tbuckley/cabot-search huggingface dataset:
Nebulizer-Induced Anisocoria
Authors: Karin Lust
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Nebulizer-Induced AnisocoriaKarin Lust, MBBS and Iain Livingstone, MBBSKarin Lust, MBBSRoyal Women's Hospital; Brisbane, Queensland, Australia 4029Search for more papers by this author and Iain Livingstone, MBBSRoyal Women's Hospital; Brisbane, Queensland, Australia 4029Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00041 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 29-year-old woman, gravid III, para II, at 20 weeks' gestation was admitted to an obstetric hospital with shortness of breath. A medical resident was asked to review the case because the patient reported headache and blurred vision and had a dilated right pupil. Prompt review revealed normal vital signs with no meningismus. Respiratory, cardiovascular, and abdominal examinations were unremarkable. Central nervous system examination revealed that the right pupil was fixed and dilated, a finding unassociated with any other neurologic sign. The patient said she had not ingested any medications or used topical ophthalmic drops. On further ...References1. Craig Cr, Stitzel RE, eds. Modern Pharmacology. 2d ed. Boston: Little, Brown; 1986. Google Scholar2. Adams RD, Victor M, eds. Principles of Neurology. 3d ed. New York: McGraw-Hill; 1993. Google Scholar Author, Article, and Disclosure InformationAffiliations: Royal Women's Hospital; Brisbane, Queensland, Australia 4029 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCardiac, Vascular, and Renal DrugsAdverse reactions to anticholinergic agents used in the management of obstructive pulmonary diseaseDrug-induced ocular side effectsCase 2Anisocoria and Topical Carbamate Exposure: Illustrative Case ReportTransient Anisocoria Caused by Aerosolized Ipratropium Bromide Exposure From an Ill-Fitting Face MaskDrug-induced ocular side effectsGlaucoma agudo de ángulo cerrado y bromuro de ipratropioIpratropium bromide 15 February 1998Volume 128, Issue 4Page: 327KeywordsDrugsHeadachesMusclesNerve endingsObstetrics and gynecologyParalysisPatient advocacyPregnancyVisionVital signs Issue Published: 15 February 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Routine Use of the Prothrombin and Partial Thromboplastin Times
Authors: Stephen B. Erban
Journal: JAMA (1989)

The prothrombin time (PT) and activated partial thromboplastin time (APTT) tests are often routinely ordered for hospitalized patients. Ordering patterns and clinical indications for the PT and APTT tests on the medical service at a teaching hospital were studied. Eighty-one percent of all patients admitted to the medical service had a PT and APTT test ordered. When compared with a modified version of guidelines for the use of the PT and APTT tests recently developed by the Medical Necessity Project of the Blue Cross and Blue Shield Associations of America and endorsed by the American College of Physicians, at least 70% of these tests were not clinically indicated. Many of the unindicated tests were ordered prior to invasive procedures or, apparently, out of habit. These inappropriate PT and APTT tests cost at least $60,948 per year for the medical service. Based on these findings, we suggest methods of reducing the inappropriate use of the PT and APTT tests.
Hospital at home or acute hospital care? A cost minimisation analysis
Authors: J. Coast, S. H Richards, T. J Peters, D. J Gunnell, M.-A. Darlow, J. Pounsford
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective:</b> To compare, from the viewpoints of the NHS and social services and of patients, the costs associated with early discharge to a hospital at home scheme and those associated with continued care in an acute hospital. <b>Design:</b> Cost minimisation analysis. <b>Setting:</b> Acute hospital wards and the community in the north of Bristol (population about 224 000). <b>Subjects:</b> 241 hospitalised but medically stable elderly patients who fulfilled the criteria for early discharge to a hospital at home scheme and who consented to participate. <b>Main outcome measures:</b> Costs to the NHS, social services, and patients over the 3 months after randomisation. <b>Results:</b>The mean cost for hospital at home patients over the 3 months was £2516, whereas that for hospital patients was £3292. Under all the assumptions used in the sensitivity analysis, the cost of hospital at home care was less than that of hospital care. Only when hospital costs were assumed to be less than 50% of those used in the initial analysis was the difference equivocal. <b>Conclusions:</b> The hospital at home scheme is less costly than care in the acute hospital. These results may be generalisable to schemes of similar size and scope, operating in a similar context of rising acute admissions. <h3>Key messages</h3> Some economic evaluations have found that hospital at home care is more costly than acute hospital care in the United Kingdom, and others have found that it is less costly Cost minimisation analysis found a mean cost to the NHS and social services of £2516 per hospital at home patient and £3292 per hospital patient For every £10 000 spent, routine hospital care could be provided for three patients, while early discharge to care in the hospital at home scheme could be provided for four patients Sensitivity analysis (making differing assumptions for the cost of both services within reasonable boundaries) does not change the result that hospital at home is less costly than hospital care; only when hospital costs are assumed to be less than 50% of the original estimate does the difference become equivocal Costs to patients were similar in the two arms of the trial
The Comparative Effect on Bone Density, Endometrium, and Lipids of Continuous Hormones as Replacement Therapy (CHART Study)
Authors: Leon Speroff
Journal: JAMA (1996)

To compare the effect of continuous norethindrone acetate (NA)-ethinyl estradiol (EE2) combinations with matching unopposed EE2 or placebo.A 2-year, double-blind, placebo-controlled, parallel-group clinical trial.Outpatients at 65 centers.Asymptomatic or mildly symptomatic women aged 40 years or older who had undergone the onset of spontaneous menopause within the last 5 years and who had an intact uterus.Patients were equally randomized to placebo or 1 of 8 treatment groups: 0.2 mg of NA and 1 microg of EE2; 0.5 mg of NA and 2.5 microg of EE2; 1 mg of NA and 5 microg of EE2; 1 mg of NA and 10 microg of EE2; 1 microg of EE2; 2.5 microg of EE2; 5 microg of EE2; or 10 microg of EE2.Bone mineral density (BMD) measured by quantitative computed tomography, serum lipids, and endometrial effects as assessed by rate of hyperplasia and proliferative status.Twelve hundred sixty-five patients entered the study. Bone mineral density increased significantly from baseline (P<.001) in the 1 mg NA-5 microg EE2 and the 1 mg NA-10 microg EE2 treatment groups at each annual assessment. Among the unopposed EE2 groups, only the 10-microg group had increased BMD above baseline, but also was accompanied by an unacceptably high rate of endometrial hyperplasia. The NA-EE2 treatment groups had a significant linear dose-response trend for increasing BMD. Increased endometrial proliferation and hyperplasia occurred with increasing unopposed estrogen doses. The combination of NA and EE2 effectively protected the endometrium against hyperplasia. The percentage of change in the ratio of high-density lipoprotein cholesterol to low-density lipoprotein cholesterol was positive for all treatment groups. The increase in triglyceride levels associated with EE2 was attenuated with NA-EE2 treatment.Daily treatment with NA-EE2 was well tolerated and protected the endometrium from EE2-induced proliferation and hyperplasia. The NA-EE2 treatments produced a dose-related significant increase in BMD that was not present with unopposed EE2 treatment. The overall effect of NA-EE2 treatments on lipid measures was favorable.
Transmission of a Malignant New Growth by Means of a Cell-Free Filtrate
Authors: Peyton Rous
Journal: JAMA (1983)

A tumor of the chicken, histologically a spindle-celled sarcoma, has been propagated in this laboratory since October, 1909,<sup>1</sup>and in the past few months has developed extreme malignancy.<sup>2</sup>From a bit inoculated into the breast muscle of a susceptible fowl there develops rapidly a large, firm growth; metastasis takes place to the viscera; and within four to five weeks often the host dies. The behavior of the new growth has been throughout that of a true neoplasm, for which reason the fact of its transmission by means of a cell-free filtrate assumes exceptional importance. <h3>EXPERIMENTS</h3> For the first experiments on the point use was made of ordinary filter-paper and the ground tumor suspended in Ringer's solution. It was supposed that the slight paper barrier, which allows the passage of a few red blood-cells and lymphocytes, would suffice to hold back the tumor and render the filtrate innocuous. Such
RADIOIMMUNOASSAY OF MAMMALIAN TYPE C VIRAL PROTEINS
Authors: Wade P. Parks, David M. Livingston, George J. Todaro, Raoul E. Benveniste, Edward M. Scolnick
Journal: The Journal of Experimental Medicine (1973)

A radioimmunoassay specific for a murine leukemia virus structural protein, the gs antigen, detects an antigenic reactivity in normal murine cells in culture and natural tissues. The assay was shown to measure an antigen that is highly related to the virion protein as shown by absorption tests, immunoadsorbent chromatography, and by analysis of linearized dose-response curves. These findings combined with the finding of viral-specific RNA indicate that portions of the viral genome are being expressed with a much greater frequency than previously appreciated.
Angiotensin II blockade: a strategy to slow ageing by protecting mitochondria?
Authors: E. M. V. de Cavanagh, F. Inserra, L. Ferder
Journal: Cardiovascular Research (2010)

Protein and lipid oxidation—mainly by mitochondrial reactive oxygen species (mtROS)—was proposed as a crucial determinant of health and lifespan. Angiotensin II (Ang II) enhances ROS production by activating NAD(P)H oxidase and uncoupling endothelial nitric oxide synthase (NOS). Ang II also stimulates mtROS production, which depresses mitochondrial energy metabolism. In rodents, renin–angiotensin system blockade (RAS blockade) increases survival and prevents age-associated changes. RAS blockade reduces mtROS and enhances mitochondrial content and function. This suggests that Ang II contributes to the ageing process by prompting mitochondrial dysfunction. Since Ang II is a pleiotropic peptide, the age-protecting effects of RAS blockade are expected to involve a variety of other mechanisms. Caloric restriction (CR)—an age-retarding intervention in humans and animals—and RAS blockade display a number of converging effects, i.e. they delay the manifestations of hypertension, diabetes, nephropathy, cardiovascular disease, and cancer; increase body temperature; reduce body weight, plasma glucose, insulin, and insulin-like growth factor-1; ameliorate insulin sensitivity; lower protein, lipid, and DNA oxidation, and mitochondrial H2O2 production; and increase uncoupling protein-2 and sirtuin expression. A number of these overlapping effects involve changes in mitochondrial function. In CR, peroxisome proliferator-activated receptors (PPARs) seem to contribute to age-retardation partly by regulating mitochondrial function. RAS inhibition up-regulates PPARs; therefore, it is feasible that PPAR modulation is pivotal for mitochondrial protection by RAS blockade during rodent ageing. Other potential mechanisms that may underlie RAS blockade's mitochondrial benefits are TGF-β down-regulation and up-regulation of Klotho and sirtuins. In conclusion, the available data suggest that RAS blockade deserves further research efforts to establish its role as a potential tool to mitigate the growing problem of age-associated chronic disease.
Neonatal Homicide Following Roe v Wade
Authors: Steve M. Skinner
Journal: JAMA (1992)

<h3>To the Editor.</h3> —The letter by Dr Lester<sup>1</sup>in<i>JAMA</i>entitled, "<i>Roe v Wade</i>Was Followed by a Decrease in Neonatal Homicide" is a beautiful example of how statistics can be manipulated to support whatever view one holds on an issue. While it may be true that numbers don't lie, they can be distorted. Lester claims "neonatal homicide is accurately recorded," but then goes on to say that "in 1980, for example, only 48% of the infants who died under the age of 1 year were autopsied." If less than half of infant deaths were followed by autopsies, then surely our "accurate records" on neonatal homicide must be viewed with at least a little suspicion. His article includes a table that illustrates that while homicide rates of persons less than 28 days old significantly decreased in the first 10 years after<i>Roe v Wade</i>, the homicide rates for all
The Acute Abdomen in Infancy and Childhood
Authors: William B. Kiesewetter
Journal: JAMA (1971)

This book represents another addition to the growing library of works in the field of pediatric surgery. It is written in a refreshing, readable style that brings to mind one of Dr. Raffensperger's predecessors at Children's Memorial Hospital, the late Willis Potts. It has a very good and up-to-date bibliography on all of the topics covered. There are at least three chapters in the book that should prove particularly useful. The one on intestinal obstruction in the newborn covers the subject well and is nicely illustrated. Trauma is dealt with very well, as one would expect from the broad experience of the authors at a city hospital. There is a singularly good coverage of medical causes of abdominal pain, about which all surgeons must repeatedly remind themselves. The wealth of good, commonsense material presented in this work would have benefited by a lot of close editorial work which neither the
differential effects of the angiotensin-converting enzyme inhibitor lisinopril versus the beta-adrenergic receptor blocker atenolol on hemodynamics and left ventricular contractile function in experimental mitral regurgitation
Authors: Shintaro Nemoto, Masayoshi Hamawaki, Gilberto De Freitas, Blase A Carabello
Journal: Journal of the American College of Cardiology (2002)
3 Self-reported skin morbidity in an adult urban population. Associations with socio-demographical factors
Authors: F. Dalgard, A. Svensson, J. Sundby
Journal: British Journal of Dermatology (2003)

The aim of this study was to quantify self reported skin morbidity in an adult urban population and explore the associations with socio‐demographical factors. The method used was a questionnaire on self reported skin complaints. It was developed and validated in a previous study. The design of this study was cross‐sectional. 41 352 adults randomly selected in the city of Oslo, in age groups 30, 40, 59, 60, 75 and 76 years, received a postal questionnaire. This included questions on socio demographical data, general health, lifestyle, psycho‐social items and self reported health. After three reminders, 18 770 persons responded, thereby obtaining a response rate of 46%. A non responder study has been conducted. The results show that itch is the dominating skin complaint in all age groups. The 30 years old men report 28,5% skin morbidity compared to 18,5% for the elderly and respectively 37% and 16% for the women. 24,4% of the men living alone report skin complaints, against 20% of the married men, 27,1% of women living alone, against 20% of the married women, all significantly. The reported skin morbidity is over 40% for responders with Oriental or Asian background compared with 23% for those of Norwegian background. Also the reported skin morbidity for men worsens significantly with employment grade from 20% to 27% for the lower grade. The same trend is observed for education and income variables.
Carnitine Palmitoyltransferase-1b Deficiency Aggravates Pressure Overload–Induced Cardiac Hypertrophy Caused by Lipotoxicity
Authors: Lan He, Teayoun Kim, Qinqiang Long, Jian Liu, Peiyong Wang, Yiqun Zhou, Yishu Ding, Jeevan Prasain, Philip A. Wood, Qinglin Yang
Journal: Circulation (2012)

Background— Carnitine palmitoyltransferase-1 (CPT1) is a rate-limiting step of mitochondrial β-oxidation by controlling the mitochondrial uptake of long-chain acyl-CoAs. The muscle isoform, CPT1b, is the predominant isoform expressed in the heart. It has been suggested that inhibiting CPT1 activity by specific CPT1 inhibitors exerts protective effects against cardiac hypertrophy and heart failure. However, clinical and animal studies have shown mixed results, thereby creating concerns about the safety of this class of drugs. Preclinical studies using genetically modified animal models should provide a better understanding of targeting CPT1 to evaluate it as a safe and effective therapeutic approach. Methods and Results— Heterozygous CPT1b knockout (CPT1b +/− ) mice were subjected to transverse aorta constriction–induced pressure overload. These mice showed overtly normal cardiac structure/function under the basal condition. Under a severe pressure-overload condition induced by 2 weeks of transverse aorta constriction, CPT1b +/− mice were susceptible to premature death with congestive heart failure. Under a milder pressure-overload condition, CPT1b +/− mice exhibited exacerbated cardiac hypertrophy and remodeling compared with wild-type littermates. There were more pronounced impairments of cardiac contraction with greater eccentric cardiac hypertrophy in CPT1b +/− mice than in control mice. Moreover, the CPT1b +/− heart exhibited exacerbated mitochondrial abnormalities and myocardial lipid accumulation with elevated triglycerides and ceramide content, leading to greater cardiomyocyte apoptosis. Conclusions— CPT1b deficiency can cause lipotoxicity in the heart under pathological stress, leading to exacerbation of cardiac pathology. Therefore, caution should be exercised in the clinical use of CPT1 inhibitors.
A NEW TYPE OF EXAMINATION FOR MEDICAL STUDENTS
Authors: MATHER CLEVELAND
Journal: JAMA (1926)

In the spring of 1925, Prof. Ben D. Wood of Columbia University succeeded in interesting the Department of Anatomy, Pharmacology and Orthopedic Surgery in a new type of examination. We of the Department of Anatomy were glad to turn from the old essay type of examination to a more comprehensive test of the students' knowledge of the subject. The old type of examination had almost uniformly consisted of eight or ten essay questions for which a total of three hours was allotted. We felt that too much of the students' time was given to English composition and relatively few facts could be developed for the energy expended.  These examinations of the new type are very easy to correct and grade, but their composition is a matter of considerable difficulty. The instructors engaged in producing an examination of the comprehensive objective type must be scrupulously careful to avoid ambiguity in any
Charities are disappointed with the voluntary nature of new agreement on aid
Authors: A. Gulland
Journal: BMJ (2011)

Aid organisations have reacted with dismay to the outcome of talks designed to make the delivery of aid more effective.

The charities Save the Children and Oxfam reacted with disappointment because the aid commitments specified for the emerging countries were only voluntary. 

Government ministers from around the world met this week in Busan, South Korea, at a high level forum on aid effectiveness, organised by the Organisation for Economic Cooperation and Development (OECD).

The meeting was arranged to monitor and speed up the progress made since a multilateral agreement in Paris in 2005 to improve the quality and effectiveness of aid. A report by the OECD in June this year found that only one out …
The Academic Physician-Investigator: A Crisis Not To Be Ignored
Authors: Edwin C. Cadman
Journal: Annals of Internal Medicine (1994)

The academic physician-investigator faces many challenges. Obtaining funding to support research is the greatest impediment. The National Institutes of Health, the single largest source of grants for the academic physician-investigator, approved only 14.2% of new investigator grant applications in 1990, compared with 40% in 1965 and 1975. Physicians submitted 25% of all applications, and they have priority scores similar to those applications submitted by investigators with PhD degrees. The 14.2% funding rate for new investigator-initiated grants is considerably less than the 56% success rate of amended renewal investigator-initiated grants. These trends in funding can be discouraging to the new physician-investigator. In addition, more emphasis is placed on clinical practice to generate money to support the new academic physician. These two facts, reduced probability of obtaining a grant and the perceived need to see more patients for salary support, may jeopardize retention of young faculty members. Moreover, training to prepare physicians for academic careers has been poor, with no attention given to the projected needs of the academic centers or the nation. This article describes the dilemma facing young physician-investigators and provides recommendations for improvement to the leaders of American medicine.
Urokinase-generated plasmin activates matrix metalloproteinases during aneurysm formation
Authors: Peter Carmeliet, Lieve Moons, Roger Lijnen, Myriam Baes, Vincent Lemaître, Peter Tipping, Angela Drew, Yves Eeckhout, Steve Shapiro, Florea Lupu, Désiré Collen
Journal: Nature Genetics (1997)
Skimping on care of the newborn is false economy.
Authors: B D Speidel
Journal: BMJ (1986)

Night terrors occur in about 3% of children between 1 and 14 years old.They are uncommon in adults and occur only in predisposed people, who usually have a family history of sleep disorders.According to Schatzman,8 murders during night terrors are very rare indeed.Only two cases have been reported in England in the past 25 years, though there have been other reports of violent acts committed during sleep that did not result in death.4The most recent case is that of Kemp, who killed his wife during a night terror in which he dreamed he was being chased by Japanese soldiers.8This case is of interest because it lacks some of the usual features of a night terror.The apparent detailed recall of the dream content, with vivid imagery and a narrative, approximates much more closely to a nightmare.Night terrors allow a defence of sane automatism, which, if successful, results in acquittal.For most other violent automatic acts carried out in an organic confusional state there is a mandatory referral to hospital, usually a secure one.This difference seems illogical and suggests that the law on automatism needs revision.