tbuckley/cabot-search huggingface dataset:
The prejudices of good people
Authors: Aneez Esmail
Journal: BMJ (2004)

Leadership is needed to combat continued institutional racism 

> If it is only bad people who are prejudiced, that would not have such a strong effect.Most people would not wish to imitate them—and so, such prejudices would not have much effect—except in exceptional times. It is the prejudices of good people that are so dangerous.

Vikram Seth. A suitable boy . London: Phoenix, 1993.

In October 1998 a young black man, David “Rocky” Bennett, died while under the care of the NHS at a psychiatric secure unit in Norwich. An inquiry team led by a retired high court judge, John Blofeld, found that Mr Bennett, who had schizophrenia, was killed by being held face down on the floor for 28 minutes by at least four mental health nurses. He had been restrained with unacceptable force after he punched a nurse, believing that he was being racially victimised. Apart from investigating the circumstances of Mr Bennett's death, the inquiry team looked more broadly at the way in which black and ethnic minority communities are treated by the mental health services of the NHS. Blofeld concluded that people from black and ethnic minority communities are not getting the service they are entitled to. He described the institutional racism that was responsible for this as a “disgrace” and a “festering abscess which is at present a blot upon the good name of the NHS.”1

The term “institutional racism” was defined in 1999 by another retired high court judge, William Macpherson, in …
Papillary Muscle Displacement Causes Systolic Anterior Motion of the Mitral Valve
Authors: Robert A. Levine, Gus J. Vlahakes, Xavier Lefebvre, J. Luis Guerrero, Edward G. Cape, Ajit P. Yoganathan, Arthur E. Weyman
Journal: Circulation (1995)

Background Systolic anterior motion (SAM) of the mitral valve in hypertrophic cardiomyopathy (HCM) has generally been explained by a Venturi effect related to septal hypertrophy, causing outflow tract narrowing and high velocities. Patients with HCM, however, also have primary abnormalities of the mitral apparatus, including anterior and inward or central displacement of the papillary muscles, and leaflet elongation. These findings have led to the hypothesis that changes in the mitral apparatus can be a primary cause of SAM by altering the forces acting on the mitral valve and its ability to move in response to them. Despite suggestive observations, however, it has never been prospectively demonstrated that such changes can actually cause SAM. Methods and Results To test this hypothesis in vivo, anterior papillary muscle displacement was created in 7 dogs studied by echocardiography, with controlled cardiac output and heart rate. In all 7 dogs, papillary muscle displacement caused SAM, with an outflow tract gradient (33±19 mm Hg) and mitral regurgitation in 6. As in patients with HCM, the mitral valve was displaced anteriorly and the coaptation point shifted toward the insertion of the leaflets, creating longer distal residual leaflets that moved anteriorly. Conclusions Primary changes in the mitral apparatus can cause SAM without septal hypertrophy. In this model, SAM appears to be determined by the ability of the leaflets to move anteriorly (papillary muscle displacement causing slack and increased residual leaflet length) and their interposition into the outflow stream by anterior displacement, determining the direction of this motion. Geometric factors observed in HCM and in patients with SAM without HCM can therefore play a primary role in causing SAM.
Intravascular ultrasound assessment of lumen size and wall morphology in normal subjects and patients with coronary artery disease.
Authors: S E Nissen, J C Gurley, C L Grines, D C Booth, R McClure, M Berk, C Fischer, A N DeMaria
Journal: Circulation (1991)

BACKGROUND Necropsy studies demonstrate that coronary artery disease (CAD) is frequently complex and eccentric. However, angiography provides only a silhouette of the vessel lumen. Intravascular ultrasound is a new tomographic imaging method for evaluation of coronary dimensions and wall morphology. Few data exist regarding intravascular ultrasound in patients with CAD, and no data exist for subjects with normal coronaries. METHODS AND RESULTS We used a multielement 5.5F, 20-MHz ultrasound catheter to examine eight normal subjects and 43 patients with CAD. We assessed the safety of coronary ultrasound and the effect of vessel eccentricity on comparison of minimum luminal diameter by angiography and ultrasound. Normal and atherosclerotic wall morphology and stenosis severity were also evaluated by intravascular ultrasound. The only untoward effect was transient coronary spasm in five patients. At 33 sites in normal subjects, the lumen was nearly circular, yielding a close correlation between angiographic and ultrasonic minimum diameter (r = 0.92). At 90 sites in patients with CAD, ultrasound demonstrated a concentric cross section; correlation was also close (r = 0.93). However, at 72 eccentric sites, correlation was not as close (r = 0.77). For 41 stenoses, correlation between angiography and ultrasound for area reduction was moderate (r = 0.63). In normal subjects, wall morphology revealed a thin (0.30 mm or less) intimal leading edge and subadjacent sonolucent zone (0.20 mm or less). Patients with CAD exhibited increased thickness and echogenicity of the leading edge, thickened sonolucent zones, and/or attenuation of ultrasound transmission. CONCLUSIONS These data establish that intravascular ultrasound is feasible and safe and yields luminal measurements that correlate generally with angiography. Differences between angiographic and ultrasound measures of lumen size in eccentric vessels probably reflect the dissimilar perspectives of tomographic and silhouette imaging techniques. Intravascular ultrasound provides detailed images of normal and abnormal wall morphology not previously possible in vivo.
Cost-effectiveness of Interferon Treatment for Hepatitis C
Authors: Eric Henley
Journal: JAMA (1999)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Increase in tuberculosis causes concern to Dutch
Authors: T. Sheldon
Journal: BMJ (1995)

Dutch doctors are concerned that the latest tuberculosis figures suggest that the disease is spreading faster than expected from high risk groups to the general population. Last year cases of tuberculosis in Amsterdam increased by 37%, reaching the highest figure since 1966, according to the tuberculosis prevention department of the city's public health service. Numbers increased by 74% among people born in the Netherlands, compared with an increase of only 20% among people born elsewhere, such …
EDUCATION FOR MEDICINE AND, YEA, FOR LIFE
Authors: Calvin H. Plimpton
Journal: JAMA (1961)

It might be regarded as impertinent for a college president to comment on medical education, but in this instance, medicine was his first love. The transition from one profession to another has thrown medical education into greater perspective and hence sharper focus. This is helpful, for the greater the energy and the greater the accuracy in defining our goals, the more apt we are to approach them. This very process converts a bland and flaccid generalization into a powerful and personal creed. William Ernest Hocking has a story of 2 cities in Iran. They were fierce but equal rivals in all their activities. The ruler of one, however, erected a special building for the citizens of his city and posted a guard to keep out their rivals. In a short while this city began to prosper at a greater rate than its rival. Buildings became more beautiful. Streets were clean
Call for an evidence based debate on assisted dying
Authors: J. Collier
Journal: BMJ (2011)

As members of the steering committee of Healthcare Professionals for Assisted Dying, founded by Ann McPherson,1 we welcome both O’Neill’s and Terry Pratchett’s contributions to the assisted dying debate.2 We believe that an honest and open exploration of the issues surrounding assisted dying is crucial.

We were therefore dismayed by the motion proposed by Yorkshire Regional Council at the BMA annual representatives meeting that criticised the …
Some are more equal than others
Authors: Xiaolei Ze, Fanny Le Mougen, Sylvia H. Duncan, Petra Louis, Harry J. Flint
Journal: Gut Microbes (2013)

The microbial communities found in the mammalian large intestine and rumen efficiently degrade many recalcitrant substrates that are resistant to the host's digestive enzymes. These communities are known from molecular profiling to be highly diverse at the species and strain level, but it may be that only certain specialized organisms ("keystone species") have the ability to initiate degradation of such substrates, thus releasing energy on which the rest of the community depends. We have recently reported that Ruminococcus bromii has a superior ability to degrade certain forms of particulate resistant starch (RS) when compared with other highly abundant species of amylolytic bacteria found in the human colon and have presented evidence that this bacterium provides an example of a keystone species within the microbial community with respect to RS fermentation. The concept of keystone species can be equally relevant to other activities, e.g., those involved in stabilizing the community.
Meigs's Syndrome with Ovarian Carcinoma
Authors: A. L. Deacon
Journal: BMJ (1954)

COMMENTThe patient had been taking two tablets of " veriloid-VP" three times daily after meals for six weeks before ad- mission.The drug had been prescribed for hypertension, first diagnosed five years previously.Each tablet contains 2 mg. of veriloid and 15 mg. of phenobarbitone.On the day of admission she had had her last dose after lunch, and symptoms had occurred when she began her tea.According to Kauntze and Trounce (1951), some patients taking 12 mg. of veriloid daily had toxic symptoms, including a substernal burning sensation (sometimes amounting to pain), salivation, globus or choking sensation, vomiting, coldness and tingling in the finger-tips, hiccup, and collapse.They stated that toxic symptoms are minimized by com- bining the veriloid with phenobarbitone and administering the tablets immediately after meals.In our patient the symptoms were so severe as to simulate myocardial infarction, and continued for several hours, but appeared to be controlled partially by atropine and, more effectively, by ephedrine.In a search of the literature we can find no reference to toxic symptoms so severe and protracted as these with moderate dosage of the drug.Several authors comment on the narrow margin between therapeutic and toxic levels in some patients (Freis et al., 1949; Kauntze and Trounce, 1951), but it is said that the emetic property of the drug precludes serious overdosage.Our patient vomited, but continued to have severe toxic symptoms for several hours.It is therefore clear that vomiting does not always occur in time to prevent very un- desirable effects.We would like to thank Dr.
Poly(ethylene glycol)-block-cationic polylactide nanocomplexes of differing charge density for gene delivery
Authors: Chih-Kuang Chen, Charles H. Jones, Panagiotis Mistriotis, Yun Yu, Xiaoni Ma, Anitha Ravikrishnan, Ming Jiang, Stelios T. Andreadis, Blaine A. Pfeifer, Chong Cheng
Journal: Biomaterials (2013)
Characterization of a soluble suppressor of human B cell immunoglobulin biosynthesis produced by a continuous human suppressor T cell line.
Authors: T A Fleisher, W C Greene, T Uchiyama, C K Goldman, D L Nelson, R M Blaese, T A Waldmann
Journal: The Journal of Experimental Medicine (1981)

A human suppressor T cell maintained in long-term culture with conditioned medium containing interleukin 2 elaborates a suppressor factor(s) that specifically inhibits human polyclonal B cell immunoglobulin biosynthesis. This soluble immune suppressor supernate of immunoglobulin production (CTC-SISS-B) shares a number of features with the previously described suppressive mediator elaborated by concanavalin A-activated human peripheral T cells (SISS-B) including: (a) the inhibition by a noncytotoxic mechanism, (b) the suppression of immunoglobulin biosynthesis either through direct action on the B cell or indirect action via the monocyte, (c) the loss of inhibition in the presence of the monosaccharide L-rhamnose, (d) the elaboration by cells irradiated with 500 ro 2,000 rad, and (e) molecular weights of 60,000--90,000. Furthermore, the suppression by this mediator appears to be specific for B cell immunoglobulin production in that CTC-SISS B has no effect on T cell proliferation to mitogens, antigens, an allogeneic cells or on T cell-mediated cytotoxicity. These data indicate that one possible mechanism of suppressor T cell inhibition of human immunoglobulin production is via the generation of a lectinlike suppressor lymphokine that interacts with defined saccharide determinants on the cell surface of either the B cell or monocyte.
Simple Goiter and Its Variants: Euthyroid and Hyperthyroid Multinodular Goiters*
Authors: HUGO STUDER, FABIO RAMELLI
Journal: Endocrine Reviews (1982)

IN THE past two decades, research on simple goiter has concentrated on the mechanisms which govern the adaptation of the thyroid gland to iodine deficiency. As a result of these investigations, the pathogenesis of goiters induced by shortage of iodine is rather well understood at the present time. The accumulated knowledge has been laid down in a number of easily accessible reviews (1–57). In contrast to previously published work, the present review is devoted to those aspects of simple goiter which have not been explained by the investigations on iodine deficiency. They include structural and functional heterogeneity between single follicles or between different regions of a goiter, the growth of goiters in spite of abundant iodine supply, the development of single and multiple nodules, the pathogenesis of cold and hot follicles, and the pathogenesis of hyperthyroidism in simple goiter. Simple goiter is a slowly developing diffuse or nodular enlargement of the thyroid gland resulting from excessive replication of epithelial cells with subsequent generation of new follicles of widely differing structure and function.
Hypothesis that people with coronary heart disease are living longer is supported
Authors: P S Watson, D C Bensley
Journal: BMJ (1997)

Nicotine replacement therapy should be prescribable on NHSEditor-I welcome the publication of the open letter to the prime minister about tobacco-the most important preventable cause of death in Europe. 1 As Jo E Asvall points out in the letter, tobacco control demands the support of, and action by, the total government, not just the Department of Health.Among the actions Asvall calls for is that "support for smoking cessation is made widely available, particularly through primary health care professionals, including doctors, nurses, pharmacists, and dentists."Nicotine replacement therapy (nicotine gum, patches, nasal spray, and oral inhaler) is now fully established as an effective adjunct to such professional advice and support.Systematic review of many trials has shown a doubling of sustained smoking cessation when nicotine replacement therapy is compared with placebo. 2 The offer of nicotine patches to motivated subjects for a week in the first instance could be a useful policy. 3 But the recommendation of such therapy by health professionals and the use of such therapy by smokers are severely limited by NHS "blacklisting."I can prescribe on the NHS for alcohol problems and even obesity.I can also prescribe for tobacco addiction-but only products of unproved efficacy for this problem, such as tranquillisers and antidepressants, not one of proved effectiveness.Why not nicotine replacement therapy?So much for evidence based medicine.
Festive cheer for all?
Authors: I. R White, M. McKee
Journal: BMJ (1997)

Christmas and alcohol are inextricably linked. But the evidence based party goer has to weigh up a complex body of research. Like smoking, heavy drinking increases the risk of death from many causes. However, as Sir Richard Doll points out on page 1664, there is now convincing evidence that one can reduce one's risk of heart disease by drinking a moderate amount each day in middle and old age.1

For many people the emphasis on cardioprotective effects may bring reassurance, and for some this will be justified. For most people, however, the relevant comparison is not with non-drinkers but with “safe” drinkers.2 From this viewpoint the excess of coronary heart disease deaths in non-drinkers is likely to be smaller than the excess of deaths from other causes in heavy drinkers. Furthermore, media euphoria over the cardioprotective effect obscures …
[267] FUNCTIONAL ANALYSIS OF TELOMERE DYSFUNCTION AND DNA DAMAGE CHECKPOINT ABROGATION DURING HEPATOCARCINOGENESIS
Authors: A. Lechel, Y. Begus, R.R. Plentz, Y.N. Park, M. Roncalli, M.P. Manns, S. Kubicka, K.L. Rudolph
Journal: Journal of Hepatology (2007)
Extremely low-coverage sequencing and imputation increases power for genome-wide association studies
Authors: Bogdan Pasaniuc, Nadin Rohland, Paul J McLaren, Kiran Garimella, Noah Zaitlen, Heng Li, Namrata Gupta, Benjamin M Neale, Mark J Daly, Pamela Sklar, Patrick F Sullivan, Sarah Bergen, Jennifer L Moran, Christina M Hultman, Paul Lichtenstein, Patrik Magnusson, Shaun M Purcell, David W Haas, Liming Liang, Shamil Sunyaev, Nick Patterson, Paul I W de Bakker, David Reich, Alkes L Price
Journal: Nature Genetics (2012)
Incidence of Neuroblastoma After a Screening Program
Authors: Stéphane Barrette, Mark L. Bernstein, Leslie L. Robison, Yvan Samson, Josée Brossard, Sheila Weitzman, William G. Woods
Journal: Journal of Clinical Oncology (2007)

Purpose A significant increase in the incidence of neuroblastoma occurred among a 5-year birth cohort (May 1989 to April 1994) during an active urinary screening program for its early detection. We examined the postscreening incidence of neuroblastoma in the subsequent 5-year birth cohort (May 1994 to April 1999), with follow-up to 2002, to determine whether the incidence remained increased. Patients and Methods We reviewed institutional records of patients diagnosed with neuroblastoma during the period from 1994 to 2002 who were born in 1994 to 1999 in the province of Quebec, as well as in the state of Minnesota and the province of Ontario, regions that had served as controls during the screening interval. We calculated and compared incidence rates during the 1994 to 2002 time period. Results For the 5-year birth cohort as a whole, the rate of newly diagnosed neuroblastoma was higher in Quebec than in the control populations of Minnesota and Ontario (standardized incidence ratio, 1.34; 95% CI, 1.03 to 1.70). However, in years 4 and 5 of the interval, population-based incidence declined to the same levels as those seen in the control areas. Conclusion The institution of a urinary screening program for neuroblastoma led to increased awareness of the diagnosis and an elevated rate of diagnosis even after the completion of the screening evaluation. However, this halo effect was transient, with diagnostic rates subsequently decreasing within the range seen in control populations.
Expression of HLA class II antigens on skin fibroblasts in scleroderma
Authors: M. C. BRANCHET, S. BOISNIC, O. BLeTRY, L. ROBERT, D. CHARRON, C. FRANCeS
Journal: British Journal of Dermatology (1992)

Summary

Skin biopsies were taken from 11 patients with morphoea, nine with acrosclerosis and 10 with diffuse systemic sclerosis and processed for immunohistochemical studies using a panel of monoclonal antibodies including antibodies to MHC class II antigens. A significantly higher percentage of HLA-DR positive dermal cells were observed in the reticular dermis in biopsies from patients with morphoea (44·1 ± 16·2%). acrosclerosis (15·9 ± 5·4%) and systemic sclerosis (39·5 ± 2·3%) when compared with the controls (6·6 ± 2%), A smaller percentage of dermal cells also expressed HLA-DP and -DQ. The degree of mononuclear cell infiltrate in the biopsies, however, did not correlate with the percentage of HLA class II positive fibroblasts. In organ culture, the expression of the HLA class II antigens was almost totally lost after 3 days and was no longer detected on fibroblasts after 3 weeks of culture.
Nephrotic Syndrome in Adult Africans in Nairobi
Authors: R. D. Barr, P. H. Rees, P. E. Cordy, A. Kungu, B. A. Woodger, H. M. Cameron
Journal: BMJ (1972)

The adult nephrotic syndrome as met with in Nairobi is predominantly encountered in young sophisticated African women, most of whom began to use skin-lightening creams containing mercury before the symptomatic onset of their illness. The particular form of mercury involved is well known to cause the nephrotic syndrome in other circumstances-for example, when applied to the skin in the treatment of psoriasis. In these circumstances the pathogenetic mechanism is thought to be of an idiosyncratic type. The use of mercury-containing skin-lightening creams in the patients studied seemed to be particularly associated with a "minimal-change" ("light-negative") renal glomerular lesion, this lesion being present in half of the patients. The prognosis in this group of patients seems remarkably good, with 50% entering remission, 77% of these doing so spontaneously on discontinuing the use of the creams.