tbuckley/cabot-search huggingface dataset:
Rationing failure. The ethical lessons of the retransplantation of scarce vital organs
Authors: P. A. Ubel
Journal: JAMA (1993)

Because of a shortage of transplantable livers and hearts, the transplant community has had to decide—by who gets an organ—who lives or dies. Despite this shortage, whether one has previously received a transplant is not used as a criterion to distribute organs. The existing allocation system distributes 10% to 20% of available hearts and livers to retransplant patients. This article examines three differences between primary transplantation and retransplantation that may affect the priority that retransplant candidates should receive in vying for organs: (1) the special obligations that transplant teams have not to abandon patients on whom they have already performed a transplant, (2) the fairness of allowing individuals to get multiple transplants while some die awaiting their first, and (3) the difference in efficacy between primary transplantation and retransplantation. Only this last difference holds up to critical analysis. Our moral duty to direct scarce, lifesaving resources to those likely to benefit from them, suggests that, all other things equal, primary transplant candidates should receive priority because their mortality after transplantation is lower. Consistency also demands that previous transplant history be taken into account, as we already allocate organs according to ABO blood group matching, a factor that affects transplant outcome approximately the same amount as a previous transplantation. We therefore conclude that the system should be revised so that primary transplant candidates have a better chance of receiving organs than retransplant candidates. (<i>JAMA</i>. 1993;270:2469-2474)
Eosinophil-induced chronic active hepatitis in the idiopathic hypereosinophilic syndrome
Authors: Anthony Foong, John V. Scholes, Gerald J. Gleich, G. M. Kephart, Peter R. Holt
Journal: Hepatology (1991)

A 19-yr-old man had features of chronic hepatitis with piecemeal necrosis as the sole clinical feature of the idiopathic hypereosinophilic syndrome. Liver biopsy specimens demonstrated the presence of activated eosinophils and, by immunohistochemical staining, major basic protein in areas of hepatic cell damage. The case demonstrates the clinical presentation of the idiopathic hypereosinophilic syndrome as chronic hepatitis and the association between eosinophil infiltration and degranulation with the presence of hepatocyte necrosis.
Treatment of Myxedema-Associated Cardiogenic Shock
Authors: Irwin Klein
Journal: Annals of Internal Medicine (1993)

Letters15 July 1993Treatment of Myxedema-Associated Cardiogenic ShockIrwin Klein, MDIrwin Klein, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-2-199307150-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:MacKerrow and colleagues [1] reported on the ability of triiodothyronine to treat cardiogenic shock resulting from severe hypothyroidism (myxedema); however, certain points must be clarified.First, the authors conclude that their patient had Sheehan syndrome because she was unable to lactate after her last pregnancy. In the absence of significant hemorrhage or obstetrical trauma, an equally likely diagnosis would be lymphocytic hypophysitis [2], which would account for secondary adrenal and thyroid failure.That the patient failed to improve and, in fact, worsened over the first 5 days while receiving therapy with oral l-thyroxine, 50 g/d, is not ...References1. MacKerrow SD, Osborn LA, Levy H, Eaton RP, Economou P. Myxedema-associated cardiogenic shock treated with intravenous triiodothyronine. Ann Intern Med. 1992; 117:1014-5. Google Scholar2. Portocarrero CJ, Robinson AG, Taylor AJ, Klein I. Lymphoid hypophysistis: an unusual cause of hyperprolactinemia and enlarged sella turcica. J Am Med Assoc. 1981; 246:1811-3. Google Scholar3. Klein I. Thyroid hormone and high blood pressure. In: Laragh JH, Brenner BM, Kaplan NM, eds. Endocrine Mechanisms in Hypertension. v. 2. New York: Raven Press; 1989:61-80. Google Scholar4. Ojamaa K, Balkman C, Klein I. Acute effects of T3 on arterial smooth muscle cells. Ann Thorac Surg. 1993; (In press). Google Scholar5. Klein I. Thyroid hormone and the cardiovascular system. Am J Med. 1990; 88:642-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1993Volume 119, Issue 2Page: 168-169KeywordsHypothyroidismLactatesPregnancyShockSmooth muscle cellsSystemic vascular resistanceThyroidThyroid hormonesThyroxineTriiodothyronine Issue Published: 15 July 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Dipyridamole-Thallium Cardiac Imaging
Authors: Robert N. Class
Journal: Annals of Internal Medicine (1989)

Letters and Corrections1 July 1989Dipyridamole-Thallium Cardiac ImagingRobert N. Class, MD, Robert F. Carretta, MD, Phillip Matin, MDRobert N. Class, MDSearch for more papers by this author, Robert F. Carretta, MDSearch for more papers by this author, Phillip Matin, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-1-90_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: The recent letter by Friedman and colleagues (1) provides the valuable warning that death may occur after oral administration of dipyridamole. It was unfortunate that permission for an autopsy was refused, because some questions go unanswered in the case report. As the title of the letter (1) indicates, death occurred during myocardial imaging; however, there is a notable absence of information concerning the myocardial images.As cardiovascular imaging specialists, we estimate that two or three planar images could have been recorded during the described interval of approximately 25 minutes after the onset of ischemic electrocardiographic changes, chest...References1. FriedmanGoldbergHauserO'Neill HSAW. Death with dipyridamole-thallium imaging [Letter]. Ann Intern Med. 1988; 109:990-1. LinkGoogle Scholar2. OkadaDaiBoucherPohost RYCG. Significance of increased lung thallium-201 activity on serial cardiac images after dipyridamole treatment in coronary heart disease. Am J Cardiol. 1984; 53:470-5. CrossrefMedlineGoogle Scholar3. BulkleyRouleauStraussPitt BJHB. Idiopathic hypertrophic subaortic stenosis: detection by thallium 201 myocardial perfusion imaging. N Engl J Med. 1975;293:1113-6. CrossrefMedlineGoogle Scholar4. MarkhamWinnifordFirth RMB. Symptomatic, electrocardiographic, metabolic, and hemodynamic alterations during pacing-induced myocardial ischemia. Am J Cardiol. 1983;51:1589-94. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Roseville Hospital Roseville, CA 95661-3477 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1989Volume 111, Issue 1Page: 90-91KeywordsAutopsyCardiovascular imagingElectrocardiographyElectrode recordingOral administrationThorax Issue Published: 1 July 1989 PDF downloadLoading ...
Yersinia enteritis and Crohn's disease.
Authors: R E Barry, D I Lobba
Journal: BMJ (1977)

Bacteriological cultures of human milk samples Growth of bacteria No of Per cent cases No growth .. .528 49 <10000/ml .. .408 38 10 000-20 000/ml 88 8 >20000ml ...51 5 Total .1075 100was put together and used without heating.The milk with growth less than 20 000 bacteria/ml was also pooled but used only after heating.Milk with growth of more than 20 000 bacteria/ml was discarded.We believe that the most important point in achieving "clean" milk is to give the mothers adequate instructions about how to collect and store their breast milk properly.This information can best be given at home if the milk is brought from there.The goal should be milk without bacteria.If growth of bacteria is found the reason must be discussed with the donor.When donors are informed that "clean" milk can be given to infants without harmful heating they really try and usually succeed in keeping their milk uncontaminated.According to our experience carefully collected breast milk can be kept in a refrigerator for at least three days without any growth of bacteria.So, depending on the way milk is collected and stored, pooled human milk can also be used without heating.The question to be answered, however, remains how much contaminated milk needs to be pasteurised and in what way.
Eosinophilic Esophagitis and IgE Mediated Allergy in Children: Detection of Specific IgE by a Microarray-Based assay (MBa)
Authors: G. Cavagni, P. De Angelis, L.E. D'Urbano, K. Pellegrino, F. Rea, C. Riccardi, F. Torroni, R. Luciano, F. De Benedetti, L. Dall'Oglio
Journal: Journal of Allergy and Clinical Immunology (2011)
Immune-Complex Disease in Typhoid Fever
Authors: DONATO ALARCÓN-SEGOVIA
Journal: Annals of Internal Medicine (1975)

Comments and Correction1 May 1975Immune-Complex Disease in Typhoid FeverDONATO ALARCÓN-SEGOVIA, M.D., F.A.C.P., JORGE C. ALCOCER, M.D.DONATO ALARCÓN-SEGOVIA, M.D., F.A.C.P.Search for more papers by this author, JORGE C. ALCOCER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-5-720_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: During an episode of typhoid fever, a patient developed transient proteinuria, microscopic hematuria, as well as urinary hyaline and granular casts and pericarditis. Concurrent low complement levels suggested that these unusual manifestations were due to immune-complex disease involving Salmonella antigens.A 23-year-old man became suddenly ill with diarrhea, vomiting, and fever. When admitted 7 days latter he had a temperature of 39 °C, the spleen tip was palpable, and on proctoscopic examination the mucosa was friable and hemorrhagic. Urinalysis showed proteinuria of 3.25 g/litre and the sediment contained erythrocytes as well as hyaline and granular casts. A... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DONATO ALARCÓN-SEGOVIA, M.D., F.A.C.P.; JORGE C. ALCOCER, M.D.Affiliations: Department of Immunology and Rheumatology Instituto Nacional de la Nutrición México 22, D.F., México PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySalmonella typhimurium infection leading to acute interstitial nephritisTyphoid colitis with massive lower gastrointestinal bleeingSalmonella food poisoningTyphoid and Paratyphoid Fever 1 May 1975Volume 82, Issue 5Page: 720-721KeywordsAntigensDiarrheaFeversMucous membranesProteinuriaSalmonellaSpleenTemperatureTyphoidVomiting ePublished: 1 December 2008 Issue Published: 1 May 1975 PDF downloadLoading ...
The Diagnostic Evaluation and Multidisciplinary Management of Neurofibromatosis 1 and Neurofibromatosis 2
Authors: David H. Gutmann
Journal: JAMA (1997)

Neurofibromatosis 1 and neurofibromatosis 2 are autosomal dominant genetic disorders in which affected individuals develop both benign and malignant tumors at an increased frequency. Since the original National Institutes of Health Consensus Development Conference in 1987, there has been significant progress toward a more complete understanding of the molecular bases for neurofibromatosis 1 and neurofibromatosis 2. Our objective was to determine the diagnostic criteria for neurofibromatosis 1 and neurofibromatosis 2, recommendations for the care of patients and their families at diagnosis and during routine follow-up, and the role of DNA diagnostic testing in the evaluation of these disorders.Published reports from 1966 through 1996 obtained by MEDLINE search and studies presented at national and international meetings.All studies were reviewed and analyzed by consensus from multiple authors.Peer-reviewed published data were critically evaluated by independent extraction by multiple authors.The main results of the review were qualitative and were reviewed by neurofibromatosis clinical directors worldwide through an Internet Web site.On the basis of the information presented in this review, we propose a comprehensive approach to the diagnosis and treatment of individuals with neurofibromatosis 1 and neurofibromatosis 2.
Effects of the CCR5-Δ32 mutation on antiviral treatment in chronic hepatitis C
Authors: Golo Ahlenstiel, Thomas Berg, Rainer P Woitas, Frank Grünhage, Agathe Iwan, Lothar Heß, Hans H Brackmann, Bernd Kupfer, Andrea Schernick, Tilman Sauerbruch, Ulrich Spengler
Journal: Journal of Hepatology (2003)
Obstetric ultrasonography: wider role for radiographers?
Authors: J B Witcombe, A Radford
Journal: BMJ (1986)

Most obstetric ultrasound scanning is carried out by radiographers, who have professional constraints that forbid them to disclose the result of any investigation to any patient or to hold themselves as professionally qualified to diagnose. A nationwide survey was carried out to explore the paramedical aspects of obstetric ultrasound services and determine how radiographers reconcile their professional constraints with the needs and expectations of patients. It was concluded that over 70% of obstetric scanning in the United Kingdom is carried out by radiographers who tell patients some results and report both numerical and interpretational data to referring clinicians. This survey suggests that constraints on radiographers who perform obstetric ultrasonography are excessively restrictive and conflict with everyday clinical demands. The medical supervision of some obstetric ultrasound units should be improved, and partners of patients should not be encouraged to expect access to obstetric scans unless radiographers have close medical support.
Toxic Shock Syndrome: Clinical, Laboratory, and Pathologic Findings in Nine Fatal Cases
Authors: Stephen M. Larkin, David N. Williams, Michael T. Osterholm, Robert W. Tofte, Zoltan Posalaky
Journal: Annals of Internal Medicine (1982)

Clinical, laboratory, and pathologic findings in nine of the 12 patients who died from toxic shock syndrome in Minnesota are reported. All patients met the toxic shock syndrome case definition except for desquamation, which occurred in only one patient. Eight were menstruating and at least four were wearing tampons at the time of the acute illness. One patient was using napkins only. Noncardiogenic pulmonary edema was the only clinical development that could be used to predict a fatal outcome. Specific pathologic findings included various degrees of fatty metamorphosis of the liver; pronounced hemophagocytosis by reticuloendothelial macrophages; and a characteristic vaginal lesion consisting of mucosal separation beneath the basal layer with ulceration, severe vasodilatation, inflammation and thrombosis, but with minimal bacterial invasion. This vaginal lesion was noted in two tampon users, but an identical lesion was found in a menstruating patient who used only napkins.
Francis Weir Wigzell
Authors: W K Stewart, Stuart McDowall
Journal: BMJ (2005)

A pioneer of open heart surgeryBill Cleland was one of the surgeons who developed open heart surgery in London in the late 1950s.He was at Hammersmith Hospital in 1952-3 when Professor Dennis Melrose developed the first heart-lung machine.Melrose and Cleland conducted extensive animal tests before trying the machine in 1953 on patients whose prognosis was poor.In the early days there were postoperative deaths, which taught them the importance of meticulous postoperative care, and the clinical programme was restarted successfully in 1957.Cleland was one of the machine's earliest users, and it enabled him to perform a wide range of new operations, specialising in mitral valvotomy, the surgical treatment of ventricular septal defect, and aortic valve replacement.He was the first to operate on the newly identified condition of obstructive cardiomyopathy-known in the United States as hypertrophic subaortic stenosisby excising muscle from the interventricular septum via the aortic valve.Russian surgeons were impressed by Melrose's heart-lung machine, and Professor Aleksandr Bakulev from the then Soviet Union bought one; he then invited the Hammersmith team to operate in Moscow in May 1959.It was at the height of the cold war and they were the first foreign doctors to perform surgery there.Melrose, Cleland, and another surgeon, Hugh Bentall, went.The Russians chose two adults and four children with congenital heart defects.Two of them had Fallot's tetralogy, which Cleland and his colleagues had never operated on before.All six operations were successful.Cleland remarked that this was helped by God, who had so little to do in Russia that he was able to give the children his undivided attention.The trip was a success in other ways.Cleland took his cine camera and filmed the army parade in Red Square, and was astonished not to be arrested.The team then returned on the inaugural UK flight of the Tupolev 104, the Soviet Union's first jet powered passenger airliner.Cleland was a meticulous surgeon, possessed of great energy, and a great teacher.He was warm hearted, and remained calm in emergencies.He was
Trusts cancel 10% of operating theatre sessions
Authors: L. Eaton
Journal: BMJ (2002)

Thousands more operations could be carried out in the NHS each year if operating theatres were better managed, says a report published by the Audit Commission.

Poor management information systems, failure to restructure historic patterns of allocating operating theatre time, and consultants taking annual leave at short notice have all undermined the efficient use of operating theatres, it says.

One trust in north west England could have carried out a further 3000 operations a year—the equivalent of …
Emotional Bother, Rather than Disease Severity, Determines Environmental Control Practices in Inner-City Preschool Children
Authors: J. Curtin-Brosnan, P.A. Eggleston, E.C. Matsui, N.N. Hansel, C.S. Rand, K.A. Callahan, G.B. Diette
Journal: Journal of Allergy and Clinical Immunology (2006)
Modified intention to treat reporting in randomised controlled trials: systematic review
Authors: I. Abraha, A. Montedori
Journal: BMJ (2010)

<b>Objectives</b> To determine the incidence and characteristics of randomised controlled trials that report using the modified intention to treat approach, and how the approach is described. <b>Design</b> Systematic review. <b>Data sources</b> PubMed, Embase, Cochrane central register of controlled trials, ISI Web of Knowledge, Ovid, HighWire Press, Science-Direct, Ingenta, Medscape, BioMed Central, Springer, and Wiley, from inception to December 2006. <b>Main outcome measures</b> Incidence of trials in which use of modified intention to treat was reported, and how the approach was described (classified according to the type and number of deviations from the intention to treat approach). <b>Results</b> 475 randomised controlled trials reported use of a modified intention to treat analysis. Of these, 76 (16%) were published in five highly cited general medical journals. The incidence of all trials that reported use of modified intention to treat published in journals indexed in Medline increased from 0.006% in 1982-6 to 0.5% in 2002-6 (P&lt;0.001 for linear trend). When the description of the modified intention to treat was examined in each trial, 192 (40%) reported one type of deviation from the intention to treat approach, 261 (55%) reported two or more types, and 22 (5%) did not describe any type. In 266 (56%) of the trials the deviation was related to the treatment received, in 196 (41%) to a post baseline assessment, in 118 (25%) to a baseline assessment, in 108 (23%) to a target condition, and in 23 (5%) to follow-up. Post-randomisation exclusions occurred in 380 (80%) trials. The results reported by 270 of the 352 (77%) superiority trials favoured the drug under investigation. All of the 123 trials using equivalence or non-inferiority methods to investigate interventions reported results that favoured their assumptions. <b>Conclusions</b> Randomised controlled trials that report using a modified intention to treat are increasingly being published in the medical literature. The descriptions of such an approach were ambiguous, and may cover any type of descriptions for exclusion, such as missing data and deviation from protocol. Explicit statements about post-randomisation exclusions should replace the ambiguous terminology of modified intention to treat.
Cardiac Syncope From Fluid Extravasation From Subclavian Vein Catheter
Authors: John D. Conger
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Sepsis<sup>1,2</sup>and a variety of thromboembolic complications<sup>3-5</sup>have been reported with the use of indwelling venous polyethylene catheters. The following case demonstrates an additional problem encountered during clysis and central venous pressure (CVP) monitoring through a long catheter with the tip located in the subclavian vein. <h3>Report of a Case.—</h3> A 40-year-old Vietnamese woman was admitted to the Navy Hospital Ship USS Repose with a large anterior mediastinal mass and venous distention of the head, neck, and upper extremities. Biopsy was diagnostic for reticulum cell sarcoma with invasion of the anterior chest wall. Because of her critical condition, a long central venous pressure catheter was introduced into the right subclavian vein from the antecubital fossa. Forty-eight hours later, while a rapid infusion of 500 ml of physiological saline was being administered for oliguria thought to be on a prerenal basis, the patient suddenly became diaphoretic
Agranulocytosis and Anaemia Associated with Disseminated Tuberculosis
Authors: P. E. R. Tattersall
Journal: BMJ (1957)

RESULTS OF AMNION IMPLANTATIONBRofu 1351all pulses palpable except anterior tibial.Right lumbar sympathectomy performed on June 4, 1956.August: Good result-no claudication.January, 1957: Some soreness under big toe and increasing discoloration.February 5: Arteriogram showed localized block at about the adductor opening.Amnion graft carried out.May 18: No improve- ment at all.Case 7.-A woman aged 65 was seen in February, 1957, with a history of typical intermittent claudication which had begun in November, 1956, on the left side-the claudication distance was 25 yards.She complained also of cold feet, particularly on the left side.Dyspnoea, orthopnea, and angina also limited walking.B.P. 200/150.On left side only femoral pulse palpable.On right side popliteal and dorsalis pedis pulses could also be felt.Left foot cold.April 5: Left arteriogram showed that the femoral artery was patent as far as the adductor opening, but was grossly irregular, and below this there were only poor collateral vessels.Amnion graft implanted.June
Linker of Nucleoskeleton and Cytoskeleton Complex Proteins in Cardiac Structure, Function, and Disease
Authors: Matthew J Stroud, Indroneal Banerjee, Jennifer Veevers, Ju Chen
Journal: Circulation Research (2014)

The linker of nucleoskeleton and cytoskeleton (LINC) complex, composed of proteins within the inner and the outer nuclear membranes, connects the nuclear lamina to the cytoskeleton. The importance of this complex has been highlighted by the discovery of mutations in genes encoding LINC complex proteins, which cause skeletal or cardiac myopathies. Herein, this review summarizes structure, function, and interactions of major components of the LINC complex, highlights how mutations in these proteins may lead to cardiac disease, and outlines future challenges in the field.
Influence of interferon-based therapy on liver fibrosis progression in HIV/HCV coinfected patients: A retrospective repeated liver biopsy analysis
Authors: Patrick Ingiliz, Marc-Antoine Valantin, Paul Preziosi, Laetitia Finzi, Raluka Pais, Larysa Fedchuk, Stéphanie Dominguez, Christine Katlama, Thierry Poynard, Yves Benhamou
Journal: Journal of Hepatology (2011)