tbuckley/cabot-search huggingface dataset:
Practice parameter for the use of fresh-frozen plasma, cryoprecipitate, and platelets. Fresh-Frozen Plasma, Cryoprecipitate, and Platelets Administration Practice Guidelines Development Task Force of the College of American Pathologists
Authors: E. Shannon Cooper, Arthur W. Bracey, Andrew E. Horvath, Jacob N. Shanberge, Toby L. Simon, David H. Yawn
Journal: JAMA (1994)

THESE guidelines have been prepared to assist the ordering physician in selecting the proper blood component for obtaining and maintaining hemostasis. While it is not possible to detail every clinical situation for which these components may be indicated, these guidelines will cover most important states. Since these guidelines were developed for adult patients, they may not apply in all cases for pediatric transfusions. Also, these guidelines do not eliminate the need for expert consultation in this complex area of medical practice, and in situations that involve very complex massive bleeding physicians may not be able to adhere to them. It should be understood that adherence to parameters does not guarantee a successful outcome. Rather, these parameters are provided as an educational tool to assist physicians in providing quality care. If equally valid parameters or views advanced by other respected groups are applicable, the physician is, of course, free to follow
LDL subclass distribution is associated with coronary calcification in postmenopausal women
Authors: Rachel H. Mackey, Lewis H. Kuller, Kim Sutton-Tyrrell, Karen A. Matthews, Rhobert W. Evans, Richard Holubkov, James D. Otvos
Journal: Circulation (2001)

0030 Major lipoprotein classes consist of particles of various sizes, densities and composition. Associations between lipoprotein subclasses and coronary calcification were evaluated in 287 healthy women, 8 years post-menopause (age 56.9 to 65.4, mean=61.7 y). Coronary calcification score (CCS) was measured by electron beam CT and lipoprotein subclasses were determined by NMR spectroscopy. The mean CCS was 53 (range 0-1175) but 54% of the women had zero scores. CCS was analyzed as categories (CCS: 0, 1-99, ≥100). Current smoking was strongly associated with greater CCS but age and SBP were not significantly associated. Higher CCS was associated with higher triglycerides, total cholesterol and LDL-C, by NMR or usual methods, and total HDL-C by usual methods at the same visit (p &lt; 0.05 for all). Large HDL and total HDL-C by NMR were weakly but not linearly related to CCS. Higher CCS was associated with higher levels of all VLDL subclasses categorized as small, medium or large (p&lt;0.01). Only the smallest LDL subclass (L1) was related to CCS (p&lt;0.01). Mean LDL particle size was smaller for higher CCS category (21.1 vs. 20.7 nm, p&lt;0.01, for CCS = 0 vs CCS &gt; 100). The number of LDL particles was also strongly related to CCS (p&lt;0.001). Ordinal logistic regression was used to determine whether the lipoprotein subclasses were predictive of CCS category after adjustment for age, SBP, current smoking, and usual measures of LDL-C, HDL-C and triglycerides. Women with LDL particle concentrations ≥ 1800 nmol/L or levels of large VLDL &gt; 27 mg/dL were more likely to be in a higher CCS category than those without these risk factors (OR = 2.09, 95% CI: 1.18, 3.70; OR= 2.21, 95% CI: 1.19,4.10, respectively.) After adjustment, higher CCS was still related to higher levels of small LDL (L1), but not to mean (LDL) particle size. These relationships were confirmed using linear regression with log-transformed variables. In postmenopausal women the size and number of LDL particles may be better predictors of atherosclerosis than total LDL-C. The level of large VLDL triglyceride contributes to decreased LDL size and increased number of LDL particles at a given level of LDL-C, via CETP and hepatic lipase.
Amnesic patients give clues on structure of memory
Authors: E. Blume
Journal: JAMA (1983)

Human memory is not a single phenomenon but, rather, is made up of several distinct components, according to scientists who have been studying this function of the brain. At a recent National Institute of Mental Health (NIMH) science writers' seminar, speakers explained that particular memory components can make possible different kinds of learning. Such components may or may not be impaired in a given amnestic syndrome and may respond in their own ways to psychoactive drugs. Probably the most dramatic evidence for the existence of distinct memory components comes from patients who have sustained severe bilateral damage to the hippocampus and the amygdala—parts of the brain's limbic system. Such patients suffer from a syndrome known as global anterograde amnesia; they are essentially incapable of learning new information. A patient with global amnesia is unable to remember what he had for breakfast, and, if he has moved since the brain damage
Finland's health care system. Universal access to health care in a capitalistic democracy
Authors: T. Hermanson
Journal: JAMA (1994)

In Europe, several countries with national health services have started experimenting with planned markets.<sup>1</sup>Finland has a national health care system funded through general taxation, with good access to care and a large emphasis on primary care and preventive services. In 1993, Finnish health care financing was reorganized with the purpose of increasing efficiency and performance. <h3>Background</h3> Since her independence in 1917, Finland has been a republic, combining a parliamentary system with a strong presidency. It is a country of 5 million inhabitants but is sparsely populated. The Finnish population is culturally and racially homogeneous. In contrast to Sweden and Denmark, there is very little immigration into Finland. Finland's economy was formerly dominated by agriculture; however, in the past few decades it has been primarily transformed into services (60% of the population) and industry (30% of the population).<sup>2</sup>Finland governs by a capitalistic democracy, but its people have
Hepatitis B virus replication modulates pathogenesis of hepatitis D virus in chronic hepatitis D
Authors: A Smedile
Journal: Hepatology (1991)

Hepatitis D virus and hepatitis B virus nucleic acids were detected by Northern and Southern blot hybridlzation in the sera and livers of 85 chronic carriers of HBsAg and anti-hepatitis D followed up for a mean of 10 yr. We identified three subsets of patients: 13 with hepatitis D virus and hepatitis B virus viremia, 53 with serum hepatitis D virus RNA, but without hepatitis B virus DNA and 19 negative for both nucleic acids. Genomic and subgenomic forms of hepatitis D virus RNA were detected only in patients with hepatitis D virus and hepatitis B virus viremia. Histological findings and disease activity at admission were comparable in the three groups of patients, but the outcome was significantly worse in patients with active replication of both viruses; two of them died of terminal liver failure and hepatocellular carcinoma developed in two; the remaining patients had an uneventful course. These results suggest that active hepatitis B virus replication represents an important previously unrecognized determinant of severe liver damage in patients with chronic hepatitis D virus infection. Since hepatitis B virus provides the means for hepatitis D virus secretion and release from infected cells, active hepatitis B virus multiplication favoring the spread of hepatitis D virus from cell to cell may increase the pathogenetic potential of the defective agent. (Hepatology 1991;13:413–416.)
House staff supervision and working hours
Authors: Bertrand M. Bell
Journal: JAMA (1990)

<h3>To the Editor.—</h3> As chairman of the committee that made the recommendations that led to reforms in the working conditions and supervision of residents in New York,<sup>1</sup>I can state that the article by Kenneth E. Thorpe,<sup>2</sup>"House Staff Supervision and Working Hours: Implications of Regulatory Change in New York State," must be read with an important caveat. Thorpe's article, including the methodology and cost estimates, is based on the presumption that graduate medical education will not change. This is not the case. The "Bell Committee" recognized that while the practice of hospital medicine has radically changed since World War II, the format and concept of residency training has hardly changed. The committee's recommendations were made to help facilitate change in graduate medical education that would improve the quality of care and the quality of medical education. The committee found that many program directors were unaware and did
LONDON
Journal: JAMA (1941)

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Pseudosepticemia
Authors: CARL W. NORDEN
Journal: Annals of Internal Medicine (1969)

Laboratory contamination of blood cultures with Escherichia coli resulted in initiation of treatment of seven patients who in fact did not have septicemia. Penicillinase that had been added to these blood cultures was found to contain the same serotype of E. coli that was isolated from the blood cultures. Prompt investigation resulted in recognition of the source of contamination and the discontinuance of potentially hazardous antibiotic therapy to these patients. The potential for contamination of cultures exists in all bacteriology laboratories; the ability to detect it rapidly must be insured. The availability of a designated member of the laboratory or the medical staff to review all cultures, to relate them to the clinical situation, and to make appropriate investigation into questionable situations provides an important safeguard in routine hospital practice.
Patient Safety and Medical Malpractice
Authors: Munsey S. Wheby
Journal: Annals of Internal Medicine (2004)

Letters1 June 2004Patient Safety and Medical MalpracticeMunsey S. Wheby, MDMunsey S. Wheby, MDImmediate Past President, American College of Physicians.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-11-200406010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Gale's proposal for an injured patient superfund is an interesting concept and one that deserves further exploration.The College is aggressively pushing for changes to the U.S. medical tort system. We are examining options such as a no-fault system, alternative dispute resolution, and enterprise liability.Currently, we are primarily concerned with reforming the tort system by capping noneconomic damage awards (that is, awards for pain and suffering) at $250 000. Such a cap has already been successfully tested in California. A recent study by economist Kenneth Thorpe titled “The Medical Malpractice ‘Crisis’: Recent Trends and the Impact of ...Reference1. Thorpe KE. The medical malpractice ‘crisis’: recent trends and the impact of state tort reforms. Health Aff. Web Exclusive. 21 January 2004. Accessed at content.healthaffairs.org/cgi/reprint/hlthaff.w4.20v1.pdf on 7 April 2004. Google Scholar Author, Article, and Disclosure InformationAffiliations: Immediate Past President, American College of Physicians. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPatient Safety and Medical Malpractice: A Case Study Troyen A. Brennan and Michelle M. Mello Patient Safety and Medical Malpractice Harry L. Gale Metrics 1 June 2004Volume 140, Issue 11Page: 933KeywordsInsuranceSafety ePublished: 1 June 2004 Issue Published: 1 June 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Rabies Prophylaxis
Authors: Thomas T. Weis
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Corey and Hattwick's excellent article on rabies prophylaxis (232:272, 1975) will serve as the current standard reference for these long-held principles. One important footnote is necessary to make the article complete and prevent misinterpretation. The authors properly stress the use of the rabies fluorescent antibody examination to assist a physician in determining when prophylaxis is appropriate. As they note, the test is reliable and rapid and it is assumed that the results will be available two days after the animal bite. Thus, prophylaxis should be witheld until the results are available. Unfortunately, in rural America, where most of the animal rabies exists, the time factor between bite and the results of the fluorescent antibody examination is often three to five days. It must be clearly understood that when a bite occurs in an area where prompt fluorescent antibody results cannot be rapidly obtained, prophylaxis should be started
Immunotherapy with allergens
Authors: P. S. Creticos
Journal: JAMA (1992)

ALLERGEN immunotherapy is the process by which increasing doses of allergen are injected subcutaneously over time as a treatment to prevent allergic symptoms that usually occur on exposure to allergen. The effects of this therapy on the immunologic processes ascribed to allergic responses have been studied in great detail. <h3>EFFECTS OF IMMUNOTHERAPY ON THE INFLAMMATION ASSOCIATED WITH ALLERGIC REACTIONS</h3> A number of different tools have allowed an in-depth look at the effects of immunotherapy on the cellular events, inflammatory responses, and immunologic changes that occur in allergic diseases. The nasal challenge model<sup>1</sup>has provided a means of investigating the effects of immunotherapy at both the clinical and cellular levels. Typically, standardized inhalation of allergen (nasal provocation) induces clinical symptoms of allergic rhinitis that correlate with the appearance of various inflammatory mediators (histamine, kinins, prostaglandins, leukotrienes) in the nasal secretions. Stepwise increases of the (pollen) challenge dose induces incremental increases
Impact of Promotion of the Great American Smokeout and Availability of Over-the-Counter Nicotine Medications, 1996
Journal: JAMA (1997)

The 1996 Great American Smokeout (GASO), sponsored by the American Cancer Society (ACS), was held on November 21 and included a national promotional campaign in collaboration with a distributor of over-the-counter (OTC) nicotine medications. The 1996 GASO was the first to use a national promotion that included paid advertising of the GASO through television, magazines, and newspapers; direct-to-consumer promotions; and educational activities about GASO in retail stores that sell OTC nicotine medications. To estimate the impact of this promotional partnership between ACS and a distributor of OTC nicotine medications on smoking-cessation activity, the collaborators analyzed data from three sources. This report summarizes the findings, which suggest that the promotional campaign, combined with OTC availability of nicotine medications, encouraged smoking-cessation activity.
Hazard and Risk Assessment of Chemical Mixtures Using the Toxic Equivalency Factor Approach
Authors: Stephen H. Safe
Journal: Environmental Health Perspectives (1998)

There is considerable public, regulatory, and scientific concern regarding human exposure to endocrine-disrupting chemicals, which include compounds that directly modulate steroid hormone receptor pathways (estrogens, antiestrogens, androgens, antiandrogens) and aryl hydrocarbon receptor (AhR) agonists, including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds.Based on quantitative structure-activity relationships for both AhR and estrogen receptor (ER) agonists, the relative potency (RP) of individual compounds relative to a standard (e.g., TCDD and 17f-estradiol) have been determined for several receptor-mediated responses.Therefore, the TCDD or estrogenic equivalent (TEQ or EQ, respectively) of a mixture is defined as TEQ= £[ TI x RPi or EQ= E EiE] x RP,, where T, and Ej are concentrations of individual AhR or ER agonists in any mixture.This approach for risk assessment of endocrine-disrupting mixtures assumes that for each endocrine response pathway, the effects of individual compounds are essentially additive.This paper will critically examine the utility of the TEQ/EQ approach for risk assessment, the validity of the assumptions used for this approach, and the problems associated with comparing low dose exposures to xeno and natural (dietary) endocrine disruptors.
Erratum to: Interim analysis of survival in a prospective, multi-center registry cohort of cutaneous melanoma tested with a prognostic 31-gene expression profile test
Authors: Eddy C. Hsueh, James R. DeBloom, Jonathan Lee, Jeffrey J. Sussman, Kyle R. Covington, Brooke Middlebrook, Clare Johnson, Robert W. Cook, Craig L. Slingluff, Kelly M. McMasters
Journal: Journal of Hematology & Oncology (2017)
Abstract 74: Coronary Artery Lesions in Children with Kawasaki’s Disease: A 10-Year Follow-up in Moscow
Authors: Olga Bockeria, Galina Lyskina, Olga Shirinskaya, Anna Satyukova, Nina Gagarina
Journal: Circulation (2015)

Background: Kawasaki’s disease (KD) is an acute systemic vasculitis in childhood. Lesion in the coronary arteries (CA) causes an acute or chronic ischemia, myocardial infarction and sudden death. Materials and Methods: The study included 189 children with KD for the period of 9 years (2004 - 2013). The age of the patients at the time of the acute stage of the disease was 1 month - 12 years 8 months . Boys and girls ratio was 1.8:1. 92% of the children were ill at the age of up to 5 years. Mean follow-up period was 15,8 months. We performed coronary angiography by CT scan in 14 children and by catheter in 9 children in CCVS. Echo was done in all 189 children. Results: Aneurysms of CA were found in 59 (31.2%) patients according to echocardiography data. The frequency of aneurysm formation in children first year of life was higher than in children older than 1 year (41.3% and 29.3%). Thirty eight (20%) patients had multiple aneurysms. Small aneurysms with a diameter less than 5 mm were found in 16.4% of patients, average (5 - 8 mm) - in 9%, giant (greater than 8 mm) - in 5.8% of patients. Transient CA ectasia was diagnosed in 13.2% of children. Sensitivity of echocardiography in diagnosis of CA aneurysms was 88.5% in comparison with MSCT coronary angiography, specificity - 92.3%. Mean aneurysms' diameter measured by ECHO was 7,1 ± 3,3 mm, while CT contrast study revealed 7,3 ± 3,1 mm (p&gt; 0.05). We found an involution of 40.2% of aneurysms during follow-up. Thrombi were found in 8 of 11 patients with giant aneurysms by echocardiography. Five thrombi disappeared after conservative therapy, 2 increased and occluded the RCA. CA stenosis greater than 75% was revealed in 2 patients with giant aneurysms in 2 years 7 months and in 3.5 months after manifestation of KD by using coronary arteriography. Conclusion: Kawasaki’s disease is a frequent cause of aneurysms, thrombosis and stenosis in coronary arteries in early childhood. Giant aneurysms often predispose to occlusion of the CA. Echocardiography is a highly specific and sensitive method for the visualization of CA aneurysms and thrombi. Other methods are useful when distinguishing stenosis and thrombosis in small CA is required.
CPR-Not-Indicated and Futility
Authors: Ramy A. Mahmoud
Journal: Annals of Internal Medicine (1996)

Letters1 January 1996CPR-Not-Indicated and FutilityRamy A. Mahmoud, MD, MPHRamy A. Mahmoud, MD, MPHWalter Reed Army Institute of Research; Washington, DC 20307Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-1_Part_1-199601010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Waisel and Truog [1] give examples of four hospitals' CPR-not-indicated policies and then provide three proposals for discrete conceptual views of such policies. Although I appreciated the clear and thought-provoking review of issues related to futility, I question their definition of physiologic futility, which states that “CPR is futile only if it is impossible to do cardiac massage and ventilation.” It is possible to envision instances in which it is physically possible to do cardiac massage and ventilation but not possible to achieve the proximal physiologic objectives of CPR. Physiologic futility may be more closely related to ...REFERENCE1. Waisel DB, Truog RD. The cardiopulmonary resuscitation-not-indicated order: futility revisited. Ann Intern Med. 1995; 122:304-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Walter Reed Army Institute of Research; Washington, DC 20307 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byControversial issues in critical care for the elderly: a perspective from Canada 1 January 1996Volume 124, Issue 1_Part_1Page: 76KeywordsCardiac musclesCardiopulmonary resuscitationCrimeHealth careMedical educationOxygenRespiratory physiologySafety Issue Published: 1 January 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Author index
Authors: Agrawal 509 Aguilar, Armand 702, Arteaga More, Vamvakas 508 Van 't Veer, L 405, Van Berkel, M 507, Van Blitterswijk, Van Camp, B 107 Van Der Heijden, J 606 Van Der Luit, A 604 Van Der Sijp, Van Duijn, Van Eijk, Van Groeningen, C 503, Van Oosterom, Van Spronsen, Van Triest, Van Valckenborgh, Van Weerden, Von Hoff, Vardakis 508 Vassal
Journal: Annals of Oncology (2005)
Phoenix in flight. All systems go
Authors: H. B. Curry
Journal: JAMA (1972)

The occasion of this lectureship offers a yearly opportunity to review a major issue facing our profession. In the 1970s the unavoidable issue is the problem of change. The challenge is not just to describe changes as they occur, but to search for ways of controlling change—of building on what has gone before, rather than permitting older institutions to be torn down; of achieving orderly evolution, rather than submitting to revolution. In the insignia of the American Board of Family Practice we find a symbol of change. It is the phoenix, the mythical bird of ancient Egypt, said to be as large as an eagle, with plumage of brilliant scarlet and gold. This legendary bird, as it grew old, would fashion a nest of aromatic boughs and spices. Then, by flapping its wings, the phoenix would set itself ablaze, to be consumed in its own flames. But, invariably, a new