tbuckley/cabot-search huggingface dataset:
General Internal Medicine in the Medical School
Authors: DAVID A. MAJOR
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 June 1982General Internal Medicine in the Medical SchoolDAVID A. MAJOR, M.D., WILBUR W. OAKS, M.D., HOWARD A. MILLER, M.D.DAVID A. MAJOR, M.D.Search for more papers by this author, WILBUR W. OAKS, M.D.Search for more papers by this author, HOWARD A. MILLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-96-6-795_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: AS major contributors to the functions and governance of an academic general internal medicine division that has entered its 21st year we write to offer comments on the editorial on this topic by Tarlov (1). Subspecialty divisions emerged and enlarged as research became one of the missions of departments of medicine. The emergence of general internal medicine divisions has been based primarily on the need for teachers and clinicians with broad backgrounds to fulfill the other two of the three major missions of departments of medicine: education and service (2).In this period of limited financial resources...References1. TARLOV A. Academic general internal medicine. Ann Intern Med. 1982;96:239-40. LinkGoogle Scholar2. FRIEDMANPOZENROSENCRANSEISENBERGGERTMAN RJAJP. General internal medicine units in academic medical centers: their emergence and functions. Ann Intern Med. 1982;96:233-8. LinkGoogle Scholar3. WEISSMAJOR BD. Feelings and values in the clinical setting: a challenge to medical education. Forum on Medicine. 1979;2:9, 590-3. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID A. MAJOR, M.D.; WILBUR W. OAKS, M.D.; HOWARD A. MILLER, M.D.Affiliations: The Hahnemann Medical College & Hospital Philadelphia, PA 19102 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1982Volume 96, Issue 6_Part_1Page: 795-795KeywordsAcademic medicineSub-specialty care ePublished: 1 December 2008 Issue Published: 1 June 1982 PDF downloadLoading ...
Association between previous tuberculous infection and glioma.
Authors: P Macpherson
Journal: BMJ (1976)

chlorambucil have been implicated in the emergence of a terminal acute leukaemia in CLL.4So far as we know AML and CLL occurring together without previous treatment has only once been reported previously.5The CLL was, perhaps, temporarily suppressed but seemed to have been relatively unaffected by the treatment of AML.Indeed, this patient with well documented AML has done extraordinarily well to be still in remission five years after what some would consider to be a mild form of treatment.Any immunological suppression associated with his CLL obviously did not preclude him from keeping the AML in check.
Platelets, vasoconstriction, and nitroglycerin during arterial wall injury. A new antithrombotic role for an old drug.
Authors: J Y Lam, J H Chesebro, V Fuster
Journal: Circulation (1988)

Endothelial injury in vivo is associated with platelet deposition and a localized platelet-dependent vasoconstrictive response. To assess the influence of nitroglycerin on platelets and vasoconstriction, quantitative 111In-labeled platelet deposition (no platelets x 10(6)/cm2) of the injured segment and the degree of angiographic vasoconstriction (percent diameter narrowing proximal and distal to the dilated segment) produced during injury by balloon angioplasty of the common carotid arteries were studied in heparinized normal pigs that were sacrificed immediately after the procedure. In deeply injured (injury extending through the internal elastic lamina) compared with mildly injured (deendothelialization only) arteries, there was both greater platelet deposition (63.8 vs. 6.9, p = 0.04) and more vasoconstriction (30% vs. 19%, p = 0.02). In the presence of deep arterial wall injury, nitroglycerin given intravenously at a dose sufficient to lower mean arterial pressure by 9 +/- 2% significantly decreased both platelet deposition (16.2 vs. 63.8, p less than 0.008) and the vasoconstrictive response (20 vs. 30%, p less than 0.02) relative to control. However, in the presence of mild arterial wall injury, nitroglycerin decreased vasoconstriction relative to control (10% vs. 19%, p less than 0.01) without causing a significant decrease in the already low level of platelet deposition (5.6 vs. 6.9, respectively; p = NS), suggesting a direct smooth muscle relaxant effect of nitroglycerin. This is the first reported in vivo effectiveness of nitroglycerin in the reduction of platelet deposition after deep arterial injury.
Decreased Circulatory Response to Hypovolemic Stress in Young Women With Type 1 Diabetes
Authors: Marcus Lindenberger, Torbjörn Lindström, Toste Länne
Journal: Diabetes Care (2013)

Diabetes is associated with hemodynamic instability during different situations involving acute circulatory stress in daily life. Young men with type 1 diabetes have been shown to have impaired circulatory response to hypovolemic stress. The effect of type 1 diabetes on cardiovascular response to hypovolemia in young women is unknown, however.Lower body negative pressure of 30 cm H2O was used to create rapid hypovolemic stress in 15 young women with type 1 diabetes (DW) and 16 healthy women (control subjects [C]). Compensatory mobilization of venous capacitance blood (capacitance response) and net fluid absorption from tissue to blood were measured with a volumetric technique. Overall cardiovascular responses and plasma norepinephrine levels were measured.Capacitance response was reduced (DW, 0.67 ± 0.05; C, 0.92 ± 0.06) and developed slower in DW (P < 0.01). Capacitance response was further reduced with increasing levels of HbA1c. Fluid absorption was almost halved in DW (P < 0.01). The initial vasoconstrictor response was reduced and developed slower in DW (P < 0.05). Arterial vasoconstriction was further reduced in the presence of microvascular complications (P < 0.05).DW present with decreased and slower mobilization of venous capacitance blood and decreased net fluid absorption from tissue to blood during hypovolemic circulatory stress. Collectively, this indicates that DW are prone to hemodynamic instability, especially in the presence of microvascular complications and poor glycemic control.
'Black lung' takes toll in suffering, not death
Authors: Virginia Snodgrass Cowart
Journal: JAMA (1982)

Although coal workers' pneumoconiosis (CWP) has been found in 70% to 80% of subjects in the ongoing National Coal Workers Autopsy Study (NCWAS), it has been considered as the underlying cause of death in only 4.2%. Thus, while there can be no doubt that CWP, or  lung, is prevalent in the coal mining population, it seems more likely to cause pain and suffering than actual death.  The ten-year NCWAS experience was presented at a recent international conference on occupational lung disease in Chicago sponsored by the American College of Chest Physicians. The report was given by Francis H. Y. Green, MD, a pathologist with the National Institute for Occupational Safety and Health at Morgantown, WVa.  The voluntary autopsy study, Green said, was initiated under a 1969 law intended primarily to provide services to survivors of miners who were seeking to establish evidence for black lung benefit claims. Since the
Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: Report of the BIOMED-2 Concerted Action BMH4-CT98-3936
Authors: J J M van Dongen, A W Langerak, M Brüggemann, P A S Evans, M Hummel, F L Lavender, E Delabesse, F Davi, E Schuuring, R García-Sanz, J H J M van Krieken, J Droese, D González, C Bastard, H E White, M Spaargaren, M González, A Parreira, J L Smith, G J Morgan, M Kneba, E A Macintyre
Journal: Leukemia (2003)
A New Technique for the Detection of Left to Right Cardiac Shunts Using an Esophageal Geiger-Muller Tube.
Authors: G. H. Ira
Journal: Annals of Internal Medicine (1963)

s1 April 1963A New Technique for the Detection of Left to Right Cardiac Shunts Using an Esophageal Geiger-Muller Tube.G. H. Ira Jr., M.D., E. S. Orgain, M.D., F.A.C.P.G. H. Ira Jr., M.D.Search for more papers by this author, E. S. Orgain, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-711_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExternal detection of left to right cardiac shunting depends on the characteristics of the downslope of dilution curves that sample at a peripheral site with suitable materials, e.g., dye or radioisotopes. In principle, the injection site is relatively far removed from the sampling site, and the descending slope is influenced by numerous other factors besides the actual shunting. A sampling site closer to the injection site would improve the descending slope of the curves, especially if an actual recirculation "hump" could be demonstrated.A new approach has been attempted, utilizing the esophagus as a means of placing a small Geiger-Muller... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: G. H. IraJr., M.D.; E. S. Orgain, M.D., F.A.C.P.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1963Volume 58, Issue 4Page: 711-711KeywordsEsophagus ePublished: 1 December 2008 Issue Published: 1 April 1963 PDF downloadLoading ...
Elastic properties of the centrilobular emphysematous space
Authors: J. C. Hogg, S. J. Nepszy, P. T. Macklem, W. M. Thurlbeck
Journal: Journal of Clinical Investigation (1969)

Bronchograms were performed using finely particulate lead on emphysematous lungs obtained at necropsy. X-ray films were taken of these lungs at distending pressures of 0, 5, 10, and 20 cm H(2)O. The volumes of individual centrilobular emphysematous spaces were calculated at each distending pressure from measurements made on these bronchograms and pressure-volume curves were constructed for each space. The pressure-volume characteristics of seven normal lungs and one lung with centrilobular emphysema was also measured. The normal lungs, the lung with centrilobular emphysema, and the centrilobular emphysematous spaces were compared by expressing the volume of air contained in them at each distending pressure as a per cent of the volume contained at 20 cm H(2)O distending pressure. We conclude that centrilobular emphysematous spaces have a high residual volume, are less compliant than normal lung tissue, and are much less compliant than the emphysematous lungs which contain them. Furthermore, these spaces undergo little volume change in the tidal breathing range and probably add a relatively nondistensible series dead space to the surrounding lung parenchyma.
Trauma Systems at Risk
Authors: Donald Trunkey
Journal: JAMA (1996)

In 1976, the American College of Surgeons Committee on Trauma published "Optimal Resources for Care of the Seriously Injured."<sup>1</sup>These guidelines initially defined the optimal qualities of a trauma center, but quickly evolved into guidelines for a trauma system. From the very beginning the Committee on Trauma was anxious to regionalize trauma care for several reasons. First and foremost was to provide consistent quality care to patients who often present in the middle of the night and/or when there are multiple patients. An analogy has been made between a trauma center and the fire department. Firefighters are required to be in house 24 hours a day to respond immediately to a fire to save property and sometimes even lives. The trauma system guidelines were designed to provide a similar type of response while reducing costs by preventing duplication and minimizing redundancy within the system. Trauma regionalization has become unique
Fluid restitution and blood volume redistribution in anesthetized rabbits in response to vasoactive drugs.
Authors: S M Anderson, G F Rich, C Roos, L P Lee, J S Lee
Journal: Circulation (1994)

BACKGROUND Vasoactive drugs could alter the fluid restitution from the tissue and redistribute blood volume between the macrocirculation and microcirculation. METHODS AND RESULTS With bolus injections of vasoactive drugs in anesthetized rabbits, we measured the changes in blood and plasma density for the determination of the volume of restitution and redistribution. Epinephrine 3.5 micrograms/kg caused a fluid loss to the tissue, leading to a transient decrease in total blood volume by 2.30 mL/kg. Because of blood volume redistribution, the peak volume reduction was accompanied by a volume reduction of 0.81 mL/kg from the macrocirculation and 1.49 mL/kg from the microcirculation. Phenylephrine 70 micrograms/kg caused a peak reduction in total blood volume of 1.40 mL/kg (with 0.41 mL/kg from macrocirculation and 0.99 mL/kg from microcirculation). Nitroprusside 7 micrograms/kg increased the blood volume by 1.44 mL/kg (0.83 mL/kg macro and 0.61 mL/kg micro), nitroglycerin 7 micrograms/kg by 1.48 mL/kg (0.97 mL/kg macro and 0.51 mL/kg micro), and isoproterenol 7 micrograms/kg by 2.07 mL/kg (0.68 mL/kg macro and 1.39 mL/kg micro). All plasma (or blood) density changes measured for the five drugs (with epinephrine, phenylephrine, and nitroprusside done over a wide dosage range) correlated linearly with the drug-induced changes in arterial pressures. CONCLUSIONS These results indicate that vasoactive drugs alter total blood volume and the volume of microcirculation and macrocirculation.
On the variety of “deictic codes”
Authors: Boris M. Velichkovsky
Journal: Behavioral and Brain Sciences (1997)

Eye movements play a variety of roles in perception, cognition, and communication. The roles are revealed by the duration of fixations reflecting the quality of processing in the first line. We describe possible roles of eye fixations in different temporal diapasons. These forms of processing may be specific to sensorimotor coordinations. Any generalization to other domains should be cautious.
Impact of allergic rhinitis on asthma: effects on bronchial hyperreactivity
Authors: I. Cirillo, A. Pistorio, M. Tosca, G. Ciprandi
Journal: Allergy (2009)

Background: Remarkable relationship exists between upper and lower airways. Bronchial hyperreactivity (BHR) is a paramount feature of asthma and may be considered a strong risk factor for the onset of asthma in patients with allergic rhinitis. Objective: This study is aimed at evaluating the presence of BHR in a large group of patients with moderate‐severe persistent allergic rhinitis alone, and at investigating possible risk factors related to severe BHR. Methods: Three hundred and forty‐two patients with moderate‐severe persistent allergic rhinitis were prospectively and consecutively evaluated. Clinical examination, skin prick test, spirometry and bronchial methacholine (MCH) test were performed in all patients. Results: Twenty‐two (6.4%) patients had severe BHR, 74 (21.6%) patients had mild BHR and 192 (56.2%) had borderline BHR; 54 (15.8%) patients had a negative MCH test. The logistic regression analysis evidenced that trees and house dust mites sensitization (OR Adj : 8.1), rhinitis duration &gt; 5 years (OR Adj : 5.4) and FEV 1 ≤ 86% of predicted (OR Adj : 4.0) were significantly associated with severe BHR. The discriminative ability of this model is appreciably satisfactory, being the AUC = 0.90. Conclusion: This study highlights the close link between upper and lower airways and the role of some risk factors, such as tree and mite sensitization, &gt; 5‐year duration, and ≤ 86% FEV 1 values, as risk factors for severe BHR in patients with moderate‐severe persistent allergic rhinitis alone. Therefore, BHR is frequently present in patients with chronic rhinitis and should be suspected in the presence of defined risk factors.
LAWS, REGULATIONS, AND POLICY: Genetically Engineered Salmon on the FDA’s Table
Authors: David A. Taylor
Journal: Environmental Health Perspectives (2010)

A large fraction of emissions of carbon dioxide (CO 2 )-the greenhouse gas produced by human activities in the greatest quantities-is long lived in the atmosphere, so decisions made today to continue adding CO 2 into the atmosphere may lock future generations into a range of human health and environmental impacts, some of which could become very severe, according to a committee of the National Research Council (NRC).In a report that looks at the short-and long-term effects of the stabilization of Earth's temperature, the NRC committee quantifies, as much as possible, the outcomes of different stabilization targets for the planet, with a focus on the United States. 1The report synthesizes global warming science in myriad fields along with research on the potential impacts for human health and other arenas.Then the committee adds a twist: rather than expressing climate goals in terms of stabilizing atmospheric concentrations of CO 2 , the authors assess such goals using global mean temperature change as the primary metric.The twist allows the authors to link the potential impacts from climate change more directly to temperature change.Research to date suggests many potential impacts can be directly linked to temperature, or to things that can be themselves linked to temperature (e.g., precipitation), although some (e.g., ocean acidification) are linked directly to CO 2 concentration, says Damon Matthews of Concordia University, a report coauthor."But in this report we were . . .noting the additional impacts you would expect for a given degree
Oxygen radicals generated at reflow induce peroxidation of membrane lipids in reperfused hearts.
Authors: G Ambrosio, J T Flaherty, C Duilio, I Tritto, G Santoro, P P Elia, M Condorelli, M Chiariello
Journal: Journal of Clinical Investigation (1991)

To test whether generation of oxygen radicals during postischemic reperfusion might promote peroxidation of cardiac membrane lipids, four groups of Langendorff-perfused rabbit hearts were processed at the end of (a) control perfusion, (b) 30 min of total global ischemia at 37 degrees C without reperfusion, (c) 30 min of ischemia followed by reperfusion with standard perfusate, (d) 30 min of ischemia followed by reperfusion with the oxygen radical scavenger human recombinant superoxide dismutase (h-SOD). The left ventricle was homogenized and tissue content of malonyldialdehyde (MDA), an end product of lipid peroxidation, was measured on the whole homogenate as well as on various subcellular fractions. Reperfusion was accompanied by a significant increase in MDA content of the whole homogenate and of the fraction enriched in mitochondria and lysosomes. This phenomenon was not observed in hearts subjected to ischemia but not reperfused, and was similarly absent in those hearts which received h-SOD at reflow. Reperfused hearts also had significantly greater levels of conjugated dienes (another marker of lipid peroxidation) in the mitochondrial-lysosomal fraction. Again, this phenomenon did not occur in ischemic hearts or in reperfused hearts treated with h-SOD. Unlike the effect on tissue MDA and conjugated dienes, reperfusion did not significantly stimulate release of MDA in the cardiac effluent. Treatment with h-SOD was also associated with significant improvement in the recovery of cardiac function. In conclusion, these data directly demonstrate that postischemic reperfusion results in enhanced lipid peroxidation of cardiac membranes, which can be blocked by h-SOD, and therefore is most likely secondary to oxygen radical generation at reflow.
5α-Reductase Inhibitors and the Risk of Cancer-Related Mortality in Men With Prostate Cancer
Authors: Laurent Azoulay, Maria Eberg, Serge Benayoun, Michael Pollak
Journal: JAMA Oncology (2015)

5α-Reductase inhibitors (5-ARIs) are widely used in the treatment of benign prostatic hyperplasia. However, randomized clinical trials have raised concerns that their use may be associated with an increased risk of high-grade prostate cancer tumors that would ultimately lead to worse prostate cancer outcomes. To date, few observational studies have addressed this important safety concern.To determine whether the use of 5-ARIs before prostate cancer diagnosis is associated with an increased risk of cancer-specific and all-cause mortality in men with a new diagnosis of prostate cancer in the real-world setting.A retrospective cohort study was conducted in a cohort of 13,892 men with a new diagnosis of prostate cancer between January 1, 1999, and December 31, 2009, who were followed up until October 1, 2012. Patients were individually linked across 4 databases from the United Kingdom: National Cancer Data Repository, Clinical Practice Research Datalink, Hospital Episodes Statistics database, and Office for National Statistics database.Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% CIs of prostate cancer-specific and all-cause mortality associated with prediagnostic use of 5-ARIs. For each outcome, 2 models were constructed, one adjusted for predefined covariates (conventional model) and another adjusted for high-dimensional propensity score (HD-PS) deciles.During a mean (SD) of 4.5 (3.1) years, 5001 deaths occurred, including 2429 from prostate cancer (crude incidence rate of 3.86 per 100 person-years [95% CI, 3.71-4.02]). In the conventional model, use of 5-ARIs before prostate cancer diagnosis was not associated with an increased risk of prostate cancer-specific mortality (crude incidence rates, 3.76 [95% CI, 3.04-4.59] [use] vs 3.87 [95% CI, 3.71-4.03] [nonuse] per 100 person-years; adjusted hazard ratio [aHR], 0.86 [95% CI, 0.69-1.06]) and all-cause mortality (crude incidence rates, 8.42 [95% CI, 7.32-9.64] [use] vs 7.93 [95% CI, 7.71-8.16] [nonuse] per 100 person-years; aHR, 0.87; 95% CI, 0.75-1.00). Similar results were observed with the HD-PS adjusted model (prostate cancer-specific mortality: aHR, 0.90 [95% CI, 0.73-1.13]; and all-cause mortality: aHR, 0.92 [95% CI, 0.80-1.07]).The use of 5-ARIs was not associated with an increased risk of prostate cancer-specific and all-cause mortality in men with a new diagnosis of prostate cancer. While these results provide reassurance, additional studies are needed to replicate these findings.
Metabolic Complications of Jejunoileal Bypass Operations for Morbid Obesity
Authors: H W Scott, R H Dean, H J Shull, F W Gluck
Journal: Annual Review of Medicine (1976)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China in December 2019 and quickly spread around the globe, killing more than 4 million people and causing a severe economic crisis. ...Read More