tbuckley/cabot-search huggingface dataset:
Respiratory Syncytial Virus Pneumonia
Authors: G. J. Kasupski
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The report by Crane et al (1981;246:366) of a fatal respiratory syncytial virus (RSV) pneumonia in a severely immunocompromised adult is of considerable interest and importance. We recently described a nosocomial outbreak of RSV infection in an oncology unit, in which two patients with acute lymphoblastic leukemia had roentgenographically confirmed pneumonias develop (<i>Am J Med Sci</i>, to be published). Substantial rises in complement-fixing antibody titers to RSV provided the basis for our diagnoses, and extensive microbiological investigations failed to reveal any other etiologic agent. Both patients made uneventful, although gradual, recoveries. The patient described by Crane et al received induction chemotherapy during his illness and failed to produce anti-RSV antibodies. In contrast, our patients did not receive chemotherapy during their illness, and both showed specific humoral antibody responses to RSV infection. Humoral antibody responses may have contributed to our patients' survival but did not prevent invasion of
Systematic review of clinical effectiveness of pressurised metered dose inhalers versus other hand held inhaler devices for delivering corticosteroids in asthma
Authors: D. Brocklebank, J. Wright, C. Cates
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objective:</b> To determine the clinical effectiveness of pressurised metered dose inhalers (with or without spacer) compared with other hand held inhaler devices for the delivery of corticosteroids in stable asthma. <b>Design:</b> Systematic review of randomised controlled trials. <b>Data sources:</b> Cochrane Airways Group trials database (Medline, Embase, Cochrane controlled clinical trials register, and hand searching of 18 relevant journals), pharmaceutical companies, and bibliographies of included trials. <b>Trials:</b> All trials in children or adults with stable asthma that compared a pressurised metered dose inhaler with any other hand held inhaler device delivering the same inhaled corticosteroid. <b>Results:</b> 24 randomised controlled trials were included. Significant differences were found for forced expiratory volume in one second, morning peak expiratory flow rate, and use of drugs for additional relief with dry powder inhalers. However, either these were within clinically equivalent limits or the differences were not apparent once baseline characteristics had been taken into account. No significant differences were found between pressurised metered dose inhalers and any other hand held inhaler device for the following outcomes: lung function, symptoms, bronchial hyper-reactivity, systemic bioavailability, and use of additional relief bronchodilators. <b>Conclusions:</b> No evidence was found that alternative inhaler devices (dry powder inhalers, breath actuated pressurised metered dose inhalers, or hydrofluoroalkane pressurised metered dose inhalers) are more effective than the pressurised metered dose inhalers for delivery of inhaled corticosteroids. Pressurised metered dose inhalers remain the most cost effective first line delivery devices. <h3>What is already known on this topic</h3> Many inhaler devices are available for administering inhaled corticosteroids Current guidelines for their use are inconsistent and not evidence based <h3>What this study adds</h3> This systematic review found no evidence that alternative inhaler devices are more effective than pressurised metered dose inhalers for giving inhaled corticosteroids. Pressurised metered dose inhalers (or the cheapest device) should be first line treatment in all patients with stable asthma
Cytopathological Interpretation and Medical Consultation
Authors: G D Malkasian
Journal: JAMA (1989)

DURING the years since the introduction of the Papanicolaou classification, there has evolved increased understanding of cervical and vaginal neoplasia. This classification did not reflect an equivalent tissue diagnosis that could be unequivocally interpreted by the attending clinician, and it did not reflect the now-accepted noncancerous cervical and vaginal changes. It was time for the development of new terminology and classifications of cervical and vaginal cytology that would reflect clearly current knowledge of the histological changes as related to cytological findings. Furthermore, there was the clamor about the need for evaluation and regulation of laboratories providing interpretation of the smears. Obviously, without a standard, clearly understood terminology, there would be no acceptable way to evaluate the interpretation of the cytological smears on a nationwide basis. To this end, the American College of Obstetricians and Gynecologists wholeheartly participated, along with 10 other groups, in the Workshop on the Terminology for Cervical
Ventricular Tachyarrhythmia Associated With Psychological Stress
Authors: Michael A. Brodsky
Journal: JAMA (1987)

Psychological stress has been reported to be a risk factor for sudden cardiac death in individuals both with and without underlying structural heart disease. From a group of 80 patients presenting with life-threatening ventricular tachyarrhythmia, six were identified without underlying structural heart disease. Five of these six patients experienced marked psychological stress. Each of these five patients underwent arrhythmia evaluation, demonstrating recurrent rapid monomorphic ventricular tachycardia related to changes in tone of the sympathetic nervous system. Subsequently, solitary beta-adrenergic blocker therapy was given to each patient. During therapy, four of the five patients had a marked reduction of both arrhythmia and symptoms during a follow-up ranging from 29 to 49 (mean, 38) months.
Demand for patient care.
Authors: S N Donaldson, A Barr
Journal: BMJ (1977)

occasion, 20 or so ticks off my skin, not giving them time to dig in.They are easy to remove if it is done promptly after a walk through their habitat.Ticks can transmit a variety of arbovirus and rickettsial infections to man, but probably rarely do so in Britain.Some 33 cases a year of Q fever are reported in Scotland.Possibly some of these may have been transmitted by tick bites but probably most infections are acquired through milk, meat, or the handling of infected animals or their afterbirths.
On Resetting of "Barostats" in Hypertensive Patients
Authors: Richard H. Thurm
Journal: JAMA (1967)

Approximately ten years ago, it was shown that when hypertension was induced in dogs by a Goldblatt clamp, the carotid sinus was reset, becoming insensitive to the elevated pressure. Is it then conceivable that antihypertensive therapy may result in a lowering of this "barostat" setting, permitting discontinuation of therapy? The US Public Health Service Cooperative Study of Hypertension provided an opportunity to evaluate this question. Sixty-nine "responders" to various antihypertensive agents had their medications discontinued after an average response period of more than two years, with uninterrupted recordings of the pressure at home. Twenty-five patients remained responders (average diastolic pressure below 90 mm Hg) for at least five months. Of this group, nine required reinstitution of therapy, 5 to 24 months later, due to the gradual rise of their diastolic pressures.
Cell Lineage Analysis of a Mouse Tumor
Authors: Dan Frumkin, Adam Wasserstrom, Shalev Itzkovitz, Tomer Stern, Alon Harmelin, Raya Eilam, Gideon Rechavi, Ehud Shapiro
Journal: Cancer Research (2008)

Abstract Revealing the lineage relations among cancer cells can shed light on tumor growth patterns and metastasis formation, yet cell lineages have been difficult to come by in the absence of a suitable method. We previously developed a method for reconstructing cell lineage trees from genomic variability caused by somatic mutations. Here, we apply the method to cancer and reconstruct, for the first time, a lineage tree of neoplastic and adjacent normal cells obtained by laser microdissection from tissue sections of a mouse lymphoma. Analysis of the reconstructed tree reveals that the tumor initiated from a single founder cell, ∼5 months before diagnosis, that the tumor grew in a physically coherent manner, and that the average number of cell divisions accumulated in cancerous cells was almost twice than in adjacent normal lung epithelial cells but slightly less than the expected figure for normal B lymphocytes. The cells were also genotyped at the TP53 locus, and neoplastic cells were found to share a common mutation, which was most likely present in a heterozygous state. Our work shows that the ability to obtain data regarding the physical appearance, precise anatomic position, genotypic profile, and lineage position of single cells may be useful for investigating cancer development, progression, and interaction with the microenvironment. [Cancer Res 2008;68(14):5924–31]
Taste and smell: the neglected senses
Authors: Terra Ziporyn
Journal: JAMA (1982)

The author of this theory is the Epicurean poet Lucretius (first century BC), but he almost could have been a modern proponent of a steric theory of taste or smell. Beyond that likeness, the word "theory" is important because that, more than fact, has characterized much of our "information" about taste and smell to this day. Thus, although more than 2 million American adults suffer from loss or impairment of olfactory of gustatory senses (so says the recent report of the Panel of Communicative Disorders to the National Advisory Neurological and Communicative Disorders and Stroke Council), biomedical scientists still do not understand much more than Lucretius did about why sugar tastes sweet or fire smells smoky. What they are beginning to understand, however, is that the "chemical senses" have considerable medical significance. As a consequence of this spreading awareness, the National Institute of Neurological and Communicative Disorders and Stroke recently
Health risks of volunteering
Authors: J. O. Drife
Journal: BMJ (2009)

The urge to do voluntary work overseas is strongest at the extremes of medical life. If, like me, you are an ageing academic, think carefully. Your health is precious, and there are several hazards that aren’t mentioned on the Foreign Office website.

Physical violence: The Foreign Office advises you to be sensible and avoid high risk areas, but that isn’t always possible. In South Kensington, for example, the desire to throttle someone can become overwhelming as you wait for hours …
Lung Carcinomas with EGFR Exon 19 Insertions Are Sensitive to Gefitinib Treatment
Authors: Aglaya G. Iyevleva, Natalia V. Mitiushkina, Nina A. Karaseva, Sergey V. Orlov, Larisa N. Volodina, Yulia E. Kulikova, Alexandra M. Lozhkina, Alexandr O. Ivantsov, Vladislav I. Tiurin, Alexandr V. Togo, Evgeny N. Imyanitov
Journal: Journal of Thoracic Oncology (2014)
The Dispensary Question.
Authors: Wm. E. Wirt
Journal: JAMA (1894)

Cleveland, Ohio, Nov. 1,1894. <h3>To the Editor:</h3> —I have noticed that ourJournalhas from time to time denounced the " dispensary abuse," but, on the other hand, I have noticed the apparent apathy of the profession in regard to this question. I would call your attention to the fact that here in Cleveland we have the profession at large agitated over the question of the dispensary abuse, partly brought about by a trial going on between two homeopathic physicians in regard to this dispensary question —the judges in the case being two trustees of their college In my own case the trial was before a jury in a justice court. I sued the defendant for services rendered. The defendant came to the college dispensary looking for the surgeon who treated cripples. On being questioned he asserted a willingness to pay. He stated that he had a correspondence with Columbus, Ohio,
The Use of ACTH and Cortisone in Dermatology
Authors: John G. Downing
Journal: New England Journal of Medicine (1952)

PROBABLY the most important recent development in dermatologic therapy has been the availability of adrenocorticotrophic hormone and cortisone. With the startling announcements in the lay press of their remarkable curative powers, patients with acute or chronic dermatoses began requesting their therapeutic trial. These drugs, even in ointment form, are alleged in newspaper and magazine accounts to have cured almost all cutaneous eruptions, from simple eczema to pemphigus.Medical literature has, fortunately, been more conservative. Various reports have shown how valuable Cooperative work between dermatologists and internists has been in properly evaluating new drugs, and as a result definite progress has . . .
Abstract PL04-02: The breast epithelial hierarchy and its implications for tumor heterogeneity
Authors: Jane E. Visvader, Anne Rios, Naiyang Fu, Emma Nolan, Geoffrey Lindeman
Journal: Cancer Research (2014)

Abstract Breast cancer is a highly heterogeneous disease at both the molecular and pathological levels. To understand this heterogeneity and ‘cells of origin’ of breast cancer, it is important to dissect the normal mammary epithelial hierarchy. Discrete populations of mouse and human mammary epithelial cells can be isolated on the basis of cell surface marker expression. To date, subpopulations that are highly enriched for mammary stem (MaSC), luminal progenitor and mature luminal cells have been identified. Notably, these are functionally analogous across human and mouse and share highly conserved transcriptomes. Lineage tracing is an important strategy for assessing the stem cell hierarchy as it allows stem and progenitor cell fate to be studied in situ in the context of development, tissue maintenance and disease. We have combined lineage tracing with a novel three-dimensional (3D) imaging strategy to explore the relative contributions of stem and progenitor cells to post-natal mammary gland development and tissue homeostasis. Cell lineage tracing studies also provide the current gold standard for identifying ‘cells of origin’ in cancer. Towards this end, we are utilizing newly generated transgenic strains harboring lineage-specific gene regulatory regions to direct the expression of specific mammary oncogenic lesions to discrete epithelial cell types. In terms of human breast cancer, the interrogation of molecular profiles has provided insight into potential ‘cells of origin’ in preneoplastic tissue for basal-like cancers arising in BRCA1 mutation carriers. Finally, the identification of deregulated genes/pathways in these crucial target cell populations may enable earlier detection of malignancies and lead to preventative therapies for individuals at high risk of developing breast cancer. Citation Format: Jane E. Visvader, Anne Rios, Naiyang Fu, Emma Nolan, Geoffrey Lindeman. The breast epithelial hierarchy and its implications for tumor heterogeneity. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr PL04-02. doi:10.1158/1538-7445.AM2014-PL04-02
A Randomized Controlled Trial of Academic Group Practice
Authors: Harold I. Goldberg
Journal: JAMA (1987)

We conducted a controlled trial of the adoption of a group-practice model within an academic department of medicine. Ongoing randomization yielded similar groups of patients and residents. To determine the effect of the intervention on medicine-clinic operation, we monitored the hospital outpatient activity of 28 residents and 2299 patients during an 11-month study period. The group-practice clinics generated 20% more patient encounters per month than did the traditional, control clinics (328 vs 273 encounters), primarily because twice as many voluntary, overflow clinic sessions were scheduled (20.2 vs 9.7 sessions). Yet, because group-practice registration was decentralized, patients spent 15% less time in completing scheduled visits (93.2 vs 109.9 minutes). Regular utilizers of the group practices made 7% more scheduled clinic visits on average (3.27 vs 3.05 visits), but 39% fewer walk-in visits (0.14 vs 0.23 visits). Hospital-wide, continuity of care was not affected. We conclude that adoption of a group-practice model at our institution improved clinic productivity, enhanced patient flow, and decreased unscheduled clinic visits.
May the force be with you
Authors: Des Spence
Journal: BMJ (2007)

“Use the force, Luke. Let go!” He turned off his targeting computer—certain folly! But the torpedoes went down the ventilation shaft and Death Star, the most advanced weapon ever to threaten the universe, exploded. The whole cinema jumped and whooped as one. My brother shouted, “Even better than Smokey and the Bandit .” We spent the next few years imaging we were duffle coated Jedi knights, following the code and saving the universe, tapping into the timeless and invisible power of “the force.” Light-sabre sticks spluttered and buzzed as …
The cost of reading
Authors: T. Dalrymple
Journal: BMJ (2010)

A famous author who was also a doctor, Somerset Maugham, once wrote that he was so devoted to reading that he would rather read a train timetable than nothing at all. I understand this state of mind well. Once, in a hotel room in Los Angeles, I had nothing but the telephone directory and spent two hours happily reading it. I was most impressed by the number of private detectives (none called Philip Marlowe).

The other day I was on a train with nothing to read but a bookseller’s catalogue, from 1960, of “Old Medicine and Science.” This, too, I read happily for two hours. Ah, if I had only had the number …
Facet joints and low back pain.
Authors: M Mehta
Journal: BMJ (1978)

data).Under these circumstances the usual effects of noradrenaline, causing marked reductions in heart rate and cardiac output, do not occur.Thus atropine, alone or after beta-blockers, can raise blood pressure and heart rate while maintaining cardiac output.From these observations therefore we would endorse the use of atropine in doses of at least 3 mg as bolus injections.Furthermore, as an alternative to isoprenaline in patients still hypotensive we would recommend graded infusions of noradrenaline to restore blood pressure provided atropine has been given previously.Under these circumstances heart rate and cardiac output are likely to be satisfactorily maintained and blood pressure restored.
Thermal compression and molding of atherosclerotic vascular tissue with use of radiofrequency energy: Implications for radiofrequency balloon angioplasty
Authors: Benjamin I. Lee, Gary J. Becker, Bruce F. Waller, Kevin J. Barry, Raymond J. Connolly, Jonathan Kaplan, Alan R. Shapiro, Paul C. Nardella
Journal: Journal of the American College of Cardiology (1989)
Like a virgin (mother): analysis of data from a longitudinal, US population representative sample survey
Authors: A. H. Herring, S. M. Attard, P. Gordon-Larsen, W. H. Joyner, C. T. Halpern
Journal: BMJ (2013)

<b>Objective</b> To estimate the incidence of self report of pregnancy without sexual intercourse (virgin pregnancy) and factors related to such reporting, in a population representative group of US adolescents and young adults. <b>Design</b> Longitudinal, population representative sample survey. <b>Setting</b> Nationally representative, multiethnic National Longitudinal Study of Adolescent Health, United States. <b>Participants</b> 7870 women enrolled at wave I (1995) and completing the most recent wave of data collection (wave IV; 2008-09). <b>Main outcome measures</b> Self reports of pregnancy and birth without sexual intercourse. <b>Results</b> 45 women (0.5%) reported at least one virgin pregnancy unrelated to the use of assisted reproductive technology. Although it was rare for dates of sexual initiation and pregnancy consistent with virgin pregnancy to be reported, it was more common among women who signed chastity pledges or whose parents indicated lower levels of communication with their children about sex and birth control. <b>Conclusions</b> Around 0.5% of women consistently affirmed their status as virgins and did not use assisted reproductive technology, yet reported virgin births. Even with numerous enhancements and safeguards to optimize reporting accuracy, researchers may still face challenges in the collection and analysis of self reported data on potentially sensitive topics.
Long-incubation (virus B, HAA-associated) hepatitis.
Authors: S Sherlock
Journal: Gut (1972)

Virus B hepatitis is differentiated from virus A hepatitis by the presence ofAustralia antigen in the serum.This most interesting antigen was discovered incidentally.In 1965, Blumberg, a geneticist, and his colleagues were working in Philadelphia on the development of antibodies against human serum lipoproteins in multiply transfused subjects.They found that in two haemo- philic patients there was an antibody which reacted with an antigen in a single serum in their panel and this came from an Australian Aborigine'.The antibody, an immunoglobulin G, was found in many patients who had been multiply transfused.Later it was detected in some 20 % of patients with viral hepatitis.Because of its discovery in an Aboriginal serum, the antigen was called Australia antigen.The more general term, hepatitis-associated antigen (HAA), is also employed.The antigen is present in about 82 % of sera from patients suffering from long-incubation hepatitis if tested within 12 days of the onset of symptoms.It is usually cleared from the serum by three to four weeks.Patients transfused with blood containing the antigen will either develop icteric or anicteric hepatitis or will remain asymptomatic2.Virus B hepatitis has an incubation period of 50 to 160 days compared with virus A infection which has an incubation period of 15 to 50 days.297 on August 20,
DHEA in Elderly Women and DHEA or Testosterone in Elderly Men
Authors: K. Sreekumaran Nair, Robert A. Rizza, Peter O'Brien, Ketan Dhatariya, Kevin R. Short, Ajay Nehra, Janet L. Vittone, George G. Klee, Ananda Basu, Rita Basu, Claudio Cobelli, Gianna Toffolo, Chiara Dalla Man, Donald J. Tindall, L. Joseph Melton, Glenn E. Smith, Sundeep Khosla, Michael D. Jensen
Journal: New England Journal of Medicine (2006)

Dehydroepiandrosterone (DHEA) and testosterone are widely promoted as antiaging supplements, but the long-term benefits, as compared with potential harm, are unknown.We performed a 2-year, placebo-controlled, randomized, double-blind study involving 87 elderly men with low levels of the sulfated form of DHEA and bioavailable testosterone and 57 elderly women with low levels of sulfated DHEA. Among the men, 29 received DHEA, 27 received testosterone, and 31 received placebo. Among the women, 27 received DHEA and 30 received placebo. Outcome measures included physical performance, body composition, bone mineral density (BMD), glucose tolerance, and quality of life.As compared with the change from baseline to 24 months in the placebo group, subjects who received DHEA for 2 years had an increase in plasma levels of sulfated DHEA by a median of 3.4 microg per milliliter (9.2 micromol per liter) in men and by 3.8 microg per milliliter (10.3 micromol per liter) in women. Among men who received testosterone, the level of bioavailable testosterone increased by a median of 30.4 ng per deciliter (1.1 nmol per liter), as compared with the change in the placebo group. A separate analysis of men and women showed no significant effect of DHEA on body-composition measurements. Neither hormone altered the peak volume of oxygen consumed per minute, muscle strength, or insulin sensitivity. Men who received testosterone had a slight increase in fat-free mass, and men in both treatment groups had an increase in BMD at the femoral neck. Women who received DHEA had an increase in BMD at the ultradistal radius. Neither treatment improved the quality of life or had major adverse effects.Neither DHEA nor low-dose testosterone replacement in elderly people has physiologically relevant beneficial effects on body composition, physical performance, insulin sensitivity, or quality of life. (ClinicalTrials.gov number, NCT00254371 [ClinicalTrials.gov].).