tbuckley/cabot-search huggingface dataset:
Tight jeans as a compression garment after major trauma.
Authors: J H Scurr, P Cutting
Journal: BMJ (1984)

A propos d'une observation: un jeune homme atteint de traumatisme grave dans un accident de la route, portant un jeans tres serre avec une ceinture de cuir tres large, n'est pas en etat de choc en arrivant a l'hopital. Des que les vetements sont coupes l'abdomen et la jambe augmentent de volume et la tension arterielle s'effondre: hemorragies internes multiples necessitant une reanimation (fracture du bassin)
Once bitten, twice shy
Authors: J Marshall, E Sharp, I G Barrison
Journal: BMJ (1994)

Confronted by the recurrence of abscesses without any relevant medical history, we could only treat the patient with drainage and antibiotics. The cause of the problem turned out to be rather unexpected.

A 24 year old woman presented with fever and an abscess in her left antecubital fossa. She claimed that three weeks previously she had attended a blood donor session and an attempted cannulation at the site of the abscess had been unsuccessful. General examination was otherwise unremarkable and the only admitted history was of tonsillectomy, appendicectomy, and extraction of wisdom teeth. Incision and drainage of the abscess in the left antecubital fossa was undertaken on the night of admission and a s haemolytic streptococcus and Escherichia coli were grown from the pus evacuated.

Her fever settled with intravenous antibiotics, but four days after admission a further abscess appeared on the dorsum of the right foot. Further …
Seasonal variation of disease activity of systemic lupus erythematosus in Finland: a 1 year follow up study
Authors: T Hasan
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objectives:</b> To study the role of different seasons in the disease activity of patients with systemic lupus erythematosus (SLE). Additionally, to evaluate whether the outdoor behaviour during the summer or a photoprovocation test affects disease activity. <b>Methods:</b> 33 patients with SLE were examined by a rheumatologist and a dermatologist at a university hospital in winter, spring, and summer. The activity of SLE was assessed by the ECLAM index. Their outdoor behaviour was recorded by a questionnaire during the summer. In the winter, 12 patients were photoprovoked by ultraviolet A and B radiation on a small skin area. <b>Results:</b> The ECLAM scores were higher in spring and tended to be higher in summer than in winter (p = 0.006 and p = 0.051). This finding, as well as the outdoor behaviour, were independent of the patients' own impression of their photosensitivity. Overall, the sun protection actions were inadequate. The photoprovocation had no statistical effect on disease activity, but one patient had a violent exacerbation of SLE manifestations shortly after the photoprovocation. <b>Conclusions:</b> In the northern climate SLE may be activated during the sunny season. Therefore, more effort should be focused on sun protection of patients with SLE.
Succinylcholine in Electro-shock
Authors: J. M. Price, W. J. B. Rogers
Journal: BMJ (1952)

<h3>Background and Objective</h3> Several studies report poorer quality healthcare for patients presenting at weekends. Our objective was to examine how timely surgery for patients with hip fracture varies with day and time of their presentation. <h3>Methods</h3> This population-based cohort study used 2017 data from the National Hip Fracture Database, which recorded all patients aged 60 years and over who presented with a hip fracture at a hospital in England, Wales and Northern Ireland. Provision of prompt surgery (surgery within 36 hours of presentation) was examined, using multivariable logistic regression with generalised estimating equations to derive adjusted risk ratios (RRs). Time was categorised into three 8-hour intervals (day: 08:00–15:59, evening: 16:00–23:59 and night: 00:00–07:59) for each day of the week. The model accounted for clustering by hospital and was adjusted by sex, age, fracture type, operation type, American Society of Anesthesiologists grade, preinjury mobility and location. <h3>Results</h3> We studied 68 977 patients from 177 hospitals. The average patient presenting during the day on Friday or Saturday was significantly less likely to undergo prompt surgery (Friday during 08:00–15:59, RR=0.93, 95% CI 0.91 to 0.96; Saturday during 08:00–15:59, RR=0.91, 95% CI 0.88 to 0.94) than patients in the comparative category (Thursday, during the day). Patients presenting during the evening (16:00–23:59) were consistently significantly less likely to undergo prompt surgery, and the effect was more marked on Fridays and Saturdays (Friday during 16:00-23:59, RR=0.83, 95% CI 0.80 to 0.85; Saturday during 16:00–23:59, RR=0.81, 95% CI 0.78 to 0.85). Patients presenting overnight (00:00–07:59), except on Saturdays, were significantly more likely to undergo surgery within 36 hours (RR&gt;1.07). <h3>Conclusion</h3> The provision of prompt hip fracture surgery was complex, with evidence of both an ‘evening’ and a ‘night’ effect. Investigation of weekly variation in hip fracture care is required to help implement strategies to reduce the variation in timely surgery throughout the entire week.
Breaking Tolerance to Double Stranded DNA, Nucleosome, and Other Nuclear Antigens Is Not Required for the Pathogenesis of Lupus Glomerulonephritis
Authors: Samuel T. Waters, Marcia McDuffie, Harini Bagavant, Umesh S. Deshmukh, Felicia Gaskin, Chao Jiang, Kenneth S.K. Tung, Shu Man Fu
Journal: The Journal of Experimental Medicine (2004)

In lupus-prone NZM2328 mice, a locus Cgnz1 on chromosome 1 was linked to chronic glomerulonephritis, severe proteinuria, and early mortality in females. A locus Adnz1 on chromosome 4 was linked to antinuclear antibody (ANA) and anti–double stranded DNA (dsDNA) antibody (Ab) production. In this investigation, two congenic strains, NZM2328.C57L/Jc1 (NZM.C57Lc1) and NZM2328.C57L/Jc4 (NZM.C57Lc4), were generated by replacing the respective genetic intervals containing either Cgnz1 or Adnz1 with those from C57L/J, a nonlupus-prone strain. The NZM.C57Lc1 females had markedly reduced incidence of chronic glomerulonephritis and severe proteinuria. NZM.C57Lc4 females had chronic glomerulonephritis and severe proteinuria without circulating ANA, anti-dsDNA, and antinucleosome Ab. These data confirm the linkage analysis. Unexpectedly, NZM.C57Lc1 females had little anti-dsDNA and related Ab, suggesting the presence of a second locus Adnz2 on chromosome 1. The diseased NZM.C57Lc4 kidneys had immune complexes by immunofluorescence and electron microscopy. The eluates from these kidneys did not contain ANA, anti-dsDNA, and antinucleosome Ab, indicative of the presence of non–anti-dsDNA nephritogenic Ab. Thus, breaking tolerance to dsDNA and chromatin is not required for the pathogenesis of lupus nephritis. These results reaffirm that anti-dsDNA and related Ab production and chronic glomerulonephritis are under independent genetic control. These findings have significant implications in the pathogenesis of systemic lupus erythematosus.
Characteristics of Physicians with Participatory Decision-Making Styles
Authors: Sherrie H. Kaplan
Journal: Annals of Internal Medicine (1996)

Objectives: To identify physician and practice characteristics associated with a physician's propensity to involve patients in diagnostic and treatment decisions, or participatory decision-making style. Design: A representative cross-sectional sample of patients participating in the Medical Outcomes Study characterized each physician's style by using a self-reported questionnaire. A single averaged style score was generated for each physician. Style scores were compared among physicians who differed in age, sex, minority status, specialty, primary care training or training in interviewing skills, satisfaction with professional autonomy, and practice volume. Settings: Solo practices, multispecialty groups, and health maintenance organizations in Boston, Chicago, and Los Angeles. Participants: 7730 patients sampled over 9 days from the practices of 300 physicians. Physicians were practicing general internal medicine, family medicine, cardiology, and endocrinology. Measurements: Participatory decision-making style was measured using a three-item scale on a questionnaire that was completed by patients after their office visit. Physician and practice characteristics were reported by physicians on self-administered questionnaires. Results: Among patients of physicians who were rated in the lowest (least participatory) quartile, one third changed physicians in the following year; among patients of physicians who were rated in the highest quartile, only 15% changed physicians. Higher scores were associated with greater patient satisfaction. Physicians who had had primary care training or training in interviewing skills scored higher than those without such training. Physicians in higher-volume practices were rated as less participatory than those in lower-volume practices. Physicians who were satisfied with their level of professional autonomy were rated as more participatory than those who were dissatisfied. Conclusion: Participatory decision-making style is influenced by physicians' background, training, practice volume, and professional autonomy. Because participatory decision-making style is related to patient satisfaction and loyalty to the physician, cost-containment strategies that reduce time with patients and decrease physician autonomy may result in suboptimal patient outcomes.
THE EFFECT OF AGE ON THE pH OF THE SKIN SURFACE IN THE FIRST WEEK OF LIFE.
Authors: J. MARTIN BEARE, E. A. CHEESEMAN, A. A. H. GAILEY, D. W. NEILL, J. D. MERRETT
Journal: British Journal of Dermatology (1960)

Journal Article THE EFFECT OF AGE ON THE pH OF THE SKIN SURFACE IN THE FIRST WEEK OF LIFE. Get access J. MARTIN BEARE, M.D., M.R.C.P., J. MARTIN BEARE, M.D., M.R.C.P. Royal Victoria Hospital and Queen's University, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar E. A. CHEESEMAN, Ph.D., E. A. CHEESEMAN, Ph.D. Royal Victoria Hospital and Queen's University, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar A. A. H. GAILEY, M.D., M.R.C.P., A. A. H. GAILEY, M.D., M.R.C.P. Royal Victoria Hospital and Queen's University, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar D. W. NEILL, M.Sc, F.R.I.C., D. W. NEILL, M.Sc, F.R.I.C. Royal Victoria Hospital and Queen's University, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar J. D. MERRETT, B.Sc. J. D. MERRETT, B.Sc. Royal Victoria Hospital and Queen's University, Belfast, Northern Ireland Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 72, Issue 2, 1 February 1960, Pages 62–66, https://doi.org/10.1111/j.1365-2133.1960.tb13846.x Published: 01 February 1960
Medical Responsibility for Community Blood Centers
Authors: William H. Crosby
Journal: New England Journal of Medicine (1970)

AMERICAN surgeons returning from World War II demanded blood. A spin-off of that war was the modern concept of the use of transfusion to support complicated surgery. In support of this concept, transfusion services developed contemporaneously to collect, store and deliver blood that could safely be used for large or small transfusions. At present in the United States each year about 6,000,000 units of blood are collected, and about 5,000,000 are transfused. This blood is stored and safely used up to four weeks after collection (although the outdaring period remains three weeks in most areas). In well run blood banks . . .
Dioxin-Induced Changes in Epididymal Sperm Count and Spermatogenesis
Authors: Warren G. Foster, Serena Maharaj-Briceño, Daniel G. Cyr
Journal: Environmental Health Perspectives (2009)

BackgroundA single in utero exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on gestation day 15 decreased epididymal sperm count in adult rats and thus was used to establish a tolerable daily intake for TCDD. However, several laboratories have been unable to replicate these findings. Moreover, conflicting reports of TCDD effects on daily sperm production suggest that spermatogenesis may not be as sensitive to the adverse effects of TCDD as previously thought.Data sourcesWe performed a PubMed search using relevant search terms linking dioxin exposure with adverse effects on reproduction and spermatogenesis.Data synthesisDevelopmental exposure to TCDD is consistently linked with decreased cauda epididymal sperm counts in animal studies, although at higher dose levels than those used in some earlier studies. However, the evidence linking in utero TCDD exposure and spermatogenesis is not convincing.ConclusionsAnimal studies provide clear evidence of an adverse effect of in utero TCDD exposure on epididymal sperm count but do not support the conclusion that spermatogenesis is adversely affected. The mechanisms underlying decreased epididymal sperm count are unknown; however, we postulate that epididymal function is the key target for the adverse effects of TCDD.
Aneurin Bevan on the NHS.
Authors: R. Maxwell
Journal: BMJ (1992)

but probably inevitable even in a more relaxed political round.'It might, however, at least be possible to produce climate, given the emotions roused by the NHS reforms.agreement on a language and grammar of evaluation that As the debate is not likely to be ended by a general would allow disagreements to be discussed more fruitfully election-and might even be intensified if a Labour govern-than at present.ment was to modify the system once again -there seems to be RUDOLF KLEIN a strong argument for trying to generate a consensus about the Professor of Social Policy, criteria .be usedin evaluating whatever policies arepursued Centre for the Analysis of Social Policy,
Inflammatory Myofibroblastic Tumor
Authors: Aisheng Dong, Yang Wang, Hui Dong, Jing Gong, Chao Cheng, Changjing Zuo, Jianping Lu
Journal: Clinical Nuclear Medicine (2013)

Purpose The aim of this study was to evaluate retrospectively 18F-FDG PET/CT findings of inflammatory myofibroblastic tumor (IMT) and their correlation with the pathologic findings. Patients and Methods FDG PET/CT findings were reviewed in 5 patients with IMT and 1 patient with spindle cell sarcoma transformed from IMT. PET/CT scans were performed in all 6 patients before surgery. Follow-up FDG PET/CT scan was performed in 1 patient. The location, size, maximal standardized uptake value (SUVmax), and pathologic findings of the tumors were reviewed. The correlation between the FDG uptake and pathologic findings were analyzed. Results A total of 10 lesions were detected in all 6 patients. The tumor locations were liver (n = 3), retroperitoneum (n = 2), spleen (n = 1), lung (n = 1), and bone (n = 3). Seven IMTs and 1 spindle cell sarcoma transformed from IMT were confirmed by pathology. The mean SUVmax of the pathologically proven tumors was 10.9 ± 5.5, with a high variability of SUVmax among tumors ranging from 3.3 to 20.8. The tumors (n = 7) with high cellularity had stronger FDG uptake, while the tumors (n = 1) with low cellularity had relatively low FDG uptake. The tumors with nuclear atypia and relatively high proliferative index had very strong FDG uptake, while those with low proliferative index or negative Ki-67 staining had relatively lower FDG uptake. One small tumor with abundant plasma cells showed high FDG uptake, while 1 large tumor with focal inflammatory cell infiltrate showed lower FDG uptake. One patient developed local recurrences and distant metastases revealed by the second FDG PET/CT scan 7 months after resection. Conclusions FDG uptake in IMTs varied from low to high FDG uptake, which may be due to tumor cellularity, biological behaviors of the tumor cells, the composition and the proportion of inflammatory cells, and the extent of activation of the inflammatory cells. FDG PET/CT may be useful for detection of the primary tumors, local recurrences, and distant metastases.
Bile Acids and Bile Salts: Ionization and Solubility Properties
Authors: Martin C. Carey
Journal: Hepatology (1984)

The number, position and orientation of nuclear OH substituents profoundly influence the equilibrium solubilities of undissociated bile acids in water. Estimates from several studies range from 5 × 10″ 8 for lithocholic acid to 1.6 × 10 −3 Af for ursocholic acid at 37°C. Fully dissociated sodium bile salts are extremely soluble in water, attaining values as high as 1 to 2 M. However, ionized unconjugated bile salts are appreciably less soluble than their glycine and taurine conjugates. In contrast to aqueous solutions of typical soaps and detergents, aqueous bile salt systems in concentrations beyond the micellar phase limit exhibit no liquid-crystalline phases. The critical micellar temperatures of the common di- and trihydroxy bile salts lie below 0°C, hence most bile salts form micelles at all ambient temperatures. With many monohydroxy and certain uncommon dihydroxy bile salts, the critical micellar temperatures lie above body temperature, and a micellar phase is observed only at temperatures in excess of 50°C. The pKa’ values of aqueous micellar concentrations of bile salts are influenced by the nuclear substituents, the state of conjugation and bile salt concentration. In contrast, the intrinsic thermodynamic pK’a values of all monocarboxy-lated bile salts in monomeric solution are similar, are not influenced by nuclear substituents and are equivalent to that expected for propionic acid (pKa’ ˜4.8 to 5.0). These values can be deduced by extrapolation from acidimetric titrations of bile salts in aqueous methanol mixtures or from acidometric aqueous titration of the carboxylate groups of pansulfated bile salts which remain water soluble when the ionic group of the side chain is protonated. The precipitation pH values of the common protonated bile acids are influenced by bile salt concentration, the state of conjugation and the solubilizing capacity of bile salt micelles for the otherwise sparingly soluble undissociated bile acid species.
A randomized trial of vasopressin and vasopressin plus nitroglycerin in the control of acute variceal hemorrhage
Authors: Alexander E. S. Gimson, David Westaby, John Hegarty, Alastair Watson, Roger Williams
Journal: Hepatology (1986)

A randomized trial was undertaken to determine efficacy of nitroglycerin when added to a vasopressin infusion in both reducing the complication rate and giving improved control of acute variceal hemorrhage. Seventy-two bleeding episodes in 57 patients were included, with vasopressin beng used on 34 occasions and vasopressin plus nitroglycerin on 38 occasions, for an infusion period of 12 hr. At the end of the 12-hr period, hemorrhage had been controlled significantly more frequently in those receiving combined therapy (26 of 38; 68%) than in those given vasopressin alone (15 of 34; 44%, p&lt;0.05), although this difference was not statistically significant if those patients in whom therapy was discontinued due to drug complications were excluded from the analysis [hemorrhage controlled in the combined group (68%) and vasopressin alone (48%); x 2 =2.4, p&gt;0.05]. Major complications requiring cessation of therapy were significantly less common in those given nitroglycerin—one occasion compared to seven in those given vasopressin alone (p&lt;0.02). Thus, the addition of nitroglycerin to a vasopressin infusion results in a lower rate of complications and is more effective in controlling variceal hemorrhage.
Do patients fasting before and after operation receive their prescribed drug treatment?
Authors: R Wyld, W S Nimmo
Journal: BMJ (1988)

Periods of fasting perioperatively make normal drug treatment difficult to maintain. One hundred and seventy patients admitted consecutively for operations (excluding those having cardiac, neurosurgical, and orthopaedic operations) were studied to identify whether they received their prescribed drugs. Seventy two were receiving drugs unrelated to their operation or anaesthesia. One thousand seven hundred and forty six single prescriptions (that is, single doses) were recorded as to be given on the day of surgery and the next day, of which 256 (15%) were not administered. All prescriptions of analgesics and premedicants were given; when these were excluded the proportion of prescriptions that were not given rose to 29%. The prescriptions omitted included 38 out of 95 for drugs for cardiovascular disease, 34 out of 103 for drugs for respiratory disease, and 10 out of 61 for drugs for endocrine disorders. The omission of drugs was not known to the medical staff and may introduce variability in the response of patients perioperatively.
The Increasing Urgency for Standards in Basic Biologic Research Published Recently in <i>Cancer Research—</i>Letter
Authors: Keith Dredge
Journal: Cancer Research (2014)

Freedman and Inglese (1) provided an excellent synopsis of the causes for irreproducibility in cancer research and the need for standards, complementing previous concerns on this issue (2). In addition to recommendations provided by these articles, there are some tangible next steps that should be considered to improve the standards in basic biologic research. In relation to standards, the research community needs to be realistic about what is achievable and who will take responsibility for the implementation and monitoring in individual laboratories to enhance the quality of data. Despite some academic institutions moving to introduce GLP (4), for most research institutes this is unaffordable (not only in terms of cost but also in time and expertise/resources) and could stifle innovation and the creativity so valuable in basic biologic research. However, there are aspects of GLP and statistics worth considering to improve standards but points 1 to 4 need to be addressed by grant funding bodies, organizations, and/or publishers before academic groups or individual researchers will be motivated to implement points 2 to 7 within their laboratories. To achieve this, a cultural change is likely required, even beyond those challenges described in Clifton Leaf's The Truth in Small Doses (5). Nevertheless, the implementation of some initial steps at organizational levels has the potential to transform aspects of the culture, which in turn will increase standards in basic biologic research.K. Dredge is Director of Drug Development at Progen Pharmaceuticals Ltd.
P Wave Dispersion, as A Predictor for Atrial Fibrillation Development, Before and After Transcatheter Aortic Valve Implantation
Authors: Telat Keleş, Hüseyin Ayhan, Nihal Akar Bayram, Tahir Durmaz, Cemal Köseoğlu, Büşra Çolak, Cenk Sarı, Haci Ahmet Kasapkara, Emine Bilen, Serdal Baştuğ, Murat Akçay, Engin Bozkurt
Journal: Journal of the American College of Cardiology (2013)
Utilization Review Coordinator
Authors: Denis A. Boyle
Journal: JAMA (1976)

To the Editor.—   Crawshaw's commentary (235:2721, 1976) on the functions of a review coordinator shows a lack of understanding of the utilization review effort.  After reading his commentary, one is hard put to decide whether his subtle discontent is against Dr Loudmouth, confused Ms Coordinator, or the procrustean administrator. In his critical assessment, he impugns unworthy motives to all concerned.  In my experience, utilization review coordinators are a happy group who use every bit of medical acumen they have accrued. They are implementing rules and criteria that have been set up by their medical staff. Any confrontation with Dr Loudmouth is the task of the physician who represents the peer group making the judgment. The inaccuracies  this description by someone on the outside looking in are understandable.