tbuckley/cabot-search huggingface dataset:
Fatal Retroperitoneal Hemorrhage
Authors: Henry W. Murray
Journal: JAMA (1979)

RENAL cortical abscess (renal carbuncle) is an uncommon disorder that may be associated with a variety of clinical and pathological complications. These have included perforation (with or without fistula formation) into contiguous areas such as the peritoneal cavity, perinephric space, and renal pelvis.<sup>1</sup>Peritonitis, perinephric abscess, and urinary tract infection or obstruction may follow. Chronic renal cortical abscess may also closely mimic renal neoplasms and occasionally be responsible for prolonged fever of unknown origin. Recently, we cared for a patient with a renal cortical abscess in whom a massive retroperitoneal hemorrhage developed. Bleeding appeared to result from abscess erosion into the renal vasculature. This case illustrates an unusual and catastrophic complication of a visceral abscess. <h3>Report of a Case</h3> A 42-year-old alcoholic woman was hospitalized because of one day of severe right upper quadrant pain and abrupt abdominal distension. She was acutely ill and tachypneic. The blood pressure was
Abstract CT302: A phase II clinical trial of weekly paclitaxel and carboplatin in combination with panitumumab in metastatic or recurrent breast cancer patients with triple negative disease
Authors: Stacy Cowherd, Susan Melin, Steven Akman, John Cole, Julia Lawrence
Journal: Cancer Research (2014)

Abstract Purpose: Metastatic triple negative breast cancer is an unmet need in oncology. A targeted therapy for triple negative breast cancer has not been found so metastases are treated with chemotherapy as a single agent or in combination. The epidermal growth factor receptor (EGFR) is frequently over-expressed in triple negative breast cancer. This EGFR receptor can be targeted with agents such as cetuximab or panitumumab. We designed a single-arm clinical trial to investigate the activity of panitumumab in combination with carboplatin and paclitaxel in women with triple negative breast cancer. Patients and Methods: Patients with metastatic disease and who had received no greater than one prior chemotherapy regimen were eligible for the study. Patients received paclitaxel 80mg/m^2 and carboplatin with AUC 2 on days 1, 8, and 15. In addition they received panitumumab 6mg/kg on days 1 and 15. The primary endpoint was overall response rate. We evaluated patients for toxicity prior to each cycle. We also subtyped the breast tumor specimens using microarray into basal-like, Her-2 enriched, luminal A, luminal B, and normal-like to assess for differential response to therapy among these subtypes. Results: We enrolled 14 patients into the study at two sites (Wake Forest University Baptist Medical Center and Ochsner Medical Center). The average age of enrolled patients was 54.1 years. Nine out of the 14 women were African American and 5 patients were Caucasian. The median number of cycles received by the cohort was 3.5 (1-9) with median time to progression of 98 days. Common grade 3 and 4 adverse events included lymphopenia in 5 patients and neutropenia in 9 patients. Seven participants experienced grade 1/2 mucositis and two participants had grade 3 mucositis. Seven patients experienced grade 1/2 acneiform rash. Response to therapy based on tumor subtype (basal-like, Her-2 enriched, luminal A, luminal B, or normal-like) will also be presented, data in progress. Conclusion: Adding the EGFR inhibitor panitumumab to carboplatin/paclitaxel was a well-tolerated and effective therapy for metastatic triple negative breast cancer. This combination could be most appropriate for certain subtypes of triple negative disease. Citation Format: Stacy Cowherd, Susan Melin, Steven Akman, John Cole, Julia Lawrence. A phase II clinical trial of weekly paclitaxel and carboplatin in combination with panitumumab in metastatic or recurrent breast cancer patients with triple negative disease. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr CT302. doi:10.1158/1538-7445.AM2014-CT302
Strong allergic patch test reactions may indicate a general disposition for contact allergy
Authors: J. Brasch, A. Schnuch, W. Uter
Journal: Allergy (2006)

Background: Patch test patients have two or more positive reactions to unrelated allergens more often than to be expected by chance. This study evaluates synchronous patch test reactions to test the hypothesis that in such cases an allergen‐independent disposition for contact sensitization may be involved. Methods: Data of 87 834 patients tested with a standard patch test series in 42 centers of a Central European Network were retrospectively evaluated. Analyses were done for synchronous positive reactions of graded strength to nickel sulfate, fragrance mix, and to those five allergens that followed in frequency of positive results. All seven allergens selected were not related by chemical structure or exposure. Descriptive univariate and bivariate analyses as well as a polytomous logistic regression analysis were performed. Odds ratios with 95% confidence intervals were calculated. Results: With an increasing strength of a positive reaction to nickel or to fragrance mix the likelihood of further positive reactions to unrelated contact allergens increased significantly, and the mean strength of such additional reactions raised steadily with an increasing strength of a nickel or fragrance reaction. Conclusions: Our findings support the idea that patients who respond with a strong patch test reaction may have a particular general disposition to acquire contact sensitivity to additional unrelated allergens. They should therefore not only be advised to avoid their known allergen but in addition to minimize exposure other contact allergens.
Diabetic Ketoacidosis Associated With Orlistat Treatment
Authors: Sami T. Azar, Mira S. Zantout
Journal: Diabetes Care (2001)

Diabetic Ketoacidosis Associated With Orlistat Treatment Orlistat is a drug frequently prescribed as an adjuvant in weight control therapy (1-2).Orlistat inhibits gastric and pancreatic lipases in the lumen of the gastrointestinal tract to decrease the systemic absorption of dietary fat (1,2).In clinical trials, steatorrhoea and other gastrointestinal disorders are the most frequently reported side effects (3).Other reported adverse effects include hypertension (4) and depression (5).No cases of severe hyperglycemia or diabetic ketoacidosis (DKA) have been previously reported with this drug.We report an 18-year-old Caucasian woman with type 1 diabetes for the past 3 years who had a progressive increase in weight, reaching 89 kg, and a height of 164 cm (BMI 33 kg/m 2 ).She was administered several weight-reducing regimens, but to no avail.One month before her hospitalization, she began taking, on her own, orlistat (120 mg three times per day) in addition to a low-calorie diet.This was accompanied by one to three watery bowel movements per day.She was progressively lethargic, and her insulin dose requirement increased from 86 to 98 U/day, in three preprandial injections of regular insulin with one evening dose of long-acting insulin.She had no other underlying illnesses and was not on any other medication.Her home blood glucose monitoring revealed progressive worsening of her diabetes control.On the day of presentation in the emergency room, she was complaining of severe lethargy, abdominal discomfort, nausea, and two episodes of vomiting.Laboratory data showed severe hyperglycemia (blood glucose 550 mg/dl), acidosis (pH 7.0), hyperosmolar state (Na 153 mEq/l, K 3.0 mEq/l, BUN 60 mg/dl, creatinine 1.8 mg/ dl), severe ketosis (ketone bodies 40 mg/ dl), and positive urinary ketones.She was afebrile (37.2°C), weighed 85 kg, had an HbA 1c 12%, and was dehydrated (ϳ10% of her body weight).Orlistat was stopped, and the patient was started on intravenous hydration and insulin.The patient showed significant improvement over a period of 5 days.On discharge, she was back on her baseline insulin dosage of 82 U/day, and she was hemodynamically stable.In this patient, orlistat, probably secondary to the watery stools, seemed to have progressively caused dehydration and a decrease in intravascular volume.Initially, this lead to insulin resistance and increased insulin requirements, followed by DKA.This is the first report of DKA precipitated by orlistat in a type 1 diabetic patient.We advise caution and close monitoring of patients with type 1 diabetes who are given orlistat for obesity management.
Inhibition of establishment and growth of mouse liver metastases after treatment with interferon gamma and β-1,3-<scp>D</scp>-glucan
Authors: Baldur Sveinbjørnsson, Christian Rushfeldt, Rolf Seljelid, Bård Smedsrød
Journal: Hepatology (1998)

The purpose of this study was to investigate the combined antitumor effect of aminated β-1,3- d -glucan (AG) and interferon-gamma (IFN-γ) in an experimental liver metastasis model. Liver metastases were established by inoculation of C-26 colon carcinoma cells into the superior mesenteric vein of syngeneic mice. Treatment of mice started 24 hours after inoculation of tumor cells by daily intravenous injections of either AG, IFN-γ, or a combination of both for a duration of 6 days. The resultant liver metastases were then quantified after an additional period of 11 days. Combination of IFN-γ and AG inhibited the growth of liver metastases almost entirely. IFN-γ was also very efficient, while AG alone did not exert any significant antitumor effect. These results, along with histological studies from mice receiving AG and IFN-γ, indicated that activation and recruitment of liver macrophages may be a part of the mechanism responsible for the inhibition of metastatic growth observed in this study.
Problems in Transfusion Therapy
Authors: Samuel Charache
Journal: New England Journal of Medicine (1990)

I have two patients in the hospital today. Both have sickle cell disease, and questions about the hazards of transfusion therapy have been raised in both their cases. Two articles in this issue of the Journal explore such questions but do not provide the answers.A 53-year-old woman with sickle cell disease needed a hip prosthesis revised — a moderately long operation during which she would be expected to receive three or four units of blood. Had such a procedure been available 15 years ago, the risks would have been very high. Today they are acceptable, partly because of the . . .
The class I-b molecule Qa-1 forms heterodimers with H-2Ld and a novel 50-kD glycoprotein encoded centromeric to I-E beta.
Authors: P R Wolf, R G Cook
Journal: The Journal of Experimental Medicine (1995)

Recent biochemical characterization of the T23-encoded Qa-1 molecule revealed an additional higher molecular mass species of 50 kD coprecipitated with the 48-kD Qa-1 molecule in H-2b and H-2d mouse strains. We now demonstrate that the 50-kD protein coprecipitated with Qa-1 is the class I-a antigen Ld in all H-2Ld-positive mouse strains examined. Furthers analyses of a panel of recombinants revealed that the 50-kD protein coprecipitated with Qa-1 in H-2b haplotype mouse strains is encoded or controlled by a gene centromeric to major histocompatibility complex class II I-E beta. We have designated this gene and corresponding protein product as Qsm, Qa-1 structure modifier. Both Ld and Qsm can interact with Qa-1 to form cell surface-expressed heterodimers in vivo. These Qa-1 heterodimers are not expressed in H-2k haplotype cells. The Qa-1/Ld and Qa-1/Qsm heterodimers are associated by noncovalent interactions and occur only between fully processed proteins. In addition, we show that the Qsm-encoded protein can form heterodimers with Ld as well, and that the Ld molecules participating in these interactions with Qa-1 and Qsm may be devoid of beta 2-microglobulin and/or peptide. These data represent the first demonstration that class I molecules can be expressed as heterodimers (Qa-1/Ld) on the cell surface, and map a gene (Qsm) that may potentially encode a novel class I molecule, or another protein, that associates with both Qa-1 and Ld. These interactions may enable increased levels of Qa-1 to reach the cell surface and may subsequently influence T cell recognition of Qa-1 and/or Ld molecules.
Mothers' attitudes in infant feeding at Newcastle General Hospital in summer 1975.
Authors: C J Bacon, J M Wylie
Journal: BMJ (1976)

Two-hundred successively delivered mothers were asked about their attitudes towards feeding their babies, the influences on them, and their personal and social backgrounds. Initially 39% intended to breast-feed, though in the first few weeks many gave up. Choosing to breast-feed, and success in doing so, were strongly associated with higher social class. The commonest reason given by those who chose the bottle was the embarrassment of breast-feeding. Efforts to increase the numbers of mothers choosing to breast-feed should concentrate on those mothers who remain undecided on their method of feeding. If they are to breast-feed their babies successfully they will need careful advice and support both before and after delivery.
Diabetogenic effects of nifedipine
Authors: A V Zezulka, J S Gill, D G Beevers
Journal: BMJ (1984)

effects of fibre depleted foods.These include dental disease, excessive energy intake, and rapid absorption of carbohydrate with conse- quent hyperinsulinaemia.There is now experimental evidence that fibre depleted foods, at least those containing sugars, do enhance energy intake and insulin responses by comparison with their "natural" fibre rich counterparts,3-6 or with chemical sweeteners,7 and that they lead to weight gain and to undesirable changes in the lipid compo- sition of blood6 and bile.8These experimental findings harmonise with epidemiological data linking obesity, type II diabetes, hyperlipid- aemia, and gall stores with the Western diet.Cleave's last publication about the dangers of sugar was entitled "Overconsumption, now the most dangerous cause of disease in westernised countries.9"Foods and drinks containing fibre depleted sugar are not the only reason for people overnourishing themselves.Thanks to their palatability, cheapness, and universal availability allied to their ease and speed of consumption and their rapid and complete absorption they are uniquely capable of causing obesity and all the other conse- quences of overnutrition.Our bodies are adapted to taking in carbohydrate in small packages.To remove the packaging before eating the contents is to open Pandora's box.That too is the fibre hypothesis.
Guidelines International Network: Toward International Standards for Clinical Practice Guidelines
Authors: Amir Qaseem
Journal: Annals of Internal Medicine (2012)

Reader Survey: Are standards needed for clinical guideline development? Tell us what you think. Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. Institute of Medicine and the United Kingdom's National Institute for Health and Clinical Excellence have developed recommendations to define trustworthy guidelines within their locales. Many groups charged with guideline development find the lengthy list of standards developed by such organizations to be aspirational but infeasible to follow in entirety. Founded in 2002, the Guidelines International Network (G-I-N) is a network of guideline developers that includes 93 organizations and 89 individual members representing 46 countries. The G-I-N board of trustees recognized the importance of guideline development processes that are both rigorous and feasible even for modestly funded groups to implement and initiated an effort toward consensus about minimum standards for high-quality guidelines. In contrast to other existing standards for guideline development at national or local levels, the key components proposed by G-I-N will represent the consensus of an international, multidisciplinary group of active guideline developers. This article presents G-I-N's proposed set of key components for guideline development. These key components address panel composition, decision-making process, conflicts of interest, guideline objective, development methods, evidence review, basis of recommendations, ratings of evidence and recommendations, guideline review, updating processes, and funding. It is hoped that this article promotes discussion and eventual agreement on a set of international standards for guideline development.
Seven doctors to face GMC over Shipman inquiry findings
Authors: Clare Dyer
Journal: BMJ (2004)

Seven doctors—six general practitioners and a pathologist—who were criticised by the inquiry into the serial killer GP Harold Shipman are to face charges of serious professional misconduct, the General Medical Council confirmed last week.

Retired consultant pathologist David Bee, who carried out the postmortem examination on Renate Overton, 47, a patient with asthma murdered by Dr Shipman, faces a hearing on 27 September.

No date has yet been set for the GPs' hearing. The six—Peter Bennett, Susan Booth, Jeremy Dirckze, Stephen Farrar, Alistair MacGillivray, and Rajesh Patel—all worked at the Brooke and Clarendon practices, near Dr Shipman's sole practice in Hyde, Greater Manchester. They all regularly countersigned …
In vivo validation of a thermodilution method to determine regional left ventricular blood flow in patients with coronary disease.
Authors: C J Pepine, J Mehta, W W Webster, W W Nichols
Journal: Circulation (1978)

Several methods have been used to measure left ventricular regional blood flow in humans. However, limitations and lack of validation in patients are major problems. A continuous thermodilution technique to measure regional left ventricular blood flow in patients with coronary disease was validated in vivo. This technique permits simultaneous assessment of venous blood flow draining predominantly from the anterior wall and of the total left ventricular effluent. Thermodilution measurements with simultaneous electromagnetic flowmeter recordings from anterior descending vein grafts were compared in patients with occluded or subtotally occluded anterior descending coronary arteries. The thermodilution method yielded values for both absolute anterior regional blood flow and changes in anterior regional flow that compared closely to anterior descending bypass graft flow measured independently. The multithermistor technique may be useful in monitoring flow effects of regional coronary disease over time, as well as in studies of agents purported to alter regional blood flow.
The phase image: its relationship to patterns of contraction and conduction.
Authors: E Botvinick, R Dunn, M Frais, W O'Connell, D Shosa, R Herfkens, M Scheinman
Journal: Circulation (1982)

To determine the relationship of phase changes and abnormalities of ventricular contraction and conduction, we performed phase image analysis of blood pool scintigrams in 29 patients. Eleven patients had no evidence of blood pool contraction or ECG conduction abnormalities, four had contraction abnormalities, seven had abnormal conduction and seven had abnormalities of both variables. The phase delay generally related to the degree of contraction abnormality. The mean phase delay in hypokinetic segments differed from that in normokinetic segments in the same patient (p less than 0.025), the phase delay of akinetic and dyskinetic segments differed from that in normokinetic segments (p less than 0.001) and the phase delay in dyskinetic segments differed from that in akinetic segments (p less than 0.005), but there was a significant overlap in the phase delay in normal and hypokinetic segments. Also, in patients with conduction abnormalities, the minimal associated regional phase delay presented a phase dispersion and a pattern of contraction consistent with the pattern of conduction and different from normal. A single study performed both at rest and with stress demonstrated the effect of heart rate on phase assessment and confirmed the independent effects of contraction and conduction on phase delay. Acquisition and analytic methods should add significantly to the resolution of the phase method.
Research call: emotional metrics
Authors: T. Greenhalgh
Journal: BMJ (2011)

Following the success of the UK Cabinet Office’s efforts to develop a metric of happiness with which to benchmark the impact of government reforms, and with a view to developing robust measures of other politically relevant emotions, tenders are now invited for a number of additional programmes of research. 

The following are considered high priority:

Acquiescence: We urgently seek a valid and reliable metric that will gauge the extent to which individuals will accede …
Suction Biopsy of the Rectal Mucosa for Diagnosis of Arteritis in Rheumatoid Arthritis and Related Diseases
Authors: ROBERTO E. SCHNEIDER
Journal: Annals of Internal Medicine (1968)

In order to investigate the usefulness of rectal biopsy in the diagnosis of arteritis, 1 to 3 rectal suction biopsies were obtained from 53 patients with a variety of collagen diseases. Six of 36 patients with well-established rheumatoid arthritis or other collagen diseases and with complete hospital records were found to have arteritis within the submucosa of rectal suction biopsies. Seventeen patients with incomplete records had no arteritis on biopsy, nor was arteritis seen in control biopsies obtained from 66 patients with ulcerative colitis and regional enteritis or in whom rectal biopsy was obtained for other diagnostic purposes. Five of 22 patients with rheumatoid arthritis had arteritis. Suction biopsy of the rectal mucosa is recommended as an easy, painless, and safe procedure for the histologic demonstration of vasculitis in suspect patients. However, the ultimate validity of this approach requires further study and confirmation.
The Structure of the American Medical Practice, 1875-1941
Authors: Lester S. King
Journal: JAMA (1984)

Shortly before his untimely death George Rosen gave a series of three lectures at the University of Pennsylvania, Philadelphia, in honor of Richard H. Shryock. Rosen chose as his subject, "The Structure of American Medical Practice, 1875-1975." Afterward he started to revise the lectures into a book. He had completed the first two sections of the revision, carrying the story up to 1941. However, he died quite suddenly before he had made progress on the final section, which would have brought the analysis to 1975. It seemed appropriate to publish the text, incomplete though it was. Charles Rosenberg edited the work and added a prologue that covered the period 1800 to 1875, which laid a background for the era that Rosen discussed. The bibliography had not been quite up to date but Rosenberg remedied this in an excellent bibliographic essay that he added. As the title indicates the book deals
Like/As: Metaphor and Meaning in Bioethics Narrative
Authors: Laurie Zoloth, Leilah Backhus, Teresa Woodruff, Alyssa Henning, Michal Raucher
Journal: The American Journal of Bioethics (2008)

We would like to thank Cynthia Cohen for her critique of the report of the first stages of the NIH Roadmap Grant on Oncofertility, which is just in the first years of the animal modeling phase, alt...