tbuckley/cabot-search huggingface dataset:
Synopsis of Surgery
Authors: John G. Raffensperger
Journal: JAMA (1969)

Students searching for a quick source of knowledge will treasure<i>Synopsis of Surgery</i>. Drs. Liechty and Soper, with other University of Iowa faculty members, have out-lined the entire spectrum of surgery. The first ten excellent chapters deal with those aspects of surgery which are common to all specialties. Surgeons could well afford to review the material on wound healing, fluids and electrolytes, blood coagulation, infection, and nutrition. The remaining 32 chapters review the entire gamut of surgery by organ systems and the subspecialties. The authors utilize clever teaching aids to describe surgical pathophysiology lucidly. Excellent illustrations clarify complex problems such as renal vascular hypertension and bilirubin metabolism. The book is very readable and well organized and will be useful to teachers as well as students. The strength of the book is in its succinct correlation of the basic science with clinical surgery. On the other hand, in their brevity, many
Gallstone Ileus Diagnosed by Technetium-99m Dimethyliminodiacetic Acid Cholescintigraphy A Case Report
Authors: CHARLES M. ELKIN, S WEISSMANN, LEONARD M. FREEMAN
Journal: Clinical Nuclear Medicine (1984)

Tc-99m IDA cholescintigraphy frequently provides information regarding nonbiliary pathology, such as small bowel obstruction. The cholescintigraphic finding of functional cystic duct obstruction concomitant with persistent small bowel dilatation and lack of progression of labeled bile suggests the diagnosis of gallstone ileus.
Promising New Technique May Accelerate Genome Mapping
Authors: Beverly Merz
Journal: JAMA (1989)

CHAOS, CONSENSUS, COMPLETION. That's how Charles Cantor, PhD, envisions the human genome project's progression. Cantor, director of the Department of Energy's Human Genome Center at Lawrence Berkeley (Calif) Laboratory, admits that the effort to map and sequence the human genome is still in the first stage, but he thinks that a new mapping technique using landmarks called sequence tagged sites (STSs) is bringing it closer to the second. Last month, he and 1000 other representatives of science, government, and industry met in San Diego to discuss how to accelerate the pace. The meeting, sponsored by the Human Genome Organization and<i>Science</i>magazine, was one of several recent gettogethers of what may come to be known as the Human Gene Club—a motley crew of geneticists, molecular biologists, chemists, and physicists, each of whom has varied approaches to and stakes in the project. For the first time, there was a glimmer of
Legal and Medical "Insanity"
Authors: W. L. Neustatter
Journal: BMJ (1946)

term acade,nic and practical.The academic solution is very unsatisfactory.The patient asks, "Have I, or have I not, amoebic dysentery ?" and one is bound to answer, " I do not know."The practical solution is to tell the patient to return immediately there is any recurrence of the diarrhoea, and if this is in fact due to amoebic dysentery one will always find the vegetative form of the amoeba.Of course, there are various objections to this procedure, among which is the fact that the patient may in the meantime develop an acute hepatitis, but this in no way affects the general principle.In addition, one may resort to stool culture on special media and, I understand, there is some work being done on a complementdeviation reaction.Tropical medicine, like all other branches of medicine, con- sists of a structure of knowledge and experience based on an appreciation of fundamentals, among which is the action of emetine on the amoeba of dysentery.That so many miscon- ceptions have arisen is, I feel certain, due to the fact that a large number of doctors during the war, through no fault of their own, have had thrust upon them a subject which they have rarely, if ever, had to consider before.-Iam, etc., London, W.1. D. LAWRENCE.Novel Method of Digital Traction SIR,--Dr.MacLeod (Oct. 26,p. 614) is incorrect in thinking that nail traction in the treatment of fractured phalanges is novel.While in charge of the fracture department at Guy's Hospital I used this method for many years as the routine treatment for oblique fractures of the phalanges.The method was described and illustrated in an article on " Fractures of the Upper Limb" (Guy's Hospital Reports, 1921, 71, 360), and on several other occasions.In most cases I found it pos- sible to perforate the free edge of the nail painlessly and without anaesthesia, and a fine salmon gut suture was my material of choice for traction.The method is one I found of great use, and when established the traction, which in my practice was maintained via a rubber " accumulator," is quite painless.-Iam, etc., London.W. 1.
CONSIDERATIONS IN DETERMINING A MODEL FOR THE MENTAL HOSPITAL
Authors: MORRIS S. SCHWARTZ, CHARLOTTE GREEN SCHWARTZ
Journal: American Journal of Psychiatry (1959)

In this paper, we have discussed what we consider to be a basic problem in the field of inpatient care: the relative lack of exploration and analysis of the considerations basic to developing a model for an inpatient facility. We have suggested 3 considerations that we feel are important in such analysis : the feasible and the desirable institution, the theoretical orientation toward mental illness and its treatment, and the purposes and interests practitioners would like the facility to pursue. It is our conviction that if practitioners explore the implications of this kind of analysis, they may be able to formulate more adequate models for inpatient facilities and thus achieve their central objective of contributing more effectively to patient welfare.
DEVELOPMENT OF A STANDARD INPUT FUNCTION FOR PATLAK TUMOR IMAGING
Authors: B. A. Harkness, F. H. Fahey, H. D. Gage, K. R. Zasadny, R. L. Wahl, J. W. Keyes
Journal: Clinical Nuclear Medicine (1994)

Harkness, B. A.; Fahey, F. H.; Gage, H. D.; Zasadny, K. R.; Wahl, R. L.; Keyes, J. W. Jr. Author Information
Blood Pressure Response to Changes in Serum Ionized Calcium During Hemodialysis
Authors: JOHN C. MAYNARD
Journal: Annals of Internal Medicine (1986)

The effect of an increasing serum ionized calcium concentration on blood pressure during hemodialysis was studied in a prospective cross-over trial. Twelve patients were dialyzed three times with a dialysate Ca concentration of 5.5 mg/dL and three times with one of 7.5 mg/dL. Dialysis with the high Ca dialysate was associated with less fall in the mean arterial pressure (p < 0.001). No statistically significant changes occurred in serum osmolality, body weight, or heart rate after dialysis at the two dialysate Ca levels. Increasing the Ca concentration in dialysate may protect against intradialytic hypotension in some patients.
Diagnostic Evaluation of Elderly Patients with Mild Memory Problems
Authors: Jason H.T. Karlawish, Christopher M. Clark
Journal: Annals of Internal Medicine (2003)

This case-based discussion focuses on the clinical presentation and diagnostic assessment of a uniquely challenging group of elderly patients: those with symptoms of mild memory problems. Such patients present a challenge to clinicians because of flux in our understandings of normal, age-related cognitive changes; of cognitive changes due to neurodegenerative illnesses; and of the relationships between depression and cognitive impairment. In addition, symptoms of memory problems may be reported by an observer rather than by the patient. These challenges warrant stepwise evaluation of elderly patients who present with symptoms of memory loss.
Time course of response to oral and inhaled corticosteroids in non-asthmatic chronic airflow obstruction.
Authors: D C Weir, A S Robertson, R I Gove, P S Burge
Journal: Thorax (1990)

One hundred and twenty one patients considered on clinical grounds to have non-asthmatic chronic airflow obstruction completed a double blind, crossover trial comparing oral prednisolone 40 mg per day with inhaled beclomethasone dipropionate 500 micrograms thrice daily, each given for 14 days, with a 14 day washout period between treatments. The time course of response was analysed for the 57 occasions where there was a significant increase in mean daily peak expiratory flow (PEF) over the treatment period. Mean daily PEF was still rising at day 14 on 12 occasions. After withdrawal of treatment mean daily PEF remained above pretreatments levels for more than two weeks in half the responses analysed. The peak response occurred earlier with inhaled beclomethasone (median 9.5 (range 3-14) days) than with oral prednisolone (median 12 (range 1-14) days), though both treatments produced a response that was sustained for a similar period. The results suggest that a trial of treatment with corticosteroids in this group of patients should last more than 14 days, and that in a study with a crossover design the washout period should be longer than two weeks.
Counterimmunoelectrophoresis and Bacterial Meningitis-Reply
Authors: John Eckfeldt
Journal: JAMA (1978)

In Reply.—  Hamoudi and Fleer present some interesting data. Their data for CIE on CSF in cases of suspected meningitis are similar to our own. The sensitivity of the test for the various organisms is surprisingly close to what we reported considering our limited number of cases. We did find rare false-positives, which they apparently have not (yet) observed. However, they do have many cases that were CIE-positive but culture-negative, which they attribute to partial treatment before obtaining cultures. One cannot be certain that a few of those cases are not false-positives.  When one attempts to evaluate any new test that is designed to diagnose a disease for which there is no sure way of distinguishing patients with and without disease, the trap of circular reasoning must be recognized. There is no good experimental approach to this problem. But, to assume that all patients who show positive results with the
Increased Susceptibility to Malaria during the Early Postpartum Period
Authors: Nafissatou Diagne, Christophe Rogier, Cheikh S. Sokhna, Adama Tall, Didier Fontenille, Christian Roussilhon, André Spiegel, Jean-François Trape
Journal: New England Journal of Medicine (2000)

Pregnancy is associated with increased susceptibility to malaria. It is generally agreed that this increased risk ends with delivery, but the possible persistence of increased susceptibility during the puerperium has not been investigated.
Census of single homeless people in Sheffield.
Authors: S L George, N J Shanks, L Westlake
Journal: BMJ (1991)

OBJECTIVE--To determine the number of single homeless people in Sheffield and to examine their demography and social and medical details. DESIGN--Census carried out between 8 am and 8 pm on one day. Participants completed a questionnaire designed to provide data relating to employment history, contact with welfare and health services, social state, prison history, medical history, and health state. SETTING--Sites in Sheffield identified by local workers as being places of residence of homeless people. SUBJECTS--340 single homeless people. MAIN OUTCOME MEASURES--Self reported history of alcohol or drug misuse, existence of a chronic medical condition, and use of general practitioner and hospital services. RESULTS--The mean age of the population was 42.5 years and a quarter of the population were aged less than 30; there were 48 women. Significant differences were noted between men and women with respect to self reported psychiatric illness (77/266 men v 27/42 women), self reported alcoholism (83/273 v 4/44), prison history (152/255 v 8/41), and registration with a general practitioner (73/275 v 38/46). Various chronic medical conditions were reported, and the perceived health state of the population was low; 129 claimed to have been admitted to a psychiatric hospital. 220 people were registered with a general practitioner, and 179 claimed to see their doctor. Sixty five had attended or been admitted to a general hospital in the month preceding the study, 45 for accident and emergency services. CONCLUSIONS--The homeless in this population were younger than those found in previous studies. The prevalence of psychiatric illness was high in the population, and the overall health state was poor. Most subjects obtained health services from general practitioners.
Beauty Parlor Stroke Syndrome: Report of Five Cases
Authors: Michael I. Weintraub
Journal: JAMA (1993)

<h3>To the Editor.</h3> —Concern for iatrogenic arterial injury was recently raised by the observation of stroke symptoms in two elderly women after shampoo treatment in a beauty parlor.<sup>1</sup>The hazard of sustained hyperextension and rotation on vertebral artery flow has not been previously addressed in the elderly population who are disproportionately at risk for cerebrovascular disease. The following five cases suggest that every adult should be made aware of the potential dangers of extreme and sustained neck posture during activities of daily living. <h3>Report of Cases.—Case 1.</h3> —A 79-year-old woman developed vertigo during shampooing, followed by nystagmus and ataxia. Magnetic resonance imaging result was normal but magnetic resonance angiography with dynamic positioning demonstrated marked flow reduction at the atlanto-occipital junction of the right vertebral artery by left rotation and hyperextension (Figure). After this procedure, the patient's symptoms temporarily intensified and returned to baseline after 12 hours. <h3>CASE 2.</h3>
Endoscopic Electrocoagulation in Upper Gastrointestinal Hemorrhage
Authors: John P. Papp
Journal: JAMA (1974)

Emergent upper gastrointestinal endoscopy was performed in seven actively bleeding patients. The site of bleeding was found. Electrocoagulation with a flexible suction coagulator electrode (Cameron-Miller) passed through an endoscope (Olympus GIF) resulted in cessation of bleeding in all cases. The lesions coagulated were as follows: four benign gastric ulcers, one duodenal ulcer, one area of hemorrhagic gastritis, and one gastric varix. No morbidity or death occurred as a result of the electrocoagulation. The patient with a gastric varix died due to esophageal variceal bleeding. The remaining six patients were treated medically. No longer is endoscopy only a diagnostic technique; it can also be therapeutic. This new technique may be a valuable addition to the approach of treatment of upper gastrointestinal hemorrhage. (<i>JAMA</i>230:1172-1173, 1974)
The histone deacetylase HDAC11 regulates the expression of interleukin 10 and immune tolerance
Authors: Alejandro Villagra, Fengdong Cheng, Hong-Wei Wang, Ildelfonso Suarez, Michelle Glozak, Michelle Maurin, Danny Nguyen, Kenneth L Wright, Peter W Atadja, Kapil Bhalla, Javier Pinilla-Ibarz, Edward Seto, Eduardo M Sotomayor
Journal: Nature Immunology (2008)
Homocysteine and Risk of Premature Coronary Heart Disease
Authors: Paula M. Gallagher, Raymond Meleady, Denis C. Shields, Kok Soon Tan, Dorothy McMaster, Rima Rozen, Alun Evans, Ian M. Graham, Alexander S. Whitehead
Journal: Circulation (1996)

Background Plasma homocysteine levels are modulated by nutritional and genetic factors, among which is the enzyme methylenetetrahydrofolate reductase (MTHFR). A common defective (thermolabile) variant of this enzyme is causally associated with elevated plasma homocysteine, itself an independent risk factor for coronary heart disease. Methods and Results To examine the hypothesis that the allele (T) that codes for the thermolabile defect increases the risk of coronary heart disease, we studied 111 patients with clinical and objective investigational evidence of coronary heart disease and 105 control subjects. The frequencies of the thermolabile defect (T) in patients and control subjects were measured, and the prevalence of elevated plasma total homocysteine according to genotype was assessed. The frequency of the defective allele was higher in patients than in control subjects with an OR of 1.6 (95% CI, 1.1 to 2.4; P =.02). The OR in the coronary heart disease group for the homozygous TT genotype was 2.9 (95% CI, 1.2 to 7.2; P =.02); 17% of patients and 7% of control subjects had the TT genotype. Plasma total homocysteine levels were significantly associated with disease status, a relationship that matched the strength of the association between disease and homozygous inheritance of the defective enzyme. Conclusions Homozygotes for the defective allele (T) are at increased risk of premature coronary heart disease. MTHFR, which modulates basal plasma homocysteine concentration, is folate dependent, and dietary supplementation or fortification with folic acid may reduce plasma homocysteine levels and consequent coronary risk in a significant proportion of the general population.
A Common<i>MUC5B</i>Promoter Polymorphism and Pulmonary Fibrosis
Authors: Max A. Seibold, Anastasia L. Wise, Marcy C. Speer, Mark P. Steele, Kevin K. Brown, James E. Loyd, Tasha E. Fingerlin, Weiming Zhang, Gunnar Gudmundsson, Steve D. Groshong, Christopher M. Evans, Stavros Garantziotis, Kenneth B. Adler, Burton F. Dickey, Roland M. du Bois, Ivana V. Yang, Aretha Herron, Dolly Kervitsky, Janet L. Talbert, Cheryl Markin, Joungjoa Park, Anne L. Crews, Susan H. Slifer, Scott Auerbach, Michelle G. Roy, Jia Lin, Corinne E. Hennessy, Marvin I. Schwarz, David A. Schwartz
Journal: New England Journal of Medicine (2011)

The mutations that have been implicated in pulmonary fibrosis account for only a small proportion of the population risk.
Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study
Authors: J. Phua, Y. Koh, B. Du, Y.-Q. Tang, J. V. Divatia, C. C. Tan, C. D. Gomersall, M. O. Faruq, B. R. Shrestha, N. Gia Binh, Y. M. Arabi, N. Salahuddin, B. Wahyuprajitno, M.-L. Tu, A. Y. H. A. Wahab, A. A. Hameed, M. Nishimura, M. Procyshyn, Y. H. Chan
Journal: BMJ (2011)

<b>Objectives</b> To assess the compliance of Asian intensive care units and hospitals to the Surviving Sepsis Campaign's resuscitation and management bundles. Secondary objectives were to evaluate the impact of compliance on mortality and the organisational characteristics of hospitals that were associated with higher compliance. <b>Design</b> Prospective cohort study. <b>Setting</b> 150 intensive care units in 16 Asian countries. <b>Participants</b> 1285 adult patients with severe sepsis admitted to these intensive care units in July 2009. The organisational characteristics of participating centres, the patients' baseline characteristics, the achievement of targets within the resuscitation and management bundles, and outcome data were recorded. <b>Main outcome measure</b> Compliance with the Surviving Sepsis Campaign's resuscitation (six hours) and management (24 hours) bundles. <b>Results</b> Hospital mortality was 44.5% (572/1285). Compliance rates for the resuscitation and management bundles were 7.6% (98/1285) and 3.5% (45/1285), respectively. On logistic regression analysis, compliance with the following bundle targets independently predicted decreased mortality: blood cultures (achieved in 803/1285; 62.5%, 95% confidence interval 59.8% to 65.1%), broad spectrum antibiotics (achieved in 821/1285; 63.9%, 61.3% to 66.5%), and central venous pressure (achieved in 345/870; 39.7%, 36.4% to 42.9%). High income countries, university hospitals, intensive care units with an accredited fellowship programme, and surgical intensive care units were more likely to be compliant with the resuscitation bundle. <b>Conclusions</b> While mortality from severe sepsis is high, compliance with resuscitation and management bundles is generally poor in much of Asia. As the centres included in this study might not be fully representative, achievement rates reported might overestimate the true degree of compliance with recommended care and should be interpreted with caution. Achievement of targets for blood cultures, antibiotics, and central venous pressure was independently associated with improved survival.
Serum 7α–hydroxycholesterol reflects hepatic bile acid synthesis in patients with obstructive jaundice after external biliary drainage
Authors: Shuichiro Okamoto, Kazuhisa Fukushima, Hidetaka Higashijima, Ichiro Makino, Masanori Kishinaka, Hitoshi Oda, Hiroyuki Yamashita, Hitoshi Ichimiya, Kazuo Chijiiwa, Syoji Kuroki
Journal: Hepatology (1994)

ABSTRACT To examine the hypothesis that serum levels of 7α–hydroxycholesterol reflect bile acid synthesis in the liver, we analyzed serum 7α–hydroxycholesterol and bile acid output in 13 patients with obstructive jaundice after relief of biliary obstruction. Before biliary drainage, the serum level of 7α–hydroxycholesterol was 92 ± 12 pmol/ml (mean ± S.E.M.) and was significantly lower than the control value (226 ± 26 pmol/ml, p&lt;0.01). After biliary drainage, serum 7α–hydroxycholesterol level and biliary bile acid outputs began to rise in some patients, indicating reversible liver dysfunction. In other patients, serum 7α–hydroxycholesterol levels and bile acid outputs did not increase, suggesting severe or irreversible liver dysfunction. On and after the third day of biliary decompression, serum 7α–hydroxycholesterol levels correlated well with bile acid excretion (p&lt;0.01, r=0.93). Other liver function parameters, such as serum bilirubin, serum bile acids, albumin, and bile flow, also revealed significant correlation with serum 7α–hydroxycholesterol levels. We conclude that the serum 7α–hydroxycholesterol level clearly reflects bile acid synthesis in the liver and that it may serve as a useful parameter for the assessment of hepatic functional recovery in patients with obstructive jaundice after biliary drainage. (Hepatology 1994;20:95-100.)
Ulcerative colitis following B lymphocyte depletion with rituximab in a patient with Graves' disease
Authors: D. E. Fassi, C. H. Nielsen, J. Kjeldsen, O. Clemmensen, L. Hegedus
Journal: Gut (2008)

The possible adverse consequences of biological therapies in inflammatory bowel diseases (IBDs) were recently highlighted in this journal by D’Haens ( Gut 2007; 56 :725–32). We here describe a hitherto unappreciated adverse effect to treatment with the B lymphocyte (B cell) depleting agent rituximab (RTX),1 namely the occurrence of ulcerative colitis and arthritis shortly after treatment with RTX. Our patient, a 45-year-old Caucasian female, had had mild irritable bowel symptoms since 1992 at which time rigid sigmoidoscopy and bowel x ray were normal. She had never received any therapy, had never previously had joint pain, and was not predisposed to IBD.

In April 2005 she was diagnosed with Graves’ disease, and after uncomplicated standard methimazole therapy she received four weekly doses of 375 mg/m2 RTX from day 1 to 22 as part of a clinical trial.2 The trial was approved by the local ethics committee …
HOW LONG MAY MAN LIVE WITH OBSTRUCTIVE JAUNDICE?
Authors: OWEN H. WANGENSTEEN
Journal: JAMA (1928)

Man ordinarily tolerates mechanical obstruction of the common bile duct fairly well. Death from obstructive jaundice in the first few weeks of its course is quite rare and is only occasionally observed. After a period varying from four to six months, however, patients suffering from occlusion of the common bile duct usually deteriorate rapidly and die. During the greater portion of this time, save for the loss of weight and accompanying loss of strength incident to the altered digestion and assimilation of the ingested food, the patient remains ordinarily wholly free from any threatening symptoms. Then suddenly the picture of a rapidly progressive intoxication is superimposed on the silent jaundice; ascites, coma and spontaneous hemorrhages may supervene, and death quickly follows.  Somewhat more than a year ago, a patient was admitted to the surgical service of the University Hospital with a profound icterus of more than three and one-half years'