tbuckley/cabot-search huggingface dataset:
Abstract 1753: Lower Procedural Success and Higher Complications in Octogenarians with STEMI Referred for Emergency Cardiac Catheterization: Results from the American College of Cardiology - National Cardiovascular Data Registry (ACC-NCDR®)
Authors: Jeptha P Curtis, Yongfei Wang, Saif S Rathore, Andrew Epstein, Brahmajee Nallamothu, John Rumsfeld, Harlan M Krumholz
Journal: Circulation (2006)

Background : Primary PCI has become the treatment of choice for patients with ST segment elevation myocardial infarction (STEMI), but the effectiveness of implementing a strategy of emergency catheterization and primary PCI in octogenarians is not known. We hypothesized that older patients would have more severe coronary disease, lower procedural success, and higher rates of procedural complications that might ultimately reduce the effectiveness of this strategy.  Methods: We identified all STEMI patients in the ACC National Cardiovascular Data Registry Cath/PCI registry who underwent emergency catheterization in 2005. Patients transferred from another hospital, with prior CABG, or who received fibrinolytic therapy were excluded. We examined characteristics and presenting cardiac status, and compared coronary anatomy, rates of primary PCI, procedural complications, and in-hospital outcomes of patients ≥ 80 years with patients aged   Results: Of the 19,229 patients eligible for analysis, 1,904 (10.0%) were ≥ 80. Octogenarians were more likely than younger patients to present with heart failure or cardiogenic shock and have left main or 3 vessel disease (all P   Conclusions: In this unselected cohort of STEMI patients referred for emergency catheterization, octogenarians were less likely to have anatomy amenable to PCI, less likely to achieve TIMI 3 flow, and at higher risk of procedural complications. These factors contribute to the higher in-hospital mortality and highlight the need for additional studies to determine the benefits of primary PCI in this vulnerable population.
Review of medical provision in English ice hockey
Authors: K Cady, K Evans, S Bourgein
Journal: British Journal of Sports Medicine (2010)

Ice hockey is the world's fastest sport played on two feet, with players reaching in excess of 35 mph forwards, and 15 mph travelling backwards. The high intensity intermittent skating, combined with rapid changes in velocity and frequent body contact, indicate a high injury potential. English Ice Hockey Association (EIHA) and Ice Hockey UK organise and regulate the sport, including the implementation of medical procedures. The aim of this study was to investigate the current level of provision of first aid in English Ice Hockey from grass roots to semiprofessional level. A total of 18 medical staff completed a questionnaire regarding their role as first aiders in an EIHA registered team. A second questionnaire was issued to 116 players and parents competing in an EIHA recognised league regarding their perception of medical provision in the sport. Results show that 88% of medical staff and 55% of players/parents believed the current medical provision to be insufficient. Of the 18 medical staff, half were graduate sports therapists, two were physiotherapists and nine had attended the EIHA Ice Hockey First Aid course. None of the medical staff had a written job description and only 78% had attended relevant continuing professional development in the last 12 months. 94% of home fixtures were attended by medical staff, compared to 77% of away fixtures. Regarding medical staff appointments, “personal contact” was the most popular method of appointment with interviews or adverts for job vacancies the least popular. In conclusion, evidence suggests the affiliated medical person are sufficiently qualified to provide first aid for ice hockey, but the regularity and methods by which the medical staff are appointed needs to be reviewed. The EIHA Ice Hockey First Aid course has influenced the number of first aiders working in the sport with 50% of staff questioned possessing the qualification.
Biopsy in Syphilitic Proctitis
Authors: Roger J. Lewis
Journal: JAMA (1975)

To the Editor.—  Nazemi et al described Syphilitic Proctitis in a Homosexual (231:389, 1975). They say, reasonably, that proctoscopy is necessary with a dark-field examination of exudates from the  They go on to state, Biopsy is, of course, necessary for differentiation of malignant, fungal, tuberculous, or other granulomatous and inflammatory lesions.  I take issue with this statement, for biopsy is not a wholely benign procedure. Follow-up examination with proctoscopy after adequate antibiotic therapy for syphilis should establish whether the lesion persists. If it does, then biopsy would be indicated.
Germany plans law to limit hospital rooms to two beds
Authors: A. Tuffs
Journal: BMJ (2011)

German patients who have to share a hospital room with more than two other patients should be offered a discount as a way to improve the quality of care, an MP has suggested in a new draft bill.

Jens Spahn, a health spokesman for the Christian Democrats, the major partner in Germany’s ruling coalition, also proposes that the law on the quality of care should include a target maximum waiting time of three weeks to see a GP or a non-hospital specialist and that health …
The use of pioglitazone and the risk of bladder cancer in people with type 2 diabetes: nested case-control study
Authors: L. Azoulay, H. Yin, K. B. Filion, J. Assayag, A. Majdan, M. N. Pollak, S. Suissa
Journal: BMJ (2012)

To determine if the use of pioglitazone is associated with an increased risk of incident bladder cancer in people with type 2 diabetes.Retrospective cohort study using a nested case-control analysis.Over 600 general practices in the United Kingdom contributing to the general practice research database.The cohort consisted of people with type 2 diabetes who were newly treated with oral hypoglycaemic agents between 1 January 1988 and 31 December 2009. All incident cases of bladder cancer occurring during follow-up were identified and matched to up to 20 controls on year of birth, year of cohort entry, sex, and duration of follow-up. Exposure was defined as ever use of pioglitazone, along with measures of duration and cumulative dosage.Risk of incident bladder cancer associated with use of pioglitazone.The cohort included 115,727 new users of oral hypoglycaemic agents, with 470 patients diagnosed as having bladder cancer during follow-up (rate 89.4 per 100,000 person years). The 376 cases of bladder cancer that were diagnosed beyond one year of follow-up were matched to 6699 controls. Overall, ever use of pioglitazone was associated with an increased rate of bladder cancer (rate ratio 1.83, 95% confidence interval 1.10 to 3.05). The rate increased as a function of duration of use, with the highest rate observed in patients exposed for more than 24 months (1.99, 1.14 to 3.45) and in those with a cumulative dosage greater than 28,000 mg (2.54, 1.05 to 6.14).The use of pioglitazone is associated with an increased risk of incident bladder cancer among people with type 2 diabetes.
The Prophylactic Use of Cephalosporins for Surgery
Authors: Bruce L. Moskovitz
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Drs DiPiro, Bowden, and Hooks<sup>1</sup>are correct in their conclusion that there is no evidence to suggest that the prophylactic use of second- or third-generation cephalosporins results in postoperative infection rates lower than those with first-generation cephalosporins. Nonetheless, strong arguments can be made for the adoption of new antimicrobials for particular surgical procedures. Because of their extended half-lives, some of these agents may be administered as a single preoperative dose, thereby effecting substantial savings over a perioperative, multi-dose regimen, as is necessary with "older" agents. One possible added benefit would be the presence of adequate drug concentrations even if surgery were delayed following drug administration. The choice of antimicrobial prophylaxis should be tailored to cover those organisms that have been implicated in producing postoperative infections in the particular hospital. In this regard, some hospitals report a rise in the frequency of infections due to the Enterobacteriaceae
The linearity of the end-systolic pressure-volume relationship in man and its sensitivity for assessment of left ventricular function.
Authors: H C Mehmel, B Stockins, K Ruffmann, K von Olshausen, G Schuler, W Kübler
Journal: Circulation (1981)

The linearity and sensitivity of the end-systolic pressure-volume (P-Ves) relation to the inotropic state of the left ventricle were investigated in 11 patients with coronary heart disease and one patient with congestive cardiomyopathy. To minimize autonomic reflex responses, propranolol, 0.15 mg/kg, and atropine, 1 mg, were administered i.v. at the beginning of the study. Three ventriculograms were performed: at rest, after oral isosorbide dinitrate, 10 mg (systolic pressure decrease greater than or equal to 15 mm Hg), and during infusion of methoxamine, 2 mg/min (systolic pressure increase greater than or equal to 10 mm Hg). The three points of the Pv-Ves relation showed linearity (r greater than or equal to 0.96). The relation between the slope k of the P-Ves relation and the left ventricular ejection fraction at rest was best described by an exponential function (r = 0.94). The use of peak systolic pressure instead of end-systolic pressure showed equally good results. The intercept of the P-Ves line on the abscissa, which represents the theoretical end-systolic volume at zero pressure, was not related to the ejection fraction under control conditions. The P-Ves relation in postextrasystolic beats was displaced toward the left (smaller end-systolic volumes) and became steeper.
Mechanism of Cytotoxicity by Natural Killer (NK) Cells
Authors: R B Herberman, C W Reynolds, J R Ortaldo
Journal: Annual Review of Immunology (1986)

Exhausted CD8 T (Tex) cells are a distinct cell lineage that arise during chronic infections and cancers in animal models and humans. Tex cells are characterized by progressive loss of effector functions, high and sustained inhibitory receptor expression, ...Read More
Catchment areas in general practice and their relation to size and quality of practice and deprivation: a descriptive study in one London borough
Authors: C. Jenkins, J. Campbell
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To relate the sizes of general practice catchment areas in one London borough to list size, deprivation payments, medical staffing, and locally and nationally recognised measures of quality. <b>Design</b>: Study of general practice catchment area maps. <b>Setting</b>: London borough of Lambeth. <b>Subjects</b>: 60 out of the 71 general practices in Lambeth. <b>Main outcome measures</b>: Practice catchment area size with corrections for numbers of doctors and patients. <b>Results</b>: Catchment area size varied greatly between practices, showing an almost 150-fold difference between the largest and smallest practices. This size differential was even more marked when the size of the catchment area was corrected for the number of general practitioners in the practice, where a 300-fold difference was found. Substantial differences existed between practices in each of the four locally assigned quality bands. The weakest practices had catchment areas three times as large as those of the strongest practices. When corrected for medical staffing, the difference was eight times as great. A calculated measure of patient dispersion showed that the practice population of the strongest practices was four times as densely clustered as that of the weakest practices, whose patients were more widely geographically dispersed. <b>Conclusions</b>: Large variations exist in the size of catchment areas of inner city practices even when corrected for numbers of doctors and patients. These differences are associated with variations in quality of care. <h3>Key messages</h3> The organisation and distribution of catchment areas in general practice have received little attention Data from general practices in one inner London borough were used to investigate the relation between catchment area size and a range of practice characteristics. The variation in size of catchment areas between practices was large, even when corrected for medi- cal staffing and practice list size An inverse relation was reported between the quality of service provision and the size of the catchment area
THE PRESENT USE OF ELECTROCONVULSIVE THERAPY
Authors: R.D. Weiner, M.D, A.D. Krystal, M.D
Journal: Annual Review of Medicine (1994)

▪ Abstract Physicians attempting to treat certain severe mental disorders have recently shown renewed interest in electroconvulsive therapy (ECT). A number of technical innovations have made ECT safer, as well as more effective. These innovations include oxygenation, muscular relaxation, unilateral nondominant electrode placement, use of brief-pulse stimuli, titrated stimulus dosing, electroencephalographic (EEG) monitoring, determination of seizure adequacy, and pharmacologic enhancement of treatment response.
Treatment of Status Epilepticus-Reply
Authors: Edwin Dodson
Journal: JAMA (1994)

<h3>In Reply.</h3> —Drs Slovis and Wrenn posit that in hypoglycemic patients glucose administration should not be delayed until after thiamine administration because they feel that thiamine deficiency is rare and its neurological consequences take time to develop, whereas the hazards of hypoglycemia are immediate. They are probably correct if thiamine cannot be given quickly, but as a general recommendation, thiamine should be readily available in emergency departments for quick intravenous administration. There are no randomized, controlled studies comparing outcomes after giving one or the other first, and such a study would be very difficult to do. However, if thiamine can be given without undue delay, it should be administered first. Thiamine is indicated in status epilepticus whenever glucose is indicated because alcoholism is a relatively common cause of convulsive status in adults. Administering thiamine begins to reverse the consequences of thiamine deficiency quickly.<sup>1,2</sup>Thiamine deficiency is more prevalent than
Reviews, Notes, and Listings: Principles and Practice of Pain Management
Authors: Michael Von Korff
Journal: Annals of Internal Medicine (1993)

Literature of Medicine1 October 1993Reviews, Notes, and Listings: Principles and Practice of Pain ManagementMichael Von Korff, MDMichael Von Korff, MDHealth Cooperative of Puget Sound, Seattle, WA 98101.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-7_Part_1-199310010-00038 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Principles and Practice of Pain ManagementFirst edition. Carol A. Warfield; ed. 552 pages. New York: McGraw-Hill; 1993. $79.00.The scientific study of pain has led to innovations in the practice of medicine, including patient-controlled analgesia, improved palliative care of patients with advanced cancer, and simple monitoring of the adequacy of pain management on the hospital ward by asking patients to rate their pain on a 0 to 10 or verbal descriptor scale. Progress in scientific understanding of pain mechanisms and control will increasingly require physicians to keep abreast of developments in the principles and practice of controlling pain and restoring function.Although ... Author, Article, and Disclosure InformationAffiliations: Health Cooperative of Puget Sound, Seattle, WA 98101. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1993Volume 119, Issue 7_Part_1Page: 640KeywordsAnalgesiaHospital medicinePainPain managementPalliative carePatientsPelvisPeripheral neuropathyPsychologyThorax ePublished: 15 August 2000 Issue Published: 1 October 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Metabolic clearance of biologically active luteinizing hormone in man.
Authors: J D Veldhuis, F Fraioli, A D Rogol, M L Dufau
Journal: Journal of Clinical Investigation (1986)

The plasma metabolic clearance of biologically active luteinizing hormone (bioactive LH) was studied using the rat interstitial cell testosterone (RICT) bioassay in six hypogonadotropic men after single bolus injection of highly purified human LH and during continuous steady-state infusions of three graded doses of LH. The LH bolus disappearance curves provided estimates of metabolic clearance rates (MCR) of 24.1 +/- 4.7 (+/- SD) ml/min for bioactive LH vs. 56.2 +/- 12 ml/min for immunoactive LH in the same men (P = 0.03). A lower MCR of bioactive LH compared with immunoactive LH was also observed during continuous infusions of physiological doses of LH; for example, the mean steady-state MCRs for bioactive and immunoactive LH were, respectively, 26.1 +/- 3.1 and 34.2 +/- 3.2 ml/min (P = 0.02). Moreover, the stepped-dose infusion regimens permitted us to demonstrate that increasing doses of pure human LH resulted in progressive and parallel decreases in the apparent MCRs of both bioactive and immunoactive LH. Based on the respective steady-state MCRs calculated at physiological plasma concentrations of immunoactive and bioactive LH, we estimate a mean endogenous production rate for bioactive hormone of 1,937 IU/24 h, and for immunoactive LH of 589 IU/24 h in normal men. These results indicate that previous estimates of LH production rates from immunoassay data alone markedly underestimate the quantity of biologically active hormone secreted in man.
Therapeutics: From the Primitives to the 20th Century
Authors: Lester S. King
Journal: JAMA (1974)

Ackerknecht believes that "the new era in medicine, beginning in the 1930's, is an era of therapeutics." In the 19th century some truly effective remedies appeared, such as synthetic drugs and the beginning of serum therapy and hormone therapy. Following this, the rapid progress in the 20th century is well known, but in the earlier periods the therapeutics comprised a melancholy story. Ackerknecht concentrates on the absurdities, lack of logic, magical practices, superstition, polypharmacy and bloodletting, with occasional grudging admiration for a few physicians, discussed in some detail. Unfortunately, Ackerknecht does not provide any sort of conceptual background or sense of development. The book is not really<i>history</i>, as many historians like to understand the term. Rather is the book a chronologically arranged compendium of facts and assertions (not always accurate) and criticisms (not always valid), all presented in a fashion quite condescending and supercilious towards earlier times. A few
MERBAPHEN (NOVASUROL) AS A DIURETIC IN CONGESTIVE HEART FAILURE
Authors: H. M. MARVIN
Journal: JAMA (1926)

Merbaphen (novasurol), a double salt of sodium oxymercurichlorphenyl oxyacetate with diethylbarbituric acid, was introduced in Germany nearly a decade ago for the treatment of syphilis.<sup>1</sup>It contains approximately 34 per cent of mercury, but is administered in the form of a 10 per cent solution by intramuscular or intravenous injection. Its diuretic value was first pointed out by Saxl and Heilig,<sup>2</sup>and in the five years since the appearance of their paper the drug has been employed chiefly as a diuretic rather than as an antisyphilitic. Their report was soon followed by many others,<sup>3</sup>all of them emphasizing the extraordinary diuresis which often followed the administration of merbaphen, and many of them asserting that it is superior to all other diuretics, as indicated by its effects in patients who had failed to respond to the drugs customarily used. Burwinkel alone of those quoted voices a more conservative
Coinheritance ofBRCA1 andBRCA2 mutations with Fanconi anemia and Bloom syndrome mutations in Ashkenazi Jewish population: Possible role in risk modification for cancer development
Authors: M. Koren-Michowitz, E. Friedman, R. Gershoni-Baruch, F. Brok-Simoni, Y. Patael, G. Rechavi, N. Amariglio
Journal: American Journal of Hematology (2005)

Fanconi anemia (FA) and Bloom syndrome (BS) are rare autosomal recessive genetic disorders manifesting in childhood, with a predisposition to cancer development in adolescence and adulthood. Both syndromes are relatively prevalent among the Ashkenazi Jewish population, and, in both syndromes, mutations specific to this population have been identified. Similarly, unique Ashkenazi mutations were found in the genes BRCA1 and BRCA2. These two genes, when mutated, play important roles in familial breast and ovarian carcinogenesis. The genes involved in the pathogenesis of the FA and BS belong to the general class of instability genes. Heterozygosity for the FA gene has no known promalignant potential, while the BS mutation carrier state was associated with an increased frequency of colorectal cancer. The especially frequent carrier state among the Ashkenazi Jewish population coupled with the high prevalence of BRCA1 and BRCA2 in the same population has led us to search for coinheritance affecting the potential for cancer development. One hundred Ashkenazi women with known BRCA1 and BRCA2 mutations were screened for the FA mutation IVS4+4 A-->T and the BS mutation blm(Ash). Our results indicate that there is an increased prevalence of both FA and BS mutation carriers among the population studied compared with the general Ashkenazi population (prevalence of FA mutation 4/100 women [4%] as compared to 35/3104 previously published controls [1.1%], P=0.031, and for BS mutation 3/100 [3.2%] as compared to 36/4001 [0.9%], P=0.058). There was no statistically significant effect of the coinheritance on cancer prevalence, type of cancer, or age of cancer onset. Coinheritance of FA and/or BS mutations seems to be more prevalent among BRCA mutation carriers, but a larger study encompassing more women may help in clarifying this issue.
DNA Double-Strand Break Repair of Blood Lymphocytes and Normal Tissues Analysed in a Preclinical Mouse Model: Implications for Radiosensitivity Testing
Authors: Claudia E. Rübe, Saskia Grudzenski, Martin Kühne, Xiaorong Dong, Nicole Rief, Markus Löbrich, Christian Rübe
Journal: Clinical Cancer Research (2008)

Radiotherapy is an effective cancer treatment, but a few patients suffer severe radiation toxicities in neighboring normal tissues. There is increasing evidence that the variable susceptibility to radiation toxicities is caused by the individual genetic predisposition, by subtle mutations, or polymorphisms in genes involved in cellular responses to ionizing radiation. Double-strand breaks (DSB) are the most deleterious form of radiation-induced DNA damage, and DSB repair deficiencies lead to pronounced radiosensitivity. Using a preclinical mouse model, the highly sensitive gammaH2AX-foci approach was tested to verify even subtle, genetically determined DSB repair deficiencies known to be associated with increased normal tissue radiosensitivity.By enumerating gammaH2AX-foci in blood lymphocytes and normal tissues (brain, lung, heart, and intestine), the induction and repair of DSBs after irradiation with therapeutic doses (0.1-2 Gy) was investigated in repair-proficient and repair-deficient mouse strains in vivo and blood samples irradiated ex vivo.gammaH2AX-foci analysis allowed to verify the different DSB repair deficiencies; even slight impairments caused by single polymorphisms were detected similarly in both blood lymphocytes and solid tissues, indicating that DSB repair measured in lymphocytes is valid for different and complex organs. Moreover, gammaH2AX-foci analysis of blood samples irradiated ex vivo was found to reflect repair kinetics measured in vivo and, thus, give reliable information about the individual DSB repair capacity.gammaH2AX analysis of blood and tissue samples allows to detect even minor genetically defined DSB repair deficiencies, affecting normal tissue radiosensitivity. Future studies will have to evaluate the clinical potential to identify patients more susceptible to radiation toxicities before radiotherapy.