tbuckley/cabot-search huggingface dataset:
Psychoanalysis: waning or waxing?
Authors: N. A. Clemens
Journal: JAMA (1994)

To the Editor.  —Dr Somerfeld-Ziskind 1 begins a recent review of a book on biological  with the gratuitous sentence: Now that psychoanalysis is on the wane, inevitably earlier opinions in psychiatry will resurface. While it may be comforting to some to repeat the myth that psychoanalysis is in some sort of decline, the facts about psychoanalysis support exactly the opposite conclusion.  In the United States, the membership of the American Psychoanalytic Association has gone from 1880 in 1974, to 2828 in 1984 to 3050 in 1994 (oral communication, American Psychoanalytic Association, August 1994). Most of these members are physicians. In addition, the membership of Division 39 of the American Psychological Association, the section concerned with clinical psychoanalysis, has risen from 1950 in 1984 to 3801 in 1994 (oral communication, American Psychological Association, August 1994).  While surveys over these years have shown a slight decline in the number of psychoanalytic
Efficacy of Uniphyl, salbutamol, and their combination in asthmatic patients on high-dose inhaled steroids.
Authors: R N Rivington, L P Boulet, J Côté, H Kreisman, D I Small, M Alexander, A Day, Z Harsanyi, A C Darke
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

A group of 32 patients with moderately severe, chronic asthma (mean FEV1 55% of predicted), maintained on moderately high doses of inhaled corticosteroids (mean dose 1,100 micrograms/d), participated in this double-blind, placebo-controlled crossover study. The effect on pulmonary function of adding theophylline (U, once daily Uniphyl), inhaled salbutamol (S, 200 micrograms four times per day), and their combination (C) or placebo (P) was assessed on Day 14 of each treatment phase. Patients recorded peak expiratory flow, asthma symptom severity (morning and evening), and use of rescue salbutamol inhaler in daily diaries. Mean FEV1 between 0730 and 1800 h and maximum FEV1 between 0730 and 1300 h were significantly higher on U, S, and C compared with P (p < 0.006). Morning peak flow and FEV1 (0730 h) were significantly higher on U and C compared with S and P (p < 0.01). Evening peak flow was higher on U than P (p < 0.001), and C was higher than S and P (p < 0.01). Rescue salbutamol inhaler use was significantly higher on P than on U, C, or S (p = 0.0001). Patient rating of asthma symptoms during C was significantly better than on S or P (p < 0.05). Patient rating of asthma control and study phase preference was significantly higher on combination and Uniphyl alone than on placebo, the combination also being superior to salbutamol alone. Addition of Uniphyl or a combination of Uniphyl and salbutamol significantly improves pulmonary function and asthma symptoms in patients treated with high doses of inhaled corticosteroids and as-needed beta agonists.(ABSTRACT TRUNCATED AT 250 WORDS)
Influence of Initial Treatment on the Survival and Recurrence in Patients With Differentiated Thyroid Microcarcinoma
Authors: Jasna Mihailovic, Ljubomir Stefanovic, Ranka Stankovic
Journal: Clinical Nuclear Medicine (2013)

Purpose Differentiated thyroid microcarcinoma (DTM) has a good prognosis and survival, but recurrent disease may appear during follow-up. The aim of this study was to evaluate the influence of initial treatment including surgery and radioactive iodine (131I) on the survival and recurrence in patients with DTM. Methods Between January 1979 and December 2006, 130 patients with DTM were retrospectively evaluated, with a median follow-up of 10 years. Total/near-total thyroidectomy was performed in 121 (93.1%) of 130 patients, followed with 131I ablation in 71 (54.6%) of 130 patients. Results The probability of disease-specific survival was 97.7% ± 1.3% after 5 and 10 years; the probability of disease-specific survival was 95.9% ± 2.2% after 15, 20, 25, and 28 years after the initial treatment and was significantly influenced by recurrence, clinical stage, and patients’ age (P = 0.0001, P = 0.0005, and P = 0.02, respectively). Sex, histopathological type of the tumor, metastases at presentation, initial treatment, performance of radioactive therapy, and risk categories had no influence on survival (P = 0.8, P = 0.6, P = 0.1, P = 0.4, P = 0.5, and P = 0.1, respectively). The overall recurrence rate was 10.8%, (6.9% in lymph nodes, 1.5% in thyroid bed, and 2.3% at distant sites), with a median appearance time of 30 months. Recurrences were significantly influenced by regional metastases at presentation, radioiodine ablation, and initial treatment (P = 0.0002, P = 0.005, and P = 0.003, respectively); there was no relationship based on age, sex, histological type of the tumor, and tumor multifocality. Conclusions To perform more accurate surveillance for recurrence, total/near-total thyroidectomy followed by radioiodine ablation may be the optimal initial treatment for patients with DTM.
Economics, Ethics, and End-of-Life Care
Authors: Stefan C. Weiss
Journal: JAMA (1999)

PRESSURE TO REDUCE TOTAL HEALTH CARE EXPENDITURES IN THE UNITED States has intensified. Despite a contracting health care budget that has sensitized society to the issues of resource allocation, the demand for the health care dollar has continued to expand. The disciplines of economics and bioethics have each outlined strategies to mitigate this conflict. Yet because of divergent core preferences, the proposed strategies are discordant. Whereas economics is chiefly concerned with the quantitative analysis of the production, distribution, and consumption of goods and services—an approach that often creates value-loaded trade-offs— bioethics often addresses the variance among competing values without accounting for resource scarcity. When the overall priority is to decrease monetary costs, selecting the most desirable way to allocate resources depends on which values are assumed to be paramount. If we are to develop morally acceptable principles for allocating scarce resources, the two approaches must reach a concordance. Decisions regarding the delivery of health care at the end of life underscore the inherent conflict between economics and bioethics. Many argue that because 10% to 12% of all health care expenditures and 27% of Medicare expenditures are spent at the end of life, and because these expenditures frequently fail to provide significant health benefits, the elimination of such care would make resources available for other unmet needs. Opponents counter that cost savings projected from reduced care at the end of life are illusory, and that such reductions in care breach the maxim that the least advantaged should be accorded the maximum benefit from an unequal distribution of any primary good. Rationing itself is not denounced as ethically unacceptable, so long as the deprivation of goods is egalitarian. This attitude contrasts with British National Health Service guidelines that explicitly refuse specific health care services to persons because of advanced age. This month, MSJAMA considers how economics and bioethics can reconcile in order to generate strategies for delivering care at the end of life. Because the United States accords no general legal right to health care, health care at the end of life, extensive or minimal, is a moral claim. However, structuring resources according to a population-based health approach, and forgoing care of marginal benefit, would potentially achieve greater utility. But to apply a policy of rationing to persons at the end of life—the necessary consequence of a population-based approach—is inconsistent with many principles of social justice. As cost pressures continue to conflict with accepted ethical standards, medical students and physicians, as patient advocates, will be required to examine death more broadly, and pursue constructs outside the biological sciences.
Metronidazole Interferes with Theophylline Measurements
Authors: DORON GARFINKEL
Journal: Annals of Internal Medicine (1987)

Letters and Corrections1 January 1987Metronidazole Interferes with Theophylline MeasurementsDORON GARFINKEL, M.D., FREDERIC GLAZENER, M.D., BRIAN B. HOFFMAN, M.D.DORON GARFINKEL, M.D.Search for more papers by this author, FREDERIC GLAZENER, M.D.Search for more papers by this author, BRIAN B. HOFFMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-1-171_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Monitoring serum drug concentrations has contributed to the more rational use of drugs. The most important of the laboratory methods currently used for routine drug determinations are immunoassays and those based on high-performance ligand chromatography (HPLC). These methods do not establish the structure of the drug being measured. In an HPLC assay, the elution time of a drug from the column is typically used to identify it. However, the elution time is not necessarily unique to one drug, and a potential for error exists when another compound coelutes with the drug. We report a case in which...References1. CLARK D. Case report: theophylline method problem. Am Assoc Clin Chem. 1982;(Nov):1-3. Google Scholar2. CLARK D. Theophylline assay by liquid chromatography: removal of acetazolamide interference. Clin Chem. 1979;25:1183. CrossrefMedlineGoogle Scholar3. KELLYPRENTICEHEARNE RDG. Cephalosporin antibiotics interfere with the analysis for theophylline by high-performance liquid chromatography. Clin Chem. 1978;24:838-9. CrossrefMedlineGoogle Scholar4. WOODMANCANADASEIDMAN TAJ. Interference of allopurinol and alloxanthine in ultraviolet theophylline assay. Am J Hosp Pharm. 1977;34:984-5. MedlineGoogle Scholar5. FRUTKOFFMENCZELKIDRONI IJG. Monitoring of serum theophylline by high-performance liquid chromatography without interference by various coadministered drugs. Isr J Med Sci. 1982;18:639-41. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Stanford University School of Medicine Veterans Administration Medical Center Palo Alto, CA 94304 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMethylxanthines: Toxicity to humans. 1. Theophylline 1 January 1987Volume 106, Issue 1Page: 171-171KeywordsAttentionChromatographyDrugsImmunoassaysResearch laboratoriesTherapeutic drug monitoring Issue Published: 1 January 1987 PDF DownloadLoading ...
Plasma oxidized low-density lipoprotein as a prognostic predictor in patients with chronic congestive heart failure
Authors: Takashi Tsutsui, Takayoshi Tsutamoto, Atsuyuki Wada, Keiko Maeda, Naoko Mabuchi, Masaru Hayashi, Masato Ohnishi, Masahiko Kinoshita
Journal: Journal of the American College of Cardiology (2002)
THE PRESENCE IN PENICILLIUM FUNICULOSUM OF AN INHIBITOR TO THE ANTIVIRAL AGENT HELENINE
Authors: Ping-Yao Cheng, Richard E. Shope
Journal: The Journal of Experimental Medicine (1966)

The present findings indicate that the wide fluctuation observed in the antiviral activity of various crude helenine preparations may be attributable to the presence of varying amounts of inhibitor. Antiviral activity could be enhanced by removal of the inhibitor. A meaningful value for helenine titer in a preparation clearly should be determined in the inhibitor-free zone.
The Feeling of Professional Identity in an Integrated Psychosomatic Approach
Authors: E. Gaus, M. Klingenburg, K. Köhle
Journal: Psychotherapy and Psychosomatics (1984)

Apart from the efficacy of an integrated psychosomatic approach there emerge problems with the psychosomaticist's feeling of professional identity which are delineated and discussed in the light of the authors' experience. For many years they took part in institutionalizing an approach combining internal and psychological medicine on the basis of a psychoanalytic orientation in a ward setting and an outpatient clinic for hypertensives which were both attached to a university hospital. The core conflict of professional identity in an approach like this is concerned with educational incompatibilities in the different fields, frictions of daily routines, and institutional tensions arising from controversial theoretical backgrounds and faculty policies. Different cognitive and action styles, varying attitudes concerning matters of timing and different necessities of empathy versus distance must be integrated like other polarities. Discussions about the favors of an integrated psychosomatic approach tend to underestimate the outlined problems of professional identity.
ANOTHER POINT OF RESEMBLANCE BETWEEN ANAPHYLACTIC INTOXICATION AND POISONING WITH WITTE'S PEPTON
Authors: Arthur D. Hirschfelder
Journal: The Journal of Experimental Medicine (1910)

Kraus and Biedl ( I ) have recently called attention to the similarity which exists between the effects of anaphylactic intoxication and poisoning with Witte's pepton.In both conditions there are produced fall in blood pressure from vascular dilatation, leucopenia, and, in meat-fed dogs, loss of coagulability of the blood.Still more striking is the fact that if the Witte's pepton be injected slowly or in small doses the animal becomes immune to a subsequent injection for about twenty-four hours.W. H. Thompson (2) has shown that the portion of the pepton which acts upon the circulation is not the purified pepton (amphopepton) nor even the secondary or simpler proteoses (deuteroproteoses), but only the higher proteoses (proto-and heteroproteoses) which still contain most of the proteid components (Bausteine) and maintain much of the original architecture of the proteid molecule.Rosenau and Anderson (3) and Wells ( 4) have shown that one injection of these proteoses does not sensitize to a subsequent injection.On the other hand, Vaughan and Wheeler (5) have been able to split the proteid molecule by boiling with 2 per cent.sodium hydrate in 95 per cent.alcohol, obtaining a toxic portion and a portion which sensitizes to subsequent injection but which is itself not specially toxic.Abderhalden and his pupils (6) have shown that after intravenous injection of horse serum, egg albumin, gliadin, casein, edestin, or gelatin into rabbits, there appears in the serum a proteolytic enzyme which splits the pepton obtained from
A randomized study of minimal curettage followed by topical photodynamic therapy compared with surgical excision for low-risk nodular basal cell carcinoma
Authors: L. Berroeta, C. Clark, R.S. Dawe, S.H. Ibbotson, C.J. Fleming
Journal: British Journal of Dermatology (2007)

Journal Article A randomized study of minimal curettage followed by topical photodynamic therapy compared with surgical excision for low‐risk nodular basal cell carcinoma Get access L. Berroeta, L. Berroeta Department of Dermatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K. E‐mail: lauraberroeta@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar C. Clark, C. Clark Department of Dermatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K. E‐mail: lauraberroeta@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar R.S. Dawe, R.S. Dawe Department of Dermatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K. E‐mail: lauraberroeta@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar S.H. Ibbotson, S.H. Ibbotson Department of Dermatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K. E‐mail: lauraberroeta@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar C.J. Fleming C.J. Fleming Department of Dermatology, Ninewells Hospital and Medical School, Dundee DD1 9SY, U.K. E‐mail: lauraberroeta@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 157, Issue 2, 1 August 2007, Pages 401–403, https://doi.org/10.1111/j.1365-2133.2007.07996.x Published: 01 August 2007
Serum Uric Acid and Risk for Cardiovascular Disease and Death: The Framingham Heart Study
Authors: Bruce F. Culleton, Martin G. Larson, William B. Kannel, Daniel Levy
Journal: Annals of Internal Medicine (1999)

Background: Hyperuricemia is associated with risk for cardiovascular disease and death. However, the role of uric acid independent of established risk factors is uncertain. Objective: To examine the relation of serum uric acid level to incident coronary heart disease, death from cardiovascular disease, and death from all causes. Design: Community-based, prospective observational study. Setting: Framingham, Massachusetts. Patients: 6763 Framingham Heart Study participants (mean age, 47 years). Measurements: Serum uric acid level at baseline (1971 to 1976); event rates per 1000 person-years by sex-specific uric acid quintile. Results: During 117 376 person-years of follow-up, 617 coronary heart disease events, 429 cardiovascular disease deaths, and 1460 deaths from all causes occurred. In men, after adjustment for age, elevated serum uric acid level was not associated with increased risk for an adverse outcome. In women, after adjustment for age, uric acid level was predictive of coronary heart disease (P = 0.002), death from cardiovascular disease (P = 0.009), and death from all causes (P = 0.03). After additional adjustment for cardiovascular disease risk factors, uric acid level was no longer associated with coronary heart disease, death from cardiovascular disease, or death from all causes. In a stepwise Cox model, diuretic use was identified as the covariate responsible for rendering serum uric acid a statistically nonsignificant predictor of outcomes. Conclusions: These findings indicate that uric acid does not have a causal role in the development of coronary heart disease, death from cardiovascular disease, or death from all causes. Any apparent association with these outcomes is probably due to the association of uric acid level with other risk factors.
OCCURRENCE OF LOW SALT SYNDROME DURING TREATMENT WITH CHLORAMPHENICOL
Authors: Frank J. Catanzaro
Journal: JAMA (1952)

Chloramphenicol has been observed to cause diarrhea.<sup>1</sup>We believe this to be the first reported case of salt depletion resulting from diarrhea produced by the drug. <h3>REPORT OF A CASE</h3> Mrs. A. K., an 81-year-old housewife, entered the St. Louis City Hospital on Feb. 4, 1951, with the complaint of shortness of breath and cough for three days. In March, 1947, the patient had the first of a series of episodes of acute heart failure with severe dyspnea, orthopnea, and cough. Three similar episodes occurred during the next three years; the last, September, 1950, was so severe as to necessitate hospitalization. For the first time, she was given digitalis, which seemed to prevent a recurrence of acute symptoms until Feb. 1, 1951, when dyspnea and cough again developed and were accompanied now, for the first time, by noticeable swelling of both ankles. Past history revealed that the patient had
Multiple Chemodectomas
Authors: ALAN F. WEISSMAN, CARMEN E. GONZALEZ, BRAHM SHAPIRO, BARRY SHULKIN, ISAAC R. FRANCIS, KEVIN LEACH
Journal: Clinical Nuclear Medicine (1994)

Chemodectomas resemble pheochromocytomas in that they are derived from neural crest tissue. Their distribution in the body may be quite different, however, as chemodectomas are more frequently found in the aortic and carotid bodies, while pheochromocytomas are most common in the adrenal medulla. The authors present a case of a patient with a known history of chemodectoma, imaged with I-123 MIBG to rule out recurrent disease. Images of the chest revealed a thoracic tumor representing recurrent periaortic tumor, but an additional carotid body tumor (which was later demonstrated by angiography) was masked by salivary gland uptake. In patients with chemodectomas, SPECT imaging of the neck may be necessary to distinguish normal salivary gland uptake from tumoral uptake of MIBG. In general, knowledge of the characteristics of the individual neural crest derived tumor is mandatory for maximal effectiveness of I-123 MIBG scintigraphy.
Lovastatin vs Cholestyramine Therapy for Primary Hypercholesterolemia-Reply
Authors: Jonathan A. Tobert
Journal: JAMA (1988)

<h3>In Reply. —</h3> In response to Dr Goldstein, our study was a comparison of the tolerability and lipid-lowering effects of lovastatin and cholestyramine, so that our conclusion that lovastatin is more effective than cholestyramine applies only to the effects of the two drugs on lipids and lipoproteins, in particular the primary variables total and low-density lipoprotein (LDL) cholesterol. On this basis, 40 mg of lovastatin twice a day was approximately twice as effective as 12 g of cholestyramine twice a day, producing mean reductions in total and LDL-cholesterol of 34% and 42%, respectively, compared with 17% and 23% for cholestyramine. We agree that the ultimate value of lipid-lowering agents should be based on their effects on artherosclerosis. Several clinical trials to examine the effects of lovastatin and the closely related simvastatin on coronary lesion progression and coronary event rates are under way or about to begin. Although the results of
Development of Knowledge Concerning the Gastric Intrinsic Factor and Its Relation to Pernicious Anemia
Authors: William B. Castle
Journal: New England Journal of Medicine (1953)

THOMAS ADDISON,1 physician to Guy's Hospital, London, published his classic description of pernicious anemia in 1855. Since then nature has held almost a ninety-nine-year lease on a recognized mystery. Happily, her foreclosure of the mortgages on the lives of the tenants of this disorder has become rare since 1926. At that time George R. Minot and William P. Murphy, of Boston, discovered what was in effect a regular means of cure for pernicious anemia. Although their liver feeding and its subsequent refinements by others saved many lives, the exact cause of the disease has remained obscure. Today, however, it can . . .
THE FUTURE OF THE ASSOCIATION
Authors: S. J. Ross
Journal: BMJ (1910)

<h3>Objective</h3> Many patients receiving dual antiplatelet therapy still had recurrent strokes. We aimed to identify factors associated with recurrent stroke at 90 days in patients receiving dual antiplatelet therapy in Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. <h3>Methods</h3> Patients with transient ischaemic attack or minor stroke receiving clopidogrel and aspirin in the trial were analysed in the study. The primary outcome was recurrent stroke within 90 days after the index event. Cox proportional hazard model with backward selection was used to identify factors associated with stroke. <h3>Results</h3> Among 2584 patients, 212 (8.2%) had a recurrent stroke, 216 (8.4%) had a composite of stroke, myocardial infarction, or vascular death and 204 (7.9%) had ischaemic stroke within 90 days. Multivariate analysis identified the following factors associated with stroke: history of hypertension with poor blood pressure control (HR, 1.92; 95% CI 1.22 to 3.03), the high baseline National Institute of Health Stroke Scale (NIHSS) score of 2 and 3 (2.12 (1.07 to 4.21) and 4.11 (2.05 to 8.22), respectively), time from onset to randomisation of &lt;12 hours (1.47 (1.12 to 1.94)), the lipid-lowering therapy (0.61 (0.47 to 0.83)), the open-label aspirin dose at day 1 of ≥300 mg (1.98 (1.45 to 2.69)). Intracranial arterial stenosis (ICAS) was significantly associated with stroke in the sensitivity analysis (2.17 (1.16 to 4.04)). <h3>Conclusions</h3> The high baseline NIHSS score, hypertension with poor blood pressure control, ICAS, time from onset to randomisation of less than 12 hours and no lipid-lowering therapy were associated with stroke, suggesting that patients with identified predictors still remain to be at high risk of recurrent stroke although being under the dual antiplatelet therapy. <h3>Trial registration number</h3> http://clinicaltrials.gov/show/NCT00979589. ClinicalTrials.gov number: NCT00979589