tbuckley/cabot-search huggingface dataset:
Sebelius apologizes for health insurance website's woes
Authors: Michael McCarthy
Journal: BMJ (2013)

The US secretary of health and human services, Kathleen Sebelius, has accepted responsibility for the botched rollout of the online health insurance exchange, HealthCare.gov, and has apologized to millions of people who have been frustrated by the site’s glitches and crashes while trying to shop for coverage.

At a hearing before the House Energy and Commerce Committee on Wednesday 30 October, Sebelius said, “I am as frustrated and angry as anyone with the flawed launch of HealthCare.gov, so let me say directly to these Americans: you deserve better. I apologize. I’m accountable to you for fixing these problems, and I’m committed to earning your confidence back by fixing the site.” 

The health insurance exchanges were designed to provide online marketplaces …
Epidemiologic Comparisons of Incidence of Toxic Shock Syndrome
Authors: DONALD R. PETERSON
Journal: Annals of Internal Medicine (1982)

Despite many imperfections in the nationwide reporting of toxic shock syndrome, the available data provide some useful information. The crude toxic shock morbidity rate has been estimated as approximately 0.50 per 100 000 United States population per year. This morbidity rate exceeds those for paralytic poliomyelitis, tetanus, tularemia, diphtheria, and typhoid fever, and is about one half of the rate for meningococcal infections and pertussis. The estimate of 8.9 cases of toxic shock syndrome per 100 000 menstruating women is similar to the crude rates for primary and secondary syphilis and mumps. From these comparisons, the incidence of toxic shock syndrome does not appear as low as some might suppose.
Part 1: Migraine Headaches
Authors: Arnold P. Friedman
Journal: JAMA (1972)

Despite numerous theories on the pathogenesis of migraine, the exact site of origin of a migraine attack remains unknown. Although most attention has been directed toward the peripheral nervous system, the central nervous system plays an important though incompletely understood role. There are a variety of types of migraine, but similar mechanisms seem to operate in all variants. Based on present evidence, the symp-, toms of migraine are related to a disturbance of the central vasomotor centers, the extracranial and intracranial blood vessels, and the microcirculation.1,2Each attack represents an initial phase of arterial vasoconstriction, largely intracranial, and associated with a slowly spreading process of cortical depression accounting for the slow progressive march of neurological symptoms, followed by a phase of painful arterial vasodilatation with increased blood flow of the extracranial or scalp arteries associated with a localized sterile inflammation of the arterial wall. However, this traditional view that
Letter: Status of ward sisters.
Authors: C M Hall
Journal: BMJ (1974)

effects should "have the fullest possible con- fidence" in her method.It may be that the confused image some women have of oral contraceptives is a re- flection of the difficulties many doctors clearly have in deciding when the above symptoms are a sign of serious biochemical alterations.If this is the case, it may be even more difficult for health personnel who are not qualified medical practitioners to dispense these pharmacologically active compounds with the high standard of care that is expected in Britain.-Iam, etc.,
Stress-Induced Cortisol Release in Hypothalamic Hypoadrenalism
Authors: Allan R. Glass
Journal: JAMA (1979)

A 52-year-old woman experienced hypoadrenalism (mean 8 AM plasma cortisol level, 3.7 μg/dL) after hypothalamic surgery and radiotherapy for craniopharyngioma. Despite low plasma adrenocorticotropic hormone levels (less than 25 pg/mL), absent diurnal variation of the plasma cortisol level, and subnormal urinary 17-hydroxycorticosteroid response to metyrapone, she had normal plasma cortisol responses to insulin-induced hypoglycemia and to administration of vasopressin or synthetic adrenocorticotropic hormone. Stress-induced cortisol release may be preserved despite notable abnormalities in regulation of cortisol secretion by diurnal and feedback-mediated mechanisms. (<i>JAMA</i>241:1612-1613, 1979)
Mucosal-associated invariant T cell alterations in obese and type 2 diabetic patients
Authors: Isabelle Magalhaes, Karine Pingris, Christine Poitou, Stéphanie Bessoles, Nicolas Venteclef, Badr Kiaf, Lucie Beaudoin, Jennifer Da Silva, Omran Allatif, Jamie Rossjohn, Lars Kjer-Nielsen, James McCluskey, Séverine Ledoux, Laurent Genser, Adriana Torcivia, Claire Soudais, Olivier Lantz, Christian Boitard, Judith Aron-Wisnewsky, Etienne Larger, Karine Clément, Agnès Lehuen
Journal: Journal of Clinical Investigation (2015)

Obesity and type 2 diabetes (T2D) are associated with low-grade inflammation, activation of immune cells, and alterations of the gut microbiota. Mucosal-associated invariant T (MAIT) cells, which are innate-like T cells that recognize bacterial ligands, are present in blood and enriched in mucosal and inflamed tissues. Here, we analyzed MAIT cells in the blood and adipose tissues of patients with T2D and/or severe obesity. We determined that circulating MAIT cell frequency was dramatically decreased in both patient groups, and this population was even undetectable in some obese patients. Moreover, in both patient groups, circulating MAIT cells displayed an activated phenotype that was associated with elevated Th1 and Th17 cytokine production. In obese patients, MAIT cells were more abundant in adipose tissue than in the blood and exhibited a striking IL-17 profile. Bariatric surgery in obese patients not only improved their metabolic parameters but also increased circulating MAIT cell frequency at 3 months after surgery. Similarly, cytokine production by blood MAIT cells was strongly decreased after surgery. This study reveals profound MAIT cell abnormalities in patients harboring metabolic disorders, suggesting their potential role in these pathologies.
Dose in Granulocyte Transfusion
Authors: Elliott F. Winton, W. Ralph Vogler, Lewis Glasser
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 February 1983Dose in Granulocyte TransfusionELLIOTT F. WINTON, M.D., W. RALPH VOGLER, M.D., LEWIS GLASSER, M.D.ELLIOTT F. WINTON, M.D.Search for more papers by this author, W. RALPH VOGLER, M.D.Search for more papers by this author, LEWIS GLASSER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-2-257 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In a recent article, Winston and associates (1) presented data that led them to conclude that therapeutic granulocyte transfusions offered no substantial benefit over optimal antimicrobial therapy alone in managing infected patients with granulocytopenia. We have difficulty extrapolating their observations to granulocyte transfusion therapy as given at our institution (2) and others (3) where doses of three to six times as many granulocytes are administered routinely. The authors have criticized other randomized trials of granulocyte transfusions in neutropenic patients for having too few patients. We find the major weakness of this study to be too few granulocytes...References1. WINSTONHOGALE DWR. Therapeutic granulocyte transfusions for documented infections: a controlled trial in ninety-five infectious granulocytopenic episodes. Ann Intern Med. 1982;97:509-15. LinkGoogle Scholar2. WINTONMOFFITTVOGLER ESW. Influence of quantity of granulocytes transfused on response. In: VOGLER WR, ed. Cytapheresis and Plasma Exchange: Clinical Indications. New York: Alan R. Liss;1982:75-91. Google Scholar3. HUESTISBOVEBUSCH DJS. Hemapheresis. In: HUESTIS DW, BOVE JR, BUSCH S, Eds. Practical Blood Transfusion. 3rd ed. Boston: Little Brown and Company; 1981:315-72. Google Scholar4. APPELBAUMBOWLESMAKUCHDEISSEROTH FCRA. Granulocyte transfusion therapy of experimental Pseudomonas septicemia: study of cell dose and collection technique. Blood. 1978;52:323-31. CrossrefMedlineGoogle Scholar5. GLASSER L. Functional considerations of granulocyte concentrates used for clinical transfusions. Transfusion. 1979;19:1-6. CrossrefMedlineGoogle Scholar6. FREIREICHLEVINWHANGCARBONEBRONSENMORSE ERJPWE. The function and fate of transfused leucocytes from donors with chronic myelocytic leukemia in leukopenic recipients. Ann NY Acad Sci. 1964;113:1081. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1983Volume 98, Issue 2Page: 257-257KeywordsAntimicrobialsGranulocytesRandomized trials Issue Published: 1 February 1983 PDF downloadLoading ...
Brain Abscess Due to<i>Haemophilus aphrophilus</i>
Authors: John B. Isom, Philip D. Gordy, John C. Selner, Lewis J. Brown, Mary Willis
Journal: New England Journal of Medicine (1964)

THOUGH recent reports have stated that the incidence of brain abscess has not changed greatly1 , 2 the distribution of infective sources has altered with a decrease in the number of abscesses associated with otogenous infection.3 The most common causative organisms have been streptococci, staphylococci and pneumococci.4 , 5 This report concerns an abscess due to organism, Haemophilus aphrophilus, not commonly encountered in human infections.Case ReportG.C. (U.O.M.S.H. 32–77–82), an 11-year-old girl, was admitted to the University of Oregon Medical School Hospital on December 24, 1963, in a state of moderate dehydration and stupor. The illness had begun on November 20 with . . .
FEVER, AND THE RELATIONS OF MICROORGANISMS TO THE DISEASE.Read in the Section on Practice of Medicine, at the Forty-fifth Annual Meeting of the American Medical Association, held at San Francisco, June 5-8, 1894.
Authors: WASHINGTON AYER
Journal: JAMA (1894)

cocci was evident.The clinical history of each case fully confirmed the microscopic examination, al¬ though the patients had not been seen and the slides of blood drops were merely numbered from one to eighteen.Acting upon the suggestions of the micro¬ scope, iron and quinin were given in large doses, Tvith a generous diet.Under this treatment, the blood corpuscles of the patients speedily recovered their normal appearance, and in a short time all the seamen returned to duty.The surgeon in charge of the hospital (Heber Smith, M.D.), in his report to Washington, says : "It is possible that a microscopic examination of the blood of all the men on board the corvette before she sailed from Brazil, would have revealed just those members of her crew who were io suffer from the disease."
BACILLUS COLI INFECTIONS
Authors: D. Nabarro
Journal: BMJ (1930)

~~~~~~~~~~~~~~~~~~~~~~~~~~MEDICL JOUPRNA are infected; the ureters are never free from B. coli if the bladder is inifected.In the spontaneous infections, by tying off the bladder and ureters separately, Helilnholz has shown that the bladder is often infected, while onie or both ureters are free from infection, and that although pyelitis and pyelonephritis may appear, kidney abscesses do not occur in the spontaneous infection.It seems worth whilo to turn from the consideration of children to review briefly B. coli urinary infections in adults.After puberty such infections are far less comiimon than in childhood, and a marked disproportioln exists between the sexes.In men, apart from calculus, prostatic abnormalities, anid urethral stricture, B. coli infections of the bla(lder or ureters are rare.Inl women, on the other hand, the B. coli infection is by nio meanis unicommoni.The associated conditionis are pregnancy, gynaecological operations, the trauma of the honeymoon, and long periods of retention such as may occur on long car or railway journeys.Further, such infections-provided that the infecting organiism is the B. coli only-produce but little upset, and are probably frequently missed.The facts of this brief statement seemu to poinlt very definitely to an ascending ratlher than to a blood infection, and support the clinical finding of children's physicians that pyelitis is genierally an ascending infection with a correspondingly greater inci- dence in girls.If these infections (B.coli) were blood- bornie, then men would be nlot less susceptible than women, and evidence of disturban-ce in other organs of the body would be common and not infrequently severe.Certain figuires have been obtained from the Children's Hospital in Birmilnglham.Starting from tho year 1925 117 consecutive and unselected cases of pyelitis were taken.with the object of tracing the children, re-examining them, and determiniing as far as possible their present condition.In this way it is hoped to throw some light on the etiology of the condition. Age.No. Male.
Familial Tendency for Abdominal Aortic Aneurysms
Authors: Kaj Johansen
Journal: JAMA (1986)

To examine the hypothesis that a tendency toward aneurysmal degeneration of the abdominal aorta may be inherited, we compared the family histories of 250 patients with abdominal aortic aneurysm (AAA) with those of 250 control subjects. Among the control subjects, six (2.4%) reported having a first-degree relative with an aneurysm, compared with 48 (19.2%) of the patients with AAA. After adjustment for age and sex, this corresponds to an estimated 11.6-fold increase in AAA risk among persons with an affected first-degree relative. This study suggests that the relatives of patients with AAA may themselves be at significantly increased risk for the development of aneurysmal degeneration. Because early diagnosis and elective management of AAA significantly prolong life, noninvasive screening to detect early AAA formation may be warranted in relatives of patients with AAA. (<i>JAMA</i>1986;256:1934-1936)
Influence of acute alterations in heart rate and systemic arterial pressure on echocardiographic measures of left ventricular perfornmance in normal human subjects.
Authors: J Hirshleifer, M Crawford, R A O'Rourke, J S Karliner
Journal: Circulation (1975)

To study the effects of acute alterations in heart rate and systemic arterial pressure on the mean velocity of left ventricular circumferential fiber shortening (Vcf) and on mean posterior wall velocity (Vpw), we performed ultrasound studies in 25 normal human subjects between the ages of 21 and 29 years. When heart rate was augmented by the administration of intravenous atropine from 64 +/- 2.2 (SEM) to 98 +/- 2.7 beats/min, mean normalized Vcf increased from 1.22 +/- 0.05 to 1.38 +/- 0.06 circumferences (circ)/sec(P less than 0.001). Mean normalized Vpw increased from 0.76 +/- 0.03 to 0.89 +/- 0.04 sec-1 (P less than 0.001). Mean Vcf and mean Vpw uncorrected for end-diastolic diameter increased in a similar fashion (P less than 0.01). After atropine administration, systemic arterial pressure was augmented by means of a phenylephrine infusion in 23 subjects by an average of 39 mm Hg (range 20-50 mm Hg). During the phenylephrine infusion, average heart rate decreased from 96 +/- 2.6 to 91 +/- 3.1 beats/min (NS), while mean normalized Vcf declined from 1.38 +/- 0.06 to 1.09 +/- 0.05 circ/sec (P less than 0.001) and normalized Vpw from 0.89 +/- 0.04 to 0.65 +/- 0.04 sec-1 (P less than 0.001). Nonnormalized velocities exhibited similar alterations (P less than 0.01). We conclude that in the normal human subject mean Vcf and mean Vpw are sensitive to acute alterations in heart rate and systemic arterial pressure. Thus, when ultrasound measures are used for serial assessment of left ventricular performance, the level of heart rate and systemic arterial pressure at which studies are obtained must be considered. Further, the sequential use of atropine and phenylephrine, as described in this study, provides an experimental model for the evaluation of the effects of drug treatment and other interventions on left ventricular performance in man.
Daunorubicin continuous infusion induces more toxicity than bolus infusion in acute lymphoblastic leukemia induction regimen: a randomized study
Authors: M Hunault-Berger, N Milpied, M Bernard, J-P Jouet, M Delain, B Desablens, A Sadoun, F Guilhot, P Casassus, N Ifrah
Journal: Leukemia (2001)
Family-Based Treatment of Early Childhood Obsessive-Compulsive Disorder
Authors: Jennifer Freeman, Jeffrey Sapyta, Abbe Garcia, Scott Compton, Muniya Khanna, Chris Flessner, David FitzGerald, Christian Mauro, Rebecca Dingfelder, Kristen Benito, Julie Harrison, John Curry, Edna Foa, John March, Phoebe Moore, Martin Franklin
Journal: JAMA Psychiatry (2014)

IMPORTANCE Cognitive behavior therapy (CBT) has been established as efficacious for obsessive-compulsive disorder (OCD) among older children and adolescents, yet its effect on young children has not been evaluated sufficiently.OBJECTIVE To examine the relative efficacy of family-based CBT (FB-CBT) involving exposure plus response prevention vs an FB relaxation treatment (FB-RT) control condition for children 5 to 8 years of age.DESIGN, SETTING, AND PARTICIPANTS A 14-week randomized clinical trial (Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children [POTS Jr]) conducted at 3 academic medical centers between 2006 and 2011, involving 127 pediatric outpatients 5 to 8 years of age who received a primary diagnosis of OCD and a Children's Yale-Brown Obsessive Compulsive Scale total score of 16 or higher.INTERVENTIONS Participants were randomly assigned to 14 weeks of (1) FB-CBT, including exposure plus response prevention, or (2) FB-RT. MAIN OUTCOMES AND MEASURESResponder status defined as an independent evaluator-rated Clinical Global Impression-Improvement scale score of 1 (very much improved) or 2 (much improved) and change in independent evaluator-rated continuous Children's Yale-Brown Obsessive Compulsive Scale total score.RESULTS Family-based CBT was superior to FB-RT on both primary outcome measures.The percentages of children who were rated as 1 (very much improved) or 2 (much improved) on the Clinical Global Impression-Improvement scale at 14 weeks were 72% for FB-CBT and 41% for FB-RT.The effect size difference between FB-CBT and FB-RT on the Clinical Global Impression-Improvement scale was 0.31 (95% CI, 0.17-0.45).The number needed to treat (NNT) with FB-CBT vs FB-RT was estimated as 3.2 (95% CI, 2.2-5.8).The effect size difference between FB-CBT and FB-RT on the Children's Yale-Brown Obsessive Compulsive Scale at week 14 was 0.84 (95% CI, 0.62-1.06). CONCLUSIONS AND RELEVANCEA comprehensive FB-CBT program was superior to a relaxation program with a similar format in reducing OCD symptoms and functional impairment in young children (5-8 years of age) with OCD.
The Advancement of Women in Academic Medicine
Authors: Jane Green Schaller
Journal: JAMA (1990)

THE FIRST known woman medical graduate in the United States, Elizabeth Blackwell, surmounted numerous difficulties and graduated from Geneva Medical College, New York, about 1850. Over the next 120 years, few women followed her. Since the 1970s, however, the number of women entering medicine has burgeoned, so that in the academic year 1989-1990, 38% of entrants and 33.9% of graduates of US medical schools were women.<sup>1-3</sup>In 1988 residency training groups, 49% of pediatric residents were women, 46% of obstetrics and gynecology residents, 39% of psychiatry residents, 30% of family practice residents, and 26% of internal medicine residents.<sup>1</sup>A smaller proportion of women have been trained in surgery or the various surgical specialties. There is no evidence to support the often expressed fears that women will either practice significantly fewer hours or drop out of professional activities more often than do men.<sup>3</sup>A number of women now
302 HEPATOCYTE DIFFERENTIATION OF FRESHLY ISOLATED AND IN VIVO ACTIVATED HEPATIC STELLATE CELLS TRANSPLANTED INTO RATS AFTER CARBON TETRACHLORIDE DAMAGE
Authors: A. Gumerova, A. Shafigullina, G. Burganova, M. Kaligin, A. Titova, E. Sharipova, A. Muchamedov, A. Trondin, M. Titova, A. Kiassov
Journal: Journal of Hepatology (2013)
Acute Leukemia and Infection
Authors: Michael V. Viola
Journal: JAMA (1967)

The clinical records of 78 patients with acute leukemia revealed that infection was the major single cause of death. Gram-negative bacteremia was responsible most often, although staphylococcal bacteremia was still a significant cause of death. Pneumonitis, bacteremia, and skin infections were the most common types of bacterial infections. An increase in the occurrence of infections with gram-negative organisms was noted. The source of most cases of gram-negative bacteremia was ulceration of the intestinal tract, although a number of patients had no source demonstrable. Serious fungal infections occurred in 14% (11) of patients studied. Most disseminated fungal infections were not diagnosed during life. Infections of all types increase with the duration of the disease and with the use of multiple therapeutic agents. Granulocytopenia appears to predispose to bacteremia and fungal infections.
A Critique of the Parameters Used in the Evaluation of Acid-Base Disorders
Authors: William B. Schwartz, Arnold S. Relman
Journal: New England Journal of Medicine (1963)

DISORDERS of acid–base equilibrium can be caused by primary disturbances in the pulmonary regulation of the concentration of carbonic acid in body fluids, by changes in the concentration of bicarbonate and other buffer anions induced by metabolic disturbances or by some combination of the two. The degree and direction of primary respiratory disturbances can be evaluated by the determination of carbon dioxide tension (pCO2) in the blood, since this quantity is directly proportional to the actual amount of dissolved carbonic acid. For the assessment of metabolic disturbances, Van Slyke and Cullen1 proposed many years ago that the bicarbonate . . .
Collateral Circulation and Survival Related to Gradual Occlusion of the Right Coronary Artery in the Pig
Authors: GEORGE D. LUMB, LAWRENCE B. HARDY
Journal: Circulation (1963)

Studies of survival following ligation and gradual occlusion of the right coronary artery 5 mm. from its ostium have been made in 95 pigs. The pig was selected for the experiments because its coronary artery distribution closely resembles that of the human. Gradual occlusion was produced by constrictors made of a hygroscopic plastic. Survival following gradual occlusion is considered to be due to the development of collateral circulation. Comparisons of survival have been made in untreated animals and in animals treated with an orally administered, long-acting nitrate (pentaerythritol tetranitrate). Increased survival in the animals which received medication is thought to be due to the drug's acting as an aid to collateral circulation.