tbuckley/cabot-search huggingface dataset:
Early Discharge of Newborns-Reply
Authors: M. Bruce Edmonson
Journal: JAMA (1997)

<h3>In Reply</h3> —We believe that meaningful discussion about the neonatal effects of early postpartum discharge should be based on carefully specified outcomes and agree with Drs Cass and Volk that any associated risks should be quantified in a clinically interpretable fashion. The manuscript we originally submitted to<i>JAMA</i>included an economic interpretation of readmission risk based on NNT, but this analysis was deleted as a result of an editorial decision. Briefly, our analysis was based on the observed rates of early (days 1-2) discharge and feeding-related readmissions in the study cohort. We conservatively applied the upper 95% CI for the crude case-control OR (1.7) to estimate the maximal absolute increase in readmission risk associated with early discharge. We then used standard methods<sup>1</sup>to estimate that prevention of a single readmission would require an additional postpartum hospital day for at least 866 well newborns. Based on Wisconsin hospital costs for routine postpartum
Effects of vasopressin on the circulation and its baroreflex control in healthy men.
Authors: P E Aylward, J S Floras, W N Leimbach, F M Abboud
Journal: Circulation (1986)

Information on the hemodynamic effects of vasopressin (AVP) in healthy humans is very limited despite its known importance in body fluid homeostasis and release in pathologic states such as hemorrhage and trauma. Although it is a potent vasoconstrictor in vitro, it does not cause the expected rise in arterial pressure when given systemically to animals with intact baroreflexes. It has been proposed that this is because AVP facilitates baroreflex control of the circulation. In this study, we assessed the effect of infusion of AVP on resting circulatory variables and on the baroreflex control of forearm vascular resistance and heart rate in healthy men. AVP in a dose of 0.4 ng/kg/min, which raised plasma level of AVP to 24 +/- 4 pg/ml, a value known to have a significant antidiuretic effect, had little hemodynamic effect, producing only mild bradycardia and a slight increase in central venous pressure. Reflex changes in heart rate during neck suction (-15 and -30 mm Hg) and neck pressure (+15 and +30 mm Hg) were not altered. Reflex responses to lower body negative pressure and to its release were also unchanged by this dose of AVP. In contrast, a higher dose of AVP (4 ng/kg/min), which raised plasma levels to 290 +/- 41 pg/ml, a concentration known to occur as a result of hemorrhagic hypotension and circulatory stresses, did cause hemodynamic changes. There was tachycardia (from 63 +/- 2 to 68 +/- 2 beats/min), a decrease in pulse pressure (from 62 +/- 2 to 53 +/- 2 mm Hg), an increase in central venous pressure (from 2.6 +/- 0.5 to 4.1 +/- 0.4 mm Hg), and surprisingly in view of the known vasoconstrictor effect of AVP, an increase in forearm flow (from 4.4 +/- 0.7 to 5.9 +/- 1.2 ml/min/100 ml tissue) and a decrease in forearm vascular resistance (from 24 +/- 4 to 18 +/- 3 U); there was no significant change in mean arterial pressure (from 83 +/- 2 to 83 +/- 3 mm Hg). Reflex changes in heart rate were unaltered. The maximal vasoconstrictor response in the forearm attained during lower body negative pressure was not influenced by AVP, but the reflex vasodilator response to the sudden release of lower body negative pressure was significantly augmented, vascular resistance falling to 23 +/- 4 U before and 13 +/- 2 U during AVP. The unanticipated findings in this study include the biphasic changes in heart rate with increasing doses of AVP, the absence of a pressor response, and the vasodilatation in forearm vessels.(ABSTRACT TRUNCATED AT 400 WORDS)
The Intracellular Sensor NOD2 Induces MicroRNA-29 Expression in Human Dendritic Cells to Limit IL-23 Release
Authors: Oliver Brain, Benjamin M.J. Owens, Tica Pichulik, Philip Allan, Elham Khatamzas, Alasdair Leslie, Tessa Steevels, Sameer Sharma, Alice Mayer, Ana Maria Catuneanu, Victoria Morton, Mei-Yi Sun, Derek Jewell, Margherita Coccia, Oliver Harrison, Kevin Maloy, Susann Schönefeldt, Simon Bornschein, Adrian Liston, Alison Simmons
Journal: Immunity (2013)
A Model for Epidemiologic Research
Authors: Theodore C. Doege
Journal: JAMA (1978)

Health sciences students should understand the fundamentals of epidemiologic methods that can lead to major advances in the treatment of disease. To this end, the research process is defined and a three-dimensional model that considers some basic elements of epidemiologic research--time, place, and strategy--is described. The strategies available to the investigator (descriptive, analytic, and experimental) and the possible time frames (retrospective, concurrent, and prospective) are illustrated in terms of field investigations that involve problems of infection, nutrition, dysplasia, metabolism, and cancer. It is believed that epidemiologic studies, no matter where they are performed, have certain features in common, especially those related to the elements of strategy and time.
THE SALVAGED AREA AT RISK IN RESCUE PERCUTANEOUS CORONARY INTERVENTION: QUANTIFICATION BY CARDIOVASCULAR MAGNETIC RESONANCE
Authors: Jessica Sánchez-Quinones, Juan Miguel Ruiz-Nodar, Feliu Rey Eloisa, Jose Valencia, Garcia-Carbonell Milagros, Patricio Perez-Berbel, Vicente Mainar Tello, Patricia Martin, Francisco Sogorb Garri
Journal: Journal of the American College of Cardiology (2010)
THE INFLUENCE OF HIGH ALTITUDES ON THE ARREST OF PULMONARY PHTHISIS.
Authors: BOYD CORNICK
Journal: JAMA (1893)

A generation ago, in prescribing change of climate for consumption, the usual medical advice was that the patient should take a sea-voyage, should spend a period of time in travel, or should resort to some locality with a mild and equable temperature; little regard being paid to other factors of climate than temperature alone. But with the appearance in 1864 of Dr. Hermann Weber's "Climate of the Swiss Alps," began a change in medical opinion in favor of high altitudes, a rarefied atmosphere being esteemed the most important climatic factor. The latest phase of this changed opinion has been well formulated by James Alex Lindsay. M.A., M.D., in his work on "The Climatic Treatment of Consumption." Says Dr. Lindsay: "The characteristics of mountain climates which are fairly constant, are as follows: Increased rarefaction, directly proportionate to the elevation; great purity of the air, and freedom from organic contamination; much ozone;
Oxidative Stress at Onset and in Early Stages of Type 1 Diabetes in Children and Adolescents
Authors: Carmen Domínguez, Elena Ruiz, Miguel Gussinye, Antonia Carrascosa
Journal: Diabetes Care (1998)

OBJECTIVE In diabetes, the persistence of hyperglycemia has been reported to cause increased production of oxygen free radicals through glucose autooxidation and nonenzymatic glycation. The aim of this study was to determine whether oxidative cellular damage occurs at the clinical onset of diabetes and in later stages of the disease in young patients. RESEARCH DESIGN AND METHODS Indicative parameters of lipoperoxidation, protein oxidation, and changes in the status of antioxidant defense systems were evaluated in single blood samples from 54 diabetic children, adolescents, and young adults and 60 healthy age- and sex-matched control subjects. RESULTS Malondialdehyde and protein carbonyl group levels in plasma were progressively higher in diabetic children and adolescents than in control subjects (P &amp;lt; 0.0001). The highest erythrocyte superoxide dismutase (SOD) activity was found in diabetic children at onset of clinical diabetes. In diabetic adolescents, SOD was also significantly higher (P &amp;lt; 0.0001) than in control subjects. Erythrocyte glutathione peroxidase was significantly lower in diabetic children and adolescents compared with control subjects (P &amp;lt; 0.002). A significant decline in blood glutathione content at the recent onset of diabetes was found (P &amp;lt; 0.0001). Furthermore, our results demonstrated progressive glutathione depletion during diabetes evolution. The plasma α-tocopherol/total lipids ratio and β-carotene levels during diabetes development (P &amp;lt; 0.001) were low. CONCLUSIONS This cross-sectional study in young diabetic patients showed that systemic oxidative stress is present upon early onset of type 1 diabetes and is increased by early adulthood. Decreased antioxidant defenses may increase the susceptibility of diabetic patients to oxidative injury. Appropriate support for enhancing antioxidant supply in these young diabetic patients may help prevent clinical complications during the course of the disease.
Effects of isometric exercise on the end-diastolic pressure, volumes, and function of the left ventricle in man.
Authors: A P Flessas, G P Connelly, S Handa, C R Tilney, C K Kloster, R H Rimmer, J F Keefe, M D Klein, T J Ryan
Journal: Circulation (1976)

Changes induced in left ventricular (LV) hemodynamics by isometric exercise were analyzed in 43 patients: 30 with coronary heart disease (CAD), four with noncoronary heart disease, nine normal. Volumes were angiographically determined and correlated with left ventricular end-diastolic pressure (LVEDP) both at rest and during the fifth minute of 30% sustained handgrip (HNG). All normals and eight with CAD improved LV function during HNG. LVEDP decreased or remained constant, end-diastolic volume (EDV) decreased, end-systolic volume (ESV) decreased, as ejection fraction (EF) remained constant. None of these eight CAD cases altered their regional LV contraction pattern during HNG. Twenty-five patients, 21 CAD and four nonCAD, showed diminished LV function during HNG. LVEDP increased, EDV decreased, ESV increased, as EF declined. In these 21 CAD patients, at least one major coronary vessel was narrowed 70% or more and, with but two exceptions, was not supported by adequate collaterals. In 18, new asynergic zones developed in previously normally contracting areas or pre-existing asynergic zones extended during HNG.
Dorsal Buccal Mucosal Graft Urethroplasty for Anterior Urethral Stricture by Asopa Technique
Authors: V.L.N. Murthy Pisapati, Srimannarayana Paturi, Suresh Bethu, Srikanth Jada, Ramreddy Chilumu, Rahul Devraj, Bhargava Reddy, Vidyasagar Sriramoju
Journal: European Urology (2008)
Calcium/Vitamin D Supplementation and Cardiovascular Events
Authors: Judith Hsia, Gerardo Heiss, Hong Ren, Matthew Allison, Nancy C. Dolan, Philip Greenland, Susan R. Heckbert, Karen C. Johnson, JoAnn E. Manson, Stephen Sidney, Maurizio Trevisan
Journal: Circulation (2007)

Background— Individuals with vascular or valvular calcification are at increased risk for coronary events, but the relationship between calcium consumption and cardiovascular events is uncertain. We evaluated the risk of coronary and cerebrovascular events in the Women’s Health Initiative randomized trial of calcium plus vitamin D supplementation. Methods and Results— We randomized 36 282 postmenopausal women 50 to 79 years of age at 40 clinical sites to calcium carbonate 500 mg with vitamin D 200 IU twice daily or to placebo. Cardiovascular disease was a prespecified secondary efficacy outcome. During 7 years of follow-up, myocardial infarction or coronary heart disease death was confirmed for 499 women assigned to calcium/vitamin D and 475 women assigned to placebo (hazard ratio, 1.04; 95% confidence interval, 0.92 to 1.18). Stroke was confirmed among 362 women assigned to calcium/vitamin D and 377 assigned to placebo (hazard ratio, 0.95; 95% confidence interval, 0.82 to 1.10). In subgroup analyses, women with higher total calcium intake (diet plus supplements) at baseline were not at higher risk for coronary events ( P =0.91 for interaction) or stroke ( P =0.14 for interaction) if assigned to active calcium/vitamin D. Conclusions— Calcium/vitamin D supplementation neither increased nor decreased coronary or cerebrovascular risk in generally healthy postmenopausal women over a 7-year use period.
Hospital Utilization and the Supply of Physicians
Authors: Milton I. Roemer
Journal: JAMA (1961)

Among the many factors affecting the hospital utilization rate in a region, little attention has been given to the supply of physicians. Characteristics of patients have been studied as well as policies of hospitals and practices of physicians. This paper explores the relationship of the physician-population ratio to the hospital admission rate in the 48 continental states of the United States. After making statistical corrections for insurance coverage and the available supply of hospital beds, it was found that below a threshold supply of 110 physicians per 100,000, the rate of hospital admissions tends to go up as the supply of physicians goes down. Possible explanations for this are explored. Rising hospital admission rates, therefore, may be partially due to the existing lag in the output of physicians. The implications of this for medical education are discussed.
THE DUALITY OF MAN.CHAIRMAN'S ADDRESS IN THE SECTION ON OPHTHALMOLOGY AT THE FIFTY-EIGHTH ANNUAL SESSION OF THE AMERICAN MEDICAL ASSOCIATION, ATLANTIC CITY, N. J., JUNE, 1907.
Authors: G. C. SAVAGE
Journal: JAMA (1907)

In his address before the Medical Club of Philadelphia a short while ago Mr. Gilder, editor of the<i>Century</i>, urged "the establishment of an institute for the investigation of faith cure and other treatments not recognized by the medical profession." His suggestion should not be passed over lightly, for such things constitute a problem which should be solved, and that, too, by medical men. In all of these faith fads and fancies there is an element of truth which should be freed from the abominable errors that becloud it. If the solution is ever found it must come from the study of man as a dual creature, spirit and matter, spirit a unit, the material body a union. Life, not alone of man, but of the lower animals also, is the mystic union of spirit and matter. This mystic union we may never understand, nor can we ever know how
Discovery of a previously unrecognized microdeletion syndrome of 16p11.2–p12.2
Authors: Blake C Ballif, Sara A Hornor, Elizabeth Jenkins, Suneeta Madan-Khetarpal, Urvashi Surti, Kelly E Jackson, Alexander Asamoah, Pamela L Brock, Gordon C Gowans, Robert L Conway, John M Graham, Livija Medne, Elaine H Zackai, Tamim H Shaikh, Joel Geoghegan, Rebecca R Selzer, Peggy S Eis, Bassem A Bejjani, Lisa G Shaffer
Journal: Nature Genetics (2007)
Pregnancy in Adolescence
Authors: Iris F. Litt
Journal: JAMA (1996)

In this issue ofThe Journal, Spitz et al<sup>1</sup>examine child-bearing rates for US teenagers in the decade of the 1980s. The authors wisely divide these data into 5-year periods. To have done otherwise would have been misleading, for these rates prove to have been mercurial: stable from 1980 to 1985, markedly increased for 1985 to 1990. An analysis of more recent data shows rates declining in 1991 to 1992.<sup>2</sup>Accordingly, before attributing meaning to these data, one must take a longer view. In the 1970s, birth rates among adolescents declined sharply, probably owing to the legalization and availability of abortion; for reasons that are not clear, these rates then leveled off until 1988, when they rose to a new peak for 10- to 17-year-olds.<sup>3(p334)</sup> See also p 989. Using as the denominator the numbers of sexually active adolescent girls rather than all those in a given
The site of primary T cell activation is a determinant of the balance between intrahepatic tolerance and immunity
Authors: David G. Bowen, Monica Zen, Lauren Holz, Thomas Davis, Geoffrey W. McCaughan, Patrick Bertolino
Journal: Journal of Clinical Investigation (2004)

Hepatic immunobiology is paradoxical: although the liver possesses unusual tolerogenic properties, it is also the site of effective immune responses against multiple pathogens and subject to immune-mediated pathology. The mechanisms underlying this dichotomy remain unclear. Following previous work demonstrating that the liver may act as a site of primary T cell activation, we demonstrate here that the balance between immunity and tolerance in this organ is established by competition for primary activation of CD8+ T cells between the liver and secondary lymphoid tissues, with the immune outcome determined by the initial site of activation. Using a transgenic mouse model in which antigen is expressed within both liver and lymph nodes, we show that while naive CD8+ T cells activated within the lymph nodes were capable of mediating hepatitis, cells undergoing primary activation within the liver exhibited defective cytotoxic function and shortened half-life and did not mediate hepatocellular injury. The implications of these novel findings may pertain not only to the normal maintenance of peripheral tolerance, but also to hepatic allograft tolerance and the immunopathogenesis of chronic viral hepatitis.
Problems with ABPI proposals to release data on payments to doctors
Authors: B. Goldacre
Journal: BMJ (2014)

Whitehead of the Association of the British Pharmaceutical Industry (ABPI) says the drug industry will soon declare all payments to doctors.1 2 There are several problems with his new promises.

Firstly, industry has been promising such transparency for years, without delivering. At the same time, the same companies are campaigning against transparency in other areas.

Secondly, industry representatives now say—when directly questioned about completeness—that EU privacy law will permit individual doctors …
Exposure to Shear Stress Alters Endothelial Adhesiveness
Authors: Philip S. Tsao, Neil P. Lewis, Susan Alpert, John P. Cooke
Journal: Circulation (1995)

Background Shear stress increases the release of nitric oxide (NO) by endothelial cells (ECs). We and others have provided evidence that endothelium-derived NO inhibits monocyte adhesion to the vessel wall. We therefore hypothesized that previous exposure to shear stress would inhibit endothelial adhesiveness for monocytes by virtue of its effect to increase NO release. Methods and Results Confluent monolayers of bovine aortic endothelial cells, human aortic endothelial cells, or human venous endothelial cells were exposed to laminar fluid flow. Culture media were collected for measurement of NO (by chemiluminescence) and the prostacyclin metabolite 6-keto-prostaglandin F 1α . NO x and 6-keto-prostaglandin F 1α accumulated in the conditioned medium during laminar fluid flow from 30 minutes to 24 hours in a time-dependent fashion. In another set of studies, ECs previously exposed to flow or to static conditions were washed with Hanks’ buffer and exposed to THP-1 cells for 30 minutes. Adherent cells were counted by microscopy. Previous exposure to flow reduced endothelial adhesiveness for monocytes by 50% ( P &lt;.05). The effect of flow on endothelial adhesiveness occurred within 30 minutes. This effect was abrogated by nitro- l -arginine (an antagonist of NO synthesis), as well as by tetraethylammonium ion (an antagonist of the flow-activated potassium channel); the effects of these inhibitors were reversed by the NO donor SPM-5185. Although the cyclo-oxygenase inhibitor indomethacin totally inhibited the flow-induced production of prostacyclin by ECs, it minimally affected adherence of THP-1 cells. The early effect of flow on endothelial adhesiveness was not mediated by alterations in the expression of the endothelial adhesion molecules VCAM-1 or ICAM-1 as assessed by fluorescent activated cell sorting. Conclusions Shear stress alters endothelial adhesiveness for monocytes; at early time points, this effect is largely due to flow-stimulated release of NO and, to a lesser extent, prostacyclin. This effect of flow occurs within 30 minutes and is probably due to alterations in the signal transduction or activation state (rather than the expression) of endothelial adhesion molecules.
Reduced Intravascular Infection by Antibiotic Bonding
Authors: Robert S. Baltimore
Journal: JAMA (1991)

To the Editor.  —The article by Kamal et al 1 concerns an important issue in hospital care: prevention of intravascular catheter-related infections. However, I think that the title of the article and the wording of the Results section suggest that the incidence of actual infection was reduced.  In this study, the authors claim that bonding of antibiotic to the inner luminal and outer surface of the catheter reduced catheter infection ; I think this term is misleading. In the title, abstract, and the body of the article, they repeatedly refer to organisms isolated from catheters as representing infections. In fact, catheters do not become infected, they become contaminated or colonized. People become infected, but there is a conspicuous absence of data demonstrating that infection in the patients in whom these catheters were placed was reduced. Actually, the 13 cases of septicemia in the control group and the 10 in the antibiotic-bonded group
Surgeon leaders support publishing outcomes but warn of limitations
Authors: J. Wise
Journal: BMJ (2013)

Leaders of the main surgical specialties have said that they support the principle of publishing outcomes of individual surgeons in England but warn that some of the currently available data are limited and could be misinterpreted by the public. 

The move comes as performance data for individual vascular surgeons in the UK is published for the first time this week,1 together with updated information on cardiac surgeons. The release of the data concerning 3500 surgeons will be staggered over the next few months. Five more specialties will go live in the next seven days, and three more will follow in the autumn.

Fewer …
Stenting and platelet glycoprotein IIb/IIIa inhibitors improve electrocardiographic ST-segment resolution after primary percutaneous coronary angioplasty for acute myocardial infarction
Authors: Bruce R. Brodie, Thomas D. Stuckey, Grace Kissling, Charles Hansen, Debra S. VerSteeg, Denise Muncy, Susan Moore, Navin Gupta, Mark Pulsipher
Journal: Journal of the American College of Cardiology (2003)
Goats' milk for infants and children.
Authors: L S Taitz, B L Armitage
Journal: BMJ (1984)

15-4 mg/l and only 1-6 mg/1 on two separate admissions. The only answer is to base treatment on repeated plasma samples,2 though in two of the five patients thought to need intravenous theo? phylline on admission, repeat concentrations could not be obtained. In a further seven patients who had not had previous theophylline treatment median plasma theophylline concentration after 24 hours' main? tenance treatment was 8-2 mg/1 (range 5*4-21'6). The real possibility of unexpected toxicity is highlighted by the case of one patient admitted and treated in the same manner on two separate occasions, in whom plasma theophylline con? centration after 24 hours was 8*4 mg/1 on the first occasion and 21-6 mg/1 on the second. We believe none the less that to achieve rapid relief a bolus intravenous dose of amino phylline is necessary.3 We suggest that our present practice combines safety with achieve? ment of accepted therapeutic plasma con? centrations.1 We are, however, well aware of the need for caution as advised by Dr Stewart and her colleagues. These problems should be borne in mind when considering long term theophylline treatment. S P CONWAY D R N Gillies J N LlTTLEWOOD St James's University Hospital, Leeds LS9 7TF