tbuckley/cabot-search huggingface dataset:
Test Your Knowledge: Ten Questions about the Common Cold
Authors: Gavin Yamey
Journal: PLoS Medicine (2005)

Question 1.How is a common cold infection usually spread?Through droplets in the air Through hand-to-hand contact, with subsequent passage to the nostrils or eyes Question 2. Roughly what proportion of general practice consultations are taken up by upper respiratory tract infections, nasal congestion, throat complaints, and cough?About 3% About 10% About 30%
Evaluation of Neuroleptic Drug Use by Nursing Home Elderly Under Proposed Medicare and Medicaid Regulations
Authors: J Garrard, L Makris, T Dunham, L L Heston, S Cooper, E R Ratner, D Zelterman, R L Kane
Journal: JAMA (1991)

Federal regulations for use of neuroleptic drugs in Medicare- and Medicaidcertified nursing homes throughout the United States were implemented October 1,1990. These regulations constitute the first time that prescription drugs are required, by law, to be justified by indications documented in the medical chart. This study used extant data to estimate ineligible neuroleptic use at the individual and nursing home levels had these regulations been in effect in 1976 through 1985. Subjects, randomly sampled admissions (N = 5752) and residents (N = 3191), were followed up for up to 24 months in 60 nursing homes. One half of neuroleptic use in each cohort could be considered ineligible under the regulations; all but one of the nursing homes had one or more individuals who were treated with the ineligible use of neuroleptics. Improvements in documentation and/or prescription of neuroleptic drugs for nursing home elderly will be needed to ensure compliance with these new regulations. (<i>JAMA</i>. 1991;265:463-467)
Lymphangioma of the Duodenum: (Diagnosis by Endoscopic Resection)
Authors: T. Sauerbruch, E. Keiditsch, H. Kaess
Journal: Endoscopy (1977)

Submucosal lymphangiomas of the gastrointestinal tract are extremely rare entities. A case of a lymphangioma of the duodenum in a 66-year-old woman is reported. Diagnosis was made by endoscopy and tumor excision with a diathermy snare. The patient complained of crampy upper abdominal pain which only partially was referable to an gastric ulcer and stopped after polypectomy. Endoscopically, compressibility of the tumor is a characteristic sign. Roentgenographically, it may be easily overlooked.
Medical Audit JCAH-Style: A Positive View
Authors: Russell B. Roth
Journal: JAMA (1977)

To the Editor.—  Methinks Dr Rosenberg doth protest too much (237:1935, 1977). His advocacy of process audit would be admirably suited to ensure that the contemporaries of Dr Benjamin Rush bled off the proper amount of blood or gave the correct number of purgatives to their yellow fever patients. It would serve well in China today to be certain that needles of the correct size were inserted into the proper places, together with the right concoctions of herbs for the management of kidney stones. It would ignore the basic evaluative question—how much good did all these things do?  The PEP is directed toward an answer to this question. That it does not go all the way is because outcomes take time to emerge. Dr Rosenberg criticizes PEP because it does not answer outcome questions about hysterectomies and the treatment of tracheobronchitis. Process evaluators never even bother to ask the questions.
TB in Leicester: out of control, or just one of those things?
Authors: J. M Watson
Journal: BMJ (2001)

Last year in England and Wales 235 schoolchildren aged 5-14 were notified with tuberculosis. Most will not have been infectious—for example, those with tuberculous lymphadenitis—but some of the 148 children with pulmonary tuberculosis will have been smear positive and potential sources of infection. For each of these children local tuberculosis services will have searched for linked cases by screening household members and other close contacts, including those at school.1

Evidence of transmission of infection from a child index case in a school to other children is not often found1—but outbreaks in schools do occur. Although adults, usually staff, are often the source of infection, schoolchildren have also been reported.2–6 The essential element in these outbreaks is an infectious patient whose illness may have been undiagnosed for a long period. Local environmental circumstances and the opportunity to expose many people also contribute to the scale of an outbreak.

What therefore should we be asking about the recent outbreak of tuberculosis in Leicester7 that has made headline news? Is it a one off event due to unusual circumstances or a sign of a growing problem in …
Patient Characteristics and ICU Organizational Factors That Influence Frequency of Pulmonary Artery Catheterization
Authors: John Rapoport
Journal: JAMA (2000)

ContextHemodynamic monitoring of patients with a pulmonary artery catheter is controversial because there are few data confirming its effectiveness, and patient and intensive care unit (ICU) organizational factors associated with its use are unknown.ObjectiveTo determine pulmonary artery catheter use in relationship to type of ICU organization and staffing, and patient characteristics, including severity of illness and insurance coverage.Design, Setting, and PatientsRetrospective database study of 10,217 nonoperative patients who received treatment at 34 medical, mixed medical and surgical, and surgical ICUs at 27 hospitals during 1998 (patients were enrolled in Project IMPACT).Main Outcome MeasuresPulmonary artery catheter use based on severity of illness measured by the Simplified Acute Physiology Score, resuscitation status at ICU admission, and ICU organizational variables, including type, size, and model.ResultsA pulmonary artery catheter was used for 831 patients (8.1%) in the ICU. In multivariate analysis adjusted for severity of illness, age, diagnosis, and do-not-resuscitate status, full-time ICU physician staffing was associated with a two-thirds reduction in the probability of catheter use (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.28-0.45). Higher catheter use was associated with white race (OR, 1.38; 95% CI, 1.10-1.72) and private insurance coverage (OR, 1.33; 95% CI, 1.10-1.60). Admission to a surgical ICU was associated with a 2-fold increase in probability of catheter use (OR, 2.17; 95% CI, 1.70-2.76) compared with either medical or mixed medical and surgical ICUs.ConclusionOrganizational characteristics of ICUs, insurance reimbursement, and race, as well as clinical variables, are associated with variation in practice patterns regarding pulmonary artery catheter use. Understanding such influences, combined with studies measuring clinical and economic outcomes, can contribute to the development of policies for the rational use of pulmonary artery catheters.
Dictionnaire Français de Médecine et de Biologie
Authors: Norman Howard-Jones
Journal: JAMA (1972)

A brief notice of the first volume of this dictionary, which covered the letters A-D, was published in an earlier issue ofThe Journal(Sept 27, 1971). There will be a supplementary volume of such material as data tables and biographical notes. The publication of this completed dictionary, comprising 150,000 technical terms, represents a major event in medical documentation, for it is more comprehensive than any other comparable work in any language, and probably more authoritative. Its principal author, A. Manuila, MD, ScD, and his coauthors have benefitted from the collaboration of 350 distinguished specialists in medicine and cognate disciplines. The dictionary is unique in its comprehensive treatment of synonyms, and its numerous notes on such points as usage and analogies. The definitions are clear and concise, but comprehensive enough to give the work the quality of a veritable encyclopedia of modern biomedical science. It does not entirely steer clear
The Influence of Context on Antimicrobial Prescribing for Febrile Respiratory Illness
Authors: Courtney Hebert, Jennifer Beaumont, Gene Schwartz, Ari Robicsek
Journal: Annals of Internal Medicine (2012)

Background: Little is known about the influence of contextual factors on a physician's likelihood to prescribe antimicrobials for febrile respiratory illness (FRI). Context includes epidemiologic context (for example, a pandemic period) and personal context (for example, recent exposure to other patients with FRI). Objective: To examine the association between contextual factors and antimicrobial prescribing for FRI. Design: 5.5-year retrospective cohort study. Setting: A network of Midwestern primary care providers. Patients: All patients presenting with FRI during influenza seasons between 2006 and 2011. Measurements: Antimicrobial prescribing for FRI during pandemic and seasonal influenza periods. Results: 28 301 unique patient encounters for FRI with 69 physicians in 26 practices were included. An antibiotic was prescribed in 12 795 (45.2%) cases. The range of prescribing among physicians was 17.9% to 83.7%. Antibiotics were prescribed in 47.5% of encounters during the seasonal period and 39.2% during the pandemic period (P < 0.001). After multivariable adjustment for patient and physician characteristics, antibiotic prescribing was lower in the pandemic period (odds ratio [OR], 0.72 [95% CI, 0.68 to 0.77]) than in the seasonal period. The likelihood of prescribing an antibiotic decreased as the number of FRI cases that a physician had seen in the previous week increased (OR, 0.93 [CI, 0.86 to 1.01] for 2 to 3 patients with FRI seen in the previous week; OR, 0.84 [CI, 0.77 to 0.91] for 4 to 6 patients; OR, 0.71 [CI, 0.64 to 0.78] for 7 to 11 patients; and OR, 0.57 [CI, 0.51 to 0.63] for ≥12 patients compared with the reference range of 0 to 1 patients). Pandemic season and recent personal context were also associated with antiviral prescribing. Limitation: Retrospective study in a single geographic area. Conclusion: Epidemiologic context and the number of cases of FRI that a physician had recently seen were associated with his or her likelihood to prescribe antimicrobials for FRI. Interventions that enhance a physician's contextual awareness may improve antimicrobial use. Primary Funding Source: NorthShore University HealthSystem.
Tetracycline and Blood Urea Nitrogen
Authors: Hershel Jick
Journal: JAMA (1972)

<h3>To the Editor.—</h3> Dr. Tannenberg's letter (221:713, 1972) raised three main questions about our report on tetracycline and rises in blood urea nitrogen (BUN) level (220:377, 1972) that we would like to clarify. First, he indicates that we failed to clearly define what is meant by clinically significant rises in BUN level. We find this criticism difficult to understand since we noted the following: (1) reported cases were those "deemed by the attending physician to be related to any... drugs"; (2) "the mean rise in BUN in those with a rise in BUN level was 28.3 mg/100 ml (range, 6 to 77/100 ml)"; (3) the rise was "frequently associated with overt symptoms such as nausea and vomiting"; and (4) "in all cases (the rise in BUN level) prompted discontinuation of the suspected drug or drugs." We feel this is a reasonably adequate description of the cases we reported, and we
A METHOD OF TESTING ABSORPTION FROM VARIOUS OINTMENT BASES
Authors: JOHN RAE
Journal: British Journal of Dermatology (1944)

Journal Article A METHOD OF TESTING ABSORPTION FROM VARIOUS OINTMENT BASES Get access JOHN RAE JOHN RAE Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 56, Issue 3-4, 1 March 1944, Pages 92–94, https://doi.org/10.1111/j.1365-2133.1944.tb10821.x Published: 01 March 1944
Synthesis and release of platelet-activating factor is inhibited by plasma alpha 1-proteinase inhibitor or alpha 1-antichymotrypsin and is stimulated by proteinases.
Authors: G Camussi, C Tetta, F Bussolino, C Baglioni
Journal: The Journal of Experimental Medicine (1988)

TNF and IL-1 stimulate the synthesis and release of platelet-activating factor (PAF) by neutrophils and vascular endothelial cells. Serum inhibits PAF production even after inactivation of an acetylhydrolase that degrades PAF. Human plasma was fractionated by gel filtration chromatography, and two inhibitory fractions were detected, one containing PAF-acetylhydrolase activity and the other alpha 1-proteinase inhibitor. Low concentrations of this antiproteinase and of human plasma alpha 1-antichymotrypsin inhibited TNF-induced PAF synthesis in neutrophils, macrophages, and vascular endothelial cells. Both antiproteinases also inhibited PAF production stimulated by phagocytosis in macrophages and induced with IL-1 in neutrophils or with TNF in vascular endothelial cells. These results suggest that a proteinase activated on the plasma membrane or secreted by these cells is involved in promoting PAF synthesis. Indeed, addition of elastase to macrophages, neutrophils, and endothelial cells stimulated synthesis and release of PAF much faster than TNF. A similar stimulation was observed in incubations with cathepsin G. To identify a proteinase activated in TNF-treated cells, neutrophils and endothelial cells were incubated with specific chloromethyl ketone inhibitors of elastase and cathepsin G. Synthesis of PAF was significantly inhibited by low concentrations of the cathepsin G inhibitor. The finding that antiproteinases are inhibitory at concentrations 100-fold lower than those present in plasma raises questions as to the ability of TNF and IL-1 to stimulate neutrophils in circulation or endothelial cells to synthesize PAF. We propose that PAF production is limited to zones of close contact between cells, which exclude antiproteinases.
Human babesiosis in ireland: Further observations and the medical significance of this infection
Authors: P. C. C. Garnham, J. Donnelly, H. Hoogstraal, C. C. Kennedy, G. A. Walton
Journal: BMJ (1969)

Three splenectomized persons in Yugoslavia, California, and Ireland have been reported to be infected by three different Babesia species; two cases were fatal. In a study of the site where the fatal infection was contracted in Ireland, blood samples from 36 persons who had recently been bitten by ticks were inoculated into two splenectomized calves; no response to Babesia divergens was detected. Field-collected Ixodes ricinus ticks inoculated into another splenectomized calf resulted in fever and recovery of the agent of tick-borne fever (Cytoecetes phagocytophilia). This attempt to determine the presence of latent infection in human beings with intact spleens should be repeated on a larger scale in areas with a demonstrably high incidence of Babesia in ticks and animals. Few places in the world are free of piroplasms; their presence may present a hazard to splenectomized persons or to those whose splenic function is deficient.
Triglyceride enrichment of HDL enhances in vivo metabolic clearance of HDL apo A-I in healthy men
Authors: Benoît Lamarche, Kristine D. Uffelman, André Carpentier, Jeffrey S. Cohn, George Steiner, P. Hugh Barrett, Gary F. Lewis
Journal: Journal of Clinical Investigation (1999)

Triglyceride (TG) enrichment of HDL resulting from cholesteryl ester transfer protein–mediated exchange with TG-rich lipoproteins may enhance the lipolytic transformation and subsequent metabolic clearance of HDL particles in hypertriglyceridemic states. The present study investigates the effect of TG enrichment of HDL on the clearance of HDL-associated apo A-I in humans. HDL was isolated from plasma of six normolipidemic men (mean age: 29.7 ± 2.7 years) in the fasting state and after a five-hour intravenous infusion with a synthetic TG emulsion, Intralipid. Intralipid infusion resulted in a 2.1-fold increase in the TG content of HDL. Each tracer was then whole-labeled with 125I or 131I and injected intravenously into the subject. Apo A-I in TG-enriched HDL was cleared 26% more rapidly than apo A-I in fasting HDL. A strong correlation between the Intralipid-induced increase in the TG content of HDL and the increase in HDL apo A-I fractional catabolic rate reinforced the importance of TG enrichment of HDL in enhancing its metabolic clearance. HDL was separated further into lipoproteins containing apo A-II (LpAI:AII) and those without apo A-II (LpAI). Results revealed that the enhanced clearance of apo A-I from TG-enriched HDL could be largely attributed to differences in the clearance of LpAI but not LpAI:AII. This is, to our knowledge, the first direct demonstration in humans that TG enrichment of HDL enhances the clearance of HDL apo A-I from the circulation. This phenomenon could provide an important mechanism explaining how HDL apo A-I and HDL cholesterol are lowered in hypertriglyceridemic states.
Benign Gastric Ulcer and Cimetidine: Questions About Study Design
Authors: ANDREW B. SACHERE
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 October 1985Benign Gastric Ulcer and Cimetidine: Questions About Study DesignANDREW B. SACHERE, M.D.ANDREW B. SACHERE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-4-636 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: A number of problems in the lead article in the May issue by Dr. Graham and associates (1) make it difficult for us to agree with the authors' interpretations as well as to glean information useful in the clinical setting.The authors do not state how the study population of 172 patients was selected. Selection biases and proper extrapolation to patients at large are therefore unclear. Did the trial and placebo groups differ significantly in number of biopsies per patient?No rationale is given for the limits of 0.5 to 2.5 cm in ulcer diameter as an...References1. GRAHAM D, AKDAMAR K, and DYCK W. Healing of benign gastric ulcer: comparison of Cimetidine and placebo in the United States. Ann Intern Med. 1985;102:573-6. LinkGoogle Scholar2. ISENBERG J, PETERSON W, and ELASHOFF J. Healing of benign gastric ulcer with low-dose antacid or cimetidine: a double-blind, randomized, placebo-controlled trial. N Engl J Med. 1983;308:1319-24. CrossrefMedlineGoogle Scholar1. GRAHAM D. The role of the clinican in research. Am J Gastroenterol. 1984;79:335-40. MedlineGoogle Scholar2. GRAHAM D, AKDAMAR K, and DYCK W. Healing of benign gastric ulcer: comparison of Cimetidine and placebo in the United States. Ann Intern Med. 1985;102:573-6. LinkGoogle Scholar3. DERSIMONIAN R, CHARETTE L, MCPEEK B, and MOSTELLER F. Reporting on methods in clinical trials. N Engl J Med. 1982;306:1332-7. CrossrefMedlineGoogle Scholar4. PIPER D, SHINNERS J, GREIG M, THOMAS J, and WALLER S. Effect of ulcer healing on the prognosis of chronic gastric ulcer. Gut. 1978;19:419-24. CrossrefMedlineGoogle Scholar5. LEWIS J. Treatment of gastric ulcer: what is old and what is new. Arch Intern Med. 1983;143:264-74. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ANDREW B. SACHERE, M.D.Affiliations: University of Medicine and Dentistry of New Jersey New Brunswick, NJ 08901 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCurrent treatment of acute myeloid leukaemia in adults 1 October 1985Volume 103, Issue 4Page: 636-637KeywordsBiopsyExtrapolationGastric ulcersUlcers ePublished: 1 December 2008 Issue Published: 1 October 1985 PDF downloadLoading ...
Can the SMART Study Data Be Used to Assess Risk Factors for Renal Disease?
Authors: Samir K. Gupta
Journal: Annals of Internal Medicine (2009)

Letters17 February 2009Can the SMART Study Data Be Used to Assess Risk Factors for Renal Disease?Samir K. Gupta, MD, MSSamir K. Gupta, MD, MSFrom Indiana University School of Medicine, Indianapolis, IN 46202.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-4-200902170-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In the recent analysis by the SMART (Strategies for Management of Anti-Retroviral Therapy) Study Group (1), resumption of continuous antiretroviral therapy after structured treatment interruption did not fully abrogate the increased risk for serious adverse events and death associated with initial assignment to the drug conservation group of the trial. This suggests that even short periods of untreated HIV infection may confer a greater overall risk for major complications than that posed by the antiretroviral treatments themselves. However, there was a statistically significant interaction between the study period (premodification vs. postmodification) and the treatment group assignment (continuous ...Reference1. El-Sadr WM, Grund B, Neuhaus J, Babiker A, Cohen CJ, Darbyshire J, et al; SMART Study Group. Risk for opportunistic disease and death after reinitiating continuous antiretroviral therapy in patients with HIV previously receiving episodic therapy: a randomized trial. Ann Intern Med. 2008;149:289-99. [PMID: 18765698] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Indiana University School of Medicine, Indianapolis, IN 46202.Disclosures: Dr. Gupta has received advisory and speaking fees from Gilead Sciences (the manufacturer of tenofovir disoproxil fumarate) and is the principal investigator of a phase IV study, sponsored by Gilead Sciences, of renal toxicities associated with antiretroviral therapies. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk for Opportunistic Disease and Death after Reinitiating Continuous Antiretroviral Therapy in Patients with HIV Previously Receiving Episodic TherapyCan the SMART Study Data Be Used to Assess Risk Factors for Renal Disease? James D. Neaton and Metrics Cited byEffect of Tenofovor Diproxil Fumarate on Renal Function and Urinalysis Abnormalities in HIV-Infected Cameroonian Adults 17 February 2009Volume 150, Issue 4Page: 282KeywordsAntiretroviral therapyAntiretroviralsDrugsHIV infectionsMedical risk factorsRenal analysisRenal diseasesToxicity ePublished: 17 February 2009 Issue Published: 17 February 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...