tbuckley/cabot-search huggingface dataset:
Reliability of automated platelet counts: Comparison with manual method and utility for prediction of clinical bleeding
Authors: Jeffry B. Lawrence, Roslyn A. Yomtovian, Christine Dillman, Susan R. Masarik, Viroje Chongkolwatana, Richard J. Creger, Agnes Manka, Terry Hammons, Hillard M. Lazarus
Journal: American Journal of Hematology (1995)

Abstract The 20 × 10 9 /L (20,000/μl) threshold for prophylactic platelet transfusion may be unnecessarily high. The widespread use of this threshold may reflect lack of confidence in the reliability of low platelet counts. We evaluated the performance of automated platelet counts and their relation to clinical bleeding. First, we prepared serial blood dilutions with “target” platelet counts from 2 to 40 × 10 9 /L For the 48 measurements on 2 × 10 9 /L “target” dilutions, values of 1 or 2 × 10 9 /L were obtained with the Sysmex NE‐8000 analyzer (mean 1.44 × 10 9 /L; SD 0.31 × 10 9 /L). Similarly, for 5 × 10 9 /L “target” counts, automated counts were 3‐6 × 10 9 /L (mean 4.42 × 10 9 /L; SD 0.18 × 10 9 /L). Similar results were observed with all other “target” levels, with coefficients of variation (CV) from 6.39% to 7.71% with 10‐40 × 10 9 /L “target” values. Secondly, we compared triplicate automated and manual platelet counts on thrombocytopenic patients with platelet counts from 4–30 × 10 9 /L. The triplicate automated platelet counts differed by no more than 5 × 10 9 /L among themselves, whereas the manual counts varied by as much as 30 × 10 9 /L. Mean platelet counts: automated, 14.40 × 10 9 /L (CV 10.12%); manual, 16.48 × 10 9 /L (CV 30.39%) ( P = 0.038 for counts; P &lt; 0.001 for CV). Finally, we prospectively evaluated bleeding in thrombocytopenic patients (1,809 patient‐days of observation). Univariate and multivariate logistic regression analysis revealed highly significant correlations between the automated platelet count and major and minor bleeding manifestations. Thus, automated platelet counts are highly reliable and accurately predict clinical bleeding. The use of automated analyzers should facilitate improved prophylactic platelet transfusion protocols.
Genetic Varieties of Ichthyosis.
Authors: R. S. Wells
Journal: Annals of Internal Medicine (1967)

s1 May 1967Genetic Varieties of Ichthyosis.R. S. Wells, M.D.R. S. Wells, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1069_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the last 4 years a total of 637 patients with various types of ichthyosis have been examined. The majority of these could be classified under one of four headings depending on clinical characteristics and mode of inheritance. Ichthyosis vulgaris (335 patients) is inherited as an autosomal dominant trait and has an estimated frequency of approximately 1 in 1,000 persons. Sex-linked (or more precisely X-linked) ichthyosis (194 patients) was found to have a frequency of approximately 1 in 6,000 men, and it has been established beyond doubt that the gene for sex-linked ichthyosis and that for the Xg blood group... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: R. S. Wells, M.D.Affiliations: London, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1069-1069KeywordsAutosomal dominant traitsBlood groupsGenetics ePublished: 1 December 2008 Issue Published: 1 May 1967 PDF downloadLoading ...
CARDIAC HYPERTROPHY AS OBSERVED IN CHRONIC NEPHRITIS.
Authors: NATHANIEL BOWDITCH POTTER
Journal: JAMA (1906)

The frequency of a pronounced hypertrophy of the heart in kidney disease was first pointed out by Bright<sup>1</sup>in 1836. It was exhibited in 23 per cent. of his cases, in most of them affecting the left ventricle, without any cardiac or aortic lesion as a cause. His theory, chemical in nature, considered that an altered condition of the blood either stimulated the heart excessively or else affected the arteries and capillaries in some way to make it more difficult for the heart to drive the blood through to the veins. G. Johnson<sup>2</sup>confirmed his findings and adopted the second possibility as an explanation, assuming that the blood is laden with impurities as a result of the renal disease, and that these poisons stimulate the arterioles to contract by way of the vasomotor nerves and so necessitate an hypertrophy of the left ventricle. His conception assumed the existence
Freezing the Number of Residency Positions-Reply
Authors: Kenneth I. Shine
Journal: JAMA (1995)

<h3>In Reply.</h3> —I agree with Dr Luke's observation and suggestions. In testimony before the Subcommittee on Health of the House Committee on Ways and Means (March 23, 1995), I suggested a mandatory requirement for pass-through of Medicare continuing medical education reimbursement by health maintenance organizations enrolling Medicare recipients. This could be an important first step in the creation of an all-payers system for support of GME.
Effect of ciclesonide on allergen challenge in subjects with bronchial asthma
Authors: B. B. Larsen, L. P. Nielsen, R. Engelstätter, V. Steinijans, R. Dahl
Journal: Allergy (2003)

Background: The aim of this clinical trial was to investigate whether repeated inhalation of the new inhaled steroid ciclesonide reduces the early‐phase (EAR) and late‐phase (LAR) reactions after allergen challenge in patients with mild allergic asthma. Also, this study provides further data on safety and tolerance of ciclesonide. Methods: The study was designed as a double‐blind placebo‐controlled randomized crossover trial. Following a baseline period, patients were randomized to either of two treatment sequences (ciclesonide/placebo, placebo/ciclesonide) each of which lasted for one week and were separated by 3–5 weeks from the alternate treatment sequence. Patients received 800 µg ciclesonide twice daily by means of a Cyclohaler. At the end of each treatment patients were subjected to an allergen challenge. Results: Thirteen asthmatic patients (mean FEV 1 of 91% predicted) who experienced an EAR and LAR after allergen challenge participated in the study. The time‐average FEV 1 decreases 0–2 h (2–12 h) after allergen challenge as measure of the EAR (LAR) were significantly reduced ( P &lt; 0.05, one‐sided) from 0.426 L to 0.233 L (EAR) and from 0.443 L to 0.213 L (LAR), respectively. Thus, the study results suggest that ciclesonide significantly lowered the extent of EAR and LAR compared to placebo. Ciclesonide was well tolerated and no drug‐related adverse events were reported. Cortisol excretion in 24‐h urine showed no significant difference between ciclesonide and placebo. Conclusions: The study supports the efficacy and safety of ciclesonide.
The mean predicts the number of deviants: Author's reply
Authors: G. Rose
Journal: BMJ (1990)

because they contain added iron and vitamin D and have limited saturated fat and sodium contents, without limiting energy content.Regarding cost we can quibble over figures, but let's accept an extra cost ofE l.43 a week of using a follow on milk (or infant formula) instead of cows' milk.This is the equivalent each day of one to two disposable nappies, or a newspaper, or two cigar- ettes, or 28 ml beer.Nevertheless, for some families even this extra cost may be the proverbial straw-but the answer to this is to change other aspects of public policy, not to continue to recom- mend substandard child feeding customs that are being abandoned by many other countries in the developed world.
Smooth muscle cells express urokinase during mitogenesis and tissue-type plasminogen activator during migration in injured rat carotid artery.
Authors: A W Clowes, M M Clowes, Y P Au, M A Reidy, D Belin
Journal: Circulation Research (1990)

Although the level of plasminogen activator (PA) expression has been correlated with cellular proliferation and migration in vitro, this relation has not been established in tissue undergoing repair. In a rat model of arterial injury, we have measured the expression of PAs by vascular smooth muscle cells (SMCs) during entry into the growth cycle (0-24 hours) and subsequent migration from the media to the intima (starting at approximately 4 days). In normal rat carotid, low levels of urokinase-type PA (uPA) and tissue-type PA (tPA) are present; after removal of the endothelium, only uPA is detected in the media. uPA activity in extracts of carotid arteries increases and reaches a maximum between 16 and 24 hours after injury; uPA mRNA increases steadily and is maximal at 7 days. tPA activity appears at 3 days and is maximal at 7 days; tPA mRNA is present in normal vessels and reaches a maximum by 7 days. Most of the tPA in the media is associated with SMC and not with regenerating endothelium. Furthermore, tPA is present in the media before the SMCs migrate into the intima. These results demonstrate that PA expression by vascular SMCs is differentially regulated, with uPA present during mitogenesis and tPA during migration.
Clinical Course of Hypertrophic Cardiomyopathy in a Regional United States Cohort
Authors: Barry J. Maron
Journal: JAMA (1999)

ContextHypertrophic cardiomyopathy (HCM) has been regarded as a disease that causes substantial disability, with annual mortality rates of up to 6%, based largely on reports from tertiary referral centers.ObjectiveTo assess the clinical course of HCM in a patient cohort more closely resembling the true disease state.DesignRetrospective cohort study.SettingA regional cohort from Minnesota and adjoining regions, free of referral center bias, studied at Minneapolis Heart Institute.PatientsTwo hundred seventy-seven consecutively studied HCM patients, none referred for specialized HCM care, managed clinically in a standard fashion.Main Outcome MeasuresMortality and clinical course of HCM.ResultsDuring a mean (SD) follow-up of 8.1 (6.6) years, 45 patients died and 29 of these deaths were directly related to HCM; however, 8 of the 29 HCM deaths were not premature (occurring &gt;75 years of age). Annual HCM mortality rate was 1.3% (0.7% for sudden cardiac death). Patients identified in adulthood (n=234) showed no statistically significant difference in mortality when compared with expected mortality, as calculated for the general US or Minnesota populations (P=.17). Patients identified as children (n=43) showed decreased survival compared with the general population (P&lt;.001). At most recent clinical evaluation, 192 patients (69%) had no or mild symptoms and 69 (25%) experienced incapacitating symptoms or HCM-related death; 53 (19%) of the patients had achieved estimated life expectancy of 75 years or older. More advanced symptoms at diagnosis—occurrence of atrial fibrillation (often associated with stroke), the presence of basal outflow obstruction of at least 30 mm Hg, and marked left ventricular wall thickness of more than 25 mm—were clinically important independent predictors of HCM mortality.ConclusionsIn a regionally selected patient population most closely resembling the true disease state, HCM did not significantly increase the risk of premature death or adversely affect overall life expectancy. Prevailing misconceptions of HCM as a generally unfavorable condition may largely be related to the skewed patient referral patterns characteristic of tertiary care centers. Hypertrophic cardiomyopathy is nevertheless a highly complex disease capable of serious clinical consequences and premature death in some patients.
False-Positive 123I-MIBG Scintigraphy Due to Multiple Focal Nodular Hyperplasia
Authors: Chanika R. Kulatunge, Hongju Son
Journal: Clinical Nuclear Medicine (2013)

123I-MIBG accumulation in focal nodular hyperplasia was demonstrated. A 16-year-old girl who received radiotherapy for neuroblastoma at the age of 5 presented for abdominal pain. Three MIBG-avid tumors within the liver were proven to be focal nodular hyperplasias through biopsy. Previous neuroblastoma was transformed to non-MIBG-avid ganglioneuroma. MIBG accumulation does not necessarily indicate the presence of neuroendocrine tumor.
Post-insertion tailoring of plastic biliary stents: A novel technique
Authors: M. Mutignani, S. Dokas, V. Perri, A. Tringali, G. Costamagna
Journal: Endoscopy (2006)

Although the insertion of multiple plastic biliary stents is a well established procedure, it can be technically difficult, particularly when proximal benign common bile duct or malignant hilar strictures must be negotiated [1]. When multiple stents are placed, it is therefore not uncommon for one or more stents to protrude markedly into the lumen of the duodenum. When faced with this situation the endoscopist has three options: to remove the protruding stent, with the risk of displacing one or more stents already in place; to attempt to reposition the stent using grasping forceps; or, finally, to leave the protruding stent in situ, which has a small associated risk of trauma to the duodenum [2] or of stent occlusion. It is well known that metal biliary or duodenal stents can be trimmed [3] [4] [5]; however, there are no available published data on tailoring plastic biliary devices.
Blood Pressure 1 Year After Completion of Web-Based Pharmacist Care
Authors: Beverly B. Green, Melissa L. Anderson, James D. Ralston, Sheryl L. Catz, Andrea J. Cook
Journal: JAMA Internal Medicine (2013)

Meta-analyses provide strong evidence that blood pressure (BP) control improves with “team-based” hypertension care provided by a health professional such as a pharmacist or nurse, separate from physician care.1 Few studies have analyzed whether team care leads to sustained BP reductions after the end of an intervention.

In the Electronic Communications and Home Blood Pressure Trial (e-BP),2 patients with uncontrolled BP were registered to use an existing patient website (with a patient-shared electronic health record [EHR] and secure e-mail) and randomly assigned to receive the following interventions: (1) usual care (UC), (2) home BP monitoring (BPM) and website training, or (3) BPM and website training plus pharmacist team-care delivered via the website (Pharm). At the end of the 1-year intervention, Pharm patients were twice as likely to have controlled BP.2 Our objective was to determine if BP reductions were sustained after the intervention ended.
Pruritus after administration of hetastarch.
Authors: N E Parker, J B Porter, H J Williams, N Leftley
Journal: BMJ (1982)

Cetrimide allergy presenting as suspected non-accidental injurySuspected non-accidental injury is becoming a more frequent paediatric diagnosis in Britain.I describe a case of presumed non-accidental injury that proved to be an allergic response to cetrimide (12% solution), a commonly prescribed preparation.Case report made.
Abstract 4822: Identifiying the anti-Tr antigen in paraneoplastic cerebellar degeneration
Authors: Peter A.E. Sillevis Smitt, Esther de Graaff, Peter Maat, Esther Hulsenboom, Robert van den Berg, Martin van den Bent, Jeroen Demmers, Casper Hoogenraad
Journal: Cancer Research (2012)

Abstract Introduction: Paraneoplastic cerebellar degeneration (PCD) is characterized by subacute cerebellar ataxia which coincides with the presence of specific tumour types and antineuronal antibodies. One particular form of PCD is associated with Hodgkin Lymphoma (HL) and the presence of antibodies against cerebellar Purkinje cells in several of these patients’ sera. These later called anti-Tr antibodies recognize a specific punctuate immunoreactivity in the large dendritic tree as well as the soma of the Purkinje cells, but not in the axons. Although this characteristic immunoreactive pattern is considered to be a good hallmark for the presence of anti-Tr antibodies, further diagnosis is elaborate. In order to aid this diagnosis, and to understand the pathogenic nature of the PCD we aimed to identify the antigen recognized by anti-Tr antibodies. Objective: We aimed to identify the long sought antigen recognized by anti-Tr antibodies. Methods: To identify the antigen we performed immunoprecipitation using four anti-Tr positive sera on total rat brain extract followed by mass spectrometry. By Western blotting and cell-based assays we subsequently determined the region of the epitope recognized by the anti-Tr antibodies. Deletion and mutant constructs were generated to further map the antigenic region. Results: We identified Delta/Notch-like epidermal growth factor (EGF)-related Receptor (DNER) as the Tr antigen. In a cell-based screening assay 191 control samples were negative, whereas all of the 12 anti-Tr positive sera stained HA-tagged-DNER expressing cells. Using deletion constructs we pinpointed the main epitope to the extracellular domain. Glycosylation inhibitor tunicamycin and N-glycosylation mutations in DNER abolished the anti-Tr staining, indicating that DNER must be glycosylated to be recognized by anti-Tr antibodies. Conclusion: Anti-Tr positive sera recognize DNER. Using the cell based assay, presence of anti-Tr antibodies in patients with PCD and HL can now be screened both quickly and reliably. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4822. doi:1538-7445.AM2012-4822
An atlas of genetic influences on human blood metabolites
Authors: So-Youn Shin, Eric B Fauman, Ann-Kristin Petersen, Jan Krumsiek, Rita Santos, Jie Huang, Matthias Arnold, Idil Erte, Vincenzo Forgetta, Tsun-Po Yang, Klaudia Walter, Cristina Menni, Lu Chen, Louella Vasquez, Ana M Valdes, Craig L Hyde, Vicky Wang, Daniel Ziemek, Phoebe Roberts, Li Xi, Elin Grundberg, Melanie Waldenberger, J Brent Richards, Robert P Mohney, Michael V Milburn, Sally L John, Jeff Trimmer, Fabian J Theis, John P Overington, Karsten Suhre, M Julia Brosnan, Christian Gieger, Gabi Kastenmüller, Tim D Spector, Nicole Soranzo
Journal: Nature Genetics (2014)
UN report warns that poor water supply continues to pose major health threat
Authors: R. Dobson
Journal: BMJ (2003)

More than two million people—many of them children—die every year from diarrhoea and a range of other conditions associated with poor water and sanitation, a report from the United Nations has said.

The first UN world water development report, to be launched on 22 March, argues that one of the biggest threats to health remains lack of water and poor sanitation. It estimates that 1.1 billion people have seen no improvement in their water supplies beyond a basic minimum and that 2.4 billion do not have adequate sanitation. As a result, a million people die of malaria each year, and another two billion people are infected with schistosomes and …
METHOD FOR APPLYING PARAFFIN TO EXTENSIVE BURNS
Authors: William P. Van Wagenen
Journal: JAMA (1924)

<h3>To the Editor:</h3> —A simple, yet effective, time and labor saving means of applying paraffin to extensive burns is afforded by attaching the usual hot water jacketed sp[ill]ayer to a gas oxygen machine or a compressed air tap. A square foot of surface can be adequately covered in two or three minutes. This method far surpasses the use of a camel's hair brush in the evenness as well as the speed of application.
Pesticide Storage in Human Fat Tissue
Authors: William S. Hoffman, William I. Fishbein, Morten B. Andelman
Journal: JAMA (1964)

IT IS WELL RECOGNIZED that traces of pesticides, retained on vegetables, fruits, and forage material, may be ingested either directly by man or by edible animals that are in turn consumed by man. The chlorinated hydrocarbon pesticides are more likely than others to be biologically magnified in a food chain because of their relative stability and their solubility and persistence in animal fat. To investigate the nature and extent of the storage of chlorinated pesticides in human fat, analyses of fat specimens, obtained at autopsy from 282 persons who had died of various diseases, were carried out by the newly developed method of microcoulometric gas chromatography. The details of the method are described elsewhere.<sup>1</sup>The results are summarized here. Of the score or more of chlorine-containing pesticides that have been extracted and analyzed by this method, only two were consistently found in the human fat samples in concentrations of
Summary of Three Lectures on Transfusion: Its Physiology, Pathology, and Practice
Authors: W. Hunter
Journal: BMJ (1889)

first real advance in our knowledge of the physiology of transfusion was made when Leacock in 1817 and Blundell in 1825 drew attention to the marked difference in the result, according as the blood transfused was obtained from an animal of the same species-" similar" blood, or from an animal of another species- " disimilar" blood.The later researches of Panum, Ponfick,
Seeking the Just Price: Constructing Relative Value Scales and Fee Schedules
Authors: JACK HADLEY
Journal: Annals of Internal Medicine (1987)

Many conceptual issues underlie the current policy debate over how to reform the fee-for-service method of paying physicians, including the development of a relative value scale for physicians' services and the relationship between a relative value scale and a fee schedule. We consider the relationship between fees and costs and the criteria for judging whether a fee is appropriate or right and then propose a two-step process for constructing a relative value scale. A fee schedule based on a relative value scale is the most practical way to reform the current fee-for-service system and makes the most sense from both clinical and economic viewpoints.
Every Kidney Counts
Authors: William E. Braun
Journal: New England Journal of Medicine (1992)

It is time to expand procedures that will improve the success rates for cadaveric renal allografts, not just for 1 to 2 years but for 10 to 30 years. The number of human kidneys available for transplantation is extremely limited, and there is no ethically acceptable repository that can suddenly be tapped to improve the terrible imbalance between supply and demand. Every kidney counts. Patients who receive cadaveric renal allografts should be given the opportunity to achieve today's best rates of success: 80 percent of the grafts should survive for 5 to 10 years and 60 percent for 10 to . . .