tbuckley/cabot-search huggingface dataset:
Federal and State Relations and the Practice of Medicine
Authors: Christian A. Herter
Journal: New England Journal of Medicine (1955)

ADMITTEDLY, this is a difficult subject to discuss. It is particularly difficult to compress it within the bounds of a short paper. Perhaps, however, this necessity has a certain virtue in preventing a discursive presentation that might well prove less profitable.As one has seen the development of these relations three outstanding characteristics have appeared: the concept of public responsibility for health services for certain groups in the population; the development of a partnership in federal and state governments for financing services; and the trend to utilize the services of private physicians in providing this care.Tradition is of no . . .
Excluding older patients from trials is "bad science," conference hears
Authors: M. Limb
Journal: BMJ (2011)

“Ageism” is thwarting the development of more effective drugs for older people, say pharmacologists.

A conference of experts in London raised strong objections to clinical trials placing an upper age limit on patient participants, which some dubbed “arbitrary” and scientifically unjustified.

The conference, Prescribing without evidence, was held at the Royal College of Physicians on 27 September by the British Pharmacological Society and the Faculty of Pharmaceutical Medicine.

Some 100 experts discussed the problems of prescribing medicines for certain patient groups, including older people, …
BMA chairman resigns over MTAS letter to the <i>Times</i>
Authors: Lynn Eaton
Journal: BMJ (2007)

A meta-analysis of 42 trials of the type 2 diabetes drug rosiglitazone (Avandia) has shown a significantly raised risk of myocardial infarction and an increase in cardiovascular deaths that did not quite reach statistical significance (New England Journal of Medicine 2007 May 21 doi: 10.1056/ NEJMoa072761).The analysis by Steven Nissen and Kathy Wolski, of the Cleveland Clinic, Cleveland, Ohio, included 15 560 patients randomly assigned to regimens that included rosiglitazone, and 12 283 patients assigned to regimens that did not.The mean age of patients was 56 years, and the mean baseline glycated haemoglobin concentration was about 8.2%.Patients receiving rosiglitazone had an odds ratio for myocardial infarction of 1.43 (95% confidence interval 1.03 to 1.98, P=0.03).The odds ratio for death from cardiovascular causes was 1.64 (0.98 to 2.74, P=0.06).An editorial (doi: 10.1056/NEJMe078099) criticised the Food and Drug Administration for approving the drug on the basis of only its efficacy in glycaemic control in short term studies and also for a poor system for reporting adverse events after marketing.Bruce Psaty of the University of Washington in Seattle and Curt Furberg of Wake Forest University in Winston-Salem, North Carolina, also say that the Food and Drug Administration Revitalization Act, now moving through Congress, should be strengthened so that the FDA can follow a drug through its life cycle, with new emphasis on postmarketing.The FDA posted a safety alert on its website, cautioning patients taking the drug who have heart disease or are at high risk of a heart attack to talk to their doctors (www.fda.gov).GlaxoSmithKline said it "strongly disagrees" with the findings (www.gsk.com). Study links diabetes drug to heart deathsUK
Thymic Selection Determines γδ T Cell Effector Fate: Antigen-Naive Cells Make Interleukin-17 and Antigen-Experienced Cells Make Interferon γ
Authors: Kirk D.C. Jensen, Xiaoqin Su, Sunny Shin, Luke Li, Sawsan Youssef, Sho Yamasaki, Lawrence Steinman, Takashi Saito, Richard M. Locksley, Mark M. Davis, Nicole Baumgarth, Yueh-hsiu Chien
Journal: Immunity (2008)
Neurological Surgery: A Comprehensive Reference Guide to Diagnosis and Management of Neurosurgical Problems
Authors: Donald L. Erickson
Journal: JAMA (1990)

The excellent reputation of Youmans'<i>Neurological Surgery</i>has been established by the first two editions. This tradition persists with publication of a third edition to which some 220 authors have contributed. Most chapters are rewritten, many of them by different individuals, thereby not only updating material, but adding new perspectives in these six volumes. The diagnostic section now contains a comprehensible discussion regarding the physics of magnetic resonance imaging, as well as a comparison with computed tomography and recommendations as to which modality to select for diagnosis of various lesions. The scan reproductions are of high quality, and the wide variety of abnormalities demonstrated makes this a convenient reference. Positron emission tomography scanning and thermography are new additions presented in this section as well. Although positron emission tomography scanning has not been readily available or particularly useful clinically, the potential is enormous, and its principles are clearly explained. Volume 2
Hemoglobins in Development and Differentiation
Authors: Yuet Wai Kan
Journal: JAMA (1982)

In recent years, considerable interest in fetal hemoglobins has been stimulated by scientific and practical considerations. From the scientific point of view, learning about the mechanisms that regulate fetal hemoglobins may provide insights into the mechanisms that control the activity of various genes during development in general. On a practical level, understanding more about fetal hemoglobins may help in the treatment of hemoglobin disorders such as sickle cell anemia and Cooley's anemia. A large body of experimental and clinical evidence suggests that if fetal hemoglobin production could be induced in patients with these disorders, their disease would be substantially ameliorated, if not actually cured. Current research focuses on understanding the mechanisms of fetal hemoglobin regulation, with the hope that this knowledge will produce practical approaches to treatment. This book covers, in a comprehensive manner, the current knowledge of hemoglobins in various stages of development in man and other species, and
Propoxyphene Hydrochloride Poisoning
Authors: Joel S. Karliner
Journal: JAMA (1967)

ACUTE POISONING after ingestion of propoxyphene hydrochloride (Darvon) is unusual. A fatal overdose is rarer still. There appear to be only two known detailed reports of deaths directly attributable to propoxyphene ingestion,<sup>1,2</sup>although there is mention in the literature of at least one other fatality.<sup>3</sup>This communication describes a patient who died nine days after taking about 2.3 gm of propoxyphene hydrochloride. <h3>Report of a Case</h3> A 65-year-old white woman underwent pneumonectomy on the right in December 1963 for an endobronchial papillary squamous cell carcinoma. Postoperatively she did well, and at her last clinic visit in February of 1966, she was asymptomatic. Propoxyphene had been prescribed initially for incisional pain and again in April 1965 for headache. In March 1966 she was brought to the emergency room about one hour after she had ingested, according to her husband, approximately thirty-five 65-mg capsules of propoxyphene hydrochloride. Upon arrival she
Inhalation exposure of rats and mice to 1,3-butadiene induces N6-adenine adducts of epoxybutene detected by 32P-postlabeling and HPLC.
Authors: P Koivisto, I D Adler, M Sorsa, K Peltonen
Journal: Environmental Health Perspectives (1996)

In this paper we report DNA binding of butadiene monoepoxide, a first metabolite of 1,3-butadiene catalyzed by monooxygenases. We prepared alkylated purines as marker compounds for 32-P-postlabeling and electrochemical analysis and developed methods to measure the corresponding products. The traditional postlabeling assay was modified by incorporating a solid phase extraction column and high-performance liquid chromatography (HPLC) enrichment steps to the assay prior to labeling. The final analysis of adducted N6 adenines is based on two dimensional thin-layer chromatography (TLC) and an on-line HPLC/radioactivity analysis. The qualitative and quantitative results are based on positively identified marker compounds. Alkylated N7 guanines were released from DNA by neutral thermal hydrolysis, prepurified by HPLC, and analyzed by HPLC with a sensitive electrochemical detection procedure. By using these methods, we found alkylation of calf thymus DNA exposed to butadiene monoepoxide in vitro at adenine N6 and guanine N7 sites. Analysis of lung DNA samples from mice and rats exposed to butadiene through inhalation showed that adenine N6 adducts were formed in vivo in a dose responsive manner.
Immunologic Reaction to Duck Embryo Rabies Vaccine
Authors: Peter L. Perine
Journal: JAMA (1968)

Local cutaneous reactions and diffuse neurological dysfunction occurred in a patient during immunization with duck embryo rabies vaccine. Attempts to isolate an infectious agent were not successful, and it was concluded that the illness was the result of an immunologic reaction to the vaccine. The patient recovered without specific therapy. The patient's serum contained precipitating antibodies against the vaccine, and intradermal testing with the vaccine induced induration at 24 hours. These findings were interpreted to indicate that both Arthus-like reactions and delayed hypersensitivity may have to be operative in the clinical disorder.
Not enough evidence to justify ovarian cancer screening
Authors: R. Woodman
Journal: BMJ (1999)

Screening women for ovarian cancer should not be considered until the potential benefit, harm, and cost have been assessed in randomised clinical trials, says a report from the NHS Centre for Reviews and Dissemination.

Dr Ruth Bell, a visiting research fellow at the centre, and her coauthors said that a systematic review of prospective screening studies showed that ultrasound screening and the serum test for CA125 could detect ovarian cancer …
Transfemoral Aortic Valve Implantation for Severe Aortic Regurgitation After David Procedure
Authors: Alexander Lauten, Axel Linke, Hans R. Figulla, Khosro Hekmat, Andreas Ragoschke-Schumm, Florian Krizanic, Christian Jung, Bjoern Goebel, Markus Ferrari
Journal: Journal of the American College of Cardiology (2010)
Renal Tubular Acidosis Secondary to Degraded Tetracycline.
Authors: John M. Weller
Journal: Annals of Internal Medicine (1964)

s1 April 1964Renal Tubular Acidosis Secondary to Degraded Tetracycline.John M. Weller, M.D., F.A.C.P., Laurence Wegienka, M.D.John M. Weller, M.D., F.A.C.P.Search for more papers by this author, Laurence Wegienka, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-738_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA 39-year old female acutely developed severe acidosis following ingestion of outdated tetracycline. Studies with the ammonium chloride loading test done 2 months after the acute episode showed a persistent renal tubular defect in hydrogen ion excretion. This tubular disorder appeared to be a primary deficiency in renal tubular cell hyrogen ion production or transport, or both. There was no evidence for defective renal tubular bicarbonate re-absorption, inadequate ammonia formation or insufficiency of phosphate ion excretion to act as a hydrogen ion acceptor. Re-valuation 1½ yr later, also with ammonium chloride loading, showed that renal tubular hydrogen ion excretion had... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1964Volume 60, Issue 4Page: 738-738KeywordsAmmoniaBicarbonatesChloridesExcretionIngestionPhosphatesTetracyclinesTubular cells Issue Published: 1 April 1964 PDF downloadLoading ...
WHO is producing a reproductive health library for developing countries
Authors: A M. Gulmezoglu, J. viller, G. Carroli, J. Hofmeyr, A. Langer, K. Schulz, R. Guidotti
Journal: BMJ (1997)

Editor—We agree with Neil Pakenham-Walsh and colleagues that lack of access to reliable, up to date medical information on effective treatments is one of the most important problems faced by health workers in developing countries.1 To address this need in reproductive health we have initiated the World Health Organisation Reproductive Health …
A phase 1 study of heat/phenol‐killed, <i>E. coli</i>‐encapsulated, recombinant modified peanut proteins Ara h 1, Ara h 2, and Ara h 3 (EMP‐123) for the treatment of peanut allergy
Authors: R. A. Wood, S. H. Sicherer, A. W. Burks, A. Grishin, A. K. Henning, R. Lindblad, D. Stablein, H. A. Sampson
Journal: Allergy (2013)

Abstract Background Immunotherapy for peanut allergy may be limited by the risk of adverse reactions. Objective To investigate the safety and immunologic effects of a vaccine containing modified peanut proteins. Methods This was a phase 1 trial of EMP ‐123, a rectally administered suspension of recombinant Ara h 1, Ara h 2, and Ara h 3, modified by amino acid substitutions at major IgE‐binding epitopes, encapsulated in heat/phenol‐killed E. coli . Five healthy adults were treated with 4 weekly escalating doses after which 10 peanut‐allergic adults received weekly dose escalations over 10 weeks from 10 mcg to 3063 mcg, followed by three biweekly doses of 3063 mcg. Results There were no significant adverse effects in the healthy volunteers. Of the 10 peanut‐allergic subjects [4 with intermittent asthma, median peanut IgE 33.3 kU A /l (7.2–120.2), and median peanut skin prick test wheal 11.3 mm (6.5–18)]; four experienced no symptoms; one had mild rectal symptoms; and the remaining five experienced adverse reactions preventing completion of dosing. Two were categorized as mild, but the remaining three were more severe, including one moderate reaction and two anaphylactic reactions. Baseline peanut IgE was significantly higher in the five reactive subjects (median 82.4 vs 17.2 kU A /l, P = 0.032), as was baseline anti‐Ara h 2 IgE (43.3 versus 8.3, P = 0.036). Peanut skin test titration and basophil activation (at a single dilution) were significantly reduced after treatment, but no significant changes were detected for total IgE, peanut IgE, or peanut IgG4. Conclusions Rectal administration of EMP ‐123 resulted in frequent adverse reactions, including severe allergic reactions in 20%.
Multiple Vesico-Urethral Biopsies Following Radical Prostatectomy: The Predictive Roles of TRUS, DRE, PSA and the Pathological Stage
Authors: Vincenzo Scattoni, Marco Roscigno, Marco Raber, Francesco Montorsi, Luigi Da Pozzo, Giorgio Guazzoni, Massimo Freschi, Patrizio Rigatti
Journal: European Urology (2003)
Yellow jacket venom allergens, hyaluronidase and phospholipase: Sequence similarity and antigenic cross-reactivity with their hornet and wasp homologs and possible implications for clinical allergy☆, ☆☆, ★, ★★
Authors: T KING, G LU, M GONZALEZ, N QIAN, L SOLDATOVA
Journal: Journal of Allergy and Clinical Immunology (1996)
Vocal Arts Medicine: The Care and Prevention of Professional Voice Disorders
Authors: Gregory J. Matz
Journal: JAMA (1994)

The subspecialty of laryngology was well established in the middle part of the 19th century when the laryngeal mirror was developed. Lately, the establishment of video-stroboscopy evaluation of the larynx and pharynx has made laryngology a dynamic specialty. I could not tell from the title what audience or readership would benefit but ultimately found that<i>Vocal Arts Medicine</i>would be of value and interest to practicing otolaryngologists, residents in training, voice and speech therapists, and teachers of voice. This excellent book represents a multidisciplinary approach to the evaluation and treatment of speech and voice disorders and is well edited by authors experienced in this field. It is highly readable with excellent graphic design. Especially noteworthy is new information on voice education and health care of young voices. I particularly liked the interesting information learned on disorders of speaking and the professional voice. The chapter on physi
Evidence from samples of one
Authors: Astier M Almedom
Journal: BMJ (2004)

P ersonal accounts of medical ordeals make illuminating contributions to the published literature on evidence. Left undocumented, the triumphs over cancer of Susan Sontag ( Illness as Metaphor ) and Michael Gearin-Tosh ( Living Proof ), the late Alice Trillin's battles with the aftermath of treatment for lung cancer ( N Engl J Med 1981;304: 699), and Lenore Manderson's account of a sudden onset of brachial plexopathy ( Internal Medicine Journal 2002;32: 353) might have been classified as “anecdotal evidence,” for which evidence based medicine has little or no place. Some doctors do, however, use evidence from single case studies, gaining understanding of medical phenomena encountered in their social and ecological contexts.

The following brief summary of an ongoing longitudinal observation study of childhood idiopathic thrombocytopenic purpura (ITP) aims to contribute to this body of literature. Although case specific by nature, certain principles pertaining to medical decision making processes are likely to be transferable. The subject of this case study happens to be my first born child, who had the …
Weight loss and incidence of diabetes with the Veterans Health Administration MOVE! lifestyle change programme: an observational study
Authors: Sandra L Jackson, Qi Long, Mary K Rhee, Darin E Olson, Anne M Tomolo, Solveig A Cunningham, Usha Ramakrishnan, K M Venkat Narayan, Lawrence S Phillips
Journal: The Lancet Diabetes & Endocrinology (2015)
Apo E structure determines VLDL clearance and atherosclerosis risk in mice
Authors: Christopher Knouff, Myron E. Hinsdale, Hafid Mezdour, Michael K. Altenburg, Masahiko Watanabe, Steven H. Quarfordt, Patrick M. Sullivan, Nobuyo Maeda
Journal: Journal of Clinical Investigation (1999)

We have generated mice expressing the human apo E4 isoform in place of the endogenous murine apo E protein and have compared them with mice expressing the human apo E3 isoform. Plasma lipid and apolipoprotein levels in the mice expressing only the apo E4 isoform (4/4) did not differ significantly from those in mice with the apo E3 isoform (3/3) on chow and were equally elevated in response to increased lipid and cholesterol in their diet. However, on all diets tested, the 4/4 mice had approximately twice the amount of cholesterol, apo E, and apo B-48 in their VLDL as did 3/3 mice. The 4/4 VLDL competed with human LDL for binding to the human LDL receptor slightly better than 3/3 VLDL, but the VLDL clearance rate in 4/4 mice was half that in 3/3 mice. On an atherogenic diet, there was a trend toward greater atherosclerotic plaque size in 4/4 mice compared with 3/3 mice. These data, together with our earlier observations in wild-type and human APOE*2-replacement mice, demonstrate a direct and highly significant correlation between VLDL clearance rate and mean atherosclerotic plaque size. Therefore, differences solely in apo E protein structure are sufficient to cause alterations in VLDL residence time and atherosclerosis risk in mice.
Soluble vascular cell adhesion molecule-1 (VCAM-1) in the serum of patients with atopic dermatitis
Authors: W.H. Chun, H.J. Lee, K.H. Lee
Journal: British Journal of Dermatology (1997)

Journal Article Soluble vascular cell adhesion molecule‐1 (VCAM‐1) in the serum of patients with atopic dermatitis Get access W.H. Chun, W.H. Chun Department of Dermatology. Yonsei University College of Medicine, Seoul. Korea Search for other works by this author on: Oxford Academic Google Scholar H.J. Lee, H.J. Lee Department of Dermatology. Yonsei University College of Medicine, Seoul. Korea Search for other works by this author on: Oxford Academic Google Scholar K.H. Lee K.H. Lee Department of Dermatology. Yonsei University College of Medicine, Seoul. Korea Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 136, Issue 1, 1 January 1997, Page 136, https://doi.org/10.1111/j.1365-2133.1997.tb08767.x Published: 01 January 1997
Causes of Photopenic Defects in the Lower Sternum on Bone Scintigraphy and Correlation With Multidetector CT
Authors: Shirou Ishii, Fumio Shishido, Masayuki Miyajima, Koutarou Sakuma, Takeshi Shigihara, Ken Kikuchi, Masaru Nakajima
Journal: Clinical Nuclear Medicine (2011)

Purpose: To determine the cause of this photopenia in the lower sternum on bone scintigraphy and its correlation with sternal foramen on multidetector computed tomography (MDCT). Methods: Between January and December 2008, we studied 1053 patients who underwent bone scintigraphy and CT scanning that included the chest. Bone scintigraphy showed photopenic areas in the lower sternum in 58 of these 1053 patients. The study population consisted of 19 men and 37 women, aged from 15 to 87 years (mean: 60.4 years). Results: Of the 58 patients with photopenic areas in the lower sternum, 25 (43%) showed a sternal foramen by MDCT, whereas 33 patients (57%) showed no sternal foramen. However, of the total study population of 1053 patients, MDCT showed sternal foramen in 33 patients (3.1%). In 7 of the 33 patients with sternal foramen by MDCT, bone scintigraphy showed no photopenic areas. On the basis of CT morphometry of the sternum, the possible causes of photopenia in the lower sternum in patients without sternal foramen are as follows: thin middle portion of sternum bone marrow, a focal defect or notch in the posterior sternal cortex, high accumulation of peripheral lesions, and bone metastasis. Conclusion: This study revealed that not all patients showing photopenic areas in the lower sternum have sternal foramen and not all patients with sternal foramen show photopenic areas by bone scintigraphy. It is important to exclude metastasis when photopenic areas are detected, and inform the clinician to avoid the serious complication of cardiac tamponade.
The Evaluation of Hospital Death Rates
Authors: Lincoln E. Moses
Journal: JAMA (1986)

The article by Luft and Hunt<sup>1</sup>in this issue ofThe Journalhas acquired an urgent relevancy since it was accepted for publication. In that time interval, the Department of Health and Human Services has begun to release individually identified hospital death rates. Luft and Hunt examined the 1982 experience of patients undergoing cardiac catheterization in the 151 member hospitals of the Commission on Professional and Hospital Activities known to have had cardiac catheterization laboratories in that year. Confidentiality mechanisms ensured that the authors were blind to the identity of the hospitals from which the data came. The age of the patient and the patient's disease are both powerful influences on the probability of death, so the investigators sorted the patients into 12 categories, defined as the possible combinations of three age groups and four diagnostic groups. For each of these 12 categories, the whole-study death rate (across the