tbuckley/cabot-search huggingface dataset:
Why Do Symptomatic Patients Delay Obtaining Care for Tuberculosis?
Authors: STEVEN ASCH, BARBARA LEAKE, RONALD ANDERSON, LILLIAN GELBERG
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The resurgence of tuberculosis (TB) has coincided with deteriorating access to care for high-risk populations. We sought to determine what perceived access barriers delayed symptomatic TB patients from obtaining care. In order to do this, we conducted a survey in Los Angeles County, California, using a consecutive sample of patients with active TB as confirmed by the county TB control authority. The measures used in the study were a self-reported delay in seeking care of more than 60 d from symptom onset, a period sufficient to cause skin-test conversion in exposed contacts, and self- reported access barriers. The county TB registry provided supplementary clinical data. We found that one in five of the 248 symptomatic respondents (response rate: 60%) delayed obtaining care for > 60 d (mean = 74 d, SD = 216 d). During the delay, patients exposed an average of eight contacts. As compared with the rest of the sample, delay was more common in those who were unemployed (25% versus 14%), concerned about cost (27% versus 14%), anticipated prolonged waiting-room time (26% versus 14%), believed they could treat themselves (31% versus 14%), anticipated difficulty in getting an appointment (28% versus 16%), were uncertain about where to get care (33% versus 16%), and feared immigration authorities (47% versus 18%) (p < 0.05). Logistic regression revealed that uncertainty about where to get care, unemployment, and belief in the efficacy of self-treatment independently predicted delay > 60 d. Illness severity as measured by chest radiography, sputum smears, and symptoms had little impact on delay. We conclude that because access variables such as lack of employment and knowledge about where to obtain care were more closely associated with clinically significant delay than was severity of illness, these results raise concerns about the equity of access to care among TB patients. The results suggest that improving the availability of services for high-risk groups may substantially reduce TB patients' delay in obtaining care, and thus may limit the spread of the disease.
PRIORITY IN ISOLATION OF PARATHYROID HORMONE
Authors: Louis Berman
Journal: JAMA (1927)

<h3>To the Editor:</h3> —The appearance in book form of the Harvey Lectures for 1926 containing an article by Dr. J. B. Collip on the hormone of the parathyroid glands provides me with a reason for putting on record a statement of the facts relating to the question of priority in the separation of this substance. Dr. Collip refers to the work of previous investigators, lumping them all together as if they had all failed whereas he alone is entitled to the credit for both the originality of the conception and execution of the idea which resulted in obtaining the internal secretion of the parathyroids in a soluble form. In May, 1924, I presented to the Society of Experimental Medicine and Biology, at the invitation of Prof. William J. Gies, the following abstract of my work in this field: Parathyroid glands from oxen were extracted with acidified alcohol. Lipins and proteins
Composition of pigmented centers of cholesterol gallstones
Authors: Peter F. Malet, Clarke E. Williamson, Bruce W. Trotman, Roger D. Soloway
Journal: Hepatology (1986)

Most cholesterol gallstones have visually pigmented centers, but it is unclear whether this represents simple co-precipitation of pigment with cholesterol during stone nidation or nidation on a true pigment stone center. To clarify this issue, we selected from among 67 sets of cholesterol gallstones, 12 sets with the most conspicuously pigmented centers. The composition of the centers and the peripheries of these 12 stones was analyzed using infrared spectroscopy and compared with that of 10 black pigment gallstones. The pigmented centers of cholesterol stones contained 80.1 +/- 7.9% (mean +/- S.E.) cholesterol, 6.2 +/- 3.4% calcium bilirubinate (only 4 of the 12 centers had measurable calcium bilirubinate), trace amounts of calcium phosphate and no calcium carbonate or calcium palmitate. The peripheral areas of the cholesterol stones contained 91.6 +/- 2.3% cholesterol and no detectable calcium salts. For comparison, the composition of the centers of 10 black pigment gallstones was 13.5 +/- 2.2% cholesterol, 28.2 +/- 5.3% calcium bilirubinate, 5.5 +/- 2.4% calcium phosphate and 10.6 +/- 5.8% calcium carbonate. The composition of only one cholesterol stone center (15.8% cholesterol, 26.8% calcium bilirubinate) resembled that of a pigment stone, but even this center differed from that of a typical pigment stone in that it contained only a trace amount of calcium phosphate and no calcium carbonate. Thus, the chemical composition of pigmented centers of cholesterol gallstones is quantitatively different from that of black pigment stones, suggesting that cholesterol gallstones do not form on a pigment stone nidus.
Septic Arthritis in Sickle-Cell States: Pathophysiology of Impaired Response to Infection and Implications for Management.
Authors: Donald W. Palmer
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Septic Arthritis in Sickle-Cell States: Pathophysiology of Impaired Response to Infection and Implications for Management.Donald W. Palmer, M.D., Michael H. Ellman, M.D., Sergio Jacobelli, M.D.Donald W. Palmer, M.D.Search for more papers by this author, Michael H. Ellman, M.D.Search for more papers by this author, Sergio Jacobelli, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-870_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwo patients with septic arthritis and sickle-cell disorders responded poorly to therapy. Although prompt responses are reported in nonsicklers,Escherichia coliandSalmonella enteritidispersisted in joints of sicklemic patients for 53 and 42 days in spite of extraordinary doses of parenteral antibiotics. Synovial fluid gases were measured in one patient before, during, and after septic arthritis. The O2saturation of articular capillary blood in equilibrium with the joint fluid was calculated, and the percentage of sickled cells and resultant increase in viscosity were predicted for local capillary blood. The ratio of articular blood flow to articular oxygen consumption was... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Ill. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAvascular necrosis of temporomandibular joint in sickle cell diseaseHistologic documentation of gonococcal infection in the absence of a culturable organismRheumatological Manifestations of Sickle Cell Disease and other Hereditary Haemoglobinopathies 1 May 1972Volume 76, Issue 5Page: 870-870KeywordsArthritisBlood cellsBlood flowCapillariesCellsEscherichia coliOxygen consumptionPulse oximetrySalmonella enteritidisSynovial fluid Issue Published: 1 May 1972 PDF DownloadLoading ...
SARCOIDOSIS WITH ERYTHRODERMIA AND ULCERATION.
Authors: J. R. SIMPSON
Journal: British Journal of Dermatology (1963)

Journal Article SARCOIDOSIS WITH ERYTHRODERMIA AND ULCERATION. Get access J. R. SIMPSON, M.B., M.R.C.P. J. R. SIMPSON, M.B., M.R.C.P. Consultant Dermatologist, Royal Devon and Exeter Hospital, Exeter Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 75, Issue 5, 1 May 1963, Pages 193–198, https://doi.org/10.1111/j.1365-2133.1963.tb13548.x Published: 01 May 1963
FAM83A and FAM83B: candidate oncogenes and TKI resistance mediators
Authors: Steven Grant
Journal: Journal of Clinical Investigation (2012)

The growth and survival of tumor cells can depend upon the expression of a single oncogene, and therapeutically targeting this oncogene addiction has already proven to be an effective approach in fighting cancer. However, it is also clear that cancer cells can adapt and become resistant to therapy through compensatory activation of downstream pathways that relieve the cell of its addicted phenotype. In this issue of the JCI, two groups--Lee et al. and Cipriano et al.--identify two related candidate oncogenes that might both contribute to therapeutic resistance to tyrosine kinase inhibitors (TKIs). If validated, this information could help to identify new targets for therapeutic interventions in breast cancer and possibly other cancers and may also assist in the development of strategies designed to overcome resistance to currently available TKIs.
Treatment of Esophagobronchial Fistula
Authors: Eugene G. Laforet
Journal: JAMA (1978)

<h3>To the Editor.—</h3> It is a surgical axiom, hoary but perhaps worthy of occasional reiteration, that a live kitten is better than a dead lion. A recent article inThe Journal(238:2048-2049, 1977) provides a case in point and also argues that the retrospectoscope, if used gently and appropriately, is still our most valuable medical tool. A patient is described in whom the late development of an esophagobronchial fistula complicated spontaneous esophageal rupture. Because of uncontrolled pulmonary sepsis secondary to constant soiling by esophageal secretions, surgery was undertaken. This involved direct repair of a 2-cm distal esophageal tear and resection of the involved left lower lobe— certainly a justifiable and classic approach. Unfortunately, however, the patient did not survive. Therefore, it seems reasonable to suggest an alternative mode of management for such problems—less "surgical" perhaps, less "complete" certainly, but nevertheless fairly effective. I refer to the use of a Celestin
Photopenia of a Hemithorax on Technetium-99m HMDP Bone Scintigraphy Resulting from Massive Pleural Effusion
Authors: WEI-JEN SHIH, PEGGY A. DOMSTAD, FRANK DeLAND
Journal: Clinical Nuclear Medicine (1985)

Accumulation of Tc-99m labeled phosphonate bone scanning agent in a pleural effusion usually shows a mild and diffuse increase in radioactivity of the involved thorax. A malignant neoplasm was thought to account for this accumulation. The photon deficiency of the hemithorax on Tc-99m HMDP bone scintigraphy was shown in a case of massive pleural effusion, which was proved by autopsy to be due to metastatic breast carcinoma in the pleura. Two factors caused these scintigraphic findings: 1) a large amount of fluid in the pleural cavity caused photon attenuation; 2) the higher body background in the noninvolved hemithorax and other areas of the body was due to renal dysfunction resulting from chronic pyelonephritis. Whether the accumulation of the radiopharmaceutical agent in the pleural effusion was malignant or benign could not readily be distinguished.
David Gardner-Medwin
Authors: A. Craft
Journal: BMJ (2014)

Sepantronium bromide (YM-155) is believed to elicit apoptosis and mitotic arrest in tumor cells by reducing (BIRC5, survivin) mRNA. In this study, we monitored changes in survivin mRNA and protein after treating MDA-MB-231 cells with YM-155 concurrent with evaluation of whole transcriptomic (WT) mRNA and long intergenic non-coding RNA at 2 time points: 8 h sub-lethal (83 ng/mL) and 20 h at the LC<sub>50</sub> (14.6 ng/mL). The data show a tight association between cell death and the precipitating loss of survivin protein and mRNA (-2.67 fold-change (FC), p&lt;0.001) at 20 h, questioning if the decline in survivin is attributed to cell death or drug impact. The meager loss of survivin mRNA was overshadowed by enormous differential change to the WT in both magnitude and significance for over 2000 differentially up/down-regulated transcripts: (+22 FC to -12 FC, p&lt;0.001). The data show YM-155 to up-regulate transcripts in control of circadian rhythm (NOCT, PER, BHLHe40, NFIL3), tumor suppression (SIK1, FOSB), histone methylation (KDM6B) and negative feedback of NF-kappa B signaling (TNFAIP3). Down-regulated transcripts by YM-155 include glucuronidase (GUSBP3), numerous micro-RNAs, DNA damage repair elements (CENPI, POLQ, RAD54B) and the most affected system was the ataxia-telangiectasia mutated (ATM)/Fanconi anemia E3 monoubiquitin ligase core complexes (FANC transcripts - A/B/E/F/G/M), FANC2, FANCI, BRCA1, BRCA2, RAD51, PALB2 gene and ATR (ATM- and Rad3-Related) pathway. In conclusion, these findings suggest that a primary target of YM-155 is the loss of replicative DNA repair systems.
A recurrent neomorphic mutation in MYOD1 defines a clinically aggressive subset of embryonal rhabdomyosarcoma associated with PI3K-AKT pathway mutations
Authors: Shinji Kohsaka, Neerav Shukla, Nabahet Ameur, Tatsuo Ito, Charlotte K Y Ng, Lu Wang, Diana Lim, Angela Marchetti, Agnes Viale, Mono Pirun, Nicholas D Socci, Li-Xuan Qin, Raf Sciot, Julia Bridge, Samuel Singer, Paul Meyers, Leonard H Wexler, Frederic G Barr, Snjezana Dogan, Jonathan A Fletcher, Jorge S Reis-Filho, Marc Ladanyi
Journal: Nature Genetics (2014)
BRAIN BLOOD FLOW SINGLE-PHOTON TOMOGRAPHY IN INTERVENTIONAL NEURORADIOLOGY
Authors: D. Mathews, B. S. Walker, P. D. Purdy, D. A. Eckard, Devous Sr, F. J. Bonte
Journal: Clinical Nuclear Medicine (1993)

Mathews, D.; Walker, B. S.; Purdy, P. D.; Eckard, D. A. M.D.; Sr, Devous; Bonte, F. J. Author Information
MORE LOCAL AND LESS GENERAL ANESTHESIA IN GYNECOLOGIC OPERATIONS.
Authors: J. CLARENCE WEBSTER
Journal: JAMA (1904)

General anesthesia is of great value in diagnosing many intrapelvic and intra-abdominal conditions, especially in girls, nervous women and in those with tense or thick abdominal walls. Ether and chloroform are the drugs most frequently employed for this purpose. During recent years I have to a great extent discarded these, using nitrous oxid gas in preference, except in eases in which it is contraindicated. The great advantages of this anesthetic are its rapidity of action, safety and absence of after-sickness. The gas is administered through a Packard inhaler, air being inhaled with it. In carrying out operative procedures I use nitrous oxid and ether, except where there is some contraindication, in the majority of cases. I have found the Packard inhaler very suitable for the administration. A mixture of nitrous oxid gas and air is first given, and as unconsciousness is developed, ether vapor is gradually forced into the inhaler
Enhanced adrenergic neurotransmission in diabetic rabbit carotid artery
Authors: B. Tesfamariam, R. A Cohen
Journal: Cardiovascular Research (1995)

The aim was to examine the effects of diabetes mellitus on adrenergic neurotransmission and smooth muscle responsiveness in the densely innervated carotid artery from six-week alloxan diabetic rabbits.Rings of carotid arteries were isolated from normal and diabetic rabbits and isometric tension was measured in response to stimulation of adrenergic nerves, alpha adrenoceptors, and activation by calcium.Basal content and stimulated overflow of endogenous noradrenaline were reduced by approximately 25% in arteries from diabetic as compared to normal rabbits. In contrast, responses to endogenous noradrenaline released from adrenergic nerves by electrical stimulation or tyramine displacement were not different between arteries from normal and diabetic groups. Neuronal uptake blockade using cocaine caused a significantly smaller leftward shift in the contractions produced by electrical stimulation and exogenously applied noradrenaline in arteries from diabetic rabbits. The tonic, but not phasic, contractions caused by phenylephrine were larger in arteries from diabetic rabbits. Calcium-induced contractions caused by readdition of calcium to a calcium-free medium containing potassium (15 mmol.litre-1) were also significantly larger in arteries from diabetic rabbits. BAY K 8644, a calcium channel activator, caused an increase in calcium induced contractions and abolished the difference between the two groups.Although neurogenic contractions of diabetic carotid artery are normal, there is inefficient or reduced neuronal uptake as well as increased activity of calcium channels in the smooth muscle which increase contractions to alpha adrenoceptor agonists.
Daunorubicin in patients with relapsed and refractory acute nonlymphoblastic leukemia previously treated with anthracycline
Authors: T. Velu, L. Debusscher, P. Stryckmans
Journal: American Journal of Hematology (1988)

Abstract While the efficacy of daunorubicin (DNR) in first induction of patients with acute nonlymphoblastic leukemia (ANLL) has been well documented, little data are available concerning the activity of DNR in patients with relapsed and refractory ANLL previously treated with anthracycline. We administered DNR (60 mg/m 2 /day for 3‐5 days) in 21 patients with relapsed (n=12) or refractory (n=9) ANLL previously treated with anthracycline. The general response rate was 48%, with a complete response (CR) rate of 38%. Five of 12 patients with relapsed ANLL and 3 of 9 patients with refractory ANLL achieved CR. Among these cases with CR in refractory ANLL, the evolution of one patient is particularly illustrative since he had received previously a large cumulative dose of anthracycline (540 mg/m 2 ) and has been shown to be refractory to high‐dose cytosine arabinoside. This study suggests that previous administration of DNR or adriamycin does not Induce significant resistance to anthracycline: DNR appears to be almost as efficient in patients with relapsed and refractory ANLL previously treated with anthracycline as in first induction.
Hypercholesterolaemia: not all cases warrant treatment.
Authors: J Patmore, S Coyle, R Jones, G Wieringa
Journal: BMJ (1993)

Increasing numbers of patients are being treated for hypercholesterolaemia on the basis of total cholesterol concentrations.We describe a 49 year old woman so treated whose high total cholesterol concentration was explained by a high density lipoprotein cholesterol concentration of 3-9 mmol/l and a serum apoprotein AI concentration of 2 75 g/l; this indicated hyper-a.lipoproteinaemia, a condition with no association with cardiovascular disease. Case reportFollowing routine health screening by her general practitioner a 49 year old woman was found to have a raised serum total cholesterol concentration of 9-4 mmol/l.She had not smoked for 15 years, was not diabetic, was of normal weight, took regular exercise, and had no family history of ischaemic heart disease.She had no symptoms suggestive of cardiovascular disease and on examination had no comeal arcus and tendinous or cutaneous xanthomas.Her electrocardiogram was normal.Her medical history included successful renal transplantation at the age of 37 and a total hysterectomy at the age of 45 followed by the start of hormone replacement treatment.One year later she was found to be moderately hypertensive and was started on a cardioselective l blocker (metoprolol).Her other medications were prednisolone (enteric coated) 10 mg twice daily, azathioprine 125 mg/day, and piperazine oestrone 1-5 mg/day.After the finding of hypercholesterolaemia she was placed on a cholesterol lowering diet and her total cholesterol concentration fell to 8-1 mmol/l over the next two months.No further reduction was achieved, however, and treatment with bezafibrate was started.Eight weeks later her cholesterol concentration remained at 8-2 mmol/l, and simvastatin 10 mg at night was substituted.This reduced her total cholesterol concentration to 7-1 mmol/l, where it fell within the range for triggering low density lipoprotein cholesterol estimation.
Prosthetic Heart Valves
Authors: Colin McCord
Journal: JAMA (1969)

This volume, with 66 papers by 236 authors, ranges widely across the field of valve-replacement surgery, including such related subjects as normal valve structure and function, in vitro testing of prosthetic valves, materials for prosthetic valves and other devices in contact with blood, and myocardial function. Papers from most of the major centers involved in this work present early and late clinical results in several thousand valve-replacement operations. While much of this material has appeared in the literature in a somewhat different form, there is certainly no other single source which brings together so much information about valves. Tremendous advances have taken place in the last eight years. The first conference, in 1960, contained reports on a total of 11 mitral-valve replacements with only one patient surviving for ten months. Of 36 patients with aortic-valve replacement, the mortality was 42%. The reports in this volume indicate that total valve replacement
Ethics. Research, and Animal Welfare
Authors: C. E. Clarke
Journal: JAMA (1967)

<h3>To the Editor:—</h3> Dr. Maurice B. Visscher in his fine essay on vivisection and medical ethics (<b>199</b>: 631, 1967) warns of the threat to experimental medicine and biology posed by government-bureau restraint. Certainly any reasonable man must agree with him. But does not the same argument apply to government-bureau restraint of medical practice? Dr. Visscher cites John Dewey's observation that opponents of animal experimentation demand what is in effect "class legislation, putting scientific men under peculiar surveillance and limitation." Does not this argument pertain also to legislation putting under such surveillance and limitation the practicing physician, who applies medical science to the care of the human individual? Are practicing physicians less to be trusted ethically than research scientists? My experience does not tell me so—and I do not intend by this remark offense to those in research. Experience does tell me that the great majority of people in medical research
Don't forget HIV testing in the over 60s
Authors: P. Hewitt, C. Chapman, R. Anand, N. Hewson, S. Brailsford, R. Tedder
Journal: BMJ (2011)

White reported routine offers of HIV tests at an accident and emergency department,1 while Das and colleagues discussed primary HIV infection as “easily missed.”2 Our recent experience with three older people suggests that opportunistic offers of HIV testing should be more widespread.

All three were repeat blood donors aged over 64 years who had seroconverted since their …
LOCAL ANESTHETICS IN ARTICULAR PAIN
Authors: R. E. Logan
Journal: JAMA (1934)

<h3>To the Editor.—</h3> The recent reply of Dr. J. C. Weisman (The Journal, March 3, p. 714) to the criticism (January 13, p. 148) of the use of local anesthetics in articular pain (Paris letter, Nov. 4, 1933, p. 1492) so supported my experience that I desire to add my own observations. I have not used such treatment in acute conditions. In chronic painful articular conditions, two recent cases have convinced me of the efficacy of local anesthesia in certain cases. I would feel hesitant in using it in unquestioned infection or in polyarthritis. But occasionally a case appears in which there are no definite demonstrable infective foci and drug therapy appears to be ineffectual. These persons are disabled, are never free from pain, and have usually made the rounds of doctors and have had a session with the chiropractors. H. M., a man, aged 43, seen in bed, for