tbuckley/cabot-search huggingface dataset:
Case of Secondary Anaemia Becoming Pernicious: With Detailed Examination of the Blood
Authors: W. Edgecombe
Journal: BMJ (1901)

SECONDARY ANAEMIA BECOMING -PERNICIOUS.' 1073 columns. 2 and 3, on the other hand, accurately represent the number of cases ,and deaths in the inoculated and uninocu- lated,.inasmuch as none of those inoculated in previous years contracted enteric fever.A further point adverted to by Colonel Fawcett is the cir- cumstance that the only case which occurred among the inoculated was that of a patient admitted to hospital on the thirty-third day after inoculation.It would seem that the disease was in this case contracted before anything in the nature of protection had been established by the inoculation.
Ascites Secondary to Transudation From A Renal Cadaveric Transplant
Authors: William F. Clark
Journal: JAMA (1976)

IDIOPATHIC ascites is not an uncommon complication of long-term intermittent hemodialysis,<sup>1</sup>but ascites secondary to renal fluid transudation is extremely unusual. We report a case of massive ascites that appears to be secondary to transudation from a cadaveric renal graft. <h3>Report of a Case</h3> A 46-year-old woman who had been treated by hemodialysis since 1968 for chronic renal failure secondary to glomerulonephritis received a cadaveric renal transplant in her right iliac fossa on Dec 16, 1971. She was then observed as an outpatient and admitted to the hospital for open reduction and internal fixation of an intratrochanteric fracture of the right hip in June 1972 and for the treatment of a urinary tract infection in July 1974. On Aug 6, 1974, the patient was readmitted to the hospital complaining of a painless, diffuse abdominal swelling and a 3.6-kg (8-1b) weight gain over the past seven to ten days. Her
Serum lactate dehydrogenase and platelet count predict survival in thrombotic thrombocytopenic purpura
Authors: Jeffrey F. Patton, Kenneth R. Manning, Douglas Case, John Owen
Journal: American Journal of Hematology (1994)

Abstract A significant number (some 20%) of patients with thrombotic thrombocytopenic purpura do not respond to standard therapy and die. We reasoned that early identification of those who are likely to fail standard therapy would allow the rational introduction of other treatment modalities. To this end we prospectively evaluated 27 consecutive patients, examining serum LDH levels and platelet counts as markers of disease activity and as predictors of outcome. All patients were treated, according to a written protocol, with high volume plasma exchange (35 ml/kg), prednisone, aspirin, and persantine. Twenty‐one of the 27 patients (78%) are alive following therapy. Initial LDH and platelet values did not distinguish between the survivors and nonsurvivors. However, by day 3 of therapy both LDH levels and platelet counts differed significantly between the two groups. Mean day 3 LDH level for survivors was 364 units/L, and for nonsurvivors, 891 units/L ( P &lt; 0.005). Mean day 3 platelet count for survivors was 119,000/μL, and for nonsurvivors, 46,000/μL ( P &lt; 0.005). Receiver Operator Characteristic curves were constructed and assessed by calculating the area under the curve. This analysis showed that LDH is able to discriminate survivorship one day earlier than platelet count. Both LDH level and platelet count are excellent predictors of survival, under standard therapy, after 3 days of treatment. Early identification of those at greatest risk will facilitate the early institution and evaluation of alternative methods of treatment, such as splenectomy, intravenous Ig, or Vincristine. © 1994 Wiley‐Liss, Inc.
Prediction of Mitral Pressure Gradient from Heart Sounds
Authors: B. G. Wells
Journal: BMJ (1957)

RDICAL JOUR 551 due to the use of complan.Nitrogen-balance studies were carried out at intervals and are shown in Fig. 5.The low level of circulating eosinophils during the first two weeks give an indication of the severe stress response leading to the heavy loss of nitrogen in the urine during this period.The necessary high-level protein intake to com- bat this was achieved without any difficulty, and it was possible to maintain a positive nitrogen balance almost from the start.As much as II lb. (680mg.) of complan daily was easily tolerated in the form of drinks made with water or milk, usually without the addition of flavouring.This alone gave a total of 210 g. of protein and 3,000 calories.It will be seen that serum proteins were up to normal level within four weeks, and weight loss was never severe.One final point might be mentioned in connexion with this case.Apart from pre-operative medication the only sedative drugs ordered during the entire course of treatment were morphine i gr. (16mg.) shortly after admission, and quinalbarbitone (" seconal") 1+ gr. (100mg.) on two sub- sequent occasions.Occasional doses of aspirin may also have been given, but it is obvious that pain was never severe at any time.Mortality The mortality rates in those under 60 years and in those 60 and over are shown in Table III.The poor prognosis in the elderly patient is at once apparent, and is a reminder that a very guarded prognosis must always be given for the TABLB III.-MortalityTotal No. of cases .520Fatal cases .46Gross mortality
Spirometry in young children
Authors: I. Steenbruggen, R.J. Roorda
Journal: European Respiratory Journal (2003)

alveolar macrophages [2], as well as from the pulmonary fibroblasts [3].Its action is basically opposed to that of TNF-a, which is a rather inflammatory cytokine [2].It is considered, as well as IL-4, a major IL in the T-helper cell type 2 immune response [4].Interestingly, IL-10 levels have been found to be high in rat tissues with pulmonary fibrosis, while in rats with IL-10 deficiency, the inflammatory response has been found to be more intense than in the wild animals [5].In in vitro studies, the addition of IL-10 in fibroblasts has lessened the expression of type 1 collagen, the production of which is stimulated by transforming growth factor-b [6].Those observations support the findings of BERGERON et al. [1], as well those from our own studies, that IL-10 might be an important target for future therapies, as well as a diagnostic tool.We think that investigating the interleukin-10 pathways and possible therapeutic uses might be important in discovering more about idiopathic pulmonary fibrosis and providing patients with a more effective treatment.Moreover, serum and tissue cytokine profiles might be important in this direction.
Failure of serum myoglobin and creatine kinase isoforms kinetics to predict early coronary patency after thromsolysis in time for rescue angioplasty
Authors: T. Laperche, J. Benessiano, P.G. Steo, M. Dehoux, D. Himbert, J.M. Juliard, R. Gourgon
Journal: Journal of the American College of Cardiology (1991)
THE TREATMENT OF PULMONARY TUBERCULOSIS.
Authors: JOHN M. LISLE
Journal: JAMA (1900)

The most common point of infection in tuberculosis is the mucous membrane of the bronchi and of air passages. It is there that it must be attacked. It does not affect the blood, hence its medication could not interfere with the operations of the germ unless such medication were carried far beyond the ability of the patient to sustain. Stomachic medication is open to the same objection. The chief reliance of the profession has been cod-liver oil and creosote. The former is a comparatively easily assimilated tissue builder, but is not a remedial agent in any sense of the word. It may temporarily upbuild a patient, but it does not cure because it does not eliminate the bacillus. Having for several years condemned the use of creosote in tuberculous cases, I am glad to note its abandonment by the more observing of the profession, but sorry to see them substituting
Rapid Classification of Positive Blood Cultures
Authors: James R. Johnson
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The authors of a recent study<sup>1</sup>evaluating the interpretation of positive blood cultures are to be commended for publicizing the unglamorous but important truth that infectious disease specialists commonly categorize positive blood cultures as reflecting true bacteremia as opposed to contamination, based on a few simple clinical and laboratory parameters. Whether it was really necessary to perform complex statistical analyses on an extensive data set to reach the study's conclusions is arguable, since the same conclusions probably could have been arrived at equally well through brief conversations with the participating infectious diseases specialists. The important point is that infectious disease specialists do indeed use time to culture positivity, number of cultures positive, organism type, and the pretest clinical likelihood of bacteremia to assess the validity of a positive blood culture. Infection at a different site caused by the same organism is also an important consideration; this
Blindness in a Strict Vegan
Authors: Dan Milea, Nathalie Cassoux, Phuc LeHoang
Journal: New England Journal of Medicine (2000)

To the Editor: Vegetarians are at risk for nutritional deficiency if they do not receive vitamin supplementation. We report a case of severe bilateral optic neuropathy in a patient who had been a vegan for many years and who did not take vitamin supplements. The patient, a 33-year-old man who had started a strict vegetarian diet at the age of 20 years, was referred for evaluation of progressive visual loss. “Improved health” was the reason for the diet, which contained no eggs, dairy products, fish, or other sources of animal proteins. He did not smoke or use alcohol, and his . . .
Influence of endothelial nitric oxide on neurogenic contraction of human pulmonary arteries
Authors: C Martinez, E Cases, JM Vila, M Aldasoro, P Medina, V Marco, S Lluch
Journal: European Respiratory Journal (1995)

The present study was designed to investigate the contribution of the endothelium and that of the L-arginine pathway on the contractile responses of isolated human pulmonary arteries to electrical field stimulation (EFS) and noradrenaline. Isometric tension was measured in artery rings obtained from portions of human lung after thoracic surgery for removal of lung carcinoma (18 patients). Electrical field stimulation (EFS) induced frequency-dependent contractions of isolated human pulmonary arteries which were abolished by tetrodotoxin, guanethidine and prazosin (all at 10(-6) M). The increases in tension were of greater magnitude in arteries denuded of endothelium. NG-nitro-L-arginine methyl ester (L-NAME) (10(-4) M) potentiated the contractile response to EFS in artery rings with endothelium but not in endothelium-denuded arteries. The potentiation induced by L-NAME was completely reversed by L-arginine (10(-4) M) but not by D-arginine (10(-4) M). Indomethacin (3 x 10(-6) M) had no significant effect on the contractile response to EFS. Contractile responses to noradrenaline were similar in arteries with and without endothelium. Our results suggest that electrical field stimulation releases endothelium-derived nitric oxide, which inhibits the contractile responses of human pulmonary arteries. Although adrenergic nerves seem to be responsible for the contraction, the transmitter involved in the release of nitric oxide does not appear to be noradrenaline.
Yogurt-Induced Cataracts: Comments on Their Significance to Man
Authors: Curt P. Richter
Journal: JAMA (1970)

In a previous report entitled "Cataracts Produced in Rats by Yogurt," we intentionally omitted any reference to the possible significance of our findings to man.<sup>1</sup>Press discussions, however, dealt mainly with this aspect. Further, these discussions did not distinguish between the original yogurt and commercially produced yogurt of the variety used in our experiments. The original yogurt, long used in many parts of the world, is made from whole milk, while commercial yogurt, produced extensively in this country for slimming purposes, is made from defatted milk with added skim-milk powder. We would like to make a few comments pertaining to these discussions. The original yogurt, recommended by Metchnikoff for a long, active, healthy life, is undoubtedly one of the best of all foods known to man. It has long served as the chief source of nourishment for many people and is one of the safest of all foods in
Editorial board charged with wrongly accusing author
Authors: C. White
Journal: BMJ (2002)

<h3>Abstract</h3> <h3>Background</h3> Long-range persistent correlations in stride time (ST) and length (SL) are the fundamental traits of treadmill gait. Our recent work showed that the ST and SL time series’ statistical properties originated from the superposition of large-scale trends and small-scale fluctuations (residuals). Trends served as the control manifolds about which ST and SL fluctuated. The scaling exponents of the residuals were slightly smaller than 0.5. <h3>Research question</h3> Do random changes in treadmill belt speed affect the trend properties and scaling exponents of ST/SL residuals? <h3>Methods</h3> We used Multivariate Adaptive Regression Splines (MARS) to determine gait trends during a walk on a treadmill whose belt speed was perturbed by a strong random noise. Then, we calculated the scaling exponents of MARS residuals with the madogram estimator. <h3>Results</h3> Except for the ST at the lowest treadmill speed <i>v</i> = 0.8 m/s, the normalized trend duration was at least three times greater than that for the unperturbed walk. The Cauchy distribution scale parameter, which served as a measure of the width of SL and ST trend slope distributions, was at <i>v</i> = 1.2 m/s, almost 50% and 25% smaller than the unperturbed values. The differences were even greater at <i>v</i> = 1.6 m/s: 73% and 83%. For all speeds, the ST and SL MARS residuals were strongly anti-persistent. At <i>v</i> = 1.2 m/s, the corresponding scaling exponents were equal to 0.37±0.10 and 0.25±0.09. Apart from ST at <i>v</i> = 0.8 m/s, the ST/SL scaling indices were close to 0.5. <h3>Significance</h3> Persistence of gait parameters is closely related to the properties of their trends. Longer trends with a gentle slope and strong anti-persistence of ST/SL residuals are the manifestations or tight control required during the perturbed treadmill walk.
Radical Cure of Inguinal and Femoral Hernia with a Polythene Insert
Authors: W. Thompson
Journal: BMJ (1951)

The existence of vasopressin-sensitive neurons in the nucleus of the solitary tract of the rat and the presence in this brain area of vasopressin binding sites were investigated using extracellular single- unit recordings from brain-stem slices and light microscopic autoradiography. About 45% of the recorded neurons responded to vasopressin at 5–2000 nM by a reversible, concentration-dependent increase in firing rate. The action of vasopressin was direct, was suppressed by a vasopressor antagonist, and was mimicked by a vasopressor agonist. Oxytocin was 10–100 times less efficient than vasopressin and a specific antidiuretic agonist was without effect. Using light microscopic autoradiography and 3H-arginine vasopressin as a ligand, high-affinity vasopressin binding sites were found distributed over the whole rostrocaudal extent of the nucleus of the solitary tract. Binding was displaced by unlabeled vasopressor agonist but not by unlabeled antidiuretic agonist. Thus, the nucleus of the solitary tract contains V1-type vasopressin receptors which are, at least in part, located on neuronal membranes and whose activation generates bioelectrical signals. Solitary tract vasopressin-sensitive neurons may be the target of a vasopressinergic innervation originating in the hypothalamic paraventricular nucleus and could be involved in the central regulation of cardiovascular functions.
249. Minimal Dose of AAV8/DC190-ASM Necessary for Therapeutic Efficacy in a Mouse Model of Niemann-Pick Disease
Authors: R. J. Ziegler, C. M. Barbon, S. D. Bercury, M. L. Hawes, E. H. Schuchman, R. J. Desnick, S. H. Cheng
Journal: Molecular Therapy (2005)

Niemann-Pick disease type B (NPD) is a congenital defect caused by a deficiency of the lysosomal hydrolase, acid sphingomyelinase (ASM). This panethnic disorder results in the pathological accumulation of sphingomyelin (SPM) in the macrophages of lung, spleen, liver and bone marrow. While a broad continuum of clinical manifestations occurs in NPD patients, significant morbidity results as a consequence of progressively worsening pulmonary involvement. Previously, we reported that systemic administration of 3x1011 drp of a recombinant adeno-associated virus vector (AAV8) encoding human ASM under the transcriptional control of a liver-restricted promoter (DC190) into acid sphingomyelinase knockout mice (ASMKO) resulted in expression and secretion of therapeutic levels of the enzyme, as measured by SPM clearance in visceral tissues. Furthermore, substrate depletion in lung was accompanied by significant reduction in the levels of proinflammatory cytokines and complete reversal of lung pathology. The goal of the present study was to define the minimal dose of AAV8/DC190-ASM necessary for therapeutic efficacy in the ASMKO mice. As expected, administration of lower doses (3X1010 to 1X1011 ) of AAV8/DC190-ASM resulted in expression and secretion of correspondingly lower levels of ASM. Encouragingly, while uptake of ASM was found to be dose-dependent, all doses were capable of substantially reducing SPM levels in the affected tissues, including the lung, by day 60 post-treatment. To assess the kinetics of clearance, ASMKO were administered various doses of AAV8/DC190-ASM and groups were sacrificed at day 14 or day 28 post-administration. Maximal tissue levels of ASM were achieved as early as 14 days post-injection. At the highest dose (3X1011 drp), SPM levels in the liver, spleen, lung and bone marrow were largely normalized by day 14. Importantly, as an extension of our previous observations, we found that decreased SPM levels in the lung coincided with a reduction in the levels of pro-inflammatory mediators (e.g. MIP-1|[alpha]|) in the bronchoalveolar lavages of ASMKO mice. It was also noted that liver-restricted expression of human ASM promoted immune tolerance to the expressed enzyme in the ASMKO mice at all the doses tested. Hence, AAV8-mediated liver-restricted expression of ASM was capable of correcting the visceral storage disease and abrogating the chronic pulmonary inflammatory manifestations shown associated with NPD. Therapeutic efficacy could be attained with a 10-fold lower dose of vector (3X1010 drp/mouse) than previously studied and near-complete correction was observed within two weeks post-administration. Based on these findings, it is anticipated that yet lower doses of AAV8/DC190-ASM may be therapeutically efficacious in the ASMKO mice.
The need for outcome measures in medical education
Authors: Lambert Schuwirth, Peter Cantillon
Journal: BMJ (2005)

Complex educational interventions demand complex and appropriate evaluations 

H ow can we ever be sure that educational approaches such as problem based learning are better than traditional ones? Change merely for the sake of change is futile. Changes in medical education should lead to better outcomes, but what is the best way to show cause and effect?

For simple research questions straightforward methods suffice, but more complex questions require more complicated study designs. A question such as “Is drug A more effective than a placebo?” is highly relevant, and the methods needed to answer it may be relatively straightforward. However, the question “Why does drug A lead to a better outcome than a placebo?” is more complicated, and “Does using drug A lead …
Treatment of Gonorrhoea in the Female
Authors: T. E. Osmond
Journal: BMJ (1944)

Consulting Venereologist to the Army Gonorrhoea in the female is similar in many respects to that in the male, but in some ways is of considerably more importance, since many women suffer from the disease without knowing it and therefore probably convey it to a greater number of people than they would otherwise.Incidentally, too, gonor- rhoea not only may infect the eyes of the child during its passage through the birth canal but is also a very common cause of sterility, mainly as a result of salpingitis causing occlusion of the Fallopian tubes.In the case of gonorrhoea in a married woman consent should be obtained to tell the husband not only in order that he may be examined and, if necessary, treated, but also to avoid the risk of marital infelicity should he find out accidentally; in the case of a girl under 21 the parents should be told if circumstances appear to demand it.Such action is likely to prevent difficulties arising later, especially if the girl should become engaged to be married.It is a great mistake to adopt a policy of secrecy, and all those who are, or are likely to be, involved should be told in confidence.
Pathway from Central Obesity to Childhood Asthma. Physical Fitness and Sedentary Time Are Leading Factors
Authors: Yang-Ching Chen, Yu-Kang Tu, Kuo-Chin Huang, Pau-Chung Chen, Da-Chen Chu, Yungling Leo Lee
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Available prospective studies of obesity and asthma have used only body mass index (BMI) as an indicator for adiposity; studies using detailed obesity measures are lacking, and the role of physical fitness level and sedentary time remains unexplored in the link between obesity and asthma.To compare various anthropometric measures of obesity in relation to childhood asthma, and to further characterize the interrelations among central obesity, physical fitness level, sedentary time, and asthma.The nationwide Taiwan Children Health Study followed 2,758 schoolchildren from fourth to sixth grade, annually collecting data regarding physical fitness, sedentary time, obesity measures (comprising body weight and height, abdominal and hip circumference, skin fold thickness, and body composition), asthma, and pulmonary function tests. The generalized estimating equation was used for 3 years of repeated measurements to analyze the interrelation among obesity, sedentary time, physical fitness level, and asthma; a structural equation model was used to explore the pathogenesis among these factors. Asthma incidence was analyzed during a 2-year follow-up among centrally obese and nonobese groups in baseline children without asthma.Central obesity most accurately predicts asthma. Low physical fitness levels and high screen time increase the risk of central obesity, which leads to asthma development. Obesity-related reduction in pulmonary function is a possible mechanism in the pathway from central obesity to asthma.Central obesity measures should be incorporated in childhood asthma risk predictions. Children are encouraged to increase their physical fitness levels and reduce their sedentary time to prevent central obesity-related asthma.
Recalibration of the delirium prediction model for ICU patients (PRE-DELIRIC): a multinational observational study
Authors: M. van den Boogaard, L. Schoonhoven, E. Maseda, C. Plowright, C. Jones, A. Luetz, P. V. Sackey, P. G. Jorens, L. M. Aitken, F. M. P. van Haren, R. Donders, J. G. van der Hoeven, P. Pickkers
Journal: Intensive Care Medicine (2014)
Contact Lenses and Oral Contraceptives
Authors: M. Ruben
Journal: BMJ (1966)

It is difficult to definitely associate intolerance to contact lenses with the use of oral contraceptives.  Edema of the cornea could be secondary to cornealepithelial changes.  The quantity of tears formed while oral contraceptive agents are taken may be a cause of corneal lens intolerance.  Excess mucus formation and decrease of the serous component might affect the lubricant qualities of tears.  Pregnancy will also result in loss of contact lens tolerance both for scleral and corneal lenses.