tbuckley/cabot-search huggingface dataset:
The National Practitioner Data Bank: Bane or Benefit?-Reply
Authors: Fitzhugh Mullan
Journal: JAMA (1992)

<h3>In Reply.</h3> — We concur with Dr Goffen's concern about the "remarkable variability" of reporting of adverse actions and malpractice payments on physicians throughout the United States. Indeed, much of the variability in the observed rates derives from the variability in practices relating to disciplinary actions and reporting rather than to the quality of the physicians in a given state or locale. This same problem presents itself to physicians engaged in credentialing or peer review work. It is their job to assess information provided to them by the physician in question or from other sources when deciding whether to grant privileges, licenses, and membership. The NPDB simply makes that information available in a uniform and regularized fashion. The task of peer review and decision making remains firmly in the hands of physician-led credentialing authorities. One can only agree with Goffen's concern about the apparent irregularity in the system. The solution
Risk of disability and mortality due to overweight in a Finnish population.
Authors: A Rissanen, M Heliovaara, P Knekt, A Reunanen, A Aromaa, J Maatela
Journal: BMJ (1990)

OBJECTIVE--To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN--Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING--34 Communities throughout Finland. SUBJECTS--12,053 Women and 19,076 men who were employed and aged 25-64 at baseline. MAIN OUTCOME MEASURES--Mortality and work disability pensions from all and specified causes. RESULTS--Body mass index was a weak predictor of death but a strong predictor of early work disability, which increased linearly with body mass index. After adjustment for age, geographical region, occupation, and smoking the relative risks of work disability for women and men with a body mass index greater than or equal to 30 kg/m2 were, respectively, 2.0 (95% confidence interval 1.8 to 2.3) and 1.5 (1.3 to 1.7) when compared with those of subjects with body mass index less than 22.5 kg/m2. The increased risks were due to an excess of cardiovascular and musculoskeletal diseases but not of mental diseases. One fourth of all disability pensions from cardiovascular and musculoskeletal causes in women and half as many in men could be attributed to overweight (body mass index greater than 25 kg/m2) alone. CONCLUSIONS--Though modest overweight has little impact on mortality it predicts severe functional impairment. A considerable proportion of work disability pensions could probably be prevented by efficient weight control.
Chronic Rheumatic Fever with Erythema Marginatum in an Adult
Authors: ABRAHAM S. ABRAHAM
Journal: Annals of Internal Medicine (1974)

Letters1 September 1974Chronic Rheumatic Fever with Erythema Marginatum in an AdultABRAHAM S. ABRAHAM, M.D., M.R.C.P., DAVID FRANKEL, JACOB MENCZEL, M.D.ABRAHAM S. ABRAHAM, M.D., M.R.C.P.Search for more papers by this author, DAVID FRANKELSearch for more papers by this author, JACOB MENCZEL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-3-406_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We present here a case report of an adult with chronic rheumatic fever. This syndrome was first described in children by Taranta, Spagnuolo, and Feinstein (1) in 1962, but we have been unable to find any reference in the English medical literature to a case in adults.The patient, a 46-year-old woman, suffered an attack of acute rheumatic fever 20 years ago with resulting valvular damage. During the last 3 years, she has been admitted three times to our hospital; the reason for admission and the cardiac findings on each occasion are summarized in Table 1.Laboratory...References1. TARANTASPAGNUOLOFEINSTEIN AMA: Chronic rheumatic fever. Ann Intern Med 56:367-388, 1962 LinkGoogle Scholar2. COMMITTEE REPORT: Jones criteria (revised) for guidance in the diagnosis of rheumatic fever. Circulation 32:664-668, 1965 CrossrefMedlineGoogle Scholar3. FEINSTEINSPAGNUOLO AM: Duration of activity in acute rheumatic fever. JAMA 175:1117-1119, 1961 CrossrefMedlineGoogle Scholar4. FRIEDBERG C: Rheumatic fever in the adult: criteria and implications. Circulation 19:161-164, 1959 CrossrefMedlineGoogle Scholar5. FITZGERALDEINSENVAN SCOTT TAE: Dermatology in General Medicine. New York, McGraw-Hill Book Co., 1971, p. 1538 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine Shaare Zedek Hospital Jerusalem, Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1974Volume 81, Issue 3Page: 406-407KeywordsChildrenErythemaResearch laboratoriesRheumatic fever Issue Published: 1 September 1974 PDF DownloadLoading ...
Thalidomide and prednisolone versus prednisolone alone as consolidation therapy after autologous stem-cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the ALLG MM6 multicentre, open-label, randomised phase 3 study
Authors: Anna Kalff, Nola Kennedy, Angela Smiley, H Miles Prince, Andrew W Roberts, Kenneth Bradstock, Richard De Abreu Lourenço, Chris Frampton, Andrew Spencer
Journal: The Lancet Haematology (2014)
Load sensitivity of left ventricular relaxation in normal and failing hearts: evidence of a nonlinear biphasic response
Authors: S Prabhu
Journal: Cardiovascular Research (1999)

This investigation sought to define the effect of heart failure (HF) on the load sensitivity of left ventricular (LV) relaxation and to correlate alterations in load sensitivity with the variables of ejection timing, systolic load profile and elastic recoil.Nine dogs instrumented with LV micromanometers and piezoelectric crystals were studied before and after HF produced by prolonged rapid LV pacing. After pharmacologic autonomic blockade and atrial pacing at 160 bpm, hemodynamic measurements were recorded at steady-state and during vena caval occlusion. LV relaxation for individual beats during caval occlusion was assessed using tau, the monoexponential time constant, and systolic load was estimated using end-systolic circumferential force (ESF).The tau-ESF relation was nonlinear and biphasic, with an initial decrease in tau followed by a delayed increase, and was described by a parabolic equation with a curvilinearity coefficient a. Examination of ejection variables and systolic load profile indicated that the initial acceleration of relaxation reflected the influence of increased elastic recoil, whereas the late slowing reflected the influence of earlier end-ejection and delayed systolic loading. HF produced significant baseline prolongations of tau (P < 0.005), time to relaxation onset (P < 0.001) and time to peak force (P < 0.015) compared to control. The curvilinearity coefficient of the tau-ESF relation was significantly increased (18.1 +/- 20.1.10(-5) vs. 3.99 +/- 2.89.10(-5) g-2, P = 0.048), indicating increased load sensitivity of relaxation. This increased load sensitivity correlated with delayed onset but increased overall magnitude of the effects of earlier end-ejection and late systolic loading on relaxation.The tau-ESF relationship during transient load reduction is nonlinear and biphasic with an initial acceleration of relaxation, reflecting the impact of elastic recoil, and delayed slowing, reflecting changes in ejection timing and systolic loading sequence. This relation is more curvilinear in the failing heart, indicating increased load sensitivity of LV relaxation. These changes primarily occur due to alterations in the impact of ejection timing and systolic load profile rather than increased elastic recoil.
Artificial cardiac pacemakers.
Authors: J. H. Bett, D. W. Evans
Journal: BMJ (1968)

Tricyclic Antidepressants SIR,-I am worried by one sentence in the article on tricyclic antidepressants (13 April, p. 102): "Jaundice, which is very un- common, is of the cholestatic type similar to that found in chlorpromazine."This is mis- leading.Jaundice is one of the more frequent side- effects reported from imipramine and imitrip- tyline, the most widely used members of the group.Its incidence is probably related to the amount of drug prescribed, and is only likely to be "very uncommon" with the newer compounds.I doubt, too, if the jaundice is always of the chlorpromazine type; this implies a cholestatic reaction which is usually benign.Some patients almost cer- tainly have a far more serious hepatic reac- tion, and death can result from liver-cell failure.-I am, etc.,
Fatal Rabies Encephalitis despite Appropriate Post-Exposure Prophylaxis
Authors: Martin Shill, Roy D. Baynes, Steven D. Miller
Journal: New England Journal of Medicine (1987)

RABIES encephalitis was one of the earliest diseases known.1 Because rabies is uniformly fatal, every attempt must be made to prevent invasion of the virus. Since the introduction of a rabies vaccine in 1885, post-exposure vaccination has formed the cornerstone of prophylaxis after the bite of a rabid animal. Occasional cases of failure of prophylaxis followed the use of the early duck-embryo vaccine and rabies immune globulin.1 In several of these cases, however, unacceptably long delays had preceded the institution of therapy.1 In one case, in which duck-embryo vaccine and rabies immune globulin were promptly administered, a suboptimal immune response . . .
Active Life Expectancy
Authors: Sidney Katz, Laurence G. Branch, Michael H. Branson, Joseph A. Papsidero, John C. Beck, David S. Greer
Journal: New England Journal of Medicine (1983)

This study was designed to demonstrate the feasibility of forecasting functional health for the elderly. Using life-table techniques, we analyzed the expected remaining years of functional well-being, in terms of the activities of daily living, for noninstitutionalized elderly people living in Massachusetts in 1974. The expected years, or active life expectancy, showed a decrease, from 10 years for those aged 65 to 70 years to 2.9 for those 85 or older. Active life expectancy was shorter for the poor than for others, and women had a longer average duration of expected dependence than men. The measure of active life expectancy provides important information about health at a given population level, in terms other than death. This information can be used for actuarial purposes in planning and policy making. It is also useful in identifying high-risk populations for which preventive health care and medical care can compress morbidity during the last years of life.
Abstract 1952: Targeting the CCL2/CCR2 chemokine pathway in breast tumors through intratumoral delivery of calcium cross linked TAT peptide: siRNA complexes
Authors: Wei Bin Fang, Corey Berkland, Nikki Cheng
Journal: Cancer Research (2012)

Abstract Breast tumors exhibit inflammatory responses through recruitment of stromal cells in the primary tumor microenvironment, including fibroblasts and macrophages. Accumulation of these stromal cells correlates with development of invasive breast cancer and poor patient prognosis. These stromal cells express high levels of the inflammatory chemokine CCL2, corresponding to overexpression of its receptor CCR2 in the tumor epithelium. Our laboratory and others have shown that CCL2/CCR2 signaling mediates stromal: tumor interactions to regulate breast cancer cell survival, invasion and metastasis. While the CCL2/CCR2 signaling represents a novel and potentially effective therapeutic target in invasive breast cancer, it is necessary to develop new tools to specifically inhibit CCL2/CCR2 signaling in vivo. siRNA knockdown could specifically target CCL2 or CCR2, but is unstable and toxic when delivered in vivo. The HIV-1 derived TAT peptide penetrates cell plasma membranes at high efficiency and contains nuclear translocation signals to enhance siRNA delivery to the nucleus. Recent studies from our research team have shown that CaCl2 condenses TAT/nucleic acids to nanoparticles facilitating cellular uptake. The goals of these studies are to design TAT nanoparticle formulas to target CCL2 and CCR2 protein expression in breast tumors. Using an in vitro luciferase reporter system, we identified specific N/P ratios and CaCl2 concentrations that would transfect stromal cells and PyVmT mammary tumor cells. TAT/CaCl2 nanocomplexes carrying GFP plasmid or Cy3 labeled siRNAs were then injected into PyVmT mammary tumors. We observed visible GFP expression and Cy3 labeled siRNA uptake in over 50% of the PyVmT mammary tumor at low and high N/P ratios. Normal mammary tissues did not show significant uptake of TAT nanoparticles. Flow cytometry analysis showed that high N/P ratios resulted in efficient TAT/CaCl2/siRNA uptake in breast cancer associated fibroblasts and macrophages. TAT/CaCl2/siRNA nanocomplexes formed at low N/P ratios resulted in efficient siRNA uptake in tumor epithelial cells. Preliminary studies of PyVmT mammary tumors showed a reduction in CCL2 and CCR2 expression upon delivery of TAT/CaCl2 nanoparticles carrying CCL2 or CCR2 siRNAs. These data indicate this nanoparticle strategy represents a novel, feasible approach to target the CCL2/CCR2 signaling in breast cancer, with important implications on therapeutic targeting. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1952. doi:1538-7445.AM2012-1952
Visual Hallucinations With Iminodibenzyl Antidepressants
Authors: Richard W. Hudgens
Journal: JAMA (1966)

DRUGS of the iminodibenzyl group have been effective in the treatment of primary depression. The use of these antidepressants—amitriptyline, imipramine, nortriptyline, desipramine, etc—has rarely been associated with grave side effects; and the minor toxic reactions only occasionally have necessitated discontinuation of treatment with the drugs. There have been case reports of confusional states occurring during imipramine therapy, mostly in older patients. In addition, several authors have noted visual hallucinations coinciding with the use of imipramine. In the first such report published in 1958, Lehmann, Cahn, and deVerteuil1 described this condition in five of 84 patients. In 1965, Klein<sup>2</sup>reviewed the literature on this subject and reported visual hallucinations in 12 patients on imipramine therapy. Eleven of them were receiving 300 mg daily and one was receiving 150 mg daily. Transient visual hallucinations developed in the three patients described below while on amitriptyline therapy. All of them had primary depressions, and
Aggressive Behavior — Its Psychiatric and Physiologic Aspects, Especially in Combat Veterans
Authors: Leo Alexander
Journal: New England Journal of Medicine (1948)

IMPULSIVE aggressive behavior is more frequent among the cases encountered in military psychiatric practice, especially in or near combat zones, than in civilian practice exclusive of cases appearing in combat veterans.While serving with an overseas general hospital as chief of the neuropsychiatric section, I was impressed with the number of cases in which aggressive behavior presented the predominant symptoms and cause for admission or consultation. In the study of these cases from the psychiatric as well as from the neurophysiologic point of view, the courtesy and co-operation of Dr. Denis Hill made it possible for the patients to be . . .
Physical Activity and the Risk of Coronary Heart Disease
Authors: Henry Blackburn, David R. Jacobs
Journal: New England Journal of Medicine (1988)

In this issue of the Journal, Wood and colleagues1 at Stanford report on a clinical trial comparing two methods of weight loss: restricting energy intake and increasing energy expenditure. Each method was equally effective in reducing fat weight, raising plasma levels of high-density lipoprotein cholesterol, and decreasing triglyceride concentrations. This excellent study improves our understanding of mechanisms of weight loss and sets the stage for pragmatic tests of optimal programs for treating obesity while simultaneously modifying plasma lipid levels and improving functional capacity.In addition to the findings of Wood et al., there is much evidence for a favorable . . .
Evaluation of 99mTc-Pyridoxylideneglutamate for the Differential Diagnosis of Jaundice
Authors: KATTADIYIL P. POULOSE, WILLIAM C. ECKELMAN, RICHARD C. REBA, MARGARET GOODYEAR
Journal: Clinical Nuclear Medicine (1976)

Hepatobiliary imaging with 99mTc-pyridoxylideneglutamate (Tc-PG) was performed in 38 patients and 6 normal subjects. Visualization of the gallbladder was possible within 20 minutes post injection in normal subjects. In patients with a direct bilirubin concentration greater than 10 mg/dl, neither the gallbladder nor the intestines were visualized irrespective of the etiology and thus the study was not helpful to differentiate the intrahepatic from extrahepatic obstruction. However, when the direct bilirubin concentration was less than 10 mg/dl, visualization of the tracer in the intestines was helpful to exclude complete extrahepatic biliary obstruction. Although the images produced with 99mTc-PG were qualitatively superior to 131I Rose Bengal, they did not result in any additional etiological information.
Clinical Practice Guidelines for Chronic Cardiovascular Disorders: A Roadmap for the Future
Authors: Elliott M. Antman, Mariell Jessup
Journal: JAMA (2014)

The World Health Organization lists ischemic heart disease and stroke as the top 2 leading causes of death worldwide in 2011, responsible for 7 million and 6.2 million deaths, respectively.1 The concept of risk factors for atherosclerotic cardiovascular disease (CVD) was introduced in 1961, based on epidemiologic observations from the Framingham Heart Study. Hypertension and abnormal blood lipid levels were key risk factors shown to be associated with an increased risk of angina pectoris, myocardial infarction, and sudden cardiac death; later, stroke was identified as an important outcome as well, especially in women and racial/ethnic subgroups. Accordingly, clinicians want to provide their patients with the best possible advice with respect to the management of cardiovascular risk, often implementing evidence-based clinical practice guidelines designed to improve health outcomes.
Was the Schoolmaster Abroad?
Authors: W. L. Shelton
Journal: JAMA (1905)

Woodlawn, Kan., June 20, 1905. <h3>To the Editor:</h3> —I note with "laughter akin to tears" the article inThe Journal, June 17, by "An Examiner," under the above caption. This matter would be far more laughable were it not so serious. Would it not be eminently proper and just toward all concerned to divulge the name of any institution responsible for the addition to the profession of such graduates as this one? Why talk of medical ethics when, for for fear of injuring the business of some diploma mill or of incurring the displeasure of those connected therewith, we remain quiet and allow impositions like this to be perpetrated, unheralded to the profession? Publicity in such instances as this would do more toward "regulating" medical schools of questionable repute and methods than all the state and medical society laws and resolutions that have ever been enacted. We are under no
Ectopic (Inappropriate) Hormone Production by Tumors: Mechanisms Involved and the Biological and Clinical Implications*
Authors: STEPHEN B. BAYLIN, GEOFFREY MENDELSOHN
Journal: Endocrine Reviews (1980)

THE PRODUCTION of hormones and other “marker proteins” by tumors has come to play an increasingly important role for clinicians involved in the diagnosis and management of patients with neoplasia and for investigators involved in basic studies of tumor biology and endocrinology. It has become apparent during the past 30 to 40 years that a wide range of endocrine tumors secrete hormones not normally associated with the gland in which the neoplasm arises and that nonendocrine tumors can synthesize and/or secrete certain polypeptide hormones and other “tumor-associated” proteins. The production of such tumor markers has come to be referred to as “ectopic” or “inappropriate” when the marker in question is not obviously associated with the tissue from which the tumor derives. Since the recognition of this aspect of tumor behavior, considerable attention has been focused on the ectopic endocrine syndromes which may arise in patients with cancer because of such protein production, and on the important clinical implications of these syndromes for diagnosis and patient management.
Radiation Exposure and Thyroid Cancer—Reply
Authors: John D. Boice
Journal: JAMA (2006)

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Tuberculosis treatment outcomes in Europe: a systematic review
Authors: A. Faustini, A. J. Hall, C. A. Perucci
Journal: European Respiratory Journal (2005)

In order to facilitate the control of tuberculosis (TB), the World Health Organization (WHO) has defined a standardised short-course chemotherapy and a strategy, directly observed therapy. In 2000, WHO surveillance of TB treatments in Europe recorded a successful outcome rate of 77%. The aim of this report is to estimate treatment outcomes in European countries based on published studies and to identify their determinants. A systematic review was conducted of published reports of TB treatment outcomes in Europe. Meta-analysis, meta-regression and subgrouping were used to pool treatment outcomes and analyse associations with mean age, sex, immigration status and multidrug resistance. Of the 197 articles identified in the search, 26 were eligible for the review; 74.4% of outcomes were successful, 12.3% were unsuccessful and 6.8% of patients died. Heterogeneity was high for all outcomes. National estimates were possible for six countries. Multidrug resistance was inversely associated with successful outcome, which were fewer in populations with &gt;9% multidrug-resistant TB, and in patients aged &lt;44 yrs. Successful tuberculosis treatment outcomes were below the 85% threshold suggested by the World Health Organization. There was an inverse association with levels of multidrug-resistant tuberculosis. The unexplained heterogeneity between the studies for unsuccessful outcomes seems to be due to differing interpretations given to World Health Organization definitions.