tbuckley/cabot-search huggingface dataset:
Oral Antihyperglycemic Therapy for Type 2 Diabetes
Authors: Eric S. Holmboe
Journal: JAMA (2002)

Oral agents are the mainstay of pharmacologic treatment for type 2 diabetes, and physicians now have a number of agents to choose from. However, more choices translate into more complex decision making. Many patients with diabetes have associated comorbidities, and most diabetic patients will require more than 1 agent to achieve good glycemic control. This article illustrates several of the pharmacologic approaches to type 2 diabetes through 4 situations that use principles of evidence-based medicine. The scenarios also highlight some of the difficulties in choosing the optimal pharmacologic treatment regimen for individual patients. Physicians should also recognize that type 2 diabetes is a multisystem disorder that requires multidisciplinary care, including education and ongoing counseling for effective patient self-management of the disease. Finally, patient preferences are a vital component of informed decision making for pharmacologic treatment of diabetes.
Legal Abortion: The Continuing Battle
Authors: William J. Curran
Journal: New England Journal of Medicine (1974)

This article surveys recent legislative proposals and court decisions pertaining to abortion. The Health Programs Extension Act of 1973, which is now in force, declares that receipt of federal funds does not authorize a court to force a hospital to perform abortions against the religious or moral convictions of the institution. Included in the act is a provision preventing federally supported hospitals from descriminating against doctors and other staff members who refuse to engage in abortion or sterilization procedures. The first part of this act was upheld in a federal court in Idaho (Watkins vs. Mercy Medical Center) in a case in which a doctor was denied reappointment to the medical staff of a Catholic hospital because of his refusal to abide by the Code of Ethics for Catholic Hospitals, which forbids both abortion and sterilizations. Legislation now pending before Congress can also be described as anti-abortion. The Legal Services Corporation bill contains a provision barring Legal Services attorneys from representing clients in abortion litigation. An amendment to the Medicaid Law prevents federal benefits for abortions. An amendment attached to a bill on medical experimentation would prohibit experimentation on live fetuses. Furthermore, Representative Hogan and Senator Helms have entered into both houses a constitutional amendment designed to protect the fetus "from the moment of conception."
Incidental Finding of Pulmonary Sarcoidosis During Stress Thallium Imaging
Authors: ROBERT D. STOFFEY, ROBERT G. LECKIE, ARTHUR B. BUCKNER
Journal: Clinical Nuclear Medicine (1992)

Uptake of TI-201 in sarcoid lymphadenopathy was an incidental finding during a radionuclide cardiac thallium stress and redistribution study of a 38-year-old black man with abnormal treadmill EKG results suggestive of a false positive study. Mild heterogeneity of the thallium uptake was noted in the myocardium. No ischemia or prior infarct was demonstrated. Interestingly, thallium also was seen in bilateral hilar and right paratracheal regions, most consistent with stage I pulmonary sarcoidosis. A gallium scan and chest radiograph are shown supporting the diagnosis of sarcoidosis, which was not known to the radiologist at the time of the thallium test.
Developmental toxicity of ethylene glycol monopropyl ether acetate (EGPEA) in the rat.
Authors: W J Krasavage, G V Katz
Journal: Environmental Health Perspectives (1984)

Pregnant rats were exposed by inhalation to vapor concentrations of 100, 200, 400 or 800 ppm of ethylene glycol monopropyl ether acetate on days 6 through 15 of gestation. Concentrations of 400 and 800 ppm reduced the feed intake, mean body weight and red blood cell counts. Mean corpuscular volume and mean corpuscular hemoglobin were increased. Clinical signs of toxicity included lethargy and red discolored urine in the dams exposed to 400 or 800 ppm. The incidence of resorptions was significantly increased and the mean fetal body weight was reduced in litters of dams exposed to 800 ppm. Reproductive indices were not affected. Examinations at cesarean section revealed no major external malformations. Internal soft tissue examinations revealed three fetuses with a cardiovascular defect consisting of a right-sided aortic arch. Two of these fetuses were from dams exposed to 800 ppm, while the third was from a control litter. Skeletal examinations revealed no major skeletal malformations, while minor rib anomalies were slightly increased in litters from dams exposed to 400 or 800 ppm of ethylene glycol monopropyl ether acetate. The incidence of common skeletal variants was slightly increased at 200 ppm.
Bacterial Endocarditis Following Aortic Valve Replacement
Authors: LAWRENCE H. COHN, WILLIAM C. ROBERTS, S. DAVID ROCKOFF, ANDREW G. MORROW
Journal: Circulation (1966)

The clinical and pathologic findings in three patients with bacterial infection at the sites of prosthetic aortic valves are described. Each presented typical clinical features of acute bacterial endocarditis followed by the sudden development of severe and ultimately fatal aortic regurgitation. Pathologically the infectious process was characterized by extensive necrosis of the aortic annulus, disruption of the aortic wall, and the formation of abscesses in the periaortic tissues. In two patients the prosthetic valve was partially detached from the annulus, whereas in the other it was totally dislodged and impacted in the aortic arch shortly before death. In all, secondary operative intervention would have been fruitless because of the extent of the infection and the character of the tissue at the aortic root. In one patient fatal staphylococcal endocarditis followed dental extractions despite penicillin prophylaxis. A more comprehensive antibiotic regimen for patients with prosthetic cardiac valves is suggested.
The effect of inhaled lidocaine-hydrofluoroalkane 134a in prednisone-dependent eosinophilic bronchitis
Authors: M. Duong, A. M. Wilson, L. Jayaram, M. Dolovich, F. Hargreave
Journal: European Respiratory Journal (2008)

inflammatory/remodelling process either from current environmental exposure or from a persistent activation of the immune system of undetermined origin.
Gene therapy for nucleus pulposus regeneration by heme oxygenase-1 plasmid DNA carried by mixed polyplex micelles with thermo-responsive heterogeneous coronas
Authors: Ganjun Feng, Hongying Chen, Junjie Li, Qiang Huang, Melanie J Gupte, Hao Liu, Yueming Song, Zhishen Ge
Journal: Biomaterials (2015)
Cytomegalovirus-esophagitis as initial presentation of HIV infection mimicking adenocarcinoma
Authors: G. Weinberg, B. Siegmund, M. Grünbaum, C. Loddenkemper, T. Schneider
Journal: Endoscopy (2010)

A 49-year-old man presented with dysphagia and weight loss of 5 kg within 2 months. An esophagogastroduodenoscopy (EGD) was performed in a community hospital. An ulcerated tumor of the cardia was seen and a biopsy was interpreted as a well-differentiated adenocarcinoma. The patient was referred to our hospital to complete the staging and initiate surgical intervention. The EGD was repeated and the previously described cardiac tumor was confirmed ([Fig. 1]).
Evidence-Based Medicine and the Search for a Science of Clinical Care
Authors: John M. Byrne
Journal: Annals of Internal Medicine (2005)

Medical Writings: Book Notes15 November 2005Evidence-Based Medicine and the Search for a Science of Clinical CareJohn M. Byrne, DOJohn M. Byrne, DOFrom Loma Linda University, School of Medicine, VA Loma Linda Healthcare System Loma Linda, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-10-200511150-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Daly J. 290 pages. Berkeley, CA: Univ California Pr; 2005. $65.00. ISBN 0520243161. Order at www.ucpress.edu.Field of medicine: Evidence-based medicine and clinical epidemiology.Format: Hardcover book.Audience: Teachers, students, and evidence-based medicine practitioners.Purpose: To provide a comprehensive history of the origins and development of evidence-based medicine and its permeation into clinical practice.Content: The author details the emergence of evidence-based medicine as a scientific method for clinical decision making and traces the intellectual contributions of its leaders. She articulates the rationale for evidence-based medicine but also challenges its tenets by enumerating the history and work of its many ... Author, Article, and Disclosure InformationAffiliations: From Loma Linda University, School of Medicine, VA Loma Linda Healthcare System Loma Linda, California. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 November 2005Volume 143, Issue 10Page: 772KeywordsClinical trialsComputer and information sciencesDecision makingEvidence based medicineHealth services researchMedical educationPatientsPublic policySoftware toolsVision ePublished: 15 November 2005 Issue Published: 15 November 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Tight Heart Rate Control Reduces Secondary Adverse Events in Patients With Type B Acute Aortic Dissection
Authors: Kazuhisa Kodama, Kazuhiro Nishigami, Tomohiro Sakamoto, Tadashi Sawamura, Touitsu Hirayama, Hiroyasu Misumi, Koichi Nakao
Journal: Circulation (2008)

Although type B aortic dissection has been treated with beta blockers to lower the arterial blood pressure (BP), there has been little evidences about reduction in heart rate (HR). We assessed whether tight HR control improved the outcome of medical treatment in patients with aortic dissection.From 1997 to 2005, 171 patients with acute aortic dissection medically treated and controlled to lower BP under 120 mm Hg were enrolled. Based on the average HR at 3, 5, and 7 days after the onset, patients were divided into tight HR (<60 beat per minute) control group (32 patients; mean HR of 56.6+/-3.1 beat per minute) and conventional HR (>/=60 beat per minute) control group (139 patients; mean HR of 71.7+/-8.2 beat per minute). We compared the frequency of aortic events including late organ or limb ischemia, aortic rupture, recurrent dissection, and aortic expansion of >5 mm, and surgical requirement between two groups. During a median follow-up of 27.0 months, late organ or limb ischemia, aortic rupture, recurrent dissection, pathological aortic expansion, and aortic surgery occurred in 0, 8, 14, 39, and 26 patients, respectively. Reduction in aortic events was observed in tight HR control group (12.5%) compared to conventional HR control group (36.0%), (Odds ratio: 0.25, C.I.: 0.08 to 0.77, P<0.01).The present study demonstrated that tight heart rate control improved the outcome of medical treatment in patients with aortic dissection.
The Use of a Combination of Carbolic Acid and Chloroform in Enteric Fever
Authors: R. H. Quill
Journal: BMJ (1894)

M-RIRCAL JOURA 909 and other observers.By the differences in the character of their flagella Nicolle and Morax divide tlle spirillum of cholera and its allies into three types: Type I.A non-motile Indian spirillum from Koch's laboratory not having flagella.II.Motile spirilla having flagella.Type A. Having one flagellum at one end or two flagella one at each end.(Sources-Shanghai, Hamburg, Courbevoic, Seine water, and sp.Deneke.)Loeffler, Trenkmann, Neuhaus, and Straus had already noticed this.Type B
Hydrophobic adhesin of E coli in ulcerative colitis.
Authors: D A Burke, A T Axon
Journal: Gut (1988)

Pathogenic E coli have adhesive properties which are mirrored by an increase in their surface hydrophobicity. E coli isolated from patients with ulcerative colitis possess a mannose resistant adhesin similar to that found in pathogenic E coli. In this study 42 E coli isolates from patients with colitis have been compared with 15 from controls to assess hydrophobicity and cellular adherence. The salting out method and the buccal epithelial cell technique were used respectively. E coli isolated from colitics are significantly more hydrophobic than control E coli (p less than 0.001). The salting out score correlates negatively with the buccal epithelial cell adhesion index. When E coli are grown at 18 degrees C both properties are temporarily reduced suggesting that they are related to each other. The salting out method clearly differentiates between E coli isolated from colitics and controls, and offers a simple method of detecting adhesive E coli in inflammatory bowel disease.
Haemophilia Associated with Normal Coagulation Time
Authors: C. Merskey
Journal: BMJ (1951)

ADDENDUM.-Two years after completing its first tour, the Northamptonshire Mass Radiography Unit went round the county again.The final results of this survey are not yet available, but a preliminary inspection of the records suggests that the incidence of newly discovered active pul- monary tuberculosis among male boot and shoe operatives is now no higher than among men in other occupations.The exact significance of this finding cannot be appreciated until it is known how many of these men were examined for the first time; how many Were new entrants to the industry what type of case was discovered; and what was the age distribution of the population examined.It is, however, likely that boot and shoe factories in Northamptonshire are already reaping the benefits of having had a thorough comb- out of chronic carriers during 1945-6.
Relative Cost Differences Among Physicians' Specialty Practices
Authors: Edmund R. Becker
Journal: JAMA (1988)

Practice costs, defined as those costs of medical practice that exclude the physician's own time and effort, represent a substantial portion of the resources necessary to perform a service. In this article we describe the development of the practice cost index used in constructing the Resource-Based Relative Value Scale (RBRVS). We derived the practice cost index value for each specialty, using specialty-specific practice costs and gross revenue data. The index values for all other specialties are standardized to the value for general surgery, and these are used to adjust the resource-based relative values for services performed by each specialty; in this way, the RBRVS incorporates practice cost variations. The data used in the construction of the practice cost index are the 1983 Physician Practice Cost and Income Survey data, adjusted to reflect the relative levels of 1986 professional liability insurance. Our findings show that, among most specialties, the range of relative difference in practice costs as a percentage of gross revenue is approximately 15%. Four specialties fall outside this range: pathology, psychiatry, rheumatology, and orthopedic surgery. We discuss problems with the available data on practice costs as these relate to their use in the RBRVS and conceptual issues in applying practice costs to the construction of the RBRVS. (<i>JAMA</i>1988;260:2397-2402)
Bacterial Interference and Toxic Shock Syndrome
Authors: J.R. Tagg, G. Peters, E.D. Gray, L.W. Wannamaker
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 December 1983Bacterial Interference and Toxic Shock SyndromeJ.R. TAGG, PH.D., G. PETERS, M.D., E.D. GRAY, PH.D., L.W. WANNAMAKER, M.D.J.R. TAGG, PH.D.Search for more papers by this author, G. PETERS, M.D.Search for more papers by this author, E.D. GRAY, PH.D.Search for more papers by this author, L.W. WANNAMAKER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-6-879_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Although an etiologic association between toxic shock syndrome and vaginal colonization withStaphylococcus aureusis generally accepted as being beyond doubt, many questions regarding the pathogenesis of the syndrome remain unanswered. The ability of potentially pathogenic bacteria to colonize body surfaces may be enhanced by their production of inhibitory substances that restrict the growth of other bacteria (1). Evaluation of bacteriocin production by strains ofS. aureus associated with toxic shock syndrome has been our primary interest. These proteinaceous antibiotic agents have inhibitory activity directed predominantly against other bacteria of either the same or closely-related species (2)....References1. WANNAMAKER L. Bacterial interference and competition. Scand J Infect Dis. 1980;24:82-5. Google Scholar2. TAGGDAJANIWANNAMAKER JAL. Bacteriocins of gram-positive bacteria. Bacteriol Rev. 1976;40:722-56. CrossrefMedlineGoogle Scholar3. DAJANIWANNAMAKER AL. Bacteriocin of phage type 71 S. aureus. Ann NY Acad Sci. 1974;236:389-94. CrossrefMedlineGoogle Scholar4. TAGGBANNISTER JL. "Fingerprinting" β-haemolytic streptococci by their production of and sensitivity to bacteriocine-like inhibitors. J Med Microbiol. 1979;12:397-411. CrossrefMedlineGoogle Scholar5. KREISWIRTHLOFOLAHLBETLEYBERGDOLLSCHLIEVERTNOVICK BSMMPR. Cloning a toxic shock syndrome antigen. [Abstract]. Abstracts of the Annual Meeting of the American Society of Microbiology. 1983;59:D3. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Division of Infectious Diseases University of Minnesota Minneapolis, MN 55455 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySyntheses and Reactions of Bicyclic Heterocyclic Nucleosides and NucleotidesLantibiotic-mediated anti-lactobacillus activity of a vaginal Staphylococcus aureus isolate 1 December 1983Volume 99, Issue 6Page: 879-880KeywordsAntibioticsBacteriaBacterial pathogensPathogenesisProteinsStaphylococcus aureusToxic shock syndrome ePublished: 1 December 2008 Issue Published: 1 December 1983 PDF downloadLoading ...
Cost effectiveness of heart drugs varies widely, study shows
Authors: Roger Dobson
Journal: BMJ (2007)

The government has admitted that it will have to wait years before it discovers whether there are real productivity gains from the new consultants' contract.NHS leaders also told the House of Commons Committee of Public Accounts last week that lessons had been learnt from mistakes made when the contract was introduced, such as not piloting it before implementation.They were giving evidence as part of the committee's inquiry into the consultants' contract.The session was prompted by the publication earlier this month of a report from the government's
Payment Reform for Safety-Net Institutions — Improving Quality and Outcomes
Authors: C. Jason Wang, Kathleen N. Conroy, Barry Zuckerman
Journal: New England Journal of Medicine (2009)

In the U.S. health care system today, many hospitals have the market power to raise the prices of their services without showing evidence of improvements in the quality of care.1 In an effort to realign incentives, health care reformers are now proposing to link provider payments to quality of care and health outcomes. As we move toward such a payment system, however, we must ensure that reimbursement is adjusted for patients' coexisting conditions so that hospitals cannot get high marks for quality by choosing to treat only patients who are considered to be at low risk.Although risk adjustment has . . .
Preliminary Observations on the Use of Topical Tazarotene to Treat Basal-Cell Carcinoma
Authors: Ketty Peris, Maria Concetta Fargnoli, Sergio Chimenti
Journal: New England Journal of Medicine (1999)

To the Editor: Tazarotene is a novel receptor-selective retinoid originally developed for the topical treatment of mild-to-moderate plaque psoriasis.1 On the basis of recent hypotheses about the effects of this agent on the differentiation and proliferation of keratinocytes,2 we performed an open-label clinical trial to evaluate the efficacy and tolerability of topical tazarotene (0.1 percent in gel) in the treatment of basal-cell carcinoma. Patients were not eligible for treatment if they had received any therapy for basal-cell carcinoma within four weeks before enrollment in the study. Twenty patients with basal-cell carcinoma (11 men and 9 women; age range, 37 to . . .
Patient and Clinician Perceptions of Therapeutic Alliance as Predictors of Improvement in Depression
Authors: Marleen De Bolle, Jeffrey G. Johnson, Filip De Fruyt
Journal: Psychotherapy and Psychosomatics (2010)

&lt;i&gt;Background:&lt;/i&gt; Meta-analyses have consistently concluded that a positive therapeutic alliance is associated with better clinical outcomes and progress. To date, however, very few studies have focused on sociodemographic or clinical patient characteristics as moderators of alliance. &lt;i&gt;Method:&lt;/i&gt; A multicenter longitudinal treatment outcome study was conducted to investigate the associations of patient and clinician perceptions of the therapeutic alliance with improvement in depression, and to investigate whether these associations were influenced by sociodemographic or clinical characteristics of the patient. Clinician-rated Montgomery Åsberg Depressive Rating Scale scores and both patient- and therapist-rated Helping Alliance Questionnaire (HAQ-I) scores were obtained from 567 outpatients with major depressive disorder who received 6 months of combined psycho- and pharmacotherapy. &lt;i&gt;Results:&lt;/i&gt; Multilevel repeated-measures analyses indicated that patient- and therapist-rated HAQ-I scores, 4 weeks after treatment began, positively predicted subsequent clinical change, controlling for the effect of early improvement and a range of patient characteristics. Next to alliance, early improvement, initial depressive symptom severity, a history of psychiatric disorders, and occupational status affected the rate of clinical improvement. Personality pathology comorbidity, marital and occupational status, and the atypical character of the major depressive episode (MDE) moderated the alliance-outcome relationship, depending on the informant (patient or therapist) of therapeutic alliance. &lt;i&gt;Conclusions:&lt;/i&gt; The present findings suggest that therapist and patient ratings of therapeutic alliance predict therapeutic progress, and that this relation may be moderated by client characteristics, including personality pathology comorbidity, marital status, occupational status, and the atypical character of the MDE.
Reversing gp100/IFA-induced impairment of anti-CTLA-4 checkpoint blockade therapy
Authors: Yared Hailemichael, Tihui Fu, Hiep Khong, Zhimin Dai, Padmanee Sharma, Willem W Overwijk
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Cancer immunotherapies have been advanced by the recent FDA approval of anti-CTLA-4 antibody (Ipilimumab, Yervoy®) and soon-to-be approved anti-PD-1 antibody, immunological checkpoint-blocking agents with significant anti-tumor activity against melanoma and other cancers. A