tbuckley/cabot-search huggingface dataset:
Helping with the Math Homework
Authors: JOHN STONE
Journal: Annals of Internal Medicine (1979)

Ad Libitum1 December 1979Helping with the Math HomeworkJOHN STONE, M.D.JOHN STONE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-6-923_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn the beginningthere were polynomialsdifferences of squarestrial and errorand the sum of two cubes.X2 minus Y2has always hadthe same meaningwhatever it is.But when Pythagoraslooked intothe eye of the triangleand saw the solutionI wasn't there.Nor have I ever foundanything morethan safety in numbers.This is the new maththese are your problemsand I was bornbefore the back of the book.What I have been saying is this:I can lead youonly so far into wisdom.Soonyou must begin to learnhow... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Atlanta, Georgia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1979Volume 91, Issue 6Page: 923-923KeywordsSafety ePublished: 1 December 2008 Issue Published: 1 December 1979 PDF downloadLoading ...
A NICE example? Variation in provision of bariatric surgery in England
Authors: A. Owen-Smith, R. Kipping, J. Donovan, C. Hine, C. Maslen, J. Coast
Journal: BMJ (2013)

Demand for surgery to treat morbid obesity outstrips supply. <b>Amanda Owen-Smith and colleagues</b> find regional commissioning policies are not consistent with NICE guidance and provision of surgery varies widely
Nasogastric Feeding in the Elderly
Authors: K. Sriram
Journal: JAMA (1984)

To the Editor.—  Your consultant's answers to the question on  Feeding in the Elderly 1 are vague. I would like to add a few important points. The decision to prolong life or not is difficult, and, unfortunately, there are no clear legal guidelines that physicians can depend on.  Nasogastric feeding using soft, thin tubes 2 does not cause physical discomfort. However, for ease of administration and long-term maintenance, a feeding gastrostomy or jejunostomy is necessary (and not gastroenterostomy, as mentioned in the answer). The former is ideal for uncooperative patients who frequently pull out tubes, but leakage of gastric contents with skin excoriation, aspiration, or tube migration is a serious problem. A feeding jejunostomy, performed with meticulous surgical detail, is most ideal for long-term enteral nutrition.  Continuous feeding is unphysiological and limits patients' activity. Intermittent (or bolus) feedings via a jejunostomy are not well tolerated and can be used
W. T. G. Morton and the Ether Dome
Authors: Ellsworth C. Larson
Journal: JAMA (1965)

<h3>To the Editor:—</h3> In the section onMEDICAL NEWSin Oct 11. 1965, issue ofThe Journal(<b>194</b>:31) appears an item reporting "Ether Dome To Be Dedicated As a National Historic Site" at Massachusetts General Hospital. This article is replete with the names of medical notability who will participate in this ceremony. But not mentioned anywhere here is the name of the man who first introduced ether as a general anesthetic in the "Ether Dome." I think that this is a lamentable omission. These eminent contemporary physicians, the visitors who attend the dedication, and the readers ofThe Journalcould well be reminded that some of the most memorable contributions to medicine and to the welfare of humanity have come from without the exclusive domain of the profession of medicine. It was as a medical student at Harvard University School of Medicine that William Thomas Green Morton gave the
Evidence of Airway Inflammation and Remodeling in Ski Athletes with and without Bronchial Hyperresponsiveness to Methacholine
Authors: EEVA-MAIJA KARJALAINEN, ANNIKA LAITINEN, MALCOLM SUE-CHU, ALAN ALTRAJA, LEIF BJERMER, LAURI A. LAITINEN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Asthma-like symptoms, methacholine hyperresponsiveness, and use of asthma medication are prevalent in elite cross-country skiers. We quantitated mucosal inflammatory cell infiltration and tenascin expression in the subepithelial basement membrane in endobronchial biopsy specimens of the proximal airways from 40 elite, competitive skiers (mean: 17.5; range: 16 to 20 yr) without a diagnosis of asthma, in 12 subjects with mild asthma, and in 12 healthy controls, through immunohistochemistry and indirect immunofluorescence, respectively. All of the subjects were nonsmokers. T-lymphocyte, macrophage, and eosinophil counts were, respectively, greater by 43-fold (p < 0.001), 26-fold (p < 0.001), and twofold (p < 0.001) in skiers, and by 70-fold (p < 0.001), 63-fold (p < 0.001), and eightfold (p < 0.001) in asthmatic subjects than in controls. In skiers, neutrophil counts were more than twofold greater than in asthmatic subjects, and mast cell counts were not significantly different than in controls. Tenascin expression (as measured through the thickness of the tenascin-specific immunoreactivity band in the basement membrane) was increased in skiers (median: 6.7 μ m; interquartile range [IQR]: 5.3 to 8.5 μ m, p < 0.001) and asthmatic subjects (mean: 8.8 μ m; IQR: 7.2 to 10.8 μ m, p < 0.001) compared with controls (mean: 0.8 μ m; IQR: 0 to 3.1 μ m) and did not correlate with inflammatory cell counts. Inflammatory changes were present irrespective of asthmalike symptoms, hyperresponsiveness, or atopy. Prolonged repeated exposure of the airways to inadequately conditioned air may induce inflammation and remodeling in competitive skiers.
The effect of age on heart rate in subjects free of heart disease. Studies by ambulatory electrocardiography and maximal exercise stress test.
Authors: J B Kostis, A E Moreyra, M T Amendo, J Di Pietro, N Cosgrove, P T Kuo
Journal: Circulation (1982)

To delineate the effects of true aging, undetected heart disease and deconditioning on heart rate, we performed 24-hour ambulatory electrocardiography and maximal exercise stress test on 101 subjects with normal hearts. The maximal heart rate recorded was 180 beats/min; the minimum was 35 beats/min. A distinct diurnal pattern was observed. With increasing age, a decrease of the maximal heart rate achieved during exercise stress test (r = 0.27, p = 0.05) or spontaneously recorded during the day (r = 0.41, p = 0.0005) or night (r = 0.24, p = 0.03) was observed. The resting and average heart rates were not affected by age. Older subjects had lower exercise tolerance (r = 0.41, p = 0.0001). Low exercise tolerance was associated with higher increments of heart rate for submaximal exercise levels (r = 0.0001) and lower maximal heart rates (r = 0.43, p - 0.008). These changes of heart rate with age are not due to undetected cardiac disease, because the subjects included in the study were meticulously screened by noninvasive and invasive means.
Health Status Predicts Long-Term Outcome in Outpatients With Coronary Disease
Authors: John A. Spertus, Philip Jones, Mary McDonell, Vincent Fan, Stephan D. Fihn
Journal: Circulation (2002)

Background — Although patient-reported health status measures have been used as end points in clinical trials, they are rarely used in other settings. Demonstrating that they independently predict mortality and hospitalizations among outpatients with coronary disease could emphasize their clinical value. Methods and Results — This study evaluated the prognostic utility of the Seattle Angina Questionnaire (SAQ), a disease-specific health status measure for patients with coronary artery disease. Patients were enrolled in a prospective cohort study from 6 Veterans Affairs General Internal Medicine Clinics. All patients reporting coronary artery disease who completed a SAQ and had 1 year of follow-up were analyzed (n=5558). SAQ predictor variables were the physical limitation, angina stability, angina frequency, and quality-of-life scores. The primary outcome was 1-year all-cause mortality, and a secondary outcome was hospitalization for acute coronary syndrome (ACS). Lower SAQ scores were associated with increased risks of mortality and ACS admissions. Prognostic models controlling for demographic and clinical characteristics demonstrated significant independent mortality risk with lower SAQ physical limitation scores; odds ratios for mild, moderate, and severe limitation were 1.5, 2.0, and 4.0 versus minimal limitation ( P &lt;0.001). Odds ratios for mild, moderate, and severe angina frequency were 0.8, 1.2, and 1.6 ( P =0.078). The odds ratios for ACS admission among those with mild, moderate, and severe angina frequency were 1.4, 2.0, and 2.2, respectively ( P =0.016). Conclusions — SAQ scores are independently associated with 1-year mortality and ACS among outpatients with coronary disease and may serve a valuable role in the risk stratification of such patients.
Effects of chitin and chitosan particles on BALB/c mice by oral and parenteral administration
Authors: Yoshinori Tanaka, Shin-ichiro Tanioka, Miyoko Tanaka, Takahiko Tanigawa, Yukisato Kitamura, Saburo Minami, Yoshiharu Okamoto, Mariko Miyashita, Masanobu Nanno
Journal: Biomaterials (1997)
Human recombinant apolipoprotein E redirects lipopolysaccharide from Kupffer cells to liver parenchymal cells in rats In vivo.
Authors: P C Rensen, M Oosten, E Bilt, M Eck, J Kuiper, T J Berkel
Journal: Journal of Clinical Investigation (1997)

Chylomicrons have been shown to protect mice and rats against a lethal dose of lipopolysaccharide and may serve as a therapeutic means to protect against endotoxemia. However, the requisite of isolation from human lymph hampers pharmaceutical application. Recently, we developed recombinant chylomicrons from commercially available lipids and human recombinant apolipoprotein E. The current study explored the effectiveness of these apoE-enriched emulsions in redirecting LPS from Kupffer cells to liver parenchymal cells. Upon injection into rats, 125I-LPS rapidly and specifically associated with the liver (64.3+/-3.1% of the injected dose) and spleen (4.1+/-0.7%). The uptake of LPS by the spleen was four- to fivefold reduced upon incubation with the apoE-enriched emulsion or free apoE (P < 0.0001), but not with emulsion alone or Lipofundin. Within the liver, 125I-LPS mainly associated with Kupffer cells. The uptake by Kupffer cells was eight- to ninefold reduced by the apoE-enriched emulsion or apoE alone (P < 0.01), and a 19.6-fold increased uptake ratio by liver parenchymal cells over Kupffer cells was observed. The emulsion without apoE had no effect on the in vivo kinetics of LPS. LPS interacted selectively with the apoE moiety of the recombinant chylomicron. Emulsion-associated and free apoE bound approximately two molecules of LPS, possibly by its exposed hydrophilic domain involving arginine residues. We anticipate that the protecting effect of endogenous chylomicrons against LPS-induced endotoxemia may result from the apoE moiety and that human recombinant apoE may serve as a therapeuticum to protect against endotoxemia.
The Therapy of Acute Granulocytic Leukemia in Patients More Than Fifty Years Old
Authors: VICTOR GRANN
Journal: Annals of Internal Medicine (1974)

The records of ninety-three patients with acute granulocytic leukemia, who were more than 50 years old and were treated at a university hospital, a cancer center, and at seven community hospitals in Connecticut, were reviewed. Twenty-eight, or 44%, of patients treated with cytosine arabinoside and thioguanine attained a complete remission. This was increased to 51%, if patients treated for less than 30 days were excluded. Forty percent of patients in complete remission are alive at 25 months. The median survival time of patients attaining a complete remission was 19 months, as compared with 2 months for patients not attaining a remission. Age had no effect on remission rate, although patients 50 to 59 years of age appear to have a slightly longer survival time. No difference was noted in remission rate or survival of patients treated in the community hospital, cancer center, or university hospital. This study indicates that patients more than 50 years old have the opportunity for nearly the same response rate and survival as younger patients with acute granulocytic leukemia.
Adhesion of human lung microvascular endothelial cells (HLMVEC) is decreased by conditioned media (CM) from D.pteronyssinus-treated confluent human type II alveolar epithelial cells (cA549) containing elevated TGFb1
Authors: A. Capetandes, J. Zimmermann, M. Frieri
Journal: Journal of Allergy and Clinical Immunology (2005)
Selection in Reported Epidemiological Risks: An Empirical Assessment
Authors: Fotini K Kavvoura, George Liberopoulos, John P. A Ioannidis
Journal: PLoS Medicine (2007)

Background Epidemiological studies may be subject to selective reporting, but empirical evidence thereof is limited. We empirically evaluated the extent of selection of significant results and large effect sizes in a large sample of recent articles. Methods and Findings We evaluated 389 articles of epidemiological studies that reported, in their respective abstracts, at least one relative risk for a continuous risk factor in contrasts based on median, tertile, quartile, or quintile categorizations. We examined the proportion and correlates of reporting statistically significant and nonsignificant results in the abstract and whether the magnitude of the relative risks presented (coined to be consistently ≥1.00) differs depending on the type of contrast used for the risk factor. In 342 articles (87.9%), ≥1 statistically significant relative risk was reported in the abstract, while only 169 articles (43.4%) reported ≥1 statistically nonsignificant relative risk in the abstract. Reporting of statistically significant results was more common with structured abstracts, and was less common in US-based studies and in cancer outcomes. Among 50 randomly selected articles in which the full text was examined, a median of nine (interquartile range 5–16) statistically significant and six (interquartile range 3–16) statistically nonsignificant relative risks were presented (p = 0.25). Paradoxically, the smallest presented relative risks were based on the contrasts of extreme quintiles; on average, the relative risk magnitude was 1.41-, 1.42-, and 1.36-fold larger in contrasts of extreme quartiles, extreme tertiles, and above-versus-below median values, respectively (p < 0.001). Conclusions Published epidemiological investigations almost universally highlight significant associations between risk factors and outcomes. For continuous risk factors, investigators selectively present contrasts between more extreme groups, when relative risks are inherently lower.
Tick-Borne Diseases — A Growing Risk
Authors: Daniel B. Fishbein, David T. Dennis
Journal: New England Journal of Medicine (1995)

Ten tick-borne diseases are now recognized in the United States. Three of these have been discovered in the past three decades: Lyme disease in the 1970s, human ehrlichiosis (caused by Ehrlichia chaffeensis) in the 1980s, and a new human ehrlichial infection, human granulocytic ehrlichiosis, in the 1990s.1 Tick-borne diseases have challenged researchers and physicians since studies in the early 1900s established the wood tick (Dermacentor andersoni) as a vector of Rocky Mountain spotted fever. This disease, although uncommon, was widely feared because of its case fatality rate of 70 percent. Deaths decreased dramatically after the introduction of . . .
Detection of functionally altered hepatitis C virus-specific CD4+ T cells in acute and chronic hepatitis C
Authors: Axel Ulsenheimer, J. Tilman Gerlach, Norbert H. Gruener, Maria-Christina Jung, Carl-Albrecht Schirren, Winfried Schraut, Reinhart Zachoval, Gerd R. Pape, Helmut M. Diepolder
Journal: Hepatology (2003)

Chronic hepatitis C is characterized by a weak or absent hepatitis C virus (HCV)-specific CD4(+) T-cell response in terms of antigen-specific proliferation or interferon gamma (IFN-gamma) secretion. To clarify whether this is due to the absence or functional impairment of antigen-specific CD4(+) T cells we developed an assay that relies on the induced expression of the T-cell activation marker CD25 and is therefore independent from cytokine secretion or proliferation. In 10 of 20 patients with chronic hepatitis C, a significant number of antigen-specific activated CD4(+) T cells (mean 1.06%/patient; range, 0% to 5.2% of CD4(+) T cells) could be shown, whereas antigen-specific proliferation was present in only 1 of 20 patients. IFN-gamma secretion was absent in all 13 patients tested. However, significant antigen-specific interleukin 10 (IL-10) and transforming growth factor beta (TGF-beta) secretion was present in 6 of 10 and 3 of 10 patients, respectively. In 8 patients with acute hepatitis C, irrespective of disease outcome, HCV-specific CD4(+) T cells were detected in all patients and at a significantly higher frequency (mean 3.7%/patient; range, 1.16% to 7.17%) in the first weeks of disease. A chronic course of disease was associated either with a loss of both IFN-gamma secretion and proliferation, resembling an anergic state, or a loss of T-cell proliferation followed by a rapid decline in IFN-gamma-producing cells, corresponding to exhaustion of the specific immune response. In conclusion, functional changes of HCV-specific CD4(+) T cells or failure to develop a long-lasting T-helper response may contribute to chronic hepatitis C viral persistence.
The “Chinese room” argument and patient education
Authors: Gérard Reach
Journal: BMJ (2008)

Consultations with Mrs L are difficult: sometimes, she comes without her diabetes logbook, or forgets to have the requested HbA1c assay. Above all, she comes either alone or accompanied by someone who, like herself, speaks nothing but Chinese. All I can do, in order to understand her repeatedly high HbA1c levels, is to look at her logbook and try to understand the documented insulin doses and the blood glucose concentrations. 

Recently, I admitted her to hospital. Firstly, we verified that the technical aspects of blood glucose determination and insulin injection were perfectly correct. I also told her that I needed an interpreter. A Chinese neighbour who was fluent in French came with Mrs L on the …
A MALAPROPISTIC "MITIGATES"
Authors: HERMAN KLEIN
Journal: Annals of Internal Medicine (1968)

Letters and Comments1 September 1968A MALAPROPISTIC "MITIGATES"HERMAN KLEIN, M.D.HERMAN KLEIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-69-3-641_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:I wish to point out that on p. 1296 of the June 1968 issue of the ANNALS(see penultimate line of Summary), the word should be "militates against" and not "mitigates." This common usage of the word "mitigate" is an error.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HERMAN KLEIN, M.D.Affiliations: Holloman Air Force Base New Mexico 88330 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1968Volume 69, Issue 3Page: 641-641 ePublished: 1 December 2008 Issue Published: 1 September 1968 PDF downloadLoading ...
New variant Creutzfeldt-Jakob disease is more common in Britain than elsewhere
Authors: J W Ironside, R S G Knight, R G Will, P G Smith, S N Cousens
Journal: BMJ (1998)

EDITOR—Although the overall incidence of Creutzfeldt-Jakob disease in the United Kingdom is similar to that in other countries in Europe,1 there is a major difference in terms of new variant Creutzfeldt-Jakob disease2 : 25 cases of new …
Multiple Bronchiolar Stenoses in a Patient with Generalized Airways Obstruction
Authors: J. R. Esterly, B. E. Heard
Journal: Thorax (1965)

PET scans of the mouse brain are usually performed with anesthesia to immobilize the animal. However, it is desirable to avoid the confounding factor of anesthesia in mouse-brain response. <b>Methods:</b> We developed and validated brain PET imaging of awake, freely moving mice. Head-motion tracking was performed using radioactive point-source markers, and we used the tracking information for PET-image motion correction. Regional <sup>18</sup>F-FDG brain uptake in a test, retest, and memantine-challenge study was measured in awake (<i>n</i> = 8) and anesthetized (<i>n</i> = 8) C57BL/6 mice. An awake uptake period was considered for the anesthesia scans. <b>Results:</b> Awake (motion-corrected) PET images showed an <sup>18</sup>F-FDG uptake pattern comparable to the pattern of anesthetized mice. The test–retest variability (represented by the intraclass correlation coefficient) of the regional SUV quantification in the awake animals (0.424–0.555) was marginally lower than that in the anesthetized animals (intraclass correlation coefficient, 0.491–0.629) over the different regions. The increased memantine-induced <sup>18</sup>F-FDG uptake was more pronounced in awake (+63.6%) than in anesthetized (+24.2%) animals. Additional behavioral information, acquired for awake animals, showed increased motor activity on a memantine challenge (total distance traveled, 18.2 ± 5.28 m) compared with test–retest (6.49 ± 2.21 m). <b>Conclusion:</b> The present method enables brain PET imaging on awake mice, thereby avoiding the confounding effects of anesthesia on the PET reading. It allows the simultaneous measurement of behavioral information during PET acquisitions. The method does not require any additional hardware, and it can be deployed in typical high-throughput scan protocols.
Idiopathic Thrombocytopenic Purpura: Detection of Accessory Splenic Tissue
Authors: DIETLIND L. WAHNER-ROEDLER, H CLARK HOAGLAND, HEINZ W. WAHNER
Journal: Clinical Nuclear Medicine (1981)

The presence of Howell-Jolly bodies in the peripheral blood smear does not rule out the possibility that small amounts of splenic tissue are present. The liver-spleen scintigram appears to be the most sensitive test at this time for the detection and localization of functional accessory splenic tissue. Three of seven patients with idiopathic thrombocytopenic purpura and splenectomy had no Howell-Jolly bodies before removal of an accessory spleen. Therefore, the performance of a routine blood smear as the only test appears to be of limited value. Our data and a review of the literature do not allow a definitive statement as to the effectiveness of accessory splenectomy in patients with recurrent idiopathic thrombocytopenic purpura and with accessory splenic tissue. However, until this is clarified, accessory splenectomy should be considered as a possible therapeutic modality.
A novel missense mutation of SLC7A9 frequent in Japanese cystinuria cases affecting the C-terminus of the transporter
Authors: Y. Shigeta, Y. Kanai, A. Chairoungdua, N. Ahmed, S. Sakamoto, H. Matsuo, D.K. Kim, M. Fujimura, N. Anzai, K. Mizoguchi, T. Ueda, K. Akakura, T. Ichikawa, H. Ito, H. Endou
Journal: Kidney International (2006)