tbuckley/cabot-search huggingface dataset:
Rural Health Care
Authors: Donald L. Madison
Journal: JAMA (1983)

The nation's attention to the problems of rural health care seems to go in cycles. World War II interrupted an era of major growth in rural public health departments, and after the war a second cycle of attention led to such actions as the Hill-Burton program, state programs of fellowships to medical students in exchange for subsequent rural settlement, several attempts at regionalization of rural hospitals, and a number of new medical schools in rural states. This activity had declined by the mid-1950s, but a new cycle of concern and activity started in the 1970s. Now, following a decade of rural-related interventions (National Health Services Corps, grants for community-sponsored rural practice, another wave of new medical schools, Area Health Education Center programs, training programs for new health practitioners), attention to problems in rural health is once again on a downward course. The publication of<i>Rural Health Care</i>is a part
Phase II Trial of Gemcitabine in Refractory or Relapsed Small-Cell Lung Cancer: Eastern Cooperative Oncology Group Trial 1597
Authors: Gregory A. Masters, Lieven Declerck, Charles Blanke, Alan Sandler, Russell DeVore, Kathy Miller, David Johnson
Journal: Journal of Clinical Oncology (2003)

Purpose: Gemcitabine has shown a broad range of activity in solid tumors, including previously untreated small-cell lung cancer (SCLC). The objective of this phase II trial was to investigate the activity of gemcitabine in patients with relapsed SCLC. Patients and Methods: SCLC patients with measurable disease who had experienced treatment failure with one prior chemotherapy regimen were considered eligible. Patients were required to have Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and adequate organ function; signed informed consent was also required. Treatment consisted of gemcitabine 1,000 mg/m 2 on days 1, 8, and 15 of a 28-day cycle. Patients were stratified according to their previous response to first-line chemotherapy (primary refractory v primary sensitive disease). Results: Forty-six patients were enrolled onto this phase II trial (20 refractory and 26 sensitive patients). Forty-two of these patients were assessable for response and survival, and 44 were assessable for toxicity. Median patient age was 60 years, and median ECOG performance status was 1. Principal grade 3/4 hematologic toxicities included neutropenia (27%) and thrombocytopenia (27%). The main grade 3/4 nonhematologic toxicities were pulmonary (9%) and neurologic toxicity (14%). Objective responses occurred in 11.9% of patients overall, including one patient with refractory SCLC (5.6%) and four patients with sensitive SCLC (16.7%). Median survival for the overall group was 7.1 months. Survival was not significantly different for patients with refractory versus sensitive disease. Conclusion: Gemcitabine has modest activity in previously treated SCLC patients. The favorable toxicity profile warrants further investigation, either in combination chemotherapy regimens or with targeted biologic compounds.
Acceptability of pulmonary function testing maneuvers in a pre-school cohort
Authors: K.T. Sullivan Dillie, B.A. Anderson, D.F. DaSilva, M. Evans, R. Kelley, M. Krawiec, T.E. Pappas, K.A. Roberg, C.J. Tisler, J.E. Gern, R.F. Lemanske
Journal: Journal of Allergy and Clinical Immunology (2005)
A 64 year old woman with headache and breathlessness
Authors: R. Lord, W. Flight, A. Sweeney, N. Chaudhry
Journal: BMJ (2012)

A 60 year old woman presented to the chest clinic with four years of worsening dyspnoea. On waking she felt unrefreshed and had a headache. She felt sleepy throughout the day. Her medical history included kyphoscoliosis, spina bifida, hypertension, and osteoporosis. The drugs she was taking included amiloride, furosemide, nitrazepam, and calcium-vitamin D supplements. She was born in the United Kingdom, was a lifelong non-smoker, and a retired teacher. She owned no pets and reported no exposure to asbestos. 

On physical examination, her respiratory rate was 28 breaths/min and oxygen saturation was 86% on ambient air. Temperature and haemodynamics were normal. General inspection showed marked kyphosis and rapid shallow breathing. She had a global reduction in breath sounds but no crackles, wheeze, or rub. The rest of the examination was unremarkable, with no evidence of right heart failure.

Blood tests showed a raised haemoglobin of 157 g/L (reference range 115-165), but other haematological, biochemical, and inflammatory markers were normal. Arterial blood sampling on ambient air showed pH 7.36, arterial carbon dioxide tension 9.14 kPa, arterial oxygen tension 6.4 kPa, base excess 7.8, and bicarbonate 33 mmol/L. Her body mass index was within the normal range. Figure 1⇓ shows the chest radiograph.





### 1 What is the primary abnormality on the chest radiograph?

#### Short answer

The primary abnormality of the chest radiograph is severe kyphoscoliosis with profoundly reduced lung volumes.

#### Long answer

This radiograph shows kyphoscoliosis with predominantly left lateral mediastinal displacement. Lung volumes are profoundly reduced, and this is more marked on the left. The left hemidiaphragm is raised with the gastric bubble …
Occam's Razor versus Saint's Triad
Authors: Anthony A. Hilliard, Steven E. Weinberger, Lawrence M. Tierney, David E. Midthun, Sanjay Saint
Journal: New England Journal of Medicine (2004)

A 60-year-old woman with a history of seronegative rheumatoid arthritis presented to the emergency department with a 10-day history of worsening dyspnea on exertion, nonproductive cough, and fever and a 7-day history of pain in the right leg and buttock.
Polysyllabic House Calls
Authors: Andrew M. Sherrington
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Dr. Weightman (<i>JAMA</i><b>192</b>:260 [April 19] 1965) can put his hat right back on again. "Domiciliary consultative service" is not a synonym for "house calls." The National Health Service makes it possible for any British general practitioner dissatisfied with the progress of one of his patients who is ill at home to call out a hospital specialist to examine him and consult with the general practitioner about the case. This is usually called "a domiciliary" for short. "Domicile" implies private home, as opposed to public homes or institutions (eg, asylums, nursing homes, etc).
298 ISOLATION AND CULTIVATION OF PURE HUMAN ADULT LIVER STEM CELL POPULATIONS FROM PATIENT LIVER RESECTATES
Authors: N. Fekete-Drimusz, I. Meder, U. Rüdrich, K. Preis, R. Gutierrez, M.P. Manns, F. Vondran, M. Bock
Journal: Journal of Hepatology (2013)
Augmentation therapy for severe alpha 1-antitrypsin deficiency: is the jury still out on a trial?
Authors: J K STOLLER
Journal: Thorax (1998)

As with the administration of insulin for diabetes mellitus, the rationale for administering purified α1-antiprotease in severe α1-antitrypsin (α1AT) deficiency—a treatment dubbed “augmentation therapy”—is to provide the substance whose deficiency is deemed responsible for the pulmonary sequelae of α1AT deficiency. Indeed, even as intravenous augmentation therapy has been advocated for severely deficient individuals with established airflow obstruction by some official societies (but not all),1 2 and even as one commercial product has been licensed by the United States Federal Drug Administration with other intravenous and inhaled preparations currently under investigation, the efficacy of augmentation therapy continues to be actively debated. As with many controversies in medicine, this one centres on the nature and adequacy of available supportive evidence versus the gaps in current knowledge. In the wake of the recently published outcome data from the American National Heart, Lung, and Blood Institute (NHLBI) sponsored Registry of Patients with Severe Deficiency of α1-Antitrypsin,3and a European comparison between rates of decline in forced expiratory volume in one second (FEV1 ) in untreated Danish versus treated German subjects with α1AT deficiency,4 it is appropriate to examine the current state of evidence regarding augmentation therapy for severe α1AT deficiency and to re-assess the evidence supporting this practice. This editorial takes an epistemological view of the evidence—how do we know what we know and is the evidence compelling? Also, in the context of current views, what are the implications of present knowledge on future studies of emerging treatments?

To consider current evidence about the efficacy of augmentation therapy, it is useful to recall a debate in medicine that consumed attention approximately 100 years ago—how to prove that an infectious agent was responsible for causing infection? Just …
Abstract 49: Constructing pathway based predictors of cancer clinical outcome
Authors: Sam Ng, Charlie Vaske, Steve Benz, James Durbin, Chris Szeto, Laura Heiser, Nicholas Wang, Jim Korkola, Nora Bayani, Paul Spellman, Joe W. Gray, David Haussler, Joshua Stuart
Journal: Cancer Research (2011)

Abstract Current efforts to understand the mechanism of cancer involve using various whole-genome -omics measurements over large patient cohorts. Since a patient response to treatments is highly variable, the challenge then is to integrate the data in order to infer patient-specific disease mechanisms. Recent advances in the analysis of cancer (TCGA ovarian serous carcinoma and glioblastoma multiforme) has shown that a pathway interpretation of DNA copy number, DNA methylation, mRNA expression, and mutations offers a powerful framework for interpreting complex data. The hope is that a pathway-level interpretation of -omics data can identify pathway signatures to predict differences in clinical outcome, whereas traditional machine learning algorithms do not take advantage of the pathway structure of biological data. We are developing a pathway prediction method based on PARADIGM to discriminate patient outcome based on pathway signatures. Utilizing conditional random fields (CRFs) allow for formal search for a graphical model that optimizes the prediction of a particular variable of interest (VOI) defined by the given classification task, as opposed to a generative model that optimizes the model to explain the data. The method first merges pathways to build a core network around the VOI. The model then seeks to extend the pathway to include new genes and interactions which improve the model's predictive ability on the training data. Application of our method to 50 breast cancer cell-lines treated with 80 different compounds revealed general and subtype-specific signatures of response in breast cancer. We compared our CRF-based method against a compendium of standard machine-learning algorithms and found that our CRF outperformed all methods on a majority of drugs tested. We also tested the method on a cancer benchmark consisting of a dozen prediction challenges all involving the prediction of clinical outcomes on large patient cohorts using gene expression and copy number data. Again, the CRF model outperformed a majority of classifiers and performed comparably to the best classifiers on most challenges. We expect our method to generalize to a wide variety of biological systems for which high-throughput genomics and functional genomics are available. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 49. doi:10.1158/1538-7445.AM2011-49
European Court gets tough over medical school restrictions
Authors: Annette Tuffs
Journal: BMJ (2007)

The governments of Austria and Belgium are worried that they will have too many applicants to their medical schools from other European countries if they follow a ruling of the European Court. The court ruled that their schools must not discriminate against European Union applicants from beyond their borders. 

The two European states received a letter from the EU commission on 24 January demanding changes in what it described as “discriminatory” rules on university admissions. It follows the court's decision this January that condemned both countries' introduction of quotas that restrict the number of medical students who are not resident in that particular state. …
Annual Physical Examination: Necessary or Needless?
Authors: Daniel Reinharth
Journal: Annals of Internal Medicine (2003)

Letters4 March 2003Annual Physical Examination: Necessary or Needless?Daniel Reinharth, MDDaniel Reinharth, MDEast Meadow, NY 11554-2201 (Reinharth)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-5-200303040-00024-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I enjoyed Dr. Laine's editorial on the annual physical examination (1), as I have long shared many of her opinions and have had many similar discussions with the internal medicine residents I have precepted. I would like to add a few points to Dr. Laine's eloquent presentation.I believe that the health benefits primary care physicians provide are often incremental. Studies have shown that physician advice to quit smoking increases quitting rates by a couple of percentage points per year. It seems likely that the same would hold true for other health behaviors. There are probably very ...Reference1. Laine C. The annual physical examination: needless ritual or necessary routine? [Editorial]. Ann Intern Med. 2002;136:701-3. [PMID: 11992306] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: East Meadow, NY 11554-2201 (Reinharth) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Annual Physical Examination: Needless Ritual or Necessary Routine? Christine Laine Metrics Cited byPrinciples of Screening 4 March 2003Volume 138, Issue 5Page: W-48KeywordsBehaviorDietExerciseHealth carePrimary carePrimary care physiciansSubstance abuse ePublished: 4 March 2003 Issue Published: 4 March 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ice hockey injuries: incidence, nature and causes.
Authors: Y Tegner, R Lorentzon
Journal: British Journal of Sports Medicine (1991)

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey games. All twelve Swedish elite hockey teams were observed during the season 1988-1989 when a total number of 664 games were played. There was a total number of 285 injuries, of which the majority were minor (61%) and only 9% were classified as major. Seventy-four per cent of the injuries occurred during games and 26% during practice. The overall incidence of injury was 53.0 per 1000 player-game hours. Eighty-five per cent of injuries were caused by trauma and 15% by over-use. Injuries were most often localized to the head/face (39%) or the lower limb (32%). Most injuries resulted from stick contact or player contact including checking. A reduction of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, and more widespread use of visors.
Prediction of Fetal Sex from Cytologic Examination of Amnionic Fluid
Authors: Anthony P. Amarose, Arthur J. Wallingford, E. Jurgen Plotz
Journal: New England Journal of Medicine (1966)

SPECTROPHOTOMETRIC analysis of the amnionic fluid obtained from Bh-negative sensitized women has become an accepted and established procedure in determining the presence and severity of the hemolytic process within the fetus. Bevis,1 , 2 in Great Britain, first denoted the significance of this procedure, since confirmed by Liley,3 , 4 Freda5 , 6 and other observers.7 , 8 The purpose of this report is not to present our experience with spectrophotometric analysis of amnionic fluid but to describe our results in antenatal determination of fetal sex by the use of samples of amnionic fluid for cytologic examination. These samples were obtained for the purpose of clinical management of . . .
What attributes should clinical ethics committees have?
Authors: R. Gillon
Journal: BMJ (2010)

<h3>Aims</h3> There is growing concern about the mental health and well-being of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for selfharm and referrals to child and adolescent mental health services (CAMHS). We investigated whether there have been similar trends in selected mental and physical health outcomes among CYP in national health surveys from England, Scotland and Wales. <h3>Methods</h3> Data on 1 40 830 participants (4–24 years) were analysed from the Health Survey for England (18 surveys 1995 – 2014; N=92 422), Scottish Health Survey (8 surveys 2003–14; n=16 862), and Welsh Health Survey (8 surveys 2007–2014; n=31 546). Seven outcome indicators were studied: WarwickEdinburgh Mental Wellbeing Score (WEMWBS); above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score; and self/parent reported variables: general health, any long-standing health condition, long-standing mental health condition. Regression models were used to investigate time trends in each variable. <h3>Results</h3> Across all participants aged 4–24, prevalence of a selfreported mental health condition increased six-fold over the 19 year period in England (from 0.8% to 4.8%, p&lt;0.001), more than doubled in Scotland over 11 years (2.3 to. 6.0%, p&lt;0.001) and increased by more than half in Wales over 7 years (2.6% to 4.1%, p&lt;0.001). In England, prevalence of any long-standing health condition and fair/poor self-reported health decreased over the same period (both p&lt;0.001). Among young children (4–12y), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England (SDQE: OR=0.97(0.96–0.98), p&lt;0.001) and girls in Scotland (SDQE: OR=0.96(0.93–0.99), p=0.005). The proportion with high SDQE scores (13–15y) decreased in England (OR=0.98 (0.96–0.99), p=0.006) but increased in Wales (OR=1.07(1.03–1.10), p&lt;0.001). The proportion with high GHQ scores decreased among English women (16–24y) (OR 0.98(0.98–0.99), p=0.002). WEMWBS scores were unchanged. <h3>Conclusions</h3> There has been a striking increase in the selfreported prevalence of long-standing mental health conditions among CYP in England, Scotland and Wales in recent years, although this was not always reflected in change in scores on validated questionnaires. These findings reinforce the need to consider what constitutes a mental health problem for young people and ensure that appropriate resources and services are available to support them and their families.
Anatomy, Visualization and Sampling of the Biliary Tree in Animals and Man
Authors: Steven M. Strasberg, Robert P.C. Harvey, Steven Gallinger
Journal: Hepatology (1984)

Difficulties in obtaining proper bile samples are due to inaccessibility of the biliary tree and to distortions induced by sampling methods. One must be cognizant of the effects of diet on bile secretion and gallbladder motility. Experimental methods which interrupt the enterohepatic circulation or alter the intestinal migrating myoelectric complex induce spurious changes in bile flow and composition. Biliary tract pressure-flow relationships must be maintained or the gallbladder will be made functionless. Dead space errors lead to distortions unless studies are performed in the steady state, or dead space is measured and corrections are applied. Surgery has major effects on some parameters of interest, and animals should be allowed to recover when these are studied. The effect of the mixing of bile with other secretions in the duodenum must be considered when using bile-rich duodenal fluid. For some parameters of bile secretion, mixing is unimportant but for others, special precautions for handling bile and interpreting results are required.
Abstract 4134: Development of MUT-MAP, a high-throughput multi-analyte mutation panel for cancer biomarkers discovery.
Authors: Rachel Nga Wan Tam, Erica Schleifman, Ling-Yuh Huw, Rupal Desai, Rajesh Patel, Rajiv Raja
Journal: Cancer Research (2013)

Abstract Molecular profiling plays an increasingly vital role in determining treatment options in oncology. These include expression profiling, mutation detection as well as copy number variation analysis (CNV). Hence there is an increasing need for a robust and high-throughput technology to detect oncogenic hotspot mutations - and copy number variation (CNV) in various kinds of cancer. Although there are commercial assays or kits available to detect genetic aberrations in a given oncogene, there is a need to simultaneously detect these hotspots in more than a few of these genes using very little DNA. Recent technological advances such as next-generation sequencing (NGS) platforms are the powerful tools to unravel the complex biological and genetic mechanisms in different human diseases. However, there are several challenges facing NGS platforms, such as high cost, and DNA input requirement, and difficult data analysis pipeline which require much longer data turnaround time that is not feasible in the clinical setting. We have developed a high-throughput microfluidic panel for detecting 120 somatic mutations across 11 genes of therapeutic interest using TaqMan or allele-specific PCR (AS-PCR) technologies. The 11-gene mutation panel is designed to detect hotspot mutations that have higher oncogenic potential. Additionally, we can detect (CNV) changes in a total of 18 genes. This mutation panel only requires as little as 2 ng of high quality (fresh frozen) or 100 ng of formalin-fixed, paraffin-embedded (FFPE) genomic DNA. A pre-amplification of 38 amplicons is carried out to enrich DNA carrying the targeted mutations, using custom-designed primer sets followed by detection of the mutations using TaqMan/AS-PCR assays carried out on a Biomark microfluidics system. Mutation, CNV calls including an automated data analysis process have been implemented to run 88 samples per day. We will present data showing validation of this platform using plasmids and archival samples, including correlation between amplified and unamplified samples on alternate mutation detection platforms that will demonstrate sensitivity and selectivity. The platform is being routinely used in our labs to analyze tissues from patients enrolled in clinical trials. Citation Format: Rachel Nga Wan Tam, Erica Schleifman, Ling-Yuh Huw, Rupal Desai, Rajesh Patel, Rajiv Raja. Development of MUT-MAP, a high-throughput multi-analyte mutation panel for cancer biomarkers discovery. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4134. doi:10.1158/1538-7445.AM2013-4134
Transesophageal echocardiography (TEE) in pediatric heart transplantation: Comparison to surface transthoracic echo
Authors: Motohiro Kawauchi, Steven R. Gundry, Mark M. Boucek, Mohammad Kanakriyeh, T. Hozumi, M. Shakudo, P Shaw, Leonard L. Bailey
Journal: Journal of the American College of Cardiology (1991)
Role of subnano-, nano- and submicron-surface features on osteoblast differentiation of bone marrow mesenchymal stem cells
Authors: Dongwoo Khang, Jungil Choi, Yeon-Min Im, Youn-Jeong Kim, Je-Hee Jang, Sang Soo Kang, Tae-Hyun Nam, Jonghan Song, Jin-Woo Park
Journal: Biomaterials (2012)