tbuckley/cabot-search huggingface dataset:
The Legalization of Physician-Assisted Suicide
Authors: David Orentlicher
Journal: New England Journal of Medicine (1996)

With the enactment of an Oregon statute permitting physician-assisted suicide,1,2 the recognition of a constitutional right to assisted suicide by two U.S. courts of appeals,3,4 discussed elsewhere in this issue of the Journal, 5 and the acquittals of Dr. Jack Kevorkian,6,7 there appears to be a dramatic shift in right-to-die law. Although the law previously distinguished between the withdrawal of life-sustaining treatment and assisted suicide, these recent events suggest that the distinction is being abandoned and that the law is undergoing a profound change.I will argue here that this interpretation is mistaken. Instead of a shift in . . .
Diagnosis and Prognosis of Mitral-Valve Prolapse
Authors: Richard B. Devereux
Journal: New England Journal of Medicine (1989)

Mitral-valve prolapse is one of the most prevalent cardiac conditions and one of the most controversial: uncertainty persists about how it should be diagnosed and about its clinical importance. Historically, mitral-valve prolapse was first recognized by auscultation of midsystolic clicks and late systolic murmurs, and its presence is still usually suggested by auscultatory findings. However, the recognition of the variability of the auscultatory findings1 and of the high level of skill needed to perform such an examination has prompted a search for reliable laboratory methods of diagnosis. M-mode echocardiography and two-dimensional echocardiography have played an increasingly important part in the . . .
A Two-Step Strategy for Identification of High-Risk Subjects for a Clinical Trial of Prevention of NIDDM
Authors: K M Venkat Narayan, Robert L Hanson, David J Pettitt, Peter H Bennett, William C Knowler
Journal: Diabetes Care (1996)

OBJECTIVE To evaluate 2-h plasma glucose (2HPG), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1), a combination of FPG and HbA1 (FPG-HbA1), and other factors as screening tests for identifying high-risk subjects for a clinical trial of prevention of NIDDM and to identify strategies to minimize the total number of oral glucose tolerance tests (OGTTs) required to recruit eligible subjects to the trial. RESEARCH DESIGN AND METHODS One thousand, one hundred and eight nondiabetic Pima Indians aged 25–64 years were followed for up to 5 years, and factors predicting NIDDM, defined by World Health Organization criteria (2HPG ≥ 11.1 mmol/l), were assessed using Cox's proportional hazards analysis. Various threshold values of FPG, HbA1, and FPG-HbA1 were determined, which, when combined with an OGTT, identified subjects with impaired glucose tolerance (IGT) (2HPG ≥ 7.8 and &amp;lt; 11.1 mmol/l) at a number of specified risks for developing NIDDM in 5 years. The value of each of the three tests was then assessed by calculating (for each threshold) the numbers to be screened, the numbers requiring an OGTT, and the sample size of IGT subjects needed to detect a 33% reduction in NIDDM by an experimental intervention at a power of 80%. RESULTS During a median of 4.3 years of follow-up, 91 (8.2%) of the 1.108 nondiabetic subjects developed NIDDM. The estimated 5-year cumulative incidence rate was 13.5%. Each of the variables, 2HPG, FPG, HbA1, FPG-HbA1, BMI, IGT, and systolic (sBP), diastolic (dBP), and mean (MBP) blood pressures, predicted NIDDM (P &amp;lt; 0.05 for each) when controlled for age and sex. In a stepwise proportional hazards analysis model, 2HPG and FPG-HbA1 (P &amp;lt; 0.001 for each) were selected as the best set of predictors of NIDDM and of fasting hyperglycemia (FPG ≥ 7.8 mmol/l). CONCLUSIONS A two-step strategy, in which high-risk individuals are first identified by FPG or FPG-HbA1 and then the OGTT is used to select subjects with IGT, requires fewer OGTTs than when using 2HPG as the initial screening test without substantially increasing the numbers that would need to be screened. Such a strategy also offers the advantage of reducing the necessary sample size and is therefore an effective, efficient, and convenient method of identifying eligible subjects for a clinical trial of prevention of NIDDM.
Global Gene Expression Profiling of a Population Exposed to a Range of Benzene Levels
Authors: Cliona M. McHale, Luoping Zhang, Qing Lan, Roel Vermeulen, Guilan Li, Alan E. Hubbard, Kristin E. Porter, Reuben Thomas, Christopher J. Portier, Min Shen, Stephen M. Rappaport, Songnian Yin, Martyn T. Smith, Nathaniel Rothman
Journal: Environmental Health Perspectives (2010)

Benzene, an established cause of acute myeloid leukemia (AML), may also cause one or more lymphoid malignancies in humans. Previously, we identified genes and pathways associated with exposure to high (> 10 ppm) levels of benzene through transcriptomic analyses of blood cells from a small number of occupationally exposed workers.
A Geospatial Analysis of the Effects of Aviation Gasoline on Childhood Blood Lead Levels
Authors: Marie Lynn Miranda, Rebecca Anthopolos, Douglas Hastings
Journal: Environmental Health Perspectives (2011)

Aviation gasoline, commonly referred to as avgas, is a leaded fuel used in small aircraft. Recent concern about the effects of lead emissions from planes has motivated the U.S. Environmental Protection to consider regulating leaded avgas.In this study we investigated the relationship between lead from avgas and blood lead levels in children living in six counties in North Carolina.We used geographic information systems to approximate areas surrounding airports in which lead from avgas may be present in elevated concentrations in air and may also be deposited to soil. We then used regression analysis to examine the relationship between residential proximity to airports and North Carolina blood lead surveillance data in children 9 months to 7 years of age while controlling for factors including age of housing, socioeconomic characteristics, and seasonality.Our results suggest that children living within 500 m of an airport at which planes use leaded avgas have higher blood lead levels than other children. This apparent effect of avgas on blood lead levels was evident also among children living within 1,000 m of airports. The estimated effect on blood lead levels exhibited a monotonically decreasing dose-response pattern, with the largest impact on children living within 500 m.We estimated a significant association between potential exposure to lead emissions from avgas and blood lead levels in children. Although the estimated increase was not especially large, the results of this study are nonetheless directly relevant to the policy debate surrounding the regulation of leaded avgas.
School-Based Intervention for the Treatment of Tsunami-Related Distress in Children: A Quasi-Randomized Controlled Trial
Authors: R. Berger, M. Gelkopf
Journal: Psychotherapy and Psychosomatics (2009)

&lt;i&gt;Background:&lt;/i&gt; On December 26, 2004, a tsunami hit the southern coast of Sri Lanka, leaving thousands dead and injured. Previous research has found significant mental health problems among children exposed to major disasters. School-based universal interventions have shown promise in alleviating distress and posttraumatic symptomatology in children and adolescents. This study evaluated the efficacy of a school-based intervention in reducing stress-related symptomatology among Sri Lankan children exposed to the tsunami. &lt;i&gt;Methods:&lt;/i&gt; In a quasi-randomized controlled trial 166 elementary school students (ages 9–15) with significant levels of tsunami exposure and previous traumatic background were randomly assigned to a 12-session structured program ‘ERASE Stress Sri Lanka’ (ES-SL) or to a waiting list (WL) religious class control group. Students were assessed 1 week prior and 3 months after the intervention on measures of posttraumatic symptomatology [including posttraumatic stress disorder (PTSD) and severity of posttraumatic symptomatology], depression, functional problems, somatic problems and hope. &lt;i&gt;Results:&lt;/i&gt; This study shows a significant reduction on all outcome variables. PTSD severity, functional problems, somatic complaints, depression and hope scores were all significantly improved in the ES-SL group compared to the WL group. No new cases of PTSD were observed in the experimental group. &lt;i&gt;Conclusion:&lt;/i&gt; This study adds to the growing body of evidence suggesting the efficacy of school-based universal approaches in helping children in regions touched by war, terror and disaster and suggests the need to adopt a two-stage approach toward dealing with trauma-exposed students, namely, starting with a universal intervention followed by targeted specialized interventions for those still suffering from posttraumatic distress.
Thymic stromal lymphopoietin induction by polyinosinic:polycytidylic acid in human keratinocytes is preferentially mediated through protein kinase R and retinoid-inducible gene I and not Toll-like receptor 3
Authors: Bettina Seidl, Behnam Kalali, Markus Gerhard, Johannes Ring, Markus Ollert, Martin Mempel
Journal: Journal of Allergy and Clinical Immunology (2009)
Minimum information needed by prescribers
Authors: F. Schneiweiss
Journal: BMJ (1978)

tricyclic and, if that should fail, of an MAO inhibitor.I have been impressed with the good response of about half of these very severely affected patients to such therapy.Elithorn' stated that migraine is "undeniably a hunting-ground for the drug-happy physician."This, of course, is true, but such a statement should not deter efforts to find an effective treatment for this distressing and persistent disorder.
Wernicke's encephalopathy. Complication of intravenous hyperalimentation
Authors: J. Kramer
Journal: JAMA (1977)

ONE of the most dramatic presentations in clinical medicine is the syndrome of Wernicke's encephalopathy. Although the classic triad of confusion, ophthalmoplegia, and ataxia has been described in nonalcoholic patients with various gastrointestinal disorders and subsequent malnutrition, the recent literature would suggest that these cases are now rare. The diagnosis can be easily overlooked when the patient is in a group not usually suspected to develop the disorder. Such oversight can leave the patient with permanent and devastating neurologic deficits that might otherwise have been avoided by timely specific treatment. In a middle-aged, nonalcoholic woman, Wernicke's encephalopathy followed intravenous hyperalimentation without concomitant vitamin therapy. <h3>Report of a Case</h3> A 63-year-old woman was in good health until June 3, 1976, when she was admitted to another hospital after falling from a ladder. She was noted to be confused on admission and skull and spine roentgenograms disclosed a small basilar skull fracture
A NEW OPERATION FOR THE RADICAL CURE OF HEMORRHOIDS.
Authors: N. H. HENDERSON
Journal: JAMA (1895)

had unadvisedly used the term, blister.The can- tharides plaster was carefully tested before being used.The chief value of the present case lies in its control experiments.The patient, while obviously in a condition extremely susceptible to suggestion, at no time was in the true hypnotic state.These cases and those in which bleeding occurs at written points in dermographic subjects, explain the cases of stigmatization which from time to time appear in religious communities and of which the latest case was reported by Dr. M. F. Cooney as hav- ing occurred in Kentucky.In many of these cases the influence of suggestion is evident, from the fact that the side wound of Christ occurred on the right side in lieu of the left, because of the ignorance of the stigmatized subject.
CT Scanning and Subdural Empyema
Authors: Daniel Remmler
Journal: JAMA (1982)

<h3>To the Editor.—</h3> We would like to submit our experience concerning the failure of computed tomographic (CT) scanning to detect subdural empyema in corroboration of the recently reported observations of Ralph O. Dunker, MD, and Rashida Khakoo, MD (1981;246:1116). In their article they described two patients who had subdural empyemas rapidly develop as a consequence of fulminant sinusitis. Although the clinical course in these patients strongly suggested an infectious, space-occupying lesion, CT scans remained nondiagnostic. Our recently reported experience, which studied the intracranial complications of frontal sinusitis, included three subdural empyemas.<sup>1</sup>These cases exhibited a similar progression of neurological signs and symptoms. In all three cases, CT scans failed to disclose the presence of subdural pus. Subsequently, carotid arteriography was performed and in each instance demonstrated a subdural empyema. Interestingly, the epidural abscesses in our study were more readily detected on CT scans. We hope that future experience with
Acid, motility, and ulcers: a comparison of cisapride with placebo in the prevention of duodenal ulcer relapse.
Authors: D D Kerrigan, M E Taylor, N W Read, A G Johnson
Journal: Gut (1993)

In a single centre double blind study of 66 patients, the value of cisapride (10 mg twice daily) was compared with placebo in the prevention of duodenal ulcer relapse. Patients who remained ulcer free attended for clinical review every two months and had a mandatory endoscopy at 0, 4, 8, and 12 months or if symptoms suggestive of ulcer recurrence developed. The 12 month crude relapse rates (that underestimate the probability of ulcer recurrence) showed that cisapride was superior to placebo (34% (11/32) relapsed on cisapride v 68% (23/34) on placebo, p = 0.007). This finding was confirmed using lifetable analysis, with a 35% reduction (95% confidence intervals 10-59%, p &lt; 0.05) in the proportion of ulcer relapses in patients who had received cisapride compared with those treated with placebo. These results are similar to those reported in maintenance trials of H2 receptor antagonists analysed by the same method. Drug related adverse clinical events were mainly trivial, but led to three patients on cisapride and one on placebo withdrawing from the trial.
TRANSILLUMINATION OF THE VESICOVAGINAL SEPTUM
Authors: George M. Laws
Journal: JAMA (1924)

The ease with which the base of the female bladder can be transilluminated prompts me to call attention to the method. With an electrically lighted cystoscope in the fluid filled bladder, the perineum is retracted with a Sims speculum, and the room is darkened. The lamp is carried close to the base of the bladder, and therefore an instrument of the "convex" type is preferable; but if one also wishes to palpate the structures between the beak of the cystoscope, using it as a sound, and a finger in the vagina, then the "concave" cystoscope should be selected. The procedure has occasionally been found helpful: (<i>a</i>) in orientation, for example, by easily locating on one side of the septum a point readily visible on the other side, such as the orifice of a small vesicovaginal fistula; and (<i>b</i>) in seeing the relative thickness of the intervening tissues, for example, in
Immunoelectron microscopic characterization of a subpopulation of freshly isolated epidermal Langerhans cells that reacts with anti-CD23 monoclonal antibody
Authors: C. TORRESANI, G. C. MANARA, C. FERRARI, G. DE PANFILIS
Journal: British Journal of Dermatology (1991)

Large subsets of leucocytes were recently shown to express the low affinity receptor for the Fc portion of IgE. Because Langerhans cells (LC) are epidermal leucocytes, we investigated whether LC of normal human subjects might express this receptor. Whereas conventional immunofluorescence on epidermal sheets gave negative results, highly sensitive immunoelectron microscopy revealed that a subset (about one‐third) of freshly isolated LC express the CD23 molecule.
Circadian variation of transient myocardial ischemia in patients with coronary artery disease.
Authors: M B Rocco, J Barry, S Campbell, E Nabel, E F Cook, L Goldman, A P Selwyn
Journal: Circulation (1987)

To examine whether a significant circadian variation of transient myocardial ischemia exists and to better understand the character of such variation, 32 patients with chronic stable symptoms of coronary artery disease underwent one or more days of ambulatory monitoring of ischemic ST segment changes during daily life. A total of 251 episodes of ischemic ST segment depression occurred in 24 (75%) of the 32 patients with a median duration of 5 min (range 1 to 253). A significant circadian increase in ischemic activity was found with 39% of episodes and 46% of total ischemic time occurring between 6 A.M. and 12 P.M. (p less than .05 and p = .02, respectively). In 21 patients with ST segment depression during the 6 hr after waking and the 6 hr before sleep, 68% of episodes occurred in the morning compared with 32% in the evening. There were no significant differences in heart rate at onset, heart rate at 1 min before onset, and activity score associated with ST segment depression. The proportion of minutes showing ST segment depression when the heart rate was above the lowest rate associated with ST segment depression was significantly greater in the morning compared with the evening (26% vs 15%; p = .03). Thus the early morning increase in ST segment depression does not appear to be explained by differences in extrinsic activity and/or stress measured by physical activity score and heart rate response. More importantly, this phenomenon is often ignored by the usual patterns of drug administration for angina.(ABSTRACT TRUNCATED AT 250 WORDS)
Measurement of Bronchial and Alveolar Nitric Oxide Production in Normal Children and Children with Asthma
Authors: Emmanouil Paraskakis, Caterina Brindicci, Louise Fleming, Renata Krol, Sergei A. Kharitonov, Nicola M. Wilson, Peter J. Barnes, Andrew Bush
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Airway inflammation is characteristic of asthma. Distal inflammation may be particularly important.To calculate alveolar nitric oxide (NO) concentration (C(alv)) and bronchial flux NO (J(NO)) in children.We measured C(alv) and J(NO) from the fractional exhaled NO (FeNO(50)) measured at multiple exhalation flow rates in 132 children (aged 4-18 yr) with known atopic status, medication, and asthma control.Of participants, 85% (112/132) completed all measurements. In 20 of 112, the result did not fit the linear model. Thus, J(NO) and C(alv) were assessed in 92 (70%) subjects. The median (range) values of asthmatic (n = 52), normal (n = 20), and nonasthmatic atopic (n = 20) children were as follows: FeNO(50): 28.1 (4.3-190), 10.35 (3.3-29), 21.8 (8.7-69) ppb, respectively; J(NO): 1,230 (204-9,236), 480 (196-1,913), 1,225 (486-4,119) pl/s, respectively; C(alv): 2.22 (0.44-6.63), 1.63 (0.44-3), 1.21 (0.03-2.85) ppb, respectively. A reproducibility study in 18 other children gave intraclass correlation coefficients (single measures) of 0.99 (J(NO)) and 0.81 (C(alv)). J(NO) and C(alv) were higher in children with asthma than normal children (p = 0.0004 and p = 0.0002, respectively). Children with poorly controlled asthma (n = 27) had higher FeNO(50) measurements than children with good symptom control (n = 25): C(alv): mean (+/- SD), 3.17 +/- 1.62 versus 2.26 +/- 1.30 ppb, p = 0.03; J(NO): mean (+/- SD), 2,634 +/- 2,255 versus 1,193 +/- 1,294 pl/s, p = 0.007, respectively.Measurement of J(NO) and C(alv) is feasible in 70% of school-age children. FeNO(50) and J(NO) give the same information (r = 0.97, p < 0.0001), C(alv) is higher in asthmatic children than in normal children and is affected by asthma control, but not by atopy. C(alv) may possibly reflect alveolar inflammation in asthma.
Netter's Internal Medicine
Authors: R. Falik
Journal: JAMA (2004)

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Huge Intramyocardial Echinococcal Cyst Resulting in a Significant Left Ventricular Cavity Obliteration Evaluated by Real-Time 3-Dimensional Transesophageal Echocardiography and Multidetector Computed Tomography Before and After Complete Excision
Authors: Hacer Ceren Tokgoz, Ibrahim Halil Tanboga, Zulal Alnur Uslu, Altug Tuncer, Cihangir Kaymaz
Journal: Circulation (2011)
Reactivation and dissemination of blastomycosis complicating hodgkin's disease: A case report and review of the literature
Authors: Eric W. Winquist, Sharon L. Walmsley, Neil L. Berinstein
Journal: American Journal of Hematology (1993)

Abstract Patients presenting with Hodgkin's disease (HD) may show lung involvement characterized by contiguous spread from ipsilateral hilar lymph nodes. Lung consolidation or noncontiguous pulmonary involvement makes an alternative diagnosis more likely. This report describes a patient with HD in whom concurrent pulmonary blastomycosis was recognized only after chemotherapy had started and dissemination had occurred. Although Blastomyces dermatitidis may behave as an opportunitist pathogen, there are no previous reports of blastomycosis in patients with HD. Undiagnosed active opportunistic infection at the time of diagnosis of HD may complicate staging as well as treatment. Biopsy of lung lesions with stain and culture for opportunistic pathogens should be considered in patients with newly diagnosed HD disease and atypical patterns of lung involvement.