tbuckley/cabot-search huggingface dataset:
Child Abuse and Neglect
Authors: Dennis H. Penzell
Journal: JAMA (1986)

To the Editor.—  Your recent COUNCIL REPORT on child abuse and neglect, 1 as well as an earlier JAMA article, 2 concerning sexual abuse in children, enumerated many physical and behavioral signs of sexual abuse. Considering the lack of physical abnormalities, except for venereal infections, there may be very few signs leading to a clear conclusion of sexual abuse. 3 Frequently, the true diagnosis lies hidden, while the victim receives medical care for other complaints. 4   I would like to suggest a potentially important physical finding not mentioned in the COUNCIL REPORT or several other recent articles concerning sexual abuse in children. 2-5   The appearance of unexpected loose hair or hairs in the perianal or genital area of prepubertal children should make the examiner suspicious of sexual abuse.  Report of a Case.—  A 5-year-old male child was brought into our clinic for his annual school examination. The examination was entirely
Hypoglycemia due to Serum-Complexed Insulin in a Patient with Diabetes Mellitus
Authors: Stewart G Albert, Dennis A Popp
Journal: Diabetes Care (1984)

A 28-year-old woman with insulin-dependent diabetes mellitus presented with a “hyperlabile” state of hyperglycemia and ketoacidosis alternating with hypoglycemia. Measurements of total and free insulin levels suggested that the clinical syndrome may have been due to antibody binding of insulin. Equilibrium analysis of insulin binding to the patient's serum demonstrated two classes of anti-insulin activities. The first class was of high affinity (dissociation constant ≈10−9 M) and low capacity (150 μU/ml). At low total serum insulin concentrations, most of the circulating insulin was bound to the high-affinity binding activity, and the patient presented with hyperglycemia or ketosis. The second class of insulin binding activity had a lower affinity (dissociation constant ≈5 × 10−7 M). The insulin that was bound to this low-affinity serum substance still maintained biologic activity in vivo. Isophane insulin (NPH) had a markedly prolonged serum half-life, which resulted in delayed hypoglycemia. Serum insulin complexes—that is, bound insulin—may not be “inactive” but may contribute to total insulin action. A determination of insulin activity, not only free insulin levels, may help explain hypoglycemia in selected patients with diabetes mellitus.
An Immunological Basis for Disproportionate Diabetes Risks in Children With a Type I Diabetic Mother or Father
Authors: Hans-Michael Dosch, Julio M Martin, Brian H Robinson, Hans K Åkerblom, Jukka Karjalainen
Journal: Diabetes Care (1993)

Children of mothers with type I diabetes carry a diabetes risk of ∼2.3–2.6%, whereas children of type I diabetic fathers carry a risk two to three times higher (1,2). In a follow-up study in Dallas, Texas, the discordance currently exceeds 10-fold (JD Capra, unpublished observations). Although parental imprinting or silent fetal loss have tentatively been invoked, no evidence supports such mechanisms. The hypothesis below describes an immunological mechanism that could explain this discrepancy in diabetes risk.
Psychotherapy of the dying patient.
Authors: W A Cramond
Journal: BMJ (1970)

In general no mention is made of attitudes to the dying in standard medical textbooks for the medical student, nor in training manuals for nurses. Most of these authors comment on the doctor's need to deny the fact of death and the loss of the patient.  traditional detached professional attitude is regarded as the only possible means of coping with daily disaster and with the threat to the doctor's own omnipotent fantasies. The dedication to forestall death is an indication that the medical profession believes that death is never ap propriate.1 Yet death is an ever-present reality in medical and nursing practice and a time of crisis for the patient, the family, and for the medical and nursing attendants. This paper is an attempt to outline certain practical steps that can usefully be taken in this situation and is based on my experi ence of psychotherapy of a number of patients over the past year or two. I was particularly influenced by the very fine thoughtful contribution to the literature by Norton,2 who described in detail the partial analysis of a young married woman dying of m?tastases from a breast cancer over the last three and a half months of her Ufe. This sensitive paper is a very good example of how analytical insights can be applied in short-term therapy to a frequently recurring clinical situation.
Giardia in the Well
Authors: Karl Kappus
Journal: JAMA (1988)

To the Editor.  —The article by Drs Shaw and Stevens 1 about reactive arthritis in a patient with giardiasis perpetuates the common misconception that  well  is the usual source of Giardia infection in the United States. While fecally contaminated well water is occasionally implicated, 90% of infections are acquired by drinking unfiltered surface water (usually municipal drinking water from streams or rivers) or from diaper-aged children who attend day-care centers. Chlorinated municipal drinking water that meets standards for coliform bacteria can still transmit Giardia if the process for water treatment does not include filtration. At present, 36 to 40 million Americans live in communities, primarily in mountainous regions, that are supplied by unfiltered surface water. In addition, many people visit these areas during summer and winter vacations.  Many physicians are still unaware of the high rate of Giardia infection among children who attend day-care centers. Based on telephone
Coronary Thrombosis and Sudden Death
Authors: J. H. Rogers
Journal: JAMA (1963)

<h3>To the Editor:—</h3> Currently there appears to be general agreement that true coronary thrombosis accounts for but few of the many sudden deaths attributable to heart attacks. This opinion is based on autopsy studies which show a low incidence of thrombosis in the coronary arteries in these cases. Cadaver blood from people who die suddenly from any cause is said to be noncoagulable due to increased fibrinolytic activity in these subjects as compared to those who die a more prolonged or lingering death. Since there must be a considerable lapse of time (hours) between the time of sudden death and the time of necropsy, it appears to me there could easily be a dissolving of the coronary thrombi which cause sudden death, and thereby gross underestimation of the importance of true coronary thrombosis in these cases. What is your opinion of this concept?
Telomerase reverse transcriptase promoter mutation is an early somatic genetic alteration in the transformation of premalignant nodules in hepatocellular carcinoma on cirrhosis
Authors: Jean Charles Nault, Julien Calderaro, Luca Di Tommaso, Charles Balabaud, Elie Serge Zafrani, Paulette Bioulac‐Sage, Massimo Roncalli, Jessica Zucman‐Rossi
Journal: Hepatology (2014)

Genetic determinants of the early steps of carcinogenesis on cirrhosis are still poorly understood. We aimed to evaluate the occurrence of telomerase reverse transcriptase (TERT) promoter mutations in the transformation of cirrhotic nodules into hepatocellular carcinoma (HCC). We analyzed a series of 268 liver samples, including 96 nodules developed in 58 patients with cirrhosis and 114 additional cirrhosis. All samples were screened for TERT promoter mutations, and in 31 nodules, for 10 genes recurrently mutated in HCC. Immunohistochemistry (IHC) analyses were performed for glypican 3, glutamine synthase, and heat shock protein 70. Six liver pathologists reviewed all the samples. Among The 96 nodules, 88 were firmly diagnosed as low-grade dysplastic nodules (LGDNs; 32 cases), high-grade dysplastic nodules (HGDNs; 16 cases), early HCC (eHCC; 23 cases), or small and progressed HCC in 17 cases. The agreement between the initial diagnosis from pathological report and the final expert consensus report was moderate for the diagnosis of benign versus malignant nodules (weighted kappa = 0.530). TERT promoter mutations were highly related to the step-wise hepatocarcinogenesis because mutations were identified in 6% of LGDNs, 19% of HGDNs, 61% of eHCCs, and 42% of small and progressed HCC. TERT promoter mutation is the most frequent molecular alteration in eHCC given that the IHC criteria for diagnosis of malignancy were found in only 39% of the cases. TERT promoter mutation was also the earliest genetic alteration because mutations in 10 other genes were only identified in 28% of the small and progressed HCC.Frequency of TERT promoter mutations rapidly increases during the different steps of the transformation of premalignant lesions into HCC on cirrhosis. Consequently, somatic TERT promoter mutation is a new biomarker predictive of transformation of premalignant lesions into HCC.
Deaths from nvCJD rise sharply
Authors: J. Jones
Journal: BMJ (1999)

Deaths from new variant Creutzfeldt-Jakob disease (nvCJD) rose to their highest ever reported quarterly total at the end of 1998. Nine deaths from the new variant form of the disease were reported to the National CJD Surveillance Unit in Edinburgh over that period, compared with two recorded for each of the previous three quarters.

Scientists at the unit say that the “unusual” rise in the number of reported deaths should be interpreted with caution as it may reflect improvements in detecting …
How does estrogen enhance endotoxin toxicity? let me count the ways
Authors: Jacquelyn J. Maher
Journal: Hepatology (1998)

The relationship among gender, lipopolysaccharide (LPS), and liver disease is complex.Accordingly, the effect of estrogen on activation of Kupffer cells by endotoxin was studied.All rats given estrogen intraperitoneally 24 h before an injection of a sublethal dose of LPS died.Mortality was prevented totally by pretreatment with gadolinium chloride, a Kupffer cell toxicant.Peak serum tumor necrosis factor-␣ (TNF-␣) values as well as TNF-␣ mRNA in the liver after LPS were twice as high in the estrogen treated group as in the untreated controls.Plasma nitrite levels and inducible nitric oxide synthase in the liver were also elevated significantly in estrogen-treated rats 6 h after LPS.Furthermore, Kupffer cells isolated from estrogen-treated rats produced about twice as much TNF-␣ and nitrite as controls did in response to LPS.In addition, Kupffer cells from estrogen-treated rats required 15-fold lower amounts of LPS to increase intracellular Ca 2؉ than controls did, and Kupffer cells from estrogen-treated animals expressed more CD14, the receptor for LPS/LPS binding protein, than controls.Moreover, estrogen treatment increased LPS binding protein mRNA dramatically in liver in 6-24 h.It is concluded that estrogen treatment in vivo sensitizes Kupffer cells to LPS, leading to increased toxic mediator production by the liver. COMMENTS
US doctors investigate more than 50 possible cases of monkeypox
Authors: F. Charatan
Journal: BMJ (2003)

Laboratory tests have confirmed an outbreak of monkeypox in the United States. By 16 June nine cases had been confirmed and more than 80 were under investigation.

Monkeypox is a rare viral disease that is allied to smallpox but is less lethal and that occurs mostly in central and western Africa. It is called monkeypox because it was first found in 1958 in laboratory monkeys.

Early in June at least 20 cases from three midwestern states were reported to the federal Centers …
The Tobacco Industry and Pesticide Regulations: Case Studies from Tobacco Industry Archives
Authors: Patricia A. McDaniel, Gina Solomon, Ruth E. Malone
Journal: Environmental Health Perspectives (2005)

Tobacco is a heavily pesticide-dependent crop. Because pesticides involve human safety and health issues, they are regulated nationally and internationally; however, little is known about how tobacco companies respond to regulatory pressures regarding pesticides. In this study we analyzed internal tobacco industry documents to describe industry activities aimed at influencing pesticide regulations. We used a case study approach based on examination of approximately 2,000 internal company documents and 3,885 pages of U.S. Environmental Protection Agency documents obtained through Freedom of Information Act requests. The cases involved methoprene, the ethylene bisdithiocarbamates, and phosphine. We show how the tobacco industry successfully altered the outcome in two cases by hiring ex-agency scientists to write reports favorable to industry positions regarding pesticide regulations for national (U.S. Environmental Protection Agency) and international (World Health Organization) regulatory bodies. We also show how the industry worked to forestall tobacco pesticide regulation by attempting to self-regulate in Europe, and how Philip Morris encouraged a pesticide manufacturer to apply for higher tolerance levels in Malaysia and Europe while keeping tobacco industry interest a secret from government regulators. This study suggests that the tobacco industry is able to exert considerable influence over the pesticide regulatory process and that increased scrutiny of this process and protection of the public interest in pesticide regulation may be warranted.
DIAGNOSTIC AND FOLLOW-UP IMAGING FOR FIBROMUSCULAR DYSPLASIA: A REPORT FROM THE UNITED STATES FIBROMUSCULAR DYSPLASIA PATIENT REGISTRY
Authors: Adam Ralko, Xiaokui Gu, Eva Kline-Rogers, Heather Gornik, Jeffrey Olin, Robert McBane, Michael Bacharach, Soo Hyun Kim, Pamela Mace, Mark Grise, Bruce Gray, James Froehlich
Journal: Journal of the American College of Cardiology (2012)
Identification of Primary Sensitizers in Patients with Double Sensitization to House Dust Mite and Shrimp Using Component-Resolved Diagnosis
Authors: Sasikarn Suesirisawad, Narissara Suratannon, Piyawadee Lertchanaruengrith, Jarungchit Ngamphaiboon, Pantipa Chatchatee
Journal: Journal of Allergy and Clinical Immunology (2013)
Atlas of Topographical Anatomy of the Brain and Surrounding Structures for Neurosurgeons, Neuroradiologists, and Neuropathologists
Authors: Richard O. Burns
Journal: JAMA (1979)

A new atlas of topographical anatomy of the brain and surrounding structures has been recently completed by Wolfgang Seeger. The author expressed his intention of providing a text of anatomy designed primarily for the microneurosurgeon, but it should be extremely useful to macroneurosurgeons and to those in the related subspecialties of neuroradiology and neuropathology. The book exemplifies Teutonic logic by beginning with a discussion of the classification of nomenclature as used in the text. The remainder of part 1 consists of a series of beautiful plates depicting basic anatomy in relationships that are importantly enhanced by a small drawing of the skull on each plate that correlates the position of the depicted anatomic structures with the position of the head. The latter portion of part 1 is a useful series of drawings representing the correlation between the structures of the brain that can be seen by computerized tomography (CT) and
The Role of Medical Liability Reform in Federal Health Care Reform
Authors: Michelle M. Mello, Troyen A. Brennan
Journal: New England Journal of Medicine (2009)

Although enthusiasm for health care reform is resounding in Washington these days, the specific shape reform will take and the compromises that will have to be made along the way are opaque. Currently, much of the discussion centers on possibilities for insurance mandates, a public insurance plan modeled after Medicare, and the methods that will be used to control costs.1 Many other issues will have to be addressed, including physician payment reform, the future of Medicare Advantage, providers' participation in public programs, the role of expansions of Medicaid, and of course, the funding mechanism for any increase in government expenditures. . . .
Clinical Activity of Lenalidomide in Visceral Human Immunodeficiency Virus–Related Kaposi Sarcoma
Authors: Maud Steff, Véronique Joly, Julie Di Lucca, Judith Feldman, Samuel Burg, Laure Sarda-Mantel, Gilles Peytavin, Eduardo Marinho, Béatrice Crickx, Eric Raymond, Sylvie Lariven, Eve Maubec
Journal: JAMA Dermatology (2013)

Curative treatment of aggressive Kaposi sarcoma (KS) with conventional chemotherapy in human immunodeficiency virus (HIV)-infected patients remains difficult. The administration of thalidomide, an immunomodulatory drug with antiangiogenic effects, is limited by its toxicity. This engenders interest in evaluating thalidomide analogues such as lenalidomide with better toxicity profiles. To our knowledge, we describe for the first time a patient with visceral KS successfully treated with lenalidomide.A man with advanced visceral HIV-related KS progressing after 11 months of highly active antiretroviral therapy (HAART) and 2 lines of conventional chemotherapy (pegylated liposomal doxorubicin and docetaxel) was treated with lenalidomide on a compassionate use basis. He showed a rapid partial response without any substantial adverse effect but experienced relapse after 5 months of treatment, in a context of virologic failure.Similar to our observation, good partial response without toxic effects has been reported in 3 patients with only skin involvement. Because immune reconstitution syndrome may occur in HIV-infected patients with KS undergoing HAART, KS improvement may be partly explained by immune recovery. An ongoing US phase 1/2 trial will better evaluate the efficacy and tolerance of lenalidomide in patients with HIV-related KS with and without visceral involvement.
1290 Activated hepatic stellate cells express a superoxide-generating NAD(P)H oxidase
Authors: K BROWN, M MATHAS, D SPITZ
Journal: Hepatology (2003)

Phagocytes such as neutrophils, monocytes and macrophages play an essential role in host defenses against pathogens. To kill these pathogens, phagocytes produce and release large quantities of antimicrobial molecules such as reactive oxygen species (ROS), microbicidal peptides, and proteases. The enzyme responsible for ROS generation is called NADPH oxidase, or respiratory burst oxidase, and is composed of six proteins: gp91phox, p22phox, p47phox, p67phox, p40phox and Rac1/2. The vital importance of this enzyme in host defenses is illustrated by a genetic disorder called chronic granulomatous disease (CGD), in which the phagocyte NADPH oxidase is dysfunctional, leading to life-threatening recurrent bacterial and fungal infections. However, excessive NADPH oxidase activation and ROS over-production can damage surrounding tissues and participate in exaggerated inflammatory processes. As ROS production is believed to be involved in several inflammatory diseases, specific phagocyte NADPH oxidase inhibitors might have therapeutic value. In this commentary, we summarize the structure and activation of the phagocyte NADPH oxidase, and describe pharmacological inhibitors of this enzyme, with particular emphasis on peptide-based inhibitors derived from gp91phox, p22phox and p47phox.
The Appropriateness of Carotid Endarterectomy-Reply
Authors: Nancy J. Merrick
Journal: JAMA (1987)

In Reply.—  We would like to thank Drs Smith and Stiers for providing information about the number of and mortality from carotid endarterectomies in VA hospitals. Although the number of procedures has leveled off, the number performed in 1984 is still substantially higher than that for 1981, the year of our study. Although a mortality rate of 2.28% compares favorably with national rates, it may not be low enough to justify surgery for many patients, particularly those who are asymptomatic. Besides mortality, complications of carotid endarterectomy include stroke and myocardial infarction, and their rates generally exceed mortality rates. 1,2 Our expert panel suggested that appropriateness of carotid endarterectomy's use would drop substantially if a surgeon's known complication rate was 5% to 8% and would be totally inappropriate if that rate exceeded 8%. Had we adjusted appropriateness scores for the 5.6% complication rate in this study, then 77% of the procedures
IMPORTANCE OF CASE RECORDS OF WAR VETERANS
Authors: William J. Ladyman
Journal: JAMA (1931)

<h3>To the Editor:</h3> —I have been liaison officer for the American Legion at the U. S. Veterans' Hospital, Whipple, Ariz., for a period of three years. During that time, I have often been embarrassed in the prosecuting of disabled World War veterans' claims for government compensation by the fact that many medical doctors had destroyed their office records for the years 1918 to 1930, inclusive. Or, in some instances in which physicians had died in the meantime, the widow or the administrator of the estate had destroyed their records. I think it is important that all physicians should be warned to preserve their records of treatment of disabled World War veterans, especially from 1918 to date, and in cases in which physicians die, it would also be well to preserve the records carefully for future reference. As you well know, the Veterans' Bureau will accept statements from competent medical practitioners
Cancer of the Uterus and Ovary
Authors: W. L. Johnson
Journal: JAMA (1969)

This small, hardbound volume comprises papers presented at the Annual Clinical Conference held in 1966. Publication of a similar conference on cervical cancer in 1960 was well received. It is unfortunate that the meeting held in 1966 does not reach publication until 1969. The conference leads off with a description of tumor classification, and the remainder of the book is divided into three sections: carcinoma of the corpus, carcinoma of the ovary, and carcinoma of the cervix. These sections deal with methodology, evaluation (survival rates), and the complications of treatment of these sites of malignancy. Most of the methodology and evaluation is from the series at M. D. Anderson Hospital. The good results bear out the value of the concepts and treatment described. Long-term follow-up on pelvic exenterations and new techniques of computer calculation of radium dosimetry are presented. Of particular value is the consideration which the treatment failures receive
Randomised controlled trials: evaluating and communicating treatment effects
Authors: P. Sedgwick, K. Joekes
Journal: BMJ (2014)

Researchers investigated the efficacy of the anticoagulant fondaparinux in older acute medical inpatients at moderate to high risk of venous thromboembolism. A double blind randomised placebo controlled trial study design was used. The intervention was 2.5 mg fondaparinux subcutaneously once a day for six to 14 days. Participants were 849 acute medical patients aged 60 years or more who were admitted to hospital.1

The primary outcome was venous thromboembolism detected by routine bilateral venography. In total, 644 patients (75.9%) were available for the analysis of the primary outcome. Venous thromboembolism was detected in 5.6% (18/321) of patients treated with fondaparinux and 10.4% (34/323) of those given placebo. The reduction in risk of venous thromboembolism with fondaparinux compared with placebo represented an absolute risk reduction of 4.9% (95% confidence interval 0.7% to 9.2%) and relative risk reduction of 46.7% (7.7% to 69.3%). The number needed to treat was 20.4.

Which of the following statements, if any, are true?

Statements a and b are true, whereas c is false.

The aim of the trial was to investigate the efficacy of …
Incorporating semantics and individual differences in models of working memory
Authors: Janice M. Keenan, Jukka Hyönä, Johanna K. Kaakinen
Journal: Behavioral and Brain Sciences (2003)

Ruchkin et al.'s view of working memory as activated long-term memory is more compatible with language processing than models such as Baddeley's, but it raises questions about individual differences in working memory and the validity of domain-general capacity estimates. Does it make sense to refer to someone as having low working memory capacity if capacity depends on particular knowledge structures tapped by the task?
Phosphatidylinositol 3-kinase and p38 mitogen-activated protein kinase regulate induction of Mcl-1 and survival in glucocorticoid-treated human neutrophils
Authors: Arash S. Saffar, Stéphane Dragon, Peyman Ezzati, Lianyu Shan, Abdelilah Soussi Gounni
Journal: Journal of Allergy and Clinical Immunology (2007)