tbuckley/cabot-search huggingface dataset:
The Proxy War — SCHIP and the Government's Role in Health Care Reform
Authors: Sara Rosenbaum
Journal: New England Journal of Medicine (2008)

The conflagration over the reauthorization of the State Children's Health Insurance Program (SCHIP) offers a compelling example of Washington's current inability to address even seemingly uncontroversial matters such as improved health care coverage for children. After the House failed to override President George W. Bush's veto of a SCHIP expansion in October, Congressional leaders regrouped to develop a compromise measure that would address Bush's claim that the original bill "moves the health care system in the wrong direction."1 SCHIP permits coverage of children in families whose incomes (according to evaluation methods developed by the states) are at or below 200% . . .
Impact of donor and recipient IL28B rs12979860 genotypes on hepatitis C virus liver graft reinfection
Authors: Christian M. Lange, Darius Moradpour, Alexandra Doehring, Hans-Anton Lehr, Beat Müllhaupt, Stephanie Bibert, Pierre-Yves Bochud, Anca T. Antonino, Manuel Pascual, Harald Farnik, Ying Shi, Wolf Otto Bechstein, Christian Moench, Martin-Leo Hansmann, Christoph Sarrazin, Jörn Lötsch, Stefan Zeuzem, Wolf-Peter Hofmann
Journal: Journal of Hepatology (2010)
The Rape of the Phallus —A Sequel
Authors: William Keith C. Morgan
Journal: JAMA (1965)

First, may I thank through these columns the several hundred correspondents who have taken the time to put into writing their feelings about "The Rape of the Phallus." To the vast majority who supported me, my thanks; to the few who were abusive, scurrilous, and occasionally anonymous, my sympathy; to those three who saw fit to mention my meager effort and H. L. Mencken in the same breath, my intense gratitude; and to the Editor and his staff, the laurel crown for realizing that the function of the press, medical or otherwise, is to educate and not to propagandize. As for those who deplore the use of satire in a medical topic such as this, I recommend the writings of Aristophanes, Juvenal, Swift, Voltaire, and Baltimore's own H. L. Mencken. And to the several correspondents who queried my qualifications to express an opinion on this subject, may I remind them
The Lewis A. Conner Lecture of the American Heart Association
Authors: ARTHUR L. BLOOMFIELD
Journal: Circulation (1950)

Some considerations concerning the fundamental pathology of bacterial endocarditis which have a bearing on treatment are discussed. In using antibiotics the importance of time-dose relationships is emphasized. It is pointed out that tests for strain sensitivity give a useful clue to the total daily dosage but that regardless of this, treatment must be carried out over a period of at least a month in order to achieve permanent bacteriologic cures. The difficulties and complications of treatment are discussed. Special methods for the treatment of highly resistant strains and the results with some of the newer antibiotics are outlined.
Allergy to Iprindole (Prondole) with Hepatotoxicity
Authors: K. P. Murphy
Journal: BMJ (1970)

MDICBLOUNAL 681 be expected in patients with folic acid deficiency (clinical or subclinical).The find- ings of Kaimis, Sumrnerly, and Giles (per- sonal cormmunication to Marks and Shuster, 12 September, p. 618) and the demon- stration of malabsorption in the proximnal small bowel' which is the site of absorption of folic acid, would seem to indicate that, in addition to an increased demand, there may be malabsorption of folic acid in these patients which would further exacerbate folate deficiency.As correctable malabsorption of vitamin B12 has been described in patients with folic acid deficiency,9"0 it would seem likely that the malabsorption of vitamin B12 in patients with various skin diseases is also due to folic acid deficiency.I wonder whether the authors have repeated the study after a course of folic acid.It would also be interesting to see whether the small bowel dysfunction in dermatogenic enteropathy reverts to normal on folic acid therapy alone without local treatment of the rash.If it does (as I suspect) in addition to the local treatment of dermatosis early folic acid therapy would seem to be indicated in patients with enteropathy, even when there are no obvious haematological changes.Similar explanation probably holds true in enteropathy associated with various chronic debilitating illnesses and also in conditions where increased cellular proliferation is a predomiunant feature.-Iam, etc.,
Electrical responses of guinea pig coronary artery to transmural stimulation.
Authors: K D Keef, D L Kreulen
Journal: Circulation Research (1988)

Isolated segments of the guinea pig circumflex coronary artery were stimulated transmurally with brief duration (0.05 msec) pulses while recording intracellularly. Resting membrane potential was -60.3 +/- 4.3 mV (n = 66). Transient depolarizations (TDs) graded in amplitude with stimulus intensity were elicited with single stimuli. An action potential of 47 +/- 5 mV was superimposed upon the TD above a threshold membrane potential of -48 +/- 4 mV. Following the spike, a period of slow repolarization requiring 77 +/- 33 seconds was observed. Repetitive stimulation led to summation of TDs and a slow depolarization (less than or equal to 21 mV) that persisted for up to 90 seconds. The TD was reduced in amplitude when the membrane was depolarized with increased [K]o and enhanced when the membrane was hyperpolarized by adding potassium back to a potassium-depleted tissue. Phentolamine (10(-5) M), prazosin (10(-6) M), guanethidine (2 X 10(-5) M), alpha,beta-methylene ATP (2 X 10(-5) M), tetrodotoxin (10(-6) M), and 10-20 mM norepinephrine did not block TDs, action potentials, or slow depolarization. TDs were abolished following cold storage (4 degrees C) for 4 days and significantly reduced in a 2.25-mM CdCl2 solution with 0.25 mM CaCl2. Acetylcholine (10(-8) M to 10(-5) M) produced membrane hyperpolarization and reduced the amplitude of TDs and altered their time course. Atropine (10(-5) M) blocked the effects of acetylcholine but had no effect on the response to nerve stimulation. These observations indicate that TDs exhibit some, but not all, of the properties characteristic of excitatory junction potentials obtained with release of neurotransmitter substances in other vessels. If these TDs are neural events, they must involve a transmitter other than norepinephrine, acetylcholine, or ATP.
Art and medicine 3: Bouvez, by Dr Leon Cobb
Authors: R. Stanwell-Smith
Journal: Journal of the Royal Society of Medicine (2004)

Water has been termed `blue gold' and the availability of safe drinking water is one of the world's more glaring inequalities. Thus this picture, inviting us to drink in the message of water and health, was an appropriate entry for the Brooke Epidemiology Art Prize, arranged jointly by the Section of Epidemiology and Public Health and the Medical Art Society. The work, in acrylic, uses a glacier blue glaze to register the dream of the young African man for clean water, while the black and red impasto (seen as dark contrast in the black and white reproduction) represents the ever-present dysentery and other infections transmitted by the water in his environment. Entrants were asked to provide a commentary with their work: in his, Dr Cobb included statistics to underline the contrast between the developed and developing world. In the developed world, the bottled-water business is worth £1 billion a year, not least because bottled mineral water costs a thousand times more per litre than the essentially identical product from the tap. Meanwhile, in many parts of Africa and other water-poor countries, the drinking water sources frequently contain concentrations of faecal or thermotolerant coliforms as high as 100 000/dL when the WHO guideline is 0/dL. Over 1.1 billion people in the developing world have no access to safe drinking water and climate change is increasing water shortages, predicted to affect more than half the world by 2032.

Even without the eloquent theme of blue gold and red danger in Bouvez, the painting's message of plentiful and fashionable water here, and clean water as more a dream than a reality `over there', is sharply realized. Water is becoming a valuable market, and the World Trade Organization and industry groups think that the only way to handle this increasing scarce resource is to set a price on it. The global toll annually from waterborne diseases is around 3 million deaths.
Crime and the Aged
Authors: Manuel Rodstein
Journal: JAMA (1975)

IN ADDITION to economic loss, physical assault, and psychologic damage, crimes committed against the aged have many profound effects on their entire way of life, including their medical care, nutrition, mental health, social life, housing, and means of transportation. These crimes are significant contributory factors to migration of the aged from their neighborhoods and their willingness to accept long-term care in institutions. <h3>Incidence</h3> The aged who reside in the inner city are frequently the victims of crime. In New York City, where 35% or 400,000 of those 60 years of age and over reside in the 26 poorest neighborhoods, over 40% of the aged surveyed reported being victims of personal crime in the past, varying from purse-snatching to forcible entry into their homes.<sup>1</sup> An excellent study of more than 500 individuals aged 65 years and over in the inner city of Houston revealed that 29.8% had been criminally victimized
Polyclonal B cell chronic lymphoproliferative disease with hairy cell morphology: A case report and clonal studies
Authors: Kosei Matsue, Haruko Nishi, Shigeru Onozawa, Mami Itoh, Kohji Tsukuda, Masaki Yamaguchi, Shinji Nakao, Makoto Kashimura
Journal: American Journal of Hematology (1996)

We describe a patient who has a chronic polyclonal B lymphocyte proliferation with a hairy-cell appearance. A 48-year-old Japanese woman with marked splenomegaly, systemic lymphadenopathy, and leukocytosis was referred to our hospital. Laboratory examination revealed marked polyclonal IgG hypergammaglobulinemia. Morphologic examination of the patient's peripheral blood, including May-Glemsa staining and scanning electron microscopy, showed a monotonous proliferation of hairy-appearing mature lymphocytes. An immunophenotypic study revealed an expansion of cells with mature B cell antigens positive for CD11c; however, light-chain restriction was not seen. The lack of both immunoglobulin heavy-chain and T cell receptor gene rearrangements by Southern blot analysis indicated the polyclonal nature of the proliferating B cells. This was confirmed further by a clonal analysis of the patient's lymphocytes using an X-chromosome-linked restriction fragment polymorphism within the X-linked phosphoglycerate kinase (PGK) gene. Since chronic B cell lymphoproliferation with a hairy cell appearance has not been described previously, this case might be extremely rare, and has important implications for the pathogenesis of mature B cell lymphoproliferative diseases, including hairy cell leukemia. © 1996 Wiley-Liss, Inc.
Systemic Steroid Exposure Is Associated with Differential Methylation in Chronic Obstructive Pulmonary Disease
Authors: Emily S. Wan, Weiliang Qiu, Andrea Baccarelli, Vincent J. Carey, Helene Bacherman, Stephen I. Rennard, Alvar Agustí, Wayne H. Anderson, David A. Lomas, Dawn L. DeMeo
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Rationale: Systemic glucocorticoids are used therapeutically to treat a variety of medical conditions. Epigenetic processes such as DNA methylation may reflect exposure to glucocorticoids and may be involved in mediating the responses and side effects associated with these medications.Objectives: To test the hypothesis that differences in DNA methylation are associated with current systemic steroid use.Methods: We obtained DNA methylation data at 27,578 CpG sites in 14,475 genes throughout the genome in two large, independent cohorts: the International COPD Genetics Network (ndiscovery = 1,085) and the Boston Early Onset COPD study (nreplication = 369). Sites were tested for association with current systemic steroid use using generalized linear mixed models.Measurements and Main Results: A total of 511 sites demonstrated significant differential methylation by systemic corticosteroid use in all three of our primary models. Pyrosequencing validation confirmed robust differential methylation at CpG sites annotated to genes such as SLC22A18, LRP3, HIPK3, SCNN1A, FXYD1, IRF7, AZU1, SIT1, GPR97, ABHD16B, and RABGEF1. Functional annotation clustering demonstrated significant enrichment in intrinsic membrane components, hemostasis and coagulation, cellular ion homeostasis, leukocyte and lymphocyte activation and chemotaxis, protein transport, and responses to nutrients.Conclusions: Our analyses suggest that systemic steroid use is associated with site-specific differential methylation throughout the genome. Differentially methylated CpG sites were found in biologically plausible and previously unsuspected pathways; these genes and pathways may be relevant in the development of novel targeted therapies.
The Protective Effect of a New Agent, Ketotifen Syrup, in the Treatment of Childhood Asthma
Authors: Ole ØSterballe, Elisabeth Addi Lykkegaard Nielsen
Journal: Allergy (1979)

Twenty-two children with perennial extrinsic allergic asthma participated in a double-blinded, controlled, cross-over study of Ketotifen syrup during a 2 x 6-week period. The placebo was identical with the active drug in taste, colour, and consistency. The dosage level was, on weight basis, a little higher than the standard dosage for adults. The double-blinded investigation was supplemented with a 1 2-week open study of the tolerance for Ketotifen. This study also involved 22 patients, 12 new ones, and 10 from the double-blind study. The study showed Ketotifen to have no effect on changes in lung function (peak flow), on reduction in frequency of asthmatic attacks, or on consumption of additional medicine. The tolerance for Ketotifen was good, but physicians are advised to watch for increases in weight and decreases in blood pressure during tests on children which involve higher dosage levels.
Identification of DNA-binding lymphocytes in patients with systemic lupus erythematosus.
Authors: A D Bankhurst, R C Williams
Journal: Journal of Clinical Investigation (1975)

Antigen-ginding lymphocytes capable of binding native DNA (DNA-ABC) were identified in the peripheral blood of normal controls and patients with systemic lupus erythematosus (SLE) by autoradiography with 125I-nDNA. 12 patients with active SLE had 404 +/- 273 (mean +/- SD) DNA-ABC/105 lymphocytes, while 7 inactive SLE patients and 13 normals had 120 +/- 48 and 48 +/- 36, respectively. All three groups were significantly different from one another (p less than 0.01). No significant correlation was detected between the quantity of anti-native DNA (nDNA) antibody and number of DNA-ABC; however, most patients with large amounts of anti-nDNA antibody had both active disease and large numbers of DNA-ABC. Numbers of DNA-ABC and lymphocytes with surface immunoglobulin (Ig) did not change significantly after an 18-h incubation at 37degreeC. After depletion of B-lymphocytes by passage over bead columns coated with a complex of IgG and anti-IgG, the great majority of DNA-ABC were removed in both normal subjects and SLE patients. Labeling lymphocytes sequentially with 125I-nDNA, followed by an indirect fluorescence technique for identification of surface Ig, indicated that the great mahority of radiolabeled cells had surface Ig by fluorescence microscopy in four normals (average 93%) and five patients with active SLF (average 82%). The predominance of nDNA-sensitive B-lymphocytes in the peripheral blood of both normals and SLE patients is consistent with the concept that the induction of the anti-nDNA antibody response is due to the stimulation of preexisting nDNA-specific B lymphocytes by mechanisms other than those necessarily involving participation of nDNA-specific T lymphocytes.
546 Infection of primary human macrophages with hepatitis C virus in vitro: Induction of tumor necrosis factor alpha and interleukin 8
Authors: T LASKUS, M RADKOWSKI, M NOWICKI, J WILKINSON, D ADAIR, A HORBAN, J RAKELA
Journal: Hepatology (2003)

Peritoneal macrophages were collected from juvenile turtles 72 h after intraperitoneal inoculation with a 3% Sephadex suspension. The macrophages were assayed for their chemiluminescent (CL) properties, reflecting their respiratory burst activity, after stimulation with Zymosan A, phorbol 12-myristate 13-acetate (PMA), N-formyl-methionyl-leucyl-phenylalanine (fMLP), and calcium ionophore A23187. Except for fMLP, all triggering agents induced a marked CL response. Luminol was used as the chemiluminescent probe. When comparing CL responses in temperatures ranging from 15 to 35°C, lower assay temperatures induced lower and slower CL responses. Stimulation with viable Salmonella muenchen resulted in a distinct response. Bacteria, inactivated by means of heat or acetone, induced a faster and stronger oxidative burst. Opsonization of either viable or heat-inactivated S. muenchen with non-inactivated anti-S. muenchen serum, prepared in turtles, induced faster and higher CL responses. On the other hand, opsonization of acetone-inactivated S. muenchen caused CL responses to be slower and weaker. S. muenchen, opsonized with heat-inactivated turtle anti S. muenchen serum, induced higher responses than non-opsonized bacteria, but slower and weaker responses than bacteria opsonized with native turtle antiserum. No response was recorded after stimulation with LPS and the supernatant of heat-inactivated bacteria.
Unit for Alcoholics
Authors: M. M. Glatt
Journal: BMJ (1956)

Unit for Alcoholics SIR,-Commenting on the opening of a unit for alcoholics in Belfast you state (Jourpal, June 2, p. 1310) that, " although the treatment of chronic alcoholics is undertaken in a number of hospitals, special units for these patients are few and far between."No officially recognized units for alcoholics exist in England and Wales, and there are apparently no more than two hospitals with a few beds set aside for the care of these patients, both with long waiting-lists.Is there a need for such units ?Doctors specially interested in the problem of alcoholism have repeatedly stressed how woefully inadequate the present facilities are for the treat- ment of alcoholic patients under the N.H.S.1 2 For the past three weeks we had at least one daily request for the urgent admission of alcoholic patients to this hospital, coming from doctors, social workers, or probation officers.The offer to put the patient on a waiting-list is of course quite a ridiculous reply to such urgent requests.But what are the alternatives ?If the patient has private means, he has the choice of quite a number of homes in which he can receive specialized care and treatment.For the great majority of sufferers from alcoholism the only possibilities seem to be admission to an observation ward for a few days or be- coming a voluntary patient in the local mental hospital.However, most alcoholics are reluctant to go to mental hospitals, where they believe they are not really welcome and where they feel rather out of place, as usually there are no other alcoholic patients.Thus the alcoholic, after being sobered up and detoxicated, usually takes his discharge, only to continue his rounds of court attendances and hospital admissions, becoming more frustrated, more resentful, and a more difficult patient with each subsequent hospital admission.However, not only American experiences but also those of many doctors in this country who are treating alcoholics have helped to explode the common misconceptions that alcoholics are uncooperative and hopeless patients.Given adequate facilities, the alcoholic can be helped and he is well worth while helpihg.If, for example, alcoholics are admitted to a hospital where they find a number of other alcoholic patients they will be found to be very co-operative and pleasant patients.Moreover, due to their intelligence, drive, and ability, they contribute a great deal to the hospital community as a whole.3As stated in your annotation " Alcoholism and Mortality" (Journal, June 9, p. 1350) the number of deaths from liver cirrhosis in England and Wales has declined markedly since the beginning of the century, but has shown again a slight increase in the past few years.Changes in the death rate from liver cirrhosis are said to indicate changes in the rate of alcoholism.'In 1948 the number of " chronic alcoholics " (that is, those alcoholics showing complications) in England
Improved survival of gastric cancer with tumour Epstein–Barr virus positivity: an international pooled analysis
Authors: M Constanza Camargo, Woo-Ho Kim, Anna Maria Chiaravalli, Kyoung-Mee Kim, Alejandro H Corvalan, Keitaro Matsuo, Jun Yu, Joseph J Y Sung, Roberto Herrera-Goepfert, Fernando Meneses-Gonzalez, Yuko Kijima, Shoji Natsugoe, Linda M Liao, Jolanta Lissowska, Sung Kim, Nan Hu, Carlos A Gonzalez, Yashushi Yatabe, Chihaya Koriyama, Stephen M Hewitt, Suminori Akiba, Margaret L Gulley, Philip R Taylor, Charles S Rabkin
Journal: Gut (2013)

<h3>Background and objective</h3> About 9% of gastric carcinomas have Epstein–Barr virus (EBV) in the tumour cells, but it is unclear whether viral presence influences clinical progression. We therefore examined a large multicentre case series for the association of tumour EBV status with survival after gastric cancer diagnosis, accounting for surgical stage and other prognostic factors. <h3>Methods</h3> We combined individual-level data on 4599 gastric cancer patients diagnosed between 1976 and 2010 from 13 studies in Asia (n=8), Europe (n=3), and Latin America (n=2). EBV positivity of tumours was assessed by in situ hybridisation. Mortality HRs for EBV positivity were estimated by Cox regression models stratified by study, adjusted for distributions of sex (71% male), age (mean 58 years), stage (52% tumour-node-metastasis stages III or IV), tumour histology (49% poorly differentiated, 57% Lauren intestinal-type), anatomic subsite (70% non-cardia) and year of diagnosis. Variations by study and continent were assessed using study-specific HRs for EBV positivity. <h3>Results</h3> During median 3.0 years follow-up, 49% of patients died. Stage was strongly predictive of mortality, with unadjusted HRs (vs stage I) of 3.1 for stage II, 8.1 for stage III and 13.2 for stage IV. Tumour EBV positivity was 8.2% overall and inversely associated with stage (adjusted OR: 0.79 per unit change). Adjusted for stage and other confounders, EBV positivity was associated with lower mortality (HR, 0.72; 95% CI 0.61 to 0.86), with low heterogeneity among the study populations (p=0.2). The association did not significantly vary across patient or tumour characteristics. There was no significant variation among the three continent-specific HRs (p=0.4). <h3>Conclusions</h3> Our findings suggest that tumour EBV positivity is an additional prognostic indicator in gastric cancer. Further studies are warranted to identify the mechanisms underlying this protective association.
Effective Testimony during Cross-Examination
Authors: R. R. Merliss, Leo Gelfand, Raoul Magana
Journal: New England Journal of Medicine (1959)

ALTHOUGH a few physicians testify frequently, a courtroom appearance is an unusual event for the average practitioner. This inexperience puts him at a serious disadvantage on the occasions when he is called into court and asked to present his opinion to a judge and jury.His lack of "courtroom wisdom" may lead to timidity and uncertainty. His behavior may affect his credibility. He may fall readily into the multiple traps the skilled attorney will set for him, or he may become exasperated by the insistent questioning, and display anger or curtness and antagonize an uncritical jury.Most inexperienced medical witnesses . . .