tbuckley/cabot-search huggingface dataset:
Variability of Urinary Albumin Excretion in Patients With Microalbuminuria
Authors: George Phillipou, Patrick J Phillips
Journal: Diabetes Care (1994)

OBJECTIVE To estimate the within-person variability (SDi) for the overnight urinary albumin excretion rate (AER) in diabetic patients with persistent microalbuminuria. RESEARCH DESIGN AND METHODS Thirteen normotensive diabetic patients in stable medical control, with normal renal function and without any associated cardiovascular or other clinical disorders, collected overnight urines at monthly intervals during one year. AER was determined by radioimmunoassay. RESULTS Analysis of individual series of AER showed a significant trend (P ≤ 0.01) in three cases. The remaining patients (eight men, two women; seven with insulin-dependent diabetes mellitus) had a median mean AER 102 μg/min (range 30–238 μg/min). Because the individual mean AERs were significantly associated with their respective SDiS, the data was loge transformed. Log2SDi was estimated as 0.420, and its 90% probability range (0.353–0.490) was calculated using the bootstrap method. CONCLUSIONS The high within-person variance for AER means that only people with an initial AER in the range of 53–76 μg/min have a high probability (P ≥ 0.95) of being classified as microalbuminuric (20–200 μg/min) on a subsequent specimen. However, subjects with an initial AER ≥53 or ≥80 μg/min have a 95 and 99% probability of persistent microalbuminuria. The large variability of AER limits its potential as a serial marker to detect any gradual deterioration of established renal dysfunction.
Erosion number and area progression in the wrists and hands of rheumatoid patients: a quantitative microfocal radiographic study.
Authors: J.C Buckland-Wright, G.S Clarke, S.R Walker
Journal: Annals of the Rheumatic Diseases (1989)

Microfocal radiography has been used to evaluate the relation between erosion number and erosion area in the hands and wrists of 51 patients with early to moderately advanced rheumatoid arthritis. The hands of these patients showed different patterns of erosion progression, in terms of the relation between changes in number and area, and included those showing a decrease in one or both of the erosion parameters. The mean number of erosions in the group increased between the first and second visits. By the third visit (a mean of 48 months from the onset of symptoms) the mean number of erosions in the wrist and hand of the group had approached a constant value of 75 erosions. Over the same period the mean erosion area of the group continued to increase. Measurement of changes in erosion area is a more sensitive indicator of erosion progression than erosion number, both within the group and in individual patients.
THE FUNCTION OF THE STATE HOSPITAL AS AN EDUCATIONAL AND SOCIAL AGENCY
Authors: WINFRED OVERHOLSER
Journal: JAMA (1942)

In selecting a subject which might be of interest to a group of physicians concerned with hospital standards and with medical education, it has seemed that some consideration might well be given to a group of institutions which constitute one half of the hospital beds of the entire country, namely, the state mental hospitals. These institutions deal with a field of medicine which has developed rapidly during the last quarter century and which has become more and more clearly recognized as closely related to general medicine and to the other specialties. Furthermore, they are of interest as being predominantly public in ownership and operation, less than 2.5 per cent of the mentally ill of the entire country being cared for in private hospitals. Although instances of mental disorder have been recorded from the dawn of history, and although this form of disease was the subject of consideration by Hippocrates and
Tougher Drug Tests for Centennial Olympic Games
Authors: Andrew A. Skolnick
Journal: JAMA (1996)

US ATHLETES preparing for the Centennial Olympic Games in Atlanta, Ga, scheduled for July, are being subjected to the most stringent, expensive, and intrusive drug-testing program in international sports. At any time of day, on any day, members of the US Olympic Committee (USOC) drug control crew may knock on the athlete's door without warning to witness the collection of a urine sample. By most accounts, only a small minority of elite athletes are willing to use pharmaceutical tricks in hopes of gaining an edge over their competitors. Nevertheless, the actions of these few have created major headaches for sport governing bodies. The desire to win at any cost has been driving more and more of the offenders to use increasingly sophisticated chemical tactics in hopes of escaping detection by current drug-testing methods. According to Wade Exum, MD, MBA, USOC director of Drug Control Administration, USOC budgets approximately $1.5 million
Accumulation of peripheral autoreactive B cells in the absence of functional human regulatory T cells
Authors: Tuure Kinnunen, Nicolas Chamberlain, Henner Morbach, Jinyoung Choi, Sangtaek Kim, Joseph Craft, Lloyd Mayer, Caterina Cancrini, Laura Passerini, Rosa Bacchetta, Hans D. Ochs, Troy R. Torgerson, Eric Meffre
Journal: Blood (2012)
Scientific Evidence versus Therapeutic Demand: The Introduction of the Sulfonamides Revisited
Authors: Barron H. Lerner
Journal: Annals of Internal Medicine (1991)

Because of recent changes in Federal Food and Drug Administration (FDA) regulations, new medications may now be marketed before completion of rigorous controlled testing. In order to understand the ramifications of this development, it is instructive to recall the introduction of the sulfonamides in the 1930s. The sulfonamides, the first effective antibacterial agents, were marketed in an era of relatively few regulations. Although investigators at times designed controlled trials to evaluate use of the drugs, both researchers and practitioners generally prescribed them for severe infections, despite a lack of conclusive data as to their efficacy. The clinical usefulness of sulfonamides for a given condition often became known through uncontrolled case studies and comparisons with historical control groups. Given the relaxation of FDA regulations, this method of drug evaluation may again become more commonplace.
THE WORK OF THE SECTION ON LARYNGOLOGY, OTOLOGY AND RHINOLOGY
Authors: W. V. MULLIN
Journal: JAMA (1930)

The office of chairman of this section is solely an honorary one, and of that honor I am duly cognizant, and accordingly most grateful. After having served three years as secretary I found the duties of chairman were exceedingly simple until I realized that the responsibility entails the choice of an appropriate subject and the delivery of an annual address.  I have read the addresses of my predecessors as far back as 1916, when I first became actively interested in the meetings of the American Medical Association. A few of the chairmen have written on purely scientific subjects, but the majority chose subjects of a problematic nature that seemed pertinent at the time. Considerations connected with the World War naturally furnished topics of preeminent interest during a portion of this period. Constructive thought was given to all those addresses and many helpful suggestions were offered, both legislative and scientific. Facing
Degeneration of Intramural Pericytes in Diabetic Retinopathy
Authors: D. J. Addison, A. Garner, N. Ashton
Journal: BMJ (1970)

Retinal pericyte degeneration, a usual finding in diabetic retinopathy, has been shown to be a change probably peculiar to the retina rather than part of a more widespread angiopathy. Thus in a patient with diabetic retinopathy the characteristic eosinophilic degeneration of the pericyte nuclei ceased at the optic disc and could not be found in vessels of the optic nerves and brain.
Doctors must be trained to deal with adolescents
Authors: R. Viner
Journal: BMJ (1998)

EDITOR—Siersted et al report an association between high levels of undiagnosed asthma in adolescents and family problems, as well as the health risk factors of high body mass index, passive smoking, and low physical activity.1 The high rate of underdiagnosed asthma in young people is, however, explained only through the misinterpretation or neglect of symptoms of asthma by patients, parents, or …
The Number of Physicians as a Constraint on Delivery of Health Care
Authors: Boris Senior
Journal: JAMA (1972)

The belief that there is a severe shortage of physicians in the United States is widespread, and corrective measures to increase the supply have been undertaken. We have examined the validity of this belief, using as criteria inter alia general and infant mortality, morbidity statistics, comparisons with other countries, and the potential increase in the demand for services following the removal of financial constraints. We have found no unambiguous evidence of a shortage of physicians of the magnitude described. Nor is there likely to be a substantial increase in demand for physicians' services under a national health insurance program. There are shortages in geographical areas and in specialties, but the production of more physicians appears to be an inefficient remedy.
Identification of a RING protein that can interact in vivo with the BRCA1 gene product
Authors: Leeju C. Wu, Zhuo Wei Wang, Julia Tsou Tsan, Monique A. Spillman, Anne Phung, Xie L. Xu, Meng-Chun W. Yang, Larn-Yuan Hwang, Anne M. Bowcock, Richard Baer
Journal: Nature Genetics (1996)
THE VALUE OF THE XANTHINE DIURETICS IN CONGESTIVE HEART FAILURE
Authors: H. M. MARVIN
Journal: JAMA (1926)

The so-called xanthine (or caffeine) group of drugs is generally regarded<sup>1</sup>as consisting of caffeine, theobromine and theophylline. Caffeine has long been considered practically useless, so far as its diuretic action in human beings is concerned, and the term "xanthine diuretic" is therefore restricted to theobromine and theophylline, both of which are frequently employed in combination with other substances. Of these combinations, theobromine sodiosalicylate (diuretin) is probably the best known and the most widely employed at the present time. Theophylline, as Christian<sup>2</sup>has sagely remarked, "is in the pharmacopeia but not in the pharmacy"; the cost of its commercial production from tea is so great that the synthetic preparation, theocin, is the only one available for clinical use. Although these drugs have been in use for a long period of years, there is a surprising lack of clinical studies on which their intelligent employment in cardiac patients may
REVIEW OF FIVE HUNDRED AND THIRTYFOUR OPERATIONS ON THE MAMMARY GLAND
Authors: JOHN B. DEAVER
Journal: JAMA (1913)

There are two important epochs in the surgical history of mammary carcinoma. The modern operation, based on the knowledge of the lymph-vascular drainage of the breast, has raised the percentage of ultimate cures, as the introduction of antiseptics and asepsis lowered its primary mortality. This is the more remarkable in view of the extensive operation now performed, so that the reduction of the primary mortality of 25 per cent. in preantiseptic days to less than 1 per cent, with modern technic is approximately parallel to the reduction in local recurrences from 65.6 per cent. to 6.5 per cent. Elaboration of Halsted's principles has carried the operative incision further and further away from the primary focus of disease until the limits of surgery must surely have been reached, with results that are highly disappointing save when compared with results of past decades. Why must the ultimate cancer be sought for in
Assessment of ventilatory abnormality in the asymptomatic subject: an exercise in futility.
Authors: B J Sobol
Journal: Thorax (1966)

<h3>Objective:</h3> The aim of this study was to explore the role of predominantly nondopaminergic (PND) features in evaluating disease severity and progression of Parkinson disease (PD). <h3>Methods:</h3> Principal component analysis was used on the baseline data of 396 patients to explore consistency of interrelations between important PND domains (cognitive impairment, depressive symptoms, excessive daytime sleepiness, psychotic symptoms, autonomic dysfunction, and postural instability and gait difficulty) across different ranges of disease duration. Hereafter, we evaluated the reliability and validity of a composite score of all PND domains and examined reproducibility of the findings in a large independent cohort. <h3>Results:</h3> Principal component analysis revealed a consistent 1-factor solution across groups with different disease durations. Cronbach α of the total group was 0.75 for the PND composite score, and corrected item-total correlations were all above the criterion value of 0.3. Validity of the PND composite score was confirmed by significant positive correlations with Hoehn and Yahr stage, severity of motor symptoms, disease duration, and age. Findings were replicated in the independent cohort. <h3>Conclusions:</h3> Our findings show the robustness of a composite score of PND domains as a measure of disease severity across the disease course of PD. Composite measures of PND domains, which largely are insensitive to dopaminergic medication, may provide a more complete and accurate evaluation of disease severity and progression in PD.
Side-effects of Chloramphenicol and Aureomycin
Authors: T. Tomaszewski
Journal: BMJ (1951)

Bin one on the first day and in two after the dose had been greatly increased.Slight looseness of the bowels, not severe enough to call for cessation of treatment, was noted in four patients.In febrile patients with concentrated urine, an appearance highly suggestive of bilirubinuria was encountered and a positive reaction was obtained with the methylene-blue and nitric-acid tests.This result was found to be a fallacy, however, as similar reactions were given with a suspension of H.P.C. in water. SummaryA cinchoninic acid derivative, 3 -hydroxy -2 -phenyl - cinchoninic acid (H.P.C.), has been used in a small series of patients.Fever and acute arthritis were speedily relieved in rheu- matic fever.Results in polyarteritis nodosa were equivocal.The most striking effects in our series were obtained in three patients with scleroderma, a disease hitherto not respon- sive to any known treatment.Improvement occurred in all cases, as shown by the histological examination of biopsy specimens obtained before and after treatment.The results were striking and have so far been maintained in one case, but were only temporary in two.Very slight and inconstant improvement followed the administration of H.P.C. in chronic lupus erythematosus.but was not confirmed by histological examination.Toxic effects were infrequent and less severe than those which may follow the use of sodium salicylate, and con- sisted in slight nauisea, diarrhoea, and, more rarely, vomiting.We are grateful to Professor J. W. McNee, whose personal association with the original group of workers in Johns
The Unfairness of Life for Children With Handicaps
Authors: David L. Coulter
Journal: JAMA (1980)

LIFE is sometimes manifestly unfair. It is not always fair to those having normal intelligence and good health, but it is especially unfair to the handicapped, who are least able to cope with our modern, complex environment. There are many physical and mental handicaps that may impair a person's social functioning. Some conditions such as cerebral palsy are obvious, but many people are greatly impaired by conditions barely perceptible to society, in ways that are easy for physicians to overlook. Children with epilepsy and limited intelligence present special problems in this regard. A recent tragic failure by society, family, and medicine to help such a patient caused me to see these problems more clearly. <h3>A Program for Failure</h3> "Danny" was an 18-year-old who, since the age of 8 years, had had temporal lobe seizures probably as a result of an earlier head injury. His EEG had focal abnormalities over the
NICE recommendation on the use of pressure ulcer risk scores is flawed
Authors: Katrin Balzer, Sascha Köpke, Gabriele Meyer
Journal: BMJ (2014)

The updated National Institute for Health and Care Excellence guideline on preventing pressure ulcers claims to reflect current evidence.1 However, its recommendation on assessing pressure ulcer risk is surely not evidence based.

For risk assessment in adults, health professionals are advised to “consider using a validated scale to support clinical judgment.”1 This recommendation is mainly based on expert opinion—the …
Doctors Have Feelings Too
Authors: Deborah L. Kasman
Journal: Annals of Internal Medicine (1994)

Letters15 August 1994Doctors Have Feelings TooDeborah L. Kasman, MDDeborah L. Kasman, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-4-199408150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:I want to thank Dr. Sinatra and several other physicians who have written to me of their pain and many years of buried feelings. I held the pain of the experience at Moses Lake in my heart for 3 to 4 years before timidly sharing it with my best friend from medical school. Her prompting caused me to show it to others, who also encouraged me to publish it. Being a physician means being at the core of human feelings—celebrating birth, helping families recover from illness, watching tragic deaths, or helping families to cope with chronic and terminal ... Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 August 1994Volume 121, Issue 4Page: 309KeywordsBirthEmotionsHeartResidency Issue Published: 15 August 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Serum chemokine CXC ligand 10 (CXCL10) predicts fibrosis progression after liver transplantation for hepatitis C infection
Authors: Marie-Luise Berres, Christian Trautwein, Maximilian Schmeding, Dennis Eurich, Frank Tacke, Marcus Bahra, Peter Neuhaus, Ulf P. Neumann, Hermann E. Wasmuth
Journal: Hepatology (2010)

The recurrence of liver fibrosis after liver transplantation (LT) for hepatitis C virus (HCV) infection is responsible for graft loss and patient mortality. Although the contribution of the immune system to fibrosis recurrence is anticipated, systematic studies evaluating immune parameters as predictive markers of allograft fibrosis are lacking. The infiltration of immune cells into the graft is governed by chemokines. Here we assessed the predictive value of serum levels of chemokines [chemokine (C-X-C motif) ligand 9 (CXCL9), CXCL10, CXCL11, and chemokine (C-C motif) ligand 2 (CCL2)] with respect to fibrosis recurrence after LT in 90 HCV-infected organ recipients. Chemokines were determined within the first and third years after LT and were correlated with histological fibrosis progression in protocol biopsy samples at 1, 3, 5, and 7 years (median follow-up = 3 years). The association of chemokines with fibrosis progression was assessed by univariate and multivariate analyses and by Cox regression analysis. The results for the analyzed chemokines showed that CXCL10 levels in the first year after LT were strongly associated with early fibrosis recurrence (P = 0.005) independently of risk confounders (including the donor age, HCV viral load, HCV genotype, acute rejection, and inflammatory activity). As assessed by Cox regression analysis, a CXCL10 serum level ≤ 140 pg/mL was significantly predictive of the absence of F2 fibrosis (P = 0.001), whereas a level ≤ 220 pg/mL early after LT predicted the absence of F3 fibrosis during follow-up (P = 0.035). Conclusion: CXCL10 is an independent biomarker of the recurrence of significant fibrosis after LT for HCV infection. These results might guide patients' care after transplantation and help us to select optimal candidates for antiviral therapy post-LT. (HEPATOLOGY 2011;53:596-603)
Isolation of the target antigen of human anti-tubular basement membrane antibody-associated interstitial nephritis.
Authors: M D Clayman, L Michaud, J Brentjens, G A Andres, N A Kefalides, E G Neilson
Journal: Journal of Clinical Investigation (1986)

Using a monoclonal anti-tubular basement membrane antibody (alpha TBM-Ab) affinity column, we isolated from collagenase-solubilized human renal tissue (HSRTA) a predominantly 48,000-mol-wt moiety (H3M-1) which is selectively recognized by antisera from two patients with alpha TBM-Ab-associated interstitial nephritis (alpha TBM disease). Whereas both antisera had alpha TBM-Ab titers of 1:64-1:128 by immunofluorescence on tissue sections, their reactivity with H3M-1 in a solid-phase radioimmunoassay was demonstrable at dilutions up to 1:10,000. While these sera displayed some reactivity with pre-column HSRTA, this was markedly less than with H3M-1. HSRTA depleted of H3M-1 by passage over the alpha TBM-Ab affinity column was almost completely depleted of reactivity. Neither pooled normal human sera nor sera from patients with a variety of renal lesions not associated with alpha TBM-Ab (including interstitial nephritis and antiglomerular basement membrane disease) were reactive with H3M-1. Both patient antisera containing alpha TBM-Ab were also highly reactive with R3M-1, the 48,000-mol-wt rabbit glycoprotein antigen of experimental alpha TBM disease. Furthermore, a competitive inhibition radioimmunoassay revealed that alpha TBM-Ab from rodents with experimental alpha TBM disease could inhibit 45-98% of the R3M-1 binding reactivity of patient antisera and 85% of the H3M-1 binding reactivity of patient antisera, thus suggesting paratypic cross-reactivity. We conclude, therefore, that tubular basement membrane target epitopes and their paratypic recognition are highly conserved among mammals.
The JAK2 Inhibitor AZD1480 Potently Blocks Stat3 Signaling and Oncogenesis in Solid Tumors
Authors: Michael Hedvat, Dennis Huszar, Andreas Herrmann, Joseph M. Gozgit, Anne Schroeder, Adam Sheehy, Ralf Buettner, David Proia, Claudia M. Kowolik, Hong Xin, Brian Armstrong, Geraldine Bebernitz, Shaobu Weng, Lin Wang, Minwei Ye, Kristen McEachern, Huawei Chen, Deborah Morosini, Kirsten Bell, Marat Alimzhanov, Stephanos Ioannidis, Patricia McCoon, Zhu A. Cao, Hua Yu, Richard Jove, Michael Zinda
Journal: Cancer Cell (2009)
Dutch plan to prescribe heroin for long term misusers
Authors: T Sheldon
Journal: BMJ (1994)

Doctors are planning to prescribe heroin to a few drug misusers in several Dutch cities. They argue that people who have misused drugs for, in some cases, over 20 years should be regarded as having a chronic medical condition. Prescribing small amounts of heroin daily under medical supervision and on condition that the users take part in social rehabilitation programmes could help stabilise lives and reduce suffering, they argue.

Politicians are keen to find solutions to the increasing …
On One Hundred and Four Abdominal Sections Performed during 1884
Authors: T. Savage
Journal: BMJ (1885)

TIE work in abdominal section undertaken by ne during last year embraces a series of 104 operations, and these comprise all the eases which came under my immediate notice which I had the opportunity of operating upon.There has not been in the series the slightest attempt at selection of cases, such as choosing the most suitable, and rejecting those which did not seem to promise to be successful Had there been such attempt, I should have had four deaths less to record, being deaths in patients upon whom I operated with the idea of giving them the slight chance of life which the operation afforded, knowing well beforehand how slight that chance was.The following Analysis tail show the Naturc of the Cascs.