tbuckley/cabot-search huggingface dataset:
DIABETES MELLITUS COMPLICATED BY LIPEMIA RETINALIS AND XANTHOMA DIABETICORUM
Authors: Samuel A. D. Machlis
Journal: JAMA (1924)

This case is of interest not only as an instance of severe diabetes which responded excellently to therapy, but also of two relatively rare complications; namely, lipemia retinalis and xanthoma diabeticorum. Thirty-one cases of lipemia retinalis have been reported; the thirty-first was reported last year by Muskat<sup>1</sup>at this hospital. Eighty-one cases of xanthoma diabeticorum have been reported. The present case adds one instance to each series. A white man, aged 24, was brought into the ward in the service of Drs. Loeb and Kerr, in deep coma, with air hunger, pinched features, and a powerful acetone odor to the breath. The physical examination was grossly negative except that ophthalmoscopy showed normal disks in both eyes, but with the retinal vessels pure, shining white. There was a faint apical, systolic blow, poorly transmitted toward the axilla, but no cardiac enlargement was demonstrable. The ankles were slightly edematous. On the
The definition of alcoholism
Authors: Matthew Owen Howard, Dennis Donovan
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine<sup>1</sup>purport to offer a definition of alcoholism that is scientifically valid and clinically useful. Alcoholism is described as a "primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by... distortions in thinking, most notably denial." Denial is construed as "a range of psychologic maneuvers that decrease awareness of the fact that alcohol use is the cause of a person's problems rather than a solution to those problems" that "becomes an integral part of the disease and is nearly always a major obstacle to recovery." While the committee has done much to elucidate important aspects of alcoholism and to encourage consistent application of the term, its identification of denial as a cardinal feature
LEGAL AND PSYCHIATRIC PROBLEMS IN THE CARE AND TREATMENT OF SEXUAL OFFENDERS (A NATIONAL SURVEY)
Authors: GIULIO DI FURIA, HAYDEN L. MEES
Journal: American Journal of Psychiatry (1964)

The sexual offender presently is the subject of a legal and psychiatric dilemma. On the one hand, state legislatures have frequently provided money and laws to establish treatment for them in hospitals because it is generally agreed that prison does no good. In a nation-wide survey with useful responses from 122 hospitals, we find indications that matters are not significantly improved when sex offenders are sent to treatment centers. Not all institutions feel the same, however, since at least 17 respondents felt most were helped by hospitalization and another 18 felt about half were helped. It is suggested that the intent of the law is correct, and that hospitals should take the initiative in developing effective treatment programs and legislative changes to fit the programs; otherwise, the pendulum of legal opinion may swing back to custodial rather than treatment orientation and we will lose the opportunity to fulfill our self-imposed obligation to society.
No laughing matter?
Authors: L. Farrell
Journal: BMJ (1995)

It was the usual labour ward pandemonium: a slow breech delivery; a distressed, grossly overweight, multiparous woman with her feet up in stirrups; an exasperated nurse holding her hand; and blood, sweat, tears, liquor, meconium, and other less salubrious body fluids flying everywhere. My colleague was a tall, handsome, effortlessly charming Australian. We were waiting at the business end; we had been very concerned about fetal distress, and had almost reached panic level, but the clinical picture had suddenly improved and the crisis seemed to be over. We had both heaved a huge sigh of relief and …
Memoirs of an Obese Physician
Authors: Joseph F. Majdan
Journal: Annals of Internal Medicine (2010)

On Being a Doctor16 November 2010Memoirs of an Obese PhysicianJoseph F. Majdan, MDJoseph F. Majdan, MDFrom Jefferson Medical College, Philadelphia, PA 19107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-10-201011160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Because of society's negative view of obesity, obese people continue to suffer indignities and prejudices even in this “politically correct” world. Physicians also harbor a similar prejudicial view of obese patients (1). As a medical student and now as an attending physician and as someone who has been obese for much of my life, I have had to face both simmering and overt prejudice from the profession I hold in the highest esteem.I vividly recall that during medical school, a physician approached me as I stood with my tray in the cafeteria line. He said loudly for all to ...References1. Foster GD, Wadden TA, Makris AP, Davidson D, Sanderson RS, Allison DB, et al. Primary care physicians' attitudes about obesity and its treatment. Obes Res. 2003;11:1168-77. [PMID: 14569041] CrossrefMedlineGoogle Scholar2. The management of obesity. N Y State J Med. 1958;58:79-87. [PMID: 13493797] MedlineGoogle Scholar3. Warner CH, Warner CM, Morganstein J, Appenzeller GN, Rachal J, Grieger T. Military family physician attitudes toward treating obesity. Mil Med. 2008;173:978-84. [PMID: 19160616] CrossrefMedlineGoogle Scholar4. Alpert JS. “So, doctor, what's so bad about being fat?” Combating the obesity epidemic in the United States [Editorial]. Am J Med. 2010;123:1-2. [PMID: 20102980] CrossrefMedlineGoogle Scholar5. Yanovski SZ. Are anorectic agents the ‘magic bullet’ for obesity? [Editorial]. Arch Fam Med. 1993;2:1025-7. [PMID: 8111481] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Jefferson Medical College, Philadelphia, PA 19107.Corresponding Author: Joseph F. Majdan, MD, Jefferson Medical College, 1001 Locust Street, Suite 409B, Philadelphia, PA 19107. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWorking toward eradicating weight stigma by combating pathologization: A qualitative pilot study using direct contact and narrative medicineAn obesity educational intervention for medical students addressing weight bias and communication skills using standardized patientsUpdate: Metabolic and Cardiovascular Consequences of Bariatric Surgery 16 November 2010Volume 153, Issue 10Page: 686-687KeywordsDietEmotionsFatsFellowshipsObesityOverweightResidencySurgeonsSurgeryWeight loss ePublished: 16 November 2010 Issue Published: 16 November 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Hepatobiliary transporters and drug-induced cholestasis
Authors: Christiane Pauli‐Magnus, Peter J. Meier
Journal: Hepatology (2006)

Drug-induced liver injury is an important clinical problem with significant morbidity and mortality. Whereas for most hepatocellular forms of drug-induced hepatic injury the underlying pathophysiological mechanism is poorly understood, there is increasing evidence that cholestatic forms of drug-induced liver damage result from a drug- or metabolite-mediated inhibition of hepatobiliary transporter systems. In addition to their key role in determining hepatic drug exposure and clearance, the coordinated action of these transport systems is essential for bile formation and the biliary secretion of cholephilic compounds and xenobiotics. Any drug-mediated functional disturbance of these processes can lead to an intracellular accumulation of potentially harmful bile constituents and result in the development of cholestatic liver cell damage. In addition to direct drug-mediated inhibition of hepatocellular transport, function of these transporters can be altered by pre-existing hepatic disease and genetic factors, which contribute to the development of drug-induced cholestasis in susceptible individuals. This review summarizes current knowledge about the function of hepatobiliary uptake and efflux systems and discusses factors that might predispose to drug-induced cholestasis. (HEPATOLOGY 2006;44:778–787.)
Diagnosis of Meralgia Paresthetica
Authors: Arthur D. Ecker
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Meralgia paresthetica (MP) is a disorder of the lateral femoral cutaneous nerve, the sensory nerve of the anterolateral aspect of the thigh. The symptoms are intermittent numbness, tingling, pain, and/or a burning sensation, often worse when standing or walking. Diagnosis utilizing contact chromothermography was recently reported in a case of MP.<sup>1</sup>My experience with this technique in 14 such cases yielded the following results in the affected region: six were isothermic (temperature equal to that of surrounding skin and of the opposite thigh), five were hypothermic (cool), and three were hyperthermic (warm). There was no correlation with either duration of symptoms or intensity of sensory impairment. Forty-six years ago, Dr Woltman and I<sup>2</sup>reported that "appreciation of touch, pain and temperature was diminished in 68 per cent of 150 cases." Since then, in about 200 cases of MP, I have usually found the following sensory
Abstract 5134: Mechanistic dissection of EWS-FLI impact on Ewing's sarcoma cell behavior
Authors: Aashi Chaturvedi, Stephen L. Lessnick, Mary C. Beckerle
Journal: Cancer Research (2010)

Abstract Ewing's sarcoma is caused by the oncogenic fusion of the EWS and FLI genes to encode a chimeric EWS-FLI protein product. The disease is often metastatic at presentation. This study aims to define the molecular mechanism by which the EWS-FLI oncoprotein influences metastatic potential by testing the impact of EWS-FLI expression on cytoarchitecture, adhesion, and migration of Ewing's sarcoma cells. We compared the behavior of A673 Ewing's sarcoma cells with A673 cells in which we knocked down expression of EWS-FLI by RNA-interference. Knock-down of EWS-FLI results in enhanced cell spreading and the establishment of robust actin stress fibers and focal adhesions. Consistent with these morphological attributes, a quantitative cell adhesion assay revealed that parental A673 cells are less adhesive than those in which EWS-FLI expression was reduced by RNA interference. Knockdown of EWS-FLI in A673 cells is also associated with increased cell motility and loss of anchorage-independent cell growth. Gene expression profiling revealed that expression of EWS-FLI causes downregulation of transcripts encoding several focal adhesion proteins and integrin adhesion receptors by 2-4 fold. By Western immunoblot analysis, we demonstrated that knock-down of EWS/FLI oncoprotein expression in human A673 cells leads to increased expression of focal adhesion constituents such as the actin regulator, zyxin. Introduction of a zyxin expression construct into A673 Ewing's sarcoma cells was sufficient to restore the integrity of the actin cytoskeleton and focal adhesions, and to enhance cell adhesion. In contrast, restoration of zyxin expression in A673 sarcoma cells did not affect cell motility, matrigel invasion, or anchorage-independent cell growth. Thus, oncogenic transformation by EWS-FLI is associated with changes in cytoskeletal architecture, cell adhesion, cell motility/invastion, and cell growth control. Re-expression of a single focal adhesion protein, zyxin, is sufficient to restore cytoskeletal integrity and partially rescue the adhesion deficits seen in A673 sarcoma cells. These studies provide evidence for a zyxin-dependent pathway downstream of EWS-FLI that controls cell morphology and adhesion, as well as zyxin-independent pathways that influence motility/invasion and anchorage-independent cell growth. Loss of adhesion coupled to reduced zyxin expression may be an early step in the establishment of metastatic potential of Ewing's sarcoma cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5134.
Incidence of Suppressed Renin Activity and of Normokalemic Primary Aldosteronism in Hypertensive Negro Patients
Authors: MORTON C. CREDITOR, UNA K. LOSCHKY
Journal: Circulation (1968)

In 35 normokalemic Negro patients with benign essential hypertension, plasma renin activity (PRA) was measured by the method of Boucher and associates, while they were on regular diets, after ambulation, sodium restriction and thiazide medication, and again after rigid sodium depletion in the hospital. In nine (26%) inadequate PRA response was elicited even after the latter regimen. In only two of these (6%) was elevated excretion of aldosterone demonstrated. Suppressed PRA is commonly encountered in apparent benign essential hypertension and it occurs much more frequently than normokalemic primary aldosteronism does. Casual measurement of PRA in ambulatory patients is of little differential diagnostic value in primary aldosteronism.
Cd4+ T Cell Division in Irradiated Mice Requires Peptides Distinct from Those Responsible for Thymic Selection
Authors: Jeremy Bender, Tom Mitchell, John Kappler, Philippa Marrack
Journal: The Journal of Experimental Medicine (1999)

We investigated the mechanism by which α/β T cells expand upon transfer to T cell–deficient host mice by injecting carboxyfluorescein diacetate succinimidyl ester–labeled T cells into mice depleted of T cells by sublethal irradiation. We found that CD4+ T cells divided when transferred to irradiated hosts and that the division of more than half of these cells required class II expression. However, division of transferred CD4+ T cells did not occur in irradiated hosts that expressed class II molecules occupied solely by the peptide responsible for thymic selection, indicating that peptides distinct from those involved in thymic selection cause the division of CD4+ T cells in irradiated mice. These data establish that class II–bound peptides control the expansion of CD4+ T cells transferred to T cell–deficient hosts and suggest that the same peptides contribute to the maintenance of T cell numbers in normal mice.
Efficacy of Control Measures in Preventing Nosocomial Transmission of Multidrug-Resistant Tuberculosis to Patients and Health Care Workers
Authors: Susan A. Maloney
Journal: Annals of Internal Medicine (1995)

To assess the efficacy of control measures in decreasing nosocomial transmission of multidrug-resistant tuberculosis.Retrospective cohort study.A teaching hospital in New York City.40 patients hospitalized with multidrug-resistant tuberculosis (case-patients) and health care workers receiving tuberculin skin testing.Centers for Disease Control and Prevention (CDC) 1990 guidelines for preventing transmission of tuberculosis, including 1) prompt isolation and treatment of patients with tuberculosis; 2) rapid diagnostic techniques for processing Mycobacterium tuberculosis specimens; 3) negative-pressure isolation rooms; and 4) molded surgical masks for health care workers.Proportion of case-patients with nosocomially acquired tuberculosis and rate of tuberculin skin test conversion among health care workers before and after implementation of control measures.The proportion of patients with multidrug-resistant strains of M. tuberculosis decreased after the interventions (10 of 70 [14%] compared with 30 of 95 [32%] patients before the intervention; relative risk [RR], 0.5; 95% CI, 0.2 to 0.9). Before onset of multidrug-resistant tuberculosis, case-patients in the intervention period were as likely to be hospitalized on high-risk wards containing patients with tuberculosis (4 of 10 compared with 17 of 30 patients; RR, 0.7; P = 0.5) but were less likely to be exposed to another case-patient with tuberculosis (1 of 10 compared with 20 of 30 patients; RR, 0.2; P = 0.003). Tuberculin skin test conversion rates for health care workers assigned to wards housing patients with tuberculosis were lower in the intervention period than in the preintervention period (4 of 78 [5%] compared with 15 of 90 [17%] conversions; P = 0.02), decreasing to levels observed for workers assigned to other wards (4 of 78 [5%] compared with 9 of 228 [4%] conversions; P = 0.7).Implementing control measures reduced nosocomial transmission of multidrug-resistant strains to patients and health care workers.
Cross country skiing
Authors: P Blackman
Journal: British Journal of Sports Medicine (2004)

Edited by H Rusko. London: Blackwell, 2003, £31.50, pp 198, softcover. ISBN 0632055715

Heikki Rusko has put together a comprehensive text with largely evidence based opinions on sports science and coaching and their relevance to Nordic skiing. In depth analysis and discussion on central issues is interesting, although at times becomes bogged down with too many laborious statistical …
Value of laparotomy in the diagnosis of obscure gastrointestinal haemorrhage.
Authors: M P Lewis, D E Khoo, J Spencer
Journal: Gut (1995)

Over a nine year period a total of 137 patients were investigated for obscure gastrointestinal bleeding on one surgical unit. In 20 patients visceral angiography strongly suggested the presence of caecal or right colonic angiodysplasia. These patients were treated by an appropriate colectomy and they are not considered further in this study. Similarly lesions of the small bowel detected by preoperative investigations are not considered here. Fifty five patients were offered diagnostic laparotomy after the failure of other investigations to establish a diagnosis. Two patients refused. A diagnostic laparotomy was performed in the remaining 53. At operation if no visible lesion was seen an on table enteroscopy was performed using a colonoscope passed per oram and, if necessary, per anum. In nine (17%) patients no cause for bleeding was found. In 18 (34%) patients there was a small bowel vascular anomaly, in 14 (26%) a small bowel tumour, in four (7.5%) a bleeding Meckel9s diverticulum, and in eight (15%) other miscellaneous lesions. Laparotomy, with on table enteroscopy where indicated, elucidated the cause of bleeding in 44 patients (83%). It was associated, however, with a postoperative death rate of 7.5% (four patients). After seemingly appropriate surgery, rebleeding occurred in 14 patients (26%). Of 18 patients with small bowel vascular anomalies seven rebled (39%), at an average follow up interval of 32 months.
Endoscopic Discovery and Capture of Taenia Saginata
Authors: P. Descombes, J.L. Dupas, J.P. Capron
Journal: Endoscopy (1981)

The authors report the first case of endoscopic finding and removal of a beef tapeworm (Taenia saginata). The parasite was discovered in the duodenal bulb of a 72-year-old woman, who complained of epigastric pain.
Quantitative Doppler assessment of valvular regurgitation.
Authors: M Enriquez-Sarano, K R Bailey, J B Seward, A J Tajik, M J Krohn, J M Mays
Journal: Circulation (1993)

Quantitation of valvular regurgitation remains a challenge. The accuracy of quantitative Doppler is controversial, and its ability to measure regurgitant volume is unknown; therefore, it is not widely used.In 120 patients (20 without regurgitation, 19 with aortic regurgitation, and 81 with mitral regurgitation), the stroke volume through the mitral annulus and left ventricular outflow tract were measured using pulsed-wave Doppler concurrently with left ventricular stroke volume calculated using left ventricular volumes measured by two-dimensional echocardiography Simpson's biapical method. Regurgitant volume and fraction were thus computed using Doppler or ventricular methods. In normal patients there were good correlations between Doppler and left ventricular measurements of stroke volume. Doppler regurgitant volume and fraction were 4.4 +/- 4.4 mL and 5.3 +/- 4.5%, respectively. In patients with aortic regurgitation, there were good correlations between Doppler and left ventricular measurements of stroke volume, regurgitant volume, and regurgitant fraction (r = 0.97, r = 0.95, and r = 0.93, respectively; p < 0.0001). In patients with mitral regurgitation, despite good correlations between Doppler and ventricular methods for stroke volume, regurgitant volume, and regurgitant fraction (r = 0.94, r = 0.93, and r = 0.94, respectively; p < 0.001), these variables were overestimated by Doppler. However, in the last 54 patients compared with the first 27, overestimation decreased significantly for regurgitant volume (5 +/- 10 mL versus 18 +/- 27 mL, p < 0.05) and regurgitant fraction (3.3 +/- 6.7% versus 6.2 +/- 6.8%, p = 0.05).Quantitative Doppler can be performed in large numbers of patients in a clinical laboratory. Its potential limitation was identified as overestimation of mitral regurgitation, which is overcome with increased experience. Its achieved accuracy in mitral and aortic regurgitation allows measurement not only of regurgitant fraction but most importantly of regurgitant volume.
Expanding Patient Involvement in Care
Authors: SHELDON GREENFIELD
Journal: Annals of Internal Medicine (1985)

An intervention was developed to increase patient involvement in care. Using a treatment algorithm as a guide, patients were helped to read their medical record and coached to ask questions and negotiate medical decisions with their physicians during a 20-minute session before their regularly scheduled visit. In a randomized controlled trial we compared this intervention with a standard educational session of equal length in a clinic for patients with ulcer disease. Six to eight weeks after the trial, patients in the experimental group reported fewer limitations in physical and role-related activities (p < 0.05), preferred a more active role in medical decision-making, and were as satisfied with their care as the control group. Analysis of audiotapes of physician-patient interactions showed that patients in the experimental group were twice as effective as control patients in obtaining information from physicians (p < 0.05). Results of the intervention included increased involvement in the interaction with the physician, fewer limitations imposed by the disease on patients' functional ability, and increased preference for active involvement in medical decision-making.
Cross sectional studies
Authors: P. Sedgwick
Journal: BMJ (2010)

Researchers investigated public perception, anxiety, and behaviour with regard to the outbreak of swine flu.1 A cross sectional survey was used, with random dialling of telephone numbers in England, Scotland, and Wales. In total, 997 adults aged over 18 years—who had heard of swine flu and spoke English—were interviewed between 8 May and 12 May 2009. Proportional quota sampling was used with quotas based on age, sex, work status, region, and social grade. Which of the following statements, if any, are true?