tbuckley/cabot-search huggingface dataset:
Preoperative Hemoglobin Level as a Predictor of Survival After Coronary Artery Bypass Grafting
Authors: Albert H.M. van Straten, Mohamed A. Soliman Hamad, André J. van Zundert, Elisabeth J. Martens, Jacques P.A.M. Schönberger, Andre M. de Wolf
Journal: Circulation (2009)

The predictive value of the preoperative hemoglobin value after coronary artery bypass grafting (CABG) has not been well established. We studied how the preoperative hemoglobin level affects the survival of patients after CABG. Late mortality was compared with that of a general population.Early and late mortality of all consecutive patients undergoing isolated CABG between January 1998 and December 2007 were determined. Patients were classified into 4 groups stratified by preoperative hemoglobin level. The cutoff point for anemia was 13 g/dL for men and 12 g/dL for women. Expected survival of a matched general Dutch population cohort was obtained from the database of the Dutch Central Bureau for Statistics. After the exclusion of 122 patients who were lost to follow-up and 481 patients with missing preoperative hemoglobin levels, complete data were obtained in 10,025 patients. Multivariate logistic regression analyses revealed anemia to be an independent risk factor for higher early mortality. Cox regression analyses revealed low hemoglobin level, both as a continuous variable and as a dichotomous variable (anemia), to be a predictor of higher late mortality. Compared with expected survival, patients with the lowest preoperative hemoglobin levels had a worse outcome, whereas patients with the highest hemoglobin levels had a better outcome.A lower preoperative hemoglobin level is an independent predictor of late mortality in patients undergoing CABG, whereas anemia is a risk factor for early and late mortality. Compared with the general population, anemic patients had worse survival than expected, whereas nonanemic patients had better survival than expected.
Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of sarcoidosis
Authors: M. Bartheld, M. Veseliç-Charvat, K. Rabe, J. Annema
Journal: Endoscopy (2010)

Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of mediastinal lymph nodes is increasingly used to detect noncaseating granulomas in patients with suspected sarcoidosis. The optimal needle size and tissue processing method for detecting noncaseating granulomas are debated. We assessed the value of cell-block analysis when added to conventional cytological evaluation of EUS aspirates obtained by 22-gauge needles in patients with stage I and II sarcoidosis.Data from 101 consecutive patients (55 % of whom had previously had a nondiagnostic bronchoscopy) with suspected pulmonary sarcoidosis (stage I and II), who underwent EUS-FNA of mediastinal lymph nodes with 22-gauge needles were retrospectively analyzed.The sensitivity of EUS in detecting granulomas was 87 % (cytology and cell-block analysis together) (stage I, 92 %; stage II, 77 %). In 33 % of cytology negative patients (n = 6), granulomas were present in the cell block. The optimal yield for granuloma detection was reached with four needle passes. One patient developed mediastinitis after EUS-FNA.Cell-block analysis added to conventional cytological evaluation of 22-gauge EUS aspirates, results in a high yield in detecting granulomas in patients with suspected sarcoidosis and reduces the false-negative rate substantially. EUS has a considerably higher yield in stage I compared with stage II sarcoidosis. For an optimal yield, four needle passes are required.
The Danger of the Stercolith
Authors: S. Barling
Journal: BMJ (1938)

The symptom of pruritus was studied in one general practice. Approximately 2.8 per cent of consultations were found to involve pruritus. Information about site, duration, precipitating factors, relieving factors, and relationship of time of day to pruritus was obtained from 100 patients. Seventy-four of the patients were female, of whom one-third were in the age range 20—29 years. The cause of pruritus was classified into 29 categories. Only three patients had an underlying systemic disease causing their itch. Four patients were referred for a dermatologist9s opinion. The importance of pruritus the symptom in relation to both disease and patient behaviour is considered.
Bone Lead Levels and Delinquent Behavior
Authors: Claire B. Ernhart
Journal: JAMA (1996)

<h3>To the Editor.</h3> —Dr Needleman and colleagues<sup>1</sup>report that lead exposure is associated with increased risk for delinquency in boys. However, their findings are far from definitive. Although the sample was adequate in size (212 after exclusions), and high-risk cases were oversampled, the measures of delinquency, including self-reports at ages 7 and 11 years, parent and teacher Child Behavior Checklist (CBCL) T scores greater than 70, and CBCL delinquency cluster scores, all failed to reach statistical significance. There were, however, some significant associations between lead level and parent and teacher ratings of aggression and other behavioral disturbances. The results of a replication 2 years later were not reported, and there was no indication as to whether they were confirmatory. A major concern in research on lead effects is the control of confounding factors. These variables typically contribute appreciably more to analytic models than does lead. Thus, it was startling
Fatal virus-associated hemophagocytic syndrome associated with coexistent chronic active hepatitis B and acute hepatitis C virus infection
Authors: Mikkel Faurschou, Ove Juul Nielsen, Per Boye Hansen, Birgitte Ravn Juhl, Hans Hasselbalch
Journal: American Journal of Hematology (1999)

A 28-year-old man was admitted to our department with intermittent fever, hepatosplenomegaly and pancytopenia. Liver parameters and serum ferritin were markedly elevated. Bone marrow biopsy showed hypocellularity, histiocytic hyperplasia, and hemophagocytosis consistent with a virus-associated hemophagocytic syndrome (VAHS). There was serological evidence of chronic active hepatitis B and acute hepatitis C virus infection. The patient died despite aggressive immunosuppressive and supportive treatment. Autopsy revealed signs of acute viral hepatitis with cholestasis. Histiocytes engaged in hemophagocytosis were observed in bone marrow and spleen. The condition was interpreted as VAHS associated with chronic active hepatitis B and acute hepatitis C virus infection. To our knowledge this is the first report of a hemophagocytic syndrome in that setting.
Delayed Vascular Reactivity to Ischemia in Diabetic Microangiopathy
Authors: B Haitas, A Barnes, M E C Shogry, M Weindling, P Rolfe, R C Turner
Journal: Diabetes Care (1984)

To investigate vascular responses in insulin-dependent diabetic patients both with and without retinopathy, we have assessed vasodilation by forearm transcutaneous pO2 measurement after 10 min of ischemia produced by a sphygmomanometer cuff. Diabetic patients with proliferative retinopathy had a delayed vasodilatory response at 60 s (mean ± SD pO2 = 9 ± 3 mm Hg) compared with those having diabetes without retinopathy (15 ± 4 mm Hg, P &amp;lt; 0.01) and matched normal subjects (14 ± 4 mm Hg, P &amp;lt; 0.01). Recently diagnosed insulin-dependent diabetic patients had a very similar response (15 ± 5 mm Hg) to matched normal subjects (15 ± 3 mm Hg). The diminished vascular reactivity may be a consequence of microangiopathy and neuropathy, although patients with an impaired vascular response might be particularly at risk from the development of capillary closure.
"Re-cognising" risks: from space shuttles to chest drains
Authors: Tara Lamont
Journal: BMJ (2011)

The NPSA will shortly be abolished in its present form—what have we learnt?

It starts with a meeting at the National Patient Safety Agency (NPSA) to discuss a reported death of a patient from enoxaparin overdose. The national database shows more than 2000 similar incidents reported by staff of dosing errors involving low molecular weight heparins, with varying degrees of harm to patients. How could these be avoided? To the pharmacist present, the solution is clear: doctors just need to be more careful when calculating treatment doses for each patient, by weight and clinical indication. The trainee doctors exchange wry glances—do they know how hard it is to get accurate information about each patient? And to remember the right dose for each of the 10 different heparins used at this hospital? The nurses present look at each other and shrug. What are the chances of any of the medical wards having the right weighing equipment for every patient, including the bedbound, who may need hoists and under-bed scales? And the design expert notes the lack of prompt on the prescribing chart to …
Several studies have shown salmeterol to be more potent than salbutamol for systemic effects
Authors: J Bennett, A E Tattersfield
Journal: BMJ (1997)

Editor—In their editorial on spacer devices in the treatment of asthma Christopher O'Callaghan and Peter Barry suggest1 that the finding of Smyth et al that salmeterol is some 10 times more potent than salbutamol for systemic effects may …
Pulmonary infection during the acute respiratory distress syndrome.
Authors: K R Sutherland, K P Steinberg, R J Maunder, J A Milberg, D L Allen, L D Hudson
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Pulmonary infection is thought to be a common complication of ARDS. We undertook this prospective study to determine the incidence of pulmonary infection in patients with ARDS, and to evaluate the impact of nosocomial pneumonia on severity of ARDS and on survival. Two hundred one bronchoscopies were performed in 105 patients with ARDS with retrieval of distal airway secretions by bronchoalveolar lavage (BAL) and protected specimen brush (PSB). Whenever possible, bronchoscopy was performed at predetermined times: Day 3, Day 7, Day 14, and Day 21 after the onset of ARDS. The majority of patients were receiving antibiotics at the time of study. Changes in bacterial flora over time were determined by quantitative cultures of BAL and PSB. Bacterial growth was common, but usually at small concentrations. Only 16 patients met quantitative culture criteria for pneumonia (PSB > or = 10(3) cfu/ml or BAL > or = 10(4) cfu/ml). Correlation was poor between clinical evidence of pneumonia and pneumonia by quantitative culture criteria: clinical criteria had a very low sensitivity (24%) for predicting positive quantitative culture results, and a low specificity (77%) for predicting negative quantitative culture results. There was no correlation between total colony counts on BAL or PSB and severity of ARDS as judged by Pao2/FIo2 ratios, days receiving ventilation, or compliance. Furthermore, there was no correlation between bacterial growth and survival. We conclude that pneumonia defined by quantitative bacteriology is uncommon in ARDS. The potentially confounding role of broad-spectrum antibiotics should be studied further.
Increased Bronchial Hypersensitivity after Early and Late Bronchial Reactions Provoked by Allergen Inhalation
Authors: L. Machado
Journal: Allergy (1985)

The non-specific bronchial reactivity following bronchial allergen challenge was studied in 40 patients with allergic bronchial asthma, particularly in subjects without definite late reactions 6 h after the provocations (reduction in peak expiratory flow or forced expiratory volume in 1 s of less than 15% of the control value at this time). Among a group of 21 patients submitted to bronchial provocation tests, 13 carried out maximal exercise tests 6 and 1 week after the allergen challenge. In another group of 19 patients, the bronchial hyperreactivity to methacholine was assessed before and 6 h and 1 week after challenge. Two patients with a dual response (early & late) reacted with bronchial obstruction to the exercise. Exercise tests performed after 1 week did not provoke asthma in any patient. In the methacholine group a marked increase in responsiveness to methacholine 6 h after the provocation was observed in those patients with a dual response who were tested and in those with equivocal late reactions and even in three patients with an isolated immediate reaction. The increases responsiveness was still present in many patients 1 week after challenge. The airway caliber did not influence the degree of responsiveness to methacholine. Nor did the degree of responsiveness have any influence on the patterns of reactions observed after allergen exposure. It was concluded that in some individuals exposure to the relevant allergen predisposes them to exercise-inducible bronchial obstruction. Further, it was confirmed that non-specific bronchial reactivity can be increased not only in patients with late responses - both definite and equivocal--but also in some patients with immediate reactions alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Parsing Neurobiological Dysfunctions in Obesity: Nosologic and Ethical Consequences
Authors: Carl E. Fisher, Michael J. Devlin, Paul S. Appelbaum
Journal: The American Journal of Bioethics (2010)

In 2007, Nora Volkow, the director of the U.S. National Institute on Drug Abuse, argued in the American Journal of Psychiatry that obesity should be considered a brain disorder and considered for i...
SERUM PRECIPITABLE IODINE CONCENTRATIONS DURING PREGNANCY 1
Authors: Martin Heinemann, Carl E. Johnson, Evelyn B. Man
Journal: Journal of Clinical Investigation (1948)

Circulating thyroid hormone is measured more accurately by determination of serum precipitable iodine than of basal metabolic rate (1 to 8).Since the latter increases during pregnancy (9 to 14) serum precipitable iodines were investigated in 43 pregnant women and followed in some subjects after delivery.
Interferon beta prevents recurrence of hepatocellular carcinoma after complete resection or ablation of the primary tumor—A prospective randomized study of hepatitis C virus–related liver cancer
Authors: Kenji Ikeda, Yasuji Arase, Satoshi Saitoh, Masahiro Kobayashi, Yoshiyuki Suzuki, Fumitaka Suzuki, Akihito Tsubota, Kazuaki Chayama, Naoya Murashima, Hiromitsu Kumada
Journal: Hepatology (2000)

Because hepatocellular carcinoma often recurs after surgical resection or ethanol injection therapy, we conducted a prospective randomized controlled trial of interferon (IFN) in patients with chronic liver disease caused by hepatitis C virus (HCV). Twenty eligible patients with cirrhosis were randomized into two groups: 10 patients treated with 6 million units of natural IFN-β twice a week for 36 months and 10 patients without IFN therapy. One patient within the treatment group discontinued interferon therapy after 19 months of treatment because of a mild degree of retinopathy. None of the patients in either group lost HCV-RNA until the end of the observation. Although 7 (70.0%) of 10 patients in the nontreatment group showed tumor recurrence, only 1 (10.0%) of 10 patients with IFN therapy developed tumor recurrence during a median observation period of 25.0 months. Cumulative recurrence rates of the treated and untreated groups were 0% and 62.5% at the end of the first year, and 0% and 100% at the second year, respectively (log-rank test, P = .0004). In conclusion, intermittent administration of IFN suppressed tumor recurrence after treatment with surgery or ethanol injection in patients with HCV-related chronic liver disease.
When to Start ART in Africa — An Urgent Research Priority
Authors: Kevin M. De Cock, Wafaa M. El-Sadr
Journal: New England Journal of Medicine (2013)

Proof of the prevention benefit of antiretroviral therapy (ART) raises questions about when to initiate ART in the course of HIV disease. But the effect of early initiation on morbidity and mortality is uncertain. A trial is required to determine when to initiate ART in Africa.
Case 85-1962
Authors: William H. Baker, Robert E. Scully
Journal: New England Journal of Medicine (1962)

Presentation of CaseA thirty-one-year-old married woman was referred to the hospital because of vaginal bleeding.Three weeks before entry the patient experienced the sudden onset of "gushing" vaginal bleeding, with the passage of large clots. The bleeding continued for three days, requiring the use of three boxes of sanitary pads, and she became weak and dizzy. On admission to another hospital the hemoglobin was 9.5 gm. per 100 ml. After a transfusion of blood a uterine curettage was performed; pathological examination revealed adenocarcinoma of the endometrium.The menses began when the patient was sixteen years of age and had . . .
The underrecognized progressive nature of N370S Gaucher disease and assessment of cancer risk in 403 patients
Authors: Tamar H. Taddei, Katherine A. Kacena, Mei Yang, Ruhua Yang, Advitya Malhotra, Michael Boxer, Kirk A. Aleck, Gadi Rennert, Gregory M. Pastores, Pramod K. Mistry
Journal: American Journal of Hematology (2009)

Mutations in GBA1 gene that encodes lysosomal glucocerebrosidase result in Type 1 Gaucher Disease (GD), the commonest lysosomal storage disorder; the most prevalent disease mutation is N370S. We investigated the heterogeneity and natural course of N370S GD in 403 patients. Demographic, clinical, and genetic characteristics of GD at presentation were examined in a cross-sectional study. In addition, the relative risk (RR) of cancer in patients compared with age-, sex-, and ethnic-group adjusted national rates of cancer was determined. Of the 403 patients, 54% of patients were homozygous (N370S/N370S) and 46% were compound heterozygous for the N370S mutation (N370S/other). The majority of N370S/N370S patients displayed a phenotype characterized by late onset, predominantly skeletal disease, whereas the majority of N370S/other patients displayed early onset, predominantly visceral/hematologic disease, P < 0.0001. There was a striking increase in lifetime risk of multiple myeloma in the entire cohort (RR 25, 95% CI 9.17-54.40), mostly confined to N370S homozygous patients. The risk of other hematologic malignancies (RR 3.45, 95% CI 1.49-6.79), and overall cancer risk (RR 1.80, 95% CI 1.32-2.40) was increased. Homozygous N370S GD leads to adult-onset progressive skeletal disease with relative sparing of the viscera, a strikingly high risk of multiple myeloma, and an increased risk of other cancers. High incidence of gammopathy suggests an important role of the adaptive immune system in the development of GD. Adult patients with GD should be monitored for skeletal disease and cancers including multiple myeloma.
Non-surgical management of peripheral vascular disease
Authors: J R Murray
Journal: BMJ (1980)

for cure of hypertension, and a further 48% and 30°' respectively for improvement (for example, easier medical control of blood pressure).We have recently performed percutaneous dilatation in two patients with severe renal artery stenosis, one a 37-year-old female with a two-year history of poorly controlled hypertension, and the other a 50-year-old female with a similar five-year history.They have since been normotensive on no treatment after six and three months respectively, and there were no complications.Clearly, long-term follow-up is needed; but it does appear that in selected cases trans- luminal angioplasty is a very effective technique.Advantages include avoidance of general anaesthetic and a major surgical procedure, shortened hospital stay, and decreased cost.It can be repeated if necessary, and in the event of failure surgical treatment is not precluded.In the future, therefore, the method will probably receive more than a passing mention in articles on the treatment of arterial disease.
Effects of Thiazide Diuretics on Plasma Lipids and Lipoproteins in Mildly Hypertensive Patients
Authors: Richard H. Grimm, Arthur S. Leon, Donald B. Hunninghake, Kristine Lenz, Peter Hannan, Henry Blackburn
Journal: Annals of Internal Medicine (1981)

A blood lipid-lipoprotein elevating effect of the diuretics hydrochlorothiazide and chlorthalidone in mildly hypertensive men has been established by a cross-over, randomized controlled trial, confirming previous clinical observations. Compared to baseline, plasma total cholesterol increased 6% and 8% and triglycerides 17% and 15% under treatment with hydrochlorothiazide and chlorthalidone, respectively. A cholesterol-lowering diet largely prevents this increase. Because these effects may be long-lasting and may cancel part of the potential benefit of blood pressure control in mildly hypertensive patients, with thiazide diuretics attention should be given to prescription of a cholesterol-lowering diet and to periodic monitoring of blood lipid levels. Different antihypertensive agents might be considered in patients with elevated blood lipid levels. Other antihypertensive agents currently in use need to be studied for potential effects on lipid metabolism.
Comparison of an LH&amp;ndash;RH Analogue (Goeserelin Acetate, &amp;lsquo;Zoladex&amp;rsquo;) with Combined Androgen Blockade in Advanced Prostate Cancer: Final Survival Results of an International Multicentre Randomized&amp;ndash;Trial
Authors: C.J. Tyrrell, J.E. Altwein, F. Klippel, C. Jurincic-Winkler, E. Varenhorst, G. Lunglmayr, F. Boccardo, I.M. Holdaway, J.-M. Haefliger, J.P. Jordaan
Journal: European Urology (2000)
Consultant Surgeons and Vasectomy
Authors: M. Waite
Journal: BMJ (1973)

In late 1971 410 consultant general surgeons and urologists—74% of a national random sample—responded to a postal survey about vasectomy. Probably about 50,000 vasectomies were performed by surgeons in England and Wales in 1970. The service was largely a private one: 60% of consultants9 hospital vasectomies were not done under the National Health Service, and, in addition, 26% of the consultants who worked in relevant specialties performed vasectomies elsewhere than in hospital (usually in private nursing homes). Based again on consultants9 estimates, probably 6,000 men in 1970 had their requests for vasectomy turned down by surgeons, or more than one turned down for every 10 done. The most common reason was that patients were “too young.” About 90% of the consultants thought vasectomy could normally be performed safely and adequately as an outpatient procedure, yet only 64% said that 90% or more of their hospital vasectomies were done on this basis. While 69% regarded services in their areas as adequate, most were in favour of more special vasectomy clinics.
Clostridium difficile and inflammatory bowel disease.
Authors: C Greenfield, J R Aguilar Ramirez, R E Pounder, T Williams, M Danvers, S R Marper, P Noone
Journal: Gut (1983)

Stools from 109 patients with inflammatory bowel disease (13.4%) contained Clostridium difficile or its toxin, an incidence similar to the stools of 99 control patients with diarrhoea (11.9%), but significantly higher than the stools of 77 control patients with a normal bowel habit (1.4%). Sixty-six per cent of the diarrhoea controls, but only 11% of the inflammatory bowel disease patients, reported recent antibiotic use: however, 67% of inflammatory bowel disease patients were taking sulphasalazine. The presence of Cl difficile in the stool was not related to the clinical assessment of inflammatory bowel disease relapse, but it was related to hospital admission. During the one year study, 31 of the 109 patients (28%) with inflammatory bowel disease had one or more stool samples that were positive for Cl difficile.