tbuckley/cabot-search huggingface dataset:
Postoperative Pulmonary Complications
Authors: Valerie A. Lawrence
Journal: Annals of Internal Medicine (2002)

Letters17 September 2002Postoperative Pulmonary ComplicationsValerie A. Lawrence, MDValerie A. Lawrence, MDSouth Texas Veterans Health Care System; University of Texas Health Science Center at San AntonioSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-6-200209170-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Measurement of oxygenation, purely numerically, as a surrogate, without clear linkage to clinically important outcomes, may not advance the science or art of patient care and research in perioperative pulmonary risk management. Data from a large trial of pulse oximetry in the operating room and postanesthesia care unit suggest that there is more measurable hypoxemia than there are important clinical sequelae of it (1). Mild hypoxemia, which probably has little clinical significance as a postoperative pulmonary complication, should not be considered as such in the same league as pneumonia.There may be other reasons to care about oxygenation ...References1. Moller JT, Johannessen NW, Espersen K, Ravlo O, Pedersen BD, Jensen PF, et al . Randomized evaluation of pulse oximetry in 20,802 patients: II. Perioperative events and postoperative complications. Anesthesiology. 1993;78:445-53. [PMID: 8457045] CrossrefMedlineGoogle Scholar2. Greif R, Laciny S, Rapf B, Hickle RS, Sessler DI. Supplemental oxygen reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 1999;91:1246-52. [PMID: 10551573] CrossrefMedlineGoogle Scholar3. Greif R, Akça O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. Outcomes Research Group. N Engl J Med. 2000;342:161-7. [PMID: 10639541] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Valerie A. Lawrence, MDAffiliations: South Texas Veterans Health Care System; University of Texas Health Science Center at San Antonio PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDevelopment and Validation of a Multifactorial Risk Index for Predicting Postoperative Pneumonia after Major Noncardiac Surgery Ahsan M. Arozullah , Shukri F. Khuri , William G. Henderson , and Jennifer Daley , for the Participants in the National Veterans Affairs Surgical Quality Improvement ProgramPostoperative Pulmonary Complications Sarah Jane Ramsay Metrics 17 September 2002Volume 137, Issue 6 Page: 551 Keywords Hypoxia Muscles Nausea Oxygen Pneumonia Postanesthesia care unit Pulse oximetry Risk management Surgery Vomiting ePublished: 17 September 2002 Issue Published: 17 September 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
NIH Peer Review
Authors: Monto Ho
Journal: Annals of Internal Medicine (1978)

III. Comments1 November 1978NIH Peer ReviewMonto Ho, M.D.Monto Ho, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-5-865_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAll of us have been brought up under the National Institutes of Health (NIH) system of sponsored research. We are grateful to it and we cherish it. By and large, it has been singularly effective in promoting and maintaining excellence in American biomedical research. I believe that the peer review system, in which I have now participated both as a recipient and as a peer, is a key element in this system. I also believe that it can and should be continually improved.Much thought has gone into the mechanics of the peer review system. This is not my concern... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh School of Medicine Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1978Volume 89, Issue 5_Part_2Page: 865-866KeywordsPeer reviewSystematic reviews ePublished: 1 December 2008 Issue Published: 1 November 1978 PDF downloadLoading ...
An unusual cause of abdominal distension
Authors: A-W N Meshikhes, M A Suwaymel
Journal: Gut (2006)

A 42-year-old man was admitted with severe epigastric and left hypochondrial abdominal pain associated with nausea and abdominal distension but no vomiting or constipation. He denied any history of weight loss or anorexia. He had had a …
Spatial Parameters and Shape Factors of the Normal Atrial Vectorcardiogram and Its Scalar Components
Authors: DANIEL A. BRODY, JOHN W. COX, ANN B. MCEACHRAN, HANNELORE H. GILES, VICTOR J. RUESTA, Harry A. Phillips, Charles O. Eddlemon
Journal: Circulation (1969)

New quantitative norms for clinical evaluation of the atrial vectorcardiogram are presented. Real-time computer processing digitizes atrial electrocardiograms, reduces random noise content, rectifies base-line configuration, and corrects preamplifier distortion. Axial-system leads of 106 normal persons were so treated. The basic information derived includes spatial distribution and magnitudes of P, T P , and polar P vectors; length, width, and planarity of P loops; spatial P-T P angles; and the Eulerian angles of P-loop normalization. Normal P vectors show predominant leftward, inferior, and anterior orientation, with opposing T P direction. Polar P vectors show predominant superior, anterior, and leftward clustering. The scatter of parameters in the orthogonallead frontal plane is about the same as for the tetrahedral system. Similarly, the atrial deflections of normals show equally rich notching in both systems. Resolution of the P-wave population into uncorrelated components, followed by resynthesis from these principal factor wave forms, revealed a fairly continuous "spectrum" of signal configurations. This technique, and extensive attempts by alternate means, failed to support the view that normal P waves can be separated into distinctive right and left atrial components.
Abstract 2338: Functional investigation of the CRD-BP hnRNP-K-Homology domains for C-myc messenger RNA interaction
Authors: Gerrit van Rensburg, Mark Barnes, Chow Lee
Journal: Cancer Research (2014)

Abstract The coding region determinant binding protein (CRD-BP) is an oncofetal protein, being ubiquitously expressed during embryogenesis, yet highly repressed in adult tissues, except in cancerous tissues [Bell et al, 2013; Mueller-Pillasch et al, 1999]. CRD-BP was inherently identified by its ability to physically associate with c-myc mRNA, and has been shown to protect the transcript from degradation, hence prolonging its mRNA half-life [Prokipcak et al, 1994, Noubissi et al, 2006]. In addition to c-myc mRNA, several other mRNAs bound by CRD-BP have gene products implicated in the development and progression of cancer [Bell et al, 2013]. As an RNA binding protein (RBP), CRD-BP is the Mus musculus variant and homologous to the Homo sapiens IMP-1/Insulin-Like Growth Factor 2 with 99.31% similarity, both categorized into a larger family named VICKZ (Vera/Vg1 RBP, Insulin-Like Growth Factor 1,2,3/IMP-1,2,3, CRD-BP, KOC, and ZBP-1). The VICKZ family of RBPs contains two RNA Recognition Motifs (RRM) and four heterogeneous nuclear ribonucleoprotein [hnRNP]-K-Homology (KH) domains. Deletion analysis had shown that the KH domains, and not the RRM domains, of IMP1 are important for binding RNA substrates. To understand which of the KH domains are critical for interaction with RNA, site-directed mutagenesis was performed to introduce an aspartic acid (D) at the first glycine (G) of the G-X-X-G region in the KH domains of CRD-BP. This D-X-X-G variation was individually introduced to the four KH domains of CRD-BP. These four CRD-BP KH domain variants were expressed, purified and assessed for ability to bind c-myc mRNA using electromobility shift assays (EMSA). In addition, plasmids carrying these variants of FLAG-CRD-BP were transfected into HeLa cells. Immunoprecipitation (IP) using anti-FLAG was performed, followed by RT-qPCR to measure the relative amounts of c-myc mRNA associated with each of the variants as compared to the controls. The in vitro EMSA and IP cell data were all consistent with the notion that all KH domain(s) are critical for CRD-BP-c-myc RNA interaction. Using EMSA, additional binding assessments were carried out in a systematic fashion to determine the smallest region of c-myc mRNA bound by CRD-BP. These results will be presented and discussed, as they provide insight into the role played by the KH domains of CRD-BP in binding RNA, as well as what RNA characteristics are important for binding to CRD-BP. Citation Format: Gerrit van Rensburg, Mark Barnes, Chow Lee. Functional investigation of the CRD-BP hnRNP-K-Homology domains for C-myc messenger RNA interaction. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2338. doi:10.1158/1538-7445.AM2014-2338
Nutritional and Health Status of Tibetan Children Living at High Altitudes
Authors: Nancy S. Harris, Patricia B. Crawford, Yeshe Yangzom, Lobsang Pinzo, Palden Gyaltsen, Mark Hudes
Journal: New England Journal of Medicine (2001)

Children living at high altitudes often have delayed growth, but whether growth retardation is related to altitude or to other factors is not known.
Anti-Intellectualism in Medicine
Authors: Gilbert E. Corrigan
Journal: JAMA (1974)

<h3>To the Editor.—</h3> In response to the editorial (227:432, 1974), it is important to establish that clinical medicine is not an intellectual pursuit. It uses intelligence, but theoretical concepts beyond the biochemical-mechanistic theory of life are absent. This is particularly true for psychiatry which, although it deals with the inanimate, has severe intellectual limitations. There is no anti-intellectualism where there is no intellectualism. <h3>Intellectualism.—</h3> 1. Philos. The doctrine that knowledge is wholly derived from the actions of the intellect, i.e., from pure reason. 2. The exercise of the intellect alone; devotion to a merely intellectual culture or pursuits. (<i>Oxford English Dictionary</i>) The current major unrecognized act of anti-intelligence lies in the "problem-oriented" methodology sweeping across American medicine. This system denies the extensive nosological researches of the past. It severely restricts the use of the established taxonomy of disease and replaces these meaningful terms with noncategorical statements which have good form
The Specificity and Orientation of a TCR to its Peptide–MHC Class II Ligands
Authors: Derek B Sant'Angelo, Greg Waterbury, Paula Preston-Hurlburt, Sangwook Tim Yoon, Ruslan Medzhitov, Soon-cheol Hong, Charles A Janeway
Journal: Immunity (1996)

A T cell–mediated immune response is mainly determined by the 3–5 aa residues that protrude upwards from a peptide bound to an MHC molecule. Alterations of these peptide residues can diminish, eliminate or radically alter the signal that the T cell receives through its T cell receptor (TCR). We have used peptide immunizations of normal mice and mice carrying α or β chain TCR transgenes to identify three distinct peptide contact points. One, near the carboxyl terminus of the peptide, involves the β chain CDR3 region; the second was centrally located and interacted with both the α and β chain CDR3 loops; the third was near the amino terminus of the peptide, and affected Vα gene usage, but not the structure of CDR3 of either TCR chain. Based on these results, we propose an orientation for the TCR of this cloned line and argue for its generality.
The Tyrosine Phosphatase, SHP-1, Is a Negative Regulator of Endothelial Superoxide Formation
Authors: Florian Krötz, Barbara Engelbrecht, Martin A. Buerkle, Florian Bassermann, Hanna Bridell, Torsten Gloe, Justus Duyster, Ulrich Pohl, Hae-Young Sohn
Journal: Journal of the American College of Cardiology (2005)
Scintigraphic Assessment of “Effort” Axillary-Subclavian Vein Thrombosis
Authors: ALESSANDRO GIORDANO, MARCO MUZI, MICHELE MASSARO, FRANCESCO RULLI
Journal: Clinical Nuclear Medicine (1992)

"Effort" axillary-subclavian vein thrombosis (Paget-Schroetter syndrome) is an uncommon deep venous thrombosis due to repetitive activity of the upper limb. Clinical suspicion is usually confirmed by contrast venography. This report describes a case where the diagnosis was made by radionuclide venography (Tc-99m DTPA). The examination was carried out in the acute phase and clearly demonstrated the presence and the site of the obstruction as well as the collateral vessels. Despite a complete clinical recovery, obtained by medical therapy, further examinations performed in the follow-up period showed persistence of the thrombotic obstruction and a rich development of collateral vessels. In the authors' opinion, radionuclide venography is worth considering as a first-choice procedure when an axillary-subclavian vein thrombosis is suspected, and contrast venography should be performed only when surgical treatment is indicated.
Pomalidomide plus low-dose dexamethasone in myeloma refractory to both bortezomib and lenalidomide: comparison of 2 dosing strategies in dual-refractory disease
Authors: Martha Q. Lacy, Jacob B. Allred, Morie A. Gertz, Suzanne R. Hayman, Kristen Detweiler Short, Francis Buadi, Angela Dispenzieri, Shaji Kumar, Philip R. Greipp, John A. Lust, Stephen J. Russell, David Dingli, Steven Zeldenrust, Rafael Fonseca, P. Leif Bergsagel, Vivek Roy, A. Keith Stewart, Kristina Laumann, Sumithra J. Mandrekar, Craig Reeder, S. Vincent Rajkumar, Joseph R. Mikhael
Journal: Blood (2011)
Treatment of AML and MDS relapsing after reduced-intensity conditioning and allogeneic hematopoietic stem cell transplantation
Authors: B Oran, S Giralt, D Couriel, C Hosing, E J Shpall, E de Meis, I F Khouri, M Qazilbash, P Anderlini, P Kebriaei, U Popat, A Carrasco-Yalan, R E Champlin, M de Lima
Journal: Leukemia (2007)
To Tell the Truth
Authors: H. H. Neumann
Journal: JAMA (1965)

<h3>To the Editor:—</h3> Paul S. Rhoads, in a recent article in JAMA (<b>192</b>:661-665 [May 24] 1965), advocates telling the truth to the patient with terminal illness. This attitude may ease the task of the practicing physician, yet it is too unnecessarily harsh to be passed over in silence. Dr. Rhoads states that rarely will such patients accept the information with composure; for most, anxiety and depression will befog the mind. When a physician's efforts to heal fail, he should continue to give hope. Having practiced for over 30 years, it impressed me how even the best-informed and intelligent, desperately ill, can readily be made to doubt the obvious hopelessness of their case. If reversals are presented as temporary and improvement presented as to be expected, this is permissible deception. Human beings do not prefer knowledge and certainty in this respect, regardless of their claim to the contrary. Man does
Influence of the Vitamin D Receptor Gene Polymorphism on Bone Loss in Men after Liver Transplantation
Authors: Jordi Guardiola, Xavier Xiol, Richard Sallie, Joan M. Nolla, Daniel Roig-Escofet, Eduardo Jaurrieta, Luis Casais
Journal: Annals of Internal Medicine (1999)

Background: Bone loss is a frequent complication after liver transplantation. Objective: To investigate whether vitamin D receptor gene polymorphism influences bone loss in men after liver transplantation. Design: Prospective cohort study. Setting: University hospital. Patients: 55 male candidates for liver transplantation. Measurements: Lumbar spine bone mineral density was measured before and 3, 6, 12, and 24 months after liver transplantation. Vitamin D receptor genotype was determined by restriction endonuclease BsmI. Results: Vitamin D receptor genotypes were significantly associated with post-transplantation changes in bone mineral density (P = 0.028). Within 3 months after transplantation, patients with the genotypes Bb or BB showed a vertebral bone loss substantially greater than that in patients with the bb genotype (between-group difference in the percentage change with respect to baseline bone mineral density, 3.7% [95% CI, 0.6% to 6.9%]). In 3 to 24 months after transplantation, bone mineral density increased steadily in the three allelic groups. Conclusions: Vitamin D receptor gene polymorphism influences bone loss after liver transplantation. Patients with the bb genotype are, to some extent, protected against post-transplantation bone loss.
Patient Demands and Requests for Cancer Tests and Treatments
Authors: Keerthi Gogineni, Katherine L. Shuman, Derek Chinn, Nicole B. Gabler, Ezekiel J. Emanuel
Journal: JAMA Oncology (2015)

Surveyed physicians tend to place responsibility for high medical costs more on "demanding patients" than themselves. However, there are few data about the frequency of demanding patients, clinical appropriateness of their demands, and clinicians' compliance with them.To assess how frequently patients demand or request medical tests or treatments, what types they demand, the clinical appropriateness of their demands, and how frequently clinicians comply.Immediately after visits, clinicians--physicians, fellows, nurse practitioners, and physician assistants--were interviewed about whether the patient made a demand or request and their type and appropriateness. Interviews occurred in oncology outpatient facilities at 3 Philadelphia-area hospitals between October 2013 and June 2014.The 4 main outcomes were (1) frequency of patient demands for medical tests or treatments, (2) the types of tests or treatments demanded, (3) clinicians' assessment of the clinical appropriateness of the demands, and (4) how frequently clinicians complied.There were 5050 patient-clinician encounters involving 3624 patients and 60 clinicians. Overall, of the 5050 encounters, 440 (8.7%) included a patient demand or request for a medical intervention. Clinicians complied with 365 of the clinically appropriate demands (83.0%). In only 50 of the 440 encounters with demands (11.4%) did the patient demand or request clinically inappropriate interventions. Clinicians complied with 7 of these inappropriate demands or requests (14%). Clinicians complied with inappropriate demands or requests in only 0.14% (7 of 5050) of encounters. Of the 440 patient demands, 216 (49.1%) were for imaging studies; 68 (15.5%) were for palliative treatments, excluding chemotherapy or radiation; and 60 (13.6%) were for laboratory tests. In a multivariable model, having lung/head and neck cancer (odds ratio [OR], 1.74; 95% CI, 1.26-2.41), receiving active treatments (OR, 1.40; 95% CI, 1.11-1.77), and a fair- or poor-quality patient-clinician relationship (OR, 2.82; 95% CI, 1.13-7.07) were associated with patients making demands or requests (all P < .01).Patient demands occur in 8.7% of patient-clinician encounters in the outpatient oncology setting. Clinicians deem most demands or requests as clinically appropriate. Clinically inappropriate demands occur in 1% of encounters, and clinicians comply with very few. At least in oncology, "demanding patients" seem infrequent and may not account for a significant proportion of costs.
Look, no hands!
Authors: Eric M. Patterson, Janet Mann
Journal: Behavioral and Brain Sciences (2012)

Contrary to Vaesen's argument that humans are unique with respect to nine cognitive capacities essential for tool use, we suggest that although such cognitive processes contribute to variation in tool use, it does not follow that these capacities are necessary for tool use, nor that tool use shaped cognition per se, given the available data in cognitive neuroscience and behavioral biology.
Genetic and Clinical Features of 42 Kindreds with Resistance to Thyroid Hormone: The National Institutes of Health Prospective Study
Authors: Francoise Brucker-Davis
Journal: Annals of Internal Medicine (1995)

Objective: To determine the genetic and clinical features of resistance to thyroid hormone in a study from a single institution. Design: Prospective, controlled study. Setting: National Institutes of Health. Patients: 104 patients with resistance to thyroid hormone from 42 kindreds and 114 unaffected relatives sharing the patients' environmental and genetic back-grounds. Measurements: Thyroid, cardiovascular, psychometric, hearing, speech, and growth testing; thyroid tests done at baseline and after TSH-releasing hormone stimulation; and DNA analysis for detection of mutations in the thyroid hormone receptor β (TR β) gene (exons 9 and 10). Assessment of tissue-specific compensation for resistance. Results: Inheritance was autosomal dominant in 22 families, sporadic in 14 families, and unknown in 6 families. We found mutations in 25 kindreds (64 patients); 16 mutations were in exon 9 and 9 were in exon 10 of the TR β gene. In persons with resistance to thyroid hormone, we measured the increased incidence of goiter (65%), attention-deficit hyperactivity disorder (60%), IQ less than 85 (38%), speech impediment (35%), and short stature (18%). We also described new clinical features, such as frequent ear, nose, and throat infections (56%); low weight-for-height in children (32%); hearing loss (21%); and cardiac abnormalities (18%). Genotype, age, whether the mother had resistance to thyroid hormone, and sex influenced the phenotype. Tissue resistance varied from kindred to kindred and involved, in decreasing order, the pituitary gland, the brain, the bone, the liver, and the heart. Conclusions: This study underscores the incidence of classic features of resistance to thyroid hormone, describes new clinical characteristics of this condition for the first time, and stresses the heterogeneity of the phenotype. Ann Inten Med. 1995; 123:572-583.
The Cost of Third-Year Clerkships at Large Nonuniversity Teaching Hospitals
Authors: Ethel Weinberg
Journal: JAMA (1994)

Large nonuniversity teaching hospitals are major providers of the clinical training component of undergraduate medical education, yet little information is available to policymakers, participating hospitals, or sponsoring medical schools on the institutional costs of this service.To determine the costs associated with teaching students in required third-year clerkships for a group of large nonuniversity teaching hospitals.A total of 201 medical students from nine large nonuniversity teaching hospitals affiliated with nine medical schools that participate in required third-year clerkships.During a typical week, students completed 24-hour time and activity logs that classified each activity, instructor, and audience. From these logs, the number of teaching hours by full-time faculty and others were estimated and costs were calculated.Full-time faculty provided a mean of 0.242 h/d of formal teaching, 0.326 h/d of informal teaching, and 0.581 h/d of supervised patient care training per student, an estimated direct faculty cost of $412 per week per student. The cost of direct and indirect departmental and academic administration, as well as other direct out-of-pocket medical education costs, added $250 per week per student. The average annual clinical program cost of third-year clerkships to nonuniversity hospitals and their full-time faculties was $31,776 per student. This figure does not include the substantial contributions of teaching by other than paid faculty (eg, volunteer physicians and residents), which was important in terms of activity and service provided.Direct and indirect costs of third-year medical student education for most hospitals in this study was more than $1 million per year, well in excess of the average support provided by sponsoring medical schools.