tbuckley/cabot-search huggingface dataset:
Anesthesia and Co-Existing Disease
Authors: Stanley I. Samuels
Journal: JAMA (1983)

Many years ago, when I was much younger, there was a song to  effect that love was better  second time around. A somewhat perverse idea, but if perhaps not altogether true for love, could it be true for something as unromantic as a medical textbook? What brought these somewhat idiosyncratic thoughts to mind was receiving for review  second edition of Anesthesia and Co-Existing Disease , edited by Stoelting, Dierdorf, and McCammon. The original edition was published in 1983 and was well received at that time. What has  new edition to offer  second time around?  First, a new editor has been added, and  multiauthored text of  original edition has been replaced by an edition that is, as  preface states, the product of  Editors. Be that as it may,  new format is virtually identical with that of  multiauthored first edition. Second,
Opiate Withdrawal Using Clonidine
Authors: Mark S. Gold
Journal: JAMA (1980)

Clonidine hydrochloride was administered to ten patients in an inpatient setting after abrupt discontinuation of chronic methadone hydrochloride administration. Clonidine produced a rapid and statistically significant decrease in opiate withdrawal signs and symptoms. Clonidine administration for 14 days enabled all patients to be successfully detoxified from chronic opiate administration. In all patients studied, clonidine was a safe and effective nonopiate treatment of opiate withdrawal that suppressed the affect, signs, and symptoms of opiate withdrawal. These data support the hypothesis that the alpha 2-adrenergic agonist, clonidine, has substantial antiwithdrawal effect by replacing opiate-mediated inhibition with alpha 2-mediated inhibition of brain noradrenergic activity.
Symptoms of Hypoglycemia in Children With IDDM
Authors: Rory J McCrimmon, Ann E Gold, Ian J Deary, Christopher J H Kelnar, Brian M Frier
Journal: Diabetes Care (1995)

OBJECTIVE To examine the symptoms of hypoglycemia in children with insulin-dependent diabetes, from the perspective both of the child and of the child's parents, and to compare the symptom reporting of the diabetic children with that of adult diabetic patients. RESEARCH DESIGN AND METHODS Interviews were conducted with 100 parents and 43 of their children. The frequency and intensity of symptoms of hypoglycemia were documented using a structured interview and classified into groups using Principal Components Analysis (PCA). RESULTS Diabetic children and their parents showed close agreement concerning the relative frequency and the intensity of symptoms reported. PCA of the symptom reports showed that diabetic children and their parents identified the same distinct subgroups of hypoglycemia-related symptoms: behavioral disturbance and autonomic-neuroglycopenic subgroups. CONCLUSIONS Hypoglycemic symptoms in children with diabetes clearly differ from those experienced by insulin-treated adults and, in particular, include behavioral changes as primary features of a low blood glucose. These observations have important implications for parental education on hypoglycemia.
Mutational analysis of CDKN2A genes in patients with squamous cell carcinoma of the skin
Authors: Z. Saridaki, T. Liloglou, A. Zafiropoulos, E. Koumantaki, O. Zoras, D.A. Spandidos
Journal: British Journal of Dermatology (2003)

Nonmelanoma skin cancers [squamous cell carcinomas (SCC) and basal cell carcinomas (BCC)] are the most common neoplasias of the Caucasian population.The purpose of our study was to determine the involvement of CDKN2A genes in the development of sporadic nonmelanoma skin cancer in Greek patients.Allelic imbalance analysis was performed in 22 SCC and five Bowen's disease specimens. Mutational analysis was performed on exons 1alpha, 1beta and 2 of the CDKN2A locus in 22 SCC, five Bowen's disease and 39 BCC specimens. Exon 1alpha was additionally screened in 28 BCC specimens to complete the mutational analysis of a previous study.Overall, 52% (14 of 27) of the SCC and Bowen's disease specimens exhibited loss of heterozygosity (LOH) in at least one microsatellite marker, whereas, only two of 27 (7%) exhibited microsatellite instability. LOH in 9p appears to be equally involved in both BCC and SCC tumours. Exons 1alpha, 1beta and 2 of the CDKN2A locus were screened for mutations. A Val28Gly substitution in exon 1alpha and a CCC-->TTT (Ala57Val and Arg58Ter) substitution in exon 2, resulting in a change in the amino acid sequence, are reported for the first time in two SCCs, the latter being indicative of a combination of an ultraviolet (UV) radiation-induced mutation and a point mutation. A previously described polymorphism of CDKN2A, the gene for p16INK4a, Ala148Thr, was also detected in an allelic frequency of 3.72%. No mutation was found in any of the five Bowen's disease specimens, or in exon 1beta of CDKN2A, also the gene for p14ARF.Mutations and the high incidence of 9p LOH detected in our SCC samples imply that inactivation of CDKN2A genes, via allelic loss and/or mutation (probably UV-induced) may play a significant role in nonmelanoma skin cancer development, particularly in the more aggressive SCC type.
Doctor in the lab.
Authors: G A Summers
Journal: BMJ (1971)

The note also states that "during 1970, 101 cases of malaria were reported by [Public Health] laboratories in the United King- dom."This figure is a serious underestimate of the total number of cases of malaria noti- fied in Britain.Information provided by the Department of Health and Social Security indicates that the quarterly returns of the Registrar General for 1970 quote 137 confirmed notifications of malaria in England and Wales.In addition to that the Scottish Home and Health Department received in 1970 not less than 24 notifications of malaria of which 19 were confirmed.This brings the known number of malaria cases in England, Wales, and Scotland to at least 156.Carswell and Stevenson2 reported recently that over the period 1965-9 the number of cases of malaria seen in Scotland averaged 20 per annum.Malaria is not notified in Northern Ireland but the cases confirmed by the Public Health Laboratories in 1970 were in- cluded in the figures reported in your note.
P157Humoral transfer of remote ischemic preconditioning′s protection from donor pigs in vivo to an in in vitro bioassay of isolated perfused recipient rat hearts
Authors: A Skyschally, C Schulte, G Heusch, P Kleinbongard
Journal: Cardiovascular Research (2014)

Remote ischemic preconditioning (RIPC), i.e. brief episodes of ischemia/reperfusion in a remote organ, protects the heart against infarction after myocardial ischemia/reperfusion. However, the transfer of protection from the remote ischemic/reperfused organ to the heart is still not understood. Here we address the transfer of a blood-borne cardioprotective factor from a donor pig undergoing a RIPC protocol and subsequent myocardial ischemia/reperfusion to an isolated perfused recipient rat heart undergoing global ischemia/reperfusion. Methods: Anesthetized pigs were subjected to either RIPC (4 cycles of 5 min hindlimb occlusion/5 min reperfusion) or placebo. Plasma was separated from arterial blood samples collected 60 min after RIPC or placebo, respectively, and stored at 80°C. Myocardial ischemia was induced by 60 min occlusion of the left anterior descending coronary artery (LAD) with subsequent 180 min reperfusion. The area at risk (AAR) was determined by atrial injection of 5 ml Patentblau after LAD re-ligation at the end of the experiment and infarct size by TTC staining. Isolated rat hearts were mounted on a Langendorff apparatus and perfused at a pressure of 75 mmHg with Krebs-Henseleit-buffer before undergoing 30 min global ischemia and 120 min reperfusion at 37° C. Pre-warmed pig plasma was added to the Krebs-Henseleit-buffer (1:10) for 8 min before and 5 min after ischemia. Infarct size was determined by TTC staining. Results: In pigs, infarct size was 47.6±5.5% of the AAR with placebo and 22.1±3.5% with RIPC (mean±SEM; p<0.05; 2-sided t-test). In the isolated rat hearts, perfusate-supplementation with plasma from pigs which underwent RIPC resulted in an infarct size of 25.9±1.9% of the left ventricle as compared to 39.3±2.3% with plasma from pigs of the placebo group (p<0.05). Infarct size in an ischemia/reperfusion protocol without plasma infusion was 42.0±1.2%. The infarct size in isolated recipient rat hearts correlated to that of the donor pigs (r=0.74; n=12). Conclusion: After RIPC in pigs, a cardioprotective, humoral signal can be transferred to an in vitro bioassay of isolated rat hearts.
Guidelines for the Treatment of Acidaemia with THAM
Authors: Gabriel G. Nahas, Kenneth M. Sutin, Charles Fermon, Stephen Streat, Lars Wiklund, Staffan Wahlander, Paul Yellin, Helmut Brasch, Marc Kanchuger, Levon Capan, Joseph Manne, Helmut Helwig, Michael Gaab, Ernst Pfenninger, Torbj??rn Wetterberg, Martin Holmdahl, Herman Turndorf
Journal: Drugs (1998)
Laparoscopy in the Diagnosis of Liver Metastases in 80 Cases of Malignant Melanoma
Authors: H. Bleiberg, E. La Meir, F. Lejeune
Journal: Endoscopy (1980)

80 patients with histologically proven malignant melanoma were submitted to laparoscopy. 44 had advanced disease and 36 were clinically locoregional (23 stage I, 13 stage IIb). Results of a liver scan and liver function tests were available before starting this procedure. In all cases, biopsies were obtained through the laparoscope using a Menghini liver biopsy needle, specimens, being taken under visual control from the macroscopically suspected area. If no lesions was seen, two needle biopsies were taken at random from the anterior and posterior areas of both lobes. The liver was invaded in 11% of the patients with advanced disease, and in 23% of those with stage IIb. All the positve laparscopies occurred with biochemistry and/or liver scan were also abnormal, and biopsies taken at random in normal-looking livers were all negatives. Benign tumors were found in 13% of the cases. Some of these were indistinguishable from metastatic melanoma on the basis of their maroscopic aspect alone.
Repeated Direct-Current Countershock Without Myocardial Injury
Authors: Thomas Q. Kong, William L. Proudfit
Journal: JAMA (1964)

THE EFFECTIVENESS of direct-current (DC) countershock in the treatment of arrhythmias that are refractory to drug therapy has been established,<sup>1</sup>but the safety of the procedure is still questioned. Electric burns, myocardial injury, and asystole are feared complications. In experimental studies, Lown and associates<sup>1</sup>have noted electrocardiographic changes compatible with myocardial infarction in one third of the dogs that received DC countershock. The purpose of this communication is to report the use of DC countershock at least 140 times in a patient, with no resulting damage to the myocardium, as demonstrated at autopsy examination. <h3>Report of a Case</h3> A 62-year-old man was admitted to Cleveland Clinic Hospital on Oct 14, 1962, for investigation and treatment of hypertension. He had known of his hypertension for two years and had been receiving reserpine and a diuretic, which were only moderately effective. For two years he had had occasional episodes
Integrated backscatter for quantification of left atrial spontaneous echo contrast
Authors: Allan L. Klein, R.Daniel Murray, Ian W. Black, Shalabh Chandra, Richard A. Grimm, Alwyn P. D'Sa, Dominic Y.C. Leung, David Miller, Annitta J. Morehead, Susan E. Vaughn, James D. Thomas
Journal: Journal of the American College of Cardiology (1996)
Surface gene mutants of hepatitis B virus in infants who develop acute or chronic infections despite immunoprophylaxis
Authors: H Hsu, M Chang, Y Ni, H Lin, S Wang, D Chen
Journal: Hepatology (1997)

Serum hepatitis B virus (HBV) DNA from 4 infants with fulminant hepatitis B, 3 infants with acute self-limited hepatitis B, and 15 infants with chronic HBV infection were amplified by polymerase chain reaction followed by direct sequencing of the region of HBV genome encoding the major antigenic epitopes of hepatitis B surface antigen (HBsAg). All infants were born to carrier mothers and administered immunoprophylaxis from birth. Serum HBV DNA from 13 carrier children born to carrier mothers who did not receive immunoprophylaxis and had comparable length of infection were studied as controls. An S mutant (residue 126, Thr to Ala) initially found in an infant with fulminant hepatitis was replaced by another S mutant (residue 145, Gly to Arg) 4 days later. In a girl with chronic hepatitis B, Ala-126 variant and Arg-145 variant were found at 17 and 25 months of age, respectively. The Arg-145 variant persisted for 8 years in an asymptomatic male carrier and for 1 year in an infant with chronic hepatitis B. The Ala-126 variant persisted for 11 years in one child who had an early loss of hepatitis B e antigen. In the majority of the infants' mothers, corresponding mutations in HBsAg were not detected in serum by direct sequencing. The S mutants detected in three carrier infants were not found in their mothers' serum after cloning and sequencing of 10 DNA clones from each maternal sample. None of the 13 control patients had detectable S mutants. These results suggest that S variants emerge or are selected under the immune pressure generated by the host or by administration of hepatitis B immune globulin and hepatitis B vaccination. An S mutant (residue 129, Gln to Arg) found in one mother-infant pair suggested a direct maternal-infant transmission, resulting in immunoprophylaxis failure. None of the family members of children infected with Arg-145 variant had the same variant infection, implying this variant's low transmissability.
Merck's Recall of Rofecoxib — A Strategic Perspective
Authors: Felix Oberholzer-Gee, S. Noorein Inamdar
Journal: New England Journal of Medicine (2004)

When Merck announced the voluntary withdrawal of its acute-pain medication, rofecoxib (Vioxx), on September 30, 2004, its stock price collapsed, wiping out more than a quarter of the company's market value in a single day. A second blow came on November 1, when an article in the Wall Street Journal suggested that Merck had known about elevated risks of heart attack and stroke for years and had tried to intimidate scientists who questioned the safety of rofecoxib. On that day, Merck's stock price fell by another 10 percent. The recall came as a shock not only to patients and their . . .
Dizziness and rash in an HIV positive man
Authors: D. Bradshaw, N. Nwokolo
Journal: BMJ (2012)

A 32 year old homosexual Indian man who was positive for HIV (CD4 cell count 416×106/L, HIV-1 RNA 64 000 copies/mL) presented to his HIV doctor with a two month history of dizziness and 7 kg weight loss. He felt unsteady on walking but denied true vertigo, falls, visual disturbance, or loss of consciousness. He reported loss of eyebrow hair and an itchy rash. HIV-1 positivity had been identified four years previously, but he had not had any HIV related illnesses and took no drugs. He had not received antiretroviral drugs because his CD4 cell count was greater than the 350×106/L threshold below which current UK guidelines recommend treatment for HIV.1 Examination showed an ataxic gait with negative rombergism, but otherwise normal neurology. A generalised scaly maculopapular eruption including the palms, soles, and genitalia and loss of eyebrow hair were seen. Three irregular ulcers were visible on the hard palate.



### 1 What is the likely diagnosis for a patient with this history and these findings?

#### Short answer

Secondary syphilis with neurological involvement.

#### Long answer

The most likely diagnosis is secondary syphilis with neurological involvement. Guttate psoriasis may mimic the rash of secondary syphilis and is more common in HIV infection, but it would not cause abnormal neurology or systemic symptoms. Mycosis fungoides and leprosy are rarer causes of a similar rash. Primary toxoplasmosis and viral infections (for example, infection with cytomegalovirus and Epstein-Barr virus) may cause systemic illness and rash, but …
Whose data are they anyway?
Authors: Kinesh Patel
Journal: BMJ (2012)

I accept my body is mine to do with as I please—heaven knows, no one else would want it. And no, this is not a moment of existential angst. But the question that strikes me is how much should the information about me be mine?⇑

I’ve taken some time off the clinical treadmill, which is driving me relentlessly forward to a consultant job, where the managers won’t think I need any more of that pesky training that interferes so with service delivery. I’m doing a research degree for the next couple of years, which …
An N-terminal truncated carboxypeptidase E splice isoform induces tumor growth and is a biomarker for predicting future metastasis in human cancers
Authors: Terence K. Lee, Saravana R.K. Murthy, Niamh X. Cawley, Savita Dhanvantari, Stephen M. Hewitt, Hong Lou, Tracy Lau, Stephanie Ma, Thanh Huynh, Robert A. Wesley, Irene O. Ng, Karel Pacak, Ronnie T. Poon, Y. Peng Loh
Journal: Journal of Clinical Investigation (2011)

Metastasis is a major cause of mortality in cancer patients. However, the mechanisms governing the metastatic process remain elusive, and few accurate biomarkers exist for predicting whether metastasis will occur, something that would be invaluable for guiding therapy. We report here that the carboxypeptidase E gene (CPE) is alternatively spliced in human tumors to yield an N-terminal truncated protein (CPE-ΔN) that drives metastasis. mRNA encoding CPE-ΔN was found to be elevated in human metastatic colon, breast, and hepatocellular carcinoma (HCC) cell lines. In HCC cells, cytosolic CPE-ΔN was translocated to the nucleus and interacted with histone deacetylase 1/2 to upregulate expression of the gene encoding neural precursor cell expressed, developmentally downregulated gene 9 (Nedd9)--which has been shown to promote melanoma metastasis. Nedd9 upregulation resulted in enhanced in vitro proliferation and invasion. Quantification of mRNA encoding CPE-ΔN in HCC patient samples predicted intrahepatic metastasis with high sensitivity and specificity, independent of cancer stage. Similarly, high CPE-ΔN mRNA copy numbers in resected pheochromocytomas/paragangliomas (PHEOs/PGLs), rare neuroendocrine tumors, accurately predicted future metastasis or recurrence. Thus, CPE-ΔN induces tumor metastasis and should be investigated as a potentially powerful biomarker for predicting future metastasis and recurrence in HCC and PHEO/PGL patients.
The lithic technology of <i>Cebus apella</i> and its implications for brain evolution and the preconditions of language in <i>Homo habilis</i>
Authors: Gregory Charles Westergaard
Journal: Behavioral and Brain Sciences (1996)

Abstract Wilkins &amp; Wakefield (1995) provide a thoughtful contribution to our understanding of language origins. In this commentary I attempt to define the relationship between object-manipulation and primate brain function further by reviewing research on aimed throwing and the production and use of stone tools by tufted capuchin monkeys ( Cebtis apella ). I propose that examining the relation between brain function and object-manipulation in Cebus will provide insight into the preconditions of language in our hominid ancestors.
WHAT IS A "DISEASED" TONSIL?
Authors: J. B. Cavenagh
Journal: BMJ (1923)

A 07 of tonsillectomy so long as the patient returns to the environment in which he first contracted rheumatic infec- tion.The ideal treatment consists in the removal, first of the septic tonsils from the patient, and then of the patient from his old surroundings to the happy conditions described by Dr. A. P.
Integration of reflectance confocal microscopy in sequential dermoscopy follow-up improves melanoma detection accuracy
Authors: I. Stanganelli, C. Longo, L. Mazzoni, S. Magi, M. Medri, G. Lanzanova, F. Farnetani, G. Pellacani
Journal: British Journal of Dermatology (2014)

Successful treatment of melanoma depends on early diagnosis, but its varied clinical presentation means that no single noninvasive method or criterion can provide reliable detection in all cases.To determine whether combining sequential dermoscopy imaging with reflectance confocal microscopy (RCM) can improve melanoma detection and reduce the burden of unnecessary excisions.We conducted a retrospective study with median follow-up of 25 months. We included equivocal pigmented lesions that lacked clear dermoscopy criteria for melanoma at baseline but were excised subsequently because of changes during digital monitoring. RCM imaging was performed before excision. Main melanoma dermoscopy features, seven-point checklist score at baseline, and changes in structure and/or colour, and development of new melanoma-specific criteria at follow-up (scored as major, moderate or minor) were considered. Main melanoma RCM criteria were evaluated and diagnosis was made. Histopathological diagnosis was the reference standard for defining parameter frequency and diagnostic accuracy.Seventy lesions were included. Major changes were more frequently correlated with melanoma diagnosis, although one-third (four of 12) of melanomas showed moderate or minor changes. Cytological atypia and architectural disarrangement on RCM were correlated with melanoma diagnosis. A correct melanoma diagnosis was achieved with RCM in almost all cases (11 of 12, 92%). Referring for excision only those lesions with RCM-positive features and/or presenting major changes at digital dermoscopy follow-up, theoretically 27 of 58 naevi could be saved from surgery.Integration of RCM in the clinical and instrumental strategy for managing difficult pigmented lesions provided additional diagnostic information useful in the decision-making process.
Low Birth Weight and Maternal Virus Diseases
Authors: Morris Siegel
Journal: JAMA (1966)

A prospective study on maternal virus diseases occurring from 1957 through 1964 disclosed an increase in frequency of prematurity following hepatitis, measles, and rubella. The occurrence of low birth weight was largely related to retarded intrauterine growth following rubella, and to premature onset of labor in hepatitis and measles. Data for mumps and chickenpox in mothers revealed no association with prematurity. There appeared to be no significant difference in the virulence of rubella virus prevalent in epidemic and nonepidemic years as determined by the frequency of low birth weight. These results agree with those previously reported for fetal deaths in the same affected population. In a study of maternal virus diseases, an interrelationship between prematurity and other fetal effects of maternal infection, such as fetal death and congenital defects, was found.
Not a Way to do Esophageal Bougienage
Authors: R. P. Bhutiawi, A. J. Warrington
Journal: Endoscopy (1990)

Corrected by: Erratum: Not a Way to do Esophageal BougienageEndoscopy 1991; 23(01): 54-54DOI: 10.1055/s-2007-1010611
Statistical Methods in Medicine
Authors: Brian MacMahon
Journal: New England Journal of Medicine (1955)

Analysis of ResultsMeasurementSufficient reference has already been made to the importance of ensuring that any two compared measurements are made on individuals or groups that are meaningfully comparable. It must further be ensured that the measurements themselves are derived in comparable ways — in other words, in such ways that any differences reflect real differences between the things measured and not merely differences in the technics of measurement. For many objective measurements there is no great difficulty on this score, sex, age, temperature and the presence or absence of specific disease, for instance, being usually determinable with little . . .