tbuckley/cabot-search huggingface dataset:
Health System Reform
Authors: Victor R. Fuchs
Journal: JAMA (1994)

Early in his administration, President Clinton placed health system reform at the top of the nation's domestic policy agenda. Since then proposals from all parts of the political spectrum have proliferated. Many of these proposals are embodied in specific legislation now under consideration by Congress. Unfortunately, none of the proposed plans will finance coverage efficiently and equitably and slow the rate of growth of health care spending while providing the flexibility, freedom of choice, and improvement in quality that is desirable and feasible. In my judgment, a different approach is needed to achieve these objectives. I believe we must develop a national financial plan to cover basic care for all, accelerate the present trend toward integrated health care systems, attack directly the major causes of increased health care spending, and completely change the nation's policy regarding malpractice. The approach outlined herein consists of five interrelated components.  A Value-Added Tax Earmarked
VOLVULUS OF THE GALLBLADDER
Authors: William B. Holden
Journal: JAMA (1927)

A man, aged 49, Japanese, referred to me by Dr. Tanaka, Dec. 29, 1926, had had beriberi in 1918 and typhoid in 1925; otherwise the history was negative. The day before he was admitted to the hospital, he noticed a distention of the abdomen followed by nausea in about two hours. Five hours later, he began to complain of pain in the epigastrium, which soon became so severe that a physician was called. He was given an enema and one-fourth grain (16 mg.) of morphine, which was repeated in one hour. He slept well that night, but the pain was again severe the next morning. On the evening of the second day, the patient was brought to the hospital. Physical examination was negative except for the abdomen, which was not distended, but extremely rigid and tender. The upper part of the abdomen was very tender, especially under the right
CD40 Triggering of Heterodimeric IL-12 p70 Production by Dendritic Cells In Vivo Requires a Microbial Priming Signal
Authors: Oliver Schulz, Alexander D Edwards, Marco Schito, Julio Aliberti, Shivanthi Manickasingham, Alan Sher, Caetano Reis e Sousa
Journal: Immunity (2000)
Woman with IQ of 70 should be sterilised for her own safety, court rules
Authors: C. Dyer
Journal: BMJ (2015)

A mother of six with an IQ of 70 and an “extraordinary, tragic, and complex” obstetric history should be sterilised for her own safety, a High Court judge has ruled.

Mr Justice Cobb held that the 36 year old, DD, who has an autistic spectrum disorder, lacked the capacity to decide for herself and should be sterilised rather than have an intrauterine device …
Creating new criminals
Authors: T. McClintock
Journal: BMJ (1995)

Locking up juvenile offenders is more likely to result in them reoffending

At its conference last week, the Conservative party announced plans for a new “get tough” policy of longer and harsher prison sentences for persistent and violent offenders. The British government is also planning to impose strict new regimes on juvenile offenders, looking to the “glasshouses” of British military prisons for inspiration.1 The issue of locking up children and young people is nothing new. Parkhurst Prison for Boys was established in 1838 mainly as a consequence of the “moral panic” about juvenile gangs destroying property.2 3 Whether there was in fact an upsurge in juvenile crime is not known, but a perception that there was led to a drive to protect juveniles both from themselves and from contamination by professional criminals. The same pressures are at work today.

The interpretation of juvenile law breaking as posing a serious threat to social order has not really changed over the past 150 years. The British press has championed the right of victims to be protected from what is portrayed as a new breed of juvenile criminal,4 and public outcry against foreign trips designed to act as character building exercises for young offenders has increased the pressure to detain young offenders. Yet in the 1980s considerable expertise was developed in the United Kingdom …
Effects of Prenatal Micronutrient and Early Food Supplementation on Maternal Hemoglobin, Birth Weight, and Infant Mortality Among Children in Bangladesh
Authors: Lars Åke Persson, Shams Arifeen, Eva-Charlotte Ekström, Kathleen M. Rasmussen, Edward A. Frongillo, Md Yunus, for the MINIMat Study Team
Journal: JAMA (2012)

Nutritional insult in fetal life and small size at birth are common in low-income countries and are associated with serious health consequences.To test the hypothesis that prenatal multiple micronutrient supplementation (MMS) and an early invitation to food supplementation would increase maternal hemoglobin level and birth weight and decrease infant mortality, and to assess whether a combination of these interventions would further enhance these outcomes.A randomized trial with a factorial design in Matlab, Bangladesh, of 4436 pregnant women, recruited between November 11, 2001, and October 30, 2003, with follow-up until June 23, 2009.Participants were randomized into 6 groups; a double-masked supplementation with capsules of 30 mg of iron and 400 μg of folic acid, 60 mg of iron and 400 μg of folic acid, or MMS containing a daily allowance of 15 micronutrients, including 30 mg of iron and 400 μg of folic acid, was combined with food supplementation (608 kcal 6 days per week) randomized to either early invitation (9 weeks' gestation) or usual invitation (20 weeks' gestation).Maternal hemoglobin level at 30 weeks' gestation, birth weight, and infant mortality. Under 5-year mortality was also assessed.Adjusted maternal hemoglobin level at 30 weeks' gestation was 115.0 g/L (95% CI, 114.4-115.5 g/L), with no significant differences among micronutrient groups. Mean maternal hemoglobin level was lower in the early vs usual invitation groups (114.5 vs 115.4 g/L; difference, -0.9 g/L; 95% CI, -1.7 to -0.1; P = .04). There were 3625 live births out of 4436 pregnancies. Mean birth weight among 3267 singletons was 2694 g (95% CI, 2680-2708 g), with no significant differences among groups. The early invitation with MMS group had an infant mortality rate of 16.8 per 1000 live births vs 44.1 per 1000 live births for usual invitation with 60 mg of iron and 400 μg of folic acid (hazard ratio [HR], 0.38; 95% CI, 0.18-0.78). Early invitation with MMS group had an under 5-year mortality rate of 18 per 1000 live births (54 per 1000 live births for usual invitation with 60 mg of iron and 400 μg of folic acid; HR, 0.34; 95% CI, 0.18-0.65). Usual invitation with MMS group had the highest incidence of spontaneous abortions and the highest infant mortality rate.Among pregnant women in poor communities in Bangladesh, treatment with multiple micronutrients, including iron and folic acid combined with early food supplementation, vs a standard program that included treatment with iron and folic acid and usual food supplementation, resulted in decreased childhood mortality.isrctn.org Identifier: ISRCTN16581394.
Development and significance of antibodies to salmon calcitonin in patients with Paget's disease on long-term treatment.
Authors: N J Woodhouse, S M Mohamedally, F Saed-Nejad, T J Martin
Journal: BMJ (1977)

Sixteen consecutive patients in one unit were studied during long-term treatment of Paget9s disease of bone with salmon calcitonin. Eleven patients developed detectable antibody titres at some time during treatment. In one patient with a high antibody titre evidence of resistance to treatment emerged two years after the development of antibodies, but no other patient showed evidence of resistance. The clinical and biochemical response could be maintained in the absence of an acute calcium-lowering effect of calcitonin. Although antibodies often develop during treatment with heterologous calcitonin, they are only rarely the cause of clinical resistance.
6. Airway Behavior and Its Regulation: How Do Structural Changes Affect Airway Behavior?
Authors: James C. Hogg
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

"6. Airway Behavior and Its Regulation: How Do Structural Changes Affect Airway Behavior?." American Journal of Respiratory and Critical Care Medicine, 153(6_pt_2), pp. S16–S18
Acute Doxorubicin Overdoses
Authors: Charles F. Curran
Journal: Annals of Internal Medicine (1991)

Letters1 December 1991Acute Doxorubicin OverdosesCharles F. Curran, PhDCharles F. Curran, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-11-913_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Twelve accidental acute doxorubicin overdoses (range, 3 to 10 times intended dose) have been reported to Adria Laboratories (Columbus, Ohio) since 1977. Nine patients (75%) received doxorubicin as part of a multidrug regimen. Of these, three patients were also simultaneously overdosed with other antineoplastic agents. Eight patients (67%) were given overdoses during the first administration of doxorubicin.Leukopenia or pancytopenia was universal. Mucositis, generally requiring 2 to 6 weeks for resolution, was reported in six of the seven (86%) patients who recovered, but in only one of the five (20%) patients who died. Two patients developed heart...References1. Anonymous. Inquests. The Pharmaceutical Journal. 1977;219:139. Google Scholar2. HaradaOhmuraNishizawaTsuchida THOS. Efficacy and side effects of the regional arterial infusion of anti-cancer drugs combined with direct hemoperfusion in malignancies of the urinary tract. J Urol. 1982;128:524-7. CrossrefMedlineGoogle Scholar3. KamidonoFujiiHamamiNakanoUmezuOda SAGYKY. New preoperative chemotherapy for bladder cancer using combination hemodialysis and direct hemoperfusion: preliminary report. J Urol. 1984;131:36-40. CrossrefMedlineGoogle Scholar4. KiharaNakazawaAgishiHondaOta THTHK. Superiority of selective bolus infusion and simultaneous rapid removal of anticancer agents by charcoal hemoperfusion in cancer treatment. Transactions of the American Society of Artificial Internal Organs. 1988;34:581-4. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Charles F. Curran, PhDAffiliations: Adria LaboratoriesColumbus OH 43216 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImplementation of Analytical Control of Low Volume Pediatric Cytotoxic Drugs Preparations using a UV/Raman SpectrophotometerChemotherapeutic Agents and ThalidomideAnticancer drugs and immunomodulators 1 December 1991Volume 115, Issue 11Page: 913-914KeywordsHeart ePublished: 1 December 2008 Issue Published: 1 December 1991 PDF downloadLoading ...
On the detection of fakes
Authors: Theodore Dalrymple
Journal: BMJ (2007)

Medical books these days don't have such good titles as they once had. The other day, for example, I came across a book that I had long wanted to possess, published in 1843: On Feigned and Factitious Diseases Chiefly of Soldiers and Seamen, On the Means Used to Simulate or Produce Them, and On the Best Modes of Discovering Impostors . It was by Hector Gavin MD, who at the time was surgeon to the London Orphan Society and to the British Penitent Female Refuge. These days, of course, no British female is penitent.

The book was the prize essay in military surgery in the University of Edinburgh for 1835-6, written when Gavin was 20 years old. We mature physically earlier …
Angiotensin II Inhibits Protein Kinase A–Dependent Chloride Conductance in Heart via Pertussis Toxin–Sensitive G Proteins
Authors: Kazuhiko Obayashi, Minoru Horie, Lai-Hua Xie, Kunihiko Tsuchiya, Akira Kubota, Hitoshi Ishida, Shigetake Sasayama
Journal: Circulation (1997)

Background Angiotensin II receptors are reported to be abundant in the guinea pig ventricle; their coupling to adenylate cyclase in the heart, however, remains controversial. Therefore, we investigated the effect of angiotensin II on Cl − conductance activated by cAMP-dependent protein kinase. Methods and Results After minimizing the contribution of other ionic currents, exposure of single guinea pig ventricular cells to isoproterenol (40 to 50 nmol/L; 36°C) elicited a typical protein kinase A–dependent Cl − conductance. Subsequent application of angiotensin II reduced the isoproterenol-induced conductance with an IC 50 of 0.24±0.08 nmol/L. Angiotensin II also inhibited the Cl − currents, which were activated through stimulation of adenylate cyclase by forskolin and histamine receptors. CV-11974 (1 μmol/L), an antagonist selective for the angiotensin type 1 receptor, prevented the effect of angiotensin II. Angiotensin II did not inhibit the current that had been persistently activated by intracellular GTPγS (100 μmol/L), a nonhydrolyzable guanine nucleotide, plus isoproterenol. In addition, prior incubation of myocytes with pertussis toxin prevented the angiotensin II inhibitory action. Cl − conductance, when activated directly by intracellular dialysis with cAMP (1 mmol/L), was not affected by angiotensin II. Radioimmunologic measurement of cellular cAMP in the dissociated myocytes showed that angiotensin II inhibited the isoproterenol-induced increase of cAMP. Conclusions Angiotensin II receptors negatively couple to adenylate cyclase via pertussis toxin–sensitive G proteins, thereby inhibiting cardiac protein kinase A–dependent Cl − conductance.
To change or not to change. A dilemma for the National Board of Medical Examiners
Authors: J. P. Hubbard
Journal: JAMA (1971)

For the past two years, the National Board of Medical Examiners has set as the theme for its annual invitational conferences the changes in medical education and the effect of these changes on the nationwide examinations of the board. In the March 1970 conference, students, interns, and residents were included as members of a panel to interact with each other and to respond to questions from the floor; in the March 1971 conference, the panelists were chairmen (past or present) of the board's committees that are responsible for creating the examinations in the basic sciences (morning panel) and the clinical sciences (afternoon panel). A significant similarity appeared between the opinions of the recipients of medical education in 1970 and the providers of medical education in 1971, demonstrating thereby, on the one hand, the present-day sense of responsibility and participation of students in the affairs of the faculty and, on the
The Alcoholism Problems: Selected Issues
Authors: Martin Marcovici
Journal: JAMA (1984)

The literature on alcoholism is again enriched by an outstanding clinician, researcher, and writer. Dr Sidney Cohen, the well-known editor of<i>Drug Abuse and Alcoholism Newsletter</i>, presents a collection of 31 selected papers (29 by him and two others by Drs R. Moore and R. Phillipson). The book is divided into three parts. The first focuses on the nature of alcohol as a drug. It includes among other topics, a diagnostic evaluation of the measurement of blood alcohol concentration and its use to determine traffic safety; a paper on fetal alcohol syndrome, its etiology, phenomenology, and prevention; the syndrome of pathological intoxication; alcohol and the liver; the drug and hypoglycemia; and a biopsychosocial perspective on teenage drinking, its epidemiology, prevention, and treatment. The second part, the nature of alcoholism, is a clear and multidimensional presentation of many roads to alcohol dependency as a preponderant way to deal with stress, boredom,
Previous Angina Alters In-Hospital Outcome in TIMI 4
Authors: Robert A. Kloner, Thomas Shook, Karin Przyklenk, Vicki G. Davis, Lucille Junio, Ray V. Matthews, Steven Burstein, C. Michael Gibson, W. Kenneth Poole, Christopher P. Cannon, Carolyn H. McCabe, Eugene Braunwald
Journal: Circulation (1995)

Background Ischemic preconditioning has been shown to reduce myocardial infarct size in experimental models, but its role in patients remains unclear. Angina before myocardial infarction reflects brief episodes of ischemia and may be a marker of preconditioning. As part of the Thrombolysis in Myocardial Infarction (TIMI) 4 study, we performed an analysis on the effect of a history of previous angina on in-hospital outcomes for patients with acute myocardial infarction. Methods and Results Patients eligible for thrombolytic therapy were enrolled into the study. Data were collected from case report forms regarding previous history of angina, in-hospital outcome and 6-week follow-up. Two hundred eighteen patients had a history of previous angina at any time before acute myocardial infarction, and 198 patients did not have previous angina. Patients with any previous history of angina were less likely than with those without angina to experience in-hospital death (3% versus 8%) ( P =.03), severe congestive heart failure (CHF) or shock (1% versus 7%, P =.006), or the combined end point of in-hospital death, severe CHF, or shock (4% versus 12%, P =.004). Moreover, patients with any history of angina were more likely to have a smaller creatine kinase (CK)-determined infarct size (119 versus 154 CK integrated units; P =.01) and were less likely to have Q waves on their ECG (57% versus 69%; P =.01). In the subset of patients who experienced angina within the 48 hours before infarction (compared with those who did not), there was a trend toward less likely in-hospital death (3% versus 6%; P =.09), a lower incidence of severe CHF or shock (1% versus 6% P =.008), a lower combined end point of death, CHF, or shock (3% versus 10%; P =.006), smaller infarct size assessed by CK (115 versus 151 CK units; P =.03), and a trend toward fewer Q-wave infarcts. However, patients with a history of previous angina did have a trend toward more recurrent ischemic pain. Of importance is that the beneficial in-hospital effects of previous angina were not dependent on angiographically visible coronary collaterals. Conclusions Previous angina confers a beneficial effect on in-hospital outcome after acute myocardial infarction. The reasons for this benefit are uncertain, but one potential mechanism for this observation may be ischemic preconditioning.
Passive smoking: Study was flawed from outset
Authors: J. S. Vaidya
Journal: BMJ (2003)

Editor–The study by Enstrom and Kabat has a major flaw,1 and I urge the editors of the BMJ to consider a retraction. The study assumes a considerable difference in the exposure to environmental tobacco smoke of never smokers' spouses compared to ever smokers' spouses. This is obviously wrong.

Most never …
Essential role for Ptpn11 in survival of hematopoietic stem and progenitor cells
Authors: Gordon Chan, Laurene S. Cheung, Wentian Yang, Michael Milyavsky, Ashley D. Sanders, Shengqing Gu, Wan Xing Hong, Aurora X. Liu, Xiaonan Wang, Mary Barbara, Tarun Sharma, Joehleen Gavin, Jeffery L. Kutok, Norman N. Iscove, Kevin M. Shannon, John E. Dick, Benjamin G. Neel, Benjamin S. Braun
Journal: Blood (2011)
MENSTRUATION AND OVULATION
Authors: Lawrence Sophian
Journal: JAMA (1934)

<h3>To the Editor:—</h3> The article inThe Journal, February 10, by Emil Novak, together with your editorial in the same issue, concern the possibility of estimating the time of ovulation in the twenty-eight day menstrual cycle, thereby making use of the theoretical nonfertilizable periods previous to and following the discharge and death of the ovum. Your reference to the work of Wilfred Shaw leaves an impression, which I believe erroneous, that the time of ovulation in the regular cycle is made definite by the finding of follicles in which the stage of development enables the placing of the time of rupture at the fourteenth day. The value of Shaw's observations is decreased by the small number of ovaries examined (thirty-six cases) and by the difficulty of being certain of the time of discharge of the ovum by estimating the stage of development of the corpus luteum. The degree of proliferation
Causes of Death in Acute Leukemia
Authors: Evan M. Hersh
Journal: JAMA (1965)

Major causes of death in acute leukemia were infection in 70% of patients and hemorrhage in 52%. In 38% of the patients there was more than one cause of death. Striking changes took place during the ten-year-study period. Fatal hemorrhage declined to nearly half the early rate, and fatal staphylococcal infection from 23.5% to 3.1%. At the same time fatal infections due to fungi increased from 8.2% to 23.2%.
Association Between Eye Tracking Disorder in Schizophrenia and Poor Sensory Integration
Authors: David E. Ross, Robert W. Buchanan, Deborah Medoff, Adrienne C. Lahti, Gunvant K. Thaker
Journal: American Journal of Psychiatry (1998)

Objective:The authors tested the hypothesis that eye tracking disorder in schizophrenia is associated with neurological signs.Method:The subjects were 93 normal comparison subjects and 59 schizophrenic patients. They were evaluated with the Neurological Evaluation Scale, a standardized rating instrument that assesses sensory integration, motor coordination, sequencing of complex motor acts, and other neurological signs. Also, the schizophrenic patients’ smooth-pursuit eye movements were tested in response to a 0.3-Hz sinusoidal target by means of infrared oculography. They were divided into those with (N=18) and without (N=41) eye tracking disorder by using a previously described method, which was based on mixture analysis of the distribution of position root mean square error.Results:The patients with eye tracking disorder had significantly worse performance than the patients without eye tracking disorder with respect to sensory integration, and the effect size was moderate to large. In comparison with the normal subjects, both patient subgroups had significantly worse performance on all of the Neurological Evaluation Scale subscales. Conclusions:Although neurological signs are present generally in schizophrenia, poor sensory integration is particularly pronounced in patients with eye tracking disorder. A review of the literature shows that the two abnormalities have strikingly similar patterns of validators, including 1) familial aggregation, 2) premorbid presence, 3) syndromal specificity, 4) trait status, and 5) association with the deficit syndrome. Poor sensory integration and eye tracking disorder in schizophrenia may be various manifestations of a common, underlying pathophysiological process. Am J Psychiatry 1998; 155: 1352-1357
Dermatology at a Glance. Mahbub M.U. Chowdhury, Ruwani P. Katugampola, Andrew Y. Finlay. Oxford: Wiley-Blackwell, 2013; 112 pp. ISBN: 978-0-470-65673-0. Price: £24.99.
Authors: S. Ainley, E. Burden-Teh
Journal: British Journal of Dermatology (2013)
813-3 Reduction of plasma cholesterol and fibrinogen by H.E.L.P. apheresis increases myocardial perfusion in heart transplant patients
Authors: Beate R Jaeger, Frank Bengel, Kenichi Odaka, Carlos A Labarrere, Stefan Bengsch, Clemens Engelschalk, Eckart Kreuzer, Peter Ueberfuhr, Bruno Reichart, Dietrich Seidel
Journal: Journal of the American College of Cardiology (2004)