tbuckley/cabot-search huggingface dataset:
Letters From the Grave
Authors: Ronald Lands
Journal: Annals of Internal Medicine (2012)

On Being a Doctor18 September 2012Letters From the GraveRonald Lands, MDRonald Lands, MDFrom University of Tennessee Graduate School of Medicine, Knoxville, TN 37920.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-6-201209180-00014 Audio Reading - “Letters From the Grave” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Letters From the Grave," by R. Lands. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinic visits were a problem, even when Mr. Jones first became my patient. He had difficulty walking because his legs and feet “shimmered” with tingles and vibrations from the destruction in his vertebrae and damage to his spinal cord. Lesions in his ribs and long bones caused him pain if he made an awkward or sudden move. Our appointments soon became exercises in applied time management. As soon as he sat down, he'd start to untie his necktie. Then, while giving me an update on his status since his last visit, he'd carefully remove his coat, slowly unbutton his vest, ... Author, Article, and Disclosure InformationAffiliations: From University of Tennessee Graduate School of Medicine, Knoxville, TN 37920.Corresponding Author: Ronald Lands, MD, Department of Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, Knoxville, TN 37920. PreviousarticleNextarticle Advertisement Audio Reading - “Letters From the Grave” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Letters From the Grave," by R. Lands. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 18 September 2012Volume 157, Issue 6Page: 454KeywordsChildrenLungsMemoryNursesRibsSkullSpinal cordTriageVertebraeWalking ePublished: 18 September 2012 Issue Published: 18 September 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Intravascular Ultrasound Diagnosis of a Coronary True Aneurysm After Palmaz-Schatz Stent Implantation
Authors: Teruo Noguchi, Akira Itoh, Shunichi Miyazaki, Satoshi Yasuda, Isao Morii, Satoshi Daikoku, Yoichi Goto, Hiroshi Nonogi
Journal: Circulation (1999)
Candida tropicalis Arthritis and Bursitis
Authors: Bruce A. Wall, Michael E. Weinblatt, Jeffery T. Darnall, Hyman Bernard Muss
Journal: JAMA (1982)

INFECTIONS with<i>Candida</i>organisms have been noted with increasing frequency in immunocompromised patients; however, arthritis rarely occurs.<i>Candida</i>arthritis has been treated with systemic antifungal medications with good results. We report a patient with<i>Candida tropicalis</i>arthritis and bursitis whose condition did not respond to multiple antifungal drugs and synovectomy. Control of the infection occurred only after bursectomy and arthrodesis. <h3>Report of a Case</h3> A 48-year-old man was found to have a poorly differentiated lymphocytic lymphoma confined to the bone marrow, in October 1979. Treatment with vincristine sulfate and prednisone was unsuccessful, but there was an excellent response to highdose methotrexate and leucovorin calcium rescue, with almost complete clearing of malignant cells. He was subsequently given combination chemotherapy with cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (CHOP-BLEO antineoplastic regimen). In spite of an excellent response and normal performance status, complete remission was never achieved, and repeated bone marrow aspirations always showed
Heart rate in diabetes mellitus
Authors: G. Sundkvist
Journal: BMJ (1979)

benefit of workers in other parts of the world.In the UK in 1960-5, according to Ashley,1°evidence suggested that "some 15 % of males and 180% of females are subjected to appendicectomy."What are the proportions nowadays ?What is the present situation in, say, the Hebrides compared with that in London ?In 1942 operation frequency in pre-OCTU student candidates was eight times higher than that in non-student young men.11Does a like disparity still prevail ?Furthermore, in immigrant populations in London such as Caribbeans and Asians, what are the respective frequencies of operations among them ?In the USA appendicitis incidence "has decreased 40 O in 20 years, perhaps more''l2; but from what rate to what rate ?We live in a time when the armamentarium for disease detection is far advanced and magnificent.It is therefore ironic that elementary information is almost completely lacking on a disease's precise frequency, the index of which, in a community, is more readily ascertainable than the making of an anthropometric measurement.
A Way Out
Authors: Paul Golden
Journal: Annals of Internal Medicine (1993)

On Being a Doctor1 June 1993A Way OutPaul Golden, MDPaul Golden, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-11-199306010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this essay, the author describes the course of a patient in the end-stage renal program who has been receiving hemodialysis for 6 years and then makes the decision, while of competent mind, to withdraw from dialysis to end his life. The author, the patient's personal nephrologist, describes how he explained to the patient his options in the context of advanced medical directives and durable power of attorney for health care. The patient's last day of life is remembered in first-person narrative by his physician and the patient's wife. In this anecdotal account, persons receiving dialysis are singled out as ... Author, Article, and Disclosure InformationAffiliations: Corresponding Author: Paul Golden, MD, 1401 Spanos Court, Suite 109, Modesto, CA 95355. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEthical Issues in Aging and Renal Disease 1 June 1993Volume 118, Issue 11Page: 899-900KeywordsBreathingDo not resuscitate ordersHealth careKidneysMedical dialysisMorphineNursesPatient advocacyRenal failureWalking ePublished: 15 August 2000 Issue Published: 1 June 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Online Version of the ‘Food Allergy Quality of Life Questionnaire - Adult Form’ in the USA
Authors: N.J. Goossens, B. M. J. Flokstra-de Blok, B.J. Vlieg-Boerstra, E.J. Duiverman, C. Weiss, T.J. Furlong, A.E.J. Dubois
Journal: Journal of Allergy and Clinical Immunology (2010)
Letting Him Down: making the euthanasia decision easier
Authors: Tony Sheldon
Journal: BMJ (2006)

T he man, Thijs, lies dead. His widow, Ankie, and his general practitioner, Freek, sit nearby, shocked. “That was terrible…the suffering…you would not wish that on anybody,” says Ankie. Freek replies: “Naturally…terrible.” Then the grieving widow blurts out: “Couldn't you have prevented that? You knew he never wanted that. He gave you the form years ago.”

Laten Stikken , which means “to let suffocate” but has been given the looser translation of Letting Him Down , is a film made by the Dutch Society for a Voluntary Ending of Life. It is aimed at helping GPs and patients break the silence surrounding euthanasia—a silence that the society believes is denying due consideration of patients' legitimate requests. Even though the Netherlands has agreed a legal framework for permitting voluntary euthanasia, thus achieving “quality” in practice, this most difficult decision for doctors remains a complex and lonely one.

Last year the society published Euthanasia: A Different View of Practice , which was based on a sample of 14 accounts from surviving relatives and was aimed at raising concerns from the patients' viewpoint. In the ensuing debate the society's director and a former GP, Rob Jonquiere, argued that each year hundreds of doctors delayed euthanasia until it was too late, used morphine instead …
Overexpression of Human Superoxide Dismutase Inhibits Oxidation of Low-Density Lipoprotein by Endothelial Cells
Authors: Xiang Fang, Neal L. Weintraub, C. David Rios, David A. Chappell, Ralf M. Zwacka, John F. Engelhardt, Larry W. Oberley, Tao Yan, Donald D. Heistad, Arthur A. Spector
Journal: Circulation Research (1998)

Abstract —Oxidation of LDL in the subendothelial space has been proposed to play a key role in atherosclerosis. Endothelial cells produce superoxide anions (O 2 .− ) and oxidize LDL in vitro; however, the role of O 2 .− in endothelial cell–induced LDL oxidation is unclear. Incubation of human LDL (200 μg/mL) with bovine aortic endothelial cells (BAECs) for 18 hours resulted in a 4-fold increase in LDL oxidation compared with cell-free incubation (22.5±1.1 versus 6.3±0.2 [mean±SEM] nmol malondialdehyde/mg LDL protein, respectively; P &lt;0.05). Under similar conditions, incubation of LDL with porcine aortic endothelial cells resulted in a 5-fold increase in LDL oxidation. Inclusion of exogenous copper/zinc superoxide dismutase (Cu/ZnSOD, 100 μg/mL) in the medium reduced BAEC-induced LDL oxidation by 79%. To determine whether the intracellular SOD content can have a similar protective effect, BAECs were infected with adenoviral vectors containing cDNA for human Cu/ZnSOD (AdCu/ZnSOD) or manganese SOD (AdMnSOD). Adenoviral infection increased the content and activity of either Cu/ZnSOD or MnSOD in the cells and reduced cellular O 2 .− release by two thirds. When cells infected with AdCu/ZnSOD or AdMnSOD were incubated with LDL, formation of malondialdehyde was decreased by 77% and 32%, respectively. Two other indices of LDL oxidation, formation of conjugated dienes and increased LDL electrophoretic mobility, were similarly reduced by SOD transduction. These data suggest that production of O 2 .− contributes to endothelial cell–induced oxidation of LDL in vitro. Furthermore, adenovirus-mediated transfer of cDNA for human SOD, particularly Cu/ZnSOD, effectively reduces oxidation of LDL by endothelial cells.
Cryothermal mapping of recurrent ventricular tachycardia in man.
Authors: J D Gallagher, A J Del Rossi, J Fernandez, V Maranhao, M D Strong, M White, L J Gessman
Journal: Circulation (1985)

Intraoperative reversible cryothermal mapping of recurrent ventricular tachycardia was performed in seven patients with left ventricular aneurysms with use of a 0 degrees C ice probe. A single, reproducible cryotermination site was found in each patient. The cryotermination site was uniformly located in an area where local electrograms obtained during ventricular tachycardia showed electrical activation during the diastolic portion of the surface electrocardiogram, and was different than the site of activation coincident with the onset of the QRS complex on the surface electrocardiogram (earliest reactivation site or ERS) by 4.5 +/- 2.7 cm (mean +/- SD) in five of seven patients. Sinus rhythm late potentials were recorded at the cryotermination site in five of six patients and from the ERS in one. In five patients, extensive subendocardial resection including both the ERS and cryotermination sites was performed. In two patients only the cryotermination site was excised. In six survivors, including one in whom only the cryotermination site was excised, ventricular tachycardia could not be induced 2 weeks after surgery and has not recurred during the follow-up period of 7 to 17 months (12 +/- 4.5 months, mean +/- SD). Reversible cryothermal mapping may provide additional important information not obtained by standard electrogram mapping of ventricular tachycardia that may help guide surgical therapy of recurrent ventricular tachycardia.
Gallium-67 Scintigraphy in Abdominal Anaerobic Abscesses
Authors: R DUANE HOLLAND, NIHAL S. GOONERATNE, TIMOTHY E. WEST, JOHN B. SELBY
Journal: Clinical Nuclear Medicine (1980)

Three cases of anaerobic abdominal abscesses showing poor uptake on Ga-67 scintiscans are presented. The significance of this and possible mechanisms for it are discussed.
Medicine in Rural Zaire
Authors: RICHARD C. BROWN
Journal: Annals of Internal Medicine (1979)

Abroad1 February 1979Medicine in Rural ZaireRICHARD C. BROWN, M.D.RICHARD C. BROWN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-2-271 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMisunderstandings are likely to arise between the patient and physician when their cultures differ radically. They will not see the patient's condition in the same way. What they will expect of the medical encounter will differ greatly. This is true for the practice of medicine by "western" physicians in rural Zaire.Most rural Zairians attribute serious diseases to inharmonious relationships between the affected person and a human antagonist or a malevolent spirit. Disease is caused by an enemy's effort to harm or kill his opponent. When the enemy, real or imaginary, is thought to injure his opponent by supernatural means,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHospital deaths in a high risk obstetric population: Karawa, Zaire 1 February 1979Volume 90, Issue 2Page: 271-272 Issue Published: 1 February 1979 Copyright©1979 American College of PhysiciansPDF DownloadLoading ...
Scintigraphic Findings in Acute Gangrenous Cholecystitis
Authors: WEI-JEN SHIH, PEGGY A. DOMSTAD, DANIEL E. KENADY, FRANK H. DeLAND
Journal: Clinical Nuclear Medicine (1987)

Nine patients who had surgically proven acute gangrenous cholecystitis and Tc-99m DISIDA scintigrams were reviewed retrospectively. Three types of scintigraphic findings were presented: 1) nonvisualization of the gallbladder, three cases; 2) nonvisualization of the gallbladder plus a rim sign, two cases; and 3) nonvisualization of the gallbladder plus an enlarged photon deficient area corresponding to the gallbladder fossa, four cases. A rim sign or an enlarged gallbladder fossa reflect the direct spread of inflammation from the gallbladder into the liver, causing impaired hepatocyte function. An enlarged gallbladder fossa may represent a later stage of a rim sign. Presumably tracer excretion by hepatocytes is affected initially by the inflammatory process, followed by impairment of tracer concentrating ability. Since the gallbladder may be suspended occasionally by a mesentery and not in contact with the liver, the secondary signs may be absent in acute gangrenous cholecystitis.
Factitious Feculent Urine in an Adolescent Boy
Authors: Peter Reich
Journal: JAMA (1977)

PATIENTS who pretend to be sick and willingly undergo intrusive procedures, including surgery, have been seen at every medical center. The motives for this bizarre behavior often remain obscure, even when the patient is studied thoroughly. Reviews of chronic factitious illness or Munchausen's syndrome emphasize the heterogeneity of the underlying psychiatric conditions, but also indicate a marked preponderance of patients with personality disorders, and with histories of early childhood trauma and deprivation.<sup>1,2</sup>In a study of factitious illness, Spiro identified three clinical types: sociopathic, hysterical, and schizophrenic.<sup>2</sup>Major factitious illness is rare in childhood and adolescence, although malingering with factitious fever<sup>3</sup>and other simulated symtoms can occur. We report the case of an adolescent boy who for nearly a year succeeded in simulating an enterovesicular fistula by contaminating his urine with feces and foodstuff, at times by retrograde injection of foreign substances into his bladder. The case
CCR9 Homes Metastatic Melanoma Cells to the Small Bowel
Authors: Ann Richmond
Journal: Clinical Cancer Research (2008)

The question of why certain types of tumors often metastasize to the same organs has intrigued scientists for over a century. In 1889, Paget put forth the “seed and soil” concept that cancer cells (seed) spread in a nonrandom fashion to distant target organs where they are drawn based on a
Colchicine in acute gout
Authors: I. Morris
Journal: BMJ (2003)

We describe three histories of patients with gout who were treated with doses of colchicine as advised by the British National Formulary (BNF)–that is, 1 mg initially followed by 500 μg every 2-3 hours until relief of pain is obtained or vomiting or diarrhoea occurs or until a total dose of 6 mg has been reached; the course should not be repeated within three days.1 All three patients developed nausea or diarrhoea with this regimen. We consider that an alternative low dose schedule should be used to avoid such adverse events.

Case 1 –A 91 year old woman with a history of ischaemic heart disease and non-insulin dependent diabetes developed an ulcer over the right first metatarsophalangeal joint, which was discharging a white toothpaste-like material containing urate crystals. She was given 1 mg colchicine and then 500 μg every three hours, but she developed diarrhoea, and colchicine was stopped. After three days, the toe was still painful, and the course was repeated. She developed severe diarrhoea again and became dehydrated and unwell. We rehydrated her intravenously and gave her meloxicam. After the first …
Intranasal Cobalamin: A Warning-Reply
Authors: John N. Hathcock
Journal: JAMA (1991)

<h3>In Reply.—</h3> Dr Heimburger states that the summary report of Nature's Bounty's clinical studies indicates that the rise in serum cobalamin level after a single 400-μg intranasal dose approximates that from a 100-μg intramuscular dose. Dr Heimburger then suggests that the use of an intranasal gel would have a compliance advantage over daily oral cobalamin and would not entail the inconvenience or cost of intramuscular injections. He concludes that the use of Ener-B, with proper monitoring of cobalamin status, should be considered by physicians treating patients with pernicious anemia. It is the Food and Drug Administration's (FDA) position that Ener-B Intra-Nasal Gel is a drug, a new drug, and is illegally marketed. The FDA has consistently regulated parenteral vitamin-mineral and topically administered nutritional products as drugs. On February 26, 1987, the FDA sent a regulatory letter to Nature's Bounty informing them that Ener-B was an unapproved new drug and was
Association of Hypoglycemia and Cardiac Ischemia
Authors: Cyrus Desouza, Holger Salazar, Benjamin Cheong, Joseph Murgo, Vivian Fonseca
Journal: Diabetes Care (2003)

OBJECTIVE—In some studies intensive diabetes treatment in patients with type 2 diabetes may be associated with increased cardiovascular events. It is not clear whether these events are related to hypoglycemic episodes. To determine whether episodes of hypoglycemia were more likely to be associated with cardiac ischemia than normoglycemia or hyperglycemia, we carried out a study in 21 patients with coronary artery disease (CAD) and type 2 diabetes treated with insulin who had good glycemic control. RESEARCH DESIGN AND METHODS—We carried out 72-h continuous glucose monitoring along with simultaneous cardiac Holter monitoring for ischemia. Patients also recorded symptoms of cardiac ischemia (chest pain) and symptoms of hypoglycemia. RESULTS—Satisfactory continuous glucose monitoring system recordings were obtained in 19 patients. We recorded 54 episodes of hypoglycemia (blood glucose &amp;lt;70 mg/dl; 26 of these were symptomatic) and 59 episodes of hyperglycemia (blood glucose &amp;gt;200 mg/dl; none symptomatic). Of the 54 episodes of hypoglycemia, 10 were associated with symptoms of chest pain, during 4 of which electrocardiographic abnormalities were documented. In contrast, only 1 episode of chest pain occurred during 59 episodes of hyperglycemia. No chest pain or electrocardiographic abnormalities occurred when the blood glucose was within the normal range. The difference between the frequency of ischemia during hypoglycemia and the frequency during both hyperglycemia and normoglycemia was statistically significant (P &amp;lt; 0.01). There were 50 episodes during which the blood glucose changed by &amp;gt;100 mg over a 60-min period, and ischemic symptoms occurred during 9 of these episodes (P &amp;lt; 0.01 compared with stable normoglycemia or hyperglycemia). CONCLUSIONS—Hypoglycemia is more likely to be associated with cardiac ischemia and symptoms than normoglycemia and hyperglycemia, and it is particularly common in patients who experience considerable swings in blood glucose. These data may be important in the institution of insulin treatment and attempting near-normal glycemia in patients with known CAD. Further research is needed to determine strategies to prevent ischemia associated with hypoglycemia.
Tc-99m Pentavalent DMSA Scintigraphy in Myelofibrosis Detection
Authors: John T. Koutsikos, Antigone Velidaki, Theodoros Athanasoulis
Journal: Clinical Nuclear Medicine (2006)

In a 62-year-old man with medullary carcinoma of the thyroid, a postoperative Tc-99m dimercaptosuccinic acid [(V) DMSA] study was requested. In the Tc-99m (V) DMSA scan. no abnormalities, indicating local recurrence or metastatic disease, were observed. However, there was increased uptake in the spleen and liver and significantly diffusely increased uptake in the bone marrow. The patient also had a history of myelofibrosis and these findings appear to have been the result of this pathology.
Xlr3b is a new imprinted candidate for X-linked parent-of-origin effects on cognitive function in mice
Authors: William Davies, Anthony Isles, Rachel Smith, Delicia Karunadasa, Doreen Burrmann, Trevor Humby, Obah Ojarikre, Carol Biggin, David Skuse, Paul Burgoyne, Lawrence Wilkinson
Journal: Nature Genetics (2005)