tbuckley/cabot-search huggingface dataset:
"MEDICAL LICENSE INVESTIGATION IN CALIFORNIA"
Authors: C. B. Pinkham
Journal: JAMA (1924)

<h3>To the Editor:</h3> —We hasten to correct the erroneous impression that may be created by the editorial comment entitled "Medical License Investigation in California" (The Journal, July 19), in which it was stated that, "according to present reports,... graduates of all medical schools in Missouri are to be debarred from licensure in California," whereas the facts are that graduates of the St. Louis University School of Medicine, the University of Missouri School of Medicine and the Washington University Medical School fulfilling the requirements of the California law will be accepted to a written examination in this state. However, graduates of the Kansas City College of Physicians and Surgeons, the Kansas City University of Physicians and Surgeons and the St. Louis College of Physicians and Surgeons will<i>not</i>be admitted to written examination in California. Referring to the action of the California board, the further comment was made that "the reports
Secretor state of patients with insulin dependent or non-insulin dependent diabetes mellitus.
Authors: P J Lamey, L P Samaranayake, T W MacFarlane
Journal: BMJ (1987)

<b>Objectives</b>&nbsp;To determine the skeletal safety and efficacy of long term (≥10 years) alendronate use in patients with osteoporosis. <b>Design</b>&nbsp;Open register based cohort study containing two nested case control studies. <b>Setting</b>&nbsp;Nationwide study of population of Denmark. <b>Participants</b>&nbsp;61 990 men and women aged 50-94 at the start of treatment, who had not previously taken alendronate, 1996-2007. <b>Interventions</b>&nbsp;Treatment with alendronate. <b>Main outcome measures</b>&nbsp;Incident fracture of the subtrochanteric femur or femoral shaft (ST/FS) or the hip. Non-fracture controls from the cohort were matched to fracture cases by sex, year of birth, and year of initiation of alendronate treatment. Conditional logistic regression models were fitted to calculate odds ratios with and without adjustment for comorbidity and comedications. Sensitivity analyses investigated subsequent treatment with other drugs for osteoporosis. <b>Results</b>&nbsp;1428 participants sustained a ST/FS (incidence rate 3.4/1000 person years, 95% confidence interval 3.2 to 3.6), and 6784 sustained a hip fracture (16.2/1000 person years, 15.8 to 16.6). The risk of ST/FS was lower with high adherence to treatment with alendronate (medication possession ratio (MPR, a proxy for compliance) &gt;80%) compared with poor adherence (MPR &lt;50%; odds ratio 0.88, 0.77 to 0.99; P=0.05). Multivariable adjustment attenuated this association (adjusted odds ratio 0.88, 0.77 to 1.01; P=0.08). The risk was no higher in long term users (≥10 dose years; 0.70, 0.44 to 1.11; P=0.13) or in current compared with past users (0.91, 0.79 to 1.06; P=0.22). Similarly, MPR &gt;80% was associated with a decreased risk of hip fracture (0.73, 0.68 to 0.78; P&lt;0.001) as was longer term cumulative use for 5-10 dose years (0.74, 0.67 to 0.83; P&lt;0.001) or ≥10 dose years (0.74, 0.56 to 0.97; P=0.03). <b>Conclusions</b>&nbsp;These findings support an acceptable balance between benefit and risk with treatment with alendronate in terms of fracture outcomes, even for over 10 years of continuous use.
How to lose the fight against AIDS among gay men
Authors: R Stall
Journal: BMJ (1994)

News from the AIDS front has not been good lately. Data describing the efficacy of biomedical efforts either to cure AIDS or to prevent the disease through use of vaccines are not encouraging. The realisation has been spreading within gay male communities that we are fated to live with the continuing consequences of the AIDS epidemic for the indefinite future, and perhaps for the rest of our lives. The best hope of gay communities for surviving the epidemic in some relatively intact form depends on efforts to support consistent safe sex over indefinite periods of time.

Unfortunately, evidence concerning the efficacy of efforts to support the maintenance of exclusive safe sex among gay men throughout the population over long periods is also disheartening. Studies from several different cities around the world have described widespread patterns of inconsistent safe sex over time (R Gold, second international conference on AIDS impact, Brighton, 7-10 July 1994)¢RF 1-3¢ as well as an increased prevalance of rectal gonorrhoea4 among gay and bisexual men. Perhaps most worryingly, the prevalance of HIV seropositivity among gay men in San Francisco aged 26-29 in 1993 approached that among men aged 26-29 in 1984 - a level reflecting sexual risks taken before the threat of AIDS was recognised (W Winkelstein et al, IX international conference on AIDS, Berlin, 6-11 June 1993).

These findings raise a set of disturbing questions: is the gay male community losing ground against AIDS owing …
New Anticoagulants Offer Options Beyond Warfarin to Reduce Stroke Risk
Authors: Mike Mitka
Journal: JAMA (2012)

THE EMERGENCE OF NEW ANTICOagulation medications to treat nonvalvular atrial fibrillation and reduce stroke risk has been mostly welcomed by the medical community. But identifying patients who will receive the most benefit from a particular drug remains a challenge, and wider use may be limited until bleeding risks and other concerns associated with the drugs are better understood. The prevalence of atrial fibrillation, which can cause blood clotting, continues to increase in the United States, with 1 in 4 individuals now being projected to develop the condition in his or her lifetime. Patients with atrial fibrillation have 5 times greater risk of stroke and are estimated to constitute 15% of all stroke victims and 30% of those whose strokes occur after age 80 years. Since the 1940s, and until recently, the only anticoagulation treatment to reduce stroke risk from atrial fibrillation was warfarin, a vitamin K antagonist. Warfarin reduces stroke risk by about two-thirds, but it is a difficult drug to manage. The medication, which is supposed to be taken for the rest of the patient’s life, interacts with food and other drugs, necessitating frequent coagulation monitoring and dose adjustments. Too high a dose increases bleeding risks, such as intracranial hemorrhage, while too low a dose makes the drug ineffective as an anticoagulation agent. Maintaining warfarin’s dose levels in the proper therapeutic range is difficult, with many patients achieving the target range less than 60% of the time. As such, an estimated one-third of patients with atrial fibrillation at risk for stroke either are not given warfarin or discontinue it once started. But now alternatives to warfarin are available to reduce stroke risk in patients with atrial fibrillation. In 2010, the US Food and Drug Administration (FDA) approved dabigatran etexilite, a small-molecule direct thrombin inhibitor anticoagulation agent, for this purpose. In 2011, the FDA approved rivaroxaban, a small-molecule oral direct
Colin William Ombler Windsor
Authors: R. Downing
Journal: BMJ (2006)

Medical researcher who pioneered the controlled clinical trial as a gold standard and who demonstrated the efficacy of streptomycin as a treatment for tuberculosisIn a long career-he lived to 106 and worked until he was 102-Philip D'Arcy Hart showed that pneumoconiosis was an industrial disease for which sufferers should receive compensation.In a landmark controlled clinical trial with Sir Austin Bradford Hill, Hart showed that streptomycin, then newly discovered, cured tuberculosis.In 1965 he was made a CBE for this work.He did other major epidemiology, retired at 65, and spent the next 37 years making fundamental advances on the pathogenesis of tubercle bacilli.
Learning from low income countries: Poor patients deserve more science and less advocacy
Authors: Carol C Adelman, Jeremiah Norris
Journal: BMJ (2005)

Learning from low income countries Experience in low income countries should count towards specialist registrar trainingEditor-Richards and Tumwine ask for discussion on the subject of poor countries making the best teachers. 1When will the postgraduate tutors and royal colleges recognise that medical experience in developing countries should be counted towards specialist registrar training?I recently spoke to a specialist registrar whose 12 months in the main teaching hospital in Malawi counted for nothing towards his training.As a specialist registrar training in chest medicine, he will have seen more tuberculosis than most chest physicians working in provincial England will see in a lifetime.This is particularly frustrating as the numbers of cases of tuberculosis are rising progressively in the United Kingdom, and training in the diagnosis and management of this disease needs to be improved as much as possible.
Prolonged peritoneal dialysis in patients awaiting renal transplantation.
Authors: S. L. Cohen, A. Percival
Journal: BMJ (1968)

tation, and this is a report of our experience of peritoneal dialysis for periods of two to seven months. Patients and MethodsDetails of the 27 patients who received peritoneal dialysis for more than two months are shown in Table I.They were TABLE I.-Details of L' Patients Receiving Prolonged Peritoneal Dialysis Age {Range 8-46 years AeMean.28-6f Male 16SeOemalc .... . .
Neonatal hypernatraemia in two siblings with Netherton's syndrome
Authors: S.K. JONES, LAURA M. THOMASON, SANDRA K. SURBRUGG, W.L. WESTON
Journal: British Journal of Dermatology (1986)

We report two siblings with Netherton's syndrome who developed hypernatraemia during the neonatal period. Although this is likely to have been due to trans‐epidermal water loss in erythrodermic infants rather than to Netherton's syndrome specifically, this complication should be remembered in erythrodermic infants as a preventable cause of neonatal morbidity.
A Study of Biochemical Markers of Reperfusion Early After Thrombolysis for Acute Myocardial Infarction
Authors: Thierry Laperche, P. Gabriel Steg, Monique Dehoux, Joëlle Benessiano, Gilles Grollier, Etienne Aliot, Jean-Marie Mossard, Pierre Aubry, Damien Coisne, Michel Hanssen, Marie-Christine Iliou
Journal: Circulation (1995)

Background In acute myocardial infarction (AMI), early noninvasive identification of patients with occluded infarct-related arteries (IRAs) after thrombolysis has important prognostic and therapeutic implications. The aims of this study were to evaluate biochemical methods for the early diagnosis of patency after thrombolysis prospectively and to establish the optimal diagnostic criteria retrospectively. Methods and Results In 97 patients with AMI treated with thrombolytic agents ≤6 hours after the onset of symptoms, myoglobin, troponin T, creatine kinase, the MB isoenzyme and MM isoforms of creatine kinase were measured just before thrombolysis began and 90 minutes later. IRA patency was assessed by means of 90-minute coronary angiography. For each marker, compared with the expected sensitivity and specificity based on published thresholds for the diagnosis of patency, the observed values were consistently lower but were markedly improved in a subset of patients treated &gt;3 hours after the onset of symptoms. With receiver-operator characteristic curve analysis of the slopes of increase and relative increases in each marker over 90 minutes, the best diagnostic performance was achieved by use of the relative increase in myoglobin, troponin T, and MM3/MM1 creatine kinase isoforms in patients treated &gt;3 hours after onset (areas under the curve of 0.84, 0.83, and 0.85, respectively). Conclusions Effective early noninvasive diagnosis of patency after thrombolysis is possible in patients treated &gt;3 hours after symptom onset by use of criteria derived from the relative increase over 90 minutes in plasma markers, particularly myoglobin, troponin T, and MM3/MM1 creatine kinase isoforms. The diagnostic performance of the relative increase in myoglobin appears to be less susceptible to small changes in the diagnostic threshold value.
Abstract 3704: Gemtuzumab ozogamicin conjugated gold nanoparticles induce cell death in D1.1 leukemia cells when exposed to a radiofrequency field
Authors: Katherine A. Willborn, Evan S. Glazer, Katrina L. Briggs, Steven A. Curley
Journal: Cancer Research (2010)

Abstract Introduction: Acute T-cell leukemia cells may express the marker CD33. Gemtuzumab is a monoclonal antibody against CD33, used clinically in combination with ozogamicin, a cytotoxic antibiotic, for treatment of acute leukemias. It has been previously demonstrated that gold nanoparticles delivered intracellularly and exposed to nonionizing radiofrequency (RF) fields induce hyperthermic cytotoxicity. RF fields are not cytotoxic without the presence of nanoparticles. The purpose of this experiment is to investigate cell death in cells treated with gemtuzumab ozogamicin conjugated to gold nanoparticles after RF field exposure. Methods: D1.1 (acute T-cell leukemia) cells were plated in 60mm cell culture dishes. Two groups (n=3 in each group) of plated cells were treated for two hours with gemtuzumab ozogamicin conjugated to 10nm solid gold nanoparticles in media. One group of cells was then exposed to a radiofrequency field for a total generator energy of 1500 W-minutes. The control cells were treated with the same gold conjugate, but were not exposed to an RF field. Two days later, cell viability, apoptosis, and death was determined by flow cytometry. The groups were compared with Student's t-test. Results: RF fields induced apoptosis in 58.7% ± 3.95% of treated cells, compared with 8.66% ± 0.56% of the controls (p=0.002). The viability after RF exposure was 13.9% ± 6.11% while gemtuzumab ozogamicin gold conjugate alone decreased viability to 74.2% ± 0.85% (p=0.003). The temperature of the media was kept below 40°C to avoid nonspecific cell injury. Conclusions: Multimodality therapy (chemotherapy and nanoparticle-mediated hyperthermia) induced significantly more death in acute T-cell leukemia cells than antibody-chemotherapy alone. Antibodies specific to molecular targets on cells permit targeting of the heat mediator (nanoparticles) while preventing non-specific delivery of both nanoparticles and chemotherapeutic agent. The use of non-invasive RF fields to specifically induce cell death by hyperthermia with nanoparticles may present new options for the treatment of leukemias. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3704.
Gauging the Accuracy of Laboratory Testing From Medicare Data
Authors: Donald J. Venes
Journal: JAMA (1993)

In Reply.  —In our article we made one fundamental point: health insurance claims data can be fruitfully used to track patient outcomes and to screen for laboratories that are having a higher than expected frequency of bad outcomes. We illustrated this use of claims data by examining Medicare patient outcomes following outpatient PT testing. We found that risks for stroke and myocardial infarction were higher when patients had been tested in low-volume physician office laboratories, when the site of testing switched between successive tests, and when the patient had no history of testing in the prior 6 months. We also found that patients in states with stronger regulatory climates had lower risk for stroke; similar results for myocardial infarction were not statistically significant.  According to our approach with a large database of laboratories and clinicians, all factors that lead to adverse outcomes that are attributable to physicians' activities once the
The Bitter Herbs of Seder: More on Horseradish Horrors
Authors: Haya R. Rubin, Albert W. Wu
Journal: JAMA (1988)

<h3>To the Editor.</h3> —In a recent letter, Dr Spitzer<sup>1</sup>described syncope after the ingestion of a large amount of wasabe (a Japanese horseradish preparation commonly served with sushi). We report a similar episode at a Jewish Passover Seder. The Seder is a traditional Passover meal involving a series of ceremonial rituals, among them eating "bitter herbs" to commemorate the bitterness of Jewish slavery in ancient Egypt. Raw horseradish is commonly used for this purpose. <h3>Report of a Case.</h3> —A 55-year-old hypertensive man, who was being treated with a thiazide diuretic, conducted his family's Passover Seder. One of the bitter herbs was ground horseradish that had been prepared in an electric food processor earlier in the day and placed in an airtight container. The family had neglected to follow its custom of uncovering the horseradish before the Seder. In the usual Orthodox fashion, the man consumed the bitter herb after
THE INFLUENCE OF THE THYROID ON CARBOHYDRATE METABOLISM
Authors: John H. King
Journal: The Journal of Experimental Medicine (1909)

1. The thyroid exerts a retarding action on the carbohydrate destroying mechanism of the body. 2. This retarding action is not changed when the gland is boiled, showing that it is not a ferment action. 3. Iodothyrin, the active principle of the gland, exerts this retarding influence more markedly even than the whole thyroid. 4. This antagonism between the thyroid and the carbohydrate destroying mechanism is a direct one, as other ductless glands and the nervous system are eliminated from the experiments. 5. These results confirm those of Falta along similar lines.
New York City push against sugary drinks sparks controversy
Authors: J. Lenzer
Journal: BMJ (2010)

In a push to reduce obesity, the mayor of New York City has proposed a ban that would prevent the use of government subsidised food stamps to purchase soda or sugary drinks.

Mayor Michael R Bloomberg submitted the proposal to the US Department of Agriculture, which allocates funding for the food stamps programme. The stamps are used by 1.7 million New York City residents on low incomes. The proposal follows a failed attempt to impose a penny per ounce tax on the drinks.

According to a news release by the mayor, the city currently “subsidizes a serious public health epidemic” by allowing the use of food stamps to purchase sugary …
Points: Dicyclomine hydrochloride in infantile colic
Authors: M. Goodman
Journal: BMJ (1985)

relatively little time available to talk to their inpatients because they are responsible for patients in several hospitals and are also concerned in work in the community, which may be particularly time consuming.Psychiatric firms usually have one junior trainee per site (or part ofone), and there are no housemen, so on call duties are shared by SHOs/registrars, whose posts usually coalesce to form training programmes involving enough firms and units to allow varied experience in a rotating scheme.Cuts in the numbers of junior psychiatric training posts are being proposed in many places and in some cases are draconian.If these numbers are reduced in this way without either a significant increase in consultant numbers or a commensurate increase in non-trainee junior posts then the standard of service may decline unacceptably in many places.Some regions err in supposing that manpower needs and use in psychiatry are essentially the same as in medical and surgical specialties.
Improving patient care
Authors: Fiona Godlee
Journal: BMJ (2007)

One thing that unites BMJ readers must surely be their desire to improve patient care, whether through research, education, health systems management, or direct clinical contact with patients. But what does this really mean? A couple of months ago Don Berwick, president of the Institute of Healthcare Improvement (IHI), asked us what the BMJ 's mission was. On hearing that is was, yes, to improve patient care (http://resources.bmj.com/bmj/sitemap/about-bmj/Our-vision-and-mission), he challenged us to get more concrete. What exactly did we want to improve and how?

This got us thinking. Those of you who have heard Don Berwick speak will know that he is a hard man …
Mentally ill patients need protection from inappropriate genetic testing
Authors: A. Brooks
Journal: BMJ (1998)

People with mental disorders must be protected from inappropriate genetic testing, a report from the Nuffield Council on Bioethics has recommended.

The working party, chaired by Dame Fiona Caldicott, principal of Somerville College, Oxford, investigated the ethical issues surrounding research and its applications into the genetics of mental disorders. Dame Fiona said: “In response to the recent and frequent discovery of genes associated with a variety of diseases, there is a temptation to rely on ‘geneticisation' as the ultimate answer to …
<i>Serratia marcescens</i> Endocarditis: A Regional Illness Associated with Intravenous Drug Abuse
Authors: JOHN MILLS, DENIS DREW
Journal: Annals of Internal Medicine (1976)

From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, except that 9 of the isolates exhibited colonial variation, with each variant having different antibiotic sensitivities. Aortic or mitral valves were involved in 13 patients, and heart failure developed in 9 of these. Twelve patients had embolic episodes to brain, iliofemoral arteries, or lung. Five of 6 patients with tricuspid valvulitis were cured by antibiotics either with (1) or without excision of the valve. All 12 patients with aortic or mitral valvulitis treated medically died; 11 had unremitting sepsis. Aortic valve replacement and antibiotics were effective in 1. Gentamicin combined with either carbenicillin or chloramphenicol was the most effective treatment regimen.
Better collaboration between primary and secondary doctors is key to integrated care
Authors: L. Hitchen
Journal: BMJ (2010)

GPs should be at the forefront of integrated care in their role as commissioners and they must secure support of their secondary care colleagues from the outset, says a report from the think tank the Nuffield Trust. 

The report follows the publication in July of the government white paper Equity and Excellence: Liberating the NHS , which called for more integrated healthcare systems to ensure that health and social care organisations work more closely together to improve patient care and the patient experience ( BMJ 2010;341:c3796, doi:10.1136/bmj.c3796). 

Chris Ham, coauthor of the report and chief executive of the King’s Fund, told the BMJ that commissioners need to be fully informed by the best evidence and experience. Involving secondary care clinicians in their decision making would provide this level of expertise.

“When you put the argument to them [GPs and doctors in secondary care] on why care …