tbuckley/cabot-search huggingface dataset:
A Student-Community Planned Health Project for the Poor
Authors: Ralph Freidin, Robert Levy, Robert Harmon
Journal: New England Journal of Medicine (1970)

Abstract A student-community planned clinic was begun in an inner-city high-rise housing development; continuous evening operation has been maintained for two years. The problems encountered included apathy of public officials and medical professionals, wariness of people in the community, lack of money and complications in medical staffing. In spite of these difficulties, an apparently stable community-student-physician relation has developed. During the first year of operation 1426 patients were seen, almost exclusively for minor illness. However, 53 per cent of patients in whom secondary diagnoses were made (9.5 per cent of all patients) had serious medical problems underlying the minor illnesses that led them to seek medical care. Almost 17 per cent of all patients were referred to municipal hospitals or other medical centers in the city. The clinic therefore appeared to provide an effective portal of entry for patients into the existing health-care system of the city.
High-Dose Penicillin and Bleeding
Authors: PHILLIP L. ROBERTS
Journal: Annals of Internal Medicine (1974)

Letters1 August 1974High-Dose Penicillin and BleedingPHILLIP L. ROBERTS, M.D.PHILLIP L. ROBERTS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-2-267 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The penicillin analog, carbenicillin, has been associated with abnormal bleeding and in-vivo inhibition of platelet function (1). We document here the clinical course of a patient receiving high-dose penicillin therapy who developed a transient bleeding diathesis, with prolongation of the bleeding time.A 62-year-old white woman presented with fever, cerebellar ataxia, and bilateral extensor plantar responses. She had had acute rheumatic fever in childhood and two prior episodes of bacterial endocarditis. Physical examination showed classic findings of mitral insufficiency. Three blood cultures grew viridans streptococcus; on 6 February, 1973, we instituted therapy with two million units of...References1. MCCLURECASSERLYMONSIER PJC: Carbenicillin-induced bleeding disorder (letter). Lancet 2:1307-1308, 1970 CrossrefMedlineGoogle Scholar2. FLEMINGFISH AE: Influence of penicillin on the coagulation of blood. Br Med J 2:243-244, 1947 CrossrefMedlineGoogle Scholar3. SMITHLERNERWEINSTEIN HPL: Neurotoxicity and massive intravenous therapy with penicillin, a study of possible predisposing factors. Arch Intern Med 120:47-53, 1967 CrossrefMedlineGoogle Scholar4. CAZENAVEPACKHAMGUCCIONE JMM: Effects of penicillin G on platelet aggregation, release and adherence to collagen. Proc Soc Exp Biol Med 142:159-166, 1973 CrossrefMedlineGoogle Scholar5. LAIROSNERRITZ MFN: Hemolytic anemia due to antibodies to penicillin. JAMA 198:483-484, 1966 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Dedham Medical Associates Dedham, Massachusetts 02026 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWarfarin-drug interactions: An emphasis on influence of polypharmacy and high doses of amoxicillin/clavulanateDRUGS IN DONATED BLOODReview of Hypertrophic CardiomyopathyEffects of Cephalothin and Penicillin G on Platelet Function in Vitro 1 August 1974Volume 81, Issue 2Page: 267-268KeywordsAtaxiaBloodEndocarditisFeversHemorrhageMitral insufficiencyPenicillinPlateletsRheumatic feverStreptococcus Issue Published: 1 August 1974 PDF downloadLoading ...
THE INFLUENCE OF PREGNANCY AND LACTATION UPON THE REGENERATION OF SERUM PROTEIN
Authors: Daniel Melnick, George R. Cowgill
Journal: The Journal of Experimental Medicine (1937)

1. In view of the markedly short period of gestation in the dog and in view of the relatively large litters that are cast and nursed, this species when compared with the human being undergoes a much greater physiological strain during pregnancy and lactation. This is evidenced by marked decreases in the hematocrit values, in total cell volumes and in the serum protein concentrations, by an appreciable plasma hydration, and in some cases by significant reductions in the total circulating serum protein. 2. When pregnant dogs are fed a protein-free diet at a high level of caloric intake and are subjected to our standardized plasmapheresis technique, it is possible to deplete the animal of its reserve serum protein stores and reduce the serum protein concentration to the basal level (3.5 to 4.2 per cent) within the extremely short period of from 2 to 3 days. This indicates that the dog during pregnancy possesses a very limited amount of reserve serum protein. 3. Once the basal serum protein level is attained, the pregnant or lactating dog exhibits a marked impairment in its ability to regenerate serum protein. The synthesis of body proteins in the fetus during pregnancy and the milk proteins during lactation is considered to be actually an internal plasmapheresis, leading to a depletion of the serum protein by the preferential utilization of the materials from which this complex is made. These parasitic effects on the maternal organism are believed to be of primary importance, over and above any hydremia, in causing the lowered serum protein concentrations characteristic of pregnancy.
Tenofovir disoproxil fumarate monotherapy for nucleos(t)ide analogue-naïve and nucleos(t)ide analogue-experienced chronic hepatitis B patients
Authors: Sang Kyung Jung, Kyung-Ah Kim, So Young Ha, Hyun Kyo Lee, Young Doo Kim, Bu Hyun Lee, Woo Hyun Paik, Jong Wook Kim, Won Ki Bae, Nam-Hoon Kim, June Sung Lee, Yoon Jung Jwa
Journal: Clinical and Molecular Hepatology (2015)

This study investigated the antiviral effects of tenofovir disoproxil fumarate (TDF) monotherapy in nucleos(t)ide analogue (NA)-naive and NA-experienced chronic hepatitis B (CHB) patients.CHB patients treated with TDF monotherapy (300 mg/day) for ≥12 weeks between December 2012 and July 2014 at a single center were retrospectively enrolled. Clinical, biochemical, and virological parameters were assessed every 12 weeks.In total, 136 patients (median age 49 years, 96 males, 94 HBeAg positive, and 51 with liver cirrhosis) were included. Sixty-two patients were nucleos(t)ide (NA)-naïve, and 74 patients had prior NA therapy (NA-exp group), and 31 patients in the NA-exp group had lamivudine (LAM)-resistance (LAM-R group). The baseline serum hepatitis B virus (HBV) DNA level was 4.9±2.3 log IU/mL (mean±SD), and was higher in the NA-naïve group than in the NA-exp and LAM-R groups (5.9±2.0 log IU/mL vs 3.9±2.0 log IU/mL vs 4.2±1.7 log IU/mL, P<0.01). The complete virological response (CVR) rate at week 48 in the NA-naïve group (71.4%) did not differ significantly from those in the NA-exp (71.3%) and LAM-R (66.1%) groups. In multivariate analysis, baseline serum HBV DNA was the only predictive factor for a CVR at week 48 (hazard ratio, 0.809; 95% confidence interval, 0.729-0.898), while the CVR rate did not differ with the NA experience.TDF monotherapy was effective for CHB treatment irrespective of prior NA treatment or LAM resistance. Baseline serum HBV DNA was the independent predictive factor for a CVR.
Induction of epithelial hyperplasia by Candida albicans
Authors: R.A. CAWSON
Journal: British Journal of Dermatology (1973)

Journal Article Induction of epithelial hyperplasia by Candida albicans Get access R.A. CAWSON R.A. CAWSON Department of Oral Medicine and Pathology, Guy's Hospital Medical School, London SEI 9RT Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 89, Issue 5, 1 November 1973, Pages 497–503, https://doi.org/10.1111/j.1365-2133.1973.tb03011.x Published: 01 November 1973 Article history Accepted: 04 April 1973 Published: 01 November 1973
Differential metabolism of 25-hydroxyvitamin D3 by cultured synovial fluid macrophages and fibroblast-like cells from patients with arthritis.
Authors: M E Hayes, D Bayley, P Still, J Palit, J Denton, A J Freemont, R G Cooper, E B Mawer
Journal: Annals of the Rheumatic Diseases (1992)

Differential metabolism of 25-hydroxyvitamin D3 (25(OH)D3) has been shown for macrophages and fibroblast-like cells (possibly synoviocytes) cultured for two to 50 days after isolation from the synovial fluid of 12 patients with various forms of inflammatory arthritis. Macrophages synthesised the active metabolite of vitamin D3, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), the synthesis of which was increased by bacterial lipopolysaccharide, a known macrophage activating factor. In contrast, fibroblast-like cells formed 24, 25-dihydroxyvitamin D3 (24,25(OH)2D3), synthesis of which was stimulated by 1,25(OH)2D3 and inhibited by lipopolysaccharide. The synthesis of 1,25(OH)2D3 and 24,25(OH)2D3 by macrophages and fibroblast-like cells respectively was inhibited by ketoconazole, indicating that both hydroxylases are dependent on cytochrome P-450. Mean (SEM) synovial fluid and serum 25(OH)D3 concentrations were 16.7 (1.7) and 22.2 (2.6) ng/ml and those of 1,25(OH)2D3 were 29.4 (4.8) and 43.3 (4.0) pg/ml respectively. In most cases concentrations were lower in synovial fluid than in paired serum samples, but in two patients 1,25(OH)2D3 concentrations were greater in synovial fluid than in serum, suggesting local synthesis within the affected joints.
Plasma Cortisol and Progression of Dementia in Subjects With Alzheimer-Type Dementia
Authors: John G. Csernansky, Hongxin Dong, Anne M. Fagan, Lei Wang, Chengjie Xiong, David M. Holtzman, John C. Morris
Journal: American Journal of Psychiatry (2006)

Objective: Studies of subjects with dementia of the Alzheimer type have reported correlations between increases in activity of the hypothalamic-pituitary-adrenal (HPA) axis and hippocampal degeneration. In this study, the authors sought to determine whether increases in plasma cortisol, a marker of HPA activity, were associated with clinical and cognitive measures of the rate of disease progression in subjects with Alzheimer-type dementia. Method: Thirty-three subjects with very mild and mild Alzheimer-type dementia and 21 subjects without dementia were assessed annually for up to 4 years with the Clinical Dementia Rating scale and a battery of neuropsychological tests. Plasma was obtained at 8 a.m. on a single day and assayed for cortisol. Rates of change over time in the clinical and cognitive measures were derived from growth curve models. Results: In the subjects with dementia, but not in those without dementia, higher plasma cortisol levels were associated with more rapidly increasing symptoms of dementia and more rapidly decreasing performance on neuropsychological tests associated with temporal lobe function. No associations were observed between plasma cortisol levels and clinical and cognitive assessments obtained at the single assessment closest in time to the plasma collection. Conclusions: Higher HPA activity, as reflected by increased plasma cortisol levels, is associated with more rapid disease progression in subjects with Alzheimer-type dementia.
Increased Platelet and Erythrocyte External Cell Membrane Phosphatidylserine in Type 1 Diabetes and Microalbuminuria
Authors: Shahid T. Wahid, Sally M. Marshall, Trevor H. Thomas
Journal: Diabetes Care (2001)

The cosegregation of traditional risk factors, such as smoking, hypertension, dyslipidemia, and hyperglycemia, per se do not fully account for the excessive cardiovascular risk in diabetes (1,2), thus suggesting that there are other contributory factors. Diabetes is associated with several defects of coagulation and fibrinolysis that predispose to a thrombogenic tendency (3,4,5). Phospholipids are distributed asymmetrically between the inner and outer leaflets of the normal cell membrane lipid bilayer (6), with the cholinephospholipids (phosphatidylcholine and phosphatidylsphingomyelin) predominantly in the external leaflet and the aminophospholipids (phosphatidylserine [PS] and phosphatidylethanolamine) located internally. This equilibrium can be disrupted by activation of the calcium-dependent scramblase enzyme (6). PS is a potent activator of thrombin and other clotting factors (6), thus promoting a procoagulant environment that may increase the risk of cardiovascular disease. Therefore, we investigated whether there is an increase in PS in the outer leaflet of the lipid bilayer of erythrocyte and platelet cell membranes in type 1 diabetic patients and whether this is associated with changes in the appearance of scramblase.

Consent for the study was obtained from 13 healthy control …
Reply to Dennis Morrod’s Letter to the Editor and Fritz H. Schröder’s Reply to Dennis Morrod’s Letter to the Editor re: Monique J. Roobol, Ewout W. Steyerberg, Ries Kranse, et al. A Risk-Based Strategy Improves Prostate-Specific Antigen–Driven Detection of Prostate Cancer. Eur Urol 2010;57:79–85
Authors: Freddie C. Hamdy
Journal: European Urology (2010)
Gain of CBL-interacting protein, a possible alternative to CBL mutations in myeloid malignancies
Authors: J Adélaïde, V Gelsi-Boyer, J Rocquain, N Carbuccia, D J Birnbaum, P Finetti, F Bertucci, M J Mozziconacci, N Vey, D Birnbaum, M Chaffanet
Journal: Leukemia (2010)
We should encourage browsing
Authors: J. P. Kassirer
Journal: BMJ (2011)

Scant attention was aroused by the results of a small study that many might applaud but that I perceive as alarming. A survey of nearly 200 junior doctors in internal medicine showed that more than three quarters read the medical literature in response to a specific patient encounter. And nearly 95% consider electronic textbooks the most effective source of knowledge ( Medical Teacher 2010;32:773-5, doi:10.3109/01421591003692698). Similar observations are reported among medical students ( Academic Medicine 2006;81:489-94, doi:10.1097/01.ACM.0000222273.90705.a6).

A reason to applaud is that rapid access to authoritative information can benefit the care of patients. A reason for concern is that the information being sought is narrowly restrictive. The survey findings bolster an informal appraisal that I have made over several years: that nearly all medical students and junior doctors use electronic textbooks to look for patient related information. Indeed, they are simply trying to solve a highly specific problem by using purposeful, targeted searching and focused retrieval of information, which is generally what they were taught to do in medical school. They rarely just browse for medical information.

Browsing, in contrast, does not focus on answering …
Systemic Overexpression of Angiopoietin-2 Promotes Tumor Microvessel Regression and Inhibits Angiogenesis and Tumor Growth
Authors: Yiting Cao, Pierre Sonveaux, Shanling Liu, Yulin Zhao, Jing Mi, Bryan M. Clary, Chuan-Yuan Li, Christopher D. Kontos, Mark W. Dewhirst
Journal: Cancer Research (2007)

Abstract Angiopoietin-2 (Ang-2) is a conditional antagonist and agonist for the endothelium-specific Tie-2 receptor. Although endogenous Ang-2 cooperates with vascular endothelial growth factor (VEGF) to protect tumor endothelial cells, the effect on tumor vasculature of high levels of exogenous Ang-2 with different levels of VEGF has not been studied in detail. Here, we report that systemic overexpression of Ang-2 leads to unexpected massive tumor vessel regression within 24 h, even without concomitant inhibition of VEGF. By impairing pericyte coverage of the tumor vasculature, Ang-2 destabilizes the tumor vascular bed while improving perfusion in surviving tumor vessels. Ang-2 overexpression transiently exacerbates tumor hypoxia without affecting ATP levels. Although sustained systemic Ang-2 overexpression does not affect tumor hypoxia and proliferation, it significantly inhibits tumor angiogenesis, promotes tumor apoptosis, and suppresses tumor growth. The similar antitumoral, antiangiogenic efficacy of systemic overexpression of Ang-2, soluble VEGF receptor-1, and the combination of both suggests that concomitant VEGF inhibition is not required for Ang-2–induced tumor vessel regression and growth delay. This study shows the important roles of Ang-2–induced pericyte dropout during tumor vessel regression. It also reveals that elevated Ang-2 levels have profound pleiotropic effects on tumor vessel structure, perfusion, oxygenation, and apoptosis. [Cancer Res 2007;67(8):3835–44]
Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study
Authors: H. P Derkx, J.-J. E Rethans, A. M Muijtjens, B. H Maiburg, R. Winkens, H. G van Rooij, J A. Knottnerus
Journal: BMJ (2008)

<b>Objective</b> To assess the quality of telephone triage by following the consecutive phases of its care process and the quality of the clinical questions asked about the patient's clinical condition, of the triage outcome, of the content of the home management advice, and of the safety net advice given at out of hours centres. <b>Design</b> Cross sectional national study using telephone incognito standardised patients. <b>Setting</b> The Netherlands. <b>Participants</b> 17 out of hours centres. <b>Main outcome measures</b> Percentages of clinical obligatory questions asked and items within home management and safety net advice, both in relation to pre-agreed standards, and of care advice given in relation to the required care advice. <b>Results</b> The telephone incognito standardised patients presented seven clinical cases three times each over a period of 12 months, making a total of 357 calls. The mean percentage of obligatory questions asked compared with the standard was 21%. Answers to questions about the clinical condition were not always correctly evaluated from a clinical viewpoint, either by triagists or by general practitioners. The quality of information on home management and safety net advice varied, but it was consistently poor for all cases and for all out of hours centres. Triagists achieved the appropriate triage outcome in 58% of calls. <b>Conclusion</b> In determining the outcome of the care process, triagists often reached a conclusion after asking a minimal number of questions. By analysing the quality of different phases within the process of telephone triage, evaluation of whether an appropriate triage outcome has been arrived at by means of good clinical reasoning or by an educated guess is possible. In terms of enhancing the overall clinical safety of telephone triage, apart from obtaining an appropriate clinical history, adequate home management and safety net advice must also be given.
Heart Rate Turbulence in Patients with Stable Coronary Artery Disease and Its Relationship with The Severity of The Disease
Authors: Onur Baydar, Veysel Oktay, Ümit Yaşar Sinan, Uğur Coşkun, İsmail Polat Canbolat, Ahmet Yıldız, Okay Abacı, Cüneyt Kocaş, Tevfik Gürmen, İnci Fıratlı
Journal: Journal of the American College of Cardiology (2013)
Rapid Increase in Diabetes Incidence Among Chinese Canadians Between 1996 and 2005
Authors: Avreet Alangh, Maria Chiu, Baiju R. Shah
Journal: Diabetes Care (2013)

To examine trends in diabetes incidence among Ontario residents with Chinese and European origins.Respondents to population-based health surveys in 1996, 2001, 2003, and 2005 who were aged≥30 years, who did not have diabetes, and who self-identified as having European (n=76,285) or Chinese (n=1,041) origins were followed for diabetes incidence through a validated administrative data-derived diabetes registry.Age- and sex-standardized diabetes incidence increased from 1.3 to 19.6 per 1,000 person-years in the Chinese population and from 7.8 to 10.0 in the European population. Relative to the 1996 European population, the adjusted hazard ratio for diabetes was 4.50 (95% CI 1.89-7.49) for the 2005 Chinese population and 1.22 (1.05-1.39) for the 2005 European population.Diabetes incidence increased much more rapidly between 1996 and 2005 in the Chinese population than in the European population, independent of age, obesity, and other risk factors.
A randomized prospective trial of intravenous nitroglycerin in patients with acute myocardial infarction.
Authors: J T Flaherty, L C Becker, B H Bulkley, J L Weiss, G Gerstenblith, C H Kallman, K J Silverman, J Y Wei, B Pitt, M L Weisfeldt
Journal: Circulation (1983)
Role of Bone Scanning in Detection of Subclinical Bone Metastasis in Nasopharyngeal Carcinoma
Authors: JONATHAN S. T. SHAM, C M TONG, D CHOY, DAVID W.C. YEUNG
Journal: Clinical Nuclear Medicine (1991)

One hundred thirty-two new patients with nasopharyngeal carcinoma and no evidence of distant metastases were evaluated for bone metastases with bone scanning. Forty-four patients had abnormal hypercaptation. These abnormal findings were considered related to benign diseases in 39 patients after correlating clinical examinations and skeletal radiographs. The remaining five patients had positive bone scanning which was suggestive of bone metastasis. There were 13 patients who developed symptomatic bone metastases over a follow-up period of 0.2-41 months. In three of these, the bone metastases corresponded to the sites of abnormal hypercaptation in the initial positive bone scanings. In view of the low sensitivity and specificity of bone scanning in this setting, routine bone scanning for staging nasopharyngeal carcinoma is not recommended. But in the research setting, baseline scanning is useful to make subsequent scanning more valuable, and it reduces false-positive results.
Self-Monitoring of Blood Glucose Can Be Effective in Type 2 Diabetes Only If It Serves a Clearly Identified Purpose
Authors: Antonio Nicolucci, Monica Franciosi, Fabio Pellegrini, Giorgia De Berardis
Journal: Diabetes Care (2002)

The use of self-monitoring of blood glucose (SMBG) in type 2 diabetic patients is still a matter of debate, as documented by the letter from Dr. Court (1). Despite its recommendation for all diabetic patients by the American Diabetes Association, the evidence supporting its effectiveness in improving glycemic control is questionable. A recent meta-analysis of all randomized trials on this topic failed to show any benefit for patients practicing SMBG (2). Previous observational studies were also unable to document a relation between frequency of SMBG and metabolic control (3).

From this point of view, …
Promoting better health
Authors: A A Gildersleve
Journal: BMJ (1988)

A case of tracheal compression in an infant after repair of a tracheo-oesophageal fistula and oesophageal atresia is reported. Tracheopexy completely relieved the symptoms of apnoeic attacks, cyanosis, and convulsions. We suggest that tracheal compression in infants and children with repaired oesophgeal atresia can not only cause life-threatening attacks but also be responsible for recurrent chest infections. All infants and children with signs and symptoms of tracheal compression as shown by the presence of a barking type of cough, recurrent chest infections, or persistent mild respiratory symptoms should be referred for thorough investigation of the tracheobronchial tree.
ON INTESTINAL OBSTRUCTIONS
Authors: B. W. Brown
Journal: BMJ (1853)

Read sbefore, a .lfeetinq of the .Midland Branich of the Provinctial * I venture to introduce this tern in order to mark the distinictinii between z.one-of equal geniality of climae, andl those of like temperatture, or iSo- thenrmal zones, both of which differ fronti each other, and from geographical zones, as mush s the mtAtic differs from the common equator.