tbuckley/cabot-search huggingface dataset:
Inflammatory Markers at Hospital Discharge Predict Subsequent Mortality after Pneumonia and Sepsis
Authors: Sachin Yende, Gina D'Angelo, John A. Kellum, Lisa Weissfeld, Jonathan Fine, Robert D. Welch, Lan Kong, Melinda Carter, Derek C. Angus
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Survivors of hospitalization for community-acquired pneumonia (CAP) are at increased risk of cardiovascular events, repeat infections, and death in the following months but the cause is unknown.To investigate whether persistent inflammation, defined as elevating circulating inflammatory markers at hospital discharge, is associated with subsequent outcomes.Prospective cohort study at 28 sites.We used standard criteria to define CAP and the National Death Index to determine all-cause and cause-specific 1-year mortality. At hospital discharge, 1,799 subjects (77.5%) were alive and vital signs had returned to normal in 1,512 (87%) subjects. The geometric means (+/-SD) for circulating IL-6 and IL-10 concentrations were 6.9 (+/-1) pg/ml and 1.2 (+/-1.1) pg/ml. At 1 year, 307 (17.1%) subjects had died. Higher IL-6 and IL-10 concentrations at hospital discharge were associated with an increased risk of death, which gradually fell over time. Using Gray's survival model, the associations were independent of demographics, comorbidities, and severity of illness (for each log-unit increase, the range of adjusted hazard ratios [HRs] for IL-6 were 1.02-1.46, P < 0.0001, and for IL-10 were 1.17-1.44, P = 0.01). The ranges of HRs for each log-unit increase in IL-6 and IL-10 concentrations among subjects who did and did not develop severe sepsis were 0.95-1.27 and 1.07-1.55, respectively. High IL-6 concentrations were associated with death due to cardiovascular disease, cancer, infections, and renal failure (P = 0.008).Despite clinical recovery, many patients with CAP leave hospital with ongoing subclinical inflammation, which is associated with an increased risk of death.
Growth Hormone Therapy for the Elderly: The Fountain of Youth Proves Toxic
Authors: Kevin E. Yarasheski
Journal: JAMA (1993)

<h3>To the Editor.</h3> —We<sup>1</sup>and others<sup>2,3</sup>have proposed the use of recombinant human growth hormone (GH) therapy for the elderly in an attempt to retard the undesirable changes in muscle mass and function, body fat, and bone mineral content associated with advancing age, and the subsequent impact these have on health care costs. Our initial enthusiasm for this idea has declined as the result of an unexpectedly high incidence of side effects of GH therapy in this population. In 12 healthy older men (63 to 76 years of age) and two women (68 and 73 years of age) who received daily GH (12.5 γg/kg per day, n=12) or placebo injections (n=2) for 4 months to assess the effects of GH therapy on body composition and muscle strength, we have experienced a notable subject attrition rate related to symptoms of carpal tunnel compression, fluid retention, and arthralgia—complications not frequently
Depression and Candida
Authors: David A. Edwards
Journal: JAMA (1985)

<h3>To the Editor.—</h3> The reply given by Dr Coleman<sup>1</sup>to the question regarding the potential relationship between<i>Candida albicans</i>and depression is in error. The clinical association between<i>C albicans</i>colonization and depression has appeared in the literature<sup>2</sup>before Dr Crook's statement.<sup>3</sup>Although the exact mechanism(s) for this association remain unclear, there are a number of possible explanations. The "drunken yeast syndrome" has been described in the foreign medical literature since the 1950s.<sup>4</sup>It has been proved to be due to ethanol production by<i>C albicans</i>and other organisms. Ethanol is a known central nervous system depressant. In addition, canditoxin, a high-molecular-weight mycotoxin isolated from virulent strains of<i>C albicans</i>, has been reported to produce clear behavioral changes in experimental animals.<sup>5</sup>Although relatively high doses of this compound were used, these changes, nevertheless, were noticeable and reported. It is conceivable that a similar condition may
Electron Microscopic Changes in Myocardium of Alcoholic Heart Disease.
Authors: Carl S. Alexander
Journal: Annals of Internal Medicine (1966)

s1 May 1966Electron Microscopic Changes in Myocardium of Alcoholic Heart Disease.Carl S. Alexander, M.D., F.A.C.P.Carl S. Alexander, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-5-1154_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMyocardium was obtained by needle biopsy from 43 patients with alcoholic heart disease and from one with idiopathic nonalcoholic heart disease. Electron microscopic observations in alcoholic heart disease revealed changes believed to be characteristic for this condition. These include fragmentation and loss of myofibrils, edema sufficient at times to cause cystic dilatation of sarcoplasmic reticulum or cisternae, lipid accumulation and fibrosis. The most striking changes involved the mitochondria which were swollen, increased in number, and showed evidence of degeneration, suggesting a disturbance in formation or release of energy. Mitochondrial changes were not observed in the nonalcoholic heart or in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Carl S. Alexander, M.D., F.A.C.P.Affiliations: Minneapolis, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1966Volume 64, Issue 5Page: 1154-1154KeywordsAlcoholicsBiopsyCardiovascular therapyCystic fibrosisEdemaElectron microscopyHeartLipidsMitochondriaMyocardium ePublished: 1 December 2008 Issue Published: 1 May 1966 PDF downloadLoading ...
Chorea precipitated by sulphasalazine.
Authors: A G Quinn, W R Ellis, D Burn, N Cartlidge
Journal: BMJ (1991)

longer deserves (although it certainly did from 1988 to 1990) for indiscriminately encouraging markets, and also opprobrium it certainly does deserve (currently) for interfering obsessively in increasing central control of a supposedly newly devolved NHS.In the end we are left with the contracting process and the purchaser's ability to identifyneed-yet the rhetoric of consumerism.This may produce two forces for higher spending.Firstly, rationing based on purchasers' priorities translated into contracts with providers may still be politically unacceptable (hence the recent problems over interleukin at the Christie Hospital, Manchester).Yet, secondly, consumers will demand "production line" medicine and "trendy" procedures, whether they meet need, defined by experts, or not.In aggregate these forces will push for higher NHS spending.This may be fine.After all, Britain is a very low spender on health.And public spending is the most effective and efficient way to increase expenditure on health.The problem hitherto has been the conventional wisdom, on the right and the left, that only moving to an insurance based or partly private financing system could boost aggregate spending.It would be an ironv to be savoured if the long term fallout of the review was higher public spending and little or no reliance on competitive markets.
Genetics in Obstetrics and Gynecology
Authors: Stephen R. Carr
Journal: JAMA (1993)

In this new edition Drs Simpson and Golbus propose "to provide a practical volume on genetics and teratology as it relates to the clinical practice of obstetrics and gynecology." The degree to which the authors succeed in presenting just that far exceeds this rather unassuming raison d'être. They acknowledge in their preface that they don't intend to offer an exhaustive treatise on all genetic information of interest to all obstetricians and gynecologists. What they have provided is a tightly edited volume that speaks much louder than its relatively short 350 pages might indicate. It is my habit to divide medical information into three broad categories. The first is information that is immediately useful and will directly help me to provide high-quality care to my patients. The second is information that may not be of immediate utility in my practice but provides a fuller understanding of processes and pathophysiology. The third
Sociopathy: Adaptation, abnormality, or both?
Authors: Don Joseph Stein
Journal: Behavioral and Brain Sciences (1997)

Mealey's article on the sociobiology of sociopathy raises questions about the relationship between adaptiveness and abnormality. Although sociopathy may be adaptive, simply defining medical and psychiatric disorders in terms of evolutionary function is problematic. Rather, sociopathy may be characterized as a relatively atypical disorder, an entity to which it may be useful to extend the metaphors of the medical model.
MENINGOCOCCIC MENINGITIS IN EARLY INFANCY
Authors: Alan Brown
Journal: JAMA (1933)

<h3>To the Editor:</h3> —InThe Journal, September 2, page 795, Dr. J. M. Ravid of New York refers to cases of meningitis in the new-born and in early infancy. We are aware of these case reports and of others in the literature on meningitis in very young infants. In our article inThe Journal, July 22, page 272, we reported the occurrence of a case of meningococcic septicemia with meningitis in an infant, aged 22 days, with a diagnosis correctly made within twenty-four hours of onset, immediate, adequate serum therapy given by the most desired routes, and early recovery. Later on in the article we mentioned that our patient was "the youngest patient in whom the condition has been reported." Possibly this statement is ambiguous, but since our case report referred to early diagnosis, serum treatment and rapid recovery, we feel that our patient is the youngest on record. Although
The Familial Occurrence of the Syndrome of Mid-Late Systolic Click and Late Systolic Murmur
Authors: WILLIAM E. SHELL, JOSEPH A. WALTON, MARY E. CLIFFORD, PARK W. WILLIS
Journal: Circulation (1969)

Patients with late systolic murmurs, with and without mid-late systolic extra sounds, have recently been shown to have mitral regurgitation. This syndrome has been found to be familial in each of the four families we have studied. These families were found to have a high prevalence of mid-late systolic extra sounds, late systolic murmurs, pansystolic murmurs, abnormal electrocardiograms, and unexplained premature sudden death. The prognosis for these patients is unknown but is generally considered good. Periodic medical observation of these patients and their families seems warranted, however, in view of the current lack of knowledge concerning the cause of the chest pain, the rate of progression of the mitral regurgitation, the significance of the electrocardiographic abnormalities, the frequency of important arrhythmias, and the mechanism of sudden death. In addition, antibiotic prophylaxis to attempt to prevent bacterial endocarditis seems clearly indicated.
Fraud and Misconduct in Medical Research
Authors: David A. Kronick
Journal: JAMA (1994)

More so than many other forms of intellectual activity, scientific research is a cooperative effort in which scientists depend on their colleagues for accuracy and truthfulness in reporting their work. Violation of this trust, when it occurs, is treated with dismay and contempt when it is uncovered. Although the frequency with which this kind of conduct occurs is not known, the high visibility of fraud in scientific reports in the last two decades has lessened public confidence in scientific research. It has also created an increased diligence on the part of the scientific community to deal with the problems involved. A bibliography with the title<i>Misconduct and Fraud in the Life Sciences</i>, covering the literature from January 1977 through 1987, compiled by Jacqueline van de Kamp and Martin M. Cummings (National Library of Medicine Literature Search No. 87-14) contains 450 citations. The interesting collection of essays on the same subject
Overtaxed US emergency care system needs reorganisation
Authors: Nellie Bristol
Journal: BMJ (2006)

The underfunded, overburdened, and disorganised emergency care system in the United States is barely capable of caring for its daily volume of patients and would be overwhelmed by a mass casualty event. This is a conclusion of the US Institute of Medicine given in a series of studies released last week in Washington, DC.

Although most Americans expect and get appropriate emergency care, “what the public perceives and what is …
HUMORAL AND CELLULAR ASPECTS OF THE IMMUNE RESPONSE TO THE SOMATIC ANTIGEN OF SALMONELLA ENTERITIDIS
Authors: Maurice Landy, Ronald P. Sanderson, Anne L. Jackson
Journal: The Journal of Experimental Medicine (1965)

A study was made of the cellular and humoral aspects of the immune response of the rabbit to the somatic polysaccharide of Salmonella enteritidis. The response to a single intravenous injection was characterized by the appearance of elevated titers of bactericidal antibody between 2 and 3 days later. The maximum titer was dose-dependent and occurred between 5 and 7 days, thereafter declining rapidly during the first month. The significant stabilized levels which then persisted for at least 1 year were also dose-dependent. Most of the antibody produced (>99 per cent) was associated with the macroglobulin fraction of serum. Plaque-forming cells (PFC) elaborating antibody specific for this somatic antigen were detected and enumerated by the technique of localized hemolysis in gel employing polysaccharide-coated sheep erythrocytes. Significant numbers of PFC were encountered in the spleen as early as 14 to 18 hours after a single intravenous injection of antigen; after 36 hours the number of PFC rose rapidly and culminated in a maximum population at 5 days, followed by a rapid decline and plateau similar to that for circulating antibody. The spleen was the principal organ involved in the systemic response, but other lymphoid tissues including bone marrow, peripheral blood leucocytes, and thymus contributed significantly. After an interval of 3 months the effect on humoral antibody titers of a second injection of antigen was dependent on the amount of polysaccharide administered; markedly greater titers were now obtained with 0.02 to 0.002 microg, whereas 0.2 to 20 microg resulted in a duplication of the initial humoral response. The cellular response to a second dose of 5 microg was accelerated; larger numbers of PFC appeared more rapidly, attained a maximum population by day 3, and exceeded the primary response by a factor of two. This acceleration in the attainment of maximum numbers of PFC and the increased bactericidal antibody titers following a second injection of limiting amounts of antigen suggest that these somatic polysaccharides may in fact evoke a "secondary" type of response in the rabbit.
Value of breast imaging in women with painful breasts: observational follow up study
Authors: L. E M Duijm, G. L Guit, J. H C L Hendriks, J. O M Zaat, W. P T M Mali
Journal: BMJ (1998)

To determine the value of breast imaging in patients with localised or diffuse pain in the breast in whom physical examination shows no abnormalities.Observational follow up study.Radiology department of a teaching hospital in the Netherlands.Altogether 987 women referred for radiological breast imaging because of pain alone and a control group of 987 asymptomatic women referred for a screening mammogram.Correlation of the radiological findings with clinical and pathological findings over two years of follow up.Radiological examination of the painful breast(s) showed the following: normal findings in 854 (86.5%) women, benign abnormalities in 85 (8.6%; mainly small cysts or mastopathy), abnormalities that were probably benign in 36 (3.6%), suspicious findings in 8 (0.8%), and malignancy in 4 (0.4%). Biopsy of the painful area was performed in 10 of the 939 women with normal findings or benign abnormalities, in two of 36 women with radiological abnormalities that were probably benign, and in all women with suspicious or malignant findings. Only the four lesions that had been classified radiologically as malignant were found to be malignant at surgery. The prevalence of breast cancer was similar in symptomatic and control women.Breast imaging in women who present with pain alone is of value only in providing reassurance--no abnormalities are usually found in the painful area, radiological abnormalities classified as benign do not generally have any clinical consequences, and the prevalence of cancer is low in these women. Biopsy of the painful area should be performed only where radiological findings are suspicious.
Heart Valve Replacement
Authors: H. N. Macdonald
Journal: BMJ (1970)

BIUTISHinserted it slightly crookedly so that its mouth was directly adjacent to the mouth of the outlet (Fig 2).This led to air being drawn into the set.Approximately 25 ml. of air alternated with 25 ml. of fluid in the tubing of the set, and when the drip chamber was filled it emptied again within six seconds.We later found that this situa- tion can also occur if the force required to insert the air inlet into the bottle pushes the shaft of the needle back into its plastic holding.We have mentioned this complication, which can occur with some of the other Baxter sets, to the manufacturers.They point out that if the directions for use are correctly followed air should not be drawn into any drip set.Nevertheless, they have agreed to modify the sets to make such events impossible.-Weare, etc.,
Pay of Medical Assistants
Authors: M. K. Bedarkar, M. Butler, A. E. Dike, P. M. Gilham, M. F. Gillison, M. M. Thalanany, M. A. K. Kareenu, R. E. Gillson, A. D. Harris, A. L. McKnight, J. D. Rivett, T. Nyunt, J. D. S. Vernon, M. R. Wolfendale
Journal: BMJ (1970)
I-123 MIBG and Serial Radionuclide Angiocardiography in Doxorubicin-related Cardiotoxicity
Authors: RENATO A. VALDÉS OLMOS, WILLEM W. ten BOKKEL HUININK, JANNEKE C. GREVE, CORNELIS A. HOEFNAGEL
Journal: Clinical Nuclear Medicine (1992)

In six patients with doxorubicin-related cardiotoxicity, the severity of decrease in left ventricle ejection fraction (LVEF) was associated with faster myocardial I-123 MIBG washout rates. In four patients with severely decreased LVEF (range 19% to 28%), the 4-hour washout rate varied from 43% to 56%. In two patients with moderate cardiotoxicity (LVEF 42% and 43%), the washout rates were 37% and 35%, respectively. In contrast, in another patient thought to have initial left ventricular dysfunction (LVEF dropped from 66% to 54%), the myocardial I-123 MIBG retention rate was not reduced (6% washout). Subsequent continuation of chemotherapy in this patient was without complication. Reduced I-123 MIBG uptake in the left ventricle generally correlated with areas with abnormal Fourier amplitude values, but in one of the patients with moderate cardiotoxicity, the I-123 MIBG uptake was not reduced in a region with loss of amplitude, indicating dysfunction but probably no myocardial denervation. Analysis of the regional myocardial retention in patients with cardiotoxicity showed no significant difference in the I-123 MIBG washout rates of both segments with or without loss of amplitude. These data suggest that in spite of a localized loss of ventricular function demonstrated by radionuclide angiocardiography, doxorubicin-related cardiotoxicity appears to be based on a global process of myocardial adrenergic derangement.
Angiitis and Photocopier Fumes
Authors: TEE L. GUIDOTTI
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 October 1983Angiitis and Photocopier FumesTEE L. GUIDOTTI, M.D., M.P.H.TEE L. GUIDOTTI, M.D., M.P.H.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-4-570_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Tencati and Novey (1) suggesting that an inhaled agent associated with photocopy paper produced an atypical cutaneous vasculitis is very provocative. Unfortunately, the report must be considered incomplete as important data essential to the interpretation of the case are missing.The authors have omitted several key items of information, both in the clinical description and characterization of exposure. There is no information on the patient's current medications, history of allergies, and findings on chest roentgenograms that may show a vasculitic process in the lung. Essential exposure information also not given includes estimates of the...Reference1. TENCATINOVEY JH. Hypersensitivity angiitis caused by fumes from heat-activated photocopy paper. Ann Intern Med. 1983;98:320-2. LinkGoogle Scholar1. WINKELMANN R. The spectrum of cutaneous vasculitis. Clinics Rheum Dis. 1980;6:413-52. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Graduate School of Public Health San Diego State University San Diego, CA 92182 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHealth effects of laser printer emissions: a controlled exposure study‘Tonerziekte’: beroepsziekte of idee-fixe?Hypersensitivity pneumonitis: Correlation of cellular and immunologic changes with clinical phases of disease 1 October 1983Volume 99, Issue 4Page: 570-570KeywordsAllergy and immunologyLungsThoraxVasculitis Issue Published: 1 October 1983 PDF DownloadLoading ...
“Folic Acid”: Pteroylglutamic Acid and Related Substances
Authors: Frederick Sargent
Journal: New England Journal of Medicine (1947)

Therapeutic UsesThe diseases in which pteroylglutamic acid has proved to be therapeutically effective are as follows: blood dyscrasias, including Addisonian pernicious anemia (hematologic phase), megaloblastic anemia of infancy, (?) refractory megaloblastic anemia, (?) tropical macrocytic anemia, nutritional neutropenia and nutritional macrocytic anemia, both primary (due to poor diet) and secondary (associated with pregnancy, pellagra, some cases of sprue syndrome, chronic alcoholism, gastric carcinoma and gastric resection); and gastrointestinal disturbances, such as certain cases of tropical and nontropical sprue, chronic diarrhea and celiac disease.Conditions that have failed to respond to pteroylglutamic acid are certain blood dyscrasias (the neurologic phase . . .
TCT-671 Relationship Between Plaque Morphologies And Clinical Presentation In The ADAPT-DES IVUS Substudy
Authors: Liang Dong, Gary S. Mintz, Bernhard Witzenbichler, D. Christopher Metzger, Michael Rinaldi, Ernest L. Mazzaferri, Peter L. Duffy, Giora Weisz, Thomas Stuckey, Bruce R. Brodie, Ke Xu, Gregg W. Stone, Akiko Maehara
Journal: Journal of the American College of Cardiology (2013)
"COMPLEMENTARY FEEDING OF NEW-BORN"
Authors: B. A. Melgaard
Journal: JAMA (1925)

To the Editor:  —I cannot agree with the statement of Dr. Bliss in his communication toThe Journal, May 16. Much controversy has been aroused over the cause and treatment of inanition fever, and this goes back much farther than the last two years. A prominent Eastern pediatrician made the statement in the Section on Diseases of Children at the Boston session that if the Lord intended the baby to have any nourishment the first few days of life He would have supplied it. The answer to this was well put in saying that this is not a question of theology.  A large number of infants need something to burn before it is provided by the mother. The gratifying results one sees when fluids, sugar solutions or milk dilutions are given to dehydrated infants more than offsets any danger there may be of the baby later refusing the breast.  I