tbuckley/cabot-search huggingface dataset:
A Healthy Young Man Has a Dental Extraction: Why Do All These Tests?
Authors: Neal Little
Journal: JAMA (1991)

To the Editor. —  I read with interest the question 1 and answer 2 concerning innocent enzyme elevations. Dr Fenton requested an explanation for some enzyme elevations in creatine kinase and alanine aminotransferase in a patient who was otherwise healthy and had been referred for medical clearance before a dental procedure.  While Dr Zimmerman's answer was an interesting discussion of these two enzyme levels, the fundamental question that needs to be answered here is, Why are these tests ordered in the first place in someone about to undergo a dental procedure? These tests seem like an enormous waste of time, money, and effort in an otherwise healthy 21-year-old. They also illustrate the principle that if screening is done in a population at low risk for the disease being screened, then abnormalities are more likely to represent false positives than true positives.  Wasteful and unnecessary testing such as this should not
Serial Hemodynamic Study of Cerebral Infarction in Man
Authors: WARREN H. KEMPINSKY, WILLIAM R. BONIFACE, JOSE B. A. KEATING,, PETER P. MORGAN
Journal: Circulation Research (1961)

It has sometimes been proposed that the early period of resolution of neurologic deficit, which often follows acute cerebral infarction, is due to relaxation of a surrounding, second ary vasoconstriction. To investigate this as sumption, cerebral hemodynamics were studied by the inert gas method in 13 patients with re cent cerebral infarction. In 10 instances in the acute stage, there were no significant dif ferences between mean hemodynamic values based on jugular bulb blood samples from the side of the infarct and those from the contra- lateral side. Similarly, comparisons of mean values failed to disclose significant differences between studies performed shortly after the onset of the stroke and those done three weeks later, at a time when all patients investigated demonstrated clinical improvement. The inert gas method is not applicable to the study of the infarct itself, but it is considered valid for the demonstration of cerebral vasocon triction if the latter is sufficiently widespread. In the absence of hemodynamic change, it was concluded that this study does not support the vasoconstriction explanation. It was rec ognized, however, that vasoconstriction would need to be quite widespread to be detected by this method.
How are cognition and movement control related to each other?
Authors: Maurizio Gentilucci, Sergio Chieffi
Journal: Behavioral and Brain Sciences (2004)

Our commentary focuses, first, on Glover's proposal that only motor planning is sensitive to cognitive aspects of the target object, whereas the on-line control is completely immune to them. We present behavioural data showing that movement phases traditionally (and by Glover) thought to be under on-line control, are also modulated by object cognitive aspects. Next, we present data showing that some aspects of cognition can be coded by means of movement planning. We propose a reformulation of Glover's theory to include both an influence of cognition on on-line movement control, and a mutual influence between motor planning and some aspects of cognition.
A STUDY OF THE EFFECT OF PKEDNISONE AND AN ANTIHISTAMINE ON PATCH TEST REACTIONS
Authors: E. FEUERMAN, A. LEVY
Journal: British Journal of Dermatology (1972)

Journal Article A STUDY OF THE EFFECT OF PKEDNISONE AND AN ANTIHISTAMINE ON PATCH TEST REACTIONS Get access E. FEUERMAN, E. FEUERMAN Department of Dermatology (Head: Prof E. Feuerman), Beilinson Medical Centre, Tel Aviv University School of Medicine, Petah Tikva, Israel Search for other works by this author on: Oxford Academic Google Scholar A. LEVY A. LEVY Department of Dermatology (Head: Prof E. Feuerman), Beilinson Medical Centre, Tel Aviv University School of Medicine, Petah Tikva, Israel Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 86, Issue 1, 1 January 1972, Pages 68–71, https://doi.org/10.1111/j.1365-2133.1972.tb01895.x Published: 01 January 1972 Article history Accepted: 14 July 1971 Published: 01 January 1972
Endoscopic Discovery of a<i>Taenia</i>in the Duodenal Bulb
Authors: N. Antaki
Journal: Endoscopy (2002)

Figure 1 A 70-year-old woman underwent esophagogastroduodenoscopy for iron-deficiency anemia. A flat white noodle-like formation was seen coiled up, making several loops, in the duodenal bulb. During the procedure, it moved down and disappeared into the jejunum. This is the second reported case of endoscopic discovery of Taenia in the bulb. The usual site of the adult Taenia is the small bowel. In this case, the scolex was probably attached in the upper jejunum and the anterior portion of the body had moved up into the bulb. This is confirmed by the fact that the proglottids seen in the image, appear wider than long; this is found in the anterior and middle region of most Taenia species.
The Recent Decline in Ischemic Heart Disease Mortality
Authors: MICHAEL P. STERN
Journal: Annals of Internal Medicine (1979)

Age-adjusted overall ischemic heart disease mortality declined by 20.7% in the United States between 1968 and 1976. Declines were recorded in both sexes, in all age groups, and in three major race/ethnic groups. The decline cannot be explained by shifts in assignment of cause of death on death certificates. Available evidence suggests that improvements in diet with concomitant declines in serum cholesterol concentration, decreased cigarette smoking, improved hypertension control, and possibly increased leisure-time physical exercise explain a portion of the decline. Coronary care units have probably also contributed. Emergency medical services and coronary bypass surgery were not widely enough applied during this period to have contributed to the decline. Several strategies are suggested for further elucidating the relative contributions of various preventive and curative programs. Such information is urgently needed to foster optimum allocation of scarce resources between competing (and expensive) programs.
Kinetics and Thermodynamics of Dissolution of Lecithin by Bile Salts
Authors: Siegfried Lindenbaum, Natarajan Rajagopalan
Journal: Hepatology (1984)

The kinetics of dissolution of dispersions of egg phosphatidylcholine (lecithin) by bile salts was studied by observing the decrease in turbidity as mixed micelles of lecithin and bile salts were formed. The rate of dissolution of lecithin corresponding to formation of mixed micelles was studied in the presence of dihydroxy bile salts, sodium deoxycholate, sodium chenodeoxycholate, sodium ursodeoxycholate and one trihydroxy bile salt, sodium cholate. The rate of dissolution of lecithin and mixed micelle formation decreased in the order: chenodeoxycholate greater than deoxycholate greater than cholate greater than ursodeoxycholate. Kinetic solvent isotope studies in D2O, along with measurement of enthalpies of mixed micelle formation both in H2O and D2O, suggest that formation and stabilization of mixed micelles are related to "hydrophobicity" as estimated by high performance liquid chromatography retention factors.
A Prospective Study of Dehydroepiandrosterone Sulfate, Mortality, and Cardiovascular Disease
Authors: Elizabeth Barrett-Connor, Kay-Tee Khaw, Samuel S.C. Yen
Journal: New England Journal of Medicine (1986)

It has been postulated that dehydroepiandrosterone (DHEA) and its sulfate ester, dehydroepiandrosterone sulfate (DHEAS), the major secretory products of the human adrenal gland, may be discriminators of life expectancy and aging. We examined the relation of base-line circulating DHEAS levels to subsequent 12-year mortality from any cause, from cardiovascular disease, and from ischemic heart disease in a population-based cohort of 242 men aged 50 to 79 years at the start of the study. Mean DHEAS levels decreased with age and were also significantly lower in men with a history of heart disease than in those without such a history. In men with no history of heart disease at base line, the age-adjusted relative risk associated with a DHEAS level below 140 micrograms per deciliter was 1.5 (P not significant) for death from any causes, 3.3 (P less than 0.05) for death from cardiovascular disease, and 3.2 (P less than 0.05) for death from ischemic heart disease. In multivariate analyses, an increase in DHEAS level of 100 micrograms per deciliter was associated with a 36 percent reduction in mortality from any causes (P less than 0.05) and a 48 percent reduction in mortality from cardiovascular disease (P less than 0.05), after adjustment for age, systolic blood pressure, serum cholesterol level, obesity, fasting plasma glucose level, cigarette smoking status, and personal history of heart disease. Our conclusions are limited by the single determination of DHEAS levels, but the data suggest that the DHEAS concentration is independently and inversely related to death from any cause and death from cardiovascular disease in men over age 50.
Simvastatin plus ezetimibe reduced major atherosclerotic events in patients with chronic kidney disease
Authors: Maurice Laville
Journal: Annals of Internal Medicine (2011)

Source Citation Baigent C, Landray MJ, Reith C, et al; SHARP Investigators. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011;377:2181-92. 21663949
Expression of public idiotypes in patients with Lyme arthritis.
Authors: J S Axford, R A Watts, A A Long, D A Isenberg, A C Steere
Journal: Annals of the Rheumatic Diseases (1993)

OBJECTIVE: Joints are often affected in Lyme disease and in some instances this may be due to immune autoreactivity. To characterise further the immune response in this disease investigations were carried out to determine the expression of three public idiotypes on serum immunoglobulins in patients with Lyme disease during the development of varying degrees of arthritis. METHODS: The expression of idiotypes (Ids) 16/6, BEG2, and PR4, first identified on monoclonal antibodies to DNA, was determined by an enzyme linked immunosorbent assay (ELISA) in serial blood samples from 12 patients with Lyme disease over a mean period of six years during the development of a variety of arthritic symptoms, and in serum samples from healthy control subjects and control subjects with systemic lupus erythematosus. RESULTS: Expression of serum IgM or IgG public Ids 16/6 and BEG2 was significantly increased in patients with Lyme disease. IgA Id 16/6 expression, in contrast, was significantly increased only during episodes of arthritis and was also related to its severity. IgM and IgG Id 16/6 expression was related to their respective total immunoglobulin concentration and, in the case of IgM, to the level of IgM antibodies to Borrelia burgdorferi, whereas similar findings were not apparent with IgA antibodies. This may indicate that the IgA response is related to the pathogenesis of arthritis, especially as total IgA and IgA Id 16/6 levels were found to increase over the duration of disease. Sequential analysis of antibodies also showed restriction in the expression of Id 16/6 as it was never found on all immunoglobulin isotypes at the same time, and Id PR4 was never expressed. Ids 16/6 and BEG2 expression, however, may be associated as seven patients expressed these idiotypes simultaneously. CONCLUSIONS: These data indicate the use of public idiotypes in the immune response against B burgdorferi, which may be restricted in terms of idiotype class and isotype expression, and a possible association between IgA antibodies bearing Id 16/6 with arthritis.
Translation Attenuation through eIF2α Phosphorylation Prevents Oxidative Stress and Maintains the Differentiated State in β Cells
Authors: Sung Hoon Back, Donalyn Scheuner, Jaeseok Han, Benbo Song, Mark Ribick, Junying Wang, Robert D. Gildersleeve, Subramaniam Pennathur, Randal J. Kaufman
Journal: Cell Metabolism (2009)
The CPC as an Anachronism
Authors: Mack Lipkin
Journal: New England Journal of Medicine (1979)

When Cabot introduced the Clinical Pathological Conference (CPC) at the turn of the century, gross and microscopical pathology was a rapidly developing new field. Accurate morphologic diagnosis had become common only in the late 19th century. The physicians most eager to keep up with advances in scientific medicine made a large and appreciative audience for the CPC, which became a tradition.Over the decades the conferences served several purposes. They brought unusual cases to the attention of the staff; they often sharpened diagnostic skills; for many clinicians they provided the major opportunity to observe gross and microscopic lesions. Today, pathophysiological . . .
Antibiotic drug research and development
Authors: J.-P. Paccaud
Journal: BMJ (2012)

Should it be funded through public-private partnerships to succeed?

Two linked articles highlight two very good reasons for international health authorities and governments to be seriously worried about the emergence of antimicrobial resistance: the worldwide spread of multidrug resistant bacterial strains (doi:10.1136/bmj.e1567) and the paucity of antibacterial compounds currently being researched (doi:10.1136/bmj.e1782).1 2

As antimicrobial resistance spreads worldwide and increasingly affects patients with very little buying power, traditional market forces will no longer provide the antibiotics that the world badly needs. The World Health Organization recently published a thoughtful analysis of the situation, along with measures that should be taken to face the threat.3 However, no clear way of increasing new antibiotic research and development has emerged.

The development of antibiotics has been increasingly challenging in recent years. Despite tremendous advances in the biological sciences, the difficulty in identifying new mechanisms to kill human bacterial pathogens has discouraged the few companies that are still active in the field. Clearly, we can no longer rely on direct competition between private companies alone to drive the emergence of new drugs.

So and colleagues propose sharing the risks of the antibiotic drug development process by spreading the burden across all stakeholders, from academia to the private sector, as a potential answer to the current crisis.2 Such broad sharing of resources, competences, …
A randomised controlled trial of four weeks versus seven weeks of pulmonary rehabilitation in chronic obstructive pulmonary disease
Authors: R H Green
Journal: Thorax (2001)

<h3>BACKGROUND</h3> Pulmonary rehabilitation programmes have been shown to improve both exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). The optimal duration for a pulmonary rehabilitation programme is, however, unknown. To assess whether the current pulmonary rehabilitation programme could be shortened a randomised controlled trial was conducted in 44 patients with COPD who were allocated to either a seven week or a four week course. <h3>METHODS</h3> Patients were randomised to either our standard seven week twice weekly outpatient based programme or a comparable but shortened four week course. They were assessed at baseline and at completion by the Chronic Respiratory Questionnaire (CRQ), the Breathing Problems Questionnaire (BPQ), the incremental shuttle walking test (SWT), and the treadmill endurance test (TET). <h3>RESULTS</h3> Twenty one patients (61% men) of mean (SD) age 68 (9.2) years and forced expiratory volume in one second ( FEV<sub>1</sub>) 1.08 (0.4) l completed a conventional seven week course and 23 (67% men) of mean (SD) age 69 (8.8) years and FEV<sub>1</sub> 1.03 (0.3) l completed a shortened four week course. Patients who completed the seven week rehabilitation programme had greater improvements in all outcome measures than those undertaking the four week course. These differences reached clinical and statistical significance for the total CRQ score, which was the primary outcome variable (mean difference (95% confidence intervals (CI) of difference) –0.61(–0.15 to –1.08), p&lt;0.05), and the CRQ domains of dyspnoea (–0.80 (95% CI –0.13 to –1.48), p&lt;0.05), emotion (–0.89 (95% CI –0.33 to –1.45), p&lt;0.005), and mastery (–0.84 (95% CI –0.10 to –1.58), p&lt;0.05). There were also trends towards greater improvements in exercise assessments in the seven week group but the differences did not reach statistical significance (SWT: mean difference –16.9 (95% CI 24.8 to –58.6), p=0.41; TET: geometric mean difference –1.21 (95% CI –0.60 to –2.47), p=0.56). <h3>CONCLUSIONS</h3> A seven week course of pulmonary rehabilitation provides greater benefits to patients than a four week course in terms of improvements in health status. Larger prospective studies are required to determine the optimal duration of a pulmonary rehabilitation programme.
Dilation of Pupil During Eye Examination
Authors: Frank J. Weinstock
Journal: JAMA (1977)

<h3>To the Editor.—</h3> The importance of eye examinations and the information to be derived from them by ophthalmologists as well as nonophthalmologists (family practitioners, interests, pediatricians, and medical and surgical subspecialists) is well known and accepted without the need for discussion. To evaluate an eye adequately in and outside of the ophthalmologic office, it is often required to dilate the pupil. I recommend, as do many ophthalmologists, that pupils be dilated much more frequently than is apparently done. However, dilation is sometimes contraindicated. One situation is where a patient has narrow angles (often unsuspected by the physician) with a shallow anterior chamber and a predisposition to acute angle closure glaucoma. Unfortunately, one is often unaware of this predisposition to angle closure, although occasionally the patient may be aware of his inability to tolerate dilation. If not, the presence of a shallow anterior chamber should alert the physician to potential problems
Adenocarcinoma Occurring in a Hyperplastic (Metaplastic) Polyp of the Colon
Authors: G. Franzin, P. Novelli
Journal: Endoscopy (1982)

A case of adenocarcinoma occurring in a hyperplastic (metaplastic) polyp of the colon is presented. The polyp, two cm in diameter, was located in the transverse colon of a 45-year old male patient, and was removed endoscopically. From the periphery to the centre, the polyp showed epithelial changes progressing from hyperplastic to severely dysplastic, terminating in a central focus of invasive adenocarcinoma. It is suggested that the considerable number of absorptive cells in large hyperplastic polyps may occasionally result in an excessive absorption of carcinogen thus leading to dysplastic changes.
Medicine and Politics
Authors: John Lister
Journal: New England Journal of Medicine (1967)

THE remarkable article in the Lancet on September 24, 1966, by Professor Henry Miller would have attracted more attention initially if it had been entitled "Medicine and Politics" instead of appearing under the rather cryptic title of "Fifty Years after Flexner." For many must have imagined that they would be reading a heavy bacteriologie discourse on how in these fifty years, the bacteria had given way to increasing numbers of elusive viral organisms as the commonest cause of all kinds of infections and other disease. But, fortunately, there are those who either read the Lancet from cover to cover or . . .
Diagnostic Uses of Ultrasound
Authors: W. S. Chilcote
Journal: JAMA (1976)

The explosive growth of medical diagnostic sonar in recent years has resulted in a dearth of adequate texts. Until now, persons entering the field could avail themselves only of individual publications in scientific journals, occasional collections of papers, or manufacturers' pamphlets. This book is an excellent example of the proper texts just now coming on the scene. The authors plainly state this book is an overview and a basic procedure manual for the field. The entire subject of ultrasound cannot be covered in 468 pages, and this work does not claim to be encyclopedic. The four authors give full coverage to the areas of physics, cardiac diagnosis, scanning and A-mode investigation, and Doppler ultrasound. This authorship allows a thoroughness not in the realm of a single author and avoids the overlap and confusion of styles seen in a collection of papers. All chapters are clearly and succinctly written. They cover
THE PSYCHIATRIC MANIFESTATIONS OF HYPOGLYCEMIA
Authors: Edwin J. Kepler, Frederick P. Moersch
Journal: American Journal of Psychiatry (1937)

It is important for the psychiatrist to appreciate fully the protean nature of hypoglycemic episodes. Invariably, the hypoglycemic attack is characterized by some psychiatric phenomena and indeed the mental symptoms may dominate the clinical picture. As has been pointed out by Allan and others,18 the psychiatrist is frequently called on to render an opinion in cases in which there are bizarre or unusual mental phenomena and he should be "hypoglycemia conscious." There are three major groups of hypoglycemia, (1) that due to injections of insulin, (2) that due to organic pathologic changes in the pancreas or other organs, and (3) that due to unknown causes. The condition is most prevalent in middle life and probably is not as common as was formerly suspected. In our series of 21 cases of noninduced hypoglycemia, nine were proved to be due to islet tumors of the pancreas and operation offered the only hope of improvement, nine patients were operated on but no islet tumor was demonstrated; the etiology in most of these cases was indeterminate. The diagnosis of hypoglycemia may be relatively simple if the cardinal factors of the condition are kept in mind. At times, however, the diagnosis may be exceedingly difficult. This is true as all too frequently the patient presents himself for diagnosis under such unusual or trying situations that the neurologist or psychiatrist, unless he is hypoglycemia conscious, will attempt to explain the findings on the basis of some neurologic or psychiatric disorder. The diagnosis of hypoglycemia is usually made early in the disease, although at times eight to ten years may elapse before the nature of the condition is recognized. The symptoms of hypoglycemia may range from mild apathy to mania or coma; there is no single mental syndrome that is pathogonomonic of the condition. As important as a low value for the fasting blood sugar may be, a single low value for the blood sugar does not in itself prove that the symptoms are hypoglycemic in origin. The exact mechanism by which hypoglycemia produces its effects on the nervous system is not known. In our treatment of 13 patients who had schizophrenia we have been able to observe the mental and nervous phenomena during approximately 350 deep comas. Profound changes in cerebral functions occur during hypoglycemia and the possibility that hypoglycemia may produce pathologic changes in the central nervous system should be appreciated. Thus far, we have encountered no ill effects from the use of insulin-shock therapy in schizophrenia.