tbuckley/cabot-search huggingface dataset:
Simplified Count-based Estimates of Left Ventricular Volume
Authors: STEVEN J. LAVINE, DAVID P. SHREINER, VENKATARAMAN KRISHNASWAMI, MORTEZA AMIDI, WILLIAM P. FOLLANSBEE
Journal: Clinical Nuclear Medicine (1986)

Accurate count-based radionuclide estimates of left ventricular volume without the use of a blood sample have not been well described. Resting gated blood pool scans were obtained within 24 hours of catheterization in 31 patients (group 1), and simultaneously with thermodilution cardiac outputs in 29 other patients (group 2) at rest and during an induced-volume change (intervention). End-diastolic and end-systolic volumes were calculated from the single-plane angiogram in Group 1 and from the combination of thermodilution stroke volume and radionuclide ejection fraction in group 2. Excellent correlations were noted between scintigraphic counts and angiographic volumes (r = 0.964), between scintigraphic counts and thermodilution-derived volumes (r = 0.979), and between interventional scintigraphic counts and interventional thermodilutionderived volumes (r = 0.941). Thermodilution and scintigraphic volume changes during the intervention were well correlated (r = 0.85). Accurate count based estimates of left ventricular volume without a blood sample are feasible at rest and during an intervention.
Corticosteroids and liver amoebiasis.
Authors: P C Stuiver, T J Goud
Journal: BMJ (1978)

Patients with amoebiasis who receive steroid treatment may suffer adverse affects including acute amoebic dysentery and exacerbation of the amoebiasis. In some cases the presenting symptoms are initially misdiagnosed and steroids prescribed, which provokes fulminating progression of hepatic amoebiasis. Repeated stool examinations often yield negative results. Any patient being considered for treatment with corticosteroids who has lived in the tropics should be investigated for amoebiasis serologically and by repeated stool examination. Even after negative results the possibility of amoebiasis should be reconsidered if diarrhoea or fever develops during or after steroid treatment.
A STORY OF CHICKAMAUGA.
Authors: R. STANSBURY SUTTON
Journal: JAMA (1898)

There was a great deal of sickness at Chickamauga Park. You would not expect to put 60,000 men in a camp seven miles square and keep them there all summer without sickness. Furthermore, a large number, the great majority, were from northern climates and not only had they that to contend with, but their entire mode of living had been changed, and they were necessarily subjected to daily drill of about five hours, required to educate them to be soldiers. In addition to this they had their camp duties to perform and their own necessities to look after, and it was but natural that some of them should become ill. Volunteer soldiers, without experience in camp life, great numbers of whom at home were unaccustomed to hard work and plain food, would naturally suffer some inconvenience. In every army there is an element which, if not restrained, will abuse themselves
Fast Silencing Reveals a Lost Role for Reciprocal Inhibition in Locomotion
Authors: Peter R. Moult, Glen A. Cottrell, Wen-Chang Li
Journal: Neuron (2013)

Alternating contractions of antagonistic muscle groups during locomotion are generated by spinal "half-center" networks coupled in antiphase by reciprocal inhibition. It is widely thought that reciprocal inhibition only coordinates the activity of these muscles. We have devised two methods to rapidly and selectively silence neurons on just one side of Xenopus tadpole spinal cord and hindbrain, which generate swimming rhythms. Silencing activity on one side led to rapid cessation of activity on the other side. Analyses reveal that this resulted from the depression of reciprocal inhibition connecting the two sides. Although critical neurons in intact tadpoles are capable of pacemaker firing individually, an effect that could support motor rhythms without inhibition, the swimming network itself requires ∼23 min to regain rhythmic activity after blocking inhibition pharmacologically, implying some homeostatic changes. We conclude therefore that reciprocal inhibition is critical for the generation of normal locomotor rhythm.
Study of Internal Medicine Manpower: XX
Authors: Srinivas S. Vasireddi
Journal: Annals of Internal Medicine (1995)

Letters15 March 1995Study of Internal Medicine Manpower: XXSrinivas S. Vasireddi and Jayadeva ChowdappaSrinivas S. VasireddiSearch for more papers by this author and Jayadeva ChowdappaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-6-199503150-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Lyttle and Levy [1] prominently highlight the inroads made by international medical graduates (IMGs) into the subspecialties of internal medicine and project them as an indirect cause of a future shortage of primary care physicians. The 110% cap on residencies may not guarantee a solution but will definitely restrict freedom of choice for all residents. We must seek a solution to the maldistribution of physicians that leads to a significant primary care physician shortage [2] and must not restrict IMG residents who deliver health care to the under-served in many inner-city areas shunned by U.S. graduates. The ...References1. Lyttle CS, Levey GS. The National Study of Internal Medicine Manpower: XX. The changing demographics of internal medicine residency training programs. Ann Intern Med. 1994; 121:435-41. Google Scholar2. Starfield B, Simpson L. Primary care as part of U.S. health care services reform. JAMA. 1993; 269:3136-9. Google Scholar3. Varki A. Of pride, prejudice, and discrimination: why generalizations can be unfair to the individual. Ann Intern Med. 1992; 116:762-4. Google Scholar4. Vasireddi SS. Primary care as part of U.S. health care services reform (Letter). JAMA. 1993; 270:2434. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1995Volume 122, Issue 6Page: 477-478KeywordsForecastingGraduate medical educationHealth careHealth care providersLegislationPrimary carePrimary care physiciansResidencySub-specialty care Issue Published: 15 March 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Life-Threatening Asthma during Treatment with Salmeterol
Authors: Miles Weinberger, Mutasim Abu-Hasan
Journal: New England Journal of Medicine (2006)

To the Editor: Although the addition of a long-acting β2-agonist such as salmeterol to an inhaled corticosteroid has been demonstrated to provide greater control of asthma than does a substantially increased dose of the inhaled corticosteroid,1 this medication was associated with an increased risk of asthma-related death in a large population study.2 We have identified two adolescent boys with poorly controlled asthma and a history consistent with sudden asphyxial episodes during modest exertion while receiving inhaled corticosteroids and salmeterol. In addition to reporting an inadequate response to their rescue inhaler when symptomatic, they had no apparent bronchoprotective effect . . .
FIRST AID TEACHING TECHNIC
Authors: C. J. POTTHOFF
Journal: JAMA (1941)

Present day warfare, with participation by the entire population in the defense and offense effort, necessitates training of the whole population, each segment for its duties. Into the public mind today the need for preparation is being instilled, and much thought is being given to devising the direction and method of training. If the whole population is to be trained for the emergencies of war, one of the first objectives will be the training in methods of first aid. In Britain such training has formed an important aspect of defense work. In this country the American Red Cross is even now extending its first aid program; plans call for an immense expansion of this training.  Without doubt, physicians will play an important part in the local programs. Red Cross units commonly have physicians among their directors and look to them for guidance in phases of activity related to health work.
Illegal Use of Psychoactive Drugs
Authors: Bruce R. Ditzion
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Illegal use of psychoactive drugs by young people has received great publicity in both lay and medical publications. Much interest has been expressed about what physicians can and cannot do about this problem. Paralleling the use of these illegal drugs is the massive consumption of prescription psychoactive drugs. American pharmacists filled 225 million prescriptions for stimulants, sedatives, and tranquilizers in 1970 (<i>New York Times</i>, March 14, 1971, p 36). Until recently, this phenomenon received very little attention. Several issues require discussion. Does such widespread use reflect the common incidence of emotional problems seen by physicians? Are prescription drugs always good treatment for these problems? Are there more appropriate substitutes, such as counseling by the physician or referral to another professional for psychological evaluation and treatment? Is there a relationship between the massive use of legal prescriptions and nonprescription psychoactive drugs by adults and illegal drug use by
Unpublicized hallucinogens. The dangerous belladonna alkaloids
Authors: D. J. Muller
Journal: JAMA (1967)

Teen-agers and young adults are beginning to use the dangerous belladonna alkaloids to make chemical trips, as illustrated here by three cases. The diagnosis should be strongly considered in the younger patient with delirium. In view of their great toxic potential all belladonna alkaloids should be controlled by prescription.
Aspirin versus coumadin in the prevention of reocclusion and recurrent ischemia after successful thrombolysis: a prospective placebo-controlled angiographic study. Results of the APRICOT Study.
Authors: A Meijer, F W Verheugt, C J Werter, K I Lie, J M van der Pol, M J van Eenige
Journal: Circulation (1993)

BACKGROUND Successful coronary thrombolysis involves a risk for reocclusion that cannot be prevented by invasive strategies. Therefore, we studied the effects of three antithrombotic regimens on the angiographic and clinical courses after successful thrombolysis. METHODS AND RESULTS Patients treated with intravenous thrombolytic therapy followed by intravenous heparin were eligible when a patent infarct-related artery was demonstrated at angiography &lt; 48 hours. Three hundred patients were randomized to either 325 mg aspirin daily or placebo with discontinuation of heparin or to Coumadin with continuation of heparin until oral anticoagulation was established (international normalized ratio, 2.8-4.0). After 3 months, in which conservative treatment was intended, vessel patency and ventricular function were reassessed in 248 patients. Reocclusion rates were not significantly different: 25% (23 of 93) with aspirin, 30% (24 of 81) with Coumadin, and 32% (24 of 74) with placebo. Reinfarction was seen in 3% of patients on aspirin, in 8% on Coumadin, and in 11% on placebo (aspirin versus placebo, p &lt; 0.025; other comparison, p = NS). Revascularization rate was 6% with aspirin, 13% with Coumadin, and 16% with placebo (aspirin versus placebo, p &lt; 0.05; other comparisons, p = NS). Mortality was 2% and did not differ between groups. An event-free clinical course was seen in 93% with aspirin, in 82% with Coumadin, and in 76% with placebo (aspirin versus placebo, p &lt; 0.001; aspirin versus Coumadin, p &lt; 0.05). An event-free course without reocclusion was observed in 73% with aspirin, in 63% with Coumadin, and in 59% with placebo (p = NS). An increase of left ventricular ejection fraction was only found in the aspirin group (4.6%, p &lt; 0.001). CONCLUSIONS At 3 months after successful thrombolysis, reocclusion occurred in about 30% of patients, regardless of the use of antithrombotics. Compared with placebo, aspirin significantly reduces reinfarction rate and revascularization rate, improves event-free survival, and better preserves left ventricular function. The efficacy of Coumadin on these end points appears less than that of aspirin. The still-high reocclusion rate emphasizes the need for better antithrombotic therapy in these patients.
Xenon handling in the liver: red cell capacity effect.
Authors: C A Goresky, A J Schwab, C P Rose
Journal: Circulation Research (1988)

Xenon, despite its lack of chemical reactivity, associates preferentially with red cells in blood. To characterize the effect of this and the nature of xenon-tissue interaction in the liver, multiple indicator dilution studies were performed in the anesthetized normal dog through portal vein injection and hepatic vein collection of anaerobic blood samples. Two experimental runs were carried out in each animal, one at the prevailing hematocrit and the other at reduced hematocrit after bleeding and replacement with dextran. For comparison, the injection mixtures contained labeled red blood cells (a vascular reference), sucrose (an interstitial space reference), and labeled water (which freely enters liver cells), as well as labeled xenon. At the higher hematocrit, the labeled xenon curves generally rose earlier, peaked higher, and decayed more quickly than the labeled water curve; at the lower hematocrit, the xenon curve was delayed and diminished in magnitude in relation to the labeled water curves. Analysis of the curve shapes indicated that xenon, like labeled sucrose and water, underwent delayed wave flow-limited distribution. With knowledge of the red cell plasma partition coefficient (2.89 ml/ml), it was possible to both account for the change in form of the xenon curves with hematocrit and to use the data to estimate the liver cell tissue plasma xenon partition coefficient. Values averaged 1.93 ml/ml liver space, or 1.79 ml/g, and did not change significantly from first to second runs. Theoretical analysis indicated that flow cannot be estimated from xenon downslopes.
Impaired Insulin Signaling in Human Adipocytes After Experimental Sleep Restriction
Authors: Josiane L. Broussard, David A. Ehrmann, Eve Van Cauter, Esra Tasali, Matthew J. Brady
Journal: Annals of Internal Medicine (2012)

Chinese translation Background: Insufficient sleep increases the risk for insulin resistance, type 2 diabetes, and obesity, suggesting that sleep restriction may impair peripheral metabolic pathways. Yet, a direct link between sleep restriction and alterations in molecular metabolic pathways in any peripheral human tissue has not been shown. Objective: To determine whether sleep restriction results in reduced insulin sensitivity in subcutaneous fat, a peripheral tissue that plays a pivotal role in energy metabolism and balance. Design: Randomized, 2-period, 2-condition, crossover clinical study. Setting: University of Chicago Clinical Resource Center. Participants: Seven healthy adults (1 woman, 6 men) with a mean age of 23.7 years (SD, 3.8) and mean body mass index of 22.8 kg/m2 (SD, 1.6). Intervention: Four days of 4.5 hours in bed or 8.5 hours in bed under controlled conditions of caloric intake and physical activity. Measurements: Adipocytes collected from subcutaneous fat biopsy samples after normal and restricted sleep conditions were exposed to incremental insulin concentrations. The ability of insulin to increase levels of phosphorylated Akt (pAkt), a crucial step in the insulin-signaling pathway, was assessed. Total Akt (tAkt) served as a loading control. The insulin concentration for the half-maximal stimulation of the pAkt–tAkt ratio was used as a measure of cellular insulin sensitivity. Total body insulin sensitivity was assessed using a frequently sampled intravenous glucose tolerance test. Results: The insulin concentration for the half-maximal pAkt–tAkt response was nearly 3-fold higher (mean, 0.71 nM [SD, 0.27] vs. 0.24 nM [SD, 0.24]; P = 0.01; mean difference, 0.47 nM [SD, 0.33]; P = 0.01), and the total area under the receiver-operating characteristic curve of the pAkt–tAkt response was 30% lower (P = 0.01) during sleep restriction than during normal sleep. A reduction in total body insulin sensitivity (P = 0.02) paralleled this impaired cellular insulin sensitivity. Limitation: This was a single-center study with a small sample size. Conclusion: Sleep restriction results in an insulin-resistant state in human adipocytes. Sleep may be an important regulator of energy metabolism in peripheral tissues. Primary Funding Source: National Institutes of Health.
Actinomycosis of the Urinary Bladder
Authors: Donald T. King
Journal: JAMA (1978)

ACTINOMYCOSIS of the female genital tract has followed the use of intrauterine contraceptive devices (IUDs).<sup>1</sup>Though actinomycosis from this source occasionally spreads to other areas in the abdomen and thorax, it rarely extends to the urinary tract, where the kidney is more often affected than the ureters or bladder. Actinomycosis of the bladder, though most uncommon, may imitate malignant neoplasms because it presents as multiple fistulas or as a mass lesion. We describe actinomycosis of the urinary bladder in association with an IUD to illustrate the need to consider this infection in the differential diagnosis of bladder masses. <h3>Report of a Case</h3> A 36-year-old woman had a three-month history of cramping right-lower quadrant pain that intensified on urination. She denied burning with urination or urinary urgency. The results of a pelvic examination showed an enlarged irregular uterus of six to eight weeks' size with a contiguous 4×5-cm mass at
Coarctation of the aorta: Prevalence of intracranial aneurysm
Authors: Heidi M. Connolly, John Huston, Robert D. Brown, Carole A. Warnes, Naser M. Ammash, Jane A. Emerson, Ana G. Rosales, A. Jamil Tajik
Journal: Journal of the American College of Cardiology (2003)
First left-right comparative study of topical rapamycin vs. vehicle for facial angiofibromas in patients with tuberous sclerosis complex
Authors: M. Tanaka, M. Wataya-Kaneda, A. Nakamura, S. Matsumoto, I. Katayama
Journal: British Journal of Dermatology (2013)

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder causing multiple hamartomas. Treatment of TSC lesions with mammalian target of rapamycin inhibitors is effective. Recently, several reports have shown the efficacy of topical rapamycin (sirolimus) for angiofibromas. However, almost all studies have been case studies and the 0·1% solution caused skin irritation. A comparative study of topical rapamycin and a vehicle has not yet been reported.To compare the efficacy of topical rapamycin formulation with that of vehicle for angiofibromas.A left-right comparative study between rapamycin 0·2% topical formulation and vehicle was conducted in 11 patients with TSC. Two formulations, an ointment and a gel, were prepared and in vitro percutaneous absorption of rapamycin was determined.In vitro percutaneous absorption of rapamycin was significantly greater with the gel compared with the ointment. In the clinical study, the rapamycin-treated cheek showed significant improvements relative to the vehicle-treated cheek in all outcome measures after 12 weeks of treatment. The improvement was particularly remarkable in children aged ≤ 10 years. No side-effects were noted, and rapamycin was not detected in the blood of the patients.Topical rapamycin was significantly effective against angiofibromas. Both formulations used were effective and safe. The 0·2% gel is especially useful because of its better skin penetration and low irritancy. Initiation of topical rapamycin therapy in early childhood would be beneficial for patients with TSC.
Senescence in the skin
Authors: G. STUTTGEN, A. OTT
Journal: British Journal of Dermatology (1990)

No difference was found between groups of senescent subjects and younger adults in the control of skin temperature, heat radiation and transcutaneous oxygen pressure. Although capillary numbers decline in elderly skin, transcutaneous oxygen pressure at 43°C in elderly skin is no lower than in young subjects. Topical tretinoin (0.05%) increases heat radiation from the skin, but there is no correlation with an improvement in superficial wrinkles. No conclusion is possible regarding the effects of topical tretinoin on transcutaneous oxygen diffusion due to a wide variability in results; sometimes it is increased and sometimes it is decreased. In different regions of the skin, such as the face and thigh, increased skin radiation and skin contact temperature are not associated with increased transcutaneous oxygen diffusion.
The gastric brooding frog
Authors: D. Wingate
Journal: Gut (1984)

In the fall of 2017, the #MeToo movement ushered in one of the most astonishing revolts against the perils of workplace-related harassment. Several unsuccessful campaigns geared towards ending the harassment and subjugation of women in corporate organisations finally got a thrust that resulted in significant and far-reaching changes in many organisations. While the #MeToo movement highlighted the pains and struggles of gender inequality over the years, an unintended consequence has been the shadow it has cast over the plight of other minority groups facing harassment in the workplace. In several academic and healthcare (learning) environments, people of colour, like women, face explicit and implicit forms of harassment on a regular, if not daily basis. Unlike gender harassment, however, racial harassment affects both sexes with relatively more predominance among men. The effect of racial harassments does not just impact performance and self-confidence but also influences the opportunities available to black professionals to advance their academic and professional careers. In the academic and healthcare industries, the issue of how to tackle implicit bias and unfair practices is not clear-cut. While the subjugated feel the impact of bias, the perpetrators of the actions either lack the ability (or are unwilling) to acknowledge these biases. Furthermore, the complexities inherent to the different contexts make it problematic if not impossible, to call out racist behaviours. In this paper, a real-life case scenario is used to provide a scholarly analysis of the dynamics of racial harassment, implicit bias and the impact on minority leader roles in healthcare delivery.
Should Physicians Address Patients' Spiritual Needs?
Authors: E. A. Catlin
Journal: JAMA (2002)

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