tbuckley/cabot-search huggingface dataset:
Accrediting Correctional Health Care
Authors: Arthur S. Harrow
Journal: Annals of Internal Medicine (1993)

Letters1 July 1993Accrediting Correctional Health CareArthur S. Harrow, MDArthur S. Harrow, MDHenrico County Jail; Richmond, VA 23294Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-1-199307010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Glaser and Greifinger [1] and the accompanying correspondence [2] regarding correctional health care interested me because part of my medical practice for the past 4 years has included inmate care. I agree with the concern about lack of adequate medical care for this group as well as the need for accreditation of correctional medical facilities. Several accrediting agencies do exist.In the Commonwealth of Virginia, all medical facilities at correctional institutions are required to meet state Department of Corrections standards regarding patient care. All facilities are strongly encouraged, but not yet required by law, ...References1. Glaser JB, Greifinger RB. Correctional health care: a public health opportunity. Ann Intern Med. 1993; 118:139-45. Google Scholar2. Cunningham LW. Correctional health care (Letter). Ann Intern Med. 1993; 118:158. Google Scholar Author, Article, and Disclosure InformationAffiliations: Henrico County Jail; Richmond, VA 23294 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1993Volume 119, Issue 1Page: 93KeywordsHealth careHealth care facilitiesInterleukinsNursesPatientsPsychiatry and mental healthSyphilis Issue Published: 1 July 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Diagnosis and Treatment of Streptococcal Pharyngitis-Reply
Authors: Marvin S. Krober
Journal: JAMA (1985)

<h3>In Reply.—</h3> We are well aware of the limitations on the use of bacitracin disks on primary plates for identification of group A streptococci<sup>1</sup>and used subcultures when necessary for accurate identification. As rapid diagnostic techniques of adequate sensitivity and specificity become available,<sup>2</sup>these will indeed represent a significant advance in the diagnosis of streptococcal pharyngitis. Fuchs has obtusely suggested that the analysis of our data be restricted only to those patients with a fourfold rise in antibody titer. There is, in fact, a statistically significant difference in the symptomatic response of penicillin-treated vs placebo-treated patients when the analysis is limited to this group. However, we disagree with the exclusion of those patients with positive cultures and absence of fourfold rise in antibody titer. We believe, along with Wannamaker,<sup>3</sup>that penicillin treatment may suppress the serologic response to group A streptococcal infection. We agree with Odio and,
Keeping hand hygiene high on the patient safety agenda
Authors: S. Stone, G. Kontowski, R. Gallagher, J. Storr, L. Teare
Journal: BMJ (2013)

WHO’s call to action reminds us that “patients have a voice too” 

The World Health Organization’s annual global hand hygiene day is on 5 May (www.who.int/gpsc/5may/en). The day offers participating hospitals tools to improve hand hygiene and supports WHO’s first global patient safety challenge, launched in 2005 to reduce the global burden of healthcare associated infection through sustained improvements in hand hygiene. By 5 May last year, 130 countries had registered with WHO’s “save lives: clean your hands” initiative (www.who.int/gpsc/5may/background/en). This year the number is 170. WHO’s call to action for 5 May 2013 asks hospitals to “continue to focus on hand hygiene monitoring and feedback” and reminds them that “patients have a voice too.” This reminder has particular resonance for the English NHS in light of recent events where patient safety had low priority, even though England and Wales were the first, in December 2004, to roll out a national Cleanyourhands campaign.1

Research published in the BMJ a year ago showed that the Cleanyourhands campaign, coordinated by the National …
Thin Filament Mutations
Authors: Jil C. Tardiff
Journal: Circulation Research (2011)

Sixteen years ago, mutations in cardiac troponin (Tn)T and α-tropomyosin were linked to familial hypertrophic cardiomyopathy, thus transforming the disorder from a disease of the β-myosin heavy chain to a disease of the cardiac sarcomere. From the outset, studies suggested that mutations in the regulatory thin filament caused a complex, heterogeneous pattern of ventricular remodeling with wide variations in clinical expression. To date, the clinical heterogeneity is well matched by an extensive array of nearly 100 independent mutations in all components of the cardiac thin filament. Significant advances in our understanding of the biophysics of myofilament activation, coupled to the emerging evidence that thin filament linked cardiomyopathies are progressive, suggests that a renewed focus on the most proximal events in both the molecular and clinical pathogenesis of the disease will be necessary to achieve the central goal of using genotype information to manage affected patients. In this review, we examine the existing biophysical and clinical evidence in support of a more proximal definition of thin filament cardiomyopathies. In addition, new high-resolution, integrated approaches are presented to help define the way forward as the field works toward developing a more robust link between genotype and phenotype in this complex disorder.
Afferent neural pathway in the regulation of cardiopulmonary responses to tissue hypermetabolism.
Authors: C S Liang, W B Hood
Journal: Circulation Research (1976)

We studied the role of neural transmission from hypermetabolic peripheral tissues in the regulation of cardiac output and pulmonary ventilation in chloralose-anesthetized dogs. Cross-circulation techniques with femoral-femoral or femoral-aortic anastomoses were used to produce a vascularly isolated, but normally innervated, hindlimb or lower half-body, 2,4-Dinitrophenol (DNP) was infused into the arterial side of the perfusion circuit to triple oxygen consumption and to increase lactate production by the cross-perfused area. After infusion of DNP, cardiac output and mean systemic arterial blood pressure increased, but neither heart rate nor pulmonary artery wedge pressure changed significantly. Pulmonary minute ventilation and arterial pH also increased, while arterial PCO2 fell. These changes were abolished when the nerve connections between the perfused limb and its parent body were severed. Normal saline, when administered in a similar manner, did not increase either ventilation or cardiac output, and simple denervation without previous infusions of DNP also had no effect. These results indicate that there are receptors sensitive to metabolic changes in the tissue, and that neural transmission is an important afferent link in regulating the cardiopulmonary responses to increased tissue metabolism.
The Importance of Indication in the Diagnostic Value of Push Enteroscopy
Authors: S. Lin, M. S. Branch, M. Shetzline
Journal: Endoscopy (2003)

Small-bowel enteroscopy (SBE) is frequently used to examine patients suspected of small-bowel disease. Unfortunately, the diagnostic yield varies widely, from 13 % to 78 % of cases. This disparity may be in part attributable to the vast array of indications for the use of the procedure. The purpose of this study was to examine the diagnostic yield of small-bowel enteroscopy for various indications.This is a retrospective cohort study of all patients who underwent SBE over a 5-year period, from 1995 to 1999.The indications were grouped into in-patient gastrointestinal blood loss (46% of the patient population), outpatient gastrointestinal blood loss (33 %), abnormal radiographic study (7%), iron-deficiency anemia (5%), and others (9%, defined as anemia not otherwise specified, abdominal pain, nausea and vomiting, diarrhea, and weight loss). The overall diagnostic yield was 42 %. Gastrointestinal bleeding had the highest yield, at 44% (in-patient gastrointestinal blood loss 51%, outpatient gastrointestinal blood loss 40%; P=0.1314). Patients with iron-deficiency anemia had a yield of 42%, and patients with a previous abnormal radiograph had a yield of 41%. The combined diagnostic yield for the indications in the "other" category was 21% --significantly lower than in patients with gastrointestinal bleeding, abnormal radiographs, and iron deficiency (P=0.049).SBE is safe and useful in the evaluation of small-bowel disease. Although the overall yield is highly dependent on the specific indication, it is effective for patients with in-patient or outpatient gastrointestinal blood loss, patients with abnormal radiographs that demonstrate small-bowel pathology considered to be within reach of the enteroscope, and iron-deficiency anemia. There are insufficient data to support the use of enteroscopy for other indications such as anemia not otherwise specified, abdominal pain, nausea and vomiting, and chronic diarrhea, and in these cases it is unlikely to be useful.
The Glucocorticosteroid, Budesonide, Partially Blocks Histamine Release from Human Lung Tissue <i>in Vitro</i>
Authors: H. Bergstrand, B. Lundquist, B.‐Å. Petersson
Journal: Allergy (1986)

IgE‐receptor dependent, but not A23187‐induced, histamine release from passively sensitized chopped human lung tissue, or from a dispersed lung cell population obtained from the tissue after enzymatic digestion, is reduced after incubation overnight of cells/tissue with the glucocorticosteroid budesonide (10 ‐7 M). Since the inhibitory effect of budesonide is reduced in the continuous presence of diluted reagin‐rich serum used for passive sensitization, but not in the presence of heat‐inactivated serum, it is suggested that the glucocorticosteroid acts by reducing the binding of IgE‐antibody to the target cell(s).
Management With Combination Therapy
Authors: Paul P. Carbone
Journal: JAMA (1973)

In the original CURRENT CONCEPTS IN CANCER series on Hodgkin's Disease inThe Journalin 1965, Gellhorn<sup>2</sup>suggested that "the objectives of therapeutic management in advanced Hodgkin's disease are to suppress symptomatic manifestations, anticipate or control complications, and provide support to the sufferers of a debilitating disease." At that time, four classes of drugs were available for the treatment of patients with stage III and IV disease; namely, alkylating agents, particularly mechlorethamine hydrochloride (nitrogen mustard), vinblastine sulfate (Velban), procarbazine hydrochloride (Natulan [Great Britain]; Matulane, comparable US product), and prednisone (Deltasone). Furthermore, he suggested the sequential use of single agents from each class, an JAMA, Jan 8, 1973 • Vol 223, No 2 ticipating no cross resistance. Single agents in patients with stage III or IV disease produce tumor regressions 50% to 70% of the time, but only 10% to 20% of the patients achieve complete remissions.<sup>3</sup>In these patients,
Angioimmunoblastic Lymphadenopathy with Dysproteinemia
Authors: ALFRED D. STEINBERG
Journal: Annals of Internal Medicine (1988)

Angioimmunoblastic lymphadenopathy with dysproteinemia is a disorder characterized by a sudden onset of constitutional symptoms and lymphadenopathy. Patients often have hypergammaglobulinemia, autoantibodies, rashes, thrombocytopenia, or hemolytic anemia. Diagnosis requires a lymph node biopsy that shows architectural effacement, absence of germinal centers, arborization of postcapillary venules, and a polymorphous infiltrate that includes immunoblasts. Early in the disease, activated T cells in blood and lymph nodes stimulate B cells to proliferate and produce antibody. However, late in the disease, immune suppression may result from increased suppressor function. Clonal rearrangements, which are seen in all patients with regard to either the T-cell receptor beta-chain gene or immunoglobulin genes, have been followed by malignant transformation and frank lymphoma in some patients. Thus, this disorder stands partway between benign lymphoid proliferation and clonal lymphoid transformation. The prognosis of this disorder is poor; 75% of patients die within 2 years or develop a lymphoid malignancy. The rest usually go into a sustained remission. Current treatment with corticosteriod and immunosuppressive agents is unsatisfactory, especially because of late immunosuppression and predisposition to infections.
Married Mental Patients in Crisis: A Research Report
Authors: DOROTHY MILLER, ROBERT C. BARNHOUSE
Journal: American Journal of Psychiatry (1967)

Married hospitalized mental patients differ significantly from unmarried patients; they exhibit fewer overt psychotic symptoms and have greater financial, social, and emotional resources. Their complaints are likely to be of an interpersonal or environmental nature involving the marriage partner. Yet married patients receive a standard type of treatment including ECT, drugs, and group therapy; very little family therapy is offered. The authors feel that marital conflict and environmental problems should be included in the treatment of married patients if an effective reentry into society is to be attained.
Unnatural History of Tetralogy of Fallot
Authors: Judith A.A.E. Cuypers, Myrthe E. Menting, Elisabeth E.M. Konings, Petra Opić, Elisabeth M.W.J. Utens, Willem A. Helbing, Maarten Witsenburg, Annemien E. van den Bosch, Mohamed Ouhlous, Ron T. van Domburg, Dimitris Rizopoulos, Folkert J. Meijboom, Eric Boersma, Ad J.J.C. Bogers, Jolien W. Roos-Hesselink
Journal: Circulation (2014)

Prospective data on long-term survival and clinical outcome beyond 30 years after surgical correction of tetralogy of Fallot are nonexistent.This longitudinal cohort study consists of the 144 patients with tetralogy of Fallot who underwent surgical repair at <15 years of age between 1968 and 1980 in our center. They are investigated every 10 years. Cumulative survival (data available for 136 patients) was 72% after 40 years. Late mortality was due to heart failure and ventricular fibrillation. Seventy-two of 80 eligible survivors (90%) participated in the third in-hospital investigation, consisting of ECG, Holter, echocardiography, cardiopulmonary exercise testing, N-terminal pro-brain natriuretic peptide measurement, cardiac magnetic resonance (including dobutamine stress testing), and the Short Form-36 questionnaire. Median follow-up was 36 years (range, 31-43 years). Cumulative event-free survival was 25% after 40 years. Subjective health status was comparable to that in the normal Dutch population. Although systolic right and left ventricular function declined, peak exercise capacity remained stable. There was no progression of aortic root dilation. A previous shunt operation, low temperature during surgery, and early postoperative arrhythmias were found to predict late mortality (hazard ratio, 2.9, 1.1, and 2.5, respectively). An increase in QRS duration and a deterioration of exercise tolerance and ventricular dysfunction did not predict mortality. Insertion of a transannular patch was a predictor for late arrhythmias (hazard ratio, 4.0; 95% confidence interval, 1.2-13.4).Although many patients needed a reoperation or developed arrhythmias, late mortality was low, and the clinical condition and subjective health status of most patients remained good. Previous shunt, low temperature during surgery, and early postoperative arrhythmias were found to predict late mortality.
High prevalence of left ventricular hypertrophy in young urban black men with hypertension
Authors: W.S. Post, J.L. Weiss, R.S. Blumenthal, G. Gerstenblith, A.R. Capriotti, M.C. Roary, S. Hall, M.T. Kim, M.N. Hill
Journal: Journal of the American College of Cardiology (1998)
Silent Pulmonary Emboli Without Infarction: Neovascular Formations by the Systemic Arterial Circulation of the Lung as Cause.
Authors: Roe E. Wells
Journal: Annals of Internal Medicine (1964)

s1 April 1964Silent Pulmonary Emboli Without Infarction: Neovascular Formations by the Systemic Arterial Circulation of the Lung as Cause.Roe E. Wells Jr., M.D., F.A.C.P., George T. Smith, M.D.Roe E. Wells Jr., M.D., F.A.C.P.Search for more papers by this author, George T. Smith, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-714_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe problem of clinical diagnosis of pulmonary emboli is emphasized by the quantitative morphologic examinations of the lungs of patients dying of this entity, in which the terminal event has been preceded by numerous prior episodes. These were apparently unknown to both patient and physician. Despite the fact numerous emboli were found in the lungs of these patients less than 10 per cent gave rise to infarction. Experimental studies by Liebow and others who have ligated the main pulmonary arteries of the dog does not proceed to infarction because of the development of bronchial arterial-pulmonary arterial collateral circulations. Similar studies... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1964Volume 60, Issue 4Page: 714-714KeywordsInfarctionLungsNeovascularizationPulmonary arteries Issue Published: 1 April 1964 PDF DownloadLoading ...
The evolutionary versus socio-economic view on grandparenthood: What are the grandparents' underlying motivations?
Authors: Alexander Pashos
Journal: Behavioral and Brain Sciences (2010)

Abstract Coall &amp; Hertwig (C&amp;H) give an ambitious review about the broad range of grandparenting literature from the perspective of different disciplines. They aim to show, how evolutionary theory, sociology, and economics can mutually enrich each other. However, the differences between the evolutionary and the socio-economic perspective should be more clearly pointed out, because they usually deal with different research questions. Grandparents' well-being could be divided into its underlying components.
Measurement of Blood Flow in the Right and Left Coronary Artery Beds in Humans and Dogs Using the 133Xenon Technique
Authors: A. Pitt, G. C. Friesinger, R. S. Ross
Journal: Cardiovascular Research (1969)

Myocardial blood flows in the distribution of the right and left coronary arteries have been measured by the 133xenon method by selectively and sequentially injecting the arteries. In human and dog studies, a highly statistically significant difference between right and left flow was found. (In humans, right 48 ml./100 g/min, left 76 ml./100 g/min.)
Q fever treated with erythromycin.
Authors: L J D'Angelo, R Hetherington
Journal: BMJ (1979)

population of the UK should be raised to about 5 ,ug/day in order that the elderly and others with a limited intake of dietary vitamin D and with infrequent exposure to UVL reach a minimal acceptable vitamin D state.Such a state is that sufficient to prevent the occurrence of osteomalacia, which would require plasma 25-OHD concentrations of 7-5-10 0 nmol/l (3-4 ng/ml).Although fatty fish (for example, sardines) and Ovaltine could provide 5 Ftg of vitamin D/day if consumed frequently, they are not widely eaten and therefore some other foodstuff requires to be fortified.The alternative view of these findings accepts that the vitamin D state of the British population as a whole is undoubtedly adequate for normal health due virtually entirely to solar UVL.The contribution of dietary vitamin D is unimportant compared with the effects produced by UVL (plasma 25-OHD concentrations of 50-75 nmol/l (20-30 ng/ml)).Even if a dietary vitamin D intake of 5 Ftg was accepted as the minimum recom- mended, however, rather than an intake equivalent to the UVL received by the British (about 50 Lg/day5), such levels would be impossible to reach without fortification given the low concentration at which this substance occurs in food.Physiologically, therefore, vitamin D is an essential metabolite with the rare property of being formed by UVL rather than an enzyme, and should not be regarded as a nutrient.This conclusion has obvious implications, but the recent successful efforts23 to improve the vitamin D state of the elderly using UVL are to be welcomed as being the more physiological approach.Although UVL may be harmful to skin, only small quantities at wave- lengths of 300-310 nm are required to produce vitamin D.We are indebted to the subjects for their participation in this study, and to the nutrition field-workers Miss E Allen and Mrs E Muncaster, and the nurse Mrs K Hodgson.We also thank Mr J Ashford for the 25-OHD assays and Mr K Day for the computer data analysis.
Are drugs targeted at Alzheimer's disease useful? 1. Useful for what?
Authors: R Levy
Journal: BMJ (1990)

Are drugs targeted at Alzheimer's disease useful?' Useful for what?R Levy Whether drugs aimed specifically at Alzheimer's disease are useful is best approached by considering the various possible expectations about drugs used in this devastating condition.Reversal or arrest of underlying neurobiological process suggestion of benefit in association with tacrine Nottingham
The occurrence of cryoproteins in synovial fluid; the association of a complement-fixing activity in rheumatoid synovial fluid with cold-precipitable protein
Authors: Robert L. Marcus, Alexander S. Townes
Journal: Journal of Clinical Investigation (1971)

A significant portion of a complement-fixing activity found in the synovial fluid of patients with rheumatoid arthritis, and previously implicated as a possible cause of the low synovial fluid complement levels in these patients behaves as a high solubility cryoprotein. Analysis of rheumatoid synovial fluid cryoproteins has revealed mixed immunoglobulins, bound complement components, fibrinogen, DNA, and rheumatoid factor. Sorbitol density gradient studies on whole synovial fluid before and after removal of this activity has shown that the complement-fixing activity migrates in the 19S and heavier regions and that portion is removed with cryoprecipitation. Cryoproteins found in nonrheumatoid synovial fluid are generally devoid of complement-fixing activity and predominantly contain fibrinogen. DNA and IgG are also present, with IgG occurring significantly less frequently than in rheumatoid cryoproteins. These findings are discussed in relationship to recent studies demonstrating the presence of complement-fixing antibody to denatured DNA in rheumatoid cryoproteins.
Renal Micropuncture Study of the Development of Anuria in the Rat with Mercury-induced Acute Renal Failure*
Authors: William J. Flanigan, Donald E. Oken
Journal: Journal of Clinical Investigation (1965)

Acute renal failure in man may result from such factors as trauma, transfusion accidents, sep- sis, burns, and acute poisoning with carbon tetra- chloride, ethylene glycol, or mercury.Regardless of the etiology and despite marked variability in the histologic appearance of the kidneys of indi- vidual cases, most patients with acute renal fail- ure develop oliguria or anuria together with evi- dence of impaired tubular function.The cause of this decrease in urine volume, however, has not been well defined.Some theories commonly conjured to explain the oliguria of acute renal insufficiency stem largely from pathological find- ings rather than from functional studies in vivo.Of these findings, three have been stressed as pos- sibly being responsible for oliguria: tubular ob- struction by cellular debris (1-3), tubular com- pression by interstitial edema (4-7), and "pas- sive backflow" of glomerular filtrate through holes in the wall of the tubule (6, 8, 9).We have at- tempted to determine the possible role of these fac- tors in mercury-induced acute renal failure in the rat. MethodsSprague-Dawley rats weighing 190 to 250 g were placed in metabolic cages 12 to 16 hours before ex- *