tbuckley/cabot-search huggingface dataset:
Departing from guidelines in patients' best interest is defensible, says negligence expert
Authors: Z. Kmietowicz
Journal: BMJ (2015)

Medical negligence experts have joined the debate on prescribing oseltamivir (Tamiflu) to prevent flu in elderly people in nursing homes, advising doctors that they can depart from guidelines when it is in their patients’ best interests to do so.

Caroline Fryar, head of advisory services at the Medical Defence Union, said that guidelines informed clinical practice but did not dictate it. She said, “Doctors are expected to be familiar with any nationally recognised guidelines that are relevant to their specialty, as well as any local guidelines. This does not mean they cannot depart from guidance in specific situations when they consider it to be in the patient’s interests to do so.”

Fryar was responding on thebmj.com to an article by Margaret McCartney, a Glasgow GP who had …
Final Results of the Can Routine Ultrasound Influence Stent Expansion (CRUISE) Study
Authors: Peter J. Fitzgerald, Akio Oshima, Motoya Hayase, Jonas A. Metz, Steven R. Bailey, Donald S. Baim, Michael W. Cleman, Ezra Deutsch, Daniel J. Diver, Martin B. Leon, Jeffrey W. Moses, Stephen N. Oesterle, Paul A. Overlie, Carl J. Pepine, Robert D. Safian, Jacob Shani, Charles A. Simonton, Richard W. Smalling, Paul S. Teirstein, James P. Zidar, Alan C. Yeung, Richard E. Kuntz, Paul G. Yock, for the CRUISE Investigators
Journal: Circulation (2000)

Intravascular ultrasound (IVUS) can assess stent geometry more accurately than angiography. Several studies have demonstrated that the degree of stent expansion as measured by IVUS directly correlated to clinical outcome. However, it is unclear if routine ultrasound guidance of stent implantation improves clinical outcome as compared with angiographic guidance alone.The CRUISE (Can Routine Ultrasound Influence Stent Expansion) study, a multicenter study IVUS substudy of the Stent Anti-thrombotic Regimen Study, was designed to assess the impact of IVUS on stent deployment in the high-pressure era. Nine centers were prospectively assigned to stent deployment with the use of ultrasound guidance and 7 centers to angiographic guidance alone with documentary (blinded) IVUS at the conclusion of the procedure. A total of 525 patients were enrolled with completed quantitative coronary angiography, quantitative coronary ultrasound, and clinical events adjudicated at 9 months for 499 patients. The IVUS-guided group had a larger minimal lumen diameter (2.9+/-0.4 versus 2.7+/-0. 5 mm, P<0.001) by quantitative coronary angiography and a larger minimal stent area (7.78+/-1.72 versus 7.06+/-2.13 mm(2), P<0.001) by quantitative coronary ultrasound. Target vessel revascularization, defined as clinically driven repeat interventional or surgical therapy of the index vessel at 9 month-follow-up, occurred significantly less frequently in the IVUS-guided group (8.5% versus 15.3%, P<0.05; relative reduction of 44%).These data suggest that ultrasound guidance of stent implantation may result in more effective stent expansion compared with angiographic guidance alone.
Expression of the chemokines MCP-1/CCL2 and RANTES/CCL5 is differentially regulated by infiltrating inflammatory cells
Authors: Uwe Haberstroh, Johanna Pocock, Carmen Gómez-Guerrero, Udo Helmchen, Alf Hamann, Jose C. Gutierrez-Ramos, Rolf A.K. Stahl, Friedrich Thaiss
Journal: Kidney International (2002)
Noncoronary Factors in the Anginal Syndrome
Authors: James S. Forrester, Michael V. Herman, Richard Gorlin
Journal: New England Journal of Medicine (1970)

Of 253 consecutive subjects examined prospectively for gallbladder disease, hiatus hernia and cervical-spine disease during hospitalization for coronary angiographic studies, 170 had all three examinations and formed the major subgroup for analysis. There was no significant increase in the prevalence of any of these disorders either in the coronary patients with prandial angina or in those with nocturnal chest pain. Fifty-one subjects exhibiting classic angina pectoris but with normal coronary arteriograms were similarly studied. No differences were found in the prevalence of gallbladder disease, hiatus hernia or cervical-spine disease in this group. The noncardiac factors mentioned showed no consistent association with coronary heart disease, nor did they appear to contribute significantly to the genesis of prandial or nocturnal angina or to the syndrome of angina pectoris with normal coronary arteriograms.
Coronary arterial origin in persistent truncus arteriosus.
Authors: S Shrivastava, J E Edwards
Journal: Circulation (1977)

Specimens of heart from 30 subjects with persistent truncus arteriosus were studied for the nature and sites of coronary arterial origin. These factors were related to the sinuses of the truncus valve. Bicuspid truncal valve was observed in six cases (20%) and tricuspid in 21 cases (70%). Single coronary artery was observed in four cases (three with tricuspid and one with quadricuspid truncal valves). In three other cases the coronary arteries arose separately but near one another. There was a strong tendency for the left coronary artery to arise from a more posterior level than it does normally from the aorta. It was common for the posterior descending artery to arise from the left circumflex artery. This arrangement was noted in eight of 25 cases (32%) with single posterior descending coronary artery. In five other cases, two posterior descending arteries were present, one arising from the left circumflex and the other from the right coronary artery.
American Cutaneous Leishmaniasis
Authors: Bryce C. Walton
Journal: JAMA (1974)

American leishmaniasis, a disease limited to the American tropics and relatively unfamiliar to North American physicians, is seen in the United States with increasing frequency since the advent of air travel. In contrast to a recent report of successful treatment with metronidazole, our experience of failure in five of six cases indicates that this drug is ineffective. Unlike<i>Leishmania tropica</i>, which causes the Old World form of cutaneous leishmaniasis,<i>L braziliensis</i>can persist after disappearance of the primary ulcer and subsequently produce severely mutilating mucosal lesions. Because of this danger, complete eradication of the parasite is extremely important and, in spite of recognized disadvantages, pentavalent antimonial compounds remain the drugs of choice for this infection. (<i>JAMA</i>228:1256-1258, 1974)
SPECT-CT Improves Scintigraphic Accuracy of Osteoid Osteoma Diagnosis
Authors: Karim Farid, Ghada El-Deeb, Nadine Caillat Vigneron
Journal: Clinical Nuclear Medicine (2010)

A 34-year-old woman with a history of chronic foot pain was admitted for bone evaluation. Bone scan revealed focal foot uptake in the early and late images. SPECT images combined with low dose CT revealed uptake at the site of a nidus considered to be osteoid osteoma. CT images are usually used for attenuation correction in SPECT, to improve anatomic localization and for precise morphologic information. This case demonstrated that fusion of the SPECT and CT images was useful to arrive at a rapid diagnosis of osteoid osteoma.
Comparison of albendazole, mebendazole and praziquantel chemotherapy of Echinococcus multilocularis in a gerbil model.
Authors: D H Taylor, D L Morris, D Reffin, K S Richards
Journal: Gut (1989)

The efficacy of albendazole (50 mg/kg/d), mebendazole (50 mg/kg/d) and praziquantel (500 mg/kg/d) against established intraperitoneal infections of Echinococcus multilocularis in gerbils was compared by monitoring parasite weight and making ultrastructural observations on treated and untreated material. Praziquantel was the most active protoscolicidal agent, reducing protoscolex viability to less than 2%, although it did not inhibit cyst growth. Albendazole was the most effective agent in reducing cyst growth and was, when compared with other regimes significantly more effective than mebendazole (p less than 0.05), praziquantel (p less than 0.01) or untreated controls (p less than 0.01).
Two Cases of Suppurating Hydatid of the Liver, Projecting Backward, Drained through the Chest Wall after Resection of Rib
Authors: S. Paget
Journal: BMJ (1895)

If a double ligature will suffice that is probably the best, taking care after dividing the pedicle to put a separate silk ligature on each open mouth.Some of the deaths from hremorrhage have been attributed to a " small " vessel slip- ping from the main pedicle ligature, and the course I suggest will entirely frustrate this danger.At the same time it is very essential to ligature every bleeding point in any adhesions, for everything in this neighbourhood is usually very qrascular.
A comparative study of the pathergy reaction among Turkish and British patients with Behcet's disease.
Authors: H Yazici, M A Chamberlain, Y Tuzun, S Yurdakul, A Muftuoglu
Journal: Annals of the Rheumatic Diseases (1984)

Forty-eight Turkish and 12 British patients along with 24 Turkish and 7 British healthy controls were assessed for the presence of the pathergy phenomenon. A photographic method with 'blind' reading was utilised. The pathergy phenomenon was present only among the Turkish patients.
Beneficial effects of captopril in acute coxsackievirus B3 murine myocarditis.
Authors: S Rezkalla, R A Kloner, G Khatib, R Khatib
Journal: Circulation (1990)

To date, there is no universally accepted therapy for viral myocarditis. We investigated the effect of the angiotensin converting enzyme inhibitor captopril on both early and late phases of coxsackievirus murine myocarditis. Mice were infected with coxsackievirus B3 and were divided into two main protocols. Mice in the early treatment protocol (n = 30) were treated on day 1 after infection with either captopril or saline through day 6 of infection and euthanized on day 6 of infection. In the late treatment protocol, mice (n = 60) were treated starting on day 10 of infection through day 30 of infection with either captopril or saline. Mice were killed on days 20 and 30 of infection. In the early treatment protocol, heart weight was 67 +/- 14 mg in the captopril-treated group versus 98 +/- 17 mg in the control group (p less than 0.0001). The degree of inflammation, necrosis, and dystrophic calcification assessed with a semiquantitative histological score was significantly less in the captopril-treated group. The degree of pathological involvement determined by planimetry of histological sections was 8.1 +/- 7.2% for the captopril-treated group versus 22.5 +/- 10.0% for the saline-treated group (p less than 0.0001). In the late treatment protocol, captopril also caused a reduction in heart weight as compared with controls at day 20 (116 +/- 21 mg in captopril-treated group vs. 166 +/- 34 mg in controls, p less than 0.0001) and also at day 30 (136 +/- 23 mg in captopril-treated group vs. 185 +/- 48 mg in controls, p less than 0.004). On days 20 and 30 of infection, the degree of inflammation, necrosis, and dystrophic calcification was similar in both groups. We conclude that captopril is beneficial in acute coxsackievirus B3 murine myocarditis because it reduces heart weight and necrosis when administered early and reduces heart weight when administered in a delayed manner.
Effect of splenic congestion associated with hemolytic anemia on mortality of rats challenged with haemophilus influenzae b
Authors: L. T. Chen, E. R. Moxon
Journal: American Journal of Hematology (1983)

Abstract The effect of splenic congestion associated with acute hemolytic anemia on susceptibility to bacterial infection was investigated in rats inoculated with Haemophilus influenzae b by intranasal (in) or intravenous (iv) challenge. The rats were made anemic by phenylhydrazine treatment and were challenged with 10 6 (in) or 5 × 10 7 (iv) H influenzae b. Forty‐eight hours after in inoculation of bacteria, the number of bacteria in the blood was 10 times greater in the anemic rats with extensive splenic congestion than in controls. After iv inoculation of bacteria, a significantly (P &lt; 0.001) higher mortality rate was found in the anemic rats with extensive splenic congestion and fewer bacteria were present in the spleens but not the livers, as compared to normal rats. Since phenylhydrazine‐induced hemolytic anemia exhibited an extensive congestion in the spleen, higher mortality rate observed in the anemic rats challenged with H influenzae b may result, in part, from decreased intravascular clearance of bacteria by the spleen.
Biologics for tendon repair
Authors: Denitsa Docheva, Sebastian A. Müller, Martin Majewski, Christopher H. Evans
Journal: Advanced Drug Delivery Reviews (2014)

Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately, our understanding of tendon biology lags far behind that of other musculoskeletal tissues, thus impeding the development of new treatment options for tendon conditions. Hence, in this review, after introducing the clinical significance of tendon diseases and the present understanding of tendon biology, we describe and critically assess the current strategies for enhancing tendon repair by biological means. These consist mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage. A deeper understanding of how tendon tissue and cells operate, combined with practical applications of modern molecular and cellular tools could provide the long awaited breakthrough in designing effective tendon-specific therapeutics and overall improvement of tendon disease management.
Intraepithelial lymphocytes of human gut: isolation, characterisation and study of natural killer activity.
Authors: N Cerf-Bensussan, D Guy-Grand, C Griscelli
Journal: Gut (1985)

A method using a mechanical procedure for isolation of lymphocytes from the epithelium of human intestinal mucosa allows the study of some of their characteristics and functions. Most of the isolated cells are of the T lineage (E+ and T3+) and express the phenotype associated with cytotoxic-suppressor T cells (T8). A large number contain intracytoplasmic granules. Granules are stained with alcian blue (pH 2.2), are metachromatic with Toluidine blue (pH 4) and some are shown to incorporate 35sulphate, suggesting that they contain sulphated mucopolysaccharides. As these cells are similar in many respects to the large granular lymphocytes that mediate natural killer activity in the peripheral blood, their natural cytotoxicity was tested against K 562 target cells. No activity was detected among the human intraepithelial lymphocytes and treatments with known potentiators of natural killer activity, ie, interferon or PHA-depleted conditioned medium containing Il-2, failed to reveal any cytotoxic activity.
Oral vanadyl sulfate improves hepatic and peripheral insulin sensitivity in patients with non-insulin-dependent diabetes mellitus.
Authors: N Cohen, M Halberstam, P Shlimovich, C J Chang, H Shamoon, L Rossetti
Journal: Journal of Clinical Investigation (1995)

We examined the in vivo metabolic effects of vanadyl sulfate (VS) in non-insulin-dependent diabetes mellitus (NIDDM). Six NIDDM subjects treated with diet and/or sulfonylureas were examined at the end of three consecutive periods: placebo for 2 wk, VS (100 mg/d) for 3 wk, and placebo for 2 wk. Euglycemic hyperinsulinemic (30 mU/m2.min) clamps and oral glucose tolerance tests were performed at the end of each study period. Glycemic control at baseline was poor (fasting plasma glucose 210 +/- 19 mg/dl; HbA1c 9.6 +/- 0.6%) and improved after treatment (181 +/- 14 mg/dl [P < 0.05], 8.8 +/- 0.6%, [P < 0.002]); fasting and post-glucose tolerance test plasma insulin concentrations were unchanged. After VS, the glucose infusion rate during the clamp was increased (by approximately 88%, from 1.80 to 3.38 mg/kg.min, P < 0.0001). This improvement was due to both enhanced insulin-mediated stimulation of glucose uptake (rate of glucose disposal [Rd], +0.89 mg/kg.min) and increased inhibition of HGP (-0.74 mg/kg.min) (P < 0.0001 for both). Increased insulin-stimulated glycogen synthesis (+0.74 mg/kg.min, P < 0.0003) accounted for > 80% of the increased Rd after VS, and the improvement in insulin sensitivity was maintained after the second placebo period. The Km of skeletal muscle glycogen synthase was lowered by approximately 30% after VS treatment (P < 0.05). These results indicate that 3 wk of treatment with VS improves hepatic and peripheral insulin sensitivity in insulin-resistant NIDDM humans. These effects were sustained for up to 2 wk after discontinuation of VS.
A SIMPLE APPARATUS FOR ACCURATELY FIXING BLOOD-SLIDES BY HEAT
Authors: GEORGE B. LAWSON
Journal: JAMA (1910)

Three days later I was called again.The abdominal pains had grown worse, especially on the lower left side, and radiated down the left thigh.She had frequent soft stools and the rumbling of gas was marked.Temperature was 100 F.; pulse, 124.Peristaltic waves could be seen over the lower left abdomen, where there was also tenderness and more resistance than on the right side.The hernia] mass was a little larger, was tender, and was no longer reducible.Operation was now most urgently advised, but absolutely refused.During the day, the temperature rose to 102.0 F. and an indistinct mass could he felt in the lower left quadrant of the abdomen.On the evening of the next day, the bowels moved, but with much difficulty and straining.There was considerable resistance in
Side-effects of indomethacin.
Authors: P L Boardman, F D Hart
Journal: Annals of the Rheumatic Diseases (1967)

This paper reports side-effects on indomethacin in patients with rheumatic disorders, with particular reference to factors which may affect their frequency and severity.Side-effects occur in three major groups; referable to the central nervous system, the gastrointestinal system, and the skin.Percy, Stephenson, and Thompson (1964) emphasized the psychic side- effects, including depression and hallucinations; epilepsy and coma have occurred (Thompson and Percy, 1966), and Robinson (1965) reported narco- lepsy and suicide.Rashes related to the administration of indomethacin include urticaria and purpura.Activation of latent infection was reported by Solomon (1966).In contrast, Robinson, Fitzpatrick, and Graessle (1965) reported increased resistance of mice and rats to bacterial infection when treated with indomethacin.
Physical Medicine and Rehabilitation
Authors: Arthur L. Watkins
Journal: New England Journal of Medicine (1956)

TO those interested in the field of physical medicine and rehabilitation the major sources of publications in this country are the Archives of Physical Medicine and Rehabilitation, the American Journal of Physical Medicine and the Physical Therapy Review. In addition, of course, articles appear in the various specialty journals, all of which are now interested in rehabilitation and present papers of interest to specialists in physical medicine (physiatrists) as well as specialists in their own fields. The present review of literature in recent years is devoted to selections of certain articles found in these journals and also those . . .
THE RELATION BETWEEN ANTIANAPHYLAXIS AND ANTIBODY BALANCE
Authors: Marion C. Morris
Journal: The Journal of Experimental Medicine (1936)

1. Sensitized guinea pigs injected with normal rabbit or guinea pig serum previous to intravenous inoculation of antigen may be protected against a few lethal doses of antigen. The protection is greater with foreign than with homologous serum and appears to be related roughly to the amount of serum introduced. 2. Sensitized guinea pigs injected with antibody-containing serum preliminary to intravenous injection of antigen, show no greater refractoriness to anaphylaxis than do those injected with normal serum. 3. Moreover, in many instances, the injection of an excess of antibody into the circulation of sensitized guinea pigs, leads to an increased susceptibility of these animals to anaphylaxis. 4. These results indicate that an excess of circulating antibody is not responsible for a state of antianaphylaxis, but on the contrary, may contribute toward the anaphylactic reaction itself.
The Risk of Hip Fractures in Older Individuals With Diabetes
Authors: Lorraine L. Lipscombe, Sophie A. Jamal, Gillian L. Booth, Gillian A. Hawker
Journal: Diabetes Care (2007)

Compared with men and women without diabetes, individuals with type 2 diabetes have higher bone mineral density (BMD). However, they may still be at increased risk for hip fractures. Using population-based Ontario health care data, we compared the risk of hip fractures among men and women with and without diabetes.Using a retrospective cohort design, we identified Ontario residents aged > or =66 years with diabetes from a validated registry from 1994 to 1995 (n = 197,412) and followed them for their first hip fracture until 31 March 2003 (mean 6.1-year follow-up). Hip fracture rates were compared with those of age-matched Ontario residents without diabetes (n = 401,400), and results were stratified by sex and adjusted for age and other covariates.Compared with individuals without diabetes, individuals with diabetes had greater comorbidity, were less likely to have had a BMD test, and were more likely to be taking medications that increase risk of falling and decrease BMD. After adjusting for these differences and age, we found that diabetes increased fracture risk in both men (hazard ratio 1.18 [95% CI 1.12-1.24], P < 0.0001) and women (1.11 [1.08-1.15], P < 0.0001).Men and women with diabetes have a higher risk of hip fractures compared with individuals without diabetes. Further research to elucidate the mechanisms underlying this increased risk of fracture is needed, as well as increased attention to fracture prevention strategies in patients with diabetes.
Combination of extracorporeal shock-wave lithotripsy and dissolution of gallbladder stones with methyl tert-butyl ether: A randomized study
Authors: Michael Neubrand, Joseph Holl, Michael Sackmann, Ulrich Klüppelberg, Jürgen Pauletzki, Gustav Paumgartner, Tilman Sauerbruch
Journal: Hepatology (1994)

We conducted a prospective randomized study in gallstone patients to determine whether a combination of extracorporeal shock-wave lithotripsy and subsequent dissolution with methyl tert-butyl ether increases the success rate of methyl tert-butyl ether dissolution and shortens treatment time compared with monotherapy with methyl tert-butyl ether. Fifty patients were randomized into two groups. Twenty-five patients underwent extracorporeal shock-wave lithotripsy before contact dissolution with methyl tert-butyl ether, and 25 patients were treated with methyl tert-butyl ether alone. All patients had at least three stones or stones larger than 30 mm that were radiolucent on x-ray and had densities of less than 140 Hounsfield Units (HU) on computed tomography. Overall, the combined approach neither shortened the treatment time significantly vs. monotherapy with methyl tert-butyl ether nor reduced the time of hospitalization. The success rate was slightly but not significantly increased compared with that of methyl tert-butyl ether therapy alone. The recurrence rate was similar in the two groups after a median follow-up of 1 yr. However, when subgroups of patients with at least one stone larger than 15 mm or with stones with densities of more than 60 HU were analyzed, the clearance rate after 5 mo was significantly higher (p < 0.005 and p < 0.025, respectively) in patients subjected to a combination of extracorporeal shock-wave lithotripsy and methyl tert-butyl ether dissolution. Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether did not expose patients to more adverse effects than did treatment with methyl tert-butyl ether alone.