tbuckley/cabot-search huggingface dataset:
Medicaid and the U.S. Path to National Health Insurance
Authors: Michael Sparer
Journal: New England Journal of Medicine (2009)

The 2008 presidential election has rekindled long-simmering hopes for comprehensive health care reform. The policy debate includes references to new government programs (perhaps a federal program for the uninsured to buy into) and vague formulas for cost containment (usually involving overly optimistic assessments of savings to be generated by using health information technology). Ironically, however, the debate generally ignores what I see as the most plausible path toward universal coverage: first, expanding Medicaid to cover the largest portion of the uninsured, Americans with incomes below 350% of the federal poverty level (around $62,000 for a family of three); and second, . . .
Biofeedback and Behavioral Medicine: an Overview
Authors: David Shapiro
Journal: Psychotherapy and Psychosomatics (1979)

Biofeedback is a behavioral method of achieving or enhancing voluntary control of physiological processes. Basic studies indicate that a variety of autonomic nervous system and other internal bodily changes can be modified with the method. It has been shown that specific responses and patterns of responses can be controlled. Biofeedback appears to be a promising method of altering symptoms of psychophysiological and medical disorders, e.g., high blood pressure, vascular changes in migraine, neuromuscular abnormalities, and cardiac arrhythmias. This research has stimulated a renewed interest in the role of behavior and the usefulness of behavioral principles in the etiology, treatment, and prevention of medical disorders. The term 'behavioral medicine' calls atttention to this new perspective in medicine.
730-4 Vessel Size and the Outcome of DCA
Authors: Gregory C. Robertson, Tomoaki Hinohara, Matthew R. Selmon, James W. Vetter, Bruce J. McAuley, Dennis J. Sheehan, Richard Prokopchak, William O. Suddath, Jacqueline H. Lee, Lissa J. Braden, John B. Simpson
Journal: Journal of the American College of Cardiology (1995)
Which Colonic Adenomas Became Malignant?
Authors: Stefan J. Urbanski
Journal: Annals of Internal Medicine (1993)

Letters1 August 1993Which Colonic Adenomas Became Malignant?Stefan J. Urbanski, MDStefan J. Urbanski, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-3-199308010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The study by Koretz [1] is controversial and the conclusions are based on historical data and the premise that colonic adenomas represent a homogeneous group.Rather, one can divide colonic adenomas into two groups: those that do not become malignant (uncommitted to malignant transformation [>95% of all sporadic colonic adenomas]) and those that transform into adenocarcinomas (committed to malignant transformation [<5% of all sporadic colonic adenomas]).Evidence suggests that several histologic subtypes differ in risk for malignant transformation. Analyses of so-called flat adenomas [2] and serrated adenomas [3] suggest that these lesions transform into carcinoma (not degenerate ...References1. Koretz RL. Malignant polyps: are they sheep in wolves' clothing? Ann Intern Med. 1993; 118:63-8. Google Scholar2. Wolber AR, Owen DA. Flat adenomas of the colon. Hum Pathol. 1991; 22:70-4. Google Scholar3. Longacre TA, Fenoglio-Preiser CM. Mixed hyperplastic adenomatous polyps/serrated adenomas. A distinct form of colorectal neoplasia. Am J Surg Pathol. 1990; 14:524-37. Google Scholar4. Urbanski SJ, Haber G, Kortan P, Marcon NE. Small colonic adenomas with adenocarcinoma. A retrospective analysis. Dis Colon Rectum. 1988; 31:58-61. Google Scholar5. Cooper HS. Surgical pathology of endoscopically removed malignant polyps of the colon and rectum. Am J Surg Pathol. 1983; 7:613-23. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1993Volume 119, Issue 3Page: 250-252KeywordsAdenocarcinomaAdenomasColonoscopyLesionsLungsPopulation statistics ePublished: 15 August 2000 Issue Published: 1 August 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Taiwan transplant team blamed for HIV positive organ blunder
Authors: J. Parry
Journal: BMJ (2011)

Taiwan’s Ministry of Health has blamed the transplant team and a hospital laboratory technician at the National Taiwan University Hospital for the transplantation of organs from an HIV positive donor in August this year. The report does not name any single individual to take the blame.

In a report released on 6 October, the team was excoriated for its failure to follow standard operating procedures. “We have described in detail how this incident happened, analysed the causes of the problem and uncovered some shortcomings. It’s our hope that all the hospitals can …
Translating animal research into clinical benefit
Authors: Daniel G Hackam
Journal: BMJ (2007)

<h3>Background</h3> Infective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE. <h3>Objectives</h3> Limited information exists about IE in patients with cancer. We aimed to evaluate the characteristics of patients with cancer and IE at our tertiary care centre, including a comparison of the microorganisms implicated and their association with mortality. <h3>Methods</h3> A retrospective chart review of patients with cancer who had echocardiography for suspicion of endocarditis was conducted. A total of 56 patients with a confirmed diagnosis of cancer and endocarditis, based on the modified Duke criteria, were included in the study. Baseline demographics, risk factors for developing IE, echocardiography findings, microbiology and mortality data were analysed. <h3>Results</h3> Following the findings of vegetations by echocardiography, the median survival time was 8.5 months. <i>Staphylococcus aureus</i> was the most common organism identified as causing endocarditis. The mitral and aortic valves were the most commonly involved sites of endocarditis. Patients with <i>S. aureus</i> endocarditis (SAE) had a significantly poorer survival when compared with patients without SAE (p=0.0217) over the 12-month period from diagnosis of endocarditis. <h3>Conclusions</h3> Overall survival of patients with cancer and endocarditis is poor, with a worse outcome in patients with SAE.
Measurement of postpartum blood loss
Authors: N. Prata, C. Gerdts
Journal: BMJ (2010)

<h3>Background</h3> Human hookworm infection is a major public health issue in tropical low and middle-income countries with severe consequences. To date, improvement of water supply, sanitation, and hygiene is the major contributor to disease control, and additional control tools are needed. Here, we assess a phase I trial of a new hookworm vaccine candidate <i>Na</i>-APR-1 (M74)/Alhydrogel and <i>Na</i>-GST-1/Alhydrogel in Gabonese school-age children. <h3>Methods</h3> A double-blind, randomised, controlled, dose-escalation phase I clinical trial that aims to evaluate safety, reactogenicity and immunogenicity of <i>Na</i>-APR-1 (M74)/Alhydrogel co-administered with <i>Na</i>-GST-1/Alhydrogel hookworm vaccines in children aged 6 to 10 years living in hookworm-endemic area of Lambaréné, compared to the hepatitis B vaccine (ENGERIX-B). Children received three doses of assigned vaccines, delivered intramuscularly (deltoid) on Days 0, 56, and 112 or 180. Safety is measured from Day 0 through Day 14 by the occurrence of solicited injection site and systemic reactogenicity events. Clinical laboratory evaluations were performed approximately 14 days after each immunisation. Unsolicited adverse events were collected from Day 0 through approximately 1 month after each vaccination. <h3>Results</h3> A total of 135 children were screened, and 60, aged 6 to 10 years old, were randomised into 3 groups and received 10 µg, 30 µg or 100 µg of <i>Na</i>-APR-1 (M74)/Alhydrogel and <i>Na</i>-GST-1 Alhydrogel, respectively, compared to ENGERIX-B. At baseline, the mean age of the study population was 7.4 years and the sex ratio 1.3 (male: female). From Day 0 up to Day 14 after vaccination, the main solicited adverse events were pain and swelling at injection sites with 135 (26 of grade 2 and 1 of grade 3) and 9 events, respectively. Regarding systemic adverse events, 3 occurrences of grade 1 headache were recorded. Immunogenicity analyses are underway. <h3>Conclusion</h3> The preliminary results confirm that co-administration of the two hookworm vaccine candidates is safe and well-tolerated in Gabonese children.
OBSERVATIONS ON THE HEARTS OF MEN ENGAGED IN ATHLETICS
Authors: T. K. Richards
Journal: JAMA (1930)

It is not an unusual occurrence at athletic contests to see a collapse during or at the end of a hard race. When he collapses the clinical picture is that of utter exhaustion, the patient gasping for air and yet being unable to take a full breath. He complains of abdominal pain and is more comfortable lying on his side doubled up, with both hands pressed tightly against the abdomen. The pulse is rapid and not of good quality. Although the patient is perspiring freely, his body feels cold. There is often considerable nausea and not uncommonly vomiting, and in extreme cases there may be unconsciousness. Various reasons have been given in explanation of the cause of this collapse. Rarely it has been brought about by rupture of a heart valve. Some medical observers have attributed it to an acute cardiac dilatation. The latter condition does not seem to fit
Drug Development for Neglected Diseases — The Trouble with FDA Review Vouchers
Authors: Aaron S. Kesselheim
Journal: New England Journal of Medicine (2008)

A new federal program will give the sponsor of a drug for a tropical disease a “voucher” entitling the company to expedited FDA review of a new drug application for any other product it makes. Dr. Aaron Kesselheim writes that as enacted, however, priority-review vouchers represent an inefficient and potentially dangerous way of encouraging research into tropical diseases.
Measles and Vaccinia Antibodies in Multiple Sclerosis
Authors: John M. Adams
Journal: JAMA (1978)

To the Editor.—  Finding elevated levels of vaccinia antibodies in CSF in 30% of patients with multiple sclerosis (MS) seriously implicated vaccinia virus. 1,2 These reports complemented the finding of elevated levels of measles antibodies in CSF recorded previously from many laboratories implicating measles virus. 3-5 To my knowledge, no reports have appeared confirming the finding of high levels of antibodies to both vaccinia and measles virus in CSF of patients with MS.  In the original report by Kempe and associates, 1 including this writer, specimens from 25 patients with MS had been previously studied, and three were found to have elevated titers to measles virus and vaccinia virus in their sera and CSF (Table).  The pathogenesis is not clearly understood, but most recently Gutstein and Cohen 6 showed that antibodies enter the spinal fluid from the serum by passive diffusion. They state further, This mechanism may also explain the presence
A Highly Structured, Nuclease-Resistant, Noncoding RNA Produced by Flaviviruses Is Required for Pathogenicity
Authors: Gorben P. Pijlman, Anneke Funk, Natasha Kondratieva, Jason Leung, Shessy Torres, Lieke van der Aa, Wen Jun Liu, Ann C. Palmenberg, Pei-Yong Shi, Roy A. Hall, Alexander A. Khromykh
Journal: Cell Host & Microbe (2008)
Bone microstructural changes revealed by high-resolution peripheral quantitative computed tomography imaging and elevated DKK1 and MIP-1α levels in patients with MGUS
Authors: Alvin C. Ng, Sundeep Khosla, Natthinee Charatcharoenwitthaya, Shaji K. Kumar, Sara J. Achenbach, Margaret F. Holets, Louise K. McCready, L. Joseph Melton, Robert A. Kyle, S. Vincent Rajkumar, Matthew T. Drake
Journal: Blood (2011)
Correspondence from Scotland.
Authors: W. S. Caldwell
Journal: JAMA (1897)

<h3>To the Editor:</h3> —I have spent a few days in Glasgow, visiting the old Royal and the new Western Infirmary. It was at the former, I believe, where Mr. Lister began his career as a teacher and investigator, and where he developed our modern knowledge as to the nature of wound infection; researches that have been of incalculable benefit to the world, and given its author a place among the few, the immortal few, that were not born to die. I was a little late at my first visit to the Royal and the operator (whose name I will not mention) was all ready to begin a Syme's operation for disease of the bones of the foot. To my amazement he reached out and gave me a hearty welcome by shaking me by the hand. I took my seat and watched carefully what he would do next as the patient
Guns in the Household
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1993)

Last October several bizarre coincidences led to the death of a 16-year-old Japanese exchange student in a suburb of Baton Rouge, Louisiana. The student and his American friend, looking for a Halloween party, missed the correct house by a few doors and rang the wrong doorbell. The exchange student, in the spirit of the holiday, was moving around in mimicry of John Travolta in the movie Saturday Night Fever, and the frightened woman who answered the door called to her husband to get his gun. The husband mistook a camera in the student's hand for a weapon, and when the . . .
Neuroprotective ferulic acid (FA)–glycol chitosan (GC) nanoparticles for functional restoration of traumatically injured spinal cord
Authors: Wei Wu, Seung-Young Lee, Xiangbing Wu, Jacqueline Y. Tyler, He Wang, Zheng Ouyang, Kinam Park, Xiao-Ming Xu, Ji-Xin Cheng
Journal: Biomaterials (2013)
What is Change of Type in Diseases?
Authors: W. O. Markham
Journal: BMJ (1865)

must not be surprised if his lectures on Ml1edical Errors "excite", as our French brethren say, "susceptibilities".If he had contented himself with pointing out the illogical therapeutical doings of the Arabians, or of the Greeks or Romans of old, or even of our dead and buried great ones of the last generation, he would probably have not been troubled with objectors.But to prove to a modern living doctor that some favourito method of cure of his-in defence of which he is ready to stake his reputation and all his convictions-is a perfect delusion, na- turally renders that doctor atrabilious.It has very much, in fact, the effect of treading on a man's fa- vourite-that is, miost exquisitely tender-corn.It is, indeed, at all tines, a serious thing to be shown up as an illogical dealer with facts by so high an au- thority as Dr. Barclay, and in a work, too, especially devoted to the treatment of the " fallacies of the faculty"; and persons naturally become very thinskinned when, in addition, they are castigated before that high court, the College of Physicians.Happy are such persons, therefore, if they can find a
A PROTECTIVE METHOD OF APPLYING RADIUM IN THE CERVIX
Authors: W. J. Woolston
Journal: JAMA (1924)

Radium is applied to the cervix in one of three ways: (1) in a screened capsule in the cervical canal; (2) in a screened capsule in the cervical canal, with a second container crosswise resting against the vaginal surface of the cervix for "cross-fire"; (3) by embedding needles (emanation or element) into the cervical tissue. The important detail is the screening of the vagina, bladder and rectum, so that the operator may feel reasonably assured that in those cases in which a heavy dosage is required there will be no damage done to the neighboring structures. With this idea in mind, we experimented with several substances, and finally chose dental impression compound. This is molded into the form of a hollow cone and made to fit snugly over the cervix in such a manner that the margins of the cone completely fill the fornices of the vagina; thus, it acts
The Etiology and Treatment of Psoriasis
Authors: J. H. Heaney
Journal: BMJ (1927)

T-HFJ BRITIS rig-lt of the hole in tlhe iiieso z!l9n, anid this complication wi1 llinot be seenl.2. ITnfection of the Sobrt-,e Line.-SeveralFrench surgeons mainitatin that vomiting beginning a couple of (lays after the operation may be due to infection of the peritoneumr around the suture linoe.It is quite possible thla-t this may be true, but I lhave no recollection of seeing it.3. Adhesion of the Sutuare Line.-I am persuaded that the commonest cause of persistenit and sometimes dangerous vVlmlitinig after gastric operations is a sticking togethler of tile aniterior anid postLerior suture lines in tlle mucosa.Of course, a careless surgeoniimay actually sew them together, at any rate at a poinit or two, but apart from this gross technical elrol it is possible for the cut edges to adhere.If this occurs tVte ' , l be copious and persistent vomiting, wlhich differs t. om that; of vicious circle in that no bile is brought up.Yfhl-e cilo canniiot enter the stomach, and the gastr'ic cointenlts cantiot leave it.I first learnt of this daniger after performing gastro-jejunostomy for pyloric ulcer.The patient, a woman, vomited about twice a day for three days, br-inging up all she took and much gastric juice besides, but no bile.
P760Glucose-insulin and sphingosine-1-phosphate therapy against de novo AHF: two new approaches to treatment of acute heart failure (AHF)
Authors: G Deshpande, S Lecour, LH Opie
Journal: Cardiovascular Research (2014)

Purpose: Acute heart failure (AHF) is a clinical emergency, with high mortality and re-hospitalizations. We established a model of de novo AHF to study the molecular survivor activating factor enhancement (SAFE) pathway activated by sphingosine-1-phosphate (S1P), a component of HDL. S1P activates SAFE pathway by binding to its receptors which via the phosphorylation of signal transducer and activator of transcription 3 (STAT3) translocate to the nucleus and promote cell survival and improve recovery. We tested the involvement of the S1P-activated SAFE pathway in rat hearts subjected to de novo AHF. We also examined the combined effect of metabolic therapy by glucose-insulin (GI) and S1P. Methods: AHF was induced by a reducing the aortic perfusion pressure of the Langendorff perfused rat heart from 100cm H2O to 20cm H2O. Acute stress was imposed in the AHF phase by low glucose (2.5mmol/L) and elevating free fatty acids (FFA) (1.3mmol/L), thus creating combined hypotensive and metabolic stress. GI 11.1mmol/L and 0.3mU respectively was added in the recovery phase following AHF. The involvement of the (SAFE) pathway was examined, by AG490, a pharmacological inhibitor of SAFE, and by Western blots for activation of signal transducer and activator of transcription 3 (STAT3). Results: S1P improved the heart rate (HR) versus controls (148.8±26.4 vs. 37.9±9.7; n=6; p<0.01) BPM. Treatment by AG490 reduced heart rate vs. S1P (42.3±17.1 vs. 148.8±26.4; p<0.05 vs. S1P+AG490; n=6). STAT3 was increased (p<0.05) in the nuclear fraction in hearts treated with S1P vs. those treated with S1P+AG490. There was no change in the LV developed pressure. Combined GI and S1P in the recovery phase improved HR vs. controls (214.4±19.2 vs. 66.5±22.6 BPM; p<0.001vs. controls; n=8) and improved LV developed pressure, indicating better contractility (177.2±38.6 vs. 20.5±8.3 mmHg, p<0.001vs. controls; n=8). Conclusions: S1P activates the SAFE pathway by upregulating STAT3 in the nuclear fraction in model de novo AHF and improves cardiac function by increasing HR, thus indicating enhanced sinus node activity. The combination of metabolic GI and molecular S1P therapies improves HR and contractility, thus suggesting principles of future therapy against AHF.
Delineation of impaired regional myocardial perfusion by positron emission tomography with H2(15)O.
Authors: M N Walsh, S R Bergmann, R L Steele, J L Kenzora, M M Ter-Pogossian, B E Sobel, E M Geltman
Journal: Circulation (1988)

Positron emission tomography with 15O-labeled water (H2(15)O) can be used to delineate abnormal regional myocardial blood flow in experimental animals. To determine the feasibility of this method in humans, we studied 33 subjects (9 normal volunteers and 24 patients with angiographically documented coronary artery disease) at rest and after myocardial hyperemia induced with intravenous infusion of dipyridamole. At rest, the myocardial region demonstrating the lowest relative H2(15)O activity exhibited 71 +/- 8% of activity in the region with peak activity in control subjects and 62 +/- 17% in patients (p = NS). After the dipyridamole infusion, differences between the two groups were accentuated. In control subjects, activity in the region with lowest relative radioactivity averaged 77 +/- 5% of that in the region with peak activity. In patients, it averaged 55 +/- 22% of activity in the region with peak activity (p less than 0.01). Results in patients with ischemia with or without a history of remote myocardial infarction were not significantly different. In 22 of the 24 patients, the region with lowest relative perfusion corresponded anatomically to the region of myocardium distal to a stenosis. Thus, delineation of regional myocardial perfusion in patients with coronary artery disease is possible with positron emission tomography and H2(15)O. Further studies will be necessary to prospectively determine sensitivity and specificity.
THE RELATION OF ALTERED LOCAL TISSUE REACTIVITY (SHWARTZMAN PHENOMENON) TO INFECTION AND INFLAMMATION
Authors: Alan R. Moritz
Journal: The Journal of Experimental Medicine (1937)

Living B. aertrycke were effective in place of aertrycke filtrate as either the preparatory or the provocative injection in the production of a positive Shwartzman reaction. When living B. aertrycke were injected subcutaneously a more severe inflammation resulted, organization was delayed, and more living organisms survived at the site of inoculation in rabbits that had received 24 hours later an intravenous injection of B. aertrycke filtrate than was the case in similarly infected rabbits that had not received a subsequent injection of bacterial filtrate. When a local state of hypersusceptibility was created by the subcutaneous injection of B. aertrycke filtrate, the subsequent (24 hours) injection of living B. aertrycke led to the development at the site of subcutaneous preparation of a hemorrhagic necrosing inflammation in which the bacteria localized.
Topics in Gastroenterology 5
Authors: Charles B. Clayman
Journal: JAMA (1979)

A thorough and comprehensive review of selected subjects is provided in what is generally a lucid and assimilable fashion. If any criticism at all can be leveled, it might be that a bit more space has been given to cancer of the colon and surgery of the bile ducts, at the expense of the section on drugs and the liver, and five briefer topics, including a delightful and informative discussion of the virology and pathogenesis of acute infectious diarrhea.