tbuckley/cabot-search huggingface dataset:
The Physiology of Reproduction
Authors: Richard J. Blandau
Journal: JAMA (1988)

This monumental two-volume set is a continuation of the three editions of<i>Sex and Internal Secretions</i>, the first being published in 1932. This work, containing 2633 pages and prepared by 99 leading authorities who provided more than 25 000 references, is destined to become the standard reference in reproductive physiology, endocrinology, and reproductive behavior. Specialization in research has reached a point where an authoritative discourse requires a highly selected group effort. In reviewing the list of contributors, we find many of the names of those who have participated in the spectacular pace of progress in this field during the past few decades. Volume 1 begins with detailed accounts of the male and female gametes, including sex determination, spermatozoa and ova and their transport to the site of fertilization, embryogenesis, implantation, and placentation. This is followed by a detailed presentation of the 20th-century research on the male and female gonads, including
Educational Programs in US Medical Schools, 1996-1997
Authors: Barbara Barzansky
Journal: JAMA (1997)

We use data from the 1996-1997 Liaison Committee on Medical Education Annual Medical School Questionnaire, which had a 100% response rate, to describe medical education programs in the United States. In the 1996-1997 academic year, there were 95 568 full-time medical school faculty members, a 4.5% increase from 1995-1996. In clinical departments, the largest increases were in emergency medicine (a 29% increase from 1995-1996) and family medicine (a 13% increase). Of all full-time faculty members in clinical departments, 76.9% have an MD or DO as the highest degree, 4.5% have both an MD and PhD, 13.9% have a PhD, and 4.7% have an academic or professional bachelor's or master's degree as their final degree. The total number of applicants for the class entering in 1996 was 46 968 (0.8% increase from 1995), while the number of first-time applicants decreased 1% from 1995. First-year medical students who were members of underrepresented minority groups numbered 2236, a 4% decrease from 1995. In 1996-1997, the total number of medical students was 66712 (0.3% less than in 1995-1996). For students graduating during the 1995-1996 academic year, 13% took longer than 4 years to complete the program. There were 47 medical schools that reported that 1 or more hospitals used for required clinical clerkships had changed ownership, merged, or closed during 1996. Medical schools used an average of 6 (range, 1-36) hospitals for core clinical clerkship. Ninety-five schools required a passing grade on Step 1 of the US Medical Licensing Examination (USMLE) for promotion or graduation; 54 schools required a passing grade on Step 2 of the USMLE.
The Euclid House: A Therapeutic Community Halfway House for Prisoners
Authors: STEWART L. ALEDORT, MORGAN JONES
Journal: American Journal of Psychiatry (1973)

Euclid House represents an attempt to create an effective therapeutic community for prisoners in a halfway house staffed almost totally by blacks and by some ex-offenders. This experiment is viewed as a long-term investment in training staff, developing ideas and concepts, and taking chances in order to tap the creativeness of the staff and residents. The ultimate hope is that this model will serve for some prisoners as an alternative to incarceration.
Effect of Postoperative Low-Dose Dopamine on Renal Function after Elective Major Vascular Surgery
Authors: Lee Baldwin
Journal: Annals of Internal Medicine (1994)

Objective: To determine the effect on renal function of postoperative low-dose dopamine in volume-replete patients after elective, major vascular abdominal surgery. Design: Randomized, double-blind, placebo-controlled trial. Setting: Intensive care unit of a referral hospital in Brisbane, Australia. Patients: 37 patients having elective repair of an abdominal aortic aneurysm or having aortobifemoral grafting; 18 received dopamine, and 19 received placebo. Two patients were excluded from the 5-day analysis because of perioperative death. Interventions: Patients were randomly assigned to receive either placebo or a low-dose infusion of dopamine (3 µg/kg per minute) in saline. Patients in both groups were given sufficient crystalloid to maintain a urine flow of more than 1 mL/kg per hour during the first 24 postoperative hours. Care in the intensive care unit was otherwise usual and was the same for each group. Measurements: Plasma creatinine levels, urea levels, and creatinine clearance were measured preoperatively and postoperatively (at 24 hours and 5 days). Urine flow and the volume of crystalloid during the first 24 hours were recorded. Results: Two postoperative deaths occurred in the dopamine group (from renal failure and myocardial infarction). Four patients had myocardial infarction, three of whom received dopamine. Plasma creatinine levels remained unchanged in both groups. At 24 hours, the mean plasma urea level decreased by 1.07 mmol/L in the dopamine group compared with 1.84 mmol/L in the placebo group, a difference of 0.77 (95% CI, −0.12 to 1.67). The mean 24-hour creatinine clearance increased by 0.165 mL/s (9.89 mL/min) in the dopamine group and by 0.199 mL/s (11.98 mL/min) in the placebo group (P > 0.2). Urine volumes were slightly higher in those receiving dopamine (1.83 mL/kg compared with 1.6 mL/kg, a difference of 0.23 [CI, −0.18 to 0.64]). None of these differences were statistically or clinically significant. Conclusions: Within the limits of the small size of the study, low-dose dopamine appeared to offer no advantage to euvolemic patients after elective abdominal aortic surgery. However, patients with acute oliguric renal failure were not included in the study.
755-3 Improved Prognosis for Heavy Weight Patients Receiving Thrombolysis in Acute Myocardial Infarction — Bigger is Better: Results from GUSTO
Authors: David J. Moliterno, Christopher Granger, Robert M. Califf, John M. Elliott, Amanda Stebbins, Eric J. Topol
Journal: Journal of the American College of Cardiology (1995)
Synovial Fluid Analysis for Diagnosis of Intercritical Gout
Authors: Eliseo Pascual, Enrique Batlle-Gualda, Agustín Martínez, José Rosas, Paloma Vela
Journal: Annals of Internal Medicine (1999)

Background: The diagnosis of gout in the intercritical phase can be difficult. Objective: To determine whether synovial fluid analysis allows the diagnosis of intercritical gout. Design: Cross-sectional study. Setting: Outpatient rheumatology clinics. Patients: 101 patients with gout. Intervention: Arthrocentesis of 80 knees and 21 first metatarsophalangeal joints (each joint from a different patient) that had been inflamed but were currently asymptomatic. Measurements: Frequency with which arthrocentesis yielded synovial fluid; presence of monosodium urate crystals in the synovial fluid sample; and, for synovial fluid with crystals, the number of microscope fields that had to be scanned before crystals were found. Results: Synovial fluid was obtained from 91 of 101 joints. The fluid from all 43 patients not receiving hypouricemic agents contained monosodium urate crystals. These crystals were found in the synovial fluid of only 34 of 48 patients receiving hypouricemic agents. In 90% of the synovial fluid samples that contained crystals, crystals were seen in the first five microscope fields examined. Conclusions: Arthrocentesis of asymptomatic knees and first metatarsophalangeal joints and synovial fluid analysis are simple procedures that facilitate the diagnosis of gout during intercritical periods.
Clinical Aspects of Iron Deficiency
Authors: Carol K. Kasper
Journal: JAMA (1965)

In 100 hospitalized older patients with iron-deficiency anemia, the mean corpuscular hemoglobin concentration (MCHC) varied with the degree of anemia, but the degree of poikilocytosis and cell size did not; in 21 patients mean corpuscular volumes (MCV's) were normal or above normal. Nucleated red blood cells (RBC's) were seen on the blood smears of 22 patients. Platelet counts often were considerably increased. Diameters of primitive bonemarrow erythroblasts were smaller than those of normal persons. Chronic, occult bleeding from the gastrointestinal tract was the usual cause of iron loss. More than 12 different gastrointestinal lesions were found in this group; no one type of lesion predominated. In 21 patients no source of blood loss could be found.
Keloidal basal cell carcinoma: not a distinctive clinicopathological entity
Authors: M. Jones, M. Bresch, D. Alvarez, A. Böer
Journal: British Journal of Dermatology (2008)

Keloidal basal cell carcinoma (BCC) has been reported as a rare but distinctive variant of BCC.To determine the frequency of keloidal collagen in BCC and to correlate it with clinical, histopathological and immunohistochemical features.Over 12 months, all cases of BCC with thick sclerotic collagen were collected and studied for clinical diagnosis, site, histopathological features and immunohistochemistry (collagen I, III, IV, laminine) in comparison with five keloids.Of 1011 BCCs seen, 18 showed thick sclerotic collagen. In two cases, these stained positive for collagen type IV or laminine, indicating basement membrane material. In 16 cases, sclerotic bundles stained positive for collagen type I but not for types III, IV, and laminine, as do keloids. The clinical diagnosis was BCC (13), squamous cell carcinoma (one) or keloid (one). Fourteen lesions came from the face, nine of them from the ear. Keloidal collagen was extensive in 10 lesions, including all from the ear. Histologically, tumours often had morphoeiform zones (14), necrosis en masse (eight) and ulceration (nine).Keloidal collagen in BCC is not as rare as reported and consists of type I collagen, the same as in keloids. It does not characterize a distinctive clinicopathological entity but is found in different histological types of BCC with varying clinical appearance. Keloidal collagen in BCC is associated with morphoeiform features, ulceration and necrosis. Interestingly, extensive keloidal collagen is more often seen in BCC on the ear, a site prone to develop keloids.
PRIMARY ENDOTHELIOMA OF THE GALL BLADDER.
Authors: WILLHELM BECKER
Journal: JAMA (1903)

<h3>NARRATION OF CASE.</h3><h3>History.</h3> —Mrs. R., age 65, referred by Dr. W. F. Malone. Usual diseases of children. Appendicitis three years ago. Full recovery. Thirteen months ago loss of appetite and loss in weight. Family history negative. <h3>Present State.</h3> —Weight 52 kilo. Emaciation and weakness very marked. Almost complete anorexia. Dull continuous pain over gastric region; slight tenderness over region of the gall bladder. This is only elicited at intervals. Stiller's sign absent. Abdomen is distended to the utmost in both the gastric and umbilical regions. Ten c.m. below the umbilicus the resonance of percussion takes on a lower pitch. (Percussion from above downward.) No stool the last ten days. Patient vomits continually, which consists of a foamy, brownish, malodorous mass, made up of fermenting food remnants. Total absence of HCl free or combined. Presence of an immense number of sareinæ. No Oppler-Boas
Maximizing the Potential of an Aging Population
Authors: Abby C. King, Jack M. Guralnik
Journal: JAMA (2010)

WITH THE AGING OF THE POPULATION, THE BURden of disability will have an increasingly profound influence across a number of domains ranging from health care expenditures and provision of care to older persons’ quality of life. Although a slow but steady decline in older Americans’ disability rates was documented during the last 2 decades of the 20th century, recent national data suggest that this decline may have ended, with disability rates increasing among community-dwelling adults aged 65 years or older during the first 5 years of the 21st century. Among the potential reasons for this trend are greater morbidity accompanying better chronic disease survival rates, increasing obesity among midlife and older adults, and the effects of aging-associated patterns of disuse and deconditioning—all of which are linked with functional impairment. Such factors are exacerbated by reduced socioeconomic circumstances. Evidence has accumulated in recent years about how older adults may maintain levels of functioning sufficient for participation in physical and social activities. Two pathways for improving or maintaining functional health are physical activity and social engagement.
Obesogens beyond Vertebrates: Lipid Perturbation by Tributyltin in the Crustacean <i>Daphnia magna</i>
Authors: Rita Jordão, Josefina Casas, Gemma Fabrias, Bruno Campos, Benjamín Piña, Marco F.L. Lemos, Amadeu M.V.M. Soares, Romà Tauler, Carlos Barata
Journal: Environmental Health Perspectives (2015)

The analysis of obesogenic effects in invertebrates is limited by our poor knowledge of the regulatory pathways of lipid metabolism. Recent data from the crustacean Daphnia magna points to three signaling hormonal pathways related to the molting and reproductive cycles [retinoic X receptor (RXR), juvenile hormone (JH), and ecdysone] as putative targets for exogenous obesogens.The present study addresses the disruptive effects of the model obesogen tributyltin (TBT) on the lipid homeostasis in Daphnia during the molting and reproductive cycle, its genetic control, and health consequences of its disruption.D. magna individuals were exposed to low and high levels of TBT. Reproductive effects were assessed by Life History analysis methods. Quantitative and qualitative changes in lipid droplets during molting and the reproductive cycle were studied using Nile red staining. Lipid composition and dynamics were analyzed by ultra-performance liquid chromatography coupled to a time-of-flight mass spectrometer. Relative abundances of mRNA from different genes related to RXR, ecdysone, and JH signaling pathways were studied by qRT-PCR.TBT disrupted the dynamics of neutral lipids, impairing the transfer of triacylglycerols to eggs and hence promoting their accumulation in adult individuals. TBT's disruptive effects translated into a lower fitness for offspring and adults. Co-regulation of gene transcripts suggests that TBT activates the ecdysone, JH, and RXR receptor signaling pathways, presumably through the already proposed interaction with RXR. These findings indicate the presence of obesogenic effects in a nonvertebrate species.
Long-Term Survival of Patients With Radiation Heart Disease Undergoing Cardiac Surgery
Authors: Willis Wu, Ahmad Masri, Zoran B. Popovic, Nicholas G. Smedira, Bruce W. Lytle, Thomas H. Marwick, Brian P. Griffin, Milind Y. Desai
Journal: Circulation (2013)

Thoracic radiation results in radiation-associated heart disease (RAHD), often requiring cardiothoracic surgery (CTS). We sought to measure long-term survival in RAHD patients undergoing CTS, to compare them with a matched control population undergoing similar surgical procedures, and to identify potential predictors of long-term survival.In this retrospective observational cohort study of patients undergoing CTS, matched on the basis of age, sex, and type/time of CTS, 173 RAHD patients (75% women; age, 63±14 years) and 305 comparison patients (74% women; age, 63±4 years) were included. The vast majority of RAHD patients had prior breast cancer (53%) and Hodgkin lymphoma (27%), and the mean time from radiation was 18±12 years. Clinical and surgical parameters were recorded. The preoperative EuroSCORE and all-cause mortality were recorded. The mean EuroSCOREs were similar in the RAHD and comparison groups (7.8±3 versus 7.4±3, respectively; P=0.1). Proximal coronary artery disease was higher in patients with RAHD versus the comparison patients (45% versus 38%; P=0.09), whereas redo CTS was lower in the RACD versus the comparison group (20% versus 29%; P=0.02). About two thirds of patients in either group had combination surgical procedures. During a mean follow-up of 7.6±3 years, a significantly higher proportion of patients died in the RAHD group than in the comparison group (55% versus 28%; P<0.001). On multivariable Cox proportional hazard analysis, RAHD (2.47; 95% confidence interval, 1.82-3.36), increasing EuroSCORE (1.22; 95% confidence interval, 1.16-1.29), and lack of β-blockers (0.66; 95% confidence interval, 0.47-0.93) were associated with increased mortality (all P<0.01).In patients undergoing CTS, RAHD portends increased long-term mortality. Alternative treatment strategies may be required in RAHD to improve long-term survival.
Risky Business: Needlesticks in Residency
Authors: David J. Shulkin
Journal: JAMA (1991)

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Pelvic Inflammatory Disease
Authors: Herbert B. Peterson
Journal: JAMA (1991)

--To examine available data regarding optimal antimicrobial therapy for pelvic inflammatory disease (PID) and to address selected treatment issues confronting clinicians caring for women with PID.--Studies evaluated to help establish the Centers for Disease Control's 1989 Sexually Transmitted Diseases Treatment Guidelines and other reports published since 1985. A MEDLINE search of English-language literature was conducted using the indexing terms "pelvic inflammatory disease" or "pelvic infections" or "salpingitis" and "treatment". In addition, abstracts and bibliographies of articles and books were reviewed.--Studies were selected for detailed review if they evaluated the effectiveness of an antimicrobial regimen for treatment of PID.--All studies were evaluated to determine the numbers of women treated and the percentage with clinical or microbiologic evidence of cure.--A variety of combination antimicrobial regimens are highly effective in providing clinical and microbiologic evidence of cure; few data are available to assess optimal therapy for prevention of late sequelae. Because PID is polymicrobial in cause, recommended antimicrobial regimens are broad-spectrum in coverage.--No single agent that provides sufficient coverage is currently available. Several combination regimens appear highly effective clinically even among women with tubo-ovarian abscess formation. Uncertainties regarding the effectiveness of antimicrobial therapy for prevention of late sequelae complicate decisions regarding the choice among regimens and the appropriateness of ambulatory treatment of women with PID. Pending better data, hospitalization should be strongly considered, where feasible, particularly for those women with PID desiring further childbearing. Sex partners of all women with PID should be treated.
Consistent parallel relationships among myocardial oxygen consumption, coronary blood flow, and pericardial infusate adenosine concentration with various interventions and beta-blockade in the dog.
Authors: R M Knabb, S W Ely, A N Bacchus, R Rubio, R M Berne
Journal: Circulation Research (1983)

Coronary blood flow responds uniquely to changes in myocardial demand, regardless of the stimulus. If adenosine mediates this response, interstitial fluid adenosine concentration should also change in parallel with myocardial oxygen consumption and coronary blood flow during alterations of cardiac work. We tested this hypothesis by measuring coronary blood flow, myocardial oxygen consumption, and the concentration of adenosine in pericardial infusates, an index of interstitial fluid adenosine concentration, during six experimental conditions and control states in anesthetized, open-chest dogs. Significant alterations of myocardial oxygen consumption and coronary blood flow during aortic constriction, vagal stimulation, atrial pacing, or intravenous infusion of calcium chloride, norepinephrine, or isoproterenol were accompanied by significant alterations in pericardial infusate adenosine concentration. Significant linear relationships were determined among myocardial oxygen consumption, coronary blood flow, and pericardial infusate adenosine concentration for each of the experimental stimuli and their paired control values. There were no significant differences among the six different conditions for any of these relationships. In addition, these relationships were not altered by beta-blockade in five dogs subjected to aortic constriction and calcium infusion. Although beta-blockade may alter the effects of a stimulus, myocardial oxygen consumption, coronary blood flow, and adenosine all are affected proportionately. The results suggest that adenosine production responds to alterations of myocardial oxygen consumption independently of the stimulus which produces the change in oxygen demand, and the resultant change in interstitial fluid adenosine concentration may initiate the change in coronary blood flow to maintain the balance between oxygen supply and demand.
Reply to the Letter of Dr. Mosca
Authors: D. W. Lee, A. C. Chan
Journal: Endoscopy (2002)

We thank Dr. Mosca for his interest and comments regarding our recent study [1]. Our hospital is a newly equipped public community hospital which provides 24-hour emergency medical and surgical services. It has been estimated that in an average district general hospital, 125 ERCPs would be performed each year [2]. In our study, we had performed 341 ERCPs over a 20-month period (i. e. around 200 ERCPs per year). This would be a reasonable workload if we kept the number of endoscopists to a minimum. Whether it is practicable to have just one or two specialist endoscopists to perform all elective and on-call emergency ERCPs remains arguable, and would certainly depend on other factors such as hospital policy and resource allocation. A common scenario in our locality is that ERCP is performed by endoscopists with some form of training and experience. The findings from our study revealed that this practice should be re-evaluated and perhaps abandoned in order to achieve better patient care.