tbuckley/cabot-search huggingface dataset:
Ehrlichiosis — In Pursuit of an Emerging Infection
Authors: William Schaffner, Steven M. Standaert
Journal: New England Journal of Medicine (1996)

Ehrlichia are obligate intracellular coccobacilli resembling rickettsia that have historically been associated with diseases of animals. The etiologic agent of the hemorrhagic illness canine ehrlichiosis, Ehrlichia canis, was first recognized in 1935, and other ehrlichia species, which infect horses and ruminants, have since been discovered.The first human ehrlichial infection to be recognized was Sennetsu fever, a mononucleosis-like illness described in Japan in 1954. The first report of ehrlichial infection in the United States was in 1986: a man acquired the infection from a tick bite while traveling in Arkansas.1 Because the patient had an increase in antibodies to E. . . .
Time to Progression in Metastatic Breast Cancer Patients Treated With Epirubicin Is Not Improved by the Addition of Either Cisplatin or Lonidamine: Final Results of a Phase III Study With a Factorial Design
Authors: Alfredo Berruti, Raffaella Bitossi, Gabriella Gorzegno, Alberto Bottini, Palmiro Alquati, Andrea De Matteis, Francesco Nuzzo, Giorgio Giardina, Saverio Danese, Mario De Lena, Vito Lorusso, Antonio Farris, Maria Giuseppa Sarobba, Enza DeFabiani, Giorgio Bonazzi, Federico Castiglione, Cesare Bumma, Gregorio Moro, Paolo Bruzzi, Luigi Dogliotti
Journal: Journal of Clinical Oncology (2002)

To investigate the value of the addition of either cisplatin (CDDP) or lonidamine (LND) to epirubicin (EPI) in the first-line treatment of advanced breast cancer.Three hundred seventy-one metastatic breast cancer patients with no prior systemic chemotherapy for advanced disease were randomized to receive either EPI alone (60 mg/m(2) on days 1 and 2 every 21 days), EPI and CDDP (30 mg/m(2) on days 1 and 2 every 21 days), EPI and LND (450 mg orally daily, given continuously), or EPI, CDDP, and LND. Time to progression, response rates, side effects, and survival were compared according to the 2 x 2 factorial design of this study.The groups were well balanced with respect to prognostic factors. Time to progression did not differ in the comparison between CDDP arms and non-CDDP arms (median, 10.9 months v 9.4 months, respectively; P =.10) or between that of LND arms and non-LND arms (median, 10.8 months v 9.9 months, respectively; P =.47), nor did overall survival. The response rate did not significantly differ in the comparison between LND arms and non-LND arms (62.9% v 54.0%, P =.08). No difference in treatment activity was observed between CDDP arms and non-CDDP arms. Toxicity was significantly higher in the CDDP arms, leading to CDDP dose adjustment in 40% of cases. The most frequent side effects were of a hematologic and gastrointestinal nature. The addition of LND produced more myalgias and fatigue.Neither CDDP nor LND was able to significantly improve the time to progression obtained by EPI. CDDP, however, significantly worsened the drug's tolerability.
Ultrasound ability in early diagnosis of stress fracture of metatarsal bone
Authors: F Banal
Journal: Annals of the Rheumatic Diseases (2005)

A 42 year old woman, with rheumatoid arthritis for 14 years, treated with leflunomide 20 mg/day and prednisolone 5 mg/day, had mechanical pain over the dorsum of the right foot for 3 weeks. She had increased her walking activities a couple of weeks before the pain started. On clinical examination, there was a marked swelling and painful area on the second metatarsal. Plain radiographs were normal.

Sonography of the foot was obtained with a Esaote MP system and a 7.5–13 MHz linear transducer. Only the dorsal aspect of the foot was required in a longitudinal and axial view. A hypoechoic haematoma with periosteal …
Isolation and characterization of Tha p 1, a major allergen from the pine processionary caterpillar <i>Thaumetopoea pityocampa</i>
Authors: I. Moneo, J. M. Vega, M. L. Caballero, J. Vega, E. Alday
Journal: Allergy (2003)

Background: Pine processionary caterpillars induce dermatitis by a toxic–irritative mechanism. The existence of true allergic reactions to allergens from these caterpillars has been recently demonstrated by positive immediate skin prick tests and specific IgE determination by immunoblotting using crude larval extracts. The aim of this work was to purify allergens from the crude larval extract in order to characterize IgE‐binding proteins from these caterpillars. Methods: Allergens were separated by ethanol gradient fractionation and reversed phase HPLC. The N‐terminal amino acid sequence of a selected allergen was obtained after SDS‐PAGE and transfer. The clinical relevance of this allergen was measured using sera from patients allergic to caterpillar. Results: An allergen with a molecular weight close to 15 kDa was purified. It was recognized by 9 out of 11 allergic patients (82%). Its N‐terminal amino acid sequence had no homologies to any other protein already described in data bases. For this reason, no information about its biological function could be obtained. Conclusions: This 15‐kDa IgE‐binding protein is a major caterpillar allergen and shows no homologies to other insect allergens already described.
Clinical management of children and adults with cystic fibrosis
Authors: A K Webb, T J David
Journal: BMJ (1994)

The cystic fibrosis population is increasing by 120-140 patients a year, and by the year 2000 there could be 6000 patients in the United Kingdom, with equal numbers of adult and paediatric patients.1 It is hoped that better understanding of the underlying defect will be translated into practical treatment such as gene replacement, for at present the median survival for adults is only into the third decade.2 The review looks at the current management of cystic fibrosis. The modes of presentation are listed (box 1) because some are not well known. Overdiagnosis remains a problem. In some parts of Britain up to 10% of patients referred to regional centres with cystic fibrosis are found to have an alternative diagnosis.3 The total absence of one or more of the major features - malabsorption due to pancreatic insufficiency, chronic suppurative lung disease, and failure to thrive - should lead to caution about the diagnosis. The main reasons for these errors are a disregard of the clinical features or the lack of them, incorrect performance of the sweat test, and faulty interpretation of the results of the test. Some patients (less than 10% seen in the United Kingdom, but up to 38% in one Canadian series), have sufficient pancreatic function for normal digestion, so that even the most sophisticated direct pancreatic function testing can exclude only pancreatic insufficiency and not cystic fibrosis itself. Homozygosity for one of the recognised gene deletions clearly indicates cystic fibrosis. Unfortunately, a cystic fibrosis mutation cannot be detected in about a fifth of patients; thus, negative results in the search for homozygosity of a cystic fibrosis gene does not exclude the diagnosis. In many cases, the final diagnosis still hinges on the accurate performance and correct interpretation of the sweat test. ### Box 1 - Modes of presentation in cystic fibrosis #### Well recognised modes of presentation in newborn infants
Researching a Historical Book
Authors: W. D. Snively
Journal: JAMA (1969)

Our research for a book<sup>1</sup>began as an exploratory walk down an abandoned wagon trail in 1961. Some weeks before, one of us had read of an Ohio River ghost town in western Kentucky across from Illinois; it had been the site of a ferry used heavily from 1823 to 1833. What piqued our interest was the tradition that the ferry crossing and its approaches had witnessed murders of hundreds, perhaps thousands, of westbound pioneers. From the time of its first settlement, the portion of the western bulge of Kentucky that lies between the Tidewater and Cumberland rivers has been known as the "Western Country," but on very early maps it appeared as "The Barren and Naked Land" (Fig 1). The latter designation stemmed from the Indian custom of occasionally burning forest to increase forage for buffalo. Beech, hard maple, papaw, wild plum, black and white oak, red cedar,
Comparison of effects of propranolol and metoprolol on airways obstruction in chronic bronchitis.
Authors: D J Sinclair
Journal: BMJ (1979)

show any abnormality.Carcinoma of the breast was diagnosed and a mammo- gram was performed.This showed a large circular mass with increased density, homogeneous and with well-demarcated borders, compressing the surrounding breast tissue.There was no thickening of the skin.Aspiration produced from a tense cyst about 70 ml of chocolate-coloured fluid containing flakes of tissue.About 50 ml of air was injected and a contrast mammogram was taken with the patient erect.2It showed a fluid level and confirmed the diagnosis of a cyst (figure).This was removed intact leaving a rim of atrophied breast tissue.Macroscopically the cyst was very tense, globular, and of about 10 cm in diameter.The outer wall was shaggy.It was multiloculated and contained chocolate-coloured fluid with whitish tissue debris.Histologically it was a typical epidermal cyst lined with stratified squamous epithelium and the cavity contained laminated layers of keratin.
Endocardial catheter mapping: wire skeleton technique for representation of computed arrhythmogenic sites compared with intraoperative mapping.
Authors: R N Hauer, M T de Zwart, J M de Bakker, J F Hitchcock, O C Penn, M Nijsen-Karelse, E O Robles de Medina
Journal: Circulation (1986)

Guiding surgical therapy of ventricular tachycardia by preoperative endocardial catheter mapping necessitates improvement of the accuracy of localization of the arrhythmogenic site. We therefore used a new mathematical cineradiographic method during catheter mapping to compute the position of left ventricular arrhythmogenic sites relative to three anatomic reference points: the centers of aortic and mitral valve ostia and the left ventricular apex. To enable the surgeon to identify the position of the computed sites, a wire skeleton (one for each patient) representing a single or multiple arrhythmogenic site(s) relative to the anatomic reference points was constructed. This wire skeleton was inserted into the left ventricular cavity during surgery. Side branches of the device indicated preoperatively localized arrhythmogenic sites. Results in eight consecutive patients were compared with those of intraoperative simultaneous mapping of 64 endocardial sites. Sixteen morphologically distinct monomorphic ventricular tachycardias were mapped by catheter and 15 by intraoperative mapping. In 12 ventricular tachycardias an identical morphology was recorded during both techniques. The distance between arrhythmogenic sites localized with both methods was 1 cm or less in 11 of these 12 ventricular tachycardias and 2 cm in one ventricular tachycardia. These results indicate that endocardial catheter mapping combined with wire skeleton representation of computed positions of arrhythmogenic sites is reliable for guiding surgical therapy of ventricular tachycardia and since some of the ventricular tachycardias were inducible only during either preoperative or intraoperative mapping, both techniques have an additive value. In addition, the wire skeleton proved convenient during surgery by identifying the arrhythmogenic sites.
COMPRESSION TECHNIC IN GASTRODUODENAL ROENTGEN DIAGNOSIS
Authors: P. G. BOMAN
Journal: JAMA (1930)

It has aptly been said that the greatest obstacle to accurate diagnosis of intra-abdominal conditions is the abdominal wall. That efforts are being made to overcome this obstacle is evident when one sees the proctologist with his 32-centimeter sigmoidoscope exploring the lower region of the intestinal tract and the gastroscopist searching for pathologic conditions within the stomach. If the ambitions of these specialists could be realized, there would be no need for this presentation. However, between the domain of the proctologist and that of the gastric endoscopist there lies a considerable area, largely unmapped and uncharted. Roentgenology has stepped in to bridge the gap left by the endoscopist. That it has been successful to a large degree is evident from the role which gastro-intestinal roentgenology holds today. Few physicians or surgeons would willingly practice their profession without this most valuable diagnostic aid. This year marks the twenty-fifth anniversary of the
Infant-scalp Vein Needles
Authors: M. L. Snaith
Journal: BMJ (1967)

almost the whole of my as yet unpublished paper.In brief, our disagreement, if any, seems to stem from the fact that they refer to "the risk of arterial bleeding" while I wrote about " spontaneous rupture of large arteries."Our interpretation of some of the published reports on arterial complications in Ehlers-Danlos syndrome also differs, because, unlike them, I find it impossible to identify the clinical type of the syndrome in the patients described.-Iam, etc.,
The role of attention in auditory information processing as revealed by event-related potentials and other brain measures of cognitive function
Authors: Risto Näätänen
Journal: Behavioral and Brain Sciences (1990)

Abstract This article examines the role of attention and automaticity in auditory processing as revealed by event-related potential (ERP) research. An ERP component called the mismatch negativity , generated by the brain's automatic response to changes in repetitive auditory input, reveals that physical features of auditory stimuli are fully processed whether or not they are attended. It also suggests that there exist precise neuronal representations of the physical features of recent auditory stimuli, perhaps the traces underlying acoustic sensory (“echoic”) memory. A mechanism of passive attention switching in response to changes in repetitive input is also implicated. Conscious perception of discrete acoustic stimuli might be mediated by some of the mechanisms underlying another ERP component (NI), one sensitive to stimulus onset and offset. Frequent passive attentional shifts might accountforthe effect cognitive psychologists describe as “the breakthrough of the unattended” (Broadbent 1982), that is, that even unattended stimuli may be semantically processed, without assuming automatic semantic processing or late selection in selective attention. The processing negativity supports the early-selection theory and may arise from a mechanism for selectively attending to stimuli defined by certain features. This stimulus selection occurs in the form ofa matching process in which each input is compared with the “attentional trace,” a voluntarily maintained representation of the task-relevant features of the stimulus to be attended. The attentional mechanism described might underlie the stimulus-set mode of attention proposed by Broadbent. Finally, a model of automatic and attentional processing in audition is proposed that is based mainly on the aforementioned ERP components and some other physiological measures.
Other Women's Children
Authors: Malinda H. Bell
Journal: JAMA (1991)

This novel accurately depicts the angst of a female physician who tries to be all things to all people and loses touch with herself in the process. "No wonder I find it mildly soothing to contemplate an airplane crash, a disaster that is beyond my decisions, my interventions, my expertise." Perri Klass has created a character, Amelia, who is so real and so vulnerable that I suspect most of the material is autobiographical. Amelia tries to protect her family from the unpleasantries of her duties as a pediatrician but is only marginally successful. She then puts her family in the situation of not giving her moral support because they don't understand what she has been up against. "If part of my life is making the decision about [a child's DNR order], then how do I downshift and find the right way to navigate the other parts...?" Like many physicians, she
The decrease in C-reactive protein concentration after diet and physical activity induced weight reduction is associated with changes in plasma lipids, but not interleukin-6 or adiponectin
Authors: Alena Dvořáková-Lorenzová, Pavel Suchánek, Peter J. Havel, Petr Stávek, Ludmila Karasová, Zdenĕk Valenta, Jaroslav Tintĕra, Rudolf Poledne
Journal: Metabolism (2006)
The Ecologic Method in the Study of Environmental Health. I. Overview of the Method
Authors: Stephen D. Walter
Journal: Environmental Health Perspectives (1991)

This paper summarizes the salient features of the ecologic method, with emphasis on its application in the study of environmental health. Various types of ecologic design are described, with examples. Finally, the main advantages and disadvantages are indicated. A companion paper discusses the methodology of ecologic designs in more detail and describes a census of data sets with potential suitability for the ecologic study of water quality and human health.
Psychosomatic Aspects of Hyperprolactinemia
Authors: Maurizio Fava, Giovanni A. Fava, Robert Kellner, Maire T. Buckman, Jonathan Lisansky, Emanuela Serafini, Leopoldo DeBesi, Ismaele Mastrogiacomo
Journal: Psychotherapy and Psychosomatics (1983)

A review of some recent studies on the psychosomatic aspects of hyperprolactinemia is presented. Women seem to be more prone to suffer from the behavioral effects of prolactin than males. Women with hyperprolactinemic amenorrhea rated themselves significantly more hostile, more depressed and more anxious than women with amenorrhea only and other control groups. Hyperprolactinemic males did not rate themselves more hostile and depressed than matched controls. Psychological distress and hostility appear to remit upon treatment with bromocriptine. Postpartum patients matched for prolactin levels with hyperprolactinemic women showed significantly less depression and anxiety but about the same levels of hostility. Hostility, depression and loss of libido may coexist in the same hyperprolactinemic patient but they may be also present independently.
A Military Medical School
Authors: Richard L. Egan
Journal: JAMA (1972)

One day last fall, when the House of Representatives passed HR2 authorizing the Department of Defense to establish and operate  medical school, the reaction was certainly restrained. If the corresponding Senate bill is passed and the legislative intent materializes, the traditional relationship between medicine and the military, and between higher education and the federal government, will have been drastically changed.  The recruitment of physicians by the military has always been difficult as indicated by the peristence of the doctor draft. Now, with  national commitment to an all-volunteer military force, and  history of limited interest by physicians in military service beyond the draft, there is concern for the future adequacy of medical care available to members of the military forces.  Introduced by F. Edward Hebert (D-La), the chairman of the House Armed Services Committee, HR 2, a bill to establish  Uniformed Services University of the Health Sciences,
For and against: Should Nottingham University give back its tobacco money? For Against
Authors: R. Smith
Journal: BMJ (2001)

# For and against: Should Nottingham University give back its tobacco money? {#article-title-2}

Richard Smith, editor of the BMJ , is professor of medical journalism at Nottingham University, which has taken £3.8m from British American Tobacco to fund an international centre for the study of corporate responsibility. He argues that the university should return the money. The university's vice chancellor, Sir Colin Campbell, argues the opposite. Readers are asked to vote on bmj.com whether the university should return the money and whether Smith should resign if it doesn't.

Read Smith's arguments for returning the money

Read Campbell's arguments against returning the money

View the results of the voting

Comment on the debate

Read what other people have had to say about it

# For {#article-title-3}

By taking money from the tobacco industry, the University of Nottingham debases itself. It offers the industry—at a cheap price—a respectability it doesn't deserve. Using the money to support an international centre for the study of corporate responsibility is especially unfortunate because the industry has repeatedly behaved irresponsibly. Whatever the internal justification for taking the money, the name of Nottingham University is besmirched.

The question of where “to draw the line” in relation to the tobacco industry arises constantly. Some people think that any contact with the industry is wrong, but the BMJ has not adopted this policy. Thus we publish research funded by the industry, arguing that we would distort the scientific record by refusing to publish. The BMJ has also carried an advertisement from a tobacco company looking for an occupational physician. Our logic was that employees of a tobacco company deserve the best physician they can get; and in Britain you find the best possible doctor by advertising in the BMJ . We have been criticised for both these actions.

So my reaction to Nottingham University taking this money is not a kneejerk response. The university has, I …
The Poor Quality of Early Evaluations of MRI-Reply
Authors: Lawton S. Cooper
Journal: JAMA (1988)

<h3>In Reply. —</h3> The four letters responding to our article have a common defensive theme, particulars of which warrant some comment. The following is a restatement (in italics) or a direct quote, followed by our response in each of four instances. <i>The 54 articles we reviewed were the earliest evaluations of MRI and had the limited goals of developing</i>"diagnostic criteria for the presence or absence of disease" (Drs Berk and Siegelman) and "determining whether a disease could be identified by this new method" (Dr Baum). Answering these questions requires the proper determination of sensitivity and specificity, the lack of which we found so disturbing in so many of the cited articles. We have again gone over all 54 articles, which were originally selected because they evaluated the clinical usefulness of MRI in specific diseases; we found that 49 of them concluded that the procedure was useful, very useful,
Poem not containing the word &lt;emph type="ital"&gt;snake&lt;/emph&gt;
Authors: Ted McMahon
Journal: JAMA (2008)

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