tbuckley/cabot-search huggingface dataset:
EPIDEMIOLOGY OF POLIOMYELITIS
Authors: J L. Pomeroy
Journal: JAMA (1926)

To the Editor:  —From time to time the possibility of milk-borne epidemics of poliomyelitis has been considered. In corroboration of statements made in the article by Dr. Aycock (The Journal, July 10), I wish to report the analysis of sixty cases of poliomyelitis handled by the Los Angeles County Health Department in 1925. There were thirty-two males and twenty-eight females, with ages as follows:    It will be noticed that there were 6⅔ per cent under 1 year, 40 per cent between 1 and 3 years, and 73 per cent of the total number under 8 years of age, proving that in this series the youngest children were by far the more susceptible but that a small percentage of adults and older children may contract the disease.  There were four families with two cases, and in each one of these the onset was so close together that it furnishes more evidence
Third National Conference
Authors: Rutledge W. Howard
Journal: JAMA (1973)

In October 1972 the American Medical Association, through its Council on Medical Education, was host to representatives of 41 state medical associations and two territories at the third biennial conference on continuing medical education.  Participants took part in discussions on the pros and cons of continuing education as a requirement for membership in state medical associations. Opinion was divided on the issue about evenly, leaving the carrot and the stick in balance.  Peer review as an educational necessity was also a conference topic, and struck a more favorable response, particularly when considered as an educational needs indicator, and especially when freed from its regulatory and punitive connotation. In fact, the participants appeared in general agreement that peer review, perhaps better termed quality of care assurance, and education, are one and the same thing.  Accreditation by state medical associations of community hospitals and other locally focused providers of continuing medical education
The Value of Aggressive Therapy in the Hypertensive Patient with Azotemia
Authors: WILLIAM J. MROCZEK, MICHAEL DAVIDOV, LILLIAN GAVRILOVICH, FRANK A. FINNERTY
Journal: Circulation (1969)

By giving diazoxide intravenously and furosemide orally the diastolic blood pressure was kept under 110 mm Hg and the urinary output over 1 L/day for a 2-week period in 25 hypertensive patients with azotemia. During the first 2 weeks of treatment three patients died. Although the 40% decrease in mean arterial pressure in the remaining patients was associated with immediate improvement in the cardiovascular status, for example, clearing of congestive heart failure and papilledema, there was a 19% average increase in BUN and 17% average increase in serum creatinine values. Three months later, however, maintenance of the reduced arterial pressure was associated with average reductions of 24 mg/100 ml in BUN and of 2.8 mg/100 ml in serum creatinine below control values. Each of the patients who remained on therapy continued to do well. Twenty-six months later six additional patients had died. In the remaining 16 patients the average mean arterial pressure was 117 mm Hg; papilledema had cleared; the average concentration of BUN was 22 mg/100 ml; the average serum creatinine was 1.8 mg/100 ml.
Analgesic Nephropathy: Removal of Phenacetin from Proprietary Analgesics
Authors: R. M. Murray
Journal: BMJ (1972)

Since phenacetin was withdrawn from Askit Powders and Beecham's Powders in 1966 these preparations have declined in importance as a cause of analgesic nephropathy in Western Scotland. In most patients with analgesic nephropathy who persist in abuse of compound analgesics renal function continues to decline. The deterioration, however, is less rapid among those taking aspirin and caffeine mixtures than in those taking preparations which also contain phenacetin.
RELATIONSHIP OF BODY MASS INDEX WITH TOTAL MORTALITY, CARDIOVASCULAR MORTALITY AND MYOCARDIAL INFARCTION AFTER CORONARY REVASCULARIZATION: EVIDENCE FROM A META-ANALYSIS
Authors: Abhishek Sharma, Ajay Vallakati, Andrew Einstein, Carl Lavie, Armin Arbab-Zadeh, Francisco Lopez-Jimenez, Debabrata Mukherjee, Edgar Lichstein
Journal: Journal of the American College of Cardiology (2014)
The normal HCT trial re-revisited: what were the actual findings?
Authors: Anatole Besarab, W Kline Bolton, Allen R. Nissenson, Steven J. Schwab
Journal: Kidney International (2012)

The Authors Reply: Below is our response to the open commentary1.Coyne D.W. The health-related quality of life was not improved by targeting higher hemoglobin in the Normal Hematocrit Trial.Kidney Int. 2012; 82: 235-241Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar on the Normal Hematocrit Cardiac Trial (NHCT). •The academic coauthors of the New Engl J Med (NEJM) report2.Besarab A. Bolton W.K. Browne J.K. et al.The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin.N Eng J Med. 1998; 339: 584-590Crossref PubMed Scopus (1881) Google Scholar of the NHCT urge readers to revisit the publication, which definitively does not recommend use of epoetin to target hematocrit 42%. Dr Coyne's commentary in KI does not cite this conclusion, implying that benefit occurred at higher hematocrit.•The commentary describes statistical reporting ‘discrepancies’, but fails to acknowledge that we originally submitted the nominal P-value of 0.01 for the primary end point, replaced in the manuscript by repeated confidence intervals methodology following NEJM editorial comment and external statistician input.3.Goodkin D.A. The normal hematocrit cardiac trial revisited.Semin Dial. 2009; 22: 495-502Crossref PubMed Scopus (12) Google Scholar•The manuscript submitted to the NEJM stated, ‘There were no statistically significant differences in quality-of-life scores between groups or over time, using intent-to-treat analysis… and assigning scores of zero for patients who had died’. This sentence was deleted by the editors, with only ‘improved physical function scores among 12-month survivors with increases in hematocrit’ remaining. Epoetin responders may have different outcomes than nonresponders.•The NEJM paper reported a statistically insignificant higher rate of hospitalization among the target 42% group, no different from the KI commentary in that the adjusted risk of hospitalization was insignificantly different (P=0.06).•Aggregate non-access thrombotic events (22% vs. 18%) were added to the epoetin alfa package insert, but were reported only by individual events in the NEJM.•All coauthors of the NEJM paper had full access to the patient data and contributed to each revision. This was the first large study to report adverse outcomes associated with targeting normal hematocrit in chronic kidney disease. There was no intent to mislead anyone.
INHIBITION OF CARDIAC FIBROSIS MEDIATED BY NON-MYOCYTE PROLIFERATION IN HYPERTROPHIC CARDIOMYOPATHY
Authors: Polakit Teekakirikul, Seda Eminaga, Okan Toka, Libin Wang, Hiroko Wakimoto, Matthew Nayor, Tetsuo Konno, Cordula M. Wolf, Ronny Alcalai, Joshua Gorham, Joachim P. Schmitt, Brendan Caine, Roger R. Markwald, Standley R. Hoffman, Jeffery D. Molkentin, Christine E. Seidman, Jonathan G. Seidman
Journal: Journal of the American College of Cardiology (2010)
Orthophosphate transport in the erythrocyte of normal subjects and of patients with X-linked hypophosphatemia.
Authors: H S Tenenhouse, C R Scriver
Journal: Journal of Clinical Investigation (1975)

We have examined the mechanism of TCA-soluble orthophosphate (Pi) transfer across the membrane of mature human erythrocytes in normal subjects and in patients with X-linked hypophosphatemia (X-LH). The studies were carried out largely at pH 7.4 and 37 degrees C, in partial stimulation of conditions in vivo. (a) At physiological concentrations (1-2 mM) Pi enters the intact normal erythrocyte down its chemical gradient and under no conditions could we identify a steady-state trans-membrane gradient for Pi greater than 0.6. Calculations of the phosphate anion distribution ratio using the Nernst equation yield theoretical values that closely approximate observed values. (b) Glycolytic inhibitors have little effect on total entry of 32Pi inti erythrocytes but they do affect the intracellular distribution of Pi. In the presence of iodoacetamide, label accumulates almost exclusively in the orthophosphate pool and less than 1% enters the organic phosphate pool. (c) Specific activity measurements in unblocked cells indicate that Pi anion equilibrates first with its intracellular Pi pool. These initial findings imply that neither group translocation, nor energy coupling, influence Pi permeation into the human erythrocytes. (d) The relationship between 32P entry and extracellular Pi concentration is parabolic in the presence of chloride, and linear in the presence of sulfate. The kinetics of concentration dependent entrance cannot be examined and saturability of Pi entry cannot be identified under these conditions. (e) The competitive inhibitor arsenate partially inhibits the initial rate and steady-state flux of orthophosphate in erythrocytes treated with iodoacetamide to inhibit glycolysis. However, a significant portion of Pi transport escapes arsenate inhibition. (f) Activation energies for Pi entry, in nonglycolizing erythrocytes are much higher than those required by simple diffusion in an aqueous system. (g) Neither the inward or outward movement of Pi is modulated by trans-phosphate. These latter findings suggest that transport of phosphate across the human erythrocyte is compatible with slow facilitated diffusion with symmetry for influex and efflux. The transmembrane chemical distribution ratio, and the equilibrium flux of Pi were not different from normal in the X-LH erythrocyte. Nor did the extracellular Pi concentration, arsenate, or temperature affect Pi entry differently in the two types of cells. We dedjce that different gene products serve the diffusional type of Pi transport in the erythrocyte membrane and the saturable component of transepithelial absorption in the gut and kidney. Only the latter is affected by the X-LH mutation. The former is apparently present not only in erythrocytes but also in epithelial tissue, where it can serve the absorption of pharmacologic amounts of Pi in the therapeutic repair of the depleted phosphate pools in X-LH.
China wants to make health care more affordable to poor
Authors: Jane Parry
Journal: BMJ (2008)

China will increase its healthcare spending by 25%, with a budget of ¥83.2bn (£5.8bn; €7.6bn; $11.7bn) earmarked for 2008, up from ¥66.5bn last year.

The announcement was made by China’s Premier Wen Jiabao speaking at the opening day of the meeting of China’s legislative body, the National People’s Congress on 5 March. A package of healthcare reforms would soon be announced, he added.

Of this budget, more than ¥20bn has been earmarked for central and western governments to upgrade the township health institutions in a bid to redress the balance between urban and rural healthcare provision, deputy health minister Gao Qiang added.

China is grappling with major flaws in this healthcare system, …
Slit Roentgenokymography of Calcified Aortic Valves
Authors: Gilbert H. Alexander
Journal: JAMA (1970)

<h3>To the Editor.—</h3> The article by Forker et al (<b>212</b>:774, 1970) emphasized calcific aortic stenosis with atypical features. Another publication demonstrated the unexpected finding of this lesion in elderly patients who had systolic murmurs.<sup>1</sup> These lesions are readily diagnosed with the moving slit roentgenokymograph. I have used this kymogram in about 3,600 cases in ten years in correlation with an active cardiopulmonary laboratory and cardiovascular surgical service. This method has been of great value for case finding at unexpected lesions and the preliminary screening of patients before catheter studies. The greatest yield of unexpected lesions has been the finding of a calcified aortic valve. The figure in the right anterior oblique is a typical case. Moving slit roentgenokymography has been almost completely ignored in the United States because the equipment first available in this country was the moving film type. However, kymography of the type illustrated is extraordinarily
The Effects of rAAV2-Mediated NGF Gene Delivery in Adult and Aged Rats
Authors: Ke Wu, Craig A Meyers, Nicole K Guerra, Michael A King, Edwin M Meyer
Journal: Molecular Therapy (2004)

Nerve growth factor (NGF) therapy has been proposed to treat patients with age-related cognitive deficits, including those with Alzheimer's disease. One promising approach to delivering this protein into brain involves viral vectors. However, little is known about the effects of aging on gene transfer in brain generally and in particular its effect on transgenic NGF expression. To examine the transgene expression and biological effects of NGF gene transfer in adult and aged rats, we delivered mouse NGF with C-terminal myc-tag, using a recombinant adeno-associated virus serotype 2 (rAAV2) vector, into the septum of 6- and 21-month-old Fischer 344/Brown Norway hybrid rats. Other animals received a control vector encoding green fluorescent protein. As expected, this strain of rat demonstrated very few age-related deficits in spatial memory-related behavior in the Morris water task either before gene transfer (6 vs 21 months) or afterward (up to 11 vs 26 months). We found that rAAV2 vectors drove transgene expression in aged rats up to 5 months, although the level of transgene expression was lower than that of adult animals. We also showed that NGF gene transfer into the septum of aged animals induced local trophic effects by increasing the number and soma area of septal cholinergic neurons and improved distal synaptic activity by increasing the level of depolarization-induced acetylcholine (ACh) release from hippocampal synaptic terminals. Interestingly, NGF gene transfer suppressed depolarization-induced ACh release in adult rats. These findings show for the first time, to our knowledge, that septal NGF gene transfer modulates hippocampal nerve terminal function. These results are relevant for the potential clinical application of NGF gene therapy.
Secretory Otitis Media: The Cantekin Affair-Reply
Authors: Erdem I. Cantekin
Journal: JAMA (1992)

In Reply.  —Dr Jacobson suggests that our article fails to deal with the question of whether antibiotics provide symptomatic relief, as distinguished from the question of whether antibiotics clear otitis media.  The study in question was focused on otitis media with effusion (secretory otitis), sometimes called asymptomatic otitis media. Therefore, by inclusion criteria the patients did not have the kind of symptoms to which Jacobson refers.  The symptoms to which Jacobson refers are associated with acute otitis media. Several recent studies (Dutch, Danish, Swedish, Israeli, and multinational) show that antibiotic treatment for acute otitis media is not effective. 1-5 Jacobson will be interested to learn that the acute otitis media study conducted at the Otitis Media Research Center in Pittsburgh and completed in 1985 showed that amoxicillin was not effective in clearing severe episodes of acute otitis media. 6   Dr Gates and Klein express a continued belief in the effectiveness
One in four autopsy reports in UK is substandard, report finds
Authors: Susan Mayor
Journal: BMJ (2006)

A quarter of reports on autopsies requested by UK coroners are poor or unacceptable, concludes an audit of coroners' autopsy practice. The audit report calls for national criteria and standards to improve the quality of autopsies.

The report reviewed coroners' autopsies from one week in May 2005 in England, Wales, Northern Ireland, Guernsey, Jersey, and the Isle of Man. Scotland was not included because it operates under a different legal system.

Sebastian Lucas, one of the report's authors and clinical coordinator at the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), an independent body that reviews the quality and safety of medical care, said: “We don't manage death well in this country. It is important that the aim of coronial autopsy is clarified. We want the public to agree what level of investigation is appropriate and then [we want] measures in place to reduce the huge variation in the quality of autopsies.”

About 45% of deaths in England and Wales are referred to a coroner, who can request …
Cardiac Arrhythmias Resulting from Tracheal Suctioning
Authors: CHANG SHIM
Journal: Annals of Internal Medicine (1969)

Seventeen patients with lung disease were monitored with an electrocardiogram during tracheal suctioning after they had breathed both air and 100% oxygen. Eight of them had a tracheostomy, three had an orotracheal tube, and six had no intubation. The incidence of transient cardiac arrhythmia during tracheal suctioning was significant while breathing air (35%). Arrhythmias included frequent atrial premature contractions, nodal tachycardia, transient sinus arrest, incomplete heart block, and frequent premature ventricular contractions. After a brief period of breathing 100% oxygen tracheal suctioning was no longer associated with significant arrhythmia. Tracheal suctioning should be done after the patient breathes 100% oxygen in order to avoid complicating, potentially dangerous cardiac arrhythmias.
Science Literacy and the Role of the Physician
Authors: William R. Hendee
Journal: JAMA (1988)

BASIC standards for science education in the United States are declining. John Brademas, president of New York University, notes<sup>1</sup>: Our elementary and secondary schools are producing a nation of scientific illiterates. Only one in three adults knows clearly what a molecule is and but one in six understands the meaning of the term DNA. More than half of our high school students take no mathematics or science beyond the tenth grade, and... virtually every state is short of teachers in these fields. At the college level, the situation is little better. The percentage of freshmen interested in science has been sliding for the past decade. Compared with students in 17 other countries, including Poland, Thailand, and Hungary, 10-year-olds in the United States placed in the middle and 14- and 17-year-olds placed in the bottom of their respective groups when tested recently for science achievement.<sup>2</sup>These results reflect major
Right Ventricular Oscillatory Power Is a Constant Fraction of Total Power Irrespective of Pulmonary Artery Pressure
Authors: Nabil Saouti, Nico Westerhof, Frank Helderman, J. Tim Marcus, Anco Boonstra, Pieter E. Postmus, Anton Vonk-Noordegraaf
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Pulmonary hypertension (PH) is characterized by increased arterial load requiring more right ventricular (RV) hydraulic power to sustain adequate forward blood flow. Power can be separated into a mean and oscillatory part. The former is associated with mean and the latter with pulsatile blood flow and pressure. Because mean power provides for net blood flow, the ratio of oscillatory to total power (oscillatory power fraction) preferably should be small. It is unknown whether this is the case in pulmonary arterial hypertension (PAH).To derive components of power generated by the right ventricle in PAH.Thirty-five patients with idiopathic PAH (IPAH) and 14 subjects without PH were included. The patients were divided in two groups, "moderate" and "high," based on pulmonary artery (PA) pressure. PA pressures were obtained by right heart catheterization and PA flows by magnetic resonance imaging. Total hydraulic power (Power(total)) was calculated as the integral product of pressure and flow. Mean hydraulic power (Power(mean)) was calculated as mean pulmonary artery pressure times mean flow. Their difference is oscillatory power (Power(oscill)). Total hydraulic power in subjects without PH compared with moderate and high IPAH was 0.29 ± 0.10 W (n = 14), 0.52 ± 0.14 W (n = 17), and 0.73 ± 0.24 W (n = 18), respectively. The oscillatory power fraction is approximately 23% and not different between groups.In this study, oscillatory power fraction is constant at 23% in non-PH and IPAH, implying that a considerable amount of power is not used for forward flow, making the RV less efficient with respect to its arterial load. Our findings emphasize the need to develop new therapy strategies to optimize RV power output in PAH.
Familial articular chondrocalcinosis in Spain.
Authors: A Balsa, E Martin-Mola, T Gonzalez, A Cruz, S Ojeda, J Gijon-Banos
Journal: Annals of the Rheumatic Diseases (1990)

One hundred and one first degree relatives of 35 patients with chondrocalcinosis were examined for the presence of familial disease. Eleven subjects from nine families showed radiological chondrocalcinosis, a prevalence of familial disease of 26%. Two different patterns of disease were noted--the older generation was more commonly affected, and the younger generation and second degree relatives were exempt. Clinical and radiological differences were found between the early and late onset groups, but not between late onset and sporadic forms of chondrocalcinosis. These findings support the suggestion that the true prevalence of familial disease. is underestimated. A dominant, autosomal transmission with variable penetrance is consistent with our findings, which suggests that homozygous patients with familial chondrocalcinosis may present a more severe form of the disease.
Fever in the vaccinated returning traveller
Authors: J. Powell
Journal: BMJ (2009)

A 64 year old woman presented to hospital with fevers, chills, lethargy, and poor appetite. The symptoms had begun six days previously, when returning to the United Kingdom after a three week holiday visiting friends and family in Gujarat, India. She also felt nauseous, had a moderately severe bilateral frontal headache, and was constipated. Her only medical history was a thyroidectomy in 1982. Before travelling she received all relevant vaccinations, including hepatitis A and B and typhoid fever. She had not taken malarial prophylaxis. Her only regular medication was thyroxine 150 μg once a day. On examination the patient seemed well. Her temperature was 37.3°C, pulse 80 beats/min regular, blood pressure 101/67 mm Hg, and respiratory rate 15 breaths/min. Her abdomen was soft but tender in the right upper quadrant, with no demonstrable organomegally; bowel sounds were normal. Routine investigations showed a haemoglobin of 113 g/l, mean corpuscular volume 85 fl (78-100), white cell count 3.4×109/l (4.5-11.0), neutrophils 2.1×109/l (1.80-7.70), lymphocytes 0.99×109/l (1.10-4.80), platelets 194×109/l (140-450), C reactive protein 126 mg/l (<5), erythrocyte sedimentation rate 40 mm/h, sodium 136 mmol/l (135-145), potassium 3.6 mmol/l (3.5-5.1), creatinine 61 μmol/l (53-97), urea 3.1 mmol/l (2.5-6.7), alanine aminotransferase 68 U/l (0-55), alkaline phosphatase 242 U/l (40-150), total bilirubin 11 μmol/l (3-21), albumin 35 g/l (35-50), and corrected calcium 2.45 mmol/l (2.15-2.58). Malaria parasites were not seen on three thick and thin blood films over three days. Chest radiography showed no abnormalities. ### Short answers
USEFULNESS OF COPEPTIN IN THE EARLY DIAGNOSIS OF ACUTE CORONARY SYNDROME IN THE CARDIOVASCULAR EMERGENCY DEPARTMENT
Authors: Alexandra Arias-Mendoza, Leopoldo Bueno-Ayala, Jose Briseño-de la Cruz, Julio Sandoval-Zarate, Hector Gonzalez-Pacheco, Carlos Martinez-Sanchez
Journal: Journal of the American College of Cardiology (2013)