tbuckley/cabot-search huggingface dataset:
THE TORSION OF ARTERIES FOR THE ARREST OF HÆMORRHAGE.Read at the Sixteenth Annual Meeting of the Mississippi Valley Medical Association, at Louisville, Oct. 9, 1890.
Authors: J. B. MURDOCH
Journal: JAMA (1890)

There is no subject of greater interest to the practical surgeon than the arrest of hæmorrhage. This remark is equally true whether the hæmorrhage comes from a wound accidentally inflicted, or one made intentionally, by the surgeon's knife. Without the means of stopping the flow of blood from bleeding vessels, the surgeon's art would be greatly crippled, and surgical operations, where blood-vessels must be divided, would be impossible. There is no sight so appalling as a formidable hæmorrhage. When a large artery is opened, the blood gushes out in an angry stream, the face becomes pale, the color leaves the lips, the respiration becomes sighing, the heart fails to beat, and death closes the scene. Without any knowledge of the circulation or nature of the blood, or of the means by which its flow from a wound could be arrested, what a terrible and mysterious sight it must have been
What's potty about early toilet training?
Authors: Rosemarie Anthony-Pillai
Journal: BMJ (2007)

I have returned to work after eight months' maternity leave following the birth of my daughter. These have been months filled with wishing people would forget that I am a doctor and treat me like any new mother, and wishing that others would remember that I am a doctor and stop treating me like an idiot. With motherhood comes not only a new baby but endless good advice. So it is always a good idea to challenge perceived wisdom. One area I would like to tackle is the issue of toilet training.

In the West, a toddler learns to toilet train any time after 18 months, the average being around two and half years. This has been the case for the past 40 years, following work done in the late 1960s which developed the idea of child readiness—physiological, emotional, and social. This child centred approach was in stark contrast to the parent centred strict toileting of the 1930s, which was felt to have adverse behavioural consequences. My own opinion is that the development of …
Advances in Understanding and Management of Myeloproliferative Neoplasms
Authors: A. M. Vannucchi, P. Guglielmelli, A. Tefferi
Journal: CA A Cancer Journal for Clinicians (2009)

According to the 2008 World Health Organization classification system for hematologic malignancies, the myeloproliferative neoplasms (MPN) include chronic myelogenous leukemia, polycythemia vera, essential thrombocythemia, primary myelofibrosis, mastocytosis, chronic eosinophilic leukemia-not otherwise specified, chronic neutrophilic leukemia, and "MPN, unclassifiable." All of these clinicopathologic entities are characterized by stem cell-derived clonal myeloproliferation, and their phenotypic diversity is ascribed to the occurrence of distinct oncogenic events. In the last 4 years, new JAK2 and MPL mutations have been added to previously described ABL and KIT mutations as molecular markers of disease in MPN. These discoveries have markedly simplified the approach to clinical diagnosis and have also provided molecular targets for the development of small-molecule drugs. In the current article, the authors provide a clinically oriented overview of MPNs in terms of their molecular pathogenesis, classification, diagnosis, and management.
THE EARLY RECOGNITION AND MANAGEMENT OF DEFECTIVE DEVELOPMENT IN CHILDREN.
Authors: LOUIS FAUGÈRES BISHOP
Journal: JAMA (1897)

Too long has the treatment of the defectively developed mind been postponed beyond the age of infancy, and often are individuals thus affected relegated to the hopelessly idiotic group, without a careful study of the possibilities of each. The very poverty of our knowledge of the subject challenges study and investigation. The great variations in degree make it difficult to recognize in early childhood the mildest forms, and the worst cases are so bad that they offer no encouragement to treatment. The cases that require the greatest attention are those in which we can hope to rescue the individual from the class of useless idiots, and by intelligent education place him as an humble member of the productive classes. The etiology of idiocy has always been a source of speculation. Most lay people and many medical men fall into the habit of concentrating their attention too much on the size
Author's reply to Moore and colleagues
Authors: D. Spence
Journal: BMJ (2014)

Pain is indeed an important issue. But the current definition—“pain is what the patient says it is”—is far too loose.1 2 3 The reported incidence of pain varies 10-fold by country,4 so this definition is simply biologically implausible. Pain is cultural, not merely medical, and it is the major medically unexplained symptom. To suggest that one …
The Psychiatry of Stroke
Authors: James A. Greene
Journal: JAMA (1997)

As much as anything else, this book epitomizes the development of medical, and especially geriatric, psychiatry. Perhaps 20, certainly 40 years ago, a book of this nature and title would have produced little interest and even less data of relevance to the average practitioner diagnosing and treating strokes. However, development of new brain imaging technologies and more recognition of the psychiatric needs of patients in nursing homes, especially those with dementia, bring us to the point of "a realization that the limits to therapy and rehabilitation are largely set by mental impairment—and that because such impairment may be treatable, it must be initiated." The book is written to appeal to and enlighten multidisciplinary professionals who evaluate and treat the stroke patient. The literature review is both current and comprehensive. Neuropsychiatry and social psychiatry both form a basis for discussion and include physical foundations of stroke, stroke-related syndromes, and the
CONVULSIONS AS MANIFESTATION OF MULTIPLE SCLEROSIS
Authors: Guy H. Williams
Journal: JAMA (1952)

With the ever-increasing knowledge of the convulsive disorders, the idiopathic epileptic group becomes progressively smaller. Trauma, infection, expanding lesions, degenerative processes, and toxic agents involving the cerebrum or subcortical structures of the brain have been shown to be responsible for convulsive attacks. General biochemical and physiological changes have also been shown to produce seizures. Although the cause of multiple sclerosis remains obscure and possibly falls into one of the previously enumerated categories, disseminated sclerosis has rarely been regarded as responsible for either Jacksonian or generalized convulsions. A search of the medical literature reveals few reported cases in which convulsive disorders are recorded as being symptomatic of multiple sclerosis. In 1881, Ross,<sup>1</sup>in his textbook on the diseases of the nervous system, referred to epileptiform seizures in a small number of patients with disseminated sclerosis. His reference was apparently concerned with the Jacksonian type of seizure rather than with the
Identification of endogenous electrophiles by means of mass spectrometric determination of protein and DNA adducts.
Authors: P B Farmer, E Bailey, S Naylor, D Anderson, A Brooks, J Cushnir, J H Lamb, O Sepai, Y S Tang
Journal: Environmental Health Perspectives (1993)

Monitoring exposure to alkylating agents may be achieved by quantitatively determining the adduct levels formed with nucleic acids and/or proteins. One of the most significant results arising from the application of this approach has been the discovery in control populations of "background" levels of alkylated nucleic acid bases or alkylated proteins, in particular hemoglobin (Hb). In the case of Hb, a wide variety of such adducts have been detected and quantitated by mass spectrometric techniques, with methylated, 2-carboxyethylated, and 2-hydroxyethylated modifications being most abundant. Although the source of these alkylation products is unknown, both endogenous and exogenous sources may be proposed. We have recently confirmed the presence of the N-terminal hydroxyethylvaline adduct in control human Hb using tandem mass spectrometry (MS-MS) and have now established background levels using GC-MS in more than 70 samples. Smoking raises the levels of the adduct up to 10-fold and occupational exposure to ethylene oxide up to 300-fold. Background levels of alkylated nucleic acids may be studied by analysis of N7-alkylated guanine or N3-alkylated adenine, which are excised from nucleic acids after their formation and are excreted in urine. Although the presence of some of these urinary constituents may be accounted for by their natural occurrence in RNA or diet, the endogenous or exogenous source of others is unknown. Quantitative methods using MS-MS have now been developed for five of the observed urinary alkylguanines [N7-methyl-, N2-methyl-, N2-dimethyl-, N7-(2-hydroxyethyl)-, and N2-ethylguanine].(ABSTRACT TRUNCATED AT 250 WORDS)
Immunodiffusion studies on synovial fluid from patients with rheumatoid arthritis: the reaction of fibrinogen with a streptococcal extract.
Authors: H J Rylance
Journal: Annals of the Rheumatic Diseases (1978)

Synovial fluids (83.3%) from patients with rheumatoid arthritis gave a positive reaction when examined by immunodiffusion against a Lancefield extract of Group A Type 12 streptococci. None of the patients with osteoarthrosis reacted positively. An antiserum was prepared to the material in synovial fluid reacting with the streptococcal extract. This antiserum reacted positively with all synovial fluids tested including the osteoarthrosis patients. It also reacted with all plasma samples tested but only with a few (18.2%) of serum samples. Immunodiffusion and absorption experiments demonstrated that the material reacting with the streptococcal extract was fibrinogen. Of 12 other streptococci examined only one, a Group C organism, gave a similar positive reaction with synovial fluids.
SOME UNUSUAL CONGENITAL DEFORMITIES.
Authors: JOHN RIDLON
Journal: JAMA (1896)

Believing it to be the duty of a specialist to present a record of unusual cases to his associates, I beg to offer for your consideration a brief report of the following cases that have come under my observation during the past three years. <h3>Case 1. Congenital constriction bands, etc.</h3> —H. D., male, 2½ years old, the first child of healthy parents. There is no physical defect or deformity in the family for at least three generations. The pregnancy and birth were uneventful and in all respects normal. The mother is unable to offer any suggestions as to a possible cause for the deformities. Left hand: The index finger was joined (webbed) to the ring finger, and the ring finger to the little finger from the tips nearly to the junction of the proximal and middle phalanges; and the middle finger was amputated at the end of the proximal phalanx
Alterations in Exhaled Gas Profile during Allergen-induced Asthmatic Response
Authors: SUMITA B. KHATRI, METRI ÖZKAN, KEVIN MCCARTHY, DANIEL LASKOWSKI, JEFFREY HAMMEL, RAED A. DWEIK, SERPIL C. ERZURUM
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

The source of exhaled carbon monoxide (CO) and the relationship to airway inflammation are not clear. If CO is produced by the inflamed airway, we hypothesized that inflammation induced by allergen challenge would increase exhaled CO of atopic asthmatics. Eight atopic asthmatics underwent whole lung allergen challenge. CO, nitric oxide (NO), oxygen, and carbon dioxide (CO2) were measured simultaneously in exhaled breath which was collected into Mylar balloons before (baseline), immediately after, and at subsequent times after allergen. NO was higher in asthmatics than control subjects at baseline, increased further in seven of the eight asthmatics after allergen, and was inversely correlated to specific conductance. In contrast, exhaled CO of asthmatics was not higher than that of control individuals at baseline, decreased immediately after allergen, and returned to baseline levels during the late asthmatic response. Thus, allergen-induced airway inflammation did not lead to increased exhaled CO in asthma.
Association Dedicated to Crash Injury Control
Authors: Phil Gunby
Journal: JAMA (1992)

NEXT WEEK, physicians and others will gather in the Chicago suburb of Des Plaines, Ill, for a course in using the Abbreviated Injury Scale to assess the severity of trauma from traffic violence. (Please see accompanying article.) Such courses are just one activity of the Association for the Advancement of Automotive Medicine. Founded 35 years ago by the Medical Advisory Committee to the Sports Car Club of America ("six practicing physicians whose avocation was motor racing"), it changed its name in 1987 from the American Association of Automotive Medicine (<i>JAMA</i>. 1972;219:984-990) to the present Association for the Advancement of Automotive Medicine. The association, which will hold its 36th annual scientific conference October 5 through 7 in Portland in cooperation with the Oregon Health Sciences University School of Medicine, describes itself as the only international professional multidisciplinary organization dedicated entirely to crash injury control. It also refers to itself as the
Mandatory Premarital Testing for Human Immunodeficiency Virus
Authors: Bernard J. Turnock
Journal: JAMA (1989)

During the first 6 months of legislatively mandated premarital testing for human immunodeficiency virus in Illinois, 8 of 70,846 applicants for marriage licenses were found to be seropositive, yielding a seroprevalence of 0.011%. The total cost of the testing program for 6 months is estimated at $2.5 million or $312,000 per seropositive individual identified. Half of the reported seropositive individuals reported a history of risk behavior. During the same period, the number of marriage licenses issued in Illinois decreased by 22.5%, while the number of licenses issued to Illinois residents in surrounding states increased significantly. We conclude that mandatory premarital testing is not a cost-effective method for the control of human immunodeficiency virus infection.Data obtained from the Illinois Department of Public Health were analyzed to assess the economic, social, and public health impact of legislatively mandated premarital HIV antibody testing that took effect in Illinois in January 1988. In the first six months of the program, eight seropositive individuals were identified out of 70,846 applicants for marriage licenses, at an estimated cost of $2.5 million. During the same period, the number of marriage licenses issued in Illinois decreased by 22.5% while increasing significantly in surrounding states. The authors conclude that mandatory or publicly supported HIV antibody screening in premarital and other low-prevalence populations is not cost effective.
Reliability and Convergent Validity of the Cutaneous Sarcoidosis Activity and Morphology Instrument for Assessing Cutaneous Sarcoidosis
Authors: Misha Rosenbach, Howa Yeung, Emily Y. Chu, Ellen J. Kim, Aimee S. Payne, Junko Takeshita, Carmela C. Vittorio, Karolyn A. Wanat, Victoria P. Werth, Joel M. Gelfand
Journal: JAMA Dermatology (2013)

A validated scoring system is essential to assess the effect of therapeutic interventions on a disease. The instrument introduced here captures sarcoidosis disease activity in a reliable, reproducible manner, which will help standardize clinical trial outcomes and allow comparative efficacy studies in the future and may help lead to more robust data regarding the effect of different treatments on cutaneous sarcoidosis.To assess the reliability and convergent validity of the Cutaneous Sarcoidosis Activity and Morphology Instrument (CSAMI) and Sarcoidosis Activity and Severity Index (SASI) for evaluating cutaneous sarcoidosis outcomes.Cross-sectional study evaluating cutaneous sarcoidosis disease severity using CSAMI, SASI, and Physician's Global Assessment (PGA) as reference in the dedicated cutaneous sarcoidosis clinic of a teaching hospital.Eight dermatologists evaluating cutaneous sarcoidosis in 11 patients.Evaluation using the study instruments.Primary outcomes included interrater and intrarater reliability and convergent validity; secondary outcomes, correlation with quality-of-life measures and time required for completion.All instruments demonstrated good to excellent intrarater reliability. Interrater reliability was excellent for CSAMI Activity scores (intraclass correlation coefficient, 0.82 [95% CI, 0.66-0.94]) and fair to poor for CSAMI Damage scores (0.42 [0.21-0.72]), modified Facial SASI (0.40 [0.17-0.72]), and PGA scores (0.40 [0.18-0.70]). CSAMI Activity and Damage scores and modified Facial SASI all demonstrated convergent validity with statistically significant correlations with PGA scores. Trends for correlations were seen between CSAMI scores and specific Skindex-29 quality-of-life domains. Although CSAMI required longer time to complete than SASI, both were scored within adequate time for use in clinical trials.CSAMI appears to be a reliable and valid outcome instrument to measure cutaneous sarcoidosis and may capture a wide range of body surface and cutaneous morphologic types. This instrument can be adopted into clinical practice and clinical trials to allow physicians to assess the intensity of their patients' cutaneous sarcoidosis disease activity. Widespread use of one metric for disease severity assessment can help standardize the evaluation of the effect of various treatments on the disease. Future research is necessary to demonstrate its sensitivity to change and to confirm its correlation with quality-of-life measures.
Low level in vivo gene transfer into the arterial wall through a perforated balloon catheter.
Authors: M Y Flugelman, M T Jaklitsch, K D Newman, W Casscells, G L Bratthauer, D A Dichek
Journal: Circulation (1992)

BACKGROUND Gene transfer into the arterial wall may provide a novel therapeutic strategy for the treatment of coronary artery restenosis. Previously described methods for gene transfer into the arterial wall require total vessel occlusion for 30 minutes. We sought to develop a protocol for gene transfer within a more clinically relevant time frame. METHODS AND RESULTS We used a perforated balloon (Wolinsky) catheter to inject retroviral vector-containing virions into rabbit aortas in vivo. The virions were injected within 1 minute. Aortas were removed 5-14 days after injection and analyzed for evidence of gene transfer. In initial studies, nine rabbits were injected with a vector expressing the beta-galactosidase gene, and nine rabbits were injected with either non-beta-galactosidase-containing vectors or with a vehicle control. Histochemical staining of aortic tissues revealed blue (positive) cells in eight of nine experimental rabbits and six of nine controls. Because of the lack of specificity of the beta-galactosidase detection system, we adopted a polymerase chain reaction-based protocol in which oligonucleotide primers were used to amplify specific vector-related sequences from aortic tissue extracts. The polymerase chain reaction protocol, calibrated with standards containing known numbers of transduced cells, revealed low amounts of vector-related sequences in six of 12 vector-injected rabbits and in one of 13 controls (p less than 0.03). Comparison with standards indicated that fewer than 100 transduced cells were present in a 2-cm length of the injected aortic tissue. CONCLUSIONS Although in vivo gene transfer through an infusion balloon catheter can be accomplished within 1 minute, the therapeutic use of this protocol is limited by the small number of cells that are transduced.
ABSENCE OF LECITHIN FROM THE STROMATA OF THE RED CELLS OF CERTAIN ANIMALS (RUMINANTS), AND ITS RELATION TO VENOM HEMOLYSIS
Authors: Joseph C. Turner
Journal: The Journal of Experimental Medicine (1957)

Lipide extracts of the red cells of several animal species have been analyzed chromatographically. Genetically determined differences in phospholipide composition were found. Lecithin is absent from the cells of ox, sheep, and goat. Cells containing lecithin are susceptible to the direct hemolysin of cobra venom while cells not containing lecithin are resistant. The facts indicate that the direct hemolysin is a lecithinase.
Quinones and Aromatic Chemical Compounds in Particulate Matter Induce Mitochondrial Dysfunction: Implications for Ultrafine Particle Toxicity
Authors: Tian Xia, Paavo Korge, James N. Weiss, Ning Li, M. Indira Venkatesen, Constantinos Sioutas, Andre Nel
Journal: Environmental Health Perspectives (2004)

Particulate pollutants cause adverse health effects through the generation of oxidative stress. A key question is whether these effects are mediated by the particles or their chemical compounds. In this article we show that aliphatic, aromatic, and polar organic compounds, fractionated from diesel exhaust particles (DEPs), exert differential toxic effects in RAW 264.7 cells. Cellular analyses showed that the quinone-enriched polar fraction was more potent than the polycyclic aromatic hydrocarbon (PAH)–enriched aromatic fraction in O2•− generation, decrease of membrane potential (ΔΨm), loss of mitochondrial membrane mass, and induction of apoptosis. A major effect of the polar fraction was to promote cyclosporin A (CsA)–sensitive permeability transition pore (PTP) opening in isolated liver mitochondria. This opening effect is dependent on a direct effect on the PTP at low doses as well as on an effect on ΔΨm at high doses in calcium (Ca2+)-loaded mitochondria. The direct PTP effect was mimicked by redox-cycling DEP quinones. Although the aliphatic fraction failed to perturb mitochondrial function, the aromatic fraction increased the Ca2+ retention capacity at low doses and induced mitochondrial swelling and a decrease in ΔΨm at high doses. This swelling effect was mostly CsA insensitive and could be reproduced by a mixture of PAHs present in DEPs. These chemical effects on isolated mitochondria could be reproduced by intact DEPs as well as ambient ultrafine particles (UFPs). In contrast, commercial polystyrene nanoparticles failed to exert mitochondrial effects. These results suggest that DEP and UFP effects on the PTP and ΔΨm are mediated by adsorbed chemicals rather than the particles themselves.
Subcutaneous Sumatriptan in Acute Migraine
Authors: Michael S. Korenfeld
Journal: JAMA (1991)

To the Editor.  To I read with interest the recent article by Cady et al 1 entitled Treatment of Acute Migraine With Subcutaneous Sumatriptan. The prospect of a new drug that is safe and effective for migraine headache treatment is exciting.  I did, however, note that 1.1% of patients at initial exposure to sumatriptan and 1.6% of patients who were given two consecutive doses of sumatriptan experienced nonspecified visual disturbances. Because the drug produces 5-HT 1D receptor-specific vasoconstriction of cranial arteries in humans, it is possible that this effect may extend to the arteries, perfusing the optic nerve and the retina.  Phelps and Corbett 2 and Drance et al 3 have shown an increased incidence of low-tension glaucoma and an increased vasospastic arterial response in persons with migraine. The visual disturbances described after administration of sumatriptan could have resulted from relative ischemia secondary to posterior ciliary artery or central retinal