tbuckley/cabot-search huggingface dataset:
Treatment of Acute Hypertensive Crises in Surgical Patients
Authors: Elio Baldini, John R. Lincoln
Journal: JAMA (1964)

VARIOUS DEGREES of acute elevation of blood pressure have been reported to produce complications, ranging in severity from headache, nausea, and vomiting to serious or even fatal vascular accidents.<sup>1-5</sup>We consider any abrupt increase in systolic blood pressure of 30% or more to be a distinct threat, and classify it arbitrarily as an "acute hypertensive crisis." Acute hypertensive crises during and after operation are commonly the result of faulty anesthetic equipment or technique, particularly errors that cause hypercapnia, hypoxia, or a sudden increase in blood volume. Prudence dictates that such causes should be meticulously investigated and remedied before reliance is placed on a drug to treat one sign of a serious physiologic disturbance. Occasionally correction of all detectable errors fails to restore an elevated blood pressure to normal; or factors beyond the control of the anesthetist, such as untoward responses to pressor drugs, the patient's underlying disease, or the
Key Role of flt3 Ligand in Regulation of the Common Lymphoid Progenitor but Not in Maintenance of the Hematopoietic Stem Cell Pool
Authors: Ewa Sitnicka, David Bryder, Kim Theilgaard-Mönch, Natalija Buza-Vidas, Jörgen Adolfsson, Sten Eirik W Jacobsen
Journal: Immunity (2002)
The Pneumococcus at the Gates
Authors: Alexander Tomasz
Journal: New England Journal of Medicine (1995)

There is bad news and some good news about the pneumococcus. The study by Hofmann et al. in this issue of the Journal 1 is a chilling reminder that the United States is no longer safe from the spread of penicillin-resistant and multidrug-resistant pneumococci. Fortunately, the mortality rate from pneumococcal pneumonia, according to the study by Pallares et al.,2 also in this issue, appears to be the same whether infections are caused by sensitive strains or resistant strains. In the study by Hofmann et al., which was conducted in metropolitan Atlanta, right at the gates of the Centers for Disease Control . . .
A Role for Repressive Histone Methylation in Cocaine-Induced Vulnerability to Stress
Authors: Herbert E. Covington, Ian Maze, HaoSheng Sun, Howard M. Bomze, Kristine D. DeMaio, Emma Y. Wu, David M. Dietz, Mary Kay Lobo, Subroto Ghose, Ezekiel Mouzon, Rachael L. Neve, Carol A. Tamminga, Eric J. Nestler
Journal: Neuron (2011)
A simple risk index for rapid initial triage of patients with ST-elevation myocardial infarction: an InTIME II substudy
Authors: David A Morrow, Elliott M Antman, Robert P Giugliano, Richard Cairns, Andrew Charlesworth, Sabina A Murphy, James A de Lemos, Carolyn H McCabe, Eugene Braunwald
Journal: The Lancet (2001)
Communications and emotions
Authors: R. Buckman
Journal: BMJ (2002)

Papers p 679 Clinical review p 697

Anyone who wants to be regarded as a good doctor needs to possess effective communication skills. Everyone expects that of us, but the truth is that good communication is often quite difficult and training for it is still developing.

Communication skills make an appreciable difference to clinical management. We take for granted our own communication abilities in history taking, but further training can enhance our ability to diagnose and treat conditions, including depression.1 Communication is often a major component of the medical management in chronic and palliative care: sometimes it is all we have to offer. Compared with most medications, communication skills have undoubted palliative efficacy (often reducing symptoms significantly), a wide therapeutic index (overdose is rare), and the commonest problem in practice is suboptimal dosing. At a more mercenary level, poor communication skills have been shown to be a predictor of medicolegal vulnerability and …
Hyperosmolality Induced by Propylene Glycol
Authors: Corinne L. Fligner
Journal: JAMA (1985)

An 8-month-old male infant was treated with topical silver sulfadiazine for a burn and complicating toxic epidermal necrolysis involving 78% of his total body surface area. Transdermal absorption of propylene glycol from the silver sulfadiazine produced hyperosmolality with an increased osmolal gap. A peak propylene glycol concentration of 1,059 mg/dL was documented, and its osmotic effect was that predicted from its concentration. Our data support either zero-order elimination at a rate of 13.5 mg/dL/hr or first-order elimination with a half-life of 16.9 hours. Elevated concentrations of propylene glycol may have contributed to the patient's cardiorespiratory arrest. The osmolal gap may be used as a screen for suspected propylene glycol intoxication in selected clinical settings. (<i>JAMA</i>1985;253:1606-1609)
Infusion of hemolyzed red blood cells within peripheral blood stem cell grafts in patients with and without sickle cell disease
Authors: Courtney D. Fitzhugh, Hayato Unno, Vincent Hathaway, Wynona A. Coles, Mary E. Link, R. Patrick Weitzel, Xiongce Zhao, Elizabeth C. Wright, David F. Stroncek, Gregory J. Kato, Matthew M. Hsieh, John F. Tisdale
Journal: Blood (2012)
WHO issues guidelines on retaining health workers in rural areas
Authors: J. Zarocostas
Journal: BMJ (2010)

The World Health Organization has published international guidelines to help countries retain doctors, and other health personnel, in rural areas, especially in poor nations, where acute shortages impede access to health care of millions of vulnerable people.

WHO says that about half of the world’s population lives in rural areas but that these areas are served by only 24% of the world’s doctors.

The situation is especially dire in 57 poor countries where a critical shortage of trained health workers means that “an estimated one billion people have no access to essential healthcare services.”

But shortages are also common in rich countries such as the United States, …
Nontuberculous Mycobacterial Lung Disease Prevalence at Four Integrated Health Care Delivery Systems
Authors: D. Rebecca Prevots, Pamela A. Shaw, Daniel Strickland, Lisa A. Jackson, Marsha A. Raebel, Mary Ann Blosky, Ruben Montes de Oca, Yvonne R. Shea, Amy E. Seitz, Steven M. Holland, Kenneth N. Olivier
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Single-site clinic-based studies suggest an increasing prevalence of pulmonary nontuberculous mycobacteria (NTM) disease, but systematic data are lacking.
Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.
Authors: J L Pepin, G Ferretti, D Veale, P Romand, M Coulomb, C Brambilla, P A Levy
Journal: Thorax (1992)

BACKGROUND: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different. METHODS: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep. RESULTS: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram. CONCLUSIONS: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea.
Absence of hepatitis B virus precore mutants in patients with chronic hepatitis B responding to interferon-α
Authors: Jianye Xu, David Brown, Tim Harrison, Yue Lin, Geoffrey Dusheiko
Journal: Hepatology (1992)

Precore defective HBV mutants may gradually prevail because of immune selection and explain spontaneous seroconversion from HBeAg to anti-HBe in HBV carriers. We have analyzed whether the presence of precore HBV mutants is a determinant of responsiveness to interferon-alpha therapy. Fifteen carriers (nine responders and six nonresponders) who were treated with interferon-alpha were examined. Serum samples were collected before and after therapy. After extraction of DNA, the precore region was amplified by the polymerase chain reaction, and the product was identified by gel electrophoresis and ethidium bromide staining and then Southern blotting and molecular hybridization. The amplified products in all patients were asymmetrically amplified by a modified polymerase chain reaction, and the precore region was directly sequenced. All patients were HBV DNA positive initially. Circulating HBeAg-negative mutants were not identified before treatment in either responders or nonresponders. All nine responders were negative for HBV DNA in serum by dot blot during or after treatment, but seven remained positive by polymerase chain amplification and Southern-blot hybridization. All of the nonresponders remained positive for HBV DNA by dot blot. A silent mutation involving the substitution of an A for G at position 1888 was found in seven carriers; however, no HBeAg-negative mutants were detected in the follow-up of either responders or nonresponders to interferon-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)
The Child-Pugh classification as a prognostic indicator for survival in primary sclerosing cholangitis
Authors: K Shetty, L Rybicki, W D Carey
Journal: Hepatology (1997)

Clinical decisions in primary sclerosing cholangitis (PSC) depend upon understanding its variable natural history. Several prognostic models for survival have been developed. We explored the Child-Pugh Classification (CPC) to determine if it predicts survival as well as a disease-specific model (DSM). We identified 208 PSC patients who satisfied established criteria. Prognostic variables were measured from the first visit. Kaplan-Meier survival estimates were obtained for CPC twice, once censoring observations at orthotopic liver transplantation and again considering orthotopic liver transplantation as a failure. A stepwise Cox proportional hazards-model was used to identify the factors associated with mortality. For 208 patients, the mean follow-up was 70 months (SD + 55). Kaplan-Meier 7-year survivals for CPC A, B, and C were 89.8%, 68%, and 24.9%, respectively (P < .001). The Cox model identified CPC and age as the most significant predictors of mortality. Adding the DSM risk score did not significantly improve the fit of the model (P = .75). The following were concluded: 1) CPC is a powerful predictor of survival in PSC; 2) DSM does not enhance the predictive ability of CPC; and 3) CPC may be used as an alternative to the DSM in research studies and clinical decision-making.
Medical audit data: counting is not enough: Authors' reply
Authors: C. Lyons, R. Gumpert
Journal: BMJ (1990)

the 35 who had moved into it (excluding the six children who had moved away or had no records).Doctors who are enthusiastic immunisers in practices with a high turnover of children therefore have to work exceptionally hard, as immunised children who move away tend to be replaced by those who have not been immunised.Un- fortunately, not even enthusiasts can give preschool boosters to children who have not completed the primary course.The practice's overall uptake of the preschool booster was disappointing at 68%, well below that of the primary course, which then averaged 85% across the new contract's three immunisation groups.The uptake has since been improved to 77% and can no doubt be improved further.For many practices, however, a target of 90% seems even more unreasonable for the preschool booster than for the primary course.
Forced evictions in Africa create healthcare crisis
Authors: Peter Moszynski
Journal: BMJ (2006)

Amnesty International has warned that an “epidemic” of forced evictions in Africa is leading to a development and healthcare crisis. New research conducted by Amnesty International and the Geneva based Centre on Housing Rights and Evictions concludes that more than three million Africans have been forcibly evicted from their homes since 2000.

“The figures are truly staggering and clearly indicate that forced evictions are one of the most widespread and unrecognised human rights violations in Africa,” said Kolawole Olaniyan, director of Amnesty International's Africa programme.

Primary healthcare clinics and water and sanitation systems …
Vitiligo in diabetes mellitus
Authors: I.M. GOULD, R.S. GRAY, S.J. URBANIAK, R.A. ELTON, L.J.P. DUNCAN
Journal: British Journal of Dermatology (1985)

We studied the association between vitiligo and diabetes mellitus, and found that vitiligo is associated with insulin-dependent diabetes but not with non-insulin-dependent diabetes. This gives further weight to the theory that vitiligo is an autoimmune disease.
Multivariable Prediction of Renal Insufficiency Developing After Cardiac Surgery
Authors: Jeremiah R. Brown, Richard P. Cochran, Bruce J. Leavitt, Lawrence J. Dacey, Cathy S. Ross, Todd A. MacKenzie, Karyn S. Kunzelman, Robert S. Kramer, Felix Hernandez, Robert E. Helm, Benjamin M. Westbrook, Robert F. Dunton, David J. Malenka, Gerald T. O’Connor
Journal: Circulation (2007)

Renal insufficiency after coronary artery bypass graft (CABG) surgery is associated with increased short-term and long-term mortality. We hypothesized that preoperative patient characteristics could be used to predict the patient-specific risk of developing postoperative renal insufficiency.Data were prospectively collected on 11,301 patients in northern New England who underwent isolated CABG surgery between 2001 and 2005. Based on National Kidney Foundation definitions, moderate renal insufficiency was defined as a GFR <60 mL/min/1.73 m2 and severe renal insufficiency as a GFR <30. Patients with at least moderate renal insufficiency at baseline were eliminated from the analysis, leaving 8363 patients who became our study cohort. A prediction model was developed to identify variables that best predicted the risk of developing severe renal insufficiency using multiple logistic regression, and the predictive ability of the model quantified using a bootstrap validated C-Index (Area Under ROC) and Hosmer-Lemeshow statistic. Three percent of the patients with normal renal function before CABG surgery developed severe renal insufficiency (229/8363). In a multivariable model the preoperative patient characteristics most strongly associated with postoperative severe renal insufficiency included: age, gender, white blood cell count >12,000, prior CABG, congestive heart failure, peripheral vascular disease, diabetes, hypertension, and preoperative intraaortic balloon pump. The predictive model was significant with chi2 150.8, probability value <0.0001. The model discriminated well, ROC 0.72 (95%CI: 0.68 to 0.75). The model was well calibrated according to the Hosmer-Lemeshow test.We developed a robust prediction rule to assist clinicians in identifying patients with normal, or near normal, preoperative renal function who are at high risk of developing severe renal insufficiency. Physicians may be able to take steps to limit this adverse outcome and its associated increase in morbidity and mortality.
Abstract ADV23: Bridging the gap: An advocate's breast cancer journey.
Authors: Desiree Walker
Journal: Cancer Research (2013)

Abstract The poster will prtray the various steps an advocate can take in the world of breast cancer. It will also define the journey through self-advocacy, local advocacy, patient advocacy and legislatie advocacy. These actions support bridging the gap trhough education and empowerment. Citation Format: Desiree Walker. Bridging the gap: An advocate's breast cancer journey. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr ADV23. doi:10.1158/1538-7445.AM2013-ADV23
Doppler assessment of right ventricular filling in a normal population. Comparison with left ventricular filling dynamics.
Authors: W A Zoghbi, G B Habib, M A Quinones
Journal: Circulation (1990)

To examine whether alterations in right ventricular filling dynamics occur with increasing age and to compare right and left ventricular filling in normal subjects, pulsed Doppler echocardiographic studies were performed at the tricuspid and mitral anuli in 50 normal volunteers (23 males and 27 females) with an age range of 5-66 years. An age-related decrease in peak early filling velocity, increase in peak late velocity, and augmentation in the late/early ratio of peak velocities at the tricuspid anulus were observed (r = -0.68, 0.63, and 0.84, respectively). Significant correlations were also found between age and first third, first half, and atrial filling fractions (r = -0.60, -0.72, and 0.69, respectively). Weaker relations were observed between heart rate and Doppler-derived diastolic parameters (r = 0.18-0.54). Right ventricular filling indexes related significantly to those of the left ventricle (r = 0.58-0.88), the best being for the late/early ratio of peak velocities. With inspiration, an increase in early and late right ventricular filling occurred, whereas a reduction in filling occurred in the left ventricle. Thus, careful consideration for age, heart rate, and respiration is necessary in examining the effect of disease states or therapeutics on the filling dynamics of either the right or left ventricle.
Adverse Effects of ACE Inhibitors
Authors: Zafar H. Israili
Journal: Annals of Internal Medicine (1993)

Letters15 February 1993Adverse Effects of ACE InhibitorsZafar H. Israili, MD and W. Dallas Hall, MDZafar H. Israili, MDSearch for more papers by this author and W. Dallas Hall, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-4-199302150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Edwards is correct that our statement may be misleading. The case reports he and Drs. Chu and Chow describe, as well as those in our review and recent ones [1-3], confirm that angioneurotic edema can occur even after prolonged therapy with ACE inhibitors. Because most cases occur within a week [4], we used the word “usually”.In some instances, the symptoms of angioedema may be very mild and subside without the patient's awareness. The symptoms may incorrectly be attributed to other causes such as food allergy, insect sting, or other drug reactions. Continued use of ACE inhibitors ...References1. Israili ZH, Hall WD. Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. Ann Intern Med. 1992; 117:234-42. Google Scholar2. Bielory L, Lee SS, Holland CL, Jaker M. Long-acting ACE inhibitor-induced angioedema. Allergy Proc. 1992; 13:85-7. Google Scholar3. Venable RJ. Angioedema after long-term enalapril use. J Fam Pract. 1992; 34:201-4. Google Scholar4. Slater EE, Merrill DD, Guess HA, Roylance PJ, Cooper WD, et al. Clinical profile of angioedema associated with angiotensin converting-enzyme inhibition. JAMA. 1988; 260:967-70. Google Scholar5. Chin HL, Buchan DA. Severe angioedema after long-term use of an angiotensin-converting enzyme inhibitor (Letter). Ann Intern Med. 1990; 112:312-3. Google Scholar6. Aldis WL. Cromolyn for cough due to angiotensin-converting enzyme inhibitor therapy (Letter). Chest. 1991; 100:1741-2. Google Scholar7. Reisen L, Schneeweiss A. Complete spontaneous remission of cough induced by ACE inhibitors during chronic therapy in hypertensive patients. J Hum Hypertens. 1992; 6:333-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIncidence and Predictors of Angioedema in Elderly Hypertensive Patients at High Risk for Cardiovascular Disease: A Report From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) 15 February 1993Volume 118, Issue 4Page: 314-315KeywordsACE inhibitor therapyACE inhibitorsDrugsEdemaFood allergiesHeart failureInflammationInhalationPulmonary functionUrticaria Issue Published: 15 February 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
<i>CCR</i> 20th Anniversary Commentary: Radioactive Drones for B-cell Lymphoma
Authors: Susan J. Knox, Ronald Levy
Journal: Clinical Cancer Research (2015)

Abstract In a study published in the March 1, 1996, issue of Clinical Cancer Research, Knox and colleagues (1) demonstrated the safety and efficacy of Yttirium-90 (90Y)-anti-CD20 monoclonal antibody therapy, as well as the benefit of preinfusion of unlabeled antibody on radiolabeled antibody biodistribution. Subsequent clinical trials with this radiolabeled antibody led to regulatory approval of this treatment for B-cell lymphoma.Clin Cancer Res; 21(3); 493–4. ©2015 AACR. See related article by Knox et al., Clin Cancer Res 1996;2(3) Mar 1996; 457–70
Chilblain lupus erythematosus (Hutchinson) A CLINICAL AND LABORATORY STUDY OF 17 PATIENTS
Authors: L. G. MILLARD, N. R. ROWELL
Journal: British Journal of Dermatology (1978)

Chilblain lupus erythematosus (LE) is a chronic unremitting form of LE ssen predominantly in women. It occurs commonly on the digits, calves and heels. Nasal lesions are rare. Chronic facial discoid LE usually appears before the chilblain form but, in most instances, resolves even though the chilblain lesions persists. Transformation to systemic LE occurs more often in those who develop both forms of cutaneous LE simultaneously and in the erythema multiforme syndrome. The chilblain lesions are the result of microvascular injury secondary to exposure to cold and possibly hyperviscosity from immunological abnormalities, Elevated serum gammaglobulins, positive latex factor and speckled pattern antinuclear factor are common. None of the usual treatments for cutaneous LE is effective for the chilblain lesions, probably because none is directed towards prevention and treatment of the microvascular stasis.