tbuckley/cabot-search huggingface dataset:
IMPORTANCE OF EARLY DIAGNOSIS.
Authors: JOHN C. MORFIT
Journal: JAMA (1899)

From both the scientific and practical standpoint, the diagnosis of a disease or ailment ought to be the most attractive factor in the practice of medicine or surgery. In any case the diagnosis is the foundation or base on which we build our plan of treatment and make our prognosis. It is the fulcrum on which moves the lever of judgment and logical deduction, that raises our unknown quantity into the light of scientific certainty. It is often asserted that any one who can correctly diagnose will have no trouble in treating the pathologic conditions with which he is confronted. I have as frequently heard the statement that scarcely over 50 per cent. of cases treated are accurately diagnosed. There may have been some foundation for the latter statement in former times, but certainly, today, there is less justification for its utterance. There is still, however, too much empiricism. Nature
Schizophrenia in Twins and the Diffuse Ego Boundary Hypothesis
Authors: MARTIN G. ALLEN, WILLIAM POLLIN
Journal: American Journal of Psychiatry (1970)

In a sample of 31,818 male veteran twins, 1.14 percent were found to be schizophrenic. This incidence of schizophrenia is similar to that in the general population, suggesting that there is no clear difference in incidence of schizophrenia between twins and nontwins. The incidence of schizophrenia in monozygotic twins in this sample was no greater than in dizygotic twins; this accords with the results of four other major twin studies. Thus the data do not support the hypothesis that greater diffusion of ego boundaries and confusion of identity occur in twins, or especially "identical" (MZ) twins, or is significant in the occurrence of schizophrenia in twins. Neither, however, do they refute it, Since compensating factors may be present.
Transmission of Duck Hepatitis B Virus from Chinese Carrier Ducks to Japanese Ducklings: A Study of Viral DNA in Serum and Tissue
Authors: Masao Omata, Osamu Yokosuka, Fumio Imazeki, Yasuhisa Matsuyama, Katsuo Uchiumi, Yoshimi Ito, Junko Mori, Kunio Okuda
Journal: Hepatology (1984)

Human hepatitis B-like viruses have been found in several animal species, including Chinese ducks. Sera from Chinese carrier ducks which were positive for duck hepatitis B virus (DHBV) were inoculated in 33 Japanese one-day-old ducklings. The same sera were inoculated in four 3-week-old ducklings, and three 3-month-oId ducks. Ten uninoculated ducklings served as controls. Hepatitis B e-antigen positive human sera and DNA polymerase-positive woodchuck sera were also inoculated into ducklings. DHBV was demonstrated in serum of all ducklings inoculated at one day of age and persisted for more than 6 months in 17 of 20 ducks. In the three ducks in which viremia disappeared, viral DNA was found in liver tissue. Southern hybridization revealed only free viral DNA in infected ducks. Only 1 of 7 ducklings inoculated at 3 weeks or later developed persistent infection. No cross-infectivity by hepatitis B virus or by woodchuck hepatitis virus was demonstrated. By inoculating DHBV-positive sera into 1-day-old ducklings of a virus-free Japanese flock, we were able to transmit DHBV in all of them and established a chronic carrier state in all ducks which were inoculated at 1 day of age.
Meckel's Diverticulum
Authors: Brian T Bucher, Martin S Keller
Journal: New England Journal of Medicine (2010)

A 10-year-old boy presented to the emergency department with increasing periumbilical and epigastric pain after a 3-week period of intermittent abdominal discomfort. After clinical evaluation, computed tomography showed a proximal small-bowel intussusception. The results of a small-bowel series suggested the presence of a Meckel's diverticulum (Panel A, arrow), but no heterotopic gastric mucosa was identified on subsequent radionuclide scanning with the use of technetium-99m–labeled pertechnetate. Laparoscopy revealed a diverticulum on the antimesenteric border of the terminal ileum (Panel B, arrow), with its embryonic origin illustrated by the prominent vestige of the vitelline artery (arrowhead). No heterotopic gastric mucosal tissue was . . .
Angled views in cineangiocardiography of congenital heart disease.
Authors: K E Fellows, J F Keane, M D Freed
Journal: Circulation (1977)

Simple and compound sagittally angled views of the heart obtained cineangiocardiographically with a parallelographic U-arm device were evaluated clinically in 132 patients with congenital heart disease. The principle advantage of the apparatus was the case with which axial and oblique projections were obtained without repositioning of the patient, although rotation and angulation of the image intensifier-X-ray tube unit resulted in some increase in scattered radiation. Certain angled views, particularly the 40 degree cranial and the compound 25 degrees cranial/70 degrees left oblique projections, were better than standard frontal and lateral views for visualization of pulmonary arteries in the mediastinum, in ventricular septal defects and anomalies of the left ventricular outflow tract.
THE SOCIAL EVIL—SHOULD IT BE REGULATED? CAN IT BE EXTERMINATED?
Authors: W. L. ALLEN
Journal: JAMA (1897)

The subject for this evening's discussion is one entered into with considerable hesitation. The more the subject is studied the greater and more difficult does the question become. Philanthropists and moralists are in favor of an aggessive war of of extermination. City and government officials favor, as a rule, some sort of regulation; physicians are found on both sides of the controversy. That the subject is one of most vital importance, one which threatens our very existence as a healthy race, is evidenced by the fact that it has stamped nearly three millions of the people of these United States with syphilis. That the subject is of enough economic importance for the best thought of our legislative bodies is evidenced by the statement that the men in our cities pay to prostitutes $300,000,000 annually. This statement alone would seem of almost enough importance to cause the mathematic American to stop
387. Advantageous Properties of the piggyBac Transposon System for Gene Transfer in Human Cells
Authors: Matthew H. Wilson, Craig J. Coates, Edward J. Rebar, Alfred L. George
Journal: Molecular Therapy (2006)

Transposon systems permit non-viral delivery of genetic cargo into the genome of human cells and hold promise for eventual use in gene therapy. Transposon systems with activity in vertebrates include Sleeping Beauty (SB) and Mos1 of the Tc1/Mariner family and piggyBac which represents a different class of transposable element. We undertook evaluation of these three different transposable elements in human cells in order to compare the properties between each transposon system. This permitted direct comparison of the activity of native and hyperactive SB, native and hyperactive Mos1, and native piggyBacin plasmid vectors differing only by the transposase cDNA and inverted repeat (IR) elements. Mos1 required full internal sequences to be present for measurable transposition activity in human cells. The piggyBac transposable element could be reduced to a 311bp left IR and a 236bp right IR with retention of full activity. Evaluation of overall transposable activity revealed Mos1 << SB < piggyBac in cultured human cells. Hyperactive mutants of the Mos1 transposase were evaluated and showed little increase in transposition over native Mos1 in human cells. Interestingly, piggyBac showed more activity than native or even hyperactive SB (two-to-ten fold more active than hyperactive SB12 transposase combined with hyperactive pT3 transposon). Additionally, overproduction inhibition, a known major limitation of SB, was lacking with piggyBac. We evaluated piggyBac transposition following transient transfection of 50ng, 100ng, and 2μg transposon DNA while varying the transposase DNA amount. In all cases, piggyBac lacked overproduction inhibition while SB transposition could be driven to very low levels at higher amounts of transposase DNA. Such results revealed that piggyBac transposition was limited only by the amount of transposon DNA present. Finally, we evaluated the addition of a zinc finger DNA binding domain element to the N-terminus of the different transposase enzymes. Zinc finger DNA binding domain addition ablated Mos1 activity and decreased SB activity which was only reliably measured using a combination of hyperactive transposase and transposon mutants. However, chimeric-piggyBac transposase activity appeared unaffected by N-terminal zinc finger DNA binding domain addition when compared to the native system. These results demonstrate that the piggyBac transposon system has advantageous properties when compared to other transposon systems with activity in human cells thereby making it a viable alternative system for gene therapy.
Choosing a Parenteral Anticoagulant Agent
Authors: David L. Diuguid
Journal: New England Journal of Medicine (2001)

For decades, if a patient required a parenteral anticoagulant agent, the choice was simple: unfractionated heparin was the only such agent available. Unfractionated heparin has a long track record of effectiveness in both the treatment of and prophylaxis against arterial and venous thromboembolic disease. However, because of differences among batches of heparin and problems related to the bioavailability of the drug, monitoring of the anticoagulant effect of heparin has been not only necessary but also problematic. In addition, heparin-induced bleeding and thrombocytopenia can threaten life and limb. Moreover, there have always been problems with the use of unfractionated heparin to . . .
Long-term efficacy and safety of emtricitabine plus tenofovir DF vs. tenofovir DF monotherapy in adefovir-experienced chronic hepatitis B patients
Authors: Thomas Berg, Fabien Zoulim, Bernd Moeller, Huy Trinh, Patrick Marcellin, Sing Chan, Kathryn M. Kitrinos, Phillip Dinh, John F. Flaherty, John G. McHutchison, Michael Manns
Journal: Journal of Hepatology (2013)
Hemodynamic effects of vapreotide, a new somatostatin analogue, in patients with cirrhosis
Authors: A. Gadano, F. Vachiéry, C. Denié, C. Trombino, R. Moreau, S. Yong, S. Hillaire, D. Valla, P. Schneider, D. Lebrec
Journal: Journal of Hepatology (1998)
Surgery for Mitral Stenosis
Authors: EDWARD F. BLAND
Journal: Circulation (1952)

The renewed interest in surgery for mitral stenosis is reviewed and the progress of the past five years summarized. The present status of the indirect operation (pulmonary-azygos shunt) is discussed, and the notable advances with the direct attack (finger-fracture valvuloplasty and commissurotomy) have been brought up to date (May 1951) by means of a survey of selected centers here and abroad. Detailed information is available on 352 patients who have had an operation on the mitral valve. It is quite likely that the total now approaches 500 cases. The over-all operative mortality has been 15 per cent. Post-operative embolism occurred in 6 per cent. Clinical improvement in the majority has been prompt and striking, and this has been fully supported by catheterization data. An appraisal of the more remote effects must await the passage of time. Those most likely to benefit are patients under the age of 50 with only slight to moderate cardiac enlargement who are nevertheless seriously limited by pulmonary hypertension and congestion. A formidable procedure of this magnitude should be reserved for those in trouble; it has no place in the management of patients with little or no disability.
Dietary calcium, sex hormones, and bone mineral density in men.
Authors: P J Kelly, N A Pocock, P N Sambrook, J A Eisman
Journal: BMJ (1990)

OBJECTIVE--To evaluate the factors that determine bone mineral density at axial and appendicular sites in normal men. DESIGN--Measurement of bone mineral density of the radius by single photon absorptiometry and of the lumbar spine and hip by dual photon absorptiometry to assess their relation with various determinants of bone mineral density. Dietary calcium was assessed from a questionnaire validated against a four day dietary record. SETTING--Local community, Sydney, Australia. PATIENTS--48 Men (aged 21-79, median 44) recruited from the local community including 35 male cotwins of twin pairs of differing sex recruited from the Australian National Health and Medical Research Council twin registry for epidemiological studies on determinants of bone mineral density. MAIN OUTCOME MEASURES--Bone mineral density of the axial and appendicular skeleton and its relation to age, anthropometric features, dietary calcium intake, and serum sex hormone concentrations. RESULTS--Dietary calcium intake (g/day) was a significant predictor of bone mineral density of axial bones, explaining 24% and 42% of the variance at the lumbar spine and femoral neck respectively. This effect was independent of weight. In contrast with the axial skeleton, bone mineral density at each forearm site was predicted by weight and an index of free testosterone but not by dietary calcium intake. CONCLUSIONS--Dietary calcium intake has a role in the determination or maintenance, or both, of the axial but not the appendicular skeleton in adult men.
Pitfalls With Planar Scintigraphy
Authors: Bjoern Jobke, Bernd Tomandl
Journal: Clinical Nuclear Medicine (2009)

We present a case that demonstrates possible pitfalls in planar scintigraphy for the purpose of screening for bone metastases with incidental osteomas. Tc-99m bone scans have a known high sensitivity for active osseous processes but little specificity for the type of lesion such as osteosclerotic or osteolytic metastases. The presented patient had a vulvar carcinoma with metastases to bone, an uncommon metastatic site in this primary malignancy. Although rare cases of active osteomas have been reported, incidental discovery of osteomas in regions of bone scan enhancement should alert one for underlying metastatic disease in patients with primary malignant disease.
Progressive perfusion impairment during prolonged low flow myocardial ischemia in dogs.
Authors: L H Frame, W J Powell
Journal: Circulation Research (1976)

Recent studies have shown that after total coronary artery occlusion, there is impaired "reflow" of blood accompanied by myocardial and capillary endothelial cell swelling. To investigate the effect of prolonged low flow myocardial ischemia on coronary vascular resistance, regional hypoperfusion of the distal left anterior descending coronary artery was studied in 31 autonomically blocked dogs on right heart bypass. Heart rate, aortic pressure, and, during ischemia, left ventricular end-diastolic pressure were held constant. The distal left anterior descending coronary artery was perfused at a substantially reduced perfusion pressure which resulted in an antegrade coronary blood flow that usually was between 3% and 7% (0.5-1 ml/min) of control. When relative hypothermia (33-34 degrees C) was induced in nine dogs, left anterior descending coronary artery vascular resistance did not change during 2.5-3 hours of low flow ischemia. Under euthermic conditions (37-40 degrees C) in 17 dogs there was a consistent progressive increase in distal left anterior descending coronary artery vascular resistance starting at 90 minutes (median) after onset of ischemia. By 110-140 minutes ischemic antegrade flow decreased by 35 +/- 4% (SEM) (P less than 0.01). Directionally similar flow changes were observed in six euthermic experiments using the krypton-85 washout technique. Light microscopy did not reveal hemorrhage as a cause of the increased vascular resistance. The perfusion impairment did not occur in two euthermic, nonischemic hearts. In five dogs elevation of serum osmolality by 23 +/- 11 mOsmol/liter with mannitol attenuated the progressive decrease in flow. Thus, a progressive perfusion defect exists in the ischemic low flow state in the heart which presumably contributes to the extent of eventual necrosis.
Prediction models in cancer care
Authors: Andrew J. Vickers
Journal: CA A Cancer Journal for Clinicians (2011)

Prediction is ubiquitous across the spectrum of cancer care from screening to hospice. Indeed, oncology is often primarily a prediction problem; many of the early stage cancers cause no symptoms, and treatment is recommended because of a prediction that tumor progression would ultimately threaten a patient's quality of life or survival. Recent years have seen attempts to formalize risk prediction in cancer care. In place of qualitative and implicit prediction algorithms, such as cancer stage, researchers have developed statistical prediction tools that provide a quantitative estimate of the probability of a specific event for an individual patient. Prediction models generally have greater accuracy than reliance on stage or risk groupings, can incorporate novel predictors such as genomic data, and can be used more rationally to make treatment decisions. Several prediction models are now widely used in clinical practice, including the Gail model for breast cancer incidence or the Adjuvant! Online prediction model for breast cancer recurrence. Given the burgeoning complexity of diagnostic and prognostic information, there is simply no realistic alternative to incorporating multiple variables into a single prediction model. As such, the question should not be whether but how prediction models should be used to aid decision-making. Key issues will be integration of models into the electronic health record and more careful evaluation of models, particularly with respect to their effects on clinical outcomes.
SPECT Imaging of the Spleen in Inflammatory Pseudotumor
Authors: MARK GLAZER, VIDYA SAGAR
Journal: Clinical Nuclear Medicine (1993)

Single-photon emission computed tomography imaging of the liver using labeled RBCs is very useful to evaluate the vascularity of hepatic lesions. This case describes a 59-year-old woman with a lesion in her spleen seen on ultrasound, CT, and MRI. Splenic SPECT with labeled RBCs showed the mass to be avascular. Histologic study of the resected spleen showed an avascular mass with a final diagnosis of inflammatory pseudotumor of the spleen.
Violence hinders efforts to stem Haiti cholera epidemic as deaths continue to rise
Authors: J. Zarocostas
Journal: BMJ (2010)

Efforts by Haitian and international health personnel to contain the cholera outbreak on the devastated island are being hampered by violence and widespread insecurity, top humanitarian officials and agencies say.

Violence and instability since the 28 November presidential and legislative elections, “has had a detrimental effect on the fight against the cholera epidemic,” says the Pan American Health Organization (PAHO), the regional arm of the World Health Organization.

Similarly, the European Union’s Humanitarian Affairs commissioner Kristilina Geogieva, said that insecurity in Haiti “is killing more people by preventing treatment than by violence in the streets.”

The Haitian ministry of health …
A CASE OF ACUTE BRONCHIOLECTASIS
Authors: H. H. Stewart, J. H. Biggart
Journal: BMJ (1931)

Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder characterised by bilateral vestibular schwannomas and other CNS tumours including meningiomas and spinal schwannomas. Occasionally, peripheral neuropathy occurs in these patients but this is the first report of focal amyotrophy. Clinical, electrophysiological, and imaging data from four NF2 patients seen at a specialist neurofibromatosis clinic over a 4 year period are described in whom symptomatic focal amyotrophy preceded the diagnosis of NF2. Two presented with wasting and weakness of a single muscle group, several years before NF2 was diagnosed. In one patient a mononeuritis multiplex was the presenting feature of NF2, and in one patient focal wasting and weakness developed after the diagnosis of NF2 was made. In none of the four cases could a focal peripheral nerve or root neurofibroma be identified despite extensive imaging with MRI, and the limitations of neuroimaging for identifying a structural cause in patients with NF2 with a focal peripheral nerve lesion is discussed. It is likely that NF2 may affect peripheral nerve structures in a manner distinct from a compressive schwannoma.
Arrhythmias in the Denervated Transplanted Human Heart
Authors: DAVID K. BERKE, ANTHONY F. GRAHAM, JOHN S. SCHROEDER, DONALD C. HARRISON
Journal: Circulation (1973)

Multiple cardiac arrhythmias have been noted following cardiac transplantation, and these observations suggest that denervation does not protect the heart from the initiation of arrhythmias. The sequential electrocardiograms of 45 of 47 cardiac transplant patients at Stanford were reviewed. Currently, 16 patients are alive for periods up to 40 months post-transplantation. Atrial arrhythmias were noted in 72% of patients, and were usually associated with acute rejection episodes. Ventricular premature beats were detected in 57% of patients post-transplantation. Two documented episodes of ventricular fibrillation have occurred during severe acute rejection episodes. Two long-term survivors died suddenly of a presumed ventricular arrhythmia, and at autopsy both showed severe coronary atherosclerosis. This experience suggests that innervation is not necessary in the genesis of cardiac arrhythmias in the transplanted human heart.
Gamma-M deficiency predisposing to meningococcal septicaemia.
Authors: J R Hobbs, R D Milner, P J Watt
Journal: BMJ (1967)

Before his death from cerebrospinal fever Dr. G. D. Heist showed that he was one of the rare individuals whose blood had no bactericidal action on meningococci (Heist et al., 1922). His father and four uncles also died of illnesses resembling meningococcal infections. We have observed two patients with fulminating meningococcal septicaemia who had abnormally low serum yM globulins. Noting the susceptibility of Dr. Heist and possibly his family to meningococcal infections, and the possibility of a causal relation between a deficiency of serum yM globulin and meningococcal infection, we carried out a survey of the immunoglobulin levels in the relatives of our two patients and made a study of antibodies to meningococci.
EU expansion will open patient floodgates, minister warns
Authors: Katka Krosnar
Journal: BMJ (2004)

The Irish health minister, Micheal Martin, has warned that migration of patients could become a major issue in an enlarged European Union.

The current 15 member union, of which Ireland currently holds the rotating six month presidency, expands on 1 May to take in 10 new members, most of them former communist countries.

Mr Martin told the BMJ that two rulings by the European Court of Justice …
Italian law on advance directives offers no choice for patients
Authors: F. Turone
Journal: BMJ (2011)

Italy’s lower house of parliament, the Chamber of Deputies, has passed a law on advance directives that explicitly excludes the option for people to refuse artificial hydration and nutrition, applies only to patients who have a neurological condition that is difficult to assess, and gives doctors the right to disregard patients’ wishes.

Ignazio Marino, a senator for the opposition Democratic Party and transplant surgeon who heads the parliamentary investigative commission on the health system and who is one of Italy’s most prominent supporters of patient choice, said, “This law basically tells doctors that they can stop …
303 THE 70 KDA PEROXISOMAL MEMBRANE PROTEIN IS INVOLVED IN THE ACTIVATION OF HEPATIC STELLATE CELLS
Authors: J. Woudenberg, F.A.J. van den Heuvel, K.P. Rembacz, S. Dunning, T.E. Woudenberg-Vrenken, M. Buist-Homan, H. Moshage, K.N. Faber
Journal: Journal of Hepatology (2009)