tbuckley/cabot-search huggingface dataset:
Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities
Authors: Ida Martinelli, Tullia Battaglioli, Paolo Bucciarelli, Serena Maria Passamonti, Pier Mannuccio Mannucci
Journal: Circulation (2004)

Background— One third of cases of upper-extremity deep vein thrombosis (DVT) are primary, ie, they occur in the absence of central venous catheters or cancer. Risk factors for primary upper-extremity DVT are not well established, and the recurrence rate is unknown. Methods and Results— We studied 115 primary upper-extremity DVT patients and 797 healthy controls for the presence of thrombophilia due to factor V Leiden, prothrombin G20210A, antithrombin, protein C, protein S deficiency, and hyperhomocysteinemia. Transient risk factors for venous thromboembolism were recorded. Recurrent upper-extremity DVT was evaluated prospectively over a median of 5.1 years of follow-up. The adjusted odds ratio for upper-extremity DVT was 6.2 (95% CI 2.5 to 15.7) for factor V Leiden, 5.0 (95% CI 2.0 to 12.2) for prothrombin G20210A, and 4.9 (95% CI 1.1 to 22.0) for the anticoagulant protein deficiencies. Hyperhomocysteinemia and oral contraceptives were not associated with upper-extremity DVT. However, in women with factor V Leiden or prothrombin G20210A who were taking oral contraceptives, the odds ratio for upper-extremity DVT was increased up to 13.6 (95% CI 2.7 to 67.3). The recurrence rate was 4.4% patient-years in patients with thrombophilia and 1.6% patient-years in those without thrombophilia. The hazard ratio for recurrent upper-extremity DVT in patients with thrombophilia compared with those without was 2.7 (95% CI 0.7 to 9.8). Conclusions— Inherited thrombophilia is associated with an increased risk of upper-extremity DVT. Oral contraceptives increase the risk only when combined with inherited thrombophilia. The recurrence rate of primary upper-extremity DVT is low but tends to be higher in patients with thrombophilia than in those without.
Oestrogen treatment in carcinoma of the prostate.
Authors: R J Shearer, W F Hendry, J D Ferguson
Journal: BMJ (1973)

influenzae resistant to trimethoprim is in- creasing rapidly.The suggestion was based on their finding that many strains showed long trailing end-points in sensitivity tests by both the disc and the serial dilution methods.The effects were first observed in the disc method and the authors then assumed that they were due to the use of a medium which contained substances that partially reversed the action of trimethoprim and the sulphon- amides.However, they rejected this explana-
Acquired cystic disease of the kidney: an indication for renal transplantation?
Authors: B J Thompson, D A Jenkins, P L Allan, R J Winney, J C Dick, S R Wild, J L Anderton, G D Chisholm
Journal: BMJ (1986)

Arthritis and HLA-B27 in Papua New Guinea Visitors to the hospitals of Papua New Guinea are often surprised by the many beds occupied by young men with an asymmetrical arthritis, predominantly affecting the legs.Scrutiny of their notes often elicits the enigmatic term "tropical arthritis."Such patients have been the subject of several studies.Maddocks came down firmly in favour of Reiter's disease as the diagnosis in most of these cases.'A later study from Goroka Base Hospital founTd no extra-articular manifestations of Reiter's disease and concluded that the disease was a distinctive type of arthritis of unknown aetiology.2Subsequently Brewerton et al described a close link between HLA-B27 and Reiter's disease.3HLA studies in patients with arthritis in Papua New Guinea have not previously been published. Patients, methods, and resultsWe studied 64 patients with arthritis, who presented to the physician (JER) at Goroka Base Hospital between October 1984 and March 1985.During this period only four other patients with arthritis were seen (two with gout, one with osteoarthritis, and one with rheumatic fever).All patients were examined by JER.Sixty two were of highland origin and two were from the coast.Histocompatibility testing was done by the procedure outlined by Bhatia et al.4The frequency of HLA antigens in the patients was compared with that in 128 Papua New Guinean blood donors matched for age, sex, and province of origin (two controls per patient).HLA-B27 was found in 45 (70%) of the 64 patients and in 16 (13%) of the 128 controls.It was present in all 10 patients with the classic triad of symptoms of Reiter's disease and in 13 (87%) of the 15 patients with less complete forms of Reiter's disease (table).Information about sexual exposure before arthritis was not readily obtained.Shigella flexneri serotype I had been isolated from one patient during an earlier admission for dysentery.Keratoderma blennorrhagicum and other mucocutaneous lesions (except balanitis) were not seen.HLA-B27 was noted in 22 (56%) of the 39 patients with symptoms confined to joints. CommentNo other report has documented the acquisition of antibodies in relation to clinical symptoms in similar detail.Antibody against p24 and p55
Benefits of Reducing Prenatal Exposure to Coal-Burning Pollutants to Children’s Neurodevelopment in China
Authors: Frederica Perera, Tin-yu Li, Zhi-jun Zhou, Tao Yuan, Yu-hui Chen, Lirong Qu, Virginia A. Rauh, Yiguan Zhang, Deliang Tang
Journal: Environmental Health Perspectives (2008)

Coal burning provides 70% of the energy for China's industry and power, but releases large quantities of polycyclic aromatic hydrocarbons (PAHs) and other pollutants. PAHs are reproductive and developmental toxicants, mutagens, and carcinogens.We evaluated the benefit to neurobehavioral development from the closure of a coal-fired power plant that was the major local source of ambient PAHs.The research was conducted in Tongliang, Chongqing, China, where a coal-fired power plant operated seasonally before it was shut down in May 2004. Two identical prospective cohort studies enrolled nonsmoking women and their newborns in 2002 (before shutdown) and 2005 (after shutdown). Prenatal PAH exposure was measured by PAH-DNA adducts (benzo[a]pyrene-DNA) in umbilical cord blood. Child development was assessed by the Gesell Developmental Schedules at 2 years of age. Prenatal exposure to other neurotoxicants and potential confounders (including lead, mercury, and environmental tobacco smoke) was measured. We compared the cohorts regarding the association between PAH-DNA adduct levels and neurodevelopmental outcomes.Significant associations previously seen in 2002 between elevated adducts and decreased motor area developmental quotient (DQ) (p = 0.043) and average DQ (p = 0.047) were not observed in the 2005 cohort (p = 0.546 and p = 0.146). However, the direction of the relationship did not change.The findings indicate that neurobehavioral development in Tongliang children benefited by elimination of PAH exposure from the coal-burning plant, consistent with the significant reduction in PAH-DNA adducts in cord blood of children in the 2005 cohort. The results have implications for children's environmental health in China and elsewhere.
Time to Read
Authors: THOMAS J. MOORE
Journal: Annals of Internal Medicine (1975)

Comments1 January 1975Time to ReadTHOMAS J. MOORE, M.D.THOMAS J. MOORE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-1-125_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In his letter concerning the value of reading medical abstracts and editorials (Ann Intern Med 81: 417, 1974), Dr. Oster claims that an investment of 5 hours each month would enable an average reader to attain "a superficial acquaintance" with the current medical literature. Actually the time required would be much longer.Dr. Oster did not allow time for reading either classified ads or letters to the editor, both of which are obviously required for a true "superficial acquaintance." In addition, he did not compute the time required for turning all those pages. This alone can add... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Peter Bent Brigham Hospital Boston, Massachusetts 02115 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1975Volume 82, Issue 1Page: 125-125 Issue Published: 1 January 1975 PDF DownloadLoading ...
Book: Betrayal of Trust: The Collapse of Global Public Health
Authors: A. Attaran
Journal: BMJ (2001)

Laurie Garrett Hyperion Books, $16.95, pp 768 ISBN 0 7868 8440 1 Oxford University Press, £24.95, pp 540 ISBN 0 19 8509952 (UK edition available October 2001) Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Reading most public health books is merely sad; reading Laurie Garrett's Betrayal of Trust, however, is absolutely terrifying. This book is divided into five chapters, any one of which is the stuff of nightmares. All concern “the collapse of global public health,” as the subtitle reads. Garrett's tone is journalistic, even pugilistic, as she relates in each chapter another instance of public health systems gone to pot. Her … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Cardiac tamponade and Kussmaul's sign.
Authors: D H Spodick
Journal: Circulation (1981)

SignTo the Editor:The caveat about streptokinase for vein graft thrombosis by Holmes and colleagues (Circulation 63: 729, 1981) comes at an ap- propriate time.Amid the many enthusiastic reports of this procedure, cautionary comments by the outstanding Mayo group remind us that sooner or later every new cure finds complications and side effects.Curiously, the authors suspected cardiac tam- ponade because they detected Kussmaul's sign.This is surprising; that sign does not occur in cardiac tamponade unless there is un- derlying visceral pericardial constriction.Unfortunately, many physicians of considerable sophistication are not aware of this and references to this sign by distinguished physicians tend to perpetuate the error.
Complications of Diagnostic Gastrointestinal Endoscopy
Authors: R. Hart, M. Classen
Journal: Endoscopy (1990)

See also: Pneumoperitoneum Following Colonoscopy in a Patient with a Solitary Rectal UlcerEndoscopy 1991; 23(04): 242-243DOI: 10.1055/s-2007-1010672 See also: Hemoperitoneum due to Necrosis of a Small Intestinal Leiomyosarcoma Following ColonoscopyEndoscopy 1993; 25(03): 253-254DOI: 10.1055/s-2007-1010306 See also: Subserosal Hematoma of the Duodenum as a Complication of Diagnostic EsophagogastroduodenoscopyEndoscopy 1993; 25(03): 253-253DOI: 10.1055/s-2007-1010305 See also: Complications of Diagnostic Gastrointestinal EndoscopyEndoscopy 1991; 23(04): 245-246DOI: 10.1055/s-2007-1010676
Reticulocytopenia and "absence" of red cell autoantibodies in immune haemolytic anaemia.
Authors: U M Hegde, E C Gordon-Smith, S M Worlledge
Journal: BMJ (1977)

A raised reticulocyte count is common in patients with immune or autoimmune haemolytic anaemia, and the result of the direct antiglobulin test (DAGT) is usually positive because of IgG or IgG and complement components on the red cells. We report on three patients who had low reticulocyte counts when they were most anaemic, and in whom no red cell autoantibodies could be detected by the DAGT. We postulate that reticulocytes may be selectively destroyed if antibodies are directed against antigenic sites on these young red cells, thus giving rise to a population of cells whose antigenic sites are poorly expressed. This theory might explain the low reticulocyte counts and the "absence" of antibodies (as tested by the DAGT) in such patients. Radioisotopic studies with 51Cr and 59Fe may provide useful information on the rate and sites of red cell destruction.
Effect of Digitalis on Atrioventricular Conduction and Circus-Movement Tachycardias in Patients with Wolff-Parkinson-White Syndrome
Authors: HEIN J. WELLENS, DIRK DURRER
Journal: Circulation (1973)

During regular driving of the right atrium using the single-test stimulus method, atrioventricular conduction and initiation of tachycardias were studied in six patients with the Wolff-Parkinson-White syndrome (W-P-W), before and 45 min after the administration of ouabain (0.75-1.5 mg into the right atrium). Following ouabain (1) all patients showed shortening of the refractory period of their anomalous pathway; (2) at least five of them showed lengthening of the refractory period of the A-V nodal-His pathway; and (3) all patients showed prolongation of the A-V nodal transmission time (prolongation of the A-H interval). In four patients who suffered from circus-movement tachycardias these changes resulted in two patients in marked shortening of the range of premature beat intervals during which a tachycardia could be initiated and complete inability to initiate a tachycardia in the other two. These results suggest that digitalis can be of prophylactive value in patients with the Wolff-Parkinson-White syndrome and circus-movement tachycardias.
The WHO dengue classification and case definitions: time for a reassessment
Authors: Jacqueline L Deen, Eva Harris, Bridget Wills, Angel Balmaseda, Samantha Nadia Hammond, Crisanta Rocha, Nguyen Minh Dung, Nguyen Thanh Hung, Tran Tinh Hien, Jeremy J Farrar
Journal: The Lancet (2006)
Salons face 20 000 fine for allowing under 18s to use sunbeds
Authors: C. Dyer
Journal: BMJ (2010)

A law banning people aged under 18 years from using sunbeds in England and Wales narrowly scraped through all its parliamentary stages just before parliament was dissolved for the 6 May UK general election.

The Sunbeds (Regulation) Act, which started as a private member’s bill introduced by the Welsh MP Julie Morgan, survived the parliamentary “wash up” in which bills are rushed through before the axe falls.

The legislation was backed by a wide …
Violent Injuries among Women in an Urban Area
Authors: Jeane Ann Grisso, Donald F. Schwarz, Nancy Hirschinger, Mary Sammel, Colleen Brensinger, Jill Santanna, Robert A. Lowe, Elijah Anderson, Leslie M. Shaw, Courtney A. Bethel, Leslie Teeple
Journal: New England Journal of Medicine (1999)

Although the rate of death from injuries due to violent acts is much higher among black women than among white women in the United States, little is known about the nature and correlates of violent injuries among black women living in urban areas.
Acid Sphingomyelinase Overexpression Enhances the Antineoplastic Effects of Irradiation In Vitro and In Vivo
Authors: Eric L Smith, Edward H Schuchman
Journal: Molecular Therapy (2008)

Exposure of cells or animals to stress frequently induces acid sphingomyelinase (ASM)-mediated ceramide production that leads to cell death. Consistent with this, overexpression of ASM in subcutaneous B16-F10 mouse melanomas, in combination with irradiation, resulted in tumors that were up to 12-fold smaller than irradiated control melanomas. Similarly, when irradiated melanomas were pretreated with a single, peritumoral injection of recombinant ASM (rhASM), the tumors were up to threefold smaller. The in vivo effect of ASM was likely due to enhanced cell death of the tumor cells themselves, as well as the surrounding microvascular endothelial cells. In vitro, rhASM had little or no effect on the growth of tumor cells, even in combination with irradiation. However, when the culture media was acidified to mimic the acidic microenvironment of solid tumors, rhASM-mediated cell death was markedly enhanced when combined with irradiation. Microscopic analysis suggested that this was associated with an increase in autophagy. rhASM has been produced for the treatment of the lysosomal storage disorder, type B Niemann-Pick disease, and is currently being evaluated in a phase-1 clinical trial. Based on the data presented in this article, we propose that further investigation of this protein and gene as antineoplastic agents also is warranted.
Endoscopic Ultrasonography in the Diagnosis and Staging of Pancreatic Adenocarcinoma
Authors: L. Palazzo, G. Roseau, B. Gayet, V. Vilgrain, J. Belghiti, F. Fékété, J.-A. Paolaggi
Journal: Endoscopy (1993)

Endoscopic ultrasonography (EUS) was compared to ultrasonography (US) and CT scan (CT) in order to evaluate its role in the diagnosis and the locoregional spread assessment of pancreatic cancer. Sixty-four patients suspected of pancreatic cancer were studied prospectively, and the results of imaging techniques were compared to histology and surgical exploration. There were 49 cases of pancreatic adenocarcinoma, 11 of pancreatitis, 2 of common bile duct carcinoma, 1 lymphoma and 1 hepatocellular carcinoma with peripancreatic metastatic lymph nodes. EUS was significantly more accurate (91 %) than CT (66 %) and US (64 %) for diagnosis of pancreatic cancer. EUS was able to image all 7 cancers less than 25 mm in diameter, US and CT only one. There were 4 false positives with EUS which were all cases of pseudotumorous pancreatitis. For detecting lymph node involvement, EUS was significantly more sensitive (62 %) and accurate (74 %) than US (8 % and 37 %) and CT (19 % and 42 %), respectively. Invaded lymph nodes adjacent to large tumors and micrometastatic involvement were responsible for this lack of sensitivity. EUS was significantly more sensitive (100 %) than CT (71 %) and US (17 %) for detecting venous involvement. The specificity of EUS was lower (67 %) because of duodenal bulb stenosis and large tumors. In conclusion, this prospective and comparative study confirms that EUS is an accurate tool for diagnosis and locoregional spread assessment of pancreatic cancer when performed in a reference center. EUS is of particular interest for small tumors. However, EUS does not enable differentiation of pseudotumorous pancreatitis from adenocarcinoma.
Erythrocyte membrane changes of chorea-acanthocytosis are the result of altered Lyn kinase activity
Authors: Lucia De Franceschi, Carlo Tomelleri, Alessandro Matte, Anna Maria Brunati, Petra H. Bovee-Geurts, Mariarita Bertoldi, Edwin Lasonder, Elena Tibaldi, Adrian Danek, Ruth H. Walker, Hans H. Jung, Benedikt Bader, Angela Siciliano, Emanuela Ferru, Narla Mohandas, Giel J. C. G. M. Bosman
Journal: Blood (2011)
Metal Stents for Benign and Malignant Bile Duct Strictures Stents for Benign and Malignant Bile Duct Strictues
Authors: T. Rösch
Journal: Endoscopy (1998)

Self-expanding metal stents provide a much larger diameter--up to 30 Fr--in comparison with plastic stents, which have a maximum diameter of 12 Fr. Although they have consequently been found to be far superior to plastic prostheses, they are not removable, and in benign strictures metal stents should therefore be used only in exceptional situations. Metal stents are the preferred mode of treatment for malignant strictures, provided the patient has a sufficient life expectancy although this is hard to predict in individual cases. Metal stents also seem to be superior in hilar malignancy, but the data here are limited. Future developments may include the use of covered metal stents and self-expanding stents (made of plastic or other materials) that are removable or self-dissolving.
P459The effect of arginine on postocclusive reactive hyperaemia
Authors: Z Melik, K Cankar
Journal: Cardiovascular Research (2014)

Purpose: Postocclusive reactive hyperaemia (PORH) is one of the provocation tests for registering differences in vasodilation capabilities in healthy and diseased subjects. One of the hypotheses of essential hypertension is that endothelial dysfunction due to reduced availability of nitric oxide plays a key role in initiation, development and progression of the disease. The aim of our study was to determine whether the ingestion of L-arginine improves PORH in subjects with a family history of hypertension. Methods: 53 healthy male volunteers, from 20 to 56 years old, were divided into four groups according to the family history of hypertension and age (YN - young without a family history of hypertension, YH - young with a family history of hypertension, ON - older without and OH - older with a family history of hypertension). We measured ECG, heart rate, systolic and diastolic blood pressure, cardiac output, stroke volume, total peripheral resistance (Task Force Monitor) and laser Doppler (LD) flux in the cutaneous microvessels in the fingertip at rest and after eight minutes lasting occlusion of digital arteries. Measurements were repeated after administration of 0.9 g L-arginine. Values were expressed as mean ± SEM. The study was approved by the National Medical Ethics Committee; written informed consent was obtained from each subject. Results: After the ingestion of L-arginine the heart rate (YN 67.7 ± 4.3 vs. 62.7 ± 3.3; YH 63.2 ± 2.2 vs. 60.3 ± 2.0; ON 64.7 ± 3.3 vs. 57.7 ± 2.6 OH 62. 5 ± 2.9 vs. 58.1 ± 2.2 beats/min) and the cardiac output (YN 7.07 ± 0.5 vs. 6.53 ± 0.4; YH 7.19 ± 0.3 vs. 6.38 ± 0.2; ON 7.7 ± 0.5 vs. 6.7 ± 0.4; OH 6.4 ± 0.5 vs. 5.9 ± 0.4 L/min) statistically significantly decreased in all groups (paired t-test, p<0.05), while SBP and DBP and LD flux did not change. In contrast, stroke volume decreased (116.0 ± 6.5 vs. 108.2 ± 5.9 mL) and total peripheral resistance increased (868.9 ± 96 vs. 1114.4 ± 48 MPa·s/m3) only in YH group (paired t-test, p<0.05). PORH remained the same as before ingestion of L-arginine except in the ON group, where it statistically significantly decreased (area and maximal LD flux; paired t-test, p<0.05). Conclusions: After ingestion of L-arginine we observed decreased heart rate and cardiac output in all tested groups. LD flux during PORH decreased only in the group of older subjects without a family history of hypertension. These results support the view that the PORH is largely independent of NO production.
Criteria, competencies, and confidence tricks
Authors: Richard Wakeford
Journal: BMJ (2006)

Baker proposes that focus groups of professionals, managers, and the public should be convened to detail the minimum standards expected of doctors regarding their fitness to practise.1 Although the intention of this proposal is laudable, it is unrealistic and unworkable for several reasons: the medical profession is too complex and changeable to characterise in this way; the standards, criteria, and thresholds may be contentious and unacceptable if they are too concise (see examples below) or too lengthy to allow “ownership” by the profession; long educational checklists are not helpful in practice.

Firstly, the work of doctors is highly complex and case specific (box). It develops along with the doctor's own professional expertise, and it cannot be analysed by simple lists and straightforward criteria.2 This may frustrate people like Baker, who argues that if there is a lack of clarity about what is unacceptable, “How can patients decide when a doctor should be reported for investigation, and what …
T cell‐mediated inhibition of erythropoiesis in myelodysplastic syndromes
Authors: Tomohiro Sugawara, Kazuyasu Endo, Tomoaki Shishido, Akiyoshi Sato, Junichi Kameoka, Osamu Fukuhara, Kaoru Yoshinaga, Akira Miura
Journal: American Journal of Hematology (1992)