tbuckley/cabot-search huggingface dataset:
Risk of Confusion in Dosing Tamiflu Oral Suspension in Children
Authors: Ruth M. Parker, Michael S. Wolf, Kara L. Jacobson, Alastair J.J. Wood
Journal: New England Journal of Medicine (2009)

To the Editor: The medical community should be made aware of the serious potential for dosing errors in children prescribed Tamiflu (oseltamivir) oral suspension, as illustrated in the case described below. After the diagnosis of novel H1N1 influenza, a 6-year old received a prescription for Tamiflu (oseltamivir) oral suspension (12 mg per milliliter) at a dose of 3/4 teaspoon PO BID. However, the parents, one a primary care physician and the other one of the authors, had great difficulty determining the correct dose to administer to their child. The medication bottle was accompanied by a prepackaged syringe with markings of . . .
Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: A population-based study
Authors: Amit K. Gupta, L. Joseph Melton, Gloria M. Petersen, Lawrence J. Timmons, Santhi Swaroop Vege, William S. Harmsen, Nancy N. Diehl, Alan R. Zinsmeister, David A. Ahlquist
Journal: Clinical Gastroenterology and Hepatology (2005)
Is this conjectural phenotypic dichotomy a plausible outcome of genomic imprinting?
Authors: Benjamin James Alexander Dickins, David William Dickins, Thomas Edmund Dickins
Journal: Behavioral and Brain Sciences (2008)

Abstract What is the status of the dichotomy proposed and the nosological validity of the contrasting pathologies described in the target article? How plausibly can dysregulated imprinting explain the array of features described, compared with other genetic models? We believe that considering alternative models is more likely to lead in the long term to the correct classification and explanation of the component behaviours.
Hard data, soft data
Authors: J. Aronson
Journal: BMJ (2012)

What is the opposite of “hard”? There are several different answers (table⇓), but the thesaurus neglects hard and soft data, which are rarely defined and much misunderstood. The implication of the last definition in the table is that soft data are unreliable, but that is not necessarily so.

View this table:

Different meanings of the word “hard” and their antonyms (source Chambers Thesaurus )



The late Alvan Feinstein, erstwhile editor of the Journal of Clinical Epidemiology , published 57 articles in the journal Clinical Pharmacology and …
Cholecystectomy for gall stones.
Authors: N. Finlayson
Journal: BMJ (1989)

Cholecystectomy for gall stonesA good thing if they cause symptoms Langenbuch described the first successful cholecystectomy for gall stones in 1882, and it has now become one of the safest and commonest major operations.''More recently reliable and uninvasive investigations have shown that gall stones are very common but that they cause symptoms infrequently.So who should be advised to undergo cholecystectomy for gall stones and when should the operation be performed?Gall stones are common in economically advanced countries: they were found in 6-2% of men and 12 2% of women aged 45-69 by cholecystography in Wales3; in 12 4% of men and 23 7% of women of all ages in a necropsy study in England4; and in 8 2% of male and 9 4% of female Italian civil servants in an ultrasonographic study5 6.These studies all included people who had had a cholecystectomy.Two thirds or more of stones in the Italian studies had caused no symptoms, and only a 10th of people with stones in the English study had had a cholecystectomy.In the Italian studies upper abdominal pain was strongly associated with gall stones, but non-specific symptoms such as epigastric burning, bloating, belching, heaviness, nausea, vomiting, and intolerance of fatty food were not.Hence we must conclude that gall stones are common, that most cause no symptoms, and that when they do they cause pain or acute cholecystitis but not non-specific dyspepsia.How likely are asymptomatic stones to become sympto- matic?Previous beliefs that symptoms developed frequently were based on studies of patients who had already had symptoms or whose gall stones had been diagnosed in hospital and who may therefore not have been entirely without symptoms.I8 Gracie and Ransohoff more recently reported a study of 123 truly symptomless people found to have gall stones at routine medical examination and showed that the
PTH-117 Thymic Stromal Lymphopoietin Is Primarily Reduced In Refractory Coeliac Disease Duodenal Mucosa
Authors: P Biancheri, A Di Sabatino, G Fornasa, C Papadia, R Shidrawi, E Woods, A Forbes, M Rescigno, GR Corazza, TT MacDonald
Journal: Gut (2014)

<h3>Introduction</h3> Thymic stromal lymphopoietin (TSLP), a cytokine released by enterocytes and gut dendritic cells, promotes the development of Foxp3+ regulatory T cells and at the same time inhibits the development of pro-inflammatory T helper (Th)1 and Th17 cells. While mucosal TSLP expression is down-regulated in untreated coeliac disease (CD), its levels are unknown in refractory CD (RCD), in which the transformation of aberrant intraepithelial T cells predisposes to the emergence of enteropathy-associated T cell lymphoma. Therefore, we evaluated the expression of TSLP and its receptor (TSLP-R) in the duodenal mucosa of patients affected by RCD. <h3>Methods</h3> Duodenal biopsies were collected from 12 RCD patients, 16 uncomplicated CD patients before and after 12 months of gluten-free diet, and 14 control subjects. The gene expression of TSLP and TSLP-R was evaluated on biopsy homogenates by quantitative RT-PCR, and the data were normalised for cytokeratin 18 expression. The protein expression of TSLP and TSLP-R was studied on biopsy homogenates by immunoprecipitation and on biopsy sections by confocal microscopy. <h3>Results</h3> <i><i>In vivo</i></i> mucosal TSLP expression was significantly reduced both at the mRNA and protein levels in the duodenum of RCD and untreated CD patients compared to treated CD patients and controls, without differences between RCD and untreated CD patients and between treated CD patients and controls. TSLP transcript down-regulation in untreated CD mucosa was confirmed after normalisation for cytokeratin 18. TSLP-R was expressed in the duodenal mucosa both at the gene and the protein level, without significant differences between RCD, untreated and treated CD patients and control subjects. Confocal microscopy analysis confirmed these findings. <h3>Conclusion</h3> TSLP expression is primarily reduced in the duodenal mucosa of RCD patients. Further studies are needed to clarify the influence of TSLP reduction on the process of immunosurveillance in RCD. <h3>Disclosure of Interest</h3> None Declared.
Lack of Correlation between Genetic Polymorphisms in Tamoxifen Metabolizing Enzymes with Primary Endpoints in the IMPACT Trial.
Authors: J. Rae, J. Thibert, M. Sikora, M. Johnson, A. Skene, R. A'Hern, I. Smith, M. Dowsett
Journal: Cancer Research (2009)

Abstract Background. Several studies aimed at correlating genetic variants in the enzymes responsible for tamoxifen metabolism and disposition with therapeutic outcomes have provided equivocal and conflicting data. The IMPACT trial compared the preoperative used of tamoxifen with anastrozole alone or in combination in postmenopausal breast cancer patients and provided strong evidence that tamoxifen-induced changes in the nuclear proliferation marker Ki67 can act as a surrogate marker of tamoxifen response. An advantage of this study design is that all patients contribute data to the end-point analyses which included changes in Ki67 and objective clinical response as defined by the WHO criteria. We therefore genotyped patients from IMPACT for variants in the enzyme (cytochrome p450 2D6 (CYP2D6)) responsible for the conversion of tamoxifen to its potent anti-estrogenic metabolite endoxifen, as well as the enzyme responsible for the detoxification and inactivation of endoxifen via conjugation (UDP-glucuronosyltransferase 2B7 (UGT2B7).Results: Depending on their CYP2D6 variant genotype, patients were assigned an 'activity score' based on predicted allele activities from 0 (no activity) to 2 (high activity). Patients were also tested for the UGT2B7*2 variant, which has lower enzymatic activity and is therefore correlated with higher serum endoxifen concentrations. Of the 135 patient samples available for genotype determinations, 123 and 134 we evaluable for CYP2D6 and UGT2B7, respectively. There was no evidence of an association between CYP2D6 score, as determined by genotype alone, with suppression of Ki67 after 2 or 12 weeks, or with objective clinical response after 16 weeks of therapy in the tamoxifen alone, anastrozole alone or combination groups. Furthermore, this lack of association was not altered by adjustment of the CYP2D6 score for concomitant medications, known to inhibit CYP2D6 and to correlate with lower serum endoxifen concentrations. Lastly, while a statistical test for a potential interaction between CYP2D6 genotype and UGT2B7 genotype was negative, there was a marginally statistically significant association between UGT2B7 genotype alone with suppression of Ki67 after 2 weeks in the tamoxifen only group.Conclusion: Although this was a small study, these data do not support the hypothesis that patients must have active CYP2D6 in order to benefit from tamoxifen therapy. Larger more definitive studies are underway to test the effects of drug metabolizing enzymes on anti-estrogen therapies. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2011.
Young doctors' views on alternative medicine.
Authors: D T Reilly
Journal: BMJ (1983)

A survey was undertaken to explore attitudes to alternative medicine among 100 general practitioner trainees. A positive attitude emerged from the 86 respondents, with 18 doctors using at least one alternative method themselves and 70 wanting to train in one or more. A total of 31 trainees had referred patients for such treatments; 12 of these doctors made referrals to non-medically qualified practitioners. The most commonly used alternative treatments were hypnosis, manipulation, homoeopathy, and acupuncture. A total of 22 doctors had been treated, or had treated themselves, by an alternative treatment, and this personal experience was linked to a greater professional use. These findings indicate that alternative methods of treatment are currently being used to complement orthodox medicine and an expansion in their use appears imminent.
Examination Gloves as Barriers to Hand Contamination in Clinical Practice
Authors: Robin J. Olsen
Journal: JAMA (1993)

<h3>Objective.</h3> —To test the effectiveness of vinyl and latex gloves as barriers to hand contamination with gram-negative organisms and enterococci during routine hospital procedures. <h3>Design and Interventions.</h3> —We studied 137 procedures during which a health care worker's gloved hand contacted a patient's mucous membrane and was thus potentially contaminated with gram-negative rods or enterococci. Quantitative hand cultures were obtained from each health care worker before and after the gloved contact using a modified glove juice method, and the exterior glove surface was also quantitatively cultured after patient contact. Used gloves were then tested for leaks using the American Society for Testing and Materials' watertight test. <h3>Setting.</h3> —Harborview Medical Center, a 330-bed city-county hospital and level I regional trauma and burn center, is both a teaching facility affiliated with the University of Washington and the major provider of care to indigent and uninsured persons in Seattle—King County, Washington. <h3>Patients and Other Participatns.</h3> —Respiratory therapists performing endotracheal tube care on intubated intensive care unit patients, registered nurses performing digital rectal stimulation for bowel training on patients with spinal cord injury in the rehabilitation ward, and dentists performing routine dental examinations and procedures on healthy outpatients in the dental clinic. <h3>Main Outcome Measure and Results.</h3> —Eighty-six of the 135 gloves cultured had gram-negative rods or enterococci on the external surface after use and were thus sources of potential hand contamination. Microbial contamination of the health care worker's hands occurred in 11 (13%; 95% confidence interval, 6% to 20%) of these 86 events, and was more frequent with vinyl (10 of 42) than latex (one of 44) gloves (<i>P</i>&lt;.01). After use, glove leaks were also more frequent in vinyl gloves (26 of 61) than with latex gloves (six of 70) (<i>P</i>&lt;.001). Even when leaks were present, gloves prevented hand contamination in 77% of instances and quantitative counts of microorganisms contaminating hands were 2 to 4 logs less than counts on external glove surfaces. Health care workers reported awareness of the presence of glove leaks in only seven (22%) of the 32 events in which leaks were subsequently demonstrated. <h3>Conclusions.</h3> —Under conditions of routine use, gloves effectively function as a protective barrier even when leaks are present. Latex gloves were less frequently associated with leaks and hand contamination. Since hand contamination occurred after 13% of exposures and cannot be readily identified by health care workers, routine hand washing should be done after each patient contact. (<i>JAMA</i>. 1993;270:350-353)
Keeping Informed by Tape and Disk
Authors: J. C. Graves, V. Graves
Journal: BMJ (1958)

MEDICAL URNL583young doctors are adequately trained for general practice, and established practitioners can obtain all the con- tinuing education they require.It has not been possible in this article to do more than mention briefly some of the main problems and offer a few suggestions to solve them.The views expressed are my own, but I am grateful for the help and encouragement of many nmxembers of the College of General Practitioners throughout the country.
THE TREATMENT OF KERATOCONUS WITH GALVANOCAUTERY.
Authors: HERMAN KNAPP
Journal: JAMA (1900)

In 1892, I published five cases of keratoconus<sup>1</sup>which I had treated with galvanocautery. <h3>Case 1.</h3> —Operation was performed on both eyes. On the left eye the apex was cauterized with a fine loop in an area of 2×3 mm. and then pierced, so that the aqueous spurted out. Healing was free from dangerous reaction, but slow. The chamber closed and opened seven times. Before the operation patient read J. 1 at 1" and with —7D. 20/200; eighteen months after the operation he read J. 1 fluently at 10", and with —4D. 20/40. The right eye, on account of the slow healing of its fellow, was cauterized cautiously and repeatedly until I saw the aqueous just begin to ooze out. There was a good deal of reaction, and the lens having become cataractous—by overheating the aqueous—had to be needled. Recovery favorable. Vision with +12D. +4cyl. 20/70. The recovery has
De novo maintenance therapy with denileukin diftitox (Ontak®) in a patient with peripheral T‐cell lymphoma is associated with prolonged remission
Authors: Bryan Y. Wong, Yupo Ma, Robert Fitzwilson, Nam H. Dang
Journal: American Journal of Hematology (2008)

Abstract Peripheral T‐cell lymphoma (PTCL) is an aggressive form of non‐Hodgkin's lymphoma (NHL), associated with poor prognosis and without standard approach to treatment. Denileukin diftitox (Ontak®) is a synthetic fusion protein combining the receptor‐binding domain of interleukin‐2 to the enzymatically active portion of diphtheria toxin. While approved for the treatment of cutaneous T‐cell lymphoma, it has demonstrated activity in non‐Hodgkin's lymphomas of both T‐cell and B‐cell origin. This report documents the first case of de novo maintenance therapy with denileukin diftitox sustaining an ongoing complete response at the molecular level for 2 years in a patient with PTCL. Am. J. Hematol. 2008. © 2008 Wiley‐Liss, Inc.
A young stroke: the need for vigilance
Authors: R. Miller, C. Griffin, J. Shah, A. Metha, P. Sharma
Journal: Journal of the Royal Society of Medicine (2006)

Stroke is a very common clinical presentation and young patients (545 years old) may present without any apparent risk factors.It is therefore important to exclude all aetiological causes in order to reduce their chances for a subsequent event. CASE HISTORYA 29-year-old right-handed Australian Caucasian woman was admitted following a sudden onset of an expressive dysphasia but no other neurological symptoms.She had no relevant past or family medical history and her only regular medication was the oral contraceptive pill.She consumed 14 units of alcohol per week, smoked 10 cigarettes per day and admitted to occasionally smoking cannabis but denied any other recreational drug abuse.On examination she was afebrile, in sinus rhythm and had a blood pressure of 135/60 mm Hg in the right arm and 120/65 mm Hg in the left arm.Cardiac and respiratory systems were unremarkable with no evidence of cardiac murmurs, all peripheral pulses were present.Examination confirmed an expressive dysphasia and no other neurological signs.The patient was commenced on 300 mg aspirin and admitted for further investigations.Her dysphasia rapidly resolved.However, the following morning she awoke with a dense right hemiplegia and complete aphasia.The following investigations were normal or nondiagnostic: full blood count, renal, liver and thyroid function, syphilis serology, coagulation screen, vitamin B12, red cell folic acid, homocysteine, serum glucose, proteins C and S, activated protein C resistance, antibody to thrombin III, autoantibody screen, lupus anticoagulant and factor V Leiden.Her ESR was 66 mm/h, C-reactive protein 31 mg/L and total cholesterol was 6.5 mM/L.Electrocardiogram, Doppler scan and bubble echocardiogram was normal with no evidence of a patent foramen
Computational Identification of Protein-Protein Interactions in Rice Based on the Predicted Rice Interactome Network
Authors: Pengcheng Zhu, Haibin Gu, Yinming Jiao, Donglin Huang, Ming Chen
Journal: Genomics Proteomics & Bioinformatics (2011)

Abstract Plant protein-protein interaction networks have not been identified by large-scale experiments. In order to better understand the protein interactions in rice, the Predicted Rice Interactome Network (PRIN; http://bis.zju.edu.cn/prin/) presented 76,585 predicted interactions involving 5,049 rice proteins. After mapping genomic features of rice (GO annotation, subcellular localization prediction, and gene expression), we found that a well-annotated and biologically significant network is rich enough to capture many significant functional linkages within higher-order biological systems, such as pathways and biological processes. Furthermore, we took MADS-box domain-containing proteins and circadian rhythm signaling pathways as examples to demonstrate that functional protein complexes and biological pathways could be effectively expanded in our predicted network. The expanded molecular network in PRIN has considerably improved the capability of these analyses to integrate existing knowledge and provide novel insights into the function and coordination of genes and gene networks.
The Obese Patient
Authors: Frederick G. Berlinger
Journal: JAMA (1977)

This scholarly volume, divided into ten chapters, attempts to outline all the pertinent data associated with modern concepts of obesity. As Dr Lloyd H. Smith, Jr, points out in the foreword, obesity "has been called the main public health problem in the United States." Numerous volumes on the subject have been published in the past, and the author himself asks in the preface, "Why, then, another book?" He answers that there is no coherent scientific review of this subject generally available at this time. Whether or not this statement is completely accurate,<i>The Obese Patient</i>certainly is relevant, coherent, and surprisingly complete in only 450 pages. The book places more emphasis on basic science than on clinical applications. It should have specific appeal to persons at several levels, including advanced students of both medicine and the various basic sciences, subspecialists such as endocrinologists, and, to a lesser extent, any practicing
Clinical Remarks on a Case of Abscess in the Left Temporo-Sphenoidal Lobe following Suppuration in the Middle Ear
Authors: W. W. Cheyne
Journal: BMJ (1890)

tum to cure threadwoims nor was it justifiable to cut the cervix in order to reach the interior of the cavity of the fundus uteri, more especially when they had amply sufficient means for dilating the uterus to enable One to get at the disease.-Dr. HBRMAN,Nil reply, said that the discussion had shown what great differences of opinion existed as to the frequency of corpo- real endometritis.He thought the divergence of view depended on the amount of evidence which satisfled different persons as to the existence of corporeal endometritis.There were some who seemed to think that any patient with slightly increased men- strual flow and a little leucorrhoea, and in whom nothing could be found to account for it, had corporeal endometritis.If that were sufficient evidence, then endometritis was common.It was matter of opinion, and he did not say that this view was un- reasonable; but he did not accept it, and was quite sure that cases requiring the curette and caustic were not common.Some other cases had been described, in which he should absolutely dissent from the diagnosis, namely, cases in which there was "intense agony."If he saw such a case, he should feel sure there was something else than endometritis.Again, if there was amenor- rheea and no discharge, he should think the diagnosis of endo- metritis was negatived.Dr. Murdoch Cameron's suggestion to use a rifle brush was a practical one.Dr. Dolris, of 1a'ris, had introduced such an instrument, which he called an " couvilton."lie (Dr.Ilerman) had not yet used it.He could not follow Dr.Duke in advising the use of an intrauterine stem.He (Dr.IIerman) should think it a most efficient means of exciting and keeping up endometritis.lIe was sorry that he could not follow so esteemed a leader as Dr. Graily Hewitt in his estimate of the effects of uterine displacement in causing endometritis, excepting as to backward displacements, a small minority of which he thought did do so.In such cases, all that was wanted was to support the uterus, and then the endometritis would spontaneously get well.He did not assert that febrile diseases in infancy led to uterine disease in the adult; but the occurrence of endometritis in the adult in the course of febrile disease he thought could not now be questioned.The discharges which had been referred to as occurring in children he thought due to vulvitis, not endometritis.He agreed with what had fallen from Dr. Walker as to the mi-- chief of over-estimating the influence of uterine disease in the production of nervous symptoms.He agreed also with Dr. Horrocks as to the probable effect of alcohol in causing endome- tritis, but he had no evidence of it to bring forward.
Plasma DNA in the diagnosis of pulmonary embolism.
Authors: W R Breitwieser, C W Hartman, W S Morris, M K Fleetwood, J A Baxter, R E Albertini
Journal: Thorax (1983)

To assess the diagnostic value of measuring free plasma deoxyribonucleic acid (DNA) in patients suspected of having pulmonary embolism, we prospectively assayed the plasma of 40 consecutive patients who underwent pulmonary angiography for the presence of free plasma DNA. Fifteen of them had angiographic evidence of pulmonary embolism. Of these 15 only two (13%) had a positive result in the test for free double-stranded plasma DNA. We concluded that measuring free double-stranded plasma DNA is of no value in the diagnosis of pulmonary embolism.