tbuckley/cabot-search huggingface dataset:
Early, Therapeutic, Social and Vocational Problems in the Rehabilitation of Persons With Spinal Cord Injuries
Authors: Edward E. Gordon
Journal: JAMA (1979)

Dr Weiss (of instant prosthesis fame) and his colleagues have presented a remarkable treatise on vertebral and spinal cord injuries created out of their own experiences and investigations. Some aspects are treated encyclopedically, particularly the detailed discussion on pros and cons of various orthopedic procedures to achieve stabilization and anatomic normalization of the canal. The main author further pursues his experiences with balanced spring fixation for spine instability, devoting a third of the book to the surgical technique, biomechanical experiments of spring fixation, and clinical results in 152 cases complete with roentgenographic documentation. Further original work applies to clinical and experimental pathological characteristics of traumatic myelopathy, theoretical and clinical considerations of the distressing problem of spasticity, and some pathophysiological investigations of the Hoffmann reflex (evoked muscle potential by discharge from anterior horn cells by stimulation of afferents in a mixed nerve trunk), which disclosed that the cord in spinal shock
The 31st Pilgrim---Sister Bettie
Authors: J W Fletcher
Journal: BMJ (2002)

A sister too, there was, a worthy woman

> That in her own ward held just dominion,
> 
> A wenche thikke and well-I-growen was
> 
> With pointed nose and eyghen mischievous
> 
> And buttocks brode and brestes round and hye
> 
> But right fair werr her cheekes, I wol not lye.
> 
> Girt close she was with starched apron
> 
> In proper modesty and nice discretion
> 
> While at her waist she wore a belte red
> 
> A smalle cap she had upon her head.
> 
> About the …
Maharishi Ayur-Veda
Authors: Gordon C. White
Journal: JAMA (1991)

To the Editor.  —My objection to the Letter From New Delhi1 is not toward the potential usefulness of Ayur-Veda, but to the inconclusiveness of some of the research cited by the authors to substantiate their claims of its usefulness.  Under  Mind , regarding the 500 studies on the effects of TM, when errors that can result from preselection, experimenter effects, and expectancy/ placebo effects are taken into consideration, most of the research referred to is of questionable validity.  More specifically, the reference that the authors cite 2 to document  changes indicative of a state of restful alertness, is over 16 years old. More recent and in-depth research on the metabolic effects of TM has been published by Kesterson and Clinch, 3 who state that TM did not produce a hypometabolic state as reported before and that the decrease in metabolism observed in their subjects was equivalent to that observed in
Shouldn't Adults with Growth Hormone Deficiency Be Offered Growth Hormone Replacement Therapy?
Authors: David M. Cook
Journal: Annals of Internal Medicine (2002)

Growth hormone as therapy for adults with growth hormone deficiency has not been universally accepted by endocrinologists who treat adult patients. The following are addressed in this commentary: the evidence on safety and efficacy in the literature supporting the idea that growth hormone should be offered as replacement therapy to adults who are growth hormone deficient; common concerns of the average prescribing endocrinologist, including the purported association between insulin-like growth factor-I and malignant neoplasms and quality-of-life issues with long-term therapy; and controversial subjects, such as differences in dosing for adults versus children and diagnostic issues. This analysis should encourage reluctant practitioners to at least consider growth hormone replacement therapy for patients with definite growth hormone deficiency—that is, patients with symptomatic panhypopituitarism.
Negative pigment network: An additional dermoscopic feature for the diagnosis of melanoma
Authors: Maria A. Pizzichetta, Renato Talamini, Ash A. Marghoob, H. Peter Soyer, Giuseppe Argenziano, Riccardo Bono, M. Teresa Corradin, Vincenzo De Giorgi, Marian A. Gonzalez, Isabel Kolm, Andrew W. Kopf, Joseph Malvehy, Niccolò Nami, Margaret Oliviero, Giovanni Pellacani, Susana Puig, Harold Rabinovitz, Pietro Rubegni, Stefania Seidenari, Ignazio Stanganelli, Andrea Veronesi, Iris Zalaudek, Pierfrancesco Zampieri, Scott W. Menzies
Journal: Journal of the American Academy of Dermatology (2012)
Thyroid Storm With Normal Serum Triiodothyronine Level During Diabetic Ketoacidosis
Authors: Naseer Ahmad
Journal: JAMA (1981)

IT IS now established that nonthyroidal illness can alter thyroid hormone metabolism in such a way that the serum level of triiodothyronine (T<sub>3</sub>) is decreased and the level of reverse triiodothyronine (rT<sub>3</sub>) is elevated in otherwise euthyroid persons.<sup>1</sup>The list of such nonthyroidal illnesses in which these findings occur has been growing. In patients with hyperthyroidism and intercurrent, nonthyroidal illness, the serum T<sub>3</sub>level may be normal or even less than normal and there is a concomitant increase in the rT<sub>3</sub>level.<sup>2-4</sup>Although one recent report describes a patient with diabetic ketoacidosis, hyperthyroidism, and a normal T<sub>3</sub>level,<sup>4</sup>and another describes a patient in whom thyroid storm developed postoperatively and who at that time had a normal T<sub>3</sub>level,<sup>5</sup>the occurrence of thyroid storm in a patient with a normal T<sub>3</sub>level and severe intercurrent illness has not been
James D. Waltner, MD: doctor for a small planet
Authors: Elizabeth Rasche González
Journal: JAMA (1980)

In the emergency room last night, 13-year-old Tommy was screaming and vomiting. He had gulped down half a 10-oz bottle of Nyquil, and the ephedrine was wreaking havoc with him. This morning he has only a very bad hangover—and a visitor. The visitor, who is presently stopping by the nurse's station en route to Tommy's hospital room, is an ordained minister in the Universal Life Church, a conscientious objector, a talented musician, and an expert in animal husbandry who finds a flock of dependent but misanthropic geese preferable to watchdogs for guarding his wood-and-solar-heated home in the mountains of northern New Mexico. James D. Waltner, MD, is also pediatrician, adopted uncle, surrogate parent, and health educator to hundreds of families in Rio Arriba County, one of the most economically depressed areas in the nation. Most of his patients are direct descendents of the Spanish<i>conquistadores</i>. A few are Native American
Interstitial Pulmonary Edema
Authors: ARNOLD CHAIT
Journal: Circulation (1972)

The diagnosis of interstitial pulmonary edema can be made only on the basis of the chest roentgenogram. This often is the first sign of left heart failure, which may be completely unsuspected clinically in the absence of alveolar edema. Kerley lines, or septal lines, are the most familiar roentgen sign of this condition. Other, more common findings include: perivascular and peribronchial cuffing, subpleural thickening, perihilar haze, and a generalized loss of translucency of the lung. Meticulous roentgen technic is essential for recognition of these subtle signs.
A Study in Frontal Plane Vectorballistocardiography
Authors: GWENDOLYN L. MORRIS, JOHN R. BRAUNSTEIN
Journal: Circulation (1955)

Frontal plane ballistocardiograms obtained from 10 normal subjects were analyzed and compared with abnormal records obtained from patients with known cardiovascular disease. The normal vector loop is described, and the importance of the transverse ballistocardiogram is discussed. It is suggested that the orientation of the J loop may be related to the anatomic position of the heart. No such relationship was noted with the frontal plane H, I or K vector loops.
Lung cancer in Malaysia.
Authors: M A Menon, H S Saw
Journal: Thorax (1979)

Between 1967 and 1976, 388 cases of lung cancer were seen at the University Hospital, Kuala Lumpur, with histological confirmation in 72%. Most were aged from 50--80, with a male to female ratio of 2.8 : 1. The patients were predominantly of Chinese origin (82%) and from the lower socioeconomic strata. A history of smoking was elicited in 78%. The chief clinical and radiological features and the diagnostic methods are presented. The incidence of the histological types was squamous carcinoma 34%, adenocarcinoma 25%, large cell carcinoma 12%, small (oat) cell carcinoma 12%, "unidifferentiated/anaplastic" 15%, and others 2%. Malays appeared to have a higher percentage of adenocarcinoma. A comparison between the histologically confirmed group and the rest showed no significant difference in features. Problems pertaining to the management of Malaysian patients are discussed.
Upper body pain: possible tipoff to Pancoast tumor
Authors: Terra Ziporyn
Journal: JAMA (1981)

The bone scans and chest and spine films may say no, but the pain says yes. In patients with Pancoast (superior pulmonary sulcus) tumors, at least, the most reliable indicator of initial, recurrent, or progressive disease may be as simple as pain in the shoulder, chest, or arm. Pancoast tumors represent 3% to 4% of all lung cancers and often can be detected only by an apical lordotic chest film, which is not routinely requested. Moreover, because of the tumors' proximity to the brachial plexus and the spinal column, one of their major neurological complications, epidural spinal cord compression (ESCC), may be missed. According to Ronald M. Kanner, MD, initial radiation therapy for the tumor may include the vertebral body and reduce osteoblastic activity, or the tumor may grow into the intervertebral foramen without producing bone changes. Thus, the ability of bone scans to detect ESCC is impeded. Myelography is
Abstract P6-11-11: Trastuzumab beyond Progression in HER2-Positive Advanced Breast Cancer: The Royal Marsden Experience
Authors: T Waddell, A Kotsori, A Constantinidou, N Yousaf, S Ashley, M Parton, S Johnston, I. Smith
Journal: Cancer Research (2010)

Abstract Background: Routine clinical practice and a growing body of evidence support the continuation of trastuzumab (T) in patients with HER-2 positive (+ve) advanced breast cancer progressing on previous T-based therapy. Despite this, recent UK clinical guidance advises against continuing T on evidence of disease progression (PD) in the absence of brain metastases. This retrospective study therefore evaluated the outcome of patients (pts) with HER-2+ve locally advanced (LA) or metastatic breast cancer (MBC) who continued T beyond PD, treated in our Unit. Patients and methods: HER-2+ve pts receiving T for LA or MBC were identified from our prospectively maintained database and pharmacy records. Those receiving T beyond PD after adjuvant or one line of T for advanced disease were assessed for response and outcome. From thetimepoint of T continuation beyond PD we calculated the overall disease control rate (response or stable disease), time to progression (TTP), and overall survival (OS). Results: 114 pts with HER-2+ve LA or MBC treated with T beyond PD were identified. At the time of analysis 35 (31%) pts were still alive with a median follow up of 20 months (mo). The main site of disease was visceral in 84 (74%) pts, including 37 (32%) pts with CNS involvement. 30 (26%) pts had soft tissue or bone metastases only. Fifty nine (52%) pts had received adjuvant chemotherapy and 13 (11%) pts had received adjuvant T. Seventy six (66%) pts had 1 line of chemotherapy prior to continuation of T beyond PD and 21 (19%) had 2 or more lines. Fifty three (46%) pts had previously received taxanes + T for their LA or MBC. Post-progression, 66 (58%) pts received T combined with chemotherapy; 12 (11%) taxane-based, 32 (28%) capecitabine and 22 (19%) vinorelbine. Information regarding response was not available in 21(18%) pts. Of the ninety three (82%) pts with documented clinical (n=16) or radiological (n=77) response evaluation, 68 (60%) pts were considered as having stable disease (SD) or better and 25 (22%) as having PD. The median duration of T was 10 mo (95% CI: 8-11 mo), the median TTP was 24wks (95% CI: 21-28 wks) and the median OS was 19 mo (95% CI:12-24mo). In a sub-group analysis of the 81(71%) pts who received T as first-line Rx or relapsed within 12 wks of adjuvant T, overall disease control was achieved in 50 (61%) pts, the median TTP was 25wks (95% CI:18-33 wks) and the median OS was 22 mo(95% CI:17-27mo). In terms of safety, only 6 (5%) pts overall had to discontinue T secondary to decline in left ventricular ejection fraction. Conclusion: Our results from an unselected group of patients are supported by positive results from other studies and provide additional evidence that continuation of trastuzumab beyond disease progression is of clinical benefit. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-11-11.
Association Between IL-13 -1112 C/T Promoter Polymorphism and Patterns of Allergen-Induced Asthmatic Response in House Dust Mite Allergic Patients
Authors: Krzysztof Kowal, Pawel Bernatowicz, Agnieszka Pampuch, Lech Chyczewski, Anna Bodzenta-Lukaszyk
Journal: Journal of Allergy and Clinical Immunology (2015)
Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort
Authors: D. A Mulrooney, M. W Yeazel, T. Kawashima, A. C Mertens, P. Mitby, M. Stovall, S. S Donaldson, D. M Green, C. A Sklar, L. L Robison, W. M Leisenring
Journal: BMJ (2009)

<b>Objectives </b>To assess the incidence of and risks for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities among adult survivors of childhood and adolescent cancers. <b>Design </b>Retrospective cohort study. <b>Setting </b>26 institutions that participated in the Childhood Cancer Survivor Study. <b>Participants </b>14 358 five year survivors of cancer diagnosed under the age of 21 with leukaemia, brain cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, kidney cancer, neuroblastoma, soft tissue sarcoma, or bone cancer between 1970 and 1986. Comparison group included 3899 siblings of cancer survivors. <b>Main outcome measures </b>Participants or their parents (in participants aged less than 18 years) completed a questionnaire collecting information on demographic characteristics, height, weight, health habits, medical conditions, and surgical procedures occurring since diagnosis. The main outcome measures were the incidence of and risk factors for congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities in survivors of cancer compared with siblings. <b>Results </b>Survivors of cancer were significantly more likely than siblings to report congestive heart failure (hazard ratio (HR) 5.9, 95% confidence interval 3.4 to 9.6; P&lt;0.001), myocardial infarction (HR 5.0, 95% CI 2.3 to 10.4; P&lt;0.001), pericardial disease (HR 6.3, 95% CI 3.3 to 11.9; P&lt;0.001), or valvular abnormalities (HR 4.8, 95% CI 3.0 to 7.6; P&lt;0.001). Exposure to 250 mg/m<sup>2</sup> or more of anthracyclines increased the relative hazard of congestive heart failure, pericardial disease, and valvular abnormalities by two to five times compared with survivors who had not been exposed to anthracyclines. Cardiac radiation exposure of 1500 centigray or more increased the relative hazard of congestive heart failure, myocardial infarction, pericardial disease, and valvular abnormalities by twofold to sixfold compared to non-irradiated survivors. The cumulative incidence of adverse cardiac outcomes in cancer survivors continued to increase up to 30 years after diagnosis. <b>Conclusion </b>Survivors of childhood and adolescent cancer are at substantial risk for cardiovascular disease. Healthcare professionals must be aware of these risks when caring for this growing population.
<i><scp>S</scp>taphylococcus aureus</i>‐derived extracellular vesicles induce neutrophilic pulmonary inflammation via both <scp>T</scp>h1 and <scp>T</scp>h17 cell responses
Authors: M.‐R. Kim, S.‐W. Hong, E.‐B. Choi, W.‐H. Lee, Y.‐S. Kim, S. G. Jeon, M. H. Jang, Y. S. Gho, Y.‐K. Kim
Journal: Allergy (2012)

Abstract Background Recent evidence indicates that S taphylococcus aureus , one of the most important human pathogens, secretes vesicles into the extracellular milieu. Objective To evaluate whether inhalation of S . aureus ‐derived extracellular vesicles ( EV ) is causally related to the pathogenesis of inflammatory pulmonary diseases. Methods S taphylococcus aureus EV were prepared by sequential ultrafiltration and ultracentrifugation. The innate immune response was evaluated in vitro after the application of EV to airway epithelial cells and alveolar macrophages. In vivo innate and adaptive immune responses were evaluated after airway exposure to EV . Adjuvant effects of EV on the development of hypersensitivity to inhaled allergens were also evaluated after airway sensitization with S . aureus EV and ovalbumin ( OVA ). Results Staphylococcus aureus and S . aureus EV were detected in house dust. Alveolar macrophages produced both tumor necrosis α ( TNF ‐α) and interleukin 6 ( IL ‐6) after in vitro stimulation with S . aureus EV , whereas airway epithelial cells produced only IL ‐6. Repeated airway exposure to S . aureus EV induced both T h1 and T h17 cell responses and neutrophilic pulmonary inflammation, mainly via a Toll‐like receptor 2 ( TLR 2)‐dependent mechanism. In terms of adjuvant effects, airway sensitization with S . aureus EV and OVA resulted in neutrophilic pulmonary inflammation after O VA challenge alone. This phenotype was partly reversed by the absence of interferon γ ( IFN ‐γ) or IL ‐17. Conclusion S taphylococcus aureus EV can induce T h1 and T h17 neutrophilic pulmonary inflammation, mainly in a TLR 2‐dependent manner. Additionally, S . aureus EV enhance the development of airway hypersensitivity to inhaled allergens.
Aspirin inhibits ox-LDL-mediated LOX-1 expression and metalloproteinase-1 in human coronary endothelial cells
Authors: J MEHTA, J CHEN, F YU, D LI
Journal: Cardiovascular Research (2004)

Aspirin is thought to exert salutary effects in vascular disease states by inhibiting platelet aggregation. Endothelial activation, accumulation of oxidized low-density lipoprotein (ox-LDL) and intense inflammation also characterize atherosclerotic plaque in acute myocardial ischemia. Ox-LDL induces expression of lectin-like receptors (LOX-1) on endothelial cells and leads to the expression of matrix metalloproteinases (MMPs), which destabilize the atherosclerotic plaque. We hypothesized that aspirin may interfere with LOX-1 expression and subsequent MMP activation.Cultured human coronary artery endothelial cells (HCAECs) were incubated with aspirin (1-5 mM), sodium salicylate (5 mM) or the cyclo-oxygenase inhibitor indomethacin (0.25 mM) before treatment with ox-LDL. Aspirin, in a dose- and time-dependent fashion, reduced ox-LDL-mediated LOX-1 expression (P<0.01). Ox-LDL also increased MMP-1 expression and activity, and treatment of HCAECs with aspirin decreased this effect (P<0.01). Ox-LDL also enhanced the activity of p38MAPK in HCAECs, and aspirin blocked this effect of ox-LDL (P<0.01). Treatment of HCAECs with salicylate, but not indomethacin, resulted in a suppression of LOX-1 expression, an effect similar to that of aspirin. Importantly, both aspirin and salicylate, but not indomethacin, decreased superoxide anion generation in ox-LDL-treated HCAECs (P<0.05).These observations suggest that aspirin inhibits ox-LDL-mediated LOX-1 expression and interferes with the effects of ox-LDL in intracellular signaling (p38MAPK activation) and subsequent MMP-1 activity. These novel effects of aspirin may complement its platelet inhibitory effect in acute myocardial ischemia.
Topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjögren syndrome
Authors: Peter Marsh, Stephen C Pflugfelder
Journal: Ophthalmology (1999)

Objective To review the efficacy and side effects of topical nonpreserved corticosteroid therapy for treatment of severe keratoconjunctivitis associated with Sjögren syndrome. Design Retrospective, noncomparative case series. Participants Twenty-one patients with Sjögren syndrome-associated keratoconjunctivitis sicca and annoying ocular irritation. Intervention Treatment with topical nonpreserved methylprednisolone sodium succinate. Main outcome measures Symptom severity, frequency of instillation of artificial tears, corneal fluorescein staining scores, resolution of filamentary keratitis, steroid-related side effects. Results Before starting methylprednisolone therapy, all patients were experiencing moderate-to-severe eye irritation despite prior punctal occlusion in most cases and frequent use of nonpreserved artificial tears by all. After 2 weeks of topical application, three to four times per day, moderate (43%) or complete (57%) relief of irritation symptoms was experienced by all patients and no complications were observed. An average decrease in corneal fluorescein scores of 2.6 ± 0.5 points (on a 12-point scale) was observed, and filamentary keratitis resolved in all ten eyes with this condition. Therapy was stopped after 2 weeks in eight patients, and six of these patients reported that their symptoms remained at a tolerable level for weeks to months. Lower dose steroid therapy was continued in the remaining patients, whose symptoms worsened after attempted weaning. Complications of corticosteroid therapy in patients receiving prolonged therapy included increased intraocular pressure in one patient at 3 months, worsening of pre-existing posterior subcapsular cataracts in one patient at 6 months, and formation of posterior subcapsular cataracts in another patient at 6 months. Conclusions These findings indicate that topical nonpreserved methylprednisolone is an effective treatment option for patients suffering from severe keratoconjunctivitis sicca who continue to experience bothersome eye irritation despite maximum aqueous enhancement therapies. They also suggest that inflammation is a key pathogenic factor in this condition. Careful monitoring is essential in dry eye patients treated with corticosteroids for more than 2 weeks because steroid-related complications (increased intraocular pressure and cataract formation) were observed after several months of therapy in this series. Because of the chronic nature of this disease and the likelihood of patients developing steroid-related complications with their long-term use, topical nonpreserved methylprednisolone therapy appears to be most appropriate for short-term “pulse” treatment of exacerbations of keratoconjunctivitis sicca.