tbuckley/cabot-search huggingface dataset:
Time to consider the best way to plan for single rooms
Authors: A. W. Rigg
Journal: BMJ (2013)

The question is: can the NHS afford single beds and what is practicable?1 Nussbaum is right: nurse numbers must be considered first and above everything else.2 But what about cleaners? And what kit should each room have? The winter crisis in admission beds is completely missing from the debate. All hospitals need bigger footprints if single rooms are planned. There …
Pneumothorax as Complication of Acupuncture
Authors: John J. Kuiper
Journal: JAMA (1974)

<h3>To the Editor.—</h3> It is likely that pneumothorax is the most common, or the most easily recognized, potentially serious complication of acupuncture—at least as practiced in the western world. The recent article inThe Journal(228:1552, 1974) by Carron et al describes two such occurrences, and cites as a reference a third (<i>Med J Aust</i>1:941, 1973). The letters to the editor section of the<i>New England Journal of Medicine</i>(290:167, 1974; 290:633, 1974) provides two additional cases. A sixth patient, receiving her third treatment for atypical migraine in August 1973, noted left medial scapular pain and progressive dyspnea one hour following paravertebral insertion of acupuncture needles. When she sought medical attention 48 hours later, a 35% left pneumothorax was documented (Figure) and treated with insertion of a chest tube. Re-expansion of the lung allowed removal of the chest tube on the third day and discharge from the hospital after
Chronic Congestive Heart Failure Is Associated With a Phenotypic Shift of Intramyocardial Endothelial Cells
Authors: Monique M.H. Marijianowski, Marjolein van Laar, Johannes Bras, Anton E. Becker
Journal: Circulation (1995)

Background There is evidence that patients with chronic congestive heart failure have endothelial cell–related abnormalities of the peripheral circulation and the coronary microvasculature. For that reason, we have studied the phenotypic expression of endothelial cells in hearts of patients with congestive heart failure. Methods and Results We studied cardiac explants (n=19) and autopsy hearts (n=5) of patients with chronic congestive heart failure caused by either a dilated cardiomyopathy (n=12) or ischemic heart disease (n=12) and compared them with normal hearts (n=12). The antigenic expression obtained with several endothelial cell markers (factor VIII–related antigen, EN-4, Ulex europaeus agglutinin–1 (UEA-1), PAL-E, endoglin, and endothelin) and adhesion molecules (intercellular adhesion molecule [ICAM], vascular cell adhesion molecule [VCAM], or E-selectin) was compared by use of immunohistochemical techniques. On the basis of the initial findings, the number of PAL-E– and EN-4–positive vessels was counted. The incidence of PAL-E–positive vessels per area was quantified and related to the percentage of heart muscle cells and the total number of vessels per area. In control hearts, endothelial cells rarely were positive for PAL-E. In hearts of patients with ischemic cardiomyopathies, there was distinct staining with this marker. Hearts of patients with dilated cardiomyopathies showed a marked increase in the number of PAL-E–positive endothelial cells. Vessels with a muscular media were PAL-E–negative. Two-sample analysis revealed a statistically significant difference between hearts with dilated cardiomyopathies and ischemic cardiomyopathies ( P &lt;.01), between hearts with dilated cardiomyopathies and control hearts ( P &lt;.01), and between hearts with ischemic cardiomyopathies and control hearts ( P &lt;.01). Endoglin and ICAM were positive but nondiscriminating. Endothelin, VCAM, and E-selectin were negative. Conclusions A phenotypic shift in endothelial antigen expression of the coronary microvasculature occurs in both ischemic hearts and hearts with dilated cardiomyopathies, as revealed by PAL-E, compared with control hearts. The change may relate to compensatory mechanisms in long-standing chronic heart failure.
Helicobacter pylori upregulates expression of epidermal growth factor-related peptides, but inhibits their proliferative effect in MKN 28 gastric mucosal cells.
Authors: M Romano, V Ricci, A Di Popolo, P Sommi, C Del Vecchio Blanco, C B Bruni, U Ventura, T L Cover, M J Blaser, R J Coffey, R Zarrilli
Journal: Journal of Clinical Investigation (1998)

Acute exposure to Helicobacter pylori causes cell damage and impairs the processes of cell migration and proliferation in cultured gastric mucosal cells in vitro. EGF-related growth factors play a major role in protecting gastric mucosa against injury, and are involved in the process of gastric mucosal healing. We therefore studied the acute effect of H. pylori on expression of EGF-related growth factors and the proliferative response to these factors in gastric mucosal cells (MKN 28) derived from gastric adenocarcinoma. Exposure of MKN 28 cells to H. pylori suspensions or broth culture filtrates upregulated mRNA expression of amphiregulin (AR) and heparin-binding EGF-like growth factor (HB-EGF), but not TGFalpha. This effect was specifically related to H. pylori since it was not observed with E. coli, and was independent of VacA, CagA, PicA, PicB, or ammonia. Moreover, H. pylori broth culture filtrates stimulated extracellular release of AR and HB-EGF protein by MKN 28 cells. AR and HB-EGF dose-dependently and significantly stimulated proliferation of MKN 28 cells in the absence of H. pylori filtrate, but had no effect in the presence of H. pylori broth culture filtrates. Inhibition of AR- or HB-EGF- induced stimulation of cell growth was not mediated by downregulation of the EGF receptor since EGF receptor protein levels, EGF binding affinity, number of specific binding sites for EGF, or HB-EGF- or AR-dependent tyrosine phosphorylation of the EGF receptor were not significantly altered by incubation with H. pylori broth culture filtrates. Increased expression of AR and HB-EGF were mediated by an H. pylori factor > 12 kD in size, whereas antiproliferative effects were mediated by both VacA and a factor < 12 kD in size. We conclude that H. pylori increases mucosal generation of EGF-related peptides, but in this acute experimental model, this event is not able to counteract the inhibitory effect of H. pylori on cell growth. The inhibitory effect of H. pylori on the reparative events mediated by EGF-related growth factors might play a role in the pathogenesis of H. pylori-induced gastroduodenal injury.
Retroperitoneal fibrosis in a patient with macroprolactinoma treated with bromocriptine.
Authors: A. Herzog, H. Minne, R. Ziegler
Journal: BMJ (1989)

Many reports document a variety of neurological complications resulting from both intravenous and intrathecal administration of methotrexate, but acute cerebral oedema is not among them.We describe a patient with acute myeloid leukaemia who developed cerebral oedema after treatment with intrathecal methotrexate.A 23 year old Jamaican woman was admitted with a diagnosis of acute pnyeloid leukaemia (M3).
Carbamazepine-induced thrombocytopenia defined by a challenge test
Authors: Takashi Ishikita, Akira Ishiguro, Kohji Fujisawa, Ichiro Tsukimoto, Toshikazu Shimbo
Journal: American Journal of Hematology (1999)

Carbamazepine (CBZ), a widely used anticonvulsant, occasionally causes serious hematologic disorders. A 12-year-old boy was admitted because of a diffuse petechial rash and profound thrombocytopenia (10 × 109 platelets/l), after having been treated for epilepsy with CBZ for 12 days. Seven days following withdrawal of CBZ and initiation of prednisolone therapy, the platelet count recovered. In a subsequent challenge test with CBZ, platelet counts again decreased, and the levels of platelet-associated IgG and serum interleukin-6 increased. No antibodies against platelet glycoprotein IIb/IIIa or Ib were detected in plasma. We believe that this is the first reported occasion when CBZ-induced thrombocytopenia has been defined by a rechallenge test. Am. J. Hematol. 64:52–55, 1999. © 1999 Wiley-Liss, Inc.
What It Is, What It Does and What It Might Do: A Review of Michael Moore's<i>Sicko</i>, 113 Minutes, Dog Eat Dog Films, USA, 2007
Authors: Theodore R. Marmor, Kieke G. H. Okma, Joseph R. Rojas
Journal: The American Journal of Bioethics (2007)

Within two weeks of its American screening, Michael Moore's Sicko had already divided the American public into zealous supporters and agitated detractors. Amidst extraordinary media attention, it c...
Human T‐lymphotropic virus type I‐associated benign transient immature T‐cell lymphocytosis
Authors: Garth D. Ehrlich, Tin Han, Richard Bettigole, Stuart A. Merl, Bruce Lehr, Russell H. Tomar, Bernard J. Poiesz
Journal: American Journal of Hematology (1988)

Abstract We describe a case of human T‐lymphotropic virus type I (HTLV‐I)‐associated transient benign immature T‐cell lymphocytosis in a black female patient, which over the course of several months underwent spontaneous complete remission. The patient presented with a white blood cell count of 20,000/μl and a T4/T8 ratio of 1.7:1. The majority of cells appeared to be lymphoid in origin, and cell marker analyses established that the circulating lymphocytes were predominantly immature T‐cells. HTLV‐I was detected at this time by a p19 indirect immunofluorescent slide assay. Over a 1‐month period of time the patient's clinical status evolved into a mature T‐lymphocytosis with a T4/T8 ratio of 4.5:1. HTLV‐I was detected by anti‐p19 immunofluorescence by cell sorter analyses and by dot‐bloc nucleic acid hybridization. Serological testing demonstrated that the patient had anti‐HTLV‐I antibodies and antimembrane antibodies specific for an HTLV‐I producing cell line. In a competitive HTLV‐I ELISA assay only HTLV‐I proteins could effectively compete out the seroreactivity. The patient also had a high serum level of soluble interleukin‐2 (IL‐2) receptors, which is associated with HTLV‐I infection. This is the first reported case of immature T‐lymphocytosis in a patient infected with HTLV‐I. The patient's HTLV‐I markers disappeared with time, and her lymphocytosis subsequently spontaneously resolved. She remains disease free and virus negative after 2 years of follow‐up study.
Observations on Vascular Injuries
Authors: A. M. Boyd
Journal: BMJ (1946)

PREVENTION OF INFANT DEATHS MEDBRTJISH 895 which babies have to be reared than by studying their morbid pathology.Liaison should not be an end in itself but an integral part of the infant services, and it cannot be planned as a separate entity.Regard must be paid to these principles if liaison is to be effective.
Thallium/Gallium Scintigraphy Revisited: Added Value of SPECT-CT/MR Image Fusion for Characterizing Brain Lesions
Authors: T Delman, N P. Shah, M E. Oates
Journal: Clinical Nuclear Medicine (2006)

s of the 19th Annual Northeast Regional Scientific Meeting Greater New York and New England Chapters of The Society of Nuclear Medicine, Oct 28–30, 2005, Newport, Rhode Island
Early Palliative Care in Advanced Lung Cancer
Authors: Jaclyn Yoong, Elyse R. Park, Joseph A. Greer, Vicki A. Jackson, Emily R. Gallagher, William F. Pirl, Anthony L. Back, Jennifer S. Temel
Journal: JAMA Internal Medicine (2013)

BACKGROUND Early ambulatory palliative care (PC) is an emerging practice, and its key elements have not been defined. We conducted a qualitative analysis of data from a randomized controlled trial that demonstrated improved quality of life, mood, and survival in patients with newly diagnosed metastatic non-small cell lung cancer who received early PC integrated with standard oncologic care vs standard oncologic care alone. Our objectives were to (1) identify key elements of early PC clinic visits, (2) explore the timing of key elements, and (3) compare the content of PC and oncologic visit notes at the critical time points of clinical deterioration and radiographic disease progression. METHODS We randomly selected 20 patients who received early PC and survived within 4 periods: less than 3 months (n = 5), 3 to 6 months (n = 5), 6 to 12 months (n = 5), and 12 to 24 months (n = 5). We performed content analysis on PC and oncologic visit notes from the electronic health records of these patients. RESULTS Addressing symptoms and coping were the most prevalent components of the PC clinic visits. Initial visits focused on building relationships and rapport with patients and their families and on illness understanding, including prognostic awareness. Discussions about resuscitation preferences and hospice predominantly occurred during later visits. Comparing PC and oncologic care visits around critical time points, both included discussions about symptoms and illness status; however, PC visits emphasized psychosocial elements, such as coping, whereas oncologic care visits focused on cancer treatment and management of medical complications. CONCLUSIONS Early PC clinic visits emphasize managing symptoms, strengthening coping, and cultivating illness understanding and prognostic awareness in a responsive and time-sensitive model. During critical clinical time points, PC and oncologic care visits have distinct features that suggest a key role for PC involvement and enable oncologists to focus on cancer treatment and managing medical complications.
"MEDICAL JURISPRUDENCE IN DIVORCE."
Authors: CARL H. VON KLEIN
Journal: JAMA (1885)

An address delivered (by invitation) before the "Ohio State Bar Association," at their annual meeting Dec. 30 and 31, 1884, Columbus, O. Mr. President, Gentlemen of the Ohio State Bar Association: No branch of science seems to have been more neglected than that pertaining to Medical Jurisprudence in Divorce. Will you, then, pardon my zeal upon this subject? I do not desire to bring to your attention, gentlemen of the bar, a subject with which you are unacquainted, nor is it my object to send this address to the forensic world as upon a new field of science. But rather as an attempt to show what beneficial effects might result from a more thorough and scientific study of the subject. My humble judgment leads me to believe that many cases of divorce are obtained improperly from the very fact, known to laymen, as well as to your own and my
Management of Tic Douloureux
Authors: Henry A. Shenkin
Journal: JAMA (1978)

To the Editor.—  The SPECIAL COMMUNICATION on tic douloureux by Loeser (239:1153, 1978) is to be faulted on several counts. The most important indiscretion is the endorsement of an experimental procedure for general use long before it has even minimal proof of long-term efficacy. Tic douloureux is a notoriously remittent disease, and over the last 30 years, those who have had broad experience in the management of this painful condition have seen procedures as well recommended as Jannetta's1approach fall into oblivion with the passage of time.  Secondly, the author fails to place temporizing procedures such as alcoholic injection in their proper role. Permanent interruption of the trigeminal nerve as an initial procedure is frought with the danger of replacing the pain of tic douloureux with unbearable paresthesias, a pitiful, and for the most part an untreatable, state. It is well known2that facial anesthesia dolorosa can be
Repeated Hemodialysis in Chronic Uremia
Authors: Larry H. Kretchmar
Journal: JAMA (1963)

REPEATED HEMODIALYSIS in patients with chronic uremia is being undertaken on an experimental basis at several medical centers. In addition to prolonging the patients' lives, these procedures are providing a better understanding of chronic renal disease. The case reported here is of interest for these reasons: (1) Dialysis was performed when uremic symptoms became pronounced, not on a fixed schedule to maintain BUN at normal levels. (2) The Kolff twin coil kidney, a high flow apparatus now available in many hospitals, was used, rather than one of the slow flow machines more commonly used for dialysis of chronic uremia at some research centers.  Report of a Case  A 43-year-old nurse in terminal uremia due to chronic glomerulonephritis survived 8 months with the aid of 14 dialyses. A permanent indwelling teflon shunt, which had to be replaced after 20 weeks, was used to provide access to an artery and vein.
Julian Magnus Lloyd
Authors: Stuart Tindall, James Tindall, Helen Joesbury
Journal: BMJ (2005)

​FormerFormer general practitioner Sheffield (b Newport, Gwent, 1944; q Sheffield 1969; MRCGP, DCH, DObst RCOG), d 25 January 2005.




Figure 1






After house officer posts Julian joined a partnership in Sheffield, until ill health forced his early retirement in 1993. A student elective at the steelworks in Ebbw Vale kindled a lifelong interest in occupational health, which later developed into a second career. He was an elected member of Sheffield local medical committee from 1973 to 1991 and an active freemason. Julian relished good food and fine wines, keeping an eclectic cellar. He developed type 1 diabetes at the age of 11 and had a renal transplant in 1992, but was disabled by bilateral below knee amputations the following year. In 1970 he married Helen Joesbury, a fellow student, and they had three adopted children.
Cardiovascular Effects of Sustained Norepinephrine Infusions. II. Morphology
Authors: Eric A. Schenk, Arthur J. Moss
Journal: Circulation Research (1966)

The major toxic effect of norepinephrine (NE) infusion in dogs, cats, and rabbits in doses relatively comparable to those used clinically has been shown to be on the heart. Noncardiac lesions were those of congestion, and were seen in animals receiving the higher doses. The dogs in these dose groups showed evidence of progressive deterioration of cardiac function. All dogs which developed cardiac lesions also developed an acute adrenalitis. The cardiac lesions in all animals consisted of focal degeneration and necrosis of myofibers, and subendocardial hemorrhage. These lesions healed within two weeks by fibrosis.
Effects of Lidocaine, Propranolol, and Sotalol on Ouabain-lnduced Changes in Transmembrane Potential of Canine Purkinje Fibers
Authors: BARRY J. KOERPEL, LARRY D. DAVIS
Journal: Circulation Research (1972)

Isolated canine papillary muscle-false tendon preparations stimulated at 95/min were perfused with Tyrode's solution containing ouabain, 2.1 x 10 -7 M. Action potentials of Purkinje fibers were recorded. Initially ouabain increased the slope of phase-4 depolarization. Subsequently it decreased the maximum diastolic potential and the rising velocity of phase 0, the amplitude, and the duration of the action potential. The slope of phase-4 depolarization increased progressively, and eventually the configuration of the action potential changed to resemble that of sinoatrial node fibers. Onset of enhanced phase-4 depolarization was delayed significantly by treatment before exposure to ouabain with lidocaine, 3.7 x 10 -5 M, or propranolol, 2.1 x 10 -5 M, but not with sotalol, 3.2 x 10 -4 M. Enhanced phase-4 depolarization produced by exposure to ouabain was reduced in slope by subsequent treatment with lidocaine or propranolol but not sotalol. Application of lidocaine or propranolol to fibers with action potentials in the configuration characteristic of sinoatrial node fibers returned the contour of the action potentials toward normal; sotalol was not effective in this regard. These results, coupled with the relative effectiveness of these drugs in intact animals with digitalis arrhythmias, support the hypothesis that enhanced phase-4 depolarization of Purkinje fibers is a factor in the production of digitalis-induced ventricular arrhythmias.
Treat sickest hepatitis C patients first, new US guidelines recommend
Authors: M. McCarthy
Journal: BMJ (2014)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Treat sickest hepatitis C patients first, new US guidelines recommend Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Long term prognosis of fatty liver: risk of chronic liver disease and death
Authors: S Dam-Larsen
Journal: Gut (2004)

<b>Background and aims:</b> Fatty liver is a common histological finding in human liver biopsy specimens. It affects 10–24% of the general population and is believed to be a marker of risk of later chronic liver disease. The present study examined the risk of development of cirrhotic liver disease and the risk of death in a cohort diagnosed with pure fatty liver without inflammation. <b>Methods:</b> A total of 215 patients who had a liver biopsy performed during the period 1976–1987 were included in the study. The population consisted of 109 non-alcoholic and 106 alcoholic fatty liver patients. Median follow up time was 16.7 (0.2–21.9) years in the non-alcoholic and 9.2 (0.6–23.1) years in the alcoholic group. Systematic data collection was carried out by review of all medical records. All members of the study cohort were linked through their unique personal identification number to the National Registry of Patients and the nationwide Registry of Causes of Death, and all admissions, discharge diagnoses, and causes of death were obtained. <b>Results:</b> In the non-alcoholic fatty liver group, one patient developed cirrhosis during the follow up period compared with 22 patients in the alcoholic group. Survival estimates were significantly (p&lt;0.01) different between the two groups, for men as well as for women, with a higher death rate in the alcoholic fatty liver group. Survival estimates in the non-alcoholic fatty liver group were not different from the Danish population. <b>Conclusions:</b> This study revealed that patients with type 1 non-alcoholic fatty liver disease have a benign clinical course without excess mortality.
Nemaline bodies in the heart: anomalous Z bands with a periodic structure suggesting tropomyosin in human cardiac muscle biopsies
Authors: M. J. DAVIES, S. BALLANTINE, S. DARRACOTT, M. BRAIMBRIDGE
Journal: Cardiovascular Research (1973)

Masses of anomalous Z-band material, the so-called nemaline bodies, have been seen in two biopsies of human myocardium. Neither patient had a clinical picture suggesting cardiomyopathy and it is likely that nemaline bodies are a non-specific feature of developing myocardial hypertrophy in man analogous to that seen in the experimental animal.
INSUSCEPTIBILITY TO SENSITIZATION AND ANAPHYLACTIC SHOCK
Authors: Warfield T. Longcope
Journal: The Journal of Experimental Medicine (1922)

1. Attempts to produce anaphylactic shock in white rats by second intravenous or subdural injections of horse serum have failed. 2. It was impossible to demonstrate either by skin reactions or by the uterine reaction that white rats can be sensitized to horse serum. 3. It was not possible to sensitize guinea pigs passively with the serum of white rats presumably immunized to horse serum. 4. In spite of the fact that the white rat could not be made anaphylactic to horse serum, the tissues of the animal reacted with the horse serum to form precipitins in fair concentration and the antigen disappeared from the circulation soon after the precipitins reached their greatest concentration in the blood. 5. These experiments would indicate that in the white rat anaphylaxis and precipitin formation are independent and represent different types of immunological processes.