tbuckley/cabot-search huggingface dataset:
Comparison of concentrations of two proteinase inhibitors, porcine pancreatic elastase inhibitory capacity, and cell profiles in sequential bronchoalveolar lavage samples.
Authors: H M Morrison, J A Kramps, J H Dijkman, R A Stockley
Journal: Thorax (1986)

Bronchoalveolar lavage is used to obtain cells and proteins from the lower respiratory tract for diagnosis and research. Uncertainity exists about which site in the lung is sampled by the lavage fluid and what effect different lavage volumes have on recovery of the constituents of lavage fluid. Dilution of alveolar lining fluid by lavage fluid is variable and results are usually expressed as protein ratios to surmount this problem. We have compared cell profiles and the concentrations of two proteinase inhibitors--the low molecular weight bronchial protease inhibitor antileucoprotease and alpha 1 proteinase inhibitor, together with alpha 1 proteinase inhibitor function and its relationship to the cell profile in sequential bronchoalveolar lavage fluid samples from patients undergoing bronchoscopy. There was no difference in total or differential cell counts or albumin or alpha 1 proteinase inhibitor concentrations between the first and second halves of the lavage. Both the concentration of antileucoprotease and the ratio of antileucoprotease to albumin were, however, lower in the second half of the lavage (2p less than 0.01 and 2p less than 0.05 respectively). There was no difference in the function of alpha 1 proteinase inhibitor (assessed by inhibition of porcine pancreatic elastase--PPE) between aliquots (0.28 mole PPE inhibited/mol alpha 1 proteinase inhibitor; range 0-1.19 for the first half and 0.37 mol PPE inhibited/mol alpha 1 proteinase inhibitor; range 0.10-0.80 for the second half). About 60-70% of alpha 1 proteinase inhibitor in each half of the lavage fluid was inactive as an inhibitor. The function of alpha 1 proteinase inhibitor did not differ between bronchitic smokers and ex-smokers. Alpha 1 proteinase inhibitor function was not related to the number of total white cells, macrophages, or neutrophils in the lavage fluid. Contamination of lavage by red blood cells was found to alter the concentration of alpha 1 proteinase inhibitor but not its function when aliquots with and without erythrocytes were compared. These results show that the only difference between the two halves of these lavage samples is in the amount of antileucoprotease present, suggesting that more proximal secretions are being harvested early in the lavage procedure. Much of the alpha 1 proteinase inhibitor present in the samples is functionally inactive, but this is not clearly related to any particular cell type or to smoking habits, and does not differ between different stages of the lavage procedure. Much of the alpha1 proteinase inhibitor present in the samples is functionally inactive, but this is not clearly related to any particular cell type or to smoking habits, and does not differ between different stages of the lavage procedure. Finally, the presence of erythrocytes probably does affect alpha(1) proteinase inhibitor concentration and such samples should be excluded from analysis.
A step up in experience
Authors: G. Yamey
Journal: BMJ (1999)

Becoming an MRCP brought me to a crossroads, and the signposts were blank. I was in no hurry to commit to a four or five year training programme and was eager to have a period of reflection before the next phase of my professional life. As I trawled through the pages of the BMJ classified for that dream job (minimal on-call, stimulating, life affirming and enriching), I spotted a LAS tucked away under “Rehabilitation Medicine”. It would be nine to five, with two half days for research, as a registrar to a brain injuries unit for young adults in East London. This appealed to my interests in neurology and disability and had a strong psychosocial flavour, so I took up the …
Australian government forced to bail out medical malpractice insurer
Authors: C. Zinn
Journal: BMJ (2002)

Australia's largest medical malpractice insurer, which represents 60% of the nation's doctors, has received a surprise temporary bail out from the federal government after fears that it could collapse.

The Australian Medical Association had warned that thousands of doctors would have to stop private work if United Medical Protection was forced to withdraw. The federal government has avoided an immediate crisis by offering a A$35m (£13m; $18.5m; €16.32m) guarantee to the fund last Thursday (28 March), but the insurer faces further demands that could threaten its future.

The …
A PLEA FOR THE SCIENTIFIC ADMINISTRATION OF ANESTHETICS.
Authors: JAMES TAYLOE GWATHMEY
Journal: JAMA (1906)

There is no more reason why we should adhere to the drop method of chloroform or the cone method of ether when a better and more exact method is produced than that we should continue to use the "one horse shay" when the automobile is available. Nor is it sensible to continue the foolish custom of allowing the most inexperienced interne to narcotize instead of having a professional anesthetist in every hospital. Furthermore, because a man has given an anesthetic many times during his hospital service and irregularly afterward, it is no evidence of his ability to do the same thing several years after, with even a reasonable degree of success. The wonderful advancement in all departments of medicine has come from men devoting their exclusive time to some one branch of it, and especially is this true of anesthetics. We are indebted to England, where the professional anesthetist prevails
Diagnosis and Treatment of Urinary Tract Infection in Children
Authors: Ralph A. Straffon
Journal: JAMA (1960)

Inadequately treated, persistent, or recurrent urinary tract infections in childhood probably account for many cases of unexplained chronic pyelonephritis producing renal insufficiency in adult life. A group of 74 children with recurrent or persistent urinary tract infections were studied to aid in planning a therapeutic program. Of 18 children treated with long-term antimicrobial therapy and double-voiding techniques when reflux was present, 17 had sterile urine at the time of follow-up. These results were better than those in the group treated by antimicrobial therapy plus urethral dilatation or plastic surgery on the vesical neck with or without reimplantation of the ureter. A program for investigation and therapy utilizing this information is presented for the management of urinary tract infection in children.
Autumn Books: Sightless and suffering
Authors: P. Trevor-Roper
Journal: BMJ (1986)

<b>Introduction and Objective:</b> Low peak inspiratory flow rate (PIFR) can cause suboptimal inhaler usage, leading to ineffective bronchodilation.<sub>1</sub> This study aim was to determine the frequency of PIFR with a manual inspiratory flow meter in patients using inhaler devices. <b>Methods:</b> A descriptive, cross-sectional study including adult patients assisting lung function laboratory on their routine follow-up of their chronic respiratory disease using inhaled medication. In-Check DIAL G16® device was used to simulate the resistance of the inhaler and determine the patient’s PIFR. <b>Results:</b> Total number was 155 patients, mean age of 63±15.2 years, 58.1% women. 64 (41.3%) patients used inhalers with an optimal PIFR greater than 60 L/ minute. The specific values of each one are observed in table 1, finding statistically significant differences by both group comparisons (p &lt;0.01). Good correlation was found when PIFR was compared with peak inspiratory flow measured in liters with spirometry (r<sup>2</sup> Pearson= 0,724; p&lt;0,05). <b>Conclusions:</b> Low PIFR was frequently determined in patients using various inhalers devices, and consequently, not reaching its optimal value for adequate treatment. 1Kawamatawong T., et. al. Peak inspiratory flow rate measurements by using In-Check Dial for the different inhaler devices in elderly with obstructive airway diseases. Journal of Asthma and Allergy 2017: 10; 17-21.
Zotarolimus-Eluting Peripheral Stents for the Treatment of Erectile Dysfunction in Subjects With Suboptimal Response to Phosphodiesterase-5 Inhibitors
Authors: Jason H. Rogers, Irwin Goldstein, David E. Kandzari, Tobias S. Köhler, Curtiss T. Stinis, Paula J. Wagner, Jeffrey J. Popma, Michael R. Jaff, Krishna J. Rocha-Singh
Journal: Journal of the American College of Cardiology (2012)
Misoprostol, Diarrhea, and Psyllium Mucilloid
Authors: Arthur M. Bobrove
Journal: Annals of Internal Medicine (1990)

Letters and Corrections1 March 1990Misoprostol, Diarrhea, and Psyllium MucilloidArthur M. Bobrove, MDArthur M. Bobrove, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-112-5-386_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:Misoprostol (Cytotec, G.D. Searle and Co., Chicago, Illinois) is a prostaglandin E1analog that was developed in an effort to protect the stomach from nonsteroidal anti-inflammatory drug-induced ulcers. Clinical studies (1, 2) have confirmed that misoprostol prevents mucosal lesions associated with nonsteroidal anti-inflammatory drugs and aspirin use, and is indicated in patients with disabling arthritis who require nonsteroidal anti-inflammatory drug therapy despite the risk for serious gastrointestinal complications (that is, gastric ulcer or gastrointestinal bleeding). Although misoprostol appears to be extremely safe, some patients nevertheless experience lower abdominal cramping or diarrhea. The observation that patients routinely taking...References1. Graham S, Agrawal N, and Roth S. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. Lancet. 1988;2:1277-80. CrossrefMedlineGoogle Scholar2. Lanza F, Peace K, and Gustitus L A blinded endoscope comparative study of misoprostol versus sucralfate and placebo in the prevention of aspirin-induced gastric and duodenal ulceration. Am J Gastroenterol. 1988;83:143-6. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Arthur M. Bobrove, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEffect of Psyllium Fiber Supplementation on Diarrhea Incidence in Enteral Tube‐Fed Patients: A Prospective, Randomized, and Controlled TrialDrug interactions with the dietary fiber Plantago ovata huskThe effects of psyllium hydrophilic mucilloid on diarrhea in enterally fed patientsAcute Upper Gastrointestinal Bleeding in Elderly Persons 1 March 1990Volume 112, Issue 5Page: 386-386KeywordsAspirinDiarrheaDrug therapyDrugsGastric ulcersHemorrhageLesionsProstaglandinStomachUlcers ePublished: 1 December 2008 Issue Published: 1 March 1990 PDF downloadLoading ...
NICE lifts cost limit on drugs to improve access to end of life treatments
Authors: Z. Kmietowicz
Journal: BMJ (2009)

The NHS drugs watchdog has loosened the terms of approval for expensive treatments that extend life in patients with a short life expectancy. Drugs that would normally be ruled out of use on the NHS because they did not represent a cost effective use of resources are now more likely to be made available.

The National Institute for Health and Clinical Excellence (NICE) has issued its appraisal committees with supplementary advice when considering whether to approve treatments licensed for terminal illness that affect small numbers of patients, normally fewer than …
Imipramine, Sleep, And Enuresis
Authors: Christopher Cooper
Journal: JAMA (1974)

To the Editor.—  In a recent letter (227:327, 1974), Martin suggests that imipramine's effect on nocturnal enuresis may be understood in terms of the drug's sleep effects.  Evidence from adult human subjects indicates that the frequency of spontaneous shifts to stage I sleep from other sleep stages is actually increased, rather than decreased, consequent to administration of imipramine. 1 This finding generates the prediction that far from decreasing the frequency of lightening of the electrocardiographic pattern and thereby making enuresis less likely, imipramine will increase the frequency of lightening of sleep constituting the enuretic episode.  It is inviting to speculate that reductions in frequency of wetting may be attributed to a labile sleep pattern comprising frequent shifts to stage I sleep so that individual stage III and stage IV components are of short duration, although the total time spent in these latter (deep) sleep stages is unchanged. Thus, the likelihood
LOWER LEVELS OF SERUM 1,5-ANHYDROGLUCITOL ARE ASSOCIATED WITH NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME
Authors: Junko Ito, Ryuichi Kato, Kaoru Sakurai, Toru Ogawa, Takanori Tahara, Yasuhiro Yokoyama, Takashi Ashikaga, Yasuhiro Satoh
Journal: Journal of the American College of Cardiology (2011)
Sensitivity and Specificity of Prenatal Features of Physiological Shunts to Predict Neonatal Clinical Status in Transposition of the Great Arteries
Authors: Jean-Marie Jouannic, Laurent Gavard, Laurent Fermont, Jérôme Le Bidois, Sophie Parat, Pascal R. Vouhé, Yves Dumez, Daniel Sidi, Damien Bonnet
Journal: Circulation (2004)

Background— Although prenatal diagnosis of transposition of the great arteries (TGA) reduces neonatal mortality, the preoperative course can be complicated in infants with a restrictive foramen ovale (FO) or a ductus arteriosus (DA) constriction. We sought to determine the specificity and sensitivity of prenatal features of physiological shunts in predicting postnatal clinical status in prenatally diagnosed TGA in babies delivered in a tertiary care center providing all facilities for neonatal urgent care. Methods and Results— The outcomes of 130 fetuses with TGA were reviewed over a period of 5.5 years. Restriction of the FO and/or constriction of the DA could be analyzed in 119/130 fetuses at 36±2.7 weeks of gestation. Twenty-four out of 119 had at least 1 abnormal shunt (23 FO, 5 DA, and 4 both). Thirteen of 130 neonates had profound hypoxemia (PaO 2 &lt;25 mm Hg) and metabolic acidosis (pH &lt;7.15) in the first 30 minutes and required immediate balloon atrioseptostomy. Two who had abnormal FO and DA died despite aggressive resuscitation. The specificity and sensitivity of the fetal echo in predicting neonatal emergency were 84% and 54%, respectively. The specificity and sensitivity of a combination of restrictive FO and DA constriction were 100% and 31%, respectively. Conclusions— Restriction of the FO and/or of the DA has a high specificity to predict the need for emergency neonatal care in fetuses with TGA, but the sensitivity is too low to detect all high-risk fetuses. Exceptional procedures should be considered for fetuses that have a combination of restrictive FO and DA constriction.
Walking the walk
Authors: J. O. Drife
Journal: BMJ (2003)

Since January each consultant obstetrician in our hospital has been spending a week at a time in the delivery suite. The days of the senior registrar are long gone and now there aren't enough registrars. After years of preaching the need for a consultant based service, I could hardly refuse to join the rota.

I had not done routine labour ward sessions since my lecturer days. For 20 years it had been emergencies only, often at the …
Wound of the Elbow-Joint Treated According to the Antiseptic System
Authors: A. Marshall
Journal: BMJ (1870)

Culture narrowly defined is the learned or shared beliefs, values and behaviours of a group. However, concepts of culture are complex and influenced by many factors, such as ethnicity, socioeconomic status, gender, education, sexual orientation, or immigration status. Health care professionals are expected to demonstrate cultural competency, and possess some knowledge of cultural values, beliefs and practices and practice proficient communication skills. Cultural sensitivity reflects a health care professional9s awareness and respect for the patient9s cultural viewpoint. Cultural concordance between health care professionals and patients and families has the potential to provide a framework of expectations about communication and complex decision-making in the setting of end of life care. The literature reflects the disparities in end of life care for minority and vulnerable populations, with underutilisation of hospice care, higher likelihood of using life-sustaining treatment at the end of life and dying in the hospital. Most of the literature focuses on the different cultural perspectives about communication, death and end-of-life care decision-making. There is a paucity of literature about the impact of cultural concordance between health care professionals and patients/families in palliative care and end of life care. Through several case studies, we will identify potential benefits and challenges for health care professionals who have ethnic, language or racial concordance with patients and families. Using components of effective communication strategies for advance care planning with seriously ill patients, we will add new insight for providing patient-centred, culturally effective care within a culturally diverse health care setting.
LARYNGECTOMY FOR CARCINOMA.
Authors: E. FLETCHER INGALS
Journal: JAMA (1903)

The text for this article was furnished by a patient who was brought to our clinic for diseases of the chest, throat and nose at Rush Medical College by Dr. Geo. A. Torrison, who had found him among his patients about six months previously. Dr. O. T. Freer had also seen the patient with him and a microscopic examination of a small mass removed for the purpose had confirmed their diagnosis of carcinoma of the larynx, which diagnosis was also concurred in by Prof. L. Hektoen. <h3>THE PATIENT AND HIS HISTORY.</h3> The patient, L. T., was a large, fine-appearing man, 47 years of age, who came to this country from Norway thirty years ago. He weighed about 200 pounds and had every appearance of robust health excepting the one symptom of hoarseness. He was a jeweler by trade, married and had three healthy children. He stated that
Antacids vs Placebos in Peptic Ulcer Therapy
Authors: Daniel Hollander
Journal: JAMA (1973)

The ability of an antacid preparation to relieve discomfort and to promote healing of peptic ulceration was compared to a placebo in a controlled double-blind outpatient study. Antacids were more effective than placebos in the promotion of healing (<i>P</i>=.04) and relief of discomfort (<i>P</i>=.03) of gastric ulcerations. In duodenal ulceration, a trend in favor of antacid therapy was found with respect to promotion of healing and relief of peptic discomfort. This trend, however, was not statistically significant (<i>P</i>&gt;.15).
Oral Contraceptives and Thromboembolic Disease
Authors: Victor A. Drill
Journal: JAMA (1972)

Studies in more than 70,000 women show no relation of the different doses of mestranol or ethinyl estradiol in oral contraceptives to the occurrence of superficial and deep-vein thromboembolic disease involving the lower extremities. The disease incidence did not differ significantly between the two estrogens or the different doses of the two estrogens employed in oral contraceptives, and no correspondence was seen between the dosage of estrogen and the incidence of disease. At all dosages of the estrogens, the incidence of thromboembolic disease was not greater than the average normal rate of 2.2 cases per 1,000 women of childbearing age per year.
Myenteric plexus in Hirschsprung's disease.
Authors: B Smith
Journal: Gut (1967)

ABSTRACT. In uremic patients, various uremic toxins are accumulated and exert various biologic effects on uremia. Indoxyl sulfate (IS) is one of uremic toxins that is derived from dietary protein, and serum levels of IS are markedly increased in both uremic rats and patients. It has been previously reported that the accumulation of IS promotes the progression of chronic renal failure (CRF). This study demonstrates the role of rat organic anion transporters (rOATs) in the transport of IS and the induction of its nephrotoxicity. The administration of IS to 5/6-nephrectomized rats caused a faster progression of CRF, and immunohistochemistry revealed that IS was detected in the proximal and distal tubules where rOAT1 (proximal tubules) and/or rOAT3 (proximal and distal tubules) were also shown to be localized. In <i>in vitro</i> study, the proximal tubular cells derived from mouse that stably express rOAT1 (S2 rOAT1) and rOAT3 (S2 rOAT3) were established. IS inhibited organic anion uptake by S2 rOAT1 and S2 rOAT3, and the Ki values were 34.2 and 74.4 μM, respectively. Compared with mock, S2 rOAT1 and S2 rOAT3 exhibited higher levels of IS uptake, which was inhibited by probenecid and cilastatin, organic anion transport inhibitors. The addition of IS induced a decrease in the viability of S2 rOAT1 and S2 rOAT3 as compared with the mock, which was rescued by probenecid. These results suggest that rOAT1 and rOAT3 play an important role in the transcellular transport of IS and the induction of its nephrotoxicity.
Results of Parks operation for faecal incontinence after anal sphincter injury.
Authors: G G Browning, R W Motson
Journal: BMJ (1983)

Parks operation for faecal incontinence was performed on 97 patients with total loss of anorectal control due to injury. All had sustained complete division of the anal sphincters as a result of trauma, anal surgery, or obstetric tears and either were incontinent or had been given a colostomy. In all patients the divided sphincters were repaired using an overlapping technique; in 93 the repair was protected by a temporary defunctioning stoma. There was no operative mortality. Continence was completely restored in 65 (78%) and improved in a further 11 (13%) of the 83 patients assessed from four to 116 months postoperatively. Minor complications which did not affect the eventual clinical outcome occurred in 23 patients. Factors associated with failure of the operation included breakdown of the repair in the early postoperative period, fistula, and pelvic floor neuropathy. The results show that even after severe injury to the sphincters surgical reconstruction can restore continence in most patients.
Modulation by prostaglandins of adrenergic transmission in the isolated perfused rabbit and rat kidney.
Authors: K U Malik, J C McGiff
Journal: Circulation Research (1975)

In the isolated perfused rabbit kidney prostaglandins (PGS) E1 (0.02-0-1 ng/ml), E2 (0.02-0.1 ng/ml), and A2 (1-5 ng/ml) inhibited the vasoconstrictor responses to sympathetic nerve stimulation by 21-44%, 31-39%, and 20-23%, respectively, without alerting those to injected norepinephrine. In contrast, in the rat kidney PGE1 (0.5 ng/ml), PGE2 (0.5 ng/ml), and PGA2 (5 ng/ml) enhanced the vasoconstrictor responses to sympathetic nerve stimulation by 41%, 27%, and 11%, respectively; the equiconstrictor responses to injected norepinephrine remained unaltered. Higher concentrations of these agents produced vasodilation in the rabbit kidney and vasoconstriction in the rat kidney. In both species PGF2alpha produced vasoconstriction and enhanced the response to both adrenergic stumuli. In the rabbit kidney inhibitors of PG synthesis augmented the responses to sympathetic nerve stimulation without altering those to injected norepinephrine, whereas in the rat kidney inhibition of the responses to both adrenergic stimuli occurred. Arachidonic acid inhibited the vasoconstrictor responses to sympathetic nerve stimulation in the rabbit kidney, but in the rat kidney it caused augmentation of these responses. Since these effects of arachidonic acid were reduced by indomethacin, they appear to be mediated through the acid's conversion to PGS. We conclude that PGS of the E series modulate adrenergic transmission in the kidney and that their modulatory actions are species dependent.