tbuckley/cabot-search huggingface dataset:
Drinking and smoking in the land of the long white cloud.
Authors: R Smith
Journal: BMJ (1982)

Turning my back on two long chains of purple mountains, the Richmond and Arthur ranges, and walking out of the sun, the brightest in the world, into a dark, cold bar in Motueka, New Zealand, I was reminded immediately of a bar in the Maryhill Road, Glasgow.Three short, toothless, drunk men, who looked 50 but were probably 35, and who may have been working but were more likely unemployed, sat at a table covered in empty bottles and full ashtrays, pointing fingers at each other and discussing the state of Kiwi rugby.Outside might have been scenery that has travel agents reaching for the thesaurus but inside it was just like an inner-Glaswegian scene of excessive drinking, heavy smoking, and premature aging.New Zealand, "Godzone" as the Australians like to sarcastic- ally call it, has alcohol and smoking problems that rank alongside those of Scotland, a country notorious for such problems.About 4000 New Zealanders a year die because of their smoking (the population is just over 3m), and Maori women have one of the highest incidences of lung cancer in the world.' (Despite this the New Zealand government is helping build a cigarette factory in Samoa.)New Zealanders drink a little more alcohol than the Scottish and have just as many alcohol-associated problems.I worked for a year in New Zealand in 1978 after having worked in Scotland: alcoholic cardiomyopathy, liver failure from alcoholic cirrhosis, and other physical complications of alcohol
Preventable Communicable Diseases Do Recur
Authors: Abraham Gelperin
Journal: JAMA (1972)

To the Editor.—  The list of preventable communicable diseases that are transmitted primarily by people to people is limited only by the availability, to date, of reasonably effective and safe antigenic preparations. However, outbreaks of controlled diseases such as rubella, 1 diphtheria, 2 and poliomyelitis 3 continue to cause consternation, even among public-health professionals. Recent outbreaks again demonstrate that detailed studies purporting to determine the reasons for the isolated reappearances of a totally preventable disease suggest that the natural history of these diseases as well as the dynamics of the host-parasite relationship remain immutable basics.  Subsequent to the initiation of intensive programs of immunization against diphtheria carried out by local and state health departments with collaboration of practicing physicians during the late 1920s, the morbidity and mortality from this disease declined markedly. However, the incidence of this disease increased sharply during the mid 1930s, as in Cincinnati, in spite of
THE DEMONSTRATION OF PULMONARY ARTERIOVENOUS SHUNTS IN NORMAL HUMAN SUBJECTS, AND THEIR INCREASE IN CERTAIN DISEASE STATES *
Authors: Anthony D. Jose, William R. Milnor
Journal: Journal of Clinical Investigation (1959)

The evidence for existence of arteriovenous shunts in the normal human lung is strong but necessarily indirect. Simultaneous measurements of oxygen tension in alveolar air and in arterial blood consistently show a degree of venous admixture in both normal and abnormal subjects (1), but no information has been obtained about the path taken by this unventilated blood. The passage of small glass or plastic beads through the pulmonary circulation has demonstrated potential pathways as large as 200ju in diameter (2, 3), but this technique involves an artificial distention of the vascular bed and gives no information about the extent to which such pathways may function physiologically. The present investigation was based on the hypothesis that the decreased venous inflow to the right atrium and reduced blood flow through the pulmonary vessels during the Valsalva maneuver, as well as the rebound effects after release of the maneuver, might alter the flow through such shunts, and that this alteration could be detected by continuous measurement of the systemic arterial oxygen saturation. No distinction would necessarily be made by this technique between true arteriovenous anastomoses, with ventilation-perfusion ratio of zero, and poorly ventilated alveolar capillaries, with ventilation-perfusion ratio below the average for the whole capillary bed. We have studied nine normal subjects, and 16 patients with cardiac or pulmonary disease; results in 12 additional patients with intracardiac shunts have been included for comparison.
MPs accuse health authority of concealment
Authors: J Warden
Journal: BMJ (1994)

A health authority in Britain has been accused of deliberately covering up millions of pounds of debts and concealing its true financial position. The criticism of South Birmingham Health Authority, whose debts have grown to around £16m, is made by the House of Commons public accounts committee.

The committee concludes that the 1991 merger that created South Birmingham was ill prepared and badly implemented. Financial problems emerged within the first year, but information was concealed so that bad news could be fed out in increments, say the MPs. South Birmingham, which is the most indebted health authority in Britain, has been severely censured. Its £16m annual deficit is being funded by …
Points: A happier old age in Denmark?
Authors: D. Slater
Journal: BMJ (1982)

A Ledermann and colleagues (12 June, p 1784) reporting thrombocytopenia following benoxaprofen therapy.They state that thrombocytopenia associated with benoxaprofen has not been reported before.We reported thrombocytopenia in association with leucopenia and toxic epidermal necrolysis in a 62- year-old woman after only nine days' treatment with benoxaprofen, and this was published in May 1982.
House dust mite exposure as a risk factor for asthma: benefits of avoidance
Authors: G. B. Marks
Journal: Allergy (1998)

There is a dose‐response relation between the level of exposure to house dust mite allergen and the risk of acquiring sensitization to this allergen as well as the risk of developing asthma. This relation is apparent at levels of exposure below 10 μg/g. In communities where nearly all houses have house dust mite allergen levels above this threshold, all susceptible individuals will be affected, and the relation to house dust mite exposure will not be apparent. Although these observational data would suggest that reducing exposure to house dust mite allergen should lessen the risk of developing sensitization and asthma, definitive evidence from randomized controlled trials is not yet available. Of the many clinical trials of house dust mite avoidance as therapy for asthma, only a few have produced sustained, substantial reductions in allergen levels in the bed. These effective interventions all included allergen‐impermeable encasement of mattresses along with other strategies. In most trials where allergens levels were successfully reduced, there were clinical benefits for patients with asthma.
CICATRIZATION OF WOUNDS
Authors: Alexis Carrel, P. Lecomte du Noüy
Journal: The Journal of Experimental Medicine (1921)

1. The latent period of cicatrization varies generally from 5 to 7 days. 2. It stops abruptly and contraction starts with its maximum velocity. 3. The formula of du Noüy applies to the beginning of the contraction period as well as to the subsequent periods.
Prognostic Value of Myocardial Perfusion Imaging in Patients With High Exercise Tolerance
Authors: Sofia N. Chatziioannou, Warren H. Moore, Patrick V. Ford, Ronald E. Fisher, Vei-Vei Lee, Carina Alfaro-Franco, Ramesh D. Dhekne
Journal: Circulation (1999)

Background —Although high exercise tolerance is associated with an excellent prognosis, the significance of abnormal myocardial perfusion imaging (MPI) in patients with high exercise tolerance has not been established. This study retrospectively compares the utility of MPI and exercise ECG (EECG) in these patients. Methods and Results —Of 388 consecutive patients who underwent exercise MPI and reached at least Bruce stage IV, 157 (40.5%) had abnormal results and 231 (59.5%) had normal results. Follow-up was performed at 18±2.7 months. Adverse events, including revascularization, myocardial infarction, and cardiac death, occurred in 40 patients. Nineteen patients had revascularization related to the MPI results or the patient’s condition at the time of MPI and were not included in further analysis. Seventeen patients (12.2%) with abnormal MPI and 4 (1.7%) with normal MPI had adverse cardiac events ( P &lt;0.001). Cox proportional-hazards regression analysis showed that MPI was an excellent predictor of cardiac events (global χ 2 =13.2; P &lt;0.001; relative risk=8; 95% CI=3 to 23) but EECG had no predictive power (global χ 2 =0.05; P =0.8; relative risk=1; 95% CI=0.4 to 3.0). The addition of Duke’s treadmill score risk categories did not improve the predictive power of EECG (global χ 2 =0.17). The predictive power of the combination of EECG (including Duke score categories) and MPI was no better than that of MPI alone (global χ 2 =13.5). Conclusions —Unlike EECG, MPI is an excellent prognostic indicator for adverse cardiac events in patients with known or suspected CAD and high exercise tolerance.
Glomerulitis in Typhoid Fever
Authors: Visith Sitprija, Vichitra Pipatanagul, Vijitr Boonpucknavig, Somnate Boonpucknavig
Journal: Annals of Internal Medicine (1974)

Renal biopsies were done on three unselected patients with typhoid fever. There was no clinical evidence of renal disease, except for mild and transient proteinuria in two patients; renal function was normal in all. Immune complex glomerulitis, with deposition of immunoglobulins and C3 globulin, was seen in all patients. Salmonella Vi antigen was also found in the glomerular capillary wall, suggesting the direct role of Salmonella typhi in the pathogenesis of the glomerular lesion. A repeat renal biopsy in one patient showed rapid resolution of the lesion. The occurrence of immune complex glomerulitis with typhoid fever may be frequent but overlooked because of the lack of clinical manifestations.
Dantrolene Hepatitis-Reply
Authors: Richard Schneider
Journal: JAMA (1976)

The issue raised by Dr Assatourians is what is the most informative and safest procedure in a patient who has total bilirubin levels of 32 mg/100 ml; alkaline phosphatase, 215 IU/100 ml; and SGOT, 260 IU/100 ml. This combination of laboratory abnormalities might well be seen in drug jaundice but is certainly compatible with extrahepatic obstruction. Even if there were only a 25% chance that this patient had a dilated biliary tree, I would prefer not to risk bile peritonitis with a liver biopsy. The risks of liver biopsy in patients with obstructive jaundice have been reviewed by Harold Conn, MD, in an editorial (<i>Gastroenterology</i>68:817, 1975) and are not negligible. In addition, a liver biopsy cannot always differentiate between extrahepatic and intrahepatic cholectasis. Endoscopic retrograde cholangiopancreatography is a rapid and safe method of visualizing the biliary tract. Our selection of it as our initial diagnostic approach seems
To a Fellow Traveler
Authors: Beatriz Rodriguez
Journal: Annals of Internal Medicine (2012)

Ad Libitum21 February 2012To a Fellow TravelerBeatriz Rodriguez, MDBeatriz Rodriguez, MDFrom Rockford, IL 61107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-4-201202210-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The happily entwined do knowwhen, without intended design,some seed of interest might growas we look out at distant eyes.Witty words, a curious gazemystify, disturb the watersthey may unearth old, buried daysbut need not be the devil's fodder.Your fickle nature you may fear.But I see the goodness of it.A vow confers a freedom hereto learn to love in light of it.And is it flesh we so desire?Thoughts may stray to pale realms of skin,but to share words and minds entire,that is the far more precious thing.and we cannot share daily ... Author, Article, and Disclosure InformationAffiliations: From Rockford, IL 61107.Current Author Address: Beatriz Rodriguez, MD, 1826 Rothschild Lane, Rockford, IL 61107; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 February 2012Volume 156, Issue 4Page: 316KeywordsFearInterleukins ePublished: 21 February 2012 Issue Published: 21 February 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Proposed EU data protection regulation is a threat to medical research
Authors: M. C. Ploem, M. L. Essink-Bot, K. Stronks
Journal: BMJ (2013)

A suggested amendment would make most epidemiological and health research impossible

Legislation going through the European Parliament this summer could prohibit most epidemiological and other medical research if amendments proposed by one committee are accepted. The main goals of the legislation will be to strengthen the digital privacy rights of European citizens, improve Europe’s online economy, strengthen the free market, and end the divergence between national data protection laws of the 27 member states of the European Union. This is all well and good, as long as data protection is balanced fairly against adequate provision for legitimate data processing. 

The European Commission proposed last year that the EU’s 1995 Data Protection Directive 95/46/EC should be replaced by the General Data Protection Regulation.1 In line with the current directive, the draft regulation prohibits the processing of sensitive personal data, including “data concerning health.” However, the draft allows exceptions, including data processing for research and statistics. Research deserves a special position within the normative framework, not only because its focus is not on the individual, but also because it serves an important public interest—the generation of valuable knowledge for society. 

So far, so good. But, in December 2012, the European parliament’s Committee on Civil Liberties, Justice and Home Affairs (LIBE …
Serum screening for Down's syndrome: some women's experiences.
Authors: H Statham, J Green
Journal: BMJ (1993)

To describe the experiences of a small group of women who had positive results after serum screening for Down's syndrome.Semistructured telephone interviews and correspondence with women after a positive screening result (four women) negative amniocentesis results (eight), or termination of a pregnancy with a confirmed abnormality (eight).20 women who contacted Support After Termination For Abnormality about their experiences of serum screening for Down's syndrome.Women's knowledge and understanding of the test; staff misconceptions; communication of results; how women coped with the diagnostic process; attitudes to the test and to termination of abnormal fetuses.All women were made anxious by their positive screening test, no matter how they were told. The women's experiences suggested that medical staff were unclear about the implications of screening tests and how to interpret risk. Even after receipt of negative amniocentesis results some women remained anxious. Staff did not always recognise women's concerns while awaiting amniocentesis results.The way in which serum screening is being implemented does not always meet the needs of women with positive results. Some of the problems were not specific to screening for Down's syndrome. When screening tests are introduced policies should be adopted to ensure appropriate support for participants.
Lesion-directed treatment for actinic keratoses
Authors: R. Sheehan-Dare
Journal: British Journal of Dermatology (2014)

ORIGINAL ARTICLE, p 1114 Actinic keratoses represent a significant and increasing burden on healthcare systems in many parts of the world. For such a common problem, significant uncertainties still exist over their management. It is generally accepted that a number of actinic keratoses may progress to squamous cell carcinoma,1 but incontrovertible evidence that their treatment reduces the risk is lacking. Nevertheless, there is a widely held belief among many clinicians that treatment of individual actinic keratoses is worthwhile for risk prevention or simply because many of these lesions are symptomatic or of cosmetic concern. Several treatment guidelines list both cryotherapy and the carbon dioxide laser among treatment options,2 3 although evidence of efficacy for the latter has been scarce to date.4 In this issue of BJD, Zane et al.5 provide us with a welcome addition to the comparative data on lesion‐directed treatments for actinic keratoses. In a randomized comparison of cryotherapy and carbon dioxide laser ablation, they demonstrated overall equivalent lesion clearance rates at 3 months of 78·2% and 72·4%, respectively, although thicker lesions responded significantly better to cryotherapy at this time point (cryotherapy 80·2%, laser treatment 59·8%). However, at 12 months, of the lesions apparently clear at 3 months, significantly fewer remained clear in the carbon dioxide laser arm (37%) than with cryotherapy (66·8%).
Abstract C66: MUC1-C oncoprotein induces aldehyde dehydrogenase expression and activity in breast cancer cells
Authors: Rehan Ahmad, Maroof Alam, Hasan Rajabi, Akriti Kharbanda, Donald Kufe
Journal: Cancer Research (2013)

Abstract Aldehyde dehydrogenase 1A1 (ALDH1A1) activity is used as a marker of breast cancer stem cells; however, little is known about the regulation of ALDH1A1 expression. Mucin 1 (MUC1) is a heterodimeric protein that is aberrantly overexpressed in about 90% of human breast cancers. The present studies have been performed on breast cancer cells that were stably silenced for MUC1 expression or overexpress the oncogenic MUC1-C subunit. We demonstrate that MUC1-C is sufficient for induction of MEK-ERK signaling and that treatment with a MUC1-C inhibitor suppresses ERK activation. In turn, MUC1-C induces ERK-mediated phosphorylation and activation of the CCAAT/enhancer-binding protein β (C/EBPβ) transcription factor. The results further show that MUC1-C and C/EBPβ form a complex on the ALDH1A1 gene promoter and activate ALDH1A1 gene transcription. Importantly, MUC1-C-induced upregulation of ALDH1A1 expression is associated with marked increases in ALDH activity as detected by the aldefluor assay. These findings demonstrate that MUC1-C (i) activates a previously unrecognized ERK-C/EBPβ-ALDH1A1 pathway, and (ii) promotes the induction of ALDH activity in breast cancer cells. Note: This abstract was not presented at the conference. Citation Format: Rehan Ahmad, Maroof Alam, Hasan Rajabi, Akriti Kharbanda, Donald Kufe. MUC1-C oncoprotein induces aldehyde dehydrogenase expression and activity in breast cancer cells. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr C66.
Small-bowel perforation after endoscopic resection of a Peutz-Jeghers polyp in an infant using double-balloon enteroscopy
Authors: T. Spahn, W. Kampmann, M. Eilers, M. Mueller, B. Rodeck
Journal: Endoscopy (2007)

Double-balloon-enteroscopy (DBE) provides a facility for the diagnosis and treatment of small-intestinal disease [1]. To date its use has not been described in infants. A boy aged 3 years and 10 months who had small-intestinal bleeding underwent esophagogastroduodenoscopy in another hospital, when two gastric polyps were found. He was referred to us for DBE. Peutz-Jeghers syndrome was diagnosed on the basis of the findings of gastric polyps and circumoral pigmentation ([Figure 1]). DBE was performed after informed consent was obtained, using a Fujinon EN-450 P5/20 endoscope (Fujinon-Toshiba ES System Co. Ltd., Tokyo, Japan) under general anesthesia. A large polyp (3 cm) was found in the proximal jejunum, which had surface erosions ([Figure 2 a]). The polyp was removed using a diathermy loop. Histological examination confirmed the diagnosis of a Peutz-Jeghers polyp ([Figure 2 b]). There were erosions within the polyp ([Figure 2 c]), suggesting a possible source of bleeding. A double-balloon colonoscopy performed subsequently was unremarkable, but ileoscopy was not possible.
Physicians and Sexually Transmitted Disease: A Call to Action
Authors: Edward N. Brandt
Journal: JAMA (1982)

He who knows syphilis, knows medicine." When Dr Osler coined this axiom early in the 20th century, he, no doubt, was trying to impress upon his colleagues and residents the importance of medical knowledge of this once formidable scourge (see also p 2020). In those days, syphilis was the unchallenged champion of venereal diseases. Today, old and new sexually transmitted diseases (STDs) occur with an even greater frequency and are represented by a broader range of clinical manifestations. Practitioners and residents well versed about these infections are an essential part of the front-line defense to combat the STD epidemic of the 1980s and 1990s. Herein are some thoughts about how we can work together to win this battle. Historically, the availability of penicillin in the early 1950s led to the great medical advances in the 20th century. For the first time, physicians could safely cure infectious diseases, eg, syphilis, instead
OK, OK, OK: The Facts of Kew—More on Squatter's Palsy-Reply
Authors: David J. Kumaki
Journal: JAMA (1987)

<h3>In Reply.—</h3> I appreciate all of the many comments that my letter has fostered, including those of Dr Caccamise and others who have written me directly. I would like to stress that my postulated mechanism of injury was only a hypothesis, and other possibilities certainly exist. However, the peripheral neuropathy seen with<i>Shigella</i>infections is felt to be quite rare, and as the patient had a single isolated nerve lesion, I still feel that it more likely was due to compression neuropathy. As others have pointed out to me since the report was written, the exact mechanism of injury in common peroneal nerve palsy is still somewhat in question.<sup>1</sup>
Mycoplasma pneumoniae Pneumonia and Clindamycin Therapy
Authors: Jerry D. Smilack
Journal: JAMA (1974)

A double-blind study was undertaken to evaluate the efficacy of clindamycin hydrochloride hydrate as compared with tetracycline hydrochloride and placebo in the treatment of<i>Mycoplasma pneumoniae</i>. Thirty-two young adult men were studied. Clindamycin failed to cause defervescence or roentgenographic resolution more promptly than placebo. Tetracycline was associated with a shortening of the duration of fever. (<i>JAMA</i>228:729-731, 1974)
Eponym's 's: Argyll Robinson, Not pseudo-Turner, Was e. e. cummings' endocrinologist-Reply
Authors: Victor C. Vaughan
Journal: JAMA (1986)

<h3>In Reply.—</h3> The letters of Dr Talbott and Messrs Duplantier and Laborde confirm our impression that objections to dropping the '<i>s</i>seem to rest on familiarity and tradition and a sense of comfort rather than on any clearly articulated principle. Many of us felt at first that "Down syndrome" or "Hodgkin disease" sounded a little odd, but with a little practice the use of eponyms without '<i>s</i>becomes quite easy and comfortable—a short step over a small hump toward an ultimately pleasant consistency. I am distressed that Mr Duplantier and Mr Laborde find dropping the '<i>s</i>to be "blatant linguistic impropriety," violating "linguistic dynamics." The matter seems less linguistic than related to common sense. I should point out that the no '<i>s</i>convention did not originate with the National Board of Medical Examiners but with the American Medical Association in its 1976 revision of the<i>Manual for Authors &amp; Editors</i>