tbuckley/cabot-search huggingface dataset:
The Practical Values of Certain Antiseptic Agents
Authors: A. Edington
Journal: BMJ (1889)

or when the spinal symptoms have been severe and long-continued, death ensues.Rabbits were extremely insusceptible, doses up to 2 grammes, given subcutaneously, producing no effect except slight diarrhoea.In cats, however, 1 gramme caused excitement, great dilatation of pupils, very great increase in the reflexes, and diarrhoea: 1.7 gramme caused violent tetanus, extreme diarrheea, and death from exhaustion in six hours.The po8t-mortem appearances were extremely striking.The muscles did not respond to stimulation, the small intestine presented a moniliform appearance, and was so contracted as to occlude the lumen, while the bladder was also ex- tremely contracted.The heart's action was comparatively little affected until just before death, which seemed to be due to failure of respiration.(To be continued.)
Hydrochloric Acid Burns of the Stomach
Authors: Arthur S. Tucker
Journal: JAMA (1960)

The ingestion of caustic acid produces effects on the gastrointestinal tract quite different from those caused by strong alkalis. Either acid or alkali usually results in a stomatitis and inflammatory reaction of the tongue and pharynx. In the case of alkalis, however, the major damage usually is in the esophagus; with acids it is usually in the stomach. Alkalis cause so much spasm on contact with the esophageal mucous membrane that they may not reach the stomach at all; if they do, they tend soon to be neutralized by the gastric acids and are unlikely to produce a lasting burn. Acids, on the other hand, are less damaging to the squamous cells lining the esophagus but set up severe reactions when they come in contact with the columnar epithelium of the stomach. Active muscular spasm is initiated in the stomach, particularly in the antrum, where the corrosive is retained long
Is tennis a predisposing factor for degenerative shoulder disease? A controlled study in former elite players
Authors: J Maquirriain, J P Ghisi, S Amato
Journal: British Journal of Sports Medicine (2006)

High demands imposed to the shoulder during tennis activity can decrease the efficiency of static and dynamic constraints. Subtle or frank instability of the glenohumeral joint may occur, and long term degenerative changes may be expected.To determine and compare the prevalence of primary glenohumeral osteoarthritis in senior tennis players and matched controls.Cross sectional controlled study.18 asymptomatic senior tennis players were studied (17 male; mean (SD) age, 57.2 (8.8) years) with no history of shoulder surgery or major trauma. There were 18 matched controls. Radiographs were used to determine glenohumeral osteoarthritic changes: joint space narrowing, humeral and glenoid subchondral sclerosis, humeral and glenoid juxta-articular cysts, osteophytes, humeral and glenoid flattening, humeral posterior displacement and glenoid posterior erosion. Findings were classified as normal, minimal, moderate, or severe changes.33% of the players (95% confidence interval (CI), 13% to 59%) had osteoarthritic changes in their dominant shoulder (n = 6; five with minimal changes, one with moderate changes), and 11% of the controls (95% CI, 1% to 34%) had articular degeneration on their dominant side (n = 2; both minimal changes) (p = 0.04, Wilcoxon test). The osteoarthritic group was significantly older than the players without degenerative changes (p = 0.008).The prevalence of glenohumeral osteoarthritis in the dominant shoulder was greater in former elite tennis players than in sedentary controls. Prolonged intensive tennis practice may be a predisposing factor for the development of mild degenerative articular changes in the dominant shoulder.
Bacteriuria in Elderly Institutionalized Men
Authors: Lindsay E. Nicolle, Janet Bjornson, Godfrey K. M. Harding, J. A. MacDonell
Journal: New England Journal of Medicine (1983)

Over a two-year period we obtained monthly urine samples from all noncatheterized male residents on two geriatric wards to determine the occurrence and optimal management of bacteriuria in this population. Among 88 men the prevalence of bacteriuria was 33 per cent, and the incidence was 45 infections per 100 patients per year. Outcomes after single-dose therapy for asymptomatic bacteriuria with 43 courses of trimethoprim/sulfamethoxazole and 23 of tobramycin included 15 cures, 40 relapses, and 11 treatment failures. Thirty-six residents who had a relapse or in whom single-dose therapy failed were randomly assigned to receive therapy to eradicate bacteriuria or to receive no therapy. All 20 residents who received no therapy remained bacteriuric. The 16 residents who received therapy had fewer months of bacteriuria after randomization, but at the end of the study only one remained free of bacteriuria. Mortality and infectious morbidity after randomization were similar in the two groups. These data suggest that asymptomatic bacteriuria is common in elderly institutionalized men and that therapy is neither necessary nor effective.
DISPOSAL OF RADIOACTIVE EXCRETA IN SANITARY LANDFILLS
Authors: Carol S. Marcus
Journal: Clinical Nuclear Medicine (1984)

Ordinarily, radioactive excreta from patients who have had diagnostic nuclear medicine studies is disposed of through sewage. Occasionally, pediatric patients or incontinent adults soil disposable diapers, and these have traditionally been discarded via ordinary hospital trash, soon to be deposited at a sanitary landfill. The introduction of radiation monitoring at the Puente Hills Sanitary Landfill Site caused many dumpsters to be returned to hospitals for radioactive contamination, mostly from Ga-67 and Tc-99m. This leads to excess garbage lying around hospital grounds, administrator panic, changes in nuclear medicine practice, and increased in-house surveillance to prevent radioactive bins from arriving at the landfill. The expense of all this has been considerable. The three most active Los Angeles County Hospitals estimate a cost of about $240,000 per year to avoid being “caught”. The NaI(T1) detector was originally set at 4X bkgrd (bkgrd=5000 cpm). After initial discussion with the Director of Radiation Management for Los Angeles County the detector threshold was raised to 6X bkgrd. At present, it is planned that the threshold will be raised to 10X bkgrd, thus “missing” most nuclear medicine waste but picking up potentially serious radioactive dumping. Documentation of events at individual hospitals and at Puente Hills is helping us evolve a sensible strategy for radiation monitoring which may well be applicable to other cities.
The streaming liver: Can the age of a hepatocyte be determined from its position on the portohepatic radius?
Authors: Wouter H. Lamers
Journal: Hepatology (1990)

Hepatocyte age was estimated from its distance from the portal tract. We have previously shown that hepatocytes are formed adjacent to the portal tract and stream toward the terminal hepatic vein, advancing at a daily velocity of 2 μm. Thus, the farther a cell from the portal tract, the older it is. This relationship between cell age and distance served here for the study of age–dependent changes in the hepatocyte, particularly nuclear area and DNA content. DNA content was derived from the absorbance of Feulgen–stained nuclei in 5–μm–thick tissue sections. Absorbance and nuclear area were measured with a cytophotometer. Since most nuclei of the tissue section were sliced, DNA content was estimated also in intact nuclei which were sampled by fine needle aspiration, and stained with either Feulgen or propidium iodide. Feulgen–stained nuclei were scanned by a cytophotometer, while the DNA content of propidium iodide–stained nuclei was measured by flow cytometry. Absorbance was expressed in relationship to the mean absorbance of diploid periportal littoral cells. Littoral absorbance was delined as one absorbance unit. A high correlation between nuclear absorbance and area was observed in nuclear suspensions (adjusted r–square 0.79), so that nuclear area may serve as a good predictor of nuclear DNA content, which is valuable in routine sections which are stained with H and E. Most periportal hepatocytes were polyploid and their mean absorbance was 1.68 units. Nuclear absorbance increased with cell distance from the portal tract. Within 100 pm it rose from 1.68 to 1.92 units. Nuclear area increased by 13%. Since the cell covers the 100 pm distance in 60 days, its absorbance increases daily by 0.006 units. Yet since the advancing hepatocyte gets older as it advances, nuclear absorbance increases with hepatocyte age, and so does nuclear area.
Britain's gift: a "Medline" of synthesised evidence
Authors: R. Smith, I. Chalmers
Journal: BMJ (2001)

America's two greatest gifts to the world are jazz and Medline. Now the British government has the chance to match Medline by funding universal free access to what might be described as “a Medline of synthesised, reliable, and up to date evidence.” This could be even more useful to clinicians and patients and has the potential to change health care across the world.

Medline is an electronic index of nearly 4500 journals from over 70 countries compiled by Washington's National Library of Medicine. It has been available online since 1971. Later, Hilary Clinton, then America's first lady, announced worldwide free access to Medline through the internet (www.ncbi.nlm.nih.gov/entrez/). Since then the number of people using it has increased exponentially, and many of them are patients. There is no better free starting point for finding high quality medical information.

But a search of Medline may be frustrating. Although Medline often includes abstracts and free access to the full text of some articles (including those in the BMJ ), clinicians and patients may be overwhelmed by an avalanche of references and abstracts. They only rarely have the time and resources to sift through the output of a search, let alone obtain the full texts of all the articles that may answer their questions. Clinicians and patients need ready access to syntheses of valid, up to date information relevant to their questions.

Recent …
Pediatric Mental Health Care Dysfunction Disorder?
Authors: Erik Parens, Josephine Johnston, Gabrielle A. Carlson
Journal: New England Journal of Medicine (2010)

In February, the American Psychiatric Association released draft revisions for the next iteration of its diagnostic manual (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-V]). One of the draft's most talked-about features is a new diagnostic category for children: temper dysregulation disorder with dysphoria (TDD). The addition has been praised by some as a verdict on one of the hottest questions in child psychiatry: Is the dramatic increase in the number of children with a diagnosis of bipolar disorder appropriate? The answer appears to be no. But the creation of this new category raises another . . .
"Vascular" Purpura Caused by Oxytetracycline
Authors: Myron R. Schoenfeld
Journal: JAMA (1964)

<h3>To the Editor:—</h3> The following report briefly records a unique case of "vascular" purpura occurring as an allergic reaction to small doses of oxytetracycline. Hazards associated with the administration of the drug in the presence of intrinsic renal disease have been recognized. Two cases of thrombocytopenic purpura following the use of oxytetracycline have been reported previously. The patient was a 73-year-old white male who was admitted to our hospital because of empyema secondary to bronchopneumonia. He was treated with surgical drainage and chloramphenicol (Chloromycetin), 500 mg four times daily for four weeks. At the end of this time, the empyema completely resolved. Two weeks later, a low-grade fever recurred because of the exacerbation of a long-standing chronic pyelonephritis, and treatment with oxytetracycline, 500 mg four times daily, was started. On the third day, severe purpura developed. The blood count, platelet count, bone marrow smear, bleeding time, clotting time, and prothrombin
Positional identification of TNFSF4, encoding OX40 ligand, as a gene that influences atherosclerosis susceptibility
Authors: Xiaosong Wang, Massimiliano Ria, Peter M Kelmenson, Per Eriksson, David C Higgins, Ann Samnegård, Christina Petros, Jarod Rollins, Anna M Bennet, Björn Wiman, Ulf de Faire, Charlotte Wennberg, Per G Olsson, Naoto Ishii, Kazuo Sugamura, Anders Hamsten, Kristina Forsman-Semb, Jacob Lagercrantz, Beverly Paigen
Journal: Nature Genetics (2005)
Recalcitrant Papules and Plaques on Perianal Area and Buttocks
Authors: Helena Collgros, Maribel Iglesias-Sancho, Maria-Jose Aldunce-Soto
Journal: JAMA Dermatology (2014)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Liver infiltrating T lymphocytes express interferon gamma and inducible nitric oxide synthase in chronic hepatitis C virus infection
Authors: S Schweyer
Journal: Gut (2000)

<h3>BACKGROUND</h3> Pathogenesis of hepatitis C virus (HCV) associated liver injury is thought to be due to the host antiviral immune response. Using a quantitative, competitive RT-PCR technique, we recently showed that expression of interferon γ (IFN-γ) and IFN-γ inducible type of nitric oxide synthase (iNOS) is increased in homogenised liver tissue of patients with chronic HCV infection. <h3>AIMS</h3> To determine the cellular origin of IFN-γ and iNOS expression and to examine the hypothesis that T cell derived IFN-γ secretion induces iNOS in hepatocytes in chronic HCV infection. <h3>METHODS</h3> By applying a non-radioactive in situ hybridisation method combined with indirect immunofluorescence, 33 liver biopsy specimens from patients with chronic HCV infection were studied for cellular expression of IFN-γ and iNOS mRNA. <h3>RESULTS</h3> In chronic HCV infection, both IFN-γ and iNOS gene expression were significantly increased. IFN-γ and iNOS mRNA were observed in CD3+ lymphocytes infiltrating portal tracts and hepatic lobules, but not in hepatocytes. <h3>CONCLUSIONS</h3> Results are consistent with previous reports that IFN-γ and iNOS transcripts are elevated in chronic HCV infection. In contrast to the hypothesis, IFN-γ expressing T cells do not induce iNOS in hepatocytes, but probably in T cells. T lymphocytes expressing IFN-γ and/or iNOS have the potential to participate in autocrine and paracrine pathways that may contribute to the pathobiology of chronic hepatitis C.
Inhaled Granulocyte/Macrophage–Colony Stimulating Factor as Therapy for Pulmonary Alveolar Proteinosis
Authors: Ryushi Tazawa, Bruce C. Trapnell, Yoshikazu Inoue, Toru Arai, Toshinori Takada, Yasuyuki Nasuhara, Nobuyuki Hizawa, Yasunori Kasahara, Koichiro Tatsumi, Masayuki Hojo, Haruyuki Ishii, Masanori Yokoba, Naohiko Tanaka, Etsuro Yamaguchi, Ryosuke Eda, Yoshiko Tsuchihashi, Konosuke Morimoto, Masanori Akira, Masaki Terada, Junji Otsuka, Masahito Ebina, Chinatsu Kaneko, Toshihiro Nukiwa, Jeffrey P. Krischer, Kohei Akazawa, Koh Nakata
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Inhaled granulocyte/macrophage-colony stimulating factor (GM-CSF) is a promising therapy for pulmonary alveolar proteinosis (PAP) but has not been adequately studied.To evaluate safety and efficacy of inhaled GM-CSF in patients with unremitting or progressive PAP.We conducted a national, multicenter, self-controlled, phase II trial at nine pulmonary centers throughout Japan. Patients who had lung biopsy or cytology findings diagnostic of PAP, an elevated serum GM-CSF antibody level, and a Pa(O(2)) of less than 75 mm Hg entered a 12-week observation period. Those who improved (i.e., alveolar-arterial oxygen difference [A-aDO(2)] decreased by 10 mm Hg) during observation were excluded. The rest entered sequential periods of high-dose therapy (250 microg Days 1-8, none Days 9-14; x six cycles; 12 wk); low-dose therapy (125 microg Days 1-4, none Days 5-14; x six cycles; 12 wk), and follow-up (52 wk).Fifty patients with PAP were enrolled in the study. During observation, nine improved and two withdrew; all of these were excluded. Of 35 patients completing the high- and low-dose therapy, 24 improved, resulting in an overall response rate of 62% (24/39; intention-to-treat analysis) and reduction in A-aDO(2) of 12.3 mm Hg (95% confidence interval, 8.4-16.2; n = 35, P < 0.001). No serious adverse events occurred, and serum GM-CSF autoantibody levels were unchanged. A treatment-emergent correlation occurred between A-aDO(2) and diffusing capacity of the lung, and high-resolution CT revealed improvement of ground-glass opacity. Twenty-nine of 35 patients remained stable without further therapy for 1 year.Inhaled GM-CSF therapy is safe, effective, and provides a sustained therapeutic effect in autoimmune PAP. Clinical trial registered with www.controlled-trials.com/isrctn (ISRCTN18931678), www.jmacct.med.or.jp/english (JMA-IIA00013).
Payment by results—new financial flows in the NHS
Authors: Jennifer Dixon
Journal: BMJ (2004)

Neonatal immaturity of the immune system is currently believed to generally limit the induction of immune responses to vaccine Ags and to skew them toward type 2 responses. We demonstrated here that <i>Bordetella pertussis</i> infection in very young infants (median, 2 mo old) as well as the first administration of whole-cell pertussis vaccine induces <i>B. pertussis</i> Ag-specific IFN-γ secretion by the PBMC of these infants. IFN-γ was secreted by both CD4<sup>+</sup> and CD8<sup>+</sup> T lymphocytes, and the levels of Ag-induced IFN-γ secretion did not correlate with the age of the infants. Appearance of the specific Th-1 cell-mediated immunity was accompanied by a general shift of the cytokine secretion profile of these infants toward a stronger Th1 profile, as evidenced by the response to a polyclonal stimulation. We conclude that the immune system of 2-mo-old infants is developmentally mature enough to develop Th1 responses in vivo upon infection by <i>B. pertussis</i> or vaccination with whole-cell pertussis vaccines.
Putting Power into Patient Choice
Authors: Nancy W. Dickey, Peter McMenamin
Journal: New England Journal of Medicine (1999)

In June 1998, the House of Delegates of the American Medical Association (AMA) adopted a set of recommendations for reform of the health care system. They were outlined in a report by the AMA's Council of Medical Service.1 In this report we call for a fundamental rethinking of the predominant method of health care financing that would shift decision-making authority from employers to individual patients.BackgroundThe patient–physician relationship must ultimately be one of trust, but all too often trusting relationships are disrupted not because of dissatisfaction between patient and physician but because of choices made by the patient's employer, . . .
Eradication of p53-Mutated Head and Neck Squamous Cell Carcinoma Xenografts Using Nonviral p53 Gene Therapy and Photochemical Internalization
Authors: Alioune Ndoye, Gilles Dolivet, Anders Høgset, Agnès Leroux, Alexandre Fifre, Patrick Erbacher, Kristian Berg, Jean-Paul Behr, François Guillemin, Jean-Louis Merlin
Journal: Molecular Therapy (2006)

Photochemical internalization (PCI) technology has been used for PEI-mediated p53 gene transfer in mice bearing head and neck squamous cell carcinoma (HNSCC) xenografts. Using luciferase as a reporter gene, PCI led to a 20-fold increase in transgene expression 48 h after transfection and sustained transgene expression for 7 days. Therefore, iterative p53 gene transfer was performed by means of a weekly single injection of PEIGlu4/p53 complexes alone or with PCI for 5 (group A) or 7 (group B) weeks. The efficiency of p53 gene therapy was evaluated by following tumor growth and expression of P53-related downstream proteins (P21, MDM2, Bcl2, Bax). Apoptosis induction was evidenced through caspase-3 activation and PARP cleavage. Using PCI, tumor growth inhibition was observed in all transfected animals. Further, successful tumor cure was achieved in 17% (group A) and 83% (group B) of animals. PCI-mediated p53 gene transfer led to higher P53 protein expression that was correlated with induction of Bax and P21 proapoptotic proteins, repression of Bcl2 as well as activation of caspase-3, and cleavage of PARP. The present study demonstrates that PCI enhances the in vivo efficiency of PEI-mediated p53 gene transfer and can be proposed for p53 gene therapy in HNSCC.
Homosexuality and parenthood.
Authors: M B King, P Pattison
Journal: BMJ (1991)

Concern about homosexuals as parents rests on three main planks.Firstly, homosexual parents might consciously or unconsciously provide inappropriate role models for sexual development-they might convince their children of the desirability of homo- sexuality or disturb them by overt expression of affection for each other.Secondly, and particularly in relation to homosexual men, they might have sexual relations with their children.Thirdly, the children might be stigmatised by others, particularly their peers, intolerant of their parents' sexuality.There is also an explicit assumption that homosexuality is undesirable and its development in the child is to be avoided.
A dangerous complication of thoracocentesis
Authors: S. R. Eccles
Journal: BMJ (2013)

A 19 year old man with no previous medical problems presented with a six day history of breathlessness and left sided chest pain that had started acutely. His respiratory rate was 22 breaths/min, with oxygen saturations of 95% in room air. A chest radiograph showed a large left pneumothorax with slight mediastinal shift (fig 1⇓).



Fig 1 Chest radiograph taken at presentation



A chest drain that was inserted initially improved his symptoms, but he rapidly deteriorated in the first hour after drain insertion. His breathlessness and pain worsened. He coughed up a large volume of frothy clear yellow sputum. His respiratory rate increased to 35 breaths/min and oxygen saturations fell to 85% on high flow oxygen. Chest radiography was repeated (fig 2⇓).



Fig 2 Chest radiograph taken one hour after insertion of a chest drain





### 1 After chest drain insertion for treatment of a pneumothorax, should the fluid at the underwater seal of the bottle oscillate, bubble, or both?

#### Short answer

The fluid at the underwater seal should oscillate and bubble.

#### Long answer

After insertion of an intercostal chest drain, the drain should be connected to a drainage system containing a valve mechanism.1 In most cases this will be a bottle with an underwater seal that allows fluid or air to escape, but not enter, the pleural cavity. During inspiration the pressure in the pleural cavity falls, causing an upward movement of fluid (towards the pleural cavity) at the underwater seal. During expiration, the pressure in the pleural cavity rises, which causes downward movement of the fluid. This up …