tbuckley/cabot-search huggingface dataset:
Nonstreptococcal Exudative Pharyngitis
Authors: Robert J. Glaser
Journal: JAMA (1983)

To the Editor.—  Having had many years ago a particular interest in group A streptococcal disease, I read the letter from MD, Ohio and Dr Montgomerie's response (1982;248: 1643). From the clinical description provided by the letter writer, I wondered whether the patient might not have had nonstreptococcal exudative pharyngitis. I haven't seen that entity referred to in years, but during World War II, when group A streptococcal infection was such a problem for certain of the military units, there was a description of exudative pharyngitis that was clinically indistinguishable from that caused by group A streptococcus. The only difference was that this streptococcus could not be recovered, and it was assumed that the disease was viral in origin.  I remember it particularly well because the year I was chief resident in medicine at the Barnes Hospital in the Washington University Medical Center, I came down with what both I
Blood Dendritic Cells From Myeloma Patients Are Not Infected With Kaposi's Sarcoma-Associated Herpesvirus (KSHV/HHV-8)
Authors: Qing Yi, Marianne Ekman, Doina Anton, Susanne Bergenbrant, Anders Österborg, Patrik Georgii-Hemming, Göran Holm, Kenneth Nilsson, Peter Biberfeld
Journal: Blood (1998)
Radiation Therapy and Thanatology
Authors: Walter G. Gunn
Journal: JAMA (1984)

The case of the critically or chronically ill patient and his family has its focus sharpened when that conjoint case includes the terminally ill. Attention to psychosocial, as well as medical needs of such patients is a rare art requiring thoughtful daily provision of such support. The volume at hand is an introductory guidebook to a portion of such care—in this instance, the patient with advanced cancer being treated by ionizing radiation. The first half of the book is a multiauthored collection of short chapters—some good, some not so good—collectively titled: "The Patient and Radiation Therapy—Art Versus Science." At best, it provides helpful simple suggestions to comfort very ill patients. The viewpoint of the patient is well covered in a chapter by Bricout and McKenzie, and a sensible chapter by Torpie on patients' rights. Torpie includes the suggestion that, present-day computers being what they are, it should not be too
Production and Secretion of Immunoglobulins by <i>in Vitro</i>‐Activated Human B Lymphocytes
Authors: R. Agger, J. Petersen, B. Dinesen, A. Wiik, V. Andersen
Journal: Allergy (1982)

Activation induced by pokeweed mitogen in cultures of mononuclear cells from human blood was followed sequentially by simultaneous quantitation of live cells, thymidine incorporation, cells displaying cytoplasmic IgM, IgG, IgA or IgD, cells secreting IgM, IgG or IgA and cumulated IgM secretion. Maximal cellular activity was found after 7 days of culture, with means of 16000 IgM‐, 20700 IgG‐ and 9900 IgA‐secreting cells per 10 6 originally cultured cells. The cumulated IgM secretion after 21 days of culture averaged 10400 ng per 10 6 originally cultured cells. A close correlation was found between the number of IgM‐secreting cells and the cumulated IgM secretion.
Peripheral Diabetic Neuropathy Treated With Amitriptyline and Fluphenazine
Authors: Jonathan L. Davis
Journal: JAMA (1977)

The pain of diabetic peripheral neuropathy responds poorly to current modes of treatment. We treated eight patients with this disorder whose pain was refractory to standard regimens but who experienced remarkable pain relief within two to five days after treatment with fluphenazine hydrochloride, amitriptyline hydrochloride, or a combination of the two. In four patients whose regimens were discontinued, pain recurred within two days and again remitted on reinstitution of the drug regimens. These findings suggest that fluphenazine alone or in combination with amitriptyline may be of benefit in treating the painful peripheral neuropathy associated with diabetes. (<i>JAMA</i>238:2291-2292, 1977)
Endothelial Cell–Specific Deficiency of Ang II Type 1a Receptors Attenuates Ang II–Induced Ascending Aortic Aneurysms in LDL Receptor <sup>−/−</sup> Mice
Authors: Debra L. Rateri, Jessica J. Moorleghen, Anju Balakrishnan, A. Phillip Owens, Deborah A. Howatt, Venkateswaran Subramanian, Aruna Poduri, Richard Charnigo, Lisa A. Cassis, Alan Daugherty
Journal: Circulation Research (2011)

Rationale: Human studies and mouse models have provided evidence for angiotensin II (Ang II)–based mechanisms as an underlying cause of aneurysms localized to the ascending aorta. In agreement with this associative evidence, we have published recently that Ang II infusion induces aneurysmal pathology in the ascending aorta. Objective: The aim of this study was to define the role of angiotensin II type 1a (AT 1a ) receptors and their cellular location in Ang II–induced ascending aortic aneurysms (AAs). Methods and Results: Male LDL receptor −/− mice were fed a saturated fat–enriched diet for 1 week before osmotic mini-pump implantation and infused with either saline or Ang II (1000 ng/kg per minute) for 28 days. Intimal surface areas of ascending aortas were measured to quantify ascending AAs. Whole body AT 1a receptor deficiency ablated Ang II–induced ascending AAs ( P &lt;0.001). To determine the role of AT 1a receptors on leukocytes, LDL receptor −/− ×AT 1a receptor +/+ or AT 1a receptor −/− mice were irradiated and repopulated with bone marrow–derived cells isolated from either AT 1a receptor +/+ or AT 1a receptor −/− mice. Deficiency of AT 1a receptors in bone marrow–derived cells had no effect on Ang II–induced ascending AAs. To determine the role of AT 1a receptors on vascular wall cells, we developed AT 1a receptor floxed mice with depletion on either smooth muscle or endothelial cells using Cre driven by either SM22 or Tek, respectively. AT 1a receptor deletion in smooth muscle cells had no effect on ascending AAs. In contrast, endothelial-specific depletion attenuated this pathology. Conclusions: Ang II infusion promotes aneurysms in the ascending aorta via stimulation of AT 1a receptors that are expressed on endothelial cells.
Controversial embryo bill receives second hearing in Lords
Authors: Lynn Eaton
Journal: BMJ (2007)

The government's human embryology and fertilisation bill had its second reading in the House of Lords this week, amid concerns that it would enable lesbian couples to have fertility treatment more easily. Some groups have also objected to the fact that it allows the creation of “interspecies embryos” for research purposes.

The bill drops the requirement that fertility specialists, when considering whether a woman is suitable for fertility treatment, have to take account of the need of the child for a father. This has not prevented lesbians from accessing in vitro fertilisation in the past, but its removal will deal with government concerns that the clause could amount to discrimination in the provision of goods and services.

The bill also recognises same sex couples as legal parents, in keeping with changes in the law allowing civil partnerships.

Introducing …
Diagnosis of pseudomembranous colitis.
Authors: A Kappas, N Shinagawa, Y Arabi, H Thompson, D Burdon, F Dimock, R H George, J Alexander-Williams, M R Keighley
Journal: BMJ (1978)

Twenty-eight patients with histologically proved pseudomembranous colitis have been seen in one hospital since July 1975. All patients with the disease had received antibiotics, six for infections not requiring operations; the other 22 cases all occurred after major surgery. All the patients had diarrhoea; six patients also had fever with clinical signs of sepsis, and three had abdominal pain thought to be due to anastomotic dehiscence after colonic resection. Pseudomembranous colitis was associated with white blood counts over 15 000/mm3 in 17 patients and albumin concentrations of less than 30 g/1 in 18. Pseudomembranous colitis was an incidental finding at necropsy in two of six patients who had not had an operation. Of the 22 patients who had had major surgery, nine died from this complication; in all except two of these cases the diagnosis was made only at necropsy. If pseudomembranous colitis is suspected on clinical grounds or if there is an unexplained complication after colorectal surgery repeat sigmoidoscopy and testing for faecal toxins should be carried out to establish the diagnosis so that prompt supportive treatment can be given.
THE CONSTITUTIONAL TREATMENT OF INTERSTITIAL GINGIVITIS.
Authors: J. H. SALISBURY
Journal: JAMA (1900)

At no previous period in the history of medicine has the importance of a thorough acquaintance with the human system as a whole and of the interdependence of the various organs been so well recognized as to-day. Since local diseases are scarcely ever uninfluenced by the systemic condition, it becomes important to consider their constitutional as well as their local treatment. Interstitial gingivitis is a disease comparatively unknown to the general practitioner, but it is to be hoped that the recent investigations which have thrown such a clear light upon its nature and effects will arouse the interest of the profession, so that its treatment will be undertaken at a stage when there is hope of recovery without permanent injury to the gums or teeth and before serious affection of other organs arise from it.** Interstitial gingivitis, or so-called pyorrhea alveolaris, has been classified by Dr. Talbot<sup>1</sup>as due
Collagen Scar Formation After Acute Myocardial Infarction
Authors: Paavo Uusimaa, Juha Risteli, Matti Niemelä, Jarmo Lumme, Markku Ikäheimo, Antti Jounela, Keijo Peuhkurinen
Journal: Circulation (1997)

Background Left ventricular function after acute myocardial infarction (AMI) is determined by the expansion of the infarct zone and remodeling of the noninfarcted myocardium. An occluded infarct-related artery (IRA) is an independent risk factor for remodeling. Methods and Results Changes in myocardial collagen metabolism were evaluated in 36 patients with suspected AMI. The plasma creatine kinase MB fraction and myoglobin release curves were analyzed for assessment of early reperfusion and infarct size. Collagen scar formation was evaluated by measurement of serum concentrations of the aminoterminal propeptide of type III procollagen (PIIINP), the aminoterminal propeptide of type I procollagen (intact PINP), and the carboxyterminal propeptide of type I procollagen (PICP). Plasma renin activity and urine excretion of cortisol and aldosterone were also measured. Coronary angiography and left ventricular cineangiography were performed during early hospitalization. The serum concentration of PIIINP increased from 3.50±0.20 to a maximum of 5.08±0.36 μg/L (n=32) in the patients with AMI, whereas the concentrations of intact PINP and PICP tended to decrease. The area under the curve (AUC) of PIIINP during the first 10 postinfarction days was larger in patients with severe heart failure or ejection fractions ≤40% than in those with no heart failure or with an ejection fraction &gt;40% ( P &lt;.05 and P &lt;.01, respectively), and it was also larger in the patients with TIMI grade 0 to 2 flows than in those with TIMI 3 flows ( P &lt;.05), despite similar enzymatically determined infarct sizes. No significant correlations between PIIINP and neurohumoral parameters were observed. The AUC of PIIINP and the change in PIIINP during the first 4 days were significantly correlated with indices of cardiac function. Conclusions Collagen scar formation after AMI can be quantified by measurement of serum PIIINP concentrations. Scar formation is more prominent in large infarctions causing left ventricular dysfunction and in patients with occluded IRAs.
The Prognosis and Role of Surgery in Spontaneous Intracranial Haemorrhage
Authors: J. M. Small, J. MacD. Holmes, R. C. Connolly
Journal: BMJ (1953)

SENSITIVITY OF H. INFLUENZAEEDIJISL obtained with the usually recommended therapeutic doses.Terramycin comes next in order of effectiveness, followed by streptomycin and aureomycin.Penicillin in vitro is as effective as chloramphenicol and terramycin, or even better, on a weight-for-weight basis, but blood concentrations within the effective range are difficult to obtain and maintain.Deterioration of aureomycin at 37°C. may be responsible for the comparatively low rating of the drug, but clinical impressions in chronic H. influenzae infections also suggest the superiority of chloramphenicol.
Determinants of Arterial Nitrate-Mediated Dilatation in Children
Authors: Mikko J. Järvisalo, Terho Lehtimäki, Olli T. Raitakari
Journal: Circulation (2004)

Background— Impaired arterial dilatation response to nitroglycerin has been observed in adults with risk factors for atherosclerosis and in patients with established atherosclerotic disease. This defect parallels changes in vascular endothelial function and may be attributed to increased oxidative stress. Because atherosclerosis begins in childhood, we examined the correlates of nitrate-mediated dilatation (NMD) in children, including brachial artery endothelial function, oxidized LDL, and carotid artery intima-media thickness (IMT). Methods and Results— Brachial artery flow-mediated endothelium-dependent dilatation (FMD) and nitrate-mediated smooth muscle function, IMT of the carotid bulb, and brachial artery and oxidized LDL were measured in 142 children (mean age, 11 years; range, 8 to 17 years), including 87 healthy children, 41 diabetic children, and 14 children with familial hypercholesterolemia. NMD correlated directly with FMD ( r =0.46, P &lt;0.001) and inversely with brachial artery baseline diameter ( r =−0.36, P &lt;0.001), age ( r =−0.25, P =0.003), body mass index ( r =−0.31, P &lt;0.001), diabetes ( r =−0.22, P =0.008), oxidized LDL ( r =−0.18, P =0.045), and IMT ( r =−0.33, P &lt;0.001). In a multivariate regression model, the significant correlates for NMD were FMD response (β=0.003, P &lt;0.001), brachial artery diameter (β=−0.03, P =0.01), oxidized LDL (β=−0.07, P =0.02), and IMT (β=−0.15, P =0.03). Conclusions— Reduced endothelial function, increased oxidative stress, and preclinical carotid atherosclerosis are independent determinants of impaired NMD in children. These data thus suggest that primary nitrate tolerance occurs in children at risk for atherosclerosis.
Brain-dead kidney donor: selection, care, and administration.
Authors: A R Luksza
Journal: BMJ (1979)

Over four and a half years a district general hospital provided 34 cadaveric kidneys for transplantation. All brain-dead patients were regarded as potential donors, flow charts being used to maintain circulation and urine formation and facilitate administration. With this system the time lapse between diagnosis of brain death and removal of kidneys ranged from three to six hours and ischaemia was minimised. It is concluded that adoption of the system by other hospitals of comparable size would result in enough good-quality kidneys to satisfy present needs, thus reducing the initial high failure rate and enabling more patients to be accepted for dialysis.
Human leukocyte antigen class II molecules confer both susceptibility and progression in Japanese patients with primary biliary cirrhosis
Authors: Takeji Umemura, Satoru Joshita, Tetsuya Ichijo, Kaname Yoshizawa, Yoshihiko Katsuyama, Eiji Tanaka, Masao Ota
Journal: Hepatology (2011)

Abstract Along with twin and family studies, recent genome-wide association studies suggest that genetic factors contribute to the susceptibility and severity of primary biliary cirrhosis (PBC). Although several reports have demonstrated that the human leukocyte antigen (HLA) DRB1*08:03 allele is associated with disease susceptibility in Japan, the precise analysis of HLA haplotypes and the role of amino acid alignment have not been fully clarified. We investigated HLA class I A, B, and C and HLA class II DRB1 and DQB1 alleles and haplotypes in 229 Japanese patients with PBC and compared them with the published data of 523 healthy subjects. Significant associations were found with PBC susceptibility for the DRB1*08:03-DQB1*06:01 (13% versus 6%; P = 0.000025; odds ratio [OR] = 2.22) and DRB1*04:05-DQB1*04:01 haplotypes (17% versus 13%; P = 0.044; OR = 1.38). Conversely, there were significant protective associations with the DRB1*13:02-DQB1*06:04 (2% versus 5%; P = 0.00093; OR = 0.27) and DRB1*11:01-DQB1*03:01 haplotypes (1% versus 4%; P = 0.03; OR = 0.37). The frequency of the DRB1*09:01-DQB1*03:03 haplotype was significantly higher in patients who had received orthotopic liver transplantation (33% versus 11%; P = 0.0012; OR = 3.96). Furthermore, the frequency of serine at position 57 ( P = 0.0000015; OR = 1.83) of the DRβchain differed the most in patients with PBC, compared with healthy subjects. Conclusion : This study established the role of HLA haplotypes in determining PBC susceptibility and progression in the Japanese population. Further resequencing of the HLA region is required to more precisely identify the genetic components of PBC. (Hepatology 2012)
Information shared in mentoring must remain confidential
Authors: R. Freeman
Journal: BMJ (1997)

Editor–While Robert Alliott makes passing mention of mentoring schemes in several regions in his article in Career Focus,1 he does not acknowledge the evident and specific influence on his own study of the pioneering three year mentor project in South Thames, which is currently being evaluated. A particularly relevant finding from this evaluation is the link between effective outcomes of mentoring interventions and the mentee's reliance on the confidentiality of information shared with the mentor. Alliott's suggested extended use of such privileged information, even …
Depression: Its Diagnosis and Treatment; Lithium: The History of Its Use in Psychiatry
Authors: Ronald R. Fieve
Journal: JAMA (1970)

This is the third and shortest monograph in the "Modern Problems of Pharmacopsychiatry" series. Kline briefly outlines the psychiatric uses of the term "depression," combining various current theories with his own, and presents a modified version of Lehmann's classification of depressive illnesses. He compares the effectiveness of monoamine oxidase inhibitors and tricyclic antidepressants in the reactive and endogenous depressions but notes that studies attempting to demonstrate the superiority of one drug over another in a particular subtype of depression are inconclusive. Considering contraindications, prior treatments, degree of sedation desired, and possible side effects, he gives suggestion on choice of appropriate medication. Recommended doses are tabulated for the major tricyclics and monoamine oxidase inhibitors (MAOI). The physician is cautioned against the legal risk he takes in prescribing the sometimes efficacious combination of MAOI and tricyclics. The controversial issue of the value of lithium salts in recurrent depressions is presented without definitive
TETANUS PROPHYLAXIS AND SUSPECTED WOUNDS.
Authors: JOSEPH McFARLAND
Journal: JAMA (1903)

In 1899, in association with E. M. Ranck, I published a paper in the<i>Journal of Comparative Medicine and Veterinary Archives</i>entitled "Tetanus Toxin and Antitoxin." In addition to general facts regarding tetanus, the tetanus bacillus and the toxin and antitoxin, there were recorded some practical experiences with the antitoxin as a prophylactic, which, probably because of the nature of the rest of the paper, escaped the attention they deserved. The observations to which I again call attention were made in one of the large antitoxin factories of this country on a number of horses somewhat exceeding 800, and continuing over a period of nearly four years. These 800 horses were used for immunization experiments in manufacturing different therapeutic serums, and were constantly being injected and bled at frequent intervals, and occasionally suffered from local lesions consequent upon the irritative action of the injected toxins. At the time the laboratory
Defining Patient Complexity From the Primary Care Physician's Perspective
Authors: Richard W. Grant, Jeffrey M. Ashburner, Clemens S. Hong, Yuchiao Chang, Michael J. Barry, Steve J. Atlas
Journal: Annals of Internal Medicine (2011)

Background: Patients with complex health needs are increasingly the focus of health system redesign. Objective: To characterize complex patients, as defined by their primary care physicians (PCPs), and to compare this definition with other commonly used algorithms. Design: Cohort study. Setting: 1 hospital-based practice, 4 community health centers, and 7 private practices in a primary care network in the United States. Participants: 40 physicians who reviewed a random sample of 120 of their own patients. Measurements: After excluding patients for whom they were not directly responsible, PCPs indicated which of their patients they considered complex. These patients were characterized, independent predictors of complexity were identified, and PCP-defined complexity was compared with 3 comorbidity-based methods (Charlson score, Higashi score, and a proprietary Centers for Medicare & Medicaid Services algorithm). Results: Physicians identified 1126 of their 4302 eligible patients (26.2%) as complex and assigned a mean of 2.2 domains of complexity per patient (median, 2.0 [interquartile range, 1 to 3]). Mental health and substance use were identified as major issues in younger complex patients, whereas medical decision making and care coordination predominated in older patients (P < 0.001 for trends by decade). Major independent predictors of PCP-defined complexity (P < 0.001) included age (probability of complexity increased from 14.8% to 19.8% with age increasing from 55 to 65 years), poorly controlled diabetes (from 12.7% to 47.6% if hemoglobin A1c level ≥9%), use of antipsychotics (from 12.7% to 31.8%), alcohol-related diagnoses (from 12.9% to 27.4%), and inadequate insurance (from 12.5% to 19.2%). Classification agreement for complex patients ranged from 26.2% to 56.0% when PCP assignment was compared with each of the other methods. Limitation: Results may not be generalizable to other primary care settings. Conclusion: Primary care physicians identified approximately one quarter of their patients as complex. Medical, social, and behavioral factors all contributed to PCP-defined complexity. Physician-defined complexity had only modest agreement with 3 comorbidity-based algorithms. Primary Funding Source: Partners Community Healthcare, Inc.
FDG Uptake in a Benign Paranasal Sinus Schneiderian Papilloma
Authors: Eugene Lin
Journal: Clinical Nuclear Medicine (2007)

A 60-year-old man with a history of colon cancer underwent a F-18 fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG PET/CT) scan. The PET/CT demonstrated focal uptake in the right maxillary sinus, corresponding to a small soft tissue density. The CT appearance suggested an inflammatory polyp or retention cyst. However, because of the intense FDG uptake, the patient underwent biopsy followed by excision. The lesion was a mixed oncocytic/inverted Schneiderian papilloma without malignancy. The PET/CT was vital for diagnosis as the CT features were nonspecific. Schneiderian papillomas can have intense FDG uptake, even when benign.
Oral N-acetylcysteine rescues lethality of hepatocyte-specific Gclc-knockout mice, providing a model for hepatic cirrhosis
Authors: Ying Chen, Elisabet Johansson, Yi Yang, Marian L. Miller, Dongxiao Shen, David J. Orlicky, Howard G. Shertzer, Vasilis Vasiliou, Daniel W. Nebert, Timothy P. Dalton
Journal: Journal of Hepatology (2010)