tbuckley/cabot-search huggingface dataset:
One in three doctors don't tell patients about services they can't have
Authors: S. Gottlieb
Journal: BMJ (2003)

Nearly one in three doctors in the United States report withholding information from patients about useful medical services because they aren't covered by the patients' health insurance companies.

The authors of a new study say their work offers the first evidence for what many have long suspected: that coverage limitations imposed by managed care companies are infiltrating doctor-patient communications. “Patients aren't getting the whole story,” said Matthew Wynia, director of the Institute for Ethics at the American Medical Association and lead author of the study ( Health Affairs 2003;22:190-7).

Dr Wynia and his …
The future shape of accident and emergency services
Authors: P. Newman
Journal: BMJ (1996)

None the less, recent British reports of increasing rates of tuberculosis among the homeless and in larger cities, and of nosocomial outbreaks of tuberculosis and multidrug resistant tuberculosis in patients with HIV, make it clear that Britain is not immune to conditions that can foster transmission of tuberculosis.14 [17][8][19] This situation could be exacerbated if evolving changes in the NHS affect local tuberculosis control programmes"9 and result in less follow up and lower com- pletion rates for treatment.The United States Centers for Disease Control recommends that all patients be considered for directly observed therapy, but that if more than 90% of patients in an area are completing treatment the approach could be applied only to unreliable patients.'Britain may be spared the need for directly observed therapy if rates of noncompletion are still as low as the 4% reported among children 1 Centers for Disease Control.Initial therapy for tuberculosis in the era of multidrug resistance: recommendations of the advisory council for the elimination of tuberculosis.MMWR Morb
Illness associated with contamination of drinking water supplies with phenol.
Authors: S N Jarvis, R C Straube, A L Williams, C L Bartlett
Journal: BMJ (1985)

In January 1984 the River Dee in north Wales was contaminated with phenol, with subsequent contamination of the tap water received by about two million consumers. A retrospective postal survey of 594 households was undertaken to determine whether consumption of this contaminated water was associated with illness. Subjects in areas that received contaminated water reported significantly more gastrointestinal illness than those in a nearby unexposed area (32.6% v 8.7%, p less than 0.00001) as well as reporting a higher incidence of any symptoms (43.6% v 18.4%, p less than 0.00001). Symptoms were consistent with phenol poisoning and bore a strong temporal relation to the pollution of the supply, but they developed at concentrations of phenols previously considered to be safe by the water authorities concerned. Chlorophenols produced during the treatment of water may have aggravated the problem.
Care of Patients with a Low Probability of Acute Myocardial Infarction
Authors: Harvey V. Fineberg, David Scadden, Lee Goldman
Journal: New England Journal of Medicine (1984)

We conducted a cost-effectiveness analysis to examine the clinical and economic consequences of alternatives to admission to a coronary-care unit for patients who have a relatively low probability of acute myocardial infarction. Despite the fact that all our assumptions were slanted to favor the current standard policy of admission to a coronary-care unit, our analysis shows that admission to an intermediate-care unit providing resuscitative facilities and prophylactic lidocaine is highly cost effective. For patients with about a 5 per cent probability of infarction, admission to a coronary-care unit would cost $2.04 million per life saved and $139,000 per year of life saved, as compared with intermediate care. For the expected number of such patients annually in the United States, the cost would be $297 million to save 145 lives. At probabilities of infarction up to about 20 per cent, the incremental cost to save a year of life by choosing a coronary-care unit over an intermediate-care unit would be higher than the estimated cost of saving a year of life by treating a 40-year-old man with mild hypertension. Our results suggest that many patients who have a low risk of acute myocardial infarction would be appropriate candidates for admission to an intermediate-care unit.
Suppression of Plasma Androstenedione and Testosterone in Hirsute Women.
Authors: J. R. Givens
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Suppression of Plasma Androstenedione and Testosterone in Hirsute Women.J. R. Givens, M.D., W. L. Wiser, M.D., R. N. Anderson, Ph.D., R. S. Wilroy, M.D., S. A. Coleman, M.D., S. A. Fish, M.D.J. R. Givens, M.D.Search for more papers by this author, W. L. Wiser, M.D.Search for more papers by this author, R. N. Anderson, Ph.D.Search for more papers by this author, R. S. Wilroy, M.D.Search for more papers by this author, S. A. Coleman, M.D.Search for more papers by this author, S. A. Fish, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-858_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study documented hyperandrogenism in 18 hirsute women and determined if the condition was gonadotropin dependent. Plasma androstenedione, testosterone, and luteinizing hormone (LH) were measured by radioimmunoassay. All had 24-hour urinary 17-ketosteroids, 17-ketogenic steroids, and pregnanetriol measured, and those with Cushing's syndrome and congenital adrenal hyperplasia we e excluded from the study. Six underwent bilateral longitudinal ovarian wedge resection and had polycystic ovarian disease. The mean plasma androstenedione of 18 patients was 332 ng/100 ml (SE ± 24.6 ng/100 ml). The normal mean androstenedione is 180 ng/100 ml. Mean plasma testosterone was 77 ng/100 ml (±12.2). The normal range for... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. R. Givens, M.D.; W. L. Wiser, M.D.; R. N. Anderson, Ph.D.; R. S. Wilroy, M.D.; S. A. Coleman, M.D.; S. A. Fish, M.D.Affiliations: Memphis, Tenn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 858-858KeywordsBlood plasmaCongenital adrenal hyperplasiaGonadotropinsLuteinizing hormoneRadioimmunoassaysSteroidsTestosterone ePublished: 1 December 2008 Issue Published: 1 May 1972 PDF downloadLoading ...
Postheparin plasma diamine oxidase values in the follow up of patients with small bowel Crohn's disease.
Authors: L D'Agostino, S Pignata, B Daniele, M Visconti, C Ferraro, G D'Adamo, G Tritto, G Ambrogio, G Mazzacca
Journal: Gut (1991)

Measurement of postheparin plasma diamine oxidase (PHD) activity has been proposed to assess mucosal integrity in several diseases of the small intestine. In Crohn9s disease, PHD values identify a group of patients with predominantly small bowel mucosal damage. To determine the role of mucosal involvement in the progression of small bowel Crohn9s disease and whether different PHD values can predict different outcomes the changes in PHD values in 41 patients with small bowel Crohn9s disease admitted consecutively to our department were investigated. The test was performed during periods of active disease and after either medical or surgical treatment had resulted in improvement. PHD values were significantly lower than in normal subjects (normal range 3.7-7.7 U/ml). In 35 patients with active disease (Crohn9s disease activity index (CDAI) greater than 150) two groups were identified by choosing a cut off value of 2 U/ml: 93% of the 15 patients with PHD values lower than 2 U/ml (mean (SD) 1.36 (0.46) U/ml) relapsed at least once in the following year, while only the 20% of the 20 whose values were higher than 2 U/ml (mean (SD) 3.69 (1.50)) relapsed in the same period. The data were statistically significant (Yates9s corrected chi 2 = 15.63; p less than 0.0001). The positive and negative predictive values of the test were 93% and 80%, respectively. During relapses, PHD values were consistently lower than previous values, and increased significantly after effective medical or surgical treatment. In the six patients in whom there were no changes in disease activity (CDAI persistently less than 150), there was no change in PHD values. This test may be useful for identifying Crohn9s disease patients who are likely to relapse. Furthermore, the data indicate that mucosal damage is common in active small bowel Crohn9s disease and improves at least in part after treatment.
NONINVASIVE DIAGNOSIS OF ISCHEMIA-CAUSING CORONARY STENOSIS USING CORONARY CT ANGIOGRAM (CCTA): COMPARISON OF TRANSLUMINAL ATTENUATION GRADIENT (TAG) AND FRACTIONAL FLOW RESERVE COMPUTED FROM CCTA (FFRCT)
Authors: Yeonyee Elizabeth Yoon, Jin-Ho Choi, Ji-Hyun Kim, Kyung-Woo Park, Joon-Hyung Doh, Bon-Kwon Koo, James Min, Andrejs Erglis, Hyeon Cheol Gwon, Yeon Hyeon Choe, Dong-Ju Choi, Hyo-Soo Kim, Byung-Hee Oh, Young-Bae Park
Journal: Journal of the American College of Cardiology (2012)
The labial melanotic macule: a review of 79 cases
Authors: G. GUPTA, R.E.A. WILLIAMS, R.M. MACKIE
Journal: British Journal of Dermatology (1997)

Seventy-nine patients presented to the pigmented lesion clinic between 1983 and 1996 with labial melanotic macules. We have followed up these patients for up to 13 years and 3 months (mean 6 years, 3 months). We present evidence that this is a benign entity. The appropriate management is reassurance and discharge, with the advice to return only if the lesion grows or darkens. This did not occur in any of our patients during the time of their follow-up.
RELIEF OF CARDIAC DYSPNEA BY DRINKER RESPIRATOR
Authors: Eugene F. Wolfe
Journal: JAMA (1933)

The chief use of the Drinker respirator in the past has been in the treatment of respiratory weakness or paralysis. It has been employed most often in the treatment of two types of patients: (1) adults and children suffering from respiratory weakness due to anterior poliomyelitis and (2) new-born infants suffering from birth asphyxia. During the observation of patients in both of these groups, one of us (D. P. M.) has been struck by the apparently beneficial effect of artificial respiration on the circulation. The rate and volume of the pulse of adults has been improved greatly by the treatment, and the cardiac action of new-born infants has been improved and maintained for long periods without spontaneous respiration taking place. Such clinical observations and additional experimental ones on asphyxiated animals have suggested that the respirator might be of some value in the treatment of patients in whom the failure of
Emotional Aftermath of the Persian Gulf War: Veterans, Families, Communities, and Nations
Authors: Landy F. Sparr
Journal: JAMA (1997)

In the past decade and a half, scientific literature about posttraumatic stress disorder (PTSD) has grown exponentially. Much of it stems from studies of the aftereffects of combat experience. In particular, in the wake of the Vietnam War, there was both a new realization and appreciation of the emotional sequelae of participation in battle. It is not surprising, then, that the resulting massive amount of trauma literature would be utilized in the event of another large-scale armed conflict such as the 1990-1991 Gulf War, aka Operation Desert Storm. Just as the mental health community thought that everything possible had been written about war-related stress, an opportunity arose to examine the issue in situ. The result is an intriguing and far-reaching volume edited by Drs Robert Ursano and Ann Norwood,<i>Emotional Aftermath of the Persian Gulf War</i>, which retrospectively explores preparations for the psychological effects of war. This volume not only
Effect of Nicotine Chewing Gum in Combination with Group Counseling on the Cessation of Smoking
Authors: Philip Tønnesen, Vibeke Fryd, Michael Hansen, Jacob Helsted, Anne Birgitte Gunnersen, Hans Forchammer, Mette Stockner
Journal: New England Journal of Medicine (1988)

We studied the effectiveness of chewing gum containing nicotine, in combination with group counseling, for subjects who were attempting to stop smoking. We used the Horn–Russell scale, based on a smoking questionnaire, to measure dependence on cigarettes; 173 smokers were grouped as highly dependent on nicotine or as having medium to low degrees of dependence. In a randomized double-blind study, the 60 highly dependent smokers were given gum containing 4 mg of nicotine (n = 27) or 2 mg of nicotine (n = 33), and the 113 smokers with medium or low dependence were given gum containing 2 mg of nicotine (n = 60) or a placebo gum (n = 53). All smokers took part in group counseling. In the highly dependent group, abstinence from cigarettes was chemically verified after six weeks, one year, and two years; 81.5 percent, 44.4 percent, and 33.3 percent of the subjects given gum containing 4 mg of nicotine were abstinent after those follow-up periods; the rates of abstinence were 54.5 percent, 12.1 percent, and 6.1 percent, respectively, for the subjects given gum containing 2 mg of nicotine. In the group with medium or low dependence, the rates of abstinence after the same periods were 73.3 percent, 38.3 percent, and 28.3 percent for the subjects given gum containing 2 mg of nicotine and 41.5 percent, 22.6 percent, and 9.4 percent for those given placebo gum. The differences in outcomes were significant at the 5 percent level for all comparisons, with the exception of the 2-mg nicotine gum versus the placebo gum at one year. This study indicates that the effectiveness of nicotine gum is not due to a placebo effect and that it is related to dose. The use of nicotine gum in appropriate doses should be helpful to persons who are attempting to stop smoking. (N Engl J Med 1988; 318:15–8.)
Antimicrobial resistance in developing countries
Authors: C A Hart, S Kariuki
Journal: BMJ (1998)

In 1990, an estimated 78% of the world's total population lived in the developing world. Of the 39.5 million deaths in the developing world, 9.2 million were estimated to have been caused by infectious and parasitic diseases. 98% of child mortality occurs in the developing world, due mainly to infections. Based upon information gathered through searches of the Medline and Bath Information and Data Services computerized databases, discussions with colleagues, and personal experiences, the authors consider the progress and impact of bacterial resistance to antimicrobial drugs in the developing world. While antibiotics are important in developing countries, they are often scarce commodities which are affordable and therefore available to only the comparatively wealthy. Because the use of antibiotics is unregulated in many developing countries, antibiotics are often misused and overused. Such use has provoked the development of infectious agents which are resistant to antimicrobial drugs, such as strains of pneumococcal meningitis, tuberculosis, and typhoid fever. Levels of morbidity and mortality are increasing as a result. Better access to diagnostic laboratories is needed, as well as improved surveillance of the emergence of resistance, better regulation of antibiotics' use, and better education of the public, physicians, and veterinarians in the appropriate use of drugs.
STUDIES OF THE RETICULOENDOTHELIAL SYSTEM (RES). I. MEASUREMENT OF THE PHAGOCYTIC CAPACITY OF THE RES IN MAN AND DOG*
Authors: Masahiro Iio, Henry N. Wagner
Journal: Journal of Clinical Investigation (1963)

When human serum albumin is aggregated under standardized conditions, a polymer is obtained that can be successfully used to study the phagocytic capacity of the reticuloendothelial system (RES) in man. In addition to careful control of pH, temperature, amount of agitation, and concentration of the albumin solution, it is necessary to monitor the changes in optical density, to insure adequacy of the prepared material by bioassay in man, or dog, or both, and to conduct simultameous control studies in normal subjects during the study of patients. Large doses of aggregated albumin can be safety administered over prolonged periods to human subjects without evidence of hypersensitivity or excessive radiation. The phagocytic capacity of the RES in both man and dog was determined experimentally with the analytical method of Michaelis and Menten. In man, this maximal rate of phagocytosis of aggregated albumin was 1.07 mg per minute per kg of body weight. (auth)
Prolonged activity of a recombinant factor VIII-Fc fusion protein in hemophilia A mice and dogs
Authors: Jennifer A. Dumont, Tongyao Liu, Susan C. Low, Xin Zhang, George Kamphaus, Paul Sakorafas, Cara Fraley, Douglas Drager, Thomas Reidy, Justin McCue, Helen W. G. Franck, Elizabeth P. Merricks, Timothy C. Nichols, Alan J. Bitonti, Glenn F. Pierce, Haiyan Jiang
Journal: Blood (2012)
A comparison of fexofenadine/pseudoephedrine (F/P) and loratadine/montelukast (L/M) in the treatment of seasonal allergic rhinitis (SAR)
Authors: M.L. deTineo, R. Moinuddin, B. Maleckar, R.M. Naclerio, F.M. Baroody
Journal: Journal of Allergy and Clinical Immunology (2003)
Abstract B11: Coupling between the DNA methylation and the alternative splicing
Authors: Oriane Mauger, Christian Muchardt, Eric Batsché
Journal: Cancer Research (2013)

Abstract Pre-messenger RNAs (pre-mRNAs) maturation is initiated cotranscriptionally and chromatin-borne information participates in alternative splicing. We have found recently that elevated levels of trimethylation of histone H3 on Lys9 (H3K9me3) and the chromodomain protein HP1γ are a characteristic of the alternative exons of several genes including CD44 (Saint-André et al. 2011). On this gene, we have shown that the endogenous RNA interference pathway is involved in the H3K9me3 targeting on the variant exons through the recruitment of the nuclear argonaute proteins (AGO1 or AGO2) (Ameyar-Zazoua et al. 2012). Because the DNA methylation is an epigenetic mark accompanying the transcriptional silencing, we now explore whether the DNA modification into the active genes could play a role in the regulation of the alternative splicing. Studying the transcriptome and the genome of murine ES cells, allowed us to show that the enzymes that methylate DNA (DNMT1, 3a and 3b) regulate the splicing of many genes. In Hela cells the DNMT1 depletion causes a decrease in the inclusion of alternative exons of CD44. Similar results were obtained after depletion of MBD1 and MBD2, two proteins that bind to methylated DNA. Together these results suggest that DNA methylation regulates splicing of CD44 by a direct mechanism involving MBD1 and MBD2. The disregulation of the DNA methylation on CpGs is a hallmark of the tumorigenesis. However, the effect of DNA methylation changes within coding regions of the genes is poorly understood. We used the well-known model of breast tumor progression based on the MCF10A cells, to investigate the changes into the DNA methylation of the CD44 coding region. We found that the intragenic DNA methylation is modified between the MCF10A parental cells and the derived DCIS and CA1A transformed cells and this is correlated with the inclusion of the CD44 alternative exons. Altogether these results suggest that modifications of DNA methylation could contribute to the disregulations of alternative splicing decisions contributing to the tumor progression. Ameyar-Zazoua M, Rachez C, Souidi M, Robin P, Fritsch L, Young R, Morozova N, Fenouil R, Descostes N, Andrau JC, Mathieu J, Hamiche A, Ait-Si-Ali S, Muchardt C, Harel-Bellan A, Batsché E (2012) Argonaute proteins couple chromatin silencing to alternative splicing. Nat. Struc. Mol. Biol 19:998-1004. Saint-André V., Batsché E., Rachez C. and Muchardt C. (2011) Histone H3 lysine 9 tri-methylation and HP1γ favor inclusion of alternative exons. Nat. Struc. Mol. Biol 18:337-44. Citation Format: Oriane Mauger, Christian Muchardt, Eric Batsché. Coupling between the DNA methylation and the alternative splicing. [abstract]. In: Proceedings of the AACR Special Conference on Chromatin and Epigenetics in Cancer; Jun 19-22, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2013;73(13 Suppl):Abstract nr B11.
Use of Testosterone To Prevent Cyclophosphamide-Induced Azoospermia
Authors: Antonio Masala
Journal: Annals of Internal Medicine (1997)

Background: Prepubertal patients receiving chemotherapy are relatively resistant to cyclophosphamide-induced germinal cell alterations. Objective: To study the possible protective effect of testosterone used to inhibit germinal cell activity in men who are receiving cyclophosphamide. Design: Randomized, clinical trial. Setting: University medical center. Patients: 15 patients with the nephrotic syndrome who were treated with cyclophosphamide for 6 to 8 months. Intervention: Five patients received daily oral cyclophosphamide, five received cyclophosphamide in monthly bolus injections, and five received monthly intravenous boluses of cyclophosphamide plus testosterone (100 mg intramuscularly every 15 days). Measurements: Sperm counts, serum follicle-stimulating hormone levels, and serum luteinizing hormone levels were measured before, during, and after treatment with cyclophosphamide alone or cyclophosphamide plus testosterone. Results: The 10 patients who did not receive testosterone became azoospermic during cyclophosphamide therapy. In only 1 of the 10 patients did the sperm count return to normal 6 months after discontinuation of therapy. Follicle-stimulating hormone levels were elevated in these patients (mean ± SE, 19.20 ± 1.28 IU/L in patients receiving oral cyclophosphamide and 16.04 ± 2.22 IU/L in patients receiving intravenous cyclophosphamide alone). All 5 patients who received testosterone became azoospermic or severely oligospermic during treatment but had a normal sperm count 6 months after the discontinuation of therapy. In these patients, the mean sperm count was 45.78 ± 3.89 × 106/mL and follicle-stimulating hormone levels were normal (5.08 ± 0.56 IU/L). Conclusion: Testosterone given to men before and during an 8-month cycle of cyclophosphamide therapy for the nephrotic syndrome may preserve fertility.