tbuckley/cabot-search huggingface dataset:
Book: Practising Evidence Based Geriatrics
Authors: L. Flicker
Journal: BMJ (2000)

Sharon E Straus, David L Sackett Radcliffe Medical Press, £25, pp 166 ISBN 1 85775 394 1 Rating: ![Graphic][1]</img> ![Graphic][2]</img> ![Graphic][3]</img> Interventions in geriatric medicine, particularly in assessing patients, have been extensively investigated. A growing body of evidence has shown that relatively simple unglamorous interventions are the most appropriate response to the health needs of elderly people with complex and disabling illnesses. Unfortunately, the funding for geriatric medicine is often justified by its ability to ensure the smooth running of the acute health … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
A BRIEF REVIEW OF FINSEN'S PHOTOTHERAPY.
Authors: P. C. CLEMENSEN
Journal: JAMA (1902)

It is now about eight years since Professor Finsen of Copenhagen published the results of his first investigations concerning the action of light upon the skin. The results of his experiments were essentially the same as those obtained by a number of other investigators, notably Widmark of Stockholm, namely, that sunburn or erythema solare is not caused by the heat of the sun, as was formerly believed, but is due to the action of the ultra-violet or so-called chemical rays. Having convinced himself of the fact that the blue and the ultra-violet rays of light were capable of inciting an inflammation of a healthy unprotected skin, Finsen concluded that it would be of material benefit to exclude these rays in the treatment of certain inflammatory conditions of the skin, for example, variola; since in that disease suppuration and pitting are most marked upon the parts exposed to light. In summing
Arteriographic predictors of spontaneous improvement in left ventricular function after myocardial infarction.
Authors: H Schwartz, R L Leiboff, R J Katz, A G Wasserman, G B Bren, P J Varghese, A M Ross
Journal: Circulation (1985)

To better characterize the changes in left ventricular ejection fraction after myocardial infarction, we compared radionuclide ventriculograms obtained acutely and 2 weeks after acute myocardial infarction in 40 patients. These patients underwent angiography within a mean of 4 hr and 20 min after the onset of symptoms of infarction and either received no therapy (32 patients who were control subjects in a thrombolysis trial) or did not experience reperfusion (eight patients) despite receiving streptokinase infusions. In all 40 patients, the change in left ventricular ejection fraction over 2 weeks was small (+2.6%). Patients were then grouped according to the presence or absence of residual flow on their angiograms. Residual flow was considered to be present in 21 patients, in 12 by virtue of subtotal occlusion of the artery supplying the area of infarct and in nine because of well-developed coronary collaterals to the distal infarct artery. Mean change in ejection fraction for patients with residual flow was +6.9 +/- 2.3% vs -2.2 +/- 1.7% for patients without residual flow (p less than .01). Fourteen of 21 (67%) patients with residual flow had a spontaneous rise in ejection fraction of greater than 5%, as compared with two of 19 (11%) patients without residual flow (p less than .01). Time to peak level of creatine kinase (CK) was significantly shorter in the residual flow group (15 vs 23 hr, p less than .01), while the peak level of CK was lower (1550 vs 2220 IU) in these patients. This latter difference did not reach statistical significance (p = .10).(ABSTRACT TRUNCATED AT 250 WORDS)
A Phylogenetic Method for Detecting Positive Epistasis in Gene Sequences and Its Application to RNA Virus Evolution
Authors: Beth Shapiro, Andrew Rambaut, Oliver G. Pybus, Edward C. Holmes
Journal: Molecular Biology and Evolution (2006)

RNA virus genomes are compact, often containing multiple overlapping reading frames and functional secondary structure. Consequently, it is thought that evolutionary interactions between nucleotide sites are commonplace in the genomes of these infectious agents. However, the role of epistasis in natural populations of RNA viruses remains unclear. To investigate the pervasiveness of epistasis in RNA viruses, we used a parsimony-based computational method to identify pairs of co-occurring mutations along phylogenies of 177 RNA virus genes. This analysis revealed widespread evidence for positive epistatic interactions at both synonymous and nonsynonymous nucleotide sites and in both clonal and recombining viruses, with the majority of these interactions spanning very short sequence regions. These findings have important implications for understanding the key aspects of RNA virus evolution, including the dynamics of adaptation. Additionally, many comparative analyses that utilize the phylogenetic relationships among gene sequences assume that mutations represent independent, uncorrelated events. Our results show that this assumption may often be invalid.
Bacterial Endocarditis Associated With a Permanent Transvenous Cardiac Pacemaker
Authors: Ira S. Schwartz
Journal: JAMA (1971)

To our knowledge, the first case of acute bacterial endocarditis in a patient with a permanent pervenous cardiac pacemaker occurred on the mural endocardium of the right atrium along the course of the pacemaker catheter. It is suggested that bacteremia, probably originating from a sacral decubitus ulcer, resulted in implantation of organisms on the damaged atrial endocardium with subsequent septic embolization.
Dutch court rules on nurses' role in euthanasia
Authors: T. Sheldon
Journal: BMJ (1995)

In a legal test case a Dutch appeal court has accepted that there may be exceptional circumstances in which nurses can help doctors to carry out euthanasia without facing prosecution. But the ruling, supported by the justice minister, Winnie Sorgdrager, rules out the possiblity that nurses can act as the “extended arm” of doctors.

The ruling states that nurses cannot, for example, give lethal injections under instructions. Euthanasia must from the beginning to the end remain in the hands of doctors, who are advised to choose a single action that they can carry …
IS CONSUMPTION AN INFECTIOUS DISEASE?
Authors: U. P. STAIR
Journal: JAMA (1883)

I wish briefly to offer a few observations upon the subject of the nature and origin of tuberculosis. At the recent meeting of the State Medical Society of Wisconsin, held at Milwaukee, September 4, 5 and 6, a resolution was adopted declaring in substance that we now<i>know</i>consumption to be an infectious disease, and that the authority of the State Board of Health should be sought to the end that persons afflicted should be “separated from intimate association with the well in our public institutions.” It would seem to me that the passing of this resolution as based upon what we actually know concerning the origin and nature of consumption, is wholly premature. We certainly do<i>not know</i>that consumption is an infectious disease. On the contrary, the vast majority of the profession, from actual clinical experience as we believe, are pretty well satisfied that it is not. We
Patients prefer “medical labels” to lay language, studyfinds
Authors: Roger Dobson
Journal: BMJ (2003)

GPs need to watch their language when they are diagnosing what's wrong with a patient. Although health professionals are being encouraged to use lay language to improve communication in consultations, patients may actually prefer medical terminology, a new study says.

Patients see a medical label such as gastroenteritis as an assurance that their problem has been taken more seriously, while the equivalent lay label, stomach upset, is seen as implying that patients can take care of themselves, says the study (Family Practice 2003;20: 248-53 [PubMed]).

In the research the authors carried out a questionnaire survey among 900 consecutive patients attending nine general practices across England. A total of 740 questionnaires were completed, and each patient rated a series of statements involving either a lay or a medical term.

The research, by a team from the Department of General Practice at Guy's, King's College, and St Thomas's Hospitals Schools of Medicine and Dentistry, examined patients' views on the impact of lay and medical terminology of diagnoses for stomach and throat problems. The authors say that the sample of patients is likely to be similar to that of most UK general practices.

The authors say that the patients associated the medical terms with a sense of professionalism and saw them as giving the doctor a clearer role in the consultation. In contrast they saw the lay labels as more blaming of the patient.

“Patients rated the medical label (gastroenteritis/tonsillitis) as indicating that the problem had been taken more seriously, that the patient would be allowed time off work, that the problem had a definite cause, that the patient would feel more confident in the doctor [and] be more satisfied with their visit to the doctor,” says the report.

“In contrast, the use of a lay label (stomach upset/sore throat) was seen to imply that the patient could take care of themselves, that the problem would not last very long and that it had been brought on by the patient.”
Methylxanthines as Adenosine Receptor Antagonists
Authors: WILLIAM J. PARSONS
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 October 1985Methylxanthines as Adenosine Receptor AntagonistsWILLIAM J. PARSONS, M.D., GARY L. STILES, M.D.WILLIAM J. PARSONS, M.D.Search for more papers by this author, GARY L. STILES, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-4-643_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the recent report concerning theophylline toxicity and the beta-adrenergic receptor system by Kearney and associates (1), theophylline and caffeine are referred to as "adrenergic agonists." We believe this assertion warrants clarification.Methylxanthines, such as theophylline and caffeine, have long been known to inhibit phosphodiesterase activity. Although this was previously thought to be their primary mode of action, recent data suggest that the physiologic effects of methylxanthines are medicated principally through antagonism of adenosine receptors (2). Adenosine receptors are effectively blocked by caffeine at micromolar concentrations (observed clinically), whereas millimolar concentrations are required to inhibit phosphodiesterase...References1. KEARNEYMANOGUERRACURTISZEIGLER TAGM. Theophylline toxicity and the beta-adrenergic system. Ann Intern Med. 1985; 102:766-9. LinkGoogle Scholar2. FREDHOLM B. Are methylxanthine effects due to antagonism of endogenous adenosine? Trends Pharmacol Sci. 1980; 1: 129-32. CrossrefGoogle Scholar3. DALY J. Adenosine receptors. In: COOPER DM, SEAMON KB, eds. Advances in Cyclic Nucleotide and Protein Phosphorylation Research. New York: Raven Press; 1985:29-46. Google Scholar4. STILES G. The A1 adenosine receptor: solubilization and characterization of a guanine nucleotide-sensitive form of the receptor. J Biol Chem. 1985;260:6728-32. CrossrefMedlineGoogle Scholar5. ROBERTSONWADEWORKMANWOOSLEYOATES DDRRJ. Tolerance to humoral and hemodynamic effects of caffeine in man. J Clin Invest. 1981;67:1111-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center Durham, NC 27710 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAutophagy Inhibition by Caffeine Increases Toxicity of Methamphetamine in SH-SY5Y Neuroblastoma Cell LineAdenosine receptors on human airway epithelia and their relationship to chloride secretion 1 October 1985Volume 103, Issue 4Page: 643-643KeywordsAdenosineAttentionCaffeineMethylxanthinePhosphodiesterasesTheophylline toxicity Issue Published: 1 October 1985 PDF DownloadLoading ...
Short-term treatment of spontaneously hypertensive rats with liver growth factor reduces carotid artery fibrosis, improves vascular function, and lowers blood pressure
Authors: B SOMOZA, F ABDERRAHIM, J GONZALEZ, M CONDE, S ARRIBAS, B STARCHER, J REGADERA, M FERNANDEZALFONSO, J DIAZGIL, M GONZALEZ
Journal: Cardiovascular Research (2005)

Liver growth factor (LGF), a mitogen for liver cells, reduces fibrosis in a rat model of cirrhosis. The present study assesses the possible vascular antifibrotic and antihypertensive effects of LGF treatment on spontaneously hypertensive rats (SHR).Six-month-old male SHR and normotensive Wistar Kyoto rats (WKY) were treated with LGF (4.5 microg LGF/rat i.p. twice a week for 2 weeks). Haemodynamic parameters were measured in anaesthetized rats. Vascular structure and function were studied in carotid arteries using optical and confocal microscopy, radioimmunoassay for desmosine, and isometric tension recording.LGF reduced systolic and diastolic blood pressure only in SHR. When compared to those of untreated SHR, carotid arteries from LGF-treated SHR showed: 1) a 50% reduction in collagen area and an increase in vascular smooth muscle cell number in the media, 2) no difference in total elastin content, but an increase in size of fenestrae in the internal elastic lamina, and 3) enhanced relaxation to acetylcholine, sodium nitroprusside, and forskolin. These effects were specific for SHR, since no changes were observed in LGF-treated WKY.Short-term treatment with a low dose of LGF induced a large improvement in vascular structure and function and significantly reduced blood pressure in a rat model of essential hypertension. The present results could open future research to explore the vascular effects of this endogenous factor in order to determine its potential as an antifibrotic and antihypertensive agent in humans.
Lineage switch from acute myeloid leukemia to acute lymphoblastic leukemia: Report of an adult case and review of the literature
Authors: A. Lounici, P. Cony-Makhoul, P. Dubus, F. Lacombe, J.P. Merlio, J. Reiffers
Journal: American Journal of Hematology (2000)

Lineage switch from AML to ALL is an extremely rare phenomenon, and we report the case of an adult diagnosed with AML at 46 years of age who relapsed with ALL. At initial diagnosis, blast cell morphology and immunophenotyping were consistent with the diagnosis of M4-AML. Complete remission was achieved, and the patient underwent autologous BMT. At relapse, six months after ABMT, blast cells were different from those seen at initial diagnosis, for morphology (L2-ALL), cytochemistry, and immunophenotyping. The karyotype was normal at both diagnosis and relapse. No evidence of bcr-abl fusion genes was found by RT-PCR. Monoclonal IgH and TCR gamma gene rearrangement were evidenced by PCR analysis at relapse but not on blast cells at AML diagnosis.
Effects of Adenovirus Vaccine on Acute Respiratory Disease in U.S. Army Recruits
Authors: Robert W. Sherwood
Journal: JAMA (1961)

During the developmental period of the adenovirus vaccine, field trials of bivalent Types 4 and 7 vaccine conducted by the Army Medical Service in 1956 and 1957 resulted in 90% to 98% reduction in hospitalization due to adenovirus disease in recruits. During the respiratory disease season of 1960-1961, a standardized, commercially prepared, Types 4 and 7 vaccine was used at all recruit training stations. Preliminary results indicate that this vaccine was about 50% effective in reducing hospitalization resulting from adenovirus disease. It is evident from the earlier experience that, even though the commercial vaccine now being used is estimated to have saved the Army about $5,000,000 during the last respiratory disease season, there is an urgent requirement to make available adenovirus vaccine of greater antigenicity.
Hemoperitoneum after colonoscopy
Authors: W. Tagg, S. Woods, R. Razdan, J. Gagliardi, P. Steenbergen
Journal: Endoscopy (2008)

Colonoscopy is the primary screening procedure for colorectal cancer and carries very low risk of complications (between 0.3 % and 0.35 %) [1]. It is estimated that 1.69 million colonoscopies are performed each year in the USA alone [2]. The most common complications are intraluminal gastrointestinal bleeding and colonic perforation [1]. Infrequently, hemoperitoneum occurs, mostly involving damage to the spleen. We present a case of hemoperitoneum following colonoscopy without splenic injury.
Regulator calls time on "unacceptable care" in hospitals and care homes in England
Authors: J. Wise
Journal: BMJ (2014)

The wide variation in the quality and safety of care in England is unacceptable, concludes the Care Quality Commission’s annual report on the state of healthcare and adult social care.1

The independent regulator’s fifth annual report said that there were examples of outstanding care and many services were good but that there were also services that were inadequate or needed improvement. Wide variation in care was shown between trusts, between hospital sites, and within services.

The CQC’s report said that tight budgets should not excuse inadequate care and that providers must learn from the examples of others with the same resources. Strong and effective leadership at all levels within an organisation was vital, it said.

Its chief executive, David Behan, said, “The …
A CASE OF ACRODYNIA
Authors: P. W. Emerson
Journal: JAMA (1921)

L. R., a boy, aged 4½, whose parents were healthy and had two heatlhy children, and whose past history was negative, was admitted to the Children's Hospital, Boston, Feb. 16, 1921, showing general weakness, loss of knee jerks, and redness and peeling of the finger tips and toes, which at first glance seemed on the one hand to be a case of multiple neuritis, and on the other, a postscarlatina case. I looked up the cases of acrodynia reported by Weston 1 and by Byfield, 2 and the case fits in so well with that disease that I believe it is worth reporting.  Six weeks before admission, he seemed tired, and after playing for half an hour, would want to sit down and rest. He did not want to eat anything, was constipated, and did not sleep well. His mother noticed that his hands and feet were cold. He could walk.
Percutaneous angioplasty of stenosed gastroepiploic artery grafts
Authors: Takaaki Isshiki, Tetsu Yamaguchi, Tsutomu Tamura, Fumihiko Saeki, Yuko Furuta, Yuji Ikari, Noriyasu Chiku, Hisayoshi Suma
Journal: Journal of the American College of Cardiology (1993)
One Hundred and Thirty-Nine Consecutive Ovariotomies Performed between January 1st, 1884, and December 31st, 1885, without a Death
Authors: L. Tait
Journal: BMJ (1886)

rabin, and afterwarcds urobilin, and the greater part of the rest of the corpuscles to form urea.SLnce delivering this lecture to my class at the College of Mledicine, I have read, with very great'interest and profit, the paper on urea by Dr. Noel
Hyperfibrinogenemia Is Associated With Specific Histocytological Composition and Complications of Atherosclerotic Carotid Plaques in Patients Affected by Transient Ischemic Attacks
Authors: Alessandro Mauriello, Giuseppe Sangiorgi, Giampiero Palmieri, Renu Virmani, David R. Holmes, Robert S. Schwartz, Raimondo Pistolese, Arnaldo Ippoliti, Luigi Giusto Spagnoli
Journal: Circulation (2000)

Background —Epidemiological studies have demonstrated that hyperfibrinogenemia is an independent risk factor for cerebrovascular atherosclerosis. However, the underlying mechanisms are poorly understood. We studied whether hyperfibrinogenemia could modify the histological composition of atherosclerotic plaque and precipitate carotid thrombosis resulting from rupture of the plaque. Methods and Results —We studied the histological composition of 71 carotid atherosclerotic plaques from patients who had undergone surgical endarterectomy after a first episode of transient ischemic attack. Patients were divided into 3 groups corresponding to the tertiles of plasma fibrinogen values. Hypercholesterolemia, hypertriglyceridemia, hypertension, diabetes, and smoking habit were also assessed. At the histological analysis, plaques of patients in the highest tertile of fibrinogen (&gt;407 mg/dL) were characterized by a high incidence of thrombosis (66.7% of cases) compared with plaques of subjects in the lower (21.7%) ( P =0.002) and middle (29.2%) ( P =0.009) tertiles. Plaque rupture was significantly associated with high fibrinogen levels (54.2%, P =0.003). Multivariate logistic regression indicated that hyperfibrinogenemia was an independent risk factor for a decrease in cap thickness ( P =0.0005), macrophage foam cell infiltration of the cap ( P =0.003), and thrombosis ( P =0.003). When the presence of other risk factors was accounted for, hyperfibrinogenemia remained an independent predictor of carotid thrombosis with an odds ratio of 5.83, compared with other risk factors. Conclusions —The results of the present study add to the evidence that hyperfibrinogenemia, independently of other risk factors, is associated with a specific histological composition of carotid atherosclerotic plaques that predisposes them to rupture and thrombosis.
A Rare Cause of Radiculomyelitis
Authors: Ahmet K. Kilic, Asli T. Kurne, Isil Saatci, Ersin Tan
Journal: JAMA Neurology (2014)

IMPORTANCE Dural arteriovenous fistula is a very rare cause of myelitis that can only be treated interventionally or surgically.OBSERVATIONS A man in his 30s with paraparesis and urinary incontinence had a long-segment thoracic lesion on spinal magnetic resonance imaging.Transverse myelitis was the initial diagnosis.Although a pulse steroid and intravenous immunoglobulin treatment regimen was given, no definite clinical response was seen.A spinal angiogram was performed in our center demonstrating right T7 to T8 spinal dural arteriovenous fistula.The fistula was occluded with embolization and the patient showed recovery following the endovascular treatment.CONCLUSIONS AND RELEVANCE Myelitis usually is known to respond well to immunosuppressive treatments.Despite adequate medical treatment, if slow progression is seen in the follow-up clinically and radiologically, dural arteriovenous fistulas should be kept in mind in the etiopathogenesis.
Clinically Silent Atrial Septal Defects with Evidence for Cerebral Embolization
Authors: JOHN R. HARVEY
Journal: Annals of Internal Medicine (1986)

The cause of stroke in young patients frequently cannot be established. Eleven consecutive patients, age 50 and younger, had clinical evidence of cerebral embolization. Results of physical, radiographic, electrocardiographic, and two-dimensional echocardiographic examinations were normal in all patients. During normal respiration, eight of the patients had right-to-left shunts at the atrial level shown by microcavitation contrast two-dimensional echocardiography. Six of the eight patients with positive contrast studies had cardiac catheterization. Five of six patients had an atrial septal defect, normal right and left heart pressures, and small right-to-left shunts during a Valsalva strain. Four patients had surgical closure of the defect, which ranged in size from 5 to 10 mm. The remaining patients received anticoagulants. Interatrial communications appear to be common in young patients with stroke, suggesting paradoxical embolization as a possible mechanism. Contrast two-dimensional echocardiography should be done in such patients because it is the only noninvasive technique that reliably finds these defects.