tbuckley/cabot-search huggingface dataset:
The physiology of external cardiac massage: high-impulse cardiopulmonary resuscitation.
Authors: G W Maier, G S Tyson, C O Olsen, K H Kernstein, J W Davis, E H Conn, D C Sabiston, J S Rankin
Journal: Circulation (1984)

In intact chronically instrumented dogs, left ventricular dynamics were studied during cardiopulmonary resuscitation (CPR). Electromagnetic flow probes measured cardiac output and coronary blood flow, ultrasonic transducers measured cardiac dimensions, and micromanometers measured left ventricular, right ventricular, aortic, and intrathoracic pressures. The dogs were anesthetized with morphine, intubated, and fibrillated by rapid ventricular pacing. Data were obtained during manual external massage with dogs in the lateral and supine positions. Force of compression was varied from a peak intrathoracic pressure of 10 to 30 mm Hg, and compression rate was varied from 60 to 150/min. Increasing force of compression increased stroke volume up to a peak intrathoracic pressure of approximately 20 mm Hg, beyond which stroke volume remained constant or declined. Stroke volume appeared to result primarily from direct transmission of manual compression force to the heart rather than from positive intrathoracic pressure because peak cardiac or vascular pressures or the change in these pressures were consistently two to four times greater than the corresponding intrathoracic pressures during manual compression. With increasing compression rate, stroke volume remained relatively constant, and total cardiac output increased significantly: 425 +/- 92 ml/min at 60/min, 643 +/- 130 ml/min at 100/min, and 975 +/- 219 ml/min at 150/min (p less than .05). Left ventricular dimensions decreased minimally at higher manual compression rates. In four patients undergoing CPR, systolic and diastolic arterial blood pressure increased with faster compression rates, correlating well with data obtained in the dog. Dynamic coronary blood flow in canine experiments decreased to zero or negative values during compression. Antegrade coronary flow occurred primarily during noncompression periods and seemed to be related to diastolic aortic perfusion pressure; coronary flow at a compression rate of 150/min averaged 75% of control. Therefore stroke volume and coronary blood flow in this canine preparation were maximized with manual chest compression performed with moderate force and brief duration. Increasing rate of compression increased total cardiac output while coronary blood flow was well maintained. Direct cardiac compression appeared to be the major determinant of stroke volume during manual external cardiac massage.
"The Professional Spirit"
Authors: Leonard W. Larson
Journal: JAMA (1961)

Tonight, in taking office as president of the American Medical Association, I shall not belabor you with the multitude of problems and challenges confronting American medicine. I believe that all of you are well aware of the critical, changing times in which we live. Instead, I should like to offer a few personal comments on a subject dear to my heart. All of you, I am sure, have also given it much serious thought over the years. It is something which continually should occupy the minds of all physicians who aspire to be<i>truly good</i>doctors. This something is the<i>true professional</i>spirit. Actually, this spirit—given full sway in both our private meditations and daily actions—can help provide the criterion for meeting the countless baffling questions presented by modern life. <h3>An Unchangeable Force</h3> I like to think of the professional spirit as an unchangeable force in medicine. True, its<i>outward</i>
NSAIDs were associated with increased risk for mortality or recurrent MI in patients who had previous MI
Authors: Roy M. Poses
Journal: Annals of Internal Medicine (2011)

Source Citation Schjerning Olsen AM, Fosbøl EL, Lindhardsen J, et al. Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation. 2011;123:2226-35. 21555710
Management of medical research. Management at MRC is modern and flexible.
Authors: M P Haggard
Journal: BMJ (1993)

Council (MRC), finds himself when defending peer review is apparent in his letter' in response to my and Jenny Harrow's papers.2If he believes that our work should not have been published then he is a long way down the road to accepting the fallibility of the peer review system that allowed this, which is the very system he seeks to support.On the other hand, if he believes that peer review delivers the "right" answers then this too gives validity to our peer reviewed arguments about its shortcomings, suggesting that the MRC should give them deeper consideration than it has done.Rees is in danger of seeming to endorse peer review when its findings concur with his own while rejecting its outcomes if they are at odds with his views.
Letter: Puerperal rubella vaccination and anti-D immunoglobulin.
Authors: B Alderman, D W Charters
Journal: BMJ (1974)

revealed antibody and therefore a state of inm unity.The seronegative cases have re- main.dseronegaFive after Ig prophylaxis and have delivered normal children with no increased levels of IgM in the cord sample.On the other hand if seroconversion had occurred following the administration of Ig the patient and her medical practitioner could be advised accordingly, but this has not occurred in our experience.It would probably be preferable, as suggested by Drs.Forrest and Menser, to have an Ig preparation with a high antibody titre, but as this is not generally available and becaus,e there is some variation in the antibody titre of the normal pooled Ig product, we have used a large dose of 3 g administered in two separate doses.Though this is considerably greater than what is advocated we think it is justifiable in the circumtances.-Iam, etc.,
REPORT OF CASE OF OBSTRUCTION TO INTESTINE DUE TO ASCARIS
Authors: W. P. Baugh
Journal: JAMA (1923)

In this case<i>Ascaris lumbricoides</i>caused an obstruction of the small intestine, necessitating resection. Miss R., aged 36, referred by Dr. Mouldon Smith of Ardmore, Tenn., was admitted to the Benevolent Society Hospital at Albany, Ala., Nov. 6, 1922, with intense pain in the abdomen, in the right hypochondriac region. She was poorly nourished, was suffering great shock, and presented all the symptoms of an intestinal obstruction. The history was negative except that she had had several attacks of pain in the abdomen for the last two years which had been diagnosed as subacute appendicitis. A median abdominal incision was made. When the abdominal cavity was entered a considerable portion of the ileum was seen to be collapsed, with a definite line of demarcation at each extremity, with beginning gangrene. A large mass was observed; radiating from this mass, there were cordlike structures in the intestine extending from both sides
Prioritizing Congenital Syphilis Control in South China: A Decision Analytic Model to Inform Policy Implementation
Authors: Nicholas X. Tan, Chara Rydzak, Li-Gang Yang, Peter Vickerman, Bin Yang, Rosanna W. Peeling, Sarah Hawkes, Xiang-Sheng Chen, Joseph D. Tucker
Journal: PLoS Medicine (2013)

Background Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS) cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. Methods and Findings Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111) CS cases averted per 100,000 live births (58% decrease). The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160) CS cases averted per 100,000 live births (85% decrease). Conclusions The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures that include earlier and more extensive screening are necessary for reaching policy goals. Please see later in the article for the Editors' Summary
THE IMMUNIZING ANTIGEN OF THE PNEUMOCOCCUS
Authors: William A. Perlzweig, Chester S. Keefer
Journal: The Journal of Experimental Medicine (1925)

Actively immunizing fractions of protein nature have been isolated from broth culture filtrates of Pneumococcus Type I by ultrafiltration, precipitation at a definite hydrion concentration, and the separation of a soluble picrate fraction. The method appears to be suitable for the initial purification of this antigen.
Brugada syndrome and fever: Genetic and molecular characterization of patients carrying mutations
Authors: D KELLER, J ROUGIER, J KUCERA, N BENAMMAR, V FRESSART, P GUICHENEY, A MADLE, M FROMER, J SCHLAPFER, H ABRIEL
Journal: Cardiovascular Research (2005)

Brugada syndrome (BrS) is characterized by ventricular tachyarrhythmias leading to sudden cardiac death and is caused, in part, by mutations in the SCN5A gene encoding the sodium channel Na(v)1.5. Fever can trigger or exacerbate the clinical manifestations of BrS. The aim of this work was to characterize the genetic and molecular determinants of fever-dependent BrS.Four male patients with typical BrS ST-segment elevation in V1-V3 or ventricular arrhythmias during fever were screened for mutations in the SCN5A gene. Wild-type (WT) and mutant Na(v)1.5 channels were expressed in HEK293 cells. The sodium currents (I(Na)) were analysed using the whole-cell patch clamp technique at various temperatures. Protein expression of WT and mutant channels was studied by Western blot experiments.Two mutations in SCN5A, L325R and R535X, were identified. Expression of the two mutant Na(v)1.5 channels in HEK293 cells revealed in each case a severe loss-of-function. Upon the increase of temperature up to 42 degrees C, we observed a pronounced acceleration of Na(v)1.5 activation and fast inactivation kinetics. Cardiac action potential modelling experiments suggest that in patients with reduced I(Na), fever could prematurely shorten the action potential by virtue of its effect on WT channels. Further experiments revealed that L325R channels are likely misfolded, since their function could be partially rescued by mexiletine or curcumin. In co-expression experiments, L325R channels interfered with the proper function of WT channels, suggesting that a dominant negative phenomenon may underlie BrS triggered by fever.The genetic background of BrS patients sensitive to fever is heterogeneous. Our experimental data suggest that the clinical manifestations of fever-exacerbated BrS may not be mutation specific.
Etanercept treatment of rheumatoid arthritis in the "real world"
Authors: M D Smith
Journal: Annals of the Rheumatic Diseases (2002)

A recent paper in the Annals of the Rheumatic Diseases attempted to examine the “real world” experience of etanercept treatment by examining the incidence of flares of rheumatoid arthritis (RA) disease activity in a cohort of patients with RA who had started treatment with etanercept before September 1999.1 The number of flares and patients experiencing flares within the first year of etanercept treatment was compared with that seen in the same cohort of patients the year before they started etanercept. It is well documented that the withdrawal rate from disease modifying antirheumatic drug (DMARD) treatment in RA increases with the length of time the patient has been receiving the drug and that a number of these withdrawals relate to loss of efficacy.2–4 Therefore, it is reasonable to assume that the number of disease …
THE FIGHT AGAINST TUBERCULOSIS IN THE LIGHT OF THE EXPERIENCE GAINED IN SUCCESSFUL COMBAT OF OTHER INFECTIOUS DISEASES.
Authors: ROBERT KOCH
Journal: JAMA (1901)

The task with which this Congress will have to busy itself is one of the most difficult, but it is also one in which labor is most sure of its reward. I need not point again to the innumerable victims tuberculosis annually claims in all countries, nor to the boundless misery it brings on the families it attacks. You all know that there is no disease which inflicts such deep wounds on mankind as this. All the greater, however, would be the general joy and satisfaction if the efforts that are being made to rid mankind of this enemy, which consumes its inmost marrow, were crowned with success. There are many, indeed, who doubt the possibility of successfully combating this disease, which has existed for thousands of years, and has spread all over the world. This is by no means my opinion. This is a conflict into which we may
Myocardial Dysfunction and Adrenergic Cardiac Innervation in Patients With Insulin-Dependent Diabetes Mellitus
Authors: Roldano Scognamiglio, Angelo Avogaro, Dario Casara, Cristina Crepaldi, Marco Marin, Monica Palisi, Roberto Mingardi, Giuseppe Erle, Giuseppe Fasoli, Sergio Dalla Volta
Journal: Journal of the American College of Cardiology (1998)
The DAVID (Dual Chamber and VVI Implantable Defibrillator) II Trial
Authors: Bruce L. Wilkoff, Peter J. Kudenchuk, Alfred E. Buxton, Arjun Sharma, James R. Cook, Anil K. Bhandari, Michael Biehl, Gery Tomassoni, Anna Leonen, Linette R. Klevan, Alfred P. Hallstrom
Journal: Journal of the American College of Cardiology (2009)
Fractionation of cells on a discontinuous Ficoll gradient. Study of subpopulations of human T cells using anti-T-cell antibodies from patients with systemic lupus erythematosus.
Authors: W Glinski, M E Gershwin, A D Steinberg
Journal: Journal of Clinical Investigation (1976)

Patients with active systemic lupus erythematosus (SLE) had a decrease in a subpopulation of cells (fraction D) when peripheral blood lymphocytes were separated on a discontinuous Ficoll gradient. Preincubation of SLE cells at 37 degrees C for 30 min led to a marked decrease in this fraction, composed primarily of thymus-derived (T) cells. Supernates of such preincubations were found to cause a reduction in fraction D cells from normal humans. The active factor in the supernate was found to be an IgG antibody. Similarly, serum from patients with active SLE produced a reduction in fraction D cells from normal donors. This activity was also found in the IgG fraction, and could be absorbed with a pure T-cell population. Depletion of macrophages and complement did not reduce the SLE anti-T-cell antibody-mediated loss of cells from fraction D; however, heat-aggregated human gamma globulin led to impairment of the reaction. These findings suggest that antibody-dependent direct lymphocyte-mediated cytotoxicity may play a role in T-cell lymphopenia of SLE. It was further noted that the SLE anti-T-cell antibodies, in contrast to rabbit antihuman thymocyte serum, recognized fraction D cells but not fraction E cells from normals. Since both fractions are largely T cells, it appeared that the SLE serum was directed against cell-membrane antigenic determinants present on fraction D T cells, which were absent or reduced in quantity on fraction E T cells. Thus, evidence was presented indicating the presence of at least two subpopulations of cells in man. This was supported by differential absorption of the anti-T-cell sera with fractions D and E.
Some statistical misconceptions in Chow's <i>Statistical significance</i>
Authors: Jacques Poitevineau, Bruno Lecoutre
Journal: Behavioral and Brain Sciences (1998)

Chow's book makes a provocative contribution to the debate on the role of statistical significance, but it involves some important misconceptions in the presentation of the Fisher and Neyman/Pearson's theories. Moreover, the author's caricature-like considerations about “Bayesianism” are completely irrelevant for discarding the Bayesian statistical theory. These facts call into question the objectivity of his contribution.
Levothyroxine dose and fractures in older adults
Authors: G. P. Leese, R. V. Flynn
Journal: BMJ (2011)

Within-city variation in air pollution has been associated with childhood asthma development, but findings have been inconsistent. We examined whether perinatal air pollution exposure affected asthma onset during “pre-school and “school age” periods in a population-based birth cohort. 65 254 children born between 1999 and 2002 in the greater Vancouver metropolitan region were followed until age 10 years using linked administrative health databases. Asthma cases were sex- and age-matched to five randomly chosen controls. Associations between exposure to air pollutants estimated with different methods (interpolation (inverse-distance weighted (IDW)), land use regression, proximity) and incident asthma during the pre-school (0–5 years) and school age (6–10 years) periods were estimated with conditional logistic regression. 6948 and 1711 cases were identified during the pre-school and school age periods, respectively. Following adjustment for birthweight, gestational period, household income, parity, breastfeeding at discharge, maternal age and education, asthma risk during the pre-school years was increased by traffic pollution (adjusted odds ratio using IDW method per interquartile increase (95% CI): nitric oxide 1.06 (1.01–1.11), nitrogen dioxide 1.09 (1.04–1.13) and carbon monoxide 1.05 (1.01–1.1)). Enhanced impacts were observed amongst low-term-birthweight cases. Associations were independent of surrounding residential greenness. Within-city air pollution variation was associated with new asthma onset during the pre-school years.
Significance of long term components of heart rate variability for the further prognosis after acute myocardial infarction
Authors: M. Malik, A J. Camm
Journal: Cardiovascular Research (1990)

Study objective – The study examined heart rate variability to find out whether shorter ECG records can predict long term mortality following acute myocardial infarction as efficiently as 24 h recordings. Design – Heart rate variability was assessed in 24 h electrocardiograms recorded during the first 2 weeks following acute myocardial infarction and in separate l h portions of the complete recording. The spectral analysis of complete 24 h records was performed and different short and long term components of heart rate variability were used to distinguish between patients with and without later complications. Subjects – 20 patients who initially survived acute myocardial infarction but later experienced serious events (death or symptomatic sustained ventricular tachycardia) during a 6 month follow up (group I) were compared with 20 patients (group II) who remained free of complications for more than 6 months after discharge and who were matched with group I for age, gender, infarct site, ejection fraction, and β blocker treatment. Measurements and main results – The distinction based on components limited to changes of heart rate within periods ≤1 h was as significant (p<0.00l, paired t test) as when using the components limited to changes of periods ≤10 h. However, heart rate variability of separate 1 h portions of the complete 24 h records differed between the groups significantly only for certain 1 h intervals of the day (the p values varied from 0.2 to 0.0005). Conclusions – Whilst the maximum value of short term heart rate variability is sufficient for stratifica- tion of the high risk post-myocardial infarction patients, an arbitrarily selected short term ECG recording is unlikely to register the maximum heart rate variability. It is concluded that the heart rate variability assessed from arbitrary 1 h electrocardiographic records is not as prognostically important as the variability estimated from 24 h recordings.
Compliance with Handwashing in a Teaching Hospital
Authors: D Pittet, P Mourouga, T V Perneger
Journal: Annals of Internal Medicine (1999)

Transmission of microorganisms from the hands of health care workers is the main source of cross-infection in hospitals and can be prevented by handwashing.To identify predictors of noncompliance with handwashing during routine patient care.Observational study.Teaching hospital in Geneva, Switzerland.Nurses (66%), physicians (10%), nursing assistants (13%), and other health care workers (11%).Compliance with handwashing.In 2834 observed opportunities for handwashing, average compliance was 48%. In multivariate analysis, noncompliance was higher among physicians (odds ratio [OR], 2.8 [95% CI, 1.9 to 4.1]), nursing assistants (OR, 1.3 [CI, 1.0 to 1.6]), and other health care workers (OR, 2.1 [CI, 1.4 to 3.2]) than among nurses and was lowest on weekends (OR, 0.6 [CI, 0.4 to 0.8]). Noncompliance was higher in intensive care than in internal medicine units (OR, 2.0 [CI, 1.3 to 3.1]), during procedures that carry a high risk for contamination (OR, 1.8 [CI, 1.4 to 2.4]), and when intensity of patient care was high (compared with < or = 20 opportunities for handwashing per hour of care, 21 to 40 opportunities: OR, 1.3 [CI, 1.0 to 1.7]; 41 to 60 opportunities: OR, 2.1 [CI, 1.5 to 2.9]; and > 60 opportunities: OR, 2.1 [CI, 1.3 to 3.5]).Compliance with handwashing was moderate. Variation across hospital ward and type of health care worker suggests that targeted educational programs may be useful. Even though observational data cannot prove causality, the association between noncompliance and intensity of care suggests that understaffing may decrease quality of patient care.
Post-marketing studies of new insulins: sales or science?
Authors: E. A. M. Gale
Journal: BMJ (2012)

<b>Edwin Gale's</b> analysis of registered post-marketing studies of new treatments for diabetes showed that studies of insulin analogues have involved some 400 000 participants worldwide. One company recruited nearly 360 000 individuals. Most studies were performed in middle or low income countries, had limited scientific value, and promoted wider use of more expensive insulins