tbuckley/cabot-search huggingface dataset:
Notes on an Exceptional Case of Aphasia
Authors: G. E. Paget
Journal: BMJ (1887)

Fortunately for those afflicted with uterine tumours, it now matters little which of the old ways of operation is the best; whether the ovaries can be removed or not, whether the extra-or intra-peritoneal method be the better way of performing hysterectomy, or whether the convalescence lasts in the one case six weeks, or in the other twenty days, the treatment introduced by Dr. Apostoli must take precedence of all others.The success of this treatment is a great fact, aind in saying that I accept toto animno his teachings, I do not speak without some experience of his practice.We have already-my son and I- in scarcely five months, applied electricity in strong, accurately measured doses upwards of 1,200 times, in considerably more than over a hundred patieuts, the majority in cases of uterine fibroids.The labour has not been small-indeed, it has been very hard-and it is not easy to get the scienre of the suhject into an old head.On the other hand, it has opened out a delightful study,.which increases in interest every day the deeper we get into it.When I came back fromn mr,y holiday in the beginning of July, there were waiting for me several cases for hysterectomly or for the removal of the ovaries for bleeding fibroids, and there have been others since.These have all gone home without operation, with menstruation almost normal, and improving after their return, with the tumours in every case reduced in size, with pain gone, and with a freedom to walk about and.enjoy life such as they were loig strangers to.In one case only has, there been a return of hbcmorrhage.The tumour' had gone down two-thirds, she was apparently well, and, unwilling to detain her longer in town, she was allowed to go home too soon.All were more than pleased to have escaped the risks and miseries of a surgical operation that at once put their lives in peril.We-every one of us-consider far too lightly the misery that such operations cost our patients and their friends.Should these improvements be permanent (and we hav6 Dr. Apostoli's word for it that if the treatment be carried out long enough such is generally the case, and, so far, I am able to endorse almost every statement that he has made) it follows that the field for hysterectomy for the removal of ovaries for fibroids is narrowed down to the smallest limits.I have never been in favour of hysterectomy, simply because its death-rate is so high, and because It is perf6rmed for the removal of a tumour that rarely kills.'-So strongly do I now feel on this subject, that ! would consider myself guilty 'of a criminal act were I to aadviso any patient to run the risk of her life-and such a risk-before having given a fair trial to this treatmeint, even were I sure that the mortality wouldl not be greater than that which hySterectomny has given me in my private cases-under 4 per cent.Twenty-Six Cases of Hysterectomy..
A Practical Guide to the Management of the Painful Neck and Back. Diagnosis, Manipulation, Exercises, Prevention
Authors: W. Y. Loebl
Journal: Annals of the Rheumatic Diseases (1978)

the author accepts as a syndrome with high titre of antibodies to ribonucleoprotein and a favourable prognosis.The final chapter deals with immune complex disease and the complement system, followed by an appendix covering immu- nological tests in the rheumatic diseases.The book is well written, clearly set out, very readable, and covers a large field with commendable brevity.
EWS-erg and EWS-Fli1 fusion transcripts in Ewing's sarcoma and primitive neuroectodermal tumors with variant translocations.
Authors: M Giovannini, J A Biegel, M Serra, J Y Wang, Y H Wei, L Nycum, B S Emanuel, G A Evans
Journal: Journal of Clinical Investigation (1994)

We have determined the frequency of EWS fusion transcripts in a series of primary Ewing's sarcomas and peripheral primitive neuroectodermal tumors and cells lines. Type 1 and 2 EWS-Fli1 fusions were demonstrated in 8 cell lines and 14 patient samples. Five patients with cytogenetically characterized rearrangements of chromosome 22 that did not involve chromosome 11 were included in these studies. A novel EWS-Fli1 in-frame isoform fusing EWS to exon 8 of Fli1 was isolated from a tumor with a variant t(12;22;22)(q14;p1;q12) translocation. Three in-frame isoforms of a novel hybrid transcript derived from the fusion of EWS with the ETS domain of the human erg gene were identified in patient samples and a cell line with cytogenetically unidentified or cryptic translocations involving chromosomes 21 and 22. Interphase analysis by fluorescent in situ suppression hybridization using two overlapping erg yeast artificial chromosome clones demonstrated disruption of the erg gene on chromosome 21 in a patient sample with monosomy 22. Our results provide new information about the involvement of EWS in small round cell tumors involving exchange of its putative RNA-binding domain with DNA-binding domains derived from different members of the ETS family of transcription factors. These studies emphasize the utility of reverse transcriptase PCR analysis and fluorescent in situ hybridization as additional diagnostic tools for differential diagnosis among small round cell tumors.
Primary Nerve Suture
Authors: Fritz J. Cramer
Journal: JAMA (1972)

<h3>To The Editor.—</h3> The rationale for immediate primary nerve suture and delayed tendon suture was presented by Rix (<b>217</b>:1864, 1971) and disparaged by Raskind et al (<b>217</b>:1864, 1971). Rix met the objections on two bases. The first was the inadmissibility of evidence concerning the results of nerve suture drawn from collected data of war wounds with that of sharply incised nerves, in civilian circumstances. To this might be added that the nerve branches were monofunctional, sensory (not proximal nerve trunks of mixed motor and sensory functions), also that the transpired time was short and the surgical setting was ideal (unlike conditions prevailing in the evacuation of war wounded), and that the surgeon was experienced, knowledgeable, and, of great importance, he was available. As the second basis for support of the procedure, Rix quotes Seddon, who has subsequently<sup>1</sup>reaffirmed his earlier refutation of the attitude prevailing after World
We mustn't forget other essential health services during the Ebola crisis
Authors: S. L. Nam, K. Blanchet
Journal: BMJ (2014)

<h3>Introduction</h3> Falling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals’ knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people. <h3>Methods and analysis</h3> A randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a wait-list control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants’ confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial. <h3>Ethics and dissemination</h3> The trial protocol was approved by the Human Research Ethics Committee, The University of Sydney, Australia. Trial results will be disseminated via peer reviewed journals, presentations at international conferences and participants’ newsletters. <h3>Trial registration number</h3> Trial protocol was registered with the Australian and New Zealand Clinical Trials Registry (Number ACTRN12614000224628) on 3 March 2014.
Cardiac arrhythmias in the conscious dog after excision of the sinoatrial node and crista terminalis.
Authors: D E Euler, S B Jones, W P Gunnar, J M Loeb, D K Murdock, W C Randall
Journal: Circulation (1979)

A stable junctional rhythm was produced in 16 dogs after surgical excision of the sinoatrial node and a large section of the crista terminalis.An unstable ectopic atrial rhythm appeared within the first week after surgery in 94% of the dogs.The pacemaker instability was characterized by spontaneous pacemaker shifts and periodic episodes of asystole which were prominent for several months after surgery in most of the dogs.In contrast to sinus arrhythmia observed before surgery, the ectopic atrial arrhythmias were not related to the respiratory cycle.The prompt disappearance of the asystoles after atropine or during tread- mill exercise indicated the essential role of the vagus in producing the unstable rhythms.Atropine increased the average rate of the ectopic rhythms from 63 ± 3 beats/min to 107 ± 9 beats/min (p < 0.001) and shortened the corrected recovery time (CRT) following overdrive pacing from 3.8 ± 0.3 seconds to 1.9 ± 0.6 seconds (p < 0.001).Propranolol, in the absence of atropine, decreased the spontaneous heart rate from 56 ± 5 beats/min to 39 ± 6 beats/min (p < 0.01), and increased the CRT to 6.5 ± 2 seconds (p < 0.001) when ad- ministered after atropine.The data suggest that unstable ectopic atrial pacemakers could be responsible for some of the arrhythmias associated with the sick sinus syndrome in man.THE PRODUCTION OF A STABLE junctional rhythm (JR) or ectopic atrial rhythm (EAR) after the removal or suppression of the sinoatrial node (SAN) in acute animal experiments has long been recognized.'However, little is known about the stability of supraventricular subsidiary pacemakers in chronic SAN dysfunction.Depression of automaticity in escape pacemakers has been implicated in the production of arrhythmias associated with the sick sinus syndrome in man.5'I Early experimental studies by Borman and Meek showed that atrial pauses were common for several days after experimental destruc- tion of the SAN by implantation of radon seeds.7In more recent experiments, surgical exclusion of the SAN from the remainder of the right atrium resulted in a transitory period of pacemaker instability after the animals recovered from anesthesia.The instability
Cystic Lesions With Suspected Soft Tissue Infiltration
Authors: Theresia Weber, Alexandra von Baer, Markus Schultheiß, Clemens Maier-Funk, Markus Luster, Thomas F. E. Barth, Bernhard O. Boehm
Journal: JAMA Surgery (2013)

In April 2010, a 19-year-old soccer player presented with a 4-week history of pain after a tap against his right knee. Medical and family histories were unremarkable and no abnormalities were found on physical examination. A radiograph of the right knee showed osteolytic lesions in the distal femur and the head of the tibia. On magnetic resonance imaging, the epiphyseal lesions were visualized as cystic and nonsclerotic and extended to the articular surface of the distal femur and proximal tibia (Figure 1). Soft tissue extension was suspected from the tibia. Laboratory test results showed normal blood cell count, renal function, and concentration of C-reactive protein. Aneurysmatic bone cysts were suspected and a biopsy was performed. Histopathological examination detected spindle cell infiltrates with hemorrhages, fragmented trabecular bone, and numerous osteoclastic giant cells proliferating at a rate of 10% suggesting an aggressive giant cell lesion. Since it was still not determined whether the lesions were malignant, flourodeoxyglucose F 18positron emission tomography/computed tomographywasperformedand foundadditional lesions in the left distal femur and the leftmandible. Biopsyof themandible showed the same type of tissue as seen in the right femur and tibia. Quiz at jamasurgery.com A B
TCT-843 Drug eluting balloon vs drug eluting stent in PCI: insights from a meta-analysis of 1462 patients.
Authors: Alessandro Lupi, Andrea Rognoni, Italo Porto, Gioel G. Secco, Maurizio Lazzero, Pieter R. Stella, Francesco Liistro, Leonardo Bolognese, Angelo S. Bongo, Imad Sheiban, Pierfrancesco Agostoni
Journal: Journal of the American College of Cardiology (2013)
The Auscultatory Gap in Sphygmomanometry
Authors: JOHN MARTIN ASKEY
Journal: Annals of Internal Medicine (1974)

An auscultatory gap in sphygmomanometry is a period of abnormal silence or diminished intensity during one of the Korotkov sound phases. During the silent gap the pulse wave is palpable. The common auscultatory gap occurs in the second or murmur phase. Although recognized clinically a year after Korotkov introduced the auditory method (1906), the clinical importance of the auscultatory gap was not recognized until 1917, when Cook and Taussig emphasized the need for preliminary palpation of the pulse. Failure to determine palpatory pressure could lead to failure to recognize 5% of patients with hypertension. Sporadic reports (1927, 1928) reemphasized the importance of the unrecognized gap in masking hypertension. Another decade passed, however, before official recommendations were made to avoid this pitfall. The gap is recognized only when the point of obliteration of the pulse is determined by palpation prior to deflation of the armcuff.
Nasal polyposis and its impact on quality of life: comparison between the effects of medical and surgical treatments
Authors: I. Alobid, P. Benítez, M. Bernal‐Sprekelsen, J. Roca, J. Alonso, C. Picado, J. Mullol
Journal: Allergy (2005)

Background: Nasal polyposis (NP) is not a life‐threatening disorder but may have a great impact on the quality of life (QoL). The objective of this study: (i) to investigate the health burden incurred by NP compared with the Spanish general population using the Short Form‐36 Health Survey (SF‐36) questionnaire; (ii) to compare the QoL outcome after medical or surgical treatment; and (iii) to assess and compare the effect of medical and surgical treatment on nasal symptoms. Methods: About 109 patients with nasal polyps were included. Fifty‐three patients were randomly allocated to receive oral prednisone for 2 weeks and 56 to undergo endoscopic sinus surgery. All patients administered intranasal budesonide for 12 months. Patients were evaluated for nasal symptoms, polyp size, and QoL. Results: In comparison with the Spanish general population, patients with NP had worse scores on all SF‐36 domains except for physical functioning. Nonasthmatic patients with NP had better QoL than asthmatic patients with NP on role physical functioning, body pain, and vitality ( P &lt; 0.05). At 6 and 12 months, a significant improvement on all of SF‐36 domains was observed after both medical and surgical treatment reaching the levels of general population ( P &lt; 0.05). Nasal symptoms and polyp size improved after both medical and surgical treatment at 6 and 12 months ( P &lt; 0.05). Conclusion: These results suggest that NP has considerable impact on a patient's QoL and that both medical and surgical treatment led to similar effects in improving QoL.
Familial colorectal cancer.
Authors: H J Thomas
Journal: BMJ (1993)

appearance of hepatitis B surface antigen.Only two of these men had been successfully immunised; the only two men who had become carriers of the hepatitis B virus were non- responders to the vaccine.These data must be interpreted in the context of the known relation between disease and age at infection in unimmunised people.Infection in childhood carries the highest risk of persistent viral carriage but a small risk of acute hepatitis.In contrast, adult infection causes acute hepatitis in 30-50% of people but leads to carriage in fewer than 10%.Successful immunisation will not result in persistent protective antibody levels and those exposed to infection may be infected, as shown by anticore seroconversion.This will rarely be associated with acute hepatitis.Despite the loss of antibody it seems that people are still protected against becoming carriers of the virus.Clearly, longer follow up of immunised people is needed to guide policy, but currently no reason exists for recommending booster vaccinations as a public health measure.The medical students who believed that vaccination implied lifelong protection may yet turn out to be right.Whether antibody responses after vaccination should be verified and subsequent decay documented, will depend on local resources and individual decisions by both the vaccinator and the person who has been vaccinated.
Retention or Resumption of Employment After Aortocoronary Bypass Operations
Authors: Alfred J. Anderson
Journal: JAMA (1980)

Employment status and factors related to resumption of employment were studied in 564 male patients one and four years following an aortocoronary bypass operation. For age categories of less than 55, 55 to 59, and 60 years or older at the time of the operation, 90%, 68%, and 44%, respectively, remained employed four years later. Age at the time of the operation, development of angina pectoris after the operation, a previous myocardial infarction, and the physical requirements of the patient's employment were found to be related to the decision not to work four years after the operation. Of patients not employed prior to the operation, 22% were employed four years later. (<i>JAMA</i>243:543-545, 1980)
Factors Affecting Left Ventricular Ejection Fraction Using Automated Quantitative Gated SPECT
Authors: ISIS GAYED, EMMA CID, FERNANDO BOCCALANDERO, DONALD PODOLOFF
Journal: Clinical Nuclear Medicine (2003)

Background Factors affecting the accuracy of left ventricular ejection fraction (LVEF) quantification using automated quantitative gated SPECT have not been adequately investigated in patients in the clinical setting. Therefore, the authors studied the effect of defect size and Tc-99m tetrofosmin dose on the accuracy of LVEF calculation using the automated QGS program. Materials and Methods Thirty-two consecutive patients underwent gated rest and stress myocardial perfusion SPECT after administration of 8 and 27 mCi Tc-99m tetrofosmin, respectively. The LVEF was obtained for both the rest and stress studies using the QGS program and compared with the LVEF obtained using quantitative echocardiography performed within 2 weeks. Myocardial perfusion defects were recorded as scarring, ischemia, or mixed scarring and ischemia in 12 left ventricular segments. The defect size was evaluated by adding the number of affected segments. Results The mean LVEF calculated using high-dose stress QGS, low-dose rest QGS, and echocardiography was 49.2% ± 15%, 46.2% ± 17% and 48.7% ± 16.9% respectively, with no statistically significant differences. The LVEF obtained using high-dose stress QGS correlated better with echocardiography than did that obtained using low-dose rest QGS (r = 0.86 versus 0.76). In addition, when the high-dose stress LVEF in the 14 patients with normal myocardial perfusion was compared with that in 11 patients who had one- or two-segment perfusion defects, and 7 patients who had perfusion defects in ≥ three segments, there was good correlation with echocardiography in the three patient groups (r = 0.85, 0.88, and 0.91, respectively). Conclusions Myocardial perfusion defects do not affect the accuracy of LVEF calculation using automated QGS. High-dose gated myocardial SPECT demonstrated better correlation with quantitative echocardiography LVEF results.
Modified Mediterranean diet and survival
Authors: Emanuele Cereda, Alexis E Malavazos, Carla Favaro, Anna M Pagani
Journal: BMJ (2005)

EDITOR—The EPIC-elderly cohort study was designed to investigate the association between a modified Mediterranean diet and longer life expectancy among an elderly subpopulation (older than 60) that is part of the larger EPIC (European Prospective Investigation into Cancer and Nutrition) cohort.1 2



Focusing the attention on …
Decreased Sarcoplasmic Reticulum Calcium Content Is Responsible for Defective Excitation-Contraction Coupling in Canine Heart Failure
Authors: Ion A. Hobai, Brian O’Rourke
Journal: Circulation (2001)

Background —Altered excitation-contraction (E-C) coupling in canine pacing-induced heart failure involves decreased sarcoplasmic reticulum (SR) Ca uptake and enhanced Na/Ca exchange, which could be expected to decrease SR Ca content (Ca SR ) and may explain the reduced intracellular Ca (Ca i ) transient. Studies in other failure models have suggested that the intrinsic coupling between L-type Ca current ( I Ca,L ) and SR Ca release is reduced without a change in SR Ca load. The present study investigates whether Ca SR and/or coupling is altered in midmyocardial myocytes from failing canine hearts (F). Methods and Results —Myocytes were indo-1–loaded via patch pipette (37°C), and Ca i transients were elicited with voltage-clamp steps applied at various frequencies. I Ca,L density was not significantly decreased in F, but steady-state Ca i transients were reduced to 20% to 40% of normal myocytes (N). Ca SR , measured by integrating Na/Ca exchange currents during caffeine-induced release, was profoundly decreased in F, to 15% to 25% of N. When Ca SR was normalized in F by preloading in 5 mmol/L external Ca before a test pulse at 2 mmol/L Ca, a normal-amplitude Ca i transient was elicited. E-C coupling gain was dependent on Ca SR but was affected similarly in both groups, indicating that intrinsic coupling is unaltered in F. Conclusions —A decrease in Ca SR is sufficient to explain the diminished Ca i transients in F, without a change in the effectiveness of coupling. Therefore, therapeutic approaches that increase Ca SR may be able to fully correct the Ca handling deficit in heart failure.
UTILITY OF HIGH-DENSITY LIPOPROTEIN (HDL) CHOLESTEROL, PARTICLE CONCENTRATION, AND SIZE IN PREDICTING FUTURE MAJOR ADVERSE CARDIOVASCULAR EVENTS AMONG PATIENTS UNDERGOING ANGIOGRAPHY: THE INTERMOUNTAIN HEART COLLABORATIVE STUDY
Authors: Heidi Thomas May, Jeffrey Anderson, Deborah Winegar, Jeffrey Rollo, Margery Connelly, James Otvos, J. Muhlestein
Journal: Journal of the American College of Cardiology (2014)
THE SIGNIFICANCE OF THE POSITION OF A "CONTRACTION RING": In Cases of Extreme Pelvic Contraction with Vertex Presentation
Authors: C. D. Lochrane
Journal: BMJ (1920)

A4,RNG of contracted uterine musc'lature is liable to form i41.the region of the juion on. of the upper and lowet qfterine segments in delayedlab6ur.O,.Je of the commonest conditions in which delay occurs ine¢onitracted pelvis.When, in: ddition to a marked degree Qf pelvic contraction, the fet1is presents by the vertex, th'q site of this ring, in relation' to'1the fetal parts, is of con- siderable importanco, both froin the point of view of etiology and of treatment.;In obstructed labour -due'' to'con'tracted pelvis with a vertex presentation it is at least doubtful if a true " retraction " (Bandl) ring can form before sufficient upper uterine segment retraction has occurred to elevate the site oft the ring above the level .oefthfetal.shoulders.But case are -occasionally seen i-in wlich the formation of a: "ring> has become so marked before this stage, that iti:X found constricting the fetai neek more or less closely.The trunk a,nd limbs .of the fetus.are then imprisoned abote the r'ing in an unretracted, but .oftenapparently tonically conti acted, upper uterine segment.With a