tbuckley/cabot-search huggingface dataset:
INTERESTING CASES OF APPENDICITIS.Read before the New York State Medical Association, Oct. 9, 1894.
Authors: JOSEPH D. BRYANT
Journal: JAMA (1894)

Believing that the results of experience constitute the only true guide to the wisdom and efficiency of any measure, especially one of a surgical nature I have, therefore, no hesitation in placing before you now for the purposes of thought and practice a record of four cases of appendicitis that have come recently under my observation, together with the lessons they teach :Case 1.\p=m-\Thatof E. B. J., M.D., of Pennsylvania, aged 28, and of good habits in all respects.This patient came to my office for consultation and treatment June 13, 1894, with the following history :1. Had always been in good health up to the time of the first attack of appendicitis.2. Had suffered from four attacks of this disease before coming to my notice, from the last of which he had just recovered.The first attack happened without apparent cause, during the last week in November, 1893, six months before I saw him.This attack was a slight one, lasting but three or four days, and was not severe enough to prevent proper atten¬ tion to office duties.The second attack happened about six weeks later, and was not severer at the outset than the first one.This attack lasted four days, and on the second day a slight chill occurred, attended with some elevation of temperatuie.Subsequent to this attack, tenderness in the right ileo-inguinal region was constant in a varying degree.No definite tumor was discernible.The third attack was about three months after the second one, and it will be noticed that this was the severest attack of all.This, like the others, came without apparent cause, but unlike them was announced by a sudden, severe sharp pain which obliged the patient to go to bed at once, where he remained for the next four weeks.During the greater part of this time he had a marked elevation of temperature which, however, did not reach above 101 F. per rectum during the entire course of the attack.A hard, tender tumor made its appearance in the right iliac region during this attack which increased to the size of one's fist; then gradually diminished in size and sensitiveness but did not wholly disappear.The fourth and final attack occurred May 30, 1894, or only about two Had always enjoyed good health until the summer of 1893, during which season he had suffered from occasional diarrhea and uneasy sensations in the "right side of the belly," as he expressed it.Suddenly, in September, 1893, he was attacked with severe pain at the right side of the lower
Preserving the Right to Future Children: An Ethical Case Analysis
Authors: Gwendolyn P. Quinn, Daniel K. Stearsman, Lisa Campo-Engelstein, Devin Murphy
Journal: The American Journal of Bioethics (2012)

We report on the case of a 2-year-old female, the youngest person ever to undergo ovarian tissue cryopreservation (OTC). This patient was diagnosed with a rare form of sickle cell disease, which required a bone-marrow transplant, and late effects included high risk of future infertility or complete sterility. Ethical concerns are raised, as the patient's mother made the decision for OTC on the patient's behalf with the intention that this would secure the option of biological childbearing in the future. Based on Beauchamp and Childress's principlism approach of respect for autonomy, nonmaleficence, beneficence, and justice, pursing OTC was ethically justified.
Recurrent Pleural and Pericardial Effusions Due to Sarcoidosis
Authors: Sankar D Navaneethan, Sundar Venkatesh, Rakesh Shrivastava, Jagat Mehta, Robert Israel
Journal: PLoS Medicine (2005)

A 54-year-old man presented with fever, shortness of breath, and left-sided pleuritic chest pain. His bilateral pleural effusions and pericardial effusion turned out to be due to sarcoidosis.
Report says 100 Roma women have been forcibly sterilised in Slovakia
Authors: K. Krosnar
Journal: BMJ (2003)

The Slovak health ministry is investigating a new report that claims that more than 100 Roma (Gypsy) women were forcibly sterilised or coerced into being sterilised in Slovakia over the last 13 years—many in the last five years.

The report, by the New York based Centre for Reproductive Rights and the Slovak Centre for Civil and Human Rights, says the practice stems from Communist times, when Roma women were paid to have a sterilisation to keep the Roma population down.

“In almost all cases the operation is not discussed with the woman in advance, but she …
Interleukin‐10 haplotype associated with total serum IgE in atopic dermatitis patients
Authors: H. D. Shin, B. L. Park, L. H. Kim, J.‐S. Kim, J.‐W. Kim
Journal: Allergy (2005)

Background: The genetic background of atopic dermatitis (AD) is not clearly understood. Interleukin (IL)‐10 is a powerful Th‐2 cell cytokine produced by lymphoid cells that exerts its function by inhibiting macrophage/monocyte and T‐cell lymphocyte replication and secretion of inflammatory cytokines [IL‐1, tumour necrosis factor‐ α (TNFA), IL‐6, IL‐8 and IL‐12]. Objective: In an effort to discover additional polymorphism(s) in genes whose variant(s) have been implicated in total immunoglobulin E (IgE) level in AD patients, we scrutinized the single nucleotide polymorphisms (SNPs) in the IL10 gene as a potent candidate for contributing to the level of IgE in serum. Methods: We recruited 334 AD patients and assayed their serum total IgE levels using the LIPA‐200 system. Four SNPs in the IL10 gene were genotyped using the single‐base extension (SBE) method. Logistic regression analyses were performed with single polymorphisms and haplotypes (ht) to determine their association with the level of serum total IgE. Results: Genetic association analysis of total serum IgE in AD patients revealed that one of the IL10 ht, IL10‐ht2 , was associated with decreased serum total IgE in gene dose‐dependent manner ( P = 0.02–0.001). Conclusions: It was predicted that the inhibition of innate immunity by increased IL‐10 production in IL10‐ht2 ‐bearing individuals might be associated with decreased total serum IgE levels among AD patients. The greater effects of IL10 ht on decreased total serum IgE levels suggest that the effect of IL‐10 polymorphism might be the result of a combined genotype (ht) rather than single polymorphisms.
Workgroup Report: Indoor Chemistry and Health
Authors: Charles J. Weschler, J.R. Wells, Dustin Poppendieck, Heidi Hubbard, Terri A. Pearce
Journal: Environmental Health Perspectives (2005)

Chemicals present in indoor air can react with one another, either in the gas phase or on surfaces, altering the concentrations of both reactants and products. Such chemistry is often the major source of free radicals and other short-lived reactive species in indoor environments. To what extent do the products of indoor chemistry affect human health? To address this question, the National Institute for Occupational Safety and Health sponsored a workshop titled "Indoor Chemistry and Health" on 12-15 July 2004 at the University of California-Santa Cruz. Approximately 70 experts from eight countries participated. Objectives included enhancing communications between researchers in indoor chemistry and health professionals, as well as defining a list of priority research needs related to the topic of the workshop. The ultimate challenges in this emerging field are defining exposures to the products of indoor chemistry and developing an understanding of the links between these exposures and various health outcomes. The workshop was a step toward meeting these challenges. This summary presents the issues discussed at the workshop and the priority research needs identified by the attendees.
Impaired Maturation of Neutrophils
Authors: Alec Morley
Journal: New England Journal of Medicine (1970)

Under normal circumstances the recognizable neutrophilic precursor cells in the bone marrow are not self-sustaining but are continually maintained by an input of cells coming ultimately from a self-replicating precursor or stem-cell compartment that cannot be recognized morphologically. The stem-cell input is amplified by division of cells up to and including the myelocyte stage, with the degree of amplification depending on the number of divisions that occur. Cells no longer divide past the myelocyte stage, but they continue to mature until they are released into the blood as segmented neutrophils. The number of blood neutrophils directly or indirectly regulates this . . .
Variable HIV peptide stability in human cytosol is critical to epitope presentation and immune escape
Authors: Estibaliz Lazaro, Carl Kadie, Pamela Stamegna, Shao Chong Zhang, Pauline Gourdain, Nicole Y. Lai, Mei Zhang, Sergio A. Martinez, David Heckerman, Sylvie Le Gall
Journal: Journal of Clinical Investigation (2011)

Induction of virus-specific CD8+ T cell responses is critical for the success of vaccines against chronic viral infections. Despite the large number of potential MHC-I–restricted epitopes located in viral proteins, MHC-I–restricted epitope generation is inefficient, and factors defining the production and presentation of MHC-I–restricted viral epitopes are poorly understood. Here, we have demonstrated that the half-lives of HIV-derived peptides in cytosol from primary human cells were highly variable and sequence dependent, and significantly affected the efficiency of cell recognition by CD8+ T cells. Furthermore, multiple clinical isolates of HLA-associated HIV epitope variants displayed reduced half-lives relative to consensus sequence. This decreased cytosolic peptide stability diminished epitope presentation and CTL recognition, illustrating a mechanism of immune escape. Chaperone complexes including Hsp90 and histone deacetylase HDAC6 enhanced peptide stability by transient protection from peptidase degradation. Based on empirical results with 166 peptides, we developed a computational approach utilizing a sequence-based algorithm to estimate the cytosolic stability of antigenic peptides. Our results identify sequence motifs able to alter the amount of peptide available for loading onto MHC-I, suggesting potential new strategies to modulate epitope production from vaccine immunogens.
Effect of Controlling Hyperglycemia With Diet on QT Abnormalities in Newly Diagnosed Patients With Type 2 Diabetes
Authors: Rajeev Kumar, Miles Fisher, Rhinnanon Whitaker, Peter W. Macfarlane
Journal: Diabetes Care (2004)

everal clinical trials (1) have demonstrated that vitamin E does not reduce future major cardiovascular (CV) events.However, these trials could not rule out the potential benefit for highrisk subgroups.Diabetic individuals who are homozygous for the haptoglobin 2 allele (Hp 2-2) are at high risk for CV events (2-4); moreover, the Hp 2-2 protein product is an inferior antioxidant compared with the Hp 1 allele (5).We therefore hypothesized that vitamin E may reduce CV events in Hp 2-2 diabetic individuals.Hp type was measured in 3,167 participants (1,078 with diabetes) of the Heart Outcomes Prevention Evaluation (HOPE) trial, which evaluated the 4.5year effects of 400 IU vitamin E daily on the primary composite of CV death, myocardial infarction, and stroke (1).No significant benefit of vitamin E supplementation was detected in either the entire group or in the diabetic subset, consistent with what was previously reported for the entire HOPE cohort (1).In Hp 2-2 diabetic participants, there was a trend toward a reduced primary composite outcome (relative risk 0.70 [95% CI 0.45-1.10])and a statistically significant reduction in the risk of CV death (0.45 [0.23-0.90])and nonfatal myocardial infarction (0.57 [0.33-0.97]).However, this trend was not observed for strokes (1.15 [0.47-2.82]),and there was no statistical interaction between vitamin E use and haptoglobin type for either the composite outcome or any of its components.In conclusion, the absence of any statistical interaction indicates that these data do not support the hypothesis that the effects of vitamin E differed by Hp phenotype.Therefore, the results noted above in Hp 2-2 diabetic individuals demonstrating a significant reduction in CV death and myocardial infarction could be spurious and clearly require prospective testing in future trials.
IT-18 * GLIOBLASTOMA STAT3 AND PD-L1 EXPRESSION DRIVES ACCUMULATION OF IMMUNOSUPPRESSIVE LEUKOCYTES
Authors: R. Kumar, T. Peterson, I. Parney
Journal: Neuro-Oncology (2014)

BACKGROUND: Glioblastoma (GBM) is a devastating disease with a median survival of 14 months. Immunotherapies hold promise but are compromised by tumor-mediated immunosuppression including accumulation of regulatory T-cells (TREG's) and myeloid-derived suppressor cells (MDSC's). Mechanisms leading to TREG and MDSC expansion in GBM patients are unclear. Tumor-derived STAT3 and PD-L1 have been implicated in direct GBM-mediated immunosuppression. We hypothesized that they might also be critical for accumulation of TREG's and MDSC's. METHODS: STAT3 and PD-L1 expression was knocked down (KD) in primary human GBM cell cultures using lentiviral constructs expressing shRNA and confirmed by western blot. Wild type, PD-L1-KD, or STAT3-KD GBM cells were co-cultured with healthy donor human CD4+ lymphocytes or CD14+ monocytes. TREG (CD4 + /CD25 + /FoxP3+), monocytic MDSC's (CD14 + /HLA-DR-), and granulocytic MDSC's (CD11b + /CD14-/CD15+/-/CD33+) frequencies were measured by flow cytometry. RESULTS: Lentiviral shRNA produced efficient STAT3 and PD-L1 KD in primary human GBM cell cultures. STAT3-KD did not alter PD-L1 expression, suggesting they are independently regulated. GBM co-culture produced TREG expansion from naïve CD4+ cells (2.01% + /-1,03% vs. 0.77% + /-0.10% of CD4+) but this was markedly reduced with GBM cell STAT3-KD and PD-L1-KD (1.15% + /-0.04%, 1.35% + /-0.04%; P < 0.05). Monocytic MDSC's were 1.24% of naïve CD14+. This increased with GBM co-culture (7.61% + /-1.87%) but decreased to 0.48% + /-0.34% with STAT3-KD and 4.43% + /-0.64% with PD-L1-KD (P< 0.05). Similar results were seen for granulocytic MDSC's. CONCLUSION: These findings provide clear evidence that expression of STAT3 and PD-L1, two important immunosuppressive signals, are independently regulated in human GBM cells. Furthermore, GBM cell STAT3 and PD-L1 expression are critical drivers of immunosuppressive leukocyte (TREG and MDSC) accumulation from naïve CD4+ and CD14+ cells in addition to their more widely appreciated direct immunosuppressive effects on activated T cells. These findings suggest that targeting both STAT3 and PD-L1 may have synergistic immunomodulatory effects of potential benefit to GBM patients.
Neighborhoods, Race, and Nephrology Care
Authors: Sharon Stein Merkin
Journal: Journal of the American Society of Nephrology (2010)

Access to nephrology care is essential to mitigating the progression of renal failure.1 There is some evidence of racial disparities with regard to this care, disparities whereby black individuals are less likely to received timely care compared with their white counterparts.2 The underlying causes of these racial differences are not fully understood but most likely include a combination of socioeconomic and social factors. In this issue of JASN , Prakash et al. 3 explore the association between living in a predominantly black neighborhood and obtaining nephrology care before the onset of ESRD.

Prakash et al. 3 list some of the characteristics of predominantly black neighborhoods that might affect health outcomes and behaviors, including lack of availability of healthful foods and recreational facilities as well as cultural and health beliefs. There is strong evidence, however, that this segregation of minorities into distinct neighborhoods also runs along socioeconomic boundaries. Data from the National Health and Nutrition Examination Survey(NHANES),a nationally representative sample of the United States, shows not only that white and black populations are segregated in distinct communities but also that those neighborhoods are distinct in terms of socioeconomic status (SES) to the point that there is little overlap between them.4 Thus, even among low socioeconomic neighborhoods, black individuals live in more disadvantaged areas compared with their white counterparts.4 The spatial isolation of minorities into disadvantaged neighborhoods may be driving the racial disparities in access to nephrology care. …
AUTO-DISINFECTION OF WOUNDS BY THE USE OF ETHER SOLUTION
Authors: A. Distaso, T. R. Bowen
Journal: BMJ (1917)

A Adevice for .stirring the fluid during tlle urogress of m tnufacture is advisable, btut not absolutely necessary if.only small quantities are required.In all our work we hlave used the ordinary lighting eurrent of tlle laboratory, and during the process of ele6trolysis the fluid has been stirred by a revolving glass rod, bent into a series of right angles, dlriven by a 2-volt motor.I We lave tried tle plan of placing the negative electrode below tlje positive electrode, and allowing lthe electricity to operate tllrotughl a cylinder of saline, but this method is in our experience not so acceptable in practice as that in whichi the stirrer is used.Dia.framn illutstra-ting thlc Ap)paratut-.
Preparation of Individual Infusion Fluids
Authors: J. C. Eaton
Journal: BMJ (1962)

TUBERCULOSIS AMONG INDIAN IMMIGRANTS MEITreatment and Prevention So far as treatment is concerned, Indian patients locally diagnosed as tuberculous have all gone into hospital when so advised, for triple-drug therapy.In spite of language difficulties, these Indians have co-operated well in their treatment.With one exception, all have been or should be made sputum-negative.If experience with earlier-diagnosed cases is any guide, they will continue to take antituberculous drugs at least as regularly as their English fellow-patients after returning to work.In this section the only possibly unfavourable factor is drug resistance, which has been recorded four times among the 60 cases.Primary resistance at the time of diagnosis was to streptomycin, P.A.S., and isoniazid, one case each.These three cases were rendered sputum-negative during standard triple-drug therapy.The fourth became resistant to streptomycin and P.A.S. during treatment (which began in 1955), but sputum-conversion was obtained after further treatment with isoniazid and viomycin.The occurrence of three primarily resistant cases among the 28 Indians who were sputum-positive (9.3%) compares unfavourably with the 3.1 % primarily resistant cases recently described in England (Public Health Laboratory Service Report, 1961).Great care should be taken in the initial treatment of tuberculous Indians.Original contacts have attended for examination and B.C.G. -vaccination in large numbers, but language difficulties and the unfamiliar spelling and peculiar complexity of Indian names, together with frequent change of lodgings, make record-keeping and follow-up difficult.There is clearly a need for B.C.G. vaccination of newly arrived susceptible Indians (Corbett, 1961).The Diagnostic Problem In spite of the changed immigration policy there is still a two-stage diagnostic problem.Immigrants arriving in the area ought not to be allowed to join general practitioners' lists until satisfactory chest radiography reports have been received.Also, some system should be devised which will ensure that all these vulnerable Asiatic immigrants have their chests radio- graphed at least once a year.It is not enough to wait until the onset of symptoms sends them to their doctors and until their doctors then refer them to the chest service.By that time other susceptibles in the crowded households will have been at risk.It is gratifying to find that some general practitioners are apparently referring Indian patients to chest x-ray units at every visit to their surgeries, a practice which could with profit be widely extended.
Diminished synthesis of an alpha chain mutant, hemoglobin I (α16 lys → glu)
Authors: G. J. Folayan Esan, F. J. Morgan, J. V. O'Donnell, S. Ford, A. Bank
Journal: Journal of Clinical Investigation (1970)

In patients heterozygous for abnormal hemoglobins there is usually less than 50% of the mutant hemoglobin present in peripheral blood. The synthetic rates of alpha-chain mutants compared to alpha(A) have not been reported to date. In this study the production of alpha(A)- and alpha(I)-chains has been measured in peripheral blood and bone marrow of two patients with approximately 30% hemoglobin I, an alpha-chain abnormality (alpha(16 lys --> glu)). The results suggest that the decreased amount of alpha(I) compared to alpha(A) is due solely to diminished biosynthesis of the alpha(I)-chains. The relative rates of synthesis of alpha(I)- and alpha(A)-chains are similar in both nucleated red cells and reticulocytes indicating that no change occurs during erythroid cell maturation which preferentially affects either alpha(I) or alpha(A) production.
A Study of the Clinical Reactions to Venous Angiocardiography
Authors: Frederic L. Eldridge, Herbert N. Hultgren, Chi Kong Liu, Margaret Blumenfeld
Journal: New England Journal of Medicine (1955)

THE rapid advances in cardiac surgery during the past ten years have increased the need for accurate diagnosis of lesions of the heart and great vessels. This has resulted in an ever-increasing use of the technic of angiography.The contrast agents employed in angiography contain iodine in amounts varying from 50 to 66 per cent of their weight; they are directly irritating to living tissue,1 , 2 and all are markedly hypertonic —for example, 70 per cent Diodrast (iodopyracet) has nine times, 75 per cent Neo-Iopax (sodium iodomethamate) has ten times, and 70 per cent Urokon (sodium 3 acetylamino-2, 4, 6-triiodobenzoate) has . . .
Rituximab decreases the risk of lymphoma in patients with HIV-associated multicentric Castleman disease
Authors: Laurence Gérard, Jean-Marie Michot, Sara Burcheri, Claire Fieschi, Pacale Longuet, Véronique Delcey, Véronique Meignin, Felix Agbalika, Sylvie Chevret, Eric Oksenhendler, Lionel Galicier
Journal: Blood (2012)
Military Medicine Prepares Health and Safety Tips for Those Serving in Somalia, Requests Feedback
Authors: Phil Gunby
Journal: JAMA (1993)

TEMPERATURES WILL climb into the 30s Centigrade (high 80s Fahrenheit) this month in Somalia. Military physicians are cautioning US troops there that "effects of the hot environment in this area are worsened by high humidity, making the heat significant even for the indigenous people." That reminder is found in<i>Staying Healthy in Somalia: Preliminary Recommendations</i>, a pocket-sized booklet swiftly prepared by the Preventive Medicine Consultants Division, Office of the Surgeon General of the US Army, for use as Operation Provide Hope got under way (<i>JAMA</i>. 1993;269:11-12). At least two other booklets have been prepared just as promptly. One is<i>Sustaining Soldier Health and Performance in Somalia: Guidance for Small Unit Leaders</i>, prepared by the US Army Research Institute of Environmental Medicine, Natick, Mass, and Walter Reed Army Institute of Research, Washington, DC, for the Army Medical Research and Development Command, Fort Detrick, Md. The other is<i>Operation Restore Hope: Health</i>
Value of the M. C. V.
Authors: N K Shinton, P C Elwood
Journal: BMJ (1972)

mean level of serum vitamin B12 among smokers is significantly less than among non-smokers.They discuss various factors which may have affected the serum B12 level, but they do not mention folate deficiency, which is common during pregnancy.Low serum Bi2 levels have been observed in over 40% of patients with megaloblastic anaemia due to folate deficiency, and the levels rise slowly to within the normal range on treatment with folic acid alone.1 2 As Dr.McGarry and Miss Andrews have not published the serum folate levels in their group of pregnant women, it is not possible to draw conclusions from the B12 levels unless all the women were taking folic acid.-Iam, etc.,