tbuckley/cabot-search huggingface dataset:
Autopsies and Sudden Unexpected Death in Adults
Authors: Paul deR Kolisch
Journal: JAMA (1980)

<h3>To the Editor.—</h3> Lundberg and Voigt (242:2328, 1979) warm the cockles of the pathologist's heart. I have often said that one could easily get away with murder in many of our economyminded rural areas. (Perhaps I should not exempt some of our suburban and even urban areas.) The excuses or explanations for not performing autopsies in cases of sudden unexpected death in adults (SUDA) are, indeed, mutable. One of the reasons that we hear excuses is that we do not assign costs to where responsibility lies. All too often the medical care dollar is siphoned off to pay for law enforcement efforts in the case of the SUDA autopsy. Once we insist that the responsible agency pay for law enforcement activities, it will be forced to budget for them. We will see action rather than hear excuses. In the light of current demands for cost containment, it is even more
Nonlethal Mushroom Poisoning
Authors: DANIEL J. McCORMICK
Journal: Annals of Internal Medicine (1979)

The harvesting and consumption of wild mushrooms has become a popular pastime in many areas of the United States. Reports of mushroom poisonings and fatalities have been increasing since 1964. Between May 1973 and April 1978, 16 cases of mushroom poisoning were treated at our institution, including 13 within a 12-month period ending April 1978. All patients exhibited either gastrointestinal or neurologic symptoms, which responded to supportive therapy. There were no fatalities. In most cases, the clinical course can be predicted and appropriate therapy instituted if the mushroom is identified or if the interval between the ingestion and the onset of symptoms can be ascertained and certain characteristic symptoms are observed.
Recovery of hypoxic neonatal hearts after cardioplegic arrest
Authors: J. E BAKER
Journal: Cardiovascular Research (1993)

Surgery for repair of congenital heart defects in the infant may be affected by hypoxia associated with the defect. The effects of chronic hypoxia on systemic ventricular function are not well characterised and few studies have considered myocardial preservation in the hypoxic neonatal heart. The aim was to determine how chronic hypoxia would affect left ventricular function in neonatal rabbit hearts subjected to global ischaemia.Hearts from rabbits one, four, and six weeks of age and raised at 9% O2 were compared with hearts from rabbits raised in ambient air. Haemodynamic variables were measured with an isolated heart preparation before and after cardioplegic arrest. Creatine kinase was measured during reperfusion and myocardial oxygen consumption (MVO2) during ischaemia.At all ages, hypoxic hearts had significantly lower peak dP/dt and contractility index (dP/dt/left ventricular pressure (LVP)) than normoxic controls. After ischaemia and reperfusion, one week hypoxic hearts did not differ significantly in recovery from controls. Four week hypoxic hearts had significantly higher stroke volume and aortic flow, and six week hearts had significantly higher coronary flow than age matched controls. Contractility index did not show significant differences between hypoxic and control animals at any age. Hypoxic hearts released less creatine kinase in the coronary effluent during reperfusion than did control hearts of similar age. Six week hypoxic hearts had significantly higher MVO2 measured during the second administration of cardioplegia compared with six week control hearts but MVO2 did not differ significantly at one and four weeks of age.Despite reduced baseline function, chronically hypoxic immature rabbit hearts can recover from an ischaemic insult as well as age matched controls, with less evidence of myocardial necrosis. This parallels clinical findings in cyanotic infants.
Latex allergy in fruit‐allergic patients
Authors: J. C. García Ortiz, J. C. Moyano, M Alvarez, J. Bellido
Journal: Allergy (1998)

The purpose of this study was to investigate the prevalence of latex allergy in fruit-allergic patients, and to assess its clinical significance. Fifty-seven fruit-allergic patients and 50 non-fruit-allergic atopic patient controls were studied. All patients were questioned about conventional immediate symptoms after contact with latex products. Patients also underwent skin prick testing and determination of specific serum IgE to latex, as well as a screening test for environmental allergens. Immunologic latex sensitization occurred in 49/57 (85.9%) fruit-allergic patients, who showed a positive STP and/or CAP to latex, but in only two controls (P < 0.001). Six out of 57 (10.5%) fruit-allergic patients suffered from clinically relevant latex allergy. Symptoms included contact urticaria, angioedema, conjunctivitis, generalized urticaria, and moderate anaphylactic reactions. No control reported symptoms with latex products (P = 0.052). In all patients, clinical symptoms to fruits preceded a history of latex allergy. The fruits most associated were melon, peach, and banana. From our data, we conclude that there is a potential for allergic reactions to latex in patients with allergy to fruit. All patients with fruit allergy should be screened for individual risk of latex allergy.
Your career: planning for the unexpected
Authors: R. Smith
Journal: BMJ (2002)

Career Focus p s115 

Are you somebody who plans ahead in life? Do you have an idea of what you might be doing in 10 years' time? The training and work of doctors is increasingly controlled. In Britain, for example, specialist training is defined, general training is being defined, and lifelong appraisal and revalidation are being introduced. Everybody will need to have a personal development plan. Doctors might therefore feel that their working life is being planned for them, but these innovations come at a time when the future is highly uncertain. Will the NHS still exist in 10 years' time? What changes will the new genetics and information technology bring? Will Britain be part of the United States of Europe by 2020? What will it be like …
Lipoprotein(a) and Risk of Myocardial Infarction-Reply
Authors: Elliot S. Barnathan
Journal: JAMA (1994)

<h3>In Reply.</h3> —Although it would have been helpful to know the age range of the nested study group, the age range of the population it was drawn from was reported (40 to 84 years), indicating that conclusions drawn should not apply to those less than 40 years of age. The lack of data on men less than 40 years of age prompted me to restrict my comments to men older than 40 years when I suggested that we not use routine screening of Lp(a) levels in this type of population (ie, white American men older than 40 years). I did not make any recommendation with regard to healthy men (or women) less than 40 years of age because of the lack of large, well-designed prospective studies in these population groups. In the study by Ridker et al,<sup>1</sup>analyses stratified by age did not reveal a significant predictive utility of
Evaluation of sulphasalazine in the treatment of spondyloarthropathies.
Authors: M Dougados, A Maetzel, M Mijiyawa, B Amor
Journal: Annals of the Rheumatic Diseases (1992)

Sulphasalazine has been shown to have an effect in patients with spondyloarthropathies, but the clinical indication for its use is controversial and its long term effect has not yet been evaluated. Treatment with sulphasalazine was analysed retrospectively in a group of 372 patients with a wide range of spondyloarthropathies to determine subsets of patients showing differential effects of the drug. One hundred and one patients received sulphasalazine at a mean daily dose of 2 g (ankylosing spondylitis, 54 patients; psoriatic arthritis, 21 patients; reactive arthritis, four patients; arthritis related to inflammatory bowel disease, six patients; undifferentiated spondyloarthropathy, 16 patients). A comparison between treated and untreated patients suggests that only patients with active and severe disease were treated whatever the precise diagnosis or the amount of axial disease in the spondyloarthropathy. After six months of treatment improvement was noted in 59 patients unrelated to their subgroup or amount of axial disease. After a mean follow up of 20 months, 37 patients were still receiving treatment, 33 had discontinued the drug because of inefficacy, 14 because of side effects, six because of remission of the disease, and 11 for other reasons. Comparison between the beginning and end of treatment showed a statistically significant decrease in morning stiffness, erythrocyte sedimentation rate, and daily dose of non-steroidal anti-inflammatory drugs (NSAIDs). It is concluded that: (a) a low percentage of patients with spondyloarthropathy have active disease requiring treatment with sulphasalazine despite the use of NSAIDs (27% in this study); (b) in this subgroup of patients sulphasalazine seems to be of clinically relevant benefit in 59%; and (c) this benefit does not seem to be correlated with either the precise diagnosis of spondyloarthropathy or the amount of axial disease.
Lies, damned lies, and science
Authors: P. Wilmshurst
Journal: BMJ (1995)

The makers of this Horizon documentary propose that a significant amount of scientific fraud occurs in Britain and that we need mechanisms similar to those in other developed countries to detect fraud and prosecute the guilty. The “British scientific establishment” maintains that this is unnecessary. Credited with speaking on behalf of the establishment, or at least the Royal Society, Professor Peter Lachmann correctly stated that in Britain the number of reported cases of fraud, compared with the total amount of science done, is extemely low. Has editing misrepresented him? Certainly he seems to suggest that the low rate of reported cases of fraud in Britain is because of the greater integrity of British scientists. Others provided the more credible explanation.

Michael Baum, professor of surgery at the Royal Marsden Hospital, London, admitted that he had become aware of scientific fraud in his department but failed to report it. Clearly it is difficult to choose between exposing a colleague and discrediting the department on the one hand, and allowing dishonest science to stand uncorrected, potentially harming the public, …
Pharmacological Action of Antihistamine Compounds
Authors: J. H. Burn
Journal: BMJ (1950)

We owe the development of a specialized group of com- pounds known as " antihistamine compounds " to the Swiss pharmacologist Daniel Bovet, who worked in the Institut Pasteur in Paris.Although he recorded preliminary obser- vations in 1937, his first full paper was published in 1944 (Bovet, 1944).There are three highly active substances present in the body-adrenaline, acetylcholine, and histamine-and antagonists to the first two of these have long been known.Some of the ergot alkaloids and syn- thetic compounds such as "priscol" are anti-adrenaline compounds, while atropine and synthetic compounds like "trasentin " are anti-acetylcholine compounds.Bovet's contribution was to devise tests by which antihistamine compounds could be recognized, and to foresee that the more highly active substances would have a clinical appli- cation in allergic states like hay-fever and urticaria.The pharmacological work which has been carried out on antihistamine compounds in the last few years has shown that these are not highly specialized substances with unusual properties as has been commonly believed, but that they share properties with well-known drugs like atropine, procaine, quinidine, and pethidine, and that these sub- stances in their turn can exert an antihistamine action.I propose to describe briefly how this work has developed and its practical consequences, and to suggest the basis which underlies the results.In 1945 Dr. G. S. Dawes was working in my laboratory to find substitutes for quinidine, and made the important observation that several substances having a quinidine action on cardiac muscle were also local anaesthetics (Dawes, 1946).Thus cocaine, procaine, and amethocaine were among these substances.This observation recalled the fact that quinine and quinidine are both local anaes- thetics, and thus it appeared there was a close relation between power to prolong the refractory period of cardiac muscle and local anaesthetic action.This was not all.Dawes then observed that various substances used as spasmolytics to relax smooth muscle, such as atropine, papaverine, trasentin, and "syntropan," also had a quinidine-like action on the heart.All these substances were also known to have local anaesthetic action.Finally, he examined the analgesic substance pethidine, and found that it exerted a quinidine-like action on the heart and possessed a local anaesthetic action.Thus Dawes's work suggested that the power of lengthening the refractory period, local anaesthetic action, spasmolytic action, and analgesic action were related to one another in many compounds.
Re: Athanassios Oeconomou, Helmut Madersbacher, Gustav Kiss, Thomas J. Berger, Michael Melekos and Peter Rehder. Is Botulinum Neurotoxin Type A (BoNT-A) a Novel Therapy for Lower Urinary Tract Symptoms Due to Benign Prostatic Enlargement? A Review of the Literature. Eur Urol 2008;54:765–77
Authors: Giuseppe Brisinda, Serafino Vanella, Giorgio Maria
Journal: European Urology (2009)
In vitro fertilisation for all?: Central planning is required
Authors: G. M Lockwood
Journal: BMJ (2003)

Editor—Ashcroft confuses two issues.1 Local health care provision should reflect the overall profile of the health needs of the local population. However, this fact does not justify a local political process deciding whether childless women with a fertility problem should be given free cycles of in vitro fertilisation treatment.

Suppose that the bulk of the population of a local region is retired. The priorities might then be hip replacements and cataract surgery. Nevertheless, a significant number of couples might have fertility problems that could be treated by in vitro fertilisation. In this case, it would surely be appropriate for those couples to be treated in another region for no more than the costs of travel.

Facilitation of such a process demands exactly the kind of central planning that Ashcroft opposes.
Dermatological Signs of Internal Disease
Authors: E. Dorinda Shelley
Journal: JAMA (1989)

Too often the skin is viewed as a freefloating organ, detached from the rest of the body and capable of causing a variety of vexing problems understood only by a higher being and a handful of dermatologists. This book attempts to sort out and organize some of the perplexing cutaneous signs that should signal internal disease to the trained medical eye. It also attempts to bridge the gap between dermatology and those other specialties that often encounter a wide variety of cutaneous problems, particularly internal medicine, pediatrics, and family practice. The text has been written by six dermatologists of the younger generation, with each author contributing five to ten chapters of varying complexity. They represent academic departments in different regions of the country, including two chairmen, and bring a wide range of expertise and opinion to the book. They have written clearly and succinctly with a uniform style that makes
Feeding Tube Placement in the Debilitated Patient
Authors: Lawrence R. Kaplan
Journal: JAMA (1976)

To the Editor.—  Nutritional care of the postoperative or critically ill patient has received increased attention in current medical literature. Although the technology of total parenteral hyperalimentation has burgeoned, continuous enteral alimentation through a pediatric feeding tube is often the preferred therapeutic route.  Passage of a No. 8 French nasogastric feeding tube in a cooperative patient with an intact swallowing reflex is not a difficult procedure. However, frequently a patient is either unwilling or unable to swallow, and the thin, flexible tube is found curled in the hypopharynx.  When routine placement of a pediatric feeding tube fails, we use an alternative method that is simple, rapid, and requires minimal patient cooperation. The technique involves the use of a flexible-channel biopsy forceps from a fiberoptic endoscope. The feeding tube is first advanced through the patient's nose and brought out through the mouth. The distal end of the tube is then grasped
Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management
Authors: S. Vincent Rajkumar
Journal: American Journal of Hematology (2013)

Multiple myeloma accounts for approximately 10% of hematologic malignancies.The diagnosis requires 10% or more clonal plasma cells on bone marrow examination or a biopsy proven plasmacytoma plus evidence of associated end-organ damage. In addition, the presence of 60% or more clonal plasma cells in the marrow is also considered as myeloma regardless of the presence or absence of end-organ damage.In the absence of concurrent trisomies, patients with 17p deletion, t(14;16), and t(14;20) are considered to have high-risk myeloma. Patients with t(4;14) translocation are considered intermediate-risk. All others are considered as standard-risk. RISK-ADAPTED INITIAL THERAPY: Standard-risk patients can be treated with lenalidomide plus low-dose dexamethasone (Rd), or a bortezomib-containing triplet such as bortezomib, cyclophosphamide, dexamethasone (VCD). Intermediate-risk and high-risk patients require a bortezomib-based triplet regimen. In eligible patients, initial therapy is given for approximately 4 months followed by autologous stem cell transplantation (ASCT). Standard-risk patients can opt for delayed ASCT if stem cells can be cryopreserved. In patients are not candidates for transplant, initial therapy is given for approximately 12-18 months.After initial therapy, lenalidomide maintenance is considered for standard-risk patients who are not in very good partial response or better, while maintenance with a bortezomib-based regimen should be considered in pateints with intermediate or high-risk myeloma.Patients with indolent relapse can be treated first with two-drug or three-drug combinations. Patients with more aggressive relapse often require therapy with a combination of multiple active agents.
Inhibition of human gall bladder mucus synthesis in patients undergoing cholecystectomy.
Authors: M Rhodes, A Allen, R H Dowling, G Murphy, T W Lennard
Journal: Gut (1992)

Hypersection of gall bladder mucus is associated with gall stone formation in animal models. Aspirin inhibits both mucus synthesis and secretion, prevents gall stone formation in animals and reduces gall stone recurrence in man after dissolution therapy. Mucus biosynthesis in human gall bladder mucosal explants is inhibited by aspirin in vitro. We have studied the effects of aspirin in vivo. Fifty five patients with functioning gall bladder and stones have been randomised, 27 to group 1 (aspirin EC 300 mg once daily for seven days before cholecystectomy) and 28 to group 2 (controls). Gall bladder bile composition was analysed and mucus synthesis rates measured using 3H-glucosamine incorporation into mucosal explants cultured for 24 hours. Patient age, sex, and gall bladder histology were similar in both groups. There were no differences in stone composition, gall bladder bile calcium concentration, cholesterol saturation and cholesterol nucleation time. The mean 3H-glucosamine incorporation in aspirin treated patients was 1347 fmol/g wet weight as compared with 2008 fmol/g wet weight in controls (95% confidence interval 222-1100, p&lt;0.005, unpaired t test). This reduction in biosynthesis was associated with gall bladder bile mucus concentrations of 7.6 mg/ml in patients and 7.1 mg/ml in controls (ns). Treatment with aspirin led to a significant reduction in mucus biosynthesis by the gall bladder mucosa. This action is consistent with a role for aspirin in the prevention of gall stones.
Carbonic Anhydrase II Deficiency in 12 Families with the Autosomal Recessive Syndrome of Osteopetrosis with Renal Tubular Acidosis and Cerebral Calcification
Authors: William S. Sly, Michael P. Whyte, Vasantha Sundaram, Richard E. Tashian, David Hewett-Emmett, Pierre Guibaud, Marc Vainsel, H. Jorge Baluarte, Alan Gruskin, M. Al-Mosawi, Nadia Sakati, Arne Ohlsson
Journal: New England Journal of Medicine (1985)

Osteopetrosis with renal tubular acidosis and cerebral calcification was identified as a recessively inherited syndrome in 1972. In 1983, we reported a deficiency of carbonic anhydrase II, one of the isozymes of carbonic anhydrase, in three sisters with this disorder. We now describe our study of 18 similarly affected patients with this syndrome in 11 unrelated families of different geographic and ethnic origins. Virtual absence of the carbonic anhydrase II peak on high-performance liquid chromatography, of the esterase and carbon dioxide hydratase activities of carbonic anhydrase II, and of immunoprecipitable isozyme II was demonstrated on extracts of erythrocyte hemolysates from all patients studied. Reduced levels of isozyme II were found in obligate heterozygotes. These observations demonstrate the generality of the findings that we reported earlier in one family and provide further evidence that a deficiency of carbonic anhydrase II is the enzymatic basis for the autosomal recessive syndrome of osteopetrosis with renal tubular acidosis and cerebral calcification. We also summarize the clinical findings in these families, propose mechanisms by which a deficiency of carbonic anhydrase II could produce this metabolic disorder of bone, kidney, and brain, and discuss the clinical evidence for genetic heterogeneity in patients from different kindreds with this inborn error of metabolism. (N Engl J Med 1985; 313:139–45.)
Staphylococci-induced Human Platelet Injury Mediated by Protein A and Immunoglobulin G Fc Fragment Receptor
Authors: Jack Hawiger, Sylvia Steckley, Dianne Hammond, Charles Cheng, Sheila Timmons, Alan D. Glick, Roger M. Des Prez
Journal: Journal of Clinical Investigation (1979)

Bloodstream infections with staphylococci are accompanied by thromboembolic complications. We have studied the mechanism of the interaction of staphylococci with human blood platelets.
EVOLUTIONAL AND INVOLUTIONAL TYPES OF MENTAL AND NERVOUS DISEASE.
Authors: EDWARD E. MAYER
Journal: JAMA (1901)

The different epochs of life are factors of great moment both in the production and in the exacerbation of nervous instability. They are rarely passed through, even in the most healthy individual, without some psychical or physical manifestation. Each crisis in life determines new impulses, new thought, and new actions, which give each epoch a distinct physiology and psychology. We purpose to discuss in this paper the effect these periods have upon the brain and nervous constitution, considering chiefly the minor and transient disorders influenced or excited by them, and to attempt to explain the preventive measures necessary and advisable, possible and ideal, which may determine their development. The territory that we especially wish to cover shades insensibly into the two extremes, mental soundness and mental disease. This borderland is especially important on acount of the fact that the psychoses as a rule gradually pass through a prodromic stage of