tbuckley/cabot-search huggingface dataset:
Appendectomies During Physicians' Boycott
Authors: James J. James
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The article by Pantell and Irwin on appendectomy rates during the course of the San Francisco (SF) physicians' boycott of 1975 is noteworthy in that it is one of the few publications in the medical literature that attempts actually to measure impacts on the quality of care secondary to a withholding of physician services. From the time of the first documented physicians' strike in North America (Saskatchewan, Canada, July 1962) up to the present, there have been many strikes but little in the way of substantive documentation of their effects. In the course of a study on the impacts of the Los Angeles (LA) County physicians' malpractice slowdown of January 1976, I had the occasion to review extensively the history of physicians' strikes up to that time.<sup>1,2</sup>Overall, I found physicians' strikes noteworthy for a definite reluctance on the part of physicians to participate. This was
The G protein coupled receptor kinase 2 plays an essential role in beta-adrenergic receptor-induced insulin resistance
Authors: Ersilia Cipolletta, Alfonso Campanile, Gaetano Santulli, Emma Sanzari, Dario Leosco, Pietro Campiglia, Bruno Trimarco, Guido Iaccarino
Journal: Cardiovascular Research (2009)

AimsInsulin (Ins) resistance (IRES) associates to increased cardiovascular risk as observed in metabolic syndrome. Chronic stimulation of β-adrenergic receptors (βAR) due to exaggerated sympathetic nervous system activity is involved in the pathogenesis of IRES. The cellular levels of G protein coupled receptor kinase 2 (GRK2) increase during chronic βAR stimulation, leading to βAR desensitization. We tested the hypothesis that GRK2 plays a role in βAR-induced IRES.
Pulmonary Dysfunction in Transfusion-dependent Patients with Thalassemia Major
Authors: Vittorio Carnelli, Emanuela D'Angelo, Matteo Pecchiari, Massimo Ligorio, Edgardo D'Angelo
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Pulmonary function tests were performed on 62 transfusion-dependent patients with thalassemia major, ranging in age from 8 to 33 years, and receiving chelation therapy with desferrioxamine or deferiprone. Percent predicted values for FVC, FEV1, and PEF were significantly reduced, whereas FEV1/FVC and maximal expiratory flow at 25% FVC were within normal limits, indicating a restrictive disease. Both FVC and FEV1 were negatively correlated with transfusional iron burden as indexed by age. Single-breath carbon monoxide transfer factor was reduced, even after correction for low hemoglobin concentration, and was negatively correlated with iron burden and iron overload, as indexed by serum ferritin levels. Owing to low hemoglobin concentration, blood-diffusing capacity was reduced, in spite of increased lung capillary blood volume, which was, however, adequate to normalize blood diffusing capacity when hemoglobin concentration was only partially restored by transfusion. The diffusing capacity of the alveolar-capillary membrane was substantially decreased and negatively correlated with age and serum ferritin, the fall being primarily attributed to increased membrane thickness. These findings suggest that lung fibrosis and/or interstitial edema related to iron overload are the main cause of pulmonary dysfunction observed in patients with thalassemia major.
CORNEAL ULCER CURED BY TONSILLECTOMY: REPORT OF CASE
Authors: Charles B. Williams
Journal: JAMA (1923)

Mr. P. O. B., aged 35, an oil field contractor, came to me, April 12, 1922, for treatment of corneal ulcer of the left eye. He had been an active, healthy man save for an attack of what was diagnosed as influenza in January, 1922, from which he seemed to have never quite fully recovered. About the middle of March, a foreign body, presumably a small piece of steel, that had injured the left eye was removed in Fort Worth, where the patient remained during the following three weeks under the care of a competent oculist. When first seen by me there was a shallow ulcer of the left cornea covering the inner third of the surface, with a deep area about 1 by 2 mm. at the upper, inner margin of the pupil. Iritis was not particularly marked. Pain was sufficiently intense to interfere with sleep. <h3>METHODS OF TREATMENT</h3>
AUTO-INFECTION VERSUS TYPHOID FEVER AS SEEN IN YOUNG CHILDREN.
Authors: W. C. HOLLOPETER
Journal: JAMA (1898)

An irregular type of fever incident to auto-infection is frequently found in artificially reared children. It is also encountered in young adolescence, and may be found in breast-fed children of irregular habits. When associated with a depressed system or unhygienic surroundings the fever is most likely to assume a more protracted and intermittent type. When found in breast-fed children, the fever is suddenly ushered in at a high grade (103 to 104 degrees), very frequently sustaining this elevation of temperature for several days, when it may break into an intermittent form. The fever associated with intestinal toxemia has many times led to the diagnosis of typhoid fever, from which it can only be discriminated in young children by a careful analysis of the various symptoms, conditions and surroundings, diet and exposure, and all the many complications incident to artificial management. The clinical picture of a child suffering from auto-infection so
Carbapenemase-producing Klebsiella pneumoniae in the Czech Republic in 2011
Authors: J Hrabák, C C Papagiannitsis, V Študentová, V Jakubu, M Fridrichová, H Zemlickova
Journal: Eurosurveillance (2013)

Carbapenemase-producing Enterobacteriaceae and Pseudomonas spp. are increasingly reported in many countries all over the world. Due to the resistance of those bacteria to almost all antibiotics (e.g. beta-lactams, aminoglycosides, fluoroquinolones), treatment options are seriously limited. In the Czech Republic, the incidence of carbapenemase-producing Enterobacteriaceae seems to be low, restricted to only three cases detected between 2009 and 2010. Here, we describe molecular typing of 15 carbapenemase-producing Klebsiella pneumoniae isolates identified in the Czech Republic during 2011. Five VIM-1-producing isolates belonging to sequence type (ST) 11 and one VIM-4-producing isolate of ST1029 have been detected. bla VIM-1 and bla VIM-4 as a part of class 1 integrons were chromosomally located or carried by a plasmid belonging to A/C replicon type (bla VIM-4 ). KPC-3-producing isolates of ST512, recovered from six patients, caused an outbreak. Three more isolates producing KPC-2 enzyme belonged to ST258. Both bla KPC genes were part of the Tn4401a transposon carried on plasmids of the pKpQIL type. The isolates were resistant to all antibiotics tested except colistin and/or gentamicin. Four of these 15 strains were recovered from patients repatriated to the Czech Republic from Greece and Italy. This is the first report of outbreaks caused by carbapenemase-producing Enterobacteriaceae in the Czech Republic.
P04.16 * THE BIOMARKER POTENTIAL OF MGMT PROTEIN EXPRESSION IN GLIOBLASTOMA IS IMPROVED BY EXCLUSION OF NON-TUMOR CELLS
Authors: J. Klitkou, R. H. Dahlrot, S. Hansen, B. W. Kristensen
Journal: Neuro-Oncology (2014)

INTRODUCTION: Methylation of the DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT) gene promoter is predictive of benefit from temozolomide (TMZ) in glioblastoma (GBM). Non-tumor cells are numerous in GBMs and a potential source of bias in attempts to determine MGMT status by immunohistochemistry. The aim of the present study was to explore the prognostic potential of MGMT protein expression excluding these cells. METHOD: Immunofluorescence multiplexing and automated analysis were combined to quantify MGMT (green fluorescence) in tumor cell nuclei using image analysis algorithms. Microglia/macrophages, lymfocytes and vascular structures (red fluorescence) known to express MGMT were excluded from the analysis. The study included paraffin sections from 173 primary GBM's. RESULTS: High area fraction of tumor cell nuclei expressing MGMT was associated with poor prognosis (HR = 1.59, p = 0.005). Prognostic value of MGMT expression was particularly strong in patients treated with TMZ as first line therapy (HR = 2.31, p = 0.0003). The 2-year survival in this group was 44 % versus 7 % for patients with low and high expression respectively. Non-tumor cell nuclei often showed higher MGMT expression than adjacent tumor cells. Exclusion of these cells was shown to improve the prognostic value of MGMT expression. CONCLUSION: MGMT protein expression in tumor cell nuclei holds prognostic potential in GBM. Exclusion of non-tumor cells from the analysis is crucial to avoid false positives. The path to possible clinical implementation will require further testing in independent patient cohorts as well as development of a highly robust multiplexing assay with not yet defined cut-off levels.
Setting the Record Straight in the Breast-Cancer Trials
Authors: Marcia Angell, Jerome P. Kassirer
Journal: New England Journal of Medicine (1994)

In 1985 the Journal published a paper from the multicenter National Surgical Adjuvant Breast and Bowel Project (NSABP) showing that lumpectomy was as effective as mastectomy in the treatment of early breast cancer1. A follow-up paper in 1989 confirmed the finding2. It was published in the Journal along with two other papers from the NSABP: one showing that adjuvant chemotherapy was effective for node-negative, estrogen-receptor-negative breast cancer,3 and the other showing that tamoxifen was effective for node-negative, estrogen-receptor-positive breast cancer4. The trials (known as Protocols B-06, B-13, and B-14) were coordinated by Dr. Bernard Fisher of the . . .
EXPERIMENTAL STUDIES ON THE ETIOLOGY OF TYPHUS FEVER
Authors: Peter K. Olitsky
Journal: The Journal of Experimental Medicine (1922)

We have presented experiments to show that the typhus virus in the tissues of the guinea pig during the height of reaction to the experimental disease does not lose its infecting power when the cells of the brain or of the spleen are disintegrated by repeated freezing and thawing, or by freezing and desiccating, or by crushing by mechanical means, or by grinding into a homogeneous pulp with sand. The virus after such treatment is as actively infective as in the same tissue not subjected to the disintegrating influences. The possibility exists, therefore, of an extracellular condition of the typhus virus. Fourteen attempts to filter through Berkefeld V and N candles the virus contained in the disintegrated tissue have all resulted in failure.
Stereoselective actions of thiadiazinones on canine cardiac myocytes and myofilaments.
Authors: R J Solaro, G Gambassi, D M Warshaw, M R Keller, H A Spurgeon, N Beier, E G Lakatta
Journal: Circulation Research (1993)

Thiadiazinones are cardiotonic agents that have potent, direct, and stereoselective actions on the myofilament response to Ca2+ in intact myocardium. Their mechanism of action is unknown. We studied the effects of racemic thiadiazinone, EMD 53998 (5-[1-(3,4-dimethoxybenzoyl)-1,2,3,4-tetrahydro-6-quinolyl]-6-meth yl-3,6- dihydro-2H-1,3,4-thiadiazin-2-one), and its enantiomers on Ca2+ signaling in myocytes, myofilaments, and myofilament proteins. Intact canine ventricular myocytes responded to the positive enantiomer, EMD 57033, with an increase in the extent of shortening during twitch contractions without increasing the peak amplitude of the Ca2+ transient. The negative enantiomer, EMD 57439, also increased the extent of shortening, but in this case there was a concentration-dependent increase in the peak amplitude of the Ca2+ transient. This is predicted from in vitro data showing that this enantiomer is a relatively potent inhibitor of phosphodiesterase activity. There was no effect of EMD 57439 on the relation between pCa and actomyosin Mg-ATPase activity of canine heart myofibrils. In contrast, EMD 57033 shifted the pCa-Mg-ATPase activity relation to the left. There was no effect of either enantiomer on Ca2+ binding to myofilament troponin C. Moreover EMD 57033, but not EMD 57439, stimulated actomyosin ATPase activity of myofilament preparations in which either troponin or troponin-tropomyosin had been extracted. EMD 57033 had no effect on Mg-ATPase activity of pure ventricular myosin. EMD 57033 also stimulated the velocity of actin filament sliding on myosin heads adhered to nitrocellulose-coated glass coverslips. We propose that the action of EMD 57033 is at the actin-myosin interface on a "receptor" that may be on actin or the crossbridge. Drug binding to this domain appears to reverse the inhibition of actin-myosin interactions by troponin-tropomyosin and also to promote transition of crossbridges from weak to strong force-generating states.
MEDICAL TREATMENT IN DISEASES OF THE LIVER AND BILE PASSAGES
Authors: ALBERT M. SNELL
Journal: JAMA (1927)

The recent accumulation of information with regard to the physiology of the liver has served to provide the medical profession with new clinical and laboratory criteria of hepatic disorders. The therapeutics of hepatic disease has lagged somewhat behind the general advance of knowledge in this field, although a number of notable contributions have been made to both medical and surgical management. <h3>GENERAL PREVENTIVE MEASURES</h3> The liver, like the kidney, is susceptible to injury from infections and toxic substances; among the latter may be mentioned a group of chemicals, such as phosphorus, chloroform, phenylhydrazine, trinitrotoluene, tetrachlorethane, trinitrophenol and carbon tetrachloride, all of which have been shown to produce hepatic lesions in the experimental animal or in man. Alcohol has always loomed large as an etiologic agent in portal cirrhosis and, while no conclusive experimental proof of its relation to hepatic disease has ever been offered, clinical experience has established its importance
Synergistic Action Between Iodine and Lithium
Authors: Peter C. Whybrow
Journal: JAMA (1972)

<h3>To the Editor.—</h3> I find of interest Dr. Wiener's comment (220:587, 1972) suggesting that a synergistic interaction between iodine and lithium carbonate may have been a major factor in precipitating a hypothyroid state in the patient whose case history was presented earlier in your column by E. D. Luby and colleagues (218:1298, 1971). It is our own experience that the production of a hypothyroid state in individuals receiving lithium is not uncommon, but in most instances antithyroid factors other than lithium, or a strong family history of thyroid disease are operative. This suggests that lithium is only a contributing rather than a sufficient cause in the production of the hypothyroid state. In 1971<sup>1</sup>we reported two cases of hypothyroidism occurring during lithium treatment. Since that time, another individual has come to our attention. Of these three individuals, one had evidence of thyroiditis, another an exceptionally strong history of three
Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma
Authors: Chung-Mau Lo, Henry Ngan, Wai-Kuen Tso, Chi-Leung Liu, Chi-Ming Lam, Ronnie Tung-Ping Poon, Sheung-Tat Fan, John Wong
Journal: Hepatology (2002)

This randomized, controlled trial assessed the efficacy of transarterial Lipiodol (Lipiodol Ultrafluide, Laboratoire Guerbet, Aulnay-Sous-Bois, France) chemoembolization in patients with unresectable hepatocellular carcinoma. From March 1996 to October 1997, 80 out of 279 Asian patients with newly diagnosed unresectable hepatocellular carcinoma fulfilled the entry criteria and randomly were assigned to treatment with chemoembolization using a variable dose of an emulsion of cisplatin in Lipiodol and gelatin-sponge particles injected through the hepatic artery (chemoembolization group, 40 patients) or symptomatic treatment (control group, 40 patients). One patient assigned to the control group secondarily was excluded because of unrecognized systemic metastasis. Chemoembolization was repeated every 2 to 3 months unless there was evidence of contraindications or progressive disease. Survival was the main end point. The chemoembolization group received a total of 192 courses of chemoembolization with a median of 4.5 (range, 1-15) courses per patient. Chemoembolization resulted in a marked tumor response, and the actuarial survival was significantly better in the chemoembolization group (1 year, 57%; 2 years, 31%; 3 years, 26%) than in the control group (1 year, 32%; 2 years, 11%; 3 years, 3%; P =.002). When adjustments for baseline variables that were prognostic on univariate analysis were made with a multivariate Cox model, the survival benefit of chemoembolization remained significant (relative risk of death, 0.49; 95% CI, 0.29-0.81; P =.006). Although death from liver failure was more frequent in patients who received chemoembolization, the liver functions of the survivors were not significantly different. In conclusion, in Asian patients with unresectable hepatocellular carcinoma, transarterial Lipiodol chemoembolization significantly improves survival and is an effective form of treatment.
Predictors of 1 year mortality and mode of death in 1033 elderly outpatients with heart failure: Data from Italian Network on congestive heart failure
Authors: G. Pulignano, D. Del Sindaco, A.P. Maggioni, D. Lucci, G. Minardi, M. Gorini, M. Porcu, F. Leggio, E. Giovannini, C. Opasich
Journal: European Journal of Heart Failure (2000)
THE SIGNIFICANCE OF VITAMINS IN PRACTICAL EXPERIENCE
Authors: L. J. Harris
Journal: BMJ (1933)

CHRONIC OSTEOMYELITISTMEDIC JOURNAL 36 (b) Secondary dressings, when done, should be done in the operating room and aseptically.(c) The injured part is not to be moved nor the wound surface to be damaged.(d) Do not hesitate to employ anaesthetics for secondary dressings.(e) Make late dressings as infrequent as early ones.IMPORTANCE OF ROUTINE In the further consideration of chronic osteomyelitis at this time it should be borne in mind that all forms of bone infection (in whatever manner they may have arisen) are under discussion.One of the too common teachings about chronic osteomyelitis, compound fractures, and, indeed, many other injuries and diseases, is that the surgeon and the method of treatment must adapt themselves to the individual patient, to the particular type of injury or disease, and to the circumstances surrounding the particular case.It is my defilnite opinion that such considerations interfere with proper treatment.In undertaking to develop a new method of therapy for these patients it was hoped that a plan might be found and systematized which would have a general application.It is my belief that such a plan has been found, and that the more nearly we can approximate a standard routine in dealing with these patients the better our results will be.We have learned that even bone and joint tubercu- lous patients with mixed infections will respond promptly to this plan of treatment, and in most cases go on in casts with infrequent dressings to as good a recovery as those who have been aspirated or drained aseptically.
Positive-Pressure Ventilation with a Face Mask and a Bag-Valve Device
Authors: Rafael Ortega, Abdel K. Mehio, Albert Woo, Dina H. Hafez
Journal: New England Journal of Medicine (2007)

Providing positive-pressure ventilation with a face mask and a bag-valve device can be a lifesaving maneuver. Although seemingly simple, the technique requires an understanding of the airway anatomy, the equipment, and the indications. Developing manual skills is necessary to provide adequate face-mask ventilation. While endotracheal intubation is frequently the definitive airway management approach for patients in respiratory failure, it is not always feasible. In these circumstances, ventilating a patient with a face mask can be an invaluable temporizing measure. The purpose of this video is to demonstrate the equipment and technique used to provide positive-pressure . . . .
Minocycline-induced discolouration of the sclerae
Authors: R.A. SABROE, C.B. ARCHER, D. HARLOW, J.W.B. BRADFIELD, R.D.G. PEACHEY
Journal: British Journal of Dermatology (1996)

We report two patients with minocycline-induced pigmentation of the sclerae. Cutaneous pigmentation is a well-recognized complication of minocycline therapy, but only five cases of pigmentation of the sclerae have been described previously. These five patients have a number of features in common with the two reported here. We propose that these patients represent the most severe end of the spectrum of minocycline-induced cutaneous changes. Patients should be warned about the possibility of the occurrence of pigmentary changes before starting therapy.
The Power of Words
Authors: Edward C. Sargent
Journal: JAMA (1984)

The patient who had undergone pneumonectomy for lung cancer had been passed along from the previous house staff team. This unfortunate, middle-aged man had received the best of what modern medicine had to offer: months of intubation, antibiotics for aspiration, pulmonary toilet, and ventilatory support, all in the intensive care unit. He was psychotic, we were told, as a result of his long stay in unreal surroundings. His therapeutic goals seemed to have been reduced to a bare minimum: "get him off the ventilator" and "get him to the floor." He was not my patient, but I talked to him on several occasions and offered him a tablet to write on. Coherent words were never forthcoming, but his eyes seemed to express appreciation for the effort. Finally, the patient was sent to the floor, and when we arrived at his bedside during rounds, I was appalled to hear the intern
Synopsis of Gynecologic Oncology
Authors: Robert E. Scully
Journal: JAMA (1975)

This volume is a unique, comprehensive treatise on gynecologic oncology, being an expanded version of a series of lectures given by the three authors to their residents, fellows, and medical students. In addition to chapters devoted to tumors of the female genital organs, there are discussions of more general topics such as cancer staging and classification, colposcopy, radiation biology and physics, chemotherapy, hyperalimentation, tumor immunology, and the care of the stoma. Basic principles of radiation therapy, chemotherapy, and tumor immunology are covered, as well as the practical aspects of these subjects. The chapters on specific tumors include a consideration of their pathology, clinical presentation, diagnosis, treatment, and prognosis. The text is up-to-date with over 700 references, many of them recent, and is supported by numerous photographs, diagrams, tables, and flow sheets. The defects of the book include those that are inevitable in any synopsis of a complicated subject. Because it