tbuckley/cabot-search huggingface dataset:
A MODIFICATION IN THE ADMINISTRATION OF TETRAIODOPHENOLPHTHALEIN BY THE ORAL ROUTE FOR CHOLECYSTOGRAPHY
Authors: Victor Knapp
Journal: JAMA (1927)

It has been the experience of every one who has employed the oral route in giving the dye for cholecystography to find undissolved capsules in the colon, when either the keratincoated or phenyl salicylate-coated preparation is used. To lessen the frequency with which this occurs, I have been using the plain gelatin capsule, uncoated. As the capsules are needed, they are filled with the dye. The number of patients who have experienced symptoms of gastric irritation is no greater with the uncoated capsule than with the coated one. The results have been better, because nondigested capsules are rarely found, so that a maximum amount of dye is available for absorption. In this way, the information obtained from this procedure is perhaps more certain, and brings the oral route somewhat nearer to the perfection that has been achieved when the dye is injected intravenously. Eight 5 grain capsules are used, as
Non-Bancroftian Elephantiasis in Tanganyika
Authors: P. Jordan, M. H. Trant, W. Laurie
Journal: BMJ (1956)

the increase, and when it is remembered that the sera of some 16% of the population contain anti-P it will be realized that it is a matter of great importance that those whose serum contains antibody of this type should not be transfused with blood that will lead to their developing potentially dangerous immune antibody. SummaryA case of naturally occurring anti-M agglutinin in the serum of an Rh-negative woman is described.The antibody was erroneously assumed to be anti-D, and a bottle of group M Rh-negative blood, cross- matched by a rapid technique at 370 C., was supposed to be compatible.The blood was not transfused.The potentially dangerous nature of antibodies of this type and their relationship to cross-matching techniques are discussed.I am indebted to Dr. A. A. Miller for permission to publish, and to Mr. J. Catterall, who carried out a
Strategies to Decrease Tuberculosis in US Homeless Populations
Authors: Timothy F. Brewer, S. Jody Heymann, Susan M. Krumplitsch, Mary E. Wilson, Graham A. Colditz, Harvey V. Fineberg
Journal: JAMA (2001)

ContextThe rate of tuberculosis (TB) among US homeless persons may be 20 times that of the general adult population. Studies suggest that the majority of urban homeless TB cases are attributable to ongoing transmission of TB. Optimal TB-control strategies in both chronically and transiently homeless populations are not known.ObjectiveTo examine the effects of TB-control strategies on projected TB cases and deaths in US homeless populations using a computer-based simulation model.Design, Setting, and PopulationThe US general population and a theoretical population of 2 million homeless individuals in 1995 were divided into 18 clinical states based on the risk for or presence of TB and human immunodeficiency virus (HIV) infection in a semi-Markov model.Main Outcome MeasuresPrevalence of transiently and chronically homeless individuals with active TB and deaths from TB as a function of public health measures taken to control and eliminate TB, including improvement of treatment effectiveness, improvement in access to treatment, and vaccination with BCG.ResultsA 10% increase in access to treatment among homeless persons with active TB produced larger declines in predicted TB cases and deaths after 10 years (cases and deaths among chronically homeless persons decreased 12.5% and 19.8% and among transiently homeless persons dropped 35.9% and 32.4%, respectively) than improvements in the effectiveness of treatment programs (cases and deaths among chronically homeless persons declined 7.2% and 3.1% and among transiently homeless persons dropped 10.9% and 4.1%, respectively). A 10% increase in access to treatment among homeless persons with latent TB infection led to a 6.7% decline in TB among chronically homeless persons and a 5.7% decline among transiently homeless persons, while a 10% improvement in effectiveness of treatment for latent TB infection was associated with declines of 3.0% and 3.3%, respectively. When treatment for latent TB infection was modeled to be the same in vaccinated and nonvaccinated populations, BCG vaccination led to TB case declines of 15.4% and 21.5% in chronically and transiently homeless populations, respectively.ConclusionsOvercoming barriers faced by homeless individuals in accessing TB treatment programs will be crucial to reducing the burden of TB in this high-risk group. Increased treatment access, improvement in the effectiveness of treatment programs, and BCG vaccination of HIV-negative homeless individuals have the best chance to markedly decrease TB morbidity and mortality.
Quinidine-Rifampin Interaction
Authors: Yaw Twum-Barima, S. George Carruthers
Journal: New England Journal of Medicine (1981)

DRUG interactions with quinidine are likely to be clinically important, since quinidine is used in the treatment and prophylaxis of potentially serious arrhythmias, and since there is a relatively narrow range between the therapeutic and toxic concentrations.1 An interaction between quinidine and the anticonvulsant drugs primidone and phenobarbital has led to a reduction in the half-life of quinidine of approximately 50 per cent.1 Enhanced quinidine elimination after hepatic-enzyme induction by the anticonvulsants was suggested as the likely mechanism. A cautious approach in determining the dosage of quinidine was urged for patients who were receiving this drug and had any change . . .
A Lecture on Vesicular Emphysema of the Lungs
Authors: G. Johnson
Journal: BMJ (1868)

DitVio-tW Axatonmial Charackrs-PAysical Sigs--The Causes, the I PaWhology, and tht .Mechanism of the Disease-The Relation of Em- thsyma to Bronchitis-The Gteneral Symptoms and Results of Ewphy- sema .-Prognosis-Treatment.LAENstc' applied the term Emphysema to two different conditions of lung.Vesiedar Emphysema consists in dilatation of the air-cells.The walls of the cells often become ruptared, so that several contiguous cells unite to form a single cavity.This is a very common and very interest- ing form of disease.Interlobldar Emnphysemna is characterised by an in- filtration of air into the cellular tissue between the lobules; sometimes, too, beneath the pleura, and into the cellular tissue of the mediastinum and of the body generally.This is a comparatively infrequent and un- important.accident.On the present occasion, I shall speak only of vesicular emphysema.Emphysema is, as you know, Greek for iq#flafion, and is correctly ap- plied by surge,ons to accidental inflation of the subcutaneous areolar tissue as occasionally happens after a wound of the lung by a fractured rib, or.during the opertion of tracheotomy.
Computer Application in a Gastrointestinal Endoscopy Unit
Authors: J. Zimmerman, E. Shapiro, Y. Porath, D. Rachmilewitz
Journal: Endoscopy (1985)

A computerized system for accurate recording of endoscopic findings in the gastrointestinal tract is described. This system is easy to use, permits rapid retrieval of data of previous examinations, and permits collection and compilation of data for any purpose. A similar system can be adopted for use in any endoscopy unit.
The Do-Not-Resuscitate Order in a Teaching Hospital
Authors: H. THOMAS FOLEY
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 September 1982The Do-Not-Resuscitate Order in a Teaching HospitalH. THOMAS FOLEY, M.D., J.D.H. THOMAS FOLEY, M.D., J.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-3-456_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Before the policies by Miles and associates (1) become bylaws or rules and regulations of hospitals other than theirs, thereby permitting third parties (such as administrators and committees) to intrude into doctor-patient relationships in those hospitals, I would like to object strongly to the guideline applying to the irreversibly and terminally ill patient whose family objects to an otherwise medically proper do-not-resuscitate order. In that case, the authors' guideline states: "a do-not-resuscitate order will not be implemented." In other words, family members have veto power over the clinician's medical conclusion that the patient's best interest is to...References1. MILESCRANFORDSCHULTZ SRA. The do-not-resuscitate order in a teaching hospital. Ann Intern Med. 1982;96:660-4. LinkGoogle Scholar2. Matter of Dinnerstein. North Eastern Reporter. 2d series. 1978;380:134. Google Scholar3. Matter of Spring. North Eastern Reporter. 2d series. 1979;399:493. Google Scholar1. SCHRAMMILESCRANFORDSCHULTZ RSRA. The do-not-resuscitate order in a teaching hospital. Ann Intern Med. 1982;96:660-4. LinkGoogle Scholar2. SCHRANKANEROBLE RJD. "No code" orders: clarification in the aftermath of Saikewicz. N Engl J Med. 1978;299:875-8. CrossrefMedlineGoogle Scholar3. HOSFORD B. Making Your Medical Decisions: Your Rights and Harsh Choices Today. New York: Ungar Publishing Co.; 1981:151-7. Google Scholar4. Matter of Storar; Matter of Eichner. New York Reports. 2d series. 1981;52:363. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1982Volume 97, Issue 3Page: 456-457KeywordsDo not resuscitate orders Issue Published: 1 September 1982 PDF DownloadLoading ...
A step in the wrong direction
Authors: S. A. King
Journal: BMJ (2013)

As a physician who trained in both psychiatry and pain management and chaired the DSM-IV (( Diagnostic and Statistical Manual of Mental Disorders , fourth edition) and DSM-IV-TR (text revision) committees on pain disorder, I am worried about subsuming these diagnoses under the new somatic symptom disorder diagnosis in DSM-5.1

This new diagnosis, at least with regard …
Heart Murmurs in Youths of Military Age
Authors: Basil M. RuDusky
Journal: JAMA (1963)

Comparison of statistics obtained on military selectees during 1941 and 1962 reveals a 63% decrease in the incidence of rheumatic valvular heart disease and a 37% decrease in the diagnosis of congenital heart disease. The decrease in rheumatic heart disease is attributed primarily to the prophylactic and therapeutic use of antibiotic and chemotherapeutic drugs. However, an important role in the decrease in the incidence of both must be assigned to the great strides made in the science of cardiac auscultation complemented by improved diagnostic techniques and their correlation with cardiac surgery. Functional, rheumatic, and congenital murmurs were found more frequently in the female group. Only 7% of patients with rheumatic heart disease were taking any type of prophylactic antibiotic, and only 12% were aware of the existence of valvular damage.
Determination of the most appropriate velocity threshold for applying hemispheric flow convergence equations to calculate flow rate: selected according to the transorifice pressure gradient. Digital computer analysis of the Doppler color flow convergence region.
Authors: Y B Deng, T Shiota, R Shandas, J Zhang, D J Sahn
Journal: Circulation (1993)

BACKGROUND While flow convergence methods have been promising for calculating volume flows from color Doppler images, it appears that the velocity threshold used and the transorifice pressure gradient dramatically influence the accuracy of application of the simple hemispheric flow convergence equation for calculation of flow rate. The present in vitro study was performed to determine whether the value of velocity threshold at which the shape of proximal isovelocity surface best fits given shape assumptions with different orifice sizes and flow rates is predictable as a function independent of orifice size from clinically measurable peak velocity or transorifice pressure gradient information. METHODS AND RESULTS In an in vitro model built to facilitate ultrasound imaging, steady flow was driven through circular discrete orifices with diameters of 3.8, 5.5, and 10 mm. Flow rates ranged from 2.88 to 8.28 L/min with corresponding driving pressure gradients from 14 to 263 mm Hg. At each flow rate, Doppler color-encoded M-mode images through the center of the flow convergence region were obtained and transferred into the microcomputer (Macintosh IIci) in their original digital format. Then, the continuous wave Doppler traces of maximal velocity through the orifice were derived for the calculation of driving pressure gradient. Direct numerical spatial velocity measurements were obtained from the digital color encoded M-mode velocities with computer software. For each flow rate, we could calculate flow volume from any number of velocity distance combinations with a number of assumptions and use the results to assess expected flow convergence shape based on a priori knowledge of the progression from oblate hemispheroid to hemisphere to prolate hemispheroid changes observed previously. Our results showed that for a given ratio of calculated flow rate to actual flow rate (0.7 and 1), the velocity threshold that could be used for the calculation of flow rate with a hemispheric flow convergence equation correlated well with the pressure gradient for a given orifice size, and the differences in velocity threshold that could be used this way among different orifice sizes once they were adjusted for the covariate pressure gradients were not statistically significant (P = .79 for ratio = 0.7, and P = .81 for ratio = 1). CONCLUSIONS Our present study provides an orifice size-independent quantitative method that can be used to select the most suitable velocity threshold for applying a simple hemispheric flow convergence equation based on clinically predictable pressure gradients ranging from 40 to 200 mm Hg, and it offers a correction factor that can be applied to the hemispheric flow convergence equation when the pressure gradient is less than 40 mm Hg.
563 HEPATITIS B VIRUS QUASISPECIES IN THE POLYMERASE GENE IN TREATMENT-NAIVE CHRONIC HEPATITIS B PATIENTS
Authors: D.Y. Kim, S.H. Ahn, H.Y. Chang, H.Y. Shim, J. Heo, M. Cho, B.S. Moon, Y.M. Moon, Y.H. Paik, K.S. Lee, K.H. Han, C.Y. Chon
Journal: Journal of Hepatology (2008)
Differential requirements for the induction of interleukin 2 responsiveness in L3T4+ and Lyt-2+ T cell subsets.
Authors: F Erard, M Nabholz, A Dupuy-D'Angeac, H R MacDonald
Journal: The Journal of Experimental Medicine (1985)

Minimal requirements for the induction of interleukin 2 (IL-2) responsiveness in purified subsets of murine T lymphocytes have been investigated. Whereas Lyt-2+ cells could be induced to IL-2-dependent growth by lectin, phorbol ester, or calcium ionophore, none of these stimuli was by itself sufficient for L3T4+ cells. The latter cells could, however, be induced to respond to IL-2 by combinations of lectin plus phorbol ester or ionophore plus phorbol ester (but not lectin plus ionophore). Under optimal conditions, growth of L3T4+ cells (like Lyt-2+ cells) was independent of accessory cells and cell-cell contact.
Sudden Cardiac Death in Air Force Recruits
Authors: Matthew Phillips
Journal: JAMA (1986)

We reviewed the clinical and autopsy records of the 19 sudden cardiac deaths that occurred among the 1,606,167 US Air Force healthy, medically screened recruits (90% male; 17 to 28 years old) during a 42-day basic training period between 1965 and 1985. Sixteen (all male) died suddenly of underlying structural heart disease, whereas no anatomic cause of death was identified in the remaining three. Thirty-two nonsudden, noncardiac deaths occurred during the same period, and only two had structural heart disease. Strenuous physical exertion was associated with sudden death in 17 of 19 cases (0.017 deaths per 50,000 exercise-hours), and the most frequent underlying etiology was myocarditis. Sudden cardiac death, a rare event in healthy young adults, is usually associated with exertion.
Softened Water-Reply
Authors: Andrew G. Shaper
Journal: JAMA (1975)

In Reply.—  The purpose of the short review was to indicate that we now have reasonable evidence that there is an important association between the softness and hardness of drinking water and death rates from cardiovascular disease. It is not unexpected that the manufacturers of water-softening equipment should be concerned about this association. I emphasized that we are, however, very far from knowing what specific factors are involved or how they work. Whether we are dealing with the presence or absence of some factor and whether this factor is injurious or protective is not known and, indeed, there is still the possibility that the reported association may not be causally related to the problem. We certainly do not have enough evidence to conclude, as Dr Keilin does, that one of the trace elements is the real culprit, despite the interesting work with cadmium in rats.  There are several studies, including
The Role of Renal Nerves and Prostaglandins in Control of Renal Hemodynamics and Plasma Renin Activity during Hypotensive Hemorrhage in the Dog
Authors: William L. Henrich, Robert J. Anderson, Arnold S. Berns, Keith M. McDonald, Penny J. Paulsen, Tomas Berl, Robert W. Schrier
Journal: Journal of Clinical Investigation (1978)

The effects of hypotensive hemorrhage (HH) on renal hemodynamics and plasma renin activity (PRA) during prostaglandin (PG) synthesis inhibition were examined in three groups of dogs. In each group of animals arterial blood pressure was lowered by a 30% decrement. In the first group of eight control animals, HH was not associated with a significant change in glomerular filtration rate (GFR, 42-36 ml/min, NS); renal blood flow (RBF) declined significantly, from 234 to 171 ml/min, P < 0.05. In the second group of eight animals, pretreated with RO 20-5720 (RO, 2 mg/kg), a competitive inhibitor of PG synthesis, HH was associated with a significant fall in GFR (43-17 ml/min, P < 0.001) and RBF (195-89 ml/min, P < 0.001). In the third group of eight animals, pretreatment with indomethacin (IN, 10 mg/kg), a chemically dissimilar PG inhibitor, HH was also associated with a significant fall in GFR (38-8 ml/min, P < 0.001) and RBF (150-30 ml/min, P < 0.001). Renal denervation attenuated this renal ischemic effect of HH in the presence of PG inhibition. In the RO group, GFR (34 vs. 17 ml/min, P < 0.005) and RBF (145 vs. 89 ml/min, P < 0.025) were significantly greater in denervated vs. innervated kidneys during HH. Similarly, in animals treated with IN, a significantly higher GFR (28 vs. 8 ml/min, P < 0.005) and RBF (101 vs. 30 ml/min, P < 0.005) occurred in denervated as compared to innervated kidneys during HH. With HH, the increase in PRA in the control group (3.34-11.68 ng/ml per h, P < 0.005) was no different than that observed in the RO group (4.96-18.9 ng/ml per h, P < 0.001) or IN group (4.71-17.8 ng/ml per h, P < 0.001). In summary, the present results indicate that renal PG significantly attenuate the effect of HH to decrease GFR and RBF. Furthermore, renal denervation exerts a protective effect against the enhanced renal ischemic effects which occur in the presence of PG inhibition during HH. Finally, PG inhibition does not alter the effect of HH to cause an increase in PRA.
S62 Appearances of empyema on CT: analysis of the MIST 2 Cohort
Authors: J. M. Franklin, J. Purcell-Jones, E. J. Helm, R. Benamore, N. M. Rahman, F. V. Gleeson
Journal: Thorax (2011)

<h3>Introduction and Objectives</h3> Several studies have described the typical imaging features of empyema on CT, including pleural thickening, pleural enhancement, septation and loculation. However, there are further CT features of empyema which are less well described, or have only been reported in small groups of patients. The aim of this study was to establish the prevalence of the different CT imaging features of empyema in a large, well-characterised cohort of empyema patients. <h3>Methods</h3> This was a retrospective cohort study comprising a subgroup of patients from the MIST 2 trial, who underwent a pre-treatment thoracic CT at a single institution. Patients in this trial had confirmed empyema using consistent diagnostic criteria. To ensure consistent and reliable image interpretation, each CT examination was assessed for predefined imaging features by three independent Thoracic Radiologists using a proforma. These features are listed in Abstract S62 table 1. We explored the sensitivity of the presence of five "classic" features of empyema described by Kearney <i>et al</i> (2000): loculation, parietal pleural thickening and enhancement and increased extrapleural fat thickness and attenuation. <h3>Results</h3> 97 patients were included in the study. Imaging features are summarised in Abstract S62 table 1. 98.5% (95% CI 90.9% to 99.9%) of patients had at least two of five classic CT features of empyema. Additionally, we noted a significant number of patients with visceral pleural enhancement (66%), with indrawing/tenting of the visceral pleural (30%) and with subvisceral oedema (34%). Parenchymal changes were seen in the majority of patients. Associated consolidation was seen in the ipsilateral lung in 63% of patients; which was adjacent to the empyema in 87% of cases. <h3>Conclusion</h3> This study describes the prevalence of multiple CT features of empyema and highlights the frequency of associated visceral changes. Many of the typical features of empyema were highly prevalent in this population but we also noted a high frequency of several other, less well-reported features. Subvisceral oedema is a previously unreported feature of empyema. These features may have implications for both diagnosis and prognosis.
Myocardial infarction after aspirin treatment, and Kounis syndrome
Authors: N. G Kounis
Journal: Journal of the Royal Society of Medicine (2005)

Erdheim-Chester diseaseDr Lee and his colleagues (April 2005 JRSM 1 ) describe a case of renal failure in which the radiographic appearance of bone pointed to Erdheim-Chester disease, a histiocytosis.Among the organs affected in this condition they mention pericardium.We think it important to emphasize the frequency with which heart, pericardium and great vessels are affected.Recording 6 new patients with cardiovascular involvement, Haroche et al. 2 have reviewed all 178 reported cases of Erdheim-Chester disease.56% had periaortic fibrosis, 44% pericardial infiltration and/or effusions and 31% myocardial infiltration.Interestingly, 6 patients had a right atrial myxoma.Of the 58 patients with follow-up data, 31% died from cardiovascular complications.
Alagille's Syndrome
Authors: SUSAN BALICH, GERALD L. JARBOE, JEFFREY S. STEVENS
Journal: Clinical Nuclear Medicine (1996)

The authors present the case of an infant with Alagille's syndrome who had cholestatic jaundice. The findings on IDA scintigraphy differed in several significant respects from previously reported cases. The hepatobiliary scintigraphic manifestations of Alagille's syndrome are more varied than previously thought.
Clinical Crossroads: An 88-Year-Old Woman Facing the End of Life
Authors: J. R. Williams
Journal: JAMA (1997)

To the Editor.  —We agree with Dr Lynn1that we can do better in caring for the chronically and terminally ill. In fact, the hospice industry already is.  The practice of hospice care and Lynn's concept of Medi-caring are on common ground. Hospice has been effectively and comprehensively treating ill patients for 2 decades. Many of the more than 30 000 patients who are admitted to our program each year are patients who do not have cancer. Our interdisciplinary teams care annually for more than 3600 patients with end-stage heart disease, 3200 patients with Alzheimer disease and other dementias, and 1600 patients with chronic obstructive pulmonary disease and other respiratory diseases.  Hospice is the most effective, most accessible alternative for these patients. We agree that more education about endof-life care is needed for physicians and caregivers, and we also agree that we should focus health care resources on such education. We