tbuckley/cabot-search huggingface dataset:
New extension of the Fontan principle: inferior vena cava-pulmonary artery bridge operation.
Authors: S Nawa, S Teramoto
Journal: Thorax (1988)

A new modification of the Fontan operation for complex cardiac anomalies is described. The technique comprises superior vena cava-pulmonary artery anastomosis and inferior vena cava-pulmonary artery bridging via a composite conduit connected to the inferior vena cava via the right atrium, totally excluding the right heart. The procedure was applied to a patient with complex cardiac abnormalities associated with asplenia. After operation the patient had good haemodynamic function initially though he died from multiorgan failure after airway bleeding on the 24th postoperative day. The procedure is a simple alternative to the complicated atrial partition required for the conventional Fontan operation.
P289 Finding the missing millions – the impact of a locally enhanced service for COPD on current and projected rates of diagnosis
Authors: C Falzon, M Soljak, SL Elkin, ID Blake, NS Hopkinson
Journal: Thorax (2012)

<h3>Background</h3> Chronic obstructive pulmonary disease (COPD) is a common and important condition but there is a considerable gap between the modelled and diagnosed prevalence of the disease.(1) In 2008 a locally enhanced service (LES) for COPD was introduced in our Primary Care Trust (PCT) which included a small financial incentive for GP’s to perform spirometry but a larger one where COPD patients were identified and received additional quality items of care including; spirometry and pulse oximetry; smoking cessation; recording of BMI and MRC dyspnoea score; review of inhaler technique; medication review; provision of a COPD rescue pack if appropriate; issuing a self-management plan; influenza and pneumococcal vaccination. In the first year this encouraged GP’s to focus case-finding efforts on those most likely to have COPD and led to a significant step up in the diagnosed prevalence.(2) <h3>Methods</h3> To evaluate longer term effects we used annual QOF reporting-year data on prevalence of COPD at PCT level from 2005 through to March 2011 obtained from the QMAS database via the NHS Information Centre. COPD prevalence data for the 4 years from the introduction of the LES (2008) were used to compare trends in COPD diagnosis between the PCT where it had been introduced, a neighbouring PCT, the London SHA and England. True COPD prevalence was estimated using data from the Health Survey for England. Diagnosed prevalence trends were extrapolated to estimate the year this level would be reached. <h3>Results</h3> The rate of increase in COPD diagnosis with the LES remained significantly increased compared to that for London as a whole (Figure 1). Extrapolating 2008–2011 trends in prevalence, the PCT where the LES was in place would be expected to reach the modelled prevalence of COPD in 2030 whereas London as a whole would not reach the true prevalence until 2080. <h3>Conclusion</h3> Current strategies for COPD case finding are inadequate given the scale of the problem. With appropriate incentives it is possible to achieve a sustained improvement in case-finding and such policies need to be implemented systematically. Nacul L, Soljak M, Samarasundera E, Hopkinson NS, Lacerda E, Indulkar T, et al. COPD in England: a comparison of expected, model-based prevalence and observed prevalence from general practise data. J Public Health. 2011; 33(1): 108–16. Falzon C, Elkin SL, Kelly JL, Lynch F, Blake ID, Hopkinson NS. Can financial incentives for improvements in healthcare quality enhance identification of COPD in primary care? Thorax. 2011; 66(7):630.
Steroid-Induced Diabetic Ketoacidosis.
Authors: I. A. Alavi
Journal: Annals of Internal Medicine (1970)

Meeting Abstracts1 May 1970Steroid-Induced Diabetic Ketoacidosis.I. A. Alavi, M.R.C.P., V. K. G. Pillay, M.R.C.P.I. A. Alavi, M.R.C.P.Search for more papers by this author, V. K. G. Pillay, M.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-787_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough diabetes mellitus is not uncommon in patients on highdose steroid treatment, ketoacidosis is distinctly rare. Indeed only a few patients have been reported, and the ketoacidosis was so mild that none required insulin. We have studied four patients with systemic lupus erythematosus (SLE) who developed diabetic ketoacidosis after treatment with large doses of steroids. All received at least 60 mg of prednisone for 2 to 8 months. In addition, two had been maintained on small doses for 1 and 10 years. Family history of diabetes mellitus was present in two. One patient was on chlorothiazide diuretic for several months,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Ill. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 787-787KeywordsDiabetes mellitusDiureticsInsulinLupus erythematosus Issue Published: 1 May 1970 PDF downloadLoading ...
Family with hepatitis-associated antigen. Spectrum of liver pathology
Authors: W. H. Bancroft
Journal: JAMA (1971)

Hepatitis-associated antigen (HAA) was detected in the serum of a 5 1/2-month-old male infant with giant cell hepatitis. Three of four other members of the family were asymptomatic carriers of HAA with normal or nearly normal results of liver function tests and no history of liver disease. Results of liver biopsies of the carriers were compatible with resolving acute hepatitis in two and chronic hepatitis in one. In these cases, the detection of HAA was a sensitive indicator of the presence of liver disease.
AIDS-related Primary Pulmonary Lymphoma
Authors: PATRICK RAY, MARTINE ANTOINE, MURIELLE MARY-KRAUSE, MARIE-GISÈLE LEBRETTE, MARIE WISLEZ, CLAUDINE DUVIVIER, MARIE-CAROLINE MEYOHAS, PIERRE-MARIE GIRARD, CHARLES MAYAUD, JACQUES CADRANEL
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

We describe 12 cases of AIDS-related primary pulmonary lymphoma occurring between 1986 and 1996 in a large French cohort of HIV-infected patients. Diagnostic criteria were: (1) histologically proven lymphomatous pulmonary involvement; (2) absence of mediastinal and/or hilar adenopathy on chest radiography; (3) absence of extrathoracic lymphoma extension. All patients were severely immunodeficient at the time of diagnosis. All but one patient presented with B and/or nonspecific respiratory symptoms. Chest radiography showed one or more marginated nodule(s) or large mass. CT scan showed a cavitary lesion in five patients. No lymph node enlargement or specific pleural effusion was detected. Transthoracic needle biopsies were performed in 10 patients and avoided open-lung biopsy for the diagnosis of lymphoma in five patients. All but one of the primary pulmonary lymphoma were high-grade B-cell non-Hodgkin's lymphomas. Using antilatent membrane protein-1 antibodies and an Epstein-Barr-Virus-encoded RNA transcript-specific probe, latent EBV infection of tumor cells was demonstrated in every case. All but one of the patients received chemotherapy. The median survival time was 4 mo, and no patient was still alive at the cut-off date for this analysis. Progessive pulmonary lymphoma was the main cause of death, but infections were also frequent.
Bad medicine: nalmefene in alcohol misuse
Authors: D. Spence
Journal: BMJ (2014)

Both Glasgow and medical school were hard drinking gigs. I enjoy alcohol and drink it for its psychoactive effect rather than for its taste or supposed health benefits. Indeed, for many years I have also struggled with smoking. Addiction is complex, with many facets, both physical and psychological, that are common to us all. I use routine, work, and responsibility to keep my own addictive tendencies in check. Today Glasgow remains a city blighted by addiction: drink, illicit and prescription drugs, gambling, and the rest. I may be a generalist, but I am also an expert on addiction.

Nalmefene (traded as Selincro, Lundbeck) has recently been approved …
DIARRHOEA IN VIPOMA PATIENTS ASSOCIATED WITH COSECRETION OF A SECOND ACTIVE PEPTIDE (PEPTIDE HISTIDINE ISOLEUCINE) EXPLAINED BY SINGLE CODING GENE
Authors: S.R Bloom, J Delamarter, E Kawashima, N.D Christofides, G Buell, J.M Polak
Journal: The Lancet (1983)
Ezetimibe Prescribing Fails to Keep Up With Evidence
Authors: Mike Mitka
Journal: JAMA (2014)

Although physicians like to think they practice evidence-based medicine, that appears to not be the case with prescribing the cardiovascular drug ezetimibe. And some critics say that use of surrogate markers to guide practice rather than clinical outcomes such as occurrence of myocardial infarction, stroke, or death has likely played a role.

Ezetimibe is an intestinal cholesterol absorption inhibitor found to reduce low-density lipoprotein cholesterol (LDL-C) levels by about 20% when given alone. It also further reduces LDL-C levels when added to statin therapy, which blocks cholesterol synthesis in the liver by inhibiting HMG-CoA reductase.
Clearing the Fields: Solutions to the Global Land Mines Crisis
Authors: Michael K. Elmore-Meegan
Journal: JAMA (1995)

The use of land mines has evolved from a predominantly defensive battlefield tactic designed to impede the movement of enemy artillery to an offensive weapon that terrorizes entire civilian populations.<i>Clearing the Fields</i>is the first serious attempt at exploring solutions and answers to a problem that kills hundreds of civilians every week around the world. Here is a book that should be read by every political and military decision maker. <i>Clearing the Fields</i>is a rich source of up-to-date information. More than 100 million mines have been deployed in over 60 countries. In the former Yugoslavia an estimated 3 million mines have been planted without maps during the past four years, with 50 000 more hidden each week. In Cambodia one of every 253 people is an amputee. On average, antipersonnel mines can be bought for $10 to $20, with many available for less than $3. In contrast, it
Marantology, a Needed Specialty
Authors: William D. Poe
Journal: New England Journal of Medicine (1972)

Doing good these days grows more difficult. To do good and survive requires an organization that confines doing good to a narrow field and sets rigid rules by which good is done. When the institution is built, complete with boards of directors, constitutions and bylaws, and executive secretaries, then, and only then, can one go about doing good. But, unfortunately, in becoming part of the superstructure, the person who would go about doing good has become a do-gooder with labels and degrees and obscure initials that he puts after his signature.Pity the poor emergency-room physician at the average hospital. . . .
Waiting times for radiotherapy after breast cancer
Authors: R. H Jack, L. Holmberg
Journal: BMJ (2010)

Minimising delay improves outcomes, so investment and planning are needed

The effect of the time interval between radiotherapy and surgery on the recurrence of breast cancer has been investigated in several countries. Some studies have indicated a positive association,1 2 whereas others have found no link.3 4 A recent systematic review concluded that an interval of more than eight to 12 weeks between breast conserving surgery and radiotherapy increased local recurrence rates when no other treatment was given.5 However, the review summarised studies that had used different cut-off points for time to radiotherapy, which hampers a straightforward interpretation.

In the linked retrospective cohort analysis (doi:10.1136/bmj.c845), Punglia and colleagues assess whether the interval between breast conserving surgery and radiotherapy affects the risk of local recurrence in women with early stage breast cancer in the United States.6 They found a significantly increased hazard of local recurrence of breast cancer in women who waited more than six weeks for radiotherapy (hazard ratio 1.19, 95% …
New Pharmacological Approaches to Therapy of NIDDM
Authors: Rubin Bressler, David Johnson
Journal: Diabetes Care (1992)

Currently available pharmacological agents have not been completely successful in restoring euglycemia in the non-insulin-dependent diabetes mellitus (NIDDM) patient. Several new approaches to the therapy of NIDDM have been formulated in recent years and are in various stages of laboratory or pharmaceutical development. Several of these agents are discussed in this article under categories relating to their mechanisms of lowering blood glucose: 1) inhibition of the release or action of counterregulatory hormones; 2) inhibition of postprandial glucose rise; 3) sensitization of tissues to insulin's actions; and 4) inhibition of gluconeogenesis, including inhibition of the long-chain acyl-CoA-carnitine acyltransferase I, the long-chain acylcarnitine translocase, and pyruvate carboxylase.
Imaging and biological function in health and disease
Authors: Joy Hirsch
Journal: Journal of Clinical Investigation (2003)

Since the invention of the microscope, imaging has guided the mainstream of science and medicine by revealing structures not visible to the human eye. Views of single cells, organelles, molecules, and even atoms obtained by modern microscopy are now central to biological investigations. In the case of the whole body, biomedical imaging also reveals structures beneath the surface. This “occlusion problem” has been solved by techniques such as x-ray, computerized tomography (CT), positron emission tomography (PET), and MRI, which provide high-resolution views of organs and tissues within the living body. Thus, structure at the highest levels of biologically relevant detail either in the living body or in vitro is currently available for investigation of biological mechanisms and for the diagnosis and treatment of disease.

Although a picture may be worth a thousand words, current standards of clinical investigation aim beyond the view in order to understand mechanisms of action. Thus, beyond this unprecedented level of structural detail, overlays of physiological mechanisms add a necessary dimension to biomedical imaging. For example, the technical and structural challenges of imaging a moving object such as a heart must be linked to functional patterns of blood flow and turbulence in order to address more complicated problems related to treatment of heart failure. In the case of the brain, advances in imaging extend well beyond the domains of structures, regardless of size, motion, or occlusion, to the domain of function by identification of active neural tissue. This new form of functional imaging adds a novel dimension to conventional imaging by isolating the neurobiology of specific mental events. Thus, current frontiers in biomedical investigation encompass not only structures and functions of subcellular, cellular, and organ systems but also structures and neural functions that are linked to perceptions, cognition, and volitional action.

In keeping with the broad scope and fast pace of new developments in structural and functional imaging, this Perspective series aims to highlight representative new areas where developments in imaging profoundly advance and redirect our understanding and treatment of human disease. Although many potential topics would serve this objective, those included here have been selected to encompass representative advances. These topics would not conventionally fall under a single organizational scheme. The unifying goal is to illuminate frontiers in biomedical imaging that impact our understanding and treatment of human disease. Thus, complex sociomedical issues, such as the scanning of nonsymptomatic individuals to screen for indications of disease, are linked to subcellular processes that lead to gene therapy as examples of new horizons that encompass both structural and functional advances in biomedical imaging. Six emerging areas of clinical investigation and the imaging technologies that drive them are organized around this unifying theme.
Severe hypocalcemia and increased creatine kinase activity.
Authors: P Timms, A M Bold, P Rothe, E Lau
Journal: BMJ (1985)

Nephrotic syndrome 65 26 2 02 20 2-42 1-40 441*Electophoretic studies showed increased creatine kinase activity to be exclusively due to the MM (skeletal muscle) isoenzyme.Conversion: SI to traditional units-Serum calcium: 1 mmol/Il 4 mg/100 ml.Serum creatinine: 1 gmol/l z 0 011 mg/100 ml.Serum magnesium: 1 mmol/I l 2 4 mg/100 ml.Serum phosphate: 1 mmol/13-1 mg/100 ml.
Staphylococcus aureus Nasal Carriage and Infection in Patients on Continuous Ambulatory Peritoneal Dialysis
Authors: Mary Anne Luzar, Gerald A. Coles, Bernadette Faller, Alain Slingeneyer, George Dah Dah, Claude Briat, Christian Wone, Yehya Knefati, Michelle Kessler, Francesco Peluso
Journal: New England Journal of Medicine (1990)

We studied 140 consecutive patients beginning continuous ambulatory peritoneal dialysis (CAPD) at one of seven hospitals to assess the relation of the nasal carriage of Staphylococcus aureus to subsequent catheter-exit-site infection or peritonitis. Shortly before the implantation of the catheters, the patients' anterior nares were cultured for the presence of S. aureus. Antibiotics were not prescribed for the S. aureus carriers, but all the patients were monitored for signs of catheter infection (median follow-up, 10.4 months).
Re: Katja Kero, Jaana Rautava, Kari Syrjänen, Seija Grenman, Stina Syrjänen. Oral Mucosa as a Reservoir of Human Papillomavirus: Point Prevalence, Genotype Distribution, and Incident Infections Among Males in a 7-year Prospective Study. Eur Urol 2012;62:1063–70
Authors: Kathleen D'Hauwers, Gunter De Win, Wiebren Tjalma
Journal: European Urology (2013)
Medical Management to Prevent Recurrent Nephrolithiasis in Adults: A Systematic Review for an American College of Physicians Clinical Guideline
Authors: Howard A. Fink, Timothy J. Wilt, Keith E. Eidman, Pranav S. Garimella, Roderick MacDonald, Indulis R. Rutks, Michelle Brasure, Robert L. Kane, Jeannine Ouellette, Manoj Monga
Journal: Annals of Internal Medicine (2013)

This article has been corrected. The original version (PDF) is appended to this article as a supplement. Background: Optimum management to prevent recurrent kidney stones is uncertain. Purpose: To evaluate the benefits and harms of interventions to prevent recurrent kidney stones. Data Sources: MEDLINE, Cochrane, and other databases through September 2012 and reference lists of systematic reviews and randomized, controlled trials (RCTs). Study Selection: 28 English-language RCTs that studied treatments to prevent recurrent kidney stones and reported stone outcomes. Data Extraction: One reviewer extracted data, a second checked accuracy, and 2 independently rated quality and graded strength of evidence. Data Synthesis: In patients with 1 past calcium stone, low-strength evidence showed that increased fluid intake halved recurrent composite stone risk compared with no treatment (relative risk [RR], 0.45 [95% CI, 0.24 to 0.84]). Low-strength evidence showed that reducing soft-drink consumption decreased recurrent symptomatic stone risk (RR, 0.83 [CI, 0.71 to 0.98]). In patients with multiple past calcium stones, most of whom were receiving increased fluid intake, moderate-strength evidence showed that thiazides (RR, 0.52 [CI, 0.39 to 0.69]), citrates (RR, 0.25 [CI, 0.14 to 0.44]), and allopurinol (RR, 0.59 [CI, 0.42 to 0.84]) each further reduced composite stone recurrence risk compared with placebo or control, although the benefit from allopurinol seemed limited to patients with baseline hyperuricemia or hyperuricosuria. Other baseline biochemistry measures did not allow prediction of treatment efficacy. Low-strength evidence showed that neither citrate nor allopurinol combined with thiazide was superior to thiazide alone. There were few withdrawals among patients with increased fluid intake, many among those with other dietary interventions and more among those who received thiazide and citrate than among control patients. Reporting of adverse events was poor. Limitations: Most trial participants had idiopathic calcium stones. Nearly all studies reported a composite (including asymptomatic) stone recurrence outcome. Conclusion: In patients with 1 past calcium stone, increased fluid intake reduced recurrence risk. In patients with multiple past calcium stones, addition of thiazide, citrate, or allopurinol further reduced risk. Primary Funding Source: Agency for Healthcare Research and Quality.
(44) Subcorneal pustular dermatosis, psoriasis and geographic-fissured tongue
Authors: T.A.J. Dawson
Journal: British Journal of Dermatology (1984)

Journal Article (44) Subcorneal pustular dermatosis, psoriasis and geographic‐fissured tongue Get access T.A.J. Dawson T.A.J. Dawson Craigavon Area Hospital, Craigavon, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 111, Issue s26, 1 July 1984, Pages 93–94, https://doi.org/10.1111/j.1365-2133.1984.tb05314.x Published: 01 July 1984
Treatment of pulmonary aspergilloma in cystic fibrosis by percutaneous instillation of amphotericin B via indwelling catheter.
Authors: P J Ryan, D E Stableforth, J Reynolds, K M Muhdi
Journal: Thorax (1995)

Pulmonary aspergilloma is a rare complication of cystic fibrosis and is a contraindication to transplantation. The elimination of an aspergilloma in a 24 year old patient with cystic fibrosis by percutaneous instillation of amphotericin B is described, enabling her to be accepted on a lung transplantation programme.
A randomized trial of education to prevent lead burden in children at high risk for lead exposure: efficacy as measured by blood lead monitoring.
Authors: Catherine M Jordan, Becky L Yust, Leslie L Robison, Peter Hannan, Amos S Deinard
Journal: Environmental Health Perspectives (2003)

In this article we report on the effectiveness of a community-based, culture-specific, controlled trial of intensive peer education aimed at preventing lead burden in children 0-36 months of age within a neighborhood with high risk for lead exposure. Mothers (n = 594) were randomly assigned to control or intervention groups. Offspring blood lead levels were assessed every 4 months. All participants received brochures on basic lead prevention strategies. Intervention participants were offered 20 bi-weekly educational sessions by same-ethnicity peer educators over the course of 1 year, and quarterly booster sessions for 2 years afterward. The intervention group's educational curriculum included information on lead sources (e.g., paint, dust, water, soil, and risks from home repairs and remodeling), health consequences of lead burden, and strategies to reduce lead exposure, including household cleaning, hygiene, safe use of water, and nutritional recommendations. Results indicated that of the 378 children contributing sufficient blood data for analysis, 23% had blood lead levels > 10 micro g/dL before 3 years of age. Intervention participants were more likely to maintain blood lead levels < 10 micro g/dL than were controls (81% vs. 73%; p = 0.08). Multivariate analyses demonstrated that the intervention reduced the risk of blood lead levels > 10 micro g/dL by approximately 34%. We conclude that although intensive education resulted in a lower proportion of children with elevated lead levels, education alone cannot be relied upon to prevent lead burden.