tbuckley/cabot-search huggingface dataset:
Home environment and severe asthma in adolescence: a population based case-control study
Authors: D. P Strachan, I. M Carey
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>: To investigate the effects of the home environment on the risk of severe asthma during adolescence. <b>Design</b>: A questionnaire based case-control study drawn from a cross sectional survey of allergic diseases among secondary school pupils in Sheffield in 1991. <b>Subjects</b>: 763 children whose parents had reported that over the previous 12 months they had suffered either 12 or more wheezing attacks or a speech limiting attack of wheeze. A further 763 children were frequency matched for age and school class to act as controls. Analysis was restricted to 486 affected children and 475 others born between 1975 and 1980 who had lived at their present address for more than three years. <b>Results</b>: Independent associations with severe wheeze were seen for non-feather bedding, especially foam pillows (odds ratio 2.78; 95% confidence interval 1.89 to 4.17), and the ownership of furry pets now (1.51; 1.04 to 2.20) and at birth (1.70; 1.20 to 2.40). These estimates were derived from subjects whose parents denied making changes in the bedroom or avoiding having a pet because of allergy. Parental smoking, use of gas for cooking, age of mattress, and mould growth in the child9s bedroom were not significantly associated with wheezing. <b>Conclusions</b>: Either our study questionnaire failed to detect the avoidance or removal of feather bedding by allergic families or there is some undetermined hazard related to foam pillows. Synthetic bedding and furry pets were both widespreadin this population and may represent remediable causes of childhood asthma.
The Rational Clinical Examination: Detecting Abnormal Systolic Murmurs
Authors: Kevin M. Fosnocht
Journal: JAMA (1997)

<h3>To the Editor.</h3> —Dr Etchells and colleagues<sup>1</sup>have published a thorough review of studies assessing the available evidence of the precision and accuracy of the clinical examination for abnormal systolic murmurs. Their conclusions, however, beg the question posed in their title: "Does this patient have an abnormal systolic murmur?" As the authors point out, "clinicians are primarily concerned whether a systolic murmur indicates a cardiac abnormality," ie, which patients need further evaluation (such as echocardiography) or therapeutic intervention (such as antibiotic prophylaxis with procedures). Two studies not included in the MEDLINE search by the authors address this issue. Roldan et al<sup>2</sup>studied the value of the cardiovascular physical examination for detecting valvular heart disease in asymptomatic subjects. They found that, of 143 subjects younger than 61 years (68 apparently healthy and 75 with no cardiac symptoms but with connective tissue diseases), a single cardiologist's determination of a murmur
Nine out of 10 palliative care experts would choose Liverpool care pathway for themselves
Authors: K. Chinthapalli
Journal: BMJ (2013)

The Liverpool care pathway represents best practice for the care of dying patients, according to 89% of UK palliative medicine consultants in an online survey by the BMJ and Channel 4’s Dispatches programme.1

The same proportion of consultants said they would choose it for themselves if they were dying from a terminal illness, and over 97% of consultants thought that the pathway allows patients to die with dignity when used correctly.

The anonymous online survey was emailed to 3021 hospital doctors in early February. The results are based on responses from 563 doctors who had used the pathway in their practice. These respondents comprised 185 palliative medicine consultants (about 40% of the total UK consultant workforce …
Chronic pain is poorly managed
Authors: Roger Dobson
Journal: BMJ (2005)

<h3>Objectives</h3> Patients are initiating recordings of their clinical encounters using a smartphone. While this is an important, universal issue, little is known about the clinician viewpoint. Understanding clinician perspectives and behaviours is key to ensuring the protection of patient and clinician interests. This study aimed to gain a deep understanding of clinician attitudes and behaviours to patient-led recordings of hospital clinical encounters. <h3>Design</h3> Semistructured interviews were conducted with 20 hospital clinicians. Participants were recruited using a combination of purposive and snowball sampling. Interviews were digitally recorded and transcribed. Transcripts were analysed using thematic analysis. <h3>Setting</h3> This study took place at two hospitals in the metropolitan area of Gold Coast, Australia. <h3>Participants</h3> Participants included clinicians with varying levels of experience, or clinical managers in the roles of: medical, nursing and midwifery, and allied health staff. <h3>Results</h3> The 20 participants interviewed were from a range of health disciplines and clinical areas and most had experienced a patient-led recording. Three themes emerged when exploring participant attitudes. First, that recording was a significant and controversial topic. Second, that experiences often informed clinician attitudes and many clinicians held conflicting views. Finally, a perceived loss of control was a significant stressor. A further three themes emerged relating to clinician behaviours when a patient asks to record. Decision-making involved balancing multiple factors often in pressurised situations. Shared decision-making was shaped by power dynamics and, finally, decision-making was not informed by hospital policy. <h3>Conclusions</h3> While patient-led recordings were viewed as beneficial, clinician welfare and patient safety may be at risk when a patient records a clinical encounter. Current safeguards, such as hospital policies, are not used and may not meet the needs of clinicians when decision-making is complicated by power dynamics. More research is needed to better understand how clinicians can be supported in this critical domain.
Immunologic responses to inhaled cotton dust.
Authors: J E Salvaggio, C E O'Neil, B T Butcher
Journal: Environmental Health Perspectives (1986)

Byssinosis, a respiratory disease of workers on cotton, flax, and soft hemp, is classically characterized as shortness of breath, cough, and chest tightness on Mondays or the first day of return to work after a time off. Exposure to these vegetable dusts can also result in other respiratory diseases, and the term cotton dust-induced respiratory disease (CDIRD) is introduced. Although clinically characterized for more than a century, the underlying pathogenesis of CDIRD remains obscure. An allergic pathogenesis has been proposed. This article reviews previous and current research findings supporting this mechanism and raises the possibility that, in some individuals, CDIRD may be due to pre-existing or occupationally induced mold allergy.
William Henry Moffatt
Authors: D H Allen
Journal: BMJ (2005)

Founder of the Northern Ireland Renal ServiceMollie McGeown overcame gender prejudice in 1950s Northern Ireland medicine to build a career that changed the lives of thousands of people affected by kidney failure.After completing an MD thesis on endocarditis followed by a PhD in biochemistry, she was awarded a five year Medical Research Council fellowship and went on to develop an international reputation in calcium metabolism, hyperparathyroidism, and kidney stone disease.In 1959 she was appointed to set up a dialysis service for Northern Ireland and carried out the first successful dialysis on a uraemic patient later that year.This was a pivotal moment for patients in Northern Ireland with kidney failure.Over 200 patients in Northern Ireland at that time died each year from this cause.In 1971 a young woman treated by Mollie for pregnancy related renal failure founded the Northern Ireland Kidney Research Fund, which has to date raised £3m (€4.38m; $5.6m).Mollie was the patron of this fund up to her death.
Systematic overview of co-proxamol to assess analgesic effects of addition of dextropropoxyphene to paracetamol
Authors: A L. W. Po, W Y Zhang
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objective:</b> To evaluate the comparative efficacy and tolerability of paracetamol-dextropropoxyphene combination and paracetamol through a systematic overview of randomised controlled trials. <b>Design:</b> Systematic retrieval of trials of paracetamol-dextropropoxyphene, paracetamol, and placebo to allow pooling of results from head to head comparison trials and single active placebo controlled trials. <b>Subjects:</b>2231 patients with postsurgical pain, arthritis, and musculoskeletal pain reported in 26 randomised controlled trials. <b>Main outcome measures:</b> Sum of difference in pain intensity; response rate ratio and difference in response rate with response defined as moderate to excellent pain relief; and rate ratio and rate difference of side effects. <b>Results:</b> The difference in pain intensity between paracetamol-dextropropoxyphene and paracetamol was 7.3% (95% confidence interval −0.2 to 14.9). The response rate ratio for the combination and paracetamol was 1.05 (0.8 to 1.3) on the basis of the head to head trials. Indirect comparisons produced quantitatively consistent results. Compared with placebo, the combination produced more dizziness (3.1; 1.1 to 8.9) whereas paracetamol resulted in more drowsiness (1.8; 1.1 to 2.9). <b>Conclusion:</b> On the basis of data on analgesic efficacy and acute safety in both head to head and indirect comparisons, there is little objective evidence to support prescribing a combination of paracetamol and dextropropoxyphene in preference to paracetamol alone in moderate pain such as that after surgery. <h3>Key messages</h3> Combinations of paracetamol with centrally acting analgesics are widely used, accounting for 73% of all prescriptions for paracetamol in a recent hospital survey in the United Kingdom The combination of paracetamol (650 mg) with dextropropoxyphene hydrochloride (32.5 mg) is particularly popular In both head to head and indirect comparisons of paracetamol and the combination, the combination was no better than paracetamol on its own Since the total number of patients in the few published head to head comparisons was modest, small differences in effect cannot be excluded but these are unlikely to be of clinical importance
Don't shoot me I'm only the pharmacist
Authors: D. Kernick
Journal: BMJ (1997)

The recent test case in the high court giving pharmacists the right to dispense in rural areas has highlighted the differences in view between pharmacists and rural practitioners. The confrontation between two professional groups involved in delivering the same service may benefit from a closer examination.

In the red corner is the Rural Pharmacists Association: “The comprehensive service that can be provided from a pharmacy is vastly superior to the supply service from a doctor's surgery.” In the blue corner is the Dispensing Doctors Association: “Pharmacists are heading the way of dinosaurs and all dispensing should be done in doctors' premises.”

Current health policy sees the pharmacist as an underutilised resource who should be part of a multidisciplinary team working within locally defined protocols, freeing up NHS resources and general practitioners' time. This approach is clearly at odds with many doctors who agree with the succinct analysis of the Dispensing …
Hand Difficulties Among Musicians
Authors: Vaughan P. Simmons
Journal: JAMA (1983)

To the Editor.—  Hand difficulties among musicians are, as pointed out by Dr Hochberg and associates, of a group of occupational maladies that have been around for a long time. Although various aspects of the occupational etiology have been discussed in a multitude of articles, there seems to me to be only one factor that is common to all— sustained contraction of a muscle group (or groups).  Whenever digits occupy a fixed position or are held rigidly, their associated muscles are contracted and their blood supply largely obliterated. On the contrary, fingers moving rhythmically to and fro are actuated by muscles that, with the assistance of venous valves, are actively pumping blood and, because of this, are apt to be able to perform longer than those maintained in a contracted state for prolonged periods.  The mechanism for this phenomenon can be readily grasped by looking at the accompanying illustration. Mr
Gastro-oesophageal reflux and the migrating motor complex.
Authors: R C Gill, J E Kellow, D L Wingate
Journal: Gut (1987)

Distal oesophageal pH and gastroduodenal motor activity were recorded simultaneously throughout nocturnal (23 30-08 30 h) and diurnal (08 30-17 30 h) periods of fasting in seven healthy subjects. At night, episodes of gastro-oesophageal reflux (GOR) accounted for 1.2 +/- 0.7% of recording time. Periods of gastric motor activity, representing the gastric component of the migrating motor complex (MMC), recurred every 78 +/- 31 min during the night and were interspersed with periods of gastric motor quiescence. Nocturnal episodes of GOR during periods of gastric motor activity were of longer duration (p less than 0.001) and more frequent (p less than 0.005) than during periods of gastric motor quiescence. At night, periodic gastric motor activity was thus correlated (p less than 0.001) with an increase in the duration and number of GOR episodes and associated with a 100-fold increase in oesophageal acid exposure. During the day, the gastric component of the MMC, recurring every 131 +/- 64 min, was correlated (p less than 0.02) with an increase in the duration and number of GOR episodes, and a three fold increase in oesophageal acid exposure. Further, 89% of nocturnal, and 83% of diurnal gastric MMCs were temporally associated with episodes of GOR. We conclude that fasting episodes of GOR occur coincidentally with the gastric component of the MMC.
An Address on Pregnancy Regarded as an Experiment Illustrating General Pathology
Authors: R. Barnes
Journal: BMJ (1876)

Delivered before the Midland Mledical Society at Birmingham. or even more remote, at any rate only concomitant expressions of a general degeneration of the circulatory apparatus.How does this case compare or contrast with the so-called uroemic eclampsia of pregnant women?In the latter case, the whole experiment is carried through
Electrocardiographic Studies in Pulmonary Disease
Authors: DAVID H. SPODICK
Journal: Circulation (1959)

Electrocardiograms of 79 consecutively admitted patients with diffuse lung diseases were analyzed. The frontal plane P-wave axis and the P-wave configuration in limb and precordial leads emerged as the common denominator for the large majority of the group. Other abnormalities were common but not so characteristic.
ApoE knockout mice expressing human matrix metalloproteinase-1 in macrophages have less advanced atherosclerosis
Authors: Vincent Lemaître, Timothy K. O’Byrne, Alain C. Borczuk, Yasunori Okada, Alan R. Tall, Jeanine D’Armiento
Journal: Journal of Clinical Investigation (2001)

Matrix metalloproteinase-1 (MMP-1), or interstitial collagenase, has been hypothesized to contribute to the progression of the human atherosclerotic lesions by digesting the fibrillar collagens of the neointimal ECM. The apolipoprotein E knockout (apoE0) mouse model develops complex atherosclerotic lesions, but mice do not possess a homologue for MMP-1. To provide an in vivo evaluation of the role of MMP-1 in atherogenesis, we created a transgenic mouse model that expresses this enzyme specifically in the macrophage, under the control of the scavenger receptor A (SCAV) enhancer/promoter. The MMP-1 transgenic mice were crossed into the apoE0 background and fed an atherogenic diet for 16–25 weeks. Surprisingly, the transgenic mice demonstrated decreased lesion size compared with control littermates. The lesions of the transgenic animals were less extensive and immature, with fewer cellular layers and a diminished content of fibrillar collagen. There was no evidence of plaque rupture. Our data suggest that remodeling of the neointimal extracellular matrix by MMP-1 is beneficial in the progression of lesions.
Chronic myelogenous leukemia stem and progenitor cells demonstrate chromosomal instability related to repeated breakage-fusion-bridge cycles mediated by increased nonhomologous end joining
Authors: Sujata Chakraborty, Jeremy M. Stark, Can-Lan Sun, Hardik Modi, WenYong Chen, Timothy R. O'Connor, Stephen J. Forman, Smita Bhatia, Ravi Bhatia
Journal: Blood (2012)
Hypoxia and reoxygenation in the isolated rabbit heart
Authors: T. YASUDA
Journal: Cardiovascular Research (1993)

Journal Article Hypoxia and reoxygenation in the isolated rabbit heart Get access TSUNEHIRO YASUDA TSUNEHIRO YASUDA Cardiac Unit, Tilton 2, Massachusetts General Hospital, Boston, MA, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 27, Issue 7, July 1993, Page 1383, https://doi.org/10.1093/cvr/27.7.1383 Published: 01 July 1993
Acute renal failure in a patient with antiphospholipid syndrome and immune thrombocytopenic purpura treated with eltrombopag
Authors: C. John Sperati, Michael B. Streiff
Journal: American Journal of Hematology (2010)

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antibodies directed against phospholipid-binding proteins such as beta-2 glycoprotein I and prothrombin, venous and/or arterial thromboembolism, and recurrent fetal loss. To fulfill diagnostic criteria, patients must have thrombotic or obstetrical morbidity and consistently positive antiphospholipid testing on two occasions separated by at least 12 weeks [2]. Other clinical manifestations include thrombocytopenia, renal insufficiency, vasculitis, and cardiac valvular abnormalities. Thrombocytopenia occurs in 20-40% of patients with APS while renal dysfunction develops in ~25% of patients with primary APS [3,4]. Thrombocytopenia is thought to be primarily due to the presence of autoantibodies directed against platelet membrane glycoproteins, although platelet activation and aggregation by APS-associated antibodies have also been implicated. Thrombocytopenia in patients with APS is typically moderate in severity with platelet counts remaining greater than 50,000 cells/mm3 in most cases,so therapy is often unnecessary. When treatment is required, therapies used for immune thrombocytopenic purpura (ITP) are often effective. Corticosteroids, intravenous immunoglobulin, dapsone, and rituximab have all been shown to be effective in APS patients with thrombocytopenia[5-7]. Since November 2008, eltrombopag (Promacta; GlaxoSmithKline,Middlesex, United Kingdom), a nonpeptide thrombopoietin receptor agonist that stimulates the development of megakaryocytes, has been approved for use in the management of chronic ITP. To date, no reports of renal toxicity have emerged with its use. We report the case of a patient with APS and steroid-dependent thrombocytopenia who developed partially reversible acute renal failure after initiation of eltrombopag that recurred on rechallenge.
Neuroscientists condemn European brain simulation project
Authors: G. Watts
Journal: BMJ (2014)

Neuroscientists across Europe are at loggerheads over the future of a €1.2bn (£955m; $1.6bn) European Union funded project intended, among other aims, to simulate the working of the human brain. In an open letter (www.neurofuture.eu) to the European Commission, 130 scientists called for the money to be reallocated to other neuroscience projects unless action was taken to revise the current spending plans.

The Human Brain Project’s website1 described its goals as “catalysing a global collaborative effort to integrate neuroscience data from around the world, to understand the human brain and its diseases, and ultimately …
Incorrect Grant Number in the Article by Park et al (Arthritis Rheum, December 2013)
Authors: Su Jin Park, Eun Jeong Cheon, Mi Hyun Lee, Hyun Ah Kim
Journal: Arthritis & Rheumatology (2014)

In the article by Park et al in the December 2013 issue of Arthritis & Rheumatism (pages 3141–3152), the grant number of one of the Korea Healthcare Technology R&D Project grants was shown incorrectly. The statement in the footnotes on the first page of the article should have read, “Supported by the Ministry of Health, Welfare, and Family Affairs (Korea Healthcare Technology R&D Project grants A084026 and A110274).”
Linear Ablation Lesions for Control of Unmappable Ventricular Tachycardia in Patients With Ischemic and Nonischemic Cardiomyopathy
Authors: Francis E. Marchlinski, David J. Callans, Charles D. Gottlieb, Erica Zado
Journal: Circulation (2000)

Conventional activation mapping is difficult without inducible, stable ventricular tachycardia (VT).We evaluated 16 patients with drug refractory, unimorphic, unmappable VT. Nine patients had ischemic and 7 had nonischemic cardiomyopathy. All patients had implantable defibrillators and had experienced 6 to 55 VT episodes during the month before treatment. Patients underwent bipolar catheter mapping during baseline rhythm. The amount of endocardium with an abnormal electrogram amplitude was estimated using fluoroscopy in 3 patients and a magnetic mapping system (CARTO) in 13 patients. For the magnetic mapping, normal endocardium was defined by an amplitude >1.5 mV; this measurement was based on sinus rhythm maps in 6 patients who did not have structural heart disease. Radiofrequency point lesions extended linearly from the "dense scar," which had a voltage amplitude <0.5 mV, to anatomic boundaries or normal endocardium. To limit radiofrequency applications, 12-lead ECG during VT and pacemapping guided placement of linear lesions. No new antiarrhythmic drug therapy was added. The amount of endocardium demonstrating an abnormal electrogram amplitude ranged from 25 to 127 cm(2). A total of 8 to 87 radiofrequency lesions (mean, 55) produced a median of 4 linear lesions that had an average length of 3.9 cm (range, 1.4 to 9. 4 cm). Twelve patients (75%) have been free of VT during 3 to 36 months of follow-up (median, 8 months); 4 patients had VT episodes at 1, 3, 9, and 13 months, respectively. Only one of these patient had frequent VT.Radiofrequency linear endocardial lesions extending from the dense scar to the normal myocardium or anatomic boundary seem effective in controlling unmappable VT.
1005-45 Dose response of sirolimus-eluting SMART™stents in porcine iliac arteries and relationship to arterial tissue sirolimus levels
Authors: Michael A Lauer, Jennifer J DeVries, Patricia A Turck, Raviprasad G Subraya, Scott D Haller, Clark Williard, Fermin O Tio, John F Dooley, Gregory A Kopia
Journal: Journal of the American College of Cardiology (2004)