tbuckley/cabot-search huggingface dataset:
Bartonella-related pseudomembranous angiomatous papillomatosis of the oral cavity associated with allogeneic bone marrow transplantation and oral graft-versus-host disease
Authors: C. Vassallo, M. Ardigò, V. Brazzelli, M. Zecca, F. Locatelli, P.E. Alessandrino, M. Lazzarino, S. Corona, P. Lanzerini, M. Benazzo, M. Fabbi, G. Borroni
Journal: British Journal of Dermatology (2007)

Patients undergoing allogeneic stem cell transplantation are at high risk for infection with a variety of pathogens during different phases of the procedure. Human infections due to Bartonella spp. are viewed as emerging diseases typical in, although not exclusive to, immunosuppressed patients, in particular those with AIDS, organ transplants and haematological malignancies. We describe four patients, three children and one adult, who developed vegetating papillomatous lesions exclusively on the oral mucosae. They shared a history of haematological malignancy and allogeneic bone marrow/stem cell transplantation, and later developed chronic graft-versus-host disease, also involving the oral mucosae. Histopathologically, the vegetating lesions were characterized by a diffuse neoangiogenesis, granulation-like tissue, and a mixed cell infiltrate predominantly composed of neutrophils. Gram-negative bacteria were found in the endothelial cells of the vessels in the deeper portion of the corium by electron microscopy. In three cases, DNA of B. henselae was detected by polymerase chain reaction (PCR), and confirmed by sequencing of the PCR products. All the lesions healed after systemic antibiotic therapy, although some recurred after months, and regressed again after systemic antibiotic treatment associated with conservative surgical excision.
Immediate Angioplasty for Acute Myocardial Infarction
Authors: R. A. Lange, L. D. Hillis
Journal: New England Journal of Medicine (1993)

During the past 10 to 15 years, pathological and arteriographic studies have shown that Q-wave myocardial infarction is usually caused by an occlusive coronary arterial thrombus. Investigations have also shown that thrombolytic therapy can restore antegrade flow in the occluded artery, reduce the size of the infarct, and improve survival. Initially, thrombolytic agents were infused directly into the occluded coronary artery during cardiac catheterization, but later studies showed that intravenous administration offered similar efficacy without the delay, the need for angiographic equipment and skilled personnel, or the morbidity and mortality associated with emergency catheterization. Thus, effective therapy for evolving myocardial . . .
Adjuvant Radiotherapy and Chemotherapy in Node-Positive Premenopausal Women with Breast Cancer
Authors: Joseph Ragaz, Stewart M. Jackson, Nhu Le, Ian H. Plenderleith, John J. Spinelli, Vivian E. Basco, Kenneth S. Wilson, Margaret A. Knowling, Christopher M.L. Coppin, Marilyn Paradis, Andrew J. Coldman, Ivo A. Olivotto
Journal: New England Journal of Medicine (1997)

Radiotherapy after mastectomy to treat early breast cancer has been known since the 1940s to reduce rates of local relapse. However, the routine use of postoperative radiotherapy began to decline in the 1980s because it failed to improve overall survival. We prospectively tested the efficacy of combining radiotherapy with chemotherapy.From 1978 through 1986, 318 premenopausal women with node-positive breast cancer were randomly assigned, after modified radical mastectomy, to receive chemotherapy plus radiotherapy or chemotherapy alone. Radiotherapy was given to the chest wall and locoregional lymph nodes between the fourth and fifth cycles of cyclophosphamide, methotrexate, and fluorouracil.After 15 years of follow-up, the women assigned to chemotherapy plus radiotherapy had a 33 percent reduction in the rate of recurrence (relative risk, 0.67; 95 percent confidence interval, 0.50 to 0.90) and a 29 percent reduction in mortality from breast cancer (relative risk, 0.71; 95 percent confidence interval, 0.51 to 0.99), as compared with the women treated with chemotherapy alone.Radiotherapy combined with chemotherapy after modified radical mastectomy decreases rates of locoregional and systemic relapse and reduces mortality from breast cancer.
Effect of fluid ingestion on neuromuscular function during prolonged cycling exercise
Authors: J-M Vallier, F Grego, F Basset, R Lepers, T Bernard, J Brisswalter
Journal: British Journal of Sports Medicine (2005)

To investigate the effects of fluid ingestion on neuromuscular function during prolonged cycling exercise.Eight well trained subjects exercised for 180 minutes in a moderate environment at a workload requiring approximately 60% maximal oxygen uptake. Two conditions, fluid (F) and no fluid (NF) ingestion, were investigated.During maximal voluntary isometric contraction (MVC), prolonged cycling exercise reduced (p<0.05) the maximal force generating capacity of quadriceps muscles (after three hours of cycling) and root mean square (RMS) values (after two hours of cycling) with no difference between the two conditions despite greater body weight loss (p<0.05) in NF. The mean power frequency (MPF) for vastus lateralis muscle was reduced (p<0.05) and the rate of force development (RFD) was increased (p<0.05) only during NF. During cycling exercise, integrated electromyographic activity and perceived exertion were increased in both conditions (p<0.05) with no significant effect of fluid ingestion.The results suggest that fluid ingestion did not prevent the previously reported decrease in maximal force with exercise duration, but seems to have a positive effect on some indicators of neuromuscular fatigue such as mean power frequency and rate of force development during maximal voluntary contraction. Further investigations are needed to assess the effect of change in hydration on neural mechanisms linked to the development of muscular fatigue during prolonged exercise.
More than 100 000 children under 5 are at risk of death in Pakistan
Authors: H. Mooney
Journal: BMJ (2010)

Six weeks after the first of the floods hit Pakistan, food, fresh water, and shelter are still in desperately short supply, and the country is facing a deteriorating humanitarian crisis.

An estimated 21 million people have been affected by the floods, half of whom have been left homeless, and thousands of children are at risk of starvation.

The floods have left vast swathes of people living in tent cities, relying on aid and handouts, and many of those affected say they have been turned away from camps by charities overwhelmed by the tide of dispossessed people. They are now …
CDC Veteran Upholds the Bottom Line: Prevention
Authors: Marsha F. Goldsmith
Journal: JAMA (1990)

THIRTY YEARS at the CDC are being celebrated by Walter R. Dowdle, PhD, this year, and throughout all of them the present deputy director has devoted his efforts to increasing the agency's preeminence in epidemiologic and laboratory surveillance, investigation, and research. "We're here to get results," says this man who has had fingers in more epidemiologic pies than most people. "The idea is the bottom line, and that's reducing the amount of death and disability due to a particular disease." Starting in 1960 as a supervisory research microbiologist in the CDC's Respiratory Virology Unit, Dowdle worked first on respiratory viruses that affect children and then on influenza. There followed (1967 and 1968) "one of the cleanest, nicest experiments that we've ever done," he says. Dowdle and colleagues developed the test that showed for the first time that there were two types of herpesviruses: "All those of type 1 were above
Physiological Value of Meat Food for Invalids, and Waste in Methods of Preparation
Authors: C. M. Jessop
Journal: BMJ (1889)

had caused lead poisoning.The water might be acted on so as to prevent its action on lead service pipes (1) by passing it over a large bed of limestone; (2) also, if water contains a free acid like Bacup and Sheffield water, it might be neutralised by adding carbonate of soda; (3) another plan would be to make borings down to the abundant underground reservoirs which existed in Bacup in the millstone grit, and mix this with the water collected from the moors; this would make the water harder.The watersupply of all large towns ought to be under the control and management of the local sanitary authority.The sanitary authority should have control of all matters relating to fit- tings, cisterns, etc.; also have a register of plumbers.Dr. Brown then gave results of experiments made by himself.
IMPROVEMENT BEYOND THE FRAMINGHAM RISK SCORE FOR PREDICTION OF MORTALITY BY THE ADDITION OF THE INTERMOUNTAIN RISK SCORE
Authors: Benjamin D. Horne, Heidi T. May, Joseph B. Muhlestein, Donald L. Lappé, Deborah Budge, Rami Alharethi, John F. Carlquist, Abdallah G. Kfoury, Jeffrey L. Anderson
Journal: Journal of the American College of Cardiology (2010)
The Effect of Pharmaceutical Benefits Managers: Is It Being Evaluated?
Authors: Kevin A. Schulman
Journal: Annals of Internal Medicine (1996)

Over the last decade, the number of pharmaceutical benefits managers has increased, and their influence has expanded rapidly. These managers now provide prescription drug coverage to more than 100 million Americans. The effect of pharmaceutical benefits managers on health care delivery remains unclear. We review the development of these organizations, their current role in the delivery of pharmaceutical therapies to patients, and their relationship with pharmaceutical manufacturers. We discuss potential advantages and disadvantages of pharmaceutical benefits manager practices and suggest ways in which these organizations can be made more accountable to the employer groups that hire them.
Improving the reach of vaccines to low-resource regions, with a needle-free vaccine delivery device and long-term thermostabilization
Authors: Xianfeng Chen, Germain J.P. Fernando, Michael L. Crichton, Christopher Flaim, Sally R. Yukiko, Emily J. Fairmaid, Holly J. Corbett, Clare A. Primiero, Alexander B. Ansaldo, Ian H. Frazer, Lorena E. Brown, Mark A.F. Kendall
Journal: Journal of Controlled Release (2011)
Egor Scheffer — Russia's Hawaiian Interloper
Authors: John B. Arthaud
Journal: New England Journal of Medicine (1969)

EARLY eighteenth-century island hopping by an opportunistic, wily German physician played a little-noted but dramatic role in Czarist Russia's colonial interests in the present states of Alaska and Hawaii.The events that led to Egor Nikolaevich Scheffer's position as collegiate assessor of the Russian Imperial Service in the Pacific Sandwich Islands1 began with his birth as Georg Anton Schäffer January 27, 1779, in Münnerstadt, Bavaria. After finishing apothecary school and practicing his profession in Hungary and Galicia, he sought a medical education."The unspecified disciplinary difficulties"2 that culminated in his expulsion reveal perhaps for the first time his inability to . . .
Serum bone gamma carboxyglutamic acid-containing protein in primary hyperparathyroidism and in malignant hypercalcemia. Comparison with bone histomorphometry.
Authors: P D Delmas, B Demiaux, L Malaval, M C Chapuy, C Edouard, P J Meunier
Journal: Journal of Clinical Investigation (1986)

Serum bone gamma-carboxyglutamic acid-containing (Gla) protein (sBGP), a sensitive and specific marker of bone turnover, was measured in 25 patients with primary hyperparathyroidism and in 24 patients with bone metastases with or without hypercalcemia. Despite similar levels of hypercalcemia, sBGP was increased in primary hyperparathyroidism (14.2 +/- 9.6 ng/ml, P less than 0.001), was decreased in malignant hypercalcemia (3.1 +/- 2.8 ng/ml, P less than 0.001), and was normal in patients with bone metastases without hypercalcemia (6.6 +/- 2.7 ng/ml). In primary hyperparathyroidism, sBGP was correlated with serum immuno-reactive parathyroid hormone (r = 0.90), calcium (r = 0.73), and with the adenoma weight (r = 0.79). After parathyroidectomy, sBGP slowly returned to normal values within 2-6 mo, suggesting that sBGP reflects increased bone turnover rather than a direct effect of parathyroid hormone on BGP synthesis at the cell level. An iliac crest biopsy was performed in 11 patients with primary hyperparathyroidism and in 9 cancer patients in a noninvaded area. sBGP was significantly correlated with all parameters reflecting bone formation but not with bone resorption. Patients with bone metastases were analyzed according to the presence or the absence of hypercalcemia. In contrast to normocalcemic patients who had normal sBGP, hypercalcemic patients had decreased sBGP (P less than 0.001) and a lower bone formation at the cellular level (P less than 0.05). Thus, biochemical and histological data suggest that an unknown humoral factor might be responsible for this uncoupling between increased resorption and decreased formation. This uncoupling, rather than local release of calcium by the metastatic process, might be responsible for hypercalcemia in patients with bone metastases.
Masquerade With Mediastinal Pleural Fluid
Authors: Garry D. Roghair
Journal: JAMA (1975)

A TRIANGULAR density in the right paraspinal area has been considered as evidence of right lower lobe atelectasis.<sup>1-3</sup>Fluid density merging with the right margin of the heart may be interpreted as an enlarging heart.<sup>4</sup>Finally, with known disease of the right lower lobe, a subsequent increase in density off the right margin of the heart may suggest development of right middle lobe disease as well. We propose that fluid accumulation in the mediastinal pleural space should be considered in lieu of any of these three possibilities. <h3>Report of a Case</h3> A 36-year-old man was admitted unconscious in October 1971 following an automobile accident. Physical examination disclosed a normal chest and a rigid abdomen with absent bowel sounds. A supine chest roentgenogram was normal. An abdominal roentgenographic series and an intravenous pyelogram suggested retroperitoneal trauma and possible liver laceration, with loss of liver margin and displacement of the
The Transplantation of Tissues and Organs
Authors: Peter F. Salisbury
Journal: JAMA (1962)

Transplantation of tissues and organs is presently an experimental tool which has found clinical use in only a few special situations. A method to circumvent or to overcome the "immunology barrier" which now confines transplantation would vastly expand the scope and possibilities of clinical surgery and medicine. The subject is under study in numerous centers. Professor Woodruff's book has brought together the most pertinent data concerning transplantation from many different disciplines and traces each area of investigation back to its historic roots. With this purpose in mind the author has succeeded in writing a readable book and not an encyclopedia. If transplantation is to become a new discipline, which seems likely, its formative stages must necessarily offend lovers of symmetry and order. A new science must search for its own keys; it finds those keys through a progression from empirical experience to generalization, hypothesis, and theory. The swirling mass of
ELF-1 Is a Transcriptional Regulator of the Tie2 Gene During Vascular Development
Authors: Antoinise Dube, Shelley Thai, John Gaspar, Susan Rudders, Towia A. Libermann, Luisa Iruela-Arispe, Peter Oettgen
Journal: Circulation Research (2001)

Vascular development requires the tightly coordinated expression of several growth factors and their receptors. Among these are the Tie1 and Tie2 receptors, which are almost exclusively endothelial cell-specific. The critical transcriptional regulators of vascular-specific gene expression remain largely unknown. The Ets factors are a family of evolutionarily conserved transcription factors that regulate genes involved in cellular growth and differentiation. We have recently shown that the Ets factor NERF is a strong transactivator of the Tie1 and Tie2 genes. To extend these studies, we have begun to identify the Ets factors that are expressed in developing blood vessels of the chicken chorioallantoic membrane (CAM), a highly vascular embryonic network. RNA was extracted from microdissected CAM blood vessels, and reverse transcriptase-polymerase chain reaction was performed using oligonucleotides encoding conserved amino acids within the Ets domain. One of the polymerase chain reaction fragments was subcloned and identified as the chicken homologue of the Ets factor ELF-1, cELF-1. ELF-1 is most closely related to the Ets factor NERF. In situ hybridization and immunohistochemistry demonstrate that cELF-1 is enriched in developing chicken blood vessels. cELF-1 is also a strong transactivator of the Tie1 and Tie2 genes and can bind to conserved Ets sites within the promoters of these genes. A complex of similar size forms when gel shifts are performed with cellular extracts derived from the CAM blood vessels, which is recognized by an antibody against cELF-1. In summary, ELF-1 belongs to a subset of Ets factors that regulate vascular-specific gene expression during blood vessel development.
Pharmacologic Therapy for Type 2 Diabetes Mellitus
Authors: Ralph A. DeFronzo
Journal: Annals of Internal Medicine (1999)

Type 2 diabetes mellitus is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. An elevated rate of basal hepatic glucose production in the presence of hyperinsulinemia is the primary cause of fasting hyperglycemia; after a meal, impaired suppression of hepatic glucose production by insulin and decreased insulin-mediated glucose uptake by muscle contribute almost equally to postprandial hyperglycemia. In the United States, five classes of oral agents, each of which works through a different mechanism of action, are currently available to improve glycemic control in patients with type 2 diabetes. The recently completed United Kingdom Prospective Diabetes Study (UKPDS) has shown that type 2 diabetes mellitus is a progressive disorder that can be treated initially with oral agent monotherapy but will eventually require the addition of other oral agents, and that in many patients, insulin therapy will be needed to achieve targeted glycemic levels. In the UKPDS, improved glycemic control, irrespective of the agent used (sulfonylureas, metformin, or insulin), decreased the incidence of microvascular complications (retinopathy, neuropathy, and nephropathy). This review examines the goals of antihyperglycemic therapy and reviews the mechanism of action, efficacy, nonglycemic benefits, cost, and safety profile of each of the five approved classes of oral agents. A rationale for the use of these oral agents as monotherapy, in combination with each other, and in combination with insulin is provided.
Medical Discipline
Authors: Bruce E. Vodicka
Journal: JAMA (1976)

IN THIS last article of the series on recent cases involving licensure and discipline of physicians, those appellate court decisions that have dealt with procedural questions will be summarized. Most procedural requirements have evolved from two essential constitutional mandates: personal notice and a hearing, which were discussed in a previous article (Part V). The procedural matters taken up here are the more mechanistic criteria that have been developed to implement these two and other constitutional requirements. The basic constitutional criterion for all matters of procedure is the fundamental fairness requirement. If it can be shown that a contested procedural rule or event at a hearing meets this test, it generally will be sustained on appeal. The necessity of preserving fundamental fairness in the hearing process is the central theme in the cases to be discussed. <h3>Notice</h3> The US Constitution requires that physicians accused of wrongdoing pursuant to applicable state licensure
An Address on Alcohol and on Drainage
Authors: R. H. Kinsey
Journal: BMJ (1883)

GBNTLEMEN,-TO you, the members of the South Midland Branch, who have conferred on me to-day the honour of electing me your President, I beg to return my warmest thanks; and, together with my friends in Bedford, rejoice in having once more an opportunity of social meeting and profitable discussion.And, in the name of all the members of our Branch, I give a hearty welcome to those gentlemen of the Cambridge and Hunting- donshire Branch, who have so cordially responded to our invitation to join us, and see, with the greatest pleasure, among us so many of those whose lifelong endeavour
Mechanism of early systolic closure of the aortic valve in discrete membranous subaortic stenosis.
Authors: H N Sabbah, P D Stein
Journal: Circulation (1982)

The mechanism of the apparent early closure of the aortic valve in patients with discrete membranous subaortic stenosis was studied. Discrete membranous subaortic stenosis was simulated in vitro to assess the fluid dynamic characteristics in the region of the aortic valve that may be responsible for the early closure. In the presence of a simulated fixed membranous subaortic obstruction, early systolic closure of the aortic valve was observed on high-speed motion pictures. Opening and early closure of the valve involved only one of the three aortic leaflets. Closure of the open leaflet was associated with the development of a pronounced pressure drop across the open leaflet caused by a large decrease of pressure in the main stream of flow relative to the pressure in the sinus of Valsalva. The pressure decrease in the main stream of flow resulted from a loss of pressure energy caused by an increase in the kinetic energy of the fluid caused by turbulence. Early systolic closure of the aortic valve in discrete membranous subaortic stenosis, therefore, results from the development of a pressure drop across the open leaflet caused by fluid dynamic factors related to the development of turbulent blood flow distal to the subvalvular obstruction.
Development of the Diabetes Knowledge (DKN) Scales: Forms DKNA, DKNB, and DKNC
Authors: Stewart M Dunn, Janet M Bryson, Penelope L Hoskins, Jan B Alford, David J Handelsman, John R Turtle
Journal: Diabetes Care (1984)

The Diabetes Knowledge Assessment (DKN) scales were developed to meet a specific need for rapid and reliable knowledge assessment in diabetic patients. Item format and item selection from an initial pool of 89 items were determined by pilot-testing over 300 diabetic subjects. Reliability analysis of the resulting 40 multiple-choice items, with a further sample of 56 subjects, gave a Cronbach's alpha coefficient of 0.92. Parallel forms DKNA, DKNB, and DKNC, each of 15 items selected from the parent set, had alpha coefficients above 0.82 and correlated 0.90 with each other. A full clinical trial, using DKNA, DKNB, and DKNC in randomized order of presentation, was conducted with 219 subjects attending a 2-day diabetes education program. Overall DKN scores improved from 7.6 (51%) to 11.3 (75%). Analysis of variance confirmed that DKNA, DKNB, and DKNC were equivalent forms at pretest. Mean posttest scores on DKNB were lower than the other scales (P less than 0.001), but variances were equivalent for all three. A specific local change in the education program format was found to account for this discrepancy in the DKNB posttest mean. In situations where comprehensive assessment of diabetes knowledge would be time-consuming and unnecessary, these results indicate that rapid and reliable assessment is possible with a scale of only 15 validated items. The development of parallel forms of the scale extends the range of retesting possibilities for diagnosis and research.