tbuckley/cabot-search huggingface dataset:
Gastric acid secretion in Chinese with particular reference to the dose of histamine required for maximal stimulation
Authors: W. P. Fung
Journal: Gut (1970)

Studies of basal and histamine-stimulated gastric acid secretion were performed in 42 controls, in 133 patients with duodenal ulceration, in 57 patients with gastric ulceration, in 13 patients with both duodenal and gastric ulceration, and in 20 patients with gastric carcinoma. All these subjects were Chinese. Statistical analysis of the results showed that all clinical groups differed from the controls in both basal and stimulated secretion. The mean basal acid output of Chinese controls and of patients with duodenal ulcer in most cases did not differ statistically when compared with western series. The basal secretion of Chinese patients with gastric ulceration, however, was statistically higher than in most of the western series. The histamine-stimulated response of Chinese controls and patients with duodenal ulcer was statistically much lower than in all western series with which they were compared. For Chinese patients with gastric ulcer, the stimulated responses were in some instances lower than and in others similar to results obtained in some western series. In contrast to most western reports, the basal and histamine-stimulated secretion in Chinese patients with gastric ulcer was significantly higher than in controls. In the Chinese controls and Chinese patients with peptic ulcers the response after histamine was generally lower than western reports. This was due to the inadequacy of the standard dose of histamine acid phosphate of 0·04 mg/kg body weight in Chinese subjects. A dose of 0·06 mg/kg body weight produced a significantly higher acid output. In the comparatively leaner Chinese subjects, therefore, a dose of histamine acid phosphate of 0·06 mg/kg is required for maximal stimulation of gastric acid secretion. This agrees well with the results of a similar study in Indian subjects.
Rehabilitation services remain important in multiple sclerosis
Authors: R. Richards
Journal: BMJ (2002)

EDITOR—Taylor's enthusiasm for the proposed “sale or return” arrangement for interferon beta seems ill informed.1 Given the variability of multiple sclerosis over time in individual patients, how is the success of treatment to be judged? Using historical controls, such as the Canadian cohort, requires the availability of detailed data to match controls to the current treatment criteria.2

In making these choices, quality adjusted life years and similar utility measures are all we have, flawed as they are. A better debate is over the cut-off …
Ichthyosis congenita type IV: a new case resembling diffuse cutaneous mastocytosis
Authors: A. BRUSASCO, C. GELMETTI, G. TADINI, R. CAPUTO
Journal: British Journal of Dermatology (1997)

The wide phenotypical heterogeneity within the ichthyosis congenita group of diseases is well known. We report a case of a very rare and unusual autosomal recessive ichthyosis congenita, type IV, according to the ultrastructural classification. Our case presented the triad clue for the diagnosis, characterized by follicular hyperkeratosis, prematurity and perinatal complications, but the clinical diagnosis was further complicated by hypereosinophilia and a strongly positive Darier's sign suggesting diffuse cutaneous mastocytosis. The diagnosis was provided only by electron microscopy, which showed the pathognomonic markers of ichthyosis congenita type IV, namely a large number of membrane structures in the stratum corneum and stratum granulosum. As a consequence, correct genetic counselling for the parents was carried out, and they were informed about the benign course of the disease after the complications of the perinatal period. This case is a further example of the reliability of ultrastructural markers in the diagnosis of inherited keratinization disorders, especially those with an unusual clinical appearance.
Diagnosis of urinary tract infection in childhood based on examination of pared non-catheter and catheter specimens of urine.
Authors: H Braude, J O Forfar, J C Gould, J W McLeod
Journal: BMJ (1967)

The accurate diagnosis of urinary tract infection.in infancy and childhood based on examination of the urine is made diffi- cult by the number of variables involved.These include the age and sex of the patient, method of collection of the urine, time interval between micturition and urine examination, and technique of examination employed.The method of collection of urine is most important and for two common methodsplastic adhesive bags and midstream specimens-we have suggested diagnostic levels for cell and bacterial counts related to the age and sex of the patient and the type of collection 'Braude et al., 1967).To determine the validity of these levels non-catheter and -atheter specimens of urine were obtained from 68 patients. MaterialIn most of the patients the suspicion had arisen on clinical grounds that urinary tract infection might be present-a suspicion based on suggestive symptoms such as abdominal pain, dysuria, frequency of micturition, enuresis, unexplained vromiting or anorexia, and, in the case of infants, unexplained failure to thrive.Also in a number of symptomless cases routine examination of the urine had suggested that infection might be present.Of the 68 patients 49 were female and 19 nale.The ages ranged from 9 days to 11 years (see Table ). MethodsWith the methods described by Braude et al. (1967) 92 non- satheter specimens-76 (82%) midstream and 16 (18%) bag- were obtained from 68 patients, and thereafter a catheter specinen was obtained from each of them.Catheterization was carried out by a modification of the technique described by MAcLeod et al. (1963), which is effective in delaying urinary 'ract infection in paraplegic patients, often for many weeks, if a daily change of catheter is made.The external genitalia, after washing with sterile water and while still moist, are kprayed with Polybactrin (neomycin sulphate 495 mg., poly- rnyxin B sulphate 150,000 units, zinc bacitracin 37,500 units, mnade up to 109 g. with a mixture of the inert and highly volatile fluids dichlorotetrafluoroethane and dichlorodifluoro- methane) from a distance of 12 in.(30 cm.), the labia being separated in the female and the foreskin retracted in the male.'he perineum is then covered with a sterile towel.The urethra is irrigated with aqueous Polybactrin Soluble G.U., consisting of bacitracin 1,000 units, neomycin sulphate 20 mg., and polymyxin B sulphate 75,000 units per 2 ml.With the use of forceps, a catheter fine enough to allow a free return flow (a sterile disposable premature infant-feeding tube size 5 French is suitable) is inserted into the anterior urethra, in females just being allowed to enter the anterior urethra and in males being introduced up to i in. (1.3 cm.).While the
Excess Deaths Associated With Underweight, Overweight, and Obesity
Authors: Katherine M. Flegal
Journal: JAMA (2005)

ContextAs the prevalence of obesity increases in the United States, concern over the association of body weight with excess mortality has also increased.ObjectiveTo estimate deaths associated with underweight (body mass index [BMI] &lt;18.5), overweight (BMI 25 to &lt;30), and obesity (BMI ≥30) in the United States in 2000.Design, Setting, and ParticipantsWe estimated relative risks of mortality associated with different levels of BMI (calculated as weight in kilograms divided by the square of height in meters) from the nationally representative National Health and Nutrition Examination Survey (NHANES) I (1971-1975) and NHANES II (1976-1980), with follow-up through 1992, and from NHANES III (1988-1994), with follow-up through 2000. These relative risks were applied to the distribution of BMI and other covariates from NHANES 1999-2002 to estimate attributable fractions and number of excess deaths, adjusted for confounding factors and for effect modification by age.Main Outcome MeasuresNumber of excess deaths in 2000 associated with given BMI levels.ResultsRelative to the normal weight category (BMI 18.5 to &lt;25), obesity (BMI ≥30) was associated with 111 909 excess deaths (95% confidence interval [CI], 53 754-170 064) and underweight with 33 746 excess deaths (95% CI, 15 726-51 766). Overweight was not associated with excess mortality (−86 094 deaths; 95% CI, −161 223 to −10 966). The relative risks of mortality associated with obesity were lower in NHANES II and NHANES III than in NHANES I.ConclusionsUnderweight and obesity, particularly higher levels of obesity, were associated with increased mortality relative to the normal weight category. The impact of obesity on mortality may have decreased over time, perhaps because of improvements in public health and medical care. These findings are consistent with the increases in life expectancy in the United States and the declining mortality rates from ischemic heart disease.
Baucus's Bill and the Long Road to Reform
Authors: John K. Iglehart
Journal: New England Journal of Medicine (2009)

In an effort to attract Republican support, Senator Max Baucus (D-MT), chair of the Senate Finance Committee, stripped his health care reform proposal of some of its most contentious elements — the creation of a public insurance option, the imposition of an employer mandate, and the provision of physician payments for counseling Medicare beneficiaries about end-of-life care. But when Baucus unveiled his bill on September 16, he did so without any Republican support, in the face of wariness from some Democrats, and with more than 500 proposed amendments that his committee will consider when it begins to mark up the . . .
Serum homocysteine, thermolabile variant of methylene tetrahydrofolate reductase (MTHFR), and venous thromboembolism: Longitudinal investigation of thromboembolism etiology (LITE)
Authors: Albert W. Tsai, Mary Cushman, Michael Y. Tsai, Susan R. Heckbert, Wayne D. Rosamond, Nena Aleksic, N. David Yanez, Bruce M. Psaty, Aaron R. Folsom
Journal: American Journal of Hematology (2003)

We sought to examine prospectively the association of serum homocysteine and the methylene tetrahydrofolate reductase (MTHFR) C677T gene polymorphism with risk of venous thromboembolism (VTE). We studied these relationships in a nested case-control study of 303 VTE cases and 635 matched controls from a population-based cohort of 21,680 adults from six U.S. communities. The highest quintile of serum homocysteine carried a non-statistically significant adjusted odds ratio of 1.55 (95% CI, 0.93-2.58) compared to the lowest quintile in the overall cohort but a significant association among adults aged 45-64 years (OR = 2.05, 95% CI, 1.10-3.83) and an inverse association in those > or = 65 years of age. Carriers of the MTHFR C677T polymorphism were not at higher risk for VTE than those with normal genotype (OR = 0.74, 95% CI = 0.56-0.98). Our prospective data showed, at most, a weak relationship between homocysteine and VTE risk, with associations larger among younger participants. MTHFR C677T was not a risk factor for VTE.
Working as a deputy in general practice
Authors: M. Jones
Journal: BMJ (1997)

Melvyn Jones explains what it is like to work for a general practitioner deputising service 

Deputising is often criticised,1 and most hospital messes are familiar with the euphemismN “ the dangerous doctor service.” But what is it like to work as a deputy and is the reputation justified?

The prime reason for doing the job is probably to earn money, and as a night and weekend service deputising lends itself to moonlighting. The ability to pick a sessionNusually at relatively short noticeNmeans that extra work does not always take up a whole weekend as a hospital locum post can do. The posts are self employed, so reasonable expenses, such as milage, are tax deductible. Some GP principals do sessions to offset the costs of providing cover for their own practice.

The work is very like other out of hours work in general practice, except that the deputy usually consults in the patient's home and there is little continuity. Some companies have experimented with base surgeries and telephone advice with mixed success.2 Deputies are driven to the patient's house and supplied with basic details. There is, however, no record of previous contacts or history.

Clinical difficulties may arise when patients try to manipulate the service to get second opinions or treatments, such as antibiotics, hypnotics, and controlled drugs. Some patients may be hostile, usually as a result of delays, but also because they are dissatisfied with their usual doctor or other NHS services. Some patients use …
Exhaled Nitric Oxide (NO) Is Reduced Shortly after Bronchoconstriction to Direct and Indirect Stimuli in Asthma
Authors: HEIDI W. F. M. de GOUW, JENNY HENDRIKS, ANDREA M. WOLTMAN, IRENE M. TWISS, PETER J. STERK
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Exhaled NO is increased in patients with asthma and may reflect disease severity. We examined whether the level of exhaled NO is related to the degree of airway obstruction induced by direct and indirect stimuli in asthma. Therefore, we measured exhaled NO levels before and during recovery from histamine and hypertonic saline (HS) challenge (Protocol 1) or histamine, adenosine 5'-monophosphate (AMP), and isotonic saline (IS) challenge (Protocol 2) in 11 and in nine patients with mild to moderate asthma, respectively. The challenges were randomized with a 2-d interval. Exhaled NO and FEV1 were measured before and at 4, 10, 20, and 30 min after each challenge. NO was measured during a slow VC maneuver with a constant expiratory flow of (0.05 x FVC)/s against a resistance of 1 to 2 cm H2O. Baseline exhaled NO levels were not significantly different between study days in Protocol 1 (mean +/- SD: 4.8 +/- 1.8 ppb [histamine] versus 5.4 +/- 2.1 ppb [HS], p = 0.4) or in Protocol 2 (7.9 +/- 4.7 ppb [histamine], 8.3 +/- 5.2 ppb [AMP], and 7.2 +/- 3.7 ppb [IS], p = 0.7). A significant reduction in exhaled NO was observed directly after HS (mean +/- SEM: 39.2 +/- 3.9 %fall) and AMP challenge (32.3 +/- 7.3 %fall) (MANOVA, p < 0.001), respectively, whereas exhaled NO levels tended to decrease after histamine challenge. Isotonic saline challenge did not induce changes in exhaled NO (p = 0.7). There was a positive correlation between %fall in FEV1 and the %fall in exhaled NO after histamine, HS, and AMP challenge as indicated by the mean slope of the within-subject regression lines (p <= 0.04). We conclude that acute bronchoconstriction, as induced by direct and indirect stimuli, is associated with a reduction in exhaled NO levels in asthmatic subjects. This suggests that airway caliber should be taken into account when monitoring exhaled NO in asthma.
Abstract IA11: Promises and challenges of applying molecular profiles to lung cancer treatment and early diagnosis.
Authors: Ignacio I. Wistuba
Journal: Clinical Cancer Research (2014)

Abstract The field of lung cancer molecular pathology is rapidly changing due to advances in our understanding of the molecular pathogenesis of tumors. In the past ten years, the identification of new molecular targets has provided unique opportunities to attack cancer with targeted therapies in a personalized manner. Recent advances in expanding the available non-small cell lung carcinoma (NSCLC) targeted therapies require the analysis of a broad panel of molecular abnormalities in tumor specimens, including gene mutations, amplifications, fusions and expression by applying different methodologies to frequently small tumor tissue (biopsy) and cell (cytology) samples. In addition, there is growing consensus that tumor tissue specimens must represent the setting of the disease to be treated, and increasingly, more tissue samples are being obtained for molecular testing of advanced, metastatic and chemo-refractory NSCLC tumors (e.g., MD Anderson BATTLE Lung Cancer Program). Currently available methodologies and technologies, including microarrays and next-generation sequencing, have variable applicability for the molecular and genomic analysis of these small specimens. Thus, the role of the pathologist is becoming increasingly important to adequately integrate routine histopathology assessments and molecular testing with clinical pathology for the most accurate tumor diagnosis and subsequent selection of the most appropriate therapy. In addition, applying high-throughput molecular methodologies currently used in studying established tumors to epithelial cell samples obtained from the airway of high-risk individuals and lung cancer patients is expanding our understanding of the early pathogenesis of lung cancer. Earlier studies have highlighted a field cancerization phenomenon in which histologically normal-appearing tissue adjacent to neoplastic and preneoplastic lesions display molecular abnormalities some of which are in common with those in the tumors. There is consensus that advances in the understanding of this field phenomenon will help to the development of biomarkers for early detection of and personalized chemoprevention of lung cancer. Citation Format: Ignacio I. Wistuba. Promises and challenges of applying molecular profiles to lung cancer treatment and early diagnosis. [abstract]. In: Proceedings of the AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer; 2014 Jan 6-9; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2014;20(2Suppl):Abstract nr IA11.
1168 IL28B GENETIC VARIATION ASSOCIATED WITH EARLY VIRAL KINETICS AND SVR IN HCV GENOTYPE 1 THE VIRAHEP-C STUDY
Authors: C.D. Howell, A.J. Thompson, K. Ryan, S. Zambeeli, A. Gorden, M. Fried, N.H. Afdhal, J.G. McHutchison, K.V. Shianna, B. Mitchell, D.B. Goldstein, A. Shuldiner
Journal: Journal of Hepatology (2010)
German doctor stands trial for forcibly administering emetic to police suspect who died
Authors: Ned Stafford
Journal: BMJ (2008)

A doctor in Bremen, Germany, is on trial for negligent manslaughter in the death in 2004 of a suspected drug dealer in police custody. The suspect was forcibly given an emetic to retrieve cocaine capsules he had allegedly swallowed.

The man’s vomit entered his lungs, resulting in oxygen deficiency, while the doctor was present.

The procedure has subsequently been declared unlawful by the European Court of Human Rights, which in 2006 said it was a violation of Article 3 of the European Convention on Human …
Oophorectomy Without Hysterectomy
Authors: Kenneth A. Pruett
Journal: JAMA (1978)

<h3>To the Editor.—</h3> In the QUESTIONS AND ANSWERS column (239:649, 1978), Dr Edward F. Lewison's answer is incomplete regarding the 52-year-old woman who is menstruating irregularly and who has recently been found to have a solitary metastatic breast carcinoma nodule in the left upper lobe. Because of the known higher incidence of genital cancer in women who have breast cancer, the patient should have endometrial sampling by biopsy or dilation and curettage to establish if she is bleeding from a hyperplastic endometrium or even from an endometrial carcinoma. Endometrial sampling done at the time of a bleeding episode would be helpful in establishing if she is indeed ovulating and would therefore be a candidate for oophorectomy as palliation of the breast cancer. I disagree with Dr Lewison's comment that concomitant hysterectomy is unwarranted. The additional risk to performing a total abdominal hysterectomy in addition to a bilateral oophorectomy is minimal
Transcriptional repression of c-Myb and GATA-2 is involved in the biologic effects of C/EBPα in p210BCR/ABL-expressing cells
Authors: Angela Rachele Soliera, Maria Rosa Lidonnici, Giovanna Ferrari-Amorotti, Marco Prisco, Ying Zhang, Robert V. Martinez, Nick J. Donato, Bruno Calabretta
Journal: Blood (2008)
Atrial Tachycardia in Acute Myocardial Infarction
Authors: LAURENCE LESSER
Journal: Annals of Internal Medicine (1977)

Letters1 May 1977Atrial Tachycardia in Acute Myocardial InfarctionLAURENCE LESSER, M.D., PAUL F. WALTER, M.D.LAURENCE LESSER, M.D.Search for more papers by this author, PAUL F. WALTER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-5-582 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSupraventricular arrhythmias are a common complication of acute myocardial infarction. Atrial tachycardia, however, has been regarded as infrequent after myocardial infarction. We determined the incidence and electrocardiographic features of atrial tachycardia in patients with acute myocardial infarction and examined the clinical features associated with this arrhythmia.A 12-month prospective analysis was made of patients admitted to the Atlanta Veterans Administration Hospital with a diagnosis of acute myocardial infarction. The criterion for acute myocardial infarction was a typical history of prolonged chest pain, plus either [a] diagnostic electrocardiographic changes consisting of new "Q" waves with evolutionary ST segment and T-wave changes,...References1. WALTERLESSER PL: Refractory paroxysmal supraventricular tachycardia incited by multiple mechanisms. J Electrocardiol 8:343-349, 1975 CrossrefMedlineGoogle Scholar2. JAMES T: Myocardial infarction and atrial arrhythmias. Circulation 24:761-771, 1961 CrossrefMedlineGoogle Scholar3. GOLDREYERDAMATO BA: The essential role of atrioventricular conduction delay in the initiation of paroxysmal supraventricular tachycardia. Circulation 43:679-687, 1971 CrossrefMedlineGoogle Scholar4. WUDENES DP: Mechanisms of paroxysmal supraventricular tachycardia. Arch Intern Med 135:437-442, 1975 CrossrefMedlineGoogle Scholar5. GALLAGHERDAMATOLAU JAS: Electrophysiologic studies during accelerated idioventricular rhythms. Circulation 44:671-677, 1971 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAcute Myocardial InfarctionWhat Determines the Choice of Treatment in Patients with Supraventricular Tachycardia?Occurrence of Frequent Complex Arrhythmias Detected by Ambulatory MonitoringArrhythmias in the Coronary Care Unit Recognized with the Aid of Automated ECG Monitoring 1 May 1977Volume 86, Issue 5Page: 582-583KeywordsAcute myocardial infarctionArrhythmiaElectrocardiographyIschemiaMyocardial infarctionTachycardia Issue Published: 1 May 1977 PDF DownloadLoading ...
THE VALUE OF SULPHATES IN CARBOLIC-ACID POISONING.
Authors: TORALD SOLLMANN
Journal: JAMA (1907)

<h3>HISTORICAL DATA.</h3> The treatment of phenol poisoning by sulphates dates from the observation of Baumann,<sup>1</sup>in 1876, that a considerable proportion of the phenol is excreted in the urine as the practically harmless phenol-sulphonic (sulphocarbolic) acid, C<sub>6</sub>H<sub>4</sub>(OH)SO<sub>3</sub>H, or, rather, as the salts of this acid with the urine bases. Baumann suggested that this constitutes a natural mechanism for the disintoxication of phenol. Since only a part of the phenol is excreted in this form, it seems reasonable to suppose that the quantity of sulphate at the disposal of the body was not sufficient to combine with all the phenol, and that the efficiency of the mechanism could, therefore, be increased by the administration of sulphates. Baumann tested this suggestion on two dogs, painting the phenol on the skin. The result was in agreement with the theory, although it was not sufficiently rigorous to