tbuckley/cabot-search huggingface dataset:
Neonatal Herpes-Reply
Authors: William A. Growdon
Journal: JAMA (1987)

In Reply.—  The growing problem of asymptomatic transmission of sexually transmitted diseases to the neonate challenges health care providers of obstetrical services.Chlamydia trachomatisand HSV are prevalent—16.8% and 2.2% by culture, respectively, in high-risk women who are sexually active and of childbearing age. The exact prevalence of HSV infection has not been addressed on a large scale; in fact, it is estimated to be much higher than was thought. Twenty-nine percent (49/169 positive for HSV type 2 antibodies) was reported for a Los Angeles private practice obstetrical population with no history of HSV infection tested with Western blot analysis.1Random culturing methods to determine HSV prevalence will always grossly underestimate the at-risk population because viral shedding is likely to be transient and infrequent as demonstrated in our article.  I believe that one cervical culture in the last trimester of all pregnant patients would be no better than serial
Focal Uptake on Bone Imaging in an Asymptomatic Schmorl??s Node
Authors: SARAH KAGEN, MAHVASH RAFII, ELISSA LIPCON KRAMER
Journal: Clinical Nuclear Medicine (1988)

A solitary focus of increased uptake was noted on a radionuclide bone scan in a 40-year-old woman with newly diagnosed breast carcinoma. She denied symptoms referable to this abnormality. Although the plain radiographs were negative, CT scan demonstrated a Schmorl's node corresponding to the image abnormality. Increased accumulation on bone scan has not previously been reported in the absence of symptoms.
Posttranslational events involved in griseofulvin-induced keratin cytoskeleton alterations
Authors: Hermann Salmhofer, Ingrid Rainer, Kurt Zatloukal, Helmut Denk
Journal: Hepatology (1994)

Alcoholic hepatitis is a disease associated with profound alterations of the hepatocytic intermediate filament cytoskeleton. Similar cytoskeletal alterations can be induced in mice with prolonged feeding of the fungistatic drug griseofulvin. Murine hepatocytic intermediate filaments are composed of equimolar amounts of keratin polypeptides A (type II) and D (type I). Griseofulvin intoxication of mice leads to diminution, derangement and even loss of the cytoplasmic keratin meshwork and formation of keratin-containing cytoplasmic inclusions, termed Mallory bodies. To study protein alterations leading to disturbance of keratin filament architecture, soluble keratin polypeptides and keratin filaments were purified from griseofulvin-damaged and control mouse livers. In griseofulvin-damaged livers, more acidic isoforms occurred in soluble keratin D, whereas the corresponding filaments had a polypeptide composition similar to that in controls. In vivo [32P]orthophosphate incorporation revealed that the shift of isoelectric forms toward more acidic spots was due to hyperphosphorylation of keratin D. The nature of the kinase(s) involved has yet to be elucidated. In addition, rapid proteolysis only of soluble keratin A was detected in vitro, and there is evidence for increased proteolysis in griseofulvin damage in vivo. The enzyme involved has features of a calpain-type protease. Posttranslational modifications play a substantial role in the disturbance of keratin intermediate filament homeostasis in vivo.
Case 42-1966
Authors: Pierre M. Dreyfus, Austin L. Vickery, Edward P. Richardson
Journal: New England Journal of Medicine (1966)

Presentation of CaseA fifty-two-year-old man entered the hospital because of difficulty in talking.For many years he had had chronic rhinitis, for which he had instilled a variety of medications. Thirteen years previously a biopsy of the left vocal cord was performed because of hoarseness; microscopical examination revealed hyperkeratosis, without evidence of malignancy. He had been well otherwise until five days before admission, when his wife noticed that he was unusually sleepy and appeared confused. After a daytime nap, which was not his usual practice, he left home in an automobile and promptly drove into a snowbank. He walked . . .
OC-087 Screen-Detected Colorectal Cancers are Associated with an Improved outcome when Compared with Interval Cancers when Matched for Stage: Abstract OC-087 Table
Authors: M D Gill, M Bramble, M Hull, S Mills, E Morris, M Bradburn, Y Bury, C Parker, T Lee, C Rees
Journal: Gut (2013)

<h3>Introduction</h3> Colorectal cancers detected through the NHS Bowel Cancer Screening Programme (BCSP) have been shown to have a more favourable outcome compared to non-screen detected cancers. The aim of this study was to identify whether this was solely due to the earlier stage shift of these cancers, or whether there were other factors involved. <h3>Methods</h3> A combination of a regional colorectal cancer registry (Northern Colorectal Cancer Audit Group) and the BCSP database were used to identify screen detected cancers and interval cancers (diagnosed after a negative faecal occult blood test, before the next screening round). All cancers were diagnosed between April 2007 and March 2010, within the North East of England. For each Dukes’ stage, patient demographics, tumour characteristics, and survival rates were compared between the screen detected and interval cancer groups. <h3>Results</h3> 322 screen detected cancers were compared against 192 interval cancers. Significant differences highlighted in bold, p &lt; 0.05. Mean follow-up 32 months. <h3>Conclusion</h3> With equivalent patient demographics and tumour characteristics, the improved survival of screen detected cancers over interval cancers for Stages C and D suggest that there may be a biological difference in the cancers in each group. Although lead-time bias may have a role, this may be related to a tumours propensity to bleed and therefore may reflect detection through current screening tests. <h3>Disclosure of Interest</h3> None Declared
Development of folliculitis and pyoderma gangrenosum in association with abdominal pain in a patient following treatment with isotretinoin
Authors: BRONWYN R. HUGHES, W.J. CUNLIFFE
Journal: British Journal of Dermatology (1990)

Journal Article Development of folliculitis and pyoderma gangrenosum in association with abdominal pain in a patient following treatment with isotretinoin Get access BRONWYN R. HUGHES, BRONWYN R. HUGHES Department of Dermatology, The General Infirmary, Leeds Dr B.R.Hughes, Department of Dermatology, The General Infermary, Great George Street, Leeds LSi3EX. Search for other works by this author on: Oxford Academic Google Scholar W.J. CUNLIFFE W.J. CUNLIFFE Department of Dermatology, The General Infirmary, Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 122, Issue 5, 1 May 1990, Pages 683–687, https://doi.org/10.1111/j.1365-2133.1990.tb07291.x Published: 01 May 1990
793 REAL-LIFE DATA OF TELAPREVIR-BASED TRIPLE-THERAPY IN PATIENTS WITH CHRONIC HEPATITIS C GT1 IN GERMANY – AN INTERIM ANALYSIS
Authors: T. Berg, P. Buggisch, D. Hueppe, H. Wedemeyer, M. Schuier, S. Decker-Burgard, S. Mauss
Journal: Journal of Hepatology (2013)
Nuclear Factor-κB as a target of cyclosporin in acute hypovolemic hemorrhagic shock
Authors: Domenica Altavilla, Antonino Saitta, Salvatore Guarini, Mariarosaria Galeano, Giovanni Squadrito, Letterio B. Santamaria, Francesco S. Venuti, Carla Bazzani, Alfio Bertolini, Francesco Squadrito
Journal: Cardiovascular Research (2001)

Background: Cyclosporin is an immunosuppressive drug that blocks Nuclear Factor κB (NF-κB) activation. We investigated the role of NF-κB in acute hypovolemic hemorrhagic (Hem) shock and the effects of cyclosporin in this model of experimental shock. Methods: Hem shock was induced in male anesthetized rats by intermittently withdrawing blood from an iliac catheter over a period of 20 min (bleeding period) until mean arterial blood pressure (MAP) fell and stabilized within the range of 20–30 mmHg. Two minutes after bleeding cessation, animals received intravenously cyclosporin (1 mg kg−1) or its vehicle. Survival rate and survival time were evaluated for 120 min after bleeding was discontinued. Plasma TNF-α levels were investigated at different time points after bleeding cessation. Moreover we investigated levels of TNF-α mRNA in the liver, vascular reactivity, liver NF-κB binding activity and levels of the inhibitory protein IκBα in the cytoplasm. Results: Hemorrhagic shocked rats died in 27±6 min following the cessation of bleeding, experienced a marked hypotension (mean arterial blood pressure=20–30 mmHg) and had enhanced plasma levels of Tumor Necrosis Factor-α (208±22 pg ml−1, 20 min after the end of bleeding). Furthermore, aortas taken 20 min after bleeding from hemorrhagic shocked rats showed a marked hypo-reactivity to phenylephrine (PE: 1 nM–10 μM) compared with aortas harvested from sham shocked rats. Hem shocked rats also had increased levels of TNF-α mRNA in the liver (15–20 min after the end of bleeding). Electrophoretic mobility shift assay showed that liver NF-κB binding activity increased in the nucleus 10 min after the end of hemorrhage and remained elevated until the death of animals. Western blot analysis suggested that the levels of inhibitory protein IκBα in the cytoplasm decreased at 5 min after the end of bleeding. Cyclosporin inhibited the loss of IκBα protein from the cytoplasm and prevented NF-κB binding activity in the nucleus. Furthermore, cyclosporin increased survival time (118±7 min; P<0.01) and survival rate (vehicle=0% and cyclosporin=80%, at 120 min after the end of bleeding), reverted the marked hypotension, decreased liver mRNA for TNF-α, reduced plasma TNF-α (28±7 pg ml−1), and restored to control values the hypo-reactivity to PE. Conclusions: Our results suggest that acute blood loss (50% of the estimated total blood volume over a period of 20 min) causes early activation of NF-κB which triggers an inflammatory cascade leading to a fatal outcome. Cyclosporin blocks NF-κB activation and protects against hypovolemic hemorrhagic shock.
High Prevalence of Coronary Atherosclerosis in Asymptomatic Teenagers and Young Adults
Authors: E. Murat Tuzcu, Samir R. Kapadia, Eralp Tutar, Khaled M. Ziada, Robert E. Hobbs, Patrick M. McCarthy, James B. Young, Steven E. Nissen
Journal: Circulation (2001)

Most of our knowledge about atherosclerosis at young ages is derived from necropsy studies, which have inherent limitations. Detailed, in vivo data on atherosclerosis in young individuals are limited. Intravascular ultrasonography provides a unique opportunity for in vivo characterization of early atherosclerosis in a clinically relevant context.Intravascular ultrasound was performed in 262 heart transplant recipients 30.9+/-13.2 days after transplantation to investigate coronary arteries in young asymptomatic subjects. The donor population consisted of 146 men and 116 women (mean age of 33.4+/-13.2 years). Extensive imaging of all possible (including distal) coronary segments was performed. Sites with the greatest and least intimal thickness in each CASS segment were measured in multiple coronary arteries. Sites with intimal thickness >/=0.5 mm were defined as atherosclerotic. A total of 2014 sites within 1477 segments in 574 coronary arteries (2.2 arteries per person) were analyzed. An atherosclerotic lesion was present in 136 patients, or 51.9%. The prevalence of atherosclerosis varied from 17% in individuals <20 years old to 85% in subjects >/=50 years old. In subjects with atherosclerosis, intimal thickness and area stenosis averaged 1.08+/-0.48 mm and 32.7+/-15.9%, respectively. For all age groups, the average intimal thickness was greater in men than women, although the prevalence of atherosclerosis was similar (52% in men and 51.7% in women).This study demonstrates that coronary atherosclerosis begins at a young age and that lesions are present in 1 of 6 teenagers. These findings suggest the need for intensive efforts at coronary disease prevention in young adults.
533 3-PYRIDINE CARBOXAMIDE INHIBITS THE DEVELOPMENT OF AN EARLY HEPATOCELLULAR CARCINOMA IN MICE AND INDUCES CELL CYCLE ARREST AND APOPTOSIS IN HEPATOCELLULAR CARCINOMA CELL LINES
Authors: S.Y. Park, K. Lee, E. Shin, M. Zhang, M.-J. Lee, J.-J. Jang
Journal: Journal of Hepatology (2009)
Natural Selection and the Origin and Evolution of Weeping in Man
Authors: Ashley Montagu
Journal: JAMA (1960)

IT IS A curious thing that man is the only creature who weeps. That is to say, man is the only creature who sheds tears when he is emotionally distressed. The shedding of tears as an accompaniment of emotional distress has been attributed to other animals, such as the dog, the elephant, the koala bear, and, of course, the crocodile. The truth, however, appears to be that while some of these animals may upon occasion exhibit the evidences of tears, this occurs very seldom, and is the exception rather than the rule. These animals, like all terrestrial vertebrates, possess a lacrimal system, and their eyes are bathed by the secretions of the lacrimal gland, but psychic weeping is not known to occur as a normal function in any animal other than man. Fish and aquatic animals whose eyes are bathed by the fluid medium in which they live do
Transfusion vs Anesthesia-Related Hepatitis-Reply
Authors: Harvey G. Klein
Journal: JAMA (1996)

In Reply.  —The letter from Drs Abouleish and Berman raises an important point. The cause of hepatitis following blood transfusion is often difficult to determine, not only for the surgical patient but also for the oncology patient, the transplant patient, and the patient in the intensive care unit. Ideally, before making a diagnosis of posttransfusion viral hepatitis, one would like to know that the patient had no exposure to the virus before transfusion, had active viral infection after transfusion, and received blood containing the implicated agent. Such information is rarely available. More often the diagnosis is suspected, established, or excluded, on the basis of clinical presentation, serum chemistry determinations, and serology.  Today, hepatitis in a surgical setting results from a number of infrequent causes in addition to allogenic blood, including medication, anesthetics, and even transmission from surgeon to patients. 1 The efficacy of blood donor screening procedures has been demonstrated
Some Abuses of Drugs in Therapy
Authors: Dale G. Friend, George A. McLemore
Journal: New England Journal of Medicine (1956)

THE tremendous advances made in drug therapy in the past decade have created considerable confusion in the minds of many. Most of the new medicinal agents have undoubtedly contributed much to the physician's ability to treat his patients better. Unfortunately, the appearance of new substances has been so rapid as to keep anyone from being able to understand them fully and to evaluate them wisely, much less to employ them with skill in the treatment of the patient.Around the turn of the century, Osler and other medical leaders were seriously concerned about the profusion of what seemed to them . . .
DISLOCATION OF BOTH HIPS AT THE SAME TIME IN THE SAME SUBJECT
Authors: H. L. Prichard
Journal: BMJ (1854)

itNAlr mnIUNOA?IONS.S" is -i IIy klie: he, however, descibes aU the exre- tios choler as alkaline, and gives as the cause the ascertained presence of carbonate of ammonia, a circum- stance to which he appears to me to attribute undue im- portance.This alkaline reaction, except in the case of the tools, is quite opposed to my own observations.[To be continue4.]
Multimodal treatment in operable breast cancer: five-year results of the CMF programme.
Authors: A Rossi, G Bonadonna, P Valagussa, U Veronesi
Journal: BMJ (1981)

The five-year results of a prospective randomised trial of radical mastectomy (179 patients) versus radical mastectomy followed by adjuvant chemotherapy (207 patients) were analysed. Chemotherapy consisted of 12 monthly cycles of cyclophosphamide, methotrexate, and fluorouracil (CMF). Both relapse-free survival (controls 44.6%, CMF group 59.5%) and total survival (controls 66.2%, CMF group 78.4%) were significantly improved. The findings were related to the number of diseased axillary nodes and amount of drug administered, and were independent of CMF-induced amenorrhoea. Menopausal state alone appeared to affect the five-year results only when the amount of drug administered was not taken into account. Salvage treatment at first relapse failed to improve total survival in the controls compared with the CMF group. Acute toxic manifestations were moderate and reversible. Chronic organ damage and increased incidence of second neoplasms (controls 1.7%, CMF group 1.4%) were not observed. The multimodality approach to treatment of primary breast cancer is a new and important advance. This and other studies are continuing.
Empirical Bioethics Research in the Developing World: When the ‘Is’ is Close to an ‘Ought’
Authors: Claudia I. Emerson, Ross E. G. Upshur, Abdallah S. Daar
Journal: The American Journal of Bioethics (2009)

If Hume were alive today and working as a bioethicist, he would (perhaps may, as he had a great fondness for armchairs) be an empirical bioethicist relying on observation to study the moral issues ...
Misdiagnosis of exercise‐induced bronchoconstriction in professional soccer players
Authors: L. Ansley, P. Kippelen, J. Dickinson, J. H. K. Hull
Journal: Allergy (2011)

Abstract Background: Physicians typically rely heavily on self‐reported symptoms to make a diagnosis of exercise‐induced bronchoconstriction ( EIB ). However, in elite sport, respiratory symptoms have poor diagnostic value. In 2009, following a change in international sports regulations, all elite athletes suspected of asthma and/or EIB were required to undergo pulmonary function testing (PFT) to permit the use of inhaled β 2 ‐agonists. The aim of this study was to examine the diagnostic accuracy of physician diagnosis of asthma/ EIB in English professional soccer players. Methods: Sixty‐five players with a physician diagnosis of asthma/ EIB were referred for pulmonary function assessment. Medication usage and respiratory symptoms were recorded by questionnaire. A bronchial provocation test with dry air was conducted in 42 players and a mannitol challenge in 18 players. Five players with abnormal resting spirometry performed a bronchodilator test. Results: Of the 65 players assessed, 57 (88%) indicated regular use of asthma medication. Respiratory symptoms during exercise were reported by 57 (88%) players. Only 33 (51%) of the players tested had a positive bronchodilator or bronchial provocation test. Neither symptoms nor the use of inhaled corticosteroids were predictive of pulmonary function tests’ outcome. Conclusion: A high proportion of E nglish professional soccer players medicated for asthma/ EIB (a third with reliever therapy only) do not present reversible airway obstruction or airway hyperresponsiveness to indirect stimuli. This underlines the importance of objective PFT to support a symptoms‐based diagnosis of asthma/ EIB in athletes.
Who Speaks for the Adolescent?
Authors: Victor C. Strasburger
Journal: JAMA (1983)

ADOLESCENT medicine began more than 30 years ago when J. Roswell Gallagher established the first Adolescent Unit at Boston Children's Hospital in 1952.<sup>1</sup>His rationale was that "medical clinics devoted to the care of a single age group foster a physician's tendency to consider his patient, diminish the likelihood that he will focus upon disease alone, and help to increase his knowledge of what patients are like and what they require at various times of their life."<sup>2</sup>A new breed of physician was spawned—part psychiatrist, part gynecologist, part internist, part dermatologist, and part pediatrician. Twenty years later, the American Academy of Pediatrics (AAP) clearly staked out adolescents as being within a pediatrician's practice "boundaries": "The purview of pediatrics includes the growth, development, and health of the child... and continues through childhood and adolescence.... The responsibility of pediatrics may therefore begin during pregnancy and usually terminates by 21 years
Action is needed now on end of life care, says King's Fund
Authors: H. Mooney
Journal: BMJ (2010)

Clinicians and NHS managers must prioritise care at the end of life, despite the economic downturn, a new report by the healthcare think tank the King’s Fund has warned.

The report calls on the NHS to provide the care that people want at the end of their life and to deliver on the government’s strategy on end of life care.

It recommends guaranteeing care within one hour of a request for help, training clinicians to help them to talk to patients and carers about the end of life, and commissioning good services from local service providers.

Rachael Addicott, senior research fellow and the lead on end of life care at the …
Peripheral assessment of phenylephrine-induced vasoconstriction by laser Doppler flowmetry and its potential relevance to homeostatic mechanisms.
Authors: D G Silverman, A B Jotkowitz, M Freemer, V Gutter, T Z O'Connor, I M Braverman
Journal: Circulation (1994)

BACKGROUND Cutaneous laser Doppler flowmetry enables monitoring of changes in skin perfusion by quantifying the phase shift of laser light induced by moving red blood cells under a fiberoptic probe. It thus can identify the presence of and response to a vasoconstrictive stimulus. However, aspects of the technique must be defined before it can be used with maximum effectiveness. We evaluated the responses of two different laser Doppler outputs, the concentration of moving blood cells (CMBC) and red cell flux (CMBC times cell velocity), and the responses at two sites of probe application, the finger and forearm, during systemic infusions of phenylephrine. METHODS AND RESULTS Eight healthy volunteers were monitored with a brachial blood pressure cuff, ECG, and laser Doppler flowmeter probes applied to the palmar surface of the fourth finger and volar forearm of the arm opposite the pressure cuff. After baseline readings were obtained, the subjects received three 10-minute intravenous infusions of phenylephrine at rates of 0.4, 0.8, and 1.6 micrograms.kg-1.min-1. The two parameters, flux and CMBC, trended similarly. Flux and CMBC at the finger declined significantly in response to each infusion (P &lt; .05 using repeated-measures ANOVA with Duncan's multiple range test). In contrast, flux and CMBC of the forearm had highly variable responses, with an overall increase during each infusion (P &lt; .05 for % delta of forearm versus % delta of finger readings during the 0.4 microgram.kg-1.min-1 infusion). Heart rate declined significantly during each infusion, consistent with a baroreceptor-mediated response, even though systolic and diastolic blood pressures each increased by less than 2 mm Hg during the 0.4 microgram.kg-1.min-1 infusion. CONCLUSIONS As expected, laser Doppler readings at the finger decreased during infusion of an alpha 1-agonist. Although, like the digital vessels, forearm vessels have the potential to constrict, the increases in forearm readings suggest that these vessels are highly susceptible to homeostatic responses. The increase in CMBC (a parameter that is sensitive primarily to local changes in vascular caliber) suggested vasodilation of the underlying vessels. The forearm vasodilation and the concomitant decline in heart rate most likely represented vagally mediated baroreceptor activity, which was altered even though blood pressure changed minimally during the 0.4 microgram.kg-1.min-1 infusion. Thus, integrated assessment of skin perfusion at the finger and forearm may provide valuable information about the direct and indirect effects of a vasoactive stimulus. The present application of laser Doppler flowmetry suggests activation of vasodilatory reflexes despite minimal changes in blood pressure.