tbuckley/cabot-search huggingface dataset:
Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study
Authors: H. F. Ashdown, N. D'Souza, D. Karim, R. J. Stevens, A. Huang, A. Harnden
Journal: BMJ (2012)

<b>Objective</b> To assess the diagnostic accuracy of pain on travelling over speed bumps for the diagnosis of acute appendicitis. <b>Design</b> Prospective questionnaire based diagnostic accuracy study. <b>Setting</b> Secondary care surgical assessment unit at a district general hospital in the UK. <b>Participants</b> 101 patients aged 17-76 years referred to the on-call surgical team for assessment of possible appendicitis. <b>Main outcome measures</b> Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios for pain over speed bumps in diagnosing appendicitis, with histological diagnosis of appendicitis as the reference standard. <b>Results</b> The analysis included 64 participants who had travelled over speed bumps on their journey to hospital. Of these, 34 had a confirmed histological diagnosis of appendicitis, 33 of whom reported increased pain over speed bumps. The sensitivity was 97% (95% confidence interval 85% to 100%), and the specificity was 30% (15% to 49%). The positive predictive value was 61% (47% to 74%), and the negative predictive value was 90% (56% to 100%). The likelihood ratios were 1.4 (1.1 to 1.8) for a positive test result and 0.1 (0.0 to 0.7) for a negative result. Speed bumps had a better sensitivity and negative likelihood ratio than did other clinical features assessed, including migration of pain and rebound tenderness. <b>Conclusions</b> Presence of pain while travelling over speed bumps was associated with an increased likelihood of acute appendicitis. As a diagnostic variable, it compared favourably with other features commonly used in clinical assessment. Asking about speed bumps may contribute to clinical assessment and could be useful in telephone assessment of patients.
The Development of Foot Deformities and Ulcers After Great Toe Amputation in Diabetes
Authors: Terri L Quebedeaux, Lawrence A Lavery, David C Lavery
Journal: Diabetes Care (1996)

OBJECTIVE Our aim was to compare the prevalence and severity of foot deformities and the development of ulcerations in patients after a great toe amputations. RESEARCH DESIGN AND METHODS We evaluated the presence of deformities of the toes and metatarsophalangeal joints (MTPJs) in patients with a great toe amputation who had an intact unamputated contralateral foot. The contralateral foot served as the patient's own control. We used a binomial test for paired data to compare the presence of deformity and ulcer formation and Fisher's exact test to compare joint flexibility in toes and MTPJs with foot deformities. RESULTS There were more deformities of the second (P = 0.012) and third (P = 0.002) toes and lesser MTPJs (P &amp;lt; 0.05) and more rigid deformities of the second (P = 0.002) and third (P = 0.016) toes and second MTPJs (P = 0.035) in feet with great toe amputations. New ulcers were more common in feet that had an amputation (P = 0.002). CONCLUSIONS We concluded that amputation of the great toe contributes to the development of deformities of the second and third toes and lesser MTPJs and new ulcer formation in patients with diabetes. When deformities were present, the second and third toes and second MTPJ were more severe in feet with a great toe amputation.
Assessment of dietary exposure to trace metals in Baffin Inuit food.
Authors: H M Chan, C Kim, K Khoday, O Receveur, H V Kuhnlein
Journal: Environmental Health Perspectives (1995)

Chronic metal toxicity is a concern in the Canadian Arctic because of the findings of high metal levels in wildlife animals and the fact that traditional food constitutes a major component of the diet of indigenous peoples. We examined exposure to trace metals through traditional food resources for Inuit living in the community of Qikiqtarjuaq on Baffin Island in the eastern Arctic. Mercury, cadmium, and lead were determined in local food resources as normally prepared and eaten. Elevated concentrations of mercury ( > 50 micrograms/100 g) were found in ringed seal liver, narwhal mattak, beluga meat, and beluga mattak, and relatively high concentrations of cadmium and lead ( > 100 micrograms/100 g) were found in ringed seal liver, mussels, and kelp. Quantified dietary recalls taken seasonally reflected normal consumption patterns of these food resources by adult men and women ( > 20 years old) and children (3-12 years old). Based on traditional food consumption, the average daily intake levels of total mercury for both adults (65 micrograms for women and 97 micrograms for men) and children (38 micrograms) were higher than the Canadian average value (16 micrograms). The average weekly intake of mercury for all age groups exceeded the intake guidelines (5.0 micrograms/kg/day) established by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives and Contaminants. The primary foods that contributed to metal intake for the Baffin Inuit were ringed seal meat, caribou meat, and kelp. We review the superior nutritional benefits and potential health risks of traditional food items and implications for monitoring metal contents of food, clinical symptoms, and food use.
CPR for Patients Labeled DNR
Authors: Niteesh K. Choudhry, Sujit Choudhry, Peter A. Singer
Journal: Annals of Internal Medicine (2003)

Letters21 October 2003CPR for Patients Labeled DNRNiteesh K. Choudhry, MD, FRCPC, Sujit Choudhry, LLB, LLM, and Peter A. Singer, MD, MPH, FRCPCNiteesh K. Choudhry, MD, FRCPCFrom University of Toronto, Toronto, Ontario M5G 2C4, Canada.Search for more papers by this author, Sujit Choudhry, LLB, LLMFrom University of Toronto, Toronto, Ontario M5G 2C4, Canada.Search for more papers by this author, and Peter A. Singer, MD, MPH, FRCPCFrom University of Toronto, Toronto, Ontario M5G 2C4, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-8-200310210-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Resuscitation orders such as LATOs attempt to bridge the gap between patients' expressed preferences regarding resuscitation and their intended goals. Values-based advance directives highlight this distinction but often fail to provide clinicians with practical guidance on how to act upon their patients' values. In contrast, as pointed out by Dr. Gillick, intervention-specific directives are problematic because they fail to consider patients' goals and often require long lists of clinical scenarios. The LATO is a hybrid that lies between these extremes. By requiring clinicians to explain some of the complexities of resuscitation choices, the LATO clarifies patients' goals and ... Author, Article, and Disclosure InformationAffiliations: From University of Toronto, Toronto, Ontario M5G 2C4, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCPR for Patients Labeled DNR: The Role of the Limited Aggressive Therapy Order Niteesh K. Choudhry , Sujit Choudhry , and Peter A. Singer CPR for Patients Labeled DNR Muriel Gillick CPR for Patients Labeled DNR Jack P. Freer CPR for Patients Labeled DNR Susan B. LeGrand CPR for Patients Labeled DNR Bernard M. Karnath Metrics 21 October 2003Volume 139, Issue 8Page: 705-706KeywordsAdvanced cardiac life supportAlgorithmsCardiopulmonary resuscitationDecision makingDo not resuscitate ordersResuscitation ePublished: 21 October 2003 Issue Published: 21 October 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
NeurosenpsychologischeUntersuchungen zur essentiellen Hypertension
Authors: C. Drunkenmölle
Journal: Psychotherapy and Psychosomatics (1972)

A psychological examination of a number of unselected hypertonic patients – 25 male and 25 female – was made. In half of them there were familial heart and circulatory diseases. In the female patients, adiposity was significantly more frequent than in a female control group. There were no significant pecularities as to clinical symptoms, remembered neurotic symptoms of childhood, family interaction, and releasing situations. The duration of the disease in the female neurotic hypertonics was three times as long as in the non-neurotic ones. In 16 male and 21 female patients a psychoneurosis could be recorded psychometrically by MMPI.
HIV-1 matrix protein p17 binds to the IL-8 receptor CXCR1 and shows IL-8–like chemokine activity on monocytes through Rho/ROCK activation
Authors: Cinzia Giagulli, Anna K. Magiera, Antonella Bugatti, Francesca Caccuri, Stefania Marsico, Marco Rusnati, William Vermi, Simona Fiorentini, Arnaldo Caruso
Journal: Blood (2012)
Progress in Group Psychotherapy
Authors: William B. Terhune, James R. Dickenson
Journal: New England Journal of Medicine (1948)

GROUP psychotherapy has aroused much interest in psychiatric and general medical circles. The literature is voluminous and varied, indicating many approaches and as many purposes, with coincident confusion. This report summarizes the recent literature. Medical group psychotherapy was initiated in Boston in 1905 by Dr. Joseph H. Pratt. Psychiatric group therapy has been practiced in the Boston Dispensary since 1930.Military necessity and a shortage of psychiatric personnel resulted in the employment of this form of treatment by the armed forces in World War II. At the same time its use became expedient in civilian mental hospitals. Results indicate the . . .
Statin Therapy Interacts With Cytomegalovirus Seropositivity and High C-Reactive Protein in Reducing Mortality Among Patients With Angiographically Significant Coronary Disease
Authors: Benjamin D. Horne, Joseph B. Muhlestein, John F. Carlquist, Tami L. Bair, Troy E. Madsen, Noal I. Hart, Jeffrey L. Anderson
Journal: Circulation (2003)

Background— Seropositivity to cytomegalovirus (CMV) and elevated C-reactive protein (CRP) may jointly predict increased mortality rates in patients with coronary artery disease (CAD). Therapy with statins reduces lipid levels but may also have other beneficial (eg, antiinflammatory) effects. This study prospectively evaluated the effect of statins on CMV-and CRP-associated death among patients with significant, angiographically defined CAD. Methods and Results— We monitored 2315 patients with angiographically significant CAD (stenosis ≥70%) for an average of 2.4 years (maximum, 5.8 years). Anti-CMV IgG antibody levels and CRP concentrations were measured at baseline, and statin prescription was recorded. As previously reported, mortality rate was higher for CMV seropositivity (+) with high CRP (hazard ratio [HR], 2.0) and lower for statins (HR, 0.50). Compared with CMV(−)/low CRP (mortality rate, 5% with statin versus 4% without statin), the protective effect of statin therapy was markedly greater for CMV(+)/low CRP (mortality rate, 2% versus 7%; HR, 0.44; 95% CI, 0.16 to 1.3), CMV negative (−)/high CRP (mortality rate, 1% versus 8%; HR, 0.16), and CMV(+)/high CRP (mortality rate, 6% versus 17%; HR, 0.42; 95% CI, 0.25 to 0.70). After adjustment, interactions were found for statin therapy with CMV(+)/low CRP ( P for interaction=0.065), CMV(−)/high CRP ( P for interaction=0.051), and CMV(+)/high CRP ( P for interaction=0.024). Conclusions— The survival benefit of statins interacted with CMV seropositivity and high CRP to significantly reduce mortality rates among patients with CAD. This finding supports the hypothesis that statins have beneficial, “lipid-independent,” antiinflammatory effects. The mechanism of statin benefit associated with CMV seropositivity remains to be determined.
Future Place of Lumbar Sympathectomy in Obliterative Vascular Disease of Lower Limbs
Authors: J. A. Gillespie
Journal: BMJ (1960)

<h3>Objectives:</h3> To identify correlates of calf cramp in children with Charcot-Marie-Tooth disease type 1A (CMT1A). <h3>Methods:</h3> Throughout Australia, 81 children aged 2–16 years with CMT1A were recruited. Measures of strength, ankle range, foot posture, balance, agility, endurance, gait, and neurophysiology were collected. Post hoc logistic regression analyses were performed to identify independent predictors of calf cramp. <h3>Results:</h3> Of the 81 children, 26 (32%) reported calf cramp, and 1 child each reported toe, quadriceps, or arm cramp. Calf cramp was associated (<i>p</i> &lt; 0.05) with older age; the presence of hand tremor; stronger foot inversion, eversion, dorsiflexion, and plantarflexion; and better performance in long-jump and 9-hole peg tests. Logistic regression analysis revealed only increasing age (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.11–1.58; <i>p</i> = 0.002) and the presence of hand tremor (OR 3.81, 95% CI 1.18–12.56; <i>p</i> = 0.028) as independent predictors of calf cramp. <h3>Conclusion:</h3> Calf cramps are common in children with CMT1A and worsen with age. This study revealed a previously unrecognized link between cramp and hand tremor in children with CMT1A. Further investigation of proposed mechanisms and risk factors common to both cramp and tremor will contribute to our understanding of these common complications of CMT1A.
Metatarsal Metastasis From Lung Cancer Read as a Benign Process on Tc-99m MDP Scintigraphy
Authors: Paulo S. Duarte
Journal: Clinical Nuclear Medicine (2007)

A 61-year-old man with lung cancer who underwent Tc-99m MDP bone scintigraphy for staging of the disease is presented. Tc-99m MDP bone scintigraphy was initially read as normal for the patient's age and a left metatarsal bone uptake was interpreted as a benign process. Magnetic resonance imaging of the left foot performed a few months later due to local pain revealed a lesion at the base of the third metatarsal. The surgical excision of this region showed a metastasis from a lung cancer.
THYROID DYSFUNCTIONS AND THEIR TREATMENT
Authors: WILLARD O. THOMPSON
Journal: JAMA (1941)

<h3>CLASSIFICATION OF DISEASES1</h3> HYPOFUNCTION Primary Cretinism Sporadic Endemic Myxedema Spontaneous Postoperative Postinfectious During administration of iodine Secondary Hypopituitarism Addison's disease HYPERFUNCTION Exophthalmic goiter (Symmetric toxic goiter) Toxic adenoma (Nodular toxic goiter) Mixed type USUALLY NO DISORDER OF FUNCTION Simple goiter (Symmetric nontoxic goiter, colloid goiter) Nontoxic adenoma (Nodular nontoxic goiter) Anomalies of development Substernal goiter Pyramidal lobe Lingual goiter Thyroglossal cyst Lateral aberrant thyroid tissue Thyroid tissue in teratoma Thyroiditis Suppurative: acute and chronic Nonsuppurative: acute and chronic Struma lymphomatosa Riedel's struma Chagas' disease (Trypanosoma cruzi) New growths Primary Papillary adenocarcinoma—30 per cent Carcinoma in adenoma (malignant adenoma)—38 per cent Diffuse adenocarcinoma—31 per cent Squamous epithelioma—1 per cent Sarcoma—1
THE DIFFUSE INFILTRATING FORM OF CARCINOMA OF THE STOMACH.
Authors: LUDVIG HEKTOEN
Journal: JAMA (1898)

On presenting a specimen of diffuse carcinoma of the stomach to the Johns Hopkins Hospital Medical Society, Professor Welch1remarked that there are three diseases that may produce gross alteration in the stomach, indistinguishable from each other to the naked eye, viz., cirrhosis or fibroid thickening of the stomach, primary infiltrating carcinoma and secondary infiltrating carcinoma of the stomach. Orth2regards the majority of instances of contraction of the stomach as due to carcinomatous infiltration, and Welch looks upon a large number of the older cases in literature reported as cirrhosis of the stomach as diffuse carcinoma of this organ, because the diagnoses were not made by microscopic examination.  The first specimen of primary infiltrating carcinoma of the stomach, which I show here, is an example of a fibrous carcinoma, or scirrhus, occurring in a woman 45 years old, who had suffered some months with ascites, which required
Cardiovascular Effects of Systemic Nitric Oxide Synthase Inhibition With Asymmetrical Dimethylarginine in Humans
Authors: Jan T. Kielstein, Burcu Impraim, Solveig Simmel, Stefanie M. Bode-Böger, Dimitrios Tsikas, Jürgen C. Frölich, Marius M. Hoeper, Hermann Haller, Danilo Fliser
Journal: Circulation (2003)

Increased blood concentrations of the endogenous nitric oxide synthase (NOS) inhibitor asymmetrical dimethylarginine (ADMA) have been linked to excess cardiovascular morbidity and mortality and to progression of renal disease. We evaluated systemic cardiovascular effects of ADMA infusion in healthy subjects using invasive techniques, ie, right heart catheter and inulin/para-aminohippurate clearance.Plasma ADMA concentrations encountered in patients with cardiovascular diseases, ie, between 2 and 10 micromol/L, caused a significant (P<0.05) decrease in concentrations of plasma cGMP, the main second messenger of NO. In addition, cardiac output was significantly lower (5.3+/-0.4 versus 5.8+/-0.6 L/min; P<0.05 versus baseline), and systemic vascular resistance was significantly higher (1403+/-123 versus 1221+/-100 dyn x s x cm(-5); P<0.05 versus baseline). The infusion of 0.25 mg ADMA x kg(-1) x min(-1) or 3 microg N(G)-nitro-L-arginine methyl ester x kg(-1) x min(-1), a potent synthetic NOS inhibitor with long action, resulted in a comparable decrease in effective renal plasma flow (from 670+/-40 to 596+/-29 mL x min(-1); P<0.05) and an increase in renovascular resistance (from 79+/-5 to 90+/-7 mm Hg x mL(-1) x min(-1); P<0.05). Moreover, administration of ADMA caused significant sodium retention and blood pressure increase (both P<0.05). The observed effects of ADMA in the systemic circulation were sustained corresponding to a mean plasma half-life of 23.5+/-6.8 minutes, calculated from plasma ADMA decay curves in healthy subjects.Systemic ADMA infusion is responsible for a short-term, modest decrease in cardiac output with comparable decrease in effective renal plasma flow while increasing systemic vascular resistance and blood pressure in a dose-related manner.
Lack of Detectable Deleterious Effects on Metabolic Control of Daily Fructose Ingestion for 2 Mo in NIDDM Patients
Authors: C Grigoresco, S W Rizkalla, P Halfon, F Bornet, A M Fontvieille, M Bros, F Dauchy, G Tchobroutsky, G Slama
Journal: Diabetes Care (1988)

The effects of a daily intake of 30 g fructose on blood glucose regulation, erythrocyte insulin receptors, and lipid metabolism have been studied in type II (non-insulin-dependent) diabetic subjects. Eight wellcontrolled patients received, in a randomly assigned crossover design over two 2-mo study periods, 30 g of fructose in exchange for an isocaloric amount of starch. Fructose could be taken at any time during the day as part of the 1400–1600 kcal allowed diet (50% carbohydrate, 30% fat, 20% protein). No significant difference was observed concerning body weight, HbA1c, fasting plasma glucose, fasting plasma insulin, uric acid, total cholesterol, high-density lipoprotein cholesterol, and triglycerides, nor was there any change in insulin binding to erythrocytes between the fructose and the control starch period. However, the mean plasma triglyceride levels after the fructose period, although still in the normal range, were significantly higher than baseline values (P &amp;lt; .05). We conclude that moderate amounts of fructose incorporated into the diet of well-controlled type II diabetic subjects have no significant deleterious effect on glycemic control, insulin receptors of erythrocytes, or lipid metabolism.
Perihepatic Abscess Detection on Cholescintigraphy
Authors: ROBERT J. BENNETT, ROBERT C. STADALNIK, JOHN P. McGAHAN
Journal: Clinical Nuclear Medicine (1981)

A case report of a 77-year-old woman with gallbladder perforation is presented. Perihepatic abscess formation was detected on radionuclide cholescintigraphy and abdominal ultrasonography. A perihepatic “halo” with nonvisualization of the gallbladder on radionuclide cholescintigraphy should the diagnosis preoperatively.
Use of 6-Phosphogluconate Dehydrogenase as a Screen Test for Cervical Carcinoma in Normal Women
Authors: G. G. Muir, G. Canti, D. Williams
Journal: BMJ (1964)

Pyogenic Infection of Liver-McKenzieIJoUkNL 1563 McFadzean et al. (1953), who successfully treated 14 cases by this method. SmmyPylephlebitis and solitary liver abscess are both sequels to intra-abdominal infection.The incidence of pylephlebitis after appendicitis was much less in the past 10 years than in the years 1930-40.The incidence of pylephlebitis and solitary liver abscess due to other causes is not reduced to the same extent.The outlook is very much better for cases treated -in the past 10 years than for cases treated in 1930-40.A clinical diagnosis can be made by recognizing a pattern of clinical features and laboratory findings.Laparotomy findings or histopathological evidence is required for confirmation of the diagnosis.Treatment is by elimination of any known intra-abdominal infection, administration of an adequate course of antibiotics, and drainage of intrahepatic abscesses if present.There is a tendency for relapse to occur when treatment is discontinued, and laboratory tests are of assistance in judging the progress of the case and in deciding when antibiotics should be discontinued.
An Indian child with lipoid proteinosis resulting from a recurrent frameshift mutation (507delT) in the extracellular matrix protein 1 gene
Authors: I. Chan, G. Bingewar, K. Patil, C. Nayak, S.L. Wadhwa, J.A. McGrath
Journal: British Journal of Dermatology (2004)

Journal Article An Indian child with lipoid proteinosis resulting from a recurrent frameshift mutation (507delT) in the extracellular matrix protein 1 gene Get access I. Chan, I. Chan Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India Search for other works by this author on: Oxford Academic Google Scholar G. Bingewar, G. Bingewar Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India Search for other works by this author on: Oxford Academic Google Scholar K. Patil, K. Patil Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India Search for other works by this author on: Oxford Academic Google Scholar C. Nayak, C. Nayak Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India Search for other works by this author on: Oxford Academic Google Scholar S.L. Wadhwa, S.L. Wadhwa Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India Search for other works by this author on: Oxford Academic Google Scholar J.A. McGrath J.A. McGrath Genetic Skin Disease Group, St John's Institute of Dermatology, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, U.K. Department of Dermatology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India J.A.McGrath. E‐mail: john.mcgrath@kcl.ac.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 151, Issue 3, 1 September 2004, Pages 726–727, https://doi.org/10.1111/j.1365-2133.2004.06159.x Published: 01 September 2004