tbuckley/cabot-search huggingface dataset:
Comparison of Depressed and Nondepressed Women with Severe Premenstrual Tension Syndrome
Authors: Judith P. Siegel, B. Meyers, M.K. Dineen
Journal: Psychotherapy and Psychosomatics (1986)

There is a need to better understand the relationship between premenstrual tension syndrome (PMS) and premenstrual depression. This research was designed to determine if severely depressed women experience a different kind of premenstrual dysfunction than nondepressed PMS patients.The nature and severity of premenstrual symptoms in both groups were evaluated and compared. The severely depressed women were found to have higher PMS scores, but did not differ from the nondepressed group in selection or ranking of symptoms. Depression appeared to influence the patient's perception and rating of symptoms, but the underlying premenstrual dysfunction was identical.
Whole-exome sequencing identifies Coronin-1A deficiency in 3 siblings with immunodeficiency and EBV-associated B-cell lymphoproliferation
Authors: Despina Moshous, Emmanuel Martin, Wassila Carpentier, Annick Lim, Isabelle Callebaut, Danielle Canioni, Fabian Hauck, Jacek Majewski, Jeremy Schwartzentruber, Patrick Nitschke, Nicolas Sirvent, Pierre Frange, Capucine Picard, Stéphane Blanche, Patrick Revy, Alain Fischer, Sylvain Latour, Nada Jabado, Jean-Pierre de Villartay
Journal: Journal of Allergy and Clinical Immunology (2013)
Asking the Courts to Set the Standard of Emergency Care -- The Case of Baby K
Authors: George J. Annas
Journal: New England Journal of Medicine (1994)

Almost two decades ago, Dr. Franz J. Ingelfinger predicted that if physicians kept turning to the courts “to resolve essentially medical matters,” the medical profession's unfortunate “dependence on the lawyer in reaching essentially medical decisions will continue”1. One can argue about what decisions are “essentially medical,” but the trend that worried Dr. Ingelfinger has continued, and now physicians and a hospital have sought legal and judicial guidance about how -- and whether -- to treat an anencephalic infant known as Baby K.Treating Baby KBaby K was born by cesarean section on October 13, 1992, at Fairfax Hospital . . .
Paired Comparison of Vascular Wall Reactions to Palmaz Stents, Strecker Tantalum Stents, and Wallstents in Canine Iliac and Femoral Arteries
Authors: Klemens H. Barth, Renu Virmani, Jens Froelich, Toshiaki Takeda, Steven V. Lossef, Joseph Newsome, Russell Jones, David Lindisch
Journal: Circulation (1996)

Background Palmaz stents, Strecker stents, and Wallstents, all used clinically, differ substantially in their physical characteristics, yet how differently the vascular wall reacts to them has not been demonstrated conclusively. We therefore undertook a side-by-side comparison. Methods and Results One stent was implanted into each canine external iliac and/or the flexing portion of the proximal femoral artery. In 9 dogs, Palmaz stents were placed vis-à-vis Strecker stents, with follow-up of 2 and 4 months. In 7 dogs, Palmaz stents were placed vis-à-vis Wallstents, with 4 months of follow-up. Angiographic midstent luminal diameters immediately after placement and at follow-up as well as midstent cross-sectional areas of neointima were compared for significant differences. In addition, neointimal maturation, medial atrophy, and stent-related trauma were assessed. Angiographically, all arteries remained open. The degree of luminal narrowing by recoil and neointima never reached 50% and was modest for Palmaz stents and Wallstents ( P =.33) but significantly higher for Strecker stents ( P &lt;.0001 compared with Palmaz stents). This corresponded histologically to a significantly thicker neointima ( P =.003) over Strecker than over Palmaz stents but not between Palmaz stents and Wallstents ( P =.18). Neointimal buildup was generally more pronounced in the femoral artery segments than in the iliac segments. Maturation of the neointima over Palmaz stents was much further advanced than over Strecker stents and slightly more advanced than over Wallstents. Pressure-related atrophy of the tunica media was least for Strecker stents and more pronounced but similar for Wallstents and Palmaz stents. Wallstent wire ends caused some wall trauma; several femoral Palmaz stent struts protruded through the media. Conclusions The lower-hoop-strength, higher-profile tantalum Strecker stent is affected by vascular wall recoil and evokes a greater degree of neointima formation than the lower-profile, higher-hoop-strength Palmaz stent and Wallstent. Medial atrophy is pronounced outside the latter two stents. The rigid Palmaz stent can penetrate through the vascular wall in flexing arteries.
CD4 Counts as Surrogate Markers for Progression to AIDS
Authors: Pamela Jo Harris
Journal: Annals of Internal Medicine (1994)

Letters1 January 1994CD4 Counts as Surrogate Markers for Progression to AIDSPamela Jo Harris, MDPamela Jo Harris, MDThe AIDS Clinical Research Center of Washington; Washington, DC 20009Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-1-199401010-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Choi and colleagues' recent article [1] addressing CD4 counts as an incomplete marker for zidovudine efficacy was, unfortunately, more of the same: statistical manipulation of contrived end points to justify administration of zidovudine. Having lived through a series of statistical machinations about zidovudine, I find them somewhat difficult to tolerate.I remember when zidovudine increased everyone's CD4 cell counts; when it increased CD4 cell counts only when they were already greater than 200 × 109; when it increased CD4 cell counts for long periods; when it raised them for only a few weeks; when high CD4:CD8 ratios ...REFERENCE1. Choi S, Lagakos SW, Schooley RS, Volberding PA. CD4+ lymphocytes are an incomplete surrogate marker for clinical progression in persons with asymptomatic HIV infection taking zidovudine. Ann Intern Med. 1993; 118:674-80. Google Scholar Author, Article, and Disclosure InformationAffiliations: The AIDS Clinical Research Center of Washington; Washington, DC 20009 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1994Volume 120, Issue 1Page: 87-88KeywordsAIDSBiomarkersHealth statistics ePublished: 15 August 2000 Issue Published: 1 January 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
INSULIN TREATMENT: A SUGGESTION FOR AN OPTICAL METHOD
Authors: W. F. Lloyd
Journal: BMJ (1923)

occurring in women: (1) well marked haemiophilia re- sembling that in the male, (2) haemorrhagic diatliesis in females not connected with haemophilic famiilies, and (3) " an abnormal tendency to bleed in female members ofadmitted haemophilic families, such tendency being slight or atypical as compared with well marked haemophila."The patient appears to belong to this last class.
Circadian Blood Pressure Patterns and Life Stress
Authors: Francesco Fallo, Luisa Barzon, Franco Rabbia, Cecilia Navarrini, Andrea Conterno, Franco Veglio, Manuela Cazzaro, Giovanni A. Fava, Nicoletta Sonino
Journal: Psychotherapy and Psychosomatics (2002)

Scarce data are available on the influence of psychological aspects on 24-hour ambulatory blood pressure patterns either in normotensive or hypertensive subjects. This study was designed to evaluate the relationship between psychological profile and changes in daytime/nighttime blood pressure rhythm.Nocturnal dipping was defined as the night/day ratio of ambulatory mean systolic and/or diastolic blood pressure < or =0.87. Three-hundred and two outpatients (M/F = 174/128; mean age = 49.8 years, SD = 13.6; range, 16-80 years) underwent 24-hour ambulatory blood pressure monitoring. They were administered a self-rating scale, the Psychosocial Index, as an indicator of stress, psychological distress, sleep disturbances, well-being, abnormal illness behavior and quality of life. There were 242 patients taking antihypertensive medication (146 adequately controlled and 96 not controlled) and 60 who were drug free (33 never-treated hypertensive and 27 normotensive subjects). Patients were divided according to the presence (n = 125) or absence (n = 177) of night blood pressure dipping. The two groups were compared using analysis of covariance, with age as a covariate.Dippers had lower (p < 0.001) nocturnal systolic and diastolic blood pressure than nondippers, and higher (p < 0.05) daytime diastolic blood pressure. Patients with nocturnal blood pressure decline had a markedly higher (p < 0.001) level of stress than nondippers. When the sample was divided according to the presence or absence of hypertension, only subjects with normal blood pressure showed nocturnal dipping associated with increased stressful life circumstances.Our findings indicate that dippers experience stressful life circumstances, both in terms of life events and chronic stress. This suggests that stress-reducing techniques may be particularly helpful in the setting of hypertension characterized by nighttime blood pressure dipping.
Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers
Authors: Robert S. Nocon, Ravi Sharma, Jonathan M. Birnberg, Quyen Ngo-Metzger, Sang Mee Lee, Marshall H. Chin
Journal: JAMA (2012)

<h3>Context</h3>Little is known about the cost associated with a health center's rating as a patient-centered medical home (PCMH).<h3>Objective</h3>To determine whether PCMH rating is associated with operating cost among health centers funded by the US Health Resources and Services Administration.<h3>Design, Setting, and Participants</h3>Cross-sectional study of PCMH rating and operating cost in 2009. PCMH rating was assessed through surveys of health center administrators conducted by Harris Interactive of all 1009 Health Resources and Services Administration–funded community health centers. The survey provided scores from 0 (worst) to 100 (best) for total PCMH score and 6 subscales: access/communication, care management, external coordination, patient tracking, test/referral tracking, and quality improvement. Costs were obtained from the Uniform Data System reports submitted to the Health Resources and Services Administration. We used generalized linear models to determine the relationship between PCMH rating and operating cost.<h3>Main Outcome Measures</h3>Operating cost per physician full-time equivalent, operating cost per patient per month, and medical cost per visit.<h3>Results</h3>Six hundred sixty-nine health centers (66%) were included in the study sample, with 340 excluded because of nonresponse or incomplete data. Mean total PCMH score was 60 (SD, 12; range, 21-90). For the average health center, a 10-point higher total PCMH score was associated with a $2.26 (4.6%) higher operating cost per patient per month (95% CI, $0.86-$4.12). Among PCMH subscales, a 10-point higher score for patient tracking was associated with higher operating cost per physician full-time equivalent ($27 300; 95% CI, $3047-$57 804) and higher operating cost per patient per month ($1.06; 95% CI, $0.29-$1.98). A 10-point higher score for quality improvement was also associated with higher operating cost per physician full-time equivalent ($32 731; 95% CI, $1571-$73 670) and higher operating cost per patient per month ($1.86; 95% CI, $0.54-$3.61). A 10-point higher PCMH subscale score for access/communication was associated with lower operating cost per physician full-time equivalent ($39 809; 95% CI, $1893-$63 169).<h3>Conclusions</h3>According to a survey of health center administrators, higher scores on a scale that assessed 6 aspects of the PCMH were associated with higher health center operating costs. Two subscales of the medical home were associated with higher cost and 1 with lower cost.
Routine thienopyridine pretreatment for acute coronary syndrome without ST elevation
Authors: J. J. Rade
Journal: BMJ (2014)

It’s time to rethink an ageing strategy

Acute coronary syndrome (ACS) results from thrombus formation at the site of ruptured or eroded atherosclerotic plaques, which restricts coronary blood flow resulting in myocardial ischemia and injury. Thrombosis is initiated by the exposure of tissue factor and collagen to the circulating blood, which leads simultaneously to local triggering of the coagulation cascade and activation and adhesion of platelets. Activated platelets release secondary agonists, including thromboxane and ADP, which recruit additional waves of platelet adhesion that facilitate thrombus growth. Given their central pathogenic importance, pharmacological inhibition of both platelet activation and thrombin generation have long been cornerstone treatments for the full spectrum of ACS.

Current European and North America guidelines provide a class I recommendation for the administration of dual antiplatelet therapy to patients presenting with non-ST elevation ACS consisting of aspirin to inhibit platelet thromboxane production and an ADP (P2Y12) receptor antagonist, such as the thienopyridine clopidogrel, to prevent secondary platelet activation.1 2 In the linked research article, Bellemain-Appaix and colleagues (doi:10.1136/bmj.g6269) explore …
Keratoconjunctivitis Sicca in Male Patients Infected with Human Immunodeficiency Virus Type 1
Authors: John Andrew Lucca, R. Linsy Farris, Leonard Bielory, Anthony R. Caputo
Journal: Ophthalmology (1990)

Keratoconjunctivitis sicca (KCS) has not been reported as occurring as a single entity in the acquired immune deficiency syndrome (AIDS) population. In a survey of human immunodeficiency virus type 1 (HIV-1) infected male patients, the authors found that 21 % (9/42) had signs and symptoms compatible with KCS with positive Schirmer test results. Tear osmolarity determinations were obtained from this group and from an age- and sex-matched group of HIV-infected patients without symptoms of KCS and with negative Schirmer test results. Eighty-nine percent of the suspect group had increased tear osmolarity, whereas none of the control patients had a hyperosmolar tear film (P < 0.0001). Results strongly suggest that KCS occurs at a significantly greater rate in male individuals infected with HIV-1 than in the general population.
Prenatal nicotine exposure increases connective tissue expression in foetal monkey pulmonary vessels
Authors: H.S. Sekhon, B.J. Proskocil, J.A. Clark, E.R. Spindel
Journal: European Respiratory Journal (2004)

Among the many deleterious effects of maternal smoking during pregnancy on foetal development, is a higher incidence of persistent pulmonary hypertension. The recent identification of nicotinic acetylcholine receptors (nAChR) on cells of the pulmonary vessel walls suggests that maternal smoking during pregnancy may produce morphological alterations in foetal pulmonary vasculature. Timed­pregnant rhesus monkeys were treated with nicotine (1 mg·kg −1 ·day −1 ) delivered by subcutaneous osmotic mini­pumps from days 26–134 of gestation (term: 165 days). Lung sections from 134‐day foetal monkeys were used for morphometric analysis, in situ hybridisation and immunohistochemical staining. Following nicotine treatment, total wall and tunica adventitia thickness of airway associated vessels (AAV) increased significantly. Nicotine exposure significantly increased collagen I and III mRNA and protein in tunica adventitia in all AAV but not in tunica media. By contrast, levels of elastin protein were significantly decreased. α7 nAChR were detected in AAV fibroblasts that expressed collagen mRNA. Choline acetyltransferase, the enzyme which synthesises acetylcholine, the ligand for α7 nAChR was also detected in endothelium and fibroblasts. These findings suggest that with smoking during pregnancy, nicotine is transported across the placenta and directly interacts with nicotinic acetylcholine receptors in pulmonary vessels to alter connective tissue expression and therefore produce vascular structural alterations.
Prime minister calls for major consultation on social care
Authors: Lynn Eaton
Journal: BMJ (2008)

Gordon Brown has announced a major consultation on the way social care is provided in England and how best to ensure suitable provision of care for the growing number of elderly people.

“We expect two million more people to have care and support needs in 20 years’ time,” he told a meeting on Monday at the healthcare charity the King’s Fund in London.

The Department of Health says that by 2028 a quarter of the adult population in England will be aged over 65 years and that the number of people aged over 85 will have doubled.

“Quite rightly, people’s expectations have risen in recent years,” Mr Brown said. “A generation of older …
Children with juvenile chronic arthritis: their beliefs about their illness and therapy.
Authors: J G Beales, P J Holt, J H Keen, V P Mellor
Journal: Annals of the Rheumatic Diseases (1983)

Seventy-five patients aged 7 to 17 with juvenile chronic arthritis were interviewed to identify their beliefs about the physical nature of their illness and the relevance and modes of action of their clinical treatment. Children in the 7-11 age group were found to perceive their arthritis largely in terms of its immediately manifestations, to have little conception of internal pathology, and to be less aware of the value of their medical therapy. Children in the 12-17 age group showed a greater tendency to recognize arthritis as a condition of internal pathology, to experience distressing fantasies about the internal appearance of their affected joints, and to appreciate the purpose of their therapy.
The Logistic Organ Dysfunction System
Authors: Jean-Roger Le Gall
Journal: JAMA (1996)

<h3>Objective.</h3> —To develop an objective method for assessing organ dysfunction among intensive care unit (ICU) patients on the first day of the ICU stay. <h3>Design and Setting.</h3> —Physiological variables defined dysfunction in 6 organ systems. Logistic regression techniques were used to determine severity levels and relative weights for the Logistic Organ Dysfunction (LOD) score and for conversion of the LOD score to a probability of mortality. <h3>Patients.</h3> —A total of 13 152 consecutive admissions to 137 adult medical/ surgical ICUs in 12 countries from the European/North American Study of Severity Systems. <h3>Outcome Measure.</h3> —Patient vital status at hospital discharge. <h3>Results.</h3> —The LOD System identified from 1 to 3 levels of organ dysfunction for 6 organ systems: neurologic, cardiovascular, renal, pulmonary, hematologic, and hepatic. From 1 to 5 LOD points were assigned to the levels of severity, and the resulting LOD scores ranged from 0 to 22 points. Model calibration was very good in the developmental and validation samples (P=.21 and P=.50, respectively), as was model discrimination (area under the receiver operating characteristic curves of 0.843 and 0.850, respectively). <h3>Conclusion.</h3> —The LOD System provides an objective tool for assessing severity levels for organ dysfunction in the ICU, a critical component in the conduct of clinical trials. Neurologic, cardiovascular, and renal dysfunction were the most severe organ dysfunctions, followed by pulmonary and hematologic dysfunction, with hepatic dysfunction the least severe. The LOD System takes into account both the relative severity among organ systems and the degree of severity within an organ system.
Major disaster planning.
Authors: A R Bliss
Journal: BMJ (1984)

In 1983 a coach crash brought a hospital9s major disaster plan into operation. The surgical aspects of the plan were assessed to see how well they matched up to three major aims: saving life, relieving pain and distress, and completing primary treatment of open wounds within eight hours of the accident. The last goal was not met for most of the 21 victims, mainly children with multiple deep dirty abrasions and extensive tissue loss. Having determined that none of the victims were in immediate danger the surgeons reassessed the priorities--in several cases disturbing dressings for a third or fourth time. The total time spent in theatre (in five theatres) was 37 hours, as opposed to the original estimated 10-15 hours. The experience gained in this accident suggests that a disaster plan should indicate the number of patients a single hospital can admit and that a senior surgeon should act as a coordinator and get surgeons working as soon as patients arrive, keeping two theatres reserved for lifesaving surgery. In this way primary treatment of wounds may be completed within eight hours of injury and the risk of infection reduced.
Fatal cyanide poisoning: accidental ingestion of amygdalin
Authors: J. R. Humbert
Journal: JAMA (1977)

To the Editor. —  Amygdalin (laetrile) tablets can release hydrocyanic acid on exposure to hydrolytic enzymes. To our knowledge, no fatality due to such poisoning has been reported to date. We wish to draw attention to the fact that when ingested accidentally by young children, amygdalin tablets may constitute a potentially fatal hazard.  Report of a Case.—  An 11-month-old girl accidentally ingested from one to five 500-mg amygdalin tablets. The tablets belonged to the child's father who has a malignant neoplasm. They were thought to be harmless by the parents and were contained in a vial along with an assortment of vitamin tablets. The patient became listless within half an hour after ingestion and vomited. Emesis was induced again by the mother who then rushed the child to the local hospital when her breathing became irregular and her state of consciousness became altered. An hour after ingestion, she was in
The Huxley Lecture on Diathesis
Authors: A. Garrod
Journal: BMJ (1927)

MEN ar-e called healthy in virtue of the inborn capacity of easy riesistance to those unhealthy influences that mnay oldinarily arise; unhliealthy in virtue of a lack of that capacity."This passage from Aristotle's " Categories,"l writteni two tlhousand three hundred years ago, may well serve as my text to-day.We all know what we have in nmind wihen we speak of health and disease, but it is not easy to frame definitions wllicil shall embrace all tllat these terms denote.We still neeid to pay heed to the warning of that great teacher Thlomas Watson,2 that disease must not be regarded as a thing, or as the-phrase goes, a separate entity, by wllich the body is possessed and damaged-something which canl be contemplated as apart from the body which it may invade."
The Risk of Having Children
Authors: Walt McDonald
Journal: JAMA (1998)

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Stage 3 immature human natural killer cells found in secondary lymphoid tissue constitutively and selectively express the TH17 cytokine interleukin-22
Authors: Tiffany Hughes, Brian Becknell, Susan McClory, Edward Briercheck, Aharon G. Freud, Xiaoli Zhang, Hsiaoyin Mao, Gerard Nuovo, Jianhua Yu, Michael A. Caligiuri
Journal: Blood (2009)