tbuckley/cabot-search huggingface dataset:
Baseline self reported functional health and vulnerability to post-traumatic stress disorder after combat deployment: prospective US military cohort study
Authors: C. A. LeardMann, T. C. Smith, B. Smith, T. S. Wells, M. A. K. Ryan
Journal: BMJ (2009)

<b>Objective</b> To determine if baseline functional health status, as measured by SF-36 (veterans), predicts new onset symptoms or diagnosis of post-traumatic stress disorder among deployed US military personnel with combat exposure. <b>Design</b> Prospective cohort analysis. <b>Setting </b>Millennium Cohort. <b>Participants</b> Combat deployed members who completed baseline (2001-3) and follow-up (2004-6) questionnaires. Self reported and electronic data used to examine the relation between functional health and post-traumatic stress disorder. <b>Main outcome measures</b> New onset post-traumatic stress disorder as measured by either meeting the DSM-IV criteria with the 17 item post-traumatic stress disorder checklist-civilian version or self report of a physician diagnosis at follow-up with the absence of both at baseline. <b>Results</b> Of the 5410 eligible participants, 395 (7.3%) had new onset symptoms or diagnosis of post-traumatic stress disorder at the time of follow-up. Individuals whose baseline mental or physical component summary scores were below the 15th centile had two to three times the risk of symptoms or a diagnosis of post-traumatic stress disorder by follow-up compared with those in the 15th to 85th centile. Of those with new onset symptoms or diagnosis of post-traumatic stress disorder, over half (58%) of cases occurred among participants with scores below the 15th centile at baseline. <b>Conclusions</b> Low mental or physical health status before combat exposure significantly increases the risk of symptoms or diagnosis of post-traumatic stress disorder after deployment. More vulnerable members of a population could be identified and benefit from interventions targeted to prevent new onset post-traumatic stress disorder.
POPULAR FALLACIES REGARDING ATHLETES AND ATHLETICS.
Authors: IRVING ROSSE
Journal: JAMA (1889)

As a branch of medicine that has for its object the bringing of man to a greater state of physical perfection, the question of athletics has for the more advanced and liberal minded of our profession the highest interest. In our parliamentary city where so many persons suffer from the effect of sedentary life, the athletic remedy seems to be the only sensible one, and it is daily becoming more apparent that a growing demand for athletics exists among the bright young men of the civil service who are fast replacing the sick, the infirm, and the political paretics that formerly filled the government departments. It is, therefore, with much gratification that we can point to the organizations of the Columbia Athletic Club of 450 members, and note the very favorable auspices under which it takes departure, owing to the liberality of a wealthy citizen, Mr. John McLean, formerly of
Endoscopic Ligation Compared with Sclerotherapy for Treatment of Esophageal Variceal Bleeding
Authors: Loren Laine
Journal: Annals of Internal Medicine (1995)

Purpose: To compare the effect of endoscopic ligation with that of sclerotherapy in the treatment of patients with bleeding esophageal varices. Data Sources: Strategies to identify published and unpublished research included searches of computerized bibliographic and scientific citations, review of citations in relevant primary articles, searches of services providing information on unpublished studies, contact with primary investigators and the ligation equipment manufacturer, and review of proceedings from pertinent scientific meetings. Study Selection: From 158 potentially relevant articles, duplicate independent review identified 7 relevant randomized trials that compared endoscopic ligation with sclerotherapy for the treatment of patients with bleeding esophageal varices. Data Abstraction: Independent, duplicate data abstraction of the population, intervention, outcome, and methodologic quality of the trials was done. Data Synthesis: Ligation therapy compared with sclerotherapy reduced the rebleeding rate (odds ratio, 0.52 [95% CI, 0.37 to 0.74]), the mortality rate (odds ratio, 0.67 [CI, 0.46 to 0.98]), and the rate of death due to bleeding (odds ratio, 0.49 [CI, 0.24 to 0.996]). Four patients would need to be treated with ligation instead of sclerotherapy to avert one rebleeding episode, and 10 would need to be treated with ligation instead of sclerotherapy to prevent one death. Esophageal strictures occurred less frequently with ligation (odds ratio, 0.10 [CI, 0.03 to 0.29]), but no significant differences were seen between treatments for pulmonary infections or bacterial peritonitis. Additionally, the number of endoscopic treatment sessions required to achieve variceal obliteration was lower with ligation than with sclerotherapy. Conclusions: On the basis of lower rates of rebleeding, mortality, and complications and the need for fewer endoscopic treatments, ligation should be considered the endoscopic treatment of choice for patients with esophageal variceal bleeding.
Methylphenidate in Tardive Dyskinesia
Authors: WILLIAM E. FANN, JOHN M. DAVIS, IAN C. WILSON
Journal: American Journal of Psychiatry (1973)

Methylphenidate, an amphetamine-like central nervous system (CNS) stimulant used successfully in reversing acute neuroleptic-induced neurological symptoms, was given in a placebo-controlled study to 17 patients with tardive dyskinesia. On global ratings three subjects were improved, six showed an increase in symptoms, and eight showed no changes. The authors conclude that methylphenidate is not effective in tardive dyskinesia and that the results of this study are in keeping with present knowledge about CNS pharmacology.
Impact of image spatial, temporal, and velocity resolutions on cardiovascular indices derived from color-Doppler echocardiography
Authors: José Luis Rojo-Álvarez, Javier Bermejo, Ana Belén Rodríguez-González, Andrés Martínez-Fernández, Raquel Yotti, Miguel A. García-Fernández, José Carlos Antoranz
Journal: Medical Image Analysis (2007)
Sodium reduction is enticing, but what is the full recipe?
Authors: Paul P Glasziou
Journal: BMJ (2007)

We select the letters for these pages from the rapid responses posted on bmj.com favouring those received within five days of publication of the article to which they refer.Letters are thus an early selection of rapid responses on a particular topic.Readers should consult the website for the full list of responses and any authors' replies, which usually arrive
Development of Transplantation Vasculopathy and Progression of Donor-Transmitted Atherosclerosis
Authors: Samir R. Kapadia, Steven E. Nissen, Khaled M. Ziada, Victor Guetta, Timothy D. Crowe, Robert E. Hobbs, Randall C. Starling, James B. Young, E. Murat Tuzcu
Journal: Circulation (1998)

Background —Transplant coronary artery disease is a combination of atherosclerosis transmitted from the donor and new lesions of allograft vasculopathy. We sought to determine the morphological characteristics of allograft vasculopathy and differentiate it from donor-transmitted atherosclerosis with serial intravascular ultrasound. Methods and Results —Intravascular ultrasound examination was performed in 93 patients at 27.2±15.0 and 369.7±23.9 days after transplantation. The maximally and minimally diseased sites were selected in each segment as defined by Coronary Artery Surgery Study classification. For each matched site, maximal plaque thickness was measured. Lesions (maximum plaque thickness ≥0.5 mm) present at baseline examination were defined as donor lesions. On follow-up, lesions that developed at previously normal sites were defined as de novo lesions. The distribution and severity of donor and de novo lesions were similar in proximal, mid, and distal segments. The de novo lesions were less focal (43% vs 74%) and more circumferential (69% vs 45%) compared with the donor lesions, but there was significant morphological heterogeneity. Similar numbers of patients with and those without donor lesions developed de novo lesions. Moreover, progression of donor lesions was not associated with the presence or absence of de novo lesions. Conclusions —Differentiation between early allograft vasculopathy from conventional atherosclerosis by distribution and morphology of lesions alone is difficult. Serial intravascular ultrasound imaging with early baseline examination is necessary to make this distinction. This distinction is important because the progression of donor lesions and the development of de novo lesions are independent of each other.
CLINICAL OBSERVATIONS ON ESSENTIAL HEMATURIA
Authors: WILLIAM F. BRAASCH
Journal: JAMA (1913)

For want of a more accurate term, I have retained that of "essential" for the type of hematuria which has not as yet been explained by any of the definitely established renal conditions causing hemorrhagic urine. The term "essential" should be limited to those cases of hematuria in which there is neither clinical evidence of renal insufficiency, visible organic change in the renal parenchyma nor any evidence of renal infection. The operative records of the Mayo clinic up to June 1, 1913, show twenty-six patients operated on for renal hematuria for which no evident cause could be found, and the clinical records show fifty-one patients not operated on in which the clinical diagnosis of essential hematuria was evident. <h3>SYMPTOMATOLOGY</h3><h3>Sex.</h3> —Of the 77 patients, 58, or 75 per cent., were males and 19, or 25 per cent., females. The preponderance of males is noteworthy and is in keeping with that of renal infection occurring in the male.
Spontaneous Pneumoperitoneum in the Newborn
Authors: Arnold Porter
Journal: New England Journal of Medicine (1956)

IN 1954 a two-day-old infant was admitted to the Rhode Island Hospital with pneumoperitoneum. At operation no abnormality could be found to explain the free air in the peritoneal cavity. The baby recovered without complications. A review of the current literature revealed only 2 similar cases, reported by Birdsong and Frame1 in 1951. The rarity of this abnormality prompted the following additional report.Case ReportB. B., a 2-day-old male infant, was referred to the private surgical service of the Rhode Island Hospital because an x-ray film had shown free air in the peritoneal cavity. He had been delivered at . . .
Effect of right ventricular anatomy on the cardiopulmonary response to exercise. Implications for the Fontan procedure.
Authors: J Rhodes, R P Garofano, F O Bowman, G P Grant, F Z Bierman, W M Gersony
Journal: Circulation (1990)

Incorporation of the right ventricle (RV) into the pulmonary circulation of patients with tricuspid atresia undergoing a Fontan procedure has been advocated. The consequences of this approach on the exercise function of these patients was studied by examining the effects of progressive and steady-state bicycle exercise tests performed by 11 patients with right atrial (RA)-RV Fontan anastomoses, seven patients with RA-pulmonary artery (PA) Fontan anastomoses, 13 patients after repair of tetralogy of Fallot, and 34 normal control patients. All patients were in New York Heart Association class I. The exercise function of the patients undergoing RA-RV and RA-PA Fontan procedures were similar. The achieved peak work loads 60% and 67% of control and peak oxygen consumptions 60% and 64% of control, respectively. Both groups also displayed excessive ventilation, elevated dead space/tidal volume ratios, and depressed cardiac output during steady-state exercise. In contrast, tetralogy of Fallot patients achieved peak work loads and oxygen consumptions 83% of control and maintained normal cardiac outputs and dead space/tidal volume ratios during steady-state exercise. These results suggest that the presence of an RV within the pulmonary circulation of the Fontan patient does not result in improved exercise function. This may be due to the development of obstructive gradients across the RA-RV conduits during exercise or to the RV's negative effect on left ventricular compliance. Moreover, in contrast with the postoperative tetralogy of Fallot patient, the hypoplastic RV of tricuspid atresia may not have sufficient myocardium to assume the active pumping function required by exercise.
The Blood Glucose Monitoring Communication Questionnaire
Authors: Korey K. Hood, Deborah A. Butler, Lisa K. Volkening, Barbara J. Anderson, Lori M.B. Laffel
Journal: Diabetes Care (2004)

OBJECTIVE—The aim of this study was to present the psychometric properties of a new tool for evaluating affective response to blood glucose monitoring (BGM) in youths with type 1 diabetes and their parents. RESEARCH DESIGN AND METHODS—Study participants included 153 youths with type 1 diabetes and their parents. Each youth and parent completed the Blood Glucose Monitoring Communication (BGMC) questionnaire, Diabetes Family Conflict Scale, and Pediatric Quality of Life Inventory. Statistical analyses evaluated the psychometric properties of the BGMC questionnaires and their association with glycemic outcomes. RESULTS—Youth and parent BGMC questionnaires had acceptable internal consistency (youth, α = 0.77; parent, α = 0.82) and 1-year test-retest reliability (youth, r = 0.60; parent, r = 0.80). Higher BGMC questionnaire scores (indicating more negative affect) showed a strong association with higher levels of diabetes-specific family conflict (youth, r = 0.33; parent, r = 0.44) and poorer health-related psychosocial quality of life (youth, r = −0.50; parent, r = −0.42). Higher BGMC questionnaire scores were also associated with poorer glycemic control (youth, r = 0.28; parent, r = 0.20), even when the effects of diabetes-specific family conflict and psychosocial quality of life were controlled. Youths with BGMC questionnaire scores in the upper quartile had A1c values 1 percentage point higher (9.1%) than youths with scores in the lowest quartile (8.0%). CONCLUSIONS—The BGMC questionnaires have strong psychometric properties and are convenient measures of affect specific to BGM. Further, BGM affect is associated with glycemic outcomes and may provide a unique contribution to factors associated with glycemic control in youths.
Is the Anterior Bone Scan Necessary in the Diagnosis of Osseous Metastases?
Authors: DAVID A. EPSTEIN, LETTY G. LUTZKER, LOUIS A. PEREZ, CARL COLLICA, JENNY CHUN, LEONARD M. FREEMAN
Journal: Clinical Nuclear Medicine (1978)

Bone imaging studies of 1650 patients with known or strongly suspected extraosseous malignancies were reviewed to determine whether a completely negative posterior view was sufficient to exclude metastatic disease. Of 708 negative posterior images, 27 (3.4%) were positive for metastasis on anterior views. Alt of the anterior lesions were in the sternum, sternoclavicular joints and first four ribs. When the posterior view is positive, further views may be unnecessary. Negative or equivocal posterior images necessitate anterior views of the thoracic cage.
Presystolic Atriogenic Mitral Reflux Developed at Abnormally Long PR Intervals
Authors: J. C. P. Williams, R. A. Vandenberg, R. E. Sturm, E. H. Wood
Journal: Cardiovascular Research (1968)

Journal Article Presystolic Atriogenic Mitral Reflux Developed at Abnormally Long PR Intervals Get access John C. P. Williams, John C. P. Williams From the Mayo Clinic and Mayo Foundation and the Mayo Graduate School of Medicine, Rochester, Minnesota, U.S.A. Search for other works by this author on: Oxford Academic PubMed Google Scholar Russell A. Vandenberg, Russell A. Vandenberg From the Mayo Clinic and Mayo Foundation and the Mayo Graduate School of Medicine, Rochester, Minnesota, U.S.A. Search for other works by this author on: Oxford Academic PubMed Google Scholar Ralph E. Sturm, Ralph E. Sturm From the Mayo Clinic and Mayo Foundation and the Mayo Graduate School of Medicine, Rochester, Minnesota, U.S.A. Search for other works by this author on: Oxford Academic PubMed Google Scholar Earl H. Wood Earl H. Wood From the Mayo Clinic and Mayo Foundation and the Mayo Graduate School of Medicine, Rochester, Minnesota, U.S.A. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 2, Issue 3, July 1968, Pages 271–277, https://doi.org/10.1093/cvr/2.3.271 Published: 01 July 1968 Article history Received: 28 November 1967 Published: 01 July 1968
Arthroscopic surgery of the knee.
Authors: D J Dandy, P F O'Carroll
Journal: BMJ (1982)

In the first 1000 arthroscopic operations performed by one surgeon 136 patients had two or more procedures, making a total of 1168 during the 1000 operations. The indications for operation were internal mechanical derangements in 565 patients, anterior knee pain in 246, disorders of the synovium in 77, ligament injuries in 63, and degenerative joint disease in 49. Complications included fracture of instruments in the knee in five patients, haemarthrosis in 10, deep vein thrombosis in three, and synovial fistula in one. In no patient was the wound infected. A total of 26 different operations was performed.
Systemic effects of high dose inhaled steroids: comparison of beclomethasone dipropionate and budesonide in healthy subjects.
Authors: P H Brown, S P Matusiewicz, C Shearing, L Tibi, A P Greening, G K Crompton
Journal: Thorax (1993)

ACKGROUND--Systemic absorption of inhaled corticosteroids may adversely influence the function of the hypothalamo-pituitary-adrenal axis, bone metabolism, and circulating leucocytes. These changes can be used to assess the safety of different types and modes of administration of these drugs. METHODS--The study was a randomised, double dummy, crossover design with nine healthy adults. It compared the effects of beclomethasone dipropionate and budesonide (given by metered dose aerosols with and without their respective large volume spacers (Volumatic and Nebuhaler) attached) on serum cortisol, 24 hour urinary free cortisol, and plasma osteocalcin concentrations, and circulating neutrophils and lymphocytes. Subjects inhaled the drug (1 mg) and matching placebo at 0900 and 2200 hours on each of six study days. Blood samples were taken hourly for six hours after the morning dose and at the end of the study period. RESULTS--All results were within the reference ranges. Both drugs caused similar reductions in serum cortisol four to six hours after inhalation. These changes were not affected by the use of a large spacer and did not persist at 24 hours. Use of spacers tended to increase the haematological effects of the steroids. Beclomethasone dipropionate inhaled through a Volumatic provoked a rise in circulating neutrophils compared with placebo although lymphocyte numbers were unaffected. Budesonide did not influence neutrophil numbers but did reduce circulating lymphocytes, numbers of which were further reduced when the Nebuhaler was used. There were no significant changes in plasma osteocalcin concentration or 24 hour urinary free cortisol excretion with budesonide, with or without a spacer. Beclomethasone dipropionate inhaled without a spacer reduced urinary cortisol and plasma osteocalcin at 24 hours; however, use of the Volumatic protected against these effects. CONCLUSIONS--Attaching a Volumatic reduces the systemic effects of 2 mg aerosol beclomethasone dipropionate on the hypothalamo-pituitary-adrenal axis and circulating osteocalcin concentrations. This study did not establish whether the Nebuhaler reduces the systemic effects of budesonide. When large spacers are used, 2 mg per day of beclomethasone dipropionate and budesonide seem to be equivalent in terms of unwanted effects.
Schizophrenia Therapy Controversy Continues
Authors: Paul Cotton
Journal: JAMA (1991)

ENDING an exclusivity arrangement may not ease the threat of  actions against the Sandoz Pharmaceutical Co of East Hanover, NJ.  The Antitrust Subcommittee of the US Senate Judiciary Committee heard testimony this month concerning the company's continued insistence on controlling physician monitoring of patients taking its schizophrenia drug clozapine (Clozaril) because of concerns about product liability suits.  Sandoz sent  representative to the hearing, citing a conflict with ongoing  suits brought by attorneys general of 29 states and the District of Columbia ( JAMA . 1991;265:837-838).  David Winter, MD, vice president for scientific and external affairs, says there is no basis for antitrust now, or even with the original exclusive linkage arrangement, under which patients could only get the drug by submitting to weekly monitoring by Caremark Home-care Inc of Lincolnshire, Ill. The testing is for agranulocytosis, a blood disorder affecting 1% to 2% of patients that can be fatal
Postoperative urinary retention in men.
Authors: S W O'Kelly, P M Spargo
Journal: BMJ (1991)

Thyroid dysfunction and affective illness SIR,-Professor E Szabadi's editorial on thyroid dysfunction and affective illness raised the question of whether subclinical dysfunction of the thyroid has a role in affective illnesses.'Lithium is well recognised to affect thyroid hormones; cases of hypothyroidism and hyperthyroidism have been reported.2Primary affective disorders may themselves have a role in the development of autoimmune thyroid disease.A recent study was designed to determine whether the development of autoimmune thyroid disease was due to lithium treatment or depressive illness.4Three main groups were studied: a control group, patients receiving treatment other than lithium for depression, and patients receiving lithium for their manic depressive illness.All patients were clinically and biochemically euthyroid.The serum samples obtained were tested for thyroid microsomal and thyroglobulin antibodies.None of the controls were positive for thyroid antibodies, but 7-5% of the patients receiving treatment other than lithium for depression were positive for the antibodies.This, however, is not significantly high when compared with the incidence in the general population.'The patients receiving lithium for their manic depressive illness showed a greatly increased incidence of thyroid antibodies (20%), in keeping with results of other studies.' 6 The authors concluded that lithium treatment induces the formation of antibodies in susceptible people, which may lead to the development of thyroid disease in these patients.A larger study will be necessary to determine whether affective disorders alone play any part in the development of subclinical hypothyroidism.
Progressive liver injury in chronic hepatitis C infection correlates with increased intrahepatic expression of Th1-associated cytokines
Authors: J Napoli, G A Bishop, P H McGuinness, D M Painter, G W McCaughan
Journal: Hepatology (1996)

An imbalance between T helper cell (Th)1 and Th2–like cytokines has been described in several chronic infectious diseases. We therefore analyzed the intrahepatic messenger RNA (mRNA) expression of Th1–like (interleukin [IL]–2, interferon [IFN]–gamma) and Th2–like (IL–4, IL–10) cytokines in chronic hepatitis C patients (n = 17) and controls (n = 6) and correlated the results with liver histology and intrahepatic viral load. Intrahepatic cytokine mRNA and hepatitis C virus (HCV) RNA were quantitatively assessed by polymerase chain reaction (PCR) using a dot– blot hybridization technique. Liver biopsy specimens were histologically graded using the Scheuer Score. IFN–gamma and IL–2 mRNA expression were significantly upregulated in chronic HCV vs. controls ( P &lt; .002, P &lt; .04, respectively). Both correlated significantly with histological fibrosis and portal tract inflammation. In contrast, the expression of IL–10 mRNA was decreased in cirrhosis and chronic HCV compared with controls ( P &lt; .02, P &lt; .0001, respectively). IL–4 mRNA was detected inconsistently at low levels in all groups. Intrahepatic viral load did not correlate with either cytokine expression or tissue injury. In conclusion, the progressive liver injury seen in chronic HCV is associated with the upregulation of intrahepatic Th1–like cytokines and the downregulation of IL–10, a Th2–like cytokine. These results suggest a role for delayed–type hypersensitivity immune reactions in HCV related liver injury.