tbuckley/cabot-search huggingface dataset:
Plasma acetylsalicylic acid and salicylic acid levels during aspirin provocation in aspirin‐sensitive subjects
Authors: B. Dahlén, L. O. Boréus, P. Anderson, R. Andersson, O. Zetterström
Journal: Allergy (1994)

The ability of aspirin and other nonsteroidal anti‐inflammatory drugs (NSAIDs) to inhibit the cyclo‐oxygenase which catalyzes formation of prostaglandins appears to be central to the mechanisms involved in aspirin sensitivity. We have investigated whether the plasma levels of acetylsalicylic acid (ASA) and its main metabolite salicylic acid (SA) at the time of intolerance reactions correspond with the concentrations required for enzyme inhibition in vitro. Twelve aspirin‐sensitive and 15 aspirin‐tolerant subjects were followed during provocation with aspirin. ASA and SA concentrations in plasma were determined by HPLC. After oral provocation (up to 460 mg cumulative dose), the levels of ASA and SA in plasma were equivalent in aspirin‐sensitive and aspirin‐tolerant subjects. For the aspirin‐sensitive subjects, at the time of adverse reaction, the concentration range was 2.9–33.3 μM for ASA and 18.1–245 μM for SA. Oral provocation with sodium salicylate yielding 10‐fold higher SA levels did not elicit intolerance reactions. Statistically significantly lower levels of ASA and SA (P&gt;0.01) evoked airway obstruction, as compared with merely extrapulmonary symptoms. Bronchial absorption of aspirin was found after inhalation of lysine‐aspirin and was comparable in asthmatic and nonasthmatic subjects. In three aspirin‐sensitive subjects who developed airway obstruction, the plasma levels for ASA and SA were 0.9–2.6 μM and 0.0–6.7 μM, respectively. In conclusion, the plasma levels of ASA reached at the time of a positive reaction are of the magnitude known to inhibit cyclo‐oxygenases. Neither differences in bioavailability of ASA nor the formation of SA seems to contribute to the aspirin‐elicited reactions.
Blood calcium levels in the presence of arteriographic contrast material.
Authors: J B Caulfield, L Zir, J W Harthorne
Journal: Circulation (1975)

One of the complications of coronary angiography is a sudden and persistant fall in blood pressure. This may be due to the presence of calcium chelating agents in the vehicle of the radio-opaque compounds. Depressed ambient calcium levels are associated with decreased myocardial contractility and when low enough cause electromechanical dissociation. Simultaneous measurements of radial artery and coronary sinus ionized calcium levels in nine patients during intracoronary injection of the contrast agent revealed a lowering of the level of ionized calcium in the coronary sinus to a point that can be expected to be associated with a decrease in myocardial contractility. This ionized calcium depression was more marked and prolonged in patients with arteriosclerosis, some reaching levels which, if persistent, could result in electromechanical dissociation.
Heart-Block in Renal Failure and Hypercalcemia
Authors: Kenneth V. Schwartz
Journal: JAMA (1976)

To the Editor.—  In a recent article (234:954, 1975), Drs Dreher and Shelp described first-degree heart-block occurring in a patient with chronic renal failure and mild hypercalcemia. They postulated that the heart-block was secondary to metastatic cardiac calcification, despite no objective evidence for this, and performed total parathyroidectomy.  It has been well documented, both experimentally 1 and clinically, 2,3 that hypercalcemia alone can be responsible for all degrees of heart-block. One might be reluctant to recommend a major surgical procedure in a relatively high-risk patient when medical therapy for hypercalcemia might reverse the electrocardiographic abnormality. At the very least, a medical trial to lower the serum calcium level with ECG correlation would be indicated.
Helicobacter pylori seroprevalence in patients with idiopathic pulmonary fibrosis
Authors: D. Bennett, E. Bargagli, R. M. Refini, M. S. Campagna, L. Gennari, R. Nuti, N. Figura, P. Rottoli
Journal: European Respiratory Journal (2013)

within Peru the MDR epidemic could worsen should fitter drug resistant Beijing strains evolve or enter the country and within the UK where the lineage profile is highly dynamic.
Anhydrous Formulation of Aluminum Chloride for Chronic Folliculitis
Authors: Walter B. Shelley
Journal: JAMA (1980)

An anhydrous ethyl alcohol solution of aluminum chloride in a 6.25% concentration has been demonstrated to be a highly effective local treatment of chronic folliculitis, especially of the buttocks. (<i>JAMA</i>244:1956-1957, 1980)
Any questions: Combination approach to pain relief
Authors: A S C Rice
Journal: BMJ (1997)

What analgesia could be used for a patient who is hypersensitive to opiates, which include morphine, pethidine, and oral codeine? The patient feels very unwell and develops low blood pressure. What analgesia should be used in the event of an accident or postoperatively? Is there a case for a challenge test when the patient is well? 

I will limit my response to the management of acute pain. As a consequence of an intercollegiate report (and other guidelines) most acute surgical hospitals now offer an acute pain service led by a consultant anaesthetist.1 2 The first action might be to contact the local pain service, which should be …
In vitro–targeted gene identification in patients with hepatitis C using a genome-wide microarray technology #
Authors: Susanne Hagist, Holger Sültmann, Gunda Millonig, Ulrike Hebling, Dörthe Kieslich, Rupert Kuner, Sabrina Balaguer, Helmut-Karl Seitz, Annemarie Poustka, Sebastian Mueller
Journal: Hepatology (2008)

Abstract Iron in association with reactive oxygen species (ROS) is highly toxic, aggravating oxidative stress reactions. Increased iron not only plays an important role in the progression of hereditary hemochromatosis (HH) but also in common liver diseases such as chronic hepatitis C. The underlying mechanisms of hepatitis C virus (HCV)-mediated iron accumulation, however, are poorly understood. We introduce an in vitro–targeted approach to identify ROS/iron-regulated genes in patients with HCV using a genome-wide DNA microarray. The sensitivity of the 32,231 complementary DNA clone-carrying microarray was approximately 20% as estimated by detecting target genes of the genome-wide transcription factor hypoxia inducible factor 1α. Upon in vitro challenge to iron and oxidative stress, 265 iron-related and 1326 ROS-related genes could be identified in HepG2 cells; 233 significantly regulated genes were found in patients with mild (HCV) or severe (HH) iron deposition. Notably, 17 of the in vitro–selected genes corresponded to the genes identified in patients with HCV or HH. Among them, natriuretic peptide precursor B (NPPB) was the only iron-regulated gene identified in vitro that was differentially regulated between HCV and HH. Reverse-transcription polymerase chain reaction confirmed most of the microarray-identified genes in an even larger group of patients (n = 12). In patients with HCV, these included genes that are associated with RNA processing (MED9/NFAT, NSUN2), proliferation, differentiation, hypoxia, or iron metabolism (ISG20, MIG6, HIG2, CA9, NDRG1), whereas none of the nine known iron-related genes showed significant differences between HCV and HH. Conclusion: Although high-density microarray technology is less suitable for routine liver diagnosis, its use in combination with prior in vitro selection is a powerful approach to identify candidate genes relevant for liver disease. (Hepatology 2009;49:378–386.)
Dreaming, fenfluramine, and vitamin C.
Authors: A Mullen, C W Wilson, B P Wilson
Journal: BMJ (1977)

The effect of increasing doses of fenfluramine on dream patterns was studied in 20 patients receiving a reducing diet with or without a controlled dietary intake of vitamin C daily. The dream pattern was unchanged in six patients and dreams disappeared in another who normally dreamed often. In 13 patients dreams increased in frequency and intensity, and in five the dreams assumed frightening proportions. There was a significant straight-line relation between response and the size of the dose. When placebo tablets were given to four patients their dreams disappeared or assumed their pretreatment normal pattern. Absence of vitamin C from the diet did not significantly affect the dream pattern. That fenfluramine has dose-related cerebral effects should be remembered in patients with a history of mental illness.
Interstitial Nephritis in Sjögren's Syndrome
Authors: W. H. TU
Journal: Annals of Internal Medicine (1968)

Renal histologic changes were studied by biopsy in eight patients with Sjögren's syndrome and at autopsy in one. Renal lesions consistent with interstitial nephritis were present in six of the patients, each of whom had proteinuria. On the basis of the reported findings and review of the literature, it is suggested that interstitial nephritis may be the principal renal lesion in Sjögren's syndrome.
P1-172: Correlation between morphology and epidermal growth factor receptor mutations in lung adenocarcinomas; significance of hobnail cell type and micropapillary pattern
Authors: Hironori Ninomiya, Miyako Hiramatsu, Kentaro Inamura, Yukitoshi Satoh, Sakae Okumura, Ken Nakagawa, Makoto Nishio, Takeshi Horai, Yuichi Ishikawa
Journal: Journal of Thoracic Oncology (2007)
"High" ear piercing and perichondritis of the pinna
Authors: S. E Kent
Journal: BMJ (2001)

EDITOR-HippisleyCox et al described sex inequalities in measurement of risk factors and treatment of ischaemic heart disease in primary care in the Trent region.1We collected similar data from a 50% sample of people with ischaemic heart disease (defined by disease codes) of 3575 years of age from 13 general practices in north Cambridgeshire and west Norfolk in 1999.We had 415 women and 790 men in our sample.We present our findings for comparison and provide a further analysis by use of statins.In our sample the difference (P=0.8) in the proportion of women (66%, n=273) and men (67%, n=532) with any record of total cholesterol concentration was not significant.The odds ratio for cholesterol measurement for men versus women adjusted for age, diabetes, hypertension, obesity, smoking status,
Bad medicine: medical nutrition
Authors: Des Spence
Journal: BMJ (2012)

Nutrition is a key priority in healthcare. The NHS currently spends £210 million on food supplements in the community alone, and has seen a 33% increase in cost over a three year period.1 Sip feeds (calorific drinks) and various puddings make up the greatest part of these costs. The burden of malnutrition in elderly people and dubious health economics are used to justify the high costs of these medicated foods2—but this money could be better spent.

Total calorie intake is the main issue when it comes to …
Permeability, zonulin production, and enteropathy in dermatitis herpetiformis
Authors: Edgardo Smecuol, Emilia Sugai, Sonia Niveloni, Horacio Vázquez, Silvia Pedreira, Roberto Mazure, María Laura Moreno, Marcelo Label, Eduardo Mauriño, Alessio Fasano, Jon Meddings, Julio César Bai
Journal: Clinical Gastroenterology and Hepatology (2005)
Circulating Biomarkers of Cell Death After Treatment with the BH-3 Mimetic ABT-737 in a Preclinical Model of Small-Cell Lung Cancer
Authors: Dimitra Micha, Jeff Cummings, Alex Shoemaker, Steven Elmore, Kelly Foster, Martin Greaves, Tim Ward, Saul Rosenberg, Caroline Dive, Kathryn Simpson
Journal: Clinical Cancer Research (2008)

Abstract Purpose: This study evaluated epithelial cell death ELISAs that measure circulating cytokeratin 18 in mice bearing small-cell lung cancer xenografts treated with a proapoptotic dose of the BH-3 mimetic ABT-737. Experimental Design: H146 tumor–bearing and non–H146 tumor-bearing severe combined immunodeficient (SCID)/bg mice were treated with ABT-737 or vehicle control. Plasma collected before and 2 to 360 hours after treatment was analyzed by M30 (caspase-cleaved cytokeratin 18) and M65 (intact and cleaved cytokeratin 18) ELISA. In parallel, tumors were interrogated for cleaved caspase-3 and cleaved cytokeratin 18 as biomarkers of apoptosis. Results: ABT-737–treated tumors regressed by 48 hours (P &amp;lt; 0.01) compared with controls, correlating with increased cleaved cytokeratin 18 (P &amp;lt; 0.01; 6 and 24 hours) and increased intact cytokeratin 18 (P &amp;lt; 0.01; 24 hours). Cleaved cytokeratin 18 levels decreased below baseline between 72 and 360 hours for ABT-737–treated and control mice whereas intact cytokeratin 18 decreased below the level of detection at 8 and 15 days in ABT-737–treated mice only. Apoptosis in tumors reflected changes in circulating cytokeratin 18 (cleaved caspase-3, P &amp;lt; 0.05 at 2 hours and P &amp;lt; 0.001 at 6, 12, and 24 hours; caspase-cleaved cytokeratin 18, P &amp;lt; 0.05 at 15 days, for drug treated versus controls). Conclusions: ABT-737 caused tumor regression by apoptosis in H146 xenografts that mapped to a drug-specific, early increase in circulating cleaved cytokeratin 18 that subsequently declined. Circulating, intact cytokeratin 18 levels correlated with tumor burden. Cleaved caspase-3 and caspase-cleaved cytokeratin 18 in tumor correlated with treatment (P &amp;lt; 0.05, 2 hours; P &amp;lt; 0.001, 6, 12, and 24 hours; cleaved caspase-3, P &amp;lt; 0.05, 15 days; caspase-cleaved cytokeratin 18), indicating that events in plasma were tumor derived. These circulating biomarker data will be translated to clinical trials wherein serial tumor biopsies are rarely obtained.
THE USE OF ELECTROSHOCK THERAPY IN TREATING PSYCHIATRIC PATIENTS WITH ASSOCIATED PULMONARY TUBERCULOSIS
Authors: HENRY P. CLOSE
Journal: American Journal of Psychiatry (1949)

1. Cases in the literature of patients developing pulmonary tuberculosis following electroshock therapy have not been adequately controlled by x-ray and clinical studies to an extent warranting definite conclusions. 2. Electroshock therapy was not found to be associated with the development of pulmonary tuberculosis in psychotic patients. 3. Case reports are presented of 8 psychotic patients with associated active pulmonary tuberculosis who were treated with electroshock in an effort to ameliorate the psychotic symptoms so that proper therapy could be directed to the tuberculous lesion. All cases showed improvement in their tuberculosis which can be indirectly attributed to the shock therapy.
The Use of Psychotherapy in General Practice
Authors: Leo Alexander
Journal: New England Journal of Medicine (1949)

PSYCHOTHERAPY is part of medical practice. As with any useful medical procedure it should not remain limited to the specialist's office. Like all medical procedures, psychotherapy contains elements of art as well as of science.In the practice of psychotherapy actions and attitudes are frequently more important than words. Emotionally sick adult people have a good deal in common with children, in particular the fact that their complaints and abnormal actions frequently express their feelings and problems in a symbolic rather than a direct manner, that they both frequently distrust words, that they learn more from example and the opportunity . . .
Causes of the haemolytic uraemic syndrome.
Authors: J. Kavi, R. Wise
Journal: BMJ (1989)

H ducreyi was isolated only rarely with conventional media and always from people with genital ulcers, which were usually acquired abroad.The Sheffield medium has been tested in the tropics, and its lack of sensitivity suggests that it is detecting organisms other than H ducreyi.20The Sheffield results thus seem to have been an artefact, and chancroid remains a very rare imported condition in Britain.As long as British facilities to treat genital ulcers remain free and easily accessible this state of affairs is likely to continue.
Upper Esophageal Ring
Authors: PAUL B. LESSER
Journal: Annals of Internal Medicine (1978)

Brief Reports1 May 1978Upper Esophageal RingPAUL B. LESSER, M.D., F.A.C.P., PATRICIA MOYER, M.D., PHILIP J. ANDREWS, M.D., JACK R. DREYFUSS, M.D.PAUL B. LESSER, M.D., F.A.C.P.Search for more papers by this author, PATRICIA MOYER, M.D.Search for more papers by this author, PHILIP J. ANDREWS, M.D.Search for more papers by this author, JACK R. DREYFUSS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-5-657_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwo patients had circumferential ringlike structures that represent probable causes for dysphagia.Patient 1: A 50-year-old Puerto Rican sugar-cane worker had quit work 2 years before admission because of the rather sudden onset of constant and painless upper dysphagia with an attendant 22.68-kg (50-lb) weight loss and weakness. Results of physical examination were unremarkable except for evidence of weight loss. Laboratory-test results were all normal including tests for collagen vascular disease.Upper gastrointestinal series initially showed impaired motility throughout the entire esophagus. A cine-esophagogram showed a ringlike structure in the upper esophagus with a 4-mm opening. Fiberoptic endoscopy showed an...References1. BROWN-KELLY A: Spasm at the entrance of the oesophagus. J Laryngol Otol 34:285-289, 1919 CrossrefGoogle Scholar2. PATERSON D: A clinical type of dysphagia. J Laryngol Rhin Otol 34:281-289, 1919 Google Scholar3. WALDMANNTURNBULL HA: Esophageal webs. Am J Roentgenol 78:567-573, 1957 Google Scholar4. KELLEYFRAZER MJ: Symptomatic mid-esophageal webs. JAMA 197:183-186, 1966 CrossrefGoogle Scholar5. SEAMAN W: The significance of webs in the hypopharynx and upper esophagus. Radiology 89:32-38, 1967 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cambridge Hospital Cambridge, Massachusetts Massachusetts General Hospital Harvard Medical School Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEsophageal Webs and RingsDysphagia resulting from an upper esophageal webDiaphragme muqueux isolé de l’œsophage cervical: étude de 3 cas Relation avec le syndrome de Kelly-Paterson et Plummer-VinsonUpper esophageal web due to a ring formed by a squamocolumnar junction with ectopic gastric mucosa (another explanation of the Paterson-Kelly, Plummer-Vinson syndrome) 1 May 1978Volume 88, Issue 5Page: 657-658KeywordsDysphagiaEndoscopyEsophagusHispanic peopleInterstitial lung diseasesWeight loss Issue Published: 1 May 1978 PDF DownloadLoading ...
A PILOT STUDY ON THE INTRODUCTION OF A LOW FODMAP DIET IN A SUBGROUP OF SYMPTOMATIC IBS PATIENTS REFERRED BY THE GASTROENTEROLOGY SERVICE IN AN IRISH TERTIARY REFERRAL CENTRE
Authors: C O'Meara, O F Craig, N Mahmud, S McKiernan, F Maccarthy
Journal: Gut (2013)

<h3>Introduction</h3> Patients with IBS frequently relate symptom exacerbation to food ingestion. However there is little evidence to support the role of food allergy in the pathogenesis of IBS. Dietary restriction of short-chain poorly absorbed carbohydrates (FODMAPs–Fermentable Oligo-, Di-, Mono-saccharides and Polyols) has recently been shown to reduce symptoms of IBS. Experience with the low FODMAP diet for the management of IBS in the Irish setting is limited. <h3>Aims/Background</h3> To determine the benefit of a low FODMAP diet in an Irish population of symptomatic IBS patients. <h3>Method</h3> 27 symptomatic IBS patients referred from the gastroenterology service for dietary intervention were sequentially recruited. Baseline IBS symptoms were evaluated using a modified validated IBS symptom score and detailed nutritional assessment was carried out. Patients were screened to determine if lactose intolerance was present. Instruction on avoidance of dietary FODMAPs and individually tailored nutritional advice was given. IBS symptoms were re-evaluated at 8 weeks and compliance with the diet assessed. Compliant, symptomatically improved patients were instructed regarding a food reintroduction programme. <h3>Results</h3> 14/27 patients have been re-evaluated to date. 13/14 had satisfactory relief of global IBS symptoms post FODMAP restriction versus 1/14 pre restriction. 10/12 patients reported an improvement in abdominal pain. 13/14 an improvement in bloating. 11/12 an improvement in flatulence. 10/13 an improvement in faecal urgency. <h3>Conclusion</h3> Introduction of a low FODMAP diet was feasible in the Irish outpatient setting and provided global relief of IBS symptoms in this cohort as well as improvements in abdominal pain, bloating, flatulence and faecal urgency.
Target cheap drinking as we did passive smoking, says chief medical officer
Authors: Z. Kmietowicz
Journal: BMJ (2009)

The chief medical officer for England has called for a minimum price of 50 pence (€0.54; $0.70) to be charged for a unit of alcohol to reduce excessive drinking and its associated harms.

Liam Donaldson said that antisocial drinking should be targeted in the same way as smoking in public places so that being drunk is no longer an aim or socially acceptable.

“England has a drink problem and the whole of society bears the burden,” said Professor Donaldson at the launch of his 2008 annual report. “The passive effects of heavy drinking on innocent parties are easily underestimated and frequently ignored. The concept of passive drinking and the devastating collateral effect that alcohol can have on others must be addressed on a national scale.”

He said that evidence shows that price and access are the two …
Patient: the True Story of a Rare Illness
Authors: L. E Thistlethwaite
Journal: BMJ (1996)

Ben Watt Viking, £12.50, pp 178 ISBN 0 670 87041 2

There is a growing trend to bare one's soul to the media, to discuss one's tragedies and, particularly, to recount a tale of overcoming major illness or disaster. While I find it difficult to watch these stories unfold on television, a well written account does help me to understand more about the human experience—knowledge that is useful for a general practitioner. The BMJ's Personal View offers moving accounts of this nature, but I have rarely read a piece as gripping, moving, and interesting as …