tbuckley/cabot-search huggingface dataset:
The Coming Din of Inequity
Authors: Ray M. Peterson
Journal: JAMA (1961)

A GREAT NATIONAL debate is now in progress as to the issue of providing medical care and hospital benefits under the social security system. That debate can be pursued intelligently and wisely only if we understand the true nature and implications of the social security financing mechanism. Advocates of the social security approach assert that it is best because the social security financing mechanism is "time-tested" and "tried and proved."<sup>1</sup>In my opinion this is not so. The social security financing mechanism has not yet met the test of time; its crucial tests still lie ahead. To argue otherwise either reveals an inaccurate or incomplete conception of the true nature of the social security financing mechanism or suggests a willful attempt to distort and misrepresent. One purpose of this paper is to set the record straight by portraying an accurate picture of the financing mechanism as now operating and
Objective Index of Haemodynamic Status for Quantitation of Severity and Prognosis of Shock Complicating Myocardial Infarction
Authors: H. Shubin, A. A. Afifi, W. M. Rand, M. H. Weil
Journal: Cardiovascular Research (1968)

The relative importance of individual and groups of haemodynamic parameters was assessed by the use of discriminant function analysis in 20 patients with acute myocardial infarction and shock. Individual measurements reflecting cardiac output and velocity of blood flow were most reliable as indicators of survival. Discriminant function may serve as an indicator of the severity of shock.
Treatment of tumor associated hemobilia with a partially covered metallic stent
Authors: R. Rerknimitr, P. Kongkam, P. Kullavanijaya
Journal: Endoscopy (2007)

A 66-year-old Thai man presented with fever, jaundice and melena. He had an underlying condition of rectal adenocarcinoma treated by low anterior resection and had recently developed liver metastasis. A CT scan of the abdomen showed new advanced lesions occupying the right posterior segment of the liver ([Figure 1]). The endoscopic finding during endoscopic retrograde cholangiopancreatography (ERCP) revealed active oozing of blood from the biliary orifice. The cholangiogram demonstrated an amorphous filling defect occupying the extrahepatic biliary tree with a concave mass sitting at the hepatic hilum ([Figure 2] and [3]). Balloon sweeping was performed many times but it seemed that the blood oozing from the papilla never stopped. Ultimately, we decided to put in a partially self-expandable metallic stent (SEMS). The stent was inserted with the proximal non-covered end placed in the left intrahepatic duct system. The technique for deployment was similar to the standard technique, but fluoroscopic monitoring was continued at all times to confirm the precise location of the SEMS placement. The oozing stopped immediately, with pure dark bile gushing out from the biliary orifice. The final cholangiogram confirmed a clear extrahepatic duct ([Figure 4]). Within a week, the obstructive jaundice resolved and the patient’s hemoglobin level was stable. No further bleeding occurred before the patient’s death 10 months later.
THE COMPLEMENT CONTENT OF HUMAN SERA WITH ESPECIAL REFERENCE TO MALARIA 1
Authors: Anna Dean Dulaney, Jane B. Priest, Mary Lou Almeda, Bii Parker
Journal: Journal of Clinical Investigation (1948)

Our interest in the complement content of sera from healthy and diseased individuals was initiated by chance observations on the cephalincholesterol flocculation test (1).'In our first performance of the test we inadvertently included several sera which had been inactivated and stored in the refrigerator over-night.All of these gave positive readings at 24 hours.Repetition of these tests, using sera from the same individuals, but fresh samples which were less than four hours old, yielded some negative and some positive re- actions.It appeared that heating sera at 560 C. for 30 minutes might have played a part in the non- specific reactions with the cephalin-cholesterol antigen.Sera from 20 healthy individuals were therefore tested before and after inactivation.None of the 20 sera gave positive readings before inactivation, whereas five gave readings after heat- ing which would be considered significant.These results demonstrated that certain normal sera may be altered by inactivation to the extent that they give false positive cephalin-cholesterol reactions.The mechanism of inactivation is not altogether understood.One important result has to do with the destruction of the hemolytic property of the serum.Denaturation of proteins may occur and there may be loss of stabilizing property.However, determination of the complement con- tent of these 20 sera, according to methods de- scribed later in this report, revealed no differences which could be related to the cephalin-cholesterol flocculation test.Later it was found that the ad- dition of varying amounts of complement or al- bumin to positively reacting sera, or to normal sera which gave positive reactions after inacti- vation, did not inhibit the positive reaction.
Immunisation of preterm infants.
Authors: S Lingam, C Miller, J Pateman, R Beaver
Journal: BMJ (1986)

It is well recognised that in patients with pituitary insufficiency thyroid hormone replacement without concomitant adrenal steroid replacement may precipitate an acute adrenal crisis.'It is less widely appreciated that similar problems may arise during treatment of primary myxoedema if the patient also has unrecognised or subclinical adrenocortical disease.We report on two patients with primary hypothyroidism in whom thyroxine replacement precipitated an acute addisonian crisis. Case reports CASE 1A 47 year old woman had presented elsewhere three years previously with a history of lethargy.No clinical or biochemical abnormality had been detected.Her symptoms persisted, and two years later a low serum thyroxine concentration and a-raised serum thyroid stimulating hormone concentration were recorded.Plasma urea and electrolyte concentrations were normal.She was prescribed thyroxine 50 tg daily, increasing to 100 tg after two weeks, but felt ill and dizzy, lost weight, and stopped taking the
Meet Minerva in cyberspace
Authors: T. Delamothe
Journal: BMJ (1997)

Minerva is the BMJ 's best loved section. Unsurprisingly, it is also the section that visitors most want to read on our internet web site. To mark the site's second birthday we have decided to grant them their wish. From this week Minerva will be available, in her entirety, at www.bmj.com.

Over the past two years we have moved from our original policy of posting only limited material from each week's journal. First, we added all the jobs that are advertised in our classified supplements. Next, we began bundling together full text articles on similar topics. Our first foray was a collection of all the papers relating to bovine spongiform encephalopathy and the new …
Letter: Vitamin D and myocardial infarction.
Authors: F Eskin
Journal: BMJ (1974)

the experience of a sighted person.Blind- foldinig will give some idea of the physical disabilities of the blind but no idea of the heightening of his other senses which he may eventually employ.It cannot reproduce the emotional background.We are so used to "eye to eye" relationships with our fellows that we inevitably feel insecure at our first meeting with someone with whom this is impossible.As for teaching, I do not foresee any im- provement in the situation as less and less time becomes available for specialized teach- ing of this sort.The task of equipping the family doctor ito anticipate the odd ophthalmnic disaster is bound to take pre- cedence over training him for all but the most rudimentary aspects of care and rehabilitation of the blind and partiallysighted.Nevertheless, the family practitioner musit have confident recourse to others who can supply this expertise, and such others will be grateful to Dr. Shaw for helping their understanding.
A QSAR evaluation of Ah receptor binding of halogenated aromatic xenobiotics.
Authors: O G Mekenyan, G D Veith, D J Call, G T Ankley
Journal: Environmental Health Perspectives (1996)

Because of their widespread occurrence and substantial biological activity, halogenated aromatic hydrocarbons such as polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and polychlorinated dibenzo-p-dioxins (PCDDs) comprise one of the more important classes of contaminants in the environment. Some chemicals in this class cause adverse biological effects after binding to an intracellular cytosolic protein called the aryl hydrocarbon receptor (AhR). Toxic responses such as thymic atrophy, weight loss, immunotoxicity, and acute lethality, as well as induction of cytochrome P4501A1, have been correlated with the relative affinity of PCBs, PCDFs, and PCDDs for the AhR. Therefore, an important step in predicting the effects of these chemicals is the estimation of their binding to the receptor. To date, however, the use of quantitative structure activity relationship (QSAR) models to estimate binding affinity across multiple chemical classes has shown only modest success possibly due, in part, to a focus on minimum energy chemical structures as the active molecules. In this study, we evaluated the use of structural conformations other than those of minimum energy for the purpose of developing a model for AhR binding affinity that encompasses more of the halogenated aromatic chemicals known to interact with the receptor. Resultant QSAR models were robust, showing good utility across multiple classes of halogenated aromatic compounds.
South London Healthcare is "the first of many" NHS trusts to face administration
Authors: I. Torjesen
Journal: BMJ (2012)

More than 20 other NHS trusts are in such serious financial difficulties that they risk following South London Healthcare NHS Trust down the pathway of administration and potential bankruptcy.

On Monday evening health secretary Andrew Lansley announced he had begun the process of placing South London Healthcare NHS Trust, which is £150m (€187m; $233m) in debt, into administration. He said that he was planning to use for the first time powers granted to him under the 2009 Health Act to appoint a “trust special administrator” to determine the best way of getting the trust’s finances …
Falsely High Potassium Values
Authors: O. H. B. Gyde, T. M. L. Price, D. N. Whitmore
Journal: BMJ (1970)

already a minimum age-limit for the pur- chase of tobacco.But there is nothing what- soever to stop children from buying their cigarettes from automatic machines which are to be found in abundance.If the Government is serious in its wish to deter people from smoking, it would be a very simple measure to ban cigarette machines completely.Such a move would have the virtue of harming nobody (except the manufacturers of cigarettes and automatic machines) while producing the maxi- mum potential benefits.-Iam, etc.,
The Trajectory of Depressive Symptoms Across the Adult Life Span
Authors: Angelina R. Sutin, Antonio Terracciano, Yuri Milaneschi, Yang An, Luigi Ferrucci, Alan B. Zonderman
Journal: JAMA Psychiatry (2013)

Long-term longitudinal studies are needed to delineate the trajectory of depressive symptoms across adulthood and to individuate factors that may contribute to increases in depressive symptoms in older adulthood.
IS THE PERCENTAGE OF MYOPIC EYES DIMINISHING?
Authors: SAMUEL D. RISLEY
Journal: JAMA (1913)

In my report of the examinations of the eyes of the schoolchildren in Philadelphia, published in 1881, it was shown that the increasing percentage of myopia in the schools as the pupils advanced in age and school progress, as was set forth by the statistics of many observers both in Europe and America, was due not so much to the want of hygienic precautions in the schools as to the existing congenital defects in the eyes of the children. Many examples, it is true, were presented showing the baneful influence of inadequately lighted schoolrooms and other faulty environments over the eyes of all young children, but it was obvious from their collated statistics that the crux of the matter lay in the congenital visual defects. The findings of the Philadelphia examinations were set forth in elaborate statistical tables, and graphically displayed in a series of percentage curves, the latter of which are here reproduced for reference (Charts 1, 2, 3
Cytomegalovirus Infections Associated with Leukocyte Transfusions
Authors: DREW J. WINSTON
Journal: Annals of Internal Medicine (1980)

Patients randomized to receive or not to receive prophylactic leukocyte transfusions were evaluated prospectively for serologic, histologic, and cultural evidence of cytomegalovirus infection. Recipients of prophylactic leukocyte transfusions and control subjects were similar with regard to age, sex, underlying disease, immunosuppressive therapy, and number of other transfusions. The recipients of prophylactic leukocyte transfusions (mean, 23.1) had significantly more cytomegalovirus infections (19 of 31 versus seven of 27, p=0.01) than did control patients receiving no leukocytes or only therapeutic leukocyte transfusions (mean, 3.8). Twenty-seven of 66 donors of leukocytes were seropositive for cytomegalovirus complement-fixation antibody, but cytomegalovirus was not isolated from any of 62 leukocyte transfusions cultured for virus. These results are consistent with the hypothesis that latent cytomegalovirus may be present in leukocytes of blood donors with previous cytomegalovirus infection and after transfusion may be activated to produce active cytomegalovirus infection.
Modifications in the Biophysical Properties of Connexin43 Channels by a Peptide of the Cytoplasmic Loop Region
Authors: Akiko Seki, Heather S. Duffy, Wanda Coombs, David C. Spray, Steven M. Taffet, Mario Delmar
Journal: Circulation Research (2004)

Connexin43 (Cx43) channels reside in at least 3 states: closed, open, or residual. It is hypothesized that the residual state results from the interaction of an intracellular "gating element" with structures at the vestibule of the pore. Recently, we showed in vitro that there is an intramolecular interaction of the carboxyl-terminal domain (referred to as "CT") with a region in the cytoplasmic loop of Cx43 (amino acids 119 to 144; referred to as "L2"). Here, we assessed whether the L2 region was able to interact with the gating particle in a functional channel. Cx43 channels were recorded in the presence of a peptide corresponding to the L2 region, delivered via the patch pipette. This manipulation did not modify unitary conductance, but decreased the frequency of transitions into the residual state, prolonged open time, and altered the voltage dependence of the channel in a manner analogous to that observed after truncation of the CT domain. The latter correlated with the ability of the peptide to bind to the CT domain, as determined by mirror resonance spectroscopy. Overall, we propose that the L2 acts as a "receptor" that interacts with a flexible intracellular gating element during channel gating. The full text of this article is available online at http://circres.ahajournals.org.
Long-term Follow-up of Pulmonary Function in Patients with Nasal Polyposis
Authors: CATHERINE LAMBLIN, ANNE BRICHET, THIERRY PEREZ, JEAN DARRAS, ANDRÉ BERNARD TONNEL, BENOÎT WALLAERT
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

The outcome of asthma and/or nonspecific bronchial hyperresponsiveness (BHR) associated with nasal polyposis (NP) is uncertain. Over a 4-yr period, we investigated the long-term changes of pulmonary function and BHR in 46 patients with NP. Each subject was assessed for nasal symptoms and tested for allergy skin prick tests, serum total IgE, spirometry, and carbachol challenge at baseline before initiating any treatment (T0). Nasal symptoms evaluation, spirometric measurements, and carbachol challenge were repeated at T1 and at T2 (respectively, 12.7 ± 0.9 and 47.9 ± 2.2 mo after T0). In addition, bronchodilator response was measured at T2. At T0, 25 patients exhibited BHR and 16 of 25 were asthmatic. All patients were treated first with topical steroids for 6 wk (beclomethasone 600 μ g/d). Eighteen patients were successfully treated with topical steroids (topical steroids responders). Intranasal ethmoidectomy was performed in 28 patients who did not improve with topical steroids alone (topical steroids nonresponders). Nasal score improved at T1 and remained improved at T2 as compared with T0 in both groups (p < 0.005). Topical steroids nonresponders demonstrated a significant decrease of FEV1, FEV1/FVC ratio, and FEF25–75 at T1 (p < 0.05) and at T2 (p < 0.0005), whereas no significant change was observed in FEV1 and FEV1/FVC ratio in responders. Δ FEV1 (%) between T2 and T0 was not related to the presence of asthma, BHR, or atopy. Bronchodilator response at T2 was similar in the two groups. BHR did not significantly change over the 4-yr follow-up period in the two groups. No change in pulmonary symptoms and/or asthma severity occurred. Our results show that nonreversible airflow obstruction appears over a 4-yr follow-up period in topical steroids nonresponders patients with NP requiring nasal surgery. The long-term contribution of these changes to the development of respiratory symptoms in patients with NP remains to be documented. Lamblin C, Brichet A, Perez T, Darras J, Tonnel AB, Wallaert B. Long-term follow-up of pulmonary function in patients with nasal polyposis.
Antagonists of GLUK5-containing kainate receptors prevent pilocarpine-induced limbic seizures
Authors: Ilse Smolders, Zuner A. Bortolotto, Vernon R. J. Clarke, Ruth Warre, Ghous M. Khan, Michael J. O'Neill, Paul L. Ornstein, David Bleakman, AnnMarie Ogden, Brianne Weiss, James P. Stables, Ken H. Ho, Guy Ebinger, Graham L. Collingridge, David Lodge, Yvette Michotte
Journal: Nature Neuroscience (2002)
Digenic inheritance of severe insulin resistance in a human pedigree
Authors: David B. Savage, Maura Agostini, Inês Barroso, Mark Gurnell, Jian'an Luan, Aline Meirhaeghe, Anne-Helen Harding, Gudrun Ihrke, Odelia Rajanayagam, Maria A. Soos, Stella George, Dirk Berger, E. Louise Thomas, Jimmy D. Bell, Karim Meeran, Richard J. Ross, Antonio Vidal-Puig, Nicholas J. Wareham, Stephen O'Rahilly, V. Krishna K. Chatterjee, Alan J. Schafer
Journal: Nature Genetics (2002)
Anti-IL-4 treatment at immunization modulates cytokine expression, reduces illness, and increases cytotoxic T lymphocyte activity in mice challenged with respiratory syncytial virus.
Authors: Y W Tang, B S Graham
Journal: Journal of Clinical Investigation (1994)

Upon respiratory syncytial virus (RSV) challenge, mice previously immunized intramuscularly with inactivated whole virus express a Th2-like pattern of cytokine mRNA, while mice immunized with live virus intranasally express a Th1-like pattern. In this study, we evaluated the effects of anti-IL-4 treatment on the induction of immune responses after immunization. Mice treated with anti-IL-4 at the time of immunization with inactivated RSV had reduced clinical illness after live virus challenge, as measured by weight loss, illness score, and virus replication. This was associated with an augmented CD8+ cytotoxic T lymphocyte (CTL) activity, increased expression of IFN-gamma mRNA relative to IL-4 mRNA, and a higher titer of RSV-specific IgG2a in the anti-IL-4 treated mice before challenge. Anti-IL-4 administration at the time of challenge had no effects on illness, immunoglobulin isotype, or cytokine patterns. These results suggest that inhibition of IL-4 action at immunization can shift the selective activation of lymphocytes to a more Th1-like response. This cytokine milieu is associated with augmented CTL activity, which may be the factor responsible for rapid viral clearance and reduced illness at the time of remote RSV challenge.
Beau's Lines
Authors: Neil J Mortimer, Jamie Mills
Journal: New England Journal of Medicine (2004)

A 62-year-old woman received six cycles of docetaxel chemotherapy during a six-month period for recurrent metastatic breast cancer. She had completed treatment four weeks before this photograph was taken. Six evenly spaced, transverse lines were noted on all her fingernails. Beau's lines are transverse depressions in the nail plate caused by temporary cessation of cell division in the proximal nail matrix. The condition may be caused by local disease of the nail fold or a systemic insult, such as an illness or the administration of a drug.
Failure to find disease similarity in sibling pairs with rheumatoid arthritis.
Authors: A J Silman, W E Ollier, H L Currey
Journal: Annals of the Rheumatic Diseases (1987)

Clinical and laboratory measures of disease expression were compared within and between 33 families with two or more affected siblings with rheumatoid arthritis (RA). None of the variables studied--age and calendar year of disease onset, pattern of joint involvement, the presence of rheumatoid nodules, Sjögren9s syndrome, a positive latex or antinuclear antibody (ANA) titre--showed a greater concordance within the families than between them. The families were then divided into those in which the affected sibling pairs were and were not HLA identical. Such a division did not alter the conclusion, with the possible exception of a positive latex titre. These results suggest that genetic or unique environmental factors within families may have only a limited role in explaining disease heterogeneity in RA. Conversely, the absence of homogeneity within the families justifies their use in genetic linkage studies and the extrapolation of results obtained from affected siblings to the commoner sporadic disease.
Sleep Disorders: Insomnia, Sleepwalking, Night Terrors, Nightmares, and Enuresis
Authors: ANTHONY KALES
Journal: Annals of Internal Medicine (1987)

All five sleep disorders reviewed in this article can be adequately evaluated in the physician's office by taking a sleep history and conducting a careful general medical and psychiatric assessment. Insomnia, the commonest sleep disorder, is more prevalent among women and elderly and psychosocially disadvantaged persons. Personality factors such as a tendency toward the internalization of emotions and the occurrence of stressful life events also play a major role in the development of chronic insomnia. A multidimensional approach is indicated for the treatment of chronic insomnia; hypnotic drugs should be used only as an adjunct to this treatment. In children, sleepwalking and night terrors (two manifestations of the same pathophysiologic substrate), nightmares, and enuresis are commonly related to developmental factors; counseling and reassurance of the parents is indicated. Psychopathologic disorders are usually present in secondary enuresis, as well as in sleepwalking, night terrors, and nightmares that occur in adulthood. Psychotherapy and the occasional use of psychotropic drugs may be necessary in the treatment given adults with these disorders.
Salt and blood pressure in Scotland.
Authors: D G Beevers, V M Hawthorne, P L Padfield
Journal: BMJ (1980)

Dietary salt intake and urinary sodium excretion were compared in normotensive and hypertensive subjects in Renfrew, Scotland. All groups had high 24-hour urinary salt excretions, and hypertensive subjects did not eat or excrete more salt than normotensive subjects. The only significant relations found were a lower sodium excretion in hypertensive women than in normotensive women (p &lt; 0.02) and a lower urinary sodium concentration in hypertensive men than in normotensive men (p &lt; 0.05). These data provide no support for the hypothesis that dietary salt is a major cause of hypertension.