tbuckley/cabot-search huggingface dataset:
Acetaminophen Overdose in the Third Trimester of Pregnancy
Authors: Amy J. Byer
Journal: JAMA (1982)

Acetaminophen is frequently used in pregnancy but can be lethal when taken in sufficient quantities. How much of an overdose crosses the placenta and exactly how the in vivo fetus deals with this insult are unknown. However, it does appear that both the mother and fetus can have a good outcome in the third trimester, if treatment is begun early and response is rapid. (<i>JAMA</i>1982;247:3114-3115)
Prevention of Schizophrenia: An Impossible Dream?
Authors: Judith L. Rapoport
Journal: American Journal of Psychiatry (2013)

Primary prevention has seemed an impossible dream for mental illness.Yet here is a study that comes up with interesting and provocative findings.The article by Ross et al. in this issue ( 1) is a rare and important scientific study of how a dietary supplement in pregnancy may alter infant behavior.The behavior that is altered is the infant brain's diminished reaction to a repeated sound.The measure was chosen because in adults, failure of this inhibitory brain system (prepulse inhibition) is seen in a high proportion of patients with schizophrenia and is also linked with the CHRNA7 genotype, which is associated with risk for schizophrenia (2).
Left Ventricular Remodeling and Heart Failure in Diabetic Patients Treated With Primary Angioplasty for Acute Myocardial Infarction
Authors: Nazario Carrabba, Renato Valenti, Guido Parodi, Giovanni M. Santoro, David Antoniucci
Journal: Circulation (2004)

Diabetes mellitus has been recognized as a strong predictor of heart failure (HF) in patients with acute myocardial infarction (AMI). However, considerable controversy exists regarding the pathogenetic mechanisms of HF after AMI in diabetic patients. We hypothesized that the increased incidence of HF in diabetic patients was associated with a greater propensity for left ventricular (LV) remodeling.A series of 325 patients (42 diabetics) with AMI successfully treated with primary angioplasty underwent serial 2D echocardiography from admission to 1 and 6 months and 6-month angiography. No significant difference was found between diabetics and nondiabetics regarding baseline clinical, angiographic, and echocardiographic characteristics, as well as 6-month restenosis and reocclusion rates. At 6 months, a similar incidence of LV remodeling was observed in diabetics and nondiabetics (33% versus 25%; P=0.234), with similar patterns of changes in LV volumes and LV global and regional systolic function. At 5 years, the incidence of HF was higher in the diabetics (43% versus 20%, P=0.001). Diabetes was found to be an independent predictor of HF at 5 years (hazard ratio, 1.8; P=0.0366). However, LV remodeling was predictive of HF in the nondiabetics (P=0.023) but not in the diabetics (P=0.123). In a subgroup of patients, higher LV chamber stiffness (as assessed by echocardiography) was detected in the diabetics with HF.The more frequent progression to HF in the diabetics after AMI is not explained by a greater propensity for LV remodeling. Other factors, such as diastolic dysfunction, may play a role.
Targeting of Epidermal Growth Factor Receptor in Patients Affected by Biliary Tract Carcinoma
Authors: Francesco Leone, Ymera Pignochino, Giuliana Cavalloni, Massimo Aglietta
Journal: Journal of Clinical Oncology (2007)

TO THE EDITOR: A study by Philip et al published in the July 1, 2006, issue of the Journal of Clinical Oncology shows the therapeutic benefit of epidermal growth factor receptor (EGFR) blockade with erlotinib in patients with biliary tract carcinoma. The results are interesting because in a cohort composed of 24 chemotherapy-refractory patients and 18 chemotherapy-naive patients, erlotinib as a single agent can achieve disease control in 50% of patients with a median duration of disease control of 5.1 months. However, the authors conclude that the activity of erlotinib is modest because only 17% of the patients achieved the primary end point of the study, which was progression-free survival at 24 weeks. Although gefitinib and erlotinib are active in unselected patients with non–small-cell lung cancer (NSCLC), clinical characteristics and tumor molecular markers associated with enhanced benefit have been identified. Notably, mutations in the tyrosine kinase domain of EGFR were subsequently found to be associated with sensitivity to small molecule inhibitors in NSCLC. Emerging data also suggest that increased EGFR copy number is a predictor of response to gefitinib therapy, regardless of EGFR kinase domain mutational status. Furthermore, in contrast to wild-type EGFR, the EGFR mutations are mutually exclusive of K-Ras mutations, which are found in biliary tract carcinomas with a particularly high incidence in some geographical areas. Mutations of the EGFR kinase domain have recently been described by our group in 15% of biliary tract carcinoma specimens. One of these mutations was a T790M substitution, which is known to correlate with an acquired resistance to small molecule inhibitor treatment in NSCLC. Whereas 28% of the EGFR-positive patients were progression free at 24 weeks, the study by Philip et al, based on the lack of correlation between EGFR expression level and treatment outcome in other tumor types, includes six undetermined and seven EGFRnegative patients. This patient number is too small to provide evidence of any correlation. Thus, it would be of interest to know if other molecular analyses, such as sequencing of EGFR tyrosine kinase or of downstream members of the signaling pathway, like K-Ras, B-Raf or PTEN, or EGFR gene amplification, have been planned in this group of biliary tract cancer patients treated with erlotinib. This finding will have extraordinary implications and will serve as a critical step toward individualized patient-specific treatment plans based on the molecular constitution of the tumor of each individual.
Ga-67 Positivity in Sarcoidosis of the Skin with Coincident Thyroid Uptake of Uncertain Etiology
Authors: ALBERT J. MORENO, JERRY M. BROWN, JOE A. SALINAS, B LYNN FEASTERS, TOMMY J. BROWN
Journal: Clinical Nuclear Medicine (1984)

Gallium-67 citrate scintigraphy of a 26-year-old woman with systemic sarcoidosis demonstrated abnormal radiotracer uptake within multiple biopsy-proven sarcoidal cutaneous lesions and within both lobes of the thyroid gland. The etiology of the thyroidal uptake of the Ga-67 was uncertain but it may represent sarcoidal involvement of the gland.
Role of Lipoxygenase Metabolites in Ischemic Preconditioning
Authors: Elizabeth Murphy, Wayne Glasgow, Teresa Fralix, Charles Steenbergen
Journal: Circulation Research (1995)

Abstract Preconditioning with brief intermittent periods of ischemia before a sustained period of ischemia has been shown to reduce infarct size and improve recovery of function in rat hearts. The mediators of this protective response are unknown in rats. We tested the hypothesis that a lipoxygenase metabolite might be involved in preconditioning, since lipoxygenase metabolites such as 12-hydroperoxyeicosatetraenoic acid have been shown to increase K + channel activity and to decrease Ca 2+ channel activity, which could have a protective effect on ischemic injury. In support of this hypothesis, we report that the lipoxygenase inhibitors nordihydroguaiaretic acid (NDGA, 5 μmol/L) and eicosatetraynoic acid (7 μmol/L) added just before and during preconditioning blocked the protective effects of preconditioning on recovery of function during reflow after 30 minutes of global ischemia. In addition, these lipoxygenase inhibitors partially blocked the ability of preconditioning to attenuate the rise in cytosolic free calcium during sustained ischemia. We also investigated the effects of preconditioning on eicosanoid metabolism by using high-performance liquid chromatography and found that 12-hydroxyeicosatetraenoic acid (12-HETE), the stable product of the lipoxygenase pathway, was made during the preconditioning protocol and that 12-HETE accumulation was blocked by NDGA. Thus, there is a correlation between functional recovery after ischemia and stimulation of the lipoxygenase pathway of arachidonic acid metabolism before the sustained period of ischemia; inhibition of the lipoxygenase pathway eliminates the protective effect of preconditioning on recovery of function after ischemia.
SURGICAL ERRORS IN SKIAGRAPHY.
Authors: CARL BECK
Journal: JAMA (1901)

The ease with which some small bones of the human body can be reproduced by the Roentgen rays on a photographic plate led many medical novices, and even ignorant laymen, to the indiscriminate use, or rather abuse, of the rays. For the ignorance of unskilful operators many distorted Roentgen ray pictures are responsible. Some of them caused such fatal errors that even well-experienced medical men felt a great disappointment in the results. But in considering all these errors, some of which were indiscriminately heralded through the medical as well as the lay press, it becomes evident that the Roentgen rays never lie, but that it is entirely our own imperfection which induces some of us to err under peculiar circumstances. In the first place, we should never forget that a socalled Roentgen-ray picture is by no means an ordinary photograph of an object, but a silhouette only (skiagraph), i. e.,
Scientific Approaches to Clinical Neurology
Authors: Charles M. Poser
Journal: JAMA (1978)

These two very large volumes constitute a smorgasbord that will appeal to some connoisseurs but not to others. As a textbook it gives short shrift to some clinically important areas; it is extraordinarily detailed, at times even confusing, for some topics and in others so highly theoretical as to be tough sledding. In addition, it suffers from the deficiency common to all such Herculean efforts: a great deal of the material is obsolete. Some of the omissions seriously detract from the value of the book. For example, in the discussion of multiple sclerosis, there is no mention of either oligoclonal IgG or of the pathophysiological changes detected by means of evoked response studies. The intriguing phenomenon of normal pressure hydrocephalus rates only a short paragraph. The chapter on dementia does not mention recent neurochemical studies in Alzheimer's disease. The use of haloperidol in the therapy of Huntington's chorea rates a
Targeting Dendritic Cells: The Role of Specific Receptors in the Internalization of Polymer Capsules
Authors: Justine D. Mintern, Chiori Percival, Marloes M. J. Kamphuis, Wei Jin Chin, Frank Caruso, Angus P. R. Johnston
Journal: Advanced Healthcare Materials (2013)

Dendritic cells (DCs) are an important target for vaccine delivery. It is shown that antibody functionalized polymer capsules can effectively target DCs; however, the internalization is highly dependent on the specific receptor targeted. This work highlights the importance of considering factors such as how the antibody/capsule is internalized, rather than just the target specificity. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Diagnosis of a thoracic inlet tumour by transbronchial biopsy.
Authors: D S Pratt
Journal: Thorax (1978)

A 67-year-old man presented to the pulmonary service with left shoulder and arm pain. Examination disclosed a left Horner9s syndrome. Supraclavicular exploration at another hospital was not helpful. Transbronchial biopsy through a flexible fibreoptic bronchoscope retrieved tissues showing poorly differentiated carcinoma. There are no previous reports of the use of the technique in the diagnosis of a Pancoast tumour with a normal standard chest radiograph.
Cardiac Arrest: Signal of Anesthetic Mishap
Authors: Leroy D. Vandam
Journal: JAMA (1985)

"I was proceeding to apply more [chloroform] to the handkerchief, when her lips, which had been previously of good colour, became suddenly blanched, and she sputtered at the mouth, as if in epilepsy. I threw down the handkerchief, dashed cold water in her face, and gave her some internally, followed by brandy without, however, the least effect, not the slightest attempt at a rally being made. We laid her on the floor, opened a vein in her arm, and the jugular vein, but no blood flowed. The whole process of inhalation, operation, venesection, and death, could not, I should say, have occupied more than two minutes."<sup>1</sup>In 1848, thus wrote surgeon T. M. Meggison, who gave the anesthetic, while Mr Lloyd began to excise a toenail from the foot of Hannah Greener, a healthy girl of 15 years. After postmortem examination and the inquest, Sir John Fife, distinguished surgeon
Combination of cardiac conduction disease and long QT syndrome caused by mutation T1620K in the cardiac sodium channel
Authors: Ralf Surber, Sabine Hensellek, Dirk Prochnau, Gerald S. Werner, Klaus Benndorf, Hans R. Figulla, Thomas Zimmer
Journal: Cardiovascular Research (2007)

The aim of the present study was to elucidate the molecular mechanism underlying the concomitant occurrence of cardiac conduction disease and long QT syndrome (LQT3), two SCN5A channelopathies that are explained by loss-of-function and gain-of-function, respectively, in the cardiac Na+ channel.A Caucasian family with prolonged QT interval, intermittent bundle-branch block, sudden cardiac death, and syncope was investigated. Lidocaine (1 mg/kg i.v.) normalized the prolonged QT interval and rescued bundle-branch block. An SCN5A mutation analysis was performed that revealed a C-to-A mutation at position 4859 (exon 28), predicted to change a highly conserved threonine for a lysine at position 1620. Mutant channels were characterized both in Xenopus oocytes and HEK293 cells. The T1620K mutation remarkably altered the properties of Nav1.5 channels. In particular, the voltage-dependence of the current decay time constants was largely lost. As a consequence, mutant channels inactivated faster than wild-type channels at potentials negative to -30 mV, resulting in less Na+ inward current (loss-of-function), but significantly slower at potentials positive to -30 mV, resulting in an increased Na+ inward current (gain-of-function). Moreover, we found a hyperpolarized shift of steady-state activation and an accelerated recovery from inactivation (gain-of-function). At the same time, channel availability was significantly reduced at the resting membrane potential (loss-of-function).We conclude that lysine at position 1620 leads to both loss-of-function and gain-of-function properties in hNav1.5 channels, which may consequently cause in the same individuals impaired impulse propagation in the conduction system and prolonged QTc intervals, respectively.
Free Medical Care
Authors: Michael L. Nash
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 November 1973Free Medical CareMichael L. Nash, M.D.Michael L. Nash, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-5-754 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The recent article by Mr. Bloom, "National Health Plans: Some Economic and Financial Aspects, (Ann Intern Med 78:954-958, 1973) was interesting and representative of many similar attempts by the laity who attempt to comment on medical care. The basic shortcoming of most of these pieces is the authors' understandable lack of experience "in the field," dealing with patients.As a military physician, I am well aware of the consequences of "free" medical care: flagrant abuses of clinic and emergency services by patients are part of the daily routine. There is no reluctance by the patient to admit...References1. PETERSON O, BURGESS A, and BERFENSTAM R: What is value for money in medical care. Experiences in England and Wales, Sweden, and the U.S.A. Lancet 1:771-776, 1967 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michael L. Nash, M.D.Affiliations: MC USAF Department of Internal Medicine U.S.A.F. Hospital Patrick AFB, Florida PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1973Volume 79, Issue 5Page: 754-755KeywordsArmed forcesHealth economics ePublished: 1 December 2008 Issue Published: 1 November 1973 PDF downloadLoading ...
Review of US Medical School Finances, 1997-1998
Authors: Jack Y. Krakower
Journal: JAMA (1999)

Based on data from the Annual Medical School Questionnaire of the Liaison Committee on Medical Education (LCME), to which 100% of schools responded, we found that revenue supporting programs and activities of the 125 accredited medical schools in the United States totaled $36997 million in 1997-1998. A large proportion of revenue (79%) was derived from 3 sources: practice plans ($12559 million; 33.9%), grants and contracts ($10916 million; 29.5%), and hospital support ($5741 million; 15.5%). An analysis of revenue trends revealed that medical schools, in aggregate, have continued to experience growth during the last 2 years. However, the aggregate numbers mask considerable variation among schools with regard to changes in financing. Between 1995-1996 and 1996-1997, 46 schools (37%) reported constant-dollar declines in the sum of practice plan and hospital revenue, and 50 schools (40%) reported a decline from 1996-1997 to 1997-1998. The financial data reviewed in this report demonstrate the continued dependence of medical schools on faculty-generated sources of revenue and confirm the perception that a growing number of medical schools are experiencing reductions in key sources of financial support. Current and projected reductions in teaching hospital revenue due to the implementation of the Balanced Budget Amendment are expected to erode further hospital support for medical school programs and activities.
Array-based DNA methylation analysis in classical Hodgkin lymphoma reveals new insights into the mechanisms underlying silencing of B cell-specific genes
Authors: O Ammerpohl, A Haake, S Pellissery, M Giefing, J Richter, B Balint, M Kulis, J Le, M Bibikova, H G Drexler, M Seifert, R Shaknovic, B Korn, R Küppers, J I Martín-Subero, R Siebert
Journal: Leukemia (2011)
Anti-D immunoglobulin.
Authors: J. Wallace
Journal: BMJ (1969)

Utidjian are quite right (8 March, p. 641).Conization (also our routine apart from pregnancy) is a more complete method of investigating a posi- tive smear than our cervical inspection and four-quadrant small biopsies.Over the period from 1958 to 1967 we have asked our patients in the interest of the baby to accept our advice, with the tiny risk that ill fortune had dealt what A. T. Hertig calls the "joker in the pack"-,that is, not only carcinoma-in-situ but 'a tiny area of invasive, perhaps metastatic, carcinoma.Since 1966 we have added to our investigatory team J. A. Jordan, an expert in modern colposcopy, which uses subepithelial vascular patterns to locate abnormal epithelium.24Small biopsies may be taken from target areas, but for the most part the dilatable pregnant cervix reflects the positive smear-namely, carci- noma-in-situ or epithelial dysplasia: these areas 'are now left alone until after delivery and planned conization eight weeks later.May I pose two questions to colleagues who undertake routine conization in preg- nancy ?(1) How often is pregnancy disturbed by this technique ?Manifestly loss of a poten- tial child and at histology the presence of no more than epithelial dysplasia is a poor bargain.(2) How often do you excise the epithelial lesion completely-that is, how often is post- delivery conization again indicated by per- sistently positive smears ?-I am, etc.,
Bicarbonate secretion and chloride absorption by rabbit cortical collecting ducts. Role of chloride/bicarbonate exchange.
Authors: R A Star, M B Burg, M A Knepper
Journal: Journal of Clinical Investigation (1985)

Cortical collecting ducts (CCD) from rabbits treated with deoxycorticosterone (DOC) actively secrete bicarbonate at high rates. To investigate the mechanism of bicarbonate secretion, we measured bicarbonate and chloride transport in CCD from rabbits treated with DOC for 9-24 d. Removal of chloride (replaced with gluconate) from both perfusate and bath inhibited bicarbonate secretion without changing transepithelial voltage. Removal of chloride only from the bath increased bicarbonate secretion, while removal of chloride only from the perfusate inhibited secretion. In contrast to the effect of removing chloride, removal of sodium from both the perfusate and bath (replacement with N-methyl-D-glucamine) did not change the rate of bicarbonate secretion. The rate of bicarbonate secretion equaled the rate of chloride absorption in tubules bathed with 0.1 mM ouabain to inhibit any cation-dependent chloride transport. Under these conditions, chloride absorption occurred against an electrochemical gradient. Removal of bicarbonate from both the perfusate and bath inhibited chloride absorption. Removal of bicarbonate only from the bath inhibited chloride absorption, while removal of bicarbonate from the lumen stimulated chloride absorption. We conclude that CCD from DOC-treated rabbits actively secrete bicarbonate and actively absorb chloride by an electroneutral mechanism involving 1:1 chloride/bicarbonate exchange. The process is independent of sodium.
Cholesterol lowering margarine launched in United Kingdom
Authors: S. Mayor
Journal: BMJ (1999)

The first margarine spread capable of reducing cholesterol concentrations was launched in the United Kingdom last week, giving a new twist to the concept of healthy eating. The margarine spread—Benecol—contains stanol esters derived from wood pulp, which reduce the amount of cholesterol absorbed by the gastro-intestinal system.

A year long study carried out in Finland has shown that the spread can reduce concentrations of total cholesterol by up to 10%and of low density lipoprotein cholesterol by up to 14%if eaten as part of a low fat, low …