tbuckley/cabot-search huggingface dataset:
Paralysis after Herpes Zoster
Authors: G. E. Beaumont
Journal: BMJ (1967)

injections of Primolut Depot (17-alpha-hexanoyl- preg-4-ene 3:20-dione), 250 mg.intramuscularly once weekly.She was Rh-positive, group A.On admission her haemoglobin estimation, total, and differential white-cell counts were within normal limits.On 14 October repeat blood count showed her total W.B.C. to be 11,100 cu.mm., of which 14% were eosinophils.From 10 to 24 September she was given A.C.T.H. injections daily, but she declined treatment by corticosteroid drugs.The rash at this stage was "less troublesome"-possibly under the influence of A.C.T.H. Weekly Primolut Depot injections were continued until she left the ward on 21 October.This preg- nancy terminated at seven and a half months with a stillbirth, and on 21 July 1964 pregnancy number five was diagnosed.At that time she complained of itching feet and spots on the arms.This pregnancy also terminated spon- taneously at about 12 weeks.She was next seen here on 11 December 1964 with a three-month history of recurrence of rash, which commenced soon after she began taking Ovulen (ethynodiol acetate 1 mg.-and mestranol 0.1 mg.).The Ovulen was stopped, and one week later the rash was fading.On 30 March she recommenced taking Ovulen, and on 17 April she developed a mild itchy eruption scattered over the trunk and limbs.She resumed her course of "pills" on 26 April, and by 13 May she had an extensive eruption on the trunk and limbs, especially over the
HCC in 2010; are we offering appropriate therapy?
Authors: J. Short, E. Blackwell, M. James
Journal: Gut (2011)

<h3>Introduction</h3> Hepatocellular carcinoma (HCC) cases are increasing in UK, related to rising prevalence of chronic liver disease and immigration from areas endemic for viral hepatitis. Treatment options for HCC include local ablative therapy (eg, RFA), transarterial chemoembolisation (TACE), surgical resection, liver transplantation and oral multikinase inhibitors in compassionate use or clinical trials. Barcelona Clinic for Liver Cancer (BCLC) staging includes disease volume, hepatic synthetic function and performance status. The authors examined whether patients received appropriate treatment according to BCLC stage.12 <h3>Methods</h3> All cases of HCC managed during 2009 were identified from the Mid-Trent Hepatobiliary Cancer MDT registry and from radiology, pathology and liver resection databases. Patient demographics, disease aetiology, Child-Pugh score, mode of HCC diagnosis and BCLC stage were determined. <h3>Results</h3> 41 HCC cases were identified during 2009. 33 were males (80%) and median (range) age was 69 (21–92) years. 20 (49%) patients had underlying alcoholic liver disease, 6 (15%) NASH cirrhosis, 5 (12%) HBV and 2 (5%) HCV infection. 8 (20%) had either no known underlying liver disease or cryptogenic cirrhosis. Child-Pugh classification A/B/C was found in 29/9/3 patients. HCC surveillance using ultrasound scanning (USS) and/or AFP estimation identified 13 (32%) cases. Definitive HCC diagnosis was by CT or MR imaging in 24 (59%) and CT/MR imaging and biopsy in 17 (41%). Median (range) AFP at diagnosis was 21 (1–100 000) ng/ml. Median (range) time from diagnosis to MDT assessment was 2 (1–26) weeks and from MDT to first treatment 4 (1–26) weeks. BCLC stage (and treatment) was 0; very early stage, n=1 (1 RFA), A; early stage, n=11 (3 resection/3 RFA/4 TACE/1 symptomatic), B; intermediate stage, n=22 (1 resection/2 RFA/14 TACE/5 symptomatic), C; advanced stage, n=4 (1 RFA/1 TACE/2 symptomatic), D; terminal stage, n=3 (3 symptomatic). 35 (85.4%) patients were treated according to BCLC recommendations. 18 (44%) patients remain alive after median (range) follow-up of 11 (1–36) months. <h3>Conclusion</h3> Over 85% of patients identified with HCC were managed according to BCLC recommendations. However, most cases (68%) were identified outside of screening programmes and over 70% were intermediate or higher BCLC stages. Detection at earlier stages with targeted surveillance may improve outcomes, although 20% had no known underlying liver disease. Therapeutic trials are required to investigate more effective therapies in those with advanced disease.
Diagnostic Requirements And Therapeutic Decisions In Pulmonary Embolism
Authors: E. James Potchen
Journal: JAMA (1967)

<h3>To the Editor:—</h3> One of the most important clinical problems in pulmonary embolic disease is to decide upon the minimal diagnostic criteria for the institution of therapy. In view of the current array of newer diagnostic methods, it becomes important for the clinician to select judiciously, those studies which are most likely to help. It is unrealistic to insist that every patient with suspected pulmonary embolic disease be studied in the same manner. In all patients, however, an awareness of the possibility together with a good history and physical examination are the best aids to diagnosis; in some patients these will be sufficient. A suggested approach to the problem of adequate diagnostic studies and when to start therapy is as follows: Minor Symptoms: Patients with minor symptoms and signs suggestive of pulmonary embolism commonly complain of transient or mild dyspnea and occasionally of pleural pain. They may have minimal
Visions of anaesthesia hell
Authors: P. Hambly
Journal: BMJ (1996)

<h3>Abstract</h3> The ribosome CAR interaction surface behaves like an extension of the decoding center A site and has H-bond interactions with the +1 codon that is next in line to enter the A site. Through molecular dynamics simulations, we investigated the codon sequence specificity of this CAR-mRNA interaction and discovered a strong preference for GCN codons, suggesting that there may be a sequence-dependent layer of translational regulation dependent on the CAR interaction surface. Dissection of the CAR-mRNA interaction through nucleotide substitution experiments showed that the first nucleotide of the +1 codon dominates over the second nucleotide position, consistent with an energetically favorable zipper-like activity that emanates from the A site through the CAR-mRNA interface. The +1 codon/CAR interaction is also affected by the identity of nucleotide 3 of +1 GCN codons which influences the stacking of G and C. Clustering analysis suggests that the A site decoding center adopts different neighborhood substates that depend on the identity of the +1 codon.
The effect of stromelysin-1 (MMP-3) on non-collagenous extracellular matrix proteins of demineralized dentin and the adhesive properties of restorative resins
Authors: T. Boukpessi, S. Menashi, L. Camoin, J.M. TenCate, M. Goldberg, C. Chaussain-Miller
Journal: Biomaterials (2008)
Endomyocardial disease and eosinophilia. Report of a case.
Authors: B E Jaski, E J Goetzl, J W Said, M C Fishbein
Journal: Circulation (1978)

While an association between blood eosinophilia and endomyocardial disease has been recognized, the role of the eosinophil in the pathogenesis of the cardiac lesions remains uncertain. In a 69-year-old-man with large cell carcinoma of the lung, marked eosinophilia was stimulated by and progressed with the course of the neoplasm which was producing an eosinophil chemotactic factor. Peripheral blood eosinophils were vacuolated and degranulated while those in the bone marrow were morphologically normal. Clinical evidence of cardiac dysfunction developed one month prior to death. At autopsy, 12 months after the onset of symptoms, endomyocardial disease was present. There were numerous eosinophils in the damaged myocardium and surrounding the pulmonary neoplasm. In patients with endomyocardial disease and eosinophilia, the eosinophil may be directly cardiotoxic or a primary mediator of cardiac damage; therapeutic attempts to reduce the number of eosinophils might be benefit.
Was GP's suspension a miscarriage of justice?
Authors: R. L. Miller
Journal: BMJ (2014)

A feature of British justice is judgment by peers, but no information is given in the case of Dr Arun Singhal about what experience, if any, tribunal members had of working in deprived inner city general practice.1

Patient A, “not wholly credible as a witness,” consulted Dr Singhal with a non-medical problem. She wished to be excused witness duty in court and became angry when …
Congenital Heart Disease After Surgery: Benefits, Residua, Sequelae
Authors: Alexander J. Muster
Journal: JAMA (1984)

This book presents a variety of topics by many experts in areas related to treatment of congenital cardiac defects. The introductory chapter by Dr Helen B. Taussig is sure to captivate the attention of the reader. It presents the author's concept that common cardiac malformations are primeval hearts that developed from more primitive cardiovascular systems during evolution of mammalia as variants of the "normal" heart with four chambers and two great arteries. These variants remain in the genetic pool encoded on the DNA acid of most mammalia. This fascinating discourse distinguishes malformations that are encoded as purely vascular (simple transposition), cardiac (tetralogy of Fallot), or cardiovascular. Dr Taussig presents a great amount of supporting human and animal data and seems to have succeeded in discrediting the popular concept of multifactorial inheritance. The University of Minnesota experience with follow-up of 1,000 consecutive patients contains valuable statistics. Another chapter discusses employability, insurability,
PREDICTORS OF SIGNIFICANT PARAVALVULAR REGURGITATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION: RESULTS FROM THE PROSPECTIVE MULTICENTER GERMAN AORTIC VALVE REGISTRY
Authors: Mohammad A. Sherif, Mohamed Abdel-Wahab, Volker Geist, Ralph Toelg, Jochen Senges, Steffen Schneider, Gert Richardt
Journal: Journal of the American College of Cardiology (2010)
Hematopoietic Stem Cell Regeneration Enhanced by Ectopic Expression of ROS-detoxifying Enzymes in Transplant Mice
Authors: Weimin Miao, Richard XuFeng, Moo-Rim Park, Haihui Gu, Linping Hu, Jin Wook Kang, Shihui Ma, Paulina H Liang, Yanxin Li, Haizi Cheng, Hui Yu, Michael Epperly, Joel Greenberger, Tao Cheng
Journal: Molecular Therapy (2013)

High levels of reactive oxygen species (ROS) can exhaust hematopoietic stem cells (HSCs). Thus, maintaining a low state of redox in HSCs by modulating ROS-detoxifying enzymes may augment the regeneration potential of HSCs. Our results show that basal expression of manganese superoxide dismutase (MnSOD) and catalase were at low levels in long-term and short-term repopulating HSCs, and administration of a MnSOD plasmid and lipofectin complex (MnSOD-PL) conferred radiation protection on irradiated recipient mice. To assess the intrinsic role of elevated MnSOD or catalase in HSCs and hematopoietic progenitor cells, the MnSOD or catalase gene was overexpressed in mouse hematopoietic cells via retroviral transduction. The impact of MnSOD and catalase on hematopoietic progenitor cells was mild, as measured by colony-forming units (CFUs). However, overexpressed catalase had a significant beneficial effect on long-term engraftment of transplanted HSCs, and this effect was further enhanced after an insult of low-dose γ-irradiation in the transplant mice. In contrast, overexpressed MnSOD exhibited an insignificant effect on long-term engraftment of transplanted HSCs, but had a significant beneficial effect after an insult of sublethal irradiation. Taken together, these results demonstrate that HSC function can be enhanced by ectopic expression of ROS-detoxifying enzymes, especially after radiation exposure in vivo. High levels of reactive oxygen species (ROS) can exhaust hematopoietic stem cells (HSCs). Thus, maintaining a low state of redox in HSCs by modulating ROS-detoxifying enzymes may augment the regeneration potential of HSCs. Our results show that basal expression of manganese superoxide dismutase (MnSOD) and catalase were at low levels in long-term and short-term repopulating HSCs, and administration of a MnSOD plasmid and lipofectin complex (MnSOD-PL) conferred radiation protection on irradiated recipient mice. To assess the intrinsic role of elevated MnSOD or catalase in HSCs and hematopoietic progenitor cells, the MnSOD or catalase gene was overexpressed in mouse hematopoietic cells via retroviral transduction. The impact of MnSOD and catalase on hematopoietic progenitor cells was mild, as measured by colony-forming units (CFUs). However, overexpressed catalase had a significant beneficial effect on long-term engraftment of transplanted HSCs, and this effect was further enhanced after an insult of low-dose γ-irradiation in the transplant mice. In contrast, overexpressed MnSOD exhibited an insignificant effect on long-term engraftment of transplanted HSCs, but had a significant beneficial effect after an insult of sublethal irradiation. Taken together, these results demonstrate that HSC function can be enhanced by ectopic expression of ROS-detoxifying enzymes, especially after radiation exposure in vivo.
Deletion of either CD55 or CD97 ameliorates arthritis
Authors: R. M. Hoek, D. de Launay, E. N. Kop, A. S. Yilmaz-Elis, O. Karpus, F. Lin, K. A. Reedquist, J. S. Verbeek, M. E. Medof, P. P. Tak, J. Hamann
Journal: Annals of the Rheumatic Diseases (2010)

CD55 (decay accelerating factor) is best known for its role in the negative regulation of the complement system. Indeed, lack of this molecule leads to disease aggravation in many inflammatory disease models. However, CD55 is abundantly present on fibroblast-like …
Ultrasonic Demonstration In Utero of an Intracranial Teratoma
Authors: Michael Crade
Journal: JAMA (1982)

ALTHOUGH most fetal head enlargement is secondary to hydrocephalus, other etiologies, including tumor growth, must be considered. Technological improvements in ultrasound imaging have led to a greater definition of fetal pathological conditions and, as is shown by this article, allow a detailed study of such abnormalities. <h3>Report of a Case</h3> A 30-year-old woman, pregnant for the first time, underwent an ultrasonic examination demonstrating a 16-week fetus with normally displayed anatomy. This included multiple images of the intracranial structures. A repeated study was done near term to evaluate for placenta previa. At this time, an abnormal fetal head was demonstrated (Figure). An estimated cranial diameter of 10.5 cm was measured. The normal anatomic characteristics were replaced by bizarre cystic and echogenic regions filling the cranial vault. Fetal movements, although limited, were recorded in an otherwise normal-appearing term fetus. A cesarean section birth was performed the next day. The infant, weighing 4,800
Positron Emission Tomography/Computed Tomography Fusion Imaging in Brown Adipose Tissue
Authors: Anthony J. Minotti, Lubdha Shah, Kimberly Keller
Journal: Clinical Nuclear Medicine (2004)

Fluorine-18 fluoro deoxyglucose positron emission tomography (F-18 FDG PET) imaging is an exciting modality for the study of pathophysiology. The fusion of computed tomography (CT) anatomic data to metabolic F-18 FDG PET data allows accurate mapping of the metabolic activity of the body. With each patient evaluated with fusion PET/CT imaging, valuable information is obtained regarding anatomic and physiological abnormalities and normal variants. We describe 4 cases in which the unusual distribution of increased FDG metabolism localized to fat, which we propose represents brown adipose tissue. The accurate anatomic localization of this hypermetabolic fat is aided by imaging these patients on a combined PET/CT system.
Long-Term Follow-up of Foamy Viral Vector-Mediated Gene Therapy for Canine Leukocyte Adhesion Deficiency
Authors: Thomas R Bauer, Laura M Tuschong, Katherine R Calvo, Heather R Shive, Tanya H Burkholder, Eleanor K Karlsson, Robert R West, David W Russell, Dennis D Hickstein
Journal: Molecular Therapy (2013)

The development of leukemia following gammaretroviral vector-mediated gene therapy for X-linked severe combined immunodeficiency disease and chronic granulomatous disease (CGD) has emphasized the need for long-term follow-up in animals treated with hematopoietic stem cell gene therapy. In this study, we report the long-term follow-up (4–7 years) of four dogs with canine leukocyte adhesion deficiency (CLAD) treated with foamy viral (FV) vector-mediated gene therapy. All four CLAD dogs previously received nonmyeloablative conditioning with 200 cGy total body irradiation followed by infusion of autologous, CD34+ hematopoietic stem cells transduced by a FV vector expressing canine CD18 from an internal Murine Stem Cell Virus (MSCV) promoter. CD18+ leukocyte levels were >2% following infusion of vector-transduced cells leading to ongoing reversal of the CLAD phenotype for >4 years. There was no clinical development of lymphoid or myeloid leukemia in any of the four dogs and integration site analysis did not reveal insertional oncogenesis. These results showing disease correction/amelioration of disease in CLAD without significant adverse events provide support for the use of a FV vector to treat children with leukocyte adhesion deficiency type 1 (LAD-1) in a human gene therapy clinical trial. The development of leukemia following gammaretroviral vector-mediated gene therapy for X-linked severe combined immunodeficiency disease and chronic granulomatous disease (CGD) has emphasized the need for long-term follow-up in animals treated with hematopoietic stem cell gene therapy. In this study, we report the long-term follow-up (4–7 years) of four dogs with canine leukocyte adhesion deficiency (CLAD) treated with foamy viral (FV) vector-mediated gene therapy. All four CLAD dogs previously received nonmyeloablative conditioning with 200 cGy total body irradiation followed by infusion of autologous, CD34+ hematopoietic stem cells transduced by a FV vector expressing canine CD18 from an internal Murine Stem Cell Virus (MSCV) promoter. CD18+ leukocyte levels were >2% following infusion of vector-transduced cells leading to ongoing reversal of the CLAD phenotype for >4 years. There was no clinical development of lymphoid or myeloid leukemia in any of the four dogs and integration site analysis did not reveal insertional oncogenesis. These results showing disease correction/amelioration of disease in CLAD without significant adverse events provide support for the use of a FV vector to treat children with leukocyte adhesion deficiency type 1 (LAD-1) in a human gene therapy clinical trial.
Publish all trial results within a year or face disciplinary action, BMA says
Authors: H. Jaques
Journal: BMJ (2013)

The BMA has backed mandatory publication of all clinical trial results, irrespective of whether they are positive or negative, and disciplinary action for doctors who elect not to publish data.

Representatives at the association’s annual meeting in Edinburgh this week passed a motion insisting that all trials relating to drugs and other therapeutic interventions be registered and their results made available within one year of completion.

Selective non-publication of “unflattering” trial data represented research misconduct and merited referral of the doctors involved to the General Medical Council, doctors agreed. …
&lt;emph type="ital"&gt;The Lighthouse at Two Lights&lt;/emph&gt;
Authors: M. Therese Southgate
Journal: JAMA (2008)

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A QPCR-Based Circulating Tumor Cell Detection Platform Predicts Survival in 776 Early Stage Breast Cancer Patients.
Authors: T. Molloy, A. Bosma, L. Baumbusch, E. Borgen, L. van't Veer, B. Naume
Journal: Cancer Research (2009)

Abstract The detection of circulating tumor cells (CTCs) in the blood of cancer patients is a promising tool for risk stratification, treatment tailoring, and monitoring of the disease state. We previously developed a QPCR-based platform for the detection of CTCs in peripheral blood, which proved to be prognostic in a cohort of metastatic breast cancer patients.In the current study, we aimed to build on this work by determining the prognostic value of our CTC assay in an independent, prospectively collected, retrospective patient series of 776 non-metastatic, stage I-III breast cancer patients (median follow-up 7.3 years). Assay positivity was observed in 83 patients (10.7%), while maintaining 96% specificity in a group of 25 healthy female controls (however a second blood sample from the healthy control that gave a positive result was found to be negative). CTC positivity as determined by our assay corresponded to a significantly poorer relapse-free survival (RFS) (HR = 1.9, 95% CI = 1.3-2.9, p = 0.02) and overall survival (HR = 1.8, 95% CI = 1.1-2.8, p = 0.02) in this group. This platform demonstrated similar prognostic power to the pan-anticytokeratin (AE1/AE3) immunohistochemistry-based detection of disseminated tumor cells (DTCs) in the bone marrow of these patients (RFS HR = 1.9, 95% CI = 1.3-2.7, p = 0.02). Importantly, multivariate analyses including tumor size, histological grade, lymph node status, and hormone receptor status, both CTC and DTC status remained significant, independent predictors of RFS (CTC status HR = 1.6, 95% CI = 1.0-2.6, p = 0.037; DTC status HR = 1.6; 95% CI = 1.1-2.5, p = 0.023). However, CTC status was prognostic in both lymph node negative patients (HR = 2.0, p = 0.04) and lymph node positive patients (HR = 1.7, p = 0.043), whereas DTC status was only prognostic in lymph node positive patients (HR = 2.0, p = 0.002).This CTC detection platform represents an objective assay with both high specificity and prognostic power, and could be an effective clinical tool for outcome prediction in breast cancer patients.This work was supported by the Sixth Framework Program of the European Commission as part of the international DISMAL collaboration for research into disseminated epithelial malignancies. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3002.
Quantitative assessment of after thrombolysis in acute myocardial infarction: Results of a randomized study of anistreplase and streptokinase
Authors: Jeffrey L Anderson, Sherman G Sorensen, Fidela Moreno, Rosemary A Hackworthy, Kevin F Browne, H.Thompson Dale, Fred Leja, Vincent Dangoisse, Victor J Marder
Journal: Journal of the American College of Cardiology (1990)