tbuckley/cabot-search huggingface dataset:
Use of Antibiotics in Respiratory Infection
Authors: Joseph Ashwal
Journal: JAMA (1979)

<h3>To the Editor.—</h3> The article by Greenberg et al entitled "Physician Opinions on the Use of Antibiotics in Respiratory Infections" (240:650, 1978) concerned itself with the management of 18 common respiratory infections in infants. The discrepancy in the use of antibiotics by family physicians compared with that of specialists in pediatric infectious disease (ID) is obvious. In 14 of 18 situations, 75% or more family physicians elected to use antibiotics. There were no circumstances when 75% of family physicians agreed not to use antibiotics. In four of 18 situations, antibiotics were used by 75% of ID specialists, while in three of 18 situations, 75% thought antibiotics were not indicated. This discrepancy generated the question in our minds, as residents, as to what our antibiotic use would be in these situations. Shortly after the study was published, all second- and third-year family practice residents of Roanoke Memorial Hospitals were given a
The Antifolate Activity of Tea Catechins
Authors: Enma Navarro-Perán, Juan Cabezas-Herrera, Francisco García-Cánovas, Marcus C. Durrant, Roger N.F. Thorneley, José Neptuno Rodríguez-López
Journal: Cancer Research (2005)

Abstract A naturally occurring gallated polyphenol isolated from green tea leaves, (−)-epigallocatechin gallate (EGCG), has been shown to be an inhibitor of dihydrofolate reductase (DHFR) activity in vitro at concentrations found in the serum and tissues of green tea drinkers (0.1-1.0 μmol/L). These data provide the first evidence that the prophylactic effect of green tea drinking on certain forms of cancer, suggested by epidemiologic studies, is due to the inhibition of DHFR by EGCG and could also explain why tea extracts have been traditionally used in “alternative medicine” as anticarcinogenic/antibiotic agents or in the treatment of conditions such as psoriasis. EGCG exhibited kinetics characteristic of a slow, tight-binding inhibitor of 7,8-dihydrofolate reduction with bovine liver DHFR (KI = 0.109 μmol/L), but of a classic, reversible, competitive inhibitor with chicken liver DHFR (KI = 10.3 μmol/L). Structural modeling showed that EGCG can bind to human DHFR at the same site and in a similar orientation to that observed for some structurally characterized DHFR inhibitor complexes. The responses of lymphoma cells to EGCG and known antifolates were similar, that is, a dose-dependent inhibition of cell growth (IC50 = 20 μmol/L for EGCG), G0-G1 phase arrest of the cell cycle, and induction of apoptosis. Folate depletion increased the sensitivity of these cell lines to antifolates and EGCG. These effects were attenuated by growing the cells in a medium containing hypoxanthine-thymidine, consistent with DHFR being the site of action for EGCG.
APPENDICITIS IN A PATIENT WITH A FETAL TYPE OF ILEUM AND CECUM GIVING RISE TO GALLBLADDER SYMPTOMS
Authors: Lewis P. Glover
Journal: JAMA (1926)

G. K., a white man, aged 22, was admitted complaining of severe pain in the upper right abdomen, with pain about the umbilical region and lower right quadrant. There had been moderate attacks of pain along the whole right side of the abdomen for two weeks. The day before admission, the patient was seized with a sudden violent pain in the upper right quadrant of the abdomen just below the costal margin, which bent him double and nearly caused him to faint. He had been constantly nauseated, and for the past two days had been vomiting everything he had eaten. He had kept the bowels open with laxatives. A previous history of some indigestion had been obtained, but no constipation, vomiting or urinary disturbance had been present. The temperature was 97.4 F., the pulse 90, and the respiration 24. The temperature rose to 99 in twelve hours.  The patient was well nourished, slight, but in general good condition.
Findings on Radionuclide Cisternography in a Large Abdominal Cerebrospinal Fluid Pseudocyst Associated with Tuberculous Peritonitis
Authors: KAZUYOSHI SUGA, YUKO ISHIKAWA, KAZUKO MOTOYAMA, NORIHIKO KUME, NAOFUMI MATSUNAGA
Journal: Clinical Nuclear Medicine (2000)

Abdominal cerebrospinal fluid (CSF) pseudocyst associated with infectious peritonitis is a rare complication of a ventriculoperitoneal shunt procedure. The authors report a rare case of a large CSF pseudocyst involving the peritoneal end, associated with tuberculous peritonitis. A radionuclide clearance study of the shunt using planar and SPECT scanning effectively revealed the abnormal collection and kinetics of CSF within the large, thick-walled CSF pseudocyst.
Guantanamo: a call for action: Good men need to do something
Authors: David J Nicholl
Journal: BMJ (2006)

EDITOR—I agree with Wilks that the declarations of the World Medical Association in relation to force feeding of hunger strikers will have limited effect unless national medical associations are willing to make their members accountable when practice departs from principles.1 Sadly, it has not been my recent experience that national medical associations and the medical establishment are prepared fully to investigate …
Combining Monophasic Action Potential Recordings With Pacing to Demonstrate Delayed Afterdepolarizations and Triggered Arrhythmias in the Intact Heart
Authors: S.H. Marieke de Groot, Marc A. Vos, Anton P.M. Gorgels, Jet D.M. Leunissen, Bert J. van der Steld, Hein J.J. Wellens
Journal: Circulation (1995)

Background In the intact heart, methodological difficulties hamper the direct visualization of delayed afterdepolarizations (DADs) responsible for triggered arrhythmias. Therefore, we tested the hypothesis that a combination of pacing and the recording of a monophasic action potential (MAP) could facilitate the recognition of ouabain-induced DADs and triggered arrhythmias by demonstrating an increase in the diastolic baseline slope (dV/dT) of the MAP recording at the end of a pacing train. Methods and Results In anesthetized dogs with chronic atrioventricular block, a right ventricular endocardial MAP was recorded during (1) control (n=11), (2) 15 to 45 minutes after administration of ouabain (45±10 μg/kg, n=11), (3) 10 minutes after administration of lidocaine (3 mg/kg, n=5), and (4) during lidocaine washout (n=3). Pacing was performed with the MAP catheter. Also, the protocol was performed in 3 dogs with conducted sinus rhythm during control and ouabain circumstances. During control, the slope value was 2±2 mV/s (mean±SD), the incidence of DADs after the stimulation train was 6%, and no ventricular tachycardias (VTs) were induced in dogs with atrioventricular block. During ouabain administration, the slope and DAD incidences increased to, respectively, 26±14 mV/s and 74% ( P &lt;.05 for both). VTs were induced frequently. Lidocaine prevented VT induction by decreasing the slope and the incidence of DADs. This effect disappeared after lidocaine washout. During conducted sinus rhythm, similar results were found. Conclusions By combining pacing and MAP recordings, the diastolic slope observed on MAP recordings in ouabain-intoxicated hearts can be used as a marker for DADs and triggered arrhythmias. This finding may be helpful in identifying triggered activity in the intact heart.
Classic Nephropathic Cystinosis as an Adult Disease
Authors: Demetrios S. Theodoropoulos
Journal: JAMA (1993)

To delineate the clinical characteristics of infantile nephropathic cystinosis in adult patients who have undergone renal transplantation.Case series.Clinical research unit.All 36 adult patients with nephropathic cystinosis referred to the National Institutes of Health.Longevity, growth, renal allograft survival, visual acuity, endocrine insufficiency, myopathy and swallowing dysfunction, cerebral calcifications, and occupational status.Of the 36 patients, seven were dead, five with functioning allografts. The 1-year and 5-year graft survival rates for 30 cadaveric allografts were 90% and 75%, respectively. The patients' mean height and weight were severely retarded. Five patients were legally blind, and three others had severely impaired vision in one eye. Thirty-one (86%) of 36 patients required thyroid hormone replacement therapy. One third had a distal myopathy, and 21 had moderate to severe swallowing abnormalities. Eight patients had cerebral calcifications on computed tomographic scan. Despite these complications, the sighted patients engaged in a normal variety of occupations. Only 11 patients were receiving adequate cystine-depleting therapy with cysteamine (mercaptamine) or phosphocysteamine.Adult patients with nephropathic cystinosis suffer serious complications of the disease.
The Value of Exercise Stress Testing
Authors: Robert DeBusk
Journal: JAMA (1975)

EXERCISE electrocardiography has wide application in the diagnosis and treatment of heart disease. This brief review emphasizes its usefulness in the management of patients with suspected or proved coronary heart disease. The following are indications for exercise electrocardiography: To aid in establishing the presence or absence of "preclinical" coronary heart disease in apparently normal individuals. To aid in establishing the presence of suspected coronary heart disease. To assess the functional significance of coronary heart disease: selection of therapy (a) in stable angina pectoris, (b) following myocardial infarction, and (c) following coronary artery bypass surgery. Evaluation of the risk of sudden cardiac death. <h3>Preclinical Coronary Heart Disease</h3> Exercise electrocardiography is useful in suggesting the presence of coronary heart disease in apparently normal individuals. This information is independent of that provided by measurement of "coronary risk factors" and, moreover, is more specific for coronary heart disease in an
Health risks in babies born after assisted reproduction
Authors: A. G Sutcliffe
Journal: BMJ (2002)

Parents who conceive after fertility treatments would like to know if their children are at excess health risks compared with children who have been conceived naturally. They would like studies to be done to monitor outcome—but not necessarily on their own children.

Outcome studies of in vitro fertilisation are relatively few to date and hampered by difficulties such as high cost, ethical considerations, recruitment of appropriate controls, and unwillingness of some parents even to tell their children how they were conceived, let alone bring them for assessments. Early studies were small, uncontrolled, and had other methodological errors. In contrast the pace of advances in the treatment of infertility has been rapid. The development of embryo cryopreservation has been followed by potentially more hazardous techniques such as intracytoplasmic sperm injection and extended embryo culture. Other techniques entail manipulating the embryo in vitro by assisted hatching and preimplantation genetic diagnosis, a diagnostic procedure.

The eldest individuals born after in vitro fertilisation are now young adults, and 1% of children in developed countries are now conceived through …
Multicenter Experience With Extraction of the Sprint Fidelis Implantable Cardioverter-Defibrillator Lead
Authors: Melanie Maytin, Charles J. Love, Avi Fischer, Roger G. Carrillo, Juan D. Garisto, Maria Grazia Bongiorni, Luca Segreti, Roy M. John, Gregory F. Michaud, Christine M. Albert, Laurence M. Epstein
Journal: Journal of the American College of Cardiology (2010)
Optimizing GH Therapy in Adults and Children
Authors: W. M. Drake, S. J. Howell, J. P. Monson, S. M. Shalet
Journal: Endocrine Reviews (2001)

Abstract Until the advent of modern neuroradiological imaging techniques in 1989, a diagnosis of GH deficiency in adults carried little significance other than as a marker of hypothalamo-pituitary disease. The relatively recent recognition of a characteristic clinical syndrome associated with failure of spontaneous GH secretion and the potential reversal of many of its features with recombinant human GH has prompted a closer examination of the physiological role of GH after linear growth is complete. The safe clinical practice of GH replacement demands a method of judging overall GH status, but there is no biological marker in adults that is the equivalent of linear growth in a child by which to judge the efficacy of GH replacement. Assessment of optimal GH replacement is made difficult by the apparent diverse actions of GH in health, concern about the avoidance of iatrogenic acromegaly, and the growing realization that an individual’s risk of developing certain cancers may, at least in part, be influenced by cumulative exposure to the chief mediator of GH action, IGF-I. As in all areas of clinical practice, strategies and protocols vary between centers, but most physicians experienced in the management of pituitary disease agree that GH is most appropriately begun at low doses, building up slowly to the final maintenance dose. This, in turn, is best determined by a combination of clinical response and measurement of serum IGF-I, avoiding supraphysiological levels of this GH-dependent peptide. Numerous studies have helped define the optimum management of GH replacement during childhood. The recent requirement to measure and monitor GH status in adult life has called into question the appropriateness of simplistic weight- and surface area-based dosing regimens for the management of GH deficiency in childhood, with reliance on linear growth as the sole marker of GH action. It is clear that the monitoring of parameters other than linear growth to help refine GH therapy should now be incorporated into childhood GH treatment protocols. Further research will be required to define the optimal management of the transition from pediatric to adult GH replacement; this transition will only be possible once the benefits of GH in mature adults are defined and accepted by pediatric and adult endocrinologists alike.
The Photography of Patients Including Discussions of Basic Photographic and Optical Principles and Infrared Techniques
Authors: James H. Rothenberger
Journal: JAMA (1960)

The first edition of this book proved to be a valuable reference work for the physician who desired photographic recording in his office, in the clinic, or during a research project. It served as a guide and a reference to the clinical photographer as well. It is an excellent introduction to the solution of photographic problems most likely to be encountered by the busy physician. During the eight years since the book was published, many new photographic techniques have come into being. New equipment and cameras have been introduced, thereby simplifying the photography of patients and lessening the chance of error. It was reasonable, therefore, to expect a new and completely rewritten second edition. With the increasing awareness by the physician of the importance of photographing the patient, this new edition should prove to be of even more help than the first. The book is divided into 10 basic chapters,
O97 GUT-DERIVED FGF15 PLAYS A CENTRAL ROLE IN FIBROSIS-ASSOCIATED HEPATOCARCINOGENESIS
Authors: I. Uriarte, M.U. Latasa, M.G. Fernandez-Barrena, O. Garcia-Irigoyen, M. Elizalde, R. Urtasun, J. Prieto, C. Berasain, M.A. Avila
Journal: Journal of Hepatology (2014)
Involvement of Mitochondrial DNA Sequence Variations and Respiratory Activity in Late Complications following Radiotherapy
Authors: Ghazi A. Alsbeih, Najla M. Al-Harbi, Medhat M. El-Sebaie, Nasser M. Al-Rajhi, Khaled S. Al-Hadyan, Khaled K. Abu-Amero
Journal: Clinical Cancer Research (2009)

Mitochondria and ionizing radiation overlap in a number of features; for instance, both generate harmful reactive oxygen species, and that radiation can induce cell death through the intermediary of mitochondria. Because a number of genetic variations in nuclear genes are frequently associated with response to cancer treatment, the aim of this case-control study was to test the hypothesis that mitochondrial DNA (mtDNA) genetic variations can contribute to patient-to-patient variability in normal tissue response to radiotherapy.Thirty-two nasopharyngeal carcinomas patients treated with definitive radiotherapy were included. The grade (G) of s.c. and deep tissue fibrosis was scored according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer grading system. Coding and RNA mtDNA (between 611 and 15,978 bp) were sequenced, and genetic variations were scored. Mitochondrial respiratory activity was measured by resazurin reduction assay.Data showed a significantly (P = 0.003) higher number of nonsynonymous genetic variations in the radiosensitive (G(2)-G(3); 16 patients) as compared with the control (G(0)-G(1); 16 patients) groups. The nonsynonymous A10398G variation in the ND3 gene was significantly associated with fibrotic reaction (P = 0.01). The radiosensitive patients had a 7-fold (95% confidence interval, 1.16-51.65) higher risk of developing moderate to severe fibrosis (G(2)-G(3)) following radiotherapy. This was significantly correlated with lower mitochondrial respiratory activity (P = 0.001).Mitochondria contribute to radiation sensitivity, and genetic variations can be associated with late reactions to radiotherapy. Predictive markers of radiosensitivity should take into account mtDNA genetic variations in addition to variations in nuclear genes.
Environmental Tobacco Smoke Exposure Among Police Officers in Hong Kong
Authors: Tai Hing Lam
Journal: JAMA (2000)

Few epidemiological studies have examined the relationship between chronic respiratory symptoms and exposure to environmental tobacco smoke (ETS) at work in adults, and none have shown clear dose-response relationships.To examine the respiratory effects of ETS exposure at home and at work among never-smoking adults.Cross-sectional, self-administered questionnaire survey conducted in December 1995 and January 1996 among 4468 male and 728 female police officers in Hong Kong who were never-smokers.Respiratory symptoms and physician consultation in the previous 14 days for such symptoms by presence and amount of ETS exposure at work.Eighty percent of both men and women reported ETS exposure at work. Significant odds ratios (ORs) for respiratory symptoms were found among men with ETS exposure at work (for any respiratory symptoms, difference in absolute rate, 20.4%; OR, 2.33; 95% confidence interval [CI], 1.97-2.75; attributable risk, 57%) and physician consultation (difference in absolute rate, 4.5%; OR, 1.30; 95% CI, 1. 05-1.61; attributable risk, 23%). Trends were similar among women for any respiratory symptoms (difference in absolute rate, 15.4%; OR, 1.63; 95% CI, 1.04-2.56; attributable risk, 39%) and for physician consultation (difference in absolute rates, 2.8%; OR, 1.45; 95% CI, 0.87-2.41; attributable risk, 31%). Positive dose-response relationships with number of coworkers smoking nearby and amount of ETS exposure in the work place were found.This study provides further evidence of the serious health hazards associated with ETS exposure at work. The findings support a ban on smoking in the workplace to protect all workers in both developed and developing countries. JAMA. 2000;284:756-763
ABC of poisoning. Problems in children.
Authors: J Henry, G Volans
Journal: BMJ (1984)

Evaluation des dangers le plus souvent l'alerte est sans fondement. Problemes courants: duree de l'observation, lavage gastrique ou ipecacuanha, doses d'antidotes pour enfants, tests toxicologiques, risque du paracetamol. Intoxication non accidentelle (une observation medicolegale resumee)
Medical Emigration from Great Britain and Ireland
Authors: J. Seale
Journal: BMJ (1964)

Two years ago I published a paper indicating that over 600 graduates of the medical schools of Great Britain and Ireland' had registered annually for practice in North America, Austra- lasia, South Africa, and the Rhodesias in the years 1956-60 (Seale, 1962).No estimate was made of the number who had subsequently returned to the British Isles, but it was, assumed that the majority had remained overseas and should be regarded as medical emigrants.Several authorities have claimed that a figure approaching 600 per year greatly overstated the true rate of medical emi- gration from the British Isles in the late 1950s.Sir Robert Platt (1962) suggested that the estimate may be "as much as 400 to 800% in error."Mr. Enoch Powell (1962),whenMinister of Health, thought that the figure represented a "grotesque allegation," and, although no precise estimate of the number of doctors emigrating was made in his paper, it can be deduced from figures he published that he considered it must be much less than 150 per year from Great Britain alone.The Lancet (1963) made a similar estimate-140 per year from Great Britain -which, it stated, was a figure " of the same order as that for overseas graduates joining the hospital service in senior posts" in Britain (my italics).With new data available a more precise estimate of the number of doctors from the British Isles emigrating perman- ently can now be made.It would appear that the number of doctors emigrating from Great Britain and Ireland to North America, Australasia, South Africa, and Southern Rhodesia during 1956-60 may have been 20% less than 600 per year- that is, 480 per year.From Great Britain alone during the same years the average number may have been as low as 370 per year-a figure between two and a half and five times as large as the estimates of Sir Robert Platt, Mr. Enoch Powell, and the Lancet of medical emigration to the whole of the rest of the world.In this paper details are given of how the more precise estimates of recent medical emigration to North America, Australasia, and parts of Africa have been arrived at, and an analysis is made of the fallacies that have led to the sub- stantial underestimates of medical emigration referred to above. CanadaSince 1953 the Department of Citizenship and Immigration in Ottawa has published each year the number of doctors enter- ing Canada as immigrants by country of origin.In the nine years 1953 to 1961 inclusive, 1,420 physicians and surgeons of English, Scottish, and Welsh origin entered Canada as immigrants (an average of 158 per year), and in another paper (Seale, 1962) it was assumed that the majority have remained in Canada.It was further assumed that medical emigration from Britain to Canada in the 1930s had been low.
Legionnaires' Disease
Authors: David W. Fraser, Theodore R. Tsai, Walter Orenstein, William E. Parkin, H. James Beecham, Robert G. Sharrar, John Harris, George F. Mallison, Stanley M. Martin, Joseph E. McDade, Charles C. Shepard, Philip S. Brachman
Journal: New England Journal of Medicine (1977)

An explosive, common-source outbreak of pneumonia caused by a previously unrecognized bacterium affected primarily persons attending an American Legion convention in Philadelphia in July, 1976. Twenty-nine of 182 cases were fatal. Spread of the bacterium appeared to be air borne. The source of the bacterium was not found, but epidemiologic analysis suggested that exposure may have occurred in the lobby of the headquarters hotel or in the area immediately surrounding the hotel. Person-to-person spread seemed not to have occurred. Many hotel employees appeared to be immune, suggesting that the agent may have been present in the vicinity, perhaps intermittently, for two or more years. (N Engl J Med 297:1189–1197, 1977)