tbuckley/cabot-search huggingface dataset:
Residents' Work Hours
Authors: Timothy Lahey
Journal: Annals of Internal Medicine (2004)

Letters2 November 2004Residents' Work HoursTimothy Lahey, MDTimothy Lahey, MDFrom Beth Israel Deaconess Medical Center, Boston, MA 02215.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-9-200411020-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In his recent commentary on reducing resident work hours (1), Dr. Charap argued that the ACGME should reconsider mandatory restrictions on resident work hours because they may result in reduced continuity of care, tarnished medical professionalism, and eroded investment in the medical community. I agree these are important dangers posed by the new hours restrictions; in fact, as a recent chief resident intimately involved in changing residency programs in response to the new regulations, I too have seen each of these risks realized. However, I believe that the proper response to these challenges is creative and long-overdue ...Reference1. Charap M. Reducing resident work hours: unproven assumptions and unforeseen outcomes. Ann Intern Med. 2004;140:814-5. [PMID: 15148068] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Timothy Lahey, MDAffiliations: From Beth Israel Deaconess Medical Center, Boston, MA 02215. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReducing Resident Work Hours: Unproven Assumptions and Unforeseen Outcomes Mitchell Charap Benefits of Resident Work Hours Regulation Kelley M. Skeff , Stephen Ezeji-Okoye , Peter Pompei , and Stanley Rockson The Effect of Work Hour Regulations on Personal Development during Residency Melinda E. Glines How Many Hours Is Enough? An Old Profession Meets a New Generation Steven A. Schroeder Residents' Work Hours Yungpo Bernard Su and Lydia Kang Residents' Work Hours Ilene M. Rosen , Judy A. Shea , and Lisa M. Bellini Residents' Work Hours Mitchell Charap Residents' Work Hours Gabriella Varallo Bedarida Residents' Work Hours Sarang Kim Metrics 2 November 2004Volume 141, Issue 9Page: 741KeywordsHappinessPatientsResidencySleep ePublished: 2 November 2004 Issue Published: 2 November 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Posterior Ventricular Aneurysms
Authors: Floyd D. Loop, Donald B. Effler, Joel S. Webster, Laurence K. Groves
Journal: New England Journal of Medicine (1973)

An extensive infarction of the posterior (diaphragmatic) left ventricular wall often compromises the posterior papillary muscle and causes early death from severe mitral regurgitation. This single fact explains the scarcity of posterior aneurysms as a clinical entity. In 11 cases of large posterior ventricular aneurysms that infringed upon but did not damage the mitral-valve mechanism, aneurysmectomy was performed. Repair of postinfarction ventricular septal defects was also necessary in two patients. The clinical diagnoses were made or confirmed by ventriculography and coronary arteriography. Of the major symptoms associated with posterior ventricular aneurysms, congestive heart failure was the most common indication for surgery. No operative deaths occurred; one patient died of a myocardial infarction in the late postoperative period. The 10 surviving patients are active, with improvement over their preoperative condition.
Genetics of ulcerative colitis: the come-back of interleukin 10
Authors: E. Louis, C. Libioulle, C. Reenaers, J. Belaiche, M. Georges
Journal: Gut (2009)

Crohn’s disease and ulcerative colitis are chronic, immune-mediated inflammatory diseases of the gastrointestinal tract, affecting up to 0.4% of the population in Western countries.1 They are considered complex multifactorial polygenic diseases. While dramatic progress has been made in deciphering the genetic architecture of Crohn’s disease, ulcerative colitis was somewhat left behind, with virtually no relevant studies published until very recently. Although both disorders are considered to belong to the same spectrum of pathologies, the first gene clearly associated with Crohn’s disease ( CARD-15 )2 3 did not seem to predispose to ulcerative colitis in any cohort in which it was tested. This finding highlighted some pathogenic differences between the two diseases, and reminded geneticists working on inflammatory bowel diseases (IBDs) of the more modest contribution of genetics to the predisposition to ulcerative colitis, reflected in a lower ratio of disease concordance between monozygotic and dizygotic twins.4 The lower heritability of ulcerative colitis also accounts for the fact that most of the linkage studies performed in the 1990s did not include sufficient ulcerative colitis-affected sib pairs to disclose ulcerative colitis-related loci. With few exceptions,5 6 7 reports of associations with candidate genes have not been confirmed. Recently, major advances in cataloguing common genetic variants in humans combined with the development of high-throughput single nucleotide polymorphism (SNP) genotyping capacity, have made large-scale, genome-wide association studies (GWASs) with hundreds of thousands of common SNPs feasible. These have dramatically increased the list of loci shown to be associated with Crohn’s disease,8 9 10 11 12 13 and now also with ulcerative colitis14 15 16 17 (table 1).

View this table:

Table 1 
Single nucleotide polymorphisms (SNPs) significantly associated with ulcerative colitis, identified through genome-wide association studies15 16 17 or systematic testing after significant association with Crohn’s disease in genome-wide association studies14 …
Abstract 4061: Computer-assisted Gleason grading of prostate cancer: Two novel approaches using nuclear shape and texture feature to classify pathologic Gleason grade patterns 3 and 4
Authors: Robert W. Veltri, Christhunesa Christudass, Jonathan I. Epstein, Sahirzeeshan Ali, Hong-Jun Yoon, Ching-Chung Li, Anant Madabhushi
Journal: Cancer Research (2012)

Abstract Introduction: We used two novel computer-assisted imaging applications that incorporate nuclear shape and texture analysis to differentiate Gleason grade patterns 3 and 4 of H&amp;Ein a tissue microarray (TMA). The two approaches utilized a variational adaptive segmentation scheme (AdACM) (Rutgers) and the cardinal multiridgelet transform (CMRT) based texture analysis (University of Pittsburgh). Methods: The TMA include 0.6 mm cores from blocks that included Gleason patterns of CaP radical prostatectomy cases from 40 patients. The TMA comprised 13 Gleason patterns 6 (3+3), 8 pattern 7 (3+4), 7 pattern 8 (4+4) and 5 pattern 9 (4+5) Gleason grade (GG) patterns. The AdACM uses 200 × 200 pixel images extracted for nuclear &amp; architectural textural features. All features were based on mathematical energy terms with a shape prior in a multi-level set formulation. The CMRT is an image transform that is translation- and rotation-invariant, and provides a means of displaying texture contents for selection of discriminative features. With a 3-scale decomposition, it gives 8 ridgelet packets and 16 statistical texture features in a 256 x 256 pixel image patch that are averaged over 9 non-overlapping patches in a given image for separation of GG patterns 3 and 4. Results: The CMRT study utilized 3 of 16 texture features extracted from images and trained a Gaussian kernel support vector machine (SVM), a leave-one-out cross-validation showed an accuracy of 94% and AUC of 0.97. For AdACM, nuclear features and architectural features were extracted. Linear Discriminant Analysis (LDA) was employed for feature selection and best features from all three classes could discriminate Gleason grade 3 vs. 4 with an accuracy of 86% via a SVM classifier. Conclusions: Unique quantitative imaging of tissue nuclear shape and texture features can accurately differentiate Gleason patterns 3 and 4. Our research will next evaluate CaP outcomes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4061. doi:1538-7445.AM2012-4061
Local Excision and Primary Radiation Therapy for Early Breast Cancer
Authors: M. B. Levene
Journal: CA A Cancer Journal for Clinicians (1981)

The patient with breast cancer who seeks a method of treatment other than mastectomy is usually highly interested in the cosmetic results of such treatment.Many factors can be identified that influ ence the cosmetic appearance after exci sion of the lump and irradiation.The major categories that affect the cosmetic results are:surgical technique, radiationdose, and radiation technique. Surgical TechniqueA circumareolar incision should be per formed when feasible.If not, the natural skin fold lines of the breast should be fol lowed rather than the radial type of inci sion.The amount of tissue taken should be as small as is consistent with the re moval of the entire gross tumor.No effort
Immunologic Responses in Urinary-Tract Infections
Authors: Jay P. Sanford
Journal: JAMA (1965)

Circulating antibodies develop in both experimental and clinical pyelonephritis. However, the relationship of such antibodies to antibacterial resistance is complex, and conclusions drawn from various observations have been controversial. In experimental pyelonephritis caused by gram-negative bacilli, preimmunization was protective; however, it was nullified by obstructive uropathy. Clinical assessment of antibody response has had two goals: determination of diagnostic value and assessment of protective effects. While a single hemagglutinin titer is of limited value, a significant rise in anti-0 hemagglutinin titer suggests pyelonephritis. In patients with cystitis, titers tend to remain stable. Immunity appears to play little role in recovery, but may be a determinant in selection of organisms involved in reinfection.
Treating inguinal hernias
Authors: Paul M Peyser
Journal: BMJ (2004)

Editor—Kingsnorth has misrepresented the role of the laparoscopic hernia repair in his article.1 A clinician reading this who has no experience of surgical options for inguinal hernia repair may come away with the impression that laparoscopic repair has largely been dismissed by the surgical community and the National Institute for Clinical Excellence (NICE).

Kingsnorth reports that the incidence of chronic groin pain after hernia repair has now overtaken that of hernia recurrence, without making it clear that among the various advantages of laparoscopic hernia repair (less postoperative pain and earlier return to normal activity) chronic groin pain almost never occurs.

The rare but serious complications that he quotes from the European Union's hernia trialists collaboration were for transabdominal pre-peritoneal hernia repairs (as opposed to totally extra peritoneal repairs),2 which are not currently recommended by NICE.

The article did not highlight the fact that laparoscopic repair is recommended by NICE for bilateral and recurrent hernia repair. The main objections to laparoscopic repair for primary hernias are apparently financial and not clinical.3

Interestingly the illustration of mesh in the preperitoneal space is the mesh placement for laparoscopic not open repairs, although this is not stated in the text. This may further mislead readers who are not aware of these differences into believing this represents mesh replacement for open hernia repair.

Kingsnorth oversees a hernia unit at Plymouth that deals exclusively with open hernia repairs. This might be regarded as a competing interest.
Police investigate parents' involvement in assisted suicide
Authors: C. Dyer
Journal: BMJ (2008)

<h3>Abstract</h3> The emergence of SARS-CoV-2/2019 novel coronavirus (COVID19) has created a global pandemic with no approved treatments or vaccines. Many treatments have already been administered to COVID19 patients but have not been systematically evaluated. We performed a systematic literature review to identify all treatments reported to be administered to COVID19 patients and assess time to clinically meaningful response for treatments with sufficient data. We searched PubMed, BioRxiv, MedRxiv, and ChinaXiv for articles reporting treatments for COVID19 patients published between 12/1/2019–3/27/2020. Data were analyzed descriptively. Of the 2,706 articles identified, 155 studies met inclusion criteria, comprising 9,152 patients from 14 different countries. The cohort was 45.4% female and 98.3% hospitalized and mean (SD) age was 44.4 years (SD 21.0). The most frequently administered drug classes were antivirals, antibiotics, and corticosteroids, and of the 115 reported drugs, the most frequently administered was combination lopinavir/ritonavir, which was associated with a time to clinically-meaningful response (complete symptom resolution or hospital discharge) of 11.7 (1.09) days. There was insufficient data to compare across treatments. A large number of treatments have been administered to the first 9,152 reported cases of COVID19. These data serve as the basis for an open-source registry of all reported treatments given to COVID19 patients. Further work is needed to prioritize drugs for investigation in well-controlled clinical trials and treatment protocols.
Preventive model of health care needed, says King's Fund
Authors: Debashis Singh
Journal: BMJ (2004)

UK government health policy will have little impact unless it includes practical measures to build a health system that promotes health rather than just caring for people when they become ill.

That is the warning from the independent charity the King's Fund, in a discussion paper by Anna Coote marking the launch of the fund's new Putting Health First programme.

Rather than ignore the NHS, the government should design and build a health system that promotes health and reduces health inequalities, it says.

The paper highlights rises in the prevalence of obesity, which it says …
Altered spectrum of nitroglycerin action in long-term treatment: nitroglycerin-specific venous tolerance with maintenance of arterial vasodepressor potency.
Authors: D J Stewart, D Elsner, O Sommer, J Holtz, E Bassenge
Journal: Circulation (1986)

The study of venodilator tolerance to nitroglycerin has been complicated by reflex compensation and by problems in analyzing venous tone in the presence of multiple determinants of venous pressure. We assessed venous tone as total effective vascular compliance (TEVC) under autonomic blockade in six dogs, in the nontolerant state, and during a 5 day infusion of nitroglycerin (1.5 micrograms/kg/min). Under long-term treatment, baseline TEVC was unaffected and the nitroglycerin dose-response relationship for TEVC was shifted to greater than 10-fold higher doses, whereas baseline mean arterial pressure (MAP) was lowered by 17 +/- 3 mm Hg without any shift in nitroglycerin responsiveness. This lowering of MAP was observed only after autonomic blockade. In six additional dogs instrumented with aortic flow probes, nitroglycerin (1.5 micrograms/kg/min) induced a 15 +/- 1% decline in peripheral vascular resistance (PVR) under autonomic blockade, but with reflexes intact these dogs showed no change in PVR and a 21 +/- 10% increase in norepinephrine release rate. We conclude that modest long-term exposure to nitroglycerin results in tolerance to its venodilating effects, whereas arteriolar action is maintained. This tolerance-induced shift in action from venous toward arteriolar dilation is normally masked by compensatory reflexes.
Compulsory screening of immigrants for TB and HIV
Authors: Ulf R Dahle
Journal: BMJ (2004)

Research on preventing road traffic injuries in developing countries is neededEditor-The dedication of the World Health Organization's World Health Day 2004 to road safety is recognition of the global threat of road traffic injuries.Increasing population size, vehicle ownership, road infrastructure, and transnational transportation have created a substantial public health burden.However, little epidemiological research has been conducted into preventing road traffic injuries in developing countries.Currently global research and development funding per disability adjusted life year for HIV, asthma, and blindness are $26.2,$10.8, and $5.4, respectively, while only $0.40 for road traffic injuries. 1 Epidemiological studies of successful interventions preventing road traffic injuries have been conducted in developed countries. 2But to assume the same effectiveness in developing countries is inappropriate because of behavioural, vehicular, and environmental differences.A pooled analysis of street lighting intervention data from developed countries shows a protective effect, 3 particularly in pedestrian injury (relative risk 0.56), the most common road traffic injuries in developing countries.Annually, 1.2 million deaths are attributed to road traffic crashes, 85% occurring in developing countries. 4If an intervention such as street lighting could reduce deaths by as much as 30%, there is a potential to save thousands of lives.Various international aid agencies are investing in road infrastructure development.These initiatives could be coupled with the need to develop concrete epidemiological data.Innovative strategies, such as step wedge study design, 5 could lead to the evolution of an evidence based public health approach to this problem.
A nitric oxide-like factor mediates nonadrenergic-noncholinergic neurogenic relaxation of penile corpus cavernosum smooth muscle.
Authors: N Kim, K M Azadzoi, I Goldstein, I Saenz de Tejada
Journal: Journal of Clinical Investigation (1991)

This study was initiated to characterize nonadrenergic-noncholinergic (NANC) inhibitory neurotransmission in penile corpus cavernosum. Using organ baths, isometric tension measurements were made in strips of human and rabbit corpus cavernosum. In examining endothelium-mediated responses, cumulative additions of exogenous acetylcholine elicited dose-dependent relaxations which were significantly reduced or completely inhibited in tissues treated with NG-monomethyl L-arginine (L-NMMA; an inhibitor of nitric oxide synthesis), oxyhemoglobin (a nitric oxide scavenger), or methylene blue (a guanylate cyclase blocker). Tissues exposed to hypoxic conditions (PO2 = 5-10 mmHg) also did not respond to exogenous acetylcholine. Mechanical removal of the endothelium in human corporal strips or in situ treatment of rabbit corpora with detergent blocked the relaxation to acetylcholine. Transmural electrical stimulation of corporal tissue strips denuded of functional endothelium, in the presence of adrenergic blockade with bretylium and muscarinic receptor blockade with atropine, caused frequency-dependent relaxation. This neurogenic relaxation was reduced or prevented by L-NMMA, oxyhemoglobin, methylene blue, and hypoxia. The effects of L-NMMA were reversed by L-arginine and the effects of hypoxia were readily reversed by normoxic conditions. Authentic, exogenous nitric oxide relaxed corporal strips which were contracted with adrenergic agonists and this effect was significantly inhibited by oxyhemoglobin. It is concluded that (a) endothelium-mediated responses of corpus cavernosum smooth muscle are mediated by a diffusible nitric oxide-like substance; (b) NANC neurogenic inhibitory responses do not require functional endothelium, and (c) nitric oxide, or a closely related substance, may act as an inhibitory neurotransmitter in penile corpus cavernosum smooth muscle.
German science in six days.
Authors: T Smith
Journal: BMJ (1982)

This must be Heidelberg because it's Thursday: the perennial aside from the package tourist had more than a ring of truth about it for six science journalists taken from Munich via W?rzburg and Nuremberg to Heidelberg and on to Bonn in a week. The tour had been arranged by the German Embassy in London to show the British visitors some aspects of biom?dical research in the Federal Republic. The topics ranged from molecular biology to solar generators with medicine somewhere in the middle. Add to the cocktail an unexpected and sustained heatwave and an equally unexpected political crisis in Bonn and my overall assessment became largely impressionistic.
The Old Folks at Home: Variations on a Theme
Authors: Robert H. Moser
Journal: JAMA (1974)

There are two good reasons not to write this column: (1) I hesitate to add to the tons of tiresome verbiage that have been published on geriatric problems, and (2) at least half the people who read this will become angered. But I am encouraged by a remarkable document that has come across my desk: Civil Action No. 2465-72, in which one Martin O. Weisbrod is the plaintiff and James T. Lynn, the Secretary of the Department of Housing and Urban Development, is the defendant. The case has to do with a challenge to the constitutionality of the Federal Employee Mandatory Retirement Law, 5 USC 8335. The American Medical Association (AMA) has taken a firm position on behalf of Mr. Weisbrod. Bernard D. Hirsh, General Counsel for the AMA, has filed an amicus curiae brief in support of the plaintiff's motion. I believe it is a landmark document, an eloquent
Secrecy and distinction awards
Authors: S Bourne, P Bruggen
Journal: BMJ (1987)

sensitivity to halothane in children with a, anti- trypsin deficiency,3 but they refer to an article in the New England 3rournal of Medicine.4Again, there is no mention of this sensitivity.This is an example ofan error compounded through misread- ing and referencing.The authors present seven cases of suspected halothane hepatitis.In case 7, however, they found no halothane antibody, but they still classified this child as having halothane hepatitis, explaining that it is possible that the antibody was produced but was undetectable.In the case report they state that a 3½/2 year old boy weighed 1800 g.This is an extremely small child.Though halothane hepatitis may occur in children, it is extremely rare, and Dr Kenna and coworkers cannot give the incidence that might be expected in children.In a review article on halothane hepatitis Stock et al concluded that there is no diagnostic test that is specific for halothane induced liver damage and that therefore the diagnosis can be made only by excluding all other causes of postoperative liver dysfunction.5Walton states that non-A, non-B hepatitis may be responsible for halothane hepatitis after a single exposure.6Thus we still cannot define specifically the diagnostic criteria for halothane hepatitis.If it exists it remains extremely rare in children and has an incidence less than that of non-A, non-B hepatitis in the general population.An extensive clinical study of preoperative liver function in asymptomatic children who received halothane and were then followed up for a long period would be needed to provide clearer conclusions.
Repair of rabbit segmental femoral defects by using a combination of tetrapod-shaped calcium phosphate granules and basic fibroblast growth factor-binding ion complex gel
Authors: Muneki Honnami, Sungjin Choi, I-li Liu, Wataru Kamimura, Tetsushi Taguchi, Hironori Hojo, Nobuyuki Shimohata, Shinsuke Ohba, Hiroyuki Koyama, Ryohei Nishimura, Ung-il Chung, Nobuo Sasaki, Manabu Mochizuki
Journal: Biomaterials (2013)
Protein sulphydryl depression during adjuvant arthritis.
Authors: A Lorber, J Leeb, P Carroll, W Baumgartner, V Hill
Journal: Annals of the Rheumatic Diseases (1975)

The changes in plasma protein sulphydryl level were measured during the course of adjuvant-induced arthritis in rats. Major depressions in the plasma sulphydryl level occurred at the onset of adjuvant disease, and the extent of the depression was related to the severity of the disease. Plasma sulphydryl levels remain unchanged when the systemic arthritis is suppressed by inclusion of a competing antigen in the adjuvant. Changes in sulphydryl content of the plasma were shown not to be due to weight loss or decrease in plasma protein level.