tbuckley/cabot-search huggingface dataset:
Professional Obligation and Supererogation With Reference to the Transplant Tourist
Authors: Benjamin Hippen
Journal: The American Journal of Bioethics (2010)

Click to increase image sizeClick to decrease image size Notes 1. For contrast, see the 1847 AMA Code of Medical Ethics: "The obedience of a patient to the prescriptions of his physician should be prompt and implicit. He should never permit his own crude opinions as to their fitness to influence his attention to them" (Ch. I, Art.I, § 6). For other examples of patient obligations, see also Ch.I, Art.II, § 6, § 9, and § 10. 2. The language of the 1847 AMA Code on the subject of physician rights, though circumscribed, is less reticent than CitationRhodes and Schiano (2010) on the matter: "In thus deducing the rights of a physician from his duties, it is not meant to insist on such a correlative obligation, that the withholding of the right exonerates from the discharge of the duty. Short of the formal abandonment of the practice of his profession, no medical man can withhold his services from the requisition either of an individual or of the community, unless under circumstances, of rare occurrence, in which his compliance would be not only unjust but degrading to himself, or to a professional brother, and so far diminish his future usefulness" (emphasis mine). 3. Severe biliary strictures are a recognized complication of transplanted livers procured from prisoners executed by a gunshot wound to the head. This raises the question of whether, granting the authors' arguments, the recipient has a beneficence claim on the expertise of his physicians to provide "clinical" guidance for methods of prisoner execution more conducive to organ preservation! 4. Said conditions are beyond the scope of this essay, and include but are not limited to obligations in emergencies (codified, for example, in EMTALA), and limits on declining to care for patients with specific conditions within one's professional competence such as HIV/AIDS (codified, for example, in the Americans with Disabilities Act). 5. "Apart from the fact that the record does not demonstrate to what extent respondent hospitals are the sole providers of dialysis treatment in the area accessible to [Payton], her present behavior, as found by the trial court, is of such a nature as to justify their refusal of dialysis treatment on either an individual or collective basis. Whatever collective responsibility may exist, it is clearly not absolute, or independent of the patient's own responsibility." 131 Cal. App. 3d 38, 182 Cal. Rptr. 225 (Cal. App. 1st Dist. 1982).
Heparin Source and Effect
Authors: ELIZABETH V. POTTER
Journal: Annals of Internal Medicine (1974)

Comments and Correction1 August 1974Heparin Source and EffectELIZABETH V. POTTER, M.D.ELIZABETH V. POTTER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-2-275_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the report by Klein and Bell (1), describing two patients who developed signs of disseminated intravascular coagulation while on heparin therapy, there is no reference to the source of the heparin used. In view of other recent reports (2, 3) describing coagulative factors in heparin obtained from hog intestine, the source becomes of utmost importance in the assessment of heparin effect. Only the Upjohn Co. was producing beef-lung heparin at the time of these last reports, and there was no increase in the incidence of thrombosis with the use of this preparation, in contrast to preparations...References1. KLEINBELL HW: Disseminated intravascular coagulation during heparin therapy. Ann Intern Med 80:477-481, 1974 LinkGoogle Scholar2. WILSON J: Pathologist says pork gut heparin encourages clots. Urology Times, November 1973, p. 12 Google Scholar3. GOLDBERG E: Prevention of post-brachial-arteriotomy thrombosis. Lancet 1:789, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ELIZABETH V. POTTER, M.D.Affiliations: Department of Medicine The Medical School Northwestern University Chicago, Illinois 60611 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrugs affecting blood clotting and fibrinolysis 1 August 1974Volume 81, Issue 2Page: 275-275KeywordsDisseminated intravascular coagulationHeparinThrombosis ePublished: 1 December 2008 Issue Published: 1 August 1974 PDF downloadLoading ...
Cost-Effectiveness of Screening for Pre-Diabetes Among Overweight and Obese U.S. Adults
Authors: Thomas J. Hoerger, Katherine A. Hicks, Stephen W. Sorensen, William H. Herman, Robert E. Ratner, Ronald T. Ackermann, Ping Zhang, Michael M. Engelgau
Journal: Diabetes Care (2008)

We appreciate Dr. Wechowski's interest (1) in our study (2) and agree that it is important to evaluate the cost-effectiveness of screening for pre-diabetes and of diabetes prevention on a country-by-country basis. Cost-effectiveness …
ACUTE OUTBREAK OF TYPHOID
Authors: Hugo A. Freund
Journal: JAMA (1934)

To the Editor:—  During a recent visit of a large circus in this city, fever was discovered in several of the performers and laborers attached to the organization. Steps were immediately taken by the local health authorities, the chief physician of the circus, and members of the staff of Harper Hospital to examine every member of the group. July 23 and 24, seventy-eight men and women, ranging from the age of 15 to 50, were found to have typhoid or were suspected of being in the early stages of the disease. All of them were brought into Harper Hospital and isolated in a separate division of the hospital. Complete isolation precautions with a separate staff of nurses and physicians were placed in charge. Blood cultures and Widal tests were immediately done on the entire group.  At this time, forty-seven of these patients have been definitely proved to have a typhoid
Replantation in China
Authors: Russell B. Roth
Journal: JAMA (1974)

To the Editor.—  Wu Ching-lo, a 28-year-old lathe operator from the outskirts of Shanghai, writes her intricate Chinese characters by holding the pencil between the index and middle fingers of her right hand and the second toe of her right foot. This is not an acrobatic exercise. It is a result of using the second toe for surgical replacement of her accidentally amputated right thumb. The surgery had been done three months before our visit to the Sixth People's Hospital in Shanghai. The patient was undergoing physiotherapy, massage, and training exercises, with excellent results in restoring a badly disadvantaged right hand to relatively full use.  At the Sixth People's Hospital, on Jan 2, 1963, the first Chinese replantation of a totally severed hand and wrist had been accomplished. Dr. Chin, chief of Orthopedic Surgery, and his colleagues spent an afternoon showing us current inpatients and several others who had returned
Nonproprietary Names
Authors: Joseph B. Jerome
Journal: JAMA (1965)

One of the Egyptian gods associated with the healing arts was Thoth. Some time later, the Greek god, Hermes, assumed a similar role, while, in Roman mythology, the same god was known as Mercury. We can trace the role of this god in the various mythologies because of his identification with an emblem showing two serpents on a staff surmounted by wings. From the name of the staff, caduceus, the ancients derived another name for this god, caducifer .  Thus, early in the history of medicine and pharmacy we find a pattern that is strikingly modern: short, apparently unrelated trademarks and a somewhat less simple, but more informative, nonproprietary name.  As the title of this paper implies, the national and international aspects of nonproprietary nomenclature will be discussed. To put a reasonable limit on such an ambitious undertaking, the discussion of the national aspects of drug nomenclature will be confined primarily
Sustained FVIII Expression and Phenotypic Correction of Hemophilia A in Neonatal Mice Using an Endothelial-Targeted Sleeping Beauty Transposon
Authors: Li Liu, Cathryn Mah, Bradley S. Fletcher
Journal: Molecular Therapy (2006)

Hemophilia A, deficiency of coagulation factor VIII (FVIII), is an attractive candidate for gene therapy as expression of modest amounts of FVIII can provide therapeutic benefit. Most gene transfer approaches for hemophilia have focused on the liver, as this is the major source of endogenous FVIII; however, increasing evidence suggests that endothelial cells are capable of synthesis and release of FVIII. Here the Sleeping Beauty (SB) transposon is employed to target long-term expression of the human B-domain-depleted FVIII gene (approved gene symbol F8) within lung endothelia of hemophilic mice. As the formation of inhibitory antibodies to FVIII has been a significant impediment toward achieving therapeutic plasma levels after gene or protein therapy, we chose to perform gene transfer in neonatal mice, which are more likely to be immune tolerant. Using this approach, low therapeutic levels of FVIII ( approximately 10%), as well as phenotypic correction of the bleeding disorder, were achieved in all animals that received the FVIII transposon and functional transposase throughout the duration of the study (24 weeks). Rechallenge of these animals with additional gene transfer did not result in significant increases in FVIII levels, due mainly to increases in inhibitory antibodies. These studies demonstrate the feasibility of using endothelial-targeted SB transposons for the treatment of hemophilia A.
DID “ZERO TOLERANCE FOR HEAD CONTACT” RULE ENFORCEMENT CHANGE THE RISK OF GAME RELATED CONCUSSIONS IN YOUTH ICE HOCKEY PLAYERS?
Authors: M Krolikowski, A Black, J Kang, C Emery
Journal: British Journal of Sports Medicine (2014)

Background Ice hockey is a popular winter sport in Canada. Concussion accounts for the greatest proportion of all injuries in youth ice hockey. Research has informed policy change enforcing the no head contact rule in all leagues in Canada in 2011. Objective To determine if the risk of game-related concussion and other injury differ for Pee Wee (ages 11–12) and Bantam (ages 13–14) players following a 2011 rule enforcement policy change compared to players in similar divisions prior to the rule change. Design Historical cohort study. Setting Ice hockey rinks. Participants Historical cohort included Pee Wee (most elite 70%, 2007/08) (n=891) and Bantam (most elite 30%, 2008/09) (n=378) players before the rule change and Pee Wee (2011/12) (n=589) and Bantam (2011/12) (n=244) players in the same levels of play after the policy change. Risk factor assessment Exposure of ice hockey teams before and after a “zero tolerance for head contact” rule enforcement policy change. Risk factors include position, and previous injury/concussion. Main outcome measurements Suspected concussions were identified by a team designate (Pee Wee) or team therapist (Bantam) and referred to a sport medicine physician. Hockey injuries included those requiring medical attention and/or time loss. Results Based on multivariate Poisson Regression (adjusted for cluster, exposure hours, position and previous injury/concussion) the risk of game-related concussion increased following the head contact rule enforcement change in Pee Wee (IRR=1.83 [95% CI; 1.18–2.86]) and Bantam (IRR=2.74 [95% CI; 1.41–5.32]). The risk of injury (excluding concussion) did not change in Bantam (IRR=1.03 [95% CI; 0.59–1.81]). Conclusions The “zero tolerance for head contact or head checks” rule change did not reduce game-related concussion risk in Pee Wee or Bantam ice hockey players. This study will inform future research examining mechanism of injury leading to concussions in youth ice hockey.
Warren Cole, MD, and the Ascent of Scientific Surgery
Authors: Edwin A. Deitch
Journal: JAMA (1992)

Dennis Connaughton's book on the career and life of Warren H. Cole is truly enjoyable on several levels. Not only does it provide insights into the character and personality of one of the giants of modern surgery, but through his eyes we can see the growth and evolution of modern medicine.  In telling the story of Dr Cole's life, frequently with Dr Cole's own words, the author has generated compelling accounts of a distinguished surgeon and of how medicine has adapted in the 20th century to meet the demands of a changing society. In fact, one of the particularly attractive elements of this biography is the in-depth historical perspective on how medical practice and education have evolved, which is particularly important today in trying to understand the future.  The book begins with a description of medicine at the turn of the century, which is then integrated with Dr Cole's earliest
RHEUMATIC FEVER AS A FAMILIAL DISEASE. ENVIRONMENT, COMMUNICABILITY AND HEREDITY IN THEIR RELATION TO THE OBSERVED FAMILIAL INCIDENCE OF THE DISEASE 12
Authors: May G. Wilson, Morton D. Schweitzer
Journal: Journal of Clinical Investigation (1937)

Age and sex distribution of siblings in 112 families Under Siblings Sex distribution 4 to 6 years 7 to 15 years Total Rheumatic 4 to 6 years and over siblings siblings 3 7 .
Tissue-Puncher and Loop-Ligation – New Aids for Surgical-Therapeutic Pelviscopy (Laparoscopy) = Endoscopic Intraabdominal Surgery*
Authors: K. Semm
Journal: Endoscopy (1978)

The optimal development of the pelviscopic instruments for diagnostic purposes provides us with the start in the field of surgical therapeutic pelviscopy. Newly developed instruments: Loop ligation-applicator, Tissue-Puncher (morcellation-forceps), Aqua-Purator and the new CO2-PNEUS-AUTOMATIC (S = security) have enabled us to replace some of the prior operations requiring classic gynecologic laparotomy with surgical-therapeutic pelviscopy: Ovarectomy, adnectomy, myomectomy, cystectomy, resection of the tube-pregnancy. After more than 2,200 smaller surgical interventions were performed successfully since 1973 via pelviscopy with the hemostasis aided by 100 degrees C destructive heat (Endocoagulatory, Crocodile-Forceps and Point-Coagulator) more than 50 ovarectomies etc, could be performed in 1977 via pelviscopy without intra- or postoperative complications.
REPORT ON LAWS REGULATING MEDICAL PRACTICE.Read before the American Academy of Medicine, at its Fourteenth Annual Meeting, at Philadelphia, December 4, 1890.
Authors: RICHARD J. DUNGLISON
Journal: JAMA (1891)

The changes in the laws of medical practice during the interval that has elapsed since the last annual meeting of the Academy at Chicago, have not been numerous or worthy of any lengthy notice. As the committee whose duty it has been to make the usual inquiry from gentlemen in each State familiar with the subject, I submit, with a few preliminary remarks, some brief extracts from the letters of such of my correspondents as have graciously responded. It will be seen that restrictive legislation is progressive and that the various State laws are, as a rule, working harmoniously and satisfactorily to the benefit of the public and the credit of the medical profession which has so zealously and actively interested itself in these statutory enactments for the protection of communities and individuals. It has been stated that nine of the different States of the Union now require an
Measurement of Coronary Blood Flow in Dogs and Man from Rate of Myocardial Nitrous Oxide Desaturation
Authors: WALTER T. GOODALE, DONALD B. HACKEL
Journal: Circulation Research (1953)

A technic of measuring left ventricular coronary blood flow in dogs and man from the rate of desaturation of nitrous oxide from the myocardium is presented. The desaturation technic appears valid in comparison with the previously described saturation technic, and affords definite technical advantages. By combining the two technics, flows may be measured within much less timethan by repeating either method alone.
Doctors urged to take up challenge of climate change
Authors: Lesley Morrison
Journal: BMJ (2008)

Doctors and scientists told fellow professionals last week that they had an important role to play in raising the matter of climate change, both by setting an example and by advocacy.

Hugh Montgomery, director of the Institute for Human Health and Performance at University College London, exhorted doctors to speak up about the matter locally and internationally; to set an example by reducing their own carbon footprints; and to collaborate with other doctors through professional networks.

He was speaking at a conference on climate change that he had organised at the Royal College of Physicians. “Our actions have never been more important,” he said.

Fiona Godlee, editor of the BMJ , also insisted that doctors had an important role to play …
Acute effects of low doses of alcohol on left ventricular function by echocardiography.
Authors: C E Delgado, N J Gortuin, R S Ross
Journal: Circulation (1975)

The ultrasound method for measuring the dimensions of the left ventricle was utilized to study the effect of oral doses of alcohol on left ventricular function in normal volunteers. Systolic time intervals were also measured. Seven subjects received 0.7 g/kg of ethanol (group I) and six subjects recieved 1.15 g/kg (group II). The peak of blood alcohol levels in the two groups were 75 mg/100 ml and 138 mg/100 ml respectively. There was a 6% decrease in the fractional change in the minor axis of the left ventricle in group I patients which resulted in a decrease in ejection fraction (p greater than 0.05). In group II patients, there was a 3% decrease in the fractional change in the minor axis of the left ventricle, but the change of ejection fraction was not significant. Since there was no significant difference between the physiological effects observed in groups I and II, the two groups were combined. In the combined group, at 30 minutes after the ingestion of alchol, the heart rate was increased by 11%, the fractional change in the minor axis of the left ventricle decreased by 6%, the ejection fraction decreased by 4% (p greater than 0.01) and Vcf decreased by 5%. These data suggest that in normal subjects myocardial contractility is depressed following the ingestion of alcohol.
Do not resuscitate order challenged in court
Authors: C. Dyer
Journal: BMJ (1996)

Decisions of “do not resuscitate” and “no treatment” based on a patient's unacceptable quality of life are to be challenged in the High Court in London in the first case of its kind. Lawyers for a severely handicapped 23 year old man are to challenge a decision by South Buckinghamshire NHS Trust not to apply cardiopulmonary resuscitation or give other treatment if his condition deteriorates. Mr Justice McCullough gave leave last week for an application …
Polybrominated biphenyls in model and environmentally contaminated human blood: protein binding and immunotoxicological studies.
Authors: J Roboz, J Greaves, J G Bekesi
Journal: Environmental Health Perspectives (1985)

A review and summary is given of analytical, biochemical, and immunological studies made following an immunodiagnostic investigation which revealed significant decreases in the numbers, and changes in the functional integrity, of both T-and B-lymphocytes in a group of Michigan dairy farmers exposed to polybrominated biphenyls (PBB) which had been inadvertently introduced into the food chain in 1973. A quantification technique based on selected ion monitoring of bromine anions, obtained in negative chemical ionization, permitted determination of 10-35 pg of individual PBB congener per mL serum, a 20-fold improvement over electron capture gas chromatography. An in vitro spiked system was established and shown to be a representative model of environmentally contaminated blood. Immunoprecipitation followed by mass spectrometric quantification determined that the distribution of PBB among plasma, erythrocytes, mononucleocytes and polymorphonucleocytes was 89:9:less than 1:less than 1. In plasma 80% of the PBB was bound to apolipoproteins B and A in a 3:1 ratio. No preferential absorption of PBB congeners was found in the blood compartments suggesting that changes in the relative abundances of PBB congeners observed in longitudinal studies on Michigan subjects reflect differences in excretion rates or metabolism. A repeat in 1981 of the immunodiagnostic tests conducted in 1976 revealed a virtually complete persistence of the immune dysfunctions in the Michigan farmers exposed to PBB a decade ago.
Effects of a Neutrophil Elastase Inhibitor (ONO-5046) on Acute Pulmonary Injury Induced by Tumor Necrosis Factor Alpha (TNF α ) and Activated Neutrophils in Isolated Perfused Rabbit Lungs
Authors: Y. MIYAZAKI, T. INOUE, MIN KYI, M. SAWADA, S. MIYAKE, Y. YOSHIZAWA
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

The aim of this study was to examine the effect of ONO-5046, a neutrophil elastase (NE) inhibitor, on a model of acute lung injury induced by tumor necrosis factor α (TNF α ) and phorbol myristate acetate (PMA)-activated neutrophils in isolated perfused rabbit lungs. 120 min after TNF α (4,000 JRU/ml) was injected into the pulmonary artery (PA), 5 × 107 PMA-stimulated neutrophils were infused into the PA together with 125I-rabbit serum albumin (RSA). In the ONO-5046-treated group (ONO), ONO-5046 (20 mg/kg/h) was continuously infused during the experimental period from 30 min prior to neutrophil administration. Saline, the ONO-5046 vehicle, was infused instead of ONO-5046 in the positive control group (ALD) and nonactivated neutrophils were infused without TNF α in the negative control group (Cont). PA pressure was monitored over a 240 min period, and bronchoalveolar lavage (BAL) was performed at the end of the experiment. Lung tissues were examined immunohistochemically for the expression of thrombomodulin (TM). The levels of TM in the perfusate were also measured by ELISA and the radioactivities in the BAL fluid, lung tissue and perfusate were determined to calculate the permeability index (PI) as an indicator of alveolar septal or vascular endothelial damage. The rabbit lungs infused with ONO-5046 showed slower and less increases in PA pressure compared with ALD group. The PI was significantly higher in ALD group (PIBAL = 0.028 ± 0.014, PILUNG = 0.04 ± 0.003) than Cont (PIBAL = 0.002 ± 0.001, PILUNG = 0.015 ± 0.003) and ONO group (PIBAL = 0.004 ± 0.003, PILUNG = 0.028 ± 0.003 (p < 0.05). ALD group had higher TM levels in the perfusate and showed decreased expression of TM on the vascular endothelium compared to Cont and ONO group, suggesting that there was shedding of TM on endothelium and ONO-5046 attenuated a shedding of TM. In conclusion, ONO-5046 attenuated acute lung injury by inhibiting the alveolar epithelial and vascular endothelial injury triggered by activated neutrophils. NE appears to play an important role in the neutrophil-induced increase of pulmonary epithelial and microvascular permeability observed in acute lung injury.