tbuckley/cabot-search huggingface dataset:
Bacteriology of Brain Abscess
Authors: A. M. McFarlan
Journal: BMJ (1943)

This paper reports the bacteriological findings in 48 cases of brain abscess which had been referred to neurosurgical clinics.I am indebted to the surgeons of seven such clinics for sending specimens of pus and for providing data about their patients. Details of the CasesSex and Age.-Of the 48 patients, 36 were male and 12 female.The ages of three were not stated; the ages of the remaining 45 ranged from 5 to 53 years, and the numbers in successive decades were 4, 8, 11, 13, 7, 2.Site of Abscess.-Forty-twopatients had a single abscess, 6 had more than one.The right side of the brain was affected in 27 cases, the left in 19, and both right and left sides in 2. Of the single abscesses 3 were cerebellar, 18 were in the frontal lobe, 5 in the parietal lobe, 15 in the temporal lobe, and 1 in the occipital lobe.In 3 cases abscesses were present in the frontal and parietal lobes, in 1 case in the frontal and temporal lobes, and in 2 cases in the temporal lobe and cerebellum.Probable Source of Infection.-Eardisease was considered to be the source of infection in 18 cases, sinusitis in 7, lung disease in 7, trauma (penetrating injury) in 3. Staphylococcal septicaemia, sub- acute bacterial endocarditis, and puerperal sepsis each provided one case.In 4 cases the source of infection was unknown.Clinical Course.-Theduration of abscess symptoms was known in 47 cases; in 15 it was less than one month at the time of admission, in 22 it was between one and three months, in 6 between four and seven months, and in.4 a year or more.Information about capsule formation was available for 39 cases.In 16 of them encapsulation was.demonstrated histologically.In 7 of these cases and in 18 others a definite tough or firm wall was noted at operation.Clinical observations indicated the absence of a capsule in 3 cases, and histological observations in 2 other cases.Of the 48 patients 20 were discharged from hospital-13 of them classified as " cured " or " recovered," and 7 as " improved."Four were " under treat- ment " at the time of the last report.Twenty-four died in hospital.In 19 of the fatal cases death resulted from the brain abscess.In 4 cases (2 of septicaemia and 2 of.pulmonaryinfection) death was
Rituximab and Omalizumab in Severe, Refractory Insulin Allergy
Authors: Patrick F.K. Yong, Rifat Malik, Sefina Arif, Mark Peakman, Stephanie Amiel, Mohammad A.A. Ibrahim, Andrew Gough
Journal: New England Journal of Medicine (2009)

To the Editor: We describe the sequential use of two targeted biologic agents to treat a patient with severe systemic insulin allergy accompanied by marked metabolic dysregulation and corticosteroid toxicity. In 1996, a 50-year-old woman received the diagnosis of type 1 diabetes. Shortly after insulin therapy was initiated, a generalized urticarial rash (resulting in excoriation, bleeding, and disrupted sleep) developed. Insulin allergy was diagnosed on the basis of positive skin-prick tests and a level of insulin-specific IgE of 5.75 kU per liter (normal value, <0.70 kU per liter). Until 2000, she was treated with a standard stepwise approach of trying . . .
THE HISTOPATHOLOGY OF PROGRESSIVE MUSCULAR DYSTROPHY AS REVEALED BY ULTRAVIOLET PHOTOMICROGRAPHY
Authors: Charles L. Hoagland, Robert E. Shank, George I. Lavin
Journal: The Journal of Experimental Medicine (1944)

Results have been presented of the application of a simplified technique of ultraviolet photomicrography to a study of the specific lesions in muscle in subjects with progressive muscular dystrophy. An exact description of the histological changes occurring in this syndrome, as revealed by photomicrographs in ultraviolet light, is difficult at this time because of the lack of an adequate system of nomenclature. Attention has been drawn, however, to lesions of consistent character, found in sections of muscle removed at biopsy, which appear to be specific for the disease. The method of simplified ultraviolet photomicrography possesses certain marked advantages over those classical methods of histology and pathology which depend on staining and examination of specimens in visible light. Not only is greater resolution achieved with ultraviolet light photomicrography but the image which is obtained in the ultraviolet may provide some idea of the chemical nature of the tissue as well, since it results chiefly from the selective absorption of light by proteins, nucleoproteins, and nucleic acids.
Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk
Authors: Wendy Y. Chen, Bernard Rosner, Susan E. Hankinson, Graham A. Colditz, Walter C. Willett
Journal: JAMA (2011)

Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood.To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption.Prospective observational study of 105,986 women enrolled in the Nurses' Health Study followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments.Relative risks of developing invasive breast cancer.During 2.4 million person-years of follow-up, 7690 cases of invasive breast cancer were diagnosed. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0 to 9.9 g per day, equivalent to 3 to 6 drinks per week (relative risk, 1.15; 95% CI, 1.06-1.24; 333 cases/100,000 person-years). Binge drinking, but not frequency of drinking, was associated with breast cancer risk after controlling for cumulative alcohol intake. Alcohol intake both earlier and later in adult life was independently associated with risk.Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.
A Quantitative Evaluation of Heart Size Measurements from Chest Roentgenograms
Authors: LESTER GLOVER, WILLIAM A. BAXLEY, HAROLD T. DODGE
Journal: Circulation (1973)

In order to assess the accuracy of radiographic parameters of left heart enlargement, quantitative biplane angiographic data was compared to chest X-ray data in 254 adults with various heart diseases. Cardiac silhouette volume measured from PA and lateral chest roentgenograms compared most favorably to the sum of the left ventricular mass, end-diastolic volume, and left atrial maximal volume (r = 0.78, P &lt; 0.01; 79% accuracy). The cardiothoracic ratio gave 70% accuracy (r = 0.64, P &lt; 0.01). Subgrouping of patients according to specific left ventricular hemodynamic alterations did not improve correlations. The roentgenographic relationship of the left ventricle and inferior vena cava correlated poorly with left ventricular size. Of 99 patients with increased left atrial maximal volumes, 81 had visible posterior displacement of the barium-outlined esophagus by the left atrium.
Effect of Hypermetabolism on the Goitre of a Sporadic Cretin
Authors: H. Zondek, H. E. Leszynsky, G. W. Zondek
Journal: BMJ (1957)

VACCINATION AGAINST POLIOMYELITISinsusceptible to infection with polioviruses.The fact that all individuals who were vaccinated with SM virus devel- oped antibody is probably a reflection of the large dose of cytopathogenic virus which was fed to them; the wide range in their antibody titres may indicate the variation in their susceptibility. Acceptable Attenuated StraimAlthough we consider, with our present knowledge, that the TN and SM strains are not at the moment acceptable for mass immunization, this does not mean that suitable strains will not be developed.We have formulated what we believe are the minimum requirements for attenuated poliovirus vaccines.These are as follows
Scrotal Abscess as a Cause of False-Positive Immunological Pregnancy Test
Authors: Elliot H. Klorfein, David M. Drylie
Journal: JAMA (1963)

VARIOUS CAUSES of false-positive biological pregnancy tests have been reported.<sup>1-3</sup>Recently a latex agglutination inhibition test has been developed. This test detects, immunologically, human chorionic gonadotrophin in urine. Urine from a pregnant female contains chorionic gonadotrophins shortly after implantation and reaches a high peak approximately 1 mo after the first missed menstrual period. If a urine specimen containing chorionic gonadotrophins is incubated with a solution containing human chorionic gonadotrophin antibodies, the gonadotrophins are neutralized. If this solution is then incubated with an antigen containing latex particles coated with human chorionic gonadotrophin, agglutination does not occur following centrifugation. The supernate will thus remain turbid and indicate a positive test. If, on the other hand, there is an absence of gonadotrophin in the urine, no neutralization occurs and subsequent incubation with the antigen produces agglutination leaving a clear supernate following centrifugation. It has been reported that 200 to 300 international units
Sentinel Node Mapping in Vulvovaginal Melanoma Using SPECT/CT Lymphoscintigraphy
Authors: Katsuhiro Kobayashi, Pedro T. Ramirez, Edmund E. Kim, Charles F. Levenback, Eric M. Rohren, Michael Frumovitz, Martha V. Mar, Isis W. Gayed
Journal: Clinical Nuclear Medicine (2009)

We report 2 cases of vulvovaginal melanoma in which sentinel node mapping, performed using Tc-99m filtered sulfur colloid SPECT/CT lymphoscintigraphy, added important information to that provided by planar imaging and played a critical role in surgical planning and subsequent management. In the first case, lymphoscintigraphy planar imaging showed only foci of tracer uptake in the right groin and an equivocal focus in the left groin. SPECT/CT precisely localized these radioactive foci to the right and left inguinal sentinel nodes. The patient then underwent bilateral inguinal sentinel node sampling. In the second case, F-18 FDG PET/CT performed prior to lymphoscintigraphy demonstrated a moderately FDG-avid right inguinal lymph node that was indeterminate in nature. SPECT/CT revealed this lymph node to be a radioactive sentinel lymph node that was seen in the right groin on planar imaging. The patient then underwent right inguinal sentinel node sampling. Because pathologic study showed metastasis to the sentinel node, a planned pelvic exenteration was canceled, and the patient was referred for systemic treatment. Preoperative SPECT/CT lymphoscintigraphy is ideal for mapping the unpredicted lymphatic drainage pathways within the complex pelvic anatomy and this technique may also be used in the preoperative workup of other gynecologic malignancies.
de Wet Stockstrom Vorster
Authors: M. Vorster
Journal: BMJ (2013)

<h3>Objectives</h3> To determine levels of cardiovascular disease (CVD) prevention and to model the potential impact of improved prevention strategies for a large rural Indian region. <h3>Design</h3> A cross-sectional study with modelling of coronary heart disease (CHD) events over 10 years. <h3>Setting</h3> Rural Andhra Pradesh, India. <h3>Participants</h3> A stratified random sample of 1079 adults 30 years and older. <h3>Main outcome measures</h3> Proportion on medical and behavioural treatments for prevention of CVD; estimated number of CHD events using a locally recalibrated Framingham risk equation. <h3>Results</h3> Among the 3.5% (95% CI 2.1% to 4.9%) with existing CVD, 49.3% (95% CI 28.8% to 69.8%) were on blood pressure (BP)-lowering medication, 4.7% (95% CI 0 to 10.4%) were on cholesterol-lowering medication, 24.6% (95% CI 9% to 40.3%) had increased exercise and 26.9% (95% CI 2.6% to 51.1%) attempted to quit smoking. Among the 7.6% (95% CI 6.2% to 8.9%) with a high global CHD risk (&gt;20% over 10 years), 29.5% (95% CI 19.5 to 39.5%) were on BP-lowering medication, 2.8% (95% CI 0 to 6.7%) were on cholesterol-lowering medication, 19.4% (95% CI 10.9% to 28%) had increased exercise and 24.8% (95% CI 15.8% to 33.8%) attempted to quit smoking. If confirmed drug therapies were provided to all individuals at high risk there would be a 28% reduction in cardiovascular events over 10 years at an approximate annual treatment cost of US$533 per event avoided. <h3>Conclusions</h3> There are serious deficiencies in CVD prevention in rural areas of India. Addressing these with simple confirmed drug treatments could produce a large reduction in the future cardiovascular burden in India.
Hepatic allograft cyclosporine concentration is independent of the route of cyclosporine administration and correlates with the occurrence of early cellular rejection
Authors: William J. Sandborn, George M. Lawson, Ruud A.F. Krom, Russell H. Wiesner
Journal: Hepatology (1992)

This study compares the hepatic–tissue cyclosporine concentrations in liver biopsy specimens from patients with and without cellular rejection after orthotopic liver transplantation. Nine patients without cellular rejection were studied, including five patients receiving intravenous cyclosporine who had biopsies on posttransplant day 7 and four patients receiving oral cyclosporine who had biopsies on day 21. In these patients no significant differences were seen in blood cyclosporine concentrations (mean ± S.D.) (310 ± 162 vs. 273 ± 310 ng/ml) and hepatic–tissue cyclosporine concentrations (3,451 ± 1,262 vs. 3,545 ± 456 ng/gm). These nine patients without cellular rejection were then compared with eight patients with cellular rejection who were receiving intravenous cyclosporine, including seven patients who had biopsies on posttransplant day 7 and one patient who had a biopsy on day 14. In patients with and without cellular rejection blood cyclosporine concentrations were 330 ± 64 vs. 294 ± 146 ng/ml, and hepatic–tissue cyclosporine concentrations were 1,879 ± 998 vs. 3,493 ± 936 ng/gm, p&lt;0.01. We conclude that hepatic–tissue cyclosporine concentrations are independent of the route of cyclosporine administration and that low hepatic–tissue cyclosporine concentrations correlate with early cellular rejection after orthotopic liver transplantation. (Hepatology 1992;15:1086-1091).
Differential Aspects of Endothelial Function of the Coronary Microcirculation Considering Myocardial Virus Persistence, Endothelial Activation, and Myocardial Leukocyte Infiltrates
Authors: Katja B. Vallbracht, Peter L. Schwimmbeck, Uwe Kühl, Ursula Rauch, Bettina Seeberg, Heinz-Peter Schultheiss
Journal: Circulation (2005)

Background— Viral cardiomyopathy resulting from myocardial virus persistence can be associated with inflammatory immune responses that involve the myocardium and coronary blood vessels. The aim of this study was to investigate the differential impact of myocardial virus persistence and inflammation on endothelial function of the coronary microcirculation. Methods and Results— In 71 patients with nonischemic cardiomyopathy, myocardial biopsies were examined for virus persistence (by polymerase chain reaction) and inflammation (by immunohistology). Endothelial function of the coronary microcirculation was examined during heart catheterization by measuring diameter (by quantitative coronary angiography) and velocity changes (by intracoronary Doppler) of the left anterior descending artery in response to acetylcholine. Coronary blood flow (CBF) was calculated. Endothelium-independent vasoreactivity to adenosine was assessed. Mean age of the patients (37 men, 34 women) was 43±13 years; mean ejection fraction was 64±11%. In 43 patients, adenovirus, enterovirus, parvovirus, or HHV-6 was detected; 28 had no virus. Endothelial function of the coronary microcirculation was significantly impaired in patients with myocardial virus persistence (V) compared with patients without virus (Co) (ΔCBF-V, 22±86%; ΔCBF-Co, 110±113%; P =0.001), which was confirmed in 51 patients with myocardial inflammation (MC) (32 with virus, 19 with no virus) (ΔCBF-MC-V, 12±89%; ΔCBF-MC-Co, 81±109%; P =0.034) and in 20 patients with normal immunohistology of the myocardial biopsies (Co) (11 with virus, 9 with no virus) (ΔCBF-Co-V, 51±72%; ΔCBF-Co-Co, 175±97%; P =0.006). Endothelial function of the coronary microcirculation was also significantly impaired in patients with myocardial inflammation/endothelial activation compared with patients without inflammatory immune response. Endothelium-independent vasodilation was not influenced significantly. Conclusions— Myocardial virus persistence and myocardial inflammation/endothelial activation are associated with endothelial dysfunction of the coronary microcirculation. Endothelial dysfunction in patients with myocardial virus persistence can occur independently of myocardial inflammation/endothelial activation but is more pronounced in patients with concurrent inflammation.
Intracoronary injections of salbutamol demonstrate the presence of functional beta 2-adrenoceptors in the human heart.
Authors: J A Hall, M C Petch, M J Brown
Journal: Circulation Research (1989)

To demonstrate the presence of functional cardiac beta 2-adrenoceptors in man, we studied the responses to intracoronary injections of salbutamol in three groups of six patients. We injected salbutamol, a selective beta 2-adrenoceptor agonist, into the right coronary artery to avoid peripheral vasodilator action and to stimulate the sinoatrial node directly. Salbutamol injections caused a sinus tachycardia. The same doses of salbutamol injected into the aortic root caused no change in heart rate, ruling out a systemic effect. The mean dose required to cause an increase in heart rate of 30 beats/min (IHR30) was 2.6 micrograms in the first group of six patients. In 12 other patients salbutamol was given after beta-blockade to confirm the beta 2-selectivity of the responses. Doses of practolol (beta 1-selective blockade) and of propranolol (beta 1- and beta 2-blockade) that had equal beta 1-blocking activity were used. In six patients who were given practolol, the mean IHR30 dose was 2.1 micrograms. In six patients who were given propranolol, the mean IHR30 dose was significantly greater at 64 micrograms (p less than 0.001, practolol vs. propranolol). This study demonstrates that direct cardiac beta 2-adrenoceptor stimulation in man has a positive chronotropic effect.
Dapsone in the treatment of lupus erythematosus
Authors: THOMAS RUZICKA, GUNTER GOERZ
Journal: British Journal of Dermatology (1981)

Dapsone yielded excellent therapeutic results in certain forms of lupus erythematosus (LE), whereas discoid lesions and the maculo-papular rash of the systemic and disseminated chronic forms of discoid LE remained uninfluenced by the drug. On the basis of these observations, we suggest the following indications for dapsone treatment in LE: 1 Vasculitic urticaria 2 Oral ulceratino 3 Non-scarring form of chronic LE 4 Chloroquine intolerance.
A CASE OF MYOSITIS OSSIFICANS
Authors: B. J. Gallagher
Journal: JAMA (1923)

Lewis<sup>1</sup>recently reported two cases of myositis ossificans in which bone developed in incisions of the abdominal wall, and he referred to eleven cases from the literature in which the same condition was found. The operation preceding the laying down of bone in the abdominal wound in eight of the thirteen cases reported was for gastro-enterostomy. On account of the apparent rarity of the condition, I am reporting a. case in which the condition occurred subsequent to gastro-enterostomy. A man, aged 38, suffered for several years with spells of indigestion of a gastric ulcer type. In April, 1921, he was operated on elsewhere; a duodenal ulcer was found, and a posterior gastro-enterostomy was performed. The wound suppurated, and several weeks elapsed before it was completely healed. In April, 1923, he consulted me on account of a ventral hernia large enough to admit the thumb, at about the center of
Restricted T-cell receptor Vβ gene usage in the skin of patients with guttate and chronic plaque psoriasis
Authors: H.M. LEWIS, B.S. BAKER, S. BOKTH, A.V. POWLES, J.J. GARIOCH, H. VALDIMARSSON, L. FRY
Journal: British Journal of Dermatology (1993)

A strong association between acute guttate psoriasis and group A, β‐haemolytic streptococcal infections is well established. Furthermore, streptococcal M proteins and toxins have been shown to act as superantigens, stimulating subpopulations of T lymphocytes expressing particular Vβ families. We have therefore studied the possible role of streptococcal superantigens in psoriasis by staining peripheral T lymphocytes and skin sections from patients with guttate or chronic plaque psoriasis for the expression of nine TCR Vβ families, using a range of monoclonal antibodies. A marked over‐representation of Vβ2+ T lymphocytes was observed in the dermis and epidermis of patients in both groups, when compared with T lymphocytes in their peripheral blood. A less marked dermal increase in Vβ5.1+ T lymphocytes was also observed in these patients. These findings are consistent with the involvement of a superantigen, possibly streptococcal, in the pathogenesis of psoriasis.
The Clinical Determination of Mitral Insufficiency when Associated with Mitral Stenosis
Authors: O. HENRY JANTON, GUENTHER HEIDORN, LOUIS A. SOLOFF, THOMAS J. E. O'NEILL, ROBERT P. GLOVER
Journal: Circulation (1954)

A review of 200 consecutive operated cases of pure mitral stenosis and 47 consecutive operated cases of mitral stenosis with an associated mitral insufficiency indicates that careful evaluation of the history, auscultatory findings, electrocardiogram and fluoroscopy permits a correct diagnosis of associated insufficiency in a majority of instances. History and auscultation remain the internists' most valuable tools despite a large array of as yet incompletely evaluated mechanical measures.
A piece of my mind. At Nisqually
Authors: J. O. Neher
Journal: JAMA (1989)

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