tbuckley/cabot-search huggingface dataset:
Risk of cancer in patients with scleroderma: a population based cohort study
Authors: C L Hill
Journal: Annals of the Rheumatic Diseases (2003)

Previous studies have suggested an increased risk of cancer among patients with scleroderma.To study a population based cohort of patients with scleroderma in South Australia.Subjects with scleroderma were identified from the South Australian Scleroderma Registry established in 1993. All subjects on the scleroderma registry were linked to the South Australian Cancer Registry to identify all cases of cancer until 31 December 2000. Standardised incidence ratios (SIRs) for cancer for subjects with scleroderma were determined using the age- and sex-specific rates for South Australia.In 441 patients with scleroderma, 90 cases of cancer were identified, 47 of which developed after inclusion on the scleroderma registry. The SIRs for all cancers among these patients were significantly increased (SIR=1.99; 95% confidence interval (95% CI) 1.46 to 2.65) compared with the cancer incidence rates for South Australia. The SIRs for lung cancer (SIR=5.9; 95% CI 3.05 to 10.31) were also significantly increased. The SIRs for all cancers among the subgroups with diffuse scleroderma (SIR=2.73; 95% CI 1.31 to 5.02) and limited scleroderma (SIR=1.85; 95% CI 1.23 to 2.68) were significantly increased.This population based cohort study provides evidence that scleroderma is associated with cancer, and in particular, lung cancer. In addition, both diffuse and limited forms of scleroderma are associated with a similarly increased risk of cancer.
Bill clarifies gap in law over living wills
Authors: Clare Dyer
Journal: BMJ (2004)

The long awaited Mental Capacity Bill, which had its first reading in the House of Commons last week, sets up a statutory framework for advance refusals of medical treatment and substitute decision making for people unable to take decisions for themselves.

The measures, which will apply in England and Wales, will plug a gap in the law whereby nobody, not even the courts, has the power to take treatment decisions on behalf of mentally incompetent adults. Under current law, the courts can merely make declarations that doctors would not be acting unlawfully in providing, withholding, or withdrawing treatment …
Recent Advances in Head and Neck Cancer
Authors: Robert I. Haddad, Dong M. Shin
Journal: New England Journal of Medicine (2008)

There are more than half a million incident cases of squamous-cell carcinoma of the head and neck worldwide each year, primarily affecting the oropharynx, oral cavity, hypopharynx, and larynx. This review considers the biologic features of these tumors, including the role of human papillomavirus as a risk factor for cancer of the oropharynx. New therapies are considered, along with management approaches.
Impending Myocardial Infarction
Authors: R. E. BEAMISH, V. MARIE STORRIE
Journal: Circulation (1960)

Coronary occlusion with myocardial infarction is a common condition with a high mortality. The mechanism of coronary occlusion in such cases is not always clear, but thrombosis, either directly or indirectly, is a dominant process. In many instances premonitory symptoms give warning that myocardial infarction is threatening. It is suggested that these symptoms form a recognizable pattern which permits recognition of impending myocardial infarction with a high degree of accuracy. Three common presentations are described. Frequency of diagnosis of impending infarction may be increased by a program of patient education. Frompt administration of anticoagulants appears to influence the outcome favorably, particularly in the first few days or weeks of symptoms.
A viral kinetic study using pegylated interferon alpha 2b and lamivudine in naive patients with HBeAg(−)/I-BV-DNA(+) chronic hepatitis B: preliminary results
Authors: Vana Sypsa, Nicolaos C. Tassopoulos, Dimitrios Chrysagis, Konstantinos Mimidis, Themistoklis Vassiliadis, Maria Raptopoulou, Ioannis Ketikoglou, Caterina Haida, Dimitris Paraskevis, Francois Lafleur, Angelos Hatzakis
Journal: Journal of Hepatology (2002)
Diagnosis of Halothane Hepatitis
Authors: John Francis Zeedick
Journal: JAMA (1971)

<h3>To the Editor.—</h3> In their excellent and well-written article, "Problems in Diagnosing Halothane Hepatitis" (<b>214</b>:1257-1261, 1970), Lomanto and Howland have made some statements in the comment section of their paper which tend to oversimplify management of the halothane or halogenated hydrocarbon hepatitis syndrome (HHS). First, the use of a three-month period between repeated halothane exposures does not guarantee that HHS will not occur on the readministration of halothane. There are case reports of the development of HHS after 15 months between exposures<sup>1</sup>and up to 54 months between exposures.<sup>2</sup> Furthermore, if HHS does<i>not</i>exist, the repeated use of halothane within three months does not appear to produce the syndrome.<sup>3,4</sup> Second, methoxyflurane is a poor substitute for halothane, because methoxyflurane is also associated with HHS.<sup>5,6</sup>
Pulmonary Pressure, Cardiac Output, and Arterial Oxygen Saturation during Exercise at High Altitude and at Sea Level
Authors: NATALIO BANCHERO, FRANCISCO SIME, DANTE PEÑALOZA, JULIO CRUZ, RAÚL GAMBOA, EMILIO MARTICORENA
Journal: Circulation (1966)

The response elicited by exercise on pulmonary pressure, cardiac output, and arterial oxygen saturation in 35 lifetime residents of high altitude has been studied at high altitude (14,900 feet above sea level), and 22 residents of low altitude have been studied at sea level. A procedure combining cardiac catheterization, arterial cannulation, and spirometry was carried out. The exercise was moderate and was performed in supine position using a bicycle ergometer, the work load being 300 kg-m/min/m2 and the average increase of the oxygen uptake being 4.7 times at sea level and 4.8 times at high altitude. Both at .sea level and at high altitude the cardiac output augmented during exercise proportionally to the increase in oxygen uptake, and thus followed the pattern of response described by other authors. The cardiac output as well as the oxygen intake, for the magnitude of exertion performed in this study, was almost the same at sea level and at high altitude. The cardiac output rose during exercise almost exclusively as a result of an increase in the heart rate, with the stroke volume remaining practically constant. Despite similar increase in cardiac output, the response of pulmonary pressure was smaller for sea-level subjects than for the high-altitude subjects. Increments of mean pulmonary pressure bf nearly 50% and 100% were observed on exercise at sea level and at high altitude, respectively. During exercise the arterial oxygen saturation did not change in the sea-level studies, but decreased significantly in the high-altitude studies. The decrement observed in high-altitude residents is related to a fall in arterial pO2 which at resting conditions is placed on the steep part of the oxygen dissociation curve.
Incidence of Diabetes in American Indians of Three Geographic Areas
Authors: Elisa T. Lee, Thomas K. Welty, Linda D. Cowan, Wenyu Wang, Dorothy A. Rhoades, Richard Devereux, Oscar Go, Richard Fabsitz, Barbara V. Howard
Journal: Diabetes Care (2002)

OBJECTIVE—To estimate incidence rates of diabetes and associated risk factors among participants of the Strong Heart Study. RESEARCH DESIGN AND METHODS—Of the 4,549 Strong Heart Study participants examined at baseline, 3,638 returned for a similar examination after an average of 4 years. The 1985 World Health Organization criteria for diabetes were used to identify new diabetes cases. Rates of diabetes among participants who did not have diabetes at baseline examination were determined. The relationships between the incidence rates of diabetes and a number of risk factors measured at baseline examination were studied. RESULTS—Significant variables associated with the development of diabetes included triglycerides, obesity, fasting plasma glucose, insulin, and degree of American Indian blood among participants with NGT at baseline. For those with IGT at baseline, significant predictors included fasting plasma glucose, 2-h glucose, BMI, degree of American Indian blood, and albuminuria. CONCLUSIONS—The high incidence rates found in this study were alarming. To slow down the rapid increase of this disease in the American Indian population, preventive programs must be designed and implemented. Patients with IGT should be treated with diabetes medication or put on a rigid weight-reduction program to reduce the risk of progression to diabetes.
New microscope techniques take the stage
Authors: May Annexton
Journal: JAMA (1978)

The world under the microscope continues to expand. At the recent meeting of the American Society for Microbiology in Atlanta, the application of a new method for viewing viruses in their fluids was described. In general, biopsy or autopsy specimens have been most amenable to scrutiny by the electron microscope (EM). Now, using the pseudoreplica technique, Andre Nahmias, MD, and associates from the Emory University School of Medicine have detected viruses in body fluids with the EM with considerable speed and accuracy. In the pseudoreplica method, an impression of a specimen adheres to a grid that is placed under the EM for analysis. What is viewed are virus particles unadulterated by extraneous material. Specimens can be processed for viral examination in less than half an hour. Viruses are distinct and definable, according to Nahmias. A major asset of the method is its rapidity. In addition, the technique facilitates definition of
Sudden Operative Death due to Massive Tumour Embolism
Authors: W. R. Probert
Journal: BMJ (1956)

The case of a young man with stage IV chemoresistant pure seminoma overexpressing KIT, who achieved complete remission (CR) after the administration of imatinib mesylate (400 mg once daily), along with a third-line chemotherapy regimen, consisting of paclitaxel (150 mg/m<sup>2</sup>), oxaliplatin (100 mg/m<sup>2</sup>) and gemcitabine (800 mg/m<sup>2</sup>) every 2 weeks with granulocyte colony-stimulating factor (G-CSF) support is reported. The patient had received first- and second-line regimens consisting of ifosfamide, bleomycin, etoposide cisplatin (5 cycles, every 3 weeks) and methotrexate, vinblastine, actinomycin D, cyclophosphamide, cisplatin (3 cycles, every 3 weeks) respectively, without having normalized β-human chorionic gonadotrophin (β-HCG) levels. Following treatment with imatinib plus third-line chemotherapy (paclitaxel, oxaliplatin, gemcitabine), the levels of β-HCG were reduced to within the normal limits during the first month of treatment. Therefore, the patient underwent surgical resection of the residual disease from the retroperitoneum and liver, which proved to be only necrotic tissue. The patient is under close follow-up, with no evidence of disease, 36 months after the completion of chemotherapy and 32 months post surgery.
Delayed Rupture of the Spleen A Case Report
Authors: DAVID A. SCHULTZ, JERRY W. FROELICH
Journal: Clinical Nuclear Medicine (1985)

The diagnosis of delayed rupture of the spleen is demonstrated and discussed by presenting a case in which the patient had significant thoracoabdominal trauma with an initially normal liver/spleen scintigram and benign hospital course. Twenty-three days after the trauma, the patient developed an acute abdominal crisis that brought him to the emergency room where an emergency ultrasound revealed hemoperitoneum and a subcapsular hematoma. At laparotomy, a splenic rupture was found. A splenectomy was not performed. Postoperative liver/spleen scintigram showed a persistent defect which was not present on the initial liver/ spleen scintigram.
PAX5 overexpression is not enough to reestablish the mature B-cell phenotype in classical Hodgkin lymphoma
Authors: L Dimitrova, V Seitz, J Hecht, D Lenze, P Hansen, M Szczepanowski, L Ma, E Oker, A Sommerfeld, F Jundt, W Klapper, M Hummel
Journal: Leukemia (2013)
Obliterative Bronchiolitis After Heart-Lung Transplantation: Apparent Arrest by Augmented Immunosuppression
Authors: ALLAN R. GLANVILLE
Journal: Annals of Internal Medicine (1987)

Obliterative bronchiolitis has been the major complication in long-term survivors of human heart-lung transplantation at our institution. We have assessed the effect of the introduction of a third immunosuppressive agent, azathioprine, on the rate of decline in airflow variables in eight heart-lung transplant recipients with obliterative bronchiolitis, and have compared this rate with that in five patients who did not receive augmented immunosuppressive therapy. Specifically, the rate of decline in forced expiratory flow rate between 25% and 75% of vital capacity improved considerably after institution of this therapy (-5.25 ± 2.85 compared with -0.27 ± 0.66 [mean ± SD];p < 0.005), whereas the effect on the ratio of forced expiratory volume in one second to forced vital capacity was more modest (-3.61 ± 1.52 compared with -0.54 ± 0.93; p < 0.005). The rate of decline in airflow variables was similar in both groups before the institution of therapy with azathioprine. These results show that augmented immunosuppressive therapy is capable of slowing the rate of progression of obliterative bronchiolitis in this population; they also suggest that the obliterative bronchiolitis may represent a form of chronic pulmonary allograft rejection.
Ammoniacal Dermatitis Treated with Folic Acid and Soya-bean Milk
Authors: R. A. Miller
Journal: BMJ (1957)

ESTIMATION OF BLOOD SUGAR m 503 correlation coefficient is 0.84, but there is a slight overall tendency for the tablets to give a high reading.In practice it was found that the mid-point between 100 and 150 mg./100 ml.gave a colour that could be recognized quite satisfactorily, and some readings of 125 mg./100 ml. are therefore shown.The mid-point 150-200 mg./100 ml.proved less easy to detect.Occasionally an impure colour was obtained and it was found necessary to repeat the test.
Response of superficial proximal convoluted tubule to decreased and increased renal perfusion pressure. In vivo microperfusion study in rats.
Authors: Y Kinoshita, F G Knox
Journal: Circulation Research (1990)

Although urinary sodium excretion is positively influenced by acute changes in renal perfusion pressure, micropuncture studies show highly conflicting results concerning the response of superficial proximal tubule sodium reabsorption to changes in renal perfusion pressure. In the present study, the changes of superficial proximal reabsorption to decreased and increased renal perfusion pressure were determined in rats by an in vivo microperfusion method. In vivo microperfusion was selected as the method to determine the proximal sodium reabsorption because this method made it possible to deliver a constant fluid and electrolyte load to the proximal tubule without the influence of possible changes of glomerular filtration rate. Renal perfusion pressure was decreased from normal pressure by inflating a suprarenal aortic cuff and was increased from the normal level by the occlusion of celiac and mesenteric arteries and the infrarenal aorta. Although fractional excretion of sodium (FENa) in the urine was decreased from 1.24 +/- 0.23% to 0.45 +/- 0.11% (n = 7, p less than 0.01) when renal perfusion pressure was decreased from 125 +/- 6 to 99 +/- 3 mm Hg, absolute tubular reabsorption by the superficial proximal convoluted tubules was not increased (from 4.4 +/- 0.5 to 4.2 +/- 0.3 nl/min/mm, n = 22). When the renal perfusion pressure was elevated from 126 +/- 4 to 149 +/- 4 mm Hg, tubular reabsorption by the superficial proximal tubules was decreased from 4.1 +/- 0.3 to 2.5 +/- 0.3 nl/min/mm (n = 36, p less than 0.01) with an accompanying increase in FENa (from 1.28 +/- 0.24% to 2.29 +/- 0.37%, n = 9, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Antibodies to hepatitis C virus in autoimmune liver disease: evidence for geographical heterogeneity
Authors: M. Lenzi, G. Ballardini, F.B. Bianchi, P.J. Johnson, I.G. McFarlane, H.M. Smith, B.M. McFarlane, C. Bridger, R. Williams, D. Vergani
Journal: The Lancet (1991)
Comparison of the Effects of Vitamins and/or Mineral Supplementation on Glomerular and Tubular Dysfunction in Type 2 Diabetes
Authors: Peter Rossing, Mark E. Cooper, Hans-Henrik Parving
Journal: Diabetes Care (2006)

Recently, Farvid et al. (1) reported on the effects of dietary supplementation of physiologic doses of vitamins and/or minerals on urinary albumin excretion rate (UAER)/urinary protein excretion rate (UPER), blood pressure, and lipid profile. Although not mentioned in the article, data on blood pressure and lipids have previously been reported elsewhere (2,3).

The main finding is a significant reduction in UAER of ∼66% in the group receiving both minerals and vitamins. Although Farvid et al. …
Stroke in Patients With Type 2 Diabetes Mellitus, Chronic Kidney Disease, and Anemia Treated With Darbepoetin Alfa
Authors: Hicham Skali, Hans-Henrik Parving, Patrick S. Parfrey, Emmanuel A. Burdmann, Eldrin F. Lewis, Peter Ivanovich, Sai Ram Keithi-Reddy, Janet B. McGill, John J.V. McMurray, Ajay K. Singh, Scott D. Solomon, Hajime Uno, Marc A. Pfeffer
Journal: Circulation (2011)

More strokes were observed in the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) among patients assigned to darbepoetin alfa. We sought to identify baseline characteristics and postrandomization factors that might explain this association.A multivariate logistic regression model was used to identify baseline predictors of stroke in 4038 patients with diabetes mellitus, chronic kidney disease, and anemia randomized to receive darbepoetin alfa or placebo. To determine whether postrandomization blood pressure, hemoglobin level, platelet count, or treatment dose were responsible for the increased risk related to darbepoetin alfa, we performed a nested case-control analysis (1:10 matching) identifying nonstroke controls with propensity matching. The risk of stroke was doubled with darbepoetin alfa. Overall, 154 patients had a stroke, 101/2012 (5.0%) in the darbepoetin alfa arm and 53/2026 (2.6%) in the placebo arm (hazard ratio 1.9; 95% confidence interval, 1.4-2.7). Independent predictors of stroke included assignment to darbepoetin alfa (odds ratio 2.1; 95% confidence interval, 1.5-2.9), history of stroke (odds ratio 2.0; 95% confidence interval, 1.4-2.9), more proteinuria, and known cardiovascular disease. In patients assigned to darbepoetin alfa, postrandomization systolic and diastolic blood pressure, hemoglobin level, platelet count, and darbepoetin alfa dose did not differ between those with and without stroke. Additional sensitivity analyses using maximal values, latest values, or changes over varying periods of exposure yielded similar results.The 2-fold increase in stroke with darbepoetin alfa in TREAT could not be attributed to any baseline characteristic or to postrandomization blood pressure, hemoglobin, platelet count, or dose of treatment. These readily identifiable factors could not be used to mitigate the risk of darbepoetin alfa-related stroke.http://www.clinicaltrials.gov. Unique identifier: NCT00093015.
Comparison of insulinotrophic actions of nateglinide with glibenclamide dissociated from absorption in conscious dogs
Authors: M. Okamoto, N. Ogihara, W. Kawamura, S. Ebihara, K. Takiguchi, T. Morita, R. Uchida, J. Yamaguchi, T. Sakai, Y. Okuda, Y. Hayashi, Y. Arakawa, M. Kikuchi
Journal: Metabolism (2002)
New UK hospital care plan for elderly
Authors: J. Warden
Journal: BMJ (1998)

<h3>Abstract</h3> Dominant negative polypeptides can act as inhibitors by binding to the wild type protein or by titrating an essential ligand. Here, we use high-throughput sequencing of DNA libraries composed of fragments of yeast genes to identify dominant negative polypeptides based on their depletion during cell growth. The method uncovers numerous inhibitory polypeptides for a protein and thus is capable of defining interacting domains with exquisite resolution, even pinpointing individual residues that contact ligands.
Prevention of falls in the community
Authors: L. Clemson
Journal: BMJ (2010)

We report a patient with proximal right upper limb tremor, secondary to direct peripheral nerve lesion caused by prior thoracic surgery. Electromyography demonstrated neurogenic abnormalities and tremor in muscles innervated by the thoracodorsal and long thoracic nerves. Somatosensory evoked potentials, transcranial magnetic stimulation, and MRI of the cervical and thoracic spine were normal. Tremor persisted in REM and non-REM sleep. These findings suggest a peripheral generator.
Torrential epistaxis with symmetrical facial-skin ulceration in sickle-cell anaemia.
Authors: F. I. Konotey-Ahulu
Journal: BMJ (1965)

Epistaxis and skin ulcerations are just two of the protean manifestations of sickle-cell anaemia.Epistaxis is common (Hughes et al., 1940;Wintrobe, 1951), even to the extent of one-third of all patients with a sickle-cell anaemia and a sickle-cell/haemoglobin-C disease (Hook and Cooper, 1958), and can be very severe (Mabayoje, 1956; Hook and Cooper, 1958).Chronic leg ulcers are the commonest skin lesions in sickle- cell anaemia.They were described in-all the earliest reports on sickle-cell anaemia (Herrick, 1910;Washburn, 1910-11;
Prolonged Observations of the Cardiovascular Status in Essential Hyperlipemia
Authors: ALFRED SOFFER, MARTIN MURRAY
Journal: Circulation (1954)

Study of the natural course of essential hyperlipemia discloses that this disease is frequently associated with premature atherosclerosis. It is, therefore, our contention that we can no longer regard essential hyperlipemia as a benign disease. Heparin administered intravenously to patients with essential hyperlipemia produces dramatic though transient lowering of total lipids. This is due predominantly to heparin's effect upon neutral fat. Normal controls show no significant differences in their lipid response to heparin, though of course the degree of these changes is comparatively smaller.