tbuckley/cabot-search huggingface dataset:
Failure to Diagnose Acute Myocardial Infarction-Reply
Authors: Harold Sexton
Journal: JAMA (1984)

<h3>In Reply.—</h3> Regarding the concerns voiced by the letters of Dr Huiras and by Ina Van Hest and Dr Zoraster, we agree that the percentages are misleading and only the zero-zero figures should have been used. In regard to the letter by Dr Beach Conger, our purpose was to demonstrate the tendency of physicians to rely on technical aids for the diagnosis of myocardial infarction and their reluctance to make such a diagnosis in the absence of laboratory substantiation regardless of whether such lack of substantiation was due to (1) insufficient enzymes to evaluate, (2) enzymes that did not reach twice normal values, or (3) cases in which there was no change in enzyme values. The same philosophy would seem to apply to all three circumstances, namely, without laboratory confirmation, regardless of cause, there is physician reluctance to make a diagnosis of acute myocardial infarction. As mentioned in the article,
Value and Limitations of Thallium-201 Scintigraphy in the Acute Phase of Myocardial Infarction
Authors: Frans J.Th. Wackers, Ellinor Busemann Sokole, Gerard Samson, J.B. V.D. Schoot, K.I. Lie, K.L. Liem, Hein J.J. Wellens
Journal: New England Journal of Medicine (1976)

We examined the diagnostic usefulness of thallium-201 scintigraphy in 200 patients with acute myocardial infarction. The scintiscans showed a defect, suggesting infarction in 165. In all 44 patients studied iwthin six hours after onset of symptoms the scintiscans indicated a defect. Frequency of positive scans was significantly higher (90 of 96) in patients studied within 24 hours after onset than in those (75 of 104) studied later (p less than 0.01).
COMPARISON OF A PACLITAXEL ELUTING STENT WITH BIODEGRADABLE POLYMER AND GLYCOLIX COATING VERSUS BARE METAL STENT DESIGN: FIRST PRESENTATION OF 9 MONTHS CLINICAL AND ANGIOGRAPHIC OUTCOME OF THE RANDOMIZED, MULTICENTER AND CONTROLLED EUCATAX TRIAL(NCT00825279).
Authors: Alfredo E. Rodriguez, Federico C. Vigo, Alejandro Delacasa, Victor Bernardi, Marcelo Bettinotti, Omar Santaera, Valeria Curotto, Carlos Fernandez-Pereira, Bibiana Rubilar, Juan Mieres, David Antoniucci, Igor F. Palacios
Journal: Journal of the American College of Cardiology (2010)
Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer
Authors: Ashish M. Kamat, Thomas W. Flaig, H. Barton Grossman, Badrinath Konety, Donald Lamm, Michael A. O'Donnell, Edward Uchio, Jason A. Efstathiou, John A. Taylor
Journal: Nature Reviews Urology (2015)

A focus group of specialized urologic oncologists has reviewed guidelines and clinical evidence and discussed their experiences regarding the optimal use of BCG in the management of patients with NIMBC. Here, they provide a review of BCG therapy, clarify complex related topics and recommend best practice guidelines to improve BCG use and patient outcomes. Multiple clinical trials have demonstrated that intravesical Bacillus Calmette–Guérin (BCG) treatment reduces recurrences and progression in patients with non-muscle-invasive bladder cancer (NMIBC). However, although BCG has been in use for almost 40 years, this agent is often underutilized and practice patterns of administration vary. This neglect is most likely caused by uncertainties about the optimal use of BCG, including unawareness of optimal treatment schedules and about patient populations that most benefit from BCG treatment. To address this deficit, a focus group of specialized urologic oncologists (urologists, medical oncologists and radiation oncologists) reviewed the current guidelines and clinical evidence, discussed their experiences and formed a consensus regarding the optimal use of BCG in the management of patients with NIMBC. The experts concluded that continuing therapy with 3-week BCG maintenance is superior to induction treatment only and is the single most important factor in improving outcomes in patients with NMIBC. They also concluded that a reliable alternative to radical cystectomy in truly BCG-refractory disease remains the subject of clinical trials. In addition, definitions for common terms of BCG failure, such as BCG-refractory and BCG-intolerant, have been formulated.
Scientists 'Build a Better Mouse' to Trap Biochemical Secrets of Radiation-Resistant Cancer Cells
Authors: Andrew A. Skolnick
Journal: JAMA (1992)

SOME SCIENTISTS appear to believe that if you build a better mouse the world will beat a path to your door. Researchers at a number of centers are scurrying to use the latest genetic engineering techniques to create better mice for the study of human diseases and the development of effective therapies. Scientists at the University of North Carolina at Chapel Hill just announced the creation of a mouse model for cystic fibrosis using advanced gene targeting techniques (<i>Science</i>. 1992;257:1083-1095). Others appear to be at various stages of success in making the mouse more like a human, at least in regard to diseases that plague our species. Soon to be announced will be the development of a transgenic mouse that appears much more resistant to lethal levels of ionizing radiation. Researchers at the Uniformed Services University of the Health Sciences (USUHS), Bethesda, Md, are seeking a patent for a genetically
Immunoglobulin and Gut Disease
Authors: JEREMIAH J. TWOMEY
Journal: Annals of Internal Medicine (1971)

Letters, Comments, and Corrections1 December 1971Immunoglobulin and Gut DiseaseJEREMIAH J. TWOMEY, M.D.JEREMIAH J. TWOMEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-75-6-970 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I have read with interest the report by Hughes and associates (Ann Intern Med 74:903-910, 1971) on their studies of small-bowel disease in immunoglobulin-deficient patients. They found a high prevalence of nodular lymphoid hyperplasia and evidence of sprue among the six patients studied. They postulated that infection may be the major pathogenetic factor in small bowel disease in Ig-deficient patients.This study also confirms our earlier observation that there is a high prevalence of gastric atrophy in Ig-deficient patients (1, 2). The fact that both their and our patients had an idiopathic delayed-onset type of Ig deficiency...References1. TWOMEYJORDANJARROLD JPT: The syndrome of immunoglobulin deficiency and pernicious anemia: a study of 10 cases. Am J Med 47:340-350, 1969 CrossrefMedlineGoogle Scholar2. TWOMEYJORDANLAUGHTER JPA: The gastric disorder in immunoglobulin deficient patients. Ann Intern Med 72:499-504, 1970 LinkGoogle Scholar3. COOKEWEINERSHINTON WWN: Agammaglobulinemia, report of two adult cases. Br Med J 1:1151-1152, 1957 CrossrefMedlineGoogle Scholar4. BRODYESTRENHERBERT ESV: Coexistent pernicious anemia and malabsorption in four patients: including one whose malabsorption disappeared with vitamin B12 therapy. Ann Intern Med 64:1246-1248, 1966 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JEREMIAH J. TWOMEY, M.D.Affiliations: Hematology Section Veterans Administration Hospital Baylor College of Medicine Houston, Tex. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1971Volume 75, Issue 6Page: 970-971KeywordsAntibodiesAtrophyInfectious diseasesInflammatory bowel diseasePathogens ePublished: 1 December 2008 Issue Published: 1 December 1971 PDF downloadLoading ...
1094 Estrogen administration protects from bile duct vanishing induced by biliary-digestive diversion in the BDL rat
Authors: G SVEGLIATIBARONI, R GHISELLI, M MARZIONI, D ALVARO, F MOCCHEGIANI, S SACCOMANNO, V SISTI, L UGILI, F ORLANDO, V SABA
Journal: Hepatology (2003)

Chronic cholestatic liver diseases include fibrosing cholangiopathies such as primary biliary cirrhosis or primary sclerosing cholangitis. These and related cholangiopathies clearly display pathologies associated with (auto)immunologic processes. As the cholangiocyte’s apical membrane is exposed to the toxic actions of the bile fluid, the interaction of bile with cholangiocytes and the biliary tree in general must be considered to completely understand the pathogenesis of cholangiopathies. While the molecular processes involved in the hepatocellular formation of bile are well understood in both normal and pathophysiologic conditions, those in the bile ducts of normal liver and in livers with cholangiopathies lag behind. This survey highlights key mechanisms known to date that are important for the formation of bile by hepatocytes and its modification by the biliary tree. It also delineates the clinical pathophysiologic findings for cholangiopathies and puts them in perspective with current experimental models to reveal the pathogenesis of cholangiopathies and develop novel therapeutic approaches.
Effect of angiotensin-converting enzyme inhibitor (SQ 20881) on the plasma concentration of angiotensin I, angiotensin II, and arginine vasopressin in the dog during hemorrhagic shock.
Authors: J J Morton, P F Semple, I M Ledingham, B Stuart, M A Tehrani, A R Garcia, G McGarrity
Journal: Circulation Research (1977)

The effect of an angiotensin-converting enzyme inhibitor on the circulating levels of angiotensin I, angiotensin II, and arginine vasopressin was studied in dogs subjected to hypotensive hemorrhagic shock. In dogs subjected to hemorrhage but not given the inhibitor, angiotensin II rose 20-fold (from 69 to 1,343 pg/ml of plasma), whereas in dogs subjected to hemorrhage but pretreated with the inhibitor, angiotensin II rose only 2-fold (from 92 to 171 pg/ml of plasma). In the pretreated dogs angiotensin I rose 30-fold (from 108 to 3,232 pg/ml of plasma). There was no statistically significant difference between the vasopressin levels found in the untreated dogs and the levels found in dogs given the inhibitor (1,016 and 1,095 pg/ml of plasma). Of the 15 dogs in the untreated group, five died before retransfusion was completed (four of cardiac failure and one of cardiac arrhythmia); none of the 10 dogs in the inhibitor-treated group died. These observations suggest that the very high levels of angiotensin II observed following severe hemorrhage do not contribute significantly to the increased secretion of vasopressin and that the inhibitor protects against death, possibly by suppressing the very high blood levels of angiotensin II observed following this type of experimental hemorrhagic shock.
TUBERCULOSIS OF THE LOWER LOBE
Authors: R. Viswanathan
Journal: BMJ (1936)

~~~~~~~~~~~~~~~~~~~~~~~~~EIA JORA removed by that route.This was one of my earlier cases, and I have not had any trouble with -the development of blood clot since I began half-hourly irrigation of the catheter and the base of the bladder with 3 per cent.sodium citrate for the first twenty-four hours after the operation.The apparatus designed by Cuthbert Dukes,7 and in use at St. Mark's Hospital, has been found valuable in this connexion.Regarding the mortality, several features must be considered.In the first place, many of these cases were recruited from the worst group of operative risks.Another feature is that the actual obstruction is fre- quently of a gradual onset over a period of years, with the result that the renal efficiency has been imperceptibly depreciated.Thus, these patients are worse risks than meil with large adenomatous prostates which become suddenly congested and develop acute retention without any previous history of urinary trouble.Again, many of the milder cases (and therefore those in better condition) were not operated upon, since they reacted satisfactorily to conservative measures.Cystoscopy, both before discharge from hospital and some months later, revealed in the main a wide shelving sulcus at the posterior lip of the bladder neck.The question which now arises is whether this will be permanent, or whether the sulcus will be obliterated by subsequent fibrosis and contraction.Time alone can solve this problem, but provided resection can be made a safe procedure, a second treatment, perhaps four or five years later, presents no insuperable difficulty, even should such be necessary.With regard to the instrumentarium, after carrying out many of the earlier resections with those instruments in common use in this country, I have recently been using the von Lichtenberg-Heywalt resectoscope.I have found this instrument generally satisfactory, especially with regard to the better visual field provided. Conclusions
The Prevalence of Alcoholism in a Community General Hospital
Authors: ROBERT A. MOORE
Journal: American Journal of Psychiatry (1971)

The Michigan Alcoholism Screening Test (MAST), medical histories, and diagnoses were employed to determine the percentage of alcoholics in a general hospital. Of 200 patients, 18 percent of the men and 5.5 percent of the women were diagnosed as alcoholic; 3.5 percent of the rest were questionable. The author believes that a simple screening test like the MAST provides a more sensitive measure of alcoholism in a general hospital population than do medical work-ups and physicians' diagnoses.
Ultrastructural analysis of hepatitis B virus in HepG2-transfected cells with special emphasis on subviral filament morphogenesis
Authors: Philippe Roingeard, Camille Sureau
Journal: Hepatology (1998)

The intracellular accumulation of empty hepatitis B virus (HBV) particles of filamentous shape leads to a direct cytopathic effect in so-called ground-glass hepatocytes. The aim of this study was to investigate how these filaments can be structurally formed at the cellular level. By electron microscopy, we reexamined the HBV-producer HepG2T-14 cells, which have been described as producing a substantial amount of empty HBV filaments compared with the other forms of HBV particles. Examination of ultrathin sections of HepG2T14 cells revealed the presence of HBV virions and filaments at the periphery of extremely large intracellular cisternae, probably related to a pre-Golgi compartment. Very long filaments appeared to be formed by a tubular budding of a long portion of the cisterna membrane. This phenomenon may be identical to that observed in the hepatocytes of HBV chronic carriers, in which the inability of the infected cell to export long HBV filamentous particles through the cellular secretion pathway seems to be at the origin of a direct cytopathic effect.
Apoe-deficient mice are resistant to the development of collagen-induced arthritis
Authors: D L Asquith, A M Miller, A J Hueber, F Y Liew, N Sattar, I B McInnes
Journal: Annals of the Rheumatic Diseases (2010)

A study was undertaken to determine whether elevated serum lipid levels induced by high fat diet feeding can affect the infl ammatory processes in collagen-induced arthritis (CIA) models in C57BL/6 wild-type (WT) and C57BL/6 ApoE-/mice.CIA was induced in male B6 WT or ApoE-/-mice, fed either normal chow diet or high fat diet, at 12 weeks of age using Type II chicken collagen, Freund's complete adjuvant and on occasion LPS boost.Autoantibody and cytokine expression were measured by ELISA and multiplex respectively.Whereas B6 WT mice developed severe articular infl ammation after collagen immunisation, ApoE-/-mice developed no clinical or histological evidence of disease whether receiving a high fat diet or normal chow diet.This lack of arthritis was not due on August 19,
Point-of-Care Prognosis for Common Musculoskeletal Pain in Older Adults
Authors: Christian D. Mallen, Elaine Thomas, John Belcher, Trishna Rathod, Peter Croft, George Peat
Journal: JAMA Internal Medicine (2013)

Many site-specific, multivariable risk models for predicting the outcome of musculoskeletal pain problems have been published. The overlapping content in these models suggests a common set of generic indicators suitable for use in primary care.To investigate whether a brief set of generic prognostic indicators can predict the outcome of musculoskeletal pain in older patients presenting to general practitioners.A prospective observational cohort study conducted from September 1, 2006, through March 31, 2007, of consecutive patients 50 years or older presenting with noninflammatory musculoskeletal pain to 1 of the 5 participating general practices in the United Kingdom.During consultation, the treating physician assessed and recorded 5 brief generic items (duration of present pain episode, current pain intensity, pain interference with daily activities, presence of multiple-site pain, and ultrashort depression screen) and recorded their overall prognostic judgment. The primary outcome was patient-rated improvement, which was measured 6 months after consultation and cross-validated with repeated measures up to 3 years.A total of 194 (48.1%) of 403 participants were classified as having an unfavorable outcome at 6 months. Inclusion of 3 generic prognostic indicators (duration of present pain episode, pain interference with daily activities, and presence of multiple-site pain) in the prognostic model improved on reliance on physicians' prognostic judgment alone (C statistic = 0.72 vs 0.62; net reclassification index = 0.136; proportion correctly classified = 69%). The improvement in prognostic accuracy was attributable to correcting physicians' tendency toward overoptimistic expectations of outcome.Three easy-to-obtain pieces of information followed by systematic recording of the general practitioners' prognostic judgment provide a simple generic assessment of prognosis at point of care in older persons presenting with musculoskeletal problems to primary care practices in the United Kingdom. Such an assessment offers a common foundation for investigating the usefulness of prognostic stratification for guiding management in the consultation across a range of common painful conditions.
Drug industry anxious about scrapping price regulation scheme
Authors: Andrew Cole
Journal: BMJ (2008)

Almost half (46%) of the United Kingdom’s drug companies expect to cut back on clinical trials in the coming year because of continued uncertainty about future arrangements for pricing drugs.

In a survey of more than 100 companies earlier this month on behalf of the Association of the British Pharmaceutical Industry and the Confederation of British Industry three quarters said they had little confidence in the current UK market environment, and 83% expected things to get worse in the next year.

The survey also showed that 30% of drug companies expect to cut staff in the next year, and more than …
Letter: Hormonal pregnancy tests and congenital malformations.
Authors: I Gal
Journal: BMJ (1975)

Dear Fellow Psychiatrists, I understand that it was your intervention that helped me so quickly (and comparatively pain- lessly) to leave the U.S.S.R., where the righttohold one's own beliefs is being constantly violated.Life in the Soviet Union has taught me that the authorities in my country are extremely sensitive to the public opinion of the Western powers.I saw that help was especially effective
Apocrine acrosyringeal keratosis in association with syringocystoadenoma papilliferum
Authors: S. Kishimoto, S. Wakabayashi, M. Yamamoto, Y. Noda, H. Takenaka, H. Yasuno
Journal: British Journal of Dermatology (2000)

Abstract We report the clinical and histopathological features of a keratosis that developed in association with syringocystadenoma papilliferum. This tumour shows a pinkish, pedunculated, spherical nodule with a cerebriform surface and visible keratinous plugs. In addition to the typical features of syringocystadenoma papilliferum, the tumour shows many hyperkeratotic columns surrounded by acanthotic epidermis with the characteristics of trichilemmal keratinization and keratohyalin granules. This keratosis seems to be derived from the middle to lower portion of the apocrine acrosyringium, based on the distribution of keratohyalin granules and the direct connection with the apocrine acrosyringium in an early lesion. Accordingly, we propose to identify this rare keratosis as apocrine acrosyringeal keratosis.
Alopecia Associated with Fluconazole Therapy
Authors: Peter G. Pappas
Journal: Annals of Internal Medicine (1995)

Objective: To describe the association between fluconazole and reversible alopecia. Design: A retrospective survey of 1) patients enrolled in NIAID Mycoses Study Group [MSG] protocols involving the long-term use of fluconazole for treatment of endemic mycoses and 2) patients treated with fluconazole outside of a protocol setting but by the MSG investigators who were MSG members. Setting: 26 MSG sites in the United States. Patients: 33 patients with various deep and superficial mycoses who developed alopecia while receiving fluconazole. Results: 11 of 26 investigators reported a total of 33 patients with substantial alopecia related to fluconazole therapy. Underlying mycoses included blastomycosis, sporotrichosis, histoplasmosis, cryptococcosis, coccidioidomycosis, and mucosal candidiasis. In separate MSG studies, 17 of 136 (12.5%) and 8 of 40 (20%) patients had substantial reversible alopecia associated with fluconazole therapy. Eight patients who were not in the protocol had similar adverse effects. Twenty-nine of 33 patients (88%) received at least 400 mg of fluconazole daily for a mean of 7. 1 months. Alopecia developed a median of 3 months after initiation of fluconazole therapy and involved the scalp in all patients. Other sites were involved in about one third of patients. Three patients required wigs because of extensive hair loss. Alopecia resolved within 6 months of discontinuation of fluconazole therapy or reduction of the daily dose by at least 50%. Conclusions: Alopecia appears to be a common adverse event associated with higher-dose (400 mg/d) fluconazole given for 2 months or longer. This effect may be severe but is reversed by discontinuing fluconazole therapy or substantially reducing the daily dose.
John Edmond O'Donovan
Authors: J. Allt-Graham
Journal: BMJ (2002)

A pioneer in critical care medicine

John O'Donovan pioneered Australian critical care medicine in a career spanning 40 years. In 1964 he co-established an intensive care unit at St Vincent's Hospital, Melbourne, bringing together all medical and surgical patients in need of acute resuscitation. In 1968 he was appointed director of intensive care and resuscitation at Box Hill and District Hospital in Melbourne as a full time specialist responsible for the management of all critically ill patients, admissions and discharges, and the education of junior doctors and nurses within the unit. Such an appointment in this fledgling specialty was the first in Australia, possibly the world.

His medical interests and publications were in intravenous fluids and resuscitation. He founded the Australian Society of Parenteral and Enteral Nutrition in 1973 and was a foundation member and secretary of the Australian Society of Critical Care Medicine from 1974 to 1979. Internationally he promoted the establishment of intensive care and emergency services, particularly in Asia.

In 1980 he was appointed consultant in charge in accident and emergency medicine at St James's Hospital, Balham, London, where he successfully made major structural and organisational changes to the department. In 1985 he returned to Australia, where he built up a successful medicolegal practice. He leaves a wife Elaine; and her two sons and daughter.

Former consultant physician and intensivist St Vincent's Hospital, Melbourne, and consultant in emergency medicine St James's Hospital, Balham, London (b 1933; q Melbourne 1957; FRACP), died from cancer on 26 December 2001.