tbuckley/cabot-search huggingface dataset:
Case 4-1961
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. Kibbee
Journal: New England Journal of Medicine (1961)

Presentation of Case A thirty-three-year-old graida 0, para 0, entered the hospital because of vaginal bleeding. Three months previously she noticed vaginal bleeding requiring 1 pad daily; at first it was pinkish and then brown with clots. Two weeks after the bleeding started she had an attack of abdominal pain. The pain, which was in the mid-line and radiated into the pelvis, was crampy in nature. There were two episodes of this pain, each lasting for two days. Two toad tests for pregnancy were negative. The vaginal bleeding continued until two months before admission, when a uterine curettage at another . . .
Somatostatin analogues suppress the inflammatory reaction in vivo.
Authors: K Karalis, G Mastorakos, G P Chrousos, G Tolis
Journal: Journal of Clinical Investigation (1994)

Somatostatin (Sms) and its agonist analogues inhibit the secretory activities of endocrine and neural cells. Recent studies have suggested that Sms has significant immunomodulatory properties. In this study, we examine the effects of two Sms octapeptide analogues on the inflammatory reaction in vivo. BIM 23014 (Somatulin) and Sandostatin were administered to male Sprague-Dawley rats subject to carrageenin-induced aseptic inflammation, at doses of 2-10 micrograms/rat, given either systemically or locally. Animals were killed 7 h after the induction of the inflammation, and the inflammatory exudates were aspirated and quantitated in terms of volume and leukocyte concentration. Sms analogues, administered via either route, significantly reduced the volume and the leukocyte concentration of the exudate in a time- and dose-dependent fashion. In corroboration of these, immunohistochemical evaluation of the levels of local inflammatory mediators, such as immunoreactive (Ir) TNF-alpha, Irsubstance P, and Ircorticotropin-releasing hormone, was inhibited significantly by Sms analogue treatment. These findings suggest that Sms analogues have significant antiinflammatory effects in vivo, associated with suppression of proinflammatory cytokines and neuropeptides. Furthermore, these data suggest that Sms agonists may be useful in the control of inflammatory reaction.
Points: Psychostimulant properties of betel nuts
Authors: M. P Deahl
Journal: BMJ (1987)

recognised or treated properly.As there is no widely accepted treatment for myalgic encephalomyelitis as an "organic" disorder it is important to recognise and treat any reversible illness, particularly if patients face "a long period of physical incapacity ... from ten to twenty years."'Physical and psychological assessment of patients with suspected myalgic encephalomyelitis may help to prevent more suicides in patients with this disorder.' 1 Ramsay AM.Post-viral fatigue syndrome: the saga of Royal Free disease.
Australia operates "closed shop" to restrict doctors from overseas, say critics
Authors: M. Sweet
Journal: BMJ (2009)

Overseas trained doctors seeking to work in Australia often face unwarranted restrictions on practising, say leading Australian medical specialists and healthcare reform advocates.

Ian Hickie, a psychiatrist at the University of Sydney, says that shortages in the medical workforce are being exacerbated by restrictions caused by an “evil axis” of immigration policy, health regulations, and the monopoly of specialist medical colleges over training and accreditation.

Australia was allowing a “closed shop” to control its medical workforce in a way that would not be tolerated in any other industry, he said. Concerns about quality and safety were often used as a “smokescreen” to maintain the position of local graduates, he added.

“We’re quite happy to have all these overseas trained doctors work in our system, so long as they don’t exercise the same economic and civil rights [as Australian graduates],” said Professor Hickie.

The recently publicised case of a Canadian doctor who has been unable to gain full rights of practice (www.smh.com.au/national/a-bitter-pill-to-swallow-when-a-doctor-feels-doublecrossed-20091012-gtyx.html) showed that workforce reform should be a major focus of the current national push for healthcare reform, he said.

Susan Douglas, who moved to Australia in 2006 to take up an appointment as senior lecturer in general practice at the Australian National University, …
Effect of Oophorectomy on Survival After Breast Cancer in<i>BRCA1</i>and<i>BRCA2</i>Mutation Carriers
Authors: Kelly Metcalfe, Henry T. Lynch, William D. Foulkes, Nadine Tung, Charmaine Kim-Sing, Olufunmilayo I. Olopade, Andrea Eisen, Barry Rosen, Carrie Snyder, Shelley Gershman, Ping Sun, Steven A. Narod
Journal: JAMA Oncology (2015)

Women who carry a germline mutation in either the BRCA1 or BRCA2 gene face a lifetime risk of breast cancer of up to 70%, and once they receive a diagnosis of breast cancer, they face high risks of both second primary breast and ovarian cancers. Preventive bilateral salpingo-oophorectomy is recommended to women with a BRCA mutation at age 35 years or thereafter to prevent breast and ovarian cancer, but it is unclear whether oophorectomy has an impact on survival in women with BRCA-associated breast cancer.To estimate the impact of oophorectomy on survival in women with breast cancer with a BRCA1 or BRCA2 mutation.Retrospective analysis of patients selected by pedigree review of families who received counseling at 1 of 12 participating clinical genetics centers. Patients were 676 women with stage I or II breast cancer and a BRCA1 or BRCA2 mutation who were observed for up to 20 years after receiving a diagnosis between 1975 and 2008. Survival experience was compared for women who did and who did not undergo oophorectomy.In all analyses, the primary end point was death due to breast cancer.Of the 676 women, 345 underwent oophorectomy after the diagnosis of breast cancer and 331 retained both ovaries. The 20-year survival for the entire patient cohort was 77.4%. The adjusted hazard ratio for death attributed to breast cancer in women who underwent oophorectomy was 0.38 (95% CI, 0.19-0.77; P = .007) for BRCA1 carriers and 0.57 (95% CI, 0.23-1.43; P = .23) for BRCA2 carriers. The hazard ratio for breast cancer-specific mortality was 0.76 (95% CI, 0.32-1.78; P = .53) for women with estrogen receptor-positive breast cancer and 0.07 (95% CI, 0.01-0.51; P = .009) for women with estrogen receptor-negative breast cancer.Oophorectomy is associated with a decrease in mortality in women with breast cancer and a BRCA1 mutation. Women with estrogen receptor-negative breast cancer and a BRCA1 mutation should undergo oophorectomy shortly after diagnosis.
Chemoprophylaxis of malaria in Africa
Authors: D. G McLarty
Journal: BMJ (1982)

Professor L J Bruce-Chwatt successfully underlined the complexity of the problem of drug-resistant malaria and showed that some conflicting opinions exist among members of the medical profession regarding the antimalarial drugs to be used for chemoprophylaxis.Resistance of Plasmodium falciparum to chloroquine in Africa, especially in East Africa, must be recognised as an established fact.It has been found
Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial
Authors: Jan Wallenborn, Götz Gelbrich, Detlef Bulst, Katrin Behrends, Hasso Wallenborn, Andrea Rohrbach, Uwe Krause, Thomas Kühnast, Martin Wiegel, Derk Olthoff
Journal: BMJ (2006)

To determine whether 10 mg, 25 mg, or 50 mg metoclopramide combined with 8 mg dexamethasone, given intraoperatively, is more effective in preventing postoperative nausea and vomiting than 8 mg dexamethasone alone, and to assess benefit in relation to adverse drug reactions.Four-armed, parallel group, double blind, randomised controlled clinical trial.Four clinics of a university hospital and four district hospitals in Germany.3140 patients who received balanced or regional anaesthesia during surgery.Postoperative nausea and vomiting within 24 hours of surgery (primary end point); occurrence of adverse reactions.Cumulative incidences (95% confidence intervals) of postoperative nausea and vomiting were 23.1% (20.2% to 26.0%), 20.6% (17.8% to 23.4%), 17.2% (14.6% to 19.8%), and 14.5% (12.0% to 17.0%) for 0 mg, 10 mg, 25 mg, and 50 mg metoclopramide. In the secondary analysis, 25 mg and 50 mg metoclopramide were equally effective at preventing early nausea (0-12 hours), but only 50 mg reduced late nausea and vomiting (> 12 hours). The most frequent adverse drug reactions were hypotension and tachycardia, with cumulative incidences of 8.8% (6.8% to 10.8%), 11.2% (9.0% to 13.4%), 12.9% (10.5% to 15.3%), and 17.9% (15.2% to 20.6%) for 0 mg, 10 mg, 25 mg, and 50 mg metoclopramide.The addition of 50 mg metoclopramide to 8 mg dexamethasone (given intraoperatively) is an effective, safe, and cheap way to prevent postoperative nausea and vomiting. A reduced dose of 25 mg metoclopramide intraoperatively, with additional postoperative prophylaxis in high risk patients, may be equally effective and cause fewer adverse drug reactions.Current Controlled Trials ISRCTN31625370 [controlled-trials.com].
Automaticity and entrance block induced by focal depolarization of mammalian ventricular tissues.
Authors: G R Ferrier, J E Rosenthal
Journal: Circulation Research (1980)

Isolated canine interventricular septa were studied with standard microelectrode techniques. Focal automaticity was induced by applying depolarizing current through an extracellular pipet in contact with the right bundle branch (RBB) of the ventricular specialized conducting system. Automaticity appeared with depolarization to transmembrane potentials of -50 mV or less. The spontaneous activity was neither depressed nor accelerated when overdrive suppression was attempted. Activity originating within the focus propagated into fully polarized surrounding tissue. However, entrance block, phasically related to the spontaneous cycle length, was an intrinsic property of these foci. Early premature beats initiated outside the focus failed to enter the focus, but the resulting electrotonus delayed the next automatic beat. Late premature beats captured and thereby accelerated the focus. Thus, the automatic foci could be extrafocal activity. Consequently, continous pacing at various rates precipitated complex rhythms with fixed coupling. Similar foci with exit conduction, entrance block, and electrotonic modulation also were demonstrated in focally depolarized papillary muscles in feline septal preparations. The unique properties of focally depolarized areas in which spontaneous activity is generated at low membrane potentials provide a mechanism capable of generating a wide array of arrhythmias.
Age-Adjusted Incidence, Mortality, and Survival Rates of Stage-Specific Renal Cell Carcinoma in North America: A Trend Analysis
Authors: Maxine Sun, Rodolphe Thuret, Firas Abdollah, Giovanni Lughezzani, Jan Schmitges, Zhe Tian, Shahrokh F. Shariat, Francesco Montorsi, Jean-Jacques Patard, Paul Perrotte, Pierre I. Karakiewicz
Journal: European Urology (2010)
Incidence of Ocular Complications in Patients Undergoing Renal Transplantation
Authors: R. Porter, A. L. Crombie, P. S. Gardner, R. P. Uldall
Journal: BMJ (1972)

The eyes of 39 patients who had received allogenic renal transplants were examined for signs of disease. Nine (23%) had early posterior subcapsular cataracts, two (5%) developed acute cytomegalovirus retinitis, and one developed steroid-induced glaucoma. The lesions which were found were all attributable to the immunosuppressive drug therapy. Thirty-five (87%) had detectable complement-fixing antibodies to cytomegalovirus.
Relevance of Recertification for Primary Care Physicians
Authors: Edward J. Volpintesta
Journal: Annals of Internal Medicine (2008)

Letters1 April 2008Relevance of Recertification for Primary Care PhysiciansEdward J. Volpintesta, MDEdward J. Volpintesta, MDFrom Bethel, CT 06810.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-7-200804010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:In response to Dr. Aleali's letter, I agree that it is important to stay current to avoid, as he warns, becoming a dinosaur. But I wasn't implying that physicians don't need to stay current and informed. What I suggested was that the current methods of recertification for generalists, particularly family doctors, are burdensome and out of sync with the real world of medicine. This is particularly true for family physicians, but it applies to all physicians who consider themselves providers of primary care.Most primary care physicians customize their practices over time and according to the types of ... Author, Article, and Disclosure InformationAffiliations: From Bethel, CT 06810.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTailoring to the Needs of One's Practice: It's about Time Edward J. Volpintesta Relevance of Recertification for Primary Care Physicians Seyed H. Aleali Relevance of Recertification for Primary Care Physicians Emilio B. Gonzalez Relevance of Recertification for Primary Care Physicians Edward J. Volpintesta Metrics Cited ByRelevance of Recertification for Primary Care PhysiciansEmilio B. Gonzalez, MD 1 April 2008Volume 148, Issue 7Page: 565-566KeywordsConflicts of interestForecastingIntensive care unitsMemoryResidencySigns and symptomsVision ePublished: 1 April 2008 Issue Published: 1 April 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Incidental Finding of Appendiceal Tubular Adenoma by F-18 FDG PET/CT
Authors: Xinchong Shi, Xiaoyan Wang, Xiangsong Zhang, Chang Yi, Zhifeng Chen
Journal: Clinical Nuclear Medicine (2011)

Preoperative diagnosis of adenomatous appendiceal lesions is challenging because of the lack of specific symptoms. We report F-18 FDG PET/CT findings of a case of tubular adenoma in the appendix, incidentally in a woman with hepatic tumor. The appendiceal lesion had a maximum standard uptake values (SUV) of 15.0 and 10.9 in delayed phase. At appendectomy, the lesion was confirmed to be a noninvasive tubular adenoma.
Adenosine deaminase deficiency with normal immune function. An acidic enzyme mutation.
Authors: P E Daddona, B S Mitchell, H J Meuwissen, B L Davidson, J M Wilson, C A Koller
Journal: Journal of Clinical Investigation (1983)

In most instances, marked deficiency of the purine catabolic enzyme adenosine deaminase results in lymphopenia and severe combined immunodeficiency disease. Over a 2-yr period, we studied a white male child with markedly deficient erythrocyte and lymphocyte adenosine deaminase activity and normal immune function. We have documented that (a) adenosine deaminase activity and immunoreactive protein are undetectable in erythrocytes, 0.9% of normal in lymphocytes, 4% in cultured lymphoblasts, and 14% in skin fibroblasts; (b) plasma adenosine and deoxyadenosine levels are undetectable and deoxy ATP levels are only slightly elevated in lymphocytes and in erythrocytes; (c) no defect in deoxyadenosine metabolism is present in the proband's cultured lymphoblasts; (d) lymphoblast adenosine deaminase has normal enzyme kinetics, absolute specific activity, S20,w, pH optimum, and heat stability; and (e) the proband's adenosine deaminase exhibits a normal apparent subunit molecular weight but an abnormal isoelectric pH. In contrast to the three other adenosine deaminase-deficient healthy subjects who have been described, the proband is unique in demonstrating an acidic, heat-stable protein mutation of the enzyme that is associated with less than 1% lymphocyte adenosine deaminase activity. Residual adenosine deaminase activity in tissues other than lymphocytes may suffice to metabolize the otherwise lymphotoxic enzyme substrate(s) and account for the preservation of normal immune function.
Polymyalgia Rheumatica: The Diagnosis
Authors: HERBERT KAPLAN
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 June 1985Polymyalgia Rheumatica: The DiagnosisHERBERT KAPLAN, M.D.HERBERT KAPLAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-6-865_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Polymyalgia rheumatica is a nice disease because it can be cured. However, it is also a specific clinical syndrome that should not be lumped with the other "wastepaper basket" diagnoses.In the report of Dr. Miller and colleagues (1) of their patients with granulomatous angiitis who presented with "polymyalgia rheumatica," their only apparent justification for this rheumatic diagnosis was their report of "arthralgias, fever (temperatures to 38.9°C), and severe muscle tenderness with proximal muscle weakness. Laboratory studies showed an elevated sedimentation rate and normal creatine phosphokinase and aldolase levels." An important physical finding in diagnosing polymyalgia rheumatica...Reference1. MILLERCHENNEYTUMULTY RJRP. Granulomatous angiitis presenting with polymyalgia rheumatica and abnormal pituitary function. Ann Intern Med. 1985;102:210-1. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1985Volume 102, Issue 6Page: 865-865KeywordsArthralgiaCreatineFeversMyalgiaPolymyalgia rheumaticaResearch laboratoriesTemperatureVasculitis Issue Published: 1 June 1985 PDF DownloadLoading ...
Malaria: New Developments in Treatment and Prevention
Authors: Paul Newton, BM, DPhil, MRCP, Nicholas White, DSc, MD, FRCP
Journal: Annual Review of Medicine (1999)

Malaria still kills some 0.5–2.5 million people per year in the tropics. Resistance to the cheap, most commonly used antimalarials continues to spread alarmingly and could outpace drug development. The artemisinin derivatives have had an important clinical impact both on the treatment of resistant falciparum malaria and on the incidence of disease in low-transmission areas. A few promising new antimalarials are being tested clinically but there is an imperative need for cheap, well-tolerated drugs that can be used in short courses, and for strategies to delay the onset of drug resistance. Bed nets have been shown to reduce the incidence of severe malaria in many areas but an effective vaccine is urgently needed.
Association of the hemochromatosis gene with pazopanib-induced transaminase elevation in renal cell carcinoma
Authors: Chun-Fang Xu, Brian H. Reck, Vicki L. Goodman, Zhengyu Xue, Lingkang Huang, Michael R. Barnes, Beena Koshy, Colin F. Spraggs, Vincent E. Mooser, Lon R. Cardon, Lini N. Pandite
Journal: Journal of Hepatology (2010)
750 A COMPARISON OF TWO ASSAYS FOR QUANTIFICATION OF HEPATITIS B SURFACE ANTIGEN IN SERUM OF PATIENTS WITH CHRONIC HEPATITIS B
Authors: M.J. Sonneveld, V. Rijckborst, C.A.B. Boucher, L. Zwang, M.F.C. Beersma, B.E. Hansen, H.L.A. Janssen
Journal: Journal of Hepatology (2011)
Phenytoin toxicity produced by tolbutamide.
Authors: E. Beech, S. V. Mathur, B. P. Harrold
Journal: BMJ (1988)

have many more observations, which I quoted earlier (8 October, p 918).I accept their point about the shorter latent period for melanoma; but the evidence for nonlinearity in the incidence-exposure relation for melanoma is also relevant.Our differences of emphasis may reflect a concentration on shorter term effects by Professor MacKie and Dr Ryecroft and my concentration on the longer term outlook.
813-1 Cytomegalovirus infectious burden is proportional to cardiac allograft vasculopathy in heart transplant recipients
Authors: Luciano Potena, Carlo Magelli, Paolo Ortolani, William F Fearon, Francesco Grigioni, Gaia Magnani, Fabio Coccolo, Alan C Yeung, Helen I Luikart, Sharon A Hunt, Edward S Mocarski, John P Cooke, David B Lewis, Angelo Branzi, Hannah A Valantine
Journal: Journal of the American College of Cardiology (2004)
Effects of a fish oil enriched diet on aspirin intolerant asthmatic patients: a pilot study.
Authors: C Picado, J A Castillo, N Schinca, M Pujades, A Ordinas, A Coronas, A Agusti-Vidal
Journal: Thorax (1988)

The effect of a fish oil enriched diet containing about 3 g of eicosapentaenoic acid was studied in 10 patients with aspirin intolerant asthma. Subjects were studied during six weeks on a control diet followed by six weeks on the fish oil diet in a single blind study design. They were asked to record their peak expiratory flow (PEF) twice daily, bronchodilator and steroid doses, and subjective ratings of pulmonary symptoms on diary cards. There were no significant changes in symptom scores over the six weeks of either the control diet or the fish oil diet. PEF values, however, were significantly lower during the fifth and sixth week of the fish oil diet than during the control diet (308 v 262 l/min week 5 and 306 v 256 l/min week 6). Bronchodilator usage was also greater during the fifth and sixth week of the fish oil diet than during the control period (12.0 v 7.4 and 13.0 v 7.4 puffs a day in weeks 5 and 6). This pilot study suggests that fish diets may have a deleterious effect on patients with aspirin intolerant asthma.
INSULIN IN DIABETIC COMA, COMPLICATING PREGNANCY
Authors: WILLIAM S. REVENO
Journal: JAMA (1923)

The efficacy of insulin as an antidote for diabetic coma has been sufficiently well established to prompt Joslin<sup>1</sup>to state that "deaths from diabetic coma are unnecessary accidents that can be avoided by sensible treatment. If the patients die from coma at the present time, it is a disgrace to the medical profession." While the literature abounds in reports of cases of diabetic coma complicating various conditions, no instance has been found in which a well advanced pregnancy has had to be reckoned with along with the coma. The case here reported is of interest, therefore, because it deals with just this sort of situation. <h3>REPORT OF CASE</h3> Mrs. E. F., aged 42, Syrian, housewife, mother of five children, was brought into Providence Hospital, June 30, at 11 p. m., in a semicomatose condition. Her temperature was 97.4, the pulse was very weak and thready, with a rate of
Carcinoid Tumors: Retrospective Review of 1490 Consecutive Appendectomies
Authors: Fatih Altintoprak, Yusuf Arslan, Enis Dikicier, Zeynep Kahyaoglu, Taner Kivilcim, Guner Cakmak, Hakan Demir, Fehmi Celebi
Journal: Annals of Oncology (2013)
Insect Bite of the Skin in Scleroderma
Authors: Leon Goldman
Journal: JAMA (1974)

ABSTRACT To the Editor.— I was interested in the recent letter of Daniel S. J. Choy (229:519, 1974) on the failure of a patient with scleroderma to respond to insect bites.Some time ago, when we were doing experiments on insect-bite reaction, I fed Aedes aegypti on the severe, hard, trophic end of the finger of a patient with acroscleroderma. Under the binocular microscope, I observed the feeding process through skin that was hard for penetration even by a 27-gauge hypodermic needle. The mosquito was observed to obtain a complete blood meal, without any awareness of the stick of the mosquito, or without local reaction, on the part of the patient. This shows, as we have observed with other feeding experiments, including the flea, that it is possible for a nonarthropod reactor to get bitten and not be aware of the bite or stick and not have an evident reaction.