tbuckley/cabot-search huggingface dataset:
What the Stethoscope Said
Authors: Lee Sataline
Journal: Annals of Internal Medicine (2002)

Letters21 May 2002What the Stethoscope SaidLee Sataline, MDLee Sataline, MDCheshire, CT 06410 (Sataline)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-10-200205210-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In a eulogy to her defunct stethoscope (1), Bonnie Salomon briefly mentions the history of this once basic diagnostic tool. I would like to add a few historical points.The French physician René Theophile Hyacinthe Laennec indeed devised the principle of the stethoscope in 1816 (2). Previously, physicians conducted auscultation by placing their ears directly against the patient's chest. Reluctant to press his ear against one young woman's embonpoint, Laennec fashioned from three quires of paper a tube with an internal diameter of “three or four lines” (7 to 9 mm). Voila! The first stethoscope. (Perhaps it ...References1. Salomon B. What the stethoscope said. Ann Intern Med. 2001;135:56-7. [PMID: 11434734] LinkGoogle Scholar2. Clendening L. Source Book of Medical History. New York: Dover Publications; 1942:313-30. Google Scholar3. Lyons AS, Petrucelli RJ. Medicine: An Illustrated History. New York: Harry Abrams; 1978:510. Google Scholar4. Mangione S, Nieman LZ. Cardiac auscultatory skills of internal medicine and family practice trainees. A comparison of diagnostic proficiency. JAMA. 1997;278:717-22. [PMID: 9286830] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cheshire, CT 06410 (Sataline) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWhat the Stethoscope Said Bonnie Salomon Metrics 21 May 2002Volume 136, Issue 10Page: 779-780KeywordsAuscultationThoraxWine ePublished: 21 May 2002 Issue Published: 21 May 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Studies on Induced Influenza in Man
Authors: Yasushi Togo
Journal: JAMA (1968)

Prophylactic administration of amantadine hydrochloride diminished significantly the occurrence and severity of experimentally induced Asian influenza illness in double-blind studies conducted in 58 volunteers. No difference in infection (seroconversion) rate was observed but serum neutralizing antibody titers were significantly lower in men receiving amantadine compared to those of control subjects. Reduction in the severity and occurrence of disease and lower postchallenge antibody level are based probably on indirect inhibition of virus multiplication and consequent diminution of antigenic stimulation.
Acute HTLV III infection associated with exanthema, diagnosed by seroconversion
Authors: GUNHILD R.LANGE WANTZIN, B.ORSKOV LINDHARDT, KAARE WEISMANN, KAY ULRICH
Journal: British Journal of Dermatology (1986)

We report three homosexual men who developed malaise, fever and a roseola-like exanthema which disappeared over 2 weeks. During 3 months follow-up, all three patients felt well and had no symptoms. HTLV III seroconversion was detected several weeks after the acute HTLV III infection. In two of the three cases the Western blot technique was able to detect HTLV III antibodies before they were detectable by the ELISA technique.
Role of PDL1 Expression and Tumor Infiltrating Lymphocytes (TILS) in Glioblastoma (GBM) and Brain Metastases (BM)
Authors: A.S. Berghoff, A.W. Wöhrer, G. Widhalm, F. Oberndorfer, K. Dieckmann, M. Filipits, C. Marosi, C. Höller, W. Wick, M. Preusser
Journal: Annals of Oncology (2014)
THE DIAGNOSTIC VALUE OF TUBERCULIN.
Authors: C. M. WOOD
Journal: JAMA (1902)

As a general proposition it may be said that prompt accurate diagnosis is the most difficult and at the same time the most important thing in medicine or surgery. This is especially true in the matter of tuberculous diseases. Recognized early, they are very largely curable; recognized late, the prognosis is relatively and almost absolutely bad. In other words, in tuberculosis the promptness of the diagnosis very largely determines whether the given case shall result in recovery or death. If, then, early diagnosis is of such great importance; if it enables us to transform a hopeless disease into one which is in a large measure curable, it behooves us to make use of every harmless means within our power to discover the lesion and determine its nature at the earliest possible moment. The microscope, the stethoscope, the clinical thermometer and the tape measure are in the hands of every physician;
Understanding the Coronary Heart Disease Versus Total Cardiovascular Mortality Paradox
Authors: Christopher J.L. Murray, Sandeep C. Kulkarni, Majid Ezzati
Journal: Circulation (2006)

Coronary heart disease (CHD) represents the largest share of cardiovascular disease in the United States, but there are conspicuous discrepancies between CHD and total cardiovascular death rates across the states, possibly due in part to variations in physician assignment of causes of death. Our aim was to identify exogenous individual- and community-level predictors of cause-of-death assignment and variability and to use these predictors to improve the comparability of CHD mortality estimates across states.We performed a multinomial logistic regression analysis to estimate the effect of individual- and community-level factors on the likelihood of a death being certified as 1 of 3 ill-defined clusters (general atherosclerosis and unspecified heart disease, heart failure, and cardiac arrest) relative to being certified as CHD. The individual-level variables were the decedent's race, sex, age, education, and place of death; the community-level variable was the number of cardiologists per capita. We used the model to estimate state-level CHD rates that are standardized with regard to the levels of individual- and community-level determinants of cause-of-death assignment. Decedents who died in hospitals and in counties with more cardiologists per capita were more likely to be assigned to CHD than to the ill-defined categories, as were white males relative to other race-sex combinations. Adjustment for these factors resulted in substantially improved correlation between death rates for CHD and all cardiovascular causes. Increases in CHD death rates across states after adjustment for external predictors of cause-of-death assignment ranged from 2% (North Dakota) to 72% (Washington, DC); New York had a decrease (1%) in CHD death rates after adjustment. Nationally, CHD death rates increased 10% for males and 15% for females. The total number of deaths in 2001 attributed to CHD in patients over 30 years of age rose from 433,625 to 489,836 after adjustment.Greater presence of medical knowledge at the time of death, reflected by place of death and cardiologists per capita, reduces the use of the ill-defined cardiovascular clusters. Racial and gender effects on CHD assignment may reflect disparities in access to care and quality of care. By adjusting for differentials in these parameters, a comparable and consistent set of CHD mortality estimates can be created. The role of the exogenous predictors in validity and comparability of cause-of-death statistics should be confirmed in carefully designed validation autopsy studies.
Abstract 4004: Mislocalization of ATBF1 is associated with progression of head and neck squamous cell carcinoma
Authors: Xiaodong Sun, Jie Li, Gabriel Sica, Song-Qing Fan, Yuxiang Wang, Zhengjia Chen, Susan Muller, Zhuo G. Chen, Dong M. Shin, Jin-Tang Dong
Journal: Cancer Research (2011)

Abstract Purpose: In prostate, breast and gastric cancers, the nuclear protein AT-motif Binding Factor 1 (ATBF1) undergoes frequent reduced mRNA expression and genomic alterations. However, the protein level and subcellular localization of ATBF1 have not been well studied in human cancers. In the present study, we examined ATBF1 expression, localization and function in head and neck squamous cell carcinomas (HNSCCs). Experimental Design: ATBF1 expression and localization were examined by immunohistochemistry in a series of 197 surgically dissected HNSCC specimens and correlated with clinical outcomes. In addition, ATBF1 expression was characterized in five HNSCC cell lines. We then mutated the nuclear localization signal (NLS) of ATBF1 and studied the effects of cytoplasmic versus nuclear ATBF1 on the growth kinetics of the 212LN cell line. Results: ATBF1 had a predominantly nuclear localization in hyperplastic squamous epithelium, and nuclear ATBF1 dramatically decreased in invasive tumors. Conversely, cytoplasmic ATBF1 levels progressively increased from dysplasia to invasive tumors. Cytoplasmic ATBF1 levels were significantly inversely correlated with overall survival and disease free survival. Similar expression patterns and subcellular localization of ATBF1 were observed in HNSCC cell lines. In order to better define the role of subcellular localization of ATBF1, we identified and mutated its nuclear localization signal (NLS). Mutation of the NLS converted the inhibitory effect of ATBF1 on cell growth to growth-promoting. Conclusions: Aberrant cytoplasmic localization of ATBF1 is significantly associated progression of HNSCC, and cytoplasmic ATBF1 may be a potential biomarker for its early detection. Our results suggest that nuclear ATBF1 functions as a tumor suppressor in head and neck squamous epithelial cells and that this tumor suppressor effect is sequestered by cytoplasmic localization during HNSCC progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4004. doi:10.1158/1538-7445.AM2011-4004
Counselling and Therapy With Refugees: Psychological Problems of Victims of War, Torture, and Repression
Authors: Harry A. Wilmer
Journal: JAMA (1996)

I eagerly read this book written by a psychologist after seven years on the team of Social Psychiatric Services for Refugees in Amsterdam, the Netherlands. With the massive influx of refugees into the western world and the horrendous political repression, imprisonment, torture, violence, and killing, there is an urgent need for helping professionals and government officials to understand how totalitarian governments destroy hppe for democracy. This book is a welcome overview of healing attempts for refugees. We must look closely at the effect of torture on men, women, and children. No more copouts like the euphemistic oxymoron "compassion fatigue," the buzzword in Washington. There are islands of dedicated people at torture centers for legal and illegal refugees in Europe and throughout the United States. This book covers a vast area of psychological theory and treatment methods for traumatized, uprooted people. It is readable but is an almost overwhelming condensation for
Symptomatic Peripheral Arterial Disease in Women
Authors: Aruna D. Pradhan, Sanjay Shrivastava, Nancy R. Cook, Nader Rifai, Mark A. Creager, Paul M Ridker
Journal: Circulation (2008)

Most investigations of novel biomarkers for prediction of cardiovascular disease pertain to coronary artery disease. Few large-scale prospective studies have critically assessed plasma-based factors as predictors of peripheral arterial disease (PAD), and comparative data between individual biomarkers and lipid levels are sparse, especially among women.We evaluated the relationship between baseline levels of several novel biomarkers and confirmed incident symptomatic PAD (n=100) in a prospective cohort study (median follow-up, 12.3 years) involving 27,935 US female health professionals > or = 45 years of age without diagnosed vascular disease at baseline. Biomarkers assessed were high-sensitivity C-reactive protein, fibrinogen, soluble intercellular adhesion molecule-1 (sICAM-1), homocysteine, lipoprotein(a), hemoglobin A1c, creatinine, and conventional lipid levels. In univariate analyses, levels of high-sensitivity C-reactive protein, fibrinogen, sICAM-1, homocysteine, lipoprotein(a), creatinine clearance, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, and the ratio of total cholesterol to HDL-C (TC:HDL-C) were significantly related to PAD (all P<0.05). However, after multivariable adjustment, risk associations were significant only for high-sensitivity C-reactive protein (adjusted hazard ratio [HR] extreme tertiles, 2.1; 95% confidence interval, 1.2 to 3.7), sICAM-1 (adjusted HR, 4.0; 95% confidence interval, 1.9 to 8.6), HDL-C (adjusted HR, 0.4; 95% confidence interval, 0.3 to 0.8), and TC:HDL-C (adjusted HR, 2.2; 95% confidence interval, 1.2 to 3.9). In a model simultaneously controlling for traditional risk factors plus these significant biomarkers, sICAM-1 remained independently predictive of PAD (adjusted HR in each tertile, 1.0 [reference], 2.3, and 3.5).Among a broad range of biomarkers of cardiovascular risk, only 4 factors, sICAM-1, high-sensitivity C-reactive protein, HDL-C, and TC:HDL-C, were significantly associated with incident symptomatic PAD in women. Findings pertaining to novel biomarkers provide clinical confirmation of a prominent role of endothelial activation and leukocyte recruitment in lower-extremity arterial disease.
Sponsorship, authorship, and accountability
Authors: Frank Davidoff, Catherine D DeAngelis, Jeffrey M Drazen, John Hoey, Lisselotte Højgaard, Richard Horton, Sheldon Kotzin, M Gary Nicholls, Magne Nylenna, A John, PM Overbeke, Harold C Sox, Martin B Van Der Weyden, Michael S Wilkes
Journal: The Lancet (2001)
Medical Safety and Side Effects of Methadone in Tolerant Individuals
Authors: Mary Jeanne Kreek
Journal: JAMA (1973)

In studies of patients having maintenance treatment for heroin addiction (stabilized with methadone hydrochloride in high doses of 80 to 120 mg daily), we found minimal side effects and no toxic effects. These studies have included a prospective study of the first consecutive 214 patients admitted to methadone treatment and reevaluation of the 129 patients of this group still in treatment after three or more years. In addition, we studied 1,435 methadone maintenance patients retrospectively and performed special studies on a smaller group. Abnormalities in liver function and serum protein tests, which were found in 57% and 49% of patients at admission, persisted without significant change during treatment. Increased sweating was reported by 48% and persistent constipation by 17% of patients after methadone treatment for three or more years.
A Systematic Review and Meta-Analysis of Interventions Used to Reduce Exposure to House Dust and Their Effect on the Development and Severity of Asthma
Authors: Clare Macdonald, Anna Sternberg, Paul R. Hunter
Journal: Environmental Health Perspectives (2007)

We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease.Electronic searches on household intervention and atopic disease were conducted in January 2007 in EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. No date or language restriction was placed on the literature search.We included randomized controlled trials comparing asthma outcomes in a household intervention group with either placebo intervention or no intervention.Fourteen studies met the inclusion criteria. Eight recruited antenatally and measured development of atopic disease. Six recruited known atopic individuals and measured disease status change. Meta-analyses on the prevention studies found that the interventions made no difference to the onset of wheeze but made a significant reduction in physician-diagnosed asthma. Meta-analysis of lung function outcomes indicated no improvement due to the interventions but found a reduction in symptom days. Qualitatively, health care was used less in those receiving interventions. However, in one study that compared intervention, placebo, and control arms, the reduction in heath care use was similar in the placebo and intervention arms.This review suggests that there is not sufficient evidence to suggest implementing hygiene measures in an attempt to improve outcomes in existing atopic disease, but interventions from birth in those at high risk of atopy are useful in preventing diagnosed asthma but not parental-reported wheeze.
THE TREATMENT OF MALIGNANT TUMORS BY THE TOXINS OF THE STREPTOCOCCUS OF ERYSIPELAS.
Authors: N. SENN
Journal: JAMA (1895)

It has been known for a long time that in exceptional cases an attack of erysipelas has exerted a curative effect on malignant tumors. A number of years ago Billroth reported a case of inoperable sarcoma of the pharynx cured by a severe attack of facial erysipelas. The tumor mass sloughed and the large defect healed rapidly by granulation, leaving a healthy scar upon the site occupied by the tumor. Isolated cases of this kind have been reported from time to time, but the diagnosis was not always established by sufficiently careful clinical observations and microscopic examination of the tumor tissue. The discovery of the microbe of erysipelas by Fehleisen, and the cultivation of the streptococcus upon artificial nutrient media outside of the body enabled investigators to produce erysipelas artificially in the uncomplicated form in man and the lower animals. As soon as it was demonstrated experimentally that simple uncomplicated
Immunoreactive corticotropin-releasing factor in human plasma.
Authors: T Suda, N Tomori, F Yajima, T Sumitomo, Y Nakagami, T Ushiyama, H Demura, K Shizume
Journal: Journal of Clinical Investigation (1985)

Plasma immunoreactive corticotropin-releasing factor (I-CRF) levels were determined by using a human CRF radioimmunoassay and an immunoaffinity procedure. The basal plasma I-CRF level in normal subjects was 6 +/- 0.5 pg/ml (mean +/- SD). We found that most plasma I-CRF levels were affected by stress, negative feedback, and circadian rhythm. Basal I-CRF levels were high in patients with Addison's disease, Nelson's syndrome, hypopituitarism stemming from pituitary macroadenoma, and CRF- and adrenocorticotropic hormone-producing tumors. A very low, but significant, amount of I-CRF was detected (1-3 pg/ml) in patients with Cushing's syndrome, in corticosteroid-treated patients, and in a patient with hypothalamic hypopituitarism. These results suggest that a major component of plasma I-CRF is of hypothalamic origin, however, other extrahypothalamic tissues cannot be ruled out as a minor source of plasma I-CRF.
Quantitative histological study of mucosal inflammatory cell densities in endoscopic duodenal biopsy specimens from dyspeptic patients using computer linked image analysis.
Authors: J S Collins, P W Hamilton, P C Watt, J M Sloan, A H Love
Journal: Gut (1990)

Inflammatory cell counting in endoscopic biopsy sections was carried out on duodenal mucosal samples from defined sites in patients with duodenal ulcer, duodenitis but no ulcer, non-ulcer dyspepsia, and asymptomatic controls using computer linked image analysis. The variables measured included polymorphonuclear and mononuclear cells per mm of superficial epithelium and per mm2 lamina propria. Duodenal ulcer crater margin and mucosal biopsy specimens from endoscopically inflamed mucosa in the group with duodenitis but no ulcer showed significantly higher inflammatory cell counts than endoscopically normal non-ulcer dyspepsia and control mucosa. Biopsy specimens from non-ulcer dyspepsia patients showed significantly higher lamina propria polymorphs than control group mucosa. Endoscopically normal duodenal ulcer and duodenitis but no ulcer mucosa also showed significantly higher acute and chronic inflammatory cell counts than controls. The prevalence of Helicobacter pylori in duodenal biopsy specimens was low (0-22%) and unrelated to local inflammatory response. Despite histological appearances, duodenal biopsy specimens from non-ulcer dyspepsia patients showed significantly higher inflammatory cell infiltration than control specimens, suggesting that at least some represent part of a spectrum of subclinical peptic disease.
Modulation of morphogenesis by noncanonical Wnt signaling requires ATF/CREB family–mediated transcriptional activation of TGFβ2
Authors: Wenlai Zhou, Lizhu Lin, Arindam Majumdar, Xue Li, Xiaoxue Zhang, Wei Liu, Leah Etheridge, Yunqing Shi, James Martin, Wim Van de Ven, Vesa Kaartinen, Anthony Wynshaw-Boris, Andrew P McMahon, Michael G Rosenfeld, Sylvia M Evans
Journal: Nature Genetics (2007)
The other side of the fence
Authors: R. A. Dobson
Journal: BMJ (2009)

Having recently been ensconced in hospital as an inpatient for seven days, I have been “released” with a new perspective on life as a patient. The clinical care I received was second to none, and I am interminably grateful to all of the healthcare professionals involved. But as the days passed, I began to understand why patients can become so upset, disillusioned, and even aggressive during their hospital stay.

Lying in a hospital bed gives …
Mediastinal Neurilemmoma Demonstrated by Positive Tc-99m(V) DMSA SPECT and Negative Ga-67 Uptake
Authors: BI-FANG LEE, NAN-TSING CHIU, MING-SHYAN HUANG, GIN-CHUNG LIU, HSIN-SU YU
Journal: Clinical Nuclear Medicine (2000)

Schwannoma is a benign neurogenic tumor arising from the sheath of a peripheral nerve. Tc-99m(V) DMSA, developed by Yokoyama et al. in 1981, has been recognized as advantageous for the scintigraphic diagnosis of various malignant tumors and their metastases. Uptake of Tc-99m(V) DMSA was seen not only in malignant tumors but also in benign lesions. Tc-99m(V) DMSA has been reported to accumulate in soft-tissue tumors, such as neurofibromatomas and Schwannomas. In the current report, the authors describe uptake of Tc-99m(V) DMSA in a mediastinal neurilemmoma, but not Ga-67, which is very useful in suggesting the nature of the tumor.
Transmission of Human Immunodeficiency Virus Type 1 from a Seronegative Organ and Tissue Donor
Authors: R.J. Simonds, Scott D. Holmberg, Richard L. Hurwitz, Theresa R. Coleman, Scott Bottenfield, Lois J. Conley, Sherry H. Kohlenberg, Kenneth G. Castro, Beverley A. Dahan, Charles A. Schable, Mark A. Rayfield, Martha F. Rogers
Journal: New England Journal of Medicine (1992)

Since 1985, donors of organs or tissues for transplantation in the United States have been screened for human immunodeficiency virus type 1 (HIV-1), and more than 60,000 organs and 1 million tissues have been transplanted. We describe a case of transmission of HIV-1 by transplantation of organs and tissues procured between the time the donor became infected and the appearance of antibodies. The donor was a 22-year-old man who died 32 hours after a gunshot wound; he had no known risk factors for HIV-1 infection and was seronegative.
Physician of the American Revolution: Jonathan Potts
Authors: Adele Hast
Journal: JAMA (1980)

This fine study delivers simultaneously both more and less than the title suggests. Jonathan Potts does not emerge as a well-delineated personality, since "little information about his private life is available" (p 204). At the same time, Potts's medical career, with stress on his service to the Continental army during the American Revolution, is placed in the historical context of 18th-century medical education, healing theory and practice, organization of the Revolutionary army medical department, and military conflicts. Jonathan Potts served in the northern medical department for the Continental army from 1776. He was deputy-general from April 1777 until his retirement due to ill health in October 1780. During the last 2 1/2 years he was also purveyor-general, responsible for obtaining medical supplies for army hospitals. He was thus in a position to see the chronic problems besetting the army in the care of its soldiers—inadequate supplies and hospital facilities, a