tbuckley/cabot-search huggingface dataset:
Ratio measures in leading medical journals: structured review of accessibility of underlying absolute risks
Authors: Lisa M Schwartz, Steven Woloshin, Evan L Dvorin, H Gilbert Welch
Journal: BMJ (2006)

<b>Objective</b> To examine the accessibility of absolute risk in articles reporting ratio measures in leading medical journals. <b>Design</b> Structured review of abstracts presenting ratio measures. <b>Setting </b> Articles published between 1 June 2003 and 1 May 2004 in <i>Annals of Internal Medicine</i>, <i>BMJ</i>, <i>Journal of the American Medical Association</i>, <i>Journal of the National Cancer Institute</i>, <i>Lancet</i>, and <i>New England Journal of Medicine</i>. <b>Participants</b> 222 articles based on study designs in which absolute risks were directly calculable (61 randomised trials, 161 cohort studies). <b>Main outcome measure</b> Accessibility of the absolute risks underlying the first ratio measure in the abstract. <b>Results</b> 68% of articles (150/222) failed to report the underlying absolute risks for the first ratio measure in the abstract (range 55−81% across the journals). Among these articles, about half did report the underlying absolute risks elsewhere in the article (text, table, or figure) but half did not report them anywhere. Absolute risks were more likely to be reported in the abstract for randomised trials compared with cohort studies (62% <i>v</i> 21%; relative risk 3.0, 95% confidence interval 2.1 to 4.2) and for studies reporting crude compared with adjusted ratio measures (62% <i>v</i> 21%; relative risk 3.0, 2.1 to 4.3). <b>Conclusion</b> Absolute risks are often not easily accessible in articles reporting ratio measures and sometimes are missing altogether—this lack of accessibility can easily exaggerate readers9 perceptions of benefit or harm.
Early Neurolysis in the Treatment of Injury of the Peripheral Nerves Due to Faulty Injection of Antibiotics
Authors: Donald D. Matson
Journal: New England Journal of Medicine (1950)

THE modern treatment of all types of infectious disease by repeated intramuscular administration of antibiotics has resulted in an increased incidence of injuries of the peripheral nerves due to improper injection into or adjacent to one of the major nerve trunks. Broadbent, Odom and Woodhall‡ suggest that in view of the established toxicity of the antibiotics in the central nervous system, this paralysis probably represents a specific peripheral neuritis due to a high local concentration of the agent. Late operative observations in 2 of their 4 patients indicated an intraneural lesion rather than an extraneural compression. All their 4 patients, . . .
HIGH DOSAGE CHLORPROMAZINE THERAPY IN ACUTE AND CHRONIC SCHIZOPHRENIA
Authors: R. H. V. OLLENDORFF
Journal: American Journal of Psychiatry (1960)

A method is given here where increasing doses of chlorpromazine are given to all groups of schizophrenics, reaching a peak level of 2100 mgs. per day for one week. This dosage is decreased and after assessment a maintenance level of chlorpromazine is rigidly upheld for indefinite periods. Three modified ECTs accompany the ascending limb and 3 or more modified ECTs the descending limb of chlorpromazine therapy. Side effects are multiple but none is considered dangerous or necessitating the discontinuation of the treatment, especially if all necessary precautions are taken and the patient is closely watched. The results of this method are sufficiently encouraging to justify its continued use. The method is not considered rigid and the level of dosage and the length of time in which higher dosage levels are given are guided, naturally, by the patient's response and the severity of the side effects. The importance of the method is felt to lie in the quick way a first remission is forced, recurring episodes and relapses reversed and chronic schizophrenic illness alleviated.
Preoperative prediction of postoperative delirium
Authors: R. C. Carson
Journal: JAMA (1994)

To the Editor.  —I wish to thank you for publishing A Clinical Prediction Rule for Delirium After Elective Noncardiac Surgery by Dr Marcantonio and colleagues. 1   No doubt you will receive correspondence criticizing the research for not including an anesthesiologist among the 14 authors of this article. Others may also be critical of the exclusion of any references from the anesthesiology literature in this study in which all of the 1341 patients studied had received anesthesia.  However, I personally am grateful for this article. Since I can now identify the appropriate candidates for interventions with [s]trategies [that] include close monitoring and correction of perioperative hypoxemia, hypotension, fluid and electrolyte balance, and severe anemia, I can rest much easier when I turn off the oxygen, ignore the blood pressure, and walk off down the hall to have coffee when patients I anesthetize do not need these interventions.
Syk- and CARD9-dependent coupling of innate immunity to the induction of T helper cells that produce interleukin 17
Authors: Salomé LeibundGut-Landmann, Olaf Groß, Matthew J Robinson, Fabiola Osorio, Emma C Slack, S Vicky Tsoni, Edina Schweighoffer, Victor Tybulewicz, Gordon D Brown, Jürgen Ruland, Caetano Reis e Sousa
Journal: Nature Immunology (2007)
Appetite and Growth
Authors: Cornelia H. M. van Jaarsveld, David Boniface, Clare H. Llewellyn, Jane Wardle
Journal: JAMA Pediatrics (2014)

Identifying early markers of future obesity risk can help target preventive interventions. Several studies have shown that a heartier appetite in infancy is a risk factor for more rapid weight gain, but to date no investigations have been able to rule out familial confounding.To use a sibling design (data from same-sex, dizygotic twin pairs) to test the hypothesis that sibling differences in infant appetite predicted differential weight gain during childhood.Gemini is a population-based twin cohort among the general United Kingdom population born between March 1, 2007, and December 15, 2007. Growth trajectories were analyzed from birth to age 15 months. Appetite-discordant pairs were selected from 800 nonidentical, same-sex twin pairs.Appetite during the first 3 months of life was assessed with the food responsiveness (FR) and satiety responsiveness (SR) subscales from the Baby Eating Behaviour Questionnaire. Discordance was defined as a within-pair difference of at least 1 SD.A mean of 11.5 weight measurements per child were available between birth and age 15 months. Multilevel models, adjusted for sex and birth weight, compared growth curves for the higher-appetite vs lower-appetite twins.In total, 172 pairs were discordant for SR and 121 pairs for FR. Within-pair analyses showed that those with higher FR and those with lower SR grew faster than their sibling. At age 6 months, those with higher FR were 654 (95% CI, 395-913) g heavier and at age 15 months were 991 (95% CI, 484-1498) g heavier. For sibling pairs discordant for SR, the weight differences between siblings were 637 (95% CI, 438-836) g at age 6 months and 918 (95% CI, 569-1267) g at age 15 months.A heartier appetite (indexed with higher FR or lower SR) in early infancy is prospectively associated with more rapid growth up to age 15 months in a design controlling for potential familial confounding, supporting a causal role for appetite in childhood weight gain. Appetite could be an early marker for risk of weight gain in the current obesogenic environment and might be a potential target for preventive interventions.
Prospects for the development of small molecular weight compounds to replace anti-tumour necrosis factor biological agents
Authors: B Foxwell
Journal: Annals of the Rheumatic Diseases (2003)

Tumour necrosis factor (TNF) blockade, achieved by the soluble receptors and antibodies, has been a major success in the treatment of rheumatoid arthritis (RA).1 The success of this treatment has also established biological agents as a new weapon in the armoury of therapeutic approaches to the treatment of autoimmune diseases. Established data and emerging evidence suggest that anti-TNF biological agents will have a therapeutic role in other autoimmune diseases. Infliximab is already licensed for Crohn’s disease and, recently, anti-TNF biological agents have shown major promise in spondyloarthropathies, psoriatic arthritis, and juvenile idiopathic arthritis.2–8 There is growing evidence that TNF blockade may be important in many other diseases, including sarcoidosis9 and psoriasis.10 Therefore, although the number of patients treated with the various anti-TNF biological agents is rapidly approaching half a million, there is no reason to suggest that the patient pool is anywhere near saturation. Rather, one can expect the number of patients with diseases likely to benefit from this form of treatment to increase.

However, there are problems with anti-TNF biological agents that limit their use. From a safety perspective, although TNF blockade has not demonstrated the massive problems of susceptibility to infections once feared, there are clearly problems, especially with patients who have latent tuberculosis.11 There is also the constant problem associated with using proteins as drugs of their administration and dosing. However, by far the biggest constraint in using anti-TNF biological agents is the cost of treatment, which is of the order of $15 000/patient/year. This has led to a relatively low uptake of the treatment in several European countries and to patients being described as “economic failures” in America. One must also add that the difficulty in producing proteins on a mass scale has led to a supply problem, especially for …
Children's book at centre of row over drug advertising campaign
Authors: U. Tayal
Journal: BMJ (2003)

The UK government is to investigate claims that a children's book on allergies was used by a major drugs company to promote a drug to children. Moreover, the drug it promoted is no longer the first choice in treatment for childhood allergies.

GlaxoSmithKline (GSK) commissioned the book, Mr Sneeze and his Allergies , which was produced in collaboration with the charity Allergy UK. Mr Sneeze is allergic to the feathers in his pillow. At the end of the book are four pages of allergy advice from Allergy UK and two pages from GSK advertising its over the counter products Piriton and Piriteze.

The …
Ataxia–Telangiectasia — Broad Implications for a Rare Disorder
Authors: M Kastan
Journal: New England Journal of Medicine (1995)

Ataxia–telangiectasia is a rare autosomal recessive disorder with diverse clinical manifestations. Patients typically come to medical attention in early childhood because of ataxia, and this is followed by progressive neuromotor degeneration, usually resulting in dependence on a wheelchair by 10 years of age. In addition to cerebellar degeneration, patients with ataxia–telangiectasia have elevated levels of alpha-fetoprotein, various immunologic deficiencies, growth retardation, premature aging, chromosomal instability, an increased frequency of lymphoreticular cancers, and hypersensitivity to ionizing radiation and radiomimetic drugs.1 The defective gene responsible for this pleiotropic disorder (ATM) was recently identified by a multinational group led by investigators . . .
Lessons Learned from the Investigational Device Exemption Review of Children's Oncology Group Trial AAML1031
Authors: Soheil Meshinchi, Stephen P. Hunger, Richard Aplenc, Peter C. Adamson, J. Milburn Jessup
Journal: Clinical Cancer Research (2012)

Abstract The U.S. Food and Drug Administration is now exerting its regulatory authority over the use of molecular diagnostics and related assays for medical decision making in clinical trials, by performing pre–Investigational Device Exemption reviews in all phases of clinical trials. In this review, we assess the analytical performance of the assay for the diagnostic, and consider how that performance affects the diagnostic and the patient and their risks and benefits from treatment. We also discuss the process involved in the first review of a new Children's Oncology Group phase III trial in acute myelogenous leukemia. The lessons learned and recommendations for how to prepare for and incorporate this new level of regulatory review into the protocol development process are presented. Clin Cancer Res; 18(6); 1547–54. ©2012 AACR.
Public Locations of Cardiac Arrest
Authors: Linda Becker, Mickey Eisenberg, Carol Fahrenbruch, Leonard Cobb
Journal: Circulation (1998)

Background —The purpose of this study was to describe the public locations of cardiac arrest and to estimate the annual incidence of cardiac arrest per site to determine optimal placement of automatic external defibrillators (AEDs). This was a retrospective cohort study. Methods and Results —Locations of cardiac arrest were abstracted from data collected by emergency medical service programs in Seattle and King County, Washington, from January 1, 1990, through December 31, 1994. Types of commercial and civic establishments were tallied and grouped into 23 location categories consistent with Standard Industrial Codes, and the number of sites within each location category was determined. With the addition of “public outdoors” and “automobiles” as categories, there were 25 location categories. During the study period, 7185 arrests occurred, 1130 (16%) of which were in public locations. An annual incidence of cardiac arrest per site was calculated. Ten location categories with 172 sites were identified as having a higher incidence of cardiac arrest (≥.03 per year per site). Thirteen location categories had a lower incidence of arrest (≤.01 per year per site). There were ≈71 000 sites within these categories. Conclusions —Placement of 276 AEDs in the 172 higher-incidence sites would have provided treatment for 134 cardiac arrest patients in a 5-year period, 60% of whom were in ventricular fibrillation. We estimate between 8 and 32 lives could be saved in 5 years. To cover the remaining 347 arrests occurring in public in a 5-year period, defibrillators would have to be placed in 71 000 sites, not including outdoors and automobiles. Placement of AEDs in public locations can be guided by the site-specific incidence of arrest.
RADIUM VERSUS SURGICAL REMOVAL OF CARCINOMA OF THE BLADDER
Authors: B. S. BARRINGER
Journal: JAMA (1922)

In this brief review of the results of the removal of carcinoma of the bladder by radium, an attempt is made to compare radium and operative removal of bladder carcinomas.The work herein reported covers a period of more than six years, from December, 1915, when the first patient with bladder carcinoma ( st i l l living) was successfully treated with radium, to January, 1922.Much of the work during this period has been of necessity experimental.Beginning with the somewhat inaccurate intra-urethral application of radium, we have steadily worked toward the more accurate and TABLE 1.
ABC of mental health: Community mental health services
Authors: K. White, D. Roy, I. Hamilton
Journal: BMJ (1997)

Community mental health centres should be located in the locality that they serve and provide the base from which multidisciplinary teams deliver the bulk of mental health services for a particular community.A multidisciplinary team may include psychiatrists, nurses, occupational therapists, psychologists, social workers, and counsellors supported by an administrative team.The psychiatrist is the bridge between inpatient and community teams and maintains close links with general practitioners, social services, and voluntary organisations.
The Noninvasive Diagnosis of Intrathoracic Splenosis Using Technetium-99m Heat-Damaged Red Blood Cells
Authors: ROBERT G. SCHIFF, JOHN LEONIDAS, ASHOK SHENDE, PHILIP LANZKOWSKI
Journal: Clinical Nuclear Medicine (1987)

Intrathoracic splenosis results from the implantation of splenic tissue in the thoracic cavity following simultaneous rupture of the spleen and diaphragm. These implants may form mass lesions that lead to an extensive, costly, and invasive series of investigations, usually resulting in unnecessary surgery. The key to diagnosis is a high index of suspicion provoked by the history of a traumatic event, possibly in the distant past. This report emphasizes that because of its ability to demonstrate the functional nature of tissue, a definitive diagnosis can be made using heat-damaged Tc-99m RBCs without the need for surgical intervention.
Mimicking white matter tract topography using core–shell electrospun nanofibers to examine migration of malignant brain tumors
Authors: Shreyas S. Rao, Mark T. Nelson, Ruipeng Xue, Jessica K. DeJesus, Mariano S. Viapiano, John J. Lannutti, Atom Sarkar, Jessica O. Winter
Journal: Biomaterials (2013)
Panculture Panned-Reply
Authors: Andrew P. Gutow
Journal: JAMA (1993)

<h3>In Reply.</h3> —I completely agree with Dr Dubé's conclusion that the practice of panculturing should not be encouraged among house staff. The knee-jerk response of obtaining blood, sputum, and urine cultures in every febrile patient is an expensive and unnecessary medical action. The widespread nature of this practice in the United States is indicated by the use of the same term to describe it by house staff at my hospital in New Haven, Conn, and Dubé's in Los Angeles, Calif. In our institution, house staff receive little or no positive feedback for a conscious and reasoned decision not to obtain a test or study, but often receive negative feedback for being "incomplete" and not obtaining a test or study. The current ethic in medical training is to reward and praise the most compulsive and complete resident. This resident is the one who suggests and then rules out with an extensive
Nearly a third of US adults have high blood pressure
Authors: Scott Gottlieb
Journal: BMJ (2004)

Nearly a third of American adults have high blood pressure, putting them at greater risk of stroke, heart attack, kidney failure, and other problems, says a new government study. The rising incidence of obesity and an ageing population are being blamed.

The new figures are from census data and a 1999-2000 national health and nutrition examination survey, which included 4531 adults. The study estimates that 31.3% of Americans have high blood pressure, up from 28.9% in the previous national health report from 1988-94. That means that about 65 million American adults who now have …
Surgical treatment of primary lung cancer and solitary brain metastasis.
Authors: A Mussi, A Janni, M Pistolesi, V Ravelli, R Buonaguidi, C A Angeletti
Journal: Thorax (1985)

Twenty patients with carcinoma of the lung and a brain metastasis have undergone combined lung and brain surgery, which was synchronous in five. There were no operative deaths. Survival from the first surgical intervention was less than one year (3-10 months) in four patients (20%), one to two years in four (20%) and more than two years (26-66 months) in five patients (25%). Seven patients (35%) are alive and well after an average period of three years and three months (15-66 months). Actuarial survival at five years is 33.6%. All patients had severe neurological symptoms and 18 (90%) had a complete remission. Our experience and data reported in the literature point to the effectiveness of combined lung and brain surgery in prolonging symptom free survival in patients with lung cancer and solitary brain metastasis.
Deal brokered for free online access to NHS research
Authors: C. White
Journal: BMJ (2003)

Under the terms of a new deal between the NHS and the online publisher Biomed Central, NHS staff will be able to place research papers on an open access website without having to pay a fee.

The move is part of a growing trend to loosen the stranglehold of medical science publishers, through licensing and online viewing fees for research published in their journals, on access to science.

The three year deal, which will take effect this April, is part of a spend of more than £1m ($1.6m; ‡1.4m) by the NHS on procuring free electronic access to …
Treatment of Depression in General Practice
Authors: D. A. W. Johnson
Journal: BMJ (1973)

With the co-operation of the family doctors in five selected urban general practices the general-practitioner treatment of 73 patients suffering from a new episode of depressive illness was evaluated over a period of four months. The purpose was to test the belief that general practitioners are best fitted to manage most psychological ailments, and depression was chosen as the psychiatric illness most commonly seen in general practice. Medication was the principal treatment offered, and this was often inadequate in dosage or the patient defaulted. Drug defaulting was thought to be due partly to failure of supervision and follow-up and to too low a consultation rate. The low consultation rate was also thought to explain why few patients thought there was a therapeutic value in the doctor-patient relationship. The results of the study indicate that patients with depressive illness do not receive the best treatment in general practice. The reasons are several and responsibility must be shared by the medical practitioners, the current system of the general practice, and the patients themselves.
Two memorable physicians
Authors: R. Gabriel
Journal: BMJ (2003)

I have had the good fortune to work for and with physicians whose grasp and practice of medicine set them comfortably beyond their competent fellows. But against my two most memorable physicians, even peers are challenged in insight, analysis, and diagnosis. I worked for the first, Norman Swift Plummer, as his house physician at Charing Cross Hospital, and for the latter, Malcolm Davenport Milne, as senior registrar at Westminster Hospital.

Plummer (1907-78) was in the top echelon of London teaching hospital physicians of his day. He was a tall, slim, grave, well dressed man, a public school product. His modest self confidence, diagnostic acumen, kindness, and advice led to …
Heparin accelerates coronary collateral development in a porcine model of coronary artery occlusion.
Authors: S M Carroll, F C White, D M Roth, C M Bloor
Journal: Circulation (1993)

BACKGROUND Coronary collaterals develop in response to an ischemic stimulus. However, collateral growth is not sufficient to result in the complete recovery of coronary reserves. Using a porcine model of gradual coronary artery occlusion, we investigated the effect of continuous heparin infusion on coronary collateral development. METHODS AND RESULTS We placed ameroid constrictors on the left circumflex coronary artery of 16 minipigs; the ameroid constrictors completely occluded the left circumflex coronary artery at 10 +/- 1 days. Half of the animals also were instrumented with subcutaneously placed osmotic pumps and catheters that delivered heparin (300 units/h) into the external jugular vein. At 2, 3, and 4 weeks, we assessed blood flow at rest and during vasodilation using radioactive microspheres. Our results indicate that the animals receiving heparin restored resting myocardial blood flow to normal levels at or before 2 weeks; in contrast, we did not see normal resting myocardial blood flow levels in the untreated-ameroid animals until 3 weeks. Under vasodilated conditions, untreated-ameroid animals experienced a severe loss of coronary reserves at 2 weeks. Although this improved with time, these animals still were significantly underperfused at 4 weeks. In contrast, in the heparin-treated animals, coronary reserves returned to near-normal levels between 3 and 4 weeks. In addition, infarct size was significantly smaller in the heparin-treated animals. CONCLUSIONS These experiments suggest that the administration of heparin in the early phases of gradual coronary occlusion accelerates the rate of return of normal blood flow under resting conditions, substantially increases the recovery of coronary reserve, and reduces the risk of infarction.