tbuckley/cabot-search huggingface dataset:
Pamidronate associated hallucinations.
Authors: D Foley-Nolan, M J Daly, D Williams, A Wasti, M Martin
Journal: Annals of the Rheumatic Diseases (1992)

cance rating of one.The combinations of NSAIDs with a fi blocker, quinidine with cimetidine, and glibenclamide with a thiazide diuretic each occurred in one patient.These combinations have a significance rating of two.The combinations of NSAIDs with methotrexate, salicylates with enalapril, and digoxin with hydroxychloroquine each occurred in two patients.These combinations have a significance rating of four.None of the patients had reported a drug interaction before admission.The mean duration of admission was 39 days (range 7-84), during which time the only adverse reactions were diarrhoea secondary to auranofin in one patient and a skin rash secondary to sodium aurothiomalate in one patient.This small study supports previous studies illustrating the potential for drug interactions in patients with arthritis and emphasises the need for continued vigilance.Most potential drug interactions involve NSAIDs.'The absence of significant clinical drug interactions might be attributed to the judicious use of NSAIDs.They were reserved for the management of definite inflammation, and of the 33 patients receiving NSAIDs, 22 were receiving half the maximum recom- mended dose.
Left Ventricular Pseudoaneurysm
Authors: Abraham H. Dachman
Journal: JAMA (1981)

CARDIAC rupture is a major cause of mortality after myocardial infarction.<sup>1,2</sup>In a small percentage of patients, cardiac rupture is not a catastrophic event, but, rather, results in the formation of a pseudoaneurysm. Pseudoaneurysm is the result of ventricular rupture contained by adherent pericardium and fibrotic tissue. Pseudoaneurysm is thus characterized by the absence of myocardial tissue in its wall and a relatively narrow ostium between the ventricle and the paraventricular chamber (Fig 1). The plain-film finding of a paracardiac mass in a diaphragmatic or posterolateral location (Fig 2) in conjunction with a history of previous myocardial infarction is highly suggestive of pseudoaneurysm and is sufficient indication for angiographic studies.<sup>3,4</sup>Left ventriculography will show a paraventricular chamber filling via a relatively narrow ostium. The diagnosis is confirmed by demonstrating an avascular wall on coronary arteriography.<sup>4</sup> <h3>Report of a Case</h3> A 62-year-old man was admitted for syncope and
A Novel Angiotensin-Converting Enzyme–Related Carboxypeptidase (ACE2) Converts Angiotensin I to Angiotensin 1-9
Authors: Mary Donoghue, Frank Hsieh, Elizabeth Baronas, Kevin Godbout, Michael Gosselin, Nancy Stagliano, Michael Donovan, Betty Woolf, Keith Robison, Raju Jeyaseelan, Roger E. Breitbart, Susan Acton
Journal: Circulation Research (2000)

Abstract —ACE2, the first known human homologue of angiotensin-converting enzyme (ACE), was identified from 5′ sequencing of a human heart failure ventricle cDNA library. ACE2 has an apparent signal peptide, a single metalloprotease active site, and a transmembrane domain. The metalloprotease catalytic domains of ACE2 and ACE are 42% identical, and comparison of the genomic structures indicates that the two genes arose through duplication. In contrast to the more ubiquitous ACE, ACE2 transcripts are found only in heart, kidney, and testis of 23 human tissues examined. Immunohistochemistry shows ACE2 protein predominantly in the endothelium of coronary and intrarenal vessels and in renal tubular epithelium. Active ACE2 enzyme is secreted from transfected cells by cleavage N-terminal to the transmembrane domain. Recombinant ACE2 hydrolyzes the carboxy terminal leucine from angiotensin I to generate angiotensin 1-9, which is converted to smaller angiotensin peptides by ACE in vitro and by cardiomyocytes in culture. ACE2 can also cleave des-Arg bradykinin and neurotensin but not bradykinin or 15 other vasoactive and hormonal peptides tested. ACE2 is not inhibited by lisinopril or captopril. The organ- and cell-specific expression of ACE2 and its unique cleavage of key vasoactive peptides suggest an essential role for ACE2 in the local renin-angiotensin system of the heart and kidney. The full text of this article is available at http://www.circresaha.org.
Variation in use of video assisted thoracic surgery in the United Kingdom
Authors: Artyom Sedrakyan, Jan van der Meulen, James Lewsey, Tom Treasure
Journal: BMJ (2004)

<h3>Introduction</h3> Chronic conditions are associated with over one-third of potentially avoidable hospitalisations. Integrated care programmes aim to help people with chronic conditions to self-manage their health, thus avoiding hospital admissions. While founded on principles of person-centred care, the experiences of people with multiple chronic conditions in integrated care programmes are not widely known. Our study will explore how person-centred care is incorporated into an integrated care programme for people with multiple chronic conditions. <h3>Methods and analysis</h3> This is a qualitative phenomenological study being conducted from March 2018 to June 2019, in a large metropolitan health service in Melbourne, Australia. Participants will be programme clients (and/or their carers) and staff working in the programme. We will interview staff about their experiences of the programme. Recruited staff will assist with recruitment of clients who recently completed an episode of care, to participate in a semistructured interview in their home. We will also analyse the medical records of interviewed clients, and observe outpatient clinics connected to the programme, based on the findings of the interviews. We will analyse all data using thematic analysis, with overarching themes representing staff and client perspectives of person-centred care. <h3>Ethics and dissemination</h3> Ethical approval was granted by Monash Health (HREC/18/MonH/33) and Monash University (12260) Human Research Ethics Committees. Our study will provide a comprehensive exploration of person-centred care in an integrated care programme. It will add information to person-centred care literature on participants’ perceptions of what works and why, including barriers and enablers to person-centred care in a complex environment. Findings of this study will be disseminated via publications, conferences and presentations to the health service participants.
Lame's Disease
Authors: Philemon Delphius
Journal: JAMA (1964)

<h3>To the Editor:—</h3> This is a relative newcomer to medicine, having been described first—orally—in 1933 when Lame graduated from medical school. Its particular interest now is that Lame himself would like to eradicate the syndrome which honors his name, and of which he is a victim, and is seriously requesting help from the members of the American Medical Association to accomplish this. Memory should be refreshed as to the exact nature of Lame's disease. Lame himself prefers the descriptive term, "anti-eponymosis," but finds little encouragement because of the still-current fashion and fancy for eponyms. The syndrome is characterized by acute onset of nausea and pain in the cervical soft tissues immediately after the subject (invariably a physician) hears or reads an eponym. The attack subsides gradually over a period of hours or days, depending on the quality and intensity of the succeeding intellectual environment and the incidence of additional eponymosis.
Physiological levels of hydrocortisone maintain an optimal chondrocyte extracellular matrix metabolism
Authors: J Wang
Journal: Annals of the Rheumatic Diseases (2003)

To investigate the effects of physiological doses of hydrocortisone on synthesis and turnover of cell associated matrix (CAM) by human chondrocytes obtained from normal articular cartilage.Human articular cartilage cells were obtained from visually intact cartilage of the femoral condyles of five donors and maintained in culture for one week to reach equilibrium in accumulated CAM compounds. 0, 0.05, 0.20, and 1.0 micro g/ml hydrocortisone was added to the nutrient media during the entire culture period. Cells were liberated and levels of CAM aggrecan, type II collagen, and fibronectin, of intracellular IGF-1, IL1alpha and beta, and of their respective plasma membrane bound receptors IGFR1, IL1RI, and the decoy receptor IL1RII, were assayed by flow cytometry.In comparison with controls, hydrocortisone treated chondrocytes, at all concentrations, expressed significantly higher plasma membrane bound IGFR1. Intracellular IGF-1 levels remained unchanged. Together with these changes, reflecting an increased ability to synthesise extracellular matrix (ECM) macromolecules, hydrocortisone treated cells expressed significantly higher amounts of the plasma membrane bound decoy IL1RII. Concurrently, intracellular IL1alpha and beta levels and membrane bound IL1RI were down regulated. Levels of CAM aggrecan, type II collagen, and fibronectin were significantly up regulated in the chondrocytes treated with hydrocortisone.0.05 micro g/ml hydrocortisone treated chondrocytes had decreased catabolic signalling pathways and showed an enhanced ability to synthesise ECM macromolecules. Because IL1 activity was decreased and the expression of IL1RII decoy receptor enhanced, more of the ECM macromolecules produced remained accumulated in the CAM of the chondrocytes. The effects were obtained at doses comparable with physiological plasma levels of hydrocortisone in humans.
The effect of an H2-receptor antagonist on food-stimjlated acid secretion, serum gastrin, and gastric emptying in patients with duodenal ulcers. Comparison with an anticholinergic drug.
Authors: C T Richardson, B A Bailey, J H Walsh, J S Fordtran
Journal: Journal of Clinical Investigation (1975)

The purpose of the present series of experiments was to measure and compare the effects of an anticholinergic drug (isopropamide) and an antagonist of the histamine H2 receptor (metiamide) on food-stimulated acid secretion. Patients with duodenal ulcers were stimulated by a steak meal, and acid secretion was measured by in vivo intragastric titration. The largest dose of isopropamide that can be taken clinically without producing intolerable side effects (maximum tolerated dose) suppressed food-stimulated acid secretion by 35%. By contrast, metiamide in a 400-mg dose produced no side effects and almost completely abolished food-stimulated acid secretion. A dose-response curve revealed that a 50-mg dose of metiamide was required to suppress food-stimulated acid secretion by 50%. Further studies showed that metiamide and isopropamide are additive in suppressing food-stimulated acid secretion, and that metiamide has no effect on serum gastrin concentration or on gastric emptying.
Talk works if the patient is willing
Authors: A. F Blakey
Journal: BMJ (1997)

Introducing the postoperative care team Effective postoperative care remains surgeons' roleEditor-I am concerned that the suggestions made by David R Goldhill might be taken too seriously rather than remain a point for discussion. 1 Goldhill is right in his assertion that patients can fare badly in their postoperative course because of lack of attention by their attendants and lack of understanding of common postoperative complications.I believe, however, that he has missed the opportunity to lay the blame at the correct door.Surely it is the surgeons' role to carry out preoperative assessment, surgery, and effective postoperative care.If they choose to emphasise their importance in the operating theatre, delegating their other responsibilities to their trainees, the nurse practitioners, and the anaesthetists, why should we encourage this path?Undoubtedly, anaesthetists are fast becoming the new generalists, with an increasing role outside the operating theatre.These new skills and responsibilities include pain control, intensive care, and transoesophageal echocardiography, to name but a few.Some of my professional colleagues may relish even more diversification and abhor my comments.Goldhill implies that anaesthetists and postoperative care nurses will lead the postoperative care team; indeed, this is already happening in North America, where they have been sent to run preoperative assessment clinics by surgeons based in the operating room.If the surgical ward round in your hospital has become a quick look through the laboratory results and a glance at the chest radiograph before a rush to the changing rooms then I suggest that waiting for the confidential inquiry into perioperative deaths to point out the obvious is not the solution.
Vote of thanks
Authors: J. Appleyard, M. Armstrong, J. B. Bassett, J. C. Bowte, K. F. Bradley, R. A. G. Brown, J. Campbell-Fergusson, S. Campbell-Smith, J. Dunlop, B. A. Enoch, D. Fagan, T. Farewell, R. D. Forrest, N. H. Gordon, R. Hole, B. D. Hore, T. Lawlor, R. A. L. Low, M. Lye, K. K. Modowal, H. Sheppard, P. Sperryn, A. J. Stewart, T. Sussman, D. Tidmarsh, P. Wilson, R. S. Winwood, J. E. Woodyard
Journal: BMJ (1969)
Surveillance of New Cigarettes
Authors: Brian Vastag
Journal: JAMA (2001)

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Managing eye conditions in general practice
Authors: T Manners
Journal: BMJ (1997)

Editor—Though general practitioners' confidence in diagnosing and managing eye conditions is not high, they can expect 2-5% of all consultations to be eye related.1 Teaching of ophthalmology at medical school is limited in duration and far removed in time from entry to general practice. Less than 5% of general practice registrars do any ophthalmology as part of vocational training (data from Joint Commitee for Postgraduate Training in General Practice), but over 70% do an accident and emergency post, usually for six months. I sent a questionnaire to all accident and …
Painless Dissecting Aneurysm of the Aorta
Authors: T. P. B. O'DONOVAN, PHILIP J. OSMUNDSON, W. SPENCER PAYNE
Journal: Circulation (1964)

A case is reported of a man who had an acute painless dissecting hematoma of the aorta, which was diagnosed clinically in the absence of hypertension or known precipitating cause. The successful surgical treatment is described and illustrated. The following diagnostic features were stressed in the absence of pain: sudden onset of symptoms, syncope, acute peripheral arterial occlusion, appearance of aortic insufficiency, and finding of bruits over the course of the aorta. The significance of the symptom of pain in the torso and the possible modes of its production in this condition are considered, and it is suggested that pain in dissecting aneurysm may imply a poor prognosis.
The Comparative Antiarrhythmic Actions of Lidocaine and its Quarternary Derivative, Methyl Lidocaine
Authors: FRANK J. KNIFFEN, TIMOTHY E. LOMAS, NANCY L. NOBEL-ALLEN, BENEDICT R. LUCCHESI
Journal: Circulation (1974)

Lidocaine has proved to be an effective antiarrhythmic agent in the management of ventricular arrhythmias subsequent to acute myocardial infarction. Lidocaine's short duration of action and its propensity for producing central nervous system (CNS) stimulation suggest that a safer and more effective therapeutic agent, based on a modification of the lidocaine structure, might be found. The quaternary ammonium compound, methyl lidocaine, was synthesized and its actions in experimentally-induced arrhythmias were studied and compared to those of lidocaine. The antiarrhythmic effects of lidocaine and methyl lidocaine were examined in the anesthetized dog against ouabain-induced ventricular tachycardia and in conscious animals with ventricular tachycardia 48 hours after two-stage ligation of the anterior descending coronary artery. Both pharmacological agents were capable of reversing digitalis-induced arrhythmias and restoring normal sinus rhythm in animals 48 hours after surgical ligation of the anterior descending coronary artery, but methyl lidocaine remained effective for a significantly longer period and its continual administration was not associated with signs of CNS toxicity. In experiments designed to determine the electrical fibrillation threshold, both drugs were able to reduce the vulnerability to ventricular fibrillation but the time course of action for each drug differed. Lidocaine had an immediate effect of increasing the ventricular fibrillation threshold whereas the peak effect of methyl lidocaine was delayed and the increase in the fibrillation threshold lasted longer. This study concludes that the quaternary derivative of lidocaine, methyl lidocaine, possesses antiarrhythmic properties similar to those of lidocaine, but differs in its duration of action and lack of overt stimulatory effects upon the central nervous system.
Bortezomib Plus Gemcitabine/Carboplatin as First-Line Treatment of Advanced Non-small Cell Lung Cancer: A Phase II Southwest Oncology Group Study (S0339)
Authors: Angela M. Davies, Kari Chansky, Primo N. Lara, Paul H. Gumerlock, John Crowley, Kathy S. Albain, Stanley J. Vogel, David R. Gandara
Journal: Journal of Thoracic Oncology (2009)
CAUSES OF FAILURE IN TREATMENT OF SUBACUTE BACTERIAL ENDOCARDITIS
Authors: Mortimer Bader
Journal: JAMA (1952)

The recovery rate of patients with subacute bacterial endocarditis has increased progressively, but death from incomplete eradication of the infection or from complications of the disease still occurs in 20% to 30% of the patients.1It seems appropriate, therefore, that in every fatal case a careful scrutiny be made into the possible causes of failure, in the hope that the knowledge thus obtained may further improve the effectiveness of treatment.  The accompanying report deals with a patient who was admitted four times to the hospital for the treatment of the original episode of subacute bacterial endocarditis and, subsequently, for relapses following apparently adequate courses of treatment. An analysis was made to determine why this patient died despite the use of various antibiotics, singly and in combination, and despite large doses of those antibiotics, apparently adequate according to careful bacteriologic and sensitivity studies.  REPORT OF A CASE  A 56-year-old man
Combination of interleukin-15 and fractionated radiotherapy for cancer treatment
Authors: Joseph Aryankalayil, Karsten Pilones, Ralph Vatner, Sandra Demaria
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Radiotherapy (RT) can induce T cell-mediated anti-tumor immune responses by multiple mechanisms. However, due to the strongly immunosuppressive tumor microenvironment that hinders T cell function, these responses are ineffective and tumors usually escape. The common gamma-chain
Examine Railway Employes' Eyes Periodically and in a Scientific Manner.
Authors: Jno. Ransom Hamill
Journal: JAMA (1898)

Chicago, Ill., August 31, 1898. <h3>To the Editor:</h3> —The importance of railway signals and their correct observation by employes is a matter the subject of which has been given a great deal of study by all railroad officers, to the extent that every conceivable form of signal that genius, talent and mechanism can contrive has been tried and each in turn served the period of its usefulness and relegated to the background, the cruder machine being supplanted by a more perfectly constructed one until today our railway signals are equal in construction to those produced in any country. The medical profession has not kept pace with these mechanical students in their teachings of how to correctly observe these signals and thereby avoid accidents. The average railway surgeon is provided with a few crude tests as to color vision and is taught how to correctly operate them by a superior medical
Multiple virus isolations in children with acute lymphoblastic leukaemia
Authors: E. Bruce, M.M. Reid, A.W. Craft, J. Kernahan, P.S. Gardner, C. Barnaby, E. Bruce, A.W. Craft, P.S. Gardner, J. Kernahan, J. McQuillin, T.C. Noble, R.H. Prudhoe, C.R. Pullan, M.M. Reid, P.R.A. Taylor, W. Walker
Journal: Journal of Infection (1979)
Organ transplants and blood transfusions may transmit West Nile virus
Authors: F. Charatan
Journal: BMJ (2002)

Four US recipients of organs from one donor have become infected with West Nile virus.

Three of the transplant recipients, resident in Florida and Georgia, developed encephalitis. One has died, and the other two are recovering in hospital.

The fourth, a Florida woman aged 71, underwent a liver transplantation at a Jacksonville hospital then developed mild symptoms of viral infection without encephalitis. She tested positive for the virus at the Florida Department of Health laboratory and is now recovering at home.

The donor, who died in Georgia …
Too frequent use of painkillers can cause rather than cure headaches
Authors: N. Hawkes
Journal: BMJ (2012)

Headaches, though common, are not always correctly diagnosed or well treated, says new guidance from the UK National Institute for Health and Clinical Excellence (NICE).1 In a significant minority of cases, painkillers taken to reduce the pain could actually be causing it.

One in every 25 GP consultations is about headache, the guidance says. Sometimes patients who have persistent pain are seeking reassurance that they do not have a brain tumour, but the great majority of headaches are not caused by tumours or by other serious health problems, said Manjit Matharu, honorary …
Detection and exclusion of interatrial shunts by two-dimensional echocardiography and peripheral venous injection.
Authors: T D Fraker, P J Harris, V S Behar, J A Kisslo
Journal: Circulation (1979)

Two-dimensional echocardiography (2-D echo) was used with peripherally injected contrast material to detect interatrial shunts in 33 patients. Group 1 consisted of 11 patients having classic clinical findings of atrial septal defect. Group 2 consisted of 12 patients with problems requiring that atrial shunting be excluded. Group 3 (control group) consisted of 10 patients undergoing cardiac catheterization for chest pain. Confirmation of the 2-D echo findings was provided by cardiac catheterization in 32 patients and postmortem examination in one. Right-to-left atrial shunts were detected in all 11 patients in group 1, although seven had no right-to-left shunt calculable by oximetry. Four patients in Group 2 had right-to-left atrial shunts. None of the patients in Group 3 had atrial shunts. In the 15 patients with atrial shunts, the degree of right-to-left shunting could be qualitatively assessed as small, moderate, or large. There were no false-negative or false-positive results by contrast 2-D echo.
Orphan drug pricing may warrant a competition law investigation
Authors: J. C. P. Roos, H. I. Hyry, T. M. Cox
Journal: BMJ (2010)

EU legislation offers an exclusive marketing period as an incentive for companies to develop drugs for rare diseases. But pricing for orphan drugs hinders access and may warrant a competition law investigation, say <b>Jonathan C P Roos</b>, <b>Hanna I Hyry</b>, and <b>Timothy M Cox</b>