tbuckley/cabot-search huggingface dataset:
The Basis in Sydenham, Rush, and Armstrong for Nathan Smith's Teaching
Authors: OLIVER S. HAYWARD
Journal: Annals of Internal Medicine (1962)

Article1 February 1962The Basis in Sydenham, Rush, and Armstrong for Nathan Smith's TeachingOLIVER S. HAYWARD, M.D.OLIVER S. HAYWARD, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-2-343 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThree medical textbooks (1-3) illuminate clearly the strife and confusion existing in the practice and teaching of medicine at the beginning of the nineteenth century. All three concern fevers, were written by Englishmen, and were edited by professors in American medical schools. One advocates bleeding, purging, and blistering; one advocates dependence on the healing powers of nature; and one advocates both!The American "editors" seem not to have altered the text in any way. But all three added footnotes praising, criticizing, or correcting their authors and added long descriptions of American diseases and treatments. One editor, Nathan Smith, added a...References1. PHLIP AP: A Treatise on Febrile Diseases, Including the Various Species of Fever, and All Diseases Attended with Fever. With Notes and Additions by Nathan Smith, M.D., vols. I and II, 2d Amer. ed. from 3d London ed., Hartford, 1816. Google Scholar2. ARMSTRONG J: Practical Illustrations of Typhus Fever, of the Common Continued Fever, and of Inflammatory Diseases &c. &c., ed. by Potter, N., Philadelphia, 1821-1822. Google Scholar3. RUSH B: The Works of Thomas Sydenham, M.D. on Acute and Chronic Diseases, with Their Histories and Modes of Cure, Philadelphia, 1809. Google Scholar4. KING L: The Medical World of the Eighteenth Century, University of Chicago Press, Chicago, 1958, p. 149. Google Scholar5. FITCH WL: Lectures on the Practice of Physic and Surgery by Nathan Smith, M.D. C.S.M.S. Prof. The. & Pract. of Phys. & Surg. in the Medical Institution of Yale College, Historical Library, Yale University School of Medicine, New Haven, 1825. Google Scholar6. SHRYOCK RH: Benjamin Rush from the perspective of the twentieth century. Trans. Coll. Physicians Phila. 14: 113, 1946. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: OLIVER S. HAYWARD, M.D.Affiliations: Silver Spring, MarylandThis study was supported by grant RG-6625 from the United States Public Health Service.Requests for reprints should be addressed to Oliver S. Hayward, M.D., 405 Silver Spring Avenue, Silver Spring, Maryland. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFascinated by Fevers: Nathan Smith (1762–1829), Early American DoctorThe first All-New England surgeonJo Gallup, New England Epidemiologist (1769–1849)Medical History Begets HumilityE. J. H. 1 February 1962Volume 56, Issue 2Page: 343-351KeywordsFeversHemorrhageMedical services ePublished: 1 December 2008 Issue Published: 1 February 1962 PDF downloadLoading ...
Baroreflex sensitivity in conscious rats: the influence of recording site
Authors: S. M GARDINER, T. BENNETT
Journal: Cardiovascular Research (1986)

Arterial blood pressures were measured simultaneously in the thoracic and abdominal aortas in the same conscious rats. Intravenous administration of sodium nitroprusside caused a greater fall in systolic blood pressure in the abdominal aorta than in the thoracic aorta, whereas intravenous administration of methoxamine caused a greater rise in systolic blood pressure in the thoracic aorta. Hence baroreflex sensitivities derived from these data (by relating systolic blood pressure to the pulse interval of the succeeding beat) were appreciably different depending on the site of measurement. The changes in diastolic and mean arterial blood pressures induced by the drugs were similar at the two recording sites. It is suggested therefore that cardiac baroreflex sensitivity should be assessed in conscious rats by relating pulse interval to mean arterial blood pressure recorded at a site other than the thoracic aorta since cannulation at that site impairs baroreflex responsiveness.
Etiology of Sporadic Hepatitis B Surface Antigen-Negative Hepatitis
Authors: JULES L. DIENSTAG
Journal: Annals of Internal Medicine (1977)

We studied serologically 45 adults who had sporadic acute viral hepatitis that was hepatitis B surface antigen (HBsAg) negative. Two cases were due to hepatitis B virus, as demonstrated by the appearance of antibody to hepatitis B core antigen. In three other patients, the serologic pattern was inconclusive. Of 40 non-B cases, 20 were type A hepatitis and 20 were non-A, non-B hepatitis. Clinically, type A and non-A, non-B hepatitis were indistinguishable; one case of fulminant disease occurred in each group. The type A cases were more frequent in young adults; non-A, non-B disease predominated in women 35 years or older. Epidemiologic backgrounds were generally similar, including illicit self-injection; but four transfusion-associated cases were limited to the non-A, non-B group. We conclude that relatively few HBsAg-negative cases are due to hepatitis B virus, and that hepatitis A virus and non-A, non-B viruses are both important in acute non-B disease.
Comroe and Dripps revisited.
Authors: R Smith
Journal: BMJ (1987)

Cardiac surgery (including open heart repairofcongenital defects and replacement of diseased valves) * Vascular surgery (including repair or bypass ofobstructions or other lesions in aorta, coronary, cerebral, renal, and limb arteries) * Drug treatment ofhypertension * Medical treatment ofcoronary insufficiency (myocardial ischaemia) * Cardiac resuscitation, defibrillation, "cardioversion" and pacing in patients with cardiac arrest, slow hearts, or serious arrhythmias * Oral diuretics (in treatment ofpatientswith congestive heart failure or hypertension) * Intensive cardiovascular and respiratory care units (including those for postoperative care, coronary care, respiratory failure, and disorders ofnewborn) * Chemotherapy and antibiotics (including prevention ofacute rheumatic fever and treatment oftuberculosis, pneumonias, and cardiovascular syphilis) * New diagnostic methods (for earlier and more accurate diagnosis ofdisease or cardiovascular and pulmonary-respiratory systems) * Prevention ofpoliomyelitis (especially ofrespiratory paralysis due to polio)
Tissue crosslinks concentrations in normal joints and chronic articular diseases
Authors: L. SINIGAGLIA, M. VARENNA, L. BINELLI, A. PARAFIORITI, M. ARRIGONI, G. ABBIATI, M. TAKAHASHI
Journal: Annals of the Rheumatic Diseases (1997)

Pigmented villonodular synovitisI write with regard to the paper by Zuber and colleagues that purports to demonstrate a case of pigmented villonodular synovitis (PVNS). 1 The pathology material presented by the authors, however, is not diagnostic of PVNS, in that the cellular infiltrate did not demonstrate the large polyhedral cellsusually dubbed histiocytes-that are requisite for the diagnosis of PVNS.Villi, nodules, giant cells, and haemosiderin are not specific, and may be seen in a variety of conditions other than PVNS.It is the histiocyte that renders the pathology of PVNS unique and diagnostic.Indeed, Lichtenstein has described PVNS as a 'histiocytosis' of the synovial membrane. 2n addition, the authors suggest that in their patient PVNS was found to aVect the second to fifth MCP joints.However, the diffuse form of PVNS is nearly always monarticular; documented cases of polyarticular (usually biarticular) involvement by PVNS are exceptionally rare, and probably number less than half a dozen in the medical literature.The patient under discussion-who presented with progressive, bilateral ulnar deviation at the MCPs-most probably had rheumatoid disease, not PVNS.If there is a 'lesson' to this case, it is that the correct diagnosis of an unusual condition such as PVNS requires awareness of the characteristic clinical presentation of the disease and attentiveness to its diagnostic histopathology.
The Bmj and the 77 specialties of medicine
Authors: R. Smith
Journal: BMJ (1997)

“The BMJ never publishes anything useful to leechologists. You haven't got a single leechologist on your editorial board. Once in a blue moon you publish a leechology paper, and it's always bloody awful. I don't know who you get to review them. What you don't seem to understand is that leechology is one of the most important specialties in medicine. There aren't enough of us, we're overworked, and general practitioners don't seem to know even the basics. Everyday we're dealing with dreadful cock ups. It's time your journal taught ordinary doctors the rudiments of leechology.”

Sadly, I hear this message regularly from representatives of the 77 different medical specialties. Some of the failures are inevitable. The BMJ is not intended to teach plastic surgery to plastic surgeons: if it did, we would lose contact with the 99.5% of our readers who are not plastic surgeons while we did so. Rather the BMJ attempts to concentrate on what matters to all doctors. Interestingly, medical educators are discovering that the knowledge and skills needed by doctors in different specialties are more similar than dissimilar.

When I meet with disgruntled specialists—as I do often—we usually have an enjoyable meeting and discover that there are many ways in which we can help each other. As it might take me a long time to work through 77 specialties in 122 countries, I thought I should write down answers to some of the questions that come up commonly.

This is usually the main question that specialists ask me, and I might tell them to employ a public relations specialist. Increasingly, medical specialties do, but they are expensive and I …
Another Presentation of Gout
Authors: Mohamed El Sandid
Journal: Annals of Internal Medicine (2004)

Letters20 April 2004Another Presentation of GoutMohamed El Sandid, MD and Ha Ta, MDMohamed El Sandid, MDFrom University of Kansas, Kansas City, KS 66180.Search for more papers by this author and Ha Ta, MDFrom University of Kansas, Kansas City, KS 66180.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-8-200404200-00037-w2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Gout of the axial skeleton is an unusual manifestation of tophaceous gout. All segments of the spine are equally affected. Clinical presentations range from neck or back pain to radiculopathy, myelopathy, and the cauda equina syndrome (1). Spinal gout may be difficult to distinguish from infections such as epidural abscess, discitis, or vertebral osteomyelitis in patients with back pain and fever.Objective: To describe a patient with an acute tophaceous gout attack of the thoracic spine mimicking a spinal epidural abscess.Case Report: A 32-year-old man with a history of gouty arthritis presented with sudden-onset constant ...References1. Barrett K, Miller ML, Wilson JT. Tophaceous gout of the spine mimicking epidural infection: case report and review of the literature. Neurosurgery. 2001;48:1170-2. [PMID: 11334288] MedlineGoogle Scholar2. Fenton P, Young S, Prutis K. Gout of the spine. Two case reports and a review of the literature. J Bone Joint Surg Am. 1995;77:767-71. [PMID: 7744902] CrossrefMedlineGoogle Scholar3. Bonaldi VM, Duong H, Starr MR, Sarazin L, Richardson J. Tophaceous gout of the lumbar spine mimicking an epidural abscess: MR features. AJNR Am J Neuroradiol. 1996;17:1949-52. [PMID: 8933885] MedlineGoogle Scholar4. Dhote R, Roux FX, Bachmeyer C, Tudoret L, Daumas-Duport C, Christoforov B. Extradural spinal tophaceous gout: evolution with medical treatment. Clin Exp Rheumatol. 1997;15:421-3. [PMID: 9272305] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Kansas, Kansas City, KS 66180. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImages in clinical medicine: TophiGout in the Spine: Imaging, Diagnosis, and OutcomesThoracic cord compression due to ligamentum flavum gouty tophus: a case report and literature reviewInterventions for tophi in goutAxial Gouty ArthropathySpinal gout in a renal transplant patient: a case report and literature review 20 April 2004Volume 140, Issue 8Page: W-32KeywordsAbscessesBiopsyFeversGoutLaminectomyLesionsLower back painMagnetic resonance imagingSpineUric acid ePublished: 20 April 2004 Issue Published: 20 April 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Portal vein filling: an unusual complication of needle-knife sphincterotomy
Authors: J. Espinel, M. Pinedo, J. Calleja
Journal: Endoscopy (2007)

The most frequent complications associated with endoscopic retrograde cholangiopancreatography (ERCP) are pancreatitis, hemorrhage, and perforation. We report an unusual case of portal vein filling after needle-knife sphincterotomy in a patient with a pancreatic carcinoma.
Dying Is Worked to Death-Reply
Authors: Samuel Vaisrub
Journal: JAMA (1975)

In reply:  Words are abstractions; death is the most real of all realities. No amount of verbal reassurance, unless it brings hope of life or afterlife, can comfort a mother whose child is about to die or a patient who faces a certain death. When a psychiatrist helps dispel anxieties in a coronary care unit, he does so precisely because he focuses on life not death.  Without denying the need for tact and sympathy, limited as their effectiveness may be, we must realize that they stem from genuine concern—a feeling that cannot be acquired by listening to lectures or wading through the vast literature dedicated to Thanatos.
Mail-order medicine; An analysis of the Sears Roebuck Foundation's Community Medical Assistance Program
Authors: R. L. Kane
Journal: JAMA (1975)

Of the 625 rural communities that originally applied to the Sears Roebuck Foundation's Community Medical Assistance Program, 253 were accepted. One hundred sixty-three went on to build clinics, and 132 had physicians at the time of follow-up. From the standpoint of physician coverage of the community once a clinic had been built, the rate of physician availability was 78 percent, The communities' success in recruiting and retaining physicians was compared against 13 variables; none was significantly related to the recruitment, and only two--numbers of service clubs and distance to nearest physician--were related to retention.
Low-Dose Trimethoprim-Sulfamethoxazole Prophylaxis for Toxoplasmic Encephalitis in Patients with AIDS
Authors: Andrew Carr, Brett Tindall, Bruce J. Brew, Deborah J. Marriott, John L. Harkness, Ronald Penny, David A. Cooper
Journal: Annals of Internal Medicine (1992)

Objective: To determine the efficacy of low-dose trimethoprim-sulfamethoxazole (trimethoprim, 160 mg plus sulfamethoxazole, 800 mg; one tablet twice daily, 2 days per week) as primary prophylaxis against toxoplasmic encephalitis in patients with human immunodeficiency virus (HIV) infection and previous Pneumocystis carinii pneumonia. Design: A retrospective study. Setting: Tertiary referral teaching hospital. Patients: During a 3-year period after primary episodes of P. carinii pneumonia, 60 patients received trimethoprim-sulfamethoxazole, and 95 patients received pentamidine (aerosolized in 78 patients and intravenous in 17 patients) as secondary prophylaxis. Results: No patient in the trimethoprim-sulfamethoxazole group and no patient seronegative for Toxoplasma gondii developed toxoplasmic encephalitis, compared with 12 of 36 (33%; 95% Cl, 19% to 51%) seropositive patients in the pentamidine group (trimethoprim-sulfamethoxazole compared with pentamidine, P = 0.008). A significant difference was seen in the time to development of toxoplasmic encephalitis between the trimethoprim-sulfamethoxazole group (no case at 1153 days) and the pentamidine group (median time, 460 days) (P = 0.004). Neither the CD4+ lymphocyte count at the start of prophylaxis nor zidovudine therapy during the period of prophylaxis influenced the rate of toxoplasmic encephalitis in any group. Conclusions: Low-dose trimethoprim-sulfamethoxazole (four tablets per week) appears to be effective prophylaxis against toxoplasmic encephalitis in HIV-infected patients with previous P. carinii pneumonia. A prospective, randomized, controlled study is needed to further evaluate these findings.
The Practice of Medicine — Good General Practice — Too Many Afferent Impulses
Authors: John Lister
Journal: New England Journal of Medicine (1954)

THE British Medical Association has just held its annual meeting in Glasgow. Sir John McNee, who has only lately retired from the Regius Chair of the Practice of Medicine in the University of Glasgow, took an unusual definition of a professorial chair as the title of his presidential address: "The Practice of Medicine."He recalled that Sir William Tennant Gairdner, a former occupant of the same chair, had been President in 1888 and had addressed the association on the subject, "The Physician As Naturalist." He had stressed the classical derivation of the word physician and acclaimed him a natural philosopher . . .
Mechanism of myocardial "stunning".
Authors: R Bolli
Journal: Circulation (1990)

Among the numerous mechanisms proposed for myocardial stunning, three appear to be more plausible: 1) generation of oxygen radicals, 2) calcium overload, and 3) excitation-contraction uncoupling. First, the evidence for a pathogenetic role of oxygen-derived free radicals in myocardial stunning is overwhelming. In the setting of a single 15-minute coronary occlusion, mitigation of stunning by antioxidants has been reproducibly observed by several independent laboratories. Similar protection has been recently demonstrated in the conscious animal, that is, in the most physiological experimental preparation available. Furthermore, generation of free radicals in the stunned myocardium has been directly demonstrated by spin trapping techniques, and attenuation of free radical generation has been repeatedly shown to result in attenuation of contractile dysfunction. Numerous observations suggest that oxyradicals also contribute to stunning in other settings: after global ischemia in vitro, after global ischemia during cardioplegic arrest in vivo, and after multiple brief episodes of regional ischemia in vivo. Compelling evidence indicates that the critical free radical damage occurs in the initial moments of reflow, so that myocardial stunning can be viewed as a sublethal form of oxyradical-mediated "reperfusion injury." Second, there is also considerable evidence that a transient calcium overload during early reperfusion contributes to postischemic dysfunction in vitro; however, the importance of this mechanism in vivo remains to be defined. Third, inadequate release of calcium by the sarcoplasmic reticulum, with consequent excitation-contraction uncoupling, may occur after multiple brief episodes of regional ischemia, but its role in other forms of postischemic dysfunction has not been explored. It is probable that multiple mechanisms contribute to the pathogenesis of myocardial stunning. The three hypotheses outlined above are not mutually exclusive and in fact may represent different steps of the same pathophysiological cascade. Thus, generation of oxyradicals may cause sarcoplasmic reticulum dysfunction, and both of these processes may lead to calcium overload, which in turn could exacerbate the damage initiated by oxygen species. The concepts discussed in this review should provide not only a conceptual framework for further investigation of the pathophysiology of reversible ischemia-reperfusion injury but also a rationale for developing clinically applicable interventions designed to prevent postischemic ventricular dysfunction.
Enhanced BBB permeability of osmotically active poly(mannitol-co-PEI) modified with rabies virus glycoprotein via selective stimulation of caveolar endocytosis for RNAi therapeutics in Alzheimer's disease
Authors: Tae-Eun Park, Bijay Singh, Huishan Li, Jun-Yeong Lee, Sang-Kee Kang, Yun-Jaie Choi, Chong-Su Cho
Journal: Biomaterials (2014)
Normal-looking skin in oncohaematological patients after allogenic bone marrow transplantation is not normal
Authors: C. Vassallo, V. Brazzelli, P.E. Alessandrino, M. Varettoni, M. Ardigo, M. Lazzarino, G. Borroni
Journal: British Journal of Dermatology (2004)

Graft-versus-host-disease (GvHD) occurs in one-third or even half of bone marrow transplant (BMT) patients, involving three major target organs: gut, liver and skin.The histopathological and immunohistochemical features of normal-looking skin in oncohaematological patients on day 100 after BMT were studied to find a possible relationship between the histopathological findings and clinical variables (history or clinical evidence of GvHD, previous therapeutic regimens or infections).Fifty-one Caucasian oncohaematological patients, who had had an allogenic BMT, had a biopsy taken from normal-looking skin in nonsun-exposed areas (buttocks or the lumbar region), around the 100th day after BMT. The histology was studied, and the influence of clinical variables on the development of every different histopathological pattern was evaluated through statistical analysis.Histopathological analysis based on morphological criteria revealed the presence of three different patterns: a postinflammatory pattern (45%), changes similar to grade I and II of GvHD (31%) and no significant changes (24%). Statistical analysis revealed that only the presence of peaks of cytomegalovirus (CMV) antigen in the blood within 100 days from BMT was significantly associated with the pattern of GvHD-like changes.Normal-looking skin in 76% of BMT patients is not necessarily histologically normal. The pattern with more prominent changes, the GvHD-like pattern, has been found to be associated with a more frequent history of CMV antigen in the blood within 100 days from BMT.
Influence of Pulmonary Capillary Wedge Pressure on Central Apnea in Heart Failure
Authors: Peter Solin, Peter Bergin, Meroula Richardson, David M. Kaye, E. Haydn Walters, Matthew T. Naughton
Journal: Circulation (1999)

Background —Recent studies suggest that acute pulmonary congestion induces hyperventilation and that hyperventilation-related hypocapnia leads to ventilatory control instability and central sleep apnea. Whether chronic pulmonary congestion due to congestive heart failure (CHF) is associated with central apnea is unknown. We hypothesized that CHF patients with central apnea would have greater pulmonary capillary wedge pressure (PCWP) than patients without central apnea and that PCWP would correlate with central apnea severity. Methods and Results —Seventy-five stable CHF patients underwent right heart catheterization and, on the basis of overnight sleep studies, were divided into central apnea (n=33), obstructive apnea (n=20), or nonapnea groups (apnea-hypopnea index [AHI] &lt;5 events per hour). Mean PCWP was significantly greater in the central than in the obstructive and nonapnea groups (mean±SEM [range]: 22.8±1.2 [11 to 38] versus 12.3±1.2 [4 to 21] versus 11.5±1.5 [3 to 28] mm Hg, respectively; P &lt;0.001). Within the central apnea group, PCWP correlated with the frequency and severity of central apnea (AHI: r =0.47, P =0.006) and degree of hypocapnia (Pa co 2 : r =−0.42, P =0.017). Intensive medical therapy in 7 patients with initially high PCWP and central apneas reduced both PCWP (29.0±2.6 [20 to 38] to 22.0±1.8 [17 to 27] mm Hg; P &lt;0.001) and central apnea frequency (AHI) (38.5±7.7 [7 to 62] to 18.5±5.3 [1 to 31] events per hour; P =0.005). Conclusions —PCWP is elevated in CHF patients with central apneas compared with those with obstructive apnea or without apnea. Moreover, a highly significant relationship exists between PCWP, hypocapnia, and central apnea frequency and severity.