tbuckley/cabot-search huggingface dataset:
Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique.
Authors: B G Denys, B F Uretsky, P S Reddy
Journal: Circulation (1993)

BACKGROUND Central venous access is an essential part of patient management in many clinical settings and is usually achieved with a blinded, external landmark-guided technique. The purpose of this study is to evaluate whether an ultrasound technique can improve on the traditional method. METHODS AND RESULTS We prospectively evaluated an ultrasound-guided method in 302 patients undergoing internal jugular venous cannulation and compared the results with 302 patients in whom an external landmark-guided technique was used. Ultrasound was used exclusively in an additional 626 patients. Cannulation of the internal jugular vein was achieved in all patients (100%) using ultrasound and in 266 patients (88.1%) using the landmark-guided technique (p &lt; 0.001). The vein was entered on the first attempt in 78% of patients using ultrasound and in 38% using the landmark technique (p &lt; 0.001). Average access time (skin to vein) was 9.8 seconds (2-68 seconds) by the ultrasound approach and 44.5 seconds (2-1,000 seconds) by the landmark approach (p &lt; 0.001). Using ultrasound, puncture of the carotid artery occurred in 1.7% of patients, brachial plexus irritation in 0.4%, and hematoma in 0.2%. In the external landmark group, puncture of the carotid artery occurred in 8.3% of patients (p &lt; 0.001), brachial plexus irritation in 1.7% (p &lt; 0.001), and hematoma in 3.3% (p &lt; 0.001). CONCLUSIONS Ultrasound-guided cannulation of the internal jugular vein significantly improves success rate, decreases access time, and reduces complication rate. These results suggest that this technique may be preferred in complicated cases or when access problems are anticipated.
Risk factors for erysipelas of the leg (cellulitis): case-control study
Authors: A. Dupuy, H. Benchikhi, J.-C. Roujeau, P. Bernard, L. Vaillant, O. Chosidow, B. Sassolas, J.-C. Guillaume, J.-J. Grob, S. Bastuji-Garin
Journal: BMJ (1999)

<h3>Abstract</h3> <b>Objective:</b> To assess risk factors for erysipelas of the leg (cellulitis). <b>Design:</b> Case-control study. <b>Setting:</b> 7 hospital centres in France. <b>Subjects:</b> 167 patients admitted to hospital for erysipelas of the leg and 294 controls. <b>Results:</b> In multivariate analysis, a disruption of the cutaneous barrier (leg ulcer, wound, fissurated toe-web intertrigo, pressure ulcer, or leg dermatosis) (odds ratio 23.8, 95% confidence interval 10.7 to 52.5), lymphoedema (71.2, 5.6 to 908), venous insufficiency (2.9, 1.0 to 8.7), leg oedema (2.5, 1.2 to 5.1) and being overweight (2.0, 1.1 to 3.7) were independently associated with erysipelas of the leg. No association was observed with diabetes, alcohol, or smoking. Population attributable risk for toe-web intertrigo was 61%. <b>Conclusion:</b> This first case-control study highlights the major role of local risk factors (mainly lymphoedema and site of entry) in erysipelas of the leg. From a public health perspective, detecting and treating toe-web intertrigo should be evaluated in the secondary prevention of erysipelas of the leg.
Penicillin Dose and Creatinine Clearance
Authors: GEORGE J. PAZIN
Journal: Annals of Internal Medicine (1976)

Comments and Corrections1 June 1976Penicillin Dose and Creatinine ClearanceGEORGE J. PAZIN, M.D.GEORGE J. PAZIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-6-754_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: When recently reviewing Bryan and Stone's excellent paper on penicillin G therapy in renal failure (Ann Intern Med82:189-195, 1975), I noticed that penicillin clearance varies almost directly with creatinine clearance (theirFigure 1). To me this suggests that the easiest way to adjust penicillin dosage in renal failure is to remember this observation and simply decrease one's usual penicillin dosage in direct proportion to the decrease in creatinine clearance. As renal insufficiency becomes worse, hepatic clearance of penicillin becomes more important, so the maximum reduction in dosage with severe renal insufficiency would be to one eighth... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: GEORGE J. PAZIN, M.D.Affiliations: University of Pittsburgh Division of Infectious Diseases Department of Medicine Pittsburgh, PA 15261 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1976Volume 84, Issue 6Page: 754-754KeywordsCreatininePenicillinRenal failure ePublished: 1 December 2008 Issue Published: 1 June 1976 PDF downloadLoading ...
NHS England announces inquiry into ailing 111 service
Authors: G. Iacobucci
Journal: BMJ (2013)

Providers of the new 111 urgent care telephone hotline should face financial penalties or even have their contracts revoked if they failed to demonstrate their ability to meet the required standards for the service, the deputy chief executive of NHS England has said.

Barbara Hakin told the organisation’s board meeting on 3 May that the service had been “undeniably unacceptable” in some areas and that clinical commissioning groups should impose tough sanctions on providers that could not demonstrate improvements against standards.

The warning came as NHS England announced an inquiry into the management and implementation of the non-emergency telephone service, which has been beset by problems since its launch on 1 April, with reports of inappropriate delays in treatment, slow response times to calls, and “severe pressure” on emergency departments.1

In papers accepted at its board meeting,2 NHS …
Annual Review of Medicine
Authors: William O. Robertson
Journal: JAMA (1961)

Possibly too few physicians are aware of, much less well acquainted with, this particular series of publications. Designed to present up-to-date, concise, and comprehensive yet critical reviews of pertinent medical topics, it provides still another economical and time-saving roadway (if not a super-highway) to knowledge. This particular volume contains 23 separate review articles. For pediatricians, those dealing with virus disease by Bang, the perinatal circulation by Stern and Lind, behavioral problems in the adolescent by Gallagher and Harris, and congenital enzyme defects by Gerrard and Marko will be of special interest. Yet, if he has the time, the pediatrician will be stimulated most by the "fringe benefit" articles. "Hormonal Control of Pigmentation" and "Biochemical Changes in the Dermatitides" are but two examples. For the person with a peripheral interest in kidney disease, at least five reviews will catch his fancy; one focusing on acute renal failure and another on the
Reactive oxygen species produced from chromate pigments and ascorbate.
Authors: Y Lefebvre, H Pezerat
Journal: Environmental Health Perspectives (1994)

The reactions of various chromate pigments and ascorbate were investigated by an ESR spin trapping technique. Production of Cr(V) was detected directly and productions of very electrophilic reactive oxygen species (ROS) was detected via the oxidation of formate. We demonstrated previously that both dissolved oxygen and Cr (V) were essential in the production of ROS in this system, and that ROS production was inhibited by catalase. We studied here the effect of solubility of different chromate pigments: sodium, calcium, strontium, basic zinc, basic lead supported on silica, and lead and barium chromates on the production of ROS in buffered medium and cell culture medium (Dublecco's Modified Eagle medium + fetal calf serum). Sodium, calcium, basic zinc, and basic lead chromates were active in the production of ROS in presence of cell culture medium, whereas lead and barium chromates were inactive.
Informed consent in clinical trials. ... of the principles of clinical trials.
Authors: H Thornton
Journal: BMJ (1993)

this would be true for participation in clinical trials.Clinical trials are here to stay.Patients who participate should not be sidelined by overbearing researchers.Trials are not a form of treatment and are not part of the patient-doctor contract.Informed consent is imperative and should not be a contest between researchers and ethicists.It is a basic right; it is about the freedom of choice.
Hemoglobin Variants and Disease Manifestations in Severe Falciparum Malaria
Authors: Jürgen May, Jennifer A. Evans, Christian Timmann, Christa Ehmen, Wibke Busch, Thorsten Thye, Tsiri Agbenyega, Rolf D. Horstmann
Journal: JAMA (2007)

ContextThe geographical distributions of hemoglobin S (HbS), hemoglobin C (HbC), and α+-thalassemia (−α) strongly suggest balancing selection with malaria. However, whereas several studies indicate that the HbS carrier state protects against all major forms of clinical malaria, malaria protection on clinical grounds has been more difficult to confirm for HbC and −α, and questions remain as to whether it applies to all forms of the disease.ObjectiveTo assess the association between major clinical forms of severe falciparum malaria and HbS, HbC, and −α.Design, Setting, and ParticipantsCase-control study of 2591 children with severe falciparum malaria enrolled at a tertiary referral center in Ghana, West Africa, and 2048 age-, sex-, and ethnicity-matched control participants recruited by community surveys.Main Outcome MeasuresFrequencies of HbS, HbC, and −α in patients and controls, including stratifications of patients for signs of disease.ResultsPatients presented with partly overlapping signs of disease, including severe anemia (64%), cerebral malaria (22%), respiratory distress (30%), hyperparasitemia (32%), prostration (52%), acidosis (59%), and hyperlactatemia (56%). Carrier states of HbS, HbC, and −α were found in 1.4%, 9.4%, and 25.2% of the patients, respectively, and 14.8%, 8.7%, and 27.3% of controls. The HbS carrier state was negatively associated with all forms of the disease studied (overall odds ratio [OR], 0.08; 95% confidence interval [CI], 0.06-0.12). The HbC carrier state showed a negative association selectively with cerebral malaria (OR, 0.64; 95% CI, 0.45-0.91), and the −α carrier state showed a negative association selectively with severe anemia (OR, 0.82; 95% CI, 0.69-0.96).ConclusionWhereas the HbS carrier state was found to be negatively associated with all major forms of severe falciparum malaria, the negative associations of the carrier states of HbC and −α appeared to be limited to cerebral malaria and severe anemia, respectively.
Does a Clean-Catch Urine Sample Reduce Bacterial Contamination?
Authors: Marketa Kyncl Leisure, Sharon M. Dudley, Leigh G. Donowitz
Journal: New England Journal of Medicine (1993)

To the Editor: Standard practice for collecting a urine specimen from women for bacterial culture includes cleansing of the perineum and urethral meatus before collection. To determine whether such cleansing affects the rate of bacterial contamination of midstream urine specimens, we studied 105 asymptomatic health care workers (Table 1). We did not exclude women who were pregnant, were menstruating, or had a known history of urinary tract infection or anatomical abnormality. Each woman collected two midstream urine samples during consecutive urinations. The first sample was not a clean-catch specimen, and the second was a clean-catch specimen. Both specimens were studied . . .
Endoscopical Findings of Fundic and Pyloric Gland Area Using Dye Scattering Method
Authors: K. Ida, Y. Kohli, K. Shimamoto, Y. Hashimoto, K. Kawai
Journal: Endoscopy (1973)

1. The application of the indirect dye scattering method, which was invented by us, is of great help to obtain the correct endoscopical diagnosis, and also make it possible to discriminate between the fundic and the pyloric gland areas. – 2. The mucosae of the two areas revealed the different fine structures respectively. – 3. The endoscopical glandular border is displaced to the oral side and the pyloric gland area becomes more extensive with aging. Many of the cases with active ulcer have a small pyloric gland areas and many of the cases with ulcer-scar and gastric polyp have extensive ones. – 4. The recognition of the fundic and the pyloric gland areas will make a great contribution to the diagnosis, the progress and the pathophysiology of various kinds of gastric diseases in the future.
Overactive Error-Related Brain Activity as a Candidate Endophenotype for Obsessive-Compulsive Disorder: Evidence From Unaffected First-Degree Relatives
Authors: Anja Riesel, Tanja Endrass, Christian Kaufmann, Norbert Kathmann
Journal: American Journal of Psychiatry (2010)

Objective: Hyperactivity in frontal-striatal circuits is assumed to be involved in the pathophysiology of obsessive-compulsive disorder (OCD). In line with that, electrocortical correlates of overactive performance monitoring have been found to be associated with OCD independent from symptom state. The purpose of the present study was to elucidate whether overactive performance monitoring may represent a candidate endophenotype for OCD. In this case, unaffected first-degree relatives of OCD patients should also show this trait. Method: Amplitudes of the error-related negativity and the correct-related negativity in the event-related brain potential during a flanker task were used to assess performance monitoring in three carefully matched groups: 30 patients with OCD, 30 unaffected first-degree relatives of OCD patients, and 30 healthy comparison subjects. Results: Relative to the healthy comparison subjects, both unaffected first-degree relatives and OCD patients showed increased error-related brain potentials. No significant correlation was obtained between amplitudes and symptom severity measures, neither in patients nor in first-degree relatives. Conclusions: Increased error-related brain potentials were observed not only in OCD patients but also in unaffected first-degree relatives. Overactive error monitoring may reflect a trait marker for OCD that is independent of the presence of clinical symptoms. Thus, enhanced error-related brain activity represents a candidate neurocognitive endophenotype for OCD.
Cobalt cardiomyopathy in a patient on maintenance haemodialysis.
Authors: I H Manifold, M M Platts, A Kennedy
Journal: BMJ (1978)

Cobalt cardiomyopathy in a patient on maintenance haemodialysis Cobalt has been incriminated in cardiomyopathies in Quebec beer drinkers,' a person exposed to industrial cobalt,2 and in patients on maintenance haemodialysis with3 and without4 cobalt therapy.We report a case of cardiomyopathy in a 17-year-old girl on maintenance haemodialysis who was given cobalt. Case reportMembranoproliferative glomerulonephritis was diagnosed in this patient in 1969 when aged 9 and haemodialysis was started in 1974.She had inter- mittent hypertension from 1973 to 1976.Bilateral nephroureterectomy was performed in 1976 because of hypertension and ureteric reflux.From 1975 she had recurrent attacks of severe symptomatic anaemia which, despite iron and folic acid therapy, required frequent transfusions, causing fluid overload.Photomicrograph showing an area of myocardial necrosis. (Haematoxylin and eosin.x 124.)
Randomised controlled trial of interferon alfa (lymphoblastoid interferon) in chronic non-A non-B hepatitis.
Authors: M. R. Jacyna, M. G. Brooks, R. H. Loke, J. Main, I. M. Murray-Lyon, H. C. Thomas
Journal: BMJ (1989)

OBJECTIVE--To determine the effect of low dose interferon alfa (human lymphoblastoid interferon) on aminotransferase activities in chronic non-A non-B hepatitis. DESIGN--Prospective randomised controlled parallel group study of active treatment versus no treatment carried out over 16 weeks and preceded by baseline measurements at weeks 8 and 4 and time zero. SETTING--HEPATOLOGY outpatient clinics in secondary referral centres. PATIENTS--Fourteen adults with histologically proved chronic hepatitis and persistently raised aminotransferase activities for six months or more. INTERVENTIONS--Seven patients randomised to receive interferon alfa 5 megaunits (MU) daily for one week, reducing to 5 MU thrice weekly for seven weeks, then 3 MU thrice weekly for eight weeks. Controls not treated. END POINT--Control of hepatic enzyme activity in chronic non-A non-B hepatitis. MEASUREMENTS AND MAIN RESULTS--Serum aspartate aminotransferase activity remained raised in controls (mean increase in study period 23.4 U/l) but fell rapidly to normal in the treated group (mean decrease 106.4 U/l). In four cases values were normal by eight weeks and in five cases by 16 weeks. Only minor side effects were recorded (fever, myalgia), which became less common as treatment progressed. CONCLUSIONS--Continuous low dose interferon alfa reduces aspartate aminotransferase activity to normal in most patients with chronic non-A non-B hepatitis and may prevent progression to cirrhosis.
Gemcitabine-loaded PEGylated unilamellar liposomes vs GEMZAR®: Biodistribution, pharmacokinetic features and in vivo antitumor activity
Authors: Donatella Paolino, Donato Cosco, Leda Racanicchi, Elena Trapasso, Christian Celia, Michelangelo Iannone, Efisio Puxeddu, Giuseppe Costante, Sebastiano Filetti, Diego Russo, Massimo Fresta
Journal: Journal of Controlled Release (2010)
STREPTOCOCCUS VIRIDANS SEPTICEMIA
Authors: Robert N. Nye
Journal: JAMA (1942)

<h3>To the Editor:—</h3> The January 31 issue ofThe Journalcontains a clinical note, "Streptococcus Viridans Septicemia: A Cure with Sulfapyridine," by Drs. G. B. Moore Jr. and A. J. Tannenbaum of Camp Claiborne, Louisiana. The title is unfortunate, since it implies that infections produced by the usual etiologic agent in cases of subacute bacterial endocarditis can be controlled by sulfapyridine. As a matter of fact, little if any evidence has been presented concerning the effectiveness of the sulfonamides in cases of subacute bacterial endocarditis caused by Streptococcus viridans. The difficulty appears to arise from the classification of the streptococcus, since not all the streptococci that produce so-called alpha hemolysis on blood-agar plates are Streptococcus viridans. A true Streptococcus viridans produces a pinpoint colony that is surrounded by a narrow zone of greenish discoloration (alpha hemolysis), whereas by far the majority of alpha hemolytic streptococci have much larger colonies that
Liquid crystalline lipid in the plasma of humans with biliary obstruction
Authors: Steven H. Quarfordt, Harald Oelschlaeger, William R. Krigbaum
Journal: Journal of Clinical Investigation (1972)

Plasma lipoprotein characteristics were evaluated in a group of patients with obstructed biliary tracts. A 1:1 molar lecithin-free cholesterol liquid crystal phase was observed in the low density flotation region of these patients. The smectic nature of this mesophase was confirmed by electron microscopy, polarized microscopy, and low angle X-ray scattering. A small amount of protein was associated with these liquid crystals, some of which appeared to be components of normal very low and high density lipoproteins. The composition and physical properties of the very low and high density lipoproteins from these obstructed patients differed from normal as well. Aberrant apoprotein patterns were observed for both obstructed very low and high density lipoproteins. A beta-electrophoretic migration was observed for a component of these two lipoprotein groups.
Development and characterization of a cloned rat pulmonary arterial smooth muscle cell line that maintains differentiated properties through multiple subcultures.
Authors: A Rothman, T J Kulik, M B Taubman, B C Berk, C W Smith, B Nadal-Ginard
Journal: Circulation (1992)

BACKGROUND Pulmonary hypertension is associated with abnormal pulmonary arterial contractility and growth. The mechanisms for these abnormalities are largely unknown. To study these processes, we sought to develop an in vitro system. Even though cultured aortic and pulmonary artery smooth muscle cells (SMCs) have been of considerable value in studying smooth muscle biology, one drawback of this system has been that these cells often lose differentiated properties in an unpredictable manner when they are passaged in culture. In addition, there appear to be significant differences in physiological and pathological responses between the systemic and pulmonary circulations, many of which could be directly related to the smooth muscle. We therefore established a cloned population of rat pulmonary arterial SMCs (PASMCs) that maintain differentiated properties through multiple subcultures. METHODS AND RESULTS PASMCs were obtained initially by enzymatic dissociation from pulmonary arteries of adult Sprague-Dawley rats. From these cells, clones were isolated. The cloned cells retained expression of functional surface receptors for angiotensin II, norepinephrine, and alpha-thrombin and high levels of the smooth muscle isoforms of alpha-actin, myosin heavy chain, myosin regulatory light chain, and alpha-tropomyosin mRNAs even after multiple passages. The cells could also be transfected and processed exogenous transcripts in a smooth muscle-specific fashion. CONCLUSIONS These cloned PASMCs retain many differentiated characteristics and should be valuable for future studies of pulmonary vascular smooth muscle cell biology.
Merkel Cell Carcinoma
Authors: Wolfram Goessling, Phillip H. McKee, Robert J. Mayer
Journal: Journal of Clinical Oncology (2002)

Article Tools REVIEW ARTICLE Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.2.588 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11786590 Merkel Cell Carcinoma Wolfram GoesslingxWolfram GoesslingSearch for articles by this author , Phillip H. McKeexPhillip H. McKeeSearch for articles by this author , Robert J. MayerxRobert J. MayerSearch for articles by this author Show More From the Department of Adult Oncology, Dana-Farber Cancer Institute, and Departments of Medicine and Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. https://doi.org/10.1200/JCO.2002.20.2.588 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology