tbuckley/cabot-search huggingface dataset:
Role of<i>Leishmania</i>spp. infestation in nondiagnostic cutaneous granulomatous lesions: report of a series of patients from a Western Mediterranean area
Authors: G. Martín-Ezquerra, R. Fisa, C. Riera, V. Rocamora, A. Fernández-Casado, C. Barranco, T. Serra, T. Baró, R.M. Pujol
Journal: British Journal of Dermatology (2009)

Leishmaniasis is a parasitic disease prevalent in countries of the Mediterranean area.The potential role of Leishmania as the aetiological factor for cutaneous granulomatous lesions in a series of patients from a Western Mediterranean area was evaluated. The practical usefulness of Leishmania-specific polymerase chain reaction (PCR) amplification and immunohistochemical techniques in skin biopsy specimens was assessed.Twenty-five skin biopsies diagnosed as nonspecific granulomatous dermatoses were included in the study. A panel of histopathological features was blindly evaluated by two independent observers. Only those cases showing nondiagnostic clinicopathological features and lacking demonstrable microorganisms after bacteriological, mycological or mycobacteriological cultures and specific stains (Ziehl-Neelsen, Giemsa, Gram, periodic acid-Schiff stains) were finally selected. Quantitative real-time PCR was performed in all selected samples. In available samples, immunohistochemical detection of specific Leishmania spp. antigens was also performed.From the selected 25 biopsies, Leishmania spp. DNA was detected by real-time PCR in 13 cases. In seven of eight PCR-positive cases the presence of a varying density of amastigotes could also be demonstrated immunohistochemically.Leishmania infection seems to be an important aetiological factor in cutaneous granulomatous lesions showing nondiagnostic features in endemic areas. In such areas, Leishmania-specific PCR amplification and/or immunohistochemical studies may be useful diagnostic tools. These techniques may be specifically indicated in the evaluation of patients showing nonspecific granulomatous inflammatory infiltrates of unknown aetiology lacking the histopathological evidence of parasites.
Ischemia and Necroses of Bone
Authors: Leonard F. Peltier
Journal: JAMA (1981)

This unusual monograph merits attention because it deals with a biologic rather than a mechanical approach to an orthopedic problem. It is a refreshing exposition of anatomic, physiological, and pathological factors associated with the pathogenesis, diagnosis, and treatment of the common syndrome of necrosis of the femoral head. The monograph begins with a careful description of normal bone circulation. This is followed by a technical section describing methods for carrying out the recommended hemodynamic and histopathologic procedures. The remainder of the book is a synthesis of the authors' experience in the application of these procedures to a large number of patients with necrosis of the femoral head. The chapter on the syndrome of bone ischemia is outstanding. There is a good discussion of the wide variety of conditions with which bone necrosis can be associated. The drawings, charts, radiographs, and photomicrographs are all clear and well chosen. The bibliography is
In with the wrong crowd
Authors: Theodore Dalrymple
Journal: BMJ (2008)

As Oscar Wilde so justly observed, work is the curse of the drinking classes. No one would have agreed more heartily than Charles Lamb, the essayist and friend of the Romantics. He hated his work in the offices of the East India Company and thought that it all but destroyed his literary gifts. When his office superior upbraided him for always arriving late at work, he replied, “Yes, sir, but to make up for it I always leave early.”

In his Last Essays of Elia , he wrote his Confessions of a Drunkard. There can hardly be a doctor in practice, at least in the United Kingdom, …
Death and Taxes
Authors: G. Stuart Mendenhall
Journal: Annals of Internal Medicine (2008)

Tax incentives can provide a large financial impetus to change behavior. Current U.S. law establishes a substantial discontinuity in the amount of estate tax that many patients will have to pay in 2010: During this year only, the tax rate drops to zero. This article discusses concerns regarding the sharp change in tax rate and the incentives it creates for persons who are nearing the end of life and provides estimates of the number of people affected by this issue.
THE RESULTS OF SHOCK THERAPY IN THE TREATMENT OF AFFECTIVE DISORDERS
Authors: DAVID C. WILSON
Journal: American Journal of Psychiatry (1939)

A follow-up study six months after discharge from the hospital of 37 patients who had shown affective disorders shows 41 per cent as greatly improved and 76 per cent definitely improved. Of 19 cases diagnosed involutional melancholia, 15, or 78 per cent, have been able to make a social and business adjustment. Moreover, this study has shown that metrazol convulsions given with care can be used in patients in the fifth decade of life. We found also that a few convulsions when used in connection with other forms of therapy may produce satisfactory results in patients suffering from the mixed forms of depression, especially with the agitated depression accompanying the period of involution.
The Attractiveness of Internal Medicine: A Qualitative Analysis of the Experiences of Female and Male Medical Students
Authors: Julia E. McMurray
Journal: Annals of Internal Medicine (1993)

Objective: To understand better the decline in medical student interest in internal medicine. Design: Qualitative analysis of 500 essays from respondents who participated in a national survey of graduating medical students from the class of 1990 in 16 medical schools. Medical students were asked the open-ended question, What suggestions do you have for improving the attractiveness of internal medicine? A model of career choice was developed for the analysis that included the following factors: ambulatory care exposure and primary care (including relationships with patients); attending physician-student interactions and learning climate; stress and workload; income and prestige; and intellectual stimulation. Participants: The original survey included 1650 fourth-year medical students; 500 essay respondents were stratified by sex and then randomly chosen for the analysis. Results: Students most frequently suggested that ambulatory care experiences be increased and that better relationships with patients be established during medical training (65% of women and 50% of men, P < 0.01). The second most frequent suggestion was to improve internal medicine attending physicians' interactions with students (51% and 48% of women and men, respectively). Students who had seriously considered a career in medicine but switched to other primary care careers (general pediatrics, family medicine) had few concerns about income and prestige, whereas those who chose internal medicine had reservations about expected workload and income. Women were more likely than men to reject internal medicine for other primary care fields (26% of women compared with 16% of men, P = 0.05). Conclusions: Students, particularly female students, expressed a strong interest in establishing better relationships with patients. Lack of respect by medical attendings and negative teaching methods were important sources of dissatisfaction among both men and women. Attention to these relationship issues, in addition to housestaff stress and expected future income, may improve the attractiveness of internal medicine.
Case 24-1974
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, William E. Strole, James J. Galdabini
Journal: New England Journal of Medicine (1974)

Presentation of CaseA 33-year-old woman was admitted to the hospital because of obstipation.The patient had known neurofibromatosis, and multiple neurofibromas had been excised in the past. Eleven years before admission she underwent cystectomy and the creation of an ileal loop because of neurofibromatosis that involved the trigone and left side of the bladder neck, with secondary hydronephrosis (Fig. 1). Six years before entry a barium-enema examination (Fig. 2) revealed a large, redundant loop of sigmoid colon, with considerable dilatation that extended from the rectum to the lower portion of the descending colon; the total amount of barium used . . .
Quantitation of hemoglobin biosynthesis with agarose isoelectric focusing
Authors: Anne G. Leary, Pamela N. Porter, Makio Ogawa
Journal: American Journal of Hematology (1983)

Abstract Isoelectric focusing in polyacrylamide gels has been widely used to separate fetal (HbF) and adult (HbA) hemoglobins, and the relative synthesis of HbA and HbF has been estimated by fluorography or autography of dried gels. In order to measure the absolute synthesis of hemoglobin, we developed a system that utilizes isoelectric focusing in agarose and quantitates the total radioactivity of separated hemoglobins. After isoelectric focusing, the protein bands are individually eluted from the agarose and the radioactivity measured by liquid scintillation counting. We used this technique to study the synthetic capabilities of erythroid precursors at sequential times in culture. As previously reported, the relative ratio of HbF decreased over time in culture. However, our results clearly revealed that the absolute synthesis of HbF did not decrease until there was a parallel decrease in hemoglobin A, and that changes in the relative ratio occur because of disproportionate increases in HbA. This methodology, allowing independent evaluation of the radioactivity in synthesized hemogrlobin, enabled us to gain new insight into the biosynthetic capabilities of erythroid precursors in clonal cell culture.
THE ARMY HOSPITAL AND SANATORIUM FOR THE TREATMENT OF PULMONARY TUBERCULOSIS, AT FORT BAYARD, NEW MEXICO.
Authors: D. M. APPEL
Journal: JAMA (1902)

In the paper which I had the honor to present to this Section in 1900 I briefly described the establishment of the general hospital for the treatment of pulmonary tuberculosis in the military post of Fort Bayard, located in the dry mountainous region of southern New Mexico at an altitude of 6,040 feet. I then stated that all the buildings of the post, and the water system and sewerage, were very much dilapidated. These are now in good repair, entirely new and modern plumbing has been installed, but as yet no new buildings for the accommodation of patients have been erected. A glass solarium with steel framework (on the paradigm system) which was contracted for in June, 1901, is now nearing completion and will afford excellent protection from the high winds which occasionally prevail, especially during the spring. The climate of Fort Bayard permits of comfortable outdoor life during the
The Athletic Heart Syndrome
Authors: Tim P. Huston, James C. Puffer, Wm. MacMillan Rodney
Journal: New England Journal of Medicine (1985)

In the process of training, the getting wind, as it is called, is largely a gradual increase in the capability of the heart.... The large heart of athletes may be due to the prolonged use of their muscles, but no man becomes a great runner or oarsman who has not naturally a capable if not a large heart.1 THE heart of an athlete has certain functional and morphologic adaptations that distinguish it from other hearts. The capacity to perform vigorous physical activity depends on the integrated functioning of many systems. The cardiovascular system plays a pivotal part, since continuous muscular . . .
Optical mapping of repolarization and refractoriness from intact hearts.
Authors: I R Efimov, D T Huang, J M Rendt, G Salama
Journal: Circulation (1994)

BACKGROUND Heterogeneities of repolarization (R) across the myocardium have been invoked to explain most reentrant arrhythmias. The measurement of refractory periods (RPs) has been widely used to assess R, but conventional electrode and extrastimulus mapping techniques have not provided reliable maps of RPs. METHODS AND RESULTS Guinea pig hearts were stained with a voltage-sensitive dye to measure fluorescence (F) action potentials (APs) from 124 sites with a photodiode array. AP duration (APD) was defined as the time between depolarization (dF/dt)max and R time points (ie, the time when AP returns to baseline or some percent thereof). However, R time points are difficult to determine because AP downstrokes are often encumbered by drifting baselines and motion artifacts, which make this definition ambiguous. In optical and microelectrode recordings, the second derivative of AP downstrokes is shown to contain an easily detected, unique local maximum. The correlation between the position of this maximum (d2F/dt2)max and R has been tested during altered AP characteristics induced by changes in cycle length, ischemia, and hypoxia. Under these various modifications of the AP, the time points of (d2F/dt2)max fell at 97.0 +/- 2.1% of recovery to baseline. Extrastimulus techniques applied to (1) isolated myocytes, (2) intact hearts, and (3) mathematical simulations indicated that (d2V/dt2)max coincided with the effective RPs of APs. The coincidence of RPs and (d2V/dt2)max was valid within 5 milliseconds, for resting potentials of -75 to -90 mV and extrastimuli three times threshold voltage. CONCLUSIONS Thus, optical APs and (d2F/dt2)max can be used to map activation, R, and RPs with AP recordings from a single heartbeat.
Metabolism and toxicology of pyrethroids with dihalovinyl substituents.
Authors: L O Ruzo, J E Casida
Journal: Environmental Health Perspectives (1977)

Replacement of the photolabile and biodegradable isobutenyl substituent of pyrethroids with a dihalovinyl group often leads to improved insecticidal potency and enhanced photostability. This type of structural modification does not greatly alter the ease of detoxification in mammals since other sites in the molecule undergo metabolic attack. The available toxicological information on dihalovinyl pyrethroids indicates that they are suitable replacements for other insecticides with less favorable persistence and toxicological characteristics.
Diagnosis, Assessment, and Treatment of Non-Pulmonary Arterial Hypertension Pulmonary Hypertension
Authors: Marius M. Hoeper, Joan Albert Barberà, Richard N. Channick, Paul M. Hassoun, Irene M. Lang, Alessandra Manes, Fernando J. Martinez, Robert Naeije, Horst Olschewski, Joanna Pepke-Zaba, Margaret M. Redfield, Ivan M. Robbins, Rogério Souza, Adam Torbicki, Michael McGoon
Journal: Journal of the American College of Cardiology (2009)
Mast cell activation and migration to lymph nodes during induction of an immune response in mice.
Authors: H W Wang, N Tedla, A R Lloyd, D Wakefield, P H McNeil
Journal: Journal of Clinical Investigation (1998)

The mast cell response in skin and lymph nodes was examined during the sensitization phase of dinitrofluorobenzene (DNFB)-induced contact hypersensitivity in mice. Degranulation of 62% of mast cells in DNFB-exposed skin was evident within 30 min of a dual application of DNFB, reaching a peak of 77% at 24 h, and persisting in 42% after 5 d. Abundant expression of macrophage inflammatory protein (MIP)-1alpha and MIP-1beta mRNAs and proteins was observed in keratinocytes, and mast cell degranulation was significantly inhibited after administration of neutralizing antibodies to MIP-1alpha, but not MIP-1beta. During DNFB sensitization, the mast cell density in the skin decreased by half, concurrent with a fivefold expansion of mast cell numbers in draining lymph nodes. Fluorescent-labeled mast cells injected into the skin appeared in draining lymph nodes after application of DNFB, followed by subsequent migration to the spleen. In lymph nodes, mast cells were an abundant and predominant source of MIP-1beta, neutralization of which partially inhibited T lymphocyte recruitment. These results indicate that mast cells contribute to the induction of this primary immune response by activation at and migration from the site of antigen encounter to draining lymph nodes, wherein they mediate T lymphocyte recruitment by production of MIP-1beta.
Backing the wrong horse
Authors: Wendy Moore
Journal: BMJ (2011)

Even the brightest medical minds have fallen victim to the scientific phenomenon known as backing the wrong horse. The Dutch physician Jan Ingenhousz (1730-99) devoted much of his life to championing smallpox inoculation using the traditional variolation method. Ingenhousz adopted the technique after moving to London in the 1760s, and then travelled to Vienna in 1768 to inoculate the family of the Austrian empress Marie Theresa and subsequently introduced the method throughout Austria.⇑

Yet when he read about Edward Jenner’s revolutionary cowpox experiment in 1798 Ingenhousz was convinced it was ill conceived and dangerous. After trying to convince the young country doctor of the error of his ways …
Pediatric and Adolescent Gynecology
Authors: S. B. Gusberg
Journal: JAMA (1967)

This excellent monograph presents the clinical and laboratory experience of a gynecologist and a pediatrician in a field which all too frequently gets lost somewhere between these two disciplines. It will serve, therefore, a most useful function, not only because it fills this gap, but also because the wide experience and numerous contributions of the senior author in intersex problems and their attendant endocrinologic and cytogenetic disturbances is judiciously balanced by the pediatric approach of the second author. The book starts with sections on embryology and reproductive physiology to furnish a scientific framework upon which the clinical presentation may rest. Other sections discuss anomalies, infections, tumors, and endocrine disorders. The authors present the reproductive physiology in this age group in brief fashion, except for the section on the menarche, which is more complete. The sections on infections and tumors are also restricted by the meagerness of knowledge in
MUSCULAR INSUFFICIENCY OF THE MITRAL VALVE.
Authors: CHARLES SPENCER WILLIAMSON
Journal: JAMA (1902)

<h3>CLINICAL HISTORY OF THE ACUTE FORM.</h3> The muscular mitral insufficiencies may present themselves in two forms: first, acute; second, chronic. The acute cases present themselves during the course of those diseases which affect the myocardium. These are diphtheria, scarlet fever, typhoid, acute articular rheumatism, and in general, the acute infections, the ones mentioned predominating. As I have seen them, the majority of the cases were in polyarthritis. During the course of the disease a systolic murmur, usually soft and blowing, will be heard in the region of the apex. At first it is often inconstant, but as the days go by it comes to be constant, always with its maximum of intensity at the apex, and seldom of great intensity. The heart presents the physical signs of a slight or moderate dilatation without hypertrophy. I have never seen extreme dilatation, never anything like enough to cause a mechanical and truly
The nature of hypertension
Authors: T. Dalrymple
Journal: BMJ (2012)

In the first edition of his great poem The Vanity of Human Wishes Doctor Johnson warns us that the scholar’s life is not an easy one: “There mark what ills the Scholar’s life assail, / Toil, Envy, Want, the Garret, and the Jail.” Of these hazards, perhaps only the first two remain; and certainly scholars in medicine starve in no garrets. But the controversies on which they expend their energy can be prolonged and vigorous, sometimes—or always, according to Schopenhauer—truth seeming a lesser imperative than victory.

Among the most famous controversies in 20th century medicine was the momentous one between Sir George Pickering (1904-80) and Sir Robert Platt (1900-78) over the nature of hypertension: whether high blood pressure was merely …
Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups
Authors: C. Shipman, M. Gysels, P. White, A. Worth, S. A Murray, S. Barclay, S. Forrest, J. Shepherd, J. Dale, S. Dewar, M. Peters, S. White, A. Richardson, K. Lorenz, J. Koffman, I. J Higginson
Journal: BMJ (2008)

<b>Objective</b> To identify major concerns of national and local importance in the provision, commissioning, research, and use of generalist end of life care. <b>Design</b> A national consultation and prioritising exercise using a modified form of the nominal group technique. <b>Participants</b> Healthcare practitioners, commissioners, academics, and representatives of user and voluntary groups. <b>Setting</b> Primary and secondary care, specialist palliative care, and academic and voluntary sectors in England and Scotland. <b>Results</b> 74% of those invited (210/285) participated. The stage of life to which "end of life care" referred was not understood in a uniform way. Perceptions ranged from a period of more than a year to the last few days of life. Prominent concerns included difficulties in prognosis and the availability of adequate support for patients with advanced non-malignant disease. Generalists in both primary and secondary care were usually caring for only a few patients approaching the end of life at any one time at a point in time. It was therefore challenging to maintain skills and expertise particularly as educational opportunities were often limited. End of life care took place among many other competing and incentivised activities for general practitioners in the community. More needs to be known about models of end of life care and how these can be integrated in a generalist's workload. A greater evidence base is needed about the effectiveness and application of current tools such as the gold standards framework and Liverpool care pathway and about models of palliation in patients with diseases other than cancer. <b>Conclusions</b> Definitions of end of life care need clarification and standardisation. A greater evidence base is needed to define models of good practice together with a commitment to provide education and training and adequate resources for service provision. More needs to be known about the context of provision and the influence of competing priorities and incentives.
Abstract 1574: The impact of human wild type EGFR on lung tumorigenesis and in vivo sensitivity to EGFR-targeted therapies
Authors: Liang Chen, Dalia Ercan, Jeonghee Cho, Pasi A. Janne, Matthew L. Meyerson, Kwok-Kin Wong
Journal: Cancer Research (2010)

Abstract Lung cancer is the leading cause of the cancer related death in the world. Non-small cell lung cancer is the major lung cancer type, of which more than 1.4 million new cases were diagnosed each year. Overexpression of wild type EGFR is common in NSCLC. However, it is not clear whether or not overexpression of wt EGFR is tumorigenic. We recently showed that overexpression of wt-hEGFR is capable of transforming cell lines. More importantly, inducible double transgenic mice overexpressing wt-hEGFR in lung epithelial compartment developed poorly differentiated lung adenocarcinoma and that the maintenance of the tumor is dependent on continuous functioning of wt-hEGFR. The tumor driven by overexpression of wt-hEGFR responds to cetuximab and erlotinib treatment. These data suggest that a subpopulation of the lung cancer may be caused by overexpression of wt-hEGFR and that these lung cancers can be treated with anti-EGFR antibodies and EGFR tyrosine kinase inhibitors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1574.