tbuckley/cabot-search huggingface dataset:
Dermatological non-disease: a common and potentially fatal disturbance of cutaneous body image
Authors: J.A. COTTERILL
Journal: British Journal of Dermatology (1981)

A group of patients presenting with dermatological complaints but with no significant objective dermatological pathology on examination are described. Twenty-eight patients, twelve male and sixteen female, age range 16--76 years, mean 46 years, were seen. Symptomatology was confined to three main body areas: the face--eight patients; scalp--nine patients; perineum--eight patients. The complaints related to the face were burning, intense itching and hirsutes. Scalp symptoms included excessive hair loss and intense irritation. Genital symptoms included itching, excessive redness, burning and discomfort, which in three instances prevented the patient sitting. A disturbed body image (dysmorphophobia) was common and the most frequent psychological illness present was depression. Two patients were demented and in two a diagnosis of schizophrenia was made. One patient committed suicide and two patients attempted suicide. Female patients presenting with facial symptoms have a more ominous prognosis, both with regard to the risk of suicide and the development of psychosis. It is important that dermatologists recognize this common group of patients with dermatological non-disease. Those patients who are anxiously preoccupied with their skin may be managed by superficial psychotherapy and antidepressants. Those patients who are truly deluded should be referred to a psychiatrist.
Error in Medicine
Authors: David D. Grove
Journal: JAMA (1995)

To the Editor.  —Dr Leape1provides a comprehensive review of the dependence of errors in medical practice on types of knowledge. Although the basic definitions of iatrogenic injury and the frequency of the injuries that follow from them may be arguable, the observation that medicine has been slow to incorporate input from other disciplines into its own efforts to improve quality of care is not.  It is interesting to consider the three categories of performance (skill-based, rule-based, and knowledge-based performance) and the generally inverse relation of reimbursement levels to the skills required to analyze and respond to unique problems.  Neither Leape nor Dr Blumenthal in his accompanying Editorial2places sufficient emphasis on the influence of the tort system on efforts to improve outcomes. As I have argued previously,3the wasteful loss of information that could be derived from systematic study of adverse outcomes is the most pernicious
Hyperthermia and Cancer Chemotherapy
Authors: E. ERNST
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 September 1984Hyperthermia and Cancer ChemotherapyE. ERNST, M.D., A. SCHERER, M.D.E. ERNST, M.D.Search for more papers by this author, A. SCHERER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-101-3-399_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The editorial by Shimm and Gerweck (1) discussed hyperthermia in the treatment of cancer. Hyperthermia combined with chemotherapy is a promising therapeutic approach to malignancy (2). How hyperthermia leads to tumor destruction is, however, still not fully understood (3).Our recent findings may help to clarify some of hyperthermia's actions. We have studied the hemorheologic effects of whole body hyperthermia in 12 healthy young volunteers (water, 42 °C, 20 minutes). The results showed a significant increase in ex-vivo blood fluidity as measured by blood and plasma viscosity (both temperature controlled) and hematocrit (10%, 7%, and 5% respectively)....References1. SHIMM D and GERWECK L. Hyperthermia in the treatment of cancer [Editorial]. Ann Intern Med. 1984;100:757-9. LinkGoogle Scholar2. HAHN G. Potential for therapy of drugs and hyperthermia. Cancer Res. 1979;39:2264. MedlineGoogle Scholar3. PETTIGREW R, GALT J, LEDGATE C, and SMITH A. Clinical effects of whole body hyperthermia in advanced malignancy. Br Med J. 1974;4:679. CrossrefMedlineGoogle Scholar4. DINTENFASS L. Rheology of Blood in Diagnostic and Preventive Medicine. London: Butterworth; 1976. Google Scholar5. RODDIC J and SHEPHERD J. The contribution of constrictor and dilator nerves to the skin vasodilatation during body heating. J Physiol (Lond). 1957;136:489. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: E. ERNST, M.D.; A. SCHERER, M.D.Affiliations: Hemorheology Research Unit University Clinics 8000 Munich 2 West Germany PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1984Volume 101, Issue 3Page: 399-399KeywordsBlood plasmaCancer chemotherapyCancer treatmentChemotherapyHematocritHyperthermiaTemperature ePublished: 1 December 2008 Issue Published: 1 September 1984 PDF downloadLoading ...
THE INFLUENCE OF IODINE ON THE EXCRETION OF CREATINE IN EXOPHTHALMIC GOITER 1
Authors: Walter W. Palmer, Donald A. Carson, Lawrence W. Sloan
Journal: Journal of Clinical Investigation (1929)

Nornal human adults taking a diet without meat, fish, peas or beans excrete no creatine in the urine.The exceptions to this thus far ob- served are the appearance of small amounts of creatine in women during the menstrual period (1) and the creatinuria in women reported by Denis and Minot (2) following the ingestion of a high protein diet.Creatine is found in the urine of individuals suffering from wasting diseases, starvation, during carbohydrate deprivation, diabetes mellitus, poisoning by phlorhizin, hydrazine, adrenalin and sodium selenite, exophthalmic goiter, fevers and the muscular atrophies and dystro- phies (3).The presence of creatine in the urine in pathological con- ditions is considered evidence of abnormal endogenous nitrogen metab- olism of muscles.Shaffer (4) reports 0.18 gram of creatine nitrogen in the twenty-four-hour urine of patients ill with exophthalmic goiter.Of the several pathological conditions studied by Shaffer only in the post partum period did he encounter values in excess of this.Associ- ated with the abnormal creatine excretion in exophthalmic goiter there was a reduced excretion of creatiniine.Normally the daily ex- cretion of creatinine nitrogen per kilogram of body weight amounts to 7 to 11 mgm., whereas in the cases of goiter only 3 to 6 mgm.are excreted.
Recent developments in training for general practice
Authors: K. Carter
Journal: BMJ (1998)

Most of the new regulations that affect general practice training are simply a consolidation of existing sets, but they differ in two important ways. They give the Joint Committee on Postgraduate Training for General Practice (JCPTGP) authority to approve all posts for general practice training both in hospitals and in GP surgeries - and the power to deselect unsatisfactory posts. Previously the posts were assessed at regional level and the committee could make recommendations only of the quality and content of the posts. The regulations also make it mandatory to pass the test of competence known as summative assessment. This article considers the development of the regulation of general practice training and outlines the current position for doctors who wish to enter general practice in the United Kingdom.

Vocational training for general practice developed during the 1970s and became mandatory in 1981 with the first set of vocational training regulations. Since that time all doctors wishing to enter general practice as principals have had to undergo a three year training programme, one year of which has to be spent in an approved training practice with a personal GP trainer.

A number of other acts of parliament have followed, notably the 1994 regulations, which drew British legislation into line with the European legislation of the preceding year that governs the free movement of doctors throughout the European Economic Area and the mutual recognition of vocational training certificates. The specific length and content of vocational training for general practice is now defined by both British and European Union regulations, and the committee administers those regulations for the entire United Kingdom.

The committee is likely to retain existing systems for the approval and inspection of posts into the coming year, and its new powers in this regard are unlikely to affect individual trainees …
Don't Tell Me What My Daddy Wants
Authors: Ronald Lands
Journal: Annals of Internal Medicine (2012)

Ad Libitum3 April 2012Don't Tell Me What My Daddy WantsRonald Lands, MDRonald Lands, MDFrom Knoxville, TN 37920.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-7-201204030-00003 Audio Reading - “Don't Tell Me What My Daddy Wants” Audio. Listen to a reading of "Don't Tell Me What My Daddy Wants" by Ronald Lands, MD. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Don't sit therein your starched white coatwith them letters after your nameand squint your big sad eyes.Don't sing your baby-talkbecause you thinkit makes me thinkyou care.Don't tell mewhat “we” need to do,what he would do for “us,”what he wants “us” to do for him.Don't ask me what he'd doif he only knewas much as “us,”as much as you.Don't wave somepaper at mewhere X marks the spot by his printed nameand tell me that's how you know.Don't say it meanshe wouldn't want to eat,to breathe,to live this way.rent-to-own furniture,... Author, Article, and Disclosure InformationAffiliations: From Knoxville, TN 37920.Current Author Address: Ronald Lands, MD, Department of Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway, Knoxville, TN 37920. PreviousarticleNextarticle Advertisement Audio Reading - “Don't Tell Me What My Daddy Wants” Audio. Listen to a reading of "Don't Tell Me What My Daddy Wants" by Ronald Lands, MD. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 April 2012Volume 156, Issue 7Page: 482KeywordsGraduate medical education ePublished: 3 April 2012 Issue Published: 3 April 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Glucose-6-Phosphate Dehydrogenase Deficiency in Military Recruits
Authors: David E. Uddin
Journal: JAMA (1974)

A survey was conducted to determine the incidence of erythrocyte glucose6-phosphate dehydrogenase (G6PD) deficiency in Navy and Marine Corps black, male recruits. The incidence of G6PD deficiency in 20,810 recruits was 12.6%. The incidence of G6PD deficiency in individuals with hemoglobin AS trait or hemoglobin AC trait was the same as the incidence in persons with hemoglobin A. Automated testing of large numbers of persons for G6PD deficiency is technically feasible.
Massive genomic variation and strong selection in Arabidopsis thaliana lines from Sweden
Authors: Quan Long, Fernando A Rabanal, Dazhe Meng, Christian D Huber, Ashley Farlow, Alexander Platzer, Qingrun Zhang, Bjarni J Vilhjálmsson, Arthur Korte, Viktoria Nizhynska, Viktor Voronin, Pamela Korte, Laura Sedman, Terezie Mandáková, Martin A Lysak, Ümit Seren, Ines Hellmann, Magnus Nordborg
Journal: Nature Genetics (2013)
Allo-HLA reactivity of virus-specific memory T cells is common
Authors: Avital L. Amir, Lloyd J. A. D'Orsogna, Dave L. Roelen, Marleen M. van Loenen, Renate S. Hagedoorn, Renate de Boer, Menno A. W. G. van der Hoorn, Michel G. D. Kester, Ilias I. N. Doxiadis, J. H. Frederik Falkenburg, Frans H. J. Claas, Mirjam H. M. Heemskerk
Journal: Blood (2010)
Using ‘number needed to treat’ to help conceptualize the magnitude of benefit and risk of tumour necrosis factor-α inhibitors for patients with severe psoriasis
Authors: J.W. Dharamsi, M. Bhosle, R. Balkrishnan, B.A. Yentzer, S.R. Feldman
Journal: British Journal of Dermatology (2009)

Risks and benefits of tumour necrosis factor (TNF) alpha inhibitors are often presented using statistical descriptions that are difficult to translate directly for patients into a clinically meaningful context.To illustrate the risks and benefits of TNFalpha inhibitors in relation to risks that patients understand.We performed a number needed to treat analysis for patients with psoriasis on TNFalpha inhibitors via a Medline and Embase search. We determined the number needed to benefit and the number needed to harm with TNFalpha inhibitor treatment. We compared the risk of serious adverse events from treatment with a TNFalpha inhibitor to the risk of death from driving a car. The risk analyses were limited to the risks of tuberculosis, lymphoma and demyelinating disease.The numbers needed to benefit were 2.1 for etanercept, 1.4 for infliximab, and 1.6 for adalimumab. Depending on the adverse event, the numbers needed to harm ranged from 380 to 360,000 treated patients per year. Screening prior to the initiation of TNFalpha inhibitor therapy reduces risk of tuberculosis. Patients are about as likely to die in a car accident as to have a serious adverse event from treatment with a TNFalpha inhibitor.All three of the TNFalpha antagonists have remarkable efficacy in patients with severe psoriasis. The risks of serious adverse events are relatively rare and comparable to the risks patients take on a regular basis such as driving a car. For many patients with severe psoriasis, the benefits of TNFalpha inhibitors may greatly outweigh the risks.
Effects of 5-hydroxytryptamine on the lower esophageal sphincter in vivo: evidence for multiple sites of action.
Authors: S Rattan, R K Goyal
Journal: Journal of Clinical Investigation (1977)

Intravenous administration of 5-hydroxytryptamine (5-HT) caused a dose-dependent contraction in the lower esophageal sphincter in the opossum. The smallest dose of 5-HT which caused a detectable contraction of the sphincter was 0.5 mug/kg, and a maximal sphincter contraction was produced by a dose of 40 mug/kg. Methysergide converted the contractile effect of 5-HT to a dose-dependent fall in the sphincter pressure; maximal inhibition of 77.2 +/- 7.2% of the resting pressure occurred with a dose of 40 mug/kg. The inhibitory effect of 5-HT was antagonized by tetrodotoxin, 5 MeO-DMT, and 5-HT tachyphylaxis. 5 MeO-DMT enhanced 5-HT-induced contraction of the sphincter. In the presence of 5 MeO-DMT and methysergide, 5-HT still caused a brief contraction of the sphincter; this contraction appeared to be due to stimulation of postganglionic cholinergic neurons as it was antagonized by tetrodotoxin or atropine. Reserpinization caused enhancement of the sphincter contraction by 5-HT. In the reserpinized animals in the presence of methysergide, 5-HT caused a small initial contraction followed by prolonged inhibition; atropine antagonized the initial contraction, while inhibition was antagonized by 5 MeO-DMT. These studies are consistent with the view that 5-HT exerts several different effects on the sphincter. 5-HT causes contraction of the sphincter by its direct action on the muscle and also by stimulation of cholinergic excitatory neurons. In addition, 5-HT inhibits the sphincter by stimulation of nonadrenergic inhibitory neurons.
Prognostic utility of intact immunoglobulin Ig′κ/Ig′λ ratios in multiple myeloma patients
Authors: A Bradwell, S Harding, N Fourrier, C Mathiot, M Attal, P Moreau, J-L Harousseau, H Avet-Loiseau
Journal: Leukemia (2012)

To determine whether isotype matched immunoglobulin (Ig; Ig'κ/Ig'λ) ratios had prognostic significance in patients with intact Ig multiple myeloma (MM). Novel immunoassays measuring serum concentrations of the Ig heavy chain/light chain (HLC) subsets IgGκ, IgGλ, IgAκ and IgAλ were compared with monoclonal protein ('M-spike') quantification by serum protein electrophoresis, β(2)-microglobulin (β(2)-M), albumin, serum free light chain (FLC) and cytogenetic markers in relation to outcome in 339 MM patients. Abnormal IgGκ/IgGλ and IgAκ/IgAλ ratios present in the respective tumor isotypes at clinical presentation were predictive of shorter progression-free survival (PFS) (hazard ratio (HR) 1.9; P=0.0002), predominantly due to the suppression of the uninvolved (polyclonal) Ig of the same isotype as the tumor (HR 1.8; P=0.002). No significant associations were observed between PFS and M-spike concentrations, suppression of non-tumor Igs of different isotypes or FLC κ/λ ratios. β(2)-M and HLC ratios were independently prognostic (P=0.045 and P=0.001). A staging system using β(2)-M and extreme HLC ratios (<0.01 or >200) had greater prognostic value than the widely used ISS staging system (HR 1.7; P=0.00002 vs HR 1.3; P=0.017). These results suggest that HLC ratios may have a role in clinical management of MM.
Breaking Olympic records
Authors: E A Newsholme
Journal: BMJ (1996)

Reading the records of the 19th century may be a pleasant pastime for today's athletes; if a hundred years ago you could have run, for example, 10 000 metres in 30 minutes, you would have been a world champion. Will athletes in another 100 years look back to present day records with the same envy? Plotting the running speeds of the record holders for 200 m, 1500 m, and the marathon (42.2 km) shows a linear increase with time from the early 1900s to today, with no evidence of an approach to a plateau.1 Indeed, Whipp and Ward have shown that women are currently improving at a faster rate than men.2 If this rate of improvement is maintained, there will come a time when the best women will beat the best men. The authors predict that this could occur around the year 2035 for most events, and much sooner in the marathon. However, …
Fluoride Therapy and The Thyroid Gland
Authors: Paul J. Davis
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The usefulness of high-dose oral sodium fluoride therapy in the treatment of various demineralizing disorders has been reported by a number of authors.<sup>1-4</sup>Fluoride, however, is known to be an antithyroid agent and has been used to treat hyperthyroidism.<sup>5</sup>Recently we have observed a patient with multiple myeloma whose clinical deterioration during fluoride administration may be attributed to the development of hypothyroidism. Thyroid replacement therapy has resulted in significant clinical improvement. <h3>Report of a Case:—</h3> A 59-year-old housewife was followed up in the clinics of the Bronx Municipal Hospital Center. The diagnosis of multiple myeloma had been made elsewhere five years ago (1961). Severe low back pain was noted initially in 1963, and was treated with radiotherapy and urethane. The patient was first seen here in 1964 when β-myeloma was confirmed and roentgenograms of the skull and spine revealed osteolytic lesions and collapse of several
NEW TWO COMPARTMENT VACUUM AMPULE
Authors: Arthur E. Smith
Journal: JAMA (1926)

The purpose of this two compartment vacuum ampule is to provide means by which fresh sterile intravenous solutions can be accurately and quickly prepared for injection. It is of value for maintaining and preparing arsphenamine, neoarsphenamine and solution of procaine hydrochloride and epinephrine hydrochloride in Ringer's solution. However, it can be employed for other drugs for intravenous or endermic injection. The advantages of this ampule are as follows: 1. In one compartment the drug is hermetically sealed in a vacuum which maintains its medicinal activity indefinitely. 2. The other compartment contains an accurate amount of sterile distilled water. 3. The drug and the vehicle are hermetically separated by an easily fractured wall. 4. At the time of use, the wall between the two compartments is fractured. This breaks the vacuum, and the vacuum draws the vehicle into the drug compartment. 5. A fresh sterile solution of known medicinal value
Intravenous adenosine suppresses cardiac release of endothelin after myocardial ischaemia and reperfusion
Authors: C. E Velasco, E. K Jackson, J. A Morrow, J. V Vitola, T. Inagami, M. B Forman
Journal: Cardiovascular Research (1993)

Intravenous adenosine decreases infarct size in experimental models of myocardial ischaemia/reperfusion. Ischaemia/reperfusion is associated with a significant increase in cardiac release of endothelin. The effect of cardioprotective doses of adenosine on endothelin release was explored in dogs undergoing 90 min coronary occlusion and 210 min reperfusion.Dogs were assigned to intravenous adenosine in a dose of 0.15 mg.kg-1.min-1 (n = 12) or control (n = 11) during the first 150 min reperfusion. Serial endothelin levels were obtained from the coronary sinus and aortic blood and measured by radioimmunoassay.Adenosine significantly reduced infarct size expressed as a percent of the risk region (28.8 6% v 14.4 2%; p = 0.03). A similar increase in aortic and coronary sinus blood endothelin was observed in both groups during temporary occlusion. A significant transcardiac increase in endothelin levels was present in the control group 60 min after reperfusion whereas no increase occurred in the adenosine treated group [control 5.6(SEM 1.9) v adenosine -0.2(1.4) pg.ml-1; p = 0.02]. Similarly, intravenous adenosine tended to prevent the increase in myocardial endothelin production seen in control animals during the early reperfusion period [control 280(146) v adenosine -57(55) pg.min-1; p = 0.05]. Endocardial blood flow in the ischaemic zone 210 min after reperfusion was significantly higher in the adenosine group, at 0.60(0.02) v 0.38(0.02) ml.min-1.g-1; p < 0.05. A significant correlation between endothelin levels, endocardial flow and infarct size was observed in the control group 3 h after reperfusion: r = 0.73, p = 0.02; r = 0.62, p = 0.03 respectively. This relationship was absent in animals treated with adenosine.Intravenous adenosine suppresses the release of endothelin from the previously ischaemic myocardium during the early reperfusion period. This effect may in part contribute to the improvement by adenosine in postischaemic microcirculatory flow resulting in attenuation of the "no reflow" phenomenon.
The Child and Television Drama: The Psychosocial Impact of Cumulative Viewing
Authors: Edward W. Collins
Journal: JAMA (1984)

Written as a cooperative effort by the Committee on Social Issues of the Group for the Advancement of Psychiatry, this short, 124-page, paperback volume tells the tale that once again people, and children in particular, seem to have to struggle with self-wrought illness. But this time instead of the rather familiar threats of pollution, overpopulation, and nuclear holocaust, the threat is from our most pervasive medium and frequent nonhuman companion—television. Were it not for the ubiquitousness of television and the heavy loading of one-way drama and violence on the screen, this volume focusing on the impact of television on children might only be an intellectual point of discussion. However, 98% of homes have at least one television set that runs an average of seven hours a day and by the age of 18 years, the average American child has viewed 20,000 hours of television, 13,000 killings, and at least 350,000