tbuckley/cabot-search huggingface dataset:
A Key Miscommunication
Authors: Melissa H. Kong, G. Ralph Corey, Thomas Bashore, J. Kevin Harrison
Journal: New England Journal of Medicine (2008)

An 81-year-old woman presented to the emergency department with increasing abdominal distention, nausea, and vomiting. She also reported increasing shortness of breath and fatigue, which had become worse over the past several weeks. She had a history of congestive heart failure, mitral regurgitation, hypertension, atrial fibrillation, hypothyroidism, peptic ulcer disease, and depression. She had no history of coronary artery disease or cardiac surgery.
Cost Containment and the Physician
Authors: Frank Matthews
Journal: JAMA (1986)

To the Editor.—  Dr Angell 1 is to be congratulated for pointing out that preventive health care probably will not save money, at least not in the America of today. I fear, however, that readers may draw incomplete conclusions from her reference to the possible savings from elimination of unneeded little-ticket items. She notes, quite accurately, that her data are from teaching hospitals; the situation in nonteaching hospitals may be very different and more difficult to correct.  Our 520-bed community hospital has no residents, and our laboratory does no routine tests—all must be ordered specifically. I have my suspicions that some of these are unnecessary. Our clinicians, however, come from diverse training programs all over the country. They are not all cost conscious, but they all think they are cost conscious, and most of them can emphatically quote literature to back their orders.  If someone—though not I, it is hoped—were
NEUROTIC AFFECTIONS OF INTERSTITIAL GINGIVITIS.
Authors: J. G. KIERNAN
Journal: JAMA (1900)

The chief function of the nervous system, beside its special function, is that of regulating growth and repair. This function, as Marinesco points out, resides even in the neuron or nerve unit. While this function of regulating growth and repair is often connected with control of the vasomotor system, still, as Collins remarks, there are trophoneuroses in which there are no appreciable vasomotor disturbances, and there are any amount of vasomotor disturbances which are in no sense connected with disturbances of nutrition. The nerves regulating growth and repair are called trophic nerves, and the conditions produced by anomalies of their action are, as already stated, called trophoneuroses. It was in the domain of bone growth that anomalies of the function of the trophic nerves were first observed. Brown-Séquard pointed out certain anomalies in the joints of locomotor ataxics; later similar disturbances were observed in the jaws of patients with this
Doctors will see increased demand during Olympics despite preparations
Authors: I. Torjesen
Journal: BMJ (2012)

Health services in London will see demand for care rise by 3-5% during the Olympic Games, despite the new system that the Health Protection Agency (HPA) has put in place to monitor and respond to outbreaks of infectious diseases and environmental hazards.1

Brian McCloskey, the agency’s Olympics lead and director for London, said that the increase would be in the order of the surge that the NHS sees in a mild winter. “It is not as much as the increased numbers that create a crisis in the health service; it is much less than that,” he said.

Much of the predicted increase would be related to excessive alcohol consumption and acute conditions rather than infectious diseases, McCloskey added. At the Olympic Games in Athens in 2004 and in Sydney in 2000 only 1% of admissions to hospital …
Book Review The Molecular Basis of Blood Diseases Third edition. Edited by George Stamatoyannopoulos, Philip W. Majerus, Roger M. Perlmutter, and Harold Varmus. 1028 pp., illustrated. Philadelphia, W.B. Saunders, 2001. $275. 0-7216-7671-5
Authors: David A. Roth
Journal: New England Journal of Medicine (2001)
The Effect of Organized Systems of Trauma Care on Motor Vehicle Crash Mortality
Authors: Avery B. Nathens, Gregory J. Jurkovich, Peter Cummings, Frederick P. Rivara, Ronald V. Maier
Journal: JAMA (2000)

Context Despite calls for wider national implementation of an integrated approach to trauma care, the effectiveness of this approach at a regional or state level remains unproven.Objective To determine whether implementation of an organized system of trauma care reduces mortality due to motor vehicle crashes.Design Cross-sectional time-series analysis of crash mortality data collected for 1979 through 1995 from the Fatality Analysis Reporting System.Setting All 50 US states and the District of Columbia.Subjects All front-seat passenger vehicle occupants aged 15 to 74 years. Main Outcome MeasuresRates of death due to motor vehicle crashes compared before and after implementation of an organized trauma care system.Estimates are based on within-state comparisons adjusted for national trends in crash mortality. ResultsTen years following initial trauma system implementation, mortality due to traffic crashes began to decline; about 15 years following trauma system implementation, mortality was reduced by 8% (95% confidence interval [CI], 3%-12%) after adjusting for secular trends in crash mortality, age, and the introduction of traffic safety laws.Implementation of primary enforcement of restraint laws and laws deterring drunk driving resulted in reductions in crash mortality of 13% (95% CI, 11%-16%) and 5% (95% CI, 3%-7%), respectively, while relaxation of state speed limits increased mortality by 7% (95% CI, 3%-10%). ConclusionsOur data indicate that implementation of an organized system of trauma care reduces crash mortality.The effect does not appear for 10 years, a finding consistent with the maturation and development of trauma triage protocols, interhospital transfer agreements, organization of trauma centers, and ongoing quality assurance.
Lung abscess: a neglected cause of life threatening haemoptysis.
Authors: N J Philpott, M A Woodhead, A G Wilson, F J Millard
Journal: Thorax (1993)

Three cases who presented with life threatening haemoptysis are reported, all of whom required surgery to control the bleeding. In all three patients chronic lung abscess was responsible for the haemoptysis. Even in the absence of typical clinical or radiographic features of an abscess this diagnosis should be considered in any patient presenting with life threatening haemoptysis.
KRAB Zinc Finger Proteins: An Analysis of the Molecular Mechanisms Governing Their Increase in Numbers and Complexity During Evolution
Authors: Camilla Looman, Magnus Åbrink, Charlotta Mark, Lars Hellman
Journal: Molecular Biology and Evolution (2002)

Krüppel-related zinc finger proteins, with 564 members in the human genome, probably constitute the largest individual family of transcription factors in mammals. Approximately 30% of these proteins carry a potent repressor domain called the Krüppel associated box (KRAB). Depending on the structure of the KRAB domain, these proteins have been further divided into three subfamilies (A + B, A + b, and A only). In addition, some KRAB zinc finger proteins contain another conserved motif called SCAN. To study their molecular evolution, an extensive comparative analysis of a large panel of KRAB zinc finger genes was performed. The results show that both the KRAB A + b and the KRAB A subfamilies have their origin in a single member or a few closely related members of the KRAB A + B family. The KRAB A + B family is also the most prevalent among the KRAB zinc finger genes. Furthermore, we show that internal duplications of individual zinc finger motifs or blocks of several zinc finger motifs have occurred quite frequently within this gene family. However, zinc finger motifs are also frequently lost from the open reading frame, either by functional inactivation by point mutations or by the introduction of a stop codon. The introduction of a stop codon causes the exclusion of part of the zinc finger region from the coding region and the formation of graveyards of degenerate zinc finger motifs in the 3′-untranslated region of these genes. Earlier reports have shown that duplications of zinc finger genes commonly occur throughout evolution. We show that there is a relatively low degree of sequence conservation of the zinc finger motifs after these duplications. In many cases this may cause altered binding specificities of the transcription factors encoded by these genes. The repetitive nature of the zinc finger region and the structural flexibility within the zinc finger motif make these proteins highly adaptable. These factors may have been of major importance for their massive expansion in both number and complexity during metazoan evolution.
Gene therapy: too much splice can spoil the dish
Authors: Didier Trono
Journal: Journal of Clinical Investigation (2012)

The use of integrating vectors for gene therapy — required for stable correction of gene expression — carries the risk of insertional mutagenesis, which can lead to activation of a tumorigenic program. In this issue of the JCI, Moiani et al. and Cesana et al. investigate how viral vectors can induce aberrant splicing, resulting in chimeric cellular-viral transcripts. The finding that this is a general phenomenon is concerning, but some of their results do suggest approaches for the development of safeguards in gene therapy vector design.
Robert Benjamin Cheetham
Authors: Tom Poole, Richard Wintle, Alison Vickers
Journal: BMJ (2008)

<b>Background: </b>In clinical acute settings, healthcare providers work in stressful environments interfering with morale and quality of work including patient care. According to Porath et al. (2015), over half of people demonstrate incivility when they are work overloaded and do not have time to be nice. Porath et al. (2015) goes on to state that 71% of healthcare personnel connected disruptive behaviors (abusive, condescending or insulting conduct) to medical errors and 27% related to patient deaths. Current literature regarding respiratory care practitioners and incivility is minimal to non-existent which warranted the need to conduct an initial assessment in one particular pediatric respiratory care department. The PICO question for this project is among respiratory care practitioners, does workplace incivility decrease employee morale, retention, and productivity?: Description of the research design in sufficient detail to permit judgment of its validity. Must indicate statistical tests used. For studies involving human subjects, must indicate that Institutional Review Board (IRB) approval was obtained. <b>Methods: </b>A 15-item questionnaire (Healthy Workforce Institute’s (2018) Disruptive Behavior Assessment) was sent to 172 RCPs through the use of a paper survey. <b>Results: </b>There was a 41% (<i>n</i>=73) return rate of surveys which showed mild incivility with 38% rarely experienced; 34% rarely witnessed. Top behaviors of incivility co-worker eye rolling, uneven work assignments based on favoritism, and co-workers being mocked or insulted indirectly. Data was analyzed using a Pearson Chi-Square method which yielded t-tests and <i>P</i>-values for significance. <b>Conclusions: </b>Despite these mild levels, this contributes low department morale, lack of trust, and incivility among individuals warranting the need for further investigations. This needs assessment project has served to be pioneering work in the area of RCP incivility.
A GOITROUS CRETIN UNDER THYROID EXTRACT
Authors: W. R. Parker
Journal: BMJ (1896)

vessels, elironii renal disease and in all forms of albumin- uria.This physiological stuJiy so far seemiis to support this cliniical experience.In anminmia, perhaps tite, inigestioIn of more tluid will prevent the fall of the blood de-cimiial.It is easy to uiiderstanid liow cases of cardiac incompetency may be severely tried by the raretied anid dry air of hiiglh altitudes, for the friction-coefficient of the blood will be iniereased by the polycyth.-vinia,and tlhe.deeper breathing will tend to mainitaini heart hurry and over-ineitemient of the weakened heart imay be iiiaiiitained by the increased respirationi.But inasmuclh s tlte breattliiig of rarefied air seenms to lead to filling of the arteries and reduction of the veins, it is quite conceivable that if applied qradatim in suitable cardiac cases, it might prove to be of conisiderable therapeutic value.Physiology and patlhology likewise join hanids in regarding cases of clhronic interstitial nephritis as unsuitable for treat- ment by the mountain cure, for in that disease polycytliemia and higlh arterial tension are prominent pathological con- ditions.Undoubtedly this plhysiological mode of treatment by mountain air is very decisive in clharacter.It is certainly of the highest value inl plhthisis.VI.-BATHS.hlot and cold baths, whetlher local (as hand baths) or
Beneficial Effects of a Dietary Approaches to Stop Hypertension Eating Plan on Features of the Metabolic Syndrome
Authors: Katherine Esposito, Dario Giugliano
Journal: Diabetes Care (2006)

We read with interest the article by Azdbakht et al. (1), showing that a nutritional approach based on a Dietary Approaches to Stop Hypertension (DASH) diet reduced the prevalence of the syndrome by about one-third. This study adds to the mounting evidence that fighting metabolic and cardiovascular disease with diet is possible (2). As the DASH diet is very similar to the Mediterranean diet, these results confirm in …
Captopril and Increased Serum Potassium Levels
Authors: Thomas G. Burnakis
Journal: JAMA (1984)

To the Editor.—  Captopril can cause an increase in serum potassium levels, particularly when coadministered with a potassium supplement.1I would like to describe what appears to be a captopril-induced increase in serum potassium level in a patient receiving a  substitute.  Report of a Case.—  A 59-year-old man was admitted to the hospital for treatment of an acute exacerbation of congestive heart failure and hypertension. His serum potassium level on admission was 4.3 mEq/L. In addition to oral nitrates and furosemide, the patient started therapy with captopril, 12.5 mg every eight hours. Serum potassium determinations over the next several days showed a small but steady increase in serum levels of this electrolyte.  A review of the patient's chart showed that he had been instructed to follow a salt-restricted diet. The patient stated that he had been watching his salt and that he had been using a  substitute.
Antihypertensive Drugs And Stroke
Authors: S.K. Robinson
Journal: JAMA (1974)

<h3>To the Editor.—</h3> The cooperative study, "Effect of Antihypertensive Treatment on Stroke Recurrence" (229:409, 1974) is a milestone since it shows that a fall in blood pressure is not followed by benefits in most patients. It shows also what has long been suspected, that mild hypertension may not be benefited by drug treatment. White men and blacks of both sexes obtained neither cerebral nor cardiovascular benefit; some subgroups (mild hypertensives or elderly black men) may have been at a disadvantage while taking drugs. There were six cases of congestive heart failure in those subjects given placebos, and none in those given drugs. Five failures were among the 35 white women. There was only one instance in four years among the 417 blacks and white men. The authors thought the improvement in congestive heart failure to be the chief benefit from drug use. However, significant cardiovascular benefits from drugs were not
Wall stress induced arrhythmia is enhanced by low potassium and early left ventricular hypertrophy in the working rat heart
Authors: S. J Evans, A. J Levi, J. V Jones
Journal: Cardiovascular Research (1995)

The aim was to investigate the effect of lowering external potassium on the sensitivity of the normal and hypertrophied rat heart to arrhythmias induced by increases in ventricular wall stress.The isolated working heart model was used to compare hypertrophied hearts from the spontaneously hypertensive rat (SHR) with hearts from normotensive control rats (NCR) from the Wistar and Wistar-Kyoto strains. Young animals [131.5(SEM 0.64) days] were used to ensure uncomplicated left ventricular hypertrophy. Arrhythmias were induced by 20 s increases in ventricular wall stress. The ECG was recorded and the arrhythmic response of each heart was compared during perfusion with Tyrode solutions containing [K] 6, 4.8, 3.6, and 2.4 mM.Hypertrophied SHR hearts showed a significantly greater arrhythmic response than control hearts at all levels of afterload increase when perfused with [K] 3.6 and 2.4 mM (t test P < 0.05 and P < 0.01). Both the number and complexity of arrhythmias were increased in the SHR hearts; ventricular tachycardia occurred in 10/12 compared with 4/12 control hearts whereas ventricular fibrillation occurred in 5/12 hearts but in none of the control hearts.At higher levels of [K] the sensitivity of SHR and normal hearts to wall stress induced arrhythmias is similar. However, as [K] is lowered to 3.6 mM or below, hypertrophied hearts show a greatly enhanced response to increases in ventricular wall stress. They develop a larger number of ventricular ectopics and more complex ventricular arrhythmias when compared to normal hearts. This may be of relevance to arrhythmic sudden death in hypertensive patients in whom left ventricular hypertrophy, potassium depletion, and blood pressure lability is common. Excessive fluctuations in systolic pressure and therefore ventricular wall stress could provide a powerful arrhythmic stimulus in hypertensive patients with left ventricular hypertrophy, even before ischaemia, cardiac failure, or extensive extracellular fibrosis have developed.
Work Environment, Skills Utilization and Health of Swedish Nurses – Results from a National Questionnaire Study
Authors: I.-L. Petterson, B.B. Ametz, J.E. Ametz, L.-G. Hörte
Journal: Psychotherapy and Psychosomatics (1995)

Nurses make up a considerable proportion of the Swedish health care staff. Few nationally representative studies of their work environment and health, however, have been published. The present questionnaire study on work conditions, skill utilization, health and well-being of a national representative sample of 3,500 Swedish nurses, indicates a high degree of job satisfaction. Despite high satisfaction, 40% of the respondents felt too tired after work to socialize with family and 45% had seriously considered quitting their jobs. Factors such as improved work climate and development of supervisory skills were suggested as psychosocial interventions. Improvement in physical work environment factors had low priority. Medical care nurses perceive a higher work load and higher job demands in relation to decision latitude, and geriatric nurses report less work development. No differences between disciplines were found in work relations. In conclusion, there is a need to further develop skills development and utilization and work organization. Results will be used in interventions to enhance the work environment for nurses.
Clinical investigation of the novel iron-chelating agent, CP94, to enhance topical photodynamic therapy of nodular basal cell carcinoma: when statistics make a difference
Authors: A. Mangano, A. Albertin, L. La Colla
Journal: British Journal of Dermatology (2009)

Conflicts of interest: none declared. Sir, We read with interest the article published by Dr Campbell and colleagues.1 While the authors are to be commended for their aim of conducting a pilot, dose‐escalating study on the effect of increasing doses of CP94 combined with 5‐aminolaevulinic acid (ALA) cream on the clinical course of surgically resected nodular basal cell carcinomas, we feel there are some issues with both the design of the study and the statistical analysis used. Regarding the study design, the major issue is that, despite the authors’ extensive use of statistics, this trial seems to be underpowered. It does not seem that the authors have performed any sample size calculation before undertaking this study. Certainly this is a pilot study, but if statistical tests are used their power should be determined a priori, and in order for a particular finding to be claimed as significant (or not) the study should be sufficiently powered.
Immunohistology of skin and oral biopsies in graft-versus-host disease after bone marrow transplantation and cytokine therapy
Authors: Hikikazu Yamada, Junichi Chihara, Ken Hamada, Masaharu Matsukura, Tatsuo Yudate, Keiji Maeda, Kazuo Tubaki, Tadashi Tezuka
Journal: Journal of Allergy and Clinical Immunology (1997)
Medical Manpower Issues: Health Policy in Action?
Authors: CHRISTOPHER C. FORDHAM
Journal: Annals of Internal Medicine (1983)

Editorials1 September 1983Medical Manpower Issues: Health Policy in Action?CHRISTOPHER C. FORDHAM III, M.D.CHRISTOPHER C. FORDHAM III, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-3-400 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis nation and modern society have become extremely complicated, and it is sometimes difficult to discern where policy-making responsibility lies. There is a national monetary policy and a national defense policy and responsible agencies and officials to conduct them. Yet there is no national health or medical policy, and no discernible agency or official in charge. Instead, health policy, insofar as it exists, is fragmented and pluralistic. State and local governments, professional associations, individual professionals, and a host of public groups join with the Federal Government in asserting their views and their influence.Rather than through a rational policy-making process,...References1. Medical Education and Medical Manpower in North Carolina. Chapel Hill, North Carolina: Area Health Education Centers Programs, School of Medicine, University of North Carolina; 1983. Google Scholar2. SCHLEITER M and TARLOV A. National Study of Internal Medicine Manpower: VIII. Internal medicine residency and fellowship training: 1983 update. Ann Intern Med. 1983; 99:380-7. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHRISTOPHER C. FORDHAMIII, M.D.Affiliations: University of North Carolina at Chapel Hill Chapel Hill, North Carolina PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1983Volume 99, Issue 3Page: 400-401 ePublished: 1 December 2008 Issue Published: 1 September 1983 PDF downloadLoading ...
A case of active chronic hepatitis with painless erosive arthritis
Authors: D. E. Barnardo, B. Vernon-Roberts, H. L. F. Currey
Journal: Gut (1973)

True arthritis is very much less common than arthralgia in patients suffering from active chronic hepatitis and only scanty information is available about the joint changes in this disease. We report here the case of a young woman with active chronic hepatitis complicated by a painless, erosive small joint arthropathy.
The Esophageal Obturator Airway-Reply
Authors: T. A. Don Michael
Journal: JAMA (1982)

<h3>In Reply.—</h3> Dr Craig's comments on the EOA are pertinent and relevant. It is clear that the esophageal obturator is, as he states, an esophageal blocker primarily and that the airway component of it is akin to that of a nasopharyngeal tube. The fact that the two are combined would, in my opinion, not disqualify the device from being called an esophageal obturator implying an esophageal blocker and, as well, an airway, implying its ability to deliver oxygen or air into the lungs. With regard to protection of the glottis from aspirated material owing to trauma in the head and facial areas in using the EOA, this has been stressed in all advanced life support courses held by the American Heart Association as an important point to consider in the protection of the glottis and the lungs from aspiration. A relative contraindication to the use of the esophageal obturator is