tbuckley/cabot-search huggingface dataset:
A case-control study of lung cancer with special reference to asbestos exposure
Authors: M. Minowa, S. Hatano, M. Ashizawa, H. Oguro, H. Naruhashi, M. Suzuki, K. Mitoku, M. Miwa, C. Wakamatsu, Y. Yasuda, K. Shirai, H. Miura
Journal: Environmental Health Perspectives (1991)

A case-control study of lung cancer was carried out in Yokosuka City, Kanagawa Prefecture, the location of a pre-war Japanese Imperial naval factory and present site of a U.S. naval base. Cytologically or pathologically confirmed male fatal cases of lung cancer during the period of 1978 to 1982 in Yokosuka Kyosai Hospital were compared with a control group in the same hospital. Controls who died from causes other than cancer, pneumoconiosis, accident, or suicide were matched by age to the cases. Information that included occupational and smoking history was obtained by interviews with the families of the 96 cases and 86 controls. Major results were as follows: a) The relative risks of lung cancer associated with asbestos exposure and suspected exposure were 2.41 (p < 0.05) and 1.56, respectively, after controlling for age and smoking history, and the relative risk associated with smoking was 6.01 (p < 0.05) after adjusting for age and asbestos exposure. b) The age- and smoking-adjusted relative risks of lung cancer associated with asbestos exposure were 3.40 (p < 0.01) and 1.72 for Kreyberg groups I and II, respectively. Significantly elevated relative risk associated with smoking history was demonstrated for Kreyberg group I, but not for group II, after controlling for age and asbestos exposure.
Emergency dorsal slit for balanitis with retention
Authors: N Thiruchelvam, P Nayak, H Mostafid
Journal: Journal of the Royal Society of Medicine (2004)

The two JRSM articles on foreskin disorders and their management1,2 prompt us to report the following case.

A boy aged was seen after 48 hours of penile pain and retention of urine. In the past a non-retractile foreskin had been noted but there had been no previous episodes of balanitis. On examination, there was ballooning and erythema of the foreskin over the glans penis. After intravenous antibiotics, examination under anaesthesia revealed frank pus within the foreskin (which later yielded a growth of Escherichia coli). The phimotic foreskin was retracted, a dorsal slit was performed, and the bladder was emptied via a 6F paediatric feeding tube (Figure 1). The child left hospital next day with a prescription for a week of oral antibiotics. At outpatient review the wound had healed; the parents then opted for circumcision.



Figure 1

Postoperative appearance



Acute urinary retention secondary to balanitis-phimosis has not, to our knowledge, been described previously. We have found one report of chronic retention (with bilateral hydroureteronephrosis and vesicoureteral reflux) from this cause, with nocturnal enuresis as the presenting symptom.3 For management we favour the dorsal slit4 since it relieves the acute urinary obstruction, facilitates the drainage of pus and preserves the foreskin. Furthermore, emergency circumcision is technically difficult because of the gross oedema and it carries a greater risk of postoperative infection.
Public health body quits responsibility deal over government's failure to act on tobacco and alcohol
Authors: M. Limb
Journal: BMJ (2013)

An expert body is withdrawing from the government’s public health “responsibility deal,” saying that its “softly softly” approach of engaging with the industry has been ineffective.

The Faculty of Public Health said it was “dismayed” and “disappointed” that ministers would not now introduce a minimum price on a unit of alcohol or standardised tobacco packs.1

It said that such measures would have brought clear gains in public health and that it was the government’s duty to legislate where necessary to protect citizens’ health.

The faculty’s president, John Ashton, said there was no …
Herpes Simplex Encephalitis: Need for Accurate Diagnosis
Authors: Richard J. Whitley
Journal: JAMA (1980)

The introduction of vidarabine for the treatment of herpes simplex viral encephalitis (HSE) has produced a major diagnostic dilemma for the medical profession. This antiviral agent is specific for herpes simplex virus but is not an effective therapeutic agent for other organisms that cause focal encephalitis and that can clinically mimic HSE. In fact, in previous and ongoing large-scale collaborative studies, only 50% of the 208 cases thus far examined for evidence of virus in brain biopsy specimens was proved to be HSE. 1   In the case presented by Bia et al (p 367), western encephalitis emerged as the primary diagnosis after proper virological examinations, including study of brain biopsy material, even though herpes simplex virus had been presumed to be responsible for the clinical findings. Other diseases that cause focal brain pathological conditions have been confused with HSE. Such processes include cryptococcal and tuberculous infections, malignant neoplasms, and arteriovenous
Surveillance of new infectious diseases focuses on wrong areas
Authors: Susan Mayor
Journal: BMJ (2008)

Systems for surveillance of new infectious diseases are currently monitoring the wrong areas of the world, warns one of the first analyses to track the history of emerging diseases in relation to location worldwide.

The study analysed a database of 335 episodes of new infectious diseases emerging in human populations for the first time between 1940 and 2004 ( Nature 2008;451:990-4). The diseases included those caused by newly evolved strains of pathogens (such as multidrug resistant tuberculosis and chloroquine resistant malaria), pathogens entering human populations for the first time (such as HIV1 and the severe acute respiratory syndrome (SARS) coronavirus), and pathogens that have probably been present in humans historically but have recently increased in incidence (such as Lyme disease).

The results showed a …
DRG Miscoding: Error or Intent?-Reply
Authors: David C. Hsia
Journal: JAMA (1993)

In Reply.  —We welcome Ms Amatayakul's clarifications. First, if DRG errors occurred at random, 50% would have overreimbursed the hospitals. The finding of 50.7%±2.6% compares with this proportion, not with total billing errors.  Second, this study merely compares the DRG billed with the DRG supported by the medical record. It reaches no conclusions regarding intent.  Third, this study compares the narrative diagnoses and procedures attested to by the attending physician, the numericICD-9-CMcodes received by the fiscal intermediary, and the correctICD-9-CMcodes as reabstracted by the American Health Information Management Association (formerly American Medical Records Association). Resequencing therefore includes any changes to the correct sequence of principal and secondary diagnoses that occurred between the physician's attestation and their arrival at the fiscal intermediary. Amatayakul is correct that the alteration could have occurred in any department that handled the codes during this period. Administrative processing undoubtedly varies from hospital
Prognosis of respiratory tract infections in primary care
Authors: S. Gjelstad, M. Lindbaek
Journal: BMJ (2013)

Accurate information can help reduce antibiotic prescribing

The same year that Alexander Fleming and colleagues received the Nobel prize for work on the antibacterial properties of penicillin (1945), Fleming warned against the risk of bacterial resistance. In Europe today, about 25 000 lives are lost each year as a direct consequence of resistant bacteria.1 Frequent outpatient prescribing of antibiotics is associated with high levels of resistant Streptococcus pneumoniae in comparisons between nations.2 Unnecessary use of antibiotics could be greatly reduced by identifying those patients who would benefit from such treatment. Two linked studies on the prognosis of respiratory tract infections provide new and practical information for the primary care doctors who must guide patients through their treatment choices for these common infections.3 4

In a systematic review (doi:10.1136/bmj.f7027), Thompson and colleagues explored the duration of various respiratory tract infections in children up to 18 years of age attending primary care.3 Reliable and scientifically sound prognostic information is essential to help reassure worried parents that antibiotics may not be necessary. This study included 23 randomised controlled trials and 25 observational studies. Rather than average illness duration—the metric used by the …
Is atriopeptin a physiological or pathophysiological substance? Studies in the autoimmune rat.
Authors: J E Greenwald, M Sakata, M L Michener, S D Sides, P Needleman
Journal: Journal of Clinical Investigation (1988)

Atriopeptin (AP), a natriuretic-diuretic and vasodilatory peptide, is synthesized and secreted from mammalian atria. The definitive role of this peptide on cardiovascular physiology and pathophysiology has yet to be determined. We developed a population of autoimmune rats sensitized against their own AP to evaluate the consequences of prolonged AP deficiency on physiological and pathophysiological processes. Natriuresis in response to acute intravenous volume expansion was inhibited in the autoimmune rat, however, natriuresis produced by chronic oral salt loading was not suppressed in these animals. Plasma AP increased threefold in the spontaneously hypertensive rat when evaluated as a function of blood pressure. Immunization of these rats had no effect on the rate of development, magnitude of their developing hypertension, or their daily sodium excretion when compared with nonimmunized controls. Mineralocorticoid escape occurred during desoxycorticosterone acetate administration to rats. The ability of rats to escape from the sodium-retaining effects of this steroid was not affected by prior immunization against AP. These results suggest that AP is an important natriuretic substance in response to acute intravascular volume loading. However, atriopeptin does not appear to be involved in the natriuretic response to chronic intravascular volume loading, blood pressure regulation, or mineralocorticoid escape.
Personal Health Services Systems
Authors: Kerr L. White
Journal: JAMA (1971)

To qualify as a "system," any arrangement for the provision of personal health services should offer a full range and all levels of patient care for defined populations, have a well-defined organization that is full accountable, and acceptable records, communications, and transportation systems. Requirements for the development of a system include leadership, capital, cash-flow, and a clear focus of control and responsibility. Regulation of personal health services systems could be achieved through franchising, with use of an instrument analogous to the Civil Aeronautics Board. Standards would need to be promulgated with respect to organization and staffing, utilization, and quality of care. Contractual negotiations between the four parties involved—consumers, physicians, fiscal intermediaries, and organizers of services and systems—should encourage diversity, competition, prudent and responsible use of the system, and sound quality.
212 CONTRAST-ENHANCED US (CEUS) IN EARLY EVALUATION OF NON-SURGICAL TREATMENT OF HCC CAN CHANGE THE PATIENT'S FOLLOW-UP AND SURVIVAL
Authors: F. Giangregorio, G. Aragona, G. Marinone, G. Comparato, L. Fanigliulo, M. Di Stasi, G. Sbolli, P. Tansini, F. Fornari
Journal: Journal of Hepatology (2010)
In CPR, Less May Be Better
Authors: Myron L. Weisfeldt
Journal: New England Journal of Medicine (2010)

Fifty years have passed since Kouwenhoven, Jude, and Knickerbocker1 proposed external chest compression to provide circulation of blood to the brain and heart after cardiac arrest. Shortly thereafter, mouth-to-mouth rescue breathing was adopted as an essential addition to this lifesaving procedure. Since that time, there has been very little fundamental change in the method or manner of cardiopulmonary resuscitation (CPR). Decades of observational studies have shown that survival is improved if CPR is performed by bystanders rather than being provided only when emergency medical services (EMS) staff arrives. The use of automated external defibrillators by bystanders and the use of . . .
Signals for stress erythropoiesis are integrated via an erythropoietin receptor-phosphotyrosine-343-Stat5 axis
Authors: M. P. Menon
Journal: Journal of Clinical Investigation (2006)

Anemia due to chronic disease or chemotherapy often is ameliorated by erythropoietin (Epo). Present studies reveal that, unlike steady-state erythropoiesis, erythropoiesis during anemia depends sharply on an Epo receptor–phosphotyrosine-343–Stat5 signaling axis. In mice expressing a phosphotyrosine-null (PY-null) Epo receptor allele (EpoR-HM), severe and persistent anemia was induced by hemolysis or 5-fluorouracil. In short-term transplantation experiments, donor EpoR-HM bone marrow cells also failed to efficiently repopulate the erythroid compartment. In each context, stress erythropoiesis was rescued to WT levels upon the selective restoration of an EpoR PY343 Stat5-binding site (EpoR-H allele). As studied using a unique primary culture system, EpoR-HM erythroblasts exhibited marked stage-specific losses in Epo-dependent growth and survival. EpoR-H PY343 signals restored efficient erythroblast expansion, and the selective Epo induction of the Stat5 target genes proviral integration site-1 (Pim-1) and oncostatin-M. Bcl2-like 1 (Bcl-x), in contrast, was not significantly induced via WT-EpoR, EpoR-HM, or EpoR-H alleles. In Kit+CD71+ erythroblasts, EpoR-PY343 signals furthermore enhanced SCF growth effects, and SCF modulation of Pim-1 kinase and oncostatin-M expression. In maturing Kit–CD71+ erythroblasts, oncostatin-M exerted antiapoptotic effects that likewise depended on EpoR PY343–mediated events. Stress erythropoiesis, therefore, requires stage-specific EpoR-PY343-Stat5 signals, some of which selectively bolster SCF and oncostatin-M action.
Mandatory Neuropeptide-Steroid Signaling for the Preovulatory Luteinizing Hormone-Releasing Hormone Discharge*
Authors: SATYA P. KALRA
Journal: Endocrine Reviews (1993)

PITUITARY hormones are secreted in the form of episodic bursts. At least two modalities of these periodic hormonal events have been identified in the rat. Generally, low amplitude episodes occurring at more or less constant frequency dominate the pituitary secretory pattern. On occasion, however, these ultradian intermittent secretory bursts are interrupted by high amplitude surges of hormone secretion lasting for a considerable length of time (1, 2). Well characterized examples of these latter events are the preovulatory gonadotropin (3, 4) and PRL (4, 5) surges in the female rat, the daily burst of ACTH secretion (6), and the periodic high mass and longer duration episodes of GH and PRL in both female and male rats (7, 8). The importance of these pituitary hormone surges in sustaining the internal milieu and the perceived corollary that subtle and progressive derangements in the periodicity and amplitude of these secretory events impel premature aging of reproductive processes are well recognized. Consequently, the neuroendocrine control of each of these seemingly abrupt massive outpourings of pituitary hormones has been the focus of expanding research efforts over several years. This article details the steady progress made toward deciphering the neurochemical pathways involved in augmenting the hypothalamic discharge of LHRH, the primary trigger for the preovulatory surge of pituitary LH secretion on proestrus, since the publication of a similar survey and related concepts a decade ago (3).
THE ANTI-ISCHEMIC EFFECT OF RANOLAZINE CLOSELY PARALLELS ITS QTC-SHORTENING EFFECT IN PATIENTS WITH LONG-QT SYNDROME 3
Authors: Ramin Farzaneh-Far, Ori Ben-Yehuda, Heather Zhang, Julia Zack, Luiz Belardinelli
Journal: Journal of the American College of Cardiology (2013)
Intra-aortic Balloon Counterpulsation
Authors: Alfred T. Culliford
Journal: JAMA (1978)

INTRA-AORTIC balloon counterpulsation (IABCP) is a useful adjunct in the treatment of patients with serious and decompensated cardiac disease. It has been used extensively as an intraoperative and postoperative aid in hemodynamically unstable patients. In addition, it is useful in treating patients with cardiogenic shock following myocardial infarction; however, there have been few reports of its successful use in the management of refractory cardiac arrhythmias. <h3>Report of a Case</h3> A 47-year-old man was admitted to the coronary care unit of another hospital with the complaint of retrosternal chest pain that had persisted for several hours. Serial enzyme determinations and ECGs established the diagnosis of acute anterior septal myocardial infarction. Shortly before discharge, he was awakened with constricting chest pain radiating to the neck. Serial ECGs showed extension of the infarction. Supraventricular tachycardia subsequently developed, which was readily controlled with edrophonium chloride. Recurrent bouts of ventricular tachycardia developed over the following
Radiation Accidents and Emergencies in Medicine, Research, and Industry
Authors: James B. McCandless
Journal: JAMA (1965)

This volume reports the proceedings of a symposium held by the Midwest Chapter of the Health Physics Society. Radiation accidents are discussed from diverse points of view by psychiatrists and lawyers, engineers, and journalists as well as radiation specialists. There are no undefined technical terms and no mathematics. The first five chapters, explaining the nature of radiation accidents, their prevention, and methods of handling, contain information about which physicians and hospital personnel should be informed. The remaining three chapters deal with administrative aspects, government services and regulations, and the ethical problems of radiation accidents.  The discussions after each chapter are pertinent. They are well salted with thought-provoking questions and occasionally peppered with controversy. The reader will be impressed by the number of different types of radiation accidents which are possible and, conversely, by the relatively low number of accidents which have occurred.  As is inevitable with symposia, in spite of
Drug Safety in the Digital Age
Authors: Thomas J. Hwang, Florence T. Bourgeois, John D. Seeger
Journal: New England Journal of Medicine (2014)

Under these circumstances, and however anomalous it may seem, the idea of bringing death with dignity to the ICU is highly germane.I believe that not only should the barriers between family and patient in the unit be minimized (and indeed many ICUs have now implemented such policies), but the process of decision making should also more fully reflect the principles of palliative care.Such an ICU culture would not only promote aggres-sive treatment but also help patients and their families make wise decisions about managing the end of life.This approach, as Cook and Rocker observe, may seem paradoxical, but it is nevertheless altogether essential.
Working-time in general practice. How general practitioners use their time.
Authors: T. S. Eimerl, R. J. Pearson
Journal: BMJ (1966)

Better understanding of the work of general practice is needed because family doctors are not only acutely concerned about their purpose and how best to achieve it, they are also prisoners of their personal experience with difficulties in appreciating how this compares with that of their peers.The public also, as consumers, expect more from general practice as standards of living rise.For these reasons the Medical Care Research Unit in Manchester is conducting a series of studies in general prac- tice, and its facilities were therefore made available to the on 5 July
Insulin Assay in Insulinomas
Authors: E. Samols, V. Marks
Journal: BMJ (1963)

revealed curves of normal contour with a slight decrease in amplitude; at this stage the B.U.N. was 19 mg/.100 ml. and the creatinine clearance 105 ml./minute.Non-functioning Kidney and Renal Agenesis (Cases 26 to 28)
The Tail End of Guinea Worm — Global Eradication without a Drug or a Vaccine
Authors: Michele Barry
Journal: New England Journal of Medicine (2007)

Thanks to a two-decade campaign, guinea worm disease is about to be eradicated without any drug therapy or vaccine. Dr. Michele Barry writes that its demise will be proof that people can be persuaded to change their behavior through innovative health education. Former President Jimmy Carter and Dr. Donald Hopkins, vice president for health programs at the Carter Center, discuss the strategy they have pursued in mobilizing poor village communities to help eradicate guinea worm disease worldwide.
FUNCTIONAL NERVOUS DISTURBANCES IN PULMONARY INVALIDS.
Authors: S. G. BONNEY
Journal: JAMA (1898)

During a six years' experience with pulmonary tuberculosis in Colorado, with opportunities for continued observation of cases, I have been enabled to note the very frequent association with this disease of the various forms of functional nervous disturbance. The conviction has arisen that there exists a relation more intimate than is perhaps generally recognized between these conditions, which may be justly considered the two most prevalent of American disorders. A brief review of my clinical observations suggests itself as a means of directing more attention to this relationship, in the hope that ultimately further researches may afford a clearer conception of the subject. Without attempting to introduce any physiologic considerations, I will simply present the result of my own experience with reference to etiologic relations, prognosis, climatic influences and management. It is with much hesitation that I submit this report, realizing only too well the opportunities for error in the
Quantitative and functional impairment of pulmonary CD4+CD25hi regulatory T cells in pediatric asthma
Authors: Dominik Hartl, Barbara Koller, Alexander T. Mehlhorn, Dietrich Reinhardt, Thomas Nicolai, Dolores J. Schendel, Matthias Griese, Susanne Krauss-Etschmann
Journal: Journal of Allergy and Clinical Immunology (2007)
Induced Sputum versus Bronchoalveolar Lavage during Acute Chest Syndrome in Sickle Cell Disease
Authors: Emmanuelle Lechapt, Anoosha Habibi, Dora Bachir, Frederic Galacteros, Annette Schaeffer, Dominique Desvaux, Laurent Brochard, Bruno Housset, Bertrand Godeau, Bernard Maitre
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Previous reports have shown that in more than 40% of adults with acute chest syndrome (ACS), fat droplets suggestive of pulmonary fat embolism were present in alveolar macrophages. To determine whether induced sputum (IS) is a reliable test for detecting this embolism, we compared bronchoalveolar lavage and IS results in 20 patients with ACS. We found a correlation between the number of Oil Red O–stained macrophages in sputum and lavage fluid (Spearman's coefficient: ρ = 0.657, p < 0.018). Sputum cytology was then studied in another 60 patients who had sickle cell disease with ACS. An elevated percentage of Oil Red O–stained macrophages was found in the sputum of 37/47 patients, but they did not include any of the patients with sickle cell disease but no clinical symptoms. Patients suffering from ACS with Oil Red O–stained macrophages had more extrathoracic concomitant pain than those without (76 vs. 50%, p < 10−8), had more neurologic symptoms (7 vs. 0%, p < 10−8), a lower differential platelet count (−49 ± 121 vs. +85 ± 229, p < 0.04), and higher abnormal transaminase values (28 vs. 17%, p < 0.01). We conclude that IS analysis is a safe, noninvasive, and useful test for fat embolism detection in ACS.