tbuckley/cabot-search huggingface dataset:
Treatment of Corneal Abrasions
Authors: Alan M. Mindlin
Journal: JAMA (1996)

<h3>To the Editor.</h3> —As I read the answer by Dr Jampel<sup>1</sup>in Questions and Answers, I was struck by a statement made regarding the treatment of corneal abrasions. Jampel suggested that a physician may use a cycloplegic agent such as 5% homatropine hydrobromide. I take issue with this statement as a nonuniversity ophthalmologist. I frequently see patients with dilated pupils who have had optic homatropine or atropine instilled at the emergency department. Use of such cycloplegics, which have effects that can last from 3 to 14 days, can be devastating to the individual both economically and psychologically. Patients might not have been told what was done or how long the effects will last. Such incidences may occur inadvertently since all mydriatics come in red-topped containers and may be confused. I have found that spending time instructing patients of what to expect and that they may be uncomfortable for 24
Cardioprotection during cardiac surgery
Authors: D. J. Hausenloy, E. Boston-Griffiths, D. M. Yellon
Journal: Cardiovascular Research (2012)

Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. For a large number of patients with CHD, coronary artery bypass graft (CABG) surgery remains the preferred strategy for coronary revascularization. Over the last 10 years, the number of high-risk patients undergoing CABG surgery has increased significantly, resulting in worse clinical outcomes in this patient group. This appears to be related to the ageing population, increased co-morbidities (such as diabetes, obesity, hypertension, stroke), concomitant valve disease, and advances in percutaneous coronary intervention which have resulted in patients with more complex coronary artery disease undergoing surgery. These high-risk patients are more susceptible to peri-operative myocardial injury and infarction (PMI), a major cause of which is acute global ischaemia/reperfusion injury arising from inadequate myocardial protection during CABG surgery. Therefore, novel therapeutic strategies are required to protect the heart in this high-risk patient group. In this article, we review the aetiology of PMI during CABG surgery, its diagnosis and clinical significance, and the endogenous and pharmacological therapeutic strategies available for preventing it. By improving cardioprotection during CABG surgery, we may be able to reduce PMI, preserve left ventricular systolic function, and reduce morbidity and mortality in these high-risk patients with CHD.
Eltrombopag for the treatment of the inherited thrombocytopenia deriving from MYH9 mutations
Authors: Alessandro Pecci, Paolo Gresele, Catherine Klersy, Anna Savoia, Patrizia Noris, Tiziana Fierro, Valeria Bozzi, Anna Maria Mezzasoma, Federica Melazzini, Carlo L. Balduini
Journal: Blood (2010)
Mechanisms and consequence of bacteria detection by the Drosophila gut epithelium
Authors: Julien Royet, Bernard Charroux
Journal: Gut Microbes (2013)

Since insect mostly developed on decaying matter and contaminated fruits, they are constantly ingesting bacteria. The insect model, Drosophila, is therefore well adapted to study the interactions that take place between the gut epithelia and either resident or infectious bacteria. In order to provide an ad hoc immune response, gut epithelial cells must detect the presence of bacteria. In a recent report, Bosco-Drayon et al. identify the main receptors by which Drosophila sense gut associated bacteria and analyze how this bacteria-receptor interaction translate into gene activation.
Serum Digitalis and Arrhythmia in Patients Undergoing Cardiopulmonary Bypass
Authors: JOHN MORRISON, THOMAS KILLIP
Journal: Circulation (1973)

To assess the possible role of digitalis in the etiology of arrhythmia following cardiopulmonary bypass, serum digoxin or digitoxin was determined serially by radioimmunoassay in 24 chronically digitalized patients undergoing open-heart surgery. After an initial fall during bypass probably secondary to intraoperative fluid, serum digitalis rebounded, rising to or surpassing the preoperative value in 21 of the 24 patients studied. Peak rebound serum digitalis occurred an average of 13 hours following onset of bypass. Eight patients receiving maintenance digoxin developed arrhythmia postbypass at or near the peak of the rebound. The arrhythmia subsided as the peak was passed. Mean serum digoxin at the time of arrhythmia was 1.3 ± 0.2 ( sd ) ng/ml. A significantly higher ( P &lt; 0.001) value than the value of 0.07 ± 0.03 ng/ml found in patients without arrhythmia. Occurrence of arrhythmia could not be correlated with diagnosis, clinical status, cardiac size, blood gas, or serum electrolyte values. In 77 control subjects with ECG evidence of digoxin toxicity, mean serum digoxin level was 3.1 ± 0.9 ( sd ) ng/ml. Since arrhythmia occurred at serum levels of digitalis lower than those observed in patients toxic to the drug who had not undergone cardiopulmonary bypass, and since the arrhythmia subsided as the serum level declined, and since the levels were higher in patients who had arrhythmia postbypass than in those who did not, this study suggests that myocardial sensitivity to the toxic effects of digitalis is increased in the first 24 hours following cardiopulmonary bypass.
Patterns of Glucose and Lipid Abnormalities in Black NIDDM Subjects
Authors: Rochelle L Chaiken, Mary Ann Banerji, RoseMarie Pasmantier, Howard Huey, Sondra Hirsch, Harold E Lebovitz
Journal: Diabetes Care (1991)

Objective We had previously shown two variants among black non-insulin-dependent diabetic (NIDDM) subjects in a normoglycemic remission: one with insulin resistance and the other with normal insulin sensitivity. This study examined whether these two variants exist in the ordinary hyperglycemic black NIDDM population. Research Design and Methods Fifty-two black NIDDM subjects were assessed for insulin-stimulated glucose disposal (euglycemic clamp), glycemic control (fasting plasma glucose and HbA1c), and fasting lipid profiles. Results The distribution of glucose disposal in 30 black NIDDM subjects (body mass index; BMI &amp;lt; 30 kg/m2) was bimodal, which indicated two populations. Eighteen of 30 subjects (BMI 26.4 ± 0.5 kg/m2) had insulin resistance (glucose disposal 3.21 ± 0.24 mg·kg−1·min−1). Twelve of 30 subjects (BMI 24.83 ± 1.1 kg/m2) had normal insulin sensitivity (glucose disposal 7.19 ± 0.46 mg·kg−1·min−1). Twenty-one of the remaining 22 subjects (BMI 33.4 ± 0.7 kg/m2) were insulin resistant (glucose disposal 2.88 ± 0.21 mg·kg−1·min−1). Fasting serum triglyceride levels were lowest in the insulin-sensitive population (0.91 ± 0.07 mM) and different from the insulin-resistant population, BMI &amp;lt; 30 and &amp;gt; 30 kg/m2, (1.20 ± 0.10 mM, P &amp;lt; 0.05 and 1.42 ± 0.17 mM, P &amp;lt; 0.025, respectively). Fasting serum low-density lipoprotein cholesterol levels were not significantly different among the groups, although it did increase with insulin resistance and increasing obesity. Total serum cholesterol levels and glycemic control were similar for all three groups. Serum high-density lipoprotein cholesterol levels were higher in women compared with men. Conclusions In the hyperglycemic black NIDDM population, two variants exist: one with insulin resistance and one with normal insulin sensitivity. This insulin-sensitive variant represents 40% of subjects with a BMI &amp;lt; 30 kg/m2. Moreover, the insulin-sensitive group has a lower risk profile for cardiovascular disease.
SHOULD HOME BP MEASUREMENTS BE A STANDARD END POINT IN RENAL DENERVATION STUDIES? RESULTS FROM ENLIGHTN I FIRST-IN-HUMANS STUDY
Authors: Vasilios Papademetriou, Costas Tsioufis, Matthew Worthley, Derek Chew, Sinhal Ajay, Ian Meredith, Stephen Worthley
Journal: Journal of the American College of Cardiology (2014)
Adapting Medical Education to Meet Increasing Manpower Requirements
Authors: Robert B. Howard
Journal: JAMA (1967)

The fact that the nation faces a serious and growing shortage of manpower in the health sciences scarcely needs further elaboration. It has been the subject of numerous reports, articles, and conferences within the past decade. Numerous factors have played a role in the development of this shortage: a rapid growth in the population; a populace increasingly well educated and thus increasingly well aware of the potential benefits of good medical care; a populace of growing affluence with consequent ability to demand and pay for good medical attention; the rapid growth of third-party payment plans, both private and public, which have extended health benefits to still larger segments of the population; and the remarkable expansion of biomedical research programs, which have been financed by the public by one means or another. At the outset, I should like to accept the manpower shortage as well established and point out further that
Underweight breast-fed babies
Authors: E. Grey
Journal: BMJ (1977)

<h3>Abstract</h3> <h3>Background</h3> MR-guided focused ultrasound (MRgFUS) is an effective treatment for essential tremor (ET). However, the optimal intracranial target sites remain to be determined. <h3>Objective</h3> To assess MRgFUS induced sequential lesions in (anterior-VIM/VOP nuclei) the thalamus and then posterior subthalamic area (PSA) performed during the same procedure for alleviating ET. <h3>Methods</h3> 14 patients had unilateral MRgFUS lesions placed in anterior-VIM/VOP then PSA. Bain-Findley Spirals were collected during MRgFUS from the treated arm (BFS-TA) and throughout the study from the treated (BFS-TA) and non-treated (BFS-NTA) arms and scored by blinded assessors. Although, the primary outcome was change in the BFS-TA from baseline to 12 months we have highlighted the 24 month data. Secondary outcomes included the Clinical Rating Scale for Tremor (CRST), Quality of Life for ET (QUEST) and PHQ-9 depression scores. <h3>Results</h3> The mean improvement in the BFS-TA from baseline to 24 months was 41.1% (p&lt;0.001) whilst BFS-NTA worsened by 8.8% (p&lt;0.001). Intra-operative BFS scores from the targeted arm showed a mean 27.9% (p&lt;0.001) decrease after anterior-VIM/VOP ablation and an additional 30.1% (p&lt;0.001) reduction from post anterior-VIM/VOP to post-PSA ablation. Mean improvements at 24 month follow-up in the CRST-parts A, B and C were 60.7%, 30.4% and 65.6% respectively and 37.8% in QUEST-tremor score (all p&lt;0.05). Unilateral tremor severity scores decreased in the treated arm (UETTS-TA) 72.9% (p=0.001) and non-treated arm (UETTS-NTA) 30.5% (p=0.003). At 24 months residual adverse effects were slight unsteadiness (n=1) and mild hemi-chorea (n=1). <h3>Conclusion</h3> Unilateral anterior-VIM/VOP and PSA MRgFUS significantly diminished contralateral arm tremor with improvements in arm function, tremor related disability and quality of life, with an acceptable adverse event profile.
p53 Mediates Cellular Dysfunction and Behavioral Abnormalities in Huntington’s Disease
Authors: Byoung-Il Bae, Hong Xu, Shuichi Igarashi, Masahiro Fujimuro, Nishant Agrawal, Yoichi Taya, S. Diane Hayward, Timothy H. Moran, Craig Montell, Christopher A. Ross, Solomon H. Snyder, Akira Sawa
Journal: Neuron (2005)
A personal therapeutic journey
Authors: C. Saunders
Journal: BMJ (1996)

I began training as a ward nurse in 1941 at St Thomas's Hospital.We had a limited pharmacopoeia, which gradually included sulphonamides but no other antibiotics, and few of the other drugs that we now take for granted.There were no diuretics, antihypertensive drugs, antiemetics, or any psychotropic drugs beyond barbiturates and chloral.Linctus, mist expectorans, or mist potassium iodids, and the evil tasting potassium citrate were regularly prescribed, and much of what we offered would today be dismissed as "custodial care."We boiled up our "porringers" for lotions, folded our dressings for autoclaving, and reused our needles after a period in spirit.Operation days were a nightmare of vomiting patients.Young patients dying of tuberculosis and septicaemia from war wounds begged us to save them somehow, but we had little to offer except devoted nursing.Osteo- myelitis led to amputation and gastric ulcers to a milk diet.Penicillin appeared after D Day, when soldiers arrived saying that they could not face another blunt needle.We had morphine by injection but used it spar- ingly.We worked a duty of 12 nights on, two nights off for three months, with split duties by day, and we had one day off a week from 5 pm the previous day.I was tired but deeply happy and satisfied.I have never lost touch with my set: the remaining members still meet regularly.Invalided out with back trouble, I returned to Oxford in 1944, completed a war degree, had a laminectomy, and became a lady almoner (now known as a medical social worker) back at St Thomas's.
Effects of Alterations of Plasma Free Fatty Acid Levels on Pancreatic Glucagon Secretion in Man
Authors: John E. Gerich, Maurice Langlois, Victor Schneider, John H. Karam, Claudio Noacco
Journal: Journal of Clinical Investigation (1974)

The present investigation was undertaken to ascertain whether alterations in plasma free fatty acids (FFA) affect pancreatic glucagon secretion in man since FFA have been reported to influence pancreatic alpha cell function in other species. Elevation of plasma FFA from a mean (+/-SE) basal level of 0.478+/-0.036 mM to 0.712+/-0.055 mM after heparin administration caused plasma glucagon levels to fall approximately 50%, from a basal value of 122+/-15 pg/ml to 59+/-14 pg/ml (P < 0.001). Lowering of plasma FFA from a basal level of 0.520+/-0.046 mM to 0.252+/-0.041 mM after nicotinic acid administration raised plasma glucagon from a basal level of 113+/-18 pg/ml to 168+/-12 pg/ml (P < 0.005). Infusion of glucose elevated plasma glucose levels to the same degree that heparin raised plasma FFA levels. This resulted in suppression of plasma glucagon despite the fact that plasma FFA levels also were suppressed. Glucagon responses to arginine were diminished after elevation of plasma FFA (P < 0.01) and during infusion of glucose (P < 0.01). Diminution of plasma FFA by nicotinic acid did not augment glucagon responses to arginine. These results thus demonstrate that rather small alterations in plasma FFA within the physiologic range have a significant effect on glucagon secretion in man. Although the effects of glucose appear to predominate over those of FFA, alterations in plasma FFA may nevertheless exert an important physiologic influence over human pancreatic alpha cell function, especially in the postabsorptive state.
Topical Antibiotics in the Treatment of Acne
Authors: Bruce Grider
Journal: JAMA (1977)

To the Editor.—  We note with interest a recent report in the MEDICAL NEWS section ofThe Journal(237:627, 1977) on the use of a 1% hydroalcoholic solution of the antibiotics erythromycin and clindamycin in the treatment of Propionibacterium acnes . Our concern is with the caveat that both these preparations must be prepared by the dermatologist himself. Since these antibiotics are available on the market in solid dosage forms (tablets or capsules), a certain degree of pharmaceutical expertise is required to convert these dosage forms into hydroalcoholic solutions for dermatological purposes with the assurance that maximum bioavailability and physical stability will be maintained. The pharmacist, by virtue of his (or her) training, is the practitioner most qualified to perform this manipulation.  While the report indicates that topical antibiotics are used for this purpose only on an experimental basis, a large number of practicing pharmacists are being called on to prepare
Domiciliary thrombolysis by general practitioners.
Authors: A. Round
Journal: BMJ (1992)

61, 62, and 63). Also, three of our patients who were operated on had small aneurysms initially that grew by over 1 cm in six months, a far quicker rate of growth than that described by others in nonhypertensive patients.On the basis of our initial findings we believe that screening should be offered to male hypertensive patients from the age of 60 and should be done regularly-for example, every three to five years-in this group.In the 388 women we have screened eight aneurysms have been detected (only two over 3 5 cm), confirming the low incidence ofaneurysms in women described by others.3One woman, aged 72, has required an elective repair of an aneurysm of 6 1 cm.Many more hypertensive women will require screening to determine more precisely the lower incidence of aneurysms in this group.Offering screening in some form to this group may well, however, prove to be just as economical as breast cancer screening, in terms of quality adjusted life years at least.Numerous studies have suggested an association between hypertension and abdominal aortic aneurysms.We believe that hypertensive people also "require special provision for screening irrespective of any plans to screen apparently healthy people."
American Medical Association condemns acts of terrorism against health care workers
Authors: J. S Todd
Journal: BMJ (1995)

EDITOR,—I am astonished that the anonymous author of the personal view entitled “Ironies in the abortion war” believes that the American Medical Association has been silent on an issue that threatens the lives of doctors.1 The association has fought against any type of terrorist attack directed at health care workers for years. At a press conference on 19 January held in response to the killings in Brookline, Massachusetts, Nancy Dickey, the vice chairperson of the association, strongly condemned the wave of violence directed at doctors …
Videocapsule et suspicion de maladie de Crohn du grêle: quel rendement diagnostique?
Authors: F Wartel, V Maunoury, A Bourreille, G Savoye, JP Galmiche, E Lerebours, A Cortot, JF Colombel
Journal: Endoscopy (2008)

Introduction: La vidéocapsule (VCE) est l'examen le plus sensible pour l'exploration de l'intestin grêle. Son rendement diagnostique en cas de suspicion de maladie de Crohn (MC) varie dans la littérature de 6 à 70% en fonction des critères de sélection des malades. Une conférence de consensus récente* recommande une exploration du grêle par la VCE chez des malades avec au moins 2 des 9 critères suivants: douleurs abdominales chroniques, diarrhée chronique, amaigrissement, manifestations extra-digestives évocatrices de MC, lésions périnéales, anémie ferriprive, élévation de la CRP, dosage d'ASCA positif et antécédent familial de MC. Le but de ce travail a été d'évaluer le rendement diagnostique de la VCE selon ces recommandations.
Tc-99m Renal Scan Demonstrating Growth in a Pediatric Renal Transplant
Authors: D METTER, R BLUMHARDT
Journal: Clinical Nuclear Medicine (1993)

Renal transplant growth of a pediatric cadaveric kidney into an adult recipient has been well described in the clinical literature. Two growth patterns are recognized: obligatory growth occurs with time and is not reversible, and compensatory hypertrophic growth is reversible and is in response to a functional demand secondary to a nephron deficit. This article presents an example of a radionuclide study illustrating this phenomenon. This is a case of a 14-year-old girl who is 2 years status post-cadaveric renal transplant secondary to glomerulone-phritis and resultant end stage renal disease. The donor was a 2-year-old child.
Effect of direct vasodilation with hydralazine versus angiotensin-converting enzyme inhibition with captopril on mortality in advanced heart failure: The Hy-C trial
Authors: Gregg C. Fonarow, Catherine Chelimsky-Fallick, Lynne Warner Stevenson, Michael Luu, Michele A. Hamilton, Jaime D. Moriguchi, Jan H. Tillisch, Julie A. Walden, Elaine Albanese
Journal: Journal of the American College of Cardiology (1992)
Sequential liver biopsies during long-term methotrexate treatment for psoriasis: a reappraisal
Authors: M. J. BOFFA, R.J.G. CHALMERS, N.Y. HABOUBI, M. SHOMAF, D.M. MITCHELL
Journal: British Journal of Dermatology (2006)

One hundred and eighty-two liver biopsies were performed over a 10-year period on patients receiving long-term, low-dose, once weekly oral methotrexate (MTX) for severe psoriasis. Forty-nine patients had two or more biopsies during continued treatment and formed the study population for our analysis. The first and last biopsies were compared to determine progression of any histological abnormalities. Liver biopsies were assessed without knowledge of the MTX dose and allocated to one of five groups according to the severity of the histological abnormalities. These were defined as: (1) normal; (2) steatosis alone; (3) inflammation without fibrosis; (4) fibrosis; and (5) cirrhosis. The mean cumulative dose of MTX at the time of the first biopsy was 2743 mg (range 315-10,024), given over 275 weeks (range 26-738). In the interval between the first and last biopsies, patients received, on average, a further 2362 mg (range 390-7155) over 225 weeks (range 60-460). There was improvement in the histological assessment in 12 patients, no change in 28 patients, and deterioration in nine patients. None developed cirrhosis. Liver biopsy findings prompted discontinuation of MTX in four of the 49 patients on long-term treatment. This has to be weighed against the cost and morbidity of the 124 biopsies performed in these patients. Our results suggest that, with careful follow-up, the risk of development or progression of liver disease in patients receiving long-term, low-dose, once weekly oral MTX for psoriasis is modest, and that the requirement for performing routine liver biopsies in these patients needs to be reconsidered.
Nosocomial Pneumonia and Mortality-Reply
Authors: Jean Chastre
Journal: JAMA (1996)

<h3>In Reply.</h3> —Evaluation of predictors of death in ICU patients is not only a question of statistics, but may serve as a paradigm of the difficulties in plausibly evaluating biological and clinical phenomena as markers of prognosis. Multiple factors affect the outcome of ICU patients, including age, severity of underlying medical conditions, acute physiologic disturbances, primary diagnosis, and response to therapy.<sup>1</sup>Consequently, interactions between such factors are complex and innumerable.<sup>2</sup>Dr Nishioka's suggestion is, nonetheless, relevant, particularly concerning the relationship between nosocomial pneumonia and nosocomial bacteremia in inducing death. Unfortunately, our database did not permit the exploration of all possible interactions and the determination of the respective effects of pneumonia and bacteremia on mortality; in this setting, an accurate analysis requires simultaneous consideration of the timedependent relationship between these 2 ICU-acquired complications (simultaneous or with order effect), the responsible pathogen(s) (identical or different), the severity of disease at the time