tbuckley/cabot-search huggingface dataset:
PMO-010 Improving the adverse event reporting process for bowel screening Wales
Authors: C Lewis
Journal: Gut (2012)

<h3>Introduction</h3> Risk management is an essential part of the clinical governance framework and central to this is adverse event reporting. The aim of this study is to increase the number of adverse events reported to Bowel Screening Wales (BSW). <h3>Methods</h3> The primary research method included a literature review. The focus for the study was adverse event reporting and recording methods. Referral patterns were recorded prior and post intervention and the data compared. The literature review informed the various processes adopted in an attempt to increase referrals for adverse events from the Local Assessment Centres (LACs). The interventions took place in all LACs throughout February 2011. They included defining and providing examples of adverse events, educating the Specialist Screening Practitioners (SSPs) and providing a more flexible approach for reporting. A file using Microsoft Office Excel was developed to categorise referrals by subject and consequence. Referrals from the beginning of the programme were collated, categorised, given a consequence score and recorded in this file. This allowed for a baseline to compare against future referrals. <h3>Results</h3> The number of adverse events reported from the launch of BSW on 27 October 2008 until 30 January 2011 was 54. This compared to 100 adverse events reported during the time period 1 February 2011 to 27 November 2011. Referrals have increased fivefold since the intervention took place. Standardising the categories and consequences allowed for monitoring and comparison on the types of events reported to BSW per LAC. This helped to focus appropriate intervention including further education for reporting where it was needed. The type and severity of adverse events reported post intervention increased for the more minor and more serious adverse events. The less serious categories 1 and 2 saw almost a sevenfold increase in the rate of reporting while the more serious categories 3, 4 and 5 experienced an increase of 1.5. There was concern that serious incidents went under-reported prior to the intervention. However, this evidence is re-assuring in that the rate of reporting is far higher for the more minor events post intervention than for the more serious events. The information for the more serious events was cross-checked retrospectively with the SSPs around Wales who confirmed these findings. <h3>Conclusion</h3> The primary aim of the study was achieved and the annual rate of adverse events reporting to BSW has increased fivefold. Ongoing education is required to ensure adverse event reporting does not get forgotten and certainly until the process has become embedded in practice. The process and framework has enabled BSW to collate information providing a consistent approach for regular review and monitoring of adverse events by the BSW programme. <h3>Competing interests</h3> None declared.
Chronic Kidney Disease
Authors: Ernesto L. Schiffrin, Mark L. Lipman, Johannes F.E. Mann
Journal: Circulation (2007)

Accelerated cardiovascular disease is a frequent complication of renal disease. Chronic kidney disease promotes hypertension and dyslipidemia, which in turn can contribute to the progression of renal failure. Furthermore, diabetic nephropathy is the leading cause of renal failure in developed countries. Together, hypertension, dyslipidemia, and diabetes are major risk factors for the development of endothelial dysfunction and progression of atherosclerosis. Inflammatory mediators are often elevated and the renin-angiotensin system is frequently activated in chronic kidney disease, which likely contributes through enhanced production of reactive oxygen species to the accelerated atherosclerosis observed in chronic kidney disease. Promoters of calcification are increased and inhibitors of calcification are reduced, which favors metastatic vascular calcification, an important participant in vascular injury associated with end-stage renal disease. Accelerated atherosclerosis will then lead to increased prevalence of coronary artery disease, heart failure, stroke, and peripheral arterial disease. Consequently, subjects with chronic renal failure are exposed to increased morbidity and mortality as a result of cardiovascular events. Prevention and treatment of cardiovascular disease are major considerations in the management of individuals with chronic kidney disease.
Major abdominal operations on patients aged 80 and over: an audit.
Authors: A V Pollock, M Evans
Journal: BMJ (1987)

Major abdominal operations on patients aged 80 and over: an audit Concern that the rates of death and complications after major abdominal operations in this hospital in a popular retirement area were inflated by the number ofpatients aged over 80 led us to conduct an audit ofpatients having such operations.Deaths and complications in patients undergoing operation according to age 95% Confidence No (%) of 2 Linn BS, LinnMW, Wallen N. Evaluationofresultsofsurgical procedures in the elderly.
Sputum neurokinin A in Egyptian asthmatic children and adolescents: relation to exacerbation severity
Authors: G. A. Mostafa, S. M. Reda, M. M. Abd El‐Aziz, S. A. Ahmed
Journal: Allergy (2008)

Background: Neurogenic inflammation may participate in the development and progression of bronchial asthma. The molecular mechanisms underlying neurogenic inflammation are orchestrated by a large number of neuropeptides including tachykinins such as neurokinin A (NKA) and substance P. Tachykinins are secreted from sensory airway nerves and inflammatory cells after allergens exposure. In clinical practice, assessment of airway inflammation is difficult. Therefore, detection of biological markers of airway inflammation in sputum might offer help for proper monitoring of asthma severity. Aim of the study: We aimed to measure sputum NKA in relation to acute asthma exacerbations of varying severity. Methods: Sputum NKA was measured by enzyme‐linked immunosorbent assay in 24 children and adolescents during and after acute asthma exacerbation and 24 healthy matched controls. Results: Sputum NKA was significantly higher in asthmatic patients during acute exacerbation than controls [217.5 (284) vs 10 (7) ng/ml, P &lt; 0.001]. When patients with acute asthma exacerbation were followed‐up till remission, sputum NKA levels decreased significantly, but they remained significantly higher than controls. Sputum NKA levels were significantly higher in severe than moderate and in moderate than mild exacerbations, and was negatively correlated to peak expiratory flow rate ( r = −0.9, P &lt; 0.001). Sputum NKA had significant positive correlations to eosinophil counts in blood and sputum ( r = 0.6, P &lt; 0.001 and r = 0.7, P &lt; 0.001 respectively). Conclusions: Sputum NKA is up‐regulated during acute asthma exacerbation and it positively correlates to its severity. Thus, NKA may aid in objective classification of the exacerbation severity. In addition, NKA may be a target for new asthma therapy.
GW25-e4371 Clinical Trial of Autologous Bone Mesenchymal cell Transplantation for Severe heart failure due to Dilated Cardiomyopathy
Authors: Meng Zili, Zhen-Ya Sheng, Hui Li, Yun-Sheng Yu, Xiao-Mei Teng, Zili Meng
Journal: Journal of the American College of Cardiology (2014)
CHANGES IN FIBROUS CAP THICKNESS IN DIABETIC PATIENTS: A SERIAL OPTICAL COHERENCE TOMOGRAPHY STUDY
Authors: Ryotaro Yamada, Hiroyuki Okura, Yoshinori Miyamoto, Takahiro Kawamoto, Yoji Neishi, Akihiro Hayashida, Tetsuo Tsuchiya, Shintaro Nezuo, Kiyoshi Yoshida
Journal: Journal of the American College of Cardiology (2011)
ASSOCIATION OF HIGH SERUM GLUCOSE LEVELS WITH LOW HDL CHOLESTEROL LEVELS IN NON-DIABETIC HYPERTENSIVE PATIENTS: IMPLICATIONS FOR THE DEVELOPMENT OF NEW DIABETES
Authors: Peter M. Okin, Kristian Wachtell, Sverre Kjeldsen, Lars Lindholm, Bjorn Dahlof, Richard Devereux
Journal: Journal of the American College of Cardiology (2012)
Recurrent Dislocation of Ankle
Authors: C. M. Finny
Journal: BMJ (1945)

ABSTRACT. Although obesity is associated with increased risks of morbidity and death in the general population, a number of studies of patients undergoing hemodialysis have demonstrated that increasing body mass index (BMI) is correlated with decreased mortality risk. Whether this association holds true among patients treated with peritoneal dialysis (PD) has been less well studied. The aim of this investigation was to examine the association between BMI and outcomes among new PD patients in a large cohort, with long-term follow-up monitoring. Using data from the Australia and New Zealand Dialysis and Transplant Registry, an analysis of all new adult patients (<i>n</i> = 9679) who underwent an episode of PD treatment in Australia or New Zealand between April 1, 1991, and March 31, 2002, was performed. Patients were classified as obese (BMI of ≥30 kg/m<sup>2</sup>), overweight (BMI of 25.0 to 29.9 kg/m<sup>2</sup>), normal weight (BMI of 20 to 24.9 kg/m<sup>2</sup>), or underweight (BMI of &lt;20 kg/m<sup>2</sup>). In multivariate analyses, obesity was independently associated with death during PD treatment (hazard ratio, 1.36; 95% confidence interval, 1.14 to 1.54; <i>P</i> &lt; 0.05) and technique failure (hazard ratio, 1.17; 95% confidence interval, 1.07 to 1.26; <i>P</i> &lt; 0.01), except among patients of New Zealand Maori/Pacific Islander origin, for whom there was no significant relationship between BMI and death during PD treatment. A supplementary fractional polynomial analysis modeled BMI as a continuous predictor and indicated a J-shaped relationship between BMI and patient mortality rates and a steady increase in death-censored technique failure rates up to a BMI of 40 kg/m<sup>2</sup>; the mortality risk was lowest for BMI values of approximately 20 kg/m<sup>2</sup>. In conclusion, obesity at the commencement of renal replacement therapy is a significant risk factor for death and technique failure. Such patients should be closely monitored during PD and should be considered for early transfer to an alternative renal replacement therapy if difficulties are experienced. E-mail: stephenm@ anzdata.org.au
Thrombolytic Therapy vs Primary Percutaneous Coronary Intervention for Myocardial Infarction in Patients Presenting to Hospitals Without On-site Cardiac Surgery&lt;SUBTITLE&gt;A Randomized Controlled Trial&lt;/SUBTITLE&gt;
Authors: Thomas Aversano
Journal: JAMA (2002)

IN SEVERAL PROSPECTIVE RANDOMized trials [1][2][3] and in a meta-analysis of such trials, 4 primary percutaneous coronary intervention (PCI) was superior to thrombolytic therapy for treatment of patients with acute myocardial infarction (MI) associated with ST-segment elevation on presenting electrocardiogram (ECG).Trial outcomes differ primarily regarding whether the superiority of primary PCI was restricted to short-term (30-day) outcomes 3 or persisted 6 months after index MI. 5,6ost institutions participating in comparative trials have been hospitals with on-site cardiac surgery and active elective PCI programs.Yet, approximately two thirds of patients with acute MI present to hospitals without such capability. 7Although some of these hospitals have the equipment and personnel capable of performing primary PCI, the requirement that cardiac surgery be available in the same hospital usually prohibits its performance, if not by state regulation, then by community standard.The fact that access to primary PCI is restricted despite its superior out-
Transcatheter occlusion of patent ductus arteriosus with Gianturco coils.
Authors: T R Lloyd, R Fedderly, A M Mendelsohn, S K Sandhu, R H Beekman
Journal: Circulation (1993)

BACKGROUND Transcatheter occlusion with Gianturco coils has been attempted in a small number of patients with tiny (&lt; or = 1.5-mm diameter) patent ductus arteriosus, and preliminary results have been encouraging. The present study extends this method to larger ductus sizes and makes recommendations for proper coil size selection. METHODS AND RESULTS Coil occlusion was attempted in 24 consecutive patients with patent ductus arteriosus who did not require other cardiac surgery. Median patient age was 4.2 years (8 months to 30 years), and mean ductus diameter was 1.7 +/- 0.8 mm. Two instances of coil embolization occurred in the first 4 patients, with successful coil retrieval. Based on this experience, we proposed that the coil helical diameter should be twice or more the minimum ductus diameter, with coil length sufficient for three or more loops. With these recommendations, coils were successfully implanted in the subsequent 20 consecutive patients. Of the 22 patients with successful coil implantation, 15 (68%) had no residual shunting, and 7 had trace residual shunting by angiography. The continuous murmur was abolished in all 22 patients. No significant complications occurred, and all patients were discharged within 24 hours of successful coil implantation. No change in the systolic pressure gradient between main and left pulmonary artery or ascending and descending aorta was observed. CONCLUSIONS Transcatheter occlusion of patent ductus arteriosus can be safely and effectively achieved in patients with ductus diameters up to 3.3 mm. Coil occlusion does not cause obstruction to flow in the left pulmonary artery or descending aorta. Coils should be selected to provide a helical diameter twice or more the minimum ductus diameter and a length sufficient for three or more loops.
FEASIBILITY OF SIMULTANEOUS Au-195m FIRST PASS VENTRICULOGRAPHY (FPV) AND T1???201 SPECT STRESS IMAGINE
Authors: Samuel L. Kipper, William L. Ashburn, Sharon L. Norris, Roderic I. Pettigrew
Journal: Clinical Nuclear Medicine (1984)

Graded sequential exercise (EX) Au-195m FPV and T1–201 SPECT imaging were performed simultaneously with a single ECG-monitored bicycle stress test. FPV was conducted at rest in the 30° RAO and 45° LAO positions and during submaxial and maximal(MAX) EX in the 30° RAO position using 15–25 mCi of Au-195m (T1/2 = 30 seconds) per injection. Just prior to the MAX FPV, T1–201 was injected; SPECT was performed 7–10 minutes later and again at 4 hours using a 180° rotation about the left hemithorax beginning in the 50° RAO position. Left ventricular ejection fraction (LVEF), regional wall motion (WM) and T1–201 SPECT images were analyzed in 24 patients (PTS) including 14 normals (NL) and 10 with coronary artery disease (CAD). Normal LVEF response was defined as an increase of at least 5 EF units above a resting LVEF of 50. WM was evaluated qualitatively from functional images and cinematic displays. All 14 NL PTS had a normal LVEF response, WM and T1–201 SPECT; while 3/3 of these parameters were abnormal in 4 CAD PTS, 2/3 in 2 and 1/3 in 4 for a combined accuracy of 100%. These preliminary results suggest that in the future, it will be feasible for myocardial perfusion and function to be asssessed from a single, non-invasive, ECG-monitored stress test by combining T1–201 SPECT and Au-195m radionuclide ventriculography. Based on this early experience, we anticipate that such a diagnostic package should prove attractive both in terms of providing added diagnostic information from a single test and by virtue of cost savings and convenience.
Thermoradiotherapy Using Interstitial Self-Regulating Thermoseeds: An Intermediate Analysis of a Phase II Trial
Authors: Serdar Deger, Kasra Taymoorian, Dirk Boehmer, Tanja Schink, Jan Roigas, Andreas H. Wille, Volker Budach, Klaus-Dieter Wernecke, Stefan A. Loening
Journal: European Urology (2003)
The Innocuousness of the Specialist.
Authors: P. Maxwell Foshay
Journal: JAMA (1899)

Cleveland, Ohio, Dec. 19, 1899. <h3>To the Editor:</h3> While it is perhaps natural that in general medical societies there has grown up a tradition that the chief offices shall be held by a general practitioner or a general surgeon, there is room for doubt as to the expediency of adhering too rigidly to such a rule. Certainly it may be permitted a general practician to advocate that occasionally an office of some consequence should be bestowed on a specialist. This would tend to broaden the professional horizon and to unify the different existing branches of medicine. It must not be overlooked that the specialists, because of their specialism, are none the less members of the great profession of medicine. It is proper that they should not be permitted to monopolize the offices, for the reason that they appeal for support to the profession itself; but entirely shutting them out from
Normoalbuminuric Renal-Insufficient Diabetic Patients
Authors: Vincent Rigalleau, Catherine Lasseur, Christelle Raffaitin, Marie-Christine Beauvieux, Nicole Barthe, Philippe Chauveau, Christian Combe, Henri Gin
Journal: Diabetes Care (2007)

About 20% of diabetic patients with chronic kidney disease (CKD) detected from the new American Diabetes Association recommendations (albumin excretion rate >30 mg/24 h or estimated glomerular filtration rate [GFR] <60 ml/min per 1.73 m2) may be normoalbuminuric. Do the characteristics and outcome differ for subjects with and without albuminuria?A total of 89 patients with diabetes and a modification of diet in renal disease (MDRD) estimated GFR (e-GFR) <60 ml/min per 1.73 m2 underwent a 51Cr-EDTA B-isotopic GFR determination and were followed up for 38 +/- 11 months.The mean MDRD e-GFR (41.3 +/- 13.1 ml/min per 1.73 m2) did not significantly differ from the i-GFR (45.6 +/- 29.7). Of the subjects, 15 (17%) were normoalbuminuric. Their i-GFR did not differ from the albuminuric rate and from their MDRD e-GFR, although their serum creatinine was lower (122 +/- 27 vs. 160 +/- 71 micromol/l, P < 0.05): 71% would not have been detected by measuring serum creatinine (sCr) alone. They were less affected by diabetic retinopathy, and their HDL cholesterol and hemoglobin were higher (P < 0.05 vs. albuminuric). None of the CKD normoalbuminuric subjects started dialysis (microalbuminuric: 2/36, macroalbuminuric: 10/38) or died (microalbuminuric: 3/36, macroalbuminuric: 7/38) during the follow-up period (log-rank test: P < 0.005 for death or dialysis), and their albumin excretion rate and sCr values were stable after 38 months, whereas the AER increased in the microalbuminuric patients (P < 0.05), and the sCr increased in the macroalbuminuric patients (P < 0.01).Although their sCr is usually normal, most of the normoalbuminuric diabetic subjects with CKD according to an MDRD e-GFR below 60 ml/min per 1.73 m2 do really have a GFR below 60 ml/min per 1.73 m2. However, as expected, because of normoalbuminuria and other favorable characteristics, their risk for CKD progression or death is lower.
Captopril-associated lymphadenopathy.
Authors: H Aberg, C Morlin, G Frithz
Journal: BMJ (1981)

Contact dermatitis related to constituent of an orthopaedic wool Tests were carried out to determine the cause of an acute vesicular eczema that occurred in six patients with plaster-of-Paris casts lined with orthopaedic wool.The reaction was concluded to have been due to one of the constituents of the wool. Patients, methods, and resultsSix patients, aged between 7 and 40, presented with an acute vesicular eczema coinciding with the application of a Gypsona plaster-of-Paris cast lined with Softexe orthopaedic wool.The time from application of the cast to presentation varied from four days to three weeks.To determine whether Results oJ patch tests at 48 and 96 hours Results of patch tests to: Case Sex Age Clestol Benzalkonium No (years) Softexe Gypsona chloride Cetrimide wool 100,, 10" 1", 01
Impact of misclassification of in vitro fertilisation in studies of folic acid and twinning: modelling using population based Swedish vital records
Authors: R J Berry, R Kihlberg, O Devine
Journal: BMJ (2005)

<h3>Abstract</h3> <b>Objective</b> To determine whether failure to adequately adjust for a reported 40% misclassification of use of in vitro fertilisation (IVF) as reported in a Swedish study could have led to a false finding that folic acid increases dizygotic twinning. <b>Design</b> Modelling with population based data. <b>Setting</b> Swedish vital records for 1995-9. <b>Main outcome measures</b> Rates of twinning calculated according to whether women used IVF to become pregnant. Estimated unadjusted and adjusted odds ratios of the association between use of folic acid and twinning by use of IVF. <b>Results</b> In 1995-9, Swedish women who used IVF had an almost 20 times the chance of having twins than women who did not use IVF (rate ratio 19.7, 95% confidence interval 18.7 to 20.6). In the absence of a true effect of folic acid, the use of a 40% misclassified surrogate variable to adjust for use of IVF would have resulted in a false finding that folic acid was associated with a more than twofold increase in twinning. <b>Conclusion</b> Use of IVF is a strong confounder because it is associated with both use of folic acid and twinning. Even when misclassification of IVF was reduced to 5%, this bias persisted in the adjusted model. Using a 40% misclassified surrogate to adjust for IVF, as reported in the Swedish study, probably led to a false finding that folic acid increased dizygotic twinning.
Prevention of Meningococcal Disease by Group C Polysaccharide Vaccine
Authors: Malcolm S. Artenstein, Ronald Gold, James G. Zimmerly, Frederic A. Wyle, Herman Schneider, Charles Harkins
Journal: New England Journal of Medicine (1970)

Group C meningococcal polysaccharide vaccine was administered to 13,763 Army recruit volunteers at five basic training centers. These men represented 20 per cent of 68,072 recruits under observation. Only minor local erythema occurred; no systemic reactions to the vaccine developed in these men. Thirty-eight bacteriologically proved cases of Group C meningococcal disease developed in the nonimmunized men; only one such case occurred in a vaccinated recruit. The 87 per cent reduction in Group C disease was statistically significant. Group B meningococci caused illness in four immunized and three control recruits, indicating the group specificity of the vaccine. Group C carrier acquisitions among vaccinated persons were markedly reduced.
IMPACT OF WEIGHT REDUCTION ON PERICARDIAL FAT AND CARDIAC STRUCTURE IN PATIENTS WITH ATRIAL FIBRILLATION
Authors: Hany S. Abed, Adam Nelson, Darryl Leong, James D. Richardson, Rajiv Mahajan, Anthony Brooks, Walter Abhayaratna, Stephen Worthley, Jonathan Kalman, Gary A. Wittert, Prashanthan Sanders
Journal: Journal of the American College of Cardiology (2013)
Signal-averaged P wave in patients with wolff-parkinson-white syndrome after successful radiofrequency catheter ablation
Authors: Ivan G. Maia, Fernando E.S. Cruz Filho, Marcio L.A. Fagundes, Silvia H. Boghossian, Lutgarde Vanheusden, Roberto M. Sa, Paulo A.G. Alves
Journal: Journal of the American College of Cardiology (1995)
MULTIPLE FRACTURE OF THE LOWER JAW COMPLICATED BY DOUBLE FRACTURE OF THE UPPER JAW.
Authors: Thomas L Gilmer
Journal: JAMA (1904)

The following case, with treatment, is considered of sufficient interest to present for your consideration: From St. Luke's Hospital record of May, 1902, is taken the following: <h3>Patient.</h3> —G. C. was brought to accident ward about 1 a. m., May 12, 1902, in police ambulance, presenting the following lesions: "1. Fracture of lower jaw multiple: (<i>a</i>) just to left of symphysis between two left incisors, compound in mouth; (<i>b</i>) on right side between bicuspid and first molar; (<i>c</i>) at angle of jaw right side, simple; whole lower jaw was flattened anteroposteriorly and dropped somewhat toward sternum. "2. Fracture of upper jaw: (<i>a</i>) palate and alveolar processes broken from attachments and freely movable; (<i>b</i>) both alveolar processes broken loose from palate; (<i>c</i>) hard palate seemed fractured—anteroposteriorly throughout nearly the whole length—near the middle line. (Later examination did not positively confirm this.) "3. Loss of teeth. Upper jaw: (<i>a</i>) four incisors;