tbuckley/cabot-search huggingface dataset:
The Pill: A Perspective for Assessing Risks and Benefits
Authors: Frederick S. Jaffe
Journal: New England Journal of Medicine (1977)

Over the past 17 years, a "contraceptive revolution" has occurred, based on highly effective methods which can be applied at a time unrelated to sexual intercourse. In the 1950s, birth control was thought to be a settled issue for the middle and upper class. Although motivated to limit family size, low-income women found the diaphragm and condom inappropriate for their life style. Between 1960-1965, Planned Parenthood's caseloads of low-income women tripled. By 1975, nearly 4 million women of low and marginal income were clinic patients, with 72% choosing oral contraceptives. Those who advocate replacing the pill because of medical risk with coitally related methods are ignoring the needs of many low-income women in the U.S. Tietze et al. have shown that except for older women who smoke, the risk of mortality from using any method of fertility control is lower than the risk from automobile accidents or from childbirth. A more comprehensive framework is needed for weighing the total benefits expected by contraceptors against the total risks of any particular method. We also need an enlarged research program for safer contraceptives; a higher priority in the National Institutes of Health budget.
A3-06: Triplets versus doublets with or without cisplatin in the first-line treatment of stage IIIB-IV non-small cell lung cancer (NSCLC) patients: preliminary results of a multicenter randomized factorial study
Authors: Corrado Boni, Editta Baldini, Luca Boni, Marcello Tiseo, Francesco Recchia, Carlo Barone, Luigi Manzione, Francesca Zanelli, Tiziana Prochilo, Andrea Ardizzoni
Journal: Journal of Thoracic Oncology (2007)
Aseptic Thrombotic Endocardial Vegetations
Authors: John F. Greene
Journal: JAMA (1973)

Serious complications of flow-directed, balloon-tipped pulmonary artery catheters are said to be uncommon. On reviewing the clinical records of patients coming to autopsy during the past 18 months in our hospital, we found 24 who had been treated with use of this catheter during their final hospitalization. In four instances aseptic thrombotic vegetative endocardial lesions had developed in areas exposed to the catheter. Four others demonstrated focal hemorrhages in the pulmonic valve cusps. Endocardial lesions associated with indwelling pulmonary artery catheters pose potential risks of embolization and infection.
Sputum in severe exacerbations of asthma: kinetics of inflammatory indices after prednisone treatment.
Authors: M M Pizzichini, E Pizzichini, L Clelland, A Efthimiadis, J Mahony, J Dolovich, F E Hargreave
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

We have investigated the time-course of symptoms, forced expiratory volume in one second (FEV1), and the airway inflammatory changes in sputum selected from saliva and blood of 10 patients with severe exacerbation of asthma betwen presentation and after 1, 2, 3, 7, and 21 days of treatment. The sputum was induced by a modified standard protocol, and we examined its safety. The severe exacerbation of asthma was defined by the presence of nocturnal symptoms disturbing sleep and/or the need for inhaled short acting beta2-agonist > or = 8 puffs/d and an FEV1 after bronchodilator < 60% of predicted. The treatment consisted of additional prednisone 30 mg daily for 5 d followed by reduction to zero by day 10. Abnormal findings [median (interquartile range)] in spontaneous and induced sputum included low viability of cells [52.0 (34.0)%]; eosinophilia [20.0 (16.4)%]; many free eosinophil granules; and increased levels of fluid-phase ECP [1960 (9204) microg/L], fibrinogen [6045 (10720) microg/L], and IL-5 [160 (212) pg/ml]. Peripheral blood eosinophils [10.4 (7.6)%] and ECP levels [34.0 (35.0) microg/L] were increased. After treatment, symptoms, FEV1, blood eosinophilia, and serum ECP improved in the first 24 h. Sputum eosinophils and ECP did not improve until 48 h and fibrinogen not until 7 d. The improvement in sputum eosinophils and ECP levels was correlated with improvement of FEV1 and in fluid-phase IL-5. Thirty sputum inductions were performed safely in the majority with inhaled isotonic or 3% saline (23.3% or 63.3%, respectively) over a short duration (mean 8.4 min). The patients who had a fall in FEV1 of > or = 10% (10 occasions) after induction differed from those with a fall of < 10% only in the amount of inhaled beta2-agonist used by the patients in the preceding 24 h [8.0 (5.0) versus 4.0 (3.0) puffs/d, p = 0.01]. The results suggest that spontaneous or induced sputum can be used safely to follow the kinetics of effects of antiinflammatory treatment in a severe exacerbation of asthma. The clinical and blood indices improve before those in sputum, raising the possibility that examination of sputum is a better guide in these patients to follow the effects of treatment.
The Pros and Cons of Immunization--II
Authors: R. Cruickshank
Journal: BMJ (1952)

<h3>Introduction</h3> Blood blister-like aneurysms (BBAs) are shallow, wide-necked aneurysms, account for 0.5–2% of ruptured intracranial aneurysms. Treatment options are complex and controversial, particularly regarding the timing of endovascular therapy. We prefer to treat these aneurysms at least a week after ictus, after balancing the risks of bleeding, vasospasm, and anticoagulation. <h3>Aim of study</h3> A tertiary neuroscience centre’s experience treating ruptured BBAs with an emphasis on endovascular treatment. <h3>Methods</h3> Clinical records of all patients with subarachnoid haemorrhage secondary to ruptured BBAs presented to our institution between September 2014 and December 2021 were retrospectively reviewed. Data collected included details of aneurysms and treatment, clinical outcomes and follow-up imaging. <h3>Results</h3> We included 19 patients. 14 patients (74%) were treated with endovascular flow diversion, 3 patients (16%) had endovascular coiling and 2 patients (10%) underwent surgical clipping. The median (IQR) time from admission to flow diverter treatment was 8 (4.5 to 15.25) days, during which no patient rebled. No haemorrhagic or thromboembolic complications occurred intraoperatively. All patients had clinical and MRI follow-up over an average of 18 months (range 6–60 months), with complete aneurysm obliteration noted in 17 patients (88%), and residual but stable aneurysm neck in 2 patients (12%). In clinical follow-up, 94% of patients (N=18) had a modified Rankin score of 2 or less after 180 days. No deaths were associated with the subarachnoid haemorrhage or treatment. <h3>Conclusions</h3> Our endovascular treatment approach for ruptured blister aneurysms is safe and effective, with a low risk of procedural complications and favourable clinical outcomes. <h3>References</h3> Peschillo, S <i>et al</i>. “A Systematic Review and Meta-analysis of Treatment and Outcome of Blister-like Aneurysms.” AJNR. <i>American Journal of Neuroradiology</i> Vol. 37,5 (2016): 856–61. DOI:10.3174/AJNR.A4606. Nasra, Mohamed <i>et al</i>. “Contemporary Treatment of Intracranial Blood Blister Aneurysms – A Systematic Review.” <i>Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association</i> Vol. 30,9 (2021): 105968. DOI: 10.1016/J.Jstrokecerebrovasdis.2021.105968. Linfante, Italo <i>et al</i>. “Flow Diversion with Pipeline Embolic Device as Treatment of Subarachnoid Hemorrhage Secondary to Blister Aneurysms: Dual-Center Experience and Review of the Literature.”<i>Journal of Neurointerventional Surgery</i><i>vol</i>. 9,1 (2017): 29–33. DOI:10.1136/Neurintsurg-2016-012287. <h3></h3> <b>Do you have any conflict of interest to declare?</b>: No
Physician Assistants and Nurse Practitioners
Authors: Lucinda G. Miller
Journal: Annals of Internal Medicine (1995)

Letters1 August 1995Physician Assistants and Nurse PractitionersLucinda G. MillerLucinda G. MillerSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-3-199508010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The American College of Physicians recently voiced its position on the role of nonphysician health care providers [1]. The College recognizes the need for an expanded role of nonphysicians to meet future demands for primary health care. The debate on midlevel practitioners has previously focused on physician assistants and nurse practitioners. I suggest that a third group of practitioners—clinical pharmacists—also be considered.Equipped with extensive didactic and clinical pharmacology training, PharmDs and other clinical pharmacists are often called on by physicians, physician assistants, and nurse practitioners for therapeutic consultations. (At our institution, 9 hours of pharmacology and ...References1. American College of Physicians. Physician assistants and nurse practitioners. Ann Intern Med. 1994; 121:714-6. Google Scholar2. Feinberg JL. Summation: progress toward prescribing authority for pharmacists. Consultant Pharmacist. 1994; 9:1121-4. Google Scholar Author, Article, and Disclosure InformationAuthors: Lucinda G. Miller PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1995Volume 123, Issue 3Page: 237-238KeywordsDrug therapyHealth care facilitiesHealth care providersLegislationNursesPharmacistsPharmacokineticsPharmacologyPrimary careRural areas ePublished: 15 August 2000 Issue Published: 1 August 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Depression and Primary Care
Authors: Kurt Kroenke
Journal: Annals of Internal Medicine (1997)

Letters15 October 1997Depression and Primary CareKurt Kroenke, MDKurt Kroenke, MDUniformed Services University of the Health Sciences; Bethesda, MD 20814Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I agree with Drs. Pincus and Sacks about the essential role that primary care clinicians must play in diagnosing depression. Because most depressed patients first present in primary care settings, linking their symptoms to depression and persuading them of the diagnosis are what I consider reasonable expectations. In this regard, the resources identified by Pincus and Sacks and their call for universal training are timely.Detection of depression, however, is necessary but not sufficient. Once recognized, depression requires empathetic responses, attentive listening to the individual story, separation of the medical from the psychosocial, and a reasoned rather than ...References1. Katon W, Von Korff M, Lin E, Walker E, Simon GE, Bush T, et al. Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA. 1995; 273:1026-31. Google Scholar2. Hall RC, Wise MG. The clinical and financial burden of mood disorders: cost and outcome. Psychosomatics. 1995; 36:S11-8. Google Scholar3. Callahan CM, Kesterson JG, Tierney WM. Association of symptoms of depression with diagnostic test charges among older adults. Ann Intern Med. 1997; 126:426-32. Google Scholar4. Unutzer J, Patrick DL, Simon G, Grembowski D, Walker E, Rutter C, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. JAMA. 1997; 277:1618-23. Google Scholar Author, Article, and Disclosure InformationAuthors: Kurt Kroenke, MDAffiliations: Uniformed Services University of the Health Sciences; Bethesda, MD 20814 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUse of Complementary and Alternative Medicine Among Persons With Diabetes Mellitus: Results of a National Survey 15 October 1997Volume 127, Issue 8_Part_1Page: 654 ePublished: 15 August 2000 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Intracerebral Platelet Accumulation as Evidence for Embolization of Carotid Origin
Authors: CHRISTOF M. KESSLER
Journal: Clinical Nuclear Medicine (1992)

Arterio-arterial embolism of carotid origin is one major cause of cerebral ischemia. To evaluate the role of blood platelets in this process, In-1 11 labeled platelet scintigraphy was performed in a series of 250 patients. Of this number, one patient with an 80% carotid stenosis and a normal intracerebral angiogram suffered a transient ischemic attack (TIA) several hours after the injection of radiolabeled platelets. The scintigram showed a pathologic platelet accumulation in the symptomatic carotid area as well as in the ipsilateral brain hemisphere. The authors conclude that this scintigraphic finding of hemispheric platelet aggregates recorded directly after a clinically observed TIA, together with previous observations of retinal emboli after amaurosis fugax attacks, provides strong evidence for the arterio-arterial embolic mechanism of TIA.
Effect of cyproterone acetate on hair growth, sebaceous secretion and endocrine parameters in a hirsute subject
Authors: F. J. EBLING, A. K. THOMAS, I. D. COOKE, VALERIE A. RANDALL, J. SKINNER, MARION CAWOOD
Journal: British Journal of Dermatology (1977)

Journal Article Effect of cyproterone acetate on hair growth, sebaceous secretion and endocrine parameters in a hirsute subject Get access F. J. EBLING, F. J. EBLING Department of Obstetrics and Gynaecology, Jessop Hospital for Women, Sheffield Search for other works by this author on: Oxford Academic Google Scholar A. K. THOMAS, A. K. THOMAS Department of Zoology, The University, Sheffield Sio 2TN Search for other works by this author on: Oxford Academic Google Scholar I. D. COOKE, I. D. COOKE Department of Zoology, The University, Sheffield Sio 2TN Search for other works by this author on: Oxford Academic Google Scholar VALERIE A. RANDALL, VALERIE A. RANDALL Department of Obstetrics and Gynaecology, Jessop Hospital for Women, Sheffield Search for other works by this author on: Oxford Academic Google Scholar J. SKINNER, J. SKINNER Department of Obstetrics and Gynaecology, Jessop Hospital for Women, Sheffield Search for other works by this author on: Oxford Academic Google Scholar MARION CAWOOD MARION CAWOOD Division of Steroid Endocrinology, University of Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 97, Issue 4, 1 October 1977, Page 371, https://doi.org/10.1111/j.1365-2133.1977.tb14244.x Published: 01 October 1977
A BETTER METHOD OF TREATING FRACTURES OF THE JAWS
Authors: FREDERICK B. MOOREHEAD
Journal: JAMA (1934)

The management of regional fractures has engaged the attention of the general surgeon and the specialist throughout the history of surgery. The only answer to any medical discussion is the patient himself. Whatever method contributes most to the well being of the sick or disabled is the method of choice. The principles and methods of modern orthodontia supply the means of managing fractures of the jaws, regardless of the type or extent of injury. The more difficult the case, the more convincing and satisfactory the method becomes. In fractures of other bones, immediate reduction and immobilization are required. In fractures of the jaws with displacement, immediate complete reduction is rarely possible. Here one must be content with gradual reduction. Overriding fractures of the femur present the sort of problem seen in the majority of all jaw fractures. Even the beginning of treatment may be delayed for days or weeks because
Wegener's Granulomatosis and Corneo-Scleral Ulcer
Authors: Harry R. Brady
Journal: JAMA (1965)

To the Editor:—  Wegener's granulomatosis is a rare collagen disease of unknown etiology originally described by Klinge. 1 Wegener 2 was the first to correlate the findings into a specific entity distinct from periartertis nodosa. Since then little has been added to basic knowledge of the etiology or pathogenesis of this disease.  The usual clinical picture has been well outlined by Fahey. 3 There is no predisposition for either sex. Age varies greatly, but is usually in the third to fifth decade. The onset is heralded by upper-respiratory-tract symptoms, most often nasal stuffiness and sinusitis. Abnormal pulmonary findings, fever, and weight loss follow, and the course progresses unfavorably, ending with renal failure as a rule. McDonald 4 characterizes the three salient findings as a necrotizing granulomatous process of the respiratory tract, a generalized vasculitis of the arteries and veins, and focal glomerulitis. 5   To our knowledge only five previous documented
A new hypothesis: imatinib affects leukemic stem cells in the same way it affects all other leukemic cells
Authors: C Tomasetti
Journal: Blood Cancer Journal (2011)

In this article, two arguments will be provided, based on both clinical data and mathematical insights on the dynamics of the leukemic cell population, to highlight the substantial effect that imatinib also seems to have on the leukemic stem cells (LSCs). The hypothesis proposed here is that imatinib may be able to affect the LSCs in the same way it affects all other leukemic cells, that is, by inhibiting their proliferation and consequently causing them to reach their life span and die out. This is, indeed, the general consensus on the effect that the drug has on leukemic non-stem cells.1, 2, 3, 4 In fact, the different lifespans in the hierarchical structure of the leukemic cell population can explain the seemingly different (short-term) outcomes observed among the various types of leukemic cells under imatinib, rather than a differential effect of the drug on them. The latter has been a typical point of view expressed in the literature on chronic myeloid leukemia (CML), see, for example, Sloma et al.2 I believe this represents an example of the usefulness of combining mathematical modeling with the experimental and clinical data to obtain a deeper understanding of the biological system under consideration and its dynamics.
Unsafe conviction rejected in Roy Meadow expert witness case
Authors: Clare Dyer
Journal: BMJ (2005)

The role of the three classic signs of "shaken baby syndrome" in diagnosing intentional head injury was endorsed by the Court of Appeal last week in a test case aimed at casting doubt on their validity.Lawyers for four people convicted of killing or causing grievous bodily harm by shaking babies in their care argued that new research had cast doubt on the link between shaking and the triad of injuries-encephalopathy, subdural haemorrhages, and retinal haemorrhages-traditionally regarded as diagnostic of shaken baby syndrome.They cited papers by neuropathologist Jennian Geddes and colleagues that hypothesised that the triad could be produced by gentle shaking or even without any trauma at all.Controversy centred particularly on a paper that looked at almost 50 paediatric cases without head injury (Neu-
Abnormal Thyroid Function Test Results in Patients Taking Salsalate
Authors: Robert J. McConnell
Journal: JAMA (1992)

To evaluate how the nonsteroidal anti-inflammatory agent salsalate affects the results of routine thyroid function tests.In a cohort of patients taking salsalate for various rheumatic conditions, thyroid function tests were performed with patients on and off the drug.Primary care of ambulatory patients in a university medical center.A convenience sample of 14 euthyroid subjects, none of whom was taking thyroid hormone or other medication recognized to alter thyroid function.Treatment with therapeutic doses of salsalate for a mean period of 44 weeks.Serum levels of thyroxine (T4), free T4, thyroid hormone binding ratio, free T4 index (the product of T4 and the thyroid hormone binding ratio), triiodothyronine, and thyrotropin.Serum T4 dropped from a mean baseline level of 96.7 nmol/L off salsalate to 53.4 nmol/L on it (P less than .001), and the free T4 index showed a parallel decline from 85.9 to 50.4 (P less than .001), with both values falling into the hypothyroid range. Similarly, free T4 levels and total triiodothyronine concentrations were low in several patients treated with salsalate. Serum thyrotropin levels declined transiently, falling from a mean of 3.2 to 1.7 mU/L (P less than .02) in patients treated for less than 3 weeks. Patients treated for longer periods had levels comparable to baseline. Despite these changes in the thyroid function test results, all subjects remained clinically euthyroid.Salsalate commonly produces abnormalities in routine thyroid function test results similar to those found in central hypothyroidism.
The Enzymatic Defect in Essential Pentosuria
Authors: Y. M. Wang, J. van Eys
Journal: New England Journal of Medicine (1970)

The enzyme defect in pentosuria has been assumed to be NADP-linked xylitol dehydrogenase, a specific enzyme found in mammalian livers. In the red blood cells of three homozygous pentosuric subjects, the activity of NADP-linked xylitol dehydrogenase was found to be subnormal. The enzyme has a Michaelis-constant value for NADP that is 10 to 20 times higher than that found in normal persons. In a heterozygous subject, two activities, one normal, one abnormal, appeared to exist. This study confirms by direct biochemical means the site of the metabolic defect in pentosuria.
Reported Outcomes in Major Cardiovascular Clinical Trials Funded by For-Profit and Not-for-Profit Organizations: 2000-2005
Authors: Paul M Ridker, Jose Torres
Journal: JAMA (2006)

published between 1990 and 2000 raised awareness in the medical community that trials funded by for-profit organizations were more likely to report positive findings than those funded by not-for-profit organizations. [1]3][14][15] Partly in response to these concerns, recommendations have been made to improve academic oversight in industry-sponsored research 16,17 and to ensure registration and publication of all clinical trials. 18,19hether this recognition has affected contemporary clinical trials is unknown.To address this question, we surveyed reported outcomes in highimpact cardiovascular clinical trials published between 2000 and 2005 in JAMA, The Lancet, and the New England Journal of Medicine, stratifying our analysis according to whether the trial was funded by for-profit or not-forprofit organizations.By focusing on manuscripts published in these 3 journals, we were able to limit our analysis to trials considered to be of high quality on the basis of prior rigorous peer and editorial review.We focused on trials of cardiovascular medicine because they are common, represent an area of considerable public health importance, and are almost equally funded by for-profit and not-for-profit entities.As a substantial number of cardiovascular clinical trials are funded jointly by for-profit and not-for-profit organizations, we were afforded the additional opportunity to address outcomes in the setting of these cost-sharing clinical trials.We also sought to evaluate reported outcomes among trials that used surrogate vs clinical end points. METHODSWe evaluated a consecutive series of 349 randomized trials related to cardiovas-
Hospital's charitable donations diverted to pay running costs
Authors: C. Zinn
Journal: BMJ (2004)

The attending physician teaching in an outpatient clinic listens while a house officer presents the history of a patient in follow-up. She is 57 years old and presents with 3 week of dizziness, which she describes as a lightheaded feeling when standing up to walk. She describes no sensation of movement of either head or room. She takes a diuretic for essential hypertension, and its dose was increased a month ago. Examinations of her heart, lungs, and neurological system an normal, as is a headhanging manoeuvre. While discussing the likelihood of possible causes of dizziness in this patient, the house officer asks the question thai is this essays title, “Where do pretest probabilities come from?”