tbuckley/cabot-search huggingface dataset:
Buprenorphine Treatment for Hospitalized, Opioid-Dependent Patients
Authors: Jane M. Liebschutz, Denise Crooks, Debra Herman, Bradley Anderson, Judith Tsui, Lidia Z. Meshesha, Shernaz Dossabhoy, Michael Stein
Journal: JAMA Internal Medicine (2014)

Buprenorphine opioid agonist treatment (OAT) has established efficacy for treating opioid dependency among persons seeking addiction treatment. However, effectiveness for out-of-treatment, hospitalized patients is not known. To determine whether buprenorphine administration during medical hospitalization and linkage to office-based buprenorphine OAT after discharge increase entry into office-based OAT, increase sustained engagement in OAT, and decrease illicit opioid use at 6 months after hospitalization. From August 1, 2009, through October 31, 2012, a total of 663 hospitalized, opioid-dependent patients in a general medical hospital were identified. Of these, 369 did not meet eligibility criteria. A total of 145 eligible patients consented to participation in the randomized clinical trial. Of these, 139 completed the baseline interview and were assigned to the detoxification (n = 67) or linkage (n = 72) group. Five-day buprenorphine detoxification protocol or buprenorphine induction, intrahospital dose stabilization, and postdischarge transition to maintenance buprenorphine OAT affiliated with the hospital's primary care clinic (linkage). Entry and sustained engagement with buprenorphine OAT at 1, 3, and 6 months (medical record verified) and prior 30-day use of illicit opioids (self-report). During follow-up, linkage participants were more likely to enter buprenorphine OAT than those in the detoxification group (52 [72.2%] vs 8 [11.9%], P < .001). At 6 months, 12 linkage participants (16.7%) and 2 detoxification participants (3.0%) were receiving buprenorphine OAT (P = .007). Compared with those in the detoxification group, participants randomized to the linkage group reported less illicit opioid use in the 30 days before the 6-month interview (incidence rate ratio, 0.60; 95% CI, 0.46-0.73; P < .01) in an intent-to-treat analysis. Compared with an inpatient detoxification protocol, initiation of and linkage to buprenorphine treatment is an effective means for engaging medically hospitalized patients who are not seeking addiction treatment and reduces illicit opioid use 6 months after hospitalization. However, maintaining engagement in treatment remains a challenge. clinicaltrials.gov Identifier: NCT00987961.
Should Patients With Stroke Wear Compression Stockings?
Authors: Nikola Sprigg, Chamila M. Geeganage, Philip M.W. Bath
Journal: Annals of Internal Medicine (2011)

Letters5 April 2011Should Patients With Stroke Wear Compression Stockings?Nikola Sprigg, MD, Chamila M. Geeganage, PhD, and Philip M.W. Bath, MDNikola Sprigg, MDFrom The University of Nottingham, Nottingham NG5 1PB, United Kingdom.Search for more papers by this author, Chamila M. Geeganage, PhDFrom The University of Nottingham, Nottingham NG5 1PB, United Kingdom.Search for more papers by this author, and Philip M.W. Bath, MDFrom The University of Nottingham, Nottingham NG5 1PB, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-7-201104050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kearon and O'Donnell's editorial (1) suggests that the lack of evidence in favor of using compression stockings supports the recommendations of the American College of Chest Physicians and the American Heart Association for the use of low-dose unfractionated heparin and low-molecular-weight heparin in patients with acute ischemic stroke and immobility who have no contraindications to anticoagulant therapy. However, this advice assumes that the balance of benefits and harms favors reducing the incidence of venous thromboembolism (VTE) over increasing the incidence of symptomatic intracerebral hemorrhage (SICH). It is unfortunate that data from large trials, such as the IST ...References1. Kearon C, O'Donnell M. Should patients with stroke wear compression stockings to prevent venous thromboembolism? [Editorial]. Ann Intern Med. 2010;153:610-1. [PMID: 20855785] LinkGoogle Scholar2. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet. 1997;349:1569-81. [PMID: 9174558] Google Scholar3. Bath PM, Lindenstrom E, Boysen G, De Deyn P, Friis P, Leys D, et al. Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. Lancet. 2001;358:702-10. [PMID: 11551576] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The University of Nottingham, Nottingham NG5 1PB, United Kingdom.Disclosures: Professor Philip Bath was the principal investigator of TAIST. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoShould Patients With Stroke Wear Compression Stockings to Prevent Venous Thromboembolism? Clive Kearon and Martin O'Donnell Should Patients With Stroke Wear Compression Stockings? Clive Kearon and Martin O'Donnell Metrics 5 April 2011Volume 154, Issue 7Page: 506KeywordsHemorrhageHeparinIschemic strokeNursesPulmonary embolismStrokeThoraxVenous thromboembolism ePublished: 5 April 2011 Issue Published: 5 April 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Onward with Chiropractic
Authors: Saul S. Radovsky
Journal: New England Journal of Medicine (1975)

Albert Einstein's famous search for a unified field theory failed, but Daniel Palmer was more fortunate. In 1895 he came up with a unified theory of disease with a single cause for which he devised a single treatment, thus cutting away the encumbering science of before and since and extracting the essence: the doctor–patient relation. Einstein's postulate, that the simplest explanation for natural phenomena was usually best, was constrained to take all phenomena into account. Palmer's was a freer spirit, unbounded by such constraints. Today, which of us ought not envy his disciples their one diagnosis and treatment, since their . . .
Oxygen, Food, and Air Travel
Authors: Rolando Berger
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 February 1990Oxygen, Food, and Air TravelRolando Berger, MDRolando Berger, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-3-236_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: I enjoyed reading Dr. Hansen's clever letter (1) regarding the article by Dillard and colleagues (2) on the oxygen requirements of patients with lung disease who must travel by airplane. I am a bit concerned, however, about his unqualified recommendation that patients with borderline hypoxemia should drink or eat a carbohydrate-rich diet before and during flights.Dr. Hansen is essentially correct in stating that in a patient with a partial pressure of arterial carbon dioxide (PaCO2) of 40 mm Hg, increasing the respiratory quotient (Rq) value from 0.75 to 0.95 would result in an increase in the...References1. Hansen J. Diet and flight hypoxemia. Ann Intern Med. 1989;111:859-60. LinkGoogle Scholar2. Dillard T, Berg B, Rajagopal K, Dooley J, and Mehm W. Hypoxemia during air travel in patients with chronic obstructive pulmonary disease. Ann Intern Med. 1989;111:362-7. LinkGoogle Scholar3. Covelli H, Black J, Olasen M, and Beekman J. Respiratory failure precipitated by high carbohydrate loads. Ann Intern Med. 1981;95:579-85. LinkGoogle Scholar4. Gieske T, Gurnshanthaigh G, and Glauser F. Effects of carbohydrates on carbon dioxide excretion in patients with airway disease. Chest. 1977;71:55-8. CrossrefMedlineGoogle Scholar5. Kwan R and Afzal M. Beneficial effects of dietary carbohydrate restriction in chronic cor pulmonale. Am J Med. 1987;82:751-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Rolando Berger, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAir Travel and Oxygen Therapy in Cardiopulmonary Patients 1 February 1990Volume 112, Issue 3 Page: 236-236 Keywords Carbon dioxide Diet Food Hypoxia Leprosy Lungs Oxygen ePublished: 1 December 2008 Issue Published: 1 February 1990 PDF downloadLoading ...
Acromegaly and Colon Cancer
Authors: MICHAEL M. RITTER
Journal: Annals of Internal Medicine (1987)

ExcerptTo the editor: An association between neoplastic lesions in the colon and acromegaly has been reported (1-3). To the best of our knowledge we report the first instance of two cases of synchronous colonic cancer 12 years after successful surgery for acromegaly.A 61-year-old white woman had been well until 17 years ago when she noticed a change in appearance and that her wedding ring, her old gloves, shoes, and hats had become too tight. Five years later the typical features of acromegaly, including carpal tunnel syndrome, macroglossia, a deep voice, and a 7-year history of oligomenorrhea were present. The...
Effect of selective A1 adenosine receptor antagonism of postdefibrillation cardiovascular depression: evidence for an antiadrenergic role of endogenous adenosine
Authors: R. C Wesley, D. Porzio, M. Sadeghi
Journal: Cardiovascular Research (1993)

The aim was to examine the effect of a selective A1 adenosine receptor antagonist (N-0861) on postdefibrillation cardiovascular depression to determine whether antagonist mediated enhanced postdefibrillation haemodynamic recovery is due to reversal of the antiadrenergic action of adenosine, an A1 receptor mediated effect.Halothane-nitrous oxide anaesthetised Duroc pigs of either sex, weight 22-25 kg, were subjected to sequential episodes of induced ventricular fibrillation lasting either 15 s (terminated by a suprathreshold shock at 60-70 A) or 35 s (subjected to a subthreshold shock at 20 A followed by a suprathreshold shock at 60-70 A) during intravenous placebo infusion (n = 10), N-0861 infusion (0.1 mg.kg-1.min-1, n = 10), and N-0861 infusion plus propranolol (2 mg.kg-1, n = 6).N-0861 significantly enhanced immediate postdefibrillation electrophysiological and haemodynamic recovery compared to placebo for ventricular fibrillation episodes lasting 35 s. Over the first 15 s postdefibrillation, N-0861 significantly (p < 0.05) shortened mean cycle length by 55%, increased mean arterial pressure by 33%, and increased the first derivative of left ventricular pressure (an indirect measure of cardiac contractility) by 100% compared to placebo. At 60 s postdefibrillation, when other variables were equal, the first derivative of left ventricular pressure in the presence of N-0861 remained 26% greater than placebo. This effect was completely antagonised by propranolol.(1) Cardiac contractility in the immediate postdefibrillation period is suppressed by the antiadrenergic action of endogenous adenosine. (2) Selective A1 adenosine receptor antagonism can markedly enhance postdefibrillation contractility. (3) These results support an antiadrenergic role of endogenous adenosine under pathophysiological conditions.
Coeliac disease in the father affects the newborn
Authors: J F Ludvigsson, J Ludvigsson
Journal: Gut (2001)

BACKGROUND AND AIMS Untreated coeliac disease in the mother is associated with lower birth weight. We examined the risk of adverse neonatal outcome when the infant's mother, father, or other relative suffered from known coeliac disease. METHODS Mothers answered a questionnaire a few days after the birth of their infant. Of a total of 10597 single birth infants from Southeast Sweden, 53 infants had a mother with coeliac disease (father 27, sibling 70, other close relative 442). Adjusted odds ratios and adjusted differences for neonatal outcome were calculated. RESULTS Infants whose father suffered from coeliac disease had a lower birth weight (95% adjusted confidence interval (CI) −459, −72 g), more often belonged to the low birth weight (LBW) category (LBW ⩽2499 g) (95% CI adjusted odds ratio (AOR) 1.48–17.18), and had a shorter pregnancy duration (95% adjusted CI −1.53, −0.08 weeks) than non-coeliac controls. They also weighed less than infants whose father suffered from other autoimmune diseases (95% CI −549, −93 g). Infants whose mother suffered from coeliac disease had a lower birth weight (95% adjusted CI −370, −74 g) and more often belonged to the LBW category (95% CI AOR 2.60–15.08) than non-coeliac controls. These infants were more often in the LBW category than infants whose mother suffered from non-diabetic autoimmune diseases (95% CI AOR 1.24–9.65). Coeliac disease in other relatives was not associated with any adverse effect on neonatal outcome. CONCLUSIONS This study suggests that even treated coeliac disease, in either of the parents, has a negative effect on pregnancy, resulting in lower birth weight and perhaps shorter duration of pregnancy.
Long life still hard on the brain
Authors: Stacie Bloom
Journal: Journal of Clinical Investigation (2005)

The average life expectancy in the US has hit a record high of 77.6 years. The Centers for Disease Control attribute this statistic to declining death rates from heart disease, cancer, stroke, HIV/AIDS, drug abuse, and firearms. But as the aging population increases, so does the risk for age-related syndromes such as Parkinson disease (PD) and Alzheimer disease (AD), for which there are no cures. Recent research offers a better understanding of the etiology of these neurodegenerative diseases and hope for future treatment. In the February 25, 2005, issue of Science, researchers discovered axonal defects that precede known AD pathology — swellings along axons containing cellular motor proteins, organelles, and vesicles (1). Hindering the axonal motor transport machinery amplified the frequency of these defects and increased amyloid deposits in the brains of mice with AD. These findings indicate that decreased axonal transport might promote the formation of senile plaques characteristic of AD. Another study, published in the April issue of the American Journal of Human Genetics, shows that a novel mutation in the leucine-rich repeat kinase 2 (LRRK2) gene causes a genetic component of PD in several families (2). These new insights into the pathophysiology of age-related neurodegenerative diseases will help ease the burden on the growing elderly population.
Coronary flow pattern in the left anterior descending artery could predict systolic function recovery after primary angioplasty: A transthoracic doppler echocardiography study
Authors: Gonzalo de la Morena-Valenzuela, Rafael Florenciano-Sánchez, Ramón Rubio-Patón, Federico Soria-Arcos, Manuel Villegas-Garcia, Mariano Valdés-Chávarri
Journal: Journal of the American College of Cardiology (2003)
B is for British
Authors: Fiona Godlee
Journal: BMJ (2006)

It's traditional at the BMJ to worry about the B. It stands for British in case you didn't know. On the one hand we are very proud of it but sometimes it seems to stand between us and our international aspirations. A few years ago our editorial board seriously discussed changing the name to the Global or the World Medical Journal . Nothing happened so I guess the decision was no.

Now I have a new worry. Have we become the English Medical Journal ? So much of our coverage is about England, so little about the other …
Let’s put worry about computer security into perspective
Authors: J E F Fitzgerald, A Nikkar-Esfahani, A A B Jamjoom, K K Shah, A G Acheson
Journal: BMJ (2008)

Vitamin D deficiency is widespread in Scotland I agree with Holick 1 and Sievenpiper et al 2 about the urgent need to highlight the neglected subject of vitamin D deficiency in the United Kingdom.We have found in our general practice in Edinburgh a (to us) surprisingly high prevalence of gross vitamin D deficiency.The deficiency affects not only our South Asian patients but also a considerable number of those with white skin colour.Between 2005 and 2007, blood samples were taken from 99 patients aged 15-85.We included patients suspected of having a possible vitamin D deficiency: patients of South Asian origin or other ethnic minorities, patients with vague musculoskeletal symptoms or overweight, patients taking antiepileptic drugs, patients using sunscreen or make up, housebound patients, and patients with little exposure to sunlight.The figure shows our as yet unpublished results.According to the definitions of most vitamin D researchers, insufficient vitamin D concentrations are those below 75 nmol/l.In our sample only 2% had a sufficient vitamin D concentration.Measurements below 25 nmol/l are defined as severe deficiency; in our sample, the proportion was 47%.We select the letters for these pages from the rapid responses posted on bmj.com favouring those received within five days of publication of the article to which they refer.Letters are thus an early selection of rapid responses on a particular topic.
Kansas doctor who performed late term abortions is acquitted
Authors: J. H. Tanne
Journal: BMJ (2009)

George Tiller, a Kansas doctor who is one of the few doctors in the United States to perform late abortions, has been acquitted on 19 counts of criminal misdemeanour. The jury of three men and three women in Wichita took less than an hour to reach its decision.

The case may play a part in hearings beginning on 31 March on the nomination of the governor of Kansas, Kathleen Sebelius, as head of the US Department of Health and Human Services.

Ms Sebelius, a Catholic, has said she opposes abortion, but she vetoed a law that would have placed further restrictions on abortion in Kansas. However, on 27 March she signed a bill that requires abortion clinics to …
High prevalence of storage mite sensitization in a general adult population
Authors: C. Vidal, O. Boquete, F. Gude, J. Rey, L. M. Meijide, M. C. Fernández‐Merino, A. González‐Quintela
Journal: Allergy (2004)

Background and aim: Occupational and nonoccupational storage mite (SM) allergy has received considerable attention in recent years. The study aimed to evaluate both the prevalence and factors associated with sensitization to SMs in a general adult population from a warm and humid area where mites are the predominant allergens. Patients and methods: An age‐stratified random sample of 720 subjects was drawn from the population older than 18 years of A‐Estrada (Galicia, Spain). From 697 eligible subjects, 469 (67%, median age 54 years, range 18–92 years, 44% males, 75% of cases from a rural environment) agreed to participate. Skin prick tests to SMs ( Lepidoglyphus destructor and Tyrophagus putrescentiae ), house dust mite ( Dermatophagoides pteronyssinus ), pollens, moulds and animal danders were performed in all cases. Wheals ≥ 4 mm were considered positive. Epidemiological data were assessed by questionnaire. A design‐based analysis was performed and all calculations were weighted to give unbiased estimates. Results: Tyrophagus putrescentiae and L. destructor were the leading causes of allergic sensitization throughout all ages. SM sensitization was found in 104 cases (weighted value 24.4%, 95% CI 20.6–28.2). SM sensitization was inversely associated with age. Multivariate analysis showed that SM sensitization was not significantly associated with sex, smoking, educational level, farming profession, rural environment, indoor humidity, presence of pets, livestock or grain storage facilities near home. Conclusions: SMs ( T. putrescentiae and L. destructor ) are major aeroallergens in adults in the region studied, even in subjects without occupational exposure.
Vitamin-D-Resistant Osteomalacia in Hemodialysis Patients Lacking Secondary Hyperparathyroidism
Authors: ANTHONY B. HODSMAN
Journal: Annals of Internal Medicine (1981)

We describe a sporadic, vitamin-D-resistant osteomalacic syndrome in 19 patients undergoing hemodialysis. The syndrome was found in less than 1.5% of patients from referring dialysis centers. All 19 patients had multiple fractures, severe myopathy, and many developed spontaneous hypercalcemia. Severe osteomalacia without evidence of secondary hyperparathyroidism distinguished this syndrome from other forms of renal osteodystrophy. Bone aluminum, measured in six patients, was greatly elevated. Therapy with calcitriol (1α, 25-dihydroxycholecalciferol) led to clinical improvement in seven patients with reduced pain and myopathy, decreased serum alkaline phosphatase, or both, but no improvement in bone histology. Patients who did not respond clinically to calcitriol developed marked hypercalcemia. The cause of this severe osteomalacia, which occurs despite normal or slightly elevated levels of serum calcium and phosphorus and fails to mineralize with calcitriol, is unclear.
Corynebacterium parvum for malignant pleural effusions.
Authors: V Foresti
Journal: Thorax (1995)

agement of malignant pleural effusion.Thoracoscopic inspection of the pleural space provides optimal conditions for effective pleurodesis by facilitating a dry pleural cavity and may be more important, with regard to success, than the choice of sclerosant.Nevertheless his experience with talc is most in- teresting, and we agree that further data in the form of a prospective randomised trial are required to clarify management which remains largely a matter of personal experience and reflects local expertise.
THE TREATMENT OF DELIRIUM TREMENS WITH INSULIN IN SUB-SHOCK DOSES
Authors: G. WILSE ROBINSON
Journal: American Journal of Psychiatry (1940)

Insulin with carbohydrates seems at this time to be the only method of treating delirium tremens which has improved upon the statistical results reported by Kraepelin, who used diet, support and paraldehyde for rest. Insulin is effective because it rapidly re-establishes normal carbohydrate metabolism. It likewise quickly replaces deficient glycogen reserves in the liver. These two factors, which are part of the same process, re-vitalize the liver and re-establish normal protein and fat metabolism. During the period of deficient carbohydrate metabolism and deficient liver function, toxic intermediate products of abnormal protein and fat metabolism have become so concentrated that they have produced the pathology and symptoms of delirium tremens. Re-establishment of the liver function advances the progress of metabolism, and these products are carried forward to their ultimate normal, less noxious end products. This reduces toxic concentrations, removes the "irritative" factor, the cerebral pathology reverses itself by natural processes, and the delirium is quickly relieved. Insulin therapy is rapid, effective and simple to administer. The series presented by Steck and by me had a combined time for complete clearing of the delirium of 2.5 days.
OUTCOMES WITH THE USE OF INTRAVASCULAR ULTRASOUND FOR THE TREATMENT OF COMPLEX BIFURCATION LESIONS
Authors: Yogesh Patel, Jeremiah Depta, Kory Lavine, Cory Foster, Michael Yeung, Sudeshna Banerjee, Eric Novak, Richard Bach, Alan Zajarias, Howard Kurz, John Lasala, Jasvindar Singh
Journal: Journal of the American College of Cardiology (2011)
Review: In older patients without CVD, statins reduce MI and stroke but not all-cause mortality
Authors: Saul Schaefer
Journal: Annals of Internal Medicine (2014)

Source Citation Savarese G, Gotto AM Jr, Paolillo S, et al. Benefits of statins in elderly subjects without established cardiovascular disease: a meta-analysis. J Am Coll Cardiol. 2013;62:2090-9. 23954343