tbuckley/cabot-search huggingface dataset:
Psychomotor Skills in Orthopaedic Surgery
Authors: Leonard F. Peltier
Journal: JAMA (1985)

Orthopedic surgery has become increasingly specialized, and with specialization has come a greater need for technical skill in the performance of the procedures. Instrumentation has become more complex and the need for manipulative skills greater. This book sets forth objectives and a curriculum for evaluating and teaching psychomotor skills to orthopedic residents. The authors present the approach of current educational psychology and methods to transferring these skills, and their book is filled with interesting semantic constructions—eg, psychomotor taxonomy, cybernetic cycle, triangulation format, gestalt assessment, and heuristic strategies—applied to problems as complex as how to make a broom handle. No exercises in a "dry lab" will ever substitute for time spent in anatomic dissection, operating in the animal laboratory, or assisting or being assisted by a patient, knowledgeable preceptor. For those interested in the application of educational theory to training residents in surgical technique, this book represents the state of
PEDIATRICS AND CHILD PSYCHOLOGY
Authors: JOHN E. ANDERSON
Journal: JAMA (1930)

In an age in which the word psychology is so widely used by so many different people in such a variety of ways, one approaches the discussion of the relation between psychology and pediatrics with some fear and trembling. This is in part due to a feeling that, when the discussion is completed, psychology may seem to be a much more prosaic endeavor than most people believe, and to hold out somewhat less hope of meeting all our unsolved problems of human relations, at least within the next generation.  To many, psychology is a word to be glibly rolled off the tongue, whenever an inexplicable fact of human action occurs or a quick and easy explanation is sought. To those who are earnestly engaged in the business of trying to formulate valid principles of human behavior and to contribute to our understanding of human nature, psychology is a term which,
Plasma catecholamines, platelet aggregation and associated thromboxane formation after physical exercise, smoking or norepinephrine infusion.
Authors: W Siess, R Lorenz, P Roth, P C Weber
Journal: Circulation (1982)

To study the possible role of catecholamines in platelet activation, platelet aggregation stimulated by ADP, collagen, arachidonic acid and L-epinephrine, thromboxane B2 (TXB2) formation and plasma levels of catecholamines and renin were studied in healthy men both before and after 6 days of propranolol treatment (40 mg three times daily) under control conditions and during sympathoadrenergic stimulation by physical exercise (200 W) or smoking. Exercise markedly increased plasma norepinephrine from 128 +/- 28 to 998 +/- 418 pg/ml (+/- SD), and plasma renin activity from 1.0 +/- 0.5 to 4.2 +/- 1.8 ng AI/ml . hour. Smoking predominantly increased plasma epinephrine, from 47 +/- 25 to 154 +/- 76 pg/ml. Propranolol did not consistently influence these variables, but blunted the circulatory response to exercise and smoking. Despite the marked increases of plasma catecholamines after both stimuli with and without beta blockade, platelet aggregation stimulated by ADP, 1-epinephrine, collagen and arachidonic acid and associated TXB2 formation were not enhanced. Moreover, as already suggested by a trend toward reduced aggregability in these settings, plasma norepinephrine levels in the same range (745 +/- 368 pg/ml) due to infusion (5 micrograms/min) significantly reduced platelet aggregation with low-dose collagen (0.25-0.75 micrograms/ml), I-epinephrine (0.2-1.0 microM) and ADP (0.5-1.5 microM). These data do not support a role of endogenous catecholamines in initiating platelet activation and TXB2 formation.
The acute hemodynamic effects of a new agent, MDL 17,043, in the treatment of congestive heart failure.
Authors: B F Uretsky, T Generalovich, P S Reddy, R B Spangenberg, W P Follansbee
Journal: Circulation (1983)

MDL 17,043 administered intravenously or orally exerts positive inotropic and vasodilator actions in experimental animal preparations. We studied its acute hemodynamic effects in 15 patients with severe congestive heart failure by right-heart catheterization. Intravenous MDL 17,043 at 10 minutes increased cardiac index (3.4 +/- 0.8 vs 1.9 +/- 0.4 l/min/m2), narrowed arteriovenous oxygen content difference (4.6 +/- 0.8 vs 7.8 +/- 2.0 vol%), increased heart rate (98 +/- 14 vs 89 +/- 18 beats/min), and decreased systemic arterial (67 +/- 10 vs 83 +/- 11 mm Hg), pulmonary capillary wedge (12 +/- 5 vs 24 +/- 5 mm Hg) and right atrial (6 +/- 5 vs 12 +/- 7 mm Hg) mean pressures significantly (p less than 0.001). In 11 patients, hemodynamics were monitored hourly for 6 hours. Compared with baseline, the cardiac index and heart rate were higher and mean systemic arterial pressure was lower for 6 hours; pulmonary capillary and right atrial mean pressures were significantly lower for 5 hours. No serious arrhythmias or side effects occurred. These data suggest that MDL 17,043 may be useful for treating congestive heart failure.
USE OF RABBITS AS SUBSTITUTE FOR WHITE MICE IN PNEUMOCOCCUS TYPE DIFFERENTIATION
Authors: HAROLD K. FABER
Journal: JAMA (1918)

In spite of the usefulness of Avery's rapid method for pneumococcus type differentiation, it is often desirable to resort to animal inoculation either for differentiation or for isolation of pneumococci. The susceptibility of rabbits to pneumococcus infection is so well known that there may be some reason why they have not been generally used instead of white mice for pneumococcus type differentiation; but the reason is not clear, and no statements on this point have come to my attention. Intraperitoneal inoculation of rabbits with pneumonic sputum has been carried out in fifteen instances, and in thirteen of these pneumococci were found in the heart's blood and peritoneal cavity in abundance, always with characteristic capsules. No other organisms were found by smear in the exudate, but in two instances in which the animals had been killed about twenty-four hours after inoculation a few colonies of other bacterial species were found in
Dr. John McLoughlin
Authors: Roy J. Popkin
Journal: New England Journal of Medicine (1960)

DR. John McLoughlin, who was to become the chief actor in the drama of the Oregon Country of the Pacific Northwest, was born on October 19, 1784, in La Rivière du Loup Parish in Canada, the second of 7 children. At the age of fourteen he went to Quebec to study medicine under Dr. James Fisher and after four and a half years of tutorship was licensed to practice. Only nineteen at the time, he settled in Quebec but he soon entered the service of the Northwest Trading Company as physician, a position that he held at various posts for . . .
Intrahepatic Bile Leak Producing Delayed Accumulation of Technetium-99m DISIDA in an Amebic Liver Abscess
Authors: R PRAKASH, A JENA, V BEHARI, M K CHOPRA
Journal: Clinical Nuclear Medicine (1986)

Sequential hepatobiliary imaging was performed in a case of hepatomegaly with associated jaundice. A huge focal defect in the superomedial aspect of the liver was identified in the early hepatic phase, and showed uptake of tracer in the delayed image. An amebic liver abscess was drained on needle aspiration.
Vermont moves closer to becoming first US state to provide "socialised medicine"
Authors: J. Lenzer
Journal: BMJ (2011)

Vermont is set to become the first US state to launch a single payer healthcare plan after a bill passed both houses of the state’s legislature. 

The plan is expected to be signed by Governor Peter Shumlin, who in February originally proposed the idea that would abolish most insurance plans and would instead provide healthcare to all residents through public funding. In the United States this is known as a “single payer” scheme and is fiercely opposed by many conservative politicians as “socialised medicine.”

Some doctors in Vermont are unhappy about the proposed changes. In an online poll of roughly 600 doctors conducted by the state representative George Till, a doctor who specialises in obstetrics and gynaecology, 28% said that they will stop practising medicine in the state if the plan is …
Sports Medicine for the Primary Care Physician
Authors: Christine E. Haycock
Journal: JAMA (1984)

This book is intended as a summary of current sports medicine data for use as a reference by primary care physicians. It is edited by Richard B. Birrer of the State University of New York, Downstate, Brooklyn, with 22 contributors in addition to Dr Birrer from various areas of the United States.  The book is generally well written and easy to read. The depth of the data presented is more than adequate for its audience. It is modestly illustrated and contains sufficient tables and figures to illustrate certain points. Each chapter is well referenced.  Particularly useful are the chapters on the role of the team physician, backed up by practical information on the field management of athletic emergencies both medical and traumatic. It is in the capacity of team doctor that many primary care physicians meet the problems not normally encountered in an office practice, and in this role the
Effect of chronic continuous positive airway pressure (CPAP) therapy on upper airway size in patients with sleep apnoea/hypopnoea syndrome.
Authors: I. L. Mortimore, P. Kochhar, N. J. Douglas
Journal: Thorax (1996)

BACKGROUND: There is evidence to suggest that chronic continuous positive airway pressure (CPAP) therapy may produce reversible changes in upper airway morphology and function in patients with sleep apnoea/hypopnoea. This study was designed to examine the effect of chronic CPAP therapy on upper airway calibre. METHODS: Twenty four men with the sleep apnoea/hypopnoea syndrome (mean (SE) apnoea/hypopnoea index 37 (5)) underwent lateral cephalometry with measurement of posterior airway space performed before and at least three months after initiation of CPAP therapy. RESULTS: There was no weight change between the two assessments and mean CPAP use was 4.8 (0.4) hours per night. Posterior airway space (PAS) was measured in erect and supine postures. PAS supine increased with CPAP therapy from a mean (SE) of 11.8 (0.8) mm to 13.4 (0.8) mm, but PAS erect did not. Correlation of the change in PAS (dPAS) before and after CPAP therapy showed an increase with increasing CPAP compliance measured as machine run time both for dPAS supine (r = 0.68) and dPAS erect (r = 0.47). CONCLUSIONS: Patients with the sleep apnoea/hypopnoea syndrome regularly using CPAP for more than four hours per night all showed an increase in dPAS supine. The use of chronic CPAP increases PAS supine probably by a reduction in upper airway oedema, and the change in size is dependent on CPAP use.
Cambridge and Peterborough CCG selects NHS consortium for 800m flagship contract
Authors: G. Iacobucci
Journal: BMJ (2014)

A partnership of NHS organisations has been selected ahead of leading private providers as the preferred bidder for the largest contract to provide NHS services in England since the government’s healthcare reforms of 2013.

UnitingCare Partnership—a consortium of Cambridgeshire and Peterborough NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust—was announced as the preferred bidder for the £800m contract to provide older people’s healthcare and adult community services across Cambridgeshire and parts of Northamptonshire and Hertfordshire.

The Cambridgeshire and Peterborough NHS clinical commissioning group (CCG), which carried out the 15 month procurement process, selected the NHS led consortium ahead of two other shortlisted bids: one from Virgin Care, a private provider, and one from the consortium Care for Life, which comprises the private company Care UK, Lincolnshire Community …
Queen Victoria's Gene: Haemophilia and the Royal Family
Authors: H. M Kingston
Journal: BMJ (1995)

We reviewed the clinical and CT findings in six patients with mesencephalic hematomas. All patients were normotensive. Headache and vomiting preceded impairment of consciousness. In all patients, unequal pupils reacted poorly to light but retained the near response. Upgaze was impaired in all patients. CT showed a unilateral nonenhancing midbrain hematoma in all cases and intra-ventricular blood in five. Four-vessel angiography in all cases showed no neoplasm, angioma, or aneurysm. All patients survived with persistent pupillary abnormalities and restriction of upward gaze.
Inhibitory effect of a human T cell hybrid factor on both cell growth and mixed lymphocyte reactivity. Correlation with class II molecule expression.
Authors: M Trucco, S Shaw, R Korngold
Journal: Journal of Clinical Investigation (1985)

We recently reported the biological activity and some of the biochemical characteristics of a factor produced by a human T cell hybrid clone able to block hematopoietic progenitor cell proliferation. This 85-kD protein factor, which we have termed colony-inhibiting lymphokine (CIL), has growth regulatory activity on bone marrow precursors bearing Ia (class II) antigens of either granulocytic-monocytic (CFU-GM) or erythroid lineage (BFU-E and CFU-E). Experiments aimed to investigate the specificity of the inhibitory effect on hematopoietic progenitor cell growth suggested that the expression of HLA-DR surface antigens was required on the target cells. We describe in this communication how DR+ cell lines ceased dividing after a few days of culture in the presence of CIL, whereas DR- cell lines were completely unaffected. The increased DR expression on the ML3 cell surface, mediated by the activity of the gamma interferon (IFN gamma), increases the sensitivity to the growth inhibition factor of the ML3 cell line. To verify the hypothesis that the DR antigens might serve as receptors for the factor, enabling it also to interfere in the immune response, we tested CIL in a mixed lymphocyte reaction (MLR), one of the best known in vitro Ia antigen-dependent T cell-mediated immune responses. CIL is able to block major histocompatibility complex-allogeneic MLR both in human and mouse systems. The data indicate that CIL recognizes a nonpolymorphic structure (presumably on all Ia molecules) presented by stimulator cells of either species, and thereby interferes with specific interactions between stimulator and responder cells. Blocking of the alloantigen stimulation stage is also indicated, since CIL is effective only if added to the culture medium during the first 48 h of the MLR. Finally, mouse monoclonal anti-DR antibodies are able to sharply reduce CIL activity on sensitive DR+ cell lines. CIL may act physiologically as a multifunctional mediator in a complex network that links regulation of bone marrow differentiation and the generation of immune responses.
The vitronectin-binding function of PAI-1 exacerbates lung fibrosis in mice
Authors: Anthony J. Courey, Jeffrey C. Horowitz, Kevin K. Kim, Timothy J. Koh, Margaret L. Novak, Natalya Subbotina, Mark Warnock, Bing Xue, Andrew K. Cunningham, Yujing Lin, Monica P. Goldklang, Richard H. Simon, Daniel A. Lawrence, Thomas H. Sisson
Journal: Blood (2011)
Life-threatening bilateral empyema and mediastinitis complicating infectious mononucleosis
Authors: Ilias A. Andrianakis, Anastasia N. Kotanidou, Marinos T. Pitaridis, George J. Saroglou, Dimitrios N. Exarhos, Charis S. Roussos, Ion P. Bellenis
Journal: Intensive Care Medicine (2002)
Utility of Selective Digestive Decontamination in Mechanically Ventilated Patients
Authors: Miquel Ferrer
Journal: Annals of Internal Medicine (1994)

Objective: To assess selective digestive decontamination for preventing nosocomial pneumonia and mortality in mechanically ventilated patients. Design: Prospective, randomized, placebo-controlled, double-blind study. Setting: Respiratory intensive care unit of a 1000-bed teaching hospital. Patients: 80 patients receiving mechanical ventilation for more than 72 hours. Interventions: Patients received selective digestive decontamination using polymyxin E, tobramycin, and amphotericin B through a nasogastric tube and also topically in the oropharynx; control patients received placebo. All patients received intravenous cefotaxime for 4 days or other systemic antibiotics if required. Measurements: Bacteriologic surveillance (three times a week) was done by quantitatively culturing tracheal aspirates, pharyngeal swabs, and gastric juice. The diagnosis of pneumonia was based on quantitative cultures of protected specimen brush samples (≥ 103 CFU/mL [colony forming units/mL]) or bronchoalveolar lavage fluid (≥ 104 CFU/mL) and autopsy findings. Results: Bronchial, oropharyngeal, and gastric colonization by gram-negative bacilli and Candida species was lower in the selective digestive decontamination group compared with the placebo group. Nonsignificant differences were found in the incidence of nosocomial infections (28% compared with 37%; odds ratio, 0.66; 95% CI, 0.35 to 1.25) and nosocomial pneumonia (18% compared with 24%; odds ratio, 0.7; CI, 0.33 to 1.46) and in the crude mortality rate (31% compared with 27%; odds ratio, 1.21; CI, 0.63 to 2.34) when comparing digestive decontamination with placebo, respectively. Conclusions: Selective digestive decontamination in our mechanically ventilated patients significantly decreased the colonization rate of gram-negative bacilli and of Candida species but not of Staphylococcus aureus. It did not decrease the incidence of nosocomial pneumonia, mortality, length of stay, or the duration of mechanical ventilation.
Retrospective analysis of the impact of HIV infection and alcohol use on chronic hepatitis C in a large cohort of drug users
Authors: Stanislas Pol, Barbara Lamorthe, Ngoc Trinh Thi, Valérie Thiers, Françoise Carnot, Hervé Zylberberg, Pierre Berthelot, Christian Bréchot, Bertrand Nalpas
Journal: Journal of Hepatology (1998)
Unrecognised severe vitamin D deficiency
Authors: John L Sievenpiper, Elizabeth A McIntyre, Mark Verrill, Richard Quinton, Simon H S Pearce
Journal: BMJ (2008)

of selection bias (the sickest children might die before reaching one of these units), but the recent dramatic improvement in outcome in paediatric intensive care units 1 implies that it is the result of improved care and that early referral to such a unit would be likely to improve mortality. Hospital treatmentThe SIGN guidelines emphasise the need for vigorous fluid resuscitation and early intubation, for which there is no good evidence but strong consensus.For fluidresistant shock, inotropes are recommended on the basis of case-control findings of an association between inadequate inotropes and worse outcome. 5The SIGN recommendation to use a third generation cephalosporin to treat meningococcal infection, rather than the narrower spectrum antibiotic benzylpenicillin, is not explained but is unlikely to affect outcome.The SIGN guidelines represent a laudable attempt to improve management.We lack high level evidence on which interventions are most likely to improve outcome, and future randomised controlled trials of interventions would be invaluable.Apart from primary prevention, major advances in improving the outcome of childhood meningococcal infection in the UK seem most likely to follow system changes to improve supervision of junior doctors in emergency departments, good access to experienced paediatricians, and early referral to specialist centres.
Cancer of the urogenital tract: bladder cancer. The radiation attack
Authors: C. A. Cuccia
Journal: JAMA (1969)

Supervoltage therapy has definitely proven its superiority over orthovoltage therapy in the treatment of carcinoma of the urinary bladder. The advantages of such a modality are so obvious that, in the treatment of deeply infiltrating, high-grade carcinomas of the urinary bladder, radiation therapy, which was originally of dubious usefulness, has become the treatment of choice. In the past, orthovoltage radiotherapy, plagued by its many limitations, such as severe skin reactions, poor patient tolerance, marked radiation cystitis, inability to deliver a cancericidal dose, and unsatisfactory tumor control, was only able to provide a five-year survival frequency not exceeding 5%. Supervoltage therapy (with 1 million to 24 million volts, cesium 137, or cobalt [<sup>60</sup>Co]), being able to deliver a cancericidal dose to the pelvis or bladder with reduced reactions and a small incidence of complications, has drastically improved such results. In addition to the technical advantages offered by supervoltage equipment, a
Coronary Heart Disease as a Cultural Disease
Authors: A. Appels
Journal: Psychotherapy and Psychosomatics (1973)

It has been the feeling of a lot of authors that the psychosocial characteristics of coronary patients reflect some characteristics of the culture we live in. This hypothesis is tested by correlating an index of the measure in which a nation is achievement oriented and the incidence of CVD in the same nation. The correlations are positive and significant. The meaning of this result is discussed in the light of prevention, which asks for a study of the doctor-society relationship.
Drug smuggler's delirium.
Authors: P S Ramrakha, I Barton
Journal: BMJ (1993)

chronic persistent hepatitis may, however, survive for years without histological progression.Initiation of treatment in these patients is controversial.The use of interferon alfa in patients with decompensated cirrhosis, organ transplant recipients, children, and patients with extrahepatic manifestations of infection has not been properly assessed.Recent reports suggest that interferon alfa can be used safely and effectively in patients with HIV infection and in patients with essential mixed cryoglobulinaemia." 12 Ribavirin, a nucleotide analogue, has been shown in pilot studies to reduce concentrations of serum alanine aminotransferase and hepatitis C virus RNA."'This drug is currently being evaluated in large multicentre randomised controlled trials.Preliminary data suggest that it is effective but decreases serum hepatitis C virus RNA at a slower rate than interferon alfa.Nevertheless, as an oral drug with few side effects, it may find a role in maintenance suppression in patients with chronic hepatitis C virus infection.Patients with both autoimmune markers and hepatitis C virus present a diagnostic and management challenge.There is at present no reliable marker to determine whether autoimmunity or hepatitis C virus infection is the major disease process.These patients should receive corticosteroids first and only if they fail interferon alfa, since interferon alfa may aggravate immune mediated hepatocyte injury in patients with autoimmune chronic active hepatitis.Patient education is an important part of management.General knowledge about hepatitis C virus among the public is slight.Patients with chronic hepatitis C should be counselled in the light of our current understanding.The route of transmission in sporadic cases of hepatitis C is still unknown.The risk of sexual transmission seems to be low when compared with hepatitis B virus, HIV, and other sexually transmitted diseases.But the risk is five times higher in partners of patients coinfected with HIV.'4 Barrier contraception has been shown to reduce the risk of transmission.'5