tbuckley/cabot-search huggingface dataset:
Comparison of Five Glucose Meters for Self-Monitoring of Blood Glucose by Diabetic Patients
Authors: Rachel A Gifford-Jorgensen, Jim Borchert, Ruth Hassanein, Lowell Tilzer, George Ann Eaks, Wayne V Moore
Journal: Diabetes Care (1986)

This study collected data regarding the accuracy of five currently marketed meters for home use of self-monitoring of blood glucose (SMBG). Data regarding ease of operation of each glucose meter as well as cost and availability of meters and necessary materials were compiled. Fasting blood glucose (BG) samples were drawn from patients in the adult and pediatric diabetes clinics at the University of Kansas College of Health Sciences and Hospital. Specimens were tested by a clinical laboratory as well as by each meter. Unadjusted meter readings of whole BG were plotted against laboratory readings of serum glucose and displayed in scattergrams. Scattergrams showed decreased machine accuracy in upper and lower BG ranges. Whole BG values (meter readings) were adjusted to serum glucose levels by multiplication by 1.12. Adjusted values were compared with laboratory serum values using ANOVA for repeated measures and Dunnett's Multiple Comparisons Test: ANOVA and Dunnett's Multiple Comparisons Test showed only Glucochek II (Medistron, Ltd., West Sussex, England; distributed in U.S. by Larken Industries, Lenexa, Indiana) using Dextrostix reagent strips (Ames Division, Miles Laboratories, Elkhart, Indiana) having a statistically significant difference from laboratory values (P &amp;lt; 0.01). This meter was recently revised and may show changed accuracy readings. Each meter exhibited inherent advantages and disadvantages regarding price, calibration, strip utilization, and ease of operation, which must be considered before recommendation by the health care provider.
The Pituitary Incidentaloma Beyond the First Year of Follow-up
Authors: Larry Frohman, Mark J. Kupersmith, Floyd Warren
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Reincke et al<sup>1</sup>coin the term<i>incidentaloma</i>to describe those pituitary tumors serendipitously detected on magnetic resonance imaging or computed tomographic scan and provide guidelines for their evaluation and treatment. We agree that modern noninvasive neuroimaging has revolutionized the approach to these and all pituitary tumors, making a conservative approach, as they suggest, more tenable. Nonetheless, we disagree with their recommendation that if a patient has a tumor less than 1 cm in size and normal visual fields and pituitary function, and on repeated magnetic resonance imaging at 1 year there is no interval change in tumor size, then no further studies are necessary. We have had experience with small pituitary tumors (as well as other parasellar tumors initially misdiagnosed as pituitary tumors before histopathologic examination) that, although the above criteria were met at 1 year, went on to enlarge and produce chiasmal compression and visual
Comparison of Methyllidocaine and Lidocaine on Arrhythmias Produced by Coronary Occlusion in the Dog
Authors: RICHARD A. GILLIS, FREDERICK H. LEVINE, HAROLD THIBODEAUX, ARTHUR RAINES, FRANK G. STANDAERT
Journal: Circulation (1973)

Methyllidocaine, a quarternary ammonium derivative of lidocaine, was tested as a treatment for the ventricular ectopic beats occurring in unanesthetized dogs 24 hours after two-stage ligation of the anterior descending branch of the left coronary artery. The electrocardiogram (lead II) and electroencephalogram were recorded. Methyllidocaine (4 and 8 mg/kg) injected i.v. during a 1-min period produced a significant reduction in ectopic beats with no significant increase in EEG activity. Lidocaine (4 and 8 mg/kg) administered similarly caused similar antiarrhythmic effects but produced a significant increase in EEG activity. A dose of 8 mg/kg caused tonic-clonic seizures in three of five dogs. Both drugs were also given i.v. (15 mg/kg) to unanesthetized cats. Methyllidocaine did not induce convulsions in four of four animals whereas lidocaine induced convulsions in three of three animals. It is concluded that methyllidocaine is as effective an antiarrhythmic agent as lidocaine but does not possess the central nervous system excitatory actions observed with lidocaine.
Phytosterolemia and Xanthomatosis
Authors: Anton F Stalenhoef
Journal: New England Journal of Medicine (2003)

A 17-year-old girl presented with multiple xanthomas of the hands (Panel A) and the Achilles tendons, as well as a family history of vascular disease. Familial hypercholesterolemia was suspected, but the plasma cholesterol level was only mildly elevated. The levels of plant sterols in the plasma as measured with gas chromatography were 950 μmol of sitosterol per liter (normal value, <16) and 378 μmol of campesterol per liter (normal value, <24). Phytosterolemia with xanthomatosis was diagnosed. Phytosterolemia is an autosomal recessive disorder characterized by increased intestinal absorption of dietary sterols (not only cholesterol, but also plant sterols) and decreased biliary . . .
PSYCHIATRY IN RELATION TO CRIME
Authors: Robert Hoffman
Journal: JAMA (1930)

To the Editor:  —I have read with considerable interest an article by one of your editorialists in the August 2 issue ofThe Journal, entitled Psychiatry in Relation to Crime. Near the bottom of the first paragraph the following statements occur:  may equally be labeled mental disease. This conclusion is permissible even when the criminal has shown no evidence of mental disease other than his criminal behavior.  I am aware that many psychiatrists have long urged the acceptance of this view, but I am somewhat surprised thatThe Journal of the American Medical Associationshould conform thereto without satisfying its readers by the presentation of reasonably obvious evidence.  Might not this theory be carried to the point of reductio ad absurdum by applying it to any abnormal behavior of any individual; for example, the quack nostrum vender or the absurd cultists? After all, the commission of a crime is merely
Referral of Patients With Pulmonary Hypertension Diagnoses to Tertiary Pulmonary Hypertension Centers
Authors: Roderick C. Deaño, Cherylanne Glassner-Kolmin, Melvyn Rubenfire, Adaani Frost, Scott Visovatti, Vallerie V. McLaughlin, Mardi Gomberg-Maitland
Journal: JAMA Internal Medicine (2013)

Pulmonary hypertension (PH) is a fatal disease. Although the prognosis of pulmonary arterial hypertension (PAH) has improved with targeted therapies, the outcome is dependent on early detection and an accurate diagnosis.To determine the accuracy of PH diagnoses in patients referred to PH centers and the frequency of PAH-specific medication use despite an uncertain or incorrect diagnosis.Multicenter, descriptive, cross-sectional study. During a 10-month period in 2010 and 2011, data on newly referred patients were collected and entered into a secure Internet database.Three large tertiary PH centers.One hundred forty consecutive patients newly referred to PH centers were invited to participate, and all consented to do so.Of 140 patients referred with a mean age of 56 years, 95 (68%) were referred by cardiologists or pulmonologists and 86 (61%) had disease classified as World Health Organization functional class III or IV. Fifty-six of the prereferral diagnoses (40%) were PAH, 42 (30%) unknown, and 22 (16%) PH secondary to lung disease or hypoxia. Of the 98 patients who received a definitive diagnosis before referral, 32 (33%) received a misdiagnosis. Fifty-nine patients underwent catheterization of the right and/or left side of the heart for the first time at the tertiary center. Of the 38 patients who underwent catheterization of the right side alone, 14 (37%) received a different diagnosis after undergoing the procedure; of the 21 patients who underwent catheterization of both sides of the heart, 11 (52%) received a different diagnosis after undergoing the procedures. Forty-two patients (30%) had started receiving PAH-specific medications before referral, with 24 of the prescriptions (57%) contrary to published guidelines.Patients referred to PH centers for diagnosis and treatment are often referred late (with functional class III or IV disease), receive misdiagnoses, and are inappropriately prescribed medications. A reevaluation of educational efforts is required to improve awareness and the care and outcome of patients diagnosed as having PH.
A quick ward assessment of older patients by junior doctors
Authors: S. E. Kurrle, I. D. Cameron, R. B. Geeves
Journal: BMJ (2015)

#### The bottom line

#### Case scenario: part 1

Mrs Brown is an 82 year old woman, living alone, who has been brought into the emergency department after her daughter found her “very muddled” at home. She is apparently normally cognitively intact and manages well independently at home. You are asked to assess her for admission.

Older people are core business in most emergency departments and acute hospitals.1 Yet acute hospitals can be dangerous and unfriendly places for older people,2 and the less time they spend in hospital, the less harm is likely to occur to them. Competent assessment and formulation of an accurate problem list can minimise inadequate or incomplete recognition of problems and inappropriate treatment, which can result in poor outcomes for the older person, including decline in function and increased mortality.3 This paper advises how a quick assessment can inform more detailed later assessment and management.

Ideally the assessment of an older patient should be comprehensive, extending beyond the standard history and clinical examination. Comprehensive geriatric assessment is multidimensional and interdisciplinary, and includes a full review of the patient’s medical and health issues, and physical, psychological, and social functioning. Systematic reviews have shown the benefits of comprehensive geriatric assessment, with a recent Cochrane review concluding that older people who underwent such assessment had …
TEN NEW CASES OF HFRS IN NORTH-EASTERN FRANCE
Authors: B. Hurault de Ligny, J.P. Prieur, J.L. Schmitt, M. Kessler, Ph. Canton, J.B. Dureux, P.E. Rollin, P. Sureau, J.B. Mccormick, E. Dournon
Journal: The Lancet (1984)
Open randomised trial of prescribing strategies in managing sore throat
Authors: P Little, I Williamson, G Warner, C Gould, M Gantley, A L Kinmonth
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To assess three prescribing strategies for sore throat. <b>Design:</b> Randomised follow up study. <b>Setting:</b> 11 general practices in the South and West region. <b>Subjects:</b> 716 patients aged 4 years and over with sore throat and an abnormal physical sign in the throat; 84% had tonsillitis or pharyngitis. Patients were randomised to three groups: prescription for antibiotics for 10 days (group 1, 246 patients); no prescription (group 2, 230 patients); or prescription for antibiotics if symptoms were not starting to settle after three days (group 3; 238 patients). <b>Main outcome measures:</b> Duration of symptoms; satisfaction and compliance with and perceived efficacy of antibiotics; time off school or work. Outcomes were documented in 582 subjects (81%). <b>Results:</b> Median duration of antibiotic use differed significantly in the three groups (10 <i>v</i> 0 <i>v</i> 0 days, P&lt;0.001); 69% of patients in group 3 did not use their prescription. The proportion of patients better by day 3 did not differ significantly (37% <i>v</i> 35% <i>v</i> 30%, P=0.28), nor did the duration of illness (median 4 <i>v</i> 5 <i>v</i> 5 days, P=0.39), days off work or school (median 2 <i>v</i> 2 <i>v</i> 1, P=0.13), or proportion of patients satisfied (96% <i>v</i> 90% <i>v</i> 93%, P=0.09), although group 1 had fewer days of fever (median 1 <i>v</i> 2 <i>v</i> 2 days, P=0.04). More patients in group 1 thought the antibiotics were effective (87% <i>v</i> 55% <i>v</i> 60%, P&lt;0.001) and intended coming to the doctor in future attacks (79% <i>v</i> 54% <i>v</i> 57%, P&lt;0.001). "Legitimation" of illness—to explain to work or school (60%) or family or friends (37%)–was an important reason for consultation. Patients who were more satisfied got better more quickly, and satisfaction related strongly to how well the doctor dealt with patient9s concerns. <b>Conclusion:</b> Prescribing antibiotics for sore throat only marginally affects the resolution of symptoms but enhances belief in antibiotics and intention to consult in future when compared with the acceptable strategies of no prescription or delayed prescription. Psychosocial factors are important in the decision to see a general practitioner and in predicting the duration of illness. <h3>Key messages</h3> Sore throat is one of the commonest presentations of upper respiratory illness to general practitioners, and attendance is increasing Prescribing antibiotics for sore throat does not reduce the extent and duration of symptoms Prescribing antibiotics enhances belief in antibiotics and intention to consult Legitimation of illness is an important reason for attending the doctor Satisfaction predicts duration of illness and closely relates to how well concerns are dealt with—unless patients are very ill, general practitioners should consider exploring concerns and should avoid or delay prescribing antibiotics
HISTORY OF COCAINE AS A LOCAL ANESTHETIC
Authors: M. G. Seelig
Journal: JAMA (1941)

<h3>To the Editor:—</h3> In the history of anesthesia, the discovery of the application of cocaine as a local anesthetic by Carl Koller has always seemed to be the one chapter free from acrimoniously disputatious conflict. The following is a letter from Dr. Koller of New York: My dear Dr. Seelig: I happened yesterday to read your article in the Howard Lilienthal dedicatory volume on the Progress of Medicine in the Last Hundred Years, and admired its broad sweep and inspired language. Coming to the passage dealing with anesthesia, I could not help being pained by your adopting the incorrect statements, not of Freud himself but of his admirers and hangers-on, that Freud had anything to do with starting cocaine as a local anesthetic in surgery. Freud has stated the facts correctly in his Autobiography, but in such ambiguous language that his enthusiastic admirers claimed for him what was not according
Volumetric and functional heterogeneity of human monocytes.
Authors: E B Arenson, M B Epstein, R C Seeger
Journal: Journal of Clinical Investigation (1980)

Volume analysis of purified human blood monocytes revealed distinct populations of large and small cells. Computer curve fitting suggested a third, intermediate-sized population. These monocytes were designated M1, M2, and M3 in order of increasing size, and their approximate volumes were 150, 250, and 480 micron3, respectively. The three subpopulations were present in all 30 normal individuals tested. Two new techniques were developed that separate monocytes into M1 + M2 and M3 fractions; one used preferential incorporation of carbonyl iron particles by M3 cells and the other used the selective aggregation of M3 cells by thrombin in the presence of platelets. The chemotactic response to zymosan-activated human serum by total monocytes, M1 + M2 monocytes, and M3 monocytes was determined by the agarose plate method. In all experiments M3 monocytes were 10-fold more responsive than M1 + M2 monocytes and were significantly more so than total monocytes. These findings suggest that M3 cells are the major subpopulation capable of directional migration. This investigation establishes the existence of volumetrically definable subpopulations of human monocytes that are functionally distinct.
From Complicity to Advocacy: The Necessity of Refugee Research
Authors: Cécile Rousseau, Laurence J. Kirmayer
Journal: The American Journal of Bioethics (2010)

The populations of the well-fed West [are] governed by fear of outsiders, whose current names are “terrorist,” “immigrant,” “refugee” or “asylum seeker.” (Critchley 2007, 6) Although the harshness ...
Rigid following of dogma will not be best for all patients
Authors: A. Ross, D. Taylor
Journal: BMJ (1998)

EDITOR—As general practitioners who run a training scheme we found the series “Getting research findings into practice” thought provoking.1 The most difficult part of general practice is arriving at a diagnosis, and the articles seem to start after the crucial decisions of general practice have been taken, after the art has been practised.

In 1948 Ryle wrote: “The three main tasks of the clinician are diagnosis, prognosis and treatment. Of these diagnosis is by far the most important, for upon it the …
Abstract 4206: Impact of nuclear telomere architecture in the transition of myelodysplastic syndromes to acute myeloid leukemias.
Authors: Macoura Gadji, Fábio Morato de Oliveira, Sabine Mai
Journal: Cancer Research (2013)

Abstract Myelodysplastic Syndromes (MDS) are a group of disorders characterized by cytopenias, with a propensity for evolution into Acute Myeloid Leukemias (AML). This transformation is driven by genomic instability and epigenetic events. However, how genomic instability occurs in this disease remains unknown. Telomere dysfunction might be the generator of genomic instability leading to cytopenias and disease progression. Despite several studies demonstrating the role of telomere dysfunction in the occurrence of hematopoietic malignancies, little is known about their role in the evolution of MDS to AML/MDS. Our preliminary data allowed us to define three-dimensional nuclear telomeric profiles on the basis of telomere numbers, telomeric aggregates, telomere signal intensities, nuclear volumes, and nuclear telomere distribution. Using these parameters, we blindly subdivided the MDS patients into nine subgroups and the AML patients into six subgroups. We showed distinct telomeric profiles specific to patients with MDS, AML, and suggested for the first time a chronological and evolutionary process of telomere dysfunction in both diseases and the transformation of MDS to AML. To validate the clinical significance of 3D telomere profiling of MDS-patients and AML-patients, we are studying new patient cohorts and patients progressing from MDS to AML over time. Such a longitudinal study will allow for precise 3D telomeric profiling during disease progression. Since transformation of MDS to AML can occur over a long period of time, we are also studying disease progression from MDS to AML using a mouse model (C57BL/6-Tg(Vava1-NUP98/HOXD13)G2Apla/J). These mice will transform their MDS-disease to AML disease in a time period of in between 4-14 months. Therefore, we are following the mice monthly up to 14 months. Our study will allow us to gain an understanding of the 3D telomeric signatures that predict and accompany the transition of MDS to AML. In addition, we will define the molecular profiles at disease transition to improve, once validated, treatment strategies for patients with MDS/AML. Citation Format: Macoura Gadji, Fábio Morato de Oliveira, Sabine Mai. Impact of nuclear telomere architecture in the transition of myelodysplastic syndromes to acute myeloid leukemias. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4206. doi:10.1158/1538-7445.AM2013-4206
'Heart at Work' campaign encourages healthier living
Authors: Marsha F. Goldsmith
Journal: JAMA (1985)

Applying "prevention technology" to save lives by teaching employed Americans how to avoid heart attacks and strokes is the aim of the American Heart Association's new "Heart at Work" program. The heart association lists among benefits that they expect may accrue to companies adopting the program improved quality of work, reduced absenteeism, reduced turnover, reduced insurance claims, and a more attractive environment for recruiting new employees. For those workers, the association says, the program will provide support in making positive life-style changes, let employees know their company cares about them, and help create an environment where employees care about each other. The program, which is available through the association's affiliates and local components in all 50 states, is based on a handsomely presented set of materials and action plans targeted at four primary and secondary risk factors for cardiovascular disease. The idea is to encourage workers to control blood pressure,
Ethics, Mandated Choice, and Organ Donation
Authors: Aaron Spital
Journal: Annals of Internal Medicine (1997)

Letters1 February 1997Ethics, Mandated Choice, and Organ DonationAaron Spital, MDAaron Spital, MDThe Genessee Hospital, Rochester, NY 14607Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-3-199702010-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Meshkov notes several flaws in the essay by Klassen and Klassen [1]. These include using preliminary experience in Virginia to predict that mandated choice would fail and exaggerating the difficulty in collecting wishes about organ donation (the authors themselves note that such information is now “routinely available” in several states). Dr. Meshkov's comments and personal story also vividly show that although transplantation does raise many ethical issues, the dire need for organs is not one of them.The Klassens make other erroneous claims and inferences. Mandated choice does not presume that prospective recipients are “the rightful owners ...References1. Klassen AC, Klassen DK. Who are the donors in organ donation? The family's perspective in mandated choice. Ann Intern Med. 1996; 125:70-3. Google Scholar2. Strategies for cadaveric organ procurement. Mandated choice and presumed consent. Council on Ethical and Judicial Affairs, American Medical Association. JAMA. 1994; 272:809-12. Google Scholar3. Spital A. Mandated choice. A plan to increase public commitment to organ donation. JAMA. 1995; 273:504-6. Google Scholar4. Spital A. Mandated choice for organ donation: time to give it a try. Ann Intern Med. 1996; 125:66-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Genessee Hospital, Rochester, NY 14607 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1997Volume 126, Issue 3Page: 251KeywordsReasoningTransplantation Issue Published: 1 February 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Peritoneal Dialysis in Quinine Sulfate Intoxication
Authors: Thomas N. Markham
Journal: JAMA (1967)

Early cinchonism developed in an 18-year-old girl after the ingestion of 3.84 gm of quinine sulfate, in an attempt to induce abortion. Initially, the exact dose was unknown and she was treated with peritoneal dialysis. Although dialysis was begun after the peak plasma levels had passed, 415 mg (10.8%) were recovered in the dialysate fluid over the next 16 hours.
EXPERIENCES WITH REGIONAL ANAESTHESIA: BASED ON 208 CASES IN WHICH IT HAS BEEN USED
Authors: H. W. L. Molesworth
Journal: BMJ (1930)

MTF,BRITTNFA 13 it is a not uncommon eveent, and may account for some of thlose cases of continual attacls of haemoptysis, witlh no definite signs of tuberculosis or gross disease, whiclh are met with fairly frequenitly.In this caniniunication.wve lhave called attention to this triangular slhadlowv, aind w-e have discussed its significanice; in our experience tlle most commuiion lesion with which it is associated is bronchiectasis, and we are in agreement with Sergent5 and Wallgreen that the presence of this shadow slhould allways raise the suspicioni of a bronclhiectasis unles.sother clinical eviden-ce is fortlhcomiiing to clinchl the diagnosis of a mediastilial effusion.Ouir best tlhanks are due to Dr. F. G. Clhandler for his kind pelmission to use the notes and skiagram of the case F. R.