tbuckley/cabot-search huggingface dataset:
What Should I Say? Communication around Disability
Authors: Lisa I. Iezzoni
Journal: Annals of Internal Medicine (1998)

On Being a Patient15 October 1998What Should I Say? Communication around DisabilityLisa I. Iezzoni, MD, MScLisa I. Iezzoni, MD, MScNote: This paper was adapted from an essay that appeared in the Winter 1998 issue of Harvard Medical Alumni Bulletin. All proper names in this paper are pseudonyms.Beth Israel Deaconess Medical Center; Boston, MA 02215Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Every so often, we all experience moments that crystallize an essential truth about our lives. Last spring, I had one in the cramped interstices of a federal office building in Washington, D.C. Before a meeting, I hurried to a back office to use the telephone, but a man was already there. We recognized each other instantly.“It's been 20 years,” I said. “You taught that great course on patients' experiences of illness. It helped me decide to go to medical school.”“I remember you well.” He paused, eyeing me with momentarily unguarded sadness. “I heard about your troubles.”My mind ... Author, Article, and Disclosure InformationAuthors: Lisa I. Iezzoni, MD, MScAffiliations: Note: This paper was adapted from an essay that appeared in the Winter 1998 issue of Harvard Medical Alumni Bulletin. All proper names in this paper are pseudonyms.Beth Israel Deaconess Medical Center; Boston, MA 02215Grant Support: By the Robert Wood Johnson Foundation Investigator Award in Health Policy Research.Corresponding Author: Lisa I. Iezzoni, MD, MSc, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, East Campus LY-326, 330 Brookline Avenue, Boston, MA 02215; e-mail, [email protected] PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTeaching health care students about disability within a cultural competency contextDisability Studies in Medical EducationDesired Educational Outcomes of Disability-Related Training for the Generalist Physician: Knowledge, Attitudes, and SkillsEvaluation of Medical Student Performance on Objective Structured Clinical Exams With Standardized Patients With and Without DisabilitiesModels of health, illness and rehabilitationReferencesReferencesDisabilityMobility difficulties are not only a problem of old age 15 October 1998Volume 129, Issue 8Page: 661-665KeywordsDisabilitiesEmotionsFearMultiple sclerosisNursesShockSurgeonsUrineWalkingWheelchairs ePublished: 15 August 2000 Issue Published: 15 October 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Neuroblastoma Screening at One Year of Age
Authors: Freimut H. Schilling, Claudia Spix, Frank Berthold, Rudolf Erttmann, Natalja Fehse, Barbara Hero, Gisela Klein, Johannes Sander, Kerstin Schwarz, Joern Treuner, Ulrich Zorn, Joerg Michaelis
Journal: New England Journal of Medicine (2002)

Neuroblastoma is the second most common type of childhood tumor. It is not known whether screening for neuroblastoma at one year of age reduces the incidence of metastatic disease or mortality due to neuroblastoma.
Policies and Practices Concerning Confidentiality in College Mental Health Services in the United States and Canada
Authors: WILLIAM J. CURRAN
Journal: American Journal of Psychiatry (1969)

According to a survey by the author, the great majority of college mental health services do not routinely inform parents of consultations, evaluations, or short-term treatment, although they do notify parents of serious illness, suicidal attempts, or hospitalization. Unless the student is sent for evaluation by the administration, a similar rule applies to college authorities. Nearly all respondents refuse psychiatric information to outside sources without student consent. The author includes a legal commentary and suggestions for some law revisions.
Rescue of amitriptyline-intoxicated hearts with nanosized vesicles
Authors: A DHANIKULA, D LAMONTAGNE, J LEROUX
Journal: Cardiovascular Research (2007)

Objective: Amitriptyline, one of the most prescribed antidepressants, is reported to claim a large number of human lives due to drug overdose related cardiac arrest. Although amitriptyline poisoning has long been recognized as a frequent and serious fatality in the medical field, few efforts have been made to devise methods for treating its toxicity. To address this issue, phospholipid-based nanosized vesicles (spherulites) were employed to reverse the cardiotoxicity induced by amitriptyline in an isolated heart perfusion model.
Pulse Methylprednisolone in Rheumatoid Arthritis
Authors: MICHAEL R. LIEBLING
Journal: Annals of Internal Medicine (1981)

Ten patients with rheumatoid arthritis unresponsive to conventional therapy participated in a double-blind cross-over trial in which they randomly received either a "pulse" of 1 g of methylprednisolone or placebo, intravenously, once a month for 6 months. Both the drug-first and placebo-first groups had the same mean American Rheumatism Association functional classification, 2.5. During the study patients on methylprednisolone "pulses," compared to placebo, showed significantly better mean tender-joint counts, walking times, and grip strength (p < 0.05). The drug-treated patients also had significantly lower levels of immune complexes (p < 0.01) and IgG (p < 0.01). Effects could still be measured an average of 2.9 ± 0.4 months after the last dose of methylprednisolone. No significant side effects were noted during the therapy. Despite these findings, "pulse" methylprednisolone did not appear to significantly retard radiologic progression of the arthritis.
Positive Hemoccult Tests and Colonoscopic Results
Authors: YARON NIV
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 September 1986Positive Hemoccult Tests and Colonoscopic ResultsYARON NIV, M.D.YARON NIV, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-3-470_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The Hemoccult test (Smith Kline Diagnostics, Inc., Sunnyvale, California) for fecal occult blood is now used worldwide as a screening test for early detection of colorectal cancer and colonic polyps (1). The Hemoccult II card has six small windows. During 3 days, all six windows are smeared. The test is considered positive if at least one window turns blue after application of the developing fluid. In the current study, I examined whether the number of positive Hemoccult windows was correlated with colonoscopic results.A screening program for early detection and secondary prevention of colorectal cancer was started...References1. SIMON J. Occult blood screening for colorectal carcinoma: a critical review. Gastroenterology. 1985;88:820-37. CrossrefMedlineGoogle Scholar2. NIV Y. Occult blood in colorectal cancer [Letter]. Gastroenterology. 1985;89:705-6. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: YARON NIV, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1986Volume 105, Issue 3Page: 470-470KeywordsCancer preventionColorectal cancerDiagnostic techniquesHematologic tests ePublished: 1 December 2008 Issue Published: 1 September 1986 PDF downloadLoading ...
Lichenoid melanodermatitis.
Authors: A.R.H.B. VERHAGEN, J.W. KOTEN
Journal: British Journal of Dermatology (1979)

Fifty-one Kenyan patients with variable round plaques on the exposed parts, predominantly on the face, and characterized by central hyperpigmentation with annular hypopigmented borders, are described. The clinical and histological picture showed transitions, which ranged from lichen planus and lichenoid poikilodermatous syndromes to dermatitis. This syndrome corresponds largely with (sub-)tropical or actinic lichen planus as reported from the Middle East, where emphasis has been given mainly to a part of the described spectrum of transitions. We suggest that this syndrome should be considered as one of Pinkus' regional lichenoid syndromes which represent hybrids between lichen planus and other conditions rather than as a mere variant of lichen planus.
α1-Microglobulin: a new antigenic component of the epidermo-dermal junction in normal human skin
Authors: P. BOUIC, J. KANITAKIS, D. SCHMITT, C. VINCENT, J.P. REVILLARD, J. THIVOLET
Journal: British Journal of Dermatology (1985)

Monoclonal antibodies to human α1-microglobulin (α1-m), a glycoprotein present in most biological fluids, reacted with the basement membrane of the epidermo-dermal junction and that of eccrine sweat glands in normal human skin. This immunofluorescence was specific in that control antibodies of known well-defined reactivity did not stain these structures. Therefore, α1-m seems to be a new antigenic component of the junction and it may be an interesting antigen to study in diseases of this area.
Passive smoking at work as a risk factor for coronary heart disease in Chinese women who have never smoked
Authors: Y He, T H Lam, L S Li, L S Li, R Y Du, G L Jia, J Y Huang, J S Zheng
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To study whether passive smoking at work is a risk factor for coronary heart disease. <b>Design</b>: Case-control study. <b>Setting</b>: Xi9an, China. <b>Subjects</b>: 59 patients with coronary heart disease and 126 controls, all Chinese women with full time jobs, who had never smoked cigarettes. <b>Results</b>: The crude odds radio for passive smoking from husband was 2.12 (95% confidence interval 1.06 to 4.25) and at work was 2.45 (1.23 to 4.88). The final logistic regression model, with passive smoking from husband and at work as the base, included age, history of hypertension, type A personality, and total cholesterol and high density lipoprotein cholesterol concentrations; the adjusted odds ratios for passive smoking from husband and at work were 1.24 (0.56 to 2.72) and 1.85 (0.86 to 4.00) respectively. For passive smoking at work, statistically significant linear trends of increasing risks (for both crude and adjusted odds ratios) with increasing exposures (amount exposed daily, number of smokers, number of hours exposed daily, and cumulative exposure) were observed. When these exposure variables were analysed as continuous variables, the crude and adjusted odds ratios were also significant. <b>Conclusion</b>: Passive smoking at work is a risk factor for coronary heart disease. Urgent public health measures are needed to reduce smoking and to protect non-smokers from passive smoking in China.
Idiopathic Hypertrophic Subaortic Stenosis: III. Intraoperative Studies of the Mechanism of Obstruction and Its Hemodynamic Consequences
Authors: GEORGE E. PIERCE, ANDREW G. MORROW, EUGENE BRAUNWALD, Harry W. Seipp, David E. Cobb, Maxine P. Montgomery
Journal: Circulation (1964)

Pressures in the left ventricle and central aorta were recorded together with instantaneous aortic blood flow at the time of operation in 9 patients. Four patients had IHSS, 4 had valvular or discrete subvalvular aortic stenosis, and 1 was considered to have a normal aortic valve and left ventricular outflow tract. In each of the 4 patients with IHSS, the pattern of aortic blood flow was distinctly abnormal when significant obstruction was present and nearly 80% of total flow took place in the first half of systole. In contrast, [see figure in the PDF file] the distribution of flow was symmetrical in all patients with discrete aortic stenosis. When flow and the pressure gradient were related at brief intervals during systole, and the orifice size calculated, it was found that the orifice was always greatest at the onset of contraction, diminished rapidly in size, and often became totally obliterated toward the end of the ejection period in patients with IHSS. The size of the orifice remained constant during systole in the patients with discrete obstruction. The abnormalities of instantaneous aortic blood flow, and the rate of systolic narrowing of the subvalvular orifice were exaggerated following premature ventricular contractions, after the administration of pharmacologic agents with positive inotropic effects (isoproterenol and calcium chloride), and after reduction of the circulating blood volume. With valvular and discrete subaortic stenosis, however, these interventions did not change the symmetrical pattern of blood flow and the orifice area was constant. Augmentation of the circulating blood volume or partial occlusion of the ascending aorta decreased the severity of outflow obstruction in every patient with IHSS and converted the abnormal flow pattern to one characteristic of discrete stenosis. These studies provide the first evidence of the instantaneous changes which occur within the outflow tract of the left ventricle in patients with IHSS, and provide information concerning the various mechanisms by which the intensity of obstruction may be modified.
Aggression in General-Hospital Patients
Authors: Ranan Rimón, Juhani Jussila, Olavi Katila
Journal: Psychotherapy and Psychosomatics (1975)

The Buss-Durkee Inventory (BDI) rating for measuring aggression was performed on 125 consecutive female patients admitted to a general hospital. The test scores of different diagnostic groups were all on a intermediate level, and with the exception of slightly lower scores in patients with blood disorders, only few differences statistical significance were observed. The factor analysis of the test results revealed three factors: in addition to aggression factor (I) and hostility factor (II) a factor called remorse factor (III) was identified. The patient groups divided according to their medical diagnoses showed no differences with regard to these factors. The variance of factor scores could not be explained by such background variables as social class, marital status or domicile. There was, however, a highly significant negative correlation (-0.33) between age and the aggression factor. Finally, the concept of suppressed aggression and hostility and the role of aggression dynamics in the development of organic illness is discussed.
Canadian pattern of care for anemia: comparison of chemotherapies in adjuvant breast cancer setting.
Authors: A Quinn, C Wong, J Younus, G Dranitsaris, R Goel, M Trudeau
Journal: Cancer Research (2009)

Abstract Abstract #2118 Background: Anemia is a common side effect of chemotherapy in adjuvant breast cancer patients (pts) but its treatment may be inconsistent. Erythropoiesis-stimulating agents (ESAs) are the only alternative to blood transfusion in the treatment of chemotherapy-induced anemia, yet their appropriate use continues to be defined. The purpose of this study was to determine the frequency of anemia associated with adjuvant chemotherapy in Canadian breast cancer pts and to explore the corrective interventions which were undertaken.&amp;#x2028; Methods: A retrospective chart review was conducted at 11 cancer centres in Ontario, Canada. Beginning on September 1, 2004 data were collected for 60 consecutive cases of adjuvant breast cancer at each centre, giving a total of 620 patients. Chemotherapy consisted mainly of FEC100, AC-T, AC, CEF, FEC50, and AC-T Dose Dense. Overall, 8% of pts were enrolled in a clinical trial and 76% received adjuvant radiotherapy. Hemoglobin level (Hb), supportive therapy (antibiotics, GCSF, ESA, and transfusion) and type of chemotherapy were recorded at each cycle.&amp;#x2028; Results: The median pt age was 53. The mean baseline Hb was 132.8 (92.0-163) g/L, 11.6% of pts had Hb&amp;lt;120g/L. During the course of chemotherapy, the percentage of subjects with Hb&amp;lt;120 at least once was 55.8%, Hb&amp;lt;110 was 37.8%, Hb&amp;lt;100 was 21.2 % and Hb&amp;lt;90 was 11.5%, with a median of 36.0, 52.5, 71.0, and 75.0 days to develop anemia respectively. For pts whose Hb dropped below 100 g/L, 45.4% occurred after the 1st cycle, 68.8% after the 2nd, 83.7% after the 3rd, and 92.2% after the 4th chemotherapy cycle. Overall, 13.2% of subjects received prophylactic antibiotics, 26.3% were supported by G-CSF, 9.0% received an ESA (epoetin alfa) during their chemotherapy and 7.4% were transfused. The rates of anemia as well as means of intervention are summarized in Figure 1. ESAs were not used prophylactically in this setting.&amp;#x2028; Conclusions: In Canada, breast cancer patients receiving adjuvant chemotherapy commonly become anemic during their course of treatment. This retrospective study demonstrated that ESAs play an important role in the management of anemia in the adjuvant setting. Canadian treatment guidelines recommend that ESA therapy be initiated when Hb &amp;lt;100 g/L. Our finding shows that ∼42% of patients whose Hb dropped below 100g/L were treated with ESAs, suggesting that ESAs were not overused in Canadian practice.&amp;#x2028; &amp;#x2028; Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2118.
Reverse Transcription-PCR for t(11;18)(q21;q21) Staging and Monitoring in Mucosa-Associated Lymphoid Tissue Lymphoma
Authors: Berthold Streubel, Daniela Huber, Stefan Wöhrer, Andreas Chott, Markus Raderer
Journal: Clinical Cancer Research (2006)

Abstract Purpose: Subclinical dissemination as well as persistence after therapy may be difficult to assess on clinical and histologic examinations in patients with mucosa-associated lymphoid tissue (MALT) lymphoma. We have analyzed the use of reverse transcription-PCR (RT-PCR) for the detection of t(11;18)(q21;q21) in histologically infiltrated and normal biopsies at diagnosis and during follow-up to determine its clinical and prognostic effect. Experimental Design: Twenty-one patients with t(11;18)(q21;q21)+ MALT lymphoma were included in this retrospective study. Presence of t(11;18)(q21;q21) was determined by RT-PCR done on 316 biopsies of various tissues obtained during staging and follow-up. Results: Infiltration with lymphoma was histologically detected in 67 of 316 biopsies, whereas molecular infiltration was established in 104 of 316 biopsies. All histologically positive specimens were also positive in RT-PCR. There was a good concordance (P = 0.0001) between histology and RT-PCR at the time of disease presentation with only one further infiltration site identified by RT-PCR. In 8 of 12 patients with persistent lymphoma, RT-PCR revealed tumor infiltration in histologically unsuspected sites. Eight of nine treated patients with histologic and clinical complete remission (CR) remained RT-PCR positive. CR on RT-PCR was achieved later than histologic CR (between 13-59 months) without any further therapy in five of these eight patients; only one patient with persistent t(11;18)(q21;q21) relapsed histologically. Conclusions: This study shows the potential of RT-PCR for t(11;18)(q21;q21) done on routine paraffin-embedded specimens to identify disseminated disease in tissues otherwise not diagnostic of MALT lymphoma involvement. T(11;18)(q21;q21) persistence in patients with clinical and histologic CR does not necessarily require therapeutic intervention.
Unusual Persistence of Tc-99m MDP Uptake in the Incisional Scar after Thoracotomy
Authors: WEI-JEN SHIH, FRANK H. DeLAND, PEGGY A. DOMSTAD, MARCUS L. DILLON
Journal: Clinical Nuclear Medicine (1984)

Postoperative scar is one of the causes of extraosseous localization of Tc-99m phosphonate bone agents. Usually, an incisional scar will not be visualized in a Tc-99m phosphonate skeletal image two weeks after surgery. A case is reported with an unusually persistent localization of radiotracer in the scar of a thoracotomy seen in three consecutive bone images done beyond two weeks postoperatively. This patient suffered from “pulmonary insufficiency” before and after the thoracotomy. The abnormal radiotracer localization in the scar is presumably related to his pulmonary insufficiency, with resulting relatively delayed wound healing.
Inhaled Human Insulin Treatment in Patients with Type 2 Diabetes Mellitus
Authors: William T. Cefalu, Jay S. Skyler, Ione A. Kourides, William H. Landschulz, Cecile C. Balagtas, Shu-Lin Cheng, Robert A. Gelfand
Journal: Annals of Internal Medicine (2001)

Background: Despite demonstrated benefits, intensive insulin therapy has not gained widespread clinical acceptance for several reasons: Multiple daily injections are inconvenient, adherence is a concern, and the time-activity profile may not mimic normal insulin secretion. As such, alternate means of administering insulin are being evaluated. Objective: To assess the efficacy and safety of pulmonary delivery of insulin in type 2 diabetic patients who require insulin. Design: Randomized, open-label, 3-month study consisting of a screening visit, a 4-week baseline lead-in phase, and a 12-week treatment phase. Setting: General clinical research center and outpatient research clinics. Patients: 26 patients (16 men, 10 women) with type 2 diabetes (average age, 51.1 years; average duration of diabetes, 11.2 years). Intervention: Patients received inhaled insulin before each meal plus a bedtime injection of ultralente insulin, performed home glucose monitoring, and had weekly adjustment of insulin dose; target level for preprandial plasma glucose was 5.55 to 8.88 mmol/L (100 to 160 mg/dL). Measurements: Glycemic control (hemoglobin A1c level) obtained at baseline and monthly for 3 months. Pulmonary function tests were done at baseline and at the end of the study. Results: Inhaled insulin treatment for 3 months significantly improved glycemic control compared with baseline: Mean hemoglobin A1c levels decreased by 0.0071 ± 0.0072 (0.71% ± 0.72%). Patients experienced an average of 0.83 mild to moderate hypoglycemic event per month; no severe events were recorded. Patients showed no significant weight gain or change in pulmonary function compared with baseline. Conclusions: Pulmonary delivery of insulin in type 2 diabetic patients who require insulin improved glycemic control, was well tolerated, and demonstrated no adverse pulmonary effects. Larger-scale studies are ongoing to provide long-term efficacy and safety data. *For members of the Inhaled Insulin Study Group, see Appendix.