tbuckley/cabot-search huggingface dataset:
Surgical Mortality as an Indicator of Hospital Quality
Authors: Justin B. Dimick, H. Gilbert Welch, John D. Birkmeyer
Journal: JAMA (2004)

ContextSurgical mortality rates are increasingly used to measure hospital quality. It is not clear, however, how many hospitals have sufficient caseloads to reliably identify quality problems.ObjectiveTo determine whether the 7 operations for which mortality has been advocated as a quality indicator by the Agency for Healthcare Research and Quality (coronary artery bypass graft [CABG] surgery, repair of abdominal aortic aneurysm, pancreatic resection, esophageal resection, pediatric heart surgery, craniotomy, hip replacement) are performed frequently enough to reliably identify hospitals with increased mortality rates.Design and SettingThe US national average mortality rates and hospital caseloads of the 7 operations were determined using the 2000 Nationwide Inpatient Sample (NIS), and sample size calculations were performed to determine the minimum caseload necessary to reliably detect increased mortality rates in poorly performing hospitals. A 3-year hospital caseload was used for the baseline analysis, and poor performance was defined as a mortality rate double the national average.Main Outcome MeasureProportion of hospitals in the United States that performed more than the minimum caseload for each operation.ResultsThe national average mortality rates for the 7 procedures examined ranged from 0.3% for hip replacement to 10.7% for craniotomy. Minimum hospital caseloads necessary to detect a doubling of the mortality rate were 64 cases for craniotomy, 77 for esophageal resection, 86 for pancreatic resection, 138 for pediatric heart surgery, 195 for repair of abdominal aortic aneurysm, 219 for CABG surgery, and 2668 for hip replacement. For only 1 operation did the majority of hospitals exceed the minimum caseload, with 90% of hospitals performing CABG surgery having a caseload of 219 or higher. For the remaining operations, only a small proportion of hospitals met the minimum caseload: craniotomy (33%), pediatric heart surgery (25%), repair of abdominal aortic aneurysm (8%), pancreatic resection (2%), esophageal resection (1%), and hip replacement (&lt;1%).ConclusionExcept for CABG surgery, the operations for which surgical mortality has been advocated as a quality indicator are not performed frequently enough to judge hospital quality.
Alteration of Bile Canalicular Enzymes in Cholestasis. A POSSIBLE CAUSE OF BILE SECRETORY FAILURE
Authors: Francis R. Simon, Irwin M. Arias
Journal: Journal of Clinical Investigation (1973)

Bile secretory failure (cholestasis) may result from several possible mechanisms involved in bile secretion. We have examined the possibility that abnormalities in enzyme content, composition, and turnover of liver plasma membrane constituents are altered in cholestasis.
Screening for medium chain acyl-CoA dehydrogenase deficiency has still not been evaluated
Authors: S. Tanner
Journal: BMJ (2001)

EDITOR—Every baby born in the United Kingdom is screened for phenylketonuria and congenital hypothyroidism at 6-14 days of age. Several screening laboratories now use tandem mass spectrometry for estimating blood phenylalanine concentration. Tandem mass spectrometry can assay simultaneously, in the same sample, many other metabolites and can thus potentially detect other metabolic disorders, including medium chain acyl-CoA dehydrogenase deficiency.

Medium chain acyl-CoA dehydrogenase deficiency is almost as common as phenylketonuria, affecting roughly 1:15 000 births in the United Kingdom. Infants with …
The Retrospective Address: Delivered at the Sixth Anniversary of the Reading Pathological Society
Authors: E. Wells
Journal: BMJ (1847)

Vinesread a paper Og tAe Epidemic Fever then prevalent in Readung.-Mr. Vines said his situation as surgeon to two large parishes in this town, as well as to the ReadIng Dispensary, independently of his private practice, had given bim more ample opportunilies of observing this epidemic than could have been possessed under other circumstances.His observations were intended to include the period of tlle latst twelve months,-viz., from the lstof September, 1845, to the lstof September, 1846.The number of cases which came under his notice during this period, amounted to 306.The smallest nuinber of cases occurred during thie months of January, April, and June, and the largest numnber in February, July, and Aimguist.The numnber of deaths within the same period ainounteJ to twelve, and of tbese, the largest number was in the imonths of March, July, and August, which corresponds nearly to the periods of the greatest amnount of cases.According to this calculation, the average proportion of deaths
Hepatic function is preserved in the absence of mature microRNAs
Authors: Nicholas J. Hand, Zankhana R. Master, John Le Lay, Joshua R. Friedman
Journal: Hepatology (2008)

MicroRNAs (miRNAs) are small noncoding RNA molecules that regulate gene expression through partial or complete complementarity with target messenger RNAs. The function of miRNAs in normal liver physiology is largely unknown. We address the role of Dicer1 in the differentiated liver. We derived mice lacking Dicer1 function in hepatocytes and assessed the loss of mature miRNA via quantitative polymerase chain reaction. Gene expression microarray analysis was performed on liver RNA from mutant and control mice. Liver sections from mutant and control mice were examined and liver function tests were performed. Mice lacking Dicer1 function in hepatocytes appeared and behaved normally. Despite the loss of mature miRNAs, hepatic function was maintained, as reflected by normal blood glucose, albumin, cholesterol, and bilirubin. However, mutant mice between 2 and 4 months of age exhibited progressive hepatocyte damage with elevated serum alanine aminotransferase and aspartate aminotransferase. Liver mass was increased in mutant mice, as were cellular markers of both proliferation and apoptosis. Microarray analysis indicated large-scale changes in gene expression, with increased expression of many miRNA targets, particularly imprinted genes. Conclusions: Loss of miRNA processing in the liver at late gestation has a remarkably mild phenotype, suggesting that miRNAs do not play an essential role in hepatic function. However, miRNA deficiency results in hepatocyte apoptosis, hepatocyte regeneration, and portal inflammation. Finally, microarray analysis of gene expression in the mutant liver supports a previously hypothesized role for Dicer1 in the repression of imprinted genes. (HEPATOLOGY 2008.)
Mechanisms of Insulin Secretion
Authors: Rachmiel Levine
Journal: New England Journal of Medicine (1970)

IN the bodily economy of animals, including man, insulin has evolved into the premier regulator of storage and conservation of the three major foodstuffs. Even the growth hormone of the pituitary gland, which promotes skeletal growth and protein synthesis, requires the presence of insulin for optimum anabolic action. Insulin is produced solely by the beta cells of the islets of Langerhans in the pancreas, and its total daily output is about 1 to 2 mg. The biologic effectiveness of the hormone is very high; about 10 molecules per cell may induce a characteristic hormonal effect.Insulin is a simple protein . . .
THE MYCOSIS FUNGOIDES CELL: THE SKIN WINDOW IN MYCOSIS FUNGOIDES
Authors: LEE J. VESPER, RICHARD K. WINKELMANN, MALCOLM M. HARGRAVES
Journal: British Journal of Dermatology (1971)

SUMMARY.— The skin‐window technique was applied to normal und involved skin sites of 17 patients with mycosis fungoides, 8 patients with parapsoriasis en plaque, and 6 patients with cutaneous lymphomata, and also to normal skin of 25 controls. Large mononuclear cells rapidly migrated in large numbers from plaques of mycosis fungoides and parapsoriasis. Identical cells were seen in skin windows from control sites at later intervals. No malignant cells were found in any of the skin windows of mycosis fungoides or purapsoriasis. Malignant cells were found in cases of malignant cutaneous lymphoma. Comparison of cells found on the skin windows from mycosis fungoides plaques to lymph node imprints indicates that the former are immature reticular cells without neoplastic features. We conclude that mycosis fungoides is a proliferation of these benign immature reticular cells in the skin.
Defining a New Paradigm for Human Arrhythmia Syndromes
Authors: Michael J. Ackerman, Peter J. Mohler
Journal: Circulation Research (2010)

Over the past 15 years, gene mutations in cardiac ion channels have been linked to a host of potentially fatal human arrhythmias including long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. More recently, a new paradigm for human arrhythmia has emerged based on gene mutations that affect the activity of cardiac ion channel- and transporter- associated proteins. As part of the Circulation Research thematic series on inherited arrhythmias, this review focuses on the emerging field of human arrhythmias caused by dysfunction in cytosolic gene products (including ankyrins, yotiao, syntrophin, and caveolin-3) that regulate the activities of key membrane ion channels and transporters.
HOXA10 is a critical regulator for hematopoietic stem cells and erythroid/megakaryocyte development
Authors: Mattias Magnusson, Ann C. M. Brun, Noriko Miyake, Jonas Larsson, Mats Ehinger, Jon Mar Bjornsson, Anton Wutz, Mikael Sigvardsson, Stefan Karlsson
Journal: Blood (2007)
Actions of estradiol on discrete attributes of the luteinizing hormone pulse signal in man. Studies in postmenopausal women treated with pure estradiol.
Authors: J D Veldhuis, W S Evans, A D Rogol, M O Thorner, P Stumpf
Journal: Journal of Clinical Investigation (1987)

We assessed the time-dependent impact of estradiol on properties of the luteinizing hormone (LH) pulse signal in 12 hypoestrogenemic postmenopausal volunteers studied basally and after 1, 5, 10, and 30 d of estradiol delivery via an intravaginal Silastic ring. Computerized analysis of the plasma LH time series revealed a significant decrease in LH pulse frequency within 24 h of estrogen treatment, followed by a secondary increase (days 5 and 10), and then a sustained decline (day 30) in LH pulsatility. Estradiol also significantly suppressed incremental and maximal (but not fractional) LH pulse amplitudes in a biphasic manner. In contrast, LH peak duration was invariant until day 30 of estradiol replacement. These observations indicate that the well recognized biphasic actions of estradiol on mean serum LH concentrations can be modeled in relation to specific and time-dependent alterations in LH pulse frequency and amplitude.
Anticoagulation in patients with atrial fibrillation
Authors: P M W Bath, M M Brown, G A MacGregor
Journal: BMJ (1994)

EDITOR, - We were pleased that our brief paper1 on anticoagulation and atrial fibrillation generated considerable correspondence.2 Many of the points raised were dealt with in the longer paper that we submitted initially, but this was reduced to a short report. Clearly, the point that Saad M B Rassam makes about the validity of the trial results2 applies to all well controlled clinical studies in …
Outcome of pregnancy in leatherworkers.
Authors: A D McDonald, J C McDonald
Journal: BMJ (1986)

A recent proposal that leatherworkers might face a reproductive hazard was tested using data from a large survey in Montreal of occupational factors in pregnancy. The outcome of pregnancy in almost 400 women employed in the manufacture of leather products, some 6000 employed in other types of manufacture, and nearly 50 000 employed but not in manufacture were compared. There was little difference between the groups in the rates of congenital malformation and spontaneous abortion, but the leatherworkers had a significant excess of stillbirths without defect (eight observed compared with fewer than three expected). The possibility of a fetotoxic agent--perhaps a constituent of glues or cements--should be investigated in the leather industry.
Review: Bedside ultrasonography has 82% sensitivity and 99% specificity for blunt intraabdominal injury
Authors: Bruce Adams, Craig Sisson
Journal: Annals of Internal Medicine (2012)

ACP Journal Club21 August 2012Review: Bedside ultrasonography has 82% sensitivity and 99% specificity for blunt intraabdominal injuryBruce Adams, MD, FACEP, Craig Sisson, MD, RDMS, FACEPBruce Adams, MD, FACEPUniversity of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA (B.A., C.S.)Search for more papers by this author, Craig Sisson, MD, RDMS, FACEPUniversity of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA (B.A., C.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-4-201208210-02012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationNishijima DK, Simel DL, Wisner DH, Holmes JF. Does this adult patient have a blunt intra-abdominal injury? JAMA. 2012;307:1517-27. https://pubmed.ncbi.nlm.nih.gov/22496266Clinical Impact RatingsEmergency Med: References1 Silen W, Cope Z. Cope's Early Diagnosis of the Acute Abdomen. 22nd ed. Revised by William Silen. Oxford: Oxford University Press; 2010. Google Scholar2 Akhtar S, Theodoro D, Gaspari R, et al. Resident training in emergency ultrasound: consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference. Acad Emerg Med. 2009;16 Suppl 2:S32-6. [PMID: 20053207] Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA (B.A., C.S.)This article was published at Annals.org on 7 August 2012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByRole of Focused Assessment with Sonography for Trauma in the Assessment of Blunt Abdominal Trauma – A ReviewBlunt Abdominal TraumaAccuracy of Focused Assessment with Sonography for Trauma (FAST) in Blunt Trauma Abdomen—A Prospective StudyChoc hémorragique compliquant un massage cardiaque externe : intérêt de l’échographie au lit du patient 21 August 2012Volume 157, Issue 4Page: JC2-12KeywordsAutopsyComputed axial tomographyLaboratory testsLaparotomyRisk managementSpecificitySystematic reviewsUltrasound imaging ePublished: 21 August 2012 Issue Published: 21 August 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Documentation of an AIDS Virus Infection in the United States in 1968
Authors: Robert F. Garry, Marlys H. Witte, A. Arthur Gottlieb, Memory Elvin-Lewis, Marise S. Gottlieb, Charles L. Witte, Steve S. Alexander, William R. Cole, William L. Drake
Journal: JAMA (1988)

The acquired immunodeficiency syndrome was first recognized as a clinical entity in the United States in the early 1980s; however, the issue of when human immunodeficiency virus, the causative agent of the acquired immunodeficiency syndrome, was introduced into at-risk populations in the United States is unresolved. Previously, we reported the case study of a 15-year-old black male who was admitted to St Louis City Hospital in 1968 for extensive lymphedema of the genitalia and lower extremities. Chlamydial organisms were widely disseminated and isolated from numerous body fluids and organs. Over a 16-month clinical course his condition progressively deteriorated, and at autopsy there was widespread Kaposi's sarcoma of the aggressive, disseminated type. Recently performed Western blot and antigen capture assays on serum and autopsy tissue specimens frozen since 1969 have disclosed that this sexually active teenager was infected with a virus closely related or identical to human immunodeficiency virus type 1. The clinical and immunologic findings together suggest that an immunosuppressive retrovirus existed in the United States before the late 1970s. (<i>JAMA</i>1988;260:2085-2087)
Comparison of four different measures of bronchial responsiveness in asthmatic children
Authors: B. E. Şekerel, Y. Saraçlar, Ö. Kalayci, F. Çetinkaya, A. Tuncer, G. Adalioǧlu
Journal: Allergy (1997)

Although several tests are available to assess the presence and severity of bronchial hyperresponsiveness (BHR), there is no agreement on the most appropriate stimulus. The most commonly used stimuli are methacholine, histamine, and exercise. Daily peak expiratory flow (PEF) variation has been reported to correlate with the severity of BHR, and in recent years this has been widely used because of its noninvasiveness and ease of performance. This study was carried out to determine the relationship among these four commonly used measures of bronchial responsiveness in asthmatic children. For this purpose, 12 asthmatic children of varying disease severity were recruited. Subjects underwent three challenges on 3 separate days in 1 week. During the week preceding the challenges (methacholine, histamine, and exercise), patients recorded PEF three times a day. All patients had PC 20 less than 8 mg/ml with methacholine and histamine. Patients with PC 20 greater than 3.5 mg/ml for both methacholine or histamine had negative exercise challenges. The strongest correlation was between histamine and methacholine ( r =0.95). Exercise‐induced bronchospasm had substantial and significant correlation with the other three measures. No significant correlation was observed between PEF variability and histamine or methacholine. The varying degrees of relationships among the four commonly used measures suggests that each method yields information on different but related phenomena. More than one measure may be required to detect the different aspects of asthmatic bronchial responsiveness.
Meteorism Produced by Nasotracheal Intubation and Ventilatory Assistance
Authors: Joel D. Cooper, Ronald A. Malt
Journal: New England Journal of Medicine (1972)

INITIALLY perplexed by massive intestinal distention complicating the postoperative course of several of our patients on intermittent positive-pressure respiration and leading to rupture of the Stomach in one, we now think that ventilatory assistance through a cuffed nasotracheal airway was at fault. Use of the more comfortable and less injurious nasotracheal tube to replace an orotracheal tube has become commonplace when patients require postoperative ventilatory help for more than a day or two, but this substitution is not without hazard.Case ReportsCase 1. After a retroperitoneal pyelolithotomy in an obese 59-year-old man with pulmonary disease, the orotracheal tube was . . .
Minocycline Exerts Multiple Inhibitory Effects on Vascular Endothelial Growth Factor–Induced Smooth Muscle Cell Migration
Authors: Jianhua S. Yao, Yongmei Chen, Wenwu Zhai, Kaiyan Xu, William L. Young, Guo-Yuan Yang
Journal: Circulation Research (2004)

Widely used tetracycline antibiotics affect many cellular functions relevant to human vascular disease including cell proliferation, migration, and matrix remodeling. We examined whether minocycline inhibited human aortic smooth muscle cell (HASMC) migration induced by vascular endothelial growth factor (VEGF). After the establishment of an optimal dose, minocycline treated HASMC were exposed to VEGF. HASMC migration, matrix metalloproteinase (MMP)-2 and MMP-9 activities, mitogen-activated protein kinase (MAPK), and phosphatidylinositol 3-kinase (PI3K) phosphorylation were determined by smooth muscle cell (SMC) invasion assay, real-time polymerase chain reaction, zymograms, and Western blot analysis, respectively. We demonstrated that VEGF and platelet-derived growth factor (PDGF)-induced SMC migration in a dose-dependent manner. MMP-9, but not MMP-2, mRNA was increased during VEGF stimulation. MMP-9 activity was increased from 1.5- to 2.5-fold in a dose-dependent manner ( P &lt;0.05). Both ERK1/2 and PI3K/AKt pathways were activated during VEGF-induced HASMCs migration. We then demonstrated that minocycline can inhibit VEGF-induced HASMC migration ( P &lt;0.05). The effects may be through the inhibition of MMP-9 mRNA transcription, protein activities and downregulation of ERK1/2 and PI3K/Akt pathway phosphorylation. Our results indicated that minocycline exerts multiple effects on VEGF-induced SMC migration, including inhibition of MMP-9 mRNA transcription and protein activities and downregulating ERK1/2 and PI3K signal pathways, suggesting minocycline may be a potentially therapeutic approach to inhibit disease process induced angiogenesis.
CEREBRAL ANEURYSM WITH RECURRENT LEAKAGE
Authors: R. M. J. Harper
Journal: BMJ (1932)

~- LMEDICAL JOURNAL_ fat overlying Sibson's fascia, and this provides an excel- lent plane in which the dissection can proceed once the openiing in the deep cervical fascia has been enlarged.These observations are founded upon twenty-six examples of " collar-stud " abscess treated by excision.Union by first intention occurred in all save two, both of these being in the supraclavicular region, and having advanced skin involvement.All the end-results have been satisfactory.I desire to make clear that in each case the glandular involvement was strictly limited.
Banning drugs from NHS stifles new development, drug company says
Authors: O. Mashta
Journal: BMJ (2009)

Drug companies are increasingly reluctant to invest money in the research and development of innovative drugs because of fears that their costs might not be met if the drugs were not approved by the National Institute for Health and Clinical Excellence (NICE), according to a drugs expert.

Jon Pender, from GlaxoSmithKline’s government affairs department, said that drug companies were not being rewarded for benefits drugs bring to health, which is stifling creativity because the emphasis is all on cost.

He was speaking during the 2009 Bupa health debate on drug pricing, shown live around …
Streptokinase and Deep Vein Thrombosis
Authors: N. L. Browse, M. L. Thomas, H. P. Pim
Journal: BMJ (1968)

Five patients with deep vein thrombosis were given streptokinase. Five others with similar phlebograms were given anticoagulants, and the results assessed by examining changes in the iliac, femoral, and calf segments of the phlebograms when repeated 7-10 days later. Those of the anticoagulant group were unchanged. Four of the five given streptokinase had a reduction in the size and extent of their thrombosis. Fresh thrombus surrounded by flowing blood was lysed. Thrombus completely blocking a vein was not lysed.The indications for the use of streptokinase in deep vein thrombosis are reviewed.
Absence of plant uptake and translocation of polybrominated biphenyls (PBBs).
Authors: S F Chou, L W Jacobs, D Penner, J M Tiedje
Journal: Environmental Health Perspectives (1978)

Studies of polybrominated biphenyl (PBB) uptake by plants have been conducted in hydroponic solutions and in greenhouse experiments with soil. Autoradiograms of corn and soybean seedlings grown in hydroponic solutions showed no translocation of 14C-PBB from 14C-PBB-treated solutions to plant tops or within the leaf from 14C-PBB-treated spots on the upper leaf surface. A significant portion of the 14C-PBB associated with the roots was removed when the roots were dipped in acetone. Three root crops (radishes, carrots, and onions) were grown in two soils, each treated with a mixture of FireMaster BP-6 (PBB) and 14C-PBB to achieve final concentrations of 100 ppm and 100 ppb. All roots showed more PBB when grown in the soil with the lower clay and organic matter content than they did when grown in the soil with more clay and organic matter. In the latter soil (clay loam) no PBB was detected in any roots from the 100 ppb treatment. More PBB was associated with roots of carrot than of radish or onion. Corn leaf whorls containing dust from a PBB contamination soil and washed radishes from a heavily contaminated garden showed no PBB.