tbuckley/cabot-search huggingface dataset:
The Use of a County Hospital Emergency Room by Diabetic Patients
Authors: Catherine C Murphy, Esther H Faulkenberry, John D Rumpel, Frances C Wheeler
Journal: Diabetes Care (1985)

The use of a county hospital emergency room (ER) by diabetic patients was investigated by comparing ER visits for diabetes to a sample to total ER visits over a period of 1 yr. The major problems of ER use by diabetic patients were an excessive number of visits for diabetes complications, a high rate of hospital admissions from the ER, and the high cost of ER use. Approximately 20% of visits for diabetic patients were attributed to preventable complications of diabetes. The rate of hospital admissions from the ER was over four times greater for the diabetic patients than for the random sample. The median cost of an ER visit was nearly three times higher for diabetic patients than for the random sample. These problems may be best resolved through improved access to primary care and educational services that can assist the person with diabetes in self-management and prevention of the acute complications of the disease.
Crucial Role of Endogenous Interleukin-10 Production in Myocardial Ischemia/Reperfusion Injury
Authors: Zequan Yang, Basilia Zingarelli, Csaba Szabó
Journal: Circulation (2000)

Background —The anti-inflammatory cytokine interleukin-10 (IL-10) has been detected in the plasma of patients with myocardial ischemia/reperfusion. The aim of our study was to investigate the role of endogenously produced IL-10 in myocardial ischemia/reperfusion. Methods and Results —In the present study, we used wild-type and IL-10–deficient mice subjected to myocardial ischemia/reperfusion. Significant levels of IL-10 were produced in wild-type mice at 2 to 6 hours after myocardial reperfusion. The genetic deletion of IL-10 enhanced neutrophil infiltration into the reperfused tissues at 6 hours after reperfusion and increased infarct size and myocardial necrosis. Furthermore, in the absence of IL-10, an enhancement of the inflammatory response was seen, as demonstrated by increased plasma levels of tumor necrosis factor-α, nitrite/nitrate (breakdown products of NO), and increased tissue expression of intercellular adhesion molecule-1. Reperfusion for 24 hours was associated with a 75% mortality rate in IL-10–deficient mice, whereas no deaths occurred in the wild-type animals. Conclusions —The present findings provide the first direct evidence that endogenous IL-10 inhibits the production of tumor necrosis factor-α and NO and serves to protect the ischemic and reperfused myocardium through the suppression of neutrophil recruitment.
Localized Leishmaniasis of Lymph Nodes
Authors: D. W. Bell, J. A. G. Carmichael, R. S. Williams, R. L. Holman, P. D. Stewart
Journal: BMJ (1958)

MEDICAL JOUIRNAL Journal (1956) various cures were proposed, but dis- appointingly little was mentioned about diagnosis.In our patient much time was wasted in conservative treatments of such kind: the logical and obvious cure is shown in Special Plate Fig. 3 and Graph 2.In these cases one began by knowing little and believing much, and en1ed by inverting the quantities.The adenoids, long ago entered in the Gilbertian classification of things " that never will be missed," deserve some respect, if not a reappraisal, of their worth.Finally, I would like to emphasize the advantages of early diagnosis and treatment in patients with speech disorders.These patients are invariably backward in reading and in their general education because of their speech defect.Some of them are of below-average intelligence and so require special help.Correcting the speech defect allows their education to proceed normally, and will also allow them to take advantage of extra coaching at school so that they may ultimately earn a living, as normal citizens, within their capacity for work and responsibility. SummaryIt is conservatively estimated that in England and Wales 250 children per year are born with potential speech defects or acquire such defects as the result of disease or of radical adenoidectomy.The mechanism of production of such defects by tonsil and adenoid operations is described.A scheme for the investigation of children with defective speech is outlined, with particular reference to nasality." Nasal escape " is defined and a summary of its causes given.The advantages of early diagnosis and treatment are stressed.A fairly complete palatopharyngeal analysis can be made on a simple lateral radiograph; even more accurate information can be obtained with a cephalometric tracing.Children with speech disorders are invariably educa- tionally backward, and correction of the defect allows their education to proceed normally so that ultimately they may earn their living as normal citizens.Three illustrative cases are reported.These are dis- cussed and their progress is charted.
New marketing code for Indian drug companies favours the companies, critics say
Authors: M. Chaudhuri
Journal: BMJ (2012)

A new code of marketing practice for the drug industry is being drawn up by the Indian government aimed at stopping the provision of gifts to doctors by drug companies to promote their products.

It lays down that “No gifts, pecuniary advantages or benefits in kind may be supplied, offered or promised to persons qualified to prescribe or supply by a pharmaceutical company.” But it also says that “Companies may legitimately provide assistance that is directly related to the bona fide continuing education of the healthcare professionals.” …
Lupus Anticoagulant in the Acquired Immunodeficiency Syndrome
Authors: Elana J. Bloom
Journal: JAMA (1986)

Prolongation of partial thromboplastin time was noted in patients with acquired immunodeficiency syndrome (AIDS) who were admitted to the hospital for diagnosis of opportunistic infection. As biopsy procedures were often indicated, detailed investigation of the abnormal coagulation study was performed in four patients. Results confirmed the presence of a lupus anticoagulant. Partial thromboplastin times of 34 consecutive subsequent patients hospitalized with the diagnosis of AIDS-associated opportunistic infection were recorded; prolongation was noted in 24 of these. None of these 38 patients exhibited clinical evidence of bleeding. One patient had a confirmed thrombotic episode. Prolonged partial thromboplastin time is a common finding in hospitalized patients with AIDS and opportunistic infection. If no clinical history of unusual bleeding is noted, the lupus anticoagulant should be suspected. Many patients with AIDS require invasive procedures for disease management; the lupus anticoagulant, an in vitro phenomenon, should not prevent these studies.
Subdural Empyema Associated with an Apparent Regional Hyperperfusion (Luxury Perfusion)
Authors: JAMES F. DeLONG
Journal: Clinical Nuclear Medicine (1978)

A patient with a subdural empyema demonstrated a late arterial “blush” during a 99mTc-pertechnetate cerebral dynamic flow study which “washed out” in the delayed images. Cerebral arteriography and subsequent autopsy documented inflammatory tissue surrounding the empyema, resulting in this scintigraphic pattern.
A Case of Ascites, Accompanied with Ovarian Disease, in Which Paracentesis Abdominis was Performed Fifty-Five Times
Authors: H. Hemsted
Journal: BMJ (1865)

possible, in the present state of our knowledge, to affix limits to the usefulness of the instrument.[Dr.Cruise, having read the foregroing, paper, proceeded to exlhibit and explain the construction of the endoseope which he uses, and to point out the means by which he obtains a light possessing the requisite qualities of inttetsity, steadiness, andfacility in adjtst- ment.These details will form part of another communication.A discussion followed the exhibition of the instruiiment, in which many present bore testimony to its v-alue.
Glucose Sensing During Hypoglycemia: Lessons From the Lab
Authors: Rory McCrimmon
Journal: Diabetes Care (2009)

Shortly after the introduction of insulin in the management of type 1 diabetes, clinicians became aware of the potential for insulin therapy to induce iatrogenic hypoglycemia. Hypoglycemia remains the major adverse effect of insulin therapy and has emerged as a significant limitation to achieving near-normal glucose control, which is required to reduce the risk of microvascular complications. The average individual with type 1 diabetes experiences around two episodes of symptomatic hypoglycemia per week. In the recent U.K. Hypoglycemia Study (1), the incidence of severe hypoglycemia (requiring external assistance) was 110 episodes per 100 patient-years in subjects with duration of diabetes  15 years. Thus, despite the introduction of insulin analogues and improved delivery systems, hypoglycemia remains a major concern for individuals with type 1 and long-duration type 2 diabetes as well as their caregivers.

When glucose levels fall, a sequence of counterregulatory responses is triggered, which mainly involves the suppression of endogenous insulin secretion and the release of counterregulatory hormones that act rapidly to promote endogenous glucose production and limit peripheral glucose utilization. As glucose levels fall further, subjective awareness of hypoglycemia results in behavioral changes that ordinarily lead an individual to seek food. In healthy individuals, this homeostatic mechanism works well and hypoglycemia is rare, but for individuals with type 1 diabetes, these compensatory systems are disrupted at every level. First, for most individuals insulin delivery to the systemic circulation following a subcutaneous injection will continue despite the development of hypoglycemia. Second, almost all individuals with type 1 diabetes will over time develop defects in the hormonal counterregulatory defense against hypoglycemia. Within 5 years of diagnosis of type 1 diabetes, hypoglycemia fails to stimulate release of the major counterregulatory hormone glucagon (2). As a result, individuals …
DNR in the OR-Reply
Authors: Robert M. Walker
Journal: JAMA (1992)

In Reply.  —I appreciate the thoughtful responses to my article and the opportunity to respond.  Part of Dr Couper's difficulty with intraoperative DNR orders relates to his broad use of the term resuscitation . He applies the term not only to intraoperative arrest but to events that can lead to arrest. By contrast, I specifically defined resuscitation as an attempt to reverse intraoperative cardiac arrest. It is only by distinguishing arrest from prearrest interventions, like vasopressor and fluid support, that we can avoid confusion in this matter.  Drs Franklin and Rothenberg write that my approach to DNR policy fail[s] to mention... the patient's option to have life support discontinued. They propose a therapeutic trial of surgery with a guarantee that life support will be discontinued in particular circumstances. I should point out that this option was addressed in my article's policy considerations. I wrote that during discussion, one may well find
Court hears assisted suicide debate
Authors: T. Rutter
Journal: BMJ (1997)

The United States Supreme Court last week heard a deeply divisive debate over the rights of patients to ask their doctor for help in ending their lives. A decision is not expected until midsummer.

It was one of the most watched debates in the court's history-over 50 friends of the court briefs were filed, representing views on each side of the issue. It has divided doctors, legal advocates, religious groups, and organisations that provide care to people who are terminally …
Southall faces further hearing—on secret medical records
Authors: Owen Dyer
Journal: BMJ (2006)

The paediatrician David Southall is facing a disciplinary hearing at the General Medical Council next month, over charges that his methods “amounted to keeping secret medical records” on two children in his care.

The hearing, announced by the GMC on Tuesday (17 October), is in addition to one already being considered after a Court of Appeal ruled that the GMC should have investigated a separate complaint made against Professor Southall ( BMJ 2005;331: 1426).

The GMC has now said that it will look into separate accusations that Professor Southall failed to act in the children's …
A Lack of DNA Mismatch Repair on an Athymic Murine Background Predisposes to Hematologic Malignancy
Authors: Marcia R. Campbell, Patrick N. Nation, Susan E. Andrew
Journal: Cancer Research (2005)

Abstract Inheritance of a germline mutation in one of the DNA mismatch repair genes predisposes human individuals to hereditary nonpolyposis colorectal cancer, characterized by development of tumors predominantly in the colon, endometrium, and gastrointestinal tract. Mice heterozygous for a mismatch repair–null mutation generally do not have an increased risk of neoplasia. However, mice constitutively lacking mismatch repair are prone to tumor development from an early age, particularly thymic lymphomas. Mismatch repair–deficient mice crossed to Apc+/− mice develop an increased spontaneous intestinal tumor incidence, demonstrating that the tumor spectrum can be genetically influenced. Here, we bred Msh2- and Msh6-deficient mice to athymic nude mice, hypothesizing that a broader tumor spectrum may be observed if mice are able to survive longer without succumbing to thymic lymphomas. However, Msh2−/−;Foxn1nu/nu and Msh6−/−;Foxn1nu/nu mice developed primarily early-onset lymphoblastic lymphomas. Using B-cell–specific markers, we found these tumors to be predominately B-cell in origin. The development of hematologic malignancy in the mouse, even in the absence of a thymus, parallels the development of B- and T-cell lymphoma and leukemia in the few rare mismatch repair–null human patients that have been identified. The persistent development of hematologic malignancy both in the mouse and in human patients deficient in mismatch repair leads us to implicate mismatch repair as an important repair mechanism in normal B- and T-cell development. Thus, mismatch repair–deficient mice may prove to be a good model to study human hematologic malignancy.
Personal-Model Beliefs and Social-Environmental Barriers Related to Diabetes Self-Management
Authors: Russell E Glasgow, Sarah E Hampson, Lisa A Strycker, Laurie Ruggiero
Journal: Diabetes Care (1997)

OBJECTIVE The specific aims of the present study were to report on the level of personal beliefs and social and environmental barriers across different regimen areas and patient subgroups and on the relationship of personal models and perceived barriers to the level of self-management. RESEARCH DESIGN AND METHODS This study focused on several issues related to personal models (representations of illness) and perceived barriers to diabetes self-management among a large heterogeneous survey sample of 2,056 adults throughout the U.S. RESULTS Respondents felt that diabetes was a serious disease and that their self-management activities will control their diabetes and reduce the likelihood of long-term complications. Most frequently reported barriers were related to dietary adherence, followed by exercise and glucose testing barriers. Both personal models and barriers significantly predicted level of self-management in all three regimen areas studied (diet, exercise, and glucose testing) after controlling for the influence of demographic and medical history factors. Regimen-specific models and barriers proved to be stronger predictors than more global measures. Differences on personal models and barriers were observed among different patient groups (e.g., age, health insurance, and insulin-taking status). Possible reasons for these differences and implications for intervention and future research are discussed. CONCLUSIONS Both the personal-model and barriers scales had good internal consistency and predicted variance in each of the self-management variables after controlling for demographic and medical history factors. These brief self-report personal-model scales demonstrated good internal reliability and were as predictive of self-management as the lengthier interview-based measures in previous studies. The assessment of the treatment effectiveness component of personal models may be sufficient for most clinical purposes.
Renal Cyst Masquerading as a Palpable `Gallbladder'
Authors: B. Nagesh Raghavendra
Journal: JAMA (1981)

<h3>To the Editor.—</h3> It is rare for a lower pole cyst of the right kidney to appear to be a palpable mass in the right upper quadrant of the abdomen. We recently encountered such a case and thought it worthwhile to report. A tennis ball-sized cystic mass clinically thought to be a distended gallbladder was palpated in the right upper quadrant of the abdomen of a 62-year-old man who was recovering from recent cardiac surgery. The mass was nontender and moved freely with respiration. The liver function test results were normal except for slight elevation of serum lactic dehydrogenase level. Sonography identified the palpable mass as a cyst arising from the lower pole of a tilted right kidney (Figure). The mass met all the sonographic criteria described for the diagnosis of a simple renal cyst.<sup>1</sup>
Genomic analysis of the clonal origin and evolution of acute promyelocytic leukemia in a unique patient with a very late (17 years) relapse
Authors: X Zhang, Q Zhang, J Dahlström, A N Tran, B Yang, Z Gu, M Ghaderi, A Porwit, J Jia, Å Derolf, D Xu, M Björkholm
Journal: Leukemia (2014)
The Artificial Kidney in Malaria and Blackwater Fever
Authors: R. C. Jackson, A. W. Woodruff
Journal: BMJ (1962)

Acute renal failure is one of the complications which for generations has been most dreaded in severe malaria and blackwater fever (Fairley et al., 1961).Maegraith (1944) pointed out that the mortality rate in blackwater fever was 20 to 25%/., and that approximately half these deaths resulted from renal failure.The use of the artificial kidney is a logical development in the manage- ment of renal failure occurring in severe Plasmodium falciparum infections with or without blackwater fever.To the best of our knowledge there are no reports in the literature of the use of an artificial kidney in malarial renal failure.We report the histories of four patients, three of whom were treated with the aid of an artificial kidney (Kolff twin-coil); two of these had severe cerebral malaria.A fourth patient's details are included, although he was not dialysed, because the history illustrates many points in the management and move- ment of these patients.Case 1 An American civil airline pilot aged 36 had been flying regularly between the United States, West Africa, South Africa, and Great Britain for 18 months, during which period he had taken prophylactic antimalarial drugs only on one or two occasions.Ten days before admission he had developed headache, malaise, nausea, and a fever;
How Well Does the HoT Score Reflect Sequence Alignment Accuracy?
Authors: Barry G. Hall
Journal: Molecular Biology and Evolution (2008)

Multiple sequence alignment is an essential tool in many areas of biological research, and the accuracy of an alignment can strongly affect the accuracy of a downstream application such as phylogenetic analysis, identification of functional motifs, or polymerase chain reaction primer design. The heads or tails (HoT) method (Landan G, Graur D. 2007. Heads or tails: a simple reliability check for multiple sequence alignments. Mol Biol Evol. 24:1380-1383.) assesses the consistency of an alignment by comparing the alignment of a set of sequences with the alignment of the same set of sequences written in reverse order. This study shows that HoT scores and the alignment accuracies are positively correlated, so alignments with higher HoT scores are preferable. However, HoT scores are overestimates of alignment accuracy in general, with the extent of overestimation depending on the method used for multiple sequence alignment.
Diagnosis of adrenal insufficiency
Authors: G R Park, P Raggatt
Journal: BMJ (1989)

increased by hypoglycaemia.A study by Watabe et al clearly showed that the adrenocorticotrophic hormone (and cortisol) responses to corticotrophin releasing factor were appreciably reduced by water loading when endogenous arginine vasopressin is suppressed.Thus hypoglycaemia is probably a more potent stimulator than corticotrophin re- leasing factor of the pituitary-adrenal axis.Consequently, though possibly of some help in diagnosing isolated adrenocorticotrophic hormone deficiency, which is rare, I do not believe that the corticotrophin releasing factor test is a substitute for assessment of the stress response.Thus it is not cost effective in the routine assessment of patients with suspected adrenal insufficiency.
Case 32-1973
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, John A. Mills, Robert L. Trelstad
Journal: New England Journal of Medicine (1973)

Presentation of CaseA 70-year-old woman was admitted to the hospital because of back pain and diarrhea.At least 30 years earlier she began to experience Raynaud's phenomenon that affected the fingers and later the feet. Twenty-six years before admission bilateral dorsal sympathectomy was performed, with only transient benefit. Twenty years before entry there was the onset of intermittent abdominal cramps and diarrhea. For many years she experienced postprandial distention without pain, often accompanied by nausea. Ten years before admission there was an attack of severe abdominal pain, with syncope and diarrhea, that persisted for three days; a barium-enema examination . . .
Patterns of Hallucinogenic Drug Abuse
Authors: Arnold M. Ludwig
Journal: JAMA (1965)

The use of hallucinogenic (psychotomimetic, dysleptic, psychedelic) substances to produce altered states of consciousness is not new,<sup>1-3</sup>but recently there has been increased interest and publicity given these agents. This renewed attention has been spurred by the discovery of several new substances, such as d-lysergic acid diethylamide (LSD), psilocybin, and psilocin, which have potencies far greater than the older agents (peyote, mescaline, teonanacatl, ololiuqui). These drugs have captured the imagination of many people who have speculated on their application in many different areas. Anthropologists<sup>4, 5</sup>have described the socially sanctioned use of some of these agents in "primitive cultures"; novelists<sup>6</sup>have conceived of their role in utopian societies; and physicians have espoused their usefulness in treating mental illness<sup>7</sup>and for the production of "model psychoses." Others have proposed or described their use as educational tools<sup>3</sup>and for inducing religious "mystical" experiences.<sup>8-10</sup>Still others have commented on
Prophylaxis of Venereal Diseases.
Authors: G. S. Peterkin
Journal: JAMA (1906)

Seattle, Wash., Feb. 14, 1906. <h3>To the Editor:</h3> —As chairman of the committee of venereal prophylaxis of the Washington State Medical Association, I desire to appeal to your readers to aid this committee in securing the names and addresses of physicians who would forward notice of any legislative action, state or municipal, or action taken by any society, corporation, or individual that would bear on this subject. The object sought is to classify and to redistribute such literature in a condensed form and thus lead t a more uniform and concentrated action. At the same time, we wish to compile a list of the physicians who desire to receive and to exchange literature, abstracts, papers, or reprints bearing on this subject and later, if possible, to establish a bureau of inquiry to which references may be made by any of those desiring knowledge on this subject. Therefore, we should be
Do low grade thyroid cancers really require thyroidectomy?
Authors: H. Rogers
Journal: BMJ (2013)

Hlodnicki, who has personally experienced thyroid cancer,1 poses some interesting questions in his rapid response to Brito and colleagues’ article arguing that zealous imaging has increased the detection and treatment of low risk tumours.2 

He states that we should not lie or tell half truths to patients. If more patients were fully informed, …