tbuckley/cabot-search huggingface dataset:
Doing Better and Feeling Worse: Health in the United States
Authors: Amasa B. Ford
Journal: JAMA (1977)

The product of a Nelson Rockefeller think tank known as<i>The Commission on Critical Choices for Americans</i>, this book samples the opinions of the Eastern medical establishment on the problems of our health care system. Of the 20 authors, all but three work in Boston, New York, or Washington, four have appointments at Harvard, and three are officials of major philanthropic foundations based in New York. In general, the contributors are exceptionally well informed, and they write interestingly and often authoritatively. Points on which most of the contributors agree are the following: (1) Despite some notable problems having to do with cost, lack of coordination, and social injustice, American medicine is doing well, both for itself and for the public. (2) Some changes can be made, using incentives rather than penalties, without abandoning pluralism or going so far as total government medicine. (3) We probably cannot dispense with "half-way" technology
G+C3 Structuring Along the Genome: A Common Feature in Prokaryotes
Authors: V. Daubin
Journal: Molecular Biology and Evolution (2003)

The heterogeneity of gene nucleotide content in prokaryotic genomes is commonly interpreted as the result of three main phenomena: (1) genes undergo different selection pressures both during and after translation (affecting codon and amino acid choice); (2) genes undergo different mutational pressure whether they are on the leading or lagging strand; and (3) genes may have different phylogenetic origins as a result of lateral transfers.However, this view neglects the necessity of organizing genetic information on a chromosome that needs to be replicated and folded, which may add constraints to single gene evolution.As a consequence, genes are potentially subjected to different mutation and selection pressures, depending on their position in the genome.In this paper, we analyze the structuring of different codon usage measures along completely sequenced bacterial genomes.We show that most of them are highly structured, suggesting that genes have different base content, depending on their location on the chromosome.A peculiar pattern of genome structure, with a tendency toward an A1T-enrichment near the replication terminus, is found in most bacterial phyla and may reflect common chromosome constraints.Several species may have lost this pattern, probably because of genome rearrangements or integration of foreign DNA.We show that in several species, this enrichment is associated with an increase of evolutionary rate and we discuss the evolutionary implications of these results.We argue that structural constraints acting on the circular chromosome are not negligible and that this natural structuring of bacterial genomes may be a cause of overestimation in lateral gene transfer predictions using codon composition indices.
Generalism as Intention
Authors: Richard J. Baron
Journal: Annals of Internal Medicine (2004)

Editorials20 April 2004Generalism as IntentionRichard J. Baron, MDRichard J. Baron, MDFrom Greenhouse Internists, PC, Philadelphia, PA 19119.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-8-200404200-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rosemary Stevens said it well: “As a would-be ‘general specialty,’ internal medicine has been in constant search of its own definition” (1). In this issue, Larson and the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine (2) attempt to define generalism, with a list of skills to be acquired and potential reforms of payment and education that might help to realize their definition. As a mid-career practitioner engaged in community-based, independent medical practice, I agree with what they say, but there is a dimension I'd like to add. Something essential about generalist practice ...References1. Stevens R. The curious career of internal medicine.. In: Maulitz RC, Long DE., eds. Grand Rounds: One Hundred Years of Internal Medicine. Philadelphia: Univ of Pennsylvania Pr; 1988:339. Google Scholar2. Larson EB. Health care system chaos should spur innovation: summary of a report of the Society of General Internal Medicine Task Force on the Domain of General Internal Medicine. Ann Intern Med. 2004;140:639-43. LinkGoogle Scholar3. Pellegrino ED, Thomasma DC. A Philosophical Basis of Medical Practice. New York: Oxford Univ Pr; 1981:71. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Greenhouse Internists, PC, Philadelphia, PA 19119.Disclosures: None disclosed.Corresponding Author: Richard J. Baron, MD, Greenhouse Internists, PC, 345 East Mount Airy Avenue, Philadelphia, PA 19119; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWorking Together—That's Innovation! Howard K. Rabinowitz Making It Possible for General Internal Medicine To Survive Robert B. Copeland Reforming Payment for Primary Care: Making It Happen Gail R. Wilensky Customizing Residency Education Holly J. Humphrey Health Care System Chaos Should Spur Innovation: Summary of a Report of the Society of General Internal Medicine Task Force on the Domain of General Internal Medicine Eric B. Larson and Starting a Conversation about the Future of Internal Medicine Metrics 20 April 2004Volume 140, Issue 8Page: 659-660KeywordsConflicts of interestHealth careMotivationResearch laboratoriesSports ePublished: 20 April 2004 Issue Published: 20 April 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Topic: The Hemodialysis Center
Authors: Norman B. Levy
Journal: Psychotherapy and Psychosomatics (1975)

Many acute psychological problems occur in hemodialysis centers. Those arising with the use of acute dialysis, a medical treatment for poisonings and metabolic derangements, are usually problems associated with delirium and the emergence of preexisting psychosis as the patient awakens from coma. In maintenance or chronic hemodialysis, the acute psychological problems seen are anxiety reactions, hostile behavior and acute depressions. As to the treatment of these problems, pyschomimetic medications should be considered as well as short-term supportive psychotherapy. Delirium requires that the medical staff be alerted so that the underlying causal medical problem may be treated. Early diagnosis of these problems is essential since most have a good prognosis if treatment is promptly instituted.
Position of the Final Intron in Full-Length Transcripts: Determined by NMD?
Authors: D. G. Scofield, X. Hong, M. Lynch
Journal: Molecular Biology and Evolution (2007)

Nonsense-mediated decay (NMD) pathways for detection and degradation of transcripts containing premature termination (stop) codons (PTCs) are ubiquitous among the eukaryotes. NMD uses the presence of a second signal downstream of a termination codon to distinguish a PTC from a true stop codon. In mammals and perhaps other eukaryotes, the second signal is a protein complex closely associated with exon-exon junctions formed after removal of spliceosomal introns. A valid transcript in such species must have its 3'-most intron positioned so as not to serve as a second signal relative to the true stop. This requirement has been termed the "55-bp rule", in reference to the position within the 3' untranslated region (3' UTR) of valid transcripts downstream of which introns should not be found. However, as more information has become available, it is apparent that the 55-bp rule still holds in species with NMD pathways, which are not intron dependent. To clarify the applicability of the 55-bp rule, we constructed a large database of 3'-most intron positions within full-length transcripts from 4 eukaryotes, 2 of which (human and mouse) use intron positions for NMD, 1 of which (Drosophila melanogaster) does not, and 1 of which (Arabidopsis thaliana) may not use intron positions. Surprisingly, we found intron numbers to be sharply reduced within 3' UTRs in comparison to coding sequences starting immediately downstream of true stop, rather than 55 bp; this strong threshold existed for all 4 species. We suggest that a more general mechanism--higher rates of intron inclusion within 3' UTRs--is better able to explain this threshold. We propose that 3' UTRs are better able to tolerate loss of intron integrity than other gene regions, due to the generally greater length of conserved sequences important within 3' UTR exons. This mechanism may also help to explain the roughly 3 times greater length of 3' UTRs in comparison to 5' UTRs.
Wakley of the Lancet
Authors: Charles G. Roland
Journal: New England Journal of Medicine (1972)

THE obscurity of Thomas Wakley today, is unfortunate, because some knowledge of the man might inspire emulation at a time when Wakley's spirit and conscience are badly needed. Yet those few who do recognize his name probably know no more than that he founded The Lancet. This accomplishment, however, although fundamental, was only a portion of his work, for he made important contributions not only to journalism but also to jurisprudence and to politics.Indeed, Wakley pursued careers in all three areas, and it does not strain the cliché to say that any of these would have been a full-time . . .
The Principles and Practice of Medicine
Authors: Lester S. King
Journal: JAMA (1976)

Four years have elapsed since the previous edition of this text. This new edition, with the same format, is 200 pages longer, has nine more chapters, and nine more contributors. As before, all contributors (now numbering 85) are either presently connected with the Hopkins or have only recently left that institution. The volume, therefore, has an admirable unity, although there is considerable variation in the skill of presentation in the individual chapters. The orientation is primarily clinical. The method of presentation in the 19 sections—each containing from one to 20 chapters—shows the conventional cross-classification. Some sections take up diseases by organ systems, others by function or by topic (eg, genetics, neoplastic diseases, infectious diseases, etc). The first section provides a general "approach to the patient," while the last handles "special topics" in medicine. The text is not as detailed as in some other comparable books, nor does it have the
Total Ventilatory Support in a Quadriplegic Patient with Radiofrequency Electrophrenic Respiration
Authors: William W. L. Glenn, Wade G. Holcomb, Albert J. McLaughlin, James M. O'Hare, James F. Hogan, R. Yasuda
Journal: New England Journal of Medicine (1972)

A patient with respiratory paralysis from injury of the cervical cord was freed from dependence upon a mechanical respirator through the use of electrical stimulation of both phrenic nerves. This was accomplished with radiofrequency transmission to two radio receiver electrode assemblies implanted subcutaneously 14 months ago. By forceful contractions of his unparalyzed neck muscles the patient is able to assist ventilation voluntarily but is unable to support adequate ventilation by voluntary effort alone for more than a few minutes. Total ventilatory support by radiofrequency electrophrenic respiration has been maintained for more than 11 months. The two sides of the diaphragm are stimulated alternately for periods of 12 hours. Normal tidal volume and blood gas concentration with the patient in the recumbent position have been demonstrated. The tracheostomy tube has been removed; the patient can speak, and he has resumed some normal activities.
Incidence of Infective Endocarditis Caused by Viridans Group Streptococci Before and After Publication of the 2007 American Heart Association's Endocarditis Prevention Guidelines
Authors: Daniel C. DeSimone, Imad M. Tleyjeh, Daniel D. Correa de Sa, Nandan S. Anavekar, Brian D. Lahr, Muhammad R. Sohail, James M. Steckelberg, Walter R. Wilson, Larry M. Baddour
Journal: Circulation (2012)

Background— The American Heart Association published updated guidelines for infective endocarditis (IE) prevention in 2007 that markedly restricted the use of antibiotic prophylaxis in certain at-risk patients undergoing dental and other invasive procedures. The incidence of IE caused by viridans group streptococci (VGS) in the United States after publication of the 2007 American Heart Association guidelines has not been reported. Methods and Results— We performed a population-based review of all definite or possible cases of VGS-IE using the Rochester Epidemiology Project of Olmsted County, Minnesota. Patient demographics and microbiological data were collected for all VGS-IE cases diagnosed from January 1, 1999, through December 31, 2010. We also examined the Nationwide Inpatient Sample hospital discharge database to determine the number of VGS-IE cases included between 1999 and 2009. We identified 22 cases with VGS-IE in Olmsted County over the 12-year study period. Rates of incidence (per 100 000 person-years) during time intervals of 1999–2002, 2003–2006, and 2007–2010 were 3.19 (95% confidence interval, 1.20–5.17), 2.48 (95% confidence interval, 0.85–4.10), and 0.77 (95% confidence interval, 0.00–1.64), respectively ( P =0.061 from Poisson regression). The number of hospital discharges with a VGS-IE diagnosis in the Nationwide Inpatient Sample database during 1999–2002, 2003–2006, and 2007–2009 ranged between 15 318 to 15 938, 16 214 to 17 433, and 14 728 to 15 479, respectively. Conclusions— On the basis of data complete through 2010, there has been no perceivable increase in the incidence of VGS-IE in Olmsted County, Minnesota, since the publication of the 2007 American Heart Association endocarditis prevention guidelines.
Four frames suffice: A provisional model of vision and space
Authors: Jerome A. Feldman
Journal: Behavioral and Brain Sciences (1985)

Abstract This paper presents a general computational treatment of how mammals are able to deal with visual objects and environments. The model tries to cover the entire range from behavior and phenomenological experience to detailed neural encodings in crude but computationally plausible reductive steps. The problems addressed include perceptual constancies, eye movements and the stable visual world, object descriptions, perceptual generalizations, and the representation of extrapersonal space. The entire development is based on an action-oriented notion of perception. The observer is assumed to be continuously sampling the ambient light for information of current value. The central problem of vision is taken to be categorizing and locating objects in the environment. The critical step in this process is the linking of visual information to symbolic object descriptions; this is called indexing , from the analogy of identifying a book from index terms. The system must also identify situations and use this knowledge to guide movement and other actions in the environment. The treatment focuses on the different representations of information used in the visual system. The four representational frames capture information in the following forms: retinotopic, head-based, symbolic, and allocentric. The functional roles of the four frames, the communication among them, and their suggested neurophysiological realization constitute the core of the paper. The model is perforce crude, but appears to be consistent with all relevant findings.
Supporting the Health Care Team in Caring for Patients With AIDS
Authors: Paul Volberding
Journal: JAMA (1989)

A multidisciplinary approach to AIDS health care is described that combines skilled generalists with subspecialists in oncology and infectious disease; incorporates assistance with the social, economic, and psychological sequelae of AIDS; and taps the resources available in the patient's community to staff inpatient and outpatient clinics. Many unresolved ethical issues posed by AIDS and the stresses of AIDS care are explored. The distribution of patients with AIDS as widely as possible throughout the physician community, publication of a newsletter of practical AIDS information, participation of staff members in decision making and formation of program goals, and collaboration with therapists have helped to reduce the stress of AIDS clinic staff members at the San Francisco General Hospital.
STUDIES ON THE PNEUMONIC EXUDATE
Authors: Frederick T. Lord, Robert N. Nye
Journal: The Journal of Experimental Medicine (1921)

1. The enzyme present in the pneumonic lung exudate still remains active after preservation for 18 months. 2. The enzyme is active at incubator temperature before and after heating to 65 degrees C. for 1 hour. It is slightly active at room temperature and inactive after heating at 75 degrees C. for 1 hour. 3. Dialysis of the enzyme is not demonstrable. 4. Activity persists when the enzyme is mixed with concentrations of sodium chloride varying from normal to thirty-two times normal.
Exome Sequencing Implicates an Increased Burden of Rare Potassium Channel Variants in the Risk of Drug-Induced Long QT Interval Syndrome
Authors: Peter Weeke, Jonathan D. Mosley, David Hanna, Jessica T. Delaney, Christian Shaffer, Quinn S. Wells, Sara Van Driest, Jason H. Karnes, Christie Ingram, Yan Guo, Yu Shyr, Kris Norris, Prince J. Kannankeril, Andrea H. Ramirez, Joshua D. Smith, Elaine R. Mardis, Deborah Nickerson, Alfred L. George, Dan M. Roden
Journal: Journal of the American College of Cardiology (2014)
Energy Density, Portion Size, and Eating Occasions: Contributions to Increased Energy Intake in the United States, 1977–2006
Authors: Kiyah J. Duffey, Barry M. Popkin
Journal: PLoS Medicine (2011)

Using data from three surveys, Kiyah Duffey and Barry Popkin found that changes in eating/drinking occasions and portion size consistently account for most of the change in daily total energy intake over a 30-year period.
The Relationship between Pre-Operative Biomarkers of Inflammation, Clinicopathological Characteristics and Cancer Specific Survival in Early Breast Cancer.
Authors: C. Obondo, J. Mansell, A. Afra, J. Doughty, A. Lannigan, D. McMillan
Journal: Cancer Research (2009)

Abstract Breast cancer is the second most common malignancy in women. Established prognostic factors include tumour size, grade, nodal involvement, and hormonal receptor status. Recently, the systemic inflammatory response (as evidenced by elevated C-reactive protein and low serum albumin) has been established as an independent predictor of survival in patients with metastatic breast cancer (1). However, the relationship between these systemic inflammatory markers, clinicopathological characteristics and cancer specific survival has not been established in early breast cancer.During the period June 2001 to May 2008, patients with early breast cancer presenting to two hospitals in the West of Scotland were prospectively included into this study (n=959). Preoperative C-reactive protein, albumin and clinico-pathological data were recorded for each patient. The thresholds for normal C-reactive protein and albumin were taken as &amp;lt;6 mg/l and &amp;gt;43g/l respectively.The median follow-up of the survivors was 4.1yrs. During this period, 93 patients died of their cancer. On multivariate analysis, tumour size (HR 2.03; 95%CI 1.41-2.91, P&amp;lt;0.001), lymph node status (HR 2.23; 95%CI 1.45-3.41, P&amp;lt;0.001), hormone receptor status (HR 1.58; 95%CI 1.24-2.00, P&amp;lt;0.001) and albumin &amp;lt;43g/l (HR 1.97; 95%CI 1.28-3.01, P=0.002) were significant independent predictors of cancer-specific survival. Lower serum albumin concentrations (&amp;lt;43g/l) were associated with deprivation (P=0.019) and significantly poorer 5-year cancer-specific survival (85 vs 92% P=0.005).The results of the present study show that lower preoperative albumin concentrations, but not elevated C-reactive protein concentrations, predict cancer-specific survival, independent of clinico-pathologic status in early breast cancer. Further, evaluation of the pre-operative systemic inflammatory response and outcome in patient subsets is warranted.1. Al Murri AM, Wilson C, Lannigan A, Doughty JC, Angerson WJ, McArdle CS, McMillan DC. Evaluation of the relationship between the systemic inflammatory response and cancer-specific survival in patients with primary operable breast cancer.Br J Cancer. 2007;96:891-5 Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6033.
Evaluation of Reticuloendothelial Function in Man
Authors: Nathan K. Salky, Nicholas R. Di Luzio, David B. P' Pool, Arthur J. Sutherland
Journal: JAMA (1964)

The CONCEPT of the reticuloendothelial system (RES) as groups of fixed macrophages in various organs which are related functionally and morphologically was developed by Aschoff in 1924.<sup>1</sup>Since that time, experimental studies have amply documented the involvement of the RES in areas of lipid metabolism, tumor growth, antibody production, and general host resistance,<sup>2</sup>but lack of a practical method of measuring RE function in man has hindered an accurate estimation of its clinical significance. In experimental studies, colloidal substances which are known to be phagocytized by RE cells and whose rate of disappearance from the circulation can be measured, such as colloidal gold or carbon, are employed to evaluate RE function. Since these colloids are not metabolized, they cannot be safely administered to human subjects in doses large enough to determine RE phagocytic activity or capacity. Recently, I<sup>131</sup>-labeled aggregated albumin has been developed for the clinical
Stress Ulcer Prophylaxis in Ventilated Patients
Authors: Charles E. Schwartz
Journal: Annals of Internal Medicine (1994)

Letters15 November 1994Stress Ulcer Prophylaxis in Ventilated PatientsCharles E. SchwartzCharles E. SchwartzSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-10-199411150-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I was excited to see the recent study by Prod'hom and colleagues [1] documenting the substantial risk for gastric colonization and “late-onset pneumonia” in patients in intensive care units treated with histamine-2 (H2) blockers for stress ulcer prophylaxis. The elevated gastric pH associated with these agents may also cause vitamin B12 malabsorption, as has been seen with omeprazole [2]. Prod'hom and coworkers' results are especially important when added to those of Cooke and colleagues [3], who showed a remarkably low overall incidence of “clinically important” upper gastrointestinal bleeding in patients in intensive care units, with mechanical ventilation ...References1. Prod'hom G, Leuenberger P, Koerfer J, Blum A, Chiolero R, Schaller MD, et al. Nosocomial pneumonia in mechanically ventilated patients receiving antacid, ranitidine, or sucralfate as prophylaxis for stress ulcer. A randomized controlled trial. Ann Intern Med. 1994; 120:653-62. Google Scholar2. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (vitamin B12). Ann Intern Med. 1994; 120:211-5. Google Scholar3. Cook DJ, Fuller HD, Guyatt GH, Marshall JC, Leasa D, Hall R, et al. Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med. 1994; 330:377-81. Google Scholar4. Freston JW. Cimetidine II. Adverse reactions and patterns of use. Ann Intern Med. 1982; 97:728-34. Google Scholar5. Drugs that cause psychiatric symptoms. Med Lett Drugs Ther. 1993; 35:65-70. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 November 1994Volume 121, Issue 10Page: 816-817KeywordsCentral nervous systemGastric ulcersHIVHallucinationsHemorrhageIntensive care unitsMedical risk factorsPneumoniaProphylaxisVentilators Issue Published: 15 November 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...