tbuckley/cabot-search huggingface dataset:
AN EVALUATION OF DINITROPHENOL AS AN AID IN WEIGHT REDUCTION
Authors: JAMES M. STRANG
Journal: JAMA (1935)

Much attention has been directed in recent years to the reduction of the weight of obese subjects. The removal of fat deposits is dependent on the creation of a deficit between the daily intake and the daily output of energy. This deficit can be obtained either by a reduction of intake or by an increase of output. In the past year a new group of chemicals, of which the principal one is alpha-dinitrophenol (1-2-4), has been advocated as a method of securing weight reduction by increasing the energy output.<sup>1</sup>These drugs have an advantage over thyroid extract in the absence of certain side reactions such as tachycardia and palpitation. It therefore becomes desirable to discover the practical value of the use of dinitrophenol<sup>2</sup>by observation of its effect on the weight change of obese patients who have been placed on carefully established regimens and to compare these results
Hormone-fuel interrelationships during fasting.
Authors: G F Cahill, M G Herrera, A P Morgan, J S Soeldner, J Steinke, P L Levy, G A Reichard, D M Kipnis
Journal: Journal of Clinical Investigation (1966)

Over 50 years ago, Benedict (2) published his extensive monograph on the metabolism of fasting in man, in which he demonstrated that carbohydrate stores provide a small but significant component of the body's fuel for only the first few days. Thereafter, protein and fat are the sole sources of fuel, the former contributing 15% of the calories and the latter the balance. The primary role of fat as fuel was apparent to Benedict and his contemporaries; it is plentiful and expendable. The significance of the protein requirement, however, was less clear; in fact, it was not fully understood until nearly 20 years later when the obligatory dependence of the central nervous system on glucose was firmly established (3). Since glycogen stores in man were known to approximate only 200 g, it was readily apparent that glucose has to be derived from protein in order to maintain cerebral metabolism during a prolonged fast. More recently, our understanding of the fasted state has been further clarified by the demonstration that free fatty acid is both the major transport form of lipid leaving adipose tissue (4, 5) and a substrate that is
The Microbiology of Evacuated Blood Collection Tubes
Authors: JOHN A. WASHINGTON
Journal: Annals of Internal Medicine (1977)

A collaborative study involving 20 clinical laboratories representing diverse geographical regions was organized to examine the microbiology of evacuated blooc collection tubes. Overall, 14% of the 1433 tubes examined contained microorganisms representing a variety of bacteria and fungi. Of note was the finding that nearly 9% of tubes with yellow closures, which are stated to be sterile by the manufacturers, contained bacteria, including Pseudomonas aeruginosa, enterococci, Serratia marcescens, and Acinetobacter calcoaceticus. Sterilization of these potential sources of infection is advisable.
ECG leads to a quick diagnosis
Authors: J Bhar-Amato
Journal: BMJ (2008)

A 19 year old man presented to the emergency department with a two hour history of palpitations and chest discomfort. He had no important medical history and took diphenhydramine occasionally for hay fever. He denied smoking, drinking alcohol excessively, and using drugs. On examination he seemed breathless, his pulse was irregular at 140 beats per minute and his blood pressure was 145/60. On further examination of his cardiovascular, respiratory, and abdominal systems no abnormality was detected.

His 12 lead electrocardiogram is shown in the top half of figure 1⇓.

The next day this patient was reviewed on the post take ward round on the coronary care unit. His 12 lead electrocardiogram is shown in the lower half of figure 1⇓.



Figure 1





### Short answers

### Long answers

#### 1. What the electrocardiogram shows

The electrocardiogram in the top half of figure 1 shows an irregular rhythm with QRS complexes of varying morphology. Some complexes are narrow and others are broad with a slurred upstroke (the “delta wave,” best seen in the lateral leads in figure …
Organophosphate Pesticide Exposure and Work in Pome Fruit: Evidence forthe Take-Home Pesticide Pathway
Authors: Gloria D. Coronado, Eric M. Vigoren, Beti Thompson, William C. Griffith, Elaine M. Faustman
Journal: Environmental Health Perspectives (2006)

Organophosphate (OP) pesticides are commonly used in the United States, and farmworkers are at risk for chronic exposure. Using a sample of 218 farmworkers in 24 communities and labor camps in eastern Washington State, we examined the association between agricultural crop and OP pesticide metabolite concentrations in urine samples of adult farmworkers and their children and OP pesticide residues in house and vehicle dust samples. Commonly reported crops were apples (71.6%), cherries (59.6%), pears (37.2%), grapes (27.1%), hops (22.9%), and peaches (12.4%). Crops were grouped into two main categories: pome fruits (apples and pears) and non-pome fruits. Farmworkers who worked in the pome fruits had significantly higher concentrations of dimethyl pesticide metabolites in their urine and elevated azinphos-methyl concentrations in their homes and vehicles than workers who did not work in these crops. Among pome-fruit workers, those who worked in both apples and pears had higher urinary metabolites concentrations and pesticide residue concentrations in dust than did those who worked in a single pome fruit. Children living in households with pome-fruit workers were found to have higher concentrations of urinary dimethyl metabolites than did children of non-pome-fruit workers. Adult urinary concentrations showed significant correlations with both the vehicle and house-dust azinphos-methyl concentrations, and child urinary concentrations were correlated significantly with adult urinary concentrations and with the house-dust azinphos-methyl concentration. The results provide support for the take-home pathway of pesticide exposure and show an association between measures of pesticide exposure and the number of pome-fruit crops worked by farmworkers.
The Vaginal Irrigation Smear
Authors: W. A. D. Anderson
Journal: JAMA (1967)

OUR INITIAL evaluation1,2of the patient-obtained cytological specimen (the vaginal irrigation smear3,4for the detection of intraepithelial and invasive cancer of the cervix was based on the reliability of suspicious and positive cytological reports. In comparison with the physician-obtained cervical scrape specimen, the irrigation smear was 73% as reliable in detecting carcinoma in situ and 84% as reliable in detecting invasive cervical cancer.1,2  Further study5showed that the atypical cytological category is also an important alerting one for tissue examination, since among patients with this grading are a considerable number with premalignant and malignant changes. When the screening methods were used at their fullest potential, that is, with consideration of all atypical, suspicious, and positive cytologic gradings, the irrigation smear was 88% as reliable as the cervical scrape in carcinoma in situ and 93% as reliable in invasive cancer. In severe dysplasia, a condition suspected of
Six year follow up of infants with bacteriuria on screening.
Authors: B Wettergren, M Hellstrom, E Stokland, U Jodal
Journal: BMJ (1990)

OBJECTIVE--To determine the value of screening for bacteriuria in infants with special emphasis on the natural course of untreated asymptomatic bacteriuria, renal growth, and renal damage. DESIGN--Prospective six year follow up of infants with bacteriuria on screening in an unselected infant population. SETTING--Paediatric outpatient clinic. PATIENTS--50 Infants (14 girls, 36 boys) with bacteriuria on screening verified by suprapubic aspiration from an unselected population of 3581 infants in a defined area of Gothenburg. INTERVENTIONS--Children with asymptomatic bacteriuria and normal findings on initial urography were untreated, although other infections were treated. MAIN OUTCOME MEASURES--Culture of urine and determination of C reactive protein concentration every six weeks for the first six months after diagnosis, every three months from six months to two years, and every six months between two and three years; thereafter yearly urine culture. Evaluation of renal concentrating capacity with a desmopressin test; radiological examination, including first and follow up urography and micturition cystourethrography without antibiotic cover; and measurement of renal parenchymal thickness and renal surface area. RESULTS--Of the original 50 infants, 37 (12 girls, 25 boys) were followed up for at least six years. Two infants developed pyelonephritis within two weeks after bacteriuria was diagnosed; the others remained free of symptoms. 45 Infants were untreated; the bacteriuria cleared spontaneously in 36 and in response to antibiotics given for infections in the respiratory tract in eight. Recurrences of bacteriuria were observed in 10 of the 50 children, of whom one had pyelonephritis. No child had more than one recurrence. At follow up urography in 36 of the 50 children (9 girls, 27 boys) after a median of 32 months no child had developed renal damage. First samples tested for renal concentrating capacity showed significantly higher values than those from a reference population (mean SD score 0.50, 95% confidence interval 0.21 to 0.79; p less than 0.001), but the last samples showed no significant difference (mean SD score 0.08, -0.24 to 0.40; p greater than 0.05). CONCLUSIONS--Mass screening for bacteriuria in infancy results primarily in detection of innocent bacteriuric episodes and is not recommended.
Remarks on those Secretions which are, and on those which are Not, the Means of Communicating Constitutional Syphilis
Authors: H. Lee
Journal: BMJ (1868)

CASE i.-L.W., aged 23, was admitted under my care into St.George's lIospital on the 17th of June, i868.There was then an oval sore upon the left labium, about an inch and a-half long, and half an inch broad, surrounded by well-defined induration.The surface of the sore was red, glazed, and presented no appearance of healing.The corresponding glands in the groin were enlarged, accurately defined, and not painfuil.A secondary eruption was commencing on the hands anid on the chest.On June igth, the secretion from the sore was ino- culated in two places.On June 2ISt, the sore was dressed with savine ointment, so as to produce a copious secretion, which was inoculated in three places on the 22nd.On the 23rd, two fresh inoculations were made.All these inoculations proved negative.CASE ii.-G.D., aged i8, was admitted under my care on June 17th, S868, with a soft oval sore on the upper part of the left thigh.The edges of this sore were well defined, and it secreted a large amount of pus.
Legionnaires' Disease
Authors: Joseph E. McDade, Charles C. Shepard, David W. Fraser, Theodore R. Tsai, Martha A. Redus, Walter R. Dowdle
Journal: New England Journal of Medicine (1977)

To identify the etiologic agent of Legionnaires' disease, we examined patients' serum and tissue specimens in a search for toxins, bacteria, fungi, chlamydiae, rickettsiae and viruses. From the lungs of four of six patients we isolated a gram-negative, nonacid-fast bacillus in guinea pigs. The bacillus could be transferred to yolk sacs of embryonated eggs. Classification of this organism is incomplete. We used yolksac cultures of the bacillus as antigen to survey suspected serum specimens, employing antihuman-globulin fluorescent antibody. When compared to controls, specimens from 101 of 111 patients meeting clinical criteria of Legionnaires' disease showed diagnostic increases in antibody titers. Diagnostic increases were also found in 54 recent sporadic cases of severe pneumonia and, retrospectively, in stored serum from most patients in two other previously unsolved outbreaks of respiratory disease. We conclude that Legionnaires' disease is caused by a gram-negative bacterium that may be responsible for widespread infection. (N Engl J Med 297:1197–1203, 1977)
Noninvasive methods to measure airway inflammation: future considerations
Authors: H. Magnussen, O. Holz, P.j Sterk, F.e Hargreave
Journal: European Respiratory Journal (2000)

This last contribution to the series focuses on open questions regarding: 1) methodological issues; and 2) the potential clinical application of the noninvasive methods such as induced sputum and the analysis of exhaled air for the assessment of airway inflammation. In addition their potential future role in occupational health and the early diagnosis of neoplastic lesions are briefly discussed. The future clinical application of noninvasive methods will depend on the progress made to improve their practicability, particularly in rendering them less time consuming and cheaper. To assess their clinical value, prospective studies are needed to establish whether patients actually benefit from the results obtained. This is also important to implement the methods into the healthcare system and to obtain adequate financial compensation. Therefore, it is necessary to know: 1) whether the assessment of airwav inflammation can aid in coming to an earlier and better defined diagnosis; 2) whether by repeated monitoring it is possible to avoid exacerbations through earlier interventions; and 3) whether the long-term outcome of patients is improved through knowledge of the type and degree of airway inflammation that is taken into account in selecting the appropriate treatment. In the meantime a wealth of data has become available, both for induced sputum and the analysis of exhaled air, which give these methods the potential to be incorporated into future clinical practice. This, however, will, amongst the other issues, depend on favourable cost-benefit ratios which should also be the subject of future prospective studies.
Type C oncornavirus isolation studies in systemic lupus erythematosus: I. Attempted detection by isopycnic sedimentation of 3H-uridine-labelled virions
Authors: P. E. Phillips, R. Hargrave, E. Stewart, N. H. Sarkar
Journal: Annals of the Rheumatic Diseases (1976)

<b>Phillips, P. E., Hargrave, R., Stewart, E., and Sarkar, N. H. (1976).</b><i>Annals of the Rheumatic Diseases</i>, <b>35</b>, 422-428. <b>Type C oncornavirus isolation studies in systemic lupus erythematosus. I. Attempted detection by isopycnic sedimentation of <sup>3</sup>H-uridine-labelled virions.</b> Type C oncornavirus isolation was attempted from cell cultures of tissues from 7 patients with systemic lupus erythematosus. Detection was based on the characteristic sedimentation of <sup>3</sup>H-uridine-labelled virions at a density of 1·16 g/ml. Cultures positive by this method were negative by two other criteria for type C viruses: characteristic virions by electron microscopy and the viral enzyme RNA-directed DNA polymerase. The positive results were probably due to cellular damage by prolonged radiolabelling, with release of organelles containing labelled RNA sedimenting at the same density as type C viruses.
Comparative Efficacy and Safety of Enalapril and Sustained-Release Nifedipine in Patients with Mild to Moderate Hypertension
Authors: P. Gueret, J.Y. Artigou, M. Benichou, J. Berland, P. Fressinaud, G. Grollier, L. NGuyen Cong Duc
Journal: Drugs (1990)
Immunomodulatory Effects of Melatonin in Asthma
Authors: E. Rand Sutherland, Richard J. Martin, Misoo C. Ellison, Monica Kraft
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Patients with nocturnal asthma demonstrate circadian variations in airway inflammation. We hypothesized that melatonin, a circadian rhythm regulator, modulates circadian inflammatory variations in asthma. The effect of melatonin stimulation on peripheral blood mononuclear cell cytokine production was evaluated at 4:00 P.M. and 4:00 A.M. in normal control subjects, patients with nocturnal asthma, and patients with non-nocturnal asthma. Melatonin was proinflammatory, causing significantly increased production of interleukin-1, interleukin-6, and tumor necrosis factor-α at 4:00 P.M. and 4:00 A.M. in all subject groups (range, 12.8 ± 3.3 to 131.72 ± 16.4%, p ≤ 0.0003). The observed increases in cytokine production did not change between 4:00 P.M. and 4:00 A.M. in control subjects or in patients with nocturnal asthma (p > 0.05, both cases). At 4:00 P.M., the cytokine response to melatonin of patients with nocturnal asthma was greater than that of control subjects or patients with non-nocturnal asthma and did not change significantly at 4:00 A.M. At 4:00 P.M., the cytokine response of patients with non-nocturnal asthma was less than that of patients with nocturnal asthma and rose significantly at 4:00 A.M. (p = 0.0001, all comparisons). Melatonin is proinflammatory in both patients with asthma and healthy subjects. Patients with nocturnal asthma demonstrate the largest daytime cytokine response and cannot be further stimulated at 4:00 A.M., suggesting chronic overstimulation in vivo. These results suggest differential immunomodulatory effects of melatonin based on asthma clinical phenotype and may indicate an adverse effect of exogenous melatonin in asthma.
Pituitary Stones and Associated Hypopituitarism
Authors: Harris C. Taylor
Journal: JAMA (1979)

IN 1975 DiChiro and colleagues<sup>1</sup>described two women with pituitary stones. They emphasized the benignity of this process and its rarity. We report two additional cases, both men, one of whom had clinical hypopituitarism. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 73-year-old white, single man was admitted to the hospital in March 1977 because of recurrent episodes of dizziness and confusion. Paroxysmal atrial fibrillation was noted at this time. Subsequent examination also disclosed a ten-second run of paroxysmal ventricular tachycardia on dynamic ECG monitoring in July 1977. A skull x-ray film in March 1977 demonstrated dense intrasellar calcification (Fig 1). Review of the history and physical examination failed to show symptoms or signs of hypopituitarism. He had no known children. Quinidine sulfate and digoxin were prescribed to treat the arrhythmia. Endocrine evaluation showed a thyroxine (T<sub>4</sub>) level of 6.0 μg/dL (normal, 3.5 to 11.9 μg/dL) and free thyroxine index of
Predicting PTH pulses and patterns in osteoporosis.
Authors: L J Deftos, S J Schiff
Journal: Journal of Clinical Investigation (1995)

The hormonal basis of the pathogenesis of osteoporosis remains elusive.Abnormalities have been postulated in this disease for the major calcium-and skeletal-regulating hormones: parathy- roid hormone (PTH), calcitonin (CT), and vitamin D metabo- lites.Unfortunately, there is no general consensus that secretory
The animal kingdom bites back
Authors: P. Garner, M. E Gibson, C. Wilson
Journal: BMJ (1994)

health disparities between local authority tenants and home owners.This process, described as residualisation, consigns the most socioeconomically vulnerable to the worst housing stock.The lack of investment in decent affordable housing produces and sustains homelessness, which in turn damages health, increases need and demand for health care, and increases the costs ofhealth care.If the government is serious about improving the health of the nation it cannot ignore the mounting evidence of the impact of socioeconomic inequality on health.6It must accept that health care and social care are two sides of the same coin and that artificially separating them works to the detriment of both.7No issue illustrates this more clearly than homeless- ness.
Total hip replacement and NICE
Authors: Matthew R Utting, B J A Lankester, L K Smith, R F Spencer
Journal: BMJ (2005)

<h3>Abstract</h3> Defects in flagella/cilia are often associated with infertility and disease. Motile male gametes (sperm cells) with flagella are an ancestral eukaryotic trait that has been lost in several lineages, for example in flowering plants. Here, we made use of a phenotypic male fertility difference between two moss (<i>Physcomitrella patens</i>) strains to explore spermatozoid function. We compare genetic and epigenetic variation as well as expression profiles between the Gransden and Reute strain to identify a set of genes associated with moss male infertility. Defects in mammal and algal homologs of these genes coincide with a loss of fertility, demonstrating the evolutionary conservation of flagellar function related to male fertility across kingdoms. As a proof of principle, we generated a loss-of-function mutant of a coiled-coil domain containing 39 (ccdc39) gene that is part of the flagellar hydin network. Indeed, the <i>Ppccdc39</i> mutant resembles the male infertile Gransden strain phenotype. Potentially, several somatic (epi-)mutations occurred during prolonged vegetative propagation of <i>P. patens</i> Gransden, causing regulatory differences of e.g. the homeodomain transcription factor BELL1. Probably these somatic changes are causative for the observed male fertility. We propose that <i>P. patens</i> spermatozoids might be employed as an easily accessible system to study male infertility of human and animals.
Neutron Contamination From Medical Electron Accelerators
Authors: Melvin L. Griem
Journal: JAMA (1985)

This report was produced by a scientific committee of eight members, chaired by Richard C. McCall. It is a reference manual dealing with the problem of neutron production that results from the operation of high-energy electron linear accelerators used in radiation therapy. As radiation therapy becomes more sophisticated, in many hospitals in the United States and abroad the trend is to higher energy machines. Accelerators operated below 10 meV do not represent a major hazard; however, as accelerators operate in the 10 to 50 meV range, neutron production may be seen. The source of neutron production in the treatment machine and the methods of protection and measurement are exquisitely detailed in this book. There is an extensive reference list to the source information. This pamphlet goes into details concerning facilities design, including wall thickness, shielding requirements, machine placement, and maze design. Information on hazards, patient risks, and operating personnel risks
Where the hearts is
Authors: I. Iheanacho
Journal: BMJ (2009)

Soon you’ll be free. You’ll shut the diary, activate the “out of office” email, and get away from it all for a fortnight of rest and recreation. What have you got to look forward to (apart from the cancelled flights and lost luggage)? Well, there’s no more journal reading for a start; in fact, no reading at all, unless you count the novel that will end up as a face screen during the sunlounger snooze.

Now’s probably the worst time, therefore, to suggest that a recent research paper …
THE TECHNIC OF LAMINECTOMY.
Authors: HARRY M. SHERMAN
Journal: JAMA (1907)

From a fairly long training in the conservatism of orthopedic surgery, to which at one time I devoted practically all my efforts, I have developed a tendency to prefer, in general, those operative methods which conserve tissue, and especially if the tissue so saved can be expected to be of use to the patient. That the laminæ of the vertebræ were orginally of use, to protect the cord and to give points of attachment for spinal muscles was obvious; that they would still be of use if, after a laminectomy, they could be restored to position and function seemed good reasoning; that this could be done I believed had been demonstrated, and I was impressed somewhat with the description of the operation as given by Bickham.<sup>1</sup>There was nothing new in this description, but it came at a time that was, or seemed, opportune, for Dr. Leo Newmark and