tbuckley/cabot-search huggingface dataset:
TULAREMIA
Authors: H. B. THOMAS
Journal: Annals of Internal Medicine (1942)

Article1 October 1942TULAREMIAA REPORT OF THREE FATAL CASES WITH AUTOPSIES*H. B. THOMAS, M.D., F.A.C.P.H. B. THOMAS, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-17-4-659 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe purpose of this report is to submit clinical and pathologic studies of three fatal cases of ulcero-glandular tularemia, two of them being of the rapidly fatal primary septicemic variety and the third of longer duration.The first fatal case with autopsy was reported in 1924 by Verbrycke1; and since then about 60 additional autopsy studies have been published.2 Duplications in the literature make it difficult to state the exact number of necropsy cases.CLINICAL PICTUREThe incubation period varies from a few hours to 13 days, but it is usually from two to five days. In the cases reported...Bibliography1. VERBRYCKE JR: Tularemia, with report of a fatal case simulating cholangitis, with postmortem report, Jr. Am. Med. Assoc., 1924, lxxxii, 1577. CrossrefGoogle Scholar2. LILLIEFRANCIS RDE (a) : The pathology of tularemia, Bulletin 167, National Institute of Health, February 1936, p. 76. (b) FOSHAY, L.: Cause of death in tularemia, Arch. Int. Med., 1937, lx, 22-38. (c) PUND, E. R., and HATCHER, M. B.: Tularemic meningitis: report of a case with postmortem observations, ANN. INT. MED., 1937, x, 1390-1398. (d) WEILBAECHER, J. O., JR., and MOSS, E. S.: Tularemia following injury while performing postmortem examination on human case, Jr. Lab. and Clin. Med., 1938, xxiv, 34-38. (e) KIMMELSTIEL, P., and CALDWELL, H. W.: Tularemic septicemia: report of a case, Am. Jr. Path., 1939, xv, 127-135. (f) BLACKFORD, S. D., and CASEY, C. J.: Pleuropulmonary tularemia, Arch. Int. Med., 1941, lxvii, 43-71. (g) RANSMEIER, J. C., and SCHAUB, I. G.: Direct cultivation of Bacterium tularense from human blood drawn during life and at autopsy, Arch. Int. Med., 1941, lxviii, 747-762. Google Scholar3. FOSHAY L: Tularemia: accurate and earlier diagnosis by means of the intradermal reaction, Jr. Infect. Dis., 1932, li, 286. CrossrefGoogle Scholar4. FRIEDEWALDHUNT WGA: The diagnosis of tularemia, Am. Jr. Med. Sci., 1939, cxcvii, 493. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: H. B. THOMAS, M.D., F.A.C.P.Affiliations: York, Pennsylvania*Received for publication December 22, 1941. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUnspezifische Entzündungen der LungeDie Pneumonien 1 October 1942Volume 17, Issue 4Page: 659-671KeywordsAutopsyPathologistsTularemiaUlcers ePublished: 1 December 2008 Issue Published: 1 October 1942 PDF downloadLoading ...
Over-the-Counter Chromium and Renal Failure
Authors: Mark F. McCarty
Journal: Annals of Internal Medicine (1997)

Letters15 October 1997Over-the-Counter Chromium and Renal FailureMark F. McCartyMark F. McCartyNutrition 21; San Diego, CA 92109Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Wasser and colleagues [1] suggest that a case of chronic active interstitial nephritis may have been attributable to previous ingestion of the nutritional supplement chromium picolinate. It appears that the authors are unaware of the major differences in the toxicology of hexavalent and trivalent forms of chromium. Hexavalent chromium is an unstable oxidizing compound that has induced acute tubular necrosis in episodes of industrial poisoning; long-term exposure in persons who work with chromium is associated with low-molecular-weight proteinuria [2]. In contrast, the nutritionally essential trivalent form of chromium is stable and essentially nontoxic on oral administration. ...References1. Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate [Letter]. Ann Intern Med. 1997; 126:410. Google Scholar2. Wedeen RP, Qian L. Chromium-induced kidney disease. Environ Health Persp. 1991; 92:71-4. Google Scholar3. Mather AK, Chandra SV, Tandon SK. Comparative toxicity of trivalent and hexavalent chromium to rabbits. II. Morphological changes in some organs. Toxicology. 1977; 8:53-61. Google Scholar4. Mertz W. Risk assessment of essential trace elements: new approaches to setting recommended dietary allowances and safety limits. Nutr Rev. 1995; 53:179-85. Google Scholar5. Anderson RA, Bryden NA, Polansky MM. Lack of toxicity of chromium chloride and chromium picolinate in rats. J Am Coll Nutr. 1997; 16:273-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Mark F. McCartyAffiliations: Nutrition 21; San Diego, CA 92109 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMinerals and Trace ElementsToxicology of Chromium(III)Chromium picolinate, zinc picolinate and zinc picolinate dihydrate added for nutritional purposes in food supplementsThe nutritional supplement chromium picolinate generates oxidative DNA damage and peroxidized lipids in vivoChromiumToxicological Profile for ChromiumDrugs and nutrition 15 October 1997Volume 127, Issue 8_Part_1Page: 654-655 ePublished: 15 August 2000 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Multicenter Randomized Controlled Trial of Withdrawal of Inhaled Corticosteroids in Cystic Fibrosis
Authors: Ian M. Balfour-Lynn, Belinda Lees, Pippa Hall, Gillian Phillips, Mohammed Khan, Marcus Flather, J. Stuart Elborn
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Lung inflammation and injury is critical in cystic fibrosis. An ideal antiinflammatory agent has not been identified but inhaled corticosteroids are widely used despite lack of evidence.Objectives: To test the safety of withdrawal of inhaled corticosteroids with the hypothesis this would not be associated with an earlier onset of acute chest exacerbations.Methods: Multicenter randomized double-blind placebo-controlled trial in 18 pediatric and adult UK centers. Eligibility criteria included age > 6.0 yr, FEV1 ⩾ 40% predicted, and corticosteroid use > 3 mo. During the 2-mo run-in period, all patients received fluticasone; they then took either fluticasone or placebo for 6 mo.Measurements and Main Results: Fluticasone group: n = 84, median age 14.6 yr, mean (SD) FEV1 76% (18); placebo group: n = 87, median age 15.8 yr, mean (SD) FEV1 76% (18). There was no difference in time to first exacerbation (primary outcome) with hazard ratio (95% confidence interval) of 1.07 (0.68 to 1.70) for fluticasone versus placebo. There was no effect of age, atopy, corticosteroid dose, FEV1, or Pseudomonas aeruginosa status. There was no change in lung function or differences in antibiotic or rescue bronchodilator use. Fewer patients in the fluticasone group withdrew from the study due to lung-related adverse events (9 vs. 15%); with a relative risk (95% confidence interval) of 0.59 (0.23–1.48) fluticasone versus placebo.Conclusions: In this study population (applicable to 40% of patients with cystic fibrosis in the UK), it appears safe to consider stopping inhaled corticosteroids. Potential advantages will be to reduce the drug burden on patients, reduce adverse effects, and make financial savings.
Persistent erythematous eyelid swelling due to metastatic lobular carcinoma of the breast
Authors: T. Zimmermann, U. Jappe, I. Hausser, G. Mechtersheimer, W. Hartschuh
Journal: British Journal of Dermatology (2002)

We report a patient with lobular carcinoma of the breast which showed as its first symptom orbital metastases presenting as persistent bilateral eyelid swellings. A 61‐year‐old woman presented with persistent erythematous swelling of both upper and lower eyelids (Fig. 1), suggesting a diagnosis of xanthelasma. Biopsy showed a monomorphous infiltrate of histiocyte‐like cells and a signet ring cell population (Fig. 2), leading to the diagnosis of metastatic signet ring cell carcinoma. The tumour cells showed strong expression of gross cystic disease fluid protein‐15, an apocrine differentiation marker (Fig. 2, inset). Further tests revealed lobular carcinoma of the breast with signet ring cell features.
Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
Authors: P. Howden-Chapman, N. Pierse, S. Nicholls, J. Gillespie-Bennett, H. Viggers, M. Cunningham, R. Phipps, M. Boulic, P. Fjallstrom, S. Free, R. Chapman, B. Lloyd, K. Wickens, D. Shields, M. Baker, C. Cunningham, A. Woodward, C. Bullen, J. Crane
Journal: BMJ (2008)

To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma.Randomised controlled trial.Households in five communities in New Zealand.409 children aged 6-12 years with doctor diagnosed asthma.Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial.The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child's general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child's bedroom were recorded hourly.Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval -20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10 degrees C (95% confidence interval 0.54 degrees C to 1.64 degrees C) and in the child's bedroom of 0.57 degrees C (0.05 degrees C to 1.08 degrees C). Lower levels of nitrogen dioxide were measured in the living rooms of the intervention households than in those of the control households (geometric mean 8.5 microg/m(3) v 15.7 microg/m(3), P<0.001). A similar effect was found in the children's bedrooms (7.3 microg/m(3) v 10.9 microg/m(3), P<0.001).Installing non-polluting, more effective heating in the homes of children with asthma did not significantly improve lung function but did significantly reduce symptoms of asthma, days off school, healthcare utilisation, and visits to a pharmacist.Clinical Trials NCT00489762.
AIDS in 1996 Much Accomplished, Much to Do
Authors: Anthony S. Fauci
Journal: JAMA (1996)

On July 7 through 12,1996, the 11th International Conference on AIDS (acquired immunodeficiency syndrome) will take place in Vancouver, British Columbia. Unlike the pessimism that prevailed during the 9th International Conference in Berlin in 1993 and, to a lesser extent, the 10th International Conference in Yokohama in 1994, the general feeling among planned participants is one of cautious optimism. One of the reasons for this swing toward optimism is the fact that a number of recent research advances have led to a greater understanding of the pathogenic mechanisms of human immunodeficiency virus (HIV) disease and form the basis for therapeutic and vaccine strategies. A few of these deserve particular attention since they reflect a convergence of greater understanding of both viral and host factors and have practical, and even immediate, implications for the care of HIV-infected individuals. It had been previously demonstrated that HIV actively replicates in lymphoid tissue<sup>1,2</sup>
Proton pump inhibitors for Barrett's oesophagus
Authors: F T M PETERS
Journal: Gut (2000)

DiVerential expression of cyclooxygenase 2 in human colorectal cancerEDITOR,-We were puzzled by the recent paper by Dimberg and colleagues (Gut 1999;45:730-732) which reported that upregulation of cyclooxygenase 2 (COX-2) protein expression was prominent in rectal adenocarcinomas compared with that in adenocarcinomas arising from the colon."Low or undetectable levels of COX-2 protein expression" were demonstrated in 15 of 19 colonic adenocarcinomas located proximal to the rectum.Overall, upregulation of COX-2 protein expression was reported in only 56% of colorectal cancers.Previous reports, 1-7 which include one by the current authors on a not dissimilar case series, 1 and two in the joint authorship of the accompanying commentary writer, 2 3 have shown consistent upregulation of COX-2 expression in colonic and rectal adenocarcinomas (in 85-90% of cases) compared with matched normal colonic mucosa using diVerent techniques, including northern blot analysis, RT-PCR, western blot analysis, and immunohistochemistry. Furthermore, four of these studies refer to the distribution of adenocarcinomas throughout the colon without showing evidence of diVerential COX-2 expression between rectal and more proximal tumours. 1 2 4 5 In the one previous study which analysed COX-2 protein expression in human colorectal cancers by western blot analysis, 7 immunoreactive COX-2 was detected in 76% of cases with a 10-fold increase in median tissue COX-2 concentration compared with normal colonic mucosa.In our view, the authors should attempt to explain the discrepancy between their results and previously published data.It is interesting to note that, in the study of Kargman et al, five of six patients taking NSAIDs had low or undetectable COX-2 protein expression. 7Moreover, aspirin has recently been shown to suppress induction of COX-2 mRNA and protein in interleukin-1 and phorbol ester stimulated human endothelial cells and fibroblasts. 8Do the authors have data on NSAID use in their cohort of patients prior to surgery?
Advantage of Including the Indian Service in the Proposed Department of Health
Authors: George W. Wimberly
Journal: JAMA (1913)

<h3>To the Editor:</h3> —I have read the text of the Owen bill as published inThe Journal(April 26, p. 1320) and am heartily in favor of its provisions. I think, however, that there is one important omission. By all means, it seems to me, the medical department of the U. S. Indian Service should be taken over by the new Department of Health. There are many reasons why this should be done. In the first place, the Indian Medical Service, taken as a whole, is wofully inefficient and is not getting results commensurate with the money being spent or the work being done; and this does not mean that the Indian Service doctors are either overpaid or overworked. It simply means that even the small salaries paid and the small amount of work being done are largely wasted because the whole effort is misdirected. The medical service furnished to
Advancing the neuroscience of social emotions with social immersion
Authors: Sören Krach, Laura Müller-Pinzler, Stefan Westermann, Frieder M. Paulus
Journal: Behavioral and Brain Sciences (2013)

Abstract Second-person neuroscience offers a framework for the study of social emotions, such as embarrassment and pride. However, we propose that an enduring mental representation of oneself in relation to others without a continuous direct social interaction is possible. We call this state “social immersion” and will explain its impact on the neuroscience of social emotions.
De novo deposition of laminin-positive basement membrane in vitro by normal hepatocytes and during hepatocarcinogenesis
Authors: Reidar Albrechtsen, Ulla M. Wewer, Snorri S. Thorgeirsson
Journal: Hepatology (1988)

De novo formation of laminin-positive basement membranes was found to be a distinct morphologic feature of diethylnitrosamine/phenobarbital-induced hepatocellular carcinomas of the rat. The first appearance of extracellularly located laminin occurred in the pre-neoplastic liver lesions (corresponding to neoplastic nodules), and this feature became successively more prominent during the course of hepatocellular carcinoma development. Most groups of tumor cells were surrounded by laminin-positive basement membrane material. The laminin-positive material was also deposited along the sinusoids, a location where no laminin was seen in normal rat liver. The amount of extractable laminin from hepatocellular carcinomas was significantly higher (approximately 100 ng per mg tissue) than that of normal liver tissue (less than 20 ng per mg). In vitro experiments demonstrated that normal and pre-neoplastic rat hepatocytes had the capacity to lay down basement membrane-like material. This occurred, however, only when the hepatocytes were cocultured with certain feeder cells or when grown in the presence of their conditioned media. These results indicate that during experimental hepatocarcinogenesis in the rat some as yet undefined humoral factor(s) might influence the hepatocytes to turn on genes encoding the basement membrane components and further stimulate the assembly and deposition of basement membranes.
Dendritic cells in chronic viral hepatitis B and C: victims or guardian angels?
Authors: A M Woltman, A Boonstra, H L A Janssen
Journal: Gut (2009)

Hepatitis viruses, of which the common types are A, B and C, are hepatotropic and primarily infect hepatocytes. Both hepatitis B virus (HBV) and hepatitis C virus (HCV) can cause chronic liver disease and may elicit progressive liver injury leading to increased risk of developing liver cirrhosis, liver failure and liver cancer.1 2 The outcome of infection, and the development of liver disease are determined by viral and host factors (fig 1).



Figure 1 
Hepatitis B virus (HBV) and hepatitis C virus (HCV) disease pathogenesis. (A) Following infection with HBV, there will be an initial acute hepatitis that could be symptomatic (nausea and icterus). Successful clearance and resolution of HBV infection (10–90%) depends on the route of infection, age and immune status of the individual, with most infections of immunocompetent adults being self-limiting. Most cases of chronic HBV infection are caused by vertical transmission from mother to neonate. If the infection is not controlled, continuing liver inflammation, tissue injury and aberrant repair result in chronic hepatitis, liver fibrosis and cirrhosis. Pro-oncogenic features of HBV itself in combination with ongoing inflammation and tissue injury result in an increased risk for the development of hepatocellular carcinoma (HCC). Persistent immune control over the HBV can be achieved in up to 20–30% of the patients after treatment with pegylated interferon α (PEG-IFNα), which has several side effects. Sustained response rates after nucleos(t)ide analogue treatment, which directly interferes with viral replication and probably has to be given life long, are even lower due to higher off-treatment relapses. In addition, breakthrough of resistant HBV variants limits long-term use. (B) Acute HCV infection is asymptomatic in most cases. HCV readily establishes chronic infection in otherwise immunocompetent adults (70–90% of HCV-infected individuals). If the infection is not controlled, continuing liver inflammation, tissue injury and aberrant repair result in …
Topical Anti-inflammatory Agents for Seborrheic Dermatitis of the Face or Scalp
Authors: Helena Kastarinen, Enembe O. Okokon, Jos H. Verbeek
Journal: JAMA Dermatology (2015)

Are there differences in effectiveness between topical anti-inflammatory treatments (steroids, calcineurin inhibitors, or lithium salts) and placebo or azoles in the treatment of seborrheic dermatitis of the face and scalp in adults?The topical anti-inflammatory treatments were more effective in achieving total clearance of symptoms than placebo by 1.4-fold to 8.5-fold, but there are no considerable differences in the anti-inflammatory topical treatments or in comparison with azoles for short-term treatment. There is no evidence of treatment effects in long-term, continuous, or intermittent use of these compounds despite the chronic nature of the disease.
Correcting Systematic Inflation in Genetic Association Tests That Consider Interaction Effects
Authors: Lynn M. Almli, Richard Duncan, Hao Feng, Debashis Ghosh, Elisabeth B. Binder, Bekh Bradley, Kerry J. Ressler, Karen N. Conneely, Michael P. Epstein
Journal: JAMA Psychiatry (2014)

<h3>Importance</h3> Genetic association studies of psychiatric outcomes often consider interactions with environmental exposures and, in particular, apply tests that jointly consider gene and gene-environment interaction effects for analysis. Using a genome-wide association study (GWAS) of posttraumatic stress disorder (PTSD), we report that heteroscedasticity (defined as variability in outcome that differs by the value of the environmental exposure) can invalidate traditional joint tests of gene and gene-environment interaction. <h3>Objectives</h3> To identify the cause of bias in traditional joint tests of gene and gene-environment interaction in a PTSD GWAS and determine whether proposed robust joint tests are insensitive to this problem. <h3>Design, Setting, and Participants</h3> The PTSD GWAS data set consisted of 3359 individuals (978 men and 2381 women) from the Grady Trauma Project (GTP), a cohort study from Atlanta, Georgia. The GTP performed genome-wide genotyping of participants and collected environmental exposures using the Childhood Trauma Questionnaire and Trauma Experiences Inventory. <h3>Main Outcomes and Measures</h3> We performed joint interaction testing of the Beck Depression Inventory and modified PTSD Symptom Scale in the GTP GWAS. We assessed systematic bias in our interaction analyses using quantile-quantile plots and genome-wide inflation factors. <h3>Results</h3> Application of the traditional joint interaction test to the GTP GWAS yielded systematic inflation across different outcomes and environmental exposures (inflation-factor estimates ranging from 1.07 to 1.21), whereas application of the robust joint test to the same data set yielded no such inflation (inflation-factor estimates ranging from 1.01 to 1.02). Simulated data further revealed that the robust joint test is valid in different heteroscedasticity models, whereas the traditional joint test is invalid. The robust joint test also has power similar to the traditional joint test when heteroscedasticity is not an issue. <h3>Conclusions and Relevance</h3> We believe the robust joint test should be used in candidate-gene studies and GWASs of psychiatric outcomes that consider environmental interactions. To make the procedure useful for applied investigators, we created a software tool that can be called from the popular PLINK package for analysis.