tbuckley/cabot-search huggingface dataset:
Survival of Persons with and without HIV Infection in Denmark, 1995–2005
Authors: Nicolai Lohse, Ann-Brit Eg Hansen, Gitte Pedersen, Gitte Kronborg, Jan Gerstoft, Henrik Toft Sørensen, Michael Væth, Niels Obel
Journal: Annals of Internal Medicine (2007)

Background: The expected survival of HIV-infected patients is of major public health interest. Objective: To estimate survival time and age-specific mortality rates of an HIV-infected population compared with that of the general population. Design: Population-based cohort study. Setting: All HIV-infected persons receiving care in Denmark from 1995 to 2005. Patients: Each member of the nationwide Danish HIV Cohort Study was matched with as many as 99 persons from the general population according to sex, date of birth, and municipality of residence. Measurements: The authors computed Kaplan–Meier life tables with age as the time scale to estimate survival from age 25 years. Patients with HIV infection and corresponding persons from the general population were observed from the date of the patient's HIV diagnosis until death, emigration, or 1 May 2005. Results: 3990 HIV-infected patients and 379 872 persons from the general population were included in the study, yielding 22 744 (median, 5.8 y/person) and 2 689 287 (median, 8.4 years/person) person-years of observation. Three percent of participants were lost to follow-up. From age 25 years, the median survival was 19.9 years (95% CI, 18.5 to 21.3) among patients with HIV infection and 51.1 years (CI, 50.9 to 51.5) among the general population. For HIV-infected patients, survival increased to 32.5 years (CI, 29.4 to 34.7) during the 2000 to 2005 period. In the subgroup that excluded persons with known hepatitis C coinfection (16%), median survival was 38.9 years (CI, 35.4 to 40.1) during this same period. The relative mortality rates for patients with HIV infection compared with those for the general population decreased with increasing age, whereas the excess mortality rate increased with increasing age. Limitations: The observed mortality rates are assumed to apply beyond the current maximum observation time of 10 years. Conclusions: The estimated median survival is more than 35 years for a young person diagnosed with HIV infection in the late highly active antiretroviral therapy era. However, an ongoing effort is still needed to further reduce mortality rates for these persons compared with the general population.
Oil shale processing as a source of aquatic pollution: monitoring of the biologic effects in caged and feral freshwater fish.
Authors: A Tuvikene, S Huuskonen, K Koponen, O Ritola, U Mauer, P Lindström-Seppä
Journal: Environmental Health Perspectives (1999)

The biologic effects of the oil shale industry on caged rainbow trout (Oncorhynchus mykiss) as well as on feral perch (Perca fluviatilis) and roach (Rutilus rutilus) were studied in the River Narva in northeast Estonia. The River Narva passes the oil shale mining and processing area and thus receives elevated amounts of polycyclic aromatic hydrocarbons (PAHs), heavy metals, and sulfates. The effects of the chemical load were monitored by measuring cytochrome P4501A (CYP1A)-dependent monooxygenase (MO) activities [7-ethoxyresorufin O-deethylase and aryl hydrocarbon hydroxylase (AHH)] as well as conjugation enzyme activities [glutathione S-transferase (GST) and UDP-glucuronosyltransferase] in the liver of fish. CYP1A induction was further studied by detecting the amount and occurrence of the CYP1A protein. Histopathology of tissues (liver, kidney, spleen, and intestine) and the percentage of micronuclei in fish erythrocytes were also determined. Selected PAHs and heavy metals (Cd, Cu, Hg, and Pb) were measured from fish muscle and liver. In spite of the significant accumulation of PAHs, there was no induction of MO activities in any studied fish species. When compared to reference samples, AHH activities were even decreased in feral fish at some of the exposed sites. Detection of CYP1A protein content and the distribution of the CYP1A enzyme by immunohistochemistry also did not show extensive CYP1A induction. Instead, GST activities were significantly increased at exposed sites. Detection of histopathology did not reveal major changes in the morphology of tissues. The micronucleus test also did not show any evidence of genotoxicity. Thus, from the parameters studied, GST activity was most affected. The lack of catalytic CYP1A induction in spite of the heavy loading of PAHs was not studied but has been attributed to the elevated content of other compounds such as heavy metals, some of which can act as inhibitors for MOs. Another possible explanation of this lack of induction is that through adaptation processes the fish could have lost some of their sensitivity to PAHs. Either complex pollution caused by oil shale processing masked part of the harmful effects measured in this study, or oil shale industry did not have any severe effects on fish in the River Narva. Our study illustrates the difficulties in estimating risk in cases where there are numerous various contaminants affecting the biota.
IgA nephropathy in patients with congenital C9 deficiency
Authors: Kazuo Yoshioka, Tsukasa Takemura, Norihisa Akano, Mitsuru Okada, Kazuro Yagi, Sunao Maki, Shinya Inai, Hironobu Akita, Yasushi Koitabashi, Yasuo Takekoshi
Journal: Kidney International (1992)
How I Encountered the Sophisticated Traditional Healer
Authors: Walinjom F. T. Muna
Journal: JAMA (1981)

I returned to my native Cameroon last year after more than a decade of sophisticated medical education in the United States. I returned looking for other challenges; challenges abound in Cameroon, but above all I am home.  There have been frustrations during the past year, but they are similar to those experienced by all Westerntrained physicians who return to the Third World. There are the familiar problems of shortages of economic resources, of reaching remote and inaccessible villages, of the lack of medical supplies and facilities... the list goes on and on. I was trained as an adult cardiologist, but the complexity and multiplicity of our national medical problems make the environment for specialized medical practice hopelessly impractical. Hypertension and valvular and congenital heart disease are rampant in Cameroon, and I have the undesired opportunity to see the natural history of untreated cardiovascular lesions.  I remember glowing with enthusiasm after
Vinyl Chloride-Associated Liver Disease
Authors: PAUL D. BERK
Journal: Annals of Internal Medicine (1976)

Although polyvinyl chloride has been produced from vinyl chlride monomer for more than 40 years, recognition of toxicity among vinyl chloride polymerization workers is more recent. In the mid 1960s, workers involved in cleaning polymerization tanks were found to have acro-osteolysis. In 1974, the same population of workers was found to be at risk for an unusual type of hepatic fibrosis and angiosarcoma of the liver. We describe two cases of vinyl chloride-associated liver injury, one of hepatic fibrosis and one of angiosarcoma. Histologic features of these lesions are similar to the hepatic fibrosis and angiosarcomas resulting from chronic exposure to inorganic arsenicals. Preliminary studies suggest that the toxicity of vinyl chloride may result from formation, during high-dose exposure, of active metabolites by mixed function oxidases of the liver. Epidemiologic studies indicate an increased incidence not only of liver disease, but also of cancers of the brain, lung, and possibly other organs.
The conditioning model of neurosis
Authors: H. J. Eysenck
Journal: Behavioral and Brain Sciences (1979)

Abstract The long-term persistence of neurotic symptoms, such as anxiety, poses difficult problems for any psychological theory. An attempt is made to revive the Watson-Mowrer conditioning theory and to avoid the many criticisms directed against it in the past. It is suggested that recent research has produced changes in learning theory that can be used to render this possible. In the first place, the doctrine of equipotentiality has been shown to be wrong, and some such concept as Seligman's “preparedness” is required, that is the notion that certain CS are biologically prepared to be more readily connected with anxiety responses than others. In the second place, the law of extinction has to be amended, and the law of incubation or enhancement added, according to which the exposure of the CS-only may, under certain specified conditions, have the effect of increasing the strength of the CR, rather than reducing it. The major conditions favouring incubation are (1) Pavlovian B conditioning, that is a type of conditioning in which the CR is a drive; (2) a strong UCS, and (3) short exposure of the CS-only.
Prospective decrease in progesterone concentrations in female lightweight rowers during the competition season compared with the off season: a controlled study examining weight loss and intensive exercise
Authors: F L Morris, W R Payne, J D Wark
Journal: British Journal of Sports Medicine (1999)

The purpose of this study was to monitor ovarian hormone function response to intense exercise and body weight changes in female athletes. Ovarian hormone function was evaluated in 12 female lightweight rowers and 10 age-height-weight matched sedentary controls. Ovarian hormone function was assessed during consecutive competition season and off season, by measurement of peak and average alternative day overnight urinary oestrone glucuronide (E1G) and pregnanediol glucuronide (PdG) excretion. Competition season was associated with a 5.8 kg (9.3%) body weight loss in the lightweight rowers. Significantly lower competition season peak and average urinary excretion of PdG were found in the lightweight rowers compared with the controls. Lower competition season peak and average urinary excretion of E1G were also found in the lightweight rowers compared with the controls, but the difference did not reach significance. The number of rowing training hours was a significant determinant of peak PdG excretion in the rowers (R2 = 0.40; p&lt;0.02). The seasonal suppression of PdG excretion was associated with degree of weight loss (R2 = 0.46; p&lt;0.01). The competition related decrease in E1G and PdG excretion for the lightweight rowers was predominantly restored during the off season when exercise intensity and duration were decreased and body weight increased. These results showed a significant (p&lt;0.05) reduction in progesterone metabolite excretion and a non-significant decrease in oestrone metabolite excretion associated with intensive competition season training loads and body weight reduction in female lightweight rowers.
Oral liarozole in the treatment of patients with moderate/severe lamellar ichthyosis: results of a randomized, double‐blind, multinational, placebo‐controlled phase <scp>II</scp> / <scp>III</scp> trial
Authors: A. Vahlquist, S. Blockhuys, P. Steijlen, K. Rossem, B. Didona, D. Blanco, H. Traupe
Journal: British Journal of Dermatology (2013)

Oral liarozole, a retinoic acid metabolism-blocking agent, may be an alternative to systemic retinoid therapy in patients with lamellar ichthyosis.To demonstrate the efficacy and safety of once-daily oral liarozole in the treatment of moderate/severe lamellar ichthyosis.This was a double-blind, multinational, parallel phase II/III trial (NCT00282724). Patients aged ≥ 14 years with moderate/severe lamellar ichthyosis [Investigator's Global Assessment (IGA) score ≥ 3] were randomized 3 : 3 : 1 to receive oral liarozole (75 or 150 mg) or placebo once daily for 12 weeks. Assessments included: IGA; a five-point scale for erythema, scaling and pruritus severity; Short Form-36 health survey; Dermatology Life Quality Index (DLQI); and safety parameters. The primary efficacy variable was response rate at week 12 (responder: ≥ 2-point decrease in IGA from baseline).Sixty-four patients were enrolled. At week 12, 11/27 (41%; liarozole 75 mg), 14/28 (50%; liarozole 150 mg) and one out of nine (11%; placebo) patients were responders; the difference between groups (liarozole 150 mg vs. placebo) was not significant (P = 0.056). Mean IGA and scaling scores decreased from baseline in both liarozole groups at weeks 8 and 12 vs. placebo; erythema and pruritus scores were similar between treatment groups. Improvement in DLQI score was observed in both liarozole groups. Treatment with liarozole for 12 weeks was well tolerated.The primary efficacy variable did not reach statistical significance, possibly owing to the small sample size following premature termination. However, once-daily oral liarozole, 75 and 150 mg, improved scaling and DLQI and was well tolerated in patients with moderate/severe lamellar ichthyosis.
Puncture through the Abdominal Parietes in Impassable Obstruction of the Bowels
Authors: H. Cooper
Journal: BMJ (1857)

Sanuary 21st, on account of incontinence of urine, which had existed for several mnonths.He had been carefully watched, and various plans of treatment adopted, among which corporal punishment appeared to have been not forgotten.The urine dribbled from him by day as well as night.He was ordered one-sixth of a grain of extract of belladonna, dissolved in a tea- spoonful of water, three times a day; no fluid was allowed after 5 P.r.; and the nurse was ordered, as usual, to see that he passed urine at night.This plan was perfectly successful.After its adoption he only wetted his bed once at night; and left the hospital quite cured three weeks after admission, making water only two or three times a day.We shall give some other cases of the treatment of this annoying and frequently obstinate affection by means of the same druig in an early number.
Defensive Medicine Among High-Risk Specialist Physicians in a Volatile Malpractice Environment
Authors: David M. Studdert, Michelle M. Mello, William M. Sage, Catherine M. DesRoches, Jordon Peugh, Kinga Zapert, Troyen A. Brennan
Journal: JAMA (2005)

How often physicians alter their clinical behavior because of the threat of malpractice liability, termed defensive medicine, and the consequences of those changes, are central questions in the ongoing medical malpractice reform debate.To study the prevalence and characteristics of defensive medicine among physicians practicing in high-liability specialties during a period of substantial instability in the malpractice environment.Mail survey of physicians in 6 specialties at high risk of litigation (emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology) in Pennsylvania in May 2003.Number of physicians in each specialty reporting defensive medicine or changes in scope of practice and characteristics of defensive medicine (assurance and avoidance behavior).A total of 824 physicians (65%) completed the survey. Nearly all (93%) reported practicing defensive medicine. "Assurance behavior" such as ordering tests, performing diagnostic procedures, and referring patients for consultation, was very common (92%). Among practitioners of defensive medicine who detailed their most recent defensive act, 43% reported using imaging technology in clinically unnecessary circumstances. Avoidance of procedures and patients that were perceived to elevate the probability of litigation was also widespread. Forty-two percent of respondents reported that they had taken steps to restrict their practice in the previous 3 years, including eliminating procedures prone to complications, such as trauma surgery, and avoiding patients who had complex medical problems or were perceived as litigious. Defensive practice correlated strongly with respondents' lack of confidence in their liability insurance and perceived burden of insurance premiums.Defensive medicine is highly prevalent among physicians in Pennsylvania who pay the most for liability insurance, with potentially serious implications for cost, access, and both technical and interpersonal quality of care.
Electronic Evaluation of Prosthetic Cardiac Valve Performance.
Authors: Benedict Kingsley
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971Electronic Evaluation of Prosthetic Cardiac Valve Performance.Benedict Kingsley, M.Sc., Edward Waxler, M.D., Leonard Dreifus, M.D., Bernard L. Segal, M.D., Peter Green, M.T.Benedict Kingsley, M.Sc.Search for more papers by this author, Edward Waxler, M.D.Search for more papers by this author, Leonard Dreifus, M.D.Search for more papers by this author, Bernard L. Segal, M.D.Search for more papers by this author, Peter Green, M.T.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-820_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA new noninvasive technique, octave band analysis, has been used for measuring objectively the sound level energy in decibels (db) and cutoff frequency in Hertz (Hz) of prosthetic valve sounds in 100 patients. The main components of this simple and portable system are a transducer, an octave band analyzer, a preamplifier, and an oscilloscope. The system is easily calibrated in decibels by using a vibration calibrator that applies to the transducer a mechanical force corresponding to an acceleration of 1 g at a frequency of 100 Hz. Frequency profiles (decibel versus frequency) have been plotted for normally functioning Starr-Edwards silastic... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Benedict Kingsley, M.Sc.; Edward Waxler, M.D.; Leonard Dreifus, M.D.; Bernard L. Segal, M.D.; Peter Green, M.T.Affiliations: Philadelphia, Pa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 820-820 ePublished: 1 December 2008 Issue Published: 1 May 1971 PDF downloadLoading ...
The Right Ventricle
Authors: E. W. Hancock
Journal: JAMA (1989)

This unusual book is a collection of 17 chapters by 25 authors on a variety of topics that have in common some aspect of the right ventricle. Topics include cardiopulmonary physiology, congenital heart disease, pulmonary disease, myocardial infarction, cardiac trauma, and postoperative care in cardiac surgery. The unevenness that seems inevitable in multiauthored books on specialized subjects is evident here, but this can be an advantage as well as a disadvantage. In contrast to highly organized comprehensive textbooks, where strict editorial guidance enforces brevity, some authors in books like this have the opportunity to expand their chapters into mini-monographs that go far to justify the enterprise as a whole. For example, the chapter by Isner on right ventricular myocardial infarction (42 pages, 34 illustrations, 152 references) is a particularly rich and valuable contribution. It describes the pathology of this condition on the basis of a fourpoint grading system for the
Lower cranial nerve motor function in unilateral vascular lesions of the cerebral hemisphere.
Authors: E W Willoughby, N E Anderson
Journal: BMJ (1984)

Motor function subserved by cranial nerves V, VII, X, XI, and XII was assessed in 100 patients with hemiparesis due to a unilateral vascular lesion of the cerebral hemisphere. Several of the findings were not described clearly in many of the standard textbooks of neurology. Weakness of sternomastoid when present was always contralateral to the hemiparesis. This emphasises the principle that the cerebral hemisphere controls movement of the body parts in or towards the contralateral half of the body rather than simply the contralateral muscle groups. An apparent exception to this was seen, however, in the small group of patients who had unilateral weakness of the tongue. In those patients deviation of the tongue was towards the hemiparetic side--that is, the cerebral hemisphere controlled the contralateral half of the tongue and hence protrusion towards the ipsilateral side. Mild dysarthria was common with both right and left sided hemiparesis.
Nurse-ing Rockefeller
Authors: Karen Birmingham
Journal: Journal of Clinical Investigation (2003)

Nearly two years after Arnie Levine’s troubled exit, and just in time for Thanksgiving, Sir Paul Nurse will take up residence as the ninth president of Rockefeller University in November. A man who freely admits that he has hitherto deliberately avoided working in the US, British-born Sir Paul says the change will do him good. “When you get a Nobel Prize you get lauded by everybody. I was worried I might rest on my laurels, so I’m now exposing myself like a baby. I could get it wrong,” he told the JCI.

Sir Paul became head of the Imperial Cancer Research Fund (ICRF) in 1996 and remained in place through its merger with the Cancer Research Campaign to become Cancer Research UK (CRUK) in February 2002. He shared the 2001 Nobel Prize with Leland Hartwell and Tim Hunt for their discoveries of key regulators of the cell cycle, and insists that a great part of the Rockefeller attraction is that he will be able to pursue his own research. “There were a couple of posts that came up in the last year while I was considering [Rockefeller]. I did think about the Director of the Wellcome Trust and the MRC chief executiveship, but I really wanted to run a lab myself and I wasn’t sure that I’d get enough time to do that in those positions.”
Is your patch test really necessary?
Authors: C. Dupont
Journal: British Journal of Dermatology (2005)

Conflict of interest: none declared. Sir, There is reasonable consensus about when patch testing should be performed.1 We are agreed on a positive cost–benefit ratio2 and the effect on the quality of life.3 The relevance of positive patch test reactions is a matter of some debate.4 Many series have shown about 40% of patients have positive results and 40% of these (i.e. 16% of total) have clinical relevance. How do these latter figures compare with the results of routine investigations in other specialities? Colonoscopy for large bowel symptoms has found pathology in 66% of cases,5 routine gastroscopy has shown malignant lesions and serious benign gastrointestinal lesions in 6% of patients studied.6 Flexible bronchoscopy in the evaluation of chronic cough7 with normal chest X‐rays showed no patients with serious pathology. It may be concluded therefore that patch testing is a useful investigation for the above‐mentioned reasons. It is also very likely that it has a considerable placebo effect and may deter many patients from consulting the unqualified for farcical allergy tests.
Letter: Smoking hazards to the fetus.
Authors: E M Ross, N R Butler, H Goldstein
Journal: BMJ (1973)

reference care of worried and "difficult" patients and the handling of particular problems such as the social and psychological management of terminal cases, we need the services of trained social workers whose jdb is primarily personal contact with the patient.We should value the essential and excellent help that they can give in overall patient care when encouraged in this func- tion by members of the medical profession who do not find their presence threatening.-We are, etc.,