tbuckley/cabot-search huggingface dataset:
Cholera and severe toxigenic diarrhoeas.
Authors: D R Nalin
Journal: Gut (1994)

Leading article -Tropical infecion ofthe gastrointestinal tract and liver series Cholera and severe toxigenic diarrhoeasThe reintroduction of cholera into South and Central America,' and its rapid spread through the region, illustrate the continued susceptibility ofmost ofthe world's population to this often lethal disease.This susceptibility is based on attributes of the pathogen, Vibrio cholerae, and its bioecology, and on the human host.Host factors include the strength (and weaknesses) of the gastric acid barrier, the faecalisation of the environment leading to contamination of drinking water and food with the pathogen, and the continued lack of education or habit formation sufficient to curtail intestinal contamination and colonisation by V cholerae.The host immune response which develops too late to protect the victim and gives variable protection to the survivor and to vaccinees.Cholera can maintain itself and increase when epidemic strains of V cholerae persist longer in the environment and multiply to higher concentrations in water, other beverages or food, notably if chitin is present.2The pathogen can pass through the stomach because ofthe absence ofnormal acidity or, when acid is present, by attachment to or within a particle.The vehicular particles may be of chitin2 zoo - or phytoplankton3 or possibly algae,3" protozoa,5 cellular debris,6 parasitic nematodes and their eggs7 or other sub- strates offering protection from acidity or other noxious environmental influences, such as heat,8 cold,9 and low salinity.8V cholerae's environmental survival and trans- mission may be linked to these vehicles.Vaccine development has consistently produced vaccines giving only a modest protection from disease (at best 50-85%) for periods typically too short (six months -one year and after this period of time, a protection of 0 to 50%) to be of practical significance in all age groups.""'3Treatment remains the main area of progess in research, with repeated findings of the success of intravenous and oral replacement of the water and electrolyte losses characterising the disease.This article will attempt at analysing how recent and future research could help to understand and to better control the cholera problem.The causative vibrio and its bioecology After the initial hypothesis'4 15 based on analogy with Japanese and American studies of V parahaemolyticus coupled with V cholerae's then unexplained chitinase production, that an estuarine or other aquatic niche for V cholerae might exist in copepods or other chitinaceous fauna, a number of confirmatory studies have been published.16 Such a niche is firmly established,3 16 and vibrio on August 21,
The asthmatic child; psychosomatic approach to problems and treatment.
Authors: Stuart M. Finch
Journal: JAMA (1963)

This book, composed of 15 chapters and written by 18 authors, covers a wide spectrum of psychological and psychiatric knowledge about the asthmatic child. For the most part, the authors have had considerable experience with these children and their families. A few of the chapter headings illustrate some of the facets covered of this syndrome: "Diagnosis of Asthma in Children," "Which Children Outgrow Asthma and Which do Not?" "The Personality of the Asthmatic Child," "Family Dynamics in Early Childhood Asthma," "The Death of an Asthmatic Child," and "Institutional Treatment of Asthmatic Children." The reader is given the opportunity to become acquainted with the various approaches which mental health workers have used to study and treat asthmatic children. Some have worked intensively with a few such youngsters, while others have studied larger numbers but less thoroughly. Some have more experience with younger children and others with adolescents. Considerable space is devoted
Stent or percutaneous transluminal coronary angioplasty for occluded coronary arteries in patients with acute myocardial infarction ineligible for thrombolysis (STOPAMI-3) trial
Authors: Julinda Mehilli, Adnan Kastrati, Josef Dirschinger, Stefan Martinoff, Markus Schwaiger, Albert Schomig
Journal: Journal of the American College of Cardiology (2003)
Atrial Reciprocal Rhythm
Authors: ALBERT D. KISTIN
Journal: Circulation (1965)

IN THE PAST reciprocal rhythm in man has been associated mostly with AV nodal rhythm; there are several reviews of the lit- erature.1-4In the described cases the AV nodal impulse activates first the ventricles, then after some delay the atria; somewhere in its course to or toward the atria the impulse presum- ably turns back to activate the ventricles again.This phenomenon was first recognized in electrocardiograms of man by White.5 Mines6 had previously observed a similar phenomenon in experimental animals, the im- pulse originating in an atrium or ventricle, traveling to the other chamber, then back to the chamber of origin, then back again to the other chamber, etc., etc. for a number of cycles.Pan7 applied this explanation to hu- man polygraphic tracings in which he believed the impulse originated in a ventricular pre- mature systole, traveled to the atria and then back to the ventricles.The phenomenon was possibly represented but not recognized in polygraphic tracings of Wenckebach.89Re- cent studies indicate that reciprocal rhythm in man may be initiated by ventricular prema- ture systoles far more frequently than has heretofore been suspected and may often ac- count for the ventricular systole which follows the commonplace interpolated ventricular pre- mature systole.10The present study is concerned with recip- rocal rhythm in the other direction; an im- pulse that originates in the SA node or an atrium turns back somewhere in its course to or toward the ventricles to activate the atria again.The study is based on the electrocardiograms of five patients that seem consistent From the Cardiopulmonary Laboratory,
Hemoglobin constant spring in bangkok: Molecular screening by selective enzymatic amplification of the α<sub>2</sub>‐globin gene
Authors: V. Thonglairoam, S. Fucharoen, V. S. Tanphaichitr, P. Pung‐amritt, S. H. Embury, P. Winichagoon, P. Wasi
Journal: American Journal of Hematology (1991)

Abstract Hemoglobin Constant Spring (Hb CS) is a hemoglobin variant with an elongated α‐globin chain secondary to a chain termination mutation. The diagnosis of HbCS by electrophoresis is difficult because it is present in very low amounts in the red cells of heterozygotes. Selective enzymatic amplification of the α 2 ‐globin gene and allele‐specific hybridization for Hb CS gene provided accurate diagnosis of Hb Constant Spring. We have used this approach to detect the α cs mutation in the cord blood that contained all four α‐globin genes but had Hb Bart on electrophoresis. The α cs mutation was found in six subjects whose Hb Bart levels were 3.0, 3.2, 3.7, 4.0, 4.9, and 9.8%. The latter also had −α mutation on the other chromosome, giving rise to the genotype α cs α/−α, which produced high Hb Bart. The gene frequency for α cs in the Thai calculated from a total of 406 cord blood studied in Bangkok was found to be ∼0.008.
Aortic Root Dissection: Unusual Echocardiographic Motion Pattern
Authors: Navin C. Nanda, Ling S. Ong, S. Serge Barold
Journal: Annals of Internal Medicine (1976)

Letters1 July 1976Aortic Root Dissection: Unusual Echocardiographic Motion PatternNAVIN C. NANDA, M.D., LING S. ONG, M.D., S. SERGE BAROLD, M.B., F.R.A.C.P., F.A.C.P.NAVIN C. NANDA, M.D., LING S. ONG, M.D., S. SERGE BAROLD, M.B., F.R.A.C.P., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-1-79 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral studies have proved the usefulness of echocardiography in the diagnosis of dissecting aneurysms involving the aortic root (1-5). The main findings include increased width of the aortic walls, parallel motion of the separated margins of the aortic walls, and aortic root enlargement with retention of normal aortic cusp motion (2). We describe here a new echocardiographic motion of the widened aortic wall in a patient with proven aortic root dissection.A 61-year-old white man was admitted to the Genesee Hospital, complaining of severe pain on the left side of the chest for several hours. The patient was known to...References1. MILLWARDROBINSONCRAIGE DNE: Dissecting aneurysm diagnosed by echocardiography in a patient with rupture of the aneurysm into the right atrium. Am J Cardiol 30:427-431, 1972 CrossrefMedlineGoogle Scholar2. NANDAGRAMIAKSHAH NRP: Diagnosis of aortic root dissection by echocardiography. Circulation 48:506-513, 1973 CrossrefMedlineGoogle Scholar3. BROWNPOPPKLOSTER CRF: Echocardiographic criteria for aortic root dissection. Am J Cardiol 36:17-20, 1975 CrossrefMedlineGoogle Scholar4. KRUEGERSTARKEFORKER SHA: Echocardiographic mimics of aortic root dissection. Chest 67:441-444, 1975 CrossrefMedlineGoogle Scholar5. MOOTHARTSPANGLERBLOUNT RRS: Echocardiography in aortic root dissection and dilatation. Am J Cardiol 36:11-16, 1975 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUsefulness of transesophageal echocardiography in assessment of aortic dissection.Spectrum of conditions initially suggesting acute aortic dissection but with negative aortogramsTwo-dimensional and doppler echocardiographic evaluation of aortic aneurysm and dissectionUnusual echographic findings in aortic dissection: Diastolic prolapse of intimal flap into left ventricleEchocardiographic diagnosis of aortic root dissection by M-mode and two-dimensional techniquesEchocardiography of the aortic root 1 July 1976Volume 85, Issue 1Page: 79-80KeywordsAneurysmsEchocardiographyThorax Issue Published: 1 July 1976 PDF downloadLoading ...
Court awards claimant $13.5m in rofecoxib lawsuit
Authors: Janice Hopkins Tanne
Journal: BMJ (2006)

A jury in New Jersey has awarded $4.5m (£2.6m; €3.7m) in compensatory damages to a 77 year old man who claimed that rofecoxib (Vioxx) had caused his heart attack. The jury decided that Merck, the maker of the cyclo-oxygenase-2 inhibitor, had deceived the US Food and Drug Administration about the safety of the drug and awarded the man an additional $9m in punitive damages.

Merck said it had given the FDA all the necessary information about rofecoxib and would appeal the ruling.

The jury decided that the heart attack …
Physician-Directed Patient Self-Management of Left Atrial Pressure in Advanced Chronic Heart Failure
Authors: Jay Ritzema, Richard Troughton, Iain Melton, Ian Crozier, Robert Doughty, Henry Krum, Anthony Walton, Philip Adamson, Saibal Kar, Prediman K. Shah, Mark Richards, Neal L. Eigler, James S. Whiting, Garrie J. Haas, J. Thomas Heywood, Christopher M. Frampton, William T. Abraham
Journal: Circulation (2010)

Previous studies suggest that management of ambulatory hemodynamics may improve outcomes in chronic heart failure. We conducted a prospective, observational, first-in-human study of a physician-directed patient self-management system targeting left atrial pressure.Forty patients with reduced or preserved left ventricular ejection fraction and a history of New York Heart Association class III or IV heart failure and acute decompensation were implanted with an investigational left atrial pressure monitor, and readings were acquired twice daily. For the first 3 months, patients and clinicians were blinded as to these readings, and treatment continued per usual clinical assessment. Thereafter, left atrial pressure and individualized therapy instructions guided by these pressures were disclosed to the patient. Event-free survival was determined over a median follow-up of 25 months (range 3 to 38 months). Survival without decompensation was 61% at 3 years, and events tended to be less frequent after the first 3 months (hazard ratio 0.16 [95% confidence interval 0.04 to 0.68], P=0.012). Mean daily left atrial pressure fell from 17.6 mm Hg (95% confidence interval 15.8 to 19.4 mm Hg) in the first 3 months to 14.8 mm Hg (95% confidence interval 13.0 to 16.6 mm Hg; P=0.003) during pressure-guided therapy. The frequency of elevated readings (>25 mm Hg) was reduced by 67% (P<0.001). There were improvements in New York Heart Association class (-0.7+/-0.8, P<0.001) and left ventricular ejection fraction (7+/-10%, P<0.001). Doses of angiotensin-converting enzyme/angiotensin-receptor blockers and beta-blockers were uptitrated by 37% (P<0.001) and 40% (P<0.001), respectively, whereas doses of loop diuretics fell by 27% (P=0.15).Physician-directed patient self-management of left atrial pressure has the potential to improve hemodynamics, symptoms, and outcomes in advanced heart failure. Clinical Trial Registration Information- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00547729.
Immunotherapy on Trial for New-Onset Type 1 Diabetes
Authors: Denise L. Faustman
Journal: New England Journal of Medicine (2008)

Type 1 diabetes mellitus is an autoimmune disease in which pathologic, autoreactive T cells of the immune system attack the insulin-secreting pancreatic islets of Langerhans. Cytotoxic T cells, which bear the CD8 protein on their membrane, kill islets, thereby leading to lifelong dependence on insulin for affected patients. Over time, poorly controlled blood glucose levels inevitably result in early illness and early death.1 Invasive blood glucose monitoring, insulin administration, and medical complications of treatment can also themselves cause illness, despite decreased glycemia.Immunosuppressive agents, one of the mainstays of approved treatments for transplantation, have been explored as therapy for patients . . .
Points: Polyunsaturated fatty acids and colchicine in multiple sclerosis
Authors: J Williams
Journal: BMJ (1979)

This would perhaps bring home to the DHSS the extent to which the consultants are financ- ing the Health Service by running their own cars.I personally as a consultant manage to run one mini.My wife wonders why I spend all this money running a car for the sake of the NHS when she never has the use of it.I feel that the time has come now for my wife to have the use of our car and to insist that the hospital provides transport when it is needed.
Effect of Intravenous Streptokinase as Compared with That of Tissue Plasminogen Activator on Left Ventricular Function after First Myocardial Infarction
Authors: Harvey D. White, John T. Rivers, Andrew H. Maslowski, John A. Ormiston, Morimasa Takayama, Hamish H. Hart, D. Norman Sharpe, Ralph M.L. Whitlock, Robin M. Norris
Journal: New England Journal of Medicine (1989)

In a double-blind trial comparing two thrombolytic agents as treatment for acute myocardial infarction, we randomized 270 consecutive patients an average (±SD) of 2.5±0.6 hours after the onset of chest pain from a first myocardial infarction — 135 to receive intravenous streptokinase (1.5 million units over 30 minutes) and 135 to receive intravenous recombinant tissue plasminogen activator (rt-PA) (100 mg over three hours). The primary end point was left ventricular function as assessed by cineangiography performed three weeks after infarction. The effects of the two agents on left ventricular function were similar. The ejection fraction was identical (58±12 percent) in both groups. The end-systolic volume was 61 ±29 ml in the streptokinase group and 66±31 ml in the rt-PA group (P not significant). Patency rates at three weeks for the infarct-related artery were also similar (75 percent in the streptokinase group and 76 percent in the rt-PA group). Reinfarction rates at 30 days were the same (5 percent) in both groups. One patient had a fatal intracerebral hemorrhage 13 hours after receiving rt-PA, and another had a fatal cerebellar hemorrhage 21 hours after receiving rt-PA for reinfarction nine days after treatment with streptokinase. An intention-to-treat analysis revealed that mortality at 30 days was 3.7 percent in the rt-PA group as compared with 7.4 percent in the streptokinase group (P>0.2). Follow-up for a mean of 9.0 months revealed no significant difference in survival; we observed 12 deaths (8.9 percent) in the streptokinase group and 8 deaths (5.9 percent) in the rt-PA group (P = 0.34). We conclude that rt-PA and streptokinase, in the doses given, have similar effects on left ventricular function after a first myocardial infarction. Because of the small number of deaths, it is not possible to determine whether their effects on mortality are similar. (N Engl J Med 1989; 320:817–21.)
Hunger strikers are not properly monitored at detention centre, doctor says
Authors: Jerome Burne
Journal: BMJ (2005)

Asylum seekers at a detention centre in the United Kingdom are not being given adequate access to emergency care, a doctor recently called in to attend to two Zimbabwean detainees on hunger strike said last week. He also said that claims by detainees being held at Harmondsworth Detention and Deportation Centre, west London, that they were tortured in Zimbabwe do not seem to have been properly investigated.

“The first man I saw had been without food for 37 days….He was emaciated, his blood pressure was 90/60 [mm Hg], his pulse 130 (sitting), and he clearly needed emergency treatment,” said Frank Arnold, who is a specialist in wound care and a volunteer worker at the Medical Foundation for the Care of Victims of Torture.

The man, known as M, was protesting about being sent back to Zimbabwe, where he claimed his life would be in danger.

Dr Arnold, invited in and speaking at the patients' request, said that the notes he was given were “inadequate.” They contained …
High-dose Nitrogen Mustard Therapy with Intermittent Aortic Occlusion
Authors: J. K. Duff, J. Dennis, R. A. Clift, P. Clifford, H. F. Oettgen
Journal: BMJ (1961)

~~~~~~~~~~~~~~~~~~~~~~~~~EIA ORA possibility in ad'vance, but it was never felt to contra- indicate treatment, as the hair regrows during maintenance therapy.Nauisea and vomiting may occur, but this depends on the dosage and susceptibility of the patient.The severity and incidence of this side-effect is, in our opinion, less than that seen using comparable doses of muistine (HN2) or thiotepa.Cyclophosphamide has been used by other workers as a prophylactic measure in conjunction with surgery.Denk et al. ( 1961) report a series of 282 cases of carcinoma of the bronchus which have been treated chemotherapeutically for two years after radical opera- tion, and claim that at 18 months the survival rate was 81 % compared with 42% without the drug.This form of treatment has not been used in this series.The long-term results are not encouraging in the present series despite continued treatment.Only two patients, both with carcinoma of the breast, responded for more than one year and only one of these remained symptom-free after 18 months.Summary A series of 76 cases of disseminated malignant diseasc have been treated with cyclophosphamide (a cyclic nitrogen mustard phosphamide ester).Twenty-three of these cases showed an objective response.Long-term results are not encouraging.Complications and side- effects are discussed.It is suggested that treatment with cyclophosphamide is worth while in patients with advanced malignant disease, although response is often short-lived.We are grateful to Mr. Victor Riddell, who was the first person to draw our attention to the potentialities of cyclo- phosphamide.We are indebted to Dr. J. L.
Transcription Factor Foxo1 Is a Negative Regulator of Natural Killer Cell Maturation and Function
Authors: Youcai Deng, Yann Kerdiles, Jianhong Chu, Shunzong Yuan, Youwei Wang, Xilin Chen, Hsiaoyin Mao, Lingling Zhang, Jianying Zhang, Tiffany Hughes, Yafei Deng, Qi Zhang, Fangjie Wang, Xianghong Zou, Chang-Gong Liu, Aharon G. Freud, Xiaohui Li, Michael A. Caligiuri, Eric Vivier, Jianhua Yu
Journal: Immunity (2015)
Checking placement of nasogastric feeding tubes in adults (interpretation of x ray images): summary of a safety report from the National Patient Safety Agency
Authors: T. Lamont, C. Beaumont, A. Fayaz, F. Healey, T. Huehns, R. Law, C. Lecko, S. Panesar, M. Surkitt-Parr, M. Stroud, B. Warner
Journal: BMJ (2011)

Nasogastric feeding tubes are commonly used for people such as stroke patients with dysphagia or those on ventilators. They are generally used in the short to medium term (up to six weeks),1 rather than for longer term feeding, which occurs via gastrostomy tubes, jejunostomies, or gastrostomy buttons.2 Although feeding by nasogastric tubes is not routinely captured in activity data, about 170 000 tubes are supplied to the NHS each year.3 Most are inserted safely, but patients can be harmed if the tube is mistakenly inserted into the lungs or later becomes displaced from the stomach. If such errors are not detected before feeding, patients can develop serious complications, such as intrapulmonary feeding and aspiration pneumonia, which can be fatal. The position of tubes should therefore always be checked before feeding is started.

The National Patient Safety Agency (NPSA) issued guidance in 2005 for safe placement and position checking of nasogastric tubes.3 The guidance highlighted the unreliability of certain tests—such as the “whoosh” test (listening for bubbling sounds after air entry) and testing for acidity with litmus paper—and instead recommended testing with pH indicator paper as the first line check. It recommended checking x ray images as the second line test, although not for routine use. Since 2005, staff in England and Wales have reported 21 deaths and 79 cases of harm resulting from feeding into the lungs through misplaced nasogastric tubes. The single greatest cause of harm resulted from misinterpretation of x ray images, which accounted for 45 serious incidents, including 12 deaths. The NPSA therefore issued a further safety alert in March 2011 focusing on safe interpretation of x ray images.4 The guidance covers adults and children (not neonates), but this short article, based on the March safety alert, summarises advice for adults only.

A …