tbuckley/cabot-search huggingface dataset:
Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study
Authors: T. Ogawa, M. Akahane, S. Koike, S. Tanabe, T. Mizoguchi, T. Imamura
Journal: BMJ (2010)

<b>Objective</b> To compare the effectiveness of cardiopulmonary resuscitation (CPR) with chest compression only and conventional CPR on outcomes after cardiopulmonary arrest out of hospital. <b>Design</b> Nationwide population based observational study. <b>Setting</b> A nationwide emergency medical service system in Japan. <b>Population</b> All consecutive patients with out of hospital cardiopulmonary arrest, January 2005 to December 2007 in Japan, witnessed at the moment of collapse. Lay people attempted chest compression only CPR (n=20 707) or conventional CPR (mouth to mouth ventilation and chest compression) (n=19 328), and patients were transferred to hospital by ambulance. <b>Main outcome measures</b> Factors associated with better outcomes (assessed with χ<sup>2</sup>, multiple logistic regression analysis, odds ratios and their 95% confidence intervals): one month survival and neurologically favourable one month survival rates defined as category one (good cerebral performance) or two (moderate cerebral disability) of the cerebral performance categories. <b>Results</b> Conventional CPR was associated with better outcomes than chest compression only CPR, for both one month survival (adjusted odds ratio 1.17, 95% confidence interval 1.06 to 1.29) and neurologically favourable one month survival (1.17, 1.01 to 1.35). Neurologically favourable one month survival decreased with increasing age and with delays of up to 10 minutes in starting CPR for both conventional and chest compression only CPR. The benefit of conventional CPR over chest compression only CPR was significantly greater in younger people in non-cardiac cases (P=0.025) and with a delay in start of CPR after the event was witnessed in non-cardiac cases (P=0.015) and all cases combined (P=0.037). <b>Conclusions</b> Conventional CPR is associated with better outcomes than chest compression only CPR for selected patients with out of hospital cardiopulmonary arrest, such as those with arrests of non-cardiac origin and younger people, and people in whom there was delay in the start of CPR.
Future gaps in workforce pose an impending crisis for the NHS, report warns
Authors: G. Iacobucci
Journal: BMJ (2013)

The NHS is facing a workforce crisis unless urgent action is taken to tackle impending staff shortages and shift the deployment of training resources, health policy experts have warned.

A report by health think tank the King’s Fund1said that the current NHS workforce was ill equipped to meet the future challenges of an ageing population with more complex needs, and warned of a mismatch between the supply and skills of different parts of the workforce and the needs of those using the service.

The paper argued that the impending shortages of general practitioners and nurses will run contrary to the need for more community based care. And while there is a forecasted oversupply of hospital …
Family Violence and the Insurance Industry: Education, Not Discrimination
Authors: R. Robert Tyson
Journal: JAMA (1995)

<h3>To the Editor.</h3> —I applaud Dr McAfee's editorial comments outlining the American Medical Association's (AMA's) commitment to diagnose and prevent family violence.<sup>1</sup>While recognizing the impact of violence on health status and society, he did not discuss the staggering medical costs associated with this behavior. In a study sponsored by the Pennsylvania Blue Shield Institute,<sup>2</sup>we found that from 1990 to 1991 medical costs associated with domestic violence totaled $326.6 million in Pennsylvania. Reviewing child abuse data, we projected another $1.7 million in health care expenditures. Medical costs of violence of all forms in the state totaled more than $434 million. Clearly, the medical manifestations of violence directly increase the cost of health care to Pennsylvania and the nation. Recognizing that merely studying the issue of violence is not enough, the Pennsylvania Blue Shield Institute provided funding for a pilot project (the South Philadelphia High School Health Academy
Technetium-99m Methylene Diphosphonate Accumulation in the Diaphragm After Severe Ischemia
Authors: ROBERT HOWMAN-GILES, PATRICK M. RAHILLY
Journal: Clinical Nuclear Medicine (1983)

HOWMAN-GILES, ROBERT M.B., B.S., F.R.A.C.P., D.D.U.; RAHILLY, PATRICK M. M.D., B.Sc., M.R.C.P Author Information
Regulation of Anti–double-stranded DNA B Cells in Nonautoimmune Mice: Localization to the T–B Interface of the Splenic Follicle
Authors: Laura Mandik-Nayak, Anh Bui, Hooman Noorchashm, Ashlyn Eaton, Jan Erikson
Journal: The Journal of Experimental Medicine (1997)

Systemic lupus erythematosus (SLE) and the MRL-lpr/lpr murine model for SLE are characterized by the presence of serum anti–double-stranded (ds)DNA antibodies (Abs), whereas nonautoimmune individuals have negligible levels of these Abs. To increase the frequency of anti-DNA B cells and identify the mechanisms involved in their regulation in nonautoimmune mice, we have used Ig transgenes (tgs). In the present study, we used the VH3H9 heavy (H) chain tg which expresses an H chain that was repeatedly isolated from anti-dsDNA Abs from MRL-lpr/lpr mice. Because the VH3H9 H chain can pair with endogenous L chains to generate anti–single-stranded DNA, anti-dsDNA, and non-DNA B cells, this allowed us to study the regulation of anti-dsDNA B cells in the context of a diverse B cell repertoire. We have identified anti-dsDNA B cells that are located at the T–B interface in the splenic follicle where they have an increased in vivo turnover rate. These anti-dsDNA B cells exhibit a unique surface phenotype suggesting developmental arrest due to antigen exposure.
The Phenobarbital Response Enhancer Module in the Human Bilirubin Udp–Glucuronosyltransferase Ugt1a1 Gene and Regulation by the Nuclear Receptor Car
Authors: Junko Sugatani, Hiroyuki Kojima, Akiko Ueda, Satoru Kakizaki, Kouichi Yoshinari, Qi-Hui Gong, Ida S. Owens, Masahiko Negishi, Tatsuya Sueyoshi
Journal: Hepatology (2001)

The UDP-glucuronosyltransferase, UGT1A1, is the critical enzyme responsible for detoxification of the potentially neurotoxic bilirubin by conjugating it with glucuronic acid. For decades, phenobarbital (PB) treatment for hyperbilirubinemia has been known to increase expression of the UGT1A1 gene in liver. We have now delineated the PB response activity to a 290-bp distal enhancer sequence (-3483/-3194) of the UGT1A1 gene. The enhancer contains 3 putative nuclear receptor motifs, and it was activated by the nuclear orphan receptor, human constitutive active receptor (hCAR), in cotransfected HepG2 cells. Bacterially expressed hCAR, acting as a heterodimer with in vitro-translated retinoid X receptor (RXRalpha), only bound to 1 of the 3 NR motifs, named gtNR1 in a gel-shift assay. Consistently, mutations of the gtNR1 site significantly decreased the activation by hCAR of the 290-bp DNA in transfection assays. Moreover, the 290-bp DNA was effectively activated in mouse primary hepatocytes in response to PB, offering an excellent clinical test for the examination of the responsiveness of the UGT1A1 to PB in the human population, particularly individuals with hyperbilirubinemia.
Meckel's Diverticulum in Childhood
Authors: R. H. Jackson, A. R. Bird
Journal: BMJ (1961)

MEDICAL JOURNALespecially noticeable in patients whose asthma started after the age of 30.Those most easily weaned were patients whose asthma was seasonal, usually in association with hay-fever, and those whose asthma did not respond.Apart from this, there were 25 periods off treatment lasting more than a year.Conclusions similar to those of this study are drawn from a review of the literature.I am indebted to Dr.
Oral spironolactone: an effective treatment for acne vulgaris in women
Authors: M.F. MUHLEMANN, G.D. CARTER, J.J. CREAM, P. WISE
Journal: British Journal of Dermatology (1986)

The effect of oral spironolactone (200 mg daily) on acne vulgaris has been studied in 21 women in a randomized, placebo-controlled, double-blind crossover study using 3 month treatment periods. Compared with placebo, spironolactone produced significant improvement as assessed by subjective benefit (P less than 0. 001), number of inflamed lesions (P less than 0 . 001) and by an independently evaluated photographic method (P less than 0 .02). There was a fall in sex hormone binding globulin but no significant changes in plasma testosterone and derived free testosterone. Initial plasma androgen levels were no higher in responders than in non-responders, nor did oral contraceptive use appear to affect clinical response. Spironolactone is a useful alternative therapy for women with acne vulgaris.
Biochemical Evidence for Impaired Nitric Oxide Synthesis in Patients With Peripheral Arterial Occlusive Disease
Authors: Rainer H. Böger, Stefanie M. Bode-Böger, Wolfgang Thiele, Wolfgang Junker, Klaus Alexander, Jürgen C. Frölich
Journal: Circulation (1997)

Background We studied urinary nitrate and cGMP excretion rates, indices of systemic NO formation, and plasma concentrations of l -arginine and the endogenous NO synthase inhibitor asymmetrical dimethylarginine (ADMA) and its inactive stereoisomer, symmetrical dimethylarginine, in 77 patients with peripheral arterial occlusive disease (PAOD) in Fontaine stages IIb through IV and in 47 young and 37 elderly healthy control subjects. Methods and Results Urinary nitrate excretion was 182.0±11.4 μmol/mmol creatinine and cGMP excretion was 186.2±13.0 nmol/mmol creatinine in young healthy control subjects. In elderly control subjects, both excretion rates were slightly lower (nitrate, 156.0±7.8 μmol/mmol creatinine; cGMP, 150.0±8.3 nmol/mmol creatinine; P =NS). In PAOD patients, there was a significant, progressive reduction of urinary nitrate (IIb, 138.4±11.9; III, 128.6±11.3; and IV, 91.9±8.0 μmol/mmol creatinine; P &lt;.05) and cGMP (IIb, 139.9±25.2; III, 115.6±13.1; and IV, 76.9±7.9 nmol/mmol creatinine; P &lt;.05) excretion rates related to the Fontaine stage of PAOD. These changes were independent of changes in renal excretory function. Plasma l -arginine concentrations were not significantly different between the groups, but ADMA concentrations were elevated in PAOD patients (young control subjects, 1.25±0.11; elderly control subjects, 1.01±0.05 μmol/L; IIb, 2.62±0.24; III, 3.06±0.48; and IV, 3.49±0.26 μmol/L; P &lt;.05 for PAOD versus control subjects). There was a significant linear correlation between urinary nitrate and cGMP excretion rates and a significant negative linear correlation between plasma ADMA concentrations and urinary nitrate excretion. Conclusions In PAOD patients, there is a progressive reduction in urinary nitrate and cGMP excretion rates, which may be caused in part by accumulation of ADMA, an endogenous inhibitor of NO synthase.
Gas and liquid reflux during transient lower oesophageal sphincter relaxation
Authors: C P BARHAM, D ALDERSON;, D SIFRIM, J JANSSENS, R H HOLLOWAY, J SILNY
Journal: Gut (1999)

Editor,—We read the paper by Sifrim et al ( Gut 1999; 44 :47–54) with interest. Transient lower oesophageal sphincter relaxations (TLOSRs) have become widely accepted as the cause of most acid reflux episodes in health and disease. It is also accepted that TLOSRs are involved in the belch mechanism. This paper refutes our assertion that the majority of acid reflux events occur in healthy individuals in association with the venting of gas, based on pressure measurements in ambulant subjects.1 2 

The current paper has shown that gas can be detected passing out of the stomach during TLOSRs. The authors found that only 18% of TLOSRs were solely gas reflux and nearly 60% of TLOSRs were associated with liquid reflux alone or neither the reflux of liquid or gas. This implies that spontaneous TLOSR occurs commonly and is not initiated by the fundal stretch “belch” mechanism. We wonder what exact teleological reason there can be for such a phenomenon.

The authors would suggest that in control subjects, acid reflux episodes are more common than simple belching. This seems contrary to …
1110 ROLES OF THE MULTIDRUG RESISTANCE GENE 3 AND PHOSPHOLIPID IN THE PATHOGENESIS OF PRIMARY BILIARY CIRRHOSIS
Authors: M. Nakamuta, Y. Nozaki, T. Yoshimoto, N. Fukushima, K. Fukuizumi, T. Fujino, T. Mizutani, N. Harada, A. Nakajima, M. Enjoji
Journal: Journal of Hepatology (2010)
SOME DISORDERS OF THE ESOPHAGUS
Authors: ARTHUR F. HURST
Journal: JAMA (1934)

The discovery of new clinical syndromes reveals a curious feature of the physician's psychology. As soon as his attention is drawn to the existence of such a syndrome he finds cases with increasing frequency and wonders how such an obvious condition could have escaped his observation in the past. Thus duodenal ulcer was, with few exceptions, never recognized before 1908, when Moynihan at last succeeded in convincing physicians that it was a very common disorder with characteristic symptoms, which Abercrombie had described to an unlistening profession eighty years before. The history of coronary thrombosis is a more recent illustration of the same phenomenon. I propose to discuss here four esophageal syndromes, all of which are still insufficiently recognized, and three of which were quite unknown to me at the time of my last visit to America in 1919. Every physician will, I feel sure, recognize them with increasing frequency during
The Rapid Injection of a Solution of Amino Acids
Authors: Richard D. Eckhardt, Charles S. Davidson
Journal: New England Journal of Medicine (1948)

EXPERIENCE with the parenteral administration of protein hydrolysates of five varieties (four acid and one enzymatically hydrolyzed) has led us to establish certain criteria for an ideal solution. In the first place, it must be shown to be nutritionally adequate by maintaining weight and nitrogen balance in the normal person when used as a sole source of nitrogen, and, in addition, positive nitrogen balance, weight gain and regeneration of serum albumin should be observed in persons depleted of protein. Secondly, side effects — that is, pyrogenic reactions, nausea, vomiting, venous thrombosis and anorexia — should be minimal. Thirdly, the solution . . .
Delayed Pulmonary Toxicity Syndrome following High-dose Chemotherapy and Bone Marrow Transplantation for Breast Cancer
Authors: STEPHEN W. WILCZYNSKI, JEREMY J. ERASMUS, WILLIAM P. PETROS, JAMES J. VREDENBURGH, RODNEY J. FOLZ
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We have intensely followed 45 consecutive women who underwent high-dose chemotherapy (cyclophosphamide/cisplatin/BCNU) and autologous bone marrow transplant (HDC/ABMT) for primary breast cancer with pulmonary function testing and computed tomography at regular intervals up to 126 wk (median follow-up, 72 wk). Our results show a high incidence of interstitial pneumonitis requiring steroids (64%), but no deaths due to pulmonary toxicity. The Dl CO reaches a nadir of 58.2 ± SEM 3.4 (expressed as a percent of baseline value) 15–18 wk following HDC/ABMT, and marginally improves with time. To a much lesser extent, vital capacity is reduced with a parallel drop in FEV1, suggesting mild restrictive changes without significant obstruction. Patients who develop pulmonary symptoms of cough or dyspnea have a corresponding significantly greater and earlier decline in Dl CO. Chest computed tomography was neither sensitive nor specific for diagnosing pulmonary toxicity. For patients who received steroids for pulmonary toxicity, there was a subsequent improvement in Dl CO of 17.1% (p = 0.0001). Because our patients do not fit with the recent definition of idiopathic pulmonary syndrome (IPS), we propose the term delayed pulmonary toxicity syndrome (DPTS) to better describe the milder form of lung toxicity seen in our patient population. We were unable to correlate the severity of DPTS with age, tobacco use, baseline pulmonary function, or systemic exposure to BCNU, cyclophosphamide, or cisplatin. These data suggest that factor(s) other than, or in addition to, chemotherapy systemic exposure can contribute to DPTS. Furthermore, early identification and institution of systemic corticosteroids may improve lung function.
Distribution of plasma cells and other cells containing immunoglobulin in the respiratory tract in chronic bronchitis
Authors: C. A. Soutar
Journal: Thorax (1977)

<b>Soutar, C. A. (1977).</b><i>Thorax</i>, <b>32,</b> 387-396. <b>Distribution of plasma cells and other cells containing immunoglobulin in the respiratory tract in chronic bronchitis</b> A study of the distribution of cells containing immunoglobulin in the respiratory tract in chronic bronchitis has been carried out on necropsy tissues from six subjects who died from complications of severe chronic obstructive bronchitis and five subjects with `incidental9 chronic bronchitis who died from unrelated disease. The results have been compared with previous reported findings in normal subjects. There was a deficiency of IgA cells in all six subjects with fatal chronic bronchitis when compared with normal subjects. The IgA cell counts in the subjects with `incidental9 chronic bronchitis corresponded to normal values for healthy non-smokers and did not share the increased cell counts in lower lobe bronchus occurring in healthy smokers. This work suggests that subjects who die from chronic obstructive bronchitis are deficient in plasma and other cells containing IgA in the respiratory tract, and that subjects with `incidental9 chronic bronchitis are normal in this respect. A preliminary study in which local bronchial secretion of IgA was estimated in the sputum of patients with severe chronic obstructive bronchitis showed that bronchial IgA secretion appeared to be low during acute infections in five out of 14 patients. This finding is consistent with the hypothesis that bronchial IgA secretion is impaired in a proportion of patients with severe chronic bronchitis.
Patterns of endothelial microfilament distribution in the rabbit aorta in situ.
Authors: D W Kim, B L Langille, M K Wong, A I Gotlieb
Journal: Circulation Research (1989)

The available data on F-actin microfilament distribution in vascular endothelial cells in vivo is limited. In this study, the appearance and distribution of endothelial cell microfilaments in the rabbit thoracic aorta, the abdominal aorta and its major arterial branch points, and the aortic bifurcation were examined. Perfusion fixed rabbit aortas were stained in situ for F-actin by infusing rhodamine phalloidin via a peristaltic pump into the aortas at a slow flow rate. This new technique resulted in excellent visualization of branch points and allowed for a precise description of the actin microfilament bundles in endothelial cells along flow dividers. In the thoracic and abdominal aorta, away from branch ostia, actin microfilaments were localized in two regions of the endothelial cells, as a prominent band that completely outlined the cell periphery, and also as short central stress fibers. The central stress fibers were more frequent and prominent in cells of the abdominal aorta. At branch sites and at the aortic bifurcation, long, thick microfilament bundles were present in endothelial cells extending from the tip of the flow divider to a few millimeters along the branch arteries, the aorta, and the iliac arteries. Peripheral actin, however, no longer completely surrounded the cells. The thick bundles were not prominent in endothelial cells located adjacent to the proximal lip of branches or at the iliac arteries opposite the flow divider. This study shows that endothelial cell F-actin microfilament distribution in vivo is well defined along the aortic-arterial system. The prominent central microfilament bundles and the reduced peripheral microfilaments seen at localized regions may reflect an adaptive response to elevated shear stress at these sites.
Play It Again, Sam — Depression Is Recurring
Authors: Burton V. Reifler
Journal: New England Journal of Medicine (2006)

Many years ago I read an editorial, author and journal now forgotten, that included in its title the phrase, "Play it again, Sam" — words attributed to, but never actually spoken by, the character played by Humphrey Bogart in the film Casablanca. I can think of no better phrase by which to emphasize the point of this editorial: again and again, research has shown that depression is an illness with a high degree of recurrence.It is difficult to overstate the effect depression has on health. The World Health Organization lists depression as the leading cause worldwide of years . . .
A Comparison of ^131I Dosage in Hyperthyroid Treatment.
Authors: Robert Miller
Journal: Annals of Internal Medicine (1971)

Meeting Abstracts1 May 1971A Comparison of 131I Dosage in Hyperthyroid Treatment.Robert Miller, M.D., Fuad S. Ashkar, M.D.Robert Miller, M.D.Search for more papers by this author, Fuad S. Ashkar, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-74-5-824_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study was undertaken to determine if there is a therapeutic advantage in calculating the dosage of 131I by formula or administering instead a fixed dosage of radioactive material. One hundred hyperthyroid patients with either Graves' disease, Plummer's disease, or toxic adenomatous disease were selected. The diagnosis was confirmed by 131I uptake and serum thyroxine (Murphy-Pattee) levels. In 60 patients the dose was calculated by using the formulaThe remaining 40 patients all received 5 mc each, regardless of uptake or gland size. All 100 patients were randomly selected into the two groups, and no attempt was made to alter... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Robert Miller, M.D.; Fuad S. Ashkar, M.D.Affiliations: Gainesville and Miami, Fla. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1971Volume 74, Issue 5Page: 824-824KeywordsThyroxine ePublished: 1 December 2008 Issue Published: 1 May 1971 PDF downloadLoading ...
Biological Principles and Modern Practice of Obstetrics
Authors: George D. Wilbanks
Journal: JAMA (1974)

The bright, inviting cover epitomizes the new illustrations, organization, and text of this edition of DeLee's classic. The new title<i>Biological Principles and Modern Practice of Obstetrics</i>indicates the emphasis on the biological basis of pregnancy, yet the book retains the practical aspects of obstetrical practice. Even the old, familiar illustrations seem brighter in this new book. It is well indexed and the references are adequate, but not excessive. Perhaps the strongest section of the book is that concerned with the "Pathology of Labor." Not only are the classic abnormalities of passengers and passages discussed, but also the very important dysfunction of powers. It is here that Dr. Friedman discusses at length his "functional divisions of labor." The reader is transported from the physiologic normal labor curve to the various pathological patterns encountered. One learns how to recognize the abnormal pattern early, to classify the dysfunction, and to treat accordingly.
Clinical Characteristics of Patients Undergoing Surgical Ventricular Reconstruction by Choice and by Randomization
Authors: Marian Zembala, Robert E. Michler, Andrzej Rynkiewicz, Thao Huynh, Lilin She, Barbara Lubiszewska, James A. Hill, Ruzena Jandova, Francois Dagenais, Eric D. Peterson, Robert H. Jones
Journal: Journal of the American College of Cardiology (2010)