tbuckley/cabot-search huggingface dataset:
Prevalence of Alzheimer's Disease
Authors: Isak Prohovnik
Journal: JAMA (1990)

<h3>To the Editor.—</h3> The study by Evans et al<sup>1</sup>on Alzheimer's disease includes a reference to a previous publication by Rocca et al.<sup>2</sup>Evans et al refer to that study as estimating Alzheimer's disease at a prevalence of 11.2% at age 66 years and older. They cite this article as being consistent with their finding of 10.3%, which was surprisingly high. I was not able to locate this finding of 11.2% prevalence anywhere in the Rocca et al article. In fact, Rocca et al plainly state in their abstract, as well as in the text, that the prevalence rate at this age ranges between 1.9% and 5.8%. The finding of 11.2% only appears in Table 2, where it seems to reflect the proportion of the general population that is older than 65 years. Considering the unexpected and important findings in the East Boston study, and since the Rocca
Percutaneous Osseous Needle Aspiration Biopsy with Nuclear Medicine Guidance
Authors: HARRY G. ZEGEL, MELVIN TURNER, MICHAEL G. VELCHIK, NOEL CAWLEY, ERNESTO LUCENA
Journal: Clinical Nuclear Medicine (1984)

ZEGEL, HARRY G. M.D.*; TURNER, MELVIN D.O.*; VELCHIK, MICHAEL G. M.D.†; CAWLEY, NOEL M.D.*; LUCENA, ERNESTO M.D.* Author Information
D-Dimer for Pulmonary Embolism
Authors: Grégoire Le Gal, Marc Righini, Philip S. Wells
Journal: JAMA (2015)

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Pseudohypertension Mimicking a Hypertensive Emergency
Authors: William F. Keenan
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Normally, the difference between invasive and noninvasive measurements of blood pressure (BP) are of the order of 10 mm Hg or less.<sup>1</sup>Roughly 30% of patients have a greater difference, and occasionally, the difference is striking. When noninvasive measurements lead to a false diagnosis of elevated BP, pseudohypertension exists. The following patient had a substantial discrepancy between invasive and noninvasive pressure readings giving the initial impression of a hypertensive crisis. <h3>Report of a Case.—</h3> A 72-year-old man had acute onset of abdominal pain. At that time, his BP was 188/110 mm Hg by auscultation. This was performed with some difficulty, as the Korotkoff's sounds could barely be heard. Pulses in the carotid, radial, antecubital, and femoral arteries were symmetrical but weak. The ECG showed no evidence of hypertrophy, ischemia, or strain. He was found to have a sigmoid volvulus. In the operating room the systolic BP
Chlorpyrifos Accumulation Patterns for Child-Accessible Surfaces and Objects and Urinary Metabolite Excretion by Children for 2 Weeks after Crack-and-Crevice Application
Authors: Paromita Hore, Mark Robson, Natalie Freeman, Jim Zhang, Daniel Wartenberg, Halûk Özkaynak, Nicolle Tulve, Linda Sheldon, Larry Needham, Dana Barr, Paul J. Lioy
Journal: Environmental Health Perspectives (2004)

The Children's Post-Pesticide Application Exposure Study (CPPAES) was conducted to look at the distribution of chlorpyrifos within a home environment for 2 weeks after a routine professional crack-and-crevice application and to determine the amount of the chlorpyrifos that is absorbed by a child living within the home. Ten residential homes with a 2- to 5-year-old child in each were selected for study, and the homes were treated with chlorpyrifos. Pesticide measurements were made from the indoor air, indoor surfaces, and plush toys. In addition, periodic morning urine samples were collected from each of the children throughout the 2-week period. We analyzed the urine samples for 3,5,6-trichloropyridinol, the primary urinary metabolite of chlorpyrifos, and used the results to estimate the children's absorbed dose. Average chlorpyrifos levels in the indoor air and surfaces were 26 (pretreatment)/120 (posttreatment) ng/m3 and 0.48 (pretreatment)/2.8 (posttreatment) ng/cm2, respectively, reaching peak levels between days 0 and 2; subsequently, concentrations decreased throughout the 2-week period. Chlorpyrifos in/on the plush toys ranged from 7.3 to 1,949 ng/toy postapplication, with concentrations increasing throughout the 2-week period, demonstrating a cumulative adsorption/absorption process indoors. The daily amount of chlorpyrifos estimated to be absorbed by the CPPAES children postapplication ranged from 0.04 to 4.8 microg/kg/day. During the 2 weeks after the crack-and-crevice application, there was no significant increase in the amount of chlorpyrifos absorbed by the CPPAES children.
Prontosil for Meningitis
Authors: F. H. Jacob
Journal: BMJ (1938)

~~~~~~~~~~~~~~~~~~~~~~~~~MEDICAL JOURNAL5. Foci of sepsis, other than in the gall-bladder, were at least as frequent in the gall-bladder cases with normal hearts as in those with evidence of cardiac damage.6.The cardiac lesion was "temporary" in some cases of gall-bladder disease and "permanent" in others, and some of the latter group displayed an unsustained amelioration of the heart condition after operation, which was probably due to the beneficial effects of the enforced rest in bed.7. The incidence of heart lesions in cases of gall-bladder disease was uninfluenced by the presence of jaundice.8. Coronary artery thrombosis occurred in 12 per cent. of cases of gall-bladder disease, and on occasion may present difficulty in differential diagnosis.9.The electrocardiographic evidence was inconsistent in many cases of myocardial insufficiency when compared with the clinical condition of the patient, but was of great value in cases in which coronary artery thrombosis had occurred.10. Cholecystectomy produced a cure of the gall-bladder symptoms in 78 per cent. of cases in which this operation was performed, and appeared to be a satisfactory measure for obtaining amelioration of the cardiac manifestations occturrinig in cases of gall-bladder disease.The presence of similar heart conditions in cases of gall-bladder disease does not constitute a contraindication to cholecystectomy.Fatal pulmonary embolism occurred as a post-operative complication in 5 per cent. of cases.11.There was some evidence to suggest that the longer disease of the gall-bladder is permitted to exist the greater is the possibility of cardiac manifestations making their appearance.The early treatment of gall-bladder disease by cholecystectomy thus appears to be indicated.12. From a study of this series of sixty-five cases of gall-bladder disease the impression was gained that infection of the gall-bladder was a definite aetiological factor in the production of the myocardial lesions com- mcnly fouind in these cases, and that the presence of obesity, though almost certainly a factor in some cases, does not always explain the cardiac damage.I have to thank Dr. L. Findlay, medical superintendent of Mill
OP0137-PC Number of Painful Regions and their Distribution Predicts Outcome of Pain in the General Population
Authors: S. Bergman
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Pain reported by a mannequin or predefined figure with body regions is important in evaluation of pain impact and development in general practice. Such reports are also of importance in classification of pain as being regional or widespread, as part of for example the 1990 ACR criteria for fibromyalgia. New proposed criteria for fibromyalgia have however omitted the evaluation of how painful regions are distributed and only focus on the number of regions. <h3>Objectives</h3> The aim was to study if the number of painful regions and their distribution (regional or widespread) independently predicted chronic widespread pain in a 12 year follow up of a cohort from the general population. <h3>Methods</h3> Within the Epipain-project a cohort of 2425 subjects from the general population in south Sweden answered a postal survey on pain and health. The questionnaire included a pain mannequin with 18 predefined regions. The number of regions was calculated and their distribution was analyzed with regard to ACR 1990 criteria for chronic widespread pain (CWP). Subjects were classified as having no chronic pain, chronic regional pain (CRP) or CWP. The survey was repeated after 3, 8 and 12 years. Odds ratios (Ors) for the independent variables pain distribution (NCP, CRP or CWP) and number of painful regions (0-18) with regard to report of CWP at follow up were analyzed with multiple logistic regression. <h3>Results</h3> Report of CWP vs. NCP at 3, 8 and 12 year follow was independently predicted by both pain distribution and the number of painful regions. ORs for subjects with CWP at baseline were 6.3 (95% CI 2.3-17.2), 5.0 (95% CI 1.9-13.3), and 4.0 (95% CI 1.6-9.7) at respectively follow up. Corresponding ORs for number of painful regions at baseline were 1.4 (1.3-1.6), 1.4 (1.2-1.5), and 1.3 (1.2-1.4). <h3>Conclusions</h3> Both the number of painful regions and their distribution (widespread or not) independently contributed to the prognosis for reporting chronic widespread pain in a 12 year follow up of pain development in the general population. This added prognostic value of pain distribution should be considered in evaluation of pain mannequins in general practice. <h3>Disclosure of Interest</h3> None Declared
FOR THE APPLICATION OF COCAIN TO THE UVULA.
Authors: HENRY W. WANDLESS
Journal: JAMA (1897)

There is always more or less difficulty to anesthetize the uvula with cocain by making application with cotton on a carrier. I had for several years used cotton on a toothpick, with very little satisfaction, and seldom getting the uvula insensible. The first attempt usually produces reflex spasms of the soft palate and faucial muscles. Rubbing the uvula with cotton keeps up this effect until the mucous membrane of the uvula is insensible to the touch. This is very disagreeable to the patient; besides, the cocain by contact spreads over the base of the tongue, the pharyngeal wall and the larynx. This often produces nausea and discomfort. I have devised a little instrument, shown in the cut, which has none of the objectionable features of the cotton probe method; besides, it does its work thoroughly and is no trouble at all. Its general contour is that of a spoon, its
Relationship between Stress Coping and Personality in Patients with Major Depressive Disorder
Authors: Toru Uehara, Kaoru Sakado, Miwako Sakado, Tetsuya Sato, Toshiyuki Someya
Journal: Psychotherapy and Psychosomatics (1999)

&lt;i&gt;Background:&lt;/i&gt; Stress coping is defined as a behavioral or cognitive response of an individual to uncomfortable or difficult situations. It has been suggested that coping, like personality, is related to the pathology and course of mental disorders. Accordingly, we here used a clinical sample to investigate the relationships between coping strategies and personality traits. &lt;i&gt;Methods:&lt;/i&gt; Subjects were 60 outpatients who were in remission from major depressive disorder and who completed the Coping Inventory for Stressful Situations (CISS) and the Munich Personality Test (MPT). &lt;i&gt;Results:&lt;/i&gt; Task-oriented coping showed a positive correlation with extraversion and frustration tolerance. Emotion-oriented coping was closely associated with neuroticism, esoteric tendencies and isolation tendency. Avoidance-oriented coping was related to extraversion. Principal component analysis indicated three corresponding factors between coping and personality; one was related to psychopathology (loading from the neuroticism, esoteric tendencies and isolation tendency scales of the MPT, and from the emotion-oriented coping scale of the CISS), a second was a social-adaptive ability component (loading from the frustration tolerance and extraversion scales of the MPT, and from the task-oriented coping and avoidance-oriented coping scales of the CISS), and a third was a passive-avoidance coping component (loaded from the emotion-oriented coping and avoidance-oriented coping scales of the CISS only). &lt;i&gt;Conclusion:&lt;/i&gt; Some personality traits such as extraversion and frustration tolerance are significantly related to task-oriented coping, and psychopathological personality traits such as neuroticism are associated with emotional-oriented coping in major depressive disorder.
Fatal Self-Administration of Sodium Azide
Authors: EDWARD A. EMMETT
Journal: Annals of Internal Medicine (1975)

A 19-year old woman ingested an unknown amount of sodium azide (NaN3). The earliest symptoms were nausea and loss of vision. Within a few hours her clinical features were dominated by central nervous system signs, acute pulmonary edema, lactic acidosis, and hypothermia. The patient died within 12 hours, hypotension and shock occurring as preterminal events. This was the first recorded case in which antidotal methemoglobin production was attempted. Sodium nitrite administration resulted in methemoglobinemia but did not appreciably alter the clinical course and may not be of major benefit. Gross examination post-mortem showed marked pulmonary edema, visceral hemorrhage and congestion, and slight cerebral edema. Microscopically, the lungs showed alveolar and interstitial edema and a polymorphonuclear infiltrate. There were petechial hemorrhages and severe nonspecific changes in the brain.
Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure
Authors: N. A T Hamdy, J. A Kanis, M. N C Beneton, C. B Brown, J. R Juttmann, J. G M Jordans, S. Josse, A. Meyrier, R. L Lins, I. T Fairey
Journal: BMJ (1995)

To determine whether alfacalcidol--used in management of overt renal bone disease--may safely prevent renal bone disease when used earlier in course of renal failure.Double blind, prospective, randomised, placebo controlled study.17 nephrology centres from Belgium, France, the Netherlands, and the United Kingdom.176 patients aged 18-81 with mild to moderate chronic renal failure (creatinine clearance 15-50 ml/min) and with no clinical, biochemical, or radiographic evidence of bone disease.Alfacalcidol 0.25 micrograms (titrated according to serum calcium concentration) or placebo given for two years.Quantitative histology of bone to assess efficacy of treatment and renal function to assess safety.132 patients had histological evidence of bone disease at start of study. Biochemical, radiographic, and histological indices of bone metabolism were similar for the 89 patients given alfacalcidol and the 87 controls given placebo. After treatment, mean serum alkaline phosphatase activity and intact parathyroid hormone concentration had increased by 13% and 126% respectively in controls but had not changed in patients given alfacalcidol (P < 0.001). Hypercalcaemic episodes occurred in 10 patients given alfacalcidol (but responded to decreases in drug dose) and in three controls. Histological indices of bone turnover significantly improved in patients given alfacalcidol and significantly deteriorated in controls: among patients with abnormal bone histology before treatment, bone disease resolved in 23 (42%) of those given alfacalcidol compared with two (4%) of the controls (P < 0.001). There was no difference in rate of progression of renal failure between the two groups.Early administration of alfacalcidol can safely and beneficially alter the natural course of renal bone disease in patients with mild to moderate renal failure.
THE IMPORTANCE OF INTRODUCING PSYCHIATRY INTO THE GENERAL INTERNSHIP
Authors: FRANKLIN G. EBAUGH
Journal: JAMA (1934)

The final report of the commission on medical education<sup>1</sup>emphasizes the general need for revision of medical training by (1) bringing clinical methods into closer relation with preliminary sciences and with anatomy and physiology, (2) permeating all teaching with the idea of prevention and demonstration of its methods, (3) emphasis on the importance of the psychologic aspect of medicine and the treatment of the person rather than the disease, and (4) recognition of the concept of medicine as a social agency. Each of these recommendations will be furthered if the principles of psychiatry can be applied more generally through the medical course and in intern training. I shall discuss the importance of psychiatry as a part of the intern's training from the following points of view: (1) the present status of psychiatry in medical school teaching and the attitude of the student toward it, (2) the part psychiatry plays
Chancellor sets out plans to speed up approval for clinical trials
Authors: N. Hawkes
Journal: BMJ (2011)

The government has promised to speed up approval for new clinical trials, and to make funding to NHS bodies conditional on their recruiting the first patients to trials within 70 days.

The announcement formed part of the budget documents published on 23 March. In his speech to the Commons, George Osborne, the chancellor of the exchequer, referred only briefly to the planned changes, promising that in the life sciences “we will radically reduce the time it takes to get approval for the clinical trials.”

The details are spelt out in a plan for growth, published by the Treasury as part of the budget documents and signed off jointly by Mr Osborne and business secretary Vince Cable. In it, the government sets out its plans to establish a new health research regulatory agency to streamline regulation and improve the effectiveness of clinical trials.

The agency will make future National Institute for Health Research funding to providers of NHS …
Breath Alcohol After Using Mouthwash-Reply
Authors: Jack G. Modell
Journal: JAMA (1994)

<h3>In Reply.</h3> —I thank Dr Brown for his interest in our study and for bringing the article by Spector<sup>1</sup>to our attention. We did not encounter this article in our literature search, and we apologize for failing to give due credit. As Brown points out, Spector also described the decay characteristics of breath-alcohol values following rinsing of the mouth with alcohol-containing solutions. In this study, the test solution was ethanol (USP) diluted with water or orange juice to produce alcohol concentrations from 6% to 25%. Spector also found that the breath alcohol values decayed exponentially with time, although his decay curves were shifted to the right of ours by about 5 minutes; this effect was possibly because of the longer rinsing periods used in his study. As Brown notes, most law enforcement agencies require a waiting period before measuring breath alcohol values; we are, however, aware of many circumstances
Cd7, CD34‐positive stem cell leukemia arising in agnogenic myeloid metaplasia
Authors: Taizo Tasaka, Masami Nagai, Satoshi Murao, Masahiro Yamaguchi, Akira Kitanaka, Kazunori Sasaki, Michio Murata, Terukazu Tanaka, Hiroko Kuwabara, Kazuma Ikeda, Jiro Takahara, Shozo Irino
Journal: American Journal of Hematology (1993)

Abstract Agnogenic myeloid metaplasia (AMM) is a chronic myeloproliferative disorder arising from a single hematopoietic cell. Approximately 5% of reported cases of AMM have terminated in leukemic crisis; however, the precise characteristics of the leukemic cells have rarely been reported. We report a case of AMM that occurred in a 42‐year‐old man and was complicated by leukemic transformation. The leukemic cells wer morphologically lymphoblastoid cells with a negative reaction to peroxidase staining, and phenotypically characterized as CD7+, CD34+, HLA‐DR+, CD4−, CD8−, CD10−, CD13−, and CD33−. Southern blot analysis revealed that T cell receptor‐β, γ, and immunoglobulin heavy chain genes in leukemic cells were retained in germ‐line configuration. These observations suggest that leukemic cells in our case involved early hematopoietic stem cells rather than those strictly committed to myeloid or lymphoid precursors. To our knowledge, this is the first report of stem cell leukemia arising in a patient with AMM. © 1993 Wiley‐Liss, Inc.
Ventilatory mechanics at rest and during exercise in patients with cystic fibrosis.
Authors: J A Regnis, P M Donnelly, M Robinson, J A Alison, P T Bye
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Ventilatory mechanics were measured at rest and during steady-state (25%, 50%, 75%) and maximal exercise (W-Max) on a cycle-ergometer in eight adult patients (FEV1 22 to 114% of predicted) with cystic fibrosis (CF). Tidal flow-volume loops were measured at rest and during exercise and placed within the maximal pre- and postexercise flow-volume loops, based on measured end-expiratory lung volume (EELV). The degree of flow limitation was expressed as the percentage of the tidal flow-volume loop that met the expiratory boundary of the maximal loop (TFVL%). Pressure-volume relationships were assessed by measurement of transpulmonary pressure (PTP). Peak inspiratory PTP was compared with maximal inspiratory pressures at rest and during exercise (Pcap(i)) at the equivalent lung volume. The maximal effective expiratory pressure (Pmax(e)) was determined using the orifice technique. Three patients with milder disease (FEV1 114, 98, 89% of predicted) did not show any flow limitation at rest or 50% W-Max but two did show some flow limitation at W-Max (0, 3, 23 TFVL%) with a decrease in EELV (-400, -200, -300 ml). There was considerable reserve for inspiratory and expiratory pressure generation at W-Max. Flow limitation was noted at rest in three patients and at 50% W-Max in the five patients with more severe airways obstruction. The increased flow was achieved by an increase in EELV in all five patients (+400, +430, +330, +150, +700 ml at W-Max). Pcap(i) was reached in two patients (-28, -36 cm H2O), while Pmax(e) was exceeded by four patients suggesting inefficient pressure generation. Expiratory flow limitation, hyperinflation, and pressure swings approaching capacity severely compromised the capacity to generate ventilation in some patients with CF.