tbuckley/cabot-search huggingface dataset:
Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids
Authors: E M Ohman, K K Teo, A H Johnson, P B Collins, D G Dowsett, J T Ennis, J H Horgan
Journal: BMJ (1982)

Serial estimations of activities of creatine kinase and its MB isoenzyme, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase and of concentrations of alpha(1)-acid glycoprotein were performed in 15 healthy well-trained male marathon runners. Estimations were made initially within three days before a race and then one, 24, and 96 hours after the race. Technetium-99m pyrophosphate myocardial scintigraphy was carried out at the initial prerace assessment and repeated 48 to 96 hours after the race. None of the subjects developed cardiac symptoms during or after the race.Activities of creatine kinase and creatine kinase MB became maximal 24 hours after the race. One and 96 hours after the race two and five subjects, respectively, showed amounts of creatine kinase MB totalling 5% or more of total creatine kinase. Lactate dehydrogenase activity peaked at one hour after the race, and activities of aspartate and alanine aminotransferases peaked at 24 and 96 hours after the race, respectively. Activities of all these enzymes showed a significant increase from prerace values during the rest of the study. Electrocardiographic features noted were similar to those reported elsewhere in athletes under similar conditions. They included first-degree heart block, incomplete right bundle-branch block, left ventricular hypertrophy, pseudoischaemic T-wave changes, and early repolarisation of variant ST-segment elevations in precordial leads. Technetium-99m pyrophosphate myocardial scintigraphy did not show evidence of myocardial damage before or after the race. Alpha(1)-acid glycoprotein concentrations were normal throughout.These data suggest that reliance on standard enzyme estimations and electrocardiographic criteria may yield false-positive indicators of myocardial injury during prolonged strenuous exercise. Technetium-99m pyrophosphate scintigraphy and alpha(1)-acid glycoprotein measurements offer additional information and may usefully be employed in evaluating circulatory collapse associated with such exercise.
The Natural History and Treatment of Ovarian Cancer
Authors: D L Longo, R C Young
Journal: Annual Review of Medicine (1981)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China in December 2019 and quickly spread around the globe, killing more than 4 million people and causing a severe economic crisis. ...Read More
Correlation between histologic findings on punch biopsy specimens and subsequent excision specimens in recurrent basal cell carcinoma
Authors: Klara Mosterd, Monique R.T.M. Thissen, Arienne M.W. van Marion, Patty J. Nelemans, Bjorn G.P.M. Lohman, Peter M. Steijlen, Nicole W.J. Kelleners-Smeets
Journal: Journal of the American Academy of Dermatology (2011)
All About My Mother
Authors: R. Hurley
Journal: BMJ (2010)

Spain has the world’s highest rate of organ donation from the dead, with a system in which the family must give consent, a central theme of Pedro Almodovar’s film All About My Mother . Manuela’s life is turned upside down when she helplessly watches her only son, Esteban, mowed down and killed by a car in the pouring rain. They’d been to see a performance of Tennessee Williams’s A Streetcar Named Desire to celebrate Esteban’s 17th birthday. After waiting at the stage door to see the actress Huma Rojo, who had played Blanche DuBois, he had chased their heroine into the street for an autograph.

Manuela, a nurse who coordinates transplants at a Madrid hospital, finds herself …
Family Practice: Resuscitation or Reform?
Authors: George A. Silver
Journal: JAMA (1963)

WHETHER we practice or teach medicine, we share with our patients a recognition of the importance of the family practitioner. His role in prevention, diagnosis, and management of disease is so crucial that in many instances the specialist is unable to carry out his own role as well or at all without him. A failure or decline of family medical care is a serious problem. The evidence is inescapable that the family doctor, as personified by the general practitioner, is disappearing. Our concern in this circumstance imposes upon us the need to consider appropriate reforms and seize the opportunity of making changes that will restore and preserve family medical care.  We are familiar with the data showing that over the past 50 years the proportion of general practitioners has declined from over 90% of all practicing physicians to under 50%. Inasmuch as the number of physicians in practice has not
Notes on an Epidemic of Rubella
Authors: W. J. J. Arnold
Journal: BMJ (1897)

firm, is located rather higher than usual, and far back.The os is not patulous.The body of the uterus, enlarged to the extent of an eight or nine weeks pregnancy, is detected readily by bimanual examination.On September 24th, labour-like pain was experienced, and a mass was expelled from the vagina.This mass, which was of the size of an orange, contained an embryo of about i4 inch in length and il ounce of dark biliary-looking fluid.2REMARKS.-Inthis case the death of the embryo was pro- bably due to defective evolutional power in the fecundated ovum, and no external haemorrhage occurred for three months after its death.CASE IV, Retention of a 3 or a 32 Months' Fa?tus for -Five Months after its Death.-R.S., aged 40, and married fourteen years, had had five children and two miscarriages.,The miscarriages occurred between the births of the fourth and fifth children, and the last child was born in I890.She ceased menstruating on August 26th, I895, and thereafter there was complete amenorrhoea until February 12th, 1896, when a dark blood-coloured discharge from the vagina was observed.On March i8th, 1896, the patient came under my care, and she stated that daily since February 12th the blood-coloured discharge from the vagina had been noted.She had complained of no pain.On March i8th the following notes were made." Abdominal examination is negative.Vaginal examination:The cervix, which is soft, is located towards the left wall of the pelvis, and the os is slightly open.By bimanual examin- ation the body of the uterus is readily defined, and is equal in size to about a ten weeks pregnancy.The consistence of the uterus is doughy, and its right half is lobulated.No colostrum could be obtained from the breasts."From March i8th until April 24th there was daily a blood- coloured discharge from the vagina.On April 24th with a slight labour-like pain, a mass was expelled from the vagina.This mass contained what appeared to be a 3 or a 32 months fcetus, and, although the membranes were perfectly intact, the sac contained no fluid.REMARKS.-In this case the fectus had probably died in the early part of
Induction of histamine release in vitro from rat peritoneal mast cells by extracts of grain dust.
Authors: C P Warren, V Holford-Strevens
Journal: Environmental Health Perspectives (1986)

The ability of extracts of grain dust and wheat to induce histamine release from rat peritoneal cells was investigated. Some grain dusts, with a high endotoxin content, were found to produce cytotoxic histamine release. Extract of wheat dust, with a low endotoxin release, produced noncytotoxic histamine release from peritoneal cells but not from purified mast cells. This reaction was dependent on the presence of phosphatidyl serine. The agent did not appear to be a lectin because histamine release was not enhanced by passive sensitization of mast cells with IgE. The activity occurred only over a narrow range of concentrations of the extract of wheat. The cause was unclear.
Patient Package Inserts
Authors: Louis A. Morris
Journal: JAMA (1979)

To the Editor.—  In a recent letter, Gross (240:1240, 1978) raised some objections to the Food and Drug Administration's survey regarding oral contraceptive patient information 1 (238:2504, 1977), which he thinks cast real doubt on the validity of the entire study. By its very nature, any survey will possess some forms of bias that will influence study results, and the FDA survey is no exception. However, it is our belief that the approach taken by the FDA in enlisting respondents' help without deceiving them as to the purpose or sponsor of the survey yielded valid data on which to base policy decisions. Other approaches may not have given more accurate data but only that influenced by other, perhaps more serious forms of bias.  The ultimate validity of the FDA survey will not be determined by arguments about specific procedures used to solicit responses in this study, but more appropriately by additional
On Rules and Regulations
Authors: Charles D. Aring
Journal: JAMA (1978)

IN THEIR delightful and justly popular book entitled<i>Anything Can Happen</i>, the Papashvillys observed that "rules are made to take up the slack when the brains run out." Mozart also thought that "all must be done by rules when genius is lacking." What makes the times so contentious and hedged round with regulation of all sort? Do we lack ingenuity? Working relationships that ought to be relaxed and gracious are being contained by a spate of rules. Diversity is discouraged, and the chances for mediocrity are enhanced. Russell Baker, in one of his fine columns in the<i>New York Times</i>(July 26, 1977, p 29), pointed out that bringing problems to the courts encourages failure of the imagination. So, too, a plethora of rules restrains generous spontaneity. Rules run the risk of restricting the improvisory process.<sup>1</sup>For example, with the burgeoning of mandatory programs for continuing education, the pleasant
Do Perfluoroalkyl Compounds Impair Human Semen Quality?
Authors: Ulla Nordström Joensen, Rossana Bossi, Henrik Leffers, Allan Astrup Jensen, Niels E. Skakkebæk, Niels Jørgensen
Journal: Environmental Health Perspectives (2009)

Perfluoroalkyl acids (PFAAs) are found globally in wildlife and humans and are suspected to act as endocrine disruptors. There are no previous reports of PFAA levels in adult men from Denmark or of a possible association between semen quality and PFAA exposure.We investigated possible associations between PFAAs and testicular function. We hypothesized that higher PFAA levels would be associated with lower semen quality and lower testosterone levels.We analyzed serum samples for levels of 10 different PFAAs and reproductive hormones and assessed semen quality in 105 Danish men from the general population (median age, 19 years).Considerable levels of perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid were found in all young men (medians of 24.5, 4.9, and 6.6 ng/mL, respectively). Men with high combined levels of PFOS and PFOA had a median of 6.2 million normal spermatozoa in their ejaculate in contrast to 15.5 million among men with low PFOS-PFOA (p = 0.030). In addition, we found nonsignificant trends with regard to lower sperm concentration, lower total sperm counts, and altered pituitary-gonadal hormones among men with high PFOS-PFOA levels.High PFAA levels were associated with fewer normal sperm. Thus, high levels of PFAAs may contribute to the otherwise unexplained low semen quality often seen in young men. However, our findings need to be corroborated in larger studies.
Wanted: Specimens of Nervous System From Fatal Cases of Poliomyelitis
Authors: Simon Flexner
Journal: JAMA (1910)

<h3>To the Editor:—</h3> I should be greatly indebted to you for any assistance that you could render me through the columns ofThe Journalin enabling us to secure specimens of the nervous systems from fatal cases of epidemic poliomyelitis, a disease which is widely prevalent throughout the United States and Canada at present. We should like to obtain portions of the spinal cord and, by preference, of the lumbar tions cervical enlargement removed as soon after death as possible, and preserved in plenty of pure glycerin, Squibb's or Merck's or Kahlbaum's. These specimens are to be used for experimental purposes; they can be sent by express at our expense, or by mail addressed to me at the Rockefeller Institute, Sixty-sixth Street and Avenue A, New York City.
Vascular Health in Kawasaki Disease
Authors: Elif Seda Selamet Tierney, Dana Gal, Kimberly Gauvreau, Annette L. Baker, Shari Trevey, Stephen R. O'Neill, Michael R. Jaff, Sarah de Ferranti, David R. Fulton, Steven D. Colan, Jane W. Newburger
Journal: Journal of the American College of Cardiology (2013)
The diagnosis of pulmonary thromboembolism in sickle cell disease
Authors: Brian K. Walker, Samir K. Ballas, Edward R. Burka
Journal: American Journal of Hematology (1979)

Abstract The symptoms of thromboembolism in sickle cell anemia patients with acute chest syndromes are difficult to differentiate from the similar symptoms of painful thoracic crises and infectious pulmonary episodes. Furthermore, the chronic pulmonary abnormalities in sickle cell disease frequently contribute to the confusing results of noninvasive diagnostic procedures usually employed in evaluating pulmonary thromboembolism. In this study the chronic pulmonary status of asymptomatic sickle cell patients was defined, and this information was used in the evaluation of patients with acute chest syndromes suggestive of pulmonary thromembolism. Sixteen asymptomatic sickle cell patients were prospectively studied by chest roentgenography, spirometry, arterial gas analyses, and radioisotopic lung scans. There was an appreciable degree of preexisting chronic restrictive lung disease with mild to moderate arterial hypoxemia and abnormal lung scans in more than half of the patients. These prospective baseline data were incorporated into the diagnostic evaluation of four of these patients who later developed an acute chest syndrome suggestive of pulmonary thromboembolism. Determination of the cause of the chest pain was greatly facilitated by the existence of the baseline pulmonary data. In another patient persistence of abnormal studies following a presumed thromboembolic episode aided diagnostic evaluation when another episode of chest pain occurred. The findings indicate that comprehensive pulmonary studies in sickle cell patients while in an asymptomatic state will provide baseline data which aid the evaluation of possible pulmonary thromboembolism in acute chest syndromes without resorting to high‐risk invasive studies.
10 RIBAVIRIN CONCENTRATION AT WEEK FOUR IS AN INDEPENDEND PREDICTOR FOR SUSTAINED VIROLOGICAL RESPONSE AFTER TREATMENT OF HEPATITIS C GENOTYPE 2/3 (NORDYNAMIC TRIAL)
Authors: P.B. Christensen, A.A. Alsio, M.R. Buhl, M. Farkkila, K. Morch, P. Sangfelt, M. Lagging, G. Norkrans, C. Pedersen
Journal: Journal of Hepatology (2008)
Risk Group Assessment and Clinical Outcome Algorithm to Predict the Natural History of Patients With Surgically Resected Renal Cell Carcinoma
Authors: Amnon Zisman, Allan J. Pantuck, Jeffery Wieder, Debby H. Chao, Fredrick Dorey, Jonathan W. Said, Jean B. deKernion, Robert A. Figlin, Arie S. Belldegrun
Journal: Journal of Clinical Oncology (2002)

To create a comprehensive algorithm that can predict postoperative renal cell carcinoma (RCC) patient outcomes and response to therapy.A prospective cohort study was performed with outcome assessment on the basis of chart review of 814 patients who underwent nephrectomy between 1989 and 2000. At diagnosis, M1 or N1/N2M0 metastatic disease (M) was present in 346 patients (43%), whereas 468 patients had no metastatic disease (NM) (N0M0). On the basis of UCLA Integrated Staging System category and the presence of metastases, patients were divided into low-risk (LR), intermediate-risk (IR), and high-risk (HR) groups. Decision boxes integrating tumor-node-metastasis staging, tumor grade, and performance status were compiled for determining a patient's risk group.NM-LR patients had 91% disease-specific survival at 5 years, lower recurrence rate, and better disease-free survival compared with NM-IR and HR patients. Disease progressed in 50% of NM-HR patients. Disease-specific survival of NM-HR patients who received immunotherapy (IMT) for recurrent disease was similar to that of M-LR patients treated with cytoreductive nephrectomy and adjuvant IMT. Time from recurrence to death for NM-HR patients was inferior to that for M-LR patients. After IMT, approximately 25% of M-LR and 12% of M-IR patients had long-term progression-free survival. M-HR patients did poorly despite IMT.Stratifying RCC patients into high-, intermediate-, and low-risk subgroups provides a clinically useful system for predicting outcome and provides a unique tool for risk assignment and outcome analysis. Subclassifying RCC into well-defined risk groups should allow better patient counseling and identification of both NM-HR subgroups that need adjuvant treatment and nonresponders who need alternative therapies.
THE PRESENT STATUS OF THERAPEUTICS.
Authors: W. G. MOORE
Journal: JAMA (1906)

When I was a student at Jefferson Medical College one of the members of its distinguished faculty made the assertion that he "could encircle the globe and cure more diseases with four remedies than could be cured with all the balance of the materia medica." The four remedies named were quinin, opium, mercury and iodid of potassium. None will deny the therapeutic power of these drugs nor the vast scope of their usefulness. Indeed, the more we consider the statement the more we question whether it does not hold good to-day, notwithstanding that it was made more than twenty-five years ago. We are forced to ask ourselves whether therapeutics has been standing still while pathology, bacteriology, chemistry, diagnosis and surgery have rushed into such prominence as to challenge the admiration of all who keep pace with the progress of the sciences, and while preventive medicine and sanitation, which stand alone
Postprandial abdominal pain, megaloblastic anaemia, and severe weight loss in an 80 year old man
Authors: A U Dignass
Journal: Gut (2005)

Background: Several prognostic models have been developed to stage hepatocellular carcinoma (HCC) but there is no general consensus on which is the most reliable.We compared three prognostic indices (Okuda, CLIP, and BCLC scoring systems) in a large series of cirrhotic patients with HCC undergoing nonsurgical treatment in terms of their ability to classify patients into different risk groups Methods: We retrospectively studied 268 Italian patients with HCC.A total of 146 patients were treated with ablation, 132 with percutaneous ethanol injection, and 14 with radiofrequency ablation; 103 underwent transcatheter arterial chemoembolisation and 19 had supportive care alone.Factors determining survival were analysed by univariate and multivariate analysis using the Kaplan-Meier method and Cox proportional hazard regression models.Okuda, CLIP, and BCLC scores evaluated before treatment were applied.Results: Median survival was 25.7 months.In a multivariate analysis, portal vein thrombosis, a fetoprotein, total bilirubin, and tumour size were significant predictors of survival.Okuda, CLIP, and BCLC scores were all able to predict survival (p,0.001).They identified two, four, and six risk groups, respectively, with a median survival ranging from 27 to 19 months for Okuda, 30 to 5 months for CLIP, and 43 to 7 months for BCLC.Conclusions: Both CLIP and BCLC scores were more effective than the Okuda score in stratifying patients into different risk groups with early-intermediate HCC.However, the BCLC scoring system gave a better prediction of prognosis in patients with disease diagnosis at a very early stage.
Combination treatment is rare in patients with rheumatoid arthritis
Authors: B. Pal, H. Amlesh
Journal: BMJ (1998)

EDITOR—The title of Brooks's clinical review article—“Recent advances: rheumatology”—is not appropriate for the contents, which really dealt only with the therapeutics of rheumatoid arthritis rather than advances in rheumatology.2 On the topic of disease modifying antirheumatic drugs the author stated that combination treatment was now the rule rather than the exception. This assumption may not be true in many …
Isoimmunization after Multiple Transfusions
Authors: Mary M. Lostumbo, V. Holland, Paul J. Schmidt
Journal: New England Journal of Medicine (1966)

THE risk of isoimmunization after blood transfusion depends on the relative frequency of blood-group factors, their antigenicity and the number and timing of exposures (transfusions). There have been several approaches to determine the frequency of production of irregular antibodies, but the numbers and sequence of immunologic stimulations are usually not known or the results are based upon selected populations.1 2 3 4 Other investigations have attempted deliberate sensitization, an artificial situation that does not represent standard transfusion practice.5 , 6 However, using gene frequencies and the incidence of antibodies in several populations, Giblett1 has calculated the probability of stimulating one or more antibodies after one . . .
Gas Sterilization of Fiber Endoscopes
Authors: A. Ujeyl*, D. Wurbs, W. Adam, M. Classen
Journal: Endoscopy (1978)

Excitants of disease can be transmitted by endoscopes from one patient to another. Owing to their complicated construction and the heat-sensitive material fiber glass endoscopes are difficult to disinfect or sterilize. Of the known procedures of sterilization only gas sterilization with ethylene oxide can be used. Clinical examinations and laboratory experiments demonstrate the reliable efficacy of this procedure of sterilization of fiber glass endoscopes. On account of known risks the indications for gas sterilization are compiled.
Effect of cigarette smoking on gastric emptying.
Authors: D S Grimes, J Goddard
Journal: BMJ (1978)

Gastric emptying after a test meal was studied in 17 normal volunteers--10 habitual smokers and seven non-smokers. The solid component of the test meal was labelled with technetium and the liquid component with indium. After one meal the habitual smokers smoked two cigarettes. Emptying curves were produced for both technetium and indium, and the differences between curves for meals with and without cigarettes were analysed. Cigarette smoking accelerated the rate at which the liquid component of a meal left the stomach. This may be important in the pathogenesis of duodneal ulcer and the delay in healing caused by cigarette smoking.
<scp>TLR</scp>2 down‐regulates Fcε<scp>RI</scp> and its transcription factor <scp>PU</scp>.1 in human Langerhans cells
Authors: N. Herrmann, S. Koch, N. Leib, J. Bedorf, H. Wilms, S. Schnautz, R. Fimmers, T. Bieber
Journal: Allergy (2013)

Epidermal Langerhans cells (LC) expressing the high-affinity receptor for IgE (FcεRI) play a key role in atopic dermatitis (AD). AD skin is highly colonized with Staphylococcus aureus (S.a.), which are sensed by Toll-like receptor 2 (TLR2). We hypothesized that TLR2 may impact on the expression of FcεRI on LC.To study a putative impact of TLR2 signaling on FcεRI, we analyzed FcεRI and known transcription factors of the receptor after ligand binding to TLR2.We generated LC from CD34(+) progenitors in vitro (CD34LC) expressing FcεRI and TLR2 as well as its partners TLR1 and TLR6. The expression of FcεRI and known transcription factors of the receptor was analyzed on the protein and RNA level by flow cytometry, Western blotting, and real-time PCR.For CD34LC from 123 donors, we observed a high heterogeneity in FcεRI surface expression correlating with mRNA level of its α-chain. Stimulation of TLR1/2 or TLR2/6 dramatically down-regulated FcεRI on protein and mRNA level of both α- and γ-chain. Further analysis of putative transcription factors for FCER1A revealed the lack of GATA1 in CD34LC, weak expression of ELF1 and YY1, and high expression of PU.1. While ELF1 and YY1 appeared to be little affected by TLR2 engagement, PU.1 was significantly down-regulated.Taken together, our findings show that in human, LC ligation of TLR2 by S.a.-derived products down-regulates FcεRI and its transcription factor PU.1, thus suggesting that FcεRI is controlled by PU.1 in these cells.