tbuckley/cabot-search huggingface dataset:
Physician, humble thyself
Authors: E. Frank
Journal: BMJ (2009)

Two examples of doctors’ sense of entitlement still bother me. The first was at an American Medical Association meeting, while I was riding in a cab with several colleagues to dinner after a long day of meetings. My colleagues were complaining, as they often did, about their working conditions and pay, feeling underappreciated and undercompensated, like many American doctors seem to. About 10 minutes into the drive I asked them, “How do you feel about complaining like this in front of a taxi driver?” The question produced an awkward silence. The cabbie was no longer invisible to them, and how he might hear my friends’ concerns, given his view of his own job, was uncomfortably obvious.

The second example was with a then close friend of mine, a fellow physician at a large …
Lack Of In Vivo Activation of the Interferon System in Hbsag–Positive Chronic Active Hepatitis
Authors: Alain Poitrine, Suzanne Chousterman, Michel Chousterman, Sylvie Naveau, Ming Nguy Thang, Jean-Claude Chaput
Journal: Hepatology (1985)

The in vivo activation state of the interferon system was biochemically evaluated in patients with HBsAg-positive liver disease by assaying the interferon-induced enzyme, 2'5'-oligoadenylate synthetase, in peripheral blood mononuclear cells. All patients with chronic active hepatitis had normal levels of enzyme activity. Increased values were found in 77% of patients with acute hepatitis, 50% of those with chronic persistent hepatitis and 54% chronic healthy carriers. These results provide evidence for lack of activation of the interferon system in HBsAg-positive chronic active hepatitis and support the hypothesis that an in vivo defective interferon response may aid in development of chronic active hepatitis.
The reproducibility of radionuclide angiographic measurements of left ventricular function in normal subjects at rest and during exercise.
Authors: M T Upton, S K Rerych, G E Newman, E P Bounous, R H Jones
Journal: Circulation (1980)

In this investigation we determined the reproducibility of radionuclide measurements of left ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, pulmonary transit time, pulmonary blood volume and cardiac output in 10 normal subjects.First-pass radionuclide angiocardiograms were performed at rest and during upright, submaximal bicycle exercise on day 1 and day 3.The resting heart rate for the group decreased from 79 i 17 beats/min on day 1 to 71 ± 14 beats/min on day 3 (p < 0.01).This biologic variation probably contributed to the small but significant decreases in ejection fraction (62 7 to 59 ± 7%, p < 0.05) and cardiac output (7.7 + 1.9 to 6.6 ± 1.5 l/min, p < 0.02), and the increase in pulmonary transit time (5.8 1.6 to 6.2 ± 1.3 seconds, p < 0.05) between day 1 and day 3.The mean variabilities in ejection fraction, cardiac output and pulmonary transit time were 4.0 ± 3.8%, 1.24 ± 1.23 1/min and 0.65 ± 0.64 second, respectively.No significant differences between studies were observed in resting end-diastolic volume, end-systolic volume and stroke volume.The mean variability in end- diastolic volume was 9.9 ± 5.1 ml.Heart rate varied less during exercise to the same work load, and only pulmonary transit time and blood volume differed significantly between studies.During exercise the mean variabilities in ejection fraction, end- diastolic volume, cardiac output and pulmonary transit time were 3.2 ± 2.5%, 9.8 ± 6.2 ml, 1.59 ± 0.67 1/min and 0.25 ± 0.25 second, respectively.Radionuclide measurements of left ventricular function are highly reproducible if obtained under comparable hemodynamic conditions.RADIONUCLIDE ANGIOCARDIOGRAPHY, a simple, noninvasive method for evaluating cardiac performance at rest and during exercise, is useful in a wide variety of clinical settings.Radionuclide measurements of left ventricular ejection fraction (EF), volumes and cardiac output (CO) correlate closely with those obtained by contrast ventriculography and dye-dilution techniques.'-'Because sequen- tial studies can be easily performed, radionuclide
Health Agencies Update
Authors: Joan Stephenson
Journal: JAMA (1997)

<h3>Latex Allergy Alert</h3> Concerned about the substantial numbers of people employed in the health care industry who have work-related allergic reactions to natural rubber latex, the National Institute for Occupational Safety and Health (NIOSH) has issued an alert that spells out guidelines for reducing the risk such reactions pose to workers. Reports of allergic reactions triggered by job-related exposures to latexin gloves and other products have increased in recent years, particularly among the 7.7 million or more people employed in the health care industry. An estimated 8% to 12% of health care workers regularly exposed to latex are sensitized, compared with 1% to 6% of the general population, and some experience reactions severe enough to interfere with their ability to continue working in their current jobs. The NIOSH alert advises health care workers and employers that if latex gloves are designated as appropriate protection for handling infectious materials, reduced-protein, powder-free
Frontal fibrosing alopecia: clinical presentations and prognosis
Authors: K.T. Tan, A.G. Messenger
Journal: British Journal of Dermatology (2008)

Frontal fibrosing alopecia is an uncommon condition characterized by progressive frontotemporal recession due to inflammatory destruction of hair follicles. Little is known about the natural history of this disease.To determine the clinical features and natural history of frontal fibrosing alopecia.We studied the cases notes of patients diagnosed with frontal fibrosing alopecia from 1993 to 2008 at the Royal Hallamshire Hospital, Sheffield.There were 18 patients aged between 34 and 71 years. Three were premenopausal. All had frontotemporal recession with scarring. This was associated with partial or complete loss of eyebrows in 15 patients while four had hair loss at other sites. One had keratosis pilaris-like papules on the face, and one had follicular erythema on the cheeks. Three patients had oral lichen planus, of whom two also had cutaneous lichen planus affecting other sites of the body. Treatments given included intralesional triamcinolone acetonide, 0.1% tacrolimus ointment and oral hydroxychloroquine. Progression of frontotemporal recession was seen in some patients, but not all. In one patient the hair line receded by 30 mm over 72 months, whereas in another patient there was no positional change in the hair line after 15 years.Frontal fibrosing alopecia is more common in postmenopausal women, but it can occur in younger women. It may be associated with mucocutaneous lichen planus. Recession of the hair line may progress inexorably over many years but this is not inevitable. It is not clear whether or not treatment alters the natural history of the disease - the disease stabilized with time in most of the patients with or without continuing treatment.
"Sauna-Takers' Disease": Title Disputed
Authors: Kristina Antoniades
Journal: JAMA (1977)

To the Editor.—  A recent article by Metzger et al (236:2209, 1976) describes a man who, when bathing in his basement sauna, threw stagnant water from a cedar bucket over heated rocks to create steam. Because his episodes of respiratory symptoms were related to pouring bucket water over the heated rocks, the patient removed the container and became asymptomatic. After being symptomless for some time, he began using a metal water bucket, but again kept stagnant water there for three weeks; similar symptoms again developed. A diagnosis of hypersensitivity pneumonitis due toPullularia(Aureobasidium pullulans), a fungus, was made. The case seems well described and elegantly documented.  What I take objection to is the main title of the article, Sauna-Takers' Disease, which implies that this is something that might happen to anybody who uses and is fond of taking saunas. The cause of this man's disease was not the sauna,
Epidemiology of Insulin-Using Commercial Motor Vehicle Drivers: Major variability of state licensing requirements in the U.S.
Authors: Idamae F Gower, Thomas J Songer, Harold Hylton, Neill L Thomas, Jean-Marie Ekoe, Lester B Lave, Ronald E LaPorte
Journal: Diabetes Care (1992)

OBJECTIVE Licensing agencies in many areas, including the U.S., prohibit insulin-using individuals from driving CMVs or large trucks. This study examined the debate over the risks of licensing insulin-using individuals to drive CMVs as an occupation, and the variations in regulations of different states. RESEARCH DESIGN AND METHODS As part of an ongoing review of the regulations governing interstate commerce in the U.S., we surveyed all 50 states and Washington, D.C. to determine the regulations concerning intrastate driving. We received responses from 48 states and D.C., representing 95% of the U.S. population. RESULTS Only 9 states reported preventing insulin users from acquiring a CMV license, whereas 39 states and D.C. permitted licensing within state boundaries. Of the states allowing insulin users to drive, 26 placed special requirements on CMV licensing. CONCLUSIONS The results indicate that, despite a standardized U.S. federal law for driving across states, enormous variability exists in the policies for driving within states, ranging from no restrictions to a complete ban on CMV driving for insulin users.
Relative risk regression analysis of epidemiologic data.
Authors: R L Prentice
Journal: Environmental Health Perspectives (1985)

Relative risk regression methods are described. These methods provide a unified approach to a range of data analysis problems in environmental risk assessment and in the study of disease risk factors more generally. Relative risk regression methods are most readily viewed as an outgrowth of Cox's regression and life model. They can also be viewed as a regression generalization of more classical epidemiologic procedures, such as that due to Mantel and Haenszel. In the context of an epidemiologic cohort study, relative risk regression methods extend conventional survival data methods and binary response (e.g., logistic) regression models by taking explicit account of the time to disease occurrence while allowing arbitrary baseline disease rates, general censorship, and time-varying risk factors. This latter feature is particularly relevant to many environmental risk assessment problems wherein one wishes to relate disease rates at a particular point in time to aspects of a preceding risk factor history. Relative risk regression methods also adapt readily to time-matched case-control studies and to certain less standard designs. The uses of relative risk regression methods are illustrated and the state of development of these procedures is discussed. It is argued that asymptotic partial likelihood estimation techniques are now well developed in the important special case in which the disease rates of interest have interpretations as counting process intensity functions. Estimation of relative risks processes corresponding to disease rates falling outside this class has, however, received limited attention. The general area of relative risk regression model criticism has, as yet, not been thoroughly studied, though a number of statistical groups are studying such features as tests of fit, residuals, diagnostics and graphical procedures. Most such studies have been restricted to exponential form relative risks as have simulation studies of relative risk estimation procedures with moderate numbers of disease events.
Evidence that calcitonin stimulates 1,25-dihydroxyvitamin D production and intestinal absorption of calcium in vivo.
Authors: P Jaeger, W Jones, T L Clemens, J P Hayslett
Journal: Journal of Clinical Investigation (1986)

Although it is well established that parathyroid hormone and phosphate are important regulators of 1,25-dihydroxyvitamin D [1,25(OH)2D] production, it remains unclear whether calcitonin affects vitamin D metabolism in vivo. Experiments were performed in the rat to determine the effect of chronic calcitonin infusion (0.2 U X h-1) on plasma levels of vitamin D metabolites and on calcium metabolism. Thyroparathyroidectomized animals fed a calcium-replete or calcium-free diet were studied for as long as 2 wk before they were killed. In control rats, a calcium-free diet alone for 12 d resulted in an increase in 1,25(OH)2D levels from 24 +/- 5 to 139 +/- 37 pg . ml-1, P = 0.025. The infusion of calcitonin also stimulated 1,25(OH)2D levels compared with controls on a regular diet (80 +/- 17 vs. 38 +/- 6 pg . ml-1, P less than 0.05) and on a calcium-free diet (460 +/- 50 vs. 139 +/- 37 pg . ml-1, P less than 0.001). In addition, calcitonin increased plasma calcium levels in animals on a regular diet by 50%; this effect was most likely due to increased intestinal absorption of calcium, because removal of calcium from the diet markedly blunted this effect. In contrast, calcitonin administration did not significantly affect 25(OH)D plasma levels. Collectively, these data suggest that calcitonin and calcium are independent regulators of 1,25(OH)2D production and that calcitonin stimulates intestinal absorption of calcium, by increasing circulating levels of 1,25(OH)2D.
Recovery Period of the Bladder after Exposure to Soluble Virulence Factor Produced by &lt;i&gt;Escherichia coli&lt;/i&gt;
Authors: G&uuml;ven Aslan, Nuran Esen, A. Adil Esen, Meral Koyuncuo&gbreve;lu, &Idot;lhan &Ccedil;elebi, Nuran Yulu&gbreve;
Journal: European Urology (2001)
Doctors and the global population crisis.
Authors: S Adam, A McPherson
Journal: BMJ (1977)

The doctors who are willing to perform abortions under the 1967 British Abortion Act cannot be dismissed as individuals who do not "respect human life." It is their respect for the life of the mother and the potential life of the fetus which determines their willingness to perform necessary abortions. It is their respect for human life which is causing them to press for legislation which will take the abortion decision out of the hands of doctors and put it under control of women themselves.
Morecambe Bay hospital trust is still not meeting its improvement targets, CQC says
Authors: C. Dyer
Journal: BMJ (2013)

University Hospitals of Morecambe Bay NHS Foundation Trust, where police have been investigating a series of mother and baby deaths, has managed to meet fully only seven of 40 demands for improvement in emergency services and governance set by the Care Quality Commission in January 2012.

A follow-up inspection by the CQC, carried out last April but just published, has found that 30 of its 40 recommendations have been only partly met and three remain outstanding.1

The crisis hit hospital trust in the north of England has been subjected to a number of reviews. One, conducted by PricewaterhouseCoopers and published by the foundation trust regulator Monitor in February 2012, found that “the trust’s governance processes, systems …
Letter: TSH level and thyroid function.
Authors: W M Tunbridge, P Harsoulis, A W Goolden
Journal: BMJ (1974)

residual radioactivity in serum after incubation with resin is assessed and therefore a free thyroxine index is calculated as de- scribed by Dr. D'Haene and his colleagues by dividing P.B.I. by T-3 B.C. index.We hope this comment clarifies the situation and reinforces the need for a clear understanding of the method used to assess the T-3 resin uptake.-Weare, etc.,
SOME CONSIDERATIONS REGARDING THE HYGIENE OF EARLY SCHOOL LIFE.
Authors: JULIUS NOER
Journal: JAMA (1901)

The medical man's point of view regarding the hygiene and physical regimen of school life often gives rise to misunderstanding and not infrequently to the most unreasonable opposition from the pedagogue. The physician, says the pedagogue, is too materialistic, is too much occupied with the pathologic side of the child and not infrequently is biased, catering to the hysteric dilettante for the mere sake of humoring the misguided parents. Under the head of "Mental Fatigue in School"<sup>1</sup>appears, among other propositions of a similar character, the following translation, from a paper by Prof. Albert Spitzner, Leipzig: "The propositions generally advanced, that present methods of public education imperil the health of children, is not only applied to certain evils for which individual teachers or schools are called to account, but directly attack the normal foundation of a school. The censure of physicians does not refer to the harming of already
Lytic Lesions in Breast Cancer
Authors: Daniela Katz, Dvora Aharoni
Journal: New England Journal of Medicine (2004)

A previously healthy 54-year-old woman presented with a two-week history of pelvic pain. On physical examination, she had limited movement, without tenderness in the bones. An initial radiographic survey of skeletal bone showed multiple lytic lesions in the axial skeleton (Panel A, arrow), the ribs, the skull (Panel B, arrow), bilaterally in the pelvis, both femurs (Panel C, arrow), and both humeri (Panel D, arrow). Blood tests showed normocytic normochromic anemia with a hematocrit of 24.9 percent, along with a sedimentation rate of 140 mm per hour. Calcium levels and the results of kidney-function and liver-function tests were normal. The . . .
A Near Miss — Osler's Early Description of Cushing's Syndrome with, Regrettably, No Post-Mortem Examination
Authors: Mark D. Altschule
Journal: New England Journal of Medicine (1980)

In May 1898, William Osler read a paper before the 24th annual meeting of the American Neurological Society. The paper was published in the Journal of Nervous and Mental Diseases in February 1899.1 The title of the paper was "An Acute Myxcedematous Condition, with Tachycardia, Glycosuria, Melæna, Mania, and Death." The article was based on the case report of a male patient he had seen in February and March of 1897. One of the more striking aspects of the clinical picture was a gain in weight of 37 pounds (17 kg) in the three months from October to the end . . .
Minocycline for the treatment of cutaneous silicone granulomas
Authors: P Senet, H Bachelez, L Ollivaud, D Vignon-Pennamen, L Dubertret
Journal: British Journal of Dermatology (1999)

Journal Article Minocycline for the treatment of cutaneous silicone granulomas Get access P Senet, P Senet Service de Dermatologie, Institut de Recherche sur la Peau, Pavillon Bazin, Paris, France, Search for other works by this author on: Oxford Academic Google Scholar H Bachelez, H Bachelez Service de Dermatologie, Institut de Recherche sur la Peau, Pavillon Bazin, Paris, France, Search for other works by this author on: Oxford Academic Google Scholar L Ollivaud, L Ollivaud Service de Dermatologie, Institut de Recherche sur la Peau, Pavillon Bazin, Paris, France, Search for other works by this author on: Oxford Academic Google Scholar D Vignon‐Pennamen, D Vignon‐Pennamen Service d'Anatomopathologie, Hôpital Saint‐Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10, France Search for other works by this author on: Oxford Academic Google Scholar L Dubertret L Dubertret Service de Dermatologie, Institut de Recherche sur la Peau, Pavillon Bazin, Paris, France, Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 140, Issue 5, 1 May 1999, Pages 985–987, https://doi.org/10.1046/j.1365-2133.1999.02853.x Published: 01 May 1999
Efficacy of BCG Vaccine
Authors: Jeremy George Wheeler
Journal: JAMA (1994)

To the Editor.  —Dr Colditz and colleagues1have reviewed and digested an enormous amount of data in producing their meta-analysis of the efficacy of BCG vaccine in the prevention of TB. However, there are major considerations that cast doubt on their conclusions.  Among these considerations is the implication in the title and the text that there is only one BCG vaccine. Numerous authors have called attention to the fact that the BCG vaccines produced in different laboratories vary in almost every measurable characteristic.2,3Variations might be expected to occur in a vaccine that had to be subcultured as often as every 2 weeks from its release in 1922 until freeze-dried strains were developed in the mid 1960s.4Strains have been found to differ in their survival on culture media, colony formation, viability, drug resistance, DNA restriction fragments, virulence in animals, anti-TB and antitumor protection in animals, production
Response to Letter Regarding Article, “Cardiac Memory in Patients With Wolff-Parkinson-White Syndrome: Noninvasive Imaging of Activation and Repolarization Before and After Catheter Ablation”
Authors: Yoram Rudy, Subham Ghosh, Edward K. Rhee, Jennifer N. Avari, Pamela K. Woodard
Journal: Circulation (2009)

Syndrome: Noninvasive Imaging of Activation and Repolarization Before and After Catheter Ablation"We thank Berger and colleagues for their queries about our article. 1Three-dimensional CARTO mapping was not performed because it was not clinically indicated in this pediatric study (it prolongs procedure and fluoroscopy time).The objectives of the study were to guide ablation by noninvasively imaging preexcitation sites before the procedure and then, after the procedure, to study changes in epicardial activation and repolarization.ECG imaging (ECGI) was validated extensively in canine experiments and in humans by direct epicardial mapping during cardiac surgery and by localization of known pacing sites (references 1 ).Activation recovery interval (ARI), computed from QRS maximum negative derivative to T-wave maximum positive derivative, correlates with action potential duration. 2ARI dispersion imaged by ECGI was shown to quantify dispersion of repolarization. 3The QT interval in the letter by Berger et al is defined from Q-start to T-end.It differs from ARI and does not reflect action potential duration.In fact, it is not uncommon for QT and ARI to change in different directions.Moreover, QT interval of a single electrogram does not reflect spatial properties, and even QT differences between several electrograms are a poor estimate of repolarization dispersion. 4e do not have data for quantification of myocardial damage.Average duration of radiofrequency was 2.3Ϯ1.2minutes and number of lesions 3.1Ϯ1.6,with power setting of 50 Watts and temperatures between 50 and 60°C.Three patients (W5, W6, W8) had cryo-ablation (duration 20.6Ϯ19.4minutes, number of lesions 7.6Ϯ2.5,temperature Ϫ70°C).The lesions were focal, shown to cause significant myocardial injury only in a small percentage of patients. 5ECGI postablation was performed 45 minutes after the procedure end to eliminate any effects of local temperature transients.Moreover, ARI changes were imaged over a much larger epicardial area than the focal lesion size and occurred independently of the ablation method (radiofrequency or cryo).
Real-Time Patch-Cram Detection of Intracellular cGMP Reveals Long-Term Suppression of Responses to NO and Muscarinic Agonists
Authors: Bhavya Trivedi, Richard H Kramer
Journal: Neuron (1998)

Cyclic GMP (cGMP) is a crucial intracellular messenger in neuronal, muscle, and endocrine cells. The intracellular concentration of cGMP is regulated by various neurotransmitters, including acetylcholine (ACh) and nitric oxide (NO). While much is known about the biochemical steps leading to cGMP synthesis, little is known about cGMP kinetics in intact cells. Here, we use "patch-cramming," in which an excised, inside-out membrane patch containing cyclic nucleotide–gated ion channels is used as a biosensor, to obtain the first real-time measurements of cGMP in intact cells. Patch-cramming experiments on neuroblastoma cells show that both muscarinic agonists and NO rapidly elevate cGMP. NO elicits cGMP responses repeatedly without decrement, whereas responses to muscarinic agonists exhibit a profound and prolonged desensitization. Remarkably, muscarinic agonists also cause long-term (>30 min) suppression (LTS) of cGMP responses elicited by NO. Biochemical measurements reveal that rat sympathetic neurons also exhibit LTS of cGMP, suggesting that LTS is a widespread mechanism that may contribute to synaptic plasticity.