tbuckley/cabot-search huggingface dataset:
Anaphylactic reactions to ketoconazole.
Authors: C P van Dijke, F R Veerman, H C Haverkamp
Journal: BMJ (1983)

available suggests that convulsions are the only serious complication of acute zimeldine overdosage.[Sales of zimeldine in all countries were discontinued by Astra Pharma- ceuticals in September 1983 because of the company's concern about reports of serious neurological side effects including the Guillain Barr6 syndrome.]I Dawling S, Braithwaite RA.Simplified method for monitoring tricyclic antidepressant therapy using gas-liquid chromatography with nitrogen detection.7
How to Determine Patient Weights in Excess of Balance Limits
Authors: Herbert S. King
Journal: JAMA (1977)

<h3>To the Editor.—</h3> The balances available in most offices, clinics, and hospitals, for weighing patients usually are limited to weight up to 157.5 kg (350 lb), with some available that have a maximum of 180 kg (400 lb). On occasion, it becomes desirable to weigh certain obese patients who exceed these limits. This communication is intended to call attention to a very simple procedure for using the existing balances for this purpose. One often hears of the following rather cumbersome solutions: Obtain a balance with a higher maximum. (These are either impossible or difficult to obtain.) Place two scales next to each other and have the patient stand with one foot on one scale and one foot on the other. (If, unrealized by either the patient or the examiner, the patient unconsciously shifts his weight during the process of weighing toward one leg rather than the other, the
Increased calcium intake does not suppress circulating 1,25-dihydroxyvitamin D in normocalcemic patients with sarcoidosis.
Authors: J N Basile, Y Liel, J Shary, N H Bell
Journal: Journal of Clinical Investigation (1993)

Ca absorption is regulated by 1,25(OH)2D, and serum values vary inversely with Ca intake. In sarcoidosis, 1,25(OH)2D is produced by alveolar macrophages in response to gamma-interferon, and patients may develop hypercalcemia after prolonged exposure to sunlight and increased dermal production of vitamin D3. To determine if increased Ca intake suppresses serum 1,25(OH)2D in normocalcemic patients and to identify those at risk, 17 normal subjects and 11 patients were studied on a metabolic ward for two and one-half days while receiving first 400 and then 1,000 mg/d of Ca. On the low Ca intake, serum angiotensin-converting enzyme (ACE), an index of disease activity, was higher in only three of the patients than in the controls, mean serum 1,25(OH)2D was higher in the patients, and mean serum total Ca, serum Ca++, and urinary Ca were not different in the two groups. On the higher Ca intake, mean urinary Ca increased in both groups, but mean serum 1,25(OH)2D was suppressed only in the normal subjects. Thus, 1,25(OH)2D production is abnormally regulated, indicating that (a) normocalcemic patients with sarcoidosis are at risk for developing abnormal Ca metabolism, and (b) a better index of disease activity is provided by the oral Ca suppression test than by serum ACE.
Defining Women at High Risk of Ovarian Cancer
Authors: Grover C. Bagby, Tanja Pejovic
Journal: Cancer Research (2007)

In Response: 

Drs. Swisher and King comment on strategies we applied to define risk, culture epithelial cells, and interpret the literature dealing with women at risk of ovarian cancer. We agree that we should have better stated what we meant: that the current genetic screening methods “cannot
A Computer's Intuition
Authors: Robert L. Rowan
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In a recent feature (From Other Pages,<i>JAMA</i><b>189</b>, July 20, 1964, adv p 80) it is stated that computers cannot "play a hunch." I disagree; computers do use intuitive induction or the "hunch." In fact, the computer can guess at a diagnosis on a percentage basis far more accurately than any individual. The hunch is really a form of less likely differential diagnosis. A well-educated (programmed) computer can evaluate these lesser possibilities on a sound mathematical basis. A scale of zero to ten can be used, zero meaning the diagnosis is not possible and ten referring to an absolute diagnosis. The figure two or three in this scale would be in the "hunch" zone. Its presence in computer thinking is quite real. Physicians are developing a poor attitude toward automation. The computer will never replace the doctor-patient relationship, but it can help us in untold ways,
Fertility and Contraception in the Human Female
Authors: Robert W. Kistner
Journal: JAMA (1968)

This relatively small text exemplifies the adage that good things come in small packages. The result might have been expected, considering the background of the authors, who are distinguished and experienced investigators. The subject is particularly current and provocative. Although the authors adequately emphasize diagnostic procedures and therapeutic regimens, the rapid advances of the past decade have made it necessary to include discussions of a more theoretical nature. To convert the onerous formulas and laboratory experiments into the vocabulary of the practicing obstetrician-gynecologist is a tedious task, but the authors have demonstrated their ability to sift the vast amount of data and, in clear and concise fashion, to designate logical approaches for the clinician. The major advances in the field of human reproductive physiology during the past decade include a rational approach to the problems of infertility, an improved understanding of the endocrinology of the menstrual cycle and of abnormal
Structure of the human activating natural cytotoxicity receptor NKp30 bound to its tumor cell ligand B7-H6
Authors: Yili Li, Qian Wang, Roy A. Mariuzza
Journal: The Journal of Experimental Medicine (2011)

Natural killer (NK) cells are lymphocytes of the innate immune system that participate in the elimination of tumor cells. In humans, the activating natural cytotoxicity receptors (NCRs) NKp30, NKp44, and NKp46 play a major role in NK cell-mediated tumor cell lysis. NKp30 recognizes B7-H6, a member of the B7 family which is expressed on tumor, but not healthy, cells. To understand the basis for tumor surveillance by NCRs, we determined the structure of NKp30, a member of the CD28 family which includes CTLA-4 and PD-1, in complex with B7-H6. The overall organization of the NKp30-B7-H6-activating complex differs considerably from those of the CTLA-4-B7 and PD-1-PD-L T cell inhibitory complexes. Whereas CTLA-4 and PD-1 use only the front β-sheet of their Ig-like domain to bind ligands, NKp30 uses both front and back β-sheets, resulting in engagement of B7-H6 via the side, as well as face, of the β-sandwich. Moreover, B7-H6 contacts NKp30 through the complementarity-determining region (CDR)-like loops of its V-like domain in an antibody-like interaction that is not observed for B7 or PD-L. This first structure of an NCR bound to ligand provides a template for designing molecules to stimulate NKp30-mediated cytolytic activity for tumor immunotherapy.
Angina-Like Syndrome with Diazoxide Therapy for Hypertensive Crisis
Authors: SHIRLEY A. KANADA
Journal: Annals of Internal Medicine (1976)

In 14 patients with hypertensive crisis treated with diazoxide, close monitoring of blood pressure, heart rate, and symptoms was performed. Standard 12-lead electrocardiograms were recorded before and after diazoxide. All patients showed a significant fall in blood pressure after drug administration. Seven patients (50%) showed significant ST-T changes after diazoxide. Six patients (43%) developed substernal discomfort demonstrated by substernal pain of tightness. Five patients (35%) had both chest discomfort and ST-T changes. One of these patients with substernal pain and ST elevation had evidence of acute myocardial infarction with serial enzyme studies. In the patients with significant ST-T changes, the average fall in blood pressure was significantly greater than the average fall in blood pressure in the patients without significant ST-T changes. These findings suggest that both ST-T changes and substernal discomfort were due to myocardial ischemia secondary to a sudden severe drop in blood pressure.
Association Between Pharmacokinetics of Adalimumab and Mucosal Healing in Patients With Inflammatory Bowel Diseases
Authors: Xavier Roblin, Hubert Marotte, Melanie Rinaudo, Emilie Del Tedesco, Amelie Moreau, Jean Marc Phelip, Christian Genin, Laurent Peyrin–Biroulet, Stephane Paul
Journal: Clinical Gastroenterology and Hepatology (2013)
Latent Change Score Modeling as a Method for Analyzing the Antidepressant Effect of a Psychosocial Intervention in Alzheimer's Disease
Authors: Katja Werheid, Ylva Köhncke, Matthias Ziegler, Alexander Kurz
Journal: Psychotherapy and Psychosomatics (2015)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Developing and evaluating interventions for patients with age-associated disorders is a rising field in psychotherapy research. Its methodological challenges include the high between-subject variability and the wealth of influencing factors associated with longer lifetime. Latent change score modeling (LCSM), a technique based on structural equation modeling, may be well suited to analyzing longitudinal data sets obtained in clinical trials. Here, we used LCSM to evaluate the antidepressant effect of a combined cognitive behavioral/cognitive rehabilitation (CB/CR) intervention in Alzheimer's disease (AD). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; LCSM was applied to predict the change in depressive symptoms from baseline as an outcome of the CORDIAL study, a randomized controlled trial involving 201 patients with mild AD. The participants underwent either the CORDIAL CB/CR program or standard treatment. Using LCSM, the model best predicting changes in Geriatric Depression Scale scores was determined based on this data set. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The best fit was achieved by a model predicting a decline in depressive symptoms between before and after testing. Assignment to the intervention group as well as female gender revealed significant effects in model fit indices, which remained stable at 6- and 12-month follow-up examinations. The pre-post effect was pronounced for patients with clinically relevant depressive symptoms at baseline. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; LCSM confirmed the antidepressant effect of the CORDIAL therapy program, which was limited to women. The effect was pronounced in patients with clinically relevant depressive symptoms at baseline. Methodologically, LCSM appears well suited to analyzing longitudinal data from clinical trials in aged populations, by accounting for the high between-subject variability and providing information on the differential indication of the probed intervention.
Myocardial, Perivascular, and Epicardial Fat
Authors: Patricia Iozzo
Journal: Diabetes Care (2011)

Myocardial fat content refers to the storage of triglyceride droplets within cardiomyocytes. In addition, the heart and arteries are surrounded by layers of adipose tissue, exerting vasocrine and paracrine control of the subtending tissues. The rapid development of the field of noninvasive imaging has made it possible to quantify ectopic fat masses and contents with an increasing degree of accuracy. Myocardial triglyceride stores are increased in obesity, impaired glucose tolerance, and type 2 diabetes. The role of intramyocardial triglyceride accumulation in the pathogenesis of left ventricular (LV) dysfunction remains unclear. Increased triglyceride content is associated with states of fatty acid overload to the heart, saturating the oxidative capacity. It may initially serve as a fatty acid sink to circumscribe the formation of toxic lipid species and subsequently foster cardiac damage. Epicardial and perivascular fat depots may exert a protective modulation of vascular function and energy partition in a healthy situation, but their expansion turns them into an adverse lipotoxic, prothrombotic, and proinflammatory organ. They are augmented in patients with metabolic disorders and coronary artery disease (CAD). However, the progressive association between the quantity of fat and disease severity in terms of extent of plaque calcification or noncalcified areas, markers of plaque vulnerability, and number of vessels involved is less confirmed. Functional or hybrid imaging may contribute to a better definition of disease severity and unveil the direct myocardial and vascular targets of adipose tissue action.
Uptake and Population-Level Impact of Expedited Partner Therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: The Washington State Community-Level Randomized Trial of EPT
Authors: Matthew R. Golden, Roxanne P. Kerani, Mark Stenger, James P. Hughes, Mark Aubin, Cheryl Malinski, King K. Holmes
Journal: PLoS Medicine (2015)

Background Expedited partner therapy (EPT), the practice of treating the sex partners of persons with sexually transmitted infections without their medical evaluation, increases partner treatment and decreases gonorrhea and chlamydia reinfection rates. We conducted a stepped-wedge, community-level randomized trial to determine whether a public health intervention promoting EPT could increase its use and decrease chlamydia test positivity and gonorrhea incidence in women. Methods and Findings The trial randomly assigned local health jurisdictions (LHJs) in Washington State, US, into four study waves. Waves instituted the intervention in randomly assigned order at intervals of 6–8 mo. Of the state's 25 LHJs, 24 were eligible and 23 participated. Heterosexual individuals with gonorrhea or chlamydial infection were eligible for the intervention. The study made free patient-delivered partner therapy (PDPT) available to clinicians, and provided public health partner services based on clinician referral. The main study outcomes were chlamydia test positivity among women ages 14–25 y in 219 sentinel clinics, and incidence of reported gonorrhea in women, both measured at the community level. Receipt of PDPT from clinicians was evaluated among randomly selected patients. 23 and 22 LHJs provided data on gonorrhea and chlamydia outcomes, respectively. The intervention increased the percentage of persons receiving PDPT from clinicians (from 18% to 34%, p < 0.001) and the percentage receiving partner services (from 25% to 45%, p < 0.001). Chlamydia test positivity and gonorrhea incidence in women decreased over the study period, from 8.2% to 6.5% and from 59.6 to 26.4 per 100,000, respectively. After adjusting for temporal trends, the intervention was associated with an approximately 10% reduction in both chlamydia positivity and gonorrhea incidence, though the confidence bounds on these outcomes both crossed one (chlamydia positivity prevalence ratio = 0.89, 95% CI 0.77–1.04, p = 0.15; gonorrhea incidence rate ratio = 0.91, 95% CI .71–1.16, p = 0.45). Study findings were potentially limited by inadequate statistical power, by the institution of some aspects of the study intervention outside of the research randomization sequence, and by the fact that LHJs did not constitute truly isolated sexual networks. Conclusions A public health intervention promoting the use of free PDPT substantially increased its use and may have resulted in decreased chlamydial and gonococcal infections at the population level. Trial Registration ClinicalTrials.gov NCT01665690
What Is the Impact of Tamoxifen on Radiation-Induced Fibrosis in Patients Receiving Breast-Conserving Therapy
Authors: Mehmet Koc
Journal: Journal of Clinical Oncology (2007)

TO THE EDITOR: Bartelink et al reported the impact of higher radiation dose on local control and survival in patients who underwent breast conservation therapy for early breast cancer. They used 10-year results of the randomized boost versus no boost European Organisation for Research and Treatment of Cancer 22881-10882 trial. A total of 5,318 patients with microscopically complete excision followed by whole-breast irradiation of 50 Gy were randomly assigned to receive either a boost dose of 16 Gy (2,661 patients) or no boost dose (2,657 patients), with a median follow-up of 10.8 years. The major purpose of this report was to find out the long-term impact of a boost irradiation of 16 Gy on local control, fibrosis, and overall survival for patients with stage I and II breast cancer who underwent breastconserving therapy. They reported that severe fibrosis was statistically significantly increased in the boost group, with a 10-year rate of 4.4% v 1.6% in the no-boost group. It is well known in the literature that higher radiation doses significantly increase severe fibrosis that resulted in poor cosmetic results. However, in Bartelink et al, there is no information about the percentage of patients within the boost or no-boost group that received tamoxifen (TAM) treatment. In addition, the differences between TAM treatment versus no TAM treatment in the boost group must be explained (if any). Apart from its (anti)hormonal properties, TAM also has a number of nonhormonal effects. The induction of transforming growth factor (TGF) is one of the documented nonhormonal effects of TAM. It generally inhibits the growth of epithelial cells, but induces chemotaxis of fibroblasts. This may explain the importance of TGFin the pathogenesis of fibrosis in a large number of animal models and human disorders. Nonhormonal effects of TAM can cause fibrosis of liver, skin, muscle, lungs, and mammary gland, most likely by the induction of TGFsecretion. Johansen et al also recently reported that TAM was significantly associated with breast fibrosis. I believe that in the article by Bartelink et al, if the impact of TAM on fibrosis were analyzed in subgroups of boost versus no-boost groups in a study with a large sample size (ie, 5,318 patients) and 10-year period, the contribution to the literature would be enormous.
Human Renal Function Following Methoxyflurane Anesthesia
Authors: Richard B. Merkle
Journal: JAMA (1971)

The surgical repair of retinal detachment was chosen as the operative procedure to use in the investigation of the effects of methoxyflurane on renal function during the first three days after surgery. This was done in order to exclude any additive effect of hypotension, blood loss, or traumatic surgery on the kidney. In this controlled, prospective study, 25 patients received methoxyflurane and 25 received halothane. There was significant rise in the mean serum creatinine level and fall in the mean urine osmolality among patients who received methoxyflurane. No such changes were seen in those given halothane. These data suggest an effect of methoxyflurane on renal function, even when the severe symptomatic syndrome previously described does not occur.
Improved Glycemic Control After Supervised 8-wk Exercise Program in Insulin-Dependent Diabetic Adolescents
Authors: Ron Stratton, Don P Wilson, Robert K Endres, David E Goldstein
Journal: Diabetes Care (1987)

Eight insulin-dependent adolescents (4 boys, 4 girls) participated in an 8-wk program of supervised exercise, and 8 matched controls were encouraged to exercise on their own without supervision. All 16 subjects were asked to follow a standard ADA diet plan, kept a self-reported log of caloric intake, and met with a dietitian weekly to review their diets. Exercise for the supervised subjects was scheduled between the routine afternoon snack and the evening meal, and subjects were asked not to consume additional food on exercise days. After the 8-wk program, glycemic control, as measured by glycosylated serum albumin and blood glucose values (but not by glycosylated hemoglobin), improved in the supervised- exercise group despite reduced daily insulin dosage. Cardiorespiratory fitness, as measured by voluntary maximum treadmill time (Bruce protocol) and submaximal exercise heart rates, also improved. No changes were observed in the unsupervised control group.
Effects of Anesthetics on the Circulation
Authors: William K. Hamilton
Journal: JAMA (1964)

This is an edited version of a meeting sponsored by the National Research Council Committee on Anesthesia and the Section on Anesthesia of the New York Academy of Medicine. The meeting took place in May, 1963, with 29 participants from Canada, Northern Ireland, Sweden, Denmark, England, and the United States. Material is presented to provide an up-to-date summary of current information. The purpose is well accomplished through talented participants and skillful editing.  Subject matter is organized into three functional categories: regulation of circulation by the central nervous system, cardiac rhythm and contractility, and distribution of cardiac output to various tissues of the body. As this work is a symposium or summation, much of the material is printed in more detail elsewhere. However, thorough and current bibliographical listing is provided for those desiring this more detailed information. The information concerning neural regulation is especially valuable, as this material is frequently difficult
Exome Sequencing Comes to the Clinic
Authors: Ricki Lewis
Journal: JAMA (2015)

Vincent Pieterse was so eager to enter the world on December 16, 2002, that he couldn’t wait for the hospital. His startled father, Marc, delivered the boy in the family’s home in a small village in the southernNetherlands.Vincent seemed healthy as a baby, but at school he acquired labelsofnonverbal learningdisabilityandmildautism.Byage8,his learningdisability, autism, hypotonia, extra teeth, and elastic skin prompted a pediatrician to gently suggest the possibility of a genetic syndrome. But tests for select neurological diseasesandchromosomal abnormalitieswere negative, and no relatives shared symptoms with Vincent. When the diagnostic odyssey ruled out gene after gene, Marc read about exome sequencing and realized that the approach could provide information on many genes, perhaps identifying a treatable problem. Sequencing would also reveal whether Vincent had a new (de novo) mutation or whether his parents had passed the condition on. Finally, in 2012, on Marc’s persistence, Joris Veltman, PhD, an investigator at Radboud University in Nijmegen who was conducting an exome sequencing study of children with severe intellectual disability (de Ligt J et al. N Engl J Med. 2012;367[20]:1921-1929), agreed to sequence the exomes of the boy and his parents. SequencingVincent’s exome, the 1%of the genome that encodes protein and accounts for85%of inheriteddisease, uncovered a de novomutation in a gene that encodes a specific ribosomal protein, but no information indicated how the mutation could be pathogenic. “So I looked at the literature, and found a publication on Diamond-Blackfan anemia (DBA),”Marc recalled. Based on the publication (Lipton JF, Ellis SR. Curr Opin Pediatr. 2010;22[1]:1219), some of Vincent’s symptoms matched the ribosomopathyDBA,but hedidn’t have anemiaandhismutationhadneverbeenassociated with DBA. Marc contacted the lead author of the publication, Jeffrey Lipton, MD, PhD, from Schneider Children’s Hospital in New Hyde Park, NY, and by fall 2014, the researchers foundthatVincent’sRNAprocessingwasnormal. But Marc, convinced that his son had DBA, emailed a dozen researchers studying thedisorder, includingAlysonMacInnes,PhD, from the Sanquin Research and Landsteiner Laboratory in Amsterdam,who began coordinatingstudiesofVincent’sribosomesinseveralmodel systems.MacInneswas intrigued by Vincent’s case history, mutation, and the sequence of events. “Marc’s email turned a corner into the future of genetic research. Instead of a patient going to the clinic with a list of features, getting a diagnosis, doing the exome sequencing, and thenenlisting a researcher to figure out the molecular mechanism, it’s going in reverse. Now the patient, armed with exome data, contacts the researcher, who figures out the mechanism, and then with theclinician is able todetermine thediagnosis,” she said. Robert Marion, MD, pediatrician and chief of the division of genetics at The Children’s Hospital at Montefiore, agreed. “It used to be we’d look at a kid and come up withadifferentialdiagnosisbasedonthefeatures, and then we’d test. Now we do testing first.”