tbuckley/cabot-search huggingface dataset:
Denial in the medical interview
Authors: E. J. Wiseman
Journal: JAMA (1995)

To the Editor.  —I enjoyed the recent JAMA article entitled  in the Medical Interview. 1 Although recognizing the potential impact of denial, the authors did not discuss how the process of denial has been incorporated into psychiatric and medical nosology. Denial was included as a critical component of the definition and criteria for the diagnosis of alcoholism formulated by the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine. 2   The American Psychiatric Association, however, did not rely on the concept of denial in developing diagnostic criteria for alcohol dependence. Rounsaville et al 3 recognized that individuals who denied alcohol use would fail to meet criteria from the Diagnostic and Statistical Manual (DSM) , 4 but proposed that the criteria were intended to define the minimum symptoms necessary for diagnosis rather than to guide patient assessment. Thus, paradoxically, nonpsychiatrists assigned more
Hypotensive effect of propranolol and phenoperidine in tetanus.
Authors: K L Woods
Journal: BMJ (1978)

consider, however, that the risks of lactic acidosis make the use of phenformin undesirable.Stanozolol on the other hand has been shown to be effective when given alone for periods up to 30 months and it is relatively free from side effects.8We should like to suggest that stanozolol is effective in reversing the deficiency of fibrinolysis found in Behqet's disease and that it deserves further consideration as long-term therapy to prevent the development of potentially serious thrombotic episodes in patients with this condition.
The reproducibility of submaximal work heart rates-an interim report.
Authors: K. Sykes, E. Pace, E. J. Charlesworth
Journal: British Journal of Sports Medicine (1976)

Work heart rates were taken from four subjects performing standardized bouts of work on the Monark Ergometer. Whilst a linear relationship was observed between heart rate and work intensity on any one day, it is evident that day to day variations in the position (intercept) of these lines exists. The slopes are virtually identical for all subjects and for different days, however the position of the lines differs widely both between and within subjects. The best linear regression equation developed for the prediction of heart rate after 180 seconds of work from pre-exercise heart rate and work intensity was found to have 95% confidence limits of +/- 12.7 beats. Heart rates are reproducible 95% of the time to within +/- 12.2 beats when pre-exercise heart rate is ignored.
Excretion of Street Rabies Virus in the Saliva of Dogs
Authors: John B. Vaughn
Journal: JAMA (1965)

Dogs, of all domestic animals, are the most common source of human rabies.<sup>1</sup>In the United States, 600,000 to 1,000,000 people are bitten by dogs each year.<sup>2</sup>Of the 212 human deaths from rabies from 1946 to 1959, where the species of biting animal was known, 84% were attributed to dogs.<sup>1</sup>The total number of reported human deaths due to rabies in this period markedly decreased.<sup>3</sup> Because the United States' population of dogs increased from about 12 million in 1946<sup>1</sup>to approximately 25 million in 1960,<sup>4</sup>and is possibly still increasing, it is reasonable to expect that in the next decade many more physicians will have to decide whether or not to administer antirabies treatment to a person who has been bitten by a dog. As part of this decision the physician will have to consider carefully the evidence for true exposure to rabies
Regurgitation of Blood into Insulin Cartridges in the Pen-like Injectors
Authors: Kazuo Sonoki, Mototaka Yoshinari, Masanori Iwase, Kenji Tashiro, Kenzo Iino, Masanori Wakisaka, Masatoshi Fujishima
Journal: Diabetes Care (2001)

Diabetic Ketoacidosis Associated With Orlistat Treatment Orlistat is a drug frequently prescribed as an adjuvant in weight control therapy (1-2).Orlistat inhibits gastric and pancreatic lipases in the lumen of the gastrointestinal tract to decrease the systemic absorption of dietary fat (1,2).In clinical trials, steatorrhoea and other gastrointestinal disorders are the most frequently reported side effects (3).Other reported adverse effects include hypertension (4) and depression (5).No cases of severe hyperglycemia or diabetic ketoacidosis (DKA) have been previously reported with this drug.We report an 18-year-old Caucasian woman with type 1 diabetes for the past 3 years who had a progressive increase in weight, reaching 89 kg, and a height of 164 cm (BMI 33 kg/m 2 ).She was administered several weight-reducing regimens, but to no avail.One month before her hospitalization, she began taking, on her own, orlistat (120 mg three times per day) in addition to a low-calorie diet.This was accompanied by one to three watery bowel movements per day.She was progressively lethargic, and her insulin dose requirement increased from 86 to 98 U/day, in three preprandial injections of regular insulin with one evening dose of long-acting insulin.She had no other underlying illnesses and was not on any other medication.Her home blood glucose monitoring revealed progressive worsening of her diabetes control.On the day of presentation in the emergency room, she was complaining of severe lethargy, abdominal discomfort, nausea, and two episodes of vomiting.Laboratory data showed severe hyperglycemia (blood glucose 550 mg/dl), acidosis (pH 7.0), hyperosmolar state (Na 153 mEq/l, K 3.0 mEq/l, BUN 60 mg/dl, creatinine 1.8 mg/ dl), severe ketosis (ketone bodies 40 mg/ dl), and positive urinary ketones.She was afebrile (37.2°C), weighed 85 kg, had an HbA 1c 12%, and was dehydrated (ϳ10% of her body weight).Orlistat was stopped, and the patient was started on intravenous hydration and insulin.The patient showed significant improvement over a period of 5 days.On discharge, she was back on her baseline insulin dosage of 82 U/day, and she was hemodynamically stable.In this patient, orlistat, probably secondary to the watery stools, seemed to have progressively caused dehydration and a decrease in intravascular volume.Initially, this lead to insulin resistance and increased insulin requirements, followed by DKA.This is the first report of DKA precipitated by orlistat in a type 1 diabetic patient.We advise caution and close monitoring of patients with type 1 diabetes who are given orlistat for obesity management.
Health reforms will not succeed without public engagement, say providers
Authors: Z. Kmietowicz
Journal: BMJ (2011)

The challenges facing the NHS in England to provide better care and services for patients while making £20bn (€22.8bn; $32.2bn) of savings will not be overcome by amendments to the health bill promised by the government without engaging the public and the community, a leading figure from the not for profit sector has said.

Victor Adebowale, chief executive of the health and social care organisation Turning Point, told a meeting at the King’s Fund that patients feel disengaged from the process of new services opening and other services closing.

“That £20bn of savings is being enacted as we speak, and it is not going to be managed without some very big decisions. That kind of change without engaging communities …
Epidermal Growth Factor Receptor Gene in Primary Tumor and Metastatic Sites from Non-small Cell Lung Cancer
Authors: Lorenzo Daniele, Paola Cassoni, Elisa Bacillo, Susanna Cappia, Luisella Righi, Marco Volante, Fabrizio Tondat, Giorgio Inghirami, Anna Sapino, Giorgio V. Scagliotti, Mauro Papotti, Silvia Novello
Journal: Journal of Thoracic Oncology (2009)
Doctors in training: wasteful and inefficient?
Authors: T. K Rosborough
Journal: BMJ (1998)

The United States government seems almost certain to decrease funding for graduate medical education in teaching hospitals. At the same time competition in healthcare delivery is forcing hospitals to cut costs. If teaching medical graduates increases hospital costs and if trainees cause waste and inefficiency in patient care hospitals may choose to eliminate their teaching programmes. As hospitals throughout the developed world are being subjected to market pressures they need to know the contribution and the costs of training doctors. Is the widely held belief that doctors in training cause waste and inefficiency true?

The costs of a graduate medical education programme include the salaries of trainees and their teachers, administrative support, space, supplies, and equipment. The programme for 30 residents in internal medicine at this hospital costs about $5m (£3.3m). In the United States the revenue for residency training programmes comes from several sources: the federal government's Medicare programme, income generated by the teaching faculty in patients' fees and research grants, and sometimes endowment funds. For our programme, the total revenue is about $6.5m (£4.3m), almost 90% of which comes from Medicare. The surplus is mainly due …
Three difficult cases: the challenge of autoimmunity, immunodeficiency and recurrent infections in patients with Good syndrome
Authors: S.J. Arnold, T. Hodgson, S.A. Misbah, S.Y. Patel, S.M. Cooper, V.A. Venning
Journal: British Journal of Dermatology (2014)

Good syndrome (GS) is a rare, adult-acquired primary combined immunodeficiency syndrome arising in the context of previous or current thymoma. Patients with GS frequently develop recurrent sinopulmonary infections and are also at high risk of autoimmune manifestations, including skin conditions such as lichen planus. We report three middle-aged patients with GS complicated by multiple autoimmune and infectious manifestations. The combination of immunodeficiency, autoimmunity and recurrent infections seen in patients with GS continues to present a management challenge, particularly in patients with oral mucosal disease and recurrent candidiasis. Clinicians should be prompted to investigate an underlying immunodeficiency in patients with multiple autoimmune conditions and recurrent sinopulmonary infections.
A NEW SPIROMETER.
Authors: CHAS. DENISON
Journal: JAMA (1892)

The superiority of this instrument, over any other spirometer in use, rests in its simplicity of construction. It does not depend upon water which will evaporate, or metal which will corrode, as is the case with the Hutchinson spirometer; nor does it require a certain amount of resistance to be overcome, as in elastic measurers. With Marsh's rubber spirometer this resistance is found by actual measurement to be equivalent to twenty millimeters of mercury, before any test of the expired breath can be recorded. This new spirometer is capable of giving in cubic inches of air,the exact measurement of the<i>vital capacity</i>of the most delicate child or woman or of the strongest man. It is large enough to contain 6 small or 2 large breaths, so that an average record may thus be obtained if desired. If rightly made it is as nearly perfect as such a simple thing
Reduction in exhaled nitric oxide immediately after methacholine challenge in asthmatic children
Authors: G L Piacentini
Journal: Thorax (2002)

<b>Background:</b> The measurement of exhaled nitric oxide (NO) has recently been proposed as a useful technique for the evaluation of airway inflammation in asthma. The purpose of this study was to determine the effect of methacholine bronchial provocation on the levels of exhaled NO in asthmatic children. <b>Method:</b> Exhaled NO was measurement immediately before and after methacholine provocation in 51 children with mild to moderate asthma. <b>Results:</b> A significant decrease occurred in the level of exhaled NO (p&lt;0.0001) after methacholine bronchial provocation which was not correlated with the percentage fall in forced expiratory volume in 1 second (FEV<sub>1</sub>). <b>Conclusions:</b> The methacholine test should not be used immediately before measurement of exhaled NO in children with asthma.
Comparing morbidity and mortality of HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative and myeloablative conditioning: influence of pretransplantation comorbidities
Authors: Mohamed L. Sorror, Michael B. Maris, Barry Storer, Brenda M. Sandmaier, Razvan Diaconescu, Christopher Flowers, David G. Maloney, Rainer Storb
Journal: Blood (2004)
Exploration of Both Kidneys Before Nephrectomy Through a Double Lumbar Incision—Question of Priority.
Authors: Thorkild Rovsing
Journal: JAMA (1907)

Copenhagen, July 12, 1907. <h3>To the Editor:</h3> —In a paper entitled "Exploration and Decapsulation of the Other Kidney Before Completing a Nephrectomy" and published inThe Journal, June 1, 1907, Dr. George M. Edebohls describes as his own a method to expose and examine both kidneys through a double lumbar incision, which, since 1893, I have had in use and recommended in cases where it was impossible by other means to decide if a single or both kidneys were affected by a disease which required extirpation. Dr. Edebohls now proposes "that no nephrectomy should be completed without examination and decapsulation (!) of the remaining kidney." I do not fear that any surgeon who skilfully masters modern diagnostic methods will follow Edebohls' ultramontane proposition and perform such a lot of superfluous lumbar incisions, and therefore, I should have remained quiet if Dr. Edebohls had not forced me to speak by the following
Clozapine as a First Treatment for Schizophrenia
Authors: Margaret G Woerner, Delbert G Robinson, Jose Ma J Alvir, Brian B Sheitman, Jeffrey A Lieberman, John M Kane
Journal: American Journal of Psychiatry (2003)

OBJECTIVE: The authors' goal was to explore whether clozapine given as the first antipsychotic treatment favorably affects the course of schizophrenia. METHOD: Thirty-four inpatients experiencing their first episode of schizophrenia or schizoaffective disorder were treated first with clozapine and then followed for up to 4 years. In a previous study, the authors followed patients experiencing their first episode of schizophrenia or schizoaffective disorder who were given fluphenazine as the first treatment. In the current study and the previous study, response criteria required sustained remission of positive symptoms. RESULTS: Nineteen of the 34 subjects met response criteria while taking clozapine. The median time to treatment response was 11 weeks (range=2–13). Using survival analysis, the authors determined that the cumulative response rate for the 34 patients was 66.4% at the end of 13 weeks, which is comparable to the response rate to fluphenazine in the previous study. All responses to clozapine occurred by 13 weeks. Eight (42%) of the clozapine responders discontinued clozapine before 6 months, and only six (32%) remained on clozapine for all of their time in the study. CONCLUSIONS: The authors found no benefit for clozapine over conventional antipsychotics for acute treatment of the first episode of schizophrenia or schizoaffective disorder. Long-term benefits could not be studied because of the high rate of early discontinuation of clozapine treatment.
A lesson learnt: Always listen to the patient
Authors: W. D Carroll
Journal: BMJ (1998)

It was almost 3 00 pm and I was at home trying hard to sleep off the effects of a set of nights on call as a senior house officer in paediatrics when I was awoken by my worried wife and presented with our 4 year old child, Steven. Sleepily, I took a quick bedside history. My wife and two sons had been to the fairground in the morning. Steven had been apparently well, but had been complaining of pain “in his willy” since lunchtime, and when she eventually examined him she was alarmed to find that his scrotum was massively swollen.

From my bed and with only a halfhearted glance at my son, I decided that swollen testicles merited a turf to the surgeons. Two telephone calls later they were on the way to the casualty department to see a …
Abstract 139: The identification of potent inhibitor of apoptosis protein (IAP) inhibitors for clinical development
Authors: Stephen J. Morris, Helen Ashdown, Alain Boudreault, Jon Durkin, John Gillard, Kim Hewitt, James Jaquith, Lori Jerome, Alain Laurent, Stephane Maltais, Danielle Methot, Harshila Patel, Andrea Romeo, M Devalaraja, R Humphreys
Journal: Cancer Research (2010)

Abstract The inhibitor of apoptosis proteins (IAPs) are important regulators of cell death. Over-expression of IAPs, including XIAP, cIAP1 and cIAP2, predicts poor patient outcome in several types of cancer. XIAP binds to and inhibits caspases 3, 7 and 9. Inhibition of IAP function can enhance cell death in tumor cells. Inhibition of IAPs is being explored clinically with XIAP anti-sense (AEG35156) and small molecule inhibitor (HGS1029) strategies. We describe small molecule inhibitors of the IAPs that have been designed to bind to the homologous BIR3 domains on the IAPs, which is the site of binding of second mitochondria-derived activator of caspase (SMAC). Structure-activity trends of IAP inhibitors were evaluated for binding potency and selectivity towards IAP BIR domains and analyzed for their ability to sensitize cancer cells to death alone or in conjunction with the agonistic TRAIL receptor 1 monoclonal antibody, mapatumumab, or chemotherapeutic agents. Bridging selected compounds at various sites led to compounds with binding affinities for IAPs in the picomolar range. In cellular assays, IAP inhibitor compounds caused rapid and robust loss of cIAP1, consistent with stimulation of E3 ligase activity. In vitro cytotoxicity assays demonstrated sensitization of tumor cell lines to co-treatment with mapatumumab or chemotherapy at low nanomolar concentrations. In vitro ADME studies were conducted in multiple species to select stable molecules which were negative in CYP and hERG binding assays. Selected compounds had high protein binding in plasma from multiple species. IV administration in mice resulted in Cmax values in excess of the EC50 required for cancer cell death in vitro. Efficacy of lead compounds was demonstrated against several xenograft tumor models as single agents and in combination with either mapatumumab or conventional chemotherapeutics. This led to the identification of a highly potent compound series from which a clinical development candidate, HGS1029, was selected. Solid tumor and lymphoid malignancies Phase 1 cancer trials with HGS1029 have been initiated. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 139.
Catheter and Surgical Treatment of Cardiac Arrhythmias
Authors: Melvin Scheinman
Journal: JAMA (1990)

Over the past decade, numerous impressive advances have been made using nonpharmacologic methods for control of cardiac arrhythmias. These methods include surgical or catheter ablation of abnormal foci. Current techniques involve catheter ablation of the atrioventricular junction to control supraventricular arrhythmias. In addition, surgical techniques have proved to be remarkably safe and effective for treatment of patients with accessory pathways and those with atrioventricular nodal reentrant tachycardia. Patients with drug-refractory ventricular tachycardia may benefit from surgical resection of the ventricular tachycardia focus. The use of these interventional methodologies has radically altered the approach to management of patients with drug-refractory cardiac arrhythmias. (<i>JAMA</i>. 1990;263:79-82)
Rapid active transport of immunoglobulin A from blood to bile.
Authors: E Orlans, J Peppard, J Reynolds, J Hall
Journal: The Journal of Experimental Medicine (1978)

Immunoglobulins were isolated from the serum or ascitic fluid of Lou/Wsl rats bearing plasmacytomas and labeled with 125I. When labeled IgA was injected i.v. it disappeared from the blood serum much more rapidly than IgG2 so that after 3 h less than 10% remained. This rapid disappearance of the injected IgA was not seen in rats with ligated bile ducts. In rats with cannulated bile ducts, the labeled IgA appeared rapidly in the bile so that 25% of the injected dose was recovered in 3 h; at the peak of this biliary excretion the specific radioactivity of the bile (cpm/milligram protein) was about 200 times greater than that of the blood serum. Thus much of the IgA which finds its way into the blood is rapidly and actively transported across the liver so that it enters the gut lumen via the biliary tract.
Principles of Neural Science
Authors: Vincent P. Calabrese
Journal: JAMA (1992)

This book has expanded in size through three editions but has maintained its preeminence as a leading text of neurobiology. I use the word "neurobiology" deliberately as it is often referred to as a neurophysiology text. It is not—it is much more. It is a textbook that tries to integrate biochemistry, physiology, and structure with function. The preface gives the philosophical background of the book, namely, "to write a coherent introduction to the nervous system for a broad range of students of behavior, biology and medicine." I might add that it is also an excellent review of neurobiology for the practitioner who wants to keep up to date with the latest in basic science. The chapters are clearly written (despite multiple authors) and cross-referenced. The cartoons and diagrams are clearly labeled with comprehensive explanations nicely integrated with the text. The reader who has not been in a laboratory for 20
Linoleic and linolenic acids and acne vulgaris
Authors: A.C. Logan
Journal: British Journal of Dermatology (2007)

Journal Article Linoleic and linolenic acids and acne vulgaris Get access A.C. Logan A.C. Logan Integrative Care Centre of Toronto, 3600 Ellesmere Road, Unit 4, Toronto, ON, M1C 4Y8, Canada E‐mail: aclnd@cfs‐fm.org Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 158, Issue 1, 1 January 2008, Pages 201–202, https://doi.org/10.1111/j.1365-2133.2007.08317.x Published: 01 January 2008
Dual Antiplatelet Therapy After Stent Implantation—Reply
Authors: Fausto Feres, Ricardo A. Costa, Deepak L. Bhatt
Journal: JAMA (2014)

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Contrasting Effects of Lower Body Positive Pressure on Upper Airways Resistance and Partial Pressure of Carbon Dioxide in Men With Heart Failure and Obstructive or Central Sleep Apnea
Authors: Takatoshi Kasai, Shveta S. Motwani, Dai Yumino, Joseph M. Gabriel, Luigi Taranto Montemurro, Vinoban Amirthalingam, John S. Floras, T. Douglas Bradley
Journal: Journal of the American College of Cardiology (2013)