tbuckley/cabot-search huggingface dataset:
Effect of Inspiratory Flow Pattern and Inspiratory to Expiratory Ratio on Nonlinear Elastic Behavior in Patients with Acute Lung Injury
Authors: Cyrus Edibam, Albert J. Rutten, Daniel V. Collins, Andrew D. Bersten
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Ventilatory modes employing different inspiratory flow patterns and inspiratory to expiratory ratios may alter lung strain in acute lung injury patients. To determine whether variations in lung strain existed between pressure-controlled, volume-controlled, and pressure-controlled inverse ratio modes of ventilation, we randomly applied each for 30 minutes in 18 acute lung injury patients, keeping tidal volume, respiratory rate, fractional inspired oxygen, and total positive end-expiratory pressure constant. After each mode, a multiple linear regression analysis of dynamic airway pressure and airflow was performed with a volume-dependent single compartment model of the equation of motion, and an index of nonlinear elastic behavior was calculated. In five additional patients, concurrent dynamic computerized axial tomography scanning at juxtadiaphragmatic and subcarinal levels was added. Although static mechanics, oxygenation, and hemodynamics were no different between pressure-controlled, volume-controlled, and pressure-controlled inverse ratio ventilation, we found significant differences in nonlinear behavior. This was least with pressure-controlled followed by volume-controlled ventilation, and pressure-controlled inverse ratio ventilation had the greatest nonlinear elastic behavior. Dynamic computerized axial tomography analysis revealed more overinflated units in the left subcarinal slice with pressure-controlled inverse ratio ventilation. Ventilator flow pattern and inspiratory to expiratory ratio independently influence lung strain in acute lung injury; however, further studies are needed to determine the biologic significance.
One in three children malnourished in parts of Europe
Authors: K. Krosnar
Journal: BMJ (2001)

A new report from Unicef, the United Nations Children's Fund, has shown a sharp increase in child poverty and a growing gap in the health status of rich and poor populations in the former Soviet Union and former Eastern European bloc.

Despite a general growth in most economies in the Commonwealth of Independent States and central and eastern Europe in the second half of the decade since the fall of the Communist regime, inequality has increased, and almost 18 million children (17% of children) in the region are living on less than $2.15 (£1.50) a day, said the study, published last week. Rising numbers of children are …
Effect of repaglinide addition to metformin monotherapy on glycemic control in patients with type 2 diabetes.
Authors: R Moses, R Slobodniuk, S Boyages, S Colagiuri, W Kidson, J Carter, T Donnelly, P Moffitt, H Hopkins
Journal: Diabetes Care (1999)

OBJECTIVE: To compare the effect of repaglinide in combination with metformin with monotherapy of each drug on glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 83 patients with type 2 diabetes who had inadequate glycemic control (HbA1c &amp;gt; 7.1%) when receiving the antidiabetic agent metformin were enrolled in this multicenter, double-blind trial. Subjects were randomized to continue with their prestudy dose of metformin (n = 27), to continue with their prestudy dose of metformin with the addition of repaglinide (n = 27), or to receive repaglinide alone (n = 29). For patients receiving repaglinide, the optimal dose was determined during a 4- to 8-week titration and continued for a 3-month maintenance period. RESULTS: In subjects receiving combined therapy, HbA1c was reduced by 1.4 +/- 0.2%, from 8.3 to 6.9% (P = 0.0016) and fasting plasma glucose by 2.2 mmol/l (P = 0.0003). No significant changes were observed in subjects treated with either repaglinide or metformin monotherapy in HbA1c (0.4 and 0.3% decrease, respectively) or fasting plasma glucose (0.5 mmol/l increase and 0.3 mmol/l decrease respectively). Subjects receiving repaglinide either alone or in combination with metformin, had an increase in fasting levels of insulin between baseline and the end of the trial of 4.04 +/- 1.56 and 4.23 +/- 1.50 mU/l, respectively (P &amp;lt; 0.02). Gastrointestinal adverse events were common in the metformin group. An increase in body weight occurred in the repaglinide and combined therapy groups (2.4 +/- 0.5 and 3.0 +/- 0.5 kg, respectively; P &amp;lt; 0.05). CONCLUSIONS: Combined metformin and repaglinide therapy resulted in superior glycemic control compared with repaglinide or metformin monotherapy in patients with type 2 diabetes whose glycemia had not been well controlled on metformin alone. Repaglinide monotherapy was as effective as metformin monotherapy.
TREATMENT OF HEMORRHAGE FROM THE GENITALS IN OBSTETRIC PRACTICE.
Authors: GUSTAVUS M. BLECH
Journal: JAMA (1898)

Pathologic hemorrhage means danger to the life of the patient. Hemorrhage in obstetric practice, particularly during and after parturition, occurs with sufficient frequency to warrant the practitioner to be prepared for it whenever called to a case of labor. Hemorrhage even of a threatening character may also occur at any time during pregnancy. Hemorrhage, like all other emergency cases, calls for prompt action on the part of the physician. There is no time to look up the subject in text books or even to consult a more experienced practitioner, hence everyone is expected to be thoroughly familiar with the pathology and therapy of all emergencies of whatever character. However, in spite of the most rational aid rendered, life can not always be saved, but if the surgeon does not lose his presence of mind, diagnoses the case properly, has all the necessary apparatus at hand, and above all operates aseptically
Body Image and Psychopathology in Male Bodybuilders
Authors: B. Mangweth, H.G. Pope Jr., G. Kemmler, C. Ebenbichler, A. Hausmann, C. De Col, B. Kreutner, J. Kinzl, W. Biebl
Journal: Psychotherapy and Psychosomatics (2001)

&lt;i&gt;Background:&lt;/i&gt; To compare male bodybuilders to men with eating disorders and control men regarding body image, psychopathology and sexual history. &lt;i&gt;Method:&lt;/i&gt; We compared 28 male bodybuilders, 30 men with eating disorders (anorexia nervosa, bulimia or binge eating disorder defined by DSM-IV), and 30 controls, using a battery of questionnaires covering weight history, eating behavior, body image, lifetime history of psychiatric disorders, and sexuality. Eating-disordered and control men were recruited from a college student population and studied during the course of an earlier investigation. &lt;i&gt;Results:&lt;/i&gt; Bodybuilders exhibited a pattern of eating and exercising as obsessive as that of subjects with eating disorders, but with a ‘reverse’ focus of gaining muscle as opposed to losing fat. Bodybuilders displayed rates of psychiatric disorders intermediate between men with eating disorders and control men. In measures of body image, the bodybuilders closely resembled the men with eating disorders, but significantly differed from the control men, with the former two groups consistently displaying greater dissatisfaction than the latter. Sexual functioning did not distinguish the three groups except for the item ‘lack of sexual desire’ which was reported significantly more often by both bodybuilders and men with eating disorders. &lt;i&gt;Conclusion:&lt;/i&gt; On measures of body image and eating behavior, bodybuilders share many features of individuals with eating disorders.
Inhibition by dextran of Pseudomonas aeruginosa adherence to epithelial cells.
Authors: S Barghouthi, L M Guerdoud, D P Speert
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Adherence of Pseudomonas aeruginosa to cells of the respiratory tract of patients with cystic fibrosis (CF) appears to be a necessary precondition for colonization and infection. To date no effective anti-adhesive strategy has been devised for preventing P. aeruginosa infection in these vulnerable hosts. The purpose of these studies was to evaluate the potential for preventing adhesion of P. aeruginosa to epithelial cells with dextran. Dextran (3,000-70,000 MW) inhibited adhesion of P. aeruginosa to buccal and A549 pulmonary epithelial cells; the 3,000 MW compound, at 10 mM was most inhibitory. Adhesion was inhibited optimally at pH 7.4 and was independent of charge; dextran and dextran sulfate were equally inhibitory. Dextran was most inhibitory if added to the epithelial cells before the P. aeruginosa; adhesion was reversed only minimally by adding dextran after the bacteria were bound. The inhibitory effect appeared to be nonspecific because other neutral polysaccharides (glycogen and mannan) were also inhibitory, dextran blocked attachment of other respiratory tract pathogens (Staphylococcus aureus, Group A streptococcus, and Haemophilus influenzae), and because dextran did not bind specifically to bacteria or to epithelial cells. Dextran is an inexpensive and nontoxic agent and may be useful in patients with CF to prevent colonization and infection with P. aeruginosa.
Erythema Multiforme and Furosemide Therapy
Authors: Thomas P. Gibson
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Erythema multiforme occurred in a patient treated with furosemide. Although a variety of untoward reactions associated with furosemide therapy have been reported,<sup>1,2</sup>erythema multiforme has been incriminated only once.<sup>3</sup> <h3>Report of a Case.—</h3> A 65-year-old man was admitted to the hospital on Sept 17, 1969, with congestive heart failure. One week before admission his doctor noted atrial fibrillation, bilateral pleural effusions, and edema of the ankles. Treatment with digoxin, 0.25 mg was started. Two days before admission, 40 mg of furosemide were given orally. There was no history of allergies, other medications, or recent infections. The patient was a confused and cyanotic man with distended neck veins, atrial fibrillation, bilateral pleural effusions, cardiomegaly, and a protodiastolic gallop. The skin was unremarkable. In addition to salt and fluid restriction, administration of digoxin and furosemide was continued. Four days later a nonpruritic maculopapular rash appeared over the
Alabama Coronary Artery Bypass Grafting Project
Authors: William L. Holman, Richard M. Allman, Monique Sansom, Catarina I. Kiefe, Eric D. Peterson, Kevin J. Anstrom, Steadman S. Sankey, Steve G. Hubbard, Robert G. Sherrill, None for the Alabama CABG Study Group
Journal: JAMA (2001)

Efforts to improve quality of care in the cardiac surgery field have focused on reducing the risk-adjusted mortality associated with common surgical procedures, such as coronary artery bypass grafting (CABG). However, the best methodological approach to improvement is under debate.To test an intervention to improve performance of CABG surgery.Quality improvement project based on baseline (July 1, 1995-June 30, 1996) and follow-up (July 1-December 31, 1998) performance measurements from medical record review for all 20 Alabama hospitals that provided CABG surgery.Medicare patients discharged after CABG surgery in Alabama (n = 5784), a comparison state (n = 3214), and a national sample (n = 3758).Confidential hospital-specific performance feedback and assistance with multimodal improvement interventions, including the option to share relevant experience with peers.Duration of intubation, reintubation rate, aspirin therapy at discharge, use of the internal mammary artery (IMA), hospital readmission rate, and risk-adjusted in-hospital mortality.Proportion of extubation within 6 hours increased from 9% to 41% in Alabama, decreased from 40% to 39% in the comparison state, and increased from 12% to 25% in the national sample. Use of IMA increased from 73% to 84%, 48% to 55%, and 74% to 81%, respectively, in the 3 samples, but aspirin use increased only in Alabama (from 88% to 92%). The amount of improvement in all 3 of these process measures was greater in Alabama than in the other samples (IMA use for Alabama vs comparison state was P =.001 and for Alabama vs national sample, P =.02; and P<.001 for all other comparisons). Risk-adjusted mortality decreased in Alabama (4.9% to 2.9%), but this decrease was not statistically significantly different from mortality changes in the other groups (odds ratio, 0.76; 95% confidence interval, 0.54-1.07 vs national sample).Confidential peer-based regional performance feedback and process-oriented analysis of shared experience are associated with some improvement in quality of care for patients who underwent CABG surgery.
Tobacco meets its match
Authors: Theodore Dalrymple
Journal: BMJ (2008)

One day a comprehensive history of opposition to tobacco will be written. In it, James I’s famous Counterblaste will be given an honourable mention, with its denunciation of tobacco and “the black stinking fumes thereof, nearest resembling the horrible Stygian smoke of the pit that is bottomless.”

Less prominent in the history, no doubt, will be Thomas Reynolds’ Anti-Tobaccoism: Three Hundred and Sixty-Five interviews with Smokers, Chewers and Snufftakers in a Series of Letters to John Lee, One of the Vice-Presidents of the British Anti-Tobacco Society , published some time in the 1850s, with “prefatory remarks” by Thomas Hodgkin, of Hodgkin’s disease, who opined that reading these letters would be more profitable to most persons than …
Treatment of psoriasis with a combination of dithranol and coal tar
Authors: E. Young, H. Weelden
Journal: British Journal of Dermatology (1987)

Journal Article Treatment of psoriasis with a combination of dithranol and coal tar Get access E. Young, E. Young Department of Dermatology, University Hospital, Utrecht, The Netherlands. Search for other works by this author on: Oxford Academic Google Scholar H. van Weelden H. van Weelden Department of Dermatology, University Hospital, Utrecht, The Netherlands. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 116, Issue 2, 1 February 1987, Pages 281–282, https://doi.org/10.1111/j.1365-2133.1987.tb05835.x Published: 01 February 1987
Adoptive immune transfer in liver transplantation of HBV-related liver diseases
Authors: Henry L.Y. Chan, Alex Yui Hui
Journal: Hepatology (2003)

We read with great interest the report by Lo et al. 1 The very low rate of hepatitis B virus (HBV) recurrence (5 of 50 patients in a median follow-up of 14.5 months) with lamivudine monoprophylaxis is particularly impressive, and this raises the possibility that adoptive immune transfer is playing a protective role.In our center, however, the rate of HBV recurrence is much higher despite the rapidly tapering steroid dosage, use of lamivudine monoprophylaxis, and similar patient and donor population as the series reported by Lo et al. 1 Twenty-three patients suffering from HBV-related liver diseases
Medical Education in Colombia
Authors: ALFREDO F. JACOME-ROCA
Journal: Annals of Internal Medicine (1979)

Letters1 August 1979Medical Education in ColombiaALFREDO F. JACOME-ROCA, M.D.ALFREDO F. JACOME-ROCA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-2-324_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I read with interest the paper by G. T. Harrell in the August 1978 issue, "Medical Education in Colombia" (1).His overall view of the problem is good and one should not expect every single subject in such a complicated field to be covered with detail. I have a few comments to make.With regard to faculty members, I should point out that at least in some Colombian schools there are a good number of U.S.-trained specialists; they count on private practice as a major source of income just as locally trained faculty members do.The number...References1. HARRELL G. Medical education in Colombia. Ann Intern Med. 1978;89:283-4. LinkGoogle Scholar2. PAREDES R. Reorientacion de la educacion medica en Colombia. ASCOFAME, ed. Bogota, Colombia; 1970. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Javeriana University School of Medicine Bogota, Colombia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1979Volume 91, Issue 2Page: 324-325KeywordsMedical education Issue Published: 1 August 1979 PDF DownloadLoading ...
Ethnicity as a variable in epidemiological research
Authors: P A Senior, R Bhopal
Journal: BMJ (1994)

Ethnicity is used increasingly as a key variable to describe health data, and ethnic monitoring in the NHS will further stimulate this trend. We identify four fundamental problems with ethnicity in this type of research: the difficulties of measurement, the heterogeneity of the populations being studied, lack of clarity about the research purpose of the research, and ethnocentricity affecting the interpretation and use of data. Ethnicity needs to be used carefully to be a useful tool for health research. We make nine recommendations for future practice, one of which is that ethnicity and race should be recognised and treated as distinct concepts.
Hermansky-Pudlak syndrome type 7 (HPS-7) results from mutant dysbindin, a member of the biogenesis of lysosome-related organelles complex 1 (BLOC-1)
Authors: Wei Li, Qing Zhang, Naoki Oiso, Edward K Novak, Rashi Gautam, Edward P O'Brien, Caroline L Tinsley, Derek J Blake, Richard A Spritz, Neal G Copeland, Nancy A Jenkins, Dominick Amato, Bruce A Roe, Marta Starcevic, Esteban C Dell'Angelica, Rosemary W Elliott, Vishnu Mishra, Stephen F Kingsmore, Richard E Paylor, Richard T Swank
Journal: Nature Genetics (2003)
Antihypertensive Treatment Improves Endothelium-Dependent Hyperpolarization in the Mesenteric Artery of Spontaneously Hypertensive Rats
Authors: Uran Onaka, Koji Fujii, Isao Abe, Masatoshi Fujishima
Journal: Circulation (1998)

Background —The vascular endothelium releases endothelium-derived hyperpolarizing factor (EDHF). The mesenteric arteries of 6- to 8-month-old spontaneously hypertensive rats (SHRs) exhibit an impairment of the hyperpolarization induced by acetylcholine via EDHF. Methods and Results —We determined whether antihypertensive treatment can improve EDHF-mediated responses in SHRs. Beginning at age 8 to 9 months, the animals were treated with either enalapril (40 mg · kg −1 · d −1 ) (SHR-Es) or a combination of hydralazine (25 mg · kg −1 · d −1 ) and hydrochlorothiazide (7.5 mg · kg −1 · d −1 ) (SHR-Hs) for 3 months. The control groups were age-matched SHRs (SHR-Cs) and Wistar Kyoto rats (WKYs). The two treatments lowered the blood pressure to comparable extents. The acetylcholine-induced hyperpolarization in the mesenteric artery of treated SHRs improved to a level comparable to that in WKYs (acetylcholine 10 −5 mol/L with norepinephrine 10 −5 mol/L: SHR-E, −14.4±1.8; SHR-H, −12.0±1.3; SHR-C, −7.2±1.2; and WKY, −13.3±2.3 mV). EDHF-mediated relaxation, as assessed by relaxation to acetylcholine resistant to N G -nitro- l -arginine in norepinephrine-contracted rings, was markedly improved in treated SHRs (maximal relaxation: SHR-E, 79.3±3.2%; SHR-H, 47.4±8.6%; SHR-C, 4.8±2.4%; and WKY, 45.1±6.0%). When the rings were contracted with 77 mmol/L KCl to eliminate EDHF response, no difference was found in relaxation to acetylcholine among the four groups. Similarly, the hyperpolarization and relaxation to levcromakalim, a K + channel opener, were comparable among the groups. Conclusions —Antihypertensive treatment improved EDHF-mediated hyperpolarization and relaxation in the mesenteric artery in SHRs, whereas NO-mediated relaxation did not appear to be modulated by drug therapy. Thus, alterations in the EDHF system may play a pivotal role in endothelial dysfunction and its improvement with drug therapy in SHRs.
Impact of Blood Pressure and Blood Pressure Change During Middle Age on the Remaining Lifetime Risk for Cardiovascular Disease
Authors: Norrina Allen, Jarett D. Berry, Hongyan Ning, Linda Van Horn, Alan Dyer, Donald M. Lloyd-Jones
Journal: Circulation (2011)

Background— Prior estimates of lifetime risk (LTR) for cardiovascular disease (CVD) examined the impact of blood pressure (BP) at the index age and did not account for changes in BP over time. We examined how changes in BP during middle age affect LTR for CVD, coronary heart disease, and stroke. Methods and Results— Data from 7 diverse US cohort studies were pooled. Remaining LTRs for CVD, coronary heart disease, and stroke were estimated for white and black men and women with death free of CVD as a competing event. LTRs for CVD by BP strata and by changes in BP over an average of 14 years were estimated. Starting at 55 years of age, we followed up 61 585 men and women for 700 000 person-years. LTR for CVD was 52.5% (95% confidence interval, 51.3–53.7) for men and 39.9% (95% confidence interval, 38.7–41.0) for women. LTR for CVD was higher for blacks and increased with increasing BP at index age. Individuals who maintained or decreased their BP to normal levels had the lowest remaining LTR for CVD, 22% to 41%, compared with individuals who had or developed hypertension by 55 years of age, 42% to 69%, suggesting a dose-response effect for the length of time at high BP levels. Conclusions— Individuals who experience increases or decreases in BP in middle age have associated higher and lower remaining LTR for CVD. Prevention efforts should continue to emphasize the importance of lowering BP and avoiding or delaying the incidence of hypertension to reduce the LTR for CVD.
Accelerated Bone Loss in Hypothyroid Patients Overtreated with L-Thyroxine
Authors: Glenn M. Stall, Susan Harris, Lori J. Sokoll, Bess Dawson-Hughes
Journal: Annals of Internal Medicine (1990)

Objective: To compare the rate of bone mineral loss in thyroxine-treated women with low thyrotropin (thyroid stimulating hormone, TSH) levels with that in women without known thyroid disease. Design: Cases selected from a prospective calcium trial. Setting: Subjects were recruited from the Boston area. Measurements and Main Results: Of 361 women enrolled in a 2-year calcium supplement trial, 18 received thyroxine for hypothyroidism. Of these, 10 were considered overtreated, because they had low TSH levels. Rates of loss of bone mineral density from the radius, spine, and hip during 1.9 ± 0.6 years were measured by single- and dual-photon absorptiometry. When compared with women with no known thyroid disease (236 controls for the spine, 246 for the radius, and 237 for the femoral neck), women with low TSH levels had greater annualized, adjusted mean rates of bone loss from the spine (-2.89% ± 0.65% compared with -1.13% ± 0.13%, P = 0.009) and similar but not significant trends at the radius (-1.18% ± 0.75% compared with -0.13% ± 0.17%) and femoral neck (-1.39% ± 0.80% compared with -0.28% ± 0.19%). These means were adjusted for variables that affected the rate of loss in the control group (baseline bone mineral density and body mass index, calcium intake, and years since menopause). There were no statistical differences between the low TSH and control groups for any laboratory variables measured, including serum calcium, phosphorus, parathyroid hormone or alkaline phosphatase, plasma 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D, or 24-hour urine calcium-to-creatinine ratio. Conclusions: Thyroxine-treated women with low TSH levels lose bone mineral from the spine more rapidly than do women without known thyroid disease. These patients are therefore at increased risk for osteoporosis. The absence of detectable biochemical changes in women with low TSH levels may result from their relatively modest degree of overtreatment.