tbuckley/cabot-search huggingface dataset:
Adrenal Steroids and Diseases
Authors: Don H. Nelson
Journal: JAMA (1965)

This is probably the largest as well as the best of a series of books which in recent years have appeared on the adrenal steroids and disease. Certainly it is the most complete of these volumes which have been prepared for the use of the clinician. The author has covered almost every aspect of adrenal-steroid secretion and the effect of such secretion in either producing or affecting the course of disease in man. There are excellent sections on steroid chemistry, synthesis of the steroids, adrenal-function tests, Cushing's syndrome, virilizing syndromes, congenital-adrenal hyperplasia, primary aldosteronism, and others. The author, who has worked in this field for many years, has demonstrated his grasp of the development of our knowledge of the adrenal gland and, in putting together the volume, he has done a highly commendable job of covering the literature. Bibliographic references are numerous. Although many volumes which try to provide such
Suppression of Cellular Immunity in Men With a Past History of Posttraumatic Stress Disorder
Authors: Noriyuki Kawamura, Yoshiharu Kim, Nozomu Asukai
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: High rates of medical morbidity have been reported in subjects with posttraumatic stress disorder (PTSD). The authors examined immune function in subjects in remission from past PTSD. METHOD: The initial study group was composed of 1,550 Japanese male workers. Japanese versions of the Events Check List, the Impact of Event Scale—Revised, and the Diagnostic Interview Schedule for DSM-IV were used to identify subjects who had a past history of PTSD. Twelve of the workers were identified as having such a history. These men were matched in age and smoking habits, which affect immunity, to 48 comparison subjects who had similar stressful life experiences but no current or past history of PTSD. Natural killer (NK) cell activity, lymphocyte subset counts, and production of interferon γ (IFN-γ) and interleukin-4 (IL-4) were measured in the 60 men by means of phytohemagglutinin stimulation. RESULTS: The number of lymphocytes, number of T cells, NK cell activity, and total amounts of IFN-γ and IL-4 were significantly lower in the 12 men with a past history of PTSD. CONCLUSIONS: PTSD leaves a long-lasting immunosuppression and has long-term implications for health.
The Prevention of Heart Failure — A New Agenda
Authors: Jay N. Cohn
Journal: New England Journal of Medicine (1992)

Chronic congestive heart failure is often a lethal disease. Even though clinical trials have documented improved survival when enalapril1 2 3 or hydralazine plus isosorbide dinitrate3 , 4 was added to digoxin and diuretic therapy, more than 40 percent of the patients in such trials died in the first four years after enrollment. The emphasis has therefore begun to shift toward preventive strategies that are based on physiologic data supporting the idea that cardiac dysfunction and symptoms progress independently from the underlying myocardial disease.5 The results of three different approaches to the prevention of heart failure are described in this issue of the Journal . . .
Magnetic resonance imaging--1: Basic principles of image production.
Authors: P Armstrong, S F Keevil
Journal: BMJ (1991)

<h3>Objective</h3> The Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group (WG) operates research activities for the validation of US as an outcome measurement instrument according to the Filter 2.0 framework. <h3>Methods</h3> Original publications on definitions and scoring systems for pathophysiological manifestations and elementary lesions of various rheumatic disorders were reviewed from the onset of the WG research in 2005. <h3>Results</h3> Definitions and scoring systems according to new terminology are provided. <h3>Conclusion</h3> We have redefined OMERACT US pathology and elementary lesions as well as scoring.
Hospital Outbreak of Infections with Group A Streptococci Traced to an Asymptomatic Anal Carrier
Authors: William Schaffner, Lewis B. Lefkowitz, Jay S. Goodman, M. Glenn Koenig
Journal: New England Journal of Medicine (1969)

A PROTRACTED epidemic of 21 postoperative infections due to M-nontypable, Group A betahemolytic streptococci ceased after the implicated source, an anesthesiologist, was found to be an anal carrier of large numbers of streptococci. This is the second such outbreak reported and raises the possibility that dissemination of streptococci from an anal source is more common that is currently suspected.The OutbreakNine wound infections caused by Croup A betahemolytic streptococci occurred during three weeks in August, 1968, among general surgical, orthopedic and gynecologic patients (Fig. 1). The patients shared no common ward or operating theater and had contact with a . . .
College Credit for Medical Study.
Authors: John Rogers
Journal: JAMA (1904)

New York City, April 13, 1904. <h3>To the Editor:</h3> —In the first editorial inThe Journal, April 9, on page 956, the Medical College of Cornell University is mentioned as giving a six-year course, at the end of which the A.B. and M.D. degrees can both be obtained. Kindly note that this is an error. The university, during the first four years of the existence of its medical department, did have such a course, but since 1902 the time required for obtaining the combined degrees has been extended to seven years. In spite of this extension of time more students every year have considered it advantageous to take their A.B. degree as a precedent to entering the medical course. I trust that you will correct the statement you have made, asThe Journalhas such wide circulation.
Mechanism for fetal hemoglobin induction by histone deacetylase inhibitors involves γ-globin activation by CREB1 and ATF-2
Authors: Jose Sangerman, Moo Seung Lee, Xiao Yao, Eugene Oteng, Cheng-Hui Hsiao, Wei Li, Sima Zein, Solomon F. Ofori-Acquah, Betty S. Pace
Journal: Blood (2006)
Denial in the Medical Interview
Authors: Richard S. Moon
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Drs Ness and Ende<sup>1</sup>discuss denial in the medical interview as if only patients used it. Denial can occur on either side of the desk: physicians are not immune to this defense mechanism. Usually it is an individual defense, protective of an individual physician, patient, or opinion, but occasionally physician denial affects most of the profession. Forty years ago, most physicians did not recognize child abuse as a common cause of childhood injury. Instead, the victims were labeled as physically weak (weak bones, easy bruising) or emotionally disturbed (accident-prone). Physician denial interacts with patient denial to undermine the correct diagnosis and best treatment of patients' problems. Addressing patient denial alone leaves an irrational influence in the decision chain. Physicians must learn to recognize their own sources of denial and adjust for them. Medical organizations and medical schools should be aware that physician denial exists and help
Systemic Aspergillosis Caused By Aspergillus niger After Open-Heart Surgery
Authors: Thomas A. Mahvi
Journal: JAMA (1968)

Systemic aspergillosis caused by<i>Aspergillus niger</i>occurred in a 9-year-old boy after he had undergone open-heart surgery. There were several possible alternate routes of inoculation. The clinical manifestations of the disease appear to be similar to those of most mycotic infections caused by opportunistic fungi.
HYPODERMIC GENERAL ANESTHESIA
Authors: EUGENE R. LEWIS
Journal: JAMA (1923)

This constitutes a report of my individual experience covering more than fifteen years' use of scopolamin and morphin in conjunction with local anesthetics in nose, throat and ear surgery. After a summer semester spent at the University of Freiburg in 1905, during which my attention had been attracted by the twilight sleep in vogue in the obstetric pavilion, I conceived the idea that a modification of this hypodermic narcosis might be advantageous to ear, nose and throat surgery. Many years later I learned that the same idea had occurred to Dr. Myron Metzenbaum, and that in 1900 he had begun the application of this to surgery in this field. To Dr. Metzenbaum belongs the credit of introducing the use of this anesthesia, at least to laryngologic surgery, and as far as I know, his work may antedate that of the obstetricians. I have been unable to find the exact date
Induction of Abortion by Extra-amniotic Administration of Prostaglandins E2 and F2 
Authors: M. P. Embrey, K. Hillier, P. Mahendran
Journal: BMJ (1972)

The use of prostaglandins E<sub>2</sub> and F<sub>2</sub>α, administered by extra-amniotic instillation, for the induction of abortion was studied in 94 patients in the first and second trimesters of pregnancy. Abortion was successfully induced in 87% of patients within 36 hours and in 94% within 48 hours. The mean abortion time was 22·4 hours. In 60% of patients abortion was complete. Though the differences were not statistically significant, on average multigravid patients aborted more quickly than primigravidae, while the mean abortion time in PGE<sub>2</sub>-treated patients was less than in those receiving PGF<sub>2</sub>α. No serious complications occurred. Some side effects were observed. Occasional vomiting was the commonest symptom but the incidence of side effects was lower than with alternative routes of administration. A leucocytosis was often noted but there were no significant instances of infection. The method has proved a safe and effective means of terminating pregnancies in the second trimester.
Radiographers increase cancer detection rate, but at cost
Authors: Roger Dobson
Journal: BMJ (2008)

Breast cancer is more likely to be detected when mammograms are read by two radiologists as well as two radiographers. But double reading by both groups of professionals leads to more false-positive screens.

Research based on more than 140 000 mammograms shows that when both radiographers and radiologists double read mammograms the rate of detection of cancer rises by 7% ( European Journal of Cancer 2008 Apr 7; doi: 10.1016/j.ejca.2008.03.003). But the positive predictive value of a referral for further investigation falls from 47.5% to 36.6% (P<0.001).

“Cancer detection rates increased after the introduction of radiographer double reading in addition to radiologist double reading. This increase was the combined …
Studies in porphyria: functional evidence for a partial deficiency of ferrochelatase activity in mitogen-stimulated lymphocytes from patients with erythropoietic protoporphyria.
Authors: S Sassa, G L Zalar, M B Poh-Fitzpatrick, K E Anderson, A Kappas
Journal: Journal of Clinical Investigation (1982)

In this paper we show that the ferrochelatase defect in erythropoietic protoporphyria (EPP) can readily be identified in mitogen-stimulated lymphocytes since such cells from patients with EPP accumulate approximately twice as much protoporphyrin IX as cells from normal subjects when incubated with a porphyrin precursor, gamma-aminolevulinic acid (ALA). Treatment of cultures with ALA and with the iron chelator, CaMgEDTA significantly increased the level of protoporphyrin IX in mitogen-stimulated lymphocytes from normal subjects, while the same treatment failed to produce an increase in protoporphyrin IX in cell preparations from EPP patients. In contrast to the results with the chelator treatment, supplementation of the cultures with iron and ALA reduced the level of protoporphyrin IX in normal cells, but not in EPP cells. These findings are compatible with a partial deficiency of ferrochelatase in EPP lymphocytes. The gene defects of acute intermittent porphyria and hereditary coproporphyria have previously been identified using lymphocyte preparations from the gene carriers of these diseases. The present study demonstrates that EPP represents another form of human porphyria in which the gene defect of the disease can now be identified in lymphocyte preparations.
A8.5 Baricitinib effects on serum cholesterol and circulating lipid particles in a phase 2B study in patients with rheumatoid arthritis
Authors: J Kremer, MC Genovese, E Keystone, P Taylor, SH Zuckerman, DE Schlichting, SD Beattie, WL Macias
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Baricitinib, a novel oral JAK1/2-inhibitor, was evaluated in a Phase 2b study in patients with moderate-to-severe RA. The primary ACR20 12-week-endpoint was met, and maintained through 24 weeks.<sup>1</sup> <h3>Objective</h3> To evaluate changes in serum LDL, HDL, and total cholesterol over 24 weeks of baricitinib treatment compared with placebo. <h3>Methods</h3> Patients were randomised to QD dosing with placebo (n = 98) or 1, 2, 4, or 8 mg of baricitinib with ˜50 patients per treatment arm. Serum lipids were determined at screening, baseline and at Weeks 2, 4, 8, 12, 14, 16, 20, 24, and particle size and number were determined by Nuclear Magnetic Resonance (NMR) at baseline, Weeks 12/24. <h3>Results</h3> Baricitinib treatment resulted in dose- and time-dependent increase relative to placebo in LDL, HDL and total cholesterol detectable by Week-2. The mean percent increase in total cholesterol in the combined baricitinib arms was 9.5% (p &lt; 0.001) at Week-12 and 11.3% by Week-24. LDL-cholesterol increased 10.5% (p &lt; 0.001) in combined baricitinib arms at Week-12 and 13.7% by Week -24, HDL-cholesterol increased 11.8% (p = 0.004) and 13.4% respectively. While the magnitude of increase in HDL-cholesterol correlated with reductions in C-reactive protein observed at week-12, no similar correlation was noted for the increase in LDL-cholesterol. NMR-analysis revealed significant changes in baricitinib-treated groups relative to placebo in the size (LDL) and number (HDL, VLDL) of particles by Week-12 that were sustained at 24 weeks. The increase in LDL-cholesterol was associated with an increase primarily in the large LDL particles, which was significant at all baricitinib doses. Large LDL in the combined baricitinib arms (N = 203) had a mean value of 486 nmol/L at Week-0 which increased to 539 nmol/L at Week-12 (p = 0.001) and to 564 nmol/L at Week-24 (N = 154). No significant increases in small, medium small, or very small LDL-particles, or in total number of LDL-particles in any of the treatment arms were observed. An increase in HDL (10.3%, p = 0.006) and VLDL (28.7%, p = 0.074) particle numbers was apparent at Week-12 in the combined baricitinib arms which persisted to Week-24 with no significant increases in the mean particle size for HDL or VLDL through 24 weeks. While this analysis reflects pooled doses, the effects on lipids were most marked at 8 mg QD. <h3>Conclusions</h3> The increase in LDL-cholesterol with baricitinib treatment is attributed to a shift towards larger particles rather than an overall increase in LDL-particle number at Week-12 and persisting through 24 weeks, while changes observed in HDL-cholesterol were associated with an increase in total number of HDL-particles.<sup>1</sup> <h3>Reference</h3> Genovese MC, Keystone E, Taylor P, <i>et al</i> . <i> Arthritis Rheum </i> 2012; <b> 64 </b>:2487.
X-linked macrocytic dyserythropoietic anemia in females with an ALAS2 mutation
Authors: Vijay G. Sankaran, Jacob C. Ulirsch, Vassili Tchaikovskii, Leif S. Ludwig, Aoi Wakabayashi, Senkottuvelan Kadirvel, R. Coleman Lindsley, Rafael Bejar, Jiahai Shi, Scott B. Lovitch, David F. Bishop, David P. Steensma
Journal: Journal of Clinical Investigation (2015)

Macrocytic anemia with abnormal erythropoiesis is a common feature of megaloblastic anemias, congenital dyserythropoietic anemias, and myelodysplastic syndromes. Here, we characterized a family with multiple female individuals who have macrocytic anemia. The proband was noted to have dyserythropoiesis and iron overload. After an extensive diagnostic evaluation that did not provide insight into the cause of the disease, whole-exome sequencing of multiple family members revealed the presence of a mutation in the X chromosomal gene ALAS2, which encodes 5'-aminolevulinate synthase 2, in the affected females. We determined that this mutation (Y365C) impairs binding of the essential cofactor pyridoxal 5'-phosphate to ALAS2, resulting in destabilization of the enzyme and consequent loss of function. X inactivation was not highly skewed in wbc from the affected individuals. In contrast, and consistent with the severity of the ALAS2 mutation, there was a complete skewing toward expression of the WT allele in mRNA from reticulocytes that could be recapitulated in primary erythroid cultures. Together, the results of the X inactivation and mRNA studies illustrate how this X-linked dominant mutation in ALAS2 can perturb normal erythropoiesis through cell-nonautonomous effects. Moreover, our findings highlight the value of whole-exome sequencing in diagnostically challenging cases for the identification of disease etiology and extension of the known phenotypic spectrum of disease.
Complications of Endoscopic Retrograde Cholangiopancreatography during Live Endoscopy Workshop Demonstrations
Authors: A. Schmit, G. Lazaraki, A. Hittelet, M. Cremer, O. Le Moine, J. Devière
Journal: Endoscopy (2005)

Endoscopy workshops are thought to be associated with larger numbers of complications than routine clinical treatment. In this study, patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during live demonstrations were compared with matched patients treated in an ERCP unit.Patients who underwent ERCP during workshops over a 12-year period were reviewed. The control for each patient was the next patient admitted to the same ERCP unit with similar indications. Possible delays before treatment, ERCP indications, the use of general anesthesia, standard endoscopic and special treatments, success and complication rates for ERCP, prolonged hospitalization periods, and financial benefits for patients were assessed.A total of 168 workshop patients and 168 control patients were compared. ERCP was delayed in 18 patients to allow treatment during the workshops. General anesthesia was used in 87.5 % of the workshop patients, in comparison with 44 % of the control patients (P < 0.001). The duration of the endoscopies and radiation exposure did not differ, and the endoscopic treatments carried out also did not differ significantly, with the exception of cholangiopancreatoscopy (7 % in the workshop group versus 0 %; P < 0.01). The success and complication rates were similar in the workshop and control patients, as was the duration of hospitalization. Among the patients treated during workshops, 45 % benefited financially, as they were not charged for stents or other devices.These results suggest that, in this setting, ERCP performed during live demonstrations is safe and raises no major ethical problems.
Chylothorax after coronary artery bypass grafting.
Authors: V R Kshettry, R Rebello
Journal: Thorax (1982)

Localised pulmonary artentis in rheumatoid disease SIR,-Drs JG Armstrong and RH Steele in their report "Localised pulmonary arteritis in rheumatoid disease" (April 1982, p313) write that acute fibrinoid arteritis local- ised to one area of the lung has not been described previ- ously as a manifestation of rheumatoid disease.May we draw your attention to our publications.?' 2 In these we described a case of a 56-year-old woman with seropositive rheumatoid arthritis and migrating pneumonia.The transthoracic biopsy revealed a necrotis- ing angiitis.The administration of corticosteroids resulted in a quick and complete cure of the pulmonary disease.We would consider this as a localised pulmonary manifestation of rheumatoid disease, although the localisation changed in the manner of a "migrating' infiltration.
Simplified antibiotic regimens compared with injectable procaine benzylpenicillin plus gentamicin for treatment of neonates and young infants with clinical signs of possible serious bacterial infection when referral is not possible: a randomised, open-label, equivalence trial
Authors: Antoinette Tshefu, Adrien Lokangaka, Serge Ngaima, Cyril Engmann, Fabian Esamai, Peter Gisore, Adejumoke Idowu Ayede, Adegoke Gbadegesin Falade, Ebunoluwa A Adejuyigbe, Chineme Henry Anyabolu, Robinson D Wammanda, Clara L Ejembi, William N Ogala, Lu Gram, Simon Cousens
Journal: The Lancet (2015)
The Diagnosis of Acute Glomerulonephritis
Authors: Michael P. Madaio, John T. Harrington
Journal: New England Journal of Medicine (1983)

WE define acute glomerulonephritis as the sudden appearance of hematuria, proteinuria, and red-cell casts. The last finding, which rarely occurs in other types of renal disease,1 is virtually diagnostic of active glomerular inflammation. The clinician should carefully examine the urinary sediment for red-cell casts and should not delegate this critical test to the laboratory performing routine urinalysis. In the absence of such casts, dysmorphic red cells in the urine viewed under a phase-contrast microscope have also been shown to correlate closely with active glomerular disease.2 Hematuria, which is virtually always present, can be persistent or intermittent, gross or microscopic. Proteinuria . . .
Individualizing Nicotine Replacement Therapy for the Treatment of Tobacco Dependence
Authors: Caryn Lerman, Vyga Kaufmann, Margaret Rukstalis, Freda Patterson, Kenneth Perkins, Janet Audrain-McGovern, Neal Benowitz
Journal: Annals of Internal Medicine (2004)

Background: Despite the well-documented efficacy and different pharmacokinetic and pharmacodynamic properties of different forms of nicotine replacement therapy, empirical data are insufficient to guide practitioners in selecting a particular form of treatment for individual patients with tobacco dependence. Objective: To evaluate the comparative efficacy of transdermal nicotine and nicotine nasal spray and identify predictors of treatment outcome. Design: Randomized, open-label clinical trial with a 6-month follow-up period. Setting: 2 university-based smoking cessation research programs. Participants: 299 treatment-seeking smokers who were followed for 6 months after the target quit date. Intervention: Behavioral group counseling and 8 weeks of therapy with nicotine nasal spray or transdermal nicotine. Measurements: Demographic characteristics, smoking history, depression symptoms, and body mass index were measured at baseline. Smoking practices were biochemically verified at the end of treatment and at 6 months after the target quit date. Results: Abstinence rates for the transdermal nicotine and nicotine nasal spray groups were not significantly different at 6-month follow-up (15.0% vs. 12.2%, respectively; P > 0.2). Interactions in abstinence rates for subgroups of smokers were statistically significant (P < 0.05). Smokers who had low to moderate dependence levels, were not obese, and were white achieved higher abstinence rates with transdermal nicotine, whereas smokers who were highly dependent, obese, or members of minority groups achieved higher abstinence rates with nasal spray. Limitations: The subgroup findings need confirmation in additional large studies before they are routinely applied. Conclusions: Ethnicity, weight, and level of nicotine dependence may help identify smokers who have greater or lesser abstinence rates with either transdermal or nasal spray nicotine.