tbuckley/cabot-search huggingface dataset:
Helicopter, other `air ambulances': time to assess effectiveness?
Authors: Virginia S. Cowart
Journal: JAMA (1985)

A sheaf of news releases on expanded or new hospital-based "air ambulance" services has gone out in recent months as this type of service enters a high growth phase. Now that dedicated hospital-based programs have been in operation in this country a dozen years, some observers suggest, it may be possible to begin to assess their effectiveness. The main question is whether these programs— which at a starting cost of about $500,000 a year admittedly are very expensive to maintain—upgrade the delivery of emergency services enough to be worth the tab. Also to be answered is whether helicopter transport itself may, at least on occasion, put patients at increased risk of further injury. What appears to be the progenitor of all programs in the United States is at St Anthony's Hospital in Denver. Henry Cleveland, MD, one of its founders, is forthright in his assessment of air transportation for medical
Geriatric patients in an acute medical ward.
Authors: C McArdle, J C Wylie, W D Alexander
Journal: BMJ (1975)

During a nine-month study 160 out of 482 bed-weeks in an acute medical ward were accounted for by 11 patients who no longer needed to be there. This was unsatisfactory both for the 11 patients concerned and for those patients requiring admission for whom the beds were blocked.
Methods of assessing neurobehavioral development in children exposed to methyl parathion in Mississippi and Ohio.
Authors: Perri Zeitz, Kirsten Kakolewski, Rubina Imtiaz, Wendy Kaye
Journal: Environmental Health Perspectives (2002)

Methyl parathion (MP), an organophosphate pesticide, was sprayed illegally for pest control in U.S. residences and businesses in Mississippi and Ohio. To evaluate the association between MP exposure and neurobehavioral development, children 6 years of age or younger at the time of the spraying and local comparison groups of unexposed children were assessed using the pediatric environmental neurobehavioral test battery (PENTB). The PENTB is composed of informant-based procedures (parent interview and questionnaires) and performance-based procedures (neurobehavioral tests for children 4 years of age or older) that evaluate each of the four broad domains (cognitive, motor, sensory, and affect) essential to neurobehavioral assessment. Children were classified as exposed or unexposed using urinary p-nitrophenol (PNP) levels and environmental wipe samples for MP. Exposure was defined as a urinary PNP level of greater than or equal to 100 ppb for the child or any other individual living in the household. Environmental wipe sample levels of greater than or equal to 150 g MP/100 cm2 and greater than or equal to 132.9 g MP/100 cm2 were used to define MP exposure for children living in Mississippi and Ohio, respectively. The PENTB was first administered in summer 1999 (year 1). The PENTB was readministered in summer 2000 (year 2) to children who participated in year 1 of the study. A description of the methods used in the study are presented. Results of data analyses for both years of the study will be presented in a separate publication.
Effect of moderate arterio-venous shunt on regional extraction, blood flow and oxygen consumption in the dog heart
Authors: K. L BRIDEN, H. R WEISS
Journal: Cardiovascular Research (1981)

The effects of a moderate sized arterio-venous shunt on the relationship of oxygen supply to consumption were studied on a regional basis in the dog left ventricle. Experiments were conducted on fourteen hearts, seven in control pentobarbital-anaesthetised, open-chest dogs and seven in dogs with an additional abdominal aorto-caval shunt. Regional oxygen extraction was determined by a microspectrophotometric method and coronary blood flow was measured with radioactive microspheres. The shunt, when opened, allowed cardiac output to increase by 50%. This was accomplished by increasing stroke volume, not heart rate. In control animals the subendocardium exhibited higher oxygen extraction, coronary flow, and oxygen consumption than did the subepicardium. There were no differences between base and apex. In open-shunt animals, subepicardial-subendocardial differences in extraction, flow and consumption were abolished. Subepicardial values for these in shunt animals were not different from the values obtained for the subepicardial values of controls. The subendocardium of shunt animals exhibited significant differences between base and apex for blood flow and oxygen consumption. There was a significant difference in subendocardial oxygen consumption between groups, the effect of the arterio-venous shunt being to reduce subendocardial consumption, especially in the apex, without reducing subepicardial oxygen consumption.
Tachycardia during cisapride treatment.
Authors: P. P. Humphrey, K. T. Bunce
Journal: BMJ (1992)

that heterosexual transmission of HIV is understood and that manifestations of AIDS and HIV infection that are particular to women are recog- nised-notably, disease of the female genital tract.But the overwhelming evidence shows that most manifestations of HIV infection are gender nonspecific in type and incidence.Ford is unfair and, indeed, incorrect in citing the recent clinical teaching text by my colleagues Parkin and Peters.2Their case oriented book, based on actual patients, uses a problem solving approach to help clinicians learn about AIDS.Most cases of AIDS in the developed world have been in men, and so real patients are described as man/he/him; it would be offensive to those men gratuitously to change their gender.Sadly, as heterosexual spread of HIV and ignorance and denial of it continue more cases will be seen among women, but the delay between infection and disease means that this spread will not be apparent as clinical disease for some years.Current cumulative figures on AIDS in the United Kingdom show 5215 cases in men and 341 in women.In the vast majority of case histories, radiographs, and histological material, and most clinical slides, however, gender would be in- distinguishable.Furthermore, Ford says that only two of 153 presentations in this book are of women, but, in fact, of 138 cases, 10 are in women and for 27 the gender is not specified; of 63 clinical photographs, six are of women and one shows a family.Parkin was a coauthor of a report on one of the first women in the United Kingdom (a mono- gamous English housewife) to acquire AIDS through heterosexual transmission.I Parkin and other members of my team have repeatedly emphasised the importance of heterosexual spread over many years and have learnt much from patients; we have endeavoured to pass this on to our colleagues and the public in many forums.Ford's attack on young and enthusiastic colleagues is unwarranted.
ABC of Rheumatology: ARTHRITIS IN CHILDREN
Authors: T R Southwood
Journal: BMJ (1995)

Diagnosis of juvenile chronic arthritisAll three of these criteria must be met: * Arthritis persisting for more than three months * Onset of arthritis before age 16 * Exclusion of other diseases that may cause arthritis Arthritis is defined as: * Swelling of at least one peripheral joint or * At least two of the following signs-limited range of movement, tenderness or pain on movement of joint, or increased warmth of skin overlying joint Children with arthritis may not complain of pain, but most do experience some discomfort Common mistakes in diagnosis of juvenile chronic arthritis are:Diagnosis in absence of persistent, objective joint swelling Failure to exclude differential diagnosesRheumatic symptoms, such as limping or limb pain, are common in children, yet childhood arthritis and other rheumatic diseases are rare.Diagnosis and treatment of these conditions therefore require a high level of clinical awareness and careful assessment.Laboratory investigations are rarely pathognomonic and are used instead to help differential diagnosis, to detect complications, and to monitor disease activity.Drug treatment depends on a sound knowledge of the variable nature and prognosis of the conditions and a clear understanding of the pharmacology, risks, and benefits of anti-inflammatory and antirheumatic drugs in children.Persistent swelling of joints characterises a heterogeneous group of diseases termed juvenile chronic arthritis, formerly known as Still's disease.This group of diseases is, for the most part, genetically and clinically distinct from rheumatoid arthritis in adults.About one child in every 1000 has juvenile chronic arthritis, amounting to over 12 000 affected children in Britain.Each year one new case would be expected in every 10 000 children.R.< vR ~~~~~~~~~~~~~~~~~.gi i; ..:. . . . . .
Role of the Cyclic AMP—Dependent Protein Kinase in Signal Transduction
Authors: Edwin G. Krebs
Journal: JAMA (1989)

The first example of an enzyme that undergoes phosphorylation and dephosphorylation was phosphorylase, which catalyzes the initial step in the breakdown of tissue glycogen, a process that occurs when cells are stimulated by certain hormones. The phosphorylation reaction that activates phosphorylase is catalyzed by an enzyme designated "phosphorylase kinase," whereas the dephosphorylation reaction is catalyzed by an enzyme called "phosphorylase phosphatase." Phosphorylase kinase, like phosphorylase itself, is regulated by phosphorylation-dephosphorylation. In this instance the enzyme is phosphorylated and activated by a protein kinase that is the intracellular target of adenosine 3′,5′-cyclic phosphate, the second messenger of hormone action that was discovered by the late Earl Sutherland. Knowledge of these steps led to the establishment of the glycogenolytic cascade in which adenosine 3′,5′-cyclic phosphate, formed as a result of hormone action, first activates the adenosine 3′,5′-cyclic phosphate—dependent protein kinase, which in turn activates phosphorylase kinase, which then converts inactive phosphorylase to its active form. This is followed by the breakdown of glycogen. (<i>JAMA</i>. 1989;262:1815-1818)
VALUE OF EXERCISE IN PERIPHERAL ARTERIAL DISEASE
Authors: Lawrence H. Wisham
Journal: JAMA (1953)

Many therapeutic agents are used in the treatment of occlusive peripheral arterial disease. Most of them are utilized to obtain an increased blood flow in the tissues of the extremities. An agent commonly used is therapeutic exercise. Exercise is done either in the form described by Buerger or that described by Buerger and modified by Allen.1Allen, Barker, and Hines state:  is surprising that this method of treatment has been used so widely and yet there has been so little curiosity manifested as to whether or not it is effective in increasing the flow of blood through the extremity. The theory apparently has been that if the blood vessels were alternately emptied and distended, they would eventually accept an increased function in the transportation of blood. So far as we know there is not the slightest physiologic evidence that this occurs.1  It was the purpose of our
MEDICAL DISCOVERIES BY THE NON-MEDICAL.
Authors: GEORGE M. GOULD
Journal: JAMA (1903)

I have been struck by the fact that the majority of great medical discoveries, truths and instruments, have not been made completely and suddenly, but have been led up to by preliminary and progressive steps, and that the layman has so often made these discoveries prior to the medical practitioner. This great medical truth is, indeed, but an illustration of the general law that all professional progress, in whatever branch of study, is somehow or other a result of stimulus from without. There is so much interest, and there are so many lessons to be drawn from such observations in medical history, that I have in late years kept minutes of this class of truths, from which I make the following selections: When we commence observation of the origins of medical discovery and treatment, we are struck by the fact that "our brothers the animals" were first in learning not
Prolonged Emotional Disturbance and Essential Hypertension
Authors: B. Heine, P. Sainsbury
Journal: Psychotherapy and Psychosomatics (1970)

The hypothesis that prolonged emotional disturbance leads to a sustained rise in blood pressure was tested by correlating the blood pressures of depressed patients who had recovered from their illnesses with the total duration of their illnesses. Spells of illness previously suffered correlated significantly with recovered systolic pressure even when the effect of age was eliminated. The correlation held in women for both systolic and diastolic pressure but not for men. The mean blood pressure of the group when depressed was significantly higher than that for matched controls. Other variables such as genetic history differing treatment or clinical characteristics did not explain the results. These findings support the hypothesis that repeated spells of depressive illness, when characterised by anxiety and agitation, lead to a sustained rise in blood pressure.
Quality improvement over time: hospital characteristics associated with increased usage of beta-blockers after myocardial infarction
Authors: Jennifer A. Mattera, Jeph Herrin, Elizabeth H. Bradley, Eric S. Holmboe, Paul Frederick, Hal V. Barron, Katherine A. Littrell, Nathan R. Every, Harlan M. Krumholz
Journal: Journal of the American College of Cardiology (2002)
Clarification of comments on trial of aminosidine in visceral leishmaniasis
Authors: P Olliaro, T K Jha
Journal: BMJ (1998)

EDITOR—We would like to clarify five points in relation to Lockwood's commentary on our randomised controlled trial of aminosidine (paromomycin) for treating visceral leishmaniasis in Bihar, India.1

Patients being screened for possible inclusion in the study were tested for HIV infection; all of the 120 patients included were negative for HIV. None of the patients tested (around …
Dual SPECT Imaging With Tc-99m Pyrophosphate and Tl-201 of Circumferential Subendocardial Myocardial Infarction in Aortic Stenosis Without Coronary Artery Stenosis
Authors: Tetsuhiro Yamano, Yoshikazu Kosugi, Takeshi Nakamura, Takahisa Sawada, Akihiro Azuma, Hiroaki Matsubara, Hiroki Sugihara
Journal: Clinical Nuclear Medicine (2008)

An 88-year-old woman with aortic stenosis, who had demonstrated fever for several preceding days, complained of angina and orthopnea. Although the symptoms were suggestive of acute myocardial infarction, coronary angiography failed to demonstrate coronary artery stenosis. Dual SPECT with Tc-99m pyrophosphate and Tl-201 demonstrated an abnormal accumulation of the former tracer throughout the inner layers of the left ventricle, indicating circumferential subendocardial infarction. Confirmation of this diagnosis is often difficult, and there have been only a few documented cases. However, the present images clearly depicted this unusual view of infarction in a patient with aortic stenosis but without coronary artery stenosis.
Benzodiazepine Prescription Regulations-Reply
Authors: Michael Weintraub
Journal: JAMA (1992)

In Reply.  —As noted in our article, 1 my colleagues and I agree with Dr Sampson that triplicate prescription blanks for benzodiazepines create important practical impediments to appropriate prescribing. Control mechanisms always have positive and negative aspects. Perhaps the self-regulation imposed by the multicopy prescription programs will lead to more thoughtful prescribing and better patient outcomes. The programs may also lead to the prescribing of less effective, more toxic, but uncontrolled alternatives, as our study indicated. Even worse, regulations may lead to failure to prescribe indicated therapy. I do not believe that a complete assessment of the benefit-to-detriment relationship of the triplicate prescription program for benzodiazepines has yet been carried out.  Several states have instituted programs in which pharmacists computerize information on the patient receiving and the physician prescribing certain medications. While perhaps avoiding some of the practical problems noted by Sampson, such a system still intrudes on the patient-physician
A Novel OPA3 Mutation Revealed by Exome Sequencing
Authors: Beenish Arif, Kishore R. Kumar, Philip Seibler, Franca Vulinovic, Amara Fatima, Susen Winkler, Gudrun Nürnberg, Holger Thiele, Peter Nürnberg, Ahmad Zeeshan Jamil, Anne Brüggemann, Ghazanfar Abbas, Christine Klein, Sadaf Naz, Katja Lohmann
Journal: JAMA Neurology (2013)

We sought to unravel the genetic cause in a consanguineous Pakistani family with a complex neurological phenotype.Neurological and ophthalmological examination, including videotaping and fundoscopy, and genetic investigations, including homozygosity mapping and exome sequencing, were performed at the University of the Punjab and the University of Lübeck. Participants included 2 severely affected cousins from consanguineous parents, 10 of their reportedly unaffected relatives, and 342 Pakistani controls. Motor symptoms in the 2 patients started at the age of 3 to 4 years and included chorea, cerebellar ataxia, dystonia, and pyramidal tract signs. Genome-wide genotyping delineated 2 regions of homozygosity on chromosomes 13q12.11 to 13q12.13 and 19q12 to 19q13.41. Exome sequencing revealed 2 rare, homozygous variants (c.32 T>A [p.L11Q] in OPA3 and c.941 C>G [p.A314G] in TSHZ3) that segregated with the disease. Only the OPA3 variant was absent in the control subjects and predicted to be damaging. Subsequent ophthalmological assessment revealed bilateral optic atrophy in both patients.Mutations in OPA3 have been reported in Costeff optic atrophy syndrome. We identify a novel missense mutation in OPA3 as the cause of a complex neurological disorder, expanding the OPA3 -linked phenotype by early-onset pyramidal tract signs and marked lower limb dystonia. Investigation of optic atrophy was initiated only after genetic analysis, a phenomenon referred to as reverse phenotyping.
Long-term All-Cause Mortality in Cancer Patients With Preexisting Diabetes Mellitus
Authors: Bethany B. Barone, Hsin Chieh Yeh, Claire F. Snyder, Kimberly S. Peairs, Kelly B. Stein, Rachel L. Derr, Antonio C. Wolff, Frederick L. Brancati
Journal: JAMA (2008)

<h3>Context</h3>Diabetes mellitus appears to be a risk factor for some cancers, but the effect of preexisting diabetes on all-cause mortality in newly diagnosed cancer patients is less clear.<h3>Objective</h3>To perform a systematic review and meta-analysis comparing overall survival in cancer patients with and without preexisting diabetes.<h3>Data Sources</h3>We searched MEDLINE and EMBASE through May 15, 2008, including references of qualifying articles.<h3>Study Selection</h3>English-language, original investigations in humans with at least 3 months of follow-up were included. Titles, abstracts, and articles were reviewed by at least 2 independent readers. Of 7858 titles identified in our original search, 48 articles met our criteria.<h3>Data Extraction</h3>One reviewer performed a full abstraction and other reviewers verified accuracy. We contacted authors and obtained additional information for 3 articles with insufficient reported data.<h3>Results</h3>Studies reporting cumulative survival rates were summarized qualitatively. Studies reporting Cox proportional hazard ratios (HRs) or Poisson relative risks were combined in a meta-analysis. A random-effects model meta-analysis of 23 articles showed that diabetes was associated with an increased mortality HR of 1.41 (95% confidence interval [CI], 1.28-1.55) compared with normoglycemic individuals across all cancer types. Subgroup analyses by type of cancer showed increased risk for cancers of the endometrium (HR, 1.76; 95% CI, 1.34-2.31), breast (HR, 1.61; 95% CI, 1.46-1.78), and colorectum (HR, 1.32; 95% CI, 1.24-1.41).<h3>Conclusions</h3>Patients diagnosed with cancer who have preexisting diabetes are at increased risk for long-term, all-cause mortality compared with those without diabetes.
717. Cancer Gene Therapeutic Approaches Using an AAV-Mediated Gene Delivery System Containing Antisense VEGF-A cDNA
Authors: Keerang Park, Mee-Young Ahn, Seock-Yeon Hwang, Young-Hwa Cho, Bong-Su Kang, Youn-Ju Kim, Sung-Ha Cho, Young-Min Kim, So-Yong Yi, Sun-Kyung Kim, Eun-Jung Park, Kang-Eun Lee
Journal: Molecular Therapy (2005)

Gene therapy has offered potential promises for treatment of cancers, as a variety of genes controlling molecular processes can be introduced by gene transfer, which can arrest angiogenesis, tumor growth, invasion and/or metastasis. The establishment of an angiogenic requirement for tumor growth led to develop anti-angiogenic therapies, ranging from inhibition of expression of angiogenic molecules, through overexpression of antiangiogenic factors. Although adenovirus-based vector has been commonly used for this strategy due to advantages of gene therapy over purified antiangiogenic factors, gene expression mediated by adenoviral vector is greatly limited by an effective host immune response and also secondary to the episomal nature of the vector. However, the advantages of rAAV over other vectors are multiple, including a non-pathogenic vector with a very limited host immune response and long-term persistent expression of AAV transgenes. Here we investigated the potential anti-angiogenic cancer gene therapy of AAV-mediated gene delivery system containing antisense VEGF-A (rAAV-AShVEGF-A). The efficiency of rAAV transduction of T84, LCSC#1, MKN45, MKN74 and NUGC3 human cancer cell lines is significantly high (>90%). The expression of VEGF-A was greatly reduced (>60%) when T84 and LCSC#1 were treated with rAAV-AShVEGF-A. Moreover, the growth of tumor implanted in nude mice were highly inhibited (>40%) by injection of rAAV-AShVEGF-A. We also performed the preclinical safety evaluations of repeated dose toxicity, immunotoxicity, genotoxicity and reproductive performance toxicity on rAAV vectors. No results of preclinical tests that we carried out in this study revealed any adverse effects as a gene delivery system.
Blood Transfusion Therapy in Behçet's Disease
Authors: J. DESMOND O'DUFFY
Journal: Annals of Internal Medicine (1974)

Comments and Corrections1 February 1974Blood Transfusion Therapy in Behçet's DiseaseJ. DESMOND O'DUFFY, M.B., HOWARD F. TASWELL, M.D.J. DESMOND O'DUFFY, M.B.Search for more papers by this author, HOWARD F. TASWELL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-80-2-279_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In 1971, while reporting on the clinical manifestations of 10 patients with Behçet's disease, we alluded to the beneficial results of hemotherapy in 3 patients (1). In one woman (Case 9), fulminant colitis and mucosal ulcers disappeared after transfusion with 3 units of fresh, whole blood. Remission continued for 2 years, that is, from April 1970 to May 1972. Then, uveitis, oral and vaginal ulcers, synovitis, colitis, erythema nodosum, and anemia recurred. A rectovaginal fistula developed, and colectomy was advised. The patient refused surgery but again agreed to try blood transfusions (the hemoglobin level was 8.8 g/dl)....Reference1. O'DUFFYCARNEYDEODHAR JJS: Behçet's disease. Report of 10 cases, 3 with new manifestations. Ann Intern Med 75:561-570, 1971 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mayo Clinic and Mayo Foundation Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBehçet's DiseaseKutaneo-uveales Syndrom (Behçet)Behçet's diseaseBehçet disease (Behçet syndrome)TREATMENT OF BEHCET'S DISEASE WITH TRANSFER FACTOR11Supported by NIH grant 1R01AM19644and AMO1RR-65Ocular manifestations of Behcet's diseaseNeurologic involvement in seven patients with Behçet's diseaseFurther studies of platelet rosettes around granulocytes in Behcet's syndrome 1 February 1974Volume 80, Issue 2Page: 279-279KeywordsAnemiaBlood transfusionColectomyColitisErythemaFistulasHemoglobinSurgeryUlcersUveitis Issue Published: 1 February 1974 PDF DownloadLoading ...