tbuckley/cabot-search huggingface dataset:
Performance of algorithms and pre-test probability scores is often overlooked in the diagnosis of pulmonary embolism
Authors: M. Newnham, H. Stone, R. Summerfield, N. Mustfa
Journal: BMJ (2013)

The mantra that pre-test probability (PTP) scoring should be the first stage in diagnosing pulmonary embolism is supported by a wealth of evidence.1 2 3 Unfortunately, the performance of diagnostic algorithms and PTP scores in clinical settings is often overlooked; when applied incorrectly the predictive potential is negated.

Our retrospective study of …
Ear Piercing Hazard of Nickel-Gold Sensitization
Authors: A. A. Fisher
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The clinical note of Johnson et al (227:1165, 1974) emphasizes the danger of a viral infection with the production of hepatitis.<i>Staphylococcus</i>infections are also not unusual. Another lesser-known hazard is the production of allergic contact sensitivity to nickel and gold. In the past year, I have studied six women and one man who became sensitized to nickel from having their ears pierced and nickel-plated or nickel-gold alloy earrings inserted. One other patient became sensitized to gold from the procedure. Gaul (200:176, 1967) reported that: [The ear piercing] fashion has inadvertently produced an outbreak of earlobe dermatitis... [An] unknown number of subjects will develop a generalized nickel sensitivity... [that] will persist indefinitely [by having their ears pierced and then wearing nickel-containing jewelry.] There is no doubt that injury to the skin from mechanical, physical, or chemical agents followed by intimate contact with sensitizing allergens favors the development
Schistocytes in megaloblastic anemia
Authors: Barbara J. Bain
Journal: American Journal of Hematology (2010)

A 76-year-old man presented feeling generally unwell. He was found to be anemic and thrombocytopenic with a white cell count of 4 × 109/l, a hemoglobin concentration of 57 g/l, a mean cell volume of 122 fl and a platelet count of 155 × 109/l. His blood film (image) showed numerous schistocytes and some keratocytes (Image: bottom left). Some observers suspected a microangiopathic hemolytic anemia. However, other film features included oval macrocytes, teardrop poikilocytes, Howell-Jolly bodies (Image: bottom right image), basophilic stippling and occasional hypersegmented neutrophils. In addition, the macrocytes were not polychromatic. He was found to have a serum vitamin B12 concentration of 30 ng/l (normal range 160–900) and subsequent investigations confirmed a diagnosis of pernicious anemia. In severe megaloblastic anemia it is usual for there to be marked poikilocytosis including red cell fragments, which are sometimes hypochromic. This sometimes leads to a paradoxically lower mean cell volume than is seen in less severe cases. The erythrocyte changes reflect the severity of the dyserythropoiesis and should not be taken as evidence of microangiopathic hemolysis. In addition to hypersegmented neutrophils, oval macrocytes are a very consistent finding and are useful in suggesting the correct diagnosis. Teardrop poikilocytes are also common and occasional Howell-Jolly bodies may be found. A correct morphological diagnosis can be important as some patients have normal vitamin B12 and folate assays despite a tissue deficiency.
London mayor attacked for doing "irreparable damage" on MMR
Authors: A. Ferriman
Journal: BMJ (2002)

London's mayor, Ken Livingstone, was attacked by representatives at the BMA's annual representative meeting last week for saying that the baby he and his partner are expecting will not be given the triple jab against measles, mumps, and rubella (MMR). Mr Livingstone said that his child would have single vaccines only and advised other parents to do the same.

Dr Anthony Grewal, a GP from Hillingdon, west London, asked the conference: “How unhelpful can you get? I call upon him and indeed all …
The Brown Lectures on Pathology
Authors: V. Horsley
Journal: BMJ (1885)

cease, as the plica duodeno-jejunalis.The free edge of the plica will correspond to, although it will not be identical with, the free-edg6 of the tiv fold.It-is '-o0 necessary to assume that the ddenum mo '*e us membrane.Repeated ilhtao1 are, ~i r,~siwtatpi~tn ~~b wit dof the .wvwcov
THE VARICOSE VEINS SLOUGH
Authors: NORMAN J. KILBOURNE
Journal: JAMA (1930)

Communications that I have received show that sloughs following the injection treatment of varicose veins are occurring with more frequency than one would suppose from case series reported. These sloughs, if not properly treated, may cause prolonged disability. The literature on the subject is not only disappointing but actually misleading—disappointing because it gives no adequate guidance to those so unfortunate as to have incurred these accidents, and misleading because, as I shall show, it contains misstatements partly responsible for the sloughs. <h3>DIAGNOSIS</h3> An absolute diagnosis cannot be made at the time of injection. As has been frequently stated, some injection fluids, if they escape outside a vein, cause an immediate burning pain at the site of injection; but the converse statement does not hold true. An immediate pain at the site of injection does not necessarily mean an extravascular escape of fluid. Many perfect injections give pain at the site
BMA calls for 10% pay increase
Authors: J. Wise
Journal: BMJ (1998)

The capacity of arrestees to comprehend their <i>Miranda</i> rights adequately and to waive them intelligently remains largely unexamined by most defense attorneys and forensic practitioners. Although much is now known about <i>Miranda</i> comprehension, only recently has forensic research emerged on <i>Miranda</i> reasoning. This archival study utilizes an extensive dataset of 847 pretrial detainees who were administered the Standardized Assessment of Miranda Abilities. This study focuses on how forensic practitioners can evaluate <i>Miranda</i> misperceptions that may have contributed to highly consequential decisions to cooperate with law enforcement without seeking legal counsel. Specific items from the Miranda Acquiescence Questionnaire of the Standardized Assessment of Miranda Abilities clearly identified detainees with impaired <i>Miranda</i> reasoning. Two important patterns of <i>Miranda</i> misperceptions were observed: adversarial perspective on arrest and trusting law enforcement. For instance, more than 20 percent of detainees with impaired reasoning wrongly believed that cooperating with police could only have positive outcomes. Even more troubling, more than one fourth of detainees erroneously believed that they must always comply with police requests, which obviously could entail self-incrimination. These findings are then placed in a broader context when examining the professional roles of forensic practitioners in recognizing, understanding, and evaluating for impaired <i>Miranda</i> abilities.
PUERPERAL ALBUMINURIA.Read in the Section of Obstetrics and Diseases of Women, at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May, 1890.
Authors: S. P. DEAHOFE
Journal: JAMA (1890)

By albuminuria I mean a condition in which albumen appears in the urine. It may or may not be associated with a decided diffuse nephritis; I say decided, for it is more than likely that if albumen exists for any length of time in the urine, there is more or less nephritis. I have never been able to distinguish between albumen of Bright's disease and that where the disease does not exist. Semmola, in the Archives oj Physiology, states that there is a difference in the appearance of the precipitate; and that the albumen of Bright's disease diffuses more rapidly through animal membranes. A very important form of albuminuria is that found during pregnancy; most frequently in primiparæ, and frequently associated with other symptoms of Bright's disease. The following is a very interesting case: Mrs. D., aged 32, primipara. Family history: Father was an epileptic; other than this it
Development of anti-human colonic mucin monoclonal antibodies. Characterization of multiple colonic mucin species.
Authors: D K Podolsky, D A Fournier, K E Lynch
Journal: Journal of Clinical Investigation (1986)

Structural relationships between colonic mucin species were assessed using a library of monoclonal antibodies (MAbs) directed against purified human colonic mucin (HCM). After immunization of mice with purified mucin from normal human colonic mucosa, 14% of 1,920 fusion products screened were positive for anti-HCM activity in a solid-phase assay. Patterns of selective binding by hybridomas to six discrete HCM species (I-VI) separated by DEAE-cellulose chromatography suggested the presence of both shared and species-specific antigenic determinants among HCM species I-VI. 23 anti-HCMs MAbs (7 IgM, 7 IgG1, and 9 IgG2) demonstrating a range of anti-HCM species specificities, were produced and used to study structural relationships between mucin species. Binding of various mucin species by individual anti-HCM MAbs was shown by competitive solid-phase radioimmunoassay to reflect the presence of identical epitopes on the different species. Adsorption of HCM species on a variety of affinity resins prepared with anti-HCM MAbs demonstrated that binding to multiple mucin species by a single MAb was related to intrinsic structural determinants. Four anti-HCM MAbs recognized protease-sensitive antigenic structures, which suggests that they may be directed to core HCM proteins. 12 of the anti-HCM MAbs were shown by solid-phase assay to recognize either complete (n = 5) or partial (n = 7) isolated colonic mucin oligosaccharide side chains of defined structure. Collectively, these data show the presence of both shared and unique antigenic structural determinants among colonic mucin species. Chromatographic heterogeneity of mucin glycoproteins seems to be related to the existence of biologically significant subclasses in the normal human colon.
LOW TESTOSTERONE LEVEL IS ASSOCIATED WITH IMPAIRED MICROVASCULAR FUNCTION IN MEN
Authors: Frank Edward Corrigan, Danny Eapen, Pankaj Manocha, Muhammad Hammadah, Suliman Alradawi, Jennifer Vazquez, Lynn Cunningham, Irina Uphoff, Laurence Sperling, R. Wayne Alexander, Kenneth L. Brigham, Arshed Quyyumi
Journal: Journal of the American College of Cardiology (2012)
Dextrose 50 % solution as a submucosal fluid cushion in the resection of sessile colorectal polyps
Authors: P. Katsinelos, J. Kountouras, G. Chatzimavroudis, G. Paroutoglou, C. Zavos
Journal: Endoscopy (2008)

We read with considerable interest the paper by Hurlstone et al. [1], which compared dextrose 50 % (D50) with sodium hyaluronic acid (SHA) for the development of long-lasting submucosal elevation to improve the technical feasibility of en bloc endoscopic mucosal resection (EMR) of sessile colorectal polyps with a diameter of < 30 mm. They found no difference in the rates of complete resection (D50 59/82 vs. SHA 56/81), recurrence, and complications between the two groups.
High incidence of herpes zoster in patients with systemic lupus erythematosus: an immunological analysis.
Authors: K Nagasawa, Y Yamauchi, Y Tada, T Kusaba, Y Niho, H Yoshikawa
Journal: Annals of the Rheumatic Diseases (1990)

The incidence of herpes zoster was determined in patients with systemic lupus erythematosus (SLE) and the cellular and humoral immunity to varicella zoster virus (VZV) investigated in 45 of these 92 patients. The incidence of herpes zoster was high, occurring in 40 patients (43%), though it was benign in all. Patients with SLE who had had zoster showed significantly higher antibody titres than normal subjects. On the other hand, only 13 of 43 (30%) patients with SLE showed positive delayed hypersensitivity skin reactions to VZV antigen, despite a history of infections with VZV, whereas all 15 normal subjects had positive reactions. Skin reactions to VZV correlated directly with the ratio of OKT4+ to OKT8+ T cells and inversely with the dose of corticosteroids. These results suggest that the high incidence of herpes zoster in patients with SLE is probably due to defects in cellular immunity and that normal or higher titres of antibodies to VZV will not act as a preventive against zoster. In addition, reactivation of VZV, whether symptomatic or not, seemed often to occur in patients with SLE.
Pearls in Diagnostic Radiology
Authors: James E. Crowe
Journal: JAMA (1981)

The most interesting approach to learning for most radiologists is that of examining the x-ray films of a case that can be diagnosed on the basis of the radiological findings. Dr Rosenbaum has used this case-oriented approach in his collection of 60 cases. The cases are divided among 12 fascicles under general headings that include chest, cardiovascular, gastro-intestinal, genitourinary, and orthopedic radiology. Four of the fascicles deal exclusively with pediatric cases. Individual fascicles are stapled together, then placed in a three-ring binder. This arrangement conveniently allows one to use one or a few of the fascicles rather than carry the entire collection. The diagnosis of each case is presented as an unknown. The x-ray films are shown on the first two pages, along with pertinent clinical information in most cases. This is followed by two pages of discussion and a few references. The discussion of the radiological, pathological, and clinical
Long-term outcome of juvenile idiopathic arthritis following a placebo-controlled trial: sustained benefits of early sulfasalazine treatment
Authors: M. A J van Rossum, R. M van Soesbergen, M. Boers, A. H Zwinderman, T. J W Fiselier, M. J A M Franssen, R. ten Cate, L. W A van Suijlekom-Smit, N. M Wulffraat, W. Kuis, W. H J van Luijk, J. C M Oostveen, B. A C Dijkmans
Journal: Annals of the Rheumatic Diseases (2007)

A previous 24-week randomised trial demonstrated that sulfasalazine (SSZ) treatment was superior to placebo (PLAC) in suppressing disease activity in patients with oligo- and polyarticular onset juvenile idiopathic arthritis (JIA). The current study determines the long-term outcome of the trial participants and evaluates whether the benefits of SSZ allocation are sustained over time.Between 2001 and 2003, 32 SSZ and 29 PLAC patients (90% of all patients) were prospectively examined clinically and by chart review, median 9 years (range 7 to 10) after trial inclusion. In the follow-up assessment, variables of the American College of Rheumatology Pediatric 30 (ACR Pedi 30) criteria were collected. The assessor was blinded to trial treatment allocation.After the trial, patients had been routinely followed in rheumatology referral centres, and treated at the discretion of the attending physician. Almost all patients continued or started disease-modifying antirheumatic drugs (DMARDs) (SSZ 91%, PLAC 93%; SSZ treatment in about 80%). DMARD treatment appeared less intensive in the SSZ group as evidenced by a significantly shorter duration of SSZ use (median 2.5 vs 5.2 years; p = 0.02) and a trend towards less use of methotrexate and other DMARDs. More than one-third of the patients reported long periods of non-compliance with DMARD treatment in both groups. At follow-up, 74% of the patients had active joints, and 30% showed active polyarthritis. Almost all outcome scores were better for SSZ compared with PLAC patients. Differences (often exceeding 50%) were significant for the number of active joints, patients' overall well-being, number of patients with episodes of clinical remission off medication (CROM) and duration of these episodes, patients in CROM and ACR Pedi 30 response at follow-up. Additional exploratory analyses performed to detect potential confounders related to patient characteristics or follow-up treatment showed that DMARD treatment compliance was positively correlated with an ACR Pedi 30 response (odds ratio 3.8, 95% confidence interval (CI) 1.1 to 13.4; p = 0.03). Adjusted for compliance, an SSZ patient was 4.2 times as likely as a PLAC patient to be an ACR Pedi 30 responder at follow-up (95% CI 1.3 to 14.3; p = 0.02).This follow-up study shows that effective suppression of disease activity by SSZ treatment early in active disease in JIA patients has beneficial effects that persist for many years. Given these results, compliance with DMARD treatment deserves serious attention.
Retraction: Absence of Human T-Cell Lymphotropic Virus Type I in Cutaneous T-Cell Lymphoma
Authors: R. M. Hamm, F. Lawler, D. Scheid, V. L. Ernster, Henry Mark Kuerer, E. S. Hwang, L. J. Esserman, J. D. Boice, J. H. Olsen, L. C. Hartmann, D. J. Schaid, T. A. Sellers
Journal: New England Journal of Medicine (1999)

entitled "Cat Scratch Disease" might convey the misleading message that masses assumed to be caused by either B. henselae (cat scratch), as shown, or mycobacteria (e.g., Mycobacterium avium complex and others) should be treated with direct puncture and drainage.Such an erroneous approach frequently leads to a draining sinus with an avoid-The New England Journal of Medicine Downloaded from nejm.org
Potential Pharmacokinetics Interference Between α-Glucosidase Inhibitors and Other Oral Antidiabetic Agents
Authors: André J. Scheen, Pierrè J. Lefèbvre
Journal: Diabetes Care (2002)

In the study recently reported by Chiasson et al. (1), it was concluded that miglitol, a pseudomonosaccharide α-glucosidase inhibitor, can be combined effectively with metformin therapy to give significantly greater reductions in HbA1c and postprandial plasma glucose levels than metformin alone in middle-aged patients in whom type 2 diabetes is insufficiently controlled by diet alone. The combined therapy had a good safety profile, with only a trend toward an increase in the number of gastrointestinal side-effects due to miglitol acting at the small intestine by delaying the digestion of complex carbohydrates (2).

The absorption of metformin occurs mainly in the small intestine, and …
Transcriptional activation of Fsp27 by the liver‐enriched transcription factor CREBH promotes lipid droplet growth and hepatic steatosis
Authors: Xu Xu, Jong‐Gil Park, Jae‐Seon So, Ann‐Hwee Lee
Journal: Hepatology (2014)

Fat‐specific protein 27 (Fsp27) is a lipid droplet‐associated protein that promotes lipid droplet (LD) growth and triglyceride (TG) storage in white adipocytes. Fsp27 is also highly expressed in the steatotic liver and contributes to TG accumulation. In this study we discovered that the liver produces Fsp27β, an alternative Fsp27 isoform, which contains 10 additional amino acids at the N‐terminus of the original Fsp27 (Fsp27α). White adipose tissue (WAT) and the liver specifically expressed Fsp27α and Fsp27β transcripts, respectively, which were driven by distinct promoters. The Fsp27β promoter was activated by the liver‐enriched transcription factor cyclic‐AMP‐responsive‐element‐binding protein H (CREBH) but not by peroxisome proliferator‐activated receptor gamma (PPARγ), which activated the Fsp27α promoter. Enforced expression of the constitutively active CREBH strongly induced Fsp27β and the human ortholog CIDEC2 in mouse hepatocytes and HepG2 cells, respectively. In contrast, loss of CREBH decreased hepatic Fsp27β in fasted mice, suggesting that CREBH plays a critical role in Fsp27β expression in the liver. Similar to Fsp27α, Fsp27β localized on the surface of lipid droplets and suppressed lipolysis. Consequently, enforced expression of Fsp27β or CREBH promoted lipid droplet enlargement and TG accumulation in the liver. Conclusion : The CREBH‐Fsp27β axis is important for regulating lipid droplet dynamics and TG storage in the liver. (H epatology 2015;61:857–869)
Fluoridation of drinking water.
Authors: D A Breen, J W Chalmers, I H MacLean
Journal: BMJ (1993)

drop out (36% with SSRI and 39% with tricyclic antidepressants; p=0-34).Both studies quoted by Hale as showing an advantage of SSRIs over tricyclic antidepressants in long term compliance were placebo controlled, not including tricyclic antidepressants.In summary, there seems little evidence to support the routine first line use of SSRIs.The debate has now shifted to the issues of suicide by overdose and costs.This cannot be resolved by reference to the trial data and will be the subject of a further paper.SmithKline Beecham and Lilly Industries Ltd refer to data from unpublished studies, which therefore cannot be commented on.The burden of proof must lie with those who advocate the use of expensive new drugs on the basis of improved tolerability.
ATM Is Upregulated During the Mitogenic Response in Peripheral Blood Mononuclear Cells
Authors: Toshiyuki Fukao, Hideo Kaneko, Geoff Birrell, Magtouf Gatei, Hideaki Tashita, Toko Yoshida, Simone Cross, Padmini Kedar, Dianne Watters, Kum Kum Khana, Ihor Misko, Naomi Kondo, Martin F. Lavin
Journal: Blood (1999)
Expression and Functional Significance of Nicotinamide N-methyl Transferase in Skeletal Muscles of Patients with Chronic Obstructive Pulmonary Disease
Authors: Ho Cheol Kim, Mahroo Mofarrahi, Theodoros Vassilakopoulos, Francois Maltais, Ioanna Sigala, Richard Debigare, Ioannis Bellenis, Sabah N. A. Hussain
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Nicotinamide N-methyl transferase (NNMT) is highly expressed in quadriceps muscles of patients with chronic obstructive pulmonary disease (COPD). However, its expression in the diaphragm of these patients has not been assessed. The functional significance of NNMT induction in skeletal muscles of patients with COPD is also unknown.(1) To compare NNMT expressions in the diaphragm and quadriceps muscles of patients with COPD. (2) To identify the influence of proinflammatory cytokines on NNMT expression. (3) To assess the influence of NNMT on indices of myogenesis (satellite cell migration and proliferation) and the defense against oxidative stress.Costal diaphragm muscle biopsies were acquired from 13 patients with moderate and severe COPD and 8 control subjects. Quadriceps muscle biopsies were obtained from 12 patients with COPD and 14 control subjects.NNMT expressions were significantly elevated in the diaphragm and quadriceps muscles of patients with COPD; however, the relative induction of NNMT expression was greater in the quadriceps muscle (10-fold) than it was in the diaphragm (2-fold). NNMT expressions correlated negatively with the severity of COPD and limb muscle wasting. In skeletal myoblasts, NNMT expression was significantly induced by IL-6, transforming growth factor beta, and tumor necrosis factor-alpha. Overexpression of NNMT in myoblasts triggered a significant increase in proliferation and migration, but had no influence on cell death. Carbonyl formation, induced by exposing myoblasts to H(2)O(2), was significantly attenuated when NNMT was overexpressed.Up-regulation of NNMT expression in the skeletal muscles of patients with COPD may represent an adaptive response designed to improve myogenesis and defend against oxidative stress.
Italian courts find 175 doctors and managers guilty of fraud
Authors: F. Turone
Journal: BMJ (2003)

A total of 175 doctors and health managers were found guilty of fraud and corruption in Italy last week, after the country's biggest trial of doctors for embezzlement came to an end. The doctors were sentenced to prison terms ranging from two months to three and a half years, though it is likely that many will avoid imprisonment by appealing against their convictions, a process that can take years.

The defendants were found guilty of …