tbuckley/cabot-search huggingface dataset:
Diabetic Pyomyositis
Authors: Michele Y.Y. Seah, Sadanand N. Anavekar, Judy A. Savige, Louise M. Burrell
Journal: Diabetes Care (2004)

Pyomyositis is a pyogenic infection of the skeletal muscle that can lead to abscess formation (1,2). It commonly occurs in the tropics, but is also recognized in temperate climates, with HIV infection and diabetes being the main predisposing factors (3,4). The diagnosis of pyomyositis is difficult due to its vague clinical presentation and poor localizing signs. Early in its course, the differential diagnosis includes musculoskeletal aches, osteomyelitis, septic arthritis, muscle hematoma, muscle rupture, thrombophlebitis, or deep venous thrombosis. A delay in diagnosis may result in compartment syndrome, sepsis, and death. The long-term sequelae of pyomyositis include osteomyelitis of adjacent bones, muscle scarring, prolonged hospitalization, and significant functional impairment (5). We report a patient with diabetes who presented with a painful leg and was diagnosed with pyomyositis.

A 63-year-old man with type 2 diabetes presented with a 1-week history of increasing pain and swelling over his left lower limb. He was unable to weight-bear and had systemic features of malaise, fever, and rigors. There was no history of trauma. Comorbidities included ischemic heart disease, hypertension, …
A Comparison of Some Aspects of Structured and Unstructured Psychiatric Interviews
Authors: MARCEL T. SAGHIR
Journal: American Journal of Psychiatry (1971)

The author presents the results of a comparison between a standardized interviewing instrument and the traditional free-style medical interview that involved two groups of interviewers. The author's ratings of their conduct of the interviews, their styles, and their points of emphasis indicated that the standardized instrument was more comprehensive in its coverage of psychiatric pathology. On the other hand, the free-style interview allowed significant individual variation in emphasis, which contributes to differences among observers and impedes comparability of the work of different researchers.
Genetic profiling and epidermal growth factor receptor-directed therapy in nonsmall cell lung cancer
Authors: J. Cadranel, G. Zalcman, L. Sequist
Journal: European Respiratory Journal (2010)

The principle of preferentially selecting patients most likely to benefit from therapy according to their genetic profile has led to substantial clinical benefit in some tumour types, and has potential to considerably refine treatment in advanced nonsmall cell lung cancer (NSCLC). Effective, reliable use of molecular biomarkers to inform clinical practice requires the standardisation of testing methods and careful assessment of biomarkers’ predictive and prognostic value. Although a number of studies have shown that patients with activating mutations in exons 18–21 of the epidermal growth factor receptor (EGFR) gene respond particularly well to gefitinib and erlotinib, a prospective, randomised study was needed to differentiate between the prognostic and predictive value of EGFR mutations. From one such study, it appeared that mutational testing should become standard at diagnosis, at least for adenocarcinoma patients with a never or low smoking history, as clinical predictors are insufficient to optimise treatment. However, outstanding questions remain: what are the treatment options for patients with tumours resistant to erlotinib/gefitinib? What conclusions about treatment can we draw from EGFR copy number or KRAS mutation status? What role should anti-EGFR antibodies play in NSCLC treatment, and in which patients? This review considers current evidence linking biomarker profile to efficacy of EGFR-targeted therapy in NSCLC, and clinical implications of recent findings.
An escalating dose finding study of liposomal doxorubicin and vinorelbine for the treatment of refractory or resistant epithelial ovarian cancer
Authors: R. Tambaro, S. Greggi, R.V. Iaffaioli, A. Rossi, C. Pisano, L. Manzione, E. Ferrari, M. Di Maio, F. Iodice, G. Casella, G. Laurelli, S. Pignata
Journal: Annals of Oncology (2003)
Mitochondrial DNA evolution in the Drosophila obscura group.
Authors: A Latorre, E Barrio, A Moya, F J Ayala
Journal: Molecular Biology and Evolution (1988)

We report a restriction-site study of the mitochondrial DNA (mtDNA) of seven species of the Drosophila obscura group. One species (D. azteca) belongs to the affinis subgroup; the other six species are classified in the obscura subgroup, three of them being from the old-world species (D. obscura, D. ambigua, and D. subobscura) and three from the new-world species (D. pseudoobscura, D. persimilis, and D. miranda). The mtDNA patterns suggest that the phylogeny of the group needs to be revised. The Nearctic obscura species appear as more closely related to D. azteca (affinis subgroup) than to the Palearctic species. The three Palearctic species are, in turn, a very heterogeneous group, with D. obscura no more closely related to D. subobscura and D. ambigua than to D. affinis or the Nearctic obscura species. The rates of mtDNA evolution are variable: some lineages have evolved at rates two or three times greater than others. If an average rate of 0.5% nucleotide substitutions/Myr is assumed, the divergence among the four main lineages in the phylogeny would have occurred 12-15 Myr ago, during the Miocene, which is consistent with biogeographic information.
Model for end‐stage liver disease‐based allocation system: On the right path, but not there yet
Authors: Ângelo Zambam de Mattos, Angelo Alves de Mattos
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. To the Editor: This letter regards the interesting article published by Northup et al.1 The researchers demonstrated that, under the Model for End‐Stage Liver Disease (MELD)‐based allocation system for liver transplantation, patients with exceptions to this system, especially those with hepatocellular carcinoma (HCC), have a great advantage over nonexception candidates in waiting list mortality and in access to transplant, leading to inequity.1 Their results raise the issue of the rationales on which a transplantation policy should be based, equity, utility, benefit, need, and fairness, as pointed out by the editorial related to the article.2 We conducted a study to evaluate the impact of the MELD‐based allocation system on survival of liver transplant candidates in southern Brazil. The study compared pre‐MELD era, when allocation was based on time spent on the waiting list, to post‐MELD era, when allocation was based on MELD score.3 Interestingly, the American situation regarding patients enlisted to transplant with exceptions to the MELD‐based system is quite similar to the Brazilian one, which can be exemplified by the percentage of enlisted patients with HCC, 19.00% in the American study1 and 19.60% in the post‐MELD era of the Brazilian study.3 Differently from Northup et al.,1 we used an intention‐to‐transplant approach, evaluating survival of patients enlisted to transplantation, regardless of being transplanted.3 We estimated long‐term survival of transplant candidates using the parametric models that best fitted their Kaplan‐Meier's survival curve (Gompertz's model for pre‐MELD era and normal‐log model for post‐MELD era), demonstrating that patients enlisted to transplant during the pre‐MELD era had an estimated 5‐year survival of 43.17% and a 10‐year survival of 41.75% independently of being transplanted, whereas those enlisted during the post‐MELD era had estimated survivals of 53.54% and 44.64%, respectively. Therefore, our study showed that, despite the possibility of some distortions caused by using MELD score for allocation, there was an improvement comparing to the previously used allocation system. In spite of our findings, we share the concerns of Northup et al.1 regarding some inequity caused by the MELD‐based allocation system. We understand that, besides increasing the number of donors and developing treatments to avoid transplantation, improving the allocation system is of major importance. Aiming at this, we consider that studying survival using an intention‐to‐transplant approach is essential, because it reflects the results of the population of patients needing transplantation as a whole, rather than reflecting only the outcomes of those who received the organ or of the ones who died on the waiting list.
Sicca syndrome and silicoproteinosis in a dental technician
Authors: R Orriols, J Ferrer, JM Tura, C Xaus, R Coloma
Journal: European Respiratory Journal (1997)

Secondary sicca syndrome has been described in silicotic and exposed nonpneumoconiotic individuals. Systemic autoimmune pathogenic mechanisms have been thought to be responsible. Salivary gland mineral deposition has not so far been implicated. We describe the case of a dental technician who sand-blasted dental prostheses and developed silicoproteinosis and sicca syndrome. Immunological studies were negative. Scanning electron microscopy study and energy-dispersive X-ray analysis were carried out in the patient's lung and salivary gland and in two salivary glands from nonexposed individuals diagnosed with sicca syndrome. High peaks of silicon and aluminium were detected in the patient's lung and salivary gland. Silicon/sulphur and aluminium/sulphur ratios were higher in the patient's glands (0.612 and 0.402, respectively) than in the two control salivary glands (0.193 and 0 and 0.127 and 0, respectively). We suggest that, in this case, sicca syndrome could have been caused by inorganic deposition.
Pfeiffer's Bacillus Meningitis: Recovery after Sulphapyridine
Authors: C. A. Birch
Journal: BMJ (1943)

Haemothorax due* to Strangulated Diaphragmatic HerniaHaemothorax as the predominant clinical sign following acute strangulation of a diaphragmatic hernia is unusual enough to warrant record. CASE HISTORYThe patient, a farm labourer aged 37, gave a history of previous good health, although he had complained to his family of occasional indigestion.On Jan. 14, 1942, he felt severe abdominal pain immediately after supper.He was seen by one of us (S.M. S.), who found him shocked and restless, with temperature 970, pulse 100,
Predicting survival in malignant mesothelioma
Authors: A.W. Musk, N. Olsen, H. Alfonso, A. Reid, R. Mina, P. Franklin, J. Sleith, N. Hammond, T. Threlfall, K.B. Shilkin, N.H. de Klerk
Journal: European Respiratory Journal (2011)

Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days; ~4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions.
Assault Weapons as a Public Health Hazard in the United States
Authors: Yank D. Coble
Journal: JAMA (1992)

MOST of the scientific research relating to firearms and their effects on public health has concentrated on handguns. Despite the severity of the firearm problem in this country, and the wealth of publicity associated with it, more scientific investigation is needed on all firearm injuries<sup>1</sup>and those due to special classes of guns like assault weapons. The purpose of this report is to review what is known about assault weapons and their impact on public health and to discuss legislation to restrict the sale and private ownership of assault weapons. This report adds to the information provided by Substitute Resolution 264 (A-89), Restriction of Assault Weapons, which states that "the AMA [American Medical Association] supports appropriate legislation that would restrict the sale and private ownership of large-clip, high-rate-of-fire automatic and semiautomatic firearms, or any weapon that is modified or redesigned to operate as a large-clip, high-rate-of-fire automatic or semiautomatic weapon."
A PROPOSED STANDARD SYSTEM OF NOMENCLATURE OF HUMAN MITOTIC CHROMOSOMES
Authors: J. Lejeune, A. Levan, J.A. Böök, E.H.Y. Chu, C.E. Ford, M. Fraccaro, D.G. Harnden, T.C. Hsu, D.A. Hungerford, P.A. Jacobs, S. Makino, TheodoreT. Puck, A. Robinson, J.H. Tjio, D.G. Catcheside, H.J. Muller, Curt Stern
Journal: The Lancet (1960)
Ovarian Pregnancy and Intrauterine Device
Authors: M. Steven Piver
Journal: JAMA (1967)

THE MECHANISM of action of intrauterine contraceptive devices (IUCDs) is still unknown. The reported tubal pregnancies in association with IUCDs make it evident that, in these cases, the device did not interfere with fertilization of the ovum in the fallopian tube. The purpose of this report is to record the first case of ovarian pregnancy, to our knowledge, in association with an IUCD. <h3>Report of a Case</h3> In June 1966, a 29-year-old, white, gravida 6 para 5 had a Lippes loop inserted. She did well until Jan 3, 1967, when her menses lasted for ten days. Bleeding began again on Jan 15 and persisted for ten days, and for eight more days beginning Jan 30. She continued to bleed almost daily until the time of her admission on Feb 23. Four weeks prior to admission, pain developed in the right lower quadrant of the abdomen, and continued until surgery. Examination
Role of the Hepatic Artery in the Metabolism of Phenacetin and Acetaminophen: An Intravital Microscopic and Multiple–Indicator Dilution Study in Perfused Rat Liver
Authors: Sandy K. Pang, Igor A. Sherman, Andreas J. Schwab, Wanping Geng, Ford Barker, John A. Dlugosz, Guy Cuerrier, Carl A. Goresky
Journal: Hepatology (1994)

We studied the pattern of intermixing of the hepatic arterial and portal venous flows in a perfused rat liver preparation under constant flow (12 ml/min) with intravital epifluorescent microscopy; changes in the steady state extraction ratio of carbon 14—labeled phenacetin and tritiated acetaminophen, probes metabolized primarily in perivenous and periportal regions of the rat liver, respectively; and the spaces accessed by noneliminated reference indicators introduced as a bolus into the hepatic artery and portal vein at different hepatic arterial/portal venous flow regimens of 0:12, 2:10 and 4:8. The sinusoidal velocities for the hepatic arterial— and portal venous (hepatic arterial/portal venous flow at 4:8)—infused fluorescein isothiocyanate—erythrocytes (100 μ1/min) were 327 ± 78 and 301 ± 63 μm/sec, respectively, and the velocity for the solely portal venous–perfused liver (12 ml/min) was 347 ± 74 μm/sec the flow–weighted sinusoidal velocity was highly correlated to the sinusoidal volume for the dually perfused rat liver. Small but significant decreases in the extraction ratio of [14C]phenacetin (from 0.989 to 0.984 and 0.980) and tritiated acetaminophen (from 0.631 to 0.607 to 0.563), delivered simultaneously into the hepatic artery and portal vein, were observed with an increment of hepatic arterial flow within the same liver preparation; oxygen consumption rate also fell slightly, in parallel fashion. When a multiple–indicator dilution dose containing chromium 51—labeled RBCs, iodine 125—labeled albumin and tritiated water or [14C]urea was injected into the hepatic artery (which accesses both the peribiliary capillary plexus [nonsinusoidal] and the sinusoidal bed) and portal vein (which enters only the sinusoids) at 10–min intervals within each steady state, the blood volume, total albumin space, albumin Disse space, total water and parenchymal cellular water spaces were unchanged after portal venous injection for all hepatic arterial/portal venous flow ratios, suggesting that the arterial flow is ineffective in perturbing average sinusoidal flow dynamics. However, slightly larger total water spaces were obtained with hepatic arterial injection. This excess water space was almost completely accounted for by the “nonsinusoidal” extravascular space associated with the peribiliary capillary plexus; it averaged 0.03 ml/gm and was independent of flow. The anomaly, a reduced flow–weighted sinusoidal velocity for the dually perfused liver, an unchanged diameter of the terminal hepatic venule (32 μm) among the hepatic arterial/portal venous flow ratios and the reduction in the extraction ratio of the drug probes and oxygen consumption rates suggest that some of the arterial flow must have entered the sinusoids somewhat downstream. (Hepatology 1994;20:672-683).
Zoonotic orthopoxviruses encode a high-affinity antagonist of NKG2D
Authors: Jessica A. Campbell, David S. Trossman, Wayne M. Yokoyama, Leonidas N. Carayannopoulos
Journal: The Journal of Experimental Medicine (2007)

NK and T lymphocytes express both activating and inhibiting receptors for various members of the major histocompatibility complex class I superfamily (MHCISF). To evade immunologic cytotoxicity, many viruses interfere with the function of these receptors, generally by altering the displayed profile of MHCISF proteins on host cells. Using a structurally constrained hidden Markov model, we discovered an orthopoxvirus protein, itself distantly class I–like, that acts as a competitive antagonist of the NKG2D activating receptor. This orthopoxvirus MHC class I–like protein (OMCP) is conserved among cowpox and monkeypox viruses, secreted by infected cells, and bound with high affinity by NKG2D of rodents and humans (KD ∼ 30 and 0.2 nM, respectively). OMCP blocks recognition of host-encoded ligands and inhibits NKG2D-dependent killing by NK cells. This finding represents a novel mechanism for viral interference with NKG2D and sheds light on intercellular recognition events underlying innate immunity against emerging orthopoxviruses.
Similar levels of mRNA from the W1282X and the delta F508 cystic fibrosis alleles, in nasal epithelial cells.
Authors: T Shoshani, E Kerem, A Szeinberg, A Augarten, Y Yahav, D Cohen, J Rivlin, A Tal, B Kerem
Journal: Journal of Clinical Investigation (1994)

The effect of nonsense mutations on mRNA levels is variable. The levels of some mRNAs are not affected and truncated proteins are produced, while the levels of others are severely decreased and null phenotypes are observed. The effect on mRNA levels is important for the understanding of phenotype-genotype association. Cystic fibrosis (CF) is a lethal autosomal recessive disease with variable clinical presentation. Recently, two CF patients with mild pulmonary disease carrying nonsense mutations (R553X, W1316X) were found to have severe deficiency of mRNA. In the Jewish Ashkenazi CF patient population, 60% of the chromosomes carry a nonsense mutation, W1282X. Patients homozygous for this mutation have severe disease presentation with variable pulmonary disease. The presence of CF transcripts in a group of patients homozygous and heterozygous for this mutation was studied by reverse transcriptase PCR of various regions of the gene. Subsequent hybridization to specific CF PCR probes and densitometry analysis indicated that the CF mRNA levels in patients homozygous for the W1282X mutation are not significantly decreased by the mutation. mRNA levels were compared for patients heterozygous for the W1282X mutation. The relative levels of mRNA with the W1282X, and the delta F508 or the normal alleles, were similar in each patient. These results indicate that the severe clinical phenotype of patients carrying the W1282X mutation is not due to a severe deficiency of mRNA. In addition, the severity, progression, and variability of the pulmonary disease are affected by other, as yet unknown factors.
Safety and Efficacy of Enoxaparin vs Unfractionated Heparin in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes Who Receive Tirofiban and Aspirin&lt;SUBTITLE&gt;A Randomized Controlled Trial&lt;/SUBTITLE&gt;
Authors: Michael A. Blazing
Journal: JAMA (2004)

ContextEnoxaparin or the combination of glycoprotein IIb/IIIa inhibitor tirofiban with unfractionated heparin independently have shown superior efficacy over unfractionated heparin alone in patients with non–ST-elevation acute coronary syndromes (ACS). It is not clear if combining enoxaparin with glycoprotein IIb/IIIa inhibitors is as safe or as effective as the current standard combination of unfractionated heparin with glycoprotein IIb/IIIa inhibitors.ObjectiveTo assess efficacy and safety of the combination of enoxaparin and tirofiban compared with unfractionated heparin and tirofiban in patients with non–ST-elevation ACS.Design, Setting, and ParticipantsA prospective, international, open-label, randomized, noninferiority trial of 1 mg/kg of enoxaparin every 12 hours (n = 2026) compared with weight-adjusted intravenous unfractionated heparin (n = 1961) in patients with non–ST-elevation ACS receiving tirofiban and aspirin. Phase A of the A to Z trial was conducted between December 1999 and May 2002.Main Outcome MeasuresDeath, recurrent myocardial infarction, or refractory ischemia at 7 days in the intent-to-treat population with boundaries set for superiority and noninferiority. Safety based on measures of bleeding using the Thrombolysis in Myocardial Infarction (TIMI) classification system.ResultsA total of 169 (8.4%) of 2018 patients randomized to enoxaparin experienced death, myocardial infarction, or refractory ischemia at 7 days compared with 184 (9.4%) of 1952 patients randomized to unfractionated heparin (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.71-1.08). This met the prespecified criterion for noninferiority. All components of the composite primary and secondary end points favored enoxaparin except death, which occurred in only 1% of patients (23 for enoxaparin and 17 for unfractionated heparin). Rates for any TIMI grade bleeding were low (3.0% for enoxaparin and 2.2% for unfractionated heparin; P = .13). Using a worst-case approach that combined 2 independent bleeding evaluations, use of enoxaparin was associated with 1 additional TIMI major bleeding episode for each 200 patients treated.ConclusionsIn patients receiving tirofiban and aspirin, enoxaparin is a suitable alternative to unfractionated heparin for treatment of non–ST-elevation ACS. The 12% relative and 1% absolute reductions in the primary end point in favor of enoxaparin met criterion for noninferiority and are consistent with prior trials performed without the use of glycoprotein IIb/IIIa inhibitors.
Effect of Postmenopausal Status and Age at Menopause on Type 2 Diabetes and Prediabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 17 (TOPICS 17)
Authors: Yoriko Heianza, Yasuji Arase, Satoru Kodama, Shiun Dong Hsieh, Hiroshi Tsuji, Kazumi Saito, Hitoshi Shimano, Shigeko Hara, Hirohito Sone
Journal: Diabetes Care (2013)

Findings on the effect of menopause or age at menopause on the presence of hyperglycemia are controversial, and why women after menopause have a higher probability of having hyperglycemia than men in the same age range remains unknown.