tbuckley/cabot-search huggingface dataset:
THE EFFECTS OF TOTAL BODY IRRADIATION ON SOME ASPECTS OF HUMAN IRON METABOLISM
Authors: Jack Levin, J. Robert Andrews, Nathaniel I. Berlin
Journal: Journal of Clinical Investigation (1961)

Erythropoietic function was studied in ten patients following 90 to 100 r total-body irradiation. The plasma Fe59 disappearance rate was measured serially up to 64 days following irradiation, and red cell uptake of Fe59 was measured in four patients. All ten patients demonstrated a marked increase in the T1/2 of the plasma iron disappearance rate during the week following irradiation. There was a second increase in the T1/2 22 to 29 days following irradiation in all six patients studied, indicative of radiation injury and prolonged functional change. Two patients with normal marrows did not demonstrate changes in their red phatic leukemia had significant depression of uptake. At this dose level, the T1/2 of the plasma radioiron disappearance seems to be a sensitive indicator of radiation damage, is associatsd with a decrease in plasma iron turnover, and increases prior to changes in the hemoglobin concentration or reticulocyte count. (auth)
Pulmonary rehabilitation and readmissions in COPD: Hospital readmissions did not fall
Authors: Daniel K C Lee
Journal: BMJ (2005)

Learning from low income countries Experience in low income countries should count towards specialist registrar trainingEditor-Richards and Tumwine ask for discussion on the subject of poor countries making the best teachers. 1When will the postgraduate tutors and royal colleges recognise that medical experience in developing countries should be counted towards specialist registrar training?I recently spoke to a specialist registrar whose 12 months in the main teaching hospital in Malawi counted for nothing towards his training.As a specialist registrar training in chest medicine, he will have seen more tuberculosis than most chest physicians working in provincial England will see in a lifetime.This is particularly frustrating as the numbers of cases of tuberculosis are rising progressively in the United Kingdom, and training in the diagnosis and management of this disease needs to be improved as much as possible.
Plan-Do-Study-Act Cycle Rejuvenates a Marriage
Authors: Manoj Jain
Journal: Annals of Internal Medicine (2008)

On Being a Doctor5 August 2008Plan-Do-Study-Act Cycle Rejuvenates a MarriageManoj Jain, MD, MPHManoj Jain, MD, MPHFrom QSource, Tennessee's Quality Improvement Organization, Memphis, TN 38115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For nearly 18 years of our marriage, my wife and I had a game. I would say “I love you” on the phone to her, especially when I knew she would be among a group of her coworkers.She would reply giggling, as if I were tickling her, “Me too,” too embarrassed to return the reply in public.“Me too what?” I would prod her.“You know … .”“I am not getting off the phone until you say it,” I would insist.Sometimes I would win the battle, and she would whisper “I love you.” At other times, I ... Author, Article, and Disclosure InformationAffiliations: From QSource, Tennessee's Quality Improvement Organization, Memphis, TN 38115.Corresponding Author: Manoj Jain, MD, MPH, QSource, Tennessee's Quality Improvement Organization, 3175 Lenox Park Boulevard, Suite 309, Memphis, TN, 38115; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byQuality improvement can revolutionize tuberculosis care in India: A reviewStrategies to overcome barriers to implementing osteoporosis and fracture prevention guidelines in long-term care: a qualitative analysis of action plans suggested by front line staff in Ontario, CanadaAn interdisciplinary knowledge translation intervention in long-term care: Study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial 5 August 2008Volume 149, Issue 3Page: 209-210KeywordsAdolescentsFearGamesHealth care qualityPerceptionQuality improvementShouldersSoapsSportsTouch ePublished: 5 August 2008 Issue Published: 5 August 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Effect of Acute Renal Failure on Mortality
Authors: Elliott M. Levy
Journal: JAMA (1996)

To determine if the high mortality in acute renal failure is explained by underlying illnesses (comorbidity).Cohort analytic study.An 826-bed general hospital providing primary, secondary, and tertiary care.From 16,248 inpatients undergoing radiocontrast procedures between 1987 and 1989, we identified 183 index subjects who developed contrast media-associated renal failure (defined as an increase in serum creatinine level of at least 25%, to at least 177 micromol/L [2 mg/dL], within 2 days of receiving contrast material) and 174 paired subjects, matched for age and baseline serum creatinine level, who underwent similar contrast procedures without developing renal failure.Death during hospitalization.The mortality rate in subjects without renal failure was 7%, compared with 34% in the corresponding index subjects with renal failure (odds ratio, 6.5; P<.001). After adjusting for differences in comorbidity, renal failure was associated with an odds ratio of dying of 5.5. Subjects who died after developing renal failure had complicated clinical courses characterized by sepsis, bleeding, delirium, and respiratory failure; most of these complications developed after the onset of renal failure. Deaths from renal causes were rare.The high mortality rate in acute renal failure is not explained by the underlying conditions alone. Renal failure appears to increase the risk of developing severe nonrenal complications that lead to death and should not be regarded as a treatable complication of serious illness.
Bone Scintigraphy in Engelmann-Camurati Disease
Authors: Alvaro De Bonilla Damiá, Cinta Calvo Morón, Pablo Antonio De la Riva Pérez, Teresa Cambil Molina, Manuela Molina Mora, Auxiliadora Fernández Fatou, Juan Castro Montaño
Journal: Clinical Nuclear Medicine (2010)

Engelmann-Camurati Disease is a rare bone disorder with low incidence (1:1 million births). In this article, we describe the case of a patient who presented with pain in the upper and lower limbs. She had an important anxiety-depressive component in relation to pain and limitation of physical activity, crying, and anxiety symptoms. We carried out a bone scan that showed abnormal uptake of tracer in the diaphysis of long bones. Radiographic findings included cortical symmetrical thickening in the same locations, and general biochemistry was abnormal.
Allergy to pine nuts in a bird fancier
Authors: A. Jansen, A. Vermeulen, P. H. Dieges, A. W. Toorenenbergen
Journal: Allergy (1996)

A patient is described with the bird-egg syndrome who experienced an anaphylactic reaction after eating some of her parrot's food (pine nuts: Pinus pinea). Specific IgE against this nut and another pine nut (P. cembra) was demonstrated by RAST. Cross-reactivity between these botanically related seeds was shown by RAST inhibition. Besides avian antigens, bird food antigens should be taken into consideration when symptoms of allergy occur on exposure to birds.
Time for a moratorium on vitamin D meta-analyses?
Authors: M. J Bolland, A. Grey, I. R Reid
Journal: BMJ (2009)

In 2003, Latham and colleagues performed a systematic review and meta-analysis of the effect of vitamin D or its metabolites on falls and found no effect.1 At least eight further meta-analyses have been performed, including that reported by Bischoff-Ferrari and colleagues.2 Four reported a positive effect, and five no effect, or benefits limited to certain subgroups. The differences between conclusions often …
Measurement of renal perfusion and blood flow with fast computed tomography.
Authors: M D Bentley, L O Lerman, E A Hoffman, M J Fiksen-Olsen, E L Ritman, J C Romero
Journal: Circulation Research (1994)

Fast computed tomography (CT) is one of the few methods available to measure cortical and medullary renal blood flow (RBF) directly. Because these measurements are complicated by passage of the contrast medium into extravascular compartments, we used the residual opacity following the vascular blush as an index to account for extravascular iohexol. Kidneys of anesthetized dogs were examined in situ by fast CT following intra-aortic injections of iohexol. Perfusion was analyzed during a control period and three subsequent periods in which RBF was reduced by 10%, 30%, and 50%. Cortical microvascular distribution volume changed from 19.7 +/- 2.8% to 19.8 +/- 1.7%, 15.3 +/- 1.2%, and 9.9 +/- 1.7%, respectively, without significant alterations in cortical mean transit time. Microvascular distribution volume was divided by mean transit time to determine tissue perfusion. Cortical perfusion changed from 3.8 +/- 0.7 to 3.9 +/- 0.6, 3.1 +/- 0.5, and 2.2 +/- 0.5 mL.min-1.mL tissue-1. Total cortical blood flow (cortical perfusion multiplied by cortical volume) decreased from 164 +/- 32 to 159 +/- 31, 117 +/- 20, and 86 +/- 22 mL/min, respectively. Medullary microvascular distribution volume, mean transit time, perfusion, and total blood flow remained unchanged. Fast CT-determined total RBFs (cortex plus medulla) were similar to simultaneous electromagnetic flow measurements. These results indicate that renal regional perfusion is more dependent on the microvascular distribution volume than mean transit time and that variations in renal tissue perfusion with reduction of RBF are more apparent in the cortex than in the medulla.
Violence in America: Time to Bite the Bullet Back
Authors: Stan Bugaieski
Journal: JAMA (1992)

To the Editor.  —I am pleased to see  organized medicine is finally realizing that violence in the United States is a major issue and has decided to put forth efforts to address and reduce this major problem.1  I am a gun owner, hunter, and member of the National Rifle Association (NRA), but I do not agree with the NRA when it comes to certain of their stands on gun control, for example, their stand on assault weapons. I back you on your recommendations and proposed new legislation. Common sense should prevail.  Perhaps we here in central Illinois have a different population base, but the leading cause of death in both black and white teenage boys in Peoria is not gunshot wounds. Are there any statistics separating rural from urban populations and separating different geographic areas of the United States?
Long-term Follow-up in Untreated Plummer??s Disease (Autonomous Goiter)
Authors: JAN D. WIENER
Journal: Clinical Nuclear Medicine (1987)

Plummer's disease presents a spectrum of forms and its evolution is often slow. Longitudinal studies have been limited both in number of patients and duration of follow-up. In order to answer the question of whether euthyroid patients with no local symptoms should be treated prophylactically, 70 patients were reexamined 5.2-21.8 years (average, 8.9) after Plummer's disease had been diagnosed. Data are included on four others who developed symptoms that indicated treatment within five years. Gross (clinically relevant) changes were seen in 24 cases. Of these, 16 were progressive, including 12 where hyperthyroidism developed. Gross regressive changes included two cases with complete remission. Minor changes (28 cases) were about as often regressive as progressive. Most patients with a solitary autonomous nodule showed either gross changes or no change, whereas minor changes prevailed in multifocal autonomy. All eight male patients had a solitary nodule, 28 of 66 females had multifocal autonomy. Gross changes were seen in nine of 12 patients under 40 years at presentation, more often than in those over 49 years; seven of these changes were progressive. Six short case reports illustrate the great diversity in evolution. It is concluded that treatment seems wise in teenagers and in elderly patients with borderline (biochemical) hyperthyroidism but others generally may be left untreated, as long as they have few or no complaints.
HERMES: good reasons for harmonising education and training in respiratory medicine
Authors: R. Loddenkemper, T. Severin, J-L. Eisele, P. L. Haslam
Journal: European Respiratory Journal (2006)

ERMES (Harmonised Education in RespiratoryMedicine for European Specialists) was launched in 2005 by the European Respiratory Society (ERS), with the aim of harmonising education and training in respiratory medicine.The first deliverable component, a core syllabus representing the content of required knowledge in our specialty [1], will be released at the 2006 ERS Annual Congress in Munich.It is hoped that this document will be used at the national level for the development of training programmes for both trainees and young respiratory specialists, as a first step towards harmonisation in Europe.Medicine was one of the first professions regulated at the European Union (EU) level.Rules for mutual recognition of diplomas were first set in 1975 in directive 75/362/EEC.This directive concerned the mutual recognition of diplomas, certificates and other evidence of formal qualifications in medicine.Since then, it has been amended several times and lately replaced by a new directive 2005/36/EC, which sets the rules for a whole range of regulated professions.This directive guarantees automatic recognition of diplomas and certificates in all EU countries, thus granting free access to the European job market to all European specialists in respiratory medicine.
A potent oral P‐selectin blocking agent improves microcirculatory blood flow and a marker of endothelial cell injury in patients with sickle cell disease
Authors: Abdullah Kutlar, Kenneth I. Ataga, Lillian McMahon, Joanna Howard, Frederic Galacteros, Ward Hagar, Elliott Vichinsky, Anthony T.W. Cheung, Neil Matsui, Stephen H. Embury
Journal: American Journal of Hematology (2012)

Abnormal blood flow accounts for most of the clinical morbidity of sickle cell disease (SCD) [1,2]. Most notably, occlusion of flow in the microvasculature causes the acute pain crises [3] that are the commonest cause for patients with SCD to seek medical attention [4] and major determinants of their quality of life [5]. Based on evidence that endothelial P-selectin is central to the abnormal blood flow in SCD we provide results from four of our studies that are germane to microvascular blood flow in SCD. A proof-of-principle study established that doses of heparin lower than what are used for anticoagulation but sufficient to block P-selectin improved microvascular blood flow inpatients with SCD. An in vitro study showed that Pentosan Polysulfate Sodium (PPS) had greater P-selectin blocking activity than heparin. A Phase I clinical study demonstrated that a single oral dose of PPS increased microvascular blood flow in patients with SCD. A Phase II clinical study that was not completed documented that daily oral doses of PPS administered for 8 weeks lowered plasma levels of sVCAM-1 and tended to improve microvascular blood flow in patients with SCD. These data support the concept that P-selectin on the microvascular endothelium is critical to both acute vascular occlusion and chronically impaired microvascular blood flow in SCD. They also demonstrate that oral PPS is beneficial to microvascular sickle cell blood flow and has potential as an efficacious agent for long-term prophylactic therapy of SCD.
APLASTIC ANEMIA PRECEDING ACUTE MYELOBLASTIC (HISTIOCYTIC) LEUKEMIA
Authors: Frank J. Manganaro
Journal: JAMA (1960)

A young woman, who had had a normal pregnancy and delivery more than a year before, was hospitalized for weakness, myalgia, pharyngitis, cough, and fever. The diagnosis was aplastic anemia; the treatment included corticotropin, hydrocortisone, an antibiotic, and transfusion of whole blood. After discharge and several months of improvement, there was a recurrence. During the second hospitalization treatment included antibiotics, mercaptopurine, methotrexate, corticotropin-zinc hydroxide, and prednisolone. A second remission was obtained, during which she received five transfusions. The final hospitalization was for recurrence of severe menorrhagia with ecchymoses, leukemic infiltrations of the skin, and pneumonitis; the blood picture now was that of acute monocytic leukemia. The history illustrates the fact that acute leukemia is sometimes preceded by atypical manifestations, which in this case took the form of aplastic anemia.
Congenital Hemihypertrophy with Aortic, Skeletal, and Ocular Abnormalities
Authors: M. Henry, J. P. Louis, J. C. Hoeffel, C. Pernot
Journal: BMJ (1973)

87 subclinical viral hepatitis.Consequently there should be little risk in otherwise healthy long-term carriers of HBA visiting barbers or dentists or working as nurses, physicians, and so on.Earlier opinions on this problem (Chalmers and Alter, 1971) can probably be modified provided that the results of this study are confirmed. References
Comparison of Valvular Resistance, Stroke Work Loss, and Gorlin Valve Area for Quantification of Aortic Stenosis
Authors: Wolfram Voelker, Helmut Reul, Georg Nienhaus Ing, Thomas Stelzer Ing, Bernhard Schmitz Ing, Anselm Steegers Ing, Karl R. Karsch
Journal: Circulation (1995)

Background Valvular resistance and stroke work loss have been proposed as alternative measures of stenotic valvular lesions that may be less flow dependent and, thus, superior over valve area calculations for the quantification of aortic stenosis. The present in vitro study was designed to compare the impacts of valvular resistance, stroke work loss, and Gorlin valve area as hemodynamic indexes of aortic stenosis. Methods and Results In a pulsatile aortic flow model, rigid stenotic orifices in varying sizes (0.5, 1.0, 1.5, and 2.0 cm 2 ) and geometry were studied under different hemodynamic conditions. Ventricular and aortic pressures were measured to determine the mean systolic ventricular pressure (LVSP m ) and the transstenotic pressure gradient (ΔP m ). Transvalvular flow (F m ) was assessed with an electromagnetic flowmeter. Valvular resistance [VR=1333 · (ΔP m /F m )] and stroke work loss [SWL=100 · (ΔP m /LVSP m )] were calculated and compared with aortic valve area [AVA=F m /(50√ΔP m )]. The measurements were performed for a large range of transvalvular flows. At low-flow states, flow augmentation (100→200 mL/s) increased calculated valvular resistance between 21% (2.0-cm 2 orifice) and 66% (0.5-cm 2 orifice). Stroke work loss demonstrated an increase from 43% (2.0 cm 2 ) to 100% (1.0 cm 2 ). In contrast, Gorlin valve area revealed only a moderate change from 29% (2.0 cm 2 ) to 5% (0.5 cm 2 ). At physiological flow rates, increase in transvalvular flow (200→300 mL/s) did not alter calculated Gorlin valve area, whereas valvular resistance and stroke work loss demonstrated a continuing increase. Our experimental results were adopted to interpret the results of three clinical studies in aortic stenosis. The flow-dependent increase of Gorlin valve area, which was found in the cited clinical studies, can be elucidated as true further opening of the stenotic valve but not as a calculation error due to the Gorlin formula. Conclusions Within the physiological range of flow, calculated aortic valve area was less dependent on hemodynamic conditions than were valvular resistance and stroke work loss, which varied as a function of flow. Thus, for the assessment of the severity of aortic stenosis, the Gorlin valve area is superior over valvular resistance and stroke work loss, which must be indexed for flow to adequately quantify the hemodynamic severity of the obstruction.
Medical Ethics in Imperial China: A Study in Historical Anthropology
Authors: Robert M. Veatch
Journal: JAMA (1979)

Professional medical ethics and the scholarly study of medical ethics may both have reached the point where they are stymied by a parochialism. They cannot see the alternatives to the Hippocratic tradition that holds that the physician should try to benefit the patient or at least do no harm. Completely unexpected—at least for those who were not familiar with the German original—is an exciting exploration by Paul Unschuld of medical ethics in China of the Imperial period (about 500 BC through the 19th century). A complex and comprehensive treatise, the volume may be difficult reading for those not comfortable with social theory done in what the Germans call the critical perspective. The most comfortable reading of this volume would require knowledge not only of sociological theory, comparative medical ethics, and Chinese history but also a tolerance for the assumption that groups develop their ethics to legitimate pursuit of their self-interest.
Influence of natural and recombinant interleukin 2 on endothelial cell arachidonate metabolism. Induction of de novo synthesis of prostaglandin H synthase.
Authors: K Frasier-Scott, H Hatzakis, D Seong, C M Jones, K K Wu
Journal: Journal of Clinical Investigation (1988)

We studied the effects of natural and recombinant human IL-2 (rIL-2) on secretion of prostacyclin (PGI2), vWf, and tissue-type plasminogen activator (tPA). IL-2 elicited a steady increase in PGI2 synthesis by cultured human umbilical vein endothelial cells (HUVECS) and bovine aortic endothelial cells but had no effect on vWf or tPA. Both purified natural IL-2 (nIL-2) and rIL-2 induced significant PGI2 synthesis. Substitution of the cysteine residue at position 125 of rIL-2 with serine or alanine led to loss of PGI2-stimulatory activity in HUVECS without affecting thymidine incorporation in lymphocytes. HPLC analysis of arachidonate metabolites detected predominantly 6 keto-PGF1 alpha (6KPGF1 alpha) peak. Treatment of cultured endothelial cells with cycloheximide and actinomycin D resulted in inhibition of 6KPGF1 alpha synthesis. The Western blot using a polyclonal antibody against PGH synthase revealed an increment in the 70-kD subunit of PGH synthase by nIL-2 and rIL-2, but not by alanine-substituted rIL-2. We conclude that IL-2 stimulated sustained PGI2 production by a mechanism that includes the de novo synthesis of PGH synthase. This mechanism for regulating AA metabolism probably has important physiologic implications.
Risk of hip fracture associated with untreated and treated chronic hepatitis B virus infection
Authors: Dana D. Byrne, Craig W. Newcomb, Dena M. Carbonari, Melissa S. Nezamzadeh, Kimberly B.F. Leidl, Maximilian Herlim, Yu-Xiao Yang, Sean Hennessy, Jay R. Kostman, Mary B. Leonard, A. Russell Localio, Vincent Lo Re
Journal: Journal of Hepatology (2014)
Pediatric Secrets: Questions You Will Be Asked on Rounds, in the Clinic, on Oral Exams
Authors: Basil J. Zitelli
Journal: JAMA (1990)

The new attending, striding down the corridor in his cuffed gray, light wool slacks and polished loafers, is now armed with a new tool to pimp the interns and students. The pseudo-Socratic method of posing a series of rapid-fire, difficult questions is a time-honored method of teaching. Pimping— good pimping—is an art, or so it is reported.<sup>1</sup>Richard Polin and Mark Ditmar have compiled<i>Pediatric Secrets</i>to address questions that are commonly posed in the daily routine of a pediatric teaching hospital. Questions were submitted by house staff at Children's Hospital of Philadelphia and medical students from the University of Pennsylvania. The result is a unique, concise summary of pediatrics. Twenty chapters cover major disciplines in pediatrics. Each chapter is comprised of a series of questions asking, "What are the causes...," "What clinical signs and symptoms...," "What is the treatment for...," and many other broad-based queries.