tbuckley/cabot-search huggingface dataset:
A Quality of Mercy: A Report on the Critical Condition of Hospital and Medical Care in America
Authors: Alister Brass
Journal: JAMA (1971)

No American can be unaware that we have a "health care crisis" on our hands. So<i>A Quality of Mercy</i>, which agonizes over runaway costs, manpower shortage, alienated physicians, choked hospitals, overdoctored suburbs and deprived neighborhoods, offers us no surprises. Neither does it propose any new solutions. Yet despite several inaccuracies (especially with regard to everybody's whipping boy, the AMA), a tendency to rant, and more than a trace of holier-than-thou, the book contains meat enough for anxiety. In particular, the chapters on the insidious influence of the pharmaceutical industry and on the basic philosophic flaws in a peer review system need careful attention by any physician liable to encounter articulate critics of the status quo. The book has other defects. Author Greenberg, a medical journalist from Rhode Island, has chosen to use a day in the life of Boston's Beth Israel Hospital as his stalking horse. But instead of
Water fluoridation, tooth decay in 5 year olds, and social deprivation measured by the Jarman score: analysis of data from British dental surveys
Authors: C M Jones, G O Taylor, J G Whittle, D Evans, D P Trotter
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To examine the effect of water fluoridation, both artificial and natural, on dental decay, after socioeconomic deprivation was controlled for. <b>Design:</b> Ecological study based on results from the NHS dental surveys in 5 year olds in 1991–2 and 1993–4 and Jarman underprivileged area scores from the 1991 census. <b>Setting:</b> Electoral wards in three areas: Hartlepool (naturally fluoridated), Newcastle and North Tyneside (fluoridated), and Salford and Trafford (non-fluoridated). <b>Subjects:</b> 5 year old children (n=10 004). <b>Intervention:</b> Water fluoridation (artificial and occurring naturally). <b>Main outcome measure:</b> Ward tooth decay score (score on the "decayed, missing, and filled tooth index" for each electoral ward). <b>Results:</b> Multiple linear regression showed a significant interaction between Jarman score for ward, mean number of teeth affected by decay, and both types of water fluoridation. This confirms that the more deprived an area, the greater benefit derived from fluoridation, whether natural or artificial (R<sup>2</sup>=0.84, P&lt;0.001). At a Jarman score of zero (national mean score) there was a predicted 44% reduction in decay in fluoridated areas, increasing to a 54% reduction in wards with a Jarman score of 40 (very deprived). The area with natural fluoridation (at a level of 1.2 parts per million—higher than levels in artificially fluoridated areas) had a 66% reduction in decay, with a 74% reduction in wards with a Jarman score of 40. <b>Conclusion:</b> Tooth decay is confirmed as a disease associated with social deprivation, and the more socially deprived areas benefit more from fluoridation. Widespread water fluoridation is urgently needed to reduce the "dental health divide" by improving the dental health of the poorer people in Britain. <h3>Key messages</h3> Tooth decay in 5 year old children is strongly associated with social deprivation Artificial fluoridation of water produced a 44% reduction in tooth decay in 5 year old children in Britain The more deprived an area, the greater the benefit derived from water fluoridation
Shorter Anogenital Distance Predicts Poorer Semen Quality in Young Men in Rochester, New York
Authors: Jaime Mendiola, Richard W. Stahlhut, Niels Jørgensen, Fan Liu, Shanna H. Swan
Journal: Environmental Health Perspectives (2011)

In male rodents, anogenital distance (AGD) provides a sensitive and continuous correlate of androgen exposure in the intrauterine environment and predicts later reproductive success. Some endocrine-disrupting chemicals can alter male reproductive tract development, including shortening AGD, in both rodents and humans. Whether AGD is related to semen quality in human is unknown.We examined associations between AGD and semen parameters in adult males.We used multiple regression analyses to model the relationships between sperm parameters and two alternative measures of AGD [from the anus to the posterior base of the scrotum (AGD(AS)) and to the cephalad insertion of the penis (AGD(AP))] in 126 volunteers in Rochester, New York.AGD(AS), but not AGD(AP), was associated with sperm concentration, motility, morphology, total sperm count, and total motile count (p-values, 0.002-0.048). Men with AGD(AS) below (vs. above) the median were 7.3 times more likely (95% confidence interval, 2.5-21.6) to have a low sperm concentration (< 20 × 10⁶/mL). For a typical study participant, sperm concentrations were 34.7 × 10⁶/mL and 51.6 × 10⁶/mL at the 25th and 75th percentiles of (adjusted) AGD(AS).In our population, AGD(AS) was a strong correlate of all semen parameters and a predictor of low sperm concentration. In animals, male AGD at birth reflects androgen levels during the masculinization programming window and predicts adult AGD and reproductive function. Our results suggest, therefore, that the androgenic environment during early fetal life exerts a fundamental influence on both AGD and adult sperm counts in humans, as demonstrated in rodents.
Socioeconomic Status and Mortality
Authors: Mehdi H. Shishehbor, David Litaker
Journal: Annals of Internal Medicine (2006)

Letters16 May 2006Socioeconomic Status and MortalityMehdi H. Shishehbor, DO, MPh and David Litaker, MD, PhDMehdi H. Shishehbor, DO, MPhFrom the Cleveland Clinic, Cleveland, OH 44195. and David Litaker, MD, PhDFrom the Cleveland Clinic, Cleveland, OH 44195.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-10-200605160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Alter and colleagues (1) address an important question regarding mediating factors that potentially account for the contribution of socioeconomic status to health care disparities. However, because of the potential social and political implications of these results, careful consideration should be given to several key issues that limit the authors' interpretations. First, it has been previously suggested that socioeconomic status is a multidimensional construct. Although operational definitions are numerous, most incorporate aspects of educational attainment, occupation, and social class. Use of self-reported income as a single measure to represent this construct therefore has the potential to markedly reduce ...References1. Alter DA, Chong A, Austin PC, Mustard C, Iron K, Williams JI, et al. Socioeconomic status and mortality after acute myocardial infarction. Ann Intern Med. 2006;144:82-93. [PMID: 16418407] LinkGoogle Scholar2. Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88:1973-98. [PMID: 8403348] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Mehdi H. Shishehbor, DO, MPh; David Litaker, MD, PhDAffiliations: From the Cleveland Clinic, Cleveland, OH 44195.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSocioeconomic Status and Mortality after Acute Myocardial Infarction David A. Alter , Alice Chong , Peter C. Austin , Cameron Mustard , Karey Iron , Jack I. Williams , Christopher D. Morgan , Jack V. Tu , Jane Irvine , and C. David Naylor , for the SESAMI Study Group*Socioeconomic Status and Mortality David A. Alter , for the SESAMI Study Group Metrics Cited byDo marginalized neighbourhoods have less healthy retail food environments? An analysis using Bayesian spatial latent factor and hurdle modelsLatent variable model for suicide risk in relation to social capital and socio-economic statusThe Spatial Pattern of Suicide in the US in Relation to Deprivation, Fragmentation and RuralitySpatial path models with multiple indicators and multiple causes: Mental health in US counties 16 May 2006Volume 144, Issue 10 Page: 781-782 Keywords Conflicts of interest Health care Medical risk factors Mortality Socioeconomic status ePublished: 16 May 2006 Issue Published: 16 May 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Mass Screening for Sickle Cell Hemoglobin
Authors: Robert M. Nalbandian
Journal: JAMA (1975)

The problem of screening large civilian and military populations for sickle cell hemoglobin and related conditions has been approached recently by three distinct methods. One method specifies hemoglobin electrophoresis as the initial screening technique, followed by a solubility (dithionite) test when a (nonspecific) "S band" is noted. Another method requires the use of the automated dithionite test, followed, when positive, by hemoglobin electrophoresis. A third method is a dual, automated technique for detecting anemia or hemoglobin S or both in the initial screening study; hemoglobin electrophoresis studies are done when indicated. All three methods provide data suitable for accurate diagnosis and genetic counseling, but substantial variations in costs and redundancy of data are found among these methods. Because it gives the "biggest diagnostic bang for the buck", the third merits widespread adoption.
Targeting the Double-Strand DNA Break Repair Pathway as a Therapeutic Strategy
Authors: Christopher J. Lord, Michelle D. Garrett, Alan Ashworth
Journal: Clinical Cancer Research (2006)

Abstract DNA repair pathways are crucial for the maintenance of genome integrity. The pathway that repairs DNA double-strand breaks (DSB) has components involved in both signaling and repairing DNA damage. Impairing DSB repair using specific inhibitors of signaling or repair might, in principle, sensitize tumor cells to particular DNA-damaging agents. Moreover, the existence of specific defects in DNA repair pathways in tumors provides the rationale for the use of “synthetic lethal” approaches targeting this cellular “Achilles' heel.” Here, we discuss the mechanisms involved in DSB repair and detail potential therapeutic approaches based on targeting this pathway.
Munro Kerr's Operative Obstetrics
Authors: J. P. Greenhill
Journal: JAMA (1971)

This book has been a classic since the first edition appeared in 1908. Much of the credit for the success belongs to Moir who wrote all the recent editions. In the preparation of this edition he enlisted the aid of Myerscough, a distinguished obstetrician and gynecologist. As with previous editions, the book is written in a delightful, conversational style begun by Kerr and continued by Moir. Included are numerous instructive and well-described case reports which provide helpful breaks in the scientific text. The book is intended for those physicians who know the rudiments of obstetrics and who plan to practice midwifery. It has been extensively revised. It contains an improved section on analgesia and anesthesia and new topics such as shock in obstetrics, problems associated with abortion, Rh immunization, and blood coagulation defects. In the discussion on placenta previa and cesarean section, I was glad to see emphasis on the
The Surgery of the Central Nervous System: A Textbook for the Postgraduate Students
Authors: Oscar Sugar
Journal: JAMA (1974)

This massive text for postgraduate students is largely the work of one experienced British neurosurgeon whose personal opinions give color and flavor uncommon in these days of symposia and compendia. He has deliberately omitted most operative details, leaving these to personal tutelage at the operating tables, special articles, and atlases. Surgery of peripheral and sympathetic nervous systems is also omitted. What<i>is</i>presented is a practical exposition of surgery of the central nervous system, each chapter of which contains etiology, pathogenesis, symptoms and signs, modes of treatment, and end results. The presentation is actually clinical surgical neurology, emphasizing study of the nervous system. There is an amount of neuropathological detail in keeping with the three general references at the end of the preface—Greenfield's<i>Neuropathology</i>, Russel and Rubinstein's<i>Pathology of Tumors of the Nervous System</i>, and Wilson's<i>Neurology</i>. Outstanding are the sections on decision-making; where alternative treatments are available, advantages and
Neural Control of Endocrine Function
Authors: G Farrell, E W Rauschkolb
Journal: Annual Review of Medicine (1961)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China in December 2019 and quickly spread around the globe, killing more than 4 million people and causing a severe economic crisis. ...Read More
Pseudoephedrine Sales and Seizures of Clandestine Methamphetamine Laboratories in Kentucky
Authors: Jeffery Talbert, Karen Blumenschein, Amy Burke, Arnold Stromberg, Patricia Freeman
Journal: JAMA (2012)

To the Editor: The illicit production of methamphetamine from the precursor pseudoephedrine in clandestine laboratories fuels up to 35% of the domestic supply.1 Public health, law enforcement, and medical associations support restricted access to methamphetamine precursors; manufacturers oppose restrictions.
Case of Lesion of Sensibility and Motion in a Person laboring under Syphilis
Authors: P. W. Swain
Journal: BMJ (1842)

Robert Rosevear, aged twenty-eight, contracted a venereal disease when at the age of twenty, for which he was treated by an empiric.He soon after suffered ani attack of rheumatism, which lasted, with varying intensity, for some months.Three years ago a severe pain fixed itself in the region of the occiput and upper cervical vertebrT, and soon after these parts began to enlarge.It appears that he took very little notice of these symptoms for some time, until their increasing intensity compelled him to seek assistance in medical advice.Accordingly, he was directed to take iodine, anld was treated for a venereal periostitis.The treatment that was applied had the effect of diminishing the enlargement in the occipital region, although a con- siderable tumefaction still remained, which continues at the present day.Eighteenl months ago, the pain in this tumefatetion became much aggravated, and extended dowin the back.The patient now, for the first time, began to suffer from slight twitchings, principally in the lower
The use of anaesthesia to diagnose malingering in the 19th century
Authors: H Connor
Journal: Journal of the Royal Society of Medicine (2006)

Malingering is the purposeful simulation or exaggeration of mental or physical illness in order to gain some end. Soon after anaesthesia was introduced ether, and then chloroform, were used to assist in the detection of suspected malingerers. This raised diagnostic issues, some of which were not understood or appreciated at the time. It also raised ethical concerns, attitudes to which were often very different from those which might be expected among modern doctors. In the 19th century malingering was seen most commonly among soldiers and it is with them that this paper is chiefly concerned.
Successful, Normal Childbirth After Kidney Homotransplantation
Authors: Joseph J. Kaufman
Journal: JAMA (1967)

IN APRIL, 1966 the first normal delivery at term after a kidney homotransplantation occurred at the Medical College of Virginia.1On Sept 19, 1966, the second such event in this country occurred at the University of California, Los Angeles, Center for the Health Sciences. The similarity between the two cases is noteworthy. Both women had received a kidney homograft from a living relative a little more than a year earlier. Both patients maintained excellent renal function throughout pregnancy; both had normal vaginal deliveries at term, and in each case the newborn child appears to be entirely normal, despite maintenance of immunosuppressive therapy during pregnancy.  Report of a Case  A 35-year-old married woman (023-10-30) was admitted to the UCLA Hospital on June 18, 1965, for a possible kidney homotransplantation. In April 1964 her blood urea nitrogen was 60 mg/100 cc, and she required several transfusions for anemia. A diagnosis of
Dietary Calcium and Lower Blood Pressure
Authors: David A. McCarron
Journal: JAMA (1996)

Dietary calcium intake fails to meet recommended levels in virtually all categories of Americans.<sup>1,2</sup>The health implications of this trend were recently addressed by a National Institutes of Health Consensus Conference,<sup>2</sup>which noted that several other common medical conditions besides osteoporosis are associated with low dietary calcium intake. The articles by Bucher et al<sup>3,4</sup>in this issue and the April 3 issue ofThe Journalfocus on one of these conditions: increased arterial pressure. These meta-analyses of randomized controlled trials of blood pressure and calcium levels in 2412 in the April 3, 1996, issue. adults and in 2459 pregnant women provide compelling evidence that both normotensive and hypertensive individuals may experience reductions in blood pressure when calcium intake is increased. Do these reports represent this week's favorite nutrient-disease relationship, only to be cast aside when a subsequent study fails to See also p 1113 and p 1016
Statins and familial hypercholesterolaemia
Authors: A. Neil, S. E Humphries
Journal: BMJ (2009)

LDL cholesterol should be lowered by at least 50% from baseline with a high potency statin

In the linked study (doi: 10.1136/bmj.a2423), Versmissen and colleagues report the outcome of treatment with statins for primary prevention of coronary heart disease in a large cohort of patients with heterozygous familial hypercholesterolaemia.1 This autosomal dominant monogenic disorder affects about one in 500 people and is the most common genetic cause of premature coronary disease. It results in the accumulation of low density lipoprotein (LDL) from birth, the approximate doubling of usual LDL cholesterol concentrations, and the subsequent development of tendon xanthomata and atheroma. Before effective treatment with statins became available, mortality from coronary disease was increased nearly 100-fold in adults aged 20-39, and about fourfold in those aged 40-59.2

The findings from Versmissen and colleagues’ study add to the evidence base for treating familial hypercholesterolaemia. Because it is unethical to withhold treatment from patients at such high coronary risk, no randomised placebo controlled trials of statins have assessed clinical outcomes in this group, and so this study is particularly useful. Clinical management has relied on extrapolating the results of …
Recombinant mouse cytomegalovirus expressing a ligand for the NKG2D receptor is attenuated and has improved vaccine properties
Authors: Irena Slavuljica, Andreas Busche, Marina Babić, Maja Mitrović, Iva Gašparović, Đurđica Cekinović, Elitza Markova Car, Ester Pernjak Pugel, Ana Ciković, Vanda Juranić Lisnić, William J. Britt, Ulrich Koszinowski, Martin Messerle, Astrid Krmpotić, Stipan Jonjić
Journal: Journal of Clinical Investigation (2010)

Human CMV (HCMV) is a major cause of morbidity and mortality in both congenitally infected and immunocompromised individuals. Development of an effective HCMV vaccine would help protect these vulnerable groups. NK group 2, member D (NKG2D) is a potent activating receptor expressed by cells of the innate and adaptive immune systems. Its importance in HCMV immune surveillance is indicated by the elaborative evasion mechanisms evolved by the virus to avoid NKG2D. In order to study this signaling pathway, we engineered a recombinant mouse CMV expressing the high-affinity NKG2D ligand RAE-1γ (RAE-1γMCMV). Expression of RAE-1γ by MCMV resulted in profound virus attenuation in vivo and lower latent viral DNA loads. RAE-1γMCMV infection was efficiently controlled by immunodeficient hosts, including mice lacking type I interferon receptors or immunosuppressed by sublethal γ-irradiation. Features of MCMV infection in neonates were also diminished. Despite tight innate immune control, RAE-1γMCMV infection elicited strong and long-lasting protective immunity. Maternal RAE-1γMCMV immunization protected neonatal mice from MCMV disease via placental transfer of antiviral Abs. Despite strong selective pressure, the RAE-1γ transgene did not exhibit sequence variation following infection. Together, our results indicate that use of a recombinant virus encoding the ligand for an activating NK cell receptor could be a powerful approach to developing a safe and immunogenic HCMV vaccine.
Reperfusion injury and its pharmacologic modification.
Authors: L H Opie
Journal: Circulation (1989)

Reperfusion injury includes a spectrum of events, such as reperfusion arrhythmias, vascular damage and no-reflow, and myocardial functional stunning. The concept of reperfusion injury remains controversial with many proposed mechanisms when applied to humans, whereas in animal models, there are two main proposed mechanisms: calcium over-load and formation of oxygen free radicals. To prove that reperfusion injury is specifically caused by reperfusion would require evidence that an intervention given at the time of reperfusion can diminish or abolish the injury as in the case of arrhythmias, which are thought to be mediated by excess recycling of cytosolic calcium with delayed afterdepolarizations and ventricular automaticity. In the case of myocardial stunning, the phenomenon may be mediated, at least in part, by a burst of free radicals formed within the first minute of reperfusion and improved by free radical scavengers given at the time of reperfusion. The alternate hypothesis is that cytosolic calcium overload damages mechanisms for normal intracellular calcium regulation so that the stunned myocardium responds to agents that are thought to increase intracellular cytosolic calcium, such as beta-receptor agonists. A further component of reperfusion injury, under active investigation, is microvascular damage with alterations at the level of platelets, leukocytes, and endothelial integrity. From the therapeutic point of view, the divergent results of experimental interventions and the possibility that the abrupt onset of reperfusion in animals differs from the situation in humans with thrombolysis means that the best way currently available to limit reperfusion injury is by minimizing the ischemic period by early reperfusion and by optimizing the metabolic status of the ischemic myocardium at the end of the ischemic period.
Father of the bride
Authors: J. O. Drife
Journal: BMJ (2011)

Our daughter got married at the end of May. The date was decided long before William and Kate announced their own plans, and we were lucky that the royal couple chose April. I was able to sit in front of the television, hankie at the ready, picking up hints on how a bride’s father should behave. Calm, supportive, dignified, and immaculate: check.⇑

I suspect, however, that Mr Middleton did not have to tie the ribbons onto his car …