tbuckley/cabot-search huggingface dataset:
Endotracheal Intubation in Guillain-Barré Syndrome
Authors: Siegfried I. Beer
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The CLINICAL NOTE by Newsum et al (1979;242:1650) speaks against tracheostomy in cases of Guillain-Barré syndrome (GBS) in need of assisted ventilation. Translaryngeal intubation is offered as a safe alternative for two weeks only, after which tracheostomy is suggested. We would like to present a case of GBS with respiratory failure illustrating that nasotracheal intubation could be used for a longer period. <h3>Report of a Case.—</h3> A 5-year-old girl weighing 16 kg was admitted with a two-day history of increased weakness of the legs, bilateral palpebral ptosis, and slurring speech. Over the next 24 hours her condition deteriorated, and cranial as well as somatic nerves were involved. Respiratory muscle and bulbar paralysis made a nasotracheal intubation with a 5.0-mm uncuffed tube and mechanical ventilation necessary. Her maximum inspiratory and expiratory pressures were low.<sup>1</sup>This condition continued for 30 days, and gradually the girl was weaned from
Prenatal screening for trisomy 18 with free beta human chorionic gonadotrophin as a marker.
Authors: K Spencer, A S Mallard, E J Coombes, J N Macri
Journal: BMJ (1993)

To determine the relation between maternal serum alpha fetoprotein and free beta human chorionic gonadotrophin concentrations in pregnancies complicated by trisomy 18 and establish whether prenatal biochemical screening for this condition could be developed in a way similar to that proposed for trisomy 21.Serum alpha fetoprotein and free beta human chorionic gonadotrophin concentrations in women with singleton pregnancies affected by cytogenetically confirmed trisomy 18, uncomplicated by neural tube defect or ventral wall defect, were identified from prospective trisomy 21 screening programmes. Additionally, stored maternal serum from similar pregnancies was analysed retrospectively. Analyte concentrations from singleton unaffected pregnancies were identified from a prospective screening programme as controls. Statistical parameters of the affected and unaffected populations were compiled.Biochemical screening laboratories in Britain and the United States.52 women with singleton pregnancies complicated by trisomy 18; control population of 6661 women with unaffected singleton pregnancies.Median values of each analyte and their distribution in the affected and unaffected populations; detection rate of trisomy 18 and the false positive rate.Maternal serum alpha fetoprotein and free beta human chorionic gonadotrophin concentrations were significantly lower in pregnancies complicated by trisomy 18 (median values 0.71 and 0.37 respectively). By using a multivariate risk algorithm incorporating maternal age risk of trisomy 18 and the concentration of the two biochemical markers it was predicted that 50% of trisomy 18 cases (unaffected by neural tube defect or ventral wall defect) could be detected with a 1% false positive rate.Second trimester biochemical screening for trisomy 18 could be a valuable addition to trisomy 21 screening programmes.
Mandatory drug tests in prisons
Authors: S. M Gore, A G. Bird
Journal: BMJ (1995)

EDITOR,—The recent report on Styal prison by the Inspectorate of Prisons highlights the problem of women who start to inject drugs during incarceration, calls for quantitative research on illicit drug taking, and recommends a “clinical model” of drug reduction.1 The Home Office's response is in stark contrast: it is to introduce mandatory drug tests at the prison.2 Prisoners from whom a urine sample is required need not be chosen randomly, refusal to provide a sample breaches prison rules and is punishable, and samples are attributable.

Mandatory testing, also dubbed a “war on drugs,”3 has been publicised on television and radio …
New UK policy on overseas doctors: International medical graduates invest £7500 in getting first job
Authors: Sasi Attili
Journal: BMJ (2006)

EDITOR—The following is the approximate investment each overseas doctor has to put in before applying for jobs in the United Kingdom:

IELTS (language exam): £150 PLAB1 (medical exam): £145 PLAB2 (medical exam): £430 Provisional GMC registration: £100 …
Does eczema in infancy cause hay fever, asthma, or both in childhood? Insights from a novel regression model of sibling data
Authors: John L. Hopper, Quang M. Bui, Bircan Erbas, Melanie C. Matheson, Lyle C. Gurrin, John A. Burgess, Adrian J. Lowe, Mark A. Jenkins, Michael J. Abramson, E. Haydn Walters, Graham G. Giles, Shyamali C. Dharmage
Journal: Journal of Allergy and Clinical Immunology (2012)
The Diagnosis of Intracranial Lesions in AIDS-Reply
Authors: Charles M. Elkin
Journal: JAMA (1985)

In Reply.—  While Denton et al offer a viable alternative, we believe our approach toward patients with AIDS who have intracranial lesions results in rapid diagnosis and therapy without any risk of surgical intervention. Diagnostic specificity depends on the roentgenographic appearance of toxoplasmosis in the AIDS population and the effectiveness of the therapeutic antibiotic trial. Patients must meet clinical criteria for AIDS. If the CT appearance is atypical or the lesions progress despite adequate therapy, biopsy is indicated.  While stereotactic guided-needle biopsy is relatively safe, the amount of tissue obtained is often small. If the specimen is not adequate, additional samples or an open biopsy may be required. In our early experience, biopsies were performed in all cases. Once the pattern of findings in AIDS was elucidated, we avoided possible hemorrhagic complications of biopsy.
Echocardiographic ejection fraction in patients with acute heart failure: correlations with hemodynamic, clinical, and neurohormonal measures and short‐term outcome
Authors: Nir Uriel, Guillermo Torre‐Amione, Olga Milo, Edo Kaluski, Loïc Perchenet, Alex Blatt, Isaac Kobrin, Arkadi Turnovski, Shoshana Kaplan, Maurizio Rainisio, Aline Frey, Zvi Vered, Gad Cotter
Journal: European Journal of Heart Failure (2005)
Doctors' experience with handheld computers in clinical practice: qualitative study
Authors: Ann Scheck McAlearney, Sharon B Schweikhart, Mitchell A Medow
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To examine doctors9 perspectives about their experiences with handheld computers in clinical practice. <b>Design</b> Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. <b>Setting</b> Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. <b>Participants</b> 54 doctors who did or did not use handheld computers. <b>Results</b> Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. <b>Conclusions</b> Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors9 comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.
Development and Testing of Formal Protocols for Oxygen Prescribing
Authors: GORDON H. GUYATT, DOUGLAS A. McKIM, BRUCE WEAVER, PEGGY A. AUSTIN, ROBERT E. J. BRYAN, STEPHEN D. WALTER, MIKA L. NONOYAMA, IVONNE M. FERREIRA, ROGER S. GOLDSTEIN
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

The absence of standardized assessment protocols with well- defined measurement properties limits comparison of outcomes among those receiving long-term oxygen therapy (LTOT). We describe simple protocols for a hospital test, a simulated home test, and an actual home test, their reliability and relationship to each other. Stable patients with exercise hypoxemia participated. In 74 patients who completed four exercise tests, correlations between tests ranged from 0.85 to 0.78. Of these 27.0% had the same prescription from all four tests. In 46% prescriptions were within 1 L/ min and in 27% within 2 L/min. During exercise the hospital tests suggested slightly higher oxygen prescriptions than did the simulated home tests (2.5 L/min versus 2.0 L/min, p < 0.001). In 23 patients who participated in actual home assessments, the correlations between the home test, the hospital, and the simulated home tests were 0.22 (95% CI − 0.24 to 0.67) and 0.27 (95% CI − 0.18 to 0.72). In conclusion, standardizing tests for the assessment of LTOT is important. We describe simple hospital and simulated home tests that are reproducible, easy to carry out, and correlate well with each other.
Contribution of left ventricular contraction to the generation of right ventricular systolic pressure in the human heart.
Authors: M P Feneley, T P Gavaghan, D W Baron, J A Branson, P R Roy, J J Morgan
Journal: Circulation (1985)

To determine whether left ventricular (LV) contraction contributes to the generation of right ventricular (RV) systolic pressure in humans, LV and RV pressures and their first derivative (dP/dt) were recorded simultaneously with micromanometer-tipped catheters in 11 conscious subjects. Seven subjects had normal LV and coronary angiograms. Four subjects had moderate LV dysfunction (resting ejection fraction 0.40 to 0.50), and three of these had coronary artery disease. During normal sinus rhythm, LV contraction slightly preceded RV contraction (mean 20 msec), and LV and RV dP/dt recordings showed single positive systolic peaks that were coincident. During endocardial pacing of the RV free wall, RV contraction preceded LV contraction (mean 23 msec) and two systolic RV dP/dt peaks were recorded, the first (peak I) occurring significantly before (mean +/- SD = 67 +/- 23 msec, p less than .01), and the second (peak II) coincident with the single systolic LV dP/dt peak. RV ectopic beats produced a similar RV dP/dt pattern, with peak I occurring 63 +/- 11 msec (p less than .01) before, and peak II coincident with the single LV dP/dt peak. Conversely, during LV ectopic beats, LV contraction preceded RV contraction (mean 63 msec) and two systolic RV dP/dt peaks were recorded, but peak I was coincident with the single LV dP/dt peak, while peak II occurred significantly later (63 +/- 26 msec, p less than .01). In two subjects right bundle branch block produced similar findings. In three subjects left bundle branch block produced little ventricular asynchrony (mean 14 msec), but did delay the development of peak LV dP/dt after LV contraction.(ABSTRACT TRUNCATED AT 250 WORDS)
THE NATURE AND ORIGIN OF THE NITROGENOUS COMPOUNDS IN THE FECES IN INFANTILISM
Authors: F. H. McCrudden, H. L. Fales
Journal: The Journal of Experimental Medicine (1913)

Previous studies have shown that the nitrogenous metabolism is on a low plane in infantilism of the type of Herter, and have indicated undernutrition as a possible cause of the failure to grow. 1 As causes of the undernutrition, improper digestion or poor absorption were thought of on account of the large quantities of nitrogen in the feces. 2 The analyses reported in the present paper were carried out for the purpose of determining the nature of the nitrogenous compounds in the feces with the hope that we might be able, with these data, to explain the cause of the loss of nitrogenous material or, at least, to eliminate certain hypotheses which had been made concerning this loss.For this purpose, determinations of the total nitrogen, and nitrogen in the form of soluble protein, ammonia, purin compounds, bacterial bodies, and amino acids were made.Fairly definite conclusions regarding completeness of digestion, absorption of protein and protein digestion products, and the amount and nature of bacterial action may be reached from these data in so far as these points relate to t h e problem in hand; namely, whether or not protein is insufficiently, or too rapidly, or completely hydrolyzed, or undergoes changes giving harmful or useless derivatives, or is incompletely absorbed,--all of which possibilities are in accord with the data already obtained.The feces used were obtained from F. S., one of the patients examined in previous studies, and from E. B,,
Gastric versus transpyloric feeding in severe traumatic brain injury: a prospective, randomized trial
Authors: Jose Acosta-Escribano, Miguel Fernández-Vivas, Teodoro Grau Carmona, Juan Caturla-Such, Miguel Garcia-Martinez, Ainhoa Menendez-Mainer, Manuel Solera-Suarez, José Sanchez-Payá
Journal: Intensive Care Medicine (2010)
Longitudinal Visualization of Spontaneous Coronary Plaque Rupture by 3D Intravascular Ultrasound
Authors: Takafumi Hiro, Takashi Fujii, Shinji Yoshitake, Tetsuya Kawabata, Kyounori Yasumoto, Masunori Matsuzaki
Journal: Circulation (2000)

A 60-year-old man, 4 years after an anterior myocardial infarction at the middle segment of the left anterior descending coronary artery (LAD), underwent coronary angiography (CAG) because of severe continuous chest pain for Ͼ3 hours 3 weeks earlier.CAG revealed no significant stenosis but showed a wall fissure with a double-contrast opacification at the proximal segment of the LAD (short arrow on CAG in the Figure), which had not been detected by CAG 4 years earlier.This ulceration may have developed at the time of chest pain, and any thrombus might have formed at the lesion, then autolyzed.Two-dimensional intravascular ultrasound (2D-IVUS) revealed a plaque ulceration in an eccentric plaque (Figure, asterisk).The rupture occurred at the shoulder of the
Analysis of osteoblast mineral deposits on orthopaedic/dental implant metals
Authors: Matthew W. Squire, John L. Ricci, Rena Bizios
Journal: Biomaterials (1996)

Neonatal rat calvarial osteoblasts were cultured on Ti-6Al-4V, Co-Cr-Mo alloy, 316L stainless steel and polystyrene (reference substrate) in the presence of ascorbic acid and 10 mm β-glycerophosphate for 16, 17, 18, 19, 20, 21, 24 and 28 d. Scanning electron microscopy examination revealed that osteoblasts cultured on these orthopaedic/dental implant metals synthesized and deposited an extracellular matrix containing collagenous and non-collagenous components, as well as mineral nodules of various morphologies. Energy dispersive spectrometry revealed that the mineral deposits consisted of three distinct chemical compositions: calcium phosphate, calcium-sulphur-phosphorus, and calcium only. Backscattered electron imaging demonstrated that both the calcium phosphate and calcium-only deposits were electron dense, while the calcium-sulphur-phosphorus deposits were electron translucent. X-ray diffraction analysis indicated that the bulk of the osteoblast mineral deposits was amorphous hydroxyapatite; in addition, electron diffraction analysis revealed small regions of crystalline hydroxyapatite.
Group of British doctors call for a boycott of the Israel Medical Association
Authors: Owen Dyer
Journal: BMJ (2007)

A group of British doctors has called for a boycott of the Israeli Medical Association (IMA) and its expulsion from the World Medical Association (WMA) in a letter published in the Guardian newspaper. The petition, signed by 130 doctors, argues that by refusing to criticise Israeli policies in the Palestinian territories occupied by Israel, the IMA is failing to uphold international medical ethical standards.

The Israel Defense Forces “have systematically flouted the fourth Geneva convention guaranteeing a civilian population unfettered access to medical services and immunity for medical staff,” the letter says, citing reports of soldiers attacking ambulances; patients and essential drugs obstructed at checkpoints, and bombing of the public health infrastructure.

“The Israeli Medical Association has a duty to protest about war crimes of this kind but has refused to do so,” it continues. “Eighteen leading Palestinian health organisations have appealed to fellow professionals abroad to recognise how the IMA has forfeited its right to membership of the international medical community.”

Derek Summerfield of the Institute of Psychiatry, one of the letter's organisers, said a boycott was the only remaining option when all normal channels have been exhausted. “We've sent exhaustive reports, with evidence carefully documented by leading human rights organisations, to the IMA, the World Medical Association, and the BMA, but they've been ignored.”

Dr Summerfield said that the BMA …
Review of social service organisation needed?
Authors: G. Lythe
Journal: BMJ (1980)

Nor do I agree with him that money, fame, and power are the usual motives behind such forgeries.There is, however, a long tradition among scientists of faking results in order to establish a pet theory, and those like Cyril Burt who have followed it include Haekel, Mendel, Kammering, Blondlot, Dubois, and (I believe) Teilhard de Chardin.To my mind, Malcolm Bowden's book Ape Man: Fact or Fallacy ?4 has irrevocably implicated Teilhard not only in the Piltdown forgery, but also in manufacturing evidence concerning Pekin and Java Man.Teilhard's motive was to establish the rather potty theory of evolution spelled out in "The Phenomenon of Man."The esteem that this book was held in and his own continuing high reputation must make him a candidate for the title of "Faker of the Century.
Animal Experimentation-Reply
Authors: Francis E. Warren
Journal: JAMA (1962)

<h3>To the Editor:—</h3> This is in reference to Dr. Blair's objections to the publication of the article on head irradiation of the burro. I and other investigators at our laboratory share Dr. Blair's feelings toward the agony of animals committed to death by ionizing radiation though not his objection regarding the necessity of conducting such studies. As was the case with all previous experimental studies conducted by our group, the head-irradiation study was conducted according to the "Principles of Laboratory Animal Care" as promulgated by the National Society for Medical Research. The philosophical questions involved in the use of animals for experimental work are great in number and defy any light rationalization. We must work somewhere within the bounds set by standards of human dignity and ever work toward limiting any suffering vis-a-vis the necessity of obtaining certain information. All of our previous experimental studies have been directed toward obtaining
Eric Greenwood Jenner
Authors: R. Martin
Journal: BMJ (2002)

Retired general practitioner Brechin, Angus (b Stockport 1921; q Cambridge/London 1944; MBE, MRCGP), died on 25 September after a short illness.

Eric became a medical officer in the Royal Air Force and then moved to a general practice in Gainsborough. He arrived in Brechin in 1953, where his wife, Grizelda, later became a partner. Eric had a strong community spirit, becoming a member of the regional hospital board, a baillie on Brechin Town Council, and dean of the Guildry Incorporation. He worked with the Civic Trust and was instrumental in keeping open the Mechanics Institute. As a young man Eric bred and trained English setters for field trials. He was a talented artist. Predeceased by Grizelda, he leaves four children and five grandchildren.
Safety of Vinyl Ether
Authors: M. Dawkins
Journal: BMJ (1964)

Safety of Vinyl EtherSIR,-Some years ago attention was drawn to the safety of vinyl ether as a sole anaes- thetic for short operations,' inasmuch as it appeared that since the war there had been over 500,000 administrations with only one death.Vinyl ether (" vinesthene ") is put up in ampoules of 3 and 5 ml., and in bottles of 25 ml.for longer operations.Thanks to the courtesy of the sole manufacturers in stating the number of ampoules that have been issued it is possible to estimate the number of anaesthetics given with a fair degree of accuracy.This number now stands at over
Dietary fish oil attenuates cardiac hypertrophy in lipotoxic cardiomyopathy due to systemic carnitine deficiency
Authors: R TAKAHASHI, K OKUMURA, T ASAI, T HIRAI, H MURAKAMI, R MURAKAMI, Y NUMAGUCHI, H MATSUI, M ITO, T MUROHARA
Journal: Cardiovascular Research (2005)

1,2-Diacylglycerol (DAG), a lipid second messenger that activates protein kinase C (PKC), is increased with a distinct fatty acid composition in the heart of the juvenile visceral steatosis (JVS) mouse, which develops pathological cardiac hypertrophy with lipid accumulation induced by the perturbation of fatty acid beta-oxidation due to systemic carnitine deficiency. Fish oil (FO) may exert its beneficial effects on the cardiomyopathy in JVS mice by modifying the molecular species composition of myocardial DAG. To test this hypothesis, we investigated the effects of dietary FO on the hypertrophied hearts in JVS mice.Both control and JVS mice were fed a FO diet (containing 10% FO) or a standard diet from 4 weeks of age.At 8 weeks of age, the ventricular-to-body weight ratio in JVS mice was 2.7-fold higher than that in controls (9.9 +/- 0.1 vs. 3.7 +/- 0.1 mg/g, P < 0.01) and was reduced by dietary FO (7.7 +/- 0.1 mg/g, P < 0.01 vs. JVS mice). In JVS mice, myocardial DAG levels were elevated by 2.3-fold with a distinct fatty acid composition with increases in C18:1n-7,9 and C18:2n-6 fatty acids compared with controls; dietary FO had no effects on the total DAG levels but significantly altered the fatty acid composition of DAG with reduction of both fatty acid species. Immunoblot analysis showed that dietary FO prevented the membrane translocation of cardiac PKCs alpha, beta2, and epsilon in JVS mice. Dietary FO did not affect the plasma and myocardial total carnitine levels in JVS mice. Furthermore, dietary FO significantly improved the progressive left ventricular dysfunction and survival rate in JVS mice.Dietary FO may attenuate cardiac hypertrophy with improvements in cardiac function and survival in JVS mice via modification of the molecular species composition of myocardial DAG and the consequent inhibition of PKC redistribution. These results suggest the implication of the molecular species composition of DAG in the pathogenesis of lipotoxic cardiomyopathy due to perturbations of fatty acid beta-oxidation.