tbuckley/cabot-search huggingface dataset:
Nausea, Vomiting, and Epigastric Pain in an Elderly Diabetic
Authors: Mario Medero
Journal: JAMA (1985)

A 61-year-old man presented with the complaints of nausea, vomiting, and severe epigastric pain. An anteroposterior roentgenogram of the abdomen demonstrated a conclusive diagnostic finding. <h3>History</h3> The patient was a noncompliant, poorly regulated diabetic receiving 54 units of isophane insulin (NPH [neutral protamine hagedorn] insulin) and 20 units of insulin by subcutaneous injection daily. His medical history was significant for multiple sequelae of diabetes. On physical examination, he was febrile (temperature, 38.5 °C), alert, and in no apparent distress. His abdomen was moderately distended, tender, and had normal bowel sounds. Laboratory findings included an elevated serum glucose level of 345 mg/ dL, urine glucose concentration of 3%, and white blood cell count of 19,000/cu mm. Roentgenograms of the chest and abdomen demonstrated radiological findings that will be described subsequently (Fig 1). (To the reader: Observe the area of the stomach with extra care.) <h3>Diagnosis</h3> Gastric emphysema associated with gastroparesis in
Transforming growth factor-β1 incorporation in an α-tricalcium phosphate/dicalcium phosphate dihydrate/tetracalcium phosphate monoxide cement: release characteristics and physicochemical properties
Authors: E.J. Blom, J. Klein-Nulend, J.G.C. Wolke, K. Kurashina, M.A.J. van Waas, E.H. Burger
Journal: Biomaterials (2002)
Management of urinary incontinence in women: summary of updated NICE guidance
Authors: A. Smith, D. Bevan, H. R. Douglas, D. James
Journal: BMJ (2013)

Urinary incontinence has substantial implications for the individual and family and has considerable resource implications for the health service. Monthly data in the UK show that 46% of women attending a primary care clinic report having urinary incontinence.1 Women with urinary incontinence can present with either stress urinary incontinence, urgency urinary incontinence, or mixed urinary incontinence (see box for definitions), each of which has a different care pathway based on the predominant symptom. As new treatments (such as botulinum toxin A and surgical tapes for mid-urethral procedures) have become available, and as new variations periodically arrive on the market, updated guidance is needed to reflect these changes. This article summarises the most recent recommendations from the National Institute for Health and Care Excellence (NICE) on the care for women with urinary incontinence,2 and replaces previous NICE clinical guideline 40 (published October 2006). #### Definitions of terms
Tryptic digestion of spectrin in variants of hereditary elliptocytosis.
Authors: T Coetzer, S S Zail
Journal: Journal of Clinical Investigation (1981)

Spectrin, either in the form of unfractionated low ionic strength extracts of erythrocyte membranes or purified by chromatography on Sepharose (CL)4B, was subjected to tryptic digestion at 0 degrees C. Four patients, each with a different variant of hereditary elliptocytosis, were studied. In one patient, whose erythrocytes showed significant fragmentation on heating on 45 degrees C, such preparations generated a remarkably different pattern of polypeptide fragments on tryptic digestion at low ionic strength. In this patient 32P was released at a slower rate on tryptic digestion of labeled band 2, and an unusual 32P-labeled peptide fragment was also generated, in contrast to control preparations in which such a peptide could not be easily distinguished. There was increased susceptibility of this patient's spectrin to tryptic digestion at physiological ionic strength, but the qualitative pattern of polypeptide fragments was normal. Phosphorylation of spectrin by membrane protein kinase was markedly impaired in this patient, whereas phosphorylation of casein ws unimpaired. However, the phosphorylation of spectrin in her intact erythrocytes was normal. Our findings suggest an abnormality of spectrin structure which we postulate is causally related to the predisposition to hemolysis in this patient, but do not distinguish whether this is a primary abnormality or a post-translational modification of the spectrin molecule. The other three patients showed normal tryptic digestion of spectrin.
514. Effect of DNA-PKcs on AAV Replication
Authors: Young-Kook Choi, Irene Zolotukhin, Barry J. Byrne, Sihong Song
Journal: Molecular Therapy (2005)

Top of pageAbstract
DNA dependent protein kinase (DNA-PK) is a DNA repair enzyme with multiple functions. It has been shown that it plays an important role in determining the molecular fate of the rAAV genome in mouse muscle and liver. DNA-PKcs inhibits AAV integration in vitro and in vivo. In the present study, we sought to determine the effect of DNA-PKcs on recombinant adeno-associated virus (rAAV) replication. We co-infected 293 cells with rAAV vector (UF5) and recombinant herpes simplex virus (rHSV) helper virus. The replicated forms were detected by southern blot analysis. When cells were treated with a DNA-PKcs inhibitor, wortmannin (WM), rAAV replication is significantly reduced in a dose-dependent manner. Similar results were obtained from MO59K (DNA-PKcs positive) cells. In order to confirm this observation, we have employed small interference RNA (siRNA) to target DNA-PKcs. Transfection of this synthetic siRNA resulted in 70% to 90% reduction of the mRNA and the protein levels of DNA-PKcs. Remarkably, this treatment significantly decreased rAAV replication. In order to avoid the possible side effects by viral infection on DNA-PK activity, we co-transfected the siRNA treated 293 cells with vector (pUF5) and helper (pDG) plasmids. Results from these experiments again showed that targeting of DNA-PKcs decreased rAAV replication by at least two folds compared to the controls. Our results demonstrated that inhibition of DNA-PKcs by a DNA-PK inhibitor or siRNA decreased rAAV replication suggesting the important role of this cellular enzyme in AAV replication.
Lymphocytic infiltration of the skin is a photosensitive variant of lupus erythematosus: evidence by phototesting
Authors: F. Weber, M. Schmuth, P. Fritsch, N. Sepp
Journal: British Journal of Dermatology (2001)

Lymphocytic infiltration of the skin (LIS) is a disorder in which photosensitivity has been suspected but never proven.To carry out a systematic photobiological investigation in patients with LIS and to compare the photobiological features of LIS with those of other photosensitive disorders.We performed provocative phototesting with ultraviolet (UV) A and UVB in 10 patients with active LIS.In all patients, UVA and/or UVB elicited abnormal papular phototest reactions resembling lesions of LIS both clinically and histologically. Lesions typically developed 3--6 days (mean +/- SD 100.8 +/- 20.9 h) after the first UV exposure.This characteristic latency interval together with certain clinical features, i.e. onset in summer, predilection for the face and persistence of the lesions, indicate that LIS is a photosensitive disorder distinct from polymorphic light eruption but indistinct from lupus erythematosus (LE). Both our photobiological findings and the effective treatment with hydroxychloroquine in half of our patients strengthen the proposal that the two entities LIS and LE tumidus are identical. As diagnosis cannot be made by histological, immunofluorescence or laboratory criteria, provocative phototesting may be a diagnostic aid in this disorder.
Childhood Immunizations to Be Reconciled in 1995
Authors: Charles Marwick
Journal: JAMA (1994)

STARTING next year, the voices of the various groups responsible for recommendations about the use of childhood vaccines will sing in unison. Since 1965, efforts have been made to try to ensure compatibility in the recommendations dealing with vaccine use made by public health and physicians' groups, but differences still arose. A number of groups routinely make such recommendations. They include the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP). Late last year, these groups gave a mandate to the CDC to develop a common immunization schedule for the administration of childhood vaccines. The mandate was backed by the CDC's working group on immunization, and an ad hoc group was created to draft such as a schedule. <h3>'An Unambiguous Message'</h3> "There are many reasons for providing an unambiguous message
ON THE COMPOSITION OF URINARY ALBUMIN
Authors: Florentin Medigreceanu
Journal: The Journal of Experimental Medicine (1911)

A few findings which seem to be of importance may be pointed out:- Table I shows the analytical figures of serum-albumin, serum-globulin, and fibrin of the normal dog. The main difference between albumin and globulin appears in the relation of the precipitable to the non-precipitable total nitrogen and amino-nitrogen. Precipitable total nitrogen as well as amino-nitrogen is considerably larger in the albumin than in the globulin. In the cases of uranium nitrate nephritis (table II), the important figures approximate very closely those of normal serum-albumin. The samples from dog 3, that had been poisoned at the same time with phosphorous oil and uranium nitrate, show relatively large variations as compared with the figures from specimens from the other dogs, chiefly as regards the amino-nitrogen distribution: i. e., in dog 3, (1) the amount of amino-nitrogen to the total nitrogen in the solution before precipitation is higher; (2) the percentage of precipitable amino-nitrogen is larger; and (3) the ratio of precipitable amino-nitrogen to precipitable total nitrogen exceeds that of the other cases. All these changes, together with the fact that the total precipitable nitrogen did not undergo any quantitative variation, suggest that in the case of dog 3 the analyzed material contained a higher amount of lysin or cystin. It may further be mentioned that the analytical figures in this case differ also from those of the normal serum-albumin and still more from those of the serum-globulin. These changes, however, were not found in the case of dog 4, although this animal was treated in the same manner as the preceding dog. In the cases of nephritis in man (table III), striking differences were met with in the case of acute scarlet fever nephritis (No. 1a) and in the case (No. 2) of a patient with chronic nephritis and Pott's disease. This patient died a few weeks after the specimen for analysis was collected. The autopsy showed a general amyloidosis. The variations in both cases consist in a lowering of the ratio of amino-nitrogen to total nitrogen in the solution before precipitation, and corresponding to this, a fall of the same ratio in the filterable nitrogen. Such a change points to a relatively larger amount of prolin and oxyprolin or tryptophan in these cases. As a whole, one may conclude that Van Slyke's method, carefully applied and sufficiently controlled, may also be used for the study of urinary albumin. The results already obtained indicate that definite differences in the composition of urinary "albumin" may be detected. As yet it is premature to establish a definite relationship between the chemical composition of the "albumin" and the clinical or pathological conditions under which it appears, but it seems hopeful that further work may lead to the finding of such a relationship.
Estrogen Replacement Therapy: New Options, Continuing Concerns-Reply
Authors: Jane A. Cauley
Journal: JAMA (1997)

In Reply.  —We thank Dr Atkins for his clarification of our report of bone mineral density (BMD) and breast cancer. Dr Atkins is correct in his interpretation. We believe that the risk/benefit ratio for estrogen replacement therapy (ERT) needs to be reevaluated with respect to BMD, osteoporosis, breast cancer, and coronary heart disease. In our previous analysis of the determinants of ERT, we found that a history of osteoporosis or spine fracture was a primary determinant of ERT—in particular, continued long-term ERT. 1 Hence, women who are long-term users of ERT are more likely to have osteoporosis and, by inference, lower BMD and lower risk of breast cancer.
Thirty years on quinidine for paroxysmal ventricular tachycardia
Authors: A. Hollman
Journal: Journal of the Royal Society of Medicine (2005)

9 mm/h.Ureterolysis and ureteric reimplantation was planned, but had to be delayed when the patient had a major myocardial infarction. COMMENT COMMENTQuinidine was promoted by Thomas Lewis for the termination and prevention of atrial fibrillation, 1 after Karel Wenckebach had shown in 1914 that the related drug quinine could halt paroxysms of this arrhythmia. 2 In 1951 Maurice Sokolow reported conversion to normal rhythm with no important side-effects in 80% of 111 personal cases of atrial fibrillation and flutter, using blood level control.
Complementary and Alternative Medical Education
Authors: Peter Manu
Journal: Annals of Internal Medicine (2004)

Letters6 January 2004Complementary and Alternative Medical EducationPeter Manu, MDPeter Manu, MDFrom The Zucker Hillside Hospital–North Shore Long Island Jewish Health System, Glen Oaks, NY 11004.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-1-200401060-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Wetzel and her colleagues (1) have pleaded forcefully for the inclusion of complementary and alternative medicine (CAM) topics in medical education and have advocated a teaching partnership with schools preparing chiropractors, acupuncturists, mind-body therapists, massage therapists, and naturopaths. The goal of this effort is to make practicing physicians aware of the benefits of these interventions and familiar with the local alternative practitioners and offerings.The proposal did not discuss the central dimension of the issue, however, which is that CAM practitioners divert a substantial portion of patients' health care dollars away from the evidence-based, comprehensive, and ...Reference1. Wetzel MS, Kaptchuk TJ, Haramati A, Eisenberg DM. Complementary and alternative medical therapies: implications for medical education. Ann Intern Med. 2003;138:191-6. [PMID: 12558358] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Zucker Hillside Hospital–North Shore Long Island Jewish Health System, Glen Oaks, NY 11004. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComplementary and Alternative Medical Therapies: Implications for Medical Education Miriam S. Wetzel , Ted J. Kaptchuk , Aviad Haramati , and David M. Eisenberg Complementary and Alternative Medical Education Edzard Ernst Complementary and Alternative Medical Education Mary P. Guerrera Complementary and Alternative Medical Education Miriam S. Wetzel , Ted J. Kaptchuk , David M. Eisenberg , and Aviad Haramati Complementary and Alternative Medical Education Samuel Neff Metrics 6 January 2004Volume 140, Issue 1Page: 67-68KeywordsComplementary and alternative medicineGeriatric careHealth careMedical educationPain managementPalliative carePatientsPrimary carePrimary care physicians ePublished: 6 January 2004 Issue Published: 6 January 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Behavioural treatment of scratching in patients with atopic dermatitis
Authors: L. MELIN, T. FREDERIKSEN, P. NOREN, B.G. SWEBILIUS
Journal: British Journal of Dermatology (1986)

A behavioural method of habit reversal, in combination with a hydrocortisone cream, was compared with the use of cream alone in the treatment of 17 patients with atopic dermatitis. The patients were assigned randomly to two groups, one of which received the combination treatment and the other regular ointment treatment. The patients' skin status was assessed before and after treatment, and the patients recorded their scratching during the study. Both groups improved, but the group which received habit-reversal therapy improved significantly more. A strong correlation was found between reduction in scratching and improvement in skin status.
Reuben D. Mussey.
Authors: W. L. Schenck
Journal: JAMA (1896)

New Castle, Colo, June 8, 1896. <h3>To the Editor:</h3> —During my first course of lectures at the Ohio Medical College, 1848-9, R. D. Mussey was Professor of Surgery. He was always kind to his students and patients, though sometimes decidedly brusque with those who had by improprieties brought themselves to grief. As an illustration, a man was placed on the table at the Commercial Hospital with a bubo in either groin. The Professor said: " Young gentlemen, we open these abscesses with a number of small punctures," suiting his action to the word. The patient's hand went involuntarily to the wound with the cry of "Oh God! oh God!" The Professor bluntly said: "Turn over, sir; 'the way of the transgressor is hard; they that sow to the wind must reap the whirlwind.' We open this, you see, in the same way." Age had made his hand tremulous, and it trembled
Kinetics of vascular normalization by VEGFR2 blockade governs brain tumor response to radiation
Authors: Frank Winkler, Sergey V. Kozin, Ricky T. Tong, Sung-Suk Chae, Michael F. Booth, Igor Garkavtsev, Lei Xu, Daniel J. Hicklin, Dai Fukumura, Emmanuelle di Tomaso, Lance L. Munn, Rakesh K. Jain
Journal: Cancer Cell (2004)
Behandlung innerer Krankheiten: Richtlinien und Ratschläge für Studierende und Ärzte
Authors: F. D. Zeman
Journal: JAMA (1961)

This is a new edition of a textbook published in 1940. One of the problems for the American physician in reading European textbooks on treatment is the interpretation of the names of recommended drugs. In this volume, the difficulty is overcome by including an alphabetically listed appendix of all the drugs mentioned in the text with their chemical names, the manufacturer's name, and prices for different strengths and quantities. The author has recommended only those preparations which he has found effective. The first section is devoted to the fundamentals of treating the patient. The author has covered these broad areas with great lucidity and understanding, particularly the physician's obligation to give his patient support in combatting anxieties and fears. A special section is devoted to the injurious effects of therapy, emphasizing general allergic reactions, harmful effects of cortisone, and commonly prescribed drugs. The author is frank in assessing the dangers
End-of-Life Care Discussions Among Patients With Advanced Cancer
Authors: Jennifer W. Mack, Angel Cronin, Nathan Taback, Haiden A. Huskamp, Nancy L. Keating, Jennifer L. Malin, Craig C. Earle, Jane C. Weeks
Journal: Annals of Internal Medicine (2012)

Background: National guidelines recommend that physicians discuss end-of-life (EOL) care planning with patients with cancer whose life expectancy is less than 1 year. Objective: To evaluate the incidence of EOL care discussions for patients with stage IV lung or colorectal cancer and where, when, and with whom these discussions take place. Design: Prospective cohort study of patients diagnosed with lung or colorectal cancer from 2003 to 2005. Setting: Participants lived in Northern California, Los Angeles County, North Carolina, Iowa, or Alabama or received care in 1 of 5 large HMOs or 1 of 15 Veterans Health Administration sites. Patients: 2155 patients with stage IV lung or colorectal cancer. Measurements: End-of-life care discussions reported in patient and surrogate interviews or documented in medical records through 15 months after diagnosis. Results: 73% of patients had EOL care discussions identified by at least 1 source. Among the 1470 patients who died during follow-up, 87% had EOL care discussions, compared with 41% of the 685 patients who were alive at the end of follow-up. Of the 1081 first EOL care discussions documented in records, 55% occurred in the hospital. Oncologists documented EOL care discussions with only 27% of their patients. Among 959 patients with documented EOL care discussions who died during follow-up, discussions took place a median of 33 days before death. Limitations: The depth and quality of EOL care discussions was not evaluated. Much of the information about discussions came from surrogates of patients who died before baseline interviews could be obtained. Conclusion: Although most patients with stage IV lung or colorectal cancer discuss EOL care planning with physicians before death, many discussions occur during acute hospital care, with providers other than oncologists, and late in the course of illness. Primary Funding Source: National Cancer Institute and Department of Veterans Affairs.
Endoscopic treatment of a solitary hamartomatous polyp in the intrahepatic biliary duct
Authors: T. Solakoglu, E. Akin, S. Yavuz, O. Ersoy
Journal: Endoscopy (2013)

Hamartomatous polyps are usually found as part of Peutz–Jeghers Syndrome (PJS) and are uncommon, but occasionally a solitary hamartomatous polyp may develop in an otherwise healthy patient [1]. Hamartomatous polyps may appear commonly in the stomach, small bowel, or colon, with hamartomatous features on histology [2] [3]. Polyps at extraintestinal sites such as the gallbladder, nose, uterus, urinary tract, and respiratory tract, are rarely found in patients with PJS [2] [3] [4]. A recent case report described a sessile hamartomatous polyp in the second duodenal portion occupying the region of the ampulla of Vater [5]. To the best of our knowledge, hamartomatous polyps in the intrahepatic biliary duct have not been reported to date in the English literature. We describe the case of a solitary hamartomatous polyp in the intrahepatic biliary duct.
In Search of the Most Relevant Parameter for Quantifying Lung Inflammatory Response to Nanoparticle Exposure: Particle Number, Surface Area, or What?
Authors: Klaus Wittmaack
Journal: Environmental Health Perspectives (2006)

Little is known about the mechanisms involved in lung inflammation caused by the inhalation or instillation of nanoparticles. Current research focuses on identifying the particle parameter that can serve as a proper dose metric.The purpose of this study was to review published dose-response data on acute lung inflammation in rats and mice after instillation of titanium dioxide particles or six types of carbon nanoparticles. I explored four types of dose metrics: the number of particles, the joint length--that is, the product of particle number and mean size--and the surface area defined in two different ways.With the exception of the particle size-based surface area, all other parameters worked quite well as dose metrics, with the particle number tending to work best. The apparent mystery of three equally useful dose metrics could be explained. Linear dose-response relationships were identified at sufficiently low doses, with no evidence of a dose threshold below which nanoparticle instillation ceased to cause inflammation. In appropriately reduced form, the results for three different sets of response parameters agreed quite well, indicating internal consistency of the data. The reduced data revealed particle-specific differences in surface toxicity of the carbon nanoparticles, by up to a factor of four, with diesel soot being at the low end.The analysis suggests that the physical characterization of nanoparticles and the methods to determine surface toxicity have to be improved significantly before the appropriate dose metric for lung inflammation can be identified safely. There is also a need for refinements in quantifying response to exposure.