tbuckley/cabot-search huggingface dataset:
Treatment of Status Epilepticus-Reply
Authors: Sanford Schneider
Journal: JAMA (1976)

One of the basic tenets of medical education that I try to teach is that there is rarely a single method or procedure of medical practice that should always be adhered to with slavish rigidity. In other words, there is always more than one way to "skin a cat." The letters by Drs Zmyslowski and Siris point this out, as have the many communications sent to me directly after the report of the "Schneider Method" for control of status epilepticus. Dr Zmyslowski has used a single bolus of lidocaine intravenously before resorting to the use of general anesthesia in the treatment of status epilepticus. I have no quarrel with this point of view, except that, in my experience, lidocaine has generally been very ineffective in consistently controlling status epilepticus on a fairly large number of occasions. Also, since the myocardial toxicity of lidocaine is enhanced by hypoxia and
A New Tongue-Depressor.
Authors: G. ALVIN HILL
Journal: JAMA (1901)

Any metallic tongue-depressor, however carefully made, will, after a time, become unsightly from the wearing off of the plating, and no amount of cleaning will give it the appearance of being clean; so fastidious patients are very apt to look askance at it. Another annoying objection to all instruments made of metal not corrugated or roughened is their tendency to slip backward or sidewise on the tongue, causing irresistible gagging and a necessary pause in one's examination or operation, not to mention a less docile state of that member afterward. With the instrument here described these unpleasant features are entirely obviated. The spatula is of hard, nicely finished wood, which, on being placed on the tongue, adheres to it, so that considerable forward traction can be made and thus effectually draw the base of that organ away from the fauces, allowing more room for inspection or such applications as may
Bundle-Branch Block Complicating Acute Myocardial Infarction
Authors: Stephen Scheidt
Journal: JAMA (1972)

Nineteen patients with right bundle-branch block (RBBB) and 20 with left bundle-branch block (LBBB) were treated in a coronary care unit for acute myocardial infarction during a 4 1/2-year period. Twenty-six percent of patients with RBBB developed cardiogenic shock, 32% had complete atrioventricular block, and 26% had ventricular asystole. Mortality was 37%, primarily from myocardial failure rather than asystole or arrhythmia. Pacemaker therapy was generally unsuccessful in reducing mortality. In contrast, 70% of the group with LBBB suffered life-threatening ventricular arrhythmia during or in close proximity to the acute phase of myocardial infarction. Mortality was 35%. Electrophysiologic mechanisms may influence ventricular irritability in patients with LBBB and ischemic heart disease. Consideration should be given to prophylactic antiarrhythmic therapy in these patients at least during hospitalization for acute myocardial infarction.
Levels of Plasma Complement Split Products C3a desArg and C5a desArg and their Peripheral Blood Receptors are Elevated in Outpatient Adult Asthmatics with Decreased Asthma Control as Determined by the ACT and ATAQ Questionnaires
Authors: R. Shams, D.P. Erstein, M.S. Dzhindzhikhashvili, F. Hajee, S. Chice, M. Nowakowski, H.G. Durkin, R. Joks
Journal: Journal of Allergy and Clinical Immunology (2009)
On Sudden Heart Failure in Toxaemic Conditions with a Special Reference to Diphtheria and Beri-Beri
Authors: A. Stanley
Journal: BMJ (1903)

HAVING had the unusual experience of being in charge con- secutively of a comparatively large number of cases of diphtheria and beri-beri, I feel justified in treating of this' important subject of sudden heart failure, as it is in these two diseases par excellence that degeneration of the heart muscle is so frequentand terrible a cause of death.Shortly after making a clinical study of the heart condition in diphtheria while in charge of a diphtheria ward at the North-Western Fever Hospital, London, I came out to China, and was especially struck by finding an almost precisely similar heart condition in the beri-beri cases in the Shanghai Municipal Isolation Hospital.And this heart condition, >compared with that caused by certain poisons, such as alcohol and arsenic, and associated with certain diseases, such as influenza, typhoid fever, and plague, appears to show a close relationship among many bacterial and chemical poisons in their action on the heart.Inasmuch as the heart is the most sensitive part of the human machine from the point of view of both prognosis and treatment, the subject is an important one and merits close attention.In both diphtheria and beri-beri sudden heart failure is the most terrible complication, and one in which, as a rule, no treatment is available in preventing death.So marked a feature is this of beri-beri that the Japanese have given the name of "shio-shin"(signifying literally "heart stroke")to this mode of fatal termination; and this connexion with diphtheria-a disease which is also associated with peripheral neuritis-is a suggestive leading motive in etiology.In both these diseases the occurrence of vomiting is almost the invari- able herald of a rapid fatal termination by heart failure.Practically speaking, the main signs met with in heart failure occurring in any of these conditions are vomiting, restlessness, lilac-tinted pallor, dyspnoea, increasing weak- ness of the pulse, and coldness of the extremities.These symptoms occurring together in diphtheria or beri-beri denote, as a rule, a fatal termination.The syncopal attack is marked rather by duration than by intensity; loss of consciousness is rare.Heart failure may occur in diseases accompanied by neuritis before any skeletal muscular paralysis is obvious, and the usual time for death from this cause to take place appears to be about the end of the first week in diphtheria and towards the end of the first month in beri-beri.
Vietnam tops world smoking league for men
Authors: J. Wise
Journal: BMJ (1997)

Vietnam has the highest reported smoking prevalence among men in the world–seven men in 10 smoke. This figure is likely to rise still further because developing countries are increasingly being targeted by international tobacco corporations searching for new markets.

A survey of 2004 men and women in Hanoi, Ho Chi Minh City, and two rural communities found that 73% of men smoked but only …
Epidemiology of patellar tendon injury in elite male soccer players
Authors: M Hägglund, M Waldén, J Zwerver, J Ekstrand
Journal: British Journal of Sports Medicine (2011)

Background Patellar tendon injuries are common in jumping sports. The epidemiology in soccer is not well described. Objective To study the epidemiology of patellar tendon injury in elite male soccer players and evaluate potential risk factors. Design Prospective cohort study. Setting Men's professional soccer. Participants 51 European elite soccer clubs (2229 players) from three different cohorts; Swedish First League and Union of European Football Associations (UEFA) Champions League cohorts playing at home grounds with natural grass, and UEFA Artificial Turf cohort playing on third generation artificial turfs, were followed between 2001 and 2009 over a varying number of seasons. Assessment of risk factors Internal (age, stature, body mass) and external (total exposure, training/match exposure ratio, team home surface, seasonal distribution, playing position) risk factors were investigated using multivariate logistic regression. Main outcome measurements Patellar tendon injury (insidious onset tendinopathy or acute partial rupture) leading to time-loss from soccer. Results 139 patellar tendon injuries were recorded (1.5% of all injuries) with an incidence of 0.12 injuries/1000 h and a season prevalence of 2.4%. Most injuries (60%) were minimal to mild (&lt;8 days absence), and 19% were recurrent complaints. No difference in season prevalence (OR 0.96, 95% CI 0.62 to 1.48) or incidence (RR 1.22, 95% CI 0.84 to 1.77) was observed between teams playing on artificial turf and natural grass. Multivariate logistic regression showed that high total exposure hours (OR 1.02 per 10 h increase; 95% CI 1.00 to 1.04) and increased body mass (OR 1.16 per 5 kg increase; 95% CI 1.00 to 1.34) were significant risk factors for patellar tendon injury. Conclusion Although mainly mild in nature, patellar tendon injuries are fairly common in elite soccer and the recurrence rate is high. Exposure to artificial turf did not increase the risk of injury. Increased body mass and high total amount of exposure were identified as risk factors for patellar tendon injury.
1059-3 Prospective evaluation of integrating the existing emergency medical system with automated external defibrillators operated by volunteers and lay persons for out-of-hospital cardiac arrest: The Brescia early defibrillation study (BEDS)
Authors: Riccardo Cappato, Antonio Curnis, Paolo Marzollo, Giosué Mascioli, Tania Bordonali, Sonia Beretti, Fausto Scalfi, Luca Bontempi, Adriana Carolei, Luigi De Ambroggi, Livio Dei Cas
Journal: Journal of the American College of Cardiology (2004)
Grading obesity hypoventilation syndrome severity
Authors: C. Cabrera Lacalzada, S. Díaz-Lobato
Journal: European Respiratory Journal (2008)

To the Editors: 

Obesity hypoventilation syndrome (OHS) is commonly defined as a combination of obesity (body mass index (BMI) >30 kg·m−2), waking arterial hypercapnia (arterial carbon dioxide tension ( P a,CO2) >6.0 kPa (45 mmHg)) and sleep-disordered breathing. Essential to the diagnosis is exclusion of other causes of alveolar hypoventilation 1. The lack of a standardised definition of OHS in general, and of OHS–obstructive sleep apnoea relationships in particular, leads to confusion.

One of the main aspects that has not been clarified is the assessment of OHS severity. This appears to be directly related to the degree of hypercapnia, the degree of hypoxaemia and the presence of complications 2, 3. Nevertheless, …
ABC of vascular diseases. Treating aortic aneurysms.
Authors: P R Taylor, J H Wolfe
Journal: BMJ (1991)

Rupture of an abdominal aortic aneurysm remains one of the most dangerous events in vascular surgery, the mortality being close to 100% if the condition is not treated.The diagnosis may, however, be difficult as many other life threatening conditions produce a similar clinical picture.Any delay in operating on these patients has a serious adverse effect on their outcome; many die before they reach the operating theatre, so the mortality in the community remains over 90%.The perioperative mortality has P.`Z vt _ remained constant at 30-50% despite advances in anaesthetic and surgical techniques during the past two decades.In contrast, mortality after elective repair of an aneurysm that has not ruptured is usually between 2% and 5%.Even operations on selected patients over the age of 80 have a mortality of only about 10%.The most important way of improving the poor prognosis of patients with ruptured Digital subtraction angiogram showing abdominal aortic aneurysms is to diagnose the aneurysm before it ruptures.contrast in the aorta and diseased iliac Careful assessment by surgeons and cardiologists can then be made before arteries.The thrombus in the aneurysmal sac operation is contemplated.is to the left of the aortic lumen. IncidenceThe incidence of abdominal aortic aneurysm is increasing in the United Differential diagnoses for ruptured Kingdom; it is more common among men than women, the ratio being Differential diagnoses for ruptured about 5:1.Although the natural course is unknown, aneurysms expand at a abdominal aortic aneurysm rate of about 0 5 cm a year and this rate increases as the aneurysm enlarges.* Myocardial ischaemia The risk of rupture increases proportionately with the diameter, but even * Perforated ulcer aneurysms <4 cm have a slight risk of rupture.Less than half the patients * Acute cholecystitis with symptomatic aneurysms will survive a year, and asymptomatic * Acute pancreatitis aneurysms also carry a high risk.The average time between diagnosis and * Renal or ureteric colic rupture is 16 months.* Bowel obstruction Ruptured abdominal aortic aneurysms are responsible for 1-1 5% of all deaths in men over the age of 65 in the Western World, with an incidence of 25-30/100 000 population. ScreeningScreening has recently been advocated to reduce the high incidence of Atheroma is associated with: ruptured aneurysms.The group at risk comprises men over 65, among whom there is a 2% prevalence of abdominal aneurysms >4 cm in diameter.. HypertensionFurthermore, a single ultrasound scan that shows an entirely normal aorta * Diabete in a 60 year old man does not need to be repeated.Aneurysms <4 cm in * Smoking diameter can usually be treated conservatively and followed up with six * sex monthly ultrasound scans.Whether to operate on asymptomatic aneurysms * Sex <5 cm in diameter is controversial, but the risk of rupture was shown to be * Hyperlipidaemia small in two recent population studies; the operation is indicated only if the aneurysms expand or start to cause symptoms.
Targeting the p53 Pathway in Retinoblastoma with Subconjunctival Nutlin-3a
Authors: Rachel C. Brennan, Sara Federico, Cori Bradley, Jiakun Zhang, Jacqueline Flores-Otero, Matthew Wilson, Clinton Stewart, Fangyi Zhu, Kip Guy, Michael A. Dyer
Journal: Cancer Research (2011)

Retinoblastoma is a rare childhood cancer of the retina that begins in utero and is diagnosed in the first years of life. The goals of retinoblastoma treatment are ocular salvage, vision preservation, and reduction of short- and long-term side effects without risking mortality because of tumor dissemination. To identify better chemotherapeutic combinations for the treatment of retinoblastoma, several groups have developed genetic mouse models and orthotopic xenograft models of human retinoblastoma for preclinical testing. Previous studies have implicated the MDMX protein in the suppression of the p53 pathway in retinoblastoma and shown that the MDM2/MDMX antagonist, Nutlin-3a, can efficiently induce p53-mediated cell death in retinoblastoma cell lines. However, Nutlin-3a cannot be administered systemically to treat retinoblastoma, because it has poor penetration across the blood-ocular barrier. Therefore, we developed an ocular formulation of Nutlin-3a, Nutlin-3a(OC), and tested the pharmacokinetics and efficacy of this new formulation in genetic and human retinoblastoma orthotopic xenograft models of retinoblastoma. Here, we show that Nutlin-3a(OC) specifically and efficiently targets the p53 pathway and that the combination of Nutlin-3a(OC) with systemic topotecan is a significantly better treatment for retinoblastoma than currently used chemotherapy in human orthotopic xenografts. Our studies provide a new standardized approach to evaluate and prioritize novel agents for incorporation into future clinical trials for retinoblastoma.
Research into HIV vaccines needs to change direction
Authors: Bob Roehr
Journal: BMJ (2008)

HIV vaccine research should turn away from clinical trials and refocus instead on more basic studies, a meeting in Bethesda, Maryland, decided last week.

“Despite hundreds and hundreds of millions of dollars, the reality in 2008 is that an HIV vaccine clearly remains beyond our grasp,” said Warner Greene, director of the Gladstone Institute of Virology and Immunology at the University of California, San Francisco, at the opening session.

Last autumn a second candidate for an HIV vaccine failed. Although few expected it to protect against infection, the hope had been that it might bolster immune defences and result …
HETEROGENEITY OF THE INHERITED GROUP-SPECIFIC COMPONENT OF HUMAN SERUM
Authors: Alexander G. Bearn, F. David Kitchin, Barbara H. Bowman
Journal: The Journal of Experimental Medicine (1964)

Heterogeneity of the group-specific (Gc) components in normal human serum has been demonstrated by the use of a lithium borate buffer system in conventional vertical starch gel electrophoresis and by prolonged immunoelectrophoresis in agar gel. In both Gc 1-1 and Gc 2-2 phenotypes a protein component migrates ahead of the main band. Immunological evidence indicates that the faster migrating band contains Gc specificity. The possibility that the two electrophoretically distinct Gc components share a common polypeptide chain is discussed.
Serum levels of osteopontin are increased in SIRS and sepsis
Authors: Rosanna Vaschetto, Stefania Nicola, Carlo Olivieri, Elena Boggio, Fabio Piccolella, Riccardo Mesturini, Federica Damnotti, Davide Colombo, Paolo Navalesi, Francesco Della Corte, Umberto Dianzani, Annalisa Chiocchetti
Journal: Intensive Care Medicine (2008)
Forty hospitals performed as badly as or worse than Stafford, analysis finds
Authors: C. White
Journal: BMJ (2010)

Forty hospitals performed as badly as or worse than Stafford Hospital, indicates an in-depth analysis of quality indicators for 2007-8, carried out by the international consultancy PricewaterhouseCoopers.

The figures emerged last week at an open panel discussion on hospital reconfiguration organised by the independent think tank 2020health (www.2020health.org).

They back up concerns raised earlier this year by Brian Jarman, head of the Dr Foster Intelligence Unit at Imperial College London, about excess deaths at 25 trusts in England ( BMJ 2010;340:c1745, doi:10.1136/bmj.c1745).

In 2009 the former health services watchdog, the Healthcare Commission, found higher than expected death rates between 2005 and 2008 at Mid Staffordshire NHS Foundation Trust, and a full public inquiry into events there has now begun ( BMJ 2010;341:c3952, 21 Jul, doi:10.1136/bmj.c3952).

Ian Wootton, who co-leads on healthcare …
The Great Northwest and the Great Wide World
Authors: Lloyd G. Stevenson
Journal: JAMA (1966)

William Osler was not only a lover of old books, he was also a connoisseur of old journals. The<i>Medical Repository</i>of New York, the<i>Medical Museum</i>of Philadelphia and other pioneer American medical journals gave, he thought, "an impression of capable and scholarly editorial control and a high grade of original contribution." The<i>American Journal of the Medical Sciences</i>he considered "one of the few great journals of the world, and the one from which one can almost write the progress of American medicine" during the 19th century. But later and lesser journals may also be seen as the mirrors of American medicine in their time. A general medical periodical should of course reflect both national and international developments. It also should exhibit a certain regional, or even local character, for this was deemed an important part of medical journalism in a time when many local and regional "endemic"
TCT-713 The double-edged sword of antiplatelet treatment following transcatheter aortic valve implantation – a collaborative patient level pooled analysis
Authors: Mariëlla E. Hassell, David Hildick-Smith, Eric Durand, Esther M. Wiegerinck, Sumeet Sharma, Jan Baan jr., Helene Eltchaninoff, Petra Poliacikova, Jan Piek, Ronak Delewi
Journal: Journal of the American College of Cardiology (2014)
Home birth as safe as in hospital for low risk women, study shows
Authors: H. MacDonald
Journal: BMJ (2009)

Home birth is as safe as hospital birth for women at low risk, according to the results of a Dutch cohort study of 529 688 women. But the authors say that a prospective study is needed ( British Journal of Obstetrics and Gynaecology 2009;116:1-8).

“In our research, we studied more than half a million women in primary care and compared planned home births with planned hospital births,” said the lead researcher Simone Buitendijk, head of the child health programme at the Netherlands Organisation for Applied Scientific Research.

All low risk women, who gave birth between January 2000 and December 2006, were included. Just over 60% planned to give birth at home, 30.8% in hospital, and the rest …
Wonder in medicine
Authors: D. K Sokol
Journal: BMJ (2009)

Permanent residents at high altitude may develop excessive polycythaemia (H-Hb) and pulmonary hypertension, which often leads to cardiac failure. Inhibitors of calcium channels have been shown to reverse pulmonary hypertension in respiratory diseases and in primary pulmonary hypertension, but their efficiency has not been evaluated in high-altitude-induced pulmonary hypertension. Systolic pulmonary arterial pressure (Ppa) was studied by Doppler echocardiography, at rest and after sublingual nifedipine, in 31 asymptomatic residents at 3,600 m. Individuals were separated into two groups according to resting Ppa: a group with low Ppa (&lt; or =4.7 kPa, n=17) and a group with high Ppa (&gt;4.7 kPa, n=14). Individuals were also split into two groups according to haemoglobin (Hb) concentration: a normocythaemic (L-Hb) group ([Hb] &lt; or =180 g.L(-1), n=17) and a H-Hb group ([Hb] &gt;180 g.L.(-1), n=14). No significant difference in Ppa was observed between the L-Hb and H-Hb groups. There was no correlation between [Hb] and Ppa. Nifedipine induced a decrease of &gt;20% in Ppa in two-thirds of the subjects. This response was correlated with higher levels of basal Ppa (p&lt;0.001) and was inversely correlated with age in the L-Hb group (p&lt;0.05). Pulmonary vasoreactivity to nifedipine was independent of the degree of H-Hb. Pulmonary hypertension secondary to chronic altitude hypoxia may be reversible, despite a possible remodelling of the pulmonary arterioles.
Medulloblastoma Growth Factor
Authors: Tracy Hampton
Journal: JAMA (2013)

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