tbuckley/cabot-search huggingface dataset:
Mental Health and Hispanic Americans: Clinical Perspectives
Authors: Eduardo R. Val
Journal: JAMA (1983)

At present, Hispanics rank second in number among minority populations, and demographers are projecting a not very distant time when Hispanics will be the largest minority in the United States. Since this group is sociologically, ethnically, and culturally heterogeneous, presenting very complex and challenging social and health issues, a reference source such as the present volume is most welcome. The editors of this work had as a goal to provide practical information as well as theoretical formulations concerning the Hispanic patient, and they have succeeded admirably. Careful editing of a well-organized wealth of material is evident throughout the volume. The book is divided into four sections, on sociocultural issues, major syndromes, special concerns, and provision of services. Each subject is examined from a general knowledge perspective and is then discussed and applied to the Hispanic population. There is a well-balanced review of the pertinent literature. Some chapters are more research
THE NATIONAL NUTRITION
Authors: Logan Clendening
Journal: JAMA (1941)

<h3>To the Editor:—</h3> In the fall of 1940 a nutrition conference on white bread announced in the press apparently following a suggestion of Surgeon General Parran (Nutrition and National Wealth: Dietary Deficiency Is Widespread and Serious, with More Than 40 per Cent of the Population on Inadequate Rations,<i>Technology Review</i><b>42</b>:323 [Aug.] 1940) that 40 million Americans were suffering from vitamin deficiency. Then at the meeting of the first National Nutrition Conference for Defense, May 25-27, 1941, in Washington, that eminent bedside clinician Paul V. McNutt upped the General 5 million (what is 5 million Americans among bureaucrats?) and said that 45,000,000 "lack the foods we know are essential for health" and that "another 50,000,000 have impaired health because they do not eat the right food." These statements, which were practically unsupported by any statistical survey, are so astonishingly at variance with the experience of my colleagues and myself
Conservative Treatment of Chronic Heart Block
Authors: D. Redwood
Journal: BMJ (1969)

A study of 203 patients with chronic heart block treated with oral long-acting isoprenaline showed that 85 (42%) were maintained satisfactorily on the drug for a mean period of 18.2 months. The survival rates at one, two, and three years were 76%, 64%, and 57% respectively. In 115 patients treatment by pacing became necessary to control symptoms, and in these patients the survival rates at one, two and three years were 83%, 72%, and 60%. The two most valuable guides to patients9 response to oral isoprenaline are the response to a trial dose of intravenous isoprenaline and the type of dysrhythmia associated with their Adams-Stokes attacks. Patients with heart failure with slow ventricular rates and those with angina of effort do not respond to treatment with sympathomimetic drugs. The majority of patients with chronic heart block are elderly, and in view of the complexity of pacing systems, and the need for skilled supervision of paced patients, oral long-acting isoprenaline remains of value in the longterm management of chronic heart block, provided patients are carefully selected for this form of therapy.
Hypersensitivity Pneumonitis
Authors: Moisés Selman, Annie Pardo, Talmadge E. King
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Hypersensitivity pneumonitis (HP) is a complex syndrome resulting from repeated exposure to a variety of organic particles. HP may present as acute, subacute, or chronic clinical forms but with frequent overlap of these various forms. An intriguing question is why only few of the exposed individuals develop the disease. According to a two-hit model, antigen exposure associated with genetic or environmental promoting factors provokes an immunopathological response. This response is mediated by immune complexes in the acute form and by Th1 and likely Th17 T cells in subacute/chronic cases. Pathologically, HP is characterized by a bronchiolocentric granulomatous lymphocytic alveolitis, which evolves to fibrosis in chronic advanced cases. On high-resolution computed tomography scan, ground-glass and poorly defined nodules, with patchy areas of air trapping, are seen in acute/subacute cases, whereas reticular opacities, volume loss, and traction bronchiectasis superimposed on subacute changes are observed in chronic cases. Importantly, subacute and chronic HP may mimic several interstitial lung diseases, including nonspecific interstitial pneumonia and usual interstitial pneumonia, making diagnosis extremely difficult. Thus, the diagnosis of HP requires a high index of suspicion and should be considered in any patient presenting with clinical evidence of interstitial lung disease. The definitive diagnosis requires exposure to known antigen, and the assemblage of clinical, radiologic, laboratory, and pathologic findings. Early diagnosis and avoidance of further exposure are keys in management of the disease. Corticosteroids are generally used, although their long-term efficacy has not been proved in prospective clinical trials. Lung transplantation should be recommended in cases of progressive end-stage illness.
Thrombospondin Type-1 Domain-Containing 7A in Idiopathic Membranous Nephropathy
Authors: Nicola M. Tomas, Laurence H. Beck, Catherine Meyer-Schwesinger, Barbara Seitz-Polski, Hong Ma, Gunther Zahner, Guillaume Dolla, Elion Hoxha, Udo Helmchen, Anne-Sophie Dabert-Gay, Delphine Debayle, Michael Merchant, Jon Klein, David J. Salant, Rolf A.K. Stahl, Gérard Lambeau
Journal: New England Journal of Medicine (2014)

Idiopathic membranous nephropathy is an autoimmune disease. In approximately 70% of patients, it is associated with autoantibodies against the phospholipase A2 receptor 1 (PLA2R1). Antigenic targets in the remaining patients are unknown.
Plasma renin activity and aldosterone concentration in children.
Authors: M J Dillon, J M Ryness
Journal: BMJ (1975)

Using semi-micro methods, plasma renin activity (PRA) and plasma aldosterone concentration (PA) were measured concurrently in 79 healthy children aged 1 month to 15 years to establish a reference range. PRA and PA varied inversely with age. Eleven children with renal hypertension had higher PRA and PA than age-matched controls. In contrast, PRA was much greater in 38 saline-depleted children. PA was not uniformly increased in this group and was within the normal range in children with adrenal diseases compared with the high values seen in other salt-wasting states. The findings emphasise the need to relate data from patients to age-matched control values before attempting interpretation and suggest that sodium depletion is a more potent stimulator of renin-aldosterone release than renovascular disease or renal scarring in children. Plasma renin-aldosterone profiles were also valuable in discriminating between renal and adrenal causes of salt loss in childhood.
Hyponatremia: A Prospective Analysis of Its Epidemiology and the Pathogenetic Role of Vasopressin
Authors: ROBERT J. ANDERSON
Journal: Annals of Internal Medicine (1985)

We prospectively evaluated the frequency, cause, and outcome of hyponatremia (plasma sodium concentration, < 130 meq/L), as well as the hormonal response to this condition, in hospitalized patients. Daily incidence and prevalence of hyponatremia averaged 0.97% and 2.48%, respectively. Two thirds of all hyponatremia was hospital acquired. Normovolemic states (so-called syndrome of inappropriate secretion of antidiuretic hormone) were the most commonly seen clinical setting of hyponatremia. The fatality rate for hyponatremic patients was 60-fold that for patients without documented hyponatremia. Nonosmotic secretion of vasopressin was present in 97% of hyponatremic patients in whom it was sought. In edematous and hypovolemic patients, plasma hormonal responses (increases in plasma renin activity and aldosterone and norepinephrine levels) were compatible with baroreceptor-mediated release of vasopressin. Hyponatremia is a common hospital-acquired electrolyte disturbance that is an indicator of poor prognosis. Nonosmotic secretion of arginine vasopressin is a major pathogenetic factor in this electrolyte disturbance.
AIDS drug scandal in South Africa continues
Authors: P. Sidley
Journal: BMJ (1998)

The controversy surrounding attempts by a South African research team to market a cheap but untested drug against HIV infection has taken yet another twist and now involves the country's deputy president, Thabo Mbeki, as well as its health minister, Dr Nkosazana Zuma.

Both politicians have taken a high profile stance in favour of getting the drug—which has been condemned by South Africa's drug regulatory authorities—on to the market as quickly as possible. Now they have been accused by opposition parties of trying to acquire a stake in the company that owns the patent of the drug known as Virodene.

In 1997 press reports were published about a miracle cheap cure which …
THE MENTAL HOSPITALIZATION OF THE AGED: IS IT BEING OVERDONE?
Authors: LAWRENCE KOLB
Journal: American Journal of Psychiatry (1956)

The number and percentage of aged persons in the population is increasing and will continue to increase for many years. The percentage of such persons admitted to public mental hospitals is increasing much more rapidly than their percentage in the population; and their admission rate to mental hospitals is increasing much more rapidly than that of younger persons. Although the incidence of mental disease increases with age, there is no evidence that a unilateral increase of mental disease among the aged in recent years has anything to do with these differential increases. Sociologic factors are mainly responsible. In order of increasing numerical importance, delirious and other dying persons, non-psychotic feeble persons, nonpsychotic old persons with chronic illness, and tractable old persons who technically may be called psychotic are being sent to our mental hospitals because there is no other place for them to go. No question about their mental condition would be raised if there were other facilities. The increase of admissions of the aged to mental hospitals has been greater in the United States than in certain European countries with similar cultures. This is due to a relatively greater development abroad of other outlets for the infirm aged, and to drifting in this country toward the area of least resistance which is the state hospital. Existing abuses at the institutional level should be corrected by: 1. Increased subsidies by the states and local government agencies to private general hospitals for the care of chronically ill, medically indigent aged persons. 2. Building by the states and local government agencies of hospitals for chronically ill, medically indigent persons. 3. Building by the states and local government agencies of homes for the aged designed for comfort rather than for mass herding and operated with rehabilitation programs. They should have adequate medical services. 4. There should be liaison between mental hospitals and public homes for the aged so that the aged who become troublesomely psychotic at the homes could be quickly transferred to a hospital and tractable old patients at the hospitals could, on request, be transferred to homes. Intensified social programs and aid to the aged at the preinstitutional level tend to prevent or retard mental and physical deterioration and make institutionalization unnecessary in many cases.
Review: Aliskiren plus ACEIs or ARBs increases hyperkalemia more than aliskiren, ACEIs, or ARBs alone
Authors: Louise Moist
Journal: Annals of Internal Medicine (2012)

Source Citation Harel Z, Gilbert C, Wald R, et al. The effect of combination treatment with aliskiren and blockers of the renin-angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis. BMJ. 2012;344:e42. 22232539
Medical Education in the United States Before the Civil War
Authors: Chester R. Burns
Journal: JAMA (1972)

Norwood's book, first published in 1944 and now handsomely reprinted, originated as a doctoral dissertation in the Department of History at the University of Southern California. It was a survey of the evolution of medical schools in the United States before the Civil War with an emphasis on the economic and social aspects of the individual institutions. Prior to 1944, no historian had examined the development of American medical schools as a whole. Moreover, few medical historians were correlating medical education (or science and practice) with the social and intellectual developments of the total American enterprise. Norwood did both. After a brief review of the colonial background and an analysis of important factors in early medical education, Norwood provides a detailed description of the medical schools that emerged in Pennsylvania, New York, New England, the Old South, and Transappalachia. He concludes with a profile of the characteristics unique to American
The Flying Saucer Syndrome And the Need for Miracles
Authors: Joost A. M. Meerloo
Journal: JAMA (1968)

To the Editor:—  Science, unable to prove that certain phenomena donotexist, can describe the sources of subjective interpretation and the failures in objectivity that hamper verification of the phenomena. In dealing with the magical needs of their patients some physicians have accepted the illusions of these patients as verifiable truths.1  In this connection I offer a brief analysis of possible errors in observation. Air Force research efforts have not been able to discover an incontrovertible token or verifiable piece of hardware left behind by the presumed flying saucers.  Possible sources of error may help us to judge the saucer reports:   Memory distortions. Man's reservoir of memories continually projects old fantasies and fictions into new experiences. They are a source of continual observational error.  The personal search for magic. Especially now when there is deep anxiety concerning the future of the world, man resorts to magical
Effects of atrial natriuretic peptide on transmural blood flow and reactive hyperemia in the presence of flow-limiting coronary stenosis in the awake dog: evidence for dilation of the intramural vasculature.
Authors: A Chu, A Stakely, C C Lin, F R Cobb
Journal: Circulation Research (1989)

The effects of atrial natriuretic peptide (ANP) on transmural myocardial blood flow distribution and the reactive hyperemic response in the presence and absence of flow-limiting coronary stenosis were examined in chronically instrumented conscious dogs. Ten-second coronary occlusion without subsequent flow restriction resulted in marked reactive hyperemic responses (Doppler flow probes), mean flow debt repayment was 481 +/- 55%. When the 10-second coronary occlusions were followed by a 20-second partial restriction that allowed normal preocclusion coronary inflow, the subsequent reactive hyperemia was significantly augmented, mean flow debt repayment was 938 +/- 91% (p less than 0.05). Pretreatment with ANP (3 micrograms/kg) did not alter the flow debt repayment after a 10-second occlusion without restriction (474 +/- 30%, NS) but attenuated the augmentation of reactive hyperemia resulting from the 20-second inflow restriction, flow debt repayment (613 +/- 66%, NS). Regional myocardial blood flow to the ischemic region was measured during restricted inflow after a 10-second coronary occlusion before and after ANP pretreatment. Before ANP, subendocardial flow decreased (0.54 +/- 0.04 ml/min/g) and subepicardial flow significantly increased (1.03 +/- 0.12 ml/min/g) when compared with the nonischemic zone (subendocardial, 1.03 +/- 0.09 ml/min/g; subepicardial, 0.87 +/- 0.09 ml/min/g, p less than 0.05), indicating maldistribution of the restricted inflow. The resultant subendocardial-to-subepicardial ratio in the ischemic region was significantly decreased when compared with the nonischemic region (0.56 +/- 0.03 vs. 1.18 +/- 0.04, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Post-influenzal Encephalitis
Authors: T. H. Flewett, M. J. Chamberlain
Journal: BMJ (1970)

SIR,-Your leader on this subject (20 December, p. 702) sums up the position most accurately, and implies that something should be done to alter the present ridiculous wastage.In the Manchester Regional Board area consultants have, during the last few months, been allowed to prescribe cheaper nylon or Asian hair wigs.This has given rise to various problems, not the least of which is a reluctance by the suppliers of wigs under central contracts to assist the patient in her choice.It is now possible for patients to be referred to any shop supplying wigs.
A SUBCUTANEOUS SALINE SYPHON SYRINGE.
Authors: HORACE FOX
Journal: JAMA (1897)

This simple instrument is brought to the notice of the profession for the following reasons, to-wit: It is compact, therefore it can be readily carried in an ordinary physician's bag and constitute a part of the physician's armamentarium. It is simple in construction, therefore there is practically nothing to hinder it from being in good working order at any and all times. Its parts can be quickly, thoroughly and easily adjusted, therefore it can be made ready for use at a moment's notice. When its parts are properly adjusted it is impervious to air. It can be made thoroughly aseptic by boiling or immersing in an antiseptic solution without injury to any of its component parts. The fluid can be injected simultaneously into different portions of the body with great ease. One quart of the normal saline solution can be subcutaneously injected in about fifteen minutes, provided its distribution and
Combined Supravalvular Aortic and Pulmonic Stenosis
Authors: M. G. BOURASSA, L. CAMPEAU
Journal: Circulation (1963)

The association of supravalvular aortic stenosis and postvalvular pulmonic stenosis is described in three patients. In addition to the clinical findings resulting from obstruction to both ventricular outflow tracts, other unusual features were also present, such as a difference in the pulses and blood pressure of the upper extremities and absence of poststenotic dilatation of the ascending aorta. Diagnosis was established at cardiac catheterization by the demonstration of important pressure gradients in the aorta and in the pulmonary arteries with characteristic and almost identical pressure tracings on both sides. The pathologic lesions demonstrated in our patients by selective angiocardiography, surgery, and autopsy are discussed. The possibility of a common etiology for both entities is suggested.
Adverse events reporting in English hospital statistics: Vague numbers are being perpetuated
Authors: Iain H Glencross
Journal: BMJ (2004)

EDITOR—Aylin et al write in their Dr Foster's case notes that about 850 000 medical errors occur in NHS hospitals every year, resulting in 40 000 deaths.1 They reference this to a PowerPoint presentation (itself unreferenced) given in Australia in 2001. The figures appear in Organisation with a Memory …
Malabsorption Syndrome in Paget's Disease of Bone
Authors: B. N. Somayaji
Journal: BMJ (1968)

Of eight patients with Paget9s disease one had diarrhoea, steatorrhoea, impaired xylose absorption, and macrocytic anaemia due to folic acid deficiency, while another had diarrhoea and very low xylose absorption. In both patients jejunal biopsy was normal, and they responded to folic acid therapy with considerable increase in xylose absorption. Low xylose excretion was seen in three more patients, one of whom also had steatorrhoea. Thus malabsorption may be a systemic complication of Paget9s disease of bone, possibly due either to secondary folate deficiency or to relative ischaemia of the bowel.
Facts and Fallacies of Current Medical Therapy for Uncomplicated Duodenal Ulcer
Authors: Joseph B. Kirsner
Journal: JAMA (1964)

THE REMARKABLE ADVANCES made in medicine do not include the cause and cure of peptic ulcer. Treatment continues to be dominated by speculation, insufficient awareness of the "spontaneous" remissions and exacerbations, and by excessive reliance upon therapeutic trials in animals and in vitro testing. The presence of ulcer deformities or scars in the stomach and duodenal bulb on routine x-ray examination, at operation or autopsy, in patients without previously suspected peptic ulcer, has encouraged the attitude that, since some ulcers apparently heal without treatment, therapy is unnecessary. While ulcers may heal "spontaneously," peptic ulcer very often is a chronic recurrent disease complicated by stenosis, obstruction, hemorrhage, or perforation; it requires adequate medical management based upon the available knowledge of its pathogenesis and course. Physiologically, peptic ulcer represents the failure of localized areas of the gastroduodenal mucosa to withstand the destructive effects of acid and pepsin in the gastric content. Factors
Lymphocyte apoptosis induced by Fas ligand- expressing ovarian carcinoma cells. Implications for altered expression of T cell receptor in tumor-associated lymphocytes.
Authors: H Rabinowich, T E Reichert, Y Kashii, B R Gastman, M C Bell, T L Whiteside
Journal: Journal of Clinical Investigation (1998)

We have recently reported that tumor-associated lymphocytes obtained from ascitic fluids of women with ovarian carcinoma (OvCA) demonstrate a marked decrease in expression of cytoplasmic CD3-zeta and surface CD3-epsilon chains, which is associated with altered function of T cell receptor (TcR). We now demonstrate that OvCAs in situ and in culture express functional Fas ligand (FasL), capable of triggering an intrinsic cell death program in Fas-expressing T cells. The possibility of a relationship between cell death and altered expression of TcR was examined. The data indicate that alterations in expression of CD3-zeta and CD3-epsilon chains in T cells coincubated with OvCA are related to tumor-induced apoptosis, as the addition of pan-caspase inhibitors, DEVD-cho or YVAD-cho, prevents both the in vitro induction of T cell death by OvCA cells and the changes in the level of expression of CD3-zeta and CD3-epsilon chains. In the presence of Fas-Fc fusion protein, but not Fc-control protein, the loss in expression of CD3-zeta and CD3-epsilon chains induced in T cells by FasL+ OvCA cells was prevented. These results suggest that the loss in expression of CD3-zeta and CD3-epsilon chains in T lymphocytes interacting with OvCA cells is associated with apoptosis mediated by FasL-expressing tumor cells.
END-RESULTS FROM THE SURGICAL TREATMENT OF HYPERTHYROIDISM
Authors: CHARLES H. FRAZIER
Journal: JAMA (1928)

Careful preoperative preparation, fractional operations and perfection of operative technic in the surgical treatment of hyperthyroidism have so minimized the operative risk that consideration of mortality statistics no longer holds any significance. The occasional death is usually an unavoidable circumstance encountered by the surgeon in endeavoring to save a patient who has been "carried along" by ill advised conservation until he has passed the stage of operability—a statement justified when it is remembered that every patient with hyperthyroidism has been at one stage of the disease a perfectly safe operative risk. Mortalities, therefore, are due not to the operation but to the lack of operation. The time has arrived when attention should be focused on the morbidity statistics of "goiter surgery." What are the end-results of the surgical treatment of hyperthyroidism? Does operation offer a sufficient guarantee of cure, increase of life expectancy, and relief of disabling symptoms to justify