tbuckley/cabot-search huggingface dataset:
LOCAL IMMUNITY IN EXPERIMENTAL ERYSIPELAS
Authors: Harold L. Amoss, Eleanor A. Bliss
Journal: The Journal of Experimental Medicine (1927)

The experiments recorded show that the skin involved in the zone of inflammation produced by the endodermal injection of virulent living erysipelas streptococci into rabbits becomes, after the lesion has healed, partially but not completely resistant to subsequent infection with the homologous organism. In the majority of experiments the lesion resulting from the first endodermal injection spread downward, i.e., ventrally, to the site of needle puncture forming an oval or elongated inflammatory zone. Subsequent injections of the same strain into the skin beyond and ventral to the apparent edge of the lesion showed that these areas in the supposed direction of the lymph flow likewise became resistant but not quite to the same degree as in the inflammatory area. The contiguous areas above, behind, and in front of the healed lesion exhibited only a very mild degree of resistance. The other side of the rabbit where no previous injections had been made reacted as did the normal skin. Repeated injections on the same side bring about diminishing local reaction until there is almost no lesion following the injection of the standard skin dose. Thus there is a gradual spread of skin resistance on the inoculated side, whereas the non-injected side of the rabbit reacts normally. Finally, however, after many injections over relatively long periods the non-injected side becomes resistant, but at this time, there is evidence of general humoral immunity as shown by the presence of agglutinins and antitoxin in the blood. The local resistance is apparently not entirely specific, for the areas with the previous lesion and ventral to it become more resistant to another strain of beta hemolytic streptococcus, though in less degree, and to a virulent strain of Staphylococcus aureus to a still less degree. The most plausible explanation of the spread of the local immunity ventrally is that the streptococci follow the lymph channels. Indeed, in human erysipelas, the organisms are recovered by cutipuncture as far as 3 cm. beyond the advancing edge of the lesion where there is no gross evidence of inflammation. This aspect of local immunity will be considered in subsequent publications. The skin of the rabbit involved in the inflammatory reaction following the endodermal injection of living streptococci becomes resistant to subsequent injection of the homologous strain and of other strains of erysipelas streptococci which are not immunologically identical. The local immune areas are resistant but not to the same degree to a strain of hemolytic streptococci isolated from follicular tonsillitis and to a virulent Staphylococcus aureus. The areas contiguous to the local lesion but outside the apparent boundary of inflammation become more resistant to subsequent injection. But the regions ventral to those areas become more resistant than those dorsal, anterior, or posterior to the inflammatory zone. The skin on the non-injected side of the rabbit becomes resistant pari passu with the development of humoral immunity.
The Retrieval of Medical Literature
Authors: Peter C. Amadio
Journal: JAMA (1986)

<h3>To the Editor.—</h3> I am writing in response to the article and editorial on full-text medical literature data bases in the Nov 15, 1985, issue.<sup>1</sup>There is no question that computerized data retrieval systems greatly increase the accessibility of medical data to the practitioner. However, a disturbing tendency toward fragmentation of the provision of such data may decrease the utility of electronic medical data retrieval. I am referring to the increasing number of information networks available. Not long ago, the only computerized data base available was that provided by the National Library of Medicine (MEDLARS). To my knowledge, this is still by far the most comprehensive single data base, containing nearly 4 million citations. It provides abstracts of some of the more recent articles but otherwise only gives a bibliographic citation. Other data bases have begun to include either more elaborate abstracts or full text, but from a limited
Research related to rehabilitation.
Authors: N K Wenger
Journal: Circulation (1979)

Progress in cardiac rehabilitation demands that rehabilitation efforts for the patient after myocardial infarction or aortocoronary bypass surgery be integrated into a comprehensive program of acute and ambulatory cardiac care. To permit a more rapid return of coronary patients to a normal or near-normal lifestyle and role in society, further delineation of the scientific bases for all components of rehabilitation programming and identification of both barriers to and facilitators of rehabilitation are necessary to improve rehabilitative services.
STUDIES ON NEWCASTLE DISEASE VIRUS
Authors: F. B. Bang
Journal: The Journal of Experimental Medicine (1948)

The application of the 50 per cent embryo mortality to a study of the virus of Newcastle is described. It has been evaluated by a series of duplicate titrations of the same sample of virus. In seven such titrations the largest difference between the two was 10(-0.4). It is therefore believed that a difference of 0.6 log is probably significant and of 1.0 log almost certainly significant. This would mean that we can almost certainly detect a loss of 90 per cent of activity. Neither temperature of incubation nor route of inoculation in the test embryos had consistent effect on the measurement of virus activity. The effect of increasing age of the incubated embryo, from 10 days up to 16 days, is slight and inconsistent. The addition of chicken red blood cells to a dilution of virus may lower the titer of the preparation, but the change is not sufficient to be of importance in the routine handling of the virus.
Diabetes Process and Outcome Measures in the Department of Veterans Affairs
Authors: Clark T. Sawin, Debby J. Walder, Dean S. Bross, Leonard M. Pogach
Journal: Diabetes Care (2004)

To evaluate performance of process and outcome measures in the care of patients with diabetes seen in Department of Veterans Affairs (VA) facilities.Retrospective audits of records and databases were conducted on randomly selected patients with diabetes over 5 years (1995 [baseline] and 1997-2000) in 22 VA networks. Performance on diabetes-specific and preventive processes was measured.Nationally, significant improvements over time were observed for all measures (P < 0.001). For example, the percentage of patients receiving a dilated retinal examination rose from 44% in 1995 to 67% in 2000. The percentage of patients who received a urinary protein test rose from 23% in 1997 to 54% in 2000. Those who received influenza vaccination rose from 34% in 1995 to 78% in 2000. However, there was significant regional variation among all measures.Adherence to diabetes-specific and preventive care measures in the VA improved from 1997 to 2000 compared with a 1995 baseline. The improvement occurred in a setting of the provision of guidelines, the contractual setting of specific targets, and the timely feedback of results to medical center and network directors. Future studies are needed to determine whether adherence to these measures will decrease the rates of complications in VA patients with diabetes.
Mycobacterium gordonae in the Acquired Immunodeficiency Syndrome
Authors: JOHN CHAN
Journal: Annals of Internal Medicine (1984)

ExcerptTo the editor: We recently treated a patient with the acquired immunodeficiency syndrome and disseminated infection due to Mycobacterium gordonae. Infection with this organism has not previously been reported in association with the syndrome.A 41-year-old man who abused intravenous drugs developedPneumocystis cariniipneumonia in November 1981. He responded to treatment with intravenous sulfamethoxazole and trimethoprim. In July 1982 he developed esophageal candidiasis which was treated with ketoconazole. The next month, a sputum specimen showed acid-fast bacilli on stain. He was treated by his physician with isoniazid. In November 1982, because of persistent fever and weakness, a bone marrow...
778-2 Prehospital Thrombolysis in Acute MI Prevents Symptoms of Congestive Heart Failure — A Long-term Follow-up Study
Authors: A. Teddy Weiss, Dan Gilon, Iris Shviro, Dan Sapoznikov, Shimon Rosenheck, Morris Mosseri, Chaim Lotan, Yoseph Rozenman, Mervyn S. Gotsman
Journal: Journal of the American College of Cardiology (1995)
Corporate Practice of Medicine, Federal Income Taxes and Pension Plans
Authors: William J. Curran
Journal: New England Journal of Medicine (1969)

IN three separate decisions during late 1968, the federal district courts have given important victories to medical groups that have formed "professional service corporations" to take advantage of federal tax benefits available to corporations, especially regarding pension and profit-sharing plans. In all three cases,1 the courts held Internal Revenue Code regulations invalid under the law. The courts held that the regulations, which would have prevented these particular organizations from qualifying as corporations under the federal tax laws, were discriminatory toward these professional corporations, imposing upon them more stringent standards than would be applied to other business corporations.It is well . . .
Pathogenesis of hyperadrenergic orthostatic hypotension. Evidence of disordered venous innervation exclusively in the lower limbs.
Authors: D H Streeten
Journal: Journal of Clinical Investigation (1990)

The pathogenesis of hyperadrenergic orthostatic hypotension was studied in eight patients. Correction of the abnormal orthostatic changes by an inflated pressure suit (MAST) confirmed previous evidence of excessive gravitational pooling of blood in the leg veins. Intravenous L-norepinephrine infusion raised diastolic blood pressure in the same relationship to the infusion-induced increments in plasma norepinephrine concentrations as in normal subjects, indicating normal arteriolar responses. Contractile responses of the veins to infused L-norepinephrine were measured with a linear variable differential transformer (LVDT). The venous responses of hand veins in the patients fell within the 95% confidence limits of the responses of normal hand veins, as did the responses of foot veins in the seven normal subjects. However, foot veins of the patients with hyperadrenergic orthostatic hypotension, and both hand and foot veins of patients with "diffuse" autonomic failure, were supersensitive to norepinephrine, as reflected by a steeper slope of the regression of log (norepinephrine infusion rate) on percentage reduction in venous distensibility, and a significantly lower ED50 (i.e., norepinephrine infusion rate that induced 50% reduction in venous distensibility). The findings suggest anatomical or functional postganglionic denervation of lower limb veins causing excessive gravitational blood pooling with consequent orthostatic hypotension in these patients.
Trends in Graduate Medical Education and Specialty Certification
Authors: Edithe J. Levit, Melvin Sabshin, C. Barber Mueller
Journal: New England Journal of Medicine (1974)

Abstract To obtain a quantitative measure of the extent to which graduate education and qualification for specialty certification have become an integral part of the total educational experience, samples of 1960 and 1964 graduates of United States medical schools were tracked through residency training and the specialty certification process, and into present professional activities. Of 1337 physicians studied, about 90 per cent had residency training; over 70 per cent completed residency and entered the certification process. Of the 1960 graduates whose career choices were then recognized by established specialty boards, 99 per cent entered residency, 86 per cent completed residency and entered the certification process, and 73 per cent had achieved specialty certification. The overwhelming motivation for graduate education and specialty certification evidenced by these graduates, together with a shortening of formal medical education, and approval of the specialty of family practice (1969), warrant the conclusion that during the 1970's, virtually all United States graduates will undertake residency training and seek specialty certification. (N Engl J Med 290:545–549, 1974)
Blind eye to complaints allowed psychiatrists to abuse patients
Authors: Clare Dyer
Journal: BMJ (2005)

An NHS culture of turning a blind eye allowed two psychiatrists to get away with sexually abusing scores of vulnerable women patients through the 1970s and 1980s. This was the conclusion this week of the report of an independent inquiry commissioned by the Department of Health.

Concerns and complaints about William Kerr and Michael Haslam were never acted on by the NHS, and they were allowed to retire in 1988. They were …
On Economic Justifications of Bioterrorism Defense Spending
Authors: Fritz Allhoff
Journal: The American Journal of Bioethics (2005)

*The opinions contained in this article are those of the author and do not necessarily represent those of the American Medical Association. ACKNOWLEDGMENTS The author would like to thank Chris Buford, Shane Green, and Justin List for helpful discussions regarding this paper. Notes *The opinions contained in this article are those of the author and do not necessarily represent those of the American Medical Association. 1. For a case study in the cost-effectiveness of anthrax defense spending, see CitationFowler et al. (2005). 2. I will assume that, of any competing spending programs that are weakly justified, the one with the lower cost–benefit ratio is the only which is strongly justified. There are complications with this assumption, particularly as pertains to maximization over two variables, but they are not important for the purposes of this paper. 3. For a more in-depth discussion of some of these issues, see CitationGreen (2005).
Sexual relationships between doctors and former patients
Authors: Julian Sheather
Journal: BMJ (2006)

<h3>Abstract</h3> Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic and debilitating disease that is characterized by unexplained physical fatigue unrelieved by rest. Symptoms also include cognitive and sensory dysfunction, sleeping disturbances, orthostatic intolerance and gastrointestinal problems. The pathogenesis is not fully understood. Using regression, Bayesian and enrichment analyses, we conducted targeted and untargeted metabolomic analysis of 888 metabolic analytes in plasma samples of 106 ME/CFS cases and 91 frequency-matched healthy controls. In ME/CFS cases, the regression, Bayesian and enrichment analyses all revealed abnormal levels of several membrane lipids indicating dysregulation of the Kennedy pathway: decreased plasma levels of plasmalogens, phosphatidylcholines, phosphatidylethanolamines, sphingomyelins, and phospholipid ethers. Enrichment analyses revealed decreased levels of cholines, ceramides and carnitines, and increased levels of long chain triglycerides, dicarboxylic acids, hydroxy-eicosapentaenoic acid, and the tricarboxylic acid cycle intermediates alpha-ketoglutarate and succinate. Using machine learning algorithms with selected metabolites as predictors, we were able to differentiate female ME/CFS cases from female controls (highest AUC=0.794) and ME/CFS cases without self-reported irritable bowel syndrome (sr-IBS) from controls without sr-IBS (highest AUC=0.873). Our findings are consistent with earlier ME/CFS work indicating compromised energy metabolism and redox imbalance, and highlight specific abnormalities that may provide insights into the pathogenesis of ME/CFS.
Years of Life Lost Due to Obesity
Authors: Kevin R. Fontaine, David T. Redden, Chenxi Wang, Andrew O. Westfall, David B. Allison
Journal: JAMA (2003)

Public health officials and organizations have disseminated health messages regarding the dangers of obesity, but these have not produced the desired effect.To estimate the expected number of years of life lost (YLL) due to overweight and obesity across the life span of an adult.Data from the (1) US Life Tables (1999); (2) Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994); and (3) First National Health and Nutrition Epidemiologic Follow-up Study (NHANES I and II; 1971-1992) and NHANES II Mortality Study (1976-1992) were used to derive YLL estimates for adults aged 18 to 85 years. Body mass index (BMI) integer-defined categories were used (ie, <17; 17 to <18; 18 to <19; 20 to <21; 21 to 45; or > or =45). A BMI of 24 was used as the reference category.The difference between the number of years of life expected if an individual were obese vs not obese, which was designated YLL.Marked race and sex differences were observed in estimated YLL. Among whites, a J- or U-shaped association was found between overweight or obesity and YLL. The optimal BMI (associated with the least YLL or greatest longevity) is approximately 23 to 25 for whites and 23 to 30 for blacks. For any given degree of overweight, younger adults generally had greater YLL than did older adults. The maximum YLL for white men aged 20 to 30 years with a severe level of obesity (BMI >45) is 13 and is 8 for white women. For men, this could represent a 22% reduction in expected remaining life span. Among black men and black women older than 60 years, overweight and moderate obesity were generally not associated with an increased YLL and only severe obesity resulted in YLL. However, blacks at younger ages with severe levels of obesity had a maximum YLL of 20 for men and 5 for women.Obesity appears to lessen life expectancy markedly, especially among younger adults.
196. Genetic Manipulation of Dendritic Cells through the Use of Immunolipoplexes To Induce T Cell-Specific Tolerance In Vivo
Authors: Peng H. Tan, Robert I. Lechler, Giovanna Lombardi, Andrew J.T. George
Journal: Molecular Therapy (2006)

Background: Genetic manipulation of dendritic cells (DCs) is important in the context either of using mature DCs to immunize patients, or immature DCs to induce tolerance. We have previously described a novel method of transfecting monocyte-derived human DC using immunolipoplexes containing anti-CD71 or anti-CD205 monoclonal Abs 1. In this report we test the feasibility of the immunolipoplexes and selection protocol for therapeutic intervention. We went on to transfect DC with a novel gene to knock-down the expression of co- stimulatory molecules which was previously reported to be effectively in vitro 2. Methods & Results: Using an adoptive transfer model, we demonstrated that OVA- specific T cells could be tolerised in vivo when the mice were vaccinated with these CTLA4-KDEL transfected dendritic cells. We demonstrated antigen-specific tolerance could be achieved in vivo using OVA-transgenic mice. Like our human in vitro data, in an allogeneic model, the allogeneic T cells exposed to DC that were transfected with our novel gene did not proliferate. We then went on to characterize the mechanism of T cell hyporesponsiveness. Like the human work, it was mediated through Th2-deviation of cytokine profile. Conclusions: This work demonstrates feasibility of the immunolipoplexes to deliver a therapeutic gene that resulted in a significant functional effect in vivo. Therefore, the immunolipoplexes may have a role in delivering a magic bullet for clinical tolerance induction protocols. References: 1 Tan PH et al. Immunolipoplexes: an efficient, non-viral alternative for transfection of human dendritic cells with potential for clinical vaccination. Mol Ther 2005; 11: 790–800. 2 Tan PH et al. Creation of tolerogenic human dendritic cells via intracellular CTLA4: a novel strategy with potential in clinical immunosuppression. Blood 2005; 106: 2936–2943.
Unnecessary school absence after minor injury: case-control study
Authors: P. M Barnes, L. Price, A. Maddocks, R. A Lyons, P. Nash, M. McCabe
Journal: BMJ (2001)

Children acquire many of the academic and social skills they need for their adult lives at school. Excessive absence from school is associated with educational failure, particularly when children miss more than 11% of school days.1 Each year, one in three British children goes to an emergency department for treatment, predominantly with minor injuries, but the effect on school attendances has not been quantified.2

This study was designed to investigate the number of days missed from school after children attended one of three local emergency departments with minor injuries. We defined minor injuries as those not requiring admission to hospital and not affecting mobility or the ability of the child to care for himself or herself.

This case-control study involved children resident in, and attending school full time in, the Welsh counties of Swansea and Neath Port Talbot during the autumn school term of 1999. A case was defined …
Modern Medicine and Jewish Ethics
Authors: Rabbi Amy Eilberg
Journal: JAMA (1987)

<h3>Jewish Values in Bioethics, edited by Levi Meier, 195 pp, $29.95, New York, Human Sciences Press, 1986.</h3> Theorists and practitioners alike in the health care field have begun to turn to the great religious traditions in the search for answers to a dizzying array of new questions in biomedical ethics. However, it soon becomes clear that even a single religious tradition rarely speaks in an unequivocal voice on the contemporary issues at hand. Rather, each tradition speaks with its own cacophony of voices, reflecting a long history of interpretation and competing sources of authority. Furthermore, it is not at all clear how best to make use of the insights of historical religions, whose authoritative texts often predate by centuries and millennia the appearance of the realities under discussion. Most important, how does one place medicine and religion in effective dialogue, such that the religious tradition can open itself to the
The effect of endurance running training on asthmatic adults.
Authors: W Freeman, M G Nute, C Williams
Journal: British Journal of Sports Medicine (1989)

Nine mild to moderate asthmatic adults (three males, six females) and six non-asthmatics (one male, five females) underwent endurance running training three times per week for five weeks, at self selected running speeds on a motorized treadmill. After training, the asthmatic group had a significantly higher maximum oxygen uptake, significantly lower blood lactate and heart rate in submaximal running, and significantly reduced time to complete a two mile treadmill run, partly attributable to the ability to exercise at a higher % VO2 max after training. These training induced changes of the asthmatic group were generally of a greater magnitude than those shown by the non-asthmatic group. Although seven of the nine asthmatics did show a reduction in the post-exercise fall in FEV1 after the five week training period, this was not statistically significant for the asthmatic group as a whole. The results of this study therefore suggest that endurance running training can improve the aerobic fitness of asthmatic adults, and may reduce the severity of exercise-induced asthma.