tbuckley/cabot-search huggingface dataset:
Thrombocytopenic Purpura Following Rubella
Authors: A. Thomas Adkins
Journal: JAMA (1965)

NINE CASES of thrombocytopenic purpura associated with rubella were seen on the Hematology Service at Texas Children's Hospital, Houston, from April to July 1964. During this time a particularly virulent rubella epidemic occurred over most of the state. Despite the ubiquity of rubella, we have found only 30 cases complicated by thrombocytopenic purpura in the medical literature.1,2Undoubtedly the frequency is higher than this, but thrombocytopenia is rarely mentioned as a complication of this exanthem. Twelve other cases of thrombocytopenic purpura were seen during this same four-month period. A history of exposure to rubella prior to the onset of purpura was obtained in most cases. Though it is possible that some of these patients had subclinical rubella, only those cases with typical rubella (German measles) were included in this report.  The occurrence of purpura associated with rubella appears to have no relationship to the severity of the primary rubella
Rare Form of Right Ventricular Outflow Tract Obstruction
Authors: Ryan W. Zuzek, Richard D. White, Monvadi B. Srichai, Wael A. Jaber
Journal: Circulation (2004)

A 44-year-old woman had undergone repair of a perimem- branous ventricular septal defect at age 9.She had been doing well medically until she developed fever, bloody diarrhea, nausea, vomiting, generalized abdominal pain, and a 10-lb weight loss shortly after undergoing a dental procedure.Blood cultures were positive for Gram-negative bacilli (Alcaligenes xylosoxidans), and intravenous antibiotics were initiated.Her symptoms improved, but repeat blood cultures remained positive.Bacterial endocarditis was suspected, warranting transthoracic and transesophageal echocardiography.The patient was transferred to The Cleveland Clinic for further evaluation and treatment.Transesophageal echocardiography (Movies I and II) and cardiac magnetic resonance imaging (Movies III and IV) demonstrated a variant of "double-chamber right ventricle," with resultant right ventricular outflow tract obstruction demonstrated by flow turbulence and increased flow gradient within the RV.Furthermore, a small vegetation was noted on the pulmonic valve.The patient underwent open-heart surgery, which consisted of debridement of the bacterial vegetations from the pulmonic valve and right ventricle, resection of the right ventricular infundibular muscle, repair of the tricuspid valve with sutured commissuroplasty, and closure of a patent foramen ovale.On the most recent follow-up examination, she was doing well.
Morphometric evaluation of the contractile apparatus in primary cultures of rabbit cardiac myocytes.
Authors: M L Decker, M Behnke-Barclay, M G Cook, M Lesch, R S Decker
Journal: Circulation Research (1991)

Rabbit cardiac myocytes remain quiescent for more than 1 month when cultured at low density. During this period, myofibrillar volume density declines sixfold as myofibrils are disassembled or degraded and are replaced by actin and alpha-actinin-positive, myosin-negative structures that resemble myofibrils but lack thick filaments. Such structures are termed minute myofibrils. The length of the sarcomeres in these altered myofibrils is significantly less than length values obtained from freshly isolated heart cells or from contracting myocytes. A number of high density cultures develop spontaneous, synchronous contraction during the second week of culture. Myofibrillar volume density is stabilized when beating begins, and no further decline is observed in the succeeding weeks of culture. Such contracting myocytes display myofibrils typical of normal heart with no visible evidence of minute myofibrils. The volume density of the transverse tubular system also declines significantly in both beating and nonbeating myocytes, and its reduction appears more closely correlated with cell spreading than with beating per se. No quantitative changes in volume density of mitochondria or sarcoplasmic reticulum could be documented, but the structural organization of the sarcoplasmic reticulum seems to be greatly influenced by the physiological state of the heart cell. The present observations document the importance of mechanical factors in regulating the integrity of the contractile apparatus in cardiac myocytes and emphasize the utility of the cultured heart cell to directly investigate structure-function relations in individual myocytes.
Whole-chromosome imbalance pattern of comparative genomic hybridization in neuroblastomas is associated with regressive disease from mass screening cases showing spontaneous regression
Authors: Kazuhiko Uchida, Misako Hirai, Sadao Yoshida, Hironobu Kashiwagi, Saito Soichiro, Michio Kaneko, Ohkawa Haruo, Akira Nakagawara, Miwa Masanao
Journal: Nature Genetics (2001)
Weight Lifting and Rupture of Silent Aortic Aneurysms
Authors: J. A. Elefteriades
Journal: JAMA (2003)

To the Editor: It is unclear whether aortic dissection is associated with high-intensity strength training. Methods. From our Yale University aortic database, and from outside cases brought to our attention after lay press reports of our aortic research, we identified and reviewed case materials of 5 patients who experienced acute dissection of the ascending aorta in the setting of high-intensity weight training or other strenuous exercise. Results. The 5 patients ranged in age between 19 and 53 years. None had previously diagnosed aneurysm or personal history of hypertension or collagen vascular disease. Only 1 patient had a family history of aortic disease. None had signs of Marfan syndrome. All patients were involved in strenuous strength training at the instant that their dissection pain occurred. Two patients were weight training, a third was attempting to move a heavy granite structure, and the other 2 were doing push-ups. All patients manifested acute ascending aortic dissection. Diagnosis was made by computed tomography scan in 3 patients, by echocardiography in 1, and by autopsy in the fifth. The diameter of the aorta on the imaging studies performed immediately after dissection ranged from 4.0 to 5.2 cm, indicating underlying enlargement, but not to a level expected to present a high risk of dissection. Three patients underwent successful urgent surgical repair of the acute dissection. These patients survived and are without sequelae at 4, 20, and 48 months. One patient died shortly after diagnosis and before transfer to another facility could be made, and the fifth died before a diagnosis was made. Pathological analysis, available in 4 patients, showed underlying cystic medial necrosis, which was of mild to moderate severity in 2 patients. Comment. The risk of weight lifting as a cause of aortic dissection has generally been underappreciated. We recommend caution in patients with known aneurysms or connective tissue diseases, a family history of aneurysm or dissection, or underlying hypertension, as well those at or beyond middle age, because aneurysm, connective-tissue disease, family history, and hypertension predispose to aortic dissection and because aortic stiffness increases with age. None of the patients in this series, however, had these known risk factors. Furthermore, because limiting maximal effort prevents extreme ( 200 mm Hg) elevations in blood pressure, it also seems reasonable to limit weight lifting in individuals at risk.
B55β-Associated PP2A Complex Controls PDK1-Directed Myc Signaling and Modulates Rapamycin Sensitivity in Colorectal Cancer
Authors: Jing Tan, Puay Leng Lee, Zhimei Li, Xia Jiang, Yaw Chyn Lim, Shing Chuan Hooi, Qiang Yu
Journal: Cancer Cell (2010)
Progressive Thorium Dioxide Myelopathy
Authors: George L. Maltby
Journal: New England Journal of Medicine (1964)

THIS seems to be an era of steadily increasing use of many contrast mediums in an effort to study and diagnose various problems. This practice is increasing in all branches of medicine but especially in delineating the nervous system and its vascular supply. This is good, and certainly none can detract from the great advances in neurologic surgery that have been made possible by the pioneer studies of Dandy1 with air, Egas Moniz et al.2 with cerebrovascular investigations and the numerous other methods that have been employed to make the various areas of the central nervous system more easily and . . .
Psychotropic and Medical Drug Interactions
Authors: Jambur Ananth, Karen Johnson
Journal: Psychotherapy and Psychosomatics (1992)

In a number of situations, drugs used to treat psychiatric and physical illnesses are coadministered to patients suffering primarily from a psychiatric illness. Hence, coadministration of medical and psychiatric drugs is not uncommon. With increasing use of multiple drugs, our ability to treat a number of disorders has increased, but simultaneously, the problem of drug interactions has also assumed importance. A number of factors contribute to such drug interactions in psychiatric patients. All these interactions are both pharmacologically and genetically determined. Genetic susceptibility is not practical to determine. It is therefore essential for the physician to employ drug combinations only when necessary, be aware of the known clinically significant interactions, anticipate and watch for them, avoid dangerous combinations, and monitor the patients receiving combination of drugs with vigilance.
Trimethoprim therapy for urinary tract infection. Long-term prophylaxis in a uremic patient
Authors: C. M. Kunin
Journal: JAMA (1978)

THE COMBINATION of trimethoprim/sulfamethoxazole has been reported by several groups to be effective for prophylaxis of recurrent urinary tract infections in otherwise healthy women.<sup>1,2</sup>Previous studies in this laboratory have shown that therapeutically adequate concentrations of trimethoprim can be achieved in the urine of patients with renal failure provided the creatinine clearance is not below 10 ml/min.<sup>3</sup>Trimethoprim is not currently available as a single agent in this country, but can be obtained for investigative purposes. We were asked to care for a patient with severe renal failure, due to chronic pyelonephritis and bilateral vesicoureteral reflux, who was suffering from recurrent episodes of urinary infection associated with<i>Proteus mirabilis</i>. The patient was allergic to sulfonamides and had adverse reactions to drugs commonly used to treat urinary tract infections; she had no known adverse reaction to trimethoprim. Trimethoprim was administered to the patient after she was informed of its
Units of management in reorganised NHS: what choice for senior medical staff?
Authors: H M Buckland
Journal: BMJ (1982)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Units of management in reorganised NHS: what choice for senior medical staff? Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
FDG PET/CT Delayed Diuretic Imaging Technique for Differentiating Invasive Pelvic Cancer
Authors: Yu-Wen Chen, Ming-Yii Huang, Po-Nien Hou, Chin-Chuan Chang, Chuan-Shaio Lee, Shi-Long Lian
Journal: Clinical Nuclear Medicine (2009)

A 72-year-old woman was diagnosed as having a International Federation of Gynecology and Obstetrics (FIGO II) stage cervical cancer with diffuse uterus corpus invasion without evidence of rectal or urinary bladder invasion as determined by endoscopic examinations. Recently, 2 sharp elevations of serum tumor marker squamous cell carcinoma (SCC) were noted while she was receiving radiation therapy. Therefore, a PET/CT scan was performed using fluorodeoxyglucose (FDG) to restage the cervical cancer. FDG-avid cervical tumor was shown to extend into the anterior uterine wall by use of a diuretic imaging technique, which lowered tracer activity in the bladder and improved visualization of lower pelvic structures, which otherwise might have been obscured by urine-FDG activity.
The Role of the Systemic Inflammatory Response in Long Term Outcome from Operable Breast Cancer.
Authors: N. Henley, S. Tovey, C. Doran, D. McMillan
Journal: Cancer Research (2009)

Abstract Aims: It is recognised that the presence of a systemic inflammatory response has independent prognostic value in a number of advanced and operable tumours. There is also evidence in advanced breast cancer (Al Murri et al., 2006). However, results in operable breast cancer have been conflicting. Therefore, we prospectively examined the relationship between the systemic inflammatory response and long term survival in primary operable breast cancer.Methods: Patients with invasive primary operable breast cancer (n=154) treated at Royal and Western Infirmaries, Glasgow between October 2000- January 2002 were studied. The systemic inflammatory response, as evidenced by elevated CRP and Il-6, was measured pre-operatively and approximately 12 months later. An elevated CRP was defined as &amp;gt;10mg/l, and IL-6 as &amp;gt;5ng/l. Demographic and clinical data including age, tumour size, histological grade, lymph node status oestrogen receptor (ER) status and HER2 status were recorded. The Nottingham prognostic index (NPI) was calculated and subdivided into good (0-3.4), intermediate (3.41-5.4) and poor (&amp;gt;5.41) prognosis. Patients were followed-up until 1st March 2009.Results: Mean age was 59 (range 34-87). HER-2 was positive in 18 patients (12%), ER status was positive in 121 patients (79%). NPI was good/ intermediate/poor in 55 (36%)/ 73 (47%)/ 26 (17%). Circulating concentrations of interleukin-6 were significantly correlated with those of C-reactive protein (rs=0.449, p&amp;lt;0.001). Median follow-up was 8 years (range 7 – 8.5 years). During this period, there were 20 breast cancer deaths and 16 of other causes. On univariate analysis, NPI (p&amp;lt;0.001), pre-operative CRP (p=0.03), pre-operative IL-6 (p=0.05) and post-operative CRP (p=0.05) predicted breast cancer specific survival. In contrast, post-operative IL-6, ER and HER2 status did not. On multivariate analysis, NPI (HR 7.78 95% CI: 3.44-17.61 p&amp;lt;0.001) and pre-operative CRP (HR 6.36 95% CI: 2.11-19.18, p=0.001) predicted breast cancer specific survival.Conclusions: The results of the present study suggest that the presence of a systemic inflammatory response prior to surgery, in particular CRP, predicts breast cancer specific survival independent of tumour based factors. Therefore measurement of the systemic inflammatory response may be useful in the pre-operative assessment of patients with primary operable breast cancer.We acknowledge the advice and support of Timothy G Cooke who died 20th July 2008.ReferenceAl Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC. Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer. 2006;94:227-30. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4050.
Quality of Life of Pancreatic Transplant Recipients
Authors: Frances K Milde, Laura K Hart, Pamela S Zehr
Journal: Diabetes Care (1992)

OBJECTIVE To comprehensively assess and compare pancreas/kidney transplant recipients' quality of life. RESEARCH DESIGN AND METHODS This quasi-experimental comparative study of 31 successful and 13 failed pancreas transplant recipients collected data from persons who had received pancreas and kidney transplants ≥6 mo prior at a university tertiary care center. Physical and social function, symptoms, mental state, and sense of well-being of the recipients were assessed. RESULTS Groups did not differ significantly regarding age, gender, marital status, onset or length of diabetes, comorbidity, type of prior dialysis, current kidney function, length of time since transplant, physical activity, symptom burden, emotional state, feelings of well-being, and present quality of life and health. A significant time by group interaction occurred for quality of life (P = 0.0013) and health (P = 0.0001). The successful group indicated that both quality of life and health were significantly better than in the past, and continued improvement was expected. The unsuccessful group did not have this perception. Members of the failed group were significantly more satisfied with their social support. The unsuccessful group's major concerns related to diabetes, not immunosuppression. CONCLUSIONS Recipients of successful pancreas transplants perceived their improvement in health and quality of life to be significantly greater than the unsuccessful recipients.
Extracting higher-level relationships in connectionist models
Authors: Gary F. Marcus
Journal: Behavioral and Brain Sciences (1997)

Connectionist networks excel at extracting statistical regularities but have trouble extracting higher-order relationships. Clark &amp; Thornton suggest that a solution to this problem might come from Elman (1993), but I argue that the success of Elman's single recurrent network is illusory, and show that it cannot in fact represent abstract relationships that can be generalized to novel instances, undermining Clark &amp; Thornton's key arguments.
A collapse with hypertension and hypokalaemia
Authors: Hannah Pintilie, William Petchey, Ketan Dhatariya, Mahzuz Karim
Journal: BMJ (2014)

A 60 year old white man was admitted from the emergency department after an unwitnessed collapse and generalised weakness and malaise. He had no medical history of note and was taking no drugs. On clinical assessment he had hypertension, which had not previously been documented, with a blood pressure of 187/91 mm Hg. Blood tests showed severe hypokalaemia (2.1 mmol/L (reference range 3.6-5.0), having been normal (4.7) nine months earlier) and metabolic alkalosis (bicarbonate 38 mmol/L, 22-30). Random blood glucose was 6.0 mmol/L (3.5-7.8).

On the post take ward round, he was noted to have clubbing of the nails and a tanned appearance. A 60 pack year smoking history was elicited. Further biochemical tests were requested and, because his chest radiograph was abnormal, chest computed tomography was performed (fig 1⇓).





### 1. What does this axial computed tomogram through the chest show?

#### Short answer

A large mass in the right hilar and posterior lower lobe with confluent hilar lymphadenopathy.

#### Long answer

A large soft tissue mass is seen in the right hilum and posterior lower lobe with confluent hilar lymphadenopathy (fig 2⇓). It encases the segmental bronchi of the …
Pathologic Basis of Disease
Authors: Martha L. Warnock
Journal: JAMA (1980)

This new edition of a standard text and its new coauthor are to be warmly welcomed. Robbins and Cotran have made a major effort to discuss the pathophysiological mechanisms along with the morphological features of disease. This approach assumes knowledge of physiology, biochemistry, anatomy, and beginning clinical medicine and should appeal to the student who can now recognize the relevance of basic science courses. The topics are almost the same as in the last edition: only a chapter on aging has been deleted. The authors state that more than half of the book has been rewritten. Indeed, important new material appears in every chapter. Several areas caught my eye as innovations. The new concepts of small airways disease in relation to emphysema and chronic bronchitis are admirably dealt with, the morphological explanation for the physiological disturbances of the nephritic syndrome appears for the first time, and concepts of chronic hepatitis
Naftifine cream 1% versus econazole cream 1% in the treatment of tinea cruris and tinea corporis
Authors: Larry E. Millikan, Wesley K. Galen, Garry B. Gewirtzman, Stephen N. Horwitz, R. Kenneth Landow, Lee T. Nesbitt, Harry L. Roth, John Sefton, Robert M. Day
Journal: Journal of the American Academy of Dermatology (1988)
Assessment of Tumor Invasion of the Distal Esophagus in Carcinoma of the Cardia Using Endoscopic Ultrasonography
Authors: S. Natsugoe, H. Yoshinaka, T. Moringa, M. Shimada, S. Hokita, M. Baba, S. Takao, T. Fukumoto, H. J. Stein, T. Aikou
Journal: Endoscopy (1996)

Background and Study Aims: Esophageal invasion by carcinoma of the cardia may affect the surgical approach. Accurate assessment of esophageal invasion is difficult using endoscopy, computed tomography, or barium contrast radiography. The aim of the present study was to evaluate the use of endoscopic ultrasonography (EUS) in the prediction of esophageal invasion by carcinoma of the cardia.
α-Fetoprotein in Nonneoplastic Hepatic Disorders
Authors: Joseph R. Bloomer
Journal: JAMA (1975)

Serum α-fetoproteinmeasuredwere measured by radioimmunoassay in patpatients with biopsy-proved nonneoplastic hepatic disorders; 22% had values greater than 40 ng/ml, whereas only 1 of 350 patients with nonhepatic benign diseases had a value greater than this. Levels exceeded 40 ng/ml in more than 30% of patients with various types of hepatitis, and in 0% to 15% with inactive postnecrotic cirrhosis, primary biliary cirrhosis, biliary tract ob-astruction, and alcoholic liver disease. Values greater than 500 ng/ml were observed solely in viral subacute hepatic necrosis. Only one patient had a level exceeding 3,000 ng/ml, the concentration at which α-fetoprotein is detectable by agar-gel diffusion. Of 75 patients with hepatoma, serum α-fetoprotein levels exceeded 40 ng/ml in 69%, and exceeded 3,000 ng/ml in 48%. These studies indicate that serum protein levels exlevels are elevated in severalenonneoplastic hepatic disorders when a sensitive assay is used; this phenomenon may reflect hepatic regeneration.serum α-fetoproteinlevated in several nonneoplastic hepatic disorders when a sensitive assay is used; this s used; this ph reflect hepatic regeneration.  (JAMAation. (JAMA233
Sabbatical Leaves for Practicing Internists
Authors: W.A. Reynolds
Journal: Annals of Internal Medicine (1989)

Letters and Corrections1 July 1989Sabbatical Leaves for Practicing InternistsW.A. Reynolds, MDW.A. Reynolds, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-1-96_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:At the recent annual session of the American College of Physicians, I had the pleasure of moderating a session devoted to discussing mini-sabbatical leaves for practicing internists. There appears to be much interest in finding out about opportunities appropriate for internists in the United States and abroad. I am compiling a file of information and would appreciate hearing from physicians who might wish to contribute; particularly, reporting on firsthand experiences in the Third World that might appeal to other internists. Other experiences in the United States and abroad in medical institutions which might be adaptable for a... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: W.A. Reynolds, MDAffiliations: Missoula, MT 59807 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe professional sabbatical: A systematic review and considerations for the health-system pharmacistOuter space commercialization and its ethical challenges to international law and policy 1 July 1989Volume 111, Issue 1Page: 96-96KeywordsHearing ePublished: 1 December 2008 Issue Published: 1 July 1989 PDF downloadLoading ...