tbuckley/cabot-search huggingface dataset:
Second-Trimester Maternal Serum Levels of Alpha-Fetoprotein and the Subsequent Risk of Sudden Infant Death Syndrome
Authors: Gordon C.S. Smith, Angela M. Wood, Jill P. Pell, Ian R. White, Jennifer A. Crossley, Richard Dobbie
Journal: New England Journal of Medicine (2004)

Unexplained stillbirth and the sudden infant death syndrome (SIDS) share some features. A raised maternal serum level of alpha-fetoprotein during the second trimester of pregnancy is a marker of placental dysfunction and a strong predictor of the risk of unexplained stillbirth. It is unknown whether alpha-fetoprotein levels also predict the risk of SIDS.We linked a prenatal-screening database for women in western Scotland with databases of maternity, perinatal death, and birth and death certifications to assess the association between second-trimester levels of maternal serum alpha-fetoprotein and the subsequent risk of SIDS.Among 214,532 women with singleton births, there were 114 cases of SIDS (incidence, 2.7 per 10,000 births among women with alpha-fetoprotein levels in the lowest quintile and 7.5 per 10,000 births among those with levels in the highest quintile). When the lowest quintile was used as a referent, the unadjusted odds ratios for SIDS for the second through fifth quintiles were 1.7 (95 percent confidence interval, 0.8 to 3.5), 1.8 (95 percent confidence interval, 0.9 to 3.7), 2.5 (95 percent confidence interval, 1.3 to 4.8), and 2.8 (95 percent confidence interval, 1.4 to 5.4), respectively (P for trend = 0.001). The risk of SIDS varied inversely with the birth-weight percentile and the gestational age at delivery; after adjustment for these factors, the odds ratios for SIDS were 1.7 (95 percent confidence interval, 0.8 to 3.5), 1.7 (95 percent confidence interval, 0.8 to 3.5), 2.2 (95 percent confidence interval, 1.1 to 4.4), and 2.2 (95 percent confidence interval, 1.1 to 4.3), respectively (P for trend = 0.01).There is a direct association between second-trimester maternal serum alpha-fetoprotein levels and the risk of SIDS, which may be mediated in part through impaired fetal growth and preterm birth.
Urologist who was jailed for manslaughter is allowed back to work
Authors: C. Dyer
Journal: BMJ (2014)

A consultant urologist who was jailed for manslaughter after he failed to treat a life threatening infection in a young mother quickly enough has been allowed to return to work under conditions set by a fitness to practise panel.

Sudhanshu Garg, 46, served one year of a two year jail sentence after he pleaded guilty to manslaughter through gross negligence in 2012.1 He also admitted having altered patient notes in an attempt to cover his mistake. 

In August 2008 he had been on call over the bank holiday weekend at Bradford Royal Infirmary, in his first consultant post, when Lisa Quinn, 37, was admitted with a kidney infection. Garg saw her 24 …
On the association of the platelet-specific alloantigen, Pena, with glycoprotein IIIa. Evidence for heterogeneity of glycoprotein IIIa.
Authors: K Furihata, D J Nugent, A Bissonette, R H Aster, T J Kunicki
Journal: Journal of Clinical Investigation (1987)

Neonatal alloimmune thrombocytopenic purpura associated with a new platelet-specific alloantigen Pena has been reported. We now provide direct evidence that the Pena determinant is associated with glycoprotein (GP) IIIa, but that it is distinct from epitopes that define the PlA system. By ELISA wherein monoclonal antibodies specific for GPIIb (Tab) and specific for GPIIIa (AP3) were used to capture and hold antigens from a platelet lysate prepared under conditions that generate free GPIIb and GPIIIa, anti-Pena reacted with GPIIIa held by AP3 but not with GPIIb held by Tab. In an alternative ELISA where purified GPIIIa from both PlA1-positive and PlA1-negative platelets were used individually as antigen, anti-Pena reacted with both allelic forms of GPIIIa. By radioimmuno-precipitation, anti-Pena precipitated a single surface-labeled membrane protein with electrophoretic characteristics in sodium dodecyl sulfate-polyacrylamide gels, under nonreduced or reduced conditions, identical to those of GPIIIa. By fluorocytometry, platelets from several donors, regardless of PlA phenotype, bound an amount of anti-Pena roughly equivalent to one-half that amount of anti-PlA1 bound by PlA1 homozygous (A1/A1) platelets and roughly equal to that amount of anti-PlA1 bound by PlA1 heterozygous (A1/A2) platelets. Using platelets from donors typed homozygous for PlA1 and Pena in a quantitative indirect binding assay, 14-24,000 molecules of anti-Pena and 41-51,000 molecules of anti-PlA1 were bound per platelet at saturation. Anti-Pena completely inhibited ADP-induced aggregation of Pena-positive platelets, regardless of PlA phenotype. These results indicate that the Pena determinant is associated with GPIIIa but distinct from PlA.
Case 13-1975
Authors: Robert W. Carey, James J. Galdabini
Journal: New England Journal of Medicine (1975)

Presentation of CaseA 64-year-old man was admitted to the hospital because of neutropenia.He was well until two months previously, when he noticed a few "cold sores," accompanied by chilliness. Several days later he went to a physician, who admitted him to another hospital. Examination revealed slight splenomegaly. The hematocrit was 37 per cent; the white-cell count was 2300, with a normal differential count. Bone-marrow aspiration revealed decreased cellularity; most of the cells were of the lymphocytic type, with a small amount of cytoplasm; the nuclei contained coarse chromatin, some of it clumped, and occasional nucleoli and had infrequent . . .
Doctors and the Press — Mass Medication — Smoking and Carcinoma
Authors: John Lister
Journal: New England Journal of Medicine (1954)

AN eminent English physician told me how he once delivered a paper at the annual meeting of the Young Turks in Atlantic City. To his consternation and to the embarrassment of his American hosts, a full report appeared in the evening newspaper. He assured his friends that he had held no press conference and had spoken to no one outside the medical profession since reading his paper. He told them that he had gone straight from the meeting to the Chalfont Haddon Hotel, where the only stranger he had spoken to was a good-looking woman medical student, who had approached . . .
Home Alone, and in Danger
Authors: Edward W. Campion
Journal: New England Journal of Medicine (1996)

For anyone who has ever worked in an emergency room, the presentation is all too familiar. The ambulance brings in a patient who is stuporous and dehydrated, often with decubitus ulcers and covered with feces and urine. No one knows of any family members, and the only accompanying medical information is “found at home.” At times physicians seem to dislike caring for such patients. Their feelings range from embarrassment to hostility. Sometimes the patient is referred to demeaningly as “gomer,” “failure to thrive,” “social problem,” or worse. These reactions are not only unprofessional but also sad and ironic. As a . . .
Turkish police targeted doctors who helped protesters, report says
Authors: S. Arie
Journal: BMJ (2013)

A new report confirms that Turkish authorities deliberately targeted health workers who gave medical help to antigovernment protesters injured during clashes with authorities in June.

The report comes as Turkey prepares to debate a bill that would criminalise improvised emergency care that was not authorised by the government and could see doctors fined or imprisoned for responding to the needs of injured protesters on the streets in future.

The report by the US based group Physicians for Human Rights quotes several doctors saying that they were attacked by police while trying to treat protesters.1

One volunteer doctor in Istanbul said, “Last Saturday I was wearing a beret that said I was a doctor. The police were deliberately shooting at my beret. Finally I took my beret off. It …
RADIOACTIVE IRON ABSORPTION IN CLINICAL CONDITIONS: NORMAL, PREGNANCY, ANEMIA, AND HEMOCHROMATOSIS
Authors: W. M. Balfour, P. F. Hahn, W. F. Bale, W. T. Pommerenke, G. H. Whipple
Journal: The Journal of Experimental Medicine (1942)

Radio iron is a tool which makes iron absorption studies quite accurate in dogs and reasonably satisfactory in human beings. This method is vastly superior to others previously used. Normal human pregnancy without significant anemia may show active radio iron absorption—16 to 27 per cent of iron intake. The pregnant woman as a rule shows 2 to 10 times the normal absorption of radio iron. Diseased states in which iron stores are known to be very abundant—pernicious anemia, hemochromatosis, familial icterus, and Mediterranean anemia —show very little absorption, probably less than normal. This is in spite of a severe anemia in all conditions except hemochromatosis. Chronic infections in spite of anemia show no utilization of radio iron, whether it may be absorbed or not. Leukemia shows little utilization of radio iron in red cells in spite of absorption (autopsy), probably because of white cells choking the red marrow. Polycythemia shows very low values for iron absorption as do normal persons. Two pregnant women showed only normal iron absorption. We believe that reserve stores of iron in the body, rather than anemia, control iron absorption. This control is exerted upon the gastro-intestinal mucosa which can refuse or accept iron under various conditions.
COMPARATIVE EFFECTIVENESS AND SAFETY OF ANTITHROMBOTIC THERAPY IN OLDER PATIENTS WITH ATRIAL FIBRILLATION AND NON-ST ELEVATION MYOCARDIAL INFARCTION (NSTEMI) TREATED WITH CORONARY STENTING
Authors: Emil L. Fosbol, Tracy Wang, Jonathan Piccini, Renato Lopes, Roger Mills, Winslow Klaskala, Shuang Li, Matthew Roe, Eric Peterson
Journal: Journal of the American College of Cardiology (2012)
Prison mental health services are underfunded, report says
Authors: Owen Dyer
Journal: BMJ (2008)

Google, the search engine giant, has launched Google Health, a free service for patients offering a personal electronic medical record (www.google.com/health).But the move has prompted fears over the security of health information stored in this way.President George Bush has promoted electronic health records as a means of reducing medical errors and cutting the costs of health care in the United States.But uptake has so far been slow.The new Google service will compete with similar services offered by other commercial internet health services, such as WebMD.Electronic medical histories are also stored by major health insurance companies.An individual will be able to create an account, protected by a password, and enter personal medical records, either by keying them in or by importing electronic records from hospitals, laboratories, and pharmacies that are Google Health partners.When new information is added the service will check for potential interactions between drugs, allergies, and conditions.Patients can also search for doctors by specialty or location and for hospitals, and they can permit their doctors or others to see their medical information and add to it.The New York Times reported that the service was popular when tested among patients at the Cleveland Clinic in Ohio earlier this year (www.nytimes.com,20 May, "Google offers personal health records on the web").The system allowed clinic patients to add information when they saw doctors who were not affiliated with the clinic, said Martin Harris, the clinic's chief information officer.But Pamela Hartzband and Jerome Groopman, both from Harvard University, complained in the New England Journal of Medicine in April (2008;358:1656-8) that electronic health records have led to a sea of results being pasted from previous records, instead of being focused and selective.Furthermore, they said that electronic records have "become a powerful vehicle for per-Fears over security as Google launches free electronic health records service for patients UK NEWS Finding a solution to hospital associated infections, p 1210 World NEWS Italian police arrest drug officials over alleged falsification of data, p 1208 bmj.com
THE MATERNAL TRANSMISSION OF VACCINIAL IMMUNITY IN SWINE
Authors: John B. Nelson
Journal: The Journal of Experimental Medicine (1932)

The introduction of vaccinia virus into the skin of swine calls forth a typical vesicular reaction which may be followed by a solid immunity. This acquired state of resistance was utilized in determining the route of immunity transmission from sow to young. The suckling young of immune sows, vaccinated on the 7th day or earlier, showed no reaction to the virus. Their hand-fed litter mates, however, were susceptible and reacted with the formation of vesicles. These observations indicate that the porcine placenta is largely impermeable to protective substances and establish the fact that colostrum functions as the vehicle for their transmission as it does for antibodies.
Anaphylaxis to polyvinylpyrrolidone in an analgesic preparation
Authors: A.C. Rönnau, M. Wulferink, E. Gleichmann, E. Unver, T. Ruzicka, J. Krutmann, M. Grewe
Journal: British Journal of Dermatology (2000)

A 32-year-old patient developed an anaphylactic reaction minutes after oral intake of acetaminophen-containing tablets (Doregrippin®). Scratch testing of the whole preparation was positive in contrast with the negative results obtained with pure acetaminophen. Therefore, scratch tests with the remaining drug components were performed and showed polyvinylpyrrolidone (PVP) to be the aetiological agent. Furthermore, specific IgE antibodies against PVP were demonstrated using a dot blot technique, thus ruling out a pseudo-allergic reaction. This case underlines the necessity to consider not only the active ingredient, but also additives as the causative agent.
Exposure to Bright Light and Darkness to Treat Physiologic Maladaptation to Night Work
Authors: Charles A. Czeisler, Michael P. Johnson, Jeanne F. Duffy, Emery N. Brown, Joseph M. Ronda, Richard E. Kronauer
Journal: New England Journal of Medicine (1990)

Working at night results in a misalignment between the sleep-wake cycle and the output of the hypothalamic pacemaker that regulates the circadian rhythms of certain physiologic and behavioral variables. We evaluated whether such physiologic maladaptation to nighttime work could be prevented effectively by a treatment regimen of exposure to bright light during the night and darkness during the day. We assessed the functioning of the circadian pacemaker in five control and five treatment studies in order to assess the extent of adaptation in eight normal young men to a week of night work. In the control studies, on the sixth consecutive night of sedentary work in ordinary light (approximately 150 lux), the mean (+/- SEM) nadir of the endogenous temperature cycle continued to occur during the night (at 3:31 +/- 0:56 hours), indicating a lack of circadian adaptation to the nighttime work schedule. In contrast, the subjects in the treatment studies were exposed to bright light (7000 to 12,000 lux) at night and to nearly complete darkness during the day, and the temperature nadir shifted after four days of treatment to a significantly later, midafternoon hour (14:53 +/- 0:32; P less than 0.0001), indicating a successful circadian adaptation to daytime sleep and nighttime work. There were concomitant shifts in the 24-hour patterns of plasma cortisol concentration, urinary excretion rate, subjective assessment of alertness, and cognitive performance in the treatment studies. These shifts resulted in a significant improvement in both alertness and cognitive performance in the treatment group during the night-shift hours. We conclude that maladaptation of the human circadian system to night work, with its associated decline in alertness, performance, and quality of daytime sleep, can be treated effectively with scheduled exposure to bright light at night and darkness during the day.
An unsuspected cause of chronic diarrhoea
Authors: S. Greco, G. Maconi, M. Lazzaroni, L. Pastore, G. B. Porro
Journal: Gut (2007)

A 45-year-old Italian man, living in Italy, was admitted to our clinic with a 6-month history of chronic diarrhoea (soft stool, 3–4 times/day), iron-deficiency anaemia, recurrent abdominal pain, weight loss (10 kg over 6 months) and weakness. Examination was normal apart from moderate pallor and a soft but diffusely tender abdomen. He was not febrile: there was no pathological sign apart from increased bowel sounds. Other investigations showed haemoglobin 10.8 g/dl, …
Complex Electrophysiological Characteristics in Atrioventricular Nodal Reentrant Tachycardia With Continuous Atrioventricular Node Function Curves
Authors: Ching-Tai Tai, Shih-Ann Chen, Chern-En Chiang, Shih-Huang Lee, Zu-Chi Wen, Chuen-Wang Chiou, Kwo-Chang Ueng, Yi-Jen Chen, Wen-Chung Yu, Jin-Long Huang, Mau-Song Chang
Journal: Circulation (1997)

Background Although typical atrioventricular nodal reentrant tachycardia (AVNRT) with discontinuous AV node function curves has been well studied, there has been a lack of any significant information about AVNRT without evidence of dual AV nodal pathway physiology during atrial extrastimulus testing or atrial pacing. Methods and Results Group 1 included 9 patients with continuous curves during atrial extrastimulus testing but without a jump (≥50 ms) of the atrial–His bundle (AH) interval during incremental atrial pacing. The maximal AH interval during atrial pacing (266±61 versus 168±27 ms, P =.007) or extrastimulus testing (290±60 versus 176±18 ms, P =.005) shortened significantly after ablation. Antegrade and retrograde AV node properties were similar before and after ablation. Group 2 included 14 patients with continuous curves and a jump of the AH interval during incremental atrial pacing. The atrial pacing cycle length with 1:1 AV conduction and effective refractory period (ERP) of the antegrade AV node increased significantly, whereas the maximal AH interval during atrial pacing (358±70 versus 203±28 ms, P =.001) or extrastimulus testing (338±75 versus 196±34 ms, P =.002) shortened significantly after ablation. Group 3 included 24 patients with discontinuous curves. The maximal AH interval during atrial pacing or extrastimulus testing and the ERP of the antegrade fast AV node shortened, whereas the ERP of the antegrade AV node increased significantly after ablation. The maximal AH interval before ablation, extent of decrease in maximal AH interval after ablation, ERP of the retrograde AV node before ablation, and tachycardia cycle length were significantly shorter in group 1 than groups 2 and 3. Conclusions In AVNRT with continuous AV node function curves, dual AV nodal pathway physiology may or may not be demonstrated during atrial pacing. Significant shortening of the maximal AH interval during atrial pacing after radiofrequency ablation suggests successful elimination of AVNRT.
Symmetrical peripheral gangrene complicating Klebsiella pneumoniae sepsis associated with antiphospholipid antibodies
Authors: J-H Yoo
Journal: Annals of the Rheumatic Diseases (2004)

OBJECTIVE--To determine the incidence of drug related problems that fail to be noted on casualty cards in patients subsequently admitted, and to compare medication histories as recorded by accident and emergency (A&amp;E) senior house officers (SHOs) and a pharmacist. METHODS--An initial retrospective survey of 1459 acute inpatient admissions through A&amp;E over a three month period was followed by a prospective study of 33 elderly patients. RESULTS--In the retrospective survey, 52 medication related problems were confirmed after examination of the medical records, of which only 16 were identified in A&amp;E. In the prospective study, 125 currently prescribed items were identified by the pharmacist compared to 77 by A&amp;E SHOs; 66% of the missed information was clinically relevant. Of 17 previous adverse drug reactions identified by the pharmacist only six were also recorded by the A&amp;E officer. Only four over the counter medicines were identified by the A&amp;E SHOs compared to 30 by the pharmacist. CONCLUSIONS--More accurate recording of drug history on casualty cards should be undertaken, particularly in respect of over the counter medication and the identification of drug related problems.
The relationship of human atrial cellular electrophysiology to clinical function and ultrastructure.
Authors: L Mary-Rabine, A Albert, T D Pham, A Hordof, J J Fenoglio, J R Malm, M R Rosen
Journal: Circulation Research (1983)

Although previous studies have described the electrophysiological and ultrastructural characteristics of human cardiac fibers, no attempt has been made as yet to describe quantitatively the relationship between the ultrastructural and cellular electrophysiological derangements occurring with cardiac disease, and their clinical manifestations. In this study, we used standard microelectrode techniques to record the action potential characteristics of human atrial fibers obtained during cardiac surgery and correlated the electrophysiological parameters with clinical and ultrastructural data. Ultrastructure was studied by optical and electron microscopy. We found a multiple linear regression among maximum diastolic potential, atrial size and pressure, P wave duration and ultrastructure changes. Proliferations of Z band material, widening of intercalated discs, and degenerative changes were quantified and correlated with electrophysiological and clinical data. These studies emphasize the relationship between hemodynamic anomalies and resultant changes in both human atrial fiber structure and electrical function. Finally, the likelihood of occurrence of arrhythmias can be predicted using the analytic method described.
Hepatitis C in a French population-based survey, 1994: Seroprevalence, frequency of viremia, genotype distribution, and risk factors
Authors: F Dubois, J Desenclos, N Mariotte, A Goudeau
Journal: Hepatology (1997)

The aims of this study were the following: (1) to estimate the prevalence of hepatitis C virus (HCV) antibody (anti-HCV) in a population-based survey of French residents not selected for risk factors; (2) to investigate the association between anti-HCV seropositivity, viremia, the infecting HCV genotype, and the alanine transaminase (ALT) level; and (3) to identify risk factors for HCV infection by a nested case control study within this survey sample. The anti-HCV seroprevalence survey was performed in 6,283 volunteers (20- to 59-years-old) randomly selected from 45,377 consecutive individuals undergoing routine medical checkup in social security medical centers covering 4 of the 22 “regions” of France. Seventy-two volunteers were anti-HCV positive, a crude prevalence of 1.15%. Fifty percent of these positive volunteers also had an abnormal ALT level and 81% were HCV-RNA positive by polymerase chain reaction (PCR). The prevalence weighted for age, sex, and place of residence was 1.05% (95% CI: 0.75-1.34). The weighted prevalence was lower among men &gt; 40-years-old (0.5%; 95% CI: 0.1-1.0) and was close to 1% in all other age and sex groups. Prevalence was inversely correlated with socioprofessional status with the highest rate being found among those with no paid employment (2.2%; 95% CI: 1.3-3.0). The HCV prevalence (1.7%; 95% CI: 1.0-2.3) was highest in southeastern France. Seventy-eight percent of positive intervenous (I.V.) drug abusers were infected with HCV genotypes 1a or 3, whereas 80% of the transfusion-associated cases were infected by HCV genotypes 1b or 2a. Only three variables were significantly associated with HCV seropositivity in multivariate analysis: I.V. drug abuse (21 cases, 14 men all &lt; 40-years-old), previous transfusion (22 cases, 18 women), and not having paid employment. Although routes of transmission other than I.V. drug abuse and transfusion may not be formally excluded they were not found to be statistically significant. Hepatitis C appears to be a major public health concern in France. A more active screening policy may be required because only 17 of 72 cases (24%) were aware of their HCV seropositivity before enrollment in the study.