tbuckley/cabot-search huggingface dataset:
The Birth of Language: The Case History of a Non-Verbal Child
Authors: Marjorie C. Meehan
Journal: JAMA (1966)

In the past, most children who failed to learn to talk properly were labeled mentally deficient and forgotten in institutions. Gradually we have learned to identify and treat certain groups—those due to metabolic disorders, autism, brain damage. Diagnosis is still difficult and usually requires the cooperation of pediatricians, neurologists, otologists, speech therapists, psychiatrists. If brain damage is diagnosed, the tremendous problem of treatment remains. This book tells the story of the successful treatment of one such child.  Joan was premature—birth weight 992 gm (2 lb, 3 oz). Except for retrolental fibroplasia from which she recovered completely, she made good physical progress, eating, sleeping, and growing well. But she was a restless, unresponsive infant. By age 3, she was active, destructive, apparently unable to recognize or distinguish members of her family, unable to use language or to communicate in any way. She was examined at a speech clinic at 3 1/2
The SUVmax for 18F-FDG Correlates With Molecular Subtype and Survival of Previously Untreated Metastatic Breast Cancer
Authors: Jian Zhang, Zhen Jia, Min Zhou, Joseph Ragaz, Yong-Ping Zhang, Bi-Yun Wang, Zhong-Hua Wang, Xi-Chun Hu, Ying-Jian Zhang
Journal: Clinical Nuclear Medicine (2013)

The objectives of this study were to determine if the baseline SUVmax measured by F-FDG PET/CT correlates with molecular subtype and to explore the impact of baseline SUVmax on the survival of patients with metastatic breast cancer (MBC).Patients with MBC were screened with PET/CT from February 2007 until December 2010. Multivariate linear regression analysis was performed to identify independent variable correlation with SUVmax. Prognostic variables identified by univariate analysis, with P < 0.1, were analyzed in the multivariate Cox model.A total of 244 MBC patients were eligible for this study. Multivariate linear regression analysis showed that molecular subtype, visceral metastasis, and number of metastatic organs could be used to predict the logarithmic values of SUVmax (lgSUVmax) for previous untreated MBC patients, whereas for those with 1 or more line previous treatment, the number of metastatic organs was identified as the only independent variable correlating with lgSUVmax. Cox regression analysis indicated that only in patients with previously untreated MBC did baseline SUVmax (continuous variable) act as an independent prognostic factor (hazard ratio = 1.049 for progression-free survival, 1.124 for overall survival).Baseline SUVmax correlates with molecular subtypes only in previously untreated MBC patients. PET/CT imaging can be used as a potential prognostic tool for patients with newly diagnosed MBC.
The Helix-Loop-Helix Protein Id1 Requires Cyclin D1 to Promote the Proliferation of Mammary Epithelial Cell Acini
Authors: C. Elizabeth Caldon, Alexander Swarbrick, Christine S.L. Lee, Robert L. Sutherland, Elizabeth A. Musgrove
Journal: Cancer Research (2008)

Abstract Overexpression of the helix-loop-helix (HLH) protein Id1 has been associated with metastasis in breast cancer, but its role in models of early breast tumorigenesis is not well characterized. We show that the down-regulation of endogenous Id1 via proteosomal degradation and relocalization from the nucleus to the cytoplasm is an early event in the formation of mammary epithelial acini. Overexpression of Id1 in both human MCF-10A and primary mouse mammary epithelial cells disrupted normal acinar development by increasing acinar volume. This occurred in an HLH domain–dependent fashion via an increase in S phase. Id1 overexpression also increased apoptosis leading to accelerated luminal clearance, and this was reversed by coexpression of the proto-oncogene Bcl2, leading to large, disorganized structures with filled lumina. Id1 overexpression was unable to increase the volume of cyclin D1−/− acini, indicating that Id1 is dependent on cyclin D1 for its proliferative effects. In summary, Id1 may contribute to early breast cancer by promoting excessive proliferation through cyclin D1. [Cancer Res 2008;68(8):3026–36]
Right atrial tuberculoma: report of a case with complete recovery.
Authors: H Krishnaswami, G Cherian
Journal: Thorax (1984)

Localised tuberculous myocardial lesions (tuberculomas) are extremely rare and usually diagnosed at necropsy.' 2 We present here the clinical, angiographic, and pathological findings in a patient with myocardial tuberculosis pre- senting as an obstructing mass in the right atrium.The disease was successfully treated by antituberculous chemotherapy.Case report
E PLURIBUS UNUM, EX UNO PLURA: Quantitative and Single-Gene Perspectives on the Study of Behavior
Authors: Ralph J. Greenspan
Journal: Annual Review of Neuroscience (2004)

Genetic studies of behavior have traditionally come in two flavors: quantitative genetic studies of natural variants and single-gene studies of induced mutants. Each employed different techniques and methods of analysis toward the common, ultimate goal of understanding how genes influence behavior. With the advent of new genomic technologies, and also the realization that mechanisms underlying behavior involve a considerable degree of complex gene interaction, the traditionally separate strands of behavior genetics are merging into a single, synthetic strategy.
Case of Munchausen Syndrome: Philadelphia, Baltimore
Authors: J. MULLER
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 May 1973Case of Munchausen Syndrome: Philadelphia, BaltimoreJ. MULLER, M.D., M. A. MCDONNELL, M.D., B. L. EVATT, M.D., W. R. BELL, M.D.J. MULLER, M.D.Search for more papers by this author, M. A. MCDONNELL, M.D.Search for more papers by this author, B. L. EVATT, M.D.Search for more papers by this author, W. R. BELL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-5-784_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: A 28-year-old Italian man admitted to The Johns Hopkins Hospital on 17 January 1973 for complaints of leg swelling and pleuritic chest pain appears to be the patient reported by Buxton, Meyers, and Gardner in your Letters section (Ann Intern Med77: 477, 1972). His history of tuberculosis, sarcoidosis, multiple pulmonary emboli, inferior vena cava umbrella and ligation, and cryoglobulinemia was essentially the same as related in his University of Pennsylvania admission. He omitted his claim of a previous myocardial infarction for lack of electrocardiographic documentation. He submitted a new but invalid Blue Cross-Blue Shield identification card.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. MULLER, M.D.; M. A. MCDONNELL, M.D.; B. L. EVATT, M.D.; W. R. BELL, M.D.Affiliations: Hematology Division Department of Medicine The Johns Hopkins Medical Institutions Baltimore, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMore on "Munchausen Syndrome"RICHARD B. DEVEREUX, M.D., THOMAS R. MILLER, M.D. 1 May 1973Volume 78, Issue 5Page: 784-784KeywordsElectrocardiographyInferior vena cavaInflammationIschemiaLigation assayMyocardial infarctionSarcoidosis ePublished: 1 December 2008 Issue Published: 1 May 1973 PDF downloadLoading ...
Biased Estimates of Expected Acute Myocardial Infarction Mortality Using Medis-Groups Admission Severity Groups
Authors: Mark S. Blumberg
Journal: JAMA (1991)

This study examines whether the MedisGroups admission severity groups give unbiased estimates of 30-day mortality in 3037 Medicare-aged patients who were hospitalized in 1985 through 1986 with acute myocardial infarction. The average observed death rate for all acute myocardial infarction patients in the study who were in a given admission severity group was used to estimate the expected death probability for each case in a given group. (This is the same method used by the Pennsylvania Health Care Cost Containment Council for risk adjusting hospital mortality by diagnosis related groups in that state.) When compared with observed deaths, estimates of expected mortality were significantly biased for many patient attributes (eg, age, location of acute myocardial infarction, history of congestive heart failure, serum potassium level, serum urea nitrogen level, pulse rate, and blood pressure). These results are consistent with a conclusion that the MedisGroups scoring algorithm omits some important risk variables, inappropriately includes some other variables reflecting postadmission status, and gives the wrong weights to some appropriate risk variables. To the extent that these findings are also applicable to current MedisGroups scoring algorithms and to other conditions and procedures, MedisGroups admission severity groups cannot fairly adjust for interhospital case mix differences in outcome studies.
Access to Care in Regionalized Health Care Systems
Authors: Paul James
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Dr Grumbach and colleagues<sup>1</sup>are to be commended for their creative study of coronary artery bypass surgery (CABS) outcomes, geographic access, and regionalization of health care in the United States and Canada. We found the study particularly thought-provoking with respect to the issues of access and regionalization of services for rural patients. The results clearly demonstrate a reduced mortality rate for CABS patients in hospitals of high procedural volume across different health care environments. However, the study raises significant questions regarding the indicators of quality that are most appropriate to measure in regionalized health care systems. Research suggests that the prevalence of coronary artery disease is as high in rural areas as it is in urban locales.<sup>2</sup>If the rate of CABS is lower in rural locales, the issue of equitable access becomes an important health policy concern. This issue becomes even more important as
Increased plasma-soluble fibrin monomer levels in patients with disseminated intravascular coagulation
Authors: Hideo Wada, Yoshihiro Wakita, Tsutomu Nakase, Minori Shimura, Katuyo Hiyoyama, Shozaburo Nagaya, Hiroshi Deguchi, Yoshitaka Mori, Toshihiro Kaneko, Katsumi Deguchi, Junichi Fujii, Hiroshi Shiku
Journal: American Journal of Hematology (1996)

Plasma-soluble fibrin monomer (SFM) level in patients with disseminated intravascular coagulation (DIC) was significantly higher than the level in patients with pre-DIC or in non-DIC patients, and the level in patients with pre-DIC was significantly higher than that in non-DIC patients. There was no significant difference in plasma SFM levels among various diseases underlying DIC. Plasma SFM level in patients with good outcome was significantly decreased after treatment for DIC. The sensitivity of fibrin degradation products and platelet number was high for DIC, but not for pre-DIC. The sensitivity of thrombin-antithrombin III complex, plasmin-plasmin inhibitor complex, and SFM was high for both DIC and pre-DIC. The specificity of these markers was also high. Receiver operating characteristic analysis suggests that plasma SFM level could be the most useful marker for the diagnosis of both DIC and pre-DIC. © 1996 Wiley-Liss, Inc.
For-Profit Hospital Status and Rehospitalizations at Different Hospitals: An Analysis of Medicare Data
Authors: Amy J.H. Kind, Christie Bartels, Matthew W. Mell, John Mullahy, Maureen Smith
Journal: Annals of Internal Medicine (2010)

Background: About one quarter of rehospitalized Medicare patients are admitted to hospitals different from their original hospital. The extent to which this practice is related to for-profit hospital status and affects payments and mortality is unknown. Objective: To describe and examine predictors of and payments for rehospitalization at a different hospital among Medicare patients rehospitalized within 30 days at for-profit and nonprofit or public hospitals. Design: Cohort study of patients discharged and rehospitalized from January 2005 to November 2006. Setting: Medicare fee-for-service hospitals throughout the United States. Participants: A 5% random national sample of Medicare patients with acute care rehospitalizations within 30 days of discharge (n = 74 564). Measurements: 30-day rehospitalizations at different hospitals and total payments or mortality over the subsequent 30 days. Multivariate logistic and quantile regression models included index hospital for-profit status, discharge counts, geographic region, rural–urban commuting area, and teaching status; patient sociodemographic characteristics, disability status, and comorbid conditions; and a measure of risk adjustment. Results: 16 622 patients (22%) in the sample were rehospitalized at a different hospital. Factors associated with increased risk for rehospitalization at a different hospital included index hospitalization at a for-profit, major medical school–affiliated, or low-volume hospital and having a Medicare-defined disability. Compared with patients rehospitalized at the same hospital, patients rehospitalized at different hospitals had higher adjusted 30-day total payments (median additional cost, $1308 per patient; P < 0.001) but no statistically significant differences in 30-day mortality, regardless of index hospital for-profit status. Limitation: The database lacked detailed clinical information about patients and did not include information about specific provider practice motivations or the role of patient choice in hospitalization venues. Conclusion: Rehospitalizations at different hospitals are common among Medicare patients, are more likely among those initially hospitalized at a for-profit hospital, and are related to increased overall payments without improved mortality. Primary Funding Source: University of Wisconsin Hartford Center of Excellence in Geriatrics, National Institutes of Health.
Bradykinesia in Parkinson's disease and cocontraction activity in dystonia are unlikely to be due to adaptive changes in the CNS
Authors: A. Berardelli, R. Agostino, A. Currà, M. Manfredi
Journal: Behavioral and Brain Sciences (1996)

Abstract Latash &amp; Anson's explanation of bradykinesia in patients with Parkinson's disease and cocontraction in dystonic patients is intriguing. However, the proposed adaptive changes in the central nervous system do not fit well with both clinical and experimental evidence of motor impairment in these patients. In particular, we question the explanation of: (1) the role of postural reactions and spatial accuracy in bradykinesia, (2) certain abnormalities during the execution of sequential and simultaneous movements, (3) the sudden changes in mobility (ON and OFF) of Parkinsonian patients, and (4) the meaning of reflex circuitry changes in dystonia.
Influenza and Infant Mortality
Authors: G. W. Griffith, A. M. Adelstein, P. M. Lambert, J. A. C. Weatherall
Journal: BMJ (1972)

Early neonatal mortality in England and Wales in the second quarter of 1970 after a major influenza epidemic was slightly but significantly higher than in the corresponding quarter of the previous year. An increase was also noted in the first quarter of 1970. Analysis of infant mortality and an index of influenza prevalence over the past quarter-century indicates that similar increases occurred in relation to four of the other five major influenza epidemics during the period, the exception being the "Asian 'flu" epidemic of the autumn of 1957. It is suggested that the increased mortality in 1970 was the consequence of an increase in the prematurity rate, but we have no evidence to indicate whether the effect is specifically due to the virus or is nonspecific in nature.
A Clinical Lecture on Common Diseases of the Rectum
Authors: C. Heath
Journal: BMJ (1891)

WV E are constantly having in the wards cases of severe disease of the rectum-I mean cases of piles whvich require operation, *cases of fistula, and cases of cancer.I propose to-day to speak rathier of the commoner cases of disease of the rectum, suchi as you will meet withi among out-patients and in your own lractice later on.Ordinarily the rectum performs its funntion without anl y disagreeables, and whenone e has a hlealthty evacuation of the bowels there is a feeling of relief whlich is somewhlat remarkable.That evacuation, of course, slhould be perfectly painless, and in the great majority of instances it is so; but you will find, whlen you get into prac- tice, that patients will complain to you in te e first place that they cannot get the bowels open, and then perhiaps they will say that whleii theyhave had them opened they suffer such pain that they dread every operation.With regard to the question whether a daily action of the bowels is essential to good healthl, I may say that no doubt, with the great majority of persons, a daily action is a necessity, but still you inay meet with people who are a little different in that respect, and wvill go two, or even three or four, days without evacuation and without any discomfort.I mention that because it is well to consider the idiosyncrasy of each individual.It is of no use, where you have torpid bowels and a weak condition of the muscular fibre generally, sucl as you meet with for instance in elderly females and ana-mic persons, to try and force them by violent purgation into the ordinary dailyhabits of healthy people.Of course, if you take a healthy person, you have there a standard, but you may find variations from it for which you must be prepared.As to the time at which the bowels should be opened, that of course, in manycases, is a matter of simple convenience.The busy man, going off to catch a train immediately after breakfast, had better perhaps havehis bowels opened at night, but a person whohas a little leisure, and, moreover, is able to enjoy that matutinal pipe which, I am told, is so extremely useful in producing an alvine action, may well repair to the water closet after breakfast ; but take my word for it, that patients whohave anything the matter with the rectum, who suffer in any way upon the dischlarge of fTeces, should, as a rule, have their bowels opened at night; and the reason is obvious.The action of the bowels takes place more conveniently after theyhave undressed: tllat is an important
Reassessment of failed beta-blocker treatment in angina pectoris by peak-exercise heart rate measurements.
Authors: G Jackson, L Atkinson, S Oram
Journal: BMJ (1975)

Twenty-one patients with angina pectoris were treated with adrenergic beta-receptor antagonists. Previously the resting heart rate had been used as a guide to treatment, a reduction in the rate to 55-60 beats/min without symptomatic improvement indicating failure of medical treatment. These patients were re-evaluated before coronary arteriography using the peak-exercise heart rate as an index of adrenergic beta-receptor antagonism. The dose of beta-blocking drugs was increased to produce a peak-exercise heart rate of less than 100 beats/min or a consistent rate of 100-125 beats/min which would not lessen in spite of progressive dose increments. The resting heart rate was ignored. On these criteria 15 patients previously considered to have responded inadequately to beta-blockade responded satisfactorily and were therefore removed from the waiting list for coronary arteriography. They all remained well up to two years later. Six patients failed to respond and had coronary arteriography with a view to surgical treatment. Reliance on the resting heart rate as the index of optimum adrenergic beta-receptor antagonism is likely to lead to premature or unnecessary referral for surgery; the failure of beta-blockade in the treatment of angina pectoris can be determined simply and accurately by using peak-exercise heart rate.
FIBRINOLYSIS ASSOCIATED WITH ONCOGENIC TRANSFORMATION
Authors: L. Ossowski, J. P. Quigley, G. M. Kellerman, E. Reich
Journal: The Journal of Experimental Medicine (1973)

Fetal bovine and dog serum were selectively freed of plasminogen by affinity chromatography. The resulting serum as well as native and reconstituted serum (obtained by the addition of purified plasminogen to the plasminogen-depleted serum) were used to examine the role of plasminogen in (a) growth of normal and SV-40-transformed hamster embryo fibroblasts in liquid medium, (b) growth of SV-40-transformed hamster embryo fibroblasts in soft agar, (c) aggregation — a characteristic morphological change of SV-40-transformed hamster cells, and (d) migration of SV-40-transformed and control 3T3 cells from a monolayer into a "wound." The results demonstrated that exponential growth of both normal and transformed cells in liquid medium proceeded at the same rate in the presence or absence of plasminogen. In contrast, removal of plasminogen markedly depressed the plating efficiency of transformed cells in soft agar, eliminated their characteristic aggregation, and substantially reduced the extent of migration. The role of plasminogen and its activation in oncogenic transformation is discussed.
Traumatic Shock in Man
Authors: Gerald S. Moss, Jack D. Saletta
Journal: New England Journal of Medicine (1974)

TRAUMATIC shock often involves a combination of reduced blood volume, overwhelming sepsis and cardiac failure. However, initially the most prominent physiologic derangement is a reduced blood volume. It is this aspect of traumatic shock that will be emphasized in the following report. Many of the data are taken from studies carried out in Vietnam by Army and Navy research teams.Effects of Acute Volume ReductionHemodynamic ChangesThe effects of acute reduction in blood volume on the circulation include increased heart rate, reduced stroke volume, reduced cardiac output, vasodilatation in some organs and vasoconstriction in others. Studies analyzing heart-muscle mechanics . . .
US Supreme Court v Obamacare: round 2
Authors: D. Kamerow
Journal: BMJ (2015)

Will the Affordable Care Act be gutted because of a small drafting error?



The US Affordable Care Act (“Obamacare”) was designed to expand health insurance coverage in three major ways: allowing young people through to age 25 to be included on their parents’ policies; expanding the Medicaid program for poor people to include those earning up to 133% of the federal poverty level; and providing federal subsidies to help low and middle income people afford mandated health insurance.

The third mechanism, subsidies, in the form of tax credits, has become the latest focal point for controversy. A little known lawyer discovered four words in the 1000 page law that cast doubt on whether the subsidies could be given to around seven million people who were already receiving them.1

Obamacare gave each state the option of setting up its own marketplace (called an exchange) to sell health insurance policies to its citizens. If the state declined, then the federal exchange—healthcare.gov—took over that state’s enrollments. Only 13 states set up their own exchanges, …