tbuckley/cabot-search huggingface dataset:
Physician Fraud and Medicaid
Authors: Matilde Rios
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The article "Fraud by Physicians Against Medicaid" by Jesilow et al<sup>1</sup>is seriously misleading. Its main conclusion, appearing in the abstract, is that "sanctioned physicians show an overrepresentation of psychiatrists, foreign medical graduates, and minority group physicians." The text of the article does not substantiate this conclusion. The authors do not, in fact, provide additional information other that of 138 physicians, sanctioned by Medicaid between 1977 and 1982, slightly more than one third were international medical graduates; blacks and psychiatrists were also overrepresented. The key issue here is the term<i>overrepresentation</i>. As the article stands, it leaves the impression that these minority physicians cheat more than their mainstream counterparts. Representation, however, or representativity, can only be defined with regard to a population. If the population is that of all physicians, then one third of international medical graduates would indeed be disproportionate. It is known, however, that
Heparin therapy for thromboembolic disorders. A prospective evaluation of 134 cases monitored by the activated coagulation time
Authors: P. G. Hattersley
Journal: JAMA (1983)

One hundred thirty-four patients with venous thrombosis or pulmonary embolism, confirmed by radiological techniques, received continuous-pump heparin therapy while their responses were monitored by the activated coagulation time (ACT). The suggested protocol was as follows: (1) give an intravenous bolus of about 50 units/kg; (2) follow with 15 to 25 units/kg/hr; (3) modify infusion rate to maintain ACT of 150 to 190 s; (4) after two or three days with ACT in target range, start oral warfarin sodium therapy; (5) after three to five days of warfarin therapy, if prothrombin time is two to 2 1/2 times the control value, discontinue heparin administration. One hundred thirty-two patients responded, with no heparin failures. Dangerous bleeding occurred in two who received excessive amounts of heparin. Some patients, mostly with short ACTs, responded slowly; some, many with long ACTs, had minor bleeding. The protocol proved successful and safe when followed closely.
Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
Authors: Oliver A. Cornely, Johan Maertens, Drew J. Winston, John Perfect, Andrew J. Ullmann, Thomas J. Walsh, David Helfgott, Jerzy Holowiecki, Dick Stockelberg, Yeow-Tee Goh, Mario Petrini, Cathy Hardalo, Ramachandran Suresh, David Angulo-Gonzalez
Journal: New England Journal of Medicine (2007)

Patients with neutropenia resulting from chemotherapy for acute myelogenous leukemia or the myelodysplastic syndrome are at high risk for difficult-to-treat and often fatal invasive fungal infections.
Relationship Between Testosterone Level and Early Repolarization on 12-Lead Electrocardiograms in Men
Authors: M. Juhani Junttila, Jani T. Tikkanen, Kimmo Porthan, Lasse Oikarinen, Antti Jula, Tuomas Kenttä, Veikko Salomaa, Heikki V. Huikuri
Journal: Journal of the American College of Cardiology (2013)
Increase in exhaled nitric oxide levels in patients with difficult asthma and correlation with symptoms and disease severity despite treatment with oral and inhaled corticosteroids
Authors: R G Stirling, S A Kharitonov, D Campbell, D S Robinson, S R Durham, K F Chung, P J Barnes
Journal: Thorax (1998)

Patients with difficult asthma suffer chronic moderate to severe persistent asthma symptoms despite high doses of inhaled and oral corticosteroid therapy. These patients suffer a high level of treatment and disease related morbidity but little is known about the degree of airway inflammation in these patients.Fifty two patients were examined to assess levels of exhaled nitric oxide (NO) as a surrogate marker of inflammatory activity in this condition. From this group, 26 patients were defined with severe symptoms and current physiological evidence of reversible airway obstruction requiring high dose inhaled (> or = 2000 micrograms beclomethasone dipropionate (BDP) equivalent) or oral steroid therapy to maintain disease control.Exhaled NO levels were higher in subjects with difficult asthma (mean 13.9 ppb, 95% CI 9.3 to 18.5) than in normal controls (7.4 ppb, 95% CI 6.9 to 7.8; p < 0.002), but lower than levels in steroid naive mild asthmatics (36.9 ppb, 95% CI 34.6 to 39.3; p < 0.001). Prednisolone treated patients had higher exhaled NO levels than patients only requiring inhaled corticosteroids (17.5 ppb, 95% CI 11.1 to 24.0 versus 7.2 ppb, 95% CI 4.6 to 9.8; p = 0.016), suggesting greater disease severity in this group. Non-compliance with prednisolone treatment was observed in 20% of patients but this did not explain the difference between the treatment groups. Exhaled NO levels were closely correlated with symptom frequency (p = 0.03) and with rescue beta agonist use (p < 0.002), but they did not correlate with lung function.Exhaled NO may serve as a useful complement to lung function and symptomatology in the assessment of patients with chronic severe asthma, and in the control and rationalisation of steroid therapy in these patients.
Anorexia Nervosa and Acanthocytosis
Authors: Joseph A. Silverman
Journal: JAMA (1979)

<h3>To the Editor.—</h3> In a recent article, Amrein et al (241:2190, 1979) state: "Perhaps the most distinctive hematologic feature of anorexia nervosa is the development of notable acanthocytosis on the blood smear." Lest readers assume that this finding is either common or diagnostic, the following remarks are offered: In the past 12 years, 88 patients with anorexia nervosa were admitted to our institution, all of whom received complete blood cell counts; in addition, bone marrow examinations were performed in 72. Clinical findings have been reported elsewhere.<sup>1,2</sup> Acanthocytosis was never noted in our patient group. Is it possible that this rare finding is unique to the case of Amrein et al and perhaps unrelated to anorexia nervosa?
Jejunal pH and folic acid.
Authors: J A Blair, W T Cooke, C H Swan
Journal: BMJ (1971)

successfully lay emphasis on an already well- established point-namely that a rise in Paco2 may be accompanied by a rise in serum potassium.In addition, they do well to re- mind us that respiratory compensation for metabolic acidosis may be abolished under anaesthesia.These are important points well made.However, I am fearful lest a casual reader of their paper may now think suxamethonium to be exonerated as a potential cause of hyperkalaemia in renal failure.As I believe this matter to be still sub judice, may I make the following observations.They state that in cases la, 4, 5, 6, and 9the compensation for metabolic acidosis present during spontaneous conscious breath-lUg is to a greater or lesser extent abolished under anaesthesia.However, in case la there is no direct evidence of preoperative hyper- ventilation, and in case 4 there is direct evidence of the absence of preoperative hyperventilation.In case 6 the pTreoperative Paco2 is within normal limits, the pH may also be, depending on t;he third decimal place, and the calculated base excess is only marginally below the lower limit of normal.It is interesting, too, that while case 9 ex- hibited a marked rise in serum potassium level, the rise in Paco.and the fall in pH were less than those seen in cases 5 and 6, where the serum potassium remained essen- tially normal.They state that case 2 was spontaneously overbreathing.The preoperative Paco2 is, however, normal and the mild alkalosis is metabolic in origin, not respiratory.In three of the eight cases where suxa- methonium was employed (cases la, 3, and 4) there was a marked rise in serun potassium.The largest rise (1 mEq/l) was seen in case 3.Here it is not associated with any marked change in Paco2, but rather with a small rise in pH.It may well represent an effect due to suxamethonium.No details of suxamethonium dosages are given, and intraoperative blood samples were drawn at least 30 minutes after induction of anaesthesia (with one exception).In normal man the rise in serum potassium after suxa- methonium is probably dose-related.It is maximal at about 7 minutes post-injection and is of the order of 0.55 mEq/l after a 100 mg dose.' Thirty minutes after a 40 mg dose, however, one would not expect to detect this rise.The brief repor,t by Powell and Golby2 of a study in rats strongly suggests that potas- sium release following suxamethonium is highly abnormal in acute renal failure.A fuller report of this study is in press.It has been shownS in burned patients that the rise in seruxn potassium after suxa- methonium is exacerbated by any con- comitant acute rise in Paco2.In contrast, when suxamethonium was not employed no rise in potassium levels were seen.In conclusion, it seems that the relative importance of the administration of suxamethonium and of changes in acid/base status is not yet settled.It is likely that both, on occasions, are significant factors in the production of hyperkalaemia, and, they may well be additive.-Iam, etc.,
Cortisone and A.C.T.H. in Treatment of Non-rheumatic Conditions
Authors: G. M. Aber, G. N. Chandler, S. J. Hartfall
Journal: BMJ (1954)

RHEUMATIC CONDITIONSof the drug, which had been given at a dosage of 25 mg.daily, and splenectomy was undertaken during a second course of A.C.T.H. Relapse again occurred when the drug was discontinued.A third course of A.C.T.H., later changed to cortisone, was continued in gradually diminishing dosage for a further period of 14 weeks, and no ill effects have attended its final withdrawal, 28 weeks after the onset.The direct Race- Coombs test, positive at the outset, is now only weakly so.Comment.-In this small group, one child responded after one transfusion, and another after transfusion and A.C.T.H.The other two were given intensive hormone therapy, and both were submitted to splenectomy.The relatively large requirements of A.C.T.H. made it diffi- cult to achieve haematological response and clinical control without the production of side-effects.Undue gain in weight, mooning of the face, and glycosuria were recorded, but without biochemical or electro-
STUDIES ON INFLAMMATION
Authors: Valy Menkin
Journal: The Journal of Experimental Medicine (1930)

Colloidal iron or ferric chloride injected into the inflamed peritoneal cavity is fixed in the cavity and fails to reach the retrosternal lymphatic nodes, whereas, in the absence of inflammation, iron accumulates in these nodes and becomes demonstrable by the Prussian blue reaction. Quantitative studies show that after intraperitoneal injection of ferric chloride the retrosternal lymphatic nodes of animals with normal peritoneal cavity contain approximately 56 per cent more iron than do the nodes of animals with inflamed peritoneal cavity. Ferric chloride injected into the circulating blood enters an inflamed area in the skin and the inflamed tissue gives the Prussian blue reaction. Quantitative determinations show that the amount of iron in inflamed areas is much greater than that found in inflamed areas of animals that have received no iron.
Selenium and vitamin E, alone or together, did not prevent prostate cancer
Authors: Richard M. Hoffman
Journal: Annals of Internal Medicine (2009)

Source Citation Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009;301:39-51. 19066370
Legal challenge to rationing of haemophilia treatment is lost
Authors: C. Dyer
Journal: BMJ (1997)

A High Court judge in London last week refused to give the families of four boys with haemophilia the go ahead to challenge a decision by their local health authorities to withdraw treatment with the genetically engineered blood clotting agent recombinant factor VIII.

Duncan Ouseley, QC for the boys, aged between 5 years and 9 years, told Mr Justice Jowitt that South Lancashire, East Lancashire, and Bury and Rochdale Health Authorities had all made “flawed” decisions and failed to consider each individual case on its merits. But the judge said that …
Alpha 1-adrenoceptor activation mediates the infarct size-limiting effect of ischemic preconditioning through augmentation of 5'-nucleotidase activity.
Authors: M Kitakaze, M Hori, T Morioka, T Minamino, S Takashima, H Sato, Y Shinozaki, M Chujo, H Mori, M Inoue
Journal: Journal of Clinical Investigation (1994)

We have reported that ischemic preconditioning may limit infarct size by increasing 5'-nucleotidase activity. The present study tested whether alpha 1-adrenoceptor stimulation in ischemic preconditioning mediates the infarct size-limiting effect through augmentation of 5'-nucleotidase activity. The coronary artery was occluded four times for 5 min separated by 5 min of reperfusion (ischemic preconditioning) in 82 dogs. Then the coronary artery was occluded for 90 min followed by 6 h of reperfusion. Infarct size normalized by risk area was smaller after ischemic preconditioning than in the control group (40.6 +/- 2.3 vs 6.7 +/- 2.0%, P < 0.001), even though no difference existed in endomyocardial collateral flow during ischemia (8.7 +/- 1.0 vs 8.9 +/- 1.0 ml/100 g per min). Ectosolic and cytosolic 5'-nucleotidase activity was increased after ischemic preconditioning. However, prazosin blunted the infarct size-limiting effect of ischemic preconditioning (infarct size: 42.8 +/- 3.7%). Intermittent alpha 1-adrenoceptor stimulation by methoxamine mimicked the increase in 5'-nucleotidase activity and the infarct size-limiting effect, which were abolished by alpha, beta,-methyleneadenosine 5'-diphosphate. Identical results were obtained in the conscious model (n = 20). Therefore, we conclude that increases in ectosolic 5'-nucleotidase activity due to alpha 1-adrenoceptor activation may contribute to the infarct size-limiting effect of ischemic preconditioning.
Editorial: Considerations of risks versus benefits.
Authors: H L Falk
Journal: Environmental Health Perspectives (1975)

An evaluation of risks versus benefits from new products should be encouraged, even when dealing with agents which may cause cancer or malformations in laboratory animals, because there is evidence that safety thresholds exist even for such exposures. However, it is not easy to describe risk and benefit in comparable terms when they may involve generations to come and events in the future.
An immunological mechanisms for the reduced indidence of malignant melanoma in patients with acne?
Authors: David A. Paslin
Journal: British Journal of Dermatology (1984)

Journal Article An immunological mechanisms for the reduced indidence of malignant melanoma in patients with acne? Get access David A. Paslin David A. Paslin 460 34th Street, Oakland, CA 94609, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 110, Issue 1, 1 January 1984, Pages 124–125, https://doi.org/10.1111/j.1365-2133.1984.tb07324.x Published: 01 January 1984
DOSAGE OF ANTIMALARIAL DRUGS
Authors: J. B. Rice
Journal: JAMA (1946)

To the Editor:—  The article entitled Chloroquine for Treatment of Acute Attacks of Vivax Malaria by Most and his associates in the July 20 issue ofThe Journalbrings up a point which has given us some concern.  During the research period the investigators cooperating with the Board for the Coordination of Malarial Studies of the National Research Council were instructed by the board to calculate dosages of Aralen (Chloroquine) in terms of the amount of base contained, regardless of the salt used. This was entirely logical, since the investigators were engaged in comparative studies on a large number of compounds and their chief concern was to obtain information on the active principles of the drugs involved.  When the compounds were carried over into clinical research this practice was continued, and in the case of Aralen, although the diphosphate was used, dosages continued to be expressed in terms of the
C-Terminal-Truncated Microdystrophin Recruits Dystrobrevin and Syntrophin to the Dystrophin-Associated Glycoprotein Complex and Reduces Muscular Dystrophy in Symptomatic Utrophin/Dystrophin Double-Knockout Mice
Authors: Yongping Yue, Mingju Liu, Dongsheng Duan
Journal: Molecular Therapy (2006)

C-terminal-truncated (DeltaC) microdystrophin is being developed for Duchenne muscular dystrophy gene therapy. Encouraging results have been achieved in the mdx mouse model. Unfortunately, mdx mice do not display the same phenotype as human patients. Evaluating DeltaC microdystrophin in a symptomatic model will be of significant relevance to human trials. Utrophin/dystrophin double-knockout (u-dko) mice were developed to model severe dystrophic changes in human patients. In this study we evaluated the therapeutic effect of the DeltaR4-R23/DeltaC microdystrophin gene (DeltaR4/DeltaC) after serotype-6 adeno-associated virus-mediated gene transfer in neonatal u-dko muscle. At 2 months after gene transfer, the percentage of centrally nucleated myofiber was reduced from 89.2 to 3.4% and muscle weight was normalized. Furthermore, we have demonstrated for the first time that DeltaC microdystrophin can eliminate interstitial fibrosis and macrophage infiltration and restore dystrobrevin and syntrophin to the dystrophin-associated glycoprotein complex. Interestingly neuronal nitric oxide synthase was not restored. The most impressive results were achieved in muscle force measurement. Neonatal gene therapy increased twitch- and tetanic-specific force. It also brought the response to eccentric contraction-induced injury to the normal range. In summary, our results suggest that the DeltaR4/DeltaC microgene holds great promise in preventing muscular dystrophy.
Generalized pustular psoriasis precipitated by phenylbutazone and oxyphenbutazone
Authors: H. RESHAD, G.K. HARGREAVES, C.F.H. VICKERS
Journal: British Journal of Dermatology (1983)

Journal Article Generalized pustular psoriasis precipitated by phenylbutazone and oxyphenbutazone Get access H. RESHAD, H. RESHAD Manchester and Salford Hospital for Skin diseases, Quay Street, Manchester M33HL Search for other works by this author on: Oxford Academic Google Scholar G.K. HARGREAVES, G.K. HARGREAVES Manchester and Salford Hospital for Skin diseases, Quay Street, Manchester M33HL Search for other works by this author on: Oxford Academic Google Scholar C.F.H. VICKERS C.F.H. VICKERS Royal Liverpool Hospital, Prescot Street, Liverpool L69 3BX Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 109, Issue 1, 1 July 1983, Pages 111–113, https://doi.org/10.1111/j.1365-2133.1983.tb04000.x Published: 01 July 1983 Article history Accepted: 24 November 1982 Published: 01 July 1983
Background of Discontent — This Little Lot
Authors: John Lister
Journal: New England Journal of Medicine (1964)

IT is certainly true that very few older family doctors would like to go back to the conditions of practice before the National Health Service, and a whole new generation of doctors has grown up who have never known anything but National Health Service medicine. The older doctors are glad to be free of the anxiety of bad debts and glad to be rid of the financial barrier in treating their poorer patients and the aged sick. The younger doctors have never had to face these problems.And yet the partnership between the doctors and the State, in the care . . .
Free air, but where?
Authors: P. Morar, J. Hodgkinson, H. Hirji, S. Gould
Journal: BMJ (2013)

A 62 year old fit and well Romanian man presented to our department with a two week history of worsening acute localised pain in the upper abdomen and vomiting. His surgical history included an open appendicectomy as a child and laparoscopic cholecystectomy 20 years ago. On presentation he had fever (39°C) and tachycardia (104 beats/min). His blood pressure was 125/73 mm Hg. He displayed generalised abdominal tenderness, worse in the right upper quadrant, with localised guarding in the right upper quadrant. 

Blood tests showed a raised white cell count of 16×109/L (reference range 4-10×109/L) and a C reactive protein concentration of 277 mg/L (reference value <9 mg/L; 1 mg/L=9.25 nmol/L). A frontal projection erect chest radiograph was reported as showing pneumoperitoneum (fig 1⇓).



Fig 1 Frontal projection erect chest radiograph





### 1 What is the differential diagnosis given the clinical features only?

#### Short answer

The differential diagnoses include visceral perforation (gastric or duodenal) with abscess formation, biliary obstruction or cholangitis, acute pancreatitis, infective colitis, hepatic abscess, right lower lobar pneumonia, myocardial infarction, and gastritis.

#### Long answer

The differential diagnoses include any cause of acute intra-abdominal sepsis and localised peritonism. In association with upper abdominal signs, peptic ulcer disease is most likely (incidence 3.77-9.8/100 000).1 However perforated diverticulitis would be considered in patients of this age (incidence 3.9/100 000).2 Common biliary diseases such as …
THE OCCURRENCE OF SPECIFIC IMMUNITY PRINCIPLES IN THE BLOOD OF VACCINATED CALVES
Authors: James W. Jobling
Journal: The Journal of Experimental Medicine (1906)

The immunity which human beings develop towards vaccinia, after a successful vaccination, is the classical example of an artificially induced active immunity.The duration of the immunity to vaccinia is variable but extends frequently over many years.Many animals are subject to inoculation with vaccinia and they show, as in the case of man, a state of immunity following the disappearance of the successful vaccination.The calf, as is well known, is now generally employed for the production of the vaccine-virus which is used to protect human beings from smallpox.At one period in the development of specific serum therapy an attempt was made to utilize the immune principle which it was presumed existed in the blood of animals which have passed through a successful vaccination.The hope was entertained that, possibly, the serum of the vaccinated calf might exercise curative properties upon persons suffering with smallpox.This hope has not been realized.In order to prove the existence of immunity principles in the blood of vaccinated animals the attempt was made to protect, by inoculation of the blood of these calves and monkeys, fresh animals from vaccinia.In spite of some successful results the experiment may be said to have often failed.'-The failure of the blood of vaccinated animals regularly to confer passive immunity or to exert curative effects cannot be held to disprove the existence in the blood of immunity substances.Tests of the kind mentioned are exceedingly gross.Moreover,