tbuckley/cabot-search huggingface dataset:
Resting Comfortably in Bed
Authors: Tavis Dancik
Journal: Annals of Internal Medicine (2009)

Ad Libitum3 March 2009Resting Comfortably in BedTavis Dancik, BSTavis Dancik, BSFrom Birmingham, MI 48009.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-5-200903030-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The medical team had just left his bedside. The curtain was still drawn in tight around his bed, except for the gap through which they made their brisk exit. The TV that he had been watching was now off and hidden beyond the curtain wall. Just out of reach stood his tray table with the breakfast that he had been working on.A bag of his belongings was clutched to his chest with one hand. In his other, he held the card of his primary care physician that was just handed back to him. Upon his lap sat his open ... Author, Article, and Disclosure InformationAffiliations: From Birmingham, MI 48009.Current Author Address: Tavis Dancik, MD, 715 Lake Park Drive, Birmingham, MI 48009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 3 March 2009Volume 150, Issue 5Page: 356KeywordsPrimary care physiciansThoraxUlcers ePublished: 3 March 2009 Issue Published: 3 March 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Treatment of Burns
Authors: David W. Furnas
Journal: JAMA (1969)

The burn injury spans a spectrum ranging from annoying erythema to instant incineration; it afflicts 2 million US patients per annum, of whom one quarter are bed-disabled. Burns are the most frequent fatal accident besetting the youngest and the oldest members of our population. And "in general, there is no injury which is less expertly treated by the medical profession at large than a burn," profess the authors in introducing<i>The Treatment of Burns</i>. This volume, when it receives the wide circulation it deserves, will, I hope, do much to belie its own gloomy pronouncement. The burn therapy scene has recently been one of revolution, and the Brooke Army Surgical Research Unit has been a site of much of the ferment. As commanders of this unit (and now as professors at the University of South Carolina), the authors have led many of the revolutionary campaigns: topical antibacterial therapy, fluid replacement,
Aplastic anemia associated with intravenous chloramphenicol
Authors: Jane B. Alavi
Journal: American Journal of Hematology (1983)

Abstract A patient is presented who developed aplastic anemia 3 months after exposure to intravenous chloramphenicol. She died of this disease 4 years later. Other cases of marrow aplasia due to parenteral chloramphenicol are reviewed, in order to emphasize that this complication, although rare, is not restricted to the use of oral chloramphenicol.
Health services quality improvement in Guaymate, Dominican Republic, as the framework for US global health education: a case study
Authors: Minesh Shah, Andrew Dykens, Amy Huang, Shannon Galvin, Juliet Sorensen
Journal: The Lancet Global Health (2014)

BackgroundWe explored the feasibility of a partnership approach between the community, the US Peace Corps, and the University of Illinois to improve the quality of local primary health-care services in Guaymate, Dominican Republic. The aim was to do community-based participatory research (CBPR) as a framework for responsible global health education for US trainees.MethodsWe used mixed methods to characterise the partnership, assess the health service effect of a quality improvement process, and qualitatively examine the value of the global health education experience. Outcome variables include partner contributions and benefits to assess the partnership; client perceptions of access, safety, and continuity to assess service quality; and US trainee perceptions of personal and community effect to assess global health education. We used CBPR to identify local priorities for health service quality improvement.FindingsWithin the partnership, the local health institution leadership guides the project in consideration of local priorities; the Peace Corps provides coordination support, community expertise, and local trust; and the academic institution offers technical, public health, and research support. The local community benefits through improved access to quality primary health care services. US trainees learn principles of primary health care, community participation, social determinants of health, and health services strengthening. Local priorities identified for health service quality improvement were at the local municipal hospital and community health education.InterpretationThis partnership approach has been successfully implemented in Guaymate, Dominican Republic, and has shown promise as a generalisable model. The anticipated partnership outcome is local primary health-care quality improvement that sustainably addresses locally prioritised public health issues within a responsible approach to global health education.FundingNorthwestern University School of Law.
Residential Exposure to Traffic and Spontaneous Abortion
Authors: Rochelle S. Green, Brian Malig, Gayle C. Windham, Laura Fenster, Bart Ostro, Shanna Swan
Journal: Environmental Health Perspectives (2009)

BackgroundStudies have shown associations between air pollution or traffic exposure and adverse birth outcomes, such as low birth weight. However, very few studies have examined the effect of traffic emissions on spontaneous abortion (SAB).ObjectiveThe goal of this study was to determine whether residential exposure to vehicular traffic was associated with SAB.MethodsPregnant women from a prepaid health plan in California were recruited into a prospective cohort study in 1990–1991. Three measures of traffic exposure were constructed for the 4,979 participants using annual average daily traffic (AADT) counts near each residence and distance from residence to major roads. SAB was examined in relation to the traffic exposure measures using logistic regression adjusting for a number of demographic and lifestyle variables.ResultsOf the traffic measures, maximum annual average traffic within 50 m showed the strongest association with SAB, although it was not statistically significant. The adjusted odds ratio (AOR) for the top 90th percentile (AADT greater than 15,199) versus the bottom 75th percentile (AADT = 0–1,089) was 1.18 [95% confidence interval (CI), 0.87–1.60]. However, subgroup analyses showed statistically significant associations for traffic with SAB among African Americans (AOR = 3.11; 95% CI, 1.26–7.66) and nonsmokers (AOR = 1.47; 95% CI, 1.07–2.04).ConclusionIn this cohort, living within 50 m of a road with AADT of 15,200 or more was significantly associated with SAB among African Americans and nonsmokers. Further research is needed to confirm these results and possibly elucidate the mechanisms responsible for the findings.
910 ELECTRON MICROSCOPIC FINDINGS IN NON-ALCOHOLIC FATTY LIVER DISEASE; IS THERE ANY DIFFERENCE BETWEEN HEPATOSTEATOSIS AND STEATOHEPATITIS?
Authors: E. Ahishali, K. Demir, B. Ahishali, F. Akyuz, B. Pinarbasi, S. Poturoglu, D. Ibrisim, M. Gulluoglu, S. Ozdil, F. Besisik, S. Kaymakoglu, G. Boztas, Y. Cakaloglu, Z. Mungan, Y. Canberk, A. Okten
Journal: Journal of Hepatology (2008)
The cardiac sphincter in the cat
Authors: C. G. Clark, J. R. Vane
Journal: Gut (1961)

A study of the function of the lower end of the oesophagus in the cat confirms that it behaves as a true physiological sphincter, even though histological evidence for such a structure is absent. Sphincteric action is a function of the circular muscle fibres in the lowest 2 cm. of the oesophagus. Reflex changes in tone of the sphincter are mediated through the autonomic nervous system. The effects of possible neurohumoral transmitters, nerve stimulation, and antagonists have been studied.
Phase 3 study of the multidrug resistance modulator PSC-833 in previously untreated patients 60 years of age and older with acute myeloid leukemia: Cancer and Leukemia Group B Study 9720
Authors: Maria R. Baer, Stephen L. George, Richard K. Dodge, Kieran L. O'Loughlin, Hans Minderman, Michael A. Caligiuri, John Anastasi, Bayard L. Powell, Jonathan E. Kolitz, Charles A. Schiffer, Clara D. Bloomfield, Richard A. Larson
Journal: Blood (2002)
Atlas of Clinical Syndromes: A Visual Aid to Diagnosis for Clinicians and Practicing Physicians
Authors: Stephen G. Kahler
Journal: JAMA (1993)

Dysmorphology, the science of human clinical teratology, is one specialty in which the external physical examination has not been supplanted (rightly or wrongly) by laboratory and imaging methods of diagnosis. Syndrome identification is intensely visual, as words alone are often inadequate to describe physical features. The past 20 years has seen the publication of several guides to the common and less common disorders. All have a mix of photographs (or line drawings) and text, discussing features, etiology, prognosis, recurrence risks, etc. <i>Atlas of Clinical Syndromes</i>is now in its second edition (corresponding to the third German edition). As in the previous edition, each page of text is faced by a page of photographs. Most topics are covered in two pages, but some use four. The current edition covers 282 disorders: all the common chromosomal, Mendelian, environmental, and idiopathic ones as well as several uncommon disorders that do not yet have
Albendazole Therapy and Enteric Parasites in United States–Bound Refugees
Authors: Stephen J. Swanson, Christina R. Phares, Blain Mamo, Kirk E. Smith, Martin S. Cetron, William M. Stauffer
Journal: New England Journal of Medicine (2012)

Beginning on May 1, 1999, the Centers for Disease Control and Prevention (CDC) recommended presumptive treatment of refugees for intestinal parasites with a single dose of albendazole (600 mg), administered overseas before departure for the United States.We conducted a retrospective cohort study involving 26,956 African and Southeast Asian refugees who were screened by means of microscopical examination of stool specimens for intestinal parasites on resettlement in Minnesota between 1993 and 2007. Adjusted prevalence ratios for intestinal nematodes, schistosoma species, giardia, and entamoeba were calculated among refugees who migrated before versus those who migrated after the CDC recommendation of presumptive predeparture albendazole treatment.Among 4370 untreated refugees, 20.8% had at least one stool nematode, most commonly hookworm (in 9.2%). Among 22,586 albendazole-treated refugees, only 4.7% had one or more nematodes, most commonly trichuris (in 3.9%). After adjustment for sex, age, and region, albendazole-treated refugees were less likely than untreated refugees to have any nematodes (prevalence ratio, 0.19), ascaris (prevalence ratio, 0.06), hookworm (prevalence ratio, 0.07), or trichuris (prevalence ratio, 0.27) but were not less likely to have giardia or entamoeba. Schistosoma ova were identified exclusively among African refugees and were less prevalent among those treated with albendazole (prevalence ratio, 0.60). After implementation of the albendazole protocol, the most common pathogens among 17,011 African refugees were giardia (in 5.7%), trichuris (in 5.0%), and schistosoma (in 1.8%); among 5575 Southeast Asian refugees, only giardia remained highly prevalent (present in 17.2%). No serious adverse events associated with albendazole use were reported.Presumptive albendazole therapy administered overseas before departure for the United States was associated with a decrease in the prevalence of intestinal nematodes among newly arrived African and Southeast Asian refugees.
Anterior Mitral Leaflet Mobility Is Limited by the Basal Stay Chords
Authors: Wolfgang A. Goetz, Hou-Sen Lim, Filip Pekar, Hashim A. Saber, Patricia A. Weber, Emmanuel Lansac, Dietrich E. Birnbaum, Carlos M.G. Duran
Journal: Circulation (2003)

We hypothesize that 2 tendon-like anterior basal stay chords, which remain taut during the entire cardiac cycle, limit the motion of the anterior mitral leaflet.Sonomicrometric crystals were implanted in 6 sheep at the insertion of stay chords at anterior mitral leaflet (S1 and S2), papillary muscle tips, fibrous trigones, mitral annulus, and the tip of the anterior leaflet (AL). Distances between crystals were recorded before and after section of stay chords. During the cardiac cycle, the angle alpha between mitral annulus and AL changed by +54.2+/-12.4 degrees; the angles between mitral annulus and S1 (beta1) changed by +25.7+/-14.6 degrees, and between mitral annulus and S2 (beta2) by +20.4+/-7.8 degrees. During diastole, AL twice crossed the virtual plane formed by the stay chords: during E-wave by a maximum of 6.5 mm (mean, 2.5+/-2.2 mm) and during A-wave by a maximum of 3.2 mm (mean, 1.7+/-0.9 mm). After section of both stay chords, total anterior mitral leaflet motion increased as follows: AL, +6.9+/-3.4 degrees; S1, +13.1+/-4.4 degrees; and S2, +30.9+/-11.7 degrees (P<0.05).Although the lateral movement of anterior mitral leaflet is limited by stay chords, the midportion moves unimpaired toward the septum, like a sail, between the 2 stay chords during diastole. A diastolic left ventricular-inflow and systolic left ventricular-outflow funnel mechanism is created. Stay chord section increased lateral anterior mitral leaflet movement.
Pulmonary oedema and haemoptysis induced by strenuous swimming
Authors: D Weiler-Ravell, A Shupak, I Goldenberg, P Halpern, O Shoshani, G Hirschhorn, A Margulis
Journal: BMJ (1995)

Hospitals responding to questionnaire that had an acute pain service by region No (%) of Region hospitals East Anglia 5 (62) Mersey 3 (37) North East Thames 9 (45) North West Thames 8 (44) North West 7 (50) Northem 5 (35) Oxford 5 (62) South East Thames 5 (33) South West Thames 6 (50) South West 7 (58) Trent 4 (28) West Midlands 5 (28) Wessex 4 (44) Yorkshire 7 (50) Wales 6 (43) Scotland 7 (41) Northern Ireland 4 (67)only 18 hospitals and the relative rarity of specific "pain nurses" and dedicated medical sessions gives concern as to the permanence of these services.Pain, Discomfort and Palliative Care, a Welsh Health Planning Forum document, gives clear advice and targets for both the purchaser and the provider- including the establishment of an acute pain service in all hospitals in Wales by 1995.4However, at the time of this survey, fewer than 50% of responding units in Wales had achieved this.Although patient controlled analgesia and epidural opioid administration were available in most units, in many units such techniques were seldom used.Inter- mittent intramuscular injection of opioid is still widely used in a large number of hospitals.This may.not necessarily be detrimental; good levels of analgesia can be achieved, as has been shown by Gould et al.5 It is to be hoped that an increasing number of hospitals will establish acute pain services.To this end, continued pressure should be placed on the purchaser to demand optimal acute pain management from their provider units-and be prepared to pay for it.
THE EFFECT OF FEEDING PROTEIN AND UREA ON THE RENAL CONCENTRATING PROCESS 1
Authors: Franklin H. Epstein, Charles R. Kleeman, Stewart Pursel, Achiel Hendrikx
Journal: Journal of Clinical Investigation (1957)

The role of dietary protein in the treatment of renal disease remains a controversial one, in part because the influence of diets high or low in pro- tein upon normal renal function is not completely understood.In the rat much evidence has accumulated that high-protein intakes lead to renal hypertrophy (1-3) and that low-protein diets may be associated with impairment of some renal func- tions (4).Pullman, Alving, Dern, and Landowne (5) have recently reviewed this subject and demonstrated that in normal men a high-protein diet slightly increases and a low-protein diet slightly depresses glomerular filtration rate, renal plasma flow and TmPAH.The present experiments were undertaken to in- vestigate the effects of alterations in dietary pro- tein on the ability of normal kidneys to concen- trate the urine.Maximum renal concentrating capacity was altered strikingly by changing the dietary intake of nitrogen, both as protein and (an unexpected finding) as preformed urea. METHODSNormal young men abstained from fluids for 12 hours prior to coming to the laboratory at 8 a.m. on the day of the experiment.In order to assure a constant and maximal antidiuretic stimulus throughout all ex- periments, Pitressin®D4 was infused at the rate of 200 milliunits in 50 cc. of normal saline per hour.Subjects remained in the supine position, standing only to void.Urine was collected at intervals until its osmolal con- centration (freezing point) had reached a constant maxi- mum.In some subjects mannitol was then infused, so that the maximum ability of renal tubules to reabsorb
Expression of human BRCA1 variants in mouse ES cells allows functional analysis of BRCA1 mutations
Authors: Suhwan Chang, Kajal Biswas, Betty K. Martin, Stacey Stauffer, Shyam K. Sharan
Journal: Journal of Clinical Investigation (2009)

To date, inheritance of a mutant BRCA1 or BRCA2 gene is the best-established indicator of an increased risk of developing breast cancer. Sequence analysis of these genes is being used to identify BRCA1/2 mutation carriers, though these efforts are hampered by the high frequency of variants of unknown clinical significance (VUSs). Functional evaluation of such variants has been restricted due to lack of a physiologically relevant assay. In this study we developed a functional assay using mouse ES cells to study variants of BRCA1. We introduced BAC clones with human wild-type BRCA1 or variants into Brca1-null ES cells and confirmed that only wild-type and a known neutral variant rescued cell lethality. The same neutral variant was also able to rescue embryogenesis in Brca1-null mice. A test of several BRCT domain mutants revealed all to be deleterious, including a VUS. Furthermore, we used this assay to determine the effects of BRCA1 variants on cell cycle regulation, differentiation, and genomic stability. Importantly, we discovered that ES cells rescued by S1497A BRCA1 exhibited significant hypersensitivity after γ-irradiation. Our results demonstrate that this ES cell–based assay is a powerful and reliable method for analyzing the functional impact of BRCA1 variants, which we believe could be used to determine which patients may require preventative treatments.
Evaluation of Superficial Femoral Artery Compromise and Limb Growth Retardation After Transfemoral Artery Balloon Dilatations
Authors: Hae Y. Lee, S. Chandra Bose Reddy, P. Syamasundar Rao
Journal: Circulation (1997)

Background Abnormalities of arterial pulse and limb growth after retrograde femoral arterial catheterization have been well documented. However, the magnitude of such complications after transfemoral artery balloon dilatation has not been thoroughly investigated. This study sought to evaluate the prevalence of these abnormalities in children who have undergone transfemoral artery balloon dilatation. Methods and Results Data on 43 consecutive patients (1 day to 15.5 years old at the time of balloon dilatation) seen on follow-up (42±23 months) (group 1) were compared with those of 35 patients undergoing retrograde femoral arterial catheterization (group 2) and 47 control patients. Interventional ankle/control ankle blood pressure index (AAI), ratio of interventional/control lower limb length (LLI), and leg length difference (LLD) were measured. Ages and weights at study were similar in all three groups, as were the ages and weights at intervention and duration of follow-up in groups 1 and 2. The AAI was lower ( P =.023) in group 1 (0.95±0.13) than in groups 2 (1.0±0.1) and 3 (1.01±0.09). The prevalence of subjects with AAI ≤0.9 was higher ( P =.003) in group 1 than in the other two groups. The LLI and LLD were similar ( P &gt;.1) in all three groups. AAI and LLD in the balloon group are not significantly associated with age and weight at intervention, duration of follow-up, or size of the balloon or balloon catheter shaft. Conclusions Transfemoral artery balloon dilatation procedures produce superficial femoral artery compromise, but there was no significant limb growth retardation at a 3.5-year mean follow-up, which may be related to development of collateral circulation. Study of a larger number of children at a longer follow-up interval may be necessary to further confirm these observations.
Diagnostic yield of push-type enteroscopy in relation to indication
Authors: B Landi, M Tkoub, M Gaudric, R Guimbaud, J P Cervoni, S Chaussade, D Couturier, J P Barbier, C Cellier
Journal: Gut (1998)

Background —Push-type enteroscopy, a recent method for investigating the small intestine, is currently undergoing assessment. Its diagnostic yield varies in the studies reported to date. Aim —To assess the diagnostic value of push-type enteroscopy according to indication. Patients and methods —From January 1994 to September 1995, 152 consecutive patients (mean age 34 years) underwent push-type enteroscopy (jejunoscopy, n=93; retrograde ileoscopy, n=17; and double way enteroscopy, n=42). The indications were: unexplained iron deficiency anaemia or macroscopic gastrointestinal bleeding (n=76), radiological abnormalities of the small intestine (n=23), chronic diarrhoea and/or malabsorption syndrome (n=18), abdominal pain (n=12), and miscellaneous (n=23). All patients had undergone previous negative aetiological investigations. Results —The jejunum and ileum were explored through 120 cm (30–160 cm) and 60 cm (20–120 cm). Digestive bleeding: lesions of the small bowel were found in 6% of the patients with isolated iron deficiency anaemia and 20% of patients with patent digestive haemorrhage. Radiological abnormalities of the small intestine: push-type enteroscopy provided a diagnosis or modified the interpretation of radiological findings in 18/23 cases (78%). Chronic diarrhoea and/or malabsorption: push-type enteroscopy yielded explanatory findings in four cases (22%). Abdominal pain: push-type enteroscopy provided no diagnosis. Conclusion —In this series, push-type enteroscopy was of particular value in investigating patients with radiological abnormalities of the small intestine. It was of some value in the exploration of patent digestive haemorrhage or chronic diarrhoea, but not of abdominal pain. Its value was limited in the exploration of iron deficiency anaemia.