tbuckley/cabot-search huggingface dataset:
Reduced Forearm Blood Flow in Children and Adolescents With Type 1 Diabetes (Measured by Near-Infrared Spectroscopy)
Authors: Gerhard Pichler, Berndt Urlesberger, Paul Jirak, Heinz Zotter, Elke Reiterer, Wilhelm Müller, Martin Borkenstein
Journal: Diabetes Care (2004)

OBJECTIVE—The aim of this study was to measure forearm blood flow (FBF) to detect any possible changes that might indicate vascular disorders in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS—FBF was measured by near-infrared spectroscopy (NIRS), venous occlusion at rest, and after handgrip exercise. A total of 40 children and adolescents with type 1 diabetes and 40 healthy children and adolescents (6–18 years) were matched for age and sex for comparison. RESULTS—In the diabetic group (age 12.79 ± 2.9 years, duration of diabetes 51.5 ± 36 months), FBF at rest was significantly lower (1.39 ± 0.76 ml · 100 g muscle–1 · min–1) than in control subjects (age 12.66 ± 2.9 years, FBF at rest 1.90 ± 1.19 ml · 100 g muscle–1 · min–1). After exercise, FBF increased significantly less in the diabetic group (0.70 ± 0.82 ml · 100 g muscle–1 · min–1) compared with the control subjects (1.15 ± 1.05 ml · 100 g muscle–1 · min–1). FBF at rest decreased with increasing age in both groups. The change in FBF after exercise was independent of age in the diabetic group and increased with increasing age in control subjects. FBF is reduced with impaired hyperemic response after exercise in children and adolescents with type 1 diabetes. CONCLUSIONS—These data suggest that vascular disorders in childhood are detectable noninvasively by NIRS.
Hyperbilirubinemia in Lapatinib Treated Patients Is Associated with Gilbert's Syndrome <i>UGT1A1</i> Polymorphism.
Authors: C. Spraggs, L. Budde, L. Briley, N. Bing, B. Newstat, E. Rappold, V. Mooser, L. Cardon, S. Stein
Journal: Cancer Research (2009)

Abstract Background: Lapatinib, an oral EGFR/HER2 tyrosine kinase inhibitor, is approved in combination with capecitabine for the treatment of patients with advanced or metastatic HER2-positive breast cancer who have been treated previously with an anthracycline, taxane and trastuzumab. Treatment associated elevations in transaminases and bilirubin have been observed in lapatinib clinical trials. A common TA repeat polymorphism in the promoter region of uridine diphosphoglucuronyl transferase (UGT1A1*28, TA7 allele) reduces UGT1A1 enzyme levels and has been associated with hyperbilirubinemia for a range of drugs. We sought to determine the effect of the UGT1A1*28 variant on bilirubin elevation in lapatinib treated patients.Patients and Methods: Association between the UGT1A1 TA repeat polymorphism and total bilirubin levels (TBL) was examined in lapatinib treated patients using data pooled from 12 trials in advanced and metastatic breast cancer. A total of 899 lapatinib treated (as monotherapy or combined with chemotherapy) patients provided a germline DNA sample and were available for this analysis. UGT1A1 TA repeat genotype was determined by PCR amplification and sequencing. For case-control analysis, patients were defined as having normal TBL at baseline, with on-treatment TBL ≥1.5 and ≤1 times upper limit of normal for cases and controls, respectively, and at least 13 weeks of treatment for controls.Results: The UGT1A1 TA repeat polymorphism strongly correlated with lapatinib associated hyperbilirubinemia. A significant association (P=1.03x10-5, 60 cases and 396 controls) was observed. For hyperbilirubinemia cases, 21/60 (35%) were carriers of two TA7 alleles and 28/60 (47%) were carriers of one TA7 allele. Overall, when compared with other genotypes, the odds ratio (95% confidence interval) of the TA7/TA7 genotype for developing hyperbilirubinemia was 10.7 (5.3-21.6).Conclusion: These data suggest that UGT1A1*28 accounts for the major proportion of total bilirubin elevation observed during lapatinib treatment. This is consistent with an underlying predisposition to Gilbert's syndrome. Given the life-threatening nature of advanced and metastatic breast cancer and the benign clinical course of Gilbert's syndrome, these data support treatment continuation with lapatinib for patients with mild to moderate, isolated, indirect bilirubin elevation, when accompanied by appropriate ongoing safety evaluation (eg, bilirubin fractionation, ALT evaluation) to exclude liver injury risk in these patients. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1112.
FURTHER OBSERVATIONS AND EXPERIMENTS ON GOITRE (SO CALLED THYROID CARCINOMA) IN BROOK TROUT (SALVELINUS FONTINALIS)
Authors: David Marine
Journal: The Journal of Experimental Medicine (1914)

1. Goitre in fish is a non-infectious, non-contagious, symptomatic manifestation of a fault of nutrition, the exact biochemical nature of which has not been determined. 2. Feeding the highly artificial and incomplete diet of liver is the major etiological factor in bringing about this fault of nutrition which is at once corrected by feeding whole sea fish. 3. Water plays no essential part in the etiology, transmission, or distribution of the disease in the fish of this hatchery.
Medullary Aplasia in Chronic Myeloid Leukaemia during Busulphan Therapy
Authors: F. G. J. Hayhoe, D. Kok
Journal: BMJ (1957)

Busulphan (1: 4-dimethanesulphonyloxybutane; "my- leran ") is now well established as an effective and rela- tively safe agent in the control of chronic myeloid leuk- aemia.Haddow and Timmis (1953) first noted the strong
THE IDENTIFICATION OF CRIMINALS THROUGH THE FUNDUS OF THE EYE.
Authors: M. F. WEYMANN
Journal: JAMA (1902)

Commensurate with the importance of the certain identification of criminals have been the efforts at elaborating a reliable system for this purpose. Most prominent in this line stands out the method of M. Bertillon; vet even in it there occur so many data subject to change by reason of growth, voluntary effacement or disfiguration, that further additions are by no means undesirable. I wish here to call attention to the fact that anybody could at any time, with a certainty, be identified by the anatomical conformation of the fundus oculi; in fact, the disposition of the arteria centralis retinæ and its branches alone would be sufficient for the purpose. I admit that a casual observation would fail to do so, but identification by a previously made—and that with the greatest exactitude—drawing of the fundus would leave no room for doubt. While there are many details sufficiently characteristic in the papilla,
Digoxin Prescribing-Reply
Authors: Michael Weintraub
Journal: JAMA (1980)

<h3>In Reply.—</h3> Not all drugs should be prescribed generically, as indicated by Drs Carter and Tarshis. Digoxin is one that is best prescribed by brand name. As pointed out in our article, the Food and Drug Administration itself did not approve digoxin for substitution under the New York State generic prescribing law. I think that there is enough "bobbling" room in the current digoxin bioavailability standards to raise the question of clinical difficulties when patients' therapies are switched from one generic manufacturer's formulation to another. As Drs Carter and Tarshis point out, one could measure the serum digoxin concentration each time a question arises. However, at Strong Memorial Hospital, this test costs $20. The patient could purchase an 18-month supply of Lanoxin in our pharmacy for the same amount of money. Additionally, this analysis assumes that the serum digoxin concentration will nearly always be helpful in caring for the patient.
Sensitivity and Specificity of Helical Computed Tomography in the Diagnosis of Pulmonary Embolism
Authors: Suman W. Rathbun, Gary E. Raskob, Thomas L. Whitsett
Journal: Annals of Internal Medicine (2000)

Purpose: To determine the sensitivity and specificity of helical computed tomography (CT) for the diagnosis of pulmonary embolism and to determine the safety of withholding anticoagulant therapy in patients who have clinically suspected pulmonary embolism and negative results on helical CT. Data Sources: The MEDLINE database was searched for all reports published from 1986 to October 1999 that evaluated the use of helical CT for the diagnosis of pulmonary embolism. Bibliographies of the retrieved articles were cross-checked to identify additional studies. Study Selection: All prospective English-language studies were selected. Retrospective studies, review articles, and case reports were excluded, and 5 of the 20 identified articles were excluded. The scientific validity of the remaining 15 articles was assessed. Data Extraction: Two of the authors used a priori, predefined criteria to independently assess each study. A third author resolved disagreements by adjudication. The predefined criteria were inclusion of a consecutive series of all patients with suspected pulmonary embolism, inclusion of patients with and those without pulmonary embolism, a broad spectrum of patient characteristics, performance of helical CT and pulmonary angiography (or an appropriate reference test) in all patients, and independent interpretation of the CT scan and pulmonary angiogram (or reference test). Specific data on sensitivity and specificity and the associated 95% CIs were recorded when available. Data Synthesis: No study met all of the predefined criteria for adequately evaluating sensitivity and specificity. The reported sensitivity of helical CT ranged from 53% to 100%, and specificity ranged from 81% to 100%. In no prospective study was anticoagulant therapy withheld without further testing for venous thromboembolism in consecutive patients with suspected pulmonary embolism. One prospective study reported the outcome of selected patients with negative results on helical CT who did not receive anticoagulant therapy. Conclusions: Use of helical CT in the diagnosis of pulmonary embolism has not been adequately evaluated. The safety of withholding anticoagulant treatment in patients with negative results on helical CT is uncertain. Definitive large, prospective studies should be done to evaluate the sensitivity, specificity, and safety of helical CT for diagnosis of suspected pulmonary embolism.
Methods for estimating burden of tuberculosis in India need to be improved
Authors: C. Travasso
Journal: BMJ (2014)

An inventory survey and a national survey of the prevalence of tuberculosis should be carried out to improve estimation of the burden of the disease in India, a new report from the World Health Organization has recommended . 

Around one in four of the world’s cases of tuberculosis occurs in India, but the true burden in the country is believed to be even higher owing to underdiagnosis and under-reporting.

India’s most recent national survey of the prevalence of tuberculosis took place in 1955. Since then figures on incidence, …
Complementary therapies used by patients with cancer
Authors: E J Maher, T Young, I Feigel
Journal: BMJ (1994)

As a result the Royal Pharmaceutical Society of Great Britain issued a statement to pharmacists last April, saying that all dispensed oral liquid medicines should be supplied in a child resistant container from 1 January next year.As supplies of these bottles and caps become available during this year they will begin to be used by pharmacists.Discussions are currently taking place between the society and the pharmaceutical industry about the use of child resistant containers for original pack oral liquid medicines; it is hoped that the containers will be used for these by 1 January 1996.
Inadvertent Rubella Vaccination of Pregnant Women
Authors: Shelby A. Wyll
Journal: JAMA (1973)

Two hundred fifteen cases of inadvertent rubella vaccination in early pregnancy or shortly before conception have been studied to determine the risk of fetal infection with rubella vaccine-like virus (RVV). Of the 215 women, 184 (86%) did not have prevaccination sero-immunity screening. Only 24 women (11%) were known to be susceptible prior to vaccination. One hundred seven (50%) of the pregnancies ended with induced abortions, 12 (5%) with spontaneous abortions, and 96 (45%) with live births. None of the live-born infants had serologic or clinical evidence of congenital rubella; however, RVV was isolated from abortion specimens in seven cases, three of which had isolates from fetal tissue. The similarities between RVV and wild rubella virus infection of decidual, placental, and fetal tissue strongly suggest that RVV poses a definite hazard to the fetus.
Orthostatic increase of respiratory gas exchange in hyperventilation syndrome
Authors: W. GARDNER
Journal: Thorax (2000)

The paper by Malmberg et al in the current issue of Thorax 1 deals with the difficult subject of the hyperventilation syndrome and finds that these patients have a disproportionately high ventilatory response to change of body position from supine to standing. The authors suggest that this can be used as a diagnostic criterion for hyperventilation syndrome. Hyperventilation is a confused and poorly documented subject and the publication of this paper provides an opportunity to review some of the particularly controversial aspects of this subject.

The first issue concerns the basis for the labelling of these patients as “hyperventilation syndrome”. Some of the controversies about the use of this term have recently been reviewed by Folgering2and by Gardner.3 The physiological definition of hyperventilation is alveolar ventilation that is inappropriately high for the metabolic production of carbon dioxide, leading to reduction of arterial Pco2  (Paco 2) below the normal range (hypocapnia) and respiratory alkalosis. The combination can lead both to vasoconstriction in selected vascular beds and to neuronal hyperexcitability producing symptoms involving most systems of the body. Many psychosomatic syndromes have been described in the past in which hyperventilation has a variable and uncertain role but the term “hyperventilation syndrome” was first used in 1938 to describe patients with the somatic symptoms of both hypocapnia and anxiety.4 This theme was extended by subsequent authors5-7 and the definition arrived at by Lewis and Howell in 1986 on the basis of a questionnaire of delegates at a psychophysiology meeting8 was “a syndrome induced by physiologically inappropriate hyperventilation and usually reproduced in whole or in part by voluntary hyperventilation”. However, the term “hyperventilation syndrome” is now used in so many different contexts that it could be argued that it has ceased to have any universal meaning. …
Chloral in Cases of Insanity
Authors: G. B. Wadsworth
Journal: BMJ (1870)

Towards the end of the month (February 25th), she expressed her- self as feeling better; the paroxysms of headache had been less severe, and she was able to sit up a short time.The strabismus was the same; but ophthalmoscopic examination showed the optic discs less swollen and more defined, and the retina paler.She then left her bed and gradually improved, the pain being less and her health altogether better; and on March 26th, she left off the bromide of potassium.She walked about the ward looking very well, but the strabismus remained in some degree; and, although the face exhibited no paralysis, yet it showed the want of power before mentioned, when the muscles were tested.She occasionally had returns of the pain in the head.She then left the hospital; but was seen on April ioth, free from pain.The case was thus a most difficult one in which to form an accurate diagnosis.
Centrally-induced vasopressor responses to carbachol are augmented in DOCA-salt hypertensive rats
Authors: H. TAKAHASHI, A. INOUE, K. TAKEDA, H. OKAJIMA, S. SASAKI, I. IYODA, M. YOSHIMURA, M. NAKAGAWA, H. IJICHI
Journal: Cardiovascular Research (1984)

Increased sympathetic nervous system activity and vasopressin release has been demonstrated in established DOCA-salt hypertension in the rat. To determine the importance of these mechanisms in centrally-mediated pressor responses in this model of hypertension, both awake rats and rats anaesthetised with urethane were given intracerebroventricular injections of carbachol. The systolic blood pressure after implanting a silicon rubber mould containing DOCA, and with subsequent substitution of 1% saline in tap water, increased from 112 +/- 3 mmHg to a stable 188 +/- 7 mmHg by the end of 4 weeks, measured using a tail-cuff method. The blood pressure consistently became elevated when carbachol was injected into the cerebral ventricles of awake rats. Of the three groups of normotensive rats (NTR), sham-operated rats (SHAM) and DOCA-salt hypertensive rats (DOCA), the magnitude of the pressor phase was largest in the DOCA rats. The heart rate in all three groups of rats decreased similarly. When the rats were later anaesthetised with urethane to allow recording of abdominal sympathetic nerve activity, the carbachol injections caused biphasic blood pressure responses and sympathetic nerve discharge consisting of initial vasodepression and sympathetic nerve inhibition of short duration. This was followed by a sustained pressor phase accompanied by a corresponding increase in sympathetic nerve activity. The magnitude of the pressor response was again larger in the DOCA than in the SHAM rats. Spinal section abolished the initial depressor phase but did not much affect the sustained pressor phase.(ABSTRACT TRUNCATED AT 250 WORDS)
Escape from highly effective public CD8+ T-cell clonotypes by HIV
Authors: Maria Candela Iglesias, Jorge R. Almeida, Solène Fastenackels, David J. van Bockel, Masao Hashimoto, Vanessa Venturi, Emma Gostick, Alejandra Urrutia, Linda Wooldridge, Mathew Clement, Stéphanie Gras, Pascal G. Wilmann, Brigitte Autran, Arnaud Moris, Jamie Rossjohn, Miles P. Davenport, Masafumi Takiguchi, Christian Brander, Daniel C. Douek, Anthony D. Kelleher, David A. Price, Victor Appay
Journal: Blood (2011)
Pathogenic role of hepatitis B virus in hepatitis B surface antigen—negative decompensated cirrhosis
Authors: Hau-Tim Chung, Ching-Lung Lai, Anna S. F. Lok
Journal: Hepatology (1995)

This study was conducted to determine the rate of detection of serum hepatitis B virus (HBV) DNA in hepatitis B surface antigen (HBsAg)-negative decompensated cirrhotic patients who had hepatitis B core and/or surface antibodies (anti-HBc and/or anti-HBs), and to compare the outcome of HBsAg-positive cirrhotic patients who did or did not clear HBsAg during follow-up. Six (5%) of 121 HBsAg-positive cirrhotic patients lost HBsAg after 0.2 to 17.1 years (mean, 9.1 +/- 6.2 yr) of follow-up. The cumulative rates of loss of HBsAg at 1, 5, 10, and 15 years were, respectively, 1.3%, 1.3%, 7.4%, and 44.5%. Compared with the patients who remained HBsAg-positive, those who lost HBsAg had milder disease at presentation and significantly longer survival. Of the patients who lost HBsAg, 83% had improvement in liver function after the loss of HBsAg, and all were alive at the time of writing (0.8 to 5.7 years after loss of HBsAg), whereas 27% of those who remained HBsAg-positive had died and 29% had deterioration in liver function. The rate of detection of serum HBV DNA by polymerase chain reaction (PCR) assay was higher in HBsAg-positive cirrhotic patients who lost HBsAg:67% versus cirrhotic patients who had no previous history of chronic HBV infection; 16% (cryptogenic) and 29% (hepatitis C virus and/or alcohol-induced liver disease). In summary, we found that using PCR, serum HBV DNA can be detected in 28% of HBsAg-negative cirrhotic patients who were studied, but the pathogenic significance of such small amounts of virus is not clear.(ABSTRACT TRUNCATED AT 250 WORDS)
The Usefulness of Urban Paramedics-Reply
Authors: B. I. Bodai
Journal: JAMA (1986)

<h3>In Reply.—</h3> Prehospital care evolved from the original model of a "mobile cardiac care unit." Initially, only a defibrillator was present on the ambulance. Now in California over 40 different IV medications can be employed for the treatment of multiple medical and surgical emergencies. A fundamental assumption has been made that what can be treated in the hospital will respond to prehospital interventions. The above letters reflect that hypothesis. However, there is little proof that this assumption is valid. We believe prehospital care is uniquely different from hospitalbased treatment. The prehospital rescuers are limited to only four hands. Each therapeutic intervention must be performed in sequence rather than in parallel, as is often the case in the emergency department. In addition, with a multitude of emergencies to treat, the paramedics are required to become diagnosticians, yet their diagnostic equipment consists of only a stethoscope, a sphygmomanometer, and an electrocardiographic monitor.
Inflammatory Bowel Disease: Diagnosis and Therapeutics
Authors: Anthony J. DiMarino
Journal: Annals of Internal Medicine (2003)

Medical Writings: Book Notes15 July 2003Inflammatory Bowel Disease: Diagnosis and TherapeuticsAnthony J. DiMarino Jr, MDAnthony J. DiMarino Jr, MDDivision of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-2-200307150-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cohen RD, ed. 364 pages. Totowa, NJ: Humana Pr; 2003. $125.00. ISBN 0896039099. Order phone 973-256-1699.Field of medicine: Gastroenterology.Format: Hardcover book.Audience: Patients with inflammatory bowel disease (IBD)ulcerative colitis and Crohn diseasetheir families, and physicians and other medical personnel involved in the care of patients with IBD.Purpose: To provide a concise overview of the medical and socioeconomic issues involved in the diagnosis and treatment of patients with IBD.Content: This multiauthored book contains 17 chapters that range from tracing the history and early descriptions of IBD through the etiology and epidemiology and diagnosis and management. Special chapters ... Author, Article, and Disclosure InformationAffiliations: Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 2003Volume 139, Issue 2Page: 156KeywordsGrowth hormoneInflammatory bowel diseaseMedical geneticsMedical staffNicotineNutritionPatientsProbioticsSoftware toolsSurgery ePublished: 15 July 2003 Issue Published: 15 July 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Uncleaned Anesthesia Equipment
Authors: Gerald S. Linder
Journal: JAMA (1976)

<h3>To the Editor.—</h3> The article by Dryden (233:1297, 1975) stressed the concept of aseptic technique in inducing anesthesia teams to develop bacterially clean systems for each patient. The use of sterile, disposable equipment, such as endotracheal tubes, masks, breathing bags, and circuits, is the first step in achieving clean systems (but was not mentioned in the article). To this list should be added the use of sterile, disposable, endotracheal tube stylets. There is a "blind spot" in anesthesia practice that is widespread and defeats the use of aseptic equipment: This is the use of unsterile endotracheal tube stylets to which unsterile lubricant is added. Many of these stylets are makeshift from copper electrical wire, coat hangers, and knitting needles and thus pose an additional injury hazard. Sterile, self-lubricating, disposable endotracheal tube stylets are now available commercially and should be used routinely to maintain the shield of asepsis and to help