tbuckley/cabot-search huggingface dataset:
Treatment of Heart Diseases
Authors: Samuel Zoneraich
Journal: JAMA (1993)

James T. Willerson has edited an excellent text illustrated with superb artwork. Furthermore, through regular updates, the reader will be exposed to the latest achievements in the rapidly evolving field of cardiology.  The book includes seven chapters, written by specialists and pioneers who focus on the treatment of the most common heart diseases: coronary heart disease, arrhythmias and abnormalities in conduction, hyperlipidemias, and hypertension.  In chapter 2 Packer draws the reader's attention to the alarming increase in incidence and prevalence of chronic congestive heart failure. Despite significant improvements in diagnostic techniques and treatment, nearly 400 000 individuals in the United States develop congestive heart failure each year. Packer not only presents an excellent overview of the state of the art but also outlines in small and well-documented subchapters the nature and treatment of congestive heart failure resulting from involvement of the valves, myocardium, pericardium, and primary pulmonary hypertension.  When it
Corrigendum to “UK malaria treatment guidelines” [Journal of Infection 54 (2007) 111–121]
Authors: David G. Lalloo, Delane Shingadia, Geoffrey Pasvol, Peter L. Chiodini, Christopher J. Whitty, Nicholas J. Beeching, David R. Hill, David A. Warrell, Barbara A. Bannister
Journal: Journal of Infection (2009)
OC-080 Ibd-Sshamp (Supported, Self help and Management Programme); UK’S first Internet based Remote Management System for Managing Stable IBD
Authors: M W Johnson, K Lithgo, T Price
Journal: Gut (2013)

<h3>Introduction</h3> In February 2012 the Luton &amp; Dunstable University Hospital in Hertfordshire, became the first hospital in UK to commence a remote management programme for stable inflammatory bowel disease (IBD) patients. The project, entitle IBD-SSHAMP (Supported, Self Help And Management Programme), was funded by an Innovation Award presented by the East of England Primary Care Trust (PCT) Innovation Team. The aim was to discharge patients from routine clinic visits, whilst maintaining an efficient remote monitoring system that could be co-ordinated through our specialist nurses. <h3>Methods</h3> The first stage was to ensure we had a complete and up-to-date database containing all of our IBD patients. After a retrospective 10 year review we identified a total of 2790 IBD patients, from 19 different ethnic backgrounds. Of these, 26 patients lacked mental capacity with learning disability or dementia and 117 did not have internet access. 370 of our original cohort had died by the time of commencing the project. Using Patient Knows Best we developed individualise websites to offer a communication portal between patients and specialist care, through which we could monitor their symptoms and offer management advice through a traffic light system. An alert is sent out to the IBD nurses and clinician involved if any patients symptom indices deteriorate markedly. Periodic faecal calprotectin and inflammatory markers will also be used to support the monitoring process. Virtual clinics will be held for these patients twice a year. If necessary patients can be seen in hospital clinics usually within 24–48 hrs. <h3>Results</h3> Of the available 2,277 IBD patients, we have successfully discharged 400 onto the first wave of IBD-SSHAMP, with a further 300 due to follow shortly in the second wave. With confidence in the system building amongst the relevant clinicians the second wave will primarily contain patients stable on immunosuppressants eg. azathioprine. With most patients being seen at 6 monthly intervals, and follow up clinic appointments costing our PCT £85, this project could potentially save them £119,000 per year, whilst still providing a patient friendly and efficient management system. <h3>Conclusion</h3> IBD-SSHAMP is the UK's first internet based remote management system for managing stable IBD patients. It aims to reduce cost and free up NHS outpatient time, whilst providing an efficient monitoring and management programme. This is a proof of concept project, from which further data outcomes will be presented. <h3>Disclosure of Interest</h3> None Declared
THE PATHOLOGY THAT REMAINS AFTER THE NON-SURGICAL TREATMENT OF PERITONITIS.
Authors: H. D. NILES
Journal: JAMA (1903)

Faithful followers of the teachings of rational medicine believe that actual disease within the abdomen, as in other parts of the body, always means a pathology, the removal or correction of which is essential to the restoration of normal health; and that the efficiency of any treatment for disease in this region, as elsewhere, should be estimated chiefly by the effect it has in removing or modifying the pathology which produces the symptoms. In the management of peritonitis, where the morbid processes are concealed beneath a rigid or distended abdomen, there are many temptations to lure us from these teachings; and doubtless at times we all find ourselves reading, discussing, or perhaps practicing treatments which, in the light of the revelations of the modern operating-room, we must know are contrary to sound surgical principles and common sense. I believe that we are especially prone to fall into these errors in our
Daily Assessment of Pain in Adults with Sickle Cell Disease
Authors: Wally R. Smith, Lynne T. Penberthy, Viktor E. Bovbjerg, Donna K. McClish, John D. Roberts, Bassam Dahman, Imoigele P. Aisiku, James L. Levenson, Susan D. Roseff
Journal: Annals of Internal Medicine (2008)

Background: Researchers of sickle cell disease have traditionally used health care utilization as a proxy for pain and underlying vaso-occlusion. However, utilization may not completely reflect the amount of self-reported pain or acute, painful episodes (crises). Objective: To examine the prevalence of self-reported pain and the relationship among pain, crises, and utilization in adults with sickle cell disease. Design: Prospective cohort study. Setting: Academic and community practices in Virginia. Patients: 232 patients age 16 years or older with sickle cell disease. Measurements: Patients completed a daily diary for up to 6 months, recording their maximum pain (on a scale of 0 to 9); whether they were in a crisis (crisis day); and whether they used hospital, emergency, or unscheduled ambulatory care for pain on the previous day (utilization day). Summary measures included both simple proportions and adjusted probabilities (for repeated measures within patients) of pain days, crisis days, and utilization days, as well as mean pain intensity. Results: Pain (with or without crisis or utilization of care) was reported on 54.5% of 31 017 analyzed patient-days (adjusted probability, 56%). Crises without utilization were reported on 12.7% of days and utilization on only 3.5% (unadjusted). In total, 29.3% of patients reported pain in greater than 95% of diary days, whereas only 14.2% reported pain in 5% or fewer diary days (adjusted). The frequency of home opiate use varied and independently predicted pain, crises, and utilization. Mean pain intensity on crisis days, noncrisis pain days, and total pain days increased as the percentage of pain days increased (P < 0.001). Intensity was significantly higher on utilization days (P < 0.001). However, utilization was not an independent predictor of crisis, after controlling for pain intensity. Limitations: The study was done in a single state. Patients did not always send in their diaries. Conclusion: Pain in adults with sickle cell disease is the rule rather than the exception and is far more prevalent and severe than previous large-scale studies have portrayed. It is mostly managed at home; therefore, its prevalence is probably underestimated by health care providers, resulting in misclassification, distorted communication, and undertreatment.
Congenital Complete Heart-block: The Effect of Atropine
Authors: G. M. Currie
Journal: BMJ (1940)

MTHE BRITIA 769 ably smaller percentages of women than men were found to be carriers.We can find only one reference in the report to the effect of cleanliness of the throats tested: on page 55, referring to the tonsils of nine schoolboys, it is stated: "From six of these cases the Type 19 strepto- coccus was isolated, while the remaining three gave com- pletely sterile swabs-probably as a result of recent gargling or throat-painting."Antiseptics were in some disrepute at the end of the last war, in great part owing to the conflicting results obtained by those attempting to eliminate meningococcus carriers.Now that it is known that carriers are so numerous among the general population and that the form of meningo- coccus carried (Group II) is comparatively harmless, the Ministry of Health (1940) discourages the search for carriers and states in its Memorandum that local treat- ment of the nasopharynx is probably useless.We hope, however, that contacts and carriers are not dis- couraged from using such simple hygienic measures as advocated here in addition to the fresh air and exercise prescribed.Infection, as stated on page 10 of the Ministry's Memorandum, appears to be through the nose and mouth, and it must surely be an advantage for indi- viduals to take any steps likely to clear away infecting bacteria while they are still only on the surface of the epithelium.From our personal experience of "gargling fatigues" we know that the men generally appreciate being en- couraged to keep their mouths and throats clean-so much so, in fact, that they sometimes make solutions of anything available, such as common salt or vinegar, to use at other than the official times.There seems little doubt that it is sometimes beneficial to change temporarily the antiseptic used as a throat-or mouth-wash, and the usual solutions of potassium per- manganate or even boric acid may thus come in useful as a change for a day or two from more powerful anti- septics such as thymol and iodine. Conclusion
Natural History of Male Psychologic Health
Authors: George E. Vaillant
Journal: New England Journal of Medicine (1979)

Four decades ago 204 men were selected as adolescents for an interdisciplinary study of health; since then they have been followed biennially. Of the 185 men who remained in the study and in good health until 1964 (age, 42±1 years), 100 men remained in excellent physical health over the next 11 years, 54 acquired minor problems, and 31 acquired serious chronic illness or died. Of 59 men with the best mental health, assessed from the age of 21 to 46 years, only two became chronically ill or died by the age of 53. Of the 48 men with the worst mental health from the age of 21 to 46, 18 became chronically ill or died. The relation between previous mental health and subsequent physical health remained statistically significant when the effects on health of alcohol, tobacco use, obesity, and longevity of ancestors were excluded by multiple regression analysis. The data suggest that good mental health retards midlife deterioration in physical health. (N Engl J Med 301:1249–1254, 1979)
Union calls for halt in creeping NHS privatisation
Authors: Lynn Eaton
Journal: BMJ (2007)

In a damning report, a leading public sector union has condemned government policies for undermining some of the key principles of the NHS, for introducing inefficiencies, and for risking undermining the quality of care.

Unison specifically points the finger at independent sector treatment centres, which it calls private sector treatment centres, as being at the root of the problems.

The union's report, In the Interests of Patients , examines the changes in government policy since 2002, which have seen the development of many competing providers from the public, private, and voluntary sectors.

“The government is fundamentally altering the way in which NHS services are delivered, moving towards the creation of a competitive, commercial market in the provision of NHS healthcare,” says the report. “There is also a growing realisation …
CCM2 Mediates Death Signaling by the TrkA Receptor Tyrosine Kinase
Authors: Liraz Harel, Barbara Costa, Marianna Tcherpakov, Marc Zapatka, Andre Oberthuer, Loen M. Hansford, Milijana Vojvodic, Zehava Levy, Zhe-Yu Chen, Francis S. Lee, Smadar Avigad, Isaac Yaniv, Leming Shi, Roland Eils, Matthias Fischer, Benedikt Brors, David R. Kaplan, Mike Fainzilber
Journal: Neuron (2009)
Interface in Medical Education
Authors: Arthur Loewy
Journal: JAMA (1979)

<h3>To the Editor.—</h3> In the article "The Interface Between Undergraduate and Graduate Medical Education" (241:1148, 1979), William D. Holden, MD, names a problem in medical education but does not define it. For my personal use, I define the interface as the transition from juvenile education to adult education. My insight was stimulated some years ago when, in another context, I heard William Griffith, of the Department of Education of the University of Chicago, make the following statement: "I think that one of our greatest problems in dealing with [teaching] adults is the fact that they have been children." There is a difference between juvenile and adult education; the difference is definable and recognizable, but the details of a medical school curriculum content, elective or required, are not much to the point. The schoolchild, college student, and medical student are fit into the juvenile education system lacking well-defined personal goals and
A point mutation in the FMR-1 gene associated with fragile X mental retardation
Authors: Kristel De Boulle, Annemieke J.M.H. Verkerk, Edwin Reyniers, Lieve Vits, Jan Hendrickx, Bernadette Van Roy, Feikje Van Den Bos, Esther de Graaff, Ben A. Oostra, Patrick J. Willems
Journal: Nature Genetics (1993)
Jejunal transport of electrolytes and water in intestinal disease
Authors: S. F. Phillips, W. C. Schmid
Journal: Gut (1969)

The role of decreased absorption of electrolytes and water by the jejunum in the pathogenesis of diarrhoea was examined in patients with intestinal scleroderma, ileocolitis, gastric hypersecretion, or extensive ileal resection. Absorption of electrolytes and water from a 20-cm segment of jejunum was compared in 10 patients and six healthy volunteers. Malabsorption of electrolytes and water by the jejunum may contribute to diarrhoea in scleroderma, regional enteritis, and gastric hypersecretion. After ileal resection, jejunal absorption was normal.
Explicit Criteria for Use of Laboratory Tests
Authors: GEORGE A. GOLDBERG
Journal: Annals of Internal Medicine (1974)

Letters1 December 1974Explicit Criteria for Use of Laboratory TestsGEORGE A. GOLDBERG, M.D., JOSEPH A. ABBOTT, M.D., F.A.C.P.GEORGE A. GOLDBERG, M.D.Search for more papers by this author, JOSEPH A. ABBOTT, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-6-857 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Several studies have pointed out or implied overuse of laboratory tests by physicians (1-3). However, such overuse has not been defined objectively or demonstrated explicitly. Therefore, we tested the application of an objective method (4) to evaluate laboratory test misuse. We focused on the digoxin assay, preset explicit criteria for an acceptable pattern of ordering and using this single test, and measured physician performance against these criteria at San Francisco General Hospital.Specific criteria defining acceptability both for ordering a digoxin assay and for acting upon an abnormal result were developed by faculty and ratified by house...References1. EDWARDSLEVINBALAGTAS LSR: Ordering patterns and utilization of bacteriologic culture reports. Arch Intern Med 132:678-682, 1973 CrossrefMedlineGoogle Scholar2. GRINERLIPTZIN PB: Use of the laboratory in a teaching hospital: implications for patient care, education, and hospital costs. Ann Intern Med 75:157-163, 1971 LinkGoogle Scholar3. SCHROEDERKENDERSCOOPER SKJ: Use of laboratory tests and pharmaceuticals: variation among physicians and effect of cost audit on subsequent use. JAMA 225:969-973, 1973 CrossrefMedlineGoogle Scholar4. GOLDBERGNEEDLEMANWEINSTEIN GJS: Medical care evaluation studies. A utilization review requirement. JAMA 220: 383-387, 1972 CrossrefMedlineGoogle Scholar5. WILLIAMSONALEXANDERMILLER JMG: Continuing education and patient care research. JAMA 201:938-942, 1967 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Medical Service San Francisco General Hospital and Department of Medicine University of California at San Francisco San Francisco, California 94110 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCorporatization of Medicine: The Use of Medical Management Information Systems to Increase the Clinical Productivity of PhysiciansDrug Concentration MonitoringPrudent laboratory usage, cost containment, and high quality medical care:Surveillance of Test UseOne hundred digitalis blood levels 1 December 1974Volume 81, Issue 6Page: 857-858KeywordsLaboratory tests Issue Published: 1 December 1974 PDF DownloadLoading ...
Serum Inhibitor of C5 Fragment-Mediated Polymorphonuclear Leukocyte Chemotaxis Associated with Chronic Hemodialysis
Authors: Simeon E. Goldblum, Dennis E. Van Epps, William P. Reed
Journal: Journal of Clinical Investigation (1979)

Abnormal granulocyte chemotaxis has been described in chronic hemodialysis patients. In this study, sera from 53 hemodialysis patients were tested for chemotactic inhibitory activity by a modified Boyden technique. Chemotactic inhibitory activity, defined as >20% inhibition of normal granulocyte chemotaxis, was found in 45% of patients. Only sera from patients having undergone >3 mo hemodialysis displayed chemotactic inhibitory activity and retained this inhibitory activity when retested 9 mo later. Four of five patients who had initially undergone <3 mo hemodialysis and lacked serum chemotactic inhibitory activity developed inhibitory activity when tested 9 mo later. Clinical evaluation of patients with serum chemotactic inhibitory activity showed that these patients did not have a significantly increased incidence of infection, although a trend toward decreased mortality during the time of study was observed (P = 0.0721).
In vitro adrenergic and cholinergic innervation of the developing rat myocyte.
Authors: W J Marvin, D L Atkins, V L Chittick, D D Lund, K Hermsmeyer
Journal: Circulation Research (1984)

We studied the development of selective adrenergic and cholinergic neuroeffector transmission in primary cultures of isolated ventricular muscle cells. Explants of either thoracolumbar sympathetic ganglia or sacrococcygeal spinal cord were added to newborn rat ventricular cultures harvested prior to the onset of in vivo autonomic innervation. Neuronal growth, migration, and the formation of neuromuscular junctions were observed with light and scanning electron microscopy. Glyoxylic acid histofluorescence, reflecting catecholamine synthesis, was found in only the sympathetic neuromuscular cultures. Choline acetyltransferase activity was detected in both spinal cord and sympathetic neuromuscular cultures, but was significantly higher in the spinal cord neuromuscular cultures. The isolated ventricular muscle cells remained at a constant spontaneous contraction frequency, regardless of the type of culture preparation. Guanethidine sulfate application produced a positive chronotropic response, blocked by propranolol, in the sympathetic neuromuscular cultures, but not in the spinal cord neuromuscular cultures. Bethanechol sulfate produced a negative chronotropic response, blocked by atropine, in the spinal cord neuromuscular cultures, but not in the sympathetic neuromuscular cultures. Isolated ventricular muscle cells in the absence of neurons failed to respond to either agent. Direct microelectrode stimulation of adrenergic or cholinergic neurons likewise respectively produced either a positive or negative ventricular muscle cell chronotropic response. These studies are the first to establish the selective production of functional cholinergic and adrenergic innervation of isolated cardiac muscle cells in vitro.
Transient Diaphyseal Tibial Tc-99m MDP Uptake and Bone Marrow Edema in Acute Rheumatic Fever
Authors: PATRICK J. PELLER, JAY H. ANDERSON
Journal: Clinical Nuclear Medicine (1992)

The authors describe a patient with acute rheumatic fever and polyarthritis in whom scintigraphy unexpectantly identified Tc-99m MDP uptake in the diaphyses of both tibiae. A dramatic rise in antistreptolysin-O titer and rapid resolution of tibial abnormalities paralleled marked articular improvement. Magnetic resonance imaging demonstrated a pattern consistent with marrow edema in the area of abnormal Tc-99m MDP accumulation. This finding has not been previously described in acute rheumatic fever, and it was suspected that the changes in the tibiae resulted from subclinical diaphyseal hyperemia from the inflammatory process observed in the contiguous joints.
Patients' Reactions to Psychiatric Consultation
Authors: Lorrin M. Koran
Journal: JAMA (1979)

Physicians are often concerned that patients will resent a request for psychiatric consultation. To investigate this problem, 60 patients undergoing psychiatric consultation in a general hospital were inverviewed 24 hours after the consultation. Nearly two thirds of these patients believed that the consultation was beneficial. Patients' attitudes were independent of their demographic characteristics, reason for referral, and hospital service involved. Patients with long-term illnesses more often had positive attitudes than patients with short-term illnesses. Patients who were initially hostile or ambivalent usually had positive attitudes 24 hours later. Substance abusers and patients who denied clearly recognizable psychiatric disorders often did not value the consultation. Even so, their physicians frequently believed that the consultation was useful. We attribute the positive attitudes of patients in our study largely to the referring physicians' preparing them for psychiatric consultation.
Elective Operations for Duodenal Ulcer
Authors: Paul H. Jordan
Journal: New England Journal of Medicine (1972)

THE objectives of surgery for duodenal ulcer have been to eradicate the disease, to leave the gastrointestinal digestive apparatus as normal as possible, and to achieve these goals with the lowest possible mortality and recurrence rates. Unfortunately, there is no physiological test or group of tests that can predict the type of operation most likely to cure an individual patient and still produce the fewest untoward side effects. Numerous procedures such as gastroenterostomy, segmental gastric resection and antral exclusion operations have been tried and largely discarded. The principal operations currently in vogue consist of some modification of vagotomy and a . . .