tbuckley/cabot-search huggingface dataset:
"Overuse"--an overused term?
Authors: P L Gregory
Journal: British Journal of Sports Medicine (2002)

Use of the term overuse injury should be avoided until there is definite proof of the cause of the injury

Injuries are often categorised as being due to trauma or overuse. When no moment of trauma is recalled, then an assumption is made that an injury is the result of overuse. In this article, I will argue that there is insufficient evidence to support this extensive use of the term “overuse” and that there are problems associated with using it. Thus, we should avoid the term, which implies the cause of the injury, until we have proof of the cause.

Overuse injury is now categorised in medical subject headings as “cumulative trauma disorder (CTD)”. This is a subcategory of sprains and strains. CTD is defined as a “Harmful and painful condition caused by overuse or overexertion of some part of the musculoskeletal system, often resulting from work-related physical activities. It is characterized by inflammation, pain, or dysfunction of the involved joints, bones, ligaments, and nerves.” The term includes overuse injury, overuse syndrome, repetition strain injury, repetitive strain injury, and repetitive motion disorders. As CTD is defined as being caused by overuse, this definition fails to clarify the meaning of overuse injury. Overuse probably implies there is an amount of use that is excessive, and if use reaches or exceeds that amount then injuries arise.

Consider now this term as used in sports medicine. Traumas, such as a fractured tibia caused by a tackle in soccer, are likely to be most common among players who play or train most. Yet, overuse is not said to be the cause of this injury. Injuries arising from obvious trauma are excluded from the category of overuse injuries. Such a trauma may be witnessed or may be felt as an acute moment of injury. An …
Impaired Toll-like Receptor 9 Expression in Alveolar Macrophages with No Sensitivity to CpG DNA
Authors: Kenichiro Suzuki, Takafumi Suda, Tateaki Naito, Kyotaro Ide, Kingo Chida, Hirotoshi Nakamura
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Unmethylated CpG motifs in bacterial DNA or synthetic oligodeoxynucleotides (ODN) potently stimulate the innate immune system, and they are recognized by Toll-like receptor 9 (TLR9), which is expressed by monocytes/macrophages, dendritic cells, and B cells. However, it is unknown whether alveolar macrophages (AMs) express functional TLR9. To clarify this, we analyzed mRNA expressions of TLRs in murine AMs by real-time polymerase chain reaction, and compared with those in other tissue macrophages and lung antigen-presenting cells. In addition, we determined the sensitivity of these cell populations to CpG-ODN. Interestingly, TLR9 mRNA was almost absent in AMs, but highly expressed in bone marrow–derived macrophages and peritoneal macrophages, whereas TLR2 and TLR4 were present in all macrophage populations. Consistent with the receptor expression, AMs showed no sensitivity to CpG-ODN, whereas other macrophage populations secreted tumor necrosis factor α, interleukin 12 p40, and interleukin 6, and enhanced expression of CD40, CD80, and CD86, in response to CpG-ODN. Lung dendritic cells and B cells highly expressed TLR9 mRNA and responded to CpG-ODN. These results indicate selective loss of TLR9 expression in AMs with no sensitivity to CpG-ODN, suggesting that dendritic cells and B cells play a role in the immune response against bacterial DNA in the lung.
Pacemaker Treatment of Heart Block
Authors: Simon Dack
Journal: JAMA (1967)

The implanted cardiac pacemaker has become the standard method of treatment of heart block. In the short period of five or six years, improvement in engineering, materials, and components has made available a dependable pacemaker unit which can function for two or three years without reoperation. Improved surgical technique has also led to a simplified operative approach which we believe will improve the short- and long-term results of cardiac pacing. <h3>The Epicardial-Type Pacemaker</h3> The first type of implanted pacemaker which achieved wide application was the epicardial type. Myocardial electrodes were sewn into the epicardial surface of the left ventricle through a thoracotomy incision and the wires were brought down through a subcutaneous tunnel to the lower left part of the abdomen and attached to the generator which was implanted subcutaneously. In 1964 a review inThe Journal<sup>1</sup>indicated that this was a safe and life-saving procedure with minimal operative mortality
Your Child's Care: 1001 Questions and Answers
Authors: W. W. Bolton
Journal: JAMA (1961)

Lacking the endurance and fortitude to make an exact count, I can only state that there must be at least 1,001 and probably close to 2,000 questions answered in this book. As this quantity suggests, the authors of this revised and retitled edition of<i>A Pediatrie Manual for Mothers</i>have left few areas untouched. The type of approach is somewhat unusual in that much more space is devoted to the general problem of child care than the problems of specific ages or growth levels. After this, the discussions go off in many different directions, starting with an arbitrary collection of topics ranging from hiccups to nephrosis and tuberculosis in infants and children. Discussions of the eyes and teeth follow; next is material on contagious diseases, skin abnormalities, heart disease, cancer, diabetes, and allergy. Should not such a volume be absolutely barren of specific treatment guides? The authors probably wrestled with this problem and apparently had a high resolve to avoid producing a book that might in any way replace the family physician, but, in a
Diagnostic Methods in Clinical Cardiology
Authors: William L. Winters
Journal: JAMA (1983)

This is a well-written, condensed review of the noninvasive diagnostic techniques employed by clinical cardiologists. The chapters include electrocardiography, echocardiography, phonocardiography, and external pulse recordings embracing a nice review of systolic time intervals, radioisotope examination of the heart, nonangiographic radiological examination of the heart, and various blood tests. There is particular reference to cardiac enzymes, lipid abnormalities, and review of antiarrhythmic medication with correlation of dosage and administration with blood levels. A chapter on hemodynamic monitoring deals primarily with the technique of insertion of the Swan-Ganz catheter and measurements made therewith, as well as the very basics of catheterization of the right and left sides of the heart, with indications in various organic heart disease states.  The chapters are brief and cover only the most fundamental observations. However, for the physician in general medicine or the neophyte cardiologist, the information supplied is basic and accurate, and each chapter contains an
Impotence Is Not Always Psychogenic
Authors: Richard F. Spark
Journal: JAMA (1980)

The concept that impotence is psychogenic in 95% of cases is reconsidered. Screening serum testosterone levels of 105 consecutive patients with impotence showed that 37 patients had previously unsuspected disorders of the hypothalamic-pituitary-gonadal axis. Twenty patients had hypogonadotropic-hypogonadism, seven had hypergonadotropic-hypogonadism, eight had hyperprolactinemia, and two had occult hyperthyroidism. Once the specific defect was defined, appropriate therapy was instituted, and potency was restored in 33 patients. Screening serum testosterone levels is useful in identifying hypothalamic-pituitary-gonadal dysfunction in patients with impotence.
Actual management: partial separation of excess lipid from plasma
Authors: G. Nyamugunduru, H. Roper
Journal: BMJ (1997)

We formulated a hypothesis to explain our patient's progressively worsening metabolic acidosis despite treatment for shock and hyperglycaemia. We proposed that the oxygen carrying capacity of her blood was impaired by the lipid, leading to tissue hypoxia and lactic acidosis. Plasma lactic acid concentrations could not be measured. We hoped our patient would be improved by removal of some of the excess lipid.

We first tried lipid separation by plasmapheresis. This method failed as the grossly lipaemic blood clogged the plasma filter. We next tried a cell separator but this machine failed to distinguish blood cells from the lipaemic sludge and the tubing became clogged and blocked. Eventually separation by centrifuge was successful. A unit of blood (450 ml) was removed from the patient through a femoral venous line and centrifuged, separating the red cells from …
Classical Skeletal Injuries Shown on 18F-FDG PET/CT Following Successful Cardiopulmonary Resuscitation
Authors: Yu-Ting Huang, Aravind S. Ravi Kumar
Journal: Clinical Nuclear Medicine (2013)

Rib and sternal fractures are relatively common following conventional cardiopulmonary resuscitation (CPR). This case demonstrates the 18F-FDG PET/CT appearances of typical CPR-related multiple rib and sternal fractures in a 55-year-old man with suspected cardiac sarcoidosis. The PET/CT scan was performed to assess disease activity of cardiac sarcoidosis, and no active cardiac inflammation was detected. The patient initially presented with an out-of-hospital cardiac arrest and successfully received bystander CPR.
The natural abundance of lambda2-light chains in inbred mice.
Authors: T Cotner, H N Eisen
Journal: The Journal of Experimental Medicine (1978)

The amino acid sequence of the constant (C) domain of the light chain of the mouse myeloma protein M315 has not been identified so far in any other myeloma protein. In this study, serological analysis with antiserum to the C-domain of this light chain (L315) showed that approximately equal to 1% of Igs in normal mouse serum have L chains of the L315 type (called lambda2). Corroborative evidence was obtained by analysis of the carboxyterminal amino acid removed from normal light chains by carboxypeptidase A. A survey of 35 inbred mouse strains showed that all had lambda2; the serum level of Igs with lambda2-chains ranged from approximately equal to 140 microgram/ml in AL/N mice to approximately equal to 25 microgram/ml in SJL, BSVS, and eight other strains. In accord with the anti-Dnp activity of M315, sera from mice immunized with Dnp-KLH had three- to fivefold more lambda2 than sera from control mice immunized with KLH. It was also possible to measure serum immunoglobulin molecules bearing the lambda2 variable region of M315 (VL315). In BALB/c sera, the concentration of VL315 was about sixfold lower than that measured for lambda2. Thus, lambda2-chains are divided into at least two subsets: those whose V domain is indistinguishable from VL315 and those whose VL differs from VL315. A 10-fold increase in VL315 was obtained by immunizing BALB/c mice with Dnp-KLH. The relationship of the VL domains of normal immunoglobulin lambda2-chains to the embryonic Vlambda gene recently sequenced by Tonegawa et al., is discussed.
Horizontal Nonparenteral Spread of Hepatitis B Among Children
Authors: Alan M. Leichtner, Jeanne Leclair, Donald A. Goldmann, Richard T. Schumacher, Ira H. Gewolb, Aubrey J. Katz
Journal: Annals of Internal Medicine (1981)

Two families with an unusually high incidence of hepatitis B infection (15 of 21 persons) were investigated over an 18-month period. Serologic evidence of past or present infection—hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc)—was found in 11 of the 12 members of one family, four of whom were chronic HBsAg carriers, and in four of nine members of a contact family. Anti-HBc was the only serologic marker of infection in five persons. Histocompatibility leukocyte antigen (HLA) typing failed to show an association between carriage of HBsAg and specific HLA markers. Chewing gum was a potential vehicle as HBsAg was detected in gum samples from three of four children who were chronic HBsAg carriers. Horizontal, nonparenteral transmission of hepatitis B virus probably accounted for the clustering of infection in these families, especially via the exchange among children of objects contaminated with oral secretions.
Innovative Thinking for the Improvement of Medical Systems
Authors: Paul Plsek
Journal: Annals of Internal Medicine (1999)

If health care systems are not delivering the desired results, those systems must be changed in some way. Innovative thinking is sometimes needed to generate ideas for improvement. Many persons erroneously believe that innovative thinking is a special gift or that it requires an air of lightheartedness that seems inappropriate in a health care setting. Current research in the cognitive sciences has yielded methods to help individual persons and groups generate innovative ideas. These methods do not require any special gift and can be practiced in a serious way. Through a case example from a health maintenance organization, this paper shows that, given some direction, groups of health care professionals can produce useful and innovative ideas. The tools of idea generation are based on three principles: mental attention, escape, and movement. Activities that help persons pay attention to their current situations in a different way, escape their current mental patterns about the situation, and maintain movement in their thoughts support efforts to generate innovative, testable ideas for health system improvements. This paper illustrates several methods of stimulating innovative thinking and shows the ways in which they can be applied in health care.
Reperfusion Pulmonary Edema
Authors: Joseph M. Klausner
Journal: JAMA (1989)

Reperfusion following lower-torso ischemia in humans leads to respiratory failure manifest by pulmonary hypertension, hypoxemia, and noncardiogenic pulmonary edema. The mechanism of injury has been studied in the sheep lung lymph preparation, where it has been demonstrated that the reperfusion resulting in pulmonary edema is due to an increase in microvascular permeability of the lung to protein. This respiratory failure caused by reperfusion appears to be an inflammatory reaction associated with intravascular release of the chemoattractants leukotriene B4 and thromboxane. Histological studies of the lung in experimental animals revealed significant accumulation of neutrophils but not platelets in alveolar capillaries. We conclude that thromboxane generated and released from the ischemic tissue is responsible for the transient pulmonary hypertension. Second, it is likely that the chemoattractants are responsible for leukosequestration, and, third, neutrophils, oxygen-derived free radicals, and thromboxane moderate the altered lung permeability. (<i>JAMA</i>1989;261:1030-1035)
Blo t 13 allergen from Blomia tropicalis shows high frequency of IgE binding in allergic cuban patients and cross-reactivity with Dermatophagoides siboney extract
Authors: L. Puerta, A. Labrada, M. Labrada, K. Uyema, S. Jiménez, L. Caraballo
Journal: Journal of Allergy and Clinical Immunology (2003)
High frequency of epithelial chimerism in liver transplants demonstrated by microdissection and STR-analysis
Authors: Wolfram Kleeberger, Thomas Rothämel, Sabine Glöckner, Peer Flemming, Ulrich Lehmann, Hans Kreipe
Journal: Hepatology (2002)

It has recently been shown that epithelial cells derived from stem cells originating outside the liver are integrated into liver allografts. Whether epithelial intragraft chimerism protects transplants from rejection or chronic transplant dysfunction, and whether it interferes with recurrence of primary liver disease, is not known. Twenty-seven sequential biopsies derived from 9 liver-transplant recipients were studied for chimerism of hepatocytes and cholangiocytes. The target cells were isolated by laser microdissection after cytokeratin immunolabeling and genotyped using DNA analysis of a highly polymorphic short tandem repeat. Irrespective of whether early (up to 4 weeks) or late (more than 12 months) posttransplantation biopsies were studied, cholangiocyte chimerism was almost constantly found in 91% of the samples. No significant differences occurred between samples derived from patients with chronic organ dysfunction (n = 3), recurrent hepatitis (n = 3), or mild, unspecific changes (n = 3). By contrast, hepatocyte chimerism tended to occur later (55% vs. 22%) and appeared to be associated with recurrent hepatitis (67% vs. 27%). In this respect, chronic organ dysfunction did not differ from mild, unspecific changes. While cholangiocyte chimerism represents a constant and early phenomenon in liver transplantations, an enhanced chimeric integration of recipient-derived hepatocytes can be observed in recurrent hepatitis, supporting the concept of an increased recruitment of extrahepatic progenitor cells to the liver in chronic hepatitis.
Preclinical activity of a novel CRM1 inhibitor in acute myeloid leukemia
Authors: Parvathi Ranganathan, Xueyan Yu, Caroline Na, Ramasamy Santhanam, Sharon Shacham, Michael Kauffman, Alison Walker, Rebecca Klisovic, William Blum, Michael Caligiuri, Carlo M. Croce, Guido Marcucci, Ramiro Garzon
Journal: Blood (2012)
Pulmonary Ventilatory Defects and Occupational Exposures in a Population-based Study in Spain
Authors: JORDI SUNYER, MANOLIS KOGEVINAS, HANS KROMHOUT, JOSEP M. ANTÓ, JOSEP ROCA, AURELIO TOBIAS, ROEL VERMEULEN, FELIX PAYO, JOSÉ A. MALDONADO, JESUS MARTINEZ-MORATALLA, NEREA MUNIOZGUREN
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We assessed the association between occupational exposures and symptoms of chronic bronchitis and pulmonary ventilatory defects in a general population-based study of five areas in Spain. This study forms part of the European Community Respiratory Health Study (ECRHS). Subjects (n = 1,735; age range, 20–44 yr; 52.4% of those initially selected) completed a respiratory questionnaire on symptoms and occupation and underwent baseline spirometry. Occupation was translated with an ad hoc developed job-exposure matrix (JEM) into none, low, and high exposure to biological dust, mineral dust, and gases and fumes. Exposure to high levels of biological dust was associated with cough for more than 3 mo (odds ratio [OR], 1.9; p = 0.07), a reduction in FEF25–75 to 478 ml/s (SD 178), and a reduction in FEV1 to 151 mL (SD 71). These associations remained after excluding subjects with asthma symptoms or bronchial responsiveness. Smokers tended to have a higher risk for respiratory symptoms, but smoking did not modify the association of occupation with pulmonary function. Exposure to mineral dust and gases/fumes was less consistently related to pulmonary function or to respiratory symptoms and this association further decreased after excluding subjects with asthma. In conclusion, exposure to high levels of biological dust in young adults is associated with symptoms of chronic bronchitis and pulmonary ventilatory defects, independently of asthma and smoking.
Cognitive neuropsychological evidence for common processes underlying generation and storage of language representations
Authors: Nadine Martin
Journal: Behavioral and Brain Sciences (2003)

Ruchkin et al. offer a compelling case for a model of short-term storage without a separate buffer. Here, I discuss some cognitive neuropsychological data that have been offered in support of and against their model. Additionally, I discuss briefly some new directions in cognitive neuropsychological research that bear on the role of attention in Ruchkin et al.'s model.
"Homeward bound": a minimal care rehabilitation unit.
Authors: M A Sutton
Journal: BMJ (1986)

A 20 bed minimal care rehabilitation unit was set up by Newham District Health Authority in a small hospital originally scheduled for closure when a new district general hospital was opened. During the first year 114 patients were admitted (throughput 5.7), with a median length of stay of 30 days; in the second year 173 patients were admitted (throughput 8.65) with a median length of stay of 28.5 days. The cost per inpatient day was less than that of an inpatient day at the district's long stay geriatric unit. Before the unit opened 24% of the acute beds had been occupied for more than six weeks, whereas two years later only 6% of the acute beds were occupied for such a period.
Legal safeguards for audit process are a bad idea
Authors: K. Walshe
Journal: BMJ (1999)

Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on the 2 April 2020. The aim of this paper was to document policy decisions made in response to the COVID-19 pandemic from January to August 2020. We reviewed policy documents from the Public Health Institute of Malawi, the Malawi Gazette, the Malawi Ministry of Health and Population and the University of Oxford Coronavirus Government Response Tracker. We found that the Malawi response to the COVID-19 pandemic was multisectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. Key policies identified during the review include international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and public transport, and mandatory face coverings and a testing policy covering symptomatic people. Supportive interventions included risk communication and community engagement in multiple languages and over a variety of mediums, efforts to improve access to water, sanitation, nutrition and unconditional social-cash transfers for poor urban and rural households.
Petit Mal Status in Adults
Authors: STEPHEN W. THOMPSON
Journal: Annals of Internal Medicine (1968)

Petit mal is primarily a childhood disorder and becomes less common in adult life. Petit mal status (spike-wave stupor) is an unusual complication, but one third of cases reported since 1950 have been in young adults, usually under 40 years old. Four adults who had petit mal since childhood are presented. Three of these patients, one of whom was age 61, had discrete episodes of petit mal status, while the fourth had prolonged depression of mental function due to constantly recurring petit mal attacks. These patients were initially thought to be psychotic. The clinical features of these and of previously reported cases of petit mal status are considered; their salient characteristics are emphasized, and the differential diagnosis is discussed.