tbuckley/cabot-search huggingface dataset:
Meckel’s diverticulum diagnosed by double-balloon enteroscopy
Authors: K. Ohnita, H. Isomoto, Y. Mizuta, S. Akazawa, Y. Akazawa, K. Ohba, M. Yoshimura, S. Shikuwa, K. Omagari, F. Fujita, K. Abe, S. Kohno
Journal: Endoscopy (2007)

A 17-year-old boy presented with a 5-day history of melena. His past medical history and his family history were unremarkable. On admission, physical examination revealed pallor and severe hypotension (blood pressure 84/42 mm Hg), but no abdominal signs. Hematologic analysis on admission showed a red blood cell count of 101 × 104/mm3, a hemoglobin level of 2.9 g/dl and a hematocrit of 9.2 %. Upper gastrointestinal endoscopy demonstrated no bleeding; colonoscopy revealed blood clots but no source of bleeding. Angiography, radio-labeled red-cell scintigraphy, and technetium-99 m pertechnetate scintigraphy also failed to detect the source of bleeding.
Meta-analyses I
Authors: P. Sedgwick
Journal: BMJ (2011)

Researchers undertook a meta-analysis of the effectiveness of parenteral corticosteroids for relief of acute severe migraine headache in adults.1 Seven randomised controlled trials were identified in which single dose parenteral dexamethasone, administered alone or in combination with standard abortive therapy, was compared with placebo or any other standard treatment for acute migraine in adults. For each trial, the relative risk for recurrence of headache within 72 hours for the dexamethasone treatment arm compared with the placebo arm was obtained.

The results of the meta-analyses are presented in the figure⇓. When combined with standard abortive therapy, single dose parental dexamethasone was more effective than placebo in reducing recurrence of headache within 72 hours (relative risk 0.74, 95% confidence interval 0.60 to 0.90).



Forest plot of the effectiveness of dexamethasone compared with placebo in preventing the recurrence of acute severe migraine headache in adults



Which of the following …
Chlorpropamide-alcohol flushing and proteinuria in non-insulin-dependent diabetics.
Authors: A H Barnett, R D Leslie, D A Pyke
Journal: BMJ (1981)

persisted in many regions of Slovakia up to the middle of the century, and long-term isolation might have increased the frequency of the hypothetical gene(s) controlling susceptibility to Creutzfeldt-Jakob disease. Cases and investigationsFrom August 1972 to February 1980 four cases of Creutzfeldt-Jakob disease occurred in neighbouring localities, two of them in one village.A review of hospital files in the neighbouring district and adjacent region of Hungary disclosed a further four definite and one probable case that had occurred in the same period.In the eight definite cases the patients had rapidly progressing dementia with severe neurological disturbances and the disease was diagnosed on the basis of light microscopy findings of unequivocal spongiosis, astrocytosis, and neuronal loss (Dr Eva Mitrovd, Research Institute of Preventive Medicine, Bratislava).The ninth patient had a characteristic electroencephalogram but necropsy was performed late and the changes were not entirely diagnostic of Creutzfeldt-Jakob disease.The Slovak patients all came from families that had lived in the area for many generations.Three indices of genetic structure in the population were investigated: the endogamy v exogamy rate, the mean marital distance, and the inbreeding coefficient.The first two indices were examined in five villages, including those where the patients came from, whereas the last was determined only in the village where two patients were discovered.The parish records covered 200-250 years.
Mutations of an E3 ubiquitin ligase c-Cbl but not TET2 mutations are pathogenic in juvenile myelomonocytic leukemia
Authors: Hideki Muramatsu, Hideki Makishima, Anna M. Jankowska, Heather Cazzolli, Christine O'Keefe, Nao Yoshida, Yinyan Xu, Nobuhiro Nishio, Asahito Hama, Hiroshi Yagasaki, Yoshiyuki Takahashi, Koji Kato, Atsushi Manabe, Seiji Kojima, Jaroslaw P. Maciejewski
Journal: Blood (2009)
Acromegaly Treated with Chlorpromazine
Authors: Howard D. Kolodny, Lawrence Sherman, Amarjit Singh, Sooseng Kim, Fred Benjamin
Journal: New England Journal of Medicine (1971)

Short-term therapy with chlorpromazine, medroxyprogesterone acetate and a combination of the two drugs was given to a young man with active acromegaly. Serial levels of serum growth hormone with the patient fasting and during six-hour oral glucose tolerance tests were determined before any treatment, during treatment and between treatment periods. There was a marked decrease in fasting levels by the 12th day of each treatment period. On the 10th day of chlorpromazine therapy the fasting level was still above normal, though decreased from the base-line level. On the 12th and 17th days of this therapy fasting concentrations were near the normal range. The clinical manifestations improved during the course of chlorpromazine therapy. The known pharmacologic effects of chlorpromazine suggest that the site of its action on growth-hormone suppression is the hypothalamus.
Signet ring cell carcinoma of the stomach: correlation between endocytoscopy and histology
Authors: A. Fasoli, V. Pugliese, M. Furnari, B. Gatteschi, M. Truini, E. Meroni
Journal: Endoscopy (2009)

Our experience with endocytoscopy (ECS) in the lower gastrointestinal tract has shown good correlation between ECS and histology in detecting aberrant crypt foci [1] and carcinoid tumor [2]. To our knowledge, ECS imaging of gastric signet ring cell (SRC) carcinoma has not been previously described.
Acute upper airway obstruction due to supraglottic dystonia induced by a neuroleptic.
Authors: H. Newton-John
Journal: BMJ (1988)

Fairfield Hospital, Fairfield, 3078, Victoria, Australia Hugh Newton-John, fracp, consultant physician Acute dystonic reactions to neuroleptic drugs are common. The most easily recognised syndrome is the oculogyric crisis, but many other dystonic symptoms occur, including protrusion of the tongue, trismus, and torticollis.1 We report two cases of acute supra glottic dystonia after treatment with metoclopramide . alone or with prochlorperazine.
Prescribing in pregnancy. Epilepsy and anticonvulsant drugs.
Authors: A Hopkins
Journal: BMJ (1987)

An epileptic seizure is a paroxysmal discharge of cerebral neurones resulting in a clinical event apparent to the subject or an observer, or both. Tonic-clonic (grand mal) seizures are common and most disruptive of fife, but many patients have combinations of complex partial (temporal lobe) seizures and tonic-clonic seizures. Epilepsy, which is best defined as a continuing tendency to epileptic seizures, affects about 0*5% of women of childbearing age.1 Thus family doctors and obstetric units will from time to time have a pregnant woman with epilepsy under their care. A unit delivering 3000 mothers a year will have about 15 pregnant women with epilepsy on their books at any one time. It must be remembered that seizures, particularly if they occur in the third trimester, may be due to eclampsia rather than epilepsy. Although modern antenatal care makes it unlikely that eclamptic seizures will occur without previous evidence of pre-eclampsia, many patients presenting with eclampsia have not attended for antenatal care. Furthermore, eclampsia may appear suddenly, particularly during or after delivery. Epilepsy and oral contraception
Situation Normal: All Fogged Up
Authors: Jonathan R. Arnow
Journal: JAMA (1987)

To  Editor.—  As medical students, we found  Surgeon General's report on  AIDS 1 to be informative and understandable. The report is intended to provide the people of  United States with the necessary understanding of AIDS; however, as written, it is not likely to do so. Using Gunning's 2 Fog Index (a method of determining  readability of instructional materials) on several 100-word passages, we found  report to be at  15th-grade reading level. This is far above  average reading level of adult Americans (generally accepted as ninth grade or below).  Clearly, AIDS is a disease of major concern to  people of  United States; as stated by Dr Koop, public education is vital to  control of its spread. For an educational pamphlet to be truly effective at informing its readers and changing their behavior, it must be read and understood. Therefore, it
Compartment Syndrome Following Robotic-Assisted Prostatectomy
Authors: Rong-Hsin Yang, Yum-Kung Chu, Chia-Wen Huang
Journal: Clinical Nuclear Medicine (2013)

Major urologic surgery performed in the lithotomy position sometimes results in the serious complication of rhabdomyolysis. A 56-year-old man was admitted to the hospital for prostate adenocarcinoma. A whole-body bone scan was performed to exclude bony metastases, which demonstrated no bone lesions but showed intense soft-tissue activity in gluteus maximus muscles, findings suggestive of a myopathy. He had just undergone right nerve-sparing radical prostatectomy in the lithotomy position for 6 hours and presented with swollen bilateral thighs. Elevation of creatine kinase level confirmed muscle injury.
Peter Cowe Robertson
Authors: Gillon C Ferguson
Journal: BMJ (2006)

Former consultant physician Northampton General Hospital (b 1932; q St Andrews 1956; MD, FRCP, FRCP Ed), d 26 January 2006. After house jobs and national service Peter held various posts in Dundee and Edinburgh before obtaining a scholarship to McGill University, Canada, for lung function research. In 1968 he became consultant physician in Northampton, remaining there until retirement. He was the first physician in Northampton to combine general medicine with respiratory disease and set about the integration of the chest department with other hospital sevices. The care of patients with chronic obstructive airway disease was a particular interest, and he was a pioneer of home nebuliser therapy. A superb amateur musician, he participated in local choirs and orchestras, and could play a wide variety of instruments from the church organ to the bagpipes. He never married.
Nearly 1000 babies a day in sub-Saharan Africa are infected with HIV
Authors: J. Zarocostas
Journal: BMJ (2010)

Poor nations, especially those in sub-Saharan Africa with high prevalence of HIV, need to increase efforts to prevent mother to child transmission of the virus, says a report by Unicef.

Anthony Lake, Unicef’s executive director, said, “We need to do more to reach the hardest hit communities. Every day, nearly 1000 babies in sub-Saharan Africa are infected through mother to child transmission.” 

Margaret Chan, director general of the World Health Organization, said, “We have strong evidence that elimination of mother to child transmission is achievable.”

Dr Chan stressed, however, that “achieving this will require better prevention among women and mothers.”

The report shows that …
Ultrastructural features of ichthyosis hystrix strongly resembling Lambert type
Authors: W-H. Wang, L-F. Li, Q. Zhang, S-M. Yang, W. Jiang, Y-Y. Wang, P-C. Lei, X-R. Chen
Journal: British Journal of Dermatology (2007)

Ichthyosis hystrix (IH) is characterized by spiny hyperkeratotic scale, and includes Brocq type, Lambert type, Curth-Macklin type, Rheydt type and Bäfverstedt type. The first documented cases of familial IH were of Lambert type. However, the ultrastructural features of IH Lambert type have not been reported. Three patients in two generations of a family from north China were observed. The patients showed widespread verrucose lesions without blister formation. The face, palms and soles were unaffected. This presentation strongly resembled IH Lambert type. The lesions faded dramatically in summer, without treatment. Light microscopic examinations showed binuclear cells and shell formation in the granular and upper spinous layers in all specimens, with similar findings in winter, when lesions were prominent, and in summer, when lesions had subsided. Electron microscopic examination revealed binuclear keratinocytes and concentric, thin to thick, unbroken shells of tonofilaments surrounding the nuclei, and segregation of cytoplasmic components. This family is the first with familial IH strongly resembling Lambert type to be reported in China. Binuclear cells and tonofilaments shells surrounding the nucleus in upper keratinocytes were characteristic features, which were similar to those reported in IH Curth-Macklin type. The basic histopathological defects were not changed despite significant clinical improvement of the lesion.
Relation between tobacco use and urinary excretion of thromboxane A2 and prostacyclin metabolites in young men.
Authors: A Wennmalm, G Benthin, E F Granström, L Persson, A S Petersson, S Winell
Journal: Circulation (1991)

BACKGROUND Cigarette smoking is a risk factor for cardiovascular disease. The present study addressed the effect of tobacco use on the formation of two eicosanoids, thromboxane A2 and prostacyclin, which have been implicated in both acute and chronic cardiovascular disorders. METHODS AND RESULTS In 577 randomly sampled 18-19-year-old men, the urinary excretion of the 2,3-dinor metabolites of thromboxane A2 and prostacyclin (Tx-M and PGI-M, respectively) was analyzed and related to the subjects' self-reported use of tobacco. Sixty-five percent of the subjects used no tobacco, 7.5% were cigarette smokers, 22% used wet (oral) snuff, and the rest reported a mixed use of tobacco. The urinary excretion of Tx-M was higher (p less than 0.001) in cigarette smokers than in those not using tobacco (180 versus 128 pg/mg creatinine) and was correlated (r = 0.35, p less than 0.05) with the daily cigarette consumption. Snuff users had no increase in their urinary excretion of Tx-M, despite urinary cotinine levels comparable to those in the cigarette smokers (1,210 and 1,560 ng/ml, respectively). The excretion of PGI-M did not differ between non-tobacco users, cigarette smokers, and snuff users. CONCLUSIONS We conclude that cigarette smoking, but not the use of snuff, facilitates the formation of thromboxane A2. We propose that such an increased formation reflects platelet activation in the absence of vascular injury and that it may be of significance for the subsequent development of cardiovascular disease.
Pancreatic Tumor Associated with Flushing and Diarrhea
Authors: John S. Murray, Richard R. Paton, Charles E. Pope
Journal: New England Journal of Medicine (1961)

THE association of noninsulin-producing islet-cell adenomas of the pancreas, profuse diarrhea and hypokalemia with hypokalemic nephropathy has previously been reported. The following patient was successfully treated by removal of a large adenoma.Case ReportC.Q., a 49-year-old baker, first noted the onset of his illness in December, 1943, with the sudden appearance of pronounced flushing of the face and upper trunk and a generalized throbbing headache lasting 15 to 30 minutes and followed by a copious outpouring of watery brown stool. These episodes occurred 5 to 10 times daily. The symptoms subsided in 3 days, but bowel activity remained abnormal. . . .
Cataract Extraction, an Office Operation. Reply to Dr. Kollock's Letter.
Authors: T. E. Murrell
Journal: JAMA (1894)

St. Louis, Mo., Sept. 18, 1894. <h3>To the Editor:</h3> —I do not usually take public notice of such an article as the one by Dr. Kollock, of Charleston, S. C., in theJournalof September 1, condemning the methods of dealing with cataract patients as practiced more or less by Drs. Cheatham, Le Mond, myself and others. I might add,<i>many</i>others; but the wide circulation of ourJournaland the severity of the criticisms calls for a word of defense for myself, as well as for the other gentlemen named, for the quite large number who have not as yet published their experiences with this method and are conscientiously and satisfactorily making use of it. Dr. Kollock openly condemns the procedure without offering any well founded reasons for so doing beyond mere opinion. Such a course as this is not conducive to the advancement of science in any of
Two-dimensional and Doppler echocardiography alone can adequately define preoperative anatomy and hemodynamic status before repair of complete atrioventricular septal defect in infants &lt;1 year old
Authors: Thomas M. Zellers, Robin Zehr, Ellen Weinstein, Steven Leonard, W.Steves Ring, Hisashi Nikaidoh
Journal: Journal of the American College of Cardiology (1994)
AIDS related Kaposi's sarcoma presenting as ulcerative colitis and complicated by toxic megacolon.
Authors: B A Biggs, S M Crowe, C R Lucas, M Ralston, I L Thompson, K J Hardy
Journal: Gut (1987)

Gastrointestinal Kaposi9s sarcoma is a well described and usually asymptomatic manifestation of the acquired immune deficiency syndrome. We report a patient who had extensive colonic Kaposi9s sarcoma and presented with an ulcerative colitis like illness. Total colectomy was subsequently required as an emergency procedure for toxic megacolon. The patient remains well on maintenance interferon therapy 21 months after surgery.
Clinical Dosimetry During the Angiographic Examination
Authors: MARK H. WHOLEY
Journal: Circulation (1974)

Data are given on the radiation exposure occurring in high volume angiographic suites to physicians and technical personnel. Emphasis is directed to coronary artery examinations since multiple recording modalities are utilized in these examinations and consequently personnel exposures are greater than in other angiographic studies. A comparison of dose exposures when these examinations are done via the brachial versus the femoral method and an explanation of the higher doses recorded by the brachial method are discussed. A clear health hazard is identified. In those departments with a large volume of angiographic examinations, a periodic rotation of personnel should be instituted. With the availability of inexpensive dose-rate meters, the directors of cardiovascular laboratories should individually monitor and evaluate exposure to their physicians and the technical personnel involved in their examinations.
Insulin Receptor-Related Receptor as an Extracellular Alkali Sensor
Authors: Igor E. Deyev, Fabien Sohet, Konstantin P. Vassilenko, Oxana V. Serova, Nadezhda V. Popova, Sergey A. Zozulya, Elena B. Burova, Pascal Houillier, Dmitry I. Rzhevsky, Anastasiya A. Berchatova, Arkady N. Murashev, Anton O. Chugunov, Roman G. Efremov, Nikolai N. Nikol'sky, Eugenio Bertelli, Dominique Eladari, Alexander G. Petrenko
Journal: Cell Metabolism (2011)
Trial a New Monoamine Oxidase Inhibitor in Angina Pectoris
Authors: D. Phear, W. C. Walker
Journal: BMJ (1960)

RESPIRATORY INFECTION IN SCHOOLBOYSMNL 995during the day.In almost all cases there was a 12-hour interval during the night when no treatment was given.This dose was regarded as adequate for boys weighing 44-7 st.(28.6-44.5 kg.).A few very big boys weighing 7-9 st.(44.5-57.2kg.), and some with complications, were given 500 mg.q.d.s.Treatment was continued for five days in uncomplicated cases of pharyngitis, and for a week or 10 days in those with complications.The treatment was stopped in two cases (see Table I).Blood for penicillin levels was taken once from each boy during treatment.The intervals between the pre- vious dose of phenethicillin and venepuncture varied from 10 to 310 minutes.The concentration of anti- biotic in the blood was determined by the tube-dilution method, using the Oxford H staphylococcus, and standard solutions of penicillin G and phenethicillin for comparison.The control solutions of penicillin G and phenethicillin gave identical results in every case.TABLE II.-Penicillin Levels in Blood No. ofDoses Interval Case Age Weight of Between Pre-BloodNo. (Years) Phenethicilvious Dose Penicillin lin Before and Bleeding (pg./mi.)
Intracranial Aneurysms and Heredity
Authors: H. B. Eisenstadt
Journal: JAMA (1965)

<h3>To the Editor:—</h3> In the Nov 23, 1964, issue (QUESTIONS AND ANSWERS,<i>JAMA</i><b>190</b>:791), the question of intracranial aneurysms and heredity is discussed by Dr. V. A. McKusick, who came to the conclusion that this lesion has only a very modest tendency to familial aggregation. I would like to report that about 20 years ago I had the opportunity to observe two brothers and one sister who suffered from this lesion. Both brothers were my patients. One died of intracranial disease and the diagnosis was varified by autopsy. The other had a classic picture with subarachnoid hemorrhage followed by unilateral loss of vision, drop of eyelid, and impairment of eye movement. The sister had a similar attack of subarachnoid hemorrhage that was treated elsewhere. All three siblings were in their third decade of life and experienced a rupture of the lesion within a period of two to three years.
Exercise Pulmonary Hypertension in Asymptomatic Degenerative Mitral Regurgitation
Authors: Julien Magne, Patrizio Lancellotti, Luc A. Piérard
Journal: Circulation (2010)

Current guidelines recommend mitral valve surgery for asymptomatic patients with severe degenerative mitral regurgitation and preserved left ventricular systolic function when exercise pulmonary hypertension (PHT) is present. However, the determinants of exercise PHT have not been evaluated. The aim of this study was to identify the echocardiographic predictors of exercise PHT and the impact on symptoms.Comprehensive resting and exercise transthoracic echocardiography was performed in 78 consecutive patients (age, 61+/-13 years; 56% men) with at least moderate degenerative mitral regurgitation (effective regurgitant orifice area =43+/-20 mm(2); regurgitant volume =71+/-27 mL). Exercise PHT was defined as a systolic pulmonary arterial pressure (SPAP) >60 mm Hg. Exercise PHT was present in 46% patients. In multivariable analysis, exercise effective regurgitant orifice was an independent determinant of exercise SPAP (P<0.0001) and exercise PHT (P=0.002). Resting PHT and exercise PHT were associated with markedly reduced 2-year symptom-free survival (36+/-14% versus 59+/-7%, P=0.04; 35+/-8% versus 75+/-7%, P<0.0001). After adjustment, although the impact of resting PHT was no longer significant, exercise PHT was identified as an independent predictor of the occurrence of symptoms (hazard ratio=3.4; P=0.002). Receiver-operating characteristics curves revealed that exercise PHT (SPAP >56 mm Hg) was more accurate than resting PHT (SPAP >36 mm Hg) in predicting the occurrence of symptoms during follow-up (P=0.032).Exercise PHT is frequent in patients with asymptomatic degenerative mitral regurgitation. Exercise mitral regurgitation severity is a strong independent predictor of both exercise SPAP and exercise PHT. Exercise PHT is associated with markedly low 2-year symptom-free survival, emphasizing the use of exercise echocardiography. An exercise SPAP >56 mm Hg accurately predicts the occurrence of symptoms.
Nonpustular Psoriatic Lesions Detected by Tc-99m HMPAO Labeled Granulocytes
Authors: CHAN H. PARK, SUNG M. KIM, JAMES J. ZHANG, JACK McEWAN
Journal: Clinical Nuclear Medicine (1992)

A patient with a fever of unknown origin was evaluated by abdominal SPECT using Tc-99m HMPAO labeled granulocytes and a triple detector camera. Although no abscesses were located, nonpustular psoriatic skin lesions were demonstrated incidentally on the reprojectional images. Psoriatic scales contain a chemotactic factor for leukocytes, and this is a likely explanation for the increased uptake of the radiotracer by psoriatic lesions.