tbuckley/cabot-search huggingface dataset:
Silicone oil in the repair of pediatric complex retinal detachments
Authors: Ingrid U Scott, Harry W Flynn, Stanley P Azen, Mei-Ying Lai, Steven Schwartz, Michael T Trese
Journal: Ophthalmology (1999)

ObjectiveTo report anatomic and visual acuity outcomes, as well as complications, after using 1000-centistoke silicone oil as a retinal tamponade for the treatment of complex retinal detachments in a pediatric population.DesignA prospective, observational, multicenter study.ParticipantsThe study cohort consisted of 205 patients 16 years of age or younger (211 eyes) treated at community and university-based ophthalmology clinics for complex retinal detachments associated with trauma, proliferative vitreoretinopathy (PVR), giant retinal tear (GRT), or retinopathy of prematurity (ROP).InterventionVitrectomy surgery for complex retinal detachment with 1000-centistoke silicone oil as the retinal tamponade.Main outcome measuresAnatomic outcomes include complete retinal attachment and macular attachment. Visual acuity outcomes include ambulatory vision (≥4/200) and preservation of preoperative visual acuity. Complications include rates of secondary intraocular pressure (IOP) elevation (≥30 mmHg), hypotony (≤5 mmHg), corneal opacification (including band keratopathy, corneal edema, and corneal abrasions), oil emulsification, and cataract. All outcome measures were assessed 6, 12, and 24 months after surgery and at last examination.ResultsAt the 6-month examination, the retina was completely attached in 43 (57%) of 76 eyes in the trauma group, 24 (63%) of 38 PVR eyes, 23 (68%) of 34 GRT eyes, and 6 (33%) of 18 ROP eyes. The macula was attached in 60 (79%), 33 (87%), 26 (76%), and 8 (44%) eyes, respectively. Ambulatory vision was achieved in 19 (25%) eyes in the trauma group, 18 (47%) PVR eyes, 19 (56%) GRT eyes, and 4 (22%) ROP eyes. Visual acuity was preserved in 53 (70%), 26 (68%), 28 (82%), and 9 (50%) eyes, respectively. The corresponding rates of complications for traumatic, PVR, GRT, and ROP eyes were: elevated IOP—3 (4%) of 76, 1 (3%) of 38, 1 (3%) of 34, and 0 (0%) of 18; hypotony—9 (12%), 3 (8%), 2 (6%), and 2 (11%); corneal opacity—25 (33%), 8 (21%), 15 (44%), and 5 (28%); emulsification—4 (5%), 1 (3%), 3 (9%), and 1 (6%); and cataract in phakic eyes—1 (33%) of 3, 2 (67%) of 3, 2 (50%) of 4, and 1 (33%) of 3.ConclusionsRetinal reattachment and preserved visual acuity were achieved in the majority of eyes using vitrectomy and silicone oil retinal tamponade. Complete retinal and macular attachment was achieved less frequently in ROP eyes than in eyes in the other diagnostic groups. Use of 1000-centistoke silicone oil can be considered in the management of pediatric complex retinal detachments associated with multiple etiologies.
John Clive Baird Nesfield
Authors: A. Polmear
Journal: BMJ (2004)

Former general practitioner Whitstable, Kent, and medical officer St Augustine's Hospital, Chartham, Kent (b Kashmir 1913; q London/Cambridge 1938), d 6 November 2003.

John spent his early years as a doctor in the Royal Army Medical Corps in India and Burma. The bulk of his working life was spent as a general practitioner. John spent the last 10 years before retirement as a medical officer in psychiatry. An eccentric, he lived in a house full of exotic treasures in which another eccentric doctor, Somerset Maugham, had grown up. He leaves a wife, Stella; three children; and one grandchild.
India plans to track use of toilets in rural areas to encourage their use
Authors: C. Travasso
Journal: BMJ (2015)

The Indian government has announced plans to use iPads, tablets, and mobile phones to monitor the use of toilets in rural areas across the country. The findings will be posted on the website of the Ministry of Drinking Water and Sanitation to prompt behaviour change among rural communities.

A World Health Organization report in 2014 found that 597 million people …
Controversy over Sclerotherapy for Malignant Pleural Effusions
Authors: Leigh M. Vaughan
Journal: Annals of Internal Medicine (1994)

Letters15 July 1994Controversy over Sclerotherapy for Malignant Pleural EffusionsLeigh M. Vaughan, PharmD and Steven A. Sahn, MDLeigh M. Vaughan, PharmDSearch for more papers by this author and Steven A. Sahn, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-2-199407150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The 1993 retrospective review in 21 patients mentioned by Fuller [1] that showed a complete response of 88% after 1 month with the use of 500 mg of intrapleural doxycycline was not available when our review was done. We agree that the issues raised by Drs. Fuller and Ruckdeschel concerning first-dose efficacy, length of hospital stay, and total costs require further study; however, we disagree that sufficient comparative data exist to state that bleomycin is more efficacious and cost-effective than doxycycline, particularly because higher doxycycline doses may have produced different results [2, 3]. It is hoped that more ...References1. Robinson LA, Fleming WH, Galbraith TA. Intrapleural doxycycline control of malignant pleural effusions. Ann Thorac Surg. 1993; 55:1115-22. Google Scholar2. Dryzer SR, Joseph J, Baumann M, Birmingham K, Sahn SA, Strange CA, et al. Early inflammatory response of minocycline and tetracycline on the rabbit pleura. Chest. 1993; 104:1585-8. Google Scholar3. Dressler CM. Comment: cost in treating malignant pleural effusions with bleomycin. Ann Pharmacother. 1994; 28:407-8. Google Scholar4. Oxman AD. Meta-statistics: help or hindrance? ACP J Club. 1993; May-June:A13-5. Google Scholar5. Audu PB, Sing RF, Mette SA, Fallahnejhad M, et al. Fatal diffuse alveolar injury following use of intrapleural bleomycin (Letter). Chest. 1993; 103:1638. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1994Volume 121, Issue 2Page: 150-151KeywordsBloodClinical trialsDoxycyclineInfertilityPleural effusionRandomized trialsStatistical methodsSystematic reviewsTetracyclinesUnited States pharmacopeia ePublished: 15 August 2000 Issue Published: 15 July 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Declarations for new doctors are unnecessary
Authors: W. T Stevenson
Journal: BMJ (2002)

EDITOR—The declaration for new doctors devised by Sritharan et al and shown in their editorial is nonsense.1 It is meaningless waffle and unlikely to benefit anyone, and the statement that a professor of medical ethics was involved engenders little confidence.

The stated ideals of the declaration, like those of Christianity, are impossible to attain. The first hurdle comes in the first line: “I will to the best of my ability serve humanity.” When in imminent danger of falling from a rockface it is indeed possible …
Safety and Efficacy of MK-8669 (Ridaforolimus) + MK-2206 (AKT Inhibitor) in Patients with Advanced Breast Cancer with PI3K Pathway Dependence
Authors: S. Gupta, P. Munster, A. Hollebecque, G. Argiles, T. Guren, J. Cheng, R. Wang, A. Swift, A. Tosolini, S. Piha-Paul
Journal: Annals of Oncology (2014)
Abnormal myocardial repolarisation in response to hypoxaemia and fenoterol.
Authors: D G Kiely, R I Cargill, A Grove, A D Struthers, B J Lipworth
Journal: Thorax (1995)

BACKGROUND--Prolongation of the QTc interval has been associated with cardiac dysrhythmias and sudden death. QTc dispersion (interlead variability in QTc interval) has recently been proposed as being a more sensitive marker of repolarisation abnormalities and shown to be a more specific index of arrhythmia risk. Although hypoxaemia and fenoterol have previously been shown to prolong the QTc interval, this does not reflect regional myocardial repolarisation abnormalities. METHODS--Electrophysiological effects were measured at baseline and after 30 minutes steady state hypoxaemia at an arterial oxygen saturation (SaO2) of 75-80% (study 1) and at baseline then 30 minutes after inhaled fenoterol 2.4 mg (study 2). From the ECG, lead II corrected QT interval (QTc) and overall corrected QT dispersion were measured using a computer linked digitising tablet according to standard criteria. RESULTS--QTc dispersion was increased during hypoxia compared with baseline values (mean (SE) 69 (6) ms v 50 (5) ms) and after fenoterol compared with baseline (79 (13) v 46 (4) ms), respectively. There was also an increase in QTc interval and heart rate after fenoterol (493 (23) v 420 (6) ms and 98 (3) v 71 (6) bpm, respectively). The heart rate was increased during hypoxaemia compared with baseline (78 (3) v 64 (2) bpm), but no change occurred in the QTc interval. CONCLUSIONS--Both hypoxaemia and fenoterol cause myocardial repolarisation abnormalities in man in terms of increased QTc dispersion, but only fenoterol increased the QTc interval. This may be relevant in the aetiology of arrhythmias in patients with acute severe asthma where beta agonist therapy and hypoxaemia coexist.
Closer to home: but what about community pharmacies?
Authors: V.G. Hubbard, S.L. Walker
Journal: British Journal of Dermatology (2007)

Journal Article Closer to home: but what about community pharmacies? Get access V.G. Hubbard, V.G. Hubbard Department of Dermatology, Homerton University Hospital, Homerton Row, London E9 6SR, U.K. *Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, U.K. Correspondence: V.G. Hubbard. E‐mail: virginia.hubbard@homerton.nhs.uk Search for other works by this author on: Oxford Academic Google Scholar S.L. Walker S.L. Walker Department of Dermatology, Homerton University Hospital, Homerton Row, London E9 6SR, U.K. *Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 158, Issue 2, 1 February 2008, Pages 405–406, https://doi.org/10.1111/j.1365-2133.2007.08303.x Published: 01 February 2008
Effects of Physical Activity and Exercise Training on Cardiovascular Risk in Coronary Artery Disease Patients With and Without Type 2 Diabetes
Authors: Jaana J. Karjalainen, Antti M. Kiviniemi, Arto J. Hautala, Olli-Pekka Piira, E. Samuli Lepojärvi, Juha S. Perkiömäki, M. Juhani Junttila, Heikki V. Huikuri, Mikko P. Tulppo
Journal: Diabetes Care (2015)

OBJECTIVE Leisure-time physical activity (LTPA) and exercise training are essential parts of current guidelines for patients with coronary artery disease (CAD). However, the contributions of LTPA and exercise training to cardiovascular (CV) risk in CAD patients with type 2 diabetes (T2D) are not well established. RESEARCH DESIGN AND METHODS We examined the effects of LTPA (n = 539 and n = 507; with and without T2D, respectively) and 2-year controlled, home-based exercise training (n = 63 plus 64 control subjects with T2D and n = 72 plus 68 control subjects without T2D) on the CV risk profile and composite end point among CAD patients. RESULTS During the 2-year follow-up, patients with reduced LTPA at baseline had an increased risk of CV events (adjusted hazard ratio 2.3 [95% CI 1.1–5.1; P = 0.033], 2.1 [1.1–4.2; P = 0.027], and 2.0 [1.0–3.9; P = 0.044] for no LTPA, LTPA irregularly, and LTPA two to three times weekly, respectively) compared with those with LTPA more than three times weekly. Among patients who completed the 2-year exercise intervention, exercise training resulted in favorable changes in exercise capacity both in CAD patients with T2D (+0.2 ± 0.8 vs. −0.1 ± 0.8 MET, P = 0.030) and without T2D (+0.3 ± 0.7 vs. −0.1 ± 0.5 MET, P = 0.002) as compared with the control group but did not have any significant effects on major metabolic or autonomic nervous system risk factors in CAD patients with or without T2D. CONCLUSIONS There is an inverse association between habitual LTPA and short-term CV outcome, but controlled, home-based exercise training has only minor effects on the CV risk profile in CAD patients with T2D.
565 RIBAVIRIN TREATMENT OF HEV INFECTION IN IMMUNOCOMPETENT AND IMMUNOCOMPROMISED PATIENTS: WHICH PATIENTS NEED ANTIVIRAL THERAPY?
Authors: S. Pischke, P.V. Suneetha, S. Birkner, W. Kauffmann, U. Bode, C. Blume, H. Heidemann, A. Haverich, B. Bremer, C. Bara, M. Cornberg, M.P. Manns, H. Wedemeyer
Journal: Journal of Hepatology (2012)
Subjective Compared with Objective Sleepiness
Authors: Wolfgang Schmidt-Nowara
Journal: Annals of Internal Medicine (1999)

Letters19 October 1999Subjective Compared with Objective SleepinessWolfgang Schmidt-Nowara, MDWolfgang Schmidt-Nowara, MDSleep Medicine Institute; Dallas, TX 75231 (Schmidt-Nowara)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-8-199910190-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Benbadis and colleagues (1) show the difficulty of assessing sleepiness in patients. The authors failed to demonstrate a correlation between a widely used subjective rating scale, the Epworth Sleepiness Scale (ESS), and a standard objective test, the multiple sleep latency test (MSLT). It may be useful to mention research that was first reported at a symposium in 1989 (2). One hundred sixteen consecutive patients assessed for sleepiness by the MSLT also answered a standardized set of questions examining the propensity to fall asleep in six different settings. These items were similar to those in the subsequently reported ...References1. Benbadis SR, Mascha E, Perry MC, Wolgamuth BR, Smolley LA, Dinner DS. Association of the Epworth Sleepiness Scale and the multiple sleep latency test in a clinical population. Ann Intern Med. 1999;130:289-92. LinkGoogle Scholar2. Schmidt-Nowara WW, Wiggins CL, Walch JK. Sleepiness in an adult population: prevalence, validity, correlates. In: Peter JH, Penzel T, Podszus T, von Wichert P, eds. Sleep and Health Risk. Berlin: Springer-Verlag; 1991. Google Scholar3. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540-5. CrossrefMedlineGoogle Scholar4. Lavie P. Sleep habits and sleep disturbances in industrial workers in Israel: main findings and some characteristics of workers complaining of excessive daytime sleepiness. Sleep. 1981;4:147-58. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Sleep Medicine Institute; Dallas, TX 75231 (Schmidt-Nowara) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation between the Epworth Sleepiness Scale and the Multiple Sleep Latency Test in a Clinical Population Selim R. Benbadis , Edward Mascha , Michael C. Perry , Barbara R. Wolgamuth , Laurence A. Smolley , and Dudley S. Dinner Subjective Compared with Objective Sleepiness Selim R. Benbadis and Edward Mascha Metrics 19 October 1999Volume 131, Issue 8Page: 632KeywordsFallsSleepSpecificity Issue Published: 19 October 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Evaluation of hepatitis delta virus RNA levels during interferon therapy by analysis of polymerase chain reaction products with a nonradioisotopic hybridization assay
Authors: Elisabetta Cariani, Antonella Ravaggi, Massimo Puoti, Giovanni Mantero, Alberto Albertini, Daniele Primi
Journal: Hepatology (1992)

We developed a nonradioisotopic assay for detection of hepatitis delta virus RNA in serum by combining reverse transcription of RNA, polymerase chain reaction of the resultant complementary DNA and enzyme linked immunoassay detection of the polymerase chain reaction products using a monoclonal antibody specific for double-stranded DNA. This DNA enzyme immunoassay had a limit of detection of cloned hepatitis delta virus RNA similar to that of standard PCR followed by Southern-blot hybridization (∼ 10 copies/sample) and was 103 to 104 times more sensitive than direct dot-blot hybridization (∼ 105 copies/sample). Serial serum samples from six patients with chronic hepatitis delta virus infection undergoing interferon therapy were analyzed by reverse transcription–polymerase chain reaction followed by both standard hybridization and DNA enzyme immunoassay. The results of both methods were comparable, revealing disappearance of hepatitis delta virus RNA after 3 to 6 mo of therapy in three patients, two of whom had also a significant decrease in ALT activity. The DNA enzyme immunoassay test is therefore a potentially useful method for therapeutic monitoring in chronic hepatitis delta virus infection and may contribute to a wider application of polymerase chain reaction in clinical laboratories. (Hepatology 1992;15:685–689).
Usefulness of Exercise Testing in the Prediction of Coronary Disease Risk Among Asymptomatic Persons as a Function of the Framingham Risk Score
Authors: Gary J. Balady, Martin G. Larson, Ramachandran S. Vasan, Eric P. Leip, Christopher J. O’Donnell, Daniel Levy
Journal: Circulation (2004)

The purpose of this study is to determine the usefulness of exercise treadmill testing (ETT) among asymptomatic persons in predicting coronary heart disease (CHD) events over and above the Framingham CHD risk score.Subjects included 3043 members of the Framingham Heart Study offspring cohort without CHD (1431 men and 1612 women; age, 45+/-9 years) who underwent ETT and were followed up for 18.2 years. The risk of developing CHD was evaluated relative to 3 exercise test variables: (1) ST-segment depression > or =1 mm, (2) failure to achieve target heart rate (THR) of 85% predicted maximum, and (3) exercise capacity. In multivariable analyses that adjusted for age and Framingham CHD risk score, among men, ST-segment depression (hazard ratio [HR], 1.88; 95% CI, 1.21 to 2.91) and failure to achieve THR (HR, 1.70; 95% CI, 1.18 to 2.45) predicted higher CHD risk, whereas a greater exercise capacity predicted lower CHD risk (HR per MET, 0.94; 95% CI, 0.89 to 0.99). Although similar HRs were seen in women, those results were not statistically significant. Among men with 10-year predicted risk > or =20%, failure to reach THR and ST-segment depression both more than doubled the risk of an event (HR, 2.66 and HR, 2.11, respectively), and each MET increment in exercise capacity reduced risk by 13% (HR, 0.87).Among asymptomatic men, ST-segment depression, failure to reach THR, and exercise capacity during ETT provided additional prognostic information in age- and Framingham risk score-adjusted models, particularly among those in the highest risk group (10-year predicted CHD risk of > or =20%). The evaluation of exercise test variables in women is limited, given our sample size and the few CHD events in women.
Visualization of Hepatic Metastases of Medullary Thyroid Carcinoma on Tc-99m MDP Bone Scintigraphy
Authors: Iftikhar Ali, William Johns, Shiv M. Gupta
Journal: Clinical Nuclear Medicine (2006)

A 35-year-old man with a history of medullary carcinoma of the thyroid underwent a whole-body bone scan for chest wall pain. Extensive irregular radionuclide uptake was observed in hepatic metastases in both lobes, later confirmed on CT scan. A case of technetium-99m MDP uptake in hepatic metastases from medullary carcinoma of the thyroid is presented and the literature is reviewed.
THE TREATMENT OF DOUBLE FRACTURE OF LOWER JAW BY ANGLE'S FRACTURE BANDS, WITH REPORT OF CASE.
Authors: W. E. GAMBLE
Journal: JAMA (1894)

Mr. E. N., aged 40, was referred to me by O. A. King,D.D.S., of this city, July 4, 1894, for treatment of double fracture of lower jaw, the line of fracture on right side extending from third molar through angle of jaw (Fig 1, x). Third molar, being loose, was extracted. The fracture on left side was between left lateral incisor and left cuspid (Fig. l, y). The fragment was displaced one-half inch below level of teeth. By direct pressure the fragment was adjusted to its normal place. To keep it there was the problem. A roller bandage was placed the full length of fragment on the under surface of jaw, over which a four-tailed bandage was applied, secured by sewing the bandage carefully. July 5. Fragment displaced as before. Wiring the jaw was advised, but the patient desired all other means to be tried first. A leather chin cup
Patients will be able to report drugs' side effects
Authors: Keren Williams
Journal: BMJ (2004)

Patients who suspect they have experienced side effects of drugs will be able to report direct to the Medicines and Healthcare Products Regulatory Agency, under new proposals for the “yellow card” notification scheme being considered by the Department of Health. Currently only doctors, dentists, coroners, pharmacists and nurses can submit reports.

It is hoped that giving patients direct access will increase reports received by the agency. Since the yellow card scheme started 40 years ago, there have been some 500 000 reports of drug reactions, but it is widely believed many side effects go unreported. Pilot schemes should be used to …
One in Three: A Son's Journey into the History and Science of Cancer
Authors: Des Spence
Journal: BMJ (2006)

” I love you dad.” I looked at my 5 year old son and made a mental note to complain to the school about the subversive content of its discussion forum classroom activity known as circle time. I explained that he didn't even know me and that he should wait until he was at least 40 before he started making any definite commitment. He nodded, but I wasn't sure that he understood. In Britain, understatement rules supreme, and Brief Encounter —the dullest film ever made—is considered by many as our greatest love story. Emotional Americana makes many of us squirm. …
Doctors, patients, and the drug industry
Authors: F. Godlee
Journal: BMJ (2009)

<h3>ABSTRACT</h3> Maternal and newborn health (MNH) service delivery redesign aims to improve maternal and newborn survival by shifting deliveries from poorly equipped primary care facilities to adequately prepared designated delivery hospitals. We assess the feasibility of such a model in Kakamega County, Kenya, by determining the capacity of hospitals to provide services under the redesigned model and the acceptability of the concept to providers and users. We find many existing system assets to implement redesign, including political will to improve MNH outcomes, a strong base of support among providers and users, and a good geographic spread of facilities to support implementation. There are nonetheless health workforce gaps, infrastructure deficits, and transportation challenges that would need to be addressed ahead of policy rollout. Implementing MNH redesign would require careful planning to limit unintended consequences and rigorous evaluation to assess impact and inform scale-up.