tbuckley/cabot-search huggingface dataset:
Left Ventricular Assist Device Infection Is Associated With Increased Mortality but Is Not a Contraindication to Transplantation
Authors: Mathias Herrmann, Michael Weyand, Britta Greshake, Christof von Eiff, Richard A. Proctor, Hans H. Scheld, Georg Peters
Journal: Circulation (1997)

Background Left ventricular assist devices (LVADs) are increasingly used as a bridge to transplantation. Infection is a frequent and major complication associated with the use of these devices; however, the correlation of infection and outcome has not yet been evaluated in a prospective fashion. Methods and Results Twenty-five patients (24 male, 1 female) with end-stage cardiac failure and resulting organ dysfunction were included. Patients were bridged with the Novacor N100 portable LVAD (median duration of support, 55 days) and were evaluated prospectively by device surface cultures on explantation, molecular typing of isolates, and correlation of infection with survival to transplant. Twelve (48%) of 25 patients had LVAD infection as defined by recovery of multiple isolates of identical genotype from the device surface. Whereas only 5 (42%) of 12 patients with LVAD infection survived until transplantation, 11 (85%) of 13 patients without infection were successfully transplanted ( P &lt;.05). Death of the 7 patients with proven LVAD infection was associated with multiple organ failure or other signs of acute infection. Conclusions LVAD infection is associated with a significantly decreased survival probability. It does not preclude successful bridging but rather may pose an indication for urgent transplantation.
Is the sentinel lymph node biopsy accurate for patients with initially clinically axilla-positive locally advanced breast cancer after neoadjuvant chemotherapy?.
Authors: V Ozmen, ME Muslumanoglu, A Igci, E Canbay, B Ozcinar, A Mudun, Y Eralp, P Saip, S Tuzlali, M Dincer, T Dagoglu, M Kecer, M Parlak
Journal: Cancer Research (2009)

Abstract Abstract #5123 Background: Approximately one third of patients with locally advanced breast cancer (LABC) have no axillary metastatic lymph node(s) after neoadjuvant chemotherapy (NAC). Axillary dissection could be omitted in these patients if SLNB is negative. The aim of this study is to evaluate the accuracy of sentinel lymph node biopsy (SLNB) after NAC for LABC.&amp;#x2028; Materials and Methods: Between January 1992 to May 2008, a total of 69 patients with clinical or radiological positive axilla (N1 or N2) in LABC were enrolled in this study. After NAC, all patients underwent SLNB followed by complete axillary lymph node dissection. SLNB was performed with either a combined detection using blue dye and radiocolloid or blue dye alone. All the sentinel lymph nodes were examined by multisection hematoxylin eosin staining and cytokeratin- immunohistochemistry, whereas the non-sentinel nodes were examined by routine histology.&amp;#x2028; Results: Sentinel lymph nodes were successfully identified in 58 patients among 69 patients (85%). The median age was 46 (range 25 to 76). The clinical stages before chemotherapy were as follows: IIB:46%, IIIA: 22%, and IIIB: 32%, respectively. All of 58 patients had either clinically or radiologically suspicious node-positive disease based on ultrasound findings before neoadjuvant chemotherapy. Pathologic complete response were obtained in 5 patients (9%). The false negative rate was found to be 17.4 % (8/46), whereas the accuracy rate was 86.2% (50/58) among patients with succesful lymphatic mapping.&amp;#x2028; Conclusion: The accuracy of the SLNB procedure seems to be not reliable in patients with locally advanced disease with a positive axilla before NAC therapy due to its high false negative rates. Therefore, complete axillary dissection is still required in patients with a positive-axilla before chemotherapy. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5123.
Out of hours cover in Scotland is unsustainable, audit finds
Authors: Bryan Christie
Journal: BMJ (2007)

The present system of out of hours cover for primary care services in Scotland seems unsustainable and will need to change, a review of the service says.

The report, from Scotland's public spending watchdog, Audit Scotland, says that the country's health service has coped with the major challenge in 2004 of 95% of its GPs opting out of providing out of hours cover. But the number of GPs willing to continue providing this cover in return for payment has fallen from 1696 in 2004-5 to 1440 in 2006-7, it says, putting …
Cardiotonic drugs differentially alter cytosolic [Ca2+] to left ventricular relationships before and after ischemia in isolated guinea pig hearts
Authors: Q Chen
Journal: Cardiovascular Research (2003)

Objective: Cardiotonic agents may differentially alter indices of the cytosolic [Ca 2+ ]/left ventricular pressure (LVP) relationship when given before and after ischemia. We measured and calculated systolic–diastolic [Ca 2+ ], systolic–diastolic LVP, velocity ratios (VRs) d[Ca 2+ ]/d tmax to dLVP/d tmax (VR max ), d[Ca 2+ ]/d tmin to dLVP/d tmin (VR min ), and area ratio (AR, area Ca 2+ ]/area LVP per beat) before and after 30 min global ischemia in guinea pig hearts. Methods: Hearts were perfused with levosimendan, dobutamine, dopamine, or digoxin. Ca 2+ transients were recorded by indo-1 fluorescence via a fiber optic probe placed on the LV free wall. [Ca 2+ ]/LVP loops were acquired by plotting LVP time as a function of [Ca 2+ ] at multiple time points during the cardiac cycle. Results: Ischemia reperfusion increased [Ca 2+ ] and decreased contractility and relaxation and produced a flatter and broader [Ca 2+ ]/LVP loop. All drugs shifted the [Ca 2+ ]/LVP loop rightward and upward when given before and after ischemia. Dobutamine increased [Ca 2+ ] and contractility more than other drugs. Digoxin increased [Ca 2+ ] the least but increased contractility similar to dopamine and levosimendan. Before ischemia dopamine and digoxin both decreased VR max and VR min , whereas dobutamine increased VR min , but not VR max , and levosimendan had no effect on VR. VR max and VR min were markedly elevated after ischemia, but again decreased with dopamine and digoxin; dobutamine again increased VR min , but not VR max , and levosimendan decreased both VR max and VR min . Before ischemia dopamine and digoxin both decreased AR, dobutamine increased AR, and levosimendan had no effect; after ischemia AR was markedly elevated but dopamine and digoxin decreased AR, dobutamine increased AR, and levosimendan decreased AR. Conclusion: Although each drug enhanced contractility and relaxation both before and after ischemia by increasing cytosolic [Ca 2+ ] and Ca 2+ flux, dopamine and digoxin improved, and dobutamine worsened responsiveness to Ca 2+ , i.e., velocity ratio and area ratio, whereas levosimendan had no net effect before ischemia but improved responsiveness after ischemia.
Professional societies can lead the way on transparency but will need support
Authors: S. Ray, I. Simpson
Journal: BMJ (2012)

Tavare and Godlee ask what national professional societies are doing about professional transparency and outcome data.1 2 Such transparency should be part of a wider package of measures to improve services to patients.3

Clinicians are suspicious about outcomes based on poor quality data, such as hospital episode statistics, and experience of cardiac surgery shows that …
Dexamyl®, Abdominal Angina, and Celiac-Artery Compression
Authors: MARIO J.R. RAVRY
Journal: Annals of Internal Medicine (1977)

Letters and Corrections1 August 1977Dexamyl®, Abdominal Angina, and Celiac-Artery CompressionMARIO J.R. RAVRY, M.D.MARIO J.R. RAVRY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-2-246_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The existence of the celiac-artery compression syndrome as a nosologic entity is questionable. Sleisenger (Ann Intern Med 86:355-356, 1977) recently emphasized the occurrence of celiac-artery compression in 12% to 49% of asymptomatic persons and suggested that there may be other underlying causes to explain the pain in these patients. The following case report illustrates the effect of an anorexiant drug with vasoactive properties in producing abdominal angina in a patient who had coexistent asymptomatic celiac-artery compression.A 51-year-old woman complained of abdominal pain of 4 months' duration. The pain was described as being periumbilical, cramping, occurring 30...References1. OCKNER R: Blood supply of the gut and pathophysiology of ischemia, in Gastrointestinal Disease, Pathophysiology, Diagnosis, Management, edited by SLEISENGER MH, FORDTRAN JS. Philadelphia, W.B. Saunders Co., 1973, p. 378 Google Scholar2. RENTON C: Non-occlusive intestinal infarction. Clin Gastroenterol 1:655-673, 1972 Google Scholar3. Product Information: Dexamyl® Spansule® capsules and tablets, in Physicians' Desk Reference, 31st ed. Oradell, New Jersey, Medical Economics Co., 1977, p. 1456 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MARIO J.R. RAVRY, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCeliac axis compression syndrome?Exceptions to a ?critical review? 1 August 1977Volume 87, Issue 2Page: 246-246KeywordsAbdominal painAnginaDrugs ePublished: 1 December 2008 Issue Published: 1 August 1977 PDF downloadLoading ...
Columnar-lined Oesophagus (Barrett's Syndrome) - Congenital or Acquired?
Authors: O. Stadelmann, K. Elster, H.A. Kühn
Journal: Endoscopy (1981)

A segment of the distal oesophagus lined with columnar epithelium (endobrachy oesophagus, Barrett's oesophagus), is very frequently seen in association with chronic reflux conditions. Usually, this entity is an asymmetrical columnar-cell metaplasia of varying extent, with an unsharp epithelial junction line cranial, and showing various large residual islands of squamous epithelium. In addition, usually well-developed peptic lesions are also found. More rarely seen are cases with a longer, symmetrical, cranially sharply delimited columnar-epithelial-lined segment, in which peptic lesions and strictures are usually either restricted to the proximal section, or are lacking altogether. Among more than 100 patients presenting with endobrachy-oesophagus, 14 cases had the latter form of the condition. Seven had a solitary, high peptic stricture, and only 50% unequivocal hiatus hernia. In four patients there were no inflammatory changes at all. In 8 patients, fundic glands were observed. Of particular interest was the segment-like arrangement of cardiac and fundic glands in 2 of the patients. In only a single case were scar formations seen in the columnar-lined segment. Considered from the point of view of our embryological knowledge, certain forms of endobrachy-oesophagus would appear to represent a congenital anomaly.
A Practice Guideline Revisited: Screening for Hypertension
Authors: Benjamin Littenberg
Journal: Annals of Internal Medicine (1995)

In 1993, the Clinical Efficacy Assessment Subcommittee began evaluation of new topics and reevaluation of previous guidelines on common screening tests, which were published in Annals of Internal Medicine between 1988 and 1990 and republished as a collection in 1991 (Eddy DM, ed. Common Screening Tests. Philadelphia: American College of Physicians; 1991). Of the 11 guidelines contained in Common Screening Tests, only 3 (for breast, colon, and cholesterol screening) will be published with new data supporting new recommendations. Dr. Littenberg's analysis of the evidence that has appeared since the publication of the original paper on screening for hypertension (Littenberg B, Garber AM, Sox HC. Screening for Hypertension. Ann Intern Med. 1990; 112:192-202) presents a new format for updating Clinical Efficacy Assessment Project (CEAP) guidelines that have not been altered by new evidence. This “updated guideline” reports on new published studies and its analysis affirms the approved American College of Physicians recommendations of 1990. The Clinical Efficacy Assessment Subcommittee carried out the internal and external review procedures that are used for all CEAP guidelines. The plan is to keep all American College of Physicians guidelines updated in this way on a regular basis. Direct any comments or suggestions to Director, Scientific Policy, American College of Physicians, 6th Street at Race, Philadelphia, PA 19106.
An Address Delivered at the Opening of the Section of Anatomy and Physiology
Authors: J. Cleland
Journal: BMJ (1888)

Background: Immune responses to vaccination are a known trigger for a new onset of glomerular disease or disease flare in susceptible individuals. Mass immunization against SARS-CoV-2 in the COVID-19 pandemic provides a unique opportunity to study vaccination-associated autoimmune kidney diseases. In the recent literature, there are several case reports demonstrating a temporal association of SARS-CoV-2 immunization and kidney diseases. Methods: Here, we present a series of 29 cases of biopsy-proven glomerular disease in patients recently vaccinated against SARS-CoV-2 and identified patients who developed a new onset of IgA nephropathy, minimal change disease, membranous nephropathy, ANCA-associated glomerulonephritis, collapsing glomerulopathy, and diffuse lupus nephritis diagnosed on kidney biopsies post-immunization, as well as recurrent ANCA-associated glomerulonephritis. This included 28 cases of de novo glomerulonephritis within native kidney biopsies and one disease flare in an allograft. Results: The patients with collapsing glomerulopathy were of African American descent and had two APOL1 genomic risk alleles. A brief literature review of case reports and small series is also provided to include all reported cases to date (n=52). The incidence of induction of glomerular disease in response to SARS-CoV-2 immunization is unknown, however, there was no overall increase in incidence of glomerular disease when compared to the two years prior to the COVID-19 pandemic diagnosed on kidney biopsies in our practice. Conclusions: This suggests that glomerulonephritis in response to vaccination is rare, although should be monitored as a potential adverse event.
Nontuberculous Bacterial Empyema in Patients With and Without Underlying Diseases
Authors: Nicholas J. Vianna
Journal: JAMA (1971)

Forty-one (6.8%) adult patients hospitalized with primary nontuberculous bacterial pneumonia over a four-year period had empyema on admission. Staphylococcus aureus was the most common causative microorganism isolated. In 64% of the cases of empyema complicating some underlying disease, gram-negative microorganisms were isolated. Empyema may be mistaken for pulmonary infarction or masked by congestive heart failure. Fever and a peripheral leukocytosis may not be present in patients with underlying conditions. Evidence is presented that various antibiotics, administered parenterally in high doses, can sterilize empyema fluid. Effective drainage of the empyema cavity is also essential. The temperature response after closed drainage is initiated gives an indication whether open drainage will be required.
ANTERIOR COLPOTOMY WITH REMOVAL OF ONE OVARY AND BOTH TUBES—VAGINAL FIXATION.
Authors: WILLIAM N. SWIFT
Journal: JAMA (1898)

Mrs. L. R., aged 21 years, married two months. Probable gonorrhea two years before; since that time, more or less pelvic pain and very marked pain at menstrual periods. Since marriage has had great pain across lower part of abdomen. Coitus so painful that it became impossible. Examination showed uterus much enlarged, very sensitive, retroflexed and somewhat toward the left side. Enlarged tubes felt on both sides. Operation, Aug. 9, 1897. The bladder was separated from the uterus without difficulty. Plica opened with scissors. Extensive adhesions over the fundus of uterus and tubes. The uterus was seized with double hooks and delivered through the wound with some difficulty. The left tube and ovary were firmly adherent. The tube was freed from adhesions and on being opened was found to be entirely disorganized and occluded. It was removed, but the ovary was left as it was—normal. The right ovary and tube
The Tophus in Calcium Pyrophosphate Deposition Disease
Authors: James C. C. Leisen
Journal: JAMA (1980)

A 61-year-old man had a tophus on the third finger of his right hand. There was no history of arthritis, no laboratory abnormality, and no chondrocalcinosis. Crystalline material from the tophus was identified as calcium pyrophosphate dihydrate by x-ray diffraction.
IVF culture media: past, present and future
Authors: Elpiniki Chronopoulou, Joyce C. Harper
Journal: Human Reproduction Update (2014)

The advances in the world of IVF during the last decades have been rapid and impressive and culture media play a major role in this success. Until the 1980s fertility centers made their media in house. Nowadays, there are numerous commercially available culture media that contain various components including nutrients, vitamins and growth factors. This review goes through the past, present and future of IVF culture media and explores their composition and quality assessment.A computerized search was performed in PubMed regarding IVF culture media including results from 1929 until March 2014. Information was gathered from the websites of companies who market culture media, advertising material, instructions for use and certificates of analysis. The regulation regarding IVF media mainly in the European Union (EU) but also in non-European countries was explored.The keyword 'IVF culture media' gave 923 results in PubMed and 'embryo culture media' 12 068 results dating from 1912 until March 2014, depicting the increased scientific activity in this field. The commercialization of IVF culture media has increased the standards bringing a great variety of options into clinical practice. However, it has led to reduced transparency and comparisons of brand names that do not facilitate the scientific dialogue. Furthermore, there is some evidence suggesting that suboptimal culture conditions could cause long-term reprogramming in the embryo as the periconception period is particularly susceptible to epigenetic alterations. IVF media are now classified as class III medical devices and only CE (Conformité Européene)-marked media should be used in the EU.The CE marking of IVF culture media is a significant development in the field. However, the quality and efficiency of culture media should be monitored closely. Well-designed randomized controlled trials, large epidemiological studies and full transparency should be the next steps. Reliable, standardized models assessing multiple end-points and post-implantation development should replace the mouse embryo assay. Structured long-term follow-up of children conceived by assisted reproduction technologies and traceability are of paramount importance.
Impact of Pretreatment Interstitial Lung Disease on Radiation Pneumonitis and Survival after Stereotactic Body Radiation Therapy for Lung Cancer
Authors: Nami Ueki, Yukinori Matsuo, Yosuke Togashi, Takeshi Kubo, Keiko Shibuya, Yusuke Iizuka, Takashi Mizowaki, Kaori Togashi, Michiaki Mishima, Masahiro Hiraoka
Journal: Journal of Thoracic Oncology (2014)
A Successful Case of Anastomosis of the Small Intestine
Authors: H. Cripps
Journal: BMJ (1894)

_DMICAL JOUINAL 1103former by squeezing the blood and lymph onwards, the latter by causing muscular contraction; and it is surprising that they have not been more largely resorted to.In employ- ing electricity care must of course be taken to secure rhythmical contraction, since a prolonged contraction, by inducing a protracted narrowing of the venous bed, must necessarily impede the blood current.
Report shows low rate of cancer surgery in middle aged people
Authors: H. Mooney
Journal: BMJ (2011)

People in their 50s are missing out on cancer surgery, according to the findings of a new report on cancer surgery rates across England.

The report, published last week by the National Cancer Intelligence Network, found that surgical rates fall off steeply with the age of the patient treated.

Its lead author, Michael Peake, clinical lead with the network, said that although the reduction in cancer surgery with age was not “intrinsically surprising,” what was “a cause for concern” was that the drop began in age groups as young as people in their 50s.

“Crucially, it raises questions about the underlying reasons for these variations and, in turn, what can be done …
Borate and glycerol inhibition of the aggregation of guinea pig platelets by bovine factor VIII and ristocetin
Authors: Steven S. Kuwahara
Journal: American Journal of Hematology (1977)

Abstract To demonstrate the importance of the carbohydrate portions of bovine factor VIII and ristocetin for the induction of platelet aggregation, guinea pig platelets were treated with either borate or glycerol before and after addition of ristocetin or bovine factor VIII. Both borate and glycerol were capable of inhibiting the aggregation of blood platelets induced by adding bovine factor VIII or ristocetin to platelet‐rich plasma. Furthermore, aggregates formed after treatment with either agent could be dispersed by high concentrations of either borate or glycerol. These effects did not appear to be solely the result of high ionic strength or of irreversible damage to the platelets. The results obtained support the hypothesis that the binding of the carbohydrate groups of factor VIII plays an important role in the induction of platelet aggregation and in the maintenance of aggregates formed in response to the treatment of platelet‐rich plasma with bovine factor VIII or ristocetin.
Secondary dyserythropoietic activity resembling Di Guglielmo's disease in sickle-cell anaemia.
Authors: N O Osamo, W Eyetsimitan
Journal: BMJ (1976)

CommentNormotensive primary aldosteronism has not been described with adrenal adenoma, although normotension in the face of aldosterone overproduction by an adrenal carcinoma has been reported.'In our patient the reason for the normotension is not clear.It has been suggested that since it is difficult to reproduce the syndrome of primary aldosteronism by administering aldosterone alone there may be other factors, such as the concomitant production of corticosterone by the tumour.Corticosterone levels were not measured in this patient.Induction of hypertension in man by administering large doses of aldosterone alone has been reported,) so the explanation of normoten- sion in our patient remains obscure.This case showed the importance of considering the diagnosis of primary aldosteronism in any patient with hypokalaemia whatever the blood pressure.The condition is readily distinguished from Bartter's syndrome by finding a low plasma renin activitv.We should like to thank Dr A F Lever, of the MRC Blood Pressure Unit, Glasgowv, and Mr J Haggith, medical phvsicist, for their help in managing this casc, and IMrs Valerie Robson for technical help.