tbuckley/cabot-search huggingface dataset:
Effect of nifedipine on bronchomotor tone and histamine reactivity in asthma.
Authors: D O Williams, P J Barnes, H P Vickers, M Rudolf
Journal: BMJ (1981)

it is difficult to explain how successful resuscitation is possible after 40 minutes' submersion.2The reduced oxygen requirement in profound hypothermia has been suggested by some authors as the mechanism by which tissue viability is maintained in these circumstances,2 but this alone is an incomplete explanation, as for the submerged body to cool to a degree at which oxygen requirements are sufficiently reduced, heat transfer by mass flow-that is, circulation -must be present (a dead body cools relatively slowly).The degree of cooling encountered in our cases can be explained only by the fact that circulation was maintained for some or all of the period of submersion.The persistence of cardiac activity during such a pro- longed period of apnoea supports the hypothesis that some protective mechanism may be present.We do not know whether ventricular fibrillation was present before resuscitative efforts were started and must concede that these efforts alone may have initiated the arrhythmia.Our cases show yet again that successful resuscitation is possible after long periods of immersion and emphasise the importance of performing electrocardiography early in the immersion incident, preferably at the accident site, before death is pronounced.
Response to Open Peer Commentaries on “Justice Between Age Groups: An Objection to the Prudential Lifespan Approach”
Authors: Nancy S. Jecker
Journal: The American Journal of Bioethics (2014)

I thank the open peer commentators for their thoughtful suggestions and criticisms of my target article, “Justice Between Age Groups: An Objection to the Prudential Lifespan Approach” (2013). In th...
Coming to Terms with Large Databases
Authors: Thomas J. Romano
Journal: Annals of Internal Medicine (1998)

Letters1 May 1998Coming to Terms with Large DatabasesThomas J. Romano, MD, PhDThomas J. Romano, MD, PhDWheeling, WV 26003Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-9-199805010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with interest the recent editorial by Dr. Laine [1]. Although I applaud Dr. Laine's efforts, as well as those of Drs. Weinberger and IIui in editing the supplement “Measuring Quality and Cost of Care Using Large Databases” [2], I must express my dismay and extreme concern that this information will be used to hurt patients and their physicians. These editors are unwittingly providing yet another way in which managed care organizations, the federal government, and administrators can justify the withholding of funding for patient care, thus driving even more physicians crazy. I do not exaggerate ...References1. Laine C. Coming to grips with large databases [Editorial]. Ann Intern Med. 1997; 127(8 pt 1):645-7. Google Scholar2. Weinberger M, Hui S, Laine C. Measuring Quality, Outcomes, and Cost of Care Using Large Databases. Ann Intern Med. 1997; 127(8 pt 2). Google Scholar3. Gould SJ. Full House. New York: Harmony Books; 1996; 49. Google Scholar Author, Article, and Disclosure InformationAffiliations: Wheeling, WV 26003 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1998Volume 128, Issue 9Page: 780-781KeywordsDatabasesHealth carePatientsSigns and symptoms Issue Published: 1 May 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
'Contaminated' plasma: no automatic recall
Authors: Charles Marwick
Journal: JAMA (1983)

Months after donating plasma, the donor comes down with acquired immune deficiency syndrome (AIDS) or symptoms that suggest it. Should the federal government recall that batch of plasma?  The National Hemophilia Foundation thinks it should. On the other hand, the four commercial manufacturers that are licensed to market antihemophilic factor (AHF) in the United States maintain this could jeopardize the supply of AHF, which experience has shown to be life-saving treatment for many hemophiliacs.  In a hastily-called mid-July meeting, the question was put to the seven-member Blood Products Advisory Committee of the National Center for Drugs and Biologics of the Food and Drug Administration. After considerable debate, the committee, with the help of several extra advisors, said a mechanism for a recall should not be instituted at this time.  Reaching the decision was not easy. Committee members were clearly unhappy at the thought that even one unit of plasma from
A shocking tale
Authors: A. Roth
Journal: BMJ (2008)

Sammy’s mama was a feisty 78 year old who continued to live independently in her old apartment. One evening, she called her son complaining that the “air in the house is conducting current” and that she was being “constantly electrocuted” without so much as moving a finger. Mama was not one to panic easily, so Sammy rushed over only to find that whatever it was had passed, and so he returned home. …
Prolonged Treatment with Polymyxin B
Authors: Edward J. Tomsovic
Journal: New England Journal of Medicine (1960)

BECAUSE polymyxin B has significant toxic potentialities its use is sharply circumscribed, and prolonged therapy with it is avoided. This report describes an unusual case in which circumstances necessitated the administration of polymyxin B for almost one year to a patient with a single functioning kidney.Case ReportA 3-month-old male infant was admitted to the Pediatric Service, Madigan General Hospital, on May 16, 1956, because of intermittent high fever and vomiting of 6 weeks' duration. On physical examination masses were palpated in both flanks. The urine contained numerous white blood cells and gave a + + + test for . . .
Answers to the Antiphospholipid-Antibody Syndrome?
Authors: Michael D. Lockshin
Journal: New England Journal of Medicine (1995)

Truly elegant clinical science defines syndromes with precision, delineates pathogenic mechanisms, and compares treatments in prospective randomized trials. Conventional clinical science lacks precision and applies empirical remedies. According to these definitions, the clinical science focused on the antiphospholipid-antibody syndrome is conventional now, but on the verge of becoming elegant.The diagnosis of the antiphospholipid-antibody syndrome1 requires that a patient have recurrent clinical events (such as thromboses or fetal loss) and an antiphospholipid antibody (such as anticardiolipin antibody or lupus anticoagulant). The syndrome is “primary” if there is no accompanying autoimmune disease and “secondary” if the patient also has systemic lupus . . .
Handbook of Psychiatric Treatment in Medical Practice
Authors: Peter G. S. Beckett
Journal: JAMA (1964)

One cannot but agree with the thesis of this concise book, that nonpsychiatric physicans can and should be responsible for the treatment of many psychiatric patients. As a guide to these physicians, Drs. Kline and Lehmann's presentation has the merits of brevity and clarity of presentation. The opinions expressed throughout are straightforward and practical. The newer medications are considered thoroughly. A relatively minor point is that somewhat more emphasis might be given to two topics briefly considered: the very important problem of the recognition of potentially suicidal patients, and the common complaint "I have no time to see psychiatric patients." There is some implication in the book that full use of psychodynamics and interpretations in psychotherapeutic interviews require an exceptionally high degree of skill and training and are fraught with danger. From experience with seminars in psychiatry for nonpsychiatric physicians one might feel that this caution is not necessary, but
Slower rise of exhaled breath temperature in chronic obstructive pulmonary disease
Authors: P. Paredi, G. Caramori, D. Cramer, S. Ward, A. Ciaccia, A. Papi, S.A. Kharitonov, P.J. Barnes
Journal: European Respiratory Journal (2003)

In chronic obstructive pulmonary disease (COPD) there is decreased vascularity of the bronchi and inflammation of the airways that may have opposite effects on the regulation of heat loss. Exhaled air temperature increase (Δe°T) was measured in 23 patients with moderate COPD (18 male, mean age±sem 70±1 yrs; forced expiratory volume in one second (FEV 1 ) 45±3%, FEV 1 /forced vital capacity 54±4%) and 16 normal volunteers (64±4 yr) and compared to exhaled nitric oxide (eNO) and inflammatory cells in induced sputum as a marker of airway inflammation. Δe°T was measured during a flow- and pressure-controlled single exhalation with a fast-response thermometer. Δe°T was reduced in patients with COPD (1.86±0.15 Δ°C·s −1 ) compared to normal subjects (4.00±0.26 Δ°C·s −1 ). There was no difference in Δe°T between patients treated with inhaled steroids and those who were steroid naïve. Δe°T was correlated with eNO (r=0.60) but not with sputum neutrophilia. In COPD patients, Δe°T was increased (2.26±0.16 Δ°C·s −1 ) after the inhalation of 200 µg of albuterol, which is a known vasodilator, indicating that Δe°T and bronchial blood flow may be correlated. Exhaled temperature increase is reduced in chronic obstructive pulmonary disease patients and is increased by the inhalation of vasodilators and therefore may be related to changes of bronchial blood flow and tissue remodelling.
Serum fructosamine concentrations in patients with type II (non-insulin-dependent) diabetes mellitus during changes in management.
Authors: J R Baker, R N Johnson, D J Scott
Journal: BMJ (1984)

The serum fructosamine concentration was examined as a new means to monitor metabolic control in non-insulin-dependent diabetes during changes in management. Weekly fructosamine estimations were compared with glycosylated haemoglobin (HbA1c), 24 hour urinary glucose, and fasting plasma glucose concentrations in a 17 week study entailing withdrawal and reinstitution of oral treatment. The serum fructosamine concentration was more sensitive than the other measurements in detecting a deterioration in diabetic control after stopping oral hypoglycaemic drugs. The response to reinstitution of treatment was not significant in the first three weeks (p = 0.266), despite a highly significant reduction in fasting plasma glucose (p = 0.001) and 24 hour urinary glucose concentrations (p = 0.012). Compared with HbA1c, concentrations of fructosamine appeared more useful in monitoring short term (three to six weeks) changes after alterations in management of diabetes. Additional advantages were lower cost and technical simplicity of measurement.
Risk-Reducing Appendectomy and the Elimination of BRCA1 -Associated Intraperitoneal Cancer
Authors: James V. Sitzmann, Eric A. Wiebke
Journal: JAMA Surgery (2013)

Risk-reducing bilateral salpingo-oophorectomy (RRBSO) and risk-reducing mastectomy are widely used for BRCA1 and BRCA2 mutation carriers to reduce the risk of ovarian and breast cancer. To our knowledge, no risk-reduction therapy has addressed the BCRA1/2 carrier lifetime risk of intra-abdominal peritoneal carcinoma from an appendix source. We identified a BRCA1 carrier in a hereditary breast and ovarian cancer kindred who developed a low-grade malignant appendiceal mucocele 2 years after risk-reducing salpingo-oophorectomy. Our retrospective meta-analysis assessed the risk of intraperitoneal appendiceal cancer in BRCA1/2 carriers after RRBSO to determine whether elective risk-reduction appendectomy could reduce the incidence of intraperitoneal cancer. Data sources included the case report and 12 reports of BRCA1 and BRCA2 carriers after RRBSO with ovarian, fallopian tube, breast, and peritoneal cancer published from January 1, 1985, through April 30, 2012. Main outcome measures were nonovarian, non–fallopian tube, nonbreast, positive intra-abdominal peritoneal carcinoma in previously cancer-free BRCA1/2 carriers after RRBSO. The source of intraperitoneal cancer in BRCA1/2 carriers after risk-reducing salpingo-oophorectomy is highly likely the appendix. Use of risk-reduction appendectomy with RRBSO in younger BRCA1/2 carriers may reduce lifetime risk of malignant tumor and eliminate intraperitoneal cancer.
LONG-TERM MEDICATION ADHERENCE FOLLOWING ACUTE CORONARY SYNDROME IN PATIENTS WITH AND WITHOUT RECURRENT CARDIOVASCULAR EVENTS: ANALYSIS OF THE HEALTHCORE INTEGRATED RESEARCH DATABASE 2006-2011
Authors: Vanessa S. Reddy, Rakesh Luthra, Yaping Xu, Maxine Fisher, Thomas Power, Ken Wilhelm, Mark Cziraky
Journal: Journal of the American College of Cardiology (2013)
Myocardial Force-Velocity Relations Studied in Intact Unanesthetized Man*
Authors: Gerald Glick, Edmund H. Sonnenblick, Eugene Braunwald
Journal: Journal of Clinical Investigation (1965)

In 1938, A. V. Hill demonstrated that the inverse relationship between the force generated and the velocity of shortening constitutes one of the most fundamental mechanical properties of skeletal muscle (1).More recently it has been shown that a similar reciprocal relationship be- tween force and velocity also exists in the isolated cat papillary muscle (2-5).Moreover, at any given muscle length, various positive inotropic interventions, such as augmentation of heart rate (2, 3), administration of norepinephrine (3, 4), Ca++ (3), or digitalis (6), shift the force-velocity relation so that the velocity of shortening is greater at any given load and the maximal velocity of the unloaded muscle is increased.This type of shift in the force-velocity relation is interpreted to reflect an augmentation of the contractile state of the myocardium.The ability to alter the re- lationship between the force generated and the velocity of shortening in heart muscle is in con- trast with the relative stability of the forcevelocity relation in skeletal muscle.Recently, studies on isolated human papillary muscle extended to man the concept that the force-velocity relation may be used to characterize the basic contractile state of heart muscle (6).Fry, Griggs, and Greenfield (7) and Levine and Britman (8) have shown in open-chest dogs that the inverse relationship between force and instantaneous velocity is applicable to the intact canine ventricle.The objective of the present investigation was to determine whether or not the intact ventricle in conscious human subjects adheres to this basic law of muscular contraction that had been elucidated in various experimental
Frequency, sequence, and side of ovulation in women menstruating normally.
Authors: G Potashnik, V Insler, I Meizner, M Sternberg
Journal: BMJ (1987)

Frequency, sequence, and side of ovulation in women menstruating normally Ovulation in the primate is usually regarded as a consistently alternating process that occurs with equal frequency in the right and left ovaries.We investigated whether ovulation in women occurs with equal frequency in each ovary, alternating consistently between the ovaries. Subjects, methods, and resultsSixteen women ovulating normally who were awaiting donor insemination participated in the study.Pelvic ultrasonography was performed with a real time sector scanner (Advanced Diagnostic Research 4000 S/L) at least once during each cycle as close as possible to the day when basal body temperature was lowest.Ovulation was confirmed by records of biphasic basal body temperature, mean duration ofluteal phase of 14 (SEM 2) days, and a mid-luteal plasma progesterone concentration -38-4 nmol/l (12 ngtml).Statistical analysis was based on the Bernolli distribution, assuming that in normal circumstances there is a 50% chance of ovulation occurring in either ovary.A total of 97 follicles was observed in 16 women during 90 cycles.In seven cycles (8%) two follicles were observed, always in the same ovary.Of the 97 follicles, 62 (64%) were detected in the right and 35 (36%) in the left ovary (p<0-01) (table).Alternation of side of ovulation in at least four consecutive Sequence and side ofovulation in 16 women menstruating normally No of cycles (No of women) 90(16) No of follicles* 97 Right ovary (%) 62 (64) Left ovary (%) 35 (36) Alternate ovulationst:No (%) of women 5 (31) No (%) ofcycles 22 (24) Unilateral ovulationst:No (%) of women 4 (25) No (%)of cycles 19 (21) *Difference between left and right: p<0 01.fObserved in at least four consecutive cycles.cycles was found in five women (31%) and in 22 (24%) cycles.In four women ovulation was consistently unilateral from the right ovary during four to six cycles.In cycles with ipsilateral ovulation the mean follicular phase length was 15-2 (0-3) days.When ovulation occurred in the ovary contralateral to that which ovulated in the previous cycle the mean follicular phase was 14-2 (0-3) days (p<005).
Improved Programming of ICDs
Authors: Bruce L. Wilkoff
Journal: New England Journal of Medicine (2012)

It can be simply stated that there are only two goals of most therapies: to help patients feel better or to help them live longer (or both). Implantable cardioverter–defibrillators (ICDs) have the potential to achieve both goals, but what distinguishes ICD therapy from medical therapies? Specifically, physicians can determine how an ICD is programmed to deliver therapy, but do we manage programming optimally to improve survival and reduce inappropriate shocks? This is an important question, because cardiovascular implantable electronic device therapy as a class and ICD therapy in particular appear to have inherent characteristics that are distinct in important ways . . .
Unsaturated Fatty Acids in Infant Formula
Authors: John Silverio
Journal: JAMA (1978)

To the Editor.—  I read with great interest the article entitled  Science of Infant Nutrition and the Art of Infant Feeding by Calvin W. Woodruff, MD (240:657, 1978). The article is a rather complete review of this matter. I would like, however, to correct a misstatement that appears in the article.  It is stated that vegetable oils that make up the fat component [of prepared infant formulas] contain more unsaturated fatty acids than human  This statement is true when applied to infant formulas other than S-M-A.  Our extensive research has been able to bring S-M-A closer in its chemical composition to breast milk than other infant formulas. This is true as it relates to its protein quality (60:40), electrolyte content, and, especially, fat composition. The fat in S-M-A contains approximately the same amount of unsaturated fatty acids as that found in human milk. For this reason S-M-A does
Screening for chlamydia
Authors: J. Sheringham
Journal: BMJ (2010)

<h3>Abstract</h3> <h3>Background</h3> Clinical practice guidelines and population health recommendations are derived from studies that include self-reported data. Small semantic differences in question wording and response scales, may significantly affect the response. We conducted a methodological review to assess the variation in event definition(s), context (i.e., work-versus free-day), and timeframe of sleep timing and duration questions. <h3>Methods</h3> We queried multiple databases of sleep, medicine, public health, and psychology for survey-based studies and/or publications with sleep duration and/or timing questions. The text of these questions was extracted and thematically analyzed by two trained coders. <h3>Results</h3> We identified 49 surveys that included sleep duration and/or timing questions. Sample sizes of participants in the reviewed publications using these surveys ranged from 93 to 1,185,106. For sleep duration questions, participants were asked to report nocturnal sleep (22/43), sleep in the past 24-hours (15/43), their major sleep episode (3/43), or no event definition was given (3/43). Among bedtime questions, participants were asked to report the time into bed (17/40), fall asleep time (10/40), or first attempt to sleep (13/40). For wake time questions, participants were asked to report their out of bed time (3/36), the time they get up (6/36), or their wake up time (27/36). Context (e.g., work versus free day) guidance was provided in 18/43 major sleep duration questions, 31/40 bedtime questions, and 30/36 wake time questions. Timeframe (e.g., the past 4 weeks) was provided in 6/43 major sleep episode duration questions, 9/40 bedtime questions, and 3/36 wake time questions. Among the surveys analyzed, only one question asked about the method of awakening (e.g., spontaneously or by alarm clock), 15 questions assessed sleep latency, and eight measured napping. <h3>Conclusion</h3> There is large variability in the event definition(s), context, and timeframe of questions relating to duration, bed/wake times, latency, and napping. This work may inform future efforts at data harmonization for meta-analyses, provide options for question wording for researchers and clinicians, and be used to identify candidate questions for future surveys.
Serial Assessment of Doxorubicin Cardiotoxicity with Quantitative Radionuclide Angiocardiography
Authors: Jonathan Alexander, Nicholas Dainiak, Harvey J. Berger, Lee Goldman, David Johnstone, Lawrence Reduto, Thomas Duffy, Peter Schwartz, Alexander Gottschalk, Barry L. Zaret, Linda Pytlik
Journal: New England Journal of Medicine (1979)

We measured cardiac performance sequentially, using quantitative radionuclide angiocardiography to estimate left ventricular ejection fraction in 55 patients receiving doxorubicin for treatment of cancer. With final doxorubicin dosages greater than 350 mg per square meter, the lowest ejection fraction measured was significantly less than the initial determination. Five patients had severe cardiotoxicity (congestive heart failure). All had an ejection fraction of less than 30 per cent at the time of heart failure, and demonstrated moderate cardiotoxicity (a decline in ejection fraction by at least 15 per cent to a final value of less than 45 per cent) before clinical manifestations. Six patients with moderate toxicity in whom doxorubicin was discontinued did not have heart failure or a further decline in ejection fraction during the follow-up period. Moderate toxicity was continued, but mild toxicity (decline of ejection fraction by greater than 10 per cent, noted in 11 patients) was not well predicted. The assessment of radionuclide left ventricular ejection fraction during doxorubicin therapy may make it possible to avoid congestive heart failure.