tbuckley/cabot-search huggingface dataset:
The Thucydides Syndrome: The Authors Reply
Authors: Alexander D. Langmuir, Thomas D. Worthen, Jon Solomon, C. George Ray, Eskild Petersen
Journal: New England Journal of Medicine (1986)

The observations of Poole and Holladay1 in 1979, that the microbial parasite and host complex is in constant flux and therefore that historians of medicine must be duly cautious when attributing a currently named disease or syndrome to an ancient description, were fundamental to our original proposition. None-theless, we have taken the view, dismissed by them, that the plague of Athens was a disease or mixture of diseases that Thucydides described well enough to enable us to recognize it.We cannot speculate about which of our 13 hemagglutinin types of influenza, if any, was prevalent in Thucydides' day or how . . .
Malignant otitis externa.
Authors: R Mills
Journal: BMJ (1986)

<h3>Background</h3> Therapy related myeloid neoplasms (t-MNs) are complex diseases originating from an interplay between exogenous toxicities and a susceptible organism. It has been hypothesised that in a subset of cases t-MNs develop in the context of hereditary cancer predisposition syndromes. <h3>Methods</h3> The study systematically evaluated pedigrees of patients with t-MNs for cancer incidences and the possibility of a hereditary cancer predisposition syndrome. In addition, mutational analyses were performed using constitutional DNA from index patients, and deleterious heterozygous germline mutations were assessed for loss of heterozygosity in sorted leukaemic cells by single nucleotide polymorphism array. <h3>Results</h3> A nuclear pedigree was obtained in 51/53 patients with t-MNs resulting in a total of 828 individuals analysed. With a standardised incidence ratio of 1.03 (95% CI 0.74 to 1.39), the tumour incidence of first- degree relatives was not increased. However, six pedigrees were suggestive for a hereditary breast and ovarian cancer syndrome, three of a Li-Fraumeni like syndrome, and three index patients showed multiple primary neoplasms. Mutational analysis revealed two <i>BRCA1</i> (c.3112G→T, c.5251C→T), one <i>BRCA2</i> (c.4027A→G), two <i>BARD1</i> (C557S) and four <i>TP53</i> germline mutations (g.18508_18761delinsGCC, c.847C→T, c.845_848dupGGCG, c.1146delA) in nine of 53 (17%) index patients with t-MNs. Loss of heterozygosity in leukaemic cells was demonstrated for the <i>BRCA1</i>c.3112G→T and <i>TP53</i>c.845_848dupGGCG mutations, respectively. <h3>Conclusion</h3> It is concluded that a proportion of patients with t-MNs carry cancer susceptibility mutations which are likely to contribute to therapy related leukaemogenesis.
Activation of serotonin receptor-2B rescues small-for-size liver graft failure in mice
Authors: Yinghua Tian, Rolf Graf, Ashraf Mohammad El-Badry, Mickaël Lesurtel, Katarzyna Furrer, Wolfgang Moritz, Pierre-Alain Clavien
Journal: Hepatology (2010)

The implantation of grafts below 30% of the normal liver volume is associated with a high risk of failure known as small-for-size (SFS) syndrome. Strategies to rescue small grafts may have a dramatic impact on organ shortage. Serotonin is a potent growth factor for the liver. The goal of this study was to determine whether enhanced serotonin signaling could prevent the deleterious effects of SFS syndrome. We performed 30% normal liver volume transplantations in wild-type C57/BL6 and interleukin-6 (IL-6)−/− mice. Some animals received α-methyl-5-HT (DOI), an agonist of serotonin receptor-2 (5-HT2B). Endpoints included long-term survival, serum and hepatic markers of liver injury and regeneration, assessment of hepatic microcirculation by intravital fluorescence microscopy and scanning electron microscopy, and transcript levels of a variety of serotonin receptors, tumor necrosis factor α, and IL-6. All recipients of small grafts (controls) died within 2-4 days of transplantation, whereas half of those receiving DOI survived permanently. Control animals disclosed major liver injury, including diffuse microvesicular steatosis in hepatocytes, impairment of microcirculation, and a failure of regeneration, whereas these parameters were dramatically improved in animals subjected to DOI. Blockage of 5-HT2B blunted the protective effects of DOI. Whereas IL-6 levels were higher in DOI-treated animals, IL-6−/− mice were still protected by DOI, suggesting a protective pathway independent of IL-6. Conclusion: Serotonin through its action on receptor-2B protects SFS liver grafts from injury and prevents microcirculation and regeneration. The mechanism of hepato-protection is independent of IL-6. (Hepatology 2011;)
A Natural History of Athleticism and Cardiovascular Health
Authors: Ralph S. Paffenbarger
Journal: JAMA (1984)

Epidemiologic studies in Olympic year 1984 suggest that personal athleticism alters trends in life-style and coronary heart disease. Analysis of 572 first attacks among 16,936 Harvard alumni, 1962 to 1972, and 1,413 total deaths, 1962 to 1978, shows that habitual postcollege exercise, not student sports play, predicts low coronary heart disease risk. Sedentary alumni, even ex-varsity athletes, have high risk. Sedentary students becoming physically active alumni acquire low risk. Exercise benefit is independent of contrary life-style elements—smoking, obesity, weight gain, hypertension, and adverse parental disease history—in affecting coronary heart disease incidence. Hypertension is clinically the strongest predictor of coronary attack, but inadequate exercise is strongest on a community basis. Exercise level is inversely related to total, cardiovascular, and respiratory mortality but less related to cancer or unnatural deaths. The current exercise revolution may improve life-style, cardiovascular health, and longevity. (<i>JAMA</i>1984;252:491-495)
Effect of cimetidine on gastric secretion and duodenogastric reflux.
Authors: R J Melville, S I Suleiman, P F Whitfield, J V Parkin, T O Nwabunike, M Hobsley
Journal: Gut (1985)

In 19 subjects (four controls, one gastric ulcer and 14 duodenal ulcer) maximal gastric secretion was evoked with histamine 0.13 mumol/kg/h (0.04 mg/kg/h) for two to two and a half hours. A slow intravenous bolus dose of 200 mg cimetidine was given at the beginning of the last hour. Gastric secretion was measured before and after cimetidine administration and expressed both as mean acid output (mmol H+/h) and 9pyloric loss and duodenogastric reflux corrected9 volume (Vg, ml/h). Mean reduction by acid output was 86%; mean reduction by corrected volume (Vg) was only 64%. The discrepancy, which is significant (p less than 0.01), is caused by a marked increase in duodenogastric reflux after cimetidine.
Scrotal cutaneous chylous reflux
Authors: H-Y. Huang, S-L. Hu
Journal: British Journal of Dermatology (2007)

Conflicts of interest: none declared. Sir, Chylous reflux from the skin is usually associated with an underlying defect in the lymphatic vessels. We report an unusual case of scrotal cutaneous chylous reflux with clinically numerous vesicles over the scrotum and large amounts of milky fluid draining intermittently from these vesicles. A 17‐year‐old boy had had intermittent whitish discharge from the vesicles of the scrotum for 2–3 years. Each episode could be resolved after compression and bed rest. The size of the vesicles increased after the patient stood for a long time. There was no oedema of the bilateral lower extremities or erectile dysfunction. There was no history of surgery or trauma. His development and growth were within normal limits. Physical examination showed numerous 2–6 mm diameter whitish to yellowish vesicles confluent over the scrotum, with thickening of the scrotal skin (Fig. 1a). In addition, several 1–2 mm diameter whitish vesicles were scattered over the base of the penis and three or four whitish vesicles were grouped over the medial aspect of the upper right thigh. Large amounts of milk‐like fluid discharged intermittently from these vesicles after abrasion (Fig. 1b).
Diabetes Care in the Veterans Affairs System and in Managed Care
Authors: Michael A. Patmas
Journal: Annals of Internal Medicine (2005)

Letters18 January 2005Diabetes Care in the Veterans Affairs System and in Managed CareMichael A. Patmas, MD, MMMMichael A. Patmas, MD, MMMFrom Providence Portland Medical Center, Portland, OR 97213.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-2-200501180-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kerr and colleagues' article (1) comparing diabetes care in the Veterans Affairs (VA) system and in managed care reflects a deep misunderstanding of what managed care means. Furthermore, their conclusion is self-serving and misleading. The VA system is, in fact, the largest managed care organization in the United States. Analogous to a staff-model health maintenance organization, the VA benefits from having enterprise-wide electronic medical records, employed physicians with restrictive formularies, and direct control over the practice patterns of those physicians through mandated use of practice guidelines. Commercial managed care plans rely on contracted physicians who are generally ...Reference1. Kerr EA, Gerzoff RB, Krein SL, Selby JV, Piette JD, Curb JD, et al. Diabetes care quality in the Veterans Affairs Health Care System and commercial managed care: the TRIAD study. Ann Intern Med. 2004;141:272-81. [PMID: 15313743] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael A. Patmas, MD, MMMAffiliations: From Providence Portland Medical Center, Portland, OR 97213. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: The TRIAD Study Eve A. Kerr , Robert B. Gerzoff , Sarah L. Krein , Joseph V. Selby , John D. Piette , J. David Curb , William H. Herman , David G. Marrero , K.M. Venkat Narayan , Monika M. Safford , Theodore Thompson , and Carol M. Mangione Diabetes Care in the Veterans Affairs System and in Managed Care Eve A. Kerr and Carol M. Mangione Metrics 18 January 2005Volume 142, Issue 2Page: 154KeywordsElectrode recordingElectronic medical recordsHealth careHealth care qualityHealth maintenance organizations ePublished: 18 January 2005 Issue Published: 18 January 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Metabolic consequences of salbutamol poisoning reversed by propranolol.
Authors: J M Connell, G M Cook, G T McInnes
Journal: BMJ (1982)

Metabolic consequences of salbutamol poisoning reversed by propranololAdministration of salbutamol, a beta2-adrenoreceptor agonist, is associated with several metabolic consequences including disturbances of carbohydrate, lipid, and potassium homeostasis.5Although the importance of these effects during therapeutic use of the drug is not clear, severe hypokalaemia has been reported after salbutamol poisoning.2As evidence suggests that the metabolic effects are due to beta-adrenoreceptor stimulation3 it seems logical to treat these results of salbutamol poisoning with a beta-adrenergic antagonist.We report a case in which salbutamol-induced hypokalaemia was managed successfully with propranolol. Case reportA previously healthy 17-year-old girl was admitted having taken an unspecified quantity of salbutamol 2 mg tablets (Ventolin) three hours previously.On admission she was agitated and tremulous and had a tachycardia of 156 beats/minute: an electrocardiogram showed the rhythm to be sinus.Blood pressure was 110/60 mm Hg.Gastric lavage was performed with no appreciable tablet return.Initial investigation showed a plasma
Hazards of High-Dose Meperidine
Authors: Lee Morisy
Journal: JAMA (1986)

<h3>To the Editor.—</h3> We recently observed a patient who developed excitatory side effects of the central nervous system (CNS) on two separate occasions while receiving high-dose meperidine for the management of pancreatitis and its complications. <h3>Report of a Case.—</h3> A 37-year-old, 70-kg man was transferred to Hartford (Conn) Hospital approximately four weeks after admission to an outlying hospital for acute pancreatitis. No specific cause had been identified, and results from the investigation of the biliary tract were negative. He denied chronic ethanol abuse, although he admitted a drinking binge shortly before admission. A computed tomographic scan obtained shortly after admission revealed an 11-cm pancreatic pseudocyst. His convalescence was marked by exacerbations of his pancreatitis at every reinstitution of oral intake, so he was maintained on parenteral nutrition. He also required parenteral analgesics and was treated with intramuscular meperidine hydrochloride. When transferred, he was requiring approximately 400 to 500 mg/day of
Joint Study of Extracranial Arterial Occlusion
Authors: William S. Fields
Journal: JAMA (1976)

This prospective analysis of 79 patients with transient carotid ischemic attacks (TIAs) showed that only 15% of them subsequently had strokes causing serious disability or death. They were followed up from one to nine years. All had arteriography during initial evaluation. Most of the patients who suffered strokes had at least one additional risk factor for stroke, such as hypertension or a cardiac problem. Today it is probably impossible to collect data on the natural history of untreated TIAs, inasmuch as virtually all patients are receiving either specific medical or surgical therapy. (<i>JAMA</i>235:2608-2610, 1976)
Randomized Controlled Trial of an Educational Intervention for Managing Fatigue in Women Receiving Adjuvant Chemotherapy for Early-Stage Breast Cancer
Authors: Patsy Yates, Sanchia Aranda, Maryanne Hargraves, Bev Mirolo, Alexandra Clavarino, SueAnne McLachlan, Helen Skerman
Journal: Journal of Clinical Oncology (2005)

Purpose To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue. Patients and Methods This randomized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart. Instruments included a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; the Functional Assessment of Cancer Therapy–Fatigue and Piper Fatigue Scales; the Cancer Self-Efficacy Scale; the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2, T3, and T4) were conducted, controlling for the variable's corresponding baseline value. Results Compared with the intervention group, mean difference scores between the baseline (T1) and immediate after the test (T2) assessments increased significantly more for the control group for worst and average fatigue, Functional Assessment of Cancer Therapy–Fatigue, and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life. Conclusion Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue.
THU0309 Coronary Heart Disease in Systemic Lupus Erythematosus is Associated with Interferon Regulatory Factor 8 Gene Variants
Authors: D. Leonard, E. Svenungsson, J. K. Sandling, O. Berggren, A. Jönsen, C. Bengtsson, C. Wang, K. Jensen-Urstad, S.-O. Granstam, A. A. Bengtsson, J. T. Gustafsson, I. Gunnarsson, S. Rantapää-Dahlqvist, G. Nordmark, M.-L. Eloranta, A.-C. Syvänen, L. Rönnblom
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Patients with Systemic Lupus Erythematosus (SLE) have increased morbidity and mortality in coronary heart disease (CHD). Modern treatment has reduced the risk of death in SLE due to inflammation in major organs, but the mortality in cardiovascular disease shows no such decline. Both traditional cardiovascular risk factors and SLE disease specific risk factors are of importance for the development of CHD in SLE. <h3>Objectives</h3> We asked if there was a genetic influence on CHD in SLE. <h3>Methods</h3> We performed a genetic association analysis in two cohorts (n=575 and n=227) of Swedish SLE patients using a 12k custom made array (Illumina). The allele frequencies were compared for SLE patients with (n=66) and without (n=509) CHD in cohort 1. We found 61 SNPs with an association (p&lt;0.01) to CHD. Next, the allele frequencies of these 61 SNPs were compared in patients with (n=27) and without CHD (n=212) in the second cohort. In the first cohort 203 patients were examined by carotid ultrasound. Further, peripheral blood mononuclear cells from patients (non-risk allele=13, risk allele=7) were analyzed by flow cytometry. Next, the alleles of 14 SNPs in <i>IRF8</i> were subjected to analysis by electrophoretic mobility shift assay (EMSA). <h3>Results</h3> We found two highly linked (LD, r <sub>2</sub> =0.83) single nucleotide polymorphisms (SNPs) in the interferon regulatory factor 8 (IRF8) gene to be associated with CHD in both cohorts. Meta-analysis of the strongest associated SNP gave an odds ratio of 3.6 (2.1-6.3), p-value 1.9 x 10<sup>-6</sup>. The identified <i>IRF8</i> allele remained as a risk factor for CHD after adjustment for traditional CHD risk factors in a logarithmic multivariable model. Further, patients with the <i>IRF8</i> risk allele had more carotid plaques (p&lt;0.001) and increased intima-media thickness (p=0.01). By EMSA we could show weaker binding of protein to a SNP highly linked to the risk allele. By flow cytometry we noted a significantly reduced frequency of circulating B cells in patients with the <i>IRF8</i> risk allele <h3>Conclusions</h3> We have identified a novel genetic locus in <i>IRF8</i> to be associated to CHD in patients with SLE. The study highlight the fact that non-traditional risk factors for arteriosclerosis are important in SLE and that new therapeutic strategies targeting pro-inflammatory pathways are important for improving CHD morbidity and mortality among these patients. <h3>Disclosure of Interest</h3> None Declared
Chronic enteral ethanol treatment causes hypoxia in rat liver tissue in vivo
Authors: G E Arteel, Y Iimuro, M Yin, J A Raleigh, R G Thurman
Journal: Hepatology (1997)

It is known that ethanol increases oxygen consumption in in vitro liver models, which could lead to hypoxia. Although it was shown recently that one large dose of ethanol caused hypoxia in rat liver in vivo , whether ethanol produces hypoxia in a clinically relevant chronic model remains unclear. In the present study, therefore, the effect of chronic ethanol on hypoxia was investigated in vivo using the 2-nitroimidazole hypoxia marker, pimonidazole. Male Wistar rats (300-325 g) were exposed to enteral ethanol continuously for 4 weeks. In this model, rats develop steatosis, inflammation, and necrosis characteristic of early stages of clinical alcoholic liver disease in humans. One hour before they were killed, rats were injected with pimonidazole (120 mg/kg intravenously), and livers were surgically isolated, removed, and fixed. Protein-bound pimonidazole adducts were identified on formalin-fixed, paraffin-embedded tissue with immunohistochemistry. Ethanol administration for 4 weeks significantly increased serum aspartate transaminase levels and hepatic pathology scores for steatosis, inflammation, and necrosis, as expected. Ethanol treatment significantly increased both the extent and number of cells that stained positive for pimonidazole compared with control animals given an enteral diet without ethanol. Quantitative image-analysis of pimonidazole binding showed that 4 weeks of ethanol administration nearly doubled the pimonidazole-positive area in tissue. Ethanol also increased pimonidazole binding significantly at 7 days, long before inflammation and necrosis could be detected. These results indicate that chronic ethanol causes hypoxia at the cellular level in rat liver in vivo and lend support to the hypothesis that hypoxia is involved in mechanisms of early alcoholic liver injury.
Olfactory Acuity, Menstrual Abnormalities, and Oocyte Status
Authors: JOHN R. MARSHALL
Journal: Annals of Internal Medicine (1971)

Oocyte status and olfactory thresholds for three vapors were determined in 96 women with oligomenorrhea or amenorrhea and in 500 women with presumptively ovulatory menses. One percent of women with normal menses had type I hyposmia; 0.4% had type II. Both types I and II were present more frequently in patients with oocytes and menstrual abnormalities (P < 0.005). Type I was most frequently present in patients with primary amenorrhea and oocytes (20%). Type II was most frequently present in women with primary amenorrhea without oocytes (83%). Although type II appears to be associated with a loss of oocytes, loss of oocytes was not associated with the development of any specific olfactory abnormality. Determination of olfactory acuity by clinical history and threshold-testing provides important information about patients with menstrual abnormalities and can serve as a simple, predictive sign and as a guide to the clinical management of patients with primary amenorrhea.
VARIABILITY OF MENTAL RATINGS IN RETESTS OF NEUROPSYCHIATRIC CASES
Authors: Emmett L. Schott
Journal: American Journal of Psychiatry (1930)

To summarize—this study shows that the variability of mental ratings in adult neuropsychiatric cases is much greater than the variability found in normal school children, and is considerably greater than that found in the children used in this study. Part of this difference is probably due to the fact that most of the adults had mental disturbances of psychotic degree, while the disturbances in the children were of a different type—namely, behavior problems, and various mild neurotic manifestations. Of all the cases with organic diseases, causing physiological and mental deterioration, the variability was greatest in the adults and there were likewise more adults with organic as well as functional disturbances. This was further emphasized by the brief supplementary study of the 10 cases of general paresis. Age and level of I. Q. were not found to be important factors in variability in this series of cases. In the adult group the women varied more than the men while in the group of children the boys varied more than the girls. The extent of the variability in mental ratings is of much value to the psychiatrist in determining the progression toward normality or increased abnormality. When thought of in this light retests not only aid in judging the mental level, but become a type of barometer indicating the upward or downward trend of mental functioning.
Why doctors must grapple with health economics
Authors: R A Storring
Journal: BMJ (1987)

suggest that they are at high risk of developing leptospirosis, the remarkably low incidence of the disease in such communes argues to the contrary.The clustering of so many cases in the commune, the finding of only a moderate rise in the tempera- ture at the centre of a meatball cooked on a hot plate,2 and the very peculiar interaction of the index case with the commune strongly suggested that food was the common source.