tbuckley/cabot-search huggingface dataset:
Quality of the Last Year of Life of Older Adults: 1986 vs 1993
Authors: Youlian Liao
Journal: JAMA (2000)

ContextThe population is aging and life expectancy is increasing, but whether morbidity and disability late in life also increase is unknown.ObjectiveTo examine whether the use of health care services, disability and cognitive function, and overall quality of life in the year before death among older adults has changed over time.Design and SettingThe 1986 and 1993 National Mortality Followback Surveys, which were probability samples of all deaths in the United States with response rates of next of kin of 90% and 88% for those aged 65 years and older.ParticipantsNext of kin were asked to report the health status of a total of 9179 decedents who were 65 years and older in 1986 and 6735 in 1993, representing 1.5 and 1.6 million decedents aged 65 years and older.Main Outcome MeasuresDays of hospital or nursing home stays, number and length of disability in 5 activities of daily living, duration of impairment in 3 measures of cognitive function, and an overall sickness score among individuals aged 65 through 84 years and those aged 85 years and older.ResultsWomen used significantly fewer hospital and nursing home services in the last year of life in 1993 vs 1986 (mean reduction, 3.3 nights for both age groups for hospital services; mean reduction 18.4 nights for nursing home for women aged 65-84 years and 42.3 nights for women ≥85 years). Men had no changes except those aged 85 years and older had a decline in nursing home nights of 32.6. The proportion of women aged 85 years and older with restriction of at least 2 activities of daily living decreased from 62.5% in 1986 to 52.1% in 1993 (P&lt;.01), and those with normal cognitive function increased from 50.3% to 56.2% (P&lt;.05). Their mean overall sickness score decreased and quality-of-life improved. Among women aged 65 through 84 years, the number with normal cognitive function increased and the mean sickness score decreased, but those with at least 2 activities of daily living impairments increased and the overall quality of life declined. A similar pattern of change was found in the oldest-old men except that cognitive function worsened. Most parameters for men aged 65 through 84 years did not change significantly.ConclusionsMen and women at least 85 years old in the US experienced a better overall quality of life in the last year of life in 1993 than those in 1986. Most measures for men and women aged 65 through 84 years improved or did not change.
Nanopatch targeted delivery of both antigen and adjuvant to skin synergistically drives enhanced antibody responses
Authors: Germain J.P. Fernando, Xianfeng Chen, Clare A. Primiero, Sally R. Yukiko, Emily J. Fairmaid, Holly J. Corbett, Ian H. Frazer, Lorena E. Brown, Mark A.F. Kendall
Journal: Journal of Controlled Release (2012)
Staphylococcal infections in childhood dermatomyositis--association with the development of calcinosis, raised IgE concentrations and granulocyte chemotactic defect.
Authors: E.C Moore, F Cohen, S.D Douglas, V Gutta
Journal: Annals of the Rheumatic Diseases (1992)

There is a high incidence of staphylococcal infection in children with dermatomyositis, which is limited to those children who either already have or subsequently develop calcinosis. Of 15 children followed up for 3-10 years after diagnosis, all nine who developed calcinosis had infections with Staphylococcus aureus compared with none of six without calcinosis. Of these nine, the occurrence of staphylococcal infections before calcinosis was observed in four, suggested by history in two, and unclear in three children. Granulocyte chemotaxis to Staphylococcus aureus was more severely depressed in those children with calcinosis, whereas those without calcinosis did not differ significantly from controls. The chemotactic defect was due to a serum factor (patients' serum depressed control chemotaxis and control serum corrected the patients' chemotaxis). The nine children with calcinosis also had significantly higher serum IgE concentrations than non-atopic age matched controls; the six without calcinosis did not differ from controls. The increased IgE concentrations appeared to develop after staphylococcal infection and before calcinosis. Two of five patients with calcinosis had increased antistaphylococcal IgE antibodies; neither of the two patients without calcinosis had such increased antibodies. This suggests preceding immunological differences in patients with dermatomyositis who do and do not subsequently develop calcinosis, either increasing susceptibility to Staphylococcus aureus infection or potentially resulting from such infections.
HOSPITAL CONSTRUCTION WITHOUT FEDERAL FUNDS
Authors: Robert F. Purtell
Journal: JAMA (1952)

<h3>To the Editor:</h3> —In these days of widespread dependence on federal funds for hospital construction and other purposes, it is noteworthy to record an example of a community that had the will and the self-reliance to construct a hospital wing without any federal aid. Misericordia Hospital in Milwaukee recently opened a new seven story wing built entirely from funds raised by its sisters, the staff, and private contributors. At the time the new hospital wing was planned, the Hill-Burton funds were being spread about the state of Wisconsin as elsewhere in the country. The bureaucrats in Washington or Madison decided the north side of Milwaukee had adequate hospital facilities, and so the Hill-Burton funds were assigned only to the south side of Milwaukee. This excluded Misericordia Hospital; however, the Sister Superior was emphatic in stating that if the funds had been made available to her she would not have accepted
Effects of Acute Hypoxia and Exercise on the Pulmonary Circulation
Authors: ALFRED P. FISHMAN, HARRY W. FRITTS, ANDRÉ COURNAND
Journal: Circulation (1960)

The effects of acute hypoxia, of graded exercise, or both, on the pulmonary circulation were studied in 17 normal subjects. In 3 of these subjects, and in 3 patients with restricted vascular beds, the effects of these stimuli were compared during successive test periods. In 7 normal subjects, moderate exercise, associated with an increase in cardiac output of approximately 25 per cent, resulted in an average rise in pulmonary arterial mean pressure of 3 mm.Hg. More strenuous exercise in the same subjects, associated with a further increase in cardiac output of approximately 25 per cent, did not elicit further increment in pulmonary arterial mean pressure. In contrast, 10 subjects with normal pulmonary circulations, who responded to acute hypoxia with an average reduction of arterial oxygen saturation of 17 per cent, manifested an average increase in cardiac output of 5 per cent and an average rise in mean pulmonary arterial pressure of 4 mm.Hg. The critical level of arterial blood oxygen saturation for a significant rise in pulmonary arterial pressure was 85 per cent: in 6 subjects, with arterial blood O 2 saturation reduced below this level, the average pulmonary artery pressure rise was 7 mm. Hg. In the 3 subjects with normal pulmonary circulations who performed exercise and were exposed to acute hypoxia, the contrasting effects of these stimuli on the pulmonary circulation were striking. In the 3 patients with restricted vascular beds exposed successively to both stimuli, the rise in pulmonary arterial mean pressure appeared to be linearly related to the increase in pulmonary blood flow. In 1 subject, the surgical resection of the preganglionic fibers and ganglia which supply sympathetic efferent nerves to the pulmonary vascular tree was without effect on the responses of the pulmonary circulation to acute hypoxia and to exercise. The present study failed to identify the mechanism and the site of action of acute hypoxia on the pulmonary circulation.
“Picture to Puncture”
Authors: Chung-Huan J. Sun, Raul G. Nogueira, Brenda A. Glenn, Kerrin Connelly, Susan Zimmermann, Kim Anda, Deborah Camp, Michael R. Frankel, Samir R. Belagaje, Aaron M. Anderson, Alexander P. Isakov, Rishi Gupta
Journal: Circulation (2013)

Background— Comprehensive stroke centers allow for regionalization of subspecialty stroke care. Efficacy of endovascular treatments, however, may be limited by delays in patient transfer. Our goal was to identify where these delays occurred and to assess the impact of such delays on patient outcome. Methods and Results— This was a retrospective study evaluating patients treated with endovascular therapy from November 2010 to July 2012 at our institution. We compared patients transferred from outside hospitals with locally treated patients with respect to demographics, imaging, and treatment times. Good outcomes, as defined by 90-day modified Rankin Scale scores of 0 to 2, were analyzed by transfer status as well as time from initial computed tomography to groin puncture (“picture-to-puncture” time). A total of 193 patients were analyzed, with a mean age of 65.8±14.5 years and median National Institutes of Health Stroke Scale score of 19 (interquartile range, 15–23). More than two thirds of the patients (132 [68%]) were treated from referring facilities. Outside transfers were noted to have longer picture-to-puncture times (205 minutes [interquartile range, 162–274] versus 89 minutes [interquartile range, 70–119]; P &lt;0.001), which was attributable to the delays in transfer. This corresponded to fewer patients with favorable Alberta Stroke Program Early CT Scores on preprocedural computed tomographic imaging (Alberta Stroke Program Early CT Scores &gt;7: 50% versus 76%; P &lt;0.001) and significantly worse clinical outcomes (29% versus 51%; P =0.003). In a logistic regression model, picture-to-puncture times were independently associated with good outcomes (odds ratio, 0.994; 95% confidence interval, 0.990–0.999; P =0.009). Conclusions— Delays in picture-to-puncture times for interhospital transfers reduce the probability of good outcomes among treated patients. Strategies to reduce such delays herald an opportunity for hospitals to improve patient outcomes.
A New Cause of Male Infertility
Authors: Patrick C. Walsh
Journal: New England Journal of Medicine (1979)

Approximately 15 per cent of all marriages are involuntarily childless, and another 10 per cent of couples have fewer children than they desire. In 30 per cent of these marriages, the husband can be identified as the responsible factor, and in another 20 per cent a male factor is found to have an important contributing role. However, despite the frequency of disordered reproductive function in men, the cause is unclear in a substantial percentage of the cases. For example, an identifiably endocrine abnormality is present in only approximately 20 per cent of all infertile men.1 However, this is probably a . . .
HOW TO SUTURE THE WOUND IN EARLY OR INTERVAL OPERATIONS FOR APPENDICITIS, SO AS TO SHORTEN THE INDOOR CONFINEMENT TO ONE WEEK.CLINICAL EXPERIENCE IN PROOF.
Authors: J. E. SUMMERS
Journal: JAMA (1906)

Besides the all-important question as to the dangers of an operation, the next in importance with the patient and friends is the necessary time of confinement in bed and of interference with business and every-day occupations. It is surprising how many people refuse absolutely, or put off from time to time, an advisable operation; although they know from common knowledge that the danger is exceedingly slight, yet they "can not afford the time." Having in many instances known of persons whose procrastination in this direction has cost them their lives, great jeopardy or much unnecessary suffering, I have been following the several recognized surgical procedures in the diseases of the appendix in order to choose for my own guidance the safest and shortest cut toward recovery and a return to customary duties. Most of the professional grief I have suffered was during the growing period of knowledge by the medical
IMPACT OF TARGET LESION REVASCULARIZATION ON DEATH, MYOCARDIAL INFARCTION AND STROKE IN PATIENTS WITH SIROLIMUS-ELUTING STENT IMPLANTATION : INSIGHTS FROM J-CYPHER REGISTRY
Authors: Kazuhiro Nakao, Mitsuru Abe, Takuya Taniguchi, Takafumi Yamane, Yukiko Oe, Futoshi Yamanaka, Nobuhito Yagi, Nobuaki Kokubu, Yoichiro Kasahara, Yu Kataoka, Yoritaka Otsuka, Takeshi Morimoto, Kazuaki Mitsudo, Takeshi Kimura, Hiroshi Nonogi
Journal: Journal of the American College of Cardiology (2010)
Turn the computer screen round
Authors: A. N. Glaser
Journal: BMJ (2010)

<h3>Abstract</h3> The goal of human brain mapping has long been to delineate the functional subunits in the brain and elucidate the functional role of each of these brain regions. Recent work has focused on whole-brain parcellation of functional Magnetic Resonance Imaging (fMRI) data to identify these subunits and create a functional atlas. Functional connectivity approaches to understand the brain at the network level require such an atlas to assess connections between parcels and extract network properties. While no single functional atlas has emerged as the dominant atlas to date, there remains an underlying assumption that such an atlas exists. Using fMRI data from a highly sampled subject as well as two independent replication data sets, we demonstrate that functional parcellations based on fMRI connectivity data reconfigure substantially and in a meaningful manner, according to brain state.
How not to reduce uncertainties in care
Authors: N. Modi
Journal: BMJ (2013)

US Office for Human Research Protections messes up 

The randomised controlled trial has justifiably been embraced as necessary to the delivery of evidence based medicine. Randomisation reduces confounding by unknown factors, ensures every patient has a fair and equal chance of receiving the best (as yet unknown) treatment option, and is the gold standard approach to identifying effective treatments for future patients. In an ideal world every treatment uncertainty would be dealt with in this way. Recent experience in the United States highlights the unexpected barriers to doing this.

Most uncertainties in healthcare relate not to new experimental treatments but to those already in wide use. The administration of oxygen to premature babies is an example of this. A longstanding uncertainty about the treatment—the optimum saturation target—was put to the test of a randomised controlled trial. Preterm babies with respiratory immaturity often need additional oxygen, but too much oxygen is associated with a proliferative retinal vasculopathy—retinopathy of prematurity—a cardinal cause of lifelong visual impairment and blindness. For this reason, the accepted standard of care oxygen saturation range of 85-95% is used to avoid levels …
The midgut epithelium of aquatic arthropods: a critical target organ in environmental toxicology.
Authors: Barry J Beaty, Ryan S Mackie, Kimberly S Mattingly, Jonathan O Carlson, Alfredo Rayms-Keller
Journal: Environmental Health Perspectives (2002)

The midgut epithelium of aquatic arthropods is emerging as an important and toxicologically relevant organ system for monitoring environmental pollution. The peritrophic matrix of aquatic arthropods, which is secreted by the midgut epithelium cells, is perturbed by copper or cadmium. Molecular biological studies have identified and characterized two midgut genes induced by heavy metals in the midgut epithelium. Many other metal-responsive genes (MRGs) await characterization. One of the MRGs codes for an intestinal mucin, which is critical for protecting the midgut from toxins and pathogens. Another codes for a tubulin gene, which is critical for structure and function of the midgut epithelial cells. Perturbation of expression of either gene could condition aquatic arthropod survivorship. Induction of these MRGs is a more sensitive and rapid indicator of heavy-metal pollution than biological assays. Characterization of genes induced by pollutants could provide mechanistic understanding of fundamental cellular responses to pollutants and insight into determinants of aquatic arthropod population genetic structure and survivorship in nature.
Disease and Suspicion after the Persian Gulf War
Authors: Edward W. Campion
Journal: New England Journal of Medicine (1996)

In 1990 the United States and its allies sent close to a million troops to the Persian Gulf. Fewer than 150 Americans died during the six-week war against Iraq,1 but many veterans now fear that the Persian Gulf War ruined their health. Six years later, there is wide publicity about excess disease and unrecognized illnesses resulting from the war. There are also recent accusations that the government has not been honest about what happened to its troops. Two reports in this issue of the Journal shed some light on the complicated and sensitive questions about the health consequences of the . . .
Can Predictive Models for Prostate Cancer Patients Derived in the United States of America Be Utilized in European Patients? A Validation Study of the Partin Tables
Authors: Markus Graefen, Herbert Augustin, Pierre I. Karakiewicz, Peter G. Hammerer, Alexander Haese, Juri Palisaar, Jakob Blonski, Salvator Fernandez, Andreas Erbersdobler, Hartwig Huland
Journal: European Urology (2003)
RHEUMATIC DISEASES OF THE EYE.
Authors: H. W. WOODRUFF
Journal: JAMA (1901)

That the eye should be subject to rheumatic disease does not seem strange when we remember that its principal protective coat is a dense fibrous structure, the sclerotic; that it contains within it the delicate muscular fibers of the iris and ciliary body, and externally the muscular bands which move it about; that it is very vascular, one coat alone, the choroid, being largely made up of blood-vessels. The wonder is that the eye does not suffer more from a disease as prevalent as rheumatism and one which shows such a predilection for fibrous, muscular, and vascular structures. It is not the object of this paper to discuss the subject of rheumatism in general. Suffice it to say that many observers believe it to be, like gout, caused by uric acid, a product of inefficient proteid metabolism; others by lactic acid, a fermentation product of the hydrocarbons. The researches of
Transmission of Herpes Simplex-Reply
Authors: Lata S. Nerurkar
Journal: JAMA (1984)

<h3>In Reply.—</h3> The letter written by Drs Pazin and Harger is interesting, but it fails to deal with the facts and conclusions given in our article. The facts are that several clusters of genital herpes cases were reported in the Washington, DC, area in which the only known common exposures were at spas. Also, our studies showed that while herpes did not survive in spa water, it remained at high titers for several hours on plastic surfaces under conditions such as those found in spas and also survived for 15 minutes in tap water. From this we concluded that "fomites such as these may be nonvenereal routes of HSV transmission." We would like to respond to the two points raised in the letter. First, the authors of the letter state that they have never heard of a case of nonsexual spread of herpes, and, thus, they conclude it must be
Gastric Pertechnetate Contribution to Blood Pool Images
Authors: GARY M. LEVINE, RONALD J. ROSENBERG, JOHN J. SZIKLAS, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1989)

During a cardiac blood pool study (Tc-99m erythrocytes), there was an apparent "cold" area in the left lobe of the liver. At one hour, the prior void appeared to have filled in, suggesting an intrahepatic hemangioma. However, the changing pattern of radioactivity, and its shape, indicated that this actually represented Tc-99m pertechnetate in the gastric wall and stomach cavity. In a second case, the interval between intravenous injection of stannous pyrophosphate and Tc-99m pertechnetate was prolonged. Changing activity, again in the gastric wall and cavity, obscured part of the liver. This cleared with time, allowing hepatic evaluation. Thus, gastric pertechnetate can contribute to blood pool images of the heart or liver and multiple images may be needed to separate this component from nearby tissues.
More on the Most Terrible of the Ministers of Death
Authors: Alan P. Zelicoff
Journal: Annals of Internal Medicine (1998)

Letters1 May 1998More on the Most Terrible of the Ministers of DeathAlan P. Zelicoff, MDAlan P. Zelicoff, MDSandia National Laboratories; Albuquerque, NM 87185Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-9-199805010-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Barquet and Domingo [1] present an enthralling history of the smallpox virus but end their article with a regrettably incomplete summary of the recent scientific debate over the destruction of variola. Since the time of the most recent stay of execution of the virus in early 1996, some of the rich scientific and medical value of variola has come to light. Indeed, in the past few years, tantalizing bits of understanding of the unique propensity of the virus to induce immune tolerance or immunosuppression by way of cytokine inhibition [2] and of the structure-function relations of the ...References1. Barquet N, Domingo P. Smallpox: the triumph over the most terrible of the ministers of death. Ann Intern Med. 1997; 127:635-42. Google Scholar2. Smith TD, Smolak PJ, Friend D, Hagen H, Gerhart M, Park L, et al. Poxvirus genomes encode a secreted, soluble protein that preferentially inhibits β chemokine activity yet lacks sequence homology to known chemokine receptors. Virology. 1997; 236:316-27. Google Scholar3. Shchelkunov SN, Totmenin AV, Babkin IV, Safronov PF, Gutorov VV, Pozdnyakov SG, et al. [Study of the structure activity organization of smallpox virus genome. V. Sequencing and analysis of the left-hand terminus of the India-1967 strain.] Mol Biol (Mosk). 1996; 30:595-612. Google Scholar4. Sandakhchiev LS. The Scientist. 1993; 7:9. Google Scholar5. Lederberg J. Future studies of pathogens depend on conserving microbes. The Scientist. 1997; 11:8. Google Scholar Author, Article, and Disclosure InformationAuthors: Alan P. Zelicoff, MDAffiliations: Sandia National Laboratories; Albuquerque, NM 87185 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1998Volume 128, Issue 9Page: 784-785KeywordsAntigensBiologistsCloningCytokinesGeneticsImmune systemImmunosuppressivesOrgan transplantationProteinsSmallpox ePublished: 15 August 2000 Issue Published: 1 May 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...