tbuckley/cabot-search huggingface dataset:
Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant <i>Staphylococcus aureus</i>
Authors: Rodney B. Nelson
Journal: Annals of Internal Medicine (2008)

Letters1 July 2008Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureusRodney B. Nelson, MDRodney B. Nelson, MDFrom Geneva, IL 60134.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-1-200807010-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I'm concerned by 2 aspects of the study by Robicsek and colleagues (1). First, no mention is made of independent review board approval or informed consent from the experimental participants. Being identified as a carrier of MRSA has many practical (and potentially harmful) consequences on the hospital care of a patient and for options regarding posthospital care. “Harming through protection” has recently been discussed in the context of this type of study (2). The Office for Human Research Protections has backed off from its recent position that these studies require full review. However, a thrombocytopenic patient who ...References1. Robicsek A, Beaumont JL, Paule SM, Hacek DM, Thomson RB, Kaul KL, et al. Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med. 2008;148:409-18. [PMID: 18347349] LinkGoogle Scholar2. Baily MA. Harming through protection? N Engl J Med. 2008;358:768-9. [PMID: 18287599] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Rodney B. Nelson, MDAffiliations: From Geneva, IL 60134.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUniversal Surveillance for Methicillin-Resistant Staphylococcus aureus in 3 Affiliated Hospitals Ari Robicsek , Jennifer L. Beaumont , Suzanne M. Paule , Donna M. Hacek , Richard B. Thomson Jr. , Karen L. Kaul , Peggy King , and Lance R. Peterson Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureus Lance R. Peterson , Jennifer L. Beaumont , and Ari Robicsek Benefits and Drawbacks of Universal Surveillance of Methicillin-Resistant Staphylococcus aureus Daniel Diekema Metrics 1 July 2008Volume 149, Issue 1Page: 67-68KeywordsBacteremiaConflicts of interestMethicillin-resistant staphylococcus aureusPatientsReasoning ePublished: 1 July 2008 Issue Published: 1 July 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Multicenter patency trial of intravenous anistreplase compared with streptokinase in acute myocardial infarction. The TEAM-2 Study Investigators.
Authors: J L Anderson, S G Sorensen, F L Moreno, R A Hackworthy, K F Browne, H T Dale, F Leya, V Dangoisse, H W Eckerson, V J Marder
Journal: Circulation (1991)

Thrombolytic therapy has been shown to improve clinical outcome when administered early after the onset of symptoms of acute myocardial infarction; the mechanism of benefit is believed to be reestablishment and maintenance of coronary artery patency. Anistreplase is a second generation thrombolytic agent that is easily administered and has a long duration of action. To compare anistreplase (30 units/2-5 min) and therapy with the Food and Drug Administration-approved regimen of intravenous streptokinase (1.5 million units/60 min), a randomized, double-blind, multicenter patency trial was undertaken in 370 patients less than 76 years of age with electrocardiographic ST segment elevation who could be treated within 4 hours of symptom onset. Coronary patency was determined by reading, in a blinded fashion, angiograms obtained early (90-240 minutes; mean, 140 minutes) and later (18-48 hours; mean, 28 hours) after beginning therapy. Early total patency (defined as Thrombolysis in Myocardial Infarction grade 2 or 3 perfusion) was high after both anistreplase (132/183 = 72%) and streptokinase (129/176 = 73%) therapy, and overall patency patterns were similar, although patent arteries showed "complete" (grade 3) perfusion more often after anistreplase (83%) than streptokinase (72%) (p = 0.03). Similarly, residual coronary stenosis, determined quantitatively by a validated computer-assisted method, was slightly less in patent arteries early after anistreplase (mean stenosis diameter, 74.0%) than streptokinase (77.2%, p = 0.02). In patients with patent arteries without other early interventions, reocclusion risk within 1-2 days was defined angiographically and found to be very low (anistreplase = 1/96, streptokinase = 2/94). Average coronary perfusion grade was greater, and percent residual stenosis was less, at follow-up than on initial evaluation and did not differ between treatment groups. Enzymatic and electrocardiographic evolution was not significantly different in the two groups. Despite rapid injection, anistreplase was associated with only a small (4-5 mm Hg), transient (at 5-10 minutes) mean differential fall in blood pressure. In-hospital mortality rates were comparable for anistreplase and streptokinase (5.9%, 7.1%). Stroke occurred in one (0.5%) and three (1.6%) patients, respectively; one stroke was hemorrhagic. Other serious bleeding events and adverse experiences occurred uncommonly and with similar frequency in the two groups. Thus, for the end points of our study (patency, safety), anistreplase and streptokinase showed overall favorable and relatively comparable outcomes, with a few differences.(ABSTRACT TRUNCATED AT 400 WORDS)
Body Composition in Amenorrheic Athletic Women
Authors: ROSE E. FRISCH
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 July 1985Body Composition in Amenorrheic Athletic WomenROSE E. FRISCH, Ph.D.ROSE E. FRISCH, Ph.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-1-153_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The low estimations of body fat of 4% to 10% in eumenorrheic women runners reported by Marcus and associates (1) must be interpreted with caution. The weight for height reported for each of the "cyclic" runners is well above the threshold weight for height found necessary for regular cycles in nonathletic women (2). This threshold weight (2) represents about 22% fat of body weight, or a ratio of lean mass to fat of about 3.5 to 1. Normal women have about 26% to 28% fat at completion of growth compared to about 16% fat for men (3)....References1. MARCUS R, CANN C, and MADVIG P. Menstrual function and bone mass in elite women distance runners: endocrine and metabolic features. Ann Intern Med. 1985;102:158-63. LinkGoogle Scholar2. FRISCH R and MCARTHUR J. Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenance or onset. Science. 1974;174:949-51. CrossrefGoogle Scholar3. MOORE F, OLESON H, MCMURREY J, PARKER V, BALL M, and BOYDEN L. The Body Cell Mass and Its Supporting Environment. Philadelphia: W. B. Saunders Co.; 1963. Google Scholar4. BOYDEN T, PAMENTER R, GROSSO D, STANFORTH P, ROTKIS T, and WILMORE J. Prolactin responses, menstrual cycles and body composition of women runners. J Clin Endocrin Metab. 1982;54:711-4. CrossrefMedlineGoogle Scholar5. COHN S, VASWANI A, YASUMURA S, YUEN K, and ELLIS K. Improved models for determination of body fat by in vivo neutron activation. Am J Clin Nutr. 1984;40:255-9. CrossrefMedlineGoogle Scholar1. BOYDEN T, PAMENTER R, GROSSO D, STANFORTH P, ROTKIS T, and WILMORE J. Prolactin responses, menstrual cycles and body composition of women runners. J Clin Endocrinol Metab. 1982;54:711-4. CrossrefMedlineGoogle Scholar2. DRINKWATER B. Women and exercise: physiological aspects. In: TERJUNG RL, ed. Exercise and Sports Science Reviews. Lexington, Massachusetts: Collamore Press; 1984:21-51. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROSE E. FRISCH, Ph.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCorrection: Additional Reference in Letter on AmenorrheaROSE E. FRISCH, Ph.D. 1 July 1985Volume 103, Issue 1Page: 153-153KeywordsAdipose tissueBody weightFatsSports ePublished: 1 December 2008 Issue Published: 1 July 1985 PDF downloadLoading ...
Review: A Mediterranean diet reduces cardiovascular risk factors in overweight patients compared with a low-fat diet
Authors: Edward P. Havranek
Journal: Annals of Internal Medicine (2011)

Source Citation Nordmann AJ, Suter-Zimmermann K, Bucher HC, et al. Meta-analysis comparing Mediterranean to low-fat diets for modification of cardiovascular risk factors. Am J Med. 2011;124:841-51. 21854893
Occupational asthma: a review.
Authors: L J Lombardo, J R Balmes
Journal: Environmental Health Perspectives (2000)

Occupational asthma is the most common form of occupational lung disease in the developed world at the present time. In this review, the epidemiology, pathogenesis/mechanisms, clinical presentations, management, and prevention of occupational asthma are discussed. The population attributable risk of asthma due to occupational exposures is considerable. Current understanding of the mechanisms by which many agents cause occupational asthma is limited, especially for low-molecular-weight sensitizers and irritants. The diagnosis of occupational asthma is generally established on the basis of a suggestive history of a temporal association between exposure and the onset of symptoms and objective evidence that these symptoms are related to airflow limitation. Early diagnosis, elimination of exposure to the responsible agent, and early use of inhaled steroids may play important roles in the prevention of long-term persistence of asthma. Persistent occupational asthma is often associated with substantial disability and consequent impacts on income and quality of life. Prevention of new cases is the best approach to reducing the burden of asthma attributable to occupational exposures. Future research needs are identified.
Spanish Medicine-Reply
Authors: James F. Drane
Journal: JAMA (1989)

In Reply.—  Any attempt to explain something as complex as Spain's national health care system is obliged to synthesize and condemned to some degree of simplification. Dr Nieto's comments provide a slightly different evaluation of some of the developments that I reported, but I think we are in essential agreement about what is happening in Spain.  The ethical principle of socialism is equality, and this ideal is the driving force behind the new emphasis on primary rather than tertiary care in Spain's health provision system. This core principle is not entirely absent even from capitalistic political platforms and may be espoused by organizations like the World Health Organization without ceasing to be the core socialist ideal. If the older tertiary care hospitals catered to too many mildly ill patients, as Dr Nieto says, they were not poor people from rural areas. The latter were unattended rather than overattended. It was
Cellular Effects of β-Particle Delivery on Vascular Smooth Muscle Cells and Endothelial Cells
Authors: Jeannette Fareh, Rémi Martel, Pouneh Kermani, Guy Leclerc
Journal: Circulation (1999)

Background —Although endovascular radiotherapy inhibits neointimal hyperplasia, the exact cellular alterations induced by β irradiation remain to be elucidated. Methods and Results —We investigated in vitro the ability of 32 P-labeled oligonucleotides to alter (1) proliferation of human and porcine vascular smooth muscle cells (VSMCs) and human coronary artery endothelial cells (ECs), (2) cell cycle progression, (3) cell viability and apoptosis, (4) cell migration, and (5) cell phenotype and morphological features. β radiation significantly reduced proliferation of VSMCs (ED 50 1.10 Gy) and ECs (ED 50 2.15 Gy) in a dose-dependent manner. Exposure to β emission interfered with cell cycle progression, with induction of G 0 /G 1 arrest in VSMCs, without evidence of cell viability alteration, apoptosis, or ultrastructural changes. This strategy also proved to efficiently inhibit VSMC migration by 80% and induce contractile phenotype appearance, as shown by the predominance of α-actin immunostaining in β-irradiated cells compared with control cells. Conclusions — 32 P-labeled oligonucleotide was highly effective in inhibiting proliferation of both VSMCs and ECs in a dose-dependent fashion, with ECs showing a higher resistance to these effects. β irradiation–induced G 1 arrest was not associated with cytotoxicity and apoptosis, thus demonstrating a potent cytostatic effect of β-based therapy. This effect, coupled to that on VSMC migration inhibition and the appearance of a contractile phenotype, reinforced the potential of ionizing radiation to prevent neointima formation after angioplasty.
THE TREATMENT OF LACHRYMAL OBSTRUCTION.
Authors: MARK D. STEVENSON
Journal: JAMA (1907)

Before this Section it is not necessary to discuss the treatment of all the various obstructive causes of epiphora. Those cases due to psychic or reflex causes, to refractive errors or in which hypersecretion is due to other non-obstructive causes will not be considered. The treatment of those portions of the tear drainage apparatus above the lachrymal sac, being well understood, will receive but little attention. However, further consideration of the treatment of pathologic conditions of the lachrymal sac and nasal duct, especially if it leads to free discussion, seems timely, since the diverse methods now employed indicate that it is not well understood. The necessity of treating abnormal conditions in the nose will be emphasized, since they are very important in the etiology of these affections. For purposes of treatment, I divide the tear drainage apparatus into three parts. The upper portion includes the puncta and canaliculi. The treatment
Seniority Awards and Postgraduate Education
Authors: C. Watson
Journal: BMJ (1969)

<h3>Objectives</h3> Management of cardiovascular disease (CVD) is an urgent challenge in low-income and middle-income countries, and interventions may require appraisal of patients’ social networks to guide implementation. The purpose of this study is to determine whether egocentric social network characteristics (SNCs) of patients with chronic disease in western Kenya are associated with overall CVD risk and individual CVD risk factors. <h3>Design</h3> Cross-sectional analysis of enrollment data (2017–2018) from the Bridging Income Generation with GrouP Integrated Care trial. Non-overlapping trust-only, health advice-only and multiplex (trust and health advice) egocentric social networks were elicited for each participant, and SNCs representing social cohesion were calculated. <h3>Setting</h3> 24 communities across four counties in western Kenya. <h3>Participants</h3> Participants (n=2890) were ≥35 years old with diabetes (fasting glucose ≥7 mmol/L) or hypertension. <h3>Primary and secondary outcomes</h3> We hypothesised that SNCs would be associated with CVD risk status (QRISK3 score). Secondary outcomes were individual CVD risk factors. <h3>Results</h3> Among the 2890 participants, 2020 (70%) were women, and mean (SD) age was 60.7 (12.1) years. Forty-four per cent of participants had elevated QRISK3 score (≥10%). No relationship was observed between QRISK3 level and SNCs. In unadjusted comparisons, participants with any individuals in their trust network were more likely to report a good than a poor diet (41% vs 21%). SNCs for the trust and multiplex networks accounted for a substantial fraction of variation in measures of dietary quality and physical activity (statistically significant via likelihood ratio test, adjusted for false discovery rate). <h3>Conclusion</h3> SNCs indicative of social cohesion appear to be associated with individual behavioural CVD risk factors, although not with overall CVD risk score. Understanding how SNCs of patients with chronic diseases relate to modifiable CVD risk factors could help inform network-based interventions. <h3>Trial registration number</h3> ClinicalTrials.gov identifier: NCT02501746; https://clinicaltrials.gov/ct2/show/NCT02501746.
Pathology of common bile duct stenosis in cystic fibrosis.
Authors: D Bilton, R Fox, A K Webb, W Lawler, R F McMahon, J M Howat
Journal: Gut (1990)

A case of cystic fibrosis complicated by common bile duct stenosis is described. Surgery successfully relieved the obstruction, but was complicated by Candida septicaemia. The previously unreported histological abnormalities of the common bile duct are discussed.
Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS)
Authors: J W M Chan, C K Ng, Y H Chan, T Y W Mok, S Lee, S Y Y Chu, W L Law, M P Lee, P C K Li
Journal: Thorax (2003)

<b>Background:</b> Severe acute respiratory syndrome (SARS) was diagnosed in Hong Kong in over 1700 patients between March and early June 2003. <b>Methods:</b> 115 patients diagnosed with SARS were admitted to Queen Elizabeth Hospital, a large regional hospital in Hong Kong, from March 2003, of whom 100 were either discharged or were dead at 31 May. The patients were prospectively studied after admission to assess their short term outcomes and the risk factors associated with adverse outcomes, defined as death or the need for mechanical ventilation <b>Results:</b> At the time of writing 18 patients had died, with a crude mortality rate of 15.7% and a 21 day mortality of 10% (standard error 3%). Thirty nine patients (34%) were admitted to the intensive care unit, 30 of whom (26%) required mechanical ventilation. Multivariate analysis showed that age above 60 (hazards ratio (HR) 3.5, 95% CI 1.2 to 10.2; p=0.02), presence of diabetes mellitus or heart disease (HR 9.1, 95% CI 2.8 to 29.1; p&lt;0.001), and the presence of other comorbid conditions (HR 5.2, 95% CI 1.4 to 19.7; p=0.01) were independently associated with mortality. However, only the presence of diabetes mellitus and/or cardiac disease (HR 7.3, 95% CI 3.1 to 17.4; p&lt;0.001) was associated with adverse outcomes as a whole. <b>Conclusion:</b> SARS is a new disease entity that carries significant morbidity and mortality. Specific clinical and laboratory parameters predicting unfavourable outcomes have been identified.
Breast feeding should be promoted as a public health measure
Authors: A. Nicoll
Journal: BMJ (1996)

or radio (162) and newspapers (1 19) we believe that these are important vehicles for increasing public awareness of this disease.In the light of our findings we suggest that future publicity should emphasise that meningitis is not a threat only to babies and young children and that teenagers and elderly people are also particularly at risk.The importance of a petechial or purpuric rash that does not fade when pressure is applied and the need for immediate action when such a rash is found should also be highlighted.
Guide-wire technique for central vein cannulation.
Authors: J A Goy
Journal: BMJ (1976)

Acute gastric dilatation after traumaAcute gastric dilatation is a condition which, if not diagnosed and therefore not treated, carries a high mortalitv.'While it usually complicates abdominal operations it has been reported after minor operations.The widespread use of nasogastric suction after abdominal operations has led to a considerable fall in its incidence in recent years.Many young surgeons will therefore have no experience of this condition.We report here two unusual cases of acute gastric dilatation, both of which followed trauma to the upper abdomen. Case 1A 9-year-old girl was admitted after being in a road traffic accident.On physical examination she was extremely dyspnoeic, there was bruising over the right side of chest and epigastrium, and her abdomen was slightly distended and tender.A chest x-ray picture showed an extensive right-sided haemopneumothorax (see figure ), and straight films of the abdomen showed pronounced gastric dilatation with a fluid level.A nasogastric tube was passed and a large amount of gas, together with clear fluid, was aspirated.This resulted in a dramatic improvement in the patient's condition, her abdominal pain was relieved immediately, her respiratory rate fell, and her abdomen became soft and free from tenderness.The haemopneumothorax was treated by the insertion of a drain through the second intercostal space.During the next 36 hours the patient had recurrent episodes of gastric dilatation as evidenced by a tender, distended, and hyperresonant abdomen.This settled after a further 48 hours' naso- gastric suction.Her progress thereafter was uneventful. Case 2An 8-year-old boy was admitted after he had been knocked down by a car.On admission he was extremely restless.
Diagnosing Pelvic Inflammatory Disease
Authors: James G. Kahn
Journal: JAMA (1991)

<h3>Objective.</h3> —To examine the accuracy of existing diagnostic indicators for pelvic inflammatory disease and to develop guidelines for a new diagnostic model. <h3>Data Sources.</h3> —Studies were identified for the period 1969 through 1990. A Medline search of the English-language literature was conducted using the subject terms<i>pelvic inflammatory disease</i>or<i>salpingitis</i>and<i>diagnosis</i>. In addition, abstracts and bibliographies of articles and books were reviewed. <h3>Study Selection.</h3> —Studies were selected if pelvic inflammatory disease was diagnosed using laparoscopic findings or narrow clinical rules. Of the 15 reports identified, 12 were included in this analysis. The selected studies were grouped by a quality rating based on subject selection, definition of pelvic inflammatory disease, data analysis, and other measures. <h3>Data Extraction.</h3> —Diagnostic findings were divided into four categories: historical (symptoms), clinical examination (signs), laboratory, and combinations of the above. Sensitivity and specificity were extracted using raw data. Data were classified by quality rating. <h3>Data Synthesis.</h3> —Historical findings were usually not statistically significant predictors of pelvic inflammatory disease, and when they were they tended toward low sensitivity and high specificity, while clinical findings were somewhat more sensitive and about as specific. Several laboratory tests showed consistent value in pelvic inflammatory disease diagnosis, with high sensitivity and specificity. Combinations of indicators permitted high sensitivity or high specificity but not both simultaneously. <h3>Conclusions.</h3> —No single or combination diagnostic indicator was found to reliably predict pelvic inflammatory disease. Combining published evidence with practical clinical considerations, a diagnostic approach is proposed that emphasizes diagnostic sensitivity when clinical presentation is mild and more thorough evaluation when a woman is severely ill. Research is needed to evaluate the accuracy and acceptability of specific diagnostic models and to investigate new diagnostic indicators. (<i>JAMA</i>. 1991;266:2594-2604)