tbuckley/cabot-search huggingface dataset:
Stress-Induced Immunomodulation
Authors: Ronald Glaser, Bruce Rabin, Margaret Chesney, Sheldon Cohen, Benjamin Natelson
Journal: JAMA (1999)

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Aspirin induced asthma
Authors: Robert D Southward
Journal: BMJ (2004)

Response to radiation incidents and radionuclear threatsMedical treatment should be given only when safe to do so Editor-Turai et al reviewed the medical response to radiation incidents and radionuclear threats. 1 Puzzlingly, they say that providing care for a patient in a life threatening condition always has priority over decontamination from radioactive materials or those actions required for the safety of others involved (medical staff, emergency rescue teams) or related to the wider public and environment. 1I disagree.This statement will encourage inexperienced staff to disregard the safety of themselves and others in a "heroic" attempt to treat those ill and injured.The latest edition of the Major Incident Medical Management and Support Course rightly emphasises self and scene safety over that of survivors. 2Experience has shown again and again that well meaning but poorly trained or equipped rescue and medical staff are highly likely to become further victims. 3As an example, the article points out that some of the 28 radiation deaths from the Chernobyl disaster of 1986 were among fire fighters.Medical treatment should be given only when it is safe to do so: poorly considered and risky actions will simply lengthen the list of casualties.
Combination chemotherapy in rheumatoid arthritis
Authors: G R Struthers
Journal: Annals of the Rheumatic Diseases (1986)

Synovial amyloid deposits and chronic haemodialysis SIR, In their recent paper Mufioz-Gomez et al' suggested that localised synovial amyloidosis might be peculiar to chronic renal failure treated with periodical haemodialysis, and they made the assumption that it was the cause of an arthropathy.In fact localised amyloid deposition in synovium and also in articular cartilage is a common aging phenomenon2 apparently associated with osteoarthrosis, and it is relevant that four of the seven patients studied were aged 50 years or more.This type of aging deposit was actually referred to in the preceding editorial as 'joint capsule and articular cartilage' deposition.]The nature and extent of synovial amyloid deposits described in the article did not appear to differ from those associated with aging, and I would suggest that the finding of such deposits may represent no more than an accelerated age change.It is of interest in this context that synovial and articular cartilage amyloid deposits in patients with the so called amyloid arthropathy syndrome of multiple myeloma and primary amyloidosis do not appear to differ qualitatively from aging deposits either.4Such patients may, however, show gross soft tissue amyloid deposition around joints.The finding of synovial amyloid deposits in chronic haemodialysis patients may be unrelated to any arthropathy present and should not prevent other causes for an arthropathy from being sought.
Controlled trial of mobilisation and manipulation for patients with low back pain in general practice.
Authors: H Sims-Williams, M I Jayson, S M Young, H Baddeley, E Collins
Journal: BMJ (1978)

Ninety-four patients with non-specific lumbar pain who were seen by their general practitioners took part in a double-blind controlled trial to compare mobilisation and manipulation with placebo physiotherapy. Immediately after treatment most patients showed improvements in the various features studied, but for several features improvement was more common in the treated group than the controls. At three months the condition of most patients was still improved but the differences between the two groups had largely disappeared. At one year the groups were identical. Prognostic presenting features were sought, but only a shorter history correlated with clinical improvement. This study indicates the high rate of spontaneous resolution of low back pain. A course of mobilisation and manipulation may hasten improvement but does not affect the long-term prognosis.
Alternate-Day Steroid Therapy for Renal Transplant Patients-Reply
Authors: Jacob Lemann
Journal: JAMA (1981)

<h3>In Reply.—</h3> Wohlman et al believe that maintenance-level AD steroid therapy (eg, prednisone, 25 to 30 mg every other day) is a "safe and sound" method of treatment of renal allograft recipients when renal function has stabilized after the transplant. Thus, their names, along with ours, can be added to the long list of investigators who have reported a favorable experience with most renal transplant recipients who receive AD steroid therapy. Unfortunately, despite the abundance of favorable testimony, none of us has answered the critical question: in the long-term management of the renal transplant recipient, is the risk-benefit ratio of maintenance-level AD steroid therapy substantially different from that of maintenance-level daily steroid therapy? That is, from existing data, it is not clear whether maintenancelevel AD day steroid therapy preserves renal function as well as maintenance-level daily steroid therapy, and, if it does not, is this disadvantage offset by important reductions
Dementia patient's euthanasia was lawful, say Dutch authorities
Authors: T. Sheldon
Journal: BMJ (2011)

AIM: To investigate the presence of human papillomavirus (HPV) DNA in adenosquamous carcinoma of the lung--which is relatively common in Okinawa but not in mainland Japan--and examine its histological features. METHODS: Of 207 cases where primary lung cancers were surgically removed between January 1995 and June 1997 in Okinawa, 23 were adenosquamous carcinoma. HPV was detected by non-isotopic in situ hybridisation (NISH) and polymerase chain reaction (PCR) amplification with primers specific for E6 and E7 regions of the HPV genome. PCR products were analysed by Southern blotting. Immunohistochemical determination of high molecular weight cytokeratin (HMC) and involucrin was also carried out. RESULTS: 18 cases were positive for HPV DNA by PCR and NISH. HPV types 6, 11, 16, and 18 were found. Seven cases were dual positive for different types of HPV. Using NISH, HPV was also found in the squamous cell components and in neighbouring enlarged adenocarcinoma cells. The HMC and involucrin were demonstrated immunohistochemically in the same areas. CONCLUSIONS: HPV DNA was found in a high proportion (78.3%) of adenosquamous carcinomas in Okinawa, a region where HPV has previously been shown to be prevalent in squamous cell carcinoma of the lung. The adenocarcinoma cells adjacent to the squamous cell carcinoma component were enlarged and positive for HPV, HMC, and involucrin. This is thought to indicate the transition from adenocarcinoma to squamous cell carcinoma.
Intracellular lactate- and pyruvate-interconversion rates are increased in muscle tissue of non-insulin-dependent diabetic individuals.
Authors: A Avogaro, G Toffolo, M Miola, A Valerio, A Tiengo, C Cobelli, S Del Prato
Journal: Journal of Clinical Investigation (1996)

The contribution of muscle tissues of non-insulin-dependent diabetes mellitus (NIDDM) patients to blood lactate appearance remains undefined. To gain insight on intracellular pyruvate/lactate metabolism, the postabsorptive forearm metabolism of glucose, lactate, FFA, and ketone bodies (KB) was assessed in seven obese non-insulin-dependent diabetic patients (BMI = 28.0 +/- 0.5 kg/m2) and seven control individuals (BMI = 24.8 +/- 0.5 kg/m2) by using arteriovenous balance across forearm tissues along with continuous infusion of [3-13C1]-lactate and indirect calorimetry. Fasting plasma concentrations of glucose (10.0 +/- 0.3 vs. 4.7 +/- 0.2 mmol/liter), insulin (68 +/- 5 vs. 43 +/- 6 pmol/liter), FFA (0.57 +/- 0.02 vs. 0.51 +/- 0.02 mmol/liter), and blood levels of lactate (1.05 +/- 0.04 vs. 0.60 +/- 0.06 mmol/liter), and KB (0.48 +/- 0.04 vs. 0.29 +/- 0.02 mmol/liter) were higher in NIDDM patients (P < 0.01). Forearm glucose uptake was similar in the two groups (10.3 +/- 1.4 vs. 9.6 +/ 1.1 micromol/min/liter of forearm tissue), while KB uptake was twice as much in NIDDM patients as compared to control subjects. Lactate balance was only slightly increased in NIDDM patients (5.6 +/- 1.4 vs. 3.3 +/- 1.0 micromol/min/liter; P = NS). A two-compartment model of lactate and pyruvate kinetics in the forearm tissue was used to dissect out the rates of lactate to pyruvate and pyruvate to lactate interconversions. In spite of minor differences in the lactate balance, a fourfold increase in both lactate- (44.8 +/- 9.0 vs. 12.6 +/- 4.6 micromol/min/liter) and pyruvate-(50.4 +/- 9.8 vs. 16.0 +/- 5.0 micromol/min/liter) interconversion rates (both P < 0.01) were found. Whole body lactate turnover, assessed by using the classic isotope dilution principle, was higher in NIDDM individuals (46 +/- 9 vs. 21 +/- 3 micromol/min/kg; P < 0.01). Insights into the physiological meaning of this parameter were obtained by using a whole body noncompartmental model of lactate/pyruvate kinetics which provides a lower and upper bound for total lactate and pyruvate turnover (NIDDM = 46 +/- 9 vs. 108 +/- 31; controls = 21 +/- 3 - 50 +/-13 micromol/min/kg). In conclusion, in the postabsorptive state, despite a trivial lactate release by muscle, lactate- and pyruvate-interconversion rates are greatly enhanced in NIDDM patients, possibly due to concomitant impairment in the oxidative pathway of glucose metabolism. This finding strongly suggest a major disturbance in intracellular lactate/pyruvate metabolism in NIDDM.
The Carbonate Affair — Is Calcium Indictable?
Authors: Robert F. Barreras
Journal: New England Journal of Medicine (1973)

It is always distressing to hear that a trusted friend has been up to mischief. At first we try to deny the allegations — we demand rigorous proof of malfeasance and perhaps attempt to rationalize it away. If the evidence persists we may be pushed to remove him from his position of trust. However, before removing him, we must consider the alternates for his post — are they as capable as he, and are they beyond reproach? Having gone this far, and if our loyalty persists, we may accept the limits that his mischief imposes and attempt to put his . . .
Alice Hamilton, M.D., and Women's Welfare
Authors: Jacqueline Karnell Corn
Journal: New England Journal of Medicine (1976)

On the basis of her contributions to industrial medicine Dr. Alice Hamilton was an extraordinary woman of her generation. If one considers her involvements with issues concerning the social welfare of women, her status increases to an even greater degree. Perhaps the stand that Alice Hamilton took in the early part of the 20th century to preserve existing protective labor legislation for women best illustrates her commitment to, and involvement with, issues of importance to women.In the third decade of the 20th century the National Woman's Party sponsored an Equal Rights Amendment to the Constitution. The Woman's Party believed . . .
Hepatis C Virus: A Giant Leap Forward
Authors: Arie J. Zuckerman
Journal: Hepatology (1990)

A random–primed complementary DNA library was constructed from plasma containing the uncharacterized non–A, non–B hepatitis (NANBH) agent and screened with serum from a patient diagnosed with NANBH. A complementary DNA clone was isolated that was shown to encode an antigen associated specifically with NANBH infections. This clone is not derived from host DNA but from an RNA molecule present in NANBH infections that consists of at least 10,000 nucleotides and that is positive–stranded with respect to the encoded NANBH antigen. These data indicate that this clone is derived from the genome of the NANBH agent and are consistent with the agent being similar to the togaviridae or flaviviridae. This molecular approach should be of great value in the isolation and characterization of other unidentified infectious agents. A specific assay has been developed for a blood–borne non–A, non–B hepatitis (NANBH) virus in which a polypeptide synthesized in recombinant yeast clones of the hepatitis C virus (HCV) is used to capture circulating viral antibodies. HCV antibodies were detected in six of seven human sera that were shown previously to transmit NANBH to chimpanzees. Assays of ten blood transfusions in the United States that resulted in chronic NANBH revealed that there was at least one positive blood donor in nine of these cases and that all ten recipients seroconverted during their illnesses. About 80 percent of chronic, post–transfusion NANBH (PT–NANBH) patients from Italy and Japan had circulating HCV antibody; a much lower frequency (15 percent) was observed in acute, resolving infections. In addition, 58 percent of NANBH patients from the United States with no identifiable source of parenteral exposure to the virus were also positive for HCV antibody. These data indicate that HCV is a major cause of NANBH throughout the world.
Autumn Books: Men of influence
Authors: R. Schilling
Journal: BMJ (1986)

Major Greenwood's career culminated in his appointment to the first chair of epidemiology and vital statistics at the London School of Hygiene in the 1930s.Those who knew him and experienced the exceptionally high quality of his lectures and his entertaining conversation, often tinged with sardonic wit, would be moved to read and possess this elegant edition of a true medical classic.There are few left who knew Greenwood, but this work, in spite of
Phase I clinical study of intratumoral injection of Clostridium novyi-NT spores in patients with advanced cancer
Authors: F. Janku, M. Gounder, R. Murthy, C. Rudin, T. Helgason, D. Hong, R. Benjamin, L. Meyer, R. Zinner, F. Meric-Bernstam, T. Masters
Journal: Annals of Oncology (2015)
Mathematical modeling of liver injury and dysfunction after acetaminophen overdose: Early discrimination between survival and death
Authors: Christopher H. Remien, Frederick R. Adler, Lindsey Waddoups, Terry D. Box, Norman L. Sussman
Journal: Hepatology (2012)

Acetaminophen (APAP) is the leading cause of acute liver injury in the developed world. Timely administration of N-acetylcysteine (N-Ac) prevents the progression of serious liver injury and disease, whereas failure to administer N-Ac within a critical time frame allows disease progression and in the most severe cases may result in liver failure or death. In this situation, liver transplantation may be the only life-saving measure. Thus, the outcome of an APAP overdose depends on the size of the overdose and the time to first administration of N-Ac. We developed a system of differential equations to describe acute liver injury due to APAP overdose. The Model for Acetaminophen-induced Liver Damage (MALD) uses a patient's aspartate aminotransferase (AST), alanine aminotransferase (ALT), and international normalized ratio (INR) measurements on admission to estimate overdose amount, time elapsed since overdose, and outcome. The mathematical model was then tested on 53 patients from the University of Utah. With the addition of serum creatinine, eventual death was predicted with 100% sensitivity, 91% specificity, 67% positive predictive value (PPV), and 100% negative predictive value (NPV) in this retrospective study. Using only initial AST, ALT, and INR measurements, the model accurately predicted subsequent laboratory values for the majority of individual patients. This is the first dynamical rather than statistical approach to determine poor prognosis in patients with life-threatening liver disease due to APAP overdose.MALD provides a method to estimate overdose amount, time elapsed since overdose, and outcome from patient laboratory values commonly available on admission in cases of acute liver failure due to APAP overdose and should be validated in multicenter prospective evaluation.
Remarks upon the Section of Mental Diseases in the New Nomenclature of the Royal College of Physicians
Authors: H. Sutherland
Journal: BMJ (1885)

Of the mortality froir' rganiv diseas0s; thit fhi tlgdiseg'es-df the nervous system, organs of respiratio, and urinary organs, is-'on the increase; that from the diseases oft.digestive :organs is on the decline; aid that from the diseases of t} circtdatory system and organs of generation is stationary.The mortality from hydroeephalus, 1which is almost exclusivelytcon- fined to children under 10, is rapidly'diminishing.That from child- birth and metria is also diainishin .But this decline is especially, notable in-England and Wales, demoir g the improvement in the practice of midwifery in the c9untr y, for the death-rate has fallen from 320 per million in the first decade, to-15 in tho third decade.The deaths from violence and sudicides do not call for any special ob-: servation here.The mortility from o:ther causes-a heading very indefinite in its significatiea-has for its chief contributor deaths frorm unknown causes.This largely-meanp unqualified medical practice.. The,figures from 'this source are higher in the 'table for England; and Wales than in 'that for Loidon.I% is encouraging t think that this source of discrepancy is on the decline; but it still forms a heavy mor- tality, causing a serious drawback in the vital statistics.Had the promoters of the Medizal Bill devoted more energy to check unqualified practice in this country, they wpuld have rendered q mre, widely felt public service, and protected the poor and uneaucated classes from quacks and impostors.
Indomethacin and perforated duodenal ulcer.
Authors: M R Thompson, A F Morris, A O Hughes
Journal: BMJ (1980)

recently taken drugs that are known to induce liver enyzmes, and at present this must include recent exposure to enflurane.8If for repeated anaesthesia one substitutes enflurane for halothane one may be replacing the rare case of hepatic disease with the perhaps more common case of renal failure.
Neuropsychological Complications of IDDM in Children 2 Years After Disease Onset
Authors: Elisabeth A Northam, Peter J Anderson, George A Werther, Garry L Warne, Robert G Adler, David Andrewes
Journal: Diabetes Care (1998)

OBJECTIVE To compare the neuropsychological profiles of children with IDDM with a community control group at two time points: 3 months after disease onset and 2 years after the baseline assessment. RESEARCH DESIGN AND METHODS A total of 123 children (age 3–14 years) with recent IDDM onset were compared with 129 community control subjects, stratified for age and sex, on standardized measures of general intelligence, attention, speed of processing, memory, learning, executive skills, and behavioral adjustment soon after diagnosis and 2 years later. Exclusion criteria were premorbid evidence of central nervous system disease or trauma, or English not spoken in the home. RESULTS There were no differences between children with IDDM and control subjects on any measure at the initial assessment 3 months after disease onset. Two years later, children with IDDM tended to show a less positive change, relative to control subjects, in their standardized scores on measures of general intelligence, and significantly so on the vocabulary (P &amp;lt; 0.01) and block design (P &amp;lt; 0.05) subtests. Multivariate group differences were also apparent on speed of processing (P &amp;lt; 0.05) and learning (P &amp;lt; 0.01) subtests, reflecting smaller developmental gains in the children with IDDM when compared with control subjects. CONCLUSIONS The findings are consistent with previous reports, suggesting that IDDM is associated with an increased risk of mild neuropsychological dysfunction. The skills most affected in this cohort were information processing speed, acquisition of new knowledge, and conceptual reasoning abilities. Clinicians and educators should be made aware of the risk of specific neuropsychological deficits in children with IDDM.
Exaggeration of neointimal formation associated with the critical segment in bare metal stenting
Authors: Mamoo Nakamura, Toru Kataoka, Tadanori Aizawa, Hideo Tamai, Katsuhiro Kitamura, Lutz Bullesfeld, Yasuhiro Honda, Paul G. Yock, Peter J. Fitzgerald
Journal: Journal of the American College of Cardiology (2003)
Research misconduct in the UK
Authors: F. Godlee, E. Wager
Journal: BMJ (2012)

Time to act

Research misconduct can harm patients, distort the evidence base, misdirect research effort, waste funds, and damage public trust in science. Countries all over the developed world are now recognising the need to set up systems to deter, detect, and investigate research misconduct. Why does the United Kingdom have no plans to do the same?

As Aniket Tavare outlines in the linked feature (doi:10.1136/bmj.d8212),1 high profile cases of misconduct have led the United States, Canada, Sweden, Norway, and Poland, among others, to create formal mechanisms for overseeing research integrity. In most countries responsibility lies with the institutions, but oversight varies greatly, and it is unclear which systems are most effective and efficient. None is perfect—the remit of the US Office of Research Integrity is limited to publicly funded health research; Australia’s recently established Research Integrity Committee is already being criticised for lacking teeth. But each system shows that the problem has been acknowledged, that institutions accept primary responsibility, and that governments and funders are seriously committed to tackling misconduct openly and with a range of statutory powers.

In contrast, the UK has no official national body. The UK Research Integrity Office was established in 2006 and has done some useful things. But its function has always been advisory, and now that the major funders represented by Research Councils UK (RCUK) have decided not to continue the funding, it relies on voluntary funding from institutions. The Research Integrity Futures Working Group, set up by RCUK and Universities UK (UUK) and other bodies, has also apparently come to nothing. The working group’s report commissioned in 2009 called for an independent advisory body, …
Possible Dangers of Naloxone Use
Authors: M. A. Gilman
Journal: JAMA (1982)

<h3>To the Editor.—</h3> The statement by Kulig et al (1982;247:1697) that "In any case Naloxone, along with dextrose, should be administered to all unconscious patients, regardless of suspected cause of coma" should not go unchallenged. Naloxone is a most valuable tool if used in the correct context, but it may well have untoward effects that could become more frequently seen if the advice of Kulig et al is taken at face value. Andree<sup>1</sup>mentioned that naloxone has been implicated in causing ventricular fibrillation in patients suffering from hypertension and acute pulmonary edema. He then described two normotensive patients who died almost certainly as a result of the use of naloxone to reverse the effects of anesthesia. There have been a number of other reports citing the hypertensive effects of naloxone since the original report by Tanaka.<sup>2</sup> Therefore, it would be more prudent to assess the patient's condition most