tbuckley/cabot-search huggingface dataset:
Sodium Pentobarbital Versus α-Chloralose Anesthesia
Authors: Dipti P. Rath, Charles M. Little, Huzeng Zhang, Zongchen Jiang, Amir M. Abduljalil, Hui Zhu, Xiaoxin Tong, Charles Brown, Robert L. Hamlin, Pierre-Marie L. Robitaille
Journal: Circulation (1995)

Transmural analyses of the creatine phosphate (CP)/ATP ratio in various lamina of the canine myocardium have previously revealed significant variations in the CP/ATP ratio, with the subendocardial layer displaying a decreased ratio relative to the subepicardial layer. Without exception, these results were obtained under sodium pentobarbital anesthesia. These findings have been interpreted to imply that the normal endocardium may be operating in the oxygen-limited domain or that there are transmurally varying set points for the regulation of oxidative phosphorylation.In this work, we examine the effect of the anesthetic regimen on the transmural CP/ATP ratio within the left ventricular wall of the canine myocardium using spatially localized 31P-nuclear magnetic resonance (NMR) and an open-chest model. Two anesthetics were compared, alpha-chloralose and sodium pentobarbital. Under sodium pentobarbital, the CP/ATP ratio ranged from 1.92 +/- 0.06 to 2.51 +/- 0.08 from endocardium to epicardium, resulting in a transmural slope in the CP/ATP ratio of 0.149 +/- 0.047 (n = 22). Under alpha-chloralose, CP/ATP ratios ranged from 2.18 +/- 0.05 to 2.32 +/- 0.06, with a transmural slope of 0.035 +/- 0.018 (n = 38). Thus, the transmural slope in CP/ATP ratio was nearly four times greater with sodium pentobarbital than with alpha-chloralose, and the difference in these slopes was statistically significant (P = .029). No difference was observed in average CP/ATP obtained from the entire wall with either anesthetic.These results demonstrate that the transmural trend in CP/ATP ratio previously reported in the myocardium is likely to be a direct reflection of the sodium pentobarbital anesthetic regimen, not truly reflecting the trend in the normal unanesthetized animal. Moreover, since the transmural variation in CP/ATP ratio was greatly reduced with alpha-chloralose, it appears unlikely that the endocardium in the normal unanesthetized heart is operating in the oxygen-limited domain. These results also point to the importance of the anesthetic regimen in biochemical analysis, indicate the necessity of increased caution in directly translating results obtained under anesthesia, and demonstrate the unique power of in vivo NMR to extract such subtle biochemical information.
The Heart in Anemia
Authors: WILLIAM B. PORTER, G. WATSON JAMES
Journal: Circulation (1953)

The following brief summary seems justified from the large volume of accumulated data dealing with the reaction of the cardiovascular system in the anemic patient. There are four mechanisms operating in the anemic patient which may increase the supply of oxygen to the tissues when the oxygen carrying capacity of the blood is reduced. Under conditions of rest, a rapid velocity flow and tachycardia with an increase in minute volume of cardiac output is the first response to anemia. As compensation develops, tachycardia and increased velocity flow are largely replaced by selective shunting of blood and the removal of an increasing percentage of oxygen in the tissue capillaries from each gram of circulating hemoglobin. These later physiologic mechanisms are best illustrated by patients with chronic parasitic anemias. Under conditions of physical stress each of the four physiologic mechanisms contribute in meeting the demands for increased oxygen requirements. Compensation is, however, never perfect; the status of the patient is determined by the reduction in hemoglobin, the tissue oxygen requirements, the presence of physical changes in the cardiovascular and pulmonary systems, degree of oxygen abstraction from the blood, and the selective shunting of blood. In relatively acute anemia, dyspnea readily occurs on physical exercise. Reduction in the ventilatory capacity of the lung occurring in some anemic patients results from an over-all reduction in physical fitness due to the anemic state rather than to physical changes in the lung. In well compensated, chronic anemia, the vital capacity of the lungs is frequently above normal and similar to that observed in athletes and completely acclimatized, high altitude inhabitants. In the absence of cardiovascular disease or physical or metabolic factors requiring increased cardiac output, true congestive heart failure rarely results from the anemic state. Effort angina is uncommon in anemic patients and when present is usually related to underlying coronary artery disease. Cardiac hypertrophy under certain conditions results from prolonged anemia. Since cardiac hypertrophy is rightly placed in the category of organic heart disease, one is justified in classifying chronic anemia as one of the etiologic factors in the production of heart disease.
SP-01 * PEER-TO-PEER SUPPORT: A NEW WAY TO ASSIST CAREGIVERS
Authors: I. Molina, M. Page, J. Patt, S. Chang
Journal: Neuro-Oncology (2014)

The UCSF Neuro-Oncology Clinic provides treatment recommendations and care for patients with newly-diagnosed and recurrent central nervous system tumors. Due to the nature of the illness, the caregiver of the patient often has the responsibility of managing the patient's health, in addition to attending to their daily needs. Significant life changes may occur for the caregiver. The impetus of implementing the Neuro-Oncology Caregiver-to-Caregiver Peer Support Program was these observed stresses. Numerous studies have shown how peer support between patients has improved the patients' quality of life. Extrapolating this for caregivers, goals of the program include: reduction of anxiety and isolation, allowing for the exchange of navigational information and coping strategies, improving emotional support, indirectly improving the quality of life of the patient by improving the support network of the caregiver, and improving patient and caregiver satisfaction of clinic services. The peer support program allows caregivers to talk with experienced caregivers of brain tumor patients without exchanging medical advice. These experienced caregivers are formally trained by UCSF staff as peer volunteers in topics concerning confidentiality, peer support skills, and caregiver resources. Intake of peer support requests and matching is conducted by a staff member. The mode of communication is primarily over the phone, which can benefit those that do not have time to meet in person or for those that live a far distance from the clinic or peer support volunteer. The desire to obtain peer support is high. However, available time to participate is minimal due to caregiver burden, resulting in 12 matches to date. This is a novel program and collection of data will be administered at year 2 from implementation, using tools such as questionnaires, and pre- and post-surveys for both the volunteers and the caregivers seeking support.
The use of ultrasound in the diagnosis of cystic lesions of the liver and upper abdomen and in the detection of ascites
Authors: C. F. McCarthy, P. N. T. Wells, F. G. M. Ross, A. E. A. Read
Journal: Gut (1969)

The use of ultrasonic A- and B-scans has been evaluated in the diagnosis of fluid-filled lesions in the liver and abdomen, and in the detection of intraperitoneal fluid. Six patients with polycystic livers or suspected polycystic livers, three with solitary cysts, four with liver abscesses, and three with miscellaneous intraabdominal cystic lesions were scanned. The lesions could be clearly distinguished from solid masses by either technique. The presence of as little as 300 to 800 ml of intraperitoneal fluid could be detected by either the A- or B-scan.
Silibinin (Sil) prevents estradiol 17β-D-glucuronide (E217G)-induced bile salt excretory failure and internalisation of the canalicular bile salt export pump, Bsep, in the isolated rat hepatocyte couplet (IRHC) model: Possible involvement of cyclic AMP
Authors: F.A. Crocenzi, M.S. Portesio, C.L. Basiglio, R. Coleman, M.G. Roma
Journal: Journal of Hepatology (2003)
High Court quashes anaesthetist's 12 month suspension by GMC
Authors: C. Dyer
Journal: BMJ (2012)

A consultant anaesthetist has won a High Court judgment overturning findings against him by the General Medical Council of dishonesty and quashing a 12 month suspension from practice.

The case of Michael Fish is the third within three months in which judges have set aside the decisions of GMC fitness to practise panels after finding flaws in their reasoning.

Fish, who worked as a locum consultant supplied to hospitals by agencies, was accused by one agency of falsifying his time sheets to exaggerate the number of hours worked and of deleting an antifraud “declaration of truth” from timesheet forms. The panel cleared him on the first allegation …
'Groveroid' Darier's disease?
Authors: T.P. Millard, J. Dhitavat, K. Hollowood, S.M. Burge
Journal: British Journal of Dermatology (2004)

Journal Article 'Groveroid' Darier's disease? Get access T.P. Millard, T.P. Millard Department of Dermatology, Wellcome Trust Centre for Human Genetics Search for other works by this author on: Oxford Academic Google Scholar J. Dhitavat, J. Dhitavat Department of Dermatology, Wellcome Trust Centre for Human Genetics Search for other works by this author on: Oxford Academic Google Scholar K. Hollowood, K. Hollowood Department of Cellular Pathology, Oxford Radcliffe Hospitals, Headington, Oxford OX3 7LJ, U.K Search for other works by this author on: Oxford Academic Google Scholar S.M. Burge S.M. Burge Department of Dermatology, Wellcome Trust Centre for Human Genetics S.M.Burge. E‐mail: sue.burge@ndm.ox.ac.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 150, Issue 3, 1 March 2004, Pages 600–602, https://doi.org/10.1046/j.1365-2133.2004.05827.x Published: 01 March 2004
P04.05 * HISTONE MUTATIONS IN CHILDHOOD AND YOUNG ADULT HIGH GRADE GLIOMA
Authors: L. Bekaert, C. Bazille, A. Borha, A. Vasiljevic, A. Jouvet, E. Lechapt-Zalcman
Journal: Neuro-Oncology (2014)

BACKGROUND: High grade gliomas in children and young adults are clinically and genetically different from their adult counterparts. Recurrent mutations of the H3F3A gene coding for the H3.3 isoform of the H3 histone have recently been described. These mutations have been shown to be exclusive to high grade gliomas, and the majority occurs in the pediatric setting. OBSERVATION: We report on 2 cases of confirmed mutations of the H3F3A gene at the K27M site. The first patient was a young adult with a left cerebellar mass. Imaging and pathological analysis were typical of glioblastoma. The second patient was a 14-year old boy with a left thalamic lesion, rather circumscribed on MRI but with features of malignity on spectroscopy and perfusion. Pathologic analysis showed a heterogeneous tumor with regions in favor of ganglioglioma, and regions with marked anisokaryosis and rare mitoses, a slightly elevated proliferation index and high p53 positivity. Due to the presence of a histone mutation, the tumor was classified as a high grade glioma. DISCUSSION: Pathological analysis of pediatric tumors can be a challenge. Nowadays, molecular biology is an important tool to help us classify these tumors. In our first patient, the presence of a histone mutation confirmed the initial diagnosis. In the second patient however, the discovery of a histone mutation finally permitted us to classify this pathologically challenging tumor as a high grade glioma. CONCLUSION: When confronted with childhood or young adult brain tumors, it is important to search for histone mutations, since their presence can influence the final diagnosis.
Coronary Computed Tomographic Angiography and Risk of All-Cause Mortality and Nonfatal Myocardial Infarction in Subjects Without Chest Pain Syndrome From the CONFIRM Registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry)
Authors: Iksung Cho, Hyuk-Jae Chang, Ji Min Sung, Michael J. Pencina, Fay Y. Lin, Allison M. Dunning, Stephan Achenbach, Mouaz Al-Mallah, Daniel S. Berman, Matthew J. Budoff, Tracy Q. Callister, Benjamin J.W. Chow, Augustin Delago, Martin Hadamitzky, Joerg Hausleiter, Erica Maffei, Filippo Cademartiri, Philipp Kaufmann, Leslee J. Shaw, Gil L. Raff, Kavitha M. Chinnaiyan, Todd C. Villines, Victor Cheng, Khurram Nasir, Millie Gomez, James K. Min
Journal: Circulation (2012)

Background— The predictive value of coronary computed tomographic angiography (cCTA) in subjects without chest pain syndrome (CPS) has not been established. We investigated the prognostic value of coronary artery disease detection by cCTA and determined the incremental risk stratification benefit of cCTA findings compared with clinical risk factor scoring and coronary artery calcium scoring (CACS) for individuals without CPS. Methods and Results— An open-label, 12-center, 6-country observational registry of 27 125 consecutive patients undergoing cCTA and CACS was queried, and 7590 individuals without CPS or history of coronary artery disease met the inclusion criteria. All-cause mortality and the composite of all-cause mortality and nonfatal myocardial infarction were measured. During a median follow-up of 24 months (interquartile range, 18–35 months), all-cause mortality occurred in 136 individuals. After risk adjustment, compared with individuals without evidence of coronary artery disease by cCTA, individuals with obstructive 2- and 3-vessel disease or left main coronary artery disease experienced higher rates of death and composite outcome ( P &lt;0.05 for both). Both CACS and cCTA significantly improved the performance of standard risk factor prediction models for all-cause mortality and the composite outcome (likelihood ratio P &lt;0.05 for all), but the incremental discriminatory value associated with their inclusion was more pronounced for the composite outcome and for CACS (C statistic for model with risk factors only was 0.71; for risk factors plus CACS, 0.75; for risk factors plus CACS plus cCTA, 0.77). The net reclassification improvement resulting from the addition of cCTA to a model based on standard risk factors and CACS was negligible. Conclusions— Although the prognosis for individuals without CPS is stratified by cCTA, the additional risk-predictive advantage by cCTA is not clinically meaningful compared with a risk model based on CACS. Therefore, at present, the application of cCTA for risk assessment of individuals without CPS should not be justified.
Effect of Delayed vs Early Umbilical Cord Clamping on Iron Status and Neurodevelopment at Age 12 Months
Authors: Ola Andersson, Magnus Domellöf, Dan Andersson, Lena Hellström-Westas
Journal: JAMA Pediatrics (2014)

Prevention of iron deficiency in infancy may promote neurodevelopment. Delayed cord clamping (DCC) can prevent iron deficiency during the first 6 months of life. However, no data are available on long-term effects on infant outcomes in relation to time for umbilical cord clamping.To investigate effects of DCC, as compared with early cord clamping (ECC), on infant iron status and neurodevelopment at age 12 months in a European setting.Randomized clinical trial of 382 full-term infants born after a low-risk pregnancy at a Swedish county hospital. Follow-up at 12 months included evaluation of iron status (ferritin level, transferrin saturation, transferrin receptor level, reticulocyte hemoglobin level, and mean cell volume) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire, second edition (ASQ).Infants were randomized to DCC (≥180 seconds after delivery) or ECC (≤10 seconds after delivery).The main outcome was iron status at age 12 months; the secondary outcome was ASQ score.In total, 347 of 382 infants (90.8%) were assessed. The DCC and ECC groups did not differ in iron status (mean ferritin level, 35.4 vs 33.6 ng/mL, respectively; P = .40) or neurodevelopment (mean ASQ total score, 229.6 vs 233.1, respectively; P = .42) at age 12 months. Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood. Predictors of ASQ score were infant sex and breastfeeding within 1 hour after birth. For both outcomes, being a boy was associated with lower results. Interaction analysis showed that DCC was associated with an ASQ score 5 points higher among boys (mean [SD] score, 229 [43] for DCC vs 224 [39] for ECC) but 12 points lower among girls (mean [SD] score, 230 [39] for DCC vs 242 [36] for ECC), out of a maximum of 300 points (P = .04 for the interaction term).Delayed cord clamping did not affect iron status or neurodevelopment at age 12 months in a selected population of healthy term-born infants. However, it may not be possible to demonstrate minor effects on neurodevelopment with the size of the study population and the chosen method for assessment. The current data indicate that sex may influence the effects on infant development after DCC in different directions. The magnitude and biological reason for this finding remain to be investigated. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01245296.
PREDICTORS OF MORTALITY WITHIN 2-YEAR AFTER ENDOVASCULAR THERAPY FOR PATIENTS WITH CRITICAL LIMB ISCHEMIA
Authors: Tatsuya Shiraki, Osamu lida, Masashi Fujita, Tetsuya Watanabe, Masaki Awata, Fusako Sera, Shin Okamoto, Tomoharu Dohi, Takayuki Ishihara, Masaaki Uematsu
Journal: Journal of the American College of Cardiology (2012)
what's the problem?
Authors: Bertie Leigh
Journal: BMJ (2004)

s views will come as a surprise to people who suppose that negligence litigation is out of control or a large burden to the NHS.As he shows, it costs well under 1% of turnover, and most of that is the cost of caring for birth injured children, a bill that ought to be met under any system.Given that there are 850 000 adverse events causing harm, 6000 claims seems modest.The volume of claims is also falling.Making Amends noted that it had fallen in two successive years from a peak of 8000.The Legal Services Commission's new evidence to the chief medical officer's inquiry is that last year they issued only 6000 new certificates and closed 8000 files.This compares with 18 000 new certificates at the peak in 1991.Since 55% of certificates do not result in writs being issued, it is likely that only 2700 new writs will be issued next year.
Chromosome 9p21 in amyotrophic lateral sclerosis in Finland: a genome-wide association study
Authors: Hannu Laaksovirta, Terhi Peuralinna, Jennifer C Schymick, Sonja W Scholz, Shaoi-Lin Lai, Liisa Myllykangas, Raimo Sulkava, Lilja Jansson, Dena G Hernandez, J Raphael Gibbs, Michael A Nalls, David Heckerman, Pentti J Tienari, Bryan J Traynor
Journal: The Lancet Neurology (2010)
NEUROTIC INTERACTION AND PATTERNS OF PSEUDO-HEREDITY IN THE FAMILY
Authors: JAN EHRENWALD
Journal: American Journal of Psychiatry (1958)

In summary it can be stated that our focus on attitudes and traits as the elementary units of interaction in the family, and the method of preferential rating outlined here, make a quantitative treatment of such interactions possible. Our findings suggest that attitudes do not occur singly but in pairs or in compounds of higher complexity. Based on this principle our study leads to the distinction of 4 major patterns of interaction: patterns of sharing, contagion, complementarity and resistance. The findings lend themselves to diagramatic representation, 1. of interaction in a family pair, 2. of the intrafamily personality profile, and 3. of a composite picture of family interaction, or family profile. Our material illustrates at the same time the part played by patterns of sharing and contagion in the non-biological or pseudo-hereditary transmission of traits and attitudes.
Adjuvant liver perfusion in colorectal cancer: initial results of a clinical trial.
Authors: I Taylor, P Brooman, J T Rowling
Journal: BMJ (1977)

Fifty consecutive patients with colorectal cancer but no evidence of secondary deposits in the liver were included in an ongoing controlled clinical trial of adjuvant liver perfusion aimed at reducing the incidence of hepatic metastases. All patients had their primary tumour resected in the standard way. Twenty-six of the patients served as controls, and 24 received fluorouracil, 1 g daily, as a continuous infusion into the portal venous system during the first seven days after operation. The patients were matched for age, sex, and site and stage of the disease. The immediate postoperative mortality and morbidity did not differ significantly between the two groups. During the follow-up period (mean duration 15.5 months), however, six deaths occurred in the control group and only one in the perfusion group. At necropsy four of the controls had multiple liver metastases. Two of the surviving controls developed evidence of liver metastases, and two had a local recurrence. No patient in the perfusion group developed evidence of hepatic metastases. These initial results suggest that adjuvant portal venous perfusion with fluorouracil may reduce the incidence of liver metastases in colorectal cancer.
Psychological Aspects of Accidents and Accident Prevention
Authors: K. Soddy
Journal: BMJ (1947)

THE HARVEIAN ORATIONSMEDBCRLTSOURNL 623 coincidence that the first two Harveian Orators died within a few months of fulfilling their office.Daniel Whistler (1619-84), the third Orator (1659), is remembered for the first clinical description of rickets.He held in succession the offices of Registrar, Treasurer, and President of the College, not entirely to the advantage of the College funds, and his conduct was censured in the Orations of Walter Harris (1707) and John Hawys (1721); but his friend Evelyn thought him "good company and a very ingenious man."Thomas Coxe (1615-85), Orator in 1660, is warmly referred to by Thomas Sydenham as "the patron and promoter of my first endeavours."
Observations Made Upon the Bills of Mortality
Authors: A. Morabia
Journal: BMJ (2013)

John Graunt’s Observations Made Upon the Bills of Mortality inaugurated a new approach to health issues: the reliance on evidence versus belief.1 

In 1603, James I had mandated the Company of Parish Clerks to publish, on a permanent weekly basis, their annual accounts of births and deaths, called the bills of mortality. “Searchers,” mostly old women, were employed to inspect the corpses of the recently dead to establish cause of death. City clerks compiled the information recorded by parishes, and sold the bills to Londoners eager to know when and where plague was active and, for those who could afford it, whether a retreat from the city was imperative. …