tbuckley/cabot-search huggingface dataset:
Risk-stratified vs routine antithrombotics for TKA: fewer wound complications without increasing DVT
Authors: Adam Cuker
Journal: Annals of Internal Medicine (2013)

ACP Journal ClubDecember 17, 2013Risk-stratified vs routine antithrombotics for TKA: fewer wound complications without increasing DVTAdam Cuker, MD, MSAdam Cuker, MD, MSPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (A.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-12-201312170-02005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationKulshrestha V, Kumar S. DVT prophylaxis after TKA: routine anticoagulation vs risk screening approach—a randomized study. J Arthroplasty. 2013;28:1868-73. https://pubmed.ncbi.nlm.nih.gov/23796558Clinical Impact RatingsHematology: References1 Falck-Ytter Y, Francis CW, Johanson NA, et al; American College of Chest Physicians. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141:e278S-325S. [PMID: 22315265] Google Scholar2 Mont MA, Jacobs JJ, Boggio LN, et al; AAOS. Preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Am Acad Orthop Surg. 2011;19:768-76. [PMID: 22134209] Google Scholar3 Vince K, Chivas D, Droll KP. Wound complications after total knee arthroplasty. J Arthroplasty. 2007;22:39-44. [PMID: 17570276] Google Scholar Author, Article, and Disclosure InformationAffiliations: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA (A.C.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics December 17, 2013Volume 159, Issue 12Page: JC5 Issue Published: December 17, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Langerhans Cells Are Activated In The Esophagus Of Children With Eosinophilic Esophagitis
Authors: M. Chehade, A. Santopolo, M.C. Berin, H.A. Sampson, A. Polydorides, N. Harpaz, O. Yershov, K. Glatman
Journal: Journal of Allergy and Clinical Immunology (2010)
Regulatory body is ordered to inquire into doctor's decision to test patient for HIV without permission
Authors: P. Sidley
Journal: BMJ (2003)

A high court in South Africa is to force the Health Professions Council, the statutory body that registers doctors and regulates their professional affairs, to hold a hearing into the conduct of a doctor who failed to disclose the HIV status of a patient he had tested without her permission.

The decision stemmed from the council's refusal to hold an inquiry after it made a decision that was based only on the doctor's evidence.

The case arose after the patient, known only as VRM, had a stillborn baby apparently as a result of her HIV infection, a …
Ovulation Recovery after Hormonal Contraception
Authors: J. Portuondo, R. Sarasola, A. Echanojauregui, A. de los Rios
Journal: Endoscopy (1979)

In an attempt to study the ovulation recovery after hormonal contraception, 20 patients who were on B. C. P. (birth control pills) during 12--36 months, were switched to I. U. D. contraception, and the ovarian changes occurred were assessed by laparoscopy and laparoscopic ovarian biopsy. Fresh corpus leuteum was found in 12 cases (60%), some follicular activity in 4 cases (20%) and no signs of activity in 4 cases (20%). Our results suggest that neither the length of hormonal contraception nor the patient's age have any particular influence upon the return of ovulation.The ovulation recovery of 20 patients, aged 25-45, who had taken oral contraceptives for 6-30 months and then changed to Lippes Loop C IUDs, was studied on the 22nd and 23rd day of the 1st cycle following the change in the contraceptive method. The age of the patient was apparently not a determinant in ovulation recovery as 62% of those aged 25-35 years and 58% of those aged 35-45, had a successful recovery. Similarly, duration of pill use appeared to have no effect on recovery. Tables show 1) the number and % of cases by macroscopic and histologic findings; and 2) the % of cases showing ovulation recovery and failure by duration of oral contraceptive use and by the age of the patient.
ABC of Urology: COMMON PAEDIATRIC PROBLEMS
Authors: C. Dawson, H. Whitfield
Journal: BMJ (1996)

Phimosis is the most common reason for circumcision, although recurrent balanitis is also an indication. Circumcision may also be performed for religious or social reasons.



Phimosis.



At birth, adhesions are present between the glans penis and the foreskin, but separation begins to occur immediately and continues thereafter. The prepuce normally becomes retractile after the age of 2 years, but many adolescent boys retain some adhesions. Preputial adhesions are a common reason for referral to a urologist, but adhesions are normal and should be treated only if they persist into adolescence and cause problems with masturbation or sexual intercourse. A non-retractile foreskin is free of symptoms and self limiting, and circumcision is not needed. Parents often say that the prepuce “balloons” when the child urinates, but this is a sign of a non-retractile foreskin rather than phimosis. Careful examination will show that the urethral meatus is visible through the narrowed preputial opening, and with time this opening widens to allow the foreskin to retract normally. True phimosis is rare but may cause appreciable problems in either childhood or adolescence. Treatment is usually circumcision.

#### Possible indications for circumcision for phimosis

The incidence of undescended testis after the first year of life is under 1%. It is not clear why testes fail to descend into the scrotum, but recent evidence suggests that descent occurs in two distinct phases and that androgens may have an important role, possibly acting via the genitofemoral nerve. In 80% of cases the undescended testis will be palpable in the inguinal canal.



Investigation and management of undescended testis.



If the testis is palpable in the inguinal canal then orchidopexy should be carried out. The correct timing of orchidopexy has been debated. Spontaneous descent of undescended testis is rare after the age of 1 year, and …
Canada has world's highest rate of confirmed cases of A/H1N1, with Aboriginal people hardest hit
Authors: B. Kermode-Scott
Journal: BMJ (2009)

A Canadian researcher has called on Canada’s federal and provincial governments to be more forthright about the evidence that, per person, Canada is the country in the world hit hardest by the A/H1N1 flu virus. Moreover within Canada, he says, Aboriginal people are being hit much harder by the pandemic than the general population.

Alan Davidson, an associate professor and programme coordinator of health studies at the University of British Columbia (Okanagan), pointed out in a letter to a Canadian national newspaper, the Globe and Mail , on 26 June that Canada had 20 reported cases of A/H1N1 flu per 100 000 people. Dr Davidson noted that, according to the World Health Organization, the worldwide prevalence of A/H1N1 then was less than one …
Prognostic Value of Blood Sedimentation Rate in Pulmonary Tuberculosis
Authors: E. Lewis-Fanning, M. Myers
Journal: BMJ (1942)

A series of children in a London borough from 1 to 15 years of age were immunized and in part primary Schick-tested.The results for two recent complete years, 1938 and 1941, have been given.Of 437 children of school age tested in 1938, 65.2% were primary Schick-positive.The corresponding numbers for 1941 were 64.7% positive out of 2,425.Over four-fifths of the children were positive at school-entry age, but only a little over two-fifths were found positive at school-leaving age.A.P.T. given in doses of 0.1 c.cm. and 0.5 c.cm. with a fort- night's interval produced a Schick-conversion rate of 95.6 % and a Schick-negative rate of 99.1 %.A.P.T. similarly ad- ministered in doses of 0.2 c.cm. and 0.5 c.cm. gave a Schick- conversion rate of 99.3 % and a Schick-negative rate of 99.5 %.T.A.F.given in three fortnightly doses of 1 c.cm., 1 c.cm., and 1.2 c.cm. produced a Schick-conversion rate of 91.3 % (23 cases only), and in fortnightly doses of 1 c.cm., 1 c.cm., 1.5 c.cm., a Schick-conversion rate of 99.6%.Provided a suitable antigen is given in appropriate doses, no practical immunological disadvantage is apparent if an interval of two weeks between doses is employed because it is administratively advantageous locally instead of four weeks.With A.P.T. in two doses as the antigen, clinic visits will be saved if primary Schick tests are performed in all cases when the expectation of natural immunes is more than one-third of the total for the age groups concerned.In a typical London borough this can be expected from the age of 9 years onwards.The selection of the primary Schick-negatives when they form a considerable proportion of all children also assists in eliminating or indicating (if it is desired to give a single safeguarding injection) the most probable sufferers of local reactions to A.P.T.In view of the existing variability of the same types of antigens, post-Schick-testing or, as a minimum, post-Schicksampling is necessary.Diphtheria immunization clinic work for 1938 was carried out by the author, and for parts of the year by Drs.D. S. Murray and K. M. Hirst.The bulk of the 1941 clinic work was done by Dr. H. W. Swann, to whom appreciation is due for his careful work and enthusiasm, and the remainder by Dr.
Abstract SY37-01: Dissecting the canonical and noncanonical interactions of the BCL-2 family for therapeutic benefit
Authors: Loren D. Walensky
Journal: Cancer Research (2014)

Abstract BCL-2 family proteins are key regulators of apoptotic and other signaling pathways in health and disease. Discrete amphipathic alpha-helices embedded within the protein infrastructure are essential interaction motifs that can inhibit or activate their physiologic targets. The canonical complex between a pro-apoptotic BCL-2 homology domain 3 (BH3) helix and a surface groove on anti-apoptotic members portrayed a molecular wrestling match between pro- and anti-apoptotic signals. If anti-apoptotic grooves are sufficient in number to bind and sequester the pro-apoptotic BH3 signals, cell survival prevails. In contrast, if the capacity to withstand pro-apoptotic assault is breached, cell death ensues. Not only did this protein interaction paradigm provide a mechanism for apoptotic regulation, but it also informed the development of drugs to reactivate cell death through targeted inhibition of anti-apoptotic BH3-binding pockets. Given the critical roles of amphipathic alpha-helices in mediating signal transduction, we advanced all-hydrocarbon stapling to refold bioactive alpha-helical peptides for use as research tools and prototype therapeutics. Depending on their amino acid composition and design, “stapled peptides” have proven to be structurally stable, protease resistant, and cell permeable agents capable of interrogating and modulating protein interactions in vitro and in vivo. Here, I present our latest applications of Stabilized Alpha-Helices of BCL-2 domains (SAHBs) to dissect the canonical and noncanonical interactions that directly regulate the functional activity of BCL-2 family proteins and their targets. Our findings broaden the opportunities to pharmacologically modulate cell death and other physiologic processes by revealing new protein terrain for therapeutic targeting. Citation Format: Loren D. Walensky. Dissecting the canonical and noncanonical interactions of the BCL-2 family for therapeutic benefit. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr SY37-01. doi:10.1158/1538-7445.AM2014-SY37-01
Role of the Wnt-β-catenin signaling pathway in melanoma-mediated dendritic cell tolerization
Authors: Alisha Holtzhausen, Kathy Evans, Brent A Hanks
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Recent studies have shown that tumor immune evasion mechanisms significantly contribute to immunotherapy failure. Emerging data is indicating that tumor-associated dendritic cells (DCs) undergo phenotypic tolerization and promote the differentiation and activation of regulatory T
Information Requirements and Sedation Preferences of Patients Undergoing Endoscopy of the Upper Gastrointestinal Tract
Authors: C. S. J. Probert, V. Jayanthi, J. Quinn, J. F. Mayberry
Journal: Endoscopy (1991)

See also: The Needs and Wishes of Outpatients Undergoing Upper Gastrointestinal EndoscopyEndoscopy 1992; 24(08): 734-734DOI: 10.1055/s-2007-1010572
S114 Previously Unrecognised Oral Anaerobes In Pleural Infection
Authors: J. Wrightson, J. Wray, T. Street, S. Chapman, D. Crook, N. Rahman
Journal: Thorax (2014)

<h3></h3> Laboratory culture of pleural infection samples is positive in only 30% of cases, probably related to antibiotic usage and fastidious or unculturable organisms such as some anaerobes. Previous studies using capillary sequencing of the 16S rRNA gene improves rates of organism identification, but is unable to resolve the polymicrobiality thought to be present in anaerobic infection. We used ultra-deep pyrosequencing to definitively characterise anaerobic pleural infection. <h3>Methods</h3> Pleural infection samples were obtained from the Second Multicentre Intrapleural Sepsis randomised controlled Trial (MIST2), REC no. 04/MRE5/53. DNA was extracted using the FastDNA SPIN Kit. Modified ‘fusion’ primers amplified the V4–6 regions of the 16S rRNA gene. Subsequent pyrosequencing was performed on the Roche 454 GS FLX instrument. Data analyses were performed using the open souce ‘Quantitative Insights Into Microbial Ecology’ platform. Strategies were used to control for contamination. <h3>Results</h3> 172 pleural fluid samples were available, 98 of which were successfully sequenced. 32/98 samples contained anaerobes (defined when ≥10% of sequences in a sample represented anaerobes). Fusobacteriales, particularly <i>Fusobacterium nucleatum</i>, and Bacteroidales, particularly <i>Prevotella</i> spp. were commonly found although other anaerobes were seen (see Figure). Anaerobic pleural infection was usually polymicrobial, with an estimated 4–5 operational taxonomic units (“species”) per sample. Particular patterns of co-infection were <i>Fusobacterium</i><i>nucelatum</i> and Streptococcus ‘milleri’ group although <i>Prevotella</i> spp. ± <i>Fusobacterium</i> spp. ± <i>Porphyromonas</i> spp. ± <i>Treponema</i> spp. also co-infected several samples. Many species were found that have not been previously documented, including <i>Atopobium rimae, Cryptobacterium curtum, Lactobacillus spp., Stomatobaculum</i> spp., <i>Oribacterium</i> spp., <i>Prevotella baroniae, Prevotella dentalis/Hallella seregens, Prevotella scopos, Fretibacterium</i> spp., <i>Tanerella forsythia, Treponema denticola, lecithinolyticum, maltophilum, medium and socranskii. </i>Intriguingly, the original isolation and description of almost all these anaerobes were from the oropharynx and some have never been detected at other body sites. <h3>Conclusions</h3> Anaerobic infection occurs in ~33% of cases of pleural infection and is typically polymicrobial. Sequencing revealed many anaerobic bacteria never previously isolated in the pleural space. These bacteria have a strong association with the oropharynx, particularly the gingival crevices. Such findings add to our understanding of the mechanism of development of pleural infection.
Microsomal Prostaglandin E <sub>2</sub> Synthase-1 Deletion Leads to Adverse Left Ventricular Remodeling After Myocardial Infarction
Authors: Norbert Degousee, Shafie Fazel, Denis Angoulvant, Eva Stefanski, Sven-Christian Pawelzik, Marina Korotkova, Sara Arab, Peter Liu, Thomas F. Lindsay, Sun Zhuo, Jagdish Butany, Ren-Ke Li, Laurent Audoly, Ronald Schmidt, Carlo Angioni, Gerd Geisslinger, Per-Johan Jakobsson, Barry B. Rubin
Journal: Circulation (2008)

Pharmacological inhibition of cyclooxygenase-2 increases the risk of myocardial infarction (MI) and stroke. Microsomal prostaglandin (PG) E(2) synthase-1 (mPGES-1), encoded by the Ptges gene, functions downstream from cyclooxygenase-2 in the inducible PGE(2) biosynthetic pathway. We caused acute MI in Ptges(+/+) and Ptges(-/-) mice to define the role of mPGES-1 in cardiac ischemic injury.Twenty-eight days after MI, Ptges(-/-) mice develop more left ventricular (LV) dilation, have worse LV systolic and diastolic function, and have higher LV end-diastolic pressure than Ptges(+/+) mice but have similar pulmonary wet-to-dry weight ratios, cardiac mass, infarct size, and mortality. The length-to-width ratio of individual cardiomyocytes is significantly greater in Ptges(-/-) than Ptges(+/+) mice after MI, a finding consistent with eccentric cardiomyocyte hypertrophy in Ptges(-/-) mice. Expression of atrial natriuretic peptide, brain natriuretic peptide, and alpha- and beta-myosin heavy chain, markers of ventricular hypertrophy, is higher in the LV of Ptges(-/-) than Ptges(+/+) mice after MI. Ptges(+/+) mice express cyclooxygenase-2 and mPGES-1 protein in inflammatory cells adjacent to the infarct after MI but do not express these proteins in cardiomyocytes. Ptges(-/-) mice express cyclooxygenase-2 in inflammatory cells adjacent to the infarct and do not express mPGES-1 in any cells in the heart. Levels of PGE(2) but not PGD(2), thromboxane A(2), PGI(2), or PGF(2alpha) are higher in the infarct and LV remote from the infarct after MI in Ptges(+/+) than Ptges(-/-) mice.In Ptges(+/+) mice, mPGES-1 in inflammatory cells catalyzes PGE(2) biosynthesis in the LV after MI. Deletion of mPGES-1 leads to eccentric cardiac myocyte hypertrophy, LV dilation, and impaired LV contractile function after acute MI.
Observations on the Revised Curriculum of Johns Hopkins University School of Medicine
Authors: Samuel P. Asper
Journal: New England Journal of Medicine (1964)

DURING a meeting of the curriculum committee in the early days of Johns Hopkins University School of Medicine Dr. William S. Halsted, the rest-less and busy professor of surgery, became annoyed with the tedium of the discussion. He arose and said, "Gentlemen, it makes little difference how the courses are planned. I want only good teachers and receptive students." Whereupon, he withdrew. His action and words gave expression again to the Hippocratic doctrine of medical education. It has become an accepted truism that the success of a medical school's teaching program resides to a greater extent in its teachers than . . .
Thyroid Ectopia in a Congenital Hypothyroid Infant
Authors: SAM KRINSKY
Journal: Clinical Nuclear Medicine (1986)

An infant girl was referred for thyroid screening. The T4 value was 5.0 micrograms/dl (normal 5.0-13.0 micrograms/dl), and the thyroid-stimulating hormone-radioimmunoassay value was greater than 60.0 microIU/ml (normal 0-10.0 microIU/ml). Imaging failed to demonstrate thyroid tissue in the normal anatomic position in the neck. A focal collection of activity was seen, however, on a scan corresponding to the position of the base of the tongue. The finding is consistent with the diagnosis of a lingual (undescended) thyroid.
Secondary prophylaxis against myocardial infarction
Authors: P. Nicol
Journal: BMJ (1991)

exercise tests where there is no contraindication.We use (i blockers in addition to aspirin in patients with hypertension and angina and consider them in those whom we assess to be at high risk.In the remaining asymptomatic low risk group we do not think that the potential additional benefit from 0 blockers justifies their use.The potential side
New Guidance Covers Ways to Prevent and Treat Hypertension in Elderly Patients
Authors: Mike Mitka
Journal: JAMA (2011)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Business of Stem Cells
Authors: Debora Spar
Journal: New England Journal of Medicine (2004)

On February 12, 2004, a team of Korean scientists made global headlines. Using somatic-cell nuclear transfer (therapeutic cloning), they removed the nucleus of a human egg cell and replaced it with the genetic material from a single adult cell. They then stimulated the newly transformed egg cell and prompted it to begin dividing. Several days later, they had produced a line of human embryonic stem cells — the first ever created in a laboratory.Scientifically, the impact of this procedure was immense. The Korean team had demonstrated the practical ability to manufacture stem-cell lines from scratch. They had shown that . . .
Automated Cardiac Output Measurement by Spatiotemporal Integration of Color Doppler Data
Authors: Jing Ping Sun, Min Pu, Fetnat M. Fouad, Raymond Christian, William J. Stewart, James D. Thomas
Journal: Circulation (1997)

Background A new Doppler echocardiographic technique has been developed for automated cardiac output measurement (ACOM) that assumes neither a flat flow profile nor collinearity with the scan line, but clinical validation of this method is lacking. Methods and Results In 165 subjects (50 intensive care patients, 10 dobutamine echocardiography patients, and 105 normal volunteers; age, 49.4±19.3 years; 92 men), ACOM was performed in the left ventricular outflow tract (LVOT), with the color baseline shifted to avoid aliasing. ACOM was also tested in a pulsatile in vitro model. Stroke volume was calculated by double integration of Doppler signals in space (across the LVOT) and in time (through the systolic period), assuming hemiaxial symmetry: ∫∫π r v(r,t) dr dt, where v(r,t) is the velocity at a distance r from the center of the LVOT at time t during systole. Stroke volume from ACOM was compared with thermodilution (TD), aortic valve pulsed-wave Doppler (PWAO), and left ventricular echocardiographic (two-dimensional [2D]) methods. There was good correlation between ACOM and PWAO ( r =.93), TD ( r =.86), and 2D ( r =.74), with close agreement seen. ACOM had higher correlation and agreement with TD than did either PWAO ( P &lt;.02) or 2D ( P &lt;.01). ACOM was also able to track accurately the changes in cardiac output with dobutamine infusion in comparison with PWAO ( r =.94). In vitro assessment demonstrated excellent correlation ( r =.98, y =1.0 x +1.94) with little impact of pulse repetition frequency or misalignment up to 30°. Gain dependency was noted but could be optimized by visual inspection of the color image. Conclusions Automatic integration of numerical data within color Doppler flow fields is a feasible new method for quantifying flow. It is simpler and faster, requires fewer assumptions, and uses only one apical view. ACOM is a promising new approach to echocardiographic quantification that deserves further study and refinement.