tbuckley/cabot-search huggingface dataset:
Development of a Disease-specific Health-related Quality of Life Questionnaire for Sleep Apnea
Authors: W. WARD FLEMONS, MARLENE A. REIMER
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The Calgary Sleep Apnea Quality of Life Index (SAQLI) was developed to record key elements of the disease that are important to patients. All items felt to influence the quality of life of these patients were identified. Final questionnaire items were selected by interviewing 113 patients with sleep apnea and 50 snorers who rated each item on whether it was a problem and the importance of it to their overall quality of life. Items for the final questionnaire were selected based on the rank order of the frequency × importance product. The rank ordering was similar across strata of disease severity and between sexes. The Calgary SAQLI has 35 questions organized into four domains: daily functioning, social interactions, emotional functioning, and symptoms. A fifth domain, treatment-related symptoms, can be added for clinical intervention trials to record the possible negative impacts of treatment. The SAQLI has a high degree of internal consistency, face validity as judged by content experts and patients, and construct validity as shown by its positive correlations with the SF-36 and the improvement in scores in patients successfully completing a 4-wk trial of continuous positive airway pressure. It includes items shown to be important to patients with sleep apnea and is designed as a measure of outcome in clinical trials in sleep apnea. Flemons WW, Reimer MA. Development of a disease-specific health-related quality of life questionnaire for sleep apnea.
NHS, not police, should be responsible for medical examination of rape victims
Authors: C. Dyer
Journal: BMJ (2010)

The medical examination of rape victims in England and Wales should no longer be the responsibility of police forces but should be brought under the umbrella of the NHS, two reports commissioned by the government have strongly urged.

A report on the treatment of rape victims from a team led by the cross bench peer Vivien Stern has “wholeheartedly” supported a proposal to transfer the funding and commissioning of forensic medical services from the police to the NHS.

The Stern report, commissioned by the Government Equalities Office and the Home Office, endorsed the view of the taskforce on the health aspects of violence against women and children, which reported last week …
Health Data in the Information Age: Use, Disclosure, and Privacy
Authors: Leslie L. Cortés
Journal: JAMA (1994)

Medicine has a tradition of concern for the individual patient. Law has a tradition of delicately balancing the goals of society against the needs of the individual. Computer science is still too young to have a single tradition, but it has from its beginnings expressed concern for the social implications of its technologies. In this remarkable book, the three disciplines meet to consider the social consequences of comprehensive medical databases. Robust databases that include both clinical and administrative data are evolving. As these become more inclusive, comprehensively covering a defined population, they become a valuable source of data that can be used to generate hypotheses, study practice patterns, and guide public policy. The same data can also be misused to deny employment, entitlement, and opportunities to individuals or groups identified in the database. A specialized organization is needed to collect, maintain, and analyze data sets that may encompass an entire
Thromboembolic Disorders And Oral Contraceptives
Authors: Harald Frederiksen
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Drill and Calhoun (<b>206</b>:77, 1968) list the annual death rates in England and Wales from thromboembolic disorders for females and males 20 to 44 years of age and conclude that there was some increase in the death rate for both women and men, but there was no significant change in the ratio of female to male deaths during the period of large-scale use of oral contraceptives since 1961. Correct interpretation of mortality<i>ratios</i>can be difficult, since an increase in the<i>ratio</i>of female to male deaths could be the result of a decrease in the death<i>rates</i>for males as well as an increase in the death<i>rates</i>for females. If we are trying to learn whether there has been a greater increase in female mortality we must primarily rely on comparison of trends of<i>rates</i>rather than<i>ratios</i>. In fact, in England and Wales,
The Schilling Test
Authors: RALPH CARMEL
Journal: Annals of Internal Medicine (1980)

Letters1 April 1980The Schilling TestRALPH CARMEL, M.D.RALPH CARMEL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-4-570_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the October 1979 issue Drs. Jacobson and Onstad (1) described a Schilling test artifact caused by inactive commercial intrinsic factor. That report is an important reminder of the vagaries of commercial preparations and illustrates why each laboratory should monitor its methods and materials and not abandon this function to the suppliers. Similar intrinsic factor potency problems in a different laboratory procedure have also contributed to artifactual results in the radioassay for serum vitamin B12 (2).Still another intrinsic factor problem in testing vitamin B12 absorption can be mentioned. Confusing results may occur with the so-called "double-isotope"...References1. JACOBSON B and ONSTAD G. Misleading second-stage Schilling tests due to inactive intrinsic factor concentrate. Ann Intern Med. 1979;91:579-80. LinkGoogle Scholar2. KOLHOUSE J, KONDO H, ALLEN N, PODELL E, and ALLEN R. Cobalamin analogues are present in human plasma and can mask cobalamin deficiency because current radioisotope dilution assays are not specific for true cobalamin. N Engl J Med. 1978;299:785-92. CrossrefMedlineGoogle Scholar3. KNUDSEN L and HIPPE E. Vitamin B12 absorption evaluated by a dual isotope test (Dicopac®). Scand J Haematol. 1974; 13:287-93. CrossrefMedlineGoogle Scholar4. LINDENBAUM J, PEZZIMENTI J, and SHEA N. Small-intestinal function in vitamin B12 deficiency. Ann Intern Med. 1974;80:326-31. LinkGoogle Scholar5. LINDENBAUM J. Aspects of vitamin B12 and folate metabolism in malabsorption syndromes. Am J Med. 1979;67:1037-48. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: RALPH CARMEL, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1980Volume 92, Issue 4Page: 570-571KeywordsResearch laboratories ePublished: 1 December 2008 Issue Published: 1 April 1980 PDF downloadLoading ...
Preexposure Prophylaxis Against Rabies
Authors: Ernest S. Tierkel
Journal: JAMA (1967)

During investigations to determine a satisfactory, practical preexposure regimen for administering rabies vaccine to groups of people at high risk, a total of 540 volunteers received vaccine of chick or duck embryo origin. The results of these studies indicate that the most practical regimen consists of two subcutaneous injections of 1.0 ml of duck embryo rabies vaccine given a month apart followed by a booster of 1.0 ml of the vaccine seven months after the second injection. Ninety percent of the volunteers who were on this regimen had a detectable serum neutralizing antibody titer one month after the last injection.
Angiotensin-Converting Enzyme 2 — A New Cardiac Regulator
Authors: Manfred Boehm, Elizabeth G Nabel
Journal: New England Journal of Medicine (2002)

The renin–angiotensin system is a master regulator of human physiology. It controls blood pressure and fluid and electrolyte balance through coordinated effects on the heart, blood vessels, and kidneys. In the classic pathway of the renin–angiotensin system, renin is secreted from the juxtaglomerular apparatus of the kidney and acts on the circulating precursor angiotensinogen to generate angiotensin I (Figure 1). Angiotensin I has little effect on blood pressure and is converted in the lungs by angiotensin-converting enzyme (ACE) to angiotensin II. A potent vasopressor, angiotensin II acts on the heart and the kidneys by binding to the G protein–coupled receptors . . .
Gonorrhea in the Obstetric and Gynecologic Clinic
Authors: Vernal G. Cave
Journal: JAMA (1969)

Eight hundred and seventy-five patients admitted to the obstetric and gynecologic clinics of a large voluntary hospital in an urban community were examined routinely for gonorrhea with smears and cultures of specimens from the urethra, cervix vagina, and, in 153 instances, from the anal canal. Seventy-two cases of gonorrhea were proved, for a rate of infection of 8.2%. The rate of infection in the obstetric group was 5.5%, and in the gynecologic group, 11.1%. An additional eight patients with positive smears but negative cultures make a total of 80 cases of diagnosed or presumptive gonorrhea, for a rate of 9.1%. The most frequently positive site was the cervix. In this series there was no increased yield by the additional use of the Novak curettage method as compared with obtaining specimens with the platinum loop.
Medical Assessment by a Delphi Group Opinion Technic
Authors: Arthur V. Milholland, Stanley G. Wheeler, John J. Heieck
Journal: New England Journal of Medicine (1973)

Abstract The Delphi technic is a method for obtaining answers to questions that are issues of uncertainty even to experts. Its use for finding a group consensus is illustrated here by its application to a problem of predicting human mortality from an experiment in which trauma to the liver was produced in animals by a riotcontrol device. Expert surgeons were asked to fill in a questionnaire in which they estimated human mortality as a function of the severity of the injury. These initial estimates were then modified by application of a second round of the Delphi technic. Although inherent uncertainties remained, there was a marked increase in the consistency of the answers from the first to the second round. Evidence suggests an increase in reliability as well. (N Engl J Med 288:1272–1275, 1973)
Hepatitis B in general practice: epidemiology, clinical and serological features, and control.
Authors: W B Clee, P R Hunter
Journal: BMJ (1987)

In an outbreak of hepatitis B virus infection in a south Wales village 31 cases were identified over 16 months. Spread of the infection was by sharing needles and by sexual contact. Twenty seven patients were known to have symptoms, of whom nine had an anicteric illness. Generally the illness was mild with no deaths, and there was only one chronic carrier. Two patients were only transiently positive for hepatitis B surface antigen. The outbreak was controlled by vigorous contact tracing and counselling. Despite an enormous increase in workload for the general practitioner and problems including disposal of contaminated needles, outbreaks of hepatitis B virus infection may adequately be treated in the community.
Nominal Competence in Health Care
Authors: Gautham Suresh
Journal: JAMA (2014)

It had been a busy weekend on call, with several critically ill babies admitted to the neonatal intensive care unit. Mrs Johnson, the mother of one of these babies, was sitting next to her baby’s incubator. As the attending neonatologist in charge, I had just introduced myself to her. That’s when she told me that would never be able to remember my name. This was nothing new. I’ve heard similar comments from other parents in the past. Several years ago the mother of another of my patients told me proudly how she managed to remember my name: “I’ll always remember your name because I told myself that Dr Suresh sounds like David Koresh!” In addition to not remembering my name, patients (and colleagues) very frequently mispronounce my name. Some have admitted, often apologetically, that they have difficulty pronouncing my name.
The Goulstonian Lectures on the Chemistry and Pathology of Gout: Delivered before the Royal College of Physicians, March, 1897
Authors: A. P. Luff
Journal: BMJ (1897)

WHEN I accepted the duty of delivering the Goulstonian Lectures for this year I was deeply sensible of the honour -conferred upon me, and of the serious responsibility that I incurred.As the youngest Fellow of this College I should, perhaps, not have ventured to discourse to you on the subject of gout-a subject which has been so enriched and so ably dealt with in the past by many distinguished Fellows of this College-were it not that I thought the occasion was a con- venient one briefly to review the various opinions held as to the causation and nature of gout, and, at the same time, to place before you the results of some experimental work that I have, been conductlng
Advanced Lipoprotein Testing Does Not Improve Identification of Subclinical Atherosclerosis in Young Adults: The Bogalusa Heart Study
Authors: Wendy S. Tzou, Pamela S. Douglas, Sathanur R. Srinivasan, Wei Chen, Gerald Berenson, James H. Stein
Journal: Annals of Internal Medicine (2005)

Background: The clinical value of advanced lipoprotein testing relative to traditional lipid testing remains controversial. To date, no studies have evaluated associations between advanced lipoprotein testing and subclinical atherosclerosis in healthy young adults. Objective: To determine whether advanced lipoprotein testing using vertical-spin density-gradient ultracentrifugation better predicts carotid intima-media thickness, a validated measure of subclinical atherosclerosis, than does traditional lipoprotein testing in asymptomatic young adults. Design: Cross-sectional community-based study. Setting: Bogalusa, Louisiana. Participants: 311 randomly selected adults from the Bogalusa Heart Study who were 20 to 38 years of age. Measurements: The authors performed advanced lipoprotein testing using vertical-spin density-gradient ultracentrifugation, traditional testing using enzymatic methods, and Friedewald formula estimation of low-density lipoprotein cholesterol levels. A certified reader blinded to lipoprotein results determined carotid intima-media thickness by B-mode ultrasonography. C-statistics from area under the receiver-operating characteristic curves (AUCs) derived from multivariable regression models were compared. Results: Lipid values obtained with advanced lipoprotein testing did not predict carotid intima-media thickness better than traditionally measured lipid values in 236 participants for whom all data were available. A model using traditional lipoprotein measures (AUC, 0.754 [95% CI, 0.690 to 0.812]) did not differ significantly from a model using advanced lipoprotein measures (AUC, 0.779 [CI, 0.662 to 0.871]) for prediction of carotid intima-media thickness (P > 0.2). Subclass pattern of LDL, lipoprotein(a) cholesterol, intermediate-density lipoprotein cholesterol, high-density lipoprotein cholesterol subclasses, and very-low-density lipoprotein subclasses did not improve the performance of models for prediction of carotid intima-media thickness. Limitations: The study was cross-sectional, cardiac events were not determined, and only 1 method of advanced lipoprotein testing was used. Conclusions: Advanced lipoprotein testing using vertical-spin density-gradient ultracentrifugation did not improve prediction of carotid intima-media thickness in young adults and may not be useful for assessing cardiovascular risk in this population.
What the Public Wants
Authors: Hugh A. Johnson
Journal: JAMA (1963)

To the Editor:  —A good percentage of my patients are referred by lawyers, insurance adjusters, and other patients. Often, after the immediate plastic surgical problem is solved, I'm asked, Now, could you recommend a good family doctor for another problem? Please notice at once that the question is not, Could you recommend a good specialist for such and such a problem? The public seems to want good family doctors. The conclusion I draw from these incidents is that some general practitioners must not be giving people what they want. I believe the fault is that such general practitioners are trying to become specialists in many fields, and as such they are no longer performing their prime function; they have become poorly trained specialists and poor family doctors.  No one can deny that the trend must be toward more specialization in all endeavors, including the healing art. It is inevitable, for
Macrophage microvesicles induce macrophage differentiation and miR-223 transfer
Authors: Noura Ismail, Yijie Wang, Duaa Dakhlallah, Leni Moldovan, Kitty Agarwal, Kara Batte, Prexy Shah, Jon Wisler, Tim D. Eubank, Susheela Tridandapani, Michael E. Paulaitis, Melissa G. Piper, Clay B. Marsh
Journal: Blood (2012)
Current practice in transferring critically ill patients among hospitals in the west of Scotland.
Authors: W G Reeve, C J Runcie, J Reidy, P G Wallace
Journal: BMJ (1990)

To identify the requirements of an interhospital transfer service for critically ill patients.Retrospective survey of the current functions of a specialist interhospital transfer team from data collected at the time of transfer and from records of intensive care unit.Mobile intensive care unit based at a tertiary referral centre, which serves the west of Scotland.All critically ill patients (378) transferred between hospitals by the unit from 1986 to 1988.365 Patients were transferred by road and 13 by air. There was a wide variation in age (range 6 weeks to 87 years), diagnosis, reason for transfer, support required, and distance travelled. Most patients (232) were transferred for respiratory or cardiovascular support; 100 were trauma cases. 300 Patients (79%) were mechanically ventilated during transfer. No patient died in transit, although the eventual mortality was 28% (105 patients). Mortality was significantly higher in patients transferred from hospitals with intensive care units than from those without (38% (125 patients) v 23% (253); p less than 0.005).Safe interhospital transfer of critically ill patients is feasible; the high eventual mortality in some patient groups emphasises the need for accurate prediction of outcome if inappropriate transfer is to be avoided. The findings may help in organising secondary transfer services in future.
Recombinant self-assembling peptides as biomaterials for tissue engineering
Authors: Stuart Kyle, Amalia Aggeli, Eileen Ingham, Michael J. McPherson
Journal: Biomaterials (2010)

Synthetic nanostructures based on self-assembling systems that aim to mimic natural extracellular matrix are now being used as substrates in tissue engineering applications. Peptides are excellent starting materials for the self-assembly process as they can be readily synthesised both chemically and biologically. P₁₁-4 is an 11 amino acid peptide that undergoes triggered self-assembly to form a self-supporting hydrogel. It exists as unimers of random coil conformations in water above pH 7.5 but at low pH adopts an antiparallel β-sheet conformation. It also self-assembles under physiological conditions in a concentration-dependent manner. Here we describe an unimer P₁₁-4 production system and the use of a simple site-directed mutagenesis approach to generate a series of other P₁₁-family peptide expression vectors. We have developed an efficient purification strategy for these peptide biomaterials using a simple procedure involving chemical cleavage with cyanogen bromide then repeated filtration, lyophilisation and wash steps. We report peptide-fusion protein yields of ca. 4.64 g/L and we believe the highest reported recovery of a recombinant self-assembling peptide at 203 mg/L of pure recombinant P₁₁-4. This peptide forms a self-supporting hydrogel under physiological conditions with essentially identical physico-chemical properties to the chemically synthesised peptide. Critically it also displays excellent cytocompatibility when tested with primary human dermal fibroblasts. This study demonstrates that high levels of a series of recombinant self-assembling peptides can be purified using a simple process for applications as scaffolds in tissue engineering.
Zidovudine for Thrombocytopenic Purpura Related to Human Immunodeficiency Virus (HIV) Infection
Authors: Eric Oksenhendler
Journal: Annals of Internal Medicine (1989)

Study Objective: To determine whether zidovudine is effective in increasing the platelet count in patients with thrombocytopenic purpura related to human immunodeficiency virus (HIV) infection. Design: Nonrandomized controlled trial with two consecutive regimens. Setting: Immunopathology and hematology clinics at two general hospitals. Patients: Consecutive sample of 34 patients infected with HIV who had thrombocytopenic purpura (platelets < 50 X 109/L) without visceral bleeding. Twenty-nine patients completed the study; one patient was removed because of drug toxicity. Interventions: Zidovudine for 12 weeks, 250 mg every 6 hours orally in 10 patients; and 500 mg every 8 hours orally in 24 patients. Measurements and Main Results: Three of ten patients receiving 250 mg every 6 hours and 12 of 24 patients receiving 500 mg every 8 hours had a persistent increase in their platelet counts. In both groups the mean value of the platelet count increased significantly by week 12; from 28 X 109/L ± 12 (SD) to 57 X 109/L ± 36 in the first group and from 20 X 109/L ± 13 to 77 X 109/L ± 42 in the second group (P < 0.05 and P < 0.01, respectively). Conclusions: Zidovudine is effective on platelet counts in some patients with HIV-related thrombocytopenia. These results suggest that HIV itself may play a direct or indirect role in the pathogenesis of this disorder.
Letter: Semen cryobanking.
Authors: J Slome
Journal: BMJ (1974)

than 40 Mg/ 100 ml one begins to have somne awareness of the gravity of the situation.7In view of these results we think it regrettable that the authorities in Britain have not seen fit to institute a similar screening programin,e on children in British cities.No doubt too much time would be spent in d-eciding which laboratory could be trusted to provide the right blood lead levels.The appearance of the "chicken-or-the- egg" hypothesis was predictable but un- necessary in view of a nunber of ellegant s:udies from America which ihave demon- stra:.edthat hyperactivity can be induced in rats suckled by mothers fed lead in their diets,8-"1 whereas those suckled by mothers on nornal diets are unaffected.This hyperactive behaviour shows a paradoxical pattern of response to drug treatment identical with that of "pure" hyperactivity in children1l