tbuckley/cabot-search huggingface dataset:
Communication Breakdown in Referral of the Patient
Authors: E. Charles Kunkle
Journal: JAMA (1964)

REFERRAL OF A PATIENT from one physician to another for consultative advice or continuing care has long been an essential part of medical practice. Yet its present mechanism is often incomplete and needlessly inefficient. What little has been written of inadequacies in the referral process comes mainly from university public clinics, recently summarized by Williams and his associates.<sup>1</sup>In their study of one such medical center, numerous problems were identified. In particular, the patient often arrived at the clinic without information as to the specific reason for referral or regarding past findings and therapy. <h3>Methods.—</h3> This appraisal of referral practices is based on the experience of one consulting physician (a neurologist) at a university hospital in the Southeast. The data were collected from 100 consecutive private patients each of whom had recently been under the care of a physician in the home community and was referred by him. Forty
Nonviral delivery of synthetic siRNAs in vivo
Authors: Saghir Akhtar, Ibrahim F. Benter
Journal: Journal of Clinical Investigation (2007)

Sequence-specific gene silencing using small interfering RNA (siRNA) is a Nobel prize–winning technology that is now being evaluated in clinical trials as a potentially novel therapeutic strategy. This article provides an overview of the major pharmaceutical challenges facing siRNA therapeutics, focusing on the delivery strategies for synthetic siRNA duplexes in vivo, as this remains one of the most important issues to be resolved. This article also highlights the importance of understanding the genocompatibility/toxicogenomics of siRNA delivery reagents in terms of their impact on gene-silencing activity and specificity. Collectively, this information is essential for the selection of optimally acting siRNA delivery system combinations for the many proposed applications of RNA interference.
Fibrinogenopenia, Colchicine and the Shwartzman Reaction
Authors: Fred Rosner
Journal: JAMA (1964)

<h3>To the Editor:—</h3> I read with great interest the communication by Trinkner and Perkins on "Severe Acute Fibrinogenopenia Apparently Caused by Reaction to Drugs," which appeared in the July 13, 1964, issue ofThe Journal(<b>189:</b>158). Their conclusion is that fibrinogen depletion occurred secondary to the administration of sodium diatrizoate and sodium meralluride. Since I had just reviewed McKay's work on the Shwartzman reaction (<i>Fed Proc</i><b>22:</b>1373, 1963), it struck my attention that the patient reported by Trinkner and Perkins was receiving colchicine for gout. McKay quotes Galton who reports colchicine to be capable of inducing the Schwartzman reaction in pregnant golden hamsters. It seems interesting to speculate whether colchicine was at all related to the hemorrhagic manifestations of the patient of Trinkner and Perkins.
Small bowel transplantation
Authors: N. Brousse, O. Goulet
Journal: BMJ (1996)

Unique problems but now standard treatment for small bowel insufficiency Intestinal transplantation is the logical alternative to definitive parenteral nutrition in patients with chronic intestinal failure after conditions such as necrotising enterocolitis or midgut volvulus. Long term parenteral nutrition is associated with complications such as liver impairment and local and systemic infections. But since its introduction in the late 1960s, parenteral nutrition has improved greatly, especially with the development of long term home parenteral nutrition, and, as a result, interest in small bowel transplantation has waned. The evolution of the procedure, first reported in experimental animals by Alexis Carrel in 1902,1 has therefore taken longer than that of other solid organ transplants. However, recent advances in immunosuppression and the monitoring of rejection have brought small bowel transplantation into the realms of standard treatment for certain conditions.

Several features of the small bowel make it unique among transplantable organs: the large amount of lymphoid tissue contained in the mesenteric lymph nodes, Peyer's patches, and lamina propria; its heavy colonisation with microorganisms; and the expression of great quantities of class II antigens on the surface of epithelial cells. These features may contribute respectively to graft versus host disease, graft rejection, and sepsis.

Difficulties in transplanting …
IMPACT OF STENT-IMPLANTED LESION ON TIMING OF STENT THROMBOSIS OCCURRENCE: EVALUATION OF SUBACUTE, LATE, AND VERY LATE STENT THROMBOSIS
Authors: Shunsuke Kubo, Kazushige Kadota, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Naoki Oka, Harumi Katoh, Kazuaki Mitsudo, Yasushi Fuku, Tuyoshi Goto
Journal: Journal of the American College of Cardiology (2012)
Long-Term and Recent Progress in Blood Pressure Levels Among U.S. Adults With Diagnosed Diabetes, 1988–2008
Authors: Jing Wang, Linda S. Geiss, Yiling J. Cheng, Giuseppina Imperatore, Sharon H. Saydah, Cherie James, Edward W. Gregg
Journal: Diabetes Care (2011)

To examine whether there were long-term (between 1988-1994 and 2001-2008) and recent (between 2001-2004 and 2005-2008) changes in blood pressure (BP) levels among U.S. adults with diagnosed diabetes.
Elevated Placental Adenosine Signaling Contributes to the Pathogenesis of Preeclampsia
Authors: Takayuki Iriyama, Kaiqi Sun, Nicholas F. Parchim, Jessica Li, Cheng Zhao, Anren Song, Laura A. Hart, Sean C. Blackwell, Baha M. Sibai, Lee-Nien L. Chan, Teh-Sheng Chan, M. John Hicks, Michael R. Blackburn, Rodney E. Kellems, Yang Xia
Journal: Circulation (2014)

Background— Preeclampsia is a prevalent hypertensive disorder of pregnancy and a leading cause of maternal and neonatal morbidity and mortality worldwide. This pathogenic condition is speculated to be caused by placental abnormalities that contribute to the maternal syndrome. However, the specific factors and signaling pathways that lead to impaired placentas and maternal disease development remain elusive. Methods and Results— Using 2 independent animal models of preeclampsia (genetically engineered pregnant mice with elevated adenosine exclusively in placentas and a pathogenic autoantibody-induced preeclampsia mouse model), we demonstrated that chronically elevated placental adenosine was sufficient to induce hallmark features of preeclampsia, including hypertension, proteinuria, small fetuses, and impaired placental vasculature. Genetic and pharmacological approaches revealed that elevated placental adenosine coupled with excessive A 2B adenosine receptor (ADORA2B) signaling contributed to the development of these features of preeclampsia. Mechanistically, we provided both human and mouse evidence that elevated placental CD73 is a key enzyme causing increased placental adenosine, thereby contributing to preeclampsia. Conclusions— We determined that elevated placental adenosine signaling is a previously unrecognized pathogenic factor for preeclampsia. Moreover, our findings revealed the molecular basis underlying the elevation of placental adenosine and the detrimental role of excess placental adenosine in the pathophysiology of preeclampsia, and thereby, we highlight novel therapeutic targets.
Studies of the clinically uninvolved skin in patients with dermatitis
Authors: H. AL-JABERI, R. MARKS
Journal: British Journal of Dermatology (1984)

We have studied the clinically normal skin of eighty-four patients with quiescent dermatitis of different types, and fifty normal subjects. Increased susceptibility to chemical irritation was demonstrated in patients with atopic and exogenous dermatitis. There was a reduction in mean corneocyte area and a thinner horny layer in all patients, and an increased epidermal thickness in atopic dermatitis patients only. In forced desquamation studies, patients released more corneocyte clumps from the skin surface, but there were no significant differences between patients and controls in sensitivity to UVR or electrical conductivity.
Risk-Adjustment Methods Based on Health Status and Functional Status
Authors: Richard M. Allman
Journal: JAMA (1997)

<h3>To the Editor.</h3> —In the article by Dr Fowles and colleagues<sup>1</sup>comparing risk-adjustment methods for setting capitation rates, the authors conclude that risk adjustments based on diagnostic information available from administrative data or self-reported chronic conditions should be used rather than adjusting for functional status measures, such as the Medical Outcomes Study 36-Item Short-Form Functional and Perceived Health Status Survey (SF-36). However, their data demonstrate that such a functional status measure performs just as well, if not better, than diagnosis-based adjustments, particularly among high-risk persons older than 65 years. Adjustment using diagnosis-based ambulatory care groups predicted health care expenditures within 5% of actual expenses for 75% of the persons older than age 65 who were categorized as high risk. In contrast, SF-36-adjusted data were similarly accurate in 85% of the older high-risk persons. The authors suggest a number of reasons for preferring administrative claims or encounter data for adjusting
Stress and the Induction of Intravascular Platelet Aggregation in the Heart
Authors: JACOB I. HAFT, KAZEM FANI
Journal: Circulation (1973)

Intravascular aggregation of platelets similar to that found in dogs after norepinephrine infusion was demonstrated using the electron microscope in the hearts of 20 of 23 rats subjected to two forms of stress (immersion in hot water, 7 of 8 rats; repeated small electric shocks to the feet, 13 of 15 rats). Only one of 14 unstressed rats was found to have similar intravascular platelet aggregates. These findings suggest that catecholamines secreted endogenously during stress are sufficient to cause platelets to aggregate intravascularly and raise the possibility that clinical myocardial infarction occurring during severe or prolonged stress may be caused by catecholamine-induced platelet thrombi which occur at, or travel to, and occlude a coronary artery already narrowed by previous atherosclerosis.
Costosternal Chondrodynia Simulating Recurrent Breast Cancer Unveiled by FDG PET
Authors: Anita S. Mathew, Ghassan El-Haddad, David L. Lilien, Amol M. Takalkar
Journal: Clinical Nuclear Medicine (2008)

FDG-PET imaging, which is routinely used to assess recurrent breast cancer, is nonspecific for malignancies and can detect several inflammatory lesions. Costochondritis following breast reconstructive surgery, presenting with excruciating chest pain or "chondrodynia," is a rare variant of Tietze's syndrome thought to occur due to traction exerted by large breast implants. Diagnosis is usually clinical because no abnormalities are identified on conventional imaging. Two cases have been reported in the literature, but none with FDG-PET. We report a patient with treated breast cancer, presenting with chest pain where FDG-PET to assess for recurrence was consistent with costochondritis and peri-implant inflammation.
Evidence grows that women are treated less aggressively for heart disease than men
Authors: Roger Dobson
Journal: BMJ (2004)

Men in England who have a heart attack are almost twice as likely to have surgery as women with the same condition.

Men are twice as likely as women to have a myocardial infarction, and once they have a heart attack they are almost twice as likely to have surgery for it, according to research based on almost a decade of NHS data. Older people also face inequity.

“As women tend to present with coronary heart disease at older ages, this indicates that they may be the victims of a ‘double …
The Big Chill — Inserting the DEA into End-of-Life Care
Authors: Timothy E. Quill, Diane E. Meier
Journal: New England Journal of Medicine (2006)

Interview with Drs. Timothy Quill and Diane Meier on the Drug Enforcement Agency and end-of-life care. (08:39)Download On October 5, 2005, the U.S. Supreme Court heard oral arguments in Gonzales v. Oregon. On the surface, this case is about the legitimacy of physicians' prescribing of medications under Oregon's Death with Dignity Act and whether the federal government can overrule the states in defining “legitimate medical practice.” Just beneath the surface, however, lies the risk of empowering agents of the Drug Enforcement Agency (DEA) — whose traditional role is to prevent drug abuse and diversion — to evaluate the end-of-life practices of physicians whose patients die while receiving prescribed opioids or barbiturates. A finding in favor of . . .
CONTINUED FEVER—NEITHER MALARIAL NOR TYPHOID.
Authors: T. J. HAPPEL
Journal: JAMA (1903)

It may seem that the subject of continued fever is becoming too common in our meetings to merit any further time or discussion, but, so long as we are met with the<i>ipse dixit</i>of some bookmaker, that there are but two types of continued fevers, and that all such fevers must be classed with one or the other, in fact must be either malarial or typhoid, then those of us who do not accept any such dogmatic statements as necessarily true, have a right to give our reasons for our dissent. Our medical brethren in the north, as a rule, contend that every continued fever is either typhoid or malarial, while in the south many of us are sure that we have a third fever, which merits a careful study, the mortality of which is so slight that opportunities for postmortem study have been almost<i>nil</i>. The blood and
Open E. C. G. service.
Authors: K P Dawson
Journal: BMJ (1970)

wait eight weeks from the time of being diagnosed by bronchoscopy a,s having a lung cancer before being admitted to hospital for thoracotomy.If it had not been for my making a pest of myself by repeated letters and a telephone call, he would probably have waited 10 weeks.In fact, he jumped the queue for admission.Eight to ten weeks is long enough for an operable carcinoma to become inoperable.It is highly unethical for a National Health Service to be organized in such a way that there is a waiting list for cancer of two months' duration.In Manchester the waiting time for admission for treatment for lung cancer is two months; for iatrogenic abortion several days.Whether this is a local or national phenomenon I do not know, but it seems to be a highly unethical state of affairs.-I am, etc.,
Allergic Interstitial Nephritis with Diuretics
Authors: MARK A. FIALK
Journal: Annals of Internal Medicine (1974)

Letters1 September 1974Allergic Interstitial Nephritis with DiureticsMARK A. FIALK, M.D., JOHN ROMANKIEWICZ, PHARM. D., FRANCIS PERRONE, M.D., RAYMOND L. SHERMAN, M.D.MARK A. FIALK, M.D.Search for more papers by this author, JOHN ROMANKIEWICZ, PHARM. D.Search for more papers by this author, FRANCIS PERRONE, M.D.Search for more papers by this author, RAYMOND L. SHERMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-3-403 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: After the report by Lyons and associates (1) of four cases of allergic interstitial nephritis associated with diuretic agents, a similar clinical situation was seen by us in a patient who developed two episodes of renal failure after the ingestion of diuretic agents.A 67-year-old white man entered the New York Hospital with a 4-day history of confusion and was found to have bilateral subdural hematomas. He had a past history of angina pectoris and congestive heart failure, treated with digoxin and intermittent diuretics. Furosemide therapy, 40 mg/day, was begun 1 month before admission because of increasing...References1. LYONSPINNCORTELL HVS: Allergic interstitial nephritis causing reversible renal failure in four patients with idiopathic nephrotic syndrome. N Engl J Med 288:124-128, 1973 CrossrefMedlineGoogle Scholar2. BALDWINLEVINEMCCLUSKEY DBR: Renal failure and interstitial nephritis due to penicillin and methicillin. N Engl J Med 279:1245-1252, 1968 CrossrefMedlineGoogle Scholar3. SIMENHOFFGUILDDAMMIN MWG: Acute diffuse interstitial nephritis: review of the literature and case report. Am J Med 44:618-625, 1968 CrossrefMedlineGoogle Scholar4. HEPTINSTALL R: Pathology of the Kidney. Boston, Little Brown and Company, 1966, p. 456 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medicine The New York Hospital-Cornell University Medical Center New York, New York 10021 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDiureticsDiureticsDrug-Induced Renal DisordersReview: Acute tubulointerstitial nephritisInterstitial NephritisDifferent Forms of Ischemic/ Toxic Acute Renal Failure in HumansAcute Olifuric Interstitia NephritisDrug-induced acute interstitial nephritis with granulomasSTRUCTURE SIDE-EFFECT SORTING OF DRUGS.Acute interstitial nephritis associated with gentamicin and lincomycin therapy.Drug-Associated NephropathyAcute oliguric interstitial nephritis 1 September 1974Volume 81, Issue 3Page: 403-404KeywordsAnginaDiureticsHeart failureIngestionNephritisRenal failure Issue Published: 1 September 1974 PDF DownloadLoading ...
CHARACTERIZATION OF A FACTOR FORMED IN THE COURSE OF ADENOVIRUS INFECTION OF TISSUE CULTURES CAUSING DETACHMENT OF CELLS FROM GLASS
Authors: Wallace P. Rowe, Janet W. Hartley, Bernard Roizman, Hilton B. Levy
Journal: The Journal of Experimental Medicine (1958)

Infectious tissue culture fluids of the majority of serotypes of adenovirus at low dilutions detach HeLa or KB cells from glass surfaces within a few hours after inoculation. A reproducible method for testing cell detachment was devised. The factor present in infectious tissue culture fluids and responsible for cell detachment is trypsin-sensitive and non-dialyzable; it is smaller and more resistant to the effect of heat or ultraviolet light than the infectious virus particle. Cell detachment activity was found to be temperature-dependent, and the cell-detaching titer of infectious tissue culture fluids was not affected by repeated exposure to HeLa cells. Inhibition of cell detachment by human or rabbit sera was observed only when other antibodies to adenovirus antigens were also present, but the antibody inhibiting cell detachment could not be correlated quantitatively with complement-fixing or homologous neutralizing antibody.
Community clinics for leg ulcers and impact on healing.
Authors: C. J. Moffatt, P. J. Franks, M. Oldroyd, N. Bosanquet, P. Brown, R. M. Greenhalgh, C. N. McCollum
Journal: BMJ (1992)

OBJECTIVE--To evaluate the effectiveness of community clinics for leg ulcers. DESIGN--All patients with leg ulceration were invited to community clinics that offered treatment developed in a hospital research clinic. Patients without serious arterial disease (Doppler ankle/brachial index &gt; 0.8) were treated with a high compression bandage of four layers. SETTING--Six community clinics held in health centres in Riverside District Health Authority supported by the Charing Cross vascular surgical service. PATIENTS--All patients referred to the community services with leg ulceration, irrespective of cause and duration of ulceration. MAIN OUTCOME MEASURES--Time to complete healing by the life table method. RESULTS--550 ulcerated legs were seen in 475 patients of mean (SD) age 73.8 (11.9) years. There were 477 venous ulcers of median size 4.2 cm2 (range 0.1-117 cm2), 128 being larger than 10 cm2. These ulcers had been present for a median of three months (range one week to 63 years) with 150 present for over one year. Four layer bandaging in the community clinics achieved complete healing in 318 (69%) venous ulcers by 12 weeks and 375 (83%) by 24 weeks. There were 56 patients with an ankle/brachial arterial pressure index &lt; 0.8, indicating arterial disease. The 50 patients with pressure index &lt; 0.8 &gt; 0.5 were treated with reduced compression, and 24 (56%) healed by 12 weeks and 31 (75%) by 24 weeks. The figures for overall healing for all leg ulcers were 351/550 (67%) at 12 weeks and 417/550 (81%) at 24 weeks, compared with only 11/51 (22%) at 12 weeks before the community clinics were set up. CONCLUSIONS--Community clinics for venous ulcers offer an effective means of achieving healing in most patients with leg ulcers.
The Illness Narrative: Suffering, Healing, and the Human Condition
Authors: L. D. Hankoff
Journal: JAMA (1988)

This book should be of value to anyone dealing with the problem of chronic illness; and who in the practice of medicine these days does not? Kleinman, a psychiatrist with considerable skill in ethnography, has artfully defined the dilemmas and issues in chronicity—in illness, disease, and sickness. By "illness" Kleinman refers to the "innately human experience of symptoms and suffering" (p 3); "disease," to the practitioner's concern with biologic structure and functioning (p 5); and "sickness," to "the understanding of a disorder in its generic sense across a population in relation to macrosocial (economic, political, institutional) forces" (p 6). The distinctions among these definitions as well as the significant themes in chronicity are built up by the writer in an easy and understandable style around case presentations drawn from a wide variety of clinical settings in the United States and China. The health care system is increasingly preoccupied with long-term
Objective measurement of rheumatoid arthritis using technetium index.
Authors: E C Huskisson, J Scott, H W Balme
Journal: Annals of the Rheumatic Diseases (1976)

The technetium index was measured in 22 patients with rheumatoid arthritis, before and after 6 months9 treatment either with penicillamine or with anti-inflammatory drugs. The index was calculated by dividing the sum of the count rates over both knees and both wrists by the dose of technetium given. In the penicillamine group there was a significant reduction in the technetium index and the changes correlated well with some clinical measurements of improvement. It is suggested that the technetium index is a useful objective measure of the effects of drugs with a specific activity in rheumatoid arthritis.
Correction: Resisting Immune Exhaustion in HIV-1 Infection
Authors: Sarah Rowland-Jones, Thushan de Silva
Journal: PLoS Medicine (2008)

Affect Risk of Future Disease Progression?", the text that reads "25% of treated patients remained aviraemic (more than 50 copies/ml)" should be replaced with "25% of treated patients remained aviraemic (less than 50 copies/ml)".
Kenneth Lyndon Montague Mills
Authors: J. F. Mills
Journal: BMJ (2011)

<h3>ABSTRACT</h3> <h3>Purpose</h3> Gait parameters are altered and asymmetrical in individual with transtibial amputation. The purpose of this study was to evaluate and compare the effect of four different prosthetic feet on lower-limb biomechanics during gait. <h3>Methods</h3> One young adult with transtibial ampution performed four gait analysis sessions with four foot-ankle prosthesis (Variflex, Meridium, Echelon, Kinterra). Kinematic, kinetic parameters and gait symmetry were analyzed during different prosthesis conditions. <h3>Results</h3> The type of prosthesis had little effect on amputee’ spatiotemporal parameters. Throughout the stance phase, an increase hip angle and a reduced knee flexion and ankle dorsiflexion were observed in the amputated leg. For kinetic parameters, a reduced propulsive force (SI=0.42–0.65), reduced knee extension moment (mainly during Echelon and Kinterra conditions, SI=0.17 and 0.32, respectively) and an increased knee abduction moment (mainly during the Variflex and Meridium, SI=5.74 and 8.93, respectively) in the amputated leg. Lower support moments were observed in the amputated leg compared to the unaffected leg, regardless of the type of prosthesis (SI=0.61–0.80). <h3>Conclusions</h3> The prostheses tested induced different lower-limb mechanical adaptations. If better gait symmetry between lower limbs is one of the clinical goals, an objective gait analysis could help clinicians to prescribe prosthetic feet based on quantitative measurement indicators.