tbuckley/cabot-search huggingface dataset:
Rates of Cardiopulmonary Resuscitation Training in the United States
Authors: Monique L. Anderson, Margueritte Cox, Sana M. Al-Khatib, Graham Nichol, Kevin L. Thomas, Paul S. Chan, Paramita Saha-Chaudhuri, Emil L. Fosbol, Brian Eigel, Bill Clendenen, Eric D. Peterson
Journal: JAMA Internal Medicine (2013)

<h3>Importance</h3> Prompt bystander cardiopulmonary resuscitation (CPR) improves the likelihood of surviving an out-of-hospital cardiac arrest. Large regional variations in survival after an out-of-hospital cardiac arrest have been noted. <h3>Objectives</h3> To determine whether regional variations in county-level rates of CPR training exist across the United States and the factors associated with low rates in US counties. <h3>Design, Setting, and Participants</h3> We used a cross-sectional ecologic study design to analyze county-level rates of CPR training in all US counties from July 1, 2010, through June 30, 2011. We used CPR training data from the American Heart Association, the American Red Cross, and the Health &amp; Safety Institute. Using multivariable logistic regression models, we examined the association of annual rates of adult CPR training of citizens by these 3 organizations (categorized as tertiles) with a county’s geographic, population, and health care characteristics. <h3>Exposure</h3> Completion of CPR training. <h3>Main Outcome and Measures</h3> Rate of CPR training measured as CPR course completion cards distributed and CPR training products sold by the American Heart Association, persons trained in CPR by the American Red Cross, and product sales data from the Health &amp; Safety Institute. <h3>Results</h3> During the study period, 13.1 million persons in 3143 US counties received CPR training. Rates of county training ranged from 0.00% to less than 1.29% (median, 0.51%) in the lower tertile, 1.29% to 4.07% (median, 2.39%) in the middle tertile, and greater than 4.07% or greater (median, 6.81%) in the upper tertile. Counties with rates of CPR training in the lower tertile were more likely to have a higher proportion of rural areas (adjusted odds ratio, 1.12 [95% CI, 1.10-1.15] per 5–percentage point [PP] change), higher proportions of black (1.09 [1.06-1.13] per 5-PP change) and Hispanic (1.06 [1.02-1.11] per 5-PP change) residents, a lower median household income (1.18 [1.04-1.34] per $10 000 decrease), and a higher median age (1.28 [1.04-1.58] per 10-year change). Counties in the South, Midwest, and West were more likely to have rates of CPR training in the lower tertile compared with the Northeast (adjusted odds ratios, 7.78 [95% CI, 3.66-16.53], 5.56 [2.63-11.75], and 5.39 [2.48-11.72], respectively). <h3>Conclusions and Relevance</h3> Annual rates of US CPR training are low and vary widely across communities. Counties located in the South, those with higher proportions of rural areas and of black and Hispanic residents, and those with lower median household incomes have lower rates of CPR training than their counterparts. These data contribute to known geographic disparities in survival of cardiac arrest and offer opportunities for future community interventions.
STUDIES OF THE PLASMIN SYSTEM
Authors: Philip S. Norman, Betsy M. Hill
Journal: The Journal of Experimental Medicine (1958)

There are two inhibitors of plasmin in the plasma proteins of the human. alpha1-antiplasmin is heat-labile and migrates as an alpha1-globulin on electrophoresis. It combines non-dissociably with plasmin at a rate that depends on temperature. alpha2-antiplasmin is relatively more heat-stable and migrates as an alpha2-globulin on electrophoresis. It combines dissociably with plasmin independently of temperature.
Systemic transforming growth factor-beta in patients with bone marrow fibrosis—pathophysiological implications
Authors: Pranela Rameshwar, Victor T. Chang, Usha F. Thacker, Pedro Gascón
Journal: American Journal of Hematology (1998)

Idiopathic myelofibrosis (IMF) and secondary myelofibrosis (MF) are characterized by bone marrow (BM) fibrosis, neoangiogenesis, and increased extracellular matrix (ECM) proteins. These characteristics may be partially attributed to transforming growth factor beta (TGF-β), a cytokine produced by monocytes. In myelofibrosis, monocytes are increased and activated with concomitant up-regulation of intracytoplasmic TGF-β. We have therefore determined systemic TGF-β in patients with either BM fibrosis: IMF, n = 18; MF, n = 16; or without BM fibrosis: hematologic disorders with normal platelets (n = 31); high platelets (n = 9); or normal controls (n = 27). Compared with nonfibrosis sera, there was significant TGF-β elevation in BM fibrosis sera (P < 0.0001). Most (>80%) of the TGF-β is active and belongs to the −β1 isoform. In situ hybridization and immunohistochemical analyses in BM biopsy sections showed a marked increase in TGF-β1 only in patients with fibrosis. Moreover, TGF-β protein was detected mainly in myelomonocytic-like predominant areas. To determine if another functionally similar cytokine, basic fibroblast growth factor (bFGF), may be important to BM fibrosis, we quantitated sera levels and found elevation in 57% compared with 100% elevation for TGF-β. The data indicate that irrespective of etiology, systemic TGF-β is elevated in patients with BM fibrosis. TGF-β likely plays an important role in the development of BM fibrosis. The study also provides a significant parameter for early therapeutic intervention in BM fibrosis. Am. J. Hematol. 59:133–142, 1998. © 1998 Wiley-Liss, Inc.
???Ink Blot??? Bone Imaging in Metastatic Osteogenic Sarcoma
Authors: RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1989)

A Tc-99m MDP bone image in a woman with a lumbar area mass revealed an "ink blot" pattern of uptake. This was characterized by multiple lesions, irregular, extensive, and with locally avid uptake. It proved to be metastatic osteogenic sarcoma.
Renal Outcome in Type 2 Diabetic Patients With or Without Coexisting Nondiabetic Nephropathies
Authors: Teresa Yuk Hwa Wong, Paul Cheung Lung Choi, Chun Cheuk Szeto, Ka Fai To, Nelson Leung Sang Tang, Anthony Wing Hung Chan, Philip Kam Tao Li, Fernand Mac-Moune Lai
Journal: Diabetes Care (2002)

To determine the risk factors for adverse renal outcome in type 2 diabetic patients who underwent renal biopsy and were followed-up longitudinally.We examined 68 consecutive patients with type 2 diabetes during the period of 1985-1999 who underwent renal biopsy for proteinuria > or =1 g/day, renal involvement (proteinuria or renal impairment) at the absence of retinopathy, renal involvement with duration of diabetes < 5 years, or unexplained hematuria of glomerular origin. Their clinical features and underlying renal lesion were correlated with the renal outcome after longitudinal follow-up. Three groups of patients were defined based on their renal pathology: group I consisted of 24 patients (35%) with diabetic glomerulosclerosis (DGS) alone, group II consisted of 13 patients (19%) with nondiabetic nephropathy (NDN) superimposed on DGS, and group III consisted of 31 patients (46%) with NDN alone without evidence of DGS.After a mean follow-up of 123 months from the diagnosis of type 2 diabetes (74 months from the time of renal biopsy), univariate analysis showed that risk factors for reaching end-stage renal disease (requiring maintenance dialysis, or a serum creatinine [SCr] > or =700 micromol/l) included proteinuria > or = 2g/day (P = 0.0087), SCr >120 micromol/l (P = 0.0005), presence of retinopathy (P < 0.00001) at the time of biopsy, and biopsy showing DGS (groups I and II) (P = 0.035). On multivariate analysis, retinopathy was the only independent variable correlated with end-stage renal failure. This study also showed that the association of hematuria or proteinuria with the absence of retinopathy constitutes the strongest indication for a nondiabetic lesion (positive predictive values of 94%).Patients with type 2 diabetes undergoing renal biopsy constitute a heterogeneous group by their clinical presentations and underlying pathology, but longitudinal studies on the renal outcome of these patients remain limited. Our study showed that renal biopsy is indicated in selective diabetic patients because of potentially treatable nephropathy and of a better prognosis than DGS.
A METHOD OF HANDLING ALVEOLAR PYORRHEA.
Authors: GEO. T. CARPENTER
Journal: JAMA (1898)

In presenting this paper before this Section, I do so with a feeling that the practical side should not be lost sight of while we are eagerly searching out the scientific. Much has been written on the subject of pyorrhea alveolaris and there is a great difference of opinion still existing as to the etiology, pathology, diagnosis and treatment of this disease. It is not my purpose in this paper to discuss the various points above mentioned, but to give a brief outline of a method of handling these cases which has given me the most satisfactory results. It has been my experience that different cases of pyorrhea differ in their treatment. One case may yield readily to a certain treatment, while another may be very persistent in its pathologic behavior. But thoroughness in diagnosis and treatment is the key to success. In diagnosing any case, get a history of
Impaired left atrial mechanical function after cardioversion: Relation to the duration of atrial fibrillation
Authors: Warren J. Manning, David I. Silverman, Sarah E. Katz, Marilyn F. Riley, Patricia C. Come, Rosalie M. Doherty, Jiyl T. Munson, Pamela S. Douglas
Journal: Journal of the American College of Cardiology (1994)

Objectives. We hypothesized that the time course of the recovery of atrial systolic function may be related to the duration of atrial fibrillation before cardioversion and sought to study noninvesively the recovery of left atrial mechanical function utilizing serial transthoracic Doppler studies. Background. Recovery of atrial mechanical function may be delayed for several weeks after successful cardioversion of atrial fibrillation to sinus rhythm. Methods. After successful cardioversion, 60 patients with atrial fibrillation of brief (≤2 week, 17 patients), moderate (>2 to 6 weeks, 22 patients) or prolonged (>6 weeks, 21 patients) duration were followed up with serial transmitral pulsed Doppler echocardiography immediately (60 patients) and at 24 h (45 patients), 1 week (41 patients), 1 month (31 patients) and >3 months (30 patients) after cardioversion. Results. Atrial mechanical function is greater immediately and at 24 h and 1 week after cardioversion in patients with "brief" compared with "prolonged" atrial fibrillation. In all groups, atrial mechanical function increases over time, ultimately achieving similar levels. Full recovery of atrial mechanical function, however, is achieved within 24 h in patients with brief atrial fibrillation, within 1 week in patients with moderate-duration atrial fibrillation and within 1 month in patients with prolonged atrial fibrillation. Conclusions. Recovery of left atrial mechanical function is related to the duration of atrial fibrillation before cardioversion. These findings have important implications for assessing the early hemodynamic benefit of successful cardioversion.
Blood coagulation factor XIa binds specifically to a site on activated human platelets distinct from that for factor XI.
Authors: D Sinha, F S Seaman, A Koshy, L C Knight, P N Walsh
Journal: Journal of Clinical Investigation (1984)

Binding of 125I-Factor XIa to platelets required the presence of high molecular weight kininogen, was enhanced when platelets were stimulated with thrombin, and reached a plateau after 4-6 min of incubation at 37 degrees C. Factor XIa binding was specific: 50- to 100-fold molar excesses of unlabeled Factor XIa prevented binding, whereas Factor XI, prekallikrein, Factor XIIa, and prothrombin did not. When washed erythrocytes, added at concentrations calculated to provide an equivalent surface area to platelets, were incubated with Factor XIa, only a low level of nonspecific, nonsaturable binding was detected. Factor XIa binding to platelets was partially reversible and was saturable at concentrations of added Factor XIa of 0.2-0.4 microgram/ml (1.25-2.5 microM). The number of Factor XIa binding sites on activated platelets was estimated to be 225 per platelet (range, 110-450). We conclude that specific, high affinity, saturable binding sites for Factor XIa are present on activated platelets, are distinct from those previously demonstrated for Factor XI, and require the presence of high molecular weight kininogen.
Timolol-induced bronchospasm
Authors: M. Dunn
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The article "Timolol-Induced Bronchospasm in Asthmatic Bronchitis" by Schoene et al (1980; 245:1460) added further clinical evidence that timolol maleate, a β-adrenergic receptor blocking agent, should be used with caution in patients with chronic obstructive pulmonary disease with an asthmatic component. Their recommendation to correlate the patient's clinical condition after the administration of timolol drops with spirometry readings is feasible, but we think the quality of the data could be enhanced by considering the following points. The control group was not exactly comparable to the timolol group. The protocol did not suggest that periodic readings of forced expiratory volume in 1 s (FEV<sub>1</sub>) were taken after the initial 30-minute interval vs 15, 30, 60, 90, and 120 minutes in the timolol group. Therefore, factors such as fatigue in performing the spirometry were not controlled. The data could have been easily enhanced by making the investigation a double-blind
Right- or Left-Handedness
Authors: Richard S. Eustis
Journal: New England Journal of Medicine (1949)

A PHYSICIAN who is asked if it is safe and wise to train an apparently left-handed child to use pencil and pen with his right hand can find good authority in the literature for almost any answer he may choose to give. The more he studies the subject, the more confusing it becomes. The theories propounded are various and conflicting.If he then tries to form his own opinion by testing and observing his patients he soon finds that his decision whether a given child is right-handed, left-handed or ambidextrous often depends on the number and type of tests used. . . .
Mandated Choice for Organ Donation: Time To Give It a Try
Authors: Aaron Spital
Journal: Annals of Internal Medicine (1996)

A severe shortage of organs greatly limits the ability to deliver the miracle of transplantation to people suffering from end-stage organ disease. Contributing to this shortage is a high rate of refusal among families who are asked for permission to remove organs from a recently deceased relative. Mandated choice offers an alternative to obtaining consent from the family by returning control to the individual. This plan would require all adults to record their wishes about posthumous organ donation and would consider those wishes binding. By moving the decision-making process to a relaxed setting and ensuring that a person's wishes would be honored, mandated choice would hopefully take advantage of favorable public attitudes toward donation and thereby facilitate organ procurement. Preliminary research suggests that public commitment to organ donation would increase under mandated choice. A pilot study of this promising proposal should be undertaken.
Toxicological studies of shale oils, some of their components, and commercial products.
Authors: I A Veldre, H J Jänes
Journal: Environmental Health Perspectives (1979)

Estonian shale oil contains about 25--30% phenols, and their action determines the toxicity of shale oils. The clinical symptoms of intoxication are rather similar, regardless of route of administration. Due to neurotropic action, the coordination of movements is impaired, and clonic and tetanic convulsions, paresis and paralysis of extremities, and narcosis are observed. In subacute and chronic toxicity tests, dysfunction of the central nervous system was found. In long-term (4--6 month) experiments, changes in liver and kidney function were found. Shale oil has gonadotropic activity and causes changes in the sexual cycle as well as diminution of the number of primordial folicles in the ovaries or a decrease in the quantity of normal spermatogonia in testicular germinal epithelium. Shale oils produce local irritation of skin and mucous membranes. Shale oil can induce sensitization of the organism after repeated administration. The results of acute intoxication tests have proved that volatile and nonvolatile phenol fractions, isomeric dimethylphenols, and 5-methylresorcinol, must be characterized as moderately toxic substances; the LD50 ranges from 501 to 1500 mg/kg. The clinical symptoms of acute toxication are similar for all studied phenols (restlessness, unsteadiness, clonic tremor, paresis and paralysis of extremities, and death). In spite of the moderate toxicity of phenols in acute experiments, repeated administration of small doses can cause different changes in the nervous system and internal organs of experimental animals. For all the phenols studied, the maximum allowable concentration in water was limited by their effect on the organoleptic properties of water. The nonactive dose for warm-blooded animals is from 100 to 3000 times the threshold limit value of phenols on the basis of their organoleptic properties. The effect of commercial products of oil shale industry is generally determined by the toxicity of the main components: water-soluble oil shale phenols.
When Is Replacement Feeding Safe for Infants of HIV-Infected Women?
Authors: Grace C John-Stewart
Journal: PLoS Medicine (2007)

Renaud Becquet and colleagues report their fi ndings from a new study looking at the long-term safety of infant feeding interventions aimed at reducing mother-to-child HIV transmission in Africa [1].Over two years, the researchers studied the safety of infant feeding interventions (either formula feeding or shortened breastfeeding) among infants of HIV-infected mothers in Abidjan, Côte d'Ivoire. The UNAIDS GuidelinesThe authors chose to examine this issue because of the continued challenges faced by HIV-infected mothers regarding infant feeding.Breastmilk transmission of HIV contributes substantially to the risk of infant HIV infection; consequently HIV-infected mothers in Europe and the United States are counseled not to breast-feed their infants.However, avoiding breastfeeding or shortening the term of breast-feeding may be risky for infants in settings with inadequate sanitation, limited access to breast-milk substitutes, or unsafe water.Thus, UNAIDS (the Joint United Nations Programme on HIV/AIDS) recommends that HIVinfected women "replacement feed" their infants when it is acceptable, feasible, affordable, sustainable, and safe ("replacement feeding" is a term used to refer to feeding infants with milk other than breast milk, such as formula) [2].Interpreting these guidelines is particularly challenging on the ground.When is replacement feeding safe for babies?This issue of safety is the focus of Becquet et al's study-by measuring severe morbidity and mortality, the authors determined how risky replacement feeding and shortened breast-feeding were for infants born to HIV-infected mothers in an urban African setting. When Is Replacement Feeding Safe for Infants of HIV-Infected Women?Grace C.
Evaluation of Postoperative Osteomyelitis of the Sternum Comparing CT and Dual Tc-99m MDP Bone and In-111 WBC SPECT
Authors: PETER R. BESSETTE, MARK J. HANSON, DAVID J. CZARNECKI, DAVID L. YUILLE, JAMES J. RANKIN
Journal: Clinical Nuclear Medicine (1993)

BESSETTE, PETER R. M. D.; HANSON, MARK J. M. D.; CZARNECKI, DAVID J. M. D.; YUILLE, DAVID L. M. D.; RANKIN, JAMES J. M. D. Author Information
On Policymaking in Medicine
Authors: Charles N. Verheyden
Journal: JAMA (1981)

WHEN Abraham Flexner made his study of medical education and presented his findings and recommendations to the public in 1910,<sup>1</sup>he did not foresee the complex issues that presently exist in medical education. Currently there are approximately 268 national specialty organizations, 23 specialty certifying boards, 125 medical schools, 55 state and territorial medical societies, and 412 county medical societies. Some of the issues debated by and activities of these organizations include the accreditation of medical schools, residency training programs, and continuing medical education; certification and recertification; foreign medical graduates and US citizens studying medicine abroad; and government regulation of hospitals, drugs, and health care delivery—the list could go on and on. All of the organizations listed have an impact on the lives of more than 350,000 physicians in this country and on their involvement with their patients. The membership of the governing and policymaking bodies inthese organizations largely consists
Promoter Methylation Inhibits <b> <i>APC</i> </b> Gene Expression by Causing Changes in Chromatin Conformation and Interfering with the Binding of Transcription Factor CCAAT-Binding Factor
Authors: Guoren Deng, Geun-Am Song, Erik Pong, Marvin Sleisenger, Young S. Kim
Journal: Cancer Research (2004)

Abstract As an important regulator in Wnt-signaling pathway, the APC gene is involved in apoptosis and cell cycle arrest. The loss of APC function is observed in most familial adenomatous polyposis-associated and sporadic colorectal cancer. APC gene is frequently inactivated by DNA mutations. However, hypermethylation in APC gene promoter was also observed in different cancers. In this study, by analyzing the methylation status of APC promoter in 22 colorectal cancer cell lines with different APC expression levels, we identified Regions A and B in the promoter, where the methylation of CpG sites was invariably correlated with the loss of gene expression. By nuclease accessibility assay, we also observed a correlation between the closed chromatin conformation in APC promoter and loss of gene expression. When the nonexpressing cell lines were treated with a DNA methyltransferase inhibitor, 5-Aza-2′-Deoxycytidine, the APC expression in these cells was induced, CpG sites were demethylated, and closed chromatin conformation was opened. However, when these cell lines were treated with a histone deacetylase inhibitor, Trichostatin A, no significant changes in APC expression, methylation status, and chromatin conformation were observed. Using transient transfection assay, a CCAAT box located in Region B was identified, which was involved in up-regulation of APC expression. Methylation of CpG sites around the CCAAT box resulted in a significant inhibition in the gene expression. The specific binding of a transcription factor CCAAT-binding factor (CBF) to the CCAAT box was determined by electrophoretic mobility shift analysis. The binding was inhibited after CpG sites close to the CCAAT box were methylated, indicating that DNA methylation can silence gene expression through interfering with the binding of transcription factors to the promoter. The biological function of CBF in APC gene regulation was further indicated by the decrease of luciferase activities in cells cotransfected with a plasmid carrying APC promoter/luciferase gene and a plasmid expressing dominant negative CBF mutant. In summary, methylation of CpG sites around CCAAT box in APC promoter inhibits the gene expression by changing the chromatin conformation and interfering with the binding of transcription factor CBF to CCAAT box.