tbuckley/cabot-search huggingface dataset:
Methods and consequences of changes in use of episiotomy
Authors: T B Henriksen, K M Bek, M Hedegaard, N J Secher
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objectives</b>: To evaluate the use of feedback by graphical profiles of rates of episiotomy and the impact on clinical practice and perineal state after spontaneous vaginal deliveries assisted by midwives with different attitudes towards episiotomy. <b>Design</b>: Observation period in labour ward followed by feedback to midwives about their own and other midwives9 use of episiotomies. The periods before and after the intervention were compared. Subjects - All women (n=3919) delivering during the two periods who had been assisted by one of 30 midwives; each midwife supervised at least 20 deliveries during each period. <b>Main outcome measures</b>: Overall rates of episiotomies and indications, incidence of intact perineums, perineal lacerations, and tears of anal sphincter. <b>Results</b>: The overall rate of episiotomy during the observation period was 37.1% (615). During the second period the rate was 6.6% lower (95% confidence interval 3.6% to 9.6%), corresponding to a relative decrease of 17.8% (10.1% to 24.7%). Higher rates of episiotomy during the observation period were associated with larger reductions in the second period. The decrease could be explained by less use of episiotomy in deliveries with rigid perineum or impemding perineal tear. Compared with the observation period, in the second period 3.2% more women (0.3% to 6.3%) had an intact perineum after delivery and 3.4% (0.4% to 6.2%) experienced perineal tears. The overall incidence of tears of the anal sphincter remained unchanged. Women had a slightly reduced incidence of tears of the anal sphincter, however, if they were delivered by midwives who reduced a medium or high initial rate of episiotomy and a tendency towards an increased incidence of tears if they were assisted by midwives who reduced low initial rates (around 20%) of episiotomy. <b>Conclusions</b>: Changes in the use of episiotomy induced by awareness of clinical practice among midwives seem to increase the incidence of parturients with intact perineum without a concomitant rise in tears of the anal sphincter. To avoid the increase of such tears these changes should probably be restricted to midwives with rates of episiotomies above 30%.
A guide to the radiographic identification of prosthetic heart valves: an addendum.
Authors: D J Mehlman
Journal: Circulation (1984)

Several years ago "A Guide to the Radiographic Identification of Prosthetic Heart Valves" (Circulation 57:613, 1978) described the radiographic silhouettes of 40 different cardiac prosthesis in clinical use. Since that time a number of prostheses have been developed and introduced to clinical practice. Ten of these newer prostheses manufactured by six domestic companies were photographed and radiographed as they would be expected to appear in standard chest radiographs. The radiographic silhouettes are described and distinguishing features are discussed.
CLINICAL AND ANGIOGRAPHIC OUTCOMES FOLLOWING PERCUTANEOUS CORONARY INTERVENTION WITH DRUG-ELUTING STENT IN PATIENTS OF CHRONIC KIDNEY DISEASE
Authors: Takimura Hideyuki, Toshiya Muramatsu, Reiko Tsukahara, Yoshiaki Ito, Tsuyoshi Sakai, Hiroshi Ishimori, Keisuke Hirano, Masatsugu Nakano, Masahiro Yamawaki, Sinya Sasaki, Motoharu Araki, Yasunari Sakamoto, Ikki Komatsu, Takuro Takama
Journal: Journal of the American College of Cardiology (2011)
Sulphasalazine and regression of rheumatoid nodules.
Authors: H J Englert, G R Hughes, M J Walport
Journal: Annals of the Rheumatic Diseases (1987)

The regression of small rheumatoid nodules was noted in four patients after starting sulphasalazine therapy. This coincided with an improvement in synovitis and also falls in erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). The relation between the nodule regression and the sulphasalazine therapy is discussed.
Increased Neopterin in Patients With Chronic and Acute Coronary Syndromes
Authors: Martin Schumacher, Gabriele Halwachs, Franz Tatzber, Friedrich M Fruhwald, Robert Zweiker, Norbert Watzinger, Bernd Eber, Martie Wilders-Truschnig, Hermann Esterbauer, Werner Klein
Journal: Journal of the American College of Cardiology (1997)
A Randomized Comparison of a Single-incision Midurethral Sling and a Transobturator Midurethral Sling in Women with Stress Urinary Incontinence: Results of 12-mo Follow-up
Authors: René P. Schellart, Katrien Oude Rengerink, Frank Van der Aa, Jean-Philippe Lucot, Bart Kimpe, Dirk J.M.K. de Ridder, Marcel G.W. Dijkgraaf, Jan-Paul W.R. Roovers
Journal: European Urology (2014)
South Africa blames deaths of 22 infants on the legacy of apartheid
Authors: Pat Sidley
Journal: BMJ (2006)

South Africa's Department of Health has refused to hold anyone responsible for the deaths of 22 infants in KwaZulu-Natal after an outbreak of infection with Klebsiella bacteria in the neonatal nursery at the Mahatma Gandhi Memorial Hospital in Durban last year. It will also not be compensating parents who lost babies.

Instead it has blamed the system of apartheid, which ended in 1994, and past health systems for the failures—which its own scientific investigator said in a preliminary report were “mainly a microbiology/infection control issue.”

A final report has not been released, and parents have decided to sue for compensation. A smaller group of parents whose babies died as a result of …
Abstract 1055: Effect of embryonic stem (ES) cell-conditioned microenvironment on the reprogramming of melanoma
Authors: Myoung Ok Kim, Sung-Hyun Kim, Chul-Ho Jeong, Kun-Yeong Lee, Ke Yao, Ann M. Bode, Yong-Yeon Cho, Tim G. Bowden, Zigang Dong
Journal: Cancer Research (2011)

Abstract The cancer micro-environment affects cancer cell proliferation and growth. Embryonic stem (ES)-preconditioned 3-dimensional (3-D) culture of cancer cells induces cancer cell reprogramming and results in a change in cancer cell properties such as differentiation and migration in skin melanoma. However, the mechanism has not yet been clarified. Using the ES-preconditioned 3-D micro-environmental model, we provide evidence showing that the ES micro-environment inhibits proliferation and anchorage-independent growth of SK-MEL-5 and SK-MEL-28 human melanoma cells, which is accompanied by the down-regulation of c-jun and c-fos gene expression. We also found that the ES micro-environment suppresses telomerase activity and thereby induces senescence in SK-MEL-5 and SK-MEL-28 cells. Furthermore, we observed that gremlin, an antagonist of bone morphogenic protein 4 (BMP4), is secreted from ES cells and plays an important role in cellular senescence. Taken together, these results demonstrated that gremlin is a crucial factor responsible for abrogating cancer properties in the ES-preconditioned 3-D micro-environment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1055. doi:10.1158/1538-7445.AM2011-1055
Volume-dependent effects of positive airway pressure on intracavitary left ventricular end-diastolic pressure.
Authors: R V Ditchey
Journal: Circulation (1984)

To test the hypothesis that the effects of positive end-expiratory airway pressure (PEEP) on intracavitary left ventricular end-diastolic pressure (LVEDP) depend on the ventricular filling conditions under which PEEP is applied, the effects of PEEP on pressure in and around the left ventricle were determined before and after stepwise expansion of intravascular blood volume in 10 closed-chest dogs. Over a range of 0 to 20 cm of water, PEEP progressively increased both intrapericardial and intracavitary right ventricular end-diastolic pressures. These increases in pressure around the left ventricle were approximately linear and were relatively unaffected by volume loading. At the same time, PEEP always decreased transmural LVEDP by decreasing ventricular filling. However, transmural LVEDP fell more when ventricular volume was initially large, due to the nonlinear relationship between left ventricular transmural pressure and volume. As a result, intracavitary LVEDP (which reflected the sum of decreased transmural LVEDP and increased external pressure) increased when baseline ventricular volume was small and decreased when baseline ventricular volume was large. At intermediate volumes the fall in transmural pressure equaled the rise in external pressure, and intracavitary LVEDP did not change. These findings demonstrate that changes due to PEEP in intracavitary LVEDP are a complex function of increased intrathoracic pressure, decreased ventricular filling, and the operative level of left ventricular compliance.
Total Suppression of Urine due to Impacted Calculus, with Atrophy of the Other Kidney from a Previous Similar Condition
Authors: W. Hind
Journal: BMJ (1894)

the fenmale, and though the lheel closed the beak would Inot.Ill the witlhdrawal the lithrotite must have lacerated the uretlhra all alonig.For a few days there was slarp constitutioinal disturbance, and on this subsiding thle boy was sounded to see if any fragments remained.None were found, but thie sounding, probably by tearing open the hieal- ing laceration of the urethra, set up a freslh feverishi condi- tion, from wlichl the boy escaped by the skin of hiis teeth, and only after an abscess had formed over hiis sterno-*clavicular joint.The boy is now well as the others are.Notwithstanding this contretemps, I regard lithlolapaxy for email stones in boys as a very facile and attractive operation.If time should slhow that there is no great tendency to recurrence of stone, after this operation, owing to fragments left unremoved, it will run the lateral operation lhard as the routine operation for young males.The hiigh operation will be reserved probably for large stones unsuitable for removal .by the other methods.My remarks hiave been confined to the treatment of stone in cllildren.Later I hope to have extended statistics of .recentoperations at all ages, when I believe it will be found that the operation which gives the best results at one age does not necessarily do so at another, and that it is cliefy in elderly people that the suprapubic operation gives results superior to the lateral.
Evaluation of stability and simultaneous determination of fimasartan and amlodipine by a HPLC method in combination tablets
Authors: Hyeon Woo Moon, Abid Mehmood Yousaf, Kwan Hyung Cho, Chul Soon Yong, Jong Oh Kim, Han-Gon Choi
Journal: Asian Journal of Pharmaceutical Sciences (2014)

A simple, rapid, accurate, precise and robust HPLC method was developed for the simultaneous determination of fimasartan and amlodipine in tablet dosage form. Furthermore, stability of active ingredients was evaluated under normal and stress conditions. The isocratic elution was accomplished by Nucleosil C18 column (250 mm × 4.6 mm, 5 μm) at 40 °C. The mobile phase consisted of acetonitrile and 0.02 M monopotassium phosphate buffer (pH 2.2) in the ratio of 50:50 (v/v) was eluted at 1.0 ml/min. The eluent was monitored by the UV detector for fimasartan and amlodipine at 237 nm for 8 min, detection time. The validation of HPLC method was carried out in accordance with the ICH guidelines.
Variable risk of second primary malignancy in multiple myeloma patients of different ethnic subgroups
Authors: S Ailawadhi, A Swaika, P Razavi, D Yang, A Chanan-Khan
Journal: Blood Cancer Journal (2014)

Second primary malignancies (SPMs) among multiple myeloma (MM) patients have been reported with an estimated incidence varying from 1 to 15%. We have previously reported that significant disparity exists in MM survival across patients of different ethnicities. We undertook a Surveillance Epidemiology and End Results-based analysis to describe the incidence of SPMs among MM patients of different ethnicities, to explore the variable impact that SPMs might have on MM outcomes of patients across racial subgroups. We found that the risk of developing SPMs among MM patients is variable depending on the patient's ethnic background. This warrants further exploration of the impact of SPMs on outcomes of MM patients across different racial subgroups, especially in the form of prospective data collection and analyses.
What Are We Teaching About Indigent Patients?
Authors: Victor Tchertkoff
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The article by Miles<sup>1</sup>in<i>JAMA</i>paints a tragic portrait of the deviation of medicine from the Hippocratic oath. Do we x-ray the pocketbooks of all who enter our portals and cast aside those lacking gold bullion? Is the only altar and yardstick medicine now uses the almighty dollar? There may be some justification in limiting your private practice, but refusing to render emergency service at a not-for-profit hospital is immoral and inexcusable. It is paradoxical that despite the proliferation of departments and committees on medical ethics, self-centered, dollar-inspired medical behavior increases. How to address the problem? Carry a big club. Hospitals that permit dumping or refuse urgent medical care should lose their not-for-profit status. Physicians such as the orthopedist who refused to treat a Medicaid patient with a fracture should be censured and on repetition lose their hospital privilege. These avaricious physicians should note that
Incremental Diagnostic Value of LA Strain With Leg Lifts in Heart Failure With Preserved Ejection Fraction
Authors: Masaru Obokata, Kazuaki Negishi, Koji Kurosawa, Hitomi Arima, Rieko Tateno, Goro Ui, Shoichi Tange, Masashi Arai, Masahiko Kurabayashi
Journal: JACC. Cardiovascular imaging (2013)
Kielland's forceps delivery
Authors: J O Drife
Journal: BMJ (1984)

sion ?If treated with an up to date drug regimen what success is achieved in blood pressure reduction ?We hope to publish results within the next year, and should the MRC trial show benefits from the treatment of mild to moderate hypertension, we will be able to comment on case finding and general practitioner follow up as a practical alternative to an expensive screening technique.This will have important consequences for general practice, for the National Health Service, and, most im- portantly, for the patient.
A Large Intrathyroidal Parathyroid Adenoma Presenting as a Cold Lesion on Thyroid Scintigraphy
Authors: Kottekkattu K. Balan, Shiu Yan J. Wat, Nagabhushan Seshadri, M Barkej, E English, L Berman, Gordon C. Wishart
Journal: Clinical Nuclear Medicine (2007)

Intrathyroidal parathyroid adenomas are rare and are often misdiagnosed as thyroid nodules. Accurate diagnosis and preoperative localization is important for a successful surgical outcome, especially in the context of minimally invasive parathyroid surgery. Nuclear medicine imaging has been invaluable in differentiating between thyroid and parathyroid pathologies, but ultrasound scanning also has a prominent role. Cases of intrathyroidal adenomas showing significant uptake of Tc-99m pertechnetate appearing as a hyperfunctioning thyroid nodule have previously been reported. Using sonographic as well as scintigraphic methods of localization, we describe an unusual case of a large intrathyroidal parathyroid adenoma (confirmed on surgery), which appeared “cold” on a Tc-99m pertechnetate scan falsely giving the impression of a hypofunctioning nodule, mimicking thyroid neoplasm. The decision to proceed to surgery without a fine needle aspiration was taken because the clinical picture was more suggestive of a parathyroid adenoma/carcinoma than thyroid malignancy.
STUDIES ON AN UNCOMPLICATED CORYZA OF THE DOMESTIC FOWL
Authors: John B. Nelson
Journal: The Journal of Experimental Medicine (1933)

Three types of an uncomplicated fowl coryza, differing in the onset and duration of symptoms, developed after the intranasal injection into normal birds of exudate from natural cases. Protection tests were carried out with 2 of the types in an attempt to explain why the "bacillary" disease regularly ran a shorter course than the "exudate" disease. Reciprocal protection was demonstrated in one case, but in the other the birds which had recovered from the "bacillary" disease were susceptible to reinfection with exudate. There was no indication, however, that a second infectious agent was present in the exudate, and the failure to cross-immunize was ascribed, rather, to a reduction in the immunizing properties of the specific bacillus induced by artificial cultivation. It was also noted that the coryzas produced by exudate and bacilli, respectively, could be transmitted from infected birds to normal ones by direct contact. In both cases 1 bird out of 5 failed to contract coryza on exposure. These 2 birds were later injected with the respective agents to which they had been exposed and found to be resistant.
Hemodynamic Variables Affecting the Relation Between Mean Left Atrial and Left Ventricular End-Diastolic Pressures
Authors: ANDREW G. WALLACE, JERE H. MITCHELL, N. SHELDON SKINNER, STANLEY J. SARNOFF
Journal: Circulation Research (1963)

The observations reported in this paper support the view that a vigorous and properly timed atrial contraction, by transporting blood into the ventricle and by approximating the atrioventricular valve prior to ventricular systole, provides a mechanism by which mean atrial pressure is maintained at a substantially lower level for any ventricular end-diastolic pressure than would be the case if these functions of the atrium were not operative. The central nervous system, by way of efferent sympathetic pathways, can regulate appropriately the vigor and timing of atrial systole as well as the duration of the diastolic filling period. The net effect of such regulation is to decrease mean atrial pressure at any given heart rate and cardiac output, and to permit rapid heart rates which could not otherwise be tolerated without elevations of atrial pressure. The fact that MLAP-LVEDP is independent of aortic pressure and stroke volume, and of heart rate over certain ranges suggests that this hemodynamic measurement is uniquely dependent on, and therefore useful in the analysis of, atrial performance.
Firearm Violence and Public Health
Authors: Verner Nellsch
Journal: JAMA (1994)

<h3>To the Editor.</h3> —I read the Commentary by Adler et al,<sup>1</sup>and I could not believe that<i>JAMA</i>would ever print such gungrabbing nonsense. The Second Amendment was placed in the Constitution for a purpose, to prevent tyranny. The individual right to keep and bear arms, with the people as the militia, was designed to keep this country free. To advise some socialist scheme to deprive the people of their arms is not wise. Yes, there is a cost in lives for our Second Amendment freedoms, but there is a cost for all our freedoms. We need to be free to defend ourselves and our country. Instead of speaking of banning firearms, we should be planning education about firearms. When we speak about AIDS, we plan education, we do not ban sex and needles.
Evaluating the Effectiveness of Fish Consumption Advisories: Modeling Prenatal, Postnatal, and Childhood Exposures to Persistent Organic Pollutants
Authors: Matthew J. Binnington, Cristina L. Quinn, Michael S. McLachlan, Frank Wania
Journal: Environmental Health Perspectives (2013)

Because human exposure to persistent organic pollutants (POPs) occurs mainly through ingestion of contaminated food, regulatory bodies issue dietary consumption advisories to describe safe intake levels for food items of concern, particularly fish.
A Case of Bullet Wound of the Chest
Authors: F. A. Saw
Journal: BMJ (1900)

Laagte.The man arrived home on JanuarY 5th, xgoo, and he has since been discharged fit for duty.One man was injured at Grasspan November 25th, I899.The bullet entered at the insertion of the right deltoid, and made its exit at the left side of the tenth dorsal vertebra.Of course, in this case the man's arm was extended over his head when he received the wound.Nothing of importance was injured, and the man has returned to his duty.A soldier was wounded at Grasspan.The bullet took the following course:-Entrance over the middle of the sternum, exitin the left axilla, then entered inside of left upper m, and came out behind left elbow-joint.The left pleura is stated to have been aspirated.The man arrived home on January 17th perfectly recovered.J. McG., wounded at Colenso December Isth, had a Mauser bullet enter the right side of his chest in the first intercostal space, and ma4e its exit J inch to right of fourth dorsal spine.He does not seem to have had any special symptoms, and was quite well on1 arrival home on January 22nd.F. C., wounded at Colenso.The bu}let entered 2 inches to the left of the seventh dorsal spine, and mate its exit 3 inches above the left'nipple.He had some h moptysis for forty-eight hours, and pain on inspiration for ten days -he then recovered.M. L., was wounded at Magersfontein on December ixth by a Mauser bullet, which entered 2 inches below the middle of the right clavicle, and made its exit over the fifth dorsal vertebra.He had hamoptysis for twenty-four hours but no other symptoms.He arrived home on Janu- ary 2sth He has gone out filt for duty.B.T. was wounded at Magersfontein; the bullet entered 24 inches' internal to and below the right nipple, and Dassed out 2 inches from tIle spine o'f the eleventh dorsal vertebra.He had haemoptysis for s,even days after the wound, and rapidly got better.
Lung deposition of budesonide inhaled via Turbuhaler: a comparison with terbutaline sulphate in normal subjects
Authors: L Borgstrom, E Bondesson, F Moren, E Trofast, SP Newman
Journal: European Respiratory Journal (1994)

We wanted to evaluate whether lung deposition of budesonide and terbutaline sulphate differs, and to determine lung deposition of budesonide inhaled at different peak inspiratory flows, through Turbuhaler. Lung deposition of budesonide, a lipophilic substance, and of terbutaline sulphate, a hydrophilic substance, was therefore compared, after administration via an inspiratory flow-driven, multi-dose, powder inhaler (Turbuhaler, Astra Draco AB) to 10 healthy volunteers. The radionuclide 99mTc was used to label drug particles, and radioactivity, indicating drug deposition, was measured using a gamma camera. Budesonide was inhaled at a normal flow of 58 l.min-1 and at a slow flow of 36 l-min-1. At the faster flow, a mean +/- SD 27.7 +/- 9.5% of the metered dose was deposited in the lung and at the slower flow 14.8 +/- 3.3% was deposited (p &lt; 0.001). Mean lung deposition of terbutaline sulphate inhaled at 57 l.min-1 was 27.0 +/- 7.7%. We conclude that inspiratory flow has an important effect on lung deposition, but water solubility appears to have no effect.
Scaling up interventions to achieve global tuberculosis control: progress and new developments
Authors: Mario Raviglione, Ben Marais, Katherine Floyd, Knut Lönnroth, Haileyesus Getahun, Giovanni B Migliori, Anthony D Harries, Paul Nunn, Christian Lienhardt, Steve Graham, Jeremiah Chakaya, Karin Weyer, Stewart Cole, Stefan HE Kaufmann, Alimuddin Zumla
Journal: The Lancet (2012)