tbuckley/cabot-search huggingface dataset:
Weighing Risks and Benefits a Struggle for Both Physicians and Patients
Authors: Tracy Hampton
Journal: JAMA (2007)

Statistics used to quantitate risk can involve descriptions and mathematical equations that are difficult for the physicians, let alone the public, to grasp. “I don’t think it’s something that we have been particularly well trained in,” said Michael Pignone, MD, MPH, an internist and epidemiologist at the University of North Carolina at Chapel Hill. “How much exposure students get to understanding risk themselves varies from medical school to medical school.” Expertssaythatimprovingriskestimationamongphysicianswill require interventions thatgobeyondproviding information.Accordingtotheso-calledfuzzytracetheory,whenformingjudgmentsand making decisions, individuals rely more on the gist of information—its bottomlinemeaning—thanonverbatimdetails. “Most people tend to rely on gist representations when they make decisions,” saidValerieReyna,PhD,professorofhumandevelopmentandpsychologyatCornell University, in Ithaca, NY. While gist-based thinking is valuable because it allows individuals to streamlinereasoningandtoderivemeaningfrom complexfacts,Reynastressedthatinmakingmedicaldecisions, it isnot sufficient. Herresearchhasrevealedthatwhenhealth careprofessionals relyongist-based reasoning, they can make serious decision errors, suchasoverestimatinghowmuch an intervention reduces risk (Reyna VF. CurrDirPsychologicalSci.2004;13[2]:6066). To help physicians avoid such pitfalls,Reynaadvocates implementingpsy-
Circulatory Transport of Iodoantipyrine and Water in the Isolated Dog Heart
Authors: TADA YIPINTSOI, JAMES B. BASSINGTHWAIGHTE
Journal: Circulation Research (1970)

The exchanges of 125 I-labeled 4-iodoantipyrine (I-Ap), 14 C-labeled antipyrine ( 14 C-Ap), and tritiated water (THO) were studied in isolated blood-perfused, beating, nonworking dog hearts. From a first set of experiments, analysis of externally monitored myocardial clearance curves of I-Ap after its injection into coronary artery blood showed its washout to be flow limited at flows ranging from 0.8 to 3.8 ml. g -1 . min -1 . Therefore, these curves can be used for estimating coronary blood flow. In a second set of experiments, coronary sinus dilution curves of simultaneously injected I-Ap and THO were found to be indistinguishable in shape at high coronary flows. At low flows (&lt;1.8 ml. g -1 . min -1 ), THO curves showed an earlier upslope and higher peak than antipyrine, indicating either a diffusional shunt for water or a larger volume of distribution for antipyrine. 14 C-Ap had a slightly faster washout than I-Ap. The differences are partially attributable either to differences in solubility of I-Ap, 14 C-Ap, and THO in erythrocytes or to differences in their volumes of distribution, and partially to diffusional shunting of water.
Peripheral arterial insufficiency. A complication of beta-adrenergic blocking therapy
Authors: E. D. Frohlich
Journal: JAMA (1969)

Two patients with hypertension and hyperdynamic beta-adrenergic circulatory state were treated with the beta-adrenergic blocking drug, propranolol hydrochloride. Hypertension and symptoms remitted, but remission was associated with evidence of peripheral arterial insufficiency. When propranolol therapy was discontinued, arterial insufficiency disappeared. These findings suggest that beta-adrenergic blocking drugs should be used cautiously in patients with peripheral arterial insufficiency and when arterial insufficiency appears with such treatment, beta-adrenergic inhibition should be considered the cause.
Antibiotics for Neonates
Authors: Corinne Walentik
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The article on antibiotic usage by Naqvi et al (242:1981, 1979) contained what I consider to be serious flaws in the evaluation of appropriateness of the use of therapy with antibiotics in the neonatal population. Their conclusions that only 50% of antibiotics used was appropriate reflect a bias that is not consistent with generally accepted good neonatal practice. The two major categories cited were the following: (1) antibiotic therapy continued for too long a period and (2) indicated studies not done. For the first category two comments might be made. The authors themselves admit that in the too-long category, antibiotic therapy was often continued because of clinical improvement coincidental with the initiation of antibiotic therapy. The lack of 100% positive bacterial culture results in the neonatal population is well known. Indeed, in a recent study, Squire et al<sup>1</sup>reported a series of neonatal sepsis in which
Comparative National Policies of Health Care
Authors: John M. Craig
Journal: JAMA (1978)

As a long-time student of health care systems and with first-hand experience in 45 countries, Dr Milton Roemer, professor of Public Health at the University of California, Los Angeles, is an ideal person to summarize the widely variant nature of health care throughout the world. Because economics and economic philosophy determine the organization of health care, Dr Roemer has been able to simplify and categorize the forms of health care by their economic milieu into those of free enterprise (United States, Australia, Belgium), welfare states (Britain, Germany, Canada), underdeveloped countries (largely African states), and socialists (Eastern Europe, USSR, China). With these categories he characterizes and compares the aspects of health care among these groups of states—payment mechanisms, personnel and how they are trained, physical arrangements, organizational structure, functional process, statutory regulation, and planning arrangements. These are described and compared without judgment. One senses that to the planner the amorphous, eclectic,
THE SEVERE STRESS THALLIUM-201 DEFECT IN PATIENTS WITH AND WITHOUT MYOCARDIAL INFARCTION
Authors: Steven Reisman, Daniel Bermon, Jamshid Maddahi, Asher Kimchi, Franklin Murphy, Alan Rozanski, Ernest Garcia, HJC Swan
Journal: Clinical Nuclear Medicine (1982)

Reisman, Steven; Bermon, Daniel; Maddahi, Jamshid; Kimchi, Asher; Murphy, Franklin; Rozanski, Alan; Garcia, Ernest; Swan, HJC Author Information
Ischaemic Muscle Necrosis
Authors: A. R. Parkes
Journal: BMJ (1966)

no doubt gained the sympathy of a number of pathologists when he suggested -that the true qualities of a good laboratory technician are being overlooked by those pro- moting higher academic standards, paper qualifications, and State registration.Path- -ologists have long insisted that a good -technician is one who is able to carry out tests under their direction conscientiously and deftly without more than superficial concern with the underlying theory.Such persons and the qualities recommended by Mr. Spray --common sense, critical mind, conscientiousness, reliability, and ability to use their hands --are certainly invaluable.Educationalists and pathologists have, however, slowly 'become aware that among persons with these qualities are a large number-probably a
Immobilization‐induced and crowded environment‐induced stress delay barrier recovery in murine skin
Authors: None Denda, None Tsuchiya, None Hosoi, None Koyama
Journal: British Journal of Dermatology (1998)

To examine the effect of stress on skin homeostasis, cutaneous barrier recovery was measured in rate exposed to immobilization stress after tape stripping or sodium dodecyl sulphate treatment. The barrier function was evaluated by measuring transepidermal water loss. Barrier recovery was delayed in rats exposed to stress in comparison with untreated controls. This tendency was observed in both male and female animals. The delay in barrier recovery was blocked by application of the sedative drugs diazepam and chlorpromazine. The barrier recovery rate in mice which were kept at a high population density (10 animals per cage) for 2 weeks was slower than that in mice kept at lower population densities (five animals or one animal per cage). These animal models could be useful for objectively quantifying the influence of stress on the cutaneous function.
Biological Databases for Human Research
Authors: Dong Zou, Lina Ma, Jun Yu, Zhang Zhang
Journal: Genomics Proteomics & Bioinformatics (2015)

Abstract The completion of the Human Genome Project lays a foundation for systematically studying the human genome from evolutionary history to precision medicine against diseases. With the explosive growth of biological data, there is an increasing number of biological databases that have been developed in aid of human-related research. Here we present a collection of human-related biological databases and provide a mini-review by classifying them into different categories according to their data types. As human-related databases continue to grow not only in count but also in volume, challenges are ahead in big data storage, processing, exchange and curation.
Radionuclide Angiography in the Diagnosis of Splenic Rupture
Authors: Fred S. Mishkin
Journal: JAMA (1974)

In two cases of splenic rupture, static radionuclide images of the spleen were normal except for subtle signs of downward displacement. In both, radionuclide angiography clearly delineated an avascular perisplenic process strongly suggesting a hematoma. (<i>JAMA</i>229:1898-1899, 1974)
Preeclampsia — A State of Sympathetic Overactivity
Authors: Hans P. Schobel, Thorsten Fischer, Karsten Heuszer, Helmut Geiger, Roland E. Schmieder
Journal: New England Journal of Medicine (1996)

Preeclampsia is characterized by a marked increase in peripheral vascular resistance leading to an increase in blood pressure, but the triggering mechanisms are unclear.To determine whether augmented sympathetic vasoconstrictor activity may be an important mechanism in mediating the increase in vasomotor tone, we measured postganglionic sympathetic-nerve activity in the blood vessels of skeletal muscle by means of intraneural microelectrodes in nine women with preeclampsia, eight normotensive pregnant women, six normotensive nonpregnant women, and seven nonpregnant women with hypertension, both at rest and during noninvasive cardiovascular-reflex testing (with the Valsalva maneuver and the cold pressor test).The mean (+/-SE) rate of sympathetic-nerve activity in the normotensive pregnant women (10+/-1 bursts per minute) was not significantly different from that in normotensive nonpregnant women (12+/-2 bursts per minute) or hypertensive nonpregnant women (15+/-3 bursts per minute). In contrast, the rate of sympathetic-nerve activity in the patients with preeclampsia (33+/-3 bursts per minute) was more than three times as high as that in the normotensive pregnant women (P<0.05) and more than twice as high as in the group of nonpregnant women with hypertension (P<0.05). Hemodynamic and sympathetic-nerve responses to both reflex tests did not differ significantly among the four groups. Six patients with preeclampsia were studied again after delivery; mean sympathetic-nerve activity at that time had decreased significantly from the value during pregnancy (from 36+/-4 to 13+/-2 bursts per minute, P<0.01), as had mean arterial pressure (from 118+/-3 to 96+/-1 mm Hg, P<0.01).Preeclampsia is a state of sympathetic overactivity, which reverts to normal after delivery. Our data indicate that the increases in peripheral vascular resistance and blood pressure that characterize this disorder are mediated, at least in part, by a substantial increase in sympathetic vasoconstrictor activity.
Migrating Docs: Studying Physician Practice Location-Reply
Authors: Kevin Grumbach
Journal: JAMA (1995)

<h3>In Reply.</h3> —We are pleased to see that other investigators are studying the factors influencing physician practice location. Although our cross-sectional analysis does not allow us to comment on the mobility of physicians during their professional careers, it does provide useful information to policymakers considering options for influencing the supply and distribution of physicians. Our state-by-state analysis of the percentage of residents that remain in the state to practice can inform state policymakers in designing strategies consistent with their level of investment in GME and with their specific physician workforce goals. While we agree that GME programs cannot be held solely responsible for their graduates' practice location, we do believe that the location and curriculum of these programs play an important role in their graduates' practice decisions and that practice location should be considered in any system for downsizing GME positions.
Endoscopic Reduction of a Gastric Volvulus Associated with a Paraesophageal Hernia
Authors: W. T. Siu, K. K. Yau, Y. W. Luk, B. K. Law, M. K. Li
Journal: Endoscopy (2005)

Figure 1 An 83-year-old woman with a known history of hiatus hernia was admitted to our unit complaining of retrosternal discomfort and repeated vomiting. A chest radiograph on admission revealed a distended precordial gastric bubble, suggestive of intrathoracic gastric herniation. Initial upper endoscopy revealed bizarre gastric anatomy and it was not possible to negotiate the pyloric channel. Barium meal (a) and computed tomography (b) confirmed the diagnosis of paraesophageal hernia with intrathoracic upside-down stomach.
Comparison of Current Radiologic Approaches to the Diagnosis of Pancreatic Disease
Authors: S. Boyd Eaton, Donald J. Fleischli, James J. Pollard, Robert A. Nebesar, Majic S. Potsaid
Journal: New England Journal of Medicine (1968)

To assess prospective accuracy and clarify indications for diagnostic study, 45 patients suspected clinically of having pancreatic disease were studied by conventional barium examination of the upper gastrointestinal tract, hypotonic duodenography, selective angiography and selenomethionine isotope scanning. Duodenography achieved 78 per cent, isotope scanning 72 per cent, conventional upper gastrointestinal examination 57 per cent, and angiography 55 per cent correct prospective diagnoses. Isotope scanning produced most (19 per cent) false-positive and angiography most (38 per cent) false-negative interpretations (most of those falsely negative on angiography occurred in patients with pancreatitis). Specific diagnostic procedures should be chosen on the basis of the provisional clinical diagnosis. The most appropriate approaches appear to be duodenography and angiography for pancreaticoduodenal cancer, scanning and angiography for cancer of the body and tail, conventional upper gastrointestinal examination and angiography for pseudocyst, and scanning and duodenography for pancreatitis.
1018-50 Procedural Results and Long Term Clinical Outcomes in Aorto-Ostial Saphenous Vein Graft Lesions After New Device Angioplasty
Authors: S. Chiu Wong, Jeffrey J. Popma, Mun K. Hong, Lowell F. Satler, Augusto D. Pichard, Kenneth M. Kent, Ya Chien Chuang, Theresa A. Bucher, Kathi Donovan, Martin B. Leon
Journal: Journal of the American College of Cardiology (1995)
Reporting Suspected Child Abuse
Authors: Michael A. Reinhart
Journal: JAMA (1983)

<h3>To the Editor.—</h3> I refer to the question and answer entitled "Reporting Suspected Child Abuse" (1982;248:235). A few additional comments can be made. The frustrated physician who wrote the letter is to be commended for having done his best to report suspected cases of abuse. I would expect that, while criminal actions against parents or removal of children from their homes was infrequent in the cases he reported, other interventions such as involvement by Children's Protective Service workers or public health nurses and referrals to mental health agencies or parent support groups may have taken place as a result of his actions. He has probably done more good than he realizes. The time-consuming and financially draining experience of dealing with the legal system can be minimized by the efforts of the lawyer who has issued the subpoena. Medical societies can play a role in making known to juvenile court judges
Recent Trends in Therapy of Cerebral Vascular Disease
Authors: SIGMUND N. GROCH, IRVING S. WRIGHT
Journal: Circulation (1961)

The various measures available for the therapy of a patient with a stroke have been discussed. The value of vigorous conservative therapy has been emphasized. The role of anticoagulant drugs has been detailed. This mode of therapy seems most efficacious in treatment of recurrent transient ischemic attacks and the slowly progressive stroke. The value of anticoagulants in the acute phase of cerebral thrombosis and in long-term postinfarction therapy is not clear as yet. The role of anticoagulant drugs in treatment of cerebral embolism seems well established. It may be wise to delay institution of these drugs for 24 to 36 hours after the acute stroke. Surgical procedures give promise of value in certain well-defined syndromes. The patient with cerebral hemorrhage remains a formidable therapeutic problem.
Poverty in rural areas
Authors: J. Cox
Journal: BMJ (1998)

Rural societies are diverse, with a greater proportion of both people in higher socioeconomic groups and those with low pay than in urban populations. 1 2 Scattered among the relatively wealthy landowners, commuters, and professionals are rural dwellers living on very low incomes. 3 4 A recent BMJ editorial exhorted doctors to “combat the damage” of poverty.5 In doing so, doctors should look beyond the rural idyll and recognise that, as elsewhere in the world, poverty in Britain is not confined to cities.

Carr-Hill et al emphasised the importance of looking at very small units—individuals and their families—when considering health needs.6 This is particularly important in rural areas. In cities generalised observations about a street or electoral ward may be reasonably accurate, but in the …
Additivity of Protein and Nonprotein Inhibitors of Lung Surfactant Activity
Authors: ZHENGDONG WANG, ROBERT H. NOTTER
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

This study examined the degree of additivity of several physiologically relevant protein and nonprotein inhibitors in impairing the surface activity of whole and extracted calf lung surfactant (LS and CLSE) on a pulsating bubble apparatus at 37 ° C. Inhibitors investigated were albumin, hemoglobin, C16:0 and C18:1 lysophosphatidylcholine (LPC), oleic acid (OA), palmitoleic acid (PA), arachidonic acid (AA), and mixed red blood cell membrane lipids (RBCML). In the absence of inhibitors, LS (0.5 mg/ml) and CLSE (0.75 mg/ml) reached minimum surface tensions < 1 mN/m within 5 min of bubble pulsation (20 cycles/min, 50% area compression). Each inhibitor acting alone was able to reduce the surface activity of LS and CLSE, either raising minimum surface tension or increasing the time course of surface tension lowering or both. Several combinations of inhibitors exhibited additivity in impairing LS or CLSE activity at a lower concentration in mixtures than when present alone (albumin plus either C16:0 LPC, C18:1 LPC, or RBCML; hemoglobin plus either C16:0 LPC, C18:1 LPC, RBCML, PA, OA, or AA). The degree of additivity, however, was typically small in terms of the magnitude of reduction in inhibitor concentration or the rise in minimum surface tension relative to the effects of the most severe single inhibitor present. Substantial synergy was not found for any of the combinations of protein and nonprotein inhibitors investigated. Mixtures of albumin with PA or AA actually had a reduced inhibitory effect on LS and CLSE activity compared with the free fatty acids alone, apparently because of albumin binding of these molecules. In all cases, the detrimental effects of mixed inhibitors on LS and CLSE activity were reversed at increased surfactant concentration. These results indicate that surfactant dysfunction in acute respiratory distress syndrome (ARDS) could be increased in severity by interactions between some inhibitory substances, but that supplementation with exogenous CLSE would be effective in reversing inactivation by the mixtures of blood proteins, membrane lipids, and fatty acids studied.
US primary care must reorient to prevention to cut costs and improve outcomes
Authors: B. Roehr
Journal: BMJ (2010)

The United States must focus primary care on prevention, wellness, and active disease management, concludes a new report issued at a panel forum in Washington, DC, on 10 December.

There is substantial agreement on the goal of reinventing primary care to cut costs, improve patient outcomes, and advance economic opportunities, said Monique Nadeau, president of the Hope Street Group, an independent organisation that brings together business, political, and civic stakeholders to look at public policy questions. She said that achieving those goals would require substantial change, “not just more of the same.”

The group’s report offers …
Dipole Moments of Dog, Monkey, and Lamb Hearts
Authors: CLIFFORD V. NELSON, E. T. ANGELAKOS, PAUL R. GASTONGUAY
Journal: Circulation Research (1965)

The magnitude and direction of the spatial dipole moments of hearts of a dog, monkey and lamb were obtained in vivo from, multiple potentials on the body surface. A comparison between peak dipole moment and body weight in mammals showed a definite relationship. A comparison with spatial vectors calculated from the equilateral tetrahedron system showed significant differences. Graphs of instantaneous potential distributions around the chest showed that bidipolar conditions existed at certain times and locations, but the distributions were mostly unidipolar. Frontal plane angles calculated from the Einthoven triangle were about 30° too high, on the average.
Human intrathymic lineage commitment is marked by differential CD7 expression: identification of CD7− lympho-myeloid thymic progenitors
Authors: Qian-Lin Hao, Aswathi A. George, Judy Zhu, Lora Barsky, Ewa Zielinska, Xiuli Wang, Mary Price, Shundi Ge, Gay M. Crooks
Journal: Blood (2007)
Cytosolic activation of aromatic and heterocyclic amines. Inhibition by dicoumarol and enhancement in viral hepatitis B.
Authors: S De Flora, C Bennicelli, F D'Agostini, A Izzotti, A Camoirano
Journal: Environmental Health Perspectives (1994)

The aromatic amines 2-aminofluorene (2AF), 2-acetylaminofluorene, and 2-aminoanthracene, and the heterocyclic amines 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 2-amino-3,4-dimethylimidazo[4,5-f]quinoline, and 3-amino-1-methyl-SH-pyrido[4,3-b]indole (Trp-P-2) were activated by rat liver cytosolic fractions to form mutagenic metabolites in Salmonella typhimurium strains TA98, TA98NR, and TA98/1,8-DNP6. In the case of the Trp-P-2, the cytosolic activation was even more potent than the microsomal activation, which is classically ascribed to N-hydroxylation and subsequent esterification. The cytosolic activation was a) NADPH-dependent, b) induced by pretreatment of rats with 3-methylcholanthrene and especially Aroclor 1254 but not by phenobarbital, and c) inhibited by dicoumarol. The hypothesis is that, following a preliminary oxidative step in the cytosol (pure cytosolic activation) or in microsomes via prostaglandin H synthase (mixed microsomal-cytosolic activation), an oxidized intermediate of amino compounds may serve as substrate for DT diaphorase activity and bielectronically reduced to the corresponding N-hydroxyamino derivative. Purified DT diaphorase, in the presence of either NADPH or NADH as electron donor, produced mutagenic derivatives from IQ and Trp-P-2. An NADPH-dependent activation of Trp-P-2 also occurred in the liver cytosol of woodchucks (Marmota monax), but was not inhibited by dicoumarol. As previously demonstrated with liver S-12 fractions in both humans and woodchucks, the cytosolic activation of Trp-P-2 was enhanced in animals affected by hepatitis B virus infection. This enhanced metabolism, which persisted even after appearance of primary hepatocellular carcinoma in virus carriers, is likely to be ascribed to mechanisms other than DT diaphorase induction, such as glutathione depletion.