tbuckley/cabot-search huggingface dataset:
The Magical Medical Media Tour
Authors: Michael C. Magee
Journal: JAMA (1992)

<h3>To the Editor.</h3> —I read Mr Schwitzer's<sup>1</sup>article with interest. The issues that Schwitzer raises are real and should be of special concern to all health professionals. These issues form the basis for the establishment of the National Association of Physician Broadcasters (NAPB), the nation's oldest and largest organization supporting physicians in print and electronic media. The NAPB sponsors two educational meetings per year in conjunction with the American Medical Association Health Reporting Conference each spring and the American Medical Association Science Reporters Conference in the fall. At the fall 1991 meeting, at which Schwitzer was a featured panelist, we explored the ethical issues that he has raised in his article: those touching on accuracy, independence, personal rights, continuity of care, and a thoughtful process in content selection. We also released at that time the NAPB Code of Ethics, which includes 25 credos that clearly set the standard that
Hematology and Oncology
Authors: Carol K. Kasper
Journal: JAMA (1985)

Appropriate management of patients with hematologic and oncological disorders continues to be controversial. Two topics to be discussed in this year's CONTEMPO are the efficacy of platelet transfusions for patients rendered thrombocytopenic by chemotherapy and the appropriateness of chemotherapy for myelodysplastic anemia. Although no new advances have occurred in the diagnosis of iron deficiency anemia, this problem takes on particular significance in evaluating volunteer blood donors. Intensive chemotherapy for malignancies has resulted in dramatic increases in platelet transfusions,<sup>1</sup>and these are credited with reducing deaths from hemorrhage in thrombocytopenic patients. Critical questions have been raised, however, about the choice of platelet product to administer. Among patients treated with platelets from random donors harvested from individual whole-blood donations, approximately one third of those who survive the chemotherapy induction phase become alloimmunized. To delay the emergence of alloimmunization, some clinicians have advocated use of a more restricted number of HLA-unmatched donors
The Prevalence of Hypovitaminosis C
Authors: E. Cheraskin
Journal: JAMA (1985)

<h3>To the Editor.—</h3> I wish to respond to the magnificent report by Reuler et al<sup>1</sup>in which they point out the protean nature of adult scurvy and raise the question as to the real incidence and prevalence of hypovitaminosis C. I should like to provide two specific pieces of data. First, Schorah<sup>2</sup>reviewed the literature on this very subject (Table) and concluded that somewhere between 3% of young and healthy subjects and 100% of the institutionalized young suffer from hypovitaminosis C and 0% (healthy young subjects) to 50% (institutionalized elderly) may possibly demonstrate classic scurvy. In our clinic we have examined the epidemiology of vitamin C in four unique populations with over 4,000 subjects including the following: (1) a dental school patient population,<sup>3</sup>(2) patients in a dental prepayment program,<sup>4</sup>(3) orthodontic patients,<sup>5,6</sup>and (4) a selected group of Floridian dentists and their staffs.<sup>7,8</sup>Depending
Diet and Nondiet Predictors of Urinary 3-Phenoxybenzoic Acid in NHANES 1999–2002
Authors: Anne M. Riederer, Scott M. Bartell, Dana B. Barr, P. Barry Ryan
Journal: Environmental Health Perspectives (2008)

3-Phenoxybenzoic acid (3PBA), a pyrethroid metabolite, was detected in 75% of urine samples analyzed for pesticides in the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2002. NHANES also includes 24-hr diet data and information on household pesticide use, activities, occupation, demographics, and other exposure factors.The objective of our study was to explore the relative importance of diet versus nondiet predictors in explaining variability in urinary 3PBA. A secondary objective was to explore whether the NHANES data could be used to identify particular foods driving 3PBA levels.We divided subjects into child (6-10 years of age), teen (11-18 years), and adult (> or = 19 years) age groups and restricted our analyses to subjects in the morning sampling session who fasted for > or = 8 hr beforehand. Regression modeling consisted of several model-building steps and a final Tobit regression on the left-censored log 3PBA measurements. We also conducted bootstrap analyses to evaluate the stability of the regression parameters.Reported household pesticide use was not significantly associated with urinary 3PBA in any age group. Diet was significant for all three groups, and certain foods appeared to contribute more than others. Among adults, tobacco use was positively associated with 3PBA (p = 0.0326), and positive associations were suggested with the number of cytochrome p450-inhibiting medications taken (p = 0.0652) and minutes spent gardening (p = 0.0613) in the past month.Although exploratory, our findings underline the importance of collecting accurate data on household pesticide use and dietary intake when evaluating pyrethroid exposure-biomarker relationships.
Protection against endocarditis due to Staphylococcus epidermidis by immunization with capsular polysaccharide/adhesin.
Authors: S Takeda, G B Pier, Y Kojima, M Tojo, E Muller, T Tosteson, D A Goldmann
Journal: Circulation (1991)

Staphylococcus epidermidis is the principal pathogen in prosthetic valve endocarditis. The capsular polysaccharide adhesin (PS/A) has been shown to mediate attachment of bacteria to medical devices. In this study, we investigated the efficacy of active and passive immunization against PS/A in preventing S. epidermidis endocarditis in a rabbit model.Aortic valve vegetations were produced by inserting a Teflon catheter into the left ventricle through the right carotid artery. Bacteremia and endocarditis were then established by implanting in the left jugular vein a catheter that was attached to an osmotic pump and contaminated with S. epidermidis strain RP62A. During a 3-week study period, of 64 blood cultures taken every second or third day from six nonimmune rabbits, 54 (84%) yielded strain RP62A. In rabbits actively immunized with PS/A, eight of 60 blood cultures (13%) were positive (odds ratio 5.0, 95% CI, 2.0-12.3, p = 0.005). At death, all six nonimmune rabbits had infected vegetations that yielded 10(6)-10(11) colony-forming units (cfu)/g of vegetation, whereas only one PS/A-immunized rabbit had an infected vegetation. Immunization protocols designed to elicit antibody to teichoic acid but not to PS/A afforded no protection against bacteremia or endocarditis. Infusion of monoclonal antibody to PS/A through a catheter in the right jugular vein provided a level of protection against both bacteremia and endocarditis comparable to that produced by active immunization. In vitro, antibody against PS/A was opsonic for S. epidermidis.Immunoprophylaxis targeted at staphylococcal PS/A is a promising new approach to the prevention of prosthetic valve endocarditis.
Long-term follow-up of peginterferon and lamivudine combination treatment in HBeAg-positive chronic hepatitis B
Authors: Henry Lik‐Yuen Chan, Alex Yui Hui, Vincent Wai‐Sun Wong, Angel Mei‐Ling Chim, May‐Ling Wong, Joseph Jao‐Yiu Sung
Journal: Hepatology (2005)

We have previously demonstrated that combination peginterferon and lamivudine treatment has superior antiviral efficacy to lamivudine monotherapy in chronic hepatitis B. In this study, we investigated the long-term posttreatment virological response to this combination treatment. Sustained virological response of patients who completed 32-week peginterferon and 52-week lamivudine combination treatment was compared to patients who completed 52-week lamivudine monotherapy. Sustained response was defined as sustained hepatitis B e antigen (HBeAg) loss and HBV DNA < 100,000 copies/mL from treatment cessation until the end of follow-up. Forty-eight patients receiving combination treatment and 47 patients receiving lamivudine monotherapy were studied. The posttreatment follow-up of patients who received combination treatment was 117 ± 34 weeks and that of patients receiving lamivudine monotherapy was 124 ± 29 weeks. At the end of treatment, HBeAg loss occurred in 63% of patients in the combination group and 28% of patients in the lamivudine group (P = .001). The probabilities of sustained response for combination treatment and lamivudine monotherapy were 33% and 13% at week 24, 31% and 11% at week 52, and 29% and 9% at week 76, respectively (log-rank test, P = .0015). No patients developed virological relapse after week 76 until the last visit in either treatment group. All sustained responders had no biochemical relapse (alanine aminotransferase [ALT] > 2 times upper limit of normal) during follow-up. Among the non-sustained responders, biochemical relapse occurred in 32 patients (94%) in the combination group and 38 patients (88%) in the lamivudine group, respectively. In conclusion, combination treatment of peginterferon and lamivudine has a higher sustained virological response than lamivudine monotherapy up to 3 years after treatment. (HEPATOLOGY 2005.)
The population mean predicts the number of deviant individuals.
Authors: G Rose, S Day
Journal: BMJ (1990)

OBJECTIVE--To examine the relation between the prevalence of deviation and the mean for the whole population in characteristics such as blood pressure and consumption of alcohol. DESIGN--Re-examination of standardised data from the Intersalt study, an international, multicentre study on the determinants of blood pressure. SETTING AND SUBJECTS--Samples of adults representing 52 populations in 32 countries. MAIN OUTCOME MEASURES--The relations, expressed as correlation coefficients, between the mean population values for blood pressure, body mass index, alcohol consumption, and sodium intake and the prevalence of, respectively, hypertension (greater than or equal to 140 mm Hg), obesity (body mass index greater than or equal to 30 kg/m2), high alcohol intake (greater than or equal to 300 ml/week), and high sodium intake (greater than or equal to 250 mmol/day). RESULTS--There were close and independent associations between the population mean and the prevalence of deviance for each of the variables examined: correlation coefficients were 0.85 for blood pressure, 0.94 for body mass index, 0.97 for alcohol intake, and 0.78 for sodium intake. CONCLUSIONS--These findings imply that distributions of health related characteristics move up and down as a whole: the frequency of "cases" can be understood only in the context of a population9s characteristics. The population thus carries a collective responsibility for its own health and well being, including that of its deviants.
Control of Heparin Therapy
Authors: W. R. Pitney, J. E. Pettit, L. Armstrong
Journal: BMJ (1970)

Heparin therapy in 114 patients was controlled by daily blood tests—the whole blood coagulation time, kaolin-activated partial thromboplastin time of plasma, and plasma heparin assay. Bleeding episodes occurred in 7 out of 92 patients (7·6%) who had normal haemostatic mechanisms before therapy and in 11 out of 22 patients (50%) with defective haemostasis, mostly due to intravascular coagulation or renal failure. The dose of heparin ranged from 20,000 to 60,000 units in each 24-hour period. In some patients bleeding was related to overdosage, but in others the laboratory tests indicated satisfactory or suboptimal dosage at the time of bleeding. Though there were positive correlations between the results of the three tests, these were not close, and no one test was preferable. Hence laboratory control of heparin therapy is unsatisfactory and patients may bleed despite careful control of the dose by all three methods.
Manipulation of Autopsy Diagnoses by Computer Technique
Authors: J. Chandler Smith, Jessica Melton
Journal: JAMA (1964)

A new system of coding and storing autopsy records for searching by computer has been tested on a sample of 500 records. Coding is done by computer routines, handcoding being eliminated. Records are put into the system in natural language, as they are originally written. The separate words are translated into a classification code based principally on pathological process and anatomic site. All information is coded; nothing is deleted. Twenty-seven questions representing a wide range of information requests (generic to specific) were searched. The results (3,115 total answers of which three were spurious) indicated high accuracy for the system. Possible widespread application is suggested.
Commentary: the Dutch approach to unwarranted medical practice variation
Authors: G. P. Westert, M. Faber
Journal: BMJ (2011)

Medical practice varies considerably, both within and between countries. Rates of surgical procedures and medical treatment seem to be unrelated to illness and other patient related factors in many studies.1 Wennberg makes the intriguing observation that supply is the prime determinant of healthcare usage in the United States: most unwarranted healthcare is given in areas with high supply levels and does not result in improved patient outcomes. 1

Wennberg defines three categories of care: effective care, preference sensitive care, and supply sensitive care, with supply factors relating to overuse in the last two categories. Supply levels in the Netherlands vary less than in the US. This is because healthcare supply in the Netherlands was—at least until 2006—centrally planned and controlled by the government. You might therefore expect that variations in delivery of healthcare would be insignificant. Unfortunately, this is not the case. The 2010 Dutch healthcare performance report notes remarkable variations in quality and price of healthcare between care providers.2 For …
DELAYED CORNEAL ULCERATION FROM MUSTARD GAS
Authors: R. F. Moore, F. Heckford
Journal: BMJ (1929)

MTDiR BnITI 497 to be distributed to the corresponding aspect of the right lower pole.2. The communiication may.arise as a branch from the sympathetic cord between,the middle and inferior ganglia, in whliill case-the ultimate distribution is the same as in the pirev;t}IoS instance.3. Oii the left side there ma' be sever-al small filametnts arisinig fl'romi the inlfer'ior' anid mid(le cOcr'vical gaulglia, whi'ch-i pass inwatads and downwatrs closelv aisociated with the vertebral artery and reach the left recurrent nerve, when they-are distiibuted both-upwards and downwards in that nerve; those fibres passingtowards the head may be partly trac,ed into branches to the thyroid gland.These communicating fibres to the recutrent laryngeal are indicated in the accompanying illustrations.?Wff SrY$AYrIrC oIsrM/S*rho q r ro MC rTrrRoWo GAj.O _
Interferon-stimulated gene expression and hepatitis C viral dynamics during different interferon regimens
Authors: Yasuhiro Asahina, Namiki Izumi, Masakatsu Uchihara, Osamu Noguchi, Yuki Nishimura, Kazunari Inoue, Ken Ueda, Kaoru Tsuchiya, Kosei Hamano, Jun Itakura, Shozo Miyake
Journal: Journal of Hepatology (2003)
Boom in private rest homes in Southampton: impact on the elderly in residential care
Authors: S. Lowrey, R. Briggs
Journal: BMJ (1988)

A survey in 1986 of 450 elderly people in 51 private rest homes and 206 residents of seven local authority (part III) homes in the Southampton area showed no significant difference in overall dependency between the two populations. Although age and sex distributions of the residents of part III homes had remained the same between 1982 and 1986, the average level of dependency had fallen significantly. Since the provision of places increased because of expansion in the private sector residential care institutions are generally catering for a more independent population.
Value of Propantheline Bromide in Treatment of Enuresis
Authors: D. Leys
Journal: BMJ (1956)

A case is described of severe post-partum haemor- rhage due to cervical laceration in a grand multipara.The laceration extended into the lower uterine segment extraperitoneally without evidence of this when the hand explored the uterus.The lesson is emphasized that a case of post-partum haemorrhage with a contracted uterus must be examined most carefully under general anaesthesia for high vaginal and cervical tears.Tearing of the cervix or vagina should be suspected when haemorrhage occurs round the head as it is delivered.After stitching a cervical laceration and packing the uterus the patient's condition should improve when blood is transfused.If it does not, broad-ligament haematoma should be suspected and hysterectomy carried out without waiting for resuscitation of the patient-resuscitation which will not occur until haemorrhage has been arrested.Intra-arterial transfusion of blood can induce a quick response during operation when the bleeding-points have been secured.This patient required transfusion of 34 pints (19.3 litres) of blood and two operative procedures before recovery was assured.
Alpha-blockade in patients with coronary artery disease: Implications for fractional flow reserve measurements
Authors: Emanuele Barbato, Wilbert Aarnoudse, Jozef Bartunek, Stefan Carlier, Marc Vanderheyden, William Wijns, Guy R. Heyndrickx, Nico H. Pijls, Bernard De Bruyne
Journal: Journal of the American College of Cardiology (2003)
Dutch coalition government debates health costs
Authors: T Sheldon
Journal: BMJ (1994)

The degree to which the rich and healthy subsidise health costs of the poor and sick has become the big issue in current negotiations to launch a Dutch coalition government of left and right. The Labour party wants 80% of health costs related to income. But the right wing Liberal party seeks an entirely private health insurance system with the cost of premiums related to risk in a competitive market rather than the ability to pay.

Currently, 60% of the population is insured through sickness funds, …
Quality of Reporting of Randomized Trials as a Measure of Methodologic Quality
Authors: Karin Huwiler-Müntener
Journal: JAMA (2002)

The evaluation of the methodologic quality of randomized controlled trials (RCTs) is central to evidence-based health care. Important methodologic detail may, however, be omitted from published reports, and the quality of reporting is therefore often used as a proxy measure for methodologic quality. We examined the relationship between reporting quality and methodologic quality of published RCTs.Study of 60 reports of placebo-controlled trials published in English-language journals from 1985 to 1997. Reporting quality was measured using a 25-item scale based on the 1996 issue of the Consolidated Standards of Reporting Trials (CONSORT). Concealment of allocation, appropriate blinding, and analysis according to the intention-to-treat principle were indicators of methodologic quality. Methodologic quality was compared between groups of trials defined by reporting quality scores of low, intermediate, and high. Reporting quality scores were compared between groups defined by high and low methodologic quality.Among 23 trials of low reporting quality (median score, 9 [range, 3.5-10.5]), allocation concealment was unclear for all but 1 trial, but there were 16 trials (70%) with adequate blinding and 9 trials (39%) that had been analyzed according to the intention-to-treat principle. Among 18 trials of high reporting quality (median score, 18 [range 16.5-22.0]), there were 8 trials (44%) with adequate allocation concealment, 16 trials (89%) with adequate blinding, and 13 trials (72%) analyzed according to the intention-to-treat principle. The median reporting score was 15.0 for the 33 trials that were analyzed according to intention-to-treat principle and 14.5 for the 14 trials with on-treatment analyses (P =.67).Similar quality of reporting may hide important differences in methodologic quality, and well-conducted trials may be reported badly. A clear distinction should be made between these 2 dimensions of the quality of RCTs.
Smoking rises sharply among US university students
Authors: S. Gottlieb
Journal: BMJ (1998)

Cigarette use is increasing on US university campuses, with substantial numbers of students both starting to smoke and trying to stop, according to the first study to examine changes in smoking rates among university students.

Dr Henry Wechsler and colleagues found that between 1993 and 1997 the prevalence of cigarette smoking among university students increased 28%. Dr Wechsler is a professor at the Harvard …
Significance of regurgitant orifice area in determining aortic regurgitant volume studied by doppler echocardiography
Authors: Shiro Nozaki, Hirohide Matsuo, Hisaki Morita, Katsufumi Mizushige, Shoichi Senda, Shigeru Nakajima, Yoshio Yamada
Journal: Journal of the American College of Cardiology (1990)
Lead Levels in Blood Donors
Authors: Trong-Neng Wu
Journal: JAMA (1994)

<h3>To the Editor.</h3> —A system for surveillance of elevated blood lead levels (BLLs) in workers in Taiwan has begun to operate. By law, more than 4500 lead-using workers in Taiwan are included in this system. They are required to have their BLL checked every 6 months. All the test results from these laboratories are transferred to the Disease Surveillance Center in Taiwan. The Disease Surveillance Center conducts long-term follow-up to monitor changes in BLL in workers, and enrolls all workers whose BLL exceeds regulation levels (defined as 1.93 μmol/L [40 μg/dL] for men and 1.45 μmol/L [30 μg/dL] for women). Since this surveillance system began operating in July 1993, we have found 445 workers (15% prevalence among 2905 lead-using workers) whose BLL exceeds these regulation levels. About 5% to 10% of these workers with high BLLs had a history of regular blood donation (one person whose BLL exceeded 3.86 μmol/L
Effects of myocardial ischemia on quantitative ultrasonic backscatter and identification of responsible determinants.
Authors: J W Mimbs, D Bauwens, R D Cohen, M O'Donnell, J G Miller, B E Sobel
Journal: Circulation Research (1981)

Quantitative characterization of myocardial properties represent a rapidly emerging area of echocardiographic investigation. Because measurement of the ultrasonic integrated backscatter is theoretically applicable to analysis in vivo with reflected ultrasound, this study was performed to develop and evaluate a suitable method for measurement of quantitative backscatter in vivo. In view of the desirability of characterizing ischemic myocardium noninvasively, the study was performed with animal preparations simulating myocardial ischemia in humans. In one series of open-chest dogs, integrated backscatter among 22 ischemic regions was increased by 200% (P less than 0.01) compared to values in control regions within 1 hour after coronary occlusion and by 400% (-45.1 +/- 0.7 dB compared to -50.9 +/- 0.4 dB) (P less than 0.001) within 6 hours. In a second series of open-chest dogs, ischemia was quantified with 141Ce microspheres, and mean integrated backscatter was found to increase (280% of control) (P less than 0.01) in regions with flow less than 20% of control 2 hours following coronary occlusion. Additional studies with perfused hearts revealed two determinants of the increased ultrasonic backscatter observed: (1) an increase in cardiac fluid content reflected by the wet-to-dry weight ratio, and (2) the contributions of formed elements in whole blood. The results indicate that ultrasonic integrated backscatter distinguishes severely ischemic from nonischemic myocardium in vivo in open-chest animals. Because it was possible to obtain these results in the reflection mode, potential extension of the approach to clinical applications is promising.