tbuckley/cabot-search huggingface dataset:
Drug points: Ranitidine and aseptic meningitis
Authors: J M Durand, L Suchet
Journal: BMJ (1996)

In June 1993, two weeks after taking ranitidine, a 30 year old man was admitted with fever and meningism. His cerebrospinal fluid was abnormal, with white blood cell count of 223 x 106/l, a polymorphonuclear leucocyte concentration of 80%, a protein concentration of 1.2 g/l, and a glucose concentration of 2.9 mmol/l. Ranitidine was stopped, and the patient was …
Detection of <i>Borrelia burgdorferi sensu lato</i> in endomyocardial biopsy specimens in individuals with recent‐onset dilated cardiomyopathy
Authors: Miloš Kubánek, Marek Šramko, Dagmar Berenová, Dagmar Hulínská, Hana Hrbáčková, Jana Malušková, Alena Lodererová, Ivan Málek, Josef Kautzner
Journal: European Journal of Heart Failure (2012)
Commentary: Opportunities to prevent fracture are being missed
Authors: M. K. Javaid, C. Cooper
Journal: BMJ (2013)

Improving the management of osteoporosis remains important given the high cost of fragility fracture for patients, carers, clinicians, and healthcare systems.1 The availability of a wide range of effective oral, intravenous, and subcutaneous therapies that can be administered at varying intervals (daily, weekly, monthly, six monthly to annually) should make treatment the envy of other chronic disease specialties such as diabetes or hypertension, which have more limited dosage portfolios.

Yet the care of patients at high risk of fracture remains poor, as shown by the aptly titled, recent audit of services in England, Wales, and Northern Ireland, Falling Standards, Broken Promises .2 One of the reasons is that many different professionals are involved in the care pathway and no one has …
A preliminary investigation into the effect of exposure of photosensitive individuals to light from compact fluorescent lamps
Authors: E. Eadie, J. Ferguson, H. Moseley
Journal: British Journal of Dermatology (2009)

Compact fluorescent lamps (CFLs) are due to replace common incandescent lamps over the next few years. There has been no investigation of the possible effect of this on patients with photosensitive disorders.To determine the effect of exposure of photosensitive individuals to light from CFLs.The spectral emission from a sample of CFLs was measured using a calibrated spectroradiometer. The erythemal response was determined in one normal individual and four photosensitive individuals by direct exposure of the skin to light from a CFL. The susceptibility of a wider group of photosensitive individuals was predicted based on the light dose known to elicit a reaction during phototesting at discrete ultraviolet (UV) wavelengths.CFLs emit UV radiation at wavelengths down to 254 nm. Prolonged exposure of a normal individual's skin produced erythema. However, an exposure of only 2.5 min at 5 cm elicited marked erythema in one of the abnormally photosensitive patients.CFLs could be a source of harmful UV radiation to photosensitive individuals. Patients with chronic actinic dermatitis are thought to be at greatest risk. The use of a protective envelope is recommended.
The Unfortunate Case of Dr. Z: How to Succeed in Medical Practice in 1984
Authors: John F. Burnum
Journal: New England Journal of Medicine (1984)

The following address was given by Merin Gip, the Regional Inspector Commissioner of the Bureau of Health Care Delivery, at the 1984 inaugural meeting of the Coalition of Health-Care Providers and Consumers.As Regional Inspector Commissioner of the Bureau of Health-Care Delivery, I wish to give an account of the unfortunate case of Dr. Z. This material is drawn from the hearing in which he was stripped of his hospital privileges and placed on probationary office practice because of failure to adjust to the new medicine. The hearing was occasioned by conjoined charges brought by the National Board of Hospital . . .
Search for mutations in a segment of the exon 28 of the human von Willebrand factor gene: New mutations, R1315C and R1341W, associated with type 2M and 2B variants
Authors: Pilar Casaña, Francisco Martínez, Carmen Espinós, Saturnino Haya, José I. Lorenzo, José A. Aznar
Journal: American Journal of Hematology (1998)

von Willebrand Disease (vWD) is the most frequently inherited bleeding disorder in humans, and is caused by a qualitative and/or quantitative abnormality of the von Willebrand factor (vWF).A large number of defects that cause qualitative variants have been located in the A1 domain of the vWF, which contains sites for interaction with platelet glycoprotein Ib (GPIb).We have developed a new approach to detect mutations based on DdeI digestion and single-strand conformation polymorphism analysis.A segment of 487 nucleotides, extending from intron 27 to codon 1368 of the pre-pro vWF was amplified from genomic DNA.The cleavage with DdeI yields two fragments of appropriate size for this kind of analysis and confirms that the gene, rather than the pseudogene, is being investigated.Six families with type 2B vWD, one type 2M vWD family, and one another type 2A vWD family were studied.After sequencing the fragments with an altered electrophoretic pattern, we found four mutations previously described-R1308C, V1316M, P1337L, and R1306W-in patients with 2B vWD.The last one arose de novo in the patient.In addition, two new candidate mutations were observed: R1315C and R1341W.The first one was associated to type 2M vWD, whereas the one second cosegregated with type 2B vWD.The fact that these new mutations were not found in 100 normal alleles screened further supports their causal relationship with the disease.These mutations, which induce either a gain or a loss of function, further show an important regulatory role of this region in the binding of vWF to GPIb and its implications in causing disease.
Natural History of Experimental Arterial Chronic Total Occlusions
Authors: Ronen Jaffe, General Leung, Nigel R. Munce, Amandeep S. Thind, Howard Leong-Poi, Kevan J.T. Anderson, Xiuling Qi, Judy Trogadis, Ariella Nadler, Davida Shiff, Jamie Saperia, Julia Lockwood, Chaim Jacobs, Beiping Qiang, Aaron Teitelbaum, Alexander J. Dick, John D. Sparkes, Jagdish Butany, Graham A. Wright, Bradley H. Strauss
Journal: Journal of the American College of Cardiology (2009)
Only half of eligible NHS staff have basic training in child protection
Authors: S. Mayor
Journal: BMJ (2009)

The NHS must make substantial improvements to comply with measures to safeguard children who may be being abused, urges a review published by the Care Quality Commission in response to the death of a child after serious abuse was not tackled despite many contacts with health professionals.

The secretary of state for health commissioned the review after the death of baby Peter, a 17 month old who died after sustained abuse despite 34 contacts with health professionals during his short life. An initial report after his death found systemic failings in the health care he received from NHS hospitals and GPs ( BMJ 2009;338:b1967, doi:10.1136/bmj.b1967).

The review, which is based on a survey of 392 NHS trusts, showed that most organisations had “the right people and systems” to help protect children. But it found “worrying shortfalls” in the numbers of staff who were up to date with mandatory training designed to help them identify and respond to concerns about potential child neglect and abuse. …
PROTOCOLS OF MICROSCOPIC EXAMINATION OF SEVERAL GASSERIAN GANGLIA.
Authors: LEWELLYS F. BARKER
Journal: JAMA (1900)

<h3>1. Control from Autopsy 1466: Ganglion semilunare sinistrum.</h3> (From a man 39 years old, dead of chronic interstitial nephritis, arteriosclerosis, fibrous myocarditis and miliary tuberculosis of both lungs, with right-sided fibrinous pleurisy. No disease of the ganglion was suspected.) Formalin hardening and paraffin embedding were used and serial sections stained by various methods. Nerve-cells are present in normal numbers, the cells larger than the average, generally rounded or oval in shape, and they fill up the capsular spaces. In many of the sections there is a distinct group-like arrangement, several cells being closely crowded together. In some of these groups no capsular cells can be made out around the individual members of the group. The nuclei of the cells are as a rule centrally placed. The nucleoli are large and deeply staining; the nucleus itself is often fusiform or spindle-shaped, sometimes round, the alteration in shape being probably due to
Polycystic ovary syndrome.
Authors: J Ginsburg, C W Havard
Journal: BMJ (1976)

<h3>Abstract</h3> The value of novel native broadleaf woodlands for biodiversity conservation is important to consider for adequate forest management in rural landscapes. Passive reforestation has been proposed as a cost-efficient tool for creating networks of novel native forest stands that would help restoring biodiversity and associated ecosystem services. Yet to date the ecological functioning of such stands remains strongly understudied compared to forest remnants resulting from longer-term fragmentation. We assessed how the size and connectivity of newly established Pedunculate oak (<i>Quercus robur</i> L.) stands in rural landscapes of SW France affect rates of herbivory by different insect guilds as well as rates of avian insectivory and the abundance and richness of insectivorous birds. Comparing 18 novel forest stands along a gradient of size (0.04-1.15 ha) and cover of broadleaf forests in the surroundings (0-30% within a 500 radius), we found that even the smallest stands are colonised by leaf miners and chewers/skeletonizers, and that rates of herbivory are globally comparable to those reported from older and larger oak forests. The size of stands had a relatively minor effect on herbivory, whereas it increased the abundance of insectivorous bird. It also determined rates of avian insectivory as estimated by an experiment with plasticine caterpillars. These rates were however rather low and unrelated with the extent of herbivory in the stand. Overall, our study indicates that insect herbivores tend to react more rapidly to the establishment of novel native forests than their avian predators as the latter may depend on the development of larger patches of suitable habitat in the surrounding landscape. To favour a rapid build-up of diverse, and hence stable, trophic networks involving insect herbivores and their predators, woodland creation schemes should therefore primarily focus on habitat size and quality.
729 ROLE OF BMI, AGE AND SEX FOR DISEASE SEVERITY IN ACUTE HEPATITIS C: ANALYSIS OF 254 PATIENTS FROM THE GERMAN HEP-NET ACUTE HCV COHORT
Authors: K. Deterding, J. Wiegand, N. Gruener, D. Becker, M. Cornberg, M.C. Jung, H. Wedemeyer, M.P. Manns
Journal: Journal of Hepatology (2008)
The impact of Epstein-Barr virus status on clinical outcome in diffuse large B-cell lymphoma
Authors: Sarah Park, Jeeyun Lee, Young Hyeh Ko, Arum Han, Hyun Jung Jun, Sang Chul Lee, In Gyu Hwang, Yeon Hee Park, Jin Seok Ahn, Chul Won Jung, Kihyun Kim, Yong Chan Ahn, Won Ki Kang, Keunchil Park, Won Seog Kim
Journal: Blood (2007)
Massive Intravenous Digoxin Overdosage
Authors: Michael J. Reza, Rodney B. Kovick, Kenneth I. Shine, Morton Lee Pearce
Journal: New England Journal of Medicine (1974)

ACCIDENTAL or intentional oral digoxin overdosage occurs in persons with and without underlying heart disease. We recently observed a laboratory technician without prior heart disease who self-adminstered 200 mg of digoxin intravenously. Since physicians rarely order more than 100 0.25-mg tablets of digoxin per prescription, oral ingestion of more than 25 mg would be expected to be rare. Reported digoxin ingestions have not exceeded 23 to 24 mg.1 2 In our patient severe hyperkalemia (potassium level of 13.5 mEq per liter) developed. Inexcitability of cardiac tissue occurred despite adequate control of plasma potassium with hemodialysis and magnesium infusion.Case ReportA . . .
The Platelet in Diabetes
Authors: John A. Colwell, Richard W. Nesto
Journal: Diabetes Care (2003)

Accelerated atherosclerosis and the increased risk of thrombotic vascular events in diabetes may result from dyslipidemia, endothelial dysfunction, platelet hyperreactivity, an impaired fibrinolytic balance, and abnormal blood flow. There is also a correlation between hyperglycemia and cardiovascular (CV) events. The importance of platelets in the atherothrombotic process has led to investigation of using antiplatelet agents to reduce CV risk. A meta-analysis conducted by the Antiplatelet Trialists’ Collaboration demonstrated that aspirin reduced the risk of ischemic vascular events as a secondary prevention strategy in numerous high-risk groups, including patients with diabetes. Based on results from placebo-controlled randomized trials, the American Diabetes Association recommends low-dose enteric-coated aspirin as a primary prevention strategy for people with diabetes at high risk for CV events. Clopidogrel is recommended if aspirin allergy is present. There is occasionally a need for an alternative to aspirin or for additive antiplatelet therapy. Aspirin in low doses inhibits thromboxane production by platelets but has little to no effect on other sites of platelet reactivity. Agents such as ticlopidine and clopidogrel inhibit ADP-induced platelet activation, whereas the platelet glycoprotein (Gp) IIb/IIIa complex receptor antagonists block activity at the fibrinogen binding site on the platelet. These agents appear to be useful in acute coronary syndromes (ACSs) in diabetic and nondiabetic patients. A combination of clopidogrel plus aspirin was more effective than placebo plus standard therapy (including aspirin) in reducing a composite CV outcome in patients with unstable angina and non-ST segment elevation myocardial infarction. In a meta-analysis of six trials in diabetic patients with ACSs, intravenous GpIIb-IIIa inhibitors reduced 30-day mortality when compared with control subjects. Results from controlled prospective clinical trials justify the use of enteric-coated low-dose aspirin (81–325 mg) as a primary or secondary prevention strategy in adult diabetic individuals (aged &amp;gt;30 years) at high risk for CV events. Recent studies support the use of clopidogrel in addition to standard therapy, as well as the use of GpIIb-IIIa inhibitors in ACS patients.
An Evidence-Based Assessment of the NCEP Adult Treatment Panel II Guidelines
Authors: Benjamin J. Ansell
Journal: JAMA (1999)

The Second Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II) was issued without the benefit of multiple recently published large clinical trials.To analyze the panel's guidelines for treatment of high cholesterol levels in the context of currently available clinical trial results.MEDLINE was searched for all English-language clinical trial data from 1993 through February 1999 relating to the effects of cholesterol treatment on cardiovascular clinical outcomes.Studies that were selected for detailed review assessed the effects of cholesterol lowering on either coronary events, coronary mortality, stroke, and/or total mortality, preferably by randomized, double-blind, placebo-controlled design. Selection was by consensus of a general internist, a lipid clinic director, and a researcher in atherosclerotic plaque biology. A core of 37 of the 317 initially screened studies were selected and used as the primary means by which to assess the guidelines.By consensus of the group, only prespecified end points of trials were included, unless post hoc analysis addressed issues not studied elsewhere.Recent clinical trial data mostly support the Adult Treatment Panel II guidelines for cholesterol management. While existing trials have validated the target low-density lipoprotein cholesterol (LDL-C) goals in the report, studies are lacking that address mortality benefit from reduction below these levels. Few lipid-lowering trials have treated patients with low high-density lipoprotein cholesterol and/or elevated triglyceride levels with LDL-C levels at or below treatment goals.Lipid-lowering therapy generally should be more aggressively applied to patients with diabetes and/or at the time of coronary heart disease (CHD) diagnosis. The evidence for statin use in secondary CHD prevention in postmenopausal women outweighs current evidence for use of estrogen replacement in this setting. Further studies are needed to address the effects of lipid modification in primary prevention of CHD in populations other than middle-aged men and to study markers of lipid metabolism other than LDL-C.
Survival impact of cytoreduction to microscopic disease for advanced stage cancer of the uterine corpus: A retrospective cohort study
Authors: Ioannis Alagkiozidis, Allison Grossman, Nancy Z. Tang, Jeremy Weedon, Benjamin Mize, Ghadir Salame, Yi-Chun Lee, Ovadia Abulafia
Journal: International Journal of Surgery (2015)
Effects of pacing-induced ischemia on early left ventricular filling and regional myocardial dynamics and their modification by nifedipine.
Authors: Y Nakamura, S Sasayama, H Nonogi, S Miyazaki, M Fujita, Y Kihara, T Konishi, C Kawai
Journal: Circulation (1987)

The effect of pacing-induced ischemia on early left ventricular filling and regional myocardial lengthening was studied in 11 patients with coronary artery disease (CAD) and six control patients with normal coronary arteriograms. All of the 11 patients with CAD developed typical anginal pain during pacing tachycardia, and in the postpacing beat, the left ventricular end-diastolic pressure (LVEDP) rose from 13 +/- 4 to 26 +/- 4 mm Hg (mean +/- SD, p less than .01), the relaxation time constant increased from 43 +/- 9 to 59 +/- 7 msec (p less than .01), and the ejection fraction diminished from 62.1 +/- 6.7 to 51.6 +/- 10.6% (p less than .01). However, the peak rate of early left ventricular filling (LVPF) obtained from frame-by-frame analysis of left ventriculograms and the LVPF normalized for the stroke volume and for the end-diastolic volume did not change significantly. In the ischemic segment, the peak rate of lengthening (PL) decreased by 45% with ischemia, and the PL normalized for the end-diastolic segment length decreased by 42%. However, the PL normalized for the extent of systolic shortening did not change. In the control segment there was a tendency for these three variables to increase, but the changes were not statistically significant. The time difference from the PL to the LVPF increased significantly in the ischemic segment (31 +/- 28 vs 75 +/- 48 msec, p less than .05). Although the LVEDP rose slightly but significantly from 9 +/- 3 to 12 +/- 5 mm Hg (p less than .05) in the control patients in the postpacing beat, the other global hemodynamic variables and the variables of regional myocardial dynamics did not change. The administration of nifedipine in six patients with CAD resulted in the disappearance or diminution of anginal pain even with the same duration and rate of pacing and was associated with restoration of global systolic function and regional myocardial shortening and lengthening in the ischemic segment. In the control segment, the three variables of segmental lengthening increased with administration of nifedipine. Thus, the segmental myocardial lengthening rate decreased with ischemia due to a decrease in segmental shortening and impairment of myocardial distensibility. The LVPF did not decrease with ischemia despite impairment in isovolumetric relaxation, accentuation of asynchrony in left ventricular filling, and a decrease in the PL in the ischemic segment because of an increase in the PL in the nonischemic segment secondary to an increase in left ventricular filling pressure.(ABSTRACT TRUNCATED AT 400 WORDS)
Transvenous biopsy of carcinoma of bronchus causing superior vena caval obstruction.
Authors: P Armstrong, D F Hayes, P J Richardson
Journal: BMJ (1975)

Combined oestrogen-progesterone oral contraceptives are known to produce neuropsychiatric and abdominal symptoms in acute intermittent porphyria (Zimmerman et al., 1966).This is thought to be due to the induction of 8-aminolaevulate synthetase (British Medical Journal, 1972).The activity of this enzyme is increased in all forms of inherited porphyria, and, though this is probably not the primary biochemical lesion, oestrogens would tend to compound the existing defect.In porphyria variegata oestrogens do not apparently provoke acute attacks, but four cases have been reported in which the "pill" produced cutaneous symptoms associated with liver damage (Eales,
Telomeres and telomerase: A dual role in hepatocarcinogenesis
Authors: Ande Satyanarayana, Michael P. Manns, Lenhard K. Rudolph
Journal: Hepatology (2004)

Telomere shortening limits the proliferative capacity of primary human cells and restrains the regenerative capacity of organ systems during chronic diseases and aging. Telomere shortening apparently has a dual role in tumor development and progression. On the one hand, it induces chromosomal instability and the initiation of cancer; on the other hand, tumor progression requires stabilization of telomeres. The predominant mechanism of telomere stabilization in tumor cells is the activation of the telomere-synthesizing enzyme telomerase. The potential use of telomerase activators for the treatment of regenerative disorders will ultimately depend on their effects on tumorigenesis. This review focuses on the role of telomere shortening and telomerase in carcinogenesis with a special focus on hepatocellular carcinoma. (Hepatology 2004;40:276-283.)
Increased Endogenous Neuropeptide Ligand for Benzodiazepine Receptors in Hepatic Encephalopathy
Authors: Roger F. Butterworth
Journal: Hepatology (1990)

The neuropeptide diazepam binding inhibitor (DBI) is an endogeneous allosteric modulator of gammaaminobutyric acid (GABA) receptors at the benzodiazepine recognition site. Recent theories on the neurochemical cause for hepatic encephalopathy have implicated activation of inhibitory neurotransmitter GABA systems. In 20 patients with hepatic disease, blood and cerebrospinal fluid (CSF) levels of ammonia and amino acids were measured. As in previous studies there was a selective elevation of CSF amino acids as well as a correlation between CSF glutamine levels and encephalopathy. CSF DBI levels were maximally elevated 5–fold in patients with hepatic encephalopathy, but they were normal in those patients with liver disease not associated with changes in mental status and in patients with nonhepatic encephalopathy. Levels of DBI correlated with the clinical staging of hepatic encephalopathy. These data suggest that DBI may participate in the modulation of cerebral function in hepatic encephalopathy.
A Clinical Lecture ON THE TREATMENT OF A CASE OF EXTENSIVE INFANTILE PARALYSIS BY OPERATION AND APPARATUS: Delivered at Guy's Hospital
Authors: R. P. Rowlands
Journal: BMJ (1909)

EXTENSIVE On August 6th, 1894, when the child was only 3 years old, she had a chill, and cried a good deal during the night.In the INFANTIL2E PARAL2YSIS BY O)PERAtTION morning both her legs were found to be completely paralysed.' For two or three days she had retention of urine, relieved by a AND APPARATUS.catheter.There were no other children struck with paralysis 1 at the time, either in the house or neighbourhood.Rubbing DELIVERED AT GuY's HOSPITAL, and electricity were tried at various times without any appre- ciable effect, but time gradually brought a little return of