tbuckley/cabot-search huggingface dataset:
A New, Simple IPPB Device for Hospital and Home Use
Authors: Thomas L. Petty
Journal: JAMA (1968)

The use of nebulized drugs and moisture by inhalation is well established in the management of patients with chronic airway obstruction.<sup>1-3</sup>Inhalation therapy promotes bronchial hygiene. In principle, bronchial hygiene involves the inhalation of bronchodilator followed by the inhalation of moisture and in turn followed by the performance of expulsive coughing maneuvers or postural drainage to clear the lungs of retained secretions.<sup>3</sup>Patients with severe airway obstruction and respiratory insufficiency are often limited in their ability to inhale nebulized bronchodilators because of their ventilatory impairment.<sup>1</sup>These individuals need a device to perform the work of breathing during nebulization therapy. In addition, pressure breathing may be effective in relieving the work of breathing during intense dyspnea and thus allow for more rapid recovery from breathlessness than during spontaneous breathing. In the treatment of acute episodes of spasmodic bronchostenosis, intermittent positive pressure breathing (IPPB) therapy has been effective using
Distribution and kinetics of superantigen-induced cytokine gene expression in mouse spleen.
Authors: M Bette, M K Schäfer, N van Rooijen, E Weihe, B Fleischer
Journal: The Journal of Experimental Medicine (1993)

The polyclonal stimulation of T cells by bacterial superantigens is involved in the pathogenesis of the toxic shock syndrome in certain staphylococcal and streptococcal infections. Here we describe the onset and kinetics of superantigen-induced cytokine production in situ in spleens of normal BALB/c mice monitored at the level of cytokine mRNA expression by in situ hybridization. Messenger RNAs for interleukin 2 (IL-2), interferon gamma, and tumor necrosis factors (TNF) alpha and beta were not expressed at detectable levels in spleens of unstimulated animals but became visible already 30 min after intraperitoneal application of 50 micrograms staphylococcal enterotoxin B. All mRNA levels showed peak expression approximately 3 h after injection and a slow decrease up to 24 h after injection. Expression of the mRNAs was restricted to the T cell-dependent area of the periarteriolar lymphatic sheets of the spleen. Interestingly, TNF-alpha mRNA showed a biphasic response, the early appearing mRNA had the same localization as the other mRNAs, whereas after 3 h TNF-alpha mRNA showed a broader distribution indicating a second cell population producing TNF-alpha. The expression of IL-2 and TNF proteins in the serum increased in parallel to the observed mRNA changes with a slight delay. The presence of macrophages was not required for the expression of the cytokine mRNAs in the spleen as the expression was unchanged in macrophage-depleted mice. Only the second phase of TNF-alpha mRNA expression was abrogated in such animals. The expression of all mRNAs was completely suppressed by prior administration of cyclosporin A. These data show that nonphagocytic cells are the essential superantigen-presenting cells in vivo and indicate that at least part of the pathogenetic TNF-alpha is T cell derived.
Response: Arguments contradict the "foreign protein-zidovudine" hypothesis
Authors: C. A Sabin, A. N Phillips, C. A Lee
Journal: BMJ (1996)

indefinitely such as zidovudine.With a daily dose of 500 mg zidovudine a person receives 2x 1020 mol- ecules, or 2 x 106 for every human cell, every day for the rest of his life.By contrast, after 11 years of research the HIV hypothesis has yet to identify a single molecule that could be pathogenic.'3In view ofthis and the complete failure of the HIV hypothesis to produce public health benefits, non-HIV hypotheses must be studied more carefully.
Management of Gestational Diabetes Mellitus
Authors: Donald R. Coustan
Journal: JAMA (1996)

The clinical significance of gestational diabetes mellitus, or carbohydrate intolerance with onset or first diagnosis during pregnancy, is a subject of debate.<sup>1,2</sup>The concept of gestational diabetes mellitus was popularized before considerations of "evidence-based medicine" came on the scene. Like many other conditions, gestational diabetes mellitus became a clinical entity without the carefully collected epidemiologic data we now require. Nevertheless, the majority of obstetricians in the United States screen their pregnant patients for this condition.<sup>3</sup>There is a large body of evidence to support the contention that marked maternal hyperglycemia in the range found in patients with preexisting diabetes mellitus can have an adverse impact on fetal growth, development, and well-being. The mechanism appears to be fetal hyperinsulinemia evoked by hyperglycemia. The following questions need to be resolved: (1) How severe must maternal hyperglycemia be to measurably worsen pregnancy outcome? (2) Can we intervene to prevent adverse outcomes?
Ban on Amphetamines and Barbiturates
Authors: G. Scott
Journal: BMJ (1970)

MEBURNSHenjoy.I agree with Dr. Wells that transfer- ring the patient from barbiturates to nitra- zepam is usually easily achieved.If the patient is taking much in excess of twice the hypnotic dose of barbiturates I would suggest that substitution be carried out in hospital, as the withdrawal illness can be so dangerous.I think we need to learn far more about the reasons for so many people being dependent on hypnotics.Finally, many of the barbiturate addicts need skilled followup often with long-term psychotherapy.-Iam, etc.,
Continuation Pharmacotherapy in the Prevention of Relapse Following Electroconvulsive Therapy
Authors: Harold A. Sackeim, Roger F. Haskett, Benoit H. Mulsant, Michael E. Thase, J. John Mann, Helen M. Pettinati, Robert M. Greenberg, Raymond R. Crowe, Thomas B. Cooper, Joan Prudic
Journal: JAMA (2001)

ContextElectroconvulsive therapy (ECT) is highly effective for treatment of major depression, but naturalistic studies show a high rate of relapse after discontinuation of ECT.ObjectiveTo determine the efficacy of continuation pharmacotherapy with nortriptyline hydrochloride or combination nortriptyline and lithium carbonate in preventing post-ECT relapse.DesignRandomized, double-blind, placebo-controlled trial conducted from 1993 to 1998, stratified by medication resistance or presence of psychotic depression in the index episode.SettingTwo university-based hospitals and 1 private psychiatric hospital.PatientsOf 290 patients with unipolar major depression recruited through clinical referral who completed an open ECT treatment phase, 159 patients met remitter criteria; 84 remitting patients were eligible and agreed to participate in the continuation study.InterventionsPatients were randomly assigned to receive continuation treatment for 24 weeks with placebo (n = 29), nortriptyline (target steady-state level, 75-125 ng/mL) (n = 27), or combination nortriptyline and lithium (target steady-state level, 0.5-0.9 mEq/L) (n = 28).Main Outcome MeasureRelapse of major depressive episode, compared among the 3 continuation groups.ResultsNortriptyline-lithium combination therapy had a marked advantage in time to relapse, superior to both placebo and nortriptyline alone. Over the 24-week trial, the relapse rate for placebo was 84% (95% confidence interval [CI], 70%-99%); for nortriptyline, 60% (95% CI, 41%-79%); and for nortriptyline-lithium, 39% (95% CI, 19%-59%). All but 1 instance of relapse with nortriptyline-lithium occurred within 5 weeks of ECT termination, while relapse continued throughout treatment with placebo or nortriptyline alone. Medication-resistant patients, female patients, and those with more severe depressive symptoms following ECT had more rapid relapse.ConclusionsOur study indicates that without active treatment, virtually all remitted patients relapse within 6 months of stopping ECT. Monotherapy with nortriptyline has limited efficacy. The combination of nortriptyline and lithium is more effective, but the relapse rate is still high, particularly during the first month of continuation therapy.
Germinomas and teratoid siphon anomalies in softshell clams, Mya arenaria, environmentally exposed to herbicides.
Authors: G R Gardner, P P Yevich, J Hurst, P Thayer, S Benyi, J C Harshbarger, R J Pruell
Journal: Environmental Health Perspectives (1991)

Seminomas and dysgerminomas are epizootic in softshell clams, Mya arenaria, from three Maine estuaries contaminated with herbicides. The first epizootic was discovered in 22% of clams collected as Searsport near Long Cove Brook and three culverts that conveyed heating oil and jet fuel spilled from a tank farm in 1971. Data from subsequent epizootiological studies and a series of long-term experimental exposures of softshell clams to no. 2 fuel oil, JP-4, and JP-5 jet fuel at the U.S. EPA, Environmental Research Laboratory in Narragansett, Rhode Island, and in the field did not support an etiology by these petroleum products. In the two recent epizootics reported here, the germinomas have been observed in 3% of the softshell clams collected from Roque Bluffs near Machiasport and from 35% of softshell clams collected from Dennysville. Mya collected at Dennysville had pericardial mesotheliomas and teratoid siphon anomalies in addition to gonadal neoplasms. Estuaries at Dennysville had been contaminated by herbicides in a 1979 accidental spray overdrift during aerial application of Tordon 101 to adjacent forests. Further investigation determined widespread use of the herbicides Tordon 101, 2,4-D,2,4,5-T, and other agrochemicals in an extensive forestry and blueberry industry in both the Roque Bluffs and the Dennysville areas. Herbicide applications at Searsport were confirmed for railroad property bordering Long Cove estuary and for Long Cove Brook adjacent to the estuary where a highway department reportedly cleans its spray equipment. Herbicide contamination is the only common denominator identified at all three sites where Mya have been found with gonadal neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS)
Remarks of Dr. Egan at Detroit Conference.
Authors: J. A. Egan
Journal: JAMA (1898)

Springfield, ILL., Aug. 19, 1898.  To the Editor:  —As my reply to the question asked at the recent Conference of States and Provincial Boards of Health at Detroit, relative to the principal line of work of the Illinois State Board of Health, is incorrectly reported in theJournalof the 20th inst., I will ask you to kindly print my remarks in full, a copy of which accompanies this. Very truly yours,  Dr. J. A. Egan—I regret to state that the principal line of work of the Illinois State Board of Health is in connection with the enforcement of the Medical Practice Act, the duties pertaining to which have so increased during the past few years that the Board has really become one of registration and examination. It is earnestly hoped that before this Conference again meets the law will be so changed that the Board will have an
775-5 Increased Incidence of Chlamydia Bacteria Detected within Coronary Arteries of Patients with Atherosclerotic Versus Transplant Induced Coronary Artery Disease
Authors: Joseph B. Muhlestein, Elizabeth H. Hammond, John F. Carlquist, Ellen Radicke, Matthew J. Thomson, Daniel J. Parker, Labros A. Karagounis, Jeffrey L. Anderson
Journal: Journal of the American College of Cardiology (1995)
Oxford Textbook of Surgery
Authors: R W Talbot
Journal: BMJ (1995)

Ed Peter J Morris, Ronald A Malt Oxford University Press, pounds sterling125, pp 2764 + index ISBN 0 19 261800 8

Even after every mountain in the world has been climbed and all the seas navigated, people will find innovative approaches to old challenges. Production of the Oxford Textbook of Surgery, in two heavy and unwieldy volumes, must rank among such endeavours. The final chapter, entitled “How to select a surgical trainee,” is somewhat out of place in a surgical textbook, but it lists the 12 criteria identified by occupational psychologists for a surgeon in general. These include communication skills, a broad and balanced perspective, and tolerance of …
A Study of Hypotension (Shock) Produced by Meningococcus Toxin
Authors: RICHARD V. EBERT, CRAIG W. BORDEN, WENDELL H. HALL, DAVID GOLD
Journal: Circulation Research (1955)

Hemodynamic alterations were produced in dogs by injecting meningococcus toxin. Hypotension and a decrease in cardiac output occurred without significant reduction in blood volume. These changes were accentuated by small hemorrhage. Increasing the blood volume above normal led to marked increase in cardiac output with slight increase in arterial pressure. The arterial pressure was markedly increased by the administration of levarterenol but large doses were required. Cortisone did not modify the effect of meningococcus toxin on the circulation. Meningococcus toxin apparently produced its effect by increasing the volume of blood in small blood vessels.
Intratumoral Adenovirus-Mediated Suicide Gene Transfer for Hepatic Metastases from Colorectal Adenocarcinoma: Results of a Phase I Clinical Trial
Authors: Max W. Sung, Hsu-Chong Yeh, Swan N. Thung, Myron E. Schwartz, John P. Mandeli, Shu-Hsia Chen, Savio L.C. Woo
Journal: Molecular Therapy (2001)

Animal studies have shown that direct injection of an adenoviral vector (Adv.RSV-tk) expressing the herpes thymidine kinase gene into established tumors in the liver, followed by systemic ganciclovir administration, was effective in inducing tumor necrosis. Toxicities were minimal at therapeutically effective vector doses, although severe hepatic necroinflammation was seen at much higher supratherapeutic doses. We conducted a clinical phase I trial in patients with metastatic colorectal adenocarcinoma in the liver to assess the safety of intratumoral Adv.RSV-tk injection (escalating doses) followed by intravenous ganciclovir (fixed dose). The vector was injected into a metastatic tumor in the liver under local anesthesia by percutaneous needle placement with concurrent ultrasonographic monitoring to prevent injection or leakage into adjacent normal liver structures. We treated 16 patients in five dose level cohorts of Adv.RSV-tk, from 1.0×1010 to 1.0×1013 virus particles per patient. Hepatic toxicities were low, with transient grade 1 elevations in serum aminotransferase levels in 3 of 16 patients. Other toxicities were also transient: grade 2–3 fevers in 5 of 16 patients, grade 3 thrombocytopenia in 1 of 16 patients, and grade 2 leucopenia in 3 of 16 patients. These results indicate that Adv.RSV-tk can be safely administered by percutaneous intratumoral injection in patients with hepatic metastases at doses up to 1.0×1013 virus particles per patient, and can provide the basis for future clinical trials involving intratumoral adenoviral vector injection.
Trousseau's syndrome associated with tissue factor produced by pulmonary adenocarcinoma
Authors: T Sato, I Tsujino, D Ikeda, M Ieko, M Nishimura
Journal: Thorax (2006)

The case history is presented of a patient with Trousseau's syndrome in which tissue factor originating from lung cancer appeared responsible for recurrent DVT/PE. This is thought to be the first such case to be reported.
THE CULTIVATION OF MALARIAL PLASMODIA (PLASMODIUM VIVAX AND PLASMODIUM FALCIPARUM) IN VITRO
Authors: C. C. Bass, Foster M. Johns
Journal: The Journal of Experimental Medicine (1912)

The asexual cycle of Plasmodium vivax and Plasmodium falciparum has been cultivated in vitro in human blood. The parasites have been grown also in red blood cells in the presence of Locke's solution, free of calcium chlorid and in the presence of ascitic fluid. The parasites grow within red blood cells and there is no evidence that they can be grown outside of these cells. The parasites are destroyed in a very few minutes in vitro by normal human serum or by all modifications of serum that we have tested. This fact, together with numerous observations of parasites in all stages of growth apparently within red cells, renders untenable the idea of extracorpuscular development. Leucocytes phagocytize and destroy malarial plasmodia growing in vitro only when the parasites escape from their red blood cell capsule or when the latter is perforated or becomes permeable. Successive generations of Plasmodium vivax and Plasmodium falciparum have been cultivated in vitro by removing the leucocytes from the culture and by transplanting to fresh red blood cells and serum at proper intervals. The asexual cycle of Plasmodium vivax and Plasmodium falciparum cultivated in vitro does not differ from the same cycle growing in vivo. The sexual cycle has not been cultivated, though we have obtained some evidence of the possibility of its accomplishment. There can no longer be any doubt that Plasmodium vivax and Plasmodium falciparum are separate and distinct species. When grown in an identical culture medium and under exactly the same conditions they remain distinct. In twenty-nine cultures of æstivo-autumnal parasites many forms and sizes have been observed, so that evidence is supplied of the occurrence of different varieties of ætivo-autumnal malarial plasmodia. The so called tertian ætivo-autumnal variety may be seen at the proper stage in all cultures grown from merozoites. The form and appearance of the same culture of plasmodia may vary greatly under different conditions which are not necessarily destructive to the parasites. Their generation period may vary from thirty hours (ætivo-autumnal) to four days (tertian), as a result of variation in the temperature at which they were cultivated. Sexual parasites grow in the cultures and are more resistant to unfavorable conditions than schizonts, often living several days after the latter die out. Forms suggesting parthenogenesis have been observed.
Metabolic Biotinylation Provides a Unique Platform for the Purification and Targeting of Multiple AAV Vector Serotypes
Authors: Gregory S. Arnold, A. Kate Sasser, Matthew D. Stachler, Jeffrey S. Bartlett
Journal: Molecular Therapy (2006)

The development of rationally designed targeted gene delivery vectors is an important focus for gene therapy. While genetic modification of AAV can produce vectors with modified tropism, incorporation of targeting peptides into the structural context of the AAV virion often results in loss of function or loss of virion integrity. To address this issue, we have developed a targeting system using metabolically biotinylated AAV. We generated serotype 1, 2, 3, 4, and 5 AAV capsids with small peptide insertions that are metabolically biotinylated in packaging cells during vector production by coexpression of the Escherichia coli BirA, biotin ligase, gene. Biotin moieties are exposed on the surface of assembled AAV particles and can interact with avidin. Metabolically biotinylated AAV vectors produced in this manner maintained endogenous titer and tissue tropism, could be purified on monomeric avidin resin, and could be retargeted to cells engineered to express an artificial avidin-biotin receptor. This technology provides not only a single platform for the purification of multiple AAV vector serotypes, but also a means for the development of multiple targeted AAV vectors utilizing a single capsid modification via straightforward avidin-biotin ligand coupling.
Subacute Sclerosing Panencephalitis
Authors: J. T. Jabbour
Journal: JAMA (1969)

<h3>To the Editor:—</h3> The report states that there were three differences from the study by Katz et al. Transmission of an encephalitogenic agent was not possible. Much higher serum measles antibody titers were observed. There were only type B nucleiform inclusions in our patients. These observations have now been extended to four other patients. We would point out that the variation in clinical onset, stages, duration of SSPE, the immune responses in the patients, and the intensity of the measles virus infection in the brain may result in the differences in serum measles antibody titers, the pathological features, and the success or failure to transmit the agent to ferrets or monkeys. Furthermore, differences in antibody titers between laboratories may be due to the techniques employed. A thorough search for other inclusions in two other biopsy specimens from SSPE patients, as well as a review of the previous
The Dueling Obligations of Opioid Stewardship
Authors: William M. Tierney
Journal: Annals of Internal Medicine (2014)

Letters19 August 2014The Dueling Obligations of Opioid StewardshipWilliam M. Tierney, MDWilliam M. Tierney, MDFrom Regenstrief Institute, Indianapolis, Indiana.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5016-7 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Coffin and Banta-Green (1) state, “Long-term opioids for chronic nonmalignant pain may not improve and may in fact worsen functional status.” They reference a Cochrane review (2) that simply says that evidence (specifically controlled trials comparing opioids with placebo or other drugs) is insufficient to comment on the efficacy and safety of opioids for low back pain. Coffin and Banta-Green have extended this statement to include all nonmalignant pain and have used the words “may not” and “may” to imply lack of effect of opioids and possible adverse effects.Association, let alone causation, between opioids and positive ...References1. Coffin P, Banta-Green C. The dueling obligations of opioid stewardship [Editorial]. Ann Intern Med. 2014;160:207. [PMID: 24322334] doi:10.7326/M13-2781 LinkGoogle Scholar2. Chaparro LE, Furlan AD, Deshpande A, Mailis-Gagnon A, Atlas S, Turk DC. Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database Syst Rev. 2013;8:CD004959. [PMID: 23983011] doi:10.1002/14651858.CD004959.pub4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: William M. Tierney, MDAffiliations: From Regenstrief Institute, Indianapolis, Indiana.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0152. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Dueling Obligations of Opioid Stewardship Phillip Coffin and Caleb Banta-Green The Dueling Obligations of Opioid Stewardship Phillip Coffin and Caleb Banta-Green The Dueling Obligations of Opioid Stewardship Phillip Coffin and Caleb Banta-Green Metrics 19 August 2014Volume 161, Issue 4Page: 307KeywordsConflicts of interestDisclosureDrug safetyDrugsLower back painOpioidsSafety ePublished: 19 August 2014 Issue Published: 19 August 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Deregulated expression of cytokine receptor gene, CRLF2, is involved in lymphoid transformation in B-cell precursor acute lymphoblastic leukemia
Authors: Lisa J. Russell, Melania Capasso, Inga Vater, Takashi Akasaka, Olivier A. Bernard, Maria Jose Calasanz, Thiruppavaii Chandrasekaran, Elise Chapiro, Stephan Gesk, Mike Griffiths, David S. Guttery, Claudia Haferlach, Lana Harder, Olaf Heidenreich, Julie Irving, Lyndal Kearney, Florence Nguyen-Khac, Lee Machado, Lynne Minto, Aneela Majid, Anthony V. Moorman, Heather Morrison, Vikki Rand, Jonathan C. Strefford, Claire Schwab, Holger Tönnies, Martin J. S. Dyer, Reiner Siebert, Christine J. Harrison
Journal: Blood (2009)
Surgery in amoebic colitis
Authors: D. Stein, S. Bank
Journal: Gut (1970)

The feasibility of surgery in amoebic colitis is presented by illustrative case histories in two patients. Subtotal colectomy and ileostomy were carried out for fulminating colitis in the one and exteriorization, excision, and subsequent re-anastomosis of a localized perforated area of bowel in the other. It is suggested that the place of surgery in amoebic colitis should be reappraised, particularly with the advent of modern medical and surgical methods now available. The indications for contemplating surgery in abdominal amoebiasis are outlined and a workable approach is presented.