tbuckley/cabot-search huggingface dataset:
Prevalence of asthma in adults in Busselton, Western Australia.
Authors: J. K. Peat, M. Haby, J. Spijker, G. Berry, A. J. Woolcock
Journal: BMJ (1992)

To estimate whether the prevalence of asthma in adults increased over a nine year interval.Serial cross sectional studies of the population with a protocol that included both subjective and objective measurements.Busselton, Western Australia.A random sample of 553 subjects aged 18-55 years in 1981, and of 1028 subjects aged 18-55 years in 1990.Respiratory symptoms measured by self administered questionnaire, bronchial responsiveness measured by bronchial challenge with histamine, and allergy measured by skin prick tests.Symptoms with increased prevalence were those with significant association with allergy in this population. Recent wheeze increased from 17.5% to 28.8% (p < 0.001) and diagnosed asthma increased from 9.0% to 16.3% (p < 0.001). The increase was greatest in subjects less than 30 years old. The prevalence of shortness of breath coming on at rest and of hay fever also increased significantly, but the prevalence of shortness of breath on exertion, chronic cough, bronchial hyperresponsiveness, current asthma (defined as recent wheeze plus bronchial hyperresponsiveness), and allergy did not increase. The severity of bronchial responsiveness did not change significantly in any symptom group.Young adults showed a significant increase in reporting of symptoms related to allergy but not in the prevalence of current asthma. The increase in symptoms may be due to increased awareness of asthma in this community, to changed treatment patterns, or to increased exposures to allergens.
A History Lesson: Hepatitis Is Not Always What It Seems
Authors: Geoffrey M. Zucker
Journal: JAMA (1982)

Two unusual hepatic presentations of otherwise common infectious diseases are reported in this issue ofThe Journal(pp 1999 and 2000). They illustrate that while viral A, B, and non-A, non-B acute hepatitis are ubiquitous, there are other infectious agents associated with hepatitis. The clinician must therefore consider other diagnostic possibilities among different age groups. In the neonate, cytomegalic inclusion-virus is a major cause of fetal and infant morbidity, followed by rubella (congenital or acquired) and herpes simplex (type 2 more than type 1).<sup>1</sup>Hepatitis seen with these viral illnesses is usually associated with other physical findings that may aid in their diagnosis. The presence of associated heart disease, pneumonitis, retinopathy, bleeding diathesis, or skin changes may be important clues to the nature of the viral illness. When acute hepatitis alone is present in the neonate, and viral isolation and serological findings are negative, metabolic or hereditary causes should
Radiofrequency Catheter Ablation of a Left Posterior Accessory Atrioventricular Connection in a Patient with the Wolff–Parkinson–White Syndrome
Authors: Kim Eagle, Jeremy N. Ruskin, Hasan Garan
Journal: New England Journal of Medicine (1992)

Images in Clinical Medicine from The New England Journal of Medicine — Radiofrequency Catheter Ablation of a Left Posterior Accessory Atrioventricular Connection in a Patient with the Wolff–Parkinson–White Syndrome
People will be able to surf across languages for health data on the Internet
Authors: A. Sekikawa, I. Libman, L. Iochida, R. E Laporte, E. Boostrom
Journal: BMJ (1996)

supplementary oxygen who are monitored by routine oximetry and given conventional seda- tion.Until this information is available, routine use of a ,B blocker for patients undergoing endo- scopic cholangiopancreatography seems prema- ture because the risk of hypotension induced by I blockade may be an additional hazard.
Tumour necrosis factor in serum and synovial fluid of patients with active and severe rheumatoid arthritis.
Authors: C Tetta, G Camussi, V Modena, C Di Vittorio, C Baglioni
Journal: Annals of the Rheumatic Diseases (1990)

Fifteen serum samples and 29 synovial fluids of patients with rheumatoid arthritis (RA) were examined for the presence of tumour necrosis factor (TNF). The assay for TNF was based on the cytotoxic activity of this cytokine for human melanoma cells in tissue culture. High concentrations of TNF were found in serum samples of patients with severe RA, who had increased erythrocyte sedimentation rate and serum alpha 2 macroglobulin, but decreased haemoglobin and serum iron concentrations. Tumour necrosis factor was also found in the synovial fluid of 16 out of 29 patients. High TNF concentrations were found in fluids with greater than 10(10) leucocytes/l. Tumour necrosis factor was not detected in the serum of normal subjects or in synovial fluid of patients with osteoarthritis. A mediator of inflammation, such as TNF, may contribute to the severity of RA.
Effect of Oestrogens and Progestogens on Liver Function in the Puerperium
Authors: J. Clinch, V. R. Tindall
Journal: BMJ (1969)

A modified bromsulphthalein test has been used to detect alterations in liver function in puerperal women taking either a synthetic oestrogen, stilboestrol, or a pure progestogen, megestrol acetate. The oestrogen appreciably reduced the ability of the liver to excrete dye into the bile. It also reduced significantly the equivalent liver volume and the plasma clearance of dye. The progestogen did not have this effect. In so far as these results represent liver dysfunction they are due to the oestrogen component of the combined preparation.
Evaluation and Treatment of Upper and Lower Extremity Circulatory Disorders
Authors: Alan T. Marty
Journal: JAMA (1984)

The unalloyed joy of finding something new here awaits those who treat patients with ischemic fingers or toes. The first conceptual overhaul regards some biologic questions central to understanding circulatory insufficiency: namely, why do intraluminal obstructive lesions occur and how might they be avoided? Better ways to endothelialize prosthetic grafts and how antiplatelet drugs can prevent late graft occlusion are also clarified. A second defection from orthodoxy concerns "unreconstructible" patients with limb-threatening ischemia. Previous contraindications to revascularization for early gangrene, such as absence of a plantar arterial arch, are systematically contradicted. To extend the frontiers of limb salvage further, useful advice about bypassing the blind popliteal arterial segment, and empirical details about unusual techniques (such as tibiotibial bypass) are delineated. Topics scantily covered elsewhere, such as atheromatous embolization of the hand, direct arm revascularization, or the current role and type of sympathectomy for causalgia, or spastic Raynaud's disease receive much
Assessment of combined symptom and medication scores for rhinoconjunctivitis immunotherapy clinical trials
Authors: J. Clark, R. Schall
Journal: Allergy (2007)

Background: In randomized, double‐blind, placebo‐controlled clinical trials the efficacy of immunotherapy for allergic rhinoconjunctivitis is evaluated using the Average Rhinoconjunctivitis Total Symptom Score (ARTSS). Effective treatment is associated with lower ARTSS relative to placebo. For ethical reasons patients are provided with registered rescue medication, which may alleviate symptoms and thus reduce symptom scores. This effect biases the mean difference in ARTSS between effective treatment and placebo towards zero. Therefore, when rescue medication is taken by a patient, the ARTSS needs to be adjusted appropriately. Methods: We considered five outcome measures: ARTSS, Average Rescue Medication Score (ARMS), and three combined symptom and RMSs. To assess the different outcome measures regarding their power to discriminate between effective treatment and placebo, we calculated their effect size when applied to data from a clinical trial of immunotherapy for allergic rhinoconjunctivitis. Results: Of the five outcome measures considered, the average of the ARTSS and ARMS was associated with the largest effect size, and thus with the highest power to show treatment efficacy. Discriminant and multivariate analyses suggest that this average is approximately optimal among all weighted sums of ARTSS and ARMS. Conclusion: Our findings support recommendations made in a World Allergy Organisation document on methodological aspects of immunotherapy trials. The average of the ARTSS and ARMS should be considered as a primary efficacy variable in clinical trials of immunotherapy for allergic rhinoconjunctivitis.
The Relationship Between L-Chain Synthesis and γ-Globulin Production
Authors: Christine Waterhouse, George Abraham, John Vaughan
Journal: Journal of Clinical Investigation (1973)

The simultaneous administration of labeled human gammaG globulin and L-chains to subjects has allowed examination of the metabolic relationship between a component part and the whole immunoglobulin molecule. Studies were carried out in a series of control subjects and in a group of patients where substandard production of gamma-globulin was anticipated, i.e., patients with the nephrotic syndrome on chronic Imuran therapy and patients with uremia. Full expression of the plasma decay curve was obtained for both substances, that for L-chain requiring only 4-5 days except in uremic subjects and that for gamma-globulin requiring up to 30-40 days. Urinary excretion of inorganic iodide was also quantitated for 20-30 days. Equilibrium of the extravascular, vascular, and urinary radioactivity from the labeled gammaG globulin was usually not seen during this time interval suggesting more than one site of catabolism of the protein. Excess L-chain poduction was about 45% of the total L-chain production and probably in no instance could account for the low gamma-globulin production seen in certain patients with renal disease.
Further studies of alinidine induced bradycardia in the presence of caesium
Authors: P D DENNIS, E M V. WILLIAMS
Journal: Cardiovascular Research (1986)

Alinidine, the N-allyl derivative of clonidine, reduces heart rate in animals and man by a selective action on the sinoatrial node. In this study, in the presence of caesium, which blocks the time dependent inward current activated by hyperpolarisation (ih or if), alinidine still caused a concentration related bradycardia in the rabbit sinoatrial node. Within the clinical range of concentrations of alinidine the curve relating heart rate to alinidine concentration in the presence of caesium was parallel to that observed in its absence. It is concluded that the alinidine induced bradycardia cannot be attributed to blockade of ih.
Mammary Tumor Development in Dogs Is Associated with <i>BRCA1</i> and <i>BRCA2</i>
Authors: Patricio Rivera, Malin Melin, Tara Biagi, Tove Fall, Jens Häggström, Kerstin Lindblad-Toh, Henrik von Euler
Journal: Cancer Research (2009)

Breast cancer is a major contributor to overall morbidity and mortality in women. Several genes predisposing to breast cancer have been identified, but the majority of risk factors remain unknown. Even less is known about the inherited risk factors underlying canine mammary tumors (CMT). Clear breed predispositions exist, with 36% of English springer spaniels (ESS) in Sweden being affected. Here, we evaluate 10 human breast cancer genes (BRCA1, BRCA2, CHEK2, ERBB2, FGFR2, LSP1, MAP3K1, RCAS1, TOX3, and TP53) for association with CMTs. Sixty-three single-nucleotide polymorphisms (SNPs; four to nine SNPs per gene) were genotyped by iPLEX in female ESS dogs, 212 CMT cases and 143 controls. Two genes, BRCA1 and BRCA2, were significantly associated with CMT (Bonferroni corrected P = 0.005 and P = 0.0001, respectively). Borderline association was seen for FGFR2. Benign and malignant cases were also analyzed separately. Those findings supported the association to BRCA1 and BRCA2 but with a stronger association to BRCA1 in malignant cases. Both BRCA1 and BRCA2 showed odds ratios of approximately 4. In conclusion, this study indicates that BRCA1 and BRCA2 contribute to the risk of CMT in ESS, suggesting that dogs may serve as a good model for human breast cancer.
Pulmonary Arterial Thrombosis in Eisenmenger Syndrome Is Associated With Biventricular Dysfunction and Decreased Pulmonary Flow Velocity
Authors: Craig S. Broberg, Masuo Ujita, Sanjay Prasad, Wei Li, Michael Rubens, Bridget E. Bax, Simon J. Davidson, Beatriz Bouzas, J. Simon R. Gibbs, John Burman, Michael A. Gatzoulis
Journal: Journal of the American College of Cardiology (2007)
Chlamydia pneumoniae infection and mortality from ischaemic heart disease: large prospective study
Authors: N J Wald
Journal: BMJ (2000)

To determine whether there is an independent association between infection with Chlamydia pneumoniae and ischaemic heart disease.Prospective study using a nested case-control design.Medical centre in London run by BUPA, a private medical organisation.21 520 professional men aged 35-64 who attended for a medical examination in London between 1975 and 1982.Death from ischaemic heart disease.The distributions of concentrations of IgG and IgA antibodies to C pneumoniae were similar in the 647 men who subsequently died of ischaemic heart disease and in 1294 age matched controls who did not. There was no material association with heart disease irrespective of the cut-off point chosen to define seropositivity. At a cut-off point that defines 15% of controls as positive, for example, the odds ratios were 1.26 (95% confidence interval 0.95 to 1.68) for IgG and 1.09 (0.82 to 1.43) for IgA.No material association was found between infection with C pneumoniae and ischaemic heart disease. The size and prospective design of the study and the socioeconomic homogeneity of the cohort minimise both random and systematic error.
Rectoscopic Decompression of Acute Recto-sigmoid Obstruction
Authors: S. Lelcuk, A. Merhav, J. M. Klausner, M. Gutman, F. Greif, R. Rozin
Journal: Endoscopy (1987)

Effective non-operative decompression of a low obstruction of the colon can sometimes be accomplished by inserting a tube into the rectum and threading the tip up to a point proximal to the obstruction (1). Failure of this non-surgical decompression would require emergency surgery--either a diverting colostomy or a two-stage resection. A new non-surgical treatment performed on a patient with an obstructive tumor of the recto-sigmoid is described. Decompression of the obstructed bowel was achieved with a rectal tube introduced over a flexible guide wire proximal to the obstruction with the aid of a rectoscope, following which a one-stage procedure--an anterior resection was performed in one patient, while the other was referred for oncological treatment.
Practical Pediatric Electrocardiography
Authors: Jerome Liebman
Journal: JAMA (1974)

I must ask the reader in interpreting this review to accept my own personal long-standing bias against electrocardiographic primers. Such brief texts on standard electrocardiography have always been with us and, I'm sure—despite this review—will always be with us. Such books, as this one, are designed for the nonelectrocardiographer to  diagnoses for him. It also presupposes that an understanding of the nature of the electrocardiogram is not necessary in order to make simple diagnoses. My own tenet, of course, is that no primer can make an electrocardiographic diagnosis for someone who does not understand something about the underlying biology (except in the case of recognition of certain simple arrhythmias). Another unfortunate aspect in most primers, which goes along with teaching of patterns, is the inclusion of the same old-fashioned inaccuracies. A few examples include the use of the term intrinsicoid deflection (ventricular activation) where the authors relate the transmembrane
Delivery of a viral antigen to the class I processing and presentation pathway by Listeria monocytogenes.
Authors: G Ikonomidis, Y Paterson, F J Kos, D A Portnoy
Journal: The Journal of Experimental Medicine (1994)

Listeria monocytogenes is a facultative intracellular pathogen that grows in the cytoplasm of infected host cells. We examined the capacity of L. monocytogenes to introduce influenza nucleoprotein (NP) into the class I pathway of antigen presentation both in vitro and in vivo. Recombinant L. monocytogenes secreting a fusion of listeriolysin O and NP (LLO-NP) targeted infected cells for lysis by NP-specific class I-restricted cytotoxic T cells. Antigen presentation occurred in the context of three different class I haplotypes in vitro. A hemolysin-negative L. monocytogenes strain expressing LLO-NP was able to present in a class II-restricted manner. However, it failed to target infected cells for lysis by CD8+ T cells, indicating that hemolysin-dependent bacterial escape from the vacuole is necessary for class I presentation in vitro. Immunization of mice with a recombinant L. monocytogenes strain that stably expressed and secreted LLO-NP induced NP-specific CD8+ cytotoxic T lymphocytes. These studies have implications for the use of L. monocytogenes to deliver potentially any antigen to the class I pathway in vivo.
The uneasy esophagus.
Authors: R Ellis
Journal: BMJ (1980)

that should be pursued between teacher, child, and parents.There is evidence that the pendulum phenomenon is now heralding an era of "narrow punitive education associated with the bullying of children and adolescents,"'3 and that this would be welcome in some quarters.Let us hope that sufficient people feel strongly enough to ensure that the next decade does not provide further inspiration for the Pink Floyd.
TO THE MEMBERS OF THE MEDICAL PROFESSION IN THE UNITED STATES.
Authors: W W Keen
Journal: JAMA (1899)

The cause of humanity and of scientific progress is seriously menaced. Senator Gallinger has again introduced into Congress the Bill for the "Further Prevention of Cruelty of Animals in the District of Columbia," which he has so strenuously and misguidedly advocated in the last two Congresses. It is Senate Bill No. 34. Twice the Committee on the District of Columbia has, also unfortunately and misguidedly, reported the bill with a favorable consideration. It is speciously drawn to seem as if it were intended only in the interest of prevention of cruelty to animals, but the real object is twofold: 1, to prohibit vivisection and, 2, to aid the passage of similar bills in all the state legislatures. It hardly needs to be pointed out that this would seriously interfere with or even absolutely stop the experimental work of the Bureau of Animal Industry and the three medical departments of the
Promotion of Women Physicians in Academic Medicine-Reply
Authors: Bonnie J. Tesch
Journal: JAMA (1995)

<h3>In Reply.</h3> —We appreciate the interest of the correspondents in our study. Drs Nickerson, Shea, and Bennett note the similar proportions of women and men currently at associate professor rank. However, those currently at full professor rank were also previously promoted to associate professor rank. The percentage of men in our study who had ever been associate professors (83%) is much greater than the percentage of women (59%). Also, after 11 years, 38% of the women were still assistant professors. Drs Ruffin and Bland discuss characteristics of family medicine fellowships predicting later publication. These characteristics may or may not be generalizable to other specialties. Nonetheless, the point about academic socialization during fellowship has validity and may relate to the quality of mentoring. As mentioned in our discussion section, the women studied reported mentors as frequently as men, but we could not reliably assess the level of mentor support. This area
A Difficult Decision
Authors: John L. Wright
Journal: JAMA (1993)

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Nasal lavage concentrations of free hemoglobin as a marker of microepistaxis during nasal provocation testing*
Authors: Y.-J. Park, M. S. Repka-Ramirez, K. Naranch, A. Velarde, D. Clauw, J. N. Baraniuk
Journal: Allergy (2002)

The constituents of nasal mucus may be contaminated by plasma if there is epistaxis. Gross epistaxis is apparent as a red lavage fluid, while microepistaxis may yield a clear fluid. If gross or microepistaxis are present, it will be difficult to decide whether plasma protein concentrations are elevated because of plasma exudation or bleeding. In order to discriminate between these two possibilities, we measured erythrocyte-derived free hemoglobin (fHb) in nasal lavage fluids.Single-blinded subjects underwent standard hypertonic saline nasal provocation. Unilateral hypertonic nasal provocation was performed in normal, allergic rhinitis (AR) and nonallergic rhinitis (NAR) subjects (total of 1316 specimens). fHb was measured using the Sigma-Aldrich kit (St. Louis, MO). Grossly bloody specimens were analyzed separately from the remainder. Statistical analysis defined the means and 95th percentiles for fHb and albumin in the nonbloody normal group.fHb concentrations ranged from below the limits of detection (< 1 microg/ml) to > 164 microg/ml fHb was 79.3 microg/ml +/- 4.7 (mean +/- SEM) in four normal, 31 AR and 25 NAR grossly bloody specimens. The 95th percentile of fHb in the nonbloody normal samples (n = 68 subjects, n = 681 specimens) was 16.5 microg/ml. This value was defined as the threshold to detect potential microepistaxis, and corresponded to approximately 245 000 erythrocytes per ml of lavage fluid. Total protein (P < 0.05) and albumin (P < 0.001), but not markers of glandular secretion, were significantly increased in samples with fHb > 16.5 microg/ml compared to those < or = 16.5 microg/ml. Elevations of fHb without changes in albumin were more prevalent in nonallergic rhinitis.Significant bleeding into nasal lavage samples can contaminate the specimens and increase the concentrations of both fHb and plasma proteins. Increased albumin alone would indicate increased vascular permeability. The mechanism(s) leading to elevated fHb without increased plasma proteins require further investigation.