tbuckley/cabot-search huggingface dataset:
Poor team work is killing patients
Authors: S. Mayor
Journal: BMJ (2002)

Poor team work and communication are contributing to the lack of improvement in the number of patients in England and Wales who die within three days of a medical intervention. The warning comes from the 2002 report of an independent body the National Confidential Enquiry into Perioperative Deaths, which was published this week.

The report reviewed a sample of deaths occurring within three days of an intervention between 1 April 2000 and 31 March 2001, tracking …
Ritualistic Surgery — Circumcision and Tonsillectomy
Authors: Robert P. Bolande
Journal: New England Journal of Medicine (1969)

EARLIEST man cut upon the flesh and bone of his fellows in a crudely surgical fashion. Surgery is almost universally practiced in primitive tribal cultures, where its performance is only rarely directed toward the treatment or prevention of disease. Such surgery may at times be overtly hostile or punitive. More commonly, it seeks to secure for the individual distinct benefits that are quite separate from physical health. This type of surgery most often involves the production of rather stylized alterations of the skin, head, ears, nose, teeth, extremities and particularly the external genitalia, upon which circumcision, clitorectomy, infibulation, subincision and . . .
Psychiatric Skills and Knowledge for the General Practitioner
Authors: Allen J. Enelow, Leta McKinney Adler
Journal: JAMA (1964)

Since 1960, the University of Southern California School of Medicine has been conducting a program in continuing education in psychiatry for medical practitioners. Designed to help family doctors recognize and treat the majority of psychiatric illnesses, the program has emphasized case conferences and clinic courses in graduated levels of advancement. A physician, who so desires, can eventually learn to do psychotherapy in a supervised comprehensive clinic simulating conditions of a general medical practice. Continuous evaluative research is an integral part of the program. Characteristics of physician-enrollees are studied, cognitive learning gain is measured, and attitudes and behavior with patients are measured. The findings are fed back into the program to make the courses more useful and to interest more physicians in enrolling.
Gene expression signatures of peripheral CD4+ T cells clearly discriminate between patients with acute and chronic hepatitis B infection
Authors: Nirupma TrehanPati, Robert Geffers, None Sukriti, Syed Hissar, Peggy Riese, Tanja Toepfer, Jan Buer, Manoj Kumar, Carlos A. Guzman, Shiv Kumar Sarin
Journal: Hepatology (2008)

CD4+ T and regulatory T cells (Tregs) seem to play a key role in persistence of hepatitis B virus (HBV) infection. However, the molecular events by which Tregs exert their modulatory activity are largely unknown. The transcriptional profiles of CD4+ T cells of healthy controls (HCs) and patients affected by acute hepatitis B (AVH-B) or chronic hepatitis B (CHB) infection were established using a custom expression array consisting of 350 genes relevant for CD4+ T cell and Treg function. These studies were complemented by real-time reverse-transcription polymerase chain reaction. Peripheral blood mononuclear cells (PBMCs) were also analyzed for the presence of Tregs, which were more abundant in the acute stage of the disease (7%) than in HCs and CHB infection (HCs versus AVH-B, P = 0.003; AVH-B versus CHB, P = 0.04). One hundred eighteen genes (34%) intrinsically differentiate HBV-infected patients from HCs. Using gene ontology, we identified T cell receptor signaling and clusterization, mitogen-activated protein kinase kinase signaling, cell adhesion, cytokines and inflammatory responses, cell cycle/cell proliferation, and apoptosis as the most prominent affected modules. A higher expression of CCR1, CCR3, CCR4, CCR5, and CCR8 was seen in AVH-B than in CHB-infected patients and HCs. Annotation of the interconnected functional network of genes provided a unique representation of global immune activation during acute infection. Almost all genes were down-regulated in patients with CHB infection.The fingerprints enable clear discrimination between patients suffering from AVH-B or CHB infection. The observed profiles suggest accumulation of effector T cells with a potential role in necro-inflammation during the acute stage. Subsequent down-regulated effector functions support the hypothesis of suppressed CD4+ effector T cells favoring viral persistence in the chronic infection stage.
Variations in the Vaginal Bacterial Flora
Authors: WILLIAM J. BROWN
Journal: Annals of Internal Medicine (1982)

Fourteen women had specimens collected from their nares, hands, vaginal vestibule, and vagina. Samples were taken the week before, during, and the week after menstruation during three menstrual cycles for a total of nine specimens from each location. Qualitative and quantitative studies were done on the vaginal specimens; the other specimens were examined specifically for Staphylococcus aureus. The premenstrual specimens averaged the highest number of bacteria (∼lO9/mL) but the lowest number of different species (∼11). The menstrual specimens averaged the lowest total number of bacteria (∼4.0 X 107mL) but the highest average of different species (-14). The highest rate of positive cultures was for the nares, 34%; followed by vaginal vestibule, 20%; vagina, 19%; and hands, 4%. The nine sequential location samples showed the following percentages of S. aureus: nares, 57%; hands, 29%; vaginal vestibule, 57%; and vagina, 64%.
Functional similarities of hepatic cystic and biliary epithelium: Studies of fluid constituents andin vivo secretion in response to secretin
Authors: Gregory T. Everson, Merrill Emmett, William R. Brown, Paul Redmond, David Thickman
Journal: Hepatology (1990)

Hepatic cysts are a frequent manifestation of autosomal dominant polycystic kidney disease, but little is known about their functional characteristics. The goals of our study were to define the composition of hepatic cyst fluid and to determine whether hepatic cysts secrete in response to intravenously administered secretin. We percutaneously punctured five hepatic cysts and one proximal renal cyst from six subjects with autosomal dominant polycystic kidney disease and one solitary hepatic cyst from a subject without autosomal dominant polycystic kidney disease. Most fluids had an electrolyte composition similar to serum. Fluid from all hepatic cysts had glutamyltranspeptidase concentrations above those found in serum [( cyst]/[serum] = 4.93 +/- 5.92), contained secretory component (the epithelial receptor for polymeric IgA) and had glucose concentrations less than 15 mg/dl. Fluid from both hepatic and renal cysts of subjects with autosomal dominant polycystic kidney disease, but not from the subject with the solitary hepatic cyst, demonstrated extensive changes in the electrophoretic mobility of several serum proteins. Initial intracystic pressures ranged from 16 to 40 cm H2O, were reduced 57% to 97% after aspiration of a portion of cyst fluid and were held constant during the secretion study. Within 8 min of the intravenous administration of secretin, secretion of fluid increased in two of three hepatic cysts and in the renal cyst. The electrolyte composition of cyst fluids was not altered by secretin. These data suggest that hepatic cystic epithelium has functional characteristics of biliary epithelium and that secretion by both hepatic and renal cysts may be hormonally regulated.
Krayenbühl/Yasargil Cerebral Angiography
Authors: Franklin Earnest
Journal: JAMA (1983)

This superb angiography text and atlas is undoubtedly the finest work of its kind contained in one volume. The contents are divided into three sections. The first section contains a short history of cerebral angiography and a brief review of cerebral angiographic technique. The second section deals with the normal anatomy and pathological displacement of cerebral vessels. The third section discusses cerebrovascular disease, specific angiographic changes associated with neoplasm, complications of trauma, inflammatory disease, and congenital malformations. The text is precise, clearly written, and well referenced. The angiographic reproductions and drawings are of superb quality, legibly marked, and readily accessible to pertinent sections within the text. The paper and binding are of the highest quality. My only criticism is that the description of cerebral catheterization technique, now relatively well standardized, is too brief. This work will be met with enthusiastic reception by surgeons, radiologists, and neurologists as both a handy
Hepatitis C and non-Hodgkin lymphoma: The clinical perspective
Authors: Sidonie K. Hartridge-Lambert, Eytan M. Stein, Arnold J. Markowitz, Carol S. Portlock
Journal: Hepatology (2011)

Abstract Hepatitis C virus (HCV) is a commonly transmitted infection that has both hepatic and extrahepatic repercussions. These range from the inflammatory to the oncologic with an undisputed link to hepatitis, liver cirrhosis, and hepatocellular carcinoma. Its role in the development of B cell non-Hodgkin lymphoma (B-NHL) is becoming better understood, leading to opportunities for research, therapy, and even prevention. Research in the field has progressed significantly over the last decade, with the number of patients diagnosed with HCV and B-NHL rising incrementally. It is therefore becoming crucial to fully understand the pathobiologic link of HCV in B cell lymphomagenesis and its optimal management in the oncologic setting. (Hepatology 2012)
Anaphylaxis and Hypotension after Administration of Peginesatide
Authors: Charles L. Bennett, Sony Jacob, Jeffrey Hymes, Len A. Usvyat, Franklin W. Maddux
Journal: New England Journal of Medicine (2014)

Anaphylaxis and Hypotension after Administration of PeginesatideTo the Editor: Anemia in patients who have chronic kidney disease and are undergoing dialysis is treated with erythropoiesis-stimulating agents (ESAs). 1 In 2012, the Food and Drug Administration approved peginesatide, an ESA that is administered monthly to such patients. 2,3 In July 2012, a large dialysis organization with 2100 centers in the United States initiated a pilot introduction of peginesatide that included concurrent evaluation of the efficacy and safety of peginesatide and the logistics of administering it.Work groups established systems for evaluating clinical conditions, dosages of the drug, logistics of administration, and review of the efficacy and safety of the product.Personnel at each site were educated about the mechanism of action, pharmacokinetics, storage, handling, and dosing of the drug.The manufacturer provided site specialists.Although registration trials revealed no new toxic effects, by September, eight cases of anaphylaxis and hypotension among patients in the pilot initiative were reported, including two deaths from cardiorespiratory causes and three grade 4 anaphylaxis and hypotension events.In December 2012, the man-
Randomised controlled trial assessing the impact of a nurse delivered, flow monitored protocol for optimisation of circulatory status after cardiac surgery
Authors: Moira McKendry, Helen McGloin, Debbie Saberi, Libby Caudwell, Anthony R Brady, Mervyn Singer
Journal: BMJ (2004)

<h3>Abstract</h3> <b>Objective</b> To assess whether a nurse led, flow monitored protocol for optimising circulatory status in patients after cardiac surgery reduces complications and shortens stay in intensive care and hospital. <b>Design</b> Randomised controlled trial. <b>Setting</b> Intensive care unit and cardiothoracic unit of a university teaching hospital. <b>Participants</b> 174 patients who underwent cardiac surgery between April 2000 and January 2003. <b>Interventions</b> Patients were allocated to conventional haemodynamic management or to an algorithm guided by oesophageal Doppler flowmetry to maintain a stroke index above 35 ml/m<sup>2</sup>. <b>Results</b> 26 control patients had postoperative complications (two deaths) compared with 17 (four deaths) protocol patients (P = 0.08). Duration of hospital stay in the protocol group was significantly reduced from a median of nine (interquartile range 7-12) days to seven (7-10) days (P = 0.02). The mean duration of hospital stay was reduced from 13.9 to 11.4 days, a saving in hospital bed days of 18% (95% confidence interval −12% to 47%). Usage of intensive care beds was reduced by 23% (−8% to 59%). <b>Conclusion</b> A nurse delivered protocol for optimising circulatory status in the early postoperative period after cardiac surgery may significantly shorten hospital stay.
BENJAMIN RUSH.AN ADDRESS DELIVERED AT THE UNVEILING OF A MONUMENT ERECTED BY THE AMERICAN MEDICAL ASSOCIATION TO THE MEMORY OF BENJAMIN RUSH IN WASHINGTON, D. C, JUNE 11, 1904.
Authors: J. C. WILSON
Journal: JAMA (1904)

<h3>Mr. President, Members of the American Medical Association, and Honored Guests:</h3> It is proper for me to express my appreciation of the high honor which you, through your officers, have conferred on me in delegating to me the duty of addressing you on this occasion. The sentiment of elation which I might otherwise feel is tempered by a lively sense of my umvorthiness for the task. It is, however, a satisfaction to find myself associated in the work of thus commemorating the life and labors of the most distinguished of American physicians with Mr. Perry, the sculptor, to whose talent we Owe the beautiful and lifelike statue, and with Mr. Metcalfe, the designer of the pedestal on which it rests. More than twenty years have elapsed since the Rush Monument Committee was appointed. Of its original members, Gihon, Henry M. Smith, Kinloch, Gordon, Rohé, Murphy, Toner, and Henry, all but
139 Etiology, outcome and early causes of death in 427 patients with acute liver failure (ALF): A 20 year single-center experience
Authors: L.C. Faria, P. Ichai, F. Saliba, D. Azoulay, T. Antonini, S. Ben Hamida, R. Adam, H. Bismuth, D. Castaing, D. Samuel
Journal: Journal of Hepatology (2006)
Asymptomatic Cardiac Ischemia Pilot (ACIP) Study Two-Year Follow-up
Authors: Richard F. Davies, A. David Goldberg, Sandra Forman, Carl J. Pepine, Genell L. Knatterud, Nancy Geller, George Sopko, Craig Pratt, John Deanfield, C. Richard Conti
Journal: Circulation (1997)

Background Patients with ischemia during stress testing and ambulatory ECG monitoring have an increased risk of cardiac events, but it is not known whether their prognosis is improved by more aggressive treatment with anti-ischemic drugs or revascularization. Methods and Results The Asymptomatic Cardiac Ischemia Pilot study randomized 558 such patients who had coronary anatomy suitable for revascularization to three treatment strategies: angina-guided drug therapy (n=183), angina plus ischemia–guided drug therapy (n=183), or revascularization by angioplasty or bypass surgery (n=192). Two years after randomization, the total mortality was 6.6% in the angina-guided strategy, 4.4% in the ischemia-guided strategy, and 1.1% in the revascularization strategy ( P &lt;.02). The rate of death or myocardial infarction was 12.1% in the angina-guided strategy, 8.8% in the ischemia-guided strategy, and 4.7% in the revascularization strategy ( P &lt;.04). The rate of death, myocardial infarction, or recurrent cardiac hospitalization was 41.8% in the angina-guided strategy, 38.5% in the ischemia-guided strategy, and 23.1% in the revascularization strategy ( P &lt;.001). Pairwise testing revealed significant differences between the revascularization and angina-guided strategies for each comparison. Conclusions A strategy of initial revascularization appears to improve the prognosis of this population compared with angina-guided medical therapy. A larger long-term study is needed to confirm this benefit and to adequately test the potential of more aggressive drug therapy.
Special Access Programs Warrant Further Critical Attention: Authors’ Response to Open Peer Commentaries on “Ethical Justifications for Access to Unapproved Medical Interventions: An Argument for (Limited) Patient Obligations”
Authors: Mary Jean Walker, Wendy A. Rogers, Vikki Entwistle
Journal: The American Journal of Bioethics (2014)

We thank the respondents for their constructive commentaries on our paper about the ethics of special access programs (SAPs) and our proposal for mandating data collection from participating patien...
Does Transfer Factor Act Specifically or as an Immunologic Adjuvant?
Authors: Barry R. Bloom
Journal: New England Journal of Medicine (1973)

The excellent study by Bullock, Fields and Brandriss1 has demonstrated the conversion of lepromatous patients previously skin-test negative to Dharmendra lepromin to positive reactivity after a single treatment with allogeneic lymphocytes or dialyzable transfer factor. The fact that six of the nine recipients in addition showed generalized but transient indurative changes within skin infiltrates suggests that some degree of "reversal" reaction had been produced and offers the possibility that extended treatment with transfer factor would be helpful in terminating the infection or at least in reducing the bacillary load.This and other studies on the effects of transfer factor in . . .
Counselling the parents of handicapped children.
Authors: D C Taylor
Journal: BMJ (1982)

The parents of handicapped children have to adjust to a wide variety of emotional and psychological problems when first confronted with the failure of their reproductive expectations. Counselling is a formal procedure or transaction in which both counsellor and parents aim to find a mutually acceptable plan of adjustment. Parents may need support to cope with their own personal inadequacies as well as with their own personal inadequacies as well as with the needs of the child. Counselling should be a continuous process, in which the parents can learn to accept the child as a different rather than a lesser person.
Myoblasts Derived From Normal hESCs and Dystrophic hiPSCs Efficiently Fuse With Existing Muscle Fibers Following Transplantation
Authors: Sébastien Goudenege, Carl Lebel, Nicolas B Huot, Christine Dufour, Isao Fujii, Jean Gekas, Joël Rousseau, Jacques P Tremblay
Journal: Molecular Therapy (2012)

Human embryonic stem cells (hESCs) and human-induced pluripotent stem cells (hiPSCs) have an endless self-renewal capacity and can theoretically differentiate into all types of lineages. They thus represent an unlimited source of cells for therapies of regenerative diseases, such as Duchenne muscular dystrophy (DMD), and for tissue repair in specific medical fields. However, at the moment, the low number of efficient specific lineage differentiation protocols compromises their use in regenerative medicine. We developed a two-step procedure to differentiate hESCs and dystrophic hiPSCs in myogenic cells. The first step was a culture in a myogenic medium and the second step an infection with an adenovirus expressing the myogenic master gene MyoD. Following infection, the cells expressed several myogenic markers and formed abundant multinucleated myotubes in vitro. When transplanted in the muscle of Rag/mdx mice, these cells participated in muscle regeneration by fusing very well with existing muscle fibers. Our findings provide an effective method that will permit to use hESCs or hiPSCs for preclinical studies in muscle repair. Human embryonic stem cells (hESCs) and human-induced pluripotent stem cells (hiPSCs) have an endless self-renewal capacity and can theoretically differentiate into all types of lineages. They thus represent an unlimited source of cells for therapies of regenerative diseases, such as Duchenne muscular dystrophy (DMD), and for tissue repair in specific medical fields. However, at the moment, the low number of efficient specific lineage differentiation protocols compromises their use in regenerative medicine. We developed a two-step procedure to differentiate hESCs and dystrophic hiPSCs in myogenic cells. The first step was a culture in a myogenic medium and the second step an infection with an adenovirus expressing the myogenic master gene MyoD. Following infection, the cells expressed several myogenic markers and formed abundant multinucleated myotubes in vitro. When transplanted in the muscle of Rag/mdx mice, these cells participated in muscle regeneration by fusing very well with existing muscle fibers. Our findings provide an effective method that will permit to use hESCs or hiPSCs for preclinical studies in muscle repair.
A STUDY OF SERUM LIPOPROTEINS IN NORMAL AND ATHEROSCLEROTIC PATIENTS BY PAPER ELECTROPHORETIC TECHNIQUES
Authors: William P. Jencks, Marion R. Hyatt, Mera R. Jetton, Thomas W. Mattingly, E. L. Durrum
Journal: Journal of Clinical Investigation (1956)

The existence of a specific abnormality of lipid metabolism in patients with atherosclerosis has been suggested by recent studies which have shown that the concentration of certain serum lipo- proteins in patients with coronary disease is sta- tistically different from that found in "normal" individuals.Gofman and his co-workers (1) found in such patients an elevation of a beta lipo- protein sub-fraction defined by ultracentrifugal flotation rates between Sf 10 and 20.Russ, Eder, and Barr (2, 3) measured the cholesterol content of precipitated serum lipoprotein fractions and found that the total beta lipoprotein fraction was increased in serum from a group of atherosclerotic patients as compared to a control group made up largely of hospital personnel.Similar results have been obtained by Nikkila (4), who measured the cholesterol content of electrophoretically separated protein fractions, and by Antonini et al. ( 5) and Kroetz and Fischer (6) who measured lipoprotein concentration in terms of the lipid dye binding of serum proteins separated by paper electrophoresis.Studies on the validity and reproducibility of two relatively simple methods for the estimation of electrophoretically separated serum lipoproteins by measurement of their cholesterol content and dye binding capacity have recently been reported from this laboratory (7, 8).These methods are not subject to significant error due to loss of lipo- protein bound dye during alcohol rinsing, oxida- tion of cholesterol, or tailing of lipoprotein during electrophoresis similar to that found with albumin.The studies reported here were carried out in or- der to test the large scale application of these methods, to compare the results of the two meth- ods with each other and with ultracentrifugal methods, and to confirm further the association of
Combination ethacizin and treatment of resistant ventricular ectopy — Experimental, theoretical, and clinical study
Authors: V.V Nesterenko, E.P. Anyukhovsky, E.M. Bugrli, C.F. Starmer, G.G. Beloshapko, J.C. Makielski, A.V. Kuzmin, M.Ju. Menshikov, A.V. Mazaev, L.V. Rosenshtraukh
Journal: Journal of the American College of Cardiology (1990)