tbuckley/cabot-search huggingface dataset:
Controlled trial of arbaprostil in bleeding peptic ulcer.
Authors: K Lauritsen, L S Laursen, T Havelund, P Bytzer, J Rask-Madsen
Journal: BMJ (1985)

CommentOral ketoconazole appreciably reduced the rate of isolation of the outbreak strain from both systemically infected and colonised patients.The outbreak strain did not reappear when ketoconazole was with- drawn.All cases of systemic candidiasis acquired in the unit before April 1984 were caused by the outbreak strain, whereas after May 1984 all cases were caused by other strains.Control of an outbreak depends on its identification and the preven- tion of cross infection.Existing handwashing reagents can be replaced with fungicidal disinfectants such as Hibisol or Betadine, and antifungal prophylaxis can be given.Recent work in neutropenic patients in whom infection was probably due to an endogenous isolate showed that ketoconazole was as effective as amphotericin B, and prophylaxis with either agent failed.5In this study ketoconazole failed in six cases, perhaps because of poor absorption in the gut as five patients had undergone major gastrointestinal surgery.Treatment with ketoconazole resulted in the virtual elimination of the outbreak strain, the incidence of cases returning to its former value, with occasional cases caused by the patients' own yeast flora.A much shorter course of prophylaxis might have been equally effective and could be considered in any unit where the incidence of candidal sepsis is unacceptably high and cross infection a problem.We thank the consultants, medical staff, and nurses in the intensive care unit for their help; Janssen Pharmaceuticals for a grant supporting the keto- conazole studies; and Imperial Chemical Industries and Napp for grants supporting the handwashing studies.1 Burnie JP, Odds FC, Lee W, Webster C, Williams JD.Outbreak of systemic Candida albicans in intensive care unit caused by cross infection.
An Address on the Work of the British Medical Association
Authors: G. H. Porter
Journal: BMJ (1879)

is, in all probability, a small thing when compared with increasing the secretion of bile.One might expect that such powerful intestinal irritants as nagnesium-sulphate and gamboge would be likely to bring about a reflex expulsion of bile; yet no one has attributed any chola- gogue power to these.But, without attempting to reason out a ques- tion that can only be determined by experiment, we would merely add that we leave the investigation of the action of drugs on the bile-expelling mechanism to those who care to enter upon such an inquiry.We are satisfied to have shown that every substance supposed to be a cholagogue has, with the exception of calomel and manganese-sulphate, the ,power of exciting the bile-secreting mechanism; and, as our estimate of their powers, from an observation of the bile-secretion only, closely agrees with observations on the human subject, where actions on the bile-secreting and on the bile-expelling mechanisms cannot be distin- guished from one another, we cannot but infer that surely their actions on the human subject must be chiefly on the bile-secreting mechanism.With regard to calomel, we must refer the reader to our criticism of its
Injuries and foreign bodies.
Authors: H Ludman
Journal: BMJ (1981)

y';it' tt';41Xt2Fractured nasal bones-Direct violence to the nose often fractures the bones of the nasal vault.The injury can usually be recognised clinically fJ, Dsi-..-:..-" immediately afterwards by the distortion from normal shape, though this soon becomes obscured by soft tissue swelling.Injuries to other parts of the facial skeleton must be excluded.Associated fractures of the zygomaticomaxillary complex may impair normal opening of the jaw and cause faulty dental occlusion, diplopia, and anaesthesia of the skin supplied by the infra-orbital nerve.These injuries ... are always associated with rapid swelling of the soft tissues of the cheek, and a sub-conjunctival haemorrhage is usually apparent.Careful palpation ( ' @ X --: ] -E I > ' ' ' . . . . . . . . . . . . .: ~~~~~of the bony skeleton around the edge of the orbit may disclose a typical "step" deformity. Management of nasal injuriesRadiographs of the nose are not usually needed to establish the diagnosis of a fracture or the need for treatment but are often performed for ji ...medicolegal reasons.Fractures of the nasal vault require surgical reduction * ' i' ';A-t, only when there is deformity.It is often difficult to assess the deviation from normal shape until the soft tissue swelling has subsided, which may take five to seven days.Since the nasal bones will become firmly set within -,., -; = ;-three weeks of the injury, the need for treatment should be assessed after a week, and, if necessary, reduction under general anaesthetic should be 10' 4a.Y.-S.;;-; planned for the following week.Fractures of the zygoma and maxilla set firmly very much more quickly-within a few days.If a ,Q6< .t s _ ,.s ,. *; .;-,, zygomaticomaxillary tracture is suspected the patient should therefore be referred to a faciomaxillary surgeon immediately.Nasal injuries often cause deflection of the nasal septum with obstruction of the nose.This can rarely be corrected satisfactorily at the time of g I ^b -& 1 ~reducing the nasal fracture, and the deflection is best treated by (V .3.. ,..'' ,',-'submucous resection several months later.
Physiologic Repair of Aortic Atresia–Hypoplastic Left Heart Syndrome
Authors: William I. Norwood, Peter Lang, Dolly D. Hansen
Journal: New England Journal of Medicine (1983)

AORTIC-VALVE atresia associated with mitral atresia or stenosis, a diminutive or absent left ventricle, and severe hypoplasia of the ascending aorta and aortic arch make up a constellation of defects that was initially termed "hypoplasia of the aortic tract complexes" by Lev1 and later called "hypoplastic left heart syndrome" by Noonan and Nadas.2 The anatomic complexity of this cardiac malformation has been considered prohibitive of long survival, and generally, only supportive therapy has been recommended. Indeed, aortic atresia–hypoplastic left heart syndrome is uniformly fatal without surgical intervention, and prolonged survival after reparative surgery has not been reported. It is, however, . . .
Antibiotics for Otitis Media: A Clarification-Reply
Authors: Robert L. Williams
Journal: JAMA (1994)

<h3>In Reply.</h3> —Dr Rosenfeld is concerned with that portion of our article that covers OME. He suggests that four studies<sup>1-4</sup>used subtherapeutic antibiotic dosages and should therefore be excluded from the analyses. In fact, two of these studies<sup>1,2</sup>used dosages that fall in the range of recommended therapy. More importantly, however, a close reading of our article will show that his concern has already been addressed. Three of the studies<sup>2-4</sup>he questioned used antibiotics that are not generally considered to be effective in treatment of otitis media. In our meta-analyses, we performed subgroup analyses that separated the studies by whether they used antibiotics active against middle-ear pathogens. In these subgroup analyses, eliminating those studies using antibiotics of uncertain efficacy (including three of those questioned by Rosenfeld) produced no change in the results, as shown in Figs 2, 3, and 4 of the article. The fourth study<sup>1</sup>
Synergy of Interferon-α and 5-Fluorouracil in Human Renal Cell Carcinoma Requires p53 Activity
Authors: Donghao Shang, Noriyuki Ito, Jun Watanabe, Yasuo Awakura, Hiroyuki Nishiyama, Toshiyuki Kamoto, Osamu Ogawa
Journal: European Urology (2007)
Book: Friends in Low Places
Authors: G. Feder
Journal: BMJ (2002)

Sometimes you have to shout to make yourself heard. This book is an eloquent shout, a polemic from a general practitioner who argues that the world has gone mad. Symptoms of this madness include the over-regulation of professionals—including doctors, nurses, and teachers— ignoring the wisdom and experience they have gathered over the years. The continuing growth of audit and external standards feels oppressive, not only to professionals but also to managers.

Please raise your hand if you disagree with the previous two sentences. Thought so. If you like to be grabbed by the lapels in this fashion, you won't be …
General Pathology: A Programmed Text
Authors: A. E. Rodin
Journal: JAMA (1975)

Programmed instruction refers to the logical organization of information into small units for self-learning. Each unit consists of input of one or a few items, followed by a practice exercise and immediate feedback. The method has proved to enhance learning and retention, and is favored by about 80% of learners. The number of available programmed texts remains small because of the expertise and the prolonged effort required for preparation. Many published texts in the programmed pattern are relatively inadequate because of lack of refinement by field testing, absence of performance data, and uncertain objectives. Kent's text, however, is an exception, having had extensive revisions based on prior usage and precise objectives. Numerous sketches, tables, and flow charts contribute greatly to its suitability for learning. The topics included are inflammation, healing, necrosis, degeneration, developmental abnormalities and hemodynamic disorders—a content similar to that of most standard textbooks of pathology. Many useful clinical
Savile's 50 year reign of abuse spanned 28 NHS hospitals, investigation finds
Authors: I. Torjesen
Journal: BMJ (2014)

Calcification in brainstem gliomas is an unusual histologic and radiologic finding. To date, radiologic evidence of calcification in these tumors has not been reported. The two patients described here had evidence of calcification on either computerized tomography (CT) or plain skull films. Increasing availability of CT scans may provide a more accurate estimate of the incidence of calcification in these tumors.
THE PREVENTIVE TREATMENT OF TRANSFERRED OPHTHALMITIS.(SO-CALLED SYMPATHETIC OPHTHALMIA.)
Authors: CHARLES A. OLIVER
Journal: JAMA (1907)

For many months I have been engaged in the collation of the histories of all of the recorded cases of every form of so-termed "sympathetic disease"1 that had been treated in the dispensary and indoor services of Wills Hospital in Philadelphia since its opening, a period embracing more than seventy years. During these studies—in which I received excellent help from three of my personal assistants<sup>2</sup>—I soon realized that in spite of a vast yearly increase of the work done at the hospital and a broader and earlier recognition of the condition, there was a decided lessening in the number of cases, and a much less degree of fatality among those which had been treated than in former years. These findings seemed so important that I instantly chose the preventive phase of the disease as worthy to be the subject of this paper. The many desultory, and at times uncertain, cases
808-3 Impact of periprocedural plaque/thrombus reduction on myocardial injury after stent deployment
Authors: Mamoo Nakamura, Hideo Tamai, Tadanori Aizawa, Atsushi Hirohata, Yasuhiro Honda, Heidi N Bonneau, William F Fearon, Alan C Yeung, Paul G Yock, Peter J Fitzgerald
Journal: Journal of the American College of Cardiology (2004)
HERITABLE PULMONARY ARTERIAL HYPERTENSION IS ASSOCIATED WITH WORSE PULMONARY CAPACITANCE AND RIGHT VENTRICULAR STROKE WORK INDEX COMPARED TO IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION
Authors: Evan L. Brittain, Meredith E. Pugh, Lisa A. Wheeler, Quinn S. Wells, Ivan M. Robbins, James E. Loyd, Eric D. Austin, Anna R. Hemnes
Journal: Journal of the American College of Cardiology (2012)
Hyaluronan efflux from canine lung with increased hydrostatic pressure and saline loading.
Authors: M I Townsley, R K Reed, M Ishibashi, J C Parker, T C Laurent, A E Taylor
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Although lymphatic washout of hyaluronan during lung hydration has been postulated to deplete lung interstitial hyaluronan content and thereby contribute to the decreased interstitial exclusion of albumin observed under these conditions, this hypothesis has not been directly tested. In anesthetized, ventilated mongrel dogs, a prenodal lung lymphatic was cannulated for measurement of lymph flow and hyaluronan concentration. Following baseline measurements, Pla was increased in four steps of 5 cm H2O in Group 1 or set to one pressure ranging between 6 and 32 cm H2O in Group 2. In Group 3, saline (15% body weight) was infused over 30 min and then Pla increased as in Group 2. Invariably, as lymph flow increased in Groups 1 through 3, lymph hyaluronan concentration and hyaluronan flux increased significantly (p < 0.05). In a separate control group, there were no changes in lymph flow, hyaluronan concentration, or hyaluronan flux. In Group 3, lung hyaluronan content at 5 h (0.76 +/- 0.08 mg/g dry weight) was not significantly less than that during baseline (0.88 +/- 0.05 mg/g dry weight), although total uronic acid content actually increased by 38% over the same time course. In contrast, in the control group, both lung hyaluronan and uronic acid content remained stable over the experimental period. From these data, approximately 2 to 3% of lung hyaluronan is predicted to leave the interstitium via lymphatic flux per day under baseline conditions. The daily turnover of interstitial hyaluronan by this route increased to 15 to 18% of total content when Pla was elevated and to 54% following saline infusion. Thus, lung hyaluronan can be rapidly mobilized with increased lymph flow.(ABSTRACT TRUNCATED AT 250 WORDS)
THE PATHOGENESIS AND PREVENTION OF SIMPLE OR ENDEMIC GOITER
Authors: DAVID MARINE
Journal: JAMA (1935)

Note.  —This article and the articles in the previous issues ofThe Journalare part of a series published under the auspices of the Council on Pharmacy and Chemistry. Other articles will appear in succeeding issues. When completed, the series will be published in book form.—Ed.  Important contributions have been made during the last thirty years to the etiology and prevention of simple or endemic goiter. Progress in its prevention, wherever attempted, both in man and in animals, has been especially striking, and as the results are cumulative, greater benefits—indeed, complete prevention—can be predicted.  Extension of knowledge of the etiology has come about mainly through studies of thyroid chemistry, the correlation of anatomic changes with variations in the iodine content, interrelations of the thyroid with other organs of internal secretion, particularly the pituitary and sex glands, and the pharmacology, first of whole thyroid substance and later of thyroxine.  While goiter
Cardiac fibroblasts in pressure overload hypertrophy: the enemy within?
Authors: Nenad Bursac
Journal: Journal of Clinical Investigation (2014)

Cardiac fibroblasts have been long recognized as active participants in heart disease; however, their exact physiological and pathological roles remain elusive, mainly due to the lack of specific markers. In this issue of the JCI, Moore-Morris and colleagues used a fibroblast-specific collagen1a1-GFP reporter to demonstrate that fibroblast accumulation after aortic banding in murine hearts arises almost exclusively from proliferation of resident fibroblasts originating from both the epicardium and a previously unrecognized source, the endocardium. Further characterization of fibroblast origin and function in different types and stages of heart disease could lead to development of improved fibroblast-targeted cardiac therapies.
Coronary artery vasoconstriction routinely occurs after percutaneous transluminal coronary angioplasty. A quantitative arteriographic analysis.
Authors: T A Fischell, G Derby, T M Tse, M L Stadius
Journal: Circulation (1988)

To determine whether percutaneous transluminal coronary angioplasty (PTCA) increases coronary artery luminal dimensions by stretching and injuring ("paralyzing") the smooth muscle of the arterial wall, we prospectively analyzed spontaneous changes and then intracoronary nitroglycerin-induced changes in segmental coronary artery diameters during the first 30 minutes after uncomplicated single-vessel PTCA in 10 patients. Five additional patients received intravenous nitroglycerin throughout the procedure to determine whether nitroglycerin could prevent vasoconstriction after PTCA. All of the patients were maintained on oral doses of diltiazem and aspirin at the time of the study. Coronary arteriography was performed at 2, 5, 15, and 30 minutes after PTCA and then 3 minutes after 300 micrograms i.c. nitroglycerin. Quantitative measurements (computerized edge-detection) were performed at each time, in coronary segments centered in the dilated segment, distal to the dilated segment, and in a control vessel not manipulated with the balloon catheter or guidewire. Progressive vasoconstriction (defined as a loss of diameter that was reversed by intracoronary nitroglycerin) was observed after PTCA in the dilated and distal segments (10 of 10 patients) but not in the control segment. The vasoconstriction in the dilated segment at 30 minutes (mean, 30 +/- 4%) was highly statistically significant compared with vasoconstriction at 2 and 5 minutes after PTCA (p less than 0.001) and compared with the control segment at 30 minutes (p less than 0.005). There was no significant loss of diameter after PTCA in the dilated segment in the five patients who received intravenous nitroglycerin. In conclusion, 1) spontaneous coronary artery vasoconstriction after PTCA occurs routinely at and distal to the site of balloon dilatation despite pretreatment with aspirin and calcium channel blockers; 2) coronary artery vasoconstriction after PTCA is rapidly reversed by intracoronary nitroglycerin and can be prevented by the continuous administration of intravenous nitroglycerin during and after the procedure; 3) these results are incompatible with the hypothesis that PTCA improves coronary luminal dimensions by arterial "paralysis"; and 4) these findings have implications concerning the etiology and prophylaxis of abrupt vessel closure after PTCA.
Anticoagulation for Noncardiac Procedures in Patients With Prosthetic Heart Valves
Authors: Mark H. Eckman
Journal: JAMA (1990)

Hospitalizations for patients with prosthetic heart valves undergoing noncardiac surgery are frequently prolonged for intravenous heparin therapy to decrease the incidence of thromboembolism while patients are not taking oral anticoagulant agents. Because the rate of thromboembolic events is quite low and the period of increased risk is very short, the cost of preventing these rare events can be great. We performed cost-effectiveness analyses addressing these issues. We calculated the marginal cost per additional quality-adjusted year of life gained per thromboembolic event averted and per death averted. We conclude that the marginal cost of prolonging hospitalization to administer heparin is prohibitively high compared with most contemporary therapies, except when the patient has the most thrombogenic of valves. We also discuss the ethical and legal ramifications of integrating the results of cost-effectiveness analyses into clinical practice. (<i>JAMA</i>. 1990;263:1513-1521)
A fail-safe mechanism for maintaining self-tolerance.
Authors: S Guerder, P Matzinger
Journal: The Journal of Experimental Medicine (1992)

Using cytotoxic T lymphocyte (CTL) responses to the class I histocompatibility antigen Qa1 and to the minor histocompatibility antigen H-Y, we show that the immune system maintains a peripheral screening process that is able to tolerize a wide variety of potentially autoimmune CTL. The critical factor is the presence or absence of specific T helper cells. If T help is available, CTL precursors that recognize antigen are activated. In the absence of help, they are tolerized. Thus, T helper cells are guardians of peripheral tolerance in CTL.
A review of the effect of previous operations on the results of open-heart surgery
Authors: J. D. Wisheart, D. N. Ross, J. K. Ross
Journal: Thorax (1972)

The results of open-heart surgery in a group of 50 patients who had had previous cardiac operations were analysed and compared with the results in a group of 50 patients having their first operation. The hospital mortality in the re-operated group was 22% and that in the control group was 8%. Postoperative morbidity was also increased in the re-operated group. Technical hazards related to the previous operation did not contribute to the increased operative mortality, which was considered to be due to the more advanced disease present in these patients.
Central Hypothyroidism Associated with Retinoid X Receptor–Selective Ligands
Authors: Steven I. Sherman, Jayashree Gopal, Bryan R. Haugen, Alice C. Chiu, Kevin Whaley, Prem Nowlakha, Madeleine Duvic
Journal: New England Journal of Medicine (1999)

The occurrence of symptomatic central hypothyroidism (characterized by low serum thyrotropin and thyroxine concentrations) in a patient with cutaneous T-cell lymphoma during therapy with the retinoid X receptor–selective ligand bexarotene led us to hypothesize that such ligands could reversibly suppress thyrotropin production by a thyroid hormone–independent mechanism and thus cause central hypothyroidism.
Expert Medical Testimony
Authors: Leo N. Dienstag
Journal: JAMA (1977)

<h3>To the Editor.—</h3> In a recent COMMENTARY, Dr Aring suggested that physicians should refuse to testify in court except as a friend of the court. In an editorial, Richard Bergen responds by suggesting that the adversary system of litigation would suffer and is still "more often than not... just and appropriate." I would like to call attention to the fact that many malpractice cases are developed, if not manufactured, by financially involved "medical experts." These are a group of legally sophisticated physicians who review charts for attorneys, hunt for causes of action, advise and ultimately testify for the plaintiff, and are paid a percentage of the award in favorable cases. While no one questions the fairness of the adversary system or the justification of hiring expert medical consultants, rewarding them on performance before a jury creates a group of medical bounty-hunters. These medical bounty-hunters, and not just the plaintiff's attorneys,
Japanese universal health coverage: evolution, achievements, and challenges
Authors: Naoki Ikegami, Byung-Kwang Yoo, Hideki Hashimoto, Masatoshi Matsumoto, Hiroya Ogata, Akira Babazono, Ryo Watanabe, Kenji Shibuya, Bong-Min Yang, Michael R Reich, Yasuki Kobayashi
Journal: The Lancet (2011)