tbuckley/cabot-search huggingface dataset:
Partial Liquid Ventilation Ventilates Better than Gas Ventilation
Authors: YUJI FUJINO, SVEN GODDON, JEAN-DANIEL CHICHE, JONATHAN HROMI, ROBERT M. KACMAREK
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Partial liquid ventilation (PLV) improves oxygenation in several models of lung injury. However, PLV has only been compared with conventional gas ventilation (GV) with low PEEP. Both PLV and GV can markedly improve oxygenation when PEEP is set above the lower corner pressure (Plc) on the inspiratory pressure-volume (P-V) curve of the total respiratory system. We questioned if the use of PEEP set above the Plc during PLV and GV would result in similar gas exchange. Lung injury was induced in 12 sheep by saline lavage before randomization to PLV (n = 6) or GV (n = 6). Animals in the PLV group were filled with perflubron (22 ml/kg) until a meniscus at the teeth was observed. Both groups were then ventilated with pressure control (Fi O2 , 1.0; rate, 20/min; I:E, 1:1) and PEEP (1 cm H2O above the Plc on the inspiratory P-V curve). Peak inspiratory pressure (PIP) was limited to 35 cm H2O. Animals were ventilated for 5 h and then killed for histologic examinations. All 12 animals survived the 5-h ventilation period. After increasing PEEP above Plc, PaO2 increased significantly (p < 0.01) in both the GV and the PLV groups, but it did not differ significantly between groups (p = 0.86) at any time during the experiment. PaCO2 and Vd/Vt in GV increased markedly throughout the experiment after increasing PEEP (p < 0.001), but there was no significant change in PaCO2 in PLV (p = 0.13). Mean arterial blood pressure, mean pulmonary artery pressure, pulmonary artery occlusion pressure, and central venous pressure, increased and SVR decreased in GV (p < 0.05). The extent and the severity of lung injury in the dependent regions was greater in the GV group (p < 0.05). Both PLV and GV improved oxygenation, but PLV resulted in better ventilation than GV while preserving lung structure when PEEP was set 1 cm H2O above the Plc and PIP limited to 35 cm H2O.
Analgesic Drugs for Rheumatism
Authors: W. S. C. Copeman
Journal: BMJ (1963)

Analgesic Drugs for Rheumatism SIR,-Your article on analgesic drugs for rheumatism (" To-day's Drugs," November 23, p. 1317) dismisses the role of steroids in the treatment of rheumatoid arthritis in surprisingly curt fashion.It says, " Long-term trials under controlled conditions show little superiority for pred- nisone' and none for cortisone2 over aspirin in conventional doses."Anyone who has enjoyed more than theoretical experience in this field surely knows that this statement merely perpetuates a statistical understatement which was long since disproved in practice.-Iam, etc., W. S. C. COPEMAN.
Teenage Parents and Their Offspring
Authors: Thomas F. McDonald
Journal: JAMA (1981)

Teenage pregnancy has a long history. But teenage pregnancy as a problem—teen partners conceiving, not marrying or marrying under duress, and going on welfare—is new to our societal agenda. Recognition, concern, and help date only from the 1960s. Unfortunately, while much has been accomplished, many myths still persist. The publication of<i>Teenage Parents and Their Offspring</i>is therefore a welcome addition to the literature. Virtually everything scientific that has been said on the subject during the past two decades is gathered in one place. This alone would make<i>Teenage Parents</i>a valuable contribution. In addition, this recent book debunks some lingering myths and corrects several misconceptions. For example, the media-assisted hysteria over "an epidemic" of teen pregnancies is quietly laid to rest. So is the misperception that pregnant teens differ in intelligence, personality, or psychopathology from nonpregnant teens. The value of this gentle iconoclasm cannot be overstated. Despite the sober
Toxic substances from coal energy: an overview.
Authors: C M Shy
Journal: Environmental Health Perspectives (1979)

Environmental concerns over increased coal consumption are fully justified by the past history of coal use. Although improved technology has provided some safeguards, increased utilization will require mining practices, emission control technologies, and waste disposal procedures that are not yet fully integrated into the routine use of the coal energy system. The Committee on Health and Evnironmental Effects of Increased Coal Utilization identified six critical environmental issues which are of concern: coal mine worker health and safety, reclamation of arid lands from surface mining, the health effects of coal combustion products, toxic trace elements in coal combustion wastes, acid fallout, and global effects of carbon dioxide in the atmosphere. This presentation addresses the first four of these issues.
NHS in England is found to be too slow to diagnose and treat rheumatoid arthritis
Authors: S. Mayor
Journal: BMJ (2009)

Many cases of rheumatoid arthritis are not being diagnosed or treated quickly enough to stop preventable damage to joints, warns a report published by the National Audit Office (NAO), which reviews NHS services in England.

The NAO examined the efficiency and effectiveness of services for people with rheumatoid arthritis, as part of its role to scrutinise public spending on behalf of parliament. The report shows that the average time from onset of symptoms to treatment is nine months, despite the consensus that treatment of rheumatoid arthritis should start within three months of the onset of symptoms for it to be most effective. The time lag has not improved in the past five years.

“These delays can increase the risk of damage to joints and increase the need for more costly treatments and surgical intervention,” warned Chris Groom, audit manager for the report.

He estimated …
TUBERCULOSIS OF THE OS COCCYGIS
Authors: VERNON C. DAVID
Journal: JAMA (1924)

The pathologic changes in tuberculosis of the spine are well known, and the clinical picture of the disease is recognized without much difficulty. In contrast, tuberculosis of the os coccygis presents a rather characteristic pathologic picture, which has been but seldom described and is generally unrecognized clinically. This has led to failure of diagnosis, years of invalidism in the patients thus affected, and futile operative procedures for the cure of the lesion. The literature of the subject is sparce. Darrah<sup>1</sup>compiled twenty cases in 1893, and in 1904-1905 Caubet<sup>2</sup>reported three cases he had observed and reviewed twenty-five cases compiled from the literature, including Darrah's. With the exception of these reports, only one reference to the subject has been found since 1905. The histories of two patients observed during the past year will be given, as they illustrate well the essential pathology and clinical picture. <h3>Case 1.</h3> —Mrs.
Medical Malpractice and the Tort System
Authors: Peter D. Jacobson
Journal: JAMA (1989)

FEW TOPICS in health care policy generate more contentious commentary than medical malpractice. To some, the recent trend of increasing liability awards and malpractice insurance premiums is a major crisis that affects the organization and practice of medicine. To others, it is a sign that the medical profession has not yet developed adequate controls to sanction deviations from standard practice. In either case, the escalation in medical professional liability awards raises important public policy issues concerning the underlying reasons for the awards and the potential effects on medical practice and service delivery. While the full dimension of the crisis is difficult to specify, rising malpractice insurance premiums and increased claim frequency and award severity have been, until recently, its primary manifestations. Various explanations for these trends have been proposed, with little agreement as to the nature or causes of the problem.<sup>1-8</sup> Although lawyers, the legal system, the medical profession,
Atrial natriuretic peptide in acute hypoxia-exposed healthy subjects and in hypoxaemic patients
Authors: F Lordick, RW Hauck, R Senekowitsch, HP Emslander
Journal: European Respiratory Journal (1995)

Plasma atrial natriuretic peptide (ANP) is an endogenous vasodilator, which might counteract pulmonary hypertension due to hypoxaemia. The aim of this study was to investigate the influence of acute and chronic hypoxia on plasma (ANP) concentrations in humans. Venous plasma ANP concentrations in six healthy subjects were measured before and after inhalation of hypoxic air (11% O2) at rest for 30 min, and following 5 min of mild hypoxic exercise (25 W). Pulmonary arterial plasma ANP levels were determined in 31 right heart catheterized patients with lung disease. In healthy subjects, mean arterial oxygen tension (Pao2) was 6.8 +/- 1.9 kPa after 30 min hypoxia at rest, and 4.7 +/- 0.9 kPa after hypoxic exercise testing. Hypoxia at rest did not induce significant changes in ANP concentrations, whereas hypoxic exercise led to significantly increased ANP levels. Among hypoxaemic patients, significantly elevated plasma ANP levels were found only in the subgroup with increased mean pulmonary artery pressure, but not in the subgroup with normal pulmonary artery pressure. In summary, severe acute hypoxia induced by hypoxic exercise, but not moderate acute hypoxia at rest, leads to increased ANP levels in healthy subjects. Chronic hypoxia alone does not lead to elevated plasma ANP levels; whereas, hypoxia combined with pulmonary hypertension causes increased plasma ANP concentrations in diseased subjects.
Association of A1C With Cardiovascular Disease and Metabolic Syndrome in Asian Indians With Normal Glucose Tolerance
Authors: James Dilley, Anbazhagan Ganesan, Raj Deepa, Mohan Deepa, Gopalakrishnan Sharada, O. Dale Williams, Viswanathan Mohan
Journal: Diabetes Care (2007)

OBJECTIVE—This study examines the association of A1C with cardiovascular disease (CVD) risk factors, coronary artery disease (CAD), and metabolic syndrome in Asian Indians with normal glucose tolerance (NGT). RESEARCH DESIGN AND METHODS—This cross-sectional study recruited subjects from phase III of the Chennai Urban Rural Epidemiology Study (CURES), an epidemiological study in a representative population of Chennai (formerly Madras) in South India, conducted between January 2003 and June 2004. Included were 1,644 subjects with NGT, i.e., fasting plasma glucose &amp;lt;100 mg/dl (5.6 mmol/l) and 2-h postload plasma glucose &amp;lt;140 mg/dl (7.8 mmol/l). A1C was measured using the Biorad Variant machine. Metabolic syndrome was defined based on modified Adult Treatment Panel III guidelines. RESULTS—The mean ± SD A1C value in the study cohort was 5.5 ± 0.4%. A1C showed a significant association with BMI (β = 0.017, P &amp;lt; 0.001), systolic (β = 0.002, P = 0.028) and diastolic (β = 0.202, P = 0.017) blood pressure, waist circumference (β = 0.007, P &amp;lt; 0.001), serum cholesterol (β = 0.002, P &amp;lt; 0.001), triglycerides (β = 0.001, P &amp;lt; 0.001), LDL cholesterol (β = 0.002, P &amp;lt; 0.001), fasting insulin (β = 0.009, P &amp;lt; 0.001), and homeostasis model assessment of insulin resistance (β = 0.047, P &amp;lt; 0.001) after adjusting for age and sex. Regression analysis showed that A1C had a strong association with metabolic syndrome that persisted after adjusting for age and sex (odds ratio [OR] 2.9 [95% CI 2.08–4.00]; P &amp;lt; 0.001). A1C also had a strong association with CAD (2.6 [1.23–5.63]; P = 0.01), but the significance was lost when adjusted for age and sex. CONCLUSIONS—There is a strong association of A1C with prevalent CVD risk factors in Asian-Indian subjects with NGT.
Clinical Sequelae from Arterial Needle Puncture, Cannulation, and Incision
Authors: JD MORTENSEN
Journal: Circulation (1967)

A study of 3,193 arterial entries of various types disclosed 66 major complications and 321 minor complications for a total complication rate of 13%. The Seldinger technique of percutaneous arterial catheterization was followed by the highest incidence of complications, the percutaneous needle puncture method was associated with an intermediate complication rate, and the cutdown arteriotomy with suture repair resulted in the lowest complication rate. Utilizing the brachial artery as the entry site resulted in a significantly higher complication rate than utilizing other sites for entering the arterial tree did. Factors significantly increasing the risk of arterial entry include the existence of aortic valvular incompetence in the patient, systemic anticoagulation at the time of the arterial entry, and the presence of arteriosclerosis or hypertension in the patient.
Prolonged Action of the Heart, Maintained by Artificial Respiration without Other Signs in a New-Born Infant
Authors: J. J. Redfern, G. Newby
Journal: BMJ (1901)

A TRUE LITTRE'S HERNIA.[D2c.14, Y90.satisfactorily for weeks together without any attention, and its temperature does not alter to an extent that is appreciable to an ordinary thermometer.The apparatus is simple, but difficult of explanation in a few words.My excuse for entering into minute detail is that I have desired to render myself clearly understood.There are probably not a few who have felt the, want of such a contrivance, and who, like myself, have been informed by instrument makers that an electrical regulator was an im- possibility.Before closing, I desire to acknowledge my indebtedness to Mr. Weatherby, engineer, for constructing the apparatus and for valuable practical suggestions, and to Mr. A. 0. Cossor, Farringdon Road, for making the thermostat
Myocardial neutrophil accumulation after coronary intimal injury, with and without ischemia, effect of aspirin
Authors: J.A. Barrabés, D. Garcia-Dorado, J. Figueras, M.A. González, A. Garcia, B. Soriano, Y. Puigfel, J. Escudero, J. Soler-Soler
Journal: Journal of the American College of Cardiology (1998)
Cardiac arrest and ventricular arrhythmia in patients taking antipsychotic drugs: cohort study using administrative data
Authors: S. Hennessy
Journal: BMJ (2002)

To examine the rates of cardiac arrest and ventricular arrhythmia in patients with treated schizophrenia and in non-schizophrenic controls.Cohort study of outpatients using administrative data.3 US Medicaid programmes.Patients with schizophrenia treated with clozapine, haloperidol, risperidone, or thioridazine; a control group of patients with glaucoma; and a control group of patients with psoriasis.Diagnosis of cardiac arrest or ventricular arrhythmia.Patients with treated schizophrenia had higher rates of cardiac arrest and ventricular arrhythmia than controls, with rate ratios ranging from 1.7 to 3.2. Overall, thioridazine was not associated with an increased risk compared with haloperidol (rate ratio 0.9, 95% confidence interval 0.7 to 1.2). However, thioridazine showed an increased risk of events at doses > or =600 mg (2.6, 1.0 to 6.6; P=0.049) and a linear dose-response relation (P=0.038).The increased risk of cardiac arrest and ventricular arrhythmia in patients with treated schizophrenia could be due to the disease or its treatment. Overall, the risk with thioridazine was no worse than that with haloperidol. Thioridazine may, however, have a higher risk at high doses, although this finding could be due to chance. To reduce cardiac risk, thioridazine should be prescribed at the lowest dose needed to obtain an optimal therapeutic effect.
Women Peace Laureates urge protection for women in armed conflict
Authors: P. Moszynski
Journal: BMJ (2011)

Rape as a weapon of war is a crime occurring “on a massive scale” and is a threat to peace and security, says a report.

The report, from Nobel Women’s Initiative, says that although the perpetrators of these war crimes often benefit from a “culture of impunity” victims and survivors “suffer long term health consequences,” such as psychological trauma—including isolation, fear, hot flushes, feelings of unworthiness, and suicide—and medical trauma such as gynaecological fistula, sexually transmitted infections, and HIV/AIDS.

The Nobel Women’s Initiative was established in 2006 by Nobel Peace Laureates Jody Williams, Shirin Ebadi, Wangari Maathai, Rigoberta Menchu Tum, Betty Williams, …
Type 1 T Helper Cells Induce the Accumulation of Myeloid-Derived Suppressor Cells in the Inflamed Tgfb1 Knockout Mouse Liver
Authors: James G. Cripps, Jing Wang, Ann Maria, Ian Blumenthal, James D. Gorham
Journal: Hepatology (2010)

Immune-mediated liver injury in hepatitis is due to activated T cells producing interferon-γ (IFN-γ). It is important to identify negative feedback immune mechanisms that can regulate T cell activity. In this study, we demonstrate that liver inflammation mediated by type 1 T helper (Th1) cells can induce the accumulation of myeloid-derived suppressor cells (MDSCs), pleiomorphic cells capable of modulating T cell–mediated immunity, that heretofore have been studied almost exclusively in the context of tumor-associated inflammation. Mice deficient in the gene encoding transforming growth factor-β1 ( Tgfb1 −/− mice) acutely develop liver necroinflammation caused by IFN-γ–producing clusters of differentiation 4–positive (CD4+) T cells. Liver Th1 cell accumulation was accompanied by myeloid cells expressing CD11b and Gr1, phenotypic hallmarks of MDSCs. Isolated Tgfb1 −/− liver CD11b+Gr1+ cells were functional MDSCs, readily suppressing T cell proliferation in vitro . Pharmacologic inhibitors of inducible nitric oxide (NO) synthase completely eliminated suppressor function. Suppressor function and the production of NO were dependent on cell–cell contact between MDSCs and T cells, and upon IFN-γ, and were specifically associated with the “monocytic” CD11b+Ly6G− Ly6Chi subset of liver Tgfb1 −/− CD11b+ cells. The rapid accumulation of CD11b+Gr1+ cells in Tgfb1 −/− liver was abrogated when mice were either depleted of CD4+ T cells or rendered unable to produce IFN-γ, showing that Th1 activity induces MDSC accumulation. Conclusion: Th1 liver inflammation mobilizes an MDSC response that, through the production of NO, can inhibit T cell proliferation. We propose that MDSCs serve an important negative feedback function in liver immune homeostasis, and that insufficient or inappropriate activity of this cell population may contribute to inflammatory liver pathology. (Hepatology 2010;)
Nedocromil sodium: a new drug for the management of bronchial asthma.
Authors: S Lal, S Malhotra, D Gribben, D Hodder
Journal: Thorax (1984)

Nedocromil sodium (FPL 59002) is a pyranoquinoline dicarboxylic acid that has been developed for the management of bronchial asthma. We report the results of a double blind group comparative trial in which the disodium salt of nedocromil delivered by pressurised aerosol and a placebo were compared in the management of patients with a diagnosis of bronchial asthma who entered the double blind period on a minimum dose of beclomethasone dipropionate. In almost all the assessments of clinical activity nedocromil sodium was shown to be more effective than placebo. These include improvements in diary card symptom scores, reduction in concomitant use of a bronchodilator aerosol, and patients' and investigators' assessments of efficacy. Unwanted effects were few and mild. No patients were withdrawn from the trial.
Organ donation from intensive care units in England and Wales: two year confidential audit of deaths in intensive care.
Authors: S. M. Gore, D. J. Cable, A. J. Holland
Journal: BMJ (1992)

OBJECTIVES--Quantify possible increases in cadaveric organ donation from intensive care units; identify major sources of regional variation. DESIGN--Confidential audit of all deaths in intensive care units in England in 1989 and 1990 and in Wales in 1990. SETTING--15 regional and special health authorities in England; Wales. PATIENTS--24,023 audited deaths in England; 682 in Wales. MAIN OUTCOME MEASURES--Solid organ and corneal donor rates per 100 deaths; solid organ donor rate per 100 confirmed brain stem deaths; regional variation in (a) whether brain stem death was possible diagnosis, (b) general medical contraindications to donation, (c) relatives9 refusal. RESULTS--Confirmed brain stem death accounted for 2389 (10%) audited deaths in England. In 438 (18%) there was a general medical contraindication to organ donation, and of 1829 (94%) families asked about donation, 557 (30%) refused. Data for England suggested that among potential donors the heart is suitable for transplantation in 65% of cases, the kidneys in 95%, the liver in 71%, the lungs in 31%, and the corneas in 92%. Reasons for any shortfall in achievement of transplantation varied with organ type. Solid organ and corneal donor rates per 100 deaths were 5.0 and 3.9 respectively in England and 4.3 and 2.1 respectively in Wales. The solid organ donor rate per 100 confirmed brain stem deaths was 50 in England and 41 in Wales. CONCLUSIONS--A 20% increase in number of cadaveric kidney donors from intensive care could be achieved by prompt testing for brain stem death and a quarter reduction in relatives9 refusals.
Inhibition of astrocyte proliferation and binding to brain tissue of anticardiolipin antibodies purified from lupus serum.
Authors: K H Sun, W T Liu, C Y Tsai, T S Liao, W M Lin, C L Yu
Journal: Annals of the Rheumatic Diseases (1992)

Polyclonal anticardiolipin antibodies purified from pooled serum samples of patients with systemic lupus erythematosus were shown to have inhibitory effects on cultured normal rat brain astrocytes (RBA-1 cells). Anticardiolipin antibodies at concentrations from 50 to 200 micrograms/ml inhibited the [3H]thymidine incorporation of RBA-1 cells in a dose dependent manner after three days of culture. A kinetic study showed that anticardiolipin antibodies (100 micrograms/ml) maximally inhibit the proliferation of RBA-1 cells (20.6 (5.1)% of the control value) after incubation for one day. In contrast, human gamma globulin (100 micrograms/ml) had no effect on these cells. In the presence of anticardiolipin antibodies (100 micrograms/ml), the RBA-1 cells attached to the bottom of wells became spherical and the expression of glial fibrillary acidic protein in the cytoplasm was slightly reduced. Using 3,39-dihexyloxacarbocyanine iodide as an indicator, anticardiolipin antibodies depolarised the membrane potential of RBA-1 cells after one day of culture. In addition, the percentage binding of RBA-1 cells with anticardiolipin antibodies was greater than with gamma globulin as determined by flow cytometric analysis. Immunofluorescence staining of brain tissue from BALB/c mice with anticardiolipin antibodies was noted in the corpus callosum, the cellular zone near the corpus callosum, and cells scattered in brain tissue. These results suggest that anticardiolipin antibodies have an inhibitory effect on brain cells and elicit thrombus formation in brain vessels, which plays a part in neuropsychiatric lupus.
Essays on the first hundred years of anaesthesia
Authors: John B. Stetson
Journal: JAMA (1963)

Unfortunately Stanley Sykes is dead. Before he died he compiled enough essays on the first hundred years of anesthesia to fill five volumes. This reviewer sincerely hopes the last three volumes will be published. Like volume I, this book is a part of a compendium of the early development of the art and science of administering anesthetics. Also like volume I, it is written with wit and wisdom, erudition, and irreverence for the injudicious. There are 17 chapters, and the first one alone ("Thirty-seven Little Things Which Have All Caused Death") is worth the cost of the complete volume. The entire book should be read by all anesthesiologists for information as well as entertainment. Medical historians will find it a gold mine of references arranged by chapter subject. The general physician or surgeon will find it instructive and pleasant reading. Internists will especially enjoy the chapter, "Anaesthesia and the Cardiologists"