tbuckley/cabot-search huggingface dataset:
Information about Quality of Care
Authors: Clement J. McDonald
Journal: Annals of Internal Medicine (1997)

Letters1 October 1997Information about Quality of CareClement J. McDonald, MD and Raymond D. Aller, MDClement J. McDonald, MDRegenstrief Institute for Health Care; Indianapolis, IN 46202University of Utah School of Medicine; Salt Lake City, UT 84132Search for more papers by this author and Raymond D. Aller, MDRegenstrief Institute for Health Care; Indianapolis, IN 46202University of Utah School of Medicine; Salt Lake City, UT 84132Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-7-199710010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We side with Pine and colleagues [1] against Iezzoni's [2] pessimistic conclusions about electronic laboratory data. Computer-based laboratory reporting systems are present in most hospitals with more than 200 beds, and standards for electronic messages (such as ASTM [American Society for Testing and Materials] E1238 or HL7 [Health Level 7]) [3] are widely used. Mayo Clinical Laboratories and ARUP Laboratories, for example, each have more than 100 standards-based electronic interfaces operating between their referral laboratories and clients around the United States. All of the major vendors of laboratory information systems support ASTM and HL7 (64 of 67 ...References1. Pine M, Norusis M, Jones B, Rosenthal GE. Predictions of hospital mortality rates: a comparison of data sources. Ann Intern Med. 1997; 126:347-54. Google Scholar2. Iezzoni LI. How much are we willing to pay for information about quality of care? [Editorial] Ann Intern Med. 1997; 126:391-3. Google Scholar3. Health Level Seven. An Application Protocol for Electronic Data Exchange in Health Care Environments. Version 2.3. Ann Arbor, MI: Health Level Seven: 1997. Google Scholar4. Aller RD, Weilert M. Clinical Laboratory Information Systems. CAP Today. 1996; 10:1137-62. Google Scholar5. Forrey AW, McDonald CJ, DeMoor G, Huff SM, Leavelle D, Leland D, et al. The logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic reporting of clinical laboratory test results. Clin Chem. 1996; 42:81-90. Google Scholar Author, Article, and Disclosure InformationAffiliations: Regenstrief Institute for Health Care; Indianapolis, IN 46202University of Utah School of Medicine; Salt Lake City, UT 84132 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1997Volume 127, Issue 7Page: 575KeywordsClinical laboratoriesComputersComputing systemsHealth careHealth care qualityInformation technologyInternetResearch laboratoriesStandardized tests Issue Published: 1 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Interprocedural interval as a risk factor for recurrent restenosis after treatment of in-stent restenosis: differential response with and without brachytherapy
Authors: Michael P. Savage, David L. Fischman, Richard K. Valicenti, Warren K. Laskey, Theodore A. Bass, Paul S. Teirstein, Jeffrey J. Popma, Richard Kuntz
Journal: Journal of the American College of Cardiology (2002)
Long term non-invasive ventilation in the community for patients with musculoskeletal disorders: 46 year experience and review
Authors: A. Baydur
Journal: Thorax (2000)

A study was undertaken to assess the long term physiological and clinical outcome in 79 patients with musculoskeletal disorders (73 neuromuscular, six of the chest wall) who received non-invasive ventilation for chronic respiratory failure over a period of 46 years.Vital capacity (VC) and carbon dioxide tension (PCO(2)) before and after initiation of ventilation, type and duration of ventilatory assistance, the need for tracheostomy, and mortality were retrospectively studied in 48 patients who were managed with mouth/nasal intermittent positive pressure ventilation (M/NIPPV) and 31 who received body ventilation. The two largest groups analysed were 45 patients with poliomyelitis and 15 with Duchenne's muscular dystrophy. Twenty five patients with poliomyelitis received body ventilation (for a mean of 290 months) and 20 were supported by M/NIPPV (mean 38 months). All 15 patients with Duchenne's muscular dystrophy were ventilated by NIPPV (mean 22 months).Fourteen patients with poliomyelitis on body ventilation (56%) but only one on M/NIPPV, and 10 of 15 patients (67%) with Duchenne's muscular dystrophy eventually received tracheostomies for ventilatory support. Five patients with other neuromuscular disorders required tracheostomies. Twenty of 29 tracheostomies (69%) were provided because of progressive disease and hypercarbia which could not be controlled by non-invasive ventilation; the remaining nine were placed because of bulbar dysfunction and aspiration related complications. Nine of 10 deaths occurred in patients on body ventilation (six with poliomyelitis), although the causes of death were varied and not necessarily related to respiratory complications. A proportionately greater number of patients on M/NIPPV (67%) reported positive outcomes (improved sense of wellbeing and independence) than did those on body ventilation (29%, p<0.01). However, other than tracheostomies and deaths, negative outcomes in the form of machine/interface discomfort and self-discontinuation of ventilation also occurred at a rate 2.3 times higher than in the group who received body ventilation. None of the six patients with chest wall disorders (all on M/NIPPV) required tracheostomy or died. Hospital admission rates increased nearly eightfold in patients receiving body ventilation (all poliomyelitis patients) compared with before ventilation (p<0.01) while in those supported by M/NIPPV they were reduced by 36%.Non-invasive ventilation (NIV) in the community over prolonged periods is a feasible although variably tolerated form of management in patients with neuromuscular disorders. While patients who received body ventilation were followed the longest (mean 24 years), the need for tracheostomy and deaths occurred more often in this group (most commonly in the poliomyelitis patients). Despite a number of discomforts associated with M/NIPPV, a larger proportion of patients experienced improved wellbeing, independence, and ability to perform daily activities.
Closure of Atrial Septal Defects With the Amplatzer Occlusion Device: Preliminary Results
Authors: Basil (Vasilios) D Thanopoulos, Cleo V Laskari, George S Tsaousis, Armine Zarayelyan, Athina Vekiou, George S Papadopoulos
Journal: Journal of the American College of Cardiology (1998)
WHAT CAUSES FLATULENCE?
Authors: WALTER C. ALVAREZ
Journal: JAMA (1942)

Flatulence is one of the commonest symptoms complained of by patients with indigestion or what they think is indigestion. Unfortunately, in many cases the cause cannot be determined. The first thing the physician must do when a patient complains of gas is to find out what he means. Does he mean that he is belching, does he bloat, does he feel as if gas was trapped in a segment of intestine or does he pass excessive amounts of flatus? Curiously a patient may have any or all of these troubles and still not have real flatulent indigestion! The chronic belcher is swallowing air because he is nervous or frightened; the woman who bloats may have only an angioneurotic edema of her bowel; the man who feels as if he had gas in his stomach may have only a duodenal ulcer or constipation, and the man who is passing much flatus
Nonparenteral Serum Hepatitis
Authors: Richard A. Garibaldi
Journal: JAMA (1972)

Five household contacts of a renal hemodialysis patient in Memphis developed hepatitis in March and April 1970. The suspect index case was a 31-year-old man with chronic glomerulonephritis who had been undergoing hemodialysis for 18 months and whose blood was known to contain hepatitis-associated antigen. The five secondary cases were present in mid-January when the dialysis patient hemorrhaged extensively at home from an eroded external shunt cannula. The three-month incubation period, detection of hepatitis-associated antigen in three of the five, and ineffectiveness of prophylactic immune serum globulin characterized their illness as serum hepatitis. Despite intensive questioning, none of the household contacts could recall sustaining minor injuries or abrasions during the first-aid effort, and a nonparenteral route of infection was postulated.
Evidence of genetic heterogeneity in five kindreds with familial hypertrophic cardiomyopathy.
Authors: N D Epstein, L Fananapazir, H J Lin, J Mulvihill, R White, J M Lalouel, R P Lifton, A W Nienhuis, M Leppert
Journal: Circulation (1992)

BACKGROUND Recently, two families with hypertrophic cardiomyopathy have been shown to have mutations in the cardiac beta-myosin heavy chain gene (beta-MHC) located on the long arm of chromosome 14. METHODS AND RESULTS We have performed linkage analysis of five newly ascertained pedigrees with more than 50 chromosomal markers detecting polymorphisms. Our findings confirm the linkage to beta-MHC gene locus on chromosome 14 in one family (LOD score, 4.50) and suggest linkage to the same gene in another kindred. Chromosome 14 markers were not linked to the disease gene in the other three kindreds, however, and a test for genetic heterogeneity was statistically significant. Moreover, markers for the beta-MHC gene identified affected individuals who were recombinants with respect to this gene and the disease phenotype in these three kindreds. CONCLUSIONS These results provide conclusive evidence that hypertrophic cardiomyopathy in separate families is caused by mutations in disease genes at two or more locations in the genome.
A MODIFICATION OF GOCHT'S COMPRESSION DIAPHRAGM.
Authors: MAX REICHMANN
Journal: JAMA (1906)

Shortly after he had presented his first paper on x-rays to the physiomedical society at Würzburg, Roentgen found that x-rays do not emanate from the platinum of the anti-cathode only, but also from the walls of the glass tube, from the air which the rays penetrate, in fact that they fill every space in the room in which the Roentgen tube is operating. These secondary rays, as they are called, or diffused rays, as they should be called, affect the sensitized plate, and the blurred and flat negatives which we so often see must be ascribed to these unwelcome secondary rays. Roentgen himself recommended lead diaphragms to be put between tube and body to annihilate the effect of the secondary rays, and an American investigator, Charles Finley Easton, was the first (1896) to cover his tubes with a lead shell into which a changeable opening was made. Rumpel, in Hamburg,
Persistent activation of the NF-K B signaling pathway in patients with unstable angina and elevated levels of C-reactive protein
Authors: Giovanna Liuzzo, Matteo Santamaria, Francesca Ginnetti, Annalisa Porto, Dominick J. Angiolillo, Vittoria Rizzello, Luigi M. Biasucci
Journal: Journal of the American College of Cardiology (2002)
Gastroscopy in Corrosive Burn of the Stomach
Authors: David G. Ashbaugh
Journal: JAMA (1971)

Corrosive burns of the stomach often go undetected until serious, life-threatening complications occur. Early diagnosis and prompt surgical intervention may avoid these complications. Gastroscopic diagnosis of a lye burn of the stomach led to early and curative surgery in the case herein reported. In selected cases, gastroscopy appears to be a useful tool and may either establish the need for surgery or avoid a diagnostic laparotomy in suspected gastric injury.
Determination of effective and safe dose for intracoronary administration of nicorandil in dogs
Authors: S. Kojima, S. Ishikawa, K. Ohsawa, H. Mori
Journal: Cardiovascular Research (1990)

Journal Article Determination of effective and safe dose for intracoronary administration of nicorandil in dogs Get access Shoji Kojima, Shoji Kojima Correspondence to: Dr Mori Search for other works by this author on: Oxford Academic PubMed Google Scholar Shirou Ishikawa, Shirou Ishikawa Search for other works by this author on: Oxford Academic PubMed Google Scholar Kazunori Ohsawa, Kazunori Ohsawa Search for other works by this author on: Oxford Academic PubMed Google Scholar Hidezo Mori Hidezo Mori Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 24, Issue 9, September 1990, Pages 727–732, https://doi.org/10.1093/cvr/24.9.727 Published: 01 September 1990 Article history Received: 21 February 1990 Accepted: 04 April 1990 Published: 01 September 1990
Occupational Illness: Case Detection by Poison Control Surveillance
Authors: Paul D. Blanc
Journal: Annals of Internal Medicine (1989)

Study Objective: To evaluate the usefulness of poison control center detection in occupational illness surveillance. Design: Case series of all occupationally related exposures referred for poison control center consultation over 6 months. Follow-up structured interviews were done of exposed persons and health care providers. Cases were traced under established occupational illness reporting programs. Setting: A regional poison control center. Patients: Consecutive sample of 461 symptomatic occupational exposure cases. After exclusions and losses to follow-up, interview of 301 patients and the treating physician, physician's assistant, or nurse practitioner for the 223 of the patients under direct medical care. Measurements and Main Results: One hundred and fifty-five persons (61%; CI, 55% to 67%) had systemic or respiratory illness; 109 (36%; CI, 31% to 41%) had eye or skin conditions. Work practices were associated with exposures more often than technical failure; 118 persons (39%; CI, 33% to 45%) reported lack of respirators or other appropriate personal protective equipment. For 223 persons who received direct medical care, only five treating health care providers (2%; CI, 0.2% to 4%) reported occupational specialization, although occupational care was a regular practice activity for 128 of the health care providers (57%; CI, 51% to 63%). Sixty-seven cases (22%; CI, 17% to 27%) were detected by the Doctor's First Report surveillance program; 97 cases (32%; CI, 27% to 37%) comprised the maximal detection estimated for Occupational Safety and Health Administration surveillance. Conclusions: Poison control center detection provides a useful surveillance measure for occupational illness. The proportion of case detection failures by established surveillance programs suggests that the incidence of occupational illness in the United States, which is calculated from these incomplete programs, may be three to five times greater than previously estimated.
The environment and asthma in U.S. inner cities.
Authors: P A Eggleston, T J Buckley, P N Breysse, M Wills-Karp, S R Kleeberger, J J Jaakkola
Journal: Environmental Health Perspectives (1999)

The prevalence and severity of asthma has increased in the last 20 years, and the greatest increase has been seen among children and young adults living in U.S. inner cities. The reasons for this increase are obviously complex, but include environmental exposures to allergens and pollutants, changing patterns of medication, and the psychosocial stresses of living in poor inner-city neighborhoods. This paper presents an overview of environmental, immunologic, and genetic factors associated with asthma morbidity and mortality. This overview can be used to provide a framework for designing an interdisciplinary research program to address the complexities of asthma etiology and exacerbation. The strongest epidemiologic association has been found between asthma morbidity and the exposure of immunologically sensitive asthmatic patients to airborne allergens. Our current understanding of the process of sensitization suggests that there is a strong genetic predisposition to form IgE to allergenic proteins on airborne particles. Much of this work has been conducted with animal models, but in a number of instances, specific confirmation has been reported in humans. Sensitized individuals respond to inhaled exposure with immediate mast-cell dependent inflammation that may be augmented by pollutant particles, especially diesel exhaust particles. Relatively little is known about the methods of assessing exposure to airborne pollutants, especially biologically active particulates. However, to examine the relationship of morbidity in genetically predisposed individuals, it will be important to determine the most relevant method of making this assessment.
Multi-Host Transmission Dynamics of Schistosoma japonicum in Samar Province, the Philippines
Authors: Steven Riley, Hélène Carabin, Patrick Bélisle, Lawrence Joseph, Veronica Tallo, Ernesto Balolong, A. Lee Willingham, Tomas J Fernandez, Ryan O'Neal Gonzales, Remigio Olveda, Stephen T McGarvey
Journal: PLoS Medicine (2008)

Background Among the 6.7 million people living in areas of the Philippines where infection with Schistosoma japonicum is considered endemic, even within small geographical areas levels of infection vary considerably. In general, the ecological drivers of this variability are not well described. Unlike other schistosomes, S. japonicum is known to infect several mammalian hosts. However, the relative contribution of different hosts to the transmission cycle is not well understood. Here, we characterize the transmission dynamics of S. japonicum using data from an extensive field study and a mathematical transmission model. Methods and Findings In this study, stool samples were obtained from 5,623 humans and 5,899 potential nonhuman mammalian hosts in 50 villages in the Province of Samar, the Philippines. These data, with variable numbers of samples per individual, were adjusted for known specificities and sensitivities of the measurement techniques before being used to estimate the parameters of a mathematical transmission model, under the assumption that the dynamic transmission processes of infection and recovery were in a steady state in each village. The model was structured to allow variable rates of transmission from different mammals (humans, dogs, cats, pigs, domesticated water buffalo, and rats) to snails and from snails to mammals. First, we held transmission parameters constant for all villages and found that no combination of mammalian population size and prevalence of infectivity could explain the observed variability in prevalence of infection between villages. We then allowed either the underlying rate of transmission (a) from snails to mammals or (b) from mammals to snails to vary by village. Our data provided substantially more support for model structure (a) than for model structure (b). Fitted values for the village-level transmission intensity from snails to mammals appeared to be strongly spatially correlated, which is consistent with results from descriptive hierarchical analyses. Conclusions Our results suggest that the process of acquiring mammalian S. japonicum infection is more important in explaining differences in prevalence of infection between villages than the process of snails becoming infected. Also, the contribution from water buffaloes to human S. japonicum infection in the Philippines is less important than has been recently observed for bovines in China. These findings have implications for the prioritization of mitigating interventions against S. japonicum transmission.
Male Reproductive Science When Darwin Ruled and Victoria Reigned
Authors: Robert L. Martensen
Journal: JAMA (1997)

What do speculations on the physiologic life span, female men¬ struation, the laws of heredity, and global production of semen have in common? Not much to us, perhaps. Dr Green's 1897 JAMA discourse may strike today's reader more as an odd philosophy of the cosmos, akin to an early Woody Allen film, than as a science of the principles of human sexuality and re¬ production. But Green delivered his opinions straight. For him, as well as for his contemporaries, applying the 'laws of nature to human reproduction provided principles to guide behavior as well as a framework for what otherwise would seem disparate speculations. AlthoughGreenwrote as though scientistshavealways had laws of nature, the notion that inflexible natural laws govern the universe only started to appear inWestern thought during the scientific revolution, which began in the mid 16th century. As late as the 18th century, most natural philosophy left con¬ siderable room for arbitrary divine intervention. During the first half of the 19th century, physical scientists took a more confident stance, but life scientists remained ambivalent. For example, the author of an 1853 text on human physiology wrote this cautionary on natural law: A Law of Nature must possess no coercive powerwhatever; and to speak ofphenom¬
Pertussis immunisation and serious acute neurological illness in children
Authors: S. Behrman
Journal: BMJ (1981)

illness in children (16 May, p 1595).The authors have made a concerted attempt to answer the question "What is the risk of giving pertussis immunisation ?" and give estimates of risk with appropriate comments on their interpretation.I wonder, however, whether any attempt was made to assess the completeness of notification procedures from hospitals.The paper states that "there was no known non-participating unit during the second and third years"; but the study as reported in the BMJ relies heavily on the assumption that all cases of serious acute neurological illness in the relevant units over the specified time period have been included.It might be possible to assess whether this is so through hospital activity
Determination of Site of Infection in Endocarditis
Authors: GEORGE J. PAZIN
Journal: Annals of Internal Medicine (1975)

Medical-surgical treatment of antibiotic refractory endocarditis requires determination of the site of infection, which is not always possible with conventional cardiac catheterization. The cases of two patients with right-sided endocarditis who survived after combined medical-surgical therapy are presented. One had persistentPseudomonas aeruginosabacteremia and three possible sites of infection. Multiple quantitative blood cultures proximal and distal to each suspected site indicated the pulmonary valve alone was infected. The second had sustained bacteremia with three enteric organisms and no apparent valvular abnormality. Quantitative cultures excluded the abdomen as the continuing source of bacteremia and suggested the tricuspid valve was infected. This was confirmed by a second catheterization using multiple cultures in conjunction with dye dilution studies, intracardiac phonocardiography, and angiography. These bacteriologic and cardiologic techniques may be especially useful in detecting right-sided endocarditis and may also be helpful in detecting concomitant infection of both sides of the heart.
Judge rules that paediatrician who was criticised as an expert witness can be named
Authors: C. Dyer
Journal: BMJ (2011)

A consultant paediatrician who was criticised by a judge over his report as an expert witness in a suspected case of fabricated or induced illness can be named and his report disclosed, the senior family judge in England and Wales has ruled.

Nicholas Wall, president of the High Court’s family division, granted an application by Brian Morgan, a freelance journalist, to be allowed to name the paediatrician, who was an expert in care proceedings brought three years ago by Coventry City Council.

The council proposed removing three children, two of whom have special needs, from their parents after receiving a report from the paediatrician, Dipak Kanabar, suggesting that the mother had exaggerated her children’s symptoms and sought numerous medical …
A NEW ANGIOTENSIN II TYPE I RECEPTOR BLOCKER, BR-A-657, REDUCES REPERFUSION INJURY VIA ANTI-APOPTOTIC/ANTI-INFLAMMATORY EFFECT.
Authors: Dong-Ju Choi, Eun-Ji Kim, Min-Jung Park, Il-Yung Oh, Chang-Hwan Yun, Yung-Seok Cho, Tae-Jin Yeon, Gu-Yung Cho, Gu-Yung Cho, In-Ho Chae, Sung-Ji Park
Journal: Journal of the American College of Cardiology (2011)