tbuckley/cabot-search huggingface dataset:
Severe Exacerbation of Cancer of the Breast after Oöphorectomy and Adrenalectomy
Authors: Richard E. Wilson, Andrew G. Jessiman, Francis D. Moore
Journal: New England Journal of Medicine (1958)

THE recognition that the majority of breast cancers in premenopausal women and in many postmenopausal women are stimulated by estrogenic substances has become a basic guidepost in the treatment of patients with advanced carcinoma of the breast. The evidence for this assumption is to be found in clinical experience. Exacerbation of the disease shown by x-ray changes and urinary calcium excretion may be seen during the menstrual cycle in premenopausal women,1 or upon administration of estrogenic substances.2 The favorable response to ovariectomy confirms such a concept. Postmenopausal women with mammary cancers frequently have high urinary estrogen levels and may be . . .
Pre-Operative Brain Injury in Newborn Infants With Transposition of the Great Arteries Occurs at Rates Similar to Other Complex Congenital Heart Disease and Is Not Related to Balloon Atrial Septostomy
Authors: John Beca, Julia Gunn, Lee Coleman, Ayton Hope, Laura-Clare Whelan, Thomas Gentles, Terrie Inder, Rod Hunt, Lara Shekerdemian
Journal: Journal of the American College of Cardiology (2009)
Incidence of Urinary-Tract Infections Among Juvenile Diabetics
Authors: Donnell D. Etzwiler
Journal: JAMA (1965)

Urine specimens were obtained from 170 children with diabetes mellitus for culture and routine urinalysis. Unusual findings were not detected by routine urinalysis in this group except for the increased specific gravity, and sugar and acetone content. Only one child had a significant pyuria and this was associated with a urinary infection. Quantitative bacteriological studies revealed that the incidence of infection of the urinary tract among this group of juvenile diabetics is similar to that found in the general population of a comparable age.
Sulfonylurea Use During Entire Pregnancy in Diabetes Because of <i>KCNJ11</i> Mutation: A Report of Two Cases
Authors: Zsolt Gaal, Tomasz Klupa, Irene Kantor, Wojciech Mlynarski, Laszlo Albert, Justyna Tolloczko, Istvan Balogh, Krzysztof Czajkowski, Maciej T. Malecki
Journal: Diabetes Care (2012)

Mutations of the KCNJ11 gene are a common cause of permanent neonatal diabetes (PNDM) (1,2) and sometimes result in other diabetic phenotypes (2). Sulfonylureas (SUs) are effective and safe in most diabetic KCNJ11 mutation carriers (3). However, their application risk is sometimes uncertain. We have previously described glibenclamide use in a pregnant woman with KCNJ11 -related PNDM (4); for the first time, we report two cases treated with SU throughout the entire pregnancy.

The first case was a Hungarian woman with the E229 K KCNJ11 mutation resulting in relapsing neonatal diabetes. The patient experienced remission between the ages of 3 and 10 years, at which point insulin was restarted. At the age of 13, after genetic testing, the patient was switched to gliclazide 60 mg/day. The woman became pregnant at the age of 16 years. When she was referred …
Preclinical to clinical development of the novel camptothecin nanopharmaceutical CRLX101
Authors: Sonke Svenson, Marc Wolfgang, Jungyeon Hwang, John Ryan, Scott Eliasof
Journal: Journal of Controlled Release (2011)

Camptothecin (CPT) is a potent broad-spectrum anticancer agent that acts through inhibition of topoisomerase 1. Clinical development of CPT was unsuccessful due to poor drug solubility, insufficient in vivo stability of the active form, and toxicity. In order to address these issues, a polymeric nanoparticle comprised of cyclodextrin-poly(ethylene glycol) copolymer (CDP) conjugated to CPT (CRLX101) has been developed and Phase 2 clinical studies are ongoing. Camptothecin is conjugated to the polymer in its active form at 10–12 wt.% loading. CRLX101 self-assembles in solution into nanoparticles with an apparent solubility increase of > 1000-fold as compared to the parent drug camptothecin. Preclinical studies exhibited CRLX101 pharmacokinetics superior to the parent drug. Drug concentration in tumor relative to plasma and other major organs is consistent with the enhanced permeation and retention (EPR) anticipated from a nanoparticle. Significant anti-tumor activity was observed that is superior when compared to irinotecan across a broad range of xenograft models. Pharmacokinetic data are consistent with the prolonged half-life and increased AUC. The CRLX101 preclinical and clinical data confirm that CDP can address not only solubility, formulation, toxicity, and pharmacokinetic challenges associated with administration of CPT, but more importantly, can impart unique biological properties, that enhance pharmacodynamics and efficacy of camptothecin.
Junior doctors attack government's training reforms
Authors: Colleen Shannon
Journal: BMJ (2004)

Britain's junior doctors have attacked government reforms that would shorten the length of their training by several years and radically alter the career path of future consultants.

At the BMA's annual meeting for junior doctors last week delegates unanimously supported a vote of no confidence in the government's “modernising medical careers” initiative.

Medical students who decide to boycott the new “foundation” training programmes will have the full support of the BMA, pledged Mr Simon Eccles, chairman of the BMA's Junior Doctors Committee.

The BMA will now lobby for a delay in …
NOTES ON MY TRIP TO ATTEND THE SECOND PAN-AMERICAN MEDICAL CONGRESS, IN MEXICO CITY, NOV. 16-19, 1896.
Authors: AUGUSTUS P. CLARKE
Journal: JAMA (1897)

On Saturday evening November 7. we took the Fall River Line to New York and from there a train on the Pennsylvania road to Washington, where a change of coaches was made by the way of Atlanta for New Orleans, which we reached in the early part of the day. Leaving New Orleans by the evening train we passed through the famous Teche country, noted for its extensive fields of cotton and rice. Our course was then directed through the flat lands of Texas. After leaving Houston and San Antonio our grade grew more ascending. When we reached Spofford Junction we took the International Railroad for the Rio Grande and crossed by the way of Eagle Pass to Ciudad de Porfirio Diaz, on the Mexican border. The officers of the Mexican Custom House were exceedingly courteous and endeavored in every way to facilitate matters for our convenience. The grade at
Conservative Management of Intermittent Claudication
Authors: Kenneth Radack
Journal: Annals of Internal Medicine (1990)

Objective: To review the evidence for efficacy of three contemporary treatments for intermittent claudication: pentoxifylline, exercise programs, and smoking cessation. Data Identification: English-language literature search using MEDLINE, Index Medicus, and bibliographic reviews of major texts and all pertinent articles. Study Selection: For pentoxifylline, randomized, double-blind controlled trials were selected. For exercise, all controlled trials were selected, because few randomized trials have been done. For smoking cessation, 26 pertinent studies were selected after an exhaustive search. Data Extraction: Study quality was evaluated; therapeutic efficacy was estimated for pentoxifylline and exercise using meta-analytic techniques. For smoking cessation, all outcomes were determined and described. Results: For pentoxifylline, insufficiently reported data led to marked disparity in effect sizes, preventing a meaningful pooled estimate of effectiveness. The results for exercise therapy suggested that dynamic exercise is beneficial (pooled effect size for pain-free walking distance = 1.03; 95% CI, 0.6 to 1.5; P < 0.0001). Finally, smoking cessation was associated with a reduced frequency of complications due to progressive disease and improved postoperative graft patency rates. Conclusions: The limited amount and quality of reported data precluded an overall, reliable estimate of pentoxifylline's efficacy. Structured exercise programs increased pain-free walking distance, and smoking cessation improved postoperative graft patency rates and reduced the complications of peripheral arterial disease.
Myocardial lesions induced by prolonged alcohol feeding in rhesus monkeys
Authors: S. C. VASDEV, R. N. CHAKRAVARTI, D. SUBRAHMANYAM, A. C. JAIN, P. L. WAHI
Journal: Cardiovascular Research (1975)

To elucidate the effects of chronic alcohol ingestion in monkeys a synthetic, adequately balanced, fluid diet providing 40% of total calories from ethanol was gavaged through a stomach tube daily over a period of three months. Clinical, biochemical, radioisotope, and histopathological studies were performed at the beginning and end of the experiment. It was observed that chronic alcohol feeding at this dose level caused marked accumulation of triglycerides, cholesterol, and phospholipids in the serum and the liver. In the heart triglycerides and cholesterol ester were increased. Incorporation studies showed increased synthesis of triglycerides in the heart muscle and liver. Histologically the heart showed fatty change of the myocardium and evidence of focal myocytolysis, atrophy of muscle bundles, and early fibrosis. The liver showed generalized fatty change but no cirrhosis.
Selected Sexual Practices of San Francisco Heterosexual Men and Risk of Infection by the Human Immunodeficiency Virus
Authors: W. Winkelstein, M. Samuel, N. S. Padian, J. A. Wiley
Journal: JAMA (1987)

<h3>To the Editor.—</h3> Recent reviews of the acquired immunodeficiency syndrome in the United States have emphasized a concern regarding the potential spread of human immunodeficiency virus (HIV) infection from current high-risk groups to sexually active heterosexual men and women.<sup>1-3</sup>These reviews have also indicated that information about the sexual practices of American men and women, needed for effective epidemic forecasting and the planning of control strategies, is inadequate. <h3>Study. —</h3> Data regarding selected sexual practices of single men in San Francisco are available from the San Francisco Men's Health Study,<sup>4</sup>a prospective study of HIV infection and the acquired immunodeficiency syndrome in a cohort of 1034 single men 25 to 54 years of age obtained by probability sampling from a6-km-square area of the city. The Table shows the numbers and proportions of male and female sexual partners of homosexual, bisexual, and heterosexual members of the study cohort
Parotid tumor and thyroid cancer. Simultaneous occurrence after irradiation of the neck in childhood
Authors: F. O. Becker
Journal: JAMA (1975)

THE OCCURRENCE of thyroid neoplasia following thymic or tonsillar irradiation in infancy or childhood has been well reported.<sup>1</sup>The role of head and neck irradiation in childhood in the development of salivary gland neoplasms has been suggested previously.<sup>1</sup>We recently treated two patients who had received tonsillar irradiation in childhood and subsequently were found to have the simultaneous occurrence of a thyroid carcinoma and a parotid neoplasm. <h3>Report of Cases</h3><h3>Case 1.—</h3> A 26-year-old man saw his physician in March 1974, for an unrelated complaint. At that time, a mass was easily seen at the angle of the left mandible. The patient stated that it had been present for two to three years, but had not increased in size during this period. The additional finding of bilateral cervical adenopathy prompted referral of the patient to us for therapy. The patient denied any symptoms referable to the neck, including
A novel apoA-I mutation (L178P) leads to endothelial dysfunction, increased arterial wall thickness, and premature coronary artery disease
Authors: G. Kees Hovingh, Alison Brownlie, Radjesh J. Bisoendial, Marie Pierre Dube, Johannes H.M. Levels, Wilma Petersen, Robin P.F. Dullaart, Erik S.G. Stroes, Aeilko H. Zwinderman, Eric de Groot, Michael R. Hayden, Jan Albert Kuivenhoven, John J.P. Kastelein
Journal: Journal of the American College of Cardiology (2004)
Patient Health Status and Costs in Heart Failure
Authors: Paul S. Chan, Gabriel Soto, Philip G. Jones, Brahmajee K. Nallamothu, Zefeng Zhang, William S. Weintraub, John A. Spertus
Journal: Circulation (2009)

Although a variety of prognostic tools have been shown to predict rehospitalization and mortality in heart failure patients, their utility in assessing future costs is less clear. We assessed whether health status assessment with the Kansas City Cardiomyopathy Questionnaire (KCCQ) predicts future costs in stable heart failure outpatients with left ventricular dysfunction after myocardial infarction.We evaluated 12-month cost utilization data from 1516 heart failure outpatients enrolled in the Quality-of-Life Substudy of the Eplerenone Post-Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Multivariable hierarchical models assessed whether the KCCQ (categorized as 0 to <25, 25 to <50, 50 to <75, and 75 to 100) was an independent predictor of future resource use. At baseline, 685 patients (45.2%) had good health status (KCCQ scores > or =75), whereas 510 (33.6%), 262 (17.3%), and 59 (3.9%) had fair (KCCQ, 50 to 74), poor (KCCQ, 25 to 49), and the worst (KCCQ <25) health status, respectively. After multivariable adjustment, compared with patients with good health status, patients with fair health status incurred incremental 1-year costs of $1520 (cost ratio, 1.23; 95% confidence interval, 1.05 to 1.43), whereas patients with poor and the worst health status incurred incremental 1-year costs of $4265 (cost ratio, 1.63; 95% confidence interval, 1.34 to 1.99) and $8999 (cost ratio, 2.34; 95% confidence interval, 1.62 to 3.38), respectively (P<0.0001 for association with KCCQ). Further adjustment for New York Heart Association class led to only partial attenuation of this relationship (P=0.0002).Health status assessment predicts resource use and costs over the next year in stable heart failure outpatients with left ventricular dysfunction after myocardial infarction.
Health Care Utilization Patterns and Costs for Patients With Hidradenitis Suppurativa
Authors: Joslyn S. Kirby, Jeffery J. Miller, David R. Adams, Douglas Leslie
Journal: JAMA Dermatology (2014)

IMPORTANCE Hidradenitis suppurativa (HS) is a chronic cutaneous disease with acutely painful flares that require appropriate and timely treatment.OBJECTIVE To assess how individuals with HS utilize medical care, especially emergency department (ED) care, a high-cost setting, and to describe the health care costs for this group. DESIGN, SETTING, AND PARTICIPANTSCohort cost-identification study of 150 493 individuals with claims from the MarketScan medical claims database.Patients with claims for HS and psoriasis (16 736 and 110 266, respectively) and a control group with neither condition (23 491) during the study period, January 2008 to December 2010, were included.EXPOSURES An HS cohort was formed from all the patients who had 2 or more claims for HS (International Classification of Diseases, Ninth Revision [ICD-9] code 705.83) during the 3-year period.A psoriasis cohort was used as a comparison group, since it is another chronic inflammatory condition with prominent skin findings.This group included randomly selected patients who had 2 or more claims for psoriasis (ICD-9 code 696.1) during the 3-year period.A second control group included randomly selected patients who had no claims for either condition during the 3-year period.From these cohorts only patients that were continuously enrolled for the 3-year period were included. MAIN OUTCOMES AND MEASURESHealth care utilization measures including inpatient length of stay, emergency department and outpatient visits, and number of days supplied of prescription medication were investigated.Cost variables were also investigated and included inpatient, outpatient, emergency department, prescription drug, and total all-cause health care expenditures, which were adjusted for inflation and reported in 2010 US dollars. RESULTSThe largest component of the total 3-year cost for the HS group was inpatient cost (37.4%).In contrast, for the psoriasis group this was drug costs (46.5%) and for the control group, inpatient costs (40.9%).The proportion of people who were hospitalized in the HS cohort (15.8%) was higher than the psoriasis (10.8%) or control (8.6%) groups (P< .001).The proportion of patients who used the ED over the 3-year period was higher in the HS cohort (27.1%) than the psoriasis (17.4%) or control groups (17.2%) (P < .001).Similarly, the mean (SD) 3-year ED cost for the HS group was $2002 ($6632) and was higher than both comparison groups (P< .001).After adjustment for age, sex, and comorbidities, ED utilization remained higher in the HS group compared with the control (P<.001) and psoriasis (P=.02) cohorts.CONCLUSIONS AND RELEVANCE Hidradenitis suppurativa affects a younger, predominantly female population of patients.High-cost settings, such as ED and inpatient care, are used more frequently for patients with HS.Both patients and clinicians should be aware of this finding, and further research is needed to investigate the impact of health care utilization on patient outcomes.
Idiopathic Hypochromic Anaemia in Males
Authors: J. W. B. Forshaw
Journal: BMJ (1954)

Idiopathic hypochromic anaemia is a disease which occurs mainly in females, and its incidence in males appears to be very low.Chlorosis was thought to occur almost entirely in young females, but the following quotations suggest that Shakespeare was aware of the possibility that the disease might appear in males.In Antony and Cleopatra, iii, ii, 4: Caesar is sad; and Lepidus, Since Pompey's feast, as Menas says, is troubled With the green sickness.and in II King Henry IV, iv, iii, 96, referring to Prince John:There's never none of these demure boys come to any proof; for thin drink doth so over-cool their blood, and making many fish-meals, thlat they fall into a kind of male green-sickness.
Response to a Haemophilus influenzae type b diphtheria CRM197 conjugate vaccine in children with a defect of antibody production to Haemophilus influenzae type b polysaccharide
Authors: Lynda C. Schneider, Richard A. Insel, Gail Howie, Dace V. Madore, Raif S. Geha
Journal: Journal of Allergy and Clinical Immunology (1990)
ASTHMA DUE TO GRAIN RUSTS
Authors: F. T. CADHAM
Journal: JAMA (1924)

During recent years, in parts of the Northwestern states and western Canada, rust fungi have attacked a considerable portion of the growing grain. Wheat, barley, oats and rye in the maturing stage are hosts for special rusts. Wheat rust (<i>Puccinia graminis</i>) is the most prevalent. Over large sections of the country, given proper conditions of heat and moisture, no single plant stem escapes infection. Immense numbers of spores are developed, so that during the harvest season it is not uncommon to see binders working in the grain fields enveloped in a cloud of rust spores. Harvest workers must inhale great numbers of these fungi. I have seen three patients suffering from asthma, in whom the exciting cause of the attack was a proximity to these rusts. The history of each case is similar: there was a short period of exposure to the infected grain, during which the person was evidently
Points: On which side of the brain does the language function lie?
Authors: S Nightingale
Journal: BMJ (1980)

Hyperlipidaemia advances and retreatsDr A LEWIS (London WlN 1FJ) writes: How long will it be before the hazards of eating dairy foods (23 August, p 564) are remembered with amusement like those of eating meat.This dangerous stuff (especially red meat) "caused" kidney disease, hypertension, rheumatism, and gout because it was a source of uric acid and urea, with which these conditions were thought to be associated. Drugs and rheumatoid arthritisDr JACK BOURNE (Hornchurch, Essex) writes: In his letter on the effect of corticosteroids on the manifestations of rheumatoid arthritis,
Irish doctors are angry as their union boss leaves with 9.7m package
Authors: M. Houston
Journal: BMJ (2013)

The chief executive of the Irish Medical Organisation has taken early retirement amid concerns among members of the doctors’ representative body about its ability to fund his retirement package.

George McNeice has left with a package worth around €9.7m (£7.9m; $12.6m), including a pension fund of about €4.5m, a contractual termination payment of €1.5m, and delayed pension payments of €3.75m.

However, it has emerged that the terms of his contract entitled him to an overall settlement of €20m. The organisation said in a …
Aerobic work capacity in chronic fatigue syndrome.
Authors: M Mantysaari
Journal: BMJ (1991)

the colour and a tell tale extension of pigment at one edge.As the checklist acknowledges, change in behaviour is the most important fact to emphasise in a public education campaign.But some patients are oblivious to change,' I and their melanoma is diagnosed incidentally by someone else.It is thus important that doctors, paramedics, and the public are exposed to as much visual material depicting melanomas as possible, either on television or in poster form.Those doctors who see patients with malignant melanoma should show the lesions to as many colleagues as possible.
Slopes of the Carotid Pulse Wave in Normal Subjects, Aortic Valvular Diseases, and Hypertrophic Subaortic Stenosis
Authors: DOUGLAS P. LYLE, WILLIAM H. BANCROFT, MARJORIE TUCKER, E. E. EDDLEMAN
Journal: Circulation (1971)

Variations in certain slopes of the carotid pulse which exist among normal subjects, patients with aortic valvular disease, and those with hypertrophic subaortic stenosis were examined. Records from 256 subjects were quantified with computer technics. The externally recorded volume pulses were related to simultaneously recorded brachial artery pressures (cuff); thus the slopes are expressed in mm Hg/sec. Several slopes were studied: the maximum rate of pressure rise, the mean systolic upstroke (onset of carotid upstroke to peak systolic excursion), and the least square fits of the first twothirds of the upstroke and the first two-thirds of diastole. The least square slopes of 98% of the patients with aortic stenosis were &lt;457 mm Hg/sec, whereas none of those with hypertrophic subaortic stenosis was that low. The greatest overlap was between patients with aortic stenosis and those with aortic stenosis and aortic insufficiency. The slopes correlated poorly with valve areas and gradient in aortic stenosis and combined aortic stenosis and aortic insufficiency. The least square slope in normal subjects is not related to heart rate or age. Thus, the decreased slopes in patients with aortic stenosis are related to many factors, including myocardial function, but influenced by the size of the aortic valve opening and the properties of the vessels.
Penicillamine — an Anglo-American Adventure in the Treatment of Rheumatoid Arthritis
Authors: Israeli A. Jaffe
Journal: New England Journal of Medicine (1973)

The discovery of penicillin by Sir Alexander Fleming, and its subsequent purification by Florey and Chain at Oxford, was translated into clinical usefulness by a team of chemists and microbiologists at the Northern Regional Research Laboratory in Peoria, Illinois. This transatlantic collaboration has continued through the years with respect to one of the degradation products of penicillin — penicillamine, which was first discovered by the Oxford group in 1943.1 Ten years later, John Walshe, while working on the Harvard Division of the Boston City Hospital, first identified penicillamine in the urine of patients with liver disease who were receiving penicillin. . . .