tbuckley/cabot-search huggingface dataset:
Joy of rapid responses: Readers read articles more closely when they can respond
Authors: Manan Vasenwala
Journal: BMJ (2004)

Random drug testing in schools fails screening criteriaEditor-Last month the prime minister, Tony Blair, lent his weight to random drug testing in schools in an interview for a downmarket newspaper. 1He proposed a national programme be implemented soon, adhering to unspecified central directives.The Department of Health has 19 criteria for introducing new screening programmes. 2 At least 18 of these 19 criteria are not met for widespread, wide spectrum drug urine analysis in schools.The remaining criterion is that the condition is an important health problem.Drug use in young people is indeed associated with many health risks, 3 but a single, positive urine test, for any illicit drug, is probably not meaningful in a clinical sense.Each schoolchild's context of use (family history, social and emotional development) is crucial to interpreting any supposed "drug career."Use by a homeless pregnant teenage runaway from local authority care with a history of deliberate self harm and high risk sex work to pay for her drugs may be very different from a single experimental use at home with adults during a family party.Three failed criteria are especially pertinent to screening for school age drug use:(1) There should be an agreed policy on the further diagnostic investigation of people with a positive test result and on the choices available to them.(2) There should be an effective treatment or intervention for patients identified through early detection.(3) Clinical management of the condition and patient outcomes should be optimised by all healthcare providers before participation in a screening programme.In three years of experience of school health provision for alcohol and drug problems and their related referral networks I do not know of one school that could satisfy these criteria, especially the underpinning policy of promoting informed choice for children and families. 2
Common Femoral Artery Entrapment in an Infant
Authors: Charles H. Antinori
Journal: JAMA (1983)

LIGAMENTOUS arterial entrapment, particularly of the popliteal artery in adults, has been well described. We recently treated an infant who had complete obstruction of the left common femoral artery by the inguinal ligament when the leg was extended at the hip, but who had completely normal circulation in the left lower extremity when the hip was flexed. A thorough search of literature has failed to bring a similar case to our attention. <h3>Report of a Case</h3> A 2-week-old male neonate was referred to the Pediatric Service because the mother noted swelling and a dusky color of the left leg when she attempted to straighten the leg at the hip. The mother stated that the child had kept his left leg flexed at the hip since birth. The child was a product of a normal pregnancy and delivery, but had been born five weeks before term. The birth weight was 2.4
Hunger and Malnutrition
Authors: John B. Youmans
Journal: JAMA (1970)

To the Editor.—  It is unfortunate that in its report to the American Medical Association House of Delegates the Council on Foods and Nutrition has chosen seemingly to equate hunger with under nutrition and mal nutrition. Hunger is a physiological or emotional state in which an individual hungers for something, sometimes food, but very often something having no direct relation to nutrition, for example, hunger for a steak or a popsickle by a person in a perfectly normal nutritional state. Hunger is a common complaint or symptom of persons who are overweight or obese and whose intake of food is adequate and more than adequate in all respects. Actually, starvation (undernutrition) is most often accompanied by a lack of hunger. In my experience hunger as a presenting complaint by undernourished or malnourished patients has been infrequent but hunger is a common complaint of obese patients. Subclinical undernutrition or malnutrition as
Treatment of Blepharitis
Authors: D. Ainslie
Journal: BMJ (1951)

M(EDICAL JOURNAL curvature and not on the line of the lesser curvature, as is the rule in chronic gastric ulceration.The stomach contents consisted of the typical coffee-ground fluid with some super- natant small clots of blood.From their shape, their number, and their bleeding character, we may accept these as acute ulcers similar to those in the previous case, and more especially as there was in Case 2 no history of any previous subjective or objective gastric disturbance.
Radiation exposure during radiofrequency catheter ablation of accessory atrioventricular connections.
Authors: H Calkins, L Niklason, J Sousa, R el-Atassi, J Langberg, F Morady
Journal: Circulation (1991)

Catheter ablation of accessory atrioventricular (AV) connections has been demonstrated to be effective in more than 85% of patients. One of the risks of this procedure is radiation exposure during the fluoroscopic imaging necessary to guide catheter manipulation. The objective of the present study was to measure the radiation received by patients and physicians during radiofrequency catheter ablation and to estimate the resultant somatic and genetic risks.Radiation exposure to patients and physicians was measured during attempts at radiofrequency catheter ablation of accessory AV connections in 31 consecutive patients. Radiation exposure was measured using thermoluminescent sensors placed on the patient and on the physician. Somatic and genetic risks were estimated based on the radiation levels recorded using these sensors. The durations of fluoroscopy and of the catheter ablation procedure were recorded for each patient. Catheter ablation was successful in 28 of 31 patients (90%). Mean +/- SD duration of fluoroscopy was 44 +/- 40 minutes. The largest patient radiation dose was measured over the ninth vertebral body posteriorly (median, 7.26 rem [roentgen equivalents man]; range, 0.31-135.7 rem). Median radiation dose to the thyroid was 0.46 rem (range, 0.06-7.26 rem), and median radiation dose to the posterior iliac crest was 2.43 rem (range, 0.01-8.3 rem). The greatest radiation dose to the operator was recorded at the left hand (99 mrem). Mean radiation dose to the operator's eyes was 28 mrem.Radiofrequency catheter ablation of accessory AV connections may result in significant radiation exposure to the patient and to the physician. Each hour of fluoroscopic imaging is associated with a lifetime risk of developing a fatal malignancy of 0.1% and a risk of a genetic defect of 20 per 1 million births. Although these risks must be recognized, they are relatively small compared with the risks associated with alternate approaches to management, including no therapy, antiarrhythmic drug therapy, and surgery.
Combined renovascular hypertension and diabetes in rats: a new preparation of congestive cardiomyopathy.
Authors: F S Fein, J M Capasso, R S Aronson, S Cho, C Nordin, B Miller-Green, E H Sonnenblick, S M Factor
Journal: Circulation (1984)

Myocardial function, electrophysiologic characteristics, and structure were studied in rats with both renovascular hypertension and streptozotocin-induced diabetes (HD). Ventricular papillary muscles from untreated rats with HD showed a marked slowing of isometric and isotonic contractions. Peak developed tension and peak shortening were preserved, except in one animal with findings of congestive heart failure. Transmembrane action potentials increased fivefold in duration. Myocardial interstitial fibrosis was frequently observed. Physiologic parameters of rats with HD treated by left nephrectomy, captopril, and insulin were very similar to those of age-matched controls. The mortality rate of rats with HD was 43% over 5 to 6 months in the first study. In a second study, spontaneously dying rats with HD were compared with those deliberately killed. A 55% mortality was observed over 7 months. Myocardial structural damage and histologic evidence of congestive heart failure were more frequent in spontaneously dying rats with HD. Combined renovascular hypertension and diabetes in rats appears to be a new preparation of congestive cardiomyopathy.
Studies of recombinant plasminogen activator inhibitor-1 in rabbits. Pharmacokinetics and evidence for reactivation of latent plasminogen activator inhibitor-1 in vivo.
Authors: D E Vaughan, P J Declerck, E Van Houtte, M De Mol, D Collen
Journal: Circulation Research (1990)

The pharmacokinetics of human recombinant plasminogen activator inhibitor-1 (rPAI-1) was studied in rabbits. Latent rPAI-1 (0-2 units of tissue-type plasminogen activator neutralizing activity per microgram protein); reactivated rPAI-1 (approximately 150 units/micrograms); and chloramine T-oxidized, nonreactivatable rPAI-1 (approximately 0.7 units/microgram) were studied. The pharmacokinetic parameters for the disposition of rPAI-1 antigen after an intravenous bolus injection of 1.0 or 2.5 mg/kg rPAI-1 were very similar for all three forms: the initial volume of distribution was approximately 60 ml/kg, the initial half-life in plasma was 6 minutes, and the plasma clearance was approximately 4 ml/kg/min. The disposition of PAI activity after injection of reactivated rPAI-1 was similar to that of rPAI-1 antigen. Injection of latent rPAI-1 was associated with a nearly threefold increase in the specific activity of circulating PAI-1 from 2 units/micrograms to 5.0 +/- 1.1 units/micrograms (p less than 0.01) within 1 minute, followed by a cumulative 25-fold increase in specific activity over 1 hour (p = 0.01). In contrast, the specific activity of oxidized or reactivated preparations of rPAI-1 did not increase in the first several minutes after injection. These findings support the existence of a fast-acting but low-capacity mechanism for the reactivation of rPAI-1 in vivo.
Epidemic Heat Effects
Authors: Douglas H. K. Lee
Journal: JAMA (1982)

<i>Heatstroke</i>(environmentally induced hyperpyrexia) afflicts unacclimatized, susceptible persons who are suddenly exposed to unusually hot conditions. Epidemics are likely to occur in large cities that experience cold winters and include foci of urban dwellings that have been aptly named "heat islands."<sup>1,2</sup>Sporadic cases of heatstroke can occur under particularly provocative conditions, such as when infective pyrexia occurs in a person during the course of a heat wave, when dehydration occurs in persons lost in a hot desert,<sup>3</sup>in physical training camps with rigorous discipline, and in hot industries. <i>Heat exhaustion</i>(hypotension or relative hypovolemia produced or aggravated by hot environments) naturally occurs under similar conditions but is by no means confined to such circumstances. In mild degree, indeed, it is almost a universal occurrence. <i>Heat-aggravated disease</i>must be considered when heat adds to the burden on body systems that are already disturbed by disease. An otherwise unexplained increase
Work Load in Group Practices
Authors: D. Hay
Journal: BMJ (1965)

JBouwing.A family history of depressive illness should increase awareness of the possibility that a particular child's behaviour, which is causing concern, may be based on a primary disturbance of mood.Suicidal threats, gestures, and, occa- sionally, successful attempts are not unknown in the young, and suicidal threats and gestures should always be taken seriously as being distress signals.The fact that emotionally disturbed children may be referred to paediarricians, physicians, surgeons, child-guidance clinics, and school medical officers, initially makes diagnosis diffi- cult.It is customary in many child-guidance clinics outside the hospital service for a psychiatric social worker to become involved in case work with one or both parents and for a psychiatrist to be responsible for the therapy of the child.Parents bringing a child to a psychiatric clinic, especially within the hospital service, should always be seen and interviewed by the psychiatrist in charge of the case.This is a medical matter and the training, skill, and experience of the psychiatrist are needed in order to elicit accurate details concerning the medical aspects of the child's problems.Application of diagnostic criteria used for adult patients suffering from depressive ill- ness, to children and adolescents, increases the difficulties.
Percutaneous Needle Biopsy of the Lung in Evaluation of Pulmonary Disorders
Authors: Felice Manfredi
Journal: JAMA (1966)

Percutaneous needle biopsy of the lung has been shown to be of value in the diagnosis of both diffuse and localized diseases which involve the lung.<sup>1-10</sup>The use of this procedure, in which a cutting-type needle (eg, Vim-Silverman, Franklin-Silverman, Jack) is used, has now been reported in approximately 400 cases. The results have been striking. The complications in most instances have been minimal, and no deaths from the procedure have been recorded. Histologically interpretable lung tissue has been returned in approximately 90% of the biopsy attempts (Table). The percentage return of tissue has been found to be higher in solid localized peripheral lesions than those demonstrating diffuse pulmonary parenchymal involvement, but the difference has been small. Tissue which has proved to be diagnostically useful, either primarily or in a supporting manner, has been returned in 77% of biopsies (Table). These figures are similar and comparable to those published for
Survey of use of injected benzodiazepines among drug users in Britain
Authors: J Strang, P Griffiths, J Abbey, M Gossop
Journal: BMJ (1994)

Intravenous misuse of injected benzodiazepines began in Britain in the mid-1980s. At first the drugs commonly used were flurazepam and diazepam, but by the late 1980s, when the use of injected benzodiazepines had become widespread in several British cities, users were reported to be injecting mainly temazepam capsules.1 In 1989 the manufacturers replaced liquid filled temazepam capsules with semisolid gel filled capsules2 to prevent the drug from being injected. These capsules, however, are also being injected3 and seem to lead to greater morbidity in individual users. Recently the use of triazolam4 and nitrazepam has also been reported. We carried out a survey to determine the extent to which different formulations …
Abstract LB-152: PIK3CA mutation spectrum in urothelial carcinoma reflects cell context-dependent signalling and phenotypic outputs
Authors: Rebecca L. Ross, Jon M. Askham, Margaret A. Knowles
Journal: Cancer Research (2012)

Abstract Activating p110α mutations are frequently observed in urothelial carcinoma (UC). Their specific effects in urothelial cells and the reason for the large excess of helical domain mutations relative to kinase domain mutations have not been studied. Thus we investigated the phenotypic consequences of hotspot and UC-specific rare PIK3CA mutations in immortalized normal human urothelial cells (NHUC) and mouse fibroblasts (NIH3T3). Our results show that in NHUC, all PIK3CA mutants activate the AKT pathway. The potency of AKT downstream activation by helical and kinase domain mutants was related to the frequency of mutation occurrence in UC (E545K&amp;gt;E542K&amp;gt;H1047R). In NIH3T3, the H1047R kinase domain mutant induced significantly higher levels of AKT activation relative to helical domain mutant forms and this was reflected in their abilities to promote anchorage-independent growth. In NHUC, only E542K and E545K helical domain mutant forms conferred a significant proliferative advantage at confluence and in nutrient limiting conditions. Both types of mutant forms induced NHUC cell motility, though no significant differences were found between helical and kinase domain mutant forms. Our findings indicate that the cellular consequences of mutant PIK3CA are both cell type- and mutation-specific. This provides a rationale for the observed PIK3CA mutation spectrum in UC and suggests that helical domain mutations may confer a selective advantage in the urothelium in vivo by overcoming normal contact-mediated inhibitory signals and allowing nutrient-independent proliferation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-152. doi:1538-7445.AM2012-LB-152
"Nutcracker" Treatment of Clubfoot
Authors: Hugo A. Keim, Gordon W. Ritchie
Journal: JAMA (1964)

Over the past 25 years 110 children with 151 "flat-top" tali have been patients at the Shriners Hospital in Winnipeg. Seventy-seven children with 112 flat-top tali have presented with clubfoot deformities. The average age on admission was 3 years and 4 months. The flat-top talus is iatrogenic in most cases and is the direct result of the "nutcracker" treatment of clubfoot. This mechanism exists because upward pressure is exerted by the manipulating physician on the child's forefoot to correct equinus and inversion of the foot. This results in severe pressure exerted on the body of the talus, since this bone acts as the fulcrum or "nut" between the longer forefoot and the tight achilles tendon, causing a flat-top talus in the victim of this treatment.
Variability in the expression of a β2-microglobulin epitope on hepatocytes in chronic type C hepatitis on treatment with interferon
Authors: Luisa García-Buey, Miguel López-Botet, Asunción García-Sánchez, María A. Balboa, José Aramburu, Carmelo García-Monzón, Agustín Acevedo, Ricardo Moreno-Otero
Journal: Hepatology (1993)

Cytotoxic CD8+ T lymphocytes recognize viral antigens in the context of human leukocyte antigen class I molecule coexpression by target cells. Analysis of beta 2-microglobulin reactivity is useful in evaluating changes in human leukocyte antigen class I antigen distribution. In this study we analyzed liver biopsy specimens obtained from 15 patients with chronic active hepatitis type C who underwent a clinical trial with recombinant interferon-alpha 2b. We comparatively studied by immunohistochemical analysis the expression of human leukocyte antigen class I antigens in frozen liver samples obtained before entry in the protocol and in specimens taken 8 mo after initiation of treatment. Six normal liver samples were used as controls. For immunohistochemical analysis, a panel of several human leukocyte antigen class I monoclonal antibodies, specific for beta 2-microglobulin or different heavy-chain determinants, was used. In addition, we included a novel monoclonal antibody (HP-1H8), characterized in this report, which is specific for a distinct beta 2-microglobulin epitope. On entry, mean serum ALT was 240 +/- 89 IU/L and mean Knodell's index was 9.9 +/- 2.4, whereas at the time of the second biopsy mean values had diminished to 45 +/- 22 IU/L and 4.7 +/- 3.0, respectively. Liver sections from controls and patients expressed human leukocyte antigen class I light- and heavy-chain determinants in hepatocytes, biliary duct epithelium, sinusoidal lining cells and lymphocytes. Remarkably, the beta 2-microglobulin epitope recognized by the HP-1H8 monoclonal antibody was undetectable on hepatocytes from normal livers but clearly evident on hepatocytes from patients with chronic active hepatitis C before interferon treatment. Positive staining was more intense in areas of piecemeal and lobular necrosis. Double immunostaining with a CD2 monoclonal antibody demonstrated that labeling with HP-1H8 was predominantly associated with T-cell infiltration. Interestingly, the reactivity of HP-1H8 with hepatocytes was diminished or disappeared in specimens obtained during interferon treatment; the pattern of reactivity then resembled that of samples from normal controls. Our data indirectly suggest that, in addition to the increased expression of human leukocyte antigen class I molecules on hepatocytes in viral infections, conformational changes may take place in these antigens. These changes can be revealed by immunostaining with the HP-1H8 monoclonal antibody. Interferon therapy could down-regulate this expression through its effect in reducing the histological activity resulting from the lysis of virus-infected hepatocytes by cytotoxic T cells.
Clinical Characteristics of IDDM in Hispanics and Non-Hispanic Whites: Little evidence of heterogeneity by ethnicity
Authors: Jill N Kostraba, Karen J Cruickshanks, Terri G Neville, Janet Lawler-Heavner, H Peter Chase, Georgeanna J Klingensmith, Elizabeth C Gay, Richard F Hamman
Journal: Diabetes Care (1992)

OBJECTIVE To compare the clinical characteristics of IDDM in HD and NHWD subjects in order to evaluate potential heterogeneity of IDDM by ethnicity. RESEARCH DESIGN AND METHODS HD subjects (n = 73) and NHWD subjects (n = 97) were recruited from the Colorado IDDM Registry. The registry included individuals who were Colorado residents, &amp;lt; 18 yr old at diagnosis, placed on insulin within 2 wk of diagnosis, and had diabetes not secondary to other conditions. Residual β-cell function was measured as the 1-h C-peptide response to a Sustacal challenge. RESULTS HD subjects were similar to NHWD subjects in insulin dose, HbA1, HLA-DR antigens, ICAs, and family history of IDDM. HD subjects were more likely to have a family history of NIDDM than NHWD subjects (11 vs. 3%, P = 0.03). HD girls had higher C-peptide levels (0.27 vs. 0.11 nm/L [0.83 vs. 0.33 ng/ml], P = 0.01), BMI (22.7 vs. 20.9 kg/m2 P = 0.04), subscapular skinfold thickness (18.9 vs. 15.0 mm, P = 0.04), and WHR (0.81 vs. 0.77, P = 0.03) than NHWD females. After controlling for diabetes duration, BMI, sex, and family history of NIDDM, residual β-cell function was associated significantly with Hispanic ethnicity, although the term accounted for just 3% of the overall variability in C-peptide levels. CONCLUSIONS Little evidence of heterogeneity by ethnicity of IDDM patients in the Colorado IDDM Registry was found. Ethnic differences in C-peptide levels may be related to differences in body fat distribution in females rather than heterogeneity of the disease.