tbuckley/cabot-search huggingface dataset:
Subcutaneous Rheumatoid Nodules and Serum Rheumatoid Factor Without Arthritis
Authors: Ali Askari, Roland W. Moskowitz, Victor M. Goldberg
Journal: JAMA (1974)

SUBCUTANEOUS rheumatoid nodules and serum rheumatoid factor are diagnostic criteria of definite or classic rheumatoid arthritis. They are generally associated with chronic deforming arthritis and severe systemic manifestations of rheumatoid disease. The titer of rheumatoid factor usually parallels disease severity. This study describes a patient with multiple large subcutaneous rheumatoid nodules and high-titer serum rheumatoid factor without arthritis. <h3>Report of a Case</h3> A 56-year-old white man was admitted to University Hospitals of Cleveland on May 25, 1973, with the complaint of lumps in the area of both elbows for five years. These growths first appeared on the left and later on the right elbow as pea-sized growths. The swellings were painless and did not ulcerate or interfere with elbow function. The nodules grew larger and coalesced during the subsequent five years. Medical history disclosed an attack of polyarthralgias without actual swelling 12 years prior to hospital admission. Symptoms were completely
Non-HDL Cholesterol
Authors: Stanley H. Hsia
Journal: Diabetes Care (2003)

The elevated coronary heart disease (CHD) risk affecting patients with type 2 diabetes may be attributed to a combined dyslipidemia characterized by elevated triglycerides, reduced HDL cholesterol, small dense LDL particles (independent of the LDL cholesterol level), elevated triglyceride-rich remnant lipoproteins (TGRLs), and/or elevated apolipoprotein B (apoB) levels (1). All of these features have individually been implicated as contributors to CHD. Some reports suggest that the combined dyslipidemia may confer a higher magnitude of risk than elevated LDL cholesterol alone (2).

The role of triglycerides as a risk factor has been controversial. Much of its risk may be attributed to the associated low HDL cholesterol level, along with contributions from all of the other related variables. Although triglycerides do appear to be an independent risk factor (3), they likely act only as a marker for these associated features. The measurement of apoB has been advocated as an alternative index (4). Since each LDL particle contains a single apoB molecule, the apoB level reflects particle number, thus not only accounting for both remnant and LDL particles but also the density of particles when expressed in relation to particle cholesterol content. Despite these advantages, even the global standardization of apoB assays (5) has not made it routinely available to the clinician. This may be in part due to a general unfamiliarity with its interpretation outside of the research setting and because existing guidelines do not take advantage of the information it imparts. Its cost relative to its potential advantages for clinical decision-making also has not been adequately explored.

Existing guidelines, however, do take advantage of non–HDL cholesterol as an index of risk associated with this combined dyslipidemia. The recognition of this index is not new; this “beta” lipoprotein cholesterol fraction has been associated with increased CHD mortality in population-based studies that …
The inverse care law has had its day
Authors: Des Spence
Journal: BMJ (2007)

Half way through my sixth year at school I received an unconditional acceptance from university. My last few months were spent playing cards, dodging class, sharing cigarettes in the toilets, and attempting to blow up the chemistry equipment. A better preparation for university I could not have had. It was preferable to the current fad of sending our children on a gap year to naively smoke cannabis on a beach in countries that impose a life sentence for listening to Janis Joplin.

I did learn one thing in those last six months: the inverse square law. This relates …
The Eye and Its Function
Authors: John H. Dunnington
Journal: JAMA (1961)

As one might anticipate, emphasis is placed in this text upon the visual physiology of the eye. After an excellent summary of its embryology and a brief discussion of its nutrition and metabolism, the rest of the book is devoted to monocular and binocular aspects of visual function. The chapter on visual pigments includes a discussion of spectrophotometric investigation and the derivation of some formulae used in these studies. Other chapters deal with the visual pathways, the effects of retinal stimulation, and the function and innervation of intraocular muscles. A description of the extraocular muscles follows. Here, the supranuclear functions and the problems of binocular vision are discussed. The text closes with short chapters about the ocular adnexa and about the effect of some drugs upon the eye. The section on anatomy and ocular metabolism is too brief to serve as anything but background material for the discussion of the
LECTURES ON INTRACRANIAL SURGERY.II—CEREBRAL HEMORRHAGE AND ITS SURGICAL TREATMENT.
Authors: EMORY LANPHEAR
Journal: JAMA (1895)

By the expression "cerebral hemorrhage," is meant bleeding in the substance of the brain or into the cavity of the ventricles. Until very recently such cases have been regarded as beyond the pale of surgical interference. Indeed, only a few years ago Jacobson declared he could find but ten cases recorded as having beeen operated upon, and even Horsley—one of the boldest of cerebral operators— as late as July, 1890, advised tying the common carotid in every case of bad cerebral hemorrhage seen within four hours after the attack. But recently quite a number of operations have been reported with improvement in most cases, and surgeons are beginning to realize the brilliant possibilities of certain classes of hemorrhages, viz., cortical or surface hemorrhages, subcortical and ingravescent or progressive apoplexy. Most authorities have, until lately, advised against operation for the reason (as expressed by Starr, of New York) that "when a
Abstract B35: The expression of four genes as a prognostic classifier for stage I lung adenocarcinoma in 12 independent cohorts.
Authors: Hirokazu Okayama, Aaron J. Schetter, Teruhide Ishigame, Ana I. Robles, Takashi Kohno, Jun Yokota, Seiichi Takenoshita, Curtis C. Harris
Journal: Clinical Cancer Research (2014)

Abstract We previously developed and validated a prognostic classifier using the mRNA expression levels of BRCA1, HIF1A, DLC1, and XPO1. This 4-gene classifier aimed to identify stage I lung adenocarcinoma patients with a high risk of relapse. Our initial study evaluated patients in five independent cohorts from various regions of the world, suggesting that the 4-gene classifier was robust and representative of most lung adenocarcinomas. In an attempt to further validate this classifier, we have used a meta-analysis based approach to study 12 cohorts consisting of 1069 TNM stage I lung adenocarcinoma patients. These cohorts were obtained through a systematic search of public gene expression datasets and all suitable datasets were analyzed. Kaplan-Meier analysis of each cohort showed that the classifier was significantly associated with prognosis in ten of the twelve cohorts (p&amp;lt;0.05). The association was highly consistent across all cohorts regardless of the ethnic diversity or microarray platform and there was no evidence of heterogeneity across all cohorts (I2 = 0.0%, p=0.98). The pooled estimate demonstrated that patients classified as high risk had worse overall survival for all stage I (Hazard Ratio [HR], 2.66; 95% Confidence Interval [CI], 1.93-3.67; P&amp;lt;0.0001) patients and in stratified analyses of stage IA (HR, 2.69; 95%CI, 1.66-4.35; P&amp;lt;0.0001) and stage IB (HR, 2.69; 95%CI, 1.74-4.16; P&amp;lt;0.0001) patients. These results suggest that the 4-gene classifier provides independent prognostic stratification of stage IA and stage IB patients beyond conventional clinical factors and may assist clinicians in decisions regarding postoperative management of early stage patients. Citation Format: Hirokazu Okayama, Aaron J. Schetter, Teruhide Ishigame, Ana I. Robles, Takashi Kohno, Jun Yokota, Seiichi Takenoshita, Curtis C. Harris. The expression of four genes as a prognostic classifier for stage I lung adenocarcinoma in 12 independent cohorts. [abstract]. In: Proceedings of the AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer; 2014 Jan 6-9; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2014;20(2Suppl):Abstract nr B35.
To Scope or Not to Scope
Authors: Harold O. Conn
Journal: New England Journal of Medicine (1981)

IN this issue of the Journal, Peterson and his colleagues attempt to come to grips with a fierce controversy about the role of emergency endoscopy in patients with acute hemorrhage of the upper gastrointestinal tract (UGIT). Why is there such a gulf between those who defend to the death the value of emergency endoscopy and those who triumphantly fail to find any beneficial effects? The controversy began in the 1960s when Palmer demonstrated that early endoscopy could establish the site of bleeding in most of such patients. He was convinced that the "vigorous diagnostic approach" improved therapy, and recommended . . .
Where Do Residency Graduates Start Medical Practice?
Authors: Mark Steinberg
Journal: JAMA (1997)

To the Editor.  —I read with interest the article by Ms Miller and colleagues 1 on employment status of physicians after completion of residency training. I noted that no mention was made of physicians in industry. Many physicians are employed in pharmaceuticals, biotechnology, medical informatics, and medical journalism, for example. Considering that the survey was intended to aid students in making career decisions and to provide insight into the changing market for professional opportunities for physicians, the almost exclusive concentration on traditional clinical practice was disappointing.  Certainly, most physicians completing training will want to enter clinical practice. However, an increasing number may want to consider other fields in which their medical knowledge and desire to improve patient care will nonetheless be appreciated.
The impact of ethnicity on the natural history of autoimmune hepatitis
Authors: Sumita Verma, Michael Torbenson, Paul J. Thuluvath
Journal: Hepatology (2007)

The impact of ethnicity on the natural history of autoimmune hepatitis (AIH) has not been well characterized. The aim of this study was to assess the natural history of AIH in blacks in comparison with others (nonblacks). This was a 10-year (June 1996 to June 2006) retrospective analysis of patients with AIH from a single tertiary care center. The diagnosis of AIH was defined by the criteria established by the International Autoimmune Hepatitis Club. A poor outcome was defined as liver failure at presentation, failure to achieve remission, need for liver transplantation, and/or death. One hundred one patients with AIH were eligible for the study. Black patients were more likely to have cirrhosis (56.7% versus 37.5%, P = 0.061), have liver failure at the initial presentation (37.8% versus 9.3%, P = 0.001), and be referred for liver transplantation (51.3% versus 23.4%, P = 0.004). The overall mortality was also significantly higher in black patients (24.3% versus 6.2%, P = 0.009). Compared with nonblacks, blacks had more advanced hepatic fibrosis (3.6 ± 2.7 versus 2.1 ± 2.4, P = 0.013). A Kaplan-Meier analysis showed that the probability of developing a poor outcome was significantly higher in blacks ( P = 0.003). Independent predictors of poor outcome were black ethnicity, the presence of cirrhosis, and the fibrosis stage at presentation. Black males were the group most likely to have a poor outcome (85.7%). Conclusion: Blacks, especially black men with AIH, have more aggressive disease at the initial presentation, are less likely to respond to conventional immunosuppression, and have a worse outcome than nonblacks. (Hepatology 2007.)
Assessment in vitro of immunity against Toxoplasma gondii.
Authors: T C Jones, L Len, J G Hirsch
Journal: The Journal of Experimental Medicine (1975)

Studies have been made on humoral and cellular immune respones in mice immunized with an attenuated strain of Toxoplasma gondii. Heat-inactivated antitoxoplasma serum did not cause morphologic changes in the organisms, but did markedly influence their interactions with host cells. Toxoplasma exposed to antibody were no longer capable of entering fibroblasts or HeLa cells. They were readily engulfed by macrophages, but the antibody treatment strikingly altered the intracellular fate of the parasites leading to killing and digestion of the toxoplasmas in phagolysosomes. Addition of antitoxoplasma antibody immediately after infection of macrophages in vitro had no effect on intracellular multiplication of the organism. The division time of virulent toxoplasmas in mouse peritoneal macrophages in vitro was markedly prolonged in cells from immunized mice. During the first 2-3 mo after immunization, the macrophages harvested from the peritoneal cavity demonstrated this cellular immunity directly; thereafter exposure of the macrophages to immune lymphocytes and toxoplasma antigen, or to supernates from such an interaction was required for induction of the maximal capacity to inhibit growth of toxoplasmas. Induction of the alternation in macrophages by the lymphocyte product was detectable in 6 h and maximal at 18-24 h. Cultivation in vitro of macrophages from immunized animals for periods longer than 48 h rendered the cells nonresponsive to the immune lymphocyte-toxoplasma product. Macrophages from the peritoneal cavities of normal, nonimmunized mice were also incapable of developing the capacity to inhibit growth of toxoplasmas in response to this product. The nonresponsiveness of normal macrophages, or of macrophages cultured for several days in vitro was not changed by exposure of the cells to antitoxoplasma serum.
TREATMENT OF CHILDREN WITH PERENNIAL RHINITIS WITH BROMPHENIRAMINEMALEATE AND PHENYLPROPANOLAMINEHYDROCHLORIDE (LUNERIN MITE®)
Authors: N.‐L. MAX KJELLMAN
Journal: Allergy (1974)

The effect of a combined pediatric preparation of brompheniramine maleate and phenylpropanolaminehydrochloride (Lunerin mite) was studied in 17 children (aged 4-14 years) with allergic rhinitis. A double-blind cross-over technique was used, and a score system was used for evaluation of symptoms and signs. The results show that the drug had a good effect with statistical differences on the 1 per cent level between the active preparation and the placebo. The effect was less pronounced in children aged more than 10 years, for whom a higher dose of the drug is recommended. The frequency of side-effects was negligible.
181 CLINICAL SIGNIFICANCE OF THE WORSENING IN PORTAL HYPERTENSION DURING LONG-TERM DRUG TREATMENT IN CIRRHOTIC PATIENTS WHO WERE GOOD-RESPONDERS AT SHORT TERM
Authors: L. Cavasin, M. Bolognesi, P. Amodio, I.M. Casarotto, A. Gatta, C. Merkel
Journal: Journal of Hepatology (2009)
Working together to rebuild health care in post-conflict Somaliland
Authors: Andrew Leather, Edna Adan Ismail, Roda Ali, Yasin Arab Abdi, Mohamed Hussein Abby, Suleiman Ahmed Gulaid, Said Ahmed Walhad, Suleiman Guleid, Ian Maxwell Ervine, Malcolm Lowe-Lauri, Michael Parker, Sarah Adams, Marieke Datema, Eldryd Parry
Journal: The Lancet (2006)
Pneumococcal vaccine campaign based in general practice
Authors: P. McDonald, E H I Friedman, A Banks, R. Anderson, V. Carman
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b>To show whether a general practice setting is a practical and effective medium for increasing uptake of pneumococcal vaccine. <b>Design:</b>Follow up study of responses of general practices (debriefing by questionnaire or small group session) and patients (questionnaire sent to 429 patients vaccinated in a two week period) to vaccination campaign. <b>Setting and subjects:</b>Patients registered with general practices of one family health services authority. <b>Interventions:</b>Pneumococcal vaccination campaign including clinical guidelines and support materials. <b>Main outcome measures:</b>Proportion of general practitioners offering pneumococcal vaccine; proportion of patients at risk who were vaccinated between 1 May and 31 December 1995; number of splenectomised patients identified and vaccinated in same period; views of patients who were vaccinated. <b>Results:</b>Proportion of general practitioners offering pneumococcal vaccine increased from 17% to 89% during the campaign. Estimated number of patients at risk who were vaccinated increased from 656 (4%) to 5982 (33%) during campaign. Of 61 splenectomised patients identified, 30 had been vaccinated previously and 27 were vaccinated during campaign. Practices in which a general practitioner took or shared the lead had higher vaccination rates and used vaccine up faster. Of the 384 patients whose questionnaires were used in analysis, only 35 had heard of pneumococcal vaccine before the campaign, 198 reported side effects (mostly minor and local, but systemic and severe local reactions were more common than expected), and 337 were pleased they had been vaccinated (only five expressed dissatisfaction). <b>Conclusion:</b>A practice based campaign is an effective method of increasing uptake of pneumococcal vaccine by high risk groups. <h3>Key messages</h3> Pneumococcal infections are an important cause of preventable morbidity and mortality We set up a pneumococcal vaccination campaign based in the 37 general practices of Tameside family health services authority The proportion of patients thought to be at risk who were vaccinated increased ninefold after the campaign started Patients9 prior awareness of the vaccine was low, and publicity was needed Side effects from the vaccine were commonly reported, but most were minor and were well tolerated This is an appropriate and effective method of increasing vaccine coverage among people at risk of pneumococcal infection
Alveolar echinococcosis of the liver: percutaneous stent therapy in Budd-Chiari syndrome.
Authors: J Vogel, J Gorich, E Kramme, E Merkle, R Sokiranski, P Kern, H J Brambs
Journal: Gut (1996)

BACKGROUND AND AIMS: Infiltration of the hepatic veins in the alveolar echinococcosis can lead to the development of the Budd-Chiari syndrome. The medical and surgical treatment of this condition is generally unsatisfactory. The results of successful interventional treatment with percutaneous stent implantation in the hepatic veins are reported. METHODS: Using a transjugular approach, metal mesh stents (Boston Scientific, Medi-Tech Accuflex 8/60 mm) were placed in the median and left hepatic veins of a 53 year old woman. After the intervention, oral chemotherapy with albendazole (2 x 400 mg/day) was continued, but no anticoagulants were given. RESULTS: Stent placement was performed without complications. The clinical picture improved rapidly: normalisation of portal blood flow was confirmed by Doppler ultrasound and there was improvement of liver function, reduction of oesophageal varices, and disappearance of ascites. A follow-up examination at 15 months showed no evidence of stent occlusion. CONCLUSIONS: Treatment of portal hypertension in alveolar echinococcosis of the liver is problematic. In selected patients with portal hypertension secondary to hepatic vein stenoses but no cirrhosis, percutaneous stent placement in the hepatic veins represents a promising treatment alternative.
"Clean catch" urines in the newborn--bacteriology and cell excretion patterns in first week of life.
Authors: G Cruickshank, E Edmond
Journal: BMJ (1967)

IBorxsH 705 (Pryles et al., 1959), though it was thought to be 7% in one series (Virtanen et al., 1962).The method of catheterization which we have used has been widely and successfully employed in the catheterization of paraplegic patients, in whom the risk of infection is very high (McLeod et al., 1963).Though catheterization of the urinary bladder is undesirable for other reasons as well as the possible risk of infection, there are instances where it is indicated.One of these would be con- tinuing doubt about the diagnosis of urinary tract infection in children after the examination of non-catheter specimens.The method described here seems to be a safe and practical one. SummaryNon-catheter (bag or midstream specimen) and catheter specimens of urine from 68 children suspected to be suffering from infection of the renal tract have been compared.Accept- ing the catheter specimen predominantly as the indicator of urinary tract infection, it was concluded that 32 children (47%) were suffering from pyelonephritis.With the use of certain specified diagnostic criteria on single non-catheter specimens of urine 25 (780%) of the infected cases were diagnosed positively.In the 68 cases there were only five (7%) false-positives among the non-catheter specimens, suggest-ing that the criteria used reduce significantly the high incidence of false-positive results which tends to occur with random non- catheter specimens.Means by which false-negative results can be avoided include a " re-examination " standard and consideration of urinary pH.A method of bladder catheterization in children with the use of a Polybactrin technique appears to be safe and can be used in cases where diagnoses cannot be readily established from non-catheter specimens.J. W. M. wishes to thank the Royal Society for a grant for expenses, the M.R.C.
Acute erythroid leukemia: a reassessment using criteria refined in the 2008 WHO classification
Authors: Robert P. Hasserjian, Zhuang Zuo, Christine Garcia, Guilin Tang, Armen Kasyan, Rajyalakshmi Luthra, Lynne V. Abruzzo, Hagop M. Kantarjian, L. Jeffrey Medeiros, Sa A. Wang
Journal: Blood (2009)
Vasodilator Therapy of Cardiac Failure
Authors: Jay N. Cohn, Joseph A. Franciosa
Journal: New England Journal of Medicine (1977)

THE symptoms of cardiac failure are related to some combination of circulatory congestion (often referred to as "backward failure") and low cardiac output ("forward failure"). In simple pump-function terms these symptoms indicate that the heart is performing on a depressed Frank-Starling curve relating stroke volume (or cardiac output or stroke work) to ventricular diastolic filling (pressure or volume) (Fig. 1).Therapy for cardiac failure has traditionally involved the administration of an inotropic drug to increase the contractile force of the heart and the administration of a diuretic to increase the renal excretion of salt and water. Effective inotropic therapy with . . .
Virus and the Heart
Authors: WALTER H. ABELMANN
Journal: Circulation (1971)

Viral infections may overload the heart by altering pulmonary or systemic vascular resistance, may induce congenital malformations, or may invade the mature heart muscle and provoke acute and possibly chronic myocarditis. The nature of the association of myocarditis with known viral infections and the pathophysiologic effects of myocardial involvement are analyzed. Although viral myocarditis of clinical significance is relatively rare, recent advances in diagnosis and therapy warrant greater dissemination and application of existing knowlelge as well as further clinical investigation.
Increased mortality in COPD among construction workers exposed to inorganic dust
Authors: D.M. Bernstein
Journal: European Respiratory Journal (2004)

To the Editor: 

I read with interest the recent publication by Bergdahl etal. 1 on the increased mortality in chronic obstructive pulmonary disease (COPD) among construction workers exposed to inorganic dust. Within this publication, the authors stated that their “results corroborate those from previous studies, indicating an increased risk for COPD among workers exposed to dust, such as asbestos, man-made mineral fibres, mineral dust and concrete dust”.

The basis cited by Bergdahl et al. 1 for including fibre glass in the previous statement appears to be the article by Sixt et al. 2. The authors citing this article state that “increased elastic recoil pressure among workers exposed to man-made mineral fibres has …