tbuckley/cabot-search huggingface dataset:
Primary Hyperparathyroidism
Authors: Hunter Heath, Stephen F. Hodgson, Margaret A. Kennedy
Journal: New England Journal of Medicine (1980)

We examined the incidence and clinical and economic consequences of primary hyperparathyroidism in residents of Rochester, Minn, from 1965 through 1976; 90 cases were found. From January 1, 1965, to June 31, 1974, the average annual incidence was 7.8 +/- 1.2 (mean +/- S.D.) cases per 100,000 population. However, after the introduction of routine measurement of serum calcium, the average annual incidence rose to 51.1 +/- 9.6 cases per 100,000. Even after availability of routine measurement of serum calcium, the annual incidence of primary hyperparathyroidism among persons 39 years of age or younger remained below 10 cases per 100,000. However, the annual incidence increased sharply in persons 40 or more years of age, reaching 188 cases per 100,000 among women 60 years of age and over and 92 cases per 100,000 among men 60 and over. For the last 1.5 years of the study, the average annual age-adjusted incidence of primary hyperparathyroidism was 27.7 +/- 5.8 per 100,000. The frequency of urolithiasis fell from 51 to 4 per cent (P less than 0.001), and the proportion of cases without symptoms or complications of primary hyperparathyroidism rose from 18 to 51 per cent (P less than 0.005). The median charge in 1977 for diagnosis and treatment of primary hyperparathyroidism was $1700. (N Engl J Med 302:189-193, 1980).
My New Image
Authors: Burton J. Williams
Journal: New England Journal of Medicine (1994)

I don't know about you, but I'm starting to worry about my image. In the past I never really thought that much about it, but now, thanks to the advent of managed care, image is becoming the most important part of the practice of medicine. And that has me worried.Is my image good or bad, weak or strong? If Steven Spielberg were shooting it, would he choose color or black and white? Would media consultants be thinking that Kevin Costner would be perfect for the role, or would they be thinking of Walter Matthau instead?What bothers me about . . .
Caffey disease: an unlikely collagenopathy
Authors: Francis H. Glorieux
Journal: Journal of Clinical Investigation (2005)

Infantile cortical hyperostosis (also known as Caffey disease) is characterized by hyperirritability, acute inflammation of soft tissues, and profound alterations of the shape and structure of the underlying bones, particularly the long bones, mandible, clavicles, or ribs. In this issue of the JCI, Gensure et al. undertook fine mapping of the genetic locus for this disease in a large kindred of individuals with the autosomal dominant form of the condition. The authors found a novel missense mutation in COL1A1, the gene encoding the α1 chain of type I collagen, in all affected individuals in 3 discrete pedigrees. This is a surprising finding, as all other reported mutations affecting the synthesis of type I collagen lead to conditions such as osteogenesis imperfecta and Ehlers-Danlos syndrome, in which quantitative or qualitative defects in type I collagen synthesis give rise to bone fragility and/or connective tissue hyperextensibility. The deleterious effect of the mutation on collagen fibril morphology is demonstrated; however, the precise functional link between the reported missense mutation and the localized inflammation and hyperostosis seen in Caffey disease awaits future studies.
A comparison of the sports safety policies and practices of community sports clubs during training and competition in northern Sydney, Australia
Authors: A Donaldson, R Forero, C F Finch, T Hill
Journal: British Journal of Sports Medicine (2004)

Objectives: To compare the safety policies and practices reported to be adopted during training and competition by community sports clubs in northern Sydney, Australia. Methods: This cross sectional study involved face to face interviews, using an 81 item extensively validated questionnaire, with representatives of 163 community netball, rugby league, rugby union, and soccer clubs (response rate 85%). The study was undertaken during the winter sports season of 2000. Two separate 14 item scales were developed to analyse the level of safety policy adoption and safety practice implementation during training and competition. The statistical analysis comprised descriptive and inferential analysis stratified by sport. Results: The reliability of the scales was good: Cronbach’s α = 0.70 (competition scale) to 0.81 (training scale). Significant differences were found between the safety scores for training and competition for all clubs (mean difference 11.2; 95% confidence interval (CI) 10.0 to 12.5) and for each of the four sports: netball (mean difference 14.9; 95% CI 12.6 to 17.2); rugby league (mean difference 10.3; 95% CI 7.1 to 13.6); rugby union (mean difference 9.4; 95% CI 7.1 to 11.7); and soccer (mean difference 8.4; 95% CI 6.5 to 10.3). Conclusions: The differences in the mean competition and training safety scores were significant for all sports. This indicates that safety policies were less often adopted and practices less often implemented during training than during competition. As injuries do occur at training, and sports participants often spend considerably more time training than competing, sporting bodies should consider whether the safety policies and practices adopted and implemented at training are adequate.
Book Review Childhood Obesity: Contemporary Issues (Society for the Study of Human Biology Series. 44.) Edited by N. Cameron, N.G. Norgan, and G.T.H. Ellison. 272 pp., illustrated. Boca Raton, Fla., CRC Press, 2006. $89.95. 0-8493-2857-8
Authors: Susan Okie
Journal: New England Journal of Medicine (2006)
In vivo evaluation of poly(l-lactic acid) porous conduits for peripheral nerve regeneration
Authors: G.R.D. Evans, K. Brandt, M.S. Widmer, L. Lu, R.K. Meszlenyi, P.K. Gupta, A.G. Mikos, J. Hodges, J. Williams, A. Gürlek, A. Nabawi, R. Lohman, C.W. Patrick
Journal: Biomaterials (1999)
THE NORMAL VARIATION OF THE SYSTOLIC BLOOD-PRESSUREA STUDY OF ONE THOUSAND CASES
Authors: H. P. WOLEY
Journal: JAMA (1910)

The practice of taking blood-pressures in insurance examinations has become comparatively common in the last few years. The question was soon asked, What is the normal blood-pressure? Is the blood-pressure different at different ages and, if so, what is the difference? We all know that the pulse may fluctuate between certain limits, say 60 to 85, and still we would not hesitate to say that a person within those limits was in health. If it is beyond either limit we would make a further study of the case, fearing that it might be a pathologic condition. The medical examiner, from an insurance standpoint, is in the opposite position from the general practitioner in his office, for the latter is dealing almost entirely with cases in a pathologic condition, while the insurance medical examiner is dealing with healthy persons and trying to find out how far their cases may deviate from
Obesity in middle age and future risk of dementia: Dietary fat and sugar may hold the clue
Authors: Naji Tabet
Journal: BMJ (2005)

Prognosis in obesity Older people should not be misinformed about being overweightEditor-With reference to the editorial by Lean on prognosis in obesity, 1 advising apparently overweight older people to lose weight may do more harm than good.Evidence suggests that the risks of being "overweight" decrease with increasing age.On the basis of mortality, the ideal body mass index (BMI) is higher in older than young adults, with an optimum BMI for people older than 65 in the young adult "overweight" range of 27-30 kg/m 2 . 2 In a systematic review, Heiat et al concluded that the relation between BMI and mortality in people older than 65 is a flat bottomed, Ushaped curve, with mortality rising only at BMI > 31 kg/m 2 and perhaps not at any BMI in people older than 75. 2 Weight loss is more common than weight gain in older people, and associated with poor outcomes, even when the weight loss is intentional and the person was "overweight" at baseline. [3]4][5] In the prospective cardiovascular health study of some 4700 community dwelling people older than 65, weight loss of more than 5% over three years was substantially more common than weight gain of more than 5%. 3 Weight loss, but not weight gain, was associated with a significantly increased risk of mortality (relative risk 1.67, 95% confidence interval 1.29 to 2.15). 3 The association of increased mortality with weight loss persisted even at the highest third of baseline weight. 3 In a study of older men with BMI ≥ 30 kg/m 2 , intentional weight loss was associated (P < 0.001) with a greater rate of hip bone loss ( -1.7%/year) than in men with no weight loss ( -0.1%/year) or weight gain (0.5%/year). 5 The indiscriminate application of evidence from studies in younger adults to the management of older people is hazardous.We believe that many older people are trying to lose weight inappropriately.There is a need to ensure that most of our elders are given appropriate advice: "Keep physically active, eat sensibly, and maintain weight."
The effect of mechanically enhancing portal venous inflow on hepatic oxygenation, microcirculation, and function in a rabbit model with extensive hepatic fibrosis
Authors: Long R. Jiao, Alexander M. Seifalian, Nagy Habib, Brian R. Davidson
Journal: Hepatology (1999)

Enhancing the portal venous blood flow (PVBF) has been shown to reduce portal pressure and intrahepatic vascular resistance and to improve liver function in isolated cirrhotic rodent livers in vitro . The aim of this study was to assess the short-term effect of mechanically pumping the portal inflow on hepatic microcirculation (HM), oxygenation, and function in an animal model of extensive hepatic fibrosis. New Zealand white rabbits underwent laparotomy and exposure of the liver: group 1 (n = 7) were normal controls; group 2 (n = 7) had hepatic fibrosis. Total hepatic blood flow (THBF) and HM was measured along with continuous monitoring of intrahepatic tissue oxygenation using near infrared spectroscopy (NIRS). Baseline hepatic hemodynamics and liver function were measured in both groups. PVBF was then increased by 50% over a 3-hour period in the hepatic fibrosis group using a miniature portal pump designed for human implantation, and the hemodynamics were monitored continuously. Liver function tests were repeated after portal pumping. In comparison with normal controls, animals with hepatic fibrosis had a higher portal pressure (13.0 ± 3.6 vs. 3.7 ± 1.4 mm Hg, P &lt; .001, mean ± SD vs. controls), reduced PVBF (52.4 ± 24.6 vs. 96.9 ± 21.1 mL/min, P = .003), and increased portal vascular resistance ( P = .001). THBF and flow in the HM was lower than in controls, and liver function tests were abnormal. After a 3-hour period of enhanced portal flow in animals with hepatic fibrosis, the portal pressure greatly reduced (13.0 ± 3.6 to 2.5 ± 1.1 mm Hg, P &lt; .001) as did the intrahepatic portal resistance (0.32 ± 0.18 to 0.04 ± 0.03 mm Hg/mL/min, P = .006). Flow in the HM improved (143 ± 16 to 173 ± 14 flux units, P = .006) and was associated with improved hepatic tissue oxygenation, tissue oxy-hemoglobin (HbO 2 ) and cytochrome oxidase being increased by 24.4 ± 7.5 and 5.65 ± 2.30 μmol/L above the baseline value ( P &lt; .001), respectively. A 3-hour period of mechanical portal pumping produced a dramatic improvement in liver function, bilirubin (41.1 ± 25.9 to 10.0 ± 5.9 μmol/L, P = .040), aspartate transaminase (AST) (135.5 ± 52.3 to 56.3 ± 19.8 U/L, P = .006) and lactate dehydrogenase (LDH) (2,030.1 ± 796.3 to 1,309.8 ± 431.6 IU/L, P = .006; prepumping vs. postpumping, all P &lt; .050). In conclusion, portal pumping in this rabbit model with extensive hepatic fibrosis improved liver parenchymal perfusion, oxygenation, and function.
Dietary Sodium Restriction as Adjunctive Treatment of Hypertension
Authors: Myron H. Weinberger
Journal: JAMA (1988)

To examine the effect of modest dietary sodium ion restriction in treated hypertensive individuals, we studied 114 hypertensive patients undergoing individualized dietary counseling with a research dietitian to achieve reduction in dietary sodium ion intake. A significant reduction in mean sodium ion intake was achieved after the first of three lessons and was maintained for 30 weeks with no change in potassium ion intake. Significant falls in blood pressure and body weight were observed with no significant correlations noted between the two variables, implying independence of these effects. Individuals compliant with the dietary sodium ion restriction goal (urinary excretion, less than or equal to 80 mmol/d [less than or equal to 80 mEq/24 h]) were more likely to have a reduction in number of medications than those not reaching that goal. Ninety-eight of the 114 patients completed the entire 30 weeks. Patients who dropped out tended to have lower diastolic blood pressures and required fewer medications for blood pressure control than those who completed the 30 weeks. For these reasons, patients in the former group may have been less highly motivated to complete the study. These observations suggest that modest dietary sodium ion restriction is feasible in treated hypertensive patients and that adherence to such a regimen may permit blood pressure control with fewer medications.
Eunuchs and Castrations: JAMA Faces the Music
Authors: André M. Smith
Journal: JAMA (1991)

<h3>To the Editor.</h3> —Rarely is there need to respond to a medical article a century old. Such need presents itself with the reprint of Von Klein's report in<i>JAMA</i>100 Years Ago.<sup>1</sup>It revives a misunderstanding that may have begun with him and which has never been fully explained. This revival may now achieve permanent dissemination the world over in this era of electronic cataloging and retrieval if it is not addressed forthwith. There is no history of the adult male soprano in the Russian Orthodox church choir.<sup>2,3</sup>Up to the time that Von Klein claims that he heard "a band of eunuchs... who were prepared for that purpose," the five reasons for orchiectomy were torture, punishment, administrative expediency, medical necessity, and the cultivation of adult male sopranos.<sup>4</sup>The only reasons now obsolete are the administrative and the musical. The relationship of castration to music probably began
Asp1424Asn MYH9 mutation results in an unstable protein responsible for the phenotypes in May-Hegglin anomaly/Fechtner syndrome
Authors: Samuel Deutsch, Alexandra Rideau, Marie-Luce Bochaton-Piallat, Giuseppe Merla, Antoine Geinoz, Giulio Gabbiani, Torsten Schwede, Thomas Matthes, Stylianos E. Antonarakis, Photis Beris
Journal: Blood (2003)
Physician Fee Patterns under Medicare: A Descriptive Analysis
Authors: George J. Schieber, Ira L. Burney, Judith B. Golden, William A. Knaus
Journal: New England Journal of Medicine (1976)

To describe physician fee patterns under a national program, we analyzed physician reimbursement rates for 39 medical procedures for 292 local Medicare reimbursement areas. The results indicate that the maximum prevailing charge for each procedure generally ranged from three to 10 times the minimum charge. Prevailing charges, however, clustered around the mean (coefficient of variation less than 0.50) in 37 of the 39 fee distributions for general practitioners and specialists. Although differences (P less than 0.05) existed between mean general practitioner and specialist charges for 27 of the 39 procedures, these differences were generally less than 10%.
Asymptomatic Rectal Mucosal Lesions and Hepatitis B Surface Antigen at Sites of Sexual Contact in Homosexual Men with Persistent Hepatitis B Virus Infection
Authors: NEIL E. REINER
Journal: Annals of Internal Medicine (1982)

To ascertain why active and passive oral-anal and genital-anal intercourse correlate strongly with hepatitis B virus (HBV) infection in homosexual men, we studied 22 men with HBV infection for the presence of hepatitis B surface antigen (HBsAg) in gingival and anorectal mucosa, feces, and semen. Thirteen of 22 (59%) patients had asymptomatic rectal mucosal lesions consisting of punctate bleeding points. Seventy-seven percent of swabbed specimens from lesions, 62% from feces, 59% from rectal mucosa, and 50% from anal canal mucosa contained HBsAg. Sera diluted serially and tested for HBsAg by radioimmunoassay showed that men with serum titers of 105 0r greater were more likely to have HBsAg in specimens from lesions (p = 0.034), feces (p = 0.032), and normal mucosa (p = 0.001) than men with titers under 105. Asymptomatic rectal bleeding is frequent in homosexual men with persistent HBV infection. Rectal mucosa, feces, and anal canal mucosa become contaminated with HBsAg, creating a setting for de facto parenteral transmission when there is contact with oral or urethral mucosa.
Serum CC-Chemokine Ligand 18 Concentration Predicts Outcome in Idiopathic Pulmonary Fibrosis
Authors: Antje Prasse, Corinna Probst, Elena Bargagli, Gernot Zissel, Galen B. Toews, Kevin R. Flaherty, Manfred Olschewski, Paola Rottoli, Joachim Müller-Quernheim
Journal: American Journal of Respiratory and Critical Care Medicine (2009)

Idiopathic pulmonary fibrosis (IPF) is a devastating lung disease with a poor prognosis. There is great effort to find predictors of outcome. Conclusive data for any serum biomarker are lacking. We have recently documented that serum CCL18 concentrations correlate with the course of pulmonary function data in patients with pulmonary fibrosis of various causes.To test the value of serum CCL18 concentrations in IPF, we included 72 patients in a prospective study.IPF was defined according to the ATS/ERS criteria. Serum CCL18 concentrations were measured by a commercially available ELISA. Patients were followed for 24 months. Pulmonary function tests were performed at least every 6 months.Baseline serum CCL18 concentrations predicted the change in TLC and FVC at the 6-month follow-up. Receiver operating characteristics (ROC) revealed a significant relation between survival and baseline CCL18 concentrations. By ROC analysis, the cutoff value with the highest diagnostic accuracy was defined as 150 ng/ml (sensitivity, 0.83; specificity, 0.77). There was a significantly higher mortality in patients with serum CCL18 concentrations above 150 ng/ml (P < 0.0001). The hazard proportional ratio adjusted for age, sex, and baseline pulmonary function data was 8.0. There was a higher incidence of disease progression in the group with high serum CCL18 concentrations.Our data demonstrate that serum CCL18 concentrations have a predictive value in IPF and may be a useful tool in the clinical management of patients with IPF and in clinical trials.
The Polymerase Chain Reaction
Authors: Jane F. Desforges, Barry I. Eisenstein
Journal: New England Journal of Medicine (1990)

THE development of molecular genetics, both as a self-contained field and as a body of techniques broadly useful in biologic investigation, has had a profound influence on medical research. The beneficiaries include every discipline in basic science and, at least indirectly, most clinical and applied medical disciplines. Certain technical milestones can be identified over the past several decades that have been particularly important in the progress of the field. One is the discovery of restriction endonucleases, which together with the development of DNA ligation and transformation procedures, led to the ability to clone and thus propagate genes of any organism . . .
FORMATION OF SEROLOGICALLY REACTIVE DEXTRANS BY STREPTOCOCCI FROM SUBACUTE BACTERIAL ENDOCARDITIS
Authors: Edward J. Hehre, James M. Neill
Journal: The Journal of Experimental Medicine (1946)

Serologically reactive dextrans were synthesized from sucrose by 22 of 48 strains of streptococci isolated from the blood of patients with subacute bacterial endocarditis. One strain formed an appreciable amount of levan as well as dextran. Nine strains of group H streptococci from throats formed dextran serologically similar to that formed by the described endocarditis streptococci. Six strains of S. salivarius from throats and feces, which were included for comparison, formed levan which agreed in serological properties with the purified levan previously described for one strain of that species. The experimental method comprised a series of serological tests that were controlled and supplemented by physical and chemical tests, and furnished a relatively simple but entirely adequate way of recognizing and distinguishing dextrans and levans in bacterial cultures without isolation of the purified polysaccharides. The possible use of dextran and levan formation in the differential description of non-hemolytic streptococci is suggested.
The weight of cell identity
Authors: David T. Scadden
Journal: Journal of Clinical Investigation (2007)

Recent studies involving molecular modification of adult somatic cells have pointed to a remarkable plasticity in cell identity. In this issue of the JCI, Koh and colleagues assessed whether bone marrow-derived cells could alter their fate under circumstances conducive to adipocyte generation in vivo (see the related article beginning on page 3684). These cells remained true to their roots, indicating how difficult it will be to exploit cell plasticity for therapeutic purposes.