tbuckley/cabot-search huggingface dataset:
Cholangioscopic Extraction of Intrahepatic Stones Associated with Biliary Strictures using a Rendezvous Technique
Authors: I. Maetani, H. Hoshi, S. Ohashi, H. Yoshioka, Y. Sakai
Journal: Endoscopy (1993)

Two patients with a severe biliary stricture of one intrahepatic duct and associated intrahepatic stones were successfully treated after dilatation of their stricture by a new endobiliary rendezvous technique with the aid of percutaneous transhepatic cholangioscopy (PTCS). The strictured bile duct was approached from a contralateral percutaneous tract via PTCS and from the diseased duct by introducing a guidewire. This guidewire was then extracted through the other side using a PTCS-guided biopsy forceps to form a communication between both sides which could be used as a pathway for subsequent dilatation. Our technique allows the extraction of intrahepatic stones even in the presence of biliary strictures.
Biochemical Mechanism of Photohemolysis of Erythrocytes in Erythropoietic Protoporphyria.
Authors: George D. Ludwig
Journal: Annals of Internal Medicine (1967)

s1 May 1967Biochemical Mechanism of Photohemolysis of Erythrocytes in Erythropoietic Protoporphyria.George D. Ludwig, M.D., F.A.C.P., David Bilheimer, B.S., Lynne Iverson, B.S.George D. Ludwig, M.D., F.A.C.P.Search for more papers by this author, David Bilheimer, B.S.Search for more papers by this author, Lynne Iverson, B.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1060_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptErythropoietic protoporphyria (EPP), an inborn error of metabolism transmitted as a mendelian dominant trait, is characterized by increased erythrocyte protoporphyrin (EP) concentrations, solar sensitivity, and photocutaneous lesions. Increased photohemolysis of EPP red blood cells (RBC) by ultraviolet irradiation in vitro has been reported. We have found low plasma tocopherol concentrations in EPP, apparently due to its increased utilization as an antioxidant. The plasma tocopherol varied inversely with EP. Increased photohemolysis of vitamin E-deficient mouse RBCs by ultraviolet irradiation has been shown. These observations prompted the studies reported here.Photohemolysis by ultraviolet, in vitro, was demonstrated in the propositi of five... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1060-1060KeywordsAttentionBlood plasmaInborn errors of metabolismLesionsObservational studiesRed blood cells Issue Published: 1 May 1967 PDF DownloadLoading ...
Head‐high, airborne pollen grains from different areas of metropolitan Delhi
Authors: P. Malik, A. B. Singh, C. R. Babu, S. V. Gangal
Journal: Allergy (1990)

A survey of airborne pollen grains from four zones of metropolitan Delhi was conducted for 1 year (February 1988-January 1989) at human height level (5'-6'). Sampling was carried out in different inhabited areas in the four zones using Burkard Volumetric Personal Samplers. Sampling was carried out at weekly intervals, three times a day (7, 14, & 20 h) for 15 min. Poaceae, Ricinus, Cheno-Amaranth, Morus, Artemisia, Myrtaceae, Parthenium, Prosopis and Cannabis are important pollen contributors to the atmosphere, especially at lower heights. In general, pollen concentration was low at human height. Quantitative zonal variations have been recorded within an urban city.
NHS waiting list has fallen by 35% since 1998
Authors: Madeleine Brettingham
Journal: BMJ (2004)

The Labour government's systematic investment in the health service is delivering concrete results, Nigel Crisp, chief executive of the NHS, said last week in his end of year report.

The financial expansion, which started in 1998 and has seen the NHS receive several large cash injections, is now resulting in shorter waiting times and falling numbers of premature deaths.

The reduction in waiting times, which the government has been under particular pressure to deliver, gives the report a focus. The number of inpatients on waiting lists has fallen by 35% since it peaked in 1998, falling from more than a million then to 850 000 today.

The report shows that about 70 000 outpatients are now waiting …
Investigators will review conflicts of interest at NIH
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

Daniel Levinson, inspector general of the US Department of Health and Human Services, has said that his office will reopen 103 cases of conflicts of interest among scientists at the US National Institutes of Health (NIH).

The investigation will be carried out by the inspector general's Special Investigations Unit, staffed by five criminal investigators.

Mr Levinson's office was active in prosecuting Lester Crawford, the former head of the Food and Drug Administration, who was fined nearly $90 000 (£46 000; €67 000) for falsely reporting he had sold stock in companies regulated by the FDA while he still owned the shares ( BMJ 2007;334:492, doi: 10.1136/bmj.39142.592130.DB)

The special unit will also investigate conflicts of interest among about 40 000 scientific teams at about 2000 universities, medical centres, and non-profit institutions that receive research grants …
The Comatose Patient
Authors: Irwin Perlmutter
Journal: JAMA (1975)

<h3>To the Editor.—</h3> It was with great interest that the article by Posner was perused (233:1313, 1975). Dr Posner's classification of "coma" pathophysiologically into the four categories is excellent. It would be enlightening if instead of using the terms "supratentorial mass lesions" and "infratentorial mass" or "destructive lesions," the terms "supratentorial lesions" or "infratentorial lesions" were used, and if, in the subclassification of each of the first three groups, the usual diagnostic classifications of varieties of diseases were used, namely, congenital, traumatic, infectious, neoplastic and then toxic, metabolic, and degenerative. This would then include all of the possible subcategories under his first three classifications. To use the term "mass or destructive lesions" leaves certain possible causes of coma unlisted.
Glycohydrolases as markers of hepatic ischemia-reperfusion injury and recovery
Authors: W Liu, O Schöb, J E Pugmire, D Jackson, K A Zucker, D E Fry, R H Glew
Journal: Hepatology (1996)

Advances in liver surgery and transplantation have lead to a steady increase in the number of these interventions. Prompt quantitative assessment of hepatic of hepatic function and a patient's subsequent morbidity and mortality following surgery remain difficult despite the currently utilized historic markers of hepatic parenchymal injury (e.g., aspartate transaminase [AST], lactate dehydrogenase [LDH] γ–glutamyl transpeptidase [GGT]). Increases in serum glycohydrolase activities appear to provide sensitive and quantitative markers of hepatic ischemia/reperfusion injury. In 10 male swine (25 to 35 kg body weight) following 30, 45, and 90 minutes of acute hepatic ischemia, the systemic release of eight different glycohydrolases and lipid peroxides into serum were determined and compared with pre– and postischemic serum levels of LDH, GGT, and AST. The rapid release of glycohydrolases into serum was directly proportional to the length of the ischemic period from 30 to 90 minutes; e.g., β–glucosidase, mean 1.9–fold increase at 30 minutes; 8.3–fold at 45 minutes; and 22.8–fold at 90 minutes; P &lt; .002 and the activities peaked within the first 3 hours postischemia. In constrast, AST, LDH, and GGT were released slowly and peaked 20 to 30 hours after hepatic blood flow was restored. In swine with fatal outcomes (90 minutes of ischemia), all enzyme levels increased continuously during the final hours of life. However, in swine that survived hepatic ischemia/reperfusion injury (45 minutes of ischemia) the glycohydrolases, but not AST, LDH, and GGT, declined after 2 to 3 hours postischemia and the serum lipid peroxide levels followed the same pattern. Serum β–galactosidase and β–glucosidase levels are sensitive markers that rise as quickly as traditional enzyme markers (AST, LDH, GGT) following hepatic ischemic injury; moreover, the glycohydrolases have the added value of serving as predictors of survival.
Detection of Antigens in Sera of Patients with Neoplastic Disease by Schultz-Dale Test
Authors: J. G. Makari
Journal: BMJ (1958)

Burns are an unpredictable element of the modern battlespace and humanitarian operations. Most military burns are small and may not be a significant challenge for deployed healthcare assets but usually render the individual combat ineffective until healed. However, larger burns represent a more significant challenge because of the demand for fluid resuscitation therapy, early surgical intervention and regular wound management that can rapidly deplete surgical capabilities. Beyond the initial injury, longer-term consequences, such as psychological morbidity and loss of functional independence, are rarely considered as part of an ongoing care plan. Globally, most of the morbidity and mortality associated with burns are seen in less economically developed countries and are frequently associated with conflicts and natural disasters, but with simple interventions and resources, outcomes in these environments can be markedly improved. Prehospital providers should be confident to manage the initial assessment of a burn, including triaging for evacuation and packaging for safe transfer. This article provides an overview for prehospital providers on the management of thermal burns in military and humanitarian settings, with additional considerations for the management of chemical and electrical injuries.
POLIOMYELITIS ANTERIOR ACUTA ADULTORUM.
Authors: HERMAN H. HOPPE
Journal: JAMA (1900)

Poliomyelitis anterior acuta adultorum is a disease which, although it has been described many years ago, at first by M. Meyers, and later by Gumboldt in 1873, and by Shultz in 1878, is of extreme rarity, and on account of the difficulty of differential diagnosis is of sufficient interest to place two well-marked cases on record. Rand was able to collect only thirty-six cases in the adult, and in a period of ten years since I have been interested in nervous diseases, I have had an opportunity of observing but two. On account of the newer views of the pathology of poliomyelitis, and especially on account of the difficult differential diagnosis and the unusual prominence and the sharp definition of newer diseases, such as peripheral neuritis, many cases of which were formerly grouped under poliomyelitis, it is of especial interest to place on record two cases which are beyond dispute.
Coinheritance of Factor V (FV) Leiden enhances thrombin formation and is associated with a mild bleeding phenotype in patients homozygous for the FVII 9726+5G&amp;gt;A (FVII Lazio) mutation
Authors: Elisabetta Castoldi, José W. P. Govers-Riemslag, Mirko Pinotti, Debora Bindini, Guido Tans, Mauro Berrettini, Maria Gabriella Mazzucconi, Francesco Bernardi, Jan Rosing
Journal: Blood (2003)
Behçet's Disease
Authors: J. DESMOND O'DUFFY
Journal: Annals of Internal Medicine (1971)

The clinical and immunologic findings in 10 patients with Behçet's disease are described. The frequency of inflammatory lesions was aphthous stomatitis, nine patients; ocular inflammation, six; genital ulceration, eight; arthritis or arthralgias, seven; cutaneous lesions, six; nervous system involvement, four; and phlebitis and ulcerative colitis, three each. Previously unreported complications encountered singly were pancreatitis, peripheral neuropathy, subungual infarctions, and malignant lymphoma. All four biopsy specimens of mucocutaneous lesions showed vasculitis, in one associated with fibrinoid necrosis. Polyclonal immunoglobulin increases were lgA, four of nine; lgM, four of nine; and lgG, one of nine. Anticytoplasmic antibodies to human cadaver esophagus cells were present in all five tested. Search for viral inclusions and isolations proved negative. Corticosteroid treatment, although reducing painful inflammation, did not prevent neurologic progression in one patient or uveitis in another. A previously reported improvement after blood transfusion was noted in two of three patients.
Catching Babies: The Professionalization of Childbirth, 1870-1920
Authors: Judy Barrett Litoff
Journal: JAMA (1996)

Catching Babies is a meticulously researched work that examines the shift from midwife- to physician-attended births in four counties in Wisconsin between 1870 and 1920. Using information gleaned from Wisconsin's vital statistics records, midwife license applications, the Milwaukee Health Department Physicians' Register, the US Children's Bureau, census data, and contemporary medical journal articles, Charlotte G. Borst has carefully reconstructed the practice and culture of Wisconsin's midwives at the turn of the 20th century.  Borst divides the 893 midwives who form the basis of her study into three types of practitioners. Neighbor women from rural areas acted as occasional midwives to family members and friends. For these rural  who attended six or fewer births a year, midwifery was part of the strategy of neighborliness. A second group of practitioners, apprentice-trained midwives, learned their craft from older, more experienced midwives or from local physicians. Finally, school-educated midwives, who were overwhelmingly first
Stem Cells and Spinal Cord Repair
Authors: Evan Y. Snyder, Yang D. Teng
Journal: New England Journal of Medicine (2012)

For the past couple of decades, clinicians have watched the stem-cell field with a mixture of anticipation and skepticism. No group of patients has been more expectant than those with spinal cord injuries. Therapies for spinal cord injury have been promised almost since the dawning of the stem-cell field. The recent launch — and abrupt termination — of a phase 1 clinical trial for acute spinal cord injury by the biotechnology company Geron whetted the appetite, and then fueled the frustration, of these patients.A recent study by Sakai et al.1 is one of a series in this field. It . . .
Effect of aging on risk for hepatocellular carcinoma in chronic hepatitis C virus infection
Authors: Yasuhiro Asahina, Kaoru Tsuchiya, Nobuharu Tamaki, Itsuko Hirayama, Tomohiro Tanaka, Mitsuaki Sato, Yutaka Yasui, Takanori Hosokawa, Ken Ueda, Teiji Kuzuya, Hiroyuki Nakanishi, Jun Itakura, Yuka Takahashi, Masayuki Kurosaki, Nobuyuki Enomoto, Namiki Izumi
Journal: Hepatology (2010)

An increase in the aging population is an impending problem. A large cohort study was carried out to determine the influence of aging and other factors on hepatocarcinogenesis in patients treated with interferon. Biopsy-proven 2547 chronic hepatitis C patients registered at our referral center since 1992 were included. Of these, 2166 were treated with interferon-based therapy. Incidences of hepatocellular carcinoma (HCC) associated with interferon were analyzed by Kaplan-Meier and person-years methods for an average follow-up of 7.5 years. Factors associated with HCC risk were determined by Cox proportional hazard analysis. HCC developed in 177 interferon-treated patients. The risk for HCC depended on age at primary biopsy and increased more than 15-fold after 65 years of age. Even when stratified by stage of fibrosis, the cumulative and annual incidences of HCC were significantly higher in older patients than in younger patients (P < 0.001) at the same stage of fibrosis, except for cirrhosis. Progression of fibrosis over time was significantly accelerated in older patients. The impact of viral eradication on HCC prevention was less significant in older patients than in younger patients. Multivariate analysis confirmed that age, gender, liver fibrosis, liver steatosis, total cholesterol level, fasting blood sugar level, baseline and postinterferon alpha-fetoprotein level, and virological response to interferon were independent risk factors associated with HCC. Aging was the strongest risk factor for a nonvirological response to interferon-based antiviral therapy. Conclusion: Elderly patients are at a higher risk for HCC. Hepatitis C viral eradication had a smaller effect on hepatocarcinogenesis in older patients. Patients should therefore be identified at an earlier age and treatment should be initiated. HEPATOLOGY 2010
Extracranial Vascular Surgery
Authors: Richard A. Thompson
Journal: JAMA (1970)

To the Editor.—  The impressive results of extracranial vascular surgery in the treatment of transient cerebral ischemic attacks reported by Fields et al ( 211 : 1993, 1970) are considerably better than witnessed by myself. After carefully reviewing their reported data, several criticisms may be noted.  These conclusions appear better than the actual data would support, since mortality and morbidity of surgery were excluded from the final tabulation of results of treatement.  If one considers their total data from the standpoint of poor results (subsequent nonfatal or fatal stroke) and death from other causes, it can be seen from the table that there is little difference between the surgical and nonsurgical groups in each category of vascular disease.  It becomes apparent that these results are only impressive in regard to the number of patients who continue to have transient neurological symptoms without stroke. There is no clear understanding of the criteria for
Hospital chaplaincy units show bias towards Christianity
Authors: Aziz Sheikh, Abdul Rashid Gatrad, Usman Sheikh, Sukhmeet Singh Panesar, Shuja Shafi
Journal: BMJ (2004)

EDITOR—The Human Rights Act 1998 and the Patient's Charter place a legal responsibility on public bodies to ensure the rights of individuals to religious observance.1 2 Concern has, however, been expressed that access to spiritual care in hospitals for those of non-Christian faiths is limited.3 We therefore conducted a national survey of hospital chaplaincy units.

We randomly selected 100 NHS hospitals …
Salmeterol in nocturnal asthma.
Authors: S Sarin, S Shami, T Cheatle
Journal: BMJ (1991)

Results of using colour duplex sonography in 58 patients (60 limbs) with clinically suspected deep vein thrombosis No No Location of thrombus false positive Specificity (%) false negative Sensitivity (%) Axial and calf veins 0 100 6 79 Axial vein 0
SULFHEMOGLOBINEMIA FOLLOWING HABITUAL USE OF ACETANILID
Authors: Telfer B. Reynolds
Journal: JAMA (1952)

There are numerous reports in the older medical literature of cyanosis following the prolonged ingestion of acetanilid; 1 the cyanosis was assumed to be due to the presence of methemoglobin. In 1930, Harrop and Waterfield called attention to the fact that acetanilid poisoning could cause sulfhemoglobinemia. 2 There are a few other reports in the literature of single instances in which this fact was demonstrated. 3 Nevertheless, cyanosis with acetanilid poisoning is still frequently ascribed to methemoglobinemia.  Differentiation between the two pigments is relatively easy by methods now available and is of considerable practical importance, particularly with regard to therapy. Methemoglobin is rapidly reversed to normal hemoglobin by the enzyme systems in the red blood cell as soon as the offending poison is removed. Treatment of methemoglobinemia of a mild degree is, therefore, often unnecessary. In severe cases, methylene blue (1 to 2 mg. per kilogram), given orally or intravenously,
Rubella Booster Immunization
Authors: Shelby A. Wyll, Kenneth L. Herrmann, Elias Abrutyn, G. Doty Murphy, John J. Witte
Journal: JAMA (1971)

To determine the persisting effect on base-line antibody levels of a booster dose of rubella vaccine, blood specimens were obtained eight to ten weeks following revaccination from 92 study children immunized initially in July 1968. Only six of 92 (6.5%) revaccinees demonstrated a fourfold or greater rise in rubella hemagglutination-inhibiting (HI) antibody titer. The HI titers before administration of the booster dose were low in all six (1:32 or less); however, similar low titers were noted in 33 revaccinees who demonstrated no increase in antibody. These data suggest that a second dose of rubella vaccine given approximately two years following primary immunization does not significantly increase antibody levels and, therefore, may be ineffective in enhancing resistance to reinfection.
THE NEED OF CORRECTING AMETROPIA AFTER MIDDLE LIFE.
Authors: C. M. CULVER
Journal: JAMA (1902)

The Century Dictionary says that "By a middle-aged man is generally understood a man from the age of 40 to 50." Presbyopia is usually supposed to begin between the ages of 40 and 46, although, with Donders' liberal definition of presbyopia, it may be present at the age of 30 years. Presbyopia, of itself, is properly treated by the wearing of an artificial substitute for the quota of accommodation that has been lost, because of the diminution in the elasticity of the crystalline lens—a diminution incident to advancing age. Convex lenses or an equivalence of their optical power in cases in which lenses need to be used for the correction of ametropia, constitute such substitute for lost accommodative power. This being true, it is primarily essential that concomitant ametropia receive due attention, when glasses for the relief of presbyopia are chosen, the effect of such attention having the form of
Case 32-1974
Authors: Richard C. Cabot, Robert E. Scully, Betty U. McNeely, Sven Paulin, Philip B. Clement
Journal: New England Journal of Medicine (1974)

Presentation of CaseA 66-year-old man was admitted to the hospital because of a question of mesenteric vascular occlusion.He was well until the day of admission, when there was the sudden onset of pain, numbness and impaired movement in the right lower leg, which was pale and cold. He was seen at another hospital, where he was considered to have an arterial occlusion, but the signs improved. He left the hospital and returned in the evening because of sharp epigastric pain accompanied by the passage of bright-red blood per rectum. He was transferred to this hospital.There was a . . .
Control of Hypertension and Reversal of Renal Failure in Scleroderma
Authors: Paul D. Mitnick, Peter U. Feig
Journal: New England Journal of Medicine (1978)

MALIGNANT hypertension and rapid deterioration in renal function often occur in systemic scleroderma. Since medical therapy of this hypertension is frequently ineffective,1 2 3 4 5 and since the renal failure is considered irreversible,4 , 6 , 7 bilateral nephrectomy has been advocated.1 2 3 4 5 , 8 9 10 In the case of scleroderma with oliguric renal failure and malignant hypertension reported below, control of blood pressure by drugs made nephrectomy unnecessary. Six months of management by hemodialysis of presumed end-stage renal failure and pharmacologic control of blood pressure were followed by remarkable spontaneous recovery of renal function.This case and review of the literature suggest that nephrectomy should be postponed until maximal medical . . .
Health minister wants to see lawyers' leaflets banned from emergency departments
Authors: C. Dyer
Journal: BMJ (2012)

Hospitals in England are under pressure to ban advertisements by “no win, no fee” lawyers that many NHS trusts have been using to boost their revenue and defray the cost of producing information leaflets for patients.

The health minister Simon Burns has promised to ask the NHS chief executive, David Nicholson, to write to hospitals “to remind them it is not acceptable to display these adverts.” He added: “The NHS is spending more and more each year on cases brought by aggressive no win, no fee lawyers. This money should be spent on patient care, not on …