tbuckley/cabot-search huggingface dataset:
Home secretary bans mephedrone after taking advice from depleted council
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The UK home secretary, Alan Johnson, announced plans to ban mephedrone and its related compounds after the Advisory Council on the Misuse of Drugs recommended they be classified as class B drugs.

Mr Johnson said that legislation would be introduced to parliament on 30 March and that he hoped that cross party support would lead to a ban within the next few weeks.

A class B classification will put mephedrone and other cathinone derivatives alongside cannabis and amphetamines, with a maximum prison sentence of 14 years for dealing and five years for possession.

Mr Johnson said: “As a result of the council’s swift advice I am introducing legislation to ban not just mephedrone and other cathinones but also to enshrine in …
Central and peripheral actions of somatostatin on the growth hormone–IGF-I axis
Authors: Robert D. Murray, Kiwon Kim, Song-Guang Ren, Marjorie Chelly, Yutaka Umehara, Shlomo Melmed
Journal: Journal of Clinical Investigation (2004)

Somatostatin (SRIF) analogs provide safe and effective therapy for acromegaly. In a proportion of patients, however, SRIF analogs may lead to discordant growth hormone (GH) and IGF-I suppression, which suggests a more complex mechanism than attributable to inhibition of GH release alone. To elucidate whether SRIF acts peripherally on the GH–IGF-I axis, we showed that rat hepatocytes express somatostatin receptor subtypes-2 and -3 and that IGF-I mRNA and protein levels were suppressed in a dose-dependent manner by administration of octreotide. The inhibitory effect of SRIF was not apparent without added GH and in the presence of GH was specific for IGF-I induction and did not inhibit GH-induced c-myc or extracellular signal regulated kinase (ERK) phosphorylation. Pertussis toxin treatment of hepatocytes incubated with GH and SRIF, or with GH and octreotide, abrogated the inhibitory effect on GH-induced IGF-I, which confirms the requirement for the inhibitory G-protein. Treatment with SRIF and GH increased protein tyrosine phosphatase (PTP) activity and inhibited signal transducer and activator of transcription-5b (STAT5b) phosphorylation and nuclear localization. Octreotide also inhibited GH-stimulated IGF-I protein content of ex vivo–perfused rat livers. The results demonstrate that SRIF acts both centrally and peripherally to control the GH–IGF-I axis, providing a mechanistic explanation for SRIF analog action in treating patients with GH-secreting pituitary adenomas.
A 3 month old infant with a "strawberry" red mass on her nose
Authors: E. Charles, C. Milroy, N. K. Goldstraw, S. Giuliani
Journal: BMJ (2014)

A 3 month old infant presented to the general practitioner with a “strawberry” red, lobulated, and compressible mass on the tip of her nose (figure⇓). Her nasal cartilage and internal nose did not seem to be affected. The lesion had first been noticed six weeks earlier as a small red spot but had grown quickly and now covered her entire nose. She was otherwise well and had no signs of bleeding or ulceration. The parents were extremely worried and wanted urgent treatment for this lesion.





### 1. What is the diagnosis and what is the correct definition of this condition?

#### Short answer

The correct diagnosis for this lesion is infantile haemangioma of the nose in its proliferative phase.

#### Long answer

Previous terms for this type of lesion include strawberry haemangioma, strawberry naevus, and capillary haemangioma; however, these terms should no longer be used in medical practice. The International Society for the Study of Vascular Anomalies (ISSVA) classification system was issued in 1996 with the aim of establishing a common nomenclature, and it is currently the only system to be widely accepted across the different specialties involved.1 This classification system refers to the original description by Mulliken and Glowacki in 1982 and is based on endothelial characteristics and clinical behaviour.2 It divides vascular anomalies into two main categories: vascular tumours and vascular malformations.3 4

Infantile haemangioma is the most common vascular tumour of infancy, being found in about 5% of infants.5 The incidence is highest in female and premature infants.6 Unlike congenital vascular malformations, this benign lesion is typically not present at …
Injuries to children riding BMX bikes.
Authors: C M Illingworth
Journal: BMJ (1984)

One hundred children presented over 40 days with BMX bike injuries, 40 of which had been sustained while trying to perform stunts. Injuries in this series were compared with previously reported injuries from accidents on ordinary bicycles. BMX bike injuries differed little from ordinary bike injuries except in the greater proportion of injuries due to stunts and the smaller incidence of head injuries.
Mild Retinopathy Is a Risk Factor for Cardiovascular Mortality in Japanese With and Without Hypertension
Authors: Toshimi Sairenchi, Hiroyasu Iso, Kazumasa Yamagishi, Fujiko Irie, Yoshiro Okubo, Junko Gunji, Takashi Muto, Hitoshi Ota
Journal: Circulation (2011)

Background— It is unclear whether mild hypertensive retinopathy is a risk factor for mortality. This study examined whether mild hypertensive retinopathy could be a risk factor for cardiovascular mortality in subjects with and without hypertension. Methods and Results— In this cohort study, 87 890 individuals (29 917 men and 57 973 women) 40 to 79 years of age in 1993 were followed up until 2008. Retinal photography was classified as normal, grade 1, or grade 2 based on the Keith-Wagener-Barker system. Risk ratios for all-cause and cause-specific mortality for each classification were calculated with Cox proportional hazards regression models. Covariates included age, systolic blood pressure, antihypertensive medication use, and other cardiovascular risk factors. Multivariable hazard ratios for total cardiovascular disease mortality were 1.24 (95% confidence interval [CI], 1.12–1.38) and 1.23 (95% CI, 1.03–1.47) for grades 1 and 2 among men and 1.12 (95% CI, 1.01–1.24) and 1.44 (95% CI, 1.24–1.68) for grades 1 and 2 among women, respectively. Hazard ratios for total stroke mortality were 1.31 (95% CI, 1.13–1.53) and 1.38 (95% CI, 1.08–1.77) for grades 1 and 2 among men and 1.30 (95% CI, 1.12–1.50) and 1.70 (95% CI, 1.36–2.11) for grades 1 and 2 among women, respectively. For both hypertensive and normotensive subjects of each sex, multivariable hazard ratios for all-cause mortality, total cardiovascular mortality, and total stroke mortality were significantly higher for grade 1 or 2 compared with normal. Conclusions— Mild hypertensive retinopathy is a risk factor for cardiovascular mortality independently of cardiovascular risk factors among men and women with and without hypertension.
858 ROLE OF ABCB4 GENE MUTATIONS IN HEPATOBILIARY DISEASES OF THE ADULT. THE EXPERIENCE OF A LIVER UNIT IN MILAN
Authors: M. Antelmi, A. Crosignani, E. Vassallo, D. Degiorgio, D.A. Coviello, C. Colombo, M. Zuin, M. Podda, P.M. Battezzati
Journal: Journal of Hepatology (2008)
A Case of Giant Cell Tumor of Sacrum With Unusual Pulmonary Metastases
Authors: Yuyang Zhang, Isaac P. Reeve, David H. Lewis
Journal: Clinical Nuclear Medicine (2012)

A 43-year-old woman was admitted for concern of postcurettage recurrence of left sacral giant cell tumor (GCT). Both MRI and FDG PET revealed a large lesion in the left sacrum with characteristics concerning for local recurrence. Preoperative staging CT showed no evidence of remote metastases. Subsequent restaging CT and FDG PET demonstrate the interval development of a 5 × 6-mm pulmonary nodule in the right lung base within 40 days after curettage with hypermetabolic features on PET, concerning for pulmonary metastasis of GCT, which was later confirmed by biopsy. As an exception, benign GCT can demonstrate metastases, rapid growth rate, and enhanced FDG avidity on PET for both primary and metastatic lesions. Our case illustrates the importance of recognizing these exceptional features when interpreting FDG PET of GCT to prevent the misinterpretation of metastases as perhaps other etiologies, such as infection.
An attempt to save money by using mandatory practice guidelines in france
Authors: I. Durand-Zaleski, C. Colin, C. Blum-Boisgard
Journal: BMJ (1997)

In the five years up to 1996, expenditure on healthcare in France increased at an average yearly rate of 4-5%; by 1996 it amounted to about 10% of the gross domestic product.1 2 Various cost containment programmes have been proposed and implemented, many assuming that high costs are a result of unnecessary tests and treatments. We describe and make a preliminary assessment of the latest of these, introduced in France from 1994 onwards, which combines mandatory practice guidelines on procedures and drug prescribing with a system of fines for doctors who do not comply.

Two thirds of French doctors are in private practice and are paid on a fee for service basis. The French social security administration provides medical cover for 99.6% of the population, and 80% of the fee the patient pays to a private physician is reimbursed by social security. Private insurance companies reimburse the remaining portion for most people. The social security administration and the doctors' unions have negotiated contractual medical fees and these are paid to most general practitioners and to 60% of specialists. Basic fees per consultation in 1997 were F110 (£11) for a general practitioner and F150 (£15) for a specialist but additional fees could be claimed for medical or surgical procedures performed during the consultation. Thus, physicians receive most of their income from social security.2

The French healthcare system has historically provided freedom of choice for patients and doctors. Patients can see any general practitioner or specialist they choose, with no limit to the number of doctors seen or the frequency of visits. Doctors have been free to request any investigations or procedures and have prescribed as they pleased—with the exception of a few drugs restricted to hospital use. This combination of freedom of choice, the high proportion of medical expenditure …
Medical Ethics and the Issue of Torture
Authors: James H. Sammons
Journal: JAMA (1986)

From as early as 2000 BC, physicians have sworn to uphold the fundamental oaths that affirmed the sanctity of the physician's responsibilities to the patient. History chronicles the significant oaths—the Code of Hammurabi by the Babylonians, the Oath of Hippocrates during the Greek period, and in more recent years, the Code of Medical Ethics published in 1803 by Dr Thomas Percival, a physician as well as a philosopher. Without question, these provide the quintessential foundation of the profession of medicine. In keeping with this long tradition, the Preamble of the American Medical Association's (AMA) Principles of Medical Ethics states: "The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patients. As a member of this profession, a physician must recognize responsibility not only to patients, but also to society, to other health professionals and to self." The Preamble goes on to
The Identification of the Endogenous Ligands of Natural Killer T Cells Reveals the Presence of Mammalian α-Linked Glycosylceramides
Authors: Lisa Kain, Bill Webb, Brian L. Anderson, Shenglou Deng, Marie Holt, Anne Costanzo, Meng Zhao, Kevin Self, Anais Teyton, Chris Everett, Mitchell Kronenberg, Dirk M. Zajonc, Albert Bendelac, Paul B. Savage, Luc Teyton
Journal: Immunity (2014)
Training General Internists and “STARS”
Authors: Robert DiBenedetto
Journal: Annals of Internal Medicine (1995)

Letters1 January 1995Training General Internists and “STARS”Robert DiBenedetto, MDRobert DiBenedetto, MDMemorial Medical Center, Inc.; Savannah, GA 31404Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-1-199501010-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I am Program Director of an internal medicine residency program consisting of 27 residents in a community hospital-based, university-affiliated setting. During the past few years, the percentage of graduates entering primary care has decreased from 80% or more to 50%, with the remainder entering subspecialty fellowships. Consequently, I instituted a fourth year of training similar to that suggested by Dr. Fogelman [1], consisting of teaching and administrative responsibilities and an extensive training period in one or two subspecialties. We aimed for proficiency in such procedures as gastroscopy. With the number of procedures done for certification equivalent to ...Reference1. Fogelman AM. Strategies for training generalists and subspecialists. Ann Intern Med. 1994; 120:579-83. Google Scholar Author, Article, and Disclosure InformationAffiliations: Memorial Medical Center, Inc.; Savannah, GA 31404 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1995Volume 122, Issue 1Page: 72-73KeywordsFellowshipsForecastingGastroenterology and hepatologyGraduate medical educationResidencySub-specialty care Issue Published: 1 January 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
PD4-3-6: A randomised phase II study comparing two schedules of the 21-day regimen of Gemcitabine and Carboplatin in advanced NSCLC
Authors: Veerle F. Surmont, Joachim Aerts, Robertus Van Klaveren, Youke Tan, René Vernhout, Jan Van Meerbeeck
Journal: Journal of Thoracic Oncology (2007)
Oncogenic PIK3CA-driven mammary tumors frequently recur via PI3K pathway–dependent and PI3K pathway–independent mechanisms
Authors: Pixu Liu, Hailing Cheng, Stephanie Santiago, Maria Raeder, Fan Zhang, Adam Isabella, Janet Yang, Derek J Semaan, Changzhong Chen, Edward A Fox, Nathanael S Gray, John Monahan, Robert Schlegel, Rameen Beroukhim, Gordon B Mills, Jean J Zhao
Journal: Nature Medicine (2011)
Acute Meprobamate Poisoning with Gastrotomy and Removal of a Drug-Containing Mass
Authors: Howard S. Schwartz
Journal: New England Journal of Medicine (1976)

Meprobamate, a widely used sedative, causes an increasing percentage of poisonings,1 although deaths have been rare.2 , 3 Individual patient response varies — death has been reported after ingestion of 12 g,4 , 5 although patients have survived after ingestion of 38 to 40 g.6 , 7 Plasma levels between 6 and 10 mg per deciliter usually cause light coma, and 10 to 20 mg per deciliter deep coma.2 Meprobamate intoxication frequently produces severe hypotension, which is treated by plasma-volume expansion with colloid and crystalloid solutions and sympathomimetic drugs. Most patients require support of ventilation and blood pressure for only short periods; with larger doses, peritoneal . . .
THE X-Y-Z SCHEME OF IMMUNOCYTE MATURATION
Authors: Vera S. Byers, Eli E. Sercarz
Journal: The Journal of Experimental Medicine (1968)

A concentration of 5 mg/ml bovine serum albumin (BSA) prevents the in vitro elicitation of a secondary response in primed rabbit popliteal lymph nodes, if it is left in contact with the node fragments for the first 6 days of culture. No antibody formation can be detected at any time during the culture period in most cases, although occasional fragments are resistant to inhibition. Reducing the exposure time to the first 3 days of culture delays the peak of the antibody response. The inhibition is antigen specific. Reconstruction experiments demonstrate that the inhibition is not due to antigen masking of the antibody. Even shortly after optimal stimulation, the addition of 5 mg/ml BSA to the fragments was not able to prevent a normal antibody response. The implications of these findings are that (a) a high antigen concentration suspends the memory cell in a reversibly paralyzed state, (b) memory cells have a heterogeneous susceptibility to inhibition, (c) once induced, the antibody response cannot be inhibited by antigen overloading, (d) unresponsiveness in a primed animal can be due to either exhaustion of the memory cell population or paralysis of the memory cell.
Quantitation of intra-hepatic HCV-RNA according to histology and to genotypes after liver transplantation
Authors: V DIMARTINO
Journal: Hepatology (1995)

The factors that affect the uptake and distribution of trace elements are reviewed and include alteration of solubility by chelating agents and carbonate ion. The waterhyacinth, Eichhornia crassipes (Mart.) Solms, which infests waterways in many areas of the world, was used as a model system. Observed rates of uptake of 54Mn(II) and 59Fe(III) by waterhyacinth, are compared with the values expected for uptake based upon control by chelation, i.e. with dihydrogen ethylenediaminetetraacetate and control by metal(II) carbonate solubility. Manganese-54 and iron-59 appeared in the roots on the first day. The relative rate of appearance (54Mn/59Fe) of the roots was 131; experimentally significant amounts of iron did not appear in the leaves much before 10 days. The ratio of the uptake rate of manganese relative to iron is within the predicted range, assuming control by metal(II) carbonate solubility, but is several orders of magnitude less than expected for control by chelation. A coordination model was used, and the agreement is improved by assuming the iron-EDTA was protonated, though the limitations of the assumption are recognized. Fair agreement is noted if it is assumed that reduction of iron occurs in the vicinity of the roots, and if the rate ratios are compared with the stability constants for divalent-metal species.
Is chemotherapy for metastatic non-small cell lung cancer "worth it"?
Authors: J C Ruckdeschel
Journal: Journal of Clinical Oncology (1990)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1990.8.8.1293 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 2166141 Is chemotherapy for metastatic non-small cell lung cancer "worth it"? J C RuckdeschelxJ C RuckdeschelSearch for articles by this author Show More Albany Medical College, NY. https://doi.org/10.1200/JCO.1990.8.8.1293 First Page PDF © 1990 by American Society of Clinical Oncology
Reduction of radiation exposure while maintaining high-quality fluoroscopic images during interventional cardiology using novel x-ray tube technology with extra beam filtering.
Authors: A den Boer, P J de Feyter, W A Hummel, D Keane, J R Roelandt
Journal: Circulation (1994)

Radiographic technology plays an integral role in interventional cardiology. The number of interventions continues to increase, and the associated radiation exposure to patients and personnel is of major concern. This study was undertaken to determine whether a newly developed x-ray tube deploying grid-switched pulsed fluoroscopy and extra beam filtering can achieve a reduction in radiation exposure while maintaining fluoroscopic images of high quality.Three fluoroscopic techniques were compared: continuous fluoroscopy, pulsed fluoroscopy, and a newly developed high-output pulsed fluoroscopy with extra filtering. To ascertain differences in the quality of images and to determine differences in patient entrance and investigator radiation exposure, the radiated volume curve was measured to determine the required high voltage levels (kVpeak) for different object sizes for each fluoroscopic mode. The fluoroscopic data of 124 patient procedures were combined. The data were analyzed for radiographic projections, image intensifier field size, and x-ray tube kilovoltage levels (kVpeak). On the basis of this analysis, a reference procedure was constructed. The reference procedure was tested on a phantom or dummy patient by all three fluoroscopic modes. The phantom was so designed that the kilovoltage requirements for each projection were comparable to those needed for the average patient. Radiation exposure of the operator and patient was measured during each mode. The patient entrance dose was measured in air, and the operator dose was measured by 18 dosimeters on a dummy operator. Pulsed compared with continuous fluoroscopy could be performed with improved image quality at lower kilovoltages. The patient entrance dose was reduced by 21% and the operator dose by 54%. High-output pulsed fluoroscopy with extra beam filtering compared with continuous fluoroscopy improved the image quality, lowered the kilovoltage requirements, and reduced the patient entrance dose by 55% and the operator dose by 69%.High-output pulsed fluoroscopy with a grid-switched tube and extra filtering improves the image quality and significantly reduces both the operator dose and patient dose.
Atlas of Topographical Anatomy of the Domestic Animals
Authors: William R. Barclay
Journal: JAMA (1979)

This was first issued as three volumes: the first in 1960, the second in 1962, and the third in 1968. It was immediately recognized by veterinarians as an outstanding contribution in its detail, accuracy, and comprehensiveness. This second edition, adopted from the English translation by R. Getty, DVM, PhD, chairman of the Department of Veterinary Anatomy, University of Iowa, is issued in a single volume. It is remarkable for both the detail and the beauty of its illustrations and is printed on heavyweight glossy paper in a handsome binding. The work details the gross anatomy of the cow, sheep, goat, swine, horse, dog, cat, and rabbit. Although this volume is intended for use by veterinarians, it would prove indispensable to those physicians who use domestic animals in laboratory research surgery.