tbuckley/cabot-search huggingface dataset:
Endotracheal Intubation-Reply
Authors: Thomas L. Petty
Journal: JAMA (1977)

<h3>In Reply.—</h3> We completely agree with Dr Alberty that too often inexperienced persons attempt intubation that is completely unnecessary. In the past, many persons reached our hospital using a simple oral airway with self-inflating bag. Some patients had, in fact, been supported for several hours coming from rural Colorado. Thus, intubation should be attempted only by those with requisite experience, and emphasis should be placed on simpler and safer methods of respiratory support in situations where training may not be adequate. This point was stressed in our monograph<i>Intensive and Rehabilitative Respiratory Care</i>(Philadelphia, Lea &amp; Febiger Publishers, 1974, p 16).
Liver Scan in Traumatic Right Hemidiaphragmatic Hernia
Authors: YUTAKA SUZUKI
Journal: Clinical Nuclear Medicine (1985)

Liver imaging was performed in two patients with traumatic right hemidiaphragmatic hernia. It has elucidated the cause of obliteration of the right hemidiaphragmatic shadow on the chest x-ray. These cases are illustrative of the usefulness of liver imaging in the diagnosis of traumatic right hemidiaphragmatic hernia as well as hepatic injury.
Multiple Testing of Hypotheses in Comparing Two Groups
Authors: L. ADRIENNE CUPPLES
Journal: Annals of Internal Medicine (1984)

Researchers frequently encounter studies that compare two groups on many variables. We discourage the use of multiple tests of hypotheses on individual variables, an approach that ignores the correlation among the variables and increases the chance of a type I error. Instead of examining each variable separately, we recommend using multivariate procedures that integrate all measures on a person into a unified analysis of the differences between the two groups. We describe three multivariate procedures: Hotelling's T2, discriminant analysis, and logistic regression. We also discuss the use of Bonferroni's adjustment to preserve the overall chance of a type I error in conducting individual tests on each variable after doing the multivariate procedures. We review the underlying assumptions and relative merits and disadvantages of the three multivariate methods and recommend which method to use in various circumstances.
Galectin-3 ablation protects mice from diet-induced NASH: A major scavenging role for galectin-3 in liver
Authors: Carla Iacobini, Stefano Menini, Carlo Ricci, Claudia Blasetti Fantauzzi, Angela Scipioni, Laura Salvi, Samantha Cordone, Francesca Delucchi, Matteo Serino, Massimo Federici, Flavia Pricci, Giuseppe Pugliese
Journal: Journal of Hepatology (2010)
HEPATITIS E: An Overview
Authors: Eric E. Mast, M.D., M.P.H, Krzysztof Krawczynski, M.D., Ph.D
Journal: Annual Review of Medicine (1996)

▪ Abstract Hepatitis E has a worldwide distribution and causes substantial morbidity and mortality in some developing countries, particularly among pregnant women. Hepatitis E virus (HEV) has recently been cloned and sequenced and new diagnostic tests have been developed; these tests have been used to begin to characterize the natural history and epidemiologic features of HEV infection. Experimental vaccines have also been developed that offer the potential to prevent hepatitis E. However, to develop effective strategies to prevent this disease, much remains to be learned about HEV, including the vehicles of transmission, the reservoir(s) of the virus, and the natural history of protective immunity.
The Effects of Organizational Structure on Primary Care Outcomes under Managed Care
Authors: Donald A. Barr
Journal: Annals of Internal Medicine (1995)

The advent of managed care in the United States brings with it more and larger organizations involved in providing primary care.Studies of organizations in general suggest that large managed care organizations will have difficulty providing high-quality primary care largely because of their complexity and the fragmentation of their work force. Existing data confirm that these organizations have shortcomings in both patient and physician satisfaction. There are few data to indicate whether such organizations can mitigate these problems by saving costs through economies of scale. To offset their inherent weaknesses, large primary care organizations need to ensure patients' accessibility to their physicians, the continuity of the physician–patient relationship, a care environment conducive to a high-quality physician–patient interaction, and the clinical autonomy of physicians. Much additional research needs to be done to further understand these issues.
OPPORTUNITIES FOR POSTGRADUATE STUDY FOR NEGRO PRACTICING PHYSICIANS IN THE SOUTH
Authors: PAUL B. CORNELY
Journal: JAMA (1942)

There has been an increasing acknowledgment during the past thirty years of the need for keeping the general practitioners of this country abreast of medical advances so that there will not be too wide a hiatus between the development of new principles and technics and their actual application. This concern has been manifested by the American Medical Association since 1913 through its Council on Medical Education and culminated in a comprehensive study<sup>1</sup>of the educational programs of every state during the years 1937 to 1940. This need has also been emphasized by the Commission on Graduate Medical Education in its recent report,<sup>2</sup>and just recently the executive committee of the National Board of Medical Examiners has appointed a committee to study the question as to the best method of providing some kind of recognition for the progressive, up to date, efficient and well trained general practitioner.<sup>3</sup> Even
Abnormal contractile properties of muscle fibers expressing beta-myosin heavy chain gene mutations in patients with hypertrophic cardiomyopathy.
Authors: E B Lankford, N D Epstein, L Fananapazir, H L Sweeney
Journal: Journal of Clinical Investigation (1995)

Missense mutations in the beta-myosin heavy chain (beta-MHC) gene cause hypertrophic cardiomyopathy (HCM). As normal and mutant beta-MHCs are expressed in slow-twitch skeletal muscle of HCM patients, we compared the contractile properties of single slow-twitch muscle fibers from patients with three distinct beta-MHC gene mutations and normal controls. Fibers with the 741Gly-->Arg mutation (near the binding site of essential light chain) demonstrated decreased maximum velocity of shortening (39% of normal) and decreased isometric force generation (42% of normal). Fibers with the 403Arg-->Gln mutation (at the actin interface of myosin) showed lowered force/stiffness ratio (56% of normal) and depressed velocity of shortening (50% of normal). Both the 741Gly-->Arg and 403Arg-->Gln mutation-containing fibers displayed abnormal force-velocity relationships and reduced power output. Fibers with the 256Gly-->Glu mutation (end of ATP-binding pocket) had contractile properties that were indistinguishable from normal. Thus there is variability in the nature and extent of functional impairments in skeletal fibers containing different beta-MHC gene mutations, which may correlate with the severity and penetrance of the disease that results from each mutation. These functional alterations likely constitute the primary stimulus for the cardiac hypertrophy that is characteristic of this disease.
Importance of aortic baroreflex in regulation of sympathetic responses during hypotension. Evidence from direct sympathetic nerve recordings in humans.
Authors: J S Sanders, A L Mark, D W Ferguson
Journal: Circulation (1989)

Arterial baroreceptors in the carotid sinus and aortic arch regions reflexly regulate heart rate and peripheral vascular responses during changes in arterial pressure. The relative influence of these two arterial baroreflex pathways on the control of these autonomic responses is debatable. Recent studies in our laboratory demonstrate that the aortic baroreflex produces substantial and sustained inhibition of efferent sympathetic nerve activity to muscle (MSNA) during increases in arterial pressure. The regulation of MSNA by these two baroreflexes in humans during hypotension, and particularly the role of the aortic baroreflex, remains undefined. We therefore performed a new series of studies to assess the relative influence of the aortic and carotid baroreflexes on MSNA responses during sustained decreases in arterial pressure. In eight normal male subjects, aged 23 +/- 1 years (mean +/- SEM), we directly measured mean arterial pressure, heart rate, central venous pressure, and MSNA (microneurography) during hypotension (combined aortic and carotid baroreceptor deactivation) produced by intravenous infusion of sodium nitroprusside and during nitroprusside infusion with superimposed application of external neck suction. Neck suction was applied at levels sufficient to maintain transmural carotid sinus pressure above control levels (carotid baroreceptor activation) while the aortic baroreflexes remained deactivated. Central venous pressure was maintained constant with volume infusion. We also studied responses of these same subjects to direct carotid baroreceptor deactivation with the application of external neck pressure. During neck pressure alone, there was a reflex increase in mean arterial pressure; thus, during this portion of the protocol, we achieved carotid baroreceptor deactivation with some aortic baroreceptor activation. Nitroprusside infusion (combined aortic and carotid deactivation) decreased mean arterial pressure from 90.8 +/- 3.1 to 77.8 +/- 1.1 mm Hg (p less than 0.01) with concomitant increases in heart rate from 62.6 +/- 3.0 to 89.7 +/- 6.1 beats/min (p less than 0.001) and in MSNA from 273.8 +/- 43.0 to 950.6 +/- 133.5 units (p less than 0.001). During continued nitroprusside infusion with superimposed neck suction (aortic baroreceptor deactivation and carotid baroreceptor activation), mean arterial pressure decreased to 70.3 +/- 1.9 mm Hg (p less than 0.001 vs. control), heart rate decreased to 82.5 +/- 6.5 beats/min (p less than 0.01 vs. control or vs. nitroprusside alone), but MSNA remained markedly increased at 889.7 +/- 105.1 units (p less than 0.001 vs. control; p = NS vs. nitroprusside alone).(ABSTRACT TRUNCATED AT 400 WORDS)
REPORT ON WOUND TREATMENT BY BRILLIANT GREEN PASTE
Authors: A. R. Short, J. S. Arkle, C. King
Journal: BMJ (1917)

MEIALJURA J1_cooling is mixed with the iodoform in a mortar whlichl has been sterilized by means of boiling water and formaliii.The paraffin is added to the mixture at a temperature of 90°C.anid thoroughly mixed, then put into specially male collapsible tubes with nozzle ends, holding 40 to 80 granms.The paraffin used should be semi-solid, odourless, and tasteless, melting 'point 450 C., free from acidity and carbonizable-organic impurities.The iodoform should be free from moisture, acids, and fixed impurities.It is also necessary that the bismuth be chemically pure, free from arsenic, and care taken in sterilizing that the temperature does not rise too high, otherwise nitrous fumes will be evolved.A paste made by this method is found to be fairly solid in consistency, shows no signs of separation or decomporitioll, and is perfectly sterile, as certified by Dr. Slade, bacteriologist to this infirmary.Should a paste be required of a, softer consistency the formula mnay be modified as follows X Iodoform ...
Was "Commercialism" Its Basis? A Protest.
Authors: Charles L. Minor
Journal: JAMA (1900)

Asheville, N. C., Oct. 24, 1900. <h3>To the Editor:</h3> —It seems to me most unfortunate that you should have allowed your excellent tuberculosis number of October 20 to be spoiled by giving access to it, of a paper which, apparently—for I do not want to do its author an injustice in case it was meant well—is a purely commercial advertisement of a special method of treatment so indistinctly described that those wishing to test its reputed virtues will have to write to its author for particulars. I refer to the paper by Dr. Lisle, of Columbus, on the Treatment of Pulmonary Tuberculosis. I believe that any one who reads it will be convinced that, however honest the intention of its author, he has been unfortunate in the way in which he wrote, if he wished to "avoid the appearance of evil." When one comes forward with a new treatment it
Syndromes and Phenomenological Subtypes Underlying Acute Mania: A Factor Analytic Study of 576 Manic Patients
Authors: Tetsuya Sato, Ronald Bottlender, Nikolaus Kleindienst, Hans-Jürgen Möller
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: There are no factor analytic studies specifically including symptoms representative of depressive inhibition among manic patients, although Kraepelin described several mixed affective states with depressive inhibition. There is controversy as to whether atypical manic features such as aggression, psychosis, and depression are likely to coexist among manic patients. The authors' goal was to examine this controversy. METHOD: They used a standardized instrument to assess the presence or absence of 37 psychiatric symptoms in 576 consecutive inpatients who were diagnosed as having DSM-IV manic episode, nonmixed or mixed. RESULTS: A principal-component analysis followed by varimax rotation extracted seven independent interpretable factors (depressive mood, irritable aggression, insomnia, depressive inhibition, pure manic symptoms, emotional lability/agitation, and psychosis) that were relatively stable across several patient groups. A subsequent cluster analysis identified four phenomenological subtypes underlying acute mania: pure, aggressive, psychotic, and depressive (mixed) mania. Several variables, including gender, suicidality, and outcome of treatments, significantly differentiated the subtypes. CONCLUSIONS: In patients with mania, depressive inhibition may be a salient syndrome independent of depressive mood, lending some support to Kraepelin's classification of mixed manic states on the basis of the permutations of three elements—thought disorder, mood, and psychomotor activity. Depressive inhibition, together with depressive mood and emotional lability/agitation, appears to be an important phenomenological element of mixed states. Atypical manic features such as aggression, psychosis, and depression are not likely to coexist, but they are likely separately to characterize several different subtypes potentially underlying acute mania.
Electron microscopic and confocal laser scanning microscopic observation of subcellular organelles and pituitary hormone mRNA: Application of ultrastructuralIn situ hybridization and immunohistochemistry to the pathophysiological studies of pituitary cells
Authors: Akira Matsuno, Johbu Itoh, R. Yoshiyuki Osamura, Keiichi Watanabe, Tadashi Nagashima
Journal: Endocrine Pathology (1999)
Value of Primordial and Primary Prevention for Cardiovascular Disease
Authors: William S. Weintraub, Stephen R. Daniels, Lora E. Burke, Barry A. Franklin, David C. Goff, Laura L. Hayman, Donald Lloyd-Jones, Dilip K. Pandey, Eduardo J. Sanchez, Andrea Parsons Schram, Laurie P. Whitsel
Journal: Circulation (2011)

The process of atherosclerosis may begin in youth and continue for decades, leading to both nonfatal and fatal cardiovascular events, including myocardial infarction, stroke, and sudden death. With primordial and primary prevention, cardiovascular disease is largely preventable. Clinical trial evidence has shown convincingly that pharmacological treatment of risk factors can prevent events. The data are less definitive but also highly suggestive that appropriate public policy and lifestyle interventions aimed at eliminating tobacco use, limiting salt consumption, encouraging physical exercise, and improving diet can prevent events. There has been concern about whether efforts aimed at primordial and primary prevention provide value (ie, whether such interventions are worth what we pay for them). Although questions about the value of therapeutics for acute disease may be addressed by cost-effectiveness analysis, the long time frames involved in evaluating preventive interventions make cost-effectiveness analysis difficult and necessarily flawed. Nonetheless, cost-effectiveness analyses reviewed in this policy statement largely suggest that public policy, community efforts, and pharmacological intervention are all likely to be cost-effective and often cost saving compared with common benchmarks. The high direct medical care and indirect costs of cardiovascular disease—approaching $450 billion a year in 2010 and projected to rise to over $1 trillion a year by 2030—make this a critical medical and societal issue. Prevention of cardiovascular disease will also provide great value in developing a healthier, more productive society.
Comparative Study of Home Blood Glucose Monitoring Devices: Visidex, Chemstrip bG, Glucometer, and Accu-Chek bG
Authors: Shahid Aziz, Ying Hui Hsiang
Journal: Diabetes Care (1983)

Visidex (Ames Company, Elkhart, Indiana) and Accu-Chek bG (Bio-Dynamics, Boehringer Mannheim, Indianapolis, Indiana), two new devices for determining blood glucose at home, were compared with two older devices, Chemstrip bG (Bio-Dynamics) and Glucometer (Ames Company), and the standard laboratory glucose-oxidase method (Beckman autoanalyzer, Beckman Instruments, Fullerton, California). Laboratory serum glucose values up to 400 mg/dl had excellent overall correlation with Accu-Chek bG (r = 0.974), Glucometer (r = 0.974), Chemstrip bG (r = 0.963), and Visidex (r = 0.955). For glucose values ≤180 mg/dl, Glucometer had the best correlation (r = 0.921). For glucose values of 181–400 mg/dl, Accu-Chek bG had better correlation (r = 0.907) although Glucometer had closer mean value. Visidex was just as accurate as Chemstrip bG. Although the four devices tested tended to give lower values than the lab method, they are sufficiently accurate to be of clinical use in home monitoring of blood glucose. Meticulous care in running the tests is mandatory for accuracy. Individual differences among the four methods are discussed.
Phase II Trial of Irinotecan, Carboplatin, and Bevacizumab in the Treatment of Patients with Extensive-Stage Small-Cell Lung Cancer
Authors: David R. Spigel, F Anthony Greco, John D. Zubkus, Patrick B. Murphy, Ruben A. Saez, Cindy Farley, Denise A. Yardley, Howard A. Burris, John D. Hainsworth
Journal: Journal of Thoracic Oncology (2009)
Stress CMR Reduces Revascularization, Hospital Readmission, and Recurrent Cardiac Testing in Intermediate-Risk Patients With Acute Chest Pain
Authors: Chadwick D. Miller, L. Douglas Case, William C. Little, Simon A. Mahler, Gregory L. Burke, Erin N. Harper, Cedric Lefebvre, Brian Hiestand, James W. Hoekstra, Craig A. Hamilton, W. Gregory Hundley
Journal: JACC. Cardiovascular imaging (2013)

The aim of this study was to determine the effect of stress cardiac magnetic resonance (CMR) imaging in an observation unit (OU) on revascularization, hospital readmission, and recurrent cardiac testing in intermediate-risk patients with possible acute coronary syndromes (ACS). Intermediate-risk patients commonly undergo hospital admission with high rates of coronary revascularization. It is unknown whether OU-based care with CMR is a more efficient alternative. A total of 105 intermediate-risk participants with symptoms of ACS but without definite ACS on the basis of the first electrocardiogram and troponin were randomized to usual care provided by cardiologists and internists (n = 53) or to OU care with stress CMR (n = 52). The primary composite endpoint of coronary artery revascularization, hospital readmission, and recurrent cardiac testing at 90 days was determined. The secondary endpoint was length of stay from randomization to index visit discharge; safety was measured as ACS after discharge. The median age of participants was 56 years (range 35 to 91 years), 54% were men, and 20% had pre-existing coronary disease. Index hospital admission was avoided in 85% of the OU CMR participants. The primary outcome occurred in 20 usual care participants (38%) versus 7 OU CMR participants (13%) (hazard ratio: 3.4; 95% confidence interval: 1.4 to 8.0, p = 0.006). The OU CMR group experienced significant reductions in all components: revascularizations (15% vs. 2%, p = 0.03), hospital readmissions (23% vs. 8%, p = 0.03), and recurrent cardiac testing (17% vs. 4%, p = 0.03). Median length of stay was 26 h (interquartile range: 23 to 45 h) in the usual care group and 21 h (interquartile range: 15 to 25 h) in the OU CMR group (p < 0.001). ACS after discharge occurred in 3 usual care participants (6%) and no OU CMR participants. In this single-center trial, management of intermediate-risk patients with possible ACS in an OU with stress CMR reduced coronary artery revascularization, hospital readmissions, and recurrent cardiac testing, without an increase in post-discharge ACS at 90 days. (Randomized Investigation of Chest Pain Diagnostic Strategies; NCT01035047)
Points from letters: Breast-feeding
Authors: K. M Lawler
Journal: BMJ (1976)

Government's spokesmen, including the Prime Minister, admit that the counter-inflation policy of 1975-6 was unjust to certain members of the community, including consultants on the incremental scale.They argue, however, that the steps were necessary in the national interest.The professions' negotiators did not 'acquiesce' in the imposition of this counterinflation policy, but vigorously opposed it- and succeeded in securing the modification for 1976-7 which has allowed the incremental scales to be reactivated.The withholding of contractual increments (and distinction awards) which has in effect meant for some consultants a 12-month wait for what they were entitled to was secured by the Remuneration, Charges, and Grants Act 1975-which rapidly went through Parliament without opposition and specifically allows employing authorities to breach contracts in this respect."-ED, BMJ. Keeping tabs on trainers
What about stigma, evidence base, and consistency?
Authors: Trevor Turner, Sue Collinson
Journal: BMJ (2007)

Trichomonas vaginalis organisms were mixed with suspensions of Neisseria gonorrhoeae, Mycoplasma hominis or Chlamydia trachomatis to allow ingestion of these micro-organisms by the trichomonads. Culture studies indicated that gonococci and mycoplasmas were ingested and that the number of intracellular viable organisms decreased rapidly, most gonococci being killed within six hours and all mycoplasmas within three hours. Electron microscopy revealed phagocytic uptake and destruction of these two micro-organisms within the trichomonads, gonococcal degradation being associated with lysosomal enzyme activity. There was no evidence from cultural or electron microscopy studies that C trachomatis organisms persisted in mixed culture with T vaginalis.