tbuckley/cabot-search huggingface dataset:
Painless Thyroiditis and Transient Thyrotoxicosis After Graves' Disease
Authors: Jerome H. Check
Journal: JAMA (1980)

PAINLESS thyroiditis associated with transient thyrotoxicosis is a well-recognized entity and may account for 15% of all cases of thyrotoxicosis.<sup>1,2</sup>It is important to distinguish this condition from Graves' disease, because treatment of the two disorders is different. Because the uptake of iodine is depressed in transient thyrotoxicosis associated with thyroiditis, therapy with antithyroid medication or iodine 131 is ineffective, and since the disease is selflimited, surgery is inappropriate.<sup>3</sup>Therefore, a radioactive iodine uptake study in newly discovered thyrotoxic patients is indicated as a means of distinguishing these two different conditions.<sup>4,5</sup> Graves' disease is characterized by remissions and exacerbations. However, in a patient experiencing an apparent recurrence, the radioactive iodine uptake determination should be repeated, even if the serum thyroxine (T<sub>4</sub>) or triiodothyroxine (T<sub>3</sub>) level is elevated, as our case illustrates. <h3>Report of a Case</h3> The condition of a 28-year-old patient was first diagnosed as
Risk of Illness after Exposure to a Pediatric Office
Authors: Alan M. Lobovits, Jonathan Freeman, Donald A. Goldmann, Kenneth McIntosh
Journal: New England Journal of Medicine (1985)

To determine whether well children visiting a pediatrician's office are at risk of acquiring common communicable diseases, we conducted a prospective cohort study during the winter of 1983-1984. The occurrence of respiratory or gastrointestinal illness or fever in young children in the week after a visit to a pediatric office (office group) was compared with the occurrence of these illnesses in a similar group of children (home group) not exposed to the office during the study period. One home comparison subject was matched by age and sex to each of 127 children three years of age and under who were seen for well-child care in a private pediatric office with a common waiting room. The adjusted relative risk of the development of illness during the study week for the office group as compared with the home group was 0.95 (95 per cent confidence interval, 0.66 to 1.37), indicating no effect. We conclude that exposure to a pediatric office is not an important cause of the common infections in young children that have incubation periods of a week or less.
A Textbook of Clinical Pathology
Authors: Lester S. King
Journal: JAMA (1966)

While any textbook in its seventh edition can point to a built-in certificate of commendation, the present volume shows a serious drawback. The intended audience  not clearly defined. The book is designed to give the medical student, intern, resident physician, clinical pathologist, and teacher of medicine an authoritative source of information on how best to use the clinical laboratory. Claiming to emphasize function and mechanism of disease, the text aims to give understanding of laboratory procedures and to act as a guide in interpretation and evaluation. This laudable aim, unfortunately,  imperfectly achieved.  The difficulty  in large part clearly traceable to the multiple authorship. Sometimes stressing technical aspects, other times principles and concepts, the book in a sense tries to be all things to all men—and fails. The critical reader will sorely miss a uniform point of view or method of exposition. Some chapters present detailed technical aspects
Alcoholic Hepatitis — An Experimental Approach to a Conceptual and Clinical Problem
Authors: Hans Popper
Journal: New England Journal of Medicine (1974)

That excess imbibing of alcoholic beverages may lead to crippling liver injury has been well known ever since the cultivation of the grape became an early endeavor in agriculture to spread happiness on this planet. Alcoholic fatty liver and cirrhosis are widely recognized, but the link between them has been a multifaceted riddle. Foremost is the question why only some persons are at risk to become victims of a hepatic disorder that threatens health and even life when the majority of the population drink some alcohol at times and 10 million Americans are considered alcoholics. Although prevention and treatment of . . .
Prostatic Calcifications on Tc-99m-Oxidronate Bone SPECT
Authors: Frank De Geeter, Kenneth Coenegrachts
Journal: Clinical Nuclear Medicine (2006)

This report describes the appearance of prostatic calcifications on a pelvic bone SPECT with Tc-99m oxidronate in a 69-year-old man who underwent bone scintigraphy in the workup for lumbar pain and fever. The presence of prostatic calcifications was confirmed on computed tomography scan.
Statistics in the Practice of Medicine
Authors: Robert G. Hoffmann
Journal: JAMA (1963)

PRACTICING PHYSICIANS and statisticians may not seem to have many mutual interests, but perhaps they have more in common than is apparent at first. The purpose of this article is to describe a few statistical tools and to illustrate how these tools may be useful in the practice of medicine. As a starting point, consider a fairly frequently encountered medical problem, diabetes mellitus. According to some physicians, they believe that diabetics are best maintained at slightly elevated blood-glucose levels, but others feel that they should be maintained within limits of clinical normality. Which group is right or are they both right? And what is clinical normality and how is it determined? Suppose we consider the question of clinical normality first, partly because it is relatively easy to discuss and partly because it is a portion of the problem of maintaining diabetics in control. <h3>Normal Values</h3> According to one textbook,<sup>1</sup>
An Analysis of the Resident Match
Authors: Kevin Jon Williams, Victoria P. Werth, Jon A. Wolff
Journal: New England Journal of Medicine (1981)

The National Resident Matching Program (NRMP) was founded to bring fairness and order to a previously chaotic application process for internships. However, the current computer algorithm that generates the matches treats students and programs differently, in a way that favors programs whenever desires conflict. No statement from the NRMP makes this point clear, and workable alternatives to this biased algorithm have not been considered in public debate.A Controlled ExperimentA controlled way to demonstrate the favored role of programs is to switch the positions of students and programs in the algorithm and then compare the results of matching. Under . . .
Multiple medallists and type of events (Munich Olympiad 1972).
Authors: T. Khosla
Journal: British Journal of Sports Medicine (1976)

Many factors, physiological, psychological, skill, training, motivation along with the right physique for the event, form a chain of essential criteria for the ultimate position of a medallist's standing.Because physique is related to the type of event, if follows that a particular physique is ideal for those specific events in which multiple medallists are found.Some events are incompatible; champion boxers cannot become champion wrestlers or weightlifters because of differ- ences in their physique (Khosla 1968).Furthermore, a champion boxer is unlikely to win more than one medal as he is permitted to compete only in his weight group- ing or above.In some team events (basketball, volley ball, football, hockey etc.) it is theoretically possible for the competitor to achieve excellence in more than one game.It is therefore of interest to identify the group of specific events in which multiple achievements are usually attained.
Another look at osteoarthritis.
Authors: E C Huskisson, P A Dieppe, A K Tucker, L B Cannell
Journal: Annals of the Rheumatic Diseases (1979)

One hundred consecutive cases of osteoarthritis seen in a medical clinic have been reviewed and contrasted with 100 patients with rheumatoid disease. Osteoarthritis was usually a polyarticular disease and as symmetrical in distribution as rheumatoid; the knees and hands were the most commonly involved sites. Evidence of inflammation was often found in patients with osteoarthritis and included morning stiffness, redness of distal interphalangeal joints, warmth, and effusions in the knees. In many cases there was either radiological or electron microscopical evidence of deposition of calcium salts. These findings do not support the concept of osteoarthritis as a mechanical, noninflammatory 9wear and tear9 condition. An active metabolic abnormality of articular cartilage resulting in cartilage destruction, calcification, and inflammation is suggested as being more compatible with the findings.
Nifedipine therapy for patients with threatened and acute myocardial infarction: a randomized, double-blind, placebo-controlled comparison.
Authors: J E Muller, J Morrison, P H Stone, R E Rude, B Rosner, R Roberts, D L Pearle, Z G Turi, J F Schneider, D H Serfas
Journal: Circulation (1984)

Preliminary clinical and laboratory observations suggest that nifedipine might prevent progression of threatened myocardial infarction by reversing coronary spasm or might limit necrosis during the course of acute myocardial infarction. We screened 3143 patients with ischemic pain of greater than 45 min duration and randomly assigned 105 eligible patients with threatened myocardial infarction and 66 with acute myocardial infarction to receive nifedipine (20 mg orally every 4 hr for 14 days) or placebo plus standard care. Treatment was started 4.6 +/- 0.1 hr after the onset of pain. Infarct size index was calculated by the MB-creatine kinase (CK) method and expressed as CK-geq/m2 +/- SE. The incidence of progression to infarction among patients with threatened myocardial infarction was not significantly altered by nifedipine (36 of 48 [75%] for placebo-treated and 43 of 57 [75%] for nifedipine-treated patients). Furthermore, infarct size index was similar among placebo- and nifedipine-treated patients (16.9 +/- 1.5 MB-CK-geq/m2, n = 65, and 17.0 +/- 1.5 MB-CK-geq/m2, n = 68, respectively) with threatened myocardial infarction who exhibited infarction and for those with acute myocardial infarction. Among the 171 eligible patients randomly assigned to drug or placebo, 6 month mortality did not differ significantly (8.5% for placebo vs 10.1% for nifedipine, NS), but mortality in the 2 weeks after randomization was significantly higher for nifedipine-treated patients (0% for placebo compared with 7.9% for nifedipine, p = .018).(ABSTRACT TRUNCATED AT 250 WORDS)
Effect of Propranolol on Elevated Arterial Blood Pressure
Authors: DAVID W. RICHARDSON, JACK FREUND, ARTHUR S. GEAR, H. PAGE MAUCK, LESTER W. PRESTON
Journal: Circulation (1968)

Nineteen patients with moderately severe arterial hypertension received propranolol (120 mg daily), or chlorthalidone (100 mg daily), both medications together, and placebos in a double-blind crossover trial. Each treatment was given for 5 weeks; blood pressure was measured at weekly intervals. Propranolol alone reduced arterial pressure by 9/8 mm Hg, a statistically insignificant change. Use of chlorthalidone alone was accompanied by an average reduction in arterial blood pressure of 23/9 mm Hg. Both drugs together lowered blood pressure by 33/15 mm Hg. Heart rate was lower in regimens including propranolol; body weight and serum potassium and chloride concentration were lower and blood urea nitrogen and serum creatinine were higher in regimens containing chlorthalidone. Propranolol, in the dose given, is a less effective hypotensive drug than is chlorthalidone.
Alterations of Sarcoplasmic Reticulum Proteins in Failing Human Dilated Cardiomyopathy
Authors: Markus Meyer, Wolfgang Schillinger, Burkert Pieske, Christian Holubarsch, Claus Heilmann, Herbert Posival, Goro Kuwajima, Katsuhiko Mikoshiba, Hanjörg Just, Gerd Hasenfuss
Journal: Circulation (1995)

Background Previous studies provide considerable evidence that excitation-contraction coupling may be disturbed at the level of the sarcoplasmic reticulum (SR) in the failing human heart. Disturbed SR function may result from altered expression of calcium-handling proteins. Methods and Results Levels of SR proteins involved in calcium release (ryanodine receptor), calcium binding (calsequestrin, calreticulin), and calcium uptake (calcium ATPase, phospholamban) were measured by Western blot analysis in nonfailing human myocardium (n=7) and in end-stage failing myocardium due to dilated cardiomyopathy (n=14). The levels of the ryanodine receptor, calsequestrin, and calreticulin were not significantly different in nonfailing and failing human myocardium. Phospholamban protein levels (pentameric form) normalized per total protein were decreased by 18% in the failing myocardium ( P &lt;.05). However, phospholamban protein levels were not significantly different in failing and nonfailing myocardium when normalization was performed per calsequestrin. Protein levels of SR calcium ATPase, normalized per total protein or per calsequestrin, were decreased by 41% ( P &lt;.001) or 33% ( P &lt;.05), respectively, in the failing myocardium. Furthermore, SR calcium ATPase was decreased relative to ryanodine receptor by 37% ( P &lt;.05) and relative to phospholamban by 28% ( P &lt;.05). Conclusions Levels of SR proteins involved in calcium binding and release are unchanged in failing dilated cardiomyopathy. In contrast, protein levels of calcium ATPase involved in SR calcium uptake are reduced in the failing myocardium. Moreover, SR calcium ATPase is decreased relative to its inhibitory protein, phospholamban. These findings support the concept that reduced capacity of the SR to accumulate calcium may reflect a major defect in excitation-contraction coupling in human heart failure.
Structural reengineering of imatinib to decrease cardiac risk in cancer therapy
Authors: George D. Demetri
Journal: Journal of Clinical Investigation (2007)

Imatinib, a selective, small-molecule tyrosine kinase inhibitor, has life-saving clinical activity in certain cancers, but questions have been raised about the potential for cardiac toxicity through inhibition of its target, ABL kinase. In this issue of the JCI, Fernández et al. describe a novel method by which the ABL-inhibitory activity of imatinib was deleted by modifying its chemical structure (see the related article beginning on page 4044). The anticancer activity of the reengineered agent, called WBZ_4, was instead preserved against gastrointestinal stromal tumors in both in vitro and in vivo models via inhibition of KIT tyrosine kinase, and the desired safety was demonstrated with less cardiotoxicity of WBZ_4 compared with imatinib via the inhibition of JNK. The study shows that structural reengineering of a kinase-inhibitory drug to improve tolerability while preserving efficacy is feasible.
Grumpy old men
Authors: Theodore Dalrymple
Journal: BMJ (2007)

It is generally admitted, wrote R R Madden MD at the beginning of his book The Infirmities of Genius Illustrated by Referring the Anomalies in the Literary Character to the Constitutional Peculiarities of Men of Genius , published in 1833, that literary men are an irritable race, subject to many infirmities, both in mind and body. Worldly prosperity and domestic happiness are not often the result of their pursuits.

Fame and frailty, he says, are inseparable companions. This, he continues, is just as well; for it renders those of humbler capacities contented with their lot. Let us “thank God [we] are not like the . . . poor children of genius, frail in health, feeble in resolution, in small matters improvident, and …
EARLY TREPHINING IN DISEASES OF BONES.
Authors: JOSEPH RANSOHOFF
Journal: JAMA (1883)

[Read to the Section on Surgery and Anatomy, June, 1883.] A careful study of the vascular relations of a bone to its periosteum and medulla, leads to the conviction that there can be no serious deviation from the normal in either without implication of the remaining parts. Of the three component parts of a bone, the osseous tissue proper, owing to its comparatively passive nutritive state, is naturally least liable to inflamatory changes. As a rule, its morbid conditions are therefore secondary in character, and follow upon disturbances of the periosteum or medulla. From the superficial position of the former, its lesions, whether primary or secondary, are always easily recognized. Those of the medulla, on the other hand, are as usually ignored until the periosteum and the bone itself have become involved in a manner to attract attention by irregularities of outline, swelling of the soft parts, abscesses and fistulæ.
Extensive Soft Tissue Uptake of Bone Tracer in Amyloidosis
Authors: KENNETH J. LEE, ANDREW E. SOUTHEE, JOHN G. MORRIS, MONICA A. ROSSLEIGH
Journal: Clinical Nuclear Medicine (1988)

A 63-year-old man presented with a six month history of multiple myeloma with many complications, including bone pain, anaemia, weight loss, muscle wasting, peripheral neuropathy, ulnar nerve entrapment, and atrial fibrillation (without echocardiographic amyloidosis). A radiographic skeletal survey revealed lucencies in skull, proximal humeri, scapulae, pelvis, and proximal femora, but no soft tissue calcification. Bone imaging revealed widespread extraskeletal uptake of bone tracer, most prominent in pelvic and shoulder girdle musculature, due to biopsy proven amyloidosis. There were no clinically palpable abnormalities at any of the bone scan foci.
Differential effects of docosahexaenoic acid on contractions and L-type Ca2+ current in adult cardiac myocytes
Authors: G. R. Ferrier, I. Redondo, J. Zhu, M. G. Murphy
Journal: Cardiovascular Research (2002)

Beneficial effects of n-3 polyunsaturated fatty acids in Ca2+ overload have been attributed to blockade of L-type Ca2+ current (I(Ca-L)). However, cardiac contractions may be maintained despite block of I(Ca-L).This study investigates the cellular basis by which docosahexaenoic acid (DHA), a representative n-3 polyunsaturated fatty acid, inhibits I(Ca-L) while preserving contraction.Experiments were conducted in adult guinea pig ventricular myocytes with Na+ currents blocked. Contractions initiated by the voltage-sensitive release mechanism (VSRM) and calcium-induced calcium release (CICR) triggered by I(Ca-L), were activated separately with voltage clamp techniques.DHA (10 microM) inhibited I(Ca-L) and CICR contractions but not VSRM contractions. CICR contractions exhibited a bell-shaped voltage-dependence. However, in the presence of DHA, only contractions with a sigmoidal voltage-dependence characteristic of the VSRM remained. These contractions exhibited inactivation properties characteristic of the VSRM. DHA abolished I(Ca-L) elicited by test steps from -40 mV. Block was voltage-dependent, as residual I(Ca-L) was elicited by steps from -70 mV. Cd2+ inhibited residual current, but not contractions initiated by the same activation steps.Preservation of VSRM contractions during block of I(Ca-L), may explain the ability of n-3 polyunsaturated fatty acids to inhibit Ca2+ influx while preserving cardiac contractile function.
PPARG and ADIPOQ gene polymorphisms increase type 2 diabetes mellitus risk in Asian Indian Sikhs: Pro12Ala still remains as the strongest predictor
Authors: Dharambir Kaur Sanghera, Fatma Yesim Demirci, Latonya Been, Lyda Ortega, Sarju Ralhan, Gurpreet Singh Wander, Narinder Kumar Mehra, Jairup Singh, Christopher Eric Aston, John Joseph Mulvihill, Ilyas Mohammad Kamboh
Journal: Metabolism (2009)
THE EXPERIMENTAL VASCULAR LESIONS PRODUCED BY BACILLUS MALLEI
Authors: Charles W. Duval
Journal: The Journal of Experimental Medicine (1907)

1. Bacillus malleiand its poison produce a variety of vascular lesions in the rabbit and the guinea pig. 2. The type of the lesion depends upon, (a) the virulence of the culture, (b) the sex of the animal and (c) the degree of acquired immunity. 3. The vascular changes of a proliferative and degenerative nature produced by the slow action of the glanders poison in rabbits and guinea pigs are analogous to the vascular lesions caused by sub-acute glanders infection in man. 4. The most common site of the glanders vascular lesions of animals and man is the peripheral vessels, and especially the smaller visceral arteries. 5. The aorta is a less common site of the experimental lesions. 6. The vascular lesions produced experimentally by Bacillus mallei and its poison consist of three processes, (a) exudation, (b) proliferation, (c) degeneration. 7. The lesions produced by sub-acute glanders in man consist of two processes, proliferation and degeneration. 8. The primary reaction of the vessels in experimental animals and in sub-acute human glanders consists of a proliferation of the endothelium of the intima. 9. The first degenerative changes observed in experimental animals and in sub-acute human glanders occur in the "innermost layer" of the media and not in the so-called " middle zone." 10. The cause of the degenerative change in the inner layer of the media appears to be interference with the nourishment of the circular muscle fibres of the media by proliferation of the endothelium of the intima.
Timeliness of Childhood Vaccinations in the United States
Authors: Elizabeth T. Luman, Lawrence E. Barker, Kate M. Shaw, Mary Mason McCauley, James W. Buehler, Larry K. Pickering
Journal: JAMA (2005)

Only 18% of children in the United States receive all vaccinations at the recommended times or acceptably early.To determine the extent of delay of vaccination during the first 24 months of life.The 2003 National Immunization Survey was conducted by random-digit dialing of households and mailings to vaccination providers to estimate vaccination coverage rates for US children aged 19 to 35 months. Data for this study were limited to 14,810 children aged 24 to 35 months.Cumulative days undervaccinated during the first 24 months of life for each of 6 vaccines (diphtheria and tetanus toxoids and acellular pertussis; poliovirus; measles, mumps, and rubella; Haemophilus influenzae type b; hepatitis B; and varicella) and all vaccines combined, number of late vaccines, and risk factors for severe delay of vaccination.Children were undervaccinated a mean of 172 days (median, 126 days) for all vaccines combined during their first 24 months of life. Approximately 34% were undervaccinated for less than 1 month and 29% for 1 to 6 months, while 37% were undervaccinated for more than 6 months. Vaccine-specific undervaccination of more than 6 months ranged from 9% for poliovirus vaccine to 21% for Haemophilus influenzae type b vaccine. An estimated 25% of children had delays in receipt of 4 or more of the 6 vaccines. Approximately 21% of children were severely delayed (undervaccinated for more than 6 months and for > or vaccines). Factors associated with severe delay included having a mother who was unmarried or who did not have a college degree, living in a household with 2 or more children, being non-Hispanic black, having 2 or more vaccination providers, and using public vaccination provider(s).More than 1 in 3 children were undervaccinated for more than 6 months during their first 24 months of life and 1 in 4 children were delayed for at least 4 vaccines. Standard measures of vaccination coverage mask substantial shortfalls in ensuring that recommendations are followed regarding age at vaccination throughout the first 24 months of life.