tbuckley/cabot-search huggingface dataset:
Types of Cutaneous Reactions to Drugs
Authors: Rudolf L. Baer
Journal: JAMA (1967)

It has long been known that clinically recognizable adverse reactions to drugs are seen more often in the skin than in any other organ or system. This observation is substantiated by data, accumulated by the American Medical Association Registry on Adverse Reactions, which show that cutaneous manifestations have been by far the most frequently reported form of adverse reaction. One apparent reason is that skin lesions are so readily observed that both patients and physicians are quickly alerted to their possible association with a drug reaction. Because of their frequency and because their visible characteristics alone serve to separate them into a variety of specific types, cutaneous reactions play a particularly important role in the early recognition of untoward effects produced by drugs. Clinical experience has revealed propensities that certain medicaments have for causing skin reactions of a particular morphological pattern. Known associations of this nature are an important element
Carbohydrate Digestion and Absorption
Authors: Gary M. Gray
Journal: New England Journal of Medicine (1975)

DIETARY carbohydrate accounts for about half the calories ingested by man and consists of the polysaccharides, starch and glycogen, and the disaccharides, sucrose and lactose. In the Western diet, starch accounts for about 60 per cent, sucrose for 30 per cent, and lactose for 10 per cent of the ingested carbohydrate. Other oligosaccharides such as raffinose and stachyose are ingested in small amounts in legumes (kidney beans, lentils and navy beans) but cannot be hydrolyzed by intraluminal or intestinal enzymes. Although not important nutritionally, saccharides in legumes are acted upon by bacteria in the lower small intestine and colon to . . .
The Usefulness of Diagnostic Testing in the Initial Evaluation of Chronic Kidney Disease
Authors: Mallika L. Mendu, Andrew Lundquist, Ayal A. Aizer, David E. Leaf, Emily Robinson, David J. R. Steele, Sushrut S. Waikar
Journal: JAMA Internal Medicine (2015)

Chronic kidney disease (CKD) affects approximately 13% of adults in the United States and is associated with significant morbidity, mortality, and costs.1–3 There is a broad differential for CKD, including diabetes mellitus, hypertension, glomerulonephritis, tubulointerstitial disease, urologic causes, and unknown causes.2 To our knowledge, a comprehensive assessment of the tests used in CKD evaluation has not been conducted. We determined how often laboratory and imaging tests were obtained in the initial evaluation of CKD and whether these tests affected diagnosis and/or management.
Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis
Authors: Michael K. Gould
Journal: Annals of Internal Medicine (1999)

Background: Low-molecular-weight heparins may simplify the management of deep venous thrombosis. A critical clinical issue is whether this more convenient therapy is as safe and effective as treatment with unfractionated heparin. Purpose: To compare the safety and efficacy of low-molecular-weight heparins with those of unfractionated heparin for treatment of acute deep venous thrombosis. Data Sources: Reviewers identified studies by searching MEDLINE, reviewing references from retrieved articles, scanning abstracts from conference proceedings, and contacting investigators and pharmaceutical companies. Study Selection: Randomized, controlled trials that compared a low-molecular-weight heparin preparation with unfractionated heparin for treatment of acute deep venous thrombosis. Data Extraction: Two reviewers extracted data independently. Reviewers evaluated study quality using a validated four-item instrument. Data Synthesis: Eleven of 37 studies met inclusion criteria for three major outcomes. Most studies used proper randomization procedures, but only one was double-blinded. Compared with unfractionated heparin, low-molecular-weight heparins reduced mortality rates over 3 to 6 months of patient follow-up (odds ratio, 0.71 [95% CI, 0.53 to 0.94]; P = 0.02). For major bleeding complications, the odds ratio favored low-molecular-weight heparins (0.57 [CI, 0.33 to 0.99]; P = 0.047), but the absolute risk reduction was small and not statistically significant (0.61% [CI, −0.04% to 1.26%]; P = 0.07). For preventing thromboembolic recurrences, low-molecular-weight heparins seemed as effective as unfractionated heparin (odds ratio, 0.85 [CI, 0.63 to 1.14]; P > 0.2). Conclusions: Low-molecular-weight heparin treatment reduces mortality rates after acute deep venous thrombosis. These drugs seem to be as safe as unfractionated heparin with respect to major bleeding complications and appear to be as effective in preventing thromboembolic recurrences.
Relationships between Progesterone Receptor Isoforms and the HER Receptors and Ligands Network in 299 Primary Breast Cancers.
Authors: F. Révillion, C. Lindet, V. Lhotellier, L. Hornez, J. Bonneterre, J. Bonneterre, J. Peyrat
Journal: Cancer Research (2009)

Abstract Background: The effects of progesterone are mediated by two distinct nuclear receptors, called PR-A and PR-B, which are encoded by a single gene. In the normal human breast, these two isoforms are co-expressed at similar levels of expression whereas breast cancer seems to be characterized by an unbalanced expression of PR-A and PR-B, with a predominance of either one of these two isoforms. In the present study, we analyzed the relationships between the PR isoforms and the HER receptors and ligands network in primary breast cancer.Materials and Methods: This study involves 299 breast cancer samples from patients operated in our institute for locoregional disease between May 1989 and December 1991. Since PR-A has no specific sequence to distinguish it from PR-B, the mRNA expression of total PR-(A+B) isoforms as well as those of PR-B were assessed. They were quantified by real time quantitative RT-PCR using TaqMan probes, as previously described for HER receptors (Epidermal Growth Factor Receptor EGFR, HER2, HER3, and HER4) (Pawlowski et al, Clin Cancer Res 2000;6:4217-25) and HER ligands (EGF, Transforming Growth Factor alpha (TGFa), amphiregulin (AREG), betacellulin (BTC), Heparin-Binding EGF (HB-EGF), Epiregulin (EREG), and neuregulins 1-4 (NRG1-4)) (Révillion et al, Ann Oncol 2008;19:73-80).Results: PR-(A+B) and PR-B mRNA levels strongly correlated with PR and ER protein levels determined by radioligand assay. PR-(A+B) were found to correlate positively to IGF1 receptor, and both isoforms correlated negatively to histoprognostic grading. Considering the HER receptor and ligands network, PR-(A+B) were positively correlated with HER3, HER4, EGF, AREG, while they were negatively correlated with EGFR, TGFa, HB-EGF, EREG, and NRG2. Similarly, a positive correlation was found between PR-B and HER3, HER4, EGF and AREG while PR-B correlated negatively to EREG, NRG3 and NRG4. Finally, PR-(A+B) expression (higher than the lower quartile) was significantly associated with a longer overall survival (p= 0.02, Kaplan-Meier analysis).Conclusion: Our results, demonstrating strong correlations between PR isoforms and HER receptors and ligands network, reinforce the observations (Proietti et al, Mol Cell Biol 2009;29:1249-65) demonstrating that cross-talk between PR and the HER family appears to be a hallmark of breast cancer growth. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4150.
Toll-like receptor engagement converts T-cell autoreactivity into overt autoimmune disease
Authors: Karl S Lang, Mike Recher, Tobias Junt, Alexander A Navarini, Nicola L Harris, Stefan Freigang, Bernhard Odermatt, Curdin Conrad, Lars M Ittner, Stefan Bauer, Sanjiv A Luther, Satoshi Uematsu, Shizuo Akira, Hans Hengartner, Rolf M Zinkernagel
Journal: Nature Medicine (2005)
Hypercalcemia and Increases in Serum Hormone Value during Prolonged Administration of 1α,25-Dihydroxyvitamin D
Authors: Norman H. Bell, Paula H. Stern
Journal: New England Journal of Medicine (1978)

PREVIOUS studies have indicated that in pseudohypoparathyroidism there is a defect in the renal production of 1α,25-dihydroxyvitamin D. The mean concentration of the hormone in the circulation is abnormally low.1 , 2 We have reported in short-term studies that impaired intestinal absorption of calcium, hypocalcemia and secondary hyperparathyroidism can be corrected by small doses of 14α,25-dihydroxyvitamin D3.1 , 3 We now describe some complications of the long-term use of 1α,25-dihydroxyvitamin D3 in pseudohypoparathyroidism. We find that increases in serum 1α,25-dihydroxyvitamin D3 may occur after its prolonged administration, and that these increases in hormone value are associated with hypercalcemia. The increased . . .
HLA-B27 sequences identified in a mediaeval skeleton with ankylosing spondylitis
Authors: I Leden, A Götherström, L Drenzel, B Svensson
Journal: Annals of the Rheumatic Diseases (2009)

The aim of this letter is to make public an unusual skeletal remain with classic features of ankylosing spondylitis (AS). Furthermore, human leucocyte antigen (HLA)-B27 sequences have been studied.

In the National Historical Museum in Stockholm there is a male skeleton (inventory no 14549). It was found during the excavation of St Clemens, a church ruin from the Middle Ages in Visby, Sweden. The preserved parts form a block, with smooth, continuous calcifications of the long ligaments and bony ankyloses of the intervertebral joints. Several ribs are fixed to the thoracic vertebrae through ankyloses of the costovertebral joints (fig 1). Also the sacroiliac joints are fused. The man lived sometime between 900 and 1300 AD. The details of this excavation were published in …
Pancreatitis, Hypercalcemia, and Breast Carcinoma-Reply
Authors: Uzi Gafter
Journal: JAMA (1976)

We read Dr Clark's remarks with great interest. The main point discussed is the hypophosphatemia found in the case reported. Although the fact that breast neoplasms secrete substances that do not cause hypophosphatemia is well documented, the case of a patient with low phosphorus level has been reported.<sup>1</sup>Moreover, elevated levels of ectopic parathyroid hormone were found in 14 patients with breast cancer.<sup>2</sup>Unfortunately, we did not determine the serum parathyroid hormone concentration because of technical reasons. We agree with Dr Clark that administration of steroids may be a possible cause of the patient's acute pancreatitis, although it seems less likely.
Points: Relapse of duodenal ulcer
Authors: R T Ravenholt
Journal: BMJ (1987)

in addition to Doppler studies.If they judged, again exclusively by their interpretation of the femoral pulse, that there was some aortoiliac disease then blind aortoiliac surgery was advocated in addition to the distal surgery.If angiography showed a localised iliac stenosis we would proceed to angioplasty.This procedure alone might improve the patient's clinical condition or it might subsequently be necessary to proceed to bypass surgery or further angioplasty.Whereas we advocate and use extensively Doppler ultrasound in the management of peripheral vascular disease, we see it as a critical adjunct to angiography in the combined treatment of patients with peripheral vascular disease by both the surgeon and the radio- logist.1
Thymoma followed by paroxysmal nocturnal hemoglobinuria: A unique clinical association in the context of multiorgan autoimmunity with a potential role for CD8+ T lymphocytes
Authors: Giovannella Palmieri, Carmine Selleri, Liliana Montella, Goffredo Bulgarelli, Laura Vitiello, Ghassan Merkabaoui, Patrizia Ricci, Luigi Del Vecchio, Annamaria Masci, Luigi Racioppi, Bruno Rotoli
Journal: American Journal of Hematology (2006)

Abstract Seven years after a surgically resected thymoma, a female patient affected by myasthenia gravis and Good's syndrome presented with paroxysmal nocturnal hemoglobinuria (PNH). Co‐culture experiments and spectratyping analyses indicated that CD8+ lymphocytes were involved in damaging hematopoietic precursors. While PNH clones have been identified in various hematological disorders, the sequential association of thymoma and PNH has been unreported so far. Am. J. Hematol., 2006. © 2006 Wiley‐Liss, Inc.
Lead Poisoning and Fecundity in Men
Authors: Hugh H. Hussey
Journal: JAMA (1975)

Although a standard textbook of medicine devotes extensive descriptions of the effects of lead poisoning on the gut, the nervous system, the brain, the blood, the gingival lead line, and other symptoms, no mention is made of effects on the male gonads. In the current issue of the<i>Archives of Environmental Health</i>(30:396, 1975) is a report from Switzerland by Lancranjan et al that indicates serious gonadal impairment in men exposed to lead in a storage battery factory. The effects were shown to be direct in that tests for a hypothalamopituitary influence were negative. The authors studied 150 workmen who had had longterm exposure to lead in varying degrees. Clinical and toxicological criteria were used to categorize the men into four groups: lead-poisoned workmen, and those showing moderate, slight, and physiologic absorption of lead. Semen analysis demonstrated hypofertility in lead-poisoned workers as well as in those who had a moderately
Comparative radiological and morphological study of human pancreas.
Authors: J M Braganza, D W Acheson
Journal: Gut (1985)

Comparative radiological and morphological study of human pancreas SIR-It is a pity that the authors of this recent paper (Gut 1985; 26: 406) did not allude to the classical work of Birnstingl1 on the same subject.Both studies show the low specificity of pancreatographic abnormalitiesparticularly minimal-changepancreatitis (MIP) -in diagnosing chronic pancreatitis.This low specificity accounts for the poor positive predictive value (high false positive rate) of endoscopic pancreatography in the context of chronic pancreatitis.2The interpretation of MIP is
Respiratory Medicine: Recent Advances
Authors: J Briton
Journal: BMJ (1994)

Ed Peter J Barnes; Butterworth-Heinemann, pounds sterling40, pp 282; ISBN 0-7506-0712-2

Textbooks of “recent advances” inevitably occupy something of a no man's land between the definitive textbook and the specialist journal.Readers who want comprehensive coverage of a topic will tend to look first to a recent textbook; those who want to keep up with the very latest developments of a specialty will tend to do so from the journals.A textbook on recent advances needs to provide something more than these alternative sources by defining and describing what is …
RACIAL DISCRIMINATION IN THE ANNALS?
Authors: ALVA JENKINS
Journal: Annals of Internal Medicine (1969)

Letters and Comments1 May 1969RACIAL DISCRIMINATION IN THE ANNALS?ALVA JENKINS, M.D.ALVA JENKINS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1050 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: I enjoy reading the ANNALS OF INTERNAL MEDICINE for medical information but not for racial identification of patients chiefly of Afro-American heritage.The article "Rheumatoid Arthritis Terminating in Heavy-Chain Disease" (Ann. Intern. Med. 70: 335, 1969) indicates in the summary "a 51-year-old negro man." Obviously, the proofreader should be made aware that racial tags are offensive and should be corrected as readily as other terms of bad taste.How about the racial tag in Question 100 in Book A of the Self-Assessment Program?The use of the racial identification as "negro" in the case study by Dr.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ALVA JENKINS, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1050-1050KeywordsRacial and ethnic discriminationRheumatoid arthritisTaste ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
Immunotherapy for cancer
Authors: J. Grange, J. Stanford, C. Stanford
Journal: Journal of the Royal Society of Medicine (2002)

We thank Dr Ann Johnson (August 2002 JRSM1) for her thoughtful comments on our paper2. She rightly points out the similarity between the hypoxic centres of tumours and tubercles and the likelihood that potentially proliferative cancer cells are sequestered in the former, until released by resorption of the core tissues. Until recently, this was the accepted model of persistence of supposedly dormant tubercle bacilli in tuberculous scars. It has, however, now been shown by in-situ PCR that DNA specific for Mycobacterium tuberculosis is widely distributed throughout normal lung tissue in those latently infected by this organism3. Thus, it is likely that reactivation of tuberculosis occurs more often from these ‘infective micrometastases’ than from healed primary foci of infection. In both diseases, immune elimination of micrometastases may be as important as, or more important than, containment of reactivating primary lesions.

Concerning variation in growth rates of tumours, we are aware of the time taken for a single cell to develop into a clinically or radiologically evident tumour and the implications for follow-up in immunotherapeutic studies, which needs to be long-term. We would, however, like to make two observations.

First, tumours do not arise simply by steady cell proliferation, but by a highly dynamic process involving cell replication and cell destruction by apoptosis and other immune-mediated mechanisms4. Indeed, tumour growth may be more attributable to a failure of apoptosis than to more rapid cell replication. If the immune destruction of cancer cells, aided by effective immunotherapy, balances the growth of the cells, the patient remains for practical purposes healthy.

Second, reported immune responses, whether occurring as a result of natural infection or specific immuno-therapeutic strategies, have not just led to delays in tumour growth but in some cases to regression of even very large tumours and to long periods of subsequent health.

Ideally, immunotherapy would eradicate all tumour cells but even if it only prevented the overall increase of a clinically undetectable tumour load the result for the patient would be highly beneficial. Perhaps the future trend in oncology will be to enable patients to live contentedly with their tumour residues after local debulking rather than to submit them to physically damaging and psychologically stressful attempts at radical ‘cure’.
Anterior Interbody Fusion for Treatment of Cervical-Disk Conditions
Authors: Donald F. Dohn
Journal: JAMA (1966)

This exhibit is based on a series of 210 anterior-cervical fusion operations performed at the Cleveland Clinic during the past six years. Its purpose is to elucidate the following: clinical manifestations of cervical-disk disease, diagnostic maneuvers useful in selecting patients for surgery, surgical technique, and clinical results. Anterior-cervical fusion was established as a clinical method for the treatment of cervical-disk problems in 1958.<sup>1-3</sup>There have been a number of subsequent reports of clinical experience with the procedure.<sup>4-7</sup>One of the difficulties in evaluating the results of the surgical treatment of cervical-disk disease, both from reported series and from the present series, has been the tendency to group together the various types of cervical-disk conditions without distinction regarding the clinical manifestations and disabilities. This has been unfortunate because each type presents different problems in management and the results should be considered separately. An attempt has been made in the
Nitroglycerin Improves the Hemodynamic Response to Vasopressin in Portal Hypertension
Authors: Roberto J. Groszmann, David Kravetz, Jaime Bosch, Mortom Glickman, Jordi Bruix, James Bredfeldt, Harold O. Conn, Juan Rodes, Edward H. Storer
Journal: Hepatology (1982)

This study was designed to investigate whether the addition of nitroglycerin to vasopressin infusion could avoid the deleterious systemic effects of vasopressin while maintaining or enhancing the therapeutic benefits of portal pressure reduction. The effect of nitroglycerin on splanchnic and systemic hemodynamics was studied in cirrhotic patients and portal hypertensive dogs receiving i.v. vasopressin. During i.v vasopressin infusion (0.4 units per min), the cardiac output decreased in patients by 14% from 7.6 +/- 0.9 (mean +/- S.E.) to 6.5 +/- 0.7 liters per min, p less than 0.01, the mean arterial pressure increased 21% from 87 +/- 2 to 105 +/- 4, p less than 0.01, and the heart rate decreased 11% from 79 +/- 3 to 71 +/- 3, p less than 0.01. The administration of sublingual nitroglycerin (0.4 mg) returned all the systemic hemodynamic parameters to baseline values. In dogs, vasopressin infusion significantly reduced portal pressure and flow while increasing portal venous resistance. Nitroglycerin when added to the vasopressin infusion reduced portal venous resistance and further decreased portal pressure in dogs. In patients, vasopressin reduced the hepatic blood flow (44%), wedged hepatic venous pressure (11%), and the gradient between wedged and free hepatic venous pressures (23%). Nitroglycerin administration caused a further reduction of the wedged hepatic venous pressure (23.6 +/- 2.3 to 21.1 +/- 2.0, 11%, p less than 0.01). There was a small but not significant further decline (7%) in the hepatic venous pressure gradient. These results provide evidence that the addition of nitroglycerin to an i.v. infusion of vasopressin reversed the detrimental effects of vasopressin while preserving the beneficial effects.
Fish — Food to Calm the Heart
Authors: Irwin H Rosenberg
Journal: New England Journal of Medicine (2002)

In the Book of Genesis, fish appeared in the waters on the fifth day of creation, after dry land and water separated. This may be the first reference to a functional, indeed lifesaving, food for humans. In the 19th century, New England ships harvested marine oil not for food but to light lamps. Fast forward to the 20th century and the identification of the “Eskimo paradox,” which refers to the extremely low rates of death from cardiovascular disease among the Inuit, as compared with their northern European counterparts, despite similarly high intakes of fat — about 40 percent of calories. . . .