tbuckley/cabot-search huggingface dataset:
Oral, Capsulized, Frozen Fecal Microbiota Transplantation for Relapsing<i>Clostridium difficile</i>Infection
Authors: Ilan Youngster, George H. Russell, Christina Pindar, Tomer Ziv-Baran, Jenny Sauk, Elizabeth L. Hohmann
Journal: JAMA (2014)

Fecal microbiota transplantation (FMT) has been shown to be effective in treating relapsing or refractory Clostridium difficile infection, but practical barriers and safety concerns have prevented its widespread use.To evaluate the safety and rate of resolution of diarrhea following administration of frozen FMT capsules from prescreened unrelated donors to patients with recurrent C. difficile infection.Open-label, single-group, preliminary feasibility study conducted from August 2013 through June 2014 at Massachusetts General Hospital, Boston. Twenty patients (median age, 64.5 years; range, 11-89 years) with at least 3 episodes of mild to moderate C. difficile infection and failure of a 6- to 8-week taper with vancomycin or at least 2 episodes of severe C. difficile infection requiring hospitalization were enrolled.Healthy volunteers were screened as potential donors and FMT capsules were generated and stored at -80°C (-112°F). Patients received 15 capsules on 2 consecutive days and were followed up for symptom resolution and adverse events for up to 6 months.The primary end points were safety, assessed by adverse events of grade 2 or above, and clinical resolution of diarrhea with no relapse at 8 weeks. Secondary end points included improvement in subjective well-being per standardized questionnaires and daily number of bowel movements.No serious adverse events attributed to FMT were observed. Resolution of diarrhea was achieved in 14 patients (70%; 95% CI, 47%-85%) after a single capsule-based FMT. All 6 nonresponders were re-treated; 4 had resolution of diarrhea, resulting in an overall 90% (95% CI, 68%-98%) rate of clinical resolution of diarrhea (18/20). Daily number of bowel movements decreased from a median of 5 (interquartile range [IQR], 3-6) the day prior to administration to 2 (IQR, 1-3) at day 3 (P = .001) and 1 (IQR, 1-2) at 8 weeks (P < .001). Self-ranked health scores improved significantly on a scale of 1 to 10 from a median of 5 (IQR, 5-7) for overall health and 4.5 (IQR, 3-7) for gastrointestinal-specific health on the day prior to FMT to 8 (IQR, 7-9) after FMT administration for both overall and gastrointestinal health (P = .001). Patients needing a second treatment to obtain resolution of diarrhea had lower pretreatment health scores (median, 6.5 [IQR, 5-7.3] vs 5 [IQR, 2.8-5]; P = .02).This preliminary study among patients with relapsing C. difficile infection provides data on adverse events and rates of resolution of diarrhea following administration of FMT using frozen encapsulated inoculum from unrelated donors. Larger studies are needed to confirm these results and to evaluate long-term safety and effectiveness.clinicaltrials.gov Identifier: NCT01914731.
Food Allergy Attitudes and Beliefs among School Nurses in an Urban Public School District
Authors: H.P. Sharma, H. Robinson, S.A. Twichell, L. Hanks, C. Nguyen, E. Garrow, M.L. Acebal
Journal: Journal of Allergy and Clinical Immunology (2012)

Attitudes and beliefs regarding food allergy have been studied among primary care physicians, but not among school nurses. Since these perceptions may influence prevention and management of school-based reactions, we evaluated them among nurses in an urban school district. District of Columbia public school nurses were asked to anonymously complete a 10-item food allergy attitude questionnaire. Responses were tabulated across a 5-point Likert scale, ranging from strongly disagree to strongly agree. Chi-squared tests were used to test associations between nurse characteristics and item responses. A total of 162/196 (83%) eligible nurses completed the questionnaire. Most (94%) felt food allergy is a serious health problem for children. Although 94% agreed schools should have food allergy guidelines, fewer believed that nut-free schools (82%) and allergen-free tables (44%) should be implemented. Agreement with allergen-free tables was significantly associated with prior food allergy education (p=0.01) and a belief that it is hard for food-allergic students to eat at school (p=0.02). Regarding quality of life, 40% felt students with food allergy worry about their condition and only 32% believed students were teased or bullied about their food allergy. Negative perceptions of parents were identified as 55% agreed parents of food-allergic children are overprotective and 15% felt they make unreasonable requests of schools. While most nurses agreed food allergy is a serious problem that schools should address, negative attitudes exist regarding food avoidance policies, impact on affected children, and parents. Food allergy education of school nurses should address not only knowledge, but also these negative perceptions.
Paradoxical Bone Marrow Coronary Embolism Following Cardiopulmonary Resuscitation
Authors: Ching-Shen Lin
Journal: JAMA (1982)

<h3>To the Editor.—</h3> We recently encountered a case of paradoxical embolism that may be of interest to readers ofThe Journal. <h3>Report of a Case.—</h3> A 72-year-old woman was admitted because of upper abdominal pain of two weeks' duration and oliguria of a few days' duration. She was afebrile and normotensive. Both of the patient's lungs were congested, but her heart and abdomen were unremarkable. The laboratory examination disclosed the following values: hemoglobin, 9.5 g/dL; BUN, 86 mg/dL; serum creatinine, 10 mg/dL; and a moderate amount of hematuria and proteinuria. The clinical diagnosis was nephrotic syndrome. Her central venous pressure ranged from 17 to 25 mm H<sub>2</sub>O. On the second hospital day, while she was prepared for hemodialysis, cardiac arrest developed, and she was successfully resuscitated by closed-chest cardiac massage. She died two hours later. An autopsy showed the microscopic form of periarteritis nodosa of viscera with the
Mapping the Human Genome Raises Question: Which Road to Take?
Authors: Beverly Merz
Journal: JAMA (1987)

MOVE OVER, RAND MCNALLY. Molecular biologists are embarking on a cartographic project that is expected to yield the most important map in history. In the last 18 months, both the Department of Energy (DOE) and the National Institutes of Health have undertaken initiatives directed at mapping the human genome. The project is expected to require at least a decade and cost from $100 million to $3 billion. When the proposal to mount an interdisciplinary attack on the genome was suggested in January 1986 by Charles DeLisi, PhD, associate director, health and environmental research, of the DOE's Office of Energy Research, it sent shock waves through the biosciences community. Unlike physical scientists, biologists were unaccustomed to thinking in terms of "big science." However, they seem to have adapted to the idea during the ensuing months. Biologists who once asked "Should we be doing this?" are now inquiring "How should we be
Retinal Arteriolar Narrowing and Risk of Diabetes Mellitus in Middle-aged Persons
Authors: Tien Yin Wong, Ronald Klein, A. Richey Sharrett, Maria I. Schmidt, James S. Pankow, David J. Couper, Barbara E. K. Klein, Larry D. Hubbard, Bruce B. Duncan
Journal: JAMA (2002)

ContextMicrovascular processes have been hypothesized to play a role in the pathogenesis of type 2 diabetes mellitus, but prospective clinical data regarding this hypothesis are unavailable.ObjectiveTo examine the relation of retinal arteriolar narrowing, a marker of microvascular damage from aging, hypertension, and inflammation, to incident diabetes in healthy middle-aged persons.Design, Setting, and ParticipantsThe Atherosclerosis Risk in Communities Study, an ongoing population-based, prospective cohort study in 4 US communities that began in 1987-1989. Included in this analysis were 7993 persons aged 49 to 73 years without diabetes, of whom retinal photographs were taken during the third examination (1993-1995).Main Outcome MeasuresIncident diabetes (defined as fasting glucose levels of ≥126 mg/dL [7.0 mmol/L], casual levels of ≥200 mg/dL [11.1 mmol/L], diabetic medications use, or physician diagnosis of diabetes at the fourth examination) by quartile of retinal arteriole-to-venule ratio (AVR).ResultsAfter a median follow-up of 3.5 years, 291 persons (3.6%) had incident diabetes. The incidence of diabetes was higher in persons with lower AVR at baseline (2.4%, 3.1%, 4.0%, and 5.2%, from highest to lowest AVR quartile; P for trend&lt;.001). After controlling for fasting glucose and insulin levels, family history of diabetes, adiposity, physical activity, blood pressure, and other factors, persons in the lowest quartile of AVR were 71% more likely to develop diabetes than those in the highest quartile (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.13-2.57; P for trend = .002). This association persisted with different diagnostic criteria (OR, 1.92; 95% CI, 1.10-3.36; P for trend = .01, using a fasting glucose level of ≥141 mg/dL [7.8 mmol/L] as a cutoff), and was seen even in people at lower risk of diabetes, including those without a family history of diabetes, without impaired fasting glucose, and with lower measures of adiposity.ConclusionsRetinal arteriolar narrowing is independently associated with risk of diabetes, supporting a microvascular role in the development of clinical diabetes.
France could soon have draft law on assisted suicide for terminally ill people
Authors: N. Stafford
Journal: BMJ (2012)

<h3>Objective</h3> To investigate whether the health implications of having type 2 diabetes (T2D) were different in South Asian compared with white European participants. <h3>Research design and methods</h3> Prospective data from UK Biobank were used, and 457 935 participants of white European and 7102 of South Asian background were included. Cox proportional regression was performed to investigate the association between T2D and health outcome by ethnicity. <h3>Results</h3> Over a mean of 7.0 years (IQR 6.3–7.6) of follow-up, 12 974 participants had died, and 30 347 and 27 159 developed cardiovascular disease (CVD) and cancer, respectively. South Asians had a higher risk for CVD mortality (HR: 1.42, 95% CI 1.07 to 1.89) and incidence (HR: 1.78, 95% CI 1.63 to 1.94), but a decreased risk for cancer mortality (HR: 0.59, 95% CI 0.41 to 0.85) and incidence (HR: 0.80, 95% CI 0.70 to 0.92) compared with white Europeans. Compared with individuals without T2D, both white Europeans and South Asians with T2D had a higher risk for all-cause mortality (1.59 (1.48 to 1.71) vs 2.83 (1.76 to 4.53)), CVD mortality (2.04 (1.82 to 2.28) vs 4.40 (2.37 to 8.16)) and CVD incidence (1.37 (1.31 to 1.44) vs 1.60 (1.31 to 1.95)), respectively. However, the magnitude of the risk was higher for South Asians than white Europeans. <h3>Conclusions</h3> Although T2D was associated with a higher risk for all-cause mortality and CVD incidence and mortality, in both white Europeans and South Asians, the risk experienced by South Asians with T2D was higher than their white European counterparts.
THE APPLICATION OF FASCIA LATA IN PLASTIC SURGERY
Authors: C. H. Cuff, B.S. Dunelm
Journal: BMJ (1922)

MT 599 cases treated by intramuscular injection four relapses are recorded.In no case did any local trouble occur as a result of intramuscular injection.General Remtarks.In concluding this report I would draw attention to the connexion between tile malaria incidence and the deatlh rate.-Our death rate is more than twice as great as that of England and Wales; and while deaths recorded as directly due to malaria provide only 21 per cent. of tlle total, yet due weiglht should be attaclhed to the probability tllat malaria, on account of its effect in lowering the resisting power of the body to other infections, is a contributing factor to many more deaths than those of which it is the direct or recorded factor, and tllat, further, there are strong indications that malaria sequelae are responsible for many deatlhs which are recorded as due to other causes.In v;ew of these facts it cannot be too strongly represented tllat vigorous-antimalaria Imeasures shlould be instituted -throughout the island witlh a view to (a) loweringo our excessively high death rate and (b) improving the quality and quantity of our labour Supply.
Herpes Zoster During Gold Therapy
Authors: ADEL G. FAM
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 May 1981Herpes Zoster During Gold TherapyADEL G. FAM, M.D., THOMAS W. PATON, PHARM. D., DONALD H. COWAN, M.D.ADEL G. FAM, M.D.Search for more papers by this author, THOMAS W. PATON, PHARM. D.Search for more papers by this author, DONALD H. COWAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-5-712 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Studies describing the various cutaneous reactions associated with gold therapy for rheumatoid arthritis have not included herpes zoster (1). Known precipitants of zoster include lymphomas, other malignancies, immunosuppressive therapy, and heavy metal poisoning or therapy (2-5). We have observed an unusually high prevalence of herpes zoster in patients with rheumatoid arthritis treated with gold salts.The records of 159 patients (110 women and 49 men) with rheumatoid arthritis who were receiving gold sodium thiomalate while hospitalized at the rheumatic disease unit during 4 years (1975 to 1978) were reviewed. A relation between chrysotherapy and zoster was suggested...References1. PENNEYSACKERMANGOTTLIEB NAN. Gold dermatitis: a clinical and histopathological study. Arch Dermatol. 1974;109:372-6. CrossrefMedlineGoogle Scholar2. HOPE-SIMPSON R. The nature of herpes zoster: a long-term study and a new hypothesis. Proc Roy Soc Med. 1965;58:9-20. CrossrefMedlineGoogle Scholar3. OXMAN M. Varicella and herpes zoster. In: FITZPATRICK TB, EISEN AZ, eds. Dermatology in General Medicine. 2nd ed. New York: McGraw-Hill Book Co. ; 1979:1600-16. Google Scholar4. MAZURDOLIN MR. Herpes zoster at the NIH: a 20-year experience. Am J Med. 1978;65:738-44. CrossrefMedlineGoogle Scholar5. WRIGHTWINER EL. Herpes zoster and malignancy. Arch Dermatol. 1961;84:242-4. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Toronto; Toronto, Ontario Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAnalgesics, Narcotic Antagonists, and Drugs Used to Treat ArthritisDrug-induced ocular side effectsDrug-induced ocular side effectsThe risk of herpes zoster in patients with rheumatoid arthritis in the United States and the United KingdomAuranofin: A unique oral chrysotherapeutic agentMetals 1 May 1981Volume 94, Issue 5Page: 712-713KeywordsHeavy metalsImmunosuppressivesLymphomaRheumatoid arthritisSaltsSodium Issue Published: 1 May 1981 PDF downloadLoading ...
Snow in Chicago
Authors: G. Dunea
Journal: BMJ (1999)

Twenty one inches of snow came down on Chicago in one day in the first week of January, in what was the third worst snowstorm of the century. For a few hours the city ground to a halt, its roads impassable, visibility reduced to a few feet.

Then out came the snowploughs, for this is a city that once voted a mayor out of office for failing to clear the snow promptly, and soon the main highways …
Kaposi Sarcoma of the Conjunctiva-Reply
Authors: Scott M. Whitcup
Journal: JAMA (1996)

In Reply.  —I agree with Drs Flowers and Baker that conjunctival manifestations were omitted from the Table listing the ocular manifestations of AIDS. I also agree that a list of the conjunctival manifestations of AIDS should include Kaposi sarcoma, microvasculopathy, and microsporidial conjunctivitis. In keeping with the format of the Table, each of these conditions occurs in fewer than 5% of patients with AIDS. A nonspecific, mild, and transient conjunctivitis can be included on the list of the ophthalmologic findings in AIDS. However, I would add that many cases of conjunctivitis in patients with human immunodeficiency virus (HIV) infection are related to an underlying infection.Molluscum contagiosumcan cause a viral conjunctivitis, occasionally with conjunctival nodules,1and herpesvirus infection is also associated with conjunctivitis.2Finally, dry eye has been reported in as many as 21% of HIV-infected patients3and is often associated with transient conjunctivitis.
RECENT EXPERIENCE IN THE TREATMENT OF EXOPHTHALMIC GOITRE.Read at the Meeting of the New York State Medical Association, October 23, 1890.
Authors: E. D. FERGUSON
Journal: JAMA (1890)

Exophthalmic goitre is not a common disease, md yet not so rare as to render it a curiosity. Doubtless the large majority of physicians have bad more or less experience in its treatment. If that experience has corresponded with my own, it would have been marked until a recent time by eminently unsatisfactory results, at least in the majority of cases. It is true that occasionally cases would be met which did not make rapid progress downward—cases in which the disease would remain stationary, or even an improvement take place—but until about two years ago it had been the conviction of the writer that but little encouragement could be given the victims of this disease, while the idea of a cure could rarely be entertained. The variety of treatment suggested and the contradictory statements of those treating on its therapeutics justified the conclusion that either the medication was eminently unsatisfactory
Anemia following human parvovirus B19 infection in a patient with polycythemia vera
Authors: Kürşad Kaptan, Cengiz Beyan, Türker Çetin, Ali Uĝur Ural, Celalettin Üstün, Ferit Avcu, Oral Nevruz, Çakir Güney, Ayhan Kubar
Journal: American Journal of Hematology (2002)

Fig. 1.Clinical course of this patient with AATP.Each arrow denotes a transfusion
Requirement of argininosuccinate lyase for systemic nitric oxide production
Authors: Ayelet Erez, Sandesh C S Nagamani, Oleg A Shchelochkov, Muralidhar H Premkumar, Philippe M Campeau, Yuqing Chen, Harsha K Garg, Li Li, Asad Mian, Terry K Bertin, Jennifer O Black, Heng Zeng, Yaoping Tang, Anilkumar K Reddy, Marshall Summar, William E O'Brien, David G Harrison, William E Mitch, Juan C Marini, Judy L Aschner, Nathan S Bryan, Brendan Lee
Journal: Nature Medicine (2011)
Shark Oil and Medicine
Authors: C. A. Villee
Journal: New England Journal of Medicine (1970)

The report by Gallin and his colleagues elsewhere in this issue represents a new twist in the long standing relation of shark-liver oil and the practice of medicine. Shark-liver oil was a highly regarded component of several nostrums popular in the previous century that fell into disrepute with the advent of the germ theory of disease. One component of shark-liver oil is squalene, a 30-carbon polyunsaturated hydrocarbon, which was shown to be the immediate precursor of lanosterol and indirectly the precursor of cholesterol in both yeast and in rat liver. D. S. Goodman1 found squalene to be a minor but . . .
A patient with rectal discharge and fever
Authors: K. Atkinson, D. M. Bradshaw, N. Nwokolo
Journal: BMJ (2011)

A 50 year old man presented to a sexual health clinic with a three week history of fever, rectal discharge, pain, and bleeding. He did not have diarrhoea, constipation, urethral symptoms, or urinary symptoms.

He had no medical or family history of note and was taking no drugs, including recent antibiotics. He lived in an inner city area and had no history of recent travel. He was immune to hepatitis B.

Four weeks previously he had had unprotected insertive and receptive anal sex with a regular and a casual male partner on the same occasion. He had had no other sexual contacts in the previous six months.

Examination showed inflammation of the perianal skin and proctoscopy showed inflamed mucosa, discharge, and contact bleeding. Digital rectal examination was unremarkable, as was examination of the genitals, abdomen, and pharynx. He did not have lymphadenopathy.

A full sexual health screen was performed, taking samples from the urethra, rectum, and pharynx for Chlamydia trachomatis and Neisseria gonorrhoeae and blood samples for HIV, syphilis, and hepatitis B and C serology. A point of care test for HIV antibodies was negative. Microscopy of a Gram stained sample of rectal discharge showed 0-5 polymorphonuclear leucocytes per high power field; microscopy of urethral discharge was unremarkable.



### 1 What is the differential diagnosis for a patient presenting with this history and these findings?

#### Short answer

Lymphogranuloma venereum is the most likely diagnosis. Differential diagnoses include infection with the non-lymphogranuloma venereum biovar of C trachomatis , herpes simplex, and enteric pathogens in addition to gonorrhoea and inflammatory bowel disease.

#### Long answer

A diagnosis of lymphogranuloma venereum should be considered in all men presenting with rectal …
Case of Paracentesis Thoracis; with Remarks
Authors: D. M. Williams
Journal: BMJ (1874)

satisfactory w,vhich come under the notice of the practitioner.In spite of the mo.st skilftul treatmelnt, a large proportioni of themi-prove fatal.This case is no exception ; but failures are ofteni more instructive thani successes, anid there are somiie points in the history of this which make it worth adding to the genieral stock of professional experienlce.
Judge misled over call for caesarean operation
Authors: C. Dyer
Journal: BMJ (1998)

Lawyers acting for an NHS trust seeking authorisation to perform a forced caesarean operation misled the High Court judge, three appeal court judges were told last week.

A 30 year old single mother, named as Ms S, claims that two trusts, Pathfinder Mental Health Services NHS Trust and St George's NHS Trust, acted unlawfully in sectioning and detaining her under the Mental Health Act and carrying out the operation. Judgment was reserved to a later date.

Richard Gordon QC, for the woman, said that her detention was defective because she had not been properly diagnosed as suffering from mental disorder, as …