tbuckley/cabot-search huggingface dataset:
Reliability of Bone Scintigraphy for Suspected Scaphoid Fractures
Authors: Frank J. P. Beeres, Mike Hogervorst, Steven J. Rhemrev, Saskia Le Cessie, Jan Willem Arndt, Marcel P. M. Stokkel, Kees A. Bartlema, Jaap F. Hamming
Journal: Clinical Nuclear Medicine (2007)

Purpose: To examine the observer variation for bone scintigraphy in the detection of occult scaphoid fractures in daily practice, using only the early bone scanning images. Methods: One hundred bone scans of patients with a suspected scaphoid fracture but negative initial radiographs were prospectively included to calculate the inter- and intraobserver variation. Three nuclear medicine physicians independently evaluated all bone scans at 2 different points in time with a 3-month interval. The observers filled out a blinded scoring sheet for each patient. They scored if a scaphoid fracture was present or not. In addition, they scored the presence or absence of another fracture. The inter- and intraobserver variation was analyzed using the κ statistic. Results: The interobserver variation showed substantial agreement for a scaphoid fracture and almost perfect agreement for another fracture. The intraobserver variation showed almost perfect agreement for both a scaphoid fracture and another fracture. Conclusions: In the present study, early static images of bone scintigraphy for suspected scaphoid fractures showed very little inter- and intraobserver variation. In addition, expertise does not seem to have a negative influence on the results. This enhances the possibility of using bone scintigraphy in daily practice.
Measles Eradication? Data Suggest Reaching Goal Will Be Challenge
Authors: Charles Marwick
Journal: JAMA (1991)

THERE ARE indications that 1991 will see fewer US measles cases than 1990. But eradicating this disease in the United States—to say nothing of worldwide—clearly continues to pose a major challenge for those who are pursuing this goal (<i>JAMA</i>. 1991;265:2095-2096). In the past year (1990), there may have been as many as 30 000 US cases (50% more than in 1989), with nearly 100 deaths. In fact, one of every five persons with rubeola was hospitalized (for a total of at least 15 000 hospital days nationwide). If all 97 measles-associated deaths reported for 1990 are confirmed, says William Atkinson, MD, Centers for Disease Control (CDC), Atlanta, Ga, this will be the largest US toll from measles since 1966 (<i>JAMA</i>. 1966;196:29-30,38-39 and 1967;200:27). Some 203 000 cases were reported that year—comparatively low in comparison with the previous 20 years (<i>JAMA</i>. 1967;199:32)—but 261 deaths were attributed to the disease. There's no
Gastroenteritis of infancy.
Authors: A G Ironside
Journal: BMJ (1973)

Professor of Greek tells me that he truly believes the classics have made him what he is. This is a very grave statement, if well founded. Indeed, I have heard the same argument from a great many Latin and Greek scholars. They all claim, with some heat, that Latin and Greek have practically made them what they are. This damaging charge against the classics should not be too readily accepted. In my opinion some of these men would have been what they are, no matter what they were.?Stephen Leacock.
Precordial Scanning
Authors: WILLIAM P. CORNELL, EUGENE BRAUNWALD, ANDREW G. MORROW
Journal: Circulation (1961)

A precordial scanning technic and its application in the detection of left-to-right cardiac shunts in 75 patients are described. I 131 -labeled Diodrast was injected into an antecubital vein, its concentration in the central circulation was metered by means of a scintillation detector, and the time-concentration curve were recorded directly. In patients with left-to-right shunts these curves were modified in a characteristic fashion; the build-up time was normal, but the disappearance of isotope from the central circulation was slow. The product of the build-up time and disappearance rate was generally lower than in patients without cardiac shunts. The clinical value of this simple technic in detecting or excluding the presence of left-to-right shunts is discussed.
Relation of Basal Metabolic Rate to Vasodilatation and Vasoconstriction of the Extremities of Normal Subjects as Measured by Skin Temperatures
Authors: GRACE M. ROTH, CHARLES SHEARD
Journal: Circulation (1950)

Various indirect methods of measuring blood flow in the peripheral blood vessels of man are available. Irrespective of the method used for measuring blood flow, certain fundamental factors concerned with the status of the subject or patient influence the measurement of blood flow. These factors are environmental temperature, position of the extremities and food. The present investigation indicates that a consideration of the basal metabolic rate or basal heat production is another important factor.
Further studies of sulphasalazine metabolism in the treatment of ulcerative colitis.
Authors: G O Cowan, K M Das, M A Eastwood
Journal: BMJ (1977)

Sixty-four outpatients with ulcerative colitis receiving maintenance treatment with sulphasalazine were studied to relate disease activity to serum concentrations of sulphapyridine. Of 43 patients in remission, 32 had serum sulphapyridine levels over 20 microgram/ml. Ten of the 21 patients with active disease were for various reasons taking inadequate doses of sulphasalazine, as indicated by low serum sulphapyridine levels, and of the remaining 11 patients, who had serum levels over 20 microgram/ml, nine had faecal stasis proximal to active distal colitis and went into remission when treated with hydrophilic colloid or bran and an unchanged sulphasalazine dosage. This suggests that to be effective the metabolites of sulphasalazine must be delivered in the faeces to the lumen of the diseased distal segment of the colon. High serum concentrations of sulphapyridine produce side effects; therefore slow acetylators of sulphapyridine need lower doses of sulphasalazine. Estimations of serum sulphapyridine concentrations, as well as identifying the patient's acetylation phenotype, can also be useful in assessing his compliance with treatment.
Disorders of Peripheral Nerves
Authors: Lawrence C. McHenry
Journal: JAMA (1984)

Disorders of the peripheral nerves are one of the most difficult and often frustrating parts of neurology. This is amply shown by the amount of new research on diseases of the peripheral nervous system in the past ten years. This complex, and what might be considered tedious subject, has been brought into clear focus by Schaumburg, Spencer, and Thomas in the latest addition to the<i>Contemporary Neurology</i>Series library. Using a terse style, these authors have managed to reduce an overwhelming amount of material to a manageable form. The first two of 20 chapters present an up-to-date review of basic concepts and the new terminology and anatomic classification of disorders of peripheral nerves. Clear diagrams and charts aid the reader's understanding of recent developments. Following a concise review of the Gullain-Barré syndrome and related disorders (the inflammatory polyneuropathies) are six chapters devoted to the metabolic and nutritional neuropathies. An important
A CASE OF SIMPLE STRICTURE OF THE COMMON BILE DUCT TREATED BY A PLASTIC OPERATION
Authors: B. G. A. Moynihan
Journal: BMJ (1905)

the chemist, and Lambecius the bibliographer.He had read widely-Purchas, His Pilgrims, the travels of de la Martiniore in the Arctic regions, Raleigh's History of the World, Ashmole's Order of the Garter, and the Duchess of Newcastle's New Blazing World.His father advised him to study Cicero, and not to read much of Lucretius.Quotations may be taken from it, says Sir Thomas, but otherwise I do not much recommend the reading or studying of it, there being divers impieties in it, and 'tis no credit to be punctually versed in it; it containeth the Epicurean natural philosophy.iBesides his university examination, which was a kind of dispu- tation, Edward Browne was no doubt examined in this College for admisaion as a chndidate in I668, after he had been engaged in medical studies for about ten years.He took his M.D. degree at Oxford in I667, when he had studied nine years, and in his own University in I670.This degree was probably given on proof of study in the faculty.It was chiefly in less regulated periods and work that this course of education differed from that of a physician in our time.There were as yet no organized schools of medicine in England, and except in this College there was no thorough examination of candidates.The study of history is most worth pursuing when the con- sideration of the past can be made useful to us in the pre- Eent.The lesson, " Ars longa, vita brevis," is plain enough wherever we contemplate the attempts of men to learn and to teach medicine.
An Anatomical Disputation Concerning the Movement of the Heart and Blood in Living Creatures
Authors: Lester S. King
Journal: JAMA (1977)

William Harvey's book, demonstrating the circulation of the blood (1628), is probably the most important medical text ever published. Written in Latin, it has been several times translated into English, most recently in 1957 by Kenneth Franklin. He provided a good translation and also included in his book the original Latin, so that readers who had adequate Latin could compare his rendition with the original. Translation is a difficult task. How literal should a rendition be? How much freedom is allowable? How much paraphrase? How can we deal with specific words of technical import whose meaning has changed over the centuries? To what degree can we keep both the spirit and the letter of the original and yet provide an idiomatic rendition into a different language? Franklin's translation is by no means perfect, and Gweneth Whitteridge, who had devoted many years to the close study of Harvey's thought and language,
Social deprivation and health. Wealth redistribution has its price.
Authors: B G Charlton
Journal: BMJ (1993)

In deprived areas general practitioners need to work in the community with community health workers, benefits rights workers, health promotion officers, and housing officers to ameliorate the multifactorial problems caused by socioeconomic, educational, and health deprivation.Social policies aimed at a more equitable distribution of wealthby empowering deprived people through educa- tional and employment opportunities-are needed to reverse the dramatic widening of the healthwealth gap.5The message is clear.To reverse the marginalisation of disadvantaged areas additional resources must be targeted in health, education, and employment if the targets of The Health of the Nation are to have any chance of being met.Disproportionately greater resources are needed to give deprived people an average chance of health.
Ethics Committees, Due Process, and Compassion
Authors: Thomas E. Finucane
Journal: Annals of Internal Medicine (1994)

Letters1 September 1994Ethics Committees, Due Process, and CompassionJohn La Puma, MD and David Schiedermayer, MDJohn La Puma, MDSearch for more papers by this author and David Schiedermayer, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-5-199409010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Better research is needed on the quality, processes, and outcomes of ethics consultation, whether done by individual ethics consultants or by committee members. A recent article on ethics committees and an accompanying editorial [1, 2] support this view, although neither suggests quality standards that ethics consultants should be expected to meet.We have researched potential standards of quality in ethics consultation [3, 4] and have developed measurable indicators oriented to the patient or surrogate and to the provider. Our quality standards are high, in line with an era of unprecedented assessment and accountability. As practical clinical ethics ...References1. Fleetwood J, Unger SS. Institutional ethics committees and the shield of immunity. Ann Intern Med. 1994; 120:320-5. Google Scholar2. Fletcher JC, Hoffman DE. Ethics committees: time to experiment with standards. Ann Intern Med. 1994; 120:335-8. Google Scholar3. Anzia DJ, La Puma J. Quality care and clinical ethics. QRB Qual Rev Bull. 1992; 18:21-3. Google Scholar4. La Puma J, Schiedermayer D. Ethics Consultation: A Practical Guide. Boston: Jones and Bartlett; 1994. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLatent Copper Deficiency in Patients Receiving Low-Copper Enteral Nutrition for a Prolonged Period 1 September 1994Volume 121, Issue 5Page: 386-387KeywordsResearch quality assessment Issue Published: 1 September 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Evaluation of Pulmonary Artery Stiffness in Pulmonary Hypertension With Cardiac Magnetic Resonance
Authors: Javier Sanz, Mbabazi Kariisa, Santo Dellegrottaglie, Susanna Prat-González, Mario J. Garcia, Valentin Fuster, Sanjay Rajagopalan
Journal: JACC. Cardiovascular imaging (2009)
Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study
Authors: L. Gattinoni, D. Mascheroni, A. Torresin, R. Marcolin, R. Fumagalli, S. Vesconi, G.P. Rossi, F. Rossi, S. Baglioni, F. Bassi, G. Nastri, A. Pesenti
Journal: Intensive Care Medicine (1986)
Structured models of semantic cognition
Authors: Charles Kemp, Joshua B. Tenenbaum
Journal: Behavioral and Brain Sciences (2008)

Abstract Rogers &amp; McClelland (R&amp;M) criticize models that rely on structured representations such as categories, taxonomic hierarchies, and schemata, but we suggest that structured models can account for many of the phenomena that they describe. Structured approaches and parallel distributed processing (PDP) approaches operate at different levels of analysis, and may ultimately be compatible, but structured models seem more likely to offer immediate insight into many of the issues that R&amp;M discuss.
Reflections on Postgraduate Medical Education for Practicing Physicians
Authors: Laurence B. Ellis
Journal: New England Journal of Medicine (1954)

THE continuing professional education of practicing physicians constitutes one of the most important, difficult and neglected problems facing American medicine today. It is unnecessary to labor the point that the complexity and rapidity of developments in all branches of medical knowledge have forced the modern physician to be continually going to school if he is to be considered competent and well trained. It is no longer sufficient for a man to have a background of study in a good medical school and as an intern and resident. Granted, therefore, that the doctor needs retraining, a corollary is that the general . . .
α‐Thalassemia and β‐thalassemia in a turkish family
Authors: C. Altay, B. Say, S. Yetgin, Titus H. J. Huisman
Journal: American Journal of Hematology (1977)

Abstract A Turkish family is described in which three children have a clinical picture similar to that of thalassemia major, with typical red cell morphology and indices, and with about 10% Hb Bart's but without measurable amounts of Hb H. Hematological evaluation of six members of this family that included in vitro hemoglobin synthesis suggests that β‐ (or δβ‐) thalassemia, β‐silent thalassemia, and mild and severe α‐thalassemia genes are present in different combinations. The data indicate that β/α chain ratios in patients with more than one type of thalassemia should be evaluated in relationship to values obtained for several relatives even though some of the thalassemia determinants may be silent in the parents.
Vascular Endothelin-B Receptor System In Vivo Plays a Favorable Inhibitory Role in Vascular Remodeling After Injury Revealed by Endothelin-B Receptor–Knockout Mice
Authors: Nobuyuki Murakoshi, Takashi Miyauchi, Yoshihiko Kakinuma, Takashi Ohuchi, Katsutoshi Goto, Masashi Yanagisawa, Iwao Yamaguchi
Journal: Circulation (2002)

Two subtypes of endothelin (ET) receptors, ET(A) and ET(B), are distributed in vascular smooth muscle cells to cause contraction and proliferation. Vascular endothelial cells express only ET(B) receptors, which cause NO release. Although ET(A) receptor blockade is reported to be effective in ameliorating vascular remodeling, there is no report on the long-term effect of ET(B) receptor blockade on vascular remodeling after injury.ET(B) receptor-knockout (KO) mice, which were genetically rescued from lethal intestinal aganglionosis, and wild-type (WT) mice underwent complete ligation of the right common carotid artery, ie, a blood flow cessation model of vascular remodeling. Fourteen days after ligation, the intimal area, the ratio of intimal to medial areas, and the stenotic ratio in the ligated artery of KO mice were significantly increased compared with those of WT mice. The expression level of ET-1 mRNA in the ligated artery of KO mice was increased similarly to that of WT mice, whereas tissue NO(x) levels in lesions of KO mice were significantly lower than those of WT mice. Long-term treatment with the ET(A) receptor antagonist TA-0201 (0.5 mg x kg(-1) x d(-1)) significantly ameliorated vascular stenosis in both groups. Long-term treatment with the ET(B) receptor antagonist A-192621 (30 mg x kg(-1) x d(-1)) worsened vascular remodeling in WT mice.We demonstrated that inhibition of the ET(B) receptor system is harmful for vascular remodeling after injury, the mechanism of which is partly attributed to decreased NO release, in KO mice. These results suggest that the overall effect of vascular ET(B) receptors is antiproliferative in the injured artery.
Association between Ascending Aorta Dilatation and Serum γ-Glutamyltransferase Levels
Authors: Bilal Geyik, Çağdaş Kaynak, Özcan Özdemir, Aykut Yılmaz, Mustafa Yılmaztepe, Gökay Taylan, İbrahim Özyamaç, Flora Özkalaycı, Selçuk Öztürk, Ali Manav, Uğur Özkan, Yücel Kaçmaz, Nasır Sivri
Journal: Journal of the American College of Cardiology (2013)
Complication of Dicumarol Therapy
Authors: H. B. Eisenstadt
Journal: JAMA (1961)

To the Editor:—  An unusual complication of dicumarol therapy was reported inThe Journal, Dec. 10, p. 1939. The authors, however, did not mention at first that hemopericardium has been observed in connection with myocardial infarction in the absence of anticoagulant administration. They also do not discuss the reasons for deviating from the usual method recommended for myocardial infarction, which consists of immediate administration of both heparin and dicumarol, with reduction and deletion of heparin shortly after the therapeutic prothrombin level has been reached. It is difficult to ascribe the bleeding to dicumarol in their case because they had given heparin, 100 mg., every 6 hours for 16 days exclusively before they started dicumarol, and might have depleted some coagulation factors not demonstrated with the coagulation time test.  As the patient was getting along well there was no need to suddenly give such a large dose of 450 mg. of
Intracavitary Cardiac Pacing
Authors: Nathan K. Jensen
Journal: JAMA (1966)

Complications developed in four patients with heart block managed by permanent transvenous cardiac pacemaking; the complications were penetration and perforation of the right ventricle, fracture of the catheter electrode, and pacemaker-induced ventricular tachycardia-fibrillation. Analysis of these problems led to recommendations for improvement in this method of pacing.
Noninvasive evaluation of pulmonary artery pressure during exercise by saline-enhanced Doppler echocardiography in chronic pulmonary disease.
Authors: R B Himelman, M Stulbarg, B Kircher, E Lee, L Kee, N C Dean, J Golden, C L Wolfe, N B Schiller
Journal: Circulation (1989)

To determine the feasibility of noninvasive determination of right ventricular systolic pressure (RVSP) during a graded-exercise protocol, saline contrast-enhanced Doppler echocardiography of tricuspid insufficiency was performed in 36 patients with chronic lung disease and 12 normal controls. In the patients with chronic pulmonary disease, symptom-limited, incremental supine bicycle exercise and pulse oximetry were performed on and off high-flow oxygen. Technically adequate Doppler studies were initially obtained in 20 patients (56%) at rest and 14 (39%) on exercise; these numbers increased to 33 (92%) and 32 (89%), respectively, after enhancement with agitated saline (both p less than 0.001). In 10 patients with chronic lung disease who had simultaneous hemodynamic monitoring during exercise, the correlation between Doppler and catheter measurements of pulmonary artery systolic pressure was close (r = 0.98). Among controls, RVSP increased from 22 +/- 4 at rest (mean +/- SD) to 31 +/- 7 mm Hg at peak exercise. In patients with chronic lung disease, RVSP increased from 46 +/- 20 to 83 +/- 30 mm Hg (both p less than 0.001 vs. controls). Despite normal resting values for RVSP in 28% of study patients, nearly all showed abnormal increases in RVSP during supine bicycle exercise. Increases in RVSP during exercise were greatest in patients who showed oxyhemoglobin desaturation. The short-term administration of oxygen significantly blunted the increase in RVSP during exercise. Saline contrast-enhanced Doppler evaluation of tricuspid insufficiency seems a potentially valuable noninvasive method of determining the exercise response of RVSP in patients with chronic pulmonary disease.
A Benchmark for Evaluating Innovative Treatment of Left Main Coronary Disease
Authors: Joseph F. Sabik, Eugene H. Blackstone, Michael Firstenberg, Bruce W. Lytle
Journal: Circulation (2007)

Left main trunk stenosis (> or = 50%) has traditionally been treated with coronary artery bypass grafting. Improvements in coronary stents have led some to advocate percutaneous coronary intervention. To provide a benchmark of outcomes against which percutaneous coronary intervention may be compared, we (1) assessed survival and freedom from coronary reintervention after coronary artery bypass grafting in these patients and (2) identified their risk factors.From 1971 to 1998, the first 1000 primary coronary artery bypass grafting patients (n=26,927) were followed every 5 years. Of these, 3803 had left main trunk stenosis > or = 50%. A multivariable, nonproportional hazards, time-related analysis was performed to model survival and freedom from coronary reintervention (percutaneous coronary intervention or reoperation) and to identify their risk factors. Survival at 30 days, 1, 5, 10, 15, and 20 years was 97.6%, 93.6%, 83%, 64%, 44%, and 28%, respectively, and freedom from coronary reintervention was 99.7%, 98.9%, 96.6%, 89%, 76%, and 61%, respectively. Worse left ventricular function (P<0.0001), diabetes (P<0.0001), hypertension (P<0.001), peripheral arterial disease (P=0.0002), smoking (P<0.0001), and elevated triglycerides (P=0.01) decreased survival, and younger age (P<0.0001), elevated triglycerides (P=0.005), and incomplete revascularization (P=0.003) increased coronary reintervention. Internal thoracic artery grafting of the left anterior descending improved survival and decreased coronary reintervention.This study provides a 20-year outcome benchmark for surgical treatment of left main trunk disease. It indicates that simple comparisons of new treatments are inadequate without risk adjustment. Risk factor adjustment should be used when comparing coronary artery bypass grafting with current and future treatment innovations and when selecting the best treatment strategy for individual patients.