tbuckley/cabot-search huggingface dataset:
Rheumatoid factor-like reactants in sera proven to transmit non-A, non-B hepatitis: A potential source of false-positive reactions in non-A, non-B assays
Authors: Hiroyuki Shiraishi, Harvey J. Alter, Stephen M. Feinstone, Robert H. Purcell
Journal: Hepatology (1985)

Convalescent phase non-A, non-B (NANB) human and chimpanzee sera were utilized in a solid-phase radioimmunoassay (RIA) in an attempt to identify a specific NANB antigen in human plasma, plasma-derived pellets and NP-40 disrupted pellets proven to transmit NANB infection to chimpanzees. RIA reactivity was noted in 5 of 8 pedigreed NANB infectious plasmas, but did not appear to be virus-specific. The RIA reactive fraction: (i) had a density of 1.27 to 1.32 gm per cm3 in cesium chloride; (ii) showed immunoreactivity corresponding to normal IgM, but peak RIA activity coincided with an aberrant IgM having a peak sedimentation coefficient of 56 S, and (iii) eluted at higher pH (5.6 to 5.0) than normal IgM on chromatofocusing columns. The reactant shared properties with rheumatoid factor in that it was absorbed by aggregated IgG and was unstable to 2-mercaptoethanol, but it did not react in standard agglutination tests for rheumatoid factor. The reactant was detected in both the acute and chronic phase of NANB infections in chimpanzee and man. By reacting with IgG in presumptive NANB convalescent sera, this aberrant rheumatoid factor could simulate a NANB antigen and represent a cause of false-positive reactions in putative NANB assays.
Mechanisms of vasomotor rhinitis
Authors: R. Garay
Journal: Allergy (2004)

Summary Nonallergic non‐infectious perennial rhinitis (NANIPER) is a heterogeneous disorder comprising several pathophysiological entities. The etiology of some of these disorders (e.g. drug‐induced rhinitis, nonallergic rhinitis with eosinophilia syndrome [NARES], occupational rhinitis, hormonal rhinitis, emotion‐induced rhinitis, physical/chemical irritant‐induced rhinitis) is well established. In contrast, the aetiology of idiopathic forms of rhinitis (also known as vasomotor rhinitis) is largely unknown. Mechanistic studies have suggested that non‐IgE‐mediated inflammatory and/or neurogenic processes may be involved. There is evidence that localized inflammation is the underlying cause of symptoms in drug‐induced rhinitis and NARES, since eosinophilia is an important pathophysiological component in these conditions. In contrast, neurogenic reflex mechanisms initiated by environmental factors appear to be involved in idiopathic rhinitis. It has been suggested that there may be an imbalance of the sympathetic and parasympathetic nervous systems, with parasympathetic hyper‐activity and sympathetic hypo‐activity resulting in nasal congestion and rhinorrhoea. Indirect evidence suggests that C‐fibres may also play an important role in the pathophysiology of idiopathic rhinitis.
(15) DISH and DISH-like syndrome in patients treated with isotretinoin
Authors: B.M. Carey, G.J.S. Parkin, W.J. Cunliffe, J. Pritlove
Journal: British Journal of Dermatology (1987)

The possibility that diffuse idiopathic skeletal hyperostosis (DISH) could be a complication of isotretinoin therapy was not appreciated until after the drug had been introduced. We report 120 patients with acne, who were X‐rayed within 1 year of a 4‐month course of isotretinoin (mean dose 0·5 mg/kg/day). Since DISH is an age‐dependent disease, we compared the data with age‐matched controls who were X‐rayed for a non‐significant soft tissue injury. In the vast majority of the treated group, any detectable changes were subtle, and consisted of minimal hyperostoses in the anterior spinal ligaments and tibial spines and either calcaneal or Achilles'spurs. Fourteen (9%) had some relevant skeletal change, but 5% of the control group had similar changes. We have now X‐rayed again nine of the original 14 patients who were noted to have skeletal changes. One was noted to have some radiological deterioration, four were unchanged, and four showed some slight improvement. The single patient who did show deterioration had back problems preceding therapy and his radiographs demonstrated marked DISH changes in the lumbar spine. These data fit with the report by Cope, Cunningham and Kilcoyne1 who also showed a 9% incidence of DISH‐like changes. This study was also retrospective, but had no control data. We suggest that although prospective studies are needed, and are in hand, DISH is unlikely to be a significant complication of isotretinoin therapy for acne. We recommend X‐raying all patients over 35 years old, prior to therapy, and younger patients only if complaining of joint symptoms. We would recommend X‐rays of the dorso‐lumbar spine, and ankles.
Risk Charts: Putting Cancer in Context
Authors: S. Woloshin, L. M. Schwartz, H. G. Welch
Journal: JNCI Journal of the National Cancer Institute (2002)

Whether people respond to a given health threat depends in part on how large they perceive their personal risk to be. Typical presentations of health risks (e.g., in the news, in public service announcements, and in direct-to-consumer advertisements) may do little to inform these perceptions. For example, efforts to describe various diseases to the public often take the following form: “This year, approximately 182 800 women in the United States will be diagnosed with invasive breast cancer, and approximately 40 800 women will die from breast cancer” (1). Similar messages can be found for most well-known diseases [and increasingly, over the Internet, for less well-known diseases, such as hemochromatosis (2)]. What is missing from these messages is context: How does the chance of dying from breast cancer—or any other single disease—compare with the chance of dying from another disease? What is an individual’s chance of dying from any cause? Without some context, it is impossible to gauge the magnitude of a disease risk. To provide this context, we have created simple charts with age-, sex-, and smoking-specific data about the chance of dying from various common causes. In this article, we describe the method for creating these charts and make the charts publicly available.
Virtual CT Cholangioscopy: Comparison with Fiberoptic Cholangioscopy
Authors: K. Koito, T. Namieno, N. Hirokawa, T. Ichimura, T. Syonai, N. Yama, M. Mukaiya, K. Hirata, K. Sakata, M. Hareyama
Journal: Endoscopy (2001)

Background and Study Aims: No studies comparing virtual computed tomography (CT) cholangioscopy of the common bile duct compared with fiberoptic cholangioscopy are available. The aim of our study was to evaluate the feasibility of virtual CT cholangioscopy of the common bile duct.
DNA ploidy analysis of hepatic preneoplastic and neoplastic lesions in woodchucks experimentally infected with woodchuck hepatitis virus
Authors: Li-Jun Mi, Jaygonda Patil, William E. Hornbuckle, Paul J. Cote, John L. Gerin, Bud C. Tennant, Fiorenzo Paronetto
Journal: Hepatology (1994)

We analyzed the DNA ploidy and the nuclear size of hepatocytes within hepatocellular carcinoma, putative preneoplastic (clear cell and basophilic foci) and adjacent non-neoplastic liver in 30 woodchucks neonatally infected with the woodchuck hepatitis virus. In livers from control woodchucks, in clear cell foci and in most chronic portal hepatitis, the hepatocytes were diploid, with less than 10% tetraploid cells. Aneuploid peaks were found in 50% of the livers with chronic active hepatitis, in 63% of basophilic foci and in 90% of hepatocellular carcinoma. Within the same tumor, aneuploid peaks with different DNA indices were observed frequently, indicating heterogeneity of tumor. S-phase was always elevated, indicating an increased rate of proliferation. Aneuploid cells had nuclei that were larger than those of control liver cells. In some basophilic foci and in some livers with chronic active hepatitis, abnormal DNA was demonstrated before the development of hepatocellular carcinoma, suggesting that these may be populations of hepatocytes at risk of neoplastic transformation.
961-82 Abnormal Signal Averaged Electrocardiogram Predicts Mortality in Patients with Non-Ischemic Cardiomyopathy and Severe Congestive Heart Failure
Authors: Daniel M. Bloomfield, Kathleen Hickey, Robert R. Sciacca, Marlon S. Rosenbaum, James Coromilas
Journal: Journal of the American College of Cardiology (1995)
Fetal scalp sampling in labour
Authors: James P Neilson
Journal: BMJ (2008)

Lactate measurement has benefits over pH estimation

In the linked randomised controlled trial, Wiberg-Itzel and colleagues compare the effectiveness of two methods of diagnosing hypoxia in the fetus during labour—scalp pH analysis and scalp lactate analysis.1 

Fetal wellbeing during labour depends on several factors—an adequate supply of oxygenated maternal blood reaching the placental intervillous space, gas exchange across an undamaged placenta, supply of oxygenated blood to the fetus through an open umbilical vein, and sufficient metabolic reserve in the fetus to withstand the hypoxic effects of uterine contractions. The fetus may be compromised by maternal hypotension, prolonged uterine contractions, placental abruption, umbilical cord occlusion, and fetal growth restriction. Distress may also occur for no obvious reason in apparently normal labours.

The traditional mainstay of fetal assessment during labour is monitoring of the fetal heart rate—either by intermittent auscultation (using a Pinard stethoscope or hand held Doppler device) or by continuous electronic monitoring. Compared with intermittent auscultation, continuous electronic monitoring has the disadvantage that it restricts the woman’s movement. It also increases …
Maintenance of Cell Viability
Authors: NORMAN BRACHFELD
Journal: Circulation (1969)

An early distinction between the early and reversible changes of cellular ischemia and the irreversible changes of cell necrosis is essential to a rational program for the treatment of coronary artery disease, to a definition of the permissible limits of nonperfusion of the anoxic arrested heart at open-heart surgery, and to a determination of the maximal allowable transport time for cardiac transplantation. The factors in the myocardial cellular environment that support cellular viability and help maintain homeostasis are reviewed. Reversible surgically induced anoxic arrest is contrasted with the irreversible arrest and cell necrosis which often attend the myocardial anoxia of coronary occlusion. The enhancement of glycolysis, other changes in carbohydrate metabolism, and the depressed oxidation and lipid storage associated with alterations in lipid metabolism are outlined and their interrelationships discussed. The effect of the myocardial tissue acidosis which accompanies ischemic metabolism is an important factor in determining the reversibility of the effects of ischemia. The probable role of myocardial acid hydrolases in pathological ischemic autolysis is described. A sequence of cellular events induced by ischemia and leading to ultimate cell death is outlined. Promising areas for future investigation into the pathogenesis of myocardial infarction and into improved methods of treatment are suggested.
Challenging the medical materialists
Authors: T. Dalrymple
Journal: BMJ (2011)

The belief that the theory of evolution and the neurosciences have something important to tell us about the inescapable problems of human existence has once again become fashionable. In my view, this is false and facile; a reading of the first chapter of William James’s The Varieties of Religious Experience should explain why.

James (1842–1910) was one of three distinguished siblings. His brother Henry was the famous novelist, whom some find long winded and over-refined. His sister Alice became famous posthumously for the diary that she kept during her various breakdowns and the lung cancer that eventually killed her. William was one of those many distinguished doctors who never actually practised, though after he qualified …
Gonococcal ophthalmia neonatorum. Relationship of time of infection to relevant control measures
Authors: T. R. Thompson
Journal: JAMA (1974)

Gonococcal ophthalmia neonatorum occurred in one stillborn and six liveborn infants delivered at Hackley Hospital, Muskegon, Mich, between Aug 1, 1971, and Aug 1, 1972. Six infants were delivered vaginally and one was delivered by cesarean section. Five of the seven mothers had confirmed gonorrhea. Neonates acquired<i>Neisseria gonorrhoeae</i>in utero during the birth process or postnatally. Silver nitrate was put into the eyes of each liveborn infant by registered nurses. An adequate control program must include not only silver nitrate prophylaxis, but also identification of infected pregnant women at prenatal visits to the physician. (<i>JAMA</i>228:186-188, 1974)
Randomized Phase II Trial of Erlotinib Versus Temozolomide or Carmustine in Recurrent Glioblastoma: EORTC Brain Tumor Group Study 26034
Authors: Martin J. van den Bent, Alba A. Brandes, Roy Rampling, Mathilde C.M. Kouwenhoven, Johan M. Kros, Antoine F. Carpentier, Paul M. Clement, Marc Frenay, Mario Campone, Jean-Francois Baurain, Jean-Paul Armand, Martin J.B. Taphoorn, Alicia Tosoni, Heidemarie Kletzl, Barbara Klughammer, Denis Lacombe, Thierry Gorlia
Journal: Journal of Clinical Oncology (2009)

Approximately 50% of glioblastomas (GBMs) are characterized by overexpression of the epidermal growth factor receptor (EGFR) and EGFR gene amplification. In approximately 25% of instances, constitutively activated EGFR mutants are present. These observations make EGFR-inhibiting drugs a logical approach for trials in recurrent GBM.In a randomized, controlled, phase II trial, 110 patients with progressive GBM after prior radiotherapy were randomly assigned to either erlotinib or a control arm that received treatment with either temozolomide or carmustine (BCNU). The primary end point was 6-month progression-free survival (PFS). Tumor specimens obtained at first surgery were investigated for EGFR expression; EGFRvIII mutants; EGFR amplification; EGFR mutations in exons 18, 19, and 21; and pAkt. These results were correlated with outcome. Pharmacokinetic analysis was part of the study. RESULTS; Treatment was well tolerated in general; skin toxicity was the most frequent adverse effect of erlotinib. The 6-month PFS rate in the erlotinib arm was 11.4% (95% CI, 4.6% to 21.5%), and it was 24% in the control arm. Of all explored biomarkers, only low pAkt expression appeared to be of borderline significance to an improved outcome. None of the eight patients who had tumors with EGFRvIII mutant presence and PTEN expression had 6-month PFS. The use of enzyme-inducing anticonvulsants significantly increased erlotinib clearance, but pharmacokinetic findings were not related to outcome.Erlotinib has insufficient single-agent activity in unselected GBM. No clear biomarker associated with improved outcome to erlotinib was identified.
Computed tomographic scanning of the lung in patients with allergic bronchopulmonary aspergillosis and in asthmatic patients with a positive skin test to Aspergillus fumigatus.
Authors: R M Angus, M L Davies, M D Cowan, C McSharry, N C Thomson
Journal: Thorax (1994)

BACKGROUND--Allergic bronchopulmonary aspergillosis is a disease of asthmatic patients which may follow a protracted course and result in chronic lung damage such as central bronchiectasis. In asthma uncomplicated by allergic bronchopulmonary aspergillosis, in particular in asthmatic patients with immediate hypersensitivity type skin reactions to Aspergillus fumigatus, the incidence of bronchiectasis is uncertain. METHODS--Computed tomographic (CT) scans were performed in 17 asthmatic patients of mean (SE) age 60.1 (2.5) years, FEV1 49.4 (5.8)% predicted with allergic bronchopulmonary aspergillosis (all with current or previous positive precipitins to A fumigatus) and in 11 asthmatic patients of mean (SE) age 49.5 (5.8) years, FEV1 75.5 (6.5)% predicted, skin test positive for A fumigatus, but without the clinical or serological features of allergic bronchopulmonary aspergillosis (non-allergic bronchopulmonary aspergillosis group). RESULTS--Bronchial dilatation was more common in the group with allergic bronchopulmonary aspergillosis, affecting 14 patients compared with two in the non-allergic bronchopulmonary aspergillosis group. Evidence of bronchiectasis was found in 43 of a possible 102 lobes of patients with allergic bronchopulmonary aspergillosis, compared with three of a possible 66 in the non-allergic bronchopulmonary aspergillosis group. Bronchial wall thickening was common to both, affecting 16 and nine patients respectively. Pleural thickening on CT scanning was common in the group with allergic bronchopulmonary aspergillosis, being noted in 14 patients compared with only three in the non-allergic bronchopulmonary aspergillosis group. CONCLUSIONS--Bronchiectasis is common in allergic bronchopulmonary aspergillosis but occurs only occasionally in asthmatic patients with a positive skin test to A fumigatus but without other features of the disease.
SOME MEDICO-LEGAL QUESTIONS THAT ARISE FROM THE MISTAKES OF ABDOMINAL TUMORS FOR PREGNANCY.Read in the Section of Medical Jurisprudence, at the Forty-first Annual Meeting of the American Medical Association, Nashville, May, 1890.
Authors: DAVID W. YANDELL
Journal: JAMA (1890)

Some practical questions arise from the following cases: A., æt. 19, had an abdominal tumor of four months' standing. Two physicians, after a long and careful examination, pronounced it a gravid uterus. This was indignantly denied by the patient, and the most deplorable family feeling and bitter feud followed. Eight months later the mistake was discovered, and an ovarian tumor was removed weighing 119 lbs. B., a widow, married four years without issue. Twelve months after widowhood she was sent to me to be operated on for ovarian tumor. Two months later she was delivered of a healthy boy. The mistake of the physician in the first case caused the most poignant grief to a large number of excellent people. The mistake of the physician in the second case saved the woman from disgrace, for being sent a long distance from home to have the tumor removed, the labor was
Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study
Authors: James D Ralston, Debra Revere, Lynne S Robins, Harold I Goldberg
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To describe the experiences of patients with type 2 diabetes in a web based disease management programme based on an interactive electronic medical record. <b>Design</b> Qualitative analysis of semistructured interviews with patients enrolled in a diabetes care module that included access to their electronic medical record, secure email, ability to upload blood glucose readings, an education site with endorsed content, and an interactive online diary for entering exercise, diet, and medication. <b>Setting</b> Patients9 homes in Washington state, United States. <b>Participants</b> Nine participants aged 45-65 completed interviews before and after they used the programme. <b>Results</b> Six themes emerged: feeling that non-acute concerns are uniquely valued; enhanced sense of security about health and health care; frustration with unmet expectations; feeling more able to manage; valuing feedback; and difficulty fitting the programme into activities of daily life. Three themes—valuing non-acute concerns, feeling secure, and unmet expectations—have particular relevance to the design and use of web based tools for care of patients with diabetes and chronic medical conditions. <b>Conclusion</b> Participants9 experiences support further study of open access to the electronic medical record and online communication between patients and their care providers. The development of web based disease management programmes should take into account the specific needs and expectations of patients, and patients and providers should have candid discussions about what web based care can and cannot provide.
Telangiectases of the Distal Lower Extremities Associated With Paresthesia and Raynaud Phenomenon—Quiz Case
Authors: Andrew P. Word, Michelle L. Jackson, Melissa Costner, Clay J. Cockerell, Prasanna A. Sinkre
Journal: JAMA Dermatology (2013)

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Unusual surgical emergency in pregnancy.
Authors: A Mahmood
Journal: BMJ (1970)

function to account for reduced antidiuretic hormone production.The cerebral dysfunction in this patient was thought to be due to hypotension at the time of operation.It is interesting that no hypothalamic distur- bance was recognized by Javid et a.1 in their review of neurological complications after open heart surgery.There was no obvious cause for the cere- bral dysfunction in the first case, but it is interesting that polyuria and echolalia began simultaneously and that fluctuations of urine flow coincided with alterations in cerebral function.To have been able to estimate levels of antidiuretic hormone at these times would have been helpful.Polyuria after open heart surgery may be associated with diabetes mellitus, bio- chemical changes, such as hypokalaemia and as an exaggerated response to diuretics, and it can lead to peripheral circulatory failure.It is important to recognize polyuria due to diabetes inspidus as it is so amen- able to Pitressin (vasopressin) therapy.We are, etc.,
Valid evaluation of plasma catecholamines.
Authors: G Triebig
Journal: Thorax (1981)

Progressive lung disease in a malt-worker Sir,-The case report described by Ellis and Friend in your July issue (Thorax 1981;36:552-4) is indeed unusual, particularly the granulomas found in the liver.I see in the article no note of tests of the leucocyte function.Since odd cases of the so-called chronic granulomatous disease of childhood can become manifest well into adult life without any remarkable history of earlier infections (