tbuckley/cabot-search huggingface dataset:
Penicillin Sensitivity —Continued
Authors: W. E. Lockhart
Journal: JAMA (1965)

To the Editor:—  On the firing line the doctor holds a syringe loaded with penicillin. He has asked the patient whether he is allergic to  or if penicillin has ever caused a skin rash. The patient has responded in the negative and adds with assurance that he has had penicillin many times and has never had any trouble with it. The doctor gives the penicillin, and a few minutes later the patient is gasping for breath with generalized, severe urticaria, and is unconscious and convulsing. The doctor then gives epinephrine intramuscularly.  This has happened five times in my office, once after the penicillin was given orally. At a later date I placed a drop of penicillin G aqueous suspension on the volar forearm and made one scratch through the drop. In each case a wheal developed almost immediately. One of the patients felt sick because of the scratch. Since
The Responsibility of the University Hospital in the Synthesis of Medicine, Science and Learning
Authors: Walter Bauer
Journal: New England Journal of Medicine (1961)

IT is relatively recent in the history of human affairs that men first came to believe that, to a large extent, their destiny and fate rested in their own hands. In the intellectual exuberance of the seventeenth century, the great Age of Reason, whose heroic figures were Newton, Boyle, Locke and Descartes, men first believed that knowledge derived by the new method called science might very well lead to a state of happiness and perfection on earth, heretofore thought impossible.One of the hallmarks of this great century was the incredible versatility of its creative scholars and leaders. Among the . . .
Transferring patients with Ebola from west Africa to "isolation hospitals" in well resourced countries for treatment
Authors: D. P. Southall, R. MacDonald
Journal: BMJ (2014)

The latest predictions regarding the spread of Ebola in west Africa are alarming and leave little time for effective action.1 2 A possible solution would be to transfer Ebola positive patients to suitable “isolation hospitals” in well resourced countries.

Our recent experience in Liberia suggests there is too little time to create and staff enough Ebola treatment units (ETUs) to control the epidemic.3 In west Africa, increasing numbers of …
Lectures on Paralysis as an Effect of Brain-Disease
Authors: C. E. Brown-Sequard
Journal: BMJ (1876)

THE BRITISRHMEDICAL 7OURNAL.135 say, stand their ground better than the new ones-one of those parts has not been attacked by disease, and that the disease ik in other parts LECTURES ~of the brain, which are considered as not endowed with special func- ON tions as regards voluntary action.Well, this view also does not stand PARALYSIS AS AN EFFECT OF criticism, as we find; and we shall have plenty of facts to demonstrate it in the course of these lectures.We find that a disease in the very BRAIN-DlSEASE.* heart--sion i f I a call it so-of those parts which serve for the transmis- soofteorder or the will to the muscles, or in those very centres, Delivered at the Royal College of Physicians of London.old and new, is there destroying the part ; not a disease simply like that which comes from a pressure or a tumnour, however large-because ZY ~~~~~~~~nervous tissue may certainly be compressed without losing its function C. E. 11ROW N-SP~Q UARD, M.D.', F.R.C.P., F.R.S., -but in diseases where there has been actual destruction of tissue, Formnefly Physician to the Nationar'Hospital for thc Paralysed whether it has been taken away by any cause, by the knife, by a ball and Epileptic; etc.or bullet, or some other cause purely organic, there are many case-ss _________ ~~~which clearly prove that from the medulla oblongata up, to the psycho- LECTURE I.motor centres, any part can be destroyed without any loss of function ; so that, on the one hand, we find that paralysis can appear wherever JMR.PRESIDENT AND GENTLEMEN,-The views I am about to put the disease is located in the brain, whether that part is a part consi-
Shipman inquiry recommends tighter rules on controlled drugs
Authors: Clare Dyer
Journal: BMJ (2004)

Dame Janet Smith, the appeal court judge heading the inquiry into the activities of the British GP Harold Shipman, who killed at least 215 patients, called last week for a tighter system of regulating controlled drugs.

Dame Janet made the recommendation in the fourth of five reports from her inquiry, drawing lessons from Dr Shipman's ability to get the large quantities of diamorphine that he …
Autoimmune thyroid disease in anti-Ro/SS-A-positive children with annular erythema: report of two cases
Authors: S. Miyagawa, M. Tanaka, S. Okamoto, T. Ishihara, M. Nakajima, K. Taira, A. Yoshioka, H. Asada
Journal: British Journal of Dermatology (2004)

Anti‐Ro/SS‐A‐associated recurrent annular erythema is a rare disorder, and represents a cutaneous manifestation of primary Sjögren's syndrome (SS). We report two childhood cases complicated with autoimmune thyroid disease, one with Graves' disease and the other with autoimmune thyroiditis. Both children were positive for anti‐Ro/SS‐A and anti‐La/SS‐B antibodies. One patient was lacking clinical SS with objective evidence of salivary gland involvement, while the other was diagnosed with primary SS. Our observation suggests that autoimmune thyroid disease in the subset of anti‐Ro/SS‐A‐positive children with annular erythema might occur with similar frequency to that in adult primary SS.
The Production and Directed Differentiation of Human Embryonic Stem Cells
Authors: Alan Trounson
Journal: Endocrine Reviews (2006)

Human embryonic stem cells (hESCs) are being rapidly produced from chromosomally euploid, aneuploid, and mutant human embryos that are available from in vitro fertilization clinics treating patients for infertility or preimplantation genetic diagnosis. These hESC lines are an important resource for functional genomics, drug screening, and, perhaps eventually, cell and gene therapy. The methods for deriving hESCs are well established and repeatable and are relatively successful with a ratio of 1:10 to 1:2 new hESC lines produced from 4- to 8-d-old morula and blastocysts and from isolated inner cell mass cell clusters of human blastocysts. The hESCs can be formed and maintained on human somatic cells in humanized serum-free culture conditions and for several passages in cell-free culture systems. The hESCs can be transfected with DNA constructs. Their gene expression profiles are being described and immunological characteristics determined. They may be grown indefinitely in vitro while maintaining their original karyotype and epigenetic status, but this needs to be confirmed from time to time in long-term cultures. hESCs spontaneously differentiate in the absence of the appropriate cell feeder layer, when overgrown in culture and when isolated from the ESC colony. All three major embryonic lineages are produced in differentiating flat attachment cultures and unattached embryoid bodies. Cell progenitors of interest can be identified by markers, expression of reporter genes, and characteristic morphology, and the cells thereafter enriched for progenitor types and further culture to more mature cell types. Directed differentiation systems are well developed for ectodermal pathways that result in neural and glial cells and the mesendodermal pathway for cardiac muscle cells and many other cell types including hematopoietic progenitors and endothelial cells. Directed differentiation into endoderm has been more difficult to achieve, perhaps because of the lack of markers of early progenitors in this lineage. There are reports of enriched cultures of keratinocytes, pigmented retinal epithelium, neural crest cells and motor neurons, hepatic progenitors, and cells that have some markers of gut tissue and pancreatic islet-like cells. The prospects for use of hESC derivatives in regenerative medicine are significant, and there is much optimism for their potential contributions to human regenerative medicine.
CATARRHAL DISEASES OF THE NOSE AND THROAT.
Authors: J. D. ALBRIGHT
Journal: JAMA (1896)

To any careful observer, and all physicians should be such, it must have become apparent that catarrhal diseases of the nose and throat are becoming more and more frequent and play a most important part in the practice of every physician who gives more than passing attention to their treatment. There seems to be a prevailing opinion in the minds of many of our profession that the correct treatment of these diseases involve the use of special and expensive instruments and require a more than ordinary degree of skill to use them properly, so that these cases are allowed to drift to the specialist, who, by the way, is often no more than a physician who keeps posted and has the courage to apply his knowledge. By a moderate amount of study and diligent practice, by perseverance in the use of the methods at hand the general practitioner may overcome
TREATMENT OF PARAPLEGIA RESULTING FROM TRAUMA TO THE SPINAL CORD
Authors: L. W. FREEMAN
Journal: JAMA (1949)

The essentials in the care of the patient suffering from a paralysis of the legs resulting from injury to the spinal cord consist of the prompt application of the following points:   Rotation or flexion of the spine should be studiously avoided or the spinal cord may be severed.  The deformity of the spine should be promptly reduced by traction or hyperextension or both.  The patient must be turned every two hours at least.  Proper care of the bladder includes:  Avoidance of distention or continuous contraction.  Encouragement of the development of an automatic bladder.  Avoidance of urinary sepsis, or prompt treatment if it occurs.  Prevention of urinary calculi by exercising upper extremities in bed and by early ambulation.  Proper care of the skin  Avoid prolonged pressure; turn frequently.  The bed should be clean, dry, smooth and flat.  Maintain adequate protein intake.  Large decubitus ulcers should be repaired surgically.
Alopecia areata, autoimmunity, and Down's syndrome.
Authors: A Du Vivier, D D Munro
Journal: BMJ (1975)

Alopecia areata occurs more often in Down9s syndrome than would be expected by chance, sixty cases being found among 1000 patients with this syndrome compared with one case among 1000 subnormal controls. Because alopecia areata is associated with some organ-specific autoimmune disease and thyroid antibodies are often found in Down9s syndrome sera from affected patients were examined for the presence of fluorescent autoantibodies. Antibodies against thyroid components tended to be present in female mongols with alopecia areata in comparison with females in a normal population but not in male mongols. Futhermore, eight out of 23 female mongols (35%) with alopecia areata had antibodies against thyroid components compared with two out of 23 female mongols (9%) without alopecia areata.
Ability of family members to predict patient's consent to critical care research
Authors: Magali Ciroldi, Alain Cariou, Christophe Adrie, Djilali Annane, Vincent Castelain, Yves Cohen, Arnaud Delahaye, Luc Marie Joly, Richard Galliot, Maité Garrouste-Orgeas, Laurent Papazian, Fabrice Michel, Nancy Kenstish Barnes, Benoit Schlemmer, Frédéric Pochard, Elie Azoulay
Journal: Intensive Care Medicine (2007)
Plasma vasopressin concentrations and effects of vasopressin antiserum on blood pressure in rats with malignant two-kidney Goldblatt hypertension.
Authors: J Möhring, B Möhring, M Petri, D Haack
Journal: Circulation Research (1978)

Male Sprague-Dawley rats with unilateral renal artery stenosis and a contralateral untouched kidney develop a malignant hypertension (MH) which is characterized by high blood pressures, sodium and water depletion, and subsequent activation of the renin-angiotensin system. In the present studies we found plasma arginine vasopressin (AVP) concentrations-3-fold higher than those in rats with benign renal hypertension, and 4- to 5-fold higher than those in normotensive control rats. Analysis of individual values showed considerable scatter; about 50% of the values fell in the range of benign hypertensive or control rats. When a specific AVP antiserum was injected, iv, into eight conscious unrestrained MH rats, BP transiently fell toward control values in four; in one, BP fell by only 10 mm Hg, and three other MH rats showed no response. In the same rats, injection of a specific angiotensin II antiserum always induced a transient fall in BP. On the basis of these and previously reported observations, we conclude that, subsequent to sodium and water loss and activation of the renin-angiotensin system, vasopressin release is stimulated in a significant number of MH rats and that, in these rats, vasopressin may cause significant systemic vasoconstriction. Thereby vasopressin may contribute to the development of malignant renal hypertension in rats.
HEAVY AND LIGHT CHAIN ALLOTYPIC MARKERS ON RABBIT HOMOCYTOTROPIC ANTIBODY
Authors: T. J. Kindt, C. W. Todd
Journal: The Journal of Experimental Medicine (1969)

Evidence has been presented that rabbit homocytotropic antibody prepared against ovalbumin bears allotypic markers of both group a (heavy chain) and group b (light chain). This was shown by specific removal of activity in passive cutaneous anaphylaxis assays by anti-allotype immunoadsorbents. The homocytotropic antibody has properties which indicate that it belongs to a new class of rabbit immunoglobulin. These results demonstrate that this newly described class possesses the allotypes of both groups a and b, as has been previously shown for other rabbit immunoglobulin classes.
Association Between Sex Hormones and Colorectal Cancer Risk in Men and Women
Authors: Jennifer H. Lin, Shumin M. Zhang, Kathryn M. Rexrode, JoAnn E. Manson, Andrew T. Chan, Kana Wu, Shelley S. Tworoger, Susan E. Hankinson, Charles Fuchs, J. Michael Gaziano, Julie E. Buring, Edward Giovannucci
Journal: Clinical Gastroenterology and Hepatology (2012)
"Auditory hallucinations" from a hearing aid?
Authors: D. King, D. N. Brooks, M. G. Malster
Journal: BMJ (1989)

left the casualty department after being refused an injection, and a 38 year old woman reported no pain relief after diclofenac and was given pethidine.She discharged herself and did not attend follow up; results of urography were normal.We thank Mrs J Cowan for secretarial help.
An Additional Basic Science for Clinical Medicine: IV. The Development of Clinimetrics
Authors: ALVAN R. FEINSTEIN
Journal: Annals of Internal Medicine (1983)

The domain of clinimetrics is concerned with quantitative methods in the collection and analysis of comparative clinical data, and particularly with improved "measurement" of the distinctively clinical and personal phenomena of patient care. The main requirement for scientific quality in data is a consistent, reproducible process of observation and expression. This requirement can be attained with appropriate attention to basic descriptive activities and to the operational criteria that convert raw descriptions into the variables, categories, and composite aggregates of suitably chosen clinimetric scales. For this work, clinicians will be challenged to "dissect" and stipulate the components of decisions that are now made with unspecified methods or judgments. Clinimetric science provides opportunities for new approaches, new sites, and new personnel in an additional type of clinical investigation that can augment the scientific basis of clinical practice, while rehumanizing the contents of research data and restoring analytic emphasis to the art of patient care.
The Predictive Value of Microalbuminuriq in IPPM: A five-year follow-up study
Authors: Thomas Almdal, Kjrsten Nörgaard, Bo Feldt-Rasmussen, Torsten Deckert
Journal: Diabetes Care (1994)

To investigate the predictive value of microalbuminuria and the annual increase of albumin excretion as risk factors for diabetic nephropathy.A 5-year follow-up of patients with microalbuminuria (urinary albumin excretion [UAE] = 30-299 mg/24 h) and matched patients with normoalbuminuria (UAE < 30 mg/24 h). The initial classification was based on one single 24-h urine collection. The annual increase in UAE was calculated by linear regression analysis of log-transformed UAE on time. This study was conducted at the outpatient clinic of the Steno Diabetes Center. The study subjects included 118 insulin-dependent diabetes mellitus (IDDM) patients between 18 and 50 years of age with microalbuminuria and 112 matched control patients with normal UAE with an age at diabetes onset of < 31 years. The main outcome measures were UAE, annual change in UAE rate (percentage per year), and the prevalence of retinopathy.After 5 years, 39 (33%, 24-42 CI [95% confidence interval]) patients with microalbuminuria had normoalbuminuria, 57 (48%, 38-57 CI) still had microalbuminuria, and 22 (19%, 12-27 CI) had developed diabetic nephropathy. Among the 112 patients with normoalbuminuria in 1985, 9 (8%, 4-15 CI) had developed microalbuminuria, and 2 (2%, 0-6 CI) had developed diabetic nephropathy. Of the 79 patients with persistent albuminuria, only 36 (46%, 34-57 CI) were progressors with a rate of progression of > 5%/year. Progressors had significantly higher HbAlc, higher mean blood pressure, and a higher incidence of proliferative retinopathy compared with nonprogressors. Multiple regression analysis only identified mean HbAlc as an independent predictor of the rate of progression. Smoking was significantly more prevalent in patients with persistent albuminuria.Microalbuminuria is a predictor of progression to diabetic nephropathy; however, not as strong as suggested previously. Calculation of the annual increase in UAE seems to be a more specific method of identifying patients who will develop diabetic nephropathy.
Concurrent acute endobronchial and endotracheal tumour embolism
Authors: C. G. Tan, L. Shen, L. Garske, K. Tran
Journal: Thorax (2010)

Concurrent acute endobronchial and endotracheal tumour embolismA 63-year-old man presented with a 12 h history of severe cough and a fear of choking.He had a known background of locally advanced primary adenocarcinoma of the lung obstructing the right upper bronchus.Three months previously he had coughed up white tissue (confirmed as carcinoma by histology).One month previously he received a single fraction of radiotherapy.His respiratory rate was 20 breaths/min with minimal respiratory distress.His temperature was 38.98C and his SpO 2 was 94% on room air.His trachea was deviated to the right and breath sounds were decreased in the right hemithorax.Bronchoscopy 2 months previously showed a necrotic tumour causing complete occlusion of the right upper lobe bronchus and extrinsic compression of the right middle lobe bronchus.CT scan 1 month previously (figure 1) and chest x-ray after the most recent admission confirmed a bronchocentric obstructing lesion of the right bronchial tree.Intraluminal tumour extension was not visualised with either imaging modality.The chest x-ray also showed right mediastinal shift, a right pleural effusion and right upper lobe atelectasis.On the ward he suddenly developed severe respiratory distress with stridor.Within 1 min he became apnoeic and lost consciousness.His larynx showed no obstruction at endotracheal intubation.Within minutes he became unventilatable and cardiac arrest ensued.The patient could not be revived.Postmortem examination confirmed primary tumour in the right upper bronchus with a snake-like projection of tumour into the right main bronchus.There were two obstructing mobile tumour plugs, in the left main bronchus (figure 2A) and the subglottic region of the trachea (figure 2B).Endobronchial tumour embolism is rare, has primarily been described with lung surgery and is difficult to manage in the acute setting. 1 Diagnosis and reversal of this catastrophe can only be achieved by immediate rigid bronchoscopy and tumour plug extraction. 2 To our knowledge, this is the first description of endobronchial tumour embolism in a patient with lung cancer outside of the surgical setting.We believe the lesson from our case is that patients with a history of expectorating tumour plugs and a fear of choking may warrant urgent evaluation for threatened endobronchial tumour embolism.
Organized for Prohibition: A New History of the Anti-Saloon League
Authors: Norman Gevitz
Journal: JAMA (1986)

The historical literature on the temperance and prohibition movements is rather voluminous, with a number of works having already been established as classics within the field. K. Austin Kerr, relying on recently assembled and hitherto unused documentary materials pertaining to the Anti-Saloon League, has sought to add fresh insights to the crusade to make and keep America dry. Kerr argues that the League was a new type of political organization or pressure group. Unlike other organizations such as the Prohibition Party or the Women's Christian Temperance Union, which espoused a number of causes in addition to fighting the liquor traffic, the Anti-Saloon League from its beginnings in the last decade of the 19th century focused exclusively on a single issue. Though constitutionally democratic, the League was run by a few leaders who shaped policy and sharply limited the role of its mass constituency to contributing money and getting out the
Focal F-18 FDG Uptake Mimicking Malignant Gastric Localizations Disappearing After Water Ingestion on PET/CT Images
Authors: Alessio Imperiale, Sébastien Cimarelli, Dorra Ben Sellem, Cyrille Blondet, André Contantinesco
Journal: Clinical Nuclear Medicine (2006)

Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.