tbuckley/cabot-search huggingface dataset:
ABSCESS OF THE LUNG.Read before the St. Louis Medical Society, December 14, 1890.
Authors: WILLIAM PORTER
Journal: JAMA (1891)

I have not thought to present an exhaustive essay upon this theme. The subject is interesting, its literature comparatively meagre, and it is closely related to the progress of that most aggressive department of our science—surgery; so that at least I may offer a few conclusions regarding it for your discussion. Permit me at the outset, by way of definition, to say that it is not intended in this paper that the term abscess should apply to those accumulations of pus secreting cavities which are so often found in the later stages of phthisis, but only to the circumscribed suppuration which may arise independently of tubercular processes. The history of pulmonary abscess as given by the older writers is not very exact. They generally supposed that the condition was the result of delayed resolution of pneumonia, and that if the inflammation did not subside by the twenty-first day
Abstract P1-09-10: Disparities in presentation of breast cancer in a geriatric population
Authors: C Ursem, F Camacho, R Anderson, G Kimmick
Journal: Cancer Research (2013)

Abstract Background: Although there are known to be disparities by socioeconomic status (SES) in breast cancer presentation, this has not been as well studied in the elderly. We examined older women in North Carolina (NC) using insurance status as an indicator of SES. Dual Medicaid/Medicare (dMM) status was used as a surrogate for low SES and Medicare only (M) as a surrogate for higher SES. Methods: From the 1999-2002 NC Central Cancer Registry, we identified women age ≥65 years presenting with nonmetastatic breast cancer, having surgery within 60 days of diagnosis, no neoadjuvant therapy, and insured by Medicare only or dual Medicaid/Medicare. We used Chi-square tests to compare demographic and tumor characteristics, including: age, race, ACE comorbidity index, tumor size, lymph node status (LN), ER/PR status and HER2 status. Results: We identified n = 3088 women with mean age 75 (SD 6.69) years, including 560 dMM and 2528 M insured women. We found that the dMM patients were older than M patients, with 57.7% ≥75 years, vs. 42.6% (p&amp;lt;0.001) and mean age 76.9 vs. 74.5 years (p&amp;lt;0.001), as well as composed of more African Americans, 34.6% vs. 6.6% (p&amp;lt;0.001). The dMM group also had significantly more comorbidity, with ACE comorbidity index: none 21.4% vs. 40.0%, minimal 45.2% vs. 43.2%, moderate 15.5% vs. 9.8% and severe 17.9% vs. 6.9% (p&amp;lt;0.001). The dMM patients were diagnosed more often with regional as compared to local disease, 26.3% vs. 19.7% (p&amp;lt;0.001) and had larger tumors at diagnosis, mean 23.46mm vs. 18.50mm (p&amp;lt;0.001). Additionally, the dMM patients were found to have more LN involvement: 0 LN in 73.4% vs. 80.0%, 1-3 LN in 19.6% vs. 15.5%, 4-9 LN in 5.7% vs. 3.5% and ≥ 10 LN in 1.3% vs. 1.1% (p = 0.004). We did not find significant differences in tumor histology, grade, ER/PR subtype or HER2 status. Conclusions: We found that in a population of elderly breast cancer patients, lower SES as defined by Medicaid insurance status was associated with older age, African American race and more advanced comorbidity. These same patients presented with move advanced disease, characterized by larger tumors and more LN involvement. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-09-10.
STUDIES IN THE SEROLOGY OF SYPHILIS
Authors: Harry Eagle
Journal: The Journal of Experimental Medicine (1931)

The discovery (1) that there are many substances with the sensitizing properties hitherto believed peculiar to cholesterol and its derivatives, and (2) that sensitizer can be added to antigen in very large quantities, many times those currently used, and yet continue to increase its complement-fixing efficiency with no danger of giving falsely positive tests has made possible the preparation of an antigen much more sensitive than any now available for use in the Wassermann reaction. 100 gm. of dry powdered beef heart muscle are extracted with 500 cc. ether for 15 minutes at 37 degrees C. with shaking. After filtration with suction, the ether filtrate is discarded. The powder is then dried and extracted for 3 to 5 days with 500 cc. of 95 per cent alcohol, with intermittent shaking. The mixture is filtered, and the moist powder washed on the filter paper with two portions of alcohol, each 100 cc. The alcoholic filtrate and washings are combined and evaporated on the steam bath down to 250 to 300 cc. Cholesterol (0.8 per cent), and sitosterol (0.6 per cent) are then added, and dissolved at 65 degrees -75 degrees C. The excess sensitizer which crystallizes out upon cooling is dissolved just before using by immersing the antigen in a 56 degrees C. bath for a few minutes. It is diluted by pouring the saline rapidly into the antigen. A 1:40 dilution is recommended for use in water bath fixation ((1/2) hour at 37 degrees C.), as well as for the short ice box fixation (8 degrees , 4 hours) and a 1:120 dilution for use in the overnight ice box method (16 to 24 hours at 8 degrees C.), as being well beyond its anticomplementary range; the anticomplementary quantities being 1:5 and 1:25 respectively. There is reason to believe that this antigen possesses almost the maximum sensitivity obtainable. The method of preparation insures its being almost saturated with antigen-lipoids; and more sensitizer could not be added without increasing the turbidity of its dilution in saline to a point where it would interfere with the reading of hemolysis. Any further improvement must await the discovery of better sensitizers. Preliminary experiments indicate that this new sensitizer, sitosterol, will find an immediate application, not only in the Wassermann reaction, but also in a more sensitive flocculation test to be described in a following paper.
HLA-B8 and cell-mediated immunity to gluten.
Authors: F G Simpson, A W Bullen, D A Robertson, M S Losowsky
Journal: Gut (1981)

The leucocyte migration inhibition (LMI) test was used as an indicator of cell mediated immunity to gluten fraction III in 30 healthy controls and 58 patients with adult coeliac disease and the results related to HLA status and duration of treatment with a gluten- free diet.HLA-B8 controls showed significantly lower leucocyte migration indices, indicating greater immune response, than non-HLA B8 controls.Untreated coeliacs showed no difference from HLA-B8 controls.There was no difference between results from HLA-B8 and non-HLA- B8 coeliacs.Leucocyte migration was even lower in coeliacs early in treatment but rose after treatment for over one year.These results may reflect an immune response gene for gluten in linkage disequilibrium with HLA-B8.The increased immune response to gluten as measured in this test cannot be the sole factor in the aetiology of coeliac disease.Furthermore, it is necessary to re-evaluate earlier results of cell-mediated immunity in coeliac disease with reference to HLA status of the controls.
Medical Education in the Community Hospital
Authors: John R. Graham
Journal: New England Journal of Medicine (1963)

THE medical economic status of the populace in the United States has changed since the war so that the teaching centers are looking for patients and the community hospitals are looking for teachers. This situation already exists, but adjustment to it is far from complete. New concepts and attitudes, however, are emerging from both groups that, if properly developed, can lead to a sound position for medical education in both areas within the scope of the present voluntary independent system of medical care.The community hospital, on one hand, needs for its staff and patients the benefits of new developments . . .
On Bichloride of Methylene
Authors: B. W. Richardson
Journal: BMJ (1869)

against disease as compared with another.Undoubtedly, the statistics of a single town are instructive; far more instruction, however, will be gained from the compared statistics of various and many towns.In addition, also, it would tend to throw light upon the causes of diseases, on the means of their prevention, and the right understanding of their etiology, the greatest reward of the worker in the wide expanse of " the science of medicine."
The Common House Fly as a Carrier of Typhoid.
Authors: Alice Hamilton
Journal: JAMA (1904)

Chicago, March 29, 1904. <h3>To the Editor:</h3> —InThe Journal, March 10, 1903, I published the report of certain investigations carried on in the Memorial Institue for Infectious Diseases, which apparently showed that the bacillus of typhoid fever could be found on the legs of flies which had visited vaults containing typhoid discharges. The organisms which were isolated, five in number, corresponded morphologically and culturally with the bacillus of Eberth and also were agglutinated by the serum of a rabbit immunized against the latter. The weak link in the chain of evidence, however, was the fact that agglutination could not be obtained in dilutions higher than 1-200. It is true that two control organisms, isolated from the blood of typhoid patients, also failed to agglutinate in higher dilutions, but the opinion generally held now, that it is only sera of high potency which will serve to differentiate the typhoid bacillus
Follicular lymphoma and the immune system: from pathogenesis to antibody therapy
Authors: Freda K. Stevenson, George T. Stevenson
Journal: Blood (2012)

Follicular lymphoma (FL) is a B-cell tumor arising in germinal centers and retaining features of its normal B-cell counterpart. Lymphomagenesis appears stepwise from the t(14;18) translocation, through FL-like cells, to FL in situ, then to overt FL. Surface Ig is mandatory and carries a striking V-region modification because of introduction of glycan addition sites during somatic mutation. These are positively selected and acquire unusual high mannoses, which interact with lectins. The Ig-associated mannoses appear essential for FL, providing a disease- specific target for antibody attack. Antibody therapy is currently focused on anti-CD20 (rituximab), which appears to rely predominantly on the Fcγ module recruiting suitably activated macrophages. Immunogloblulin and, to some extent, CD20, can each escape antibody attack in vitro by modulation, but this is difficult to demonstrate clinically. Instead, studies of anti-CD20 therapy of FL suggest that effector modulation, similar to that seen in the suppression of autoimmune inflammation by infusions of normal human IgG, may be important. Both antigenic and effector modulations might be minimized by repeated small doses of more potent antibodies. Clearly, mechanisms of attack vary with the malignancy, the target molecule, and the antibody design, offering opportunities for optimizing this promising strategy.
Invasion of mouse erythrocytes by the human malaria parasite, Plasmodium falciparum.
Authors: F W Klotz, J D Chulay, W Daniel, L H Miller
Journal: The Journal of Experimental Medicine (1987)

Plasmodium falciparum malaria merozoites require erythrocyte sialic acid for optimal invasion of human erythrocytes. Since mouse erythrocytes have the form of sialic acid found on human erythrocytes (N-acetyl neuraminic acid), mouse erythrocytes were tested for invasion in vitro. The Camp and 7G8 strains of P. falciparum invaded mouse erythrocytes at 17-45% of the invasion rate of human erythrocytes. Newly invaded mouse erythrocytes morphologically resembled parasitized human erythrocytes as shown on Giemsa-stained blood films and by electron microscopy. The rim of parasitized mouse erythrocytes contained the P. falciparum 155-kD protein, which is on the rim of ring-infected human erythrocytes. Camp but not 7G8 invaded rat erythrocytes, indicating receptor heterogeneity. These data suggest that it may be possible to adapt the asexual erythrocytic stage of P. falciparum to rodents. The development of a rodent model of P. falciparum malaria could facilitate vaccine development.
18-year experience with transseptal procedures through baffles, conduits and other intre-atrial patches
Authors: H.G. El-Said, F.F. Ing, M.R. Nihill, R.G. Gritka, C. Morris, S. Beck, D. Getty-Housewright, M. Dyer, C.E. Mullins
Journal: Journal of the American College of Cardiology (1998)
Clinical Assessment of a Novel Recombinant Simian Adenovirus ChAdOx1 as a Vectored Vaccine Expressing Conserved Influenza A Antigens
Authors: Richard D Antrobus, Lynda Coughlan, Tamara K Berthoud, Matthew D Dicks, Adrian VS Hill, Teresa Lambe, Sarah C Gilbert
Journal: Molecular Therapy (2013)

Adenoviruses are potent vectors for inducing and boosting cellular immunity to encoded recombinant antigens. However, the widespread seroprevalence of neutralizing antibodies to common human adenovirus serotypes limits their use. Simian adenoviruses do not suffer from the same drawbacks. We have constructed a replication-deficient chimpanzee adenovirus-vectored vaccine expressing the conserved influenza antigens, nucleoprotein (NP), and matrix protein 1 (M1). Here, we report safety and T-cell immunogenicity following vaccination with this novel recombinant simian adenovirus, ChAdOx1 NP+M1, in a first in human dose-escalation study using a 3+3 study design, followed by boosting with modified vaccinia virus Ankara expressing the same antigens in some volunteers. We demonstrate ChAdOx1 NP+M1 to be safe and immunogenic. ChAdOx1 is a promising vaccine vector that could be used to deliver vaccine antigens where strong cellular immune responses are required for protection. Adenoviruses are potent vectors for inducing and boosting cellular immunity to encoded recombinant antigens. However, the widespread seroprevalence of neutralizing antibodies to common human adenovirus serotypes limits their use. Simian adenoviruses do not suffer from the same drawbacks. We have constructed a replication-deficient chimpanzee adenovirus-vectored vaccine expressing the conserved influenza antigens, nucleoprotein (NP), and matrix protein 1 (M1). Here, we report safety and T-cell immunogenicity following vaccination with this novel recombinant simian adenovirus, ChAdOx1 NP+M1, in a first in human dose-escalation study using a 3+3 study design, followed by boosting with modified vaccinia virus Ankara expressing the same antigens in some volunteers. We demonstrate ChAdOx1 NP+M1 to be safe and immunogenic. ChAdOx1 is a promising vaccine vector that could be used to deliver vaccine antigens where strong cellular immune responses are required for protection.
THE POSSIBLE ASSOCIATION OF THE CONSUMPTION OF ALCOHOL WITH EXCESSIVE MORTALITY FROM CANCER
Authors: A. Newsholme
Journal: BMJ (1903)

PAIRT II of Dr. Tatham's decennial supplement to the 55th report of the Registrar-General, published in 1897, contained extremely valuable statistics relating to the relative deathrates and what are known as the "comparative mortality figures" of men engaged in different occupations.These statistics dealt not only with deaths from all causes in con- junction, but also from certain diseases; and the latter
The Treatment of Occlusive Arterial Disease
Authors: Irving S. Wright
Journal: JAMA (1963)

THROUGHOUT his entire existence, man is poised delicately and dangerously as on the two-faced escarpment of a mountain; on one side there is the risk of hemorrhage and on the other side the deadly threat of thrombosis. By a remarkable and complex combination of chemical and physical processes, both hemorrhage and thrombosis occur almost incessantly and simultaneously in different parts of his vascular tree; yet only rarely in his lifetime does he slip off his precarious perch to a catastrophic injury or death. And, of the two, the risk of death or disability due to thrombosis or embolism is far greater than that due to hemorrhage. This article will discuss these aspects of occlusive arterial disease. The most common causes of arterial occlusion are thrombosis at the site of an atherosclerotic plaque and embolism due to a fibrillating or infarcted heart. These episodes may be acute, the critical phase
Changes in Pulmonary Mechanics after the Administration of Surfactant to Infants with Respiratory Distress Syndrome
Authors: J M Davis, K Veness-Meehan, R H Notter, V K Bhutani, J W Kendig, D L Shapiro
Journal: New England Journal of Medicine (1988)

We assessed pulmonary mechanics in 35 premature infants with respiratory distress syndrome just before and one hour after the administration of 90 mg of surfactant to each infant. Transpulmonary pressure was measured between the airway opening and an esophageal balloon with use of a differential transducer, and flow rates were measured by a pneumotachometer. Values for pulmonary mechanics were then calculated by microcomputer processing. The administration of surfactant produced a large decrease (56 percent) in the mean (±SEM) ratio of alveolar to arterial oxygen, from 7.1±0.5 to 3.1±0.2 (P<0.0001) — a change that indicates improvement in gas exchange. Associated changes in pulmonary mechanics were not demonstrable when 10 of the infants were studied during continuous mechanical ventilation. However, in the 25 infants examined during spontaneous breathing with continuous positive airway pressures (identical airway pressures before and after treatment), large and consistent improvements in pulmonary mechanics were found after the administration of surfactant. Tidal volume increased by 32 percent (P<0.03), minute ventilation by 38 percent (P<0.02), dynamic compliance by 29 percent (P<0.004), and inspiratory flow rates by 54 percent (P<0.01). We conclude that significant improvement in pulmonary mechanics results from surfactant-replacement therapy for respiratory distress syndrome, but that these mechanical changes are apparent only during spontaneous respiration and can be masked if measurements are made during mechanical ventilation. (N Engl J Med 1988; 319: 476–9.)
Liquid-Based Cytology and Human Papillomavirus Testing to Screen for Cervical Cancer: A Systematic Review for the U.S. Preventive Services Task Force
Authors: Evelyn P. Whitlock, Kimberly K. Vesco, Michelle Eder, Jennifer S. Lin, Caitlyn A. Senger, Brittany U. Burda
Journal: Annals of Internal Medicine (2011)

This article has been corrected. The original version (PDF) is appended to this article as a supplement. Background: Screening programs using conventional cytology have successfully reduced cervical cancer, but newer tests might enhance screening. Purpose: To systematically review the evidence on liquid-based cytology (LBC) and high-risk human papillomavirus (HPV) screening for U.S. Preventive Services Task Force use in updating its 2003 recommendation. Data Sources: MEDLINE, Cochrane Central Register of Controlled Trials, and PsycINFO from January 2000 through September 2010. Study Selection: Two independent reviewers selected fair- to good-quality English-language studies that compared LBC or HPV-enhanced primary screening with conventional cytology in countries with developed population-based screening for cervical cancer. Data Extraction: At least 2 independent reviewers critically appraised and rated the quality of studies and used standardized abstraction forms to extract data about test performance for detecting cervical intraepithelial neoplasia (CIN) and cancer and screening-related harms. Data Synthesis: On the basis of 4 fair- to good-quality studies (141 566 participants), LBC had equivalent sensitivity and specificity to conventional cytology. Six fair- to good-quality diagnostic accuracy studies showed that 1-time HPV screening was more sensitive than cytology for detecting CIN3+/CIN2+ but was less specific. On the basis of 2 fair- to good-quality randomized, controlled trials (RCTs) (120 533 participants), primary HPV screening detected more cases of CIN3 or cancer in women older than 30 years. Four fair- to good-quality diagnostic accuracy studies and 4 fair- to good-quality RCTs showed mixed results of cotesting (HPV plus cytology) in women aged 30 years or older compared with cytology alone, with no clear advantage over primary HPV screening. Incomplete reporting of results for all screening rounds, including detection of disease and colposcopies, limits our ability to determine the net benefit of HPV-enhanced testing strategies. Limitation: Resources were insufficient to gather unpublished data, short-term trial data showed possible ascertainment bias, and most RCTs used protocols that differed from current U.S. practice. Conclusion: Evidence supports the use of LBC or conventional cytology for cervical cancer screening, but more complete evidence is needed before HPV-enhanced primary screening is widely adopted for women aged 30 years or older. Primary Funding Source: Agency for Healthcare Research and Quality.
Leaving the Bedside: The Search for a Nonclinical Medical Career
Authors: Alford C. Diller
Journal: JAMA (1993)

This publication was produced by the AMA's Department of Physician Licensure and Career Resources. Research was performed by Joe Ann Jackson, Project Manager, and the report written by Maija Balagot, a Chicago-based communications consultant. The resulting product is a primer for the practicing physician who is considering leaving patient care or leaving medicine altogether. <i>Leaving the Bedside</i>first explores the forces pushing or pulling a physician to consider a career change. Actual case histories representative of the reasons physicians have changed to nonclinical careers are presented. Many dissatisfactions of a clinical medical career are discussed in depth. Next covered are adjustments that can be anticipated in leaving clinical medicine for a nonclinical position: the emotional stresses in changing peer groups and the changing concept of self, determining who you are and who you want to be. For most physicians, changing careers requires a lot of help from a variety of
The Blood Pressure of Hypertensive Smokers
Authors: Lawrence J. Appel
Journal: JAMA (1991)

<h3>To the Editor.</h3> —The report by Mann et al<sup>1</sup>provides intriguing results that suggest that the ambulatory systolic BP of smokers may be considerably higher than that of nonsmokers while office BPs appear remarkably similar. Those provocative findings should be interpreted cautiously given a number of methodologic concerns. First, it should be emphasized that smokers differed substantially from nonsmokers by age and, to a lesser extent, by race. Such differences in measured variables raise the possibility that the smokers and nonsmokers differed as well in terms of other important characteristics, measured or unmeasured, which potentially may confound the apparent association between smoking and ambulatory systolic BP (eg, alcohol intake). Second, in the stratified analyses, the authors "split" the matched sets of nonsmokers and smokers, originally assembled in a 2:1 ratio. As such, it appears that 20 of the nonsmokers who had been matched to smokers less than 50 years