tbuckley/cabot-search huggingface dataset:
Protective effect of intravenously administered cefuroxime against nosocomial pneumonia in patients with structural coma.
Authors: J M Sirvent, A Torres, M El-Ebiary, P Castro, J de Batlle, A Bonet
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

In comatose patients admitted to an ICU, particularly those with head injury, the incidence of early onset pneumonia is exceedingly high. We performed an open, prospective, randomized, and controlled clinical trial aiming at the reduction of the incidence of ventilator-associated pneumonia in head-injured patients and patients with stroke requiring mechanical ventilation. One hundred patients were included because of head injury or coma caused by medical stroke and with Glasgow coma scores < or = 12 and mechanical ventilation > 72 h. Patients eligible for the study (n = 50) received cefuroxime intravenously (two 1,500-mg doses 12 h apart after intubation) (the cefuroxime group) and 50 patients not receiving cefuroxime formed the control group. In the former group patients did not receive any other antibiotics before the end-point determination, whereas in the latter, 17 patients received prophylactic antibiotics as prescribed by the attending physician. The global incidence of microbiologically confirmed pneumonia was 37% (n = 37); 12 (24%) belonged to the cefuroxime group, and 25 (50%) belonged to the control group (p = 0.007). Early-onset pneumonia accounted for 70% of all the pneumonia episodes (n = 26), eight (67%) belonging to the cefuroxime group, and 18 (72%) belonging to the control group (p = 0.02). In the control group, four of 17 (23%) patients receiving prior antibiotics developed pneumonia, whereas 21 of 33 (64%) patients who did not receive antibiotics developed pneumonia (p = 0.016). The multivariate analysis revealed that the duration of mechanical ventilation (per each day) was an independent risk factor significantly associated to the development of pneumonia. Furthermore, the use of cefuroxime and/or prior antibiotics in the control group, before the pneumonia episode, had a protective effect against its development. No differences were found with regard to mortality and morbidity when comparing the study population with the control group. Nevertheless, when comparing patients with pneumonia (from both study and control groups) with those without it, there was a decrease in total hospital stay (35 +/- 13 versus 25 +/- 14 d, p = 0.048) and ICU stay (20 +/- 11 versus 11 +/- 7 d, p = 0.001). The study demonstrated that the administration of two single high doses 1,500 mg each of cefuroxime after the intubation of patients comatose because of head injury or medical stroke is an effective prophylactic strategy to decrease the incidence of ventilator-associated pneumonia.
Detection of Silent Colon Cancer in Routine Examination
Authors: D. H. Greegor
Journal: CA A Cancer Journal for Clinicians (1969)

Cancer of the colon and rectum is our most common internal cancer.1The majority of the cases can be discovered by digital and/or sigmoidoscopic ex amination.2The remainder, above the sigmoidoscopic level, can usually be de tected by barium enema roentgeno graphic examination.Although the dis ease is frequently curable by surgical excision, it kills more Americans each year than any other cancer except lung cancer.1In 1966 we analyzed all of our case records of silent colon cancer.3We in cluded only those patients who came to us for routine physical examinations with absolutely no evidence of change in bowel habits, anemia, abdominal dis comfort, rectal bleeding, or abdominal masses, but who proved to have large bowel cancer at the time of examina tion.We found seven such cases and, interestingly enough, only one lesion was within sigmoidoscopic range.The objective of our study was to determine if any clue had been present at the time of the patient's initial visit which might be applied to future routine examinations in other patients.We had always performed routine sig
New threat of antibacterial resistance emerges from India
Authors: B. Roehr
Journal: BMJ (2010)

Researchers and clinicians are troubled by a new genetic segment that confers resistance to virtually all of the β lactam class of antibiotics. The plasmid, called New Delhi metallo-s-lactamase-1 (NDM-1), was first identified in Escherichia coli and Klebsiella pneumoniae and seems to be readily exchanged between a variety of bacteria.

It was the focus of presentations at the 50th interscience conference on antimicrobial agents and chemotherapy in Boston on 12-15 September. 

NDM-1 was first detected in a patient in the United Kingdom who had gone to India for surgery. Other examples of infection with the plasmid have since been identified in Canada, Australia, Kenya, and other European countries, all with some link to countries on …
RADIOLABELED PROSTATIC ACID PHOSPHATASE ANTIBODIES IN THE RADIOIMMUNODETECTION OF PRIMARY AND METASTATIC PROSTATIC CARCINOMA
Authors: F. H. DeLand, S. J. Bennett, M. O. Nelson, F. J. Primus, D. H. Goldenberg
Journal: Clinical Nuclear Medicine (1983)

DeLand, F. H.; Bennett, S. J.; Nelson, M. O.; Primus, F. J.; Goldenberg, D. M. Author Information
Idiopathic Pneumonia Syndrome after Syngeneic Bone Marrow Transplant in Mice
Authors: Karan S. Bhalla, Rodney J. Folz
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Idiopathic pneumonia syndrome is characterized by noninfectious diffuse lung injury after myeloablative chemotherapy and bone marrow transplant. Because little is known about its pathogenesis after autologous-based regimens, we have developed a murine model that closely mimics the human lung disease process. Using an autologous regimen similar to that used for patients with metastatic breast cancer, mice developed pulmonary injury as early as 1 day posttransplant. This lung injury was most dramatically characterized by decreased lung compliance that was associated with an intense monocytic cellular infiltrate of activated macrophages. This influx was preceded by an acute elevation in monocyte chemotactic protein-1 and macrophage inflammatory protein-1alpha. The conditioning regimen caused substantial oxidative stress as manifest by elevations in lung lipid peroxidation and oxidized glutathione. To test the hypothesis that oxidation is directly responsible for the lung toxicity, we administered the antioxidant, n-acetylcysteine. These mice showed substantially less lung injury, thus providing direct evidence that oxidative stress plays a distinct role in the development of lung injury in the early periautologous bone marrow transplant period. Attenuation of lung oxidative stress and/or inflammation in patients undergoing autologous bone marrow transplant may reduce the subsequent development of idiopathic pneumonia syndrome.
Information from Pharmaceutical Companies and the Quality, Quantity, and Cost of Physicians' Prescribing: A Systematic Review
Authors: Geoffrey K. Spurling, Peter R. Mansfield, Brett D. Montgomery, Joel Lexchin, Jenny Doust, Noordin Othman, Agnes I. Vitry
Journal: PLoS Medicine (2010)

Geoff Spurling and colleagues report findings of a systematic review looking at the relationship between exposure to promotional material from pharmaceutical companies and the quality, quantity, and cost of prescribing. They fail to find evidence of improvements in prescribing after exposure, and find some evidence of an association with higher prescribing frequency, higher costs, or lower prescribing quality.
A polymorphism of the alpha1-antitrypsin gene represents a risk factor for liver disease
Authors: Sally Chappell, Nedim Hadzic, Robert Stockley, Tamar Guetta-Baranes, Kevin Morgan, Noor Kalsheker
Journal: Hepatology (2007)

Alpha1-antitrypsin deficiency (AATD) due to homozygosity of the protease inhibitor (Pi) Z variant predisposes to childhood liver disease and pulmonary emphysema. About 10% of all neonates with AATD develop liver disease, and about 3% overall progress to severe disease. AATD is a principal genetic indication for liver transplantation in children. The liver pathology is associated with accumulation of abnormally folded protein in hepatocytes, the principal producers of circulating alpha1-antitrypsin (AAT). It is currently unknown why only a small proportion of Pi ZZ individuals progress to clinically significant cirrhosis. The AAT gene shows significant variation, and we hypothesized that cryptic genetic variants within the AAT gene may contribute to susceptibility to liver disease. In a case-control study consisting of 42 patients with established moderate-to-severe liver disease and 335 homozygous Pi ZZ patients who mostly presented with chronic obstructive pulmonary disease (n = 322: 242 index cases and 80 unaffected sibs) or were asymptomatic (n = 13) with no evidence of liver disease, we identified a single nucleotide polymorphism (SNP) that conferred a significant risk for liver disease ( P = 0.007). The frequency of the SNP was no different in 242 Pi ZZ cases with chronic obstructive pulmonary disease compared with 80 nonindex cases. The SNP therefore appears to confer susceptibility to liver disease, although reporter gene assays failed to show any functional differences between alleles. Conclusion: This is the first description of a genetic modifier of liver disease in homozygous ZZ children and has potential implications for screening and possible therapies that are currently being developed. (Hepatology 2007.)
Diagnosing cancer in general practice: from suspicion to certainty.
Authors: M Nylenna
Journal: BMJ (1986)

Three hundred and eighty two patients who were suspected of having cancer by general practitioners were followed up for up to two years until the suspicion was either confirmed or rejected; 7014 patients who were not suspected of having a malignancy served as the control group. Less than every tenth suspicion proved correct. The general practitioner9s assessment of the strength of suspicion of cancer was the best predictor of outcome in the suspected patients. The incidence of cancer among the unsuspected patients did not differ from the total incidence of cancer in the study area. The patient9s fear of cancer was an important predictor of a malignancy. A higher proportion of patients who consulted for non-symptomatic reasons than for symptomatic reasons was reported to have a malignancy. No single symptom had a strong predictive value for cancer. The predictive value of a palpable lump or tumour was 2.5%.
Immigrant Attitudes Toward the Physician-Reply
Authors: Alan M. Kraut
Journal: JAMA (1990)

In Reply.—  I am most grateful to Dr Anderson for his letter. It is gratifying to learn that his clinical research as a physician-anthropologist interested in ethnomedicine confirms many of the conclusions I have drawn based on historical data and some contemporary reports. His interest in my essay suggests how much there is to be gained when doctors of medicine and doctors of history share their insights and expertise.  I do not wish to dwell on the sentence that Dr Anderson quoted out of context in the last paragraph of his letter. As an American historian working primarily in immigration and ethnic studies, I would be the last to suggest that American standards of health and hygiene are uniformly superior to those of other countries. In this case, I believe the pejorative connotation was supplied by the reader, not the author. Those who peruse the entire article should have
Three Cases of Lightning-Stroke
Authors: W. R. S. Jefferiss
Journal: BMJ (1876)

THEi recent discussion in the JOURNAL on the value of nitric acid in the treatment of chronic inflammatory disease of the cervix uteri shows how constantly we are going over again and again the same ground in medicine and surgery, for want of knowing what has been done by those who have preceded us.The entire subject is discussed in all its bearings in my work on Uterine Zialamnmationt, the first editin-of which was published in I845, the second in I8 8, the and last in I86i (page 291).
Retrograde Sigmoid Obstruction
Authors: Stanley P. Bohrer
Journal: JAMA (1963)

Dr. Robert A. Nebesar: This was the first admission to Massachusetts General Hospital of a 44-year-old white male longshoreman who had a 3-week medical history of crampy, left-sided, lower abdominal pain associated with six to eight watery bowel movements per day. Three days prior to admission his pain became more severe and he developed a temperature of 100 F (37.78 C). He had no rectal bleeding, nausea, or vomiting. On physical examination the only significant finding was left lower quadrant tenderness. His temperature was 98.6 F (37 C), the hematocrit reading was 42%, and the white blood cell count was 10,900, with 78 polymorphonuclear leukocytes. Stool examination was guaiac positive. Sigmoidoscopy and urine examination were negative. A supine plain abdominal roentgenogram was then taken (Fig 1). <h3>Discussion</h3> Dr. Joseph Hanelin: The small bowel contains gas and there is gas in the rectum. The distribution is not specifically diagnostic. I wonder,
Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries
Authors: Sivabaskari Pasupathy, Tracy Air, Rachel P. Dreyer, Rosanna Tavella, John F. Beltrame
Journal: Circulation (2015)

Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiological mechanisms underlying this disorder.Quantitative assessment of 28 publications using a meta-analytic approach evaluated the prevalence, clinical features, and prognosis of MINOCA. The prevalence of MINOCA was 6% [95% confidence interval, 5%-7%] with a median patient age of 55 years (95% confidence interval, 51-59 years) and 40% women. However, in comparison with those with myocardial infarction associated with obstructive coronary artery disease, the patients with MINOCA were more likely to be younger and female but less likely to have hyperlipidemia, although other cardiovascular risk factors were similar. All-cause mortality at 12 months was lower in MINOCA (4.7%; 95% confidence interval, 2.6%-6.9%) compared with myocardial infarction associated with obstructive coronary artery disease (6.7%, 95% confidence interval, 4.3%-9.0%). Qualitative assessment of 46 publications evaluating the underlying pathophysiology responsible for MINOCA revealed the presence of a typical myocardial infarct on cardiac magnetic resonance imaging in only 24% of patients, with myocarditis occurring in 33% and no significant abnormality in 26%. Coronary artery spasm was inducible in 27% of MINOCA patients, and thrombophilia disorders were detected in 14%.MINOCA should be considered as a working diagnosis with multiple potential causes that require evaluation so that directed therapies may improve its guarded prognosis.
Cross-reactive cytotoxic responses. H-2 restricted are more specific than anti-H-2 responses.
Authors: E Simpson, L Mobraaten, P Chandler, C Hetherington, M Hurme, C Brunner, D Bailey
Journal: The Journal of Experimental Medicine (1978)

Cross-reactive T-cell cytotoxicity is seen when cytotoxic responses are generated in mixed lymphocyte cultures either between mouse strans which differ at the major histocompatibility complex, H-2, or between H-2b mutant strains and the strain from which they were derived. This cross-reactivity can be measured with [51Cr] labeled target cells from a number of different H-2 haplotypes, and the pattern of cross-reaction indicates that the target antigens are unlikely to be any of the serologically defined public specificities. In contrast, the specificity of H-2 restricted cytotoxic responses, such as that to the male-specific antigen, H-Y, is exquisite, and male cells from strains of mice carrying H-2 haplotypes other than the responder have never been found to act as appropriate targets. The contrast between the specificity of anti-H-2 and H-2 restricted responses may argue for a greater idiotypic homogeneity of the cells makiing H-2 restricted responses, and the greater specificity of these responses may be necessary for their biological function.
An Address ON SOME INSUFFICIENTLY RECOGNIZED POINTS IN THE DIAGNOSIS OF DISEASE: Delivered before the East Yorkshire Division of the British Medical Association at Hull
Authors: D. Duckworth
Journal: BMJ (1909)

GENTLEMRN,-The title of this address may not improbabl excite some wonder in the minds of my auaience.It may appear to be a bold step to assert in these days, even tentatively, that there still remain any points which elude or fail to receive full consideration in matters relating to diagnosis.It is now a mere platitude to speak of the extraordinary progress that has been made in the science and the art of medicine in the course of the last fifty years, for this is recognized on all hands, and we know well that fresh fields of research are being opened up daily by skilled and assiduous cultivators.So much so is this the case that it has become well-nigh an impossible task for the hospital teacher or the most diligent practitioner to follow up and utilize the products of these investigators.Never in the history of medicine was the first aphorism of Hippocrates borne in upon us with greater weight and solemnity than in this twentieth century, and we may well ask ourselves, Who, indeed, is sufficient for these things?To illustrate my statement, I will only ask you to compare the classical treatise of Watson-which was the textbook in medicine of most of the greybeards now in our profession-with the outcoming new edition of Allbutt's Sy8temz of Medicine, for this provides us at once with a standard wherewith to measure the progress that has been attained in our
Conceptual Developments in Psychosomatic Medicine: 1939-1969
Authors: CHASE PATTERSON KIMBALL
Journal: Annals of Internal Medicine (1970)

The term psychosomatic medicine has undergone theoretical shifts during the last 30 years. After Cannon's initial observations of specific physiological changes accompanying specific emotions, Dunbar emphasized the relation of specific diseases to personality and life styles. Alexander introduced the ideas of illness-onset situation in terms of conflict specificity and organ vulnerability. Wolff elaborated sophisticated experimental design to investigate the relations of environment, psychological stress, and bodily reaction. Mason and others used new techniques of hormonal research to study end-organ reaction to stress. Others are focusing on intracerebral processes by which endocrine function is triggered. Miller has shown that autonomic responsivity can be conditioned. Engel and the Rochester school have emphasized illness-onset in terms of loss and development of the giving-up-given-up state with affects of displeasure, helplessness, hopelessness. Psychosomatic medicine has come to embrace all illnesses rather than 'Alexander's Holy Seven." Its preoccupation has shifted from concern with intrapsychic events and disease to emphasis on the environments in which illness occurs. A linear model of causality has given way to a cyclical model in which illness is viewed as behavior representing the final common pathway resulting from interrelated factors within the frameworks of psychology, physiology, and environment for each individual.
Total Body Perfusion
Authors: Gerald Klebanoff
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Recently we published an article citing our initial experience with asanguineous hypothermic total body perfusion (total body washout or TBW) in the resuscitation of a patient dying of stage IV hepatic coma.<sup>1</sup>The patient went on to die of<i>Pseudomonas</i>pneumonia which was present prior to the performance of the TBW. That partial success served to teach us to be more selective of future candidates and to make certain adjustments in our perfusate. These were done in our latest attempt to use the procedure in the care of a young airman dying of acute Australia antigen hepatitis. The airman had been ill and hospitalized for four weeks prior to transfer to our hospital. In the fifth week of his illness and in spite of intensive therapy with bowel antisepsis, steroids, and modified diet, he lapsed into a deepening coma. When received at our hospital, the patient
Incidence of Type 1 Diabetes in Philadelphia Is Higher in Black Than White Children From 1995 to 1999
Authors: Terri H. Lipman, Abbas F. Jawad, Kathryn M. Murphy, Alan Tuttle, Rebecca L. Thompson, Sarah J. Ratcliffe, Lorraine E. Levitt Katz
Journal: Diabetes Care (2006)

OBJECTIVE—To determine the epidemiology of type 1 diabetes in children in Philadelphia, Pennsylvania, from 1995 through 1999 and compare these data with previous cohorts. RESEARCH DESIGN AND METHODS—This is a report of a retrospective population-based registry maintained since 1985. Hospital records meeting the following criteria were reviewed: newly diagnosed type 1 diabetes, age 0–14 years, residing in Philadelphia at the time of diagnosis, and diagnosed from 1 January 1995 to 31 December 1999. The secondary source of validation was the School District of Philadelphia. Incidence rates by race and age were compared with 1985–1989 and 1990–1994 cohorts. RESULTS—A total of 234 case subjects were identified, and the registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 14.8 per 100,000/year. Incidence rates in Hispanic children (15.5 per 100,000/year) and white children (12.8 per 100,000/year) have been relatively stable over 15 years. The incidence in black children (15.2 per 100,000/year), however, has increased dramatically, rising 64% in children 5–9 years of age (14.9 per 100,000/year) and 37% in the 10- to 14-year age-group (26.9 per 100,000/year). CONCLUSIONS—The overall incidence of type 1 diabetes in Philadelphia is increasing and is similar to other U.S. registries. These are the first data reporting a higher incidence in black children in a registry of children 0–14 years of age. The etiology of the marked increase in incidence in the black population is unknown and underscores the need to establish type 1 diabetes as a reportable disease, so that environmental risk factors may be thoroughly investigated.
High-throughput transcription profiling identifies putative epigenetic regulators of hematopoiesis
Authors: Punit Prasad, Michelle Rönnerblad, Erik Arner, Masayoshi Itoh, Hideya Kawaji, Timo Lassmann, Carsten O. Daub, Alistair R. R. Forrest, Andreas Lennartsson, Karl Ekwall
Journal: Blood (2014)
Reply to the letter of Park et al.
Authors: A. Bailey, M. Bourke
Journal: Endoscopy (2008)

We would like to thank Dr. Park and colleagues for their interest in our study [1]. The authors acknowledge the limitations of measuring post-ERCP pancreatitis (PEP) in a crossover design, especially for difficult cannulation where crossover is more likely. We believe however, that our study design more closely replicates the realities of everyday ERCP practice by virtue of the involvement of multiple operators and the crossover protocol. Operator dependence is well recognized as an important factor for success and complication rates. Caution should be exercised before generalizing studies involving a single operator [2] [3] to wider practice. Such studies, by their nature, introduce an immediate bias in favor of a particular technique; usually the preferred technique of the single operator. Multicenter randomized controlled studies remain the gold standard and single-center studies with multiple operators are second best.