tbuckley/cabot-search huggingface dataset:
P242 The treatment of pseudomonas aeruginosa (PA) in non-CF bronchiectasis
Authors: O. Hewitt, L. M. Crossan, R. Hanna, J. Rendall, J. M. Bradley, J. S. Elborn
Journal: Thorax (2010)

<h3>Introduction</h3> Pseudomonas aeruginosa (PA) is a common bacteria in bronchiectasis, and infection with PA is associated with worsening symptoms that may lead to an accelerated decline in FEV<sub>1</sub>. <h3>Aims</h3> To review the current treatment of infection with PA, at the Regional Respiratory Centre, City Hospital Belfast to determine the success rate of eradication treatment and to assess if PA had any impact on lung function following 3 months of treatment. <h3>Methods</h3> Medical notes of patients that had positive culture for PA requiring nebulised antibiotic treatment from August 2007 to October 2008 were reviewed. Where available, data relating to antibiotic therapy prescribed, presence of PA and lung function was recorded at the start of treatment, following 1 month of treatment and following 3 months of treatment. <h3>Results</h3> Data from 91 patients, mean age (SD) 65 (11) years, baseline FEV<sub>1</sub> 1.5 (0.7) %, FVC 58 (21.4) % were analysed. 58/91 (64%) patients had a first ever recorded isolate of PA and 29/91 (32%) had previous sputum cultures with PA. First line treatment included oral ciproxin (n= 49/91; 54%) and IV anti pseudomonal antibiotics (n=27/91; 30%). 10/91 (11%) did not have a complete treatment due to side effects. Mean (SD) treatment duration of oral ciproxin was 3.67 (2.1) weeks; range 2–12 weeks. Patients were also prescribed nebulised antibiotic treatment: colomycin (n=84/91; 92%) and tobramycin (n=7/91; 8%). After 1 month of nebulised treatment (n=76) 55/76 (72%) had eradicated PA. Following 3 months of treatment (n=83), treatment of new isolates of PA in sputum was successful in eradication in 57/83 (69%) of patients. No improvements in lung function were noted. <h3>Conclusions</h3> The success of treatment for PA eradication is similar to those reported in cystic fibrosis and current treatment does not adversely impact on lung function.
BLOOD PRESSURE OBSERVATIONS
Authors: C. Ward Crampton
Journal: JAMA (1923)

<h3>To the Editor:</h3> —Some of the observations which are published under the title "Some Original Blood Pressure Observations," by Dr. Virgil C. Kinney (The Journal, June 16, p. 1767), while interesting, are certainly not new. What Dr. Kinney calls "a complete reversal of the normal blood pressure reaction" was reported in 1905 by me in the<i>Medical News</i>, September 16, under the title "A Test of Condition"; further, under the title "Blood Ptosis—A Test of Vasomotor Efficiency" in the<i>New York Medical Journal</i>, Nov. 8, 1913; and again in the<i>American Journal of the Medical Sciences</i>(<b>160</b>: 721 [Nov.] 1920), under the title "The Gravity Resisting Ability of the Circulation: Its Measurement and Significance (Blood Ptosis)." Sewall, in an article on "The Clinical Significance of the Postural Changes in Blood Pressure" (<i>Am. J. M. Sc</i>.<b>158</b>: 573 [Dec.] 1919) follows my work and also uses the term "blood ptosis." E.
Malondialdehyde–Deoxyguanosine Adducts among Workers of a Thai Industrial Estate and Nearby Residents
Authors: Marco Peluso, Petcharin Srivatanakul, Armelle Munnia, Adisorn Jedpiyawongse, Marcello Ceppi, Suleeporn Sangrajrang, Sara Piro, Paolo Boffetta
Journal: Environmental Health Perspectives (2009)

Humans living near industrial point emissions can experience high levels of exposures to air pollutants. Map Ta Phut Industrial Estate in Thailand is the location of the largest steel, oil refinery, and petrochemical factory complexes in Southeast Asia. Air pollution is an important source of oxidative stress and reactive oxygen species, which interact with DNA and lipids, leading to oxidative damage and lipid peroxidation, respectively.We measured the levels of malondialdehyde-deoxyguanosine (dG) adducts, a biomarker of oxidative stress and lipid peroxidation, in petrochemical workers, nearby residents, and subjects living in a control district without proximity to industrial sources.We conducted a cross-sectional study to compare the prevalence of malondialdehyde-dG adducts in groups of subjects experiencing various degrees of air pollution.The multivariate regression analysis shows that the adduct levels were associated with occupational and environmental exposures to air pollution. The highest adduct level was observed in the steel factory workers. In addition, the formation of DNA damage tended to be associated with tobacco smoking, but without reaching statistical significance. A nonsignificant increase in DNA adducts was observed after 4-6 years of employment among the petrochemical complexes.Air pollution emitted from the Map Ta Phut Industrial Estate complexes was associated with increased adduct levels in petrochemical workers and nearby residents. Considering the mutagenic potential of DNA lesions in the carcinogenic process, we recommend measures aimed at reducing the levels of air pollution.
SPECIALISM IN ITS RELATION TO GENERAL MEDICINE.ADDRESS OF CHAIRMAN OF THE SECTION ON LARYNGOLOGY AND OTOLOGY, AT THE FIFTY-EIGHTH ANNUAL SESSION OF THE AMERICAN MEDICAL ASSOCIATION AT ATLANTIC CITY, JUNE, 1907.
Authors: S. MAC CUEN SMITH
Journal: JAMA (1907)

"From the remotest past which science can fathom, up to the novelties of yesterday, an essential trait of evolution has been the transformation of the homogeneous into the heterogeneous." This statement of the great English philosopher, Herbert Spencer, is especially applicable to the development of medicine. The history of our art and science is a brilliant example of the truth of this assertion. Of humble origin, nourished and reared by superstition, for ages an integral part of theology and priestcraft, medicine has grown to be of so complex a nature that the combined intelligence of many sages is insufficient to grasp all its essentials. At first homogeneous, it is certainly now heterogeneous. "From an insignificant shrub a stately tree has developed, its numerous branches profusely laden with blossoms and fruits, and the widely-disseminated roots drawing their nourishment from a resourceful ground." The development of the art and science of medicine
Wounded Healers: Mental Health Workers' Experiences of Depression
Authors: David Peretz
Journal: JAMA (1986)

<i>Wounded Healers</i>brings together autobiographical reflections by 17 health professionals that center on their personal experiences of depression. The majority of the contributions are by mental health workers, although a few are by general practitioners. The book is not about the phenomenon of "burnout" but about various forms and degrees of clinical depression or affective disorder. One of the editors' goals is to contribute to the phenomenology of depression, and in this they succeed. They have divided the volume into six sections, such as "Trouble at Work," "Arrivals and Departures," and "Women and Depression," emphasizing particular precipitating or major background factors in the depression. The individual accounts are at times unusually well-written, moving documents of personal suffering and efforts to cope. The details of onset of illness, course, response to treatment, and outcome are clearly woven into the fabric of the statements, providing useful clinical and dynamic data. Depression, while
Commodes: inconvenient conveniences.
Authors: J R Naylor, G P Mulley
Journal: BMJ (1993)

OBJECTIVES--To investigate use of commodes and attitudes of users and carers to them. DESIGN--Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS--140 users of a commode and 105 of their carers. RESULTS--Main reasons for being supplied with a commode were impaired mobility (130 subjects), difficulty in climbing stairs (128), and urinary incontinence (127). Main concerns of users and carers were lack of privacy (120 subjects felt embarrassed about using their commode, and 96 would not use it if someone was present); unpleasant smells (especially for 20 subjects who were confined to one room); physical appearance of commode chair (101 users said it had an unfavourable appearance, and 44 had tried to disguise it); and lack of follow up after commode was supplied (only 15 users and carers knew who to contact if there were problems). Users generally either had very positive or very negative attitudes to their commodes but most carers viewed them very negatively, especially with regard to cleaning them. CONCLUSIONS--Health professionals should be aware of people9s need for privacy when advising them where to keep their commode. A standard commode is inappropriate for people confined to one room, and alternatives such as a chemical toilet should be considered. Regular follow up is needed to identify any problems such as uncomfortable or unsafe chairs. More thought should be given to the appearance of commodes in their design.
Specific fiber deficits in sensorimotor diabetic polyneuropathy correspond to cytotoxicity against neuroblastoma cells of sera from patients with diabetes.
Authors: G L Pittenger, R A Malik, N Burcus, A J Boulton, A I Vinik
Journal: Diabetes Care (1999)

OBJECTIVE: Neuropathy is the most common complication of diabetes, and toxic serum factors may contribute to its genesis. RESEARCH DESIGN AND METHODS: We assessed neurotoxicity in the serum of 39 diabetic patients and correlated it with clinical measures of somatic and autonomic nerve fiber damage. Sera were applied to N1E-115 and VSC4.1 neuroblastoma cells in vitro as models of sensory/autonomic (S/A) and motor neurons, respectively. Neurotoxicity was measured as either complete or near-complete cell death (highly toxic), inhibited cell growth (moderately toxic), or normal cell proliferation (nontoxic) compared with pooled human serum controls during culture over 4 days. RESULTS: There was an inverse correlation between neurotoxicity and vibration perception threshold (P &amp;lt; 0.01). Age (P &amp;lt; 0.02), duration of diabetes (P &amp;lt; 0.02), and HbA1c (P &amp;lt; 0.03) correlated with neurotoxicity, suggesting that glycation may contribute to cytotoxicity in this model. S/A neurotoxicity occurred more frequently in the sera of patients with type 1 (19 of 25) than type 2 (5 of 14) diabetes (P &amp;lt; 0.02). None of the sera from either type 1 or type 2 diabetic patients displayed neurotoxicity on VSC4.1 cells, whereas sera from patients with motor neuropathy were highly toxic. CONCLUSIONS: These studies indicate that there is a relationship between the specific nerve fiber dysfunction in the patient and the type of neuronal cell killed, not only for diabetic neuropathy but also for known forms of autoimmune neuropathies. Such toxic factors may contribute to diabetic neuropathy by acting in concert with hyperglycemia to damage sensory/autonomic neurons.
Randomized, Sham-Controlled Trial of Dexamethasone Intravitreal Implant in Patients with Macular Edema Due to Retinal Vein Occlusion
Authors: Julia A. Haller, Francesco Bandello, Rubens Belfort, Mark S. Blumenkranz, Mark Gillies, Jeffrey Heier, Anat Loewenstein, Young-Hee Yoon, Marie-Louise Jacques, Jenny Jiao, Xiao-Yan Li, Scott M. Whitcup
Journal: Ophthalmology (2010)
Resection of Myocardial Aneurysms after Infarction during Temporary Cardiopulmonary Bypass
Authors: C. WALTON LILLEHEI, MORRIS J. LEVY, RICHARD A. DEWALL, HERBERT E. WARDEN
Journal: Circulation (1962)

The report consists of five patients with chronic postinfarct left ventricular aneurysms. The age distribution was between 47 and 63 years. The time lapse between the initial infarct and the appearance of the left ventricular aneurysm was 2 weeks to 2 years. The time interval between the initial infarct and surgery was 5 months to 6 years. Less than adequate bedrest following the infarct, multiple infarcts, and systemic hypertension were other factors present in this group. Right heart catheterization was performed in two patients and showed reduced cardiac output and elevated pulmonary pressures in one. The electrocardiograms were consistent with extensive old myocardial infarction and ventricular aneurysm. The diagnosis was suggested by electrocardiograms and roentgenography, supported by kymography, and confirmed by angiography. The world literature on surgically treated patients with ventricular aneurysms is briefly reviewed with emphasis on the varied surgical approaches to the problem in the past. The method of complete excision with ventriculoplasty during cardiopulmonary bypass was used in all our patients during the past 4 years. The anatomic distribution of the ventricular aneurysm as well as the histopathology of the resected specimen is described. All patients survived the operation, and were observed from 6 months to 40 months after operation. There have been no late deaths to date, and all patients have been rehabilitated. Postoperative catheterization studies have confirmed the clinical improvements observed. More attention should be given to this relatively common complication after infarct because excision under temporary heart-lung bypass is a safe and feasible approach.
Public inquiries about indoor air quality in California.
Authors: J M Macher, S B Hayward
Journal: Environmental Health Perspectives (1991)

To identify the indoor air quality issues about which Californians most often sought advice from a health department or a public information agency and to evaluate how well these agencies met the public's needs, members of the California Interagency Working Group (IWG) on Indoor Air Quality kept records of inquiries they received over a 30-month period from mid-1985 through 1987. Members of the IWG answered calls from residents of a least 49 of California's 58 counties. IWG members received more public inquiries about residences than about offices, educational institutions, commercial buildings, or medical facilities. However, each call about a residence probably represented fewer people at risk of exposure to a real or a potential problem than did calls about other types of buildings. Homeowners themselves asked the majority of the questions about residences, whereas a large number of the inquiries about office buildings were made, not by affected office workers, but by building managers, contractors, consultants, or company health and safety officers. The leading topics of concern in the residences were asbestos, chemical and biological contamination, and radon. In offices, chemical contamination, the ventilation system, biological contamination, asbestos, and tobacco smoke were the most frequently mentioned sources of problems. Callers often reported experiencing headaches, allergy symptoms, nose or throat irritation, and respiratory tract problems in connection with their complaints. IWG members directed a third of the calls elsewhere, of which half were referred to consultants or testing laboratories. The IWG's experience in the State of California could help other health departments prepare to face the public's increasing concern about indoor air pollution.
Lack of effect of beta-blocker on flat dose response to thiazide in hypertension: efficacy of low dose thiazide combined with beta-blocker.
Authors: G A MacGregor, R A Banks, N D Markandu, J Bayliss, J Roulston
Journal: BMJ (1983)

Increasing the dose of a thiazide diuretic used alone in patients with essential hypertension has little further effect on blood pressure but increases the deleterious metabolic consequences of the diuretic. The effect of a beta-blocker on this flat dose response is not known. In two randomised crossover studies the effect of 12.5 mg, 25 mg, and 50 mg hydrochlorothiazide combined with 400 mg acebutolol was assessed. The mean fall in supine blood pressure was about 15% and was the same whatever dose of thiazide was used with the beta-blocker. As the dose of hydrochlorothiazide was increased, however, there was evidence of increasing metabolic consequences of the diuretic. The study did not define the minimum dose of diuretic, and doses of hydrochlorothiazide lower than 12.5 mg might be as effective. These results suggest that many patients who are being treated with a combination of a beta-blocker and a diuretic are receiving unnecessarily large amounts of the diuretic without benefit to their blood pressure and with adverse metabolic consequences.
Case 51-1981
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, Willard M. Daggett, John T. Fallon
Journal: New England Journal of Medicine (1981)

Presentation of CaseA 55-year-old man was admitted to the hospital because of intermittent claudication of the arms.He was well until five years earlier, when a diagnosis of diabetes mellitus was made. Dieting resulted in a weight reduction from 90 to 68.2 kg. On a routine annual physical examination 10 weeks before admission the radial and brachial pulses were found to be diminished bilaterally. One month before entry he began to have weakness and pain in both hands and forearms on minor exertion such as tying his necktie, shaving, or completing a single-page government form, with recovery after several . . .
Computational ecosystems for data-driven medical genomics
Authors: Jonas S Almeida
Journal: Genome Medicine (2010)

In the path towards personalized medicine, the integrative bioinformatics infrastructure is a critical enabling resource. Until large-scale reference data became available, the attributes of the computational infrastructure were postulated by many, but have mostly remained unverified. Now that large-scale initiatives such as The Cancer Genome Atlas (TCGA) are in full swing, the opportunity is at hand to find out what analytical approaches and computational architectures are really effective. A recent report did just that: first a software development environment was assembled as part of an informatics research program, and only then was the analysis of TCGA's glioblastoma multiforme multi-omic data pursued at the multi-omic scale. The results of this complex analysis are the focus of the report highlighted here. However, what is reported in the analysis is also the validating corollary for an infrastructure development effort guided by the iterative identification of sound design criteria for the architecture of the integrative computational infrastructure. The work is at least as valuable as the data analysis results themselves: computational ecosystems with their own high-level abstractions rather than rigid pipelines with prescriptive recipes appear to be the critical feature of an effective infrastructure. Only then can analytical workflows benefit from experimentation just like any other component of the biomedical research program.
A series of unfortunate events
Authors: S. Ginn
Journal: BMJ (2010)

A 24 year old man presented to the accident and emergency department because he had been planning to take an overdose, but had decided instead to seek help from mental health services. He had intended to take the contents of several blister packs of paracetamol, together with alcohol. He had been having suicidal thoughts for a week but they had become particularly pronounced over the past two days.

His recent history was one of a “series of unfortunate events” that had left him feeling desperate. Four months ago his flatmate stole money from him, which meant that he was unable to repay several loans. His debtors had started to threaten him and he had been forced to move to a different city and leave his job. He had become socially isolated, and continuing financial difficulties had resulted in poor relations with his new landlord. Just before his presentation he had been awaiting a cheque for housing benefit. However, this had not arrived, and he described this as “the last straw.” He reported feelings of hopelessness and thoughts of “what’s the point?”

He had no history of suicide attempts, self harm, or suicidal thoughts. Five years previously, however, he was admitted twice to a psychiatric ward with psychotic symptoms associated with the use of cannabis. Currently there is no evidence of psychosis, and no relevant medical history. He came to hospital on his own, but a friend provided a collateral history on the telephone. The patient says that if he goes home he is worried that he will take the large amount of paracetamol tablets that await him there.



### 1 How would you assess his risk of suicide?

#### Short answer

The likelihood of future suicide should be …
Bevacizumab and postponed suture leakages after surgery for ulcerative colitis and rectal cancer
Authors: A. Adenis, L. Vanseymortier, D. Foissey, J.-F. Colombel
Journal: Gut (2007)

Bevacizumab is a murine-anti-human monoclonal antibody directed against vascular endothelial growth factor-A, which disrupts endothelial cell survival mechanisms, and the recruitment and development of new tumour blood supply. Bevacizumab has been shown to prolong the duration of survival of patients with metastatic colorectal cancer when combined with chemotherapy.1 Owing to its antiangiogenic properties, bevacizumab is also known to alter the healing process and to increase the rate of surgical wound healing complications, either in patients who underwent …
Slippery Slopes and Landing on Your Feet
Authors: Marco D. Huesch
Journal: JAMA (2014)

Avarice is of course somewhat different from lust, but I have to plead ignorance too. No one had ever said anything to me at all when I first started about either physician incentives or conflicts of interest.

I had studied medicine in the right place. Sydney University in the 1980s graduated physicians with a proud understanding of how Australia’s single-payer system provided essentially free access to high-quality, evidence-based treatment. We prided ourselves on a primary care system that was well remunerated on a fee-for-service basis and provided high-quality prevention and wellness services, specialist gatekeeping, and chronic care management.
An Address Delivered at the Opening of the Section of Pharmacology and Therapeutics
Authors: W. Whitla
Journal: BMJ (1887)

If m denote the mortality and a the temperatnre, the following formulam x 0 = 1471.5represents the relation between death-rate and temperature.If we take from the preceding table the two coldest months in the year (December and January), we find- m x 0 = 1418.I have taken the product of death-rate and temperature for the same two months in London, and find- ?n >< 0 1881 ...
Human hepatic stellate cells express class I alcohol dehydrogenase and aldehyde dehydrogenase but not cytochrome P4502E1
Authors: Alessandro Casini, Giulia Pellegrini, Elisabetta Ceni, Renata Salzano, Maurizio Parola, Gaia Robino, Stefano Milani, Mario Umberto Dianzani, Calogero Surrenti
Journal: Journal of Hepatology (1998)