tbuckley/cabot-search huggingface dataset:
The Paediatrician's Part in the Maternity Services
Authors: N. B. Capon
Journal: BMJ (1955)

If one turns back to the middle of the eighteenth century the early Bills of Mortality give some idea of the appalling threat to infant life at that time.For instance, during the period 1730-49 almost 75% of the children born in London died before the age of 5 years.No one would contend that the Bills of Mortality presented a fully accurate picture, and at that time there was, of course, no subdivision of infant deaths into neonatal and post-natal groups.But it is reasonable to assume that stillbirths and neonatal deaths were at that time at a level that constituted a national menace.Fortunately for this country, as Sir George Newman indicated in his Charles Heath Lectures (1932), a genera ion of brilliant general physicians arose during the eighteenth century-men like Mead, Heberden, Haygarth, and Jenner.whose clinical abilities were backed up by a wealth of sound common sense that encouraged them to introduce " preventive " ideas.Some of these men, like Lettsom and Cadogan, called attention to the very high rate of mortality among infants; and the former, in his Medical Memoirs (1774) commented upon improvements noted, even at that time, in these words: " In the nurture and management of infants as well as in the treatment of lying-in women, the reformation hath equalled that in the small-pox; by these two circumstances alone incredible numbers have been rescued from the grave."It was in the same century that the obstetrician (or man-midwife) began to exert a significant influence- men like William Smellie and that famous son of Man- chester Charles White, who published in 1773 his re- markable volume On the Management of Pregnant antd Lying-in Women, and the nmeans of curing, but more especially of preveni ing, the prinicipal disorders to whichl they are liable.He strongly recommended antenatal supervision of the mother, and he is therefore entitled to an important place in the history of preventive neonatal paediatrics.The next major event in the history of my subject was the arrival upon the scene of some of the leaders in public health.Again we find a Manchester man play- ing a highly important part.Edwin Chadwick-not a doctor-held the office of Secretary to the Poor Law Commission, and in 1842 there appeared his monumental *Lloyd Roberts Lecture delivered at Manchester on
Pyrimethamine ("Daraprim") in the Treatment of Vivax Malaria
Authors: G. Covell, P. G. Shute, M. Maryon
Journal: BMJ (1953)

<h3>Abstract</h3> Giant unilamellar vesicles (GUVs) are micrometer-sized model membrane systems that can be viewed directly under the microscope. They serve as scaffolds for the bottom-up creation of synthetic cells, targeted drug delivery and have been used in many <i>in vitro</i> studies of membrane related phenomena. GUVs are also of interest for the functional investigation of membrane proteins that carry out many key cellular functions. A major hurdle to a wider application of GUVs in this field is the diversity of existing protocols that are optimized for individual proteins. Here, we compare PVA assisted and electroformation techniques for GUV formation under physiologically relevant conditions, and analyze the effect of immobilization on vesicle structure and membrane tightness towards small substrates and protons. There, differences in terms of yield, size, and leakage of GUVs produced by PVA assisted swelling and electroformation were found, dependent on salt and buffer composition. Using fusion of oppositely charged membranes to reconstitute a model membrane protein, we find that empty vesicles and proteoliposomes show similar fusion behavior, which allows for a rapid estimation of protein incorporation using fluorescent lipids.
Diagnosis and management of soft tissue sarcoma
Authors: S. Sinha, A. H. S. Peach
Journal: BMJ (2010)

#### Summary points

Soft tissue sarcomas are a heterogeneous group of tumours of mesodermal origin. Although they are rare, accounting for less than 1% of all malignant tumours, half of patients diagnosed will die from the sarcoma.1 w1 Lumps are commonly encountered in primary and specialist care, and differentiating benign from possibly malignant lesions can be difficult. The estimated benign:malignant ratio is 100:1. A family doctor will see about one case of soft tissue sarcoma for every 24 years of practice.w2 However, prognosis is related to size at presentation, so early recognition, referral to a specialist (see National Institute for Health and Clinical Excellence (NICE) guidelines), and appropriate treatment improve outcomes.2 Evidence from cohort studies suggests that patients experience delays in referral,w3 w4 and in the United Kingdom referrals to specialist sarcoma centres often fall outside the recommended two week window for suspected cancer.3 4 We review evidence from national guidelines, randomised trials, and observational studies to provide the non-specialist with a guide to diagnosis, appropriate referral, and management of patients with suspected soft tissue sarcoma, focusing on a multidisciplinary approach. We limit our discussion of management to the treatment of soft tissue sarcoma of the extremities—the most common site.

#### Sources and selection criteria

We searched Medline, PubMed, Embase, and CINAHL using the terms “soft …
Sodium chloride and water transport in the descending limb of Henle
Authors: Juha P. Kokko
Journal: Journal of Clinical Investigation (1970)

The unique membrane characteristics of the thin descending limb of Henle (DLH) play an integral part in the operation of the countercurrent system. We examined these properties in vitro by perfusing isolated thin descending limbs of rabbits. Active transport of NaCl was ruled out by failure to demonstrate either net transport or transmembrane potential difference when perfusing with isosmolal ultrafiltrate of the same rabbit serum as the bath. Transmembrane potential was zero, and net fluid transport was -0.07 ±0.06 nl mm-1 min-1, which also is not significantly different from zero. Passive permeability coefficient for Na(PNa) was determined from the disappearance rate of 22Na from isosmolal perfusion solution. PNa was surprisingly low, 1.61 ±0.27 × 10-5 cm sec-1, a figure which is significantly less than PNa in the proximal convoluted tubule (PCT). Reflection coefficient for NaCl (σNaCl) was measured by perfusing the tubule with Na-free raffinose solution in a bath of rabbit serum to which sufficient NaCl was added to obtain conditions of zero net fluid movement. The measured σNaCl of 0.96 ±0.01 is significantly greater than σNaCl in the PCT. Water permeability to osmotic gradients (Lp) was determined by perfusing with ultrafiltrate of rabbit serum in a bath made hyperosmotic by addition of either 100 mOsm raffinose or NaCl. Lp with raffinose was 1.71 ±0.15 × 10-4 ml cm-2 sec-1 atm-1 and with NaCl 1.62 ±0.05 × 10-4 ml cm-2 sec-1 atm-1, indicating much greater water permeability than in the PCT. In each case the measured increase in osmolality of the collected fluid was primarily due to water efflux without significant influx of solute.
Potassium depletion and rhabdomyolysis
Authors: A J Larner
Journal: BMJ (1994)

EDITOR, - In his report of rhabdomyolysis complicating the diabetic hyperosmolar state G M Lord discusses the possible causes of muscle cell injury and concludes that hypophosphataemia, though relevant, is insufficient by itself to cause rhabdomyolysis.1 Deficiency of total body potassium - a frequent complication …
Geriatric Dermatology: Clinical Diagnosis and Practical Therapy
Authors: Philip C. Anderson
Journal: JAMA (1989)

<h3>Skin Disorders in the Elderly,</h3> edited by B. E. Monk, R. A. C. Graham-Brown, and I. Sarkany, 340 pp, with illus, $115, Boston, Mass, Blackwell Scientific Publications; Chicago, III, Year Book Medical Publishers Inc, distributor, 1988. Geriatrics suddenly is flourishing, not because of a small increase in the proportion of elderly in the US population, but because of the much more impressive increase in their political clout with the US Congress. A large leap in expectations for better medical care has occurred in all segments of our population, but most notably among the geriatric set. Unhappily, no comparable leap has happened in the basic biosciences relevant to improving dermatologic geriatrics. Geriatrics is much more about costs, insurance, access, safe medications, unnecessary surgery, well-proven therapeutics, home care, custodial care, hospice care, and, in general, overall excellent management, than it is about new bioscience or clinical medicine. Books like these two are
Changing proximal femoral geometry in north east Scotland: an osteometric study
Authors: R A Duthie, M F Bruce, J D Hutchison
Journal: BMJ (1998)

The Western world is currently facing an "epidemic" in fractures of the proximal femur. 1 Although the unexplained increase in the age specific incidence seems to have reached a plateau, absolute numbers will continue to rise because of the increasing number of elderly people in the population.Age alone, which inevitably brings a reduction in bone density, does not explain this phenomenon fully.Recent radiological studies have suggested that the hip axis and length of the neck of the femur are increasing; these changes may increase the risk of hip fracture. 2 3We tried to confirm these radiological findings with an osteometric study.
New strategy to reveal the black seeds of melanomas (cancer stem cells) with their vulnerable characteristics at cellular and molecular levels
Authors: Beatrix Kotlan, Gabriella Liszkay, Gyorgy Naszados, Zoltan Dolescall, Laszlo Toth, Laszlo Gobor, Istvan N Vamosy, Andras Szollar, Szabolcs Horvath, Klara Eles, Orsolya Csuka, Miklos Kasler, Maria Godeny, Francesco M Marincola
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts A suitable approach to select cancer stem cells (CSC), the black seed of melanomas would enable their characterization and elimination. Cancerous tissues from primary and metastatic lesions of patients with malignant melanomas (n=150) were investigated by cell cultures and
Pulmonary response to polyurethane dust.
Authors: K L Stemmer, E Bingham, W Barkley
Journal: Environmental Health Perspectives (1975)

Weanling and 9 months or older rats were exposed to particles of an aged (PUF I) or freshly prepared (PUF II) rigid polyurethane foam by intratracheal intubation. The dose was 5 mg of particles. The response of the lung tissue was examined morphologically by serial sacrifices. Inflammation and macrophage activity were the initial responses. Fibrosis developed after 6 months. Nodular scars and perifocal emphysema were seen after 12 months. Four rats had a papillary adenoma in a major bronchus after 18 months exposure to PUF II.
Hospital Faces Uncertainty as It Copes With Surge of Patients With Fungal Meningitis
Authors: Bridget M. Kuehn
Journal: JAMA (2013)

IN THE FIRST WEEK AFTER NEWS BROKE in early October that contaminated steroid injections from a New England compounding pharmacy were the likely cause of a multistate outbreak of fungal meningitis, dozens of patients who had been exposed to potentially contaminated injections at a private pain management practice began presenting each day in the emergency department of a nearby hospital, St Joseph Mercy Ann Arbor Hospital in Ypsilanti, Mich. “In that first week, there was a day our emergency department did more than 60 spinal taps,” said Anurag Malani, MD, an infectious disease specialist at the hospital. “We had this massive influx of [exposed] patients, probably a couple hundred that first week.” Before the initial reports of the outbreak, however, the hospital had already seen 6 cases of patients with fungal meningitis, although clinicians weren’t quite sure of the cause of this cluster, explained Malani. Although this first group of patients presented with meningitis symptoms such as headache, photophobia, and neck stiffness, the symptoms were less severe than typically seen in patients with bacterial meningitis, and tests for bacterial meningitis came back negative. But patients would return to the emergency department with persistent symptoms. “We started to have an inkling something wasn’t right,” Malani said. “The US Centers for Disease Control and Prevention [CDC] notice really put things together.” The notice (http://tinyurl.com/cnvm83q) alerted physicians to the outbreak and the ongoing investigation. By early December 2012, more than 590 cases had been reported to the CDC; 152 of these patients were treated at the 537-bed hospital in Ypsilanti. Of those 152 patients, 63 remained hospitalized at press time, and 7 had died. For clinicians and the hospital administrators at St Joseph Mercy, the outbreak has created unprecedented challenges. In addition to dealing with a huge influx of patients and developing treatment protocols for an extremely rare condition, they have been preparing for what is likely to be at least several more months of care for many of the patients.
Myocardial Infarction as a Complication of Coronary Bypass Surgery
Authors: DAVID L. BREWER, ROBERT H. BILBRO, ALAN G. BARTEL
Journal: Circulation (1973)

Serial postoperative ECGs were reviewed for all patients undergoing saphenous vein-coronary artery bypass graft (CABG) during 1969-71. Only the development of new pathologic Q waves were accepted as indicative of definite acute myocardial infarction (AMI). ST-T changes regardless of characteristics were not accepted as evidence of AMI. Operative mortality was 11% (27/253) with 59% (10/17) of those autopsied having AMI. Autopsy findings showed no false positives by ECG. Of survivors, 15% (33/220) had AMI. Another 2% (five) developed leftbundle conduction abnormalities and were considered probable for AMI. Among all patients having CABG, 20% (49/243) had AMI by ECG or autopsy. Comparing patients with and without AMI, there was no significant difference in coronary risk factors, hemodynamic data, number of vessels diseased, or site(s) of grafts. There was a significant difference in preoperative functional class for angina in the two groups. Seventy-six percent of those in the MI group had New York Heart Association class IV chest pain, whereas only 52.6% of the group without MI were class IV ( P &lt; 0.05). In those with triple grafts (14 patients), five had AMI (36%) compared to 14% (20/143) with one or two grafts ( P &lt; 0.02). Of patients with a pump time greater than 120 min, 29% (8/28) had AMI compared to 11% (16/146) with shorter pump times ( P &lt; 0.02). A significantly larger number of the MI group developed class IV congestive heart failure postoperatively than the group without MI (13 vs 2%, P &lt; 0.02). Despite the use of stringent criteria, this study shows that AMI complicating CABG is a common event. Those developing AMI at surgery had more severe chest pain preoperatively, had prolonged pump times, and a significantly larger number received triple grafts. Postoperatively, there was a higher incidence of severe congestive heart failure in those having an infarct at surgery.
P240 Longitudinal study of sputum microbiology in adult non-CF bronchiectasis
Authors: J. G. Macfarlane, P. McAlinden, A. De Soyza
Journal: Thorax (2010)

<h3>Introduction and Objectives</h3> Monitoring longitudinal sputum microbiology in adults with non-CF bronchiectasis (nCF-Br) is a key strategy in guiding targeted antibiotic therapy. There is minimal published data on the microbiological profile over time in bronchiectasis.12 Similar to CF, greater pathogen diversity is now being observed; hence we have revisited this area. <h3>Methods</h3> 12 years of previous sputum culture results obtained from 143 nCF-Br patients attending a specialist clinic were retrospectively reviewed. ‘Colonisation’ (organism cultured ≥2 occasions, 3 months apart within 1-year period) and ‘isolation’ (organism cultured ≥1) were recorded. <h3>Results</h3> 88F, 55M patients; average age 60.6 (range 16–90); average FEV<sub>1</sub> 65% predicted (SD ± 26%). The most common pathogens were <i>Haemophilus influenzae</i> (52% isolated and 33% colonisation; 8% were beta-lactam producing) and <i>Pseudomonas aeruginosa</i> (43% isolated and 35% colonisation) whilst 20% patients had no pathogens cultured. 81 patients (57%) have never had <i>Pseudomonas.</i> Of 62 patients (43%) isolating <i>Pseudomonas,</i> 12 patients (8%) had single isolates, 8 (6%) had colonisation with successful eradication therapy. <i>Streptococcus pneumoniae</i> (34%), Coliforms (30%), <i>Moraxella catarrhalis</i> (27%), <i>Staphylococcus aureus</i> (24%) were other common isolates. Rarer pathogens include <i>Aspergillus</i> sp. (9%), <i>S.maltophilia</i> (8%), non-tuberculous mycobacteria (NTM 3%; <i>M. terrae</i>, <i>M. avium</i> and <i>M. simiae</i>), MRSA(3%), <i>Acinetobacter</i> sp. (3%) and <i>Achromobacter xylosoxidans</i> (3%). <h3>Conclusions</h3> We note similar rates of <i>H. influenzae</i> colonisation as previously (33% vs 40%1) but higher rates of <i>Pseudomonas</i> colonisation (35% vs 18%1 and 24%2). Including those with any prior <i>Pseudomonas,</i> the rates of <i>Pseudomonas</i> isolation reach as high as 43% (higher than reported at 31%2). Our unit receives referrals from the local immunodeficiency centre and other respiratory units but this is not felt to account for the high <i>Pseudomonas</i> rates. Ongoing surveillance of individual and geographically local microbiological profiles is important in managing patients with nCF-Br.
The role of nickel and nickel-mediated reactive oxygen species in the mechanism of nickel carcinogenesis.
Authors: X Huang, Z Zhuang, K Frenkel, C B Klein, M Costa
Journal: Environmental Health Perspectives (1994)

Increasing evidence demonstrates the reactive oxygen species (ROS) are implicated in metal carcinogenesis. Exposure of cultured Chinese hamster ovary (CHO) cells to several nickel compounds, i.e. NiS, Ni3S2, NiO (black and green), and NiCl2 has been shown to increase oxidation of 2',7-dichlorofluorescein to the fluorescent 2',7-dichlorofluorescein (DCF), suggesting that nickel compounds increased the concentration of oxidants in CHO cells. This fluorescence can be attenuated by addition of exogenous catalase to the extracellular media, indicating that H2O2 is one of the formed oxidants in this system. Fluorimetric measurements of chromogens following thiobarbituric acid reaction showed that nickel compounds also induce lipid peroxidation with a decreasing potency NiS, Ni3S2 > black NiO > green NiO > NiCl2. These results suggest that lipid hydroperoxides may also be produced through the action of nickel in intact cells. MgCl2, an antagonist of Ni-induced DNA strand breaks and cell transformation, has no effect on the formation of DCF fluorescence induced in CHO cells by nickel. The results suggest that nickel is an active inducer of ROS in intact mammalian cells and that the molecular mechanism of nickel carcinogenesis may involve multiple steps of nickel-mediated ROS.
Mortality Probability Models (MPM II) Based on an International Cohort of Intensive Care Unit Patients
Authors: Stanley Lemeshow
Journal: JAMA (1993)

<h3>Objective.</h3> —To revise and update models in the Mortality Probability Model (MPM II) system to estimate the probability of hospital mortality among 19124 intensive care unit (ICU) patients that can be used for quality assessment within and among ICUs. <h3>Design and Setting.</h3> —Models developed and validated on consecutive admissions to adult medical and surgical ICUs in 12 countries. <h3>Patients.</h3> —A total of 12610 patients for model development, 6514 patients for model validation. Patients younger than 18 years and burn, coronary care, and cardiac surgery patients were excluded. <h3>Outcome Measure.</h3> —Vital status at hospital discharge. <h3>Results.</h3> —The admission model, MPM<sub>0</sub>, contains 15 readily obtainable variables. In developmental and validation samples it calibrated well (goodness-of-fit tests:<i>P</i>=.623 and<i>P</i>=.327, respectively, where a high<i>P</i>value represents good fit between observed and expected values) and discriminated well (area under the receiver operating characteristic curve=0.837 and 0.824, respectively). The 24-hour model, MPM<sub>24</sub>(developed on 10357 patients still in the ICU at 24 hours), contains five of the admission variables and eight additional variables easily ascertained at 24 hours. It also calibrated well (<i>P</i>=.764 and<sup>P</sup>=.231 in the developmental and validation samples, respectively) and discriminated well (area under the receiver operating characteristic curve=0.844 and 0.836 in the developmental and validation samples, respectively). <h3>Conclusions.</h3> —Among severity systems for intensive care patients, the MPM<sub>0</sub>is the only model available for use at ICU admission. Both MPM<sub>0</sub>and MPM<sub>24</sub>are useful research tools and provide important clinical information when used alone or together. (<i>JAMA</i>. 1993;270:2478-2486)
SERUM OSTEOPROTEGERIN LEVELS AND LONG-TERM PROGNOSIS IN SUBJECTS WITH STABLE CORONARY ARTERY DISEASE
Authors: Shuji Otsuki, Shuichi Jono, Yasutomi Higashikuni, Atsushi Shioi, Katsuhito Mori, Kengo Tanabe, Hiroyoshi Nakajima, Kazuhiro Hara, Yoshiki Nishizawa, Yuji Ikari
Journal: Journal of the American College of Cardiology (2010)
Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores
Authors: A.M. Van Coevorden, E. Van Sonderen, J. Bouma, P.J. Coenraads
Journal: British Journal of Dermatology (2006)

Journal Article Assessment of severity of hand eczema: discrepancies between patient‐ and physician‐rated scores Get access A.M. Van Coevorden, A.M. Van Coevorden Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, the Netherlands *Northern Centre for Healthcare Research, University of Groningen Medical Centre, Groningen, the Netherlands Search for other works by this author on: Oxford Academic Google Scholar E. Van Sonderen, E. Van Sonderen Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, the Netherlands *Northern Centre for Healthcare Research, University of Groningen Medical Centre, Groningen, the Netherlands Search for other works by this author on: Oxford Academic Google Scholar J. Bouma, J. Bouma Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, the Netherlands *Northern Centre for Healthcare Research, University of Groningen Medical Centre, Groningen, the Netherlands Search for other works by this author on: Oxford Academic Google Scholar P.J. Coenraads P.J. Coenraads Department of Dermatology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, the Netherlands *Northern Centre for Healthcare Research, University of Groningen Medical Centre, Groningen, the Netherlands P.J. Coenraads. E‐mail: p.j.coenraads@med.umcg.nl Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 155, Issue 6, 1 December 2006, Pages 1217–1222, https://doi.org/10.1111/j.1365-2133.2006.07531.x Published: 01 December 2006 Article history Accepted: 03 May 2006 Published: 01 December 2006