tbuckley/cabot-search huggingface dataset:
Computer says yes
Authors: Des Spence
Journal: BMJ (2008)

In the west of Scotland, where it rains continually, many people have red hair and freckles. You could conclude, perhaps, that high rainfall causes red hair and freckles. But mere association is not causation, however plausible the link might seem. This is the fundamental flaw within all observational data: that an unknown alternative explanation (confounding factor) is responsible.

Often I sit looking at lab results on the computer. A message …
Transposition of the Great Arteries with Ventricular Septal Defect
Authors: JOHN A. WALDHAUSEN, I. BORUCHOW, WILLIAM W. MILLER, WILLIAM J. RASHKIND
Journal: Circulation (1969)

Infants with transposed great arteries need atrioseptostomy for adequate intracardiac mixing of the systemic and pulmonic circulations. Those with ventricular septal defect and pulmonary artery hypertension, with or without other associated lesions, usually require further surgical palliation. Postseptostomy measurements of pulmonary artery pressures at systemic levels were obtained in ten infants with transposition of the great arteries and ventricular septal defects. Three had, in addition, patent ductus arteriosus, and two of these had aortic coarctation (one preductal with hypoplasia of the aortic arch). One had transposition of the great arteries, ventricular septal defect, and tricuspid atresia. Four of the patients had surgical septectomy; the remaining seven had balloon atrioseptostomy. All had pulmonary artery banding; the three ductus arteriosus lesions were ligated; and both coarctations were repaired (one with reconstruction of the aortic arch). The only operative death was in one of the patients with transposition of the great arteries and ventricular septal defect only. When the interatrial communication is adequate in patients with transposition, ventricular septal defect, and pulmonary artery hypertension, pulmonary vascular obstructive changes may be prevented by pulmonary artery banding and surgical correction of the associated lesions.
Roots of the Atkins diet
Authors: Timo Strandberg
Journal: BMJ (2005)

75% of our patients started receiving intravenous antibiotics after oral antibiotics had failed.This is a much higher proportion than reported in other studies and indicates that our threshold for giving intravenous antibiotics was appropriate. 1 3 6 The high degree of satisfaction with home treatment we found has been reported from other studies of "hospital at home" programmes. 10 11 Three studies have compared the costs of treatment for cellulitis and other acute medical conditions at home and in hospital. 1 5 12These studies found that home treatment was about half as costly as hospital treatment. Meaning of this studyPatients in the two treatment arms were comparable.These findings should be generalisable to other settings with comparable systems of healthcare delivery.Only about a third of patients requiring intravenous antibiotics for cellulitis were considered suitable for home treatment during the study period.Many patients with cellulitis will require admission to hospital because of their frailty, comorbidities, home situations, or the severity of their cellulitis.Patients clearly much prefer home treatment for cellulitis. Unanswered questions and future researchHaving twice daily visits from the nurse increased the costs of home treatment in this study.A report of home treatment using once daily intravenous antibiotics and nurse visits has shown that this is a safe option. 8We considered that only about one third of patients requiring intravenous antibiotics for cellulitis were suitable for home treatment, and it is possible that a higher proportion could have been safely treated at home.This study was too small to study predictors of failure of home intravenous antibiotic treatment.We thank Pegasus Health and their extended care nurses and the staff of the emergency department of Christchurch Hospital and Felicity Beats, Margaret Sutherland, and Alison Parsons.
Artificial hearts and blood pumps in the treatment of profound heart failure.
Authors: W S Pierce
Journal: Circulation (1983)

The recent clinical use of a pneumatic artificial heart at the University of Utah has focused attention on the role of blood pumps in the support of the circulation. Pneumatically powered assist pumps are now in clinical trials in patients with profound but reversible heart failure after open-heart surgery; survival rates as high as 50% in a heretofore lethal condition have been encouraging. The results of animal studies with the pneumatic artificial heart suggest that these devices are ready for clinical trials; the major application is likely to be as a bridge to cardiac transplantation. Implantable electric motor-driven assist pumps and artificial hearts are being evaluated in animals as permanent cardiac support or replacement devices; clinical use is projected to begin late in this decade. Initially, these devices will be employed in patients with end-stage cardiac disease who are not suitable candidates for cardiac transplantation or for whom donor hearts are not available. The availability of compact blood pumps will offer new forms of therapy to patients with certain types of profound heart failure.
Apolipoprotein E receptor 2 is involved in the thrombotic complications in a murine model of the antiphospholipid syndrome
Authors: Zurina Romay-Penabad, Renan Aguilar-Valenzuela, Rolf T. Urbanus, Ronald H. W. M. Derksen, Maarten T. T. Pennings, Elizabeth Papalardo, Tuya Shilagard, Gracie Vargas, Yong Hwang, Philip G. de Groot, Silvia S. Pierangeli
Journal: Blood (2010)
Urinary Incontinence in the Elderly
Authors: KATHRYN LARSEN BURGIO
Journal: Annals of Internal Medicine (1985)

Behavioral treatment of urinary incontinence was given to 39 elderly outpatients; 19 had stress incontinence, 12 detrusor motor instability, and 8 urge incontinence without instability. Biofeedback involving the bladder and sphincter was used to teach selective control of sphincter muscles or voluntary inhibition of detrusor contractions. Traditional behavioral methods used included habit training to gradually increase the voiding interval and relaxation training to cope with the urge to void. After an average 3.5 training sessions, patients with stress incontinence reduced the frequency of incontinent episodes an average of 82% (range, 55% to 100%). Patients with detrusor motor instability showed an average 85% improvement (range, 39% to 100%), and patients with urge incontinence reduced incontinence an average of 94% (range, 83% to 100%). Furthermore, 13 of the patients achieved total continence, and 19 had fewer than one accident per week after treatment.
Duodenal perforation following bile duct endoprosthesis placement
Authors: Pascal Kusters, Eric Keulen, Frank Peters
Journal: Endoscopy (2014)

A 66-year-old woman with abdominal pain and jaundice reported to our emergency department. An ultrasound examination revealed hepatic metastases with distension of the common bile duct, indicating a primary malignancy of the pancreas or bile ducts. After an unsuccessful attempt to restore bile outflow via stenting, a second endoscopic retrograde cholangiopancreatography (ERCP) was conducted. During this procedure, a stenosis of the left hepatic ducts was observed, raising suspicion of a primary malignancy of the bile ducts. Therefore, a 15-cm-long endoprosthesis was inserted in an attempt to secure the outflow of bile from the left hepatic system. The distal part of the endoprosthesis was locked in place, just external to the papilla ([Fig. 1]). Initial improvement during the first 2 days was quickly followed by the return of severe abdominal discomfort. Computed tomography revealed intra-abdominal fluid but no signs indicating a duodenal perforation, such as intra- or retroperitoneal air or retroperitoneal fluid collections ([Fig. 2]). Interestingly, drained abdominal fluid was found to resemble bile closely. A third ERCP showed the endoprosthesis penetrating the duodenal wall and acting as a plug, thus explaining the absence of intra-abdominal air and the bile-like characteristics of the abdominal fluid ([Fig. 3]). Possibly the high pressure on the endoprosthesis caused by the malignant process pushed it toward the duodenal wall, after which it penetrated the wall. The endoprosthesis was removed and the perforation sealed with endoclips; contrast was then applied adjacent to the duodenum to evaluate the seal ([Fig. 4]).
Multicenter Trials of Treatment for Empyema — After All These Years
Authors: John E. Heffner
Journal: New England Journal of Medicine (2005)

It is paradoxical that Hippocrates established in ancient times the clinical importance of pleural infections, yet only a few high-quality trials have studied this common condition during the intervening 2400 years. Just five years ago, published guidelines for the management of empyema1 could identify only three relevant controlled trials, with a combined enrollment of fewer than 100 patients. This lack of evidence results partly from difficulties that are inherent in investigating pleural infections, which represent heterogeneous disorders with outcomes strongly influenced by multiple factors that include coexisting illnesses, underlying lung function, the severity of associated pneumonia, the extent of pleural . . .
LIVE, ORALLY GIVEN POLIOVIRUS VACCINE
Authors: Albert B. Sabin
Journal: JAMA (1960)

The phenomenon of viral interference must be taken into account in planning the use of live poliovirus vaccine in areas where conditions favor the extensive dissemination of naturally occurring polioviruses. Experience with feeding a trivalent vaccine to 26,033 children in a tropical city of 100, 000 population led to the conclusion that interference was overcome by mass feeding of vaccine to 86% of all children under 11 years within a period of about four days, and that, because dissemination of the poliovirus was self-limited, a second feeding of trivalent vaccine was necessary to achieve immunization of almost all children. Recommendations are here formulated for the eradication of poliomyelitis, but they apply only to subtropical and tropical regions with extensive dissemination of various enteric viruses and not to temperate zones with good sanitation and hygiene during certain periods of the year and under conditions of low or absent dissemination of enteric viruses.
Eosinophilia presenting as acute coronary syndrome
Authors: Chun‐Yao Huang, Tse‐Min Lu, Chiao‐Po Hsu, An‐Hang Yang, Yu‐An Ding, Chern‐En Chiang
Journal: American Journal of Hematology (2004)

Eosinophilia Presenting as Acute Coronary SyndromeTo the Editor: Cardiovascular involvement in eosinophilia includes eosinophilic myocarditis, Lo¨ffler's endocarditis, and venous thromboembolism [1].Coronary vasculitis in major coronary artery with thrombus formation presenting as acute coronary syndrome was rarely reported. CASE REPORTA 27-year-old male was admitted with a 4-day history of exacerbating cough and dyspnea.He had had bronchial asthma for 2 years.Laboratory data showed a white blood cell count of 11.0 Â 10 9 /l, eosinophils 0.5 Â 10 9 /l, and C reactive protein 8.39 mg/dl.He was treated for acute asthma attack and bronchitis.However, his dyspnea deteriorated.CXR showed progressive enlargement of cardiac shadow and pulmonary edema.Coronary angiography revealed a total occlusion of the mid-left anterior descending coronary artery (LAD), and a large amount of thrombi in the left circumflex coronary artery.Antithrombin III, protein C, protein S, anti-nuclear antibody, and anti-cardiolipin antibody were normal.Percutaneous coronary intervention was unsuccessful.Ten days after admission, whole blood test showed eosinophilia (13.7 Â 10 9 /l).Endomyocardial biopsy disclosed eosinophilic endocarditis with mural thrombus (Fig. 1).Except for IgE of 4,497 IU/ml, the survey of the causes of eosinophilia was negative.There is no evidence of systemic vasculitis.Heart function deteriorated in spite of steroid therapy.He received orthotopic heart transplantation 6 months later.The pathology of the recipient's explanted heart revealed organized thrombus with recanalization within the original lumen of LAD.No evidence of atherosclerosis was found within coronary arteries.This case has two uncommon features.First, the initial eosinophil count only mildly elevated.We overlooked the diagnosis of eosinophilia until we rechecked the total eosinophil count again and performed the endomyocardial biopsy.Although the degree of organ damage usually correlates with the total eosinophil count [1], this case alerts us to re-examine the blood and the tissue involved when there is a clinical suspicion.The second uncommon feature is the presentation of acute coronary syndrome.Coronary involvement in eosinophilia usually limits to distal coronary arteries [2], as shown in patients with Churg-Strauss syndrome [3].Coronary vasculitis in major coronary artery with thrombus formation presenting as acute coronary syndrome, as in this case, was rarely reported in patients with eosinophilia.Eosinophils exert destructive effect on cardiomyocytes and endothelium by releasing eosinophil granule proteins, which in turn interfere with cell membrane permeability, mitochondria respiration, and intrinsic coagulation system [4].This case alerts us that, in patients with acute coronary syndrome, a past history of asthma, and a mildly elevated eosinophil count, eosinophilia with coronary thrombosis should be taken into account.
A False-Positive Test for Bile
Authors: Alexander Pollack
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I have recently had an interesting experience with a falsepositive test for bile with the BiliLabstix (Ames Co.). It turned out that the patient had acute intermittent porphyria, and I feel certain that the false-positive results were due to the presence of porphobilinogen; quantitative studies showed 137.0 mg of porphobilinogen in 24 hours (normal, 0 to 4 mg). The portion of the strip that tests for bile contains two reagents: dichloraniline diazonium salt for testing for bilirubin, and<i>p</i>-dimethylaminobenzaldehyde for testing for urobilinogen. The latter, of course, is the active reagent in Ehrlich aldehyde in the Watson-Schwartz test that reacts with both urobilinogen and porphobilinogen to produce a red color. To complete the Watson-Schwartz reaction, an organic solvent is needed to separate the urobilinogen aldehyde from the porphobilinogen. My purpose in calling this to your attention is to alert physicians to the possibility of acute intermittent
First genetic evidence of GABAA receptor dysfunction in epilepsy: a mutation in the γ2-subunit gene
Authors: Stéphanie Baulac, Gilles Huberfeld, Isabelle Gourfinkel-An, Georgia Mitropoulou, Alexandre Beranger, Jean-François Prud'homme, Michel Baulac, Alexis Brice, Roberto Bruzzone, Eric LeGuern
Journal: Nature Genetics (2001)
Screening Mammography and Risk of Breast Cancer
Authors: Ferris M. Hall
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Dr Kerlikowske and colleagues<sup>1</sup>state in their introduction that "approximately 11% of screening mammographic examinations performed in the United States are interpreted as abnormal, requiring the requesting physician to assess the likelihood that the mammographic finding represents breast cancer." These authors conclude by encouraging "radiologists to use the Breast Imaging Reporting and Data System [BIRADS] assessment categories when reporting screening mammography results, so that primary care physicians can interpret such results and use LRs [likelihood ratios] to estimate a woman's likelihood of breast cancer after screening mammography." I do not agree with the assumption of this article that primary care physicians need to personally assess the likelihood of breast carcinoma after the detection of abnormalities at screening mammography, most of which are nonpalpable. In the great majority of instances, the decision to obtain additional imaging studies and/or perform biopsy is a mammographic rather than clinical decision. In those few
DOCK8 is a Cdc42 activator critical for interstitial dendritic cell migration during immune responses
Authors: Yosuke Harada, Yoshihiko Tanaka, Masao Terasawa, Markus Pieczyk, Katsuyoshi Habiro, Tomoya Katakai, Kyoko Hanawa-Suetsugu, Mutsuko Kukimoto-Niino, Tomoko Nishizaki, Mikako Shirouzu, Xuefeng Duan, Takehito Uruno, Akihiko Nishikimi, Fumiyuki Sanematsu, Shigeyuki Yokoyama, Jens V. Stein, Tatsuo Kinashi, Yoshinori Fukui
Journal: Blood (2012)
Atopic Dermatitis (AD) and Eczema Herpeticum (EH): Role of Cathelicidins in Herpes Simplex Virus (HSV) Infection
Authors: D.Y.M. Leung, A. Wollenberg, R.L. Gallo, M. Flaig, N. Novak, T. Bieber, M. Boguniewicz, J.E. Streib, C. Wong, T. Pavicic, M.D. Howell
Journal: Journal of Allergy and Clinical Immunology (2006)
Nasotracheal Intubation in the Presence of Facial Fractures-Reply
Authors: Dennis B. Hall
Journal: JAMA (1989)

<h3>In Reply.—</h3> Early fixation of facial fractures in patients with multiple trauma was not an issue in the original question posed to<i>JAMA</i>to which I offered a response and I have no personal experience in this regard. While the concept of early fixation of facial fractures in patients with multiple trauma is interesting, I challenge these authors to produce definitive evidence that it results in a shorter hospital stay. I strongly disagree with their notion that one should perform blind nasotracheal intubation in patients with acute multiple trauma with a Le Fort II or III fracture because a cribriform plate fracture may be virtually impossible to rule out in the acute setting. I suggest that the paucity of cases involving "cranial intubation" may be due to widespread education of the medical community concerning the dangers of nasotracheal intubation in patients with facial fractures (ie, the Advanced Trauma Life Support
Staphylococcal Infection of a Starr–Edwards Prosthesis, with Fatal Obstruction of the Mitral Valve
Authors: O. Michael Colvin, Robert H. Waldman, Samuel Lee
Journal: New England Journal of Medicine (1965)

IN recent years there has been increasing use of artificial cardiac valves such as the ball valve described by Starr and Edwards¶ in 1961. This report describes a patient with a Starr—Edwards prosthesis who died from occlusion of the mitral valve by thrombus and bacterial vegetations eleven months after operation.Case ReportA 46-year-old woman was admitted to the Johns Hopkins Hospital for evaluation of fever on July 15, 1963. Twenty-three years previously mitral stenosis had been diagnosed, and in 1956 valvulotomy was performed. Five years later cardiac failure recurred, and atrial fibrillation developed. A markedly stenotic mitral valve was . . .
Renal Failure and Tubular Dysfunction due to Zomepirac Therapy
Authors: Sanford E. Warren
Journal: JAMA (1983)

RENAL failure has been described due to the use of several nonsteroidal anti-inflammatory drugs that are also inhibitors of prostaglandin synthesis—phenylbutazone,<sup>1</sup>indomethacin,<sup>2</sup>aspirin,<sup>3</sup>fenoprofen,<sup>4</sup>tolmetin,<sup>5</sup>naproxen,<sup>6</sup>and ibuprofen.<sup>6</sup>This report describes acute reversible decline in glomerular filtration rate (GFR) associated with use of zomepirac sodium (Zomax), a new nonnarcotic analgesic that is also an in vitro inhibitor of prostaglandin synthesis. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 65-year-old woman was undergoing treatment for multiple medical problems, including late-onset multiple sclerosis, hypertension, hypothyroidism, and a mixed connective-tissue disease syndrome of nondeforming arthritis, esophageal dysfunction, intermittently present speckled antinuclear antibodies, and increased ESR. She had, in addition, undergone mastectomies in 1949 and 1962 for breast carcinoma, without subsequent recurrence. She came to the nephrology service in 1979 with subnephrotic-range proteinuria and a creatinine clearance of 65 mL/min. Renal biopsy was deferred because of her fragile medical
Biology of Aurora A kinase: Implications in cancer manifestation and therapy
Authors: Dhanasekaran Karthigeyan, Sallekoppal B. Benaka Prasad, Jayasha Shandilya, Shipra Agrawal, Tapas K. Kundu
Journal: Medicinal Research Reviews (2010)

The Aurora A kinase belongs to serine/threonine group of kinases, well known for its role in cell cycle, especially in the regulation of mitosis. Numerous substrates of Aurora A kinase have been identified, which are predominantly related to cell cycle progression while some of them are transcription factors. Aurora A-mediated phosphorylation can either directly or indirectly regulate the function of its substrates. There are overwhelming evidences which report overexpression and gene amplification of Aurora A in several human cancers, and suggest that Aurora A could be a bona fide oncogene involved in tumorigenesis. Hence, Aurora A plays wide-ranging roles in both mitosis and its deregulation manifests in cancer progression. These observations have favored the choice of Aurora kinases as a target for cancer therapy. Recently, numerous small molecules have been discovered against Aurora kinases and many have entered clinical trials. Most of these small-molecule modulators designed are specific against either Aurora A or Aurora B, but some are dual inhibitors targeting the ATP-binding site which is highly conserved among the three human homologues of Aurora kinase. In this review, we discuss the physiological functions of Aurora A, interactions between Aurora A kinase and its cellular substrates, tumorigenesis mediated by Aurora A kinase upon overexpression, and small-molecule modulators of Aurora kinase as targets for cancer therapy. © 2010 Wiley Periodicals, Inc. Med Res Rev 31: 757-793, 2011
Intra-aortic balloon pumping in infants and children.
Authors: L G Veasy, R C Blalock, J L Orth, M M Boucek
Journal: Circulation (1983)

From November 1981 to November 1982, intra-aortic balloon pumping (IABP) was used after surgery in eight patients who were from 6 weeks to 6 years old and who weighed from 4.2 to 16.2 kg. In seven patients, specially constructed intra-aortic balloons with 2.5 and 5.0 ml volumes mounted on No. 5F catheters were used. In the largest and oldest patient, a two-chamber 10 ml balloon was used. The pumping module used was the Datascope System 82. Effective diastolic augmentation of arterial pressure was accomplished in seven of the eight patients and suprasystolic diastolic augmentation was accomplished in four. The two youngest and smallest patients are the only long-term survivors. There were two short-term survivors who died 5 and 10 days after successful IABP. In only one patient was there no appreciable effect of IABP. Miniaturization of the equipment has permitted IABP to be used effectively in pediatric patients.
Hypovolemic Shock and Edema Due to Increased Capillary Permeability
Authors: Melvin Horwith
Journal: JAMA (1967)

A patient had fatal hypovolemic shock and edema. As in previously reported cases, the mechanism of shock appears to be loss of protein and fluid from the vascular bed. Extensive studies of all patients have revealed no cause for this extraordinary vascular permeability. Analysis of the reported cases suggests that subsequent patients with this syndrome should have analyses performed to determine the presence of vascular reactants such as kinins. A study of these cases suggests a method of treatment of similar episodes of hypovolemic shock. Observations from this case and the one previously reported from this center suggest that vasopressor agents such as catecholamines probably are contraindicated.