tbuckley/cabot-search huggingface dataset:
Insulin-induced hypoglycaemia in an accident and emergency department: the tip of an iceberg?
Authors: J Potter, P Clarke, E A Gale, S H Dave, R B Tattersall
Journal: BMJ (1982)

<h3>Background</h3> Pre-race respiratory tract symptoms (RTS) in Ironman triathletes appear to be common but the incidence and risk factors for pre-race RTS have not been well studied. <h3>Objective</h3> The objectives of this study were to determine the incidence of RTS in triathletes preparing for an Ironman Triathlon and to establish the risk factors associated with pre-race RTS. <h3>Setting</h3> International Ironman Triathlon competition. <h3>Participants</h3> 304 triathletes entering the Ironman triathlon were recruited. <h3>Assessments</h3> All the subjects completed a validated questionnaire in the 1–3 days before the race that contained sections on demographics, training and previous competitions, and a detailed section pertaining to RTS and allergies. Data on race performance were collected after the race. Subjects were divided into the following groups, based on their self-reported history of RTS in the 6 week and 1 week period prior to the race: no RTS, all RTS, only upper respiratory tract symptoms (URTS), lower respiratory tract and/or systemic symptoms (LRT+SS). <h3>Measures of outcome</h3> Incidence (%) of triathletes with RTS in the 6 weeks and 1 week before the race and factors associated with pre-race RTS. <h3>Results</h3> The main findings in this study were that 49% of the Ironman triathletes reported RTS in the 6-week period before competition. There was a strong association between self reported RTS in Ironman triathletes and a history of self reported allergies rather than training volume (in the 15 weeks before the race). Self-reported LRT+SS but not URTS in triathletes were associated with decreased training in the 6 weeks before the race. <h3>Conclusion</h3> Triathletes, in preparation for a race, report a high incidence of RTS, which appear to be related to allergies rather than other factors including training volume or the calibre of the athlete.
Beyond the Supreme Court Ruling on Alcoholism as Willful Misconduct: It Is Up to Congress to Act
Authors: Thomas V. Seessel
Journal: JAMA (1988)

By the narrowest of margins in a complicated case, the US Supreme Court on April 20 upheld the Veterans Administration (VA) ruling that two recovering alcoholic Army veterans were not entitled to an extension of time in which to use their GI Bill education benefits. The Court explicitly did not decide whether alcoholism is a disease.<sup>1</sup> In this case, Eugene Traynor and James P. McKelvey had requested additional time beyond their ten-year entitlement for GI benefits. They were unable to complete college in the ten-year period because of their alcoholism. They were not seeking special benefits. Granting the extension would not have entailed any additional government expenditures beyond those that would have been spent within the ten-year entitlement. The VA may grant an extension in cases where a disability prevents use of the benefits in ten years, provided the disability was not the result of "willful misconduct. "<sup>2</sup>The
Haematology in Diagnosis and Treatment
Authors: Scott N. Swisher
Journal: JAMA (1969)

Of all the authors who in a preface threaten to write a book for student use, very few actually do so. Most works started with this intent are directed ultimately to the author's peers or to the advanced student. The resulting effort to make the book comprehensive usually makes it incomprehensible to the beginning student. Construction of a textbook must proceed primarily from pedagogic principles rather than from the structure of knowledge in the field under consideration. Unfortunately, there are relatively few true student textbooks. The above is preliminary to saying that Drs. Maizels, Prankerd, and Richards have made an honest effort to carry out their intent of producing a book on a broad range of topics in hematology for student needs. Many topics are introduced almost as definitions, and without much development. However, this leaves room for the didactically important issues such as correlation of pathological physiology, laboratory derived
Diagnosis of aortic aneurysm using autologous platelets labelled with indium-111.
Authors: A Fenech, J K Hussey, F W Smith, P P Dendy, B Bennett, A S Douglas
Journal: BMJ (1981)

values.Blood and urine cultures, chest radiography, and complement fixation tests for mycoplasmas and herpes simplex were negative.Antinuclear antibody titre was 1/160.Serum C4 concentration was 0-14 g/l (normal range 0-2-0-5 g/l), and C3 concentration was normal.Skin biopsy showed acute haemorrhagic vasculitis.lI E~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ _ l01 l EiiJ!L~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~... ........
Specula Made of Glass
Authors: J. Murphy
Journal: BMJ (1877)

with nothing on but his shirt, quite quiet, having a cup of tea by his side, and playing with the spoon in the tea.He held his head down somewhat, and had a sullen, sulky look about him ; but beyond that he seemed hardy and well.He complained of pain and showed me where it hurt him by putting his hands to his throat and epigastrium.The tongue was coated except at the tip and edges.The fauces looked
Screening and treatment of Chlamydia trachomatis infections
Authors: S. Kalwij, M. Macintosh, P. Baraitser
Journal: BMJ (2010)

#### Summary points

Chlamydia trachomatis is the most commonly diagnosed bacterial sexually transmitted infection worldwide.1 2 Numbers of diagnoses have increased over the past 10 years as a result of more sensitive tests and increased testing. Genital infection with C trachomatis is asymptomatic in 50-88% of men and women,w1 and 46% of infections clear spontaneously within a year.3

#### Sources and selection criteria

We searched Medline databases for Chlamydia trachomatis , chlamydia screening, pelvic inflammatory disease, and ectopic pregnancy. We looked at guidelines from the National Institute for Health and Clinical Excellence and the Scottish Intercollegiate Guidelines Network, in addition to reports from the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and World Health Organization.

Persistent chlamydia infection can lead to pelvic inflammatory disease, ectopic pregnancy, and tubal infertility in womenw2 and epididymitis and epididymo-orchitis in men.2 Here, we describe the diagnosis and management of chlamydia and discuss control strategies. Guidance on the laboratory diagnosis and treatment of chlamydia has a strong evidence base, but evidence on the natural course of infection and optimum control strategies is less robust.

Infection can occur at any age but is most common in people under 25,w3 with rates of diagnosis peaking …
THE CAMPAIGN AGAINST DIPHTHERIA AND SCARLET FEVER IN CHICAGO
Authors: I. D. RAWLINGS
Journal: JAMA (1910)

Tbc above claims are based on experiments performed on dogs.The transfusion of blood was obtained by em¬ ploying veins; as jugular to jugular or better, jugular to femoral, in Ibis way eliminating any possible negative pressure or siiclion.No difficulty was encountered in successfully transfusing enough blood to resuscitate a dog that was practically exsanguinated.This experi¬ ment could be repeated again anil again on Ibe sume dog by clumping Ibe donor's vessel and bleeding the recip¬ ient until practically pulseless; (be clump was then removed and the blood allowed lo enter the recipient's circulation until Ibe pulse and respiration returned to normal, while symptoms of hemorrhage developed in the donor.Communication between the veins was estab¬ lished by means of Sweet's modification of Payr's tubes.In concluding, we wisli to express our appreciation of the services rendered by Messrs, Burleigh, llnywiird, Pitt and McElbone, undergraduates in the University of Pennsylvania.No'l'io.-After this paper liad been put in type, we performed a vein-to-vein transfusion on ¡i woman for a very severe hemorrhage following a ruptured extrauterino pregnancy.The pulse before was very weak and rapid, about 160 per minute, Five minutes a Her the medial cephalic of the husband was connected to the median cephalic of the wife the pulse was much fuller and 140 per minute.After the blood had Sowed thirty minutes the pulse was good, full and 120 per minute.No abnormal heart sounds could be heard,
More than half of smokers go on smoking after coronary events
Authors: Zosia Kmietowicz
Journal: BMJ (2005)

<h3>Introduction</h3> Intracranial dural arteriovenous fistulas (dAVFs) with perimedullary drainage are an uncommon but well-recognized lesion that can lead to spinal cord edema. The authors present a case of a foramen magnum dAVF with unilateral arterial supply from the ascending pharyngeal artery. <h3>Presentation</h3> A 49-year-old male presented with a 1-year history of slowly progressive lower extremity weakness and underwent a two-level cervical corpectomy for presumed spondylotic myelopathy. On further workup, he was found to have a dAVF arising from the ascending pharyngeal artery. <h3>Intervention</h3> Selective angiography revealed the origin of the neuromeningeal trunk, which was proximal to the arteriovenous fistula. The microcatheter was advanced into the neuromeningeal trunk past the origin of the inferior tympanic artery and origin of the hypoglossal artery. A 4×7 mm Hyperform balloon (EV3, Irvine, California, USA) was then delivered past the origin of the vessel supplying the skull base cranial nerves, but proximal to the microcatheter tip. The balloon was inflated and Onyx embolization was employed to obliterate the fistula with controlled penetration. The patient showed immediate postprocedural improvement in motor function. <h3>Discussion</h3> Embolization of branches of the ascending pharyngeal artery carries risks of inadvertent embolization of branches of the neuromeningeal trunk as well as the risk for extracranial to intracranial anastamoses. An awareness of the highly variable anatomy of the ascending pharyngeal artery is necessary for the safe treatment of lesions supplied by this artery. This is, to the authors9 knowledge, the first report of balloon-augmented embolization of an arteriovenous fistula arising from the neuromeningeal trunk.
Coitus and Associated Amniotic-Fluid Infections
Authors: Richard L. Naeye
Journal: New England Journal of Medicine (1979)

Data were analyzed from 26,886 pregnancies to determine whether coitus is involved in the genesis of amniotic-fluid infections. The frequency of infection was 156 per thousand births when mothers reported coitus once or more per week during the month before delivery, versus 117 per thousand when no coitus was reported (P<0.001). The percentage of infected infants who died was 11.0 when there was coitus versus 2.4 when there was no coitus (P<0.001). The frequencies of low Apgar scores, neonatal respiratory distress, and hyperbilirubinemia were about doubled when mothers reported coitus. The coitus-associated effects were greater in preterm than in full-term infants. The pregnancies in the study took place between 1959 and 1966, when national perinatal mortality rates were higher than they are now. Deaths from coitus-associated infections may be less frequent today. (N Engl J Med 301:1198–1200, 1979)
Pericardial adaptation in severe chronic pulmonary hypertension. An intraoperative transesophageal echocardiographic study.
Authors: D G Blanchard, H C Dittrich
Journal: Circulation (1992)

BACKGROUND The pericardium both limits cardiac distension and accentuates ventricular interdependence. Although this effect appears minimal under normal circumstances, the pericardium markedly restricts acute cardiac enlargement. Animal studies have demonstrated gradual pericardial adaptation and expansion in chronic volume overload and cardiomegaly, but the pericardial response in humans with cardiac hypertrophy and enlargement has not been examined fully. To investigate this further, 14 patients with right ventricular hypertrophy and cardiomegaly secondary to chronic pulmonary thromboembolic disease and severe pulmonary hypertension were studied during pulmonary thromboendarterectomy. METHODS AND RESULTS Simultaneous intraoperative transesophageal Doppler echocardiography and direct biventricular hemodynamic measurements were performed at steady state immediately before and after pericardiotomy. All hemodynamic variables showed no significant change before and after pericardiotomy, including heart rate (76 +/- 16 versus 75 +/- 15 beats per minute), mean pulmonary arterial pressure (46.3 +/- 11.1 versus 45.5 +/- 11.7 mm Hg), cardiac index (1.8 +/- 0.5 versus 2.0 +/- 0.6 l/min/m2), left ventricular end-diastolic pressure (5.9 +/- 5.7 versus 7.1 +/- 5.0 mm Hg), and right ventricular end-diastolic pressure (7.9 +/- 6.6 versus 8.0 +/- 6.7 mm Hg). Similarly, there were no significant changes in all Doppler echocardiographic parameters, including right ventricular end-diastolic area (23.2 +/- 5.7 versus 22.6 +/- 5.4 cm2), left ventricular end-diastolic area (15.3 +/- 5.9 versus 15.5 +/- 4.4 cm2), the position of the interventricular septum, and the Doppler-derived mitral inflow measures of diastolic function. CONCLUSIONS The pericardium appears to have little influence on the marked cardiac and septal deformations seen in patients with chronic, severe right ventricular pressure overload and cardiomegaly. This study confirms that the human pericardium is capable of adapting over time to changes in cardiac size and geometry.
The Surgical Treatment of Malformations of the Heart
Authors: Alfred Blalock
Journal: JAMA (1984)

Heretofore there has been no satisfactory treatment for pulmonary stenosis and pulmonary atresia. A "blue" baby with a malformed heart was considered beyond the reach of surgical aid. During the past three months we have operated on 3 children with severe degrees of pulmonary stenosis and each of the patients appears to be greatly benefited. In the second and third cases, in which there was deep persistent cyanosis, the cyanosis has greatly diminished or has disappeared and the general condition of the patients is proportionally improved. The results are sufficiently encouraging to warrant an early report. The operation here reported and the studies leading thereto were undertaken with the conviction that even though the structure of the heart was grossly abnormal, in many instances it might be possible to alter the course of the circulation in such a manner as to lessen the cyanosis and the resultant disability. It is
Apert syndrome results from localized mutations of FGFR2 and is allelic with Crouzon syndrome
Authors: Andrew O.M. Wilkie, Sarah F. Slaney, Michael Oldridge, Michael D. Poole, Geraldine J. Ashworth, Anthony D. Hockley, Richard D. Hayward, David J. David, Louise J. Pulleyn, Paul Rutland, Susan Malcolm, Robin M. Winter, William Reardon
Journal: Nature Genetics (1995)
Essential and non-essential amino acid requirement in injured patients receiving total parenteral nutrition
Authors: G. Iapichino, D. Radrizzani, A. Scherini, R. Malacrida, G. Bonetti, L. Leoni, P. Della Torre, G. Ronzoni, A. Colombo, M. Marengo, G. Damia
Journal: Intensive Care Medicine (1988)
Brain death. I. A status report of medical and ethical considerations
Authors: F. J. Veith
Journal: JAMA (1977)

Use of neurologic criteria to pronounce death, although accepted by many, has caused controversy among physicians, lawyers, legislators, philosophers, and theologians. The present work attempts to resolve this by accomplishing four objectives. (1) It summarizes scientific information that establishes the ability to determine the state of brain death with certainty on the basis of presently available clinical and laboratory criteria. (2) It shows that the concept of brain death is in accord with secular philosophy and the three major Western religions. (3) It documents the need for legislative recognition that death may be pronounced on the basis of neurologic criteria. (4) It reviews the present status of judicial and statutory law relating to the determination of death in the United States. (<i>JAMA</i>238:1651-1655, 1977)
THE SIGNIFICANCE OF THE VESSELS OF THE SKIN IN ESSENTIAL HYPERTENSION
Authors: J. Murray Steele, Esben Kirk
Journal: Journal of Clinical Investigation (1934)

Evidence of a varied nature has led to the widely accepted conclusion that one of the significant factors leading to elevation of the blood pressure in essential hypertension is constriction of the arterioles.A thorough re- view of the literature dealing with this problem has recently been published by Fishberg (1) and tends to show that the most important vascular terri- tory involved in this mechanism is the splanchnic region.The evidence is, as has been said, varied.As long ago as 1875 Litten (2) observed that tying off the superior mesenteric artery in dogs was fol- lowed promptly by rise of arterial pressure of from twenty to twenty-five
Stem cell highways: signalling beats trafficking?
Authors: M. Sampaolesi, S. Janssens
Journal: Cardiovascular Research (2013)

This editorial refers to ‘Migratory activity of circulating progenitor cells and serum SDF-1α predict adverse events in patients with myocardial infarction’ by O. Fortunato et al. , pp. 192–200, this issue. 

After the oocyte is fertilized, the resulting one-cell zygote gives rise to all stem cell progenies. During the developmental process, these cells are necessary to generate all specialized tissues. However, some of them elude the specification cues and remain quiescent in the adult tissue, as long as the organism does not suffer from injury, illness, or specific cell-type depletion. Most adult stem cells are quiescent,1 others, such as the intestinal stem cells, are very active and feature intense self-renewal kinetics.2 Nevertheless, when these adult stem cells are awakened by an injury or alerted upon the body's request, they need to move on and reach the damaged area using special routs known as cellular highways ( Figure 1 ). The more advanced the illness, the less the number of stem cells remaining in stock. Their ability to migrate effectively into damaged or diseased tissues makes the stem cells promising candidates for cell therapy. Unfortunately, cellular highways can also be used by cancer (stem-) cells during metastasis, e.g. when CXCR4-expressing tumour cells migrate into the lung, liver, bone marrow, and brain, matching high levels of presented SDF-1α.3 



Figure 1 
SDF-1α/CXCR4 cellular highway. Chemokines control cellular traffic by directing cells that express certain chemokine receptors to specific locations where their ligands are abundant. Besides PCs (circulating progenitor cells) other stem cell types could be recruited in specific cellular highways according to their chemokine receptor expression. ESCs, embryonic stem cells; iPSCs, induced pluripotent stem cells; MABs, mesoangioblasts; MADS, multipotent adipose-derived stem cells.



Fortunato et al. 4 explore the SDF-1α/CXCR4 cellular highway in the context of cardiac damage, highlighting the correlation between SDF-1α plasma concentration and …
Carbamazepine induced systemic lupus erythematosus: case report.
Authors: D E Bateman
Journal: BMJ (1985)

Premiere observation publiee d'un lupus erythemateux dissemine provoque par la carbamazepine (utilisee pour le traitement de crises convulsives chez une malade de 30 ans). Amelioration apres suppression de la carbamazepine, continuation de la phenobarbitone et 6 mois de prednisolone
WATER SUPPLY OF DAIRY FARMS.
Authors: G. LLOYD MAGRUDER
Journal: JAMA (1907)

The influence of a polluted water supply has long been recognized as a most potent cause of disease. Many virulent epidemics have been directly traced to this origin. The literature on this subject is so full of instances that it is needless to cite additional examples. Immediate closure of such water supplies in cities, when sewage bacteria have been detected, has been universally recommended. The recent report to the District Commissioners by the Bureau of Public Health and Marine-Hospital Service lays special stress on this point. How much more is this danger augmented when such bacteria arc found in the water supply of the dairy farms. It is well known that few farms have the proper facilities for boiling the water that is used for washing the hands of the employés, the dairy utensils and the udders of cows. Such water readily contaminates the milk, which contamination is rapidly increased
Nitrous Oxide-Oxygen Sedation-Reply
Authors: Glen C. Griffin
Journal: JAMA (1982)

In Reply.—  Although NIOSH standards for nitrous oxide levels in ambient air vary depending on its designated use, ie, dental offices vs operating rooms, Dr Spooner's suggestion that nitrous oxide levels be kept low by techniques such as scavenging is well taken. We have approached this in two ways.  A scavenger system has been installed in our office. Unfortunately, we were too late in our attempt to add a footnote to the original article recommending that scavenger equipment be included with every nitrous oxide sedation system.  Also, we have changed flow meters, so much less nitrous oxide is used and discharged into the room. The new flow meters control the concentration of nitrous oxide so it can never exceed 70%. With this equipment, flow rates as low as 1 to 2 L/min of nitrous oxide and 1 to 2 L/min of oxygen are usually sufficient. This substantially reduces the amount
Hypertension Detection and Follow-up
Authors: Robert B. Taylor
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The report by the HDFP Cooperative Group presents important evidence in favor of SC of hypertension but raises important issues concerning the influence of life-style change. The report cites a 17% lower five-year mortality for the SC group as compared with the RC group. However, the former group received not only medication but limited counseling concerning weight control, diet, and smoking. Health promotion is a social force that promises to have profound influence on medical care in the future.<sup>1</sup>Epidemiologic studies have shown that health practices can bring a dramatic decrease in mortality. A 45-year-old American man performing six or seven specific health practices has an 11-year greater life expectancy than if he adheres to three or less; the increase in longevity for a 45-year-old woman is seven years.<sup>2</sup>By contrast, all of the new drugs and scientific advances from 1900 to 1970 have increased
US reconsiders use of seclusion and restraints in psychiatric patients
Authors: F. Charatan
Journal: BMJ (1999)

The US Health Care Financing Administration has issued an interim rule detailing psychiatric patients' rights to freedom from seclusion and the use of restraints unless clinically necessary.

The new rule has added a patients' rights clause to the conditions of participation for hospitals in the Medicare and Medicaid programmes, which will affect 6200 hospitals across the United States.

The …
An Unusual Cause of Solitary Hepatic Abscess
Authors: A. K. Yates
Journal: BMJ (1959)

BMRnA~~~MEDICAL JOL-PAL without a detectable loss occurring in the antigenic activity of all of its three components.It is suggested that refrigeration at 00 C. to 10°C.would be equally suitable.At higher temperatures, such as 210 C. and 31°C., the activity is much less stable, especially in the case of the type 1 component.It is important, therefore, that transportation of unrefrigerated vaccine in temperate climates should be carried out in as short a time as possible.Since considerable reduction in the activity of the type 1 component was found to occur after 40 days' storage at 210 C., it is suggested that vaccine should not be held unrefrigerated for periods longer than seven days.It is also suggested, in view of the rapid loss in activity which was shown to occur at 310 C., that transportation of vaccine in tropical climates should not be carried out without refrigeration facilities.We thank the Glaxo Laboratories and Eli Lilly and Company for the supply of poliomyelitis vaccine.We also thank Miss K. South and Miss P. Tumber for their technical assistance.