tbuckley/cabot-search huggingface dataset:
Lingua Villosa Nigra
Authors: Asha Ramsakal, Lovpreet Mangat
Journal: New England Journal of Medicine (2007)

A 24-year-old man presented with black discoloration and hairy appearance of his tongue, which he had had for 2 days, and a sore throat. He had been taking ciprofloxacin and doxycycline for the past week for an upper respiratory tract infection. He did not smoke or use oral tobacco products, and he was not taking any bismuth-containing compounds. Physical examination revealed white tonsillar exudates and a black discoloration of the tongue; no fever, adenopathy, or hepatosplenomegaly was noted. The results of a rapid streptococcal-antigen test and a monospot test were negative. A throat culture was positive for Candida albicans. . . .
Determining an episode of care using claims data. Diabetic foot ulcer.
Authors: S S Mehta, S Suzuki, H A Glick, K A Schulman
Journal: Diabetes Care (1999)

OBJECTIVE: Amid changes in the organization and financing of health care, health care decision makers are increasingly interested in episodes of care. We sought to determine an episode of care for diabetic foot ulcer using an administrative claims database. RESEARCH DESIGN AND METHODS: We used 1993-1995 claims data to assess resource utilization for privately insured patients with diabetic foot ulcers. Over a 26-week period, we determined the episode length by comparing differences in average daily charges and proportion of patients with charges before and after foot ulcer diagnosis. All 13 weeks before diagnosis were used to calculate baseline values. Significance was determined by CIs, which were calculated by a nonparametric bootstrap technique. Costs associated with the episode were also calculated. A sensitivity analysis using weeks with highest and lowest values as baseline was also conducted. RESULTS: Based on average daily charges, the episode of care for diabetic foot ulcer was 5 weeks. Using proportion of patients with charges, the episode was longer than 13 weeks. The cost for an episode of care ranged from $900 to $2,600. In the sensitivity analyses, episodes of care ranged from 1 to 13 weeks. CONCLUSIONS: Episodes of care can be defined by the period beginning with increased resource consumption and ending when resource consumption returns to baseline levels. With the growth of managed care and disease management programs, episode-of-care analysis may have an increasingly important role in health care provision and delivery.
Intracranial hemorrhage following allogeneic hematopoietic stem cell transplantation
Authors: Yuho Najima, Kazuteru Ohashi, Maho Miyazawa, Mikako Nakano, Takeshi Kobayashi, Takuya Yamashita, Hideki Akiyama, Hisashi Sakamaki
Journal: American Journal of Hematology (2009)

Charts and radiographs of 622 allogeneic hematopoietic stem cell transplant (HSCT) recipients, over a 20-year period, were retrospectively reviewed for intracranial hemorrhage (ICH) following transplant. A total of 21 cases of ICH were identified (3.4%) including 15 cases of intraparenchymal hemorrhage (IPH), two cases of subarachnoid hemorrhage (SAH), and four cases of subdural hematoma (SDH). The median time from transplantation to the onset of ICH was 63 days (range, 6-3,488 days). The clinical features of post-transplant ICH patients were similar and included hypertension, diabetes mellitus, chronic graft-versus-host disease (GVHD), systemic infection, and veno occlusive disease (VOD), recently referred to as sinusoidal obstruction syndrome, in addition to severe thrombocytopenia. Mortality rate was especially high (89%) after IPH with a median survival of 2 days (range, 0-148 days). In contrast, all patients with SAH or SDH following HSCT survived. The cause of post-transplant ICH appears to be multifactorial, including thrombocytopenia, hypertension, acute GVHD, VOD, and radiation therapy. Most patients in our series displayed severe thrombocytopenia at the onset of ICH, even though adequate prophylactic platelet transfusions were given. By univariate analysis, cord blood transplantation, acute GVHD, systemic infection, and VOD were related to the incidence of ICH, whereas prior CNS episodes and radiation therapy did not reach statistical significance. A multivariate analysis with logistic regression identified acute GVHD as the only factor that significantly influenced ICH occurrence.
Unemployment rates: an alternative to the Jarman index?
Authors: D A Campbell, J M Radford, P Burton
Journal: BMJ (1991)

OBJECTIVE--To compare the Jarman index with alternative deprivation measures with regard to its usefulness to district health authorities as an indicator of need at small area level. DESIGN--The Jarman index (UPA (8)), Townsend9s index of material deprivation, the Scottish Development Department9s index, the Department of the Environment9s basic index, and unemployment rates were compared in respect of their correlation with measures of morbidity by electoral ward in a typical English district health authority. Measures of morbidity comprised standardised mortality ratios, admission rates (standardised and non-standardised), and permanent sickness rates. Spearman rank correlation coefficients were calculated for each combination of measures and were then ranked for each of the deprivation indices. SETTING--The 59 electoral wards of the Central Nottinghamshire Health Authority. RESULTS--The Jarman index consistently ranked lower in respect of its correlation with measures of morbidity than did the other deprivation measures. Current unemployment rates correlated well with morbidity measures, in particular with hospital admission rates, with correlations ranging from 0.669 to 0.830 for average and standardised all age admission rates. CONCLUSIONS--The Jarman index seems to be the least appropriate of these indices for health authority use. Unemployment rate merits further consideration as a simple, up to date marker for deprivation and consequent need for health service provision.
Role of Phonocardiogram (PCG) in Evaluation of Severity of Mitral Stenosis and Detection of Associated Valvular Lesions.
Authors: Borys Surawicz
Journal: Annals of Internal Medicine (1965)

s1 November 1965Role of Phonocardiogram (PCG) in Evaluation of Severity of Mitral Stenosis and Detection of Associated Valvular Lesions.Borys Surawicz, M.D., F.A.C.P., Henryk Chlebus, M.D., John T. Reeves, M.D., Frank C. Spencer, M.D., F.A.C.S.Borys Surawicz, M.D., F.A.C.P.Search for more papers by this author, Henryk Chlebus, M.D.Search for more papers by this author, John T. Reeves, M.D.Search for more papers by this author, Frank C. Spencer, M.D., F.A.C.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-907_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe contribution of phonocardiogram (PCG) in estimating the severity and "purity" of mitral stenosis was evaluated in 90 patients with pure or predominant mitral stenosis referred for surgery.Amplitude of the first sound at the apex, expressed as a percentage of the second sound amplitude, showed no correlation with severity of stenosis, but in patients with associated insufficiency the mean amplitude was significantly lower (119%) than in patients without insufficiency (160%). Amplitude of pulmonary valve closure sound, expressed as a percentage of amplitude of aortic valve closure sound did not correlate with severity of mitral stenosis or pulmonary artery pressure.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1965Volume 63, Issue 5Page: 907-907KeywordsAortic valveLesionsMitral stenosisPulmonary arteriesStenosisSurgery Issue Published: 1 November 1965 PDF downloadLoading ...
Fetotoxic effects of mono-2-ethylhexyl phthalate (MEHP) in mice.
Authors: I Tomita, Y Nakamura, Y Yagi, K Tutikawa
Journal: Environmental Health Perspectives (1986)

Mono(2-ethylhexyl) phthalate (MEHP), one of the main metabolites of di(2-ethylhexyl) phthalate (DEHP), exerted embryo/fetotoxic effects similar to those of DEHP at lower doses. Oral administration of MEHP (1 mL/kg) to the mice of 8 days gestation resulted in less than 32% of live fetuses, all of which were deformed. When DEHP (10 mL/kg) was given to the pregnant mice of 8 days gestation, approximately 0.03% and 0.003% of the administered dose was found in fetuses as DEHP and MEHP, respectively, after 12 hr. The presence of the MEHP in fetuses is probably due to the transplacental crossing of the MEHP formed in the maternal body, since the fetuses of mice up to day 9 of pregnancy showed no hydrolytic activity of DEHP to MEHP. Crossing of MEHP through the placenta was proven by an experiment in which MEHP was administered in pregnant mice. A single injection of MEHP (25 or 50 mg/kg), but not DEHP (500 mg/kg) into pregnant mice, induced a significantly high incidence of somatic mutations in the coat hair of offspring of mice (KYG, female X PW, male; C57BL/6Crj, female X PW, male). All these data suggest that MEHP could be responsible for the embryotoxic/fetotoxic effects observed with DEHP.
Measurement of Renal Plasma Flow by Iodopyracet I 131
Authors: Charles M. Elwood
Journal: JAMA (1965)

Simultaneous renal clearances of para-aminohippuric acid (PAH) and tracer doses of iodopyracet I 131 with added nonradioactive iodopyracet were performed in 20 patients by the continuous infusion technique. The mean iodopyracet I 131 PAH clearance ratio was 1.02. Sequential clearance studies suggested minimal competitive inhibition for renal excretion between PAH and iodopyracet I 131.
Haemoglobinopathy screening can be carried out in general practice
Authors: J. Logan
Journal: BMJ (2000)

EDITOR—Modell et al found that only half the couples at risk of having a child with thalassaemia received a service that allowed them an informed choice in genetic screening for the condition, with wide variation by region and ethnic group.1 For informed choice to be translated into the practical reality of a prenatal diagnostic procedure, haemoglobinopathy screening needs to be undertaken in the first trimester.

In general practice …
Shark cartilage in the water
Authors: Caroline Richmond
Journal: BMJ (2006)

How much will Herceptin really cost? Balancing local and national priorities is not newEditor-Herceptin for early stage breast cancer is a cost effective treatment, and it is right that the NHS should make it available.The challenge of funding new treatments and balancing local and national priorities is one the NHS has faced since its inception. 1 The process the National Institute for Health and Clinical Excellence (NICE) follows for evaluating new medicines is the most rigorous anywhere in the world, and local NHS organisations can have confidence that implementing our recommendations is an effective use of their resources.NICE's independent advisory committees do not rubber stamp decisions.They make them based on an objective and impartial interpretation of the evidence.Those who suggest otherwise should come forward with their evidence for doing so.It is wrong to suggest that a single recommendation from NICE will necessarily cause other services to be reduced and that these decisions are made by clinicians only.Many demands are made on available funds in any hospital at any one time and it is the responsibility of local NHS management, working with their clinical teams, to make the best use of these resources.This difficult job is made easier by NICE guidance and the support tools we offer, such as our commissioning guides and our forthcoming advice on shifting spending from less to more effective treatments.
A new hazard of medicine
Authors: S. Shafqat
Journal: BMJ (2002)

In a tragedy of mounting proportions, doctors in Karachi are facing a grave risk on account of their professional identity. In the past three years, more than 80 doctors have been killed in Pakistan's largest city, ambushed during their daily commutes by motorcyclists who deliver automatic gunfire from point blank range. Karachi has had a reputation for being something of a powder keg, but no one had anticipated it would come to this.

I, too, am a doctor in Karachi. These are not easy times for any of us, but to belong to a profession whose members are being senselessly killed is an experience bordering on torture. Panic has rippled through my city's normally thriving medical community. I know colleagues who have fled the country and left behind flourishing practices and distinguished teaching positions. Some have confined themselves indoors. The rest of us are varying our daily routines, sleeping over at the houses of friends and neighbours, and exchanging cars so we don't get …
Estrogen Receptors, Estradiol, and Diethylstilbestrol in Early Development: The Mouse as a Model for the Study of Estrogen Receptors and Estrogen Sensitivity in Embryonic Development of Male and Female Reproductive Tracts*
Authors: TAMARA L. GRECO, THERESA M. DUELLO, JACK GORSKI
Journal: Endocrine Reviews (1993)

DIETHYLSTILBESTROL (DES), a potent estrogen, once thought to be effective in preventing first trimester miscarriages, was administered in the 1950s to a population of pregnant women who were considered to be at risk (1, 2). A generation later, an increase in cases of a rare form of vaginal adenocarcinoma in girls when they reached puberty led Herbst and co-workers (3, 4) to suggest a link between prenatal exposure to DES and this cancer. There was widespread use of DES for maintenance of pregnancies between the years 1945–1971, and it has been estimated that 980,000 to 4.5 million boys and girls born during those years were exposed to DES in utero (5). For example, the annual incidence rate of genital cancer (per 10,000,000) for 16-yr-old white females born in 1955 was 17.8 as compared to 0 for 16-yr-old girls born in 1949 (4). In addition to the neoplasia, benign anomalies were also reported in women exposed to DES in utero (6–8).
Effect of Low-Level Carbon Monoxide Exposure on Onset and Duration of Angina Pectoris
Authors: Einar W. Anderson, Robert J. Andelman, Joseph M. Strauch, Nicholas J. Fortuin, John H. Knelson
Journal: Annals of Internal Medicine (1973)

This study was done to ascertain the cardiovascular effects of exposure to low levels of carbon monoxide (CO) on 10 adult men with stable angina pectoris. The patients breathed air, with 50 ppm CO or 100 ppm CO, for 4 hours on 5 successive days. After each exposure a standard treadmill-exercise ECG was recorded. The time of onset and duration of anginal pain were recorded. Mean carboxyhemoglobin (COHb) level after air was 1.3%, rising to 2.9% after 50 ppm CO and to 4.5% after 100 ppm CO. Mean duration of exercise before onset of pain was significantly shortened after both 50 and 100 ppm CO in comparison with air (P < 0.005). The duration of pain was significantly prolonged after 100 ppm compared with air (P < 0.01), but not after 50 ppm. Electrocardiograms recorded during and after exercise generally showed worsening of ST-segment changes, with earlier onset and longer duration of ST-segment depression. Low levels of CO can cause decreased exercise tolerance and worsening of myocardial ischemia in patients with angina pectoris.
Pediatric Surgery
Authors: N S Adzick, M L Nance
Journal: New England Journal of Medicine (2000)

The scope of pediatric surgery is broad, encompassing the care of patients from before birth through the adolescent years and addressing a wide range of conditions, including congenital malformations, cancer, trauma, and disorders requiring transplantation. The roots of pediatric surgery can be traced to the early 20th century, with the pioneering efforts of Dr. William E. Ladd at Children's Hospital in Boston. Since that time, several generations of surgeons have dedicated their careers to the care of children, and pediatric surgery has become a well-established specialty.1 The specialty matured with the development of postgraduate training programs, the creation of the . . .
Pneumococcal Pneumonia Treated with Antibiotics
Authors: Thomas E. Van Metre
Journal: New England Journal of Medicine (1954)

SINCE the introduction of antibacterial agents effective against the pneumococcus, there has been a definite decrease in mortality in pneumococcal pneumonia—from approximately 30 per cent in the era before specific treatment, to about 5 per cent in the antibiotic era.1 Despite these improvements, however, many patients still die of the disease, and others have an unusually slow and complicated convalescence. It is important, therefore, to study clinical findings in fatal and prolonged nonfatal cases with an unfavorable outcome.It has been well established that certain clinical findings have prognostic significance in nonspecifically treated pneumococcal pneumonia. Heffron2 collected data from large . . .
The American Society for Clinical Investigation, 1952–1975: a personal perspective
Authors: Eugene Braunwald
Journal: Journal of Clinical Investigation (2008)

In this perspective, I trace my experiences with the ASCI, beginning in 1952, when as a medical student I attended my first meeting, until 1975, when I completed my term as president of the Society.I focus attention on the sociological aspects of the Atlantic City meetings and the critically important role these meetings played in the evolution of academic medicine during the third quarter of the 20th century.
Dermatitis artefacta as the presenting feature of auto-erythrocyte sensitization syndrome and naproxen-induced pseudoporphyria in a single patient
Authors: N. H. COX, D. S. WILKINSON
Journal: British Journal of Dermatology (1992)

A female patient presented with two episodes of apparent dermatitis artefacta. Although it was clear that self-induced lesions were present on both occasions, there was also strong evidence in support of auto-erythrocyte sensitization syndrome on the first occasion and of naproxen-induced pseudoporphyria on the second occasion. The occurrence of two such rare disorders in a single patient is extremely unusual, and we discuss a possible pathogenetic link between them. The case emphasizes that patients with apparent artefactual lesions, or with a previous history of dermatitis artefacta, still require careful evaluation to identify organic disease.
Acute soccer injuries in Finland in 1980.
Authors: J Sandelin, S Santavirta, O Kiviluoto
Journal: British Journal of Sports Medicine (1985)

The present investigation analyses all the acute soccer injuries recorded in Finland during one year (1980). The mean follow-up time was 18 months. The calculated yearly injury incidence was 5.8%. No significant difference in the injury incidences between the two sexes could be detected. A major part, 64% of the injuries were located in the lower extremities. Fractures and dislocations accounted for 11% of all injuries. One quarter of the injuries were classified as mild, causing a playing disability shorter than a week. Most injuries occurred through physical contact with another player (p less than 0.001). The calculated median time of absence from practice after injury was 4 weeks.
The influence of thermal perception change using l-menthol on pacing regulation during exercise in the heat
Authors: M J Barwood, J Corbett, D White, J James
Journal: British Journal of Sports Medicine (2011)

Fatigue occurs prematurely during exercise in hot conditions. The role of thermal perception in driving pacing has yet to be determined. We tested the hypothesis that improved thermal perception (feeling cooler and more comfortable) in the absence of changed thermal state, would alter pacing and improve time trial (TT) performance. Eleven trained cyclists (mean(sd):age 30 (8) y; height 1.78 (0.06) m; mass 76.0 (8.3) kg) completed three 40 km TTs in standardised conditions (32°C, 50%RH) with thermal perception altered prior to one TT using cold-receptor-activating menthol spray (0.05% MENTHOL and surfactants) in contrast to a control spray (CS; surfactants only) and no spray control (CON). Perceptual responses (thermal comfort, sensation and perceived exertion), thermal responses (skin and rectal temperature) and performance (power output, time to completion) were measured. Data were compared within participant between trials using repeated measures ANOVA with α level for statistical tests of 0.05. MENTHOL improved thermal perception prior to and during exercise up to 15 km compared to CS and CON. There was no difference in the pacing strategy adopted as a consequence of the altered thermal perception (5 km ‘bins' or the first 1 km of each TT up to 10 km) despite a difference in skin temperature profile at the start of exercise (CS 33.3 (1.1)°C and MENTHOL 33.4 (0.4)°C cp CON 34.5 (0.5)°C). There was no performance benefit in the MENTHOL condition; TT completion time CON: 71.58 (6.21) min, CS: 70.94 (6.06) min, MENTHOL 71.04 (5.47) min. RPE was not different between trials at any stage. Thermal perception is not a primary driver of pacing at the start of exercise or during cycling in hot conditions. Prior to reaching a threshold for thermal perceptual disturbance pacing strategy may be subconsciously regulated in accordance with RPE. MENTHOL spray did not enhance initial TT performance in the conditions of the present study.
Potentiation of nonadrenergic noncholinergic relaxation of human isolated bronchus by selective inhibitors of phosphodiesterase isozymes.
Authors: L B Fernandes, J L Ellis, B J Undem
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Human bronchial rings were contracted with histamine (3 microM), and inhibitory responses were obtained with electrical field stimulation (EFS) in the presence of propranolol (1 microM), atropine (1 microM), and indomethacin (3 microM). These nonadrenergic noncholinergic (NANC) relaxations were frequency-dependent (1 to 32 Hz) and inhibited by either tetrodotoxin or Nw-nitro-L-arginine (L-NNA, 100 microM). The selective cAMP-specific phosphodiesterase (PDE) type IV inhibitors rolipram (3 microM) and Ro 20-1724 (3 microM) significantly potentiated NANC relaxations at each frequency of stimulation. The selective cGMP-specific PDE type V inhibitor zaprinast (3 microM) failed to significantly alter the maximal NANC response, but it caused a slight potentiation of the response at lower frequencies. The adenylyl cyclase stimulant forskolin, the nitric oxide donor compound 3-morpholinosydnonimine (SIN-1), and the guanylyl cyclase stimulant sodium nitroprusside caused concentration-dependent relaxation of histamine-contracted airway smooth muscle. Rolipram significantly potentiated the relaxation elicited by forskolin. Rolipram also potentiated responses to SIN-1 and sodium nitroprusside. Considered together these data support the hypothesis that cAMP plays a facilitory role in NANC relaxation of the human bronchi.