tbuckley/cabot-search huggingface dataset:
Cost-benefit analysis.
Authors: R Robinson
Journal: BMJ (1993)

Cost-benefit analysis is probably the most comprehensive method of economic evaluation available and it can be applied in two ways. The human capital approach means that the value of people's contributions is linked to what they are paid. The approach based on individuals' observed or stated preference means that their personal valuations are placed on an activity by assessing how much money they are prepared to accept for an increased risk or to pay for a particular service. Each method has its disadvantages and the most successful that has been devised so far is the "willingness to pay" (stated preference) approach, though the response to this is to a large extent dependent on the income of the person being questioned. There are still problems with its application, however, so its usefulness is limited.
Relation between Aspects of Nutritional Disturbance and Menstrual Activity in Primary Anorexia Nervosa
Authors: A. H. Crisp, E. Stonehill
Journal: BMJ (1971)

A significantly high number of patients with anorexia nervosa are overweight immediately before the onset of the condition. This premorbid weight may be a feature of their constitution but is sometimes a more transitory phenomenon. Menstruation ceases early in the condition but usually within the context of significant weight loss. However, the subsequent amenorrhoea, related to factors that presumably may not begin to operate until several weeks later, may be a symptom which first draws attention to the condition.Treatment included the restitution of body weight to the matched population mean weight for each patient. This may be important, as the mean weight at which menstrual activity returned was not significantly different from the matched population mean weight. A further treatment aim, so far as nutrition was concerned. was restoration of regular and reasonable feeding behaviour, including adequate carbohydrate ingestion. It is suggested that these findings support the view that the nutritional disturbance in anorexia nervosa is an important factor affecting menstrual activity.
Targeting VE-PTP activates TIE2 and stabilizes the ocular vasculature
Authors: Jikui Shen, Maike Frye, Bonnie L. Lee, Jessica L. Reinardy, Joseph M. McClung, Kun Ding, Masashi Kojima, Huiming Xia, Christopher Seidel, Raquel Lima e Silva, Aling Dong, Sean F. Hackett, Jiangxia Wang, Brian W. Howard, Dietmar Vestweber, Christopher D. Kontos, Kevin G. Peters, Peter A. Campochiaro
Journal: Journal of Clinical Investigation (2014)

Retinal and choroidal neovascularization (NV) and vascular leakage contribute to visual impairment in several common ocular diseases. The angiopoietin/TIE2 (ANG/TIE2) pathway maintains vascular integrity, and negative regulators of this pathway are potential therapeutic targets for these diseases. Here, we demonstrated that vascular endothelial-protein tyrosine phosphatase (VE-PTP), which negatively regulates TIE2 activation, is upregulated in hypoxic vascular endothelial cells, particularly in retinal NV. Intraocular injection of an anti-VE-PTP antibody previously shown to activate TIE2 suppressed ocular NV. Furthermore, a small-molecule inhibitor of VE-PTP catalytic activity (AKB-9778) activated TIE2, enhanced ANG1-induced TIE2 activation, and stimulated phosphorylation of signaling molecules in the TIE2 pathway, including AKT, eNOS, and ERK. In mouse models of neovascular age-related macular degeneration, AKB-9778 induced phosphorylation of TIE2 and strongly suppressed NV. Ischemia-induced retinal NV, which is relevant to diabetic retinopathy, was accentuated by the induction of ANG2 but inhibited by AKB-9778, even in the presence of high levels of ANG2. AKB-9778 also blocked VEGF-induced leakage from dermal and retinal vessels and prevented exudative retinal detachments in double-transgenic mice with high expression of VEGF in photoreceptors. These data support targeting VE-PTP to stabilize retinal and choroidal blood vessels and suggest that this strategy has potential for patients with a wide variety of retinal and choroidal vascular diseases.
Fusion of Labia Minora
Authors: G. Evans
Journal: BMJ (1961)

AIMS: (1) To compare the recovery of organisms from continuous ambulatory peritoneal dialysis (CAPD) effluent fluid obtained from patients with clinical evidence of peritonitis, with an automated system (AS) and the Septichek blood culture system; (2) to evaluate the times to detection of organisms with the two systems; (3) to identify anaerobes from CAPD samples by extended anaerobic culture and gas-liquid chromatography (GLC). METHODS: 168 CAPD effluent fluid samples were studied, representing 157 episodes of peritonitis in 97 patients. CAPD samples were inoculated into two AS bottles-one anaerobic, one aerobic-and a Septichek bottle; samples were also examined for cell count, Gram stain, and direct culture. Culture bottles were then subcultured onto various media, and any organisms isolated were identified. After routine culture, GLC was performed on culture fluid in the anaerobic AS and Septichek bottles. When volatile fatty acids were detected, the broths were cultured anaerobically on specialised medium for a further five days. RESULTS: 147 organisms were isolated from the 168 samples: 96 (57%) yielded growth of significant organisms by direct culture, as compared to 129 (76.8%) by both AS and Septichek. There was no significant difference in isolation rates between AS and Septichek, but time to detection was more rapid with the AS system (p &lt; 0.002). GLC showed volatile fatty acid in 15 specimens; of these, 14 subsequently grew anaerobic organisms. CONCLUSIONS: AS was comparable to Septichek for numbers of isolations. Speed to detection was faster with the AS, which may be an advantage in management of patients with CAPD peritonitis. GLC showed anaerobes in several cases which would not have been detected without prolonged anaerobic culture; thus anaerobic cultures are recommended for patients who are unresponsive to antimicrobials or who have evidence of bowel perforation.
Endoscopic ultrasound-guided transesophageal thoracentesis
Authors: J. DeWitt, P. Kongkam, S. Attasaranya, J. LeBlanc, S. Sherman, F. Sheski
Journal: Endoscopy (2008)

In a retrospective, single-center study, we identified nine consecutive patients (six male; median age 66 years; range 55 – 79 years) who, between January 2003 and April 2007, underwent attempted endoscopic ultrasound (EUS-)guided thoracentesis into the right (n = 7) or left (n = 2) pleural space. In all patients a diagnosis of cancer was made either prior to (n = 6) or by (n = 3) EUS. Thoracentesis was not the primary indication for EUS in any patient. Right-sided thoracentesis was performed when possible due to the dependent position of the pleural fluid relative to the right esophageal wall in the left lateral decubitus position. Prior to aspiration, no additional maneuvers (i. e. patient breath hold) were performed. Thoracentesis was successful in all patients, and a median of 12 mL (range 2.5 – 36 mL) was aspirated without complications. Pleural fluid cytology was positive for malignancy in two patients (22 %): adenocarcinoma of unknown primary (n = 1) and metastatic ovarian adenocarcinoma (n = 1). In both cases, EUS-guided thoracentesis provided the initial diagnosis of a malignant effusion (Fig. [1] [2] [3] [4]). Pleural fluid cytology in each of the remaining seven was benign.
SHRAPNEL WOUND OF THE SPINE, WITH EXCEPTIONALLY LOW TEMPERATURE
Authors: M. W. B. Oliver, F. B. Winfield
Journal: BMJ (1915)

S8HMAPNEL WOUND OF SPNEI M-RDICAL JOURNAAL 247 grow, but did not become thinner, and he Tst all sexual desire.-His urine was scaiity, but normal.Jn spite of rest in bed, and an exceptionally ample diet, he continued to lose weight; thyroid gland m-nde liim worse, but large doses of opium and bromide relieved the excitement, and his weiglht became almost stationary.On June 18th, 1911, hie weighed 127 lb.; lhe was givenI 1:-gaaiu of dried para- thlyroid gland four tiunes daily, and touir days later lie dis- continued the opium and bromlide.He gained 6.) lb. in thie first four days, 12 lb.the next five days, and 28.lb. in the first nineteen days.Simultaneously all his symptoms disappeared, and in a montlh hie w%Yas well.He continued
General practitioner centred scheme for treatment of opiate dependent drug injectors in Glasgow
Authors: L. Gruer, P. Wilson, R. Scott, L. Elliott, J. Macleod, K. Harden, E. Forrester, S. Hinshelwood, H. McNulty, P. Silk
Journal: BMJ (1997)

Injecting opiate drugs is now common in the United Kingdom, particularly in deprived urban areas.1 The judicious use of oral methadone may enable many opiate dependent drug injectors to reduce or cease injecting, with consequent improvements in health and social stability.2 Key elements of effective methadone treatment include ensuring oral ingestion of an appropriate daily dose and addressing patients' other health and social problems.3

Successive reports to government have emphasised the key role of general practitioners in treating drug injectors.4 5 6 However, few have received training in managing such patients, and consequently many experience difficulty in treating them.7 8 Coping strategies range from refusing to register any drug injectors to prescribing various substitute drugs for unsupervised use, with the consequent dangers of overdose or diversion of the drugs to the black market.9 Although some practices provide effective care 10 11 little has been published on how this can be achieved across a larger population.12

In most countries methadone must be given under supervision at specialist addiction centres.2 Although this has the advantage of ensuring a consistent approach within each clinic population, specialist services may be inaccessible to many and may lack the capacity to meet need when the prevalence of drug injecting is high. Unusually, in the United Kingdom both hospital doctors and general practitioners are allowed to prescribe methadone for dispensing by community pharmacists, thus enabling the treatment of injectors to be decentralised. However, a recently published survey of community pharmacies in England and Wales found that methadone is frequently dispensed in large amounts for unsupervised use.13 The opportunities for abuse or diversion are clear. In a recent survey of drug related deaths in Manchester a large proportion seemed to be associated with methadone.14

Greenwood reported that many …
Diet, Fat Accretion, and Growth in Premature Infants
Authors: Brian Reichman, Philippe Chessex, Guy Putet, Gaston Verellen, John M. Smith, Tibor Heim, Paul R. Swyer
Journal: New England Journal of Medicine (1981)

To compare the growth and accumulation of protein, fat, and carbohydrate in the formula-fed premature infant and in the fetus of a similar postconceptional age, we performed 22 metabolic studies in 13 infants of very low birth weight (1155 +/- 39 g [mean +/- S.E.]). Measurements combining nutritional balance and indirect calorimetry demonstrated the deposition rates of protein and fat. We found that the formula-fed, very-low-birth-weight infant who gained weight comparably to the fetus retained the same amount of protein (1.92 +/- 0.1 g per kilogram of body weight per day) but accumulated fat at a rate of 5.4 +/- 0.3 g per kilogram per day - about three times that in the fetus, as confirmed by increased skin-fold thickness. How this change in body composition affects the future growth of formula-fed premature infants, and how body composition is altered by other dietary regimens such as the provision of human milk, remain to be determined.
Abstract 661: Physical activity, sitting time, and postmenopausal breast cancer risk by histopathologic characteristics in a large US cohort
Authors: Alpa V. Patel, Janet S. Hildebrand, Mia M. Gaudet, Lauren R. Teras, Peter T. Campbell, Susan M. Gapstur
Journal: Cancer Research (2012)

Abstract There is convincing evidence that physical activity is associated with lower risk of postmenopausal breast cancer, likely through its impact on circulating sex hormones, improved insulin sensitivity, and/or weight control. However, the relationship between time spent sitting and breast cancer is not well-defined. Furthermore, it is unclear whether the relationship of physical activity or sitting time with postmenopausal breast cancer varies by histopathologic characteristics of the tumor (defined by stage, histology, or estrogen/progesterone receptor (ER/PR) status), use of postmenopausal hormones (PMH), or body mass index (BMI). Therefore, we examined recreational physical activity and leisure-time spent sitting in relation to breast cancer risk among 73,608 postmenopausal women who were cancer-free and enrolled in the American Cancer Society Cancer Prevention Study II (CPS-II) Nutrition Cohort, a prospective study of cancer incidence and mortality that began in 1992. From 1992-2007, 4,622 incident breast cancer cases were identified. Cox proportional hazards regression modeling was used to compute rate ratios (RR) and 95% confidence intervals (CI) while adjusting for potential confounders including age, race, education, BMI, PMH use, and other breast cancer risk factors. Women who engaged in the highest amount of physical activity (&amp;gt;42 MET-hours/week) had 22% lower risk of breast cancer compared to women with the least activity (0-&amp;lt;7 MET-hours/week) (RR 0.78, 95% CI 0.63-0.95; trend p=0.09). Women who walked an hour per day were 15% less likely to develop breast cancer during follow-up compared to women who walked fewer than 3 hours per week (95% CI 0.76-0.95). Sitting time was not associated with breast cancer risk (RR=0.98, 95% CI 0.89-1.09 for 6+ vs &amp;lt;3 hours/day spent sitting). When examining associations by stage, the association between physical activity and breast cancer risk was only observed for localized breast cancer (RR=0.67, 95% CI 0.51-0.89; trend p=0.03), and not for in situ or regional/distant stage. The association did not differ by histology or ER/PR status. The association between physical activity and risk was not modified by BMI (interaction p=0.73) or by PMH (interaction p=0.74), although the lower RR associated with the highest level of physical activity was noted only in non-users of PMH. These findings provide further evidence that physical activity is associated with lower risk of postmenopausal breast cancer and that the benefits of physical activity do not appear to be limited to any specific subgroup of women. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 661. doi:1538-7445.AM2012-661
759 DEVELOPMENT AND CREATION OF SENSITIVE PROGNOSTIC SCORING SYSTEM THAT IS APPLICABLE FOR THE SEVERITY OF ACUTE-ON-CHRONIC LIVER FAILURE IN HEPATITIS B
Authors: Y.B. Zheng, D.Y. Xie, C.S. Lin, Z.Y. Lei, L. Peng, B.L. Lin, W.M. Ke, Y.T. Chong, Z.L. Gao
Journal: Journal of Hepatology (2011)
Acute hospitals in England will have to report cases of female genital mutilation from September
Authors: C. Dyer
Journal: BMJ (2014)

All NHS acute hospitals in England will be obliged to report to the Department of Health monthly from September 2014 on patients who have undergone female genital mutilation (FGM) or have a family history of it.

The move is part of a government initiative to tackle a practice that is thought to be widespread among immigrants and refugees who have come to the United Kingdom from parts of Africa, Asia, and the Middle East.

Ministers from the Home Office and the Department for International Development …
Rewards of Shared Opportunity
Authors: Owen H. Wangensteen
Journal: JAMA (1977)

IT IS anticipated that 13,470 new physicians will have entered the profession of medicine by midyear. From this large group will undoubtedly emerge many future leaders. Perhaps a few will already have been identified by perceptive teachers. Collision with problems demanding solution and intimate association with like minds striving to advance medicine will mold the potential leaders into the achievers, guides, and bellwethers of the next half century. By the fact of their graduation, medical students provide evidence that they fully appreciate the importance of the best known of the Hippocratic aphorisms: "Life is short, the art long, the occasion fleeting, the experiment dangerous, and judgment difficult."<sup>1</sup> How shall I spend my life? Will it be in the service of my fellow men and women? As family physician or specialist? In the academic arena, in community service, or primarily in research? Each has its special compensations. Perhaps no profession
Immunohistology of the nasal mucosa in seasonal allergic rhinitis: Increases in activated eosinophils and epithelial mast cells
Authors: A BENTLEY, M JACOBSON, V CUMBERWORTH, J BARKANS, R MOQBEL, L SCHWARTZ, A IRANI, A KAY, S DURHAM
Journal: Journal of Allergy and Clinical Immunology (1992)
Quality of Breast Cancer Care: Perception Versus Practice
Authors: Nina A. Bickell, Jennifer Neuman, Kezhen Fei, Rebeca Franco, Kathie-Ann Joseph
Journal: Journal of Clinical Oncology (2012)

Because insurers use performance and quality metrics to inform reimbursement, identifying remediable causes of poor-quality cancer care is imperative. We undertook this descriptive cohort study to assess key predictors of women's perceived quality of their breast cancer care and actual guideline-concordant quality of care received.We surveyed inner-city women with newly diagnosed and surgically treated early-stage breast cancer requiring adjuvant treatment who were enrolled onto a randomized controlled trial (RCT) of patient assistance to reduce disparities in care. We assessed women's perceived quality of care and perceived quality of the process of getting care, such as getting referrals, test results, and treatments; we abstracted records to determine the actual quality of care.Of the 374 new patients with early-stage breast cancer enrolled onto the RCT, only a slight majority of women (55%) perceived their quality of care as excellent; 88% actually received good-quality, guideline-concordant care. Excellent perceived quality (P < .001) was significantly associated with patients' perception of the quality of the process of getting care (adjusted relative risk [RR], 1.78; 95% CI, 1.65 to 1.87). Also associated with perceived quality-and mediated by race-were trust in one's physician (adjusted RR, 1.43; 95% CI, 1.16 to 1.64) and perceived racism, which affected black women more than women of other races/ethnicities (black race-adjusted RR for perceived racism, 0.33 [95% CI, 0.10 to 0.87]; black race-adjusted RR for trust, 1.61 [95% CI, 0.97 to 1.90]; c = 0.82 for the model; P < .001). Actual quality of care provided did not affect perceived quality of care received.Patients' perceived quality of care differs from their receipt of high-quality care. Mutable targets to improve perceived quality of care include the processes of getting care and trusting their physician.
BACKSCATTER, T1 MAPPING OR PRO-COLLAGEN BIOMARKERS FOR NON-INVASIVE ASSESSMENT OF TREATMENT RESPONSE TO ANTI-FIBROTIC THERAPY IN SUBCLINICAL DIABETIC CARDIOMYOPATHY? A RANDOMIZED TRIAL
Authors: Christine L. Jellis, Jeremy Wright, Julian Sacre, Dominic Kennedy, Leanne Jeffriess, John Fenwick, Jennifer Martin, Thomas H. Marwick
Journal: Journal of the American College of Cardiology (2012)
Readings in Medical Artificial Intelligence: The First Decade
Authors: Henry S. Sacks
Journal: JAMA (1985)

We are beginning to take for granted that computers can do time-consuming but clearly defined tasks. This book describes attempts to develop systems that exhibit characteristics of intelligent human behavior, such as understanding natural language, reasoning, learning, and solving problems.Readings in Medical Artificial Intelligenceis a collection of articles first put together as background reading for a workshop, assembled by two active researchers in the field.  Most of the systems described concern computer models for narrowly defined areas of medical expertise. There are chapters about systems that select antibiotics for patients with meningitis or bacteremia, diagnose the causes of renal failure, manage ventilators for patients in the intensive care unit, prescribe cancer chemotherapy regimens, and interpret pulmonary function tests. Some of these systems can perform their tasks with results comparable to those of subspecialists. The most ambitious project attempts to create a system that covers all of internal medicine
Early Experience with an Implantable Cardioverter
Authors: Douglas P. Zipes, James J. Heger, William M. Miles, Yousuf Mahomed, John W. Brown, Scott R. Spielman, Eric N. Prystowsky
Journal: New England Journal of Medicine (1984)

We tested the efficacy and safety of a fully programmable cardioverter weighing 95 g, in terminating sustained ventricular tachycardia. The device was implanted tranvenously under local anesthesia in seven patients. On command from a programmer or automatically, the cardioverter delivered shocks through a lead inserted to the apex of the right ventricle. It also served as a demand ventricular pacemaker and could perform programmed ventricular stimulation or overdrive pacing. Cardioversion of ventricular tachycardia required less than 0.5 J (mean) and was well tolerated by the patients, who were awake and not sedated. In one patient, a shock terminated ventricular tachycardia with the device in the automatic mode but produced atrial fibrillation with a rapid ventricular response that was intermittently recognized as ventricular tachycardia, triggering additional shocks. One such shock in the ST segment produced ventricular fibrillation that was terminated transthoracically in the emergency room, without residual impairment. We conclude from these preliminary observations that cardioversion of sustained ventricular tachycardia by means of an implantable catheter device is feasible, but for the present its use in the automatic mode must be cautious and selective. The unit's small size, ease of implantation, usefulness for noninvasive electrophysiologic studies, programmability, and bradycardia pacing functions are advantages. The next-generation device must be able to defibrillate and provide better differentiation of arrhythmias.
Multiple Fractures Associated With Long-term Sodium Heparin Therapy
Authors: Martin D. Jaffe
Journal: JAMA (1965)

SODIUM HEPARIN, because of its anticoagulant and lipid-clearing effects, has gained widespread acceptance for the long-term treatment of coronary artery disease. Except for bleeding, usually the result of an excesssive therapeutic action, there have been few side effects reported. A previously unrecognized possible complication of heparin therapy is detailed here. A patient is presented in whom multiple fractures of vertebrae and ribs occurred in the last two months of a 13-month course of therapy with sodium heparin administered subcutaneously. <h3>Report of a Case</h3> A 41-year-old, married, white executive experienced angina pectoris in the summer of 1963 without clinically or electrocardiographically apparent myocardial infarction. Sodium heparin (Lipo-Hepin) therapy was started in October 1963. Each evening he received a single deep subcutaneous injection of 20,000 units (0.5 cc of 40,000 units/cc or approximately 200 mg) except for a 20-day period in August 1964, when he received approximately 280 mg nightly. The only