tbuckley/cabot-search huggingface dataset:
Tournament water skiing trauma.
Authors: S N Roberts, P M Roberts
Journal: British Journal of Sports Medicine (1996)

Tournament water skiing is an increasingly popular and internationally successful sport in Great Britain, despite the climate. The kinematics and injury patterns of the three disciplines will be unfamiliar to most clinicians and are described, with estimation of the stresses. Advances in equipment over the last 15 years have reduced the risk of severe injury in the tricks event, while high speed impacts are responsible for the majority of trauma in slalom and jump. There is a surprisingly high incidence of injury to the lumbar spine during the high impact jump event. Comparison with findings in other sports suggests that the spine may be damaged by overuse, particularly before skeletal maturity.
Nuclear war: the medical facts.
Authors: J Smith, T Smith
Journal: BMJ (1981)

This is the first of four articles describing the physical, biological, and psychological consequences of nuclear explosions. Any prediction of the effects depends critically on what military strategists call the scenario?how many nuclear weapons might be used, how quickly, where they will fall, and at what height they may be detonated. Though we have used a range of possible examples to illustrate specific effects, we make no attempt to predict the numbers or types of weapons that might be used in any future war. Every major war this century con? founded the military experts by turning out quite contrary to their expectations. First and foremost, atomic weapons cause explosions. Some of the effects of a nuclear explosion are comparable to those of a conventional (chemical) explosion: the major differences are the possible magnitude of nuclear explosions?they can be much bigger?and the release of harmful nuclear radiation. Almost all the early deaths and destruction caused by nuclear weapons are due to blast and heat?because most people close enough to the centre of the explosion to receive a potentially lethal dose of the extremely harmful initial radiation will probably have been killed or fatally injured by the explosion itself. The atomic bomb dropped on Hiroshima on 6 August 1945 had a power equivalent to 12 500 tons of conventional explosive, TNT. It was exploded in the air 500 yards above the ground and killed about 65 000 people either immediately or within a few weeks. Modern strategic nuclear weapons are more powerful. A one megaton bomb is equivalent to 1 000 000 tons of TNT; the total stock of nuclear weapons held by the United States and the USSR is estimated at around 10 000 megatons?equivalent to around 800 000 bombs of the Hiroshima size. The effect of a one-megaton explosion depends on whether it is exploded high in the air or close to the ground (fig 1). An explo? sion near enough to the ground to suck earth and building debris up into the stem of the mushroom cloud is known as a surface burst. Explosions high in the atmosphere?air bursts?do not produce this debris-filled mushroom. Regardless of height of burst, about 85% of the explosive energy of a nuclear fission weapon results in blast and heat. The remainder is produced as nuclear radiation?5% initial (produced in a minute or so) and 10% as residual radiation emitted over a period of time. An airburst at a height of 2000 yards produces an immensely hot, luminous fireball and a blast wave travelling at supersonic speed. When this wave hits the ground it is reflected, causing a secondary shock wave. These two waves fuse a little over one mile from the point vertically beneath the explosion (ground zero). The blast wave creates the greatest pressures around ground zero; as it travels outwards it gradually slows down and loses its force. Ten seconds after the explosion the shock wave is
Effect of colchicine on the antibody response. II. Demonstration of the inactivation of suppressor cell activities by colchicine.
Authors: P N Shek, C Waltenbaugh, A H Coons
Journal: The Journal of Experimental Medicine (1978)

The simultaneous administration of colchicine (CC) with a T-independent antigen, e.g. 2,4,6-trinitrophenyl-keyhold limpet hemocyanin-Sepharose, to intact animals effectively enhanced their hapten-specific plaque-forming cell (PFC) response. However, in congenitally athymic nude mice in which T-cell regulation was absent, CC was ineffective in producing enhancement. These observations suggest that the target cell acted upon by CC is most likely thymus-derived. Furthermore, the injection of CC with the co-polymer of L-glutamic acid50-L-tyrosine50 (GT) abolished GT-specific suppression of the PFC response to GT-methylated bovine serum albumin. Spleen cells from CC-treated and GT-primed hosts could no longer transfer suppressive activity to normal recipients. These results provide evidence that CC is capable of inactivating or eliminating suppressor cells or their precursors. Thus, CC-induced enhancement of the antibody response may be explained, at least in part, by its antimitotic, and hence lethal effect on dividing suppressor T cells.
Criteria for liver transplantation for HCC: What should the limits be?
Authors: Mauricio F. Silva, Morris Sherman
Journal: Journal of Hepatology (2011)

Liver transplantation is a well-established treatment in a subset of patients with cirrhosis and hepatocellular carcinoma. The Milan criteria (single nodule up to 5 cm, up to three nodules none larger than 3 cm, with no evidence of extrahepatic spread or macrovascular invasion) have been traditionally accepted as standard of care. However, some groups have proposed that these criteria are too restrictive, and exclude some patients from transplantation who might benefit from this procedure. Transplanting patients with tumors beyond the established criteria falls into two categories, those whose tumors are beyond the Milan criteria at presentation without the use of treatment prior to transplantation (expanded criteria), and those in whom treatment allows the Milan Criteria to be fulfilled (down-staging). Currently, however, there is no international consensus regarding these approaches in clinical practice. The purpose of this systematic review is to clarify this debate through a critical analysis of available data. Finally, some comments on predictive factors apart from morphological characteristics are also addressed.
Gastrointestinal Radiology: A Pattern Approach
Authors: Richard Gore
Journal: JAMA (1984)

Considering the plethora of excellent, recently published textbooks on gastrointestinal (GI) tract radiology, the need for yet another must be questioned. Happily, this originally conceived and well-executed work does fill a real void. Most texts on GI tract radiology are disease oriented, so that if one is confronted with an unusual finding on a barium study, a search for the cause presupposes a fairly good notion of the pathology involved. What this work does is to present the radiographic abnormality first and then illustrate and succinctly discuss the various possible causes. While not a replacement for the more conventional, detailed books on radiology of the gut, this format is extremely useful in the day-to-day evaluation of GI tract studies. The text is organized into 73 chapters, and each is devoted to a specific radiographic abnormality such as abdominal calcification, esophageal ulceration, thickening of gastric folds, widening of the duodenal sweep,
Treatment with beta-adrenergic blocking agents after myocardial infarction: From randomized trials to clinical practice
Authors: Sami Viskin, Ilan Kitzis, Eli Lev, Zeev Zak, Karin Heller, Yael Villa, Alejandro Zajarias, Shlomo Laniado, Bernard Belhassen
Journal: Journal of the American College of Cardiology (1995)
Steatosis of the liver and response to interferon (IFN) in chronichepatitis C
Authors: I. Ketikoglou, S. Karatapanis, G. Kafiri, I. Elefsiniotis, M. Dimopoulou, I. Lafiatis, T.H. Christoforatos, G. Karvountzis
Journal: Journal of Hepatology (2000)
ELECTROMYOGRAPHIC FINDINGS IN A CASE OF CATATONIA
Authors: BURTON A. SANDOK, ANTON A. TRATAR
Journal: American Journal of Psychiatry (1964)

A patient with the typical findings of catatonia was studied electromyographically while maintaining a fatigue-producing posture. Results would suggest that despite maximum use of motor units, the subject was able to delay the appearance of muscular fatigue clinically and electromyographically. The thesis that fatigue is delayed by the interaction of a small number of motor units is questioned. This interrelationship of observable physical occurrences with psychodynamic formulations provides a fertile area for additional study.
The Place of Surgery in Wilms' Tumors
Authors: John K. Lattimer
Journal: JAMA (1968)

The survival rate of patients treated for Wilms' tumor (nephroblastoma) has increased steadily over the past three decades. Ladd and White<sup>21</sup>were the first to show that prompt and thorough surgery, in conjunction with better preoperative and postoperative care, improved the survival rate. This was the first of three important advances in the treatment of this malignancy, and the evidence still favors the concept that surgical removal of the tumor mass should be the first step carried out, in order to insure the best results from radiotherapy and chemotherapy. Surgery alone has been effective in a few cases. For instance, in the series from Squier Urological Clinic, published in 1959,<sup>22</sup>four of the five patients treated with nephrectomy alone survived more than five years (Table 2). The larger collected series of Klapproth,<sup>23</sup>however, showed that the results of nephrectomy alone were not as good as those obtained
Ruling allows EU patients to be reimbursed for treatment outside the union
Authors: Rory Watson
Journal: BMJ (2005)

European Union patients who have received prior permission from their national health service or insurers to be treated in another EU country are entitled to have their costs covered even if they are subsequently given medical care outside the union, according to a new judgement from theEuropean Court of Justice. The ruling establishes the principle that health authorities in one member state are bound by decisions that may be taken by those in another.

The case revolved around Annette Keller, a German citizen living in Spain. In October 1994, she received an …
Phase II evaluation of an intensified induction therapy with standard daunomycin and cytarabine followed by high dose cytarabine for adults with previously untreated acute myeloid leukemia: A southwest oncology group study (SWOG‐9500)
Authors: Stephen H. Petersdorf, Cathryn Rankin, David R. Head, Howard R. Terebelo, Cheryl L. Willman, Stanley P. Balcerzak, Anand B. Karnad, Shaker R. Dakhil, Frederick R. Appelbaum
Journal: American Journal of Hematology (2007)

Induction therapy for acute myeloid leukemia (AML) usually consists of 7 days of cytarabine at 100-200 mg/m(2)/day and an anthracycline. Such combinations produce complete response (CR) rates of 60-80% in patients with de novo AML. On the basis of a previous report, suggesting a higher CR rate using a regimen of standard daunomycin and cytarabine followed by 3 days of high-dose cytarabine (HDAC), 101 eligible patients received this regimen in a phase II trial. Sixty patients [59%, 95% confidence interval (CI) 49-69%] achieved a CR, and 10 patients died of infection during induction. Although cytogenetic risk group affected overall survival (P = 0.0016) and relapse-free survival (P = 0.0043), it had no impact on CR rate (P = 0.63). Patients received postremission therapy with repetitive courses of alternate day high-dose cytarabine; this was associated with considerable toxicity and the majority of patients could not receive all of the scheduled postremission therapy. The estimated median survival was 23 months (95% CI 15-34 months), and the estimated probability of surviving 5 years was 34% (95% CI 24-43%). The results of this intensive induction regimen were similar to that seen in previous trials and were not as promising as reported in the previous pilot study.
Intracardiac echocardiographic guidance of transcatheter closure of atrial septal defects and patent foramen ovale: Comparison with transesophageal echocardiography and cine fluoroscopy
Authors: Qi-Ling Cao, Ziyad M. Hijazi, Peter Koenig, Mei Jin, Joel Sims, David J. Waight, Mary Heitschmidt, Roberto M. Lang
Journal: Journal of the American College of Cardiology (2003)
Corticosteroid resistance in chronic asthma.
Authors: J Carmichael, I C Paterson, P Diaz, G K Crompton, A B Kay, I W Grant
Journal: BMJ (1981)

Fifty-eight patients with chronic asthma in whom airflow obstruction was relieved by bronchodilator aerosols but not by oral corticosteroids were compared with 58 other chronic asthmatics who responded equally well to both treatments. The two groups were matched for age and sex. The only significant clinical differences between the two groups were that in the "corticosteroid-resistant" patients there was a more frequent family history of asthma and a longer duration of symptoms. Resistant patients also had a relatively lower peak expiratory flow rate in the morning than later in the day and a greater degree of bronchial reactivity to methacholine. Such features, however, may not be specific criteria of corticosteroid resistance since they were also observed in untreated asthmatics who subsequently responded well to corticosteroids. The failure of prednisolone to inhibit a monocyte-mediated bronchial reaction may explain why some chronic asthmatics do not respond to corticosteroids. Patients with corticosteroid-resistant asthma should be recognised at an early stage so that regular treatment with oral corticosteroids may be withdrawn. Failure to do this results in needless exposure to the risk of developing serious side effects.
American Cancer Society Textbook of Clinical Oncology
Authors: Walter G. Gunn
Journal: JAMA (1992)

The American Cancer Society (ACS) first sponsored and produced a text on clinical cancer care in 1967. For many years, and six editions, that volume,<i>Clinical Oncology: A Multi-Disciplinary Approach</i>, was largely a product of the staff and faculty of the University of Rochester School of Medicine. It was used in medical schools and graduate training and was meaty, concise, comprehensive, and hard to read, though virtually encyclopedic. Now the ACS has brought out a successor textbook of clinical oncology, which is "a new, more comprehensive text for medical students and for physicians working in, or interested in, oncology." The rationale would appear to be the need to encompass the scientific underpinnings of clinical cancer care and to relate them to the actual care of patients. Thus, there is more emphasis on biological concepts and much more discussion of life-style factors and preventive measures, as well as long overdue consideration
Twin Pregnancy and Hydramnios
Authors: K. Vartan
Journal: BMJ (1948)

advisable in the presence of acute allergic manifestations.Failure to find microfilariae in the blood does not exclude the diagnosis, as they may be very difficult to demonstrate in Loa loa.An annotation, in the Journal (July 3, p. 32) has recently drawn attention to the possibility of the successful treatment of filariasis by chemotherapy.-Weare, etc., G. MELTON.London, N.21.
ANTISTREPTOCOCCUS SERUM IN THE TREATMENT OF CONSUMPTION.
Authors: W. H. WEAVER
Journal: JAMA (1896)

For the past decade and more the tubercle bacillus has been studied and discussed to such an extent that the presence and activity of other germs as factors in the pathologic processes occurring in consumption were entirely disregarded. That the tubercle bacillus is present and determines the general character of the disease by initiating the inflammatory action is admitted. Tuberculosis of itself is not a suppurative process, hence the appearance of pus in the sputum must be considered as the beginning of a secondary infection which is more rapidly destructive. I believe that a simple tuberculosis of the lung is a mild disease and easily cured if proper antiseptic and hygienic measures are pursued. But it is seldom that a case of simple tubercular phthisis in the earlier stage comes to the physician. It is only after the complications begin that the patient feels sick enough to consult his medical
The Patient-Physician Contract
Authors: ROGER M. CASS
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 May 1983The Patient-Physician ContractROGER M. CASS, M.D.ROGER M. CASS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-5-668_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The article by Quill (1) raises interesting ethical, moral, and legal issues for the practicing internist. It is true that the physician and patient enter into a verbal contract when they agree to establish a relationship, but not mentioned in the article is the role the patient's family may play. The family may not be initially involved, but if the patient becomes seriously ill, or is hospitalized, the family often becomes a full partner in the contract. If the patient becomes incompetent, comatose, or terminally ill, the contract is basically between the physician and the family.To...Reference1. QUILL T. Partnerships in patient care: a contractual approach. Ann Intern Med. 1983;98:228-34. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROGER M. CASS, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1983Volume 98, Issue 5_Part_1Page: 668-669KeywordsComa ePublished: 1 December 2008 Issue Published: 1 May 1983 PDF downloadLoading ...
SOME ANTECEDENT FACTORS IN THE FAMILY HISTORIES OF 568 MALE SCHIZOPHRENICS OF THE UNITED STATES NAVY
Authors: C. W. WAHL
Journal: American Journal of Psychiatry (1956)

1. The frequency of various antecedent familial experiences in the histories of 568 schizophrenics from the U. S. Navy was determined and compared with incidence data from the general population, a group of 100,000 Naval recruits, and, where applicable, to a previously studied group of 392 schizophrenics from the Elgin State Hospital. 2. The factors investgiated were: (1) marked rejection and/ or overprotection by one or both parents; (2) bereavement by death or separation of one or both parents prior to the fifteenth year; (3) placement in the sibling hierarchy; (4) family size; and (5) religious affiliation. 3. It was found that among this group, 50.3% came from homes in which there was severe rejection and/or overprotection by one or both parents. Severe rejection by one or both parents was by far the most frequently manifested attitude, 34% having been so rejected, while only 9% were overprotected by one or both parents. A rejecting father was the most frequently encountered pathological parental attitude. 4. Of the entire group 41% had lost a father or mother by death, divorce, or separation before the age of 15 years, as compared with 11.4% of such loss among the generality of Navy men. Approximately 4 times as many of this schizophrenic group had been orphaned prior to their fifteenth year than in the general population. The loss of the father by death was predominant: 55% of the schizophrenic orphans had lost a father, 33% a mother, and 18% had lost both. 5. As to the sibling position, 18% were oldest children, 26% youngest, 12% next-to-youngest, and 14% were only children. All other placements constituted 31%. Youngest children slightly, but definitely, predominated. Among the Naval group 25% were oldest children, 25% youngest, 9% only children, and all other placements constituted 34%. Possible implications of ultimate sibling placement on the development of the self are discussed. 6. The average family size of members of the schizophrenic sample was 4.4 children per family. This compares with a national average of 2.2 per family. It is considered that large family membership may operate to produce specific stress situations; and mechanisms by which this might operate are described. 7. Among the group, 51% were professed Protestants, 42% Catholics, 2% Hebrews, 2% other or none. It is not certain that religious membership per se played any decided role in the development of schizophrenic illness. 8. Some of the implications of these data for identification theory and upon the genesis of schizophrenia are discussed.
National audit of care after mastectomy points to need for better information on reconstruction
Authors: S. Mayor
Journal: BMJ (2010)

Nine in 10 women with breast cancer who undergo mastectomy or reconstruction surgery rate their care as being of high quality, an audit of NHS patients in England has found. However, potential exists for reducing complications, providing more information on reconstruction, and improving pain relief after reconstruction.

The 2010 national mastectomy and breast reconstruction audit included data from all 150 NHS acute trusts in England that provide these services; 81% of eligible patients were registered in the audit. Data were also submitted from 114 independent hospitals and six trusts in Wales and Scotland, so that complete information was analysed for 18 216 women.

The results showed that around 10% of …
Augmented glucose use and pentose cycle activity in hepatic endothelial cells afterin vivo endotoxemia
Authors: Zoltán Spolarics, John J. Spitzer
Journal: Hepatology (1993)

Glucose use and pentose cycle activity were determined in freshly isolated rat hepatic endothelial cells 3 hr after an intravenous injection of Escherichia coli lipopolysaccharide (0.1 mg/kg body weight), by use of (1- 14 C)glucose, [6- 14 C]glucose and [2-H]glucose. Lipopolysaccharide treatment in vivo increased glucose use fivefold, whereas glucose oxidation in the pentose cycle was elevated from 0.2 to 1.5 nmol/hr/10 7 cells. In vitro incubation of endothelial cells from saline- and lipopolysaccharide-treated animals in the presence of phorbol 12-myristate 13-acetate (10 −6 mol/L) increased pentose cycle activity twofold and eightfold, respectively. Phorbol 12-myristate 13-acetate caused only a 40% to 60% increase in glycolysis in both groups. Addition of t-butyl hydroperoxide (0.5 mmol/L), a substrate for gluathione peroxidase, caused a 24-fold and 16-fold increase in the glucose flux through the pentose cycle in cells from saline- and lipopolysaccharide-treated rats, respectively. Oxidation of glucose through the Krebs cycle was also increased several-fold after t-butyl hydroperoxide administration. Depletion of cellular glutathione by N-ethylmaleimide (0.1 mmol/L) inhibited the phorbol 12-myristate 13-acetate-induced or t-butyl hydroperoxide-induced increase in the pentose cycle activity with no marked effects on glycolysis. Diphenyleneiodonium (0.1 mmol/L), an inhibitor of superoxide and nitric oxide synthesis inhibited the phorbol 12-myristate 13-acetate-induced increased pentose cycle activity with no effects on the t-butyl hydroperoxide-induced response. Endothelial cells from control animals treated with either 12-myristate 13-acetate or t-butyl hydroperoxide in the presence of exogenous glucose 20 mmol/L showed a similar increase in glycolysis but less increase in the pentose cycle activity as found after lipopolysaccharide treatment in the presence of glucose 5 mmol/L. This finding suggests that glucose-6-phosphate dehydrogenase or pathways dependent on pentose cycle intermediates became up-regulated after lipopolysaccharide administration. The lipopolysaccharide-induced elevated glucose use, accompanied by an increased activity of the pentose cycle, may also represent a potentiated mechanism for eliminating hydrogen peroxide derived from intracellular sources or from activated Kupffer cells and sequestered neutrophils in the hepatic sinusoid. (Hepatology 1993;17:615-620.)