tbuckley/cabot-search huggingface dataset:
A case of self-diagnosis.
Authors: E O'Brien
Journal: BMJ (1977)

Stately, plump Buck Mulligan came from the stairhead, bearing a bowl of lather on which a mirror and a razor lay crossed. A yellow dressing-gown, ungirdled, was sustained gently behind him by the mild morning air. . . . Solemnly he came forward and mounted the round gunrest. He faced about and blessed gravely thrice the tower, the surrounding country and the awaking mountains. Ulysses. James Joycc.
Clinical features and outcomes of delayed perforation after endoscopic submucosal dissection for early gastric cancer
Authors: N. Hanaoka, N. Uedo, R. Ishihara, K. Higashino, Y. Takeuchi, T. Inoue, R. Chatani, M. Hanafusa, Y. Tsujii, H. Kanzaki, N. Kawada, H. Iishi, M. Tatsuta, Y. Tomita, I. Miyashiro, M. Yano
Journal: Endoscopy (2010)

Perforation is a major complication of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). However, there have been no reports on delayed perforation after ESD for EGC. We aimed to elucidate the incidence and outcomes of delayed perforation after ESD. Clinical courses in 1159 consecutive patients with 1329 EGCs who underwent ESD were investigated. Delayed perforation occurred in six patients (0.45 %). All these patients had complete en bloc resection without intraoperative perforation during ESD. Five of six perforations were located in the upper third of the stomach, while one lesion was found in the middle third. Symptoms of peritoneal irritation with rebound tenderness presented within 24 h after ESD in all cases. One patient did not require surgery because the symptoms were localized, and recovered with conservative antibiotic therapy by nasogastric tube placement. The remaining five patients required emergency surgery. There was no mortality in this case series.
THE EPIDEMICS OF INFLUENZA OF 1890 AND 1891 IN CHICAGO.Read at the Congress of American Physicians and Surgeons before the American Climatological Association, Washington, D. C., September, 1891.
Authors: E. FLETCHER INGALS
Journal: JAMA (1891)

The epidemics occurring in Chicago the last winter and the preceding year differed from each other considerably in their effects upon the respiratory and digestive organs and the nervous system. In 1890 the disease made its appearance about the first of January, but in 1891 not until nearly the first of March. Persons of every class, all ages and either sex were attacked, but, as indicated by the observation of Dr. J. Suydam Knox, children suffered from it much less than adults; however, Dr. Charles Warrington Earle saw many cases in children whom he thought experienced the same symptoms as adults. From my own observation, it appears that children were much less frequently affected than those of more advanced years. The exact period at which the influenza first showed itself cannot be determined. Four or five weeks preceding the actual beginning of the epidemic, many patients suffered from acute rhinitis
Clinical Characteristics and Course of 63 Patients with BRAF Mutant Lung Cancers
Authors: Anya M. Litvak, Paul K. Paik, Kaitlin M. Woo, Camelia S. Sima, Matthew D. Hellmann, Maria E. Arcila, Marc Ladanyi, Charles M. Rudin, Mark G. Kris, Gregory J. Riely
Journal: Journal of Thoracic Oncology (2014)
Preparing a Jehovah's Witness for major elective surgery
Authors: L. Cooper, K. Ford, E. Miller
Journal: BMJ (2013)

A 75 year old woman who was scheduled to undergo elective right sided mastectomy and axillary node clearance was seen in the preoperative assessment clinic. She had been diagnosed as having a grade 3 invasive ductal carcinoma (human epidermal growth factor receptor 2 (HER 2) positive and oestrogen receptor (ER) positive). A course of neoadjuvant chemotherapy had been completed two months earlier. 

Because she was a Jehovah’s Witness, her advanced directive stated that she would not accept blood products. Her medical history included mitral regurgitation, diverticulitis, and autoimmune hypothyroidism for which she took levothyroxine. After extensive multidisciplinary preoperative planning, she underwent successful surgery without the use of blood products. Her haemoglobin was 90 g/L preoperatively (reference range 115-160 g/L; normocytic anaemia—folate, B12, and ferritin were within normal ranges) 122 g/L on admission, and 109 g/L postoperatively.



### 1 How should this patient be counselled preoperatively?

#### Short answer

In the United Kingdom and United States, the autonomy of competent patients must be respected above other ethical principles (this is not the case in all countries) and an individual management plan agreed and formalised with a legally binding advanced directive. The beliefs and opinions of Jehovah’s Witnesses may differ regarding blood derived products and procedures.

#### Long answer

In the UK and US, the first principle of ethics—autonomy—is placed above all others when agreeing a management plan with a patient. Not all countries share the same values. Although no one would contradict the value of autonomy as a major ethical principle, some countries consider that principles such as beneficence and justice should be included in …
IgE responses to <i>Dermatophagoides pteronyssinus</i> native major allergens Der p 1 and Der p 2 during long‐term specific immunotherapy
Authors: F. Mastrandrea, G. Serio, A. Minardi, G. Coradduzza, N. Rossi, G. Scarcia, G. Maietta, A. Iacobelli, C. Lamanna, A. Tursi
Journal: Allergy (1997)

We investigated by ELISA the IgE response to whole extract of the house‐dust mite Dermatophagoides pteronyssinus (Dp) and to the native major allergens, Der p 1 and Der p 2, in sera from 18 adult patients (group A) with Dp‐allergic asthma before ( t 0 ) and 1, 2, 3, and 4 ( t 1 – t 4 ) years after subcutaneous specific immunotherapy (SIT). A qualitative reduction ( P =0.05) of the IgE responses to Dp and Der p 2 was observed from t 1 to t 4 , but a highly statistical significant decrease appeared at t 3 , ( P &lt; 0.01). With regard to Der p 1 IgE values, the immunotherapy induced a significant decrease ( P &lt; 0.01) at t 3 , but not before. In group A, the IgE responses to Der p 1 and Der p 2 were not correlated at t 0 ( r s =0.31; P = 0.2l) but were correlated at t 3 ( r s = 0.78; P=0.001). We also examined sera from 14 adult patients (group B, same SIT schedule as group A) who were without respiratory symptoms at the end of the third year (t 3 ) of Dp SIT. At this time ( t 3 ), there were no significant differences in Der p 1 and Der p 2 IgE levels between group A and group B.
Effects of Massive Transfusion of Blood on Acid-Base Balance
Authors: Ronald D. Miller
Journal: JAMA (1971)

No correlation was observed between the amount of stored acid-citrate-dextrose blood administered and magnitude of negative base excess measured in 20 patients, some in shock and some not. Extreme variability in acid-base response to multiple blood transfusion would appear to make routine bicarbonate administration unadvisable. Four of five patients receiving greater than 100 mEq of sodium bicarbonate intraoperatively had postoperative arterial pH of greater than 7.48. Only two of 11 patients who received less than 100 mEq of sodium bicarbonate intraoperatively had postoperative arterial pH values greater than 7.48. Because of an undesirable shift of the oxygen dissociation curve to the left with an alkaline pH, it is suggested that bicarbonate therapy should be reserved for patients with severe metabolic acidosis (base excess, —7 mEq/liter or more) which can be established only by analysis of arterial blood for arterial carbon dioxide tension and pH.
Thirty-Year Incidence of Infective Endocarditis After Surgery for Congenital Heart Defect
Authors: Cynthia D. Morris
Journal: JAMA (1998)

Context.—The incidence of infective endocarditis after surgical repair of congenital heart defects is unknown.Objective.—To determine the long-term incidence of endocarditis after repair of any of 12 congenital heart defects in childhood.Design.—Population-based registry started in 1982.Setting.—State of Oregon.Participants.—All Oregon residents who underwent surgical repair for 1 of 12 major congenital defects at the age of 18 years or younger from 1958 to the present.Main Outcome Measure.—Diagnosis of infective endocarditis confirmed by hospital or autopsy records.Results.—Follow-up data were obtained from 88% of this cohort of 3860 individuals through 1993. At 25 years after surgery, the cumulative incidence of infective endocarditis was 1.3% for tetralogy of Fallot, 2.7% for isolated ventricular septal defect, 3.5% for coarctation of the aorta, 13.3% for valvular aortic stenosis, and 2.8% for primum atrial septal defect. In the cohorts with shorter follow-up, at 20 years after surgery the cumulative incidence was 4.0% for dextrotransposition of the great arteries; at 10 years, the cumulative incidence was 1.1% for complete atrioventricular septal defect, 5.3% for pulmonary atresia with an intact ventricular septum, and 6.4% for pulmonary atresia with ventricular septal defect. No children with secundum atrial septal defect, patent ductus arteriosus, or pulmonic stenosis have had infective endocarditis after surgery.Conclusion.—The continuing incidence of endocarditis after surgery for congenital heart defect, particularly valvular aortic stenosis, merits education about endocarditis prophylaxis for children and adults with repaired congenital heart defects.
Blood and Plasma Specific Gravity Changes During Acute Alterations in Hemodynamics in Splenectomized Dogs
Authors: J. W. REMINGTON, C. H. BAKER
Journal: Circulation Research (1958)

A variety of procedures were used to change hemodynamics acutely and thereby to produce changes in blood volume. Changes in plasma specific gravity showed no relation to those in aortic pressure or total peripheral resistance, but were related to central venous pressure. The simultaneous cell fraction tended to vary reciprocally with the plasma specific gravity, indicating a bulk transfer of either red cells or of plasma between the large blood vessels and peripheral beds.
Clinical experience with bethanidine in treatment of hypertension.
Authors: J Bath, D Pickering, R Turner
Journal: BMJ (1967)

At the present time probably most patients with high blood pressure in this country are being treated with guanethidine or methyldopa with or without the addition of an oral diuretic. Because of certain disadvantages of these two drugs in our experience (Lowther and Turner, 1963 ; Johnson et al., 1966) we have largely confined our attention during the past three years to debrisoquine (Kitchin and Turner, 1966) and bethan idine. Experience with the latter drug is the subject of this paper.
Anomalies of the aortic arch and ventricular septal defects.
Authors: A J Moulaert, C C Bruins, A Oppenheimer-Dekker
Journal: Circulation (1976)

This investigation presents additional evidence for the hemodynamic influence of intracardiac anomalies on the development of the aortic arch, based on measurements of different parts of the great vessels. Criteria are given to define the normal aortic arch and the different anomalies of the aortic arch, such as interruption, atresia, tubular hypoplasia, hypoplasia, abnormal long segment and juxtaductal coarctation. Two types of of malignment venentricular septal defects are described to illustrate how prenatal intracardiac flow disturbances can account for various aortic arch patterns. An explanation is proposed as to how reduced blood flow through the embryonic preductal aorta may contribute to the pathogenesis of all dimensional anomalies of the aortic arch.
Unusual Widespread Metastatic Presentation of Mixed Medullary–Follicular Thyroid Carcinoma
Authors: Parul Bhatnagar, Aseem Bhatnagar, Sawroop Kishan, C S. Bal, Ravinder Kumar Saran, Sanjeev Sinha, Ravi Kashyap
Journal: Clinical Nuclear Medicine (2004)

Mixed medullary-follicular thyroid carcinoma (MMFTC) is a rare tumor with a metastatic behavior that has not been fully appreciated. Scintigraphy and radioiodine entrapment propensity of its metastases remains largely undescribed. The authors present a case of MMFTC with widespread bone and soft-tissue metastases, where every known site of metastases concentrated radioiodine intensely. The patient responded well to radioiodine therapy. The report suggests that the tumor may have a propensity to metastasize to the skeleton, and the metastases retain the ability to accumulate radioiodine.
A novel technique of injection treatment for endoscopic sphincterotomy-induced hemorrhage
Authors: P. Katsinelos, J. Kountouras, G. Chatzimavroudis, C. Zavos, G. Paroutoglou, I. Pilpilidis, B. Papaziogas
Journal: Endoscopy (2007)

See also: Commentaire de travail de P. Katsinelos et al., pp. 631Endoscopy 2007; 39(07): 759-759DOI: 10.1055/s-0032-1306957
Livedo-like dermatitis and necrotic lesions after high-dose buprenorphine injections: a national French survey
Authors: L. Wainstein, C. Bernier, M. Gérardin, R. Bouquié, O. Espitia, J.M. Mussini, P. Jolliet, C. Victorri-Vigneau
Journal: British Journal of Dermatology (2014)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, Buprenorphine is a partial opioid agonist used as an oral maintenance treatment for opioid dependence, as a high‐dose formulation. The branded form of high‐dose buprenorphine (HDB) – Subutex® – was introduced in France in 1996. Several generic drugs have been marketed since then. HDB has become the first oral maintenance treatment for opioid dependence in France. However, the generalization of HDB has led to its misuse.1 2 Misuse of HDB injections is responsible for serious locoregional complications and represents a worrying public health concern. In France the national monitoring system of drug dependence and misuse falls under the responsibility of the French National Agency for Medicines and Health Products Safety. In order to carry out this monitoring, the agency relies on a network of 13 regional Centres for Evaluation and Information on Pharmacodependence (CEIP).3 In 2011, the CEIP of Nantes was notified of unusual cutaneous complications among injecting HDB users. French health authorities decided to implement a specific and prospective national case collection of these cutaneous complications. The CEIP of Nantes was responsible for coordinating this investigation.
Growth of clinical haematology in South Tees Health District 1983-5.
Authors: G P Summerfield, J E Chandler
Journal: BMJ (1986)

A review of the workload of two newly appointed clinical haematologists in a health district with a population of 307,000 showed that the clinical case load increased rapidly in the first two years. The management of patients with blood disorders, which had previously been dispersed among many departments both within and outside the district, was now concentrated within a single unit with occasional referral as appropriate to regional centres. The development of a clinical haematology service in district general hospitals cannot occur without funding and facilities, including suitably located beds for haematology patients and specifically appointed junior medical staff. Highly trained and experienced nursing staff are essential for the management of patients with bone marrow failure; day care facilities and community nursing are also valuable. Changes and developments in the laboratory as a result of these additional clinical activities are also necessary.
P250 BENEFICIAL EFFECTS ON WEIGHT GAIN, HEPATIC STEATOSIS AND EXPRESSION OF LIPOGENIC TARGET GENES IN A MURINE OBESITY MODEL AFTER IL-1 TYPE CYTOKINE INACTIVATION
Authors: J. Wohlfahrt, A. Fettelschoss, T. Kündig, H. Hermanns, B. Müllhaupt, J. Schmitt, A. Geier
Journal: Journal of Hepatology (2014)
Interaction between GRIP and Liprin-α/SYD2 Is Required for AMPA Receptor Targeting
Authors: Michael Wyszynski, Eunjoon Kim, Anthone W. Dunah, Maria Passafaro, Juli G. Valtschanoff, Carles Serra-Pagès, Michel Streuli, Richard J. Weinberg, Morgan Sheng
Journal: Neuron (2002)
Disorders of the Digestive System in the Elderly
Authors: Jane F. Desforges, Robert D. Shamburek, John T. Farrar
Journal: New England Journal of Medicine (1990)

CHANGES in the anatomy and physiology of the epithelium of the digestive organs because of aging are slight.1 The functional capacity of both the secretory and absorptive cells of the gut is so great that a decrease to as little as 5 to 10 percent of normal function is required for a clinical effect to be evident. In contrast to the epithelial-cell reserve, connective-tissue changes are manifested in midlife, and age-related changes in these tissues are responsible for many digestive disorders, such as colonic vascular ectasias and diverticula of the gut.The anatomical and physiologic changes that do occur in . . .
Les biopsies coliques obtenues lors de l'endomicroscopie confocale sont pré-colorées in vivo par fluorescéine et adaptées à des analyses morphologiques
Authors: E Coron, JF Mosnier, A Ahluwalia, M Le Rhun, A Tarnawski, JP Galmiche, T Matysiak-Budnik
Journal: Endoscopy (2010)

Introduction: L'endomicroscopie confocale (EMC) utilisant la flourescéine permet la visualization non-invasive des structures sous-épithéliales de la muqueuse digestive à l'échelle microscopique (»biopsie optique«). Les biopsies standards sont habituellement prélevées lors de ces procédures pour l'analyse anatomo-pathologique utilisée comme l'examen de référence. Lors de l'examen, la fluorescéine est injectée par voie i.v. Et se distribue dans tous les tissus à travers le système de circulation. Ceci laisse penser que les biopsies standardsprélevées lors de l'EMC seraient pré-colorées in vivo par la fluorescéine. Le but de cette étude a été de déterminer si les biopsies obtenues lors de l'EMC: 1) retiennent la fluorescéine et permettent la visualization des structures vasculaires sans coloration supplémentaire 2) peuvent faciliter et améliorer l'étude immunohistochimique.
The Central Middlesex Hospital
Authors: Z. Cope
Journal: BMJ (1964)

centage of body weight and this is impossible to determine in fossil forms.The third chapter discusses endocasts of brain cases and the deductions to be made from them.It appears from these casts that the middle meningeal artery is much more important in the hominids than in the apes and that the brain not only becomes larger in man but also changes its shape.The author adopted Economo's encephalometry for this investigation.Though there are minor changes-for instance, an increase in the relative height of the cerebrum-by and large the brain pattern has not altered significantly from macaque to man, with the exception of the Neanderthal, which is an aberrant form.In conclusion, the author finds that fossil brains provide little evidence for the mental capacity of early man.However, it seems possible that Australopithecus, whose larynx was modified sufficiently to enable him to articulate, though the massive mandible did not allow much freedom of the tongue, may have possessed speech.
'Disabled' Is Not 'Impaired'
Authors: Mark A. Young
Journal: JAMA (1987)

To the Editor.—   article in the June 5, 1987, issue entitled The Physically Disabled Physician1 was a welcome and well-researched report on the disabled physician's status in the medical profession.  I must, however, object toJAMA's inappropriate juxtaposition of an article on the  disabled physician next to articles on the impaired physician.  grouping of these articles together strongly implies that both are similar, sharing identical medical and social considerations.  There is an important distinction to be made between the disabled physician and the impaired physician.  impaired physician often suffers from alcohol or drug dependence, thus severely impairing his ability to practice medicine.  disabled physician, in contrast, suffers no loss in intellectual ability or in capacity for clinical decision making. As stated in Dr Wainapel's article, physically disabled physicians' needs for treatment and advocacy are distinct from those of the 'impaired physician.' To equate the
HOME DISINFECTION IN PULMONARY TUBERCULOSIS
Authors: E. L. Dove
Journal: BMJ (1918)

PreCious lllness-es;.D)ysentery, muclh malaria (before the rat bite), never syphilis {he-Avas v*ery (lethiiite as to this), n)o history of tick fever, but lere againi the possibility of this disease is not,scln(1ed, as he lias been in areas wvhere it prevailed, anid some of his friends had actually suffered from it; phlebotomus fever December, 1916.lFirst Erxminatioii.-Thepatienit was seen first by onie of ius (G.(L..) oni September 25th, 1917, iavinig beeni sent by Dr. A. 31.Elliot for exanineatioin Hle was tlenifairly well, and was only complaining of getting tired easily and of headaches.
WHO warns noise pollution is a growing hazard to health in Europe
Authors: P. Moszynski
Journal: BMJ (2011)

Traffic related noise accounts for over one million healthy years of life lost annually to ill health, disability, or early death in western Europe, according to a new World Health Organization report.

The study finds that among environmental factors contributing to disease in Europe, environmental noise leads to a disease burden that is only second in magnitude to that from air pollution. Noise pollution causes or contributes to not only annoyance and sleep disturbance but also heart attacks, learning disabilities, and tinnitus.

The report concludes that there is sufficient evidence from large scale epidemiological studies …
Physiologic Reactivity Despite Emotional Resilience Several Years After Direct Exposure to Terrorism
Authors: Phebe M. Tucker, Betty Pfefferbaum, Carol S. North, Adrian Kent, Christie E. Burgin, Don E. Parker, Akm Hossain, Haekyung Jeon-Slaughter, Richard P. Trautman
Journal: American Journal of Psychiatry (2007)

Objective: Six and a half to 7 years after the 1995 terrorist bombing in Oklahoma City, the authors assessed autonomic reactivity to trauma reminders and psychiatric symptoms in adults who had some degree of direct exposure to the blast. Method: Sixty survivors who were listed in a state health department registry of persons exposed to the bombing and 60 age- and gender-matched members of the Oklahoma City metropolitan area community were assessed for symptoms of PTSD and depression and for axis I diagnoses. Heart rate and systolic, diastolic, and mean arterial blood pressures were measured before, during, and after bombing-related interviews. The two groups were compared on both psychometric and physiologic assessments. Results: Posttraumatic stress but not depressive symptoms were significantly more prevalent in the survivor group than in the comparison group, although symptoms were below levels considered clinically relevant. Despite apparent emotional resilience or recovery, blast survivors had significantly greater autonomic reactivity to trauma reminders on all measures than comparison subjects. Conclusions: The results suggest that physiologic assessment may capture long-term effects of terrorism that are not identified by psychometric instruments. The consequences of autonomic reactivity despite emotional resilience years after experiencing trauma are unknown but theoretically could range from facilitating a protective vigilance toward future disasters to more maladaptive avoidance behaviors, somatic symptoms, or medical problems.