tbuckley/cabot-search huggingface dataset:
Hepatitis B Vaccination and Plasma HIV-1 RNA
Authors: Sarah H. Cheeseman, Raul E. Davaro, Richard T. Ellison
Journal: New England Journal of Medicine (1996)

To the Editor: We had embarked on a trial of hepatitis B virus (HBV) immunization to clarify the meaning of isolated findings of seropositivity for antibodies against the core hepatitis antigen (an...
Megavoltage Advances vs the Orthovoltage Era
Authors: M. Lederman
Journal: JAMA (1972)

Strictly speaking, the term megavoltage therapy should be applied to the use of x rays and gamma rays which have an effective energy of 1 million electron volts or more. However, for our purposes the term can be applied to cover all x rays generated by voltages greater than 1 megavolt and terminating, for medical purposes, at 43 megavolts, as well as cobalt 60 gamma radiation. From the practical point of view, the apparatus in regular use for providing high energy radiation are cobalt teletherapy units (1.2 megavoltage gamma radiation), Van de Graaf generators (1 to 2 megavoltage x rays), linear accelerators (4 to 8 megavoltage x rays), and betatrons (18 to 43 megavoltage x rays). Both the linear accelerator and the betatron have advantages over a cobalt unit in the sense that they can produce both electrons and x rays; they are capable of carrying a higher patient load
Tuberculosis in the Aged
Authors: David C. Ditmore
Journal: New England Journal of Medicine (1947)

MILLER and Henderson1 state that one of the greatest deficiencies in tuberculosis control has been the failure to make sufficient use of case-finding technics in the discovery of the elderly person with undiagnosed pulmonary tuberculosis. Meyers2 believes that the presence of communicable pulmonary tuberculosis in persons over fifty years of age is higher than that in any other age period. The frequency of tuberculosis in the aged has been noted by others.3 4 5 6 Laird6 observes that the death rate from tuberculosis per 100,000 population in people over seventy years of age in 1940 was 91 for men and 68 for women . . .
Mycoplasmas and ureaplasmas in patients with hypogammaglobulinaemia and their role in arthritis: microbiological observations over twenty years.
Authors: P M Furr, D Taylor-Robinson, A D Webster
Journal: Annals of the Rheumatic Diseases (1994)

OBJECTIVES--To study the occurrence of mycoplasmas and ureaplasmas in patients with hypogammaglobulinaemia and the relationship of these micro-organisms to septic arthritis. METHODS--Over a period of about 20 years, 53 men and 38 women with hypogammaglobulinaemia, most of whom were less than 50 years old, were examined clinically and microbiologically. Mycoplasmas and ureaplasmas were sought in the throat, urogenital tract and joints by standard cultural methods, although not consistently in the three sites of all patients. RESULTS--Arginine-hydrolysing mycoplasmas and ureaplasmas occurred with similar frequency in the sputum/throat of the hypogammaglobulinaemic patients, but no more often than might be expected in immunocompetent patients. Ureaplasmas, however, dominated in the urogenital tracts of both men and women, being found in 75% of vaginal specimens. Arginine-hydrolysing mycoplasmas occurred two to six times more frequently and ureaplasmas two to three times more frequently in urine specimens from hypogammaglobulinaemic patients than they did in such specimens from sex- and age-matched non-venereal disease, hospital patients or healthy subjects; these differences were statistically significant (p < 0.05). Enhanced mucosal colonisation probably increases the chance of spread to distant sites, such as the joints. Of the 91 patients, 21 (23%) had septic arthritis involving one or more joints. Mycoplasmas and/or ureaplasmas, but not bacteria, were isolated from the joints of eight (38%) of these patients. However, dissemination to joints apparently had not occurred in some despite the opportunity by virtue of mycoplasmal or ureaplasmal colonisation at a mucosal site. Sometimes antibiotic therapy failed clinically, and microbiologically and recommendations for management are outlined. CONCLUSIONS--Hypogammaglobulinaemic patients appear to be more susceptible to colonisation of mucous membranes, especially of the urogenital tract, with mycoplasmas and ureaplasmas than are immunocompetent individuals. These micro-organisms are responsible for about two fifths of the septic arthritides occurring in these patients.
Significance of the urinary excretion of cells after experimental medullary necrosis.
Authors: D J Davies, A Kennedy, P G Saluja
Journal: Annals of the Rheumatic Diseases (1968)

Necrosis of the renal pyramid is a well-recognized feature of the renal disease caused by prolonged heavy consumption of common analgesics.Recently it has been shown that damage of the renal papilla leading to necrosis is the primary event in this condition (Dawborn, Fairley, Kincaid-Smith, and King, 1966; Burry, de Jersey, and Weedon, 1966; Sanerkin, 1966; Kincaid-Smith, 1967).The nephrotoxicity of aspirin, phenacetin, and other related compounds has been investigated in human subjects by measuring the effect of these drugs on the rate of renal cell excretion in the urine (Harvald, Valdorf-Hansen, and Nielsen, 1960; Prescott, 1966).Although analgesics raise the rate of excretion of renal cells, the significance of this in terms of altered renal histology is not known.However, in studies of rats with necrosis of the proximal convoluted tubules caused by mercuric chloride, it was found that the rate of urinary cell excretion was a sensitive method of detecting renal tubular damage (Davies and Kennedy, 1967, a, b).Before the results of this type of investigation can be used in assessing analgesic nephrotoxicity it is important to know how well renal medullary damage can be correlated with an increase in the rate of excretion of renal cells.Ethyleneimine (vinylamine) is a compound that produces selective damage of the renal pyramid (Levaditi, 1901; Mandel and Popper, 1951).In this paper experiments are described in which the changes in renal cell excretion observed after giving this compound are correlated with the histological changes in the kidney and also with the renal concentrating power.Requests for reprints to Dr. A.
Effects of α‐thalassemia‐2 on the developmental changes of hematological values in children with sickle cell disease from georgia
Authors: A. E. Felice, K. M. McKie, M. P. Cleek, E. M. Marino, A. Kutlar, V. C. McKie
Journal: American Journal of Hematology (1987)

Abstract The hematology and pathophysiology of sickle cell disease during the postnatal development of younger hemoglobin (Hb) S homozygotes (SS) could be considerably affected by a variability of α globin gene numbers. We have documented longitudinal developmental changes of hematological values and hemoglobin composition on 147 patients with SS (αα/αα), 64 with SS (‐α/αα), and 9 with SS (–α/–α) between the ages of 1 and 15 years. Non‐steady‐state data were excluded from these analyses. The number and organization of α globin genes was established by gene mapping. As anticipated, mean corpuscular volume and erythrocyte counts correlated with α globin gene numbers throughout the 15‐year age interval. On the other hand, SS children with αα/αα, –α/, –α had similar hemoglobin concentrations up to the ages of 5–10 years. Around the age of 7, the SS patients with –α/–α developed a higher Hb concentration than that of the SS (–α/αα), which in turn was higher than that of the SS (αα/αα). The emergence of this difference coincided with a developmental increase of the mean corpuscular hemoglobin concentration (MCHC) in patients with SS (αα/αα) and the decline of Hb F % under 15%. This newly observed developmental change of the MCHC could lead to increased hemolysis and anemia after the age of 5‐10 years. It occurs to a smaller extent among SS (–α/αα) or not at all among SS (–α/αα) such that these two categories of patients have less severe hemolysis and higher hemoglobin levels at older ages. Although the proportion of Hb F was independent of α globin gene numbers, the absence of Hb Bart's suggested that α‐thalassemia promotes the intracellular assembly of Hb F over Hb S tetramers. Thus, the interaction of α‐thalassemia and Hb F in young SS patients may be more complex than revealed by Hb F levels in cell lysates. Among older SS children (&gt; 7 years) α‐thalassemia and Hb F levels exceeding 15% appear to have additive effects in diminishing the rate of hemolysis.
Treatment of Acute Myeloid Leukaemia according to the Hammersmith Protocol: Preliminary Report
Authors: W. Paolino, L. Resegotti, M. Rossi, V. Infelise
Journal: BMJ (1973)

A preliminary report is given of a trial of the T.R.A.P. regimen (thioguanine, rubidomycin, cytosine arabinoside, and prednisolone) for the treatment of acute myeloid leukaemia. Out of 27 patients treated 13 (48.1%) obtained complete remission. The treatment was well tolerated and produced especially good results in elderly patients.
CLINICAL OBSERVATIONS ON INFLUENZA
Authors: BERNARD FANTUS
Journal: JAMA (1918)

The epidemic, or rather pandemic, of influenza through which Chicago has just passed has afforded me an opportunity of making observations that it might be of interest to record, as they were made in family practice, which is not so well represented in medical literature as is that of the hospital, even though the vast bulk of the work of the medical profession lies in the former field rather than in the latter. One of the startling features of the pandemic was its sudden flaring up and its equally sudden decline, reminding one of a flame consuming highly combustible material, which died down as soon as the supply of the material was exhausted. There is every reason to believe that, within a few weeks of its onset, the infection was universally present in the nose and throat of the people, disseminated by mouth spray given off on talking by innumerable
A Third Lecture ON UNICELLULA CANCRI: THE PARASITE OF CANCER
Authors: H. Butlin
Journal: BMJ (1912)

WVHEN I was a young man there were a good many sturgeons attached -to the hospitals in London who spoke of themselves as "practical surgeons."They not only exhibited nio interest in pathology and in the scientific problems connected with their trade of surgeon,-buLt they lheld such tllings in scorn and laughed at those who did pursue them.To them sutrgery consisted in the diagnosis of disease and`-in the treatment of it, particularly by operation.They prided themselves often quite justlyon their neatness, skill, and boldness.They sometimes heard it stated that patlhology is the foundation of sur- gery.But the statement had no meaning in their ears, and they seldom gave themselves the trouble to discuss it or even to consider it.Practical surgeons may still exist, but they are not now in evidence as they used to be.They no longer make a boast of their ignorance of pathology and the scientific side of surgery, and now it is rather the fashion to admit' that pathology is the foundation of medicine and sturgery.
Peripheral arthritis in the elderly: a hospital study.
Authors: M L Jenkinson, M R Bliss, A T Brain, D L Scott
Journal: Annals of the Rheumatic Diseases (1989)

One hundred consecutive patients admitted to an acute geriatric unit were examined for evidence of peripheral arthritis with recognised criteria used to define osteoarthritis, rheumatoid arthritis, pyrophosphate arthropathy, gout, and disorders of the shoulder joint. The presence of arthritis and its severity were related both to functional independence and to a recognition by the patient that joint problems were impairing independence. Seventy six patients had clinical peripheral arthritis; 48 had arthritis contributing to loss of function, and 19 of these did not volunteer evidence of their joint disease. The common occurrence of arthritic conditions in the elderly, with consequential disability and dependency, suggests that increased medical awareness may be required to prevent unnecessary morbidity. Our findings need confirmation in community based studies.
Cases Illustrating the Significance of Vaginal Examination in Obstetric Practice
Authors: A. E. A. Lawrence
Journal: BMJ (1876)

disease and better opr-z.scct of recovery.The result is, that the sick list has been heavier b)y altl 25 per cenit., lbut that acute disease is comparatively rare andl seldoml fatal, and the downwardt progress of incurmllie maladies has been much retarded.T're ininlllse mlajority of the cases (970 per 1,ooo) terminate in recovery 1and return t) duity.T'lhose who, after suste mi(othis' treatment, art founml to ie ,till ioca- pacitateld are superannuated.The mortality from disease has rangcl from five to eighteen t,;- nantm, and shows for the twenty-eight yearsan annual mean death-rate of l.S5 per i,ooo.I)eaths from accident have averaged annually 1.3 l,ooo.Deaths from all causes have in the periml amounted to 12.7 per i,ooo.Retirements from the service by reason of l)hysical or mental inca- pacity have ranged from0 2 to 20 po/-annulm, yielding in the twentyeight years a mean rate of 8 l)er I,000ooo annually superannuated.Colm- bined with deaths, this will give a ratio of 21 per s,oo for departure from the service through disease and accident: a very moderate pro- portion when compared with the military and naval services, where, by the mean of ten years returns of the forces on the home stations, the combined rate was in the Army 43 per I,ooo, and in the Royal Navy 37 per x,ooo.* As yellow fever is a kind of bugbear to men wishing to go to the West Indies, I may remark here that in healthy islands, such as St. Kitts, it only appears once every ten years or so.Thus in St. Kitts, there were outbreaks in 18I2, 1818-19,
A Correct Nomenclature.
Authors: Geo. F. Keiper
Journal: JAMA (1895)

La Fayette, Ind., Sept. 28, 1895. <h3>To the Editor:</h3> —There is a growing tendency by physicians to call their practice by the name of " business." While the practice of medicine has its business side, which should be carefully guarded, it surely is not all business, except with those fellows who prostitute the practice to get out of it all the money they can, by leaving out of sight all the other attributes which characterize a good physician's practice. When a physician calls his practice " business," we naturally look for those tricks of trade which are reprehensible in the practice of medicine. Often we do not have to look far to find them either. In the name of the good system under which we were reared, let us cease to lower ourselves in the estimation of others by calling what we do "business;" but rather let it be known by the
Assessment of Right Ventricular Systolic Functions in Patients with Chronic Renal Failure before and after Hemodialysis
Authors: Abdulkadir Yıldız, Abdurrahman Akyuz, Murat Yuksel, Mustafa Oylumlu, Mehmet Zihni Bilik, Nihat Polat, Mehmet Ata Akil, Halit Acet, Mesut Aydin, Umit Inci, Mehmet Siddik Ulgen, Sait Alan, Nizamettin Toprak
Journal: Journal of the American College of Cardiology (2013)
Perioperative immunonutrition in patients undergoing liver transplantation: A randomized double‐blind trial
Authors: Lindsay D. Plank, Sachin Mathur, Edward J. Gane, Sze‐Lin Peng, Lyn K. Gillanders, Kerry McIlroy, Carolina Paras Chavez, Philip C. Calder, John L. McCall
Journal: Hepatology (2014)

Preliminary work suggested that perioperative immunonutrition (IMN) enriched in n‐3 fatty acids, arginine, and nucleotides may improve preoperative nutritional status, enhance postoperative recovery, and reduce postoperative infectious complications in patients undergoing liver transplantation (LT). The current study examined these outcomes in a double‐blind, randomized, controlled trial. Patients wait‐listed for LT (n = 120) were randomized to either supplemental (0.6 L/d) oral IMN or an isocaloric control (CON). Enteral IMN or CON was resumed postoperatively and continued for at least 5 days. The change in total body protein (TBP) measured by neutron activation from study entry until immediately prior to LT was the primary endpoint and TBP measurements were repeated 10, 30, 90, 180, and 360 days after LT. Infectious complications were recorded for the first 30 postoperative days. Nineteen patients died or were delisted prior to LT. Fifty‐two IMN and 49 CON patients received supplemental nutrition for a median (range) 56 (0‐480) and 65 (0‐348) days, respectively. Preoperative changes in TBP were not significant (IMN: 0.06 ± 0.15 [SEM]; CON: 0.12 ± 0.10 kg). Compared to baseline, a 0.7 ± 0.2 kg loss of TBP was seen in both groups at 30 days after LT ( P &lt; 0.0001) and, at 360 days, TBP had not increased significantly (IMN: 0.08 ± 0.19 kg; CON: 0.26 ± 0.23 kg). Infectious complications occurred in 31 (60%) IMN and 28 (57%) CON patients ( P = 0.84). The median (range) postoperative hospital stay was 10 (5‐105) days for IMN and 10 (6‐27) days for CON patients ( P = 0.68). Conclusion : In patients undergoing LT, perioperative IMN did not provide significant benefits in terms of preoperative nutritional status or postoperative outcome. (H epatology 2015;61:639‐647)
Death in Pregnancy — An American Tragedy
Authors: Jeffrey L. Ecker
Journal: New England Journal of Medicine (2014)

Interview with Dr. Jeffrey Ecker on the recent Marlise Muñoz case and its legal, ethical, and clinical implications. (11:03)Download The case of Marlise Muñoz, in which a Texas hospital was made to withdraw support from a pregnant woman who had been brain dead for 2 months, should underscore women's right to determine the course of their end-of-life care, whether or not they are pregnant.
Inhibition of Transforming Growth Factor-β Signaling Accelerates Atherosclerosis and Induces an Unstable Plaque Phenotype in Mice
Authors: Ziad Mallat, Andrea Gojova, Carmen Marchiol-Fournigault, Bruno Esposito, Caroline Kamaté, Régine Merval, Didier Fradelizi, Alain Tedgui
Journal: Circulation Research (2001)

Atherosclerosis is a disease of the arterial wall that seems to be tightly modulated by the local inflammatory balance. Whereas a large body of evidence supports a role for proinflammatory mediators in disease progression, the understanding of the role of the antiinflammatory component in the modulation of plaque progression is only at its beginning. TGF-beta1, -beta2, and -beta3 are cytokines/growth factors with broad activities on cells and tissues in the cardiovascular system and have been proposed to play a role in the pathogenesis of atherosclerosis. However, no study has examined the direct role of TGF-beta in the development and composition of advanced atherosclerotic lesions. In the present study, we show that inhibition of TGF-beta signaling using a neutralizing anti-TGF-beta1, -beta2, and -beta3 antibody accelerates the development of atherosclerotic lesions in apoE-deficient mice. Moreover, inhibition of TGF-beta signaling favors the development of lesions with increased inflammatory component and decreased collagen content. These results identify a major protective role for TGF-beta in atherosclerosis.
NASAL DISEASE A FREQUENT CAUSE OF ASTHMA.
Authors: JOHN O. ROE
Journal: JAMA (1883)

[Read in Section on Ophthalmology, Otology and Laryngology, June, 1883.] It has become a well-known fact, since it was first pointed out by Valtolini, that polypoid and other growths in the nasal passages are the frequent cause of asthmatic attacks; but it is only since Weber called attention to the relation between chronic nasal catarrh and asthma that it has been recognized, that other diseases of the nasal passages, independent of neoplastic growths, are also capable of exciting asthmatic attacks in a similar manner. Asthma is proverbially considered to be the most intractable of all diseases. Indeed, so uncertain is the effect of any remedy in its treatment, in different individuals, that physicians not unfrequently depend more on the experience of the patient respecting any particular remedy than upon the logical administration of remedies to meet the symptomatic indications. This capriciousness of asthma has led to the most diversified views
Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity.
Authors: A Hasani, D Pavia, J E Agnew, S W Clarke
Journal: Thorax (1994)

In vitro studies have suggested that both the viscoelastic properties of lung secretions and the peak flow attained during simulated cough influence clearance. This study examines the possible association of the viscoelastic properties of sputum and maximum expiratory flow with measured effectiveness of mucus clearance induced by instructed cough and by forced expiration technique (FET) in patients with airways obstruction.Nineteen patients (11 men and eight women) of mean (SE) age, % predicted FEV1, and daily sputum wet weight of 64 (2) years, 52 (6)%, and 37.5 (7.9) g respectively participated in the study. Mucus movement from proximal and peripheral lung regions was measured by an objective non-invasive radioaerosol technique. Each patient underwent three assessments: control, cough, and FET. During cough and FET, maximum expiratory flow was measured at the mouth level. Apparent viscosity and elasticity of the expectorated sputum samples were measured with a viscometer.Compared with the control run (mean (SE) clearance: 16 (3)%) there was an increase in clearance from the whole lung during cough (44 (5)%) and FET (42 (5)%), and also an enhanced clearance of inhaled, deposited radioaerosol from the trachea, inner and intermediate regions of the lungs, but not from the outer region. There were, however, no differences in regional clearance between cough and FET. Neither regional nor total clearance correlated with maximum expiratory flow, apparent viscosity, elasticity, or daily sputum wet weight.These results confirm that cough and FET both promote effective clearance but suggest that, unlike in vitro studies, sputum production and viscoelasticity, as well as maximum expiratory flow, provide no guide to clearance efficacy in humans.
Prognosis of Negative Adenosine Stress Magnetic Resonance in Patients Presenting to an Emergency Department With Chest Pain
Authors: W. Patricia Ingkanisorn, Raymond Y. Kwong, Nicole S. Bohme, Nancy L. Geller, Kenneth L. Rhoads, Christopher K. Dyke, D. Ian Paterson, Mushabbar A. Syed, Anthony H. Aletras, Andrew E. Arai
Journal: Journal of the American College of Cardiology (2006)
Echo Virus Type 9 Associated with Three Cases Simulating Meningococcemia
Authors: Thomas E. Frothingham
Journal: New England Journal of Medicine (1958)

A SEPTIC meningitis with rash was first reported in 1947.1 The etiology was unknown, but ECHO virus has recently been associated with outbreaks occurring from July through December in Europe, England, Canada and the United States.2 3 4 5 6 7 8 9 10 The rash, usually on the face and upper trunk, has been described as blotchy, maculopapular, rubelliform and occasionally petechial.5 , 8 9 10 Cases exhibiting petechial rash and meningitis have sometimes been initially regarded as meningococcemia.8 Three patients with aseptic meningitis with rash that included petechiae were admitted to this hospital in January, 1958. An initial diagnosis of possible meningococcemia was made, and treatment for this disease instituted. . . .