tbuckley/cabot-search huggingface dataset:
Abnormalities of Taste and Smell in Sjogren's Syndrome
Authors: R. I. HENKIN
Journal: Annals of Internal Medicine (1972)

Taste and smell thresholds and forced scaling levels were studied in 29 patients with Sjögren's syndrome and in 10 patients with various diseases of the parotid glands, with and without xerostomia and rhinitis sicca. Patients with xerostomia and rhinitis sicca due to Sjögren's syndrome or other causes had significant decreases in taste and smell acuity. Cyclophosphamide or X-ray treatment improved taste or smell function if the xerostomia or rhinitis sicca concomitantly improved. These studies suggest that saliva and nasal mucus are important in maintaining normal taste and smell acuity through their effects on taste bud and olfactory epithelium function.
Cardiac Resynchronization Therapy in Women
Authors: Robbert Zusterzeel, Kimberly A. Selzman, William E. Sanders, Daniel A. Caños, Kathryn M. O’Callaghan, Jamie L. Carpenter, Ileana L. Piña, David G. Strauss
Journal: JAMA Internal Medicine (2014)

IMPORTANCE Women were underrepresented in cardiac resynchronization therapy (CRT) trials for heart failure (making up about 20% of enrollees).Combining individual patient data from multiple clinical trials would enable assessment of CRT benefit in women.OBJECTIVE To evaluate whether women with left bundle branch block (LBBB) benefit from CRT-defibrillators (CRT-D) at a shorter QRS duration than men with LBBB do.DESIGN, SETTING, AND PARTICIPANTS Individual patient data were pooled from 3 CRT-D vs implantable cardioverter defibrillator (ICD) trials (4076 patients) enrolling predominantly patients with New York Heart Association (NYHA) class II heart failure and follow-up to 3 years.The effect of CRT-D compared with ICD on outcomes was assessed using random effects Cox proportional hazards.MAIN OUTCOMES AND MEASURES Time to heart failure event or death (primary) and death alone (secondary).RESULTS Women benefited from CRT-D more than men.The main difference occurred in patients with LBBB and a QRS of 130 to 149 milliseconds.In this group, women had a 76% reduction in heart failure or death (absolute CRT-D to ICD difference, 23%; hazard ratio [HR], 0.24, [95% CI, 0.11-0.53];P < .001)and a 76% reduction in death alone (absolute difference 9%; HR, 0.24, [95% CI, 0.06-0.89];P = .03),while there was no significant benefit in men for heart failure or death (absolute difference 4%; HR, 0.85 [95% CI, 0.60-1.21];P = .38)or death alone (absolute difference 2%; HR, 0.86 [95% CI, 0.49-1.52];P = .60).Neither women nor men with LBBB benefited from CRT-D at QRS shorter than 130 milliseconds, while both sexes with LBBB benefited at QRS of 150 milliseconds or longer. CONCLUSIONS AND RELEVANCEIn this population of patients with primarily mild heart failure, women with LBBB benefited from CRT-D at a shorter QRS duration than men with LBBB.This is important because recent guidelines limit the class I indication for CRT-D to patients with LBBB and QRS of 150 milliseconds or longer.While guidelines do give a class IIa indication to patients with LBBB and a QRS of 120 to 149 milliseconds, the present findings are important to communicate because women are less likely to receive CRT-D than men are.This study exemplifies the potential public health and regulatory science value of combining data from multiple clinical trials submitted to the FDA.
The Three-Year Medical Curriculum
Authors: Robert G. Page
Journal: JAMA (1970)

For several years, medical educators have been carefully examining the length of time it takes to become a practicing physician. There are points along the educational path where appropriate shortcuts might be made by students who are both interested and endowed with adequate aptitudes. The more apparent of these are (1) reducing the calendar years spent in college to less than four, (2) reducing the calendar years spent in medical college to less than four, (3) elimination of the internship, and (4) decreasing the years spent in residency training. In this presentation, I will give prime consideration to the shortening of the medical school curriculum. I will also briefly discuss the reduction of other portions of prepractitioner education. In 1967, Paul Sanazaro and I organized a conference entitled "The Optimal Preparation for the Study of Medicine," which, in essence, examined the college-medical school relationship.<sup>1</sup>As a result of that
Farmer's lung: a study of an early acute fatal case
Authors: D. F. Barrowcliff, P. G. Arblaster
Journal: Thorax (1968)

The clinical and pathological findings in a fatal case of farmer9s lung in a 17-year-old youth are described. His lungs were uncomplicated by chronic disease, and his first exposure to mouldy hay probably occurred only weeks before his death. As this was an acute attack, whose duration could be measured in days, the changes seen are probably the earliest to be recorded, and the probable nature of the sensitivity reaction can be deduced. The pathological process is seen to be an acute centrilobular bronchopneumonia of a special type and is associated with an obstructive bronchiolitis. There is a focal interstitial pneumonia with much proliferation of alveolar epithelium, and there is a necrotic exudate in which neutrophils and eosinophils are seen along with mononuclears, some lymphocytes, and plasma cells. The alveolar spaces are in many cases obscured, but others contain a haemorrhagic fluid. Alveolar capillaries show an acute vasculitis, with platelet and fibrin deposition, and with acute neutrophil infiltration. Serological and mycological data are included. Precipitins to mouldy hay and to <i>Thermopolyspora polyspora</i> were found in the serum. In dusts collected from his habitat <i>T. polyspora</i> was found. We think the bronchiolitis explains the severe dyspnoea, and the vasculitis accounts for the malaise, fever, and haemoptysis. The histological findings are compared with accounts of experimentally produced Arthus reactions and tuberculin reactions, and we give our reasons for believing the fundamental lesion to be an Arthus reaction.
The Wilson disease gene is a copper transporting ATPase with homology to the Menkes disease gene
Authors: R.E. Tanzi, K. Petrukhin, I. Chernov, J.L. Pellequer, W. Wasco, B. Ross, D.M. Romano, E. Parano, L. Pavone, L.M. Brzustowicz, M. Devoto, J. Peppercorn, A.I. Bush, I. Sternlieb, M. Pirastu, J.F. Gusella, O. Evgrafov, G.K. Penchaszadeh, B. Honig, I.S. Edelman, M.B. Soares, I.H. Scheinberg, T.C. Gilliam
Journal: Nature Genetics (1993)
Tissue Concentration of Nalidixic Acid in Chronic Pyelonephritis
Authors: R. M. Jameson
Journal: BMJ (1965)

M BWT 621 who had had a subtotal thyroidectomy but who were normocalcaemic.In each group about one-third of the patients without objective laryngeal signs complained of persistent voice changes dating from the time of operation.Our thanks are due to the various physicians and surgeons who referred patients for study.We are grateful to Associate Professor T. S.
How should we rate research?: Pedigree: paternity and progeny
Authors: Woody Caan
Journal: BMJ (2006)

EDITOR—What is meant by quality in health research?1 2 For social scientists, the Economic and Social Research Council detailed multiple problems with American metrics.3 It introduced the concept of esteem: something dynamic and cumulative (not just sitting on public committees). Pondering what is admirable, I propose two assessments, both stemming from encountering the health scientist I most “esteemed”: Peter Medawar.4 These same qualities were …
Valvoplasty for abnormalities of posterior (mural) cusp of the mitral valve
Authors: A. H. Brown, M. V. Braimbridge, A. J. Clement, E. Sabar, D. Mendel
Journal: Thorax (1968)

Five patients with abnormalities of the chordae tendineae of the posterior (mural) cusp of the mitral valve have been treated by plication of the cusp, annulus, and atrium in continuity (modified McGoon valvoplasty). They had acute symptoms with physical signs characterized by sinus rhythm and an apical pansystolic murmur radiating to the base of the heart. Investigation showed high left atrial systolic pressures in small atria. Apart from one patient who died of cerebral air embolism with a good haemodynamic result, all were immediately improved and had smooth post-operative courses. Improvement was maintained at follow-up without embolic complications despite stopping anticoagulants.
Successful treatment with infliximab and methotrexate of pyostomatitis vegetans associated with Crohn's disease
Authors: G. Bens, D. Laharie, M. Beylot-Barry, B. Vergier, I. Noblesse, C. Beylot, M. Amouretti
Journal: British Journal of Dermatology (2003)

A 35-year-old woman with severe fistulizing Crohn's disease presented with pyostomatitis vegetans affecting both the mouth and the vulva. The coalescing pustules transformed within several days into vegetating lesions on areas of inflammation. Microbial assessments revealed no pathogenic agent. Histology showed neutrophilic microabscesses, but no granulomas. Three injections of infliximab and maintenance therapy with methotrexate resulted in rapid and complete regression of both the pyostomatitis vegetans and the Crohn's disease. Infliximab and methotrexate may be a promising treatment for the rare cases of pyostomatitis vegetans associated with Crohn's disease.
Successful oral tolerance induction in severe peanut allergy
Authors: A. T. Clark, S. Islam, Y. King, J. Deighton, K. Anagnostou, P. W. Ewan
Journal: Allergy (2009)

Peanut allergy is common, potentially severe and rarely resolves causing impaired quality of life. No disease-modifying treatment exists and there is therefore a need to develop a therapeutic intervention.The aim of this study was to investigate whether peanut oral immunotherapy (OIT) can induce clinical tolerance to peanut protein.Four peanut-allergic children underwent OIT. Preintervention oral challenges were performed to confirm clinical allergy and define the amount of protein required to cause a reaction (dose thresholds). OIT was then administered as daily doses of peanut flour increasing from 5 to 800 mg of protein with 2-weekly dose increases. After 6 further weeks of treatment, the oral challenge was repeated to define change in dose threshold and subjects continued daily treatment.Preintervention challenges confirmed peanut allergy and revealed dose thresholds of 5-50 mg (1/40-1/4 of a whole peanut); one subject had anaphylaxis during challenge and required adrenaline injection. All subjects tolerated immunotherapy updosing to 800 mg protein and i.m. adrenaline was not required. Each subject tolerated at least 10 whole peanuts (approximately 2.38 g protein) in postintervention challenges, an increase in dose threshold of at least 48-, 49-, 55- and 478-fold for the four subjects.We demonstrated a substantial increase in dose threshold after OIT in all subjects, including the subject with proven anaphylaxis. OIT was well tolerated and conferred protection against at least 10 peanuts, more than is likely to be encountered during accidental ingestion.
Vertebral Osteomyelitis due to Actinobacillus actinomycetemcomitans
Authors: I. Muhle, J. Rau, J. Ruskin
Journal: JAMA (1979)

ONLY 52 cases of<i>Actinobacillus actinomycetemcomitans</i>infection have been recorded from the United States and Europe.<sup>1,2</sup>Most of the patients described had endocarditis. We report here an unusual case of systemic A<i>actinomycetemcomitans</i>infection in which there was no evidence of endocarditis. This patient had vertebral osteomyelitis and axillary abscesses. To our knowledge, hematogenous osteomyelitis due to<i>A actinomycetemcomitans</i>has not been previously recognized. <h3>Report of a Case</h3> A 45-year-old accountant was in excellent health until November 1976, when he experienced lower back pain not associated with trauma, physical strain, or any systemic symptoms. Results of physical examination and urinalysis were normal. Roentgenogram of the lumbosacral spine and an intravenous urogram were normal. The patient received analgesics and physical therapy. Over the next two months, his pain worsened and at times radiated to the right hip and leg. During this period he denied fever, chills, or night sweats. By
Transference in Short-Term Dynamic Psychotherapy
Authors: H. Davanloo, C. Benoit
Journal: Psychotherapy and Psychosomatics (1978)

The authors discuss some of the basic psychotherapeutic techniques used in short-term dynamic psychotherapy and outline the following major therapeutic techniques: (I) Suggestive technique.( 2) Abreactive technique.(3) Manipulative technique.(4) Clarifying technique.(5) Technique of inter pretation.Then they conceptualize a spectrum of psychotherapies with supportive psychotherapy at one end of the continuum and classical psychoanalysis at the other end of the continuum, with dynamic psychotherapies somewhere in this continuum.They indicate that supportive psychotherapy is the tech nique which predominantly uses suggestion, abreaction and the therapeutic weight is primarily in favour of control over impulses and strengthening the defenses.They discuss psychoanalysis as a technique which analyzes trans ference and resistance back to their genetic dynamic roots and dynamic psychotherapy as a technique which recognizes the transference and resist ance and rationally utilizes their recognition in the therapy.Then they focus on some of the major technical issues in short-term dynamic psychotherapy in the area of therapeutic alliance, using positive transference, avoiding becoming entangled in characterological issues and focus systematically on those psychological conflicts which are underlying the patient's neurotic conflict.Avoiding the development of transference neuro sis is an important therapeutic task.The rest of the paper focuses on the subject of transference.Then, based on the clinical and research data of the senior author, they come to the conclusion that there is a very high significant correlation between transference interpretation and the outcome of short-term dynamic psycho therapy.
First Clinical Study Of Breast Implants Launched
Authors: Ten Randall
Journal: JAMA (1992)

ON THE FIRST of this month, after three decades of widespread use, the first Stage 2 research protocol designed to ask basic questions about the safety of silicone gel-filled breast implants got under way. The Food and Drug Administration (FDA)-approved protocol, submitted by Mentor Corporation, Santa Barbara, Calif, is open to any woman who has a "medical need" for breast reconstruction and for whom saline-filled implants are considered medically unsatisfactory. This includes the following: Women who need reconstruction after mastectomy or other cancer treatments, or after therapeutic or prophylactic mastectomy for other medical reasons. This category includes cancer patients whose breasts were previously reconstructed with saline implants or autologous tissue techniques with unsatisfactory results. Women who need reconstruction because of severe breast or chest deformity unrelated to breast cancer or previous mastectomy. The deformity can result from congenital or developmental problems, trauma, or medical or surgical complication
Defendant: A Psychiatrist on Trial for Medical Malpractice
Authors: Dorothy M. Bernstein
Journal: JAMA (1986)

This is a slender blue paperback book that begins innocently enough as an account of one doctor's encounter with a medical malpractice suit. It ends on a deeply disturbing note. By then it is clear that medical malpractice is not just an economic or legal problem. It is one of the most personal and far-reaching of the many ailments that beset contemporary medicine. The physician is a psychiatrist who initiated treatment of her patient in December 1974. Therapy had continued and progressed during most of 1975. On December 16, 1975, the psychiatrist's telephone rang. She was informed that her patient had jumped from a rooftop and was receiving treatment in the intensive care unit at a nearby hospital. The physician had consulted with her patient by telephone earlier that morning, and the patient had made an appointment to be seen in two days. Later, it was established that the patient
Medical Consequences of Persistent Viral Infection
Authors: Peter Southern, Michael B.A. Oldstone
Journal: New England Journal of Medicine (1986)

Most of our knowledge about the medical implications of viral disease comes from studies of acute viral infections.1 2 3 As a result of such studies, we now understand the clinical courses and pathogenic mechanisms of acute infections, and attempts to control infection through manipulation of the immune system — i.e., vaccination — have been described. Yet the future of medical virology will probably relate far more to persistent viral infections and the diseases associated with them.4 5 6 Included within this group are many of the herpesviruses (herpes simplex, cytomegalovirus, Epstein–Barr virus, varicella–zoster virus), hepatitis B virus, human T-cell lymphotropic virus (HTLV) Types . . .
Watchdog brands two thirds of NHS trusts as “fair” or “weak”
Authors: Adrian O'Dowd
Journal: BMJ (2006)

Many staff working in the NHS in England will feel under attack this week after publication of the first and highly critical annual “health check” by the NHS standards watchdog.

The Healthcare Commission was about to publish its health check as the BMJ went to press. The report presents the most comprehensive assessment ever of NHS performance and will give a more detailed picture than the previous star rating system.

The NHS needs to “raise its game,” concludes the report, which rated 570 NHS trusts in England on a four …
Survival analysis of disease modifying antirheumatic drugs in Spanish rheumatoid arthritis patients.
Authors: J De La Mata, F J Blanco, J J Gomez-Reino
Journal: Annals of the Rheumatic Diseases (1995)

OBJECTIVES--To evaluate the duration of treatment and the reasons for discontinuing therapy with disease modifying antirheumatic drugs in Spanish rheumatoid arthritis patients. METHODS--An observational study was made of 629 patients with rheumatoid arthritis treated with disease modifying antirheumatic drugs between 1979 and 1991. The outcomes (treatment termination because of toxicity and lack of response) of 991 treatment starts with intramuscular gold salts, D-penicillamine, azathioprine, and methotrexate were subjected to survival analysis. Cumulative probability of continuation of each drug (drug survival) was calculated by the Kaplan-Meier method and comparison between the survival curve of each was made by log rank testing. RESULTS--Median drug survival (95% confidence interval) was 51 (25-76.9) months for methotrexate, 39.9 (19.9-48.2) months for azathioprine, 34.9 (29.4-41.4) months for gold salts, and 16.4 (13.9-21) months for D-penicillamine. The highest cumulative probability of drug survival at five years was for methotrexate (45%); that at 10 years was for gold salts (15%). Up to 60% of the patients discontinued D-penicillamine in the first two years. Lack of response was the major limiting factor for all drugs except D-penicillamine, for which it was toxicity. D-Penicillamine was associated with a greater rate of discontinuations because of toxicity in women and patients older than 65. Previous disease modifying antirheumatic drug administration did not influence current drug survival. CONCLUSION--Overall, gold salts remain useful for the treatment of rheumatoid arthritis over long periods of time in the population studied. Because of the high rate of continuation of treatment (survival) and the optimal efficacy and toxicity profiles observed with methotrexate after five years of treatment, it should be the drug of first choice for second line treatment of these RA patients.
The Effects of Stress on Physicians and Their Medical Practice
Authors: Jack D. McCue
Journal: New England Journal of Medicine (1982)

EACH day physicians encounter stresses that are an intrinsic part of medical practice. Those who are vulnerable may become unable to practice medicine without the intrusion of seriously neurotic or inappropriate behavior: that is, they become impaired physicians. In nonimpaired physicians, adaptations to the unalterable stresses of medicine may be productive and may actually improve the quality of medical care. Unfortunately, adaptations are often unproductive, resulting in poorer quality or uneconomical care, or they may adversely affect the personal lives of the physician and his or her family. A description of physicians' stresses and adaptations would facilitate educational, personal, and . . .
The effect of antisense tyrosinase-related protein 1 on melanocytes and malignant melanoma cells
Authors: C-Y. Li, T-W. Gao, G. Wang, Z-Y. Han, Z. Shen, T-H. Li, Y-F. Liu
Journal: British Journal of Dermatology (2004)

Background Tyrosinase-related proteins (TRPs) include tyrosinase, TRP-1 and TRP-2. The functions of tyrosinase and TRP-2 have been determined, but the biological role of TRP-1 is still controversial and is not well known in humans. Objectives To study further the biological role of the human TRP-1 gene in melanocytes and melanoma cells. Methods TRP-1 cDNA was subcloned into eukaryotic expression vector pcDNA3.1 in the reverse direction, and antisense recombinant vector was transfected into melanocytes and a melanoma cell line using Lipofectamine 2000. Positive cells were selected by geneticin. TRP-1 mRNA level was measured by reverse transcription–polymerase chain reaction (RT–PCR), and TRP-1 protein level by Western blot. Cell cycles were determined by flow cytometry, and the activity of tyrosinase was evaluated by L-DOPA reaction. Light microscopy, electron microscopy and flow cytometry were used to observe cell morphology and apoptosis. For in vivo assays, the antitumour activity of antisense TRP-1 against the malignant melanoma (MM) cell line, Libr, was evaluated in an animal-tumour model of subcutaneous tumours. Results Positive transfected cells steadily expressed TRP-1 antisense RNA. RT–PCR and Western blot showed a low level of TRP-1 mRNA and TRP-1 protein, respectively. Cell cycles were blocked in the G1 stage, and the activity of tyrosinase decreased significantly (P < 0·01). Light and electron microscopy showed abnormal cell morphology, and apoptosis was detected. The neoplasia activity of antisense TRP-1-transfected MM cells was significantly lower than that of MM cells (P < 0·01). Conclusions TRP-1 plays an important role in the proliferation, morphology and tyrosinase activity of melanocytes and melanoma cells.
“Prancing” Heart With Pericardial Injury
Authors: Kodai Suzuki, Hideshi Okada, Tetsuya Fukuta, Shozo Yoshida, Takahiro Yoshida, Narihiro Ishida, Katsuya Shimabukuro, Hisashi Iwata, Hiroaki Ushikoshi, Izumi Toyoda, Hirofumi Takemura, Shinji Ogura
Journal: Circulation (2015)