tbuckley/cabot-search huggingface dataset:
A 56 year old man with headache, fever, and neurological symptoms
Authors: R. Dobson, C. Shannon
Journal: BMJ (2010)

A previously fit and well 56 year old retired mechanic was admitted to hospital via the emergency department with a one week history of headache. He described the headache as being “moderately” severe and affecting his entire head. There were no exacerbating or relieving factors, and he had not had a similar headache previously.

The day before admission he developed double vision, neck stiffness, and vomiting. On the day of admission he developed drooping of the right side of his face, weakness of the right leg, and difficulty walking, with some impairment of balance. He had no history of fevers, rigors, or other systemic symptoms before admission. He had not recently travelled and had no unwell contacts. His medical history was unremarkable.

On examination he had a score of 15/15 on the Glasgow coma scale. His temperature was 38.5°C, his blood pressure was 135/68 mm Hg, and his pulse rate was 90 beats/min. He had moderate neck stiffness and a right sided facial droop indicative of a lower motor neurone seventh cranial nerve palsy. He also had subtle pass pointing and ataxia in the right upper limb, with mild heel-shin ataxia in the right lower limb consistent with right sided cerebellar signs. The remainder of the neurological examination was unremarkable.

Blood tests on admission showed a peripheral white blood cell count of 17.7×109/l (neutrophils 15.55×109/l), C reactive protein 120 mg/l, and normal urea and creatinine. His serum sodium was slightly decreased at 131 mmol/l.

Computed tomography and lumbar puncture were performed on admission. Magnetic resonance imaging was performed the next day (fig 1⇓). Analysis of his cerebrospinal fluid showed protein 0.96 g/l, glucose 1.2 mmol/l, and white cell count 535/mm3 (85% polymorphs, 10% lymphocytes, 5% atypical white cells). No organisms were seen on Gram …
Consultation and Referral in New Medical-Practice Environments: A Gloomy Outlook?
Authors: ARTHUR S. ELSTEIN
Journal: Annals of Internal Medicine (1985)

Editorials1 October 1985Consultation and Referral in New Medical-Practice Environments: A Gloomy Outlook?ARTHUR S. ELSTEIN, Ph.D.ARTHUR S. ELSTEIN, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-4-616 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThat the social structure of medical practice in the United States is undergoing rapid and profound change is a proposition beyond argument. Medical journals and the popular press testify daily to vast changes in the organizational structures within which physicians and other health professionals work and through which patients receive care. The catalyst for some of these transformations has been the federal government, responding to growing public pressure first for greater access for the elderly to adequate care and then for protection against the mounting costs created, in part, by a system that encouraged the proliferation of high-cost technologies by...References1. STARR P. The Social Transformation of American Medicine. New York: Basic Books; 1982. Google Scholar2. BANTA H. Embracing or rejecting innovations: clinical diffusion of health care technology. In: REISER SJ, ANBAR M, eds. The Machine at the Bedside: Strategies for Using Technology in Patient Care. New York: Cambridge University Press; 1984:65-92. CrossrefGoogle Scholar3. KOHRMAN C. HMOs and physicians. In: ANDERSON OW, HEROLD TE, BUTLER BW, KOHRMAN CH, MORRISON EM. HMO Development: Patterns and Prospects. Chicago: Pluribus Press; 1985:164-205. Google Scholar4. SCHAFFER W and HOLLOMAN F. Consultation and referral between physicians in new medical-practice environments. Ann Intern Med. 1985;103:600-5. LinkGoogle Scholar5. YELIN E, HENKE C, KRAMER J, NEVITT M, SHEARN M, and EPSTEIN W. A comparison of the treatment of rheumatoid arthritis in health maintenance organizations and fee-for-service practices. N Engl J Med. 1985;312:962-7. CrossrefMedlineGoogle Scholar6. LUFT H. Health Maintenance Organizations: Dimensions of Performance. New York: Wiley-Interscience, 1981. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ARTHUR S. ELSTEIN, Ph.D.Affiliations: University of Illinois at Chicago Chicago, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1985Volume 103, Issue 4Page: 616-617KeywordsElderlyPatients ePublished: 1 December 2008 Issue Published: 1 October 1985 PDF downloadLoading ...
Phase II trial of subcutaneous injections of human recombinant interleukin-2 for the treatment of mycosis fungoides and Sézary syndrome
Authors: Christiane Querfeld, Steven T. Rosen, Joan Guitart, Alfred Rademaker, Francine Foss, Rohit Gupta, Timothy M. Kuzel
Journal: Journal of the American Academy of Dermatology (2006)
Influence of Calibration on Densitometric Studies of Emphysema Progression Using Computed Tomography
Authors: David G. Parr, Berend C. Stoel, Jan Stolk, Peter G. Nightingale, Robert A. Stockley
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

The fundamental importance of calibration for any measuring device is indisputable, but computed tomography (CT) calibration in longitudinal lung densitometry studies is largely unexplored. Although the validity of CT as a measure of emphysema has been confirmed in cross-sectional studies, there are limited data on long-term reproducibility, and this is critically important for validating its use as an outcome measure in therapeutic trials. A general understanding of the strengths and pitfalls of CT densitometry is critical for physicians reviewing the published literature using this methodology. In our study of 57 patients with alpha-1 antitrypsin deficiency (phenotype PiZ), progression of voxel index determined from three successive annual scans acquired with a fully calibrated scanner was intimately associated with changes in CT air densitometry, sampled from patient images. Images were therefore reanalyzed, using a correction technique validated in phantom studies that adjusted for changes in measured air density, and the reliability of the voxel index as a measure of emphysema progression was improved. Comparison of adjusted voxel index thresholds indicated the optimum threshold was -950 Hounsfield units. Internal air calibration is therefore critical in longitudinal and multicenter lung densitometry studies of emphysema and incorporation of a correction factor is essential for quantitative image analysis.
Prognosis of Surgically Corrected Coarctation of the Aorta
Authors: BARRY J. MARON, J. O'NEAL HUMPHRIES, RICHARD D. ROWE, E. DAVID MELLITS
Journal: Circulation (1973)

A long-term retrospective analysis of 248 patients, 11-25 years after surgical correction of coarctation of the aorta, revealed a high incidence of premature cardiovascular disease. Twelve percent of patients with follow-up have died. It is suggested that premature death in patients with adequate surgical repair may be related to the duration of preoperative hypertension. Fifty-nine patients were evaluated on a standard hospital protocol. Seventy-eight percent had evidence of cardiovascular disease and over 40% had no change or had increased blood pressure over the preoperative value. These data emphasize the importance of early diagnosis and treatment for patients with coarctation of the aorta as well as the need for close postoperative follow-up.
Onset of action in the nasal antihistaminic effect of cetirizine and loratadine in patients with allergic rhinitis
Authors: N. Frossard, J. Lacronique, M. Melac, O. Benabdesselam, J.‐J. Braun, N. Glasser, G. Pauli
Journal: Allergy (1997)

Several studies have compared the cutaneous efficacy of cetirizine and loratadine and their onset of action. We assessed the nasal effect of these two antihistamines in a randomized, double‐blind, crossover, placebo‐controlled trial in order to compare objectively their efficacy and onset of action in the noses of patients with allergic rhinitis. Nasal challenge was performed by nebulization of increasing doubling doses of histamine (0, 0.04‐1.28 mg/nostril) in 12 patients (eight men, four women, aged 22‐39 years). Nasal airway resistance (NAR) was measured by posterior rhinomanometry either 1.5 h or 4 h after intake of cetirizine (10 mg), loratadine (10 mg), or placebo. Baseline NAR was identical between all study days (2.60‐2.88 cmH 2 O·1 −1 ·s). One and a half hours after intake, the increase in NAR induced by histamine was significantly reduced by both cetirizine and loratadine in contrast to placebo. However, with cetirizine the nasal obstruction was significantly lower than with loratadine ( P &lt;0.05). Four hours after intake, a similar inhibition of the nasal obstruction caused by histamine was observed with both cetirizine and loratadine ( P &lt;0.05). In conclusion, this study found cetirizine and loratadine to have similar nasal efficacy at therapeutic dosage 4 h after intake, whereas cetirizine was more effective than loratadine 1.5 h after intake. In agreement with the results observed in the skin, our study suggests a more rapid onset of action of cetirizine in the nose in allergic rhinitis.
Sodium chloride increases the ciliary transportability of cystic fibrosis and bronchiectasis sputum on the mucus-depleted bovine trachea.
Authors: P J Wills, R L Hall, W Chan, P J Cole
Journal: Journal of Clinical Investigation (1997)

Mucus retention in the lungs is an important feature of several respiratory diseases (Regnis, J.A., M. Robinson, D.L. Bailey, P. Cook, P. Hooper, H.K. Chan, I. Gonda, G. Bautovich, and P.T.P. Bye. 1994. Am. J. Respir. Crit. Care Med. 150:66-71 and Currie, D.C., D. Pavia, J.E. Agnew, M.T. Lopez-Vidriero, P.D. Diamond, P.J. Cole, and S.W. Clarke. 1987. Thorax. 42:126-130). On the mucus-depleted bovine trachea, the ciliary transport rate of sputum from patients with cystic fibrosis and bronchiectasis of other causes was slow, but the rate was doubled by increasing the sodium chloride content by 90 mM. Increasing the sputum osmolality by inspissation or by the addition of nonelectrolytes had a similar effect. The viscoelasticity of sputum, but not the bovine ciliary beat frequency, was markedly saline dependent over the pathophysiological range. This suggests that low mucus salinity, not (as is generally assumed) its under-hydration, contributes to its retention in bronchiectasis due to cystic fibrosis and other causes, probably by affecting its theology. It also indicates how the genetic defect in cystic fibrosis might lead to impaired mucus clearance. Therapies that increase the osmolality of lung mucus might benefit patients with mucus retention.
Endoscopic Mucosal Resection of Superficial Cancer in the Stomach Using the Cap Technique
Authors: M. Tani, P. Sakai, H. Kondo
Journal: Endoscopy (2003)

Clinicopathological analyses of surgically treated early gastric cancers have revealed that some of them would have been curable by endoscopic treatment. The main endoscopic treatment currently used for early gastric cancer is endoscopic mucosal resection (EMR), which allows histopathological examination of the resected specimen. It was first described by Deyhle et al. [1] in 1973 and the procedure was established by Tada et al. [2] in the 1980s under the name of strip biopsy.
Species-specific Prevalence of Vaginal Candidiasis Among Patients with Diabetes Mellitus and its Relation to their Glycaemic Status
Authors: R. Goswami, V. Dadhwal, S. Tejaswi, K. Datta, A. Paul, R.N. Haricharan, U. Banerjee, N.P. Kochupillai
Journal: Journal of Infection (2000)
Review: Periprocedural high-dose statins reduce contrast-induced acute kidney injury after coronary angiography
Authors: Richard G. Bach
Journal: Annals of Internal Medicine (2015)

Source Citation Ukaigwe A, Karmacharya P, Mahmood M, et al. Meta-analysis on efficacy of statins for prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography. Am J Cardiol. 2014;114:1295-302. 25239829
A Clinical Lecture ON THE CAUSATION OF ANGINA PECTORIS
Authors: B. Bramwell
Journal: BMJ (1910)

presented to the Rockefeller Institute for Medical Research of New York a replica of the bronze bust of Louis Pasteur, in recog- nition of assistance rendered during the recent epidemic of cerebro-spinal meningitis which prevailed in France.DR. PARTROU has founded a vegetarian society in Roumania, with branches all over the country.The society issues a journal, the aim of which is to make theã dvantages of vegetarianism known to the people.It has also established at Bucharest a restaurant which is managed on vegetarian principles.
The Incidence and Clinical Outcome of Constrictive Physiology After Coronary Artery Bypass Graft Surgery
Authors: Eui Im, Chi Young Shim, Geu-Ru Hong, Kyung-Jong Yoo, Young-Nam Youn, Byung-Chul Chang, Yangsoo Jang, Namsik Chung, Jong-Won Ha
Journal: Journal of the American College of Cardiology (2013)
Photographing Medicine: Images and Power in Britain and America Since 1840
Authors: Lester S. King
Journal: JAMA (1988)

Photographs are source material for history, but, contrary to popular opinion, they are not objective records. Rather, they reflect some message that the photographer (or those who employed him) wanted to project. To study this phenomenon the authors present some 250 photographs, all taken between 1840 and the present, and all dealing with medicine in one or another way. The text interprets what the authors consider the implicit message to have been. The pictures show a great variety of subjects, such as scenes on the wards and in the various clinics; different functioning departments of hospitals; or gatherings of people, whether dignitaries, doctors, nurses, or relatives. We are shown doctors at work, of various kinds. The range of activities has a broad scope, and the changes that time has brought about are apparent. Some of the reproductions are of fine quality, some are execrable, most are mediocre. In the text
Survival During Fasting
Authors: Gilbert B. Forbes
Journal: JAMA (1983)

<h3>To the Editor.—</h3> Drs Leiter and Marliss (1982;248:2306) present some hypothetical calculations regarding the composition of the weight loss in the Irish hunger strikers. Their conclusions suffer from lack of data on the prefasting body weights, and they have ignored some observations that have actually been made on fasting persons.<sup>1</sup>These show a remarkable consistency in the composition of the weight loss: obese persons lose about 10 g of nitrogen per kilogram of weight lost, but the nonobese differ in losing about twice as much, namely, 20 g of nitrogen per kilogram. Since the lean component of the adult body contains about 33 g of nitrogen per kilogram, one can estimate that the contribution of fat to the weight loss is about 60% for the obese persons and 30% for the nonobese. Hence, the stated conclusion of Leiter and Marliss that body fat is the limiting factor in survival
Effects of biological response modifiers on plasminogen activator activity in epidermal cell culture
Authors: JUDITH M. BROWN, D. A. CHAMBERS
Journal: British Journal of Dermatology (1984)

Journal Article Effects of biological response modifiers on plasminogen activator activity in epidermal cell culture Get access JUDITH M. BROWN, JUDITH M. BROWN Center for Research in Periodontal Diseases and Oral Molecular Biology and Departments of Biological Chemistry and Dermatology, University of Illinois Health Sciences Center, Chicago, III. 60612, U. S. A. Search for other works by this author on: Oxford Academic Google Scholar D. A. CHAMBERS D. A. CHAMBERS Center for Research in Periodontal Diseases and Oral Molecular Biology and Departments of Biological Chemistry and Dermatology, University of Illinois Health Sciences Center, Chicago, III. 60612, U. S. A. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue s27, 1 July 1984, Pages 252–256, https://doi.org/10.1111/j.1365-2133.1984.tb15617.x Published: 01 July 1984
Hepatic Folate in Man
Authors: I. Chanarin, M. Hutchinson, A. McLean, M. Moule
Journal: BMJ (1966)

Ionizing Radiation-Hems 2,249 persons were all exposed to 5 rads, and in practice their exposure was on average much lower, the exposed group would still be less than 20% of the minimum size (in man-years) to permit detection of radiation-induced leukaemia and an even smaller fraction of the size (in man-generations) required for detection of a mutation attributable to the increased radiation. Summary and ConclusionsIn order to detect radiation effects by a population study it is, of course, essential that the population be large enough for the radiation effects to be statistically significant.For exposure of man to low doses of radiation at low dose rates the minimum population size to permit detection of radiation-induced leukaemia is many tens of thousands of man-years; for detection of dominant mutations attributable to the increased radiation the necessary population (in man-generations), as estimated from mouse data, is even larger.Exposed populations which have been surveyed so far are smaller than the minimum theoretical size and would need to be studied for an impracticably long time before either a mutation attributable to the increased radiation at a single locus or radiation-induced leukaemia could be detected.Stevenson (1957), in his examina- tion of this problem, also concluded that it appeared unlikely that populations could be found of sufficient size to permit detection of mutations induced by background radiation.In conclusion it should be emphasized that, in addition to the difficulty of fulfilling the requirement for a minimum popula- tion size, if a population study were undertaken to detect radiation effects additional practical problems are fikely to be encountered in setting up a satisfactory control population (Griinberg, 1964) and in assessing mean annual doses.
Characterization of the calcium response to thyrotropin-releasing hormone in lactotrophs and GH cells
Authors: Patricia M Hinkle, Eric J Nelson, Rachel Ashworth
Journal: Trends in Endocrinology and Metabolism (1996)

Thyrotropin-releasing hormone (TRH) acts via a G-protein-coupled receptor on lactotrophs to increase the intracellular free calcium ion concentration, [Ca(2+)](i). The [Ca(2+)](i) response depends on both TRH concentration and the duration of TRH exposure. An initial, short-lived [Ca(2+)](i) spike results from release of Ca(2+) from intracellular stores, whereas a later sustained [Ca(2+)](i) increase, often characterized by [Ca(2+)](i) oscillations, results from an influx of extracellular Ca(2+) through both voltage-gated and non-voltage-gated, store-operated Ca(2+) channels. The initial spike phase predominates at high doses of TRH, whereas the plateau phase predominates at low doses. The mechanisms underlying the complex [Ca(2+)](i) response to TRH are discussed.
Abstract P3-06-13: Transient increase in breast cancer risk after a full term pregnancy among African women
Authors: D Sighoko, N Hou, T Ogundiran, C Adebamowo, A Ademola, O Ojengbede, I Anetor, S Akinleye, P Ndom, A Gakwaya, D Huo, OI Olopade
Journal: Cancer Research (2013)

Abstract Background African women affected by breast cancer (BC) have high parity with five children or more, are relatively young at first full term pregnancy (FFTP), are diagnosed at a young age and are often premenopausal at diagnosis. While several studies have assessed the role of reproductive factors for BC risk among African women, none of them have assessed whether there is dual effect of age at full term pregnancy (FTP). In this communications, using a large dataset from an on-going hospital-based case-control study, we examine the role of age at full term pregnancy on breast cancer risk among African women. Methods The study includes sites in Nigeria (University College Hospital, Ibadan), Cameroon (Yaoundé General Hospital) and Uganda (Breast Clinic of Mulago Hospital of Kampala). It was initiated in 1998 in Nigeria and extended to Cameroon and Uganda in 2011. Cases were consecutive females diagnosed with invasive BC. Controls were recruited from the community or within the hospital and have never being diagnosed with any cancer. Cases and controls were aged 18 years or more and gave informed consent. Full term pregnancy was defined as a pregnancy that lasted at least 7 months and included both live birth and stillbirth. Logistic regression models were used to assess the effects of age at first and second FTP, and their interaction with current age on BC risk. Age at menarche, parity, body mass index and hormone contraception use were included in the models. Results The study includes 1668 cases and 2399 controls recruited between 1998 and May 2013. Mean duration of live birth was 9 months (SD±0.52) and 8.8 months (SD±0.66) for a stillbirth. Overall, the mean age at FFTP was 23 years (SD±4.91) for both cases and controls. Compared to nulliparous women, parous women who had FFTP at 20 years have increased risk (OR = 1.59, CI 95%, 1.16-2.21) to develop BC in the year following the pregnancy. Up to 5 years following the FFTP, this OR is 1.38 (CI 95%, 1.06-1.80) while it is 0.77 (CI 95%, 0.62-0.95) 25 years later. This observation was also true for parous women who have had their FFTP at 25, 30, or 35 years. Moreover, a similar pattern was observed when comparing uniparous women to women with 2 or more children. Conclusion Our results show a transient increase in risk of BC after a full term pregnancy which declined and became protective over time. This observation is consistent with the effect of pregnancy on BC that has been described in other populations and may partially explain the current profile of breast cancer among African women. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-06-13.