tbuckley/cabot-search huggingface dataset:
APPENDICITIS; PROTEAN TYPES.
Authors: A. H. CORDIER
Journal: JAMA (1896)

To the members of the Jackson County Medical Society a paper on appendicitis may, on first thought, seem a trite topic for discussion, yet when the many phases of this treacherous disease are called to mind we at once realize that it is a topic the importance of which demands oft repeated discussions, that a more unanimous opinion of the pathology of the disease may be obtained, and its proper treatment better understood. In the face of our more advanced and modern pathologic knowledge we yet have conscientious practitioners who claim that they have never seen a case of appendicitis, and another class also exists, that admit having cases, but claim the ability to cure them, denying the probability of a death from the disease. A still more liberal class may be found that is willing to meet the surgeon halfway and become associated with him in the case, waiting
PROMs promote health gain and patient involvement
Authors: Andrew J Vallance-Owen
Journal: BMJ (2008)

Hawkes seems to have swallowed the paternalistic line that what doctors do to patients is more important than the outcome as perceived by them.1 How can we know if a process brings benefits and continues to improve it without measuring the outcome, and how can we rely on process alone when the evidence shows such widespread variation and inconsistency in …
NHS waiting lists and evidence of national or local failure: analysis of health service data
Authors: R. M Martin
Journal: BMJ (2003)

Objectives: To investigate the national distribution of prolonged waiting for elective day case and inpatient surgery, and to examine associations of prolonged waiting with markers of NHS capacity, activity in the independent sector, and need. Setting: NHS hospital trusts in England. Population: People waiting for elective treatment in the specialties of general surgery; ear, nose and throat surgery; ophthalmic surgery; and trauma and orthopaedic surgery. Main outcome measure: Numbers of people waiting six months or longer (prolonged waiting). Characteristics of trusts with large numbers waiting six months or longer were examined by using logistic regression. Results: The distribution of numbers of people waiting for day case or elective surgery in all the specialties examined was highly positively skewed. Between 52% and 83% of patients waiting longer than six months in the specialties studied were found in one quarter of trusts, which in turn contributed 23-45% of the national throughput specific to the specialty. In general, there was little evidence to show that capacity (measured by numbers of operating theatres, dedicated day case theatres, available beds, and bed occupancy rate) or independent sector activity were associated with prolonged waiting, although exceptions were noted for individual specialties. There was consistent evidence showing an increase in prolonged waiting, with increased numbers of anaesthetists across all specialties and with increased bed occupancy rates for ear, nose and throat surgery. Markers of greater need for health care, such as deprivation score and rate of limiting long term illness, were inversely associated with prolonged waiting. Conclusion: In most instances, substantial numbers of patients waiting unacceptably long periods for elective surgery were limited to a small number of hospitals. Little and inconsistent support was found for associations of prolonged waiting with markers of capacity, independent sector activity, or need in the surgical specialties examined. #### What is already known about this topic What is already known about this topic Many patients wait unacceptably long times for NHS surgery The size of waiting lists is of little relevance to understanding access to treatment Evidence is scant for the common assumption that the waiting problem arises from a global mismatch between supply and demand and can be solved either by greater rationing or by increasing NHS capacity #### What this study adds What this study adds Long waiting lists are not an indication of a general failure of the NHS One quarter of hospital trusts contribute between half and four fifths of the patients waiting six months or longer Measures of capacity (such as beds, operating theatres, doctors) and independent sector activity are not generally associated with prolonged waiting
Somatic Mutations in Epidermal Growth Factor Receptor Signaling Pathway Genes in Non-small Cell Lung Cancers
Authors: Shin Yup Lee, Min Jung Kim, Guang Jin, Seung Soo Yoo, Ji Young Park, Jin Eun Choi, Hyo Sung Jeon, Sukki Cho, Eung Bae Lee, Seung Ick Cha, Tae-In Park, Chang Ho Kim, Tae Hoon Jung, Jae Yong Park
Journal: Journal of Thoracic Oncology (2010)
Cervical Adenocarcinoma of Mesonephric Origin
Authors: David Rose
Journal: New England Journal of Medicine (1960)

THE following case represents the nineteenth cervical adenocarcinoma of mesonephric origin reported to date:Mrs. U.J., a 31-year-old multipara, was seen in April, 1959, because of intermittent vaginal spotting. For weeks there was occasional staining with voiding after coitus. There were no urinary symptoms and no vaginal discharge. The family history was noncontributory except that a brother had died of carcinoma at the age of 40.Catamenia had started at 12, and periods occurred every 30 to 35 days, of 5 days' duration, without dysmenorrhea. The past history was irrelevant except for a thyroidectomy 4 years previously.Physical examination showed . . .
Modeling chronic myeloid leukemia in immunodeficient mice reveals expansion of aberrant mast cells and accumulation of pre-B cells
Authors: M Askmyr, H Ågerstam, H Lilljebjörn, N Hansen, C Karlsson, S von Palffy, N Landberg, C Högberg, C Lassen, M Rissler, J Richter, M Ehinger, M Järås, T Fioretos
Journal: Blood Cancer Journal (2014)

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm that, if not treated, will progress into blast crisis (BC) of either myeloid or B lymphoid phenotype. The BCR-ABL1 fusion gene, encoding a constitutively active tyrosine kinase, is thought to be sufficient to cause chronic phase (CP) CML, whereas additional genetic lesions are needed for progression into CML BC. To generate a humanized CML model, we retrovirally expressed BCR-ABL1 in the cord blood CD34+ cells and transplanted these into NOD-SCID (non-obese diabetic/severe-combined immunodeficient) interleukin-2-receptor γ-deficient mice. In primary mice, BCR-ABL1 expression induced an inflammatory-like state in the bone marrow and spleen, and mast cells were the only myeloid lineage specifically expanded by BCR-ABL1. Upon secondary transplantation, the pronounced inflammatory phenotype was lost and mainly human mast cells and macrophages were found in the bone marrow. Moreover, a striking block at the pre-B-cell stage was observed in primary mice, resulting in an accumulation of pre-B cells. A similar block in B-cell differentiation could be confirmed in primary cells from CML patients. Hence, this humanized mouse model of CML reveals previously unexplored features of CP CML and should be useful for further studies to understand the disease pathogenesis of CML.
Atrichia with papular lesions resulting from compound heterozygous mutations in the hairless gene: A lesson for differential diagnosis of alopecia universalis
Authors: Wolfram Henn a, Abraham Zlotogorski b, HaMut Lam c, Amalia Martinez-Mir c, Hansotto Zaun a, Angela M. Christiano d
Journal: Journal of the American Academy of Dermatology (2002)
T-Cell Profiles In Bronchoalveolar Lavage (BAL) Of Wheezing Children With and Without A History Of Respiratory Syncytial Virus (RSV) Lower Respiratory Tract Infection
Authors: Chang-Kuen Kim, Jin-Tack Kim, Sally E. Wenzel, Marzena E. Krawiec
Journal: Journal of Allergy and Clinical Immunology (2014)
Efferent Vagal Innervation of the Canine Atria and Sinus and Atrioventricular Nodes
Authors: Chuen-Wang Chiou, John N. Eble, Douglas P. Zipes
Journal: Circulation (1997)

Background The purpose of this study was to investigate the functional pathways of efferent vagal innervation to the atrial myocardium and sinus and atrioventricular (AV) nodes. Methods and Results Using vagally induced atrial effective refractory period shortening, slowing of spontaneous sinus rate, and prolongation of AV nodal conduction time as end points of vagal effects, we determined the actions of phenol and epicardial radiofrequency catheter ablation (RFCA) applied to different sites at or near the atrial myocardium to inhibit these responses. We found that efferent vagal fibers to the atria are located both subepicardially and intramurally or subendocardially. Most efferent vagal fibers to the atria appear to travel through a newly described fat pad located between the medial superior vena cava and aortic root (SVC-Ao fat pad), superior to the right pulmonary artery, and then project onto two previously noted fat pads at the inferior vena cava–left atrial junction (IVC-LA fat pad) and the right pulmonary vein–atrial junction (RPV fat pad) and to both atria. A few vagal fibers may bypass the SVC-Ao fat pad and go directly to the IVC-LA or RPV fat pad and then innervate the atrial myocardium. Vagal fibers to the sinus and AV nodes also converge at the SVC-Ao fat pad (a few fibers to the sinus node go directly to the RPV fat pad) before projecting to the RPV and IVC-LA fat pads. Long-term vagal denervation of the atria and sinus and AV nodes can be produced by RFCA of these fat pads and results in vagal denervation supersensitivity. Vagal denervation prevents induction of atrial fibrillation in this model. Conclusions The newly described SVC-Ao fat pad receives most of the vagal fibers to the atria and sinus and AV nodes. Elimination of the fat pads with RFCA selectively vagally denervated the atria and sinus and AV nodes.
Type II Diabetes and Cognitive Function: A population-based study of Native Americans
Authors: Lynn P Lowe, Daniel Tranel, Robert B Wallace, Thomas K Welty
Journal: Diabetes Care (1994)

OBJECTIVE To explore the relationship between type II diabetes and cognitive function in older Native Americans and to assess the effects of other selected risk factors for cognitive dysfunction on this relationship. RESEARCH DESIGN AND METHODS Cognitive function was assessed in 80 diabetic and 81 nondiabetic Native Americans who were 45–76 years of age in a cross-sectional population-based sub-study of the Strong Heart Study. Thirteen cognitive function tests were administered during a personal interview. Information about six other risk factors for cognitive dysfunction, including depressive symptoms, physical function, alcoholism, current alcohol use, hypertension, and myocardial infarction, was ascertained from interviews andfrom abstraction of medical records. RESULTS Diabetes was associated with impairment on only two tests of cognitive function: verbal fluency (P = 0.004) and similarities (P = 0.010). Depressive symptoms were related to verbal fluency (P = 0.004), but did not explain thediabetes-related difference in performance. The effects of hypertension, depressive symptoms, and current alcohol use explained the diabetes-related performance difference on similarities. Cognitive function was not related to metabolic control (HbA1c level). CONCLUSIONS We found little evidence that type II diabetes in this population of Native Americans is associated with decrement in cognitive function. Some of the cognitive impairment previously attributed to diabetes may be related, at least in part, to the influence of other risk factors. This should be considered in the design of future studies in other populations.
Assuring the quality of diagnostic tests
Authors: M. Wilcox
Journal: BMJ (2013)

How do we know that they do what we think they do?

A linked investigation by Cohen and Swift (doi:10.1136/bmj.f837) clearly shows that the system for regulating the quality of in vitro diagnostic medical devices is fallible.1 The term in vitro diagnostic medical device (IVD) refers to any reagent, reagent product, calibrator, control material, kit, instrument, apparatus, equipment, or system used for the in vitro examination of human specimens. These devices underpin most medical diagnoses, so the consequences of using suboptimal products could be far reaching. 

It is perhaps surprising, then, that to be marketed across Europe most IVDs require the manufacturer just to self declare that the product complies with the essential requirements of relevant European laws. Once marketed, the manufacturer has a clear responsibility to ensure that the product performs as declared. If this is in doubt, then a regulator (in the United Kingdom, the Medicines and Healthcare Products Regulatory Agency) should be informed. Cohen and Swift’s investigation shows that a system of regulating the quality of these devices that is based on trust can be undermined, especially when there is no systematic safety net to identify poor test performance. There is no evidence to suggest that many devices are flawed, but it is clear that some yield results with suboptimal clinical usefulness.2 3

CE marking is a manufacturer’s declaration that a product complies with the essential requirements of relevant European laws, permitting marketing across 30 countries. The letters …
Congenital Deformity of Ribs
Authors: J. D. H. Bird
Journal: BMJ (1944)

Pathological Report.-"The tumour has a structure superficially resembling an adenomatous polyp but in many areas showing dis- orderliness suggestive of adenocarcinomatous transformation.The epithelial cells in many parts' are distinctly hyperchromatic and have an anaplastic appearance.In some areas the dema'rcation between epithelial cells and the supporting connective-tissue framework is disorderly, and there is in parts a heavy infiltration of inflammatory cells.On the whole the appearance is suggestive of a low degree of malignancy."* Case 2.-A girl aged 16, a shop-assistant and daughter of the above, was admitted to Llandough Hospital on Feb. 3, 1943, with a history of abdominal pain and vomiting for about 24 hours, the bowel action being normal.On examination the temperature was 100' and the pulse rate 126 a minute.There was marked tenderness around the umbilicus and in the right iliac fossa, but no mass was palpable.Immediate laparotomy was performed (D.B. E. F.); this revealed an ileo-ileal intussusceptioni.Reduction by the usual technique'was attempted, but the intussuscipiens then split for about 4 in.In view of this, enterectomy was performed and approximately 14 in. of gut was removed and continuity re-established by end-to-end anastomosis.Post-operative progress was satisfactory, and a year later she is symptomless.
SUGGESTIONS ON THE MANAGEMENT OF BRISME FORCE OF THE KNEE.
Authors: CHAS. F. STILLMAN
Journal: JAMA (1884)

It must first be decided that the ankylosis is fibrous, and these suggestions are only applicable to such cases as are distinctly of that character. If inflammation is present to any great degree in or about the joint, the operation is contra-indicated; but there are very few cases which do not exhibit some slight existing sub-acute inflammatory state in some parts of the osseo-ligamentous structures constituting the joint. This is sometimes sufficient to give rise to reflex contractions of the muscles governing the joint, and one authority states that the indication for dividing the tendons of these muscles, as an adjunct to the operation of brismé forcé, is the reflex spasm exhibited when the tendons are pressed upon. There are not many cases, however, where tenotomy is really necessary, if the muscular contraction be merely reflex, and not due to actual shortening of the muscular structure. It may be subdued
Routine testicular self examination: it's time to stop
Authors: Keith Hopcroft
Journal: BMJ (2012)

What do Robbie Williams and the Leicester Tigers rugby team have in common? Answer: testicles. Plenty of them. Enough cojones, in fact, to be leading lights in testicle cancer awareness.1 2 And they’re not alone. We are regularly bombarded by celebrity exhortations to be “testicle aware,” typically via some attention (and testicle) grabbing stunt.3

The specific message that cancer charities and men’s health tub thumpers ram home is that any self respecting bloke should regularly examine his testicles. Or grope his gonads. Or caress his crown jewels. Or whatever the prevailing vernacular might be—so long as it sounds non-threatening and wacky.

It’s easy for the profession and the public to get carried away with earnest health promotion dressed up as fun and assume that routine testicular self examination is self evidently A Good Thing. The trouble is, it isn’t. It’s an activity based purely on well meaning whimsy, with the potential to do harm.

There is no good evidence that routine testicular self examination is of any benefit.4 5 6 Nor will there ever be: a study of adequate power would require millions of men, simply because testicular cancer is so rare.4 This fact is distorted by all the well meaning evangelism—few consumers of men’s health media would realise, for example, that the average …
Factors Related to Glycemic Control in IDDM and Insulin-Treated NIDDM Patients in Current Practice: A comparison of care policies
Authors: Maria Paola Garancini, Giuseppe Gallus, Domenico Cucinotta, Andrea Rossi, Gabriele Riccardi
Journal: Diabetes Care (1997)

To evaluate, under routine conditions, the relation between different diabetes care policies and glycemic control through a by-center analysis procedure aimed at reducing some drawbacks of cross-sectional data.A survey on insulin-treated diabetes care management (IDDM and NIDDM) involved 16 Italian randomly selected diabetes outpatient clinics. A total of 2,142 representative patients were investigated. The standardized HbA1c average value of each center was related, by regression models, to some indicators of center care policy (average number of injections, average BMI, proportion of cases with recent fundus oculi examinations, or frequent visits) as well as to patients' average social levels (employment type). Homogeneity in patient admission criteria is assumed among the investigated centers as a basic condition for the procedure validity. Some known imbalance were controlled for both design and analysis.HbA1c showed a univariate inverse relation with daily number of injections in IDDM (P = 0.0009, r2 = 0.56) but not in NIDDM (P = 0.33). It was inversely related to both fundus examination (IDDM P = 0.04; NIDDM P = 0.099) and qualified employment (IDDM P = 0.06; NIDDM P = 0.026). A stepwise regression analysis left in the model insulin injections (P = 0.0002) in IDDM (total r2 = 0.68) and qualified employment (P = 0.016) and fundus examination (P = 0.14) in NIDDM (total r2 = 0.53), after controlling for age, sex, disease duration, insulin therapy starting delay, and insulin dose per kilogram.These results suggest that the confirmed benefits of a multiple-injection regimen in IDDM cannot be simply extrapolated to NIDDM, where patients' awareness and medical attention to complications proved to be the most important factors in current practice.
Metabolic pathways of carcinogenic chromium.
Authors: Elena Gaggelli, Francesco Berti, Nicola D'Amelio, Nicola Gaggelli, Gianni Valensin, Lucia Bovalini, Alessandro Paffetti, Lorenza Trabalzini
Journal: Environmental Health Perspectives (2002)

The products of hexavalent chromium [Cr(VI)] reduction by glutathione (GSH) alone or in the presence of equimolar quantities of aspartate (Asp) and/or glutamate (Glu) and a chromium-containing material extracted from bovine liver were studied by ultraviolet-visible spectrum (UV-vis) studies, electrospray mass spectrometry (ES-MS), electron paramagnetic resonance (EPR), and nuclear magnetic resonance (NMR). Reduction of chromate by GSH was followed by UV-vis and NMR, revealing the formation of a paramagnetic complex in which GSH acts as a ligand. ES-MS and EPR measurements provided unequivocal evidence of a dimeric Cr(V)(2)GSH(2) species in which the two metal ions are bridged by the Gamma-Glu carboxylate. The analysis of the (1)H and (13)C shifts experienced by GSH protons and the values of paramagnetic contributions to proton spin-lattice relaxation rates provided a set of constraints for structural determination. The same experiments were repeated in the presence of an equimolar concentration of Asp, revealing the formation of a dimeric Cr(V) paramagnetic complex in which the two metals are now bridged by Asp. Nuclear magnetic resonance dispersion profiles show that water is not displaced by Asp and that the correlation time of this complex is slowed by the increased complexity. When Glu is also included in the solution in equimolar concentration to GSH and Asp, data are consistent with the formation of many mono- and dinuclear species, with the three ligands competing with each other. Finally, the spectroscopic investigation of the chromium-containing material extracted from bovine liver revealed the presence of a complicate mixture of Cr(IV) or Cr(V) complexes, among which some Cr(V)-GSH species are present alone or with other ligands in the metal coordination sphere.
Lucid Dreaming Treatment for Nightmares: A Pilot Study
Authors: Victor I. Spoormaker, Jan van den Bout
Journal: Psychotherapy and Psychosomatics (2006)

&lt;i&gt;Background:&lt;/i&gt; The goal of this pilot study was to evaluate the effects of the cognitive-restructuring technique ‘lucid dreaming treatment’ (LDT) on chronic nightmares. Becoming lucid (realizing that one is dreaming) during a nightmare allows one to alter the nightmare storyline during the nightmare itself. &lt;i&gt;Methods:&lt;/i&gt; After having filled out a sleep and a posttraumatic stress disorder questionnaire, 23 nightmare sufferers were randomly divided into 3 groups; 8 participants received one 2-hour individual LDT session, 8 participants received one 2-hour group LDT session, and 7 participants were placed on the waiting list. LDT consisted of exposure, mastery, and lucidity exercises. Participants filled out the same questionnaires 12 weeks after the intervention (follow-up). &lt;i&gt;Results:&lt;/i&gt; At follow-up the nightmare frequency of both treatment groups had decreased. There were no significant changes in sleep quality and posttraumatic stress disorder symptom severity. Lucidity was not necessary for a reduction in nightmare frequency. &lt;i&gt;Conclusions:&lt;/i&gt; LDT seems effective in reducing nightmare frequency, although the primary therapeutic component (i.e. exposure, mastery, or lucidity) remains unclear.
Hematopoietic Stem Cell Mobilization Therapy Accelerates Recovery of Renal Function Independent of Stem Cell Contribution
Authors: Geurt Stokman, Jaklien C. Leemans, Nike Claessen, Jan J. Weening, Sandrine Florquin
Journal: Journal of the American Society of Nephrology (2005)

Acute renal failure and tubular cell loss as a result of ischemia constitute major challenges in renal pathophysiology. Increasing evidence suggests important roles for bone marrow stem cells in the regeneration of renal tissue after injury. This study investigated whether the enhanced availability of hematopoietic stem cells, induced by stem cell factor and granulocyte colony-stimulating factor, to the injured kidney provides an adequate strategy for stem cell-based therapy to counteract renal ischemia/reperfusion injury. It is interesting that cytokine treatment before injury resulted in significant enhancement of function recovery of the kidney. This, however, was not due to increased incorporation of tubular epithelial cells from bone marrow origin. Importantly, cytokine treatment resulted in impaired influx of granulocytes into the injured kidney. Although cytokine treatment improved renal function rapidly after ischemic injury, the results show that the underlying mechanism likely is not based on stem cell transdifferentiation but rather on altered inflammatory kinetics.
External Validation of the Mayo Clinic Stage, Size, Grade, and Necrosis (SSIGN) Score for Clear-Cell Renal Cell Carcinoma in a Single European Centre Applying Routine Pathology
Authors: Richard Zigeuner, Georg Hutterer, Thomas Chromecki, Arvin Imamovic, Karin Kampel-Kettner, Peter Rehak, Cord Langner, Karl Pummer
Journal: European Urology (2008)