tbuckley/cabot-search huggingface dataset:
Does This Patient Have an Abnormal Systolic Murmur?
Authors: Edward Etchells
Journal: JAMA (1997)

Our objective was to review the available evidence of the precision and accuracy of the clinical examination for abnormal systolic murmurs. We conducted a MEDLINE search, manually reviewed all reference lists, and contacted authors of published studies. Each study was independently reviewed by 2 observers and graded for methodologic quality. We found that most studies were conducted using cardiologist examiners. In the clinical setting, the reliability of detecting systolic murmurs was fair (kappa, 0.30-0.48). The most useful findings for ruling in aortic stenosis are a slow rate of rise of the carotid pulse (positive likelihood ratio, 2.8-130), mid to late peak intensity of the murmur (positive likelihood ratio, 8.0-101), and decreased intensity of the second heart sound (positive likelihood ratio, 3.1-50). The most useful finding for ruling out aortic stenosis is the absence of murmur radiation to the right carotid artery (negative likelihood ratio, 0.05-0.10). Smaller, lower-quality studies indicate that cardiologists can accurately rule in and rule out mitral regurgitation, tricuspid regurgitation, hypertrophic cardiomyopathy, and echocardiographic mitral valve prolapse. We conclude that the clinical examination by cardiologists is accurate for detecting various causes of abnormal systolic murmurs. Studies of the clinical examination by noncardiologists are needed.
Renal Failure Following Antibiotics.
Authors: Russell E. Randall
Journal: Annals of Internal Medicine (1967)

s1 May 1967Renal Failure Following Antibiotics.Russell E. Randall Jr., M.D., F.A.C.P.Russell E. Randall Jr., M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1052_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAcute renal failure may occur after kanamycin, bacitracin, polymyxin, and amphotericin. Recent observations with six others are listed.Neomycin:Inadvertent injection of 4, 6, 8, and 72 g in four patients resulted in deafness in two, acute renal failure in one, and permanent renal insufficiency in one. Early treament with hemodialysis reduced serum neomycin concentrations rapidly in two, Kiil dialysance measuring 57 ml/min. Mannitol diuresis removed significant amounts in another while peritoneal dialysis was much less effective. These maneuvers probably prevented acute renal failure in two whose urine contained numerous tubular cell casts. These modes of emergency therapy to prevent... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Russell E. RandallJr., M.D., F.A.C.P.Affiliations: Richmond, Virginia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHépatite et syndrome mononucléosique liés à la prise de salazosulfapyridineSulfasalazineKonservative TherapieHypersensitivity reaction to Sulfasalazine with Severe HepatotoxicityInfectious diseases. Annual review of significant publications. 1 May 1967Volume 66, Issue 5 Page: 1052-1053 Keywords Acute renal failure Attention Deafness Mannitol Neomycins Peritoneal dialysis Polymyxins Renal failure Tubular cells Urine ePublished: 1 December 2008 Issue Published: 1 May 1967 PDF downloadLoading ...
Techniques, Diagnostics, and Advances in Nuclear Cardiology
Authors: Constantin Cope
Journal: JAMA (1984)

More than two thirds of this book is directed to the novice and provides a clear, detailed presentation of the technical aspects and diagnostic uses of the various studies available to investigate cardiac functions and myocardial perfusion. Unfortunately, the later chapters are uneven in the quality of their descriptions of advances in nuclear cardiology. For example, the book does not give adequate coverage to parametric images in the evaluation of cardiac wall motion and makes no mention of the current clinical use of Fourier analysis imaging, although software for this is now available through most computer companies. In the discussion on myocardial perfusion, only a bare mention is given to seven-pinhole tomography, rotating slant-hole tomography, or single-photon-emission computed tomography. An interesting chapter on positron emission transaxial tomographic imaging is followed by a superficial discussion of nuclear magnetic resonance, which does not include cardiac imaging. These shortcomings do not take away
The Position of the Christian Science Church
Authors: Nathan A. Talbot
Journal: New England Journal of Medicine (1983)

Christian Scientists are caring and responsible people who love their children and want only the best possible care for them. They would not have relied on Christian Science for healing — sometimes over four and even five generations in the same family — if this healing were only a myth. Yet they approach the subject of healing on the basis of a very different perspective from that of medical practice.To them it is part of a whole religious way of life and is, in fact, the natural outcome of the theology that underlies it. This theology, Christian Scientists believe, . . .
Clinics are importing more foreign sperm to meet UK demand for IVF
Authors: I. Torjesen
Journal: BMJ (2014)

The UK is importing an increasing amount of foreign sperm to meet demand for in vitro fertilisation (IVF) because clinics find it easier than recruiting UK donors, a report from the Human Fertilisation and Embryology Authority has said.

The report said that demand for donated sperm and eggs is continuing to rise, from heterosexual couples as well as same sex female couples and single women.1 Of the fresh IVF cycles performed in 2013 around one in ten used donated gametes—5% used donated sperm, 4% used donated eggs, and <1% used both donated eggs and sperm or donated embryos.

The number of women registering as gamete donors each year is now almost twice that of men, and the number of newly registered sperm donors fell from 631 in 2012 to 586 in 2013. Laura Witjens, chief executive of the National Gamete Donor Trust, told The BMJ that the majority of sperm donors were recruited by …
PWE-054 Flexible Sigmoidoscopy Prior To Ctc Within The Bcsp
Authors: R Rusu, G Smith, J Martin
Journal: Gut (2014)

<h3>Introduction</h3> Patients with abnormal FOBt results within the Bowel Cancer Screening Programme (BCSP) are at increased risk of colorectal neoplasia and are therefore offered colonoscopy. Some patients, with significant co-morbidities, are not suitable for colonoscopy and are offered CT colonography (CTC) as an alternative. There has been concern that the insufflation tube used during this examination may obscure visualisation of low rectal lesions and this has been reported in the literature. At the West London Bowel Cancer Screening Centre all patients are offered a flexible sigmoidoscopy (FS) prior to CTC and our experience of this approach is reported in this abstract. <h3>Methods</h3> All patients with an abnormal FOBt result, attending a Specialist Screening Practitioner (SSP) clinic between 4<sup>th</sup> January 2012 and 1<sup>st</sup> October 2013, and who were offered CTC and FS were identified. Their endoscopic and radiologial investigations were retrieved from the hospital electronic records system and the results recorded in terms of the adenomas and cancers identified. <h3>Results</h3> 1544 patients were seen in an SSP clinic within the allocated period, and 73 (4.7%) of these were offered CTC. Of these 49 (67.1%) had a FS as the first investigation and 24 (32.9%) had a CTC as the first investigation. 10 (13.7%) refused FS and 14 (19.2%) had endoscopic investigations (12 FS and 2 colonoscopy) after the CTC, due to patient choice. 6 (8.2%) patients who underwent FS as the first investigation had subsequent colonoscopy without CTC, 5 as a large polyp requiring resection was found at FS and 1 following detection of a cancer. In 3 of these patients further adenomas were found at colonoscopy. In total 67 patients (91.8%) had CTC and in this group 12 (17.9%) had a subsequent colonoscopy as a result of the radiological findings. Of these 6 had a normal FS prior to CTC and 6 patients did not have a FS. In 8 cases (66.7%) the number of polyps seen on CTC was confirmed at colonoscopy, in 3 cases (25.0%) more lesions were found at colonoscopy than CTC and in 1 case (8.3%) CTC had identified more polyps than were seen at colonoscopy. 12 patients had FS after a normal CTC and no additional findings were seen on these examinations. No rectal lesions were identified at FS that were not seen at CTC. Overall 18 (24.7%) patients eventually had a colonoscopy. <h3>Conclusion</h3> FS prior to CTC within the BCSP does not appear to be of value in detecting additional rectal lesions missed at CTC, althou gh the numbers in this analysis are small. Initial FS avoids the need for CTC in about 8% of patients, and so should be performed before CTC, but this benefit needs to balanced against the increased workload and inconvenience to patients. In those patients in whom the initial decision is to perform CTC a quarter will eventually require a colonoscopy. <h3>Disclosure of Interest</h3> None Declared.
Transforming Academic Health Centers for an Uncertain Future
Authors: Victor J. Dzau, Alex Cho, William ElLaissi, Ziggy Yoediono, Devdutta Sangvai, Bimal Shah, David Zaas, Krishna Udayakumar
Journal: New England Journal of Medicine (2013)

With a changing health care landscape and a growing gap between the excess costs of fulfilling academic health centers' missions and the available funding, the integrity of those missions is in jeopardy. Profound changes are needed in AHCs' organization and operations.
A piece of my mind. Sacks of potatoes
Authors: E. C. James
Journal: JAMA (1989)

Chris was a 71-year-old farmer from Hoople, North Dakota, in the heart of the Red River Valley farm country. A sign at the edge of town proclaimed it "The Potato Capital of the World." We first met at 4 o'clock on a frigid February morning after his transfer from a small rural hospital. He underwent emergency surgery to repair a stomach rupture leaking into his chest. His incision extended from his back around the left side of his chest to an area below the nipple. Chris recovered, but later required resection of his left costal margin because of infection. This second incision extended from his xiphoid process, paralleling the costal margin to connect with his initial incision below the nipple. A final scar in the outline of a hockey stick was thus created. Indeed, in a state where the sport of hockey reigns supreme, Chris and I often referred to
Transfer of CD4 <sup>+</sup> T Cells Aggravates Atherosclerosis in Immunodeficient Apolipoprotein E Knockout Mice
Authors: Xinghua Zhou, Antonino Nicoletti, Rima Elhage, Göran K. Hansson
Journal: Circulation (2000)

Background —Atherosclerosis is associated with immune responses to oxidized lipoproteins and certain microorganisms, but the role of specific immunity has remained unclear. Methods and Results —To study the role of immunity in atherosclerosis, we crossed atherosclerosis-prone apoE —/– mice with immunodeficient scid/scid mice. The offspring showed a 73% reduction in aortic fatty streak lesions when compared with immunocompetent apoE –/– mice. Transfer of CD4 + T cells from apoE –/– to immunodeficient apoE –/– / scid/scid mice increased lesions by 164%. This was associated with the infiltration of transferred T cells into lesions, increased circulating interferon-γ levels, and increased I-A expression in lesions. Conclusions —CD4 + T cells carry disease-promoting immunity in atherosclerosis.
An Overview of Crisis Intervention in the Emergency Rooms of General Hospitals
Authors: GIAMPIERO BARTOLUCCI, CALVIN S. DRAYER
Journal: American Journal of Psychiatry (1973)

General hospitals throughout the land have—and in all likelihood will continue to have—emergency rooms that are more or less adequate. It seems strategically sound to do all we can to strengthen these sites of centralized help for the wide variety of medicosocial predicaments that can be expected to recur in all communities. In this paper the authors summarize some historical and theoretical considerations they believe can contribute to a productive refinement of existing emergency services at a time when direct federal support for health services is being drastically curtailed.
Genetic susceptibility to early onset pauciarticular juvenile chronic arthritis: a study of HLA and complement markers in 158 British patients.
Authors: P J Hall, S J Burman, M R Laurent, D C Briggs, H E Venning, A M Leak, P A Bedford, B M Ansell
Journal: Annals of the Rheumatic Diseases (1986)

To investigate the genetics of susceptibility to early onset pauciarticular juvenile chronic arthritis (JCA), 158 unrelated ethnic British patients with a mean disease onset of 3.2 years, together with controls, were tested for HLA-A, B, C, and DR antigens. Additionally, 117 patients were also investigated for complement Bf and C4 markers. New observations included an increased frequency of the C4B 2 allotype (p corrected (pc) less than 0.02) and C4A 4,B 2 phenotype (p less than 0.0005). Findings suggested a unique increase of the haplotype HLA-DRw8, Bf*S, C4A*4, C4B*2, HLA-B39, possibly predisposing to more severe disease. Strong positive associations were confirmed with HLA antigens A2 (pc = 2.5 X 10(-8)), DRw8 (pc = 3.5 X 10(-14)), DR5 (pc less than 0.02), DRw52 (pc = 2.8 X 10(-6)) and DR5, w8 phenotype (pc = 3.9 X 10(-6)), and negative associations with DR7 (pc = 5.8 X 10(-7)), DR4 (pc less than 0.002), and DRw53 (pc = 0.004). Antinuclear antibody (ANA) seropositivity correlated with DR5 (p less than 0.02), and in children with chronic iridocyclitis (CIR) Bw62 incidence was raised (p less than 0.03) and B44 reduced (p less than 0.03). HLA-A2 was found in 88% of ANA+, CIR+ patients (p less than 0.01). A significant excess of DR5, w8 heterozygotes was present (relative risk = 41.1) and a lack of corresponding homozygotes. Results are inconsistent with a recessive, dominant, or intermediate mode of inheritance of susceptibility, and favour the existence of at least two DR linked 'disease' genes. Moreover, there may be an interaction in heterozygotes of combinatorial factors associated with DR5 and DRw8 in enhancing susceptibility. Possible immunogenetic mechanisms underlying the observed associations with three antigen classes are discussed. Evidence here suggests a role for the HLA-DQ locus in determining susceptibility to this disease.
A DYNAMIC APPROACH TO THE STUDY OF REPLACEMENT THERAPY IN CASES OF CASTRATION
Authors: GEORGE E. DANIELS, EDWARD S. TAUBER
Journal: American Journal of Psychiatry (1941)

1. Replacement therapy should be preceded by a careful pre- and post-operative personality study and prolonged observation. 2. Psychotherapy alone may enhance sexual expression in castrates—as was strikingly demonstrated in a woman patient. 3. In a carefully controlled situation, regular intramuscular doses of testosterone propionate definitely increased signs of sexual activity in two male castrates. 4. The form which this expression took was apparently determined by the following factors: the patient's post-operative psychic make-up, the nature and handling of the transference relationship, and the nature and vicissitudes of the reality situation. 5. In some cases combined psychotherapy and replacement therapy seems indicated. 6. Replacement therapy under psychiatric observation stimulates dream production, which furnishes a valuable check on treatment and suggests a new approach to the study of dream symbolism.
Recurrent Gastrointestinal Bleeding from Jejunal Duplication
Authors: WAYNE PAPOFF, ROBERT H. REID
Journal: Clinical Nuclear Medicine (1986)

A 26-year-old man presented on several occasions over a four-year period because of lower gastrointestinal bleeding. The cause of this eluded correct diagnosis and curative therapy until liver-spleen imaging and a tagged RBC bleeding study were performed at the time of active bleeding and compared.
Serum IgE response to orally ingested antigen: A novel IgE response model with allergen-specific T-cell receptor transgenic mice
Authors: K. Shida, S. Hachimura, A. Ametani, M. Ishimori, Mei Ling, M. Hashiguchi, Y. Ueda, T. Sato, Y. Kumagai, K. Takamizawa, S. Habu, S. Kaminogawa
Journal: Journal of Allergy and Clinical Immunology (2000)
Importing social preferences across contexts and the pitfall of over-generalization across theories
Authors: Anne C. Pisor, Daniel M. T. Fessler
Journal: Behavioral and Brain Sciences (2012)

Abstract Claims regarding negative strong reciprocity do indeed rest on experiments lacking established external validity, often without even a small “menu of options.” Guala's review should prompt strong reciprocity proponents to extend the real-world validity of their work, exploring the preferences participants bring to experiments. That said, Guala's approach fails to differentiate among group selection approaches and glosses over cross-cultural variability.
EXPERIMENTAL STUDIES OF THE MODE OF ABSORPTION OF MERCURY WHEN APPLIED BY INUNCTION
Authors: JAY FRANK SCHAMBERG
Journal: JAMA (1918)

For a number of years there has been much discussion as to the manner in which mercury reaches the blood stream when rubbed into the skin in the form of inunction. Welander of Stockholm, after painstaking studies on extensive clinical material, came to the conclusion that the greatest part of the mercury applied by inunction is volatilized and absorbed through the lungs, and only a small portion through the skin. Many European clinicians were converted to this view through Welander's investigations. Welander, as a result of his work, advocated the light smearing of the skin with mercurial ointment rather than the attempt vigorously to rub the ointment in. He later advised inhalation cures, employing flat bags containing mercurial powder and worn around the neck at night. Wile and Elliott<sup>1</sup>carried out studies in the mode of absorption of mercury in the inunction treatment, and by employing nonvolatile salts of
Athletic Facial Injuries: Call in Everyone
Authors: Victor F. Szymela
Journal: JAMA (1985)

<h3>To the Editor.—</h3> I take exception to the inference by Drs Schultz and de Camara<sup>1</sup>that individuals sustaining facial bone fractures require consultation with a plastic surgeon. What about the otolaryngologist or oral and maxillofacial surgeon? Most acutely traumatized patients are initially evaluated by the emergency room physician. Subsequent consultation and referral patterns vary per individual physician's bias, local precedence, and availability of consultants. My own experience has shown that many physicians are unaware of the training and capabilities of oral and maxillofacial surgeons. Of the three aforementioned subspecialists we probably have the most extensive and concentrated training with respect to the oral-facial structure.
Independent decisions are fictional from a psychological perspective
Authors: Hans-Rüdiger Pfister, Gisela Böhm
Journal: Behavioral and Brain Sciences (2014)

Abstract Contrasting independent with socially influenced decision making does not capture crucial differences in decision making. Independence is fictional, and social influences substantially permeate preference construction. A distinction between deliberate and intuitive decision making would be more useful, and the problem in the big-data era is deciding when it is better to rely on deliberation and when to trust one's intuitions.
COMPARISON OF INTRAVENOUS (3-AMINO-1-HYDROXYPROPYLIDENE)-1, 1-BISPHOSPHONATE AND VOLUME REPLETION IN TUMOUR-INDUCED HYPERCALCAEMIA
Authors: HarmP. Sleeboom, AllanT. Van Oosterom, OlavL.M. Bijvoet, JanetH. Gleed, JeffreyL.H. O'Riordan
Journal: The Lancet (1983)
Gene expression profiling of normal breast epithelial cells following treatment with insulin-like growth factor I
Authors: Jennifer S. Oh, Pierre Buchel, Karla Martin, Jill E. Kucab, Tomo Oshimura, Lee Bennett, Kelli Reynolds, David M. Cykert, J. Carl Barrett, Richard P. DiAugustine, Cynthia Afshari, Sandra E. Dunn
Journal: Nature Genetics (2001)

Session I5 2 sis of these data also identified a subset of genes that distinguish tumor specimens from each other as well as from normal prostate tissue.Random permutation of the sample labels clearly indicates that the subset of genes separating tumor subgroups far exceeds that expected by chance alone (P=0.002).This work indicates that investigation of prostate cancer based on gene expression can identify genes that may help distinguish more aggressive forms of this disease.
Satellite cell senescence underlies myopathy in a mouse model of limb-girdle muscular dystrophy 2H
Authors: Elena Kudryashova, Irina Kramerova, Melissa J. Spencer
Journal: Journal of Clinical Investigation (2012)

Mutations in the E3 ubiquitin ligase tripartite motif-containing 32 (TRIM32) are responsible for the disease limb-girdle muscular dystrophy 2H (LGMD2H). Previously, we generated Trim32 knockout mice (Trim32-/- mice) and showed that they display a myopathic phenotype accompanied by neurogenic features. Here, we used these mice to investigate the muscle-specific defects arising from the absence of TRIM32, which underlie the myopathic phenotype. Using 2 models of induced atrophy, we showed that TRIM32 is dispensable for muscle atrophy. Conversely, TRIM32 was necessary for muscle regrowth after atrophy. Furthermore, TRIM32-deficient primary myoblasts underwent premature senescence and impaired myogenesis due to accumulation of PIAS4, an E3 SUMO ligase and TRIM32 substrate that was previously shown to be associated with senescence. Premature senescence of myoblasts was also observed in vivo in an atrophy/regrowth model. Trim32-/- muscles had substantially fewer activated satellite cells, increased PIAS4 levels, and growth failure compared with wild-type muscles. Moreover, Trim32-/- muscles exhibited features of premature sarcopenia, such as selective type II fast fiber atrophy. These results imply that premature senescence of muscle satellite cells is an underlying pathogenic feature of LGMD2H and reveal what we believe to be a new mechanism of muscular dystrophy associated with reductions in available satellite cells and premature sarcopenia.