tbuckley/cabot-search huggingface dataset:
Outcomes for Patients With Stroke in Managed Care vs Fee-for-Service-Reply
Authors: Michael J. Barber
Journal: JAMA (1997)

<h3>In Reply.</h3> —We agree with Dr Barber, as we stated in our Editorial, that more studies are needed relating appropriate outcomes of care (for example, differences in functional status related to discharge destination for stroke patients) and optimal resource allocation. We vigorously disagree with his characterizations of the study since best practices with respect to stroke management are well established.<sup>1</sup>While the study by Retchin et al<sup>2</sup>is indeed limited by lack of functional outcomes data, it is consistent with findings of inferior outcomes for elderly HMO patients from the largest, most comprehensive functional outcomes study to date.<sup>3</sup>We still, therefore, are very concerned with regard to how those who are unable to easily and effectively navigate the current health care delivery system fare under corporate medical plans. We do not consider ourselves "anti-managed care." As we pointed out in our Editorial, prepaid delivery systems have the potential to
The Place for Hysterectomy
Authors: Henry Clay Frick
Journal: JAMA (1965)

The diagnosis of carcinoma-in-situ should at all times be confirmed by an adequate cone biopsy of the cervix taken by a sharp knife with the patient anesthetized in the operating room. This procedure is performed to rule out the possibility of an invasive cancer coexisting with the intraepithelial carcinoma. Such a lesion could exist on the portio vaginalis or in the endocervical canal and be missed by the conventional punch biopsy. The management of intraepithelial cancer should be individualized and take into consideration the patient's age and her desire for future child-bearing. In the young, nulliparous female desirous of having a family, conservation of the reproductive organs is important. If pathological examination of an adequate cone biopsy specimen shows that the surgical margins are free, we feel that these patients can be safely followed without further therapy. More radical procedures such as amputation of the cervix would probably result in
Hepatitis C virus types 7, 8 and 9 should be classified as type 6 subtypes
Authors: Masashi Mizokami, Takashi Gojobori, Ken-ichi Ohba, Kazuho Ikeo, Xian-Ming Ge, Tomoyoshi Ohno, Etsuro Orito, Johnson Y.N. Lau
Journal: Journal of Hepatology (1996)
The Roles of Serum Selenium and Selenoproteins on Mercury Toxicity in Environmental and Occupational Exposure
Authors: Chunying Chen, Hongwei Yu, Jiujiang Zhao, Bai Li, Liya Qu, Shuiping Liu, Peiqun Zhang, Zhifang Chai
Journal: Environmental Health Perspectives (2006)

Many studies have found that mercury (Hg) exposure is associated with selenium (Se) accumulation in vivo. However, human studies are limited. To study the interaction between Se and Hg, we investigated the total Se and Hg concentrations in body fluids and serum Se-containing proteins in individuals exposed to high concentrations of Hg. Our objective was to elucidate the possible roles of serum Se and selenoproteins in transporting and binding Hg in human populations. We collected data from 72 subjects: 35 had very low Hg exposure as evidenced by mean Hg concentrations of 0.91 and 1.25 ng/mL measured in serum and urine, respectively; 37 had high exposure (mean Hg concentrations of 38.5 and 86.8 ng/mL measured in serum and urine, respectively). An association between Se and Hg was found in urine (r = 0.625; p < 0.001) but not in serum. Hg exposure may affect Se concentrations and selenoprotein distribution in human serum. Expression of both selenoprotein P and glutathione peroxidase (GSH-Px) was greatly increased in Hg miners. These increases were accompanied by elevated Se concentrations in serum. In addition, selenoprotein P bound more Hg at higher Hg exposure concentrations. Biochemical observations revealed that both GSH-Px activity and malondialdehyde concentrations increased in serum of the Hg-exposed group. This study aids in the understanding of the interaction between Se and Hg. Selenoproteins play two important roles in protecting against Hg toxicity. First, they may bind more Hg through their highly reactive selenol group, and second, their antioxidative properties help eliminate the reactive oxygen species induced by Hg in vivo.
ACUTE PANCREATITIS WITH FAT NECROSIS, COMPLICATED BY DIABETIC COMA
Authors: JUAN RODRIGUEZ
Journal: JAMA (1924)

Acute pancreatitis is one of the most fulminating abdominal diseases with which we have to deal. It is one that demands diagnostic acumen, and, with very few exceptions, surgery is the treatment of choice. The most characteristic symptoms are severe, persistent pain in the midepigastrium just above the umbilicus, vomiting and shock. No time must be lost in opening the abdomen, as a fatal outcome' will supervene in a few hours if this is not done. The exception for not opening the abdomen in these cases is when diabetic coma complicates the pancreatitis. This is rare, but is occasionally encountered, as demonstrated by the following case report. Incidentally, the case illustrates the value of insulin in the treatment of diabetic coma. <h3>REPORT OF CASE</h3><h3>History.</h3> —Mrs. C. H., aged 59, was admitted to the hospital in a semicomatose state. Her family history was not significant. For many years, possibly five,
Holiday Thoughts on Newspaper Clippings
Authors: John Lister
Journal: New England Journal of Medicine (1971)

THE need to have the manuscript arrive on schedule is one of the problems involved in writing a regular column. This was explained to me when I began to contribute to the Journal, and apart from one occasion when a tiresome secretary thought she knew better than I did about the airmail postal rate and understamped the letter, which was sent by sea and arrived too late for press, the London Post so far as I know has otherwise always arrived on time, though rarely with many days to spare. Nevertheless, because this means that it must be ready by . . .
Regurgitation During Induction
Authors: L. Rendell-Baker
Journal: BMJ (1967)

of a needle pick it out.It is the simplest of procedures: the mite clings to the point of the needle, it can be placed on a slide, and its lively antics watched with great amuse- ment under the microscope.This technique takes no more than a few minutes to master and yet I rarely see it practised.It is most impressive to teacher, student, nurse, and patient, and serves good purpose.The problem is quite different for the management of that very rare variety called Norwegian, or crusted, scabies of course.-I am, etc.,
Histochemistry: Theoretic and Applied
Authors: Renato Baserga
Journal: JAMA (1973)

The histochemistry text of Professor Pearse has always been one of the classics for all morphologists interested in localizing chemical compounds or reactions at the cellular level. This is now the second volume of the third edition (the first volume appeared in 1968), and it continues in the traditions of excellence established by the first edition that was published in 1953. The book is continuously revised and improved by the author so that it is kept up to date. Drastic changes have indeed occurred in the 20 years that have elapsed between the appearance of the original edition and this new effort of Professor Pearse. Volume 2, besides continuing the work on enzyme histochemistry, has some particularly interesting chapters on fluorescence microscopy, autoradiography, quantitative histochemistry, and electron histochemistry. As usual, each chapter has an abundant number of references for any investigator who wishes to study in detail a particular technique,
Abstract B2: Oligodendritic precursor mediates vascular remodeling within glioma microenvironment in PDGF-C dependent manner
Authors: Yujie Huang, David Lyden, Jeffrey Greenfield
Journal: Cancer Research (2013)

Abstract The platelet derived growth factor (PDGF) signaling pathway is upregulated in many glioma subtypes, plays a role in gliomagenesis and promotes brain tumor progression. In this study, we demonstrate a role for PDGF signaling in the maintenance of brain tumor microenvironment homeostasis. We detected PDGFRa-expressing stromal cells potentially derived from oligodendritic precursor cells in both human and mouse high-grade gliomas. PDGFRa+ cells are predominately located at the invasive front of gliomas, and have a unique perivascular distribution. We suggest that these stromal cells play an important role in both initiating angiogenesis and supporting tumor progression. In an orthotopic model of glioma in PDGFRa deficient mice, tumor growth was significantly inhibited and gadolinium enhancement was decreased shown by bioluminescence and MRI, respectively. Glioma-associated blood vessels in PDGFRa knockout mice have smaller lumens and relatively normal vascular morphology. Glioma-associated oligodendritic precursor cells promoted endothelial sprouting and tubule formation by abrogating the inhibitory effect of astrocytes. We also demonstrated stromal-derived PDGF-CC as a key factor in the recruitment and activation of PDGFRa+ stromal cells. Utilizing PDGF-CC deficient mice, we recapitulate the glioma phenotype demonstrated in PDGFRa; knockout mice, suggesting their joint contribution to this pathway's integrity. In conclusion, the PDGF-CC/PDGFRa signaling axis in glioma stroma appears to contribute to the remodeling of the vascular architecture in the brain and influences subsequent angiogenesis. Citation Format: Yujie Huang, David Lyden, Jeffrey Greenfield. Oligodendritic precursor mediates vascular remodeling within glioma microenvironment in PDGF-C dependent manner. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Invasion and Metastasis; Jan 20-23, 2013; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2013;73(3 Suppl):Abstract nr B2.
High incidence of ADH2*1/ALDH2*1 genes among Japanese alcohol dependents and patients with alcoholic liver disease
Authors: F Tanaka
Journal: Hepatology (1996)

In an attempt to clarify the genetic factors in alcoholism among the Japanese, polymorphism of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) genes has been investigated. Genetic polymorphism of ADH2/ALDH2 in 66 cases of normal subjects, 90 cases of alcohol dependent, and 31 patients with alcoholic liver disease among Japanese has been analyzed using a polymerase chain reaction assay followed by a direct sequencing method, because ethanol is mainly catabolized by ADH and ALDH and less by cytochrome P450IIE1 and catalase. The incidence of both ADH2*1/*1 and ALDH2*1/*1 was significantly higher in patients with alcohol dependence and in patients with alcoholic liver disease when compared with that in control subjects. In addition, the incidence of ALDH2*1/*2 and ALDH2*2/*2 was significantly reduced in alcoholics compared with control subjects. Genetic polymorphism of ADH2/ALDH2 in patients with alcoholic liver disease was not different from that of alcohol dependents. According to these results, not only ALDH2 gene, often claimed to be responsible for alcohol dependence among Japanese, but also ADH2 gene polymorphism, which modulates the metabolism of ethanol, play important roles in habitual alcohol intake behavior in Japanese patients and in some patients leads to alcoholic liver diseases.
An Effective Hospital Transfusion Committee
Authors: Donald V. Walz
Journal: JAMA (1964)

A transfusion committee was established in a small, nonteaching, community hospital. A monthly tally form was devised to determine blood usage in each department. During a three-year period the amount of blood used for transfusions in this hospital decreased by one third although hospital admissions increased. The greatest reduction in number of transfusions occurred in the surgical and obstetrical services. When the study was begun, the latter department had by far the highest rate of questionable transfusions. As the multipleunit usage diminished, single-unit transfusions increased. A transfusion committee, with a cooperative staff, can make significant improvements in transfusion practices.
CRC Handbook Series in Zoonoses, James H. Steele, ed in chief, Section A: Bacterial, Rickettsial, and Mycotic Diseases
Authors: Richard J. Duma
Journal: JAMA (1981)

The primary purpose of the handbook is "to provide a guide and comprehensive reference source for veterinarians, physicians, and microbiologists, biologists, parasitologists, epidemiologists, health educators, and other health specialists engaged in research, control, and educational activities." This is accomplished through an excellent group of contributors, consisting of more than 50 world-renowned, seasoned veterans and by the editor in chief, James H. Steele, DVM, MPH, a longtime giant in the field of public health and veterinary medicine (especially zoonoses). Although most of the authors are from the fields of veterinary medicine or microbiology, enough physicians, epidemiologists, public health experts, and medical educators are included so that the content is meaningful to the physician. The subject "zoonoses" is defined at the outset as "those diseases and infections that are naturally transmitted between vertebrate animals and man," a definition as suitable today as it was to Virchow more than 100 years ago. In
The New Orchestration
Authors: Samuel Vaisrub
Journal: JAMA (1974)

Reflecting on the nature of the relationships between organs, Lord Russell Brain<sup>1</sup>made the following comment: Transaction is the characteristic feature of our present epoch in medicine. Many of the most important things that happen in the body can no longer be explained simply as the result of interaction of two or more organs, but require the conception of a dynamic transaction which itself integrates the activities of the organs.... In these processes the constituents are themselves affected by what goes on. We are dealing, therefore, not with the interaction of unchanging objects like billiard balls, but with events that can only be expressed in transactional terms. In other words, though physiology and pathology have to take account of what is happening in individual organs, the transaction as a whole is the more important and unifying factor. It is 20 some years since these lines had been written. We
CASE OF POISONING BY RED PRECIPTITATE: PTYALISM: RECOVERY
Authors: F. J. Brown
Journal: BMJ (1854)

pr-oj Ae; but we fe td in affirming s angemeis insixtted could not have been moreXmplee, nor the mean employed better adapted to the ardnd.The two cs befoe deribd, occured before a cordon d be conveniently instituted.The natural conclusion prim4 fa.iededuc0ble perhaps is, that they occurred in caaequesne of the neglect of precautionary measures.But, fresa tha circumstances of the seizure, in both cases, I be- Bve" it probable they would equally have occurred, not- withstandinig the most rigorous exclusion of all coinmuni- cation from without.In the history of cholera in the English asylums, during 1848-9.*not a single patient is xeported to have been attacked through the medium of con- egion; the disease usually broke out simultaneously in various parts of the building and grounds, and frequently in the cleanest and best ventilated galleries, and among the most quiet, cleas, industrious, and respectable patients.In me eases, moreover, no cholera existed at the time in the neighbourhood.[To be continued.
Levonorgestrel Intrauterine System versus Medical Therapy for Menorrhagia
Authors: Janesh Gupta, Joe Kai, Lee Middleton, Helen Pattison, Richard Gray, Jane Daniels
Journal: New England Journal of Medicine (2013)

Menorrhagia is a common problem, yet evidence to inform decisions about therapy is limited. In a pragmatic, multicenter, randomized trial, we compared the levonorgestrel-releasing intrauterine system (levonorgestrel-IUS) with usual medical treatment in women with menorrhagia who presented to their primary care providers.We randomly assigned 571 women with menorrhagia to treatment with levonorgestrel-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone). The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) (ranging from 0 to 100, with lower scores indicating greater severity), assessed over a 2-year period. Secondary outcomes included general quality-of-life and sexual-activity scores and surgical intervention.MMAS scores improved from baseline to 6 months in both the levonorgestrel-IUS group and the usual-treatment group (mean increase, 32.7 and 21.4 points, respectively; P<0.001 for both comparisons). The improvements were maintained over a 2-year period but were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group (mean between-group difference, 13.4 points; 95% confidence interval, 9.9 to 16.9; P<0.001). Improvements in all MMAS domains (practical difficulties, social life, family life, work and daily routine, psychological well-being, and physical health) were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group, and this was also true for seven of the eight quality-of-life domains. At 2 years, more of the women were still using the levonorgestrel-IUS than were undergoing the usual medical treatment (64% vs. 38%, P<0.001). There were no significant between-group differences in the rates of surgical intervention or sexual-activity scores. There were no significant differences in serious adverse events between groups.In women with menorrhagia who presented to primary care providers, the levonorgestrel-IUS was more effective than usual medical treatment in reducing the effect of heavy menstrual bleeding on quality of life. (Funded by the National Institute of Health Research Health Technology Assessment Programme; ECLIPSE Controlled-Trials.com number, ISRCTN86566246.).
Hypoalbuminemia and Decreased Anion Gap
Authors: Albert A. Keshgegian
Journal: JAMA (1982)

To the Editor.—  The article by Nanji et al (1981;246:859) described an association between hypoalbuminemic states and a decreased anion gap, presumably owing to a decrease in unmeasured anionic albumin. However, there is no significant correlation between the individual albumin concentrations and degree of decrease in the anion gap. One would expect, if the decrease in the anion gap were directly related to the low albumin concentration, that lower albumin concentrations would be associated with lower anion gaps. In other protein disorders, such as monoclonal gammopathy in multiple myeloma 1,2 and polyclonal gammopathy in various diseases, 3,4 an association between the quantitative level of abnormal protein and the effect on the anion gap has been shown.  The authors do not report the relationship of total protein concentration and anion gap, even though in most of the hypoalbuminemic groups the total protein concentration would also be expected to be low (eg,
Serosurveillance of prevalence of undiagnosed HIV-1 infection in homosexual men with acute sexually transmitted infection
Authors: M. A Catchpole, C. A McGarrigle, P. A Rogers, L. F Jordan, D. Mercey, O N. Gill
Journal: BMJ (2000)

The prevalence of HIV-1 infection among homosexual and bisexual men attending genitourinary medicine clinics, measured through anonymised testing of samples taken to test for syphilis, has declined in recent years.1 This decline may be spurious, however, because the proportion of such men who have serum samples taken to test for syphilis has declined and because specialist HIV services have drawn patients infected with HIV away from the genitourinary medicine clinics that participate in seroepidemiological surveillance.2 We therefore studied the prevalence of HIV-1 in homosexual and bisexual men without a diagnosis of HIV-1 infection who presented with a new episode of an acute sexually transmitted infection: this group is likely to attend genitourinary medicine clinics and undergo testing for syphilis.
The Impact of Blood Glucose Self-Monitoring on Metabolic Control and Quality of Life in Type 2 Diabetic Patients
Authors: Monica Franciosi, Fabio Pellegrini, Giorgia De Berardis, Maurizio Belfiglio, Donatella Cavaliere, Barbara Di Nardo, Sheldon Greenfield, Sherrie H. Kaplan, Michele Sacco, Gianni Tognoni, Miriam Valentini, Antonio Nicolucci
Journal: Diabetes Care (2001)

The role of self-monitoring of blood glucose (SMBG) in type 2 diabetes is still a matter of debate. In the framework of a nationwide outcomes research program, we investigated the frequency of SMBG and its association with metabolic control and quality of life (QoL).The study involved 3,567 patients with type 2 diabetes who were recruited by 101 outpatient diabetes clinics and 103 general practitioners. Patients completed a questionnaire investigating SMBG practice and QoL (diabetes-related stress, diabetes health distress, diabetes-related worries, and Centers for Epidemiologic Studies-Depression scale).Data on SMBG were available for 2,855 subjects (80% of the entire study population). Overall, 471 patients (17%) stated that they tested their blood glucose levels at home > or =1 time per day, 899 patients (31%) tested their blood glucose levels > or =1 time per week, and 414 patients (14%) tested their blood glucose levels <1 time per week, whereas 1,071 patients (38%) stated that they never practiced SMBG. A higher frequency of SMBG was associated with better metabolic control among subjects who were able to adjust insulin doses, whereas no relationship was found in all other patients, irrespective of the kind of treatment. Multivariate analyses showed that an SMBG frequency > or =1 time per day was significantly related to higher levels of distress, worries, and depressive symptoms in non-insulin-treated patients.Our findings suggest that SMBG can have an important role in improving metabolic control if it is an integral part of a wider educational strategy devoted to the promotion of patient autonomy. In patients not treated with insulin, self-monitoring is associated with higher HbA(1c) levels and psychological burden. Our data do not support the extension of SMBG to this group.
Clinical Evaluation of Tc-99m Cystine A New Renal Radiopharmaceutical
Authors: M MISRA, B K DAS, S GAMBHIR,, B R MITTAL, A B SEWATKAR, S GHOSH, S N BANERJEE
Journal: Clinical Nuclear Medicine (1994)

Tc-99m cystine has been proven to be a good renal agent in animals, but its clinical evaluation has not been reported. In this study, Tc-99m cystine was used for evaluation of renal function in normal subjects and patients with chronic renal failure as well as in renal transplant patients. The results are compared with similar studies that used Tc-99m DTPA and Tc-99m GHA. The clearance values also have been compared with I-131 OIH clearance. The results show that Tc-99m cystine has good radiopharmaceutical characteristics suitable for evaluation of both renal function as well as morphology.
In Vivo Detection of Oxidation-Specific Epitopes in Atherosclerotic Lesions Using Biocompatible Manganese Molecular Magnetic Imaging Probes
Authors: Karen C. Briley-Saebo, Tuyen Hoang Nguyen, Alexander M. Saeboe, Young-Seok Cho, Sung Kee Ryu, Eugenia Volkava, Stephen Dickson, Gregor Leibundgut, Philipp Weisner, Simone Green, Florence Casanada, Yury I. Miller, Walter Shaw, Joseph L. Witztum, Zahi A. Fayad, Sotirios Tsimikas
Journal: Journal of the American College of Cardiology (2012)
New cases of acute childhood asthma decline
Authors: Roger Dobson
Journal: BMJ (2004)

The number of new cases of acute childhood asthma being seen by GPs has declined dramatically over the past decade, new research shows.

The number of cases is less than half that being seen at the peak of the epidemic in the spring of 1993, according to data collected by researchers at the Birmingham research unit of the Royal College of General Practitioners.

The researchers say that many other studies that have shown that the number of cases is still increasing use cumulative prevalence data rather than measuring active disease.

“Everyone keeps …