tbuckley/cabot-search huggingface dataset:
PORRO CESAREAN SECTIONS UNDER LOCAL (INFILTRATION) ANESTHESIA
Authors: J. P. GREENHILL
Journal: JAMA (1928)

Local anesthesia has become more and more popular in all fields of surgery. Likewise in obstetrics there has been an extended use of this form of anesthesia. For many years classic cesarean sections have been done under local anesthesia, and in 1925 De Lee<sup>1</sup>pointed out the feasibility and advantages of performing the cervical cesarean section under local (infiltration) anesthesia. However, as far as I am aware, no one has described the performance of Porro cesarean sections (supravaginal hysterectomy after cesarean section) under direct infiltration anesthesia. The four cases here reported illustrate that Porro operations can be done under infiltration anesthesia without any difficulties. For the local anesthetic, 0.5 per cent procaine hydrochloride is used, to which, after sterilization, 2 drops of 1: 1,000 epinephrine are added for each ounce. About 12 ounces (355 cc.) of this solution is prepared but I have never used that much for one
Pathophysiology of Experimental Glomerulonephritis in Rats
Authors: Marjorie E. M. Allison, Curtis B. Wilson, Carl W. Gottschalk
Journal: Journal of Clinical Investigation (1974)

Micropuncture, clearance, immunofluorescence and light microscopy techniques were used to study kidney structure and single nephron function in rats with autologous immune complex nephritis (AICN), a membranous glomerulonephritis developing over 5 to 20 mo, in the more acute and proliferative glomerular basement membrane (GBM) nephritis and in controls. Both models are known to have clinical counterparts in human disease. Kidney functional abnormalities correlated with the degree of architectural derangement. In both AICN and anti-GBM nephritis filtration fraction fell in direct proportion to the fall in glomerular filtration rate (GFR), renal plasma flow being unchanged. Fractional electrolyte excretion increased as the GFR fell. Despite marked heterogeneity of single nephron filtration rate (SNGFR) (AICN, 5-93 nl/min; anti-GBM, 0-50 nl/min) and of proximal tubular hydrostatic pressure (4-48 mm Hg), each nephron showed almost complete glomerulotubular balance, absolute reabsorption to the late proximal convolution varying directly with filtration rate. In addition SNGFR could be related both to proximal intratubular hydrostatic pressure and to calculated glomerular capillary pressure (Pg), being lowest in those nephrons with the highest intratubular pressure. Nephrons with very high filtration rates did not apparently reach filtration equilibrium. Mean SNGFR was significantly lower in the anti-GBM group, while calculated Pg was the same in both. This probably reflects the acute and diffuse involvement of the anti-GBM lesion with different filtration characteristics from the more chronic AICN disease. Tubular damage was more marked in AICN, and extraction of p-aminohippurate was reduced in this group.
RECENT INVESTIGATIONS OF ABSORPTION AND EXCRETION OF LEAD IN THE ORGANISM
Authors: J. C. AUB
Journal: JAMA (1924)

The poisoning caused by lead has been studied since very ancient times. During the last two or three centuries, plumbism has attracted particular interest because of its widespread occurrence. In 1616, Citois, a doctor from Poitiers, showed that the symptoms commonly known as the colic of Poitou were due to the use of bad wine treated with lead, and, in 1767, Sir George Bacon of England wrote an essay in which he traced the cause of so-called Devonshire colic to the use of lead in making cider. Stockhausen, about the middle of the seventeenth century, and several others, somewhat later, published excellent clinical descriptions of the disease, but the best and most accurate picture is that given by Tanquerel des Planches. His two volumes, published in 1834, contain material gathered from 1,200 cases of lead poisoning, and are so complete that later investigations have added little to the knowledge of
The fate and career destinations of doctors who qualified at Uganda's Makerere Medical School in 1984: retrospective cohort study
Authors: Yoswa M Dambisya
Journal: BMJ (2004)

concerns, they will be about under-representation of ethnic minorities and women.The high representation of ethnic minorities, and specifically those of Asian origin, indicates high academic achievement by them.It probably indicates that many of the most able school pupils from these ethnic groups, and perhaps particularly women, choose medicine as a career.The reasons for the substantial under-representation of white men merit further study.With increasing immigration from continental Europe, the broad group of white ethnicity may need further subdivision in future.
Distinct functions for the transcription factors GATA-3 and ThPOK during intrathymic differentiation of CD4+ T cells
Authors: Lie Wang, Kathryn F Wildt, Jinfang Zhu, Xianyu Zhang, Lionel Feigenbaum, Lino Tessarollo, William E Paul, B J Fowlkes, Rémy Bosselut
Journal: Nature Immunology (2008)
Prophylaxis of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis by an Endoscopic Pancreatic Spontaneous Dislodgement Stent
Authors: Atsushi Sofuni, Hiroyuki Maguchi, Takao Itoi, Akio Katanuma, Hiroyuki Hisai, Teitetsu Niido, Masayuki Toyota, Tsuneshi Fujii, Youji Harada, Tadanori Takada
Journal: Clinical Gastroenterology and Hepatology (2007)
Benign and malignant mixed tumours of the lung
Authors: P. W. Davis, J. C. Briggs, R. M. E. Seal, F. K. Storring
Journal: Thorax (1972)

Ten patients are presented with tumours complying with the criteria established by the World Health Organization for `mixed tumours of the lung9. A slowly growing intrabronchial neoplasm indistinguishable from a pleomorphic adenoma (mixed salivary tumour) and a peripheral circumscribed tumour with most of the features of a chondromatous hamartoma were considered benign. Of eight malignant neoplasms two were regarded as `pulmonary blastomas9, one with a benign epithelial tubular component and the other with cytological evidence of malignancy in the tubular epithelium; in both, the stroma was `embryonic9 and pleomorphic. Three tumours were considered carcinosarcomas with a mainly epidermoid epithelial component and a pleomorphic spindle-cell connective tissue component. In the remaining three tumours the malignant epithelial component showed mixed, viz., epidermoid, tubular, and a variety of undifferentiated appearances, while the `stroma9 exhibited features seen in both blastomas and carcinosarcomas. These three neoplasms were considered `transitional9. The spectrum of appearances encountered constitutes, in our opinion, a serious objection to the thesis that peripheral pulmonary blastomas and carcinosarcomas are distinct entities with a separate histogenesis. Exceptions were found to `blastomas9 being peripheral and carcinosarcomas being central growths. A case is made for reclassification of the benign and malignant neoplasms included in the WHO group IX `mixed tumours of the lung9.
Converting-Enzyme Inhibitors in the Treatment of Hypertension
Authors: John A. Oates, Alastair J.J. Wood, Gordon H. Williams
Journal: New England Journal of Medicine (1988)

IN 1982, Vidt and colleagues reviewed the pharmacokinetics, mechanisms of action, and therapeutic usefulness of captopril, the first of a new class of antihypertensives, converting-enzyme inhibitors.1 2 3 A review of the literature from January 1983 through August 1987 (with use of MEDLARS) revealed more than 1200 reports on 16 other such inhibitors. This review will consider the six agents most frequently mentioned — captopril, enalapril, lisinopril, pentopril, ramipril, or alacepril — and their clinical use in hypertension, discussing only double-blind placebo washout comparison studies, except for tabulation of side effects.Biochemistry and PharmacokineticsAll the converting-enzyme inhibitors reviewed have a common . . .
Paramedics and technicians are equally successful at managing cardiac arrest outside hospital
Authors: U M Guly, R G Mitchell, R Cook, D J Steedman, C E Robertson
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To examine the effect on survival of treatment by ambulance paramedics and ambulance technicians after cardiac arrest outside hospital. <b>Design</b>: Prospective study over two years from 1 April 1992 to 31 March 1994. <b>Setting</b>: Accident and emergency department of university teaching hospital. <b>Subjects</b>: 502 consecutive adult patients with out of hospital cardiopulmonary arrest of cardiac origin. <b>Interventions</b>: Treatment by ambulance technicians or paramedics both equipped with semi-automatic defibrillators. <b>Main outcome measures</b>: Rate of return of spontaneous circulation, hospital admission, and survival to hospital discharge. <b>Results</b>: Rates of return of spontaneous circulation, hospital admission, and survival to hospital discharge were not significantly different for patients treated by paramedics as opposed to ambulance technicians. Paramedics spent significantly longer at the scene of the arrest than technicians (P&lt;0.0001). <b>Conclusions</b>: The response of ambulance paramedics to patients with cardiopulmonary arrest outside hospital does not provide improved outcome when compared with ambulance technicians using basic techniques and equipped with semi-automatic defibrillators. <h3>Key messages</h3> Key messages Ambulance paramedics undergo extensive further training in resuscitation techniques No improvement in overall outcome was seen when paramedics attended the patients The government plans to have at least one paramedic in every front line ambulance by the end of 1995 The outcome of patients treated by technicians v paramedics does not justify the government9s plans
Outbreak of trichinosis near Paris.
Authors: P Bouree, J B Bouvier, J Passeron, P Galanaud, J Dormont
Journal: BMJ (1979)

A localised outbreak of trichinosis occurred in January 1976 in the southern suburbs of Paris. A total fo 125 cases was recorded including 30 children. The prominent symptoms were oedema of the face or eyelids, fever, and myalgia; diarrhoea was unusual and constipation common. An increased blood eosinophil count and raised serum concentrations of muscular enzymes strongly indicated trichinosis. This diagnosis was confirmed later immunologically. The parasite was found in only three out of 32 muscle biopsy specimens but this investigation was made relatively early in the disease. No deaths occurred. In all cases clinical recovery was fast and serum antibody titres were maximum during the first month and decreased slowly. The disease was milder and the recovery faster in children than adults. Epidemiological study suggested that horse meat was responsible for the infection, though no meat could be examined.
Bilateral Toxoplasmosis Retinitis Associated with Ruxolitinib
Authors: Roger A. Goldberg, Elias Reichel, Lauren J. Oshry
Journal: New England Journal of Medicine (2013)

Bilateral toxoplasmosis retinitis was diagnosed in a patient with polycythemia vera and myelofibrosis who was being treated with the Janus kinase inhibitor ruxolitinib, presumably as a result of immunosuppression.
BMA is frustrated by pay award for doctors on old contract
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

The BMA has greeted the new pay awards for doctors who stay on their existing contracts rather than choose the new contracts with a sense of frustration and disappointment, claiming the awards will do nothing to improve morale or the problems of recruitment and retention that the profession faces.

The above inflation increases made by the Doctors and Dentists Review Body (DDRB) range from 2.5% for hospital doctors to 2.7% for junior doctors. However, the new contracts incorporate an increase of 3.225% for 2004-5.

Sam Everington, deputy chairman of the BMA, has criticised the awards on the old contract, which have been accepted in …
How Medical Professionals Evaluate Expressions of Probability
Authors: Augustine Kong, G. Octo Barnett, Frederick Mosteller, Cleo Youtz
Journal: New England Journal of Medicine (1986)

Qualitative expressions of probability, such as "likely," have different numerical meanings to different people, which can lead to misunderstanding among physicians and between physicians and patients. In a study conducted through a nationwide interactive computer network based at Massachusetts General Hospital, we gathered information on the meaning of common expressions of probability. Three groups of medical professionals assigned percentage values to 12 expressions of the probability that a given symptom would appear in a patient with an unspecified disease. The median values assigned to these expressions by physicians, medical students, and other professionals were almost the same. Comparisons of the means for 7 of these 12 expressions with those found in an earlier study by other investigators showed that they were quantified in the same order, although they had not been assigned the same numerical values. This degree of agreement among professionals and between studies is encouraging for the future prospects of codifying the meaning of such expressions. The variation among five studies in the mean values assigned to 37 expressions in the medical literature and the variation among individual opinions show that such codification is necessary. In the meantime, the average numerical values presented here for various qualitative expressions of probability could well be used to enhance communication among medical professionals.
Syndrome of Acute Osteomyelitis of the Superior Maxilla in Early Infancy
Authors: Harold Lieberman, Jacob Brem
Journal: New England Journal of Medicine (1959)

OSTEOMYELITIS of the superior maxilla in early infancy gives rise to a train of symptoms and signs, which may be categorized as a syndrome. The condition is rare, but it is adequately described in Duke-Elder's1 textbook on ophthalmology. However, it is hardly or not at all mentioned in standard pediatric textbooks.2 3 4 5 Moreover, in a recent issue of Pediatric Clinics of North America, 6 devoted to the mouth and teeth of the child, it is also not mentioned.Usually, the earliest manifestation of this disease is an involvement of the orbital contents and nose, and therefore an ophthalmologist or rhinologist may be . . .
Anxiety, Alopecia Areata, Neurofibromatosis, Auricular Fibrillation
Authors: D. Hubble, C. H. Rogerson
Journal: BMJ (1944)

The following account of a patient is published because he displayed three disorders whose aetiology and pathogenesis are unknown.His fourth disorder-a psychological state dependent on an unusual personality-appeared to us to stand in aetiological relationship to two of his three abnormal physical states. Case RecordThe patient, a lhouse-painter aged 39, was referred to the Derby- shire Royal Infirmary on May 5, 1943, by Dr. Eileen Crowley for treatment of auricular fibrillation. Personal HistoryHis childhood was quite normal, healthy, and happy.He does not recall any fears or anxieties as a boy.He was the leader of a small group of boys who were rather " young devils."At the age of 12 he passed the necessary examination to enable him to leave school, and he went to work as a riveter's mate.By the time he was 14 he had held a variety of jobs and was earning £2 15s. a week (1918).He was restless and ambitious, and had come to realize how many limitations there were in the life of his childhood; he saw no reason why he should not go a long way.He began to serve an apprenticeship in the carriage-and-wagon works (Midland Railway), but could not tolerate the attempts of the older men to put him in his place.He had a row with one of them and walked out, thinking that he could easily get another job.The post-war difficulties had then begun and he was unable to get work.His pride was hurt, so he falsified his age and joined the Grenadier Guards at 15 years.His father got him out again, but only by paying a forfeit.He was still unable to get a job, and was burning with resentment.
Influencing Self-rated Health Among Adolescent Girls With Dance Intervention
Authors: Anna Duberg, Lars Hagberg, Helena Sunvisson, Margareta Möller
Journal: JAMA Pediatrics (2012)

<h3>Objective</h3>To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems.<h3>Design</h3>Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline.<h3>Setting</h3>A Swedish city with a population of 130 000.<h3>Participants</h3>Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group.<h3>Intervention</h3>The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance.<h3>Main Outcome Measures</h3>Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention.<h3>Results</h3>The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, −0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience.<h3>Conclusions</h3>An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention.
THE PROPHYLAXIS OF TETANUS: A SUMMARY
Authors: A. T. MacConkey
Journal: BMJ (1915)

8IIehoroidal degeneration which seenmedl of doubtful traumatic origln.These have remained oonstant since the patient came unider observation.Left Ei'yle.-Pupilcircular, 3 mm. in diameter, larger than right.Reaction to accommodation and convergence sluggish, but doubtful to light.At the outer margin andl slightlv abovo lhorizontal meridian the iris is detached from its. ciliary border for 2 mm., and shows an identical semilunar-shaped opening to the right eve.Optic disc somewhat paler than normal, withl ill-definedmarginis. 'Surrounding retina showvs some effusion.Red reflex present through openings in bdth irides, but equator of lens not visible.1,195 men -admitted aftr that date -(presumably Qctober 15tlh) Thlere was not a single case of tetanus, though many were severely wounded..Madelung.(1914), speaking of Strassburg where up to October 31st, 1914,there were 15,134 wounded with 101 deatlhs from tetanus, m entionsthat no case of tetanus occuLrred in those wlho were injectedprophylactically before admission intohospitai, but that tetanus occurred in some cases tlhouglh-tlheywe-re received aslortly after being wounded.aid on admission had-a .prophylaeticinjection of seru.Bazy (1915) relates that200 wonded had to be divided into two lots-eaclh 100 containing cases of about the same degree of severity.The one half had propljylactic injections of serum, and _among them there occurred one case of tetanus wlhici developed thec day after the injection.-Among the otlier 100wlho lhad no serum, there were 18 cases of tetanus.There were 10,896 wounded with 129 cases of tetantus, of whom 70 per cent.died.Oneaesse was admittecl into hospital on October 8tl, 1914, andlhad serum the same day.Tetanus began on December 12th and ended fatally on December 18th.
Thrombophilias and Adverse Outcomes of Pregnancy — What Should a Clinician Do?
Authors: Baha M. Sibai
Journal: New England Journal of Medicine (1999)

Approximately 1 to 5 percent of pregnant women have serious complications of pregnancy, such as severe preeclampsia, abruptio placentae, intrauterine fetal death, or severe fetal growth retardation. The rates are even higher among older women, those with preexisting vascular disease (e.g., chronic hypertension, renal disease, or type 1 diabetes mellitus), those with multiple fetuses, and those who have a history of one or more of the complications during a previous pregnancy.13 The triad of severe preeclampsia, abruptio placentae, and fetal growth retardation is an important cause of fetal death, delivery before 34 weeks of gestation, and neonatal illness and . . .
A3.12 Intrarenal Foxp3+ Regulatory T Cells Expansion and Decreased Number of Infiltrating CD4+ T Cells in Murine Lupus by IL-2 Therapy
Authors: A Rose, JY Humrich, G Riemekasten
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background and Objectives</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease characterised by an acquired IL-2 deficiency, which leads to a homeostatic imbalance between regulatory T cells (Treg) and effector T cells (Tcon). Humrich <i>et al</i>, (2010) demonstrated that the IL-2 deficiency in diseased (NZB × NZW) F1 mice can be rebalanced in lymphoid organs using a treatment with recombinant IL-2 (IL-2) by promoting the homeostatic proliferation of regulatory T cells. The aim of this study was to investigate the impact of IL-2 therapy on intrarenal Foxp3+ Treg and kidney infiltrating CD4+ cells in (NZB × NZW) F1 mouse model of lupus nephritis. <h3>Materials and Methods</h3> (NZB × NZW) F1 mice with active nephritis were treated with recombinant IL-2 either over a short period or for a total of 30 days. Absolute numbers, phenotype and proliferation of kidney infiltrating CD4+ T cells were determined by flow cytometry. <h3>Results</h3> (NZB × NZW) F1 mice treated over a short term with IL-2 showed an enhanced proliferation of Foxp3+ Treg and increased numbers and frequency of CD4+Foxp3+ Treg compared to un-treated treated control mice. On the other hand, long term IL-2 treatment did not result in a persistent expansion of the intrarenal Foxp3+ Treg population. Nevertheless, total numbers of kidney infiltrating CD4+ T cells were diminished and the CD4+ T con showed reduced signs of cellular activation. <h3>Conclusions</h3> Our data indicates that short term IL-2 treatment is able to expand the size of the intrarenal Treg pool. In contrast, long term IL-2 treatment decreases the numbers of kidney infiltrating CD4+ T cells. These results may in part explain the delay of disease progression induced by treatment with IL-2 and underline the important role of intrarenal Treg for the suppression of kidney disease in lupus mice. These results also provide additional rationales for an IL-2 based immunotherapy of human disease.