tbuckley/cabot-search huggingface dataset:
Isolated lichen planus of the nails associated with primary biliary cirrhosis
Authors: J.M. SOWDEN, P.H. CARTWRIGHT, J.R.B. GREEN, J.N. LEONARD
Journal: British Journal of Dermatology (1989)

Lichen planus is a relatively common inflammatory dermatosis with characteristic lesions affecting the skin, nails and mucous membranes. Nail changes are present in approximately 10% of patients and can occasionally occur in the absence of skin involvement. The association of lichen planus with primary biliary cirrhosis is now well recognized. We report the first case of lichen planus confined to the nails in a patient with primary biliary cirrhosis.
Fulminant hepatic failure caused by ecarazine hydrochloride (a hydralazine derivative)
Authors: Y TAMEDA
Journal: Hepatology (1996)

The cause of fulminant hepatic failure is reported to be unknown in more than half the cases in Japan. We recently reviewed 23 cases of fulminant hepatic failure that had been treated at our hospital. The cause of disease had been regarded as unknown before this study. It was found that seven of these patients had been under ecarazine hydrochloride therapy when they developed fulminant hepatic failure. We examined the reasons why fulminant hepatic failure in these seven patients had not been previously attributed to ecarazine, and found that it could be explained by the following factors: (1) the time from the start of ecarazine therapy to the onset of hepatic failure was long; (2) in all cases, hepatic failure developed more than 10 days after the clinical recognition of hepatitis; and (3) characteristic signs of drug-induced hepatic failure such as a skin rash and positive lymphocytes stimulation test with the drug were absent in all cases. Fulminant hepatic failure in these cases could be characterized by: (1) rapid decrease in serum alanine transaminase (ALT) level after discontinuation of ecarazine, (2) prolonged jaundice despite discontinuation of ecarazine, (3) high incidence of anti-nuclear antibody (ANA) (57%), and (4) histological findings of extensive hepatocellular necrosis ranging from bridging necrosis to massive necrosis. Of the seven patients, four died of fulminant hepatic failure. These four patients had received high doses of ecarazine hydrochloride for prolonged periods. Our data suggest that there may be many cases in which the cause of fulminant hepatic failure or acute hepatitis was not previously determined that can be attributed to long-term drug therapy for chronic diseases.
Reliability of Risk-Adjusted Outcomes for Profiling Hospital Surgical Quality
Authors: Robert W. Krell, Ahmed Hozain, Lillian S. Kao, Justin B. Dimick
Journal: JAMA Surgery (2014)

Quality improvement platforms commonly use risk-adjusted morbidity and mortality to profile hospital performance. However, given small hospital caseloads and low event rates for some procedures, it is unclear whether these outcomes reliably reflect hospital performance.To determine the reliability of risk-adjusted morbidity and mortality for hospital performance profiling using clinical registry data.A retrospective cohort study was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program, 2009. Participants included all patients (N = 55,466) who underwent colon resection, pancreatic resection, laparoscopic gastric bypass, ventral hernia repair, abdominal aortic aneurysm repair, and lower extremity bypass.Outcomes included risk-adjusted overall morbidity, severe morbidity, and mortality. We assessed reliability (0-1 scale: 0, completely unreliable; and 1, perfectly reliable) for all 3 outcomes. We also quantified the number of hospitals meeting minimum acceptable reliability thresholds (>0.70, good reliability; and >0.50, fair reliability) for each outcome.For overall morbidity, the most common outcome studied, the mean reliability depended on sample size (ie, how high the hospital caseload was) and the event rate (ie, how frequently the outcome occurred). For example, mean reliability for overall morbidity was low for abdominal aortic aneurysm repair (reliability, 0.29; sample size, 25 cases per year; and event rate, 18.3%). In contrast, mean reliability for overall morbidity was higher for colon resection (reliability, 0.61; sample size, 114 cases per year; and event rate, 26.8%). Colon resection (37.7% of hospitals), pancreatic resection (7.1% of hospitals), and laparoscopic gastric bypass (11.5% of hospitals) were the only procedures for which any hospitals met a reliability threshold of 0.70 for overall morbidity. Because severe morbidity and mortality are less frequent outcomes, their mean reliability was lower, and even fewer hospitals met the thresholds for minimum reliability.Most commonly reported outcome measures have low reliability for differentiating hospital performance. This is especially important for clinical registries that sample rather than collect 100% of cases, which can limit hospital case accrual. Eliminating sampling to achieve the highest possible caseloads, adjusting for reliability, and using advanced modeling strategies (eg, hierarchical modeling) are necessary for clinical registries to increase their benchmarking reliability.
Late-phase detection of recent myocardial ischaemia using ultrasound molecular imaging targeted to intercellular adhesion molecule-1
Authors: Yi Yan, Yulin Liao, Li Yang, Juefei Wu, Jing Du, Wanling Xuan, Lijing Ji, Qiaobing Huang, Yili Liu, Jianping Bin
Journal: Cardiovascular Research (2010)

In this study, we attempted to detect a recent myocardial ischaemic event using ultrasound molecular imaging (UMI) with microbubbles (MB) targeted to intercellular adhesion molecule-1 (ICAM-1) in the late phase of reperfusion. We created a myocardial ischaemia–reperfusion model in 60 C57/BL male mice to simulate an angina attack (ischaemia for 15 min, reperfusion for 1–24 h). The degree of myocardial inflammation and levels of ICAM-1 protein were determined by histological and immunohistochemical analyses. UMI with MB targeted to endothelial ICAM-1, as well as routine non-invasive methods including electrocardiography, echocardiography, and plasma troponin I levels, were utilized to evaluate ischaemia over the time course of reperfusion. Levels of ICAM-1 in the vascular endothelium were significantly increased over the time course of reperfusion (8–24 h) of the ischaemic myocardium. The video intensity of ICAM-1 molecular images of the ischaemic anterior wall was almost three times greater than that in the non-ischaemic posterior wall during the late phase (8–24 h) of reperfusion. In contrast, routine methods yielded only weak evidence of ischaemia. UMI with MB targeted to endothelial ICAM-1 provides reliable evidence of a recent myocardial ischaemic event in the late phase of reperfusion.
Further characterization of IgE‐binding antigens from guinea pig hair as new members of the lipocalin family
Authors: B. Fahlbusch, O. Rudeschko, B. Schlott, M. Henzgen, G. Schlenvoigt, H. Schubert, R. W. Kinne
Journal: Allergy (2003)

Background: Guinea pigs are important sources of inhalant allergens in home and working environments. However, little is known about the molecular characteristics and the relevant epitopes of guinea pig allergens. Recently, several allergens have been identified in hair extract and urine, and the major allergen Cav p 1 (20 kDa) has been characterized. Objective: The aim of the present study was to isolate and to characterize a further major allergen from guinea pig hair with 17 kDa. Methods: Guinea pig hair extract was fractionated using anion exchange chromatography and reverse‐phase high performance liquid chromatography. Analyses were carried out by sodium dodecyl sulphate–polyacrylamide gel electrophoresis, 2D‐PAGE, immunoblotting, immunoblot inhibition, glycoprotein detection, and N‐terminal amino acid sequencing. Results: The nonglycosylated 17 kDa allergen, which was named Cav p 2, was purified to homogeneity. On the basis its 15 N‐terminal residues, there was 69% identity with a sequence of Bos d 2, an allergenic protein from cow dander belonging to the lipocalin family. The 2D‐immunoblotting analyses of guinea pig hair extract demonstrated that Cav p 2 and Cav p 1, contained several isoforms with pI values ranging from 3.6 to 5.3. The 2D‐immunoblot inhibition disclosed cross‐reactive IgE epitopes on the allergens Cav p 2 and Cav p 1. Furthermore, Cav p 1 can form both monomers (20 kDa) and dimers (40–42 kDa). Conclusion: These studies provide important information on the isoallergen character of two relevant guinea pig allergens Cav p 1 and Cav p 2 as well as on their cross‐reactive properties.
Use of Diphenylhydantoin
Authors: MARK A. GOLDBERG
Journal: Annals of Internal Medicine (1973)

Letters, Comments, and Corrections1 February 1973Use of DiphenylhydantoinMARK A. GOLDBERG, M.D.MARK A. GOLDBERG, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-2-305_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The excellent summary of the clinical pharmacology of diphenylhydantoin by Easton (Ann Intern Med 77:421-423, 1972) unfortunately emphasizes the concept of "dilantinization" without adequate discussion of the theoretical and practical difficulties involved.Therapeutic blood levels of diphenylhydantoin can be achieved more rapidly by large, loading oral doses, but it is rarely necessary to obtain such rapid control in the ambulatory patient with intermittent seizures. In addition, the ingestion of 1000 to 1200 mg in one day is frequently associated with gastrointestinal and neurologic symptoms that may be so unpleasant the patients are reluctant to take the drug...References1. WALLISKUTTMCDOWELL WHF: Intravenous diphenylhydantoin in treatment of acute repetitive seizures. Neurology (Minneap) 18:513-525, 1968 CrossrefMedlineGoogle Scholar2. RANDKELLYWARD BWA: Electrophysiological studies of the action of intravenous diphenylhydantoin (Dilantin). Neurology (Minneap) 16:1022-1032, 1966 CrossrefMedlineGoogle Scholar3. LOUISKUTTMCDOWELL SHF: Intravenous diphenylhydantoin in experimental seizures. II. Effect on penicillin-induced seizures in the cat. Arch Neurol 18:472-477, 1968 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 byPharmacokinetics and Clinical Use of Parenteral Phenytoin, Phenobarbital, and ParaldehydeEfficacy of intravenous phenytoin in the treatment of status epilepticus: Kinetics of central nervous system penetration 1 February 1973Volume 78, Issue 2Page: 305-306KeywordsBloodClinical pharmacologyDrugsEpileptic seizuresIngestion Issue Published: 1 February 1973 PDF downloadLoading ...
Women’s Healthy Lifestyle Project: A Randomized Clinical Trial
Authors: Lewis H. Kuller, Laurey R. Simkin-Silverman, Rena R. Wing, Elaine N. Meilahn, Diane G. Ives
Journal: Circulation (2001)

Background —The Women’s Healthy Lifestyle Project Clinical Trial tested the hypothesis that reducing saturated fat and cholesterol consumption and preventing weight gain by decreased caloric and fat intake and increased physical activity would prevent the rise in LDL cholesterol and weight gain in women during perimenopause to postmenopause. Methods and Results —There were 275 premenopausal women randomized into the assessment only group and 260 women into the intervention group. The mean age of participants at baseline was 47 years, and 92% of the women were white. The mean LDL cholesterol was 115 mg/dL at baseline, and mean body mass index was 25 kg/m 2 . The follow-up through 54 months was excellent. By 54 months, 35% of the women had become postmenopausal. At the 54-month examination, there was a 3.5-mg/dL increase in LDL cholesterol in the intervention group and an 8.9-mg/dL increase in the assessment-only group ( P =0.009). Weight decreased 0.2 lb in the intervention and increased 5.2 lb in the assessment-only group ( P =0.000). Triglycerides and glucose also increased significantly more in the assessment-only group than in the intervention group. Waist circumference decreased 2.9 cm in the intervention compared with 0.5 cm in the assessment-only group ( P =0.000). Conclusions —The trial was successful in reducing the rise in LDL cholesterol during perimenopause to postmenopause but could not completely eliminate the rise in LDL cholesterol. The trial was also successful in preventing the increase in weight from premenopause to perimenopause to postmenopause. The difference in LDL cholesterol between the assessment and intervention groups was most pronounced among postmenopausal women and occurred among hormone users and nonusers.
Turning round NHS deficits: Deficits are not for turning
Authors: David Churchill
Journal: BMJ (2006)

EDITOR—Ham is right to be sceptical about the private turnaround teams.1 Personal experience with “franchising,” a similar process, has led me to a similar position.2 Faith in their abilities is misplaced for three reasons.

Firstly, the private sector underestimates the wider responsibilities of hospitals. Unlike the private sector, public institutions are not free to simply disinvest in …
TV: The Anatomists
Authors: P. Dangerfield
Journal: BMJ (2002)

Channel 4, 12 to 26 March, times vary Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> The study of anatomy is a core component of the education of all medical undergraduates. The United Kingdom's Anatomy Acts regulate the conditions for this important study to ensure that the cadavers are dissected within licensed premises and that licensed teachers carry out supervision and teaching. But how many of these medical students know anything about the reasons for this regulation or even, for that matter, anything about the history of anatomy, the focus of this series of three programmes? The subject of dissection has for long been seen as a taboo, condemned by society with the backing of religious edict. It is little wonder, therefore, that the early attempts to gain insight into the structure of the human body were carried out in a cloak and dagger manner. [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Sclerotherapy vs. esophageal transection vs. distal splenorenal shunt for the clinical management of esophageal varices in patients with child class A and B liver function: A prospective randomized trial
Authors: Seigo Kitano, Yasunori Iso, Makoto Hashizume, Hirohiko Yamaga, Nobuhiro Koyanagi, Hiroya Wada, Tetsuya Iwanaga, Masayuki Ohta, Keizo Sugimachi
Journal: Hepatology (1992)

Ninety-six patients with good liver function (Child class A or B) and esophageal varices were randomly assigned to one of three groups given different treatments: endoscopic injection sclerotherapy (n = 32), esophageal transection (n = 32) or distal splenorenal shunt (n = 32). Five patients (5.2%) had to be excluded from this study because severe chronic pancreatitis made separation of the distal splenic vein from the pancreatic bed difficult. Esophageal transection was performed for these patients. No deaths occurred during the 30 days of treatment. The 5-yr cumulative bleeding rates were 0%, 5.9% and 12.9% in the endoscopic injection sclerotherapy, esophageal transection and distal splenorenal shunt groups, respectively (no statistical significance). In no case in the three groups did death occur because of variceal bleeding. Sixteen patients died, mainly because of underlying liver disease; four were in the endoscopic injection sclerotherapy group, five were in the esophageal transection group and seven were in the distal splenorenal shunt group. No statistically significant difference in survival rate among the three groups was found. These results show that endoscopic injection sclerotherapy is a satisfactory alternative to esophageal transection or distal splenorenal shunt for the clinical management of patients with esophageal varices. (Hepatology 1992;15:63-68).
Relations of Exercise Blood Pressure Response to Cardiovascular Risk Factors and Vascular Function in the Framingham Heart Study
Authors: George Thanassoulis, Asya Lyass, Emelia J. Benjamin, Martin G. Larson, Joseph A. Vita, Daniel Levy, Naomi M. Hamburg, Michael E. Widlansky, Christopher J. O'Donnell, Gary F. Mitchell, Ramachandran S. Vasan
Journal: Circulation (2012)

Background— Exercise blood pressure (BP) is an important marker of left ventricular hypertrophy, incident hypertension, and future cardiovascular events. Although impaired vascular function is hypothesized to influence the BP response during exercise, limited data exist on the association of vascular function with exercise BP in the community. Methods and Results— Framingham Offspring cohort participants (n=2115, 53% women, mean age 59 years) underwent a submaximal exercise test (first 2 stages of the Bruce protocol), applanation tonometry, and brachial artery flow-mediated dilation testing. We related exercise systolic and diastolic BP at second stage of the Bruce protocol to standard cardiovascular risk factors and to vascular function measures. In multivariable linear regression models, exercise systolic BP was positively related to age, standing BP, standing heart rate, smoking, body mass index, and the total cholesterol–to–high-density cholesterol ratio ( P ≤0.01 for all). Similar associations were observed for exercise diastolic BP. Carotid-femoral pulse wave velocity ( P =0.02), central pulse pressure ( P &lt;0.0001), mean arterial pressure ( P =0.04), and baseline brachial flow ( P =0.002) were positively associated with exercise systolic BP, whereas flow-mediated dilation was negatively associated ( P &lt;0.001). For exercise diastolic BP, forward pressure wave amplitude was negatively related ( P &lt;0.0001), whereas mean arterial pressure was positively related ( P &lt;0.0001). Conclusions— Increased arterial stiffness and impaired endothelial function are significant correlates of a higher exercise systolic BP response. Our findings suggest that impaired vascular function may contribute to exaggerated BP responses during daily living, resulting in repetitive increments in load on the heart and vessels and increased cardiovascular disease risk.
Global Malaria Control in the 21st Century
Authors: Richard G. A. Feachem, Oliver J. Sabot
Journal: JAMA (2007)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Greatest Benefit to Mankind: A Medical History of Humanity From Antiquity to the Present
Authors: B. Hope
Journal: BMJ (1998)

Roy Porter Harper Collins, £24.99, pp 831 ISBN 0 00215173 1

Before I read this, my knowledge of medical history could be summed up in a few sentences. I knew that the medical-industrial complex had become a victim of its own success and that until quite recently doctors could not do much. I had an idea about their professional status, without knowing how that privilege was won and protected. I knew that doctors demand autonomy, but that collectively they make a wonderful political football. Someone had told me that Pasteur discovered vaccination; someone else that it was Turkish folk medicine.

Roy Porter's book gave me the chance to flesh out my paltry analysis. Here was …
High prevalence of PE in patients with unexplained exacerbation of COPD
Authors: A Patel
Journal: Thorax (2006)

▴ Tillie-Leblond I, Marquette CH, Perez T, et al. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Ann Intern Med2006;144:390–6 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] This single centre study enrolled 197 patients with COPD requiring admission to hospital for an unexplained acute exacerbation. Patients with any evidence of lower respiratory tract infection, pneumothorax, and those requiring invasive ventilation were excluded. Patients with clinical and radiological findings deemed out of keeping … [1]: {openurl}?query=rft.jtitle%253DAnnals%2Bof%2BInternal%2BMedicine%26rft.stitle%253DANN%2BINTERN%2BMED%26rft.issn%253D0003-4819%26rft.aulast%253DTillie-Leblond%26rft.auinit1%253DI.%26rft.volume%253D144%26rft.issue%253D6%26rft.spage%253D390%26rft.epage%253D396%26rft.atitle%253DPulmonary%2Bembolism%2Bin%2Bpatients%2Bwith%2Bunexplained%2Bexacerbation%2Bof%2Bchronic%2Bobstructive%2Bpulmonary%2Bdisease%253A%2Bprevalence%2Band%2Brisk%2Bfactors.%26rft_id%253Dinfo%253Adoi%252F10.7326%252F0003-4819-144-6-200603210-00005%26rft_id%253Dinfo%253Apmid%252F16549851%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/0003-4819-144-6-200603210-00005&link_type=DOI [3]: /lookup/external-ref?access_num=16549851&link_type=MED&atom=%2Fthoraxjnl%2F61%2F7%2F603.atom [4]: /lookup/external-ref?access_num=000236251800002&link_type=ISI
Tc-99m Methylene Diphosphonate Uptake by Numerous Phleboliths in the Lower Extremity Detected Incidentally During Bone Scintigraphy
Authors: Myung-Hee Sohn, Young Jin Jeong, Seok Tae Lim, Dong Wook Kim, Hwan-Jeong Jeong, Chang-Yeol Yim
Journal: Clinical Nuclear Medicine (2010)

Phleboliths are calcified thrombi within veins and very common in the veins of the lower part of the pelvis. Most adults have a small number of phleboliths. However, despite the high prevalence, phleboliths with increased uptake on bone scintigraphy have very rarely been reported in the literature. Tc-99m methylene diphosphonate bone scintigraphy was performed on a 46-year-old man with an abscess on the plantar surface of the left foot, which demonstrated incidental, irregular, mottled, increased uptake in the soft tissues of the left thigh and leg, which corresponded to numerous phleboliths on plain radiographs and CT.