tbuckley/cabot-search huggingface dataset:
The Eosinophilia-Myalgia Syndrome with Neuritis Associated with L-Tryptophan Use
Authors: Randi M. Dicker
Journal: Annals of Internal Medicine (1990)

Brief Reports15 June 1990The Eosinophilia-Myalgia Syndrome with Neuritis Associated with L-Tryptophan UseRandi M. Dicker, BS, Nicholas James, MD, Burke A. Cunha, MDRandi M. Dicker, BSSearch for more papers by this author, Nicholas James, MDSearch for more papers by this author, Burke A. Cunha, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-12-957 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe eosinophilia-myalgia syndrome, the recently described disorder (1, 2) associated with the use of L-tryptophan, may present with neuritis, among other features. A history of L-tryptophan use should be sought in patients presenting with symptoms of this disorder, particularly those with anxiety, depression, or insomnia. We report the case of a patient in which the neuritis was a prominent aspect of the syndrome.Case ReportA 48-year-old woman sought medical attention because of increasingly severe muscle aches. Six weeks before she was hospitalized, the patient had upper-back aches and soreness. The pain worsened, progressing to her shoulders, upper arms, thighs,...References1. KilbourneSwygertPhilen ELR. Interim guidance on the eosinophilia-myalgia syndrome. Ann Intern Med. 1990;112:85-7. LinkGoogle Scholar2. Eosinophilia-myalgia syndrome—New Mexico. MMWR. 1989;38:765-7. MedlineGoogle Scholar3. Boman B. L-Tryptophan: a rational anti-depressant and a natural hypnotic? Aust NZ J Psychiatry. 1988;22:83-97. CrossrefMedlineGoogle Scholar4. BeesonBass PD. The eosinophil. In: Smith LH, ed. Major Problems in Internal Medicine. Philadelphia: W.B. Saunders Co., 1977:247-8. Google Scholar5. BraunwaldIsselacherPetersdorfWilsonMartinFauci EKRJJA, eds. Harrison's Principles of Internal Medicine. 11th ed. New York: McGraw-Hill; 1987;282-3. Google Scholar6. WeatherallLedinghamWarrell DJD. Oxford Textbook of Medicine. 2d ed. New York: Oxford University Press; 1987;2215-6. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From Winthrop-University Hospital, Mineola, New York; and the S.U.N.Y. School of Medicine, Stony Brook, New York. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAbnormalities of Pharyngeal FunctionEosinophilic disordersL-Tryptophan-Associated Eosinophilia-Myalgia Syndrome: Clinical and Pathological Features of an Evolving New Disease and Current Concepts of EtiologyTreatment of the eosinophilia-myalgia syndromeIntroduction and historical overviewDrug-induced myopathiesDrugs used in non-orthodox medicine 15 June 1990Volume 112, Issue 12Page: 957-958KeywordsAnxietyInfectious diseasesInsomniaMusclesMuscular dystrophiesPainShouldersTryptophan Issue Published: 15 June 1990 PDF DownloadLoading ...
The "Mainstream of Modern Medicine" and Contemporaneous Re-Appellation
Authors: David Glasser
Journal: JAMA (1975)

<h3>To the Editor.—</h3> With its climactic, rapid retreat from the eroding Magic Mountain of Antiquity into the present-day "mainstream of modern medicine," contemporary tuberculosis must be newly regarded as a<i>subacute</i>and<i>curable</i>infectious disease. This recent departure from orthodoxy has been facilitated by a major, universally comprehensible reclassification that has been realized after 40 years. An opportune time, therefore, is at hand to discard traditional reminders of past failures to cure or control this eminently infectious disease and to eliminate the terms "TB" and "AFB" from the lexicon of acronyms favored by American phthisiologists. Such action would be consonant with the revised American Thoracic Society's<i>Diagnostic Standards</i>, which have officially succeeded in purging such terms as "active," "quiescent," "minimal," "moderately advanced," "far advanced," "reactivation," "relapse" and "primary" from the modern-day vocabulary of public and private antituberculosis practitioners. It is wholeheartedly recommended that the term "TB" be replaced by "Koch
Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus
Authors: David B. Sacks, Mark Arnold, George L. Bakris, David E. Bruns, Andrea Rita Horvath, M. Sue Kirkman, Ake Lernmark, Boyd E. Metzger, David M. Nathan
Journal: Diabetes Care (2011)

BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (HbA1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.
The IASLC/ITMIG Thymic Epithelial Tumors Staging Project: Proposals for the T component for the Forthcoming (8th) Edition of the TNM Classification of Malignant Tumors
Authors: Andrew G. Nicholson, Frank C. Detterbeck, Mirella Marino, Jhingook Kim, Kelly Stratton, Dorothy Giroux, Hisao Asamura, John Crowley, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, James Huang, Kazuya Kondo, Marco Lucchi, Edith M Marom, Meinoshin Okumura, Enrico Ruffini, Paul Van Schil
Journal: Journal of Thoracic Oncology (2014)
Foreign Bodies in Gastrointestinal Tract
Authors: Nelson S. Keeler
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I should like to commend Dr. Edward B. Benedict et al., for their article "Corsage Pin in Stomach" (<i>JAMA</i><b>175</b>:48, Jan. 7, 1961), calling attention to the fact that "long, sharp foreign bodies in most cases pass through the gastrointestinal tract without difficuly." It has been my experience that this opinion is not held by some of our colleagues in general surgery. I have heard them say on several occasions, "Why take chances when the danger may be quickly eliminated by a minor surgical procedure." Those of us who have had a chance to observe these foreign-body cases have seen many sharp objects pass without difficulty, the longest, in my case, being a 4-in. nut pick. I should like to emphasize their article by making note of an experience which I observed. A common pin was removed from the stomach of a 2-year-old by the general
Second-order indeterminacy
Authors: Marco Perugini
Journal: Behavioral and Brain Sciences (2003)

Psychological game theory, as defined by Colman, is meant to offer a series of solution concepts that should reduce the indeterminacy of orthodox game theory when applied to a series of situations. My main criticism is that, actually, they introduce a second-order indeterminacy problem rather than offering a viable solution. The reason is that the proposed solution concepts are under-specified in their definition and in their scope.
Autoregulatory circuits in myeloma. Tumor cell cytotoxicity mediated by soluble CD16.
Authors: R G Hoover, C Lary, R Page, P Travis, R Owens, J Flick, J Kornbluth, B Barlogie
Journal: Journal of Clinical Investigation (1995)

BACKGROUND. Multiple myeloma remains an incurable malignancy due to marked resistance of the tumor to standard doses of chemotherapy. Treatment approaches, using chemotherapeutic dose escalation and hematopoietic stem cell support have resulted in significant augmentation of tumor mass reduction such that complete remissions are effected in approximately 50% of patients. These remissions are however, often not durable. In the setting of minimal residual disease, therefore, adjunctive immunotherapy may be useful. METHODS. Peripheral blood mononuclear cells were studied from 28 untreated patients with multiple myeloma (MM). Mononuclear cell CD16 (FcR gamma III) expression was determined by flow cytometry. The effect of lymphocyte-derived soluble CD16, isolated by affinity chromatography, on MM cell growth and differentiation was assessed. MM cell proliferation, viability, immunoglobulin production and gene expression was studied. RESULTS. Data are presented indicating that cells expressing CD16 are increased in untreated patients with IgG-secreting myeloma. The predominant phenotype of these cells is CD8+ or CD56+. These CD16+ cells can produce a soluble form of the Fc receptor (sFcR, sCD16) that can bind to surface Ig on cultured human IgG-secreting myeloma cells and effect suppression of tumor cell growth and Ig secretion. This effector function is accompanied by concomitant suppression of c-myc as well as IgH and IgL gene transcription. Finally, prolonged exposure to sCD16 causes myeloma tumor cell cytolysis. CONCLUSIONS. sCD16 and possibly other soluble FcR are candidate molecules for adjunctive immunotherapy of myeloma, once complete responses have been effected by intensive cytotoxic therapy, now possible in up to 50% of newly diagnosed patients.
Intraperitoneal Blood Transfusion in African Adults with Hookworm Anaemia
Authors: J. M. Fowler, R. Knight, K. M. Patel
Journal: BMJ (1968)

Twenty-nine patients were given an intraperitoneal transfusion of blood. The procedure was found to be free of serious complications. Study of the absorption of an (51)Cr-labelled cells from the peritoneum in 14 patients showed that between 35 and 100% of the blood was absorbed intact in 6 to 10 days. Intraperitoneal transfusion may be indicated as an alternative or as an addition to exchange transfusion in severe hookworm anaemia.
Drug-induced small-bowel mucosal atrophy
Authors: João Santos-Antunes, Rosa Coelho, Hélder Cardoso, Guilherme Macedo
Journal: Endoscopy (2015)

A 65-year-old man being treated with olmesartan for arterial hypertension was admitted because of chronic diarrhea and marked weight loss of about 15 kg during the past year. He had no fever or abdominal pain. He had not traveled recently to other countries and had no domestic pets. Blood tests showed normocytic anemia (11.9 g/dL) and hypoalbuminemia (30.4 g/L). The leukocyte count, C-reactive protein level, and liver chemistries were normal. Serology for celiac disease was negative, the thyroid hormone levels were normal, the autoimmune study and immunoglobulin levels were normal, and the results of stool analysis (Clostridium, virology, bacteriology, mycobacteriology, and parasitology) were negative. Abdominal computed tomography was unremarkable, showing no evidence of pancreatic disease. Upper gastrointestinal endoscopy showed a paucity of duodenal folds, and the colonoscopy findings were normal. Capsule enteroscopy showed smooth mucosa in the duodenum and jejunum ([Fig. 1 a – d]), with areas of total loss of villi. Duodenal and jejunal biopsies showed unspecific mucosal atrophy, with negative results of an immunohistochemistry study for celiac disease and negativity for amyloid, granulomas, microorganisms, and malignancy.
Systemic Administration of a Recombinant AAV1 Vector Encoding IGF-1 Improves Disease Manifestations in SMA Mice
Authors: Li-Kai Tsai, Chien-Lin Chen, Chen-Hung Ting, Sue Lin-Chao, Wuh-Liang Hwu, James C Dodge, Marco A Passini, Seng H Cheng
Journal: Molecular Therapy (2014)

Spinal muscular atrophy is a progressive motor neuron disease caused by a deficiency of survival motor neuron. In this study, we evaluated the efficacy of intravenous administration of a recombinant adeno-associated virus (AAV1) vector encoding human insulin-like growth factor-1 (IGF-1) in a severe mouse model of spinal muscular atrophy. Measurable quantities of human IGF-1 transcripts and protein were detected in the liver (up to 3 months postinjection) and in the serum indicating that IGF-1 was secreted from the liver into systemic circulation. Spinal muscular atrophy mice administered AAV1-IGF-1 on postnatal day 1 exhibited a lower extent of motor neuron degeneration, cardiac and muscle atrophy as well as a greater extent of innervation at the neuromuscular junctions compared to untreated controls at day 8 posttreatment. Importantly, treatment with AAV1-IGF-1 prolonged the animals' lifespan, increased their body weights and improved their motor coordination. Quantitative polymerase chain reaction and western blot analyses showed that AAV1-mediated expression of IGF-1 led to an increase in survival motor neuron transcript and protein levels in the spinal cord, brain, muscles, and heart. These data indicate that systemically delivered AAV1-IGF-1 can correct several of the biochemical and behavioral deficits in spinal muscular atrophy mice through increasing tissue levels of survival motor neuron. Spinal muscular atrophy is a progressive motor neuron disease caused by a deficiency of survival motor neuron. In this study, we evaluated the efficacy of intravenous administration of a recombinant adeno-associated virus (AAV1) vector encoding human insulin-like growth factor-1 (IGF-1) in a severe mouse model of spinal muscular atrophy. Measurable quantities of human IGF-1 transcripts and protein were detected in the liver (up to 3 months postinjection) and in the serum indicating that IGF-1 was secreted from the liver into systemic circulation. Spinal muscular atrophy mice administered AAV1-IGF-1 on postnatal day 1 exhibited a lower extent of motor neuron degeneration, cardiac and muscle atrophy as well as a greater extent of innervation at the neuromuscular junctions compared to untreated controls at day 8 posttreatment. Importantly, treatment with AAV1-IGF-1 prolonged the animals' lifespan, increased their body weights and improved their motor coordination. Quantitative polymerase chain reaction and western blot analyses showed that AAV1-mediated expression of IGF-1 led to an increase in survival motor neuron transcript and protein levels in the spinal cord, brain, muscles, and heart. These data indicate that systemically delivered AAV1-IGF-1 can correct several of the biochemical and behavioral deficits in spinal muscular atrophy mice through increasing tissue levels of survival motor neuron.
CSF Leakage Into the Orbit Demonstrated by Tc-99m DTPA Cisternography
Authors: CHUNG-YUAN HSU, HYH-JEN WANG
Journal: Clinical Nuclear Medicine (1994)

A 35-year-old man suffered from penetrating injury of left eyeball and skull base. CSF leakage into the left orbit was demonstrated by Tc-99m DTPA cisternography.
On the Treatment of Injuries of the Abdominal Viscera
Authors: C. H. Y. Godwin
Journal: BMJ (1888)

struated last week, the first time for eleven weeks, without pain, flow copious.The diagnosis made at the time was that the swelling behind and to the left of the uterus was either a dilated Fallopian tube, which was suggested by the position of the tumour and the severity and persistence of the pain, or a himatocele from a ruptured extra-uterine gestation.The latter supposition was based on the history of amenorrhma, followed by a sudden illness, attended with pain, faintness, and pallor.The course of the case seems to me to accord with this diagnosis rather than with the former.lt is far from certain, but many cases have been pub- lished as "cures" of extra-uterine gestation by electricity in which the diagnosis rested on no better grounds.Had electricity been used in this case, it might perhaps have been erroneouslyPredited with the cure.pThe patient came again to the hospital, and was readmitted on February 9th, 1888 (the notes on this occasion were taken by Mr. C. J. Kirton, clinical clerk).She said she had been perfectly well since leaving the hospital until the last four months.She had menstruated regularly and painlessly, the last time being in Oc- tober, 1887, after which she saw nothing until December 25th, when she menstruated, the flow being ratier more copious, but
Ipsilateral breast tumor recurrence rates in breast cancer patients treated with preoperative chemotherapy, breast conserving surgery and intraoperative radiotherapy with electrons.
Authors: R Reitsamer, F Sedlmayer, C Menzel, S Glueck, M Kopp, F Peintinger
Journal: Cancer Research (2009)

Abstract Abstract #5156 Introduction: Ipsilateral breast tumor recurrence (IBTR) rates are reported to be increased in patients treated with breast conserving surgery after preoperative chemotherapy. Aim of this study was to evaluate the IBTR rate in patients who were treated with preoperative chemotherapy followed by breast conserving surgery and intraoperative radiotherapy with electrons (IOERT).&amp;#x2028; Patients and Methods: 84 patients with clinical stage II or III breast cancer were included in the study. Patients received 3 to 6 cycles of anthracyclin/taxane containing preoperative chemotherapy. All patients had breast conserving surgery with sentinel node biopsy and axillary lymph node dissection and received intraoperative radiotherapy with 9 Gy to the 90% reference isodose as an anticipated boost radiation. Whole breast radiotherapy (WBRT) was performed after surgery for all patients.&amp;#x2028; Results: Pathologic complete response was achieved in 18/84 (21%) patients. Mean resection volume was 250 ml. After a median follow-up of 30.5 months (range 6 – 77 months) no IBTR could be observed. One patient developed a locoregional recurrence in the axilla and nine patients developed distant disease, five of those died of disease. Three patients developed contralateral breast cancer. 71 patients are alive without evidence of disease.&amp;#x2028; Conclusion: Breast conserving surgery with IOERT in boost modality after preoperative chemotherapy is a reliable tool for the prevention of IBTR. The period between IOERT and WBRT is short as no adjuvant chemotherapy is necessary. Cosmetic outcome is excellent. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5156.
Stroke output variations calculated by esophageal Doppler is a reliable predictor of fluid response
Authors: Fabrice Vallée, Olivier Fourcade, Olivier De Soyres, Olivier Angles, Pascale Sanchez-Verlaan, Fabien Pillard, Nadia Smail, Michel Olivier, Michèle Genestal, Kamran Samii
Journal: Intensive Care Medicine (2005)
Doctor shortage forces leading African children's hospital to refuse emergencies
Authors: Pat Sidley
Journal: BMJ (2004)

An acute shortage of doctors at Africa's largest children's hospital, the Red Cross Children's Hospital in Cape Town, has forced the hospital to begin refusing emergency admissions.

The hospital had to close its emergency intake wards at night because it had only five doctors doing the work of 14, as vacant posts lie unfilled. In South Africa graduating doctors must undergo a community service programme for two years before they can practise on their own, but the hospital says the Department of Health has failed to place any graduating doctors at the hospital this year.

The hospital's decision has also galvanised the …
The Evolving Academic Health Center
Authors: Jonathan F. Saxton, David A. Blake, John T. Fox, Michael M. E. Johns
Journal: JAMA (2000)

SHORTLY AFTER BEING APPOINTED EXECUTIVE VICE PRESIdent for Health Affairs and Director of the Woodruff Health Sciences Center (WHSC) of Emory University, Atlanta, Ga, in July 1996, Michael M. E. Johns, MD, initiated a comprehensive, center-wide strategic assessment and planning process, building on a previous round of high-level planning by the preceding administration. Special attention was given to identifying the potential impact of the recently enacted congressional Balanced Budget Act. Each core mission was considered separately and then consolidated into the overall plan. The process enlisted hundreds of faculty and staff at all levels over 18 months. Results were further evaluated by experts specializing in organizational planning. Intensive implementation planning was conducted. Once completed and approved by the appropriate leadership and boards, the plans were communicated broadly to all staff. The WHSC strategic planning was based on the fundamental principle that each core mission—education, research, and patient care—must be considered equally. The strategic assessment showed that the environment was relatively more favorable for Emory than for most academic health centers. Atlanta continues to experience rapid population growth and is the only top-10 metropolitan area in the United States with a single comprehensive academic medical center. Managed care penetration also lagged several years behind many comparable metropolitan areas. Emory faculty and professional schools as a whole compared favorably with others in receiving research support, in student quality and achievement, and in scholarly accomplishment. Furthermore, a strong base of philanthropic leadership provides outstanding support for the WHSC. Problems in the environment included the fact that commercial health maintenance organization (HMO) enrollment in metropolitan Atlanta was increasing at twice the national rate; major competitors were merging and aggressively establishing primary care networks; Emory’s clinical enterprise was inefficient, not integrated, and not customer friendly; and Emory hospitals’ cost structure was threatened by aggressive price competition. The medical school lacked a critical mass of faculty in certain key and emerging areas of biomedical and clinical research. The medical and nursing schools had barely sufficient educational and research facilities. And because of the Balanced Budget Act and other factors, the system was projected to experience a $105 million decrease in clinical revenues over a 5-year period. Given these and other considerations, those involved in the planning process developed a vision that would leverage existing resources and add new resources in each mission area. Because the clinical mission was found to be the most imperiled, it receives the most detailed treatment in this brief case report.