tbuckley/cabot-search huggingface dataset:
Truth Telling: A Cultural or Individual Choice?-Reply
Authors: Antonella Surbone
Journal: JAMA (1993)

<h3>In Reply.</h3> —certainly agree that "autonomy and beneficence are both essential and necessary in caring for patients." My considerations were actually meant to emphasize these Reply.—I pects of our profession. Facing the reality of modern medicine, a reappraisal of the physician's role is probably necessary everywhere in the world. I remain convinced, however, that cultural differences influence, if not the principles, certainly the expression of ethics and medical ethics in different countries. For instance, the "variables unrelated to the patient" are part of what defines a culture. Cultural issues thus should not be underestimated; rather, they need to be more deeply explored. Only the combination of personal and cultural efforts, in my opinion,<sup>1</sup>will guarantee that true respect for our patients, and a correct balance between the ethical principles<sup>2</sup>will be achieved in individual circumstances as well as in the formulation of the rules guiding the practice
Journals demand that authors declare their independence of sponsors
Authors: R. Dobson
Journal: BMJ (2002)

Authors of papers submitted to the leading neurology journals will be required to declare that they have the right to publish any and all of their data, whatever the views of the sponsor. Without that and other written assurances, articles will not be considered for publication in the journals, say the editors in an editorial in the Journal of Neurology, Neurosurgery, and Psychiatry (2002;72:143).

“Corporate sponsors must not be allowed to influence publication, or indeed to prevent it, especially when the data are …
A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis
Authors: Ismail Sari, Fevzi Altuntas, Sibel Hacioglu, Ismail Kocyigit, Alper Sevinc, Suzan Sacar, Kemal Deniz, Emine Alp, Bulent Eser, Orhan Yildiz, Leylagul Kaynar, Ali Unal, Mustafa Cetin
Journal: American Journal of Hematology (2007)

Abstract The aim of the study is to review the clinical manifestations and the hematological findings of brucellosis and pancytopenia, with or without hematological malignancies. The records of 202 patients with brucellosis were evaluated retrospectively. Among these cases of brucellosis seen in a 6 year period between April 1999 and June 2005, 30 patients with pancytopenia were identified. The most common manifestation was fever, followed by weight loss, anorexia, malaise, arthralgia, and hepatosplenomegaly. Bone marrow biopsies revealed hypercellularity or normocellularity. The most common findings in the bone marrow evaluation were histiocytic hemophagocytosis and granulomas. Among all cases, we diagnosed 5 hematological malignancies (1 acute myelogenous leukemia, 2 acute lymphoblastic leukemia, and 2 multiple myeloma) concurrently with brucellosis. The clinical symptoms and findings were similar in patients with and without malignancies. In cases with malignancies, the bone marrow biopsy revealed predominant primary disease involvement. Significant increases in ESR and CRP, severe anemia and thrombocytopenia were observed in patients with malignancies. Peripheral blood counts in patients without malignancies returned to normal after antibiotic treatment for brucellosis. However, pancytopenia in two patients with malignancies did not recover because of primary resistant disease. We conclude that while histiocytic hemophagocytosis may be considered as a major cause of pancytopenia, leukemic infiltration can also be an extreme and unusual cause of pancytopenia in patients in whom brucellosis was concurrently diagnosed with hematological malignancies. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.
Recurrent Systemic Lupus Erythematosus Involving Renal Allografts
Authors: WILLIAM J. C. AMEND
Journal: Annals of Internal Medicine (1981)

Two cases of recurrent lupus erythematosus involving renal transplants are described. Neither case showed changes of transplant rejection. The clinical course, serologic tests, and renal histopathologic findings remarkably paralleled those seen during each patient's primary disease presentation. Typical and severe extrarenal manifestations of dermatitis, pleuritis, and polyarthritis were noted before renal allograft lupus involvement. Rapid renofunctional deterioration was halted in one patient by plasmapharesis. In the second patient a more protracted course involving the allograft is anticipated. Although previous experiences suggest that lupus disease activity "burns out" after the development of chronic renal failure, findings from these two cases argue against this presumption. Longer periods of transplant follow-up may show more recurrence of lupus erythematosus.
Hyperbaric oxygen. Still unproved in necrotising fasciitis.
Authors: T S Burge
Journal: BMJ (1993)

Heart Association issued a press release last year about a controlled study showing the benefit of adjunctive hyperbaric oxygen after coronary thrombolysis.Similar studies are urgently needed in stroke.Facilities in Britain are grossly inadequate, even for the acute indications for hyperbaric oxygen.Treatment of problem wounds requires a simple chamber in every hospital.This would save the NHS millions ofpounds a year.
Extrapulmonary Uptake in the Spleen During Lung Perfusion with Tc-99m MAA
Authors: D Hellín Hellín, A Colom Ferrer, J Forteza Alberti
Journal: Clinical Nuclear Medicine (1992)

We present a case of splenic uptake with Tc-99m MAA without evidence of right–left communication or the existence of free Tc-99m. The only explanation is that of a partial fragmentation of the particle, which is phagocytosed for leukocytes and trapped by the splenic sinusoids.
Clinical Significance of Erythrocyte Sorbitol—Blood Glucose Ratios in Type II Diabetes Mellitus
Authors: Kaoru Aida, Masato Tawata, Hideo Shindo, Toshimasa Onaya
Journal: Diabetes Care (1990)

The polyol pathway has been implicated in the pathogenesis of diabetic complications. To determine the activity of the polyol pathway, the ratio of erythrocyte sorbitol to blood glucose, which reflects aldose reductase activity, was evaluated in 329 patients with type II (non-insulin-dependent) diabetes mellitus and in 100 nondiabetic age-matched control subjects. Although erythrocyte sorbitol levels were markedly elevated, sorbitol-glucose ratios were significantly lower in diabetic patients than in nondiabetic subjects. Sorbitol-glucose ratios in diabetic patients decreased progressively as blood glucose and hemoglobin A1c (HbA1c) levels increased. Sorbitol-glucose ratios were also studied during a 75-g oral glucose tolerance test. Ratios were again lower in diabetic patients than those in nondiabetic subjects and significantly decreased 120 min after glucose loading. The ratio in diabetic patients also fell with increasing age of the patients. In diabetic patients with neuropathy, retinopathy, or nephropathy, however, sorbitol-glucose ratios were significantly higher than in those without these complications; ratios increased further as complications became more severe. Our findings suggest that the affinity of aldose reductase for glucose in patients with diabetic complications may be increased and that the polyol pathway is implicated in the pathogenesis of diabetic complications.
Mitral Stenosis: A Long-term Postoperative Study.
Authors: James C. Dahl
Journal: Annals of Internal Medicine (1965)

s1 May 1965Mitral Stenosis: A Long-term Postoperative Study.James C. Dahl, M.D., Paul Winchell, M.D., F.A.C.P.James C. Dahl, M.D.Search for more papers by this author, Paul Winchell, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1072_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOne hundred patients with dominant mitral stenosis were treated surgically between 1950 and 1953. Two patients have been lost to follow-up. Seventeen patients were classified as Group IV (New York Heart Association), 57 patients were Group III, 23 patients Group II, and 3 patients Group I. The surgical mortality was 9%. Eighty-one of the patients had pre-operative cardiac catheterization, 31 patients were recatheterized 6 to 8 weeks after surgery, and 30 have been restudied 10 years later. Forty-five patients are living. There has been a stable mortality rate of about 4%/year after a period of improvement lasting about 3 years... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James C. Dahl, M.D.; Paul Winchell, M.D., F.A.C.P.Affiliations: Minneapolis, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1072-1072KeywordsCardiac surgeryCatheterizationDeath ratesHeartMitral stenosisMortality ePublished: 1 December 2008 Issue Published: 1 May 1965 PDF downloadLoading ...
Prevalence of IgE antibodies to grain and grain dust in grain elevator workers.
Authors: D M Lewis, P A Romeo, S A Olenchock
Journal: Environmental Health Perspectives (1986)

IgE-mediated allergic reactions have been postulated to contribute to respiratory reactions seen in workers exposed to grain dusts. In an attempt better to define the prevalence of IgE antibodies in workers exposed to grain dusts, we performed the radioallergosorbent test (RAST) on worker sera using both commercial allergens prepared from grain and worksite allergens prepared from grain dust samples collected at the worksite. We found that the two types of reagents identified different populations with respect to the specificity of IgE antibodies present. The RAST assay performed using worksite allergens correlated well with skin test procedures. These results may allow us to gain better understanding of allergy associated with grain dust exposure, and document the utility of the RAST assay in assessment of occupational allergies.
Involvement of thromboxane A2 in propranolol-induced bronchoconstriction after allergic bronchoconstriction in guinea pigs.
Authors: N Songür, M Fujimura, K Mizuhashi, M Saito, Q Y Xiu, T Matsuda
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Although it is well recognized that beta-blockers can induce bronchoconstriction only in patients with asthma, mechanisms of the bronchoconstriction are not well known. We hypothesize that bronchoconstriction induced by beta-blockers may result from inflammatory mediators released by allergic reactions. In this study, we developed a guinea pig model for propranolol-induced bronchoconstriction (PIB) after antigen inhalation and investigated the effect of specific thromboxane (TXA2) receptor antagonists, S-1452 and ONO NT-126, on PIB in passively sensitized and artificially ventilated guinea pigs to determine whether TXA2 is involved in PIB. Propranolol caused bronchoconstriction with 10 mg/ml of propranolol was inhaled 20 min after antigen challenge. On the other hand, propranolol did not produce bronchoconstriction after antigen provocation in nonsensitized guinea pigs or after saline provocation in sensitized animals. Pretreatment of the animals with S-1452 in doses of 0.01 and 0.1 mg/kg and ONO NT-126 in doses of 1.0 and 10 micrograms/kg injected intravenously 15 min after antigen challenge as well as before antigen challenge reduced PIB in a dose-dependent manner. Bronchoconstriction caused by methacholine did not induce PIB. These results suggest that TXA2 has an important role in the pathophysiology of the PIB that develops after the allergic bronchoconstriction.
Kidney granuloma in Whipple's disease.
Authors: M Dhib, F Heron, A Francois, J Bourreile, I Landrin, M Godin
Journal: BMJ (1993)

and greatly inhibit atherogenesis.Interactions in vivo between iron and low density lipoprotein are not well defined.The apparent lack of increased atherosclerosis in haemochromatosis may simply mean that modification of low density lipoprotein catalysed by iron is maximal or nearly maximal at a low level ofexcess iron.
The Utility of SPECT Liver-Spleen Imaging in the Evaluation of a Possible Accessory Spleen
Authors: BARRY H. GUZE, RANDALL HAWKINS
Journal: Clinical Nuclear Medicine (1988)

A case where an x-ray CT examination showed the existence of an unidentified perisplenic mass is presented. This mass was determined to be an accessory spleen after an evaluation with Tc-99m labeled sulfur colloid. This report describes a clinical indication for the use of SPECT imaging of a patient when a mass of uncertain significance is discovered.
Spatial Aspects of Influenza Epidemics
Authors: Stephen B. Thacker
Journal: JAMA (1987)

The purpose of this book is to elucidate the mechanism of the spread of influenza in space and time. To complement the changes in our understanding of the influenza virus related to advances in molecular biology, the authors deal with epidemiologic data by applying robust statistical methods. The book begins with a concise and accurate review of the current understanding of the influenza virus and its epidemiology. To prepare the reader for the rest of the book, the authors summarize previous mathematical approaches to the spread of influenza. The heart of the text follows in five chapters devoted to the geography of influenza at three separate spatial levels—local, regional, and global. The book is dedicated to Edgar Hope-Simpson, and, appropriately, the authors begin their analyses with data from his Cirencester, England, practice. Spatially aggregated information from this community practice of 3500 to 4000 patients includes demographic as well as clinical
A piece of my mind. Fruit in Eden
Authors: S. H. Norris
Journal: JAMA (1989)

I now have it on competent authority that in a not-too-remote alternate universe, Adam and Eve, either less inquisitive or more leery of repercussions than they were in ours, could not be tempted to partake of the Tree of Knowledge. There was no Fall of Man, Nod is underpopulated, fig trees are foliated, snakes have legs, and God still runs the show in Eden. Never having caught on to the Big Picture, incurious Edenites may be excused an occasional lapse in rationality. If their behavior also seems a tad venal, that's only to be expected from folks who never learned Right from Wrong, who have no shame, and whose behavior must still be directed by an occasional Moral Obligation from the Almighty. For instance, the fruit industry (oranges, lemons, and grapefruit only—apples verboten) is as oddly managed there as treatment of renal failure (in-center hemodialysis, home dialysis, and renal transplantation)
General practitioners say that evidence based information is changing practice
Authors: David Tovey, Fiona Godlee
Journal: BMJ (2004)

EDITOR—As the publishers of the BMJ's Clinical Evidence we have more than a passing interest in the extent to which the provision of evidenced based information changes clinical practice. In this context, the results of an evaluation of Clinical Evidence commissioned by us assumed some importance.

A total of 5960 general practitioners in England were contacted by Stingray Research, an independent market research company, and asked to provide some broad perceptions about the role …
Adverse reactions to food additives in children with atopic symptoms
Authors: G. Fuglsang, C. Madsen, S. Halken, M. Jørgensen, P. A. Østergaard, O. Østerballe
Journal: Allergy (1994)

In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria. After a 2‐week period on an additive‐free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated “lemonade” containing the dissolved additives was used for the open challenge. Two doses were used: a low dose and a 10‐fold higher dose. Gelatin capsules were used for a double‐blind challenge. The children were 4–15 years old, and they were attending an outpatient pediatric clinic for the first time. Of the 379 patients who entered the study, 44 were excluded and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double‐blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double‐blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic skin symptoms had a statistically increased risk of a positive reaction. This may have consequences for the future clinical investigation of children with atopic cutaneous symptoms.
1155-99 Similar clinical outcomes for sirolimus-eluting stent implantation and coronary brachytherapy for the treatment of in-stent restenosis
Authors: Francesco Saia, Pedro A Lemos, Angela Hoye, Georgios Sianos, Chourmouzios A Arampatzis, Willem J van der Giessen, Pieter C Smits, Ron T van Domburg, Pim J de Feyter, Patrick W Serruys
Journal: Journal of the American College of Cardiology (2004)
Redefining Expectations of Long-Term Survival After the Fontan Procedure
Authors: Yves d’Udekem, Ajay J. Iyengar, John C. Galati, Victoria Forsdick, Robert G. Weintraub, Gavin R. Wheaton, Andrew Bullock, Robert N. Justo, Leeanne E. Grigg, Gary F. Sholler, Sarah Hope, Dorothy J. Radford, Thomas L. Gentles, David S. Celermajer, David S. Winlaw
Journal: Circulation (2014)

The life expectancy of patients undergoing a Fontan procedure is unknown.Follow-up of all 1006 survivors of the 1089 patients who underwent a Fontan procedure in Australia and New Zealand was obtained from a binational population-based registry including all pediatric and adult cardiac centers. There were 203 atriopulmonary connections (AP; 1975-1995), 271 lateral tunnels (1988-2006), and 532 extracardiac conduits (1997-2010). The proportion with hypoplastic left heart syndrome increased from 1/173 (1%) before 1990 to 80/500 (16%) after 2000. Survival at 10 years was 89% (84%-93%) for AP and 97% (95% confidence interval [CI], 94%-99%) for lateral tunnels and extracardiac conduits. The longest survival estimate was 76% (95% CI, 67%-82%) at 25 years for AP. AP independently predicted worse survival compared with extracardiac conduits (hazard ratio, 6.2; P<0.001; 95% CI, 2.4-16.0). Freedom from failure (death, transplantation, takedown, conversion to extracardiac conduits, New York Heart Association III/IV, or protein-losing enteropathy/plastic bronchitis) 20 years after Fontan was 70% (95% CI, 63%-76%). Hypoplastic left heart syndrome was the primary predictor of Fontan failure (hazard ratio, 3.8; P<0.001; 95% CI, 2.0-7.1). Ten-year freedom from failure was 79% (95% CI, 61%-89%) for hypoplastic left heart syndrome versus 92% (95% CI, 87%-95%) for other morphologies.The long-term survival of the Australia and New Zealand Fontan population is excellent. Patients with an AP Fontan experience survival of 76% at 25 years. Technical modifications have further improved survival. Patients with hypoplastic left heart syndrome are at higher risk of failure. Large, comprehensive registries such as this will further improve our understanding of late outcomes after the Fontan procedure.
NHS regulator given new powers to shut hospitals whose clinical care is poor
Authors: I. Torjesen
Journal: BMJ (2013)

Healthcare regulators in England are to receive tougher powers to act on hospitals that provide poor quality clinical care, including the ability to shut down foundation trusts that fail to improve within a set time period.

The Care Bill,1 published on 10 May, outlines new powers the government is introducing in response to Robert Francis QC’s report into failings at Mid Staffordshire NHS Foundation Trust.2 For the first time the economic regulator of the NHS, Monitor, is to be given authority to shut down foundation trusts that are failing clinically and not just financially. The Francis report found that poor quality care at Mid Staffordshire was related to too much focus on financial and organisational issues rather than on protecting patients and the quality of care.

The health minister Norman …
THE DIFFERENTIAL DIAGNOSIS BETWEEN DENGUE AND YELLOW FEVER. WITH SOME ACCOUNT OF THE EPIDEMIC OF 1897 IN TEXAS.
Authors: H A West
Journal: JAMA (1898)

The diagnosis of disease is universally and justly regarded as the foundation stone upon which rests the entire superstructure of practical medicine. The question concerns the health, life or death of the individual affected, his family and friends, the public in so far as he may be a useful and influential member of society, and the physician as affording a basis for his prognosis and treatment. But there are occasions when far more momentous interests are involved in the correct diagnosis of prevailing diseases: a complete paralysis of commerce, the wheels of industry arrested, enforced idleness with consequent poverty and suffering of thousands, enormous depreciation in property values of every kind, universal fear and panic, and the possibility of wide-spread death and desolation. To the physician himself an error in diagnosis ordinarily involves results which are comparatively inconsequential; on the other hand, there are times when such an error means
Differential expression of glycosylphosphatidylinositol-anchored proteins in a murine T cell hybridoma mutant producing limiting amounts of the glycolipid core. Implications for paroxysmal nocturnal hemoglobinuria.
Authors: L J Thomas, M Urakaze, R DeGasperi, T Kamitani, E Sugiyama, H M Chang, C D Warren, E T Yeh
Journal: Journal of Clinical Investigation (1992)

A T cell hybridoma mutant, which expressed a markedly reduced level of glycosylphosphatidylinositol (GPI)-anchored proteins on the cell surface, was characterized. The surface expression level of Thy-1 was approximately 17% of the wild-type level, whereas the surface expression of Ly-6A was approximately 2.4% of the wild-type level. We show here that these cells synthesized limiting amounts of the GPI core and that the underlying defect in these cells was an inability to synthesize dolichyl phosphate mannose (Dol-P-Man) at the normal level. The defect in Ly-6A expression could be partially corrected by tunicamycin, which blocked the biosynthesis of N-linked oligosaccharide precursors and shunted Dol-P-Man to the GPI pathway. Full restoration of Thy-1 and Ly-6A expression, however, required the stable transfection of a yeast Dol-P-Man synthase gene into the mutants. These results revealed that when the GPI core is limiting, there is a differential transfer of the available GPI core to proteins that contain GPI-anchor attachment sequences. Our findings also have implications for the elucidation of the defects in paroxysmal nocturnal hemoglobinuria.
Effects of temperature change and adrenaline on sinoatrial and atrioventricular nodal potentials
Authors: S. E. FREEMAN, R. J. TURNER
Journal: Cardiovascular Research (1974)

Transmembrane potentials were recorded in the sinoatrial (SA) and atrioventricular (AV) nodal areas of the spontaneously beating rabbit right atrium. In addition to the voltage-time record the first time derivative of the action potential was displayed as a function of voltage. A number of parameters of the AV action potential have been calculated from the resulting phase-plane trajectory. Effects of temperature reduction and catecholamine treatment are reported.