tbuckley/cabot-search huggingface dataset:
Observations on NASAL AND ORAL FOCAL SEPSIS IN THE ETIOLOGY OF GASTRO-INTESTINAL AND PULMONARY INFECTIVE DISEASES
Authors: P. Watson-Williams, F. A. Pickworth
Journal: BMJ (1928)

BIRMINGHAM.(Pathological Specimens and Rcport.)THE term " focal sepsis is usually applied in its clinical sense to established l)yogenic infection sucll as occurs wlhen an initial infective invasion, having overcome systemic and tissue defensi've reaction, persists as a chironiC localized infection.Nevertheless in patients withi n1asalpassages choked with polypus, or copiosis purulent gingivitis round the niecks of living teeth, or periapical dental abscess, one often looks in vain for systemic complications;the copious outpouring of polynmorphonuclears seems a measure of successful local riesistance to the focal infec- tioln.Clhr onic bacterial tox2aemia and-subinfection is most prone to arise from clhroonic latent focal infectionis, such as frequently occur in niasal sinusitis, With relatively noni- purulent dischar ge (sinus inifection without pus in some degree does not exist), or periapical dental sepsis, often vith no pus at all.Hence the existence of a :causAl -focal sepsis in pulmonary or gastro-initestinal infection is often to be discovered only by careful investigation.Sepsis of the mouth, pharynx, and nose may affect the lower respilratory tr'act or' gastro-initestinial tracts (a) by direct spread of infection along tlhe mucous membranies, througlh the larynx and trachea; (b)) by the blood streani or lymph-vascuilar infection; (c) by inilalation of septic particles or secretions, or by the s'wallowing of enorimoius numbers of organisms. GASTRO-INTESTINAL IN-FECTIONS.Organisms Swallowed.That patients may swallow immense ntumiibers of septic organisms with impunity is certain, for the nor mal acid gastric secretion is a potent anitiseptic barrier; but if the mass infection is continued it fairly frequently results ill gastric catarrh or gastritis, with liypoclllorhydria, constipa- tion, diarrhoca, or.recurring colitis.It would seem likely that naso-oral infection may originate local 'gastric or duodenal ulcers; or, by spreading through a' relaxed spllincter of Oddi, cholecystitis aid gall-st6fies; -o, as more commonly appealrs to happen, appendicitis.Again, Such gastro-intestissal infections may be in'directlydeterminled bv toxaemia witlh resulting endocrine exhaiiustionl.-Infection Conveycd through7t the Blood Streanm.
NIH Consensus Conference on Laparoscopic Cholecystectomy: Are Reforms Necessary?
Authors: Thomas E. Scott
Journal: JAMA (1993)

<h3>To the Editor.</h3> —As participants in the National Institutes of Health's (NIH's) most recent Consensus Development Conference, "Gallstones and Laparoscopic Cholecystectomy," held September 14-16, 1992, we were disappointed by several aspects of its process and product.<sup>1</sup>The conference consensus statement gives qualified support to the use of laparoscopic cholecystectomy, with the provision that the surgeon who performs the procedure possess the requisite training, skill, and experience. The statement offers patients no guidance, however, on what surgical training or experience should be considered adequate. The statement also notes surgeons' divided opinion on the use of intraoperative cholangiography but does not clarify the value of or indications for this procedure. As these examples suggest, the statement skirts controversy and confirms widely held views.<sup>2</sup>Some reforms in the consensus development process could help avoid such results. First, NIH staff select the conference topics without systematically assessing the clinical practice community's needs
Amino-glutethimide and Pregnancy
Authors: Thomas J. Hanson
Journal: JAMA (1974)

<h3>To the Editor.—</h3> We have recently observed the unusual association of amino-glutethimide administration with pregnancy. Amino-glutethimide is a potent inhibitor of steroid biosynthesis. It may soon be released for treatment of adrenocortical hyperfunction with excess cortisol or aldosterone secretion. The drug creates a partial block at the cholesterol desmolase reaction converting cholesterol to pregnenolone. Other blocks occur at the 21 and 11 hydroxylation reactions.<sup>1,2</sup>Genuine concern for potential side effects during gestation may be warranted in regard to the above effects, owing to this drug's relationship to thalidomide, another glutarimide. Also, the first block described is very similar to the complete defect seen in congenital lipoid adrenal hyperplasia, a fatal form with deficiencies of all steroids. <h3>Report of a Case.—</h3> A 22-year-old patient was referred for pregnancy termination at 27 weeks' gestation. A diagnosis of Cushing disease had been made elsewhere prior to conception, and she was treated with
628 RADIOFREQUENCY ABLATION VERSUS LASER ABLATION FOR THE TREATMENT OF SMALL HEPATOCELLULAR CARCINOMA: A RANDOMIZED CONTROLLED TRIAL
Authors: G.G. Pi Costanzo, R. Tortora, G. D'Adamo, A. Galeota Lanza, N. Carannante, F. Lampasi, M. De Luca, M.T. Tartaglione, C.M. Pacella
Journal: Journal of Hepatology (2011)
Southall faces accusations of ethically flawed research
Authors: Owen Dyer
Journal: BMJ (2008)

The paediatrician David Southall, who was struck off by the General Medical Council last December, faced a further GMC disciplinary panel last week into accusations that he and two colleagues conducted ethically flawed research on premature babies.

Drs Southall, Stephen Spencer, and Martin Samuels conducted research in the early 1990s at North Staffordshire Hospital into the ventilation technique known as continuous negative extrathoracic pressure. The findings, which were published in Pediatrics , concluded that the technique reduced the incidence of chronic lung disease but was associated with an increase in mortality that was “not …
The Treatment of Ruptured Liver with Absorbable Hemostatics
Authors: George W. Papen, Stanley Mikal
Journal: New England Journal of Medicine (1948)

SURGERY of the liver has lagged behind surgical operations on the other abdominal viscera, mainly because of the difficulty of controlling hemorrhage. However, with the recent development of absorbable hemostatic substances in the form of sponges and packs, control of hemorrhage from the liver can be obtained. The purpose of this paper is to present 3 cases of traumatic rupture of the liver in which hemorrhage was controlled with oxycel and gelfoam.Historical ReviewIn 1888 Langenbuch,1 with mass ligatures, controlled severe liver hemorrhage following partial resection.Kousnetzoff and Penski,2 in 1896, devised a special needle for liver suture. The . . .
Committee on Radioactive Waste Management lacks medical input
Authors: Keith Baverstock, David J Ball
Journal: BMJ (2005)

Methodological concerns about animal facilitated therapy with dolphinsEditor-We have the following concerns with Antonioli and Reveley's study of animal facilitated depression with dolphins in the treatment of depression. 1 The study was small (30 patients), only 13 people from the animal care programme and 12 from the outdoor nature programme completing the study.The authors used a conservative measure to estimate the number of patients required for this study, and even then fell short by 17%.Single women predominated in both arms.It is difficult to fathom how clinical raters can be blinded to the treatment hypothesis.The authors did not mention the ethnic group of the participants.Only people who could go to Honduras were able to take part in this study.Most people with mild depression will not be able to take a three week holiday.The findings are not generalisable as most people would not be able to afford to go to such a location and swimming and snorkeling are not necessarily favourite pastimes.There may be a vacation bias.If the study group sponsored the three week trip to Honduras we suspect that a free three week trip to a seaside location in Latin America would in itself be a powerful antidepressant.There may be a disappointment bias.If the control group were aware of the potential to be in a group where they could interact with dolphins for two weeks before they reached Honduras, they could be disappointed in missing out.People with depression perceive disappointment more intensely.The study could have been done in a more natural and plausible setting with common pets such as dogs or cats for a fraction of the cost.
Epithelial Cell Death Is an Important Contributor to Oxidant-mediated Acute Lung Injury
Authors: G. R. Scott Budinger, Gökhan M. Mutlu, Daniela Urich, Saul Soberanes, Leonard J. Buccellato, Keenan Hawkins, Sergio E. Chiarella, Kathryn A. Radigan, James Eisenbart, Hemant Agrawal, Sara Berkelhamer, Siegfried Hekimi, Jianke Zhang, Harris Perlman, Paul T. Schumacker, Manu Jain, Navdeep S. Chandel
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Acute lung injury and the acute respiratory distress syndrome are characterized by increased lung oxidant stress and apoptotic cell death. The contribution of epithelial cell apoptosis to the development of lung injury is unknown.To determine whether oxidant-mediated activation of the intrinsic or extrinsic apoptotic pathway contributes to the development of acute lung injury.Exposure of tissue-specific or global knockout mice or cells lacking critical components of the apoptotic pathway to hyperoxia, a well-established mouse model of oxidant-induced lung injury, for measurement of cell death, lung injury, and survival.We found that the overexpression of SOD2 prevents hyperoxia-induced BAX activation and cell death in primary alveolar epithelial cells and prolongs the survival of mice exposed to hyperoxia. The conditional loss of BAX and BAK in the lung epithelium prevented hyperoxia-induced cell death in alveolar epithelial cells, ameliorated hyperoxia-induced lung injury, and prolonged survival in mice. By contrast, Cyclophilin D-deficient mice were not protected from hyperoxia, indicating that opening of the mitochondrial permeability transition pore is dispensable for hyperoxia-induced lung injury. Mice globally deficient in the BH3-only proteins BIM, BID, PUMA, or NOXA, which are proximal upstream regulators of BAX and BAK, were not protected against hyperoxia-induced lung injury suggesting redundancy of these proteins in the activation of BAX or BAK.Mitochondrial oxidant generation initiates BAX- or BAK-dependent alveolar epithelial cell death, which contributes to hyperoxia-induced lung injury.
Effects of practolol on exercise tolerance and cardiac haemodynamics and metabolism in patients with coronary artery disease
Authors: G. R. DAGENAIS, A. MOISAN, Y. MARQUIS, R. O. DAVIES, S. BLOUIN
Journal: Cardiovascular Research (1976)

Sixteen male patients with typical angina pectoris secondary to coronary atherosclerosis performed two daily standardized exercise tests during two consecutive days. Three hours before each exercise they received placebo or 400 mg practolol administered orally in double-blind fashion in order to complete a cross-over design. Practolol significantly prolonged the exercise duration by 30.6% and delayed the appearance time of ischaemic electrocardiographic changes by 67.7%. Maximal heart rate, systolic pressure, and pressure-rate product were also reduced after medication. In order to investigate further the effects of this beta blocking agent, myocardial function and metabolism at rest and during supine exercise were assessed in 12 male patients with coronary artery disease before and after practolol 30 mg, iv. At rest, practolol produced a decrease in tension-time index (18%), cardiac index (17%), heart rate (10%), and stroke index (7%). A significant reduction was also observed in resting stroke work index (14%) and systolic and mean aortic pressure (6%). Left ventricular end-diastolic pressure remained unchanged. During supine exercise, only time-tension index (12%), heart rate (12%), and cardiac index (10%) were significantly reduced after the beta blocking agent. Practolol did not significantly change the arterial glucose, lactate, inorganic phosphate, potassium, calcium, magnesium, pH, PCO2, or PO2. The beta blocking agent did not modify the myocardial extraction of any of these substrates at rest or during exercise. In the dosage used in both studies, practolol significantly improved the exercise tolerance and reduced the ischaemic manifestations. The efficacy of practolol in angina pectoris may result mostly from its ability to decrease heart rate and systolic pressure during exercise.
Studies on the Control of Hypertension. VII. Effects of Ganglionic Blockade Combined With Hydralazine on the Malignant Stage Complicated by Renal Azotemia
Authors: H. MITCHELL PERRY, HENRY A. SCHROEDER
Journal: Circulation (1956)

The malignant stage of arterial hypertension complicated by azotemia is usually a rapidly fatal disorder. The elevated blood pressures of 82 patients in this stage were chronically lowered by the regular, continued use of oral ganglionic-blocking agents and hydralazine hydrochloride in doses sufficient to control their hypertension without provoking dangerous hypotension or further azotemia. By careful administration of these potent antihypertensive drugs the mortality rate of azotemic patients was significantly reduced. The malignant stage of hypertension that has progressed to moderate renal insufficiency is no longer a rapidly fatal disease when properly treated, while that which has progressed further is usually uninfluenced.
Fenoterol Inhalation Powder and Aerosol in the Treatment of Asthma
Authors: K. Kiviranta
Journal: Allergy (1985)

Twenty patients with asthma were studied. They were given either fenoterol powder or fenoterol MDI for 2‐week periods using a double‐blind cross‐over design. Identical doses of fenoterol (0.2–0.4 mg 2–4 times daily) were given to an individual patient throughout the 4‐week study period. Both forms of treatment produced an almost identical bronchodilation, and there were no statistically significant differences in symptoms or side effects. It is concluded that fenoterol powder and fenoterol aerosol are equally effective.
Phospholamban: A Prominent Regulator of Myocardial Contractility
Authors: Kimberly L. Koss, Evangelia G. Kranias
Journal: Circulation Research (1996)

Our understanding of the role of phospholamban in cardiac physiology has evolved over the past two decades to the point where this protein is now understood to be a critical repressor of myocardial contractility. Phospholamban, through its inhibitory effects on the affinity of the cardiac sarcoplasmic reticulum Ca2+ pump for Ca2+, represses both the rates of relaxation and contraction in the mammalian heart. These inhibitory effects can be relieved through (1) phospholamban phosphorylation, (2) down-regulation of phospholamban gene expression, and (3) disruption of the phospholamban-Ca(2+)-ATPase interaction. Thus, genetic approaches and pharmacological interventions, designed to relieve the phospholamban inhibitory action on the cardiac sarcoplasmic reticulum Ca2+ pump and myocardial relaxation, may prove valuable in reversing the effects of several diseases in the mammalian heart. Such interventions could be designed to inhibit the phospholamban phosphatase, stabilize the phosphorylated state of phospholamban, interrupt the phospholamban-Ca(2+)-ATPase interaction, decrease phospholamban transcription, or disrupt phospholamban mRNA stability. Development of such therapeutic strategies to target phospholamban will be an important future goal for the clinical improvement of contractility in the failing heart.
CILOSTAZOL ENHANCES MOBILIZATION AND PROLIFERATION OF CIRCULATING ENDOTHELIAL PROGENITOR CELLS AND COLLATERAL FORMATION MEDIATED BY MODIFYING VASCULO–ANGIOGENIC BIOMARKERS IN PATIENTS WITH PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
Authors: Ting–Hsing Chao, Shih–Ya Tseng, Yi–Shan Tsai, Yao–Yi Huang, Ping–Yen Liu, Horng–Yih Ou, Yi–Heng Li, Guey–Yueh Shi, Hua–Lin Wu, Jyh–Hong Chen
Journal: Journal of the American College of Cardiology (2013)
Ga-67 Scintigraphy in a Rare Case of Primary Pleural Hodgkin’s Lymphoma
Authors: HANNA BERNSTINE, ZVI BAR-SEVER, JOSEF EKSTEIN, RUTH HARDOFF
Journal: Clinical Nuclear Medicine (1999)

The use of Ga-67 scintigraphy in Hodgkin’s disease is well documented. Ga-67 uptake in the pleura has been described in cases of bacterial infection, tuberculosis, non-Hodgkin’s lymphoma, thoracic sarcoidosis, and mesothelioma. We report an unusual case of a patient with fever of unknown origin and a history of low-grade lymphoma in which Ga-67 SPECT showed pleural uptake caused by isolated Hodgkin’s disease.
To opt in or opt out of electronic patient records?: Integration technology is key to success
Authors: Jon M Orrell
Journal: BMJ (2006)

EDITOR—Watson's case that patients should have to opt out of national electronic care records is compelling.1 In the Hampshire and Isle of Wight's successful records service, however, the key feature was the use of computer integration software (XML Graphnet), which provided a breakthrough in confidentiality while linking diverse and unrelated systems together.

The alternative method …
The Recurrence of Gestational Diabetes: Could Dietary Differences in Fat Intake Be an Explanation?
Authors: Robert G Moses, Judi L Shand, Linda C Tapsell
Journal: Diabetes Care (1997)

OBJECTIVE To present the results of a comprehensive dietary review of a group of women with a recurrence of gestational diabetes mellitus (GDM), compared with a group of women with no recurrence of GDM during a subsequent pregnancy. RESEARCH DESIGN AND METHODS The dietary intake of 14 women with a recurrence of GDM was compared with 21 women with no recurrence of GDM. Women with GDM in one pregnancy have a recurrence rate of only 30–50%. While the reasons for this have not been determined, dietary factors have been considered probable. RESULTS The women with a recurrence of GDM consumed 38.4 (by diet history) and 41.4% (by food record) of their total energy intake as fats, compared with 34.1 (P &amp;lt;0.01) and 33.1% (P &amp;lt;0.001), respectively, for women with no recurrence. The percentage intake of polyunsaturated, monounsaturated, and saturated fatty acids was similar in both groups. There was a proportionate reduction in carbohydrate intake as a percentage of total energy and in fiber intake in grams for the women with a recurrence of GDM. CONCLUSIONS When the relationship between saturated fat intake and insulin resistance is considered, the possibility exists that dietary modification of fat intake before and during pregnancy may reduce the recurrence rate of GDM.
SOME SUGGESTIONS FOR MORE ACCURATE MENTAL THERAPY IN EPILEPSY
Authors: L. PIERCE CLARK
Journal: JAMA (1918)

one other case, one which occurred many years ago, which presented the same diagnostic problem.Dr. Ralph Reed, Cincinnati : It is important to remember that there may be an exhaustion of psychogenetic origin.I readily concede that many of the psychoses are of toxic origin and also many of the neuroses, but I believe that there is a
AMMONIA AS A SOURCE OF GASTRIC HYPOACIDITY IN PATIENTS WITH UREMIA *
Authors: Charles S. Lieber, André Lefèvre
Journal: Journal of Clinical Investigation (1959)

Ammonia is produced when urea passes from the blood into gastric secretion, a reaction catalyzed by a urease, present in the gastric mucosa of man and several animals (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).Fitzgerald and Murphy (15) have suggested that the ammonia formed in this process may have an important protective function by neutralizing gastric acidity.This concept was based on the observation in man that administration of urea in amounts sufficient to raise temporarily the blood urea level by 12 mg.per cent was followed by a decrease of gastric acidity.Burke and Page ( 16) were unable to confirm these findings, and Kornberg, Davies and Wood (17-19) presented evidence which sug- gested that, at least in the cat, the urease found in the stomach is of bacterial origin and does not in- fluence gastric acid secretion.This paper compares gastric ammonia and acid contents in normal and uremic subjects, the latter known to exhibit an elevated gastric ammonia concentration (20-22).Because of the influence of antibiotics on intestinal ammonia production (23-25), their effects on gastric ammonia and acid concentration were studied. MATERIALS AND METHODSFifty hospitalized subjects were studied, 24 without evidence of renal dysfunction, 25 with uremia due to chronic renal disease, and one with azotemia due to obstructive uropathy.The blood urea concentration in the patients with uremia varied from 40 to 174 mg.nitrogen per cent with an average of 100.5 mg.N per cent.The patients were fasted for 16 hours and gastric juice collected by a Levine tube with the patients placed in the left lateral position, as proposed by Henning (26), to facilitate the quantitative recovery of gastric secretion (27).After a 45 minute period of stabilization, gastric juice was as-
Involuntary Smoking in the Restaurant Workplace
Authors: Michael Siegel
Journal: JAMA (1993)

<h3>Objective.</h3> —To determine the relative exposure to environmental tobacco smoke for bar and restaurant employees compared with office employees and with nonsmokers exposed in the home (part 1) and to determine whether this exposure is contributing to an elevated lung cancer risk in these employees (part 2). <h3>Data Sources.</h3> —MEDLINE and bibliographies from identified publications. <h3>Study Selection.</h3> —In part 1, published studies of indoor air quality were included if they reported a mean concentration of carbon monoxide, nicotine, or particulate matter from measurements taken in one or more bars, restaurants, offices, or residences with at least one smoker. In part 2, published epidemiologic studies that reported a risk estimate for lung cancer incidence or mortality in food-service workers were included if they controlled, directly or indirectly, for active smoking. <h3>Data Extraction.</h3> —In part 1, a weighted average of the mean concentration of carbon monoxide, nicotine, and respirable suspended particulates reported in studies was calculated for bars, restaurants, offices, and residences. In part 2, the relative lung cancer risk for food-service workers compared with that for the general population was examined in the six identified studies. <h3>Data Synthesis.</h3> —Levels of environmental tobacco smoke in restaurants were approximately 1.6 to 2.0 times higher than in office workplaces of other businesses and 1.5 times higher than in residences with at least one smoker. Levels in bars were 3.9 to 6.1 times higher than in offices and 4.4 to 4.5 times higher than in residences. The epidemiologic evidence suggested that there may be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco smoke exposure in the workplace. <h3>Conclusions.</h3> —Environmental tobacco smoke is a significant occupational health hazard for food-service workers. To protect these workers, smoking in bars and restaurants should be prohibited. (<i>JAMA</i>. 1993;270:490-493)
An Address on the Physiology and Pathology of the Thyroid Gland: Delivered before the Medical Society of London
Authors: V. Horsley
Journal: BMJ (1896)

I TAKE it that what ought to be the substance of what I say to-night is the relationship of scientific laboratory investiga- tion to the progress and improvement of therapeutics.This, however, if treated with severe accuracy, would practically amount to a recapitulation of historical facts which are in the main very familiar to you.I do not therefore propose to expend more than a short period of the hour allotted to me in touching upon old ground, but I desire to lay before you some conclusions derived from observations which I made in I884-85-86, but have withheld from publication until now, for the reason that so many side issues came in from the original facts and required collateral investigation that I confess I was tempted to put the points aside in favour of more easily attainable knowledge, and which, at least in the case of cerebral localisation, proved of somewhat more immediate value.