tbuckley/cabot-search huggingface dataset:
HIV-Infected Surgeons
Authors: Amir Halevy
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The fallout from the Acer case in Florida and the newly focused congressional attention on HIV-infected health care workers has heightened the importance of the<i>Behringer</i>case, in which a New Jersey trial court supported a hospital's policy of restricting the surgical privileges of an HIV-infected physician. Dr Orentlicher, in a recent<i>JAMA</i>article,<sup>1</sup>provides a thorough discussion of the decision and its implications for practicing physicians. He notes that the<i>Behringer</i>court "endorsed practice restrictions that attempt to eliminate all risk of transmission." He rightly points out that such a "standard of 'zero-tolerance' risk permits the kinds of irrational or invidious discrimination that are prohibited by principles of discrimination law." While I agree with the thesis that such a standard is inherently discriminatory to physicians and has potentially harmful implications for future public policy, the evidence does not support his contention that "there is
Positive Selection for Indel Substitutions in the Rodent Sperm Protein Catsper1
Authors: Ondrej Podlaha, David M. Webb, Priscilla K. Tucker, Jianzhi Zhang
Journal: Molecular Biology and Evolution (2005)

Catsper1 is a voltage-gated calcium channel located in the plasma membrane of the sperm tail and is necessary for sperm motility and fertility in mice. We here examine the evolutionary pattern of Catsper1 from nine species of the rodent subfamily Murinae of family Muridae. We show that the rate of insertion/deletion (indel) substitutions in exon 1 of the gene is 4-15 times that in introns or neutral genomic regions, suggesting the presence of strong positive selection that promotes fixations of indel mutations in exon 1. The number of indel polymorphisms within species appears higher than expected from interspecific comparisons, although there are too little data to provide a statistically significant conclusion. These results, together with an earlier report in primates, indicate that positive selection promoting length variation in Catsper1 may be widespread in mammals. A structural model of Catsper1 suggested the importance of the exon 1-encoded region in regulating channel inactivation, which may affect sperm mobility and sperm competition. Our findings provide a necessary foundation for future experimental investigations of Catsper1's function in sperm physiology and role in sperm competition using rodent models.
Those Anti-Doctor Books
Authors: F.J. Ingelfinger
Journal: New England Journal of Medicine (1976)

IN his introduction, the author of the The Great American Medicine Show avows that his pediatrician "is about as saintly a man as we are sometimes told all doctors used to be," but nevertheless feels impelled to write about "The Unhealthy State of U.S. Medical Care and What Can Be Done about It."1 So what else is new?Then follow some 275 pages divulging that medical care is too costly, with inappropriately small returns for money spent, that private insurance is inadequate, with too limited coverage for many, that hospitals are overutilized and are not motivated to economize, that Medicaid . . .
WHAT IS THE PRESENT MEDICO-LEGAL STATUS OF THE ABDOMINAL SURGEON?Read by Invitation in the Section of Medical Jurisprudence, at the Forty-first Annual Meeting of the American Medical Association, at Nashville, Tenn., May, 1890.
Authors: WILLIAM WARREN POTTER
Journal: JAMA (1890)

The line of thought outlined in this paper, no matter how expressed, is intended to be suggestive rather than dogmatic—inquiring rather than assertive—as indicated by its title. The recent rapid advancement of the surgery of the abdomen has inevitably led to its separation from the general surgical field into a distinct specialty. It finds itself in a new environment, without traditions or statutes for its guidance, and hence with only a comparatively recent experience on which to found its legal or surgical status. For these and other reasons we may not speak in this place except suggestively or inquiringly. That abdominal surgery now holds a place distinct and apart from other branches of the surgical art, need scarcely be argued here. That it must of necessity be considered a specialty appears reasonable, when we contemplate the nature of the organs dealt with, and the variety in the character of the
Cloning and analysis of mono-specific single chain fragment variable (scFv) fragments that recognize German cockroach allergens Bla g 1, Bla g 2, Bla g 4, and Bla g 5
Authors: N.C. deVore, W.J.J. Finlay, E.N. Dobrovolskaia, J.E. Slayter
Journal: Journal of Allergy and Clinical Immunology (2005)
GONORRHEAL SPURS A MISNOMER
Authors: WILLIAM H. VON LACKUM
Journal: JAMA (1930)

One hundred consecutive cases of exostosis of the os calcis at the Mayo Clinic were reviewed with the purpose of ascertaining how frequently the gonococcus is a factor in the etiology of the disease. It is generally believed that exostosis of the os calcis is of gonorrheal origin. This idea may have orginated from a report by Baer,<sup>1</sup>in 1905, in which he recorded five cases of painful heels due to exostosis of the os calcis, and all of the patients gave a definite history of having had gonorrhea. In two of the cases in which the spine was also affected, gonococci were found in the growths removed from the heels. In another case three cultures were made at the time of operation, and, although the cultures were negative, they showed diplococci that were decolorized by Gram's stain. Waechter and Sonnenschein,<sup>2</sup>Murphy<sup>3</sup>and Epstein<sup>4</sup>recognized gonorrhea
Measurement of deoxyribonucleic acid (DNA) in canine jejunal fistular fluid.
Authors: D P Goldsmith
Journal: Gut (1969)

Two fistulas of the jejunum, each about 1 5 cm long, were placed side by side in the animal.3The amount of DNA recovered was the same if the samples were allowed to stand for one day or for seven days at -l6C.
Black esophagus complicating variceal bleeding
Authors: B. Maroy
Journal: Endoscopy (2013)

An 81-year-old frail Caucasian man experienced a first episode of acute variceal bleeding complicating portal hypertension. He had undergone right hepatectomy plus resection of hepatic segment 4 for a large, right-sided hepatoma 6 years previously. This had been followed by treatment with radioactive iodine (131I-Lipiodol), which had caused veno-occlusive disease in the remaining segments 2 and 3 leading to severe portal hypertension.
Systemic Membrane Defect in the Proximal Muscular Dystrophies
Authors: Nathan A. Pickard, Hanns-Dieter Gruemer, Harland L. Verrill, Edward R. Isaacs, Meinhard Robinow, Walter E. Nance, Edwin C. Myers, Barbara Goldsmith
Journal: New England Journal of Medicine (1978)

We studied lymphocyte capping in 61 patients with Duchenne, Becker, limb-girdle, facioscapulohumeral and congenital muscular dystrophies. All showed a markedly diminished percentage of capped cells when compared with 86 normal controls, providing support for previous evidence that an alteration in membrane fluidity may be a common pathogenic feature in several genetically distinct forms of proximal muscular dystrophy. Heterozygous carriers of Duchenne muscular dystrophy showed diminished capping that was indistinguishable from that of afflicted males and was often present even when serum enzyme levels were normal. Studies in 25 families with 16 suspected sporadic cases indicated that no more than four out of 30 afflicted males may represent new mutations. These findings imply that most cases of Duchenne dystrophy might be prevented by a population screening program for carrier females combined with prenatal detection of afflicted males.
Epipen as an Alternative to Glucagon in the Treatment of Hypoglycemia in Children With Diabetes
Authors: Teresa P.C. Monsod, William V. Tamborlane, Luisa Coraluzzi, Mary Bronson, Tony Yong-Zhan Ma, Jo Ann Ahern
Journal: Diabetes Care (2001)

OBJECTIVE—Fear of a severe hypoglycemic reaction is a major obstacle to achieving near-normal plasma glucose levels. Although parenteral glucagon is effective in treating these reactions, it is cumbersome to use, causes severe nausea, and is impractical in the school setting. Epinephrine is available as a premixed injection (Epipen) that may be used by all care providers. Using Epipen to treat hypoglycemia may be an effective, safe, and easy-to-use alternative to glucagon. RESEARCH DESIGN AND METHODS—Ten children (age 11.7 ± 2.4 years) with type 1 diabetes were studied on two occasions. After an overnight equilibration period, hypoglycemia was induced via an insulin pump (1 mU · kg–1 · min–1). At a blood glucose level of 2.8 mmol/l, either glucagon (1 mg) or epinephrine (0.3 mg), in random order, was administered intramuscularly and responses were monitored. RESULTS—Plasma free insulin concentrations were similar in both studies. Plasma glucose levels increased by 1.7 ± 0.2 mmol/l (mean ± SEM) in 10 min and by 2.6 ± 0.2 mmol/l in 15 min with administration of glucagon and were not consistently increased with administration of epinephrine (P &amp;lt; 0.01). Peak glucagon concentrations after administration of glucagon were &amp;gt;60-fold higher than basal concentrations. After administration of epinephrine, peak epinephrine levels were 20-fold higher than basal concentrations. CONCLUSIONS—Epinephrine does not seem to be an adequate substitute for glucagon in the treatment of severe hypoglycemia. The effectiveness of glucagon in reversing hypoglycemia and its side effects of nausea and vomiting are likely related to the markedly supraphysiologic plasma levels achieved with the standard intramuscular dose.
Total disconnection of the right ventricular free wall: surgical treatment of right ventricular tachycardia associated with right ventricular dysplasia.
Authors: G M Guiraudon, G J Klein, S S Gulamhusein, G A Painvin, C Del Campo, J C Gonzales, P T Ko
Journal: Circulation (1983)

Arrhythmogenic right ventricular dysplasia is a myopathy that affects the right ventricular free wall (RVFW) and gives rise to recurrent reentrant ventricular tachycardia (VT). Because the entire right ventricle is potentially arrhythmogenic, ablating a single site of VT may not eliminate the arrhythmia. We developed an operation to confine any arrhythmic activity arising from the right ventricle to that chamber: total disconnection of the RVFW from the left ventricle. We performed RVFW disconnection in two patients with refractory VT associated with arrhythmogenic right ventricular dysplasia. At least two sites or origin of morphologically distinct VT were identified in the RVFW in each patient. RVFW disconnection was carried out under normothermic cardiopulmonary bypass. An encircling incision was made along the attachment of the RVFW to the aortoventricular unit and the tricuspid annulus; the right coronary artery and its RVFW branches were left intact. Electrical activity of the two chambers became dissociated, and VT arising from the RVFW was confined to that chamber. Postoperatively, there was no clinical evidence of hemodynamic impairment (follow-up 4 months and 3 months). Left ventricular function was unchanged and right ventricular flow was maintained by atrial contraction and motion of the septum toward the RVFW during left ventricular systole. One patient had incessant right ventricular tachycardia confined to the RVFW for 3 weeks. We conclude that RVFW disconnection is feasible and applicable to patients with refractory VT originating in the diffusely diseased RVFW.
Role of Cerebrospinal Fluid [H+] in Ventilatory Deacclimatization from Chronic Hypoxia
Authors: J. A. Dempsey, H. V. Forster, G. E. Bisgard, L. W. Chosy, P. G. Hanson, A. L. Kiorpes, D. A. Pelligrino
Journal: Journal of Clinical Investigation (1979)

Once ventilatory acclimatization begins in sea level residents sojourning at high altitude, abrupt restoration of normal oxygen tensions will not restore ventilation to normal. We have investigated the role of cerebrospinal fluid (CSF) [H(+)] in this sustained hyperventilation by measuring CSF acid-base status in seven men (lumbar) and five ponies (cisternal) in normoxia, first at sea level and then periodically over 13-24 h of "deacclimatization" after 3-5 d in hypoxia (P(B) = 440 mm Hg). After 1 h deacclimatization, hyperventilation continued at a level only slightly less than that obtained in chronic hypoxia (+1-2 mm Hg Pa(CO2)), whereas CSF pH was either equal (in man) or alkaline (in pony, +0.02, P < 0.01) to sea level values. Between 1 and 12-13 h deacclimatization in all humans and ponies Va fell progressively (Pa(CO2) increased 4-7 mm Hg) and CSF pH became increasingly more acid (-0.02 to -0.05, P < 0.01). Between 12 and 24 h of normoxic deacclimatization in ponies, Pa(CO2) rose further toward normal, coincident with an increasing acidity in CSF (-0.02 pH). Similar negative correlations were found between changes in arterial pH and Va throughout normoxic deacclimatization. We conclude that [H(+)] in the lumbar or cisternal CSF is not the mediator of the continued hyperventilation and its gradual dissipation with time during normoxic deacclimatization from chronic hypoxia. These negative relationships of Va to CSF [H(+)] in normoxia are analogous to those previously shown during acclimatization to hypoxia.
Urticaria and Sinusitis
Authors: Samuel DuBose Ravenel
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Jacobson et al report that among 125 patients with chronic urticaria, the only reproducible underlying abnormalities found were disclosed from either history or physical examination, with the exception of pathological condition of the sinus. They diagnosed solely on the basis of abnormal findings on sinus x-ray films acute sinusitis in 11 patients and chronic sinusitis in. two others, in none of whom was sinusitis suspected before the radiological studies from either history or physical examination. The authors comment that "until further studies have been performed, sinus roentgenograms should be considered in all patients with chronic urticaria, especially of recent onset (six weeks to six months)." Maresh and Washburn<sup>1</sup>reported in 1940 the results of their study in which sinus x-ray films were taken of 100 healthy children over a period of years, including 3,501 separate roentgenograms of the sinuses. Among 72 healthy children examined with serial
The Effect of Ursodiol on the Efficacy and Safety of Extracorporeal Shock-Wave Lithotripsy of Gallstones
Authors: Leslie J. Schoenfield, George Berci, Richard L. Carnovale, William Casarella, Pam Caslowitz, Delbert Chumley, R. Carter Davis, Jay Y. Gillenwater, A. Cedrick Johnson, R. Scott Jones, Lee G. Jordan, David R. Kafonek, Igor Laufer, Keith D. Lillemoe, Shelly Lu, Dean Maglinte, James W. Maher, Peter F. Malet, Ronald A. Malt, Jay W. Marks, Richard W. McCallum, David L. Nahrwold, Albert Nemcek, Daniel J. Pambianco, Henry A. Pitt, Randolph B. Reinhold, Arthur Rosenthal, Janice G. Rothschild, George Saba, Bruce D. Schirmer, Harvey V. Steinberg, Robert W. Summers, William E. Torres
Journal: New England Journal of Medicine (1990)

In the treatment of gallstones with extracorporeal shock-wave lithotripsy, the bile acid ursodiol is administered to dissolve the gallstone fragments. We designed our study to determine the value of administering this agent.
Intragastric bile acid concentrations are unrelated to symptoms of flatulent dyspepsia in patients with and without gallbladder disease and postcholecystectomy.
Authors: R G Watson, A H Love
Journal: Gut (1987)

It has been proposed that duodenogastric reflux may be the basic underlying mechanism which gives rise to symptoms of flatulent dyspepsia. Fasting and postprandial gastric juice bile acid concentrations were measured in patients with flatulent dyspepsia with and without gall bladder disease and postcholecystectomy. There were 13 patients with gall bladder disease, 12 with normal gall bladders and 13 postcholecystectomy. Gastric juice was obtained by intubation. Bile acid concentrations were compared with 21 controls and 15 asymptomatic subjects with gall bladder disease. For 21 patients with gall bladder disease who underwent cholecystectomy, levels were again assessed postoperatively to allow correlation with outcome. The occurrence of reflux and the resultant gastric juice bile acids did not correlate with symptoms. Concentrations postcholecystectomy, including asymptomatic subjects were significantly higher than controls (p less than 0.01). It is concluded that limited duodenogastric reflux is common and need not be associated with symptoms even when the resultant intra-gastric concentrations are higher than normal.
Hepatic toxicity and prognosis in hepatitis C virus–infected patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy regimens: a Japanese multicenter analysis
Authors: Daisuke Ennishi, Yoshinobu Maeda, Nozomi Niitsu, Minoru Kojima, Koji Izutsu, Jun Takizawa, Shigeru Kusumoto, Masataka Okamoto, Masahiro Yokoyama, Yasushi Takamatsu, Kazutaka Sunami, Akira Miyata, Kayoko Murayama, Akira Sakai, Morio Matsumoto, Katsuji Shinagawa, Akinobu Takaki, Keitaro Matsuo, Tomohiro Kinoshita, Mitsune Tanimoto
Journal: Blood (2010)
THE ACTION OF CALOMEL ON THE BILE
Authors: W. F. VON OETTINGEN
Journal: JAMA (1926)

The green color of calomel stools has been the subject of considerable speculation and investigation. G. von Oettingen, 1 in 1848, and Buchheim, 2 in 1856, showed that there is an actual increase of bile pigments in the feces, and this naturally suggested that the calomel increased the bile flow; i. e., that it was a true cholagogue. However, direct experiments with biliary fistulas, acute and permanent, in animals and in man, showed quite definitely that the bile flow is not increased after the administration of calomel. 3   If the increase of bile pigment is not due to an increased flow of bile, it must apparently be due to the protection of these pigments against the destruction or reductive processes which ordinarily cause their disappearance or modification to yellow or colorless products, while they are passing down the course of the intestine. Hoppe Seyler 4 illustrated this by an experiment
Released Report Says Needle Exchanges Work
Authors: Charles Marwick
Journal: JAMA (1995)

A CONCERTED EFFORT is under way to get public support for lifting the ban on federal funds for needle exchange programs among intravenous drug users. The Foundation for Drug Policy, a Washington, DC—based activist group that has long supported such programs, says there is now firm evidence that doing so would reduce transmission of the human immunodeficiency virus (HIV).  It is estimated that about one third of reported cases of AIDS are related directly or indirectly to injection drug use.  The funding ban was put in place by Congress in 1988, but contained a proviso that if it were shown that needle exchange programs were effective in reducing the spread of HIV and did not encourage illegal drug use, it could be lifted.  The evidence on both of these points is now in hand, maintains David C. Condliffe, executive director of the Foundation for Drug Policy. For the convenience of
Regulating Off-Label Drug Use — Rethinking the Role of the FDA
Authors: Randall S. Stafford
Journal: New England Journal of Medicine (2008)

Off-label prescribing is legal and common, but it is often done in the absence of adequate supporting data. Dr. Randall Stafford writes that although there is a strong rationale for greater FDA involvement in off-label use, it is moving toward relinquishing control in its new draft guidelines.
A2.12 Phenotype Changes of Blood Eosinophils Reflect Activity and Severity in Systemic Sclerosis
Authors: Dirk M Wuttge, Annika Andreasson, Ellen Tufvesson, Agneta Scheja, Roger Hesselstrand, Lennart Truedsson
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background and Objectives</h3> We investigated whether surface marker expression analysis of blood eosinophils may reflect disease activity in systemic sclerosis (SSc), since a role for eosinophils in the pathogenesis of SSc may be suggested from the observation of increased counts in bronchoalveolar lavage. <h3>Materials and Methods</h3> By flow cytometer analysis, eosinophils in whole blood were identified in 32 consecutive untreated patients using surface marker CD16 and CD9. Surface expression of markers CD11b, CD44, CD48, CD54, CD81 and HLA-DR was measured. Data were related to clinical measurements of the disease activity. <h3>Results</h3> An increased blood eosinophil population with low surface expression of CD9 was identified in patients with early SSc, i.e. a disease duration of &lt;2 years, compared to patients with longer disease duration (<i>P</i> = 0.003) and controls (<i>P</i> = 0.029). CD81 expression was lower in SSc patients compared to healthy individuals (<i>P</i> = 0.003). In patients with early SSc, CD81 levels correlated inversely to degree of skin involvement (<i>r</i> = –0.67; <i>P</i> = 0.009). CD48 levels were increased in early SSc and were associated with an increased concentration of alveolar nitric oxide in these patients (<i>r</i> = 0.84; <i>P</i> &lt; 0.001). CD16 expression on blood eosinophils was also higher in patients with early disease and was associated with loss of nailfold capillaries (<i>r</i> = –0.78; <i>P</i> &lt; 0.001). <h3>Conclusions</h3> Blood eosinophils in patients with SSc display a diverse phenotype depending on disease duration. In early disease, surface marker expression on eosinophils is associated with disease activity and severity.
Late-Life Depression, Mild Cognitive Impairment, and Dementia
Authors: Edo Richard, Christiane Reitz, Lawrence H. Honig, Nicole Schupf, Ming X. Tang, Jennifer J. Manly, Richard Mayeux, Devangere Devanand, José A. Luchsinger
Journal: JAMA Neurology (2012)

To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort.A cohort study was conducted in Northern Manhattan, New York, New York.A total of 2160 community-dwelling Medicare recipients aged 65 years or older were included in the study.Depression was assessed using the 10-item version of the Center for Epidemiological Studies Depression scale (CES-D) and defined by a CES-D score of 4 or more. We used logistic regression for cross-sectional association analyses and proportional hazards regression for longitudinal analyses.Mild cognitive impairment dementia, and progression from MCI to dementia were the main outcome measures. We also used subcategories of MCI (amnestic and nonamnestic), and dementia (probable Alzheimer disease and vascular dementia, including possible Alzheimer disease with stroke).Baseline depression was associated with prevalent MCI (odds ratio, 1.4; 95% CI, 1.1-1.9) and dementia (2.2; 1.6-3.1). Baseline depression was associated with an increased risk of incident dementia (hazard ratio [HR], 1.7; 95% CI, 1.2-2.3) but not with incident MCI (0.9; 0.7-1.2). Persons with MCI and coexisting depression at baseline had a higher risk of progression to dementia (HR, 2.0; 95% CI, 1.2-3.4), especially vascular dementia (4.3; 1.1-17.0), but not Alzheimer disease (1.9; 1.0-3.6).The association of depression with prevalent MCI and with progression from MCI to dementia, but not with incident MCI, suggests that depression accompanies cognitive impairment but does not precede it.
Doctors shadow patients' experiences for "NHS Change Day"
Authors: Z. Kmietowicz
Journal: BMJ (2014)

A GP who spent NHS Change Day on 3 March in a wheelchair has said that the worst thing about the experience was the social isolation.

Jonathan Griffiths, from Cheshire, who shared his experience on Twitter and in blog posts, said that his pledge for the day, which aims to inspire staff, patients, and the public to do something better together to improve healthcare, increased his empathy for wheelchair users.

“What struck me was how the little things we all take for granted became so much more difficult. Things like getting through doors, driving …