in localizing and characterizing distal potas- sium secretion.Since, however, proximal samples must pass through the secretory site before col- lection, potassium concentration patterns cannot accurately reflect proximal tubular events (4, 5).
Medical problems of adults who were sexually abused in childhood
Authors: R E Ferner, R J Hassall, D N Bateman, M D Rawlins
Journal: BMJ (1990)

been developing such systems for the management of a varietv of medical conditions, of which a system for the diagnosis, physical examination, and treatment of hvpercholesterolaemia is cur- rentlv undergoing field trials with general practi- tioners in the west midlands.The system is supplied for the use of a Psion Organiser and incorporates regional knowledge in a particular subject as appropriate for use in primary care or by junior hospital medical staff.The medical know-
Phase II Trials Published in 2002: A Cross-Specialty Comparison Showing Significant Design Differences between Oncology Trials and Other Medical Specialties
Authors: Laura C. Michaelis, Mark J. Ratain
Journal: Clinical Cancer Research (2007)

Phase II trials play an essential role in drug development pathway, and their conclusions often impact the decision to embark on large, pivotal trials. However, the determination of agent activity is highly dependent on trial design. Formal comparisons of phase II trial designs across medical specialties are uncommon. We hypothesized that there are significant differences in the design of trials conducted by oncologists and those conducted by other medical and surgical specialties.We screened MEDLINE for the abstracts of phase II trials published in 2002. All abstracts were analyzed and classified by a priori defined variables, including study type, intervention, subspecialty, journal impact factor, method of control, and study conclusions.Our search yielded 703 abstracts of phase II trials published in 2002. A total of 586/703 (83%) were trials on antineoplastic agents. Twenty percent (143/703) of the trials included explicit control subjects. Oncology trials, as compared with all trials done by other specialties, were significantly less likely to use control subjects (13% versus 56%, P < 0.001) and were less likely to conclude that the investigational intervention was safe and efficacious and/or worthy of additional investigation (76% versus 89%, P < 0.01).There are significant differences in the phase II trials published in oncology compared with those conducted by other medical and surgical specialties. The impact that such differences have on the efficiency of drug development should be investigated.
Patterns of inheritance, not always easily visible
Authors: K. N. Khan, M. Ali, J. A. Poulter, M. McKibbin, C. F. Inglehearn
Journal: BMJ (2013)

This case report describes a boy with a rare ophthalmic disorder that uniquely demonstrates the complexities of clinically identifying the mode of disease inheritance. Although readers are unlikely to encounter this exact disorder, knowledge of the analytical approach needed to answer the questions posed will be of benefit to all specialties of medicine.

A 4 year old boy presented with symmetrical leucocoria (whitening of his ocular red reflex). His three younger siblings all had a normal eye examination, as did his parents (figure⇓). He was diagnosed as having an inherited corneal disease (Schnyder corneal dystrophy) caused by mutations in the UBIAD1 gene. This gene encodes a protein that localises to the mitochondria and regulates cholesterol and lipid metabolism. In the disease state these products become abnormally deposited within the cornea, leading to opacification.



Family pedigree and genetic results. (A) Pedigree of the family showing affected (black symbols) and unaffected (unfilled symbols) family members. (B) Electropherograms showing wild-type (normal) sequences in both parents and an unaffected sibling alongside the mutated sequence of the affected child (II:1). For the affected child, two peaks are superimposed at the site of the mutation representing the presence of both the normal “G” allele and the mutant “A” allele





### 1 What are the possible modes of inheritance in this case?

#### Short answer

All modes of inheritance are possible given the pedigree structure—autosomal dominant, autosomal recessive, X linked, mitochondrial, or sporadic.

#### Long answer

To date, Schnyder’s corneal dystrophy has been described only with autosomal dominant inheritance. Dominant disorders tend to have a strong family history, with at least one parent being affected. In some cases the disease may …
ACUTE LACUNAR DIPHTHERIA OF THE TONSILS.
Authors: HENRY KOPLIK
Journal: JAMA (1895)

Under this plan of treatment, intestinal antisepsis is furthered as is evidenced by the slight degree of tym- panitis ; absence of sordes on the teeth and especially by the character of the stools, which are much less fre- quent and are practically destitute of the very disa- greeable odor that characterized the passages of patients before the introduction of treatment directed toward intestinal antisepsis.High temperature is combated by cold sponging alone.No depressing antipyretics of any kind are used.While I claim that the course of an attack is ma- terially modified in ordinary cases, I do not claim guaiacol as a specific, for under its use during the last five years, (creasote being used part of the time, in place of guaiacol) I have lost two cases.Both of these died during the latter part of the third week, apparently of acute disorganization of the central nerve centers.The peculiar cause of death in con- nection with these two fatal cases remains to be ex- plained.In each case a younger brother succumbed to the same disease, under different treatment, and under the care of other practitioners within a short period of time.The question naturally arises, was there not some peculiar absence of resisting power in the members of the families in which these cases occurred?The course of the disease in these fatal •cases was not specially severe, but as already stated at some time during the latter part of the third week the nerve centers suddenly became involved and death resulted from asthenia.No difficulty whatever has been experienced in the administration of the remedy, which is a feature of no little value in remedies for children.
Effects of olopatadine hydrochloride, an antihistamine drug, on skin inflammation induced by repeated topical application of oxazolone in mice
Authors: T. Tamura, M. Matsubara, C. Takada, K. Hasegawa, K. Suzuki, K. Ohmori, A. Karasawa
Journal: British Journal of Dermatology (2004)

Olopatadine hydrochloride (olopatadine) is one of the second-generation antihistamines, which is prescribed for allergic disorders such as rhinitis, urticaria and eczema dermatitis.To investigate the possible anti-inflammatory effect of olopatadine on the chronic contact hypersensitivity response to repeated topical application of oxazolone in mice.The preventive and therapeutic effects of oral olopatadine were quantified by measurements of ear swelling, cytokine protein and mRNA expression in the ear lesion, and were compared with those of topical betamethasone 17-valerate (betamethasone).The ear receiving repeated applications of oxazolone exhibited erythema, oedema and abrasion. Both preventive and therapeutic administration of olopatadine (10 mg kg(-1) day(-1)) significantly inhibited the ear swelling and the increased production of interleukin (IL)-4, IL-1beta, granulocyte-macrophage colony-stimulating factor (GM-CSF) and nerve growth factor. In the histopathological analysis, olopatadine ameliorated epidermal hyperplasia and infiltration of inflammatory cells. Consistent with these results, olopatadine significantly reduced the increased expression of interferon-gamma and IL-4 mRNA. Although betamethasone (0.012 mg ear(-1) day(-1)) showed similar activities to olopatadine against these responses, it caused atrophy of the ear skin.These results indicate that olopatadine is an antihistamine agent having inhibitory activities against chronic inflammatory dermatitis, possibly resulting from its diminishing effect on elevated cytokines.
Is Prostate Cancer Screening Analogous to Lung Cancer Screening?
Authors: Andrew Farkas
Journal: JAMA (1997)

<h3>To the Editor.</h3> —Drs Collins and Barry<sup>1</sup>raise a number of important concerns about the use of screening for prostate cancer. Because the way in which questions are framed helps determine the techniques used to develop answers, we feel their concerns should be refocused. We believe 2 separate major questions need to be addressed: (1) Will screening for prostate cancer reduce morbidity, mortality, or both? (2) How aggressively should diagnosed prostate cancer be treated? Answers to the first question hinge on issues of cost-effectiveness. Answers to the second question hinge on issues of risk and effectiveness of treatment. Collins and Barry conclude that caution is necessary "regarding widespread dissemination of prostate cancer screening without the experimental evidence that such screening does more good than harm."<sup>1</sup>We believe this statement confounds the 2 questions and could therefore impede the search for answers. Whether to screen for prostate cancer is
Narcotics, Pain, and Clear-Mindedness-Reply
Authors: John Archer
Journal: JAMA (1983)

In Reply.—  Presumably, if a patient wished to endure periods of unrelieved pain for the sake of clearmindedness, he could make such an arrangement with his physician. Otherwise, I believe severe pain should be treated with adequate doses of narcotics given at appropriately frequent intervals. See also Berris and Greenblatt ( JAMA 1983;249:1708) and Sriwatanakul et al ( JAMA 1983; 250:926-929).