tbuckley/cabot-search huggingface dataset:
Whither the Chronic Disease Hospital?
Authors: Asa P. Ruskin
Journal: JAMA (1975)

RECENT legislation has mandated reclassification of chronic disease hospitals as skilled nursing facilities. This has led to governmental efforts to reduce the costs and extent of care rendered in certain instances. Many diseases run a protracted subacute or chronic course, producing symptoms and disabilities that may last for varying lengths of time or for the rest of the patient's life. Many of these conditions involve slow deterioration, with periods of exacerbation alternating with periods of partial remission. Typical of this category would be rheumatoid arthritis, multiple sclerosis, some forms of chronic pulmonary disease, and chronic renal disease. Other conditions produce rapid onset of severe disability and then tend to stabilize, a characteristic condition being the cerebrovascular accident. A third major group is that of congenital diseases and other conditions requiring prolonged rehabilitation efforts and diseases such as muscular dystrophy that cause progressive deterioration. These categories are by no means all-inclusive,
Surgical Treatment of Muscular Subaortic Stenosis
Authors: DENTON A. COOLEY, ROBERT D. BLOODWELL, GRADY L. HALLMAN, ANTONIO F. LASORTE, ROBERT D. LEACHMAN, DON W. CHAPMAN
Journal: Circulation (1967)

The results of surgical treatment of 26 patients with muscular subaortic stenosis are presented. Left ventricular septectomy was performed in 16 patients, and septal myocardiectomy via a right ventriculotomy was employed in the last ten patients. There were five hospital deaths among these patients, yielding a mortality rate of 19%. Hemodynamic studies after operation in six patients showed relief of functional left ventricular outflow obstruction in all but one patient. This patient subsequently underwent successful right ventricular septectomy. Recently we have employed a right ventriculotomy for excision of septal myocardium during digital exploration of the left ventricular outflow tract. Freedom from serious complications and effectiveness in relieving the subaortic stenosis recommend this technique for patients with obstructive cardiomyopathy.
Spontaneous Hypoglycemia with Insulin Autoimmunity in Graves' Disease
Authors: YUKlMASA Hirata, Masato Tominaga, Jun-Ichi Ito, Akito Noguchi
Journal: Annals of Internal Medicine (1974)

A patient with Graves' disease developed spontaneous hypoglycemia after treatment for 3 weeks with methimazole. The hypoglycemic attacks lasted for 4 days and disappeared spontaneously. Although the patient had never received exogenous insulin, significant insulin-binding antibodies were found in the serum, and a huge amount of immunoreactive insulin (23 100 to 35 280 μU/ml) was extracted from the serum obtained during the hypoglycemic attacks. One year after the episode of hypoglycemia, insulin-binding antibodies and elevated serum immunoreactive insulin were still present in the patient. The autoimmune concept might provide the most plausible explanation for the combination of Graves' disease and spontaneous hypoglycemia in this case.
HLA-B∗1502–bound peptides: Implications for the pathogenesis of carbamazepine-induced Stevens-Johnson syndrome
Authors: Chih-Wen Ou Yang, Shuen-Iu Hung, Chiun-Gung Juo, Ya-Ping Lin, Wu-Hsiang Fang, I.-Hsuan Lu, Shui-Tein Chen, Yuan-Tsong Chen
Journal: Journal of Allergy and Clinical Immunology (2007)
Protein contact dermatitis: myth or reality?
Authors: V. JANSSENS, M. MORREN, A. DOOMS-GOOSSENS, H. DEGREEF
Journal: British Journal of Dermatology (1995)

Protein contact dermatitis is a dermatosis which usually presents as a chronic eczema with episodic acute exacerbations a few minutes after contact with the offending allergen. Patch tests with the responsible allergen are usually negative, and the diagnosis can only be made by means of scratch or prick tests with the allergen. Sometimes, specific IgE antibodies can be detected in the blood. As there is considerable confusion about this entity, we have reviewed the cases reported in the literature.
Alterations of leptin during IFN-α therapy in patients with chronic viral hepatitis
Authors: Theodoros A. Zografos, Eirini I. Rigopoulou, Christos Liaskos, Elias Togousidis, Kalliopi Zachou, Nikolaos Gatselis, Anastasios Germenis, George N. Dalekos
Journal: Journal of Hepatology (2006)
Residential Exposure to Polychlorinated Biphenyls and Organochlorine Pesticides and Risk of Childhood Leukemia
Authors: Mary H. Ward, Joanne S. Colt, Catherine Metayer, Robert B. Gunier, Jay Lubin, Vonda Crouse, Marcia G. Nishioka, Peggy Reynolds, Patricia A. Buffler
Journal: Environmental Health Perspectives (2009)

Incidence of childhood leukemia in industrialized countries rose significantly during 1975-2004, and the reasons for the increase are not understood.We used carpet dust as an exposure indicator to examine the risk of childhood leukemia in relation to residential exposure to persistent organochlorine chemicals: six polychlorinated biphenyl (PCB) congeners and the pesticides alpha- and gamma-chlordane, p,p'-DDT (dichlorodiphenyltrichloroethane), p,p'-DDE (dichlorodiphenyldichloroethylene), methoxychlor, and pentachlorophenol.We conducted a population-based case-control study in 35 counties in northern and central California in 2001-2006. The study included 184 acute lymphocytic leukemia (ALL) cases 0-7 years of age and 212 birth certificate controls matched to cases by birth date, sex, race, and Hispanic ethnicity. We collected carpet dust samples from the room where the child spent the most time before diagnosis (similar date for controls) using a specialized vacuum.Detection of any PCB congener in the dust conferred a 2-fold increased risk of ALL [odds ratio (OR) = 1.97; 95% confidence interval (CI), 1.22-3.17]. Compared with those in the lowest quartile of total PCBs, the highest quartile was associated with about a 3-fold risk (OR = 2.78; 95% CI, 1.41-5.48), and the positive trend was significant (p = 0.017). Significant positive trends in ALL risk were apparent with increasing concentrations of PCB congeners 118, 138, and 153. We observed no significant positive associations for chlordane, DDT, DDE, methoxychlor, or pentachlorophenol. The associations with PCBs were stronger among non-Hispanic whites than among Hispanics despite similar distributions of PCB levels among controls in each racial/ethnic group.Our findings suggest that PCBs, which are considered probable human carcinogens and cause perturbations of the immune system, may represent a previously unrecognized risk factor for childhood leukemia.
The health sector cannot mount an effective response on its own to global health threats
Authors: T. Richards
Journal: BMJ (2013)

<h3>Objective</h3> According to current guidelines on atrial fibrillation (AF), the addition of an antiplatelet therapy to an anticoagulant for a stable vascular disease does not decrease the ischaemic hazard but increases the risk of bleeding. The aim of the study was to assess compliance of practices with existing clinical guidelines concerning the use of anticoagulant-antiplatelet combined therapy in patients 75 years and over with AF. <h3>Methods</h3> This prospective observational study was carried out at the University Hospital of Strasbourg (France) between August 2016 and January 2017 with data collection on 1 day of every month. To be included, the patient had to be 75 years and over with AF and treated with anticoagulant-antiplatelet therapy. The population included all the patients admitted at the hospital excluding those from the Gynaecology-Obstetrics and Paediatrics departments. With regard to clinical ongoing guidelines (French, European, American and Canadian), the patients were sorted into three groups. Group 1: combined therapy in compliance with recommendations; Group 2: combined therapy debatable as to benefit-risk ratio; and Group 3: combined therapy not compliant with recommendations. <h3>Result</h3> Ninety-three out of 3307 patients 75 years and over received anticoagulant-antiplatelet combined therapy prior to their hospital admission. Thirty-two patients (34.4% – Group 1) had experienced an acute event and/or revascularisation within the past year. Twenty-four patients (25.8% – Group 2) had not experienced recent revascularisation and had stable coronary disease but were suffering from peripheral artery disease. Group 3 consisted of 37 patients <b>(39.8%)</b>, none of which had experienced recent revascularisation or had unstable coronary disease. For all groups, the main dual therapy was acetylsalicylic acid + fluindione (59.1%). <h3>Conclusion</h3> In our study, 37 antiplatelet (39.8%) treatments could have been stopped. These results should spur prescribers into regular reassessment of combination antithrombotic therapy since it contributes to polypharmacy and increases the risk of adverse events.
Cardiac metaiodobenzylguanidine uptake in patients with moderate chronic heart failure: relationship with peak oxygen uptake and prognosis
Authors: Alain Cohen-Solal, Yves Esanu, Damien Logeart, Fabienne Pessione, Claude Dubois, Gilles Dreyfus, René Gourgon, Pascal Merlet
Journal: Journal of the American College of Cardiology (1999)
Campaign to revitalise academic medicine calls for radical thinking
Authors: Zosia Kmietowicz
Journal: BMJ (2004)

A campaign to breathe new life into academic medicine has called for a radical rethink on the way medical research is organised in order to capture global health issues that matter to patients and make a difference to their lives.

More than 90 researchers, educators, policy makers, clinicians, and funders from around the world gathered for the campaign's inaugural meeting this week …
Long-term Use of Cholesterol-Lowering Drugs and Cancer Incidence in a Large United States Cohort
Authors: Eric J. Jacobs, Christina C. Newton, Michael J. Thun, Susan M. Gapstur
Journal: Cancer Research (2011)

HMG-coA reductase inhibitors, commonly known as statins, account for the great majority of cholesterol-lowering drug use. However, little is known about the association between long-term statin use and incidence of most types of cancers. We examined the association between long-term use of cholesterol-lowering drugs, predominantly statins, and the incidence of ten common cancers, as well as overall cancer incidence, among 133,255 participants (60,059 men and 73,196 women) in the Cancer Prevention Study II Nutrition Cohort during the period from 1997 to 2007. Multivariate Cox proportional hazards regression was used to estimate relative risks (RR). Current use status and duration of use were updated during follow-up using information from biennial follow-up questionnaires. Current use of cholesterol-lowering drugs for five or more years was not associated with overall cancer incidence (RR = 0.97, 95% CI = 0.92-1.03), or incidence of prostate, breast, colorectal, lung, bladder, renal cell, or pancreatic cancer but was associated with lower risk of melanoma (RR = 0.79, 95% CI = 0.66-0.96), endometrial cancer (RR = 0.65, 95% CI = 0.45-0.94), and non-Hodgkin lymphoma (NHL; RR = 0.74, 95% CI = 0.62-0.89). These results suggest that long-term use of statins is unlikely to substantially increase or decrease overall cancer risk. However, associations between long-term statin use and risk of endometrial cancer, melanoma, and NHL deserve further investigation.
Genetic analysis of DNA from single human oocytes: a model for preimplantation diagnosis of cystic fibrosis.
Authors: C. Coutelle, C. Williams, A. Handyside, K. Hardy, R. Winston, R. Williamson
Journal: BMJ (1989)

Gene sequences in human oocytes were studied to investigate the possibility of diagnosing inherited or sporadic genetic disease before implantation after in vitro fertilisation. By specific amplification the possibility of analysing the DNA from single human oocytes for a specific gene was shown, and genotypes for markers closely linked to cystic fibrosis and Duchenne muscular dystrophy were determined. Single oocytes were used to approximate the total amount of DNA present in a single cell taken for biopsy from a 4-16 cell blastocyst. With a new technique for specific DNA amplification, the polymerase chain reaction, these data can be obtained within several hours of cell isolation. Extreme care must be taken to avoid any contamination of the sample with DNA from other sources. With this technique genotyping for single gene disorders is feasible with an accuracy and on a time scale that would allow implantation of the zygote after in vitro fertilisation without freezing.
Toenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream
Authors: Eun-Hwa Lim, Hyeong-rae Kim, Young-Ok Park, Young Lee, Young-Joon Seo, Chang-Deok Kim, Jeung-Hoon Lee, Myung Im
Journal: Journal of the American Academy of Dermatology (2014)
Simple Conditions of the Oesophagus Simulating Cancer
Authors: R. H. Franklin
Journal: BMJ (1954)

When an elderly patient complains of dysphagia of recent onset suspicion is immediately aroused that the underlying cause is malignant, and further investiga tion usually confirms this suspicion. In recent years, however, an increasing number of patients are found to be suffering from what proves to be a simple condi don. The onset of the dysphagia and the previous his tory of these patients usually give an indication that the cause may be benign, and at the present time strictures due to reflux oesophagitis are frequently diagnosed and treated. In the cases described below the situation was some what different. In each the nature of the symptoms and the radiological appearances deceived experienced sur geons into making a confident diagnosis of cancer. Three of the patients were considered unsuitable for radical cancer surgery, and in every case the dysphagia was so severe that, left untreated, death would appear to have been inevitable. These four patients have come under my care within the last 12 months.
On the Passing of Gerald C. Mueller, MD, PhD (1920–2010)
Authors: Roswell K. Boutwell, Richard R. Burgess, William F. Dove, Henry C. Pitot
Journal: Cancer Research (2011)

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On November 7, 2010, cancer research lost one of its most personable, innovative, and productive investigators, Gerald C. Mueller—known by his friends and associates as Gerry. He had a passion for research that was exemplified by his interactions with his students,
Intrapleural Corynebacterium parvum for malignant pleural effusions.
Authors: R Felletti, C Ravazzoni
Journal: Thorax (1983)

A pilot study of topical (intrapleural) treatment with Corynebacterium parvum was carried out in 10 patients with malignant pleural effusions complicating primary or secondary neoplasms and necessitating frequent thoracocentesis for symptomatic relief. The method was aspiration of all intrapleural fluid except a small portion left for dilution, and then injection of 7 mg of a preparation of Corynebacterium parvum suspended in 20 ml of normal saline solution. The treatment was repeated in each case as clinical conditions called for further thoracocentesis. In eight of these 10 patients the treatment resulted in prompt reduction of the rate of accumulation of pleural fluid and a striking change of cell sediment composition, with appreciable reduction in or complete disappearance of malignant cells and a rise in lymphocyte and neutrophil polymorph counts. The best responders were patients with primary pleural mesothelioma. Clinical improvement was evident in all responders.
Experts aren't news
Authors: B. Dixon
Journal: BMJ (1996)

A man with no credentials in seismology forecast an earthquake in the United States. His prediction was wrong, but triggered off 68 different reports in five of the country's major newspapers. Eighteen months earlier the same papers had published only eight stories following an authoritative prediction by the United States Geological Survey. This earthquake did occur—and caused six billion dollars-worth of damage.

The two cases, analysed by Conrad Smith in Public Understanding of Science (1996,5:205), will appeal to all who enjoy deriding the media. Here are several key ingredients for a robust bout of hack bashing. Journalists want pseudoscience rather than genuine science. They prefer the maverick to the …
Where Are You Going?
Authors: ELIZABETH BARRETT-CONNOR
Journal: Annals of Internal Medicine (1977)

Editorial Notes1 February 1977Where Are You Going?ELIZABETH BARRETT-CONNOR, M.D.ELIZABETH BARRETT-CONNOR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-2-236 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe story of imported malaria is depressingly repetitive. The traveler has received faulty or no advice on the need for prophylaxis, has not heeded recommendations that were made, and suffers a delay in diagnosis and treatment of malaria on return. I have seen a young woman who spent 2 weeks trying to persuade her internist that her alternate-day fever could be malaria; several expensive and some potentially hazardous investigations were performed before a blood smear confirmed the patient's diagnosis. Kean and Reilly (1) have estimated an average cost of nearly $2000 for diagnosis and treatment of malaria in U.S. hospitals,...References1. KEANREILLY BP: Malaria—the mime. Am J Med 61:159-164, 1976 CrossrefMedlineGoogle Scholar2. WALZERGIBSONSCHULTZ PJM: Malaria fatalities in the United States. Am J Trop Med Hyg 23:328-333, 1974 CrossrefMedlineGoogle Scholar3. BARRETT-CONNOR E: Chemoprophylaxis of malaria for travelers. Ann Intern Med 81:219-224, 1975 LinkGoogle Scholar4. : Information on malaria risk for international travelers. Second edition (updated). Wkly Epidemiol Rec 24:181-200, 1976 Google Scholar5. : Health Information for International Travel. DHEW Publication (CDC) 76-8280, 1976 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Community Medicine School of Medicine University of California, San Diego La Jolla, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMalaria in the emergency department 1 February 1977Volume 86, Issue 2Page: 236-237KeywordsBloodFeversMalariaProphylaxis Issue Published: 1 February 1977 PDF downloadLoading ...
Bacteriological colonisation of uterine cavity: role of tailed intrauterine contraceptive device.
Authors: R A Sparks, B G Purrier, P J Watt, M Elstein
Journal: BMJ (1981)

Intrauterine contraceptive devices (IUCDs) are thought to cause pelvic inflammatory disease by allowing vaginal bacteria to pass into the uterus along the tail of the device. In this study the uterine cavities of 22 women using an IUCD were examined by a multiple biopsy technique. All five uteruses with a tailless IUCD were sterile but 15 out of 17 with a tailed device contained bacteria. The bacteria had not reached the fundus and most were commensals. The bacteria were not introduced by insertion of the IUCD as bacteria were present in several cases long after insertion. No differences in bacterial count were found between monofilamentous and multifilamentous devices. Bacteria were cultured from only four devices, which suggested that the bacteria adhere to the endometrium and not to the device. The bacteria in the cavity represent interference by the tail with the protective mechanisms of the uterus, which explains the increase in pelvic inflammatory disease in IUCD users.
HIV Prevention in Clinical Care Settings
Authors: Jeanne M. Marrazzo, Carlos del Rio, David R. Holtgrave, Myron S. Cohen, Seth C. Kalichman, Kenneth H. Mayer, Julio S. G. Montaner, Darrell P. Wheeler, Robert M. Grant, Beatriz Grinsztejn, N. Kumarasamy, Steven Shoptaw, Rochelle P. Walensky, Francois Dabis, Jeremy Sugarman, Constance A. Benson
Journal: JAMA (2014)

Emerging data warrant the integration of biomedical and behavioral recommendations for human immunodeficiency virus (HIV) prevention in clinical care settings.
Bilateral Signet-Ring Cell Carcinoma of the Breast
Authors: CHAN H. PARK, HEE S. WHANG, HEE B. PARK
Journal: Clinical Nuclear Medicine (1996)

Signet-ring cell carcinoma of the breast, first recognized in 1976, behaves aggressively and is associated with a poor prognosis. The tumor is a rare type of breast cancer and often metastasizes to the gastrointestinal tract and female genital tract. The authors report a case of a 48-year-old woman with bilateral signet-ring cell carcinoma of the breasts with multiple skeletal metastases and gastric metastasis. The breast cancer was depicted on a Tc-99m MIBI scintimammogram.
Intrathoracic Gastric Activity on Cholescintigraphy Results in a Large Hiatus Hernia With Duodenogastric Reflux
Authors: Wei-Jen Shih, George Shih, Primo P. Milan, Chih-Yung Chang, Wen-Sheng Huang
Journal: Clinical Nuclear Medicine (2010)

When a radiopharmaceutial is seen in the intrathoracic cavity on Tc-99m iminodiacetic acid (IDA) cholescintigraphy, basically 2 abnormalities are seen: first the stomach, such as a hiatus hernia, which is abnormally located in the thoracic cavity, and duodenogastric reflux (bile) which is simultaneously seen. However, intrathoracic gastric activity seen on Tc-99m IDA hepatobiliary scintigraphy is rarely documented in a patient with hiatus hernia. This report is of an 83-year-old man with a large hiatus hernia with duodenogastric reflux who underwent hepatobiliary scintigraphy; the scans show an area of increased activity on the top of the liver due to duodenogastric reflux in a large hiatus hernia. This was confirmed by surgery: the patient successfully underwent laparoscopic paraesophageal hernia repair with Nessen fundoplication and laparoscopic cholecystectomy.
The Adrenal Cortex in Practical Medicine
Authors: Albert B. Eisenstein
Journal: JAMA (1973)

This short book presents a very brief review of the biochemistry and physiology of the adrenal cortex and moderately detailed discussions of the clinical disorders of the gland. In an attempt to be brief, the material dealing with steroid synthesis and metabolism and measurement of adrenocortical function has been presented superficially. In particular, the effects of physiological and excess amounts of cortisol on intermediary metabolism are inadequately considred. The discussion of the plasma 17-hydroxycorticosteroid determination mentions that 11-deoxycortisol compounds give the same reaction but it does not give an explanation. The importance of pregnanetriol in the diagnosis of congenital adrenal hyperplasia is pointed out, but it is not stated that this steroid is a metabolite of 17-hydroxyprogesterone. The chapters on adrenocortical diseases are more complete; however, some opinions expressed by the author would not be accepted by many endocrinologists. For example, in the chapter on Cushing syndrome it is stated
Bad News and Good News about Obesity
Authors: Theodare B. Van Itallie
Journal: New England Journal of Medicine (1986)

Obesity is known to run in families; however, the meaning of this phenomenon has long been a subject of debate among students of human biology. The problem, of course, has been to determine the relative importance of genetic and environmental influences in the development of obesity. Studies of twins have disclosed a strong genetic component to obesity,1 but some adoption surveys2 , 3 have suggested that the family environment also contributes to the obese state.In this issue of the Journal, Stunkard et al.4 report the results of an adoption study that appears to resolve the controversy. The project used the . . .