tbuckley/cabot-search huggingface dataset:
Cases in Midwifery
Authors: T. Radford
Journal: BMJ (1851)

would grace a novel, till fortune smiled upon them, and in her 45th year the lady mairried.Menstruation had proceeded regularly as to time, quiantity, and symptoms, up to the period of marriage, but subsequently it never re-appeared.As this sudden cessation coincided with gastric symptoms, a tympanitic tension of the abdomen, and, above all, a great anxiety for children, the patient was considered pregnant, and carefully watched for many months.When the illusioni was destroyed, the lady became disconsolate; and punctilious in her notions respecting honour, she brooded over the possibility of her husband supposing that the courses had already stopped previous to her marriage.She consulted me, and was ready to submit to any operation.After a minute investigation of the case, I intimated my con- viction that she was in perfect health, and that men- struation had ceased in an unusual manner.The patient would, I think, have given all she possessed to have been able to obtain another interpretation to the absence of menstruation, and left me unsatisfied.About a year after, I was asked to see the same patient, and learned, that having consulted some one else, she had taken steel, purgatives, and strong medicines, port wine and meat twice a day, without effect for the first few months, but then she had a terrific flooding.She had subsequeintly had continued sanguinoid discharge for several moniths, which had induced a state of great emaciation, and the usual symptoms of uterine disease.On examination I found a general painful swelling of the womb, witll granulations on both lips.Leeches to the seat of the disorder, and the repeated application of nitrate of silver, cured these local diseases, but her nervous system never recovered the effect of an ill-advised treatment, and to use the mildest term, she is at all times in a highly hysterical state.This sad case, and the foregoing hints, will suggest to a medical man the advice necessary to be given to women passing through this critical epoch, and with this I feel inclined to conclude a subject already perhaps irksome to many, but as women at that time are affected with so many indispositions and diseases pertinacious, complicated, and shrouded in such misty confusion, I shall redeem a former pledge by adverting, in a concluding paper, to the treatment of those diseases, and for the sake of brevity I shall embody what I have to say under the heads-bloodletting, sedatives, purga- tives, and local treatment. 8,York
The Mechanism of HIV Infection in Patients of the Florida Dentist
Authors: Virginia A. LiVolsi
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The CDC "Update on Transmission of HIV Infection During Invasive Dental Procedures—Florida"<sup>1</sup>outlined the available data on this outbreak of human immunodeficiency virus (HIV) infection in six patients of a Florida dentist who died of acquired immunodeficiency syndrome (AIDS). Each patient had undergone invasive dental procedures, and it was stated that in each instance the dentist wore a mask and gloves. No exchange of blood from needlesticks or cuts could be documented in any case. The epidemiological and molecular biological evidence in five of the six cases strongly supports the notion that the infection in these five cases was transmitted from the infected dentist. However, it is unclear how this could have occurred. I would like to propose a possible mode of transmission. Since the causative agent of AIDS can be identified in infected individuals in all body secretions, including tears, saliva, and sweat, is it
Medicine and the Cultural Background
Authors: Lester S. King
Journal: JAMA (1965)

Although in the first half of the 18th century Herman Boerhaave was unquestionably Europe's greatest physician, we might well ask why he has this reputation. With his name we associate no epoch-making discovery, no revolutionary doctrines. He was, to be sure, an outstanding clinician and teacher and a prominent chemist; yet these facts, while important, do not alone explain his great influence.  Boerhaave represented, above all, a stabilizing force in a world of turmoil. To understand his influence we must appreciate the environment in which he grew up, gain some insight into the forces at work during his formative years. For this we must understand some of the problems and issues of that period, the atmosphere that shaped his thought and provided the tensions that he tried to resolve.  The main facts of Herman Boerhaave's life are well known. 1 He was born in 1668, his father was a minister.
Book Review Workbook in Practical Neonatology Second edition. Edited by Richard A. Polin, Mervin C. Yoder, and Fredric D. Burg. 380 pp., illustrated. Philadelphia, W.B. Saunders, 1993. $45. 0-7216-4292-6
Authors: Jonathan D.K. Trager
Journal: New England Journal of Medicine (1994)
Mid Staffs shames us all
Authors: Des Spence
Journal: BMJ (2013)

I asked my son, “What’s the Hippocratic oath?” He laughed, “Is it what hypocrites take?” I prickled, for an oath is no joking matter. I took the Hippocratic oath in Latin, I think, hung over in a ceremony shortly before my medical graduation, but it mattered to me. Many universities don’t even bother with the oath today. The Francis report into Mid Staffordshire Foundation Trust means that we must re-examine our professional vows and what it means to be a doctor.

The report releases the pus that …
Pheochromocytoma in Pregnancy
Authors: John M. Maloney
Journal: New England Journal of Medicine (1955)

THE coincidence of pheochromocytoma in pregnancy presents a problem. After the diagnosis is made, several alternatives are available. It is only through reports of these cases that the best treatment can be determined. Several recent comprehensive reviews of pheochromocytoma are available.1 2 3 Case ReportThe past medical history and the family history of Mrs. E.J.C. seemed noncontributory, although she had infectious hepatitis (?) as a child and, at the age of 12, had been told that she had a heart murmur. No signs or symptoms of heart disease were ever otherwise present. In 1951, at the age of 21, in the . . .
Doctors and Overpopulation
Authors: R. J. Paget
Journal: BMJ (1972)

I write in support of the letter on overpopulation (January 8 p.  108). I agree that this is the most formidable problem facing the world today and I feel it is important that the medical profession should attempt to bring pressure on the Government in the ways that are suggested.  I would however point out that the medical profession also is too complacent in this respect and I feel that general practitioners and obstetricians are carelessly neglecting their duty if any woman at her postnatal examination is not  offered contraceptive advice.  The days should be over when the doctor dismisses the patient with the jest see you next time.  I feel obstetricians are particularly lax and that in addition to the existing reasons for hospital confinement in fourth and subsequent  pregnancies should be the discussion of the question of sterilization in the postpartum period with it being performed if requested.  Our public health colleagues are not without blame since instead of grasping the most challenging problem of preventive medicine that has ever existed they seem content to turn a blind eye and trouble themselves with relative trivia.(FULL TEXT)
Typhoid Fever in the Second Pennsylvania Infantry.
Authors: Victor C. Vaughan
Journal: JAMA (1900)

Ann Arbor, Mich., July 2, 1900. <h3>To the Editor:</h3> —In your issue of June 30, Dr. Francis R. Packard wishes to know from what source I obtained authority for the statement: "The claim is made by an assistant-surgeon of one of the Pennsylvania regiments that there was not a case of typhoid fever in his command, but the records of the Philadelphia hospitals show that certain cases sent from this regiment proved to be typhoid fever." My authority for the statement will be found on page 85, Volume xiv, "Transactions of the Association of American Physicians." In the discussion of a paper read by me, Dr. S. Solis-Cohen made the following statement: "It is a matter of record that Col. J. Biddle Porter's regiment, the Second Pennsylvania, had no typhoid fever, and but two cases of illness from any cause." It is true that Dr Packard states in his article
New football boots and toxic shock syndrome
Authors: C M Taylor, F A I Riordan, C Graham
Journal: BMJ (2006)

much more and found that through simple action planning I was able to start making the changes that improved my life and my health.I learnt pain management techniques and was able to improve my pain relief.I increased my exercise levels, improved my eating habits, and drank more water.I was able to maintain these improvements after completing the course and now, if they do slip, I notice straight away, feeling more fatigue and more pain.Living this healthy lifestyle also helps me to feel in control.
Abstract P2-18-07: Nipple sparing mastectomy-infectious complication risk. A preliminary assessment of the American Society of Breast Surgeons nipple sparing mastectomy registry
Authors: SD Mitchell, SM Feldman, PD Beitsch, SC Willey, DME Manasseh, GW Unzeitig
Journal: Cancer Research (2013)

Abstract Objectives: The American Society of Breast Surgeons (ASBS) Nipple Sparing Mastectomy Registry (NSMR) is a prospective, IRB approved, non-randomized, multi-institutional registry assessing surgical techniques, utilized metrics, oncologic outcome, and aesthetic outcome of nipple sparing mastectomies. The registry has been open for enrollment for 26 months. The target accrual is 1000 individuals. This abstract specifically analyzes rates of post-operative infection in NSMs. Methods: Fifty two investigators from 41 institutions are participating in the ASBS NSMR. A total of 373 patients underwent 631 mastectomies, with indications of prophylaxis (365), cancer (248), and unknown (18). We assessed a sub group of 449 mastectomies, with indications of prophylaxis (253) and cancer (196) that had all data sets completed. We assessed infection rates(characterized as needing oral or iv antibiotics with or without removal of implant/expander and/or debridement) in the entire group as well as by indication (cancer vs. prophylaxis). Factors such as smoking history, previous radiation therapy, previous surgery, incision type, reconstruction technique, and flap dissection technique were analyzed. Results: In a subgroup of 449 mastectomies (253 prophylactic and 196 cancer): Post operative infections were reported in 22 (4.9%) of patients: 7 (3.6%) of mastectomies with an indication of cancer and 15 (5.9%) of prophylactic mastectomies (p-value 0.3140). Infections were characterized as: treatment with oral antibiotics alone, treatment with i.v. antibiotics alone, iv antibiotics with washout or debridement, or antibiotics and implant/ tissue expander removal. No correlation was found in smoking history (p-value 1.000), previous breast surgery (p-value 0.1277) or previous radiation (p-value 0.6024). No correlation was found in incision utilized, reconstruction technique, or method of flap dissection either. Conclusion: The rate of postoperative infections in nipple sparing mastectomies is comparable if not lower than non-nipple sparing mastectomies. No statistically significant difference in infection rate was found between mastectomies completed for prophylaxis or cancer. No correlation was found between factors such as smoking history, history of radiation therapy, prior breast surgery, incision utilized, reconstruction technique, or method of flap dissection. Improved aesthetics with a nipple sparing approach (technically more demanding and typically through a smaller incision) does not come at the cost of a higher rate of infectious complications. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-07.
Scintigraphic Appearances in Patients With Pulmonary Infection and Lung Scintigrams of Intermediate or Low Probability for Pulmonary Embolism
Authors: DANJUN J. LI, IAN STEWART, KENNETH A. MILES, PHILIP E. WRAIGHT
Journal: Clinical Nuclear Medicine (1994)

Out of 294 patients with lung scintigrams of low or intermediate probability for pulmonary embolism, the appearances in 54 patients with a final diagnosis of pulmonary infection were reviewed. The most common finding was a matched defect in ventilation and perfusion occurring in 40 patients (76%). Regional reverse mismatch occurred in 13 patients (24%) and both appearances were found in one patient (2%). Reverse mismatch was also present in a further seven patients, four of whom had bronchial obstruction. Although occurring less frequently than matched defects, 81% of regional reverse mismatched defects were because of chest infection. The presence of regional reverse mismatch in patients investigated for pulmonary embolism suggests the alternative diagnosis of chest infection.
Hereditary deficiency of the seventh component of complement.
Authors: J T Boyer, E P Gall, M E Norman, U R Nilsson, T S Zimmerman
Journal: Journal of Clinical Investigation (1975)

Deficiency of the seventh component of complement has been found in the serum of a 42-yr-old Caucasian woman who has Raynaud's phenomenon, sclerodactyly, and telangiectasia. Partial deficiency was found in the serum of the patient's parents and children, indicating a pattern of inheritance of autosomal codominance. Transfusion experiments indicated that exogenous C7 had a 91-h halk-life in the patient. There was no evidence for C7 synthesis after transfusion. No C7 inhibitors were detected in the patient's serum. The patient's serum was found to support the activation of complement by both the classical and properdin pathways to the C7 stage. The addition of C7 to the patient's serum permitted it to support hemolytic reactions initiated by either pathway. No defects could be detected in plasma or whole blood coagulation. The patient's serum was deficient in opsonizing unsensitized yeast particles in serum and in the generation of chemotactic factor by antigen-antibody complexes and endotoxin. Both deficiencies were corrected by the addition of C7. These observations suggest a key role for C7 for in vitro yeast phagocytosis and chemotaxis generation. However, the patient's lack of infections indicates a relatively minor role for C7 in human resistance to infection.
Response to Comment on: Rizzo et al. Reduction of Oxidative Stress and Inflammation by Blunting Daily Acute Glucose Fluctuations in Patients With Type 2 Diabetes: Role of Dipeptidyl Peptidase-IV Inhibition. Diabetes Care 2012;35:2076–2082
Authors: Maria Rosaria Rizzo, Michelangela Barbieri, Raffaele Marfella, Giuseppe Paolisso
Journal: Diabetes Care (2012)

DeVries (1) was surprised that vildagliptin and sitagliptin groups reported different mean amplitude of glycemic excursions (MAGE) reduction because they have similar fasting and postprandial glucose levels and suggested reporting other measures of glucose variability to better understand these results.

Indeed, a previous study evaluating the role of glycemic variability in type 2 diabetic patients has demonstrated that patients with similar mean glucose and postprandial glucose have a markedly different daily glucose profile with differences both in number and duration of excursions (2). The difference in MAGE reduction found in the two study groups …
Mortality in people taking selegiline: observational study
Authors: M. Thorogood, B. Armstrong, T. Nichols, J. Hollowell
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective</b>: To evaluate mortality among patients with Parkinson9s disease receiving different treatment. <b>Design</b>: Cohort study based on computerised medical records. <b>Setting</b>: UK General Practice Research Database. <b>Subjects</b>: 12 621 patients aged between 35 and 90 years who had received a prescription for an antiparkinsonian drug, whether or not a diagnosis of Parkinson9s disease had been recorded. Patients prescribed an antipsychotic drug before or at the same time as their first antiparkinsonian drug or before age 35 were excluded to avoid including drug-induced Parkinsonism. <b>Main outcome measures</b>: Death from any cause. <b>Results</b>: 1720 deaths occurred during 14 000 person-years of observation. There was a non-significant 11% (95% confidence interval 0% to 23%) increase in the risk of death associated with taking selegiline either alone or in combination with levodopa. The death rate was higher among younger patients (aged under 80 years) and those with a recorded diagnosis of Parkinson9s disease taking selegiline alone. <b>Conclusions</b>: The results are compatible with a small excess mortality in people taking selegiline and suggest a larger excess in patients under 80 years of age and those with a confirmed diagnosis of Parkinson9s disease taking selegiline without levodopa.
Irritable bowel syndrome as a cause of chronic pain in women attending a gynaecology clinic.
Authors: P Hogston
Journal: BMJ (1987)

<h3>Abstract</h3> Many species gain anti-predator benefits by combining gregarious behavior with warning coloration, yet there is debate over which trait evolves first, and which is the secondary adaptive enhancement. Body size can also influence how predators receive aposematic signals, and potentially constrain the evolution of gregarious behavior. To our knowledge, the causative links between the evolution of gregariousness, aposematism and larger body sizes have not been fully resolved. Here, using the most recently resolved butterfly phylogeny and an extensive new dataset of larval traits, we reveal the evolutionary interactions between important traits linked to larval gregariousness. We show that larval gregariousness has arisen many times across the butterflies, and aposematism is a likely prerequisite for gregariousness to evolve. We also find that body size may be an important factor for determining the coloration of solitary, but not gregarious larvae. Additionally, by exposing artificial ‘larvae’ to wild avian predation, we show that undefended, cryptic ‘larvae’ are heavily predated when aggregated but benefit from solitariness, whereas the reverse is true for aposematic prey. Our data reinforce the importance of aposematism for gregarious larval survival, whilst identifying new questions about the roles of body size and toxicity in the evolution of grouping behavior.
Allergy to Viral and Rickettsial Vaccines
Authors: Bret Ratner, Samuel Untracht, Frederic Hertzmark
Journal: New England Journal of Medicine (1952)

THE problem of the possible acquisition of hypersensitivity to egg protein from repeated injection of vaccine derived from viruses or rickettsiae and propagated on chick embryo is a subject of current interest. An editorial comment1 on an article published by us2 raised this question and maintained that it is a possibility that must be seriously entertained, as follows: "The immunity following the injection of influenza vaccines is short-lived, and reinjections at least every two or three years and perhaps again at the first evidence of an outbreak seem to be the only long range method of effective control with the . . .
Comparative liver scanning. Technetium sulfide Tc 99m vs gold Au 198
Authors: R. E. Cantor
Journal: JAMA (1970)

In 48 patients with suspected liver metastases, liver scans were performed with both technetium sulfide Tc 99m, and gold Au 198. In 90% of the patients, (43 of 48) the interpretations of the sulfur colloid and gold scans were similar. In 10%, (five of 48) the technetium sulfide Tc 99m scans were abnormal, while the corresponding gold Au 198 scans were normal. In all five cases, there was either histologic or strong clinical and laboratory evidence of liver disease. Thus, approximately 10% more intrahepatic lesions were demonstrated with technetium sulfide Tc 99m than with gold Au 198. Spleen scans were easily obtainable in 77% (37) of patients given technetium sulfide Tc 99m. In scanning for metastases, a nonpalpable liver had only a 23% chance (three of 13) of being abnormal, while a palpable liver had a 60% chance (18 of 30) of being abnormal.
Unilateral Pulmonary Artery Absence or Hypoplasia
Authors: JOHN C. ELDER, BERNARD L. BROFMAN, PAUL M. KOHN, BERNARD L. CHARMS, Joan Lawrence, Autie Belle Godfrey
Journal: Circulation (1958)

The clinical entity of unilateral pulmonary artery absence or hypoplasia can be readily diagnosed on the basis of routine clinical evaluation. This report is based upon 5 patients in whom the diagnosis was suspected and eventually confirmed with the aid of special studies. Characteristic hemodynamic findings were demonstrated by means of cardiac catheterization and contrast visualization of the cardiopulmonary system.
Fatal Pancytopenia Associated with Viral Hepatitis
Authors: John J. Deller, William J. Cirksena, Joseph Marcarelli
Journal: New England Journal of Medicine (1962)

MANY agents have been implicated as causing pancytopenia.1 Often, the evidence is circumstantial and is based solely upon the appearance of bone-marrow depression during or shortly after exposure to one or more agents. Although the list of presumptive causes of bone-marrow hypoplasia continues to grow, the majority of cases are still designated as idiopathic. Repeated observations incriminating the same agent are necessary to establish a reasonable etiologic relation. The association of pancytopenia with viral hepatitis has rarely been recognized, and most of the reports have appeared in the foreign literature.2 3 4 Although the cases are few a striking similarity between them . . .
How Mutant CFTR May Contribute to <i>Pseudomonas aeruginosa</i> Infection in Cystic Fibrosis
Authors: Gerald B. Pier, Martha Grout, Tanweer S. Zaidi, Joanna B. Goldberg
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Patients with cystic fibrosis (CF) have a pronounced hypersusceptibility (80 to 90%) to Pseudomonas aeruginosa infection. We hypothesized that airway epithelial cell ingestion of bacteria followed by cellular desquamation may protect the lung from infection, and epithelial cells expressing mutant forms of the cystic fibrosis transmembrane conductance regulator (CFTR) may be defective in this function. We found that transformed human airway epithelial cells homozygous for the ΔF508 allele of CFTR were significantly defective in uptake of P. aeruginosa compared with the same cell line complemented with the wild-type allele of CFTR. Partial membrane expression of the ΔF508 CFTR protein occurs in cells grown at 26° C, and under these conditions uptake of P. aeruginosa occurred at levels comparable to cells with a wild-type allele of CFTR. Epithelial cell ingestion assays using isogenic bacterial strains differing in lipopolysaccharide (LPS) phenotype, along with inhibition studies, identified the LPS-core oligosaccharide as the bacterial ligand for epithelial cell invasion. Inhibition of epithelial cell ingestion of P. aeruginosa in a neonatal mouse lung infection model led to increased levels of bacteria in the lungs 24 and 48 h after infection. Defective epithelial cell internalization of P. aeruginosa may be a critical factor in hypersusceptibility of CF patients to chronic lung infections.