tbuckley/cabot-search huggingface dataset:
A NATIONAL SANITARIUM FOR CONSUMPTIVES.
Authors: W. THORNTON PARKER
Journal: JAMA (1896)

An article in the New York Medical Journal of January 4, 1896, by Dr. W. D. Bratton of the U. S. Marine-Hospital Service, concerning the Arid Region Sanitarium has attracted my attention. One would infer from this article that the idea of a national sanitarium for consumptives originated in the Marine-Hospital Service, either through Surgeon-General Woodworth, Surgeon-General Hamilton or Surgeon-General Wyman. I have examined the historical sketch of Surgeon Stoner in the annual report of the Marine-Hospital Service for 1893, but I am unable to discover therein any special reference to a national sanitarium for consumptives. Wishing to investigate the history of this movement for a national sanitarium, I wrote to the Marine-Hospital Service as follows:  To the Surgeon-General of the U. S. M.-H. Service.  Sir:  —I am very much interested in a contribution by Dr. W. D. Bratton, concerning an arid-region sanitarium in the New York Medical Journal of
Personal Health Records and Medical Care Use
Authors: Ross Koppel, Stephen B. Soumerai
Journal: JAMA (2013)

Author Affiliations: Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan (Dr Wu; chun@vghtc.gov.tw); and Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan (Dr Hsu). Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Wu reported receiving a grant from Taiwan’s National Health Research Institutes for financial support for a research assistant. Dr Hsu reported no disclosures.
In-Hospital Cardiopulmonary Resuscitation-Reply
Authors: Donald J. Murphy
Journal: JAMA (1989)

<h3>In Reply.—</h3> I agree with Drs Blackhall, Brody, and Tomlinson. We should discuss advance directives, including CPR, with our patients and their families. The question I raise is whether we<i>must</i>discuss CPR before writing a DNR order for severely demented patients or patients for whom CPR is futile. The policy I propose should not imply that we curtail communication with patients and families. Simply writing a DNR order does not excuse the physician from discussing life-sustaining therapies (feeding tubes, intravenous antibiotics, emergency surgery, and so on) that can profoundly alter the last months or years of our patients' lives. When these issues are addressed, a discussion of CPR will follow. Dr Blackhall suggests that the decision to withhold CPR because of poor quality of life can be made only by patients and their families. In most cases, I agree. But what about the severely demented patient, bedbound with decubitus
What to Do With a Patient Who Smokes
Authors: Steven A. Schroeder
Journal: JAMA (2005)

Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker's privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 As (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking, advising, and referring to a telephone "quit line" or an internal referral system. Successful treatment combines counseling with pharmacotherapy (nicotine replacement therapy with or without psychotropic medication such as bupropion). Nicotine replacement therapy comes in long-acting (patch) or short-acting (gum, lozenge, nasal spray, or inhaler) forms. Ways to counter clinicians' pessimism about cessation include the knowledge that most smokers require multiple quit attempts before they succeed, that rigorous studies show long-term quit rates of 14% to 20%, with 1 report as high as 35%, that cessation rates for users of telephone quit lines and integrated health care systems are comparable with those of individual clinicians, and that no other clinical intervention can offer such a large potential benefit.
Spastic quadriplegia due to electric shock.
Authors: J R Silver
Journal: BMJ (1973)

Sick Sinus Syndrome Sn,-T7here are two points in your leading article on sinuatrial disorder (23 June, p. 677) whikh require comment.The familial nature of this disorder requires stressing since it is not only in the younger relatives that it can be asymptonatic.Moreover, not all affected patents fai to develop a tachy- cardia on exercise, and older and affected siblings may neglect their sytoms until cerebral or cardiac catastophes occur.Earlier diagnosis by careful screening of the families of affected patients using simple clinical nethodsj can prevent unnecessary cardiac and cerebrl neurosis and allow planned follow-up of the asymptonatic but affected patients and then earlier provision of effec tive treatment when sym ms do occur.Although angina caused by persisenice of bradycardia during exercise and rest has been described as an aetiological factor for the anginal syoms and cerebra distubances of John Hunter,2 your leading article surely misplaced one reference source.'This com- muncation, the first to use the term sinuatrial disorder in 1971, suggested that acute hyperextension of the neck causing indirect trauma to the sinuatrial node may be a more common contributory cause of death in patients with closed head injury than is at present recognized.-Iam, etc., B. LIvEsLEY
Change in Medical Spending Attributable to Diabetes: National Data From 1987 to 2011
Authors: Xiaohui Zhuo, Ping Zhang, Henry S. Kahn, Barbara H. Bardenheier, Rui Li, Edward W. Gregg
Journal: Diabetes Care (2015)

OBJECTIVE Diabetes care has changed substantially in the past 2 decades. We examined the change in medical spending and use related to diabetes between 1987 and 2011. RESEARCH DESIGN AND METHODS Using the 1987 National Medical Expenditure Survey and the Medical Expenditure Panel Surveys in 2000–2001 and 2010–2011, we compared per person medical expenditures and uses among adults ≥18 years of age with or without diabetes at the three time points. Types of medical services included inpatient care, emergency room (ER) visits, outpatient visits, prescription drugs, and others. We also examined the changes in unit cost, defined by the expenditure per encounter for medical services. RESULTS The excess medical spending attributed to diabetes was $2,588 (95% CI, $2,265 to $3,104), $4,205 ($3,746 to $4,920), and $5,378 ($5,129 to $5,688) per person, respectively, in 1987, 2000–2001, and 2010–2011. Of the $2,790 increase, prescription medication accounted for 55%; inpatient visits accounted for 24%; outpatient visits accounted for 15%; and ER visits and other medical spending accounted for 6%. The growth in prescription medication spending was due to the increase in both the volume of use and unit cost, whereas the increase in outpatient expenditure was almost entirely driven by more visits. In contrast, the increase in inpatient and ER expenditures was caused by the rise of unit costs. CONCLUSIONS In the past 2 decades, managing diabetes has become more expensive, mostly due to the higher spending on drugs. Further studies are needed to assess the cost-effectiveness of increased spending on drugs.
The Nature of Treatment Selection in Coronary Artery Disease
Authors: J. FREDERICK MCNEER, C. FRANK STARMER, ALAN G. BARTEL, VICTOR S. BEHAR, YIHONG KONG, ROBERT H. PETER, ROBERT A. ROSATI
Journal: Circulation (1974)

This report presents our experience with the medical and surgical management of patients with coronary heart disease and uses this experience to document the role of a computerized medical information system in the long-term management of patients with a chronic disease. Of 781 consecutively evaluated patients, 402 were treated medically and 379 were treated with aortocoronary bypass surgery. At two years post-zero time, more than twice as many surgical survivors were pain free, but the survival was the same in the medical (83%) and surgical (85%) cohorts. The medically and surgically treated patients were compared with respect to 89 baseline characteristics. The cohorts were remarkably similar. Correction for baseline inequalities did not affect the fact that two-year survival was the same in both cohorts. One subgroup was identified in which surgically treated patients had a higher two-year survival. Other subgroups were identified in which therapy did not appear to affect two-year survival.
Continuities in vocal communication argue against a gestural origin of language
Authors: Robert M. Seyfarth
Journal: Behavioral and Brain Sciences (2005)

To conclude that language evolved from vocalizations, through gestures, then back to vocalizations again, one must first reject the simpler hypothesis that language evolved from prelinguistic vocalizations. There is no reason to do so. Many studies – not cited by Arbib – document continuities in behavior, perception, cognition, and neurophysiology between human speech and primate vocal communication.
BROMIDES, HYPOPHYSIS AND THYROID
Authors: Giovanni Moruzzi
Journal: JAMA (1949)

<h3>To the Editor:—</h3> I have read the interesting article by Ravdin, Rose and James Maxwell, which appeared inThe Journal(<b>140</b>:141-146 [May 14] 1949) under the heading "The Treatment of Thyrotoxicosis." With respect to the first part of that article, in which various treatments of thyrotoxicosis are dealt with, I wish to call the attention to the action of bromides (sodium bromide) on the thyroid and the hypophysis. In a group of researches (worked out from 1934 to 1943,<i>Arch. di fisiol.</i>, 1939-1940;<i>Boll. Soc. ital. biol. sper.</i>1936, 1939 and 1943;<i>Naturwissen.</i>, 1938-1940;<i>Riv. Svizzera di Med.</i>, 1940), my co-workers and I showed that sodium bromide when administered for a long period and in proper doses to animals (dogs, rabbits, rats) causes a remarkable decrease in the iodine content of the thyroid and, consequently, evident hypofunction of this gland. This is physiologically proved by a decrease of basal
HG-12 * LIN28 AND MYC EXPRESSING PEDIATRIC GLIOBLASTOMAS ARE SENSITIVE TO INHIBITORS OF GLUTAMINE METABOLISM
Authors: I. Taylor, S. Ahsan, M. Weingart, C. Eberhart, E. Raabe
Journal: Neuro-Oncology (2015)

We have previously shown that LIN28A protein is highly expressed in a subset of pediatric glioblastoma (GBM). Knockdown of LIN28A using lentiviral shRNA in GBM cell lines inhibits their invasion, growth and clonogenicity. LIN28A downregulates the let-7 family of tumor suppressing microRNAs, and these in turn inhibit multiple oncogenes including MYC. LIN28 is also known to regulate cellular metabolism in normal and transformed cells. We hypothesized that LIN28 would contribute to GBM tumorigenicity in part by modifying cellular metabolism. Pediatric GBM express MYC and NMYC, and these oncogenes also promote tumorigenicity through increasing proliferation, invasion and altering cellular metabolism. Addition of LIN28A to the JHH- GBM14 cell line leads to upregulation of MYC and glutaminase (GLS) as measured by western blot. The inhibitors of glutamine metabolism DON (6-Diazo-5-oxo-L-norleucine) and acivicin suppress the growth of LIN28A-transduced GBM14 cells to a greater extent than control empty-vector transduced cells in MTT assays (p = 0.008 for 5 uM DON, Student's t-test; p = 0.03, 5 uM acivicin, Student's t-test). We found that the pediatric high grade glioma cell lines SF188, UW479, SJ-GBM2, and KNS42 express varying levels of LIN28, MYC, and NMYC and have robust GLS expression by western blot. Acivicin treatment decreased the growth of SF188, KNS42 and UW479 in MTT Assays (P < .005 10 uM acivicin, Student's t-test). DON and acivicin have been tested in phase I clinical trials in children, but never extensively investigated in aggressive pediatric brain tumors. Our data suggest that LIN28 can alter GBM cellular metabolism in a way that confers sensitivity to inhibitors of glutamine metabolism and that these agents may be of therapeutic use in pediatric high grade gliomas.
On Bedside Teaching
Authors: Stephen A. Schroeder
Journal: Annals of Internal Medicine (1997)

Letters15 July 1997On Bedside TeachingStephen A. Schroeder, MDStephen A. Schroeder, MDThe Robert Wood Johnson Foundation; Princeton, NJ 08543-2316Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-2-199707150-00043 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I would like to thank Dr. LaCombe for bringing us back to the basics [1]. When I was at the University of California, San Francisco, I tried to do as much bedside teaching as possible but was frustrated by the disappearance of patients. Probably half of the patients I went to visit were off somewhere else, often in an imaging center awaiting a test. I sometimes took the entire housestaff team down with me to the radiology suite where, in less than adequate circumstances, we would at least get a history and do a preliminary physical examination. ...References1. LaCombe MA. On bedside teaching. Ann Intern Med. 1997; 126:217-20. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Robert Wood Johnson Foundation; Princeton, NJ 08543-2316 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1997Volume 127, Issue 2Page: 173KeywordsDiagnostic radiology Issue Published: 15 July 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
NHS Direct underused by ethnic minorities
Authors: A. Vass
Journal: BMJ (2002)

NHS Direct, the telephone healthcare service operated by nurses in England and Wales, is used less by ethnic minorities, people aged over 65, and disadvantaged groups than by the general population, a new report about the service in England has said. Yet these groups had “as much need as others and perhaps an even greater one.”

The report, published today by the National Audit Office, says that the service is nevertheless operating safely and effectively. Its report details only 29 cases of adverse events in the past three years—less than …
MPs call for end to cheap alcohol promotions to reduce crime
Authors: Z. Kmietowicz
Journal: BMJ (2008)

A cross party group of MPs has called for a ban on promotions of cheap alcohol at pubs and clubs and an end to supermarket discounts on alcohol to reduce drink fuelled disorder.

The home affairs select committee said that it was concerned about the pressure that easy access to cheap alcohol was putting on police.

In 2007 alcohol was 69% more affordable in the United Kingdom than it was in 1980, says the committee’s report into policing in the 21st century. Altogether 45% of victims of violence describe their assailant …
In-plane myocardial wall stress is not the primary determinant of coronary systolic flow impediment. A study in the isolated, perfused dog septum.
Authors: J R Resar, J Z Livingston, F C Yin
Journal: Circulation Research (1992)

The hypothesis that ventricular in-plane tensile wall stresses are the major determinant of systolic coronary flow was investigated in this study. We measured coronary artery inflow in the maximally vasodilated bed of the isolated beating septum (n = 10) during two modes of contraction characterized by markedly different levels of developed in-plane stress. An increase in contractility was induced by changing from the control steady-state pacing state to a postextrasystolic potentiated state induced by a modified rapid pacing protocol. Over a range of increments of passive stretch, the systolic flow impediment versus the diastolic wall strain was described by an inverse linear relation. Despite the differences in developed in-plane wall stresses between the two modes of contraction (p less than 0.001), the slope and intercept of these relations in both the control and potentiated states were not different for the low versus high developed stress modes. The systolic flow impediment versus diastolic wall strain relation for the potentiated beats, compared with the control beats, was characterized by an increase in the intercept in both the low developed stress beats (p less than 0.05) and the high developed stress beats (p less than 0.05). These data indicate that the impediment to coronary flow during systole is not primarily determined by systolic myocardial in-plane tensile wall stresses but rather by the contractile state of the muscle.
Activation of RegIII / and interferon expression in the intestinal tract of SCID mice: an innate response to bacterial colonisation of the gut
Authors: S A Keilbaugh
Journal: Gut (2005)

<b>Background and aims:</b> The mechanisms by which commensal bacteria provoke intestinal inflammation in animal models of inflammatory bowel disease (IBD) remain incompletely defined, leading to increasing interest in the innate immune response of the colonic mucosa to bacterial colonisation. <b>Methods:</b> Using gene expression profiling of colonic RNA from C.B17.SCID germ free mice and those colonised with altered Schaedler's flora, we investigated the innate immune response to bacterial colonisation in vivo. The two most consistently induced gene groups were RegIIIβ and γ as well as interferon γ (IFN-γ) response genes. <b>Results:</b> Using quantitative reverse transcription-polymerase chain reaction, we showed that RegIIIβ, RegIIIγ, and IFN-γ were constitutively expressed in the colon of conventionally housed SCID mice compared with either germ free SCID or conventionally housed BALB/c mice. Induction of these genes was reproduced by chronic monoassociation of germ free SCID mice with either of two separate gut commensal bacterial species—<i>segmented filamentous bacteria</i> and Schaedler's <i>Escherichia coli</i>. The cellular source for IFN-γ on monoassociation of SCID mice with Schaedler's <i>E coli</i> was localised to a subset of intraepithelial natural killer (IENK) cells that express asialo-GM1. In vivo IFN-γ immunoneutralisation studies failed to demonstrate any alteration in RegIIIβ or γ expression. <b>Conclusions:</b> Thus bacterial colonisation of the colon independently activates two distinct innate immune cell types at the mucosal interface with the colonic lumen, intestinal epithelial cells, and IENK cells, a response that may be regulated by the adaptive immune system. These innate immune responses may play a role in the pathogenesis of colitis in SCID adoptive transfer models in mice and possibly in patients with IBD.
Insulin Use in NIDDM: Rationale Based on Pathophysiology of Disease
Authors: Robert C Turner, Rury R Holman
Journal: Diabetes Care (1990)

Because basal hyperglycemia is a major feature in non-insulin-dependent diabetes mellitus, diabetes control can be monitored by the fasting blood glucose concentration. A hierarchical sequence of therapies is proposed in which the major aim is to maintain nearnormal fasting blood glucose concentrations, in the expectation that this will help prevent development of long-term complications. When diet and tablet therapy are no longer effective in keeping the fasting blood glucose level &amp;lt;6 mM, a basal insulin supplement from a long-acting insulin such as ultralente can be added. When monitored by fasting blood glucose concentration, there is little risk of hypoglycemia, and the patient can continue a normal life-style without restrictions concerning exercise or the size of individual meals. A basal insulin supplement does not induce marked weight gain. The dose of insulin required can be predicted from the level of the fasting blood glucose and the degree of obesity, which provides an index of the accompanying insulin resistance. Based on current evidence, insulin therapy is equally appropriate in patients with insulin deficiency and insulin resistance, because the benefit from maintaining near-normal glucose concentrations probably outweighs a putative risk of hyperinsulinemia. In more severely affected patients, additional regular insulin to cover meals is needed. Lowering fasting blood glucose to normal with a basal insulin supplement reduces endogenous insulin production, and this may be advantageous if accompanying production of islet amyloid polypeptide and islet amyloid formation are also reduced.
Canadian medical residents strike over fees
Authors: P. Vaughan
Journal: BMJ (1995)

More than 200 medical residents in the Canadian province of Saskatchewan are on strike in protest over a new $C2200 (pounds sterling1000) tuition fee. The strike began this month after the junior doctors were told that they would be replaced by international medical graduates if they did not pay tuition fees. At issue is whether house staff are students or employees.

Medical schools across Canada are watching the dispute in Saskatchewan with interest as each looks …
Human Reovirus-like Agent as the Major Pathogen Associated with “Winter” Gastroenteritis in Hospitalized Infants and Young Children
Authors: Albert Z. Kapikian, Hyun Wha Kim, Richard G. Wyatt, W. Lee Cline, Julita O. Arrobio, Carl D. Brandt, William J. Rodriguez, David A. Sack, Robert M. Chanock, Robert H. Parrott
Journal: New England Journal of Medicine (1976)

We found a human reovirus-like agent in the stools of 42 per cent of 143 infants and young children hospitalized with acute gastroenteritis between January, 1974, and June, 1975. Half the patients studied by electron microscopy and serologic technics had evidence of infection with the agent. The infection had a seasonal pattern: 59 per cent of those admitted during the cooler months (November to April) shed the agent, with a peak of 78 per cent in December, 1974, and January, 1975, combined. None of the patients admitted during the warmer months (May to October) shed the agent. None of 275 Escherichia coli isolates from 32 patients with diarrhea produced heat-labile enterotoxin, whereas 17 of the 32 had evidence of infection with the reovirus-like agent. In addition, 14 of 40 parents of 37 patients with diarrhea associated with the reovirus-like agent were also infected, but most infectious were inapparent. This agent appears to be the major cause of diarrheal illness in the young during the cooler months.
Stress inoculation training: a case study in gymnastics.
Authors: R Mace, C Eastman, D Carroll
Journal: British Journal of Sports Medicine (1986)

A young female gymnast of regional squad potential had ceased to make progress when she resumed training after a series of injuries and was given stress inoculation training to help her to regain her form. Preliminary interviews revealed that she had developed a number of negative self-statements and images which, it was hypothesised, may have been contributing towards her lack of progress. In order to replace these with positive self-statements and images a treatment programme of eight training sessions was implemented. Recorded interviews and subsequent comparison of comments made by the subject before and after the intervention programme, indicated that the training had been successful. This was endorsed by the coaches who reported an improved attitude to training and rapid progress in skill learning.