tbuckley/cabot-search huggingface dataset:
Pathologic Fracture and Lytic Lesions in Multiple Myeloma
Authors: Suresh R Nair, Stanley B Pearson
Journal: New England Journal of Medicine (2004)

A 76-year-old woman was admitted with an exacerbation of chronic obstructive pulmonary disease. Her condition improved with bronchodilators, prednisolone, an antibiotic, oxygen, and supportive measures. Two years previously, she had presented with vertebral compression fractures, Bence Jones proteinuria, and IgG paraproteinemia. The diagnosis of multiple myeloma had been confirmed by examination of the bone marrow, which showed 36 percent atypical plasma cells. The patient had tolerated chemotherapy poorly and was treated only with opiates and sodium clodronate. Three days after the present admission, pain and swelling developed in her right arm without previous trauma. Radiographs of the arm showed a . . .
ASSESSMENT OF PERFORMANCE, SYSTOLIC FUNCTION AND CONTRACTILITY, AND THEIR CORRELATIONS WITH MYOCARDIAL DAMAGE MARKERS IN PATIENTS WITH SEVERE SEPSIS AND SEPTIC SHOCK
Authors: Sergio J. Baratta, Alejandro Hita, Demian Chejtman, Jorge Bilbao, Pablo Pratesi, Diego Bernardez, Sebastián Cosenza, Juan C. Escardo, Domingo Turri
Journal: Journal of the American College of Cardiology (2011)
Do-Not-Resuscitate Orders in Radiology Departments
Authors: John E. Heffner
Journal: Annals of Internal Medicine (1999)

Letters6 July 1999Do-Not-Resuscitate Orders in Radiology DepartmentsJohn E. Heffner, MDJohn E. Heffner, MDMedical University of South Carolina; Charleston, SC 29425 (Heffner)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-1-199907060-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Mylonakis' comments and agree with the recommendation that radiologists discuss end-of-life issues with their patients before invasive procedures. Management of DNR orders in the operating room is analogous in some respects to the transport of patients with a DNR status to the radiology department. Recent guidelines emphasize the importance of honoring DNR orders or negotiating with patients temporary DNR modifications during surgical procedures (1, 2). All recommended options emphasize the importance of physician–patient discussions that clearly establish the planned responses to life-threatening events before transfer to the operating room (3, 4). Our study indicates that ...References1. Ethical guidelines for the anesthesia care of patients with do not resuscitate orders or other directives that limit treatment. American Society of Anesthesiologists 1994 Directory of Members. 59th ed. Park Ridge, IL: American Society of Anesthesiologists; 1994:746-7. Google Scholar2. Statement of advance directives by patients: do not resuscitate in the operating room. Committee on Ethics American College of Surgeons. Am Coll Surg Bull. 1994; 79:29. Google Scholar3. Walker RM. DNR in the OR: resuscitation as an operative risk. JAMA. 1991;266:2407-12. CrossrefMedlineGoogle Scholar4. Clemency MV, Thompson NJ. Do not resuscitate (DNR) orders and the anesthesiologist: a survey. Anesth Analg. 1993;76:394-401. MedlineGoogle Scholar5. Connors AF, Dawson NV, Desbiens NA, Fulkerson WJ, Goldman L, Knaus WA, et al . A controlled trial to improve care for seriously ill hospitalized patients. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). JAMA. 1995;274:1591-8. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John E. Heffner, MDAffiliations: Medical University of South Carolina; Charleston, SC 29425 (Heffner) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCompliance with Do-Not-Resuscitate Orders for Hospitalized Patients Transported to Radiology Departments John E. Heffner and Celia Barbieri Do-Not-Resuscitate Orders in Radiology Departments Eleftherios Mylonakis Metrics 6 July 1999Volume 131, Issue 1Page: 73KeywordsCardiopulmonary resuscitationDiagnostic radiologyDo not resuscitate ordersEnd of life carePatientsRadiologistsResuscitation ePublished: 15 August 2000 Issue Published: 6 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Comparison of Chemical Composition of Peritoneal Fluid and Serum
Authors: J. G. KELTON
Journal: Annals of Internal Medicine (1978)

It is hypothesized that peritoneal fluid might be used as an alternative vehicle for monitoring the clinical chemistry of patients on peritoneal dialyses and save these patients the venesection and resultant blood loss. Peritoneal fluid was obtained before 47.2% of 106 dialysis treatments and compared with simultaneous serum samples. Very close correlation was noted for phosphorus, uric acid, blood urea nitrogen, creatinine, potassium, bicarbonate, and sodium (r > 0.82,p < 10-6), and we conclude that peritoneal fluid may be useful for monitoring these chemistries. The peritoneal fluid concentrations of calcium and albumin were consistently 20% and 43% lower than the corresponding serum values. Because the peritoneal fluid is in equilibrium with the serum, it could also be used to measure protein binding of low molecular-weight substances in vivo that cross the peritoneal membrane. The results presented here fail to support the suggestion that urate is bound to serum proteins in vivo.
Accidental Poisoning with Tetrachlorethane
Authors: J. M. Ward
Journal: BMJ (1955)

MEDICAL MEMORANDA MIAJORNAL corpuscles and excess of reticulum cells.Bone-marrow sections cut from the ilium showed hypoplasia affecting granulopoiesis more than erythropoiesis.The number of mature granulocytes was greatly reduced and very few megakaryocytes were seen.The number of reticulum cells was increased.The lymphocytes appeared 'to be normal.As regards the red-cell series, there seemed to be a maturation defect at the normoblast stage.
CONGENITAL OCCLUSION OF THE LACHRYMAL CANALAND ACUTE CONTAGIOUS INFLAMMATIONS OF THE CONJUNCTIVA IN CHILDREN.
Authors: JOHN E. WEEKS
Journal: JAMA (1904)

I have endeavored to write in a more or less general manner of the acute contagious inflammations of the conjunctiva that occur in children, prefacing my remarks on the subject by a brief allusion to a perplexing condition that sometimes confronts the pediatrist. I refer to congenital occlusion of the lachrymal canal. Shortly after the secretion of the lachrymal fluid begins (from three to eight weeks after birth), one or both eyes become suffused with tears and some flakes of mucopus appear in the conjunctival sac. Pressure over the lachrymal sac may cause the escape of a minute quantity of pus from the sac. Accompanying this appearance of mucopus, there is little redness of the conjunctiva, but no marked swelling, nor is there any marked swelling of the lids. The presence of the secretion excites the concern of the parents, and the physician is called. This condition is often mistaken
Varices of the Colon
Authors: Maurice Feldman
Journal: JAMA (1962)

VARICES OF THE COLON apparently is an exceedingly rare condition. In an extensive review of the literature we were able to find only one case report, that of Levy et al. These authors also were unable to find any other recorded case. Among 2,912 consecutive adult autopsies, we encountered 2 instances of varices of the colon; one, of the cecum; the other, of the descending colon. In addition to the 2 autopsied cases, we found varices of the sigmoid colon in a clinical patient. These 3 eases of varices of the colon are reported here because of the apparent extreme rarity of the condition and for general medical interest. Report of Cases CASE1 (<i>Autopsy</i>).—A 68-year-old female was admitted to Mercy Hospital for the fourth time in one year because of intestinal bleeding. There was no associated symptom referable to the gastrointestinal tract, and the bleeding site had not been identified.
Acute Benign Pericarditis and the Coxsackie Viruses
Authors: Robert L. Gillett
Journal: New England Journal of Medicine (1959)

RECENT reports have indicated that the Coxsackie viruses may well be etiologic agents in certain cases of acute benign pericarditis. During the months of June to November, 1958, there was an outbreak of epidemic pleurodynia at one of the commands of the United States Naval Air Station, Jacksonville, Florida. During this period 8 cases of acute benign pericarditis were observed, of which 6 were from this particular command, and 2 were in patients from other military establishments not connected with the naval air station who at the time of their illnesses were residing in Jacksonville. The first patient was admitted . . .
STAPHYLOCOCCUS FILTRATES IN STAPHYLOCOCCIC INFECTIONS
Authors: Sigmund S. Greenbaum
Journal: JAMA (1930)

<h3>To the Editor:</h3> —The use of parenteral injections in human beings of the products of pathogenic microbes with the object of inducing immune states against such organisms is still in its infancy. Notable examples are the phytines (fungus products), streptococcus scarlatinal and erysipelas toxins, and Klebs-Loeffler bacillary toxin. One of the newest is perhaps the products of<i>Staphylococcus aureus</i>. It has been known for many years that<i>Staphylococcus aureus</i>and<i>albus</i>produce toxins. Von Lingelsheim in 1899 showed that the filtrates of<i>Staphylococcus aureus</i>had a necrotizing effect on rabbit skin, subsequently confirmed by others and especially by Parker in 1924, whose work actually paved the way for measuring the toxicity of filtrates from different strains. The first attempt, so far as we are aware, to induce an immune state in man with the filtrable products of<i>Staphylococcus pyogenes-aureus</i>was made in 1926. The results were read in Philadelphia, May
Passive-Active Immunization with Tetanus Immune Globulin (Human)
Authors: James A. McComb, Roderick C. Dwyer
Journal: New England Journal of Medicine (1963)

THE ease and efficiency of establishing active immunity against tetanus is universally acknowledged. In groups fifty years of age and over, especially in females, greater efforts must be made by all concerned so that immunization itself will become truly universal, since passive or passive-active immunization after injury in the nonimmune are poor substitutes for active protection acquired before exposure. There will always be circumstances, however, in which it will be desirable to give passive protection to the immunized because of the seriousness of the injury — for example, deep puncture wounds with or without massive contamination, compound fractures, shock and . . .
Acid-Base Balance in Tetanus
Authors: S. Raymond Gambino
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In the article, "Clinical Patterns in Severe Tetanus" (<i>JAMA</i><b>185</b>:559 [Aug 17] 1963) Dr. Kurt Kloetzel lists a low CO<sup>2</sup>combining capacity as the most striking chemical disturbance found. Dr. Kloetzel questions whether the low CO<sup>2</sup>combining capacity represented metabolic acidosis, respiratory alkalosis, or simply compensated bicarbonate deficit. In addition, Dr. Kloetzel found a large "anionic gap." Recently I performed serial venous electrolyte determinations (see Table) in a case of severe tetanus with respiratory failure. The patient did recover. The venous blood pH and carbon dioxide pressure (pCO<sup>2</sup>) data in my case show respiratory alkalosis to be the persistent abnormality. In my experience unsuspected respiratory alkalosis is very common in diseases affecting the central nervous system. The initial values for total CO<sup>2</sup>, pH, and pCO<sup>2</sup>suggest an underlying metabolic acidosis with complete respiratory compensation. The initial electrolyte data also show the
Lewisham A&amp;E department will be downgraded, health secretary says
Authors: I. Torjesen
Journal: BMJ (2013)

England’s health secretary, Jeremy Hunt, today tried to steer a middle course between the recommendations of an administrator appointed to solve the problems of a failing south London hospital trust and campaigners who wanted to keep open their local hospital’s emergency unit.

He announced that the emergency unit at Lewisham Hospital would not remain in its present state, but nor would it be closed or turned into an urgent care centre, as originally proposed. Instead it would be downgraded while still retaining cover by senior emergency staff for 24 hours a day, seven days a week, enabling it to provide services to 75% of the patients who currently use it.

However, the obstetrician led maternity unit at Lewisham would be downgraded to a midwife led birthing centre, as proposed. 

Hunt was responding to the report of the trust special administrator, Matthew Kershaw. Kershaw was appointed in July last year by the former health secretary, Andrew …
P4-11-05: Association between Bisphosphonate Use in Metastatic Breast Cancer (MBC) and Overall Survival.
Authors: A Mathew, IE Mathew, MQ Rosenzweig, AM Brufsky
Journal: Cancer Research (2011)

Abstract Background Pre-clinical studies on bisphosphonates in breast cancer have suggested an anti-tumor effect in addition to its bone protective role. However, randomized controlled trials of bisphosphonates versus placebo have found little evidence of increased overall survival (OS) in MBC. We conducted a retrospective single institution cohort study of MBC patients to evaluate the association between bisphosphonate use and overall survival. Methods: Baseline demographic and tumor specific data were collected on newly diagnosed MBC patients between January 1998 and December 2009. Other variables included the number and sites of each metastasis, use of baseline neoadjuvant and adjuvant chemotherapy, and use of hormonal therapy. Bisphosphonate use was defined as present if it was administered for a period of at least 3 months in the metastatic setting. Overall survival was determined from the date of diagnosis of first metastatic disease. Survival analysis was performed using the Kaplan-Meier method and Cox proportional-hazards model. Results: Data were available on 737 patients with MBC, of whom 434 died during a median follow-up of 2 years; median age was 50.3 years. 92% of patients were Caucasian; 32% were both ER and PR-negative; and 31% were HER2−positive. Over 67% of MBC patients had bone metastasis and nearly 80% received bisphosphonates. Multivariate analysis found an overall survival benefit for bisphosphonate use, with a hazard ratio of 0.63 (95% confidence interval: 0.48−0.84; p&amp;lt;0.002), when adjusted for variables with significant effect on survival on univariate analysis and other known prognostic variables. These variables include age, stage at diagnosis, race, hormone receptor status, HER2 status, and number of metastatic sites, presence of bone metastasis and the use of adjuvant therapy. The administration of adjuvant therapy did not yield a significant survival advantage in the analyses. Conclusion: This retrospective cohort study provides evidence for an OS benefit with the use of bisphosphonates in MBC even after controlling for other significant prognostic factors. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-11-05.
Dysrhythmia vs Arrhythmia
Authors: Kenneth L. Glick
Journal: JAMA (1979)

<h3>To the Editor.—</h3> I have read Dr Constant's article "Solving Nomenclature Problems in Cardiology" (240:868,1978) and found it to be both interesting and enjoyable. I would like to add one commonly misused term that Dr Constant did not mention. This term is "arrhythmia." May I point out that the only<i>a</i>rrhythmia is<i>a</i>systole. Dysrhythmia is the appropriate term.
Curcumin protects brain from oxidative stress through inducing expression of UCP2 in chronic cerebral hypoperfusion aging-rats
Authors: Li Liu, Peng Zhang, Yu Li, Gang Yu
Journal: Molecular Neurodegeneration (2012)

Background Chronic cerebral ischemia is caused by the long-term cerebral hypoperfusion, which is a common pathological process that usually occurs in conditions such as Alzheimer’s disease and vascular dementia, both of which are characterized by cognitive impairment. Oxidative stress plays an important role in nerve cell damage and cognitive dysfunction induced by chronic cerebral ischemia, but the UCP2 (The uncoupling protein 2) plays an important role in inhibiting oxidative stress. This study aims to observe the antioxidation of Curcumin on chronic cerebral ischemia model in rats and investigate change of UCP2 induced by Curcumin.
THE CONTRIBUTION OF NITRIC OXIDE AND ENDOTHELIUM-DERIVED HYPERPOLARIZING FACTOR TO RESTING AND STIMULATED VASODILATOR TONE IN AFRICAN AMERICAN AND WHITES
Authors: Muhiddin A. Ozkor, Jonathan R. Murrow, Ayaz Rahman, Nino Kavtaradze, Shawn Arshad, Hamid Syed, Ji Lin, Amita Manatunga, Arshed A. Quyyumi
Journal: Journal of the American College of Cardiology (2010)
Burst abdomen and incisional hernia.
Authors: R Bewick
Journal: BMJ (1982)

referred for further medical management.Studies of healthy competitive swimmers2 revealed values for red blood cell count and haemoglobin concentration significantly lower than expected mean values, though for indi- viduals no values lay outside the expected normal range (mean ±2 SD).Many such endurance-trained athletes have above-average work capacities3 and they expect their haema- tological values to be above average.Their values, lying at the lower end of a normal range, are medically unremarkable but appear "poor" to the layman.These athletes require reassurance, and the term "sports anaemia" may reinforce the suspicion that there is an illness which requires treatment.Indeed, it is unfortunately common practice for athletes to consume iron preparations with no medical supervision in an effort to cure or even prevent this "anaemia."
Postoperative nausea and vomiting
Authors: Brian Sweeney
Journal: BMJ (2006)

Metaclopramide with dexamethasone works and has few side effects 

F ifteen years ago Kapur described postoperative nausea and vomiting as the “big, little problem,”1 a description that still applies despite the best efforts of doctors and drug companies. In this issue of the BMJ , Wallenborn and colleagues revisit the use of metoclopramide to prevent postoperative nausea and vomiting.2 In the United Kingdom, metoclopramide is no longer a popular choice for prophylaxis or treatment. This is because the standard 10 mg dose is not very effective3; metoclopramide has unpleasant side effects such as extrapyramidal symptoms, especially with repeated doses; and it has been supplanted by newer agents that are more expensive …
Modulation of circadian expression of D-site binding protein by the schedule of parenteral nutrition in rat liver
Authors: A Ogawa
Journal: Hepatology (1997)

The aim of this study was to investigate the changes in the circadian rhythm of the expression of liver-specific genes caused by different schedules of parenteral nutrition (PN). Rats received PN continuously throughout the day or intermittently during the night or day for 7 days. They were examined for gene expression of D-site binding protein (DBP), albumin, and cytochrome P450 cholesterol 7alpha-hydroxylase (CYP7) in the liver. The nocturnal PN group showed circadian expression of DBP messenger RNA (mRNA) and protein with a peak at 10 PM, in the same manner as the control rats receiving normal chow feeding. However, the diurnal PN group showed inverted expression of DBP mRNA and protein with a peak at 10 AM. CYP7 mRNA levels exhibited good synchronization with the levels of DBP mRNA in all groups, whereas albumin mRNA levels did not show such synchronization. Gel mobility-shift assay disclosed that the binding activity of the nuclear extracts to the CYP7 gene promoter was changed by the PN schedule in accordance with the expression of CYP7 mRNA. The PN schedule modulates the circadian rhythm of DBP expression and may have an effect on hepatic bile acid formation through transcriptional regulation of the CYP7 gene.
Long term outcome of patients with gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) following exclusive Helicobacter pylori eradication therapy: experience from a large prospective series
Authors: W Fischbach
Journal: Gut (2003)

<b>Background:</b><i>Helicobacter pylori</i> plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT), and eradication therapy has become a widely accepted initial treatment of stage I disease. <b>Objective:</b> To determine the long term outcome of patients undergoing exclusive <i>H pylori</i> eradication therapy. <b>Design:</b> A prospective series of patients with newly diagnosed marginal zone B cell lymphoma of MALT. <b>Setting:</b> Multicentre study in Germany and Austria. <b>Patients:</b> Ninety five patients; 90 of these (five lost to follow up) with a mean age of 54.3 (27–85) years were followed up for at least 12 months. <b>Intervention:</b> Complete staging work up revealing stage I disease and <i>H pylori</i> infection. Patients received triple therapy (OMC: omeprazole 20 mg twice daily, metronidazole 400 mg twice daily, and clarithromycin 250 mg twice daily; or OAC: omeprazole 20 mg twice daily, amoxycillin 1000 mg twice daily, and clarithromycin 500 twice daily) for one week. <b>Results:</b> Median follow up was 44.6 (12–89) months. <i>H pylori</i> was successfully eradicated in 88 patients (98%); in two patients eradication therapy failed. Long term outcome was characterised by complete regression of lymphoma in 56 patients (62%), minimal residual disease in 17 patients (18%), partial remission in 11 patients (12%), no change in four patients (4%), and progressive disease in two patients (2%). Four patients with complete remission relapsed after 6, 8, 8, and 15 months, one revealing reinfection by <i>H pylori</i>. Regression rate was higher in stage I1 disease compared with stage I2, as diagnosed by endoscopic ultrasound. <b>Conclusion:</b> The majority of patients with low grade gastric MALT lymphoma treated by exclusive <i>H pylori</i> eradication have a favourable long term outcome, offering a real chance of cure.
Physician Opinions on the Use of Antibiotics in Respiratory Infections
Authors: Robert A. Greenberg, Edward H. Wagner, Susanne H. Wolf, Steven B. Cohen, David G. Kleinbaum, Carolyn A. Williams, Michel A. Ibrahim
Journal: JAMA (1978)

To investigate the feasibility of establishing standards of care based on a broad consensus, a questionnaire concerning the management of signs and symptoms of common respiratory infections in infants was given to a national sample of pediatric infectious disease specialists, general pediatricians, and family physicians. There was significant disagreement (p less than .01) among the three groups of physicians in 15 of the 18 clinical situations concerning the appropriateness of prescribing antibiotics. Whenever there was disagreement, the family physician group was most inclined and the infectious disease group least inclined to favor antibiotics therapy. More than 75% of each group favored antibiotics in the same situation in only three instances. These results suggest that it may be difficult to set widely accepted standards for the evaluation of medical care where there are such differences of opinion.