tbuckley/cabot-search huggingface dataset:
Systemic Review and Meta-analysis of Randomized Clinical Trials Comparing Primary vs Delayed Primary Skin Closure in Contaminated and Dirty Abdominal Incisions
Authors: Aneel Bhangu, Prashant Singh, Jonathan Lundy, Douglas M. Bowley
Journal: JAMA Surgery (2013)

<h3>Importance</h3> Surgical site infection remains a major challenge in surgery. Delayed primary closure of dirty wounds is widely practiced in war surgery; we present a meta-analysis of evidence to help guide application of the technique in wider context. <h3>Objective</h3> To determine using meta-analysis whether delayed primary skin closure (DPC) of contaminated and dirty abdominal incisions reduces the rate of surgical site infection (SSI) compared with primary skin closure (PC). <h3>Data Sources</h3> A systematic review of the literature published after 1990 was conducted of the Medline, PubMed, Current Controlled Trials, and Cochrane databases. The last search was performed on October 6, 2012. No language restrictions were applied. <h3>Study Selection</h3> Randomized clinical trials comparing PC vs DPC were included. <h3>Data Extraction and Synthesis</h3> Two of us independently selected studies based on quality assessment using the Cochrane Collaboration tool for assessing risk of bias in randomized trials. Data were pooled using fixed- and random-effects models. <h3>Main Outcome and Measure</h3> Rate of SSI, as defined by the individual study. <h3>Results</h3> The final analysis included 8 studies randomizing 623 patients with contaminated or dirty abdominal wounds to either DPC or PC. The most common diagnosis was appendicitis (77.4%), followed by perforated abdominal viscus (11.5%), ileostomy closure (6.5%), trauma (2.7%), and intra-abdominal abscess/other peritonitis (1.9%). The time to first review for DPC was provided at between 2 and 5 days postoperatively. All studies were found to be at high risk of bias, with marked deficiencies in study design and outcome assessment. When SSI was assessed across all studies using a fixed-effect model, DPC significantly reduced the chance of SSI (odds ratio, 0.65; 95% CI, 0.40-0.93;<i>P</i> = .02). However, heterogeneity was high (72%), and using a random-effects model, the effect was no longer significant (odds ratio, 0.65; 95% CI, 0.25-1.64;<i>P</i> = .36). <h3>Conclusions and Relevance</h3> Delayed primary skin closure may reduce the rate of SSI, but current trials fail to provide definitive evidence because of poor design. Well-designed, large-numbered randomized clinical trials are warranted.
Strategy to protect runaway children in England is not working, says charity
Authors: M. Gould
Journal: BMJ (2009)

A new report detailing the disturbing stories of young people forced to live on the streets concludes that government strategies to protect the estimated 100 000 people aged under 18 who run away in England each year are failing.

The report says that the cumulative cost to society for each young person who does not get help in time is at least £1m (€1.1m; $1.6m), a figure it bases on Home Office crime costings and testimony from interviewees.

In-depth interviews with 103 homeless young people under16 years of age show the extent of sexual and physical violence, drug abuse, and mental trauma, with youths by turns victim and perpetrator.

Over two thirds of the …
In situ analyses of genome instability in breast cancer
Authors: Koei Chin, Carlos Ortiz de Solorzano, David Knowles, Arthur Jones, William Chou, Enrique Garcia Rodriguez, Wen-Lin Kuo, Britt-Marie Ljung, Karen Chew, Kenneth Myambo, Monica Miranda, Sheryl Krig, James Garbe, Martha Stampfer, Paul Yaswen, Joe W Gray, Stephen J Lockett
Journal: Nature Genetics (2004)
Rectal Examination in Adolescent Males
Authors: MICHAEL E. YAFFE
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 October 1983Rectal Examination in Adolescent MalesMICHAEL E. YAFFE, M.D.MICHAEL E. YAFFE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-99-4-574_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The review by Rapp (1) on the adolescent patient fails to emphasize properly the concern and care needed in dealing with the genito-rectal examination, especially with adolescent males. An overly zealous physician neglecting to properly explain the nature and purpose of this standard procedure may induce strong patient resistance, fear, and misunderstanding. For a teenage boy struggling with sexual identity, a genito-rectal examination by a male physician can bring on fears of a homosexual assault and precipitate homosexual panic. Just as most physicians are aware of the trauma associated with the first pelvic examination in the female...Reference1. RAPP C. The adolescent patient. Ann Intern Med. 1983;99:52-60. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MICHAEL E. YAFFE, M.D.Affiliations: Harding Hospital 445 E. Granville Road; Worthington, OH 43085 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReasons to Omit Digital Rectal Exam in Trauma Patients: No Fingers, No Rectum, No Useful Additional Information 1 October 1983Volume 99, Issue 4Page: 574-574KeywordsAdolescentsAssaultFearHomosexualsSexual identity ePublished: 1 December 2008 Issue Published: 1 October 1983 PDF downloadLoading ...
Elevated expression of DKK1 is associated with cytoplasmic/nuclear β-catenin accumulation and poor prognosis in hepatocellular carcinomas
Authors: Bin Yu, Xinrong Yang, Yang Xu, Genfu Yao, Huiqun Shu, Biaoyang Lin, Leroy Hood, Hongyang Wang, Shengli Yang, Jianren Gu, Jia Fan, Wenxin Qin
Journal: Journal of Hepatology (2009)
A novel inhibitor of _protein kinase-C as a therapeutic for ischemic reperfusion injury in acute coronary syndromes
Authors: Felix Lee, Koichi Inagaki, Leon Chen, Lynn Bailey, Fumi Ikeno, Jennifer Lyons, Donna Bouley, Paul Yock, Andrew Carter, Alan Yeung, Daria Mochly-Rosen
Journal: Journal of the American College of Cardiology (2002)
Incidence and clinical significance of hyperamylasemia after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic lesions: a prospective and controlled study
Authors: G. Fernández-Esparrach, A. Ginès, P. García, M. Pellisé, M. Solé, P. Cortés, A. Gimeno-García, O. Sendino, S. Navarro, J. Llach, J. Bordas, A. Castells
Journal: Endoscopy (2007)

See also: Commentaire de travail de G. Fernández-Esparrach et al., pp. 720Endoscopy 2007; 39(08): 846-846DOI: 10.1055/s-0032-1308861
The swedish athletics study: various prevalence measures of musculoskeletal injury in elite athletics athletes
Authors: J Jacobsson, T Timpka, J Ekberg, J Kowalski, S Nilsson, P Renström
Journal: British Journal of Sports Medicine (2011)

Background Athletics is one of the most popular global sports, but little is known of injury patterns among élite athletic athletes. Injury prevalence has been proposed to be the most valid measure of injury burden in sports where athletes practice long hours and are at risk for overuse problems. Objective To compare two different indicators of injury prevalence in athletics as measures of the injury burden among adult and youth élite athletics athletes. Design Cross-sectional epidemiological study using web-based data collection. Setting Swedish élite youth (U17) and adult athletics athletes. Data were collected in April 2009. Participants 278 youth and adult athletes (91%) submitted a web-based questionnaire from an eligible study population of 301 athletes. Assessment of risk factors Athlete's sex, age and anatomical body regions were assessed as risk factors. Main outcome measures 1-year prevalence of musculoskeletal injuries causing at least 3 weeks of partial or complete absence from practice and competition; point prevalence of musculoskeletal injury. Results The 1-year injury prevalence was 43.6%. Among the age groups, the prevalence was 48.1% for adult and 37.1% for youth athletes. The point prevalence of injury was 36.2%, 38% among adult athletes and 33% among youth athletes. Female youth athletes had a tendency towards higher 1-year (p=0.06) and point (p=0.025) injury prevalence than male youth athletes. There was no sex difference in injury prevalence among the senior athletes. A majority of the injuries (74% 1-year prevalence; 78% point prevalence) reported by the athletes were located to the lower extremities. Conclusion Using either the point or 1-year retrospective window definition of prevalence, currently approximately 4 out of 10 Swedish élite athletic athletes have injuries that interfere with their performance of sports activities. Most injuries are located to the lower extremities. Prospective epidemiological studies investigating individual risk factors for athletic injuries are warranted.
Parents' perceptions of taking babies' rectal temperature.
Authors: J Kai
Journal: BMJ (1993)

OBJECTIVE--To explore the attitudes of parents to measuring their babies9 rectal temperature. DESIGN--Qualitative study using unstructured interviews of parents given "Baby Check," a scoring system designed to assess severity of illness in babies that includes measurement of rectal temperature. SETTING--One inner city general practice in Newcastle upon Tyne. SUBJECTS--42 parents of 34 babies under 6 months old. RESULTS--Parents were reluctant to measure rectal temperature in their babies; 37 parents spontaneously raised concerns. Fifteen did not undertake measurement, 16 did so once only, and 11 did so more than once. Parents9 concerns included a fear of hurting their child, anxieties about sexual intimacy and abuse, difficulty in comforting their child, and concern for their child9s feelings. Most (33) substituted axillary measurement. CONCLUSIONS--Parents9 preference for the axillary method of measuring temperature and resistance to using a rectal method in their children was based on several concerns. If parents are to be encouraged to use the rectal method of measuring temperature in sick babies any benefits must be set against the generation of considerable parental anxiety and the resources that would be necessary to negotiate with parents and change their views.
Effusive–Constrictive Pericarditis
Authors: Jaume Sagristà-Sauleda, Juan Angel, Antonio Sánchez, Gaietà Permanyer-Miralda, Jordi Soler-Soler
Journal: New England Journal of Medicine (2004)

Effusive-constrictive pericarditis is an uncommon pericardial syndrome characterized by concomitant tamponade, caused by tense pericardial effusion, and constriction, caused by the visceral pericardium. We conducted a prospective study of its clinical evolution and management.From 1986 through 2001, all patients with effusive-constrictive pericarditis were prospectively evaluated. Combined pericardiocentesis and cardiac catheterization were performed in all patients, and pericardiectomy was performed in those with persistent constriction. Follow-up ranged from 1 month to 15 years (median, 7 years).A total of 1184 patients with pericarditis were evaluated, 218 of whom had tamponade. Of these 218, 190 underwent combined pericardiocentesis and catheterization. Fifteen of these patients had effusive-constrictive pericarditis and were included in the study. All patients presented with clinical tamponade; however, concomitant constriction was recognized in only seven patients. At catheterization, all patients had elevated intrapericardial pressure (median, 12 mm Hg; interquartile range, 7 to 18) and elevated right atrial and end-diastolic right and left ventricular pressures. After pericardiocentesis, the intrapericardial pressure decreased (median value, -5 mm Hg; interquartile range, -5 to 0), whereas right atrial and end-diastolic right and left ventricular pressures, although slightly reduced, remained elevated, with a dip-plateau morphology. The causes were diverse, and death was mainly related to the underlying disease. Pericardiectomy was required in seven patients, all of whom had involvement of the visceral pericardium. Three patients had spontaneous resolution.Effusive-constrictive pericarditis is an uncommon pericardial syndrome that may be missed in some patients who present with tamponade. Although evolution to persistent constriction is frequent, idiopathic cases may resolve spontaneously. In our opinion, extensive epicardiectomy is the procedure of choice in patients requiring surgery.
Is there an Indication for Prophylactic Endoscopic Paravariceal Injection Sclerotherapy in Patients with Liver Cirrhosis and Portal Hypertension?
Authors: K.-J. Paquet, P. Koussouris
Journal: Endoscopy (1986)

From January 1, 1978, to January 1, 1980, a prospective controlled randomized trial comparing conservative treatment to prophylactic endoscopic paravariceal injection sclerotherapy of esophageal varices prior to hemorrhage was carried out. In all 71 patients liver cirrhosis was confirmed histologically. The two randomly assigned groups were comparable with respect to age, sex and degree of liver diseases and its histological type was also similar. Indications for endoscopic treatment were the existence of degree III to IV varices bearing telangiectasias on their top, and degree II to IV varices without telangiectasias but coagulation factors below 30 %, or both. Six patients had to be excluded. In group 1 A - treatment by conservative means, clinical and endoscopic monitoring - a high rate of variceal bleeding (66 %) and death (42 %) was observed. Comparing these results with those of group I B treated by sclerotherapy, bleeding and death rates (6 and 6 %) were found to be highly significantly lower. From January 1, 1980, to January 1, 1984 another 70 non-randomized patients were treated by prophylactic endoscopic paravariceal injection sclerotherapy. In this group II the frequency of hemorrhage was 4.5 % and in-hospital mortality 13 %. The main causes of death were hepatic coma, followed by hemorrhage from esophageal varices. After four years another 14 patients had died despite regular monitoring and re-injection (20 %); the main causes of death were hepatic coma and hepatocellular cancer. Five patients (7 %) were lost to follow up, while 42 (60 %) are still living. - Thus prophylactic endoscopic paravariceal injection sclerotherapy in esophageal degree III-IV varices with telangiectasias and/or poor coagulation reserves of the liver can largely prevent an esophageal variceal hemorrhage, and is able to prolong the life of these chronically ill patients to an appreciable extent.
PRS-04: A phase III randomised, double blind, placebo controlled trial of etoposide/carboplatin with or without thalidomide in advanced small cell lung cancer (SCLC)
Authors: Siow-Ming Lee, Penella J. Woll, Lindsay E. James, Matthew Hatton, Kulsam Ali, Stephen G. Spiro, Sumrana R. Ali, Allan Hackshaw
Journal: Journal of Thoracic Oncology (2007)
Palliative care in the ICU: relief of pain, dyspnea, and thirst—A report from the IPAL-ICU Advisory Board
Authors: Kathleen Puntillo, Judith Eve Nelson, David Weissman, Randall Curtis, Stefanie Weiss, Jennifer Frontera, Michelle Gabriel, Ross Hays, Dana Lustbader, Anne Mosenthal, Colleen Mulkerin, Daniel Ray, Rick Bassett, Renee Boss, Karen Brasel, Margaret Campbell
Journal: Intensive Care Medicine (2013)
Effects of acetylcholine on different muscarinic receptors in the perfused porcine ear vein
Authors: E. Schneider, W. Felix
Journal: Cardiovascular Research (1991)

Study objective – Acetylcholine (ACh) induced vasomotion was studied in the venous vessel wall of the pig. Experimental material – Fresh porcine ear veins were prepared, cannulated, and perfused in organ chambers. ACh was either applied intraluminally via the perfusion fluid or extraluminally via the organ bath solution. Measurements and main results – The porcine ear vein showed three different concentration dependent vasomotions. ACh at a concentration of more than 10−9 M caused a relaxation which was inhibited by atropine (10−6 M) or by intraluminal perfusion with distilled water for 5 min. Gallamine (10−5 M), pirenzepine (3·10−7 M), indomethacin (10−5 M), and the Ca blockers verapamil (10−6 M) and nimodipine (10−6 M) did not interfere with the relaxation. At an intraluminal concentration of more than 10−7 M the ACh induced relaxation was immediately followed by a tachyphylactic contraction; this contraction was blocked by atropine, pirenzepine, intraluminal perfusion with distilled water, indomethacin, and the Ca blockers verapamil and nimodipine. After an initial ACh application of 10−5 M (intra- or extralu-minal) 50% of the veins contracted strongly and reproducibly; this contraction was attenuated by atropine and pirenzepine but was unaffected by distilled water, gallamine or indomethacin. Intraluminal ACh evoked significantly higher dilating and tachyphylactic contractile responses compared to extraluminal ACh, indicating that the receptors for these vasomotions were located at the luminal site of the vessel. Nicotine had no effect on the vein. Conclusions – In the porcine ear vein ACh evokes three different kinds of muscarinic vasomotions. These are mediated by different receptors with different sensitivities and localised on various sites in the vessel wall. Negative feedback mechanisms may exist between them.
Doing it by the book
Authors: D. Spence
Journal: BMJ (2009)

It’s exam season. I recently happened upon my old English exam paper and stirred some old memories. The invigilator’s jangling keys, sun streaming through the windows, and students slumped at graffitied desks. I chewed my pen as I wrote a comparison of George Orwell’s Nineteen Eighty-Four and Aldous Huxley’s Brave New World . As an intense teenager I felt comfortable with dystopia. And with the return of broodiness in middle age I wonder if these fictional novels have any resonance with today’s wealthy utopia.

Nineteen …
Management of Sore Throat
Authors: Anthony L. Komaroff
Journal: JAMA (1979)

<h3>To the Editor.—</h3> In a recent letter (240:827, 1978), Chinh T. Le, MD, raised questions about my recent article on the management of sore throat (239:1429, 1978). The letter reflected a serious misreading of the article and contains some questionable recommendations. Dr Le implies that I recommended the routine use of a liquid transport medium. I did not. I stated that such a medium was useful when a substantial delay (eg, 48 hours) might occur between obtaining the specimen and inoculating the agar. Commercially available kits make this as easy as the silica gel transport method, which is also excellent. On the basis of a single report of a relatively small number of cases, Dr Le recommends dispensing with the usual policy of incubating culture plates in relatively anaerobic or increased carbon dioxide atmospheres. I would be uncomfortable with that recommendation. The recognition of β-hemolytic streptococci would surely be diminished,
Hypercarboxyhemoglobinemia from Inhalation of Cigar Smoke
Authors: ALBERT L. FREEDMAN
Journal: Annals of Internal Medicine (1975)

Letters1 April 1975Hypercarboxyhemoglobinemia from Inhalation of Cigar SmokeALBERT L. FREEDMAN, M.D.ALBERT L. FREEDMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-4-537_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe hazard of carbon monoxide (CO) inhalation has been recognized for many years, and controls have been applied to industrial and public levels. Levels of CO in city traffic and on freeways are high (20 to more than 200 ppm), and exposed nonsmokers develop carboxyhemoglobin (COHb) levels ranging from 1% up to 3.5% or 4%. Cigarette smoke contains CO at levels of about 500 ppm (1), and roughly 54% of the CO is absorbed in inhalers, producing COHb levels of 4% to 8% with a maximum of about 15% (2). Cigar and pipe smokers have "much lower levels of COHb"...References1. GOLDSMITHTERZAGHIHACKNENY JJJ: Evaluation of fluctuating CO exposures. Arch Environ Health 7:647-663, 1963 CrossrefMedlineGoogle Scholar2. GOLDSMITH J: Contribution of motor vehicle exhaust, industry and cigarette smoking to community carbon monoxide exposures. Ann NY Acad Sci 174:122-134, 1970 CrossrefMedlineGoogle Scholar3. HALDANE J: Carbon monoxide as a tissue poison. Biochem J 21:1068-1075, 1927 CrossrefMedlineGoogle Scholar4. ASTRUPKJELDSENWANSTRUP PKJ: Effects of carbon monoxide exposure on the arterial walls. Ann NY Acad Sci 174:294-300, 1970 CrossrefMedlineGoogle Scholar5. EDITORIAL: Carbon monoxide poisoning—a timely warning. N Engl J Med 278:849-850, 1968 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: S.U.N.Y. Stony Brook 400 Jericho-Hicksville Road Jericho, New York 11753 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDoes switching from cigarettes to pipes or cigars reduce tobacco smoke exposure?Gender and Smoking: Do Women Really Find it Harder to Give Up?The inhaling habits of pipe smokers 1 April 1975Volume 82, Issue 4Page: 537-537KeywordsCarbon monoxideCarboxyhemoglobinInhalation Issue Published: 1 April 1975 PDF DownloadLoading ...
Stimulation of sarcolemmal sodium-hydrogen exchange in cardiac myocytes is not responsible for the positive inotropic action of 1 adrenergic agonists
Authors: M. Puceat
Journal: Cardiovascular Research (1995)

Journal Article Stimulation of sarcolemmal sodium-hydrogen exchange in cardiac myocytes is not responsible for the positive inotropic action of α1 adrenergic agonists Get access Michel Pucéat Michel Pucéat INSERM U-390, Physiopathologie Cardiovasculaire, CHU Arnaud de Villeneuve, 371 av du doyen G Giraud, 34295 Montpellier cedex 05, France Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 29, Issue 2, February 1995, Pages 275–276, https://doi.org/10.1016/S0008-6363(96)88581-6 Published: 01 February 1995
611 HCV infection is associated with a potent anti-apoptotic response in hepatocytes
Authors: A ANDRE, C ETHIER, M BILODEAU
Journal: Hepatology (2003)

TNF-alpha is known to play an important role in inflammatory bowel disease (IBD); however, the pathophysiological role of its receptors is still under study. Acute colitis was induced in rats by intracolonic administration of trinitrobenzene sulfonic acid (TNBS). Control rats received the ethanol vehicle. Rats were sacrificed 72 h later and samples of tissue and fluids were collected. There was a significant increase in the protein levels of sTNF-alpha, sTNFRI, and sTNFRII in the peritoneal fluid (PF) of experimental rats. TNF-alpha, TNFRI, and TNFRII mRNA expression was increased significantly in the colon of experimental animals compared to controls. TRAF3 and TRAF5 expression was also significantly higher, as was that of the adhesion molecules ICAM-1 and E-selectin. The increased expression of TNF-alpha, TNFRs, and the associated signaling factors in the colon of this rat model of IBD provides further evidence for their involvement in the promotion of inflammation and tissue damage. In addition, increased levels of sTNFRs in the PF of experimental rats—particularly sTNFRII—may be involved in the development of colitis by serving as a reservoir of TNF-alpha, and thus provide a novel therapeutic target for IBD.