tbuckley/cabot-search huggingface dataset:
Medical Care for Patients with Diabetes: Epidemiologic Aspects
Authors: Maureen I. Harris
Journal: Annals of Internal Medicine (1996)

To describe the epidemiologic characteristics of physician care and self-care for adults with diabetes in the U.S. population.Data are drawn from the 1989 National Health Interview Survey, in which a personal household interview was administered to a representative sample of U.S. adults aged 18 years or older. The response rate was 96% (n = 84,572). All subjects identified as having diabetes previously diagnosed by a physician were asked a series of questions about their diabetes. Response rate for this representative sample of U.S. diabetic patients was 95% (n = 2405).Self-reported information was obtained about various aspects of diabetes care, including care by physicians and self-case practices of the diabetic persons. Sociodemographic and clinical factors that may influence diabetes care were also determined.More than 90% of diabetic adults had one physician for the usual care of their diabetes, but 32% made fewer than four visits to this physician each year. Most physician visits by diabetic patients were not made to diabetes specialists, and the visit rate to other health care professionals such as ophthalmologists, podiatrists, and nutritionists was low. About half of insulin-treated diabetic subjects used multiple daily insulin injections; and 40% of patients with insulin-dependent diabetes mellitus, 26% of those with non-insulin-dependent diabetes mellitus (NIDDM) who were taking insulin, and 5% of those with NIDDM who were not taking insulin monitored their blood glucose level daily. Diabetes patient education classes had been attended by 35% of diabetic adults.These and other data indicate that medical care for diabetic patients and their self-care practices may not be optimal for prevention of diabetes complications. The Diabetes Control and Complications Trial showed that achieving and maintaining near-normal glycemia, with a concomitant 50% to 70% reduction in diabetes complications, may require close monitoring and ongoing support from a health care team, ample financial resources, and advanced patient knowledge and motivation. Providing this level of diabetes management to all diabetic persons may require major changes in the health care system and in patient self-care practices.
Profiles in Cognitive Aging
Authors: Joseph Francis
Journal: JAMA (1995)

Trivial mental lapses often accompany advancing age, but differentiating these from the early stages of serious cognitive disorders can be a challenge even for experienced clinicians. Such questions have a greater urgency than ever, now that legislatures have largely disbanded mandatory retirement and more older persons remain active in professions that demand high mental acuity. Physicians are often asked to judge an individual's mental competence, yet few of us have the training or time to do detailed cognitive assessment. In addition, the simple screening tools we are familiar with, such as the Mini-Mental State Examination, are notoriously insensitive to early decline in highly functioning persons. Anticipating this problem nearly a decade ago, the Risk Management Foundation of the Harvard Medical Institutions underwrote a series of studies and field tests that led to the development and validation of MicroCog, a cognitive testing battery designed to be administered and scored by a
Money-Driven Medicine: The Real Reason Health Care Costs So Much
Authors: Jeanne Lenzer
Journal: BMJ (2006)

G eorge Bush promised to kill two birds with one stone when he introduced his “consumer driven” healthcare plan. According to Bush, the market based plan would contain spiralling health costs and make insurance more affordable for the 48 million uninsured US citizens. Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img>![Graphic][4]</img> Under the scheme, consumers buy high-deductible plans—insurance plans that cost less each month, but they must pay a higher portion of the bill if they use medical services. The money saved by lower monthly payments is set aside in a tax free “health savings account” held by the consumer, who can use the savings to pay for medical care. Since out-of-pocket payments with high-deductible plans can run up to $5100 (£2696; €3978) for an individual and $10 200 for a family, consumers will have considerable money at stake, or “skin in the game,” as conservatives like to put it. And having skin in the game, according to enthusiasts like Regina E Herzlinger, chair of Harvard Business School, will drive healthcare costs down and quality up, because consumers will comparison shop to get the highest quality care for the best price—much as they do for other consumer goods … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif [4]: /embed/inline-graphic-4.gif
Pili multigemini/trichofolliculoma-like organoid nevus
Authors: Leonard C. Sperling, Petra Milde, Lesley V. Landis, Larry Sargent
Journal: Journal of the American Academy of Dermatology (2014)

To the Editor: We introduce a distinctive form of epidermal nevus of the "organoid" type that we refer to as "pili multigemini/trichofolliculoma-like organoid nevus." Our patient is a healthy 6-year-old Latino girl born with a large, discrete patch of scalp alopecia that has remained unchanged, except for proportionate scalp growth. Her history and physical examination reveals normal findings, without cutaneous or dental abnormalities. The family history is unremarkable.
Science, Human Values and Psychiatry
Authors: J.H. Masserman
Journal: Psychotherapy and Psychosomatics (1967)

Research Articles| February 12 2010 Science, Human Values and Psychiatry Subject Area: Psychiatry and Psychology J.H. Masserman J.H. Masserman Northwestern University School of Medicine, Chicago, Ill., USA Search for other works by this author on: This Site PubMed Google Scholar Psychother Psychosom (1967) 15 (2-4): 179–188. https://doi.org/10.1159/000285889 Article history Published Online: February 12 2010 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation J.H. Masserman; Science, Human Values and Psychiatry. Psychother Psychosom 31 December 1967; 15 (2-4): 179–188. https://doi.org/10.1159/000285889 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsPsychotherapy and Psychosomatics Search Advanced Search This content is only available via PDF. 1967Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Article PDF first page preview Close Modal You do not currently have access to this content.
The Treatment of Pulmonary Edema in the Absence of Renal Function
Authors: Charles C. Anderson
Journal: JAMA (1979)

In doses sufficient to induce a rapid osmotic loss of fluid from the bowel, sorbitol can provide an alternate method of removing fluid in patients who lack renal function. Two patients with acute pulmonary edema and oliguric renal failure were treated with a combined therapy of sorbitol and furosemide. Their clinical, hemodynamic, and metabolic responses were strikingly similar to those achieved with furosemide therapy alone in patients with normal renal function. (<i>JAMA</i>241:1008-1010, 1979)
Neoplastic and nonneoplastic hepatic changes in lake whitefish (Coregonus clupeaformis) from the St. Lawrence River, Quebec, Canada.
Authors: I Mikaelian, Y de Lafontaine, C Menard, P Tellier, J Harshbarger, D Martineau
Journal: Environmental Health Perspectives (1998)

As part of a survey of fish diseases, lake whitefish (Coregonus clupeaformis) were collected in fall 1995 from the St. Lawrence River 15 km upstream of Quebec City, Quebec, Canada, to assess the prevalence of liver lesions. A total of 141 fish were captured and necropsied, and three standard sections of liver were taken for histological examination. Prevalences of altered hepatocyte foci, hepatocellular carcinoma, cholangioma, and cholangiocarcinoma were 0.7%, 2.1%, 0.7%, and 2.1%, respectively. Thus, the overall prevalence of liver neoplasia was 4.9% (7/141). Hepatic tumors were only observed in fish 7 years old or older. Fish age was significantly and positively correlated with the index assessing the number and size of macrophage aggregates (p<0.001; rs = 0.16). Hepatocyte vacuolation, anisokaryosis, lymphocytic infiltration, and bile duct hyperplasia were also observed but were not related to the age, length, sex, or condition factor of the fish. These results represent the first report on a series of hepatic tumors in a wild salmonid species.
Prevalence of Diphyllobothriasis
Authors: Rudolph C. Hecht
Journal: JAMA (1982)

<h3>To the Editor.—</h3> I enjoyed reading the editorial "Diphyllobothriasis" (1981; 246:2483), if for no other reason than it reminded me of my recent reading of a similar fish tapeworm epidemic in New York City some years ago.<sup>1</sup>However, I disagree with the statement that the prevalence or increase of the infestation can be ascertained or judged by the number of requests for the latest specific medication received by the Centers for Disease Control (CDC), especially since there are and have been on the market a number of other effective antihelmintics.<sup>2</sup>The increase in the number of requests received by the CDC for niclosamide may reflect only an increase in awareness by the prescribing physicians in the possibility of obtaining this medication from a single source and not an increase in incidence or prevalence, since a good number of physicians continue to prescribe one or the other of the
Radiation Risks From Chest Examinations
Authors: Harold M. Swartz
Journal: JAMA (1974)

To the Editor.—  In a recent issue ofThe Journal(226:799, 1973) a discussion of radiation exposure risks from chest x-ray examinations was inadvertently misleading. The writer discussed the radiation exposure in terms of the usual skin dose which is 30 to 50 mrem to the chest or about one third to one fourth of background radiation. The medically significant radiation exposure, however, is the gonadal dose. This dose, under optimum conditions, is only 1/400 to 1/800 of that that the skin receives (Selman J:The Fundamentals of X-ray and Radium Physiology. Springfield, Ill, Charles C Thomas Publisher, 1972, pp 475-477.) and under average conditions was still only 1 millirad in the male and 6 millirads in the female (Radiological Hazards to Patients, Ministry of Health of Scotland. London, Her Majesty's Stationery Office, 1958, 1960, and 1966).  Medical x-ray examinations are a very significant factor in radiation exposure of the
Are transient environmental agents involved in the cause of primary biliary cirrhosis? Evidence from space-time clustering analysis
Authors: Richard J. Q. McNally, Samantha Ducker, Oliver F. W. James
Journal: Hepatology (2009)

The cause of primary biliary cirrhosis (PBC) is unclear. Both genetic and environmental factors are likely to contribute. Some studies have suggested that one or more infectious agents may be involved. To examine whether infections may contribute to the cause of PBC, we have analyzed for space–time clustering using population-based data from northeast England over a defined period (1987–2003). Space–time clustering is observed when excess cases of a disease are found within limited geographical areas at limited periods of time. If present, it is suggestive of the involvement of one or more environmental components in the cause of a disease and is especially supportive of infections. A second-order procedure based on K -functions was used to test for global space–time clustering using residential addresses at the time of diagnosis. The Knox method determined the spatiotemporal range over which global clustering was strongest. K -function tests were repeated using nearest neighbor thresholds to adjust for variations in population density. Individual space–time clusters were identified using Kulldorff's scan statistic. Analysis of 1015 cases showed highly statistically significant space–time clustering ( P &lt; 0.001). Clustering was most marked for cases diagnosed within 1–4 months of one another. A number of specific space–time clusters were identified. In conclusion, these novel results suggest that transient environmental agents may play a role in the cause of PBC. (Hepatology 2009.)
Dermatological presentation of disease associated with antineutrophil cytoplasmic antibodies: a report of two contrasting cases and a review of the literature
Authors: A.D. IRVINE, I.N. BRUCE, M. WALSH, D. BURROWS, J. HANDLEY
Journal: British Journal of Dermatology (1996)

Antineutrophil cytoplasmic antibody (ANCA)-associated disease (AAD) constitutes a pathological disease spectrum of a necrotizing vasculitis of small- and medium-sized vessels, extravascular granuloma formation, and necrotizing and crescentic glomerulonephritis, and also a clinical disease continuum which ranges from renal-limited disease to a widespread systemic vasculitis, including Wegener's granulomatosis and microscopic polyangiitis. In the latter, circulating ANCA are an aid to diagnosis and also may play a pathogenic part. Two contrasting patients with AAD are described, both of whom presented primary with dermatological features. These included a cutaneous purpuric vasculitis, orogenital ulceration, infarction of the fingertip, and pyoderma gangrenosum-like ulceration. These cases will familiarize dermatologists with both the concept and dermatological features of AAD.
Transgenic Mice Overexpressing the Complement Inhibitor Crry as a Soluble Protein Are Protected from Antibody-induced Glomerular Injury
Authors: Richard J. Quigg, Chun He, Alice Lim, Dawn Berthiaume, Jessy J. Alexander, Damian Kraus, V. Michael Holers
Journal: The Journal of Experimental Medicine (1998)

Complement receptor 1–related gene/protein y (Crry) is a potent murine membrane complement regulator that inhibits classical and alternative pathway C3 convertases. In nephrotoxic serum (NTS) nephritis, injected antibodies (Abs) bind to glomeruli, leading to complement activation and subsequent glomerular injury and albuminuria. To study the phenotypic effects of continuous complement pathway blockade, transgenic mice were created that express recombinant soluble (rs) Crry directed by the broadly active and heavy metal-inducible metallothionein-I promoter. One transgenic line expressing high levels of rsCrry was propagated. Serum rsCrry levels were 18.7 ± 2.7 μg/ml (n = 5) at basal level and increased to 118.1 ± 20.6 μg/ml 4 d after addition of zinc to the drinking water. By reverse transcription polymerase chain reaction (RT-PCR), transgene messenger (m)RNA was present in liver, kidney, brain, lung, and spleen, but not in heart. By in situ RT-PCR analysis of kidneys, transgene mRNA was widely expressed both in renal glomeruli and tubules. Urinary excretion of rsCrry was 113.4 ± 22.4 μg/ml with a fractional excretion relative to creatinine of 13.2 ± 2.7%, consistent with local renal production of rsCrry and secretion into urine. The founder and all transgene positive adult animals have remained healthy with no mortality or apparent phenotypic abnormalities, including infection or immune complex disease. To determine whether rsCrry blocked complement-mediated injury, NTS nephritis was induced by injection of NTS immunoglobulin (Ig)G, followed by an 18-h urine collection to quantitate the excretion of albumin as a measure of glomerular injury. In transgene-negative littermates (n = 15), transgene-positive animals (n = 10), and transgene-positive animals fed zinc (n = 10), albuminuria was 4,393 ± 948, 1,783 ± 454, and 1,057 ± 277 μg/mg creatinine, respectively (P &amp;lt; 0.01 by ANOVA). Glomerular C3 was evident by immunofluorescence staining in 12/15 transgene-negative animals, but in none of the transgene-positive animals fed zinc. Thus, we have produced the first transgenic animals that overexpress a soluble C3 convertase inhibitor. rsCrry expression markedly ameliorates an Ab-induced disease model in vivo. These results support the hypothesis that continuous complement inhibition at the C3 convertase step is feasible and effective in complement-mediated injury states.
Fewer than one in 10 people will die at home by 2030, study predicts
Authors: Roger Dobson
Journal: BMJ (2008)

The number of people dying at home in England and Wales has nearly halved in three decades, and now less than a fifth of people die at home.

By 2030, if this trend continues, fewer than one in 10 men and women will die at home, a new study has calculated ( Palliative Medicine 2008;22:33-41).

To cope with such a decline, inpatient facilities will need to increase by more than 20%, say the researchers, from King’s College London.

“The projections underline the urgent need for planning end of life care to accommodate a large increase of ageing and deaths,” said Barbara Gomes, one of the coauthors. “Either inpatient facilities must …
LIGATURE OF COMMON CAROTID FOR ARTERIAL DILATATION AND EPILEPSY
Authors: R. Parker
Journal: BMJ (1907)

TM2 M=h 1417 hydrate may vary within fairly wide limits, not only in different individuals, but in the same individual.The important point to consider is whether, with ordinary diet, the urine always contains a small excess of sugar.If it does so, the case is suspicious, and the ultimate prognosis very doubtful-probably bad.If the sugar is of but temporary occurrence, it can be said that in the majority of cases its presence is of no importance.This temporary increase of sugar is often observed in cases of mental dis- turbance.The teaching that urines containing sugar are of high specific gravity, while generally true, is not always so.In connexion with this, it is interesting to note that a sample kindly sent me by Dr. A. W. Macintosh, of the Aberdeen Royal Infirmary, contained about 1 per cent.sugar, and yet the specific gravity was, on passing, only 1005, and aftpr cooling, 1010.On the other band, urines of high specific gravity, such as 1030, suggest at once a suspicion as to the probable presence of sugar.This, of course, is the ordinary textbook statement, but, unfortunately, is often misleading.lf, on testing such a urine with Fehling's solution, a modified reaction is obtained, this is often held as con-
Hidden dangers of sliced bread.
Authors: N J Bundred, R A Blackie, A N Kingsnorth, O Eremin
Journal: BMJ (1984)

Plumber's knee: calcinosis cutis after repeated minor trauma in a plumber Calcinosis cutis is not uncommon but little is known about its cause, and, surprisingly, it has rarely been reported after trauma.We describe here a case of calcinosis cutis apparently directly related to repeated minor trauma. Case reportA 54 year old plumber presented complaining of a swelling below his right knee.This had been present for eight years and had grown larger over the past 12 months.A similar swelling was present beneath the left knee.When questioned directly he described his method of bending water pipes by pulling them with both arms and using either knee as a fulcrum.Examina- tion showed a firm cutaneous swelling 4 cm in diameter below the right knee.Centrally it was fluctuant and had a small punctum.The lesion beneath the left knee was similar but smaller and not fluctuant.Surgical exploration of the right sided swelling showed a poorly delineated lesion composed of firm white tissue containing chalky nodules (figure).Histological examination showed an extensive area of calcinosis cutis.The nodules of calcification were up to 4-5 mm in size, situated in the mid to deep dermis, and surrounded by a giant cell reaction of foreign body type.No pre-existing lesion could be identified.The superficial dermis was histo- logically normal but the overlying epidermis was hyperkeratotic.Chemical analysis of the dry tissue showed that it contained 16-2% calcium and 10-4% orthophosphate; oxalate and carbonate were present in trace amounts.Energy dispersive x ray microanalysis confirmed the location of elemental calcium in the nodules and showed no evidence of other metallic elements in the epidermis, dermis, or nodules.Subsequent serological investigation showed normal values for sodium, potassium, bicarbonate, urea, creatinine, calcium (2-5 mmol/l), phosphate(1-01 mmol/l), alkaline and acid phosphatase, and albumin.
Monitoring resuscitation. How to start and monitor, and when to stop.
Authors: D. V. Skinner
Journal: BMJ (1989)

earlier work that showed that such children did not have an increased nocturnal urine output compared with that in controls.'2 13 To date few adverse effects with desmopressin have been reported.Because minor side effects are common with the tricyclic antidepressants and because they are dangerous drugs to have in households (because of accidental overdose) desmopressin may be a safer drug to use.At present its use in Britain is limited to four weeks because of a lack of data on its long term use.Many other countries have licensed desmopressin without restrictions on its length of use, and as more studies are completed it may well be that longer use will be allowed and indicated in Britain.If long term use or repeated courses of desmopressin are considered then comparative costs will become increasingly important.At present one week's treatment with imipramine may cost 10 pence whereas one week's treatment with desmopressin will cost between £5 and £10, depending on the dose used.