tbuckley/cabot-search huggingface dataset:
Textbook of Clinical Medicine: An Approach to Patients' Major Problems
Authors: Nicholas E. Davies
Journal: JAMA (1984)

This text on general medicine was written for "students and doctors (apart from subspecialists) [who] are not usually confronted by patients complaining that they have a specific disease, but rather by people with a problem." Toward this end the authors have divided the book into 11 chapters, each covering a conventional subspecialty of internal medicine, except for psychiatry, neurology, and dermatology. These chapters are then subdivided according to symptoms (eg, breathlessness under "Problems in Respiratory Disease"), signs (eg, cyanosis under both "Cardiovascular Problems" and "Problems in Respiratory Disease") and syndromes (eg, syndrome of acute glomerulonephritis in "Problems in Renal Medicine" and even an oddity called "funny turns" in the section on "Problems in Neurology"). Presumably, if you are a medical student or a generalist and your patient is initially seen with a fever, for example, you look for causes of fever by turning to page 22 (under "Cardiovascular Problems"), or
Evaluation of a Program for Preventing Adolescent Pregnancy
Authors: Leon Gordis, Ruth Finkelstein, Jacqueline D. Fassett, Betty Wright
Journal: New England Journal of Medicine (1970)

Abstract Birth-control services with intensive individual and group counseling were provided for preventing unplanned pregnancy in sexually active nulliparous adolescents. During the first two years of the program 100 girls were placed on contraception. Despite intensive follow-up efforts, only 50 per cent remained active with the program one year after admission. However, almost half the younger adolescents were still active in the program at the end of two years. Side effects were minimal, except for weight gain, which was most frequent among girls who were overweight at the time of admission to the program. These observations indicate the complexities involved and demonstrate the need for an interdisciplinary team approach in the prevention of adolescent pregnancy.
Kidney Transplant Outcomes for Prior Living Organ Donors
Authors: Vishnu Potluri, Meera N. Harhay, F. Perry Wilson, Roy D. Bloom, Peter P. Reese
Journal: Journal of the American Society of Nephrology (2014)

The Organ Procurement and Transplantation Network gives priority in kidney allocation to prior live organ donors who require a kidney transplant. In this study, we analyzed the effect of this policy on facilitating access to transplantation for prior donors who were wait-listed for kidney transplantation in the United States. Using 1:1 propensity score-matching methods, we assembled two matched cohorts. The first cohort consisted of prior organ donors and matched nondonors who were wait-listed during the years 1996-2010. The second cohort consisted of prior organ donors and matched nondonors who underwent deceased donor kidney transplantation. During the study period, there were 385,498 listings for kidney transplantation, 252 of which were prior donors. Most prior donors required dialysis by the time of listing (64% versus 69% among matched candidates; P=0.24). Compared with matched nondonors, prior donors had a higher rate of deceased donor transplant (85% versus 33%; P<0.001) and a lower median time to transplantation (145 versus 1607 days; P<0.001). Prior donors received higher-quality allografts (median kidney donor risk index 0.67 versus 0.90 for nondonors; P<0.001) and experienced lower post-transplant mortality (hazard ratio, 0.19; 95% confidence interval, 0.08 to 0.46; P<0.001) than matched nondonors. In conclusion, these data suggest that prior organ donors experience brief waiting time for kidney transplant and receive excellent-quality kidneys, but most need pretransplant dialysis. Individuals who are considering live organ donation should be provided with this information because this allocation priority will remain in place under the new US kidney allocation system.
Removal of a deeply migrated pancreatic stent in a normal-size pancreatic duct using a modified snare with a cut plastic sheath
Authors: M. Kim, J. Han, M. Kang, H. Chae, S. Park, S. Youn
Journal: Endoscopy (2012)

A 79-year-old man underwent endoscopic retrograde cholangiopancreatography (ERCP) for removal of stones in the common bile duct. The stones were removed successfully and a pancreatic stent was placed in the pancreatic duct to prevent post-ERCP pancreatitis. The next day the patient suddenly complained of abdominal pain; his serum amylase was 125 U/L. At a second ERCP, we found that the stent had migrated slightly toward the inner side of pancreatic duct ([Fig. 1]). In order to remedy the situation, a guide wire was inserted alongside the stent, and then we attempted to pass an extraction balloon over the stent. This pushed the stent further upstream. Subsequent attempts with biopsy forceps, a basket, and a snare caused the stent to migrate to the tail of the pancreatic duct. We tried once again with the small snare, but were unsuccessful. The wire tip of the snare only reached up to the middle of the stent, due to the resistance between the plastic sheath and stent ([Fig. 2]). Finally, we cut off about 2 cm of the plastic sheath over the distal tip ([Fig. 3]) and when the snare with the shortened plastic sheath was advanced to the proximal end of the stent, it was able to hook the proximal tip of the stent ([Fig. 4]). The snare was withdrawn carefully until the stent could be seen at the ampulla ([Fig. 5]), and was subsequently removed. The patient's abdominal symptoms resolved soon after this procedure.
Aberrant expression of tetraspanin molecules in B-cell chronic lymphoproliferative disorders and its correlation with normal B-cell maturation
Authors: S Barrena, J Almeida, M Yunta, A López, N Fernández-Mosteirín, M Giralt, M Romero, L Perdiguer, M Delgado, A Orfao, P A Lazo
Journal: Leukemia (2005)
Meeting Report: The Use of Newborn Blood Spots in Environmental Research: Opportunities and Challenges
Authors: Andrew F. Olshan
Journal: Environmental Health Perspectives (2007)

Dried blood spots (DBS) are routinely collected from newborns in the United States using a heel stick. The DBS are screened for inborn errors of metabolism and other disorders. More states are keeping residual spots and making them available for research purposes. DNA extraction from the DBS has been widely applied; however, the development of methods to measure a range of environmental toxicants in DBS has been a more recent goal for laboratory scientists and epidemiologists.The purpose of the meeting was to examine the utility of DBS to measure environmental exposures. Speakers and discussants were invited to present data and discuss approaches to measure a range of analytes using DBS.This meeting was held on 20 February 2007 at the University of North Carolina at Chapel Hill. The audience consisted of epidemiologists, chemists, and staff from state public health programs, the Centers for Disease Control and Prevention, and the National Institutes of Health. The meeting included presentations on measurement of flame-retarding chemicals and pesticides, metals, perchlorate, infectious agents, markers of immune status, and protein adducts. Analytical methods included mass spectrometry, atomic absorption, molecular methods, and microfluidic techniques. Significant progress was reported, but important challenges remain. Concerns including storage conditions, sample volume, contamination, and normalization require additional systematic evaluation. In addition, DBS storage and access policies require coordination.DBS remain a highly valuable resource for clinical, epidemiologic, and toxicologic investigation. The use of DBS to measure environmental exposures shows promise but additional work is necessary before more widespread use is warranted.
Diseases of the Nose, Throat and Ear: A Handbook for Students and Practitioners
Authors: Werner D. Chasin
Journal: JAMA (1976)

This introductory textbook for medical students and general physicians, written by two respected British otolaryngologists, has a format and type that is pleasant to read. The illustrations are sparse but of acceptable quality. Although it serves as an excellent survey, the book does contain a number of errors and omissions. In the section on nasal anatomy, as well as that on tonsil anatomy, the sphenopalatine ganglion is incorrectly described as a sensory ganglion. Choanal atresia is incorrectly described as a failure of the nerves to canalize. The lethal midline granuloma continues to be equated with Wegener granuloma, although evidence is accumulating that these are two entirely unrelated disorders. The "TMN" (tumor size, metastases, and nodal involvement) classification referred to in the section on laryngeal malignancies is described inadequately and confusingly. The authors continue to sing the praises of adenoidectomy for Eustachian tubal disease despite the serious questions that have been
Smoking in pregnancy
Authors: R. Campbell, D. J Murphy
Journal: BMJ (2009)

The age and sex specific incidence rates for cerebral infarction, primary intracerebral haemorrhage and subarachnoid haemorrhage in a population of approximately 105,000 are presented. Over four years 675 patients with a first-ever stroke were registered with the Oxfordshire Community Stroke Project. The pathological diagnosis was confirmed by computerised tomography (CT) scan, necropsy or lumbar puncture (cases of subarachnoid haemorrhage only) in 78% of cases and a further 17% were diagnosed according to the Guy9s Hospital Stroke Diagnostic Score. The proportion of all first-ever strokes by pathological type was: cerebral infarction 81% (95% confidence interval 78-84), primary intracerebral haemorrhage 10% (8-12), subarachnoid haemorrhage 5% (3-7) and uncertain type 5% (3-7). These proportions are similar to other community-based studies. The overall 30 day case fatality rate was 19% (16-22), that for cerebral infarction being 10% (7-13), primary intracerebral haemorrhage 50% (38-62) and subarachnoid haemorrhage 46% (29-63). One year post stroke 23% (19-27) with cerebral infarction were dead and 65% (60-70) of survivors were functionally independent. The figures for primary intracerebral haemorrhage were 62% (43-81) dead and 68% (50-86) of survivors functionally independent and for subarachnoid haemorrhage were 48% (24-72) dead and 76% (56-96) of survivors functionally independent. There are important differences between these rates and those from other sources possibly due to more complete case ascertainment in our study. Nevertheless, the generally more optimistic early prognosis in our study, particularly for cases of cerebral infarction, has important implications for the planning of clinical trials and for the expected impact that any treatment might have on the general population.
HLA-identical sibling allogeneic peripheral blood stem cell transplantation with reduced intensity conditioning compared to autologous peripheral blood stem cell transplantation for elderly patients with de novo acute myeloid leukemia
Authors: A-L Herr, M Labopin, D Blaise, N Milpied, M Potter, M Michallet, W Heit, F Ferrara, J Esteve, W Arcese, G Ehninger, J M Rowe, G Kobbe, A Rosselet, D Bunjes, B Rio, M Brune, A Nagler, N C Gorin, F Frassoni, V Rocha
Journal: Leukemia (2006)
AN IMPROVED PLANTAR SPLINT
Authors: Charles W. Goff
Journal: JAMA (1928)

A simple plantar splint for fractures of the phalanges of the foot can be made from one thirty-second inch tempered aluminum, cut in the shape of the plantar surface of the foot from the heel up to the metatarsophalangeal joints. The splint is cut to allow a prolongation only beneath the toe that has been injured. It is padded slightly with sheet wadding and fastened to the foot with adhesive strips. Thus all the toes, with the exception of the injured one, are allowed to retain their motion and contact with the ground. The injured toe is supported with the maximum of comfort, and greater freedom in walking is permitted without retarding callus formation. Thus a working man, and it is this class of patient in whom most of these fractures occur, can wear a size or two larger inexpensive tennis shoe over the injured foot with the splint
P88 An Evaluation Of The Patients Pathway To Accident And Emergency (a And E) Or Inpatient Admission Following An Exacerbation Of Asthma Or Chronic Obstructive Pulmonary Disease (copd) In A Large Teaching Hospital
Authors: M. Naqvi, H. Khachi
Journal: Thorax (2014)

<h3>Introduction</h3> Asthma and COPD account for a significant proportion of inpatient admissions in the UK. A national review of asthma deaths found that a significant proportion of patients die without seeking medical assistance or before emergency medical care could be provided.<sup>1</sup> <h3>Objectives</h3> Establish the pathway that patients undertake to access care in the lead up to an A and E attendance and/or inpatient admission. <h3>Method</h3> Patients attending A and E and/or following an inpatient admission due to an exacerbation of asthma or COPD were reviewed by a respiratory pharmacist during weekday working hours. Patients were identified during post take ward rounds and using hospital electronic systems. All analyses were conducted using SPSS 22. Ethics approval was not required. <h3>Results</h3> Over the six-month period, 539 (138 asthma and 403 COPD) presentations for exacerbations of asthma and COPD were reviewed. As Table 1 shows, only 48% (n = 66) and 46% (n = 185) of asthma and COPD patients respectively, received medical attention and/or had an active intervention (e.g. administration of rescue pack of oral corticosteroids and/or antibiotics) prior to presenting to hospital. The remaining 52% (n = 72) and 54% (n = 218) respectively either did not seek medical attention or were unable to be reviewed (e.g. unable to obtain an appointment with their general practitioner, GP) prior to their attendance. The results also show that the majority of patients were registered with a GP. <h3>Conclusion</h3> Despite the majority of patients having access to a GP, a significant proportion of asthma and COPD patients either did not seek medical attention prior to presenting to hospital, or were unable to be reviewed by their GP. These findings correlate with those found in the national review of asthma deaths.<sup>1</sup> At a time of increasing demands on healthcare resources, these results pose the question of how we can better triage patients to appropriate care settings to minimise unscheduled care and improve patient access and care. <h3>Reference</h3> Royal College of Physicians. Why asthma still kills: the National Review of Asthma Deaths (NRAD). <i>Confidential Enquiry Report.</i> May 2014
Effects of Endogenous Superoxide Anion and Nitric Oxide on Cholinergic Constriction of Normal and Hyperreactive Guinea Pig Airways
Authors: JACOB De BOER, F.MAY H. POUW, JOHAN ZAAGSMA, HERMAN MEURS
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

In a guinea pig model of allergic asthma, we have recently established that a deficiency of nitric oxide (NO) contributes to the increased ex vivo responsiveness of isolated perfused tracheae to methacholine after the early asthmatic reaction at 6 h after inhalational challenge of the animals with ovalbumin aerosol. Because this deficiency could be caused by a reaction of NO with enhanced levels of inflammation-induced superoxide anion (O − 2 ), we examined the effect of endogenous O− 2 on the regulation of methacholine-induced constriction by NO of intact perfused tracheal tube preparations from unchallenged (control) guinea pigs and from animals 6 h after ovalbumin challenge. In the presence of the NO synthase (NOS) inhibitor N ω-nitro-l-arginine methyl ester (l-NAME; 100 μ M), tracheae obtained from unchallenged guinea pigs showed a 1.7-fold increase in the maximal response to intraluminally applied methacholine (p < 0.05). By contrast, the maximal airway response to methacholine was significantly decreased in the presence of the O − 2 scavenger superoxide dismutase (SOD; 100 U/ml), by approximately 45% (p < 0.01). The SOD-induced decrease in responsiveness to methacholine was reversed by l-NAME. Tracheal preparations obtained at 6 h after allergen challenge showed a 1.8-fold increased responsiveness to intraluminally applied methacholine compared with controls (p < 0.001), which was not further enhanced in the presence of l-NAME. SOD had neither an effect on the increased responsiveness nor did it restore the potentiating effect of l-NAME. These results indicate that (1) in normoreactive tracheal preparations, the regulatory role of NO is partially counteracted by endogenous O− 2, and ( 2) the deficiency of NO in hyperreactive tracheae obtained at 6 h after ovalbumin challenge is not caused by its reaction with O− 2, but rather to decreased cNOS activity. De Boer J, Pouw FMH, Zaagsma J, Meurs H. Effects of endogenous superoxide anion and nitric oxide on cholinergic constriction of normal and hyperreactive guinea pig airways.
The transcription factors Blimp-1 and IRF4 jointly control the differentiation and function of effector regulatory T cells
Authors: Erika Cretney, Annie Xin, Wei Shi, Martina Minnich, Frederick Masson, Maria Miasari, Gabrielle T Belz, Gordon K Smyth, Meinrad Busslinger, Stephen L Nutt, Axel Kallies
Journal: Nature Immunology (2011)
Childhood Immunization Registries
Authors: Walter A. Orenstein
Journal: JAMA (1996)

<h3>To the Editor.</h3> —We were pleased with the overview of immunization registries, or immunization information systems (IIS), by Mr Gostin and Ms Lazzarini.<sup>1</sup>However, several points raised by the authors require clarification. According to the article, "national data systems that can track all children and identify those who need to be vaccinated do not exist." While such a national system has been proposed,<sup>2</sup>state and local data systems were selected because immunizations are provided to persons in the community by local health departments and other private and public health care providers. Therefore, to accommodate local situations and preferences, IIS are most efficiently developed by state and local health departments. Developing IIS requires a great deal of collaboration among health departments, private providers, local volunteer and professional organizations, and many others. These collaborations can best be developed at the community level. Community-based IIS can fulfill the basic purposes of
Gurmit Singh Sokhi
Authors: R. Sokhi
Journal: BMJ (2004)

Consultant in general surgery Solihull, Heartlands, and Solihull Parkway hospitals, Birmingham, and honorary senior lecturer in surgery University of Birmingham (b Lohar Partapara, Punjab, India, 1934; q Glasgow 1962; FRCS Ed), died from heart failure and obstruction of the small intestine on 17 June 2003.​2003.




Figure 1




He did all his postgraduate training at Glasgow Royal Infirmary, where he became interested in gastrointestinal endoscopy and in vascular surgery. He moved to Birmingham in 1975, where he took up his first consultant post. Research was his passion, and his main interests became the problems of biliary surgery and jaundice, and the diagnosis and management of gastrointestinal malignancy. He was a proud Sikh and served on the executive committees of various Indian medical associations. He leaves a wife, Harjit, and three children.
Mechanism for improved cardiac performance with arteriolar dilators in aortic insufficiency.
Authors: B H Greenberg, H DeMots, E Murphy, S H Rahimtoola
Journal: Circulation (1981)

To determine how arteriolar dilation improves cardiac performance in aortic insufficiency, we evaluated the acute effects of hydralazine in 10 patients with chronic severe aortic insufficiency. Control measurements of intracardiac and intravascular pressures, cardiac output and left ventricular volumes were obtained at cardiac catheterization. Hydralazine, 0.3 mg/kg i.v. (maximal dose 20 mg), was administered and all measurements were repeated 30 minutes later. A reduction in systemic vascular resistance from 1264 to 710 dyn-sec-cm-5 was associated with significant increases in forward cardiac index (2.9 to 5.1 l/min/m2) and stroke volume index (37 to 55 ml/m2). Left ventricular end-diastolic pressure was reduced from 19 to 12 mm Hg. There was a significant reduction in mean arterial pressure (88 to 83 mm Hg) and a significant increase in heart rate (81 to 94 beats/min). Regurgitant stroke volume was reduced by more than 10 ml/m2 in seven patients and for the group was significantly reduced, from 65 to 53 ml/m2. Regurgitant fraction was reduced in all patients; the overall reduction from 0.64 to 0.48 was highly significant. Ejection fraction increased more than 0.10 in four patients, by 0.08 in an additional patient and for the group increased significantly from 0.50 to 0.57. Left ventricular end-diastolic volume decreased by more than 25 ml/m2 in four patients, by 19 ml/m2 in an additional patient and was decreased significantly, from 208 to 190 ml/m2, for the group. Arteriolar dilators improve cardiac performance in aortic insufficiency by reducing the amount of aortic regurgitation and, in some patients, by substantially improving systolic pump fraction. These data suggest a role for arteriolar dilators in the management of selected patients with aortic insufficiency.
Arthritis due to synovial involvement by extramedullary haematopoiesis in myelofibrosis with myeloid metaplasia.
Authors: M H Heinicke, M H Zarrabi, P D Gorevic
Journal: Annals of the Rheumatic Diseases (1983)

A 60-year-old man presented with polyarthralgias, a psoriasiform rash, and severe elbow pain. Peripheral blood smear and bone marrow biopsy established a diagnosis of myelofibrosis with myeloid metaplasia. Biopsy of the skin lesions revealed a nonspecific dermatitis. The clinical presentation was inconsistent with psoriatic arthritis, and there was no evidence for associated gout or collagen-vascular disease. Histological examination of tissue taken at the time of synovectomy indicated elbow arthritis to be due to myeloid metaplasia involving the synovial membrane.
Immune Complex Diseases.
Authors: J. Claude Bennett
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Immune Complex Diseases.J. Claude Bennett, M.D., F.A.C.P.J. Claude Bennett, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-853_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSome clarification of the extraordinarily complex picture of immunological injury is beginning to emerge in the area of immune complex disease. Evidence is mounting for the primary role of antigen-antibody complexes as the cause for some forms of vasculitis and nephritis. Analysis of bound antibody from diseased glomeruli has been useful in defining those aspects of the immune system that are involved. The ability of the Clq component of complement to precipitate circulating soluable immune complexes, as well as the utilization of the physical property of these complexes to precipitate in the cold, has aided in the detection of such... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: J. Claude Bennett, M.D., F.A.C.P.Affiliations: Birmingham, Ala. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 853-853KeywordsAntigensImmune complexImmune systemNephritisVasculitis ePublished: 1 December 2008 Issue Published: 1 May 1972 PDF downloadLoading ...