tbuckley/cabot-search huggingface dataset:
Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision
Authors: Janice Lander, Barbara Brady-Fryer, James B. Metcalfe, Shemin Nazarali, Sarah Muttitt
Journal: JAMA (1997)

Beliefs about the safety and effectiveness of current anesthetics have resulted in many newborns being circumcised without the benefit of anesthesia.To compare ring block, dorsal penile nerve block, a topical eutectic mixture of local anesthetics (EMLA), and topical placebo when used for neonatal circumcision. The placebo represented current practice, with no anesthetic for neonatal circumcision.A randomized controlled trial.Antenatal units in 2 tertiary care hospitals in Edmonton, Alberta.A consecutive sample of 52 healthy, full-term, male newborns, aged 1 to 3 days.Physiological and behavioral monitoring occurred in a series of trials: baseline, drug application, preparation, circumcision, and postcircumcision. Surgical procedures defined the following 4 stages of the circumcision: cleansing, separation, clamp on, and clamp off. Methemoglobin level was assessed 6 hours after surgery.Heart rate, cry, and methemoglobin level.Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high-pitched cry throughout the circumcision and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). The 3 treatment groups all had significantly less crying and lower heart rates during and following circumcision compared with the untreated group. The ring block was equally effective through all stages of the circumcision, whereas the dorsal penile nerve block and EMLA were not effective during foreskin separation and incision. Methemoglobin levels were highest in the EMLA group, although no newborn required treatment.The most effective anesthetic is the ring block; EMLA is the least effective. It is our recommendation that an anesthetic should be administered to newborns prior to undergoing circumcision.
Value based pricing for NHS drugs: an opportunity not to be missed?
Authors: Karl Claxton, Andrew Briggs, Martin J Buxton, Anthony J Culyer, Christopher McCabe, Simon Walker, Mark J Sculpher
Journal: BMJ (2008)

The policy debate about price, value, and innovation in pharmaceuticals is at a critical stage for the NHS. <b>Claxton and colleagues</b> describe the key principles of value based pricing and consider some of the concerns about such a scheme
Medical Mystery: The Answer
Authors: Gerhard Kurlemann, Otfried Debus
Journal: New England Journal of Medicine (2000)

To the Editor: The carefully done and clearly documented study by Haydel and colleagues (July 13 issue) 1 represents important progress in refining criteria for the use of computed tomography (CT) in patients with minor head injury that were originally proposed by me and others. 2-4However, I believe a word of caution is in order.Their claim that the seven criteria they used had a sensitivity of 100 percent must be viewed with some skepticism.I have encountered exceptions to their rule that these findings always accompany abnormal CT scans in patients with minor head injury.Even though such exceptions must be quite rare, the failure to identify even a single intracranial hematoma would have an enormous impact on outcomes and costs.I would also be reluctant to claim that the use of this approach could substantially reduce health care expenditures until many more patients, and the actual costs of their care, have been studied.
Direct Measurement of Instantaneous Coronary Blood Flow after Total Correction of Anomalous Left Coronary Artery
Authors: ROBERT L. REIS, LAWRENCE SOREL COHEN, DEAN T. MASON
Journal: Circulation (1969)

An anomalous left coronary artery was excised from the pulmonary artery and connected by a reversed segment of autogenous saphenous vein to the ascending aorta in a 20-year-old man. Before it was anastomosed to the aorta, retrograde flow of oxygenated blood from coronary artery to pulmonary artery occurred predominantly during diastole; the pressure in the left main coronary artery was 30/15 mm Hg and rose to systemic levels following occlusion of the coronary artery at its junction with the pulmonary artery. After transplantation to the aorta, the vessel was encircled with an electromagnetic flow probe and instantaneous left coronary artery blood flow was measured simultaneously with the pressures in the left ventricle and ascending aorta. The pattern of instantaneous coronary blood flow and its relation to ventricular and aortic pressure were similar to the pattern that has been observed in normal animals. Mean flow through the left coronary artery was 104 ml/min. Following operation, the left ventricular enddiastolic pressure decreased to normal levels and the anastomosis was proved to be patent. Transplantation of the anomalous coronary artery to the systemic circulation restores normal coronary dynamics and may be preferable to simple ligation.
The utility of contrast-enhanced endoscopic ultrasound in monitoring ethanol-induced pancreatic tissue ablation: a pilot study in a porcine model
Authors: S. Giday, P. Magno, K. Gabrielson, J. Buscaglia, M. Canto, C. Ko, J. Clarke, A. Kalloo, S. Jagannath, E. Shin, S. Kantsevoy
Journal: Endoscopy (2007)

See also: Commentaire de travail de S. A. Giday et al., pp. 525Endoscopy 2007; 39(06): 578-578DOI: 10.1055/s-0032-1306945
Long term survival after evidence based treatment of acute myocardial infarction and revascularisation: follow-up of population based Perth MONICA cohort, 1984-2005
Authors: T. Briffa, S Hickling, M Knuiman, M Hobbs, J Hung, F M Sanfilippo, K Jamrozik, P L Thompson
Journal: BMJ (2009)

<b>Objective</b> To examine trends in long term survival in patients alive 28 days after myocardial infarction and the impact of evidence based medical treatments and coronary revascularisation during or near the event. <b>Design</b> Population based cohort with 12 year follow-up. <b>Setting</b> Perth, Australia. <b>Participants</b> 4451 consecutive patients with a definite acute myocardial infarction according to the World Health Organization MONICA (monitoring trends and determinants in cardiovascular disease) criteria admitted to hospital during 1984-7, 1988-90, and 1991-3. <b>Main outcome measures</b> All cause mortality identified from official mortality records and the hospital morbidity data, with death from cardiovascular disease as a secondary end point. <b>Results</b> In the 1991-3 cohort, 28 day survivors of acute myocardial infarction had a 7.6% absolute event reduction (95% confidence interval 4% to 11%) or a 28% lower relative risk reduction (16% to 38%), unadjusted for risk of death, over 12 years after the incident admission compared with the 1984-7 cohort, similar to the survival of the 1988-90 cohort. The improved survival for the 1991-3 cohort persisted after adjustment for demographic factors, coronary risk factors, severity of disease, and event complications with an adjusted relative risk reduction of 26% (14% to 37%), but this was not apparent after further adjustment for medical treatments in hospital and coronary revascularisation procedures within 12 months of the incident myocardial infarction. <b>Conclusion</b> The improving trends in 12 year survival after a definite acute myocardial infarction are associated with progressive use of evidence based treatments during the initial admission to hospital and in the 12 months after the event. These changes in the management of acute myocardial infarction are probably contributing to the continuing decline in mortality from coronary heart disease in Australia.
Antibody to Intercellular Adhesion Molecule 1 (CD54) Decreases Survival and Not Lung Injury in Baboons with Sepsis
Authors: KAREN E. WELTY-WOLF, MARTHA S. CARRAWAY, YU-CHIN T. HUANG, STEVEN G. SIMONSON, STEPHEN P. KANTROW, TAKASHI K. KISHIMOTO, CLAUDE A. PIANTADOSI
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Neutrophil influx into the lung is an important event in the pathogenesis of acute lung injury in gram-negative sepsis. We hypothesized that administration of a monoclonal antibody to intercellular adhesion molecule 1 (ICAM-1, CD54), a molecule mediating neutrophil adhesion to endothelial cells, would decrease neutrophil sequestration and transmigration in the lung and attenuate lung injury in Escherichia coli sepsis. Sepsis was induced in 12 baboons primed with heat-killed E. coli (1 × 109 CFU/kg) 12 h before infusion of live bacteria (1 × 1010 CFU/kg). Six animals received monoclonal antibody to CD54 (1 mg/kg) intravenously at the time of live E. coli infusion. After 48 h or when blood pressure could not be maintained, tissues were harvested and bronchoalveolar lavage (BAL) samples were obtained. Median survival time was decreased in anti-CD54-treated animals. This group also had decreased mean arterial pressure, increased metabolic acidosis, and decreased urine output. Measures of lung injury including gas exchange, lung lavage protein and lactate dehydrogenase (LDH), lung thiobarbituric acid-reactive species, and lung histology, including alveolar neutrophil volumes, were unaffected by treatment. The effect of anti-CD54 on neutrophil influx into tissues as measured by myeloperoxidase was organ specific. These data show that monoclonal antibody to CD54 does not ameliorate acute lung injury in E. coli sepsis, and septic primates given anti-CD54 have worsened metabolic parameters and decreased survival.
A randomized placebo-controlled trial of combined early intravenous captopril and recombinant tissue-type plasminogen activator therapy in acute myocardial infarction
Authors: Elizabeth G. Nabel, Eric J. Topol, Anita Galeana, Stephen G. Ellis, Eric R. Bates, Steven W. Werns, Joseph A. Walton, David W. Muller, Markus Schwaiger, Bertram Pitt
Journal: Journal of the American College of Cardiology (1991)
Malondialdehyde and glutathione production in isolated perfused human and rat hearts.
Authors: M Janssen, J F Koster, E Bos, J W de Jong
Journal: Circulation Research (1993)

A number of studies show the relation between oxygen-derived free radicals and cardiac ischemia/reperfusion injury. However, little is known about oxidative stress in the human heart, which can be measured by oxidized glutathione (GSSG) and malondialdehyde (MDA) formation. Furthermore, data on MDA production by rat hearts are controversial, possibly because of the use of the aspecific thiobarbituric acid assay. Therefore, GSSG and MDA were measured, with colorimetric and high-performance liquid chromatographic assays, respectively, in buffer-perfused explanted human hearts and normal rat hearts made temporarily ischemic. Human hearts received cardioplegia; rat hearts were studied in a control and an ischemic group with or without cardioplegia. Baseline GSSG release was &lt; 0.01 nmol.min-1.g wet wt-1 in both species. During reperfusion, GSSG release from human hearts and from ischemic and cardioplegic/ischemic rat hearts peaked at 0.24 +/- 0.12, 1.1 +/- 0.4, and 0.19 +/- 0.04 nmol.min-1.g-1, respectively. MDA was undetectable (&lt; 0.02 nmol.min-1.g-1) in the effluent of both species and in human hearts (&lt; 4 nmol/g protein). Rat heart reduced glutathione levels decreased 32% as a consequence of cardioplegia and ischemia. Cardioplegia induced a 41% (P = .08) decrease in rat heart MDA content, whereas cumene hydroperoxide increased it 3.6 times (P &lt; .01). Thus, after ischemia human and rat hearts release GSSG, indicating that oxidative stress has occurred. Apparently, lipid peroxidation takes place in normal rat hearts, decreases after cardioplegia, but does not increase after ischemia/reperfusion. Human hearts lack MDA under normoxic and ischemic conditions. This novel finding seems to reflect a low MDA-forming potential in both situations.(ABSTRACT TRUNCATED AT 250 WORDS)
Prevention of Schistosomiasis-Reply
Authors: Robert E. Fontaine
Journal: JAMA (1984)

In Reply.—  We appreciate Dr Karstorp's firsthand account of the trip, with her reemphasis on the surprisingly short incubation period for acute schistosomiasis and elaboration on some of the possible protective measures. We were not sufficiently precise in referring to concentrations of chlorine or iodine needed to kill cercariae. The figure of 1 ppm in our report refers to a concentration of free residual chlorine, correctly stated by Dr Karstorp. In general, water purification preparations used according to general instructions should achieve cercariacidal concentrations of free residual chlorine or iodine. 1   The risk of contracting schistosomiasis is far greater from bathing, swimming, wading, or similar activities with a relatively long exposure to large volumes of cercaria-infested water, than from brief oral exposure to small volumes of the same water. Filtration, heating, or chemical treatment, while recommended for drinking water and for situations in which bathing water can be pretreated, do
Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort
Authors: Anna S. F. Lok, Marc G. Ghany, Zachary D. Goodman, Elizabeth C. Wright, Gregory T. Everson, Richard K. Sterling, James E. Everhart, Karen L. Lindsay, Herbert L. Bonkovsky, Adrian M. Di Bisceglie, William M. Lee, Timothy R. Morgan, Jules L. Dienstag, Chihiro Morishima
Journal: Hepatology (2005)

Knowledge of the presence of cirrhosis is important for the management of patients with chronic hepatitis C (CHC). Most models for predicting cirrhosis were derived from small numbers of patients and included subjective variables or laboratory tests that are not readily available. The aim of this study was to develop a predictive model of cirrhosis in patients with CHC based on standard laboratory tests. Data from 1,141 CHC patients including 429 with cirrhosis were analyzed. All biopsies were read by a panel of pathologists (blinded to clinical features), and fibrosis stage was determined by consensus. The cohort was divided into a training set (n = 783) and a validation set (n = 358). Variables that were significantly different between patients with and without cirrhosis in univariate analysis were entered into logistic regression models, and the performance of each model was compared. The area under the receiver-operating characteristic curve of the final model comprising platelet count, AST/ALT ratio, and INR in the training and validation sets was 0.78 and 0.81, respectively. A cutoff of less than 0.2 to exclude cirrhosis would misclassify only 7.8% of patients with cirrhosis, while a cutoff of greater than 0.5 to confirm cirrhosis would misclassify 14.8% of patients without cirrhosis. The model performed equally well in fragmented and nonfragmented biopsies and in biopsies of varying lengths. Use of this model might obviate the requirement for a liver biopsy in 50% of patients with CHC. In conclusion, a model based on standard laboratory test results can be used to predict histological cirrhosis with a high degree of accuracy in 50% of patients with CHC. (HEPATOLOGY 2005.)
Surface and bulk infrared modes of crystalline and amorphous silica particles: a study of the relation of surface structure to cytotoxicity of respirable silica.
Authors: R S Pandurangi, M S Seehra, B L Razzaboni, P Bolsaitis
Journal: Environmental Health Perspectives (1990)

Surface IR (infrared) modes of crystalline and fumed (amorphous) silica particles, calcined at temperatures up to 1095 degrees C, have been studied by Fourier transform infrared spectroscopy. The ability of these same particles to lyse cells has been measured by a hemolysis protocol. The untreated crystalline and amorphous materials differ by a factor of 40 in specific surface area, and the intensity per unit mass of the sharp surface silanol band near 3745 cm-1 in the amorphous material is an order of magnitude larger than in the crystalline material. A similar difference is observed in the lysing potential of the two materials. The intensity of the silanol band increases after calcination for both materials, reaching peak values near 500 degrees C, followed by a dramatic drop at higher calcination temperatures, and reaching negligible values for materials calcined near 1100 degrees C. The lysing potential data follow essentially the same pattern for both crystalline and fumed silica. These results are consistent with the hypothesis that the surface silanol groups are involved in cell lysis. Further experiments are suggested to evaluate the relationship between the surface structure of silica particles and their potential cytotoxicity.
Q Fever Down the Drain
Authors: M. G. P. Stoker
Journal: BMJ (1957)

MECAMYLAMINE IN HYPERTENSIONMBRrnSH 425from the alimentary canal, so that the oral dose is little more than the parenteral dose.The degree of drug toleration is slight, and is not sufficient to cause difficulty in determining the requisite dose of the drug.The action is more prolonged than that of pentolinium or of chlorisondamine, so that the degree of control over the blood-pressure level is better, provided that a sufficient dose can be administered.Adequate control over the blood-pressure level is hindered in some instances by the occurrence of parasympathetic side-effects, which appear to be rather more prominent in most cases than those we have encountered with pentolinium.There are, how- ever, individual differences in patients such that, with equal falls of blood pressure, side-effects may be less in some patients when they are treated with mecamylamine and less in others when they are treated with pentolinium.Mecamylamine may be used satisfactorily in combina- tion with rauwolfia alkaloids.Delayed toxicity has not been encountered with mecamylamine during our ex- perience of eight months.
Evaluation of the<i>Bacillus subtilis</i>Inhibition-Assay Technic as a Screening Procedure for the Detection of Phenylketonuria
Authors: Emily M. Bixby, Luz G. Pallatao, Charles V. Pryles
Journal: New England Journal of Medicine (1963)

RECENTLY Guthrie1 2 3 4 described a screening technic for the early diagnosis of phenylketonuria, utilizing the inhibiting property of beta-2-thienylalanine on the growth of Bacillus subtilis. This inhibiting phenomenon is specifically prevented by phenylalanine, proline and phenylpyruvic acid. By means of this inhibition test one is able to determine the presence of high levels of these substances in blood and other fluids. The Guthrie inhibition assay has been used successfully to determine blood phenylalanine levels in a group of 16 patients during treatment with diets low in phenylalanine and to screen a large population of retardates in a state school in . . .
A gold elixir of youth in the 16th century French court
Authors: P. Charlier, J. Poupon, I. Huynh-Charlier, J.-F. Saliege, D. Favier, C. Keyser, B. Ludes
Journal: BMJ (2009)

Did gold play a part in the death of a 16th century French courtesan and favourite of Henri II?
Nuclear Angiocardiography in the Diagnosis of Congenital Heart Disease in Infants
Authors: HADWIG WESSELHOEFT, PETER J. HURLEY, HENRY N. WAGNER, RICHARD D. ROWE
Journal: Circulation (1972)

Nuclear angiocardiography with a gamma camera, a pinhole collimator, and 99m Tc pertechnetate was performed on 43 children aged 3 years or less, including 10 neonates. Twenty-six children had congenital heart disease, which was confirmed at cardiac catheterization; the rest had no structural cardiac anomaly. Use of the pinhole collimator allowed magnification of cardiac images, with enhancement of resolution. Sensitivity was improved by positioning the pinhole 14 cm rather than 19 cm from the crystal of the gamma camera. Anterior and left lateral angiocardiograms were obtained with both 35-mm images at 0.3-sec intervals and cine-images at 18 frames/sec. Abnormalities in origin, size, and position of the great arteries, in chamber configurations, and in the time and course of activity in right and left heart, lungs, and great vessels were used to assist in identification of anomalies such as transposition of the great arteries, pulmonary atresia with intact ventricular septum, truncus arteriosus, and aortic atresia. 99m Tc in a dose of 18.5 mCi/M 2 of body area was used and produced whole-body and gonadal radiation doses less than 1 rad. The low risk and simplicity of the technic make it promising as a screening procedure and as an adjunct to cardiac catheterization for cyanosed infants.
Impact of stressor exposure on the interplay between commensal microbiota and host inflammation
Authors: Jeffrey D Galley, Michael T Bailey
Journal: Gut Microbes (2014)

Exposure to stressful stimuli results in the activation of multiple physiological processes aimed at maintaining homeostasis within the body. These physiological processes also have the capacity to influence the composition of microbial communities, and research now indicates that exposure to stressful stimuli leads to gut microbiota dysbiosis. While the relative abundance of many different bacterial types can be altered during stressor exposure, findings in nonhuman primates and laboratory rodents, as well as humans, indicate that bacteria in the genus Lactobacillus are consistently reduced in the gut during stress. The gut microbiota, including the lactobacilli, have many functions that enhance the health of the host. This review presents studies involving germfree and antibiotic treated mice, as well as mice given Lactobacillus spp. to prevent stressor-induced reductions in lactobacilli, to provide evidence that the microbiota contribute to stressor-induced immunomodulation, both in gut mucosa as well as in systemic compartments. This review will also discuss the evidence that commensal gut microbes have bidirectional effects on gastrointestinal physiology during stressor exposure.
India to introduce rubella and rotavirus vaccines and inactivated polio vaccine
Authors: G. Mudur
Journal: BMJ (2014)

The Indian government has accepted the recommendations of a 14 member advisory panel of scientific and medical experts to introduce vaccines against rotavirus and rubella and the injectable inactivated vaccine against polio into the universal immunisation programme.

The government announced earlier this month that the three vaccines would be brought into the universal immunisation programme, which currently provides all newborns in India with free vaccines against diphtheria, Haemophilus influenzae B, hepatitis B, measles, pertussis, polio, tetanus, and tuberculosis. Adults in selected states are also to be provided with a vaccine against Japanese encephalitis.

Health officials have said that the new vaccines are expected to reduce deaths from diarrhoea caused by rotavirus infections and illness from congenital rubella syndrome and will help India—which was certified free of polio this year—to join a globally synchronised effort to provide long lasting protection against the polio virus. But public health experts say …
Strategies for epidemiologic studies of lead in bone in occupationally exposed populations.
Authors: P J Landrigan
Journal: Environmental Health Perspectives (1991)

Lead exposure is widespread among industrial populations in the United States. X-ray fluorescence (XRF) analysis of the lead content of bone offers a promising approach to acquisition of individualized data on chronic lead absorption in occupationally exposed populations. Dosimetric data obtained by XRF will permit accurate definition of dose-response relationships for such chronic consequences of lead exposure as central and peripheral neurologic impairment, renal disease. hypertension, and possibility reproductive dysfunction. Additionally, data on bone lead content obtained by XRF will permit validation of models describing the body lead burden and will allow direct assessment of the efficacy of therapeutic chelation. XRF data may also permit assessment of the possible role of genetic polymorphism of the enzyme delta-aminolevulinic dehydrase as a determinant of the pharmacokinetics and toxicity of lead. In both cross-sectional and prospective epidemiologic studies of body lead burden in occupationally exposed populations, the K-XRF instrument appears to be the technology of choice.