tbuckley/cabot-search huggingface dataset:
Analysis of Agreement Among Findings of Pathologists in ED01 Experiment1
Authors: D. A. Amato, S. W. Lagakos
Journal: JNCI Journal of the National Cancer Institute (1988)

The ED01 experiment, which involved determination of the effective dose to produce a 1% tumor rate, was carried out by the National Center for Toxicological Research (NCTR). The study involved >20,000 BALB/c female mice exposed to various doses of 2-acetylaminofluorene, a chemical known to produce bladder and liver carcinomas. After death, tissues from each animal were evaluated for the presence of several types of tumors by one of a team of NCTR pathologists. After the ED01 experiment was completed, the Society of Toxicology commissioned another pathologist to carry out an independent review of the bladder and liver specimens from a stratified sample of the mice. There were substantial differences in the diagnoses of both tumor types by the pathologists, but the implications for detection of a dose-response relationship are important only for liver carcinomas. [J Natl Cancer Inst 1988;80:919–925]
Corelation Between the 24-Hour Urine Aldosterone Levels and Atrial Electromechanical Conduction Time
Authors: Ahmet Soylu, Hayrudin Alibaşiç, Elif Yıldırım, Aysun Toker, Halil İbrahim Erdoğan, Mehmet Akif Düzenli, Mehmet Tokaç
Journal: Journal of the American College of Cardiology (2013)
True left ventricular aneurysm.
Authors: D A Tibbutt
Journal: BMJ (1984)

effect on the locomotor muscles.The respiratory muscles might be expected to hypertrophy under the increased demand imposed by disease, but surprisingly what are usually found are increased fatigability and atrophy.In particular, fatigue ofthe inspiratory muscles may be important in limiting exercise tolerance.27How, then, may the respiratory muscles be trained?The answer is breathing against resistance, which increases tidal volume, decreases the respiratory rate, and increases effort tolerance.Respiratory muscle endurance training can also increase exercise capacity in chronic obstructive airways disease, sometimes by as much as half, but generally less.822Nevertheless, some patients deteriorate during exercise because of severe fatigue of the diaphragm.The selection of appropriate patients on clinical grounds is difficult: it requires the services of elaborate muscle function laboratories.For that reason the recent report ofSonne and Davis is ofinterest.8Six patients with moderate to severe airways obstruction entered a six week training programme using a resistance "whistle" with variable orifice, one way valve, and mouthpiece.Training was aimed at the inspiratory muscles and was performed for 30 minutes daily.The maximal work rate increased by 37% and Vo2 max by 15%.Clearly some patients derive considerable benefit from simple training programmes of this type.Further studies of respiratory muscle function in patients with chronic obstructive airways disease should be performed to maximise benefit from such training programmes.
Molecular evolution modeled as a fractal Poisson process in agreement with mammalian sequence comparisons
Authors: D. R. Bickel, B. J. West
Journal: Molecular Biology and Evolution (1998)

The fractal doubly stochastic Poisson process (FDSPP) model of molecular evolution, like other doubly stochastic Poisson models, agrees with the high estimates for the index of dispersion found from sequence comparisons. Unlike certain previous models, the FDSPP also predicts a positive geometric correlation between the index of dispersion and the mean number of substitutions. Such a relationship is statistically proven herein using comparisons between 49 mammalian genes. There is no characteristic rate associated with molecular evolution according to this model, but there is a scaling relationship in rates according to a fractal dimension of evolution. The FDSPP is a suitable replacement for the homogeneous Poisson process in tests of the lineage dependence of rates and in estimating confidence intervals for divergence times. As opposed to other fractal models, this model can be interpreted in terms of Darwinian selection and drift.
Irish mothers called for hepatitis C virus screening
Authors: A Murdoch
Journal: BMJ (1994)

A scare over the contamination of blood products with hepatitis C virus has made Irish health authorities begin nationwide screening of up to 100 000 mothers who have received anti-D immunoglobulin since 1970. This follows the discovery, on routine testing, that nine women who donated blood in the southern Munster region had antibodies to hepatitis C virus. They had all given birth and received injections of anti-D immunoglobulin in 1977.

Health minister Brendan Howlin …
Mechanical Ventilatory Support
Authors: Ernest W. Johnson
Journal: JAMA (1986)

To the Editor.—  I have a comment about the article entitled Mechanical Ventilatory Support 1 published in the July 5 issue of JAMA . The authors are confused when comparing negative-pressure ventilators (iron lungs) and positive-pressure ventilators. Both are exactly the same in physical and physiologic principles. Putting a patient in a tank and lowering the pressure by 15 cm H 2 O is no different than applying 15 cm H 2 O at the mouth. 2   The volume ventilators have the advantage over the pressure-triggered ventilators of delivering the set volume, but the authors do not make this distinction. 3   Obviously, positive pressure can be applied by mouth as well as by tracheostomy.  The authors do an injustice to thousands of patients who have conditions such as polio or muscular dystrophy and who are currently using positive pressure by mouth during the day and other ventilation aids at night for
Thrombocytopenic Purpura Due to Cat-Scratch Disease
Authors: Otto E. Billo
Journal: JAMA (1960)

Thrombocytopenic purpura occurred in one of three siblings affected by catscratch disease. All were treated with sulfisoxazole; in addition, one received tetracycline and the other two received chloramphenicol. One who had received sulfisoxazole and chloramphenicol developed thrombocytopenic purpura. Spontaneous return of the platelet level to normal preceded subsidence of the basic infection in this case. The authors give reasons for believing that platelet depression was a complication of the underlying infection rather than coincidental or secondary to the antibiotic therapy.
CARBOHYDRATE METABOLISM IN PREGNANCY. I. THE METABOLISM OF INSULIN BY HUMAN PLACENTAL TISSUE*†
Authors: Norbert Freinkel, Charles J. Goodner
Journal: Journal of Clinical Investigation (1960)

Much clinical evidence would suggest that there is a change in carbohydrate metabolism during pregnancy (2-8).In the past, the diabetogenic effects of pregnancy have been attributed to an in- creased elaboration of hormonal contrainsulin factors.An alteration in the degradation of insulin during pregnancy might constitute a supplemental or alternative mechanism.It has been shown by Mirsky, Perisutti and Dixon (9, 10) and Tomi- zawa, Nutley, Narahara and Williams (11, 12) that various animal tissues, such as liver, contain relatively specific enzymes for the proteolytic in- activation of insulin.To date, such systems have not been studied in isolated preparations of human tissues.In the present study, the presence of an active, enzymatic mechanism for the proteolytic degradation of insulin has been demonstrated in human placental tissues.The characteristics of the system have been defined and its potential con- tributions to maternal insulin economy have been evaluated. MATERIALS
Macular corneal dystrophy type I and type II are caused by distinct mutations in a new sulphotransferase gene
Authors: Tomoya O. Akama, Kohji Nishida, Jun Nakayama, Hitoshi Watanabe, Kouichi Ozaki, Takahiro Nakamura, Atsuyoshi Dota, Satoshi Kawasaki, Yoshitsugu Inoue, Naoyuki Maeda, Shuji Yamamoto, Tsutomu Fujiwara, Eugene J.-M.A. Thonar, Yoshikazu Shimomura, Shigeru Kinoshita, Akira Tanigami, Michiko N. Fukuda
Journal: Nature Genetics (2000)
Abstract 266: Effectiveness of a New Method of Pediatric Advanced Life Support Recertification: PALS on Demand
Authors: Hiroshi Kurosawa, Takanari Ikeyama, Patricia Achuff, Madeline Perkel, Christine Watson, Vinay Nadkarni, Akira Nishisaki
Journal: Circulation (2012)

Background: Recent evidence shows poor retention of PALS provider skills. Frequent refresher training, and in-situ simulation are promising interventions. We developed a “PALS on Demand” (PoD) recertification course by deconstructing the training into six 30-min simulation scenario sessions over 6 months. We hypothesized that PoD is as effective as Standard (STD) PALS 1-day recertification delivered with simulation technology (i.e. non-inferiority study). Method: We randomized PALS certified Pediatric ICU nurses and respiratory therapists to PoD vs STD strategy. Training effectiveness outcome was prospectively defined as self-reported provider confidence and competence (Likert scale: 1 = lowest to 7=highest). We analyzed using a Mixed effect model, adjusting for baseline differences (p&lt;0.05 as significant). Results: 36 participants were eligible, completed pre-testing baseline and were randomized: PoD (n=19) and STD (n=17). Median age was 32 (IQR:28-40yrs), discipline: nurses:72%, respiratory therapists:28%, with no significant difference between group demographics . 29 had completed data for baseline, training and post-test scenarios(PoD=17/19 vs STD=16/17). In both PoD and STD groups, self-reported confidence (PoD 0.9, 95%CI, 0.5-1.4, p&lt;0.001, and STD 0.6 95%CI,0.2-1.2, p=0.009) and competence improved(PoD 0.9, 95%CI, 0.6-1.3, p&lt;0.001, and STD 0.8 95%CI, 0.5-1.2, p&lt;0.001). After adjusting for baseline demographics, gender and clinical experience, the PoD vs. STD training strategy was not significantly associated with either confidence (p=0.42) or competence (p=0.65) score improvements. Conclusion: A Simulation-based “PALS-on-Demand” (PoD) approach is feasible. In this non-inferiority study, both PoD and STD simulation-based recertification strategies improved participants’ self-reported confidence and competence equivalently. Further feasibility and objective effectiveness validation of low-dose, high-frequency training is warranted.
Derivation and Validation of a Risk Standardization Model for Benchmarking Hospital Performance for Health-Related Quality of Life Outcomes After Acute Myocardial Infarction
Authors: Suzanne V. Arnold, Frederick A. Masoudi, John S. Rumsfeld, Yan Li, Philip G. Jones, John A. Spertus
Journal: Circulation (2013)

Background— Before outcomes-based measures of quality can be used to compare and improve care, they must be risk-standardized to account for variations in patient characteristics. Despite the importance of health-related quality of life (HRQL) outcomes among patients with acute myocardial infarction (AMI), no risk-standardized models have been developed. Methods and Results— We assessed disease-specific HRQL using the Seattle Angina Questionnaire at baseline and 1 year later in 2693 unselected AMI patients from 24 hospitals enrolled in the Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients’ Health status (TRIUMPH) registry. Using 57 candidate sociodemographic, economic, and clinical variables present on admission, we developed a parsimonious, hierarchical linear regression model to predict HRQL. Eleven variables were independently associated with poor HRQL after AMI, including younger age, previous coronary artery bypass graft surgery, depressive symptoms, and financial difficulties (R 2 =20%). The model demonstrated excellent internal calibration and reasonable calibration in an independent sample of 1890 AMI patients in a separate registry, although the model slightly overpredicted HRQL scores in the higher deciles. Among the 24 TRIUMPH hospitals, 1-year unadjusted HRQL scores ranged from 67–89. After risk-standardization, HRQL score variability narrowed substantially (range=79–83), and the group of hospital performance (bottom 20%/middle 60%/top 20%) changed in 14 of the 24 hospitals (58% reclassification with risk-standardization). Conclusions— In this predictive model for HRQL after AMI, we identified risk factors, including economic and psychological characteristics, associated with HRQL outcomes. Adjusting for these factors substantially altered the rankings of hospitals as compared with unadjusted comparisons. Using this model to compare risk-standardized HRQL outcomes across hospitals may identify processes of care that maximize this important patient-centered outcome.
High Court brings GMC into legal action over RCGP membership exam
Authors: C. Dyer
Journal: BMJ (2013)

The General Medical Council has been brought into the legal battle over the Royal College of General Practitioners’ membership exam and its varying pass rates among different ethnic groups.

A High Court judge ruled on 18 October that the GMC should be a respondent along with the college in a judicial review application by the British Association of Physicians of Indian Origin.

Mrs Justice Patterson decided that there was an “arguable” case—the threshold for …
METHODS FOR THE DETERMINATION OF PNEUMOCOCCUS TYPES
Authors: Francis G. Blake
Journal: The Journal of Experimental Medicine (1917)

The determination of pneumococcus types in lobar pneumonia is of value in the field of prognosis and as a prerequisite for specific serum therapy. The method for the determination of types should be as rapid as possible and a standard technique should be employed. The most satisfactory method is by the intraperitoneal inoculation of a mouse with the patient's sputum, by which means a rapid and abundant growth of the pneumococcus is obtained and secondary organisms are rapidly eliminated in most instances. The diagnosis of type is made directly on the peritoneal exudate. Certain factors in the method commonly used have interfered with the rapid determination of types in an appreciable number of cases, notably the growth of other organisms in the peritoneal exudate together with the pneumococcus, and some confusion has arisen because occasional strains of pneumococci have been encountered that show cross agglutination reactions when undiluted immune serum is used. Such reactions have been shown to be due to a limited zone of non-specific immunity and they in no way invalidate the classification of the pneumococci into sharply defined immunological groups. The optimum dilutions of serum have been determined that will agglutinate all type strains of pneumococci and fail to cause any cross agglutination reactions when mixed with equal amounts of pneumococcus cultures and incubated for I hour at 37 degrees C. They are a 1:20 dilution of Serum I, a 1:20 dilution of Seruifa II, and a 1:5 dilution of Serum III. For the diagnosis of Subgroup II pneumococci undiluted Type II serum is required. To obviate the other difficulties of the method commonly used a new method for the determination of types has been devised. It depends upon the fact that there is produced by the growth of the pneumococcus a soluble substance which is present in the peritoneal exudate of the mouse in sufficient quantity to give a specific precipitin reaction with the homologous immune serum. The precipitin method can be used in all instances in which the determination of types by the agglutination method is possible, and it possesses certain distinct advantages which make it available when the agglutination method is impracticable. It is of particular value as a time-saving device in those instances where the presence of other organisms together with the pneumococcus in the peritoneal exudate causes a delay of 18 hours or more before the type of pneumococcus can be definitely established. It is therefore recommended as the method of choice in all cases. If desired, both the agglutination and precipitin methods may be applied to the same specimen of peritoneal washings.
Publishing: A doctor's guide to Dr Foster
Authors: R. Little
Journal: BMJ (2002)

Behind the scenes at a company that measures healthcare standards

Over the past year the media has been awash with information about the relative standards of different hospitals and consultants. Some of this information, which is aimed at the healthcare consumer, has come from the government. But also riding high on the crest of this league table wave is a small private publishing company, Dr Foster, whose logo reads: “Your guide to better health.”

The company may not yet be a household name, but it is certainly intent on creating a media impact. It has already published—last November—in association with the Times several consumer guides to hospital consultants. These guides were packed with region by region information about consultants in various specialties, including heart surgery and neurology. The Dr Foster Good Birth Guide —a 500 page compendium that the company boasts is “the only fully comprehensive guide to maternity services in the United Kingdom”—was published in January. But it is perhaps the Dr Foster Good Hospital Guide , due …
Evolution of QRS and ST-T-wave body surface potential distributions during the first year of life.
Authors: D W Benson, M S Spach
Journal: Circulation (1982)

Using a system for obtaining body surface potential distributions from 150 sites on the anterior and posterior torso, 43 body surface maps were evaluated in 31 normal infants, ages 15 hours to 10 months. Serial maps were obtained at 0.6-msec intervals during QRS and at 2.4-4-msec intervals throughout the ST-T wave. We found an orderly evolution of both QRS and ST-T wave maps during the first year of life. In the newborn, the patterns during the latter half of QRS were consistent with early completion of depolarization of the left ventricle and prolonged depolarization of the right ventricle. The patterns changed gradually such that by 5-6 months of age, the maps demonstrated simultaneous effects of both right and left ventricles during the latter half of QRS. By 9 months, the QRS patterns were similar to those of older children and adults. The changes in the ST-T-wave maps were consistent with the idea that age-related changes in the sequence of ventricular activation.
False positive findings of mammography will have psychological consequences
Authors: I S Tobias, M. Baum
Journal: BMJ (1996)

EDITOR,—We applaud E Lidbrink and colleagues' attempts to quantify the substantial disadvantages of false positive findings in patients invited to attend for breast screening.1 Clearly, a financial cost of over £250000 from a single round of screening at a well organised centre in Stockholm represents a huge sum …
Successful treatment of severe unconjugated hyperbilirubinemia via induction of UGT1A1 by rifampicin
Authors: Ewa Ellis, Martin Wagner, Frank Lammert, Antal Nemeth, Judith Gumhold, Christian P. Strassburg, Christian Kylander, Despina Katsika, Michael Trauner, Curt Einarsson, Hanns-Ulrich Marschall
Journal: Journal of Hepatology (2005)
Severity of Acute Gallstone Pancreatitis in Patients with Pancreas Divisum
Authors: N. Boon, M. Delhaye, O. Le Moine, V. De Maertelaer, J. Devière
Journal: Endoscopy (2003)

The presence of pancreas divisum may reduce the severity of acute gallstone pancreatitis (AGP), as stone impaction at the major papilla only affects the ventral pancreas.The severity of AGP was compared retrospectively in patients with and without pancreas divisum. Acute gallstone pancreatitis was defined by clinical, biological, radiological, and endoscopic features. Thirteen patients with AGP and pancreas divisum were identified among those presenting with AGP between 1989 and 2000. Pancreas divisum patients were compared to 39 control individuals with AGP and conjugate pancreas. All patients underwent biliary sphincterotomy. Levels of serum amylases, lipases, C-reactive protein (CRP), and white blood cells (WBC) were compared in patients with AGP and pancreas divisum and in control individuals before sphincterotomy. The severity of pancreatitis was assessed on the basis of CRP, Ranson's score, computed tomography, the need for intensive care and drainage of collections or necrosis, duration of hospitalization, and mortality.Patients with AGP and pancreas divisum had a lower severity grade at CT scanning than control individuals ( P = 0.005), a shorter hospitalization period (5 +/- 1.9 vs. 11.6 +/- 1.6 nights; P = 0.032), and lower mortality (none of 13 vs. four of 39; P = 0.048). Serum amylases and lipases, WBC, and Ranson's score tended to be lower in patients with AGP and pancreas divisum, but the difference was not significant in comparison with control individuals.Acute gallstone pancreatitis is less severe in patients with pancreas divisum than in those with a conjugate pancreas.
Improving Preventive Care Guidelines
Authors: Keith W. Roach
Journal: Annals of Internal Medicine (1999)

Letters2 November 1999Improving Preventive Care GuidelinesKeith W. Roach, MDKeith W. Roach, MDUniversity of Chicago Hospitals; Chicago, IL 60637 (Roach)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-9-199911020-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although preventive care guidelines are useful and may serve to increase preventive care maneuvers, I believe that Dr. Weingarten (1) misses an important point: Physicians must know the primary literature in order to tailor preventive services to their patients. In the most controversial subset of the example chosen by Dr. Weingarten, mammographic screening in women 40 to 50 years of age, none of the 10 recommendations given tell the physician or patient the information needed to make an informed decision. The primary literature tells us that there is a benefit to screening (2), with a number needed ...References1. Weingarten S. Using practice guideline compendiums to provide better preventive care. Ann Intern Med. 1999;130:454-8. LinkGoogle Scholar2. Bjurstam N, Bjorneld L, Duffy SW, Smith TC, Cahlin E, Erikson O, et al . The Gothenburg Breast Screening Trial: first results on mortality, incidence, and mode of detection for women ages 39-49 years at randomization. Cancer. 1997;80:2091-9. CrossrefMedlineGoogle Scholar3. Elmore JG, Barton MB, Moceri VM, Polk S, Arena PS, Fletcher SW. Ten-year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med. 1998;338:1089-96. CrossrefMedlineGoogle Scholar4. Gram IT, Lund E, Slenker SE. Quality of life following a false positive mammogram. Br J Cancer. 1990;62:1018-22. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Keith W. Roach, MDAffiliations: University of Chicago Hospitals; Chicago, IL 60637 (Roach) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUsing Practice Guideline Compendiums To Provide Better Preventive Care Scott Weingarten Improving Preventive Care Guidelines Scott Weingarten Metrics 2 November 1999Volume 131, Issue 9Page: 714-715KeywordsAnxietyChemopreventionNumber needed to screenPreventive medicineVaccines ePublished: 15 August 2000 Issue Published: 2 November 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...