tbuckley/cabot-search huggingface dataset:
A PECULIAR CASE OF ADDISON'S DISEASE.Read in the Section of Dermatology and Syphiligrophy at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May, 1890.
Authors: A. H. OHMANN-DUMESNIL
Journal: JAMA (1890)

Despite the fact that the literature of Addison's disease is vast and that much has been written upon this peculiar affection, its clinical characteristics and its pathology, each new case which is reported has a certain interest attaching to it which is certain to attract more or less attention. I do not purpose writing an exhaustive paper upon the subject, but merely wish to place upon record a case which proved interesting to me from the fact that a certain symptom presented itself which I have not found recorded in connection with this affection. I wish to state, how ever, that my search has been by no means exhaustive, and that similar cases might have escaped me in my rather rapid review of a portion of the literature of the subject. This symptom to which I will call attention later on in a more explicit manner is one which I
OBSERVATIONS ON PEMPHIGUS.
Authors: JOSEPH ZEISLER
Journal: JAMA (1907)

American dermatology has just cause for satisfaction in contemplating the present status of the pemphigus question, at least from a morphologic point of view. It is no longer necessary to mention dermatitis herpetiformis with an air of apology. Not only the French, under the leadership of Brocq, recognize in what they often term Duhring's disease, a clean-cut clinical entity; the English, German, Italian and practically all European dermatologists use that diagnosis continually; and even the Vienna school, obstinate until recently, has of late receded from its position to some extent. The keynote of this whole question is not one of nomenclature nor of classification. Too much printer's ink, I fear, has been wasted in this respect in the past twenty years. The advantage of narrowing down the conception of pemphigus to proper limits and using the term only in reference to more or less serious bullous affections with well-known clinical
Lower threshold for rapid antigen detection testing in patients with sore throats would reduce antibiotic use
Authors: L. Bjerrum, G. C. Cordoba Currea, C. Llor, M. Lindbaek
Journal: BMJ (2013)

Little and colleagues focus on the impact of different management strategies for acute pharyngitis on recovery time and use of antibiotics.1 Acute tonsillitis is one of the most common infections that GPs have to deal with. This study shows that clinical features other than Centor criteria can help determine the presence of group A streptococci and the effect of antibiotics. Short duration of illness seems to be important. 

The study does have limitations however. Recruitment was low—only 697 …
Small bowel involvement in Crohn's disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis
Authors: W A Voderholzer
Journal: Gut (2005)

<b>Background:</b> Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in small bowel diseases. <b>Aim:</b> The aim of this prospective study was to validate the gain in information and therapeutic impact of WCE in patients with Crohn's disease. <b>Methods:</b> Fifty six consecutive patients with Crohn's disease underwent computed tomography (CT) enteroclysis, and if stenoses &lt;10 mm were excluded, WCE was carried out. <b>Results:</b> In 15 patients (27%), WCE could not be performed due to strictures detected by CT enteroclysis. From the other 41 patients, jejunal or ileal lesions were found in 25 patients by WCE compared with 12 by CT enteroclysis (p = 0.004). This gain in information was mainly due to detection of small mucosal lesions such as villous denudation, aphthoid ulcerations, or erosions. Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum (WCE 24 patients, CT enteroclysis 20 patients). Therapy was changed due to WCE findings in 10 patients. Consecutively, all of them improved clinically. <b>Conclusions:</b> Capsule endoscopy improves the diagnosis of small bowel Crohn's disease. This may have significant therapeutic impact.
Unusual Evolution of Acquired Infundibular Stenosis in Patients with Ventricular Septal Defect
Authors: BARRY J. MARON, VICTOR J. FERRANS, ROBERT I. WHITE
Journal: Circulation (1973)

Hemodynamic and cardiac morphologic observations were made on two patients with ventricular septal defect who showed unusual evolution of obstruction to right ventricular outflow. Both patients developed progressive infundibular stenosis, one in the presence of a spontaneously closing ventricular septal defect and the other after operative closure of the defect. Light and electron microscopic examination of resected infundibular muscle revealed hypertrophy and abnormal shapes and arrangements of cardiac muscle cells. These abnormalities resembled those found in left ventricular outflow tract muscle of patients with idiopathic hypertrophic subaortic stenosis. It is suggested that the patterns of distribution and growth of these abnormal cells in the right ventricular outflow tract may lead to localized hypertrophy and to development of progressive infundibular obstruction in some patients with ventricular septal defect.
Systemic antibiotic therapy prevents bacterial infection in cirrhotic patients with gastrointestinal hemorrhage
Authors: Marcel Blaise, Dominique Pateron, Jean-Claude Trinchet, Serge Levacher, Michel Beaugrand, Jean-Louis Pourriat
Journal: Hepatology (1994)

ABSTRACT This randomized prospective study was aimed at assessing the efficiency of a systemic antibiotic therapy for the prevention of bacterial infections in cirrhotic patients with gastrointestinal hemorrhage by ruptured esophageal varices. For 15 mo, all patients hospitalized with no infection on admission, were included in the study. Starting on admission day, patients in group A received ofloxacin (400 mg/day) for 10 days, first intravenously then orally. They also received an intravenous bolus of amoxicillin plus clavulanic acid (1 g) before each endoscopy performed during hemorrhage. Patients in group B received antibiotic therapy only in cases of established or suspected infection. Chest X–ray, blood culture, urine culture and sputum and ascitic fluid culture were performed every day for 7 days, then every other day for the next 7 days. A bronchial sampling was performed with the Wimberley technique on patients with endotracheal intubation. Ninety–one patients (55 men, 54 ± 11 years, 78% Child Pugh class C) were included in the study (46 in group A, 45 in group B). Group A showed a lower incidence of bacterial infections than group B (20% vs. 66%; p&lt;0.001). Breakdown of positive bacteriological sampling was as follows: blood (6 vs. 17), ascites (3 vs. 7), lungs (2 vs. 18), urine (1 vs. 10). The 2–wk mortality rate was 24% in group A and 35% in group B. (Hepatology 1994;20:34–38.)
Pathology of the intima in coarctation of the aorta: a study using light and scanning electron microscopy
Authors: A. Kennedy, D G Taylor, T E Durrant
Journal: Thorax (1979)

In the adult type of coarctation of the aorta the lumen is constricted by a shelf of fibromuscular tissue that protrudes from the dorsal wall of the aorta at a point near the site of insertion of the ligamentum arteriosum. The intima covering this constricting shelf has been studied using conventional light microscopy and scanning electron microscopy of surgical specimens of coarctation removed at ages varying from 2 to 46 years. Immediately proximal to the stenosis, the intima was found to run in fine longitudinal folds that radiated into the orifice. On the distal side of the shelf the intima was grossly irregular with deep longitudinal and transverse folds that gave it a convoluted appearance resembling the surface of the brain. In adults and older children the intima immediately distal to the orifice was covered with a laminated layer, distinct from the elastica, which often gave positive staining reactions for fibrin. Intimal thickness increased irregularly with age, but large increases of 500 μm or greater were found only in patients over the age of 15 years. These findings are consistent with the view that the constriction has both a fibroelastic component that is congenital and a fibrous component that is acquired and progressive. It is suggested that this progressive element is caused by deposition of fibrin on an abnormal intimal surface in a region of turbulent blood flow. Such a mechanism would explain the occasional recurrence of coarctation of the aorta after surgery. This may be due to failure to remove the abnormal area of endothelium completely and to persistent abnormalities of blood flow at the site of anastomosis.
Again, the Virologist's Dilemma
Authors: A. Martin Lerner
Journal: New England Journal of Medicine (1968)

IT was Koch, in 1884, Rivers, in 1937, and Huebner, in 1957, who judiciously cautioned their colleagues that it is unscientific to use a laboratory method beyond its range of accuracy.1 , 2 Thomas Rivers, in discussing Huebner's revisions of his own alterations of Koch's postulates for establishing an etiologic association between an infectious agent and a given disease, added, "progress of knowledge in infectious diseases having left behind old rules requires new ones which will someday without doubt be declared obsolete." Particularly pertinent to a critique of the stimulating developmental paper by Burch, Chu and Sohal, which appears elsewhere in this . . .
HEAD-TO-HEAD COMPARISON OF CORONARY CALCIUM IMAGING, COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY AND EXERCISE TESTING IN REAL-WORLD PATIENTS WITH STABLE CHEST PAIN
Authors: Koen Nieman, Tjebbe Galema, Lisan Neefjes, Annick Weustink, Paul Musters, Adriaan Moelker, Pim De Feyter, Erasmus MC
Journal: Journal of the American College of Cardiology (2010)
Repetitive Monomorphic Tachycardia From the Left Ventricular Outflow Tract: Electrocardiographic Patterns Consistent With a Left Ventricular Site of Origin
Authors: David J Callans, Volker Menz, David Schwartzman, Charles D Gottlieb, Francis E Marchlinski
Journal: Journal of the American College of Cardiology (1997)

Objectives. This study sought to characterize the electrocardiographic patterns predictive of left ventricular sites of origin of repetitive monomorphic ventricular tachycardia (RMVT). Background. RMVT typically arises from the right ventricular outflow tract (RVOT) in patients without structural heart disease. The incidence of left ventricular sites of origin in this syndrome is unknown. Methods. Detailed endocardial mapping of the RVOT was performed in 33 consecutive patients with RMVT during attempted radiofrequency ablation. Left ventricular mapping was also performed if pace maps obtained from the RVOT did not reproduce the configuration of the induced tachycardia. Results. Pace maps identical in configuration to the induced tachycardia were obtained from the RVOT in 29 of 33 patients. Application of radiofrequency energy at sites guided by pace mapping resulted in elimination of RMVT in 24 (83%) of 29 patients. In four patients (12%), pace maps obtained from the RVOT did not match the induced tachycardia. All four patients had a QRS configuration during RMVT with precordial R wave transitions at or before lead V2. In two patients, RMVT was mapped to the mediosuperior aspect of the mitral valve annulus, near the left fibrous trigone; catheter ablation at that site was successful in both. In two patients, RMVT was mapped to the basal aspect of the superior left ventricular septum. Catheter ablation was not attempted because His bundle deflections were recorded from this site during sinus rhythm. Conclusions. RMVT can arise from the outflow tract of both the right and left ventricles. RMVTs with a precordial R wave transition at or before lead V2are consistent with a left ventricular origin. (J Am Coll Cardiol 1997;29:1023–7) © 1997 by the American College of Cardiology
A18: Risk Factors for Symptomatic Avascular Necrosis in Childhood-Onset Systemic Lupus Erythematous
Authors: Yelin Yang, Sathish Kumar, Earl D. Silverman, Deborah M. Levy
Journal: Arthritis & Rheumatology (2014)

Background/Purpose:

Childhood-onset systemic lupus erythematous (cSLE) has a more severe clinical course with higher disease activity and involvement of major organs compared to adult-onset SLE. Avascular necrosis (AVN) is a significant morbidity causing pain and disability, sometimes requiring joint replacement surgery. Our objective was to examine the frequency and risk factors for symptomatic AVN in cSLE.



Methods:

A single center matched case-control design was used. 617 patients with cSLE followed at SickKids Lupus Clinic between July 1982 and June 2013 were included in the study. The AVN cohort consisted of 37 patients identified with clinical findings of symptomatic AVN and diagnosis confirmed by one or more imaging modalities. Three controls were matched to each AVN patient by date and age at diagnosis (± 1 year). Baseline clinical, laboratory and treatment characteristics were compared between the patients with AVN and the controls by univariate analyses and if statistically significant, were included in a multivariable logistic regression model.



Results:

A total of 37/617 (6%) patients developed symptomatic AVN during follow-up at SickKids. The majority was female (30/37, 81%) and of Asian descent (20/37, 54%). The mean age at diagnosis was 16.1 years (±2.1), with median time to AVN of 1.52 years. Only 2/37 (5%) of patients developed AVN prior to the onset of puberty. The hip was the most commonly involved joint (26/37, 70%) with bilateral involvement in 49% (18/37) of patients. Compared to the matched non-AVN cohort, patients with AVN had higher incidence of CNS disease (p = 0.003), nephritis (p < 0.001), acute or chronic renal failure (p = 0.029), but less frequent photosensitivity (p = 0.006). Patients with AVN also required greater cumulative prednisone from cSLE diagnosis to AVN (364 ± 53 vs. 232 ± 36 mg/kg, p < 0.001), higher prednisone dose at time of AVN diagnosis (±3 months, 0.30 ± 0.25 vs. 0.19 ± 0.24 mg/kg, p = 0.012), maximal daily prednisone dose (1.25 ± 0.36 vs. 0.71 ± 0.53 mg/kg, p < 0.001) and more frequent use of pulse methylprednisolone therapy (39% vs. 10%, p < 0.001). The median prednisone dose at time of AVN was 0.27 vs. 0.09 mg/kg. Multivariable regression analysis confirmed nephritis, CNS disease, maximal daily prednisone dose and use of pulse methylprednisolone as significant predictors of symptomatic AVN development. Overall disease activity from SLE diagnosis to AVN diagnosis as measured by adjusted mean SLEDAI was not significantly different (6310 ± 976 vs. 4994 ± 440, p = 0.165).



Conclusion:

cSLE patients with severe organ involvement including nephritis and CNS disease, higher maximal daily dose of prednisone, and more frequent use of pulse methylprednisolone are more likely to develop symptomatic AVN.
Inhaled tryptase causes bronchoconstriction in sheep via histamine release.
Authors: J F Molinari, M Scuri, W R Moore, J Clark, R Tanaka, W M Abraham
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Allergen-induced bronchoconstriction involves mast cell activation. Tryptase is a mast cell serine protease that is released during this process, but little is known about the action of tryptase in the airway. The purpose of this study was to determine: (1) if aerosolized tryptase causes bronchoconstriction, and (2) the mechanism by which this occurs. We measured mean pulmonary flow resistance (RL) in five allergic sheep before and after consecutive inhalations of 100 and 500 ng tryptase (in 2 ml total volume). Inhaled tryptase at 100 and 500 ng increased RL (mean +/- SE) by 33 +/- 12 and 122 +/- 8% (p < 0.05) over baseline. The response was reproducible upon repeat challenges. These studies were repeated in the same animals after pretreatment with aerosolized APC 366 (9 mg/3 ml), a specific tryptase inhibitor. In APC-366-treated sheep, tryptase increased RL by 10 +/- 3 and 6 +/- 2% (p < 0.05 versus control values) at 100 and 500 ng, respectively. The response to tryptase was also blocked by pretreating the sheep intravenously with the histamine H1-antagonist chlorpheniramine (2 mg/kg), in which RL increased only 5 +/- 4 and 7 +/- 6% after 100 and 500 ng tryptase. APC 366, however, did not block histamine-induced bronchoconstriction. Consistent with these findings was the observation that segmental bronchial challenge with tryptase (1 microgram) resulted in a significant increase in histamine levels in bronchoalveolar lavage. Inhaled tryptase (500 ng) also caused airway hyperresponsiveness to aerosolized carbachol 2 h after tryptase challenge. This tryptase-induced airway hyperresponsiveness could be blocked either by pretreating the sheep with APC 366 (30 min before challenge) or by treating the sheep 30 min after challenge. These results indicate that inhaled tryptase causes bronchoconstriction and airway hyperresponsiveness in allergic sheep by an event that may involve mast cell activation.
Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and kindergartens in Hong Kong
Authors: Pak-Leung Ho, Susan S. Chiu, Maggie Y. Chan, Yuki Gan, Kin-Hung Chow, Eileen L. Lai, Yu-Lung Lau
Journal: Journal of Infection (2012)
Book: Life at the Extremes: The Science of Survival
Authors: G. Hutchison
Journal: BMJ (2001)

Harper Collins, £17.99, pp 326 ISBN 0 00 255946 3 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> This book is aimed at the general reader and deals with human and animal adaptation to extreme conditions: high altitude, diving, heat and cold adaptation, the limits on athletic performance, and the physiological derangements of space flight. The style is anecdotal and episodic. Pure physiological discussions cover only a page or two at a time, short enough … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
1015 DYSMETABOLIC HEPATIC IRON OVERLOAD SYNDROME: ANALYSIS OF HEPCIDIN RESPONSE TO ACUTE ORAL IRON AND CHRONIC IRON OVERLOAD
Authors: V. Paolini, P. Trombini, S. Pelucchi, R. Mariani, A. Salvioni, M. Pozzi, E. Nemeth, T. Ganz, A. Piperno
Journal: Journal of Hepatology (2009)
Modulation of in vitro erythropoiesis. Studies with euthyroid and hypothyroid dogs.
Authors: W J Popovic, J E Brown, J W Adamson
Journal: Journal of Clinical Investigation (1979)

The interactions of adrenergic agonists and thyroid hormones on the growth of erythroid colony-forming units were studied in cultures of dog marrow before and after the establishment of hypothyroidism. Erythroid colony growth in cultures form euthyroid dogs was enhanced by isoproterenol and other adrenergic agonists having beta 2-receptor specificity. With hypothyroidism, however, this responsiveness was lost, and sensitivity to alpha-agonists, such as phenylephrine and norepinephrine, was acquired. This alteration in receptor specificity appeared to be dependent upon thyroid hormone and was rapidly reversible. Preincubation of marrow cells from hypothyroid animals with thyroid hormone resulted in the reappearance of responsiveness to beta-adrenergic agonists and the loss of sensitivity to alpha-agonists. These findings are in agreement with previous suggestions that beta-adrenergic receptor activity is modulated by thyroid hormone levels and demonstrate that the specificity of adrenergic modulations of erythropoiesis in culture may accurately reflect the thyroid status of the intact animal.
Pneumoperitoneum Due to Spontaneously Perforated Pyometra
Authors: Ming-Shian Tsai, Ming-Hsun Wu
Journal: New England Journal of Medicine (2006)

n engl j med 354;21 www.nejm.org may 25, 2006 e23 A 40-year-old woman with long-standing diabetes presented to the emergency room with fever (temperature, 39.5°C) and diffuse abdominal pain. On admission, she had a distended abdomen with muscular rigidity, Blumberg’s sign, a white-cell count of 23,530 per cubic millimeter, and a C-reactive protein level of 27.5 mg per deciliter. A chest roentgenogram, obtained while the patient was erect, showed bilateral subphrenic free air (Panel A, arrowheads). Computed tomography showed a large abscess (11 cm) containing air (Panel B, arrowhead) in the lower abdomen. At laparotomy, a perforated necrotic area on the uterine fundus (Panel C, arrowhead) and infected ascites were noted. The patient was treated with subtotal hysterectomy and drainage and had an uneventful recovery.
Rationale and design of a randomized, double‐blind, placebo‐controlled outcome trial of ivabradine in chronic heart failure: the Systolic Heart Failure Treatment with the I<sub>f</sub> Inhibitor Ivabradine Trial (SHIFT)
Authors: Karl Swedberg, Michel Komajda, Michael Böhm, Jeffrey S. Borer, Ian Ford, Luigi Tavazzi
Journal: European Journal of Heart Failure (2009)
Radical-scavenging activities of marine-derived xyloketals and related chromanes
Authors: Zhongliang Xu, Bingtai Lu, Qi Xiang, Yiying Li, Shichang Li, Yongcheng Lin, Jiyan Pang
Journal: Acta Pharmaceutica Sinica B (2013)

Xyloketals, a new type of antioxidants from a marine mangrove fungus, have potential pharmacological properties. In this paper, the radical-scavenging activities of a series of synthetic xyloketals and related chromanes toward 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) were evaluated by absorption spectrometry. One of the compounds (compound 10) displayed significant antioxidative action against DPPH and ABTS. A structure-activity analysis showed that the reactive sites on these compounds correlated with a hydroxy-group and also with ketal or aromatic H substituents. Based in part on a density functional theory (DFT) calculation of compound 10, the antioxidant mechanism of this chromane was deduced as a possible radical-scavenging mechanism by a sequential proton loss electron-transfer (SPLET) process.
Metastasizing Melanoma Formation Caused by Expression of Activated N-RasQ61K on an INK4a-Deficient Background
Authors: Julien Ackermann, Manon Frutschi, Kostas Kaloulis, Thomas McKee, Andreas Trumpp, Friedrich Beermann
Journal: Cancer Research (2005)

Abstract In human cutaneous malignant melanoma, a predominance of activated mutations in the N-ras gene has been documented. To obtain a mouse model most closely mimicking the human disease, a transgenic mouse line was generated by targeting expression of dominant-active human N-ras (N-RasQ61K) to the melanocyte lineage by tyrosinase regulatory sequences (Tyr::N-RasQ61K). Transgenic mice show hyperpigmented skin and develop cutaneous metastasizing melanoma. Consistent with the tumor suppressor function of the INK4a locus that encodes p16INK4A and p19ARF, &amp;gt;90% of Tyr::N-RasQ61K INK4a−/− transgenic mice develop melanoma at 6 months. Primary melanoma tumors are melanotic, multifocal, microinvade the epidermis or epithelium of hair follicles, and disseminate as metastases to lymph nodes, lung, and liver. Primary melanoma can be transplanted s.c. in nude mice, and if injected i.v. into NOD/SCID mice colonize the lung. In addition, primary melanomas and metastases contain cells expressing the stem cell marker nestin suggesting a hierarchical structure of the tumors comprised of primitive nestin-expressing precursors and differentiated cells. In conclusion, a novel mouse model with melanotic and metastasizing melanoma was obtained by recapitulating genetic lesions frequently found in human melanoma.