tbuckley/cabot-search huggingface dataset:
Prevention of pressure sores.
Authors: B. Morton
Journal: BMJ (1967)

In 1965 routine virus studies in the Blackburn group of hospitals showed that not only polio virus, both wild and vaccine strains, were isolated but also the following entero- viruses: Coxsackie types A5, A9, B3, B4, and B5.E.C.H.O.types 3, 6, 7, 8, 15, and 22.Most of these cases occurred during July, August, and September.Infants infected with rubella in utero harbour the virus after they are born, and it can be isolated and even infect other susceptible individuals.We felt it worth while, therefore, to see if we could culture any enteroviruses from foetuses, stillbirths, and neonatal deaths where the first trimester of pregnancy coincided in whole or in part with the enterovirus outbreak.This was done in 23 cases and selection was random.In one case faeces only of a child who survived with an abnormality were examined.Investigation was not confined to infants who were con- genitally abnormal.Brain, lungs, faeces, and placenta were examined by conventional methods, being inoculated into monkey-kidney, human- amnion, and Hela-cell cultures.The foetal tissues and placentas were examined for histological changes.All results were negative except for one case.This was a full-term stillborn infant who had shown foetal distress.E.C.H.O.virus type 3 was isolated but the histology was negative.The mother's blood was examined in November 1966 and no E.C.H.O.antibodies were demonstrated.
The Ends of Human Life: Medical Ethics in a Liberal Polity
Authors: Ezekiel J. Emanuel
Journal: Annals of Internal Medicine (1992)

Part 1 The political conception of medical ethics: technology and medical ethics the ethical dimension of professions the ethical dimension of medicine medical ethics and political philosophy implications of the political conception the irresolution of medical ethical questions. Part 2 The nature of liberal political philosophy: two forms of liberalism the tenets of political liberalism. Part 3 Terminating medical care for incompetent patients: the right to refuse medical care the insignificance of who decides the relativity of extraordinary care the impossibility of substituted judgments the indeterminacy of best interests illiberal resolutions to the problem of terminating care the ill effects of irresolution. Part 4 The just distribution of medical resources: justice and health care policy the inadequacy of the right to equal access unjustified lists of basic medical services the weakness of the liberal opportunity criterion hypothetical choice procedures and conceptions of the good life the last hope - democratic political procedures the costs of not specifying basic medical services. Part 5 The liberal communitarian vision: background tenets for political philosophy the ideal of liberal communitarianism the conception of deliberation the conception of a person political rights and goods a federated system liberal and communitarian facets. Part 6 A liberal communitarian vision of health care: the basic structure of community health programmes justification of CHPs philosophical plausibility of CHPs political practicality of CHPs objections considered conclusion - medical ethics for the physician.
Atrial fibrillation complicating Wolff-Parkinson-White syndrome treated with amiodarone.
Authors: D A Chamberlain, A N Clark
Journal: BMJ (1977)

reflexes, the alpha activity in the EEG slowed to 8 Hz and maintained the frontal distribution but attenuated for short periods in response to stimula- tion.Forty-eight hours after admission the patient was alert.The final EEG performed three weeks later as an outpatient showed normally reactive 10 Hz alpha activity in a posterior distribution.The other three patients were all receiving chlormethiazole for alcohol withdrawal states.Two had generalised seizures, and all three were treated with thiamine and diazepam, and one with phenytoin and phenobarbitone.Each of the three had biochemical evidence of hepatic dysfunction, and one had mild transient hyperammonaemia.Two became comatose and one stuporous shortly after starting high doses of chlormethiazole.The initial EEGs of all three patients showed generalised or predominantly frontal alpha or slow beta activity, which did not react to the usual alerting stimuli.In the two comatose patients the activity was in the 11-12 Hz frequency range in one (see figure) and in the 12-14 Hz range in the other.The third patient, who also received phenytoin and phenobarbitone, showed frontally pre- dominant 14-16 Hz beta activity.Withdrawal of the chlormethiazole was accompanied by a return to normal consciousness with normally reactive posterior alpha activity and beta frequencies in the EEG in each case.Fpl -F3 C3- P3 -.
Anatomical Abnormalities in the Brains of Monozygotic Twins Discordant for Schizophrenia
Authors: Richard L. Suddath, George W. Christison, E. Fuller Torrey, Manuel F. Casanova, Daniel R. Weinberger
Journal: New England Journal of Medicine (1990)

Recent neuroradiologic and neuropathological studies indicate that at least some patients with schizophrenia have slightly enlarged cerebral ventricles and subtle anatomical abnormalities in the region of the anterior hippocampus. Using magnetic resonance imaging (MRI), we studied 15 sets of monozygotic twins who were discordant for schizophrenia (age range, 25 to 44 years; 8 male and 7 female pairs). For each pair of twins, T1-weighted contiguous coronal sections (5 mm thick) were compared blindly, and quantitative measurements of brain structures were made with a computerized image-analysis system.
Circulating regulatory (CD4+CD25+FOXP3+) T cells decrease in breast cancer patients after vaccination with an Ii-Key-modified class II HER2/<i>neu</i> peptide (AE37).
Authors: JD Gates, LC Benavides, MG Carmichael, MT Hueman, JP Holmes, S Khoo, A Stojadinovic, E von Hofe, S Ponniah, GE Peoples
Journal: Cancer Research (2009)

Abstract Abstract #3134 Background: CD4+CD25+FOXP3+ regulatory T cells (Tregs) have been implicated in the suppression of immune responses against various tumors. To monitor the potential induction of Tregs in breast cancer (BrCa) patients receiving a modified HLA Class II HER2/neu peptide (AE37) vaccine in a clinical trial, we have analyzed peripheral blood lymphocytes (PBL) from vaccinated patients for the presence of Tregs and correlated our findings with ex vivo immune assays and in vivo delayed type hypersensitivity (DTH) responses to the vaccine. Methods: Fifteen BrCa patients have completed 6 monthly injections of the AE37+GM-CSF vaccine in a dose escalation safety study. The AE37 peptide consists of a HER2/neu peptide (776-790) linked to the Ii-Key moiety of the HLA Class II-associated invariant chain, which enhances epitope interaction with the Class II molecule. PBL obtained pre- and post-vaccination were stained with anti-CD4/CD25 (n=15) and FOXP3 (n=9) antibodies (PCH101 and 236A/E7) and analyzed by flow cytometry. Cells were also stimulated ex vivo with AE37 peptide to measure IFN-γ ELISPOT, proliferation (3H-thymidine-cpm) and cytokine secretion (TGF-β). DTH responses to the AE37 peptide pre- and post-vaccination were also recorded. Results: The mean CD4+ and CD4+CD25+ T cell populations for all patients (n=15) did not change from pre- to post-vaccination (CD4+ = 52.3+3.3% vs. 50.5+3.9%, p=0.6; CD4+CD25+ = 1.9+0.2% vs. 2.4+0.5%, p=0.2). Tregs (CD4+CD25+FOXP3+) were reduced in all 9 patients tested pre- to post-vaccination for both FOXP3 antibodies (Ab) (FOXP3 Ab1 = 2.1+0.2% vs. 1.1+0.1%, p=0.002; FOXP3 Ab2 = 2.0+0.2% vs. 1.0+0.2%, p=0.0009). There was no difference in pre- to post-vaccination levels of TGF-β (2720+582 pg/ml vs. 3387+848 pg/ml; p=0.9). AE37-specific proliferative responses increased from pre- to post-vaccination (34+23cpm vs. 6427+1431 cpm; p&amp;lt;0.001). ELISPOT demonstrated an increased response from pre- to long term (6-12mo.) post-vaccination (Median – 2 vs. 34 spots/106 cells; p=0.003). DTH responses increased in all patients from pre- to post-vaccination (3.6+1.4 mm vs. 56.0+9.4 mm; p&amp;lt;0.0001), and there appeared to be an inverse relationship between the degree of Treg reduction and the size of DTH response to AE37 (R2=0.83).&amp;#x2028; Discussion: The novel AE37 HER2/neu peptide vaccine does not result in increased levels of Tregs. Furthermore, the reduced levels of Tregs in vaccinated patients appear to be associated with more robust responses in ex vivo immune assays and in vivo DTH reactions suggesting that the AE37 vaccine may be clinically useful. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3134.
JAMA 75 Years Ago
Authors: Robert H. Ivy
Journal: JAMA (1968)

<h3>To the Editor:—</h3> In the Journal's reprintings from 75 years ago two recent issues have recounted procedures which today would fall under the heading of plastic surgery. The first was "Cosmetic Surgery of the Nose" from Aug 20, 1892, and reprinted in the Aug 21, 1967, issue. The second, on the topic of Thiersch's grafts from Sept 10,1892, was reprinted in the Sept 11, 1967, issue. Each of these was written originally in the first person, and it was difficult to understand why the authors' names were not given when reprinted. From a visit to the library I found that the first had been written by John B. Roberts, MD, of Philadelphia, one of the leading general surgeons of the day, with a special interest in correction of deformities of the face. I succeeded Dr. Roberts as professor of maxillary surgery at the Philadelphia Polyclinic, in 1920. This hospital later
Abstract 5510: Immunogenicity of the MUC1/Poly-ICLC vaccine in individuals with the history of advanced colorectal adenoma
Authors: Takashi Kimura, John R. McKolanis, Robert E. Schoen, Olivera J. Finn
Journal: Cancer Research (2011)

Abstract Background: MUC1 is aberrantly expressed in human adenocarcinomas including colon cancer. Aberrant MUC1 is also found on colorectal adenomas where it promotes malignant transformation by interacting with beta-catenin, ras and other signaling pathways. Induction of immunity against MUC1 during premalignancy may prevent adenoma recurrence and/or their progression to colon cancer. Various MUC1 vaccines, peptide and adjuvant-based, dendritic cell-based or as various viral vectors, have been tested previously in small Phase I/II trials in patients with advanced cancer and have shown low immunogenicity and limited efficacy. In the cancer microenvironment, it is difficult to determine if low immunogenicity is due to the vaccine, to self-tolerance, to the immunosuppressive tumor microenvironement, previous treatments, age of the patient or all of the above. We are conducting a trial using MUC1 peptide and Poly-ICLC adjuvant vaccine in individuals who are cancer free but at high risk for developing cancer because of a recent history of advanced colorectal adenoma. Method: Patients with advanced colorectal adenoma which meets at least one of following criteria, 1) ≥ 1cm in maximal diameter, 2) with villous or tubulovillous histology, 3) with high-grade dysplasia, were vaccinated with 100μg of 100aa MUC1 peptide [H2N-(GVTSAPDTRPAPGSTAPPAH)5-CONH2] admixed with 500μg of Poly-ICLC (TLR-3 agonist) as adjuvant on week 0, 2, 10 and one year later. The primary objective is to evaluate the vaccine immunogenicity (anti-MUC1 IgG and T cell responses) and safety. Results: 43/65 patients have been enrolled. Among 31 patients studied to date, 16 developed anti-MUC1 IgG (52% response rate). This frequency of responders and the high levels of IgG (3-30 fold increase) have never been achieved in cancer patients. Antibody titers declined over time but could be boosted to previous or higher levels at 1 year, showing development of long-term memory. Confirmatory T cell assays are in progress. No adverse events above grade 1 have been identified, and no unanticipated adverse events have been observed. Conclusions: MUC1 poly-ICLC vaccine is highly immunogenic in this prophylactic setting without causing any significant adverse events. Recurrence of adenomas will be evaluated at year 3 and correlated with the immune response, however, a larger randomized trial will be needed to properly evaluate the clinical outcome. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5510. doi:10.1158/1538-7445.AM2011-5510
Diseases of the Liver
Authors: Harry B. Greenberg
Journal: JAMA (1970)

Descriptions of electron microscopic findings and discussions of recent developments in the surgery, biochemistry, immunology, genetics, and radiography of hepatic disease distinguish the third edition of Doctor Schiff's multiauthored book from its predecessors. In 30 chapters, 42 authors take up almost all aspects of hepatic function and disease. After describing bilirubin metabolism, Schiff and Billing discuss clinical approaches and pitfalls to the differential diagnosis of jaundice. They emphasize utilization of historical and physical findings as well as the results of needle biopsy and other clinical laboratory examinations. Rousselot and Burchell explain techniques and indications for percutaneous splenic portography and manometry, procedures they consider invaluable for assessing anatomic and hemodynamic situations in suspected portal hypertension. And finding it determinative, practical, and safe, they employ emergency splenic pulp manometry to distinguish between a variceal or nonvariceal site of acute upper-gastrointestinal hemorrhage. Throughout the book the authors present controversial issues, examine conflicting theories,
Gene Transfer to Hematopoietic Cells
Authors: Malcolm K. Brenner
Journal: New England Journal of Medicine (1996)

Although diseases of blood cells constitute a relatively small proportion of clinical disorders, many valuable studies of gene transfer have relied on hematopoietic stem cells or their progeny. What features of these cells explain their appeal in gene therapy? Perhaps most important is their hierarchical pattern of development (Figure 1). Fewer than 1 in 100,000 bone marrow cells are pluripotent, self-renewing hematopoietic stem cells, but these rare cells yield progeny that multiply by many hundredfold and, in the process, follow a particular blood-cell lineage (monocytic, lymphocytic, granulocytic, megakaryocytic, or erythrocytic). These committed progenitors then multiply by a hundredfold or more . . .
Fully covered self-expandable metallic stents in the management of complex biliary leaks: preliminary data – a case series
Authors: A. Wang, K. Ellen, C. Berg, T. Schmitt, M. Kahaleh
Journal: Endoscopy (2009)

Biliary leaks typically occur following traumatic injury [1] [2] or surgical intervention, such as cholecystectomy, partial hepatic resection, and liver transplantation. A clinically significant postoperative bile leak occurs in 0.1 % – 0.5 % of open cholecystectomies [3], 0.8 % – 2 % of laparoscopic cholecystectomies [3] [4] [5] [6], about 12 % of cadaveric liver transplantations [7], and 6 % – 14 % of hepatic resections [8].
Reevaluating the Role of LTD in Cerebellar Motor Learning
Authors: Martijn Schonewille, Zhenyu Gao, Henk-Jan Boele, Maria F. Vinueza Veloz, Wardell E. Amerika, Antonia A.M. Šimek, Marcel T. De Jeu, Jordan P. Steinberg, Kogo Takamiya, Freek E. Hoebeek, David J. Linden, Richard L. Huganir, Chris I. De Zeeuw
Journal: Neuron (2011)
Absence of Immunoreactive Vasoactive Intestinal Polypeptide in Tissue from the Lungs of Patients with Asthma
Authors: Suzanne Ollerenshaw, Deborah Jarvis, Ann Woolcock, Colin Sullivan, Tethys Scheibner
Journal: New England Journal of Medicine (1989)

Vasoactive intestinal polypeptide (VIP) is a neuropeptide present in the nerve fibers of normal lungs, where it acts to relax bronchial smooth muscle. To determine its presence or absence in the lungs of patients with asthma, we examined lung tissue obtained at autopsy or lobectomy from five patients with asthma and nine without asthma. The avidin–biotin–peroxidase complex technique was used to stain tissue for immunoreactivity to VIP. At least 80 tissue sections from each patient were examined microscopically; the airway diameter ranged from 100 μm to 1.2 cm. Immunoreactive VIP was seen within nerves in more than 92 percent of the sections from the lungs of patients without asthma. No VIP was seen in any of 468 sections we could evaluate that were obtained from the lungs of patients with asthma. As a control for the nonspecific destruction of neuropeptides, immunostaining for substance P was also carried out. Abundant amounts of this neuropeptide were seen within nerves in tissue from the lungs of all patients. We conclude that in patients with asthma there is a loss of VIP from the pulmonary nerve fibers that may diminish neurogenically mediated bronchodilation. Whether this loss is a cause or a result of asthma is unclear. (N Engl J Med 1989;320:1244–8.)
Correction of hyponatraemia improves cognition, quality of life, and brain oedema in cirrhosis
Authors: Vishwadeep Ahluwalia, Douglas M. Heuman, George Feldman, James B. Wade, Leroy R. Thacker, Edith Gavis, HoChong Gilles, Ariel Unser, Melanie B. White, Jasmohan S. Bajaj
Journal: Journal of Hepatology (2014)
Distribution of pesticides and polycyclic aromatic hydrocarbons in house dust as a function of particle size.
Authors: R G Lewis, C R Fortune, R D Willis, D E Camann, J T Antley
Journal: Environmental Health Perspectives (1999)

House dust is a repository for environmental pollutants that may accumulate indoors from both internal and external sources over long periods of time. Dust and tracked-in soil accumulate most efficiently in carpets, and the pollutants associated with dust and soil may present an exposure risk to infants and toddlers, who spend significant portions of their time in contact with or in close proximity to the floor and who engage in frequent mouthing activities. The availability of carpet dust for exposure by transfer to the skin or by suspension into the air depends on particle size. In this study, a large sample of residential house dust was obtained from a commercial cleaning service whose clients were homeowners residing in the Raleigh-Durham-Chapel Hill (Research Triangle) area of North Carolina. The composite dust was separated into seven size fractions ranging from < 4 to 500 microm in diameter, and each fraction was analyzed for 28 pesticides and 10 polycyclic aromatic hydrocarbons (PAHs). Over 20% of the fractionated dust sample consisted of particles < 25 microm in diameter. Fourteen pesticides and all 10 of the target PAHs were detected in one or more of the seven size-fractionated samples. Sample concentrations reported range from 0.02 to 22 microg/g; the synthetic pyrethroids cis- and trans-permethrin were the most abundant pesticide residue. The concentrations of nearly all of the target analytes increased gradually with decreasing particle size for the larger particles, then increased dramatically for the two smallest particle sizes (4-25 microm and < 4 microm).
Comparative Left Ventricular Dimensions in Trained Athletes
Authors: JOEL MORGANROTH
Journal: Annals of Internal Medicine (1975)

Little is known about the structure of athletes' hearts or anatomic variations associated with training. Echocardiograms of 56 active athletes were obtained. Mean left ventricular end-diastolic volume and mass were increased in athletes involved in isotonic exercise, such as swimming (181 ml, 308 g) and running (160 ml, 302 g), compared with controls (101 ml, 211 g); wall thickness was normal (≤ 12 mm). Athletes involved in isometric exercise, such as wrestling and shot putting, had normal mean left ventricular end-diastolic volumes (110 ml, 122 ml), but increased wall thickness (13 to 14 mm) and mass (330 g, 348 g). Thus, athletes participating in isotonic exercise had increased left ventricular mass with cardiac changes similar to those in chronic volume overloads. Athletes participating in isometric exercise had increased left ventricular mass with cardiac changes similar to those in chronic pressure loads. Recognizing greater left ventricular mass and volume in well-trained athletes aids in interpreting values deviating from "normal" limits.
Pulmonary T cell repertoire in patients with graft-versus-host disease following blood and marrow transplantation
Authors: Vladimir V. Yurovsky, Michele H. Cottler-Fox, Sergei P. Atamas, Carl B. Shanholtz, E. James Britt, Lyle L. Sensenbrenner, Barbara White
Journal: American Journal of Hematology (2000)

Pulmonary inflammation is one of the risk factors associated with blood and marrow transplantation (BMT). To determine the potential role of T cells in pulmonary complications after transplantation, we analyzed the T-cell repertoire expressed in bronchoalveolar lavage fluids from eleven patients with graft-versus-host disease following BMT. A reverse transcriptase-polymerase chain reaction was used to amplify rearranged TCR transcripts in unfractionated, CD4+, and CD8+ T cells from bronchoalveolar lavage fluids. The relative expression of TCR variable (V) gene families and the diversity of junctional region lengths associated with different AV and BV gene families were analyzed. Nearly all TCR AV and BV gene families were detected in bronchoalveolar lavage cells from BMT recipients. Oligoclonal patterns of TCR junctional region lengths were observed in unfractionated, CD4+, and CD8+ bronchoalveolar T cells. The oligoclonal expansion of bronchoalveolar T cells in patients was confirmed by DNA sequencing. TCRV gene expression is almost completely restored in the lungs of BMT recipients as early as two weeks after transplantation. Increased oligoclonality among TCR gene families suggests either an incomplete restoration of TCR diversity or an antigen-driven expansion of T cells in the lungs of BMT recipients with graft-versus-host disease, not necessarily related to pulmonary infection.
Is evidence-based medicine teaching and learning directed at improving practice?
Authors: Sadia Mahmood Malick, Julie Hadley, James Davis, Khalid S Khan
Journal: Journal of the Royal Society of Medicine (2010)

Introduction
Evidence-based medicine (EBM) has evolved as a key skill to be taught and learnt in medical education. There are several methods for teaching EBM1–3 but the aim of teaching should be to impart knowledge, attitudes and skills to improve clinician performance and patient care. Without an adequate assessment it is difficult to know whether a teaching intervention has the desired effect. How frequently is teaching directed to achieve these objectives and how good are we at measuring learning achievement? An overview of assessments used in studies evaluating outcomes of EBM teaching was undertaken to address this question.

There are many publications on the outcomes of EBM teaching but little has been written about the coverage of educational domains in tools used for assessing outcomes. A systematic review4,5 on this subject failed to examine if studies covered established educational domains grounded in Bloom's taxonomy6 and Kirkpatrick's hierarchy,7 which allow examination of the impact of teaching on a sliding scale from a simple record of attendance to application of evidence in practice leading to improvements in health outcomes. We evaluated how existing EBM assessments rank on these scales. We also examined measurement quality of tools in terms of validity.
Early Diagnosis and Prevention of Sporadic Colorectal Cancer1
Authors: R. Lambert, D. Provenzale, N. Ectors, H. Vainio, M. F. Dixon, W. Atkin, M. Werner, S. Franceschi, H. Watanabe, G. N. Tytgat, A. T. Axon, H. Neuhaus
Journal: Endoscopy (2001)

Most cases of colorectal (CR) cancer are sporadic; a small percentage occur in heritable syndromes such as familial adenomatous polyposis (FAP), attenuated adenomatous polyposis coli, flat adenoma syndrome, hereditary nonpolyposis CR cancer (HNPCC), juvenile polyposis syndromes, Peutz-Jeghers syndrome and hereditary non-FAP, non-HNPCC.