tbuckley/cabot-search huggingface dataset:
Focus: Washington: Health reform is dead: long live health reform
Authors: J Roberts
Journal: BMJ (1994)

Last week mourners gathered at the grave of a political dream. President Clinton, Hillary Rodham Clinton, most of Congress, and at least a third of America laid major health care reform to rest. What killed off the reform is a long and complicated saga. Yet even as Congress threw dirt on the coffin a few were still hoping that the body might have a little life left.

Experts have spent much of the past two weeks analysing the decline and fall of health reform. According to economists, the fundamental flaw was Mr Clinton's promise to provide universal health care coverage while simultaneously holding down medical costs. Washington pundits believe that tardiness and secrecy were the killers.

Mr Clinton promised health care reform during his 1992 presidential campaign, but he did not produce an outline of this top priority …
Impaired Vision after Prolonged Chloroquine Therapy
Authors: Lee R. Sataline, Howard Farmer
Journal: New England Journal of Medicine (1962)

SINCE the introduction of chloroquine (7-chlor-4–4-diethylamino-1-methylaminoquinidine) as an antimalarial drug its use has been recommended in the treatment of such diverse illnesses as lupus erythematosus, rheumatoid arthritis, parasitic infestation, cutaneous sarcoid and certain cardiac arrhythmias. It had been considered a relatively safe drug, and prolonged therapy was reported to be only occasionally associated with such minor side effects as dermatitis, diplopia, blurred vision and bleaching of the hair. These quickly disappeared upon withdrawal of the drug.1 More recently, reports of corneal infiltrates occurring with prolonged chloroquine therapy have appeared in the literature.2 , 3 The symptoms associated with these lesions were blurred . . .
CASE OF RUPTURE OF THE UTERUS DURING PREGNANCY
Authors: J. G. Swayne
Journal: BMJ (1856)

4) CAs8.A woman had her breast amputated for an ordinary scirrhus.It was a hard, firm growth, cut with a clean section, which was of a translucent bluish colour, traversed by threads of an opaque buff (milk ducts).Some highly characteristic cancer-cells were observed in the
Natural history of severe alopecia areata
Authors: J.P. Vestey, J.A. Savin
Journal: British Journal of Dermatology (1987)

Journal Article Natural history of severe alopecia areata Get access J.P. Vestey, J.P. Vestey Department of Dermatology, The Royal Infirmary, Lauriston Place, Edinburgh, EH3 9YW, U.K. Search for other works by this author on: Oxford Academic Google Scholar J.A. Savin J.A. Savin Department of Dermatology, The Royal Infirmary, Lauriston Place, Edinburgh, EH3 9YW, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 117, Issue 4, 1 October 1987, Page 531, https://doi.org/10.1111/j.1365-2133.1987.tb04937.x Published: 01 October 1987
C-reactive protein is protective against Streptococcus pneumoniae infection in mice.
Authors: C Mold, S Nakayama, T J Holzer, H Gewurz, T W Du Clos
Journal: The Journal of Experimental Medicine (1981)

C-reactive protein (CRP) has several properties that suggest that it may function as a bacterial opsonin. CRP shows binding reactivity with pneumococcal C-polysaccharide, the cell wall carbohydrate of Streptococcus pneumoniae. In this study we have demonstrated protection of mice against serotypes 3 and 4 of S. pneumoniae infection by a single prior injection of CRP. This effect was seen both in mice that lacked antibody to phosphocholine and in normal mice. Thus the opsonic properties of CRP previously described may be related to protection against pneumococcal infection.
Serotonin receptor antagonism improves distal perfusion after hindlimb ischemia in ApoE-/-Mice
Authors: Jean-Pierre Bidouard, Pierre Lainée, Yoann Grataloup, Frédérique Dol, Paul Schaeffer, Nathalie Delesque-Touchard, Steve O'Connor, Philip Janiak, Jean-Marc Herbert
Journal: Journal of the American College of Cardiology (2003)
Washington's Blood Letting
Authors: Margaret A. Morris
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Dr. A. L. Abel's "Bloodletting" (<b>214</b>:900, 1970) in reference to the last and fatal illness of George Washington states, "Benjamin Rush bled him heavily four times." This is incorrect. That Washington was bled four times is correct, but not by Rush, who lived in Philadelphia. Washington was bled first by Mr. Albin Rawlins, an overseer and resident clerk at Mount Vernon, the second and third times by Dr. James Craik (a long-time intimate friend). The fourth bleeding was by Drs. Elisha Cullen Dick of Alexandria, and Gustavus Richard Brown of Port Tobacco.
Clip Choledocholithiasis after Laparoscopic Cholecystectomy
Authors: R. Angel, N. Abisambra, J. Marin
Journal: Endoscopy (2004)

Therapeutic biliary endoscopy has been widely used to manage bile duct stones prior to, during, or after laparoscopic cholecystectomy and to treat complications of the procedure [1]. Since laparoscopic cholecystectomy came into widespread use, there have been reports on migration of the clips used to close the cystic duct or occlude the cystic artery [2] [3]. There have been cases of direct migration through the papilla causing cholangitis, and of the development of choledocholithiasis [4] [5] [6]. The present report describes a case of choledocholithiasis caused by the migration of two clips, probably from the cystic duct, which served as a nucleus for the formation of the stone.
Coronary arterial spasm as a cause of exercise-induced ST-segment elevation in patients with variant angina.
Authors: G Specchia, S de Servi, C Falcone, E Bramucci, L Angoli, A Mussini, G P Marinoni, C Montemartini, P Bobba
Journal: Circulation (1979)

Four patients with variant angina pectoris exhibited reproducible exercise-induced chest pain and ST-segment elevation. Coronary arterial spasm was documented with arteriography during exercise-induced ST-segment elevation (three patients) or after intravenous administration of ergonovine maleate (one patient). Our observations show that in patients with variant angina exercise can trigger coronary arterial spasm, thus inducing anginal pain and ST-segment elevation.
CLINICAL OBSERVATIONS OF SIMULTANEOUS HALLUCINOGEN ADMINISTRATION IN IDENTICAL TWINS
Authors: BERNARD WILKENS, SIDNEY MALITZ, HAROLD ESECOVER
Journal: American Journal of Psychiatry (1962)

1. Different initial affective responses occurred in identical twins under the influence of d-LSD-25 and psilocybin. 2. These affective displays were related to the differences in personality between the twins. 3. It was possible for the affectivity of each twin to influence the affective response of the other at various times during the studies. 4. This communication of affect substantiates the hypothesis that affective responses associated with hallucinogen administration are personality specific rather than drug specific(1, 2, 3, 4, 5). 5. The drug specific changes in the autonomic, proprioceptive and perceptual spheres were similar in both twins and not modified to any noticeable extent by environmental influences. 6. Because of their profound effects, hallucinogens should be restricted to research use exclusively in a hospital setting. In our opinion, their use at this time for any other purpose or in any other setting is dangerous.
Costs and Benefits of Cesarean Sections
Authors: G. C. Tom Nabors
Journal: JAMA (1984)

To the Editor.—  Dr Sachs et al 1 made a nice contribution with their article on cesarean section. The cost-morbidity angle of studies on the delivery of low-birth weight and breech infants needs to encompass those infants who do not die but have permanent neurological damage and live a very long time at a tremendous expense.
Improvement in Metabolic Control in Diabetic Adolescents by the Use of Increased Insulin Dose
Authors: Nicholas P Mann, Derek I Johnston
Journal: Diabetes Care (1984)

Ten diabetic adolescents who had poor blood glucose control during the preceding year were recruited into a crossover insulin dosage study. Diabetic control was assessed on two insulin dosage regimens; either 1.0 U/kg/day (“limited dosage”) or 1.4 U/kg/day (“increased dosage”). The study had a 1-mo run-in period followed by two treatment periods each of 3-mo duration. Improvement in control occurred during “increased” insulin dosage with reduction of glycosylated hemoglobin levels (P &amp;lt; 0.001), self-monitored blood glucose levels (P &amp;lt; 0.001), and 24-h urine glucose excretion (P &amp;lt; 0.01). Overnight studies did not reveal hypoglycemia (blood glucose &amp;lt; 2 mmol/L) in either group, but improved overnight glucose profiles were demonstrated on the “increased” dosage and were associated with higher free insulin levels. The study supports the case for a higher maximal insulin dosage than commonly recommended during adolescence.
Occlusion of external carotid artery causing intermittent claudication of the masseter.
Authors: R R Lewis, M G Beasley, K S MacLean
Journal: BMJ (1978)

aluminium concentration was ten times higher than normal, while no other blood values were abnormal.Finally, the interruption of oral aluminium intake and the reduction of the aluminium concentration in the dialysis fluid were followed by progressive clinical improvement and cure within one month.It is difficult to determine whether aluminium intoxication is due mainly to digestive absorption after oral intake or to the high con- centration of aluminium in dialysis fluid.Generally the concentration of aluminium in dialysis fluid plays an important part in intoxica- tion,2 though prolonged ingestion of aluminium salts during chronic renal failure may be responsible for causing encephalopathy.The fact that encephalopathy due to aluminium toxicity may be reversed by stopping aluminium administration indicates the importance of performing repeated measurements of blood aluminium concentra- tions in patients undergoing haemodialysis and of controlling the aluminium content in dialysis fluid.When considered with EEG and clinical data these measurements may lead to early diagnosis of aluminium toxicity and reversal of the usually fatal course of dialysis encephalopathy.
A glucose-controlled insulin infusion system for diabetic women during labour.
Authors: M Nattrass, K G Alberti, K J Dennis, P N Gillibrand, A T Letchworth, A L Buckle
Journal: BMJ (1978)

A glucose-controlled insulin infusion system was used to control blood glucose concentration during labour or caesarean section in six insulin-dependent diabetics. The mean blood glucose concentration during the four hours of labour immediately before delivery was 4.6-5.2 mmol/1 (82.9-93.7 mg/100 ml). Feedback control of insulin delivery by blood glucose concentration should decrease the risk of postpartum hypoglycaemia in the infant and allow normal obstetric management for the insulin-dependent diabetic in labour.
Alterations in macrophage functions by environmental chemicals.
Authors: D E Gardner
Journal: Environmental Health Perspectives (1984)

The establishment of infectious diseases is rarely entirely attributed to a single entity, but instead is the result of a primary stress and one or more secondary factors that interfere with homeostasis and the ability of the host to cope with the primary etiologic assault. Any environmental chemical that can suppress the normal functioning of the host's body defenses would be expected to increase the risk of the host to such diseases. Within the lung, the alveolar macrophages are the crucial elements responsible for defending the body against such airborne viable agents. The effects of inhaled gases and particulates on these defense cells are a major concern of the environmental health scientist since such chemicals have the capability of adversely affecting the integrity and functioning of these pulmonary defense cells. The objective of this report is to provide an overview that will improve our understanding of how a variety of environmental chemicals can alter the biochemical, physiological and immunological functioning of these cells.
PANCREATIC INSUFFICIENCY RESULTING FROM LARGE MEAT PROTEIN INTAKE
Authors: G M. PARKHURST
Journal: JAMA (1923)

In the recent intensive investigation of diabetes mellitus, stimulated by the advent of insulin, little attention has been given to the rôle of protein, especially meat protein, in producing pancreatic insufficiency. The factor of keeping the patient's carbohydrate intake well within his estimated tolerance limit has been appropriately stressed, but a number of the diet cards distributed to diabetic patients fail to impress the necessity of protein restriction. Frequently, meats are listed among the carbohydrate-free group, and mild or prediabetic patients are allowed to go the limit on these articles, because they contain no carbohydrate, as such. Von Noorden has called attention to the fact that large amounts of meat protein thrown on the digestive system by a single meal may produce a temporary paralysis of pancreatic function. That this reaction is the result of protein attack rather than due to the available glucose represented by the meat is borne
A COMPROMISE SENIOR YEAR PSYCHIATRY COURSE
Authors: PETER E. SIFNEOS
Journal: American Journal of Psychiatry (1964)

One hundred and eighty senior medical students over the past 6 years who took their fourth year psychiatry course at the Massachusetts General Hospital (representing about one-fifth of those who graduated from Harvard Medical School) were asked to fill out a "Comment-Critique" questionnaire about the course and the teaching. In addition, the ideas of the faculty members involved in the teaching of this course were obtained. The needs of the students and of the faculty are summarized. Finally, a workable senior year psychiatry course, incorporating both student and faculty points of view, with possible minor modifications, suitable for any medical school curriculum, is described briefly.
Delayed Images of Glucoheptonate Distribution after Renal Transplant
Authors: EDNA J. STRATEMEIER, ROBERT G. L. LEE, THOMAS C. HILL, MELVIN E. CLOUSE
Journal: Clinical Nuclear Medicine (1985)

Thirteen consecutive patients who had undergone renal transplantation were scanned 24 hours after glucoheptonate injection to document the incidence of gastrointestinal activity mimicking urinary extravasation. In six of the 13 patients, the activity was clearly within the small bowel or the colon but, in seven patients, the activity was noted surrounding the renal allograft. Using scintigraphy alone, it could not be determined whether this appearance represented cecal activity or urinary extravasation.
Does reperfusion extend necrosis? A study in a single territory of myocardial ischemia--half reperfused and half not reperfused.
Authors: W Ganz, I Watanabe, K Kanamasa, J Yano, D S Han, M C Fishbein
Journal: Circulation (1990)

The purpose of this study was to confirm or disprove the existence of reperfusion-induced extension of necrosis. To avoid the effect of the variability of collateral circulation when groups of dogs are compared, we compared the effect of reperfusion and nonreperfusion on myocardial necrosis in a single ischemic territory, half of which was reperfused and half of which was not. The left anterior descending coronary artery (LAD) territory between its last diagonal branch and the apex was studied because it was found to have uniform collateral blood flow. In 20 dogs, the LAD was occluded for 90-240 minutes to produce necrosis of different degrees of transmurality. Before release of this occlusion, the LAD was occluded distally halfway to the apex to keep the distal half nonreperfused. After 5 minutes of proximal reperfusion. Monastral blue dye was injected into the left atrium for demarcation of the reperfused region, and the heart was arrested, excised, cut parallel to the LAD, and placed into triphenyl tetrazolium chloride (TTC) solution for delineation of the region of necrosis. The validity of TTC staining under the conditions of this study was confirmed by light and electron microscopy. The transmurality of necrosis, measured within 1 or 0.5 cm on either side of the boundary, ranged from 30% to 88% of wall thickness and was not different in the reperfused compared with the nonreperfused region (paired t test). Reperfusion did not advance the epicardial edge of necrosis compared with the nonreperfused region. In conclusion, at 5 minutes after reperfusion, comparison of necrosis in the reperfused and nonreperfused halves of a single ischemic territory could not demonstrate an extension of necrosis by reperfusion.
Predictors of Prosthesis Survival, Growth, and Functional Status Following Mechanical Mitral Valve Replacement in Children Aged &lt;5 Years, a Multi-Institutional Study
Authors: Geetha Raghuveer, Christopher A. Caldarone, Christine B. Hills, Dianne L. Atkins, John M. Belmont, James H. Moller
Journal: Circulation (2003)

Background— Prosthesis survival, growth, and functional status after initial mechanical mitral valve replacement (MVR) in children &lt;5 years of age are poorly defined. Methods and Results— The experience of the Pediatric Cardiac Care Consortium (45 centers, 1982 to 1999), which included 102 survivors after initial MVR, was analyzed. Median follow-up: 6.0 years (interquartile range: 3.0 to 10.6 years; 96% complete). Twenty-nine survivors had undergone a second MVR at an interval of 4.8±3.8 years after initial MVR. Reasons for second MVR were prosthetic valve stenosis 24 (83%), thrombosis 4 (14%), and endocarditis 1 (3%). For those who had second MVR, prosthesis sizes were: first MVR 19±2 mm and second MVR 22±3 mm, and their body weight increased from 7.4±2.8 kg to 16.8±10.5 kg. To identify risk factors for having a second MVR, the 29 second MVR survivors were compared with the 73 who did not have a second MVR on first-MVR demographic and perioperative variables. By univariate analysis, patients with shorter prosthesis survival were younger, weighed less, had smaller prostheses, greater ratio of prosthesis size:body weight, were less likely to have a St. Jude prosthesis and more likely to have Shone’s syndrome. By multivariate analysis prosthesis survival was predicted only by first MVR age: odds ratio (OR) 7.7 (95% confidence interval [CI] 2.6–22.7) and prosthesis size: OR 6.8 (95% CI 2.6–18.2). High risk patients (age &lt;2 years and prosthesis &lt;20 mm at first MVR) had an OR=46.3 compared with low-risk patients (age ≥2 years and prosthesis ≥20 mm at first MVR) over similar follow-up intervals. Using first-MVR weight-matched controls, body weight increased similarly for patients &lt;2 years old who had a second MVR versus those who did not. Prosthesis size, however, differed significantly, with second MVR patients having smaller prostheses at first MVR (18.7±0.8 mm versus 22.4±3.6 mm, P =0.017). An estimate of current New York Heart Association (NYHA) functional status was class 1 in 76%, class 2 in 22%, and classes 3 or 4 in 2%. Conclusion— Prosthesis survival can be predicted based on first MVR age and prosthesis size. Somatic growth is comparable regardless of the need for second MVR. There is an increment in prosthesis size at second MVR, suggesting continued annular growth. Significant limitation of function after MVR is uncommon. MVR may be an appropriate strategy for children &lt;5 years old despite the risk of second MVR in the youngest patients in whom the smallest prostheses are used.
Bioweapons of Tumor Mass Destruction?
Authors: Martin J.S. Dyer
Journal: Journal of Clinical Oncology (2003)

Article Tools EDITORIALS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2003.04.155 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 12837808 Bioweapons of Tumor Mass Destruction? Martin J.S. DyerxMartin J.S. DyerSearch for articles by this author Show More MRC Toxicology Unit, University of Leicester, Leicester, United Kingdom https://doi.org/10.1200/JCO.2003.04.155 Full Text PDF Figures and Tables "Bioweapons of Tumor Mass Destruction?." Journal of Clinical Oncology, 21(16), pp. 3011–3012© 2003 by American Society of Clinical Oncology
Community Nutritional Assessment: With Special Reference to Less Technically Developed Countries
Authors: C. H. Plimpton
Journal: JAMA (1991)

This is a valuable book for assessing nutrition in Third World countries. It is far less than the university-bound health scientist in his sanctum would want or use. This is a vade mecum for the field and the periphery. It is a veritable compendium for anthropometry, going far beyond mere pinching of fat folds. The physique of the book augurs well for its life span in the mildew and fungi of the tropics and the aridity of the desert. It is a review that will survive and be of continued value. There are good chapters on assessment from health statistics, ecological variables, interpretation in different age groups, methods of data collection, and, finally, planning and implementation. There are praiseworthy cautions about overly simplified interpretations. There are some handy suggestions for laboratory tests without elaborate apparatus. But alas, the implementation is about their methods and not about what to do. None
Research on aging. An agenda for all nations individually and collectively
Authors: K. Steel
Journal: JAMA (1997)

History has demonstrated a degree of arbitrariness about national borders. Gerontology affirms this fact, for all persons of all nations desire to maintain the highest degree of function and quality of life for the longest period. The Global Issue on Aging, representing the combined effort of 97 medical journals from 31 countries, reflects the present-day interest among scientists and clinicians in the care and well-being of all who are aged and anticipates some of the highest priorities of medical and social welfare worldwide for decades to come.<sup>1</sup> In the past century, the developed world has witnessed a greater increase in life expectancy than in all recorded history to the year 1900. Coupled with the declining birth rate world-wide, the elderly are assuming a larger proportion of the population with implications for almost all aspects of society. Today in both Japan and the United States the elderly account for
Colchicine in the Prevention and Treatment of the Amyloidosis of Familial Mediterranean Fever
Authors: Deborah Zemer, Mordechai Pras, Ezra Sohar, Michaela Modan, Shaltiel Cabili, Joseph Gafni
Journal: New England Journal of Medicine (1986)

To determine whether colchicine prevents or ameliorates amyloidosis in patients with familial Mediterranean fever, we followed 1070 patients with the latter disease for 4 to 11 years after they were advised to take colchicine to prevent febrile attacks. Overall, at the end of the study, the prevalence of nephropathy was one third of that in a study conducted before colchicine was used to treat familial Mediterranean fever. Among 960 patients who initially had no evidence of amyloidosis, proteinuria appeared in 4 who adhered to the prophylactic schedule and in 16 of 54 who admitted noncompliance. Life-table analysis showed that the cumulative rate of proteinuria was 1.7 percent (90 percent confidence limits, 0.0 and 11.3 percent) after 11 years in the compliant patients and 48.9 percent (18.8 and 79.0 percent) after 9 years in the noncompliant patients (P<0.0001). A total of 110 patients had overt nephropathy when they started to take colchicine. Among 86 patients who had proteinuria but not the nephrotic syndrome, proteinuria resolved in 5 and stabilized in 68 (for more than eight years in 40). Renal function deteriorated in 13 of the patients with proteinuria and in all of the 24 patients with the nephrotic syndrome or uremia. We conclude that colchicine prevented amyloidosis in our high-risk population and that it can prevent additional deterioration of renal function in patients with amyloidosis who have proteinuria but not the nephrotic syndrome. (N Engl J Med 1986; 314:1001–5.)