tbuckley/cabot-search huggingface dataset:
Fluphenazine enanthate in the maintenance treatment of schizophrenia.
Authors: H. Palmer
Journal: BMJ (1968)

JUNWales 44% of the men and 56% of the women who committed suicide used coal gas.McCulloch, Philip, and Carstairs (1967)2 re- ported that of the 216 suicides in Edinburgh in the years 1963-5 40% were due to coal gas, the proportion being the same for both sexes.Your opening sentence should thus have referred to common methods in com- pleted suicides.The last paragraph of your leading article indicates that the neurological prognosis of patients who have inhaled carbon monoxide is generally good, and with this we would agree; but you close with the sentence: " It is a paradox that many patients might not wish it so."You have failed to appreciate that the vast majority of poisoned patients do not wish to kill themselves, and the motive is unknown for many who die.Kessell pro- posed the term " self-poisoning " as being more appropriate than " attempted suicide," as he considers the latter not only misleading but positively wrong.If these acts have a purpose it is nearly always to alter the social situation, rather than self-destruction.-Weare, etc.,
Glutathione Peroxidase 1 Activity and Cardiovascular Events in Patients with Coronary Artery Disease
Authors: Stefan Blankenberg, Hans J. Rupprecht, Christoph Bickel, Michael Torzewski, Gerd Hafner, Laurence Tiret, Marek Smieja, François Cambien, Jürgen Meyer, Karl J. Lackner
Journal: New England Journal of Medicine (2003)

Cellular antioxidant enzymes such as glutathione peroxidase 1 and superoxide dismutase have a central role in the control of reactive oxygen species. In vitro data and studies in animal models suggest that these enzymes may protect against atherosclerosis, but little is known about their relevance to human disease.
Bronchography in Children
Authors: M. Bates, I. C. W. English, H. M. Foreman, T. M. Wilson
Journal: Thorax (1951)

To produce satisfactory bronchograms in children is generally considered difficult.Most children under the age of 12 years require a general anaesthetic before the procedure is possible, and in the past this has often detracted from the quality of the bronchograms.We have gradually evolved a technique using general anaesthesia by which con- sistently satisfactory bronchograms are obtained.The method is safe, free from complications, and causes the minimum of physical or mental upset to the child.TECHNIQUES Techniques for bronchography in children can be divided into those done under (1) local anaesthesia, (2) general anaesthesia, and (3) a combination of local and general anaesthesia.(1) Methods using Locail Anaesthesia.-Theopaque oil is instilled through the nose after the nose, pharynx, and larynx have been anaesthetized.The co-operation of the child is essential, and is difficult to obtain.One cannot ensure in any case that the oil will pass into the trachea, and the dosage of oil for each lobe is there- fore difficult to judge.Another disadvantage is that the child has an anaesthetized larynx for about two and a half hours after the operation, and eating and drinking have to be guarded against during that period.A needle is passed into the trachea through the crico-thyroid membrane under local anaesthesia.The use of a needle exposes the child to a risk of infection through the puncture and surgical emphysema, locally or in the mediastinum.The insertion of a needle is a frightening procedure, and the co-operation of the child is therefore doubly difficult to obtain.If the child is co-operative these techniques have the advantage of being less complicated, no skilled anaesthetist is needed, and the child can voluntarily stop breathing when the radiographs are to be taken.(2) Methods under General Anaesthesia.-Theseme:hods usually rely on com- plete relaxation under deep anaesthesia, which often implies heavy preliminary sedation, for example, with avertin, and a long post-operative recovery period.Jacoby and Keats (1938) use deep anaesthesia with open ether and instil the opaque oil into the pharynx so that it will run over from the pyriform fossae into the larynx and trachea.The authors themselves say that occasionally broncho- graphy has to be abandoned because of cough and excess bronchial secretion.We think that the deficiencies of this method are the lack of direct control of the airway, no assurance that the oil will pass into the trachea, and no provision for removing on July 22, 2023 by guest.
TCTAP C-190 Endovascular Repair of Abdominal Aortic Aneurysm Combined with Huge Bilateral Iliac Arterial Aneurysms with Custom-Made Branched Stent Graft
Authors: Pyung Chun Oh, Woong Chol Kang, Myeong Gun Kim, Eak-Kyun Shin
Journal: Journal of the American College of Cardiology (2015)
Massive gastrointestinal bleeding in Crohn's disease: successful control by intra-arterial vasopressin infusion
Authors: J A Mellor, G N Chandler, A H Chapman, H C Irving
Journal: Gut (1982)

A case of massive lower gastrointestinal bleeding from Crohn9s disease is reported. This is an uncommon complication of the disease and the literature is reviewed. Successful control of gastrointestinal bleeding by intra-arterial vasopressin infusion has not previously been reported in Crohn9s disease. We suggest that this technique may be used in an attempt to avoid surgery.
Noninvasive identification of myocardium at risk in patients with acute myocardial infarction and nondiagnostic electrocardiograms with technetium-99m-Sestamibi.
Authors: T F Christian, I P Clements, R J Gibbons
Journal: Circulation (1991)

BACKGROUND Patients who have chest pain without electrocardiographic ST elevation are not candidates for thrombolytic therapy in most clinical trials. This study examined the value of technetium-99m-Sestamibi tomographic imaging to assess myocardial perfusion in patients during chest pain without ST elevation. METHODS AND RESULTS Tc-99m-Sestamibi was injected in 14 patients who had chest pain without ST elevation, who subsequently developed enzymatic evidence of myocardial infarction within 24 hours. Tomographic imaging was performed 1-6 hours after injection. Thirteen of 14 patients showed significant perfusion defects indicative of acute myocardial infarction consistent with absent perfusion (20 +/- 15% of the left ventricle; range, 2-53%); one patient had normal images. Because of the absence of definitive electrocardiographic changes, only five patients received reperfusion therapy within 6 hours of the onset of chest pain. Regional wall motion abnormalities were present in nine of nine patients undergoing contrast ventriculography and correlated with the location of the Tc-99m-Sestamibi perfusion defect. At the time of subsequent coronary angiography, total arterial occlusion was present in 11 of the 14 patients. The infarct-related artery could be identified in 13 of the 14 patients. In six of these 13 patients, the left circumflex was the infarct-related artery. CONCLUSIONS Patients who have chest pain without electrocardiographic ST elevation may have arterial occlusion and significant myocardium at risk. Tc-99m-Sestamibi imaging may be of benefit in identifying these patients early so that they can be considered for acute reperfusion therapy.
Whose Degree Is Best?
Authors: Amos R. Koontz
Journal: JAMA (1964)

<h3>To the Editor:—</h3> InThe Journalof Feb 15, 1964 (<b>187</b>:543) a letter from Walter Chizinsky, PhD, states that the PhD is the highest academic degree. By whose authority? Chizinsky's? Academic degrees are conferred at university commencements in the order of their rank, from the lowest to the highest. For years at Johns Hopkins commencements, the MD degrees were conferred last—after the PhD's. Both were based on the foundation of a bachelor's degree. It took four years after the bachelor's degree to get the MD, whereas the PhD could be obtained in three years ( sometimes less). If one makes a distinction between academic degrees and professional degrees (an academic distinction!) Dr. Chizinsky's contention is correct. The value or rank of an academic degree does not depend upon its name but upon its content. Undoubtedly, some PhD's are worth more than some MD's. The contrary is also the case. There
The Midnight Meal and Other Essays About Doctors, Patients, and Medicine
Authors: Joseph S. Alpert
Journal: JAMA (1997)

Dr Jerome Lowenstein is a professor of medicine and codirector of the Hypertension and Renal Disease Section at New York University Medical Center. He has trained and worked at that hospital and its sister institution, Bellevue Hospital, for more than 40 years. Since 1979, he has been involved in a seminar, the Program in Humanistic Medicine, which seeks to sensitize thirdand fourth-year medical students to various personal and psychological aspects of their patients, their work, and their eventual careers. Lowenstein's short book of essays contains reflections gleaned from almost 20 years of discussions with medical students and residents involved in the Program in Humanistic Medicine. The "midnight meal" of the title refers to the shared midnight snack supplied to house officers on call by teaching hospitals in an earlier era. Not surprisingly, many of these essays deal with techniques and thought processes that preserve patient and physician humanity and dignity
TREATMENT OF TUBERCULOSIS OF BONES AND JOINTS
Authors: G. R. Girdlestone
Journal: BMJ (1924)

length of history of ulcer symptoms.Here the tobacco factor nmuist be allowed for.Thus, if those witlh a history of one y-ear and under be coml)ared with those who have suffered for over two years, ther e is some evidence that earlier treatment is likely to yield the best results.For in the first class 71 per cent.were cured (tobacco was a factor in onily 20 per cent.);whereas in the second class 52 per cent.were cnired (tobacco influenced the result in 38 per cent.).There w-ere no recurrences in the first group and 10 per cenit.in. the second, in 5 per cent. of which tobacco may he blamed.The failur-es wer-e 5 to 7 per cent.; and w-hereas tobacco could fairly be held responsible in all of the first gr-oup, n1o such influenice could be traced in the second.Gastro-enterostomy forms an essential part of the treat- ment of the ulcer in the majority of cases, as it pelrnits regurgitation of bile and diminishes intragastric anid duo- denal tenision, and the ulcer should be invaginated wheniever possible.In the thin type the associated remedy of meseni- teric and peritoneal abnormalities is indicated.In all types the rleduction of or abstinence from tobacco is essenitial.CoNCLUSIONS.The predisposition to duodenal ulcer consists in the rela- tive inierease of the nolmal vagus stimulation, wihich estab- lishes the " duodenial stomach."Totacco is the ouitstanding cause.Factors whichl may excite ulceration in sucll a type of stomaclh are: (1) acid, (2) distension, (3) trauma, (4) inifection, and possibly (5) alcohol; the effect of all these in pr-oduicing ulceratioii is accentuated by aii inicompetent pylorus.Any combiniation of these exciting factors mav determiinle ulcer formatioin in such a type of stomach; but in the " sympathetic type " with the closed pylorus (the aniti- thesis) a gastric ulcer is the more probable result.I should like to express my gratitude to many colleagues who have allowed me free access to the notes of their cases; and to add that in this study percentages have onily been adopted as the simplest means of comparison.
Temporary inhibition of permanently implanted demand pacemakers.
Authors: P Latif, G A Ewy
Journal: Circulation (1977)

Temporary inhibition of permanently implanted demand pacemakers has been previously described. Demand pacemakers may be inhibited by waving a magnet over the region of the pacemaker generator or by chest wall stimulation. The former may not inhibit most of the bipolar pacemakers, whereas the latter may be time consuming and may casue patient discomfort. Another method is described which utilized a commercially available Cordis Omnicor Programmer, Model 166-B, to temporarily inhibit bipolar and unipolar pacemakers. By placing the programmer over the skin where the pacemaker generator is implanted and/or over the area of the subcutaneous pervenous lead and activating the programmer multiple times at a rate faster then the pacing rate, the demand pacemakers are inhibited. After testing the efficacy in vitro, the method was successfully tried on 45 patients. Fifteen of these patients had unipolar pacemakers. Pacemakers marketed by Medtronic, Cordis, Starr-Edwards, C.P.I., and Arco were tested. Temporary inhibition of permanent demand pacemakers is desirable under various clinical situations. The method herein described has the advantages of being simple, quick, painless, and is effective for both unipolar and bipolar pacemakers.
Options to Control the Health Care Costs of the Elderly
Authors: Richard F. LeBlond
Journal: JAMA (1989)

<h3>To the Editor.—</h3> I concur with Dr Schneider' that the use of age as a criterion for the rationing of health care is misdirected. The problems that face the elderly today are chronic and incurable though treatable, such as coronary artery disease, peripheral vascular disease, stroke, chronic dementing illnesses such as Alzheimer's disease, other neurological diseases such as Parkinson's disease, and disabling syndromes of the musculoskeletal system, particularly osteoporosis. Unfortunately, Dr Schneider uses as examples two infectious diseases, tuberculosis and poliomyelitis. As those of us who practice medicine are well aware, infectious diseases frequently are curable (tuberculosis) or preventable (polio). The chronic diseases previously enumerated are neither curable nor likely to be preventable with a program as cost-effective as vaccination. A more appropriate example would be coronary artery disease. Increased understanding of the etiology, pathogenesis, and treatment of coronary artery disease has led to a decline in the mortality rate
Emergency dental care in east London.
Authors: J L Carter
Journal: BMJ (1993)

Fresh frozen plasmaUsefil as a volume expander in children EDITOR,-We welcome Hannah Cohen's advice that hospital transfusion committees should draw up guidelines for the use of fresh frozen plasma.'We take issue, however, with her claim that "fresh frozen plasma has no role as a volume expander."Although this is true in most circumstances, we believe that this embargo should not be applied to infants and children whose vascular integrity fails because of endothelial dysfunction-for example, after cardiopulmonary bypass surgery.Cardiopulmonary bypass surgery in children may be associated with considerable tissue oedema.This increase in total body water is particularly apparent in infants who have undergone prolonged cardiopulmonary bypass.2In such cases intra- vascular hypovolaemia occurs despite an overall increase in total body water, with extravasation of salts and small protein molecules such as albumin.When vascular integrity is lost fresh frozen plasma may have advantages over human albumin solution because of the larger size of macromolecules,3 which may allow a more sustained effect with slower leakage through damaged capillaries into perivascular tissues.4This permits better main- tenance of intravascular volume, which is an important determinant of oxygen delivery and survival in patients at risk of multisystem failure.This point may apply to other patients requiring critical care such as neonates or patients with thermal bums.4Until the use of synthetic colloids with large macromolecular structure has been validated and proved to be safe in young infants and children we believe that fresh frozen plasma is the safest and most effective option in children with intravascular hypovolaemia and failure of vascular endothelial integrity despite the small risk of hazard.'
A new gas dilution method for measuring body volume.
Authors: N Nagao, K Tamaki, T Kuchiki, M Nagao
Journal: British Journal of Sports Medicine (1995)

This study was designed to examine the validity of a new gas dilution method (GD) for measuring human body volume and to compare its accuracy with the results obtained by the underwater weighing method (UW). We measured the volume of plastic bottles and 16 subjects (including two females), aged 18-42 years with each method. For the bottles, the volume measured by hydrostatic weighing was correlated highly (r = 1.000) with that measured by the new gas dilution method. For the subjects, the body volume determined by the two methods was significantly correlated (r = 0.998). However, the subject's volume measured by the gas dilution method was significantly larger than that by underwater weighing method. There was significant correlation (r = 0.806) between GD volume-UW volume and the body mass index (BMI), so that UW volume could be predicted from GD volume and BMI. It can be concluded that the new gas dilution method offers promising possibilities for future research in the population who cannot submerge underwater.
Local Therapy and Survival in Breast Cancer
Authors: Rinaa S. Punglia, Monica Morrow, Eric P. Winer, Jay R. Harris
Journal: New England Journal of Medicine (2007)

Some investigators have viewed breast cancer as a local disease that then spreads; others have seen it as a systemic disease from the start. This review argues for another view, since the failure to achieve initial local control allows some tumors to disseminate later, reducing a patient's chance of long-term survival. Recent evidence supports a larger role for aggressive, local therapy for breast cancer.
Effect of mithramycin on calcium and hydroxyproline metabolism in patients with malignant disease.
Authors: V. Parsons, M. Baum, M. Self
Journal: BMJ (1967)

MEDICAL JOUIRNAL more often by spasm of the umbilical cord vessels due to mani- pulation and cooling (Rhodes, 1956).Various authors have commented on the adverse effect of a long detection-delivery interval on the perinatal mortality, and it has been shown that after one hour there is a rapid rise in mortality (Fenton and D'Esopo, 1951 ; Ball et al., 1961 ; Winch and Claman, 1961; Nelson and Bums, 1963 ; Widholm and Nieminen, 1963 ; Sinnathuray, 1964).In a small series of 15 cases Campbell (1962) quotes an average detection-delivery interval of 8 minutes 20 seconds for vaginal delivery and 28 minutes for caesarean section.To reduce the foetal loss in pro- lapsed cord it is necessary to have adequate facilities, so that caesarean section or any other treatment can be initiated imme- diately the diagnosis is made.Routine vaginal examination as soon as the membranes rupture, irrespective of the presenting part and irrespective of its level, will favour early diagnosis and reduce the all-important time lag between the occurrence of cord prolapse and initiation of the appropriate treatment.The late prognosis for the survivors of cord prolapse was assessed by Cushner (1961), and 95% of those located were normal.It seems that, provided the infant is delivered alive and survives the neonatal period, no harm is done by the possible period of anoxia before delivery associated with cord prolapse. SummaryFifty cases of cord prolapse occurring in the last two years are analysed and compared with the results obtained 12 years ago in the same unit.Caesarean section is superior to all other forms of treatment; in the series surveyed it resulted in a very low perinatal mortality.It is unlikely that cord prolapse will ever be eliminated as a cause of perinatal mortality.I thank Mr. J.J. Foley, Mr. F. A. Murray, and Mr. C. W.
BMA calls for meeting after health secretary blames GPs for pressure on emergency services
Authors: Z. Kmietowicz
Journal: BMJ (2013)

The BMA has written to secretary of state Jeremy Hunt asking for an urgent meeting to discuss the best way to manage increasing demands on emergency departments and rising emergency care admissions.

In a speech to Age UK on 25 April, Hunt blamed “disastrous” changes to general practitioners’ contracts made in 2004 under the Labour government for the “decline in the quality of out of hours care” and four million extra people a year using emergency services. 

He said that it was time “to rethink the role of primary care” to prevent emergency admissions and to “make sure people with long term conditions are better looked after outside the hospital system.” Hunt said that there would be an announcement on “plans for local pioneer sites to lead the way on this” shortly.

“Too …
Congenital anaemia after transplacental B19 parvovirus infection
Authors: K.E Brown, S.W Green, J Antunez de Mayolo, N.S Young, J.A Bellanti, S.D Smith, Tj Smith
Journal: The Lancet (1994)

We report three children with congenital anaemia after intrauterine infection with B19 parvovirus. All the fetuses developed hydrops fetalis that was treated by blood transfusion. After delivery the infants had hypogammaglobulinaemia. In all three, sera lacked B19 but viral DNA was found in bone marrow. All were treated with immunoglobulin. One child died and B19 was found in various tissues. In the other two cases, virus could no longer be detected after therapy but the patients remain persistently anaemic. Persistent B19 infection should be suspected in infants with congenital red-cell aplasia.
Liver transplantation across abo blood groups
Authors: Joseph R. Bove, Harold O. Conn
Journal: Hepatology (1987)

Six hundred seventy-one first, second and third orthotopic liver allografts in 520 patients were reviewed to determine the effect of donor-recipient mismatches or incompatibilities for the ABO blood groups on graft survival. A significant advantage for ABO donor-recipient identity was found, especially in adults for first grafts. However, a surprisingly large number of ABO incompatible grafts were successful. We recommend that nonidentical or incompatible grafts be limited to patients such as small children for whom the supply of available donors is severely limited for patients in urgent need of transplantation or retransplantation.
Use of Standardized Patients to Assess Between-Physician Variations in Resource Utilization
Authors: Peter J. McLeod
Journal: JAMA (1997)

<h3>Context.</h3> —As medical costs are increasingly being scrutinized, there is heightened interest in defining variations in physician behavior in clinical settings. <h3>Objective.</h3> —To evaluate if standardized patient (SP) technology is a reliable and feasible method of studying interphysician variations in test ordering, referral requests, prescribing behavior, and visit costs. <h3>Design.</h3> —The study was conducted with blinded SP visits to family medicine and internal medicine residents, university-affiliated family physicians, and community-based family physicians. Resource utilization and visit costs were assessed using test requisitions, consult requests, and prescriptions that were collected by the SPs. <h3>Setting.</h3> —Physicians' offices in ambulatory care, hospital-based clinics and in the community. <h3>Participants.</h3> —Four persons (aged 57-77 years) trained to simulate having osteoarthritis of the hip. In one simulation, the patient had gastropathy due to nonsteroidal anti-inflammatory drug use, and in the other, the patient sought therapy for hip discomfort. <h3>Main Outcome Measures.</h3> —Reliability of cost estimates of physician services, tests, consultations, prescriptions, and total visits and test-ordering behavior for nonsteroidal anti-inflammatory gastropathy. <h3>Results.</h3> —Overall, 112 (63%) of the physicians who were sent invitations to the study agreed to participate. Of 312 total SP visits conducted over a 1-year period, unblinding due to SP detection occurred on 36 occasions (11.5%). Reliable cost estimates of physician services, tests, and consultations, and moderately reliable estimates of total visit costs, were obtained with 4 visits per practicing physician and with 2 visits per resident. There were extreme variations in total visit costs generated by the study physicians. A small number of physicians had a major impact on this variability. <h3>Conclsion.</h3> —Standardized patient technology provides a reliable, feasible method to assess variations in resource utilization between physicians.