tbuckley/cabot-search huggingface dataset:
A 74-Year-Old Woman With Diabetes
Authors: Martin J. Abrahamson
Journal: JAMA (2007)

Ms M, a 74-year-old woman with type 2 diabetes of 6 years' duration, has a glycated hemoglobin (HbA1C) value of 7.4% despite taking 3 oral antidiabetic medications, as well as coexistent hypertension and abdominal obesity. She has no known microvascular or macrovascular complications of diabetes and is otherwise healthy. She is reluctant to commence insulin treatment as she dislikes the idea of injections and wonders if there are any alternate options if she is to get her HbA(1C) value below 7%. The natural history of type 2 diabetes, reasons why many patients begin requiring insulin over time, rationale for tight glycemic control, and therapeutic options for Ms M are discussed.
"It's all about the Benjamins"
Authors: E. Davies
Journal: BMJ (2013)

For regular readers of the BMJ this film will not draw any great gasps of surprise. The US spends too much on healthcare: $2.7 trillion (£1.8 trillion; €2 trillion) in total, more than twice per head of other developed nations, almost 20% of its gross domestic product.

The system is focused too much on cure over prevention, is inherently incentivized to overtreat its patients, and has poor outcomes compared with most other developed nations.

Most of the talking heads, and the examples they give, are also names and subjects well known to anybody with an interest in the perils …
The differentiation of cholesterol and pigment gallstones
Authors: Dieter Jüngst
Journal: Hepatology (1989)

Gallbladder biles and stones were obtained at 116 cholecystectomies for symptomatic gallstone disease. All 33 patients younger than 50 years had cholesterol stones, whereas 40% of the older patients had pigment stones. We compared the reliability of three different bile tests for the differentiation between cholesterol and pigment stone patients. Whereas both the presence of cholesterol monohydrate crystals in fresh gallbladder bile and a nucleation time ≤20 days in ultrafiltered gallbladder bile had a specificity of 100% for cholesterol gallstone disease, biliary supersaturation with cholesterol (cholesterol saturation index &gt;1.0) had a low specificity. The sensitivity of nucleation time ≤20 days for cholesterol gallstone disease was 78% in concentrated gallbladder biles (biliary total lipid concentration ≥5 g/dl) but only 21% in dilute biles (biliary total lipid concentration &lt;5 g/dl). In contrast, examination for the presence of cholesterol crystals in fresh bile was reasonably sensitive both in concentrated and diute gallbladder biles (sensitivity, 84% and 72%, respectively). In addition, duodenal bile obtained from 16 patients (10 cholesterol, 6 pigment) before cholecystectom showed cholesterol crystals in 7 of the cholesterol but in none of the pigment stone patients. We conclude that examination of fresh bile for cholesterol crystals is a specific and reasonably sensitive test for cholsterol gallstone disease.
51 RESPONSE RATE ACCORDING TO WHO, RECIST AND EASL CRITERIA AFTER RADIOEMBOLIZATION OF YTTRIUM-90 GLASS MICROSPHERES IN ADVANCED HEPATOCELLULAR CARCINOMA: A EUROPEAN PILOT PHASE II STUDY
Authors: A. El Fouly, J. Ertle, G. Antoch, M. Hamami, A. Paul, A. Bockisch, G. Gerken, P. Hilgard
Journal: Journal of Hepatology (2009)
Eye Trauma in Sports: A Preventable Epidemic
Authors: Jack A. Bell
Journal: JAMA (1981)

Injuries are a major cause of morbidity in the US population. Some injuries are associated with sports participation, and some sports can result in serious eye injuries and even blindness. In 1978, more than 35,000 eye injuries, or 12% of all those reported, were related to sports and recreation equipment.<sup>1</sup> Since 1973, the number of injuries from the ten most hazardous sports has increased by 58%. It is believed that appropriate eye protection measures could have prevented 90% of the injuries.<sup>2</sup>Especially unfortunate is the fact that children aged 5 to 14 years suffer nearly one third of the sports- and recreation-related eye injuries. The children, who now have a life expectancy approaching 75 years, will have a long period to suffer from any loss of vision. What should be done to study and prevent this group of disabling injuries? The prevention of injuries to athletes requires a methodical
Congenital Aneurysm (Diverticulum) of the Right Atrium
Authors: ANDREW G. MORROW, DOUGLAS M. BEHRENDT
Journal: Circulation (1968)

A patient is described in whom a large congenital aneurysm or diverticulum of the right atrium caused repeated attacks of supraventricular arrhythmia and a strikingly reduced cardiac output. The aneurysm, which contained a large thrombus, was demonstrated by preoperative angiographic examinations. At the time of operation, regular rhythm returned at the moment the aneurysm was transsected. The patient is asymptomatic after operation, and has maintained sinus rhythm. A normal cardiac index was recorded at postoperative cardiac catheterization.
Prevention of asthma during the first 5 years of life: A randomized controlled trial
Authors: Guy B. Marks, Seema Mihrshahi, Andrew S. Kemp, Euan R. Tovey, Karen Webb, Catarina Almqvist, Rosario D. Ampon, Daniel Crisafulli, Elena G. Belousova, Craig M. Mellis, Jennifer K. Peat, Stephen R. Leeder
Journal: Journal of Allergy and Clinical Immunology (2006)
Tolmetin Anaphylactoid Reaction
Authors: Charles Y. McCall
Journal: JAMA (1980)

TOLMETIN sodium has been associated with anaphylactic reaction.<sup>1</sup>The following case describes anaphylactoid reaction with rechallenge. <h3>Report of a Case</h3> A 51-year-old man with a history of neurodermatitis treated with topical triamcinolone acetonide suffered a pulled rectus abdominalis muscle while playing tennis. Therapy with tolmetin sodium, 1,200 mg/day, was given for two months with apparent benefit. Three weeks after completion of the tolmetin therapy, a recurrence of the injury prompted the patient to self-initiate tolmetin therapy. Within 30 minutes of ingestion of the first dose, intense pruritus began. Within five minutes it had spread to become a total body urticaria. The patient noted edema of his eyes, lips, and tongue, with stridor and bronchospasm. On arrival at the hospital emergency room, his blood pressure (BP) was 130/90 mm Hg, and a slight swelling of his face and arms was recorded. Treatment consisted of diphenhydramine hydrochloride, 50 mg intramuscularly (IM),
Erythropoietin Receptor Signaling Mitigates Renal Dysfunction-Associated Heart Failure by Mechanisms Unrelated to Relief of Anemia
Authors: Atsushi Ogino, Genzou Takemura, Masanori Kawasaki, Akiko Tsujimoto, Hiromitsu Kanamori, Longhu Li, Kazuko Goto, Rumi Maruyama, Itta Kawamura, Toshiaki Takeyama, Tomonori Kawaguchi, Takatomo Watanabe, Yoshiyuki Moriguchi, Hideki Saito, Takako Fujiwara, Hisayoshi Fujiwara, Shinya Minatoguchi
Journal: Journal of the American College of Cardiology (2010)
A Public Health Approach to Gun Violence
Authors: John P. May
Journal: Annals of Internal Medicine (2013)

Letters20 August 2013A Public Health Approach to Gun ViolenceJohn P. May, MDJohn P. May, MDFrom Armor Correctional Health Services, Miami, Florida.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-4-201308200-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Physician engagement and a public health approach to gun violence as outlined by Frattaroli and colleagues (1) and sought by the editors of Annals (2) includes preventive counseling about guns during routine clinical encounters. We interviewed 53 African American men aged 18 to 34 years, the group for whom firearm injury is the leading cause of death (3), after an ambulatory care encounter unrelated to violence. During the visit, the physician briefly counseled the patients about 6 preventive health issues: alcohol, smoking, drugs, safe sex, guns, and seat belt use.In a postencounter interview, patients most commonly recalled ...References1. Frattaroli S, Webster DW, and Wintemute GJ. Implementing a public health approach to gun violence prevention: the importance of physician engagement. Ann Intern Med. 2013;158:697-8 LinkGoogle Scholar2. Laine C, Taichman DB, Mulrow C, Berkwits M, Cotton D, and Williams SV. A resolution for physicians: time to focus on the public health threat of gun violence [Editorial]. Ann Intern Med. 2013;158:493-4 LinkGoogle Scholar3. Centers for Disease Control and Prevention. Leading Causes of Death in Males United States. Atlanta, GA: Centers for Disease Control and Prevention; 2009. Accessed at www.cdc.gov/men/lcod on 13 May 2013. Google Scholar4. May JP and Martin KL. A role for the primary care physician in counseling young African-American men about homicide prevention. J Gen Intern Med. 1993;8:380-2. [PMID: 8410399] CrossrefMedlineGoogle Scholar5. Voelker R. Taking aim at handgun violence. JAMA. 1995;273:1739-40. [PMID: 7769760] CrossrefMedlineGoogle Scholar6. May JP, Christoffel KK, and Sprang ML. Counseling patients about guns. Chicago Medicine. 1994;97:13-6. Google Scholar Author, Article, and Disclosure InformationAuthors: John P. May, MDAffiliations: From Armor Correctional Health Services, Miami, Florida.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoImplementing a Public Health Approach to Gun Violence Prevention: The Importance of Physician Engagement Shannon Frattaroli , Daniel W. Webster , and Garen J. Wintemute A Public Health Approach to Gun Violence James R. Gould A Public Health Approach to Gun Violence Shannon Frattaroli , Daniel W. Webster , and Garen J. Wintemute Metrics 20 August 2013Volume 159, Issue 4 Page: 306 Keywords Alcohols Children Drug users Drugs Firearm injuries Prevention, policy, and public health Violent crime ePublished: 20 August 2013 Issue Published: 20 August 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Studies on the mechanism of solubilization of immune precipitates by serum.
Authors: J Czop, V Nussenzweig
Journal: The Journal of Experimental Medicine (1976)

Antigen (Ag)-antibody (Ab) aggregates prepared with several different antigens are solubilized by fresh serum at 37 degrees C (complex-release activity of serum or CRA). The rate of solubilization varies in different systems and is strongly influenced by the affinity of Ab for the Ag in the immune precipitate. With a given Ag-Ab precipitate, the maximum amount of complex that can be solubilized by individual sera is independent of the initial concentration of complexes and cannot be increased by prolonged incubation. CRA occurs in the absence of C2 and C4, but not in the absence of C3 and factor B of the properdin pathway. Addition of C2 to C2-deficient serum or C4 to C4-deficient serum enhances CRA. Solubilization does not involve extensive degradation of the complexed antibody, as might be detected by acrylamide gel electrophoresis of released antibody after reduction and alkylation to separate H and L chains. Immune precipitates can also be solubilized by incubation with monovalent fragments (Fab or Fab') of antibodies against determinants of the Ab molecules in the immune precipitate. In contrast, F(ab')2 fragments decrease the solubility of the immune precipitates. In view of these findings, we propose that CRA is mediated by the binding of functionally monovalent C fragments (C3 and C4) onto Ab molecules in the precipitates.
Effect of chemical structure of hydrogels on the adhesion and phenotypic characteristics of human monocytes such as expression of galectins and other carbohydrate-binding sites
Authors: Karel Smetana, Jaromír Lukáš, Věra Palečková, Jiřina Bartůňková, Fu-Tong Liu, Jiří Vacík, Hans-Joachim Gabius
Journal: Biomaterials (1997)
Immunisation before school entry: should there be a law?
Authors: N D Noah
Journal: BMJ (1987)

An epidemiologist questions whether laws mandating vaccination of children before school entry are necessary in Britain to reduce the incidence of diseases such as measles, mumps, and rubella. Using vaccination against measles as his example, Noah compares the coverage rate in the United States, where 46 states have school immunization laws, with coverage rates in Norway, the Netherlands, Sweden, Finland, and England and Wales, where immunization before school entry is not required. The United States has achieved a high vaccination rate for school age children, as have the Scandinavian countries and the Netherlands without enforcement laws. Noah concludes that better organization of health services and increased promotion of vaccination among health personnel and the public may be sufficient to raise Britain's overall immunization rate without legislation.
Cephalothin, Gentamicin, Colistin Hazards
Authors: Philip D. Hansten
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Bobrow et al (222:1546, 1972) describe a patient who developed acute tubular necrosis following the concomitant administration of cephalothin sodium and gentamicin sulfate. It should be noted that a previous paper<sup>1</sup>reported nephrotoxicity in 14 patients receiving this combination. This would tend to lend support to the possibility suggested by Bobrow et al that the combination is responsible for the nephrotoxocity rather than either agent acting alone. It is also interesting to note that cephalothin appears to increase the nephrotoxic potential of colistin.<sup>2</sup> Although Bobrow et al correctly state that cephalothin is generally not considered to be nephrotoxic, there is growing evidence that it can cause renal damage under certain conditions.<sup>3-8</sup>In most cases reported, there was at least some evidence of preexisting renal disease, and some of the doses of cephalothin were large. In two cases, an aminoglycoside other than gentamicin was given
Acute Mitral Regurgitation in Man
Authors: STUART H. BARTLE, HECTOR J. HERMANN
Journal: Circulation (1967)

Four patients are presented who developed acute mitral regurgitation 5 days, 2, 3, and 18 months, respectively, before cardiac catheterization. The hemodynamic findings in the three early cases resemble those found in the presence of a constricting pericardium: left and right ventricular, as well as left and right atrial pressures, equilibrated during diastole. As expected, giant left atrial v waves accompanied markedly elevated pulmonary arterial pressures and low cardiac indices. Biplane angiocardiography showed only slight left atrial and moderate left ventricular enlargement, but showed a large regurgitant fraction and dilated pulmonary veins. Orthopnea was transient or absent in two of the three early cases. The pericardium may play a role in the early phase of acute mitral regurgitation in mimicking signs of right heart failure and preventing pulmonary edema. Development of increased pulmonary venous capacitance may be another major early mechanism of compensation since the pericardium may be preventing left atrial enlargement. Later in the course, after 6 months, the pericardium does not appear to be a factor in the hemodynamics, as noted in our patient and in patients reported by others.
Drug Delivery: Antibody‐Functionalized Porous Silicon Nanoparticles for Vectorization of Hydrophobic Drugs (Adv. Healthcare Mater. 5/2013)
Authors: Emilie Secret, Kevin Smith, Valentina Dubljevic, Eli Moore, Peter Macardle, Bahman Delalat, Mary‐Louise Rogers, Terrance G. Johns, Jean‐Olivier Durand, Frédérique Cunin, Nicolas H. Voelcker
Journal: Advanced Healthcare Materials (2013)

Biodegradable porous silicon nanoparticles (pSiNP) functionalized with cancer cell targeting antibodies and loaded with the hydrophobic anti-cancer drug camptothecin are developed by Nicolas H. Voelcker, Frédérique Cunin, and co-workers on page 718. High targeting and killing efficiency is demonstrated in vitro on three types of cancer cells: neuroblastoma, glioblastoma and lymphoma cells.
INTRAGASTRIC ACIDITY, BACTERIA, NITRITE, AND N-NITROSO COMPOUNDS BEFORE, DURING, AND AFTER CIMETIDINE TREATMENT
Authors: G.J. Milton-Thompson, Z. Ahmet, N.F. Lightfoot, R.H. Hunt, J. Barnard, R.W. Brimblecombe, P.J. Moore, P.M.G. Bavin, D.W. Darkin, N. Viney
Journal: The Lancet (1982)
ON THE PLEA OF INSANITY IN CRIMINAL CASES
Authors: J. G. Davey
Journal: BMJ (1856)

usutum before the manual operation was performed, to guard against the risk of further bleeding.Obliquity of the uterus, to a considerable degree, existed, on which account I had the patient placed, to labour, on the back.The aid derived from the regulating bandage was very great; and when it was drawn tight, the fundus and body of the uterus were raised from the anterior dependant position, and retained in the line of the axis of the inlet of the pelvI& [To be continued.]
Norethynodrel With Mestranol in Treatment of Rheumatoid Arthritis
Authors: Myron Gilbert, Jerome Rotstein, Calvin Cunningham, Irving Estrin, Allen Davidson, Gregory Pincus
Journal: JAMA (1964)

THE AVAILABILITY of a 19-nor progestational compound mixed with a small amount of estrogenic substance provided the opportunity to study the effect of the pseudopregnant state of the course of rheumatoid arthritis in a selected group of patients. Seventeen patients, 13 females and four males, participated in the blindfold study. All had active rheumatoid arthritis not controlled by their current therapeutic regimens, which included corticoid analogues in five cases. The study was conducted over a period of 12 months. Each patient received medication for six months and placebo for six months, both in tablet form. Medication consisted of norethynodrel with mestranol (Enovid), a mixture of the progestogen and approximately 1.5% of the estrogen. Placebo tablets were sugar, identical in appearance with the medication. Patients were divided into two groups, selected on an alternate basis: (1) those who received medication for the first six months and placebo thereafter, and (2) those
When doctors and patients disagree
Authors: T. Richards
Journal: BMJ (2014)

The case of Ashya King, the child brain tumour patient whose parents took from a British hospital so he could be treated with Proton Beam Therapy (PBT) abroad, contributed to popularize that technology among a general audience.Through the content analysis of British and Spanish press coverage (N=329), our research shows that proton therapy enjoyed scarce coverage in the analysed media before Ashya King's case.His story, magnified due to the fact that his parents were Jehovah's witnesses was a cause both for public concern and media sensationalism.We show that the case brought PBT into the public sphere and, consequently, contributed to create a demand for facilities that offered this therapy.This case provides new data about how technology and medical controversy reaches different audiences: while the sphere of experts keeps debating about the benefits of the therapy, the public sphere has already decided to adopt it.
Weight and mortality in the Whitehall Study.
Authors: R J Jarrett, M J Shipley, G Rose
Journal: BMJ (1982)

Ten-year mortality rates in men aged 40-64 years in the Whitehall Study were analysed in relation to weight and height at the initial examination. At ages 40-49 "all-causes" mortality increased with increasing body mass index; but this simple relation disappeared at older ages, where there was an increased mortality in the lowest quintile of body mass index. The "all-ages" relation was "J"-shaped, and this could not be explained by the confounding effects of blood pressure, cholesterol values, and cigarette smoking. Some, but not all, of the J shape was due to a high short-term mortality in thin men from cancers (presumably already present at examination). At younger ages mortality from coronary heart disease was positively related to body mass index, but this depended on its association with other risk factors. Mortality from causes other than cancers or coronary heart disease was highest in the lowest quintile of body mass index.
A Systems Approach to Patient-Centered Care
Authors: Steven C. Bergeson, John D. Dean
Journal: JAMA (2006)

PROVIDING CARE CENTERED ON PATIENTS’ NEEDS AND expectations is a key attribute of quality care. Unfortunately, despite the intent and efforts of many to improve patient centeredness, the quality of patient-clinician relationships, patient access, and continuity of care appear to be worsening in the United States and lag behind other Organization for Economic Co-operation and Development (OECD) countries. Clinicians do not consistently address patients’ concerns, do not always assess patients’ beliefs and understanding of their illness, and often do not share management options with patients. Patients frequently fail to recall basic elements of their care plan. All this is occurring as care becomes increasingly complex and as more costs of care are borne directly by patients. In this Commentary, we propose 4 specific changes that should help the medical profession meet patients’ needs and expectations. These changes involve redesigning the systems of care that both evidence and practice suggest are more likely to succeed rather than relying on clinician rewards, feedback, or training alone. They are (1) improving access to and continuity with clinicians, (2) increasing patients’ participation in care by making it easier for patients to express their concerns and involving them more actively in the design of their care, (3) supporting patient self-management through systems that facilitate goal setting and that increase patient and family confidence in self-care, and (4) establishing more efficient and reliable mechanisms for coordinating care among settings. The evidence for most of these system changes is robust and supported by clinical trials that have demonstrated the desired outcomes. Some interventions have been widely implemented in practice and appear promising but have not been subject to clinical trials and require further evaluation. Consolidating these approaches into a coordinated series of practical system changes is the purpose of this Commentary. The magnitude of their combined effect is unknown but should be intensively studied. Although the proposed system changes could be applied to all patients, the chronic care model is an example of an evidence-based system approach that includes selfmanagement support and care coordination as key components.
The rate of hemodynamic progression is strongly predictive of clinical outcome mostly in mild and moderate aortic stenosis
Authors: Francesco Antonini-Canterin, Andrea Erlicher, Eugenio Cervesato, Rita Piazza, Pompillo Faggiano, Anna Gualeni, Cristina Romeo, Daniela Pavan, Gianluigi Nicolosi
Journal: Journal of the American College of Cardiology (2002)