tbuckley/cabot-search huggingface dataset:
A Recent Observation on Filaria Nocturna in Culex: Probable Mode of Infection of Man
Authors: G. C. Low
Journal: BMJ (1900)

FILARIA NOCTURNA IN CULEX r [JaiNE 6, 190. was enlarged, and the abdomen markedly distended.The temperature reached the normal line on the thirtieth day.The post-mortem appearances are also similar, as the follow- ing short notes of necropsies performed by Drs.FitzHugh and Handson demonstrate: CAsE S.-Trooper A. B., diagnosed as appendicitis followed by enterica.Necropey: Typhoid ulceration of lower part of ileum.Appendix large, and surrounding area matted with adhesions.Some muco-pus in lumen of appendix.Spleen large and soft.CAsE vi.-Private H. B., diagnosed as enterica with perforation.Necaopay: Typhoid ulceration of ileam, towards the lower part of which was a large perforated ulcer.General suppurative peritonitis.CASE VII.-Private G. W., diagnosed as enterica with broncho-pneumonla.Necrop8y: Typhoid ulceration of ileum; broncho-pneumonia at both bases.CAsE vIII.-PrivateG. K., diagnosed as enteric.Necrop8y: Typhoid ulceration of ileum; large spleen.CASE ix.Private A. W., diagnosed as enteric, with suppurative parot- itis.Necrop8y: Typhoid ulceration of ileum; large soft spleen; pus in both parotids.CASE X. Private E. T., diagnosed as enteric ; hmamorrhages.Necropsy:Typhoid ulceration of ileum and cmecum* large quantity ot dark blood in the intestines; towards the lower part oi ileum a large ulcer, at the base of which was adherent clot; large soft spleen.CAsE XI.Corporal A. B., diagnosed as traumatic suppurative arthritis of knee followed by enteric.Necropsy: Typhoid ulceration of ileum; large spleen; suppurative arthritis of knee.CASE XII.Private J. A., diagnosed as enteric, with
Presenting Quantitative Information About Placebo Rates to Patients
Authors: Helen W. Sullivan, Amie C. O’Donoghue, Kathryn J. Aikin
Journal: JAMA Internal Medicine (2013)

Research suggests that many people do not know the purpose of placebo groups in experiments 1 and do not adequately understand the concept of clinical trial informed consent. 2,3However, people may be able to use placebo group information to draw inferences about drug efficacy, 4 and thus some researchers suggest providing patients with clinical trial information in direct-to-consumer advertising. 5How, then, can we best explain placebo groups in this context?We tested 4 terms to convey the concept of placebo that could be included in direct-to-consumer ads.
Presence or the Emergence of a <i>F317L BCR-ABL</i> Mutation May Be Associated With Resistance to Dasatinib in Philadelphia Chromosome–Positive Leukemia
Authors: Simona Soverini, Giovanni Martinelli, Sabrina Colarossi, Alessandra Gnani, Fausto Castagnetti, Gianantonio Rosti, Costanza Bosi, Stefania Paolini, Michela Rondoni, Pier Paolo Piccaluga, Francesca Palandri, Panagiota Giannoulia, Giulia Marzocchi, Simona Luatti, Nicoletta Testoni, Ilaria Iacobucci, Daniela Cilloni, Giuseppe Saglio, Michele Baccarani
Journal: Journal of Clinical Oncology (2006)
GALACTOSYLATION OF IgG ASSOCIATED OLIGOSACCHARIDES: REDUCTION IN PATIENTS WITH ADULT AND JUVENILE ONSET RHEUMATOID ARTHRITIS AND RELATION TO DISEASE ACTIVITY
Authors: RajB Parekh, DavidA Isenberg, BarbaraM Ansell, IvanM Roitt, RaymondA Dwek, ThomasW Rademacher
Journal: The Lancet (1988)
The pill and breast cancer: why the uncertainty?
Authors: K McPherson, J O Drife
Journal: BMJ (1986)

The use of Oral contraceptive (OC) for family spacing is not associated with any change in the risk of breast cancer.  This conclusion comes as a surprise because OCs reduce the risk of ovarian and endometrial cancer which like breast cancer are hormone dependent.  Furthermore OCs may increase the risk of cervical abnormalities.  Thus epidemiologically it is difficult to understand why the breast is spared any effect protective or otherwise of the longterm use of OCs.  Current concern about OC and the breast focuses on the safety of using OCs  in reproductive life particularly before the 1st pregnancy.  Some epidemiological studies suggest an association between early use and later breast cancer; others do not.  1 possible reason for the uncertainty is that if  use promotes precancerous changes that take time to progress into a tumor which in turn takes time to be diagnosed even recent studies may give misleading results.  The New Zealand report includes most of the cases of breast cancer presenting in New Zealand in the 2 years up to June 1985 and shows no overall increased risk with over 10 years use of OCs and no increase in risk with longterm use before the 1st pregnancy and before age 25.  The Swedish report finds an association between the longterm use of OCs and risk of breast cancer that does not appear to be particularly associated with use before 1st pregnancy.  There is a 2-fold increase in risk for women who have ever used OCs for 8 or more years or for such a period before 1st pregnancy.  Disregarding a latent effect of  use of OCs on breast cancer there are other possible reasons for the discrepancy between these 2 studies.  The Swedish study was conducted at a time of increasing consciousness of a possible association between OC and breast cancer and the accuracy of recall of the use of OCs going back 20 or more years may not have been comparable between cases and controls.  Women with breast cancer have strong reasons for thinking hard about their history; controls have not.  Yet the Swedish study matched the controls with cases very closely.  In the New Zealand study the controls were not individually matched at all and this may be inadequate when one is concerned about a rapidly changing exposure rate.  Finally the types of pill used by the women in these studies may have varied.  The effect of OCs may be altered by hormone and dose as well as by duration of use and the womans age at use.
Segmented Erythrocytes Mistaken for Platelets
Authors: David Kohn
Journal: JAMA (1982)

To the Editor.—  Concerning the letter of Lindquist et al (1981;246:2577), we wonder again how one can rely on the counting of  of such low levels in such a disease.  Recently we compared the counts and peripheral blood smears in two cases of thrombotic thrombocytopenic purpura (TTP), and the impression we gained was that most of the thrombocytes are tiny microangiopathic erythrocytes. Examining more than once the buffy coats and staining with PAS confirmed our impression. Many times the number of  must be much lower than the number given. Probably the same occurs during some phase of the induction treatment in acute leukemias, where particles of destroyed cells may imitate the thrombocytes.
Regular exercise increases brain's memory region in older women, Canadian study shows
Authors: S. Mayor
Journal: BMJ (2014)

Twice weekly aerobic exercise significantly increases the volume of the brain’s hippocampal region in older women with mild cognitive impairment, a small randomised study published this week shows,1 suggesting that exercise helps to reduce cognitive decline.

Canadian researchers randomly allocated 86 women aged 70-80 with probable mild cognitive impairment to three different exercise regimes: aerobic training (brisk walking); resistance training, such as lunges and weights; or balance and muscle toning exercises. Each participant exercised for one …
Clinical utility of a commercial test based on the polymerase chain reaction for detecting Mycobacterium tuberculosis in respiratory specimens.
Authors: D P Chin, D M Yajko, W K Hadley, C A Sanders, P S Nassos, J J Madej, P C Hopewell
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Several studies have reported using methods based on polymerase chain reaction (PCR) to detect Mycobacterium tuberculosis in respiratory tract specimens. However, little is known about the actual clinical utility of PCR-based tests, and it is uncertain if PCR technology can be transferred to the clinical laboratory. To determine its utility, we evaluated a commercially developed PCR test system in a clinical laboratory using consecutive respiratory tract specimens. Microscopic examination of smears stained with acid-fast bacilli (AFB), culture, and a PCR-based test (Amplicor Mycobacterium tuberculosis assay; Roche Molecular Systems) were used to evaluate 535 consecutive sputum and bronchoalveolar lavage specimens from 227 patients. A clinical case definition of tuberculosis was used as the reference-standard to determine the utility of all diagnostic tests. For all specimens from patients with a new or a treatment-failure case of pulmonary tuberculosis, the positivity rate of PCR (58%) was similar to that of culture (56%) (p > 0.90) and substantially greater than microscopic examination of AFB-stained smears (22%) (p < 0.001). PCR and culture detected M. tuberculosis in 46 and 43%, respectively, of the specimens from patients who did not have AFB on microscopic examination of their respiratory tract specimens (p > 0.90). PCR had a false positive rate of 0.8%. In several instances, PCR detected M. tuberculosis when culture did not; and vice versa. The clinical utility of this PCR-based test is similar to that of culture for detecting M. tuberculosis in respiratory tract specimens.(ABSTRACT TRUNCATED AT 250 WORDS)
Patient led conferences: an education for doctors
Authors: M. Levy
Journal: BMJ (2001)

Scientific conferences are an excellent way of keeping up to date with the latest developments in your subject. They are also a useful means of recharging your batteries away from the relentless timetable of clinical service, and an opportunity to share experiences with colleagues in the same specialty. Having become interested in pituitary disease, I decided to go to the Pituitary Foundation's annual conference. This foundation is a patient led organisation that provides support, advice, and education for patients with the whole spectrum of pituitary pathology.

In contrast to previous conferences I have attended, where familiar faces of past and present colleagues abound, I found that I was one of only a few doctors present (apart from the few eminent professors …
Utility of serum immunoglobulin G4 in distinguishing immunoglobulin G4-associated cholangitis from cholangiocarcinoma
Authors: Abdul M. Oseini, Roongruedee Chaiteerakij, Abdirashid M. Shire, Amaar Ghazale, Joseph Kaiya, Catherine D. Moser, Ileana Aderca, Teresa A. Mettler, Terry M. Therneau, Lizhi Zhang, Naoki Takahashi, Suresh T. Chari, Lewis R. Roberts
Journal: Hepatology (2011)

Elevated serum immunoglobulin G4 (sIgG4) is a feature of autoimmune pancreatitis (AIP) and IgG4-associated cholangitis (IAC); a >2-fold increase in sIgG4 is considered highly specific for these disorders. Many patients with IAC present with biliary strictures and obstructive jaundice, making cholangiocarcinoma (CCA) an important differential diagnosis. We determined the value of sIgG4 in distinguishing IAC from CCA. sIgG4 levels were measured in a test cohort of 126 CCA and 50 IAC patients. The results were confirmed in a validation cohort of 161 CCA and 47 IAC patients. Of the 126 CCA patients in the test cohort, 17 (13.5%) had elevated sIgG4 (>140 mg/dL) and four (3.2%) had a >2-fold (>280 mg/dL) increase. Primary sclerosing cholangitis (PSC) was present in 31/126 CCA patients, of whom seven (22.6%) had elevated sIgG4 and two (6.5%) had a >2-fold elevation. Of the 50 IAC patients, 39 (78.0%) had elevated sIgG4 and 25 (50.0%) had a >2-fold increase. The results in the validation cohort were consistent with those of the test cohort.Although elevated sIgG4 levels are characteristic of IAC, some patients with CCA, particularly with PSC, have elevated sIgG4 levels, including a small percentage with a more than a 2-fold increase in sIgG4. Therefore, sIgG4 elevation alone does not exclude the diagnosis of CCA. Depending on the prevalence of the two diagnoses, the use of a 2-fold cutoff for sIgG4 may not reliably distinguish IAC from CCA. At a cutoff of 4 times the upper limit of normal, sIgG4 is 100% specific for IAC.
Suppression of HCV-specific T cells without differential hierarchy demonstrated in persistent HCV infection
Authors: Kazushi Sugimoto, Fusao Ikeda, Jason Stadanlick, Frederick A. Nunes, Harvey J. Alter, Kyong-Mi Chang
Journal: Hepatology (2003)

Hepatitis C virus (HCV) has a high propensity for persistence. To better define the immunologic determinants of HCV clearance and persistence, we examined the circulating HCV-specific T-cell frequency, repertoire, and cytokine phenotype ex vivo in 24 HCV seropositive subjects (12 chronic, 12 recovered), using 361 overlapping peptides in 36 antigenic pools that span the entire HCV core, NS3-NS5. Consistent with T-cell-mediated control of HCV, the overall HCV-specific type-1 T-cell response was significantly greater in average frequency (0.24% vs. 0.04% circulating lymphocytes, P =.001) and scope (14/36 vs. 4/36 pools, P =.002) among the recovered than the chronic subjects, and the T-cell response correlated inversely with HCV titer among the chronic subjects (R = -0.51, P =.049). Although highly antigenic regions were identified throughout the HCV genome, there was no apparent difference in the overall HCV-specific T-cell repertoire or type-1/type-2 cytokine profile relative to outcome. Notably, HCV persistence was associated with a reversible CD4-mediated suppression of HCV-specific CD8 T cells and with higher frequency of CD4(+)CD25(+) regulatory T cells (7.3% chronic vs. 2.5% recovered, P =.002) that could directly suppress HCV-specific type-1 CD8 T cells ex vivo. In conclusion, we found that HCV persistence is associated with a global quantitative and functional suppression of HCV-specific T cells but not differential antigenic hierarchy or cytokine phenotype relative to HCV clearance. The high frequency of CD4(+)CD25(+) regulatory T cells and their suppression of HCV-specific CD8 T cells ex vivo suggests a novel role for regulatory T cells in HCV persistence.
P197 Obtaining a Tissue Diagnosis in Lung Cancer Patients with Poor Performance Status May Not Influence Treatment or Confer Survival Benefit: Abstract P197 Table 1
Authors: JD Maclay, J Farley, C Tweed, J van der Horst, S Bicknell, R Milroy
Journal: Thorax (2012)

<h3>Introduction</h3> Further investigation and treatment following a radiological diagnosis of lung cancer is influenced by the fitness of a patient. A pragmatic approach to investigative procedures is often adopted based on the risks and benefits. Another consideration is whether tissue diagnosis is necessary for anticipated future treatment. Tissue diagnosis is usually deemed essential prior to administration of radical radiotherapy and chemotherapy, but less so for palliative radiotherapy. <h3>Methods</h3> All patients with lung cancer diagnosed in North Glasgow in 2009 and 2010 were prospectively recorded in a registry. We subsequently investigated the relationships between WHO performance status (PS) and tissue diagnosis, treatment and survival. Patients were followed up for at least 18 months after entry into the registry. <h3>Results</h3> 1190 patients were diagnosed with lung cancer during the study period and clinical details were recorded at a multidisciplinary meeting. PS was recorded in 91%. Overall, tissue diagnosis was achieved in 76% of patients. Tissue diagnosis was achieved in 98% of patients with PS 0 following diagnostic procedure or surgery (table 1). Nearly 90% of these patients underwent chemotherapy, surgery or radical radiotherapy. Tissue diagnosis was attempted in 71% and 46% of PS 3 and 4 respectively. Of these patients, treatment was influenced by tissue diagnosis in 15% and 0%. Survival was compared in these patients and there was no difference between patients with a PS of 3 or 4 that had tissue diagnosis attempted and those that did not (median days (interquartile range); PS3: tissue 53 (19–138) vs no tissue 59 (17–156); PS4: 18 (8–36) vs 16 (6–32)). <h3>Conclusions</h3> A significant percentage of patients with performance status 3 and 4 undergo diagnostic tests to establish a tissue diagnosis. However, treatment is only influenced by this in a minority of cases. Considering likely future treatment is important when pursuing a tissue diagnosis in these patients. In addition, attempting tissue diagnosis in these patients did not confer any survival benefit.
Toxicogenomics of subchronic hexachlorobenzene exposure in Brown Norway rats.
Authors: Janine Ezendam, Frank Staedtler, Jeroen Pennings, Rob J Vandebriel, Raymond Pieters, Paolo Boffetta, Johannes H Harleman, Joseph G Vos
Journal: Environmental Health Perspectives (2004)

Hexachlorobenzene (HCB) is a persistent environmental pollutant with toxic effects in man and rat. Reported adverse effects are hepatic porphyria, neurotoxicity, and adverse effects on the reproductive and immune system. To obtain more insight into HCB-induced mechanisms of toxicity, we studied gene expression levels using DNA microarrays. For 4 weeks, Brown Norway rats were fed a diet supplemented with 0, 150, or 450 mg HCB/kg. Spleen, mesenteric lymph nodes (MLN), thymus, blood, liver, and kidney were collected and analyzed using the Affymetrix rat RGU-34A GeneChip microarray. Most significant (p < 0.001) changes, compared to the control group, occurred in spleen, followed by liver, kidney, blood, and MLN, but only a few genes were affected in thymus. This was to be expected, as the thymus is not a target organ of HCB. Transcriptome profiles confirmed known effects of HCB such as stimulatory effects on the immune system and induction of enzymes involved in drug metabolism, porphyria, and the reproductive system. In line with previous histopathological findings were increased transcript levels of markers for granulocytes and macrophages. New findings include the upregulation of genes encoding proinflammatory cytokines, antioxidants, acute phase proteins, mast cell markers, complements, chemokines, and cell adhesion molecules. Generally, gene expression data provide evidence that HCB induces a systemic inflammatory response, accompanied by oxidative stress and an acute phase response. In conclusion, this study confirms previously observed (immuno)toxicological effects of HCB but also reveals several new and mechanistically relevant gene products. Thus, transcriptome profiles can be used as markers for several of the processes that occur after HCB exposure.
The induction of epidermal ornithine decarboxylase following tape stripping is inhibited by a topical vitamin D3 analogue (MC903)
Authors: W. P. ARNOLD, P. C. M. KERKHOF
Journal: British Journal of Dermatology (1991)

The efficacy of MC903, a vitamin D3 analogue, in reducing hyperproliferation as determined by levels of ornithine decarboxylase (ODC) was investigated in a double‐blind study of 15 patients with chronic plaque psoriasis. The lesions of psoriasis were treated for 8 weeks with MC903 in one of two different cream bases or with a placebo cream. Biopsies were taken before and after treatment. In addition an uninvolved area of skin was treated during the last 3 weeks and this as well as control areas were then sellotape stripped and biopsied after 8 h. Clinical improvement was seen in eight out of 11 patients treated with MC903 but there was no reduction in the level of ODC in psoriatic lesions after 8 weeks of treatment. The levels of ODC in the tape‐stripped uninvolved skin after 3 weeks of treatment with MC903 averaged 22·5 ± 4.2 pmol/min/mg protein as compared to 58·6 ± 12·6 pmol/min/mg protein (P= 0·004). The trauma‐induced induction of ODC activity was markedly inhibited by the application of MC903.
The Differential Diagnosis of Hypercalcemia
Authors: Edward T. Wong
Journal: JAMA (1982)

THE PROCESS of diagnosing primary hyperparathyroidism has been one of exclusion of the other causes of hypercalcemia. In the past decade, since the measurement of parathyroid hormone (PTH) by radioimmunoassay became available through commercial laboratories, its use has grown rapidly. Theoretically, PTH levels should be elevated in primary hyperparathyroidism and possibly in malignancies producing PTH ectopically (pseudohyperparathyroidism); in the other causes of hypercalcemia, the levels should be decreased.<sup>1,2</sup>The number of PTH assays ordered at this hospital has reached 350 per year, whereas during the period of 1970 to 1978 the number of new cases of primary hyperparathyroidism was less than ten per year. This suggested that many physicians were ordering PTH measurements early, if not even first, in the evaluation of hypercalcemia, the expectation being that PTH determinations would separate primary hyperparathyroidism from the other causes of hypercalcemia. Before direct measurements of PTH became available, laboratory tests reflecting a
At the Mercy of the Elements
Authors: Samuel Vaisrub
Journal: JAMA (1976)

The first to be recognized as an essential part of a metalloenzyme (carbonic anhydrase), zinc is the latest—if not the last trace metal implicated in deficiency disorders. Until recently, it was assumed that the abundant presence of zinc in meat, whole grain, legumes, and seafood would ensure the needed daily minimum of less than 5 mg/day for the synthesis of more than 20 enzymes of which zinc is an essential cofactor. This assumption appears to be illfounded.  Not too long ago, a JAMA editorial (228:1669-1670, 1974) called attention to the reported zinc deficiency, associated with the distorted or diminished taste and smell sensations that may occur in the wake of respiratory infections 1 or during the course of viral hepatitis. 2 Orally administered zinc alleviated the symptoms.  In a review of the broader ramifications of zinc deficiency, such as some gross disturbances of growth and gonadal development reported from the
Death of the teaching autopsy: Advances in technology have not reduced the value of the autopsy
Authors: G. Fruhbeck
Journal: BMJ (2004)

EDITOR—One of the proposed reasons for the death of the autopsy described by O'Grady is an increased confidence in new diagnostic tools, particularly modern imaging techniques.1 2 Surprisingly, the rate of misdiagnoses detected at autopsy (about 40%) did not improve from 1960-70, before the advent of computed tomography, ultrasound, nuclear scanning, etc, to 1980, after …
Evaluation and Management Guidelines — Fatally Flawed
Authors: Jerome P. Kassirer, Marcia Angell
Journal: New England Journal of Medicine (1998)

Earlier this year, the Health Care Financing Administration (HCFA) and the American Medical Association (AMA), through its Current Procedural Terminology editorial panel, jointly issued draft guidelines for documenting cognitive services (evaluation and management) in the medical record. The guidelines were so stupefyingly complicated, irrelevant to actual patient care, and adversarial in intent that a grass-roots rebellion arose at the AMA's meeting in June. At the committee meeting that discussed evaluation and management guidelines, delegates from nearly every state denounced the plan heatedly, and the House of Delegates overwhelmingly passed a motion rejecting the guidelines and promising to “oppose any documentation . . .
A genomic atlas of mouse hypothalamic development
Authors: Tomomi Shimogori, Daniel A Lee, Ana Miranda-Angulo, Yanqin Yang, Hong Wang, Lizhi Jiang, Aya C Yoshida, Ayane Kataoka, Hiromi Mashiko, Marina Avetisyan, Lixin Qi, Jiang Qian, Seth Blackshaw
Journal: Nature Neuroscience (2010)
Neonates must sometimes be allowed to die, but err in favour of life
Authors: Frank J Leavitt
Journal: BMJ (2005)

EDITOR—Neonatal intensive care medicine and nursing are constantly improving because staff are trying to save increasingly difficult cases.1 Staff will inevitably attempt to save cases that turn out to be hopeless, and decisions will sometimes have to be made to allow the patient to die. Such decisions have to be seen as part of a process that eventually results in more lives being …