tbuckley/cabot-search huggingface dataset:
Detection and Correction of House Staff Error in Physical Diagnosis
Authors: Nelda P. Wray
Journal: JAMA (1983)

A significant number of errors in physical examination can be detected when house staff are observed by attending physicians. In this study, observation of residents and interns showed a total error of 13.1% and 15.6%, respectively, with incorrect findings of 3.3% and 4.9% and omitted findings of 9.8% and 10.7%, respectively. Approximately two thirds of all patients examined had at least one error noted. A method was instituted for detecting and correcting these errors that can be integrated into daily attending rounds. Using this method, a statistically significant decrease in the number of errors was shown. The method used emphasizes the physical examination pertinent to the patient's main problem, consumes very little rounding time, and is well received by both attending physicians and house officers.
TETANUS FOLLOWING NASAL INJURY
Authors: Wingate M. Johnson
Journal: JAMA (1952)

<h3>To the Editor:—</h3> InThe Journalfor June 14, page 660, Dr. R. B. Tudor reported a case of tetanus resulting from a foreign body in the nose, and stated that "Only one other case was found in the literature in which tetanus unquestionably resulted from a nasal injury." Dr. Tudor's case reminded me of a patient who died from tetanus following a nasal injury whom I treated more than 25 years ago, a case which, even at this late date, is perhaps worth adding as a third case to the literature. My own recollection of the case has been reinforced by the mother's. On Feb. 22, 1927, an 18-month-old male child forced a metal button mold into one nostril. The mother heard him cry and removed the piece of metal soon after it had been inserted. Slight bleeding showed that the mucous membrane had been injured. At 6 a.
COPD–bronchiectasis overlap syndrome
Authors: John R. Hurst, J. Stuart Elborn, Anthony De Soyza
Journal: European Respiratory Journal (2015)

The overlap between chronic obstructive pulmonary disease (COPD) and bronchiectasis is a neglected area of research, and it is not covered by guidelines for clinical practice. Here, we provide a position statement from the BRONCH-UK Consortium that is intended to be of interest to both clinicians and researchers. While we are making recommendations based on expert consensus, one of our aims is to provoke debate. Through discussion of COPD–bronchiectasis overlap, we also aim to promote research in the area, driving improvements in patient care. COPD and bronchiectasis may co-exist as an overlap syndrome <http://ow.ly/DeeE6> Other members of the BRONCH-UK Consortium include D. Bilton (Royal Brompton Hospital, London, UK), J. Bradley (University of Ulster, Belfast, UK), J.S. Brown (University College London, London, UK), F. Copeland (Primary Ciliary Dyskinesia Patient Support Group, UK), J. Duckers (University Hospital of Wales, Cardiff, UK), R.A. Floto (University of Cambridge, Cambridge, UK), J. Foweraker (Papworth Hospital, Papworth, UK), C. Haworth (Cambridge Centre for Lung Infection, Papworth, UK), A.T. Hill (Royal Infirmary of Edinburgh, Edinburgh, UK), R. Hubbard (University of Nottingham, Nottingham, UK), M.R. Loebinger (Royal Brompton Hospital, London, UK), A. McGuire (London School of Economics and Political Science, London, UK), C.R. Muirhead (University of Newcastle, Newcastle, UK), V. Navaratnam (University of Nottingham, Nottingham, UK), A. Sullivan (University Hospitals Birmingham, Birmingham UK), T.M. Wilkinson (University of Southampton, Southampton, UK) and C. Winstanley (University of Liverpool, Liverpool, UK).
Alpha-fetoprotein is a predictor of outcome in acetaminophen-induced liver injury
Authors: Lars E. Schmidt, Kim Dalhoff
Journal: Hepatology (2004)

An increase in alpha-fetoprotein (AFP) following hepatic necrosis is considered indicative of hepatic regeneration. This study evaluated the prognostic value of serial AFP measurements in patients with severe acetaminophen-induced liver injury. Prospectively, serial measurements of AFP were performed in 239 patients with acetaminophen intoxication and a peak alanine aminotransferase (ALT) level above 1000 U/L. AFP was measured using an enzyme-linked immunoassay (EIA) with a detection limit below 0.4 microg/L. The optimum threshold of AFP to discriminate nonsurvivors was identified. An increase in AFP above 4 microg/L occurred in 158 (79%) of 201 survivors compared with 11 of 33 nonsurvivors (33%; P < .00001). The increase in AFP occurred a mean of 1.0 days (range, -2 to +6 days) after peak ALT in survivors compared with 4.1 days (range, +2 to +7 days) in nonsurvivors (P < .00001). Starting on the day of peak ALT, AFP values were significantly higher in survivors than in nonsurvivors. A threshold AFP of 3.9 microg/L on day +1 after peak ALT to identify nonsurvivors had a sensitivity of 100%, a specificity of 74%, a positive predictive value of 45%, and a negative predictive value of 100%. In conclusion, an increase in AFP was strongly associated with a favorable outcome in patients with acetaminophen-induced liver injury. AFP may be useful as a supplement to existing prognostic criteria. We suggest that the introduction of highly sensitive EIAs for the detection of AFP will require a reevaluation of AFP as a prognostic marker in acute nonneoplastic liver disease.
Abstract 8488: PR Interval Prolongation is Associated with Endothelial Dysfunction and Activation of Vascular Repair in High Risk Cardiovascular Patients
Authors: Yap-Hang CHAN, Chung-Wah SIU, Yuen-Fung YIU, Kai-Hang YIU, Sheung-Wai LI, Tai-Hing LAM, Chu-Pak LAU, Hung-Fat TSE
Journal: Circulation (2011)

Background: Recent studies showed that PR prolongation is associated with substantially increased risk of adverse clinical outcomes due to unclear mechanisms. Objective: To investigate the relations between PR interval and indices of vascular function and endothelial repair in patients at high risk of cardiovascular events. Methods: A total of 149 patients (mean age 63.6 ± 10.2 years; male 57%) with prior coronary artery disease, ischemic stroke and / or diabetes mellitus (diagnosed &gt;6 months) were recruited from our medical outpatient clinics. Vascular function was non-invasively measured by flow-mediated dilatation (FMD) using high-resolution vascular ultrasound (Agilent Sonos, USA). CD133+/KDR+ circulating endothelial progenitor cells (EPC) were measured by flow cytometry. PR interval was determined from 12-lead electrocardiogram. Results: Mean PR interval was 170±26 ms, with PR prolongation &gt;200 ms present in 14 subjects (9%). Mean FMD was 3.4±2.5%. PR interval was associated negatively with FMD (Pearson R=−0.27, P=0.001 ) but positively with CD133+/KDR+ EPC (Pearson R=0.23, P=0.006 ). Compared with PR interval ≤200ms, patients with PR prolongation &gt;200ms had significantly lower FMD (1.5±1.4% versus 3.6±2.6%, P=0.003, Figure 1 ) but increased CD133+/KDR+ EPC (log-transformed, unit [x10 −3 / ml]) (1.05 ± 0.33 versus 0.70 ± 0.41, P=0.00 3, Figure 2 ). Adjusted for potential confounders by the multivariable model (age, gender, smoking history, systolic and diastolic blood pressure, resting heart rate, serum LDL and HDL- cholesterol, triglycerides, fasting glucose, use of aspirin/ statins), PR prolongation was independently associated with reduced FMD by −1.5% (95%CI [−3.0% to −0.1%], P=0.039 ) and increased CD133+/KDR+ EPC (log, unit [x10 −3 / ml]) by 0.26 (95%CI [0.05 to 0.48], P=0.017 ). Conclusions: PR prolongation is associated with endothelial dysfunction with evidence of endothelial repair activation in high risk cardiovascular patients.
Genome-Scale RNAi Screen for Host Factors Required for HIV Replication
Authors: Honglin Zhou, Min Xu, Qian Huang, Adam T. Gates, Xiaohua D. Zhang, John C. Castle, Erica Stec, Marc Ferrer, Berta Strulovici, Daria J. Hazuda, Amy S. Espeseth
Journal: Cell Host & Microbe (2008)
Periodic Migrainous Neuralgia
Authors: C. W. Burke
Journal: BMJ (1964)

The findings in this paper contradict a good deal of clinical experience in the beneficial effects of antidepressant drugs on certain depressed patients.These drugs may not provide much relief for the severely depressed patient, but in a considerable number of less severely depressed patients the effect on the mood state seems specific and not simply the result of a sedative action, as suggested by the authors.More striking results might be obtained if a similar trial were to be per- formed in patients suffering from depression seen at a stage before they had been selected by failure to respond to antidepressants.How to find such patients, however, is difficult to suggest.-Iam, etc.,
[228] SYSTEMIC HYPERKINETIC STATE: AN INDEPENDENT PREDICTIVE MARKER OF EARLY MORTALITY IN CIRRHOTIC PATIENTS NOT RECEIVING BETA-BLOCKERS
Authors: C. Francoz, R. Moreau, R. Sobesky, C. Paugam-Burtz, D. Lebrec, J. Belghiti, D. Valla, F. Durand
Journal: Journal of Hepatology (2007)
Comment: The Accuracy of Staging for Combined Therapies
Authors: Philip Rubin
Journal: JAMA (1969)

With the increasing trend toward combined therapies in clinical, oncologic, investigational protocols, there is a demand for greater accuracy in staging the true extent of the cancer at the initiation of treatment. The development of a clinical form of staging is often passed over in favor of the greater accuracy of surgical evaluation. The surgical evaluation is coupled with pathological examination, further refining the accuracy of anatomic staging. However, with the application of preoperative adjuvants such as irradiation therapy and chemical agents, an alteration of staging occurs and renders surgical staging meaningless unless it is compared to a pretreatment evaluation. The obstacles to an acceptable clinical staging relate to a few key points. First, a classification must be precise, simple, and meaningful so that it can be applied generally in practice and reporting. Second, the diagnostic procedures which are used in arriving at a clinical staging must be defined and
DETERMINANTS OF STROKE AND ITS IMPACT ON OUTCOME OF ACS IN CLINICAL PRACTICE IN EUROPE: LESSONS FROM THE EURO HEART SURVEY ACS REGISTRY
Authors: Andrea Papp, Wojtek Wojakowski, Marek Gierlotka, Hector Bueno, Ralf Zahn, Uwe Zeymer, Francois Schiele, Matthias Hochadel, Jean-Pierre Bassand, Anselm Gitt
Journal: Journal of the American College of Cardiology (2011)
NOVEL KI-ras CODON 61 MUTATION IN INFILTRATING LEUCOCYTES OF ORAL SQUAMOUS CELL CARCINOMA
Authors: SidneyE. Chang, WendyE. Marnock, PenelopeJ. Shirlaw, PeterR. Morgan, NewellW. Johnson, LynneR. Hiorns, BryanD. Young
Journal: The Lancet (1989)
P17.74 * MONOFOCAL LESION OF DEMYELINATING DISEASE AND DIFFERENTIAL DIAGNOSIS WITH HIGH GRADE GLIOMA - CASE REPORT
Authors: F. Romeo, G. Maddalena, V. Conserva, V. Fumai, L. Fiorentino, E. Alloro, S. Toscano, A. D'Agostino
Journal: Neuro-Oncology (2014)

INTRODUCTION: Pseudoneoplasms of the nervous system are potential to mislead. Clinical, neuroimaging and histologic features are readily misinterpreted in degenerative disease tumor-like lesion. CASE REPORT: A 33 years-old woman was admitted to our observation with an history of intacranial hypertension syndrome and acute left hemiparesis. CT and MR imaging revealed a right frontal ring enhanced lesion with mass effect, suggestive for high grade glioma. Surgical treatment was performed: craniotomy and extensive resection of the lesion. The post-operative course was uneventful, associated to normal neurological status. Pathological examination was a surprise: “tumefactive demyelinating disease” (mixture of macrophages and reactive astrocytes, perivascular lymphocytes). CONCLUSIONS: Multiple sclerosis disease may show a variety of clinical and radiological presentations. Monofocal demyelinating lesion is atypical appearance simulating brain tumor. The knowledge of this diagnostic pitfall is essential to avoid mismanagement.
Thromboembolism After Surgery
Authors: George E. Ehrlich
Journal: JAMA (1981)

<h3>To the Editor.—</h3> In the QUESTIONS AND ANSWERS section (1981;245:75) a question was raised whether earlier surgery after severe trauma to a knee in a 44-year-old woman would have prevented a fatal thromboembolic complication. The question was answered by an orthopedist and an internist, both of whom blamed bed rest for thromboembolic complications, based on classic studies. However, early studies have relied on postmortem data and clinical evaluation. Newer methods of detection, such as the use of phlebography and iodine 125 fibrinogen, have confirmed that the earlier impressions were inaccurate, leading both to false-positives and to false-negatives.<sup>1</sup>Age, sex, anesthesia, and tourniquet time all proved relatively unimportant; bed rest should not be as strongly implicated as it was in the answers to the query, as it should afflict both sides, not merely lateralize to the side operated on. In our study cited earlier, 20 of 35 patients undergoing surgery
PRESENCE OF ENDOTHELIAL COLONY-FORMING CELLS AT ADMISSION IS ASSOCIATED WITH A REDUCTION IN INFARCT SIZE AT 6 MONTHS FOLLOW-UP: A MAGNETIC RESONANCE IMAGING STUDY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Nicolas F. Meneveau, Frederic Deschaseaux, Marie-France Seronde, Vincent Descotes-Genon, Francois Schiele, David Chalmers, Pierre Tiberghien, Jean-Pierre Bassand, Jean-Pierre Kantelip, Siamak Davani
Journal: Journal of the American College of Cardiology (2010)
Randomized Phase II Trial Evaluation of Erectile Function after Attempted Unilateral Cavernous Nerve-Sparing Retropubic Radical Prostatectomy With Versus Without Unilateral Sural Nerve Grafting for Clinically Localized Prostate Cancer
Authors: John W. Davis, David W. Chang, Pierre Chevray, Run Wang, Yu Shen, Sijin Wen, Curtis A. Pettaway, Louis L. Pisters, David A. Swanson, Lydia T. Madsen, Nelda Huber, Patricia Troncoso, R. Joseph Babaian, Christopher G. Wood
Journal: European Urology (2008)
SERUM TREATMENT OF PNEUMONIA.
Authors: J. M. ANDERS
Journal: JAMA (1904)

The most rational treatment of pneumonia is that which aims to neutralize the pneumotoxins in the circulation. By the side of this object of treatment, efforts to influence the local inflammatory process are subordinate in point of practical importance. It is now universally recognized that the continuous high death rate in this disease is dependent on the toxemia, and that the cardiac exhaustion is to a greater extent due to the same cause than mechanical embarrassment. Recognizing the fact that the principal danger arises from the general pneumococcic infection, the great desirability of finding successful means of combating this source of danger must be obvious. The effect of antipneumococcal sera, according to the reports of those who have had experience of their use, seems to manifest considerable variety both as to character and extent. A somewhat extended series of observations by a large number of careful clinical observers are now
The Placenta and Fetal Membranes
Authors: Charles B. Reiner
Journal: JAMA (1961)

This volume dealing with the placenta and fetal membranes is a most welcome addition to the very rapidly expanding list of available texts, reviews, and symposia dealing with medical and basic scientific topics. Basically, this work presents the proceedings of a conference dealing with the placenta and fetal membranes. This conference, sponsored by the Association for the Aid of Crippled Children, was held in November, 1958, at Princeton, N. J. The participants included outstanding workers in this field, both from America and abroad. The material presented at that conference is stated to have been expanded rather than condensed in this volume. The book is divided into four parts plus a useful index. Part I consists of eight reviews by as many outstanding authorities in the field of placental function, biochemistry, and morphology. The reviews of placental hormonal functions, circulation, respiratory exchange, antibody transmission, fetal nutrient supply, biochemistry, and pathology are
Lysozyme Studies in Sarcoidosis.
Authors: R. S. Pascual
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Lysozyme Studies in Sarcoidosis.R. S. Pascual, M.D., P. E. Perillie, M.D., S. Sulavik, M.D., J. A. Donadio, M.D., J. B. L. Gee, M.D., F.A.C.P., S. C. Finch, M.D.R. S. Pascual, M.D.Search for more papers by this author, P. E. Perillie, M.D.Search for more papers by this author, S. Sulavik, M.D.Search for more papers by this author, J. A. Donadio, M.D.Search for more papers by this author, J. B. L. Gee, M.D., F.A.C.P.Search for more papers by this author, S. C. Finch, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-880_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe clinical significance of lysozymuria and increased serum lysozyme activity was evaluated in 41 patients with proved sarcoid. Lysozyme activity was determined by either the lysoplate or turbidimetric method. All patients were staged according to chest radiographic findings. Most had total and differential white cell counts, blood urea nitrogen, and serum calcium determinations. Lysozymuria was present in 15 of 41 patients (37%), and lysozyme activity was increased in 14 of 23 (61%). All five patients with obvious splenic involvement had increased lysozyme activity. All patients with increased activity had early infiltrative lung disease with hilar adenopathy. Successful corticoid therapy was... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: R. S. Pascual, M.D.; P. E. Perillie, M.D.; S. Sulavik, M.D.; J. A. Donadio, M.D.; J. B. L. Gee, M.D., F.A.C.P.; S. C. Finch, M.D.Affiliations: New Haven, Conn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byElevated β2-microglobulin and lysozyme levels in patients with acquired immune deficiency syndromeLysozyme levels in sarcoidosisMethods and equipment for measuring and preparing the edges of spherical storage tank components (survey of foreign patents)Serum Lysozyme in Crohn's Disease and Ulcerative ColitisLysozyme in Leukopathic StatesLysozyme Bibliography: 1922–1972Usefulness of Serum Lysozyme Measurement in Diagnosis and Evaluation of Sarcoidosis 1 May 1972Volume 76, Issue 5Page: 880-880KeywordsBlood cellsBlood countsBlood urea nitrogenCalciumLungsLysozymeSarcoidosisThorax ePublished: 1 December 2008 Issue Published: 1 May 1972 PDF downloadLoading ...
Methodological Aspects of Nasal Allergen Challenges Based on a Three‐Year Tree Pollen Immunotherapy Study
Authors: Jan‐Åke Wihl
Journal: Allergy (1986)

During 3 years of immunotherapy with tree pollen extracts, 31 patients were provoked annually. Changes in nasal reactivity were followed by registration of expiratory nasal peak flow, number of sneezes, and amount of secretion. The reproducibility of the peak flow measurements was studied. The results from all three parameters were used to form a total nasal provocation score which, better than each parameter separately, could demonstrate the variation in sensitivity. Provocation with an allergen concentration of 1 HEP was the most effective means of showing changes in specific sensitivity of nasal mucosa.
Biochemical marker in familial amyloidotic polyneuropathy, Portuguese type. Family studies on the transthyretin (prealbumin)-methionine-30 variant.
Authors: M J Saraiva, P P Costa, D S Goodman
Journal: Journal of Clinical Investigation (1985)

A transthyretin variant with a methionine for valine substitution at position 30 [TTR(Met30)] is found in Portuguese patients with familial amyloidotic polyneuropathy (FAP). Effective, rapid, small- and semimicro-scale (immunoblotting) procedures were developed to determine whether or not TTR(Met30) is present in the plasma of an individual subject. The immunoblotting procedure employs only 0.10 ml of serum and can serve as a reliable procedure for the screening of large numbers of persons for the presence of TTR(Met30). In family studies of seven FAP kindreds, TTR(Met30) was found in 21 out of 41 asymptomatic FAP offspring, and its presence was not related to either age or sex. Thus, the mutant TTR segregated in accordance with the known autosomal dominant mode of inheritance of FAP. Total plasma TTR levels were not reduced in asymptomatic FAP offspring who were carriers of TTR(Met30), and no difference was observed between carriers and noncarriers of the mutant TTR. The ratios of the variant to normal TTR in plasma were estimated in asymptomatic FAP offspring and were similar to those found in FAP patients. In contrast, TTR(Met30) was relatively enriched in cerebrospinal fluid samples from two FAP patients. The significance of this finding is not known, but might relate to the preferential deposition of amyloid in the nervous system in FAP. A limited study was conducted involving simultaneous analysis of both stored (collected in 1975) and fresh serum from 20 FAP offspring, all of whom had been asymptomatic in 1975. In every subject, the results obtained with the stored and the fresh serum samples were in agreement. Six of these subjects developed clinical FAP since 1975; TTR(Met30) was present in each of these subjects. These several studies strongly suggest that the presence of TTR(Met30) in plasma constitutes a predictive biochemical marker of FAP in the preclinical phase of the disease.
HIV Therapy — What Do We Know, and When Do We Know It?
Authors: Paul R. Skolnik
Journal: New England Journal of Medicine (2003)

It has often been stated that the central questions in therapy for human immunodeficiency virus (HIV) infection are the same now as they were when the epidemic started. When do we start therapy, what do we start with, when should we switch, what constitutes failure of therapy, and why do our therapies fail? Information from clinical trials of various anti-HIV treatments, along with in vitro observations, has narrowed the choices. Often, the design and completion of these trials lag behind practice, but they still serve several crucial purposes. The studies confirm what we think we know, disprove beliefs based on . . .
Vagal Nerve Stimulation Markedly Improves Long-Term Survival After Chronic Heart Failure in Rats
Authors: Meihua Li, Can Zheng, Takayuki Sato, Toru Kawada, Masaru Sugimachi, Kenji Sunagawa
Journal: Circulation (2003)

Diminished cardiac vagal activity and higher heart rate predict a high mortality rate of chronic heart failure (CHF) after myocardial infarction. We investigated the effects of chronic electrical stimulation of the vagus nerve on cardiac remodeling and long-term survival in an animal model of CHF after large myocardial infarction.Two weeks after the ligation of the left coronary artery, surviving rats were randomized to vagal- and sham-stimulated groups. Using an implantable miniature radio-controlled electrical stimulator, we stimulated the right vagal nerve of CHF rats for 6 weeks. The intensity of electrical stimulation was adjusted for each rat, so that the heart rate was lowered by 20 to 30 beats per minute. The treated rats had significantly lower left ventricular end-diastolic pressure (17.1+/-5.9 versus 23.5+/-4.2 mm Hg, P<0.05) and higher maximum dp/dt of left ventricular pressure (4152+/-237 versus 2987+/-192 mm Hg/s, P<0.05) than the untreated rats. Improvement of cardiac pumping function was accompanied by a decrease in normalized biventricular weight (2.75+/-0.25 versus 3.14+/-0.22 g/kg, P<0.01). Although the 140-day survival of the untreated group was only half, vagal stimulation markedly improved the survival rate (86% versus 50%, P=0.008). Vagal stimulation therapy achieved a 73% reduction in a relative risk ratio of death.Vagal nerve stimulation markedly improved the long-term survival of CHF rats through the prevention of pumping failure and cardiac remodeling.