tbuckley/cabot-search huggingface dataset:
Influence of Racial Disparities in Procedure Use on Functional Status Outcomes Among Patients With Coronary Artery Disease
Authors: Padma Kaul, Barbara L. Lytle, John A. Spertus, Elizabeth R. DeLong, Eric D. Peterson
Journal: Circulation (2005)

Background— Although black cardiac patients receive fewer revascularization procedures than whites, it is unclear whether this has a detrimental impact on outcomes. The objective of our study was to compare 6-month functional status and angina outcomes among blacks and whites with documented coronary disease and to assess whether differential use of revascularization procedures affects these outcomes. Methods and Results— We identified a prospective cohort of 1534 white and 337 black patients undergoing cardiac catheterization between August 1998 and April 2001. Health status was assessed at baseline and 6 months with the Short-Form 36 (SF-36) Health Survey and the Seattle Angina Questionnaire (SAQ) Angina Frequency Scale. Compared with whites, blacks received fewer coronary revascularization procedures (52.5% versus 66.0%; P &lt;0.01). By 6 months, blacks had similar mortality (odds ratio, 1.03; 95% CI, 0.57 to 1.9) but worse scores in 5 SF-36 domains (physical, social, role physical, role emotional, and mental health function). Blacks also reported higher rates of angina at 6 months than whites (34.2% versus 24.6%; P &lt;0.01). After adjustment for baseline functional status and clinical and demographic variables, blacks had significantly worse summary physical component scores, summary mental component scores, and SAQ Angina Frequency Scale scores. However, differences in physical component summary scores and SAQ scores between blacks and whites were no longer significant after adjustment for revascularization status. Conclusions— Our study is among the first to document greater symptoms and functional impairment among black cardiac patients relative to whites. Differential use of coronary revascularization may contribute to the poorer functional outcomes observed among black patients with documented coronary disease.
Blood Lipid and Uric Acid Interrelationships
Authors: Donald Berkowitz
Journal: JAMA (1964)

ADEQUATE EVIDENCE is available to indicate a relationship between uric acid and lipid metabolism. Previous studies, however, have been confined to correlations between uricemia and the blood cholesterol in patients with gout or chronic hypercholesterolemia, or in other conditions where there may be an acute hyperlipidemia such as in diabetic acidosis. Preliminary findings suggesting a more precise association between the uric-acid levels and the blood triglycerides rather than the cholesterol, prompted us to investigate this more closely. <h3>Material and Methods</h3> The patients selected for study were being followed in a metabolic clinic of a large union health center and were all actively employed at various trades in the male apparel industry. They were mainly of Jewish or Italian extraction of the same socioeconomic levels, and equally divided between males and females. Their ages varied from 35 to 65 years. No patient was grossly overweight. Numerous blood-lipid determinations had been made
One Cold Beer
Authors: Elizabeth Nolan
Journal: JAMA (1986)

Marie was a vivacious blond-haired, blue-eyed, 63-year-old woman. With her 70-year-old husband of 42 years, she worked hard to advance to a middle-class life-style. She had always been busily engaged in living, attested to by her starting college classes at age 60. The diagnosis of sideroblastic anemia was also made at that time. It did not change her life-style, except to add the required transfusions to an already busy schedule. When I first met Marie, I was a medical subintern picking up my next patient in the emergency department. Her family's chief complaint was that she was falling asleep all the time: Marie fell asleep in the middle of conversation, at the dining room table, and, tonight, while playing cards. Marie couldn't confirm or deny this because she was sleeping. An extensive workup with numerous consultants at the university hospital revealed that Marie had hemochromatosis—the iron deposits from her frequent
THE SURGICAL CLINICS OF SWITZERLAND
Authors: H. S. Souttar
Journal: BMJ (1923)

Despite a marked increase in research supporting the assessment, diagnosis and treatment of personality disorder (PD) in adolescence, clinicians continue to be reluctant to apply treatment guidelines and psychiatric nomenclature in routine clinical care. This gap arises from several beliefs: (1) psychiatric nomenclature does not allow the diagnosis of PD in adolescence; (2) certain features of PD are normative and not particularly symptomatic of personality disturbance; (3) the symptoms of PD are better explained by other psychiatric syndromes; (4) adolescents9 personalities are still developing and therefore too unstable to warrant a PD diagnosis; and (5) because PD is long-lasting, treatment-resistant and unpopular to treat, it would be stigmatising to label an adolescent with borderline personality disorder (BPD). In this paper, the empirical evidence challenging each of these beliefs is evaluated in the hope of providing a balanced review of the validity of adolescent PD with a specific focus on BPD. The paper concludes with recommendations on how routine clinical care can integrate a PD focus.
Letter: Dietary fibre hypothesis.
Authors: H C Trowell
Journal: BMJ (1975)

Nutrition rehabilitation: numbers of children4 Nutritional status (weight for age) Admission Discharge Follow-up Adequately nourished (>80",, Harvard mean) 0 1 (1,) 1 (10,) I malnutrition (71-80",, Harvard mean) 4* (3"<,) 10 (7,) 34 (24",,) II malnutrition (61-70", Harvard mean) 20* (14',) 45t (32,) 60 (43",,) III' malnutrition (<61",, Harvard mean) 116 (83",,) 84t (60",,) 45 (32",) Total 140 140 140 *With oedema.tWithout oedema.essential in the management of protein energy malnutrition.Some form of nutrition rehabilitation can provide this, but modifica- tions are necessary in different areas and controlled prospective evaluation would clarify the real benefits.
BUMPH in pathology has increased exponentially with move to trust status
Authors: M J Galloway
Journal: BMJ (1996)

EDITOR,—Damian Kenny has highlighted the problem of the bureaucratic unsolicited mountainous paper heap (BUMPH) in general practice.1 This phenomenon has also been observed in hospitals. In my directorate of pathology all management paper received by the clinical director has been filed with the minutes of the monthly meetings since the directorate was established in 1989. I have analysed, retrospectively, the number of pages of BUMPH …
660 LONGITUDINAL EVALUATION OF HEPATITIS B, C AND/OR D VIREMIA IN HIV-HBV CO-INFECTED PATIENTS: VIROLOGICAL INTERACTIONS AND EFFECTS OF TREATMENT
Authors: A. Boyd, K. Lacombe, L. Serfaty, P. Miailhes, J. Gozlan, P. Bonnard, J.M. Molina, C. Lascoux-Combe, M. Desvarieux, P.M. Girard
Journal: Journal of Hepatology (2008)
TCT-5 Relationship Between High Platelet Reactivity on Clopidogrel and Outcomes After DES Implantation: Two-Year Results From the ADAPT-DES Study
Authors: Thomas Stuckey, Ajay J. Kirtane, Bruce R. Brodie, Bernhard Witzenbichler, Giora Weisz, Michael J. Rinaldi, Franz-Josef Neumann, Ivan J. Chavez, D. Christopher Metzger, Timothy D. Henry, David Cox, Peter L. Duffy, Ernest L. Mazzaferri, Roxana Mehran, Alejandra Guerchicoff, Helen Parise, Gregg Stone
Journal: Journal of the American College of Cardiology (2013)
T Rosettes in Alcoholic Cirrhosis of the Liver
Authors: Magdalena R. Berenyi
Journal: JAMA (1975)

Thirty patients with alcoholic cirrhosis of the liver were studied for in vivo and in vitro correlates of cellular immunity. Seventy-seven percent failed to be sensitized to dinitrochlorobenzene, indicating impairment of the in vivo cellular immune response. A significant decrease in the number of T-rosette-forming cells was observed in this group of patients (.01 smaller than P smaller than .025). This finding suggests that the active T-rosette test is a valuable tool in detecting partial alterations in cell-mediated immunity in alcoholic cirrhosis of the liver. Our results also suggest that rosette formation is a more sensitive indicator of cell-mediated immunity than phytohemagglutinin-stimulated blastogenesis in patients with alcoholic cirrhosis of the liver.
Two Different Kinds of Psychotherapy of Short Duration
Authors: PETER E. SIFNEOS
Journal: American Journal of Psychiatry (1967)

The author presents a conceptual framework for two different kinds of psychotherapy of short duration, which he calls the anxiety-provoking and the anxiety-suppressive types. Criteria for the selection of patients and the techniques used in each type are described, and follow-up findings from the Massachusetts General Hospital are summarized.
Terbinafine in fungal infections of the nails: a meta-analysis of randomized clinical trials
Authors: M. Haugh, S. Helou, J.P. Boissel, B.J. Cribier
Journal: British Journal of Dermatology (2002)

Summary Background Historically, there has been a general resistance to treating onychomycosis on the basis that such treatments were protracted and of uncertain outcome. However, modern treatments act more promptly and reliably. Objectives To carry out a meta‐analysis to evaluate the efficacy and safety of terbinafine in comparison with placebo, itraconazole and griseofulvin. Methods The analysis used data from published trials, supplemented where necessary by reference to the original trial reports. Results Three trials were included in which terbinafine was compared with placebo. From four trials comparing terbinafine with itraconazole, a statistically significant advantage in favour of terbinafine was observed for negative culture and microscopy at the end of the trials. Furthermore, both patients and physicians reported terbinafine to be better tolerated than itraconazole. From two trials comparing terbinafine with griseofulvin, a significantly higher rate of negative microscopy and culture was observed with terbinafine. Conclusions A significant advantage in favour of treatment with terbinafine was observed.
Commentary: daily care of aged skin
Authors: P.G. Calzavara-Pinton
Journal: British Journal of Dermatology (2013)

Journal Article Commentary: daily care of aged skin Get access P.G. Calzavara‐Pinton P.G. Calzavara‐Pinton Department of Dermatology University of Brescia Brescia Italy Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 169, Issue 3, 1 September 2013, Page 491, https://doi.org/10.1111/bjd.12538 Published: 01 September 2013
Academic medicine has pitfalls for junior researchers
Authors: Matthew Ridd, Clare Emmett, Rachel Hardwick, Sinead Wright
Journal: BMJ (2004)

Governance of academic medicine should be with public trusteesEditor-Many of the problems arising in academic medicine are due to the divergence of academic goals and the values of society.Academic institutions are not currently governed in a way that fosters a strong and healthy alliance with government and the population at large, and there is a failure to support satisfactorily the public interest against vested and other competing interests. 1e suggest that a good first step is to turn over the governance of academic medicine to public trustees with protected authority.Public trustees must ensure that the three familiar goals of research, teaching, and patient care are supplemented by the unsung fourth goal of community service.Moreover, trustees have the right to insist that most of the research and teaching programmes in academic medicine be placed in the context of the health needs of the entire population.It is also time to reform the governance of medical schools.We suggest that it fosters tunnel vision for the dean when the executive committee of the medical school is composed primarily of department chairpeople whose main responsibility is the welfare of individual departments, not the mission of the school as a whole.We advocate instead an executive committee comprising senior faculty and public representatives, while excluding department heads.If academic medicine exists to promote the public interest, is it not time to grant patients and the public at large a controlling interest in setting priorities and overseeing operations?
MALFORMATION OF THE VAGINA OBSTRUCTING LABOR
Authors: Louis E. Phaneuf
Journal: JAMA (1925)

Malformations of the vagina obstructing labor are of such rare occurrence that this case has been deemed of sufficient interest to warrant recording. <h3>REPORT OF CASE</h3><h3>History.</h3> —Mrs. E. W., aged 33, a primipara, seen at the Copp Hospital, Sept. 4, 1923, had been in labor five hours. Her father had died of pneumonia; her mother, two brothers and two sisters were living and well, and there were no chronic diseases in the family. She had had measles and pertussis in infancy; otherwise her health had been good. She began to menstruate at the age of 13; the periods were regular, of the twenty-eight day type, and lasted four days; there was no pain; she passed no clots, and her last period had occurred Nov. 26, 1922, making her confinement expected for Sept. 2, 1923. The patient had been married three years, and this was her first pregnancy. <h3>Examination.</h3> —The
Mating strategies as game theory: Changing rules?
Authors: Linda Mealey
Journal: Behavioral and Brain Sciences (2000)

Human behavior can be analyzed using game theory models. Complex games may involve different rules for different players and may allow players to change identity (and therefore, rules) according to complex contingencies. From this perspective, mating behaviors can be viewed as strategic “plays” in a complex “mating game,” with players varying tactics in response to changes in the game's payoff matrix.
Frequency and Clinical Description of High-Cost Patients in 17 Acute-Care Hospitals
Authors: Steven A. Schroeder, Jonathan A. Showstack, H. Edith Roberts
Journal: New England Journal of Medicine (1979)

Abstract To assess the potential impact of national "catastrophic" health insurance on the medical-care system, the frequency and clinical characteristics of high-cost patients were surveyed at 17 acute-care hospitals in the San Francisco Bay Area. The percentage of patients whose yearly hospital charges exceeded $4000 in 1976 ranged from 4 at a community hospital to 24 at a referral hospital. Hospital costs charged to these patients ranged from 20 to 68 per cent of total billings, with the highest percentages generally occurring at large referral hospitals. Forty-seven per cent of adult high-cost patients had chronic medical conditions, and only one in six suffered from an acute medical "catastrophe." In addition, more than 13 per cent of high-cost patients died in the hospital. National catastrophic health insurance is likely to pay for much chronic illness and terminal care and divert resources toward acute-care hospitals. (N Engl J Med 300:1306–1309, 1979)
A STUDY OF TUBERCULOSIS AMONG STUDENTS OF NURSING
Authors: HAROLD L. ISRAEL
Journal: JAMA (1941)

A program for the early detection of pulmonary tuberculosis among students of nursing was instituted at the Philadelphia General Hospital in 1935. The present report deals chiefly with information which was obtained concerning the epidemiology of tuberculosis among students of nursing in a large general hospital.  The intracutaneous tuberculin test and roentgen examination were given to each student on admission to the training school. The students who failed to react to tuberculin on admission were retested every four months until a positive reaction was observed. Fluoroscopic examination of all positive reactors was made at four month intervals and roentgen examination was made if a lesion was suspected or demonstrated by use of the fluoroscope. In recent years it has proved more satisfactory to examine all students by means of the fluoroscope because the number whose reactions remained negative to tuberculin was small. In addition, film examination was made whenever respiratory
Type 1 Diabetes and Autism: Is there a link?
Authors: Valma Harjutsalo, Jaakko Tuomilehto
Journal: Diabetes Care (2006)

In a recent issue of Diabetes Care , Freeman et al. (1) discussed a possible link between type 1 diabetes and autism spectrum disorder (ASD). Their data suggested that the prevalence of ASD in nearly 1,000 children with type 1 diabetes may be greater than that in the general population.

We investigated the presence of ASD in 5,178 children diagnosed with type 1 diabetes at age ≤14 years from the Prospective Childhood Diabetes Registry of Finland. Children with type 1 diabetes were born between 1980 and 2000. The data were linked to the nationwide Hospital Discharge Register (HDR) …
Biopersistence of inhaled organic and inorganic fibers in the lungs of rats.
Authors: D B Warheit, M A Hartsky, T A McHugh, K A Kellar
Journal: Environmental Health Perspectives (1994)

Fiber dimension and durability are recognized as important features in influencing the development of pulmonary carcinogenic and fibrogenic effects. Using a short-term inhalation bioassay, we have studied pulmonary deposition and clearance patterns and evaluated and compared the pulmonary toxicity of two previously tested reference materials, an inhaled organic fiber, Kevlar para-aramid fibrils, and an inorganic fiber, wollastonite. Rats were exposed for 5 days to aerosols of Kevlar fibrils (900-1344 f/cc; 9-11 mg/m3) or wollastonite fibers (800 f/cc; 115 mg/m3). The lungs of exposed rats were digested to quantify dose, fiber dimensional changes over time, and clearance kinetics. The results showed that inhaled wollastonite fibers were cleared rapidly with a retention half-time of < 1 week. Mean fiber lengths decreased from 11 microns to 6 microns over a 1-month period, and fiber diameters increased from 0.5 micron to 1.0 micron in the same time. Fiber clearance studies with Kevlar showed a transient increase in the numbers of retained fibrils at 1 week postexposure, with rapid clearance of fibers thereafter, and retention half-time of 30 days. A progressive decrease in the mean lengths from 12.5 microns to 7.5 microns and mean diameters from 0.33 micron to 0.23 micron was recorded 6 months after exposure to inhaled Kevlar fibrils. The percentages of fibers > 15 microns in length decreased from 30% immediately after exposure to 5% after 6 months; the percentages of fibers in the 4 to 7 microns range increased from 25 to 55% in the same period.(ABSTRACT TRUNCATED AT 250 WORDS)
Measurement of exhaled nitric oxide by three different techniques.
Authors: R A Robbins, A A Floreani, S G Von Essen, J H Sisson, G E Hill, I Rubinstein, R G Townley
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The purpose of the study was to compare exhaled nitric oxide (NO) determined by three techniques. Ninety-one subjects performed a slow vital capacity maneuver: (1) through the mouth directly into a NO chemiluminescence analyzer (peak oral NO), (2) through the mouth into a collection bag (mean oral NO), and (3) through the nose into a collection bag (mean nasal NO). Peak oral NO was higher in patients with asthma (n = 18, 174.2 +/- 27.0 ppb), but lower in smokers (n = 36, 39.6 +/- 4.8 ppb) compared with nonsmoking control subjects (n = 23, 105.5 +/- 8.4 ppb, p < 0.05 both comparisons). Mean oral NO levels were significantly lower than peak oral NO levels (p < 0.05), but still higher in patients with asthma in comparison with nonsmoking healthy control subjects and asymptomatic smokers (27.2 +/- 3.5 versus 14.5 +/- 1.1 and 7.3 +/- 0.7 ppb, respectively, p < 0.05). In contrast, there was no significant difference in mean nasal NO levels between the three groups. Peak oral NO and mean oral NO levels correlated (r = 0.772, p < 0.0001). Determination of exhaled oral NO levels is qualitatively independent of the technique used, but nasal exhalation may affect NO determination in conditions associated with airway inflammation.
Pressure-Flow Studies in Man During the Valsalva Maneuver with Observations on the Mechanical Properties of the Ascending Aorta
Authors: JOSEPH C. GREENFIELD, RONNIE L. COX, RAFAEL R. HERNANDEZ, CORINNA THOMAS, FRED W. SCHOONMAKER
Journal: Circulation (1967)

The pressure-gradient technique was used to obtain continuous measurements of both blood pressure and flow in the ascending aorta of eight normal subjects who were performing a standardized Valsalva maneuver. From these recordings the beat-to-beat changes in stroke volume, peak blood flow, peripheral vascular resistance, duration of ejection, and an index of total systolic duration were calculated. Stroke volume and peak blood flow were not changed with the onset of straining (phase I), but were decreased to approximately 50% of control values immediately prior to release (phase II). During the overshoot period (phase IV) stroke volume and peak flow were increased above control levels. Both the duration of ejection and the duration of systole were shortened during straining (phase II). The concomitant changes in blood pressure in these subjects were similar to previously reported pressure recordings. An estimate of the pressure-radius relationships in the ascending aorta of these patients was obtained angiographically. The mean cross-sectional area of the ascending aorta changed by 17% during the Valsalva maneuver.
Jerome Van Crowningshield Smith
Authors: Joseph Garland
Journal: New England Journal of Medicine (1970)

WHEN Jerome V. C. Smith came to Boston in 1822, he arrived just as John Phillips, Boston's first mayor, was about to be sworn into office at Faneuil Hall. On learning that the excitement had something to do with what he supposed was a female horse, Smith drifted along with the crowd and observed the ceremony. According to the Memorial History of Boston, "He had a presentiment that he should some day be a central figure of such an exhibition, and he shaped his course accordingly."The son of a physician, Smith was born in Conway, New Hampshire, on July . . .
Advice on withholding food and water breaks the law, group claims
Authors: Z. Kmietowicz
Journal: BMJ (2003)

A doctors group is calling for a new law to protect patients who are not dying but who are being denied food and fluids, which they say is common practice and illegal.

An advertisement in this week's BMJ that is funded by the Doctors who Respect Human Life campaign, claims that current General Medical Council's guidance allows doctors to let patients die by withholding artificial feeding and hydration even though they may not be …
Virus-induced hepatocellular carcinomas cause antigen-specific local tolerance
Authors: Gerald Willimsky, Karin Schmidt, Christoph Loddenkemper, Johanna Gellermann, Thomas Blankenstein
Journal: Journal of Clinical Investigation (2013)

T cell surveillance is often effective against virus-associated tumors because of their high immunogenicity. It is not clear why surveillance occasionally fails, particularly against hepatitis B virus– or hepatitis C virus–associated hepatocellular carcinoma (HCC). We established a transgenic murine model of virus-induced HCC by hepatocyte-specific adenovirus-induced activation of the oncogenic SV40 large T antigen (TAg). Adenovirus infection induced cytotoxic T lymphocytes (CTLs) targeted against the virus and TAg, leading to clearance of the infected cells. Despite the presence of functional, antigen-specific T cells, a few virus-infected cells escaped immune clearance and progressed to HCC. These cells expressed TAg at levels similar to HCC isolated from neonatal TAg-tolerant mice, suggesting that CTL clearance does not select for cells with low immunogenicity. Virus-infected mice revealed significantly greater T cell infiltration in early-stage HCC compared with that in late-stage HCC, demonstrating progressive local immune suppression through inefficient T cell infiltration. Programmed cell death protein-1 (PD-1) and its ligand PD-L1 were expressed in all TAg-specific CD8+ T cells and HCC, respectively, which contributed to local tumor-antigen-specific tolerance. Thus, we have developed a model of virus-induced HCC that may allow for a better understanding of human HCC.