tbuckley/cabot-search huggingface dataset:
A Conflict of Interest
Authors: Michael A. LaCombe
Journal: Annals of Internal Medicine (1993)

On Being a Doctor1 October 1993A Conflict of InterestMichael A. LaCombe, MDMichael A. LaCombe, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-7_Part_1-199310010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I didn't kill her, you know that, the doctor told his lawyer over lunch. I hate this whole business. I hate the implication that I killed her, wantonly, negligently killed her with willful disregard. Her husband knows I didn't do that. His lawyer Slattery knows I didn't do that.What the jury thinks is all that matters, said the lawyer. The inflammatory language impresses juries and may get you angry enough so you won't think clearly on the stand. It's a money game, remember. Think of it that way, just a money game. Slattery wants a big settlement, of which ... Author, Article, and Disclosure InformationAuthors: Michael A. LaCombe, MDCorresponding Author: Michael A. LaCombe, MD, Oxford Hills Internal Medicine Group, 23 Winter Street, Norway, ME 04268. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byClinical medicine: Perspectives for the future 1 October 1993Volume 119, Issue 7_Part_1 Page: 623-626 Keywords Engineers Games Heart Homicide Hospital medicine Ischemia Mouth Nurses Walking Wine ePublished: 15 August 2000 Issue Published: 1 October 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Relapsing polychondritis with crescentic glomerulonephritis.
Authors: G H Neild, J S Cameron, M H Lessof, C S Ogg, D R Turner
Journal: BMJ (1978)

Relapsing polychondritis is rare and its cause is unknown. The tissues affected are those with a high glycosaminoglycan content, such as cartilage, the aorta, the sclera and cornea, and parts of the ear. Symptoms can usually be controlled with oral steroids, but when there is coexistent progressive crescentic glomerulonephritis quadruple chemotherapy may be used. Three cases of the clinical syndrome of relapsing polychondritis were studied in which rapidly progressive cresentic glomerulonephritis developed. In two the patients appeared to respond to aggressive treatment with immunosuppressive agents and anticoagulants. The multisystemic nature of the disease, the renal lesions, and the response to treatment all suggested that the condition might be related to periarteritis nodosa.
Microsomal triglyceride transfer protein gene polymorphism strongly influences circulating malondialdehyde-modified low-density lipoprotein
Authors: Kenji Okumura, Akiko Imamura, Ryuichiro Murakami, Ryotaro Takahashi, Xian Wu Cheng, Yasushi Numaguchi, Toyoaki Murohara
Journal: Metabolism (2009)
Ban on payment to donors causes blood shortage in India
Authors: G. Mudur
Journal: BMJ (1998)

Blood banks and hospitals across India are reporting an acute scarcity of blood after a Supreme Court order to ban payment to donors came into effect on 1 January.

Blood banks in the private sector as well as in government hospitals have turned away patients, and doctors have expressed fears that the ban will drive the trade in paid blood underground.

India's annual demand for blood is about …
Coronary Care for the House Officer
Authors: Raphael F. Smith
Journal: JAMA (1990)

This book is another edition in the Williams and Wilkins<i>House Officer</i>series and is designed to serve as a reference manual for the medical trainee assigned to the coronary care unit. The book is compact in size (5 1/2 × 7 1/2 inch) and is written in a concise style to achieve this objective. Although small, the book contains 38 chapters, and each addresses a clinical condition, procedure, or problem that may be encountered in the coronary care unit. As would be expected, the diagnosis and management of acute myocardial infarction, congestive heart failure, and cardiac arrhythmias are covered thoroughly, but there are also chapters in which the psychological aspects of coronary care and the management of the geriatric patient in this clinical setting are discussed. Each chapter is followed by a list of selected references that support the abbreviated text. The senior author is the director of the
5-oxo-ETE induces pulmonary eosinophilia in an integrin-dependent manner in Brown Norway rats.
Authors: P Stamatiou, Q Hamid, R Taha, W Yu, T B Issekutz, J Rokach, S P Khanapure, W S Powell
Journal: Journal of Clinical Investigation (1998)

We have shown previously that the 5-lipoxygenase product 5-oxo-6,8, 11,14-eicosatetraenoic acid (5-oxo-ETE) is a highly potent eosinophil chemoattractant in vitro. To determine whether this substance can induce pulmonary eosinophil infiltration in vivo, it was administered to Brown Norway rats by tracheal insufflation. Eosinophils were then counted in lung sections that had been immunostained with an antibody to eosinophil major basic protein. 5-Oxo-ETE induced a dramatic increase in the numbers of eosinophils (ED50, 2.5 microg) around the walls of the airways, which reached maximal levels (five times control levels) between 15 and 24 h after administration, and then declined. LTB4 also induced pulmonary eosinophil infiltration with a similar ED50 but appeared to be somewhat less effective. In contrast, LTD4 and LTE4 were inactive. 5-Oxo-ETE-induced eosinophilia was unaffected by the LTB4 and PAF antagonists LY255283 and WEB 2170, respectively. However, it was inhibited by approximately 75% by monoclonal antibodies to CD49d (VLA-4) or CD11a (LFA-1) but was not significantly affected by an antibody to CD11b (Mac-1). In conclusion, 5-oxo-ETE induces pulmonary eosinophilia in Brown Norway rats, raising the possibility that it may be a physiological mediator of inflammation in asthma.
SURGICAL OBSERVATIONS IN THE PHILIPPINES.
Authors: J. M. BANISTER
Journal: JAMA (1904)

Having for the past twelve months been closely associated with the surgical work at the First Reserve Hospital in the City of Manila, it has occurred to me that it might be of interest to the members of the Manila Medical Society should the results of this year's experience in surgery be presented to them, covering, as it does, a wide range of surgical conditions. Moreover, I am induced to select the above as the title of my paper by reason of the erroneous views prevailing in certain quarters, both in this archipelago and in the United States, as to the results of surgical work in the Philippine Islands. I shall first give a tabulated list of the various operations performed by the surgeons on duty at the First Reserve Hospital since Jan. 1, 1903, and then adduce certain conclusions, which would seem justified by the results. The operations enumerated
Influence of Tap Water Quality and Household Water Use Activities on Indoor Air and Internal Dose Levels of Trihalomethanes
Authors: John R. Nuckols, David L. Ashley, Christopher Lyu, Sydney M. Gordon, Alison F. Hinckley, Philip Singer
Journal: Environmental Health Perspectives (2005)

Individual exposure to trihalomethanes (THMs) in tap water can occur through ingestion, inhalation, or dermal exposure. Studies indicate that activities associated with inhaled or dermal exposure routes result in a greater increase in blood THM concentration than does ingestion. We measured blood and exhaled air concentrations of THM as biomarkers of exposure to participants conducting 14 common household water use activities, including ingestion of hot and cold tap water beverages, showering, clothes washing, hand washing, bathing, dish washing, and indirect shower exposure. We conducted our study at a single residence in each of two water utility service areas, one with relatively high and the other low total THM in the residence tap water. To maintain a consistent exposure environment for seven participants, we controlled water use activities, exposure time, air exchange, water flow and temperature, and nonstudy THM sources to the indoor air. We collected reference samples for water supply and air (pre–water use activity), as well as tap water and ambient air samples. We collected blood samples before and after each activity and exhaled breath samples at baseline and postactivity. All hot water use activities yielded a 2-fold increase in blood or breath THM concentrations for at least one individual. The greatest observed increase in blood and exhaled breath THM concentration in any participant was due to showering (direct and indirect), bathing, and hand dishwashing. Average increase in blood THM concentration ranged from 57 to 358 pg/mL due to these activities. More research is needed to determine whether acute and frequent exposures to THM at these concentrations have public health implications. Further research is also needed in designing epidemiologic studies that minimize data collection burden yet maximize accuracy in classification of dermal and inhalation THM exposure during hot water use activities.
Most disputes between insurers and doctors relate to incorrect coding, conference hears
Authors: N. Siva
Journal: BMJ (2009)

Healthcare providers and patients defrauded one insurance company of almost £2m (€2.1m; $2.8m) in false claims in 2003, with three quarters of the fraud being perpetrated by the providers and the rest by policy holders, a conference was told last week.

Simon Peck, head of provider information and audit at AXA PPP Healthcare, told a BMA conference on private practice that a total of £1.8m was recovered by the company in 2003 after investigations into fraudulent claims.

Julian …
Partial liquid ventilation with small volumes of FC 3280 increases survival time in experimental ARDS
Authors: U Kaisers, M Max, J Walter, R Kuhlen, D Pappert, K Falke, R Rossaint
Journal: European Respiratory Journal (1997)

The aim of this study was to determine the prolonged effects of sequential doses of a highly purified perfluorocarbon (FC 3280) on gas exchange and survival time in experimental acute respiratory distress syndrome (ARDS). The study was prospective, randomized and controlled. Twelve pigs (body weight 30 +/- 5 (mean +/- SD) kg) were surfactant-depleted by repetitive lung lavages, reducing arterial oxygen tension (Pa,O2) to 6.9 +/- 1.6 kPa (52 +/- 12 mmHg) (mean +/- SD) at an inspired oxygen fraction (Fi,O2) of 1.0. They were then randomized to receive partial liquid ventilation by sequential intratracheal application of 7.5 mL.kg-1 FC 3280 at 30 min intervals to a cumulative dose of 15 mL.kg-1 (treatment group), or to receive no further treatment (control group). Haemodynamics and gas exchange were assessed at 30 min intervals after instillation, and hourly afterwards in both groups until death. In the treatment group, Pa,O2 was 8.9 +/- 4.4 kPa (67 +/- 33 mmHg) after 7.5 mL.kg-1 FC 3280 and 14.1 +/- 9.9 kPa (106 +/- 74 mmHg) after 15 mL.kg-1 FC 3280 (NS). In the control group, gas exchange remained unchanged. Haemodynamics were stable in the treatment group and deteriorated in the control group. Peak airway pressures and dynamic compliance were not significantly affected in the treatment group. Mean survival time was 8.2 +/- 4.5 h in the treatment group and 1.8 +/- 1.4 h in the control group (p &lt; 0.05). Upon histological examination, both study groups were not significantly different in total lung injury scores. We conclude that partial liquid ventilation with small volumes of FC 3280 provides improvement in gas exchange and increases survival time in experimental acute respiratory distress syndrome.
Patients With Recently Diagnosed Nonischemic Cardiomyopathy Benefit From Implantable Cardioverter-Defibrillators
Authors: Alan Kadish, Andi Schaechter, Haris Subacius, Emil Thattassery, William Sanders, Kelley P. Anderson, Alan Dyer, Jeffrey Goldberger, Joseph Levine
Journal: Journal of the American College of Cardiology (2006)
Surgical Errors and Safeguards
Authors: Laurence S. Fallis
Journal: JAMA (1960)

The success of a book may, in general, be gauged by the number of its editions. The appearance of a new edition is in itself evidence of the value of a publication. This fifth edition, edited by the son of the original author, has been enlarged and enhanced by contributions from a distinguished group of collaborators, covering in this manner practically all the fields of surgery. The objective of this lucidly written and profusely illustrated volume, in calling attention to diagnostic errors and indicating pitfalls that may be encountered in the performance of an operation, is commendable, since these topics receive scant attention in current literature and popular textbooks. This goal has been reached in most of the chapters, but in a few the authors have strayed from the path and expressed personal views, some of which will not find general acceptance among practicing and teaching surgeons. It is refreshing
The reforms are already working
Authors: P. R. Brimblecombe
Journal: BMJ (2011)

In her editorial Fiona Godlee wrote, “Health reform has gained a bad name in England, but perhaps that’s because we had a system that was largely working and improving when these latest changes were imposed.”1 I wonder how you came to this conclusion. Perhaps if you understood the rationale behind the reforms you would think differently. So let me enlighten …
Urine Drug Testing, Water Intoxication, and Anticholinergic Medication-Reply
Authors: David C. Klonoff, Andrew H. Jurow
Journal: JAMA (1991)

In Reply.—  We agree with Dr DeHoff that impairment of bladder emptying due to anticholinergic medication, an anatomic obstruction, or paruresis, which was present in our patient, could lead to a mistaken inference of a state of dehydration. The person might then drink a large amount of water in an attempt to correct the perceived dehydration. In the presence of impaired urine dilution, the result could be acute water intoxication.
A SYNDROME OF HYPERTENSION, CONVULSION, AND CEREBRAL HÆMORRHAGE IN THALASSÆMIC PATIENTS AFTER MULTIPLE BLOOD-TRANSFUSIONS
Authors: P. Wasi, P. Pootrakul, A. Piankijagum, S. Na-Nakorn, D. Sonakul, P. Pacharee
Journal: The Lancet (1978)
Hyperinsulinemia in Nondiabetic Asian Subjects Using Specific Assays for Insulin, Intact Proinsulin, and Des-31, 32-Proinsulin
Authors: Dinesh K Nagi, Vidya Mohamed Ali, Shahenaz Walji, Sachin K Jain, John S Yudkin
Journal: Diabetes Care (1996)

OBJECTIVE To investigate the contributions of intact proinsulin and of des-31,32-proinsulin to fasting concentrations of insulin-like molecules in nondiabetic subjects from two ethnic groups (Asian and white) and to see whether Asian subjects are hyperinsulinemic compared with white subjects using highly specific assays for insulin. RESEARCH DESIGN AND METHODS We investigated subjects with normal glucose tolerance (NGT) (82 Asian and 67 white) and impaired glucose tolerance (IGT) (16 Asian and 13 white), diagnosed by using standard World Health Organization criteria. Highly specific monoclonal antibody-based assays were used to measure insulin, intact proinsulin, and des-31, 32-proinsulin. An index of insulin secretion was derived as a ratio of incremental insulin to incremental glucose concentrations from 0 to 30 min during an oral glucose tolerance test. RESULTS Asian subjects with NGT, despite being significantly thinner than whites (BMI 24.4 ± 3.5 vs. 25.7 ± 3.7 kg/m2, P = 0.04), had a more central distribution of obesity (subscapsular-to-triceps skinfold ratios 1.36 ± 0.69 vs. 1.17 ± 0.41, P = 0.047). Asian subjects with NGT showed significant hyperinsulinemia 2 h after oral glucose load (plasma insulin median 274 pmol/l [range 26–1,505] vs. 186 pmol/l [27–720], P &amp;lt; 0.005) compared with whites. Asian subjects with NGT also had significantly higher insulin increments (P &amp;lt; 0.02) compared with white subjects and significantly higher fasting concentrations of intact proinsulin (median 2.7 pmol/l [range 0.9–14.1] vs. 2.1 [0.8-7.9], P &amp;lt; 0.02) but not of des-31, 32-proinsulin. The ratio of proinsulin-like molecules to the total sum of three insulin-like molecules, however, was similar between Asian and white subjects with NGT and IGT. CONCLUSIONS These results indicate that when specific assays for insulin are used, Asian subjects show postglucose load hyperinsulinemia and fasting hyperproinsulinemia compared with white subjects, suggesting increased insulin secretion and/or the presence of underlying insulin resistance in this ethnic group. The contribution of proinsulin-like molecules to total insulin-like molecules was similar between Asian and white subjects with NGT and IGT, and there was no contribution to hyperinsulinemia in Asian subjects.
Letter: Ischaemic heart disease in young women.
Authors: I M Stewart
Journal: BMJ (1975)

cancer were fewer thn those of Professor Cooper and his colleagues but we included only selected cases.Patients with bacterial infection, confinned by the nitroblue tetra- zolium test,8 were excluded.That raised serum muramidase levels may in some cases of untreated cancer be due to local bacterial infection cannot be ruled out, partioularly in colorectal canoer, which often infiltrates the superficial layer of the mucous membrane.This may explain why only some patients bave raised serum muranidase levels.The observation that bacterial infection is associated with raised serum muramidase levels prompted us to measure these in 40 patients, of whom 28 had a local and 12 a systemic infection.Some of the patients had cancer and others did not.The serum muraxnidase level was raised in all of the patients with systemic infections but in only five of the 28 with local infections.All of these five had cancer and their local infec- tion was in tissue surrounding the neoplasm.The nitroblue tetrazolium test was positive in four out of the five.Our findings lead us to believe that a raised serum muramidase level in some cancer patients is only a secondary phenomenon and is of no diagnostic or prognostic value.-Weare, etc.,
Q fever endocarditis in Queensland.
Authors: H G Wilson, G H Neilson, E G Galea, G Stafford, M F O'Brien
Journal: Circulation (1976)

Thirteen patients with proven Q fever endocarditis and three additional patients with probable endocarditis are reviewed. The most helpful diagnostic test is the demonstration of a high complement fixing antibody titre to Phase 1 antigen of Coxiella burneti. The macroscopic pathology of the aortic valve is described and includes aneurysmal pockets in the aortic wall and valve annulus which are demonstrable angiographically. Evidence is presented that the infection may be controlled by prolonged tetracycline therapy and that this is accompanied by a falling antibody titre to Phase 1 antigen. Valve replacement is undertaken only for symptomatic and hemodynamic indications. The combined tetracycline therapy and valve replacement have produced a fall in titres with eradication of infection and palliation of the cardiac disability in all patients followed for long periods.
Abstract A33: Markov model of VeriStrat© selection criteria for EGFR Inhibitor therapy predicts improved survival for previously treated patients with NSCLC
Authors: Richard E. Nelson, Wallace Akerley
Journal: Clinical Cancer Research (2012)

Abstract Background: EGFR inhibitor therapy extends survival as 2nd or 3rd line treatment of patients with previously treated metastatic non-small cell lung cancer (NSCLC), but a randomized trial of 2nd line therapy in unselected patients showed similar benefit versus conventional chemotherapy. EGFR mutation analysis is useful in choosing therapy, but it is applicable to only a minority of patients due to low frequency of mutation in a North American population and ignores the majority of patients who may benefit with wild type status. Alternative selection strategies are needed. VeriStrat is a protein expression profile utilizing matrix-assisted laser desorption/ionization time of flight mass spectrometry to analyze serum. The test classifies patients as VeriStrat Good or VeriStrat Poor based on likelihood of benefitting from EGFR inhibitor therapy. The objective of this research was to model the anticipated survival of patients using a Veristrat Selection Strategy for 2nd line therapy of NSCLC to the alternative treatment strategies of chemotherapy for all (Chemoall), EGFR inhibitor to all (EGFR-all) l, or to performance status selection (PS selection), a common practice, where those with good performance status receive chemotherapy and those with poor PS receive EGFR inhibitor therapy. Methods: We developed a Markov model to estimate the expected survival of patients for 4 different treatment strategies for NSCLC: (1) VeriStrat Selection, (2) chemotherapy to all patients, (3) EGFR inhibitor to all patients, and (4) PS selection. Model inputs, taken from published literature, for the base-case analysis (and ranges) were the following: PS 0-1, 50% (35%–65%); VeriStrat Good, 60% (45%–75%); VeriStrat Good if PS &amp;gt;1, 40% (25%–55%); 1-year survival on EGFR inhibitor if VeriStrat Good, 47% (43–50); 1-year survival on EGFR inhibitor if VeriStrat Poor, 12% (8–16) and 1-year survival on chemotherapy, 29% (23–35). Probabilistic sensitivity analysis was performed using 10,000 2nd order Monte Carlo simulations. Results: In the base case analysis, the median survival for EGFR-all was 8.97 months, Chemo-all was 8.48 months, PS selection was 8.20 months and VeriStrat selection was 10.03 months. In the sensitivity analysis, the VeriStrat selection strategy yielded the longest survival in each of the 10,000 simulations. Conclusion: These results suggest that VeriStrat-based selection of “standard of care” 2nd line therapy of NSCLC improves survival to a clinically significant degree. This strategy, in the absence of new therapies, appears to improve median survivals by 4–6 weeks.
Background to Britain's Health Service
Authors: Hugh Clegg
Journal: New England Journal of Medicine (1952)

HUNDREDS of thousands of words have been written about Britain's National Health Service (N. H. S.). Much that has been written has been mere propaganda. Ridiculous claims for the N. H. S. have been made in my own country by Socialist spokesmen. They have said, for example, that the fall in the infant mortality rate is due to the Labor Government's health service. This is, of course, nonsense. The infant mortality rate has been falling steadily for a large number of years—under the old system and under Liberal and Conservative governments. British medicine did not begin with the appointment of . . .
Follow-up of the Cancer Patient
Authors: John M. Merrill
Journal: JAMA (1983)

Contemporary treatment by an oncologist is presumed to have preceded the starting point of this text. The editors have allowed no indulgence in speculative measures; for example, adjuvant chemotherapy is considered at points where it is of demonstrable value or noted as a question for research protocol. At several points, particularly in the follow-up of successfully treated neoplasms, greater concern for nonneoplastic or second primary neoplastic disease should be demonstrated. The toxic effects of therapy should also be in diagnostic differentials. The one flawed chapter was that on breast cancer, where a unimodal surgical approach mentioned neither a combined modality treatment option with radiation therapy, nor any role for postprimary treatment, adjuvant chemotherapy. Diligent editing has eliminated redundancy in the brief chapters, all four to six pages devoted to each tumor type. The editorial belief that the nononcologist can provide excellent and cost-effective follow-up seems fulfilled in all solid-tumor areas.