tbuckley/cabot-search huggingface dataset:
Using Information Technology To Improve the Health Care of Older Adults
Authors: Michael Weiner, Christopher M. Callahan, William M. Tierney, J. Marc Overhage, Burke Mamlin, Paul R. Dexter, Clement J. McDonald
Journal: Annals of Internal Medicine (2003)

The high burden of illness and frailty common among our growing population of older adults often results in fragmentation of care across providers and health care systems, increasing the complexity and costs of caring for these patients. Information technology offers one way to meet this challenge. Scientists at the Regenstrief Institute have more than a quarter-century of experience in using medical informatics to support clinicians in the day-to-day care of older adults. Their research has progressed through several evolutionary cycles, beginning with the acquisition of relevant data and moving to studies of the most efficient and effective mechanisms that bring information to bear at the time of clinical decision making. Information technology designed with the input of the end user has the greatest promise of changing provider behavior because it balances technological challenges with the cultural context of the practice environment. One topic of active research is information technology to support transitions of care among sites and providers. These transitions place older adults at increased risk for avoidable illness, death, and health care costs. Information systems that improve communication among providers during these transitions have the potential to improve safety and reduce costs.
Neurostimulation: An Overview
Authors: John E. Adams
Journal: JAMA (1986)

This volume includes the collected manuscripts from a symposium entitled "Biostimulation," which was held in Monaco in June 1984. The majority of the participating authors are from European centers, with only a few authors representing work in the United States, Canada, and Mexico. As might be expected, most of the papers concern chronic electrical stimulation of the brain and spinal cord in the treatment of pain and spasticity. The treatment of seizure and movement disorders is more briefly discussed, and a few chapters describe the techniques and results of electrical stimulation therapy for scoliosis and cochlear implants in the treatment of deafness. A brief history of neurostimulation by Lazorthes, Siegfried, and Upton provides perspective on the subject, and is followed by an equally brief but quite good resume of the neurophysiological basis for and technical aspects of neurostimulation. The remaining chapters describe the various authors' methods and findings in their
Acute cerebral oedema induced by methotrexate.
Authors: S. J. Ellis
Journal: BMJ (1989)

Sick doctorsSIR,-Like others before him,' 2 Dr Clive Richards has drawn attention to the stress problems, emo- tional difficulties, and preventive care needs of general practitioners.'A national counselling service for sick doctors already exists,4 but Dr Richards rightly pointed out that coping includes "trying to prevent problems before they occur."Risk factors have been identified.For example, Walton recently noted, "it is commonly accepted that achievement-oriented compulsive people are attracted to medicine" and that this preselection of vulnerable individuals may contribute to the high incidence of mental illness, stress, and drug dependence.'Student selection methods should therefore be reconsidered as part of primary prevention.Current student selection procedures have been criticised6 and contrasted with the thorough personality assessment and psychological testing used by organisations such as IBM.7 In 1988 the World Federation of Medical Education recommended that medical schools should "use selection methods for medical students which 'go beyond intellectual ability and academic achievement to include the evaluation of personal qualities.'"" Including personality assessment in student selection might therefore provide effective primary prevention to help reduce long term unhappiness, stress, and mental illness in the profession.
The Prevelence of Aeroallergen Sensitization on Patients of the Allergy Service of Hospital Da Crianca De Brasilia, Brasilia- Brazil
Authors: Vanessa S.P. Campos, Luciana lilian Luciana, Herminio P. Ramos, Clarissa H. Dumas, Claudia F. Valente, Valeria B. Rodrigues, Wellington Borges
Journal: Journal of Allergy and Clinical Immunology (2015)
Prevalence and Site-Pathogen Studies of Neisseria meningitidis and N gonorrhoeae in Homosexual Men
Authors: William M. Janda
Journal: JAMA (1980)

Prevalence and site-pathogen studies of pathogenic Neisseria were conducted in 815 homosexual men over a 12-month period. Neisseria meningitidis was isolated from more patients than N gonorrhoeae (43.1% vs 33.1%). A high oropharyngeal carriage of n meningitidis (42.5%) was present, with much lower urethral (0.7%) and rectal (2.0%) colonization. Although N meningitidis urethral isolates were associated with urethral discharge in five of six patients, N meningitidis in the oropharynx or rectum was not usually associated with clinical illness. Neisseria meningitidis was usually isolated from only one site in individual patients. Neisseria gonorrhoeae was isolated from the urethra (18.5%), rectum (16.3%), and oropharynx (5.6%). Of the 270 patients with gonococcal infection, 49.1% had urethral gonorrhea only, and 20.7% were infected at two or more body sites. Virtually all patients with urethral infection had symptoms of urethritis, whereas 89.1% of patients with oropharyngeal infection and 61.9% of patients with anorectal infection had no local symptoms.
Points: Induced abortions after the Chernobyl accident
Authors: F. Parazzini, F. Repetto, M. Formigaro, M. Fasoli, C. La Vecchia
Journal: BMJ (1988)

p 1411), recalling feelings of "too little, too late" at the King's Cross Station tragedy.This inadequacy is shared by many doctors when they are called to cope with incidents away from the bright lights and comfortable surroundings of the surgery or hospital.The British Association for Immediate Care (BASICS) was formed in an attempt to improve prehospital care for victims of road accidents and other disasters.It provides a forum and training for doctors interested in immediate care.In recognition of this need, par- ticularly for general practitioners, the Royal College of Surgeons of Edinburgh has agreed to establish a diploma in prehospital care.BASICS doctors trained in the use of breathing apparatus were present at King's Cross but because of the inevitable delay in appreciating the size of the incident they were called some time later.They provided on site care and a site medical officer and subsequently searched the station with fire crews and helped certify and identify the dead.They too shared the feeling of grief but perhaps less the inadequacy.New members are always wel- come.At present there are only 2000 doctors in 70 immediate care schemes covering about one third ofthe United Kingdom.
Side-effects of propranolol.
Authors: D. O. Lewis
Journal: BMJ (1966)

MWICAfJOUWLhfrom any tissue tension change around a verte- bral joint or surrounding musculature.It is only when the sciatica and acute back definitely follow a specific lifting, twisting strain, and are accompanied by the neurological signs of toe weakness and dermatome arrangement of skin loss down the front and lower outer side of the calf and ankle, are we entitled to say that a displaced piece of intervertebral disc is the cause of the patient's acute back and sciatica.Even then how often has the orthopaedic surgeon the disappointment of carrying out the tiring opera- tion of a laminectomy and to his surprise find- ing no displaced nor bulging disc, yet to his pleasure and chagrin his patient is cured of the sciatica.The explanation must be that the anaesthetic caused relaxation of the patient's spinal muscles and any minor subluxation reduced itself, or else his assistant's retractors pulled upon and freed a nerve root which was adherent to the back of a disc, the seat of a previous minor tear of the disc's attachment to the posterior common ligament.
Canada could ban some reproductive technologies
Authors: D Spurgeon
Journal: BMJ (1994)

A Canadian royal commission has recommended that several aspects of new reproductive technology should be outlawed and that others should be federally regulated and licensed.

Four years of research, public hearings, and surveys involving more than 40 000 people - including 300 researchers - led the Royal Commission on New Reproductive Technologies to propose bans on four main activities. These are the use of embryos in research related to cloning and animal-human hybrids; the fertilisation of eggs from female fetuses for implantation; the sale of eggs, sperm, zygotes, and fetal …
Relationship of Dopamine Type 2 Receptor Binding Potential With Fasting Neuroendocrine Hormones and Insulin Sensitivity in Human Obesity
Authors: Julia P. Dunn, Robert M. Kessler, Irene D. Feurer, Nora D. Volkow, Bruce W. Patterson, Mohammad S. Ansari, Rui Li, Pamela Marks-Shulman, Naji N. Abumrad
Journal: Diabetes Care (2012)

Midbrain dopamine (DA) neurons, which are involved with reward and motivation, are modulated by hormones that regulate food intake (insulin, leptin, and acyl ghrelin [AG]). We hypothesized that these hormones are associated with deficits in DA signaling in obesity.We assessed the relationships between fasting levels of insulin and leptin, and AG, BMI, and insulin sensitivity index (S(I)) with the availability of central DA type 2 receptor (D2R). We measured D2R availability using positron emission tomography and [(18)F]fallypride (radioligand that competes with endogenous DA) in lean (n = 8) and obese (n = 14) females. Fasting hormones were collected prior to scanning and S(I) was determined by modified oral glucose tolerance test.Parametric image analyses revealed associations between each metabolic measure and D2R. The most extensive findings were negative associations of AG with clusters involving the striatum and inferior temporal cortices. Regional regression analyses also found extensive negative relationships between AG and D2R in the caudate, putamen, ventral striatum (VS), amygdala, and temporal lobes. S(I) was negatively associated with D2R in the VS, while insulin was not. In the caudate, BMI and leptin were positively associated with D2R availability. The direction of associations of leptin and AG with D2R availability are consistent with their opposite effects on DA levels (decreasing and increasing, respectively). After adjusting for BMI, AG maintained a significant relationship in the VS. We hypothesize that the increased D2R availability in obese subjects reflects relatively reduced DA levels competing with the radioligand.Our findings provide evidence for an association between the neuroendocrine hormones and DA brain signaling in obese females.
REPORT LXVII. ON THE EFFECTS OF FORCED FEEDING IN CASES OF PULMONARY TUBERCULOSIS AND IN NORMAL INDIVIDUALS
Authors: N. D. Bardswell, F. W. Goodbody, J. E. Chapman
Journal: BMJ (1902)

THE following work on the metabolism in pulmonary tuber- culosis was undertaken in the hope of throwing some light upon the question of how to feed patients suffering from this disease.For the opportunity of carrying out the research we are indebted to the courtesy of the Brompton Hospital Committee, and to Dr. Kingston Fowler, who placed six
Inherited Gastrointestinal-Polyposis Syndromes
Authors: Richard W. Erbe
Journal: New England Journal of Medicine (1976)

Isolated polyps in the gastrointestinal tract, particularly in the colon, are relatively common, whereas only occasionally do patients have large numbers of polyps. Many of these patients have one of the genetic gastrointestinal-polyposis syndromes, so that there may be a risk that offspring will inherit the disorder. In evaluating persons with multiple gastrointestinal polyposis, the most important information for purposes of differential diagnosis consists of the number and distribution of the polyps within the gastrointestinal tract, the pathological features of the polyps and the nature and distribution of any extraintestinal manifestations (Table 1). All these syndromes are inherited as Mendelian . . .
The Noninvasive Diagnosis of Isolated Right Ventricular Infarction
Authors: I GARTY, D ANTONELLI, J BARZILAY
Journal: Clinical Nuclear Medicine (1984)

A rare case of isolated right ventricular infarction (RVI) is described. The lack of clinical and electrocardiographic findings characteristic of isolated RVI makes this pathology a diagnostic challenge. The role of the radionuclide scintigraphic procedures as a single possible tool for the diagnosis of isolated RVI is emphasized.
The Elderly Primigravida in 1990
Authors: Robert Resnik
Journal: New England Journal of Medicine (1990)

This editorial addresses the issues raised by Berkowitz and her coworkers, who studied the pregnancy outcome of 3917 primiparous women (women who are 30 years or older and pregnant for the 1st time). The study found that this population had a slight increased risk of delivering low birth weight infants, and no increased risk in having a small for gestational age infant, an infant with low Apgar scores, or one which died in the perinatal period. Also, the study population presented with a higher rate of antepartum complications, and a substantial increased likely hood of a cesarian section for women who are older that 35 years. The author argues that the data presents encouraging news to women in their 30's and are contemplating their 1st pregnancy. Although other studies have shown that older women are more likely to deliver infants with chromosomal abnormalities, it should be noted that advances in genetic diagnosis provide women with accurate information to permit them to make necessary decisions. However, Berkowitz's findings should be interpreted with the limitation of the characteristics of the studied population, who were private patients, predominantly white, married, college educated and non-smoking.
Surgeons set new standards for cosmetic treatments
Authors: J. Wise
Journal: BMJ (2013)

The Royal College of Surgeons has said only surgeons should provide cosmetic surgery and that non-surgical cosmetic treatments should be carried out only by doctors, dentists, and nurses who have had appropriate training. Currently, procedures such as laser treatment or injections of botulinum toxin or intradermal filler can be administered by anyone.

The college has produced new guidelines, Professional Standards for Cosmetic Practice,1 in the wake of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) in 2010,2 which exposed a lack of consistent professional standards in the field of cosmetic practice.

Norman Williams, president of the Royal College of Surgeons, said: “We have serious concerns that not all those who offer cosmetic procedures are adequately qualified or that patients are getting accurate information prior to treatment.”

Most cosmetic procedures are performed outside the NHS. In 2011, 43 000 cosmetic surgical procedures were done by members of the British Association of Aesthetic …
Living with Long-Term Home Dialysis
Authors: TIMOTHY M. BROWN
Journal: Annals of Internal Medicine (1974)

Eleven of the 22 patients receiving home dialysis in the spring of 1973 from the dialysis unit of a university medical center hospital were interviewed to determine what factors might help or hinder patient adjustment to chronic renal failure alleviated by home dialysis. Two interviewers, following a relaxed protocol, talked with patients at home and recorded the interviews on tape and in notes. Four areas were identified in which well-adjusted patients differed significantly from those poorly adjusted: extent of change in physical or mental state due to disease, source and extent of financial support, role and relationship of helper to patient, and the importance that the patient perceived dialysis to have in his daily life. From the typical patients' profiles, some tentative suggestions to enhance patient adjustment are offered.
TH1 but not TH0 cell help is efficient to induce cytotoxic T lymphocytes by immunization with short synthetic peptides
Authors: A. López-Díaz de Cerio, N. Casares, J.J. Lasarte, P. Sarobe, L.A. Pérez-Mediavilla, M. Ruiz, J. Prieto, F. Borrás-Cuesta
Journal: Journal of Hepatology (2000)
Farnesyl Transferase Inhibitors for Patients with Lung Cancer
Authors: Bruce E. Johnson, John V. Heymach
Journal: Clinical Cancer Research (2004)

Abstract The ras family of genes have been identified as potential targets for therapeutic intervention because of somatic mutations in different human cancers. They are mutated in non-small cell lung cancer (NSCLC) ∼20% of the time. The enzyme farnesyl transferase is involved in posttranslational modification of the ras proteins by covalently linking a farnesyl group to the ras protein. This permits the ras protein to be translocated to the surface membrane, allowing the protein to be involved in signaling for increased proliferation and inhibition of apoptosis. The class of farnesyl transferase inhibitors is designed to block farnesylation and prevent the mature ras signaling and thus inhibit cell proliferation and facilitate apoptosis. Multiple agents that inhibit farnesylation have been developed, and two farnesyl transferase inhibitors have been tested in patients with lung cancer in three Phase II trials. R115777 has been studied in patients with NSCLC and in patients with relapsed small cell lung cancer (SCLC) after chemotherapy. There has been a single trial of L-778,123 in patients with untreated NSCLC. No objective tumor responses in patients with stage IIIB/IV NSCLC were seen in these studies. There were also no objective responses among the 22 patients with relapsed SCLC treated with R115777. The median survival for the 44 patients with NSCLC treated with R115777 was ∼8 months, whereas it was 11 months for the 23 patients treated with L-778,123. R115777 and L-778,123 were well tolerated in these studies but showed no significant activity as single-agent therapy in relapsed SCLC or untreated NSLC.
Ga-67 Uptake in Capsular Contracture Around a Breast Implant
Authors: MICHAEL F. HARTSHORNE, HALLENE A. MARAGH, ROBERT J. TELEPAK, STEPHEN R. BUNKER
Journal: Clinical Nuclear Medicine (1982)

HARTSHORNE, MICHAEL F. M.D., CPT., M.C., U.S.A.; MARAGH, HALLENE A. M.D., MAJ., M.C., U.S.A.; TELEPAK, ROBERT J. M.D., LTC., M.C., U.S.A.; BUNKER, STEPHEN R. M.D., MAJ., M.C., U.S.A. Author Information
Junior staff and waiting lists.
Authors: A B Shrank
Journal: BMJ (1987)

not stated, but when asked if this might have been due to unrelieved aortic stenosis they declined to comment.In addition, and as in the present report, most patients had significant residual aortic stenosis.Clearly these results are not as good as those which can be expected with current surgical techniques.The presenter of the French experience then went on to claim that he had not referred a patient for surgery for over a year.The mortality for this group, and the functional results, were not available.This widening indication for valvuloplasty in the absence ofverifiable data and in the light of published surgical results over many years concerns us.As a caveat we would like to point out from our own intraoperative studies that if this technique is to be used a balloon inflation time of one minute is not necessary, and is probably dangerous.4Prolonged obstruction to ventricular outflow must result in further dilatation of an already over- stretched myocardium.It has been known for many years that this may cause irreversible damage.Several of the reported deaths with this technique appear to have been due to this mechanism.We found that an initial inflation time of 15 seconds was sufficient to open the valve orifice by a measurable amount.Further short periods of inflation could then be used.This problem may in part be avoided by the use oftrefoil shaped balloons.We are anxious to join with Dr Jackson and coUeagues to counsel against the uncontrolled and unrestricted spread of this procedure to the detri- ment of patients with aortic stenosis in Britain.
An Address on Twenty-Five Years' Progress in Abdominal Surgery: At The Manchester Royal Infirmary
Authors: A. H. Burgess
Journal: BMJ (1926)

THE Year 1925, in.-hich 3 oU so greatly hion1otured me by electinig nme to yotiri presidenltial chaii, completing, as it does, the fiist quarter of the twentieth century, automatic- ally illvites retrospection.In 1900, as the resident sturgical officer at the old Manchester Royal Inifir mary, I was in very close touch with the surgical work of the iinstitution, and it
Contributions of -Cell Dysfunction and Insulin Resistance to the Pathogenesis of Impaired Glucose Tolerance and Impaired Fasting Glucose
Authors: M. A. Abdul-Ghani
Journal: Diabetes Care (2006)

Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are intermediate states in glucose metabolism that exist between normal glucose tolerance and overt diabetes. Epidemiological studies demonstrate that the two categories describe distinct populations with only partial overlap, suggesting that different metabolic abnormalities characterize IGT and IFG. Insulin resistance and impaired beta-cell function, the primary defects observed in type 2 diabetes, both can be detected in subjects with IGT and IFG. However, clinical studies suggest that the site of insulin resistance varies between the two disorders. While subjects with IGT have marked muscle insulin resistance with only mild hepatic insulin resistance, subjects with IFG have severe hepatic insulin resistance with normal or near-normal muscle insulin sensitivity. Both IFG and IGT are characterized by a reduction in early-phase insulin secretion, while subjects with IGT also have impaired late-phase insulin secretion. The distinct metabolic features present in subjects with IFG and IGT may require different therapeutic interventions to prevent their progression to type 2 diabetes.
Nonatopic wheezy children have reduced interferon‐gamma
Authors: S.C. Leech, J.F. Price, B.J. Holmes, D.M. Kemeny
Journal: Allergy (2000)

Viruses cause asthmatic exacerbations in schoolchildren. We tested the hypothesis that children who wheezed with viral respiratory tract infections secrete higher levels of the type 1 cytokine interferon-gamma (IFN-gamma) in the peripheral circulation than children who had never wheezed. Blood was taken from 13 children (eight atopic) with episodic wheeze and 11 controls. CD4 and CD8 cells were separated from peripheral blood mononuclear cells and stimulated with phorbol 12-myrisate 13-acetate (PMA) and ionomycin for 24 h. IFN-gamma, IL-4, and IL-5 were measured in the supernatant by ELISA. IFN-gamma production by CD4 and CD8 cells was lower in children with a history of wheeze (CD4, P = 0.046; CD8, P = 0.037). These children were then analysed according to atopic status. CD4 and CD8 IFN-gamma production in nonatopic wheezy children was reduced (CD4, P=0.009; CD8, P=0.003). IFN-gamma production by atopic wheezy children was lower than by controls, but the differences were not significant (CD4, P = 0.2831; CD8, P = 0.1372). CD8 IL-5 was lower in children who wheezed (P=0.012). Release of IL-4 and IL-5 by CD4 cells did not differ between the three groups. We propose that defective IFN-gamma secretion by CD4 and CD8 cells may contribute to viral-induced wheeze in nonatopic children.