tbuckley/cabot-search huggingface dataset:
Trust deficits will be wiped out by end of next financial year, NHS chief predicts
Authors: Andrew Cole
Journal: BMJ (2008)

The English NHS’s chief executive, David Nicholson, this week predicted that all deficits of NHS trusts would be wiped out by the end of the next financial year.

Speaking at the Public Accounts Committee hearing into the NHS’s financial performance in 2006-7, Mr Nicholson said that the number of failing trusts in England had been cut from more than 100 to 25 in this financial year (2007-8) and would be eliminated altogether next year.

At the same time the Department of Health predicts that the health service will record an overall surplus of £1.8bn (€2.4bn; …
Subclinical Hepatic Toxicity During Combination Chemotherapy for Breast Cancer
Authors: Cynthia A. Larroquette, Gabriel N. Hortobagyi, Aman U. Buzdar, Frankie A. Holmes
Journal: JAMA (1986)

We evaluated serial liver function tests (LFT) and serial liver imaging procedures for 190 consecutive patients with breast carcinoma to assess the incidence and severity of hepatic abnormalities during treatment with combination chemotherapy. Thirty-four percent of patients receiving adjuvant chemotherapy and 52% of patients being treated for metastatic breast cancer had one or more LFT abnormalities before initiation of therapy. Among patients with normal baseline LFT results, 77% of those receiving adjuvant chemotherapy and 82% being treated for metastatic breast cancer developed LFT abnormalities during therapy. Liver function test abnormalities were mild to moderate and never led to interruption of treatment; they appeared within the first three months of chemotherapy and normalized in 90% within one year of cessation of treatment. Our analysis suggests that LFT abnormalities detected during the administration of chemotherapy for patients with breast cancer are a manifestation of drug toxicity and that such abnormalities are insufficient evidence of hepatic metastases. (<i>JAMA</i>1986;256:2988-2990)
CHANGES IN THE HEMOSIDERIN CONTENT OF THE RABBIT'S LIVER DURING AUTOLYSIS
Authors: W. H. Brown
Journal: The Journal of Experimental Medicine (1910)

1. Hemosiderin may be produced outside of the animal body and is increased in the liver of rabbits, during autolysis, for a period of from twenty-four to forty-eight hours. 2. Post-mortem hemosiderin formation is most marked in parts of livers exposed to air, and hemosiderin is, apparently, an oxidation product of hemoglobin due to enzyme action. 3. Hemosiderin is derived from hemoglobin directly and not from hematin as an intermediate product. 4. The later stages of autolytic changes show that the acid products of proteid autolysis, especially the phosphorus acids, are capable of producing a cleavage of hemosiderin and uniting with the iron to form a new series of products which react microchemically for both phosphorus and iron. In such cleavage, pigments analogous to the bile pigments are formed. 5. The relationship observed between hemosiderin and hematoidin is such as would indicate that hematoidin is the pigment matter of hemosiderin. 6. Further, it seems probable that the vital cycle of hemoglobin metabolism in the liver is largely intranuclear; the hemoglobin is converted into hemosiderin either within the nucleus or cell protoplasm; the iron of the hemosiderin is bound by an acid radicle of the nucleo-proteid, and the hematoidin is excreted as bile pigment.
Strategies for Training Generalists and Subspecialists
Authors: Alan M. Fogelman
Journal: Annals of Internal Medicine (1994)

A strategy is proposed for attracting trainees to careers in general internal medicine coupled with a program that attracts a smaller number of trainees to research careers without attracting trainees into careers in the practice of the subspecialties. A novel training track analogous to the Medical Scientist Training Program, the Specialty Training and Academic Research (STAR) Program has been established. It is anticipated that within the next 5 years, 80% of the trainees in the department of medicine at the University of California, Los Angeles, Medical Center will be training for practice in general internal medicine; the remaining 20% will be enrolled in the STAR Program.
Amoxapine Overdose
Authors: Ken Kulig
Journal: JAMA (1982)

Amoxapine is a tricyclic antidepressant that seems to lack the cardiovascular toxic effects associated with other tricyclics when taken as an overdose. Central nervous system depression and seizures are the primary manifestations of toxic reactions to amoxapine. Because amoxapine seems to be as effective an antidepressant as other tricyclics, the lack of cardiotoxic effects may make it the drug of choice for certain psychiatric disturbances. Five cases of amoxapine overdose are discussed. (<i>JAMA</i>1982;248:1092-1094)
A Classic Twin Study of External Ear Malformations, Including Microtia
Authors: Maria A. Artunduaga, Maria D.L. Quintanilla-Dieck, Steven Greenway, Rebecca Betensky, Yamileth Nicolau, Usama Hamdan, Patricia Jarrin, Gabriel Osorno, Burt Brent, Roland Eavey, Christine Seidman, J.G. Seidman
Journal: New England Journal of Medicine (2009)

To the Editor: The pathogenesis of microtia, a rare congenital malformation of the external ear, remains elusive. Phenotypes range from minor deformities, such as preauricular tags, to anotia, the ...
Fatal Blunt Injury to the Omentum
Authors: Manuel A. Bergnes
Journal: JAMA (1966)

To the Editor:—  This report deals with an injury to the upper abdomen of a 6-year-old boy which resulted in disruption of the omentum, hemoperitoneum, and death. Fatal hemoperitoneum secondary to omental tear alone does not appear to have been described.  Report of a Case:—  A 6 1/2-year-old boy was playing with five other children around a 1/2-ton, custom-built, two-wheel utility trailer of enclosed metal body type, the tongue of which rested on the ground (Fig 1). Play consisted of climbing on top of, and crawling under the vehicle. While four children with an estimated combined weight of 140 lb climbed to the rear of the top of the trailer, the subject of this report, weighing about 45 lb, was pulling himself under it on his back by grasping the rear bumper. The trailer toppled backward and pinned him to the ground, the bumper pressing across his abdomen. A 7-year-old
Effect of Candesartan on Microalbuminuria and Albumin Excretion Rate in Diabetes
Authors: Rudy Bilous
Journal: Annals of Internal Medicine (2009)

Background: Microalbuminuria in diabetes is strongly predictive of nephropathy, end-stage renal disease, and premature cardiovascular morbidity and mortality. Effective preventive therapies are therefore a clinical priority. Objective: To determine whether the angiotensin-receptor blocker candesartan compared with placebo affects microalbuminuria incidence or rate of change in albuminuria in type 1 and type 2 diabetes. Design: 3 randomized trials of the DIRECT (Diabetic Retinopathy Candesartan Trials) Program. Setting: 309 secondary care centers. Patients: 3326 and 1905 patients with type 1 and type 2 diabetes, respectively. Most were normotensive, and all had normoalbuminuria (median urinary albumin excretion rate, 5.0 µg/min). Intervention: Candesartan, 16 mg/d increasing to 32 mg/d, versus placebo. Assignment was done centrally using an interactive voice-response system. Patients, caregivers, and researchers were blinded to treatment assignment. During a median follow-up of 4.7 years, 793 patients discontinued therapy and 63 were lost to follow-up. Measurements: Urinary albumin excretion rate, assessed annually by 2 overnight collections; if it was 20 µg/min or greater, then 2 further collections were done. The primary end point was new microalbuminuria (3 or 4 collections of urinary albumin excretion rate ≥20 µg/min). The secondary end point was rate of change in albuminuria. Results: Individual and pooled results of the 3 trials showed that candesartan had little effect on risk for microalbuminuria (pooled hazard ratio, 0.95 [95% CI, 0.78 to 1.16]; P = 0.60). Pooled results showed that the annual rate of change in albuminuria was 5.53% lower (CI, 0.73% to 10.14%; P = 0.024) with candesartan than with placebo. Limitations: Investigators recruited mainly normotensive patients or patients with well-controlled hypertension who were at low overall vascular risk, which resulted in a low rate of microalbuminuria. Studies were powered for retinal and not renal end points. Conclusion: Candesartan, 32 mg/d, for 4.7 years did not prevent microalbuminuria in mainly normotensive patients with type 1 or type 2 diabetes. Primary Funding Source: AstraZeneca and Takeda.
Health insurance fraud rises in the United States
Authors: F. Charatan
Journal: BMJ (2003)

In the current economic downturn, the number of companies offering fraudulent or spurious health insurance policies is rapidly increasing in the United States. Typically, these unlicensed companies prey on small businesses and self employed people, who are desperate for affordable coverage. Patients and doctors are therefore stuck with unpaid bills and, in the case of patients, possibly damaged credit ratings.

The fraudulent health insurance companies, which should be licensed in the state they operate in, falsely claim that they do not need licensing because they are regulated by the US Department of Labor.

Because these fraudulent companies are not authorised to sell …
Sequence of the 20-kilodalton heavy chain peptide from the carboxyl-terminus of bovine cardiac myosin subfragment-1.
Authors: I L Flink, E Morkin
Journal: Journal of Clinical Investigation (1984)

An almost complete amino acid sequence of the carboxyl-terminal 20-kD tryptic heavy chain peptide from bovine cardiac myosin Subfragment-1 (S-1) has been determined by automated sequential degradation of the undigested peptide and subfragments derived by chemical and enzymatic digestion. The fragment contains 169 residues, including two reactive cysteinyl residues which are located nine residues apart. At six positions in the sequence, two amino acid residues were present and two different versions of a chymotryptic peptide were isolated in approximately 53 and 24% yields, suggesting that there are two cardiac myosin beta-type heavy chains in this species. Analysis of the secondary structure of the 20-kD peptide predicts that there are two distinct regions within the fragment. The first region (residues 1-121) contains 12% alpha-helix, 25% beta-sheet, 40% beta-bends, and 19% coil; the second region (residues 122-169) may form an extended alpha-helix. Comparison of the bovine sequence with the deduced amino acid sequence of a recombinant plasmid containing DNA sequences coding for the beta-heavy chain of rabbit cardiac myosin (pMHC beta 174) reveals approximately 86% homology.
Lidocaine Poisoning: Treatment and Prevention-Reply
Authors: Curt R. Freed
Journal: JAMA (1985)

<h3>In Reply.—</h3> Dr Nicholson is correct in saying that lidocaine poisoning occurs both by acute overdose as well as by inappropriately high long-term infusion rates. We have shown the value of cardiac bypass support only in the acute overdose setting.<sup>1</sup>However, contrary to Dr Nicholson's assertion, we believe that restoring normal cardiac output with extracorporeal pumping would probably lead to normal clearance of lidocaine in patients with heart failure since lidocaine clearance is primarily related to hepatic blood flow. If normal clearance and distribution were restored, then the halflife of elimination of the lidocaine would be about 1.5 hours, so that short-term bypass support would be practical for eliminating a substantial fraction of the overdose. A heroic technique such as cardiac bypass can only be justified in a life-threatening setting in which lidocaine has produced refractory arrhythmias or profound hypotension. Most patients intoxicated by a longterm infusion can simply
Intravascular Ultrasound-Derived Measures of Coronary Atherosclerotic Plaque Burden and Clinical Outcome
Authors: Stephen J. Nicholls, Amy Hsu, Kathy Wolski, Bo Hu, Ozgur Bayturan, Andrea Lavoie, Kiyoko Uno, E. Murat Tuzcu, Steven E. Nissen
Journal: Journal of the American College of Cardiology (2010)
Chrysiasis revisited: a clinical and pathological study
Authors: R.W. SMITH, B. LEPPARD, N.L. BARNETT, G.H. MILLWARD-SADLER, F. McCRAE, M.I.D. CAWLEY
Journal: British Journal of Dermatology (2006)

Chrysiasis is a distinctive and permanent pigmentation of light-exposed skin resulting from the administration of parenteral gold salts. We report a study of 40 Caucasian patients with rheumatoid arthritis, treated with intramuscular sodium aurothiomalate, of whom 31 had chrysiasis. Visible changes develop above a threshold, equivalent to 20 mg/kg gold content, and their severity depends upon cumulative dose. Focal aggregates of particulate gold are deposited in the reticular and papillary dermis in amounts that correlate with the degree of pigmentation. Characteristically, initially the periorbital region is affected by a mauve discoloration, which intensifies and deepens into a blue/slate-grey colour, while extending to involve the face, neck and upper limbs. Although chrysiasis develops insidiously and patients may be unaware of the changes, positive identification is important in order to avoid misdiagnosis and medical mismanagement, and afford appropriate reassurance. Prevention is difficult, but measures to reduce sunlight exposure may be helpful.
Differential activation of NF-kB and AP-1 transcription factors may regulate hepatic epithelial and endothelial cell survival following CD40 ligation
Authors: J. Ahmed-Choudhury, C.L. Russell, S. Randhawa, J. Youster, A.G. Eliopoulos, L.S. Young, D.H. Adams, S.C. Afford
Journal: Journal of Hepatology (2001)
The New Strategy in Infective Endocarditis: Early Surgery Based on Early Diagnosis
Authors: Raimund Erbel
Journal: Circulation (2014)

P atients with infective endocarditis (IE) have a poor progno- sis because of complications such as congestive heart failure, paravalvular abscess formation, central and peripheral embolism, and hemorrhagic stroke. 1 Patients with IE and congestive heart failure (CHF) have a mortality as high as 50%. 1 The poor prognosis seems to not have improved in recent years. 2 In Sweden, 7.603 patients with IE received a close follow-up with assessment of the 30-day mortality and 5-year follow-up including autopsy in all fatal events sampled from 1997 to 2007. 2 During the observation period, no change of mortality was found despite an increase of the incidence of IE from about 7 to 7.5 per 100 000 to 8 to 8.5 per 100 000 inhabitants. 2 To provide a contemporary picture of the presentation, cause, and outcome of IE, a worldwide International Collaboration on Endocarditis-Prospective Cohort Study (ICE PCS) was started in 58 hospitals in 25 countries in 2000. 3In this issue of Circulation, Chu VH et al 4 report the recent 2008 to 2012 results of the ICE-PCS database of 1296 IE patients with left-sided IE.The hospital mortality for surgery, performed in only 661 (76%) of 863 patients with indications for surgery, reached 14.8% and the 6-month mortality reached 17.5% compared with 26% and 31.4%,respectively, when no surgery was provided.
Successful Treatment of Severe Persistent Depressive Disorder with a Sequential Approach: Electroconvulsive Therapy Followed by Cognitive Behavioural Analysis System of Psychotherapy
Authors: Stephan Köhler, Theresa Fischer, Eva-Lotta Brakemeier, Philipp Sterzer
Journal: Psychotherapy and Psychosomatics (2015)

Successful Treatment of Severe Persistent Depressive Disorder with a Sequential Approach: Electroconvulsive Therapy Followed by Cognitive Behavioural Analysis System of Psychotherapy
Controls on human research participants are "outdated"
Authors: C. Marwick
Journal: BMJ (2002)

In the United States the procedures that are supposed to protect human research participants are outdated and fail to work, a senior official at the National Institutes of Health has said.

“Not only does the research community and the public feel that the system has become burdensome and inefficient, but it has contributed to participant harms,” said Dr Ezekiel Emanuel, chief of the institutes' clinical bioethics department.

The present system of protecting human research participants requires fundamental changes, he said. Speaking earlier this month at a meeting of the President's Council on Bioethics (set up by in November last year by President George Bush), Dr Emanuel outlined a radical approach.

He summarised some of the present system's failures. Investigators are frustrated by delays in approval for studies. …
DATA CONCERNING DEFORMITIES OF EXTRAUTERINE GESTATION.
Authors: ANDREW F. CURRIER
Journal: JAMA (1899)

The subject is one which, at first thought, would seem to be narrow in its scope, and yet the proper apprehension of it involves the examination of many disconnected reports of cases of extrauterine gestation, some of which devote no attention at all to the consideration of the physical condition of the fetus, while in others the details are aggravatingly meager. The deformities which are alluded to are in almost all cases, if not in all, consequences of the latter months of fetal development, since in those fetuses which are removed during the first half of gestation I have observed no record of deformity, and in those which I have examined personally, the upper and lower extremities have appeared to be normal. The subject derives importance from the fact that the number of fetuses developed outside the uterus and born alive by extraction through an abdominal incision, is not inconsiderable,
Spinocerebellar Ataxia and HLA Linkage
Authors: John F. Jackson, Robert D. Currier, Paul I. Terasaki, Newton E. Morton
Journal: New England Journal of Medicine (1977)

To determine the possibility of genetic linkage of spinocerebellar ataxia with the histocompatibility loci, we performed HLA typing and linkage analysis on 19 members of a kindred in which spinocerebellar ataxia was segregating in an autosomal dominant inheritance pattern. The ataxia locus was located on chromosome 6 at 12-cM distance from the HLA complex with lod score of 3.15 (odds is greater than 1400:1 favoring linkage over chance findings). Thus, the presence of the ataxia gene in members of this kindred at risk can be predicted with about 90 per cent accuracy by means of HLA typing in informative matings.
Participation of fast and slow A-V nodal pathways in tachycardias complicating the Wolff-Parkinson-White syndrome. Report of a case.
Authors: F Amat-y-Leon, C Wyndham, D Wu, P Denes, R C Dhingra, K M Rosen
Journal: Circulation (1977)

Electrophysiological studies in one patient with type B pre-excitation and dual A-V nodal pathway revealed several types of paroxysmal narrow QRS tachycardia (PSVT). One type of PSVT reflected antegrade fast A-V nodal pathway and retrograde anomalous pathway conduction. This PSVT was characterized by early retorgrade activation of right atrial appendage, P following QRS and cycle length of 290 to 350 msec. A second PSVT reflected antegrade slow A-V nodal pathway and retrograde anomalous pathway conduction. This PSVT was characterized by early retrograde activation of right atrial appendage, P following QRS, and cycle length of 440 msec. A third PSVT reflected A-V nodal re-entrance with antegrade slow pathway and retrograde fast pathway conduction. This PSVT was characterized by normal retrograde atrial activation sequences, P simultaneous with QRS, and cycle length of 320 msec. All PSVT inductions could be explained in terms of antegrade and retrograde properties of fast and slow A-V nodal and anomalous pathways.
CONGENITAL MALFORMATION OF HEART, WITH MALPOSITION OF CERTAIN VISCERA AND ABSENCE OF SPLEEN.
Authors: G. W. POTTER
Journal: JAMA (1906)

The case in question was that of an infant which lived but four and one-half hours and was in the service of my colleague, Dr. H. C. Burch. The mother, Mrs. A. J. O., was a primipara; pregnancy was normal and the child, a female, was born at full term, March 4, 1906. Labor was difficult, instrumental, but was not allowed to be overprolonged. The head was right occipital anterior. The child at birth was feeble; there was difficulty in establishing respiration, and throughout the four and one-half hours of life the cry was weak and fretful. The attendant's attention was first attracted to the apex beat, which was situated three-fourths of an inch directly below the right nipple. On the death of the child an autopsy was requested and granted. Our findings were as follows: An infant of nine and one-half pounds and perfectly normal on external examination. When
DNA vaccines encoding human immunodeficiency virus–1 glycoprotein 120 fusions with proinflammatory chemoattractants induce systemic and mucosal immune responses
Authors: Arya Biragyn, Igor M. Belyakov, Yen-Hung Chow, Dimiter S. Dimitrov, Jay A. Berzofsky, Larry W. Kwak
Journal: Blood (2002)
Inhalation and Atomization.
Authors: Homer M. Thomas
Journal: JAMA (1902)

Chicago, Feb. 17, 1902. <h3>To the Editor:</h3> —On page 474 ofThe Journalof February 15, it is stated that "It is yet a question as to how much of the respiratory tract is reached by inhalations." I am surprised that the writer of the above is ignorant of the experimental work that I have done in this line. It is now positively proven that nebulized medicaments reach the pulmonary alveoli of the human lung, of the lung of dogs and of guinea-pigs. The microscopic slides which are the proof of this contention and statement are in my possession, and unquestionably prove the truth of this assertion. As far back as May 28, 1898,The Journalpublished an article by me on "Experimental Work on the Penetrability of Vaporized Medicaments into the Air Passages." This proved the existence of nebulized medicaments in the lung of a human being. Since then
Unpublished Research From a Medical Specialty Meeting
Authors: Ellen J. Weber, Michael L. Callaham, Robert L. Wears, Christopher Barton, Gary Young
Journal: JAMA (1998)

It is not known whether peer review of research abstracts submitted to scientific meetings influences subsequent attempts at publication.To determine why research submitted to a scientific meeting is not subsequently published. We hypothesized that authors of abstracts rejected by a meeting are less likely to pursue publication than those whose abstracts are accepted, regardless of research quality.Blinded review of abstracts submitted to a medical specialty meeting in 1991 and not published as full manuscripts within 5 years. In 1996, authors of 266 unpublished studies were asked to complete questionnaires.Submission of a full manuscript to a journal between 1991 and 1996; failure to submit a manuscript to a journal because the investigator believed it would not be accepted for publication.A total of 223 (84%) of the unpublished investigators returned the questionnaire. Only 44 (20%) had submitted manuscripts to a journal. Manuscript submission was not associated with abstract quality (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.80-1.64), positive results (OR, 0.75; 95% CI, 0.31-1.57), or other study characteristics. Having an abstract accepted for presentation at the meeting weakly predicted submission of a manuscript to a journal (OR, 1.88; 95% CI, 0.84-4.10). Authors of accepted abstracts were significantly less likely to believe a journal would not publish their manuscript than were authors of rejected abstracts (OR, 0.23; 95% CI, 0.0001-0.61).Study characteristics do not predict attempts to publish research submitted to a scientific meeting. Investigators whose research is rejected by a meeting are pessimistic about chances for publication and may make less effort to publish.