tbuckley/cabot-search huggingface dataset:
Living the Patient's Story
Authors: Michael A. LaCombe
Journal: Annals of Internal Medicine (1990)

On Being a Doctor1 December 1990Living the Patient's StoryMichael A. LaCombe, MDMichael A. LaCombe, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-11-890 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhat can we learn from the dying beyond a sudden sense of our own mortality? From the young woman with cancer who, in the midst of her pain and suffering, becomes abruptly still, looks about her hospital room with dawning recognition, fixing her visitors and doctor with a look of wisdom drawn from some mysterious source, and proclaims with certain finality that she loves and will miss them all—is there anything to be gained beyond the poignancy of the moment? Is it that we have become a part of her story?Or perhaps the patient will be a stern, elderly... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michael A. LaCombe, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySomeone New and Something Old 1 December 1990Volume 113, Issue 11Page: 890-891KeywordsElderlyMortality ePublished: 1 December 2008 Issue Published: 1 December 1990 Copyright & Permissions© 1990 American College of PhysiciansPDF downloadLoading ...
Histochemical demonstration of endothelial superoxide and hydrogen peroxide generation in ischaemic and reoxygenated rat tissues
Authors: C. F Babbs, M. D Cregor, S. F Badylak
Journal: Cardiovascular Research (1992)

Objective: The aims were to test and evaluate two novel and independent histochemical methods for detecting the initial postischaemic burst of superoxide and hydrogen peroxide in buffer perfused rat tissues during reflow after 60 min warm ischaemia. Methods: The first is a high manganese/diaminobenzidine technique, in which superoxide oxidises Mn2+ to Mn3+, which in turn oxidises diaminobenzidine to form amber coloured polymers, observable by light microscopy. The second is a high iron/diaminobenzidine technique, in which hydrogen peroxide oxidises diethylenetriaminepenta-acetate chelated Fe2+ to form intermediate species, which in turn oxidise diaminobenzidine similarly to Mn3+. Various isolated organs of the rat were rendered ischaemic for 60 min, and reperfused with oxygen or air equilibrated buffers containing diaminobenzidine and either Mn2+ or Fe2+. Tissues were fixed by perfusion with Trump's solution and processed for light microscopy. Results: Both manganese and iron methods consistently showed the appearance of reaction product on the luminal surfaces of arterial, capillary, and venular endothelial cells in lung, heart, and intestine of the rat during the first 2 to 3 min of reoxygenation after ischaemia. The histochemical reactions were nearly absent in non-manganese-treated and non-iron-treated controls. Superoxide dismutase strongly inhibited Mn2+/diaminobenzidine reaction product formation and catalase strongly inhibited Fe2+/diaminobenzidine reaction product formation, when tested in specially perfused lung preparations in which these specific antioxidant enzymes were concentrated. Conclusions: These histochemical techniques provide direct, visual evidence that a burst of reactive oxygen species is generated in postischaemic rat tissues. The Mn2+/diaminobenzidine and Fe2+/diaminobenzidine techniques permit investigation of the endothelium derived reactive oxygen by simple laboratory procedures available to almost any investigator at low marginal cost. The endothelial oxidants so revealed may be of pathophysiological significance in a variety of cardiovascular disorders.
Stress, the Brain and Depression
Authors: Ottar Bjerkeset
Journal: BMJ (2004)

S tress and depression are closely associated, but how strong is the evidence that stress can cause depression? Many people in today's general and psychiatric practice take this causal relation for granted, yet proving the existence of the connection means a thorough discussion of complex, interrelated topics. Stress, the Brain and Depression gives evidence for how personality features, genetic factors, and psychosocial factors influence the interplay between stress and …
THE EFFECT OF SWEATING ON PATCH TEST REACTIONS TO SOAP.
Authors: F. R. BETTLEY, KATHERINE A. GRICE
Journal: British Journal of Dermatology (1966)

Journal Article THE EFFECT OF SWEATING ON PATCH TEST REACTIONS TO SOAP. Get access F. R. BETTLEY, F.R.C.P., F. R. BETTLEY, F.R.C.P. Institute of Clinical Research, Middlesex Hospital, London, W.1 Search for other works by this author on: Oxford Academic Google Scholar KATHERINE A. GRICE, M.B., B.S., D.C.H. KATHERINE A. GRICE, M.B., B.S., D.C.H. Institute of Clinical Research, Middlesex Hospital, London, W.1 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 78, Issue 12, 1 December 1966, Pages 636–639, https://doi.org/10.1111/j.1365-2133.1966.tb12165.x Published: 01 December 1966
Prognostic Value of N-Terminal Pro–Brain Natriuretic Peptide in Patients With Chronic Stable Angina
Authors: Gjin Ndrepepa, Siegmund Braun, Kathrin Niemöller, Julinda Mehilli, Nicolas von Beckerath, Olga von Beckerath, Wolfgang Vogt, Albert Schömig, Adnan Kastrati
Journal: Circulation (2005)

Background— Patients with chronic stable angina are poorly characterized in terms of biomarkers that help in the assessment of prognosis. We investigated whether plasma levels of N-terminal pro–brain natriuretic peptide (NT-proBNP) may be used as a prognostic marker in patients with chronic stable angina treated with coronary stenting. Methods and Results— Plasma levels of NT-proBNP were measured in 1059 patients with chronic stable angina and coronary angiographic confirmation of significant coronary artery disease. The primary end point of the study was mortality. After a median of 3.6 years (interquartile range, 3.3 to 4.5 years), there were 106 deaths. Kaplan-Meier estimates of 5-year mortality were 4.7% in the first quartile, 7.8% in the second quartile, 11.4% in the third quartile, and 32.7% in the fourth quartile of NT-proBNP ( P &lt;0.001). A Cox proportional hazards model showed that NT-proBNP was the strongest correlate of mortality (adjusted hazards ratio [HR], 5.83 [95% confidence interval: 2.07 to 16.44] for the fourth versus the first quartile). A similar prognostic value of NT-proBNP was demonstrated for cardiovascular mortality (HR, 5.98 [1.55 to 23.13] for the fourth versus the first quartile) and for patients with New York Heart Association class I and II (HR, 6.03 [2.07 to 17.52] for the fourth versus the first quartile). Conclusions— Circulating levels of NT-proBNP are a strong prognostic biomarker for patients with chronic stable angina.
Confidence intervals: Authors' reply
Authors: D. Machin, M. J Gardner
Journal: BMJ (1988)

Another factor that contributes to the development and especially the severity of the infection is deficiency of the comiiplement component properdin.Meningococcal infections associated with properdin deficiency have a fatality rate approaching 75"!0I.Propcrdin stabilises the in- herentlv labile (3 and C5 convertases."The severe meningococcal infCctions in people with properdin deficiencv contrast with the mild disease in people with deficiencies of the terminal components of complement.'Several factors mav influence the outcome in patients with properdin deficiencv.Opsonisation is unimpaired in terminal deficiencies, but pro- perdin deficiency is associated with impaired serum opsonisation and bactcricidal rcactions.The abilitv to dissolve immunocomplexes in vivo is absent in serum dcficicnt in properdin."The ability to opsonisc cndotoxin coatcd oil drops is also absent., and inability to clear endotoxin could influence the progression of the diseasc.
The Assessment of Infarct Size in Postmyocardial Infarction Patients Undergoing Thallium-201 Tomographic Imaging Is Improved Using Attenuation Correction
Authors: Pierre Chouraqui, Shy Livschitz, Jack Baron, Israel Moalem, Michael Shechter
Journal: Clinical Nuclear Medicine (2004)

Purpose: Attenuation correction (ATC) has been shown to improve the accuracy of thallium-201 single photon emission computed tomography (SPECT) for the detection and evaluation of patients with coronary artery disease. The purpose of this study was to evaluate the value of ATC for the assessment of infarct size in patients after myocardial infarction (MI). Materials and Methods: Tl-201 SPECT with ATC was performed on 39 patients with 49 previous MIs. This was followed by radionuclide ventriculography for the assessment of global and regional left ventricular function. Uncorrected and corrected 24-hour redistribution SPECT images were analyzed for regional perfusion using a 5-point segmental scoring scale from 0 (normal) to 4 (absent) thallium uptake. Results: The mean number of segments with scores of >1and 2 was significantly higher without ATC than with ATC (5.3 ± 3.6 vs. 3.5 ± 3.6, P = 0.0001 for scores >1; 3.8 ± 3.6 vs. 2.5 ± 3.0, P = 0.0001 for scores of >2, respectively). The mean total number of segments with scores of >1 assessed without ATC was significantly higher compared with that assessed with ATC (16.9 ± 13.5 vs. 11.2 ± 12.2, P = 0.0001). Evaluation without ATC demonstrated only a fair correlation between the SPECT parameters (number of segments with scores of >1 and >2, and total score of segments with scores of >1) and left ventricular regional and global function, whereas there was a clear improvement in all the parameters after ATC. With ATC, a decrease in infarct size was demonstrated in 27 of the 49 infarcts (55%). Conclusions: The improved correlation with left ventricular function indicates that SPECT imaging with ATC provides a more accurate assessment of infarct size in post-MI patients. The use of nonattenuation-corrected SPECT imaging overestimates infarct size in a majority of patients.
Vitamin C Improves Endothelial Function of Conduit Arteries in Patients With Chronic Heart Failure
Authors: Burkhard Hornig, Naoshi Arakawa, Christoph Kohler, Helmut Drexler
Journal: Circulation (1998)

Chronic heart failure (CHF) is associated with endothelial dysfunction including impaired endothelium-mediated, flow-dependent dilation (FDD). There is evidence for increased radical formation in CHF, raising the possibility that nitric oxide is inactivated by radicals, thereby impairing endothelial function. To test this hypothesis, we determined the effect of the antioxidant vitamin C on FDD in patients with CHF.High-resolution ultrasound and Doppler was used to measure radial artery diameter and blood flow in 15 patients with CHF and 8 healthy volunteers. Vascular effects of vitamin C (25 mg/min IA) and placebo were determined at rest and during reactive hyperemia (causing endothelium-mediated dilation) before and after intra-arterial infusion of N-monomethyl-L-arginine (L-NMMA) to inhibit endothelial synthesis of nitric oxide. Vitamin C restored FDD in patients with heart failure after acute intra-arterial administration (13.2+/-1.7% versus 8.2+/-1.0%; P<.01) and after 4 weeks of oral therapy (11.9+/-0.9% versus 8.2+/-1.0%; P<.05). In particular, the portion of FDD mediated by nitric oxide (ie, inhibited by L-NMMA) was increased after acute as well as after chronic treatment (CHF baseline: 4.2+/-0.7%; acute: 9.1+/-1.3%; chronic: 7.3+/-1.2%; normal subjects: 8.9+/-0.8%; P<.01).Vitamin C improves FDD in patients with CHF as the result of increased availability of nitric oxide. This observation supports the concept that endothelial dysfunction in patients with CHF is, at least in part, due to accelerated degradation of nitric oxide by radicals.
Sigmoidoscopy and Bacteremia
Authors: GERALD D. GOLDMAN
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 November 1982Sigmoidoscopy and BacteremiaGERALD D. GOLDMAN, M.D., SCOTT A. MILLER, M.D., DONALD S. FURMAN, M.D., DANA BROCK, M.D., JOHN L. RYAN, M.D., PH.D., RICHARD W. MCCALLUM, M.D.GERALD D. GOLDMAN, M.D.Search for more papers by this author, SCOTT A. MILLER, M.D.Search for more papers by this author, DONALD S. FURMAN, M.D.Search for more papers by this author, DANA BROCK, M.D.Search for more papers by this author, JOHN L. RYAN, M.D., PH.D.Search for more papers by this author, RICHARD W. MCCALLUM, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-5-784_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Flexible sigmoidoscopy is now an established, safe method of examining the rectum, sigmoid, and distal descending colon. This method shows two to three times more bowel than the rigid sigmoidoscopy technique (while taking approximately twice as long), and results in a five- to sixfold increase in abnormalities detected (1). The flexible procedure is done with the same bowel preparation as rigid sigmoidoscopy but the outside diameter of the flexible scope is only 14 mm compared to 22 mm for the rigid scope.Bacteremia is a complication of a number of gastrointestinal procedures (2-4). During rigid sigmoidoscopy, a...References1. WINNANBERCIPANISH GGJ. Superiority of the flexible to the rigid sigmoidoscope in routine proctosigmoidoscopy. N Engl J Med. 1980;302:1011-2. CrossrefMedlineGoogle Scholar2. EVERETTHIRSCHMANN EJ. Transient bacteremia and endocarditis prophylaxis: a review. Medicine. 1977;56:61-76. CrossrefMedlineGoogle Scholar3. SHAHMIRSCHUMAN MB. Complications of fiberoptic endoscopy. Gastrointest Endosc. 1980;26:86-91. CrossrefMedlineGoogle Scholar4. LEFROCKELLISTLRCHIKWEINSTEIN JCJL. Transient bacteremia associated with sigmoidoscopy. N Engl J Med. 1973;289;467-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Veterans Administration Medical Center West Haven, CT, 06516 Yale University New Haven, CT 06510 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWann Rektoskopie, wann Koloskopie bei gynäkologischen Prozessen?Antibiotics Before EndoscopyROBERT G. NORFLEET, M.D. 1 November 1982Volume 97, Issue 5Page: 784-785KeywordsBacteremiaColonFlexible sigmoidoscopyRectum Issue Published: 1 November 1982 PDF downloadLoading ...
Increased infections with Herpes virus 8 (HHV8) in patients with common variable immunodeficiency (CVID) and granulomatous and lymphoproliferative interstitial lung disease (GLILD)*1
Authors: W.H. Wheat, P.R. Rai, C.A. Bates, C.D. Cool, K.K. Brown, C.H. Kirkpatrick, B.A. Lindenbaum, A.E. Serls, M. Ellison, J.M. Routes
Journal: Journal of Allergy and Clinical Immunology (2004)
Hydatids of the Brain: Optic Neuritis
Authors: T. M. Evans
Journal: BMJ (1872)

of the vagus, or else radiating in the same tract from a focus in the neighbourhood of the quadrigeminal bodies. .The analogy of epilepsy, which is supposed to have its point of departure in a tendency to ex- plosive discharge in the motor tract of the medulla oblongata, lends support to this view.I am not at all disposed to deny that disorders of local circulation occur in the course of megrim, and that the implication of the sympa- thetic may play an important part in their production ; but I regard them among the least constant and regular of the phenomena, and certainly not as essential and as the cause of the rest.
Coffee and Health: What's Brewing?
Authors: Peter Goldman
Journal: New England Journal of Medicine (1984)

IN this issue, Becker et al.1 employ such classic pharmacologic concepts as dose–response relationships and pharmacokinetics, and use established laboratory techniques to show that the well-known actions of caffeine explain the 19th-century observation that asthma was relieved by drinking "strong coffee."2 Salter's century-old description of the response of his patients to coffee2 reminds us of Withering's earlier prescient observations on the response of his patients to "infusions" or "decoctions" of another plant, the foxglove.3 Both descriptions contribute to traditions that have become the basis of modern clinical pharmacology. Of course, purified and standardized cardiac glycosides have replaced infusions of foxglove, . . .
Risk of Subsequent Basal Cell Carcinoma and Squamous Cell Carcinoma of the Skin Among Patients With Prior Skin Cancer
Authors: Margaret R. Karagas
Journal: JAMA (1992)

<h3>Objective.</h3> —The primary aims of this study were to assess risk of subsequent basal and squamous cell skin cancer among patients with a prior history of these tumors and to examine these risks in relation to patient characteristics and life-style factors. <h3>Design.</h3> —Follow-up of participants in a randomized trial of betacarotene as a possible skin cancer preventive agent. <h3>Setting.</h3> —Clinical centers in Los Angeles, Calif, San Francisco, Calif, Minneapolis, Minn, and Hanover, NH. <h3>Participants.</h3> —Patients (n=1805) who were diagnosed as having a basal or squamous cell skin cancer between January 1980 and February 1986 and were free of skin cancer at study entry. <h3>Main Outcome Measure.</h3> —Time from study entry to first new occurrence of basal and squamous cell skin cancer. <h3>Results.</h3> —The estimated risk of developing one or more new skin cancers was 35% at 3 years and 50% at 5 years. New skin cancers tended to be of the same cell type as the previous skin cancers. For both basal and squamous cell skin cancer, risk was higher among patients who were male, were over the age of 60 years, had more prior skin cancers, had severe actinic skin damage, or who burned easily with sun exposure. Compared with those who had never smoked, the rate of subsequent squamous cell skin cancer was higher among current smokers (rate ratio, 2.01; 95% confidence interval,1.21 to 3.34) and former smokers (rate ratio,1.62; 95% confidence interval, 1.07 to 2.47) and increased with both duration and amount smoked. There was no clear relationship between smoking and basal cell skin cancer; the rate appeared lower among heavy smokers but was unrelated to duration of smoking. <h3>Conclusions.</h3> —Persons with a prior nonmelanoma skin cancer had a substantial 5-year risk of developing another tumor of the same histologic type. Number of previous skin cancers, solar damage, and skin sensitivity to sun exposure were particularly related to this risk. The increased risk of squamous cell skin cancer associated with cigarette smoking merits further study. (<i>JAMA</i>. 1992;267:3305-3310)
Role of general practitioners in care of long term mentally ill patients.
Authors: T Kendrick, B Sibbald, T Burns, P Freeling
Journal: BMJ (1991)

OBJECTIVE--To assess general practitioners9 involvement with long term mentally ill patients and attitudes towards their care. DESIGN--Postal questionnaire survey. SETTING--General practices in South West Thames region. SUBJECTS--507 general practitioners, 369 (73%) of whom returned the questionnaire. MAIN OUTCOME MEASURES--The number of adult long term mentally ill patients whom general practitioners estimate they have on their lists and general practitioners9 willingness to take responsibility for them. RESULTS--110 respondents had noticed an effect of the discharge of adult long term mentally ill patients on their practices. Most (225) respondents estimated that they had 10 or fewer such patients each on their lists. Having higher numbers was significantly associated with practising in Greater London or within three miles of a large mental hospital and having contact with a psychiatrist visiting the practice. 333 general practitioners would agree to share the care of long term mentally ill patients with the psychiatrist by taking responsibility for the patients9 physical problems. Only 59 would agree to act as a key worker, 308 preferring the community psychiatric nurse to do it. Only nine had specific practice policies for looking after long term mentally ill patients and 287 agreed that such patients often come to their general practitioner9s attention only when there is a crisis. CONCLUSIONS--The uneven distribution of long term mentally ill patients suggests that community pyschiatric resources might be better targeted at those practices with higher numbers of such patients. Most general practitioners seem to be receptive to a shared care plan when the consultant takes responsibility for monitoring psychiatric health with the community nurse as key worker. The lack of practice policies for reviewing the care of long term mentally ill patients must limit general practitioners9 ability to prevent crises developing in their care.
814 EVALUATION OF TUMOR PERFUSION AT COMPUTED TOMOGRAPHY AS A TOOL TO DETECT THE EFFECT OF SORAFENIB TREATMENT IN PATIENTS WITH HEPATOCELLULAR CARCINOMA (HCC)
Authors: M. Reig, J. Rimola, A. Forner, C. Rodriguez de Lope, J.M. Llovet, C. Ayuso, J. Bruix
Journal: Journal of Hepatology (2009)
Two thirds of psychiatric patients are treated on mixed sex wards, shows census
Authors: L. Eaton
Journal: BMJ (2010)

<h3>ABSTRACT</h3> RNA-binding proteins (RBPs) are key regulators of RNA metabolism. Many RBPs possess uncharacterized RNA-binding domains and localize to multiple subcellular compartments, suggesting their involvement in multiple biological processes. We searched for such multifunctionality within a set of 143 RBPs by integrating experimentally validated target genes with the transcriptomes and translatomes of 80 human hearts. This revealed that RBP abundance is predictive of the extent of target regulation <i>in vivo</i>, leading us to newly associate 27 RBPs with translational control. Amongst those were several splicing factors, of which the muscle specific RBM20 modulated target translation rates through switches in isoform production. For 21 RBPs, we newly observed dual regulatory effects impacting both mRNA levels and translation rates, albeit for virtually independent sets of target genes. We highlight a subset, including G3BP1, PUM1, UCHL5, and DDX3X, where dual regulation is achieved by differential affinity for targets of distinct length and functionality. Strikingly, in a manner very similar to DDX3X, the known splicing factors EFTUD2 and PRPF8 selectively influence target translation rates depending on 5’ UTR structure. Our results indicate unanticipated complexity of protein-RNA interactions at consecutive stages of gene expression and implicate multiple core splicing factors as key regulators of translational output.
CHAIRMAN'S INTRODUCTORY ADDRESS.Read before the section on Ophthalmology at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: S. D. RISLEY
Journal: JAMA (1893)

I can not refrain from expressing my high appreciation of the honor you have conferred in calling me to preside over the deliberations of the section. Permit me to extend my most cordial greetings and to express the personal gratification I feel in again meeting my colleagues in ophthalmology from all sections of our country. It is fitting that I should congratulate the section that its members have again been spared through the toil and vicissitudes of a year and are still actively engaged and deeply interested in this beneficent work. The activity displayed everywhere as set forth in a rapidly growing special literature is encouraging, not to say inspiring. Not only are periodicals devoted to ophthalmology multiplying, but the character of the papers published are rapidly improving. Careful scientific work is obviously on the increase and the clinical papers also portray a class of work far superior to that