Showing papers in "JAMA in 1970"
TL;DR: Control of hypertension, labile or fixed, systolic or diastolic, at any age, in either sex appears to be central to prevention of atherothrombotic brain infarction (ABI).
Abstract: Control of hypertension, labile or fixed, systolic or diastolic, at any age, in either sex appears to be central to prevention of atherothrombotic brain infarction (ABI). Prospectively, hypertension proved the most common and potent precursor of ABI's. Its contribution was direct and could not be attributed to factors related both to stroke and hypertension. Asymptomatic, causal "hypertension" was associated with a risk of ABI about four times that of normotensives. The probability of occurrence of an ABI was predicted no better with both blood pressure measurements or the mean arterial pressure than with systolic alone. Since there was no diminishing impact of systolic pressure with advancing age, the concept that systolic elevations are, even in the aged, innocuous is premature. Comparing normotensives and hypertensives in each sex, women did not tolerate hypertension better than men.
660 citations
TL;DR: Dr. Masters offers an assortment, representative of which are "sensate focus," "endpoint release," and "coital opportunity"—joining earlier creations like "orgasmic platform."
Abstract: If written concisely and unrepetitively, this book would occupy about one-third the space, be considerably clearer, and correspondingly less impressive. Part of its impressiveness is its style: not a personal pronoun anywhere; only the Foundation. The language is somewhat simpler than its earlier companion piece, Human Sexual Response , but it is still virtually unreadable. Sample: "Women entering therapy in a state of non-orgasmic return reflected complete failure of any effective alignment of their biophysical and psychosocial systems of influence." Meaning? The convoluted phraseology, contradictions, and reifications strike a familiar note. Like the Madison Avenue ad men who gave us "midriff bulge" and "tattletale grey," Dr. Masters offers an assortment, representative of which are "sensate focus," "endpoint release," and "coital opportunity"—joining earlier creations like "orgasmic platform." The book contains a 56-page bibliography, but the text does not show that the listed material has been utilized within the book, in the usual
592 citations
TL;DR: Whether or not the Australia antigen represents a virus remains to be established; nonetheless, identification of this antigen in the serum of hepatitis patients constitutes a fascinating development that may, hopefully, presage eradication of transfusion-induced hepatitis.
Abstract: Whether or not the Australia antigen represents a virus remains to be established; nonetheless, identification of this antigen in the serum of hepatitis patients constitutes a fascinating development that may, hopefully, presage eradication of transfusion-induced hepatitis. Other recent developments discussed by the 51 contributors to Popper and Schaffner's book range from hepatic culture and transplantation to umbilical vein catheterization and phototherapy. Intense blue light, according to Hsia and Porto, decomposes the bilirubin in icteric serum and sometimes controls neonatal jaundice. They caution, however, against an ill effect from the degradation products. Reporting on another development, Chiandussi tells how to catheterize the umbilical vein. Umbilico-portal catheterization, he notes, permits selective splenic and portal phlebography, measurement of direct portal venous pressure, and decompression of the portal bed during hemorrhage from esophageal varices. He also notes that a physician can use the transumbilical catheter to infuse chemotherapeutic agents directly into a cancerous liver.
533 citations
TL;DR: Different differences in outcome were noted in specific subgroups in the frequency and pattern of transient attacks and in the occurrence and location of cerebral infarction.
Abstract: A series of 316 patients with transient cerebral ischemic attacks and no neurological deficit were randomly allocated to surgical or nonsurgical treatment categories in a controlled manner. The total group was divided by anatomical patterns of lesions (carotid stenosis, unilaterally; carotid stenosis, bilaterally; and unilateral occlusion with opposite stenosis). During an average 42-month follow-up, distinct differences in outcome were noted in specific subgroups in the frequency and pattern of transient attacks and in the occurrence and location of cerebral infarction.
452 citations
TL;DR: The author develops his argument through an exhaustive theoretical analysis, beginning with the formal organization of the profession and proceeds to the ways in which the performance of its work is organized and regulated.
Abstract: Buried in the pedantic pages of this book is a pointed challenge to medicine. Simply stated, Freidson's view is that the medical profession has become too autonomous and too powerful for the good of society, and that it must therefore be regulated. Like the prominent medical sociologist he is, the author develops his argument through an exhaustive theoretical analysis. He begins with the formal organization of the profession and proceeds to the ways in which the performance of its work is organized and regulated. He denies that the knowledge required for clinical practice is so esoteric that it cannot be questioned by lay persons. The "clinical mentality" he finds to be characterized by action orientation and pragmatism. Physicians, he concedes, do have a service orientation as well, but he believes it to be not prominent and not a sufficient basis for claims to professional autonomy. Physicians expect to be allowed
423 citations
TL;DR: Severe cardiac arrhythmia, resulting from light plane anesthesia, and intensified by hypercapnia or stress or activity or a combination of these, is the most likely explanation for sniffing death.
Abstract: An epidemic of 110 sudden sniffing deaths without plastic bag suffocation which occurred in American youths during the 1960's, appears to have originated on the West Coast. The incidence rate showed a sharp rise during the late 1960's. Volatile hydrocarbons most frequently involved were trichloroethane and fluorinated refrigerants. Sudden sniffing death occurred in all socioeconomic groups, with a preponderance in the suburban middle-income white family. Severe cardiac arrhythmia, resulting from light plane anesthesia, and intensified by hypercapnia or stress or activity or a combination of these, is the most likely explanation for sniffing death.
408 citations
TL;DR: Hepatitis-associated antigen was consistently present in sera from patients with MS-2 strain of serum hepatitis (SH); it was not present in MS-1, infectious hepatitis (IH), and Gamma-globulin consistently neutralized the infectivity of IH (MS-1) serum; in most cases it did not neutralize the infectivities of SH (MS -2) serum.
Abstract: Tests for the presence of Australia or hepatitisassociated antigen (HAA) and antibody (anti-HAA) were performed on more than 25,000 serum specimens from more than 700 patients with viral hepatitis. Hepatitisassociated antigen was consistently present in sera from patients with MS-2 strain of serum hepatitis (SH); it was not present in MS-1, infectious hepatitis (IH). Hepatitis-associated antigen was detected earlier after a parenteral exposure to SH than after an oral exposure. Antigen appeared two weeks to two months before onset of jaundice; it was transient in 65% of patients, but persisted for four months to 13 years in 35% of children. The average incubation period of IH (MS-1) was essentially the same following an oral or parenteral exposure (32 to 33 days); in SH (MS-2) it was 65 days after parenteral exposure and 98 days after oral exposure. Gamma-globulin consistently neutralized the infectivity of IH (MS-1) serum; in most cases it did not neutralize the infectivity of SH (MS-2) serum.
357 citations
TL;DR: In most patients neurological signs and mental symptoms disappeared and mental status normalized by discharge, however, 15% of survivors had signs of cerebral damage at discharge, and neuropathological findings suggested cerebral ischemia.
Abstract: A prospective study of the conditions of 100 open-heart surgery patients elicited more precise information about incidence, characteristics, and causes of central nervous system dysfunctions after surgery. Neurological, psychometric, and behavioral observations were made preoperatively and postoperatively. Half the sample developed neurological damage following recovery from anesthesia. Forty-three percent of survivors developed behavioral abnormalities preceded by focal neurological damage; intellectual functions were depressed in all such patients. In most patients neurological signs and mental symptoms disappeared and mental status normalized by discharge. However, 15% of survivors had signs of cerebral damage at discharge. Cerebral damage was significantly related to increasing age and depression of arterial pressure. In patients with cerebral dysfunction, arterial pressure fell to levels which did not support adequate cerebral perfusion. Older patients were especially vulnerable to such effects. Neuropathological findings suggested cerebral ischemia.
287 citations
TL;DR: At the 99th annual meeting of the American Medical Association in 1950, a report based on the experience with 11 patients with compression neuropathy of the median nerve at the wrist, described a clinical syndrome unknown to almost all of the physicians attending that meeting.
Abstract: At the 99th annual meeting of the American Medical Association in 1950, I presented a report entitled "Spontaneous Compression of the Median Nerve at the Wrist," before the section on Orthopedic Surgery. 1 The report based on my experience with 11 patients with compression neuropathy of the median nerve at the wrist, was discussed by Walter Graham, MD, of Santa Barbara, Calif; Clarence Luckey, MD, of Stockton, Calif; and Sterling Bunnel, MD, of San Francisco. The report described a clinical syndrome unknown to almost all of the physicians attending that meeting. During the next six years, I continued to diagnose and treat patients with carpal-tunnel syndrome. With a series of 71 patients, I believed I could speak with some authority on the cause and the proper treatment of the condition. I again turned to the section on Orthopedic Surgery to present these data and statistics, during the 105th annual meeting
274 citations
TL;DR: By proper screening, it may be possible to reduce potential disabling knee ligament rupture in loose players in contact sports and in high velocity athletics and to increase the strength of loose players and the mobility of tight players.
Abstract: With tests to determine the mobility of lower and upper extremities, 139 professional football players were classified as loose or tight, and subsequently checked for the incidence of major knee ligament rupture. Thirty-seven players sustained knee ligament rupture requiring surgery. Thirty-nine players had at least three indices of looseness. Twenty-eight (72%) of these ruptured their knee ligaments. Of the remaining 100 players with two or less indices, nine (9%) ruptured their ligaments. Only two (4%) players in the tight category (no indices of looseness) ruptured their ligaments. Increased likelihood of knee ligament rupture was found with increased looseness. Specific exercises should be designed to increase the strength of loose players and the mobility of tight players. By proper screening, it may be possible to reduce potential disabling knee ligament rupture in loose players in contact sports and in high velocity athletics.
238 citations
TL;DR: A large-scale comprehensive drugsurveillance program, now involving eight hospitals, is described, the principles and potential of this type of research are discussed, and data on some broad aspects of drug utilization and effects are presented.
Abstract: The urgent need for information about clinical drug effects may be partially met by a large-scale comprehensive drugsurveillance program designed to permit the detection of unsuspected side effects and drug interactions, the quantitation of known effects, and the evaluation of the role of influencing factors. Such a program, the Boston Collaborative Drug Surveillance Program, now involving eight hospitals, is described, the principles and potential of this type of research are discussed, and data on some broad aspects of drug utilization and effects are presented. An appropriately designed drug-surveillance program can be introduced to hospital wards with a minimum of interference with the ward routine, can be applied in a standardized form in different centers, and is indeed capable of providing valuable information about clinical drug effects.
TL;DR: Extension of these simple therapeutic measures to large numbers of poor risk patients should reduce postoperative morbidity and mortality, allow earlier discharge, and lower the costs of patient care.
Abstract: Simple pulmonary function studies can be utilized successfully for diagnosis of pulmonary problems in surgery patients preoperatively. In the present study, randomly selected "poor risk" patients were treated preoperatively and postoperatively with cessation of smoking, bronchodilator drugs, antibiotics, inhalation of humidified gases, segmental postural drainage, and chest physiotherapy. When compared to nontreated poor risk patients, the treated patients had a marked reduction in postoperative morbidity and mortality due to pulmonary complications. Although the frequency and the severity of pulmonary complications were somewhat greater in the treated patients than in a group of "good risk" patients who were considerably younger in age, the differences were not significant. Extension of these simple therapeutic measures to large numbers of poor risk patients should reduce postoperative morbidity and mortality, allow earlier discharge, and lower the costs of patient care.
TL;DR: Inoculation of dilutions of the plasma pool showed that serum hepatitis can be transmitted by materials containing HAA in amounts too low to be detected by current techniques.
Abstract: There is evidence that transmission of serum hepatitis is associated with transmission of virus-like particles, approximately 20 mμ in diameter, containing the Australia or serum hepatitis (SH) antigen, which is currently referred to as the hepatitis associated antigen (HAA). Virus-like particles containing HAA were in the following materials, inoculation of which produced serum hepatitis: (1) a pool of human plasma, (2) serum obtained during the acute phase of hepatitis from a recipient of the plasma pool, (3) a preparation of human thrombin, and (4) serum from a proved hepatitis carrier. The HAA appeared in the serum samples of 61 individuals inoculated with these materials; serum hepatitis developed in 38 of them. Inoculation of dilutions of the plasma pool showed that serum hepatitis can be transmitted by materials containing HAA in amounts too low to be detected by current techniques.
TL;DR: Gallium localization is greatest in viable tumor, less in fibrotic or necrotic tumor, and diminished by irradiation and effective chemotherapy, and diminishing by irradiated chemotherapy.
Abstract: Gallium has an affinity for some human as well as animal neoplasms. Carrier-free gallium citrate Ga 67 administered intravenously is localized in a variety of malignant tumors that can then be detected on scintiscans. Nonosseous as well as skeletal lesions can be seen, including some that are not otherwise detectable. No untoward effects were observed in 41 patients studied. Scans were abnormal in 23 patients with a variety of malignant neoplasms; reticulum cell sarcoma, lymphoblastoma, and poorly differentiated adenocarcinoma gave the most consistent results. The 18 patients in whom scans were normal included three patients with plasma cell myeloma, four with lymphocytoma, and five with Hodgkin's disease involving small retroperitoneal nodes. Gallium localization is greatest in viable tumor, less in fibrotic or necrotic tumor, and diminished by irradiation and effective chemotherapy. The mechanism is unknown.
TL;DR: The effect the program had on blood pressures (taken while the men were resting) was determined and there was a mean decrease in the diastolic pressure of the normotensive group, but no significant change in the mean systolic pressure.
Abstract: Twenty-three essential hypertensive and 22 normotensive middle-aged men participated in a controlled exercise program for six months; the effect the program had on blood pressures (taken while the men were resting) was determined. There was no other change in therapeutic management during the exercise training period. The exercise medium used was the interval training of the walkjog type, with training intensity based on the actual heart rate expressed as percent of working capacity. A drop in mean diastolic pressure of 11.8 mm Hg and in mean systolic pressure of 13.5 mm Hg occurred in the hypertensive group. There was a mean decrease of 6 mm Hg in the diastolic pressure of the normotensive group, but no significant change in the mean systolic pressure.
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TL;DR: This magnificent treatise on the human placenta is a definitive work on the normal structure of that vital and often-neglected organ and requires careful, thoughtful, and unhurried reading.
Abstract: This magnificent treatise on the human placenta is a definitive work on the normal structure of that vital and often-neglected organ. The usual book, like a bottle of wine, is soon finished, leaving only more or less pleasant memories. This book, however, large in size and broad in scope, is more like a whole wine cellar—to be read and enjoyed over a long period of time. Indeed, its wealth of material requires careful, thoughtful, and unhurried reading. The contents are arranged in a logical developmental manner, beginning with "Historical Survey" and ending, 21 chapters later, with "The Placenta in Multiple Pregnancies." No facet of structure or function is neglected. The authors draw upon their exhaustive personal knowledge, their own significant material and a scholarly, orderly, and relevant review of the literature. More than 1,500 references are cited and analyzed. The authors are extraordinarily skillful in weaving the findings of a
TL;DR: Antibiotics were used most frequently on the pediatric and surgical services, and they were most frequently used without clearly recorded evidence of infection on the surgical services.
Abstract: Between November 1967 and June 1969,24 prevalence studies of nosocomial infections and antibiotic usage were completed in seven community hospitals. Medical records of 5,256 patients were reviewed; 30.6% were receiving antibiotics, and 80% of those were receiving a single agent. Penicillin, ampicillin, and tetracycline use was similar, and these three accounted for about half of the antibiotics given. From January 1968 through June 1969, chloramphenicol use declined sharply; ampicillin and cephalosporin use increased. Antibiotics were used most frequently on the pediatric and surgical services. They were most frequently used without clearly recorded evidence of infection on the surgical services. Fewer than 30% of patients receiving penicillin, sulfonamides, and streptomycin had recorded evidence of infection when the antibiotic was first given; only 38% of 454 patients receiving antibiotics in 1969 had such evidence.
TL;DR: The dangerously high levels of plasma potassium known to follow succinylcholine chloride administration in patients with burns or trauma have also been noted in Patients with paraplegia or hemiplegia, muscular dystrophy, and multiple sclerosis.
Abstract: The dangerously high levels of plasma potassium known to follow succinylcholine chloride administration in patients with burns or trauma have also been noted in patients with paraplegia or hemiplegia, muscular dystrophy, and multiple sclerosis. Of 40 patients with these neuromuscular diseases, 15 had increases in potassium levels between 1 and 6 mEq/liter after receiving succinylcholine chloride, 1 mg/kg of body weight. Most increases over 1 mEq/liter occurred in those patients who had been ill for less than six months or, if longer, who had disease of a progressive nature. The degree and extent of muscle paralysis seemed directly correlated with relaxant-induced hyperkalemia.
TL;DR: Healthy patients with early painful herpes zoster were treated with corticosteroid orally or lactose tablets in a double-blind fashion and the duration of postherpetic neuralgia was shortened by treatment with the cortICosteroid.
Abstract: Healthy patients with early painful herpes zoster were treated with corticosteroid orally or lactose tablets in a double-blind fashion. The duration of postherpetic neuralgia was shortened by treatment with the corticosteroid. Corticosteroid therapy did not affect pain during the first two weeks or the rate of skin healing. The duration of postherpetic neuralgia could not be predicted by the healing rate of the skin. Control patients less than 60 years old had rapid resolution of their neuralgia while those more than 60 years old had slower resolution of the pain. Corticosteroid therapy did not cause generalization of the eruption.
TL;DR: Patients with M pneumoniae had higher rates of headache, fever, sore throat, skin rash, and ear complications, but lower rates of coryza and leukocytosis than patients with pneumonia of other etiologies.
Abstract: Incidence of Mycoplasma pneumoniae pneumonia was studied in a large medical cooperative in Seattle from 1963 through 1968. Twenty percent of all pneumonia was associated with M pneumoniae infection. The disease was endemic and without seasonal fluctuation during the last and the first two years of study. An epidemic started late in 1965 and peaked in January 1967. Children 5 to 9 years old consistently had the highest attack rate, while the proportion of all pneumonia due to M pneumoniae was highest among teenagers. Patients with M pneumoniae had higher rates of headache, fever, sore throat, skin rash, and ear complications, but lower rates of coryza and leukocytosis than patients with pneumonia of other etiologies. Duration of illness increased with age. Treatment with tetracyclines and erythromycin reduced the length of illness, but not the antibody response. Follow-up examinations revealed no serious sequelae.
TL;DR: The history of research with psychedelic drugs has produced a variety of methods for their use and conflicting claims about results.
Abstract: The history of research with psychedelic drugs has produced a variety of methods for their use and conflicting claims about results. First came the wave of excitement among experimentalists in the 1950s when it was claimed that lysergic acid diethylamide (LSD) could produce a model psychosis which might be useful in understanding schizophrenia. While this promise was fading, enthusiastic reports about the possibility of LSD as an aid to psychotherapy in the treatment of alcoholism and other psychiatric disorders appeared. All these approaches were represented in 1959 at the first international conference devoted entirely to LSD. 1 Since then, there have been at least five more published proceedings of such conferences on various aspects of psychedelic drugs. 2-6 The most recent conference on various means of producing states of consciousness was sponsored by the Menninger Foundation and the American Association of Humanistic Psychology on April 7 to 11, 1969, in
TL;DR: A population-based epidemiologic study of 2,184 residents of Charleston County, South Carolina, with a high morbidity and death rate from arteriosclerotic and hypertensive cardiovascular disease showed high prevalence of hypertension among Negroes compared with the prevalence in Charleston whites or American Negroes.
Abstract: A population-based epidemiologic study of 2,184 residents of Charleston County, South Carolina, with a high morbidity and death rate from arteriosclerotic and hypertensive cardiovascular disease showed high prevalence of hypertension among Negroes compared with the prevalence in Charleston whites or American Negroes The relationships of sex and age with hypertension follow different patterns in Negroes and whites In contrast to the white population, no correlation between obesity and hypertension was found in Negroes A positive correlation was found between skin pigmentation and hypertension in Negroes There was also a significant difference in prevalence of group B blood type between lighter- and darker-pigmented Negroes, the darker half having the same "B" prevalence as West African Negroes, and 50% higher prevalence than American Negroes
TL;DR: The misleading phrase "normal limits" is proposed to be dropped, and the phrase "clinical limits" be used to refer to the 2 1/2 and 97 1/ 2 percentage points of the distribution in healthy persons.
Abstract: It has been suggested that "clinical normal values" can be estimated from routine laboratory records by purely statistical methods, so that accumulation of values for healthy persons is unnecessary. The basic premise for this view is that the routine laboratory values give a mixture of two gaussian (or "normal") distributions (one for the sick and one for the healthy) and that these can be identified. The results of the proposed method are compared with observed values for healthy persons tested in the same laboratories during the same period, and are found to be unsatisfactory. The distributions in healthy persons cannot be adequately described by a normal distribution. We propose that the misleading phrase "normal limits" be dropped, and that the phrase "clinical limits" be used to refer to the 2 1/2 and 97 1/2 percentage points of the distribution in healthy persons.
TL;DR: The mortality of diabetics with mild diabetes and those without complicating diseases was also substantially greater than that of the nondiabetics, and the mortality of those with mild Diabetes and those Without Complicating Diseases was substantially greater.
Abstract: Three hundred and seventy diabetics and an equal number of matched controls were followed up over a ten-year period to compare the mortality of diabetics with that of nondiabetics, and to determine how the longevity of diabetics is affected by various complicating conditions and by the severity of the diabetes. During the ten-year study period, the death rate of the diabetics was 25.4% compared to 9.7% among the controls, a ratio of about 2.6. Some of the excess mortality was accounted for by (1) a higher prevalence of hypertension, overweight, coronary heart disease, and kidney disease, and (2) the severity of the diabetes, as indicated by a high insulin dosage, early onset, and recurrent glycosuria. However, the mortality of those with mild diabetes and those without complicating diseases was also substantially greater than that of the nondiabetics.
TL;DR: The concept of an artificial gut system which can provide prolonged nutrition to patients incapable of enteric feeding is described and has potential for maintenance of health of patients with chronic bowel disease.
Abstract: We describe the concept of an artificial gut system which can provide prolonged nutrition to patients incapable of enteric feeding. Concentrated nutrients are safely introduced into the circulation via an arteriovenous shunt, and delivered by either a day-mode (portable pump) or night-mode (gravity feed) delivery system. The system has been designed to be operated by the patient in his own home and has potential for maintenance of health of patients with chronic bowel disease.
TL;DR: Spread of staphylococci among patients appeared to have occurred primarily by way of temporary hand carriage by personnel, and the organisms exhibited limited capacity for colonization of patients not receiving antimicrobial agents.
Abstract: Between Jan 3 and Feb 21,1969, a single strain of coagulase-positive, methicillin-resistant, type 84 Staphylococcus was isolated from six hospitalized patients. Two patients died of staphylococcal pneumonia, one recovered from aspiration pneumonia, another developed a wound infection, and two became asymptomatic carriers. Extensive culturing of samples of nasal secretions from hospital personnel did not reveal a source of infection; however, the suspected index case was traced to local nursing homes where two additional cases were detected. Spread of staphylococci among patients appeared to have occurred primarily by way of temporary hand carriage by personnel, and the organisms exhibited limited capacity for colonization of patients not receiving antimicrobial agents.
TL;DR: The fluoroalkane gases used to propel aerosols were toxic to the hearts of 34 mice, sensitizing them to asphyxiainduced sinus bradycardia, atrioventricular block, and T-waue depression, and cardiac sensitization was rapid, long-lasting, and lethal.
Abstract: The fluoroalkane gases used to propel aerosols were toxic to the hearts of 34 mice, sensitizing them to asphyxiainduced sinus bradycardia, atrioventricular block, and T-waue depression. Cardiac sensitization was rapid, long-lasting, and lethal. It also occurred in rats and dogs. The propellants are postulated to possess a spectrum of cardiotoxic effects capable, in various species, of causing bradyarrhythmias, tachyarrhythmias, or myocardial depression. In humans the cardiac toxicity of aerosol propellants, particularly during asphyxia, may be a cause of sudden death in youths who "turn on" by inhaling propellants and in patients with asthma who make excessive use of bronchodilator aerosols. To a degree presently unknown, cardiac toxicity, including arrhythmias, due to propellant inhalation may be a potential hazard to frequent users of pressurized aerosol dispensers.
TL;DR: A total of 263 patients with histopathologically proved, well-differentiated papillary and follicular thyroid carcinoma were treated with sodium iodide I 131 after surgery, and a 100% follow-up was achieved with a mean of 6.3 years, and an observation period of 0 to 20 years.
Abstract: A total of 263 patients with histopathologically proved, well-differentiated papillary and follicular thyroid carcinoma were treated with sodium iodide I 131 after surgery. A 100% follow-up was achieved with a mean of 6.3 years, and an observation period of 0 to 20 years. The death rate in these patients was compared with the death rate in 50 patients with papillary and follicular carcinoma of the thyroid treated surgically before introduction of sodium iodide I 131 (control group), and followed for a mean of 6.7 years (0 to 20 years). These groups were matched in sex, but not in age distribution. In patients 40 years of age and older, the group treated with sodium iodide 1131 had a significantly lower death rate than the surgery-only group (P
TL;DR: Risk for thyroid cancer from radioactive iodine exposure in this group does not appear to be very different from that reported following x-irradiation.
Abstract: Accidental exposure of people of Rongelap Island to radioactive fallout and particularly to radioactive iodines in the fallout has resulted in the development of thyroid abnormalities in 21 of 67 of these people, 3 with malignant lesions, 16 with benign adenomatous nodules, and 2 with atrophy of the gland with hypothyroidism. The preponderance of lesions occurred in children exposed at less than 10 years of age who had received a greater thyroid exposure. Growth retardation associated with hypothyroid tendency was noted in some children who appear to be responding favorably to thyroid hormone medication. Thyroidectomy, partial to complete, has been carried out on 18 patients. Risk for thyroid cancer from radioactive iodine exposure in this group does not appear to be very different from that reported following x-irradiation.
TL;DR: The symposium reported in this book presents the current research bearing on three very closely related aspects of sleep: Its physiology, its pathology, and the use of drugs in the management of sleep disorders.
Abstract: The symposium reported in this book presents the current research bearing on three very closely related aspects of sleep: Its physiology, its pathology, and the use of drugs in the management of sleep disorders. This last section will particularly interest the practitioner. Sleep research is a new field. It has not had the tempering influence of long-standing data gathering, theorizing, and clinical application. Instead, the newly available technology of the last two decades has enabled it to burst forth from many directions at once. The book accurately represents this, and conflicting theories stand shoulder to shoulder, apparently supported by equally incontrovertible data. For example, in regard to rapid eye movement (REM) sleep, one might have difficulty in reconciling Dement's statement ("no study has shown that REM deprivation has significant functional consequences for the waking life of human subjects") with Webb's ("REM deprivation results in a hyperactive and labile response state").