tbuckley/cabot-search huggingface dataset:
A NEW INSTRUMENT FOR TEACHING THE AUSCULTATORY BLOOD-PRESSURE TECHNIC
Authors: Francis Ashley Faught
Journal: JAMA (1913)

The accompanying illustration represents a new device to facilitate the teaching of blood-pressure readings by the auscultatory method. This method is now accepted as the most reliable and accurate clinical means of determining both the systolic and the diastolic readings, as by this method the results coincide with the figures obtained by the Erlanger graphic sphymomanometer.<sup>1</sup> The chief drawback to the method has been the seeming difficulty which the average physician has in learning to perceive and interpret the sounds heard over the artery. The idea suggested itself that if the phygmometroscope<sup>2</sup>was made into a multiple of four, whereby the sounds could be heard by more than one individual at the same time, it would overcome this difficulty and make it possible for any one familiar with the sounds heard during auscultatory blood-pressure observations to direct the attention of a small group of observers during the actual
Measurement of Pregnancy-Associated Plasma Proteins during Human Gestation
Authors: Tsue-Ming Lin, Seymour P. Halbert, William N. Spellacy
Journal: Journal of Clinical Investigation (1974)

Studies of four pregnancy-associated plasma proteins (PAPP's) were made on 206 plasma samples obtained from 175 pregnant women between 12 and 44 wk of gestation. The concentration of three PAPP's (A, C, and D) were assayed by quantitative crossed immunoelectrophoresis. They showed a gradual but small rate of increase during the 2nd trimester, which became more rapid in the 3rd trimester. PAPP-A continued to rise steadily during this period, while PAPP-C and PAPP-D (recently identified as human placental lactogen) tended to reach a plateau. Although PAPP-B could not be quantitated because of technical problems, it was detected in over 50% of the samples from the last 2 mo of gestation, but was almost never seen in those obtained during the 12th-28th wk of gestation. Various parameters were analyzed to determine their possible correlation with the PAPP levels during the last month of gestation. The race and age of the mother showed no influence on any of the PAPP's, while parity, sex of fetus, and infant birth weights appeared to affect the plasma concentration of some of the PAPP's. In the two instances studied, mothers of twins showed abnormally high PAPP levels.
TC-99M SESTAMIBI (MIBI) IN THE EVALUATION OF LYMPHOMA
Authors: A. Waxman, N. Nagaraj, S. Khan, L. Heifetz, P. McAndrews, M. Avedon
Journal: Clinical Nuclear Medicine (1994)

Waxman, A.; Nagaraj, N.; Khan, S.; Heifetz, L.; McAndrews, P.; Avedon, M. Author Information
Reasons to act and the mental representation of consequentialist aberrations
Authors: Jean-François Bonnefon
Journal: Behavioral and Brain Sciences (2007)

Abstract If imagination is guided by the same principles as rational thoughts, then we ought not to stop at the way people make inferences to get insights about the workings of imagination; we ought to consider as well the way they make rational choices. This broader approach accounts for the puzzling effect of reasons to act on the mutability of actions.
TEMPORAL STABILITY OF THE ESOPHAGEAL LOCATION BY COMPUTED TOMOGRAPHY IMAGING IN PATIENTS UNDERGOING REPEAT CATHETER ABLATION OF ATRIAL FIBRILLATION
Authors: Karuna Chilukuri, Brian S. Caffo, Charles A. Henrikson, Alan Cheng, Fawaz Alhumaid, Sunil Sinha, David Spragg, Ronald Berger, Joseph E. Marine, Hugh Calkins, Saman Nazarian
Journal: Journal of the American College of Cardiology (2011)
Fulminant Type 1 Diabetes in the Course of Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome
Authors: Danièle Dubois-Laforgue, Laurence Moachon, Hélène Laude, José Timsit
Journal: Diabetes Care (2013)

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome is a life-threatening drug reaction. Its management relies on discontinuation of the culprit drug and treatment with corticosteroids (1).

A 68-year-old Filipino woman was admitted for ketoacidosis (DKA), revealing diabetes. Four months before admission, she had been treated for bronchitis with erythromycin, then moxifloxacin. A transient skin rash occurred. Six days before admission, she was treated with amoxicillin/clavulanic acid for recurrence of bronchitis, and fever and a pruritic skin rash occurred. Four days later, the patient was admitted for drowsiness, tachypnea, and vomiting. She reported no abdominal pain, no weight loss (BMI 20.3 kg/m2), and no polyuria. Physical examination disclosed facial erythema, palpebral edema, conjunctivitis, generalized maculopapular skin rash, cheilitis, and diffuse lymph node …
The κ Statistic-Reply
Authors: Ronald L. Goldman
Journal: JAMA (1992)

<h3>In Reply.</h3> —Dr Berry appears to suggest that accuracy should be used in studies such as mine to evaluate the scientific usefulness of peer assessments. However, the calculation of accuracy or other measures of validity requires a "gold standard" against which these ratings can be measured. No such gold standard currently exists; instead, as discussed in my article, peer assessment is typically used as the standard against which the validity of other measures of quality is evaluated. Thus, the scientific value of peer ratings can only be studied by measuring agreement among reviewers. The absence of a gold standard is typical of studies in which observer variability is assessed through the use of κ. The only question usually facing investigators in these studies is what measure of agreement to use, not whether to measure agreement or accuracy. Berry also cites the often-noted<sup>1-5</sup>relationship between prevalence and κ values as
REPORT ON THE VALUE OF OBJECTIVE TESTS FOR THE DETERMINATION OF AMETROPIA, OPHTHALMOSCOPY, OPHTHALMOMETRY, SKIASCOPY.By the Special Committee of the Section on Ophthalmology of the American Medical Association.
Authors: Edward Jackson
Journal: JAMA (1894)

The members of your committee are all in accord with the view held by most ophthalmologists that the objective methods of determining ametropia can not entirely replace the subjective method with test letters and trial glasses; and that, in so far as the subjective method is applicable, it may be regarded as a court of last resort. Determinations of the refraction by the various objective methods, however, constitute an essential portion of the complete examination of any eye. They are essential parts of the whole, and no examination is complete without their use. The subjective method can no more fill the whole bill than can anyone of the objective methods alone. All should be used in every case to avoid errors common to each. Although it is obvious that if the various measurements of a definite quantity are accurate, by whatever means they are made, they will agree. The range
Farmyard pox:parapox virus infection in man
Authors: W.B. Shelley, E.Dorinda Shelley
Journal: British Journal of Dermatology (1983)

Inasmuch as orf, milker's nodules and bovine papular stomatitis pox are clinically identical in man and are induced by currently indistinguishable parapox viruses, we propose a new generic term 'farmyard pox' for these diseases. This affords the clinician a diagnosis based on a common set of clinical and electron microscopic findings rather than one based on an uncertain or even misleading history. A case in point is reported in which the history failed to reveal a specific animal source of the virus, but electron microscopy confirmed the presence of parapox infection.
Lichen planus pemphigoides: its relationship to bullous pemphigoid
Authors: ANNE L. DAVIS, B.S. BHOCAL, P. WHITEHEAD, PEGGY FRITH, MICHELE E. MURDOCH, IRENE M. LEIGH, EENELLA WOJNAROWSKA
Journal: British Journal of Dermatology (1991)

Summary Clinical and immunopathological studies of three patients with lichen planus pemphigoides (LPP) were carried out to investigate the relationship between LPP and bullous pemphigoid (BP) and to determine whether the antigen in LPP is the classical BP antigen. LPP is usually considered to be the coexistence of lichen planus with BP. The bullae in LPP were subepidermal and indistinguishable from BP. Indirect immunofluorescence demonstrated antibody binding to the epidermal surface of 1 M NaCI-spIit skin and mucosae. as in BP. The tissue distribution of the LPP antigen mirrored the distribution of BP in stratified squamous epithelia but was absent from transitional epithelia (pig bladder). Immunoelectron microscopy, both direct (two cases) and indirect (one case), showed binding to the lamina lucida as with BP antigen. Western blotting of epidermal extracts using the patients sera showed that instead of reacting with the classical bullous pemphigoid antigen (220 kDa in our series), the antisera reacted with a unique band of 200 kDa in addition to the band of 1 80 kDa found as a minor antigen in bullous pemphigoid. but more commonly in pemphigoid gestationis. The relationship between these antigens awaits molecular characterization. These findings suggest that the target antigen in LPP may be unique.
Opening the black box: an encounter in the corridors of health services research.
Authors: C Pope, N Mays
Journal: BMJ (1993)

Health services research has become more prominent as a result of the NHS reforms. Both providers and purchasers want to know exactly where the money is spent and how it could be used more effectively. How best to obtain information about health services is the subject of some debate within and between disciplines engaged in such research. Because of their training doctors are often sceptical of anything other than formal clinical trials and research which produces statistical data. Some sociologists argue that another way to find out what is actually happening in the NHS is to observe people at work and talk to them. This article debates these differing views of research methods. For effective research both quantitative and qualitative approaches need to be used.
Surgical treatment of acyanotic double-outlet right ventricle
Authors: M. I. Ionescu, O. Scott, G. H. Wooler
Journal: Thorax (1967)

Two cases of double-outlet right ventricle in which surgical correction was successful are described. The diagnosis of this lesion should always be suspected in apparently large ventricular septal defects with pulmonary hypertension at systemic level, and further investigation by double catheterization or by angiography should be carried out. The catheterization data do not give accurate measurements of the pulmonary and systemic flows and resistances and are of no help in forecasting the results of surgical treatment.
Case 26-2005: Loss of Consciousness while Jogging
Authors: J. Gert van Dijk, David G. Benditt, Michele Brignole
Journal: New England Journal of Medicine (2006)

To the Editor: We fear that the discussion of “syncope” in the Case Records, as in Binder et al. (Aug. 25 issue),1 may confuse readers. Seizures, hypoglycemia, and psychiatric conditions are consid...
Severe Zinc Deficiency in Humans: Association with a Reversible T-Lymphocyte Dysfunction
Authors: John I. Allen, Neil E. Kay, Craig J. McCLAIN
Journal: Annals of Internal Medicine (1981)

Two patients developed severe zinc deficiency with acrodermatitis during parenteral hyperalimentation. The response of circulating T-lymphocytes to phytohemagglutinin was assessed both during the episode of clinical zinc deficiency and after intravenous zinc supplementation as the sole means of nutritional intervention. Maximum T-cell response to phytohemagglutinin, expressed as percent of simultaneous normal control response, was 2.1% and 27.9% in Patients 1 and 2 respectively. After 20 days of intravenous zinc supplementation (12 mg/d), repeat studies showed the T-cell response of Patient 1 to be 221% of the control, and that of Patient 2 to be 139% of control. In addition, Patient 1 was anergic during the period of zinc deficiency and normally reactive after zinc supplementation. These findings agree with extensive animal studies showing the detrimental effect of zinc deficiency on cellular immunity.
Diabetes, driving, and the general practitioner.
Authors: B M Fisher, A M Storer, B M Frier
Journal: BMJ (1985)

The medical fitness of drivers who have diabetes is assessed primarily by general practitioners. A survey was made of the knowledge of driving and diabetes of 105 general practitioners in Glasgow. Ninety four (90%) knew that people who were insulin dependent were required by law to declare their condition to the Driver and Vehicle Licensing Centre in Swansea, but most were unaware that people with diabetes should not hold a "till 70" driving licence. Seventy one doctors (69%) claimed that patients were recalled individually for fitness to drive. The minimum visual acuity for driving was stated correctly by 37 (35%). Only eight respondents knew that a hypoglycaemic diabetic driver can be charged with driving under the influence of a drug (Road Traffic Act 1972), and the practical advice that was given to patients about hypoglycaemia and driving was unsatisfactory. As a group the general practitioners showed deficiencies in knowledge regarding diabetes and driving, suggesting a need for further postgraduate education.
Package inserts for prescribed medicines: what minimum information do patients need?
Authors: F Hermann, A Herxheimer, N D Lionel
Journal: BMJ (1978)

The information a patient needs about a prescribed medicine can be determined by considering what responsibilities he can assume in relation to taking medicine. When the medicine has been dispensed the patient needs to know how to take the drug; how to store the drug; how it is expected to help; and how to recognise problems and what to do about them. A guide was designed to specify what information is required to meet these needs. Using this guide, a set of minimum information on tetracycline was prepared that aimed at being brief, specific, and readable. The best format for the information remains to be determined. Since leaflets produced by professional organisations are generally unsuitable for these purposes, information sets should be put together by small independent groups consisting of clinical pharmacologists, clinicians, pharmacists, and consumers. Each country should produce its own sets, adapting model sets to the circumstances of local practice.
Periostin-binding DNA Aptamer Inhibits Breast Cancer Growth and Metastasis
Authors: Yu Jin Lee, Il Shin Kim, Soo-Ah Park, Youndong Kim, Jeung Eun Lee, Dong-Young Noh, Kyong-Tai Kim, Sung Ho Ryu, Pann-Ghill Suh
Journal: Molecular Therapy (2013)

Periostin is an extracellular matrix (ECM) protein that is overexpressed in a variety of human cancers, and its functions appear to be linked to tumor growth, metastasis, and angiogenesis. Recent clinical evidence suggests that aberrant periostin expression is correlated with poor outcome in patients with breast cancer. To identify novel tools to regulate the functional role of periostin, we generated benzyl-d(U)TP-modified DNA aptamers that were directed against human periostin (PNDAs) and characterized their functional roles in breast cancer progression. PNDA-3 selectively bound to the FAS-1 domain of periostin with nanomolar affinity and disrupted the interaction between periostin and its cell surface receptors, αvβ3 and αvβ5 integrins. PNDA-3 markedly antagonized the periostin-induced adhesion, migration, and invasion of breast cancer cells and blocked the activation of various components of the αvβ3 and αvβ5 integrin signal transduction pathways. In a 4T1 orthotopic mouse model, PNDA-3 administration significantly reduced primary tumor growth and distant metastasis. Thus, our results demonstrated that periostin-integrin signaling regulates breast cancer progression at multiple levels in tumor cells and the tumor microenvironment. DNA aptamers targeting periostin may potentially be used to inhibit breast cancer progression. Periostin is an extracellular matrix (ECM) protein that is overexpressed in a variety of human cancers, and its functions appear to be linked to tumor growth, metastasis, and angiogenesis. Recent clinical evidence suggests that aberrant periostin expression is correlated with poor outcome in patients with breast cancer. To identify novel tools to regulate the functional role of periostin, we generated benzyl-d(U)TP-modified DNA aptamers that were directed against human periostin (PNDAs) and characterized their functional roles in breast cancer progression. PNDA-3 selectively bound to the FAS-1 domain of periostin with nanomolar affinity and disrupted the interaction between periostin and its cell surface receptors, αvβ3 and αvβ5 integrins. PNDA-3 markedly antagonized the periostin-induced adhesion, migration, and invasion of breast cancer cells and blocked the activation of various components of the αvβ3 and αvβ5 integrin signal transduction pathways. In a 4T1 orthotopic mouse model, PNDA-3 administration significantly reduced primary tumor growth and distant metastasis. Thus, our results demonstrated that periostin-integrin signaling regulates breast cancer progression at multiple levels in tumor cells and the tumor microenvironment. DNA aptamers targeting periostin may potentially be used to inhibit breast cancer progression.
Variations in histamine concentration in nasal secretion in patients with allergic rhinitis
Authors: A. Linder, K. Strandberg, H. Deuschl
Journal: Allergy (1988)

The histamine concentration and content in nasal secretion and the volume of nasal secretion in nasal washing samples were measured under different conditions in 28 patients with allergic rhinitis sensitive to birch pollen. The mean histamine concentration was significantly lower after intranasal birch pollen challenge (2.08 μg/ml) than in prechallenge samples (6.96 μg/ml), and was also significantly lower in untreated patients during the birch pollen season (2.30 μg/ml) than off‐season (7.18 μg/ml). The same relationship was found between the histamine content of the secretion samples obtained on these occasions. The mean secretion volume was greater after than before challenge, but not significantly higher during the season than off‐season. A partial reversion of the changes in histamine concentration and content that occurred during the season was observed during intranasal corticosteroid therapy. The concentration and content of histamine in nasal secretion from symptomatic patients after intranasal histamine challenge did not differ significantly from those in asymptomatic subjects before challenge. It was concluded that although the histamine level in nasal secretion can be used as a marker of changes in the severity of allergic rhinitis, it is not ideal for this purpose.
Schizophrenic patients requiring intensive care.
Authors: J B Salmon, R F Armstrong, S L Cohen, J P Cobb
Journal: BMJ (1993)

inheritance and characteristically manifests itself in the form of dissecting aortic aneurysm and aortic and arterial dilatation at a young age.3There are no obvious associated physical features, and the basic defect underlying this condition is unknown.As with the Marfan syndrome, surgical intervention has the potential to prolong life expectancy.I suggest that, in the light of two deaths from aortic dissection in separate generations of one family, the diagnoses of Erdheim's cystic medial necrosis and the Marfan syndrome should be considered in first degree relatives.
Registrar found guilty of serious professional misconduct for anonymous criticism
Authors: C. Dyer
Journal: BMJ (1997)

A registrar in the UK who wrote an anonymous letter criticising a consultant surgeon about an operation in which a patient died was recently found guilty of serious professional misconduct by the General Medical Council.

Abdul Aziz Al-Khulaifi was admonished-the least severe form of sanction available to the GMC-“in the special circumstances of the case.”

Mr …
Health experts give qualified approval to previous government's health reforms
Authors: N. Hawkes
Journal: BMJ (2011)

Market reforms of the NHS in England under New Labour had small but positive effects without causing the damage that critics feared, a new book published by the health policy think tank the King’s Fund concludes.

Although it remains difficult to separate out the effects of market policies such as patient choice, Payment by Results, foundation trusts, and diversity of providers from the “targets and terror” that coexisted with them, the authors of the study, Understanding New Labour’s Market Reforms of the English NHS , present a largely positive judgment.

Julian Le Grand, who as an adviser to Tony Blair at Number 10 Downing Street inspired many of the changes, says in a foreword that he could not know the reforms would work but that he believed they would. 

“There were plenty of people prepared to predict disaster,” he writes. Old ways of working “acquired the glow of a lost golden age” when there was no waste and no …
Does plasma protein depletion increase lung liquid conductance?
Authors: R L Conhaim, A M McGrath, B A Harms
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Lung liquid conductance (Kf) is calculated as the quotient of lung lymph flow divided by net filtration pressure (Pnf), where Pnf is the balance of osmotic and hydrostatic pressures in the lung microcirculation. In protein depletion, lymph flow rises with little change in Pnf, suggesting that calculated Kf also rises. However, several previous reports have concluded that protein depletion causes little change in Kf, leaving open the question of how lung lymph flow can rise in protein depletion with little change in Pnf. To address this, we measured Kf in sheep following two kinds of protein depletion: batch plasmapheresis (BP; n = 5) and thoracic duct drainage (TD; n = 5). Both methods lowered plasma protein concentrations by 30%, and raised lung lymph flows by 55%. Lung microvascular hydrostatic pressures and plasma-to-lymph osmotic pressure gradients both changed by 1 to 2 mm Hg. With BP, calculated Kf rose from 0.26 +/- 0.09 at baseline to 0.50 +/- 0.20 on Day 1, and to 0.39 +/- 0.27 ml/mm Hg/30 min on Day 2 (p < or = 0.05). With TD, calculated Kf rose from 0.28 +/- 0.13 at baseline to 0.43 +/- 0.19 on Day 1, and to 0.43 +/- 0.19 ml/mm Hg/30 min on Day 2 (p < or = 0.05). Calculated Kf rose because filtration increased even though the hydrostatic and osmotic driving forces responsible for filtration changed little. This is puzzling because it suggests that lymph flow rose with little or no change in the forces affecting filtration. Our findings contradict several previous reports that concluded that protein depletion produces little or no change in calculated Kf.