tbuckley/cabot-search huggingface dataset:
Measuring Coverage in MNCH: Accuracy of Measuring Diagnosis and Treatment of Childhood Malaria from Household Surveys in Zambia
Authors: Thomas P. Eisele, Kafula Silumbe, Josh Yukich, Busiku Hamainza, Joseph Keating, Adam Bennett, John M. Miller
Journal: PLoS Medicine (2013)

Background To assess progress in the scale-up of rapid diagnostic tests and artemisinin-based combination therapies (ACTs) across Africa, malaria control programs have increasingly relied on standardized national household surveys to determine the proportion of children with a fever in the past 2 wk who received an effective antimalarial within 1–2 d of the onset of fever. Here, the validity of caregiver recall for measuring the primary coverage indicators for malaria diagnosis and treatment of children <5 y old is assessed. Methods and Findings A cross-sectional study was conducted in five public clinics in Kaoma District, Western Provence, Zambia, to estimate the sensitivity, specificity, and accuracy of caregivers' recall of malaria testing, diagnosis, and treatment, compared to a gold standard of direct observation at the health clinics. Compared to the gold standard of clinic observation, for recall for children with fever in the past 2 wk, the sensitivity for recalling that a finger/heel stick was done was 61.9%, with a specificity of 90.0%. The sensitivity and specificity of caregivers' recalling a positive malaria test result were 62.4% and 90.7%, respectively. The sensitivity and specificity of recalling that the child was given a malaria diagnosis, irrespective of whether a laboratory test was actually done, were 76.8% and 75.9%, respectively. The sensitivity and specificity for recalling that an ACT was given were 81.0% and 91.5%, respectively. Conclusions Based on these findings, results from household surveys should continue to be used for ascertaining the coverage of children with a fever in the past 2 wk that received an ACT. However, as recall of a malaria diagnosis remains suboptimal, its use in defining malaria treatment coverage is not recommended. Please see later in the article for the Editors' Summary
Comparison of two methods of management of clean surgical wounds. "Open" vs "closed" postoperative wound care
Authors: R. H. Edwards
Journal: JAMA (1967)

THE METHODS of postoperative management of clean surgical wounds vary widely among surgeons. Some change all dressings daily, some remove them permanently early, some leave them untouched for 5 to 7 days or longer, and some do not apply dressings at all. Allegedly, dressings function to absorb secretions, prevent contamination, aid hemostasis, protect against injury, and eliminate dead spaces. 1,2 In general, dressings must accompany wound drains; however, the use of wound suction in the neck, axilla, groin, and elsewhere has shown that drainage of extensive wounds can be managed other than by the utilization of absorptive dressings. Short of a bulky pressure dressing, which is useful at times, an ordinary dressing perhaps has negligible effect on hemostasis and the elimination of dead space. Protection against injury is probably a relatively unimportant function of dressings, but prevention of irritation of the wound by clothing may contribute significantly to the comfort
Ga-67 Scan of a Homosexual Man with Pneumocystis Carinii Pneumonia
Authors: REGINA LIEBMAN, U YUN RYO, CARLOS BEKERMAN, STEVEN PINSKY
Journal: Clinical Nuclear Medicine (1982)

LIEBMAN, REGINA M.D.; RYO, U YUN M.D., Ph.D.; BEKERMAN, CARLOS M.D.; PINSKY, STEVEN M. M.D. Author Information
Reviews and Notes: Cardiology: Clinical Cardiac Rehabilitation: A Cardiologist's Guide
Authors: James D. Walter
Journal: Annals of Internal Medicine (1994)

Literature of Medicine15 February 1994Reviews and Notes: Cardiology: Clinical Cardiac Rehabilitation: A Cardiologist's GuideJames D. Walter and Mariell JessupJames D. WalterPhiladelphia Heart Institute, Presbyterian Medical Center, Philadelphia, PA 19104.Search for more papers by this author and Mariell JessupPhiladelphia Heart Institute, Presbyterian Medical Center, Philadelphia, PA 19104.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-4-199402150-00042 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical Cardiac Rehabilitation: A Cardiologist's GuideFrederick J. Pashkow and William Dafoe; eds. 391 pages. Baltimore: Williams & Wilkins; 1993. $59.00.Who has the largest influence on a patient's decision to enter a cardiac rehabilitation program? The patient's cardiologist, internist, or primary physician. Accordingly, this book begins with three well-written chapters describing how cardiac rehabilitation has evolved from traditional exercise training sessions to our current comprehensive programs that address all aspects of cardiovascular care.Thus, this book is written not only as an instruction manual for the implementation of a rehabilitation program but also as a guide for the busy ... Author, Article, and Disclosure InformationAffiliations: Philadelphia Heart Institute, Presbyterian Medical Center, Philadelphia, PA 19104. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1994Volume 120, Issue 4Page: 350-351KeywordsCardiac rehabilitationCardiac transplantationExercisePacemakersPeripheral vascular diseasePopulation statisticsPsychologistsSexual identitySmoking cessationVascular diseases ePublished: 15 August 2000 Issue Published: 15 February 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Franz Kafka—His Father's Son
Authors: Gerard J. McGarrity
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I'd like to offer an alternate interpretation to N.Y. Hoffman's views of Franz Kafka's latent homosexuality and lack of erotic themes in his love letters in her otherwise excellent critique (229:1623, 1974). Max Brod, Kafka's lifelong friend and biographer, distinguishes between the introspective, pessimistic, and private Kafka of his diaries and works and the humorous, optimistic, and life-loving public man. Kafka often sent love and kisses to Brod in his letters. This is the public Jewish man speaking in Prague of the early 1900s. Brod indirectly comments on this only once, when he presents several Kafka letters with the general introit: "They appear to me to be especially characteristic documents of a boundlessly rich spirit which never succumbed to routine or convention." In one letter Kafka states: "This... is a kiss from me to you—in front of the whole populace." Regarding K's lack of erotic themes in
Atorvastatin prevents carbohydrate response element binding protein activation in the fructose-fed rat by activating protein kinase A
Authors: Ricardo Rodríguez‐Calvo, Emma Barroso, Lucía Serrano, Teresa Coll, Rosa M. Sánchez, Manuel Merlos, Xavier Palomer, Juan C. Laguna, Manuel Vázquez‐Carrera
Journal: Hepatology (2008)

High fructose intake contributes to the overall epidemic of obesity and metabolic disease. Here we examined whether atorvastatin treatment blocks the activation of the carbohydrate response element binding protein (ChREBP) in the fructose-fed rat. Fructose feeding increased blood pressure (21%, P < 0.05), plasma free fatty acids (59%, P < 0.01), and plasma triglyceride levels (129%, P < 0.001) compared with control rats fed standard chow. These increases were prevented by atorvastatin. Rats fed the fructose-rich diet showed enhanced hepatic messenger RNA (mRNA) levels of glycerol-3-phosphate acyltransferase (Gpat1) (1.45-fold induction, P < 0.05), which is the rate-limiting enzyme for the synthesis of triglycerides, and liver triglyceride content (2.35-fold induction, P < 0.001). Drug treatment inhibited the induction of Gpat1 and increased the expression of liver-type carnitine palmitoyltransferase 1 (L-Cpt-1) (128%, P < 0.01). These observations indicate that atorvastatin diverts fatty acids from triglyceride synthesis to fatty acid oxidation, which is consistent with the reduction in liver triglyceride levels (28%, P < 0.01) observed after atorvastatin treatment. The expression of Gpat1 is regulated by ChREBP and sterol regulatory element binding protein-1c (SREBP-1c). Atorvastatin treatment prevented fructose-induced ChREBP translocation and the increase in ChREBP DNA-binding activity while reducing SREBP-1c DNA-binding activity. Statin treatment increased phospho-protein kinase A (PKA), which promotes nuclear exclusion of ChREBP and reduces its DNA-binding activity. Human HepG2 cells exposed to fructose showed enhanced ChREBP DNA-binding activity, which was not observed in the presence of atorvastatin. Furthermore, atorvastatin treatment increased the CPT-I mRNA levels in these cells. Interestingly, both effects of this drug were abolished in the presence of the PKA inhibitor H89.These findings indicate that atorvastatin inhibits fructose-induced ChREBP activity and increases CPT-I expression by activating PKA.
An in-Training Examination for Residents as a Guide to Learning
Authors: John P. Hubbard, Leonard T. Furlow, Donald D. Matson
Journal: New England Journal of Medicine (1967)

PREPARATION for qualification in the various medical specialties in the United States is becoming more and more complex, and establishment of minimum standards of education and competence in these special areas has become a matter of increasing importance to specialty boards, professional societies and all those concerned with graduate and continuing education of the physician.The American Board of Neurological Surgery, in keeping with its declared objectives – "to encourage the study, improve the practice, elevate the standards, and advance the science of Neurological Surgery" – has been, for many years, disturbed by the high failure rate of candidates appearing . . .
Prompt response to rituximab of severe hemolytic anemia with both cold and warm autoantibodies
Authors: Duncan Webster, Bruce Ritchie, Michael J. Mant
Journal: American Journal of Hematology (2004)

Abstract A 71‐year‐old male with severe autoimmune hemolysis with both cold agglutinins and warm antibodies was intolerant of prednisone and cyclophosphamide. Rituximab was given during a 60‐day period when he required 41 units of packed cells to maintain hemoglobin above 75 g/l. Two weeks later hemoglobin stabilized at 95 g/l, and further transfusions were not required. A second course of rituximab was given 4 months later for continued hemolysis. A satisfactory hemoglobin was maintained for 9 months from initial treatment, when hemoglobin again fell to 65 g/L. A prompt response to a third course of rituximab was obtained. This is the second patient with both cold agglutinins and warm antibodies with severe hemolytic anemia who has had a prompt response to rituximab. This treatment should be considered when a rapid response is needed or when a patient has failed to respond to more standard therapies. Am. J. Hematol. 75:258–259, 2004. © 2004 Wiley‐Liss, Inc.
Operations for portal hypertension due to extrahepatic obstruction: results and 10 year follow up.
Authors: G K Pande, V M Reddy, P Kar, P Sahni, M Berry, B N Tandon, S Nundy
Journal: BMJ (1987)

Between 1976 and 1984, 136 patients with portal hypertension due to extrahepatic obstruction were operated on. Twenty two patients had emergency and 114 elective operations. The operative mortality was 9% and 1%, respectively. Altogether 117 patients (86%) were followed up for from two to 10 years: 17 rebled, none developed encephalopathy or sepsis after splenectomy, and 90% and 75% were alive at five and 10 years respectively. Unlike endoscopic sclerotherapy and treatment with propranolol, operative treatment of variceal bleeding can usually be completed during one admission and carries a low mortality and a fairly low morbidity. Operation seems to be the best form of treatment for poor patients living far from medical facilities in developing countries and may be the treatment of choice in developed countries as well.
Combination of adenosine-deaminase and nucleic acid amplification assays for diagnosing tuberculous pleural effusion
Authors: Sunil Sethi, Jaspreet Kaur, Rakesh Yadav, Sunil Kumar Dhatwalia, Abhishek Mewara, Satyavati Rana, Dheeraj Gupta, Rupinder Tewari
Journal: Journal of Infection (2014)
Sara and George and Justice
Authors: Howard Fillit
Journal: Annals of Internal Medicine (2004)

On Being a Doctor4 May 2004Sara and George and JusticeHoward Fillit, MDHoward Fillit, MDFrom Institute for the Study of Aging, New York, NY 10153.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-9-200405040-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As an expert witness for the defense, I reviewed the case of a 90-year-old woman with Alzheimer disease who died of complications from a urinary tract infection in a nursing home. The case seemed like a typical clinical situation I had been involved with many times as a geriatrician, but in this case, the doctor was being sued for wrongful death.Sara had lived in the nursing home for 5 years. George, her devoted husband, couldn't take care of her anymore. He put her in a "good home" and visited her every week, as Sara became a nonverbal, completely dependent ... Author, Article, and Disclosure InformationAffiliations: From Institute for the Study of Aging, New York, NY 10153.Note: All names have been changed.Corresponding Author: Howard Fillit, MD, Institute for the Study of Aging, 767 Firth Avenue, Suite 4600, New York, NY 10153, e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAn Advanced Course in Long Term Care for Geriatric Medicine Fellows 4 May 2004Volume 140, Issue 9Page: 759-760KeywordsAlzheimer diseaseAntibioticsChartsHomicideLung and intrathoracic tumorsNursesNursing homesPalliative careUrine ePublished: 4 May 2004 Issue Published: 4 May 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Anaemia of Newborn Following Anterior Placenta Praevia
Authors: N. R. Butler, J. D. Martin
Journal: BMJ (1954)

MBDICLJURNAL 1455 being near and around the cricoid lamina.The source of infection was probably in the left tonsil, which was swollen and had led to the secondary swelling of the left submaxillary gland.Review of Literature Koerner (1914) regards dyspnoea and pain on swallowing as the principal and most frequent complaint in laryngeal perichondritis.Denker and Bruenings (1921) state that temperature and distressing pain usually appear in the course of acute laryngeal perichondritis, lancinating into the ears when swallowing.I have stated (Rosenbaum, 1930) that pain in swallowing, earache, and tenderness on palpation are always present; also shortness of breath, but this last re- mark is certainly wrong.Dyspnoea can be, but is not necessarily, present.Wessely (1944) proposed " prontosil " (sulphonamide) therapy in cases of phlegmonous laryngitis.The Chevalier Jacksons (1942) distinguish between oedematous septic laryngitis and laryngeal perichondritis, defining the former as an aggressive inflammatory condition in which the submucous and deeper tissues are involved, while re- garding the latter as possibly a secondary and late develop- ment of the septic type of inflammation.They state that the oedema secondary to perichondritis is pale, as compared with the intense red usually seen in septic laryngitis.They enumerate as symptoms of phlegmonous laryngitis, hoarse- ness, some fever, complete aphagia, offensive breath, and croupy voice in cases of subglottic involvement.These authors give a general picture of acute perichondritis as that of an acute watery or acute red oedema.The Jacksons (1945) also declare that the colour of the swollen tissue in perichondritis varies.That is also my opinion.Simultaneous changes occur in the character of the disease, the colour of the oedema and inflammation, and in the symptoms; but the colour of the oedema should be of no great importance to the practitioner.
CD34+ cells from AML with mutated NPM1 harbor cytoplasmic mutated nucleophosmin and generate leukemia in immunocompromised mice
Authors: Maria Paola Martelli, Valentina Pettirossi, Christian Thiede, Elisabetta Bonifacio, Federica Mezzasoma, Debora Cecchini, Roberta Pacini, Alessia Tabarrini, Raffaella Ciurnelli, Ilaria Gionfriddo, Nicla Manes, Roberta Rossi, Linda Giunchi, Uta Oelschlägel, Lorenzo Brunetti, Marica Gemei, Mario Delia, Giorgina Specchia, Arcangelo Liso, Mauro Di Ianni, Francesco Di Raimondo, Franca Falzetti, Luigi Del Vecchio, Massimo F. Martelli, Brunangelo Falini
Journal: Blood (2010)
Investigating fertility problems
Authors: A. Davis, K. Madhvani, L. Lee
Journal: BMJ (2012)

A 29 year old nulliparous woman was referred to the radiology department by her gynaecologist for a hysterosalpingogram. She had been trying unsuccessfully to conceive for 15 months. She had no medical, surgical, or gynaecological history. She had never been pregnant. Her body mass index was normal and she was a non-smoker. She described a regular 28 day menstrual cycle, with periods—which were not heavy or painful—lasting between five and six days. She had no history of sexually transmitted diseases. Day 21 progesterone concentrations indicated that she was ovulating and her partner’s semen analysis was normal. The couple were having regular intercourse. A chlamydia test was negative. Hysterosalpingography was carried out (fig 1⇓).





### 1 What is infertility?

#### Short answer

Infertility (clinical definition) is currently defined as one year of unwanted non-conception with unprotected intercourse in the fertile phase of the menstrual cycle.1

#### Long answer

Couples who have not conceived after one year of regular unprotected sexual intercourse should be offered clinical investigation, including semen analysis and assessment of ovulation.

Offer earlier investigation if the woman is aged 35 years or there is a history of predisposing factors (such as amenorrhoea, oligomenorrhoea, pelvic inflammatory disease, or undescended testes).

Couples who are worried about their fertility should be informed that 84% of couples in the general population will conceive within one year if they do not use contraception and have regular sexual intercourse. Of those who do not conceive in the first year, about half will do so in the second year (cumulative pregnancy rate 92% after two years and 93% after three years).2 3

### 2 How should a couple presenting with infertility be investigated?

#### Short answer

Focused questioning to identify known risk factors; …
Hepatic metabolism during acute ethanol administration: A phosphorus-31 nuclear magnetic resonance study on the perfused rat liver under normoxic or hypoxic conditions
Authors: Franck Desmoulin, Paul Canioni, Christian Crotte, André Gérolami, Patrick J. Cozzone
Journal: Hepatology (1987)

The effect of ethanol metabolism on the energetic parameters and intracellular pH of the isolated perfused rat liver from fed rats was studied by phosphorus-31 nuclear magnetic resonance spectroscopy. This technique allowed us to analyze nondestructively and in real time the role of low oxygen tension on the possible injurious effect of ethanol on the liver cells. A quantitative analysis of nuclear magnetic resonance data recorded on a perfused rat liver within a 30 mm diameter probe has been performed at 80.9 MHz. Under normoxic and normothermic conditions, the levels of phosphorylated metabolites detected by nuclear magnetic resonance were 2.8, 0.3 and 2 μmoles per gm liver wet weight for ATP, ADP and inorganic orthophosphate, respectively. The cytosolic pH was 7.25 ± 0.05. During a period of 4 min of hypoxia induced by reducing the perfusion flow rate to 25% of its initial value (i.e., from 12 ml to 3 ml per min per 100 gm body weight), the level of ATP dropped to 2.2 μmoles per gm liver wet weight. Concomitantly, ADP and inorganic orthophosphate increased to 0.6 and 3.3 μmolès per gm liver wet weight. Cytosolic pH fell to 7.02 ± 0.05. Perfusion of the liver with a Krebs medium containing 70 m M (0.4%) ethanol induced a sharp decrease in intracellular inorganic orthophosphate to reach 1.3 μmole per gm liver wet weight and after a lag time of 4 to 6 min, a decrease in ATP level (2.15 μmoles per gm liver wet weight). A large increase in phosphomonoesters (mainly sn -glycerol 3-phosphate) up to 6 μmoles per gm liver wet weight was also observed. No significant cytosolic pH variation was noted after 20 min of ethanol perfusion (pH 7.20 ± 0.05). In the presence of 70 m M ethanol, a 4-min period of hypoxia caused pronounced changes; in particular, the level of ATP dropped to 1.15 μmole per gm liver wet weight, and a large intracellular acidosis occurred (pH 6.80 ± 0.05). Ethanol oxidation during hypoxia is also correlated to a dramatic increase in the cytosolic content of sn -glycerol 3-phosphate, as compared to the level found under normoxic ethanol perfusion. Data presented here indicate that ethanol hepatotoxicity might be enhanced under hypoxia due to accumulation of protons in the cytosol. This severe metabolic acidosis is likely to contribute to metabolic disturbances occurring during ethanol exidation. Ethanol metabolism in fed rats gives rise to a synthesis of sn -glycerol 3-phosphate correlated with a decrease in cytosolic inorganic orthophosphate which in turn becomes limiting for ATP production. Finally, the observed increase in sn -glycerol 3-phosphate under hypoxia indicates that the sn -glycerol 3-phosphate/dihydroxyacetone phosphate shuttle could play a very important role as a compensatory mechanism in hypoxic regions of the liver in order to compensate for the decreased activity of the malate/aspartate shuttle.
Intravenous injection of recombinat hepatitis B virus (HBV) DNA achieves high-level expression of HBV as well as humoral immune response in mice
Authors: Takahiro Suzuki, Tetsuo Takehara, Tatsuya Kanto, Takuya Miyagi, Masahisa Jinushi, Yoshiko Sugimoto, Yutaka Sasaki, Norio Hayashi
Journal: Journal of Hepatology (2002)
In utero pesticide exposure, maternal paraoxonase activity, and head circumference.
Authors: Gertrud S Berkowitz, James G Wetmur, Elena Birman-Deych, Josephine Obel, Robert H Lapinski, James H Godbold, Ian R Holzman, Mary S Wolff
Journal: Environmental Health Perspectives (2003)

Although the use of pesticides in inner-city homes of the United States is of considerable magnitude, little is known about the potentially adverse health effects of such exposure. Recent animal data suggest that exposure to pesticides during pregnancy and early life may impair growth and neurodevelopment in the offspring. To investigate the relationship among prenatal pesticide exposure, paraoxonase (PON1) polymorphisms and enzyme activity, and infant growth and neurodevelopment, we are conducting a prospective, multiethnic cohort study of mothers and infants delivered at Mount Sinai Hospital in New York City. In this report we evaluate the effects of pesticide exposure on birth weight, length, head circumference, and gestational age among 404 births between May 1998 and May 2002. Pesticide exposure was assessed by a prenatal questionnaire administered to the mothers during the early third trimester as well as by analysis of maternal urinary pentachlorophenol levels and maternal metabolites of chlorpyrifos and pyrethroids. Neither the questionnaire data nor the pesticide metabolite levels were associated with any of the fetal growth indices or gestational age. However, when the level of maternal PON1 activity was taken into account, maternal levels of chlorpyrifos above the limit of detection coupled with low maternal PON1 activity were associated with a significant but small reduction in head circumference. In addition, maternal PON1 levels alone, but not PON1 genetic polymorphisms, were associated with reduced head size. Because small head size has been found to be predictive of subsequent cognitive ability, these data suggest that chlorpyrifos may have a detrimental effect on fetal neurodevelopment among mothers who exhibit low PON1 activity.