tbuckley/cabot-search huggingface dataset:
New therapeutic approach to corrosive burns of the upper gastrointestinal tract.
Authors: J Di Costanzo, M Noirclerc, J Jouglard, J M Escoffier, N Cano, J Martin, A Gauthier
Journal: Gut (1980)

The therapeutic approach to the management of corrosive burns of the upper gastrointestinal tract leaves a considerable morbidity and a heavy mortality rate. This work evaluates the effectiveness of a new therapeutic approach given to 94 consecutive patients. The management has been based on three major points: (1) the definition of extent of upper gastrointestinal lesions by immediate fibroendoscopy; (2) immediate protection of the upper gastrointestinal tract by total parenteral nutrition in cases with serious burns (41 cases), normal oral nutrition being allowed for minor burns (35 cases); (3) reparative surgical procedures for any of the sequelae of such burns during the fibrosing phase. The results were as follows: (a) healing, depending upon the degree of burn, occurred between eight to 90 days; (b) the frequency of subsequent local complications was small with total parenteral nutrition started a few hours after ingestion of the corrosive product; (c) after reconstructive surgery no serious complications occurred; (d) the overall morbidity stayed at a very low level (four patients). We conclude that the general prognosis of a severe burn of the upper gastrointestinal tract, without other trauma, is appreciably improved by the very early institution of total parenteral nutrition.
Progress in Rheumatology
Authors: John T. Talbott
Journal: JAMA (1982)

Approximately 200 pages of printed material embrace the substance of the Second International Seminar on Treatment of Rheumatic Diseases, prepared by approximately 150 contributors. A variety of subjects has been presented from a number of clinics and research laboratories, with varying degrees of impact on the understanding of musculoskeletal disorders. Several discussions center around circulating immune complexes and human leukocyte antigen (HLA)-B typing. Discussions of therapeutic measures include "Dead Sea in Balneotherapy in Osteoarthritis," "The Use of Oral Gold Salts," and preliminary reports on some of the newer nonsteroidal anti-inflammatory drugs. A section on orthopedic surgery with three contributions includes "Fitting of an Above-Knee Prosthesis in a Patient With Ankylosing Spondylitis." The concluding section of the monograph includes abstracts of additional papers presented at the seminar, such as "Surgical Treatment of Inequality of Leg Length," and "ALKappa Amyloidosis Presenting as Giant Hepatomegaly." In view of the significant number of current
Letter: S.L.E.-like syndrome associated with mitochondrial antibodies.
Authors: A Florin-Christensen, A C Boyle, M Corbett, D Doniach
Journal: BMJ (1975)

TABLE I-Mean (± S.E.) Concentrations of Potassium and Sodium in Fruit J7uices before Passage through Column of Zerolith and Concentrations after Passage Potassium Sodium (mmol/l) (mmol/l) Apple Juice Grape Juice Apple JuiceGrape Juice Before passage 28-2 ±1-5 22-7±3 0 1 0±0 1 6 0±0-5After passage of: 1 bottle (0-75 1).00 0.0 0-8 0 5 2bottles (1-5 1).00 00 00 07 3 bottles (2-25 1).0-8 0-8 0 5 1.0 4 bottles ( 30 1) 1-5 1-2 0 5 1-5 4-7 bottles (3-5 1). 30 2-9 0-6 1-5 5 bottles (3-75 1). 4-1 4-0 0-8 1-5 Conversion: SI to Traditional Units-Potassium: 1 mmol/l= 1 mEq/l.Sodium: 1 mmol/l 1 mEq/l.TABLE II-Concentrations of Potassium and Sodium in 5 ml of Fruit Juices before and after Hand-mixing with Zerolit Potassium Sodium Zerolith in Mix (mmol/l) (mmol/l) (g) Apple JuiceGrape Juice Apple Juice Grape Juice 0 25-1 16-8 1.0 10 0 1 7-2 4-1 0 5 5 0 2 3-5 2-4 0.0 3 0 3 2-7 2-0 0.0 3 0 pH.We have removed potassium from commercially available fruit juices by ion exchange chromatography in a column packed with a calcium exchanging resin.Dry Zerolith 225 Ca-form resin 150 g was swollen in distilled water for one hour and then, after thorough washing, poured into a 60-m x 3-n column.The column was washed with 300 ml distilled water.Commercially available fruit juices were then passed through the column and the eluate collected.The potassium and sodium contents of the juices were determined by flame spectrophotometry before and after chromatography.The results were compared with those obtained by hand-mixing 1 g 2 g, or 3 g dry Zerolith with 5 ml of the same juices over a period of five minutes.With the Zerolith column the potassium content of up to 3 1 (4 bottles) of a-pple or
Syringe driver in terminal care.
Authors: S B Dover
Journal: BMJ (1987)

Continuous subcutaneous infusions of drugs by syringe driver are used often and successfully in the terminal care of patients when drugs cannot be given orally. Diamorphine is the opioid of choice because of its high solubility. If other drugs such as antiemetics, anticholinergics, sedatives, or steroids are required they may also be given by syringe driver. This method is particularly useful for domiciliary care, where the practical difficulties of providing regular parenteral analgesia are otherwise formidable.
NO activity in familial combined hyperlipidemia: potential role of cholesterol remnants
Authors: E Stroes, T de Bruin, H de Valk, W Erkelens, J D Banga, H van Rijn, H Koomans, T Rabelink
Journal: Cardiovascular Research (1997)

Objective: Patients with familial combined hyperlipidemia (FCH) have an increased cardiovascular mortality despite only moderate elevations of LDL-cholesterol. Since endothelial NO release is intimately involved in the anti-atherosclerotic effects of the endothelium, we studied the effect of short-term lipid-lowering therapy on NO-mediated vasodilatation in patients with FCH. In view of only moderate LDL elevations, we evaluated whether alterations in other lipid fractions upon therapy correlated to changes in NO-mediated vasodilatation. Methods: NO activity was assessed by serotonin-induced, nitric oxide-mediated increase in forearm blood flow (FBF). Measurements were performed 2 weeks off and 4 weeks on lipid-lowering therapy in 12 FCH patients using forearm venous occlusion plethysmography. Control experiments were performed in 12 healthy subjects. Results: Serotonin-induced vasodilatation was impaired in FCH patients (FBF (unit ml/100 ml forearm tissue/min) from 3.0 (0.3) to 4.8 (0.4)) compared to controls (FBF from 2.9 (0.3) to 6.5 (0.6); p<0.05 vs. FCH). FBF response to serotonin improved significantly upon lipid-lowering therapy (from 3.0 (0.3) to 5.7 (0.5); p<0.05 treated vs. untreated). The level of improvement in endothelial function was significantly correlated to the absolute reduction of intermediate density lipoproteins upon lipid-lowering therapy (r = −0.64; p<0.05), whereas it did not correlate to changes in VLDL- or LDL-cholesterol, nor to Lp(a). Conclusion: Patients with familial combined hyperlipidemia have impaired NO-mediated vasodilatation, that responds rapidly to lipid lowering medication, and may be related to changes in intermediate density lipoproteins.
1096 DENDRITIC CELLS BUT NOT KUPFFER CELLS ARE REQUIRED FOR THE ACTIVATION OF SELF-REACTIVE CD8 T-CELLS IN THE LIVER
Authors: I. Eickmeier, K. Derkow, A. Müller, D. Seidel, A. Bergk, B. Wiedenmann, E. Schott
Journal: Journal of Hepatology (2010)
Effects of Hydralazine-Induced Vasodilation on the Energy Metabolism of Murine Tumors Studied by In Vivo31P-Nuclear Magnetic Resonance Spectroscopy1
Authors: P. Okunieff, F. Kallinowski, P. Vaupel, L. J. Neuringer
Journal: JNCI Journal of the National Cancer Institute (1988)

The effects of hydralazine on tumor energy metabolism and on some cardiovascular parameters were measured. Tumor energy metabolism was studied in C3HF/Sed mice with iso-transplants of a spontaneous murine fibrosarcoma (FSaII, α100 mm3 in volume) and31P-NMR. Cardiovascular Parameters were measured in anesthetized C3Hf/Sed mice via intracarotid catheter. Hydralazine doses of 0.25 mg/kg given ip caused an increase of the phosphocreatine to in-organic phosphate ratio (PCr: P1) in 5 of 6 animals. These doses had minimal effects on mean arterial blood pressure, though there may have been an increased cardiac output due to a decreased afterload. Hydralazine doses≧2.0 mg/kg given ip were associated with a decrease in PCr, nucleotide triphosphate, and pH, and an increase in P1 (P<.01 for control vs. 10mg hydradazine/kg). This substantial decrease in high-energy phosphates was associated with a pronounced decrement in mean arterial blood pressure. These findings provide a rational basis for the study in experimental systems of hydralazine-induced enhancement of cell killing by hyperthermia and by agents toxic to hypoxic cells. Further, these results can be taken as a sign that hydralazine should be used with care in patients under going radiation treatment. [J Natl Cancer Inst 1988;80:745–750]
2015 — The Future of Medical Libraries
Authors: Donald A.B. Lindberg, Betsy L. Humphreys
Journal: New England Journal of Medicine (2005)

The past 20 years have witnessed computer and communications revolutions, rapid progress in genetics research, increasing public interest in personal health decisions, and corresponding expansions in the services provided by the National Library of Medicine. These concomitant and linked developments have upset the information marketplace and inspired policy debates about telecommunications, intellectual property, and access to the results of government-funded research. The Internet and the World Wide Web have transformed the way libraries deliver information services and have created perceived alternatives to libraries. What will happen to medical libraries in the post-Google world?(Figure)Today, most medical libraries exist . . .
Confidential tobacco documents enter public domain
Authors: C. Dyer
Journal: BMJ (1998)

A huge cache of highly confidential tobacco industry documents is coming into the public domain after the United States Supreme Court refused last week to overturn a Minnesota judge's order for their disclosure in a $1.77bn (£1.1bn) lawsuit.

After the decision, the industry handed over 39000 documents going back decades to lawyers acting for the state of Minnesota and the healthcare company Blue Cross/Blue Shield, which are both suing for the cost of treating victims of smoking related illnesses. The defendants are nine tobacco companies, including British American Tobacco (BAT), the Council for Tobacco Research, and the Tobacco Institute.

According to a court special master, who reviewed hundreds of the documents to decide whether they should be disclosed, they show that the tobacco industry was “aware of the addictive or habit forming nature of nicotine, experimented with ‘dosages’ of nicotine, and did not reveal to consumers the extent of their knowledge.” The master, Mark …
Psoriasis associated with idiopathic CD4+ T-cell lymphopenia: a regulatory T-cell defect?
Authors: B. Baroudjian, M. Viguier, M. Battistella, N. Beneton, C. Pagès, G. Gener, E. Bégon, H. Bachelez
Journal: British Journal of Dermatology (2014)

Idiopathic CD4(+) lymphocytopenia (ICL) is a rare immunodeficiency syndrome of unknown origin for which the increased risks of opportunistic infections and of malignancies have been well established; however, skin dysimmune diseases, including psoriasis, have been scarcely reported up to now. We report herein the severe course of psoriasis in four patients with ICL, and show evidence for a defect in the skin recruitment of regulatory CD4(+) FoxP3(+) T cells. These data raise the apparent paradigm of the occurrence of a severe immunomediated disease together with a profound T-cell defect, a model that might also apply to other immune deficiencies associated with psoriasis.
US patient privacy law comes into effect
Authors: S. Gottlieb
Journal: BMJ (2003)

Patients will have the right to view and in certain cases restrict the sharing of their personal health information under new safeguards for medical records that took effect in the United States last week.

The rules require providers to give patients a notice detailing how their information will be used. Patients will have rights to view and copy their records and request corrections to errors. Most “non-routine” disclosures, such as giving information about an employee to an employer, will be forbidden without the patient's permission.

The rules are designed to cut insurers' and employers' costs by electronically processing billing, claims, and …
P171Elevated free fetal haemoglobin threatens vasculoprotection in the fetal circulation of preeclamptic pregnancy
Authors: P Brownbill, EEC Yoong, A Brook, L Erlandsson, M Gram, I Lang, G Desoye, H Schneider, S Hansson, IP Crocker
Journal: Cardiovascular Research (2014)

Placental up-regulation of free fetal haemoglobin (fHbF) occurs in preeclamptic (PE) pregnancy. Heme oxygenase-1 (HO-1) is an important vasculoprotective enzyme in the catabolism of the associated heme porphyrin structure. We have previously shown that fHbF negatively influences the vasculoprotective capacity of the fetal circulation. Here we study fHbF levels in the fetal cord blood of pregnancies complicated by PE; a pathology associated with dysregulated fetoplacental vascular tone. We have previously shown that fHbF binds nitric oxide (NO) to elicit elevated vascular resistance in the fetoplacental circulation, using ex vivo human dual placental perfusion and in vitro placental endothelial cell shear stress studies. Furthermore, fHbF causes morphological changes to the fetoplacental endothelium. Here we hypothesise that elevated levels of fHbF in fetal plasma associated with placental pathology contribute to fetoplacental hypertension. Purpose: To evaluate and derive a robust cord blood collection and processing protocol for the accurate measurement of fetal plasma fHbF levels in normal and PE pregnancies. Methods: Fetal venous cord blood was collected by syringe and needle, or Vacutainer method into either EDTA or citrate tubes, within 10 minutes of partum. Plasma recovery occurred immediately, or after 30 minutes, prior to centrifugation at 2000g x 10 min at room temperature. Following evaluation to reduce mechanical haemolysis, newly collected normal & PE plasma (n=13 & 6, respectively) was subjected to ELISAs for HbF and HO-1. Results: Venipuncture collection of cord venous blood taken from the cord-placenta insertion point by Vacutainer system with a 21G needle, into citrate collection tubes with immediate centrifugation prevented mechanical haemolysis. There was no difference in plasma HO-1 between groups (medians = 5.9 & 5.3 ng/mL; normal & PE, respectively; Mann-Whitney). Whilst there was no difference in fHbF between groups (Mann-Whitney), variability was high in the PE group and there were some very high values for fHbF compared to the normal range, whilst fHbF values in the control group were within a tighter lower range (medians & ranges = 45.9 & 0-206 and 118.8 & 29-640 μg/mL). Conclusion: Fetal plasma HO-1 levels appear stable in preeclamptic fetal plasma, permitting fHbF to remain unchecked in some cases. High pathophysiological levels of fHbF in some cases of PE pregnancies are capable of evoking elevated vascular resistance within the fetoplacental circulation, caused by nitric oxide sequestration and disruption to the endothelium. Further evaluation is required.
The effects of patterns in climate and pollen abundance on allergy
Authors: J. Emberlin
Journal: Allergy (1994)

Recent climatic trends in Europe have been examined in the context of longer term variations and vegetation zonation. The most recent computer models of future climatic changes resulting from increasing carbon dioxide emissions are discussed in relation to the possible impacts that the predicted climatic shifts may have on the distribution and abundance of the main allergenic pollen types. The probable repercussions of these changes on the patterns and incidences of seasonal allergic rhinitis are considered. This study focuses on pollen from Betula, the Poaceae, Ambrosia, Parietaria and Olea, but also examines the implications of climatic change for other aeroallergens, including those from various crops such as Brassica species (oil-seed rape) and Helianthemum (sunflowers). In the case of natural distributions, the response of the plants to climatic changes are viewed in relation to the potential migration rates of the species. For agricultural crops, shifts in the location of productive areas involve agricultural economics both at the national and European community levels. In addition to broad regional impacts, this study examines the influence of increasing ultraviolet radiation on pollen production over various areas of Europe, and considers the effect of changing airflow trajectories on the long-range transport of pollen with pollution from central and northern Europe into Scandinavia.
Prescribed regimen is effective
Authors: J.-Y. Reginster, R. D. Altman, M. C. Hochberg
Journal: BMJ (2010)

I guess the coalition must have been aware of NHS trusts' concerns before it published the white paper. 1 Yet again we go through the charade of "consultation."I try not to get upset any more, but one question intrigues me.Who were the coalition's medical advisers in drawing up the plans (if there were any)?I can't find any names in the paper itself and nobody has claimed "credit" publicly.My impression is of opposition and criticism to the plan from the medical profession, NHS management, and health economists.I have read a few supportive letters from budding entrepreneurs and those wanting to settle old scores, but there has been no systematic enthusiasm.Governments have used medical advice from interesting sources before, and any government might simply consult an
Effects of pacing on triggered activity induced by early afterdepolarizations.
Authors: B P Damiano, M R Rosen
Journal: Circulation (1984)

Early afterdepolarizations (EADs) are depolarizing potentials that occur during phase 2 or phase 3 of repolarization. They can induce triggered activity and have been proposed as a cause for arrhythmias in the heart in situ. To determine the response of EADs and triggered activity to interventions analogous to those used in the clinic for identifying arrhythmogenic mechanisms, we used a pacing protocol to study the response of EADs to sustained drive and extrastimuli. Cesium chloride (5 to 20 mM), which induces triggered arrhythmias in the intact dog, was used to induce EADs in isolated canine Purkinje fibers, and these were studied by microelectrode techniques. Cesium prolonged action potential duration and induced two types of EADs. At a potassium concentration of 4 mM, EADs occurred at membrane potentials of -3 to -30 mV. They were initiated 240 to 680 msec after the action potential upstroke and were 2 to 30 mV in amplitude. Their amplitude increased as drive cycle length increased, but their coupling interval to the action potential did not change with drive cycle length. These EADs did not induce triggered action potentials. At a potassium concentration of 2 mM, EADs usually occurred at higher membrane potentials (-50 to -70 mV) and longer coupling intervals (470 to 1360 msec) and were manifested as a delay of phase 3 repolarization. These EADs induced triggered action potentials. When the triggered rhythms became sustained, premature stimuli either reset or terminated them, depending on the maximum diastolic potential. Termination occurred more frequently as the maximum diastolic potential increased. The extent of overdrive suppression induced by pacing for 15 sec to 3 min also increased as the maximum diastolic potential increased. In summary, cesium induced EADs at low or high membrane potentials. The former did not induce triggered activity, but the latter did. The triggered rhythms that occurred were similar to abnormal automatic mechanisms in their response to overdrive pacing and extrastimuli.
Hematin and Porphyria
Authors: C.J. Watson
Journal: New England Journal of Medicine (1975)

The discovery that hematin represses induction of δ-aminolevulinic acid synthetase (ALA-S), the rate-limiting enzyme for hepatic porphyrin and heme synthesis,1 is central to recent studies seeking to provide a means of terminating or ameliorating the acute attack of acute intermittent porphyria, porphyria variegata or hepatic coproporphyria.The induction of ALA-S in the acute attack of AIP, acute intermittent porphyria, porphyria variegata or hepatic coproporphyria markedly increases the porphyrin precursors, ALA and porphobilinogen (PBG), in liver, blood plasma and urine. The enzyme is induced because of heme deficiency in the liver secondary to the genetic partial lack of uroporphyrinogen synthetase (UPG-S) . . .
Let's proceed with caution
Authors: F. Godlee
Journal: BMJ (2010)

The lively response to last month’s editorial on chronic fatigue syndrome ( BMJ 2010;340:c738, doi:10.1136/bmj.c738) brings home the inadequacy of our current understanding of this condition, or group of conditions. The responses from patients, carers, and clinicians remind us that we remain largely in the dark about its causes and prognosis, there are no accepted diagnostic tests, and treatment options are limited (www.bmj.com/cgi/eletters/340/feb11_1/c738). Sufferers must also deal with social and (if they are doctors) professional stigmatisation, as dermatologist Stephanie Munn experienced (doi:10.1136/bmj.c1179).

Little wonder if many who live or work with chronic fatigue syndrome leapt at the news last October that scientists in Nevada had found a “highly significant association” between the condition and …
Book Review Surgery of Disorders of the Foot and Ankle Edited by Basil Helal, David I. Rowley, Andrea Cracchiolo, III, and Mark S. Myerson. 894 pp., illustrated. Philadelphia, Lippincott–Raven, 1996. $175. 0-397-51423-9
Authors: Joseph Borrelli
Journal: New England Journal of Medicine (1997)
Single-Antibiotic Therapy for Streptococcal Endocarditis
Authors: Adolf W. Karchmer
Journal: JAMA (1979)

Ninety-nine patients treated with penicillin G potassium, cephalothin sodium, or vancomycin hydrochloride were studied to evaluate single-drug therapy for nonenterococcal streptococcal endocarditis. Eighty-six patients survived; of these, 66 received penicillin alone. The maximum serum bactericidal titer obtained at the expected nadir of serum antibiotic concentration was 1:8 or greater in 70 (95%) of the 74 patients studied. No relapse occurred among the 66 patients treated wih penicillin. Only one patient experienced a relapse that occurred following therapy with suboptimal doses of vancomycin. Distinct second episodes of endocarditis occurred in five patients. While 13 patients died, none died of intractable infection. The treatment of endocarditis due to penicillin-susceptible streptococci with high-dose parenteral penicillin or a bactericidal penicillin substitute for four weeks or longer results in bacteriologic cure rates comparable with those achieved with combined penicillin-streptomycin regimens.