tbuckley/cabot-search huggingface dataset:
To End an Epidemic
Authors: L C Kleinman
Journal: New England Journal of Medicine (1992)

ONE hundred years ago, diphtheria was predicted to be "the scourge of America in the future."1 Although this prediction was realized, diphtheria has since become only a chapter in the history of American public health, and the acquired immunodeficiency syndrome (AIDS) has emerged as the scourge of the future. Every epidemic disease is in some ways unique, but none is wholly so, and the history of diphtheria may be relevant today.Diphtheria was the first infectious disease to be conquered on the basis of the principles of microbiology and public health. It emerged as a threat at a time when . . .
Esophageal Function in Elderly Men
Authors: JOSEPH B. HOLLIS
Journal: Annals of Internal Medicine (1974)

We have studied esophageal motility in nonhospitalized elderly men (70 to 87 years old) and in control subjects (19 to 27 years old) without neurological disease or diabetes. Esophageal function was studied basally and after intravenous administration of 80 µg/kg body weight of edrophonium chloride. For control subjects mean basal and postinjection amplitudes were significantly greater (P < 0.05) than those for aged subjects, with a marked decline in amplitude in subjects more than 80 years old. In contrast with the decreased amplitude in the 80-year-old men, the propagation of peristaltic waves, as measured by speed, duration, and onset of contraction after a swallow, was similar for all groups and responded similarly to edrophonium chloride. No increase in abnormal spontaneous motility was noted in the elderly men. These findings suggest a weakening in esophageal smooth muscle with an intact nervous pathway. Disordered motility in elderly persons is most likely caused by disease, rather than by aging. Perhaps presbyesophagus needs to be redefined.
Sudden death in asthma.
Authors: J R Bateman, S W Clarke
Journal: Thorax (1979)

Two deaths after sudden severe asthma attacks in young people are reported from a clinic set up to identify and manage "at risk" patients. These deaths occurred despite frequent visits at which recommendations made by previous studies were implemented. The risk factors and management of such episodes have been reviewed. Precautions taken proved inadequate due to the severe, abrupt nature of the attacks, failure of the patients' immediate treatment, and delay in reaching hospital. Consideration should be given to the self-administration of subcutaneous adrenaline or specific beta-agonists, the provision of a detailed medical card, and free access to the nearest hospital in such cases.
Identifying the Sources of the Recent Decline in Perinatal Mortality Rates in California
Authors: Ronald L. Williams, Peter M. Chen
Journal: New England Journal of Medicine (1982)

Abstract The perinatal mortality rate in California decreased rapidly in the 1970s; neonatal mortality fell about twice as fast as fetal mortality. Decreases in birth-weight-specific mortality accounted for 81 per cent of the decline in the perinatal rate, with only 19 per cent due to improvements in birth weight. No improvement was observed in the birth-weight distribution for blacks. The decrease in mortality rates was significantly faster for cesarean deliveries than for vaginal births. By 1977, all birth-weight-specific fetal mortality rates for cesarean sections were equal to those for vaginal deliveries or lower. For infants weighing less than 2000 g, perinatal mortality rates were also significantly lower for infants born by cesarean section than for infants delivered vaginally. These results suggest that much of the recent decrease in perinatal mortality rates can be attributed to the advent of neonatal intensive care and the increased rate of cesarean section. (N Engl J Med. 1982; 306:207–14.)
An infant with respiratory distress
Authors: J. Canlas, A. Ayubi, F. Kagalwala, R. Prasad, J. Rawal
Journal: BMJ (2010)

A 4 month old African girl presented to the accident and emergency department with a two day history of fever, cough, and poor feeding. She was born full term at a weight of 3000 g. She had no neonatal complications. She was exclusively breast fed and her mother had no history of serious illness. On examination, she had fever, tachypnoea, and tachycardia. Her oxygen saturation was 96% on air. Fine crepitations were heard at the bases of her lungs. A gallop rhythm was detected on cardiac auscultation. Her liver was 2 cm palpable. She had swollen but non-tender wrists. Her full blood count and liver function tests were normal except for an alkaline phosphatase of 942 U/l. Her calcium was 1.5 mmol/l and phosphate 2.16 mmol/l. Radiography of the chest and right wrist was performed (fig 1⇓).



Fig 1 Chest radiograph (left) and radiograph of the right wrist (right)



### 1 What are the radiological findings?

#### Short answer

The chest radiograph (fig 2⇓) shows cardiomegaly and pulmonary plethora. The wrist radiograph (fig 2⇓) shows widening, cupping, and fraying of the epiphysis of the right radius and ulna suggestive …
Sex Differences in the Vectorcardiogram
Authors: IWAO SOTOBATA, HAROLD RICHMAN, ERNST SIMONSON, A. Fukomoto
Journal: Circulation (1968)

In a study of 101 normal men and 102 normal women (mean age, 42.5 and 42.6 years, respectively), significant sex differences were observed in 43 of 64 vectorial items analyzed (initial 0.02-sec and 0.025-sec vectors, maximal QRS and T vectors, terminal 0.02-sec vectors in frontal, horizontal left sagittal planes; Q, R, S, and T deflections in Frank's X, Y, and Z leads). The initial QRS vectors are oriented more inferiorly and posteriorly in women than in men, the maximal QRS vectors more inferiorly, the terminal vectors more leftward and superiorly, the T vector more posteriorly and inferiorly. The QRS-T angle is smaller. There is a significant tendency to smaller magnitude of all planar vectors and Q, R, S, and T deflections (except S y ) in orthogonal leads in women, and a greater incidence of initial counterclockwise rotation in the frontal plane QRS loop. Thus, sex differences show up better in the VCG than in the ECG. Separate normal 95 percentile limits for men and women are presented for all items with significant sex differences and pooled limits for VCG items without significant differences.
Attenuation of endothelin-1 induced vasoconstriction by 17β estradiol is not sustained during long-term therapy in postmenopausal women with coronary heart disease
Authors: Pardeep S Jhund, Nuala Dawson, Andrew P Davie, Naveed Sattar, John Norrie, Kevin P.J O’Kane, John J.V McMurray
Journal: Journal of the American College of Cardiology (2001)
Age-Adjusted Plasma Norepinephrine Levels Are Similar in Normotensive and Hypertensive Subjects
Authors: C. Raymond Lake, Michael G. Ziegler, Michael D. Coleman, Irwin J. Kopin
Journal: New England Journal of Medicine (1977)

The sympathetic nervous system has been implicated in the pathogenesis of hypertension because of its role in controlling blood pressure and because many drugs that have been found useful in the treatment of essential hypertension either block noradrenergic neuronal function or depress sympathetic outflow from the central nervous system, but there is no conclusive evidence for a role of the sympathetic nervous system in the development or maintenance of hypertension.1 Accurate measurement of plasma catecholamines has been facilitated by the introduction of radioenzymatic methods,2 , 3 and there are a number of reports of increased levels of circulating catecholamines in hypertensive patients. . . .
405 HARPE STUDY: PREVALENCE OF RENAL ABNORMALITIES IN CHRONIC HBV INFECTION
Authors: S. Amet, J.-P. Bronowicki, D. Thabut, F. Zoulim, M. Bourlière, P. Mathurin, V. De Lédinghen, Y. Benhamou, D. Larrey, E. Bruce, N. Janus, V. Launay-Vacher, G. Deray, S. Pol
Journal: Journal of Hepatology (2013)
Aminoguanidine corrects hyperdynamic circulation without ameliorating portal hypertension and portal hypertensive gastropathy in anesthetized portal hypertensive rats
Authors: Fa-Yauh Lee, Wang Suh-Sang, Tsai Yang-Te, Lin Hwai-Jeng, Lin Han-Chieh, Chu Chi-Jen, Wu Shwu-Ling, Tai Chung-Ching, Lee Shou-Dong
Journal: Journal of Hepatology (1997)
Diagnosis of<i>Chlamydia trachomatis</i>Infections by Direct Immunofluorescence Staining of Genital Secretions
Authors: WALTER E. STAMM
Journal: Annals of Internal Medicine (1984)

Because few clinicians have access to laboratories offering cell culture confirmation of suspected Chlamydia trachomatis genital infections, we evaluated a diagnostic method in which fluorescein-conjugated monoclonal antibodies were used to directly identify C. trachomatis elementary bodies in slides made from genital secretions. Compared with culture results, the direct smear had a sensitivity of 92% and a specificity of 96% in 576 men, most of whom had symptoms and signs of urethritis. Among 595 women attending the same clinics, sensitivity of the direct smear for cervical infection was 89% and specificity was 99%. In 225 pregnant women screened in a prenatal or abortion clinic, the sensitivity and specificity of the test were 86% and 99% respectively. Direct detection of elementary bodies in genital smears offers an alternative diagnostic approach for C. trachomatis infections.
A high prevalence of cytomegalovirus antigenaemia in patients with moderate to severe chronic plaque psoriasis: an association with systemic tumour necrosis factor ? overexpression
Authors: None Asadullah, None PRÖsch, None Audring, None BÜttnerova, None Volk, None Sterry, None DÖcke
Journal: British Journal of Dermatology (1999)

Microbiological aspects are considered to be of pathophysiological importance in psoriasis, but there has so far been no information regarding cytomegalovirus (CMV) infection. This is of interest due to the high prevalence of latent infection in the general population, the frequent reactivation in inflammatory diseases, and the immunomodulating capacity of CMV. To detect active infection we analysed CMV antigen expression of peripheral blood mononuclear cells (PBMC) from psoriatic patients (n = 30) in comparison with healthy volunteers (n = 65). Using three monoclonal antibodies and immunocytological staining (alkaline phosphatase–antialkaline phosphatase technique), we frequently found CMV antigenaemia in psoriasis (43%) compared with healthy laboratory staff (12%, P < 0.01) and blood donors (6%, P < 0.001). Clearance of CMV antigenaemia was observed with antipsoriatic treatment. CMV antigenaemia was symptomless, and was associated with seropositivity for anti-CMV IgG but not IgM antibodies, indicating subclinical activation of latent infection. Serological investigations in 85 psoriatic patients gave no evidence for a higher prevalence of latent CMV infection. In psoriatic lesions, CMV DNA was only rarely detected by polymerase chain reaction. As it has been shown that tumour necrosis factor (TNF)-α can induce CMV reactivation, we determined TNF-α plasma concentrations and mRNA expression in PBMC from psoriatic patients. Elevated TNF-α levels were found and correlated with the frequency of CMV antigen-expressing PBMC, suggesting a critical role of TNF-α in CMV activation. We speculate that active, subclinical CMV infection may be of pathophysiological importance in psoriasis.
Endorphin-mental illness link far from proved
Authors: W. A. Check
Journal: JAMA (1982)

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Topical choline salicylates implicated in Reye’s syndrome
Authors: T K Oman, M C Stewart, A Burns, T F Lang
Journal: BMJ (2008)

Salicylate use in children was implicated in the development of Reye’s syndrome.1 After the recommendation in the 1980s that preparations containing aspirin should not be given to children unless specifically indicated, Reye’s syndrome has almost disappeared from clinical practice.2 The Medicines and Health products Regulatory Agency (MHRA) states that only systemically absorbed acetylsalicylates are associated with Reye’s syndrome.

A 20 month old …
Distinction of mutagenic carcinogens from a mutagenic noncarcinogen in the big blue transgenic mouse.
Authors: M L Cunningham, J J Hayward, B S Shane, K R Tindall
Journal: Environmental Health Perspectives (1996)

The aromatic amines 2,4-diaminotoluene (2,4-DAT) and 2,6-diaminotoluene (2,6-DAT) are structural isomers that have been extensively studied for their mutagenic and carcinogenic characteristics. Both compounds are rapidly absorbed after oral administration and are equally mutagenic in the Ames test; however, 2,4-DAT is a potent hepatocarcinogen, whereas 2,6-DAT does not produce an increased incidence of tumors in rats or mice at similar doses. The Big Blue transgenic B6C3F1 mouse carries multiple copies of the lacl mutational target gene. Our studies were designed to determine whether the Big Blue system could be used to detect differences in the vivo mutagenic activity between the carcinogen-noncarcinogen pair 2,4-DAT and 2,6-DAT and to determine whether the in vivo mutagenesis assay results correspond to the rodent carcinogen bioassay results. Male B6C3F1 transgenic mice were exposed to 2,4-DAT or 2,6-DAT at 0 or 1,000 ppm in the diet for 30 and 90 days or to dimethylnitrosamine as a positive control. Mutant frequencies were nearly identical for all three groups at 30 days, while at 90 days the mutant frequency for the hepatocarcinogen 2,4-DAT (12.1 +/- 1.4 x 10(-5)) was significantly higher (p < 0.01) as compared to both age-matched (spontaneous) controls (5.7 +/- 2.9 x 10(-5)) and the 2,6-DAT-exposed group (5.7 +/- 2.4 x 10(-5)). Results from this study demonstrate that the Big Blue transgenic mutation assay can distinguish differences in vivo between the mutagenic responses of hepatic carcinogens ad a noncarcinogen; is sensitive to mutagens through subchronic dietary exposure; and yields a differential response depending upon the length of time mice are exposed to a mutagen.
The Balanced Biology of the Teaching Hospital
Authors: John H. Knowles
Journal: New England Journal of Medicine (1963)

THE time-honored functions of the teaching hospital are the indivisible and interdependent triad of patient care, teaching and research. The present conventional wisdom states that the medical school's launching pad rests on an immovable and indisputably appropriate foundation of basic, biologic science for the first two years, followed by two more years of clinical training in the subdivisions of medicine. This, in turn, is followed by two to six years of postgraduate training in an accredited teaching hospital with one or two years' additional time in a "research laboratory." Armed with M.D. and "boards," the physician can now practice medicine, . . .
Particles causing lung disease.
Authors: K H Kilburn
Journal: Environmental Health Perspectives (1984)

The lung has a limited number of patterns of reaction to inhaled particles. The disease observed depends upon the location: conducting airways, terminal bronchioles and alveoli, and upon the nature of inflammation induced: acute, subacute or chronic. Many different agents cause narrowing of conducting airways (asthma) and some of these cause permanent distortion or obliteration of airways as well. Terminal bronchioles appear to be particularly susceptible to particles which cause goblet cell metaplasia, mucous plugging and ultimately peribronchiolar fibrosis. Cancer is the last outcome at the bronchial level and appears to depend upon continuous exposure to or retention of an agent in the airway and failure of the affected cells to be exfoliated which may be due to squamous metaplasia. Alveoli are populated by endothelial cells, Type I or pavement epithelial cells and metabolically active cuboidal Type II cells that produce the lungs specific surfactant, dipalmytol lecithin. Disturbances of surfactant lead to edema in distal lung while laryngeal edema due to anaphylaxis or fumes may produce asphyxia. Physical retention of indigestible particles or retention by immune memory responses may provoke hyaline membranes, stimulate alveolar lipoproteinosis and finally fibrosis. This later exuberant deposition of connective tissue has been best studied in the occupational pneumoconioses especially silicosis and asbestosis. In contrast emphysema a catabolic response, appears frequently to result from leakage or release of lysosomal proteases into the lung during processing of cigarette smoke particles. The insidious and probably most important human lung disease due to particles is bronchiolar obstruction and obliteration, producing progressive impairment of air flow. The responsible particle is the complex combination of poorly digestive lipids and complex carbohydrates with active chemicals which we call cigarette smoke. More research is needed to perfect, correct and quantify our preliminary picture of the pathogenesis of lung disease by particles, but a useful start has been made.
Early Childhood Autism
Authors: K. Robertson
Journal: BMJ (2011)

Although it was written when autism hadn’t attained the acceptance and recognition it has now, before the current diagnostic explosion that has seen prevalence rise 10-fold, it is surprising how contemporary this book feels 45 years after publication. A considered look at autism, the book is well written, impressive, and comprehensive—and almost all the recommendations the authors made hold true today.

The first chapter is a joy to read: Wing’s husband John K Wing’s concise and thoughtful historical overview starts and ends with American psychiatrist and physician Leo Kanner, whose 1943 case series of “markedly and uniquely” different children used the term “autistic” to describe their behaviour. The authors’ holistic attitude is casually but clearly established; a diagnosis is complementary to other functional approaches, not …
Early management of myocardial infarction
Authors: A. D Short, B. West
Journal: BMJ (1994)

The challenge for GPs is to change

EDITOR,--At the same time as Hazel Wyllie and Francis Dunn were doing their study on use of aspirin in cases of chest pain in the north sector of Glasgow,1 the first part of an audit was carried out among general practitioners in all of Glasgow over a period of a year. Half of those involved in 156 incidents of chest …
VITAMIN K FOR THE NEWBORN
Authors: W. W. Waddell
Journal: JAMA (1942)

ABSTRACT To the Editor.— Dr. Sanford and his associates in an article entitled Is Administration of Vitamin K to the Newborn of Clinical Value? (The Journal, February 28, p. 697) seriously question the value of vitamin K in the prophylaxis and treatment of hypoprothrombinemia and associated hemorrhage of the newborn. I am forced to join with Dr. Quick in taking prompt and sharp exception to Dr. Sanford's conclusions.Early in 1939 in a brief preliminary article my associates and I called attention to the prompt and efficient action of vitamin K in the prevention and treatment of hypoprothrombinemia and hemorrhage in the newborn and have repeatedly stated that hemorrhagic disease would not occur in any infant adequately protected with vitamin K. We have also repeatedly expressed the hope, adequately supported by facts, that infant mortality resulting from intracranial hemorrhage will in the future possibly be materially reduced by this sound therapeutic
Lead poisoning--one approach to a problem that won't go away.
Authors: J D Bogden, J M Oleske, D B Louria
Journal: Environmental Health Perspectives (1997)

A reduction in sources of environmental lead exposure has resulted in substantial declines in mean blood lead concentrations of all age groups in the United States. However, some segments of the population continue to have unacceptable levels of lead exposure and elevated blood lead concentrations. In addition, virtually all residents of industrialized countries have bone lead stores that are several orders of magnitude greater than those of our preindustrial ancestors. Recent studies suggest that these skeletal lead stores adversely affect health and can contribute to reduced birth weights, aggressive behavior in children, and anemia, hypertension, and kidney disease in adults. Evidence is described that demonstrates that an increase in dietary calcium consumption can reduce lead absorption and toxicity from exogenous and endogenous lead exposure. A relatively inexpensive and effective way to reduce the substantial morbidity that will result from widespread lead exposure is by fortification of a variety of foods with low levels of calcium. This approach can complement other efforts to prevent lead exposure and reduce lead toxicity.
A Need for Blending
Authors: Dana L. Farnsworth
Journal: JAMA (1970)

The mood of protest so common among college students during the sixties has spread downward into the high schools and even into the elementary schools, and at the same time has become quite prominent in all the graduate schools. Medical schools and hospitals have been affected by a wide variety of criticisms and actions designed to bring about change. Several professional associations have been the object of confrontations very similar to those prevalent in colleges and universities. As among college students, the reaction among students in the health professions has varied from the extreme of viewing the efforts of medical schools, hospital trustees, donors, and professional associations as being involved in a vast conspiracy to perpetuate the present inadequacies of health care, all the way to that of ignoring acute social problems and concentrating on research problems in the laboratory. Some of the former group do not seem to understand
(35) Multicentric reticulohistiocytosis
Authors: E.A. Bingham, J.M. Beare, T.A. Dawson
Journal: British Journal of Dermatology (1984)

Journal Article (35) Multicentric reticulohistiocytosis Get access E.A. Bingham, E.A. Bingham Royal Victoria Hospital, Belfast Search for other works by this author on: Oxford Academic Google Scholar J.M. Beare, J.M. Beare Royal Victoria Hospital, Belfast Search for other works by this author on: Oxford Academic Google Scholar T.A. Dawson T.A. Dawson Craigavon Area Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue s26, 1 July 1984, Pages 79–81, https://doi.org/10.1111/j.1365-2133.1984.tb05305.x Published: 01 July 1984
Accelerating the Use of Electronic Health Records in Physician Practices
Authors: Steven Shea, George Hripcsak
Journal: New England Journal of Medicine (2010)

North Shore Hospital System on Long Island in New York recently announced that it will pay an incentive of up to $40,000 to each physician in its network who adopts its electronic health record (EHR) — paying 50% of the cost to physicians who install an EHR that communicates with the hospital and 85% of the cost if the physician also shares de-identified data on the quality of care.1 This payment would apparently come on top of the $44,000 incentive that the American Recovery and Reinvestment Act of 2009 (ARRA) has authorized Medicare to pay each eligible health care professional . . .