tbuckley/cabot-search huggingface dataset:
Transfer Rates and Use of Post–Acute Care After Surgery At Critical Access vs Non–Critical Access Hospitals
Authors: Adam J. Gadzinski, Justin B. Dimick, Zaojun Ye, John L. Zeller, David C. Miller
Journal: JAMA Surgery (2014)

There is growing interest in the use of health care resources by critical access hospitals (CAHs), key providers of medical care for many rural populations.To evaluate discharge practice patterns and use of post-acute care after surgical admissions at CAHs.We used data from the Nationwide Inpatient Sample (2005-2009) and American Hospital Association to perform a retrospective cohort study of patients undergoing common inpatient surgical procedures at CAHs or non-CAHs.The CAH status of the admitting hospital.Hospital transfer, discharge with post-acute care, or routine discharge.Among the 1283 CAHs and 3612 non-CAHs included in the American Hospital Association annual survey, 34.8% and 36.4%, respectively, reported data to the Nationwide Inpatient Sample. For each of 6 common inpatient surgical procedures, a greater proportion of patients from CAHs were transferred to another hospital (P < .01); however, patients discharged from CAHs were less likely to receive post-acute care for all but 1 of the procedures examined (P < .01, except transurethral resection of prostate, P = .76). After adjustment for patient and hospital factors, the higher likelihood of transfer by CAHs vs non-CAHs persisted for 3 procedures: hip replacement (odds ratio, 1.90; 95% CI, 1.01-3.57), colorectal cancer resection (3.37; 2.23-5.09), and cholecystectomy (1.67; 1.27-2.19) (P < .05 for each), but differences in the use of post-acute care did not. In subset analyses, Medicare beneficiaries treated in CAHs were less likely to be discharged with post-acute care after hip fracture repair (odds ratio, 0.65; 95% CI, 0.47-0.89) and hip replacement (0.70; 95% CI, 0.51-0.96).Hospital transfers occur more often after surgical admissions at CAHs. However, the proportion of patients at CAHs using post-acute care is equal to or lower than that of patients treated in non-CAHs. These results will affect the ongoing debate concerning CAH payment policy and its implications for health care delivery in rural communities.
Smith's Reference and Illustrated Guide to Surgical Instruments
Authors: Alvin M. Cotlar
Journal: JAMA (1983)

<i>Smiths' Reference and Illustrated Guide to Surgical Instruments</i>is a condensed compilation of those surgical instruments listed in 26 manufacturers' catalogues. This handy, hardcover 1,000-page volume is a must for every operating room supervisor, who will now be able to identify and discuss operating room instruments without having to contend with a mountain of catalogues and brochures. The instruments are in alphabetical order, beautifully illustrated, and meticulously classified by category, company of manufacture, complete description, and stock number. Although this is not a book for his personal library, the surgeon may now approach the subject of instrument selection and preference by consulting a single practical and understandable volume. A comprehensive index further simplifies use of this quite ambitious and effective publication.
Susceptibility to Diphtheria among Elderly Persons
Authors: Henry D. Brainerd, William Kiyasu, Mirra Scaparone, Louis O'Gara
Journal: New England Journal of Medicine (1952)

THIS study attempts to evaluate the incidence of susceptibility to diphtheria and the sensitivity to diphtheria toxoid among elderly persons. In addition, a pilot study on a method of immunizing susceptible elderly people is described.Diphtheria is ordinarily considered a disease of childhood, and thirty years ago the great majority of cases did occur in the first few years of life. According to Schick,1 67 per cent of cases occurred between the ages of two and six years, and diphtheria was "rarely observed in adult life." Similarly, Top2 stated that 80 per cent of cases occurred before the age of . . .
Fluid shear stress differentially modulates expression of genes encoding basic fibroblast growth factor and platelet-derived growth factor B chain in vascular endothelium.
Authors: A M Malek, G H Gibbons, V J Dzau, S Izumo
Journal: Journal of Clinical Investigation (1993)

Fluid shear stress has been shown to be an important regulator of vascular structure and function through its effect on the endothelial cell. We have explored the effect of shear stress on the expression of the heparin-binding growth factors platelet-derived growth factor B chain (PDGF-B) and basic fibroblast growth factor (bFGF) in bovine aortic endothelial cells using a purpose-built cone-plate viscometer. Using morphometric analysis, we have mimicked the endothelial cell shape changes encountered in vivo in response to shear stress and correlated these with changes in gene expression. Steady laminar shear stress of 15 and 36 dyn/cm2 both resulted in endothelial cell shape change, but the higher shear stress induced greater and more uniform alignment in the direction of flow and nuclear protrusion after 24 h. Steady laminar shear stress of both 15 and 36 dyn/cm2 induced a significant 3.9- and 4.2-fold decrease, respectively, in PDGF-B mRNA at 9 h. In contrast, steady laminar shear of 15 dyn/cm2 induced a mild and transient 1.5-fold increase in bFGF mRNA while shear of 36 dyn/cm2 induced a significant 4.8-fold increase at 6 h of shear which remained at 2.9-fold at 9 h. Pulsatile and turbulent shear stress showed the same effect as steady laminar shear stress (all at 15 dyn/cm2 time-average magnitude) on PDGF-B and bFGF mRNA content. Cyclic stretch (20% strain, 20/min) of cells grown on silicone substrate did not significantly affect either PDGF-B or bFGF mRNA levels. These results suggest that expression of each peptide growth factor gene is differentially regulated by fluid shear stress in the vascular endothelial cell. These results may have implications on vascular structure and function in response to hemodynamic forces and present a model for the study of transduction of mechanical stimuli into altered gene expression.
Sacral Neuromodulation for Neurogenic Lower Urinary Tract Dysfunction: Systematic Review and Meta-analysis
Authors: Thomas M. Kessler, David La Framboise, Sven Trelle, Clare J. Fowler, Gustav Kiss, Jürgen Pannek, Brigitte Schurch, Karl-Dietrich Sievert, Daniel S. Engeler
Journal: European Urology (2010)
Composite liver tumors: A radiologic-pathologic correlation
Authors: Megha Nayyar, David K. Imagawa, Temel Tirkes, Aram N. Demirjian, Roozbeh Houshyar, Kumar Sandrasegaran, Chaitali S. Nangia, Tara Seery, P Bhargava, Joon II Choi, Chandana Lall
Journal: Clinical and Molecular Hepatology (2014)

Bi-phenotypic neoplasm refers to tumors derived from a common cancer stem cell with unique capability to differentiate histologically into two distinct tumor types. Bi-phenotypic hepatocellular carcinoma-cholangiocarcinoma (HCC-CC), although a rare tumor, is important for clinicians to recognize, since treatment options targeting both elements of the tumor are crucial. Imaging findings of bi-phenotypic HCC-CC are not specific and include features of both HCC and CC. A combination of imaging and immuno-histochemical analysis is usually needed to make the diagnosis.
Kinetics and sites of destruction of111indium-oxine-labeled platelets in idiopathic thrombocytopenic purpura: A quantitative study
Authors: A. Dup. Heyns, M. G. Lötter, P. N. Badenhorst, Felicity De Kock, H. Pieters, C. Herbst, O. R. van Reenen, H. Kotze, P. C. Minnaar
Journal: American Journal of Hematology (1982)

Abstract Kinetics andw quantification of the sites of destruction of 111 ‐Indium‐oxine‐labeled autologous platelets were investigated in eight patients with idiopathic thrombocytopenic purpura. The mean platelet count was 17 ± 9 × 10 9 /liter; platelets were separated by differential centrifugation and labeled with 5.6 ± 2.5 MBq 111 In. Whole body and organ 111 In‐platelet distribution was quantitated with a scintillation camera and a computer‐assisted imaging system acquisition matrix. Areas of interest were selected with the computer and organ 111 In‐radioactivity expressed as a percentage of whole body activity. Mean platelet survival was 49.5 ± 29.6 hr and the survival curves were exponential. Equilibrium percentage organ 111 In‐radioactivity was (normal values in parentheses): spleen 33.7 ± 8.8(31.1 ± 10.2); liver 16.1 ± 9.5(13.1 ± 1.3); thorax 22.8 ± 3.7(28.2 ± 5.6). Percentage organ 111 In‐activity at the time when labeled platelets had disappeared from the circulation was: spleen 44.5 ± 16.4 (40 ± 16); liver 16.0 ± 11.5 (32.4 ± 7.2); thorax 19.7 ± 6.0 (17.7 ± 10.3). Thorax activity corresponds to bone marrow radioactivity. Three patterns of platelet sequestration were evident. Three patients had mainly splenic sequestration, two mainly hepatic sequestration, and three diffuse reticuloendothelial system sequestration with a major component of platelets destroyed in the bone marrow. Splenectomy was performed in two patients. The pattern of 111 In‐platelet sequestration was not predictive of response of glucocorticoid therapy or indicative of the necessity for splenectomy. Quantitative 111 In‐labeled autologous platelet kinetic studies provide a new tool for the investigation of platelet disorders.
Transesophageal echocardiography in infants and children with congenital heart disease.
Authors: R Weintraub, T Shiota, T Elkadi, P Golebiovski, J Zhang, A Rothman, S B Ritter, D J Sahn
Journal: Circulation (1992)

TEE applications for children and infants with congenital heart disease are now clinically established and TEE is being used in most major pediatric cardiovascular centers. This technology has evolved to the point that it is capable of providing diagnostic quality imaging, even for small infants. With expanding technology and increasing experience, new and more sophisticated applications will be found for pediatric TEE.
Dialysis and Disseminated Intravascular Coagulation
Authors: PAUL M. NESS
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 April 1981Dialysis and Disseminated Intravascular CoagulationPAUL M. NESS, M.D.PAUL M. NESS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-94-4-543_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Jacob and colleagues (1) have produced convincing evidence that hemodialysis produces neutropenia through complement activation. A recent case suggests that dialysis may produce disseminated intravascular coagulation and clinical bleeding by a similar mechanism.A 56-year-old man had recurrent episodes of bleeding during hemodialysis with a cuprophane hollow fiber dialyzer. He also had alcohol-induced liver disease and reflux esophagitis. Concern about mild bleeding history and abnormal coagulation tests prompted dialysis without heparin. Recurrent gastointestinal bleeding episodes usually began in the first hour of dialysis, frequently requiring transfusion. He had received 30 units of erythrocytes for bleeding occurring during...References1. JACOBCRADDOCKHAMMERSCHMIDTMOLDOW HPDC. Complement-induced granulocyte aggregation: an unsuspected mechanism of disease. N Engl J Med. 1980;302:789-94. CrossrefMedlineGoogle Scholar2. PERKINSROLFS HM. Quantitative assay of fibrinogen and fibrinolytic activity. Blood. 1963;22:485-97. CrossrefMedlineGoogle Scholar3. PERKINS H. Hematologic complications of extra-corporeal by-pass. J Extracorporeal Technol. 1970;9-20. Google Scholar4. MURANO G. The "Hageman" connection: interrelationships of blood coagulation, fibrino(geno)lysis, kinin generation, and complement activation. Am J Hematol. 1978;4:409-17. CrossrefMedlineGoogle Scholar5. GRALSCHROTHDEPALMAMAXWELL TPJM. Leukocyte dynamics during hemodialysis. In: KERR DNS, ed. Dialysis and Renal Transplantation. Vol. XI. London: Pitman Medical Publishing Co.; 1969:312-8. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Johns Hopkins Hospital Baltimore, MD 21205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByOn the safety of using stored bank blood for chronic hemodialysis patients 1 April 1981Volume 94, Issue 4_Part_1Page: 543-544KeywordsAlcoholic liver diseaseComplement activationDisseminated intravascular coagulationHemorrhageHeparinLiver diseasesMedical dialysisNeutropenia Issue Published: 1 April 1981 PDF DownloadLoading ...
Respiratory disease in systemic lupus erythematosus: correlation with results of laboratory tests and histological appearance of muscle biopsy specimens.
Authors: S A Evans, N D Hopkinson, W J Kinnear, L Watson, R J Powell, I D Johnston
Journal: Thorax (1992)

In systemic lupus erythematosus, certain laboratory tests and evidence from muscle biopsy specimens of lymphocytic vasculitis reflect disease activity. A study was designed to determine if such indices predict respiratory lesions, and in particular whether the presence of vasculitis in quadriceps muscle reflects respiratory muscle function.Twenty seven 27 patients with systemic lupus erythematosus were studied, ten of whom were consecutive untreated patients and 17 having clinically active disease and being treated. They were prospectively evaluated on the basis of erythrocyte sedimentation rate, lymphocyte count, C3 degradation products, quadriceps muscle biopsy, spirometry, lung volumes, carbon monoxide transfer factor, and mouth pressure during a maximal sniff.Lung function test results were abnormal in 12 patients. Vital capacity was reduced in seven, carbon monoxide transfer factor capacity in five, and mouth pressure was low (< 70% predicted) in ten. Lymphocytic vasculitis was seen in the muscle biopsy specimens of ten patients. No correlation was found between laboratory tests and lung function or mouth pressure, or between the presence of lymphocytic vasculitis and mouth pressure. In untreated patients, those with lymphocytic vasculitis had lower spirometric values.In systemic lupus erythematosus, evidence from muscle biopsy specimens of lymphocytic vasculitis is not predictive of impaired inspiratory muscle function as measured by mouth pressure. In untreated patients there were relationships between some laboratory test results and respiratory function, but this was not the case for the whole group. In systemic lupus erythematosus, laboratory tests and evidence from muscle biopsy specimens of lymphocytic vasculitis are therefore unlikely to be helpful in the assessment of respiratory disease.
Biliverdin therapy protects rat livers from ischemia and reperfusion injury
Authors: Constantino Fondevila, Xiu–Da Shen, Seiichiro Tsuchiyashi, Kenichiro Yamashita, Eva Csizmadia, Charles Lassman, Ronald W. Busuttil, Jerzy W. Kupiec–Weglinski, Fritz H. Bach
Journal: Hepatology (2004)

Heme oxygenase (HO-1) provides a cellular defense mechanism during oxidative stress and catalyzes the rate-limiting step in heme metabolism that produces biliverdin (BV). The role of BV and its potential use in preventing ischemia/reperfusion injury (IRI) had never been studied. This study was designed to explore putative cytoprotective functions of BV during hepatic IRI in rat liver models of ex vivo perfusion and orthotopic liver transplantation (OLT) after prolonged periods of cold ischemia. In an ex vivo hepatic IRI model, adjunctive BV improved portal venous blood flow, increased bile production, and decreased hepatocellular damage. These findings were correlated with amelioration of histological features of IRI, as assessed by Suzuki's criteria. Following cold ischemia and syngeneic OLT, BV therapy extended animal survival from 50% in untreated controls to 90% to 100%. This effect correlated with improved liver function and preserved hepatic architecture. Additionally, BV adjuvant after OLT decreased endothelial expression of cellular adhesion molecules (P-selectin and intracellular adhesion molecule 1), and decreased the extent of infiltration by neutrophils and inflammatory macrophages. BV also inhibited expression of inducible nitric oxide synthase and proinflammatory cytokines (interleukin 1beta, tumor necrosis factor alpha, and interleukin 6) in OLTs. Finally, BV therapy promoted an increased expression of antiapoptotic molecules independently of HO-1 expression, consistent with BV being an important mediator through which HO-1 prevents cell death. In conclusion, this study documents and dissects potent cytoprotective effects of BV in well-established rat models of hepatic IRI. Our results provide the rationale for a novel therapeutic approach using BV to maximize the function and thus the availability of donor organs.
Economic transition and changing relation between income inequality and mortality in Taiwan: regression analysis
Authors: T.-l. Chiang
Journal: BMJ (1999)

To examine the changing relation between income inequality and mortality through different stages of economic development in Taiwan.Regression analysis of mortality on income inequality for three index years: 1976, 1985, and 1995.21 counties and cities in Taiwan.All age mortality and age specific mortality in children under age 5.When median household disposable income was controlled for, the association between income inequality and mortality became stronger in 1995 than in 1976. Especially, the association between income inequality and mortality in children aged under 5, with adjustment for differences in median household disposable income, changed from non-significant in 1976 to highly significant in 1995. In 1995, the level of household income after adjustment for income distribution no longer had a bearing on mortality in children under 5.The health of the population is affected more by relative income than by absolute income after a country has changed from a developing to a developed economy.
NOTES ON THE INFLUENZA EPIDEMIC IN THE EGYPTIAN EXPEDITIONARY FORCE
Authors: J. D. Benjafield
Journal: BMJ (1919)

Whether or no this proves to be the true explanation, the interpretation of the failure of the kidney in certain stages and cases of nephritis to show any morning alkaline tide still requires investigation; this is being prosecuted.But in the cases available for the work of whIch this is a preliminary report it is not a failure of the kidney in its power to turn out acid that is indicated; the abnormality is that the kidney gives an acid urine in conditions in which a normal kidney gives an alkaline urine.The question arises, therefore, whether this abnormality may not be an expression of an effect of the disease of the kidney on the function of some other organ.The gradual return to the normal type of response shown in tests done on the same patient at intervals of two or -three weeks during recovery is striking, and in a fuller account of the work to appear later will be illustrated by protocols.
NHS review. The white paper and the independent sector: scope for growth and restructuring.
Authors: W. Laing
Journal: BMJ (1989)

well provide incentives that act against the interests of some non-remunerative local services.To avoid this danger monitoring should extend beyond clinical outcomes and incorporate more general data on the comprehensiveness of services and access to them. ConclusionSelf governing hospitals will represent an untried form of organisation operating within an untested market environment.It is impossible to say with any certainty how they or the market will perform.This will become clear only if and when the new style NHS gets under way.Recognition of the uncertainty surrounding these and other proposals led to widespread calls for experiments in the period of debate leading up to the publication of the white paper.But ministers have rejected this option.The white paper is about implementation not experimentation.Fortunately, however, the conditions that the government has specified as a prerequisite for attaining self governing status will mean that the pace of implementation can be only gradual.Indeed, after much initial enthusiasm many hospitals now seem more cautious about apply- ing for self governing status as the pitfalls become more apparent.Present indications suggest that there is unlikely to be a rush of volunteers.All of this should mean that the process of implementation will at least provide the opportunity to learn by doing and to adjust the model of a hospital trust as its strengths and weaknesses become apparent.
Number of UK women who will get breast cancer has risen to one in eight
Authors: J. Wise
Journal: BMJ (2011)

The lifetime risk of a woman in the United Kingdom developing breast cancer has risen from one in nine to one in eight, Cancer Research UK says.

The charity calculated the figures from data obtained from the Office for National Statistics and UK cancer registries. It found that the number of diagnoses of breast cancer rose from 42 400 in 1999 to 47 700 in 2008, a 3.5% rise.

The biggest rise was seen in women aged between 50 and 69 years, whose incidence rose by more than 6% in the same 10 years. Among women aged 25 to 49 the incidence fell slightly, by 0.5%.

The charity offers a number of possible explanations for the overall rise. One is that more women are now attending breast screening clinics. In 2004 the national breast screening …
Modulation of eicosanoid production by human alveolar macrophages exposed to silica in vitro.
Authors: H S Koren, M Joyce, R B Devlin, S Becker, K Driscoll, M C Madden
Journal: Environmental Health Perspectives (1992)

Repeated inhalation of silica dust can lead to inflammation and fibrosis in human lung and in experimental animal models. The alveolar macrophage is believed to play a pivotal role in this process. Numerous macrophage-derived growth factors, cytokines, and arachidonic acid metabolites have been shown to contribute to inflammation and fibrosis. The objective of this study was to determine the eicosanoid production by human alveolar macrophages in response to silica exposure in vitro and to assess the contribution of alveolar macrophages to silica-induced fibrosis and inflammation. Macrophages were obtained from healthy volunteers and were incubated for 3 or 24 hr in the presence of silica (100, 60, and 0 micrograms/mL). Supernatants were removed for eicosanoid analysis. Eicosanoids were analyzed by both high performance liquid chromatography and radioimmunoassay. The data suggest that silica causes an increased release of leukotriene B4, leukotrienes C4/D4/E4, and 5-hydroxyeicosatetraenoic acid (5-HETE) after 3 hr and decreases in prostaglandin E2 and thromboxane B2 production after 24 hr of exposure to 100 micrograms/mL silica. In addition, 12-HETE and 15-HETE production remained unchanged at either time point. These opposing effects seen with the metabolites of lipoxygenase and cyclooxygenase pathways could contribute to silica-induced fibrosis. The pattern of eicosanoid production after exposure to silica was different from that obtained when macrophages were stimulated with lipopolysaccharide for 3 or 24 hr, indicating that the response to the particles was not just due to general cellular activation.