tbuckley/cabot-search huggingface dataset:
Impact of Disease Management on Utilization and Adherence With Drugs and Tests
Authors: Patrick Thiebaud, Michael Demand, Scott A. Wolf, Linda L. Alipuria, Qin Ye, Peter R. Gutierrez
Journal: Diabetes Care (2008)

The purpose of this study was to evaluate the effect of telephonic care management within a diabetes disease management program on adherence to treatment with hypoglycemic agents, ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), statins, and recommended laboratory tests in a Medicaid population.A total of 2,598 patients with diabetes enrolled for at least 2 years in Florida: A Healthy State (FAHS), a large Medicaid disease management program, who received individualized telephonic care management were selected if they were eligible for at least 12 months before and 12 months after beginning care management. Patients were matched one-to-one on all baseline characteristics to 2,598 control patients. The impact of care management on utilization and adherence rates for diabetes-related medications and tests was analyzed with the difference-in-difference estimator.Changes in utilization were evaluated separately for those who were characterized as adherent to treatment at baseline ("users") and those who were not ("nonusers"). Both groups achieved significant improvement in adherence between baseline and follow-up. Nonusers increased their overall hypoglycemic use by 0.7 script (P < 0.001), by 0.7 script for ACEIs and statins (both P < 0.001), by 0.8 test for A1C (P < 0.001), and by 0.7 test for lipids (P < 0.001). Users increased hypoglycemic use by 1.5 scripts (P < 0.001) and insulin use by 0.9 script (P < 0.001).The FAHS telephonic care management intervention effectively induced Medicaid patients with diabetes to begin treatment and improved adherence to oral hypoglycemic agents and recommended tests. It also substantially improved adherence among baseline insulin users.
Valproate use during pregnancy was linked to autism spectrum disorder and childhood autism in offspring
Authors: Sonal Singh
Journal: Annals of Internal Medicine (2013)

ACP Journal ClubAugust 20, 2013Valproate use during pregnancy was linked to autism spectrum disorder and childhood autism in offspringSonal Singh, MDSonal Singh, MDJohns Hopkins University School of Medicine, Baltimore, Maryland, USA (S.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-4-201308200-02013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationChristensen J, Grønborg TK, Sørensen MJ, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA. 2013;309:1696-703. https://pubmed.ncbi.nlm.nih.gov/23613074Clinical Impact RatingsGIM/FP/GP: Neurology: References1 Singh S, Loke YK. Drug safety assessment in clinical trials: methodological challenges and opportunities. Trials. 2012;13:138. [PMID: 22906139] Google Scholar2 Galbally M, Roberts M, Buist A; Perinatal Psychotropic Review Group. Mood stabilizers in pregnancy: a systematic review. Aust N Z J Psychiatry. 2010;44:967-77. [PMID: 21034180] Google Scholar3 Banach R, Boskovic R, Einarson T, Koren G. Long-term developmental outcome of children of women with epilepsy, unexposed or exposed prenatally to antiepileptic drugs: a meta-analysis of cohort studies. Drug Saf. 2010;33:73-9. [PMID: 20000869] Google Scholar Author, Article, and Disclosure InformationAffiliations: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (S.S.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics August 20, 2013Volume 159, Issue 4Page: JC13KeywordsAnticonvulsantsAutismAutism spectrum disorderBipolar disorderBirthChildrenCohort studiesConfidence intervalsDrug informationEpilepsyEpileptic seizuresMedical risk factorsNeurology Issue Published: August 20, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
The Detection and Treatment of Vesical Calculi
Authors: W. D. Napier
Journal: BMJ (1873)

7I9right edge of the sternum.There was no distinct apex-beat, but a dif- fused heaving, most distinct between the fifth and seventh ribs.On auscultation at the base, there were heard two murmurs; a short blow- ing and softly flapping murmur with the first sound, and a loud harsh murmur with the second sound.The systolic murmur was heard most distinctly at the mid-sternum, opposite the third rib and above it, but was not heard at the apex.The diastolic murmur was loudest at the third costal cartilage of the right side, and was also distinct up and down the sternum; it replaced the second sound in the carotids, but was not propagated towards the apex of the heart.At the apex, over the mitral area, was heard a murmur with the first sound, longer and somewhat harsher than the systolic murmur heard at the base.The urine was scanty, high-coloured, and albuminous.The liver was enlarged, reaching three finger-breadths below the costal arch, and was tender on pressure.The abdomen was somewhat tense ; the lower ex- tremities were slightly oedematous.After admission, he improved slightly, and got some rest under the use of morphia hypodermically.He had, however, a bad syncopal attack on the third day; and, although these attacks were warded off by the use of stimulants and liquor ammoniae, internally, up to the morning of the i4th, he then died suddenly from syncope.The post nmortemz examination was made by the resident pathologist, Dr. A. H. Carter.On opening the chest, the lungs were seen to be widely separated by a very large heart.The pericardium contained no fluid, but the right pleural cavity contained half a pint, and the left somewhat more.There was also about half a pint of fluid in the peritoneum.Ri,iht Ltung%-The upper lobe was emphysematous ; the lower lobe nearly solid, from large hxmorrhagic extravasation, not very recent, and undergoing inflammatory changes.There were several smaller and more recent spots of hbemorrhage in the same lobe.Left Lu;-.-The upper lobe was emphysematous ; there was a large recent wedge-shaped haemorrhage in the lower anterior angle of the lower lobe.The liver was somewhat contracted, firm, and granular ; it weighed 47 ounces.The kidneys were large and congested, but in other respects healthy.The heart was much enlarged ; it weighed I8 ounces.There was a white friction-patch on the anterior surface, near the apex.All the cavities were dilated and full of uniform black
Measurement variability associated with KXRF bone lead measurement in young adults.
Authors: J A Hoppin, A Aro, H Hu, P B Ryan
Journal: Environmental Health Perspectives (2000)

In vivo bone lead measurement using K X-ray fluorescence (KXRF) has been used to estimate long-term lead exposure, especially in adults. Relatively few studies have been conducted on young subjects with this technique. To explore the measurement variability of KXRF bone lead measurements in young subjects, the tibiae of two male cadavers from Boston, Massachusetts, 17 and 20 years of age, were obtained for repeated bone lead measurements. Bone lead concentrations were measured using a grid of nine locations, 1 cm apart, centered at the midpoint of the tibia. Each location was sampled using five 60-min measurements. Measured concentrations ranged from &lt; 0 to 11.8 microg Pb/g bone mineral across a tibia with mean concentrations for the midpoint locations of 0.8 microg Pb/g bone mineral SD = 2.5 and 2.0 microg Pb/g bone mineral (SD = 1.9) for the left and right legs of the younger subject and 3.6 microg Pb/g bone mineral (SD = 2.6) and 6.0 microg Pb/g bone mineral (SD = 3.3) for the left and right legs of the older subject. Although bone lead concentrations did not vary significantly by measurement location in an individual leg, reported measurement uncertainty increased significantly at locations that were 1 cm from the center of the tibia horizontally (p &lt; 0.0001). Symmetry in bone lead concentration between legs was observed for the 17-year-old subject. Potential asymmetry between the left and right legs was suggested for the 20-year-old subject (p = 0.06). These data describe the degree of variability that may be associated with bone lead measurements of young subjects with low bone lead concentrations using a standard spot-source KXRF instrument. Because of the importance of conducting additional research on adolescent lead toxicity, further improvements to the precision of KXRF measurement are needed.
Retrospective Review of Adverse Effects From Propranolol in Infants
Authors: Eun-Kyung M. Kwon, Shawna Joachim, Dawn H. Siegel, Beth A. Drolet, Kristen Holland
Journal: JAMA Dermatology (2013)

Retrospective Review of Adverse EffectsFrom Propranolol in Infants P ropranolol has been prescribed for decades in in- fants for various indications, but its effectiveness in the treatment of infantile hemangiomas (IH) was only recently described. 1Its perceived safety profile and efficacy is shifting the paradigm of IH treatment, which was traditionally reserved for complicated IH, 2 to include less severe cases.The safety of systemic propranolol treatment in infants is not well studied.Reported serious adverse effects include hypoglycemia, 3 bronchospasm, and hypotension. 4We reviewed a large series of infants treated with propranolol mostly for cardiac indications and aimed to identify serious adverse effects of propranolol that resulted in hospital admission.
The Social Programs of Sweden: A Search for Security in a Free Society
Authors: Bruce E. Balfe
Journal: JAMA (1968)

Albert H. Rosenthal's new book attempts a factual presentation of the nature and extent of the social security, health insurance, public health, and welfare programs of Sweden. The comprehensive Swedish social experiment has been used as an example by both the proponents and opponents of socialism. As a result, the debate has been confusing, emotional, and at times bitter. To those who are emotional or bitter and looking for another statement to support their views, this book offers very little. To those who are confused but have an open mind, this book is very worthwhile. The two chapters describing the Social Security Programs and the Health Insurance Program are, by their nature, technical and dry. For each program, Rosenthal discusses coverage and eligibility provisions, benefits available to various categories of eligibles, the financing mechanisms which support the programs, and the administrative machinery which makes them operative. In addition, case examples
PMO-236 Are guidelines followed in histology reporting in inflammatory bowel disease (IBD)?
Authors: C Daker, M Haji-Coll, K Besherdas
Journal: Gut (2012)

<h3>Introduction</h3> IBD has 240 000 suffers in the UK. Diagnosis is made on consideration of clinical, macroscopic, microscopic and radiological findings to classify Crohns disease (CD), ulcerative colitis (UC) and IBD type unclassified (IBDTU) (previously indetermediate colitis). An accurate diagnosis to differentiate between the different types of IBD is important as evidence based treatment differs among the different types. An accurate histological classification of IBD increases diagnostic accuracy by 5%–41%. In line with the BSG 2011 IBD guidelines, histopathology should “attempt to define the type of IBD, mention other coexistent diagnoses, or complications and the absence or presence of any dysplasia and its grade”. There are eight recognised histological features consistent with a UC diagnosis and two further criteria to differentiate between active, inactive or quiescent disease. That for CD includes nine features with a further three to mark active disease. <h3>Methods</h3> To assess whether histopathology reporting in IBD are in line with BSG guidelines. Using the BSG guideline “A Structured Approach to Colorectal Biopsy” the histopathology reports of 60 IBD patients were scrutinised to see if they correlated with the guideline; examined for 8 histological features of UC, 9 for CD, disease activity, complications and presence and grade of dysplasia. <h3>Results</h3> The cohort identified 60 patients (38 UC, 22 CD). The type of IBD was specified in 25% (IBDTU 3%, UC 10%, CD 4%) and not mentioned in 40%. 23% of UC specimens were labelled as such by the histolpathologist; in that cohort there was also 3% IBDTU, 37% “IBD”, 0% CD. In the CD group; 0% IBDTU, 4% UC, 18% CD, 28% “IBD”. 80% of specimens had no mention of complications/coexistent features. Of those documented CMV was noted in only 1 UC case, fistulae in 2 CD cases and infection in a total of nine across the groups. Dysplasia was not mentioned in 22% UC and 59% CD; listed as a relevent negative finding in 71% UC and 36% CD and identified as low grade dysplasia (tubuloadenoma) in 3 UC cases and 1 CD case. The features most frequently identified: In UC: (1) severe crypt architectural distortion; (2) severe widespread decreased crypt density, In CD it was (1) mucosal surface normal, irregular, villous; (2) crypt atrophy. <h3>Conclusion</h3> In our study the majority of histology reports lack important information pertaining to and even attempting to classify IBD. On average for patients suffering from CD or UC, the histological reports only state two histological signs which are of immense importance in confirming either diagnosis. None of the histological reports mentioned all the signs in UC or CD either as positives or relevant negatives. The importance of good histological reporting may help clinicians in differentiating between the different IBD types which in turn may help guide optimum evidence based management. <h3>Competing interests</h3> None declared.
950 HEPATORENAL SYNDROME ASSOCIATED WITH BACTERIAL INFECTIONS IN CIRRHOSIS. PROGNOSTIC RELEVANCE AND IMPORTANCE OF CIRCULATORY DYSFUNCTION
Authors: C. Fagundes, M. Guevara, M. Martín-Lhahí, E. Sola, G.H. Pereira, E. García-López, E. Rodríguez, M. Pavesi, V. Arroyo, P. Ginès
Journal: Journal of Hepatology (2011)
Hyperthyroidism: An Underappreciated Cause of Diffuse Bone Disease
Authors: ARTHUR L.M. SWISLOCKI, CHARLES A. BARNETT, PAMELA DARNELL, ROBERT H. NOTH
Journal: Clinical Nuclear Medicine (1998)

A 37-year-old man and a 40-year-old woman were referred for evaluation of skeletal complaints. Tc-99m MDP bone scans were obtained. Tc-99m MDP bone scanning of the man revealed a metabolic super-scan pattern. Tc-99m MDP images of the woman mimicked autoimmune arthritis. A thyroid workup was performed at a substantial interval after bone scanning. Thyroid laboratory indices in both patients suggested Graves' Disease. I-123 scanning revealed diffuse increased uptake in both patients, confirming the diagnosis of Graves' Disease. Successful treatment was eventually achieved with I-131. We conclude that nuclear medicine physicians should be aware that hyperthyroidism may present either as a pattern of metabolic superscan or may resemble an autoimmune arthritic process; in other words, it should be understood that insofar as bone imaging, Graves' Disease is the "Great Imitator." Similarly, referring clinicians need to be aware of these relationships, and appropriately screen patients with skeletal complaints. This is especially important in an era when generalists and ancillary medical personnel are involved in the screening of patients with complex and misleading disease processes.
Mortality from coronary heart disease in the British army compared with the civil population
Authors: J G P Power
Journal: BMJ (1981)

prevalence figures, from well populations and hospital clinics, which in turn are the result of self-selection, referral patterns, and the age composition of the screened population.The data emphasise that, with a trend towards less selection of women for screening, the pre- dictive power of a positive diaphanoscopic test would be lower and that for a negative test higher than in their series.One case appears to be missing from their results but it does not materially influence the outcome.
THE MEDICAL CARE OF PATIENTS FOLLOWING TOTAL THYROIDECTOMY
Authors: EUGENE C. EPPINGER
Journal: JAMA (1934)

Total thyroidectomy has been proposed by Blumgart, Levine and Berlin<sup>1</sup>as a method of treatment in certain forms of intractable heart disease. There naturally have arisen some objections to this apparently drastic procedure, particularly in regard to the thyroprivia and its sequelae. Our purpose in this report is to consider the aftercare of patients subjected to complete thyroidectomy, especially the treatment of myxedema. Because requests have been received from physicians asking for specific details of postoperative management and because in some instances patients have been dismissed from some hospitals shortly after the operation without further attention, this discussion appears to be timely. As patients both with angina pectoris and with congestive heart failure have been subjected to this operation, the postoperative management of the two conditions will be dealt with separately. In those with angina pectoris, who as a rule do not have evidences of cardiac decompensation, the convalescent
Cachexia and Ascites in Hemodialysis Patients
Authors: Hugh H. Hussey
Journal: JAMA (1974)

Although long-term hemodialysis successfully controls uremia in end-stage kidney failure, the process is nevertheless beset with various complications. Among the worst, about which Feingold et al write in the December issue ofArchives of Internal Medicine(134:989, 1974), is progressive cachexia usually accompanied by ascites.  Early in the experience of their hemodialysis program, the authors observed seven patients (group 1) who died following a course characterized by progressive cachexia, ascites, hypertension, and a tendency to severe hypotension during dialysis. The primary change in the kidneys of all but two of the patients was arterial and arteriolar nephrosclerosis. The other two patients had old glomerulonephritis, severe interstitial nephritis, and severe arteriolar nephrosclerosis.  Seven similar patients (group 2), observed later in the authors' experience, underwent bilateral nephrectomy. Body weight had fallen appreciably in all but one patient who was already cachectic. Three patients had ascites, and all had had hypertension, uncontrollable until
Immunosuppressive Therapy for Active Lymphocytic Myocarditis
Authors: Andrea Frustaci, Cristina Chimenti, Fiorella Calabrese, Maurizio Pieroni, Gaetano Thiene, Attilio Maseri
Journal: Circulation (2003)

The beneficial effect of immunosuppressive treatment on myocarditis is still controversial, possibly because the immunologic and virological profile of potential candidates is largely unknown.Out of 652 biopsied patients, 112 had a histological diagnosis of active lymphocytic myocarditis; 41 of these 112 patients were characterized by progressive heart failure despite conventional therapy and were treated with prednisone and azathioprine for 6 months. All were resubmitted to cardiac catheterization, angiography, and endomyocardial biopsy at 1 and 6 months and followed-up for 1 year. A total of 21 patients responded with prompt improvement in left ventricular ejection fraction from 25.7+/-4.1% to 47.1+/-4.4% and showed evidence of healed myocarditis at control biopsy. Conversely, 20 patients failed to respond and showed a histological evolution toward dilated cardiomyopathy: 12 remained stationary, 3 underwent cardiac transplantation, and 5 died. We retrospectively performed a polymerase chain reaction on frozen endomyocardial tissue for the most common cardiotropic viruses and assessed circulating serum cardiac autoantibodies. Viral genomes were present in biopsy specimens of 17 nonresponders (85%), including enterovirus (n=5), Epstein-Barr virus (n=5) adenovirus (n=4), both adenovirus and enterovirus (n=1), influenza A virus (n=1), parvovirus-B19 (n=1), and in 3 responders, who were all positive for hepatitis C virus. Cardiac autoantibodies were present in 19 responders (90%) and in none of the nonresponders.In patients with active lymphocytic myocarditis, those with circulating cardiac autoantibodies and no viral genome in the myocardium are the most likely to benefit from immunosuppression. The beneficial effect of immunosuppression in hepatitis C virus myocarditis suggests a relevant immunomediated component of damage.
Saudi Arabia and Jews
Authors: IRVING E. SALIT
Journal: Annals of Internal Medicine (1977)

Comments and Correction1 February 1977Saudi Arabia and JewsIRVING E. SALIT, M.D. C.M.IRVING E. SALIT, M.D. C.M.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-86-2-246_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Dr. George Harrell's synopsis of medical education in Saudi Arabia (Ann Intern Med85:677-678, 1976) painted an interesting picture of a nation's attempt at improved health care and the conflicts encountered with religious mores and political aims. He noted that "needs are great, and help from abroad is gratefully accepted." This requires certain qualifications if only to save some people's time. The first is that Jews need not apply. Also those with "Jewish-sounding names" or Jewish ancestry need not apply. This official, vicious anti-Jewish policy extends to books and movies (but, I presume, not to vaccines or... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: IRVING E. SALIT, M.D. C.M.Affiliations: The Rockefeller University 1230 York Avenue New York, NY 10021 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1977Volume 86, Issue 2Page: 246-246KeywordsHealth careJewish peopleMedical educationVaccines ePublished: 1 December 2008 Issue Published: 1 February 1977 PDF downloadLoading ...
To the Editor of the Journal of the American Medical Association:
Authors: Charles Denison
Journal: JAMA (1885)

Dear Sir:  —I have just been reading your resume, in the Jan. 3d number, of an article by Haupt in the  Aerztliches Intelligenzblate  entitled Perception of Sound in Auscultation. Allow me to ask: Did Haupt present any solid  hearing staff or an instrument built on the solid plan to substantiate his. conclusion that  the bore of the stethoscope is quite superfluous ?  It is important to know if Haupt's conclusions are theoretical merely, in which case they are of doubtful value, or, if obtained by a comparison of instruments, with what imperfect stethoscope his solid instrument was compared.  If I mistake not, there is something wrong in the gentleman's premises. Most likely it is in the statement that the aid of the stethoscope  a hollow resonator is lost, as we use the instrument , for the tube no longer acts as a resonator when we block up both ends of it.
ASSOCIATION OF MORPHOLOGIC VARIABILITY WITH VENTRICULAR TACHYCARDIA AND VENTRICULAR PAUSE IN PATIENTS TREATED WITH RANOLAZINE OR PLACEBO FOLLOWING NON-ST-ELEVATION ACUTE CORONARY SYNDROME
Authors: Zeeshan Syed, Benjamin M. Scirica, David A. Morrow, Collin M. Stultz, John V. Guttag
Journal: Journal of the American College of Cardiology (2010)