tbuckley/cabot-search huggingface dataset:
THE ADAMS-STOKES SYNDROME AND THE BUNDLE OF HIS.
Authors: E. O. JELLICK
Journal: JAMA (1906)

We desire to put on record a case of acute epididymitis, probably gonorrheal in origin, leading to septicemic symptoms, in the course of which the Adams-Stokes syndrome appeared fourteen days before death. The autopsy of the heart demonstrated anemic necrosis of the muscular septum in the region of the bundle of His<sup>1</sup>consequent on a recent thrombosis of its nutrient arteries. Elsewhere the heart muscle was healthy.
THE UNDERLYING PRINCIPLES OF TUBERCULIN THERAPY.
Authors: F. M. POTTENGER
Journal: JAMA (1907)

Tuberculin has now been subjected to the test of time. It has been in continuous employment for fifteen years. It has been used in many experiments on animals and its virtues have been tested on human beings. In spite of this mass of laboratory and clinical experience there seems to be but a hazy idea as to what tuberculin is, how it acts, and what it is expected to do. In order to understand the principles which underlie tuberculin therapy we will discuss: First, Nature's method of cure in specific diseases; second, conditions which militate against tuberculosis in curing itself; third, the manner in which specific inoculations of tuberculin aid in the cure of tuberculosis. <h3>NATURE'S METHOD OF CURE IN SPECIFIC DISEASES.</h3> When pathogenic microbes gain entrance to the organism certain phenomena take place. If the microbes are exceedingly virulent, if the resisting power of the organism is low, or
Proportions of Kaposi Sarcoma, Selected Non-Hodgkin Lymphomas, and Cervical Cancer in the United States Occurring in Persons With AIDS, 1980-2007
Authors: Meredith S. Shiels
Journal: JAMA (2011)

Given the higher risk of AIDS-defining malignancies that include Kaposi sarcoma (KS), certain non-Hodgkin lymphomas (NHLs), and cervical cancer in persons with human immunodeficiency virus (HIV) infection, the HIV epidemic has likely contributed to the overall numbers of these cancers in the United States.To quantify the proportions of KS, AIDS-defining NHLs, and cervical cancer in the United States that occurred among persons with AIDS from 1980 to 2007.The HIV/AIDS Cancer Match Study (1980-2007) linked data from 16 US HIV/AIDS and cancer registries to identify cases with and without AIDS for KS, AIDS-defining NHLs (ie, diffuse large B-cell lymphoma [DLBCL], Burkitt lymphoma [BL], and central nervous system [CNS] lymphoma), and cervical cancer. Using linked data, we derived cancer rates for persons with and without AIDS. To estimate national counts, the rates were applied to national AIDS surveillance and US Census data.Proportion of AIDS-defining malignancies in the United States occurring in persons with AIDS.In the United States, an estimated 81.6% (95% confidence interval [CI], 81.2%-81.9%) of 83,252 KS cases, 6.0% (95% CI, 5.8%-6.1%) of 351,618 DLBCL cases, 19.9% (95% CI, 18.1%-21.7%) of 17,307 BL cases, 27.1% (95% CI, 26.1%-28.1%) of 27,265 CNS lymphoma cases, and 0.42% (95% CI, 0.37%-0.47%) of 375,452 cervical cancer cases occurred among persons with AIDS during 1980-2007. The proportion of KS and AIDS-defining NHLs in persons with AIDS peaked in the early 1990s (1990-1995: KS, 90.5% [95% CI, 90.2%-90.8%]; DLBCL, 10.2% [95% CI, 9.9%-10.5%]; BL, 27.8% [95% CI, 25.0%-30.5%]; and CNS lymphoma, 48.3% [95% CI, 46.7%-49.8%]; all P < .001 [compared with 1980-1989]) and then declined (2001-2007: KS, 70.5% [95% CI, 68.1%-73.0%]; DLBCL, 4.7% [95% CI, 4.3%-5.2%]; BL, 21.5% [95% CI, 17.7%-25.4%]; and CNS lymphoma, 12.9% [95% CI, 10.5%-15.3%]; all P < .001 [compared with 1990-1995]). The proportion of cervical cancers in persons with AIDS increased over time (1980-1989: 0.11% [95% CI, 0.09%-0.13%]; 2001-2007: 0.71% [95% CI, 0.51%-0.91%]; P < .001).In the United States, the estimated proportions of AIDS-defining malignancies that occurred among persons with AIDS were substantial, particularly for KS and some NHLs. Except for cervical cancer, the proportions of AIDS-defining malignancies occurring among persons with AIDS peaked in the mid-1990s and then declined.
Compound heterozygosity for two α‐globin gene defects, Hb taybe (α1; 38 or 39 minus thr) and a poly a mutation (α2; AATAAA → AATAAG), results in a severe hemolytic anemia
Authors: D. D. Pobedimskaya, T. P. Molchanova, S. Streichman, T. H. J. Huisman
Journal: American Journal of Hematology (1994)

Abstract We have identified two α‐globin gene variations in an Arabian male with severe hemolytic disease through sequencing of amplified DNA of his α2‐ and α1‐globin genes. One of the abnormalities involves a CAC (ACC or CCA) deletion between codons 36 and 41 of the α1‐globin gene. This leads to the synthesis of an abnormal α chain with one instead of two threonine residues at positions 38–39 and to the formation of the unstable Hb Taybe. The second variation is a mutation located in the poly A site of the α2‐globin gene (AATAA A → AATAA G ) which is common among Arabian people. Family studies have shown that the two variations are located on opposite chromosomes. The hemolytic disease in this man, resembling Hb H disease, is likely the result of a severe downregulation of both α‐globin genes on the chromosome with the α2 poly A mutation, and the instability of the α‐Taybe chain being the product of an α 1‐globin gene; this leaves only one α2‐globin gene normally active. © 1994 Wiley‐Liss, Inc.
Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars
Authors: J. Dale, H. Lang, J. A Roberts, J. Green, E. Glucksman
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objectives</b>: To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. <b>Design</b>: Prospective intervention study which was later costed. <b>Setting</b>: Inner city accident and emergency department in south east London. <b>Subjects</b>: 4641 patients presenting with primary care problems: 1702 were seen by general practitioners, 2382 by senior house officers, and 557 by registrars. <b>Main outcome measures</b>: Satisfaction and outcome assessed in subsample of 565 patients 7-10 days after hospital attendance and aggregate costs of hospital care provided. <b>Results</b>: Most patients expressed high levels of satisfaction with clinical assessment (430/562 (77%)), treatment (418/557 (75%)), and consulting doctor9s manner (434/492 (88%)). Patients9 reported outcome and use of general practice in 7-10 days after attendance were similar: 206/241 (85%), 224/263 (85%), and 52/59 (88%) of those seen by general practitioners, senior house officers, and registrars respectively were fully recovered or improving (χ<sup>2</sup>=0.35, P=0.840), while 48/240 (20%), 48/268 (18%), and 12/57 (21%) respectively consulted a general practitioner or practice nurse (χ<sup>2</sup>=0.51, P=0.774). Excluding costs of admissions, the average costs per case were £19.30, £17.97, and £11.70 for senior house officers, registrars, and general practitioners respectively. With cost of admissions included, these costs were £58.25, £44.68, and £32.30 respectively. <b>Conclusion</b>: Management of patients with primary care needs in accident and emergency department by general practitioners reduced costs with no apparent detrimental effect on outcome. These results support new role for general practitioners. <h3>Key messages</h3> We compared the costs and outcomes of general practitioners and hospital doctors treating patients with primary care problems who attended an accident and emergency department There were no significant differences between the types of doctor in terms of patients9 satisfaction and clinical outcome General practitioners provided care more cheaply than did the hospital doctors, reflecting their less frequent requests for investigations and referrals Employing general practitioners in accident and emergency departments offers a potential means of reducing the costs of treating patients with primary care problems
Procainamide and retrograde atrioventricular nodal conduction in man.
Authors: M Shenasa, C J Gilbert, D H Schmidt, M Akhtar
Journal: Circulation (1982)

Recent studies that show a depressant effect of procainamide (PA) on retrograde conduction in patients with atrioventricular (AV) nodal reentrant tachycardia (RT) have suggested possible incorporation of AV nodal bypass tracts. Electrophysiologic effects of i.v. PA, 10 mg/kg, on retrograde AV nodal conduction were examined in 13 patients without RT, demonstrable AV nodal refractory period curves, or accessory pathways. Ventriculoatrial (VA) conduction was recorded before and after PA using intracardiac electrograms, incremental ventricular pacing and extrastimulation. With incremental pacing during the control, VA block occurred at a mean cycle length (CL) of 364.6 +/- 87.9 msec. After PA, VA conduction was abolished in five of 13 patients due to onset of retrograde block in the AV node; in seven of 13, VA block occurred at a longer paced CL after PA (344.2 +/- 51.2 msec vs 477.1 +/- 93.2 msec). In one patient, PA did not affect VA conduction. PA invariably produced prolongation in the VA interval at comparable CL of pacing. With ventricular premature stimulation, the retrograde H2A2 intervals during the control period were short (less than 50 msec) in seven of 13, intermediate (60-100 msec) in three of 13 and long (greater than 100 msec) in three of 13 cases. PA either abolished H2A2 conduction (H2 but no A2) or prolonged the H2A2 intervals by 5-20 msec in most cases in this series. The data suggest that i.v. PA almost uniformly depresses retrograde AV nodal conduction in the intact human heart. This depressant response to PA is not indicative of presence of partial or complete AV nodal bypass tracts.
The Metabolic and Hemodynamic Effects of Prolonged Bed Rest in Normal Subjects
Authors: ARAM V. CHOBANIAN, ROBERT D. LILLE, ANN TERCYAK, PENGWYNNE BLEVINS
Journal: Circulation (1974)

The metabolic and hemodynamic effects of prolonged bed rest were studied in 6 normal subjects. Bed rest of 2-3 weeks duration produced exaggerated responses of heart rate, cardiac output, stroke volume, and peripheral vascular resistance to 70° tilt. Sympathetic nerve function and catecholamine metabolism were not impaired by bed rest. Pressor responses to infusions of norepinephrine and angiotensin and reflex vasoconstriction to a cool and warm environment were essentially unchanged during bed rest. Plasma catecholamines and urinary vanillylmandelic acid excretion were somewhat lower during bed rest than during ambulation, but the response of plasma catecholamines to 70° tilt was not diminished. The apparent turnover of norepinephrine in plasma was also similar in bed rest and control periods. Negative sodium and potassium balances and reductions in plasma volume were observed in all subjects, but plasma renin activity and aldosterone secretory rate showed no significant change. The major decreases in sodium balance and plasma volume occurred in the early bed rest period and did not correlate closely with the degree of orthostatic intolerance. The reductions in potassium balance appeared to be progressive throughout the study.
Growth factor receptor-Src-mediated suppression of GRK6 dysregulates CXCR4 signaling and promotes medulloblastoma migration
Authors: Liangping Yuan, Hongying Zhang, Jingbo Liu, Joshua B Rubin, Yoon-Jae Cho, Hui Kuo Shu, Matthew Schniederjan, Tobey J MacDonald
Journal: Molecular Cancer (2013)

Abstract Background Metastasis in medulloblastoma (MB) is associated with poor survival. Recent genetic studies revealed MB to comprise distinct molecular subgroups, including the sonic hedgehog (SHH) subgroup that exhibits a relatively high rate of progression. To identify targeted therapeutics against metastasis, a better understanding of the regulation of MB cell migration is needed. G protein-coupled receptor kinases (GRKs) have been implicated in cancer metastasis through their regulation of G-protein coupled receptors (GPCRs) involved in growth factor (GF)-mediated cell migration. However, the specific roles and regulation of GRKs in MB have not been investigated. Methods Microarray mRNA analysis was performed for GRKs, GPCRs, and GFs in 29 human MB, and real time RT-PCR was used to detect GRK6 expression in MB cells. Lenti- or retro-virus infection, and siRNA or shRNA transfection, of MB cells was used to overexpress and knockdown target genes, respectively. Western blot was used to confirm altered expression of proteins. The effect of altered target protein on cell migration was determined by Boyden chamber assay and xCELLigence migration assays. Results We observed co-overexpression of PDGFRA , CXCR4 , and CXCL12 in the SHH MB subtype compared to non-SHH MB (5, 7, and 5-fold higher, respectively). GRK6 , which typically acts as a negative regulator of CXCR4 signaling, is downregulated in MB, relative to other GRKs, while the percentage of GRK6 expression is lower in MB tumors with metastasis (22%), compared to those without metastasis (43%). In SHH-responsive MB cells, functional blockade of PDGFR abolished CXCR4-mediated signaling. shPDGFR transfected MB cells demonstrated increased GRK6 expression, while PDGF or 10% FBS treatment of native MB cells reduced the stability of GRK6 by inducing its proteosomal degradation. Overexpression or downregulation of Src, a key mediator of GF receptor/PDGFR signaling, similarly inhibited or induced GRK6 expression, respectively. siRNA downregulation of GRK6 enhanced CXCR4 signaling and promoted MB migration, while lentiviral- GRK6 overexpression suppressed CXCR4 signaling, potentiated the effect of AMD3100, a CXCR4 antagonist, and impaired migration. Conclusions Our findings demonstrate a novel mechanism of GF receptor/PDGFR-Src-mediated dysregulation of CXCR4 signaling that promotes MB cell migration, which could potentially be exploited for therapeutic targeting in SHH MB.
Barren in the Promised Land: Childless Americans and the Pursuit of Happiness
Authors: Jane E. Hodgson
Journal: JAMA (1996)

In a current medical news release, French researchers claim that normal human embryos can be obtained by the injection of round spermatids into oocytes. Authors believe that many patients with hitherto untreatable and unexplained azoospermia will be able to benefit from this new technique of assisted fertilization.<sup>1</sup>Thus, the new specialty of infertility continues its rapid advance since the astonishing announcement in 1978 of the birth of Baby Louise as a result of in vitro fertilization by Drs Patrick Steptoe and R. Edwards of England.<sup>2</sup> Judging from the title of Elaine Tyler May's<i>Barren in the Promised Land: Childless Americans and the Pursuit of Happiness</i>, and the fact that her father, Dr Ed Tyler, Jr, was a prominent pioneer and leader in infertility at his Los Angeles Tyler Clinic, where he launched his specialty in the early 1950s, I expected that her book would detail the rapid and
A STRIKING ACQUIREMENT OF VISUALIZING POWER AND THE DEVELOPMENT OF DREAMS FOLLOWING A CEREBRAL TUMOR EXTIRPATION
Authors: ERNEST G. GREY
Journal: JAMA (1913)

The relation of intracranial growths to mental activity is recognized as a very intimate one.Most of us are familiar with the changes in memory and disposition, the states of hebetude, lethargy and stupor, the decrease in power of attention, the so-called "dreamy states," the abnormal emotional states, fatigueability, etc., asso- ciated with cerebral tumors and their usual concomitant state of increased intracranial tension.Pfeifer1 has recently given quite a complete summary of the mental disturbances found in these types of cerebral cases.The relation of brain tumors to mental imagery, how- ever, seems to have called forth but little comment.Since 1880, when Galton made his classical study of the visualizing faculty, students of psychology have been able to classify persons in this respect.We have known that memory, that is, knowing and remembering, takes place by means of visual images, by auditory images, by motor and tactile images or by various combinations of these types\p=m-\the usual method.The case we have to present represents a striking example of the appearance (reappearance probably) of the visualizing power fol- lowing immediately-«a matter of hours-in the wake of a cerebral tumor extirpation.
Tetracycline-resistant propionibacteria from acne patients are cross-resistant to doxycycline, but sensitive to minocycline
Authors: E.A. EADY, C.E. JONES, K.J. GARDNER, J.P. TAYLOR, J.H. COVE, W.J. CUNLIFFE
Journal: British Journal of Dermatology (1993)

Antibiotic‐resistant propionibacteria are being isolated with increasing frequency from antibiotictreated acne patients. Minimum inhibitory concentrations (MICs) of three tetracyclines, extensively used in acne therapy, were determined for 46 resistant and 19 sensitive propionibacterial isolates. Sensitive strains were inhibited by ≤1 μ/ml of all three tetracyclines. For every resistant strain tested, the MIC of tetracycline exceeded that of doxycycline which, in turn, exceeded that of minocycline. The mean MIC for resistant strains was 20.61±4.56 μ/ml of tetracycline, 9.70±2.03 μ/ml of doxycycline and 1.95±0.35 μ/ml of minocyciine. In order to determine whether these strains could be inhibited by concentrations of minocycline achievable in vivo, serum levels of minocycline were determined in acne patients receiving either the recommended dose of 50 mg b.d. (20 males, 14 females), or twice this dose (21 males, 12 females). Serum levels were significantly higher (P<0.001, Student's t‐test) in patients receiving 100 mg b.d. Males on 50 mg h.d. had significantly lower serum levels than females on the same dose (P<0.05. Student's t‐test). For all patients, the mean serum level on high‐dose minocycline was 246±0.45 μ/ml, compared with 1.38±0.30 μ/ml on the smaller dose. These results indicate that tetracycline‐resistant propionibacteria should be considered clinically minocycline sensitive, if patients who harbour such strains are prescribed 100 mg b.d. The recommended dose of minocycline for treating acne, especially in male patients, should be re‐assessed.
Thymoma Associated with Myocarditis and the L.E.-Cell Phenomenon
Authors: James W. Funkhouser
Journal: New England Journal of Medicine (1961)

THE case reported below is presented because of the unusual clinical manifestations and associated pathological findings. Thymomas associated with granulomatous myocarditis have thrice been reported,1 2 3 but the association of the L.E.-cell phenomenon with this tumor has not, to my knowledge, been described.Case ReportA 53-year-old housewife was first admitted to the hospital on August 8, 1959, for evaluation of dyspnea, nausea and swelling of the lower extremities. Ten months previously an upper gastrointestinal series had revealed an enlarged cardiac silhouette. Subsequent x-ray study of the chest disclosed progressive enlargement of the cardiac silhouette that was thought to be compatible . . .
Abstract P1-03-10: A Model To Prevent Pregnancy Associated Breast Cancer: The Effect of HCG on Tumorigenesis in MMTVneu Mice
Authors: R Rouzier, M Vercambre-Donck, E Wafo, S Uzan, S. Aractingi
Journal: Cancer Research (2010)

Abstract Background: HER2 expression is associated with increased parity-induced risk of breast cancer in women, and women that have been pregnant and have breastfed acquire a 4.2-fold increased risk of developing HER2- positive breast cancers than their counterparts that never breastfed. The mechanisms responsible for the increased risk of developing HER2- positive breast cancer following pregnancy and lactation remain to be elucidated. Animal and ‘in vitro’ experiences show that human chorionic gonadotropin (hCG) is capable to protect from breast cancer. The aim of this study was to assess the effect of HCG and pregnancy on tumorigenesis in MMTVneu mice and to study the mechanisms in terms of differentiation and stem cells depletion. Methods: Mice were intraperitoneally injected BrdU then intraperitoneally injected HCG. Mice were sacrificed for the detection of label retaining cells. The two inguinal groups of mammary gland were dissected. For each gland, ducts and lobules were identified and drawn manually. We used Mercatorâ software for morphometry: ductal and lobular surface were measured and reported to the surface of the selected region. Cells retaining the label after 8-10 weeks (adulthood) were identified as LRCs. A mammary gland tumor free survival was conducted. Results: We observed that the differentiation and maturation of the mammary gland caused by the HCG was different in MMTVneu mice and controls: whereas WT littermates presented with sleek ductal appearance before parity, increased lateral side branching and budding was observed in mammary gland ducts of the MMTV-neu females and WT receiving HCG. The effect of HCG was mediated by the ovary. The effect of HCG on the stem cell pool was limited. Early HCG exposition did not modify ErbB2/Neu-induced mammary tumorigenesis but had an independent tumorigenic effect. Conclusion: Early stimulation with HCG does not mimic early parity. The tumor development was not different between MMTV-neu mice that received or not HCG. We observed an independent ovary mediated tumorigenic effect of early administration of HCG. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-03-10.
Improving Access to Primary Care
Authors: Robert P. Gibb
Journal: JAMA (1993)

<h3>To the Editor.</h3> —I hope that the excellent historical perspective and solutions to access and cost concerns through physician training and recruitment in academic community health centers presented by Ginzberg<sup>1</sup>will be heeded by politicians, their policy-making consultants, and particularly the medical academic community. To some extent, this approach for rural areas was explored by the Washington-Alaska Regional Medical Program in the early 1970s, implemented by the University of Washington School of Medicine and persisting today as the Washington-Alaska-Montana-Idaho program. Support from the involved states has varied and some of the problems with achieving the desired migration of medical practitioners to rural areas have been identified. One factor not addressed by Ginzberg is the "spousal factor," involving educational and employment opportunities and so-called cultural amenities that impact to a greater extent on spouses and families than the health care provider. Another factor is the use of nurse practitioners to increase
Doctors outraged at Patriot Act's potential to seize medical records
Authors: Jeanne Lenzer
Journal: BMJ (2006)

US doctors across the political spectrum are protesting at a provision in the Patriot Act that allows the government to seize patients' medical records without a probable cause or a warrant. The act prohibits doctors from telling anyone, including the patient, that their sensitive medical records have been seized. Doctors who violate the gagging order can be fined and prosecuted for obstruction of justice.

The Association of American Physicians and Surgeons (a libertarian group based in Tucson, Arizona) and the American Civil Liberties Union, which has many doctor members, have joined in a coalition, called Patriots to Restore Checks and Balances, to urge Congress to amend Section 215 of the act. The provision, which only recently came to light, allows the Federal Bureau of Investigation (FBI) to get a secret court order to seize …