tbuckley/cabot-search huggingface dataset:
MILK-BORNE DIPHTHERIA
Authors: MALCOLM GRAHAM
Journal: JAMA (1922)

An unusual epidemic of diphtheria occurred in Austin, Texas, in the spring of 1922. Austin has about 40,000 inhabitants, including 4,200 students at the University of Texas. During January and February, ten cases of diphtheria in all were reported; eleven new cases developed by March 20, and twenty-three more by March 30. The disease was of extraordinary virulence, and laymen early called it black diphtheria. Very early in the disease, the appearance of the throat was peculiar. Both tonsils were covered with a thin, milky-looking membrane that shaded gradually into tissue that appeared normal without any sharp line of demarcation. The mucous membrane was not of the usual vivid red. The membrane which appeared in several parts of the throat simultaneously involved an unusual area, and it quickly developed a dirty, black appearance. In cases appearing early in the epidemic, repeated large doses of antitoxin were required, which in many
Characterization of mononuclear cells in the inflammatory infiltrates of cutaneous tumours
Authors: J. Viac, R. Bustamante, J. Thivolet
Journal: British Journal of Dermatology (1977)

The identification of mononuclear cells extracted from cutaneous tumours (basal cell carcinoma, squamous cell carcinoma and superficial, spreading melanoma) has been investigated. The relative numbers of T cells and B cells have been determined using the E-rosette test and the EAC-rosette test. The results have been compared to those of delayed hypersensitivity type reactions. Different cell distribution patterns (E/EAC ratio) have been found in the infiltrates according to the type of tumour. An immunocytochemical technique has been developed for the identification in situ of immunoglobulin-producing cells in the inflammatory infiltrates. In each case the class of immunoglobulin (IgM, IgG or IgA) has been identified and the relative frequency of Ig-producing cells has been determined. The results indicate humoral and cellular immune responses with variations attributable to the type of tumour. In weakly malignant tumours, the infiltrate is characterized by an elevated number of T lymphocytes and numerous plasma cells which secrete all classes of Ig; in highly malignant tumours it is characterized by a reduced number of both T lymphocytes (E rosette) and plasma cells which do not secrete all classes of Ig.
Measuring diaphragm shortening using ultrasonography to predict extubation success
Authors: Gerard J Criner
Journal: Thorax (2014)

It is estimated that approximately 800 000 US patients annually require mechanical ventilation to treat acute respiratory failure due to medical disorders, trauma or the postoperative period.1 The use of mechanical ventilation is projected to increase significantly in the next few decades due to the impact of aging baby bloomers requiring more critical care resources.2 Although life-saving, the prolonged use of mechanical ventilation is associated with significant complications such as nosocomial pneumonia, barotrauma, patient discomfort, airway complications and respiratory muscle atrophy and accounts for a substantial percentage of the costs encountered by patients receiving care in the intensive unit.3 The process of weaning is a key element of mechanical ventilation and can occupy almost 50% of the total duration of mechanical ventilation.4 Unnecessary delays in weaning patients who are physiologically able to wean from mechanical ventilation may increase the morbidity and mortality associated with prolonged ventilation and contribute to excessive medical expenditures.5 

Trying to decide when to wean patients from mechanical ventilation can be challenging for the clinician and has been reported by some to be more art than science.6 The influence of the nurse or physician's experience in assessing the patient's readiness to wean, the psychological profile or mental preparedness of the patient and objective indices of physiological factors crucial to enable patients to sustain spontaneous ventilation have all been reported as important factors in determining the patient’s readiness to wean.7 However, recent data suggests that subjective decision-making of the clinicians is often wrong when predicting successful weaning outcome. Some authors have reported that the clinical prediction of extubation success is often incorrect …
Increased I-131 Uptake in Local Recurrence and Distant Metastases After Second Treatment With Retinoic Acid
Authors: CARSTEN KOERBER, CONNY SCHMUTZLER, JOHANN RENDL, JOSEF KOEHRLE, H. GRIESSER, DIETMAR SIMON, CHRISTOPH REINERS
Journal: Clinical Nuclear Medicine (1999)

We present a case of increased I-131 uptake in a patient with papillary thyroid carcinoma with local recurrence and distant metastases after a second treatment with retinoic acid as a sign of redifferentiation of the tumor cells. When fine-needle aspiration cytology before and after a second course of retinoic acid treatment were compared, signs of tumor cell redifferentiation were found. This was accompanied by biochemical reexpression of thyroid marker proteins.
Role of alpha-macroglobulin-elastase complexes in the pathogenesis of elastase-induced emphysema in hamsters.
Authors: P J Stone, J D Calore, G L Snider, C Franzblau
Journal: Journal of Clinical Investigation (1982)

Radiolabeled, enzymatically active or chloromethyl ketone-inactivated porcine pancreatic elastase was endotracheally instilled into hamsters. Gel filtration of the bronchopulmonary lavage fluid revealed two major radioactive fractions: one, eluting at 780,000 daltons, corresponding to an alpha-macroglobulin-pancreatic elastase complex, and another, at 68,000 daltons, corresponding to an alpha-1-protease inhibitor-pancreatic elastase complex. Elastolytic activity was recovered in the bronchopulmonary lavage fluid up to 4 d after elastase instillation and was associated with the alpha-macroglobulin-pancreatic elastase complex. Small amounts of this complex were recovered 14 d after instillation. When less than 1% (1.5--1.7 micrograms) of the usual dose of elastase was instilled into hamsters, the major radioactive complex was alpha-1-protease inhibitor-pancreatic elastase complex, and little or no elastolytic activity was found in the lavage fluid. In contrast to the instillation of 220 micrograms of elastase, no disease or hemorrhagic reaction was detected with this low dose, and without hemorrhage only insignificant amounts of alpha-macroglobulin-pancreatic elastase complexes were recovered from the lungs. To study the interaction of circulating antiproteases with elastase, hamster plasma was allowed to interact directly with the radiolabeled elastase; alpha-macroglobulin bound much more of the elastase than alpha-1-protease inhibitor, confirming the findings in the lung lavage experiments. The hamster's susceptibility to pancreatic elastase-induced emphysema may depend on the preferential binding of elastase to alpha-macroglobulin, which protects the elastolytic potential, rather than to alpha-1-protease inhibitor, which inactivates elastase. We speculate that if even a fraction of the residual radioactivity found in the hamster lungs as long as 144 d after instillation of elastase represents enzymatically active alpha-macroglobulin-pancreatic elastase complex, this could serve as a source of persistent elastolytic activity, which might explain the progressive nature of the pulmonary lesion.
Extrahepatic Portal Hypertension Caused by Chronic Pancreatitis
Authors: GEORGE F. LONGSTRETH
Journal: Annals of Internal Medicine (1971)

Of 164 patients with extrahepatic portal hypertension, only 5 had chronic pancreatitis as the only predisposing disease. Four of the five had bleeding from esophagogastric varices, and all five had splenomegaly. Previous splenoportographic studies have shown that partial or total portal system obstruction occurs frequently in chronic pancreatitis, but symptomatic portal hypertension is much less common. Gastrointestinal bleeding and splenomegaly with chronic pancreatitis should alert the physician to the possibility of extrahepatic portal hypertension and varices. If the obstruction is confined to the splenic vein, splenectomy is the treatment of choice.
On the Occurrence of Amblyopia, long after the Injury, in Cases of Concussion of the Spinal Marrow
Authors: T. W. Jones
Journal: BMJ (1869)

to ask a physician's opinion as to the possibility of removing her.His answer was, that it was too late; and too late it proved, for she died in a few days."A system which renders possible such results as these is a cruel irony on charity, absurd in principle, and most disastrous in practice.
Surveillance for hepatocellular carcinoma in elderly cirrhotic patients. Effects on cancer staging and patient survival
Authors: Franco Trevisani, Stefania De Notariis, Maria Chiara Cantarini, Gianludovico Rapaccini, Fabio Farinati, Luisa Benvegnu, Marco Zoli, Paolo Del Poggio, Maria Anna Di Nolfo, Mauro Bernardi
Journal: Journal of Hepatology (2002)
John Jeffries, “Astronaut”
Authors: Charles H. Bradford
Journal: New England Journal of Medicine (1975)

EVERY war finds heroes on opposing sides, but in the heat of conflict, very often the contestants lose sight of the valor of their opponents. However, among Boston's doctors, in the days of the Revolution, even the British admired and trusted the high-minded integrity of Joseph Warren, and even the Patriots, or "Rebels" as they liked to be called, respected the Yankee doctor who never renounced his loyalty to the King. John Jeffries was his name, a native Bostonian, and one of the world's first astronauts, if we may apply the term somewhat ambitiously to an earlier era. In the . . .
Treatment of hypercalcaemia associated with malignancy
Authors: T. Wheeler, S. Coltart
Journal: BMJ (1984)

For at least the past 100 years, a number of financial scandals have rocked the world and ruined the lives of thousands of citizens. In the past decades alone, a number of financiers (most notably Robert Madoff) have been caught and sent to jail. Financial predators have erroneously been labeled as psychopaths. In fact, many are not anti-social at all and do not display dysfunctional impulsively, but rather quite the opposite. The term that describes them best is “functional psychopaths.” This multidisciplinary paper proposes to warn banking and financial institutions about the possibility that an undetected functional psychopath (a financial predator) will, in his drive for success, run their company down. Leeson at Barings is a painful reminder of such a grim scenario. <b>TOPICS:</b>Wealth management, financial crises and financial market history, in markets
949-100 Sigmoid Interventricular Septum in the Aged Causes Hypotension During Dobutamine Stess Echocardiography
Authors: Makoto Sonoda, Katsu Takenaka, Fumiyoshi Watanabe, Tsutomu Igarashi, Miki Mashita, Toshiro Aoki, Masao Omata
Journal: Journal of the American College of Cardiology (1995)
Physician-Scientist Training
Authors: R. L. Haspel
Journal: JAMA (2006)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
COMPARATIVE NUTRITIVE VALUE OF WHITE AND STANDARD BREAD
Authors: C. Watson
Journal: BMJ (1911)

<h3>Background</h3> Individuals with low cardiovascular risk factor profiles experience lower rates of cardiovascular diseases (CVD) and mortality. However, little is known about how older persons with near ideal cardiovascular risk factors age, especially for non-cardiovascular outcomes. We tested whether older individuals with near ideal CVD risks were less likely to develop ageing-related adverse health outcomes in two large cohorts. <h3>Methods</h3> Data were from population representative primary care medical records (Clinical Practice Research Datalink, CPRD, England, n=239,591) and also healthy volunteers (UK Biobank, UKB, n=181,820), aged 60 to 69 years at baseline followed for up to 10 years. A cardiovascular risk score (CRS) summarized smoking status, low density lipoprotein cholesterol (LDL), blood pressure, body mass index (BMI), fasting glucose and physical activity, grouping individuals as low (all factors near ideal), moderate or high CRS, following the American Heart Association ‘Life’s Simple 7’ approach. Data were available on a range of prevalent and incident ageing-related adverse health outcomes from CPRD and UK Biobank. Logistic regression and Cox proportional hazards regression models (Fine and Grey models including death as a competing risk) were used to test associations between the CRS and prevalent or incidence health outcomes respectively. <h3>Results</h3> Older subjects with near ideal CVD risks had less chronic pain (UKB baseline odds ratios (OR), 0.52, 95% CI 0.50 to 0.54), lower incidence of incontinence (CPRD sub-hazard ratio (sub-HR), 0.75, 95% CI 0.63 to 0.91), falls (sub-HR, 0.82, 95% CI 0.73 to 0.91) and fragility fractures (sub-HR, 0.78, 95% CI 0.65 to 0.93). Only 5.4% in our primary care sample with near ideal CVD risks became frail (Rockwood index) versus 24.2% with high risks. All-cause mortality was markedly lower in the low CRS group (vs. high CRS, HR, 0.40: 95% CI 0.35 to 0.47). All associations showed dose-response relationships. Estimates of associations were remarkably similar in both cohorts despite differences in the cohort profiles and risk factor ascertainment, suggesting robustness of results. <h3>Conclusion</h3> Persons aged 60 to 69 years with near ideal cardiovascular risk factor profiles have substantially lower incidence of common conditions of ageing, including frailty. Optimizing CVD risk factors may substantially reduce the burden of morbidity in later life: we thus likely already have the tools for radical improvement in ageing health outcomes. However, further work is needed to provide evidence of whether this association is causal. Using largescale data from UK Biobank, we aim to expand the existing study and tease apart the roles of component risk factors using genetic evidence.
A Simple Method for Intracardiac Acoustic Auscultation and Phonocardiography
Authors: GEORGE A. FERUGLIO
Journal: Circulation (1963)

Acoustic auscultation of the cavities of the heart was carried out in 62 patients with normal hearts and with congenital or acquired heart disease. The type of instrument used is a special cardiac catheter with closed distal tip and with side openings near the tip covered by a thin latex cuff. Intracardiac sound vibrations are collected by the latex membrane, which transmits them to the column of air in the catheter and thereby to the outside of the body. The catheter can be connected either with the tubing of a binaural stethoscope, for acoustic intracardiac auscultation, or with a microphone. In the latter instance, with the help of a specially designed preamplifier, simultaneous intracardiac sounds and pulse curves can be recorded. This has a two-fold advantage: that of locating the site of recording (by the shape of the intracardiac pulse) and of correlating acoustic and mechanical intracardiac events of the cardiac cycle. The advantages of acoustic intracardiac auscultation (an aid in avoiding artifacts and locating the best area of sound production) and the practicality, reliability, and low cost of the new technic of intracardiac phonocardiography are stressed.
Maternal and neonatal effects of caesarean section
Authors: Allison Shorten
Journal: BMJ (2007)

Rising rates of caesarean section have stimulated much research and debate in the international medical literature. The proportion of caesarean sections in Australia climbed from 19.4% of all births in 1994 to 29.1% by 2004. Already high figures in the United States had risen further to 30.2% by 2005 similar to the 33% seen for Latin America in the same year. Despite its growing acceptance as an alternative to vaginal birth caesarean section is not benign surgery. In their paper in this weeks journal Villar and colleagues add to the growing body of evidence that cautions against high rates of caesarean delivery. The study supports the notion that caesarean section is justified only when benefits outweigh harms. The prospective cohort study uses a rich dataset from Latin America the earlier results of which have been published previously. The study clearly shows that high rates of caesarean section do not necessarily produce better health outcomes for mothers and babies. For the 97 095 births studied severe maternal morbidity was significantly more likely with caesarean section (odds ratio 2.0 95% confidence interval 1.6 to 2.5). Neonatal outcomes were closely related to fetal presentation at birth. Fetal mortality of 9.69% and neonatal mortality (until discharge) of 8.55% were reported for vaginal breech birth compared with 0.96% and 1.79% for elective caesarean section. The authors conclude that elective caesarean section had a protective effect for breech presentation in this group of women. However protective effects against fetal death for cephalic presentation were less obvious with significantly higher neonatal mortality (until discharge) associated with both elective and intrapartum caesarean section. (excerpt)
Stroke and the Extracranial Vessels
Authors: Louis R. Caplan
Journal: JAMA (1985)

The cerebrovascular section of the American Association of Neurological Surgeons sponsored this book as a state-of-the-art analysis of ischemic stroke and disease of the extracranial arteries. Authors were chosen for their expertise in specific areas. The book is well planned, logically organized, and carefully edited. The first 165 pages could be called the "medical" or "neurological," as opposed to the "surgical," portion of the book. After a brief historical review, the opening section considers the basic anatomy, pathology, and pathophysiology of the extracranial circulation. Following this are reviews of the clinical manifestations, epidemiology, and neuro-ophthalmological aspects of ischemic stroke, and a section on diagnostic tests, including computed tomography (CT), positron emission tomography, noninvasive imaging and analysis, and digital angiography. The medical segment of the book closes with discussions of the medical management of transient ischemic attacks and "completed" strokes. In general, the nonsurgical part of the book is humdrum. Too
Clofibrate and Atherosclerosis
Authors: Robert S. Lees
Journal: New England Journal of Medicine (1979)

Despite a variety of efforts aimed at altering its course, atherosclerosis and its sequelae are still major causes of death in the United States and other industrialized nations. In the absence of a single, clearcut etiologic agent, therapeutic interventions have focused on the known multiple risk factors for atherosclerosis, including hypercholesterolemia, hypertension, smoking and diabetes mellitus, If atherosclerosis were an acute disease, easily detected and followed, with a clear-cut outcome in a short time, it would be relatively simple to evaluate the effects of interventions designed to alter its progression. It is, on the contrary, a chronic, relapsing and remitting . . .
Nonhypoglycemic Effects of Thiazolidinediones
Authors: Akhil A. Parulkar, Merri L. Pendergrass, Ramona Granda-Ayala, Tri Richard Lee, Vivian A. Fonseca
Journal: Annals of Internal Medicine (2001)

The thiazolidinediones are a new class of compounds for treatment of type 2 diabetes. Troglitazone became available in the United States in 1997 but was withdrawn from the market in March 2000 because it caused severe idiosyncratic liver injury. Rosiglitazone and pioglitazone have been available since 1999. Because these drugs directly improve insulin resistance and decrease plasma insulin levels (a risk factor for coronary artery disease), they may decrease risk for cardiovascular disease in patients with type 2 diabetes. Research on the non–glucose lowering effects of troglitazone and, to a lesser extent, of rosiglitazone and pioglitazone have demonstrated changes in several cardiovascular risk factors associated with the insulin resistance syndrome. These beneficial effects include a decrease in blood pressure, correction of diabetic dyslipidemia, improvement of fibrinolysis, and decrease in carotid artery intima–media thickness. Other in vitro effects related to the ability of these agents to bind a newly described class of receptors (peroxisome proliferator–activated receptors) may also have implications for atherosclerosis. However, these drugs increase low-density lipoprotein (LDL) cholesterol levels and may favorably change LDL particle size and susceptibility to oxidation (although the implications of the latter changes are not clear). Furthermore, these drugs tend to cause weight gain. The authors' enthusiasm for these drugs has diminished somewhat because of reported adverse events, including rare liver failure. Nevertheless, because of the mechanism of action of the thiazolidinediones, clinical trials designed to determine whether they (or similar "insulin sensitizers") decrease cardiovascular events in people with type 2 diabetes will be of interest.
Lessons from the Darsee Affair
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1983)

It seems paradoxical that scientific research, in many ways one of the most questioning and skeptical of human activities, should be dependent on personal trust. But the fact is that without trust the research enterprise could not function. This trust is manifested in many ways. Scientists habitually challenge the validity and the interpretation of the experimental evidence reported by their colleagues at meetings or in the literature, but they trustingly assume that the evidence has been honestly gathered and reported. In their own work they are often dependent on raw data obtained by technicians, fellows, or collaborators. They may personally . . .