tbuckley/cabot-search huggingface dataset:
Streptokinase and Recombinant Tissue Plasminogen Activator (rt-PA) Are Equally Effective in Treating Acute Myocardial Infarction
Authors: Sol Sherry, Victor J. Marder
Journal: Annals of Internal Medicine (1991)

In recent trials, patients with myocardial infarction who received either recombinant tissue-type plasminogen activator (rt-PA) or streptokinase showed essentially no difference in the amount of myocardial salvage, in mortality reduction, or in the incidence of bleeding complications. These findings thus failed to fulfill the expectation that rt-PA would be twice as effective as streptokinase as a thrombolytic agent. The basis for this mistaken prediction was an unfortunate overemphasis on an inadequate surrogate endpoint, namely, the patency or reperfusion rate at 90 minutes after the start of therapy. Using the 90-minute patency or reperfusion rate as an endpoint has several serious limitations. First, it is an observation made at only one point in time during a dynamic process that may change even during the infusion proper. Second, a single view at 90 minutes completely disregards the possibility of subsequent reocclusion which often occurs within 1 hour after treatment. Third, an image at 90 minutes is more a reflection of the speed of thrombolysis than of whether lysis will eventually occur; the pace of clot lysis depends on both the agent used and the age of the thrombus. Fourth, lysis at 90 minutes is of minimal relevance for myocardial salvage unless observed within the time frame when infarction size can be limited significantly, which is generally less than 4 hours between symptom onset and the time that reperfusion is accomplished. Fifth, a stable state of vessel patency is meaningful for mortality reduction even if stabilization occurs after completion of the infarction. Such "late," but lasting, patency is a critical component of the "open vessel" principle and explains, at least in part, the survival benefit that accrues to patients treated even 24 hours after the onset of symptoms. There is currently no evidence that rt-PA has a more beneficial effect on survival or function than does streptokinase or any other plasminogen activator used in treating acute myocardial infarction; nor is there any evidence that patients who receive rt-PA therapy show a decreased incidence of bleeding complications compared with those who receive streptokinase, despite the relative fibrinogen-sparing attribute of rt-PA. Given the poor predictive value of the 90-minute angiogram for ultimate clinical advantage of one agent over another, studies that are limited to this endpoint are of marginal use in evaluating treatment regimens used in mortality studies. The best evidence to date indicates that streptokinase and rt-PA are of equivalent value for survival after acute myocardial infarction, a conclusion that can be justifiably challenged only with a valid mortality study.
Therapist Competence, Comorbidity and Cognitive-Behavioral Therapy for Depression
Authors: Willem Kuyken, Dimitrios Tsivrikos
Journal: Psychotherapy and Psychosomatics (2008)

Therapist competence has consistently been associated with therapy outcomes, although the nature of this relationship varies considerably across studies.In a naturalistic process-outcome study, 69 clients presenting with depression were treated by 1 of 18 cognitive-behavioral therapists in a 'real world' outpatient clinic. Using triangulated measures of therapists' competence, we hypothesized that greater therapist competence would be associated with improved cognitive-behavioral therapy (CBT) outcomes for clients diagnosed with depression. We hypothesized that the variation in the research to date on therapist competence and CBT for depression outcomes may be due to the moderating effects of complexity of client presentation, in terms of comorbidity.We replicated the previous finding that comorbidity compromises CBT for depression outcomes, but found that greater therapist competence was associated with improved outcomes, regardless of clients' comorbidity.Therapist competence is associated with improved therapy outcomes, and therapists who are more competent have better patient outcomes regardless of the degree of patient comorbidity.
Obesity impairs apoptotic cell clearance in asthma
Authors: Ruby Fernandez-Boyanapalli, Elena Goleva, Christena Kolakowski, Elysia Min, Brian Day, Donald Y.M. Leung, David W.H. Riches, Donna L. Bratton, E. Rand Sutherland
Journal: Journal of Allergy and Clinical Immunology (2012)
The International Society of Hematology. Proceedings of the Seventh Congress. (Rome, 7-13 September 1958.)
Authors: Lawrence C. Parish
Journal: JAMA (1961)

The excellent introduction to these volumes, presented in full in several translations, was written by Giovanni Di Guglielmo. Panels on human DNA, vitamin B<sub>12</sub>, blood and blood-forming cell cultures, hematologic genetics, leukemia, hemophilia and other hemorrhagic states, anticoagulants, and pediatric hematology are presented. To illustrate the wide scope of the volumes, one may cite the papers presented by William Dameshek on the Di Guglielmo syndrome, bone marrow infusion in hypoplastic anemia, and clinical experience with chemotherapy of leukemia; the discussion of the plasma clearance of intravenous doses of radioactive vitamin B<sub>12</sub>by D. L. Mollin and C. C. Booth; and the symposium on nucleic acids in which E. Chargaff discussed aspects of nucleic acid fractionation. Each paper is published in the language of the author. When this is not English, an English summary is supplied. For physicians interested in hematology, this set is highly recommended.
18F-FDG PET/CT in a Patient Affected by Renal Collecting Duct (Bellini) Carcinoma
Authors: Francesco Bertagna, Simona Fisogni, Regina Tardanico, Claudio Simeone, Sergio Cosciani Cunico, Raffaele Giubbini
Journal: Clinical Nuclear Medicine (2012)

Renal collecting duct (Bellini) carcinoma is a very rare variant of renal cell carcinoma. It is associated with a poor prognosis and is often metastatic at the time of diagnosis. We report a case of a 44-year-old man affected by Bellini carcinoma, who underwent postoperative staging with 18F-FDG PET/CT. It revealed high tracer uptake at multiple lymph nodal metastases.
A man with a blocked nose
Authors: O. Mulla, N. Charaklias, P. A. Nix
Journal: BMJ (2012)

A 40 year old man presented with an 11 year history of nasal blockage and anosmia. He reported that he often had “something” prolapsing from his nose. His medical history included hay fever. He took no regular drugs and had aspirin intolerance. On examination there was a glistening fleshy structure within his left nostril (figure⇓). He had similar masses of the same appearance, consistency, and structure in his right nostril, although they were much smaller.





### 1 What is the differential diagnosis of a blocked nose?

#### Short answer

A blocked nose can be secondary to the common cold, influenza virus, allergy, rhinosinusitis, nasal polyp, deviated septum, tumour (benign or malignant), septal haematoma, persisting adenoid pad, and rhinitis medicamentosa.

#### Long answer

Within the medical literature, nasal blockage is used for both nasal obstruction and nasal congestion. In most consultations, patients use it to refer to the process of nasal congestion—when the lining of the nasal passage becomes inflamed. When taking a history, it is important to establish whether this is an acute (less than 12 weeks) or chronic (greater than 12 weeks) problem. It is also important to establish whether symptoms are unilateral or bilateral because this will make the diagnostic process simpler.

The most common acute causes are common cold, influenza virus, intermittent allergic rhinitis, and acute rhinosinusitis.

Chronic allergic rhinitis, chronic rhinosinusitis (with or without nasal polyps), nasal deviation, turbinate hypertrophy, rhinitis medicamentosa, tumours, and adenoid hypertrophy in children are all chronic causes of a blocked nose.

Any allergic reaction can lead to nasal congestion as part of the inflammatory response; however, allergic rhinitis (allergy to dust, pollen, or mites) is commonly associated with nasal congestion. …
Malaria Transmission and Fetal Growth
Authors: J. D. Macgregor, J. G. Avery
Journal: BMJ (1974)

In view of the known relation between infection of the maternal circulation of the placenta with Plasmodium falciparum and impaired fetal growth a study was made of the effect on birth weights of a malaria eradication campaign in the British Solomon Islands. Mean birth weights rose substantially within months of starting antimalarial operations. The increases between 1969 and 1971 averaged 252 g in babies of primigravidae and 165 g in all babies. The proportion of babies with birth weights of less than 2,500 g fell by 8% overall and by 20% among babies of primigravidae. The adverse effect of malaria transmission on fetal growth was apparently reversible if transmission of infection in the community was interrupted up to as late as the third trimester of pregnancy. The beneficial effects of malaria eradication operations on infant survival, child development, and social attitudes in developing countries are discussed.
Repair of Mitral-Valve Prolapse
Authors: Alberto Bouzas-Mosquera, Nemesio Alvarez-Garcia, Jesus Peteiro
Journal: New England Journal of Medicine (2010)

To the Editor: In the review article by Verma and Mesana (Dec. 3 issue),1 mitral-valve prolapse is defined as the displacement of some portion of one or both mitral-valve leaflets into the left atrium during systole. This term was introduced in 1966 by Criley et al.2 and has been frequently used as a synonym for “billowing mitral leaflet,” which was used by Barlow et al.3 to describe the same condition. Unfortunately, imprecise terminology may have important implications for mitral-valve repair. According to Carpentier,4 the term “prolapse” should be reserved to indicate that the free edge of the leaflet protrudes beyond . . .
Early Tumor Shrinkage as Predictor of Outcome in Colorectal Liver Metastases Treated with Cetuximab Plus Chemotherapy
Authors: L. Ye, Y. Zhong, Y. Wei, R. Li, D. Zhu, Q. Lin, W. Chang, J. Chen, X. Qin, J. Xu
Journal: Annals of Oncology (2013)
Epidemic Varicella-Zoster Infection in Cancer Patients.
Authors: S. Schimpff
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Epidemic Varicella-Zoster Infection in Cancer Patients.S. Schimpff, M.D., A. Serpick, M.D., F.A.C.P., B. Stoler, M.D., B. Rumack, M.D., H. Mellin, M.D., G. Joseph, Ph.D.S. Schimpff, M.D.Search for more papers by this author, A. Serpick, M.D., F.A.C.P.Search for more papers by this author, B. Stoler, M.D.Search for more papers by this author, B. Rumack, M.D.Search for more papers by this author, H. Mellin, M.D.Search for more papers by this author, G. Joseph, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-837_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn initial two patients (lymphosarcoma, Burkitt's lymphoma) with varicella-zoster exposed the staff and 91 other patients: 19 exposed patients had Hodgkin's disease; 35 had advanced solid tumor; 13 had acute leukemia; and 23 had other lymphomas, myeloma, or chronic leukemia. No staff member developed varicella-zoster. Of the exposed patients, 26% with Hodgkin's disease. 3% with solid tumor, 8% with acute leukemia, and 4% with other tumors subsequently developed varicella-zoster. Herpes zoster usually appeared from 25 to 30 days after exposure. Varicella-zoster developed in 5 of the 11 (45%) exposed patients with Hodgkin's disease who had received prior radiation therapy (4,000... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: S. Schimpff, M.D.; A. Serpick, M.D., F.A.C.P.; B. Stoler, M.D.; B. Rumack, M.D.; H. Mellin, M.D.; G. Joseph, Ph.D.Affiliations: Baltimore, Md.; and Atlanta, Ga. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 837-837KeywordsAcute myeloid leukemiaBurkitt lymphomaHodgkin lymphomaLymphomaMyelomaPrecursor cellsRadiation therapy ePublished: 1 December 2008 Issue Published: 1 May 1971 PDF downloadLoading ...
CONTRAST INDUCED NEPHROPATHY AND BLEEDING: A BIDIRECTIONAL LINK WITH PROGNOSTIC VALUE IN ACS
Authors: Sergio Raposeiras Roubin, Emad Abu-Assi, Raymundo Ocaranza-Sanchez, Maria Castiñeira, Andrea Lopez, Noelia Bouzas, Jose-Maria García-Acuña, Jose Ramón González-Juanatey
Journal: Journal of the American College of Cardiology (2013)
Colposcopy services in West Midlands region.
Authors: L. A. Davies
Journal: BMJ (1989)

clinics or orthopaedic lists are dealt with in the other two weeks of the rota; during that time there is no commitment to new trauma.In this way there is no risk of night work leaving the surgeon jaded for routine work the following day.This is not a unique system, but this and other methods will have to be evolved to improve on safety of care.
Salvage therapy and long-term remission with danazol and cyclosporine in refractory evan's syndrome
Authors: Kadoudja Chemlal, Benjamin Wyplosz, Marie-Jos� Grange, Kaiss Lassoued, Jean-Pierre Clauvel
Journal: American Journal of Hematology (1999)

To the Editor: Hb S (␤6 Glu-Val), Hb D Los Angeles (␤121 Glu-Gln) and Hb O Arab (␤121 Glu-Lys) are the most common variants in Turkish population including Turkish Cypriots [1,2].Either during screening of the population or to enlighten the reason of anemia; several abnormal hemoglobin variants can be detected by screening techniques and further molecular identification of these variants is needed.There are several identification methods such as protein chemical structural analysis, restriction enzyme digestion, sequencing, and oligonucleotide hybridization [3,4].Previously, we and others reported restriction enzyme digestion protocols for direct detection of common hemoglobin variants found in general population [5][6][7][8][9].These methods were convenient, rapid, cheap, and nonradioactive.In this report, we aim to determine the feasibility of these restriction enzyme protocols in our population.During the last 4 years, 65 hemoglobin variants were referred to our laboratory for molecular analysis, excluding hemoglobin S.These were analysed according to previously reported restriction enzyme analysis protocols [5-9] (Table I).Fifty-four of them were identified.Of these 21 were Hb D Los Angeles (␤121 Glu-Gln); 23 were Hb O Arab (␤121 Glu→Lys); five were Hb C (␤6 Glu-Lys); one was Hb D Los Angeles in combination with Hb S; two were Hb E Saskatoon (␤22 Glu-Lys); and two were (␤26 Glu-Lys).Further analysis was needed in only 11 (16.9%)samples.These variants were moved as Hb D (7 case); Hb E (2 case) and Hb J (2 cases) at cellulose acetate electrophoresis.Our data revealed that our previously reported restriction enzyme digestion protocols are convenient, rapid and feasible, especially in populations where these mutations are prevalent.
Words: Protean elephants
Authors: J. Aronson
Journal: BMJ (1998)

Joseph Merrick, the famous Victorian “elephant man” described by Frederick Treves, has generally been supposed to have suffered from neurofibromatosis. However, in 1986 Tibbles and Cohen (BMJ 1986;293:683-5) suggested that he had instead a rare condition known as Proteus syndrome, and recently this diagnosis has been supported by evidence from x ray examinations and computed tomography of Merrick’s remains. Both conditions are hamartoses (from the Greek α‘μαρτ′eιν, hamartein, to err or sin), but while neurofibromatosis consists of multiple tumours of nerve cells, Proteus syndrome, a somatic mosaicism, involves abnormal growth of bone and soft tissues. 

Proteus was the original name for what we now called the amoeba and is also the name of a blind cave dwelling amphibian. But it is best known to doctors as the name of a group of bacteria, such as Proteus vulgaris, often encountered in urinary infections. 

Proteus was a god, resident in Egypt. He was the original Old Man of the Sea, a tender of seals, who had the gift of prophecy and who would answer travellers’ questions if they could only tie him down. The problem was that he wouldn’t stay put. We meet him in the Odyssey (Book 4, 360), when his daughter Eidothea (whose name means “goddess shaped”) tells Menelaus how her father will behave and what to do about it. He will, she says, change himself into every kind of beast, into water, and into fire. But, she advises, hold him fast and grip him all the tighter. Menelaus does so, and when Proteus tires of transforming himself into a lion, a snake, a panther, a bear, running water, and a large tree he tells Menelaus what he wants to know. 

Ovid writes about him too (Metamorphoses, Book 8, 731): 

Proteus, denizen of the land locking seas, 

Sometimes like a lad, sometimes a lion, 

Sometimes a snake men trembled to touch; sometimes 

A charging boar, or a sharp-horned bull; 

Often a stone, often a tree; 

Or, feigning flowing water, like a flood; 

Or water’s counterpart, a fiery flame. 

John Hurt’s sensitive portrayal of Merrick in David Lynch’s 1980 film The Elephant Man was reminiscent of cinematic portrayals of Quasimodo, by Lon Chaney in 1923, Anthony Quinn in 1957, and most memorably Charles Laughton in 1939 (we can ignore Tom Hulce’s voice over in Disney’s recent cartoon version). In Notre Dame de Paris Hugo wrote that Quasimodo looked like a giant broken and badly repaired. Could the man with the warty brow, the tetrahedral nose and the horseshoe mouth, the misshapen legs of unequal length that looked like two sickles joined at the handles, and the hump between the shoulders balanced by one in front have had the Proteus syndrome? I like to think so, even if only because it gives a fresh perspective on the phrase ringing the changes.
Comparison of PUVA and beta-carotene in the treatment of polymorphous light eruption
Authors: JOHN A. PARRISH, MARK J. LE VINE, WARWICK L. MORISON, ERNESTO GONZALEZ, THOMAS B. FITZPATRICK
Journal: British Journal of Dermatology (1979)

Journal Article Comparison of PUVA and beta‐carotene in the treatment of polymorphous light eruption Get access JOHN A. PARRISH, JOHN A. PARRISH Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar MARK J. LE VINE, MARK J. LE VINE Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar WARWICK L. MORISON, WARWICK L. MORISON Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar ERNESTO GONZALEZ, ERNESTO GONZALEZ Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar THOMAS B. FITZPATRICK THOMAS B. FITZPATRICK Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 100, Issue 2, 1 February 1979, Pages 187–191, https://doi.org/10.1111/j.1365-2133.1979.tb05560.x Published: 01 February 1979
Increased accumulation of the glycoxidation product N(epsilon)-(carboxymethyl)lysine in human tissues in diabetes and aging.
Authors: E D Schleicher, E Wagner, A G Nerlich
Journal: Journal of Clinical Investigation (1997)

N(epsilon)-(Carboxymethyl)lysine (CML), a major product of oxidative modification of glycated proteins, has been suggested to represent a general marker of oxidative stress and long-term damage to proteins in aging, atherosclerosis, and diabetes. To investigate the occurrence and distribution of CML in humans an antiserum specifically recognizing protein-bound CML was generated. The oxidative formation of CML from glycated proteins was reduced by lipoic acid, aminoguanidine, superoxide dismutase, catalase, and particularly vitamin E and desferrioxamine. Immunolocalization of CML in skin, lung, heart, kidney, intestine, intervertebral discs, and particularly in arteries provided evidence for an age-dependent increase in CML accumulation in distinct locations, and acceleration of this process in diabetes. Intense staining of the arterial wall and particularly the elastic membrane was found. High levels of CML modification were observed within atherosclerotic plaques and in foam cells. The preferential location of CML immunoreactivity in lesions may indicate the contribution of glycoxidation to the processes occurring in diabetes and aging. Additionally, we found increased CML content in serum proteins in diabetic patients. The strong dependence of CML formation on oxidative conditions together with the increased occurrence of CML in diabetic serum and tissue proteins suggest a role for CML as endogenous biomarker for oxidative damage.
Vertebroplasty for vertebral fracture
Authors: D. J. Wilson
Journal: BMJ (2011)

On the basis of current evidence, cannot be recommended as the first line treatment

In the linked meta-analysis of individual patient data (doi:10.1136/bmj.d3952), Staples and colleagues assess whether vertebroplasty for vertebral fracture is more effective than placebo in certain subgroups of people.1 

Insufficiency fractures of the vertebra are a major cause of morbidity and are estimated to affect about one in four adults over the age of 50 years. Risk factors include age, low body mass index, smoking, alcohol misuse, family history, use of corticosteroids, and chronic illness. Although these associations may be used to predict the incidence of disease,2 this remains a substantial problem in later life, and preventive treatment has yet to reduce the incidence. 

Medical interventions, such as lifestyle changes, hormone replacement, and bisphosphonates, have been used to treat vertebral fractures. However, it is unclear how best to manage the fracture, to alleviate pain, and to reduce long term disability. Since the original description of vertebroplasty in 1987,3 percutaneous cement augmentation has been widely advocated for pain management. Such procedures are normally performed on a day case basis and are undertaken using heavy sedation with fluoroscopy to guide an injection of cement into the fractured vertebra. 

Many large unblinded trials have shown that cement augmentation results in a 70-90% improvement in symptoms within …
Polysorbates and Renal Oxalate Crystals in the E-Ferol Syndrome
Authors: R. E. Brown
Journal: JAMA (1986)

<h3>To the Editor.—</h3> We concur with the conclusion of Bove et al<sup>1</sup>that a more likely cause of the E-Ferol-associated toxic reaction is polysorbate.<sup>2</sup>Furthermore, we believe that this contention is consistent with their histopathologic findings of sinusoidal dilatation and congestion in the liver, given the fact that similar changes have been produced in rats following the chronic administration of polysorbate 80 (Tween 80).<sup>3</sup> In addition, it may be possible to link their observation of oxalate-type crystals in the renal tissues<sup>1</sup>(which we have also observed in such a case; Figure and left inset) to polysorbates. Because ethylene oxide/1,2-carbon 14 either as the polyoxyethylene moiety or in singular form or both has been detected radiometrically in the urine of rats following the catabolism of intravenously administered polysorbate labeled with polyoxyethylene-carbon 14,<sup>4</sup>the formation of oxalate-type crystals in the urine could be due to this. Admittedly, this