tbuckley/cabot-search huggingface dataset:
Case 47-1976
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Martin J. Wohl, Stephen J. Galli
Journal: New England Journal of Medicine (1976)

Presentation of Case First admission. A 46-year-old black woman was admitted to the hospital because of abdominal pain and diarrhea.She was well until eight years previously, when a rash and arthralgia developed. Evaluation revealed impaired renal function and proteinuria, and tests for lupus erythematosus were strongly positive; prednisone was administered. Diabetes mellitus developed, and insulin was prescribed. Seven years before entry she was admitted to another hospital, where azathioprine was begun. Three years later she had an inferior myocardial infarct, and a year thereafter an anteroseptal myocardial infarct occurred, followed by congestive heart failure and anginal pain. Three . . .
Other factors may have contributed to epidemic of renal failure
Authors: M. Hossain
Journal: BMJ (1995)

outcomes study had a range of purposes.The two methodologies have a complementary finction and should not be promoted as polar opposites.Each methodology, however, is grounded in a distinct paradigm; in particular, qualitative methods are more concerned with developing adequate conceptual frameworks than with establishing generalisability.We suggest that, although it is common, it is inappropriate to judge qualitative methods from a quantitative standpoint, as Bisset and Chesson are attempting to do.
ACUTE SUFFOCATIVE EDEMA OF THE LUNGS IN RELATION TO DISEASES OF THE HEART
Authors: Louis Faugeres Bishop
Journal: JAMA (1922)

No one can practice medicine more than a short time without encountering people suffering from attacks characterized by edema of the lungs and great shortness of breath, followed in a short time by cough and expectoration. During the course of the attack, the lungs are filled with moist râles, which persist for several days, and then gradually disappear. There is generally a rise in temperature to about 100 F. and great prostration, the day after the attack. However, the recovery from this condition is complete, and no traces of it are left. This trouble has been described as acute suffocative edema, and it is recognized as a condition apart from other diseases. It is, as a rule, considered part of a complicating kidney or heart condition. If, during the attack, the heart happens to be overacting, the patient is often said to be suffering from dilatation of the heart. These
Melanotic Schwannoma of the Choroid
Authors: Jerry A. Shields, Ramon L. Font, Ralph C. Eagle, Carol L. Shields, J. Donald M. Gass
Journal: Ophthalmology (1994)

Purpose:The purpose of this article is to describe what is probably the first reported case of a melanotic schwannoma of the choroid and to discuss the clinical and histopathologic features that serve to differentiate this rare intraocular tumor from a malignant melanoma of the choroid.Patient and Methods: A 21-year-old woman underwent enucleation of the right eye for a slowly enlarging pigmented choroidal mass that was associated with ipsilateral blindness.The tumor was studied by light microscopy, immunohistochemistry, and electron microscopy.Findings: The tumor was composed of fascicles and whorls of pigmented and nonpigmented plump spindle cells that had light microscopic features of a schwannoma.The tumor cells showed immunoreactivity to 5-100 protein and HMB-45.Electron microscopy showed cytoplasmic processes surrounded by a continuous basement membrane and abundant extracellular collagen.The pigmented spindle-shaped cells contained melanosomes in different stages of melanogenesis.The findings were compatible with a melanotic schwannoma.Conclusion: Melanotic schwannoma has been reported in soft tissues, peripheral nerves, and in the orbit.To the authors' knowledge, this is the first report of a melanotic schwan noma of the choroid.This extremely rare pigmented choroidal tumor may be very difficult to differentiate clinically from choroidal melanoma.
Plasma Oxidizability in Subjects With Normal Glucose Tolerance, Impaired Glucose Tolerance, and NIDDM
Authors: Steven M Haffner, Ahmad Agil, Leena Mykkanen, Michael P Stern, Ishwarlal Jialal
Journal: Diabetes Care (1995)

OBJECTIVE Several lines of evidence support an atherogenic role for oxidized low-density lipoprotein (LDL). Studies on LDL oxidation in diabetes to date have examined LDL isolated from plasma, but have failed to evaluate the other pro- and antioxidant factors present in vivo, the balance of which could be crucial in determining the susceptibility of LDL to lipid peroxidation. RESEARCH DESIGN AND METHODS We examined the oxidizability of plasma from Mexican-Americans in the San Antonio Heart Study. The oxidizability of plasma in 75 subjects with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and non-insulin-dependent diabetes mellitus (NIDDM) was studied after co-incubation with a free radical initiator, 2,2'-azobis-2-amidinopropane hydrochloride (AAPH). Lipid peroxide (LPO) levels were measured by a modified fluorimetrie assay. RESULTS Baseline LPO levels (μmol/l; means ± SE) were similar in the three glucose tolerance categories (NGT, 1.99 ± 0.07; IGT, 1.88 ± 0.07; NIDDM, 1.97 ± 0.07; P = 0.521). However, after incubation with AAPH (NGT, 4.30 ±0.20; IGT, 4.45 ± 0.20; NIDDM, 5.35 ± 0.20; P = 0.003), the diabetic plasma had significantly greater amounts of LPOs compared with the other two groups. There was no significant difference in LPOs between the NGT and IGT groups. The statistical significance of increased oxidizability of the diabetic plasma persisted after exclusion of patients who smoked cigarettes (n = 15) or who had vascular disease (n = 4). CONCLUSIONS In conclusion, this study shows that the plasma of Mexican-American subjects with NIDDM is more prone to lipid peroxidation than that of non-Hispanic whites
UK report recommends further research on water fluoridation and health
Authors: S. Mayor
Journal: BMJ (2002)

Further research on the health effects of adding fluoride to drinking water is needed—especially studies of people's total exposure to fluoride, a working group set up by the Medical Research Council recommended in a report published last week.

Fluoride has been added to piped drinking water in some areas of the United Kingdom, as well as in other countries, for several decades to improve dental health. However, public support for the measure has wavered after claims that water fluoridation might be associated with health problems.

The Department of Health asked the council's working group to identify areas of uncertainty on …
Persistent hepatitis C virus infection after liver transplantation: Clinical and virological features
Authors: David R. Gretch, Carlos E. Bacchi, Lawrence Corey, Corazon Dela Rosa, Richard R. Lesniewski, Kris Kowdley, Allen Gown, Indra Frank, James D. Perkins, Robert L. Carithers
Journal: Hepatology (1995)

We report a prospective clinical and virological study of 18 patients undergoing orthotopic liver transplantation, selected because of hepatitis C virus (HCV) RNA positivity before transplantation. Nine of the 18 patients (50%) developed chronic active hepatitis (CAH) in liver allografts during the first year posttransplantation; hepatitis was first observed between 6 and 25 weeks posttransplantation. HCV viremia was measured for all patients before transplantation and on posttransplantation days 3, 7, and 14, and months 1, 6, 12, and 24 to 41, by quantitative competitive RNA polymerase chain reaction (QC-PCR). HCV RNA levels on posttransplantation days 3, 7, and 14 were significantly higher among patients who subsequently developed CAH versus those who did not (P < .02 by t-test and Mann-Whitney test on all three dates). However, HCV RNA levels in sera obtained at 1, 6, and 12 months posttransplantation did not correlate with CAH at 1 year or with HCV genotype determined in posttransplantation sera. At least two serial liver biopsy specimens from each patient were stained for HCV nonstructural 4 (NS4) antigen by immunohistochemistry. The intensity of cytoplasmic staining of NS4 antigen was significantly higher for specimens with CAH versus those without CAH (P = .028 by chi 2). Three patients developed bridging fibrosis in liver allografts during the first year after transplantation; all three patients had intense (3+) immunostaining for NS4 antigen, and the infecting genotypes were 1a, 1b, and 1a plus 1b, respectively. In summary, the 18 patients all developed high-titer viremia by 1 month after liver transplantation, whereas CAH developed in 50% of allografts during the first year after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
Prediction of Metastasis in Node-Negative, Hormone Receptor Positive, Tamoxifen Adjuvant Treated Primary Breast Cancer Patients Using Ki-67 (IHC) and RT-PCR Based 14-Gene Prognostic Signature.
Authors: C. Schlotter, K. Wassmann, U. Bosse, D. Kemming, B. Brandt, U. Vogt
Journal: Cancer Research (2009)

Abstract Background: Risk estimation based on the recommendations of St. Gallen Consensus commonly decides for additional cytostatic therapy in node-negative (N-), hormone receptor positive (HR+) primary breast cancer patients. High proliferative activity in the HR+ subtype confers a 19-fold relative risk of relapse compared with HR+ tumors of low proliferative activity. Furthermore immunohistochemically determined Ki-67 is characterized as a Luminal B marker that identifies a high risk subgroup in HR+, N- breast cancer patients.Aim of this investigation was to compare risk estimation using Ki-67 (%) with the results of a RT-PCR based multi-gene prognostic signature. Methods: Tumor tissues of totally 321 unselected primary breast cancer patients were formalin fixed and routinely processed for immunohistochemical determination and scored for protein expression of ER, PgR and Ki-67. HER2 was determined using dd-PCR. Content of both hormone receptors and proliferation activity were evaluated counting positively coloured nuclei from at least 100 tumor cells. The median follow up was 61 months. To calculate the cut off for high proliferation Ki-67 values were subjected to a log rank CART analysis. High proliferation was defined by Ki-67 of 19% and more. With this cut off it was possible to distinguish significantly various patient cohorts (N-, pT1, postmenopausal) into two different risk groups regarding metastasis free survival. The definition of low risk was low proliferation and HER2 negativity, of high risk high proliferation or HER2 positivity. The risk for metastasis of 16 new primary breast cancer patients was estimated based on two surrogate risk groups and the multi-gene prognostic signature. Results: Tamoxifen adjuvant treated HR+, HER2-, low proliferating (Ki-67 &amp;lt;19%), N- low risk patients (N= 68) and HR+, HER2-, high proliferating/HR+, HER2+, N- high risk patients (N= 84) showed a recurrence rate of 2.94% and 27.4%, respectively (P&amp;lt; .000). In the ongoing observation study all 5 low proliferating HER2- tumors had a low risk gene prognostic signature. From 11 high proliferating HER2- patients one patient had a low risk gene signature (9%), 3 patients a moderate risk gene signature (27%) and 7 patients a high risk gene signature (64%). Conclusion: Despite the small number of patients investigated up to now (N= 16) the preliminary results appear to show that low proliferative activity is associated with a low risk gene prognostic signature, whereas high proliferation means only in part a high risk gene prognostic signature. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6025.
Injection of Sodium Hypochlorite by Intravenous Drug Users-Reply
Authors: Margaret Levy
Journal: JAMA (1987)

In Reply.—  I wish to respond to further criticism of  Mom, 1 this time by Dr Hamoudi. 2   Very often, writing for me is a catharsis. Perhaps it is a mistake to publicize one's personal thoughts, feelings, and observations. One must be rather naive to quote statistics in response to such an essay. For example, I have often tried to express my feelings about death and dying in writing. Had you printed my thoughts on this subject, I wonder if there wouldn't have been an outraged colleague quoting a statistic that 78% of physicians have come to terms with death, so how dare I feel otherwise and how dare you publish this negative viewpoint.  A while ago, I read an interview with Dr Jonas Salk, who (in quoting Judaic philosophy) said that the purpose of life is the improvement of life, not (just) for oneself, but for others. I
Characterization of the T-cell repertoire in autologous graft-versus-host disease (GVHD): evidence for the involvement of antigen-driven T-cell response in the development of autologous GVHD
Authors: Yuji Miura, Christopher J. Thoburn, Emilie C. Bright, Matthias Sommer, Susan Lefell, Mikio Ueda, Shinji Nakao, Allan D. Hess
Journal: Blood (2001)
Liposarcoma of the Stomach
Authors: Paul E. Hawkins
Journal: JAMA (1965)

GASTRIC NEOPLASMS are by no means rare. Marshall and Adamson<sup>1</sup>reported 2,014 tumors of the stomach seen at the Lahey Clinic over a 27-year-period from 1932 to 1958. Stout<sup>2</sup>reported 651 tumors of the stomach examined in the Surgical Pathology Laboratory of Columbia University from 1908 to 1950. The vast majority of these tumors in the above two series were malignant; carcinoma was the most frequent finding, comprising 72% to 92% of the tumors, respectively. Benign gastric tumors accounted for 4.8% and 16.9%. Of the malignant lesions other than carcinoma, sarcomas of two main types, lymphosarcomas and leiomyosarcomas, together comprised less than 10% of the total number of gastric malignancies. Marshall and Adamson<sup>1</sup>state that malignant gastric tumors originating from fibrous tissue, blood vessels, and fatty tissue are rare and were not encountered in their series. Types of benign tumors seen were leiomyomas, adenomatous polyps, gastritis polyposa, pancreatic
Assessing observer variability.
Authors: J. Jamart
Journal: BMJ (1992)

Gall stones induced by octreotide EDITOR, -The beneficial effects of treatment with octreotide are accompanied by an increased risk of gall stones.Grant W Bigg-Wither and colleagues found that in 22 patients (13 of whom had acromegaly) octreotide increased the fasting gall bladder volume; they propose that this may predispose to the formation of gall stones.'We believe, however, that this is unlikely to be the main factor in the pathogenesis of gall stones induced by octreotide.We have measured fasting gall bladder volumes in nine acromegalic patients before and after octreotide and found no significant increase during treatment.2Furthermore, although the fasting gall bladder volume in 31 untreated acromegalic patients was 30% larger than that in normal subjects, we found only a minor increase in the prevalence of gall stones.3Octreotide impairs contraction ofthe gall bladder in response to a fatty meal and increases the residual volume of the gall bladder.This might be expected to promote the formation of stones because of relative stasis of the gall bladder.The residual volume of the gall bladder in untreated acromegalic patients, however, is three times that ofnormal subjects and yet the increase in gall stone prevalence in these individuals is small.Our data suggest that although a reduction in gall bladder emptying may well play a role in the formation of stones, an increased fasting gall bladder volume is not a major factor in their pathogenesis.Native somatostatin increases the cholesterol saturation in bile,4 and we have found similar changes in acromegalic patients with gall stones associated with octreotide.5These observations suggest that changes in bile chemistry may be at least as important as motor dysfunction of the gall bladder in the pathogenesis ofgall stones induced by octreotide.
Activation of mouse liver natural killer cells and NK1.1+T cells by bacterial superantigen-primed Kupffer cells
Authors: Hiroshi Dobashi, Shuhji Seki, Yoshiko Habu, Takashi Ohkawa, Seiichiro Takeshita, Hoshio Hiraide, Isao Sekine
Journal: Hepatology (1999)

Although bacterial superantigens have been well characterized as potent stimulators of T cells, their role in natural killer (NK)-type cells remains largely unknown. In the present study, we examined the effect of bacterial superantigens on mouse liver NK cells and NK1.1 Ag(+) (NK1(+)) T cells. C57BL/6 mice were intravenously injected with staphylococcal enterotoxin B (SEB) or streptococcal pyrogenic exotoxin A (SPE-A), and mononuclear cells (MNC) of various organs were obtained from mice 4 hours after being injected with superantigen. MNC were cultured for 48 hours, and interferon gamma (IFN-gamma) levels of supernatants were measured. The antitumor cytotoxicities of the liver and spleen MNC were also evaluated 24 hours after the mice were injected with superantigen. Liver MNC produced more IFN-gamma than did splenocytes, and peripheral blood and lung MNC did not produce any detectable IFN-gamma. In addition, liver MNC acquired a potent antitumor cytotoxicity by the SEB injection, and both NK cells and NK1(+)T cells but not cluster of differentiation (CD)8(+) T cells were responsible for the cytotoxicity as demonstrated by either in vivo or in vitro cell depletion experiments, and the NK-type cells were partly responsible for the increased serum IFN-gamma. Activation of liver NK-type cells was also supported by the fact that liver NK cells proportionally increased and NK1(+) T cells augmented their CD11a expressions after SEB injection. The pretreatment of mice with anti-IFN-gamma Ab and/or with anti-interleukin-12 (IL-12) Ab diminished the SEB-induced cytotoxicity of liver MNC. Furthermore, the in vivo depletion of Kupffer cells decreased the SEB-induced cytotoxicity of liver MNC. Consistent with these results, liver MNC stimulated with superantigens in the presence of Kupffer cells in vitro produced a greater amount of IFN-gamma than did the liver MNC without Kupffer cells or splenocytes. Our results suggest that bacterial superantigen-primed Kupffer cells produce IL-12 and other monokines, while also nonspecifically activating both NK cells and NK1(+) T cells to produce IFN-gamma.
GSK China gets record fine and top executives suspended sentences
Authors: J. Parry
Journal: BMJ (2014)

GlaxoSmithKline’s China operation has been fined ¥3bn (£299m; €379m; $488m) after being found guilty of bribery by the Changsha Intermediate People’s Court in Hunan province. In the closed door trial, which concluded on 19 September, five executives of GSK China Investment Company were also given suspended jail sentences of between two and four years. 

The former manager, Mark Reilly, was given a four year suspended sentence and will be deported. The other four were Chinese nationals: the former human resources director, Zhang Guowei, former vice president, Liang Hong, former legal affairs director, Zhao Hongyan, and former business development manager, Huang Hong, …
High BRE expression in pediatric MLL-rearranged AML is associated with favorable outcome
Authors: B V Balgobind, C M Zwaan, D Reinhardt, T J C M Arentsen-Peters, I H I M Hollink, V de Haas, G J L Kaspers, E S J M de Bont, A Baruchel, J Stary, C Meyer, R Marschalek, U Creutzig, M L den Boer, R Pieters, M M van den Heuvel-Eibrink
Journal: Leukemia (2010)
Screening for diabetic retinopathy
Authors: J M Mason, M F Drummond, E G Woodward
Journal: BMJ (1996)

EDITOR,—In his editorial on screening for diabetic retinopathy Bob Ryder asserts that single screening modalities are inadequate and that combined ophthalmoscopy and photography conducted by specialist optometrists or technicians is satisfactory.1 The main source of evidence for this is a special medical development project, funded by the government, which compared general practitioners, optometrists, and diabetologists.2 We wonder whether the project provides sound and generalisable evidence and what the economic implications are of performing photography in addition to ophthalmoscopy.

The special medical development project is …
New White Matter Brain Injury After Infant Heart Surgery Is Associated With Diagnostic Group and the Use of Circulatory Arrest
Authors: John Beca, Julia K. Gunn, Lee Coleman, Ayton Hope, Peter W. Reed, Rodney W. Hunt, Kirsten Finucane, Christian Brizard, Brieana Dance, Lara S. Shekerdemian
Journal: Circulation (2013)

Abnormalities on magnetic resonance imaging scans are common both before and after surgery for congenital heart disease in early infancy. The aim of this study was to prospectively investigate the nature, timing, and consequences of brain injury on magnetic resonance imaging in a cohort of young infants undergoing surgery for congenital heart disease both with and without cardiopulmonary bypass.A total of 153 infants undergoing surgery for congenital heart disease at <8 weeks of age underwent serial magnetic resonance imaging scans before and after surgery and at 3 months of age, as well as neurodevelopmental assessment at 2 years of age. White matter injury (WMI) was the commonest type of injury both before and after surgery. It occurred in 20% of infants before surgery and was associated with a less mature brain. New WMI after surgery was present in 44% of infants and at similar rates after surgery with or without cardiopulmonary bypass. The most important association was diagnostic group (P<0.001). In infants having arch reconstruction, the use and duration of circulatory arrest were significantly associated with new WMI. New WMI was also associated with the duration of cardiopulmonary bypass, postoperative lactate level, brain maturity, and WMI before surgery. Brain immaturity but not brain injury was associated with impaired neurodevelopment at 2 years of age.New WMI is common after surgery for congenital heart disease and occurs at the same rate in infants undergoing surgery with and without cardiopulmonary bypass. New WMI is associated with diagnostic group and, in infants undergoing arch surgery, the use of circulatory arrest.
An open letter to the health secretary: how to really save money on the NHS
Authors: Peter Lachmann
Journal: BMJ (2010)

Dear Mr Lansley

Your proposals to transfer the role of purchasing NHS services for patients from primary care trusts to general practitioners is appealing in as much as it promises some reduction in the excessive bureaucracy that resulted from the “low trust” culture introduced by the Thatcher reorganisation of the NHS in the 1980s and never reversed. However, as was so eloquently pointed out by the late Douglas Black—an eminent physician and someone who had much experience in government as well—none of the reorganisations since (and including) those of 1973 have succeeded in improving function by tampering with structure.1 Indeed they have all done the reverse, essentially, as Sir Douglas also pointed out, because they fail to appreciate that health care should be treated as a service rather than as a business. Business based models have not fared well when it is a service that is required.

However, I imagine that the main aim underlying your proposals is to save money and to provide better healthcare delivery at lower cost. There are, indeed, at least three ways in which very large sums of money could be saved in the delivery of health care, with improvement rather than detriment to the quality of service. However, none of these changes would be universally popular, and they would require time, tenacity, and political courage to bring them about. Nevertheless, without them the future of health care, not just in the United Kingdom but elsewhere, will be imperilled by ever rising costs.

Drugs are a large component of health expenditure. We now live in an environment where the population has been persuaded that medicines have to be absolutely safe and that if anybody comes to harm from taking a drug they should have the ability to seek compensation through the courts. This state …