tbuckley/cabot-search huggingface dataset:
Talking about Treatment
Authors: John C. Peirce
Journal: Annals of Internal Medicine (2000)

Letters4 January 2000Talking about TreatmentJohn C. Peirce, MD, MA, MSJohn C. Peirce, MD, MA, MSGood Samaritan Regional Medical Center; Phoenix, AZ 85006 (Peirce)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-1-200001040-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Steiner (1) has captured the difficulties in translating population-based studies into a language that informs patient's decisions. Goodman (2) adds a historical perspective that contrasts the deterministic with the probabilistic model, noting “ … that in the individual patient … the concept of probability … is ambiguous and elusive, no matter how we choose to communicate it.” This description fits the properties of complex systems wherein events often are surprising and are revealed only through nonlinear dynamics (3). It is not surprising, then, that epidemiologic biostatistics, which is the basis of most if not all of our ...References1. Steiner JF. Talking about treatment: the language of populations and the language of individuals. Ann Intern Med. 1999;130:618-21. LinkGoogle Scholar2. Goodman SN. Probability at the bedside: the knowing of chances or the chances of knowing [Editorial]. Ann Intern Med. 1999;130:604-6. LinkGoogle Scholar3. Gleick J. Chaos: Making a New Science. New York: Penguin Books; 1987. Google Scholar4. Goldberger AL. Fractal variability versus pathological periodicity: complexity loss and stereotypy in disease. Perspect Biol Med. 1997;40:543-61. CrossrefMedlineGoogle Scholar5. Holland JH. Emergence: From Chaos to Order. Reading, MA: Addison-Wesley; 1998. Google Scholar Author, Article, and Disclosure InformationAffiliations: Good Samaritan Regional Medical Center; Phoenix, AZ 85006 (Peirce) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTalking about Treatment: The Language of Populations and the Language of Individuals John F. Steiner Flock Worker's Lung William S. Beckett Probability at the Bedside: The Knowing of Chances or the Chances of Knowing? Steven N. Goodman Talking about Treatment Bimal P. Jain Talking about Treatment Benjamin Djulbegovic , Gary H. Lyman , and Iztok Hozo Talking about Treatment Richard Saitz Talking about Treatment Kenneth M. Kessler Metrics 4 January 2000Volume 132, Issue 1Page: 93-94KeywordsBiostatisticsComplex systemsEpidemiologyFallsGamesTouch Issue Published: 4 January 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ventricular Arrhythmia in Chronic Stable Angina Pectoris with Surgical or Medical Treatment
Authors: NEIL de SOYZA
Journal: Annals of Internal Medicine (1978)

Since both propranolol therapy and saphenous-vein bypass surgery have become accepted treatments for patients with symptomatic coronary-artery disease, it is important to determine if either influences the prevalence of ventricular arrhythmias in these patients. Six-hour dynamic electrocardiography was done on 130 patients with chronic stable angina pectoris at least 1 year after being randomized to surgical or medical therapy. All surgical patients had saphenous-vein grafting; 90% of the medical patients received propranolol. Data analysis showed that even though the overall prevalence of premature ventricular contractions was no different in medical and surgical patients, the prevalence of complex premature ventricular contractions was significantly higher in surgically treated patients not receiving propranolol than in propranolol-treated medical patients (p < 0.05). However, the survival rate was no different in either group, and the quality of life in the surgical patients remained superior.
Cost of Initial Therapy in the Electrophysiological Study Versus ECG Monitoring Trial (ESVEM)
Authors: Nowamagbe A. Omoigui, Frank I. Marcus, Jay W. Mason, Elizabeth A. Hahn, Vernon L. Hartz, Mark A. Hlatky
Journal: Circulation (1995)

Background Patients randomized to either serial electrophysiological testing (EPS) or serial Holter monitoring (HM) to guide antiarrhythmic therapy for life-threatening ventricular arrhythmias had equivalent rates of mortality and arrhythmia recurrence in the ESVEM study. This report analyzes the effects of EPS, HM, and clinical factors on the charges for initial evaluation and management of patients with life-threatening ventricular arrhythmias. Methods and Results Ten of 14 clinical centers participating in ESVEM provided bills from the initial hospitalization for randomized patients. Predictors of charges (1991 dollars) were analyzed by linear regression after logarithmic transformation. Initial hospital charge data were obtained for 286 patients randomized in ESVEM (88% of patients eligible for this substudy, 59% of all ESVEM patients). Patients with charge data were somewhat more likely to be older, to be female, and to have failed previous antiarrhythmic drug therapy at study entry and were less likely to have a drug predicted effective after randomization. Mean overall hospital charges were $35 986 (SD, $32 628) with a median of $24 532 (interquartile range, $16 126 to $43 593). Prerandomization patient characteristics generally had insignificant effects on charges, with the exception of presentation with resuscitated sudden death (28% increase in charges, P =.01) and heart failure (26% increase in charges, P =.02). Patients randomized to EPS had higher mean charges for evaluation ($42 002 versus $29 970, P =.0015) as well as more drug trials (3.0 versus 2.1, P =.0001) and a longer hospital stay (19.6 versus 13.9 days, P =.0007). In a multivariate regression model, failure to find an effective drug ( P =.0001), the number of drug trials ( P =.0001), and resuscitated sudden death as the presenting arrhythmia ( P =.0001) were the only independent predictors of higher initial charges. Conclusions (1) Initial hospital charges are significantly higher for EPS-guided than HM-guided therapy. (2) The higher charges for EPS-guided therapy were due to a greater number of drug trials and a lower probability of finding an effective drug. (3) Failure to find an effective drug, a larger number of drug trials, and a history of resuscitated sudden death independently predict higher charges.
FAVUS OF SCALP WITH UNUSUAL EPIDEMIOLOGICAL FEATURES.
Authors: PETER INMAN
Journal: British Journal of Dermatology (1954)

Journal Article FAVUS OF SCALP WITH UNUSUAL EPIDEMIOLOGICAL FEATURES. Get access PETER INMAN PETER INMAN Consultant Dermatologist, Sunderland and West Hartlepool Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 66, Issue 11, 1 November 1954, Pages 409–410, https://doi.org/10.1111/j.1365-2133.1954.tb12569.x Published: 01 November 1954
Ventilator Circuit Changes
Authors: Didier Dreyfuss
Journal: Annals of Internal Medicine (1996)

Letters15 May 1996Ventilator Circuit ChangesDidier Dreyfuss, MD and Kamel Djedaini, MDDidier Dreyfuss, MDHopital Louis Mourier; 92700 Colombes, FranceSearch for more papers by this author and Kamel Djedaini, MDHopital Louis Mourier; 92700 Colombes, FranceSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-10-199605150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest the article by Kollef and colleagues on circuit changes and ventilator-associated pneumonia [1]. This work was intended to confirm our finding that a ventilator circuit may be used throughout the mechanical ventilation of a patient without adverse effects [2]. Unfortunately, their study design precludes this conclusion. The fact that no difference was found between the incidence of pneumonia in patients allocated to a 7-day change and that in patients given no change does not imply that prolonged use of a single ventilator circuit is safe. A group receiving 48-hour circuit changes (current practice ...References1. Kollef MH, Shapiro SD, Fraser VJ, Silver P, Murphy DM, Trovillion E, et al. Mechanical ventilation with or without 7-day circuit changes. A randomized, controlled trial. Ann Intern Med. 1995; 123:168-74. Google Scholar2. Dreyfuss D, Djedaini K, Weber P, Brun P, Lanore JJ, Rahmani J, et al. Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis. 1991; 143:738-43. Google Scholar3. Dreyfuss D, Djedaini K, Gros I, Mier L, Le Bourdelles G, Cohen Y, et al. Mechanical ventilation with heated humidifiers or heat and moisture exchangers: effects on patient colonization and incidence of nosocomial pneumonia. Am J Respir Crit Care Med. 1995; 151:986-92. Google Scholar4. Hess D, Burns E, Romagnoli D, Kacmarek RM. Weekly ventilator circuit changes. A strategy to reduce costs without affecting pneumonia rates. Anesthesiology. 1995; 82:903-11. Google Scholar Author, Article, and Disclosure InformationAuthors: Didier Dreyfuss, MD; Kamel Djedaini, MDAffiliations: Hopital Louis Mourier; 92700 Colombes, France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byVentilator-associated pneumonia and frequency of circuit changes 15 May 1996Volume 124, Issue 10 Page: 929 Keywords Death rates Diagnostic techniques Mortality Pneumonia Reasoning Ventilator associated pneumonia Ventilators ePublished: 15 August 2000 Issue Published: 15 May 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Tertiary Contact Vaccinia in a Breastfeeding Infant
Authors: Vinaya Garde
Journal: JAMA (2004)

On May 4, 2003, a US Army soldier received primary smallpox vaccination and experienced a primary uptake reaction at the inoculation site on days 6 through 8. The vaccinee reported observing all of the standard precautions to avoid household spread. In mid May, his breastfeeding wife developed vesicles on both areolas. On May 29, their infant daughter developed a papule on her philtrum. Contact vaccinia was confirmed by positive polymerase chain reaction and culture for vaccinia of both the maternal and infant lesions. This is the first documented case of inadvertent contact vaccinia transmission from a mother to her infant through direct skin-to-skin and skin-to-mucous membrane contact while breastfeeding. The mechanism of transfer from the vaccinee to the spouse is uncertain. This report demonstrates that breastfeeding infants living in close contact with smallpox vaccinees are at potential risk for contact vaccinia, even if the vaccinee is not the breastfeeding mother, and highlights the need for special precautions to prevent secondary transfer to breastfeeding mothers.
Dr. Knopf and Morphin in Tuberculosis.
Authors: S. A. Knopf
Journal: JAMA (1907)

New York, July 30, 1907. <h3>To the Editor:</h3> —On the day following the meeting of the National Association for the Study and Prevention of Tuberculosis there appeared in the<i>Philadelphia North American</i>a sensational article, reporting that I advised the killing of dying consumptives quickly and painlessly by heavy doses of morphin, and that I admitted that it was my daily practice to do so. It was furthermore said that there had been a bitter debate and that the session adjourned in confusion. These false statements were copied by nearly all the newspapers in the United States, were cabled to Europe and made the rounds in the papers and magazines of England and the whole European continent. In spite of explanations and denials I sent to the Associated Press, in spite of a strong letter written by Dr. George Dock, the presiding officer of the meeting, and sent to the
Plasma 11-Hydroxycorticosteroid and Growth Hormone Levels in Acute Medical Illnesses
Authors: H. S. Jacobs, J. D. N. Nabarro
Journal: BMJ (1969)

Adrenal cortical response in acute medical illness has been studied by measuring the plasma 11-hydroxycorticosteroid (11-OHCS) concentration in 178 patients. Those with unbalanced diabetes, acute infections, and severe myocardial infarction had high levels. The results obtained suggest that in a patient with a severe infection and hypotension a plasma 11-OHCS level of less than 15 mug./100 ml. indicates an inadequate adrenal cortical response, and one patient with septicaemia and temporary adrenal cortical insufficiency is described. Growth hormone levels were increased in patients with severe diabetic ketosis but not in those with hyperosmolar non-ketotic diabetic coma.
Cord blood-hematopoietic stem cell expansion in 3D fibrin scaffolds with stromal support
Authors: Mónica S. Ventura Ferreira, Willi Jahnen-Dechent, Norina Labude, Manfred Bovi, Thomas Hieronymus, Martin Zenke, Rebekka K. Schneider, Sabine Neurs
Journal: Biomaterials (2012)
Malignant Transformation by Viruses
Authors: R. M. Mulligan
Journal: JAMA (1966)

This presentation of the various aspects of the malignant transformation by viruses has three major subdivisions: characteristics, genetics and immunology, and significance. The subjects covered include the following: transformation of hamster fibroblasts by polyoma virus, effects of Rous sarcoma virus on cultured chicken and duck cells, tumor development with polyoma virus in submandibular glands of newborn mice as influenced by symbiosis of epithelial and mesenchymal elements, tumor development with polyoma virus in metanephric tissue of rat embryo, effect of mammary tumor virus on epithelial cells of mouse breast in vitro, specific antigens produced by several oncogenic viruses, influence of infective symbiosis of defective oncogenic viruses, effects of adenovirussimian virus 40 hybrid on weanling hamster kidney cultures, effects of simian virus 40 on human diploid fibroblast-like cells, growth rate and tumor-forming potential of normal, malignant, and simiam virus 40 transformed euploid cells of Chinese and Armenian hamsters, immunization against viruses as
Current Problems in Physical Medicine and Rehabilitation
Authors: Arthur L. Watkins
Journal: New England Journal of Medicine (1950)

PHYSICAL medicine is an enigma to many doctors and lay groups. This may be in part explained by the paradoxical situation that it is at one and the same time a very old and a new medical specialty. The use of physical agents such as sun, heat, water, massage and exercise for therapeutic purposes can be traced back to earliest records. The acceptance as an established portion of scientific medical practice is relatively new, and physical medicine is one of the most recently accepted specialty boards. Soon after it was established, however, rehabilitation was added to the name. This term . . .
The incredible, shrinking sleep-learning connection
Authors: Jerome M. Siegel
Journal: Behavioral and Brain Sciences (2005)

Initial claims that REM sleep is important in the consolidation of all memories have been revised and reduced to the claim that sleep has a role only in the consolidation of procedural learning. Now, Walker hypothesizes that sleep has no role in the “stabilization phase of consolidation” but only in the “enhanced learning” phase of procedural learning. Evidence for this vague, truncated hypothesis remains as inconsistent as that for prior claims.
Therapeutic intervention for wear debris-induced aseptic implant loosening
Authors: Ke Ren, Anand Dusad, Yijia Zhang, Dong Wang
Journal: Acta Pharmaceutica Sinica B (2013)

Wear debris-induced aseptic loosening is an inflammatory bone disorder, which compromises the long-term success of total joint replacement. Despite the extensive research and great progress in treating inflammation-induced osteolysis for inflammatory arthritis, no drug has been proven for treatment/prevention of aseptic implant loosening. Also, there is very limited research on developing effective drug delivery systems for this pathological condition. In this review, we will discuss different therapeutic interventions and various delivery systems that have been developed for aseptic implant loosening. To provide the prospective for the future research in this area, the biology of wear particles-induced osteolysis, animal models developed for aseptic implant loosening and the potential challenges the field is facing are also presented in the discussion.
Suspect a PE? Less may be more
Authors: F. Godlee
Journal: BMJ (2013)

This week sees the start of a new series in the BMJ . As part of our Too Much Medicine campaign (www.bmj.com/too-much-medicine), the series aims to highlight clinical conditions in which overdiagnosis exposes patients to unnecessary and potentially harmful care. The first article, by Renda Soylemez Wiener and colleagues, looks at pulmonary embolism (doi:10.1136/bmj.f3368). The authors conclude that the advent and widespread uptake of high resolution CT pulmonary angiography has greatly increased the detection of small isolated pulmonary emboli that would have caused no trouble to the patient and did not need to be found.

This is an important claim. In reaching it the authors rely on clinical …
Whole-genome reconstruction and mutational signatures in gastric cancer
Authors: Niranjan Nagarajan, Denis Bertrand, Axel M Hillmer, Zhi Zang, Fei Yao, Pierre-Étienne Jacques, Audrey SM Teo, Ioana Cutcutache, Zhenshui Zhang, Wah Lee, Yee Sia, Song Gao, Pramila N Ariyaratne, Andrea Ho, Xing Woo, Lavanya Veeravali, Choon Ong, Niantao Deng, Kartiki V Desai, Chiea Khor, Martin L Hibberd, Atif Shahab, Jaideepraj Rao, Mengchu Wu, Ming Teh, Feng Zhu, Sze Chin, Brendan Pang, Jimmy BY So, Guillaume Bourque, Richie Soong, Wing-Kin Sung, Bin Tean Teh, Steven Rozen, Xiaoan Ruan, Khay Yeoh, Patrick BO Tan, Yijun Ruan
Journal: Genome biology (2012)

Gastric cancer is the second highest cause of global cancer mortality. To explore the complete repertoire of somatic alterations in gastric cancer, we combined massively parallel short read and DNA paired-end tag sequencing to present the first whole-genome analysis of two gastric adenocarcinomas, one with chromosomal instability and the other with microsatellite instability.Integrative analysis and de novo assemblies revealed the architecture of a wild-type KRAS amplification, a common driver event in gastric cancer. We discovered three distinct mutational signatures in gastric cancer--against a genome-wide backdrop of oxidative and microsatellite instability-related mutational signatures, we identified the first exome-specific mutational signature. Further characterization of the impact of these signatures by combining sequencing data from 40 complete gastric cancer exomes and targeted screening of an additional 94 independent gastric tumors uncovered ACVR2A, RPL22 and LMAN1 as recurrently mutated genes in microsatellite instability-positive gastric cancer and PAPPA as a recurrently mutated gene in TP53 wild-type gastric cancer.These results highlight how whole-genome cancer sequencing can uncover information relevant to tissue-specific carcinogenesis that would otherwise be missed from exome-sequencing data.
Generalists and Specialists
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1979)

In most discussions of the need for primary-care physicians, it is assumed that a given physician provides either specialized or primary care. Hence, the debate usually revolves about the questions of how many, or what proportions of, generalists and specialists are required to meet the national need and how these manpower goals can best be achieved. But from time to time observers have pointed out that many specialists also provide primary care and that specialists may constitute an important part of the primary-care system in this country. An article from the Robert Wood Johnson Foundation in the current issue of . . .
PROGNOSTIC IMPLICATIONS OF LOW-LEVEL CARDIAC TROPONIN ELEVATION USING THE HIGH-SENSITIVITY ASSAY FOR CARDIAC TROPONIN T: RESULTS FROM EARLY ACS &amp; SEPIA-TIMI 42
Authors: Jonathan Grinstein, Marc Bonaca, Marc Sabatine, Petr Jarolim, Michael Conrad, Eugene Braunwald, Robert Giugliano, L. Kristin Newby, David Morrow
Journal: Journal of the American College of Cardiology (2013)
A Transcriptional Signature for Active TB: Have We Found the Needle in the Haystack?
Authors: Adithya Cattamanchi, Nicholas D. Walter, John Z. Metcalfe, J. Lucian Davis
Journal: PLoS Medicine (2013)

Analysis of whole-genome RNA expression in human clinical samples is a relatively novel approach to biomarker development.The pattern of RNA expression (i.e., transcriptional signature) can provide a ''biological snapshot'' of the immune response to physiological stressors, and specific disease states may produce distinct transcriptional signatures.In this week's issue of PLOS Medicine, Michael Levin and colleagues report that a blood RNA transcriptional signature can be used to diagnose active tuberculosis (TB) in high HIV/TB prevalence settings.Using blood samples from patients referred for TB evaluation at three sites in Cape Town, South Africa (cases from an outpatient TB clinic; controls from two hospitals) and one district hospital in Northern Malawi, the authors identified a minimal set of 44 transcripts that distinguished patients with TB from patients confirmed to have an alternative diagnosis.They then converted the complex expression data into a simple-tocalculate disease risk score, which was highly sensitive (93%, 95% CI [83-100]) and specific (88%, 95% CI [74-97]) for active TB.
Preservation of Physician-Patient Relationship Seen as Integral to Health Care System Reform
Authors: Charles Marwick
Journal: JAMA (1994)

THE NEED for reform of the health care system in the United States is widely accepted, both socially and politically. But the long-term consequences have not been as widely discussed. "What do we want to preserve in the system? What do we need to change?" asks Rodney E. Nichols, chief executive officer of the New York (NY) Academy of Sciences. Changes are already here, says Parker Small, MD, professor of immunology and microbiology and professor of pediatrics, University of Florida College of Medicine, Gainesville, "and it isn't Washington that's bringing most of them about." Both spoke at a conference on the changing health care system organized by the academy's president-elect, Henry Greenberg, MD, associate professor of clinical medicine, Columbia University College of Physicians and Surgeons, New York, NY. The conference grappled with questions such as, What will happen to the physician-patient relationship? What changes are coming in medical education? What
Some Effects of High-altitude Climbing
Authors: D. S. Matthews, B. P. Tribedi, A. R. Roy, R. Chatterjee, A. Ghosal
Journal: BMJ (1955)

covered until 3 months of age or more, has no valvular defects and shows very considerable increase in heart weight due to gross left ventricular hypertrophy.On morphological grounds anoxia of the cardiac muscle during cardiac development seems to offer the most acceptable explanation of the changes found at post-mortem examination in foetal and infantile fibroelastosis, and a possible mechanism for this is offered.The connexion between foetal and infantile fibroelastosis and the endocardial sclerosis found in adults is discussed.I should like to thank Dr. W. A. Bourne for his advice and encouragement during the preparation of this paper.