tbuckley/cabot-search huggingface dataset:
Body Weight and Mortality
Authors: I-Min Lee
Journal: JAMA (1993)

<h3>Objective.</h3> —To investigate the nature of the relation between body weight and all-cause mortality. <h3>Design.</h3> —Prospective cohort study, following up men from 1962 or 1966 (1962/1966) through 1988. <h3>Setting/Participants.</h3> —Harvard University alumni with a mean age of 46.6 years in 1962/1966 and without self-reported, physician-diagnosed coronary heart disease, stroke, or cancer, who completed questionnaires on weight, height, cigarette smoking habit, and physical activity (n=19297). We calculated body mass index (weight in kilograms divided by the square of height in meters) using self-reported measures. <h3>Main Outcome Measure.</h3> —All-cause mortality (4370 deaths). <h3>Results.</h3> —In multivariate analysis adjusting for age, cigarette smoking habit, and physical activity, we found a J-shaped relation between body mass index and mortality. Relative risks of dying for men with a body mass index of less than 22.5, 22.5 to less than 23.5, 23.5 to less than 24.5, 24.5 to less than 26.0, and 26.0 or greater were 1.00 (referent), 0.99 (95% confidence interval, 0.89 to 1.20), 0.95 (0.87 to 1.05), 1.01 (0.91 to 1.10), and 1.18 (1.08 to 1.28), respectively (<i>P</i>for linear trend=.0008). Among current smokers, the relation between body mass index and mortality was U-shaped, with lowest risk of death at a body mass index of 23.5 to less than 24.5. During early follow-up (1962/1966 through 1974), we also observed a U-shaped curve, this time with lowest mortality risk at a body mass index of 24.5 to less than 26.0. To minimize confounding by cigarette smoking and bias from antecedent disease and early mortality, we conducted analysis only among never smokers and omitted the first 5 years of follow-up (510 deaths). The corresponding relative risks from this analysis, adjusted for age and physical activity, were 1.00, 1.23 (95% confidence interval, 0.90 to 1.67), 1.06 (0.80 to 1.42), 1.27 (0.96 to 1.68), and 1.67 (1.29 to 2.17), respectively (<i>P</i>for linear trend=.0001). <h3>Conclusions.</h3> —In these prospective data, body weight and mortality were directly related. After accounting for confounding by cigarette smoking and bias resulting from illness-related weight loss or inappropriate control for the biologic effects of obesity, we found no evidence of excess mortality among lean men. Indeed, lowest mortality was observed among men weighing, on average, 20% below the US average for men of comparable age and height. (<i>JAMA</i>. 1993;270:2823-2828)
AN IMPROVED STOMACH TUBE.
Authors: RICHARD F. CHASE
Journal: JAMA (1906)

The apparatus shown by cut consists of (1) an Ewald stomach tube proper, 30 inches long, marked at 22 inches from its distal end with a white band; (2) an adjustable saliva shield, to prevent saliva from flowing down tube; (3) a glass connector, and (4) a 30-inch connecting tube, to which is attached a strong valveless bulb of 3 ounces or 90 c.c. capacity. Some of the advantages of the apparatus are as follows: (1) Aspiration or expression of gastric contents; (2) lavage or douching of stomach, and (3) inflation of the stomach may be done without making a connection or disconnection of apparatus and without the use of a stop-cock or shut-off. The efficient bulb enables one to evacuate the stomach contents quickly and thoroughly as is required in poisoning. The apparatus will be found most convenient for self lavage, requiring no assistant. By substituting a "Rosenheim" douching
VARIABLE BILE RETENTION ON CHOLESCINTIGRAPHY AFTER MORPHINE ADMINISTRATION
Authors: CK Kim, J Lim, J Machac
Journal: Clinical Nuclear Medicine (1997)

Intravenous morphine sulfate has been used in conjunction with cholescintigraphy. We studied the variations in the degree and duration of the effects of 2 mg morphine on biliary kinetics in patients with gallbladder nonvisualization and undertook a comparison with biliary kinetics in patients not given morphine. Of 24 morphine-augmented cholescintigrams that were obtained without additional injection of technetium-99m diisopropyl-iminodiacetic acid (DISIDA), 19 showed continued gallbladder nonvisualization. Time-activity curves (TACs) of the liver parenchyma and common bile/hepatic duct (CD) of the entire study (before and after morphine) were obtained. In two patients, the CD was not sufficiently visualized to define a region of interest. In 17 patients, the peak CD activity was observed between 14 and 47 min after injection of99mTc-DISIDA. In these 17, the TAC of the CD was declining essentially in parallel with the TAC of the liver parenchyma at the end of the first hour before morphine. After morphine injection, CD activity slowly increased for a variable duration in nine patients, while it continued to decrease in eight. CD activity between 1 h and 2 h showed a continuously decreasing pattern in another group of 20 patients who did not receive morphine despite gallbladder nonvisualization at 1 h. In summary, no significant effect of 2 mg of intravenous morphine on biliary kinetics was detected scintigraphically in a considerable proportion of patients. Also, there was considerable variation in the duration of the effect of morphine, when such an effect was present. This observation may have significant clinical implications for morphine-augmented cholescintigraphy.
The Myth of Acute "Mild" Myocardial Infarction
Authors: JOHN E. MADIAS
Journal: Annals of Internal Medicine (1977)

Patients with acute myocardial infarction and an uncomplicated early clinical course are often thought to have suffered a mild myocardial infarction. There is also a tendency to link ECG changes suggestive of nontransmural necrosis with such a benign clinical course. Recent work proves that such patients have the same short- and long-term prognosis, similar angiographic and hemodynamic patterns, and deserve management identical to that for patients with transmural myocardial infarction. It is hoped that by combining the older modalities with new diagnostic methods it will be possible to quantitate the magnitude of old and new myocardial ischemic necrosis on which prognosis to a great extent is based.
Photographic Assessment of Baseline Fundus Morphologic Features in the Comparison of Age-related Macular Degeneration Treatments Trials
Authors: Juan E. Grunwald, Ebenezer Daniel, Gui-shuang Ying, Maxwell Pistilli, Maureen G. Maguire, Judith Alexander, Revell Whittock-Martin, Candace R. Parker, Krista Sepielli, Barbara A. Blodi, Daniel F. Martin
Journal: Ophthalmology (2012)
Propylene Glycol With Occlusion for Treatment of Ichthyosis
Authors: Lowell A. Goldsmith
Journal: JAMA (1972)

Rapid clearing of scaling skin in two common skin diseases, X-linked ichthyosis and ichthyosis vulgaris, follows the use of 40% to 60% aqueous solutions of propylene glycol combined with occlusion. Following clearing, intermittent use of this therapy keeps skin free of scales. The therapy can be extended to other skin disorders involving scale accumulation. There are several possible modes of action of this regimen.
Relation between age of mothers with breast cancer and sex of their children.
Authors: H Olsson, L Brandt
Journal: BMJ (1980)

In a consecutive series of 150 women with breast cancer 122 had borne one or more children. Sixty-two patients were aged below 55 years at diagnosis (group A) and 60 were 55 years or older (group B). In group A 91 out of 153 children (59%) were boys compared with 48 out of 141 (34%) in group B (p=0.000007). In group A 54 of the 62 patients (87%) had given birth to one or more boys compared with 35 of the 60 (58%) in group B (p=0.0003). The mean age at diagnosis in mothers of two or more boys was 49.0 years, in those of one boy 55.2 years, and in those of only girls 61.0 years. The differences between each of the mean ages was significant. The mean age at diagnosis in 28 nulliparous patients was 57.7 years. There was no significant correlation between the number of female pregnancies and age at diagnosis. These results suggest that in women liable to develop breast cancer male pregnancies are associated with an early onset of the disease.
Report Cards on Cardiac Surgeons — Assessing New York State's Approach
Authors: J Green, N Wintfeld
Journal: New England Journal of Medicine (1995)

Publication of “report cards” on hospitals and surgeons is an important new trend.1 The New York State Department of Health pioneered this practice by developing the Cardiac Surgery Reporting System (CSRS), which generated the first physician-specific mortality report ever published.2 This controversial report and its annual updates have received intense publicity, because the results indicated that the percentage of patients who died after heart surgery differed widely among surgeons, even after adjustment for differences in the patients' attributes.3,4 In addition, risk-adjusted death rates for coronary-artery bypass grafting (CABG) reportedly declined in New York after CSRS had been implemented, leading . . .
Genome-wide Analysis of Chromatin Regulation by Cocaine Reveals a Role for Sirtuins
Authors: William Renthal, Arvind Kumar, Guanghua Xiao, Matthew Wilkinson, Herbert E. Covington, Ian Maze, Devanjan Sikder, Alfred J. Robison, Quincey LaPlant, David M. Dietz, Scott J. Russo, Vincent Vialou, Sumana Chakravarty, Thomas J. Kodadek, Ashley Stack, Mohamed Kabbaj, Eric J. Nestler
Journal: Neuron (2009)
Every Acronym Should Be Defined When It First Appears in a Publication
Authors: Tsung O. Cheng
Journal: Circulation (2002)

I read the recent article on the ENTIRE trial 1 several times, each time more carefully and thoroughly than the previous time, in an attempt to find out what the acronym ENTIRE stood for.I could never find in the entire article a definition of the acronym ENTIRE, although all the other acronyms mentioned in the same article, eg, TIMI, GUSTO, ASSENT, HART, and AMI-SK, were defined.In order to allay the anxiety and aggravation of your other readers who might be frustrated by their inability to decipher this acronym, I wish to come to their help.ENTIRE stands for ENoxaparin and Tnk-tpa with or without GPIIb/IIIa Inhibitor as REperfusion strategy in ST elevation myocardial infarction. 2 Acronymophilia, 3 though prevalent in the United States, is a worldwide problem and should be resisted.It was not long ago that I pointed out the prevalence of this phenomenon in this journal.
Adaptive response of the enterohepatic circulation of bile acids to extrahepatic cholestasis
Authors: R Dumaswala, D Berkowitz, J E Heubi
Journal: Hepatology (1996)

Experimental cholestasis induced by ligation of the common bile duct results in morphological and functional changes in the rat hepatocyte. The aim of this study was to evaluate the adaptive response of the transport process involved in the enterohepatic circulation of bile salts to obstructive cholestasis. Male Sprague-dawley rats with common bile duct ligation were killed after 48 and 72 hours. Portal and systemic blood and duodenal aspirates were collected. Taurocholate transport was measured in isolated ileal brush border (BBM) and liver basolateral membranes (BLM). Drastic reduction in intraluminal bile salt concentrations in ligated rats accompanied decreases in saturable taurocholate uptake by ileal BBMs. Kinetic analysis indicated that the decrease was attributable to reduction in transporter density and alteration in affinity for the substrate, both of which accentuated with increase in postligation time. In contrast, despite 20-fold higher portal venous bile salt concentrations, taurocholate uptake by hepatic sinusoidal membrane was lower in rats. Kinetic analysis and immunoblots developed using polyclonal antisera to the liver BLM bile acid transporter demonstrated a gradual decrease in transporter density with increase in postligation time accompanied by reduced taurocholate uptake by basolateral membrane. These results further support the concept that the ileal brush border membrane transporter is regulated by the availability of the substrate, whereas regulation of the bile salt transport across the liver BLM is independent of portal venous bile acid concentration.
Left Ventricular Function After Formation of Myocardial Tunnels Used for Internal Mammary Artery Implantation
Authors: LEE P. ENRIGHT, HAMNER HANNAH, ROBERT L. REIS
Journal: Circulation (1969)

Left ventricular function curves and maximum dp/dt were determined at constant heart rate and aortic pressure in 20 dogs before and after the formation of myocardial tunnels used for internal mammary artery implantation. In five dogs, the internal mammary arteries were implanted in anterior and posterior myocardial tunnels developed by blunt dissection midway between endocardium and epicardium and extending one-half the ventricular length. In five dogs, tunnels of similar length and location were made with a scalpel. In ten additional dogs, myocardial infarction was produced by left anterior descending artery ligation six weeks prior to the time of study. Tunnels were created in these animals by blunt dissection and, after the inscription of function curves, the tunnels were enlarged with a scalpel. A repeat function curve was then inscribed. In 19 of the 20 animals, neither the creation of long myocardial tunnels nor the implantation of freely bleeding internal mammary arteries produced significant immediate alteration in the function of the normal or the functionally impaired myocardium.
Abnormal Uterine Doppler Is Related to Vasculopathy in Pregestational Diabetes Mellitus
Authors: Marek Pietryga, Jacek Brązert, Ewa Wender-Oėgowska, Romuald Biczysko, Mariusz Dubiel, Saemundur Gudmundsson
Journal: Circulation (2005)

Background— The aim of the study was to evaluate the relation between maternal placental Doppler velocimetry, levels of the maternal glucose, and clinical signs of vasculopathy in pregnancy complicated by pregestational diabetes mellitus. Methods and Results— A retrospective study of 155 pregestational diabetic women between the 22nd and 40th weeks of pregnancy, categorized in White classification as B, 49; C, 40; D, 22; R, 20; F, 5; and RIF, 19. Cases in classes R, F, and R/F were defined as having vasculopathy. Doppler velocimetry of umbilical and uterine arteries was evaluated for vascular impedance, both in terms of pulsatility index (PI) for both arteries and a notch in early diastole in the uterine arteries. The last examination before delivery was used for analysis. Increased umbilical artery PI was seen in 19 and a uterine artery abnormality in 45 cases. There was a correlation between levels of HbA lc and increased vascular impedance in the uterine and umbilical arteries. Signs of increased uterine artery vascular impedances were significantly related to pregestational vasculopathy. In cases of small-for-gestational-age newborn infants, PI was significantly increased in uterine and umbilical arteries. Furthermore, PI in macrosomic fetuses was significantly lower than in normal infants. Abnormal uterine artery Doppler was also strongly related to adverse outcome. Conclusions— Abnormal uterine artery Doppler is related to pregestational vasculopathy and adverse outcome of pregnancy. The results suggest that the uterine arteries are affected in women with clinical signs of pregestational vasculopathy. This may influence placental perfusion and fetal well-being.
The Prevalence of HTLV-III/LAV Antibodies in Heterosexuals
Authors: W. L. Whittington
Journal: JAMA (1986)

To the Editor.—  The prevalence of antibodies to human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) in those groups with the highest incidence of acquired immunodeficiency syndrome has been investigated vigorously. Reports of the heterosexual transmission of HTLVIII/LAV from both intravenous drug abusers and hemophiliacs to their sexual partners 1,2 have given credence to the theory that the virus is being introduced into populations without established risk factors in North America and Europe. The prevalence of antibody to HTLV-III/LAV in sexually active heterosexuals is unknown but is thought to be low.  As an adjunct to a study of the prevalence of antibodies to herpes simplex viruses in serum samples obtained from heterosexuals attending a sexually transmitted disease clinic during 1985, we determined the prevalence of antibodies to HTLV-III/LAV. Serum samples were screened by enzyme immunoassay, and those found positive were confirmed by Western blot technique. 3 Two (1.1%) of 185
A Colour Atlas of Rheumatology
Authors: A. K. Thould
Journal: Annals of the Rheumatic Diseases (1981)

The book is written in the form of separate articles by different authors but linked up very effectively with cross- references and a comprehensive index, so that it does not appear to be discontinuous.It is therefore easy to read, and the enthusiasm of the authors for their subjects comes across in each chapter, making the approach to a large field varied and interesting.It is also sufficiently concise for revision purposes, with adequate references for more detailed study if required.The illustrations are generally good, but pictures of macroscopic pathology are lacking in some chapters.I also thought that the separation of the morbid anatomy from the clinical picture was an artificial and unnecessary division and would probably be more useful if integrated into the relevant chapters.Altogether, this is a very readable and useful book, which is realistically priced for the undergraduate student.
ECONOMICAL INTRAVENOUS THERAPY
Authors: CARL W. WALTER
Journal: JAMA (1935)

A safe, inexpensive, readily prepared and instantly available supply of fluid for intravenous injection is a necessity in every hospital. The problem of establishing such a supply in the Peter Bent Brigham Hospital led to the consideration of the difficulties encountered in other hospitals and the investigation of the available commercial solutions. Since this form of therapy is usually an emergency measure, it is essential to have a source of supply over which the hospital has complete control. Use of a container from which fluid can be administered directly prevents delay, decreases the chance of contamination and centers the responsibility for administration of the infusion. The cost of an intravenous technic that has proved successful as judged by the abolition of reaction, availability to the clinician and economy for the hospital has not been reported. Deleterious physiologic disturbances, ranging from mere elevation of temperature to chills, cyanosis, diarrhea, nausea, vomiting,
Methodological and Conceptual Issues in Research on Quality of Life
Authors: Giovanni A. Fava
Journal: Psychotherapy and Psychosomatics (1990)

Research on quality of life may herald a welcome psychosomatic change in biomedical research and clinical practice. The many promising horizons available, however, do not prevent miscommunication, random effort and faulty reasoning. An illusion of simplicity has caused many investigators to believe that the measurement of quality of life is simple and feasible, whereas only the psychosocial variables affecting quality of life can be assessed by current, reliable psychometric methods. The areas concerned with biomedical research on quality of life are reviewed and some methodological issues are discussed.
Reversal of aplastic anaemia secondary to systemic lupus erythematosus by high-dose intravenous cyclophosphamide
Authors: M J Walport, W N Hubbard, G R V Hughes
Journal: BMJ (1982)

Aplastic anaemia is rare as a primary feature of systemic lupus erythematosus and is more commonly a complication of treatment with cytotoxic drugs. Three years after starting treatment for systemic lupus erythematosus a 22-year-old woman developed bone-marrow depression. Azathioprine was thought to be responsible and was withdrawn. The aplastic anaemia worsened despite treatment with prednisolone. In view of clinical and serological evidence of lupus disease activity the patient was given high-dose intravenous cyclophosphamide and the aplastic anaemia responded in a sustained manner. In such cases of continued disease activity high-dose immunosuppressive agents may prove effective.
Tetanus in the Puerperium
Authors: E. C. Edwards
Journal: BMJ (1943)

JOURUALPrimary Syncope.-We had one fatal case of this in a girl aged 3 with some history of bronchitis; she was being anaesthetized for a hernia operation.The case resembled in every way the well-known primary syncope of chloroform anaesthesia, and we attribute this to the same mechanism of vagal inhibition.Sugar Metabolism.-We were able to have blood-sugar estimations in only 3 cases.In each there was a rise after 30 to 45 minutes, but much less than that recorded for chloroform or ether by Hewer (1939).Acetone was found in the urine on the mnorning following operation in 23 of 68 cases, in none of which had ether been used.This is in striking contrast to Hewer's report that he did not find acetonuria in any case at all.Post-operative Vomiting.-Thiswas absent in 52 out of 80 cases, and slight in the-remaining 28.
Thousands of families to sue over retained organs
Authors: C. Dyer
Journal: BMJ (2004)

Thousands of families of people whose organs had been retained without consent by the NHS were getting ready to take their compensation battle to the High Court in London as the BMJ went to press.

More than 2000 families were set to go to court next Monday for the start of a four week hearing, after they rejected compensation offers as being too low.

The claimants, who are suing NHS trusts all over England, claim that the compensation offered—thought to be about £1000 ($1780; €1440) each—compares unfavourably with the £5000 paid to parents of children whose organs were retained by the Alder Hey children's hospital in Liverpool. They insist, however, that the litigation is not about money, which could never make up for the trauma they experienced.

The Department of Health said it had urged …
One Giant Leap for Mankind
Authors: Bernard Fisher
Journal: JAMA (1973)

To the Editor.—  As difficult as it may be for some to accept, it has not been unequivocally demonstrated that total (simple) mastectomy is a procedure that should or should not supplant radical mastectomy. 1 From the total clinical evidence available, there is no more justification for condemning total (simple) mastectomy than there is for recommending its use to the exclusion of other procedures. It is a simple fact that there has never been a comparison made of the two operations by randomly performing one or the other on a single, well-defined population of patients. Halsted indeed demonstrated that radical mastectomy reduced the incidence of local recurrence in his patients as compared to that observed by other surgeons of that era, but to the best of my knowledge, he never presented information to indicate that the operation actually enhanced survival. Biological considerations are even more compelling than clinical ones (which
Shifting Terrain in the Regulation of Off-Label Promotion of Pharmaceuticals
Authors: Michelle M. Mello, David M. Studdert, Troyen A. Brennan
Journal: New England Journal of Medicine (2009)

In January, the Food and Drug Administration (FDA) issued guidance permitting pharmaceutical and device manufacturers to distribute reprints of articles from medical journals that discuss the off-label use of products. The authors review the history of FDA regulation of off-label promotion and discuss the pertinent legal and policy issues.