tbuckley/cabot-search huggingface dataset:
Forecasting Physician Workforce Requirements
Authors: Phillip R. Kletke
Journal: JAMA (1995)

To the Editor.  —In Dr Weiner's recent analysis of the effects of health system reform on future physician workforce requirements, 1 he concluded that if there is universal insurance coverage and significant increases in managed care by the year 2000, there will be a surplus of 165000 patient-care physicians. However, Weiner's analysis does not indicate that there will be a physician surplus nearly as large in any case, regardless of whether any reform policies are implemented.  A thorough examination 2 of Weiner's assumptions and methods reveals that the growth of the physician population is the driving force behind the future physician surplus. This is not apparent in Weiner's analysis because he did not compare the results of his forecast for the reformed health care system with a baseline scenario that assumes the current health care delivery system remains at status quo—that is, with no change in insurance coverage or managed
A Textbook of Pathology: Structure and Function in Disease
Authors: Martin A. Swerdlow
Journal: JAMA (1970)

It is often said of a textbook that it is good for students, graduates, practitioners, experts, and others, which kindly interpreted usually means that it is not particularly good for anyone. This book, as Dr. Boyd states very clearly not only in the preface but indirectly between every line in the book, is indeed a book for students, for undergraduate students. This classic, now in its eighth edition, first appeared in 1932. It is a standard text, organized in the usual manner into two sections—<i>Principles of Pathology and Regional Pathology</i>(essentially organ pathology). The book has been updated by Dr. Boyd and newer concepts and information given a proper emphasis. It is well referenced, again from the viewpoint of the student, not for the graduate scientist doing a research project. The book makes a fairly effective integration of the mountains of facts and there is, in my opinion, a
Growth in US healthcare spending is at slowest in 50 years
Authors: B. Roehr
Journal: BMJ (2010)

Spending on health care in the United States grew by 4.4% in 2008, the lowest rate in the nearly 50 years since the federal government began tracking the figure, says an annual report prepared by the federal agency the Centers for Medicare and Medicaid Services.

The fall in the growth rate was attributed to belt tightening under the current economic recession, though the rate continued to outpace the overall growth in the economy, which was 3.3% in 2008.

Healthcare spending rose from 15.9% to 16.2% of gross domestic product during 2008, the report says ( Health Affairs 2010;29:147-55, doi:10.1377/hlthaff.2009.0839). In total, spending on health care …
Contribution of a General-practitioner Hospital
Authors: D. Kyle
Journal: BMJ (1971)

A properly functioning general-practitioner hospital with good facilities including visiting consultants can greatly lighten the work load of the district general hospital. A general-practitioner hospital is described, run entirely by general practitioners, which cares for over 70% of the inpatients of a group practice. It deals with 98% of all who attend casualty, and carries out almost all of its <i>x</i>-ray work. Its facilities reduce the estimated demand for outpatient appointments at the district general hospital by almost half. The social advantages of a general-practitioner hospital are obvious, and there may be economic advantages as well. Moreover, such a hospital increases the attractiveness of general practice and improves its quality. It is suggested that the general-practitioner hospital is good for the patient, the community, and the doctor—and even the Treasury. There is room for many more.
PET/CT Imaging of Metastatic Deposit in Vertebral Paget??s Disease
Authors: Ba D. Nguyen, Panol C. Ram, Michael C. Roarke
Journal: Clinical Nuclear Medicine (2005)

Metastatic involvement in monostotic Paget's disease is an event of uncommon occurrence. An osseous metastasis, clinically and radiologically difficult to differentiate from sarcomatous degeneration, is often unexpectedly discovered during evaluation for malignant transformation of Paget's disease. The authors present a case of recurrent nonsmall cell lung carcinoma with PET/CT imaging instrumental in the diagnostic biopsy of a metastatic deposit in a pagetoid lumbar vertebra.
Histone Deacetylase Inhibition Increases Levels of Choline Kinase α and Phosphocholine Facilitating Noninvasive Imaging in Human Cancers
Authors: Mounia Beloueche-Babari, Vaitha Arunan, Helen Troy, Robert H. te Poele, Anne-Christine Wong Te Fong, L. Elizabeth Jackson, Geoffrey S. Payne, John R. Griffiths, Ian R. Judson, Paul Workman, Martin O. Leach, Yuen-Li Chung
Journal: Cancer Research (2011)

Histone deacetylase (HDAC) inhibitors are currently approved for cutaneous T-cell lymphoma and are in mid-late stage trials for other cancers. The HDAC inhibitors LAQ824 and SAHA increase phosphocholine (PC) levels in human colon cancer cells and tumor xenografts as observed by magnetic resonance spectroscopy (MRS). In this study, we show that belinostat, an HDAC inhibitor with an alternative chemical scaffold, also caused a rise in cellular PC content that was detectable by (1)H and (31)P MRS in prostate and colon carcinoma cells. In addition, (1)H MRS showed an increase in branched chain amino acid and alanine concentrations. (13)C-choline labeling indicated that the rise in PC resulted from increased de novo synthesis and correlated with an induction of choline kinase α expression. Furthermore, metabolic labeling experiments with (13)C-glucose showed that differential glucose routing favored alanine formation at the expense of lactate production. Additional analysis revealed increases in the choline/water and phosphomonoester (including PC)/total phosphate ratios in vivo. Together, our findings provide mechanistic insights into the impact of HDAC inhibition on cancer cell metabolism and highlight PC as a candidate noninvasive imaging biomarker for monitoring the action of HDAC inhibitors.
Epigenetic Regulation of Vitamin D Metabolism in Human Lung Adenocarcinoma
Authors: Nithya Ramnath, Ernest Nadal, Chae Kyung Jeon, Juan Sandoval, Justin Colacino, Laura S. Rozek, Paul J. Christensen, Manel Esteller, David G. Beer, So Hee Kim
Journal: Journal of Thoracic Oncology (2014)
IMMORTALIZED MOUSE ADIPOSE STEM CELL LINES RETAIN STEM CELL PROPERTIES IN A LONG-TERM CULTURE AND IMPROVE FUNCTION OF INFARCTED RAT HEARTS
Authors: Jong-Ho Kim, Chi-Yeon Park, Jae Hyoung Park, Seung-Cheol Choi, Ji-Hyun Choi, Kuy-Sook Lee, Jesang Kim, Chul Min Ahn, Soon Jun Hong, Do-Sun Lim
Journal: Journal of the American College of Cardiology (2012)
Detection of unrecognised nocturnal hypoglycaemia in insulin-treated diabetics.
Authors: C M Asplin, T D Hockaday, R F Smith, R A Moore
Journal: BMJ (1980)

Cortisol to creatinine ratios in overnight urine samples, urinary glucose excretion, and plasma glucose concentrations were determined in 43 diabetic inpatients. All initially had normal cortisol to creatinine ratios (less than 55 x 10(-6)) and were initially treated by increasing their long-acting insulin component. Nine patients in whom this ratio became raised then had their long-acting insulin component reduced until their fasting plasma glucose concentration was 4-7 mol/l (72-126 mg/100 ml). The 34 patients who had never had a raised ratio were treated by increasing their long-acting insulin component until their fasting plasma glucose concentration was in the range 4-7 mmol/l. All the raised cortisol to creatinine ratios were clearly separate from the other values. A mean reduction in total insulin dose of 23% and in long-acting insulin dose of 53% was achieved, abolishing presumptive nocturnal hypoglycaemia by reducing the ratio to normal and dramatically improving diabetic control. Although there was no definite evidence that the patients who had raised cortisol to creatinine ratios had suffered from nocturnal hypoglycemia, these results strongly support the view that a raised ratio indicates an otherwise unrecognised episode of this condition.
Detection of a Herpes Simplex Viral Antigen in Skin Lesions of Erythema Multiforme
Authors: PAUL W. ORTON
Journal: Annals of Internal Medicine (1984)

The commonest variety of erythema multiforme follows a lesion caused by a recurrent herpes simplex virus infection. In studying the immunopathogenesis of herpes-associated erythema multiforme, we examined skin lesions for the presence of a herpes simplex viral antigen by an indirect immunofluorescence test using a monoclonal antibody to a major type-common glycoprotein antigen, gB. Focal staining showed this antigen to be present in epidermal cells in 12 of 16 skin biopsy specimens. The staining was similar to, but less intense than, that seen in biopsy samples of lesions of recurrent herpes simplex virus infections. Similar findings were not seen in control skin biopsy specimens from lesions of other skin diseases; a control monoclonal stain also was negative in biopsy specimens. These findings suggest that the immune reaction and subsequent tissue damage of herpes-associated erythema multiforme are due to the presence of herpes antigens in the skin.
High levels of mitochondrial DNA deletions in substantia nigra neurons in aging and Parkinson disease
Authors: Andreas Bender, Kim J Krishnan, Christopher M Morris, Geoffrey A Taylor, Amy K Reeve, Robert H Perry, Evelyn Jaros, Joshua S Hersheson, Joanne Betts, Thomas Klopstock, Robert W Taylor, Douglass M Turnbull
Journal: Nature Genetics (2006)
Effect of Ebola Progression on Transmission and Control in Liberia
Authors: Dan Yamin, Shai Gertler, Martial L. Ndeffo-Mbah, Laura A. Skrip, Mosoka Fallah, Tolbert G. Nyenswah, Frederick L. Altice, Alison P. Galvani
Journal: Annals of Internal Medicine (2014)

The Ebola outbreak that is sweeping across West Africa is the largest, most volatile, and deadliest Ebola epidemic ever recorded. Liberia is the most profoundly affected country, with more than 3500 infections and 2000 deaths recorded in the past 3 months.To evaluate the contribution of disease progression and case fatality on transmission and to examine the potential for targeted interventions to eliminate the disease.Stochastic transmission model that integrates epidemiologic and clinical data on incidence and case fatality, daily viral load among survivors and nonsurvivors evaluated on the basis of the 2000-2001 outbreak in Uganda, and primary data on contacts of patients with Ebola in Liberia.Montserrado County, Liberia, July to September 2014.Ebola incidence and case-fatality records from 2014 Liberian Ministry of Health and Social Welfare.The average number of secondary infections generated throughout the entire infectious period of a single infected case, R, was estimated as 1.73 (95% CI, 1.66 to 1.83). There was substantial stratification between survivors (RSurvivors), for whom the estimate was 0.66 (CI, 0.10 to 1.69), and nonsurvivors (RNonsurvivors), for whom the estimate was 2.36 (CI, 1.72 to 2.80). The nonsurvivors had the highest risk for transmitting the virus later in the course of disease progression. Consequently, the isolation of 75% of infected individuals in critical condition within 4 days from symptom onset has a high chance of eliminating the disease.Projections are based on the initial dynamics of the epidemic, which may change as the outbreak and interventions evolve.These results underscore the importance of isolating the most severely ill patients with Ebola within the first few days of their symptomatic phase.National Institutes of Health.
Coronary Arteriovenous Communication
Authors: Faruk Yenel
Journal: New England Journal of Medicine (1961)

THE least common developmental defects in the heart are those seen involving the coronary arteries. According to Gasul and Fell1 anomalous coronary arteries constitute 0.43 per cent of all congenital heart diseases. Alexander and Griffith2 found 54 cases with anomalies involving the coronary arteries among 18,950 autopsies.Coronary arteries may be abnormal developmentally in their distribution or site of origin, or because of the existence of abnormal communications. The rarest of these involve abnormal communications between two coronary vessels and constitute coronary arteriovenous fistulas. In the first case, reported by Abbott,3 the left coronary artery had communicated with the right. . . .
Cimetidine and Ranitidine-Reply
Authors: Williamson B. Strum
Journal: JAMA (1984)

In Reply.—  I appreciate Dr Rubin's thoughtful comments. We are in agreement on the most critical issue: both cimetidine and ranitidine are excellent drugs, although neither is without occasional adverse effects. Approximately 2 million prescriptions for ranitidine in the United States and 24 million prescriptions outside the United States have been filled (Glaxo, Inc, written communication, March 14,1984). Dr Rubin and I may be in agreement on two other issues: (1) The rare, unpredictable, idiosyncratic side effects of ranitidine will require more time and use to identify. Certainly no one should be surprised if additional side effects from ranitidine appear. (2) The lowest dose of H 2 -receptor antagonists that produces the desired effect should be the goal of therapy.  Where Dr Rubin and I do not agree is on the issue of the dose-dependent, and thereby more predictable, adverse effects of cimetidine for which there is scientific evidence to
Early Repair of Traumatic Rupture of the Thoracic Aorta
Authors: L. L. Bromley, J. T. Hobbs, R. E. Robinson
Journal: BMJ (1965)

Rupture of the thoracic aorta due to the trauma of abrupt deceleration is becoming more common in this age of high-speed travel and collision. The clinical picture of the torn aorta may not be recognized during life as it is not generally realized that it can occur without evidence of external injury to the chest. The injury is closed, rupture usually occurring just distal to the ligamentum arteriosum, this site being the junction of the descending aorta, which is relatively fixed by the paired intercostal vessels, and the arch of the aorta, which is only suspended by the head vessels and which moves forward on impact with a severe shearing strain. One of three things can happen: the aorta may be completely divided and the overlying parietal pleura torn, with immediate exsanguination into the mediastinum and left pleural cavity ; secondly, although rupture of the intima and media is complete, the adventitia may be incompletely disrupted, and this, together with the intact parietal pleura, temporarily contains the expanding aneurysm, which may, within minutes or hours, burst into the pleural cavity ; and, finally, the remaining adventitia and pleura can succeed in containing the aneurysm, so that a localized aneurysmal sac develops which slowly expands until it ruptures. In those patients surviving for a short time it is not possible to know whether rupture is imminent, but evidence of continued internal haemorrhage, an expanding mediastinal shadow on jc-ray examination, and an increasing pleural effusion are signs that early rupture is probable, and surgical treatment should be immediately undertaken.
The Association between Asthma and Allergic Symptoms in Children and Phthalates in House Dust: A Nested Case–Control Study
Authors: Carl-Gustaf Bornehag, Jan Sundell, Charles J. Weschler, Torben Sigsgaard, Björn Lundgren, Mikael Hasselgren, Linda Hägerhed-Engman
Journal: Environmental Health Perspectives (2004)

Global phthalate ester production has increased from very low levels at the end of World War II to approximately 3.5 million metric tons/year. The aim of the present study was to investigate potential associations between persistent allergic symptoms in children, which have increased markedly in developed countries over the past three decades, and the concentration of phthalates in dust collected from their homes. This investigation is a case–control study nested within a cohort of 10,852 children. From the cohort, we selected 198 cases with persistent allergic symptoms and 202 controls without allergic symptoms. A clinical and a technical team investigated each child and her or his environment. We found higher median concentrations of butyl benzyl phthalate (BBzP) in dust among cases than among controls (0.15 vs. 0.12 mg/g dust). Analyzing the case group by symptoms showed that BBzP was associated with rhinitis (p = 0.001) and eczema (p = 0.001), whereas di(2-ethylhexyl) phthalate (DEHP) was associated with asthma (p = 0.022). Furthermore, dose–response relationships for these associations are supported by trend analyses. This study shows that phthalates, within the range of what is normally found in indoor environments, are associated with allergic symptoms in children. We believe that the different associations of symptoms for the three major phthalates—BBzP, DEHP, and di-n-butyl phthalate—can be explained by a combination of chemical physical properties and toxicologic potential. Given the phthalate exposures of children worldwide, the results from this study of Swedish children have global implications.
The Patient Presented— With Prolix Prolixity
Authors: John D. Archer
Journal: JAMA (1975)

Technical terminology is often indispensable for efficient communication between members of a specific profession. Unnecessary jargon, however, is less easy  defend and has no place in formal writing when standard language will serve as well or better. Such jargon becomes particularly offensive when it goes so far as  violate grammatical propriety.  In plain and ordinary usage, the English verb  is transitive: it requires an object. A speaker may present a report  an audience. An author may present a manuscript  an editor.  I must acknowledge that at least one popular dictionary presents a definition for the intransitive use of the verb: to come forward or into view. 1 That dictionary, however, does little  differentiate correct usage from incorrect. On the other hand, the excellent American Heritage Dictionary , 2 which does make such distinctions, simply disdains  recognize any use of  as a verb without
John Harold Derek Millar
Authors: Lois Sproat, Lenox Millar
Journal: BMJ (2005)

​ConsultantConsultant physician Scunthorpe and Grimsby hospitals 1948-78 (b Edinburgh 1914; q Edinburgh 1936; DL, MD, FRCP Ed), d 25 October 2004.




Figure 1




At the outbreak of the second world war Derek Millar volunteered for the Royal Army Medical Corps. He was a prisoner of war for two years and led a mass escape from a camp in northern Italy, receiving the military MBE for his achievement. He worked as sole physician at Scunthorpe War Memorial Hospital, with sessions at Grimsby Hospital. He established a specialised medical unit in that time with 80 beds, and he encouraged postgraduate education. He leaves a wife, Isobel; two children; and six grandchildren.
EBAG9 tempers lymphocyte killing activity
Authors: Gaël Ménasché, Geneviève de Saint Basile
Journal: Journal of Clinical Investigation (2009)

The cytotoxic activity of lymphocytes is crucial for immune surveillance and homeostasis. Several independent, naturally occurring genetic models characterized by defects in granule trafficking or exocytosis have helped to decipher the multiple steps and molecules that regulate the cytotoxic process. The study by Rüder and colleagues in this issue of the JCI shows that an engineered absence of EBAG9, previously reported as a tumor-associated antigen, enhances cytotoxic activity of CTLs but not NK cells, likely acting on the endosomal-lysosomal trafficking of the cytotoxic effectors (see the related article beginning on page 2184). This finding adds a new piece to the puzzle of complex mechanisms that tightly regulate the capacity of the cytotoxic response and suggests a new target to negatively modulate CTL responsiveness.
Immunosuppression by Splenectomy and Lymph-node Irradiation
Authors: D. L. Benninghoff
Journal: BMJ (1966)

tion of irregular dietary patterns and con- sequent insulin overdosage is present.The mechanism is likely to be concerned with glycogen deposition, and associated fluid retention or an adreno-cortical mechanism may be concerned in the more severe and acute cases.'-I am, etc.,
GOLD and the fixed ratio
Authors: P.H. Quanjer, P.L. Enright, G. Ruppel, M.R. Miller, C.A. Vaz Fragoso, B.G. Cooper, M.P. Swanney, S. Stanojevic, R.L. Jensen, J.P. Schouten, E. Falaschetti, J. Stocks
Journal: European Respiratory Journal (2011)

More importantly, the fixed ratio is simple and, indeed, comparable to what has been a successful way of obtaining better acceptance and management of hypertension [7].The fixed ratio has been endorsed in the clinical European Respiratory Society/American Thoracic Society COPD guidelines [8] as well as the often quoted COPD guidelines from the UK National Institute for Health and Clinical Excellence [9]; the GOLD document and these two clinical guidelines are the most common guidelines followed by the medical community.It has been used extensively in research and as an inclusion criterion in numerous clinical trials; in fact, evidence-based management of COPD is more or less entirely based on studies using the fixed ratio.For this reason, GOLD believes that on balance we serve the clinicians managing COPD best by continuing with the fixed ratio.
Bilateral Subdural Hematomas Detected on Brain SPECT
Authors: Michael Wilson, Nicholas Lazzaro, Andrew Thierry, Reza Abghari
Journal: Clinical Nuclear Medicine (2007)

Extra-axial pathology is occasionally detected or suspected during brain SPECT imaging performed to evaluate cerebral dysfunction. In this case, Tc-99m bicisate (Neurolite) brain SPECT was the initial examination undertaken to evaluate cerebral dysfunction in an 86-year-old man with seizures, confusion, and headache. The brain SPECT demonstrated relatively normal bilateral brain activity. However, an elongated and markedly indented appearance of both frontoparietal regions (predominantly on the right side) were regarded as highly suspicious for bilateral subdural hematomas. This suspicion was confirmed on subsequent CT imaging, and the collections were surgically evacuated.
Evidence for a role of macrophage migration inhibitory factor in psoriatic skin disease
Authors: M. Steinhoff, A. Meinhardt, A. Steinhoff, D. Gemsa, R. Bucala, M. Bacher
Journal: British Journal of Dermatology (1999)

Macrophage migration inhibitory factor (MIF) was originally described as a T-cell-derived lymphokine with the potential to inhibit the random migration of macrophages. However, recent reports have shown a much broader tissue distribution, including the skin. Functionally, MIF appears to act as an antagonist of anti-inflammatory glucocorticoid action. To elucidate the role of MIF in inflammatory skin diseases, we investigated the production and localization of this cytokine in human skin of patients with psoriasis by means of reverse transcription-polymerase chain reaction, immunohistochemistry and Western blot analysis. In normal skin, our results showed a moderate but homogeneous MIF immunoreactivity in all epidermal layers. Endothelial cells and the outer root sheath of hair follicles were also positive for MIF. In lesional psoriatic human skin, a significant increase in MIF immunoreactivity was visible in suprabasal keratinocytes, especially of the spinous layer. In addition, endothelial cells also showed increased immunolabelling for MIF in psoriatic lesions, indicating a cell-specific upregulation of this mediator in untreated psoriasis. Western blot analysis also revealed a clear increase in MIF in homogenates of lesional skin from psoriasis patients. These results suggest a role for MIF in the inflammatory skin disease psoriasis.