tbuckley/cabot-search huggingface dataset:
A Review of the Later Results of Insulin Treatment
Authors: A. P. Thomson
Journal: BMJ (1926)

In virgins the treatment mnay be effectuailly carried otLt bm ineanis of a rectal electrode, tlec procedure being similar * that utsed for heating the prostatO in men.In married womenl ani intrapelvic electrode, introduced inlto the vagina, isusd CASE T. In a girl, aged 16, the illness began at the end of 1923.The
Noninvasive elastography-based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis
Authors: Christophe Corpechot, Fabrice Carrat, Armelle Poujol-Robert, Farid Gaouar, Dominique Wendum, Olivier Chazouillères, Raoul Poupon
Journal: Hepatology (2012)

The development of liver fibrosis markers in primary biliary cirrhosis (PBC) is needed to facilitate the assessment of its progression and the effectiveness of new therapies. Here, we investigated the potential usefulness of transient elastography (TE) in the noninvasive evaluation of liver fibrosis stage and disease progression in PBC. We performed, first, a prospective performance analysis of TE for the diagnosis of METAVIR fibrosis stages in a diagnostic cohort of 103 patients and, second, a retrospective longitudinal analysis of repeated examinations in a monitoring cohort of 150 patients followed-up for up to 5 years. All patients were treated with ursodeoxycholic acid. Diagnostic thresholds of liver stiffness in discriminating fibrosis stages ≥F1, ≥F2, ≥F3, and =F4 were 7.1, 8.8, 10.7, and 16.9 kPa, respectively. TE showed high performance and was significantly superior to biochemical markers (e.g., aspartate aminotransferase [AST]/platelet ratio, FIB-4, hyaluronic acid, AST/alanine aminotransferase ratio, and Mayo score) in diagnosing significant fibrosis, severe fibrosis, or cirrhosis. Analysis of the monitoring cohort data set using generalized linear models showed the following: (1) an overall progression rate of 0.48 ± 0.21 kPa/year ( P = 0.02) and (2) no significant progression in patients with F0-F1, F2, or F3 stages, but a significant increase (4.06 ± 0.72 kPa/year; P &lt; 0.0001) in cirrhotic patients. A cut-off value of 2.1 kPa/year was associated with an 8.4-fold increased risk of liver decompensations, liver transplantations, or deaths ( P &lt; 0.0001, Cox regression analysis). Conclusion: TE is one of the best current surrogate markers of liver fibrosis in PBC. Over a 5-year period, on-treatment liver stiffness appears stable in most noncirrhotic PBC patients, whereas it significantly increases in patients with cirrhosis. Progression of liver stiffness in PBC is predictive of poor outcome. (HEPATOLOGY 2012;56:198–208)
Efficacy of Long Detection Interval Implantable Cardioverter-Defibrillator Settings in Secondary Prevention Population
Authors: Axel Kloppe, Alessandro Proclemer, Angel Arenal, Maurizio Lunati, José Bautista Martìnez Ferrer, Ahmad Hersi, Marcin Gulaj, Maurits C.E.F. Wijffels, Elisabetta Santi, Laura Manotta, Lorenza Mangoni, Maurizio Gasparini
Journal: Circulation (2014)

Three trials demonstrated recently that a long detection window reduces implantable cardioverter-defibrillator (ICD) therapy in primary prevention patients. Avoid Delivering Therapies for Nonsustained Arrhythmias in ICD Patients III (ADVANCE III) was the only trial that enrolled both primary and secondary prevention patients.Of the 1902 patients enrolled in the ADVANCE III trial, 477 received a defibrillator for secondary prevention; 248 patients were randomly assigned to a long detection setting (30 of 40 intervals) and 229 to the nominal setting (18 of 24 intervals) for ventricular arrhythmias with cycle length ≤ 320 ms. Eight-five percent of patients were men, with a mean age of 65 ± 12 years, a previous history of ventricular fibrillation in 37% of the cases, and a mean ejection fraction of 38 ± 13%. The ICD device mix was 37% single chamber, 47% dual chamber, and 16% triple chamber. Over a median period of 12 months, the long detection period was associated with a 25% reduction in the number of overall therapies (115.6 versus 86.8 per 100 patient-years; incidence rate ratio, 0.75; 95% confidence interval, 0.61-0.93; P=0.008) and a 34% reduction in the number of shocks (rate per 100 patient-years, 51.2 versus 38.1; incidence rate ratio, 0.66; 95% confidence interval, 0.48-0.89; P=0.007). Appropriate therapies (89.7 versus 67.7; incidence rate ratio, 0.77; 95% confidence interval, 0.60-0.97; P=0.029) and appropriate shocks (37.1 versus 28.1; incidence rate ratio, 0.64; 95% confidence interval, 0.45-0.93; P=0.018) were also reduced.ADVANCE III is the first randomized trial to assess a long detection window setting in ICDs in both primary and secondary prevention populations and demonstrates a reduction of overall therapies and shocks in the subgroup of secondary prevention patients. These data suggest that even the secondary prevention population may benefit from programming that combines a long detection period with antitachycardia pacing during charging.http://www/clinicaltrials.gov. Unique identifier: NCT00617175.
Result of Enterotomy in a Case of Intestinal Obstruction
Authors: W. W. Wagstaffe
Journal: BMJ (1885)

The coincidence that, both in the case related above and in De Haen's case, the patient was periodically subject to abdominal pains, associated in the first with a constricting sensation, in the second with tympanites, may be noted as, perhaps; indicating that the intestine had not unfrequently slipped into the opening before the fatal incarceration took place.I am indebted to MIr. T.
S116 Breathlessness in COPD is associated with altered cognitive processing in the medial prefrontal cortex
Authors: M Herigstad, A Hayen, E Evans, R Davies, M Hardinge, K Wiech, KT Pattinson
Journal: Thorax (2013)

<h3>Introduction</h3> Breathlessness is the main cause of suffering in COPD. Its brain mechanisms remain poorly understood, yet may represent a novel therapeutic avenue. Until now, functional magnetic resonance imaging (FMRI) studies of breathlessness have been limited to experiments in healthy volunteers. FMRI demonstrates that imagination of painful events engages the same brain networks responsible for perception of physical pain. We adapted this technique to identify brain areas responsible for breathlessness perception in COPD. We hypothesised that healthy controls would demonstrate brain patterns similar to that observed in previous FMRI studies in healthy volunteers. As psychological dysfunction is strongly associated with COPD we hypothesised that patients would show greater engagement of cognitive brain areas. <h3>Methods</h3> 44 COPD patients and 40 matched controls undertook FMRI scanning (Siemens 3T), and psychological and physiological assessments. During scanning, participants were presented with previously validated breathlessness-related word cues and rated breathlessness on a visual analogue scale. FMRI analysis was performed with FSL (http://www.fmrib.ox.ac.uk/fsl). Significant activations were determined as Z &gt; 2.3, with a cluster probability threshold of P &lt; 0.05, corrected for multiple comparisons. A modified shuttle walk test (MSWT) and spirometry were performed. The following questionnaires were administered: Center for Epidemiological Studies Depression Scale, Dyspnoea-12, State and Trait Anxiety Inventory, bespoke catastrophising and vigilance questionnaires, Fatigue Severity Scale and St Georges Respiratory Questionnaire. <h3>Results</h3> Imaging and questionnaire results are displayed in the figure. MSWT values (mean ± SD) were 331 +/-193m (patients) and 804 +/-274m (controls) (p &lt; 0.001). FEV1 (% predicted) was 0.6 ± 02(patients) and 1.0 ± 0.2(controls) (p &lt; 0.001) <h3>Conclusions</h3> We observed differing brain activation patterns in response to dyspnoea-related word cues between COPD patients and controls. The control group displayed a similar activation pattern to that observed in previous FMRI studies of breathlessness in healthy volunteers while COPD patients display significantly greater activation in the medial prefrontal cortex (emotion control and memory consolidation). Our behavioural data demonstrates greater psychomorbidity in patients. Taking our imaging and behavioural findings together, we propose that in COPD engagement of the medial prefrontal cortex distorts the processing of breathlessness sensations towards greater reliance on fear memories and expectations, contributing to a vicious circle of avoidance and fear.
Hospital-Acquired Herpes Zoster Following Exposure to Chickenpox
Authors: Byron S. Berlin
Journal: JAMA (1970)

The opportunity for transmission of varicella-zoster (VZ) virus between patients with herpes zoster or chickenpox infections occurred. The VZ virus was introduced into the hospital environment via a retired nurse who was admitted with zoster. Chickenpox developed in the intern attending her 16 days after his initial contact with the patient. One day before the onset of his rash, the intern had close contact with a patient who had been receiving immunosuppressive therapy for a kidney transplant. Typical herpes zoster developed in this patient after an appropriate incubation period. The clinical diagnosis of VZ virus infection was documented in each case by virus isolation and serologic studies or both. The chain of infection involving these temporally related cases presents strong justification for considering some cases of zoster to be exogenous infections.
Doctor is charged with signing cremation certificates without proper investigations
Authors: C. Dyer
Journal: BMJ (2010)

Background/Aim: Acidification of exhaled breath condensate (EBC), reflecting airway inflammation and oxidative stress, has been reported in lung cancer patients undergoing lobectomy. We undertook this study to examine EBC pH changes during surgery for abdominal cancer. Patients and Methods: EBC pH was measured from 20 patients undergoing abdominal cancer resection before and during surgery. Repeated-measures of ANOVA and random-effects linear models were applied to compare mean EBC pH values in samples collected at different times. Cox and linear regression models were used to determine the association of EBC pH with occurrence of acute bronchospasm intra-operatively and the duration of hospitalization. Results: Significant acidification of EBC was observed during surgery (p=0.007) associated with 0.77% (95% confidence interval=−0.14-1.68, p-value=0.097) increase in the risk for developing acute bronchospasm, after adjustment for potential confounders. Conclusion: EBC acidification occurs in patients undergoing abdominal cancer resection and is associated with the occurrence of acute bronchospasm intraoperatively.
Prostate Cancer Screening Trials: Fending Off Critics To Recruit Men
Authors: Cori Vanchieri
Journal: JNCI Journal of the National Cancer Institute (1998)

evidence for an infectious origin, demonstrating space-time clustering of ALL associated with movement from rural areas into cities in response to increasing political stability.Alexander has proposed a hypothesis focused on a specific pathogen -the mycoplasma pneumonia bacteria.She notes that M. pneumonia "has the appropriate socioeconomic correlates and clinical symptoms," and provides evidence from U.K. public health records in support of her prediction that children whose first year of life corresponded to high incidence of reported M. pneumonia infections should be at low risk of ALL, and vice versa.
Biology of Tendon Repair
Authors: Erle E. Peacock
Journal: New England Journal of Medicine (1967)

ALTHOUGH restorative hand surgery is correctly regarded as having been developed primarily in military centers, repair of flexor tendons, one of the most frequent and difficult problems in civilian practice, was not significantly influenced by war experience. The frequency of flexor-tendon lacerations, the relatively long amplitude of tendon motion required to flex a digit, and the nonselective nature of the healing process have been responsible for discouraging results and for the increased attention that flexor-tendon repair has received in the postwar period. Now, some twenty years since injuries of flexor tendons and digital nerves have become more important than the . . .
A METHOD OF CONTROLLING RECTAL HEMORRHAGES
Authors: B. L. Myers
Journal: JAMA (1913)

The illustrated pad and cone were devised to make the administration of ether more agreeable to the patient and infinitely easier for the administrator as compared with the methods now used in over 85 per cent. of the hospitals.Unless the anesthetic is in the hands of a professional it is usually given by using an Esmarch cone, towels, petrolatum, rubber tissue and moist cotton for the eyes, all of which are useless and hard to handle, and before the patient is asleep they are usually out of place and the eyes exposed to the ether vapors.The cone in this case does not fit, conse- quently the vapors escape down the sides of the patient's face, hence the waste of ether; and the administrator has no idea of the ether percentage he is giving, but hopes the * Read before the oto-laryngologic section of the St.
Ga-67 Citrate in Diagnosing Tracheoesophageal Fistula in a Patient with AIDS Case Report
Authors: CAROLINE C. CHOW, EDUARD V. KOTLYAROV, GEORGE T. FANTRY, LISA S. PICHNEY
Journal: Clinical Nuclear Medicine (1992)

Increased radiopharmaceutical uptake in the mediastinum and/ or hilum on Ga-67 citrate scan in patients with AIDS has been attributed, to date, mostly to infectious etiologies. Because other complications are being reported in these patients, awareness of their presentation in diagnostic imaging is important. Tracheoesophageal fistula can also be accompanied by a focal area of increased uptake in the mediastinum. In this patient, a Ga-67 citrate scan was the first modality of diagnostic imaging to raise suspicion of such a diagnosis.
Recombinant AAV Serotype and Capsid Mutant Comparison for Pulmonary Gene Transfer of α-1-Antitrypsin Using Invasive and Noninvasive Delivery
Authors: Rejean Liqun Wang, Thomas McLaughlin, Travis Cossette, Qiushi Tang, Kevin Foust, Martha Campbell-Thompson, Ashley Martino, Pedro Cruz, Scott Loiler, Christian Mueller, Terence R Flotte
Journal: Molecular Therapy (2008)

Recombinant adeno-associated viral (rAAV) vectors have been widely used in pulmonary gene therapy research. In this study, we evaluated the transduction and expression efficiencies of several AAV serotypes and AAV2 capsid mutants with specific pulmonary targeting ligands in the mouse lung. The noninvasive intranasal delivery was compared with the traditional intratracheal lung delivery. The rAAV8 was the most efficient serotype at expressing α-1-antitrypsin (AAT) in the lung among all the tested serotypes and mutants. A dose of 1 × 1010 vg of rAAV8-CB-AAT transduced a high percentage of cells in the lung when delivered intratrachealy. The serum and the broncho-alveolar lavage fluid (BALF) levels of human AAT (hAAT) were about 6- and 2.5-fold higher, respectively, than those of rAAV5 group. Among the rAAV2 capsid mutants, the rAAV2 capsid mutants that display a peptide sequence from hAAT ("long serpin") indicated a twofold increase in transgene expression. For most vectors, the serum hAAT levels achieved after intranasal delivery were 1/2 to 1/3 of those with the intratracheal method. Overall, rAAV8 was the most promising vector for the future application in gene therapy of pulmonary diseases such as AAT deficiency–related emphysema. Recombinant adeno-associated viral (rAAV) vectors have been widely used in pulmonary gene therapy research. In this study, we evaluated the transduction and expression efficiencies of several AAV serotypes and AAV2 capsid mutants with specific pulmonary targeting ligands in the mouse lung. The noninvasive intranasal delivery was compared with the traditional intratracheal lung delivery. The rAAV8 was the most efficient serotype at expressing α-1-antitrypsin (AAT) in the lung among all the tested serotypes and mutants. A dose of 1 × 1010 vg of rAAV8-CB-AAT transduced a high percentage of cells in the lung when delivered intratrachealy. The serum and the broncho-alveolar lavage fluid (BALF) levels of human AAT (hAAT) were about 6- and 2.5-fold higher, respectively, than those of rAAV5 group. Among the rAAV2 capsid mutants, the rAAV2 capsid mutants that display a peptide sequence from hAAT ("long serpin") indicated a twofold increase in transgene expression. For most vectors, the serum hAAT levels achieved after intranasal delivery were 1/2 to 1/3 of those with the intratracheal method. Overall, rAAV8 was the most promising vector for the future application in gene therapy of pulmonary diseases such as AAT deficiency–related emphysema.
The History of Surgery in the United States, vol 1: Textbooks, Monographs, and Treatises
Authors: William G. Abel
Journal: JAMA (1989)

This fascinating account of surgery in the United States from 1775 through 1900 can be described as an annotated bibliography, although this simple phrase fails to do justice to a truly superb tome. It fills a literary void that most surgeons undoubtedly were unaware existed. Within this 488-page high-quality production, Ira Rutkow has succeeded in compiling for the first time a list of every book, monograph, and treatise written by an American surgeon that represents original work and not a foreign-language translation. It is composed of 552 original works that are divided into eight chapters representing various surgical disciplines, allowing easy reference for varied specialists. The annotation for each entry includes a thumbnail biography of the author; analysis of the work's contents; where possible and appropriate, high-quality illustrations from the original 18th- and 19th-century American medical publications; and lists of other works by the author, both medical and nonmedical. The
Thrombotic Thrombocytopenic Purpura
Authors: William Bell
Journal: JAMA (1991)

<h3>CASE PRESENTATION</h3> —Charles T. Bingham III, MD A 27-YEAR-OLD man was transferred to The Johns Hopkins Hospital for evaluation of delirium. Five days prior to admission he had presented to another hospital with hematemesis and syncope. Esophagogastroduodenoscopy revealed the presence of a 0.5-cm gastric ulcer. The hematocrit value and the platelet count were low. The patient was treated with packed red blood cells (RBCs) and platelets. During the next few days, he developed agitation, confusion, and hallucinosis and was transferred to The Johns Hopkins Hospital. His past medical history was remarkable for alcoholic hepatitis. The patient drank a minimum of one pint of rum plus large volumes of wine daily. He denied taking any medications. On physical examination, the patient's temperature was 38.9°C; blood pressure, 128/86 mm Hg; pulse rate, 96 beats per minute; and respirations, 24/min. The sclerae were icteric. The liver and spleen were not enlarged, and the
17β-Estradiol Regulation of Human Endothelial Cell Basal Nitric Oxide Release, Independent of Cytosolic Ca <sup>2+</sup> Mobilization
Authors: Teresa Caulin-Glaser, G. García-Cardeña, Phillip Sarrel, William C. Sessa, Jeffrey R. Bender
Journal: Circulation Research (1997)

Abstract Estradiol retards the development of atherosclerosis. Animal models have suggested that NO may be a critical effector molecule in this cardiovascular protection. In this study, female human umbilical vein endothelial cells (HUVECs) were propagated in phenol red–free gonadal hormone–free medium and pretreated with 17β-estradiol (E 2 ). Reduced NO 2 − and NO 3 − (NO X ) concentration, determined by chemiluminescence, demonstrated a rapid increase in basal HUVEC NO release in response to physiological concentrations of E 2 . The estrogen receptor (ER) antagonist ICI 164,384 inhibited the augmented NO release, demonstrating an ER-mediated component of this response. Because endothelial NO synthase (eNOS) activity is largely regulated by cytosolic Ca 2+ , relative [Ca 2+ ] i in response to E 2 was determined in a fluorometric assay. E 2 did not promote HUVEC Ca 2+ fluxes. Furthermore, eNOS activity in E 2 -pretreated endothelial whole-cell lysates was not dependent on additional Ca 2+ . Despite involving the ER, this is a nongenomic effect of E 2 , as demonstrated by maintained responses in transcriptionally inhibited cells and by the rapidity (10 minutes) of cGMP formation in an NO bioassay. We demonstrate, for the first time, that independent of cytosolic Ca 2+ mobilization, there is augmentation of eNOS activity with a resultant increase in HUVEC basal NO release in response to short-term estradiol exposure. Implications for the cardiovascular protective role of estrogen are discussed.
Physical deformity of Richard III.
Authors: P Rhodes
Journal: BMJ (1977)

My interest in Richard III, as that of many others, arose from reading Shakespeare's three parts of King Henry VI and King Richard III.I intend to follow Shakespeare in building up an image of what might have been the medical diagnosis in Richard's case, then compare that with the facts about the man as they seem to be known, and so develop a hypothesis to describe what may have happened to him at birth or in utero, which may have affected his later appearance.This method leads to a new concept about him and his possible physique.
Aseptic Meningitis Associated with High-Dose Intravenous Immunoglobulin Therapy: Frequency and Risk Factors
Authors: Elizabeth A. Sekul
Journal: Annals of Internal Medicine (1994)

Intravenous immunoglobulin is widely used to treat various autoimmune disorders. After observing instances of aseptic meningitis in treated patients, we studied the frequency and associated risk factors for aseptic meningitis in patients treated with high-dose intravenous immunoglobulin.Retrospective analysis of a prospective cohort study.Tertiary research referral center.54 consecutive patients with various immune-related neuromuscular diseases participating in ongoing therapeutic trials of high-dose (2 g/kg) intravenous immunoglobulin.Analysis of patient records for evidence of aseptic meningitis, associated risk factors, penetration of serum IgG into the cerebrospinal fluid, and clearance of cerebrospinal fluid IgG.Of 54 patients, 6 (11%; 95% CI, 4% to 23%) developed aseptic meningitis within 24 hours after completion of the infusions. Symptoms, lasting 3 to 5 days, included severe headache, meningismus, photophobia, and fever. Cerebrospinal fluid showed pleocytosis in 4 patients (leukocyte count as high as 1169 x 10(6)/L in one patient), eosinophilia in 3 patients, and IgG elevation in all patients (as great as 7 times the upper limit of normal in one patient). Repeat cerebrospinal fluid and serum studies after 24 hours showed a 46% cerebrospinal fluid IgG clearance compared with an 11% clearance of serum IgG in one patient. Cerebrospinal fluid cultures were negative. Aseptic meningitis developed in 4 of 8 patients (50%; CI, 16% to 84%) with a history of migraine but in only 2 of 46 (4%; CI, 0.5% to 15%) patients without such a history (P = 0.003). Aseptic meningitis recurred in patients who had migraine despite the use of different commercial intravenous immunoglobulin preparations and slower rates of infusion.Aseptic meningitis develops in patients receiving high-dose intravenous immunoglobulin therapy. Patients with a history of migraine are more likely to develop aseptic meningitis while receiving intravenous immunoglobulin therapy, regardless of the type of commercial preparation or the infusion rate. Possible inciting factors include the IgG itself, various stabilizing products within each of the preparations, cytokine release triggered by the therapy, or cerebrovascular sensitivity in migraineurs.