tbuckley/cabot-search huggingface dataset:
P236 The Use of Local Anaesthesia For Arterial Blood Gas Sampling - A Multicentre Survey
Authors: F Khan, A D’Silva, S Ahmed, E Patel, S Hassan, ARC Patel
Journal: Thorax (2012)

<h3>Background</h3> BTS guidance for Emergency Oxygen Use recommends that local anaesthesia should be used for all routine arterial blood gas (ABG) sampling [1]. Intradermal and/or subcutaneous local anaesthetic (LA) via small gauge needle has been shown to reduce pain associated with the procedure by more than half [2]. We aimed to quantify the prevalence of this practise and ascertain potential barriers. <h3>Methods</h3> 160 FY1 doctors with at least eight months working experience, from five hospitals in London were given a ten-item anonymised questionnaire to measure practise and opinions regarding local anaesthesia before ABG sampling. <h3>Results</h3> All 115 respondents (72% response rate) performed ABG sampling regularly, with 84% doing so at least weekly. Only 27% of respondents had ever used intradermal and/or subcutaneous LA before ABG sampling, although only 5% did this regularly. The commonest needles used were 25 gauge (orange) (49%), 28 gauge (insulin needle) (18%), and 23 gauge (blue) (16%). 70% of respondents had never used LA of any kind for ABG sampling. Topical LA use was rare. 14% of respondents had never heard of LA used for ABG sampling; 24% were unfamiliar with how to do it; 14% believed it was potentially dangerous; 34% claimed not to have time, 21% believed that LA would not reduce the overall pain of the procedure (Figure 1). Allen’s test was usually perfomed by only 25% of doctors before ABG sampling. Only 30% of respondents believed using LA would lead to less repeated ABG sampling attempts. 93% of respondents had never personally been sampled for an ABG, although 44% would prefer LA to be used on them. <h3>Conclusion</h3> The regular use of local anaesthesia before ABG sampling among FY1 doctors is rare. Awareness of the technique is poor, and education is needed. Prominence and promotion in teaching sessions and local guidelines, along with quick access to supplies is likely to help to prevent unnecessary pain in unwell patients. O’Driscoll, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax. 2008; 63 (Suppl VI):vi1–vi73. Giner J, Casan P, Belda J, et al., Pain during arterial puncture. Chest 1996; 110:1443–5.
Apolipoprotein B polymorphism and altered apolipoprotein B and low density lipoprotein cholesterol concentrations in Finnish children
Authors: M J Tikkanen, J Viikari, H K Akerblom, E Pesonen
Journal: BMJ (1988)

oscopy, false positive results are not uncommon with double contrast radiology, and up to 29% of polyps may be missed, although this figure falls to under 10% for polyps over 1 cm in diameter.'3The presence of diverticular disease makes the diagnosis of associated lesions more difficult,'0 14 some authorities recom- mending that colonoscopy should be performed in all patients with symptomatic diverticular disease. 14Another important group comprises patients with overt or occult rectal bleeding with no cause found on rigid sigmoidoscopy or barium examination: lesions may be shown in 27-81% of such cases, including tumours in 3-1 1%.4 15 Accurate cost comparisons in our hospitals are difficult to make, but the greater necessity for colonoscopy after an initial barium study would suggest that a policy of performing endoscopy initially is likely to work out less costly.For this reason and for reasons of accuracy and expediency and to avoid multiple investigations total colonoscopy may be the preferred initial investigation for those with suspected colonic disease.We have shown that radiology is not a prerequisite for adequate colonoscopic examination.
Unexpected severity of cases of influenza B infection in patients that required hospitalization during the first postpandemic wave
Authors: A. Gutiérrez-Pizarraya, P. Pérez-Romero, R. Alvarez, T.A. Aydillo, G. Osorio-Gómez, C. Milara-Ibáñez, M. Sánchez, J. Pachón, E. Cordero
Journal: Journal of Infection (2012)
Predictors of Post-ERCP Complications in Patients with Suspected Choledocholithiasis
Authors: S. N. Mehta, E. Pavone, J. S. Barkun, S. Bouchard, A. N. Barkun
Journal: Endoscopy (1998)

Background and Study Aims: Determinants of complications after endoscopic retrograde cholangiopancreatography (ERCP) have not yet been completely characterized.
Replicable Abstinence Rates in an Alcoholism Treatment Program
Authors: Otto W. Neubuerger, Sheldon I. Miller, Robert E. Schmitz, Joseph D. Matarazzo, Herb Pratt, Nancy Hasha
Journal: JAMA (1982)

Treatment outcome studies of alcoholism have historically had innumerable difficulties and controversy. Few investigators ever have reported a replication of their initial study results, let alone the crossvalidation of such initial results. This article provides results of a four-year replication study of a medical behavioral treatment approach. Comparisons of patients receiving a uniform treatment were made at yearly intervals. A few variables are identified to clarify who will or will not achieve and maintain follow-up sobriety, although it is admitted that our knowledge in this area is still rudimentary. These results affirm for the practitioner today that the alcoholic patient is treatable with a high probability of success. When the outcome of treatment is positive, the diagnosis and referral become crucial for alcoholism just as for other treatable diseases.
Quality of Life after Radical Prostatectomy or Watchful Waiting
Authors: Gunnar Steineck, Fred Helgesen, Jan Adolfsson, Paul W. Dickman, Jan-Erik Johansson, Bo Johan Norlén, Lars Holmberg
Journal: New England Journal of Medicine (2002)

We evaluated symptoms and self-assessments of quality of life in men with localized prostate cancer who participated in a randomized comparison between radical prostatectomy and watchful waiting.Between 1989 and 1999, a group of Swedish urologists randomly assigned men with localized prostate cancer to radical prostatectomy or watchful waiting. In this follow-up study, we obtained information from 326 of 376 eligible men (87 percent) concerning certain symptoms, symptom-induced distress, well-being, and the subjective assessment of quality of life by means of a mailed questionnaire.Erectile dysfunction (80 percent vs. 45 percent) and urinary leakage (49 percent vs. 21 percent) were more common after radical prostatectomy, whereas urinary obstruction (e.g., 28 percent vs. 44 percent for weak urinary stream) was less common. Bowel function, the prevalence of anxiety, the prevalence of depression, well-being, and the subjective quality of life were similar in the two groups.The assignment of patients to watchful waiting or radical prostatectomy entails different risks of erectile dysfunction, urinary leakage, and urinary obstruction, but on average, the choice has little if any influence on well-being or the subjective quality of life after a mean follow-up of four years.
POISONING BY ARSINE
Authors: M. Bannister
Journal: BMJ (1920)

Josaglands, wllich miglht subsequently be aggravated by psychic trauma or conflict, or by other toxins.In dementia praecox there seemcd to be both physical and psychic factors.If this idea of the origin were correct, we must look for prevenltion, not to the school doctor, but to the ante-natal clinic.
STUDIES ON THE ACTION OF HAGEMAN FACTOR: EVIDENCE THAT ACTIVATED HAGEMAN FACTOR IN TURN ACTIVATES PLASMA THROMBOPLASTIN ANTECEDENT*
Authors: O. D. Ratnoff, E. W. Davie, D. L. Mallett
Journal: Journal of Clinical Investigation (1961)

Wright (16).M.W. and B.Y. were bled in New York and their frozen plasma carried to Cleveland, while G.P. was bled at different times in New York or Cleveland.The identity of the defect in the three patients with PTA deficiency has been confirmed by both Dr. Robert Rosenthal (17) and ourselves
When to Touch
Authors: Diane Morse
Journal: JAMA (1990)

I had been called about the patient before. She was a young woman, in her 20s, with AIDS. She'd been hospitalized most recently because of intractable seizures, probably secondary to toxoplasmosis and lymphoma. The last time I was on call, her seizures were being treated with diazepam, and I was asked to cross-cover at night for her regular resident physician because she was still seizing. I went to her room and encountered her mother, who was clearly distraught. She begged me to tell her whether the end was near, whether she should stay the night. I didn't know what to say; although I sensed her daughter's death wasn't imminent, I couldn't promise. I told her this. She seemed incredibly despondent, but I had other calls to answer and asked the nurse to try to console her. A few days later, I was again called about the patient. She was a
557 PREVALENCE AND MUTATIONAL PATTERN OF OCCULT HEPATITIS B VIRUS ISOLATED FROM LIVER TISSUE OF HIV INFECTED PATIENTS
Authors: M.S. De Mitri, R. Cassini, L. Urbinati, M. Pavoni, C. Biagetti, D. Pocaterra, L. Calza, E. Ferlini, M. Bernardi, F. Chiodo, G. Verucchi
Journal: Journal of Hepatology (2008)
THE TREATMENT OF GRANULAR LIDS.Read before the Section on Ophthalmology, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: C. B. BLUBAUGH
Journal: JAMA (1893)

Gentlemen:—As an introduction to my article, the treatment of granular lids, I will say that I live in a portion of the Ohio valley where the soil is very sandy for miles from the river on both the West Virginia and Ohio sides. To this fact I attribute, to some extent, the unusual prevalence of the disease in that locality. During the past two years I have been so unfortunate as to have had 205 cases of more or less severity to treat. Of this number 125 were treated with good results by the method I give you to-day, and the rest by all the usual plans of treatment recommended without, in some cases, the success I had hoped for. I find that Druitt, in 1848, suggested scarifying the granulations; then, after a few days, he used lunar caustic on the granulations and applied citrin ointment to the palpebrai edges.
Older women ignorant of breast screening
Authors: L. Dillner
Journal: BMJ (1996)

Women aged over 65 in Britain do not know that they have a right to breast screening, and less than 0.5% of them ask for mammography each year, says a report from the charity Age Concern. The report includes the results of a Gallup survey of 1000 women aged 65 or over, which show that over half believed they were “at no risk at all” from breast cancer—mostly because they thought they were too old. Government figures show that two thirds of deaths from breast cancer occur in …
Dysregulation of insulin receptor substrate 2 in β cells and brain causes obesity and diabetes
Authors: Xueying Lin, Akiko Taguchi, Sunmin Park, Jake A. Kushner, Fan Li, Yedan Li, Morris F. White
Journal: Journal of Clinical Investigation (2004)

The molecular link between obesity and β cell failure that causes diabetes is difficult to establish. Here we show that a conditional knockout of insulin receptor substrate 2 (Irs2) in mouse pancreas β cells and parts of the brain — including the hypothalamus —increased appetite, lean and fat body mass, linear growth, and insulin resistance that progressed to diabetes. Diabetes resolved when the mice were between 6 and 10 months of age: functional β cells expressing Irs2 repopulated the pancreas, restoring sufficient β cell function to compensate for insulin resistance in the obese mice. Thus, Irs2 signaling promotes regeneration of adult β cells and central control of nutrient homeostasis, which can prevent obesity and diabetes in mice.
Benign Obstetric History in Women with Sickle-cell Anaemia Associated with -Thalassaemia
Authors: A. van Enk, A. Lang, J. M. White, H. Lehmann
Journal: BMJ (1972)

Two Ghanaian women with sickle-cell anaemia and α-thalassaemia were found to have an unusually benign obstetric history. In addition to two factors present which are known to moderate the clinical course of sickle-cell anaemia, good socioeconomic status and a relatively high Hb F level, it is suggested that α-thalassaemia may act among other things by lowering the haemoglobin concentration in the red cells and thereby lowering their tendency to sickle in vivo.
Cardiac Arrest in Infants After Congenital Heart Surgery
Authors: J. F. Rhodes, A. D. Blaufox, H. S. Seiden, J. D. Asnes, R. P. Gross, J. P. Rhodes, R. B. Griepp, A. F. Rossi
Journal: Circulation (1999)

The survival rate to discharge after a cardiac arrest in a patient in the pediatric intensive care unit is reported to be as low as 7%. The survival rates and markers for survival strictly regarding infants with cardiac arrest after congenital heart surgery are unknown.Infants in our pediatric cardiac intensive care unit database were identified who had a postoperative cardiac arrest between January 1994 and June 1998. Parameters from the perioperative, prearrest, and resuscitation periods were analyzed for these patients. Comparisons were made between survivors and nonsurvivors. Of 575 infants who underwent congenital heart surgery, 34 (6%) sustained a documented cardiac arrest; of these, 14 (41%) survived to discharge. Perioperative parameters, ventricular physiology, and primary rhythm at the time of arrest did not influence outcome. Prearrest blood pressure was lower in nonsurvivors than in survivors (P<0.001). A high level of inotropic support prearrest was associated with death (P=0.06). Survivors had a shorter duration of resuscitation (P<0.001) and higher minimal arterial pH (P<0.02) and received a smaller total dose of medication during the resuscitation. Although survivors had an overall shorter duration of resuscitation, 5 of 22 patients (23%) survived to discharge despite resuscitation of >30 minutes.The outcome of cardiac arrest in infants after congenital heart surgery was better than that for pediatric intensive care unit populations as a whole. Univentricular physiology did not increase the risk of death after cardiac arrest. Infants with more hemodynamic compromise before the arrest as demonstrated with lower mean arterial blood pressure and higher inotropic support were less likely to survive. The use of predetermined resuscitation end points in this subpopulation may not be justified.
Deductive Echocardiographic Analysis in Infants with Congenital Heart Disease
Authors: ROBERT SOLINGER, FRANCISCO ELBL, KAREEM MINHAS
Journal: Circulation (1974)

A step-by-step approach to cardiac diagnosis utilizing a chest X-ray and echocardiography is described and used to study a normal infant and six infant patients with angiocardiographically-proven complex congenital heart malformations. The heart is divided into three major anatomical segments in order to localize the atrial and ventricular chambers and determine the relationship of the great arteries. The atrial chambers are localized by noting the position of the liver on the X-ray. The right atrium is on the same side as the liver with few exceptions. The ventricular chambers are localized by echocardiographically identifying the tricuspid and mitral valves. They are a part of the morphologically right and left ventricles, respectively. As a general rule, the atrioventricular valve whose anterior leaflet is continuous with the posterior margin of a semilunar valve is the mitral valve. The atrioventricular valve whose anterior leaflet is not continuous with a posterior semilunar valve margin is the tricuspid valve. When the tricuspid valve is to the right of the mitral valve, the ventricles are in their normal positions (ventricular d-loop); when it is to the left, the ventricles are inverted (ventricular l-loop). The relationship of the great arteries is determined by echocardiographically identifying the semilunar valves and noting their positions relative to each other, the interventricular septum and the ventricular chambers. In a ventricular d-loop, the aortic valve is usually to the right of the pulmonary valve. In a ventricular l-loop, the opposite is true. As much as a 17% error may exist when transposition of the great arteries is a component of the malformation. Therefore, as additional aids in semilunar valve identification the R-C intervals of the valves (interval between R wave of electrocardiogram and valve closure on echogram) and outside diameters of the valve roots are measured. Usually the R-C interval is longer and, in the absence of pulmonary stenosis, the outside diameter greater for the pulmonary valve. The segmental diagnoses are then combined to obtain the "type" of heart, and a careful search is made for associated defects. Using this approach, the positions of the atrial and ventricular chambers and the relationship of the great arteries were accurately determined in the six complex cardiac malformations studied.
Adolescents and young adults with acute lymphoblastic leukemia have a better outcome when treated with pediatric‐inspired regimens: Systematic review and meta‐analysis
Authors: Ron Ram, Ofir Wolach, Liat Vidal, Anat Gafter‐Gvili, Ofer Shpilberg, Pia Raanani
Journal: American Journal of Hematology (2012)

Survival of adults with acute lymphoblastic leukemia (ALL) is inferior to that of pediatric patients. Strategies to improve the outcome of adult population are warranted. This study aims to evaluate the efficacy and safety of pediatric-inspired regimens given to adolescents and young adults (AYA), usually defined as 16-39 years, with ALL. Systematic review and meta-analysis of comparative trials of AYA patients with ALL given induction chemotherapy with either pediatric-inspired regimens or conventional-adult chemotherapy was conducted. Relative risks (RR) with 95% confidence intervals (CIs) were estimated and pooled. Our search yielded 11 trials, including 2,489 patients. AYA patients given pediatric-inspired regimens had a statistically significant lower all cause mortality rate at 3 years (RR 0.58; 95% CI 0.51-0.67). Complete remission rate after induction chemotherapy and event free survival were superior in the pediatric-inspired regimens arm (RR 1.05; 95% CI 1.01-1.10 and RR 1.66; 95% CI 1.39-1.99, respectively). Relapse rate was also lower in patients given pediatric-inspired regimens (RR 0.51; 95% CI 0.39-0.66) with comparable nonrelapse mortality between the two groups (RR 0.53, 95% CI 0.19-1.48). Pediatric-inspired regimens are superior to conventional-adult chemotherapy in AYA ALL patients. Further randomized controlled studies to investigate this approach in adult ALL patients are warranted.
Cervical Discography Defended
Authors: Oscar Sugar
Journal: JAMA (1975)

To the Editor.—  Holt's diatribe against cervical discography merits reply because of its inaccuracy, false premises, and conclusions. Discography a la Holt with a 22-gauge needle is not the same as discography with a 25- or 26-gauge needle; the larger needle could indeed damage the disks of the cervical region and permit enough contrast material to be pushed in with such force as to break through fissures, especially those that form laterally in virtually all disks in the neck. The finer-gauge needle does not permit such forceful injections. Hence, it is clear that Holt is not doing the same procedure that we and many other neurosurgeons perform.  Logically, he says, discographers should revert to physiological saline for injection; however, he is wrong when he says that none has. We have, for instance, carried out more than 200 saline disk infusions in more than 80 patients in the past three years,
Incidence of and Risk Factors for Ventilator-Associated Pneumonia in Critically Ill Patients
Authors: Deborah J. Cook
Journal: Annals of Internal Medicine (1998)

Background: Understanding the risk factors for ventilator-associated pneumonia can help to assess prognosis and devise and test preventive strategies. Objective: To examine the baseline and time-dependent risk factors for ventilator-associated pneumonia and to determine the conditional probability and cumulative risk over the duration of stay in the intensive care unit. Design: Prospective cohort study. Setting: 16 intensive care units in Canada. Patients: 1014 mechanically ventilated patients. Measurements: Demographic and time-dependent variables reflecting illness severity, ventilation, nutrition, and drug exposure. Pneumonia was classified by using five methods: adjudication committee, bedside clinician's diagnosis, Centers for Disease Control and Prevention definition, Clinical Pulmonary Infection score, and positive culture from bronchoalveolar lavage or protected specimen brush. Results: 177 of 1014 patients (17.5%) developed ventilator-associated pneumonia 9.0 ± 5.9 days (median, 7 days [interquartile range, 5 to 10 days]) after admission to the intensive care unit. Although the cumulative risk increased over time, the daily hazard rate decreased after day 5 (3.3% at day 5, 2.3% at day 10, and 1.3% at day 15). Independent predictors of ventilator-associated pneumonia in multivariable analysis were a primary admitting diagnosis of burns (risk ratio, 5.09 [95% CI, 1.52 to 17.03]), trauma (risk ratio, 5.00 [CI, 1.91 to 13.11]), central nervous system disease (risk ratio, 3.40 [CI, 1.31 to 8.81]), respiratory disease (risk ratio, 2.79 [CI, 1.04 to 7.51]), cardiac disease (risk ratio, 2.72 [CI, 1.05 to 7.01]), mechanical ventilation in the previous 24 hours (risk ratio, 2.28 [CI, 1.11 to 4.68]), witnessed aspiration (risk ratio, 3.25 [CI, 1.62 to 6.50]), and paralytic agents (risk ratio, 1.57 [CI, 1.03 to 2.39]). Exposure to antibiotics conferred protection (risk ratio, 0.37 [CI, 0.27 to 0.51]). Independent risk factors were the same regardless of the pneumonia definition used. Conclusions: The daily risk for pneumonia decreases with increasing duration of stay in the intensive care unit. Witnessed aspiration and exposure to paralytic agents are potentially modifiable independent risk factors. Exposure to antibiotics was associated with low rates of early ventilator-associated pneumonia, but this effect attenuates over time.
Erythrocyte Energy Metabolism in Hereditary Spherocytosis*
Authors: Claude F. Reed, Lawrence E. Young
Journal: Journal of Clinical Investigation (1967)

The incorporation of extracellular orthophosphate-(32)P into cellular ATP, 2,3-diphosphoglyceric acid, and inorganic phosphate has been measured over a period of 6 hours in vitro in red blood cells from normal subjects and from patients with hereditary spherocytosis who had undergone splenectomy. The pattern of labeling of the intracellular compounds was found to be the same in both types of red blood cells, as reported by other workers using much shorter periods of incubation. In addition, in the present study it was possible to compare the net flux of extracellular phosphate into ATP between the two groups of erythrocytes. These latter results suggest that the actual turnover rate of ATP was not abnormal in these patients with hereditary spherocytosis.
Extensive Squamous Cell Carcinoma of the Skin Related to Use of Sorafenib for Treatment of <i>FLT3</i>-Mutant Acute Myeloid Leukemia
Authors: Amir T. Fathi, William M. Lin, Tyler Durazzo, Adriano Piris, Hossein Sadrzadeh, Lindsay Bernardo, Darrel R. Borger, Steven L. McAfee, Daniela Kroshinsky, Yi-Bin Chen
Journal: Journal of Clinical Oncology (2014)
Staphylococcal Infections-Reply
Authors: Lowell Henderson
Journal: JAMA (1962)

<h3>To the Editor:—</h3> I appreciate Dr. Trimble's comments and concur with his point of view. The crux of the matter is whether the staphylococcus demonstrated is actually the etiologic agent of the illness. It would have been desirable for me to have prefaced my answer with such a statement before proceeding to discuss the means of eradicating a proven infection. One of my colleagues, Dr. J. H. Geraci, has a particular interest in infectious diseases, and I asked his opinion. He commented as follows: "I have read your answer to the question posed by the M.D. in New Jersey, and I have read the letter from Dr. Trimble. I would agree with Dr. Trimble that the mere presence of staphylococcus in the nose of the allergic child and in the nose and throat of the parents does not constitute staphylococcal infection. If it could be demonstrated, however, that the staphylococcus