tbuckley/cabot-search huggingface dataset:
Sustainability and Long-term Effectiveness of the WHO Surgical Safety Checklist Combined With Pulse Oximetry in a Resource-Limited Setting
Authors: Rebecca Y. Kim, Gifty Kwakye, Alvin C. Kwok, Ruslan Baltaga, Gheorghe Ciobanu, Alan F. Merry, Luke M. Funk, Stuart R. Lipsitz, Atul A. Gawande, William R. Berry, Alex B. Haynes
Journal: JAMA Surgery (2015)

Little is known about the sustainability and long-term effect of surgical safety checklists when implemented in resource-limited settings. A previous study demonstrated the marked, short-term effect of a structured hospital-wide implementation of a surgical safety checklist in Moldova, a lower-middle-income country, as have studies in other low-resource settings.To assess the long-term reduction in perioperative harm following the introduction of a checklist-based surgical quality improvement program in a resource-limited setting and to understand the long-term effects of such programs.Twenty months after the initial implementation of a surgical safety checklist and the provision of pulse oximetry at a referral hospital in Moldova, a lower-middle-income, resource-limited country in Eastern Europe, we conducted a prospective study of perioperative care and outcomes of 637 consecutive patients undergoing noncardiac surgery (the long-term follow-up group), and we compared the findings with those from 2106 patients who underwent surgery shortly after implementation (the short-term follow-up group). Preintervention data were collected from March to July 2010. Data collection during the short-term follow-up period was performed from October 2010 to January 2011, beginning 1 month after the implementation of the launch period. Data collection during the long-term follow-up period took place from May 25 to July 6, 2012, beginning 20 months after the initial intervention.The primary end points of interest were surgical morbidity (ie, the complication rate), adherence to safety process measures, and frequency of hypoxemia.Between the short- and long-term follow-up groups, the complication rate decreased 30.7% (P = .03). Surgical site infections decreased 40.4% (P = .05). The mean (SD) rate of completion of the checklist items increased from 88% (14%) in the short-term follow-up group to 92% (11%) in the long-term follow-up group (P < .001). The rate of hypoxemic events continued to decrease (from 8.1 events per 100 hours of oximetry for the short-term follow-up group to 6.8 events per 100 hours of oximetry for the long-term follow-up group; P = .10).Sustained use of the checklist was observed with continued improvements in process measures and reductions in 30-day surgical complications almost 2 years after a structured implementation effort that demonstrated marked, short-term reductions in harm. The sustained effect occurred despite the absence of continued oversight by the research team, indicating the important role that local leadership and local champions play in the success of quality improvement initiatives, especially in resource-limited settings.
Mortality in women in relation to their childbearing history.
Authors: A. Green, V. Beral, K. Moser
Journal: BMJ (1988)

With data from the Office of Population Censuses and Surveys9 longitudinal study the mortality of currently married women aged under 60 in 1971 was investigated in relation to the number of liveborn children reported at the 1971 census, adjusting for their husbands9 social class. Women who had never had children experienced a higher mortality from many causes of death than the parous women, and this was probably due, at least in part, to selective factors. When the analysis was confined to parous women mortality from diabetes mellitus and cervical cancer increased significantly and oesophageal cancer decreased significantly with increasing number of liveborn children. Mortality from all circulatory diseases and from hypertensive disease, ischaemic heart disease, and subarachnoid haemorrhage tended to rise with parity, though the trends were not statistically significant. Mortality from breast cancer decreased significantly with the number of liveborn children, but only when nullipara were included in the analyses. These data suggest that there may be residual and cumulative effects of childbearing which influence patterns of disease in the long term.
Depression Treated with Imipramine: A Follow-up Study
Authors: L. G. Kiloh, J. R. B. Ball
Journal: BMJ (1961)

This method of therapy is particularly valuable for out-patients, and most of the patients in this series were treated as such.The results obtained in this series (88% initial improvement) were maintained by most of the patients over a nine-months period.In those cases in which relapses did occur they were slight and easily controlled by further local treatment.No deaths occurred in this series.These results compare favourably with the experience of others with local therapy (Truelove, 1956, 1957, 1958; Watkinson, 1958).Corticosteroid therapy has many disadvantages when given systemically.Among these are the insidious onset of infection (British Medical Journal, 1954; Stevens, 1960), acute adrenal insufficiency in response to sudden stress (Lancet, 1957), and other multiple possible dangers (corticoid psychosis, osteoporosis, perforation of peptic ulcer, etc.).Local corticosteroid therapy, however, carries none of these risks and, so far, no complications have been reported following its use.If systemic corticoid therapy is to be used in ulcerative colitis, then the co-employment of local steroids enables a smaller dosage to be given and thus reduces the dangers.Summary One hundred cases of ulcerative colitis were treated with prednisolone-21-phosphate enemata.The results on the whole are good, an 88% improvement rate being obtained initially.A follow-up for nine months after therapy is reported.The patient should have a reserve supply of treatment for immediate use in a relapse.Very long courses of treatment have been found of value in certain cases.I thank Dr. J. M. Naish especially for his help
Incidental Detection of Helicobacter pylori Gastritis During FDG PET Scanning for Lymphoma
Authors: Jonathan D. McDivitt, Glen M. Arluk, David B. Turton
Journal: Clinical Nuclear Medicine (2008)

A 23-year-old man with history of stage IIa bulky, nodular sclerosis type Hodgkin disease (HD) in remission for the previous 4 years was referred for F-18 FDG PET/CT after presenting with fatigue and weight loss. Imaging revealed a thickened gastric body and fundus with diffusely intense FDG uptake concerning for neoplasia. Upper endoscopy with biopsy revealed chronic gastritis secondary to Helicobacter pylori infection without evidence of cancer. The patient was started on antibiotics and urea breath test proved eradication of the infection. Repeat F-18 FDG PET/CT done after treatment showed resolving inflammation with a significant decrease in metabolic uptake. This is an interesting presentation of H. pylori gastritis showing resolution of inflammation with treatment and illustrates some of the pitfalls in oncologic surveillance when using PET imaging.
Meningitis in Childhood
Authors: D. Lawson, M. Metcalfe, G. Pampiglione
Journal: BMJ (1965)

In this paper the term  meningitis  is used in a clinical sense, whether the inflammatory condition is of bacterial or non bacterial origin and whether or not it involves the brain. It covers all inflammatory disease that can be included within the terms  meningitis,  meningo-encephalitis, or  ence phalitis, with the exclusion of tuberculous meningitis and poliomyelitis. The initial signs of meningitis are usually those which indicate meningeal inflammation, but clinical signs of involve ment of the brain may follow in some cases. In fatal cases evidence of cerebral damage can usually be found at necropsy. Moreover, electroencephalographic studies often show disturb ance of cerebral function even without any clinical manifestations.
The Role of Data Audits in Detecting Scientific Misconduct-Reply
Authors: Stuart L. Nightingale
Journal: JAMA (1990)

<h3>In Reply.—</h3> We are writing in response to Dr Rosenberg's letter regarding the case report by Wyllie et al.<sup>1</sup>The information obtained from our investigation of this report does not substantiate the alleged bioinequivalency of the generic primidone and the brand-name product. In our letter of May 5, 1989,<sup>2</sup>we summarized the final report of the Therapeutic Inequivalency Action Coordinating Committee. Aside from the two hospitalizations that were not mentioned by the authors (ie, August 1985, when the patient received the generic product, and January 1986, when she was given the brand-name product), and the fact that the patient had, on occasion, lost clinical benefit as well as therapeutic blood levels while receiving both the generic and brand-name products, our investigation revealed conflicting evidence regarding the actual product that the patient was receiving at the time points critical to the authors' conclusion. For example, although the admission history
A piece of my mind. Mrs Rodell
Authors: A. Burrows
Journal: JAMA (1989)

People often ask me why I chose ophthalmology as my specialty. I state the reason quite simply: "Mrs Rodell." I met Mrs Rodell when I was in medical school. I had wanted to earn some extra money; perusing the ads in the local paper, I read: "Intelligent, blind widow needs someone to read to her a few hours a week. Special interest in topics of medicine. Excellent compensation." A few hours a week seemed reasonable and wouldn't cut into my study time too seriously. I wondered why was she interested in medicine. Was she a physician? I called and scheduled an interview. Mrs Rodell lived in a huge redbrick house in a nice section of town. A maid answered the door; she led me upstairs to a large bedroom with lace curtains and oriental rugs. Mrs Rodell sat in an immense, four-poster bed and was propped up with several plump
Mechanism of lung injury caused by PM10 and ultrafine particles with special reference to COPD
Authors: W. MacNee, K. Donaldson
Journal: European Respiratory Journal (2003)

Particulate air pollution (particles with a 50% cut-off aerodynamic diameter of 10 µm (PM 10 )) has strong associations with the adverse health events detected by epidemiological studies in chronic obstructive pulmonary disease patients in diverse geographical locations. Transition metals may determine the toxic effects of PM 10 through oxidative stress which may be injurious as shown by an increase in airspace epithelial permeability and may lead to inflammation through the activation of transcription factors for pro‐inflammatory genes in both macrophages and epithelial cells. Recently, the present authors have shown that particulate air pollution may cause further molecular events that enhance transcription factor activation by causing acetylation of histones leading to unwinding of deoxyribonucleic acid (DNA) enhancing transcription factor DNA binding and increasing transcription for pro-inflammatory genes. Further, ultrafine particles (&lt;100 nm diameter), which have marked toxicity, may be responsible for some of the PM 10 adverse effects. The current authors have demonstrated that ultrafine carbon black (ufCB) does not have its effects via transition metal-mediated mechanisms. However, ufCB and other ultrafines generate free radicals at their surface as measured by a number of chemical assays and are able to cause oxidative stress to cells and this is likely to be a factor in their ability to cause inflammation. Changes in calcium resulting from oxidative stress within cells may be an additional factor leading to transcription of pro-inflammatory genes. Understanding the mechanisms of the harmful effects of particulate air pollution in chronic obstructive pulmonary disease may help in risk strategy for individuals who are susceptible to the effects of air pollution.
Effect of dietary restrictions on disease activity in rheumatoid arthritis.
Authors: D Beri, A N Malaviya, R Shandilya, R R Singh
Journal: Annals of the Rheumatic Diseases (1988)

Additions in five steps were made, as a possible therapeutic measure, to the diet of 27 patients with rheumatoid arthritis (RA) after a period of two weeks of a basal isocaloric diet free from pulses, cereals, milk, and non-vegetarian protein foods. Fourteen patients finally took part in the trial, 10 (71%) of whom showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months. The others discontinued the diet and were then treated with conventional disease modifying drugs. The study indicates that dietary factors may influence inflammatory response in RA.
Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review
Authors: T Jefferson, C Di Pietrantonj, M G Debalini, A Rivetti, V Demicheli
Journal: BMJ (2009)

<b>Objective</b> To explore the relation between study concordance, take home message, funding, and dissemination of comparative studies assessing the effects of influenza vaccines. <b>Design</b> Systematic review without meta-analysis. <b>Data extraction</b> Search of the Cochrane Library, PubMed, Embase, and the web, without language restriction, for any studies comparing the effects of influenza vaccines against placebo or no intervention. Abstraction and assessment of quality of methods were carried out. <b>Data synthesis</b> We identified 259 primary studies (274 datasets). Higher quality studies were significantly more likely to show concordance between data presented and conclusions (odds ratio 16.35, 95% confidence interval 4.24 to 63.04) and less likely to favour effectiveness of vaccines (0.04, 0.02 to 0.09). Government funded studies were less likely to have conclusions favouring the vaccines (0.45, 0.26 to 0.90). A higher mean journal impact factor was associated with complete or partial industry funding compared with government or private funding and no funding (differences between means 5.04). Study size was not associated with concordance, content of take home message, funding, and study quality. Higher citation index factor was associated with partial or complete industry funding. This was sensitive to the exclusion from the analysis of studies with undeclared funding. <b>Conclusion</b> Publication in prestigious journals is associated with partial or total industry funding, and this association is not explained by study quality or size.
Reviews and Notes: History of Medicine: History of the Disorders of Cardiac Rhythm
Authors: John U. Doherty
Journal: Annals of Internal Medicine (1995)

Literature of Medicine1 September 1995Reviews and Notes: History of Medicine: History of the Disorders of Cardiac RhythmJohn U. Doherty, MDJohn U. Doherty, MDPennsylvania Hospital Philadelphia, PA 19107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-5-199509010-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail B L&129;deritz. 167 pages. Armonk, NY: Futura; 1995. $75.00. ISBN 0-87993-606-1. Order phone 800-877-8761.No recounting better illustrates the combination of fortuity, plodding hard work, inspiration, and creativity necessary to the progress of a medical discipline than does this text about the evolution of our understanding of cardiac rhythm disorders.Although our current understanding of arrhythmias depends on precise measurements and certain diagnoses supported by sophisticated technology, more ethereal concerns drew the ancients to study the heart and its rhythms. Aristotle (a relative latecomer; the relation between the heartbeat and the peripheral pulse had been theorized more than a millennium ... Author, Article, and Disclosure InformationAffiliations: Pennsylvania Hospital Philadelphia, PA 19107. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1995Volume 123, Issue 5Page: 396-397KeywordsArrhythmiaCreativityDrugsElectrocardiographyHeartHeart diseasesHeart rateHistory of medicineLongitudinal studiesPathogenesis ePublished: 15 August 2000 Issue Published: 1 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Prenatal Environmental Tobacco Smoke Exposure Promotes Adult Atherogenesis and Mitochondrial Damage in Apolipoprotein E <sup>−/−</sup> Mice Fed a Chow Diet
Authors: Zhen Yang, Cynthia A. Knight, Madonna M. Mamerow, Kasey Vickers, Arthur Penn, Edward M. Postlethwait, Scott W. Ballinger
Journal: Circulation (2004)

Environmental tobacco smoke (ETS) exposure is recognized as a cardiovascular disease risk factor; however, the impact of prenatal ETS exposure on adult atherogenesis has not been examined. We hypothesized that in utero ETS exposure promotes adult atherosclerotic lesion formation and mitochondrial damage.Atherosclerotic lesion formation, mitochondrial DNA damage, antioxidant activity, and oxidant load were determined in cardiovascular tissues from adult apolipoprotein E-/- mice exposed to either filtered air or ETS in utero and fed a standard chow diet (4.5% fat) from weaning until euthanasia. All parameters were significantly altered in male mice exposed in utero to ETS.These data support the hypothesis that prenatal ETS exposure is sufficient to promote adult cardiovascular disease development.
Thiopurines for the Treatment of Acute Lymphoblastic Leukemia in Children
Authors: Franklin O. Smith, Maureen M. O’Brien
Journal: JAMA Oncology (2015)

Smita Bhatia, MD, MPH; Wendy Landier, PhD, RN; Lindsey Hageman, MPH; Yanjun Chen, MS; Heeyoung Kim, MPH; Can-Lan Sun, PhD; Nancy Kornegay, MS; William E. Evans, PharmD; Anne L. Angiolillo, MD; Bruce Bostrom, MD; Jacqueline Casillas, MD, MSHS; Glen Lew, MD; Kelly W. Maloney, MD; Leo Mascarenhas, MD, MS; A. Kim Ritchey, MD; Amanda M. Termuhlen, MD; William L. Carroll, MD; F. Lennie Wong, PhD; Mary V. Relling, PharmD
TISSUE MAST CELLS AND ACUTE INFLAMMATION IN EXPERIMENTAL CUTANEOUS MUCORMYCOSIS OF NORMAL, 48/80-TREATED, AND DIABETIC RATS
Authors: Walter H. Sheldon, Heinz Bauer
Journal: The Journal of Experimental Medicine (1960)

The role of the tissue mast cells in relation to the acute inflammatory reaction to experimental cutaneous mucormycosis was studied histologically in normal rats, in animals whose tissue mast cells had been depleted of their cytoplasmic granules prior to infection by the administration of compound 48/80 and in others in whom acute alloxan diabetes with acidosis had been produced before injection of the fungus. The discharge of the tissue mast cell granules in normal rats occurred within minutes at the site of infection and appeared to initiate the rapid onset of acute inflammation. The degranulation of the tissue mast cells subsided in a short time and the cells reassumed a normal histologic appearance while inflammation progressed with the formation of circumscribed lesions. In animals pretreated with compound 48/80 in which the tissue mast cells contained no granules, the onset of inflammation was briefly delayed, the intensity of the process was somewhat decreased, fibroblastic proliferation was retarded, and the fungus growth in the early lesions was increased. However, the infection did not spread and the lesions were well localized. The tissue mast cells in the diabetic and acidotic rats completely failed to discharge their cytoplasmic granules, the onset and intensity of the acute inflammatory response were markedly delayed and decreased and the infection progressed rapidly with massive fungus growth invading adjacent tissues. A relationship between the discharged tissue mast cell granules and eosinophilic granulocytes was noted since the latter were numerous among the inflammatory cell exudate in normal rats and scarce in the lesions of the diabetic animals. It is concluded that a function of the tissue mast cells in the normal rat is the rapid initiation of acute inflammation at the site of injury and that degranulation of these cells prior to infection somewhat delays the inflammatory response and therefore slightly diminishes host resistance. Furthermore, a severe metabolic disorder such as acute alloxan diabetes with acidosis, inhibits the normal function of the tissue mast cells, delays and decreases inflammation, and in this manner contributes to the greatly increased susceptibility of the host to infection.
Reduced Atrial Tachyarrhythmia Susceptibility After Upgrade of Conventional Implanted Pulse Generator to Cardiac Resynchronization Therapy in Patients With Heart Failure
Authors: Demetris Yannopoulos, Keith G. Lurie, Scott Sakaguchi, Simon Milstein, Cengiz Ermis, Laura VanHeel, David G. Benditt
Journal: Journal of the American College of Cardiology (2007)
The Tumor Necrosis Factor Family Receptors RANK and CD40 Cooperatively Establish the Thymic Medullary Microenvironment and Self-Tolerance
Authors: Taishin Akiyama, Yusuke Shimo, Hiromi Yanai, Junwen Qin, Daisuke Ohshima, Yuya Maruyama, Yukiko Asaumi, Juli Kitazawa, Hiroshi Takayanagi, Josef M. Penninger, Mitsuru Matsumoto, Takeshi Nitta, Yousuke Takahama, Jun-ichiro Inoue
Journal: Immunity (2008)
Humanitarianism and the Medical Profession
Authors: Carl L. Kline
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In his article entitled "Objectives of a Medical Education in Our Decade" (<i>JAMA</i><b>186</b>:845 [Nov 30] 1963) Dr. D. W. Richards obliquely assaulted one of the basic mechanisms in medical education and therefore in the product of medical education, today's doctors. His article was especially timely, as we are hearing from all sides that we need to reassess ourselves as human beings in this increasingly decadent society. We pause to ask if undue emphasis upon the coldly scientific and the curtly clinical is turning us into materialistically oriented dehumanized robots. The sociological forces are all around us, but are we reading them and understanding them? Are we losing contact with the philosophical? Have we been facing up to a measurement of our empathy with our fellow man? The medical profession is constantly being pushed into the position of having to be against what is proposed to
Robotic and Laparoscopic High Extended Pelvic Lymph Node Dissection During Radical Cystectomy: Technique and Outcomes
Authors: Mihir M. Desai, Andre K. Berger, Ricardo R. Brandina, Pascal Zehnder, Matthew Simmons, Monish Aron, Eila C. Skinner, Inderbir S. Gill
Journal: European Urology (2011)
Proximal subungual candida onychomycosis. An unusual manifestation of chronic muco‐cutaneous candidosis
Authors: R. BARAN
Journal: British Journal of Dermatology (1997)

Instead of presenting the classical appearance of granulomatous dystrophic nails due to Candida, a patient with chronic mucocutaneous candidosis showed, at each recurrence, transverse cloudy leuconychia which appeared beneath the normal cuticle of several fingernails. This pattern of infection was that of proximal subungual onychomycosis. This has been demonstrated histologically and the observation widens the range of organisms known to cause this type of fungal infection.