tbuckley/cabot-search huggingface dataset:
The Pitfalls of Introducing Electronic Medical Records
Authors: Mark Faron, Thomas Hale, Linda Jesberg
Journal: Annals of Internal Medicine (2006)

Letters7 February 2006The Pitfalls of Introducing Electronic Medical RecordsMark Faron, MD, Thomas Hale, MD, and Linda Jesberg, RNMark Faron, MDFrom Mercy Medical Group, St. Louis, MO 63141.Search for more papers by this author, Thomas Hale, MDFrom Mercy Medical Group, St. Louis, MO 63141.Search for more papers by this author, and Linda Jesberg, RNFrom Mercy Medical Group, St. Louis, MO 63141.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-3-200602070-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The perspective expressed by Dr. Baron and his partners (1) demonstrated the pitfalls associated with the difficult task of implementing an electronic medical record (EMR) system. Our group has had a different experience. Mercy Medical Group, owned by the Sisters of Mercy Health System, comprises 160 physicians and includes internists, family practitioners, pediatricians, and women's health practitioners. With the financial backing of the health system, we researched several EMR vendors and chose Misys EMR (Misys Healthcare Systems, Raleigh, North Carolina) because we had been using their practice management system, which interfaced with their EMR system. Having the ...Reference1. Baron RJ, Fabens EL, Schiffman M, Wolf E. Electronic health records: just around the corner? Or over the cliff? Ann Intern Med. 2005;143:222-6. [PMID: 16061920] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mercy Medical Group, St. Louis, MO 63141.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoElectronic Health Records: Just around the Corner? Or over the Cliff? Richard J. Baron , Elizabeth L. Fabens , Melissa Schiffman , and Erica Wolf Metrics Cited byLessons Learned from Pilot Site Implementation of an Ambulatory Electronic Health Record 7 February 2006Volume 144, Issue 3Page: 220KeywordsChartsChild healthConflicts of interestDiagnostic techniquesElectronic medical recordsHealth careHealth information technologyInformation technologyObstetrics and gynecology ePublished: 7 February 2006 Issue Published: 7 February 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Neonatal Vein of Galen Malformation
Authors: Bernhard Fischer, Stefan Palkovic
Journal: New England Journal of Medicine (2002)

Figure 1. Sonographic imaging of the brain of a neonate showed a dilated hypoechoic venous lesion within the tentorial hiatus. Computed tomographic (CT) angiography demonstrated a large arteriovenous malformation of the vein of Galen (Panel A, sagittal view; Panel B, axial view). No other cerebral abnormalities were found. Gradual endovascular embolization of the dilated venous sac and all but one feeding artery (which could not be occluded) reduced the central shunt in the vein of Galen, as documented by magnetic resonance angiography (Panel C, axial view). The child developed normally over the next six years, but then a sudden headache . . .
Calmodulin Kinase II Interacts with the Dopamine Transporter C Terminus to Regulate Amphetamine-Induced Reverse Transport
Authors: Jacob U. Fog, Habibeh Khoshbouei, Marion Holy, William A. Owens, Christian Bjerggaard Vaegter, Namita Sen, Yelyzaveta Nikandrova, Erica Bowton, Douglas G. McMahon, Roger J. Colbran, Lynette C. Daws, Harald H. Sitte, Jonathan A. Javitch, Aurelio Galli, Ulrik Gether
Journal: Neuron (2006)
INVESTIGATION OF PROPOSED COLORIMETRIC METHOD FOR TITRATION OF DIPHTHERIA TOXINS
Authors: ARTHUR LOCKE
Journal: JAMA (1928)

Mishulow and Krumwiede<sup>1</sup>have recently suggested a colorimetric method for the estimation of the strength of bacterial toxins by means of titration with auric chloride, approximately as follows: Two cubic centimeters of a 1:4 dilution of the toxin sample is added to each of a series of micro test tubes containing graded volumes of 1 per cent auric chloride. The contents of the tubes are mixed and warmed for forty minutes at 50 C. At the end of this interval, the mixtures containing the smallest volumes of auric chloride are observed to have undergone little notable change. Those representing the largest volumes of the reagent may have produced heavy flocculi. Intermediately, some of the mixtures may have developed a blue coloration (by transmitted light), and some a purple coloration, and some a green.<sup>2</sup>The volume of auric chloride that has produced the most intense green color is presumed
Advanced chronic hepatitis C: How to handle if you cannot halt?
Authors: Wolf Peter Hofmann, Stefan Zeuzem
Journal: Hepatology (2009)

BACKGROUND: In patients with chronic hepatitis C who do not have a response to antiviral treatment, the disease may progress to cirrhosis, liver failure, hepatocellular carcinoma, and death. Whether long-term antiviral therapy can prevent progressive liver disease in such patients remains uncertain. METHODS: We conducted a randomized, controlled trial of peginterferon alfa-2a at a dosage of 90 microg per week for 3.5 years, as compared with no treatment, in 1050 patients with chronic hepatitis C and advanced fibrosis who had not had a response to previous therapy with peginterferon and ribavirin. The patients, who were stratified according to stage of fibrosis (622 with noncirrhotic fibrosis and 428 with cirrhosis), were seen at 3-month intervals and underwent liver biopsy at 1.5 and 3.5 years after randomization. The primary end point was progression of liver disease, as indicated by death, hepatocellular carcinoma, hepatic decompensation, or, for those with bridging fibrosis at baseline, an increase in the Ishak fibrosis score of 2 or more points. RESULTS: We randomly assigned the patients to receive peginterferon (517 patients) or no therapy (533 patients) for 3.5 years. The level of serum aminotransferases, the level of serum hepatitis C virus RNA, and histologic necroinflammatory scores all decreased significantly (P<0.001) with treatment, but there was no significant difference between the groups in the rate of any primary outcome (34.1% in the treatment group and 33.8% in the control group; hazard ratio, 1.01; 95% confidence interval, 0.81 to 1.27; P=0.90). The percentage of patients with at least one serious adverse event was 38.6% in the treatment group and 31.8% in the control group (P=0.07). CONCLUSIONS: Long-term therapy with peginterferon did not reduce the rate of disease progression in patients with chronic hepatitis C and advanced fibrosis, with or without cirrhosis, who had not had a response to initial treatment with peginterferon and ribavirin.
Reply to M. Christgen et al
Authors: Rohit Bhargava, David J. Dabbs
Journal: Journal of Clinical Oncology (2012)

concluded that qRT-PCR for HER2 assessment "could be a useful adjunct to IHC." 4(p1739) Nonetheless, we agree with Dabbs et al that clinicians have to be aware of discordant negative HER2 determination by mRNA-based assays, such as ODX.The clinical significance of discordant HER2 findings at the DNA, protein, or mRNA level warrants additional research.
Sharing evidence on humanitarian relief
Authors: Edward J Mills
Journal: BMJ (2005)

Sharing evidence on humanitarian reliefNeeds a publicly accessible, searchable, and comprehensive database O ne year ago the Asian tsunami struck, resulting in the largest humanitarian efforts of our generation.This year's hurricane Katrina and earthquake in Kashmir also showed that both developed and developing nations are ill prepared for major disasters.Rapidly sharing relevant information from relief agencies and academic and non-government organisations (NGOs) at such critical times can make an important difference to tens of thousands of people.Relief agencies conduct fact finding expeditions in emergencies, as well as important public health measurements such as water testing, measles surveillance, and conflict surveillance.Their reports often provide the most up to date and relevant evidence on relief situations, 1 but are too often shared only internally.For agencies and field coordinators to make informed decisions, access to this information is vital.We must, therefore, consider how to create and disseminate evidence regarding humanitarian interventions. 2 One absolute necessity is a publicly accessible, searchable, and comprehensive database on humanitarian disasters and approaches to relief.The lack of systematically documented or disseminated information leads to unnecessary duplication of efforts and ill informed decisions.Given the inadequacy of funding for relief aid, resources must be used wisely.Some relief databases are already accessible to the public and NGOs.The largest is Relief Web (www.reliefweb.int),established in 1996 by the United Nations, but it has been hindered by a lack of submissions from agencies and a reticence by academics to submit reports that may be under review at journals.Other resources include the SHARED Global Database, ELDIS (the Electronic Development and Environment information System), and ID21 (Information for Development in the 21st Century), but these have the same drawbacks as Relief Web and their reporting styles vary widely.Large NGOs and international agencies have, at times, maintained publicly accessible databases; smaller agencies sometimes post reports on their websites.None of these resources is sufficiently comprehensive.A comprehensive database would have many aims but would also have to overcome certain challenges (box).Furthermore, the quality of evidence needs to be considered.The thresholds for acceptable evidence on humanitarian situations may be different from those for therapeutic interventions, 3 and a formal hierarchy for it has not yet been established. 1 4Access to reports may allow evaluation of the effects of interventions
Interactions among Heparin, Cold-Insoluble Globulin, and Fibrinogen in Formation of the Heparin-Precipitable Fraction of Plasma
Authors: Nicolas E. Stathakis, Michael W. Mosesson
Journal: Journal of Clinical Investigation (1977)

Fibrinogen and the cold-insoluble globulin of plasma (CIg) are the main protein components of the heparin-precipitable fraction of normal plasma. The interactions among these proteins and heparin were examined. Heparin formed a cold-precipitable complex with purified CIg or with mixtures of CIg and fibrinogen but not with purified fibrinogen alone. Cryoprecipitation was augmented by addition of Ca++ or by selection of optimal heparin levels; it was reduced or even abolished by raising the ionic strength or pH or both, or by raising the heparin concentration above that for maximum precipitation of CIg. Fibrinogen reduced the threshold for heparin-induced CIg cryoprecipitation and, by coprecipitating with heparin and CIg, increased the amount of precipitate that formed. In contrast to the heparin-precipitable fraction of normal plasma which contained both fibrinogen and CIg, that from a patient with congenital afibrinogenemia contained CIg but lacked fibrinogen. Normal plasma depleted of CIg by immunoabsorption failed to form a heparin-induced cryoprecipitate. Thus, CIg is essential for heparin-induced cryoprecipitation to occur. Fibrinogen, as assessed by chromatographic experiments with heparin-Sepharose columns, had a considerably lower binding affinity for heparin than did CIg, suggesting that it participates in precipitate formation mainly, if not entirely, by virtue of its affinity for CIg. The region of the fibrinogen molecule accounting for its precipitation with CIg appears to be localized in the carboxy-terminal segment of the Aα-chain; fibrinogen subfractions lacking this region failed to augment cryoprecipitation of heparin-CIg mixtures and, even though such species were present in normal plasma, they failed to coprecipitate in the heparin-induced complex.
Tumor Detection with 67Ga-Citrate: A Literature Survey (1970-1978)
Authors: CHARLES D. TEATES, STUART T. BRAY, BRIAN R. J. WILLIAMSON
Journal: Clinical Nuclear Medicine (1978)

Gallium scan detection of various neoplasms is tabulated by anatomic and histologic categories. The experience with many neoplasms is sufficient to accurately predict the likelihood of detection with gallium. This tabulation helps to point out other areas where the cumulative experience is insufficient to accurately predict sensitivity rates.
Histamine and duodenal ulceration in renal transplant recipients.
Authors: A G Timoney, W K Man, J Spencer, H Taylor, G Williams
Journal: Gut (1989)

Six of 25 renal transplant recipients had a duodenal ulcer at endoscopy. Histamine concentration and the activity of histamine methyltransferase, the degrading enzyme of histamine, were measured in gastric mucosal biopsies obtained at endoscopy and compared with patients with duodenal ulcer but not undergoing transplant and with patients with an apparently normal stomach and duodenum. Histamine concentrations in the corpus (no ulcer, median: 151 nmol/g; DU, median: 122 nmol/g) and in the antrum (no ulcer, median: 118 nmol/g; with DU, median: 113 nmol/g) of renal transplant patients, irrespective of ulcer diagnosis, and in patients with a chronic duodenal ulcer (median corpus histamine: 137 nmol/g and median antral histamine: 126 nmol/g) were not different from one another but significantly lower than the corresponding values in normal subjects (median corpus histamine: 241 nmol/g, p less than 0.01, and median antral histamine: 178 nmol/g, p less than 0.05). Histamine concentration in the corpus was significantly higher than in the antrum in all three groups of patients (p less than 0.05). There were no significant differences in histamine methyltransferase activity in any of the groups studied. Mucosal histamine and histamine methyltransferase activity were significantly correlated in the corpus (p less than 0.05) and antrum (p less than 0.02). Plasma concentration of histamine after transplant was higher in the patients who subsequently were discovered to have a duodenal ulcer (p less than 0.05). The occurrence of ulcer after transplantation was not related to the serum creatinine level. The uniform depletion of gastric histamine and increase in circulatory histamine after renal transplantation may be a factor in the pathogenesis of duodenal ulcer disease in this clinical situation.
(beta) Blockers have important role in pulmonary oedema due to mitral stenosis
Authors: C. M Oakley
Journal: BMJ (1996)

of my Bangladeshi patients I find that their haemoglobin Alc concentration consistently reverts to near normal during long holidays in Bangladesh and doubles inexorably in London; they attribute this to taking less exercise and eating fewer fresh vegetables in London.Group work in the community may be a more effective way of helping understanding and modifying risk for those at high risk.3It must be recognised that the relation between genetics and past and present environment remains complex and unresolved in relation to an increased risk in south Asians.4
Selection of Kidney Recipients
Authors: Arthur J. Matas
Journal: JAMA (1987)

To the Editor.—  We have read with interest the article by Starzl et al 1 about a multifactorial system for the selection of recipients of cadaver donor kidneys. The article is the first to describe a widely applicable system for organ distribution. The described system gives points for time on the waiting list (rank order, ten points for the patient longest on the list), HLA antigen match (two points for each matched antigen), panel reactive antibody (PRA) number (one point for each 10%), medical emergency (zero to ten points), and logistical factors (zero to six points). The authors argue against a system that uses antigen match as the sole or major criterion of recipient selection. We believe that even their system gives too much weight to antigen matching.  With the exception of a six-antigen match, the value of HLA matching is controversial. Recently, Niblack et al, at the 1987 meeting
Role of free radicals in vascular dysfunction induced by high tidal volume ventilation
Authors: Leticia Martínez-Caro, José A. Lorente, Judith Marín-Corral, Carolina Sánchez-Rodríguez, Alberto Sánchez-Ferrer, Nicolás Nin, Antonio Ferruelo, Marta de Paula, Pilar Fernández-Segoviano, Esther Barreiro, Andrés Esteban
Journal: Intensive Care Medicine (2009)
Agammaglobulinemia and Insights into B-Cell Differentiation
Authors: John Manis, Robert S. Schwartz
Journal: New England Journal of Medicine (1996)

A rare disease can represent irrelevant esoterica to some but an interesting challenge to others — an oddity or an opportunity. Ogden Bruton's observations in a boy with unusual susceptibility to bacterial infections show how clinical acumen and simple technical means led to the discovery of a new disease, agammaglobulinemia.1 Echoes of Bruton's case report, which appeared 44 years ago, reverberate in this issue of the Journal with the publication of a paper by Yel et al.2 on novel and instructive molecular variants of agammaglobulinemia.Bruton's patient, a four-year-old boy, was first admitted to Walter Reed Army Hospital because of . . .
THE CURE OF VESICO-VAGINAL FISTULA BY THE FREE DISSECTION OF THE BLADDER FROM ITS VAGINAL ATTACHMENTS AND CLOSURE WITH THE BURIED CONTINUOUS TENDON SUTURE.
Authors: HENRY O. MARCY
Journal: JAMA (1897)

In 1887 my attention was first called to the ease with which the bladder wall will reunite after injury, under the most adverse circumstances, when the portion involved is free within the peritoneal cavity. The case upon which I operated at this time was that of a child eighteen months old, where an abscess in the vicinity of the appendix had resulted in a vesico-intestinal fistulous opening in the appendiceal region. Laparotomy disclosed two fistulæ of the small intestine, complicated with an opening into the bladder to the right of the fundus. The intestines were freed from adhesions and drawn out of the wound. The refreshed edges of the openings were closed by double lines of fine continuous tendon sutures, which in turn were intrafolded by a second layer of continuous tendon Lembert sutures. After the intestine had been returned, the bladder wall was freed from its adhesions, the opening
Factors influencing susceptibility to metals.
Authors: M Gochfeld
Journal: Environmental Health Perspectives (1997)

Although the long-neglected field of human susceptibility to environmental toxicants is currently receiving renewed attention, there is only scant literature on factors influencing susceptibility to heavy metals. Genetic factors may influence the availability of sulfhydryl-containing compounds such as glutathione and metallothionein, which modify the distribution and toxicity of certain metals. Age and gender play a role in modifying uptake and distribution, although the mechanisms are often obscure. Concurrent exposure to divalent cations may enhance or reduce the toxicity of certain metals through competition for receptor-mediated transport or targets. Increasing use of biomarkers of exposure should greatly increase our understanding of the underlying distribution of susceptibility to various environmental agents.
Ischemia Change in Stable Coronary Artery Disease Is an Independent Predictor of Death and Myocardial Infarction
Authors: Afshin Farzaneh-Far, Harry R. Phillips, Linda K. Shaw, Aijing Z. Starr, Mona Fiuzat, Christopher M. O'Connor, Ashwani Sastry, Leslee J. Shaw, Salvador Borges-Neto
Journal: JACC. Cardiovascular imaging (2012)
Cellular Senescence, Vascular Disease, and Aging
Authors: Jason C. Kovacic, Pedro Moreno, Elizabeth G. Nabel, Vladimir Hachinski, Valentin Fuster
Journal: Circulation (2011)

You must remember this, A kiss is just a kiss, A sigh is just a sigh, The fundamental things apply, As time goes by.-"As Time Goes By," by Herman Hupfeld, Casablanca (1942) 1T he increasing prevalence of older-age people in our society represents the culmination of centuries of medical, scientific, and social endeavors.At least in Western society, now relatively freed from pestilence, abject poverty, gross malnutrition, and polluted water and food sources, an increasing proportion of the population can expect to make it to old age.However, although US age-adjusted death rates from cardiovascular disease, coronary heart disease, and stroke continue to fall, a disproportionate number of people who reach old age (Ϸ80% of people aged Ն80 years) suffer from these diseases.1a In this 2-part review, we consider important pathobiological changes that occur with aging in the cardiovascular system, exploring promising areas of recent scientific progress and novel insights that may be translatable into targeted clinical strategies to help to alleviate the excess morbidity and mortality imposed by cardiovascular disease in the elderly.In this second installment, we focus specifically on vascular disease states of the elderly, including systolic hypertension, vascular calcification, and dementia, and we review relevant basic and clinical discoveries that further elucidate these conditions. Hardening of the Arteries: Calcification, Glycosylation, and the Vasculature in Old Age The Elderly Vascular PhenotypeAging is associated with various changes in the vascular system at differing structural and functional levels.At the macroscopic level, an increase in arterial lumen size and arterial wall thickening, mainly of the intima, are observed.
Genomic 5-hydroxymethylcytosine levels correlate with TET2 mutations and a distinct global gene expression pattern in secondary acute myeloid leukemia
Authors: N Konstandin, S Bultmann, A Szwagierczak, A Dufour, B Ksienzyk, F Schneider, T Herold, M Mulaw, P M Kakadia, S Schneider, K Spiekermann, H Leonhardt, S K Bohlander
Journal: Leukemia (2011)