tbuckley/cabot-search huggingface dataset:
The diagnostic accuracy of specific IgE to Ara h 6 in adults is as good as Ara h 2
Authors: R. J. B. Klemans, E. F. Knol, C. A. F. M. Bruijnzeel-Koomen, A. C. Knulst
Journal: Allergy (2014)

Specific IgE (sIgE) to Ara h 2 is useful in diagnosing peanut allergy. Our aim was to assess the diagnostic value of sIgE to Ara h 6, another 2S albumin, in an adult population suspected of peanut allergy. Subjects with suspected peanut allergy between 2002 and 2013 were included if a diagnostic double-blind, placebo-controlled food challenge with peanut was performed. sIgE to Ara h 2 and Ara h 6 was measured by ImmunoCAP ISAC 112. Of 107 challenged subjects, 65 had a positive challenge (61%). The discriminative ability of sIgE to Ara h 2 and Ara h 6 was comparable: AUC 0.81 vs 0.82. Positive predictive value for both tests was 95% using a cutoff value ≥1 ISU/l with poor corresponding sensitivity values (58% for Ara h 2, 62% for Ara h 6), but good specificity values (95% for both tests). In conclusion, the diagnostic value of sIgE to Ara h 6 on population level was as good as sIgE to Ara h 2. On individual level, however, 5% of the subjects showed contradicting results between both tests using a cutoff of 0.3 ISU/l, leading to a risk of misdiagnosis if only one of both tests is used.
Effect of Treatment Regimens for<i>Neisseria gonorrhoeae</i>on Simultaneous Infection with<i>Chlamydia trachomatis</i>
Authors: Walter E. Stamm, Mary E. Guinan, Carolyn Johnson, Thomas Starcher, King K. Holmes, William M. McCormack
Journal: New England Journal of Medicine (1984)

We evaluated the effect of treatment of gonorrhea on simultaneous Chlamydia trachomatis infection by randomly assigning 293 heterosexual men and 246 heterosexual women with gonorrhea to receive one of the following treatment regimens: (1) 4.8 million units of aqueous procaine penicillin plus 1 g of probenecid, (2) nine tablets of trimethoprim-sulfamethoxazole daily for three days, or (3) 500 mg of tetracycline four times a day for five days. Among the men, gonococcal infection was cured in 99 per cent given penicillin plus probenecid, 96 per cent given trimethoprim-sulfamethoxazole, and 98 per cent given tetracycline. Among the women, only 90 per cent given tetracycline were cured, in contrast to 97 per cent given penicillin plus probenecid and 99 per cent given trimethoprim-sulfamethoxazole. Chlamydial infection, present in 15 per cent of the men and 26 per cent of the women, was cured in 30 of 32 patients given trimethoprim-sulfamethoxazole and 27 of 29 given tetracycline, but in only 10 of 23 given penicillin plus probenecid. Among chlamydia-positive patients, postgonococcal urethritis in men and cervicitis in women occurred more often in patients given penicillin plus probenecid. Salpingitis developed in 6 of 20 women given penicillin plus probenecid, but in only 1 of 26 given trimethoprim-sulfamethoxazole and in none of 24 given tetracycline. We conclude that the use of penicillin plus probenecid alone for gonorrhea in heterosexual patients carries an unacceptably high risk of postgonococcal chlamydial morbidity. Trimethoprim-sulfamethoxazole and tetracycline were highly effective against both pathogens and were well tolerated in men, but both drugs caused frequent side effects in women. The failure of tetracycline to cure gonorrhea in 10 per cent of women argues against its use alone; treatment with penicillin followed by tetracycline has been recommended for further trial.
Visceral Herpesvirus Infections in Leukemic Patients Receiving Cytarabine
Authors: David H. Buss
Journal: JAMA (1980)

Autopsy evidence of herpesvirus infection was found in visceral organs of four leukemic patients who had received large doses of cytarabine (cytosine arabinoside; Ara-C) shortly before their death. In three of these patients the infection was clinically unsuspected; in the fourth, cutaneous herpes zoster developed after administration of 300 mg of cytarabine daily for the preceding five days. Although cytarabine exhibits pronounced in vitro virucidal activity against herpes viruses and has been successfully used in clinical treatment of severe herpesvirus infections, the present findings and a review of the recent literature cast doubt on the antiviral effectiveness of this drug, particularly in already immunosuppressed patients, and suggest instead that such patients actually have an increased risk for development of disseminated herpesvirus infection owing to further depression of host defenses by the drug.
Neoadjuvant Cisplatin Chemotherapy Before Chemoradiation: A Flawed Paradigm?
Authors: Rob Glynne-Jones, Peter Hoskin
Journal: Journal of Clinical Oncology (2007)

Effective chemotherapy (CT) treatment of solid tumors emerged with the introduction of anthracyclines and platinum CT in the late 1970s, at first with palliative intent, and later extended into the adjuvant setting. High response rates led to the belief that systemic CT might improve locoregional control and also decrease the risk of distant metastases. A new strategy advocated cisplatin-based neoadjuvant CT (NACT) before definitive local treatment-either surgery or radiotherapy (RT). Response to NACT was viewed as a favorable prognostic sign, which allows the selection of patients most likely to benefit from RT or chemoradiotherapy (CRT). The aim of this discussion is to raise the debate regarding NACT in reducing metastases, improving local control and selecting out good responders for nonsurgical treatment in the following sites: head and neck, esophagus, cervix, anus, nasopharynx, and bladder; as well as non-small-cell lung cancer. NACT has almost invariably failed to deliver an improved outcome in terms of disease-free survival (DFS) or overall survival (OS) when delivered before RT or CRT in all solid tumor sites. The evidence that NACT may improve outcome in terms of DFS or OS is strongest when it is administered before surgical resection, but remains scant before RT or CRT. Taxane-containing regimens look more promising than does cisplatin NACT, but have not been shown to improve on concurrent CRT. Future meta-analyses should compare induction CT followed by RT and induction followed by CRT versus RT or CRT alone.
Signaling via the RIP2 Adaptor Protein in Central Nervous System-Infiltrating Dendritic Cells Promotes Inflammation and Autoimmunity
Authors: Patrick J. Shaw, Maggie J. Barr, John R. Lukens, Maureen A. McGargill, Hongbo Chi, Tak W. Mak, Thirumala-Devi Kanneganti
Journal: Immunity (2011)
BCG Dose Reduction by Decreasing the Instillation Frequency: Effects on Local Th1/Th2 Cytokine Responses in a Mouse Model
Authors: Elizabeth C. de Boer, Sietske J. Rooyakkers, Denis H.J. Schamhart, Theo M. de Reijke, Karl-Heinz Kurth
Journal: European Urology (2005)
Points from Letters: Choreoathetosis and Encephalopathy Induced by Phenytoin
Authors: K. W. G. Heathfield
Journal: BMJ (1974)

Mileage for Consultants SIR,-In your footnote to the letter from Dr. M. C. C. Bird (11 May, p. 336) you quote the Secretary as saying that the mileage allowances in the N.H.S. have been increased three times since last December.Readers may like to know what these princely increases were.The allowance was first increasod from 5 5p to 5 6p and then to 5-7p; and
Pharmacokinetics of methoxyflurane after its intra-dermal injection as lecithin-coated microdroplets
Authors: Michael Y. Wu, Jonas Johansson, Norman H. Altman, Duncan H. Haynes, Vera Fiserova-Bergerova
Journal: Journal of Controlled Release (1989)

Recent studies (D.H. Haynes and A.F. Kirkpatrick, Anesthesiology, 63 (1985) 490–499) have shown that general anesthetic oils such as methoxyflurane (MOF) can be incorporated into lecithin-coated microdroplets of ca. 1000 Å diameter. Intradermal injection of microdroplets of selected general inhalation anesthetics results in reversible local anesthesia. The present study gives information on the time course of absorption, distribution, and elimination of MOF and its metabolites for the intradermal injection of 20 mg of microdroplet-associated MOF in rat tails. Following intradermal injection of MOF microdroplets, the bulk of the injected amount of MOF is absorbed into the blood. The absorption is biphasic with half-times of 2 h and 450 h. The levels of MOF in blood tissue peak within 3 h after injection. The concentrations of MOF metabolites peak 6 h after injection. Studies of the body burden of MOF and its metabolites suggest that the lung is a major elimination pathway, clearing as much as two-thirds of the injected MOF. This is in direct contrast to the fate of MOF administered by inhalation, for which metabolism is the major elimination pathway. With microdroplet administration, the peak levels of MOF in blood and offluoride in plasma are an order of magnitude smaller than the non-effect levels associated with general anesthesia and nephrotoxicity, respectively. This would appear to provide a sufficient margin of safety for any known adverse effect of MOF. The low levels in noninjected tissues are partly attributed to a low dose requirement for local anesthesia and partly to the respiratory-circulatory system which allows a significant amount of MOF to be removed from blood by exhalation before it reaches the other tissues.
A Broader View of Justice
Authors: Nancy S. Jecker
Journal: The American Journal of Bioethics (2008)

Abstract In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view. Keywords: justicesocial determinants of healthaccess to careuninsuredallocationrationing
Continuing Medical Education for General Practitioners
Authors: John Lister
Journal: New England Journal of Medicine (1980)

FOR many years it has been accepted that the practicing physician can maintain his competence only by regular updating. The reading of medical journals, attendance at scientific meetings, and participation in regular hospital educational activities have been the traditional methods. However, the scope of the scientific advances of the past few decades have made it increasingly difficult for physicians to ensure that their knowledge enables them to give their patients the best possible advice and to be fully aware of the potential of modern methods of diagnosis and treatment. Furthermore, as the public has become better informed on medical matters, . . .
Recent Developments in Antithromboembolic Therapy.
Authors: Irving S. Wright
Journal: Annals of Internal Medicine (1969)

s1 May 1969Recent Developments in Antithromboembolic Therapy.Irving S. Wright, M.D., F.A.C.P.Irving S. Wright, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1087_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the past 30 years antithromboembolic therapy has been the subject of very comprehensive investigations and critical evaluation. The drugs involved have been used in a great variety of conditions for both preventative and therapeutic purposes. There has been clarification as to the indications, contraindications, and debatable areas. New developments have maintained interest at a high level. This presentation includes a review of the present status and emphasizes especially the data from recent studies that have demonstrated that adequate dosage levels are essential to satisfactory results and that dosage must be carefully monitored when other medications are either added to... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Irving S. Wright, M.D., F.A.C.P.Affiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5Page: 1087-1087KeywordsDrugs ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
REPAIR AFTER INTESTINAL RESECTION.
Authors: WILLIAM A. EVANS
Journal: JAMA (1900)

The title of this paper is misleading, in that it gives the idea that healing in the intestine is to be fully considered. I shall discuss the question of stricture following anastomosis, and especially end-to-end anastomosis. The other points in the healing process will be treated very cursorily. The position which the paper advocates is that the danger from secondary stricture due to development of scar tissue in the submucosa and muscular tunics is very slight. This should be removed from the list of objections to operative procedures. I have been led to this opinion by two sets of observations. I have been confirmed in it by a tone that I find in the literature—illy defined, but present. The first observation is this: For ten years the profession has been doing anastomosis with great frequency. There has been time enough for the literature to teem with reports of secondary stricture.
Lesion morphology and coronary angioplasty: Current experience and analysis
Authors: Richard K. Myler, Richard E. Shaw, Simon H. Stertzer, Harvey S. Hecht, Colman Ryan, Joseph Rosenblum, David C. Cumberland, Mary C. Murphy, Heidi N. Hansell, Benito Hidalgo
Journal: Journal of the American College of Cardiology (1992)
Serco penalised by 81 000 a month over failings in Suffolk contract
Authors: J. Deith
Journal: BMJ (2014)

The effect of inhaled drugs favouring community-acquired pneumonia (CAP) is unclear. This case-control study was designed to determine whether inhaled drugs were risk factors for CAP. All incident cases of confirmed CAP that occurred over 1 year in patients with chronic bronchitis (CB), chronic obstructive respiratory disease (COPD) or asthma were included, as well as CB, COPD and asthma controls. Risk factors for CAP and inhaled treatment were recorded during a personal interview. An effect of inhaled drugs on the risk of CAP was observed in COPD and asthma patients after adjusting for the effect of other respiratory diseases and their concomitant treatments. In COPD patients inhaled steroids had a risk of 3.26 (1.07<b>–</b>9.98) and in asthma patients inhaled anticholinergics had a risk of 8.80 (1.02<b>–</b>75.7). In CB patients no association with CAP was observed for any inhaler. These effects were independent of adjusting variables related to severity and other respiratory and non-respiratory risk factors for CAP, including vaccines. Inhaled β2-adrenergic agonists did not show a significant effect on the risk of CAP in none of the respiratory diseases. Inhaled steroids may favour CAP in COPD patients, whereas anticholinergics may favour CAP in asthma patients. It is difficult to differentiate the effect of inhaled therapy from the effect of COPD or asthma severity on the risk of CAP, and these relationships could not be casual but call attention to inhaled therapy in COPD and asthma patients.
Effects of truncal, selective, and highly selective vagotomy on glucose tolerance and insulin secretion in patients with duodenal ulcer. Part I-Effect of vagotomy on response to oral glucose.
Authors: C S Humphrey, J R Dykes, D Johnston
Journal: BMJ (1975)

An oral glucose tolerance test was performed in patients who had undergone truncal vagotomy and pyloroplasty, bilateral selective vagotomy and pyloroplasty, or highly selective vagotomy without a drainage procedure at least six months earlier. The results were compared with those from patients with chronic duodenal ulcer before operation. In all three groups of patients after vagotomy more rapid rates of rise of blood glucose and higher peak concentrations were observed than in patients who were tested before operation. These differences were statistically significant only in patients who had undergone truncal or selective vagotomy with pyloroplasty and were probably due to more rapid rates of gastric emptying after these operations. Plasma insulin concentrations were lower after truncal vagotomy than after selective or highly selective vagotomy, the difference between truncal vagotomy and highly selective vagotomy being statistically significant. Truncal vagotomy resulted in a diminished insulin response to oral glucose, which could have been due to vagal denervation of the pancreas or, more probably, impaired release of small-bowel hormones which normally augment the pancreatic insulin response.
5-Lipoxygenase Deficiency Prevents Respiratory Failure during Ventilator-induced Lung Injury
Authors: Pietro Caironi, Fumito Ichinose, Rong Liu, Rosemary C. Jones, Kenneth D. Bloch, Warren M. Zapol
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Rationale: Mechanical ventilation with high VT (HVT) progressively leads to lung injury and decreased efficiency of gas exchange. Hypoxic pulmonary vasoconstriction (HPV) directs blood flow to well-ventilated lung regions, preserving systemic oxygenation during pulmonary injury. Recent experimental studies have revealed an important role for leukotriene (LT) biosynthesis by 5-lipoxygenase (5LO) in the impairment of HPV by endotoxin. Objectives: To investigate whether or not impairment of HPV contributes to the hypoxemia associated with HVT and to evaluate the role of LTs in ventilator-induced lung injury. Methods: We studied wild-type and 5LO-deficient mice ventilated for up to 10 hours with low VT (LVT) or HVT. Results: In wild-type mice, HVT, but not LVT, increased pulmonary vascular permeability and edema formation, impaired systemic oxygenation, and reduced survival. HPV, as reflected by the increase in left pulmonary vascular resistance induced by left mainstem bronchus occlusion, was markedly impaired in animals ventilated with HVT. HVT ventilation increased bronchoalveolar lavage levels of LTs and neutrophils. In 5LO-deficient mice, the HVT-induced increase of pulmonary vascular permeability and worsening of respiratory mechanics were markedly attenuated, systemic oxygenation was preserved, and survival increased. Moreover, in 5LO-deficient mice, HVT ventilation did not impair the ability of left mainstem bronchus occlusion to increase left pulmonary vascular resistance. Administration of MK886, a 5LO-activity inhibitor, or MK571, a selective cysteinyl-LT1 receptor antagonist, largely prevented ventilator-induced lung injury. Conclusions: These results indicate that LTs play a central role in the lung injury and impaired oxygenation induced by HVT ventilation.
An Address on THE PRINCIPLES OF DIAGNOSIS
Authors: R. Hutchison
Journal: BMJ (1928)

IT is w-ritten that there abideth Faith, Hope, Charity, these tlhree, but the greatest of these is Charity.And so imn Medicine we have Diagnosis, which is a matter of faith; Prognosis, which is a question of hope; and Treat- ment, which is only too often an affair -of charity; but the greatest of these is Diagnosis.For without accurate diagniosis it is impossible to forecast the course and out- colmie of a disease ol to treat it satisfactorily.Indeed, as someone has truly said, " The first part of treatment is diagnosis, and tile second, diagnosis, and the third, di agnosis."I need make no apology, therefore, for dir ecting your attention to some reflections on such an important subject-on this occasion.Diagnosis is based on an accurate interpretation of symptoims and signs.I am aware that there h}as been in Iecenit times an attempt to ignore any distinction betweeni these and to speak of all the manifestations of disease as symptoms.I think there is an advanitage, however, in keeping to the old division and to call " symptoms " all the subjective results of disease which are described to you by thte patient, anid " signs " all the objective phen-omena which you discover on physical examination.It is triue that tllere are some manifestations of disease whiclh occupy .anintermediate place between symptoms and signsdisorders of sensation, for instance-but this does not invalidate the general utility of keepinig the subjective anid thle objective separate.Symptoms ale elicited by taking the history and by the cross-examination of the patient upon it.This is the patient's coihtribuition to the making of tlhe diagnosis, and its value cannot be over-estimated.The importance of the symptoms-and therefore of the history-ini the diagnosis varies greatly in different cases, biut it is peihaps greatest in cases of abdominaldisease, and least in cutaneous diseases anid oroamic disease of the nervous system.If you are dealing with a stupid, deaf, or confused patienit, or onie who has little power of expi'essing himself in wvoi'ds, youir difficulty in eliciting symptoms may be very gi'eat.Inasmuch, however, -as the wvhole diagnosis may depend
Thyroid Hemiagenesis and Graves’ Disease in a Child
Authors: Mustafa Serdengeçti, Asli Ayan, Oktay Sari
Journal: Clinical Nuclear Medicine (2009)

Hemiagenesis of the thyroid is a rare malformation and Graves' disease with ophthalmopathy is reported quite rarely in adult patients but is not seen in children. This is a report of an 8-year-old girl with congenital absence of the left thyroid lobe, or hemiagenesis.
The Journal's Advertising Policy.
Authors: James L. Tracy
Journal: JAMA (1900)

Toledo, Ohio, April 17, 1900. <h3>To the Editor:</h3> WhenThe Journal'srecently announced policy concerning advertising is in full force, the enjoyment I have heretofore gotten out of its perusal will be heightened, because there will be lopped off from it the only disquieting feature which has ever manifested itself. I have always had an antipathy for unethical medical advertisements, possibly from pharisaical inclinations, but then, the antipathy exists nevertheless. My thoughts on the subject of medical advertising have been the same for so long that grooves have been worn so deeply in my gray matter that now I can not change my views. I am in fact a crank on that subject. In consequence of this lifelong habit, whenever I come across a quack advertisement in a religious newspaper, or in any paper which claims to be respectable, I make a note of it, and when I have spare
Survey of Immunity by Serologic Methods
Authors: Leo Levine, Louise Wyman
Journal: New England Journal of Medicine (1965)

SEROLOGIC surveys have been widely employed as a means of ascertaining the presence of certain diseases and the state of immunity of specific population groups and for other purposes related to the epidemiology of infectious diseases. Periodic surveys of the immunity status of a population are a valuable means by which public-health officials can assess the effectiveness of their programs of immunization. The Institute of Laboratories of the Massachusetts Department of Public Health has conducted 3 such surveys spanning a ten-year period, the years being 1954, 1961 and 1964. The antibodies assayed were diphtheria and tetanus antitoxins in 1954 and . . .
Location of parathyroid adenomas by thallium-201 and technetium-99m subtraction scanning.
Authors: A E Young, J I Gaunt, D N Croft, R E Collins, C P Wells, A J Coakley
Journal: BMJ (1983)

Solitary parathyroid adenomas were correctly located before surgery in 20 out of 21 cases by using 201mT1 and 99mTc in a subtraction technique. The technique was not useful in identifying hyperplastic parathyroid glands. The technique is recommended as a useful procedure before surgery for primary hyperparathyroidism.