tbuckley/cabot-search huggingface dataset:
Risk of new myocardial infarction in middle-aged men with manifest coronary heart disease.
Authors: C D Jenkins, S J Zyzanski, R H Rosenman
Journal: Circulation (1976)

Men incuring coronary heart disease (CHD) during surveillance of an employed population were studied for risk factors associated with additional myocardial infarctions. The coronary-prone Type A behavior pattern measured by a test score, number of cigarettes smoked daily, and serum cholesterol were significantdiscriminators between the 67 men with recurrent CHD and the 220 with but a single clinical CHD event. Diastolic blood pressure and fasting serum triglycerides were not significant discriminators. Statistical analyses directed to possible sources of bias occasioned by the combined retrospective-prospective study design revealed that these problems are negligible and do not alter the findings observed. Type A score appears relatively unaffected by whether the measure was made before or after the initial CHD event. Multivariable discriminant function equations showed Type A score to be the strongest single predictor of recurrent CHD among the variables available. Number of cigarettes smoked and serum cholesterol accounted for additional variance. Future field trials for the secondary prevention of myocardial infarction would be strengthened by consideration of the possible role of Type A behavior.
Increased cerebrovascular resistance in cirrhotic patients with ascites
Authors: Mónica Guevara, Concepción Bru, Pere Ginès, Gloria Fernández-Esparrach, Pau Sort, Ramón Bataller, Wladimiro Jiménez, Vicente Arroyo, Juan Rodés
Journal: Hepatology (1998)

Studies assessing regional hemodynamics in patients with cirrhosis and ascites have shown vasodilation in the splanchnic circulation and vasoconstriction in the renal circulation and in the brachial and femoral artery vascular territories.The aim of this study was to assess the cerebral vascular resistance in cirrhotic patients with ascites.The resistive index in the middle cerebral artery (an index of the cerebral vascular resistance)and in a renal interlobar artery were measured by Doppler ultrasonography in 7 healthy subjects: 13 patients with compensated cirrhosis and 24 patients with ascites (13 with renal failure).The arterial blood pressure and the activity of the renin-angiotensin and sympathetic nervous systems, as estimated by plasma renin activity and plasma norepinephrine concentration, respectively, were also measured. The resistive index in the middle cerebral artery was significantly increased in patients with ascites (0.68 ± 0.05, mean ± SD)as compared with patients without ascites (0.60 ± 0.01, P &lt;.05) and with healthy patients (0.52 ± 0.01, P &lt;.01).Renal resistive index was also increased in patients with ascites (0.77 ± 0.01) compared with the other two groups (0.68 ± 0.02 and 0.62 ± 0.00, respectively; P &lt; .001). The resistive index in the middle cerebral artery showed a direct correlation with renal resistive index ( r = .73, P &lt; .01), plasma renin activity ( r = .61, P &lt; .01), and norepinephrine ( r = .53, P &lt; .01). The resistive index in the middle cerebral artery showed an inverse correlation with mean arterial pressure ( r =−.45, P &lt; .01). These results indicate that in patients with cirrhosis and ascites there is a cerebral vasoconstriction which is probably related with the arterial hypotension and the overactivity of vasoconstrictor systems.
Disaster agencies treat wounded after Italian earthquake damages hospital
Authors: J. Zarocostas
Journal: BMJ (2009)

The earthquake that struck the town of L’Aquila, in central Italy, on 6 April has killed more than 270 people, injured more than 1500, made 40-50 000 people homeless, and seriously damaged the main hospital, officials from the Italian Red Cross and the World Health Organization have said.

The quake, which had magnitude 6.3, underscores the need to make hospitals safe in emergencies, said WHO.

L’Aquila’s 500 bed hospital, built 15 years ago, had to be evacuated because part of it had …
Underreporting of Alcohol-Related Mortality on Death Certificates of Young US Army Veterans
Authors: Daniel A. Pollock
Journal: JAMA (1987)

We assessed the validity of death certificate data for alcohol-related mortality in a population-based follow-up study of young, male US Army veterans. In a random sample of more than 18,000 men who entered the service between 1965 and 1971, there were 446 postservice deaths through Dec 31, 1983. For 426 of these deaths, we obtained both the death certificate and all other available medical and legal records pertaining to cause of death. A nosologist recorded each death certificate in accordance with the ninth revision of the International Classification of Diseases. A medical panel, without having access to the death certificates, assigned underlying and contributory causes of death on the basis of a review of only the medical and legal records. The panel recorded 133 alcohol-related deaths, or more than six times the number (21 deaths) determined by the original death certifiers. Omission of elevated blood alcohol levels in deaths due to injury accounts for most of the underreporting of alcohol-related mortality on the death certificates. Our findings suggest that death certificate data grossly underestimate the contribution of alcohol to mortality, especially in the area of injury, and the validity of official vital statistics for alcohol-related deaths would be enhanced if death certifiers incorporated all available antemortem and postmortem diagnostic information.
Children at risk: in the heat of the moment
Authors: P. J Robb
Journal: BMJ (2001)

As the south of England enjoyed an unexpected heat wave, I was forced into confrontation with two middle class and well presented young mothers whose small children were at risk.

At an afternoon outreach clinic, I was running about 10 minutes late and the next patient I was due to see was a 4 year old girl for assessment of possible hearing loss. As I opened the consulting room door to call her in, I was struck by a general commotion in the waiting room. The little girl appeared at my consulting room on her own.

It transpired that her younger brother had been left by mum in the car …
The Pathology of Testicular Tumors
Authors: Bernard R. Sears
Journal: JAMA (1965)

This landmark in the literature of testicular tumors proves that at least in certain matters research-by-committee can succeed handsomely. During a six-year period, the Testicular Tumor Panel of eight pathologists resident in five cities of Great Britain collected 1,194 cases. The eight pathologists individually examined every specimen and clinical abstract and have published the most exhaustive study on the subject in English, valuable alike for primary instruction, for review, and for reference. The title understates the scope of the monograph, which gives a full account of the natural history of testicular masses, proceeding from embryology through pathology to clinical behavior and clinical results. Since the authors did not plan a survey of the entire field, they omitted discussion of experimental work and of therapeutic methods. Their purpose was to scrutinize all facets of their material and to record findings. They fixed steadily on the data, used references only for illumination,
Changes in Body Composition in Patients with Small-Cell Lung Cancer
Authors: MOSHE SHIKE
Journal: Annals of Internal Medicine (1984)

Body composition was studied in 31 patients receiving chemotherapy for small-cell lung cancer. Patients were randomly assigned to receive either 4 weeks of total parenteral nutrition (study group) or to continue a self-regulated oral diet (control group). The relationship between height and total body nitrogen was altered initially for patients who had lost more than 5% of body weight. During the 4 weeks of parenteral nutrition, body weight, total body fat, and total body potassium, but not total body nitrogen, increased significantly in the study group (p < 0.001). However, after parenteral nutrition was stopped, body weight and potassium levels in the study group fell significantly and to the same extent as in the control group. Nitrogen levels showed an overall fall in the 32 weeks of observation for both groups. After the period of parenteral nutrition, the decrease in body fat was significantly greater in the control group than in the study group (p < 0.05). Thus, parenteral nutrition increased body fat and total body potassium, but not total body nitrogen.
Cost-Free Prevention to Asymptomatic Bacteriuria in Diabetic Women
Authors: Anna Cantagallo, Michela Delli Castelli
Journal: Diabetes Care (2001)

We read with interest the article of Geerlings et al. (1) that analyzed asymptomatic bacteriuria as a complication in diabetic women. It is known that urinary tract infections (UTIs) are an important problem in diabetic individuals, and bacteriuria is more common in diabetic women than in nondiabetic women (2) because of several factors that predispose diabetic individuals to infection (3). Furthermore, many UTIs are asymptomatic, and, as observed by Vejlsgaard (4), it is not clear if symptomatic infections are preceded by asymptomatic bacteriuria (ASB). Several studies confirm that there is a higher prevalence of ASB in diabetic women than in nondiabetic women (1). Unfortunately, ASB is not easily detected, even if there are some elements and clinical signs that indicate the presence of ASB. Furthermore, …
Reference equations for specific airway resistance in children: the Asthma UK initiative
Authors: J. Kirkby, S. Stanojevic, L. Welsh, S. Lum, M. Badier, C. Beardsmore, A. Custovic, K. Nielsen, J. Paton, W. Tomalak, J. Stocks
Journal: European Respiratory Journal (2010)

Plethysmographic specific airway resistance (s<i>R</i><sub>aw</sub>) is a useful research method for discriminating lung disease in young children. Its use in clinical management has, however, been limited by lack of consensus regarding equipment, methodology and reference data. The aim of our study was to collate reference data from healthy children (3–10 yrs), document methodological differences, explore the impact of these differences and construct reference equations from the collated dataset. Centres were approached to contribute s<i>R</i><sub>aw</sub> data as part of the Asthma UK initiative. A random selection of pressure–flow plots were assessed for quality and site visits elucidated data collection and analysis protocols. Five centres contributed 2,872 measurements. Marked variation in methodology and analysis excluded two centres. s<i>R</i><sub>aw</sub> over-read sheets were developed for quality control. Reference equations and recommendations for recording and reporting both specific effective and total airway resistance (s<i>R</i><sub>eff</sub> and s<i>R</i><sub>tot</sub>, respectively) were developed for White European children from 1,908 measurements made under similar conditions. Reference s<i>R</i><sub>aw</sub> data collected from a single centre may be misleading, as methodological differences exist between centres. These preliminary reference equations can only be applied under similar measurement conditions. Given the potential clinical usefulness of s<i>R</i><sub>aw</sub>, particularly with respect to s<i>R</i><sub>eff</sub>, methodological guidelines need to be established and used in prospective data collection.
Acute Renal Failure, Hemolytic Anemia, and Mycoplasma pneumoniae
Authors: Peter Schulman
Journal: JAMA (1980)

FULMINANT intravascular hemolysis is a well-described complication of<i>Mycoplasma pneumoniae</i>infection.<sup>1</sup>While the majority of patients with this disease may have raised cold hemagglutinin titers, severe hemolytic anemia is a relatively rare sequela.<sup>1</sup>The present communication describes a<i>Mycoplasma</i>infection in a patient in whom severe hemolysis and acute reversible renal failure developed. <h3>Report of a Case</h3> A 49-year-old woman with no known preexisting renal disease was well until six days before admission, when a productive, hacking cough developed for which she was given penicillin G potassium, 250 mg four times daily. When no improvement was noted two days later, she was given tetracycline hydrochloride, 250 mg four times daily. On the following day, she was noted to be jaundiced and confused and was admitted to her local hospital. Initial studies disclosed hematocrit value of 16%; BUN level, 58 mg/dL; creatinine level, 1.8 mg/dL; total bilirubin concentration, 5.5
LIMITS OF THE ANTI-INFECTIVE VALUE OF PROVITAMIN A (CAROTENE)
Authors: S. W. CLAUSEN
Journal: JAMA (1933)

Investigations have indicated with a high degree of certainty that carotene may be converted in the liver to vitamin A. This fact makes possible a chemical approach to the problem of the anti-infective action of vitamin A. In the studies about to be reported, the carotinoid pigments of the blood were determined by the method of Connor.1The pigments determined by this method include carotene and xanthophyll. In order better to understand the results obtained, the vitamin A content of the blood and of the liver in children coming to autopsy and in experimental animals was determined by a modification of the antimony trichloride test of Carr and Price.2The uncertainty of this method is recognized, but the results appear so consistent and the variations in different conditions are so large, that the method seems sufficient for our purpose. An arbitrary unit is employed. It is equal to
Angiopoietin-like 5 and IGFBP2 stimulate ex vivo expansion of human cord blood hematopoietic stem cells as assayed by NOD/SCID transplantation
Authors: Cheng Cheng Zhang, Megan Kaba, Satoru Iizuka, HoangDinh Huynh, Harvey F. Lodish
Journal: Blood (2008)

Abstract Hematopoietic stem cells (HSCs) are the basis of bone marrow transplantation and are attractive target cells for hematopoietic gene therapy, but these important clinical applications have been severely hampered by difficulties in ex vivo expansion of HSCs. In particular, the use of cord blood for adult transplantation is greatly limited by the number of HSCs. Previously we identified angiopoietin-like proteins and IGF-binding protein 2 (IGFBP2) as new hormones that, together with other factors, can expand mouse bone marrow HSCs in culture. Here, we measure the activity of multipotent human severe combined immunodeficient (SCID)–repopulating cells (SRCs) by transplantation into the nonobese diabetic SCID (NOD/SCID) mice; secondary transplantation was performed to evaluate the self-renewal potential of SRCs. A serum-free medium containing SCF, TPO, and FGF-1 or Flt3-L cannot significantly support expansion of the SRCs present in human cord blood CD133+ cells. Addition of either angiopoietin-like 5 or IGF-binding protein 2 to the cultures led to a sizable expansion of HSC numbers, as assayed by NOD/SCID transplantation. A serum-free culture containing SCF, TPO, FGF-1, angiopoietin-like 5, and IGFBP2 supports an approximately 20-fold net expansion of repopulating human cord blood HSCs, a number potentially applicable to several clinical processes including HSC transplantation.
Depression of the Chest from Posture: Consequent upon Posture in Occupation, Simulating the Depression of Phthisis
Authors: S. S. Alison
Journal: BMJ (1851)

SOME years ago, a man, about 40 years of age, requested my advice for severe pectoral symptoms, prostration of strength, and extreme emacia- tion.He believed himself to be suffering from consumption.His breathing was laboured; he spoke with eNident difficulty, and coughed almost incessantly.He expectorated a great deal, and perspired much: in short, he ran over the usual symptoms of a man in the last stage of phthisis.On his drawing off his shirt, in order to my making a closer exam- ination, I perceived that the forepart of the three upper left ribs was much depressed, and that, during inspiration, they failed to rise as in the healthy chest.So far, this corresponded with, and corroborated the idea of the patient himself, that his disease was consumption.But going further, I found that the cardiac and vocal resonance was not increased; that percussion elicited no materially dull sound; and that vesicular respiration was going forward, though mixed up with large mucous r&le.The other side of the chest was healthy in form.and likewise in sound, except that rhonchus in the larger air tubes was extensive.With these encouraging facts, I ventured to disregard the flattening of the left side, and assured the patient that his disease was not consumption.The treatment adopted was what is usual in such cases of bronchitis, and included counter-irritation.The more acute symptoms passed off, and in some months the patient was restored to his usual health.I had the curiosity to ascertain the subsequent history of this man,
Importance of Specialist Engagement in Accountable Care Organizations
Authors: Karen E. Joynt
Journal: Circulation (2014)

W e are in the midst of a tumultuous time in health policy.As new payment models gradually replace fee-forservice systems, new quality metrics proliferate, and costs of care become a bona fide health outcome, expensive imaging and procedures face increasing scrutiny.Responsible for >$300 billion in medical spending in 2010, 1 more than any other diagnostic group, cardiovascular disease is understandably at the forefront of many new efforts to improve quality and reduce costs of care.
Lack of Androgenicity of Siberian Ginseng
Authors: Donald P. Waller
Journal: JAMA (1992)

To the Editor.  —The recent controversy surrounding the case of neonatal/maternal androgenization associated with consumption of commercial purported Siberian ginseng ( Eleintherococcus senticosus ) tablets 1-3 prompted a laboratory investigation of the material's potential for androgenicity.  A tan-colored powdered substance, labeled Siberian white ginseng (lot No. 008303), was acquired from the implicated formulation's manufacturer (C. E. Jamieson Ltd, Windsor, Ontario, Canada), who identified it as raw material used in compounding formulations during the period when the adverse reaction was observed. Chemical, microscopic, and organoleptic analysis of this lot of material, as well as other lots from the same raw-material supplier—used to prepare formulations by this and other manufacturers—indicated that the material was Periploca sepium , the so-called Chinese silk vine. 3 The material examined was tested for androgenic effects using a method modified from that of Hershberger et al. 4   In summary, 20- to 22-day-old male Sprague-Dawley rats (N=10) were castrated and received
Mebendazole. Treatment of trichuriasis and ascariasis in Bahamian children
Authors: M. S. Wolfe
Journal: JAMA (1974)

Mebendazole (Vermox), a new broad-spectrum anthelminthic, was used in 107 Bahamian children with trichuriasis, 88 of whom had concomitant ascariasis, in a dose of 100 mg twice daily for three days. After treatment, three consecutive daily formalin-ether determinations and stool egg counts by the Stoll method were performed. Egg reduction rates of 97.6% and 99.5% were obtained for Trichuris trichiura and Ascaris lumbricoides , respectively. Respective cure rates were 68.2% and 98.8%. Drug tolerance was excellent and side effects were nil. Mebendazole was confirmed as a safe and easily administered broad-spectrum anthelminthic, particularly useful in trichuriasis.  ( JAMA 230:1408-1411, 1974)
Prognostic value for immediate function of one-hour renal allograft biopsy.
Authors: I W McDicken, K M Hawking, L D Lameyer, A P Blok, D L Westbroek
Journal: BMJ (1975)

<h3>Background</h3> Timely diagnosis and appropriate management of patients with ST-segment elevation myocardial infarction (STEMI) depends on accurate interpretation of the 12-lead ECG by paramedics. Computer interpretation messages on ECGs are often provided, but the effect they exert on paramedics9 decision making is not known. The objective of this pilot study was to assess the feasibility of a trial using an online assessment tool, to determine the effect of computer interpretation messages on paramedics9 diagnosis of STEMI. <h3>Methods</h3> The RESPECT pilot study is a cluster-randomised crossover trial using a bespoke, web-based assessment tool. Participants were randomly allocated 12 of 48 ECGs, with an equal mix of correct and incorrect computer interpretation messages, and STEMI and STEMI-mimics. These were viewed in two phases, with message visibility reversed between phases. <h3>Results</h3> 254 paramedics consented into the study, 205 completing the first phase and 150 completing phase two. The data were analysed in two subsets: computer message correct and computer message incorrect. In the subset of correct computer interpretations, accuracy was 84% (message hidden) and 87% (message visible). The subset of incorrect computer interpretations resulted in an accuracy of 77% (message hidden) and 71% (message visible). For the subset of correct computer interpretation, the unadjusted OR was 1.31 (95% CI 1.01–1.71), adjusted OR, 1.80 (95% CI 0.84–4.80), the ICC for participants was 0.36 and for ECGs, 0.18 Incorrect computer interpretations had an unadjusted OR of 0.76 (95% CI 0.61–0.93), adjusted OR, 0.58 (95% CI 0.41–0.80), the ICC for participants was 0.06 and for ECGs, 0.01. <h3>Conclusion</h3> A randomised crossover trial to determine the effect of computer interpretation messages is feasible. Pilot data have provided an indication about expected rates of discordance and suggest that incorrect computer messages have a stronger influence across participants and ECGs.
Letting Go: DNR Orders in Prehospital Care
Authors: Bruce E. Haynes
Journal: JAMA (1985)

We have come full circle in the 20 years since Pantridge and his associates moved the practice of cardiac resuscitation from the hospital into the community. Many victims of out-of-hospital sudden death have been saved in the intervening time, and those involved in prehospital care understandably have focused on preserving life by rapidly providing care at the scene of the patient's collapse. This emphasis saves lives, and resuscitation, at first applied almost exclusively to patients with ischemic heart disease, is now attempted for nearly everyone collapsing in public. Giving paramedics guidelines for starting resuscitation is a problem. Many jurisdictions opt for legal safety by requiring resuscitation attempts in virtually all patients. Los Angeles paramedics are instructed to begin resuscitation in all cardiac arrest patients unless there is decapitation; massive crush injury or evisceration of heart, lung, or brain; incineration; rigor mortis; postmortem lividity; or decomposition. These criteria all address the