tbuckley/cabot-search huggingface dataset:
Hospital Family Planning: Termination of Pregnancy and Contraceptive Use
Authors: J. Newton, M. Brotman, J. McEwan, C. Owens
Journal: BMJ (1973)

A review of termination of pregnancy in a district hospital catchment area for 1970 to 1972 shows how a decrease in total numbers of terminations and repeat terminations may be effected by the use of intensive family planning. In 1972 over 80% had first trimester abortions, but most of the second trimester abortions came from the manual skilled, semi-skilled, and unskilled occupational groups. Over half those attending for termination had never used any method of contraception. Acceptance of family planning after termination was high but motivation poor, emphasizing the suitability of intrauterine devices inserted at the time of termination. The complication rate after termination was low.
The Triglyceride-to-HDL Cholesterol Ratio
Authors: Cosimo Giannini, Nicola Santoro, Sonia Caprio, Grace Kim, Derek Lartaud, Melissa Shaw, Bridget Pierpont, Ram Weiss
Journal: Diabetes Care (2011)

We evaluated whether the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio is associated with insulin resistance (IR) in a large multiethnic cohort of obese youths.Obese youths (1,452) had an oral glucose tolerance test and a fasting lipid profile. Insulin sensitivity was estimated using the whole body insulin sensitivity index (WBISI) and homeostasis model assessment (HOMA)-IR and evaluated, in a subgroup of 146 obese youths, by the hyperinsulinemic-euglycemic clamp. The cohort was divided by ethnicity (612 whites, 357 Hispanics, and 483 African Americans) and then stratified into ethnicity-specific tertiles of TG/HDL-C ratio. Differences across tertiles were evaluated, and the association between the TG/HDL-C ratio and insulin sensitivity (WBISI) was defined by a multiple stepwise linear regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) was determined to calculate the TG/HDL-C ratio cutoff to identify insulin-resistant subjects by ethnicity.In each ethnic group and across rising tertiles of TG/HDL-C ratio, insulin sensitivity (WBISI) progressively decreased, whereas 2-h glucose and the AUC-glucose progressively increased. The cutoff for TG/HDL-C ratio was 2.27, and the odds of presenting with IR, in youths with TG/HDL-C ratio higher than the cutoff, was 6.023 (95% CI 2.798-12.964; P < 0.001) in white girls and boys, whereas for both Hispanics and African Americans the AUC-ROCs were not significant, thus not allowing the calculation of an optimal cutoff TG/HDL-C value.The TG/HDL-C ratio is associated with IR mainly in white obese boys and girls and thus may be used with other risk factors to identify subjects at increased risk of IR-driven morbidity.
Names for Aneurysms-Reply
Authors: Harvey A. Koolpe
Journal: JAMA (1986)

<h3>In Reply.—</h3> Dr Yao raises the issue of the significance of the term "dissecting aneurysm." We find the following in<i>The Heart: Arteries and Veins</i><sup>1</sup>: It is important to recognize the distinct nature of this lesion. The term<i>dissecting aneurysm</i>is often applied but leads to confusion with an entirely separate problem—expanding or leaking aneurysm of atherosclerotic or luetic origin.<i>Aortic dissection</i>is a much more suitable label, particularly since aneurysm formation is not a feature of the acute phase. External rupture, by far the most common cause of death from aortic dissection, tends to occur at the site of the entrance tear. This validates my comments in the original book review that aortic dissections are primarily a disease of the thoracic aorta, while aneurysms are primarily a disease of the abdominal aorta. It is true that<i>late</i>aneurysm rupture may complicate thoracic aortic dissections; however, as noted above,
Anomalous Left Coronary Artery Originating from the Pulmonary Artery
Authors: ALEXANDER S. NADAS, RAUL GAMBOA, PAUL G. HUGENHOLTZ
Journal: Circulation (1964)

Case histories of two infants with anomalous origin of the left coronary artery from the pulmonary artery are presented. Both infants underwent ligation of the left coronary artery at its entrance into the pulmonary artery. One survived the operation and is asymptomatic 3 years postoperatively, whereas the second one died at surgery. A classification of instances of anomalous left coronary artery according to adequacy of the collateral circulation between the left and right coronary systems is proposed. Surgical ligation of the pulmonary artery orifice of the left coronary artery is indicated only if the presence of a left-to-right shunt into the pulmonary artery is demonstrated. If the direction of blood flow is from pulmonary artery to left coronary artery, surgical procedures should be aimed toward increasing either pulmonary artery oxygen content or left coronary artery perfusion pressure.
Treatment of Lead-poisoning with Oral Penicillamine
Authors: A. Goldberg, J. A. Smith, A. C. Lochhead
Journal: BMJ (1963)

MEDICALBJOURNALof Eaton agent and from several recent Dutch isolates of the organism from patients with atypical pneumonia (Marmion and Hers, 1963). SummarySixteen sporadic cases in the general population and six cases in a small school outbreak of infections due to Eaton's primary atypical pneumonia agent are described with two characteristic clinical histories.The clinical features of these cases resemble those described in similar investigations in the United States.Thus patients had pneumonia, an acute febrile bronchitis or bronchiolitis, or fever of uncertain origin.Diagnosis was made by serological methods, serum antibody being detected principally by immunofluorescent methods, using the indirect staining technique.The development of a complement-fixation test for the laboratory diagnosis of infections with Eaton's agent is described, the results of which appear to be in reasonable agreement with those obtained by immunofluorescent methods.The antigenic similarity of agents causing similar illnesses in the United States, Holland, and England is shown, and evidence is presented that infection has been present in this country for at least twelve years.We are grateful to many persons who sent serum specimens and clinical information about the sporadic cases.
Musculoskeletal ultrasound: changing times, changing practice?
Authors: Bruce B Forster, Mark Cresswell
Journal: British Journal of Sports Medicine (2010)

The paper by Finnoff et al ( see page 1144 ) is an important first step in formalising a detailed curriculum for ultrasound (US) education for sports medicine fellows.1 It is also advantageous in that it is based on the existing American Institute for Ultrasound in Medicine (AIUM) curriculum, as this agency has a wealth of experience in sports medicine.

As radiologists, we are acutely aware of the great value of sonographic assessment of musculoskeletal (MSK) injuries. Non-radiologist clinicians have also recognised this utility, and begun to use laptop-sized US units which are able to achieve an image quality that is satisfactory for examining MSK systems as long as high-frequency (10–12 MHz) probes are utilised. The more recent availability of truly hand-held units has generated even greater interest in sonographic augmentation of the physical examination, although currently these ultraportable machines are used mainly for basic assessment of, for example, free fluid in the abdomen in trauma cases, and are not designated by the vendors for MSK use. Other advantages of US, such as a lack of ionising radiation, ability to perform a dynamic examination, high spatial resolution and ability to guide intervention, further exemplify this modality's important role in …
Beneficial effects of metoprolol treatment in congestive heart failure. Reversal of sympathetic-induced alterations of immunologic function.
Authors: A S Maisel
Journal: Circulation (1994)

BACKGROUND Little information is available to explain why beta-blockers are beneficial in certain patients with congestive heart failure (CHF). Since catecholamines alter immune function, we asked whether beta-blocker treatment leads to enhancement of immune function. METHODS AND RESULTS Fifteen patients with New York Heart Association class III-IV CHF secondary to dilated cardiomyopathy were titrated to a minimum dose of metoprolol 25 mg BID on a background therapy of digoxin, diuretic, and angiotensin-converting enzyme inhibitors. Cardiac and immunologic studies were done before and 6 months to 1 year after treatment. While these patients served as their own controls, an additional population of patients with heart failure was followed for a similar time period on traditional medications. A panel of seven delayed hypersensitivity skin tests were placed at 6- to 12-month intervals on the patient's forearm. Seventy percent of all CHF patients were anergic (unable to respond to more than 1 antigen). The 30% who could respond averaged 2.2 antigens. After treatment with metoprolol, only 20% remained anergic (P &lt; .001). The 80% of responders averaged 4.2 antigens (P &lt; .001). Additionally, patients treated with metoprolol had an increased percentage of T cells, natural killer cells, and increased interleukin-2 receptor density upon stimulation with concanavalin A. These changes correlated to increases in ejection fraction. Patients not treated with metoprolol remained anergic and had no beneficial immunologic changes. CONCLUSIONS It appears that patients with dilated cardiomyopathy who are treated with metoprolol have enhancement of cell-mediated immunity and improvement of T-cell function; these improvements are correlated to improvement in ejection fraction.
ErbB3 downregulation enhances luminal breast tumor response to antiestrogens
Authors: Meghan M. Morrison, Katherine Hutchinson, Michelle M. Williams, Jamie C. Stanford, Justin M. Balko, Christian Young, Maria G. Kuba, Violeta Sánchez, Andrew J. Williams, Donna J. Hicks, Carlos L. Arteaga, Aleix Prat, Charles M. Perou, H. Shelton Earp, Suleiman Massarweh, Rebecca S. Cook
Journal: Journal of Clinical Investigation (2013)

Aberrant regulation of the erythroblastosis oncogene B (ErbB) family of receptor tyrosine kinases (RTKs) and their ligands is common in human cancers. ErbB3 is required in luminal mammary epithelial cells (MECs) for growth and survival. Since breast cancer phenotypes may reflect biological traits of the MECs from which they originate, we tested the hypothesis that ErbB3 drives luminal breast cancer growth. We found higher ERBB3 expression and more frequent ERBB3 gene copy gains in luminal A/B breast cancers compared with other breast cancer subtypes. In cell culture, ErbB3 increased growth of luminal breast cancer cells. Targeted depletion of ErbB3 with an anti-ErbB3 antibody decreased 3D colony growth, increased apoptosis, and decreased tumor growth in vivo. Treatment of clinical breast tumors with the antiendocrine drug fulvestrant resulted in increased ErbB3 expression and PI3K/mTOR signaling. Depletion of ErbB3 in fulvestrant-treated tumor cells reduced PI3K/mTOR signaling, thus decreasing tumor cell survival and tumor growth. Fulvestrant treatment increased phosphorylation of all ErbB family RTKs; however, phospho-RTK upregulation was not seen in tumors treated with both fulvestrant and anti-ErbB3. These data indicate that upregulation of ErbB3 in luminal breast cancer cells promotes growth, survival, and resistance to fulvestrant, thus suggesting ErbB3 as a target for breast cancer treatment.
One year into Obamacare: where is it now?
Authors: J. Lenzer
Journal: BMJ (2014)

Jeanne Lenzer assesses how President Obama’s health policy is progressing

About one year since the launch of the Patient Protection and Affordable Care Act’s insurance exchange program, the overwhelming majority of the 48 million people who were uninsured in 2012, remain uninsured1—a problem that will persist for the next 10 years, according to government projections. The Congressional Budget Office estimates that 37 million people will not have health insurance in 2015 and 31 million will be uninsured in 2024.2

About 6.7 million (corrected from an earlier estimate of 7.3 million) were newly insured under the act known as Obamacare during 2014.3

Access to insurance has been liberalized in several ways: insurers may no longer deny coverage to individuals with pre-existing illnesses; young adults under age 26 may remain on their parents’ policy; and Medicaid has been extended to include some poor single adults and adults without children.

A Gallup poll conducted in November 2014 found that 37% of US residents approve of the act while 56% disapprove. This reverses earlier ratings in 2012, when 48% approved and 46% disapproved.4 Approval dropped substantially in November 2013, when millions of residents were notified that their previous insurance policies were being cancelled because they did not meet the minimum standards of the act, forcing them to buy more expensive policies.5 Disapproval also grew when some newly insured people learnt that they were responsible for large medical bills because of a complex scheme of deductibles, copayments, co-insurance, and out …
Your Child Is A Person: A Psychological Approach to Parenthood Without Guilt
Authors: Marjorie C. Meehan
Journal: JAMA (1966)

Until recently, many of the numerous books on child care seemed designed to create guilt feelings in parents rather than desirable personality development in children. A parent who feels guilty will eventually resent the child who occasioned this feeling, and will be unable to give him love and emotional security. Very different is this book by Chess, Thomas, and Birch. They did not start by formulating theories based on observations of disturbed adults, but instead carried out a long-term research project on children's personality development. From birth to school age, 231 New York children (136 from nativeborn college-educated parents, and 95 from Puerto Rican working-class families) were carefully observed. Babies differed in activity levels, regularity, tendencies to approach or withdraw from new situations, adaptability to change, level of sensory threshold, mood, intensity of response, distractability, persistence. The investigations studied the interactions between these characteristics of the baby's temperament and the
Iatrogenic Urethral Injury Due to Preinflation of a Foley Catheter
Authors: Thomas Sellett
Journal: JAMA (1971)

Urethral inflation of the balloon of a Foley catheter is a real patient risk during the catheterization procedure. Questionnaires returned from 152 teaching hospital departments of urology describe urethral inflation injuries ranging from transient hematuria to the death of the patient. These injuries result from operator carelessness or lack of skill.
Incidence and Determinants of Microalbuminuria in Koreans With Type 2 Diabetes
Authors: Joong-Yeol Park, Hong-Kyu Kim, Yun E Chung, Sang W Kim, Sung K Hong, Ki-Up Lee
Journal: Diabetes Care (1998)

OBJECTIVE The incidence of diabetic nephropathy in type 2 diabetes differs widely by race. Although clinical proteinuria is reportedly more common in East Asian type 2 diabetic patients than in their Caucasian counterparts, data on the incidence of microalbuminuria are not available. This study was undertaken to investigate the incidence and the determinants of microalbuminuria in Korean type 2 diabetic patients. RESEARCH DESIGN AND METHODS A cohort of 188 Korean type 2 diabetic patients with initial normoalbuminuria were followed prospectively for 5.5 ± 0.9 years in an outpatient clinic of a university hospital. The incidence of elevated urinary albumin excretion (UAE) (&amp;gt;20 μg/min) and its relationship with baseline characteristics and follow-up data were determined. RESULTS Of the 146 patients who finished the study, 37 showed persistently elevated UAE during follow-up, giving an incidence of 52/1,000 person-years. Age, duration of diabetes, and baseline UAE were significantly higher in the progressors than in the nonprogressors. More patients in the progressor group had retinopathy at baseline and at the end of follow-up. The mean values of fasting plasma glucose, HbA1, and systolic and diastolic blood pressure during the follow-up period were significantly higher in the progressors than in the nonprogressors. Cox proportional hazards analysis revealed that presence of retinopathy, duration of diabetes, mean fasting plasma glucose, and mean systolic blood pressure during follow-up are independent variables that have a statistically significant influence on the development of microalbuminuria. CONCLUSIONS The incidence of microalbuminuria in Korean type 2 diabetic patients is lower than that reported in Pima Indians with type 2 diabetes but is as high as that in Caucasians with type 1 diabetes. Presence of diabetic retinopathy, poor glycemic control, and high blood pressure are risk factors for development of microalbuminuria in Koreans with type 2 diabetes.
RADICULITIS: ITS DIAGNOSIS AND INTERPRETATION
Authors: EDWARD E. MAYER
Journal: JAMA (1918)

Radiculitis, the syndrome radiculaire of Dejerine1 is an acute inflammation of the spinal nerve roots.We mean by a radicular syndrome, alterations of sensation or of muscle power which show that the primary disease-process producing them is in the spinal roots and not in the tracts and nuclei of the spinal cord.Likewise, we must distinguish such an innervation from a peripheral one.We know that every posterior root innervates a particular skin zone, its fibers reaching this area through several peripheral nerve trunks.Radicular areas are, therefore, very different from peripheral areas of innervation.According to some, radiculitis should be used only in connection with disease of the sensory nerve roots.Such a limited pathologic picture i s, however, rarely met with and the radicular syndrome gen- erally includes an involvement of the anterior as well as of the posterior nerve roots.Wertheim -Salomonson2 believes that radiculitis should refer only to neuritis of the spinal roots (both sensory and motor), and that neuralgia of a ra¬ dicular innervation should not be grouped under this name.I agree with many French au¬ thors3 that we can¬ not always distin¬ guish between a neu¬ ralgia and a neuritis Fig. 1.-Cross section through the fourth cervical vertebra showing the menin¬ gea 1 sheaths, and the connections with the sympathetic nervous system modified from Rauber-Kopsch and Ediager.of the spinal roots, and radiculitis when used should refer to both of these.Radiculitis is more frequent in the lumbosacral than in the cervical or thoracic roots, because here the roots are longer and more perpendicular and having fewer anastomoses, their involvement is more easily distin¬ guished from neuritis of the nerve trunks.In the upper cervical region, for instance, the distance from an intervertebral foramen to the spinal ganglion is only 10 mm., but it increases the farther one goes along the cord, until in the first sacral root, this dis¬ tance is 188 mm.In the cervical region, sensory (and also motor) root symptoms invariably involve several adjacent roots and the motor root symptoms over¬ shadow those of the sensory roots.A radiculitis of
Diagnostic Accuracy of 11C-Choline PET/CT in Preoperative Lymph Node Staging of Bladder Cancer
Authors: Eugenio Brunocilla, Francesco Ceci, Riccardo Schiavina, Paolo Castellucci, Anna Margherita Maffione, Matteo Cevenini, Lorenzo Bianchi, Marco Borghesi, Francesca Giunchi, Michelangelo Fiorentino, Sotirios Chondrogiannis, Patrick M. Colletti, Domenico Rubello, Stefano Fanti, Giuseppe Martorana
Journal: Clinical Nuclear Medicine (2014)

Aim The aim of this study was to evaluate the role of 11C-choline PET/CT in the preoperative evaluation of the nodal involvement of patients with bladder carcinoma (BC) suitable for radical cystectomy and extended pelvic lymph node dissection in comparison with contrast-enhanced CT (CECT) using the pathologic specimen as reference standard. Patients and Methods Twenty-six consecutive patients (69.5 ± 9.3 years; range, 49–84) with histologically proven transitional cell BC were treated with radical cystectomy and pelvic lymph node dissection and were enrolled from April 2011 to January 2013. In all patients, paravesical, internal, eternal, and common iliac nodes as well as obturatory, presacral, preaortic, and precaval lymph nodes (LNs) were dissected up to the origin of the inferior mesentery artery. The areas of the LN dissection were grouped as follow: region A included preaortic and precaval LNs; region B included paravesical, common, internal and external iliac, obturatory, and presacral LNs in the right pelvis; region C included paravesical, common, internal and external iliac, obturatory, and presacral LNs in the left pelvis. 11C-choline PET/CT and abdominal CECT were used to assess the presence of lymph node metastases on a per patient, region, and lesion analysis using the results of surgical specimens obtained at operation as criterion standard. Results Seven of 26 patients (26.9%) showed nodal metastases at pathologic analysis. Overall, 844 LNs were evaluated, and 38 of them (4.5%) showed metastatic involvement. On a patient-based analysis, 11C-choline PET/CT showed a sensitivity of 42% and specificity of 84%, whereas, CECT showed a sensitivity of 14% and specificity of 89%. On a region-based analysis, 11C-choline PET/CT showed a sensitivity of 11% and specificity of 82%, whereas CECT showed a sensitivity of 5% and specificity of 80%. On a lesion (LN)-based analysis, 11C-choline PET/CT showed a sensitivity of 10% and specificity of 64%, whereas CECT showed a sensitivity of 2% and specificity of 63%. Conclusions 11C-choline PET/CT could provide additional diagnostic information in preoperative nodal staging of patients with invasive BC in comparison with CECT. A study with a larger population should determine if 11C-choline PET/CT could be recommended as a routine technique in high-risk patients with BC.
Significant variability in response to inhaled corticosteroids for persistent asthma
Authors: Stanley J. Szefler, Richard J. Martin, Tonya Sharp King, Homer A. Boushey, Reuben M. Cherniack, Vernon M. Chinchilli, Timothy J. Craig, Myrna Dolovich, Jeffrey M. Drazen, Joanne K. Fagan, John V. Fahy, James E. Fish, Jean G. Ford, Elliot Israel, James Kiley, Monica Kraft, Stephen C. Lazarus, Robert F. Lemanske, Elizabeth Mauger, Stephen P. Peters, Christine A. Sorkness
Journal: Journal of Allergy and Clinical Immunology (2002)
Role of activation of protein kinase C in the stimulation of colonic epithelial proliferation and reactive oxygen formation by bile acids.
Authors: P A Craven, J Pfanstiel, F R DeRubertis
Journal: Journal of Clinical Investigation (1987)

Deoxycholate (DOC), chenodeoxycholate, 12-O-tetradecanoyl phorbol-13-acetate (TPA), or 1-oleoyl-2-acetyl-glycerol (OAG) activated colonic epithelial protein kinase C as reflected by translocation from the soluble to the particulate cell fraction. Activation of protein kinase C was correlated with stimulation of enhanced proliferative activity of colonic mucosa and reactive oxygen production. TPA and OAG, but not DOC, directly activated soluble protein kinase C in vitro. However, DOC rapidly increased labeled inositol phosphate and diacylglycerol accumulation in colonic epithelial cells. Retinoic acid inhibited protein kinase C activity and suppressed DOC-, TPA-, and OAG-induced increases in reactive oxygen production. The results support a role for protein kinase C in the stimulation of colonic epithelial proliferative activity and reactive oxygen production induced by bile acids, TPA and OAG. In contrast to TPA and OAG, which activate protein kinase C directly, bile acids appear to activate protein kinase C indirectly by increasing the diacylglycerol content of colonic epithelium.