tbuckley/cabot-search huggingface dataset:
Boots on the Ground
Authors: Evan Bilstrom
Journal: Annals of Internal Medicine (2013)

On Being a DoctorNovember 5, 2013Boots on the GroundEvan Bilstrom, MDEvan Bilstrom, MDFrom Portland Veterans Affairs Medical Center, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-9-201311050-00017 Audio Reading - “Boots on the Ground” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Boots on the Ground," by E. Bilstrom. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail You always heard the thwap-thwap-thwap of the Cobra's rotor echoing off of the surrounding hills before the whir of the Blackhawk. Daily MEDEVAC flight, marking time. One day closer to going home. Wife's pretty pregnant, think we'e having a boy.Robotic days. 0530, get dressed, holster 9 mm, walk outside, put on cover. Already over 100 °F. Walk to the chapel; pick up Chaps; and grab Jack, battalion dentist. Walk to the dining facility (DFAC) for chow. Weapon clear and safe, enter a sliver of home; eggs made to order, selection of Kellogg's cereal, Fruit Loops today perhaps. Eat breakfast, retelling ... Author, Article, and Disclosure InformationAffiliations: From Portland Veterans Affairs Medical Center, Portland, Oregon.Corresponding Author: Evan Bilstrom, MD, Department of Medicine, Portland Veterans Affairs Medical Center, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239; e-mail, [email protected]. PreviousarticleNextarticle Advertisement Audio Reading - “Boots on the Ground” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Boots on the Ground," by E. Bilstrom. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics November 5, 2013Volume 159, Issue 9Page: 646-647KeywordsAntidepressantsAtropineCheesesDiazepamDustDyspneaEmotionsGamesInfectious diseasesKneesLungsMedical staffMilkPsychiatry and mental healthRelapsing feverRiversShouldersStormsUltrasound imaging ePublished: 5 November 2013 Issue Published: November 5, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Inhibition of a Demand Pacemaker and Interference with Monitoring Equipment by Radio-frequency Transmissions
Authors: B. A. Pickers, M. J. Goldberg
Journal: BMJ (1969)

During the initial testing of Radio Leicester a swept-frequency technique for testing radio antennae was shown to affect demand pacemakers by inhibition of the pacing impulse and to interfere with physiological monitoring equipment. Adequate filtering of demand pacemakers is necessary to eliminate this interference. There is no evidence that such testing has any effect on the function of fixed-rate pacemakers. There is also a potential danger to implanted demand pacemakers by the use of similar polyscope generators used for servicing radio and television apparatus in industry.
Generation of biologically active substances in a natural gas flame.
Authors: A G Braun, P Pakzaban, M A Toqan, J M Beér
Journal: Environmental Health Perspectives (1987)

Samples of gaseous and solid species taken from the central axis of a 1 megawatt heat-input natural gas flame were tested in vitro for mutagenic activity and teratogenic potential. Mutagenicity was determined by a Salmonella typhimurium forward mutation assay. Potential teratogenicity was indicated by the ability of samples to interfere with the attachment of mammalian cells to a lectin coated surface. Both the mutagenic and anti-attachment activities were found to peak in samples originating from the flame regions where the total polyaromatic compound (PAC) species concentration reached a maximum, indicating a strong correlation between PAC presence in the samples and biological activity. Additional anti-attachment activity was found close to the injection nozzle. No biologically active material was detected beyond the luminous portion of the flame.
Women’s Heart Problems Are Poorly Understood
Authors: Ruth SoRelle
Journal: Circulation (1999)

Women's Heart Problems Are Poorly UnderstoodW hy and when women develop heart disease is both poorly understood and studied, said experts at the 21st Congress of the European Society of Cardiology, held in Barcelona."Men and women are similar with regard to risk factors," said John Martin, MD, of the University of London Cardiology Group.These similar heart disease risk factors include high blood pressure, high cholesterol, smoking, and age, said Dr Martin.Yet, he said, women with diabetes often have a higher risk of heart disease than men with diabetes.Women are also more likely to die of a first heart attack than men.As with men, death rates from heart disease in women vary from country to country.Heart disease death rates for women are lowest in Spain and highest in Scotland, he said.Again, as with men, this variation in rates is not well-understood.Even more puzzling are the variations in death rates, particularly in the acute phase just after a heart attack, when the patient is hospitalized.In a recent study in the New England Journal of Medicine, (Vaccarino et al.Sex-Based Differences in Early Mortality After Myocardial Infarction.1999;341:217-225), the study's author, Viola Vaccarino, MD, and her colleagues found that younger women had an increased risk of death during hospitalization after a myocardial infarction than men of the same age.Previously, it had been thought that women were more likely to die soon after a heart attack because they tended to be older than their male counterparts.However, said Dr Vaccarino, the risk of death was higher among women only before the age of 75."If a woman gets a heart attack and is in the younger age group, she is in a high-risk group," said Vaccarino, an assistant professor of public health at the Yale School of Public Health in New Haven, Connecticut.She and her colleagues analyzed data on 384 878 patients between ages 30 and 89, who had been enrolled in the National Registry of Myocardial Infarction 2 between June 1994 and January 1998.Of these, 155 565 were women and 229 313 were men.They found that the overall mortality rate was 16.7% among women and 11.5% for men.However, among patients under 50, the mortality rate for women was more than twice that for men, according to the study.The study was observational only, she said, and the researchers were unable to determine the various reasons for the variation in death rates."We definitely need more studies to look at two areas," she said, "one is the possible behavioral/psychosocial factors for women, as well as the possible biological mechanisms that may explain this difference."Psychosocial factors are often dismissed, she said.However, she was impressed by the numbers of women who did not connect their
A viral kinetic study using pegylated interferon alfa-2b and/or lamivudine in patients with chronic hepatitis B/HBeAg negative
Authors: Vassiliki-Anastasia Sypsa, Konstantinos Mimidis, Nicholas C. Tassopoulos, Dimitrios Chrysagis, Themistoklis Vassiliadis, Antonios Moulakakis, Maria Raptopoulou, Caterina Haida, Angelos Hatzakis
Journal: Hepatology (2005)

Abstract We studied viral dynamic parameters in 44 chronic hepatitis B/hepatitis B e antigen (HBeAg)(−) patients treated with pegylated interferon alfa-2b (PEG-IFN) 100 or 200 μg weekly or lamivudine 100 mg daily or the combination of PEG-IFN 100 or 200 μg with lamivudine. Patients receiving PEG-IFN monotherapy exhibited viral load oscillations between weekly injections, which were resolved by the addition of lamivudine. The median pharmacological delay was estimated at 4.1, 5.8, and 1.8 hours in PEG-IFN monotherapy, PEG-IFN 100/200 μg + lamivudine, and lamivudine monotherapy, respectively ( P = .44). The median half-life of free virus was 12.7 hours (range, 2.4-69.2 hours). The mean antiviral effectiveness of PEG-IFN 100/200 μg monotherapy was lower than that of lamivudine (82.6% vs. 96.4%; P = .005). The mean effectiveness of PEG-IFN 100 μg + lamivudine and PEG-IFN 200 μg + lamivudine was 92.8% and 94.4%, respectively. The half-life of infected cells ranged from 2.7 to 75 days. The median half-life of infected cells in patients receiving the combination regimens of PEG-IFN and lamivudine was similar to that of lamivudine patients (5.0 days vs. 6.0 days, P = .77). In conclusion , the addition of pegylated interferon alfa-2b in lamivudine treatment was found to neither enhance the potency of blocking HBV production nor the decay rates of infected cells. Supplementary material for this article can be found on the Hepatology website ( http://www.interscience.wiley.com/jpages/0270-9139/suppmat/index.html ). (Hepatology 2005;42:77–85.)
Pathogenesis and Manifestations
Authors: Frederic A. dePeyster
Journal: JAMA (1975)

THE ANATOMIC distribution<sup>1,2</sup>of large-bowel cancer is shown in the Figure. About 2% to 4% of the tumors arise from the anus. Grossly, cancer may be exophytic, ie, growing from the bowel wall into the lumen to produce a fungating mass, or an annular tumor threatening obstruction. Endophytic lesions occur as variably sized, "punched out" ulcers or extend intramurally without ulceration (linitis plastica). Table 1 lists the histopathologic features of bowel cancer, 95% of which are adenocarcinoma.<sup>3</sup>Cloacogenic, transitional cell, and Paget extramammary and Bowen anogenital diseases are rare. The neoplastic cell is generated in the lower two thirds of the cryptal column of colonic mucosa, where kinetic activity of normal mucous, columnar, and argentaffin cells occur. This activity is characterized by rapid proliferation and orderly migration to the surface, terminating by extrusion of the cell into the bowel lumen. Whereas the DNA synthesis decreases in the normal
On the Employment of Opium in Inflammation
Authors: W. H. Ranking
Journal: BMJ (1846)

granulesbeing distinctly visible withouit magnifying aid; the pelvis and infundibula were dilated, and their lining membrane exhibited a vascular arboreseent appearance.The rest of the abdonminal viscera were healthy.Circumstances prevented an examination of the contents of the thorax.Remarks.-In this case during the early stage of the disorder, some doubt existed as to the source of the hsemorrhage.The acute pain wlhich the patient some- times suffered in the loins, and which was generally brought on or aggravated by exercise, warranted a suspicion that the seat of hmmoi rbage was in the kidney, and probably induced by the presence of a calculus.A closer investigation, howvever, satisfied me that the fons et origo was of a different character and ini a different situation.A catheter was introduced into the bladder, whlich caused muich pain in its passage from extreme sensitiveness of the mueatuis and neck of the organ.The instrument on passing the neck, received a direction towards the fundus.An obstruc-
Dutch researchers call for sex education in primary schools
Authors: Tony Sheldon
Journal: BMJ (2005)

Dutch researchers are calling for more primary school sex education after a study of sexual behaviour that shows that more teenagers are having sex than 10 years ago, and they are starting younger.

The report, produced by two Dutch sexual health organisations, concludes that it is important for teenagers' sexual health to have a “warm family environment.” Teenagers who received help and affection from their parents had less experience of sex, were more competent at negotiating with sexual partners, used contraception better, and were less likely to be forced into sex.

This first large scale study since 1995 included responses from 5000 12 to 25 year olds. It aims to mould health promotion policies in a …
Cancer of the Lung in Progressive Systemic Sclerosis
Authors: R. L. Richards, J. A. Milne
Journal: Thorax (1958)

An association between one of the collagen diseases, dermatomyositis, and malignant disease is well recognized; in a recent review Caldwell (1955) states that there are nearly 70 reported cases in which the association has been noted, and an incidence of 18 % malignancy in cases of dermatomyositis has been reported by Curtis, Blaylock, and Harrell (1952). Many authorities (Dowling, 1940; Freudenthal, 1940; Goetz, 1945; Pagel and Treip, 1955) think that dermatomyositis and the condition which is commonly called generalized or diffuse scleroderma, but which we along with others (Goetz, 1945; Cullinan, 1953, Beigelman, Goldner, and Bayles, 1953; Piper and Helwig, 1955), believe is better called progressive systemic sclerosis, are variants of the same disease. It is therefore of interest that a similar association between malignant disease and progressive systemic sclerosis is apparently rare (Talbott and Ferrandis, 1956). Apart from a report by Barlow (1939) of a patient who had diffuse scleroderma and who was found at necropsy to have an apparently simple adrenal adenoma, there were no definite records of neoplasia in cases of progressive systemic sclerosis until 1953 when Zatuchni, Campbell, and Zarafonetis reported three patients who had scleroderma, pulmonary fibrosis, and carcinoma of the lung. Jonsson and Houser (1956) have since reported another similar case. In the last two years we have seen two patients who had this combination of progressive systemic sclerosis and pulmonary carcinoma. The purpose of this paper is to present these two cases in detail, to review briefly the findings in the cases previously reported, and to discuss the association between the two diseases.
A Transcriptional Mechanism Integrating Inputs from Extracellular Signals to Activate Hippocampal Stem Cells
Authors: Jimena Andersen, Noelia Urbán, Angeliki Achimastou, Ayako Ito, Milesa Simic, Kristy Ullom, Ben Martynoga, Mélanie Lebel, Christian Göritz, Jonas Frisén, Masato Nakafuku, François Guillemot
Journal: Neuron (2014)

The activity of adult stem cells is regulated by signals emanating from the surrounding tissue. Many niche signals have been identified, but it is unclear how they influence the choice of stem cells to remain quiescent or divide. Here we show that when stem cells of the adult hippocampus receive activating signals, they first induce the expression of the transcription factor Ascl1 and only subsequently exit quiescence. Moreover, lowering Ascl1 expression reduces the proliferation rate of hippocampal stem cells, and inactivating Ascl1 blocks quiescence exit completely, rendering them unresponsive to activating stimuli. Ascl1 promotes the proliferation of hippocampal stem cells by directly regulating the expression of cell-cycle regulatory genes. Ascl1 is similarly required for stem cell activation in the adult subventricular zone. Our results support a model whereby Ascl1 integrates inputs from both stimulatory and inhibitory signals and converts them into a transcriptional program activating adult neural stem cells.
Handbook of Psychooncology: Psychological Care of the Patient With Cancer
Authors: David Peretz
Journal: JAMA (1990)

This worthwhile handbook appears as we enter the fourth decade of thanatological reform in American health care. Many of us began with high hopes in the 1960s. We believed that concern with death, dying, and bereavement would contribute to a deepened humanization of medical practice, against the prevailing ethos of technologically inspired medicine. Some among us have been forced by confrontation with disappointing reality to recognize that it is easier to lecture and write about introducing modifications into the physicianpatient relationship than it is to achieve them. In the workings of this extraordinary relationship lives the art—and heart—of medicine. It appears to me that it can be taught only to those who already possess it and seek facilitation for and affirmation of its use. The vital core of the art is empathy, and the inducing force, just as in its creation in early childhood, is a health professional role model
Asymptomatic Hyperuricemia: The Case for Conservative Management
Authors: MATTHEW H. LIANG
Journal: Annals of Internal Medicine (1978)

The management of asymptomatic hyperuricemia is controversial. Reported benefits from treatment prevention of acute gouty arthritis, chronic tophaceous gout, urolithiasis, or gouty nephropathy. A review of experimental and clinical data suggests that the risks of asymptomatic hyperuricemia are small or unknown and the efficacy of long-term treatment in preventing gout or renal disease is unproved. The costs and risks of prolonged drug administration and practical considerations such as patient compliance mitigate against long-term therapy in asymptomatic persons. We offer some recommendations for an expectant approach to the management of asymptomatic hyperuricemia.
Evidence based paediatrics: Evidence based management of childhood obesity
Authors: L. Edmunds, E. Waters, E. J Elliott
Journal: BMJ (2001)

This is the second in a series of five articles 

The parents of a 10 year old boy who is very overweight bring him to consult you. He is an only child. His mother is of normal weight but his father is a large man and is overweight. His father's two brothers are obese. His parents report that the boy's behaviour is deteriorating and that he is becoming isolated from his peers. His mother has tried various dieting strategies but these have not halted his increasing gain in weight. His parents are concerned that he will “end up like his two uncles.” The boy says he is unhappy about his size because he gets teased and has trouble making friends. His mother asks whether his health is at risk and how he can be helped.

#### Summary points

Young obese children should maintain weight or gain weight slowly rather than lose weight

Inculcating healthy eating habits is better than restricting diet

Sustainable lifestyle activities should be encouraged

Psychosocial problems are important consequences of overweight or obesity

Behavioural treatments should be individually designed

All treatments must be acceptable to the family

In 1998 the World Health Organization designated obesity as a global epidemic.1 The epidemic, which includes adults and children, is a result of societal and environmental factors that promote weight gain, factors that health professionals cannot expect to change. Results of obesity treatment programmes at obesity clinics have been disappointing, although children do better than adults. Prevention is therefore essential to reduce the health burden of obesity on society. It is vital to treat and prevent obesity in childhood, as lifestyle behaviours that contribute to and sustain obesity in adults are less well established in children and may be more amenable to change. The evidence suggests that the family provides a suitable …
Rosiglitazone and Cardiotoxicity — Weighing the Evidence
Authors: David M. Nathan
Journal: New England Journal of Medicine (2007)

The recently published meta-analysis by Nissen and Wolski,1 which suggested a significant increase in the risk of myocardial infarction associated with treatment with rosiglitazone (Avandia) and an increase of similar magnitude, albeit nonsignificant, in the risk of death from cardiovascular causes, has created a furor in the press and a quandary for physicians and their patients. Given the vagaries of meta-analyses in general and of this meta-analysis in particular — owing to the absence of primary or time-to-event data, as acknowledged both in the article and in the accompanying editorial2 — clinicians have been left uncertain as to whether rosiglitazone . . .
Sedation and Analgesia for Diagnostic and Therapeutic Procedures
Authors: David J. Fish
Journal: Annals of Internal Medicine (2003)

Medical Writings: Book Notes20 May 2003Sedation and Analgesia for Diagnostic and Therapeutic ProceduresDavid J. Fish, MDDavid J. Fish, MDDivision of Anesthesiology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-10-200305200-00036 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Malviya S, Naughton NN, Tremper KK, eds. 310 pages. Totowa, NJ: Humana Pr; 2003. $125. ISBN 0896038637. Order phone 973-256-1699.Field of medicine: Conscious sedation.Format: Hardcover book.Audience: Physicians or nurses involved in delivering conscious sedation.Purpose: To view conscious sedation including physiology, pharmacology, and monitoring.Content: The book has 12 chapters, with 3 devoted to pediatric issues. Guidelines for practice are interspersed with discussions of pharmacology and monitoring. Sedation assessment scales and nursing issues are included.Highlights: The first chapter is an excellent review of the neurobiology of sedation. Understanding the role of monitoring is well described by ... Author, Article, and Disclosure InformationAffiliations: Division of Anesthesiology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 20 May 2003Volume 138, Issue 10Page: 856KeywordsAnalgesiaAnesthesiologyAnestheticsDrug informationDrugsLibrariesPharmacologySedationSoftware tools ePublished: 20 May 2003 Issue Published: 20 May 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Influence of Some Vasoactive Drugs on Fibrinolytic Activity
Authors: MURRAY WEINER, KURT DE CRINIS, WALTER REDISCH, J. MURRAY STEELE, Louis G. Weisberg, Gordon R. Gilbert
Journal: Circulation (1959)

The phenomenon of fibrinolysis in thromboembolic disease is of great importance. In this communication the authors present striking evidence of fibrinolysis induced by drugs.
Blood Lead Is a Predictor of Homocysteine Levels in a Population-Based Study of Older Adults
Authors: Jyme H. Schafer, Thomas A. Glass, Joseph Bressler, Andrew C. Todd, Brian S. Schwartz
Journal: Environmental Health Perspectives (2004)

Lead and homocysteine are both associated with cardiovascular disease and cognitive dysfunction. We evaluated the relations among blood lead, tibia lead, and homocysteine levels by cross-sectional analysis of data among subjects in the Baltimore Memory Study, a longitudinal study of 1,140 randomly selected residents in Baltimore, Maryland, who were 50-70 years of age. Tibia lead was measured by (superscript)109(/superscript)Cd K-shell X-ray fluorescence. The subject population had a mean +/- SD age of 59.3 +/- 5.9 years and was 66.0% female, 53.9% white, and 41.4% black or African American. Mean +/- SD blood lead, tibia lead, and homocysteine levels were 3.5 +/- 2.4 microg/dL, 18.9 +/- 12.5 microg/g, and 10.0 +/- 4.1 micromol/L, respectively. In unadjusted analysis, blood lead and homocysteine were moderately correlated (Pearson's r = 0.27, p < 0.01). After adjustment for age, sex, race/ethnicity, educational level, tobacco and alcohol consumption, and body mass index using multiple linear regression, results revealed that homocysteine levels increased 0.35 micromol/L per 1.0 microg/dL increase in blood lead (p < 0.01). The relations of blood lead with homocysteine levels did not differ in subgroups distinguished by age, sex, or race/ethnicity. Tibia lead was modestly correlated with blood lead (Pearson's r = 0.12, p < 0.01) but was not associated with homocysteine levels. To our knowledge, these are the first data to reveal an association between blood lead and homocysteine. These results suggest that homocysteine could be a mechanism that underlies the effects of lead on the cardiovascular and central nervous systems, possibly offering new targets for intervention to prevent the long-term consequences of lead exposure.